| Source HCPCS Code |
|
Target NDC Code |
J7639
DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
|
⇄
|
50242-0100-39
PULMOZYME (AMP,INNER NDC) 2.5 MG/2.5 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
PC |
| Route Of Administration |
IH |
| Billing Units |
ML |
|
|
|
J7639
DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
|
⇄
|
50242-0100-40
PULMOZYME (AMP) 2.5 MG/2.5 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
PC |
| Route Of Administration |
IH |
| Billing Units |
ML |
|
|
|
J7639
Dornase alfa non-comp unit
|
⇄
|
50242-0100-40
Pulmozyme
|
| 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 |
|
|
|
|