| Source HCPCS Code |
|
Target NDC Code |
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0451-01
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| 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 |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0451-90
HIZENTRA 1 GRAM/5 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0452-02
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| 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 |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0452-91
HIZENTRA 2 GRAM/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0454-04
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| 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 |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0454-92
HIZENTRA 4 GRAM/20 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0455-10
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
| Detail Information |
| Relationship Start Date |
10/01/2013 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0455-25
HIZENTRA (SINGLE-USE,PF) 20%
|
| Detail Information |
| Relationship Start Date |
12/04/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SY |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0455-93
HIZENTRA 10 GRAM/50 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0455-97
HIZENTRA 10 GRAM/50 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
10/16/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0456-21
HIZENTRA (SINGLE-USE,PF) 20%
|
| Detail Information |
| Relationship Start Date |
04/06/2020 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0456-94
HIZENTRA 1 GRAM/5 ML SYRING
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0457-22
HIZENTRA (SINGLE-USE,PF) 20%
|
| Detail Information |
| Relationship Start Date |
04/06/2020 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0457-95
HIZENTRA 2 GRAM/10 ML SYRIN
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
⇄
|
44206-0458-24
HIZENTRA (4GM;SINGLE-USE,PF) 20%
|
| Detail Information |
| Relationship Start Date |
04/06/2020 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1559
Injection, immune globulin (hizentra), 100 mg
|
⇄
|
44206-0458-96
HIZENTRA 4 GRAM/20 ML SYRIN
|
| Detail Information |
| Relationship Start Date |
01/01/2011 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
EA |
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0451-01
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0452-02
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0454-04
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0455-10
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0455-25
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0456-21
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0457-22
Hizentra
|
| 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 |
|
|
|
|
J1559
Hizentra injection
|
⇄
|
44206-0458-24
Hizentra
|
| 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 |
|
|
|
|