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ALL MEDICAL CODES IN CATEGORY Non-Medicare Drug Codes

2025 HCPCS code S0175

Flutamide, oral, 125 mg.

2025 HCPCS code S0017

Injection of aminocaproic acid, 5 grams.

2025 HCPCS code S0023

Injection, cimetidine hydrochloride, 300 mg

2025 HCPCS code S0174

Dolasetron mesylate, oral, 50 mg. Used for circumstances falling under the Medicare statute (Use Q0180 for Medicare).

2025 HCPCS code S0191

Supply of 200 mcg of oral misoprostol; not reportable to Medicare.

2025 HCPCS code S0177

Supply of 50 mg of oral levamisole hydrochloride.

2025 HCPCS code S0178

Supply of 10 mg of oral lomustine.

2025 HCPCS code S0170

Supply of oral anastrozole, 1 mg.

2025 HCPCS code S0169

Supply of 0.25 mcg of calcitriol.

2025 HCPCS code S0013

Esketamine 1 mg nasal spray for treatment-resistant depression in adults, used with an oral antidepressant.

2025 HCPCS code S0078

Supply of 750 mg of injectable fosphenytoin sodium.

2025 HCPCS code S0142

Colistimethate sodium inhalation solution, administered via DME, concentrated form, per mg.

2025 HCPCS code S0182

Supply of 50 mg of oral procarbazine hydrochloride.

2025 HCPCS code S0117

Supply of 5 grams of topical tretinoin.

2025 HCPCS code S0190

Mifepristone, oral, 200 mg

2025 HCPCS code S0104

Zidovudine 100 mg oral.

2025 HCPCS code S0034

Injectable ofloxacin, 400 mg

2025 HCPCS code S0108

Mercaptopurine, oral, 50 mg

2025 HCPCS code S0106

Bupropion HCL sustained release tablet, 150 mg, per bottle of 60 tablets.

2025 HCPCS code S0021

Injection of cefoperazone sodium, 1 gram.

2025 HCPCS code S0148

Injection, pegylated interferon alfa-2b, 10 mcg.

2025 HCPCS code S0145

Injection, pegylated interferon alfa-2a, 180 mcg per ml.

2025 HCPCS code S0176

Hydroxyurea, oral, 500 mg

2025 HCPCS code S0194

Supply of vitamin supplement, oral, 100 capsules; not reimbursable by Medicare.

2025 HCPCS code S0139

Supply of 10 mg of minoxidil.

2025 HCPCS code S0074

Supply of 500 mg injectable cefotetan disodium.

2025 HCPCS code S0032

Injectable nafcillin sodium, 2 grams.

2025 HCPCS code S0160

Supply of 5 mg of dextroamphetamine sulfate.

2025 HCPCS code S0119

Supply of 4 mg ondansetron orally.

2025 HCPCS code S0093

Supply of a 500 mg injection of morphine sulfate as a loading dose for infusion pump administration.

2025 HCPCS code S0138

Supply of 5 mg of finasteride for the treatment of benign prostatic hyperplasia (BPH).

2025 HCPCS code S0014

Supply of tacrine hydrochloride, 10 mg.

2025 HCPCS code S0157

Supply of 0.5 grams of becaplermin gel 0.01%.

2025 HCPCS code S0088

Supply of 100 mg of imatinib.

2025 HCPCS code S0092

Injectable hydromorphone hydrochloride (250 mg loading dose for infusion pump).

2025 HCPCS code S0189

Testosterone pellet, 75 mg; for subcutaneous implantation to treat testosterone deficiency.

2025 HCPCS code S0109

Supply of 5 mg of oral methadone.

2025 HCPCS code S0187

Tamoxifen citrate (10mg) oral administration; not reportable to Medicare.

2025 HCPCS code S0132

Ganirelix Acetate, 250 mcg injection

2025 HCPCS code S0040

Supply of 3.1 grams of injectable ticarcillin disodium and clavulanate potassium.

2025 HCPCS code S0155

Supply of 50 mL sterile dilutant for epoprostenol.

2025 HCPCS code S0091

Supply of granisetron hydrochloride, 1 mg.

2025 HCPCS code S0140

HCPCS code S0140 represents the supply of 200 mg of saquinavir, an antiviral medication used to treat HIV-1 infection.

2025 HCPCS code S0080

Supply of pentamidine isethionate; one unit represents 300 mg.

2025 HCPCS code S0028

Injectable famotidine, 20 mg supply.

2025 HCPCS code S0164

Supply of 40 mg injectable pantoprazole sodium.

2025 HCPCS code S0179

Supply of 20 mg oral megestrol acetate.

2025 HCPCS code S0183

Supply of 5 mg of oral prochlorperazine maleate; not reimbursable by Medicare.

2025 HCPCS code S0156

Supply of 25 mg of exemestane.

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