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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
67877-0748-01 | J7520 | SIROLIMUS, ORAL, 1 MG | SIROLIMUS (FILM-COATED) 2 MG | PO |
67877-0753-60 | Q0167 | DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DRONABINOL (6X10;USP,SOFT GELATIN) 2.5 MG | PO |
67877-0754-60 | Q0167 | DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DRONABINOL (SOFT GELATIN) 5 MG | PO |
68330-0004-10 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE (USP) 2 GM | IJ |
68330-0005-01 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE (USP,PIGGYBACK) 1 GM | IJ |
68330-0006-01 | J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG | CEFTRIAXONE (USP,PIGGYBACK) 2 GM | IJ |
68382-0003-01 | J7500 | AZATHIOPRINE, ORAL, 50 MG | AZATHIOPRINE (USP) 50 MG | PO |
68382-0003-05 | J7500 | AZATHIOPRINE, ORAL, 50 MG | AZATHIOPRINE (USP) 50 MG | PO |
68382-0040-01 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROMETHAZINE HYDROCHLORIDE 12.5 MG | PO |
68382-0041-01 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROMETHAZINE HYDROCHLORIDE 25 MG | PO |
68382-0041-05 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROMETHAZINE HCL 25 MG | PO |
68382-0041-10 | Q0169 | PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROMETHAZINE HYDROCHLORIDE 25 MG | PO |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
S9331 | Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy 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 |
S9335 | Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9336 | Home infusion therapy, continuous anticoagulant infusion 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 | Day | N |
S9338 | Home infusion therapy, immunotherapy, 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 |
S9339 | Home therapy, peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9345 | Home infusion therapy, antihemophilic agent infusion therapy (e.g., factor VIII); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9346 | Home infusion therapy, alpha-1-proteinase inhibitor (e.g., Prolastin); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9347 | Homer infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9348 | Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e.g. Dobutamine); administrative services, professional pharmacy services, care coordination, 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 |
S3949 | Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9351 | Home infusion therapy, continuous or intermittent antimetic infusion therapy; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
S9353 | Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | Day | N |
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