top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
72603-0133-25 | J1940 | INJECTION, FUROSEMIDE, UP TO 20 MG | FUROSEMIDE (25X2ML,SDV,LATEX-FREE) 10 MG/1 ML | IJ |
72603-0139-25 | J3411 | INJECTION, THIAMINE HCL, 100 MG | THIAMINE HCL (25X2ML;MDV,LATEX-FREE) 100 MG/1 ML | IJ |
72603-0141-02 | J3030 | INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED) | SUMATRIPTAN SUCCINATE (AUTOINJECTOR) 6 MG/0.5 ML | SC |
72603-0146-01 | J1920 | INJECTION, LABETALOL HYDROCHLORIDE, 5 MG | LABETALOL HCL (USP,MDV,LATEX-FREE) 5 MG/1 ML | IV |
72603-0147-01 | J0878 | INJECTION, DAPTOMYCIN, 1 MG | DAPTOMYCIN (SDV,PF,LATEX-FREE) 350 MG | IV |
72603-0152-01 | J0878 | INJECTION, DAPTOMYCIN, 1 MG | DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG | IV |
72603-0200-01 | Q2050 | INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG | DOXORUBICIN HCL LIPOSOME 2 MG/1 ML | IV |
72603-0202-01 | J3301 | INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG | TRIAMCINOLONE ACETONIDE (LATEX-FREE) 40 MG/1 ML | IJ |
72603-0251-25 | J1940 | INJECTION, FUROSEMIDE, UP TO 20 MG | FUROSEMIDE (25X4ML,SDV,LATEX-FREE) 10 MG/1 ML | IJ |
72603-0301-01 | J9263 | INJECTION, OXALIPLATIN, 0.5 MG | OXALIPLATIN (PF,LATEX-FREE) 5 MG/1 ML | IV |
70842-0240-01 | J0349 | INJECTION, REZAFUNGIN, 1 MG | REZZAYO (LATEX-FREE) 200 MG | IV |
70860-0100-10 | J0456 | INJECTION, AZITHROMYCIN, 500 MG | AZITHROMYCIN (SDV,LYOPHILIZED) 500 MG | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E2341 | Power Wheelchair Accessory, Nonstandard Seat Frame Width, 24-27 Inches | Each | Y |
E2341 RR | Power Wheelchair Accessory, Nonstandard Seat Frame Width, 24-27 Inches | Day | Y |
E2342 | Power Wheelchair Accessory, Nonstandard Seat Frame Depth, 20 Or 21 Inches | Each | Y |
E2342 RR | Power Wheelchair Accessory, Nonstandard Seat Frame Depth, 20 Or 21 Inches | Day | Y |
E2343 | Power Wheelchair Accessory, Nonstandard Seat Frame Depth, 22-25 Inches | Each | Y |
E2343 RR | Power Wheelchair Accessory, Nonstandard Seat Frame Depth, 22-25 Inches | Day | Y |
K0056 | Seat Height Less Than 17 Or Equal To Or Greater Than 21 For A High Strength, Lightweight, Or Ultralightweight Wheelchair | Each | N |
K0056 RR | Seat Height Less Than 17 Or Equal To Or Greater Than 21 For A High Strength, Lightweight, Or Ultralightweight Wheelchair | Day | N |
E0956 | Wheelchair Accessory, Lateral Trunk Or Hip Support, Prefabricated, Including Fixed Mounting Hardware | Each | Y |
E0956 RR | Wheelchair Accessory, Lateral Trunk Or Hip Support, Prefabricated, Including Fixed Mounting Hardware | Day | N |
E0956 U1 | Wheelchair Accessory, Lateral Trunk Or Hip Support, Prefabricated, Including Fixed Mounting Hardware (For use with Group 3 and avove) | Each | Y |
E0957 | Wheelchair Accessory, Medial Thigh Support, Prefabricated, Including Fixed Mounting Hardware | Each | Y |
bottom of page