| Source HCPCS Code |
|
Target NDC Code |
Q2043
Sipuleucel-t, min. 50 million autolog. cd54+ cells (with pap-gm-csf), Leukaph. & prep, per infusion
|
⇄
|
30237-8900-06
PROVENGE INFUSION BAG
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
Q2043
Sipuleucel-t auto cd54+
|
⇄
|
30237-8900-06
Provenge
|
| 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 |
|
|
|
|