| Source NDC Code |
|
Target HCPCS Code |
00002-7575-01
OMVOH 300 MG/15 ML VIAL
|
⇄
|
C9168
Injection, mirikizumab-mrkz, 1 mg
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
00002-7575-01
OMVOH (SDV,PF,LATEX-FREE) 20 MG/1 ML
|
⇄
|
J2267
INJECTION, MIRIKIZUMAB-MRKZ, 1 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
00002-7575-01
OMVOH 300 MG/15 ML VIAL
|
⇄
|
J3590
Unclassified biologics
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
00002-7575-01
Omvoh
|
⇄
|
J2267
Inj, mirikizumab-mrkz, 1 mg
|
| 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 |
|
|
|
|