| Source HCPCS Code |
|
Target NDC Code |
J9155
|
⇄
|
55566-8301-01
|
| 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 |
|
|
|
|
J9155
|
⇄
|
55566-8301-02
|
| 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 |
|
|
|
|
J9155
Injection, degarelix, 1 mg
|
⇄
|
55566-8303-01
FIRMAGON 80 MG KIT
|
| Detail Information |
| Relationship Start Date |
04/15/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J9155
|
⇄
|
55566-8401-01
|
| 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 |
|
|
|
|
J9155
|
⇄
|
55566-8401-02
|
| 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 |
|
|
|
|
J9155
Injection, degarelix, 1 mg
|
⇄
|
55566-8403-01
FIRMAGON 2 X 120 MG KIT
|
| Detail Information |
| Relationship Start Date |
04/15/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J9155
Degarelix injection
|
⇄
|
55566-8303-01
Firmagon
|
| 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 |
|
|
|
|
J9155
Degarelix injection
|
⇄
|
55566-8403-01
Firmagon
|
| 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 |
|
|
|
|