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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
71288-0028-11 | J2248 | INJECTION, MICAFUNGIN SODIUM, 1 MG | MICAFUNGIN SODIUM (SDV,PF,LATEX-FREE) 50 MG | IV |
71288-0029-11 | J2248 | INJECTION, MICAFUNGIN SODIUM, 1 MG | MICAFUNGIN SODIUM (SDV,PF,LATEX-FREE) 100 MG | IV |
71288-0031-21 | J0295 | INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM | AMPICILLIN-SULBACTAM (SDV,PF,LATEX-FREE) 1 GM-0.5 GM | IJ |
71288-0032-21 | J0295 | INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM | AMPICILLIN-SULBACTAM (SDV,PF,LATEX-FREE) 2 GM-1 GM | IJ |
71288-0100-05 | J9045 | INJECTION, CARBOPLATIN, 50 MG | CARBOPLATIN (PF,LATEX-FREE) 10 MG/1 ML | IV |
71288-0100-15 | J9045 | INJECTION, CARBOPLATIN, 50 MG | CARBOPLATIN (PF,LATEX-FREE) 10 MG/1 ML | IV |
71288-0100-45 | J9045 | INJECTION, CARBOPLATIN, 50 MG | CARBOPLATIN (PF,LATEX-FREE) 10 MG/1 ML | IV |
71288-0100-51 | J9045 | INJECTION, CARBOPLATIN, 50 MG | CARBOPLATIN (PF,LATEX-FREE) 10 MG/1 ML | IV |
71288-0103-20 | J9036 | INJECTION, BENDAMUSTINE HYDROCHLORIDE, (BELRAPZO/BENDAMUSTINE), 1 MG | BENDAMUSTINE HYDROCHLORIDE (SDV,PF,LATEX-FREE) 100 MG | IV |
71288-0104-10 | J0641 | INJECTION, LEVOLEUCOVORIN, NOT OTHERWISE SPECIFIED, 0.5 MG | LEVOLEUCOVORIN CALCIUM (SDV,PF,LATEX-FREE) 50 MG | IV |
71288-0105-18 | J0641 | INJECTION, LEVOLEUCOVORIN, NOT OTHERWISE SPECIFIED, 0.5 MG | LEVOLEUCOVORIN CALCIUM (PF,LATEX-FREE) 10 MG/1 ML | IV |
71288-0106-10 | J9040 | INJECTION, BLEOMYCIN SULFATE, 15 UNITS | BLEOMYCIN (SDV,PF,LATEX-FREE) 15 U | IJ |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E2208 U1 | Wheelchair Accessory, Cylinder Tank Carrier, Each (For use with only Group 3 and above) | Each | Y |
E2210 | Wheelchair Accessory, Bearings, Any Type, Replacement Only, Each | Each | N |
E2210 U1 | Wheelchair Accessory, Bearings, Any Type, Replacement Only, Each (For use with only Group 3 and above) | Each | Y |
K0105 | Iv Hanger, Each | Each | N |
K0105 RR | Iv Hanger, Each | Day | N |
K0098 | Drive belt for power wheelchair, Replacement only | Each | N |
K0098 RR | Drive belt for power wheelchair | Day | N |
E2358 | Power Wheelchair Accessory, Group 34 Non-Sealed Lead Acid Battery, each | Each | N |
E2358 RR | Power Wheelchair Accessory, Group 34 Non-Sealed Lead Acid Battery, each | Each | N |
E2359 | Power Wheelchair Accessory, Group 34 Sealed Lead Acid Battery, Each | Each | N |
E2359 RR | Power Wheelchair Accessory, Group 34 Sealed Lead Acid Battery, Each | Each | N |
E2359 U1 | Power Wheelchair Accessory, Group 34 Sealed Lead Acid Battery, Each (For use only w Group 3 and above) | Each | Y |
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