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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70121-1657-01 | J3301 | INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG | PREMIERPRO RX TRIAMCINOLONE ACETONIDE 40 MG/1 ML | IJ |
70121-1658-01 | J9017 | INJECTION, ARSENIC TRIOXIDE, 1 MG | ARSENIC TRIOXIDE (SDV,PF,LATEX-FREE) 2 MG/1 ML | IV |
70121-1698-07 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE (SD,PF,LATEX-FREE) 0.2 MG/1 ML | IJ |
70121-1698-07 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE (SD,PF,LATEX-FREE) 0.2 MG/1 ML | IJ |
70121-1699-07 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE (SD,PF,LATEX-FREE) 0.2 MG/1 ML | IJ |
70121-1699-07 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE (SD,PF,LATEX-FREE) 0.2 MG/1 ML | IJ |
70121-1719-09 | J3475 | INJECTION, MAGNESIUM SULFATE, PER 500 MG | MAGNESIUM SULFATE (SD,PF,LATEX-FREE) 40 MG/1 ML | IV |
70121-1720-09 | J3475 | INJECTION, MAGNESIUM SULFATE, PER 500 MG | MAGNESIUM SULFATE (SD,PF,LATEX-FREE) 40 MG/1 ML | IV |
70121-1743-04 | J9261 | INJECTION, NELARABINE, 50 MG | NELARABINE (6X50ML;SDV,PF) 5 MG/1 ML | IV |
70121-2496-05 | J0476 | INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL | LIORESAL (PF,LATEX-FREE) 0.05 MG/1 ML | IN |
70121-2501-01 | J0475 | INJECTION, BACLOFEN, 10 MG | LIORESAL REFILL KIT (8561,PF,LATEX-FREE) 0.5 MG/1 ML | IN |
70121-2502-02 | J0475 | INJECTION, BACLOFEN, 10 MG | LIORESAL REFILL KIT (8562,PF,LATEX-FREE) 2 MG/1 ML | IN |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E1006 | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, Without Shear Reduction | Each | Y |
E1007 | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Mechanical Shear Reduction | Each | Y |
E1007 RR | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Mechanical Shear Reduction | Day | Y |
E1007 U1 | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Mechanical Shear Reduction | Each | Y |
E1008 | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Power Shear Reduction | Each | Y |
E1008 RR | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Power Shear Reduction | Day | Y |
E1008 U1 | Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Power Shear Reduction | Each | Y |
E1014 | Reclining Back, Addition To Pediatric Size Wheelchair | Each | Y |
E1014 RR | Reclining Back, Addition To Pediatric Size Wheelchair | Day | Y |
E1225 RR | Semi-Reclining Back for Customized Wheelchair | Day | N |
E1226 | Fully Reclining Back, for Customized Wheelchair | Each | Y |
E 1226 RR | Fully Reclining Back, for Customized Wheelchair | Day | N |
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