| Source NDC Code |
|
Target HCPCS Code |
13533-0810-05
XEMBIFY 20% (1 G/5 ML) VIAL
|
⇄
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
| Detail Information |
| Relationship Start Date |
11/12/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
13533-0810-05
XEMBIFY (1GM,PF,LATEX-FREE) 200 MG/1 ML
|
⇄
|
J1558
INJECTION, IMMUNE GLOBULIN (XEMBIFY), 100 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2020 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
13533-0810-05
Xembify
|
⇄
|
J1558
Inj. xembify, 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 |
|
|
|
|