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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70655-0071-25 | J2800 | INJECTION, METHOCARBAMOL, UP TO 10 ML | METHOCARBAMOL (LATEX-FREE) 100 MG/1 ML | IJ |
70655-0088-06 | J1450 | INJECTION FLUCONAZOLE, 200 MG | FLUCONAZOLE (PF,LATEX-FREE) 400 MG/200 ML | IV |
69800-0250-01 | J1554 | INJECTION, IMMUNE GLOBULIN (ASCENIV), 500 MG | ASCENIV (PF,LATEX-FREE) 100 MG/1 ML | IV |
69800-6502-01 | J1556 | INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG | BIVIGAM (LATEX-FREE) 100 MG/1 ML | IV |
69800-6503-01 | J1556 | INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG | BIVIGAM (1X100ML,LATEX-FREE) 100 MG/1 ML | IV |
69918-0700-10 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (MDV) 20 MG/1 ML | IJ |
69918-0700-11 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (10X10ML,MDV,LATEX-FREE) 20 MG/1 ML | IJ |
69918-0700-25 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (MDV) 20 MG/1 ML | IJ |
69918-0700-26 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | PREMIERPRO RX SUCCINYLCHOLINE CHLORIDE (MDV) 20 MG/1 ML | IJ |
69918-0700-27 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | PREMIERPRO RX SUCCINYLCHOLINE CHLORIDE (MDV) 20 MG/1 ML | IJ |
69918-0720-02 | J9017 | INJECTION, ARSENIC TRIOXIDE, 1 MG | ARSENIC TRIOXIDE (SDV,PF) 1 MG/1 ML | IV |
69918-0720-10 | J9017 | INJECTION, ARSENIC TRIOXIDE, 1 MG | ARSENIC TRIOXIDE (10X10 SDV,PF) 1 MG/1 ML | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | Each | Y |
L1834 | KO, without knee joint, rigid, custom fabricated | Each | Y |
L1836 | Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf | Each | Y |
L1840 | KO, derotation, medial-lateral, anterior cruciate ligament, custom fabricated | Each | Y |
L1843 | Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L1844 | KO, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated | Each | Y |
L1845 | Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L1846 | KO, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric aor polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, custom fabricated | Each | Y |
L1847 | Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L1848 | Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf | Each | Y |
L1850 | Knee orthosis, swedish type, prefabricated, off-the-shelf | Each | Y |
L1851 | Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf | Each | Y |
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