J1958

Code

J1958

Description

Injection, levetiracetam in sodium chloride, 5 mg

CMS HCPCS quarterly update

• 00143-9281-10 Levetiracetam, Hikma Pharmaceuticals USA Inc.. Billable units per 11-digit NDC: 1000.
• 00143-9282-10 Levetiracetam, Hikma Pharmaceuticals USA Inc.. Billable units per 11-digit NDC: 2000.
• 00143-9283-10 Levetiracetam, Hikma Pharmaceuticals USA Inc.. Billable units per 11-digit NDC: 3000.
• 00264-1009-90 Levetiracetam, B. Braun Medical Inc.. Billable units per 11-digit NDC: 4800.
• 00264-1509-90 Levetiracetam, B. Braun Medical Inc.. Billable units per 11-digit NDC: 7200.
• 00264-5009-90 Levetiracetam, B. Braun Medical Inc.. Billable units per 11-digit NDC: 2400.
• 14789-0110-05 Levetiracetam, Nexus Pharmaceuticals, LLC. Billable units per 11-digit NDC: 1000.
• 14789-0220-10 Levetiracetam, Nexus Pharmaceuticals, LLC. Billable units per 11-digit NDC: 2000.
• 14789-0330-15 Levetiracetam, Nexus Pharmaceuticals, LLC. Billable units per 11-digit NDC: 3000.
• 25021-0793-82 Levetiracetam, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 1000.
• 25021-0794-82 Levetiracetam, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 2000.
• 25021-0795-82 Levetiracetam, Sagent Pharmaceuticals. Billable units per 11-digit NDC: 3000.
• 36000-0352-40 Levetiracetam, Baxter Healthcare Corporation. Billable units per 11-digit NDC: 2400.
• 36000-0354-40 Levetiracetam, Baxter Healthcare Corporation. Billable units per 11-digit NDC: 7200.
• 36000-0356-40 Levetiracetam, Baxter Healthcare Corporation. Billable units per 11-digit NDC: 4800.
• 43598-0635-10 Levetiracetam, Dr. Reddy's Laboratories Inc.. Billable units per 11-digit NDC: 1000.
• 43598-0636-10 Levetiracetam, Dr. Reddy's Laboratories Inc.. Billable units per 11-digit NDC: 2000.
• 43598-0637-10 Levetiracetam, Dr. Reddy's Laboratories Inc.. Billable units per 11-digit NDC: 3000.
• 43598-0755-10 Levetiracetam, Dr. Reddy's Laboratories Inc.. Billable units per 11-digit NDC: 1000.
• 43598-0757-10 Levetiracetam, Dr. Reddy's Laboratories Inc.. Billable units per 11-digit NDC: 2000.
• 43598-0759-10 Levetiracetam, Dr. Reddy's Laboratories Inc.. Billable units per 11-digit NDC: 3000.
• 44567-0501-10 Levetiracetam, WG Critical Care, LLC. Billable units per 11-digit NDC: 1000.
• 44567-0501-90 Levetiracetam, WG Critical Care, LLC. Billable units per 11-digit NDC: 1000.
• 44567-0502-10 Levetiracetam, WG Critical Care, LLC. Billable units per 11-digit NDC: 2000.
• 44567-0503-10 Levetiracetam, WG Critical Care, LLC. Billable units per 11-digit NDC: 3000.
• 55150-0246-47 Levetiracetam, Eugia US LLC. Billable units per 11-digit NDC: 1000.
• 55150-0247-47 Levetiracetam, Eugia US LLC. Billable units per 11-digit NDC: 2000.
• 55150-0248-47 Levetiracetam, Eugia US LLC. Billable units per 11-digit NDC: 3000.
• 65145-0173-10 Levetiracetam, Caplin Steriles USA Inc.. Billable units per 11-digit NDC: 1000.
• 65145-0174-10 Levetiracetam, Caplin Steriles USA Inc.. Billable units per 11-digit NDC: 2000.
• 65145-0175-10 Levetiracetam, Caplin Steriles USA Inc.. Billable units per 11-digit NDC: 3000.
• 65219-0042-71 Levetiracetam, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 2400.
• 65219-0044-71 Levetiracetam, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 4800.
• 65219-0046-71 Levetiracetam, FreseniUS Kabi USA, LLC. Billable units per 11-digit NDC: 7200.
• 67457-0255-10 Levetiracetam, Mylan Institutional LLC. Billable units per 11-digit NDC: 1000.
• 67457-0265-10 Levetiracetam, Mylan Institutional LLC. Billable units per 11-digit NDC: 2000.
• 67457-0266-10 Levetiracetam, Mylan Institutional LLC. Billable units per 11-digit NDC: 3000.
• 70069-0845-10 Levetiracetam, Somerset Pharma, LLC. Billable units per 11-digit NDC: 1000.
• 70069-0846-10 Levetiracetam, Somerset Pharma, LLC. Billable units per 11-digit NDC: 2000.
• 70069-0847-10 Levetiracetam, Somerset Pharma, LLC. Billable units per 11-digit NDC: 3000.

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