| Source NDC Code |
|
Target HCPCS Code |
80446-0401-01
KIMMTRAK 100 MCG/0.5 ML VIAL
|
⇄
|
C9095
Inj, tebentafusp-tebn, 1 mcg
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| Relationship End Date |
09/30/2022 |
| Number Of Items In Ndc Package |
.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
80446-0401-01
KIMMTRAK 100 MCG/0.5 ML VIAL
|
⇄
|
J9274
Injection, tebentafusp-tebn, 1 mcg
|
| Detail Information |
| Relationship Start Date |
10/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
80446-0401-01
KIMMTRAK 100 MCG/0.5 ML VIAL
|
⇄
|
J9999
NOT OTHERWISE CLASSIFIED, ANTINEOPLASTIC DRUGS
|
| Detail Information |
| Relationship Start Date |
02/25/2022 |
| Relationship End Date |
09/30/2022 |
| Number Of Items In Ndc Package |
.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
80446-0401-01
Kimmtrak
|
⇄
|
J9274
Inj, tebentafusp-tebn, 1 mcg
|
| 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 |
|
|
|
|