| Source NDC Code |
|
Target HCPCS Code |
00944-2850-05
CUVITRU 4 GRAM/20 ML VIAL
|
⇄
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
| Detail Information |
| Relationship Start Date |
11/16/2016 |
| Relationship End Date |
09/30/2023 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
00944-2850-05
CUVITRU (4GM,PF,LATEX-FREE) 20%
|
⇄
|
J1555
INJECTION, IMMUNE GLOBULIN (CUVITRU), 100 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
00944-2850-05
CUVITRU (4GM,PF,LATEX-FREE) 20%
|
⇄
|
J7799
NOC DRUGS, OTHER THAN INHALATION DRUGS, ADMINISTERED THROUGH DME
|
| Detail Information |
| Relationship Start Date |
9/26/2016 |
| Relationship End Date |
12/31/2017 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
00944-2850-05
Cuvitru
|
⇄
|
J1555
Inj cuvitru, 100 mg
|
| 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 |
|
|
|
|