| Source HCPCS Code |
|
Target NDC Code |
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4622-01
ADYNOVATE 200-400 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4622-02
ADYNOVATE 200-400 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4623-01
ADYNOVATE 401-800 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4623-02
ADYNOVATE 401-800 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4624-01
ADYNOVATE 801-1,250 UNIT VI
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4624-02
ADYNOVATE 801-1,250 UNIT VI
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4625-01
ADYNOVATE 1,251-2,500 UNIT
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4625-02
ADYNOVATE 1,251-2,500 UNIT
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4626-01
ADYNOVATE 750 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2018 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4626-02
ADYNOVATE 750 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4627-01
ADYNOVATE 1,500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
04/15/2018 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4627-02
ADYNOVATE 1,500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4628-01
ADYNOVATE 3,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2017 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4628-02
ADYNOVATE 3,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| 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 |
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4622-01
ADYNOVATE
|
| 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 |
|
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4623-01
ADYNOVATE
|
| 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 |
|
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4624-01
ADYNOVATE
|
| 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 |
|
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4625-01
ADYNOVATE
|
| 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 |
|
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4626-01
ADYNOVATE
|
| 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 |
|
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4627-01
ADYNOVATE
|
| 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 |
|
|
|
|
J7207
Factor viii pegylated recomb
|
⇄
|
00944-4628-01
ADYNOVATE
|
| 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 |
|
|
|
|