| Source NDC Code |
|
Target HCPCS Code |
52769-0470-72
POLYGAM (W/50 ML DILUENT) 2.5 MG
|
⇄
|
J1566
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2006 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
52769-0470-72
POLYGAM (W/50 ML DILUENT) 2.5 MG
|
⇄
|
Q9942
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED, 10 MG
|
| Detail Information |
| Relationship Start Date |
4/1/2005 |
| Relationship End Date |
12/31/2005 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
NA |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|