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
0641-2555-45J1165West-Ward Pharmaceuticals CorpPhenytoin sodium injection50 MG5155
0641-6138-25J1165West-Ward Pharmaceuticals CorpPhenytoin sodium injection50 MG225250
0641-6139-25J1165West-Ward Pharmaceuticals CorpPhenytoin sodium injection50 MG5255125
39822-4050-3J1165X-Gen Pharmaceuticals, Inc.Phenytoin sodium injection50 MG225250
39822-4050-6J1165X-Gen Pharmaceuticals, Inc.Phenytoin sodium injection50 MG5255125
0409-1283-05J1170Pfizer Inc.Hydromorphone injection4 MG0.5100.1251.25
0409-1283-10J1170Pfizer Inc.Hydromorphone injection4 MG1100.252.5
0409-1283-31J1170Pfizer Inc.Hydromorphone injection4 MG1100.252.5
0409-1304-31J1170Pfizer Inc.Hydromorphone injection4 MG110110
0409-1312-10J1170Pfizer Inc.Hydromorphone injection4 MG1100.55
0409-1312-30J1170Pfizer Inc.Hydromorphone injection4 MG1100.55
0409-2540-01J1170Pfizer Inc.Hydromorphone injection4 MG110110
0409-2552-01J1170Pfizer Inc.Hydromorphone injection4 MG1100.252.5
0409-2634-01J1170Pfizer Inc.Hydromorphone injection4 MG1102.525
0409-2634-05J1170Pfizer Inc.Hydromorphone injection4 MG51012.5125
0409-2634-50J1170Pfizer Inc.Hydromorphone injection4 MG501125125
0409-3356-01J1170Pfizer Inc.Hydromorphone injection4 MG1100.55
0409-3365-01J1170Pfizer Inc.Hydromorphone injection4 MG1250.512.5
0641-0121-25J1170West-Ward Pharmaceuticals CorpHydromorphone injection4 MG1250.512.5
0641-2341-41J1170West-Ward Pharmaceuticals CorpHydromorphone injection4 MG2011010
0703-0018-01J1170Sicor Pharmaceuticals, Inc.Hydromorphone injection4 MG501125125
0703-0110-03J1170Sicor Pharmaceuticals, Inc.Hydromorphone injection4 MG1102.525
0703-0113-03J1170Sicor Pharmaceuticals, Inc.Hydromorphone injection4 MG51012.5125
17478-540-01J1170AkornHydromorphone injection4 MG1102.525
17478-540-05J1170AkornHydromorphone injection4 MG51012.5125
17478-540-50J1170AkornHydromorphone injection4 MG501125125
59011-444-10J1170Purdue Pharma LPHydromorphone injection4 MG110110
76045-009-05J1170Fresenius Kabi USA LLCHydromorphone injection4 MG0.5240.1253
76045-009-10J1170Fresenius Kabi USA LLCHydromorphone injection4 MG1240.256
76045-010-10J1170Fresenius Kabi USA LLCHydromorphone injection4 MG1240.512
0013-8717-62J1190Pfizer Inc.Dexrazoxane hcl injection250 MG1111
0013-8727-89J1190Pfizer Inc.Dexrazoxane hcl injection250 MG1122
0143-9247-01J1190WEST-WARDDexrazoxane hcl injection250 MG1111
0143-9248-01J1190WEST-WARDDexrazoxane hcl injection250 MG1122
47781-578-07J1190Alvogen, Inc.Dexrazoxane hcl injection250 MG1122
51991-942-98J1190Breckenridge PharmaceuticalDexrazoxane hcl injection250 MG1122
66220-110-01J1190Cumberland Pharmaceuticals IncDexrazoxane hcl injection250 MG1122
67457-207-25J1190Mylan InstitutionalDexrazoxane hcl injection250 MG1111
67457-208-50J1190Mylan InstitutionalDexrazoxane hcl injection250 MG1122
0409-2290-31J1200Pfizer Inc.Diphenhydramine hcl injectio50 MG110110
0641-0376-25J1200West-Ward Pharmaceuticals CorpDiphenhydramine hcl injectio50 MG125125
63323-664-01J1200Fresenius Kabi USA LLCDiphenhydramine hcl injectio50 MG125125
63323-664-16J1200Fresenius Kabi USA LLCDiphenhydramine hcl injectio50 MG125125
67457-124-10J1200Mylan InstitutionalDiphenhydramine hcl injectio50 MG1011010
76045-102-10J1200Fresenius Kabi USA LLCDiphenhydramine hcl injectio50 MG124124
0517-1820-01J1205American RegentChlorothiazide sodium inj500 MG1111
17478-419-40J1205AkornChlorothiazide sodium inj500 MG1111
25021-305-20J1205Sagent Pharmaceuticals IncChlorothiazide sodium inj500 MG1111
63323-658-20J1205Fresenius Kabi USA LLCChlorothiazide sodium inj500 MG1111
63323-658-27J1205Fresenius Kabi USA LLCChlorothiazide sodium inj500 MG1111
63323-658-94J1205Fresenius Kabi USA LLCChlorothiazide sodium inj500 MG1111
67457-263-30J1205Mylan InstitutionalChlorothiazide sodium inj500 MG1111
76478-711-40J1205OakChlorothiazide sodium inj500 MG1111
67457-177-50J1212Mylan InstitutionalDimethyl sulfoxide 50% 50 ml50 ML50111
17478-380-20J1230AkornMethadone injection10 MG2012020
67457-217-20J1230Mylan InstitutionalMethadone injection10 MG2012020
63323-366-01J1240Fresenius Kabi USA LLCDimenhydrinate injection50 MG125125
0641-2569-44J1245West-Ward Pharmaceuticals CorpDipyridamole injection10 MG105525
0338-1073-02J1250Baxter Healthcare CorporationInj dobutamine hcl/250 mg250 MG25018118
0338-1075-02J1250Baxter Healthcare CorporationInj dobutamine hcl/250 mg250 MG25018236
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