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    HCPCS Details

    HCPC J0641
    Short Description Inj levoleucovorin nos 0.5mg
    Long Description Injection, levoleucovorin, not otherwise specified, 0.5 mg
    Pricing indicator 51
    Coverage code D
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2023-01-01
    Date Added 2009-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00143955801 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium HIKMA PHARMACEUTICALS USA INC. 0.5 MG 1 1 100 100
    00781320194 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium SANDOZ 0.5 MG 17.5 1 350 350
    43598077311 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium DR. REDDY'S LABORATORIES, INC. 0.5 MG 25 1 500 500
    70121109901 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium AMNEAL BIOSCIENCES 0.5 MG 1 1 100 100
    70121157201 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium AMNEAL BIOSCIENCES 0.5 MG 17.5 1 350 350
    71288010410 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium MEITHEAL PHARMACEUTICALS 0.5 MG 1 1 100 100
    71288010518 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium Meitheal Pharmaceuticals, Inc. 0.5 MG 17.5 1 350 350
    72266012001 J0641 Inj levoleucovorin nos 0.5mg Levoleucovorin Calcium FOSUN PHARMA 0.5 MG 17.5 1 350 350
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/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 (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    Drug Details

    • Levoleucovorin injection is used in adults and children to prevent harmful effects of methotrexate (Trexall) when methotrexate is used to treat osteosarcoma (cancer that forms in bones). Levoleucovorin injection is also used to treat adults and children who have accidentally received an overdose of methotrexate or similar medications or who are not able to eliminate these medications properly from their bodies. Levoleucovorin injection is also used with fluorouracil (5-FU, a chemotherapy medication) to treat adults with colorectal cancer (cancer that begins in the large intestine) that has spread to other parts of the body. Levoleucovorin injection is in a class of medications called folic acid analogs. It works to prevent the harmful effects of methotrexate by protecting healthy cells, while allowing methotrexate to enter and kill cancer cells. It works to treat colorectal cancer by increasing the effects of fluorouracil.