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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
55289-0119-06 | J8498 | ANTIEMETIC DRUG, RECTAL/SUPPOSITORY, NOT OTHERWISE SPECIFIED | PROCHLORPERAZINE 25 MG | RC |
55289-0224-04 | Q0164 | PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROCHLORPERAZINE MALEATE 10 MG | PO |
55289-0224-06 | Q0164 | PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROCHLORPERAZINE MALEATE 10 MG | PO |
55289-0224-12 | Q0164 | PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | PROCHLORPERAZINE MALEATE 10 MG | PO |
55289-0226-10 | Q0177 | HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | HYDROXYZINE PAMOATE 25 MG | PO |
55289-0226-15 | Q0177 | HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | HYDROXYZINE PAMOATE 25 MG | PO |
55289-0273-10 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | ACYCLOVIR 200 MG | PO |
55289-0273-25 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | ACYCLOVIR 200 MG | PO |
55289-0273-30 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | ACYCLOVIR 200 MG | PO |
55289-0273-35 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | ACYCLOVIR 200 MG | PO |
55289-0273-50 | J8499 | PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS | ACYCLOVIR 200 MG | PO |
55289-0274-02 | Q0144 | AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM | AZITHROMYCIN 500 MG | PO |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | Each | N |
A7006 | Administration set, with small volume filter pneumatic nebulizer | Each | N |
A7007 | Large voume nebulizer, disposable, unfilled, used with aerosol compressor | Each | N |
A7008 | Large volume nebulizer, disposable, Prefilled, used with aerosol compressor | Each | N |
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