| Source HCPCS Code |
|
Target NDC Code |
J3130
|
⇄
|
00143-9750-01
|
| 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 |
|
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
00574-0821-05
TESTOSTERONE ENANTHATE (USP,MULTIPLE DOSE) 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
8/1/2007 |
| Relationship End Date |
9/30/2011 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
00591-3221-26
TESTOSTERONE ENANTHATE 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
3/9/2004 |
| Relationship End Date |
12/31/2014 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
38779-0855-03
TESTOSTERONE ENANTHATE
|
| Detail Information |
| Relationship Start Date |
4/25/2002 |
| Relationship End Date |
12/31/2014 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
38779-0855-04
TESTOSTERONE ENANTHATE
|
| Detail Information |
| Relationship Start Date |
4/25/2002 |
| Relationship End Date |
12/31/2014 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
49452-7649-01
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
3/15/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
49452-7649-02
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
3/15/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
49452-7649-03
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
3/15/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
54396-0328-16
DELATESTRYL (UNIMATIC) 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/29/2007 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
54396-0328-40
DELATESTRYL (M.D.V.) 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
4/26/2009 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
54569-4620-00
DELATESTRYL (UNIMATIC) 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
1/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
54569-5416-00
DELATESTRYL (M.D.V.) 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
7/29/2002 |
| Relationship End Date |
1/31/2003 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
54868-5016-00
DELATESTRYL 200 MG/ML
|
| Detail Information |
| Relationship Start Date |
3/9/2004 |
| Relationship End Date |
12/31/2014 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
62991-2700-01
TESTOSTERONE ENANTHATE (USP, 1X1000GM)
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
6/7/2011 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
63370-0983-15
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/19/2004 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
63370-0983-25
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/19/2004 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
63370-0983-35
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/19/2004 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
|
⇄
|
63370-0983-50
TESTOSTERONE ENANTHATE (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/19/2004 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J3130
|
⇄
|
67979-0501-40
|
| 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 |
|
|
|
|