| Source HCPCS Code |
|
Target NDC Code |
J3590
Unclassified Biologics
|
⇄
|
00002-1445-01
TALTZ 80 MG/ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
04/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00002-1445-09
TALTZ 80 MG/ML AUTOINJ (3-P
|
| Detail Information |
| Relationship Start Date |
04/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00002-1445-11
TALTZ 80 MG/ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
04/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00002-1445-27
TALTZ 80 MG/ML AUTOINJ (2-P
|
| Detail Information |
| Relationship Start Date |
04/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00002-7575-01
OMVOH 300 MG/15 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00002-7724-01
TALTZ 80 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/25/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00002-7724-11
TALTZ 80 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/25/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00002-8011-01
OMVOH 100 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00002-8011-27
OMVOH 100 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00002-8900-11
TALTZ 20 MG/0.25 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
08/12/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.25 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00002-8905-01
TALTZ 40 MG/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
08/12/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00002-8905-11
TALTZ 40 MG/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
08/12/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00002-8971-01
FORTEO 250 MCG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00004-0357-30
PEGASYS 180 MCG/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00008-2564-01
NORPLANT SYSTEM 36 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
5/12/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
ID |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00009-5175-10
SOMAVERT 10 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2003 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00009-5177-10
SOMAVERT 15 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2003 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00009-5179-10
SOMAVERT 20 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2003 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00009-5201-10
SOMAVERT 25 MG VIAL
|
| Detail Information |
| Relationship Start Date |
09/22/2014 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00009-5376-10
SOMAVERT 30 MG VIAL
|
| Detail Information |
| Relationship Start Date |
09/22/2014 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7166-01
SOMAVERT 10 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2003 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7166-30
SOMAVERT 10 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7168-01
SOMAVERT 15 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2003 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7168-30
SOMAVERT 15 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7188-01
SOMAVERT 20 MG VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2003 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7188-30
SOMAVERT 20 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7199-01
SOMAVERT 25 MG VIAL
|
| Detail Information |
| Relationship Start Date |
09/22/2014 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7199-30
SOMAVERT 25 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7200-01
SOMAVERT 30 MG VIAL
|
| Detail Information |
| Relationship Start Date |
09/22/2014 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00009-7200-30
SOMAVERT 30 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00024-5908-01
KEVZARA 150 MG/1.14 ML SYRI
|
| Detail Information |
| Relationship Start Date |
05/26/2017 |
| Relationship End Date |
01/05/2027 |
| Number Of Items In Ndc Package |
1.14 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00024-5910-01
KEVZARA 200 MG/1.14 ML SYRI
|
| Detail Information |
| Relationship Start Date |
05/26/2017 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1.14 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00024-5920-01
KEVZARA 150 MG/1.14 ML PEN
|
| Detail Information |
| Relationship Start Date |
06/19/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1.14 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00024-5922-01
KEVZARA 200 MG/1.14 ML PEN
|
| Detail Information |
| Relationship Start Date |
06/19/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1.14 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00026-0636-01
BAYHEP B (S.D.V.,200 IU/ML)
|
| Detail Information |
| Relationship Start Date |
6/18/2003 |
| Relationship End Date |
10/13/2006 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00026-0636-02
BAYHEP B
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
10/13/2006 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00026-0636-03
BAYHEP B (S.D.SRN)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
10/13/2006 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00026-0636-05
BAYHEP B (S.D.V.,200 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
10/13/2006 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00069-2151-01
HYMPAVZI 150 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
04/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00074-3799-01
HUMIRA (PF,PREFILLED SYRINGE) 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
9/12/2003 |
| Relationship End Date |
9/13/2003 |
| Number Of Items In Ndc Package |
0.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CR |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00074-3799-02
HUMIRA (PF,PREFILLED SYRINGE) 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
1/2/2003 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
0.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00078-0639-41
COSENTYX 300 MG DOSE-2 PENS
|
| Detail Information |
| Relationship Start Date |
12/16/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00078-0639-68
COSENTYX 150 MG/ML PEN INJE
|
| Detail Information |
| Relationship Start Date |
12/16/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00078-0639-97
COSENTYX 150 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
12/16/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00078-0639-98
COSENTYX 300 MG DOSE-2 SYRI
|
| Detail Information |
| Relationship Start Date |
12/16/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00078-1056-97
COSENTYX 75 MG/0.5 ML SYRIN
|
| Detail Information |
| Relationship Start Date |
06/07/2021 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00078-1070-68
COSENTYX UNOREADY 300 MG PE
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00078-1168-61
COSENTYX 125 MG/5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00169-2911-15
XULTOPHY 100 UNIT-3.6 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
04/24/2017 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00187-0004-00
SILIQ 210 MG/1.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
10/01/2025 |
| Number Of Items In Ndc Package |
1.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
00187-0004-02
SILIQ 210 MG/1.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
07/13/2017 |
| Relationship End Date |
10/01/2025 |
| Number Of Items In Ndc Package |
1.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
00338-0126-12
MYXREDLIN (REGULAR INSULIN) 100 UNIT/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
08/27/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00944-4175-05
CEPROTIN (400-600IU) 1 IU
|
| Detail Information |
| Relationship Start Date |
6/28/2007 |
| Relationship End Date |
12/31/2007 |
| Number Of Items In Ndc Package |
600 |
| Ndc Package Measure |
IU |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00944-4175-10
CEPROTIN (800-1200IU) 1 IU
|
| Detail Information |
| Relationship Start Date |
6/28/2007 |
| Relationship End Date |
12/31/2007 |
| Number Of Items In Ndc Package |
1200 |
| Ndc Package Measure |
IU |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00955-1728-01
INSULIN GLARGINE SOLOSTAR U100
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00955-1728-05
INSULIN GLARGINE SOLOSTAR U100
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
00955-1729-01
INSULIN GLARGINE 100 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
13533-0636-01
HYPERHEP B S/D (PF)
|
| Detail Information |
| Relationship Start Date |
10/14/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
13533-0636-02
HYPERHEP B S/D (SINGLE DOSE,PF)
|
| Detail Information |
| Relationship Start Date |
1/18/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
13533-0636-03
HYPERHEP B S/D (NEONATAL SINGLE DOSE,PF)
|
| Detail Information |
| Relationship Start Date |
1/18/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
13533-0636-05
HYPERHEP B S/D (SDV,PF)
|
| Detail Information |
| Relationship Start Date |
1/18/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
49502-0251-71
SEMGLEE (YFGN) 100 UNIT/ML PEN
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
49502-0251-75
SEMGLEE (YFGN) 100 UNIT/ML PEN
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
49502-0394-71
INSULIN GLARGINE-YFGN U100 PEN
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
12/04/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
49502-0394-75
INSULIN GLARGINE-YFGN U100 PEN
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
12/04/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
49669-4600-01
ALPHANATE (250-500 FVIII IU/5ML) 1 IU
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
7/24/2003 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
IU |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
49669-4600-02
ALPHANATE (1000-1500 FVIII IU/10ML) 1 IU
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
6/21/2004 |
| Number Of Items In Ndc Package |
1500 |
| Ndc Package Measure |
IU |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
49999-0425-05
NABI-HB (S.D.V.,312 IU/ML)
|
| Detail Information |
| Relationship Start Date |
7/6/2004 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
50242-0040-62
XOLAIR 150 MG
|
| Detail Information |
| Relationship Start Date |
6/20/2003 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
50242-0138-01
ACTEMRA 162 MG/0.9 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
11/06/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.9 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
50242-0143-01
ACTEMRA ACTPEN 162 MG/0.9 ML
|
| Detail Information |
| Relationship Start Date |
01/07/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.9 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
51167-0290-09
CASGEVY VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
54569-4739-00
NABI-HB
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
54569-5444-00
NABI-HB (S.D.V.,>312 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
1/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
54569-5524-00
HUMIRA (PF,PREFILLED SYRINGE) 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
8/12/2003 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
0.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CR |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
54868-2289-01
BAYHEP B (S.D.V.,200 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
54868-4822-00
HUMIRA (KIT,PF) 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
6/23/2003 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
0.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
57894-0801-01
IMAAVY 1,200 MG/6.5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
09/03/2025 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
6.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
58468-0070-01
ALDURAZYME (PF) 0.58 MG/ML
|
| Detail Information |
| Relationship Start Date |
5/12/2003 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59627-0020-01
AMEVIVE (4 VIALS W/ADMIN. SET,PF) 7.5 MG
|
| Detail Information |
| Relationship Start Date |
1/31/2003 |
| Relationship End Date |
12/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59627-0020-02
AMEVIVE (PF) 7.5 MG
|
| Detail Information |
| Relationship Start Date |
1/31/2003 |
| Relationship End Date |
12/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59627-0021-03
AMEVIVE (4 VIALS, SRN, W/DILUENT) 15 MG
|
| Detail Information |
| Relationship Start Date |
1/31/2003 |
| Relationship End Date |
12/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59627-0021-04
AMEVIVE (PF) 15 MG
|
| Detail Information |
| Relationship Start Date |
1/31/2003 |
| Relationship End Date |
12/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59730-4202-01
NABI-HB (S.D.V.,312 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59730-4203-01
NABI-HB (S.D.V.,312 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/1/2003 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59730-4204-01
NABI-HB NOVAPLUS (312 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/3/2005 |
| Relationship End Date |
9/30/2007 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
59730-4205-01
NABI-HB NOVAPLUS (312 IU/ML)
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
9/30/2007 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
60492-0051-02
NOVAPLUS HEPAGAM B (>1560/5ML,PF)
|
| Detail Information |
| Relationship Start Date |
10/1/2007 |
| Relationship End Date |
12/31/2007 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
60492-0052-02
NOVAPLUS HEPAGAM B (>312IU/ML,PF)
|
| Detail Information |
| Relationship Start Date |
10/1/2007 |
| Relationship End Date |
12/31/2007 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
61755-0020-01
PRALUENT 75 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
07/29/2015 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
61755-0020-02
PRALUENT 75 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
07/29/2015 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
61755-0021-01
PRALUENT 150 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
07/29/2015 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
61755-0021-02
PRALUENT 150 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
07/29/2015 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
61755-0050-00
EYLEA HD 8 MG/0.07 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.07 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IO |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
61755-0050-01
EYLEA HD 8 MG/0.07 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.07 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IO |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
64764-0130-01
ADZYNMA 500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
64764-0135-01
ADZYNMA 1,500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
64764-0140-05
ADZYNMA 500 UNIT KIT
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J3590
Unclassified biologics
|
⇄
|
64764-0145-05
ADZYNMA 1,500 UNIT KIT
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
66658-0234-01
KINERET 100 MG/0.67 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.67 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
66658-0234-07
KINERET 100 MG/0.67 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.67 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
68158-0149-51
PLENAXIS (S.D.V.,PF) 100 MG-0.9%
|
| Detail Information |
| Relationship Start Date |
1/25/2004 |
| Relationship End Date |
12/31/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
72126-0007-01
TEGSEDI 284 MG/1.5 ML SYRIN
|
| Detail Information |
| Relationship Start Date |
04/01/2019 |
| Relationship End Date |
09/27/2025 |
| Number Of Items In Ndc Package |
1.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
72126-0007-02
TEGSEDI 284 MG/1.5 ML SYRIN
|
| Detail Information |
| Relationship Start Date |
04/01/2019 |
| Relationship End Date |
09/27/2025 |
| Number Of Items In Ndc Package |
1.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
72511-0393-01
REPATHA 140 MG/ML SURECLICK
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
72511-0393-02
REPATHA 140 MG/ML SURECLICK
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified biologics
|
⇄
|
72511-0501-01
REPATHA 140 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
72511-0750-01
REPATHA 140 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
02/28/2027 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
72511-0760-01
REPATHA 140 MG/ML SURECLICK
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
72511-0760-02
REPATHA 140 MG/ML SURECLICK
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
72511-0770-01
REPATHA 420 MG/3.5ML PUSHTR
|
| Detail Information |
| Relationship Start Date |
10/22/2018 |
| Relationship End Date |
07/31/2026 |
| Number Of Items In Ndc Package |
3.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CARTRIDGE |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
73554-2111-01
SKYSONA INFUSION BAG-CASSET
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
73554-3111-01
ZYNTEGLO INFUSION BAG-CASSE
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0111-01
RYONCIL LESS THAN 12.5 KG KIT
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0112-02
RYONCIL 12.5 KG-LESS THAN 25KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0113-03
RYONCIL 25 KG-LESS THAN 37.5KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0114-01
RYONCIL 37.5 KG-LESS THAN 50KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0115-02
RYONCIL 50 KG-LESS THAN 62.5KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0116-03
RYONCIL 62.5 KG-LESS THAN 75KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0117-04
RYONCIL 75 KG-LESS THAN 87.5KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
Unclassified biologics
|
⇄
|
73648-0118-02
RYONCIL 87.5KG-LESS THAN 100KG
|
| Detail Information |
| Relationship Start Date |
07/30/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
82154-0449-01
PEGASYS 180 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
07/28/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
82154-0451-01
PEGASYS 180 MCG/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
07/28/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
UNCLASSIFIED BIOLOGICS
|
⇄
|
82154-0451-04
PEGASYS 180 MCG/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
07/28/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J3590
Unclassified Biologics
|
⇄
|
82194-0510-02
VYJUVEK GEL
|
| Detail Information |
| Relationship Start Date |
10/17/2023 |
| Relationship End Date |
12/31/2023 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
TP |
| Billing Units |
EA |
|
|
|