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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
71288-0160-10 | J0640 | INJECTION, LEUCOVORIN CALCIUM, PER 50 MG | LEUCOVORIN CALCIUM (SDV,PF,LATEX-FREE) 50 MG | IJ |
71288-0161-20 | J0640 | INJECTION, LEUCOVORIN CALCIUM, PER 50 MG | LEUCOVORIN CALCIUM (SDV,PF,LATEX-FREE) 100 MG | IJ |
71288-0162-30 | J0640 | INJECTION, LEUCOVORIN CALCIUM, PER 50 MG | LEUCOVORIN CALCIUM (SDV,PF,LATEX-FREE) 200 MG | IJ |
71288-0163-30 | J0640 | INJECTION, LEUCOVORIN CALCIUM, PER 50 MG | LEUCOVORIN CALCIUM (SDV,PF,LATEX-FREE) 350 MG | IJ |
70121-1454-07 | J2185 | INJECTION, MEROPENEM, 100 MG | MEROPENEM (USP) 500 MG | IV |
70121-1478-07 | J2710 | INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG | NEOSTIGMINE METHYLSULFATE (LATEX-FREE) 0.5 MG/1 ML | IV |
70121-1479-07 | J2710 | INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG | NEOSTIGMINE METHYLSULFATE (LATEX-FREE) 1 MG/1 ML | IV |
70121-1482-02 | J9050 | INJECTION, CARMUSTINE, 100 MG | CARMUSTINE (SDV,LYOPHILIZED) 100 MG | IV |
70121-1483-07 | J9017 | INJECTION, ARSENIC TRIOXIDE, 1 MG | ARSENIC TRIOXIDE (SDV,PF,LATEX-FREE) 1 MG/1 ML | IV |
70121-1552-01 | J1040 | INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG | METHYLPREDNISOLONE ACETATE NOVAPLUS (SDV) 80 MG/1 ML | IJ |
70121-1552-05 | J1040 | INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG | METHYLPREDNISOLONE ACETATE NOVAPLUS (25X1ML SDV) 80 MG/1 ML | IJ |
70121-1572-01 | J0641 | INJECTION, LEVOLEUCOVORIN, NOT OTHERWISE SPECIFIED, 0.5MG | LEVOLEUCOVORIN CALCIUM (PF) 10 MG/1 ML | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E2394 U1 | Power Wheelchair Accessory, Drive Wheel Excludes Tire, Any Size, Replacement Only, Each (For use with Group 3 and above) | Each | Y |
E2395 | Power Wheelchair Accessory, Caster Wheel Excludes Tire, Any Size, Replacement Only, Each | Each | Y |
E2395 U1 | Power Wheelchair Accessory, Caster Wheel Excludes Tire, Any Size, Replacement Only, Each (For use with Group 3 and above) | Each | Y |
E2396 | Power Wheelchair Accessory, Caster Fork, Any Size, Replacement Only, Each | Each | N |
K0065 | Spoke Protectors, Each | Each | N |
K0065 RR | Spoke Protectors, Each | Day | N |
K0069 | Rear Wheel Assembly, Complete, With Solid Tire, Spokes Or Molded, Replacement only, Each | Each | N |
K0070 | Rear Wheel Assembly, Complete, With Pneumatic Tire, Spokes Or Molded, Each | Each | N |
K0070 RR | Rear Wheel Assembly, Complete, With Pneumatic Tire, Spokes Or Molded, Each | Day | N |
K0071 | Front Caster Assembly, Complete, With Pneumatic Tire, Replacement only, Each | Each | N |
K0072 | Front Caster Assembly, Complete, With Semi-Pneumatic Tire, Replacement only, Each | Each | N |
K0073 | Caster Pin Lock,Each | Each | N |
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