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    HCPCS Details

    HCPC J1165
    Short Description Phenytoin sodium injection
    Long Description Injection, phenytoin sodium, per 50 mg
    Pricing indicator 51
    Coverage code D
    ASC payment group code
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 1997-01-01
    Date Added 1982-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00404993202 J1165 Phenytoin sodium injection Phenytoin Sodium HENRY SCHEIN, INC. 50 MG 2 1 2 2
    00404993305 J1165 Phenytoin sodium injection Phenytoin Sodium HENRY SCHEIN, INC. 50 MG 5 1 5 5
    00641049325 J1165 Phenytoin sodium injection Phenytoin Sodium HIKMA PHARMACEUTICALS USA INC. 50 MG 2 25 2 50
    00641255545 J1165 Phenytoin sodium injection Phenytoin Sodium HIKMA PHARMACEUTICALS USA INC. 50 MG 5 25 5 125
    00641613825 J1165 Phenytoin sodium injection Phenytoin Sodium HIKMA PHARMACEUTICALS USA INC. 50 MG 2 25 2 50
    00641613925 J1165 Phenytoin sodium injection Phenytoin Sodium HIKMA PHARMACEUTICALS USA INC. 50 MG 5 25 5 125
    51662125101 J1165 Phenytoin sodium injection Phenytoin Sodium HEALTHFIRST 50 MG 2 1 2 2
    51662125103 J1165 Phenytoin sodium injection Phenytoin Sodium HEALTHFIRST 50 MG 2 25 2 50
    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].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 50 MG
    HCPCS/CPT Billing Units 0.02
    Total doses ordered
    Billing Units 0.02