Code: Q0164

Description:
Description: 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
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
PROCHLORPER MAL 10 MG PO
PROCHLORPERAZINE MALEATE 10 MG TABLET
PROCHLORPERAZINE MALEATE 5 MG TABLET
PROCHLORPERAZINE 10MG UT
PROCHLORPERAZINE 5MG UT
PROCHLORPERAZINE MALEATE 5 MG TABLET PACKAGE PRICE
prochlorperazine 5 mg tablet 1 each BLIST PACK
prochlorperazine 5 mg tablet 100 each BLIST PACK
prochlorperazine 5 mg tablet 100 each Bottle
Related codes:
Code: Q0161
CHLORPROMAZINE 100 MG PO
Code: Q0162
ONDANSETRON 4 MG PO
Code: Q0163
DIPHENHYDRAMINE 50 MG PO
Code: Q0166
GRANISETRON 1 MG PO
Code: Q0167
DRONABINOL 2.5 MG PO
Code: Q0169
PROMETHAZINE 12.5 MG PO
State Average # Hospitals In Database
Connecticut (CT) $2 6
Massachusetts (MA) $2 10
Missouri (MO) $3 4
North Dakota (ND) $3 3
Nebraska (NE) $3 11
Iowa (IA) $3 3
Kansas (KS) $3 5
Maine (ME) $3 6
North Carolina (NC) $4 13
Vermont (VT) $5 2
District of Columbia (DC) $5 1
Minnesota (MN) $5 2
Utah (UT) $6 1
Idaho (ID) $7 5
Alabama (AL) $8 1
West Virginia (WV) $9 1
Wisconsin (WI) $10 14
Texas (TX) $10 12
Georgia (GA) $11 6
Oklahoma (OK) $12 1
Michigan (MI) $13 22
Nevada (NV) $26 11
Kentucky (KY) $31 2
Florida (FL) $40 55
South Carolina (SC) $40 5
Virginia (VA) $41 5
New Hampshire (NH) $48 7
Alaska (AK) $60 2
Louisiana (LA) $81 1
Pennsylvania (PA) $226 2
California (CA) $231 29
Indiana (IN) $1,505 8

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.