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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
52609-4505-06 | J0895 | INJECTION, DEFEROXAMINE MESYLATE, 500 MG | DEFEROXAMINE MESYLATE (USP,SINGLE USE) 500 MG | IJ |
52652-2001-01 | None | METHOTREXATE, 2.5 MG, ORAL | XATMEP 2.5 MG/1 ML | PO |
52652-2001-06 | None | METHOTREXATE, 2.5 MG, ORAL | XATMEP 2.5 MG/1 ML | PO |
52769-0470-72 | J1566 | INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG | POLYGAM (W/50 ML DILUENT) 2.5 MG | IV |
54482-0053-01 | J8999 | PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS | MATULANE 50 MG | PO |
54482-0054-01 | J8999 | PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS | MATULANE 50 MG | PO |
54482-0147-01 | J1955 | INJECTION, LEVOCARNITINE, PER 1 GM | CARNITOR (S.D.V.) 200 MG/ML | IV |
54569-0239-00 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE HCL 25 MG | PO |
54569-0239-01 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE HCL 25 MG | PO |
54569-0239-02 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE HCL 25 MG | PO |
54569-0239-03 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE HCL 25 MG | PO |
54569-0239-08 | Q0163 | DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | DIPHENHYDRAMINE HCL 25 MG | PO |
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 |
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