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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
67457-0987-10 | J2310 | INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG | NALOXONE HCL NOVAPLUS (MDV) 0.4 MG/1 ML | IJ |
67457-0991-15 | Q5114 | INJECTION, TRASTUZUMAB-DKST, BIOSIMILAR, (OGIVRI), 10 MG | OGIVRI (SDV,PF,LYOPHILIZED) 150 MG | IV |
67457-0996-20 | J9280 | INJECTION, MITOMYCIN, 5 MG | PREMIERPRO RX MITOMYCIN (USP;SDV,PF,LYOPHILIZED) 20 MG | IV |
67457-0997-40 | J9280 | INJECTION, MITOMYCIN, 5 MG | PREMIERPRO RX MITOMYCIN (USP;SDV,PF,LYOPHILIZED) 40 MG | IV |
67850-0021-10 | J0290 | INJECTION, AMPICILLIN SODIUM, 500 MG | AMPICILLIN (PF,LATEX-FREE) 1 GM | IJ |
67850-0022-10 | J0290 | INJECTION, AMPICILLIN SODIUM, 500 MG | AMPICILLIN (PF,LATEX-FREE) 2 GM | IJ |
67850-0024-10 | J0290 | INJECTION, AMPICILLIN SODIUM, 500 MG | AMPICILLIN (USP,PF,LATEX-FREE) 500 MG | IJ |
67850-0031-10 | J3490 | UNCLASSIFIED DRUGS | NAFCILLIN 1 GM | IJ |
67850-0032-10 | J3490 | UNCLASSIFIED DRUGS | NAFCILLIN 2 GM | IJ |
67850-0150-25 | J3490 | UNCLASSIFIED DRUGS | PANTOPRAZOLE SODIUM (LYOPHILIZED) 40 MG | IV |
67857-0809-38 | J3030 | INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED) | ZEMBRACE SYMTOUCH (AUTOINJECTOR) 3 MG/0.5 ML | SC |
67871-4790-06 | J1430 | INJECTION, ETHANOLAMINE OLEATE, 100 MG | ETHAMOLIN (10X2ML AMP) 50 MG/ML | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
A6544 | Gradient compression stocking, garter belt | Each | Y |
A6545 | Gradient compression wrap, non-elastic, below knee, 30-50 MM HG, each | Each | Y |
A6549 | Gradient compression stocking, NOS | Each | Y |
A8000 | Helmet, protective, soft, prefabricated, includes all components and accessories | Each | N |
A8001 | Helmet, protective, hard, prefabricated, includes all components and accessories | Each | N |
A8002 | Soft protective helmet, custom | Each | Y |
A8003 | Hard protective helmet, custom | Each | Y |
B9002 | Enteral Nutrition Infusion Pump, Any Type | Each | Y |
B9002 RR | Enteral Nutrition Infusion Pump, Any Type | Day | N |
B9004 | Parenteral nutrition unfusion pump, portable | Each | Y |
B9004 RR | Parenteral nutrition unfusion pump, portable | Day | N |
B9006 | Parenteral nutrition unfusion pump, stationary | Each | Y |
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