top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
33358-0300-30 | Q0164 | PROCHLORPERAZINE MALEATE, 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 | PROCHLORPERAZINE 10 MG | PO |
33358-0300-60 | Q0164 | PROCHLORPERAZINE MALEATE, 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 | PROCHLORPERAZINE 10 MG | PO |
33358-0301-02 | J8498 | ANTIEMETIC DRUG, RECTAL/SUPPOSITORY, NOT OTHERWISE SPECIFIED | PROCHLORPERAZINE 25 MG | RC |
33358-0301-12 | J8498 | ANTIEMETIC DRUG, RECTAL/SUPPOSITORY, NOT OTHERWISE SPECIFIED | PROCHLORPERAZINE 25 MG | RC |
17714-0042-24 | 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 | COMPLETE ALLERGY MEDICATION (CAPLET) 25 MG | PO |
18657-0117-04 | J3473 | INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT | HYLENEX (4X1ML,SDV) 150 U/ML | IJ |
18860-0720-10 | J2278 | INJECTION, ZICONOTIDE, 1 MICROGRAM | PRIALT (1X1ML,SINGLE-USE VIAL) 100 MCG/ML | IN |
18860-0722-10 | J2278 | INJECTION, ZICONOTIDE, 1 MICROGRAM | PRIALT (1X5ML,SINGLE-USE VIAL) 100 MCG/ML | IN |
18860-0723-10 | J2278 | INJECTION, ZICONOTIDE, 1 MICROGRAM | PRIALT (1X20ML,SINGLE-USE VIAL) 25 MCG/ML | IN |
18864-0211-03 | 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 | SERABRINA LA FRANCE 50 MG/15 ML | PO |
23155-0119-01 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | CALCITRIOL 0.5 MCG | PO |
23155-0193-41 | J0770 | INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG | COLISTIMETHATE (USP,LYOPHILIZED) 150 MG | IJ |
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 |
bottom of page