J1200
J1200 – Injection, diphenhydramine hcl, up to 50 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 30 NDCs crosswalked per 50 MG $0.752/unit ASP+6%
📋 J1200 summary
J1200 is a HCPCS Level II J-code used to bill diphenhydramine hcl, up to 50 mg, billed per 50 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J1200: Diphenhydramine Hydrochloride, Diphenhydramine
Code J1200
Billing unit 50 MG Payment limit $0.752/unit NDC-Crosswalk 30
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ1200
DescriptorInjection, diphenhydramine hcl, up to 50 mg
Billing unit50 MG
Payment limit / unit$0.752
Est. ASP / unit$0.709 est.
Mapped NDCs30
Data periodQ3 2026
Last updated2026-08-20
💊 About Diphenhydramine Injection DRUG GUIDE
Diphenhydramine Hydrochloride Injection is used in adults and children (excluding premature infants and newborns) when the oral form of diphenhydramine is not practical.
It treats allergic reactions — including as a supporting treatment during serious anaphylaxis (a life-threatening allergic emergency) alongside epinephrine — as well as other uncomplicated immediate-type allergic conditions.It is also used for active treatment of motion sickness and for parkinsonism, particularly in older adults who cannot tolerate stronger medications or in milder cases across age groups, sometimes alongside other anticholinergic agents.
Clinical overview from our editorial drug guide for Diphenhydramine Injection. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$0.752
Est. ASP / unit
$0.709 est.
Est. after 2% sequester
$0.737
HCPCS dosage
50 MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionInjection, diphenhydramine hcl, up to 50 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeN — No maintenance this year
Effective date1997-01-01
Date added1982-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J1200 = 50 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J1200 LEAST EXPENSIVE FIRST
30 NDCs map to J1200. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.752/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 23155-0263-31 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION | Heritage | 1 VIAL, GLASS in 1 PACKAGE (23155-263-31)... | 50 mg/mL | 10 | $7.52 | $0.790 | ● Active | CMS ASP |
| 00641-0376-25 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION | Hikma | 25 VIAL in 1 PACKAGE (0641-0376-25) / 1 m... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS ASP |
| 00641-6282-25 | Diphenhydramine hydrochloride 50 mg/mL INJECTION | Hikma | 25 VIAL in 1 PACKAGE (0641-6282-25) / 1 m... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS + PDAC |
| 23155-0264-41 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION | Heritage | 25 VIAL, GLASS in 1 PACKAGE (23155-264-41)... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS + PDAC |
| 25021-0481-01 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION, SOLUTION | Sagent | 25 VIAL in 1 CARTON (25021-481-01) / 1 mL... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS + PDAC |
| 63323-0664-01 | Diphenhydramine 50 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 TRAY (63323-664-... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS + PDAC |
| 63323-0664-16 | Diphenhydramine 50 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL in 1 TRAY (63323-664-16) / 1 mL i... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS ASP |
| 72485-0101-25 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION, SOLUTION | Armas | 25 VIAL, SINGLE-DOSE in 1 CARTON (72485-10... | 50 mg/mL | 25 | $18.80 | $0.934 | ● Active | CMS + PDAC |
| 83634-0781-01 | Diphenhydramine 50 mg/mL INJECTION, SOLUTION | Avenacy, | 25 VIAL, SINGLE-DOSE in 1 CARTON (83634-78... | 50 mg/mL | 1 | $0.75 | $0.934 | ● Active | PDAC |
| 72485-0101-05 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION, SOLUTION | Armas | 5 VIAL, SINGLE-DOSE in 1 CARTON (72485-101... | 50 mg/mL | 5 | $3.76 | $1.010 | ● Active | CMS + PDAC |
| 00404-9851-01 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION | Henry | 1 VIAL, SINGLE-DOSE in 1 BAG (0404-9851-01... | 50 mg/mL | 1 | $0.75 | — | ● Active | CMS ASP |
| 50090-0878-00 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION | A-S | 1 VIAL in 1 CARTON (50090-0878-0) / 50 mL... | 50 mg/mL | 1 | $0.75 | — | ● Active | CMS ASP |
| 50090-1841-00 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION | A-S | 25 VIAL in 1 PACKAGE (50090-1841-0) / 1 m... | 50 mg/mL | 25 | $18.80 | — | ● Active | CMS ASP |
| 51662-1219-01 | DIPHENHYDRAMINE HYDROCHLORIDE 50 mg/mL INJECTION | HF | 1 mL in 1 VIAL (51662-1219-1) | 50 mg/mL | 1 | $0.75 | — | ● Active | CMS ASP |
| 51662-1219-03 | DIPHENHYDRAMINE HYDROCHLORIDE 50 mg/mL INJECTION | HF | 25 POUCH in 1 CASE (51662-1219-3) / 1 mL... | 50 mg/mL | 25 | $18.80 | — | ● Active | CMS ASP |
| 76045-0102-10 | Diphenhydramine Hydrochloride 50 mg/mL INJECTION, SOLUTION | Fresenius | 24 BLISTER PACK in 1 CARTON (76045-102-10)... | 50 mg/mL | 24 | $18.05 | — | ● Active | CMS ASP |
| 67457-0124-10 | DIPHENHYDRAMINE HYDROCHLORIDE (MDV,USP) 50 MG/ML | Unknown | — | — | 1 | $0.75 | — | — | PDAC |
| 00641-0376-21 | DIPHENHYDRAMINE HCL (DOSETTE VIAL) 50 MG/ML | Unknown | — | — | 1 | $0.75 | — | — | PDAC |
| 51927-1079-00 | DIPHENHYDRAMINE HYDROCHLORIDE 1 kg/kg POWDER | Professional | 1 kg in 1 CONTAINER (51927-1079-0) | 1 kg/kg | 20 | $15.04 | — | ● Active | PDAC |
| 51552-0124-02 | DIPHENHYDRAMINE HCL (U.S.P.,N.F.) | Unknown | — | — | 20 | $15.04 | — | — | PDAC |
| 51552-0124-04 | DIPHENHYDRAMINE HCL (U.S.P.,N.F.) | Unknown | — | — | 20 | $15.04 | — | — | PDAC |
| 51552-0124-05 | DIPHENHYDRAMINE HCL (U.S.P.,N.F.) | Unknown | — | — | 20 | $15.04 | — | — | PDAC |
| 51552-0124-06 | DIPHENHYDRAMINE HCL (U.S.P.,N.F.) | Unknown | — | — | 20 | $15.04 | — | — | PDAC |
| 38779-0282-09 | Diphenhydramine Hydrochloride 1 g/g POWDER | Medisca | 1000 g in 1 JAR (38779-0282-9) | 1 g/g | 20 | $15.04 | — | ● Active | PDAC |
| 55553-0827-10 | BANARIL (VIAL) 50 MG/ML | Unknown | — | — | 1 | $0.75 | — | — | PDAC |
| 62991-1047-02 | Diphenhydramine Hcl 1 g/g POWDER | LETCO | 100 g in 1 JAR (62991-1047-2) | 1 g/g | 20 | $15.04 | — | ● Active | PDAC |
| 38779-0282-08 | Diphenhydramine Hydrochloride 1 g/g POWDER | Medisca | 500 g in 1 JAR (38779-0282-8) | 1 g/g | 20 | $15.04 | — | ● Active | PDAC |
| 38779-0282-05 | Diphenhydramine Hydrochloride 1 g/g POWDER | Medisca | 100 g in 1 JAR (38779-0282-5) | 1 g/g | 20 | $15.04 | — | ● Active | PDAC |
| 38779-0282-04 | Diphenhydramine Hydrochloride 1 g/g POWDER | Medisca | 25 g in 1 JAR (38779-0282-4) | 1 g/g | 20 | $15.04 | — | ● Active | PDAC |
| 00409-2290-31 | DIPHENHYDRAMINE HCL (LUER LOCK,CARPUJECT) 50 MG/ML | Unknown | — | — | 1 | $0.75 | — | — | PDAC |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$75.7K
Claims
97,723
Beneficiaries
39,173
Spend / beneficiary
$1.93
Spend / claim
$0.77
Trend by period
Where J1200 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #583 of 824
#578
CEFTAROLINE FOSAMIL* J0712
$80K
#579
DEFEROXAMINE MESYLAT... J0895
$78.6K
#580
DAPTOMYCIN(J0872) J0872
$78.1K
#581
GRAFIX CORE, GRAFIXP... Q4132
$76.1K
#582
PREVNAR 13 90670
$76K
#583
DIPHENHYDRAMINE HCL J1200
$75.7K
#584
ERZOFRI J2428
$74.6K
#585
TEMSIROLIMUS* J9330
$73.9K
#586
KINEVAC* J2805
$72.7K
#587
FERAHEME(Q0139)* Q0139
$72.4K
#588
REVITA, PER SQ CM** Q4180
$71.6K
Total claims — #26 of 824
#21
KEYTRUDA J9271
108,081
#22
PAVBLU Q5147
107,941
#23
EVENITY (2 SYRINGES) J3111
106,087
#24
IPRATROPIUM-ALBUTERO... J7620
105,195
#25
BOTOX COSMETIC* J0585
104,273
#26
DIPHENHYDRAMINE HCL J1200
97,723
#27
CLARISCAN* A9575
91,951
#28
ALBUTEROL SULFATE(J7... J7613
86,874
#29
BUDESONIDE* J7626
84,831
#30
DARZALEX FASPRO J9144
82,545
#31
SPIKEVAX * 91322
76,644
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $75.7K | 39,173 | 97,723 | $1.93 | $0.77 |
| 2025 (Q1-Q4) | $345.7K | 90,019 | 429,105 | $3.84 | $0.81 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$332K
Medicare paid
$256.1K
Submitted services
523,995
Denial rate
16.2%
Allowed / service
$0.76
Submitted charges
$3.59M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where J1200 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 402,518 services across 53 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under J1200
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
30 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J1200 billing FAQ
What is HCPCS code J1200?
J1200 is a HCPCS Level II J-code used to bill Injection, diphenhydramine hcl, up to 50 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1200?
One unit of J1200 represents 50 MG. Report the number of units equal to the dose administered divided by 50 MG.
How many units of J1200 should I bill?
Divide the dose administered by the code's unit size (50 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J1200?
The Medicare Part B payment limit is $0.752 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.737 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1200?
30 NDCs currently map to J1200 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J1200 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.