| Source HCPCS Code |
|
Target NDC Code |
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
64406-0911-01
ALPROLIX
|
| Detail Information |
| Relationship Start Date |
01/01/2015 |
| Relationship End Date |
04/30/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
64406-0922-01
ALPROLIX
|
| Detail Information |
| Relationship Start Date |
01/01/2015 |
| Relationship End Date |
04/30/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
|
⇄
|
64406-0933-01
|
| 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 |
|
|
|
|
J7201
|
⇄
|
64406-0944-01
|
| 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 |
|
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
71104-0911-01
ALPROLIX 500 UNIT NOMINAL
|
| Detail Information |
| Relationship Start Date |
05/29/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
71104-0922-01
ALPROLIX 1,000 UNIT NOMINAL
|
| Detail Information |
| Relationship Start Date |
05/29/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
71104-0933-01
ALPROLIX 2,000 UNIT NOMINAL
|
| Detail Information |
| Relationship Start Date |
05/29/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
71104-0944-01
ALPROLIX 3,000 UNIT NOMINAL
|
| Detail Information |
| Relationship Start Date |
05/29/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
71104-0966-01
ALPROLIX 250 UNIT NOMINAL
|
| Detail Information |
| Relationship Start Date |
05/29/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Injection, factor ix, fc fusion protein (recombinant), per iu
|
⇄
|
71104-0977-01
ALPROLIX 4,000 UNIT NOMINAL
|
| Detail Information |
| Relationship Start Date |
05/29/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
F2 |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
AHF |
|
|
|
J7201
Factor ix alprolix recomb
|
⇄
|
71104-0911-01
ALPROLIX
|
| 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 |
|
|
|
|
J7201
Factor ix alprolix recomb
|
⇄
|
71104-0922-01
ALPROLIX
|
| 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 |
|
|
|
|
J7201
Factor ix alprolix recomb
|
⇄
|
71104-0933-01
ALPROLIX
|
| 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 |
|
|
|
|
J7201
Factor ix alprolix recomb
|
⇄
|
71104-0944-01
ALPROLIX
|
| 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 |
|
|
|
|
J7201
Factor ix alprolix recomb
|
⇄
|
71104-0966-01
ALPROLIX
|
| 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 |
|
|
|
|
J7201
Factor ix alprolix recomb
|
⇄
|
71104-0977-01
ALPROLIX
|
| 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 |
|
|
|
|