| Source NDC Code |
|
Target HCPCS Code |
65219-0554-28
IDACIO STARTER PACK-PLAQUE PSORIASIS (2 TRAYS W/4 PEN PER KIT) 40 MG/0.8 ML
|
⇄
|
Q5131
INJECTION, ADALIMUMAB-AACF (IDACIO), BIOSIMILAR, 20 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/2024 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
65219-0554-28
IDACIO STARTER PACK-PLAQUE PSORIASIS 2 TRAYS W/4 PEN PER KIT 40 MG/0.8 ML
|
⇄
|
Q5144
INJECTION, ADALIMUMAB-AACF (IDACIO), BIOSIMILAR, 1 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
04/01/2025 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|