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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
68152-0112-01 | J0642 | INJECTION, LEVOLEUCOVORIN (KHAPZORY), 0.5 MG | KHAPZORY (PF,LYOPHILIZED) 175 MG | IV |
68152-0114-01 | J0642 | INJECTION, LEVOLEUCOVORIN (KHAPZORY), 0.5 MG | KHAPZORY (PF,LYOPHILIZED) 300 MG | IV |
68180-0391-06 | J8999 | PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS | IMATINIB MESYLATE (FILM COATED) 400 MG | PO |
68180-0611-01 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE 250 MG | IJ |
68180-0611-10 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE 250 MG | IJ |
68180-0622-01 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE 500 MG | IJ |
68180-0622-10 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE 500 MG | IJ |
68180-0633-01 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE 1 GM | IJ |
65162-0802-14 | None | TEMOZOLOMIDE, 20 MG, ORAL | TEMOZOLOMIDE 20MG | PO |
65162-0802-51 | None | TEMOZOLOMIDE, 20 MG, ORAL | TEMOZOLOMIDE 20MG | PO |
67457-0594-06 | J1652 | INJECTION, FONDAPARINUX SODIUM, 0.5 MG | ARIXTRA (PREFL,27GX1/2",PF) 7.5 MG/0.6 ML | SC |
67457-0595-08 | J1652 | INJECTION, FONDAPARINUX SODIUM, 0.5 MG | ARIXTRA (PF) 10 MG/0.8 ML | SC |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
A6262 | Wound filler, dry form, per gram, not elsewhere classified | Gram | Y |
A6266 | Gauze, impregnated, other than water, normal saline, or zinc paste, any width, per linear yard | Per Linear Yard | N |
A6402 | Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | Each | N |
A6403 | Gauze, non-impregnated, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing | Each | N |
A6404 | Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing | Each | Y |
A6407 | Packing strips, non-impregnated, up to two inches in width, per linear yard | Per Linear Yard | N |
A6410 | Eye Pad, sterile, each | Each | N |
A6411 | Eye Pad, non-sterile, each | Each | Y |
A6412 | Eye Patch, occlusive, each | Each | Y |
A6413 | Adhesive bandage, first-aid type, any size, each | Each | Y |
A6441 | Padding, bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard | Per Linear Yard | N |
A6442 | Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches per yard | Per Linear Yard | N |
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