NDC Look-up Sample from Medicare
NDC Look-up Sample from Medicare
April 2017 NDC - HCPCS Crosswalk for Medicare Part B Drugs
Effective April 1, 2017 through June 30, 2017
The ASP crosswalks are maintained by the Division of Ambulatory Services to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including
HCPCS Code
Short Descriptor
LABELER NAME
90630 90630 90653 90655 90656 90656 90656 90656 90656 90657 90661 90662 90662 90670 90670 90670 90672 90672 90673 90673 90674 90685 90685 90686 90686 90686 90686 90686 90686 90686 90686 90687 90687 90688 90688 90688 90688 90732 90732 90732 90732 90732 90740 90740 90740 90740 90740 90743 90743 90743 90743 90743 90743 90743 90743 90744 90744 90744 90744 90744 90744 90744 90746 90746 90746 90746 90746 90746 90746 90746 90746 90746 90747 90747 90747 90747 90747 Q2035 Q2035 Q2037 Q2037 Q2038
Flu vacc iiv4 no preserv id
Sanofi Pasteur
Flu vacc iiv4 no preserv id
Sanofi Pasteur
Iiv adjuvant vaccine im
Seqirus
IIV3 VACC NO PRSV 0.25 ML IM Sanofi Pasteur
IIV3 VACC NO PRSV 0.5 ML IM
bioCSL
IIV3 VACC NO PRSV 0.5 ML IM
Seqirus
IIV3 VACC NO PRSV 0.5 ML IM
GlaxoSmithKline
IIV3 VACC NO PRSV 0.5 ML IM
Novartis
IIV3 VACC NO PRSV 0.5 ML IM
Seqirus
IIV3 VACCINE SPLT 0.25 ML IM Sanofi Pasteur
CCIIV3 VAC NO PRSV 0.5 ML IM Novartis
Iiv no prsv increased ag im
Sanofi Pasteur
Iiv no prsv increased ag im
Sanofi Pasteur
PCV13 VACCINE IM
Wyeth/PFIZER U.S.
PCV13 VACCINE IM
Wyeth/PFIZER U.S.
PCV13 VACCINE IM
Wyeth/PFIZER U.S.
Laiv4 vaccine intranasal
MedImmune, LLC
Laiv4 vaccine intranasal
MedImmune, LLC
Riv3 vaccine no preserv im
Protein Sciences
Riv3 vaccine no preserv im
Protein Sciences
CCIIV4 VAC NO PRSV 0.5 ML IM Seqirus
IIV4 VACC NO PRSV 0.25 ML IM Sanofi Pasteur
IIV4 VACC NO PRSV 0.25 ML IM Sanofi Pasteur
IIV4 VACC NO PRSV 0.5 ML IM
GlaxoSmithKline
IIV4 VACC NO PRSV 0.5 ML IM
ID Biomedical
IIV4 VACC NO PRSV 0.5 ML IM
Sanofi Pasteur
IIV4 VACC NO PRSV 0.5 ML IM
Sanofi Pasteur
IIV4 VACC NO PRSV 0.5 ML IM
Sanofi Pasteur
IIV4 VACC NO PRSV 0.5 ML IM
Sanofi Pasteur
IIV4 VACC NO PRSV 0.5 ML IM
GlaxoSmithKline
IIV4 VACC NO PRSV 0.5 ML IM
GlaxoSmithKline
IIV4 VACCINE SPLT 0.25 ML IM Sanofi Pasteur
IIV4 VACCINE SPLT 0.25 ML IM Sanofi Pasteur
IIV4 VACCINE SPLT 0.5 ML IM
GlaxoSmithKline
IIV4 VACCINE SPLT 0.5 ML IM
ID Biomedical
IIV4 VACCINE SPLT 0.5 ML IM
Sanofi Pasteur
IIV4 VACCINE SPLT 0.5 ML IM
Sanofi Pasteur
PPSV23 VACC 2 YRS+ SUBQ/IM Merck
PPSV23 VACC 2 YRS+ SUBQ/IM Merck
PPSV23 VACC 2 YRS+ SUBQ/IM Merck
PPSV23 VACC 2 YRS+ SUBQ/IM Merck
PPSV23 VACC 2 YRS+ SUBQ/IM Merck
HEPB VACC 3 DOSE IMMUNSUP IM Merck
HEPB VACC 3 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 3 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 3 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 3 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 2 DOSE ADOLESC IM Merck
HEPB VACC 2 DOSE ADOLESC IM Merck
HEPB VACC 2 DOSE ADOLESC IM Merck
HEPB VACC 2 DOSE ADOLESC IM Merck
HEPB VACC 2 DOSE ADOLESC IM Merck
HEPB VACC 2 DOSE ADOLESC IM Merck
HEPB VACC 2 DOSE ADOLESC IM GlaxoSmithKline
HEPB VACC 2 DOSE ADOLESC IM GlaxoSmithKline
HEPB VACC 3 DOSE PED/ADOL IM Merck
HEPB VACC 3 DOSE PED/ADOL IM Merck
HEPB VACC 3 DOSE PED/ADOL IM Merck
HEPB VACC 3 DOSE PED/ADOL IM Merck
HEPB VACC 3 DOSE PED/ADOL IM GlaxoSmithKline
HEPB VACC 3 DOSE PED/ADOL IM GlaxoSmithKline
HEPB VACC 3 DOSE PED/ADOL IM GlaxoSmithKline
HEPB VACCINE 3 DOSE ADULT IM Merck
HEPB VACCINE 3 DOSE ADULT IM Merck
HEPB VACCINE 3 DOSE ADULT IM Merck
HEPB VACCINE 3 DOSE ADULT IM Merck
HEPB VACCINE 3 DOSE ADULT IM Merck
HEPB VACCINE 3 DOSE ADULT IM Merck
HEPB VACCINE 3 DOSE ADULT IM GlaxoSmithKline
HEPB VACCINE 3 DOSE ADULT IM GlaxoSmithKline
HEPB VACCINE 3 DOSE ADULT IM GlaxoSmithKline
HEPB VACCINE 3 DOSE ADULT IM GlaxoSmithKline
HEPB VACC 4 DOSE IMMUNSUP IM Merck
HEPB VACC 4 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 4 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 4 DOSE IMMUNSUP IM GlaxoSmithKline
HEPB VACC 4 DOSE IMMUNSUP IM GlaxoSmithKline
Afluria vacc, 3 yrs & >, im
bioCSL
Afluria vacc, 3 yrs & >, im
Seqirus
Fluvirin vacc, 3 yrs & >, im
Novartis
Fluvirin vacc, 3 yrs & >, im
Seqirus
Fluzone vacc, 3 yrs & >, im
Sanofi Pasteur
NDC
DRUG NAME
49281-0708-40 Fluzone Quadrivalent Intradermal 2015/2016 49281-0710-40 Fluzone Intradermal Quadrivalent 2016/2017 70461-0001-01 Fluad 2016/2017 49281-0113-25 Fluzone (Preservative Free) 33332-0015-01 Afluria (Preservative Free) 2015/2016 33332-0016-01 Afluria (Preservative Free) 2016/2017 58160-0883-52 Fluarix (Preservative Free) 2015/2016 66521-0118-02 Fluvirin (Preservative Free) 2015/2016 70461-0119-02 Fluvirin (Preservative Free) 2016/2017 49281-0396-15 Fluzone 2015/2016 62577-0614-01 Flucelvax 2015/2016 49281-0397-65 Fluzone High-Dose 2015/2016 49281-0399-65 Fluzone High-Dose 2016/2017 00005-1971-02 Prevnar - 13 00005-1971-04 Prevnar - 13 00005-1971-05 Prevnar - 13 66019-0302-10 FluMist Quadrivalent 2015/2016 66019-0303-10 Flumist Quadrivalent 2016/2017 42874-0015-10 Flublok 2015/2016 42874-0016-10 Flublok 2016/2017 70461-0200-01 Flucelvax Quadrivalent 2016/2017 49281-0515-25 Fluzone Quadrivalent (Preservative free) 2015/2016 49281-0516-25 Fluzone Quadrivalent (Preservative Free) 2016/2017 19515-0901-52 Flulaval Quadrivalent 2015/2016 19515-0908-52 Flulaval Quadrivalent (Preservative Free) 2016/2017 49281-0415-10 Fluzone Quadrivalent (Preservative free) 2015/2016 49281-0415-50 Fluzone Quadrivalent (Preservative free) 2015/2016 49281-0416-10 Fluzone Quadrivalent (Preservative Free) 2016/2017 49281-0416-50 Fluzone Quadrivalent (Preservative Free) 2016/2017 58160-0903-52 Fluarix Quadrivalent (Preservative free) 2015/2016 58160-0905-52 Fluarix Quadrivalent (Preservative Free) 2016/2017 49281-0623-15 Fluzone Quadrivalent 2015/2016 49281-0625-15 Fluzone Quadrivalent 2016/2017 19515-0898-11 Flulaval Quadrivalent 2015/2016 19515-0903-11 Flulaval Quadrivalent 2016/2017 49281-0623-15 Fluzone Quadrivalent 2015/2016 49281-0625-15 Fluzone Quadrivalent 2016/2017 00006-4739-00 Pneumovax 23 00006-4739-01 Pneumovax 23 00006-4837-02 Pneumovax 23 00006-4837-03 Pneumovax 23 00006-4943-00 Pneumovax 23 00006-4992-00 Recombivax Hb 58160-0821-11 Engerix-B 58160-0821-43 Engerix-B 58160-0821-46 Engerix-B 58160-0821-52 Engerix-B 00006-4094-02 Recombivax Hb 00006-4094-06 Recombivax Hb 00006-4094-09 Recombivax Hb 00006-4094-31 Recombivax Hb 00006-4995-00 Recombivax Hb 00006-4995-41 Recombivax Hb 58160-0820-11 Engerix-B Pediatric 58160-0820-46 Engerix-B Pediatric 00006-4094-06 Recombivax Hb 00006-4094-09 Recombivax Hb 00006-4981-00 Recombivax Hb 00006-4995-41 Recombivax Hb 58160-0820-11 Engerix-B Pediatric 58160-0820-46 Engerix-B Pediatric 58160-0820-52 Engerix-B Pediatric 00006-4094-02 Recombivax Hb 00006-4094-06 Recombivax Hb 00006-4094-09 Recombivax Hb 00006-4094-31 Recombivax Hb 00006-4995-00 Recombivax Hb 00006-4995-41 Recombivax Hb 58160-0821-11 Engerix-B 58160-0821-43 Engerix-B 58160-0821-46 Engerix-B 58160-0821-52 Engerix-B 00006-4992-00 Recombivax Hb 58160-0821-11 Engerix-B 58160-0821-43 Engerix-B 58160-0821-46 Engerix-B 58160-0821-52 Engerix-B 33332-0115-10 Afluria 2015/2016 33332-0116-10 Afluria 2016/2017 66521-0118-10 Fluvirin 2015/2016 70461-0119-10 Fluvirin 2016/2017 49281-0396-15 Fluzone 2015/2016
HCPCS PKG SIZE PKG QTY
BILL
BILL UNITS
DOSAGE
UNITS PKG
0.1 ML
0.1
10
1 10
0.1 ML
0.1
10
1 10
0.5 ML
0.5
10
1 10
0.25 ML
0.25
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.25 ML
5
1 20 20
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
1
1
1
0.5 ML
0.5
1
1
1
0.2 ML
0.2
10
1 10
0.2 ML
0.2
10
1 10
0.2 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.25 ML
0.25
10
1 10
0.25 ML
0.25
10
1 10
0.5 ML
0.5
1
1
1
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
0.25 ML
5
1 20 20
0.25 ML
5
1 20 20
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
0.5 ML
2.5
1
5
5
0.5 ML
0.5
1
1
1
0.5 ML
0.5
1
1
1
0.5 ML
0.5
10
1 10
0.5 ML
0.5
10
1 10
40 MCG
1
1
1
1
40 MCG
1
10 0.5
5
40 MCG
1
1 0.5 0.5
40 MCG
1
5 0.5 2.5
40 MCG
1
10 0.5
5
1 DOSE
1
10
1 10
1 DOSE
1
6
6
6
1 DOSE
1
6
6
6
1 DOSE
1
1
1
1
1 DOSE
1
1
1
1
1 DOSE
1
10
1 10
1 DOSE
0.5
10
1 10
1 DOSE
0.5
5
1
5
1 DOSE
1
6
1
6
1 DOSE
1
6
6
6
1 DOSE
0.5
10
1 10
1 DOSE
1
10
1 10
1 DOSE
0.5
10
1 10
1 DOSE
0.5
5
1
5
1 DOSE
0.5
10
1 10
1 EACH
1
10
1 10
1 DOSE
1
6
1
6
1 DOSE
1
6
1
6
1 DOSE
1
1
1
1
1 EACH
1
1
1
1
1 EACH
1
10
1 10
1 EACH
1
10
1 10
1 EACH
1
1
1
1
1 EACH
1
5
1
5
1 EACH
1
10
1 10
40 MCG
1
1
1
1
40 MCG
1
10 0.5
5
40 MCG
1
1 0.5 0.5
40 MCG
1
5 0.5 2.5
40 MCG
1
10 0.5
5
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
0.5 ML
5
1 10 10
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