| Source NDC Code |
|
Target HCPCS Code |
70594-0057-02
VANCOMYCIN HCL (FLEXIBLE BAG) 1.25 GM/250 ML
|
⇄
|
J3372
INJECTION, VANCOMYCIN HCL (XELLIA) NOT THERAPEUTICALLY EQUIVALENT TO J3370, 500 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
06/30/2025 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
FC |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
70594-0057-02
VANCOMYCIN HCL (PREMIX) FLEXIBLE BAG 1.25 GM/250 ML
|
⇄
|
J3375
INJECTION, VANCOMYCIN HYDROCHLORIDE (XELLIA), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
70594-0057-02
Vancomycin HCl
|
⇄
|
J3375
Inj vancomycin (xellia) 10mg
|
| Detail Information |
| Relationship Start Date |
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| Relationship End Date |
|
| Number Of Items In Ndc Package |
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| Ndc Package Measure |
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| Ndc Package Type |
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| Route Of Administration |
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| Billing Units |
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