| Source NDC Code |
|
Target HCPCS Code |
72266-0120-01
LEVOLEUCOVORIN CALCIUM (1X17.5ML;SDV,PF) 10 MG/1 ML
|
⇄
|
J0641
INJECTION, LEVOLEUCOVORIN, NOT OTHERWISE SPECIFIED, 0.5 MG
|
| Detail Information |
| Relationship Start Date |
06/25/2019 |
| Relationship End Date |
03/31/2021 |
| Number Of Items In Ndc Package |
17.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
72266-0120-01
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 |
|
|
|
|