| Source NDC Code |
|
Target HCPCS Code |
25021-0149-30
VANCOMYCIN HCL 1.5 GRAM VIAL
|
⇄
|
J3370
Injection, vancomycin hcl, 500 mg
|
| Detail Information |
| Relationship Start Date |
03/21/2025 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
25021-0149-30
VANCOMYCIN HCL SDV,LYOPHILIZED 1.5 GM
|
⇄
|
J3374
INJECTION, VANCOMYCIN HYDROCHLORIDE (MYLAN) NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
25021-0149-30
Vancomycin HCl
|
⇄
|
J3374
Inj, vancomycin (mylan) 10mg
|
| 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 |
|
|
|
|