| Source HCPCS Code |
|
Target NDC Code |
Q4107
|
⇄
|
08121-8600-24
|
| 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 |
|
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8600-47
GRAFTJACKET (MAXIMUM FORCE, 28SQ CM)
|
| 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 |
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8600-55
GRAFTJACKET (MAX FORCE,25SQ CM)
|
| 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 |
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8602-04
GRAFTJACKET (HAND SURGERY,8SQ CM)
|
| 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 |
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8604-04
GRAFTJACKET (4X4 CM)
|
| 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 |
PT |
| Route Of Administration |
TP |
| Billing Units |
EA |
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8604-07
GRAFTJACKET (MAXFORCE EXTREME 28SQ CM)
|
| 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 |
|
|
|
Q4107
|
⇄
|
08121-8604-08
|
| 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 |
|
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8605-05
GRAFTJACKET (TISSUE MATRIX, 25SQ CM)
|
| 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 |
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8605-10
GRAFTJACKET (TISSUE MATRIX, 50SQ CM)
|
| 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 |
|
|
|
Q4107
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
|
⇄
|
08121-8605-30
GRAFTJACKET SLR (SMALL LIGAMENT, 1.5SQ CM)
|
| 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 |
|
|
|