top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
44087-1112-01 | J3490 | UNCLASSIFIED DRUGS | GONAL-F RFF (29GX1/2 NEEDLE,PEN) 450 IU/0.75 ML | SC |
44087-1113-01 | J3490 | UNCLASSIFIED DRUGS | GONAL-F RFF (29GX1/2,PEN) 300 IU/0.5 ML | SC |
44087-1114-01 | J3490 | UNCLASSIFIED DRUGS | GONAL-F RFF (29GX1/2,PEN) 900 IU/1.5 ML | SC |
44087-1150-01 | J3490 | UNCLASSIFIED DRUGS | OVIDREL (SRN,PREFILLED SYRINGE) 0.25 MG/0.5 ML | SC |
44087-3388-07 | J2941 | INJECTION, SOMATROPIN, 1 MG | ZORBTIVE (MDV, VIALS W/ DILUENT) 8.8 MG | SC |
44087-6075-01 | J3355 | INJECTION, UROFOLLITROPIN, 75 IU | METRODIN 75 IU | IM |
44087-6075-03 | J3355 | INJECTION, UROFOLLITROPIN, 75 IU | METRODIN 75 IU | IM |
44087-6075-04 | J3355 | INJECTION, UROFOLLITROPIN, 75 IU | METRODIN 75 IU | IM |
44087-6150-01 | J3355 | INJECTION, UROFOLLITROPIN, 75 IU | METRODIN 150 IU | IM |
49452-6140-02 | J3415 | INJECTION, PYRIDOXINE HCL, 100 MG | PYRIDOXINE HCL (U.S.P.) | NA |
49452-6140-03 | J3415 | INJECTION, PYRIDOXINE HCL, 100 MG | PYRIDOXINE HCL (U.S.P.) | NA |
49452-6222-04 | J3490 | UNCLASSIFIED DRUGS | RIFAMPIN (U.S.P.) | NA |
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