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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
76204-0028-60 | J7631 | CROMOLYN SODIUM, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MILLIGRAMS | CROMOLYN SODIUM (2X30,PF) 10 MG/1 ML | IH |
76204-0028-60 | J7631 | CROMOLYN SODIUM, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MILLIGRAMS | CROMOLYN SODIUM (2X30,PF) 10 MG/1 ML | IH |
76204-0100-01 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (30X2.5ML,PF) 0.02% | IH |
76204-0100-01 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (30X2.5ML,PF) 0.02% | IH |
76204-0100-25 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (25X2.5ML,PF) 0.02% | IH |
76204-0100-25 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (25X2.5ML,PF) 0.02% | IH |
76204-0100-30 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (30X2.5ML,PF) 0.02% | IH |
76204-0100-30 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (30X2.5ML,PF) 0.02% | IH |
76204-0100-60 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (60X2.5ML,PF) 0.02% | IH |
76204-0100-60 | J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | IPRATROPIUM BROMIDE (60X2.5ML,PF) 0.02% | IH |
76204-0200-01 | J7613 | ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG | ALBUTEROL SULFATE (30X3ML) 0.083% | IH |
76204-0200-01 | J7613 | ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG | ALBUTEROL SULFATE (30X3ML) 0.083% | IH |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
K0856 | Power Wheelchair, Group 3 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0856 RR | Power Wheelchair, Group 3 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0010 RR | Standard weight frame motorized/power wheelchair (Rental Only) | Day | Y |
K0011RR | Standard weight frame motorized/power wheelchair with programmable contol (Rental Only) | Day | Y |
K0012 RR | Light weight portable motorized/power wheelchair (Rental Only) | Day | Y |
K0013 | Custom motorized/power wheelchair base | Each | Y |
K0813 | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0813 RR | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0814 | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0814 RR | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0815 | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0815 RR | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
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