| Source HCPCS Code |
|
Target NDC Code |
S5553
Insulin, long acting; 5 units
|
⇄
|
00024-5761-05
SOLIQUA 100 UNIT-33 MCG/ML
|
| Detail Information |
| Relationship Start Date |
01/04/2017 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00088-2219-05
LANTUS SOLOSTAR 100 UNITS/ML
|
| Detail Information |
| Relationship Start Date |
12/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00088-2220-33
LANTUS 100 UNITS/ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00088-5020-01
LANTUS SOLOSTAR 100 UNIT/ML
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
11/30/2023 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00088-5020-05
LANTUS SOLOSTAR 100 UNIT/ML
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
11/30/2023 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00088-5021-01
LANTUS 100 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
06/28/2024 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00169-2662-11
TRESIBA 100 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
02/05/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00169-3687-12
LEVEMIR 100 UNITS/ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/15/2016 |
| Relationship End Date |
12/31/2025 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00955-1728-01
INSULIN GLARGINE SOLOSTAR U
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00955-1728-05
INSULIN GLARGINE SOLOSTAR U
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
00955-1729-01
INSULIN GLARGINE 100 UNIT/M
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
49502-0250-80
SEMGLEE (YFGN) 100 UNIT/ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
49502-0251-71
SEMGLEE (YFGN) 100 UNIT/ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
49502-0251-75
SEMGLEE (YFGN) 100 UNIT/ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
49502-0393-80
INSULIN GLARGINE-YFGN U100
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
10/23/2024 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
49502-0394-71
INSULIN GLARGINE-YFGN U100
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
12/04/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
49502-0394-75
INSULIN GLARGINE-YFGN U100
|
| Detail Information |
| Relationship Start Date |
11/15/2021 |
| Relationship End Date |
12/04/2024 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
73070-0400-11
INSULIN DEGLUDEC 100 UNIT/M
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/2026 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
Insulin, long acting; 5 units
|
⇄
|
83257-0011-11
SEMGLEE (YFGN) 100 UNIT/ML VL
|
| Detail Information |
| Relationship Start Date |
08/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
INSULIN, LONG ACTING; 5 UNITS
|
⇄
|
83257-0012-33
SEMGLEE (YFGN) 100 UNIT/ML PEN
|
| Detail Information |
| Relationship Start Date |
08/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
INSULIN, LONG ACTING; 5 UNITS
|
⇄
|
83257-0014-11
INSULIN GLARGINE-YFGN U100 VL
|
| Detail Information |
| Relationship Start Date |
08/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
S5553
INSULIN, LONG ACTING; 5 UNITS
|
⇄
|
83257-0015-32
INSULIN GLARGINE-YFGN U100 PEN
|
| Detail Information |
| Relationship Start Date |
08/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|