NDC - Pre-Exposure Prophylaxis (PrEP)
Effective April 1, 2026 through June 30, 2026
The NDC - HCPCS crosswalks are intended to help understand which drug products -identified by NDCs- are assigned to which HCPCS billing codes. The information is based on published drug and biological pricing data and information submitted to CMS by manufacturers. The crosswalks are not intended to be a comprehensive list of all NDCs available in the United States. The NDC to HCPCS Crosswalks also include information on the NDC package size and the number of billable units.
Pre-Exposure Prophylaxis (PrEP)
| NDC | HCPCS Code | Labeler | Drug Name | Dosage | Package Size | Package Quantity | Billable Units | Billable Units / Pkg |
|---|---|---|---|---|---|---|---|---|
| 61958-3402-1 | J0738 | Gilead Sciences INC. | Hiv prep, inj, lenacapavir | 1 MG | 1.5 | 2 | 463.5 | 927 |
| 49702-264-23 | J0739 | VIIV HEALTHCARE | Hiv prep, cabotegravir, 1mg | 1 MG | 3 | 1 | 600 | 600 |
| 0093-7704-56 | J0750 | Teva Pharmaceuticals | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 0378-1930-93 | J0750 | Mylan Pharmaceuticals Inc. | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 0904-7172-07 | J0750 | Major Pharmaceuticals | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 16714-534-01 | J0750 | Northstar RxLLC | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 31722-560-30 | J0750 | Camber Pharmaceuticals Inc. | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 33342-106-07 | J0750 | MacLeods Pharmaceuticals Limited | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 42291-439-30 | J0750 | Avkare | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 42385-953-30 | J0750 | Laurus Labs Limited | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 42385-953-90 | J0750 | Laurus Labs Limited | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 90 | 1 | 90 | 90 |
| 42543-719-04 | J0750 | Strides Pharma Inc | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 50090-6494-1 | J0750 | A-S Medication Solutions | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 50090-7719-1 | J0750 | A-S Medication Solutions | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 51407-112-30 | J0750 | Golden State Medical Supply Inc | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 54868-5141-0 | J0750 | Physicians Total Care Inc | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 60687-719-25 | J0750 | American Health Packaging | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 61958-0701-1 | J0750 | Gilead Sciences INC. | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 61958-0703-1 | J0750 | Gilead Sciences INC. | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 15 | 15 |
| 61958-0704-1 | J0750 | Gilead Sciences INC. | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 20 | 20 |
| 61958-0705-1 | J0750 | Gilead Sciences INC. | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 25 | 25 |
| 64380-719-04 | J0750 | Strides Pharma Science Limited | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 65862-354-30 | J0750 | Aurobindo Pharma Limited | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 65862-354-30 | J0750 | Aurobindo Pharma Limited | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 68180-287-06 | J0750 | Lupin Pharmaceuticals Inc | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 69097-741-02 | J0750 | Cipla USA | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 69238-2095-3 | J0750 | Amneal Pharmaceuticals LLC | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 70710-1367-3 | J0750 | Zydus Pharmaceuticals USA | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 70710-1367-4 | J0750 | Zydus Pharmaceuticals USA | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 100 | 1 | 100 | 100 |
| 70710-1367-9 | J0750 | Zydus Pharmaceuticals USA | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 90 | 1 | 90 | 90 |
| 71205-776-30 | J0750 | Proficient Rx LP | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 71205-776-60 | J0750 | Proficient Rx LP | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 60 | 1 | 60 | 60 |
| 71205-776-90 | J0750 | Proficient Rx LP | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 90 | 1 | 90 | 90 |
| 76282-677-30 | J0750 | Exelan Pharmaceuticals Inc | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 82009-109-30 | J0750 | Quallent Pharmaceuticals LLC | Hiv prep, ftc/tdf 200/300mg | 200 MG/300 MG | 30 | 1 | 30 | 30 |
| 61958-2002-1 | J0751 | Gilead Sciences, Inc | Hiv prep, ftc/taf 200/25mg | 200/25 MG | 30 | 1 | 30 | 30 |
| 61958-2002-2 | J0751 | Gilead Sciences, Inc | Hiv prep, ftc/taf 200/25mg | 200/25 MG | 30 | 1 | 30 | 30 |
| 61958-3401-1 | J0752 | Gilead Sciences INC. | Hiv prep, oral lenacapavir | 300 MG | 4 | 1 | 4 | 4 |
