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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
66758-0016-03 | J2371 | INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS | PHENYLEPHRINE HCL (USP,PF) 10 MG/ML | IJ |
66758-0035-01 | J1626 | INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG | GRANISETRON HYDROCHLORIDE (1X1ML,SINGLE-USE) 1 MG/ML | IV |
66758-0036-01 | J1626 | INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG | GRANISETRON HYDROCHLORIDE (1X4ML,MULTI-USE) 1 MG/ML | IV |
66758-0043-01 | J9267 | INJECTION, PACLITAXEL, 1 MG | PACLITAXEL (USP,1X5ML,MULTI-DOSE) 6 MG/ML | IV |
66758-0043-02 | J9267 | INJECTION, PACLITAXEL, 1 MG | PACLITAXEL (USP,1X16.7ML,MULTI-DOSE) 6 MG/ML | IV |
66758-0043-03 | J9267 | INJECTION, PACLITAXEL, 1 MG | PACLITAXEL (USP,1X50ML,MULTI-DOSE) 6 MG/ML | IV |
66758-0046-01 | J9185 | INJECTION, FLUDARABINE PHOSPHATE, 50 MG | FLUDARABINE PHOSPHATE (SDV,PF) 25 MG/ML | IV |
66794-0151-01 | J0476 | INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL | GABLOFEN (1X1ML,SINGLE USE) 0.05 MG/1 ML | IN |
66794-0155-01 | J0475 | INJECTION, BACLOFEN, 10 MG | GABLOFEN (1X20ML,SINGLE USE) 0.5 MG/1 ML | IN |
66794-0155-02 | J0475 | INJECTION, BACLOFEN, 10 MG | GABLOFEN (1X20ML,SINGLE USE) 0.5 MG/1 ML | IN |
66794-0156-01 | J0475 | INJECTION, BACLOFEN, 10 MG | GABLOFEN (1X20ML,SINGLE USE) 1 MG/1 ML | IN |
66794-0156-02 | J0475 | INJECTION, BACLOFEN, 10 MG | GABLOFEN (1X20ML,SINGLE USE) 1 MG/1 ML | IN |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
S9377 | Home infusion therapy, hydration therapy, more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (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 |
S9379 | Home infusion therapy, infusion therapy; not otherwise classified; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9490 | Home infusion therapy, corticosteriod infusion; 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 |
S9494 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy or other drug, 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 with home infusion codes for hourly dosing schedules S9497-S9504) DME Providers can not bill for drugs or nursing visits. These services must be billed by the appropriate provider. | Day | N |
S9497 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy or other drug; once every three hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9500 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy or other drug; once every 24 hours; administration 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 |
S9501 | Home infusion therapy, antibiotic, anitiviral, or antifungal therapy or other drug; once every 12 hours; 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 |
S9502 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy or other drug; once every 8 hours, 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 |
S9503 | Home infusion therapy, antibiotic, antiviral, or antifungal or other drug; once every six hours; 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 |
S9504 | Home infusion therapy, antibiotic, antiviral, or antifungal or other drug; once every four hours, 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 |
S9537 | Home therapy; hematopoietic hormone injection therapy (e.g., erythropoietin, G-CSF, GM-CSF); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
E0776 | IV Pole | Each | N |
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