| Source HCPCS Code |
|
Target NDC Code |
J1556
INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG
|
⇄
|
59730-6502-01
BIVIGAM (LATEX-FREE) 100 MG/ML
|
| Detail Information |
| Relationship Start Date |
12/19/2012 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1556
INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG
|
⇄
|
59730-6503-01
BIVIGAM (LATEX-FREE) 100 MG/ML
|
| Detail Information |
| Relationship Start Date |
12/19/2012 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1556
INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG
|
⇄
|
69800-6502-01
BIVIGAM (LATEX-FREE) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
02/12/2020 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1556
Injection, immune globulin (bivigam), 500 mg
|
⇄
|
69800-6502-02
BIVIGAM 10% VIAL
|
| Detail Information |
| Relationship Start Date |
10/31/2019 |
| 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 |
|
|
|
J1556
INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG
|
⇄
|
69800-6503-01
BIVIGAM (1X100ML,LATEX-FREE) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
08/25/2021 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1556
Injection, immune globulin (bivigam), 500 mg
|
⇄
|
69800-6503-02
BIVIGAM 10 GM/100 ML (10%)
|
| Detail Information |
| Relationship Start Date |
10/31/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1556
Inj, imm glob bivigam, 500mg
|
⇄
|
69800-6502-01
BIVIGAM
|
| 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 |
|
|
|
|
J1556
Inj, imm glob bivigam, 500mg
|
⇄
|
69800-6503-01
BIVIGAM
|
| 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 |
|
|
|
|