| Source HCPCS Code |
|
Target NDC Code |
J7165
INJECTION, PROTHROMBIN COMPLEX CONCENTRATE, HUMAN-LANS, PER I.U. OF FACTOR IX ACTIVITY
|
⇄
|
63833-0387-02
KCENTRA (1000U,LYOPHILIZED) 1 IU
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J7165
INJECTION, PROTHROMBIN COMPLEX CONCENTRATE, HUMAN-LANS, PER I.U. OF FACTOR IX ACTIVITY
|
⇄
|
68982-0261-01
BALFAXAR (500IU;W/DILUENT,PF) 1 IU
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J7165
INJECTION, PROTHROMBIN COMPLEX CONCENTRATE, HUMAN-LANS, PER I.U. OF FACTOR IX ACTIVITY
|
⇄
|
68982-0261-02
BALFAXAR (1000IU;W/DILUENT,PF) 1 IU
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J7165
Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
|
⇄
|
68982-0261-81
BALFAXAR 500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
04/03/2024 |
| 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 |
EA |
|
|
|
J7165
Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
|
⇄
|
68982-0261-82
BALFAXAR 1,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
04/03/2024 |
| 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 |
EA |
|
|
|
J7165
Inj, human-lans, per i.u
|
⇄
|
68982-0261-01
Balfaxar
|
| 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 |
|
|
|
|
J7165
Inj, human-lans, per i.u
|
⇄
|
68982-0261-02
Balfaxar
|
| 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 |
|
|
|
|