| Source HCPCS Code |
|
Target NDC Code |
Q4097
INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG
|
⇄
|
44206-0436-05
PRIVIGEN (PF,LATEX-FREE) 10%
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
Q4097
INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG
|
⇄
|
44206-0437-10
PRIVIGEN (PF,LATEX-FREE) 10%
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
Q4097
INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG
|
⇄
|
44206-0438-20
PRIVIGEN (PF,LATEX-FREE) 10%
|
| Detail Information |
| Relationship Start Date |
4/1/2008 |
| Relationship End Date |
12/31/2008 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|