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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70748-0221-01 | J7507 | TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG | TACROLIMUS (USP) 5 MG | PO |
70748-0257-30 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (30X2ML) 15 MCG/2 ML | IH |
70748-0257-30 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (30X2ML) 15 MCG/2 ML | IH |
70748-0257-60 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (60X2ML) 15 MCG/2 ML | IH |
70748-0257-60 | J7605 | ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 15 MICROGRAMS | ARFORMOTEROL TARTRATE (60X2ML) 15 MCG/2 ML | IH |
70748-0261-30 | J7606 | FORMOTEROL FUMARATE, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS | FORMOTEROL FUMARATE (30X2ML) 20 MCG/2 ML | IH |
70748-0261-30 | J7606 | FORMOTEROL FUMARATE, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS | FORMOTEROL FUMARATE (30X2ML) 20 MCG/2 ML | IH |
70748-0261-60 | J7606 | FORMOTEROL FUMARATE, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS | FORMOTEROL FUMARATE (60X2ML) 20 MCG/2 ML | IH |
70748-0261-60 | J7606 | FORMOTEROL FUMARATE, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS | FORMOTEROL FUMARATE (60X2ML) 20 MCG/2 ML | IH |
70748-0262-01 | J7517 | MYCOPHENOLATE MOFETIL, ORAL, 250 MG | MYCOPHENOLATE MOFETIL (FILM-COATED) 500 MG | PO |
70748-0262-02 | J7517 | MYCOPHENOLATE MOFETIL, ORAL, 250 MG | MYCOPHENOLATE MOFETIL (FILM-COATED) 500 MG | PO |
70748-0347-02 | J3411 | INJECTION, THIAMINE HCL, 100 MG | THIAMINE HCL (MDV) 100 MG/1 ML | IJ |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E1010 | Wheelchair Accessory, Addition To Power Seating System, Power Leg Elevation System, Including Leg Rest, Pair | Pair | N |
E1010 RR | Wheelchair Accessory, Addition To Power Seating System, Power Leg Elevation System, Including Leg Rest, Each | Day | N |
K0037 | High Mount Flip-Up Footrest, Each | Each | N |
K0037 U1 | High Mount Flip-Up Footrest, (For use only with Group 3 and above) | Each | Y |
K0038 | Leg Strap, Each | Each | N |
K0038 RR | Leg Strap, Each | Day | N |
K0038 U1 | Leg Strap, Each (For use only with Group 3 and above) | Each | y |
K0039 | Leg Strap, H Style, Each | Each | N |
K0039 RR | Leg Strap, H Style, Each | Day | N |
K0039 U1 | Leg Strap, H Style, Each (For use only with Group 3 and above) | Each | Y |
K0040 | Adjustable Angle Footplate, Each | Each | N |
K0040 RR | Adjustable Angle Footplate, Each | Day | N |
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