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NDC | HCPCS | HCPCS Description | NDC Label | Route of Administration |
|---|---|---|---|---|
70700-0902-25 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE NOVAPLUS (25X5ML;MDV;USP) 0.2 MG/1 ML | IJ |
70700-0903-23 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE NOVAPLUS (10X20ML;MDV;USP) 0.2 MG/1 ML | IJ |
70700-0903-23 | J7643 | GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM | GLYCOPYRROLATE NOVAPLUS (10X20ML;MDV;USP) 0.2 MG/1 ML | IJ |
70710-1130-01 | Q0161 | CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN | CHLORPROMAZINE HCL (FILM-COATED) 25 MG | PO |
70710-1377-01 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (MDV, INNER PACK,STERILE) 20 MG/1 ML | IJ |
70710-1377-02 | J0330 | INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG | SUCCINYLCHOLINE CHLORIDE (MDV,STERILE) 20 MG/1 ML | IJ |
70710-1411-01 | J9041 | INJECTION, BORTEZOMIB, 0.1 MG | BORTEZOMIB (SDV,LATEX-FREE) 3.5 MG | IJ |
70710-1411-01 | J9044 | INJECTION, BORTEZOMIB, NOT OTHERWISE SPECIFIED, 0.1 MG | BORTEZOMIB (SDV,LATEX-FREE) 3.5 MG | IJ |
68001-0422-37 | J0894 | INJECTION, DECITABINE, 1 MG | DECITABINE (SDV,LYOPHILIZED) 50 MG | IV |
68001-0437-25 | J3489 | INJECTION, ZOLEDRONIC ACID, 1 MG | ZOLEDRONIC ACID (LATEX-FREE) 4 MG/5 ML | IV |
68001-0442-26 | J9070 | CYCLOPHOSPHAMIDE, 100 MG | CYCLOPHOSPHAMIDE (SDV;USP) 500 MG | IV |
68001-0443-27 | J9070 | CYCLOPHOSPHAMIDE, 100 MG | CYCLOPHOSPHAMIDE (SDV;USP) 1 GM | IV |
HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
L1970 | AFO, plastic, with ankle joint, custom fabricated | Each | Y |
L1971 | AFO, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment | Each | Y |
L1980 | AFO, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar BK orthosis), custom fabricated | Each | Y |
L1990 | AFO, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar BK orthosis), custom fabricated | Each | Y |
L2000 | KAFO, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar AK orthosis), custom fabricated | Each | Y |
L2005 | KAFO, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated | Each | Y |
L2010 | KAFO, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar AK orthosis), without knee joint, custom fabricated | Each | Y |
L2020 | KAFO, double upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar AK orthosis), custom fabricated | Each | Y |
L2030 | KAFO, double upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar AK orthosis), without knee joint, custom fabricated | Each | Y |
L2034 | KAFO, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated | Each | Y |
L2035 | KAFO, full plastic, static (pediatric size), without free motion ankle, prefaricated, inlcudes fitting and adjustment | Each | Y |
L2036 | KAFO, full plastic, double upright, with or with free motion knee, with or without free motion ankle, custom fabricated | Each | Y |
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