| Source NDC Code |
|
Target HCPCS Code |
00904-7130-06
CHLORPROMAZINE HCL (5X10,FILM-COATED) 25 MG
|
⇄
|
Q0161
CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN
|
| Detail Information |
| Relationship Start Date |
10/30/2023 |
| Relationship End Date |
03/17/2025 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
PO |
| Billing Units |
EA |
|
|
|
00904-7130-06
CHLORPROMAZINE 25 MG TABLET
|
⇄
|
Q0181
Unspecified oral, FDA approved RX anti-emetic, for use as a complete therapeutic substitute for a IV
|
| Detail Information |
| Relationship Start Date |
07/14/2021 |
| Relationship End Date |
02/28/2026 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
BLIST PACK |
| Route Of Administration |
PO |
| Billing Units |
TAB |
|
|
|