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    HCPCS Details

    HCPC J1817
    Short Description Insulin for insulin pump use
    Long Description Insulin for administration through dme (i.e., insulin pump) per 50 units
    Pricing indicator 51
    Coverage code C
    ASC payment group code
    BETOS2 code D1G
    Action code N
    Type of service 1
    Effective date 2003-01-01
    Date Added 2003-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00002751001 J1817 Insulin for insulin pump use Humalog ELI LILLY AND COMPANY 50 UNITS 10 1 20 20
    00002751017 J1817 Insulin for insulin pump use Humalog ELI LILLY AND COMPANY 50 UNITS 3 1 6 6
    00002751659 J1817 Insulin for insulin pump use Humalog ELI LILLY AND COMPANY 50 UNITS 3 5 6 30
    00002773701 J1817 Insulin for insulin pump use INSULIN LISPRO ELI LILLY AND COMPANY 50 UNITS 10 1 20 20
    00002775205 J1817 Insulin for insulin pump use Insulin Lispro Junior Kwikpen ELI LILLY AND COMPANY 50 UNITS 3 5 6 30
    00002821305 J1817 Insulin for insulin pump use Humalog Tempo Pen Lilly Usa, Llc. 50 UNITS 3 5 6 30
    00002821501 J1817 Insulin for insulin pump use Humulin R ELI LILLY AND COMPANY 50 UNITS 10 1 20 20
    00002821517 J1817 Insulin for insulin pump use Humulin R ELI LILLY AND COMPANY 50 UNITS 3 1 6 6
    00002822259 J1817 Insulin for insulin pump use Insulin Lispro Kwikpen ELI LILLY AND COMPANY 50 UNITS 3 5 6 30
    00002850101 J1817 Insulin for insulin pump use Humulin R ELI LILLY AND COMPANY 50 UNITS 20 1 200 200
    00002879959 J1817 Insulin for insulin pump use Humalog Kwikpen ELI LILLY AND COMPANY 50 UNITS 3 5 6 30
    00169210011 J1817 Insulin for insulin pump use insulin aspart NOVO NORDISK INC 50 UNITS 10 1 20 20
    00169210125 J1817 Insulin for insulin pump use insulin aspart NOVO NORDISK INC 50 UNITS 3 5 6 30
    00169330312 J1817 Insulin for insulin pump use Novolog Penfill NOVO NORDISK INC 50 UNITS 3 5 6 30
    00169633910 J1817 Insulin for insulin pump use Novolog Flexpen NOVO NORDISK INC 50 UNITS 3 5 6 30
    00169750111 J1817 Insulin for insulin pump use Novolog NOVO NORDISK INC 50 UNITS 10 1 20 20
    50090035300 J1817 Insulin for insulin pump use HUMULIN R A-S MEDICATION SOLUTIONS 50 UNITS 10 1 20 20
    50090137500 J1817 Insulin for insulin pump use Humalog A-S MEDICATION SOLUTIONS 50 UNITS 10 1 20 20
    50090166400 J1817 Insulin for insulin pump use Novolog A-S MEDICATION SOLUTIONS 50 UNITS 10 1 20 20
    50090167800 J1817 Insulin for insulin pump use Novolog Flexpen A-S MEDICATION SOLUTIONS 50 UNITS 3 5 6 30
    50090539100 J1817 Insulin for insulin pump use Insulin Lispro A-S MEDICATION SOLUTIONS 50 UNITS 10 1 20 20
    66733077301 J1817 Insulin for insulin pump use INSULIN LISPRO ELI LILLY AND COMPANY 50 UNITS 10 1 20 20
    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 UNITS
    HCPCS/CPT Billing Units 0.02
    Total doses ordered
    Billing Units 0.02