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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
63323-0981-53 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PREMIERPRO RX PIPERACILLIN AND TAZOBACTAM (SDV,PF,LATEX-FREE) 2 GM-0.25 GM | IV |
63323-0982-52 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (SINGLE USE,PF) 4 GM-0.5 GM | IV |
63323-0982-54 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PREMIERPRO RX PIPERACILLIN AND TAZOBACTAM (PF,LATEX-FREE) 4 GM-0.5 GM | IV |
63323-0983-21 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (SINGLE USE,PF) 3 GM-0.375 GM | IV |
63323-0983-53 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PREMIERPRO RX PIPERACILLIN AND TAZOBACTAM (SDV,PF) 3 GM-0.375 GM | IV |
63402-0201-00 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | LONHALA MAGNAIR (STARTER KIT) 25 MCG/1 ML | IH |
63402-0201-00 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | LONHALA MAGNAIR (STARTER KIT) 25 MCG/1 ML | IH |
63402-0301-01 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | LONHALA MAGNAIR (REFILL KIT) 25 MCG/1 ML | IH |
63402-0301-01 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | LONHALA MAGNAIR (REFILL KIT) 25 MCG/1 ML | IH |
63402-0911-30 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | BROVANA 15 MCG/2 ML | IH |
63402-0911-64 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | BROVANA (60X2ML) 15 MCG/2 ML | IH |
63459-0103-10 | Q5115 | INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG | TRUXIMA (SDV,PF) 10 MG/1 ML | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E1399 | Bag Spike | Each | Y |
E1399 | Bandaid - Any Size | Each | Y |
B4036 | Enteral feeding supply kit; gravity fed | Each | N |
B4081 | Nasogastric tubing with stylet | Each | N |
B4082 | Nasogastric tubing without stylet | Each | N |
B4083 | Stomach tube � Levine type | Each | N |
B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | Each | N |
B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | Each | N |
B9998 | Enteral Supply Kit For Prepackaged Delivery System | Each | Y |
B9998 | Gastrostomy Button Type Feeding Kits (IE Mickey) | Each | Y |
B4100 | Food thickener, administered orally, per ounce | per bottle | N |
B4102 | Enteral formula, for adults, used to replace fluids and electrolytes (e.g. clear liquids) | 500 ml = 1 unit | N |
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