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
California
Hospital Address Code Price Last Updated
Temecula Valley Hospital 31700 Temecula Parkway, Temecula Q0169 $2 [source] 4 years ago
Corona Regional Medical Center 800 S. Main Street, Corona Q0169 $2 [source] 4 years ago
Palmdale Regional Medical Center 38600 Medical Center Drive, Palmdale Q0169 $3 [source] 4 years ago
Alta Bates Summit Medical Center - Alta Bates Campus 2450 Ashby Ave, Berkeley Q0169 $9 [source] 4 years ago
Mills-Peninsula Medical Center 1501 Trousdale Dr, Burlingame Q0169 $10 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond Q0169 $12 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco Q0169 $12 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills Q0169 $12 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento Q0169 $12 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch Q0169 $12 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto Q0169 $12 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville Q0169 $12 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro Q0169 $12 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek Q0169 $12 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara Q0169 $12 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento Q0169 $12 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon Q0169 $12 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City Q0169 $12 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo Q0169 $12 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael Q0169 $12 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco Q0169 $12 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno Q0169 $12 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville Q0169 $12 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose Q0169 $12 [source] 4 years ago
Regional Medical Center Of San Jose 225 North Jackson Ave, San Jose Q0169 $57 [source] 4 years ago
Rancho Springs Medical Center 25500 Medical Center Drive, Murrieta Q0169 $3,020 [source] 4 years ago
Inland Valley Medical Center 36485 Inland Valley Drive, Wildomar Q0169 $3,020 [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.