top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
76420-0084-02 | J2001 | INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG | LIDOCAINE HCL (PF) 1% | IJ |
76420-0085-01 | J3301 | INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG | KENALOG-40 (VIAL) 40 MG/1 ML | IJ |
76961-0101-01 | J1449 | INJECTION, EFLAPEGRASTIM-XNST, 0.1 MG | ROLVEDON (SINGLE-DOSE,PF) 13.2 MG/0.6 ML | SC |
78206-0118-01 | J0702 | INJECTION, BETAMETHASONE ACETATE 3MG AND BETAMETHASONE SODIUM PHOSPHATE 3MG | CELESTONE SOLUSPAN (MDV) 3 MG/1 ML-3 MG/1 ML | IJ |
78206-0138-01 | J3490 | UNCLASSIFIED DRUGS | GANIRELIX ACETATE 250 MCG/0.5 ML | SC |
78206-0162-01 | Q5104 | INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG | RENFLEXIS (PF,LYOPHILIZED) 100 MG | IV |
79043-0200-25 | J8540 | DEXAMETHASONE, ORAL, 0.25 MG | ZCORT 7-DAY 1.5 MG | PO |
79802-0200-30 | J7599 | IMMUNOSUPPRESSIVE DRUG, NOT OTHERWISE CLASSIFIED | REZUROCK (FILM-COATED) 200 MG | PO |
80725-0600-18 | J8999 | PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS | EULEXIN (USP) 125 MG | PO |
80725-0620-25 | None | BUSULFAN, 2 MG, ORAL | MYLERAN (FILM-COATED) 2 MG | PO |
80735-0820-96 | J0291 | INJECTION, PLAZOMICIN, 5 MG | ZEMDRI (SDV,PF) 50 MG/1 ML | IV |
81284-0153-10 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (SDV,PF) 4 GM-0.5 GM | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E1028 U1 | Wheelchair Accessory, Manual Swingaway, Retractable Or Removable Mounting Hardware For Joystick, Other Control Interface Or Positioning Accessory (For use with Group 3 and above) | Each | Y |
E0958 | Manual Wheelchair Accessory, One-Arm Drive Attachment | Each | N |
E0958 RR | Manual Wheelchair Accessory, One-Arm Drive Attachment | Day | N |
E0959 | Manual Wheelchair Accessory, Adapter For Amputee | Each | N |
E0959 RR | Manual Wheelchair Accessory, Adapter For Amputee | Day | N |
E0967 | Manual Wheelchair Accessory, Hand Rim With Projections,Any Type, Replacement only, each | Pair | N |
E0969 | Narrowing Devices, Wheelchair | Each | N |
E0969 RR | Narrowing Devices, Wheelchair | Day | N |
E0971 | Anti-Tipping Device Wheelchairs | Each | N |
E0971 RR | Anti-Tipping Device Wheelchairs | Day | N |
E0971 U1 | Anti-Tipping Device Wheelchairs | Each | Y |
E0974 | Wheelchair, grade-aid, anti-rollback device | Each | N |
bottom of page