| Source HCPCS Code |
|
Target NDC Code |
J0215
INJECTION, ALEFACEPT, 0.5 MG
|
⇄
|
00469-0021-03
AMEVIVE (W/DILUENT PACK,PF) 15 MG
|
| Detail Information |
| Relationship Start Date |
2/28/2008 |
| Relationship End Date |
3/16/2012 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J0215
INJECTION, ALEFACEPT, 0.5 MG
|
⇄
|
00469-0021-04
AMEVIVE (W/DILUENT PACK,PF) 15 MG
|
| Detail Information |
| Relationship Start Date |
12/31/2007 |
| Relationship End Date |
3/16/2012 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J0215
INJECTION, ALEFACEPT, 0.5 MG
|
⇄
|
59627-0020-01
AMEVIVE (4 VIALS W/ADMIN. SET,PF) 7.5 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
1/1/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0215
INJECTION, ALEFACEPT, 0.5 MG
|
⇄
|
59627-0020-02
AMEVIVE (PF) 7.5 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
1/1/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0215
INJECTION, ALEFACEPT, 0.5 MG
|
⇄
|
59627-0021-03
AMEVIVE (4 VIALS, SRN, W/DILUENT) 15 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
2/27/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J0215
INJECTION, ALEFACEPT, 0.5 MG
|
⇄
|
59627-0021-04
AMEVIVE (PF) 15 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2004 |
| Relationship End Date |
12/30/2007 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|