top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
54868-5722-00 | J0282 | INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG | AMIODARONE (SDV,10X3ML) 50 MG/ML | IV |
54868-5724-00 | J3475 | INJECTION, MAGNESIUM SULFATE, PER 500 MG | MAGNES SULF (25X10ML) 500 MG/ML | IJ |
54868-5738-00 | Q0162 | ONDANSETRON 1 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 | ONDANSETRON HYDROCHLORIDE 8 MG | PO |
54868-5741-00 | Q0173 | TRIMETHOBENZAMIDE HYDROCHLORIDE, 250 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 | TRIMETHOBENZAMIDE 300 MG | PO |
54868-2064-00 | J2001 | INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG | LIDOCAINE HCL (M.D.V.) 2% | IJ |
54868-2064-01 | J2001 | INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG | LIDOCAINE HCL 2% | IJ |
54868-2088-00 | J2550 | INJECTION, PROMETHAZINE HCL, UP TO 50 MG | PROMETHAZINE HCL 50 MG/ML | IJ |
54868-2299-00 | J1940 | INJECTION, FUROSEMIDE, UP TO 20 MG | FUROSEMIDE (ABBOJECT) 10 MG/ML | IJ |
54868-2429-01 | J0515 | INJECTION, BENZTROPINE MESYLATE, PER 1 MG | COGENTIN (AMP) 1 MG/ML | IJ |
54868-2464-00 | Q0161 | CHLORPROMAZINE HYDROCHLORIDE, 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 | CHLORPROMAZINE HCL 25 MG | PO |
54868-2464-02 | Q0161 | CHLORPROMAZINE HYDROCHLORIDE, 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 | CHLORPROMAZINE HCL 25 MG | PO |
54868-2472-00 | J7613 | ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG | ALBUTEROL SULFATE 0.083% | IH |
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 |
bottom of page