WELCOME

NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
63323-0850-74	J2280	INJECTION, MOXIFLOXACIN, 100 MG	MOXIFLOXACIN HCL (FREEFLEX,LATEX-FREE) 400 MG/250 ML	IV
63323-0850-74	J2281	INJECTION, MOXIFLOXACIN (FRESENIUS KABI) NOT THERAPEUTICALLY EQUIVALENT TO J2280, 100 MG	MOXIFLOXACIN HCL (FREEFLEX,LATEX-FREE) 400 MG/250 ML	IV
63323-0852-25	J1170	INJECTION, HYDROMORPHONE, UP TO 4 MG	HYDROMORPHONE HCL (PF,LATEX-FREE) 1 MG/1 ML	IJ
63323-0853-25	J1170	INJECTION, HYDROMORPHONE, UP TO 4 MG	HYDROMORPHONE HCL (PF,LATEX-FREE) 2 MG/1 ML	IJ
63323-0854-10	J1170	INJECTION, HYDROMORPHONE, UP TO 4 MG	HYDROMORPHONE HCL (PF,LATEX-FREE) 4 MG/1 ML	IJ
63323-0867-10	A4216	STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML	DEXTROSE/SODIUM CHLORIDE (FREEFLEX,PF,LATEX-FREE) 5%-0.3%	IV
67457-0887-01	J1050	INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG	MEDROXYPROGESTERONE ACETATE 150 MG/1 ML	IM
67457-0887-99	J1050	INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG	MEDROXYPROGESTERONE ACETATE 150 MG/1 ML	IM
67457-0889-10	J1453	INJECTION, FOSAPREPITANT, 1 MG	FOSAPREPITANT DIMEGLUMINE (PF,LATEX-FREE) 150 MG	IV
67457-0893-08	J0594	INJECTION, BUSULFAN, 1 MG	BUSULFAN (8X10ML,SINGLE-USE) 6 MG/1 ML	IV
67457-0920-05	J3489	INJECTION, ZOLEDRONIC ACID, 1 MG	ZOLEDRONIC ACID NOVAPLUS (SINGLE USE) 4 MG/5 ML	IV
67457-0921-05	J3490	UNCLASSIFIED DRUGS	SULFAMETHOXAZOLE/TRIMETHOPRIM NOVAPLUS 80 MG/1 ML-16 MG/1 ML	IV

HCPCS Code	Description	Billing Unit	SA Type
A4326	Male external catheter with integral collection chamber, any type, each	Each	N
A4327	Female external urinary collection device, metal cup, each	Each	N
A4328	Female external urinary collection device, Pouch, each	Each	N
A4331	Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each	Each	N
A4332	Lubricant, individual sterile packet, each	Each	N
A4333	Urinary catheter anchoring device, adhevise skin attachment, each	Each	N
A4334	Urinary catheter anchoring device, leg strap, each	Each	N
A4335	Incontinence Supply; Misc. (A4335 should be used for all misc incontinence supplies that do not have a HCPCS code instead of E1399)	I.C.	Y
A4338	Indwelling catheter, Foley type, two-way latex with coating (Teflon, silicone, silicone elastomer or hydrophilic, etc,), each	Each	N
A4340	Indwelling catheter, specialty type, (e.g., coude, mushroom, wing, etc. ), each	Each	N
A4344	Indwelling catheter, Foley type, two-way, all silicone, each	Each	N
A4346	Indwelling catheter; Foley type three-way for continuous irrigation, each	Each	N