| Source HCPCS Code |
|
Target NDC Code |
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1305-01
RETACRIT 2,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1305-10
RETACRIT 2,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1306-01
RETACRIT 3,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1306-10
RETACRIT 3,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1307-01
RETACRIT 4,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1307-10
RETACRIT 4,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1308-01
RETACRIT 10,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1308-10
RETACRIT 10,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1309-01
RETACRIT 40,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1309-04
RETACRIT 40,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1311-01
RETACRIT 20,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1311-10
RETACRIT 20,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1318-01
RETACRIT 20,000 UNIT/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
00069-1318-10
RETACRIT 20,000 UNIT/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0002-01
RETACRIT 2,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0002-10
RETACRIT 2,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0003-01
RETACRIT 3,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0003-10
RETACRIT 3,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0004-01
RETACRIT 4,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0004-10
RETACRIT 4,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0010-01
RETACRIT 10,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0010-10
RETACRIT 10,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0120-01
RETACRIT 20,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0120-10
RETACRIT 20,000 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0220-01
RETACRIT 20,000 UNIT/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units
|
⇄
|
59353-0220-10
RETACRIT 20,000 UNIT/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1305-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1306-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1307-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1308-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1309-04
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1311-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
00069-1318-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
59353-0002-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
59353-0003-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
59353-0004-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
59353-0010-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
59353-0120-10
Retacrit
|
| 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 |
|
|
|
|
Q5105
Inj retacrit esrd on dialysi
|
⇄
|
59353-0220-10
Retacrit
|
| 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 |
|
|
|
|