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
Wisconsin
Hospital Address Code Price Last Updated
Aurora Lakeland Medical Center W3930 County Road Nn, Elkhorn Q0164 $7 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington Q0164 $7 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh Q0164 $7 [source] 4 years ago
Aurora Sheboygan Memorial Medical Center 2629 N 7Th St, Sheboygan Q0164 $8 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay Q0164 $9 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers Q0164 $9 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee Q0164 $9 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford Q0164 $10 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q0164 $10 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee Q0164 $11 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton Q0164 $11 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q0164 $12 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q0164 $15 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q0164 $20 [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 ยง180.