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HCPCS Details
HCPC | J1558 |
Short Description | Inj. xembify, 100 mg |
Long Description | Injection, immune globulin (xembify), 100 mg |
Pricing indicator | 51 |
Coverage code | C |
ASC payment group code | YY |
BETOS2 code | O1E |
Action code | N |
Type of service | 1 |
Effective date | 2020-07-01 |
Date Added | 2020-07-01 |
HCPCS/NDC Cross-Walk
NDC | HCPC | Description | Drug Name | Labeler Name | HCPCS Dosage | PKG Size | PKG QTY | Bill Units | Bill Units PKG |
---|---|---|---|---|---|---|---|---|---|
13533081005 | J1558 | Inj. xembify, 100 mg | Xembify | GRIFOLS USA, LLC | 100 MG | 5 | 1 | 10 | 10 |
13533081010 | J1558 | Inj. xembify, 100 mg | Xembify | GRIFOLS USA, LLC | 100 MG | 10 | 1 | 20 | 20 |
13533081020 | J1558 | Inj. xembify, 100 mg | Xembify | GRIFOLS USA, LLC | 100 MG | 20 | 1 | 40 | 40 |
13533081050 | J1558 | Inj. xembify, 100 mg | Xembify | GRIFOLS USA, LLC | 100 MG | 50 | 1 | 100 | 100 |
HCPCS Billing Calculator
Dosage given to patient (per dose) | |
---|---|
HCPCS Dosage | 100 MG |
HCPCS/CPT Billing Units | 0.01 |
Total doses ordered | |
Billing Units | 0.01 |