| Source NDC Code |
|
Target HCPCS Code |
42291-0439-30
EMTRICITABINE-TENOFOVIR DISOPROXIL FUMARATE (FILM-COATED) 200 MG-300 MG
|
⇄
|
J0750
EMTRICITABINE 200MG AND TENOFOVIR DISOPROXIL FUMARATE 300MG, ORAL, FDA APPROVED PRESCRIPTION, ONLY FOR USE AS HIV PRE-EXPOSURE PROPHYLAXIS (NOT FOR USE AS TREATMENT OF HIV)
|
| Detail Information |
| Relationship Start Date |
01/02/2024 |
| Relationship End Date |
10/31/2025 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
PO |
| Billing Units |
EA |
|
|
|
42291-0439-30
Emtricitabine/Tenofovir disoproxil fumarate
|
⇄
|
J0750
Hiv prep, ftc/tdf 200/300mg
|
| Detail Information |
| Relationship Start Date |
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| Relationship End Date |
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| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
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| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
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