| Source HCPCS Code |
|
Target NDC Code |
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0339-00
VANCOMYCIN 500 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0339-50
VANCOMYCIN 500 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0340-00
VANCOMYCIN 1 GM VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0340-01
VANCOMYCIN 1 GM VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0341-05
VANCOMYCIN HCL 5 GM VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0342-10
VANCOMYCIN HCL 10 GM VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0705-00
VANCOMYCIN HCL 750 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
08/01/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3371
INJECTION, VANCOMYCIN HCL (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3370, 500 MG
|
⇄
|
67457-0705-75
VANCOMYCIN HCL (LYOPHILIZED) 750 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J3371
INJECTION, VANCOMYCIN HCL (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3370, 500 MG
|
⇄
|
67457-0822-99
VANCOMYCIN HCL (LYOPHILIZED) 250 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0823-12
VANCOMYCIN HCL 1.25 GRAM VI
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0823-99
VANCOMYCIN HCL 1.25 GRAM VI
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0824-15
VANCOMYCIN HCL 1.5 GRAM VIA
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J3371
Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
|
⇄
|
67457-0824-99
VANCOMYCIN HCL 1.5 GRAM VIA
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J3371
Inj, vancomycin hcl (mylan)
|
⇄
|
67457-0705-75
Vancomycin Hcl
|
| 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 |
|
|
|
|
J3371
Inj, vancomycin hcl (mylan)
|
⇄
|
67457-0823-99
Vancomycin HCl
|
| 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 |
|
|
|
|
J3371
Inj, vancomycin hcl (mylan)
|
⇄
|
67457-0824-99
Vancomycin HCl
|
| 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 |
|
|
|
|