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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
50268-0163-15 | 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 AVPAK (FILM-COATED) 25 MG | PO |
50268-0398-50 | Q0177 | HYDROXYZINE PAMOATE, 25 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 | HYDROXYZINE PAMOATE AVPAK (5X10) 25 MG | PO |
50268-0399-50 | Q0177 | HYDROXYZINE PAMOATE, 25 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 | HYDROXYZINE PAMOATE AVPAK (5X10) 50 MG | PO |
50268-0527-15 | None | METHOTREXATE, 2.5 MG, ORAL | METHOTREXATE AVPAK (5X10;USP) 2.5 MG | PO |
50268-0557-15 | J7517 | MYCOPHENOLATE MOFETIL, ORAL, 250 MG | MYCOPHENOLATE MOFETIL AVPAK (HARD GELATIN) 250 MG | PO |
50268-0558-15 | J7517 | MYCOPHENOLATE MOFETIL, ORAL, 250 MG | MYCOPHENOLATE MOFETIL AVPAK (FILM-COATED) 500 MG | PO |
50268-0559-12 | J7518 | MYCOPHENOLIC ACID, ORAL, 180 MG | MYCOPHENOLIC ACID AVPAK (2X10;USP) 180 MG | PO |
50268-0560-12 | J7518 | MYCOPHENOLIC ACID, ORAL, 180 MG | MYCOPHENOLIC ACID AVPAK (ENTERIC COATED) 360 MG | PO |
50268-0684-15 | Q0164 | PROCHLORPERAZINE MALEATE, 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 | PROCHLORPERAZINE MALEATE AVPAK (USP,5X10,FILM-COATED) 5 MG | PO |
50268-0685-15 | Q0164 | PROCHLORPERAZINE MALEATE, 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 | PROCHLORPERAZINE MALEATE AVPAK (USP,5X10,FILM-COATED) 10 MG | PO |
50268-0718-13 | J7520 | SIROLIMUS, ORAL, 1 MG | SIROLIMUS AVPAK 1 MG | PO |
50268-0761-11 | None | TEMOZOLOMIDE, 20 MG, ORAL | TEMOZOLOMIDE (INNER PACK) 20 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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