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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
76204-0900-25 | J7614 | LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG | LEVALBUTEROL (PF) 1.25 MG/3 ML | IH |
76282-0640-38 | J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG | BUDESONIDE (30X2ML,SINGLE-DOSE) 0.25 MG/2 ML | IH |
76282-0640-38 | J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG | BUDESONIDE (30X2ML,SINGLE-DOSE) 0.25 MG/2 ML | IH |
76282-0641-38 | J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG | BUDESONIDE (30X2ML,SINGLE-DOSE) 0.5 MG/2 ML | IH |
76282-0641-38 | J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG | BUDESONIDE (30X2ML,SINGLE-DOSE) 0.5 MG/2 ML | IH |
76282-0642-38 | J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG | BUDESONIDE (MICRONIZED) 1 MG/2 ML | IH |
76282-0642-38 | J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG | BUDESONIDE (MICRONIZED) 1 MG/2 ML | IH |
76282-0674-30 | J0604 | CINACALCET, ORAL, 1 MG, (FOR ESRD ON DIALYSIS) | CINACALCET HYDROCHLORIDE (FILM COATED) 30 MG | PO |
76282-0675-30 | J0604 | CINACALCET, ORAL, 1 MG, (FOR ESRD ON DIALYSIS) | CINACALCET HYDROCHLORIDE (FILM COATED) 60 MG | PO |
71288-0716-10 | J2800 | INJECTION, METHOCARBAMOL, UP TO 10 ML | METHOCARBAMOL (PF,LATEX-FREE) 100 MG/1 ML | IJ |
71288-0719-11 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (MDV;USP,LATEX-FREE) 20 MG/1 ML | IJ |
71288-0723-52 | J0665 | INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG | BUPIVACAINE HCL (1X50ML,MDV,LATEX-FREE) 0.25% | IJ |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
K0890 | Power Wheelchair, Group 5 Pediatric, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Each | Y |
K0890 RR | Power Wheelchair, Group 5 Pediatric, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Day | Y |
K0891 | Power Wheelchair, Group 5 Pediatric, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Each | Y |
K0891 RR | Power Wheelchair, Group 5 Pediatric, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Day | Y |
K0108 | Medical Stroller Type Mobility Device. | Each | Y |
K0108 | Chest Strap | Each | Y |
K0108 | Cushion Cover (Incontinence Cover) | Each | Y |
K0108 | Custom Seat And/Or Back For Wheelchair | Each | Y |
K0108 | Custom Seat Insert (Manufactured Specifically Per Patient Order) (have codes designated by cushion height) | Each | Y |
K0108 | Custom, Complex, 3 Piece Occipital Head Rest With Hardware. | Each | Y |
K0108 | Extra-Large (Greater Than 18 Wide Or 18 Deep) Low Pressure And Positioning Cushion. | Each | Y |
K0108 | Fluid Supplement Pads | Each | Y |
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