| Source HCPCS Code |
|
Target NDC Code |
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0274-17
SIMLANDI(CF) 80 MG/0.8 ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
02/04/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
INJECTION, ADALIMUMAB-RYVK BIOSIMILAR, 1 MG
|
⇄
|
51759-0360-02
ADALIMUMAB-RYVK AUTOINJECTOR 40 MG/0.4 ML
|
| Detail Information |
| Relationship Start Date |
09/04/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0361-17
ADALIMUMAB-RYVK(CF) 80 MG/0.8 ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
02/05/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0368-21
ADALIMUMAB-RYVK(CF) 40 MG/0.4 ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0369-21
ADALIMUMAB-RYVK(CF) 80 MG/0.8 ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
02/05/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0384-21
SIMLANDI(CF) 80 MG/0.8 ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
02/04/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0386-22
SIMLANDI(CF) 20 MG/0.2 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
02/04/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
INJECTION, ADALIMUMAB-RYVK BIOSIMILAR, 1 MG
|
⇄
|
51759-0402-02
SIMLANDI 40 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 |
|
|
|
Q5142
INJECTION, ADALIMUMAB-RYVK BIOSIMILAR, 1 MG
|
⇄
|
51759-0402-17
SIMLANDI 40 MG/0.4 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5142
INJECTION, ADALIMUMAB-RYVK BIOSIMILAR, 1 MG
|
⇄
|
51759-0412-22
SIMLANDI 40 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 |
BX |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0497-31
SIMLANDI(CF) 20 MG/0.2 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
02/04/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0513-21
SIMLANDI(CF) 40 MG/0.4 ML AUTOINJECTOR
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0523-21
SIMLANDI(CF) 80 MG/0.8 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
02/05/2025 |
| Relationship End Date |
09/22/2026 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0624-31
SIMLANDI(CF) 40 MG/0.4 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
Injection, adalimumab-ryvk biosimilar, 1 mg
|
⇄
|
51759-0634-31
SIMLANDI(CF) 80 MG/0.8 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
02/05/2025 |
| Relationship End Date |
09/22/2026 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
KIT |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
Q5142
INJECTION, ADALIMUMAB-RYVK BIOSIMILAR, 1 MG
|
⇄
|
82009-0156-22
ADALIMUMAB-RYVK AUTOINJECTOR 40 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 |
|
|
|
Q5142
INJECTION, ADALIMUMAB-RYVK BIOSIMILAR, 1 MG
|
⇄
|
82009-0158-22
ADALIMUMAB-RYVK PFS SINGLE DOSE 40 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 |
|
|
|