| Source NDC Code |
|
Target HCPCS Code |
61953-0004-01
FLEBOGAMMA DIF 5% VIAL
|
⇄
|
90283
Immune globulin (IGIV), human, for intravenous use
|
| Detail Information |
| Relationship Start Date |
01/15/2018 |
| Relationship End Date |
01/16/2018 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
61953-0004-01
FLEBOGAMMA (DIF,PF) 5 GM/100 ML
|
⇄
|
J1572
INJECTION, IMMUNE GLOBULIN, (FLEBOGAMMA/FLEBOGAMMA DIF), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2008 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
61953-0004-01
FLEBOGAMMA (DIF,PF) 5 GM/100 ML
|
⇄
|
Q4091
INJECTION, IMMUNE GLOBULIN (FLEBOGAMMA), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
|
| Detail Information |
| Relationship Start Date |
7/1/2007 |
| Relationship End Date |
12/31/2007 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|