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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
31722-0165-31 | J1453 | INJECTION, FOSAPREPITANT, 1 MG | FOSAPREPITANT DIMEGLUMINE (SDV,LYOPHILIZED) 150 MG | IV |
31722-0204-10 | J3490 | UNCLASSIFIED DRUGS | PANTOPRAZOLE (10X40MG,SDV) 40 MG | IV |
31722-0204-31 | J3490 | UNCLASSIFIED DRUGS | PANTOPRAZOLE (1X40MG,SDV,FREEZE-DRIED) 40 MG | IV |
31722-0210-10 | J3370 | INJECTION, VANCOMYCIN HCL, 500 MG | VANCOMYCIN HCL (PF,LATEX-FREE) 500 MG | IV |
31722-0211-10 | J3370 | INJECTION, VANCOMYCIN HCL, 500 MG | VANCOMYCIN HCL (10X1GM,SDV,PF) 1 GM | IV |
31722-0211-33 | J3370 | INJECTION, VANCOMYCIN HCL, 500 MG | VANCOMYCIN HCL (SDV,PF,LATEX-FREE) 1 GM | IV |
31722-0215-01 | J0878 | INJECTION, DAPTOMYCIN, 1 MG | DAPTOMYCIN (SDV,PF,LYOPHILIZED) 350 MG | IV |
31722-0216-01 | J0878 | INJECTION, DAPTOMYCIN, 1 MG | DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG | IV |
31722-0960-60 | Q0167 | DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DRONABINOL (SOFT GELATIN) 2.5 MG | PO |
31722-0961-60 | Q0167 | DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DRONABINOL (SOFT GELATIN) 5 MG | PO |
31722-0962-60 | Q0167 | DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DRONABINOL (SOFT GELATIN) 10 MG | PO |
31722-0963-31 | J0500 | INJECTION, DICYCLOMINE HCL, UP TO 20 MG | DICYCLOMINE HCL (USP;SDV) 10 MG/1 ML | IM |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | Each | N |
A7006 | Administration set, with small volume filter pneumatic nebulizer | Each | N |
A7007 | Large voume nebulizer, disposable, unfilled, used with aerosol compressor | Each | N |
A7008 | Large volume nebulizer, disposable, Prefilled, used with aerosol compressor | Each | N |
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