Grifols

FLEBOGAMMA 10% DIF

ASP | WAC | AWP at the HCPCS Unit

Manufacturer:

Grifols

Flebogamma 10% Dif HCPCS:

J1572

HCPCS Code Descriptor:

Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg

Category:

J Code

Flebogamma 10% Dif NDCs:

61953-0005-01, 61953-0004-03, 61953-0004-02, 61953-0005-03, 61953-0004-01, 61953-0005-02, 61953-0004-05, 61953-0004-04

Primary Type:

Immunoglobulin

Generic/Specialty Status:

Single-Source

Package Type:

Vial

Route of Administration:

Intravenous

Flebogamma 10% Dif CPT Codes:

Some of the most common CPT administration codes for 'buy and bill' drugs can be found at the following link:

Potential NDC Listing Errors:

We have identified listing errors with the following NDCs:

61953-0005-02, 61953-0005-03, 61953-0004-02, 61953-0005-01

About Flebogamma 10% Dif:

FLEBOGAMMA 10% DIF is an Immunoglobulin drug manufactured by Grifols and administered via the Intravenous route of administration. The J Code: J1572 is aligned to the drug FLEBOGAMMA 10% DIF.

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J1572 Added Date:

January 1, 2008

J1572 Effective Date:

January 1, 2009

J1572 Termination Date:

HCPCS Active

We have not yet identified a manufacturer source of Flebogamma 10% Dif billing and coding information.
Our team did not identify a source for Flebogamma 10% Dif patient assistance information. Please reach out to our team if you feel that this is a mistake.
FLEBOGAMMA 10% DIF prescribing information can be found at the link below:
Our team has not yet identified a source of side effects information for FLEBOGAMMA 10% DIF. Please check back in a few weeks.