| Source HCPCS Code |
|
Target NDC Code |
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00053-7486-05
GAMMAR-P I.V. (W/DILUENT) 5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00053-7486-10
GAMMAR-P I.V. (W/DILUENT) 10 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-0471-69
POLYGAM S/D (S.D.V. W/DILUENT) 0.5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/1/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-0471-72
POLYGAM S/D (S.D.V. W/DILUENT) 2.5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/1/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-0471-75
POLYGAM S/D (S.D.V. W/DILUENT) 5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/1/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-0471-80
POLYGAM S/D (S.D.V.W/DILUENT) 10 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/1/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2620-01
GAMMAGARD S/D 0.5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2620-02
GAMMAGARD S/D 2.5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/25/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2620-03
GAMMAGARD S/D 5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
4/11/2014 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2620-04
GAMMAGARD S/D 10 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/21/2014 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2655-03
GAMMAGARD S/D (W/TRANSFER SET) 5 GM
|
| Detail Information |
| Relationship Start Date |
6/1/2007 |
| Relationship End Date |
1/3/2015 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2655-04
GAMMAGARD S/D (W/TRANSFER SET) 10 GM
|
| Detail Information |
| Relationship Start Date |
6/1/2007 |
| Relationship End Date |
1/3/2015 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2656-03
GAMMAGARD S/D (IGA<1UG/ML) (SINGLE DOSE) 5 GM
|
| Detail Information |
| Relationship Start Date |
01/24/2013 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
Injection, immune globulin, intravenous, lyophilized (e.g. powder), not oth...
|
⇄
|
00944-2657-07
GAMMAGARD S-D 5 G (IGA<1) S
|
| Detail Information |
| Relationship Start Date |
04/01/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
GM |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
00944-2658-04
GAMMAGARD S/D (IGA<1UG/ML) 10 GM
|
| Detail Information |
| Relationship Start Date |
01/24/2013 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
Injection, immune globulin, intravenous, lyophilized (e.g. powder), not oth...
|
⇄
|
00944-2659-08
GAMMAGARD S-D 10 G (IGA<1)
|
| Detail Information |
| Relationship Start Date |
04/01/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
GM |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
44206-0415-01
CARIMUNE NF (PF,NANOFILTERED) 1 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
44206-0416-03
CARIMUNE NF (PF,NANOFILTERED) 3 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
11/17/2016 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
44206-0417-06
CARIMUNE NF (PF,NANOFILTERED) 6 GM
|
| Detail Information |
| Relationship Start Date |
01/01/2006 |
| Relationship End Date |
03/23/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
44206-0418-12
CARIMUNE NF (PF,NANOFILTERED) 12 GM
|
| Detail Information |
| Relationship Start Date |
01/01/2006 |
| Relationship End Date |
03/23/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
|
⇄
|
44206-0508-62
|
| 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 |
|
|
|
|
J1566
|
⇄
|
44206-0607-56
|
| 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 |
|
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
52769-0417-06
PANGLOBULIN NF (S.D.V.,PF,NANOFILTERED) 6 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
8/31/2011 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
52769-0418-12
PANGLOBULIN NF (S.D.V.,PF,NANOFILTERED) 12 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
8/31/2011 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
52769-0470-72
POLYGAM (W/50 ML DILUENT) 2.5 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2006 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
|
⇄
|
52769-0471-75
|
| 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 |
|
|
|
|
J1566
|
⇄
|
52769-0471-80
|
| 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 |
|
|
|
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
⇄
|
64193-0250-50
IVEEGAM EN (IGIV,W/DILUENT,PF) 5 GM
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/31/2006 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1566
Immune globulin, powder
|
⇄
|
00944-2656-03
Gammagard S/D
|
| 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 |
|
|
|
|
J1566
Immune globulin, powder
|
⇄
|
00944-2658-04
Gammagard S/D
|
| 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 |
|
|
|
|