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    HCPCS Details

    HCPC J1645
    Short Description Dalteparin sodium
    Long Description Injection, dalteparin sodium, per 2500 iu
    Pricing indicator 51
    Coverage code D
    ASC payment group code
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2002-07-01
    Date Added 1997-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00069019502 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 0.2 10 1 10
    00069019602 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 0.2 10 2 20
    00069020602 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 0.3 10 3 30
    00069021702 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 1 10 4 40
    00069022002 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 0.5 10 5 50
    00069022302 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 0.6 10 6 60
    00069022802 J1645 Dalteparin sodium Fragmin PFIZER INC. 2500 IU 0.72 10 7.2 72
    00069023201 J1645 Dalteparin sodium FRAGMIN PFIZER INC. 2500 IU 3.8 1 38 38
    00069025310 J1645 Dalteparin sodium Fragmin Pfizer Labs 2500 IU 4 10 4 40
    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 2500 IU
    HCPCS/CPT Billing Units 0.0004
    Total doses ordered
    Billing Units 0.0004