| Source HCPCS Code |
|
Target NDC Code |
Q5110
INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM
|
⇄
|
00069-0291-01
NIVESTYM (PF,LATEX-FREE) 300 MCG/0.5 ML
|
| Detail Information |
| Relationship Start Date |
09/05/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM
|
⇄
|
00069-0291-10
NIVESTYM (PF,LATEX-FREE) 300 MCG/0.5 ML
|
| Detail Information |
| Relationship Start Date |
09/05/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM
|
⇄
|
00069-0292-01
NIVESTYM (PF,LATEX-FREE) 480 MCG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
09/05/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM
|
⇄
|
00069-0292-10
NIVESTYM (PF,LATEX-FREE) 480 MCG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
09/05/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0293-01
NIVESTYM 300 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
03/11/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0293-10
NIVESTYM 300 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
03/11/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0294-01
NIVESTYM 480 MCG/1.6 ML VIA
|
| Detail Information |
| Relationship Start Date |
03/11/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1.6 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0294-10
NIVESTYM 480 MCG/1.6 ML VIA
|
| Detail Information |
| Relationship Start Date |
03/11/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1.6 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0291-01
Nivestym
|
| 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 |
|
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0291-10
Nivestym
|
| 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 |
|
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0292-01
Nivestym
|
| 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 |
|
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0292-10
Nivestym
|
| 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 |
|
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0293-10
Nivestym
|
| 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 |
|
|
|
|
Q5110
Nivestym
|
⇄
|
00069-0294-10
Nivestym
|
| 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 |
|
|
|
|