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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
71288-0107-20 | J9040 | INJECTION, BLEOMYCIN SULFATE, 15 UNITS | BLEOMYCIN (SDV,PF,LATEX-FREE) 30 U | IJ |
71288-0109-20 | J9100 | INJECTION, CYTARABINE, 100 MG | CYTARABINE (SDV,PF,LATEX-FREE) 100 MG/1 ML | IJ |
71288-0112-90 | J9245 | INJECTION, MELPHALAN HYDROCHLORIDE, 50 MG | MELPHALAN HYDROCHLORIDE (W/10ML DILUENT,PF) 50 MG | IV |
71288-0113-10 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, 200 MG | GEMCITABINE (PF,LATEX-FREE) 200 MG | IV |
71288-0114-50 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, 200 MG | GEMCITABINE (PF,LATEX-FREE) 1 GM | IV |
71288-0115-30 | J9025 | INJECTION, AZACITIDINE, 1 MG | AZACITIDINE (SDV,PF,LATEX-FREE) 100 MG | IJ |
71288-0116-11 | J0594 | INJECTION, BUSULFAN, 1 MG | BUSULFAN (8X10ML,SDV,PF) 6 MG/1 ML | IV |
71288-0117-06 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG | GEMCITABINE (PF,LATEX-FREE) 38 MG/1 ML | IV |
71288-0117-28 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG | GEMCITABINE (PF,LATEX-FREE) 38 MG/1 ML | IV |
71288-0117-54 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG | GEMCITABINE (PF,LATEX-FREE) 38 MG/1 ML | IV |
71288-0118-10 | J9041 | INJECTION, BORTEZOMIB, 0.1 MG | BORTEZOMIB (SDV,PF,LATEX-FREE) 3.5 MG | IJ |
71288-0119-20 | J0894 | INJECTION, DECITABINE, 1 MG | DECITABINE (SDV,PF,LATEX-FREE) 50 MG | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E2381 U1 | Power Wheelchair Accessory, Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each (For use only with Group 3 and above) | Each | Y |
E2382 | Power Wheelchair Accessory, Tube For Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each | Each | N |
E2382 U1 | Power Wheelchair Accessory, Tube For Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each (For use only with Group 3 and above) | Each | Y |
E2383 | Power Wheelchair Accessory, Insert For Pneumatic Drive Wheel Tire (Removable), Any Type, Any Size, Replacement Only, Each | Each | N |
E2383 U1 | Power Wheelchair Accessory, Insert For Pneumatic Drive Wheel Tire (Removable), Any Type, Any Size, Replacement Only, Each (For use only with Group 3 and above) | Each | Y |
E2384 | Power Wheelchair Accessory, Pneumatic Caster Tire, Any Size, Replacement Only, Each | Each | N |
E2384 U1 | Power Wheelchair Accessory, Pneumatic Caster Tire, Any Size, Replacement Only, Each (For use only with Group 3 and above) | Each | Y |
E2385 | Power Wheelchair Accessory, Tube For Pneumatic Caster Tire, Any Size, Replacement Only, Each | Each | N |
E2385 U1 | Power Wheelchair Accessory, Tube For Pneumatic Caster Tire, Any Size, Replacement Only, Each (For use only with Group 3 and above) | Each | Y |
E2386 | Power Wheelchair Accessory, Foam Filled Drive Wheel Tire, Any Size, Replacement Only, Each | Each | N |
E2386 U1 | Power Wheelchair Accessory, Foam Filled Drive Wheel Tire, Any Size, Replacement Only, Each (For use only with Group 3 and above) | Each | Y |
E2387 | Power Wheelchair Accessory, Foam Filled Caster Tire, Any Size, Replacement Only, Each | Each | N |
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