| Source HCPCS Code |
|
Target NDC Code |
J9307
Injection, pralatrexate, 1 mg
|
⇄
|
48818-0001-01
FOLOTYN 20 MG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J9307
Injection, pralatrexate, 1 mg
|
⇄
|
48818-0001-02
FOLOTYN 40 MG/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J9307
Injection, pralatrexate, 1 mg
|
⇄
|
65219-0550-01
PRALATREXATE 20 MG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J9307
Injection, pralatrexate, 1 mg
|
⇄
|
65219-0552-02
PRALATREXATE 40 MG/2 ML VIA
|
| Detail Information |
| Relationship Start Date |
10/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J9307
Injection, pralatrexate, 1 mg
|
⇄
|
72893-0003-01
FOLOTYN 20 MG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J9307
Injection, pralatrexate, 1 mg
|
⇄
|
72893-0005-01
FOLOTYN 40 MG/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
02/04/2020 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J9307
Pralatrexate injection
|
⇄
|
72893-0003-01
Folotyn
|
| 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 |
|
|
|
|
J9307
Pralatrexate injection
|
⇄
|
72893-0005-01
Folotyn
|
| 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 |
|
|
|
|
J9307
Pralatrexate injection
|
⇄
|
48818-0001-01
Folotyn
|
| 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 |
|
|
|
|
J9307
Pralatrexate injection
|
⇄
|
48818-0001-02
Folotyn
|
| 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 |
|
|
|
|
J9307
Pralatrexate injection
|
⇄
|
65219-0550-01
Pralatrexate
|
| 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 |
|
|
|
|
J9307
Pralatrexate injection
|
⇄
|
65219-0552-02
Pralatrexate
|
| 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 |
|
|
|
|