| Source NDC Code |
|
Target HCPCS Code |
44206-0455-10
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
⇄
|
90284
Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
|
| Detail Information |
| Relationship Start Date |
10/16/2013 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
44206-0455-10
HIZENTRA (SINGLE-USE VIAL,PF) 20%
|
⇄
|
J1559
INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG
|
| Detail Information |
| Relationship Start Date |
10/01/2013 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
44206-0455-10
Hizentra
|
⇄
|
J1559
Hizentra injection
|
| 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 |
|
|
|
|