| Source NDC Code |
|
Target HCPCS Code |
51552-0979-04
HYDROXYZINE PAMOATE (U.S.P.)
|
⇄
|
Q0177
HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN
|
| Detail Information |
| Relationship Start Date |
1/1/2014 |
| Relationship End Date |
1/1/2015 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
51552-0979-04
HYDROXYZINE PAMOATE (U.S.P.)
|
⇄
|
Q0178
HYDROXYZINE PAMOATE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN
|
| Detail Information |
| Relationship Start Date |
9/1/2003 |
| Relationship End Date |
12/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|