| Source HCPCS Code |
|
Target NDC Code |
J1203
INJECTION, CIPAGLUCOSIDASE ALFA-ATGA, 5 MG
|
⇄
|
71904-0200-01
POMBILITI (PF,LYOPHILIZED) 105 MG
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1203
INJECTION, CIPAGLUCOSIDASE ALFA-ATGA, 5 MG
|
⇄
|
71904-0200-02
POMBILITI (PF,LYOPHILIZED) 105 MG
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1203
INJECTION, CIPAGLUCOSIDASE ALFA-ATGA, 5 MG
|
⇄
|
71904-0200-03
POMBILITI (PF,LYOPHILIZED) 105 MG
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1203
Inj, cipaglucosidase, 5 mg
|
⇄
|
71904-0200-01
Pombiliti
|
| 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 |
|
|
|
|