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NDC
HCPCS
HCPCS Description
NDC Label
Route of Administration
71773-0050-12
J0122
INJECTION, ERAVACYCLINE, 1 MG
XERAVA (PF,LYOPHILIZED) 50 MG
IV
71773-0100-12
J0122
INJECTION, ERAVACYCLINE, 1 MG
XERAVA (SDV,PF,LYOPHILIZED) 100 MG
IV
71839-0104-01
J1453
INJECTION, FOSAPREPITANT, 1 MG
FOSAPREPITANT DIMEGLUMINE (SDV,LATEX-FREE) 150 MG
IV
71839-0105-01
J2710
INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG
NEOSTIGMINE METHYLSULFATE (USP, MDV,LATEX-FREE) 0.5 MG/1 ML
IV
71288-0424-96
J1644
INJECTION, HEPARIN SODIUM, PER 1000 UNITS
PREMIERPRO RX HEPARIN SODIUM (MDV;25X1ML,LATEX-FREE) 10000 U/1 ML
IJ
71288-0427-11
J0583
INJECTION, BIVALIRUDIN, 1 MG
BIVALIRUDIN (SD,PF,LATEX-FREE) 250 MG
IV
71288-0432-81
J1650
INJECTION, ENOXAPARIN SODIUM, 10 MG
ENOXAPARIN SODIUM (LIGHT BLUE;10X0.3ML,PF) 30 MG/0.3 ML
SC
71288-0432-92
J1650
INJECTION, ENOXAPARIN SODIUM, 10 MG
HEALTHTRUST ENOXAPARIN SODIUM (SD,PF,LATEX-FREE) 30 MG/0.3 ML
SC
71288-0433-83
J1650
INJECTION, ENOXAPARIN SODIUM, 10 MG
ENOXAPARIN SODIUM (YELLOW;10X0.4ML,PF) 40 MG/0.4 ML
SC
71288-0433-92
J1650
INJECTION, ENOXAPARIN SODIUM, 10 MG
HEALTHTRUST ENOXAPARIN SODIUM (SD,PF,LATEX-FREE) 40 MG/0.4 ML
SC
71288-0434-92
J1650
INJECTION, ENOXAPARIN SODIUM, 10 MG
HEALTHTRUST ENOXAPARIN SODIUM (10X0.6ML,PF,LATEX-FREE) 60 MG/0.6 ML
SC
71288-0435-92
J1650
INJECTION, ENOXAPARIN SODIUM, 10 MG
HEALTHTRUST ENOXAPARIN SODIUM (SD,PF,LATEX-FREE) 80 MG/0.8 ML
SC
HCPCS Code
Description
Billing Unit
SA Type
K0840
Power Wheelchair, Group 2 Extra Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More
Each
Y
K0840 RR
Power Wheelchair, Group 2 Extra Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More
Day
Y
K0841
Power Wheelchair, Group 2 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Each
Y
K0841 RR
Power Wheelchair, Group 2 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Day
Y
K0842
Power Wheelchair, Group 2 Standard, Multiple Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Each
Y
K0842 RR
Power Wheelchair, Group 2 Standard, Multiple Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Day
Y
K0843
Power Wheelchair, Group 2 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds
Each
Y
K0843 RR
Power Wheelchair, Group 2 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds
Day
Y
K0848
Power Wheelchair, Group 3 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Each
Y
K0848 RR
Power Wheelchair, Group 3 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Day
Y
K0849
Power Wheelchair, Group 3 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Each
Y
K0849 RR
Power Wheelchair, Group 3 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Day
Y
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