| Source HCPCS Code |
|
Target NDC Code |
Q9991
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (SUBLOCADE), LESS THAN OR EQUAL TO 100 MG
|
⇄
|
12496-0100-01
SUBLOCADE 100 MG/0.5 ML
|
| Detail Information |
| Relationship Start Date |
07/01/2018 |
| 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 |
SC |
| Billing Units |
ML |
|
|
|
Q9991
Buprenorph xr 100 mg or less
|
⇄
|
12496-0100-02
SUBLOCADE 100 MG/0.5 ML SYR
|
| Detail Information |
| Relationship Start Date |
10/01/2020 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q9991
Buprenorph xr 100 mg or less
|
⇄
|
12496-0100-05
SUBLOCADE 100 MG/0.5 ML SYR
|
| Detail Information |
| Relationship Start Date |
10/01/2020 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
Q9991
Buprenorph xr 100 mg or less
|
⇄
|
12496-0100-01
Sublocade
|
| 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 |
|
|
|
|