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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70860-0206-51 | J9060 | INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG | CISPLATIN (PF,LATEX-FREE) 1 MG/1 ML | IV |
70860-0208-05 | J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | DOXORUBICIN HCL (USP,SDV,PF,LATEX-FREE) 2 MG/1 ML | IV |
72485-0212-05 | J9206 | INJECTION, IRINOTECAN, 20 MG | IRINOTECAN HYDROCHLORIDE (SDV) 20 MG/1 ML | IV |
72485-0213-15 | J9206 | INJECTION, IRINOTECAN, 20 MG | IRINOTECAN HYDROCHLORIDE (1X15ML;SDV) 20 MG/1 ML | IV |
72485-0214-01 | J9171 | INJECTION, DOCETAXEL, 1 MG | DOCETAXEL (USP,SDV) 20 MG/1 ML | IV |
72485-0215-04 | J9171 | INJECTION, DOCETAXEL, 1 MG | DOCETAXEL (USP,SDV) 20 MG/1 ML | IV |
72485-0216-08 | J9171 | INJECTION, DOCETAXEL, 1 MG | DOCETAXEL (USP,SDV) 20 MG/1 ML | IV |
72485-0221-02 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG | GEMCITABINE 38 MG/1 ML | IV |
72485-0222-10 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG | GEMCITABINE 38 MG/1 ML | IV |
72485-0223-20 | J9201 | INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG | GEMCITABINE 38 MG/1 ML | IV |
72485-0403-10 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (SDV;USP,PF,LATEX-FREE) 3 GM-0.375 GM | IV |
72485-0404-10 | J2543 | INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS) | PIPERACILLIN AND TAZOBACTAM (SDV;USP,PF,LATEX-FREE) 4 GM-0.5 GM | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E2615 | Positioning Wheelchair Back Cushion, Posterior-Lateral, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware | Each | Y |
E2615 U1 | Positioning Wheelchair Back Cushion, Posterior-Lateral, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware (For use only with Group 3 and above) | Each | Y |
E2616 | Positioning Wheelchair Back Cushion, Posterior-Lateral, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware | Each | Y |
E2616 U1 | Positioning Wheelchair Back Cushion, Posterior-Lateral, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware (For use only with Group 3 and above) | Each | Y |
E2617 | Custom Fabricated Wheelchair Back Cushion, Any Size, Including Any Type Mounting Hardware | Each | Y |
E2620 | Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware | Each | Y |
E2620 U1 | Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware (For use only with Group 3 and above) | Each | Y |
E2621 | Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware | Each | Y |
E2621 U1 | Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware (For use only with Group 3 and above) | Each | Y |
E0981 | Wheelchair Accessory, Seat Upholstery, Replacement Only, Each | Each | N |
E0992 | Manual Wheelchair Accessory, Solid Seat Insert | Each | N |
E0992 RR | Manual Wheelchair Accessory, Solid Seat Insert | Day | N |
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