| Source NDC Code |
|
Target HCPCS Code |
42358-0295-01
NULIBRY LYOPHILIZED 9.5 MG
|
⇄
|
J1809
INJECTION, FOSDENOPTERIN, 0.1 MG
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
42358-0295-01
NULIBRY 9.5 MG VIAL
|
⇄
|
J3490
Unclassified drugs
|
| Detail Information |
| Relationship Start Date |
07/16/2025 |
| Relationship End Date |
09/30/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
42358-0295-01
Nulibry
|
⇄
|
J1809
Inj, fosdenopterin, 0.1mg
|
| 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 |
|
|
|
|