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Q0164

Q0164 – Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-eme · NDC Crosswalk & Billing Units

HCPCS Level II Q-code · Medicare Part B drug billing
Q-code ● 63 NDCs crosswalked

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 Q0164 summary

Q0164 is a HCPCS Level II Q-code used to bill Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a.... The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Code Q0164 NDC-Crosswalk 63 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 codeQ0164
DescriptorProchlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Billing unitNot available in current dataset
Payment limit / unit Not available in current dataset
Mapped NDCs63
Data periodNot available in current dataset
Last updatedSource date not available

🧾 Billing & reimbursement HCPCS · CMS

Medicare payment limit / unit
—
Est. ASP / unit
—
Est. after 2% sequester
—
HCPCS dosage
—
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).
Full HCPCS code details (official CMS record)
Long descriptionProchlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment group—
Action codeN — No maintenance this year
Effective date1998-04-01
Date added1998-04-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of Q0164 = 1 unit. 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 Q0164 LEAST EXPENSIVE FIRST

63 NDCs map to Q0164. Bill units = how many HCPCS units one package represents.
NDC (11-digit)DrugLabelerPackageStrength Bill units NADAC / unit StatusSource
59651-0773-01 prochlorperazine maleate 5 mg/1 TABLET, FILM COATED Aurobindo 100 TABLET, FILM COATED in 1 BOTTLE (59651... 5 mg/1 1 $0.115 ● Active PDAC
69315-0265-01 PROCHLORPERAZINE MALEATE 5 mg/1 TABLET, FILM COATED Leading 100 TABLET, FILM COATED in 1 BOTTLE (69315... 5 mg/1 1 $0.115 ● Active PDAC
69452-0471-20 PROCHLORPERAZINE MALEATE 5 mg/1 TABLET Bionpharma 100 TABLET in 1 BOTTLE (69452-471-20) 5 mg/1 1 $0.115 ● Active PDAC
27241-0286-01 Prochlorperazine Maleate 5 mg/1 TABLET Ajanta 100 TABLET in 1 BOTTLE (27241-286-01) 5 mg/1 1 $0.115 ● Active PDAC
62135-0673-90 Prochlorperazine Maleate 5 mg/1 TABLET, FILM COATED Chartwell 90 TABLET, FILM COATED in 1 BOTTLE (62135-... 5 mg/1 1 $0.115 ● Active PDAC
69452-0309-20 PROCHLORPERAZINE MALEATE 5 mg/1 TABLET, FILM COATED Bionpharma 100 TABLET, FILM COATED in 1 BOTTLE (69452... 5 mg/1 1 $0.115 ● Active PDAC
00904-7381-06 Prochlorperazine Maleate 5 mg/1 TABLET, FILM COATED Major 50 BLISTER PACK in 1 CARTON (0904-7381-06)... 5 mg/1 1 $0.115 ● Active PDAC
68462-0889-01 PROCHLORPERAZINE MALEATE 5 mg/1 TABLET GLENMARK 100 TABLET in 1 BOTTLE (68462-889-01) 5 mg/1 1 $0.115 ● Active PDAC
60219-2038-01 prochlorperazine maleate 5 mg/1 TABLET, FILM COATED Amneal 100 TABLET, FILM COATED in 1 BOTTLE, PLAST... 5 mg/1 1 $0.115 ● Active PDAC
70954-0688-10 Prochlorperazine Maleate 5 mg/1 TABLET, FILM COATED ANI 100 TABLET in 1 BOTTLE (70954-688-10) 5 mg/1 1 $0.115 ● Active PDAC
70710-1667-01 Prochlorperazine Maleate 5 mg/1 TABLET Zydus 100 TABLET in 1 BOTTLE (70710-1667-1) 5 mg/1 1 $0.115 ● Active PDAC
50268-0684-15 PROCHLORPERAZINE MALEATE 5 mg/1 TABLET AvPAK 50 BLISTER PACK in 1 BOX (50268-684-15) /... 5 mg/1 1 $0.115 ● Active PDAC
59746-0113-06 PROCHLORPERAZINE MALEATE 5 mg/1 TABLET Jubilant 100 TABLET in 1 BOTTLE (59746-113-06) 5 mg/1 1 $0.115 ● Active PDAC
59651-0774-01 prochlorperazine maleate 10 mg/1 TABLET, FILM COATED Aurobindo 100 TABLET, FILM COATED in 1 BOTTLE (59651... 10 mg/1 2 $0.162 ● Active PDAC
69315-0266-01 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET, FILM COATED Leading 100 TABLET, FILM COATED in 1 BOTTLE (69315... 10 mg/1 2 $0.162 ● Active PDAC
68462-0947-01 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET GLENMARK 100 TABLET in 1 BOTTLE (68462-947-01) 10 mg/1 2 $0.162 ● Active PDAC
69452-0472-20 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET Bionpharma 100 TABLET in 1 BOTTLE (69452-472-20) 10 mg/1 2 $0.162 ● Active PDAC
27241-0287-01 Prochlorperazine Maleate 10 mg/1 TABLET Ajanta 100 TABLET in 1 BOTTLE (27241-287-01) 10 mg/1 2 $0.162 ● Active PDAC
62135-0674-90 Prochlorperazine Maleate 10 mg/1 TABLET, FILM COATED Chartwell 90 TABLET, FILM COATED in 1 BOTTLE (62135-... 10 mg/1 2 $0.162 ● Active PDAC
69452-0310-20 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET, FILM COATED Bionpharma 100 TABLET, FILM COATED in 1 BOTTLE (69452... 10 mg/1 2 $0.162 ● Active PDAC
00904-7382-06 Prochlorperazine Maleate 10 mg/1 TABLET, FILM COATED Major 50 BLISTER PACK in 1 CARTON (0904-7382-06)... 10 mg/1 2 $0.162 ● Active PDAC
72603-0169-01 Prochlorperazine Maleate 10 mg/1 TABLET Northstar 100 TABLET in 1 BOTTLE (72603-169-01) 10 mg/1 2 $0.162 ● Active PDAC
60219-2039-01 prochlorperazine maleate 10 mg/1 TABLET, FILM COATED Amneal 100 TABLET, FILM COATED in 1 BOTTLE, PLAST... 10 mg/1 2 $0.162 ● Active PDAC
70954-0689-10 Prochlorperazine Maleate 10 mg/1 TABLET, FILM COATED ANI 100 TABLET in 1 BOTTLE (70954-689-10) 10 mg/1 2 $0.162 ● Active PDAC
70710-1668-01 Prochlorperazine Maleate 10 mg/1 TABLET Zydus 100 TABLET in 1 BOTTLE (70710-1668-1) 10 mg/1 2 $0.162 ● Active PDAC
50268-0685-15 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET AvPAK 50 BLISTER PACK in 1 BOX (50268-685-15) /... 10 mg/1 2 $0.162 ● Active PDAC
59746-0115-06 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET Jubilant 100 TABLET in 1 BOTTLE (59746-115-06) 10 mg/1 2 $0.162 ● Active PDAC
43063-0742-15 PROCHLORPERAZINE MALEATE 10 mg/1 TABLET PD-Rx 15 TABLET in 1 BOTTLE, PLASTIC (43063-742-... 10 mg/1 2 — ● Active PDAC
62991-1122-02 PROCHLORPERAZINE MALEATE (U.S.P.) Unknown — — 200 — — PDAC
52959-0476-24 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
52959-0476-60 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
52959-0476-30 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
52959-0476-20 PROCHLORPERAZINE MALEATE (FILM-COATED) 10 MG Unknown — — 2 — — PDAC
38779-0180-08 Prochlorperazine Maleate 1 g/g POWDER Medisca 500 g in 1 JAR (38779-0180-8) 1 g/g 200 — ● Active PDAC
38779-0180-05 Prochlorperazine Maleate 1 g/g POWDER Medisca 100 g in 1 JAR (38779-0180-5) 1 g/g 200 — ● Active PDAC
38779-0180-04 Prochlorperazine Maleate 1 g/g POWDER Medisca 25 g in 1 JAR (38779-0180-4) 1 g/g 200 — ● Active PDAC
51552-0074-09 PROCHLORPERAZINE MALEATE (U.S.P.) Unknown — — 200 — — PDAC
51927-2134-00 PROCHLORPERAZINE MALEATE (U.S.P.) Unknown — — 200 — — PDAC
52959-0476-02 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
52959-0476-10 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
52959-0476-15 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
68462-0890-01 PROCHLORPERAZINE MALEATE (FILM-COATED) 10 MG Unknown — — 2 — — PDAC
72603-0168-01 PROCHLORPERAZINE MALEATE (FILM-COATED) 5 MG Unknown — — 1 — — PDAC
42291-0728-01 PROCHLORPERAZINE MALEATE (USP,FILM-COATED) 5 MG Unknown — — 1 — — PDAC
42291-0729-01 PROCHLORPERAZINE MALEATE (USP,FILM-COATED) 10 MG Unknown — — 2 — — PDAC
49452-6053-05 PROCHLORPERAZINE MALEATE (U.S.P.) Unknown — — 200 — — PDAC
33358-0300-30 PROCHLORPERAZINE 10 MG Unknown — — 2 — — PDAC
33358-0300-20 PROCHLORPERAZINE 10 MG Unknown — — 2 — — PDAC
33358-0300-10 PROCHLORPERAZINE 10 MG Unknown — — 2 — — PDAC
33358-0300-60 PROCHLORPERAZINE 10 MG Unknown — — 2 — — PDAC
00378-5110-01 PROCHLORPERAZINE MALEATE 10 MG Unknown — — 2 — — PDAC
51079-0542-01 PROCHLORPERAZINE MALEATE (USP) 10 MG Unknown — — 2 — — PDAC
51079-0542-20 PROCHLORPERAZINE MALEATE (10X10) 10 MG Unknown — — 2 — — PDAC
55289-0568-30 PROCHLORPERAZINE MALEATE 5 MG Unknown — — 1 — — PDAC
33358-0299-30 PROCHLORPERAZINE 5 MG Unknown — — 1 — — PDAC
33358-0299-20 PROCHLORPERAZINE 5 MG Unknown — — 1 — — PDAC
58864-0702-01 PROCHLORPERAZINE MALEATE 5 MG Unknown — — 1 — — PDAC
55289-0568-10 PROCHLORPERAZINE MALEATE 5 MG Unknown — — 1 — — PDAC
63629-1841-01 PROCHLORPERAZINE MALEATE 5 MG Unknown — — 1 — — PDAC
55289-0568-12 PROCHLORPERAZINE MALEATE 5 MG Unknown — — 1 — — PDAC
51079-0541-01 PROCHLORPERAZINE MALEATE (USP) 5 MG Unknown — — 1 — — PDAC
51079-0541-20 PROCHLORPERAZINE MALEATE (10X10) 5 MG Unknown — — 1 — — PDAC
00378-5105-01 PROCHLORPERAZINE MALEATE 5 MG Unknown — — 1 — — 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 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
$55.11
Medicare paid
$44.93
Submitted services
1,440
Denial rate
89.6%
Allowed / service
$0.37
Submitted charges
$674.30
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 Q0164 is utilized

⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.

📊 What bills under Q0164

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
Prochlorperazine Maleate 22
prochlorperazine maleate 6
PROCHLORPERAZINE MALEATE 4
Prochlorperazine maleate 3
NDC products by labeler
Major Pharmaceuticals 4
Amneal Pharmaceuticals NY LLC 4
Bionpharma Inc. 4
ANI Pharmaceuticals, Inc. 4
Ajanta Pharma USA Inc. 2
AvPAK 2
Aurobindo Pharma Limited 2
Jubilant Cadista Pharmaceuticals I... 2

🗃️ 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)
Not available
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
63 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
No reportable utilization
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.

❓ Q0164 billing FAQ

What is HCPCS code Q0164?
Q0164 is a HCPCS Level II Q-code used to bill Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen under Medicare Part B and most medical (not pharmacy) benefits.
Which NDCs bill under Q0164?
63 NDCs currently map to Q0164 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 Q0164 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.