The following approved medical supplies manufacturer billing codes are to be used on the Pharmacy

Claim Form (30-1) and on the CMS-1500 claim to bill medical supplies. The listed codes represent

manufacturers recognized as principal labelers of their products.

Principal LabelerThe principal labeler is the specific supplier of a product under whose brand, trademark, trade name, or other trade symbol, a medical supply is placed in its final, commercially available package. A final, commercially available package is the originally processed and labeled package that requires no further processing or labeling to be lawfully sold to a provider of service. The principal labeler of a product does not include any person who affixes supplemental labeling to an existing final, commercially available package of a medical supply.

CodeManufacturerCodeManufacturer

ABAbbott Lab.

MEAbbott Laboratories-Medisense

Products (formerly known as Medisense, Inc.)

9924G +

9924P +

9924U +

9924V +

9924X +

9926J +

9926N +

9926T +

9999A +

AWAcco (The Absorbent Cotton Co.)

CWAcme-United

ADAdria

9AAimsco Delta Hi-Tech, Inc.

QKAkorn, Inc.

3JAllegiance #

AEAllergan, Inc.

HGAllman Products

KDAllstate Medical Products, Inc.

1EAmerican Healthcare Products
Incorporated

9911A +

9911B +

3KAltex Products, Inc.

AMAmerican Hosp. Supply Corp.

QMAmerican Sun Mark Co.

AFAmerican White Cross Lab.

1BAmericare

AJAnpak Drug Co.

#Effective November 1, 2008

***Effective December 1, 2008

Apogee Medical, Inc. (now
owned by Hollister Inc. Use
code HS to bill for all
Apogee-branded products) ***

4AApothecus Pharmaceutical

Corporation

AHArbrook, Inc.

2EArgentum Medical, LLC

JGAssociated Hygienic Products

ATAstra Tech

AIAtlantic Surgical Co., Inc.

BABard, C.R.

EKBard-Parker

NABarre-National Inc.

ASBayer Corporation, Diagnostics Division (formerly Ames Company, and Miles, Diagnostic Division)

9924A +

9924D +

9924E +

9924F +

9924G +

9924H +

9924J +

9924K +

9924N +

9924P +

9924R +

9924S +

9924T +

9924U +

9924V +

9924W +

9999A

CodeManufacturerCodeManufacturer

TRBaxter Healthcare Corporation

BDBecton, Dickinson, and Co.

HCBertek Pharmaceuticals, Inc.

(formerly Dow B. Hickam, Inc.)

9986C + **

9999A +

B2Bevan Medical, Inc.

DLBiersdorf, Inc. – Duke
Laboratories

ODBioCore Medical Technologies, Inc.

FWBio-Dynamics

BXBioline Labs, Inc.

3HBioDerm, Inc.

9912S + ***

9992H + ***

9999C + ***

BRBird Corporation

3FBivona #

BCBlanchard Ostomy Products

AKBocan Drug Company

4BBoston Medical Products #

B3Bower Companies

BTBreath Easy (See Pascal Corp.)

CXBrite Life Laboratories

OIBritish American Medical, Inc.
(See Chronimed, Inc.)

BWBurroughs-Wellcome & Co.

VTCalgon Vestal Laboratories

EBCal-Med Disposables, Inc.

CNCan-Am Care Corp.

2NCardinal

**Effective October 1, 2008

#Effective November 1, 2008

***Effective December 1, 2008

XCCare-Tech Laboratories

C2Carrington Laboratories, Inc.

C6Carter-Wallace, Inc.

CQCascade Medical, Inc.

JLCatalina Biomedical Corporation

CECenci, H.R. Laboratories, Inc.

CJCenter Laboratories

OIChronimed, Inc.

(formerly known as Supreme Medical and/or British American

Medical, Inc.)

CFC.M.C. – Consolidated Midland

Corp.

CVCoast Clinical Co.

CGColgate-Palmolive Co.

NRColoplast Corporation

(formerly Mentor)

9943N + ***

JNColoplast Inc.

CAConcord Labs

7AConMed Corporation

LTControl Products

SQConvatec

(formerly Squibb, E.R.

and Sons, Inc.)

4CCovidien **

3CCure Medical, LLC

CUCutter Biological Miles Inc.,

Pharm Div.

CDCymed, Inc.

CodeManufacturerCodeManufacturer

2YDale Medical Products #

ZFDansac Ostomy Products

DADavol, Inc.

DEDean Rubber Mfg. Co.

DDDennison Manufacturing Co.

DPDepree Company

DHDepuy

5SDerma Sciences **

YJDeRoyal Industries, Inc.

DGDeseret Medical Co., Inc.

DSDe Vilbiss Company

EQDMI (Duro-Med Industries, Inc.)

DXDow Corning

ZYEagle Health Care

2AEastman Medical Products, Inc.

FOE. Fougera & Co., Div. of
Altana Inc.

LYEli Lilly and Company

EIEisele & Co., Inc.

ESElkins-Sinn, Inc.

EMEmko

EHExcel International, Inc.

1CExu-Dry Wound Care
Products, Inc.

FDFerndale Laboratories, Inc.

FHFerris Mfg. Corp.

FSFisons Corporation

GQGainor Medical

**Effective October 1, 2008

#Effective November 1, 2008

GNGeneral Bandages, Inc.

GTGentec Hospital Supply

GFGerber Family Health Care

FBGeri-Care Products

TIG. Hirsch and Company, Inc.

GOGiovano Inc.

GLGlenwood Laboratories

1DGlenwood LLC

2GGlobal Protection Corporation

9914A +

2DGo Medical (USA) Inc.

JBGood Neighbor Pharmacy, Co.

W8Goodway USA

GHGraham-Field Surgical Co., Inc.

HLHalsey Drug Co., Inc. – Blue Cross

HNHankscraft Company

HKHardwood Products Co. (Puritan)

2QHartmann-Conco, Inc.

SRHealthCall Corporation

XZHealthpoint Medical

HVHealth Tec., Inc.

HDHedeco

HRHolland-Rantos Company

HSHollister, Inc.

HOHollister-Stier Miles Inc.,

Pharm. Div.

CodeManufacturerCodeManufacturer

FXHome Diagnostics, Inc.

HUHudson Pharmaceutical Corp.

VSHumanicare International, Inc.

VUHygeia Products, Inc.

HJHY-Tape Surgical Corp.

I2ICD Industries, Inc.

IAImed

4DIndependence Medical #

3EIn-Health Technologies #

ITIntermed Associates, Inc.

IDInterstate Drug Exchange, The

INInvenex Pharmaceutical

JJJohnson & Johnson

JOJones-Zylon, Inc.

JPJung Products

PBKabi Pharmacia

KAKay’s Ostomy Center

KZKaz Incorporation

KEKendall Company, The

KGKendall-Futuro Company, The

MGKendall-McGaw Inc.

KWKenwood Laboratories, Inc.

KIKimberly-Clark Corporation

**Effective October 1, 2008

#Effective November 1, 2008

****Effective February 1, 2009

1MKimberly-Clark Corporation (formerly Ballard Medical Products Corp.)

9930A +

9930E +

9981E +

9981F +

9981H + ****

9981J +

9981K +

9999A +

KJKleinert’s

ZMKloz-Ez

LALadco Laboratories, Inc.

3LLauder Enterprises #

4LLeading Edge Innovations, Inc. **

LMLemmon Pharmacal Co.

LJLic Hygiene

LVLifescan, Inc.

1LLine One Laboratories

2ULohmann & Rauscher

LGLongs Drug Store

LLLyne Laboratories

ZXMPM Medical, Inc.

KBMajor Pharmaceutical Corp.

MAMallinckrodt Laboratories

5AMallinckrodt Medical, Inc.

CodeManufacturerCodeManufacturer

MRMarion Laboratories

LCMarion Merrell Dow, Inc.

NEMark-Clark Products

MLMarlen Mfg. & Development Co.

MFMarsan Mfg. & Co.

NHMarshall Pharmacal Corp.

M2Mason Distributors, Inc.

MXMason Laboratories, Inc.

MKMcKesson

MJMead Johnson Laboratories

MOMedi, Inc.

KXMedical Disposable Company, Inc.

NCMedical Disposables Co.

LHMedical Marketing Group

4MMediCath LLC

XQMedicore

ZHMedline Industries, Inc.

GKMedlon, Inc.

YHMenlo Care, Inc.

MWMilex Products

MM3M Minnesota Mining & Mfg. Co.

MZMoore, H.L., Drug Exchange

ZXMPM Medical

NGMurray Salk, Inc.

NVNational Vitamin Co.

NXNeotech Product, Inc.

NINilodor

NONorthern Electric

EANorwich-Eaton Pharmaceuticals

NKNovo Nordish Pharmaceutical Inc.

NUNu-Hope Laboratories

N6Nutraloric

EROTC Professional Appliances

OTOrtho Pharmaceutical Corp.

OLOstolite, Inc.

O8Owen Mumford

PZPaddock

P2Palco Laboratories

X3Palex Medical, Inc.

PQPaper-Pak Prod.

PKParmed, Pharmaceuticals Inc.

QNParthenon Co.

BTPascal Corporation

TFPayless Drug Stores, N.W.

PHPenta Products, Inc.

PCPerma-Type Co., Inc.

QFPerry Products

POPettibone Laboratories, Inc.

WSPharmaceutical Basics, Inc.

QDPharmaderm, Div. of Altana, Inc.

IZPolymar Technology International

CodeManufacturerCodeManufacturer

QYPosey, J.T.

VHPremium Plastics, Inc.

TJPrinciple Business Enterprises, Inc.

PWProctor & Gamble

8AProCyte Corporation

JDProfessional Convalescent Products

GZProfessional Medical Products

QAProfex Professional Specialties Co.

PUPurdue Frederick Company

PYPurepac Pharm. Co., Div.

QUQualitest Products, Inc.

RJRalco Mfg. Co.

4RReach Global Industries, Inc. **

JERepublic Drug Company

RXRexall Drug Company

RNRichards Pharmaceutical Co.

RORobins, A.H. Company, Inc.

OVRoche Diagnostics Corp. (formerly

known as Boehringer Mannheim Diagnostics)

9924F +

9924G +

9924K +

9924N +

9924P +

9924R +

9924S +

9924U +

9924V +

9924W +

9924X +

9999A +

**Effective October 1, 2008

#Effective November 1, 2008

***Effective December 1, 2008

QORochester Medical Corp.

9912R + ***

9914J + ***

9914K + ***

9914L + ***

9914M + ***

9959N + ***

9992H + ***

9993N + ***

9999A ***

RFRondex Laboratories

RSRoss Laboratories

RURugby Laboratories

RYRusch

DYSandoz Consumer Corporation

SXSav-On Drugs, Inc.

S7SCA Mölnlycke (formerly known
as Scott Paper Company
and/or Scott Health Care)

SCSchering Corporation

SJSchmid Laboratories, Inc.

SOScholl, Inc.

SGSearle, G.D. & Co

4PSecure Personal Care Products, LLC **

1SShamrock Marketing Company, Inc.

9911A +

9911B +

SFSheraton Laboratories, Inc.

SWSherwood Medical Industries, Inc.

OSShields Ostomy

3TShiley #

2XSims Portex #

CodeManufacturerCodeManufacturer

UTSmith and Nephew, Inc.

9912B +

9912C +

9912E + ***

9912F + ***

9912R + ***

9912S + ***

9913J +

9913P +

9913R +

9913S +

9913T +

9913W +

9915L +

9915Y +

9919J +

9919P +

9919R +

9919S +

9919T +

9919W +

9919Y +

9943F +

9943H +

9948L + **

9950E + **

9950J + **

9950K + **

9950M + **

9950N + **

9950R + **

9950S + **

9950T + **

9950W + **

9950Y + **

9956A +

9959M +

UTSmith and Nephew, Inc.

9959N +

9979B +

9979C +

9979D +

9979E +

9979F +

9979H +

9979J +

9979K +

9979L +

9979M +

9979N +

9979P +

9979R +

9979S +

9979T +

9979W +

9979Y +

9980A +

9980B +

9980C +

9980D +

9980E +

9980F +

9980H +

9980J +

9980K +

9980L +

9980M +

9980N +

9980P +

mc sup man cd

1

**Effective October 1, 2008

***Effective December 1, 2008

2 – Medical Supplies: Manufacturer Billing Codes

June 2001

mc sup man cd

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CodeManufacturerCodeManufacturer

2 – Medical Supplies: Manufacturer Billing Codes

June 2001

mc sup man cd

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UTSmith and Nephew, Inc. (continued)

9980R +

9980U +

9980W +

9980Y +

9981A +

9981B +

9981C +

9981D +

9981E +

9981F +

9981H + ****

9981J +

9981K + ****

9981M +

9981N +

9981T +

9985P + **

9985R + **

9985S + **

9985T + **

9985W + **

9985Y + **

9986A + **

9986C + **

9987B + **

9992E + ***

9992F + ***

9992G + ***

9992H + ***

9992J + ***

9992K + ***

9999A + ***

YNSolo Pak Laboratories

2VSouthwest Technologies, Inc.

3SSpectrum Medical #

TBStandard Process Labs

SNStanlabs, Inc.

3ASunbeam/Hankscraft

JFSunmark Home Health Care Co.

SLSween Corp.

W5Swiss-American Products, Inc

TSTelesis Research Group

TLTerumo Medical Corporation

TEThames Pharmacal

2TTheraSense, Inc.

9924G +

9924N +

9924U +

TYThrifty Drug Stores Co.

TMT.M.T.R. Corp.

TTTorbot Company

UFU.C.S.F.

HCUDL Laboratories/Mylan/Bertek

1HUG Healthcare (USA) Inc.

9911B +

ULUlmer Pharmacal Co.

UGUlster Scientific, Inc.

3UUltiMed, Inc

9926A +

9926H +

9926J +

9926K +

9926M +

9926N +

9926P +

9926T +

UNUnited Pharmaceuticals, Inc.

2 – Medical Supplies: Manufacturer Billing Codes

June 2001

mc sup man cd

1

**Effective October 1, 2008

#Effective November 1, 2008

***Effective December 1, 2008

****Effective February 1, 2009

2 – Medical Supplies: Manufacturer Billing Codes

June 2001

mc sup man cd

1

CodeManufacturerCodeManufacturer

2 – Medical Supplies: Manufacturer Billing Codes

June 2001

mc sup man cd

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UDUniversal

UCUrocare Products, Inc.

4UUroConcepts **

XUUrosurge Medical Supplies, Inc.

VAValu-Rite

VNVangard Laboratory

VEVeratex

VRVPI Ostomy

WGWalgreen Co.

WJWe Care Corporation

3WWelcon Medical #

WDWest Coast Labs, Inc.

WPWeyerhauser Company

WFWhitehall Labs

WHWhitestone Products Corp.

WIWhiteworth, Inc.

WNWinthrop Pharmaceuticals

X6Wisconsin Pharmacal Company

WOWolins Pharmacal Corp.

2JWound Care Concepts, Inc. dba

Gentell

2WWound Care Innovations, LLC

FCWyant Health Care

(formerly known as

Hosposable Products, Inc.)

AYWyeth-Ayerst

WYWyeth Laboratories

YOYoungs Drug Products Corp.

ZPZellerbach Paper Co.

2ZZevex Incorporated

9930A +

9999A +

ZZUnlisted Manufacturer – Attach to claim form a photocopy of page from manufacturer’s catalog or standard reference source showing the wholesale price of the medical supply furnished

2 – Medical Supplies: Manufacturer Billing Codes

June 2001

mc sup man cd

1

**Effective October 1, 2008

#Effective November 1, 2008

2 – Medical Supplies: Manufacturer Billing Codes

June 2001