| Source HCPCS Code |
|
Target NDC Code |
Q4104
SKIN SUBSTITUTE, INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER
|
⇄
|
08478-4004-02
INTEGRA BILAYER MATRIX WOUND DRESSING (2"X2")
|
| Detail Information |
| Relationship Start Date |
1/1/2009 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
TP |
| Billing Units |
EA |
|
|
|
Q4104
SKIN SUBSTITUTE, INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER
|
⇄
|
08478-4004-05
INTEGRA BILAYER MATRIX WOUND DRESSING (4"X5")
|
| Detail Information |
| Relationship Start Date |
1/1/2009 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
TP |
| Billing Units |
EA |
|
|
|
Q4104
SKIN SUBSTITUTE, INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER
|
⇄
|
08478-4004-06
INTEGRA BILAYER MATRIX WOUND DRESSING (4"X10")
|
| Detail Information |
| Relationship Start Date |
1/1/2009 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
TP |
| Billing Units |
EA |
|
|
|
Q4104
SKIN SUBSTITUTE, INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER
|
⇄
|
08478-4004-08
INTEGRA BILAYER MATRIX WOUND DRESSING (8"X10")
|
| Detail Information |
| Relationship Start Date |
1/1/2009 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
TP |
| Billing Units |
EA |
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4003-02
Integra Meshed Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4003-05
Integra Meshed Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4003-06
Integra Meshed Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4003-08
Integra Meshed Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4004-02
Integra Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4004-05
Integra Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4004-06
Integra Bilayer Wound Matrix
|
| 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 |
|
|
|
|
Q4104
Integra bmwd
|
⇄
|
08478-4004-08
Integra Bilayer Wound Matrix
|
| 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 |
|
|
|
|