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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70710-1839-01 | J9261 | INJECTION, NELARABINE, 50 MG | NELARABINE NOVAPLUS (1X50ML;SD,PF,LATEX-FREE) 5 MG/1 ML | IV |
70710-1839-08 | J9261 | INJECTION, NELARABINE, 50 MG | NELARABINE NOVAPLUS (6X50ML;SD,PF,LATEX-FREE) 5 MG/1 ML | IV |
70710-1895-06 | J9017 | INJECTION, ARSENIC TRIOXIDE, 1 MG | ARSENIC TRIOXIDE NOVAPLUS (PF,LATEX-FREE) 1 MG/1 ML | IV |
70710-1896-06 | J9017 | INJECTION, ARSENIC TRIOXIDE, 1 MG | ARSENIC TRIOXIDE NOVAPLUS (PF,LATEX-FREE) 2 MG/1 ML | IV |
70720-0101-02 | J8670 | ROLAPITANT, ORAL, 1 MG | VARUBI (CONTAINS 2 TABLETS) 90 MG | PO |
70720-0720-10 | J2278 | INJECTION, ZICONOTIDE, 1 MICROGRAM | PRIALT (1X1ML,SINGLE-USE VIAL) 100 MCG/1 ML | IN |
70720-0722-10 | J2278 | INJECTION, ZICONOTIDE, 1 MICROGRAM | PRIALT (1X5ML,SINGLE-USE VIAL) 100 MCG/1 ML | IN |
70720-0723-10 | J2278 | INJECTION, ZICONOTIDE, 1 MICROGRAM | PRIALT (1X20ML,SINGLE-USE VIAL) 25 MCG/1 ML | IN |
70720-0950-36 | J9202 | GOSERELIN ACETATE IMPLANT, PER 3.6 MG | ZOLADEX (SAFESYSTEM SRN) 3.6 MG | SC |
70720-0951-30 | J9202 | GOSERELIN ACETATE IMPLANT, PER 3.6 MG | ZOLADEX (SAFESYSTEM SRN) 10.8 MG | SC |
70748-0175-30 | 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 |
70748-0175-30 | 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 |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
A4393 | Ostomy pouch, urinary, with extended wear barrier attached, with built in convexity, (1 piece), each | Each | N |
A4411 | Ostomy skin barrier, solid 4x4 or equivalent, extended wear, with built-in convexity, each | Each | N |
A4412 | Ostomy pouch, drainable, high output, for use on a barrier with flange, (2 piece system), without filter, each | Each | N |
A4413 | Ostomy pouch, drainable, high output, for use on a barrier with flange, (2 piece system), with filter, each | Each | N |
A4416 | Ostomy pouch, closed, with barrier attached, with filter (one piece), each | Each | N |
A4417 | Ostomy pouch, closed, with barrier attached, with built in convexity, with filter (one piece), each | Each | N |
A4418 | Ostomy pouch, closed; with out barrier attached, with filter (one piece), each | Each | N |
A4419 | Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (two piece), each | Each | N |
L3978 | Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3971 | SEWHO, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3973 | SEWHO, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3975 | Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Each | Y |
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