Code: Q0169

Description:
Description: Promethazine hydrochloride, 12.5 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:
PROMETHAZINE 25 MG PO
PROMETHAZINE 12.5MG TAB OP CH
PROMETHAZINE 25MG TAB OP CH
PROMETHAZINE HCL 12.5MG ORAL
Promethazine 6.25 Mg 5 Ml Syrp
AMB PROMETHAZINE NDC -> 00603-5438-21 MCD
AMB PROMETHAZINE NDC -> 00603-5438-21
AMB PROMETHAZINE NDC -> 00591-5307-01 MCD
AMB PROMETHAZINE NDC -> 00591-5307-01
Related codes:
Code: Q0161
CHLORPROMAZINE 100 MG PO
Code: Q0162
ONDANSETRON 4 MG PO
Code: Q0163
DIPHENHYDRAMINE 50 MG PO
Code: Q0164
PROCHLORPER MAL 5 MG PO
Code: Q0166
GRANISETRON 1 MG PO
Code: Q0167
DRONABINOL 2.5 MG PO
State Average # Hospitals In Database
Missouri (MO) $2 8
Illinois (IL) $2 7
North Dakota (ND) $2 1
Kansas (KS) $3 5
North Carolina (NC) $3 23
District of Columbia (DC) $4 1
Oklahoma (OK) $4 1
Tennessee (TN) $5 1
Alabama (AL) $5 2
Texas (TX) $9 9
Michigan (MI) $10 32
Massachusetts (MA) $13 6
Idaho (ID) $15 3
Minnesota (MN) $16 2
Maryland (MD) $16 1
Connecticut (CT) $16 3
Nevada (NV) $17 9
New Hampshire (NH) $20 6
South Carolina (SC) $33 7
West Virginia (WV) $37 2
Georgia (GA) $37 7
Florida (FL) $50 69
Virginia (VA) $56 4
Pennsylvania (PA) $102 2
Kentucky (KY) $103 1
California (CA) $221 29
Indiana (IN) $6,012 2

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.