| Source NDC Code |
|
Target HCPCS Code |
00002-7533-01
HUMALOG 100 UNIT/ML VIAL
|
⇄
|
J1815
Injection, insulin, per 5 units
|
| Detail Information |
| Relationship Start Date |
03/01/2024 |
| Relationship End Date |
12/17/2025 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
00002-7533-01
HUMALOG (MDV) 100 U/1 ML
|
⇄
|
J1817
INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS
|
| Detail Information |
| Relationship Start Date |
11/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
00002-7533-01
Humalog
|
⇄
|
J1817
Insulin for insulin pump use
|
| 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 |
|
|
|
|