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J2810 - HCPCS Level II | Verity

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HCPCS Level IIdrugActive

J2810

Inj theophylline per 40 mg

BETOS: O1E

Effective: 1997-01-01

Description

Injection, theophylline, per 40 mg

Drug Products

FDA-registered drug products mapped to this HCPCS code

DEXTROSE/THEOPHYLLINE (EXCEL) 5%-80 MG/100 ML

NDC: 00264-9554-10IV

Billing: ML

THEOPHYLLINE IN DEXTROSE (USP,250MLX24) 5%-320 MG/100 ML

NDC: 00409-7705-62IV

Billing: ML

THEOPHYLLINE ANHYDROUS (USP)

NDC: 38779-1816-05

Billing: GM

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Medicare Part B Drug Pricing

ASP-Based Payment

This drug code is paid under Medicare Part B using the Average Sales Price (ASP) + 6% methodology.

ASP pricing data not currently available for this code.

Coverage Policies

No coverage policies currently reference this code

This code is not currently listed in any LCD or NCD coverage policies in our database.

About HCPCS Level II

Healthcare Common Procedure Coding System Level II codes for supplies, equipment, and non-physician services

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