| Source NDC Code |
|
Target HCPCS Code |
61476-0104-05
ALYGLO 10% (5 G/50 ML) VIAL
|
⇄
|
90283
Immune globulin (IgIV), human, for intravenous use
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
61476-0104-05
ALYGLO 100 MG/1 ML
|
⇄
|
J1552
INJECTION, IMMUNE GLOBULIN (ALYGLO), 500 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
61476-0104-05
Alyglo
|
⇄
|
J1552
Inj, alyglo, 500 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 |
|
|
|
|