| Source HCPCS Code |
|
Target NDC Code |
J7170
Injection, emicizumab-kxwh, 0.5 mg
|
⇄
|
50242-0920-01
HEMLIBRA 30 MG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J7170
Injection, emicizumab-kxwh, 0.5 mg
|
⇄
|
50242-0921-01
HEMLIBRA 60 MG/0.4 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.4 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J7170
Injection, emicizumab-kxwh, 0.5 mg
|
⇄
|
50242-0922-01
HEMLIBRA 105 MG/0.7 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.7 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J7170
Injection, emicizumab-kxwh, 0.5 mg
|
⇄
|
50242-0923-01
HEMLIBRA 150 MG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J7170
Injection, emicizumab-kxwh, 0.5 mg
|
⇄
|
50242-0927-01
HEMLIBRA 12 MG/0.4 ML VIAL
|
| Detail Information |
| Relationship Start Date |
03/12/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.4 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J7170
Injection, emicizumab-kxwh, 0.5 mg
|
⇄
|
50242-0930-01
HEMLIBRA 300 MG/2 ML VIAL
|
| Detail Information |
| Relationship Start Date |
01/16/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J7170
Inj., emicizumab-kxwh 0.5 mg
|
⇄
|
50242-0920-01
Hemlibra
|
| 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 |
|
|
|
|
J7170
Inj., emicizumab-kxwh 0.5 mg
|
⇄
|
50242-0921-01
Hemlibra
|
| 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 |
|
|
|
|
J7170
Inj., emicizumab-kxwh 0.5 mg
|
⇄
|
50242-0922-01
Hemlibra
|
| 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 |
|
|
|
|
J7170
Inj., emicizumab-kxwh 0.5 mg
|
⇄
|
50242-0923-01
Hemlibra
|
| 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 |
|
|
|
|
J7170
Inj., emicizumab-kxwh 0.5 mg
|
⇄
|
50242-0927-01
Hemlibra
|
| 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 |
|
|
|
|
J7170
Inj., emicizumab-kxwh 0.5 mg
|
⇄
|
50242-0930-01
Hemlibra
|
| 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 |
|
|
|
|