Q0169
Q0169 – Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription ant · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 62 NDCs crosswalked
📋 Q0169 summary
Q0169 is a HCPCS Level II Q-code used to bill Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use.... The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
⚠ 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 codeQ0169
DescriptorPromethazine hydrochloride, 12.5 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 NDCs62
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 descriptionPromethazine hydrochloride, 12.5 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 Q0169 = 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 Q0169 LEAST EXPENSIVE FIRST
62 NDCs map to Q0169. Bill units = how many HCPCS units one package represents.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|
| 00121-1854-16 | Promethazine Hydrochloride 6.25 mg/5mL SOLUTION | PAI | 473 mL in 1 BOTTLE (0121-1854-16) | 6.25 mg/5mL | 0.1 | $0.042 | ● Active | PDAC |
| 00116-4023-16 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SYRUP | Xttrium | 473 mL in 1 BOTTLE, PLASTIC (0116-4023-16) | 6.25 mg/5mL | 0.1 | $0.042 | ● Active | PDAC |
| 62135-0774-47 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SOLUTION | Chartwell | 473 mL in 1 BOTTLE (62135-774-47) | 6.25 mg/5mL | 0.1 | $0.042 | ● Active | PDAC |
| 27808-0051-02 | promethazine hydrochloride 6.25 mg/5mL SYRUP | Cranbury | 473 mL in 1 BOTTLE (27808-051-02) | 6.25 mg/5mL | 0.1 | $0.042 | ● Active | PDAC |
| 70752-0138-12 | Promethazine Hydrochloride 6.25 mg/5mL SOLUTION | QUAGEN | 473 mL in 1 BOTTLE, PLASTIC (70752-138-12) | 6.25 mg/5mL | 0.1 | $0.042 | ● Active | PDAC |
| 68001-0162-03 | Promethazine Hydrochloride 25 mg/1 TABLET | BluePoint | 500 TABLET in 1 BOTTLE (68001-162-03) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 00904-7304-61 | Promethazine Hydrochloride 25 mg/1 TABLET | Major | 100 BLISTER PACK in 1 CARTON (0904-7304-61... | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 68382-0041-05 | Promethazine Hydrochloride 25 mg/1 TABLET | Zydus | 500 TABLET in 1 BOTTLE (68382-041-05) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 53746-0521-10 | Promethazine Hydrochloride 25 mg/1 TABLET | Amneal | 1000 TABLET in 1 BOTTLE (53746-521-10) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 53746-0521-01 | Promethazine Hydrochloride 25 mg/1 TABLET | Amneal | 100 TABLET in 1 BOTTLE (53746-521-01) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 10702-0003-50 | PROMETHAZINE HYDROCHLORIDE 25 mg/1 TABLET | KVK-Tech, | 500 TABLET in 1 BOTTLE (10702-003-50) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 00591-5307-01 | Promethazine Hydrochloride 25 mg/1 TABLET | Actavis | 100 TABLET in 1 BOTTLE, PLASTIC (0591-5307... | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 10702-0003-01 | PROMETHAZINE HYDROCHLORIDE 25 mg/1 TABLET | KVK-Tech, | 100 TABLET in 1 BOTTLE (10702-003-01) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 00591-5307-10 | Promethazine Hydrochloride 25 mg/1 TABLET | Actavis | 1000 TABLET in 1 BOTTLE, PLASTIC (0591-530... | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 10702-0003-10 | PROMETHAZINE HYDROCHLORIDE 25 mg/1 TABLET | KVK-Tech, | 1000 TABLET in 1 BOTTLE (10702-003-10) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 68382-0041-10 | Promethazine Hydrochloride 25 mg/1 TABLET | Zydus | 1000 TABLET in 1 BOTTLE (68382-041-10) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 68382-0041-01 | Promethazine Hydrochloride 25 mg/1 TABLET | Zydus | 100 TABLET in 1 BOTTLE (68382-041-01) | 25 mg/1 | 2 | $0.045 | ● Active | PDAC |
| 10702-0002-01 | PROMETHAZINE HYDROCHLORIDE 12.5 mg/1 TABLET | KVK-Tech, | 100 TABLET in 1 BOTTLE (10702-002-01) | 12.5 mg/1 | 1 | $0.047 | ● Active | PDAC |
| 53746-0745-01 | Promethazine Hydrochloride 12.5 mg/1 TABLET | Amneal | 100 TABLET in 1 BOTTLE (53746-745-01) | 12.5 mg/1 | 1 | $0.054 | ● Active | PDAC |
| 68382-0040-01 | Promethazine Hydrochloride 12.5 mg/1 TABLET | Zydus | 100 TABLET in 1 BOTTLE (68382-040-01) | 12.5 mg/1 | 1 | $0.054 | ● Active | PDAC |
| 10702-0004-01 | PROMETHAZINE HYDROCHLORIDE 50 mg/1 TABLET | KVK-Tech, | 100 TABLET in 1 BOTTLE (10702-004-01) | 50 mg/1 | 4 | $0.082 | ● Active | PDAC |
| 00591-5319-01 | Promethazine Hydrochloride 50 mg/1 TABLET | Actavis | 100 TABLET in 1 BOTTLE, PLASTIC (0591-5319... | 50 mg/1 | 4 | $0.082 | ● Active | PDAC |
| 62135-0774-24 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SOLUTION | Chartwell | 2 TRAY in 1 BOX (62135-774-24) / 10 CUP i... | 6.25 mg/5mL | 0.1 | — | ● Active | PDAC |
| 62135-0774-23 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SOLUTION | Chartwell | 2 TRAY in 1 BOX (62135-774-23) / 10 CUP i... | 6.25 mg/5mL | 0.1 | — | ● Active | PDAC |
| 81033-0016-50 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SOLUTION | Kesin | 50 CUP, UNIT-DOSE in 1 CARTON (81033-016-5... | 6.25 mg/5mL | 0.1 | — | ● Active | PDAC |
| 29033-0500-34 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SOLUTION | Nostrum | 473 mL in 1 BOTTLE (29033-500-34) | 6.25 mg/5mL | 0.1 | — | Obsolete | PDAC |
| 62135-0774-41 | PROMETHAZINE HYDROCHLORIDE 6.25 mg/5mL SOLUTION | Chartwell | 120 mL in 1 BOTTLE (62135-774-41) | 6.25 mg/5mL | 0.1 | — | ● Active | PDAC |
| 65162-0678-90 | PROMETHAZINE HCL (USP,BANANA FRUIT) 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 43063-0876-04 | PROMETHAZINE HYDROCHLORIDE 50 mg/1 TABLET | PD-Rx | 4 TABLET in 1 BOTTLE, PLASTIC (43063-876-0... | 50 mg/1 | 4 | — | ● Active | PDAC |
| 43063-0874-20 | PROMETHAZINE HYDROCHLORIDE 25 mg/1 TABLET | PD-Rx | 20 TABLET in 1 BOTTLE, PLASTIC (43063-874-... | 25 mg/1 | 2 | — | ● Active | PDAC |
| 54868-4109-00 | HYDROXYZINE PAMOATE 100 MG | Unknown | — | — | 8 | — | — | PDAC |
| 54868-1323-02 | PROMETHAZINE HCL 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 52959-0804-08 | PROMETHAZINE 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 52959-0804-04 | PROMETHAZINE 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 52959-0914-30 | PROMETHAZINE 12.5 MG | Unknown | — | — | 1 | — | — | PDAC |
| 55289-0948-02 | PROMETHAZINE 12.5 MG | Unknown | — | — | 1 | — | — | PDAC |
| 63629-1591-03 | Promethazine Hydrochloride 12.5 mg/1 TABLET | Bryant | 2 TABLET in 1 BOTTLE (63629-1591-3) | 12.5 mg/1 | 1 | — | ● Active | PDAC |
| 63629-1591-02 | Promethazine Hydrochloride 12.5 mg/1 TABLET | Bryant | 4 TABLET in 1 BOTTLE (63629-1591-2) | 12.5 mg/1 | 1 | — | ● Active | PDAC |
| 63629-1591-01 | Promethazine Hydrochloride 12.5 mg/1 TABLET | Bryant | 12 TABLET in 1 BOTTLE (63629-1591-1) | 12.5 mg/1 | 1 | — | ● Active | PDAC |
| 00121-0927-16 | PROMETHAZINE HCL (1X473ML) 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 63739-0213-10 | PROMETHAZINE HYDROCHLORIDE (USP) 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 33358-0302-08 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 33358-0302-10 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 33358-0302-30 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 33358-0302-60 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 49999-0090-10 | PROMETHAZINE HCL 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 49999-0090-30 | PROMETHAZINE HCL 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 50383-0801-16 | PROMETHAZINE HCL (CHERRY) 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 63874-0712-12 | PROMETHAZINE HCL 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 63874-0370-60 | PROMETHAZINE HYDROCHLORIDE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 00781-1830-10 | PROMETHAZINE HCL 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 63629-1742-04 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 63629-1742-03 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 63629-1742-02 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 63629-1742-01 | PROMETHAZINE 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 60432-0608-04 | PROMETHAZINE HCL (TROPICAL FRUIT) 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 60432-0608-16 | PROMETHAZINE HCL (TROPICAL FRUIT) 6.25 MG/5 ML | Unknown | — | — | 0.1 | — | — | PDAC |
| 60760-0830-20 | PROMETHAZINE HCL 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 00781-1832-01 | PROMETHAZINE HCL 50 MG | Unknown | — | — | 4 | — | — | PDAC |
| 00781-1830-01 | PROMETHAZINE HCL 25 MG | Unknown | — | — | 2 | — | — | PDAC |
| 33358-0418-30 | PROMETHAZINE 12.5 MG | Unknown | — | — | 1 | — | — | PDAC |
| 63629-1591-04 | PROMETHAZINE 12.5 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
—
Medicare paid
$0.00
Submitted services
—
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 Q0169 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 Q0169
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)
Not available
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
62 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.
❓ Q0169 billing FAQ
What is HCPCS code Q0169?
Q0169 is a HCPCS Level II Q-code used to bill Promethazine hydrochloride, 12.5 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 Q0169?
62 NDCs currently map to Q0169 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 Q0169 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.