WELCOME

NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
70332-0103-01	Q0163	DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN	RAPIDPAQ DICOPANOL (1X150ML) 5 MG/1 ML	PO
75834-0143-05	None	TEMOZOLOMIDE, 100 MG, ORAL	TEMOZOLOMIDE 100 MG	PO
75834-0143-14	None	TEMOZOLOMIDE, 100 MG, ORAL	TEMOZOLOMIDE 100 MG	PO
75834-0144-05	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 140 MG	PO
75834-0144-14	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 140 MG	PO
75834-0145-05	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 180 MG	PO
75834-0145-14	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 180 MG	PO
75834-0146-05	None	TEMOZOLOMIDE, 250 MG, ORAL	TEMOZOLOMIDE 250 MG	PO
75834-0171-19	J0610	INJECTION, CALCIUM GLUCONATE (FRESENIUS KABI), PER 10 ML	CALCIUM GLUCONATE (25X10ML,SDV,PF) 100 MG/1 ML	IV
75834-0171-19	J0612	INJECTION, CALCIUM GLUCONATE (FRESENIUS KABI), PER 10 MG	CALCIUM GLUCONATE (25X10ML,SDV,PF) 100 MG/1 ML	IV
75843-0190-01	J0894	INJECTION, DECITABINE, 1 MG	DECITABINE (LYOPHILIZED) 50 MG	IV
75987-0080-10	J2507	INJECTION, PEGLOTICASE, 1 MG	KRYSTEXXA (LATEX-FREE) 8 MG/1 ML	IV

HCPCS Code	Description	Billing Unit	SA Type
E1270 RR	Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Elevating Leg Rests	Day	N
K0003	Lightweight Wheelchair	Each	Y
K0003 RR	Lightweight Wheelchair	Day	N
K0001	Standard Wheelchair	Each	Y
K0001 RR	Standard Wheelchair	Day	N
K0004	High Strength Wheelchair	Each	Y
K0004 RR	High Strength Wheelchair	Day	N
K0005	Ultralightweight Wheelchair	Each	Y
K0005 RR	Ultralightweight Wheelchair	Day	N
K0008	Custom manual wheelchair/base	Each	Y
K0009	Other Manual Wheelchair/Base	Each	Y
K0009 RR	Other Manual Wheelchair/Base	Day	Y