top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
76297-0001-01 | J7040 | INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) | SODIUM CHLORIDE (500ML FREEFLEX BAG) 0.9% | IV |
76297-0001-11 | J7050 | INFUSION, NORMAL SALINE SOLUTION , 250 CC | SODIUM CHLORIDE (50ML FLEBOFLEX) 0.9% | IV |
76297-0001-21 | J7050 | INFUSION, NORMAL SALINE SOLUTION , 250 CC | SODIUM CHLORIDE (100ML FLEBOFLEX) 0.9% | IV |
76297-0001-31 | J7050 | INFUSION, NORMAL SALINE SOLUTION , 250 CC | SODIUM CHLORIDE (250ML FLEBOFLEX) 0.9% | IV |
76297-0001-41 | J7030 | INFUSION, NORMAL SALINE SOLUTION , 1000 CC | SODIUM CHLORIDE (1000ML FLEBOFLEX) 0.9% | IV |
76310-0017-50 | J0207 | INJECTION, AMIFOSTINE, 500 MG | ETHYOL 500 MG | IV |
76310-0110-01 | J1190 | INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG | TOTECT (LYOPHILIZED) 500 MG | IV |
76329-1911-01 | J2270 | INJECTION, MORPHINE SULFATE, UP TO 10 MG | MORPHINE SULFATE (USP, PUMP-JET) 1 MG/ML | IJ |
76329-3302-01 | A4216 | STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML | DEXTROSE (SD;LUERJET,PF) 50% | IV |
76329-3399-05 | J2690 | INJECTION, PROCAINAMIDE HCL, UP TO 1 GM | PROCAINAMIDE HCL (LUER-JET, LUER-LOCK) 100 MG/1 ML | IJ |
76329-9060-00 | J0171 | INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG | EPINEPHRINE (MDV;USP) 1 MG/1 ML | IJ |
76388-0635-50 | J8999 | PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS | LEUKERAN (FILM-COATED) 2 MG | PO |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
K0864 | Power Wheelchair, Group 3 Extra Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0864 RR | Power Wheelchair, Group 3 Extra Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0868 | Power Wheelchair, Group 4 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0868 RR | Power Wheelchair, Group 4 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0869 | Power Wheelchair, Group 4 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0869 RR | Power Wheelchair, Group 4 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0870 | Power Wheelchair, Group 4 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0870 RR | Power Wheelchair, Group 4 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0871 | Power Wheelchair, Group 4 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0871 RR | Power Wheelchair, Group 4 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0877 | Power Wheelchair, Group 4 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0877 RR | Power Wheelchair, Group 4 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
bottom of page