NDC - HCPCS Crosswalk

Effective October 1, 2018 through December 31, 2018

The crosswalk is intended to help understand which drug products -identified by NDCs- are assigned to which HCPCS billing codes. The crosswalk is not intended to be a comprehensive list of all NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units.

NDC	HCPCS Code	Labeler	Drug Name	Dosage	Package Size	Package Quantity	Billable Units	Billable Units / Pkg
13533-636-02	90371	Grifols USA, LLC.	Hep b ig im	1 ML	1	1	1	1
13533-636-03	90371	Grifols USA, LLC.	Hep b ig im	1 ML	0.5	1	0.5	0.5
13533-636-05	90371	Grifols USA, LLC.	Hep b ig im	1 ML	5	1	5	5
59730-4202-1	90371	Biotest Pharmaceuticals Corporation	Hep b ig im	1 ML	1	1	1	1
59730-4203-1	90371	Biotest Pharmaceuticals Corporation	Hep b ig im	1 ML	5	1	5	5
13533-318-01	90375	Grifols USA, LLC.	Rabies ig im/sc	150 IU	1	1	2	2
13533-318-05	90375	Grifols USA, LLC.	Rabies ig im/sc	150 IU	5	1	10	10
13533-618-02	90375	Grifols USA, LLC.	Rabies ig im/sc	150 IU	2	1	2	2
13533-618-10	90375	Grifols USA, LLC.	Rabies ig im/sc	150 IU	10	1	10	10
49281-190-20	90376	sanofi pasteur	Rabies ig heat treated	150 IU	2	1	2	2
0052-0602-02	90585	Organon USA, Inc.	Bcg vaccine percut	50 MG	1	1	1	1
0052-0603-02	90585	Organon USA, Inc.	Bcg vaccine percut	50 MG	1	1	1	1
0052-0602-02	90586	Organon USA, Inc.	Bcg vaccine intravesical	1 EACH	1	1	1	1
0052-0603-02	90586	Organon USA, Inc.	Bcg vaccine intravesical	1 EACH	1	1	1	1
0006-4096-02	90632	Merck Sharp & Dohme Corp.	Hepa vaccine adult im	1 ML	1	10	1	10
0006-4841-00	90632	Merck Sharp & Dohme Corp.	Hepa vaccine adult im	1 ML	1	1	1	1
0006-4841-41	90632	Merck Sharp & Dohme Corp.	Hepa vaccine adult im	1 ML	1	10	1	10
58160-826-11	90632	GlaxoSmithkline	Hepa vaccine adult im	1 ML	1	10	1	10
58160-826-52	90632	GlaxoSmithkline	Hepa vaccine adult im	1 ML	1	10	1	10
70461-018-03	90653	Seqirus Inc	Iiv adjuvant vaccine im	0.5 ml	0.5	10	1	10
33332-018-01	90656	Seqirus Inc	IIV3 VACC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
49281-403-65	90662	Sanofi Pasteur	Iiv no prsv increased ag im	0.5 ml	0.5	10	1	10
0005-1971-02	90670	Wyeth/Pfizer U.S.	PCV13 Vaccine IM	0.5 ML	0.5	10	1	10
0005-1971-05	90670	Wyeth/Pfizer U.S.	PCV13 Vaccine IM	0.5 ML	0.5	1	1	1
66019-305-10	90672	MedImmune, LLC	Laiv4 vaccine intranasal	0.2 ml	0.2 ML	10	1	10
42874-017-10	90673	Protein Sciences	Riv3 vaccine no preserv im	0.5 ML	0.5	10	1	10
70461-318-03	90674	Seqirus Inc	CCIIV4 VAC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
49281-250-51	90675	sanofi pasteur	Rabies vaccine im	1 ML	1	1	1	1
58160-964-12	90675	GlaxoSmithkline	Rabies vaccine im	1 ML	1	1	1	1
63851-501-02	90675	GlaxoSmithkline	Rabies vaccine im	1 ML	1	1	1	1
49281-718-10	90682	Sanofi Pasteur	RIV4 VACC RECOMBINANT DNA IM	0.5 ml	0.5	10	1	10
49281-518-25	90685	Sanofi Pasteur	IIV4 VACC NO PRSV 0.25 ML IM	0.25 ml	0.25	10	1	10
19515-909-52	90686	GlaxoSmithKline	IIV4 VACC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
33332-318-01	90686	Seqirus Inc	IIV4 VACC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
49281-418-10	90686	Sanofi Pasteur	IIV4 VACC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
49281-418-50	90686	Sanofi Pasteur	IIV4 VACC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
58160-898-52	90686	GlaxoSmithKline	IIV4 VACC NO PRSV 0.5 ML IM	0.5 ml	0.5	10	1	10
49281-629-15	90687	Sanofi Pasteur	IIV4 VACCINE SPLT 0.25 ML IM	0.25 ml	5	1	10	20
19515-900-11	90688	GlaxoSmithKline	IIV4 VACCINE SPLT 0.5 ML IM	0.5 ml	5	1	10	10
33332-418-10	90688	Seqirus Inc	IIV4 VACCINE SPLT 0.5 ML IM	0.5 ml	5	1	10	10
49281-629-15	90688	Sanofi Pasteur	IIV4 VACCINE SPLT 0.5 ML IM	0.5 ml	5	1	10	10
13533-131-01	90714	Grifols USA, LLC.	Td vacc no presv 7 yrs+ im	0.5 ML	0.5	10	1	10
49281-215-10	90714	sanofi pasteur	Td vacc no presv 7 yrs+ im	0.5 ML	0.5	10	1	10
49281-215-15	90714	sanofi pasteur	Td vacc no presv 7 yrs+ im	0.5 ML	0.5	10	1	10
49281-400-10	90715	sanofi pasteur	Tdap vaccine 7 yrs/> im	0.5 ML	0.5	10	1	10
49281-400-15	90715	sanofi pasteur	Tdap vaccine 7 yrs/> im	0.5 ML	0.5	5	1	5
58160-842-11	90715	GlaxoSmithkline	Tdap vaccine 7 yrs/> im	0.5 ML	0.5	10	1	10
58160-842-52	90715	GlaxoSmithkline	Tdap vaccine 7 yrs/> im	0.5 ML	0.5	10	1	10
0006-4739-00	90732	Merck	PPSV23 VACC 2 YRS+ SUBQ/IM	0.5 ML	2.5	1	5	5
0006-4837-02	90732	Merck	PPSV23 VACC 2 YRS+ SUBQ/IM	0.5 ML	0.5	1	1	1
0006-4837-03	90732	Merck	PPSV23 VACC 2 YRS+ SUBQ/IM	0.5 ML	0.5	10	1	10
0006-4943-00	90732	Merck	PPSV23 VACC 2 YRS+ SUBQ/IM	0.5 ML	0.5	10	1	10
43528-002-05	90739	Dynavax Technologies Co	HEPB VACC 2 DOSE ADULT IM	1 DOSE	0.5	5	1	5
0006-4992-00	90740	Merck	HEPB VACC 3 DOSE IMMUNSUP IM	40 MCG	1	1	1	1
58160-821-11	90740	GlaxoSmithKline	HEPB VACC 3 DOSE IMMUNSUP IM	40 MCG	1	10	0.5	5
58160-821-52	90740	GlaxoSmithKline	HEPB VACC 3 DOSE IMMUNSUP IM	40 MCG	1	10	0.5	5
0006-4094-02	90743	Merck	HEPB VACC 2 DOSE ADOLESC IM	1 DOSE	1	10	1	10
0006-4094-09	90743	Merck	HEPB VACC 2 DOSE ADOLESC IM	1 DOSE	1	6	6	6
0006-4995-00	90743	Merck	HEPB VACC 2 DOSE ADOLESC IM	1 DOSE	1	1	1	1
0006-4995-41	90743	Merck	HEPB VACC 2 DOSE ADOLESC IM	1 DOSE	1	10	1	10

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