Promethazine hcl injection
Products billed under this code include Phenergan, Promethazine HCl.
Payment limit per 50 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under this code include Phenergan, Promethazine HCl.
Payment limit per 50 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Phenergan | Hikma Pharmaceuticals USA Inc. | 00641-6082-25 | 13 | $42.133 |
| Phenergan | Hikma Pharmaceuticals USA Inc. | 00641-6083-25 | 25 | $81.025 |
| Phenergan | Hikma Pharmaceuticals USA Inc. | 00641-6084-25 | 13 | $42.133 |
| Phenergan | Hikma Pharmaceuticals USA Inc. | 00641-6085-25 | 25 | $81.025 |
| Promethazine HCl | Henry Schein Inc. | 00404-9940-01 | 1 | $3.241 |
| Promethazine HCl | Henry Schein Inc. | 00404-9941-01 | 1 | $3.241 |
| Promethazine HCl | Henry Schein Inc. | 00404-9942-01 | 1 | $3.241 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-0928-25 | 13 | $42.133 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-0929-25 | 25 | $81.025 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-0948-35 | 13 | $42.133 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-0949-35 | 25 | $81.025 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-0955-25 | 13 | $42.133 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-0956-25 | 25 | $81.025 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-1495-35 | 13 | $42.133 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-1496-35 | 25 | $81.025 |
| Promethazine HCl | Hikma Pharmaceuticals USA Inc. | 00641-6208-25 | 13 | $42.133 |
| Promethazine HCl | XGen Pharmaceuticals DJB, Inc. | 39822-5525-03 | 13 | $42.133 |
| Promethazine HCl | XGen Pharmaceuticals DJB, Inc. | 39822-5550-06 | 25 | $81.025 |
| Promethazine HCl | A-S Medication Solutions | 50090-0879-00 | 25 | $81.025 |
| Promethazine HCl | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1247-01 | 1 | $3.241 |
| Promethazine HCl | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1247-03 | 13 | $42.133 |
| Promethazine HCl | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1248-01 | 1 | $3.241 |
| Promethazine HCl | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1248-03 | 25 | $81.025 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $3.241 | −$0.398 | 50 MG | Promethazine hcl injection | v1, posted September 17, 2026 |
| 3Q26 | $3.639 | +$0.295 | 50 MG | Promethazine hcl injection | v1, posted September 15, 2026 |
| 2Q26 | $3.344 | −$0.627 | 50 MG | Promethazine hcl injection | v1, posted September 15, 2026 |
| 1Q26 | $3.971 | +$1.019 | 50 MG | Promethazine hcl injection | v1, posted September 15, 2026 |
| 4Q25 | $2.952 | +$0.085 | 50 MG | Promethazine hcl injection | v1, posted September 8, 2026 |
| 3Q25 | $2.867 | −$0.446 | 50 MG | Promethazine hcl injection | v1, posted March 10, 2026 |
| 2Q25 | $3.313 | −$0.256 | 50 MG | Promethazine hcl injection | v1, posted March 10, 2026 |
| 1Q25 | $3.569 | +$0.257 | 50 MG | Promethazine hcl injection | v1, posted December 19, 2025 |
| 4Q24 | $3.312 | −$0.26 | 50 MG | Promethazine hcl injection | v1, posted June 11, 2025 |
| 3Q24 | $3.572 | +$0.473 | 50 MG | Promethazine hcl injection | v1, posted June 11, 2025 |
| 2Q24 | $3.099 | −$0.491 | 50 MG | Promethazine hcl injection | v1, posted March 11, 2025 |
| 1Q24 | $3.59 | +$0.111 | 50 MG | Promethazine hcl injection | v1, posted December 19, 2024 |
| 4Q23 | $3.479 | +$0.332 | 50 MG | Promethazine hcl injection | v1, posted October 10, 2024 |
| 3Q23 | $3.147 | +$0.035 | 50 MG | Promethazine hcl injection | v1, posted June 5, 2024 |
| 2Q23 | $3.112 | −$0.104 | 50 MG | Promethazine hcl injection | v1, posted February 23, 2024 |
| 1Q23 | $3.216 | +$0.281 | 50 MG | Promethazine hcl injection | v1, posted December 6, 2023 |
| 4Q22 | $2.935 | +$0.154 | 50 MG | Promethazine hcl injection | v1, posted June 22, 2023 |
| 3Q22 | $2.781 | +$0.211 | 50 MG | Promethazine hcl injection | v1, posted June 9, 2023 |
| 2Q22 | $2.57 | +$0.206 | 50 MG | Promethazine hcl injection | v1, posted December 14, 2022 |
| 1Q22 | $2.364 | −$0.004 | 50 MG | Promethazine hcl injection | v1, posted June 8, 2022 |
| 4Q21 | $2.368 | +$0.097 | 50 MG | Promethazine hcl injection | v1, posted June 2, 2022 |
| 3Q21 | $2.271 | −$0.101 | 50 MG | Promethazine hcl injection | v1, posted June 2, 2022 |
| 2Q21 | $2.372 | +$0.057 | 50 MG | Promethazine hcl injection | v1, posted March 1, 2022 |
| 1Q21 | $2.315 | – | 50 MG | Promethazine hcl injection | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.