| Source HCPCS Code |
|
Target NDC Code |
Q2053
BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS
|
⇄
|
71287-0219-01
TECARTUS INFUSION BAG
|
| Detail Information |
| Relationship Start Date |
04/01/2021 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q2053
BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS
|
⇄
|
71287-0219-02
TECARTUS CASSETTE
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q2053
BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS
|
⇄
|
71287-0220-01
TECARTUS INFUSION BAG
|
| Detail Information |
| Relationship Start Date |
11/02/2021 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q2053
BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS
|
⇄
|
71287-0220-02
TECARTUS CASSETTE
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q2053
Brexucabtagene car pos t
|
⇄
|
71287-0219-01
Tecartus
|
| 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 |
|
|
|
|
Q2053
Brexucabtagene car pos t
|
⇄
|
71287-0220-01
Tecartus
|
| 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 |
|
|
|
|