| Source NDC Code |
|
Target HCPCS Code |
52769-0471-80
POLYGAM S/D (S.D.V. W/DILUENT) 10 GM
|
⇄
|
J1563
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, 1G
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
3/31/2005 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
52769-0471-80
|
⇄
|
J1564
|
| 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 |
|
|
|
|
52769-0471-80
|
⇄
|
J1566
|
| 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 |
|
|
|
|
52769-0471-80
POLYGAM S/D (S.D.V. W/DILUENT) 10 GM
|
⇄
|
Q9941
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED, 1 G
|
| Detail Information |
| Relationship Start Date |
4/1/2005 |
| Relationship End Date |
6/30/2005 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
52769-0471-80
|
⇄
|
Q9942
|
| 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 |
|
|
|
|