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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
69452-0155-20 | J7507 | TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG | TACROLIMUS (HARD GELATIN) 5 MG | PO |
69452-0171-04 | Q0144 | AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM | AZITHROMYCIN (1X6, USP,FILM-COATED) 250 MG | PO |
69452-0171-13 | Q0144 | AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM | AZITHROMYCIN (USP,FILM-COATED) 250 MG | PO |
66689-0307-08 | J7517 | MYCOPHENOLATE MOFETIL, ORAL, 250 MG | MYCOPHENOLATE MOFETIL (BANANA) 200 MG/1 ML | PO |
66689-0342-16 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | ACYCLOVIR (1X473ML;USP,BANANA) 200 MG/5 ML | PO |
66689-0347-02 | J7520 | SIROLIMUS, ORAL, 1 MG | SIROLIMUS 1 MG/1 ML | PO |
66689-0681-55 | J1230 | INJECTION, METHADONE HCL, UP TO 10 MG | METHADONE HCL | NA |
66733-0773-01 | J1817 | INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS | INSULIN LISPRO 100 U/1 ML | IJ |
66733-0822-59 | J1817 | INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS | INSULIN LISPRO KWIKPEN (5X3ML, PREFILLED) 100 U/1 ML | SC |
66733-0948-23 | J9055 | INJECTION, CETUXIMAB, 10 MG | ERBITUX (PF) 2 MG/ML | IV |
66733-0958-23 | J9055 | INJECTION, CETUXIMAB, 10 MG | ERBITUX (PF) 2 MG/ML | IV |
66758-0016-03 | J2370 | INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML | PHENYLEPHRINE HCL (USP,PF) 10 MG/ML | IJ |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
S9363 | Home infusion therapy, antispasmotic therapy; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9364 | Home infusion therapy, total Parenteral nutrition (TPN); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard TPN formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem, (do not use with home infusion codes S9365-S9368 using daily volume scales) DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9365 | Home infusion therapy, total Parenteral nutrition (TPN), one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard TPN formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9366 | Home infusion therapy, total Parenteral nutrition (TPN); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment included standard TPN formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9367 | Home infusion therapy, total Parenteral nutrition (TPN); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard TPN formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9368 | Home infusion therapy, total Parenteral nutrition (TPN); more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard TPN formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9370 | Home therapy, intermittent antimetic injection therapy; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9372 | Home therapy; intermittent anticoagulant injection therapy (e.g., Heparin); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code for flushing of infusion devices with Heparin to maintain patency) | Day | N |
S9373 | Hydration infusion therapy, hydration therapy; administration services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately) per diem (do not use with S9374-S9377 using daily volume scales) DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9374 | Home infusion therapy, hydration therapy, one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9375 | Home infusion therapy, hydration therapy, more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9376 | Home infusion therapy, hydration therapy, more than two liters per day but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
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