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NDC
HCPCS
HCPCS Description
NDC Label
Route of Administration
68001-0582-41
J1631
INJECTION, HALOPERIDOL DECANOATE, PER 50 MG
HALOPERIDOL DECANOATE (MDV,LATEX-FREE) 100 MG/1 ML
IM
68047-0702-21
J8540
DEXAMETHASONE, ORAL, 0.25 MG
DEXAMETHASONE (6-DAY DOSE PACK) 1.5 MG
PO
68047-0702-35
J8540
DEXAMETHASONE, ORAL, 0.25 MG
DEXAMETHASONE (10-DAY DOSE PACK) 1.5 MG
PO
68047-0702-51
J8540
DEXAMETHASONE, ORAL, 0.25 MG
DEXAMETHASONE (13-DAY DOSE PACK) 1.5 MG
PO
68084-0229-01
J7500
AZATHIOPRINE, ORAL, 50 MG
AZATHIOPRINE 50 MG
PO
68084-0450-01
J7507
TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG
TACROLIMUS (10X10,HARD GELATIN) 1 MG
PO
68094-0063-61
J8999
PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS
MEGESTROL ACETATE (LEMON-LIME) 40 MG/1 ML
PO
68094-0063-62
J8999
PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS
MEGESTROL ACETATE (LEMON-LIME) 40 MG/1 ML
PO
68094-0101-10
J2760
INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG
PHENTOLAMINE MESYLATE (LYOPHILIZED) 5 MG
IJ
68094-0101-20
J2760
INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG
PHENTOLAMINE MESYLATE (LYOPHILIZED) 5 MG
IJ
68094-0174-62
J8999
PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS
MEGESTROL ACETATE (LEMON-LIME) 40 MG/1 ML
PO
68135-0020-01
J1458
INJECTION, GALSULFASE, 1 MG
NAGLAZYME (PF) 1 MG/ML
IV
HCPCS Code
Description
Billing Unit
SA Type
A6250
Skin sealants, protectants, moisterizers, ointments, any type, any size
Each
N
A6251
Specialty absorptive dressing, wound cover, pad size 16 sq. in. or less, without adhesive border, each dressing
Each
N
A6252
Specialty absorptive dressing, wound cover, pad size more than 16 sq. in. but less than 48 sq. in. without adhesive border, each dressing
Each
N
A6253
Specialty absorptive dressing, wound cover, pad size more than 48 sq. in. without adhesive border, each dressing
Each
N
A6254
Specialty absorptive dressing, wound cover, pad size 16 sq. in. or less, with any size adhesive border, each dressing
Each
N
A6255
Specialty absorptive dressing, wound cover, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
Each
N
A6256
Specialty absorptive dressing, wound cover, pad size more than 48 sq. in., with any size adhesive border, each dressing
Each
Y
A6257
Transparent film, 16 sq. in. or less, each dressing
Each
N
A6258
Transparent film, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
Each
N
A6259
Transparent film more than 48 sq. in., each dressing
Each
N
A6260
Wound cleansers, any type, any size
IC
N
A6261
Wound filler, gel/paste, per fluid ounce, not elsewhere classified
Ounce
Y
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