| Source NDC Code |
|
Target HCPCS Code |
58284-0228-01
BRIXADI MONTH 128MG/0.36ML
|
⇄
|
C9154
Injection, buprenorphine extended-release (brixadi), 1 mg
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| Relationship End Date |
12/31/2023 |
| Number Of Items In Ndc Package |
0.36 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
|
|
|
|
58284-0228-01
BRIXADI MONTHLY 128MG 32 MG/0.09 ML
|
⇄
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.36 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
58284-0228-01
BRIXADI MONTHLY 128MG 32 MG/0.09 ML
|
⇄
|
J0578
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), GREATER THAN 7 DAYS AND UP TO 28 DAYS OF THERAPY
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.36 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
58284-0228-01
BRIXADI MONTH 128MG/0.36ML
|
⇄
|
J3490
Unclassified drugs
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| Relationship End Date |
12/31/2023 |
| Number Of Items In Ndc Package |
0.36 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
|
|
|
|
58284-0228-01
Brixadi (monthly dosing)
|
⇄
|
J0578
Inj brixadi, more than 7 day
|
| 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 |
|
|
|
|