HCPCS Procedure & Supply Codes

Private Payer Codes

section notes

Drugs Administered

section notes
S0012‑S0013   Nasal spray
S0014   Tacrine hydrochloride, 10 mg
S0017‑S0164   Injections
S0088   Imatinib 100 mg
S0090   Sildenafil citrate, 25 mg
S0091   Granisetron 1mg
S0104   Zidovudine, oral, 100 mg
S0106   Bupropion hcl sr 60 tablets
S0108   Mercaptopurine 50 mg
S0109   Methadone oral 5mg
S0117   Tretinoin topical 5 g
S0119   Ondansetron 4 mg
S0136   Clozapine, 25 mg
S0137   Didanosine, 25 mg
S0138   Finasteride, 5 mg
S0139   Minoxidil, 10 mg
S0140   Saquinavir, 200 mg
S0142   Colistimethate inh sol mg
S0155   Epoprostenol dilutant
S0156   Exemestane, 25 mg
S0157   Becaplermin gel 1%, 0.5 gm
S0160   Dextroamphetamine
S0169   Calcitrol
S0170   Anastrozole 1 mg
S0172   Chlorambucil 2 mg
S0174   Dolasetron 50 mg
S0175   Flutamide 125 mg
S0176   Hydroxyurea 500 mg
S0177   Levamisole 50 mg
S0178   Lomustine 10 mg
S0179   Megestrol 20 mg
S0182   Procarbazine, oral
S0183   Prochlorperazine 5 mg
S0187   Tamoxifen 10 mg
S0189   Testosterone pellet 75 mg
S0190   Mifepristone, oral, 200 mg
S0191   Misoprostol, oral, 200 mcg
S0194   Vitamin suppl 100 caps
S0197   Prenatal vitamins 30 day
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