| Source HCPCS Code |
|
Target NDC Code |
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0340-61
SANDOSTATIN LAR DEPOT (1&1/2"X19G,PFS) 10 MG
|
| Detail Information |
| Relationship Start Date |
7/26/2004 |
| Relationship End Date |
9/23/2015 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0340-84
SANDOSTATIN LAR DEPOT (VIAL W/DILUENT) 10 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
10/1/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0341-61
SANDOSTATIN LAR DEPOT (1&1/2"X19G,PFS) 20 MG
|
| Detail Information |
| Relationship Start Date |
8/18/2004 |
| Relationship End Date |
9/23/2015 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0341-84
SANDOSTATIN LAR DEPOT (VIAL W/DILUENT) 20 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
10/1/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0342-61
SANDOSTATIN LAR DEPOT (1&1/2"X19G,PFS) 30 MG
|
| Detail Information |
| Relationship Start Date |
7/14/2004 |
| Relationship End Date |
9/23/2015 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0342-84
SANDOSTATIN LAR DEPOT (VIAL W/DILUENT) 30 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
10/1/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0646-81
SANDOSTATIN LAR DEPOT (1 1/2"X20G) 10 MG
|
| Detail Information |
| Relationship Start Date |
4/10/2015 |
| Relationship End Date |
5/9/2017 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0647-81
SANDOSTATIN LAR DEPOT (1 1/2"X20G) 20 MG
|
| Detail Information |
| Relationship Start Date |
4/10/2015 |
| Relationship End Date |
12/7/2016 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0648-81
SANDOSTATIN LAR DEPOT (1 1/2"X20G) 30 MG
|
| Detail Information |
| Relationship Start Date |
4/10/2015 |
| Relationship End Date |
12/5/2016 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0790-61
SANDOSTATIN LAR DEPOT (INNER PACK) 10 MG
|
| Detail Information |
| Relationship Start Date |
07/11/2017 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0797-61
SANDOSTATIN LAR DEPOT (INNER PACK) 20 MG
|
| Detail Information |
| Relationship Start Date |
07/11/2017 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0804-61
SANDOSTATIN LAR DEPOT (INNER PACK) 30 MG
|
| Detail Information |
| Relationship Start Date |
07/11/2017 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0811-81
SANDOSTATIN LAR DEPOT (1 1/2"X19G) 10 MG
|
| Detail Information |
| Relationship Start Date |
05/10/2017 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0818-81
SANDOSTATIN LAR DEPOT (1 1/2"X19G) 20 MG
|
| Detail Information |
| Relationship Start Date |
12/08/2016 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00078-0825-81
SANDOSTATIN LAR DEPOT (1 1/2"X19G) 30 MG
|
| Detail Information |
| Relationship Start Date |
12/06/2016 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00480-9256-01
OCTREOTIDE ACET ER 10 MG IM VIAL
|
| Detail Information |
| Relationship Start Date |
03/20/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00480-9257-08
OCTREOTIDE ACETATE 1 1/2"X19G 10 MG
|
| Detail Information |
| Relationship Start Date |
03/20/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00480-9258-01
OCTREOTIDE ACET ER 20 MG IM VL
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00480-9259-08
OCTREOTIDE ACETATE 1 1/2"X19G 20 MG
|
| Detail Information |
| Relationship Start Date |
09/30/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00480-9260-01
OCTREOTIDE ACET ER 30 MG IM VL
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
00480-9262-08
OCTREOTIDE ACETATE 1 1/2"X19G 30 MG
|
| Detail Information |
| Relationship Start Date |
09/30/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00703-3311-01
OCTREOTIDE ACET 100 MCG/ML
|
| Detail Information |
| Relationship Start Date |
11/14/2005 |
| Relationship End Date |
05/31/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00703-3311-04
OCTREOTIDE ACET 100 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
04/15/2017 |
| Relationship End Date |
05/31/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00703-3333-01
OCTREOTIDE ACET 200 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
04/15/2017 |
| Relationship End Date |
05/31/2023 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
00703-3343-01
OCTREOTIDE 1,000 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2017 |
| Relationship End Date |
05/31/2023 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
Injection, octreotide, depot form for intramuscular injection, 1 mg
|
⇄
|
25021-0452-01
OCTREOTIDE ACET 100 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
04/02/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
25021-0463-01
OCTREOTIDE ACET 50 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
07/18/2023 |
| Relationship End Date |
07/19/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
25021-0464-01
OCTREOTIDE ACET 100 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
06/26/2023 |
| Relationship End Date |
06/27/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
25021-0465-01
OCTREOTIDE ACET 500 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
06/26/2023 |
| Relationship End Date |
06/27/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
67457-0756-10
Octreotide Acetate 10 MG
|
| Detail Information |
| Relationship Start Date |
01/28/2026 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
67457-0759-20
Octreotide Acetate 20 MG
|
| Detail Information |
| Relationship Start Date |
01/28/2026 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
67457-0762-30
Octreotide Acetate 30 MG
|
| Detail Information |
| Relationship Start Date |
01/28/2026 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
68462-0896-01
OCTREOTIDE ACET 100 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
12/18/2023 |
| Relationship End Date |
12/19/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
68462-0896-10
OCTREOTIDE ACET 100 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
12/18/2023 |
| Relationship End Date |
12/19/2023 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
68462-0897-01
OCTREOTIDE ACET 500 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
12/18/2023 |
| Relationship End Date |
12/19/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG
|
⇄
|
68462-0897-10
OCTREOTIDE ACET 500 MCG/ML VL
|
| Detail Information |
| Relationship Start Date |
12/18/2023 |
| Relationship End Date |
12/19/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2353
Octreotide injection, depot
|
⇄
|
00078-0811-81
Sandostatin Lar Depot
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
J2353
Octreotide injection, depot
|
⇄
|
00078-0818-81
Sandostatin Lar Depot
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
J2353
Octreotide injection, depot
|
⇄
|
00078-0825-81
Sandostatin Lar Depot
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
J2353
Octreotide injection, depot
|
⇄
|
00480-9257-08
Octreotide Acetate
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
J2353
Octreotide injection, depot
|
⇄
|
00480-9259-08
Octreotide Acetate
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
J2353
Octreotide injection, depot
|
⇄
|
00480-9262-08
Octreotide Acetate
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|