| Source HCPCS Code |
|
Target NDC Code |
J2428
INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
|
⇄
|
72526-0105-11
ERZOFRI 39 MG/0.25 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.25 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J2428
INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
|
⇄
|
72526-0106-11
ERZOFRI 78 MG/0.5 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J2428
INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
|
⇄
|
72526-0107-11
ERZOFRI 117 MG/0.75 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.75 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J2428
INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
|
⇄
|
72526-0108-11
ERZOFRI 156 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J2428
INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
|
⇄
|
72526-0109-11
ERZOFRI 234 MG/1.5 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J2428
INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG
|
⇄
|
72526-0110-11
ERZOFRI 351 MG/2.25 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2.25 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J2428
Inj, erzofri, 1 mg
|
⇄
|
72526-0105-11
Erzofri
|
| 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 |
|
|
|
|
J2428
Inj, erzofri, 1 mg
|
⇄
|
72526-0106-11
Erzofri
|
| 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 |
|
|
|
|
J2428
Inj, erzofri, 1 mg
|
⇄
|
72526-0107-11
Erzofri
|
| 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 |
|
|
|
|
J2428
Inj, erzofri, 1 mg
|
⇄
|
72526-0108-11
Erzofri
|
| 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 |
|
|
|
|
J2428
Inj, erzofri, 1 mg
|
⇄
|
72526-0109-11
Erzofri
|
| 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 |
|
|
|
|
J2428
Inj, erzofri, 1 mg
|
⇄
|
72526-0110-11
Erzofri
|
| 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 |
|
|
|
|