| Source HCPCS Code |
|
Target NDC Code |
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
49502-0380-02
HULIO PEN 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
49502-0381-02
HULIO 20 MG/0.4 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
08/31/2025 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
49502-0382-02
HULIO 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
49502-0416-02
ADALIMUMAB-FKJP PEN 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
49502-0417-02
ADALIMUMAB-FKJP 20 MG/0.4 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
49502-0418-02
ADALIMUMAB-FKJP 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
83257-0016-42
HULIO 20 MG/0.4 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
83257-0017-42
HULIO 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
83257-0019-32
HULIO PEN 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
83257-0020-42
ADALIMUMAB-FKJP 20 MG/0.4 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
83257-0021-42
ADALIMUMAB-FKJP 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5140
INJECTION, ADALIMUMAB-FKJP, BIOSIMILAR, 1 MG
|
⇄
|
83257-0022-32
ADALIMUMAB-FKJP PEN 40 MG/0.8 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|