| Source HCPCS Code |
|
Target NDC Code |
J1567
|
⇄
|
00026-0645-12
|
| Detail Information |
| Relationship Start Date |
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| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
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| Ndc Package Type |
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| Route Of Administration |
|
| Billing Units |
|
|
|
|
J1567
|
⇄
|
00026-0645-15
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0645-20
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0645-24
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0645-71
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0648-15
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0648-20
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0648-24
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00026-0648-71
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00944-2700-02
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00944-2700-03
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00944-2700-04
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00944-2700-05
|
| 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 |
|
|
|
|
J1567
|
⇄
|
00944-2700-06
|
| 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 |
|
|
|
|
J1567
|
⇄
|
13533-0645-12
|
| 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 |
|
|
|
|
J1567
|
⇄
|
13533-0645-15
|
| 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 |
|
|
|
|
J1567
|
⇄
|
13533-0645-20
|
| 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 |
|
|
|
|
J1567
|
⇄
|
13533-0645-24
|
| 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 |
|
|
|
|
J1567
|
⇄
|
13533-0645-71
|
| 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 |
|
|
|
|
J1567
|
⇄
|
49669-1612-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
49669-1613-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
49669-1614-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
49669-1622-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
49669-1623-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
49669-1624-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
61953-0003-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
61953-0003-02
|
| 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 |
|
|
|
|
J1567
|
⇄
|
61953-0003-03
|
| 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 |
|
|
|
|
J1567
|
⇄
|
61953-0003-04
|
| 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 |
|
|
|
|
J1567
|
⇄
|
67467-0843-01
|
| 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 |
|
|
|
|
J1567
|
⇄
|
67467-0843-02
|
| 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 |
|
|
|
|
J1567
|
⇄
|
67467-0843-03
|
| 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 |
|
|
|
|
J1567
|
⇄
|
67467-0843-04
|
| 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 |
|
|
|
|
J1567
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
⇄
|
68516-1612-01
VENOGLOBULIN-S 5% (2.5GM VIAL,W/ADMIN SET) 50 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/28/2007 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1567
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
⇄
|
68516-1613-01
VENOGLOBULIN-S 5% (5 GM/VIAL,W/ADMIN SET) 50 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/28/2007 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1567
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
⇄
|
68516-1614-01
VENOGLOBULIN-S 5% (10 GM/VIAL,W/ADMIN SET) 50 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/28/2007 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1567
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
⇄
|
68516-1622-01
VENOGLOBULIN-S 10% (5 GM/VIAL,W/ADMIN SET) 100 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/28/2007 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1567
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
⇄
|
68516-1623-01
VENOGLOBULIN-S 10% (10 GM/VIAL,W/ADMIN SET) 100 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/28/2007 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1567
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
⇄
|
68516-1624-01
VENOGLOBULIN-S 10% (20 GM/VIAL,W/ADMIN SET) 100 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
6/28/2007 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|