| Source HCPCS Code |
|
Target NDC Code |
S0145
Injection, pegylated interferon alfa-2a, 180 mcg per ml
|
⇄
|
00004-0350-09
PEGASYS 180 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
08/10/2005 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S0145
Injection, pegylated interferon alfa-2a, 180 mcg per ml
|
⇄
|
00004-0357-30
PEGASYS 180 MCG/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
01/15/2018 |
| 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 |
SQ |
| Billing Units |
ML |
|
|
|
S0145
Injection, pegylated interferon alfa-2a, 180 mcg per ml
|
⇄
|
82154-0449-01
PEGASYS 180 MCG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
07/28/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S0145
Injection, pegylated interferon alfa-2a, 180 mcg per ml
|
⇄
|
82154-0451-01
PEGASYS 180 MCG/0.5 ML SYRI
|
| Detail Information |
| Relationship Start Date |
07/28/2022 |
| 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 |
SQ |
| Billing Units |
ML |
|
|
|
S0145
Injection, pegylated interferon alfa-2a, 180 mcg per ml
|
⇄
|
82154-0451-04
PEGASYS 180 MCG/0.5 ML SYRI
|
| Detail Information |
| Relationship Start Date |
07/28/2022 |
| 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 |
SQ |
| Billing Units |
ML |
|
|
|