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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
25682-0025-01 | J1303 | INJECTION, RAVULIZUMAB-CWVZ, 10 MG | ULTOMIRIS (SDV,PF) 100 MG/1 ML | IV |
25682-0028-01 | J1303 | INJECTION, RAVULIZUMAB-CWVZ, 10 MG | ULTOMIRIS (SDV,PF) 100 MG/1 ML | IV |
27241-0158-60 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | VALGANCICLOVIR HYDROCHLORIDE (FILM-COATED) 450 MG | PO |
27808-0051-02 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 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 | PROMETHAZINE HCL 6.25 MG/5 ML | PO |
30103-0322-54 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DORMIN SLEEP AID 25 MG | PO |
30103-0722-54 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DORMIN SLEEP AID 25 MG | PO |
31722-0040-31 | J8498 | ANTIEMETIC DRUG, RECTAL/SUPPOSITORY, NOT OTHERWISE SPECIFIED | PROMETHAZINE HCL (USP) 12.5 MG | RC |
31722-0041-31 | J8498 | ANTIEMETIC DRUG, RECTAL/SUPPOSITORY, NOT OTHERWISE SPECIFIED | PROMETHAZINE HCL (USP) 25 MG | RC |
31722-0102-10 | J0878 | INJECTION, DAPTOMYCIN, 1 MG | DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG | IV |
33358-0302-10 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 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 | PROMETHAZINE 25 MG | PO |
33358-0302-30 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 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 | PROMETHAZINE 25 MG | PO |
33358-0302-60 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 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 | PROMETHAZINE 25 MG | PO |
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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