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
Michigan
Hospital Address Code Price Last Updated
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q0169 $2 [source] 4 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q0169 $2 [source] 4 years ago
Midmichigan Medical Center Gratiot 300 E Warwick Dr, Alma Q0169 $3 [source] 4 years ago
Beaumont - Farmington Hills 28050 Grand River Ave, Farmington Q0169 $3 [source] 4 years ago
Midmichigan Medical Center Gladwin , Gladwin Q0169 $4 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q0169 $6 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q0169 $6 [source] 4 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy Q0169 $6 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre, Troy Q0169 $6 [source] 4 years ago
Up Health System – Marquette 580 West College Avenue, Marquette Q0169 $7 [source] 4 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn Q0169 $25 [source] 4 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn Q0169 $25 [source] 4 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn Q0169 $25 [source] 4 years ago
Beaumont Wayne 33155 Annapolis St, Wayne Q0169 $26 [source] 4 years ago
Oakwood Healthcare Inc Beaumont Service Center, Q0169 $26 [source] 4 years ago
William Beaumont Hospital 5450 Fort St, Trenton Q0169 $30 [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.