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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70436-0172-23 | J7518 | MYCOPHENOLIC ACID, ORAL, 180 MG | MYCOPHENOLIC ACID (FILM-COATED) 180 MG | PO |
70436-0173-23 | J7518 | MYCOPHENOLIC ACID, ORAL, 180 MG | MYCOPHENOLIC ACID (FILM-COATED) 360 MG | PO |
63629-1349-02 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE 50 MG | PO |
63629-1349-03 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE 50 MG | PO |
63629-1472-01 | None | METHOTREXATE, 2.5 MG, ORAL | METHOTREXATE 2.5 MG | PO |
69374-0300-10 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (PF) 20 MG/1 ML | IJ |
69374-0932-33 | J2710 | INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG | NEOSTIGMINE METHYLSULFATE (PF,LATEX-FREE) 1 MG/1 ML | IV |
69374-0946-04 | J1920 | INJECTION, LABETALOL HYDROCHLORIDE, 5 MG | LABETALOL HCL (PF,LATEX-FREE) 5 MG/1 ML | IV |
69374-0946-34 | J1920 | INJECTION, LABETALOL HYDROCHLORIDE, 5 MG | LABETALOL HCL (PF) 5 MG/1 ML | IV |
69374-0965-02 | J3360 | INJECTION, DIAZEPAM, UP TO 5 MG | DIAZEPAM 5 MG/1 ML | IJ |
69374-0967-50 | J7040 | INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) | SODIUM CHLORIDE (PF) 0.9% | IV |
69374-0968-10 | J7040 | INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) | SODIUM CHLORIDE (PF) 0.9% | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E1399 | T-Connector Tubing With Injection Site | Each | Y |
E1399 | Tubex Holder | Each | Y |
E1399 | Unvented - Unfiltered IV Tubing | Each | Y |
E1399 | Vented - Unfiltered IV Tubing | Each | Y |
E1399 | Y-Connector Tubing Extension With Injection Site | Each | Y |
E1399 | Peripheral IV Catheter Without Y-Injection Site | Each | Y |
S1015 | IV tubing extension set | 12/Box | N |
S5518 | Home Infusion Therapy, all supplies necessary for catheter repair | Each | Y |
S5521 | Midline Catheter For Parenteral Infusion Home Infusion Therapy, all supplies (including catheter), necessary for midline catheter insertion | Each | N |
A4265 | Paraffin | Per Pound | N |
A4402 | Lubricant - � All Brands | Per Ounce | N |
A4453 | Rectal catheter for use with manual pump-operated enema system, replacement only | Each | Y |
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