| Source HCPCS Code |
|
Target NDC Code |
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00008-0923-51
PROTONIX IV 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00008-0923-55
PROTONIX IV 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00008-0923-60
PROTONIX IV 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00008-4001-01
PROTONIX IV 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00008-4001-10
PROTONIX IV 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00008-4001-25
PROTONIX IV 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
00143-9300-10
PANTOPRAZOLE SODIUM NOVAPLUS (SDV,LYOPHILIZED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00480-4111-01
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
07/02/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
00480-4111-03
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
07/02/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
00781-3232-95
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
00781-3480-95
Pantoprazole Sodium SDV,FREEZE-DRIED 40 MG
|
| Detail Information |
| Relationship Start Date |
01/26/2026 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
25021-0751-10
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
25021-0751-11
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
31722-0204-10
PANTOPRAZOLE (10X40MG,SDV) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
31722-0204-31
PANTOPRAZOLE (1X40MG,SDV,FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
55150-0202-00
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
55150-0202-10
PANTOPRAZOLE SODIUM (FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
55154-7477-05
PANTOPRAZOLE SODIUM (LYOPHILIZED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
55154-8336-05
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
62332-0071-01
PANTOPRAZOLE SODIUM SDV,FREEZE-DRIED 40 MG
|
| Detail Information |
| Relationship Start Date |
08/06/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
62332-0071-10
PANTOPRAZOLE SODIUM SDV,FREEZE-DRIED 40 MG
|
| Detail Information |
| Relationship Start Date |
08/06/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
62756-0129-40
PANTOPRAZOLE SODIUM (LYOPHILIZED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
62756-0129-44
PANTOPRAZOLE SODIUM (LYOPHILIZED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
65219-0385-10
PANTOPRAZOLE SODIUM SDV,LYOPHILIZED 40 MG
|
| Detail Information |
| Relationship Start Date |
05/30/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
65219-0433-01
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
05/30/2026 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
65219-0433-15
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
05/29/2025 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
66794-0258-02
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
66794-0258-41
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
67850-0150-25
PANTOPRAZOLE SODIUM (LYOPHILIZED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
70095-0024-01
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
70095-0024-02
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
70095-0024-03
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
71288-0600-10
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
71288-0600-11
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
71839-0122-01
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
71839-0122-10
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
71839-0122-25
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
72572-0550-01
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
05/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
72572-0550-10
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
Injection, pantoprazole sodium, 40 mg
|
⇄
|
72603-0128-01
PANTOPRAZOLE SODIUM 40 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
72603-0128-10
PANTOPRAZOLE SODIUM (SDV,PF,LATEX-FREE) 40 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
73043-0020-10
PANTOPRAZOLE SODIUM LYOPHILIZED 40 MG
|
| Detail Information |
| Relationship Start Date |
08/08/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J2470
INJECTION, PANTOPRAZOLE SODIUM, 40 MG
|
⇄
|
73043-0020-25
PANTOPRAZOLE SODIUM LYOPHILIZED 40 MG
|
| Detail Information |
| Relationship Start Date |
08/08/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|