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How to bill 2 NDCs of the same drug on CMS 1500?

jdeleon

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In general, if I need to bill for 2 NDCs of the same drug on one claim form, where would both NDCs go? Both in Box 19? Both in Box 24a? (different lines). Example- an injection comes in a 100 mg vial and a 200 mg vial and the patient was administered 280 mg. One vial of each were used. How would I represent this on a claim form?
 
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