| Source HCPCS Code |
|
Target NDC Code |
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-01
CUVITRU (1GM,PF,LATEX-FREE) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-02
CUVITRU (1GM, INNER PACK NDC,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-03
CUVITRU (2GM,PF,LATEX-FREE) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-04
CUVITRU (2GM, INNER PACK NDC,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-05
CUVITRU (4GM,PF,LATEX-FREE) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-06
CUVITRU (4GM, INNER PACK NDC,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-07
CUVITRU (8GM,PF,LATEX-FREE) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
40 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-08
CUVITRU (8GM, INNER PACK NDC,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
40 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
⇄
|
00944-2850-09
CUVITRU (10GM,PF,LATEX-FREE) 20%
|
| Detail Information |
| Relationship Start Date |
07/01/2019 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CT |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1555
Inj cuvitru, 100 mg
|
⇄
|
00944-2850-01
CUVITRU
|
| 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 |
|
|
|
|
J1555
Inj cuvitru, 100 mg
|
⇄
|
00944-2850-03
CUVITRU
|
| 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 |
|
|
|
|
J1555
Inj cuvitru, 100 mg
|
⇄
|
00944-2850-05
CUVITRU
|
| 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 |
|
|
|
|
J1555
Inj cuvitru, 100 mg
|
⇄
|
00944-2850-07
CUVITRU
|
| 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 |
|
|
|
|
J1555
Inj cuvitru, 100 mg
|
⇄
|
00944-2850-09
Cuvitru
|
| 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 |
|
|
|
|