J0290

Code

J0290

Description

Injection, ampicillin sodium, 500 mg

CMS HCPCS quarterly update

• 00404-9803-99 Ampicillin Sodium, Henry Schein Inc.. Billable units per 11-digit NDC: 2.
• 00404-9816-99 Ampicillin Sodium, Henry Schein Inc.. Billable units per 11-digit NDC: 2.
• 00404-9818-99 Ampicillin Sodium, Henry Schein Inc.. Billable units per 11-digit NDC: 4.
• 00781-3402-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 5.
• 00781-3404-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 20.
• 00781-3407-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 10.
• 00781-3408-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 40.
• 00781-3409-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 200.
• 00781-3412-92 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 20.
• 00781-3413-92 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 40.
• 00781-9242-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 5.
• 00781-9261-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 20.
• 00781-9273-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 40.
• 00781-9402-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 5.
• 00781-9404-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 20.
• 00781-9407-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 10.
• 00781-9408-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 40.
• 00781-9409-95 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 200.
• 00781-9412-92 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 20.
• 00781-9413-92 Ampicillin Sodium, Sandoz Inc.. Billable units per 11-digit NDC: 40.
• 23155-0915-41 Ampicillin Sodium, Heritage Pharmaceuticals Inc.. Billable units per 11-digit NDC: 10.
• 23155-0916-41 Ampicillin Sodium, Heritage Pharmaceuticals Inc.. Billable units per 11-digit NDC: 20.
• 23155-0917-41 Ampicillin Sodium, Heritage Pharmaceuticals Inc.. Billable units per 11-digit NDC: 40.
• 25021-0134-10 Ampicillin Sodium, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 5.
• 25021-0135-10 Ampicillin Sodium, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 10.
• 25021-0136-10 Ampicillin Sodium, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 20.
• 25021-0137-20 Ampicillin Sodium, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 40.
• 25021-0197-99 Ampicillin Sodium, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 20.
• 44567-0100-10 Ampicillin Sodium, WG Critical Care, LLC. Billable units per 11-digit NDC: 5.
• 44567-0101-10 Ampicillin Sodium, WG Critical Care, LLC. Billable units per 11-digit NDC: 10.
• 44567-0102-10 Ampicillin Sodium, WG Critical Care, LLC. Billable units per 11-digit NDC: 20.
• 44567-0103-10 Ampicillin Sodium, WG Critical Care, LLC. Billable units per 11-digit NDC: 40.
• 44567-0104-01 Ampicillin Sodium, WG Critical Care, LLC. Billable units per 11-digit NDC: 20.
• 50090-4552-00 Ampicillin Sodium, A-S Medication Solutions. Billable units per 11-digit NDC: 4.
• 51662-1560-03 Ampicillin Sodium, HF Acquisition Co. LLC, DBA HealthFirst. Billable units per 11-digit NDC: 40.
• 51662-1595-03 Ampicillin Sodium, HF Acquisition Co. LLC, DBA HealthFirst. Billable units per 11-digit NDC: 5.
• 55150-0113-10 Ampicillin Sodium, Eugia US LLC. Billable units per 11-digit NDC: 20.
• 55150-0114-20 Ampicillin Sodium, Eugia US LLC. Billable units per 11-digit NDC: 40.
• 55150-0115-99 Ampicillin Sodium, Eugia US LLC. Billable units per 11-digit NDC: 200.
• 65219-0014-10 Ampicillin Sodium, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 5.
• 65219-0016-10 Ampicillin Sodium, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 10.
• 65219-0018-10 Ampicillin Sodium, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 20.
• 65219-0020-23 Ampicillin Sodium, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 40.
• 66794-0220-41 Ampicillin Sodium, Piramal Critical Care Inc. Billable units per 11-digit NDC: 5.
• 66794-0222-41 Ampicillin Sodium, Piramal Critical Care Inc. Billable units per 11-digit NDC: 20.
• 66794-0223-41 Ampicillin Sodium, Piramal Critical Care Inc. Billable units per 11-digit NDC: 40.
• 66794-0224-15 Ampicillin Sodium, Piramal Critical Care Inc. Billable units per 11-digit NDC: 20.
• 70860-0112-15 Ampicillin Sodium, Athenex Pharmaceutical Division, LLC. Billable units per 11-digit NDC: 5.
• 70860-0113-15 Ampicillin Sodium, Athenex Pharmaceutical Division, LLC. Billable units per 11-digit NDC: 10.
• 70860-0114-15 Ampicillin Sodium, Athenex Pharmaceutical Division, LLC. Billable units per 11-digit NDC: 20.
• 70860-0115-26 Ampicillin Sodium, Athenex Pharmaceutical Division, LLC. Billable units per 11-digit NDC: 40.
• 70860-0118-99 Ampicillin Sodium, Athenex Pharmaceutical Division, LLC. Billable units per 11-digit NDC: 20.
• 72485-0421-10 Ampicillin Sodium, Armas Pharmaceuticals Inc.. Billable units per 11-digit NDC: 20.
• 72485-0422-10 Ampicillin Sodium, Armas Pharmaceuticals Inc.. Billable units per 11-digit NDC: 40.
• 72485-0423-10 Ampicillin Sodium, Armas Pharmaceuticals Inc.. Billable units per 11-digit NDC: 20.
• 72572-0016-10 Ampicillin Sodium, Civica, Inc.. Billable units per 11-digit NDC: 20.
• 72572-0017-10 Ampicillin Sodium, Civica, Inc.. Billable units per 11-digit NDC: 40.
• 72572-0093-10 Ampicillin Sodium, Civica, Inc.. Billable units per 11-digit NDC: 20.
• 72572-0094-10 Ampicillin Sodium, Civica, Inc.. Billable units per 11-digit NDC: 40.
• 72603-0221-10 Ampicillin Sodium, Northstar RxLLC. Billable units per 11-digit NDC: 10.
• 72603-0363-10 Ampicillin Sodium, Northstar RxLLC. Billable units per 11-digit NDC: 20.
• 72603-0454-10 Ampicillin Sodium, Northstar RxLLC. Billable units per 11-digit NDC: 40.
• 72603-0578-01 Ampicillin Sodium, Northstar RxLLC. Billable units per 11-digit NDC: 20.
• 83634-0100-99 Ampicillin Sodium, Avenacy Inc.. Billable units per 11-digit NDC: 20.

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