| Source HCPCS Code |
|
Target NDC Code |
Q4096
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO
|
⇄
|
68516-4600-01
ALPHANATE (250-500 FVIII IU/5ML) 1 IU
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
IU |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q4096
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO
|
⇄
|
68516-4600-02
ALPHANATE (1000-1500 FVIII IU/10ML) 1 IU
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
1500 |
| Ndc Package Measure |
IU |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q4096
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO
|
⇄
|
68516-4601-01
ALPHANATE (SINGLE DOSE,250IU/5ML) 1 IU-1 IU
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q4096
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO
|
⇄
|
68516-4602-01
ALPHANATE (SINGLE DOSE,500IU/5ML) 1 IU-1 IU
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q4096
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO
|
⇄
|
68516-4603-02
ALPHANATE (SINGLE DOSE,1000IU/10ML) 1 IU-1 IU
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
Q4096
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT OTHERWISE SPECIFIED), PER I.U. VWF:RCO
|
⇄
|
68516-4604-02
ALPHANATE (SINGLE DOSE,1500IU/10ML) 1 IU-1 IU
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|