| Source HCPCS Code |
|
Target NDC Code |
J1554
INJECTION, IMMUNE GLOBULIN (ASCENIV), 500 MG
|
⇄
|
69800-0250-01
ASCENIV (PF,LATEX-FREE) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
10/17/2019 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1554
INJ, IMMUNE GLOBULIN (ASCENIV), 500 MG
|
⇄
|
69800-0250-02
ASCENIV 10% VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1554
Inj. asceniv
|
⇄
|
69800-0250-01
Asceniv
|
| 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 |
|
|
|
|