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NDC
HCPCS
HCPCS Description
NDC Label
Route of Administration
71839-0105-24
J2710
INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG
NEOSTIGMINE METHYLSULFATE (USP, MDV,LATEX-FREE) 0.5 MG/1 ML
IV
71839-0106-01
J2710
INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG
NEOSTIGMINE METHYLSULFATE (USP,SDV,LATEX-FREE) 1 MG/1 ML
IV
71839-0106-10
J2710
INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG
NEOSTIGMINE METHYLSULFATE (MDV,LATEX-FREE) 1 MG/1 ML
IV
71839-0106-24
J2710
INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG
NEOSTIGMINE METHYLSULFATE (USP,SDV,LATEX-FREE) 1 MG/1 ML
IV
71839-0107-01
J0878
INJECTION, DAPTOMYCIN, 1 MG
DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG
IV
71839-0108-01
J0878
INJECTION, DAPTOMYCIN, 1 MG
DAPTOMYCIN (SDV,PF,LATEX-FREE) 350 MG
IV
71839-0117-25
J1644
INJECTION, HEPARIN SODIUM, PER 1000 UNITS
HEPARIN SODIUM (SDV,25X2ML,PF) 1000 U/1 ML
IJ
71839-0118-25
J1644
INJECTION, HEPARIN SODIUM, PER 1000 UNITS
HEPARIN SODIUM (25X0.5ML,SDV,PF) 5000 U/0.5 ML
IJ
71839-0122-10
J3490
UNCLASSIFIED DRUGS
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
IV
71839-0122-25
J3490
UNCLASSIFIED DRUGS
PANTOPRAZOLE SODIUM (SDV,FREEZE-DRIED) 40 MG
IV
71839-0123-25
J7643
GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
GLYCOPYRROLATE (25X1ML;USP;SDV) 0.2 MG/1 ML
IJ
71839-0123-25
J7643
GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
GLYCOPYRROLATE (25X1ML;USP;SDV) 0.2 MG/1 ML
IJ
HCPCS Code
Description
Billing Unit
SA Type
K0108
Hardware For Custom Seat And/Or Back
Each
Y
K0108
Leg Trough
Each
Y
K0108
Misc. Part Or Component For Use With Medical Stroller.
Each
Y
K0108
Wheelchair Tiedowns (also known as transit option or transit bracket)
Each
Y
K0108
Shoe Holders
Each
Y
K0108
Special/Miscellaneous Hardware or Component For Power or Manual Wheelchair Not Otherwise Specified.
Each
Y
K0108
Standby Switch For Use With Specially Controlled Power Mobility Device.
Each
Y
K0108
Subasis Bar (Swing Away Or Stationary)
Each
Y
K0108
Thoracic Pads With Hardware
Each
Y
K0108
Wheelchair Mount For Communication Device
Each
Y
K0857
Power Wheelchair, Group 3 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Each
Y
K0857 RR
Power Wheelchair, Group 3 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Day
Y
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