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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70710-1460-02 | Q0144 | AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM | AZITHROMYCIN (CHERRY BANANA) 200 MG/5 ML | PO |
70710-1461-06 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (S.D.V.,LATEX-FREE) 50 MG/1 ML | IM |
70710-1461-09 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (S.D.V.,LATEX-FREE) 50 MG/1 ML | IM |
70710-1462-01 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (MDV,LATEX-FREE) 50 MG/1 ML | IM |
70710-1463-01 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (SDV,LATEX-FREE) 100 MG/1 ML | IM |
70710-1463-05 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (SDV,LATEX-FREE) 100 MG/1 ML | IM |
70710-1464-01 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (MDV,LATEX-FREE) 100 MG/1 ML | IM |
70710-1464-05 | J1631 | INJECTION, HALOPERIDOL DECANOATE, PER 50 MG | HALOPERIDOL DECANOATE (MDV,LATEX-FREE) 100 MG/1 ML | IM |
70710-1478-01 | J1451 | INJECTION, FOMEPIZOLE, 15 MG | FOMEPIZOLE (1X1.5ML,PF) 1 GM/1 ML | IV |
70710-1514-06 | J1652 | INJECTION, FONDAPARINUX SODIUM, 0.5 MG | FONDAPARINUX SODIUM (PREFILLED,PF) 2.5 MG/0.5 ML | SC |
70710-1514-09 | J1652 | INJECTION, FONDAPARINUX SODIUM, 0.5 MG | FONDAPARINUX SODIUM (PREFILLED,PF) 2.5 MG/0.5 ML | SC |
70710-1515-06 | J1652 | INJECTION, FONDAPARINUX SODIUM, 0.5 MG | FONDAPARINUX SODIUM (PF) 5 MG/0.4 ML | SC |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L3807 | Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L3808 | Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3809 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type | Each | Y |
L3891 | Addition to upper extremity joint, wrist, or elbow, concentric adjustable torsion style mechanism for custom frabricated orthotics only, each | Each | Y |
L3806 | WHFO, includes one or more nontorsion joint(s), elastic bands/springs, turnbuckles, may include soft interface material, straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3807 | Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L3808 | Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3809 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type | Each | Y |
L3891 | Addition to upper extremity joint, wrist, or elbow, concentric adjustable torsion style mechanism for custom frabricated orthotics only, each | Each | Y |
L3900 | WHFO, dynamic flexor hinge, reciprocal wrist extension/flexion, finger flexion/extension, wrist or finger driven, custom fabricated | Each | Y |
L3901 | WHFO, dynamic flexor hinge, reciprocal wrist extension/flexion, finger flexion/extension, cable driven, custom fabricated | Each | Y |
L3904 | WHFO, external powered, electric, custom fabricated | Each | Y |
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