| Source HCPCS Code |
|
Target NDC Code |
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-02
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-03
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-04
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-05
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-06
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-07
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-08
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-09
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-10
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-11
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-12
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2700-13
GAMMAGARD LIQUID 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
30 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
GM |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-01
CUVITRU 1 GRAM/5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-02
CUVITRU 1 GRAM/5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-03
CUVITRU 2 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-04
CUVITRU 2 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-05
CUVITRU 4 GRAM/20 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-06
CUVITRU 4 GRAM/20 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-07
CUVITRU 8 GRAM/ 40 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
40 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-08
CUVITRU 8 GRAM/ 40 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
40 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
00944-2850-09
CUVITRU 10 GRAM/50 ML VIAL
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-12
GAMUNEX-C 1 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-13
GAMUNEX-C
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-15
GAMUNEX-C 2.5 GRAM/25 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-16
GAMUNEX-C
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-20
GAMUNEX-C 5 GRAM/50 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-21
GAMUNEX-C
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-24
GAMUNEX-C 20 GRAM/200 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-25
GAMUNEX-C
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-40
GAMUNEX-C 40 GRAM/400 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
400 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-41
GAMUNEX-C 40 GRAM/400 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
400 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-71
GAMUNEX-C 10 GRAM/100 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0800-72
GAMUNEX-C 40 GRAM/400 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/27/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-05
XEMBIFY 20% (1 G/5 ML) VIAL
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-06
XEMBIFY 20% (1 G/5 ML) VIAL
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-10
XEMBIFY 20% (2 G/10 ML) VIA
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-11
XEMBIFY 20% (2 G/10 ML) VIA
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-20
XEMBIFY 20% (4 G/20 ML) VIA
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-21
XEMBIFY 20% (4 G/20 ML) VIA
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-50
XEMBIFY 20% (10 G/50 ML) VI
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
13533-0810-51
XEMBIFY 20% (10 G/50 ML) VI
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0451-01
HIZENTRA 1 GRAM/5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0451-90
HIZENTRA 1 GRAM/5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0452-02
HIZENTRA 2 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0452-91
HIZENTRA 2 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0454-04
HIZENTRA 4 GRAM/20 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0454-92
HIZENTRA 4 GRAM/20 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0455-10
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
| Detail Information |
| Relationship Start Date |
10/16/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0455-25
HIZENTRA 10 GRAM/50 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
10/16/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0455-93
HIZENTRA 10 GRAM/50 ML VIAL
|
| Detail Information |
| Relationship Start Date |
10/16/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
44206-0455-97
HIZENTRA 10 GRAM/50 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
10/16/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-01
GAMMAKED 1 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/29/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-02
GAMMAKED 1 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/05/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-10
GAMMAKED 10 GRAM/100 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/29/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-11
GAMMAKED 10 GRAM/100 ML VIA
|
| Detail Information |
| Relationship Start Date |
12/05/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-20
GAMMAKED 20 GRAM/200 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/29/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-21
GAMMAKED 20 GRAM/200 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/05/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-50
GAMMAKED 5 GRAM/50 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/29/2010 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
⇄
|
76125-0900-51
GAMMAKED 5 GRAM/50 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/05/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|