A9575

Code

A9575

Description

Injection, gadoterate meglumine, 0.1 ml

CMS HCPCS quarterly update

• 00407-2943-01 Clariscan, GE Healthcare Inc.. Billable units per 11-digit NDC: 1000.
• 00407-2943-02 Clariscan, GE Healthcare Inc.. Billable units per 11-digit NDC: 1500.
• 00407-2943-05 Clariscan, GE Healthcare Inc.. Billable units per 11-digit NDC: 2000.
• 00407-2943-06 Gadoterate Meglumine, GE Healthcare Inc.. Billable units per 11-digit NDC: 500.
• 00407-2943-12 Gadoterate Meglumine, GE Healthcare Inc.. Billable units per 11-digit NDC: 1000.
• 00407-2943-17 Gadoterate Meglumine, GE Healthcare Inc.. Billable units per 11-digit NDC: 1500.
• 00407-2943-22 Gadoterate Meglumine, GE Healthcare Inc.. Billable units per 11-digit NDC: 2000.
• 00407-2943-70 Gadoterate Meglumine, GE Healthcare Inc.. Billable units per 11-digit NDC: 10000.
• 65219-0080-05 Gadoterate Meglumine, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 500.
• 65219-0082-10 Gadoterate Meglumine, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 1000.
• 65219-0084-15 Gadoterate Meglumine, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 1500.
• 65219-0086-20 Gadoterate Meglumine, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 2000.
• 65219-0088-50 Gadoterate Meglumine, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 6000.
• 67684-2000-00 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 500.
• 67684-2000-01 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 1000.
• 67684-2000-05 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 500.
• 67684-2000-06 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 750.
• 67684-2001-00 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 500.
• 67684-2001-01 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 1000.
• 67684-2001-02 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 1500.
• 67684-2001-03 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 2000.
• 67684-2001-04 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 6000.
• 67684-3001-01 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 1000.
• 67684-3001-02 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 1500.
• 67684-3001-03 Dotarem, Guerbet LLC. Billable units per 11-digit NDC: 2000.
• 70436-0123-31 Gadoterate Meglumine, Slate Run Pharmaceuticals. Billable units per 11-digit NDC: 500.
• 70436-0123-33 Gadoterate Meglumine, Slate Run Pharmaceuticals. Billable units per 11-digit NDC: 1000.
• 70436-0123-34 Gadoterate Meglumine, Slate Run Pharmaceuticals. Billable units per 11-digit NDC: 1500.
• 70436-0123-35 Gadoterate Meglumine, Slate Run Pharmaceuticals. Billable units per 11-digit NDC: 2000.
• 70436-0123-56 Gadoterate Meglumine, Slate Run Pharmaceuticals. Billable units per 11-digit NDC: 6000.

Source: CMS ASP NDC-HCPCS crosswalk, effective October 1, 2026 through December 31, 2026.