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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
65219-0240-50 | J7060 | 5% DEXTROSE/WATER (500 ML = 1 UNIT) | DEXTROSE (FREEFLEX+ BAG) 5% | IV |
65219-0256-00 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (PHARMACY BULK;USP,PF) 36 GM-4.5 GM | IV |
65219-0256-24 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN SODIUM-TAZOBACTAM SODIUM NOVAPLUS (PHARMACY BULK,PF) 36 GM-4.5 GM | IV |
65219-0256-28 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PREMIERPRO RX PIPERACILLIN AND TAZOBACTAM (PHARMACY BULK,PF) 36 GM-4.5 GM | IV |
65219-0259-45 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (SDV,PF,LATEX-FREE) 4 GM-0.5 GM | IV |
65219-0259-55 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PREMIERPRO RX PIPERACILLIN AND TAZOBACTAM (SDV,PF,LATEX-FREE) 4 GM-0.5 GM | IV |
65219-0380-30 | J0206 | INJECTION, ALLOPURINOL SODIUM, 1 MG | ALLOPURINOL (SDV,PF,LATEX-FREE) 500 MG | IV |
70362-0702-39 | J8540 | DEXAMETHASONE, ORAL, 0.25 MG | DXEVO (11-DAY DOSE PACK) 1.5 MG | PO |
70377-0010-22 | J7527 | EVEROLIMUS, ORAL, 0. 25 MG | EVEROLIMUS (4X7) 2.5 MG | PO |
70377-0011-22 | J7527 | EVEROLIMUS, ORAL, 0. 25 MG | EVEROLIMUS (4X7) 5 MG | PO |
70377-0012-22 | J7527 | EVEROLIMUS, ORAL, 0. 25 MG | EVEROLIMUS (4X7) 7.5 MG | PO |
70377-0014-11 | J7507 | TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG | TACROLIMUS (USP,GLUTEN-FREE) 0.5 MG | PO |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
A6509 | Compression burn garment, upper trunk to waist inlcuiding arm openings (vest), custom fabricated | Each | Y |
A6510 | Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabrcated | Each | Y |
A6511 | Compression burn garment, lower trunk including leg openings (panty), custom fabricated | Each | Y |
A6512 | Compression burn garment, not otherwise classified | Each | Y |
A6513 | Compression burn mask, face and/or neck, plastic or equal custom fabricated | Each | Y |
A4635 | Underarm Pad, crutch replacement, each | Each | N |
A4636 | Replacement , handgrip, cane, crutch or walker, each | Each | N |
A4637 | Replacement, tip, cane, crutch, walker, each | Each | N |
E0100 | Canes, Includes Canes of All Materials, Adjustable Or Fixed, w/tips | Each | N |
E0105 | Cane, Quad Or Three Prong, Includes Canes of All Materials, Adjustable or fixed, w/tips | Each | N |
E0100 RR | Canes, Includes Canes of All Materials, Adjustable Or Fixed, w/tips | Day | N |
E0105 RR | Cane, Quad Or Three Prong, Includes Canes of All Materials, Adjustable or fixed, w/tips | Day | N |
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