| Source NDC Code |
|
Target HCPCS Code |
00944-0471-80
POLYGAM S/D (S.D.V.W/DILUENT) 10 GM
|
⇄
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
| Detail Information |
| Relationship Start Date |
1/1/2006 |
| Relationship End Date |
5/1/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
00944-0471-80
POLYGAM S/D (S.D.V.W/DILUENT) 10 GM
|
⇄
|
Q9941
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED, 1 G
|
| Detail Information |
| Relationship Start Date |
7/1/2005 |
| Relationship End Date |
12/31/2005 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|