| Source HCPCS Code |
|
Target NDC Code |
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00013-2406-91
FRAGMIN (SRN) 2500 IU/0.2 ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
6/25/2007 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00013-2426-01
FRAGMIN (SRN, PREFILLED,27GX1/2") 7500 IU/0.3 ML
|
| Detail Information |
| Relationship Start Date |
6/14/2002 |
| Relationship End Date |
2/5/2007 |
| Number Of Items In Ndc Package |
0.3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00013-2426-91
FRAGMIN (SRN) 5000 IU/0.2 ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/9/2006 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00013-2436-06
FRAGMIN (M.D.V.) 10000 IU/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
7/9/2006 |
| Number Of Items In Ndc Package |
9.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00013-5190-01
FRAGMIN (SRN, PREFILLED,27GX1/2") 10000 IU/ML
|
| Detail Information |
| Relationship Start Date |
6/13/2002 |
| Relationship End Date |
11/19/2006 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00013-5191-01
FRAGMIN (M.D.V.) 25000 IU/ML
|
| Detail Information |
| Relationship Start Date |
6/17/2002 |
| Relationship End Date |
11/19/2006 |
| Number Of Items In Ndc Package |
3.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0195-01
FRAGMIN 2,500 UNITS/0.2 ML
|
| Detail Information |
| Relationship Start Date |
02/01/1997 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0195-02
FRAGMIN (PREFILLED SYRINGE,PF) 2500 IU/0.2 ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0196-01
FRAGMIN 5,000 UNITS/0.2 ML
|
| Detail Information |
| Relationship Start Date |
02/01/1997 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0196-02
FRAGMIN (PREFILLED SYRINGE,PF) 5000 IU/0.2 ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0206-01
FRAGMIN 7,500 UNITS/0.3 ML
|
| Detail Information |
| Relationship Start Date |
06/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0206-02
FRAGMIN (PREFILLED SYRINGE,PF) 7500 IU/0.3 ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0217-01
FRAGMIN 10,000 UNITS/ML SYR
|
| Detail Information |
| Relationship Start Date |
04/01/2002 |
| 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 |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0217-02
FRAGMIN (PREFILLED SYRINGE,PF) 10000 IU/ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0220-01
FRAGMIN 12,500 UNITS/0.5 ML
|
| Detail Information |
| Relationship Start Date |
09/03/2007 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0220-02
FRAGMIN (PREFILLED SYRINGE,PF) 12500 IU/0.5 ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0223-01
FRAGMIN 15,000 UNITS/0.6 ML
|
| Detail Information |
| Relationship Start Date |
06/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.6 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0223-02
FRAGMIN (PREFILLED SYRINGE,PF) 15000 IU/0.6 ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.6 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0228-01
FRAGMIN 18,000 UNITS/0.72 M
|
| Detail Information |
| Relationship Start Date |
06/15/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.72 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0228-02
FRAGMIN (PREFILLED SYRINGE,PF) 18000 IU/0.72 ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.72 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
00069-0232-01
FRAGMIN (MDV) 25000 IU/ML
|
| Detail Information |
| Relationship Start Date |
03/18/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
3.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0253-01
FRAGMIN 10,000 UNIT/4 ML VI
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
4 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
Injection, dalteparin sodium, per 2500 iu
|
⇄
|
00069-0253-10
FRAGMIN 10,000 UNIT/4 ML VI
|
| Detail Information |
| Relationship Start Date |
11/22/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
4 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1645
|
⇄
|
62856-0100-10
|
| 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 |
|
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0101-10
FRAGMIN (27GX1/2"W/NDLGUARD) 10000 IU/ML
|
| Detail Information |
| Relationship Start Date |
11/20/2006 |
| Relationship End Date |
3/31/2015 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0102-01
FRAGMIN (MDV) 10000 IU/ML
|
| Detail Information |
| Relationship Start Date |
7/10/2006 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
9.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0125-10
FRAGMIN (SINGLE DOSE,PF) 12500 IU/0.5 ML
|
| Detail Information |
| Relationship Start Date |
8/25/2007 |
| Relationship End Date |
3/31/2015 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0150-10
FRAGMIN (SINGLE DOSE,PF) 15000 IU/0.6 ML
|
| Detail Information |
| Relationship Start Date |
8/25/2007 |
| Relationship End Date |
3/31/2015 |
| Number Of Items In Ndc Package |
0.6 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0180-10
FRAGMIN (SINGLE DOSE,PF) 18000 IU/0.72 ML
|
| Detail Information |
| Relationship Start Date |
8/25/2007 |
| Relationship End Date |
3/31/2015 |
| Number Of Items In Ndc Package |
0.72 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0250-10
FRAGMIN (10X0.2ML,PF) 2500 IU/0.2 ML
|
| Detail Information |
| Relationship Start Date |
6/26/2007 |
| Relationship End Date |
3/31/2015 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0251-01
FRAGMIN (MDV) 25000 IU/ML
|
| Detail Information |
| Relationship Start Date |
11/20/2006 |
| Relationship End Date |
12/1/2014 |
| Number Of Items In Ndc Package |
3.8 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0500-10
FRAGMIN (27GX1/2",10X0.2ML,PF) 5000 IU/0.2 ML
|
| Detail Information |
| Relationship Start Date |
10/10/2006 |
| Relationship End Date |
3/31/2015 |
| Number Of Items In Ndc Package |
0.2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
|
⇄
|
62856-0750-10
FRAGMIN (PREFILLED) 7500 IU/0.3 ML
|
| Detail Information |
| Relationship Start Date |
2/6/2007 |
| Relationship End Date |
2/2/2015 |
| Number Of Items In Ndc Package |
0.3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0195-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0196-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0206-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0217-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0220-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0223-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0228-02
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0232-01
Fragmin
|
| 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 |
|
|
|
|
J1645
Dalteparin sodium
|
⇄
|
00069-0253-10
Fragmin
|
| 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 |
|
|
|
|