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
12496-0300-1Q9991INDIVIOR INC.Buprenorph xr 100 mg or lessLESS THAN OR EQUAL TO 100 MG1.5111
12496-0100-1Q9992INDIVIOR INC.Buprenorphine xr over 100 mgGREATER THAN 100 MG0.5111
12496-0300-1Q9992INDIVIOR INC.Buprenorphine xr over 100 mgGREATER THAN 100 MG1.5111
70801-003-01Q9993Flexion Therapeutics, Inc.Inj., triamcinolone ext rel1 MG113232
50242-920-01Q9995Genentech, Inc.Inj. emicizumab-kxwh, 0.5 mg0.5 MG116060
50242-921-01Q9995Genentech, Inc.Inj. emicizumab-kxwh, 0.5 mg0.5 MG0.41120120
50242-922-01Q9995Genentech, Inc.Inj. emicizumab-kxwh, 0.5 mg0.5 MG0.71210210
50242-923-01Q9995Genentech, Inc.Inj. emicizumab-kxwh, 0.5 mg0.5 MG11300300
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