| Source HCPCS Code |
|
Target NDC Code |
S0080
INJECTION, PENTAMIDINE ISETHIONATE, 300 MG
|
⇄
|
13925-0515-01
PENTAMIDINE 300 MG INJECT VIAL
|
| Detail Information |
| Relationship Start Date |
04/03/2019 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
Injection, pentamidine isethionate, 300 mg
|
⇄
|
13925-0515-10
PENTAMIDINE 300 MG INJECT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
Injection, pentamidine isethionate, 300 mg
|
⇄
|
23155-0748-31
PENTAMIDINE 300 MG INJECT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
Injection, pentamidine isethionate, 300 mg
|
⇄
|
23155-0748-41
PENTAMIDINE 300 MG INJECT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
Injection, pentamidine isethionate, 300 mg
|
⇄
|
39822-3050-01
PENTAMIDINE 300 MG INJECT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
10/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
Injection, pentamidine isethionate, 300 mg
|
⇄
|
39822-3050-02
PENTAMIDINE 300 MG INJECT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
10/31/2025 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
INJECTION, PENTAMIDINE ISETHIONATE, 300 MG
|
⇄
|
63323-0113-01
PENTAM 300 MG VIAL
|
| Detail Information |
| Relationship Start Date |
03/01/2019 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
S0080
Injection, pentamidine isethionate, 300 mg
|
⇄
|
63323-0113-10
PENTAM 300 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|