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
Michigan
Hospital Address Code Price Last Updated
Mclaren Lapeer Region 1375 N Main St, Lapeer Q0164 $1 [source] 4 years ago
Up Health System – Marquette 580 West College Avenue, Marquette Q0164 $2 [source] 4 years ago
Midmichigan Medical Center Gratiot 300 E Warwick Dr, Alma Q0164 $3 [source] 4 years ago
Beaumont - Farmington Hills 28050 Grand River Ave, Farmington Q0164 $3 [source] 4 years ago
Midmichigan Medical Center Clare , Clare Q0164 $4 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q0164 $7 [source] 4 years ago
Karmanos Cancer Institute 4100 John R St, Detroit Q0164 $14 [source] 4 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn Q0164 $15 [source] 4 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn Q0164 $15 [source] 4 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn Q0164 $15 [source] 4 years ago
Beaumont Wayne 33155 Annapolis St, Wayne Q0164 $25 [source] 4 years ago
Oakwood Healthcare Inc Beaumont Service Center, Q0164 $25 [source] 4 years ago
William Beaumont Hospital 5450 Fort St, Trenton Q0164 $42 [source] 4 years ago

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 §180.