| Source NDC Code |
|
Target HCPCS Code |
71288-0104-10
LEVOLEUCOVORIN CALCIUM (SDV,PF,LATEX-FREE) 50 MG
|
⇄
|
J0641
INJECTION, LEVOLEUCOVORIN, NOT OTHERWISE SPECIFIED, 0.5 MG
|
| Detail Information |
| Relationship Start Date |
07/24/2020 |
| Relationship End Date |
05/06/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
71288-0104-10
Levoleucovorin Calcium
|
⇄
|
J0641
Inj levoleucovorin nos 0.5mg
|
| 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 |
|
|
|
|