| Source NDC Code |
|
Target HCPCS Code |
63323-0885-12
PREMIERPRO RX LEVOTHYROXINE SODIUM (SDV,PF,LATEX-FREE) 20 MCG/1 ML
|
⇄
|
J0651
INJECTION, LEVOTHYROXINE SODIUM (FRESENIUS KABI) NOT THERAPEUTICALLY EQUIVALENT TO J0650, 10 MCG
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
63323-0885-12
LEVOTHYROXINE 100 MCG/5 ML
|
⇄
|
J3490
Unclassified drugs
|
| Detail Information |
| Relationship Start Date |
06/12/2019 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
|
| Billing Units |
ML |
|
|
|
63323-0885-12
Levothyroxine Sodium
|
⇄
|
J0651
Inj, levothyroxine, freskabi
|
| 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 |
|
|
|
|