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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
67457-0153-09 | J0282 | INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG | AMIODARONE HYDROCHLORIDE (9X10ML) 50 MG/ML | IV |
67457-0153-18 | J0282 | INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG | AMIODARONE HYDROCHLORIDE 50 MG/ML | IV |
67457-0177-50 | J1212 | INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML | RIMSO-50 (ODORLESS) 50% | IL |
67457-0182-10 | J1805 | INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG | ESMOLOL HCL (10X10ML) 10 MG/1 ML | IV |
68992-3075-01 | J7503 | TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG | ENVARSUS XR 0.75 MG | PO |
68992-3075-03 | J7503 | TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG | ENVARSUS XR 0.75 MG | PO |
69097-0168-53 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (INDV30X2ML) 15 MCG/2 ML | IH |
69097-0168-53 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (INDV30X2ML) 15 MCG/2 ML | IH |
69097-0168-64 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (60X2ML) 15 MCG/2 ML | IH |
69097-0168-64 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (60X2ML) 15 MCG/2 ML | IH |
69097-0168-87 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (30X2ML) 15 MCG/2 ML | IH |
69097-0168-87 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (30X2ML) 15 MCG/2 ML | IH |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L1001 | Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment | Each | Y |
L1005 | Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment | Each | Y |
L1010 | Addition to CTLSO or scoliosis orthosis, axilla sling | Each | Y |
L1020 | Addition to CTLSO or scoliosis orthosis, kyphosis pad | Each | Y |
L1025 | Addition to CTLSO or scoliosis orthosis, kyphosis pad, floating | Each | Y |
L1030 | Addition to CTLSO or scoliosis orthosis, lumbar bolster pad | Each | Y |
L1040 | Addition to CTLSO or scoliosis orthosis, lumbar or lumbar rib pad | Each | Y |
L1050 | Addition to CTLSO or scoliosis orthosis, sternal pad | Each | Y |
L1060 | Addition to CTLSO or scoliosis orthosis, thoracic pad | Each | Y |
L1070 | Addition to CTLSO or scoliosis orthosis, trapezius sling | Each | Y |
L1080 | Addition to CTLSO or scoliosis orthosis, outrigger | Each | Y |
L1085 | Addition to CTLSO or scoliosis orthosis, outrigger, bilateral with vertical extensions | Each | Y |
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