| Source HCPCS Code |
|
Target NDC Code |
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0978-01
ALTUVIIIO 250 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0979-01
ALTUVIIIO 500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0981-01
ALTUVIIIO 1,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0982-01
ALTUVIIIO 2,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0983-01
ALTUVIIIO 3,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0984-01
ALTUVIIIO 4,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0985-08
ALTUVIIIO 250 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0986-08
ALTUVIIIO 500 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0988-08
ALTUVIIIO 1,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0989-08
ALTUVIIIO 2,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0990-08
ALTUVIIIO 3,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
|
J7214
Inj, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
|
⇄
|
71104-0991-08
ALTUVIIIO 4,000 UNIT VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| 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 |
|
|
|
|
J7214
Altuviiio per factor viii iu
|
⇄
|
71104-0978-01
ALTUVIIIO
|
| 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 |
|
|
|
|
J7214
Altuviiio per factor viii iu
|
⇄
|
71104-0979-01
ALTUVIIIO
|
| 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 |
|
|
|
|
J7214
Altuviiio per factor viii iu
|
⇄
|
71104-0981-01
ALTUVIIIO
|
| 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 |
|
|
|
|
J7214
Altuviiio per factor viii iu
|
⇄
|
71104-0982-01
ALTUVIIIO
|
| 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 |
|
|
|
|
J7214
Altuviiio per factor viii iu
|
⇄
|
71104-0983-01
ALTUVIIIO
|
| 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 |
|
|
|
|
J7214
Altuviiio per factor viii iu
|
⇄
|
71104-0984-01
ALTUVIIIO
|
| 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 |
|
|
|
|