| Source NDC Code |
|
Target HCPCS Code |
81927-0204-01
JYLAMVO 2 MG/ML ORAL SOLUTION
|
⇄
|
J8611
Methotrexate (jylamvo), oral, 2.5 mg
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
60 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BOTTLE |
| Route Of Administration |
PO |
| Billing Units |
ML |
|
|
|
81927-0204-01
JYLAMVO (ORANGE) 2 MG/1 ML
|
⇄
|
J8999
PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS
|
| Detail Information |
| Relationship Start Date |
11/21/2023 |
| Relationship End Date |
09/30/2024 |
| Number Of Items In Ndc Package |
60 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
PO |
| Billing Units |
EA |
|
|
|
81927-0204-01
JYLAMVO (ORANGE) 2 MG/1 ML
|
⇄
|
None
METHOTREXATE (JYLAMVO), ORAL, 2.5 MG
|
| Detail Information |
| Relationship Start Date |
10/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
60 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
PO |
| Billing Units |
ML |
|
|
|
81927-0204-01
Jylamvo
|
⇄
|
J8611
Oral methotrexate (jylamvo)
|
| 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 |
|
|
|
|