| Source HCPCS Code |
|
Target NDC Code |
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
08024-0724-12
HYALGAN (VIAL) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
08024-0724-20
HYALGAN (SRN,PREFILLED,LUER LOCK) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
08363-7761-01
SUPARTZ (SRN,PREFILLED) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
08363-7765-01
SUPARTZ (SRN,PREFILLED) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
18837-0265-02
HYALGAN 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
21695-0374-02
HYALGAN L/L 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
35356-0036-01
SUPARTZ 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/10/2008 |
| Relationship End Date |
7/2/2009 |
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
35356-0036-02
SUPARTZ 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/10/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
2.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J7321
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE
|
⇄
|
35356-0219-01
HYALGAN 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
6/5/2008 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J7321
|
⇄
|
54569-5543-00
|
| 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 |
|
|
|
|
J7321
|
⇄
|
89122-0724-12
|
| 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 |
|
|
|
|
J7321
|
⇄
|
89122-0724-20
|
| 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 |
|
|
|
|
J7321
|
⇄
|
89130-5555-01
|
| 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 |
|
|
|
|
J7321
Hyalgan supartz visco-3 dose
|
⇄
|
89130-4444-01
SUPARTZ FX
|
| 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 |
|
|
|
|
J7321
Hyalgan supartz visco-3 dose
|
⇄
|
89122-0724-12
HYALGAN
|
| 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 |
|
|
|
|
J7321
Hyalgan supartz visco-3 dose
|
⇄
|
89122-0724-20
HYALGAN
|
| 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 |
|
|
|
|
J7321
Hyalgan supartz visco-3 dose
|
⇄
|
50016-0957-21
VISCO-3
|
| 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 |
|
|
|
|