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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
69680-0112-25 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN (MDV) 1000 MCG/1 ML | IJ |
69680-0113-99 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN (MDV) 1000 MCG/1 ML | IJ |
69680-0121-05 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN 1000 MCG/1 ML | IJ |
69680-0121-10 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN 1000 MCG/1 ML | IJ |
69680-0121-30 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN 1000 MCG/1 ML | IJ |
69784-0002-06 | J1450 | INJECTION FLUCONAZOLE, 200 MG | FLUCONAZOLE IN SODIUM CHLORIDE (6X100;USP,PF) 200 MG/100 ML | IV |
69784-0003-06 | J1450 | INJECTION FLUCONAZOLE, 200 MG | FLUCONAZOLE IN SODIUM CHLORIDE (6X200ML;USP,PF) 400 MG/200 ML | IV |
69784-0205-60 | J7631 | CROMOLYN SODIUM, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MILLIGRAMS | CROMOLYN SODIUM 10 MG/1 ML | IH |
69784-0205-60 | J7631 | CROMOLYN SODIUM, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MILLIGRAMS | CROMOLYN SODIUM 10 MG/1 ML | IH |
69784-0620-25 | None | BUSULFAN, 2 MG, ORAL | MYLERAN (FILM-COATED) 2 MG | PO |
69794-0001-01 | J3397 | INJECTION, VESTRONIDASE ALFA-VJBK, 1 MG | MEPSEVII (PF) 2 MG/1 ML | IV |
69794-0001-01 | J3490 | UNCLASSIFIED DRUGS | MEPSEVII (PF) 2 MG/1 ML | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L0456 | Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L0457 | TLSO, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf | Each | Y |
L0458 | TLSO, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal juntion and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal and transverse planes, lateral strngth is provided by over lapping plastic and stablizing closures, includes straps and closures, prefabricated, includes fitting and adjustment | Each | Y |
L0460 | TLSO, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L0462 | TLSO, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the sysmphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plase and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment. | Each | Y |
L0464 | TLSO, triplanar control, modular segmented spinal system, four rigid plastic shells, prosterior extends from sacroccygeal junction and terminates just inferior ro scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross motor in sagittal, coronal, and tranverse planes, latral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefacticated, includes fitting and adjustment | Each | Y |
L0466 | TLSO, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Each | Y |
L0467 | TLSO, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf | Each | Y |
L0468 | TLSO, sagittal-coronal control, rigid posterial frame and flexivle soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic and lateral frame pieces, restricts gross trunk motion in sagittal and coronal, produces intracavitary pressure to reduce load on intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment | Each | Y |
L0469 | TLSO, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf | Each | Y |
L0470 | TLSO, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strngth provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal and transverse, produces intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment | Each | Y |
L0472 | TLSO, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment | Each | Y |
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