| Source NDC Code |
|
Target HCPCS Code |
61703-0124-40
PREMIERPRO RX METHOTREXATE (SDV,PF,LATEX-FREE) 25 MG/1 ML
|
⇄
|
J9250
METHOTREXATE SODIUM, 5 MG
|
| Detail Information |
| Relationship Start Date |
01/09/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
40 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
61703-0124-40
METHOTREXATE 1 GRAM/40 ML V
|
⇄
|
J9260
Methotrexate sodium, 50 mg
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
40 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
61703-0124-40
METHOTREXATE
|
⇄
|
J9250
Methotrexate sodium inj
|
| 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 |
|
|
|
|
61703-0124-40
METHOTREXATE
|
⇄
|
J9260
Methotrexate sodium inj
|
| 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 |
|
|
|
|