| Source HCPCS Code |
|
Target NDC Code |
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
00143-9152-10
VANCOMYCIN HCL SDV,LYOPHILIZED 1.25 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
00143-9153-10
VANCOMYCIN HCL SDV,LYOPHILIZED 1.5 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
25021-0147-20
VANCOMYCIN HCL 750 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
25021-0148-30
VANCOMYCIN HCL SDV,LYOPHILIZED 1.25 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
25021-0149-30
VANCOMYCIN HCL SDV,LYOPHILIZED 1.5 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
39822-0460-01
VANCOMYCIN HCL 1.25 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
12/30/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
39822-0460-02
Vancomycin HCl LYOPHILIZED 1.25 GM
|
| Detail Information |
| Relationship Start Date |
12/18/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
39822-0470-01
VANCOMYCIN HCL 1.5 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
12/30/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
39822-0470-02
Vancomycin HCl LYOPHILIZED 1.5 GM
|
| Detail Information |
| Relationship Start Date |
12/18/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
55150-0471-10
VANCOMYCIN HCL SDV,LYOPHILIZED 1.25 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
55150-0472-10
VANCOMYCIN HCL SDV,LYOPHILIZED 1.5 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
67457-0705-00
VANCOMYCIN HCL 750 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
67457-0705-75
VANCOMYCIN HCL LYOPHILIZED 750 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
67457-0823-12
VANCOMYCIN HCL 1.25 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
67457-0823-99
VANCOMYCIN HCL 1.25 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
67457-0824-15
VANCOMYCIN HCL 1.5 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
67457-0824-99
VANCOMYCIN HCL 1.5 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
68462-0477-20
VANCOMYCIN HCL 750 MG VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
68462-0477-74
VANCOMYCIN HCL LYOPHILIZED 750 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
68462-0478-30
VANCOMYCIN HCL 1.25 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
68462-0478-84
VANCOMYCIN HCL LYOPHILIZED 1.25 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
68462-0479-30
VANCOMYCIN HCL 1.5 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
68462-0479-84
VANCOMYCIN HCL LYOPHILIZED 1.5 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
72078-0065-50
VANCOMYCIN HCL 1.75 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
72078-0065-99
VANCOMYCIN HCL LYOPHILIZED 1.75 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
72078-0066-50
VANCOMYCIN HCL 2 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
⇄
|
72078-0066-99
VANCOMYCIN HCL LYOPHILIZED 2 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| 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 |
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
55150-0471-10
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
55150-0472-10
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
68462-0477-74
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
68462-0478-84
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
68462-0479-84
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
00143-9152-10
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
00143-9153-10
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
72078-0065-99
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
72078-0066-99
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
25021-0147-20
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
25021-0148-30
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
25021-0149-30
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
39822-0460-02
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 |
|
|
|
|
J3374
Inj, vancomycin (mylan) 10mg
|
⇄
|
39822-0470-02
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 |
|
|
|
|