| Source HCPCS Code |
|
Target NDC Code |
J2508
Injection, pegunigalsidase alfa-iwxj, 1 mg
|
⇄
|
10122-0160-01
ELFABRIO 20 MG/10 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2508
INJECTION, PEGUNIGALSIDASE ALFA-IWXJ, 1 MG
|
⇄
|
10122-0160-02
ELFABRIO (SDV,PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2508
INJECTION, PEGUNIGALSIDASE ALFA-IWXJ, 1 MG
|
⇄
|
10122-0160-05
ELFABRIO (SDV,PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2508
INJECTION, PEGUNIGALSIDASE ALFA-IWXJ, 1 MG
|
⇄
|
10122-0160-10
ELFABRIO (SDV,PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2508
INJECTION, PEGUNIGALSIDASE ALFA-IWXJ, 1 MG
|
⇄
|
10122-0165-02
ELFABRIO (SDV,PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/15/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2508
Pegunigalsidase alfa-iwxj
|
⇄
|
10122-0160-02
Elfabrio
|
| 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 |
|
|
|
|
J2508
Pegunigalsidase alfa-iwxj
|
⇄
|
10122-0160-05
Elfabrio
|
| 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 |
|
|
|
|
J2508
Pegunigalsidase alfa-iwxj
|
⇄
|
10122-0160-10
Elfabrio
|
| 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 |
|
|
|
|
J2508
Pegunigalsidase alfa-iwxj
|
⇄
|
10122-0165-02
Elfabrio
|
| 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 |
|
|
|
|