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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
67457-0187-50 | J0206 | INJECTION, ALLOPURINOL SODIUM, 1 MG | ALOPRIM (SINGLE USE VIAL) 500 MG | IV |
67457-0211-02 | J1451 | INJECTION, FOMEPIZOLE, 15 MG | FOMEPIZOLE (1X1.5ML,PF) 1 GM/ML | IV |
67457-0212-02 | J0883 | INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE) | ARGATROBAN (SDV,PF) 100 MG/1 ML | IV |
67457-0256-10 | J0583 | INJECTION, BIVALIRUDIN, 1 MG | BIVALIRUDIN (LYOPHILIZED) 250 MG | IV |
67457-0263-30 | J1205 | INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG | CHLOROTHIAZIDE SODIUM (USP, SDV,LYOPHILIZED) 0.5 GM | IV |
67457-0273-10 | J2800 | INJECTION, METHOCARBAMOL, UP TO 10 ML | METHOCARBAMOL (25X10ML, SDV) 100 MG/ML | IJ |
67457-0281-01 | J3415 | INJECTION, PYRIDOXINE HCL, 100 MG | PYRIDOXINE HCL 100 MG/1 ML | IJ |
67457-0291-01 | J0360 | INJECTION, HYDRALAZINE HCL, UP TO 20 MG | HYDRALAZINE HCL (PF) 20 MG/1 ML | IJ |
67457-0299-10 | J2310 | INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG | NALOXONE HCL 0.4 MG/1 ML | IJ |
67457-0316-25 | J0894 | INJECTION, DECITABINE, 1 MG | DECITABINE (LYOPHILIZED) 50 MG | IV |
67457-0317-25 | J2469 | INJECTION, PALONOSETRON HCL, 25 MCG | PALONOSETRON HCL (SDV) 0.05 MG/1 ML | IV |
67457-0323-25 | J2280 | INJECTION, MOXIFLOXACIN, 100 MG | MOXIFLOXACIN HCL (FLEXIBAG,LATEX-FREE) 400 MG/250 ML | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L2116 | AFO, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment | Each | Y |
L2126 | KAFO, fracture orthosis, femoral fracture cast orthosis, thermaplastic type casting material, custom fabricated | Each | Y |
L2128 | KAFO, fracture orthosis, femoral fracture cast orthosis, custom fabricated | Each | Y |
L2132 | KAFO, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment | Each | Y |
L2134 | KAFO, fracture orthosis, femoral facture cast orthorsis, semi-rigid, prefabricated, includes fitting and adjustment | Each | Y |
L2136 | KAFO, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment | Each | Y |
L2180 | Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints | Each | Y |
L2182 | Addition to lower extremity fracture orthosis, drop lock knee joint | Each | Y |
L2184 | Addition to lower extremity fracture orthosis, limited motion knee joint | Each | Y |
L2186 | Addition to lower extremity fracture orthosis, adjustable motion knee joint, Lerman type | Each | Y |
L2188 | Addition to lower extremity fracture orthosis, quadrilateral brim | Each | Y |
L2190 | Addition to lower extremity fracture orthosis, waist belt | Each | Y |
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