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NDC
HCPCS
HCPCS Description
NDC Label
Route of Administration
70594-0026-02
J3490
UNCLASSIFIED DRUGS
BACITRACIN (LYOPHILIZED) 50000 U
IM
70594-0026-04
J3490
UNCLASSIFIED DRUGS
BACITRACIN NOVAPLUS 50000 U
IM
70594-0034-01
J0878
INJECTION, DAPTOMYCIN, 1 MG
DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG
IV
70594-0034-02
J0878
INJECTION, DAPTOMYCIN, 1 MG
PREMIERPRO RX DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG
IV
70594-0035-02
J3243
INJECTION, TIGECYCLINE, 1 MG
TIGECYCLINE (PF,LYOPHILIZED) 50 MG
IV
70594-0036-01
J2248
INJECTION, MICAFUNGIN SODIUM, 1 MG
MICAFUNGIN SODIUM (SDV,PF,LYOPHILIZED) 50 MG
IV
70594-0037-01
J2248
INJECTION, MICAFUNGIN SODIUM, 1 MG
MICAFUNGIN SODIUM (SDV,PF,LYOPHILIZED) 100 MG
IV
70594-0045-02
J3370
INJECTION, VANCOMYCIN HCL, 500 MG
VANCOMYCIN HCL (USP,PF,LATEX-FREE) 500 MG
IV
70594-0045-02
J3372
INJECTION, VANCOMYCIN HCL (XELLIA) NOT THERAPEUTICALLY EQUIVALENT TO J3370, 500 MG
VANCOMYCIN HCL (USP,PF,LATEX-FREE) 500 MG
IV
70594-0046-02
J3370
INJECTION, VANCOMYCIN HCL, 500 MG
VANCOMYCIN HCL (USP,LATEX-FREE) 1 GM
IV
70594-0046-02
J3372
INJECTION, VANCOMYCIN HCL (XELLIA) NOT THERAPEUTICALLY EQUIVALENT TO J3370, 500 MG
VANCOMYCIN HCL (USP,LATEX-FREE) 1 GM
IV
70594-0047-01
J3370
INJECTION, VANCOMYCIN HCL, 500 MG
VANCOMYCIN HCL (PHARMACY BULK PKG,PF) 5 GM
IV
HCPCS Code
Description
Billing Unit
SA Type
E0676 RR
Intermittent limb compression device (includes all accessories), not otherwise specified
Day
Y
E0705
Transfer device, any type, each
Each
Y
E0705 RR
Transfer device
Day
N
E0935 RR
Passive motion exercise device
Day
N
E0936 RR
Continuous passive motion exercise device for use other than knee
Day
Y
E0968
Commode seat, wheelchair
Each
N
E0968 RR
Commode seat, wheelchair
Day
N
E1800 RR
Dynamic adjustable elbow extension/flexion device, includes soft interface
Day
Y
A4611 RR
Battery, heavy duty; replacement for patient-owner ventilator
Day
N
A4612
Battery, cables; replacement for patient-owner ventilator
Each
N
A4612 RR
Battery, cables; replacement for patient-owner ventilator
Day
N
A4613
Battery, charger; replacement for patient-owner ventilator
Each
N
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