| Source NDC Code |
|
Target HCPCS Code |
00074-0124-04
HUMIRA PEN STARTER PACK (PEDIATRIC,PF,LATEX-FREE) 80 MG/0.8 ML
|
⇄
|
J0135
INJECTION, ADALIMUMAB, 20 MG
|
| Detail Information |
| Relationship Start Date |
02/25/2021 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
4 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
00074-0124-04
HUMIRA PEN STARTER PACK PEDIATRIC 80 MG/0.8 ML
|
⇄
|
J0139
INJECTION, ADALIMUMAB, 1 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
01/31/2025 |
| Number Of Items In Ndc Package |
4 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|