| Source NDC Code |
|
Target HCPCS Code |
51754-2500-03
GANCICLOVIR-SODIUM CHLORIDE (PF) 500 MG/250 ML-0.8%
|
⇄
|
J1570
INJECTION, GANCICLOVIR SODIUM, 500 MG
|
| Detail Information |
| Relationship Start Date |
06/01/2017 |
| Relationship End Date |
12/31/2022 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
51754-2500-03
GANCICLOVIR-SODIUM CHLORIDE (PF) 500 MG/250 ML-0.8%
|
⇄
|
J1574
INJECTION, GANCICLOVIR SODIUM (EXELA) NOT THERAPEUTICALLY EQUIVALENT TO J1570, 500 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|