| Source NDC Code |
|
Target HCPCS Code |
55513-0077-01
IMDELLTRA 10 MG VIAL
|
⇄
|
C9170
Injection, tarlatamab-dlle, 1 mg
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
55513-0077-01
IMDELLTRA LYOPHILIZED 10 MG
|
⇄
|
J9026
INJECTION, TARLATAMAB-DLLE, 1 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| 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 |
|
|
|
55513-0077-01
IMDELLTRA 10 MG VIAL
|
⇄
|
J9999
Not otherwise classified, antineoplastic drugs
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
55513-0077-01
Imdelltra
|
⇄
|
J9026
Inj, tarlatamab-dlle, 1 mg
|
| 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 |
|
|
|
|