top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
72266-0159-10 | J1335 | INJECTION, ERTAPENEM SODIUM, 500 MG | ERTAPENEM (SDV,PF,LATEX-FREE) 1 GM | IJ |
72266-0160-10 | J3486 | INJECTION, ZIPRASIDONE MESYLATE, 10 MG | ZIPRASIDONE MESYLATE (SDV,LYOPHILIZED) 20 MG | IM |
72266-0161-01 | J9263 | INJECTION, OXALIPLATIN, 0.5 MG | OXALIPLATIN (PF) 5 MG/1 ML | IV |
72266-0162-01 | J9263 | INJECTION, OXALIPLATIN, 0.5 MG | OXALIPLATIN (PF) 5 MG/1 ML | IV |
72266-0163-06 | J3260 | INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG | TOBRAMYCIN (PF,LATEX-FREE) 1.2 GM | IV |
72266-0234-25 | J1885 | INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG | KETOROLAC TROMETHAMINE (SDV,25X1ML,PF) 15 MG/1 ML | IJ |
72266-0235-01 | J1190 | INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG | DEXRAZOXANE (SDV,PF,LATEX-FREE) 250 MG | IV |
72266-0237-05 | J3490 | UNCLASSIFIED DRUGS | DOXYCYCLINE (SDV,PF,LATEX-FREE) 100 MG | IV |
72266-0248-05 | J2805 | INJECTION, SINCALIDE, 5 MICROGRAMS | SINCALIDE (SDV,PF,LATEX-FREE) 5 MCG | IV |
72439-0500-10 | J3480 | INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ | POTASSIUM CHLORIDE (AMPULE) 2 MEQ/1 ML | IV |
72485-0101-05 | J1200 | INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG | DIPHENHYDRAMINE HCL (SDV,PF,LATEX-FREE) 50 MG/1 ML | IJ |
72485-0101-25 | J1200 | INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG | DIPHENHYDRAMINE HCL (25X1ML,LATEX-FREE) 50 MG/1 ML | IJ |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
E0849 | Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible | Per Set | Y |
E0850 | Traction Stand, Free Standing, Cervical Traction | Per Set | N |
E0855 | Cervical traction equipment not requiring additional stand or frame | Per Set | N |
E0856 | Cervical traction device, cervical collar with inflatable air bladder | Each | Y |
E0860 | Traction Equipment Over Door, Cervical | Per Set | N |
E0840 RR | Traction Frame Attached To Headboard, Cervical Traction | Day | N |
A4394 | Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce | Ounce | N |
A4395 | Ostomy deodorant for use in Ostomy pouch, solid. Per tablet | Each | N |
A4396 | Ostomy belt with peristomal hernia support | Each | N |
A4398 | Ostomy irrigation supply; bag; each | Each | N |
A4399 | Ostomy Irrigation Bag, cone/catheter, including brush | Each | N |
A4400 | Ostomy Irrigation Set | Each | N |
bottom of page