top of page
NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
67457-0380-25 | J2501 | INJECTION, PARICALCITOL, 1 MCG | PARICALCITOL 0.005 MG/1 ML | IV |
67457-0383-99 | J1644 | INJECTION, HEPARIN SODIUM, PER 1000 UNITS | HEPARIN SODIUM (MDV,25X1ML) 5000 U/1 ML | IJ |
67457-0384-99 | J1644 | INJECTION, HEPARIN SODIUM, PER 1000 UNITS | HEPARIN SODIUM (MDV,25X30ML) 1000 U/1 ML | IJ |
67457-0385-99 | J1644 | INJECTION, HEPARIN SODIUM, PER 1000 UNITS | HEPARIN SODIUM (MDV,25X10ML) 1000 U/1 ML | IJ |
67457-0389-25 | J2501 | INJECTION, PARICALCITOL, 1 MCG | PARICALCITOL 0.005 MG/1 ML | IV |
67457-0395-25 | J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | DOXORUBICIN HCL (USP,STERILE,SDV) 2 MG/ML | IV |
67457-0396-10 | J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | DOXORUBICIN HCL (USP,STERILE,MDV) 2 MG/ML | IV |
67457-0397-99 | J2780 | INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG | RANITIDINE (10X2ML,SDV,USP) 25 MG/1 ML | IJ |
67457-0398-62 | J2780 | INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG | RANITIDINE (SDV,USP) 25 MG/1 ML | IJ |
67457-0399-25 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN 1000 MCG/1 ML | IJ |
67457-0400-05 | J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG | CYANOCOBALAMIN 1000 MCG/1 ML | IJ |
67457-0404-10 | J0290 | INJECTION, AMPICILLIN SODIUM, 500 MG | AMPICILLIN (USP,CRYSTALLINE) 10 GM | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L3967 | SEWHO, abduction positioning (airplane design), thoracic component and support bar, without joints, 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 |
L3976 | Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3977 | Shoulder elbow wrist hand finger orthosis, 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 |
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 |
L3976 | Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Each | Y |
L3977 | Shoulder elbow wrist hand finger orthosis, 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 |
bottom of page