| Source HCPCS Code |
|
Target NDC Code |
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
00026-0635-04
BAYGAM (S.D.V.,PF)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/13/2006 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
00026-0635-12
BAYGAM (S.D.V.,PF)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/13/2006 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
13533-0335-04
GAMASTAN (SDV,PF,LATEX-FREE) 15%-18%
|
| Detail Information |
| Relationship Start Date |
08/24/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
13533-0335-12
GAMASTAN (SDV,PF,LATEX-FREE) 15%-18%
|
| Detail Information |
| Relationship Start Date |
08/24/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
Injection, gamma globulin, intramuscular, 1 cc
|
⇄
|
13533-0335-13
GAMASTAN VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2020 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
Injection, gamma globulin, intramuscular, 1 cc
|
⇄
|
13533-0335-40
GAMASTAN VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2020 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
13533-0635-03
GAMASTAN S/D (1X2ML,PF,LATEX-FREE)
|
| Detail Information |
| Relationship Start Date |
1/17/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
13533-0635-04
GAMASTAN S/D (S.D.V.,PF)
|
| Detail Information |
| Relationship Start Date |
10/04/2005 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
13533-0635-12
GAMASTAN S/D (S.D.V.,PF)
|
| Detail Information |
| Relationship Start Date |
10/04/2005 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
|
⇄
|
14362-0115-02
|
| 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 |
|
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
54569-5275-00
BAYGAM (S.D.V.,PF)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/3/2006 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
54569-5276-00
BAYGAM (S.D.V.,PF)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
1/31/2003 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
54569-5828-00
GAMASTAN S/D (SDV)
|
| Detail Information |
| Relationship Start Date |
09/26/2006 |
| Relationship End Date |
12/31/2018 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
|
⇄
|
54868-4193-00
BAYGAM (S.D.V.,PF) 15%-18% (DF & C)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/3/2006 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1460
Injection, gamma globulin, intramuscular, 1 cc
|
⇄
|
70594-0084-01
AMPICILLIN 250 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/11/2022 |
| Relationship End Date |
01/11/2022 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J1460
Injection, gamma globulin, intramuscular, 1 cc
|
⇄
|
70594-0084-02
AMPICILLIN 250 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/11/2022 |
| Relationship End Date |
01/11/2022 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J1460
Gamma globulin 1 cc inj
|
⇄
|
13533-0335-04
GAMASTAN
|
| 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 |
|
|
|
|
J1460
Gamma globulin 1 cc inj
|
⇄
|
13533-0335-12
GAMASTAN
|
| 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 |
|
|
|
|