Default Fee Schedules Part 4

Default Fee Schedules Part 4

CodePriceTypeDescription
G96590HCPCS / CPT®>85Y NO HX COLO CA/RSN SCOPE
G96600HCPCS / CPT®DOC MED RSN SCOPE PT >85Y
G96610HCPCS / CPT®>85Y SCOPE OTHR RSN
G96620HCPCS / CPT®PRIOR DX/ACTIVE CLIN ASCVD
G96630HCPCS / CPT®FAST/DIR LDL = 190 MG/DL
G96640HCPCS / CPT®TAKING STATIN OR REC’D ORDER
G96650HCPCS / CPT®NO STATIN/NO ORDER STATIN
G96660HCPCS / CPT®FAS/DIR LDL 70-189MG/DL MST
G96740HCPCS / CPT®PT W/CLIN ASCVD DX
G96750HCPCS / CPT®PT W/FAST/DIR LAB LDL-C >190
G96760HCPCS / CPT®40-75Y W/TYPE 1/2 W/LDL-C RS
G96780HCPCS / CPT®ONCOLOGY CARE MODEL SERVICE
G96790HCPCS / CPT®ACUTE CARE PNEUMONIA
G96800HCPCS / CPT®ACUTE CARE CONGESTIVE HEART
G96810HCPCS / CPT®ACUTE CARE CHRONIC OBSTRUCT
G96820HCPCS / CPT®ACUTE CARE SKIN INFECTION
G96830HCPCS / CPT®ACUTE CARE FLUID OR ELECTROL
G96840HCPCS / CPT®ACUTE CARE URINARY TRACT INF
G96850HCPCS / CPT®ACUTE NURSING FACILITY CARE
G96860HCPCS / CPT®NURSING FACILITY CONFERENCE
G96870HCPCS / CPT®HOSPICE ANYTIME MSMT PER
G96880HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G96890HCPCS / CPT®INPT ELECT CAROTID INTERVENT
G96900HCPCS / CPT®PT REC HOSPICE DUR MSMT PER
G96910HCPCS / CPT®PT HOSP DUR MSMT PERIOD
G96920HCPCS / CPT®HOSP RECD BY PT DUR MSMT PER
G96930HCPCS / CPT®PT USE HOSP DURING MSMT PER
G96940HCPCS / CPT®HOSP SRV USED PT IN MSMT PER
G96950HCPCS / CPT®LONG ACT INHAL BRONCHDIL PRE
G96960HCPCS / CPT®MED RSN NO PRESC BRONCHDIL
G96970HCPCS / CPT®PT RSN NO PRESC BRONCHDIL
G96980HCPCS / CPT®SYS RSN NO PRESC BRONCHDIL
G96990HCPCS / CPT®LONG INHAL BRONCHDIL NO PRES
G97000HCPCS / CPT®PT IS W/HOSP DURING MSMT PER
G97010HCPCS / CPT®CHILD ANBX 30 PRIOR DX ESTAB
G97020HCPCS / CPT®PT USE HOSP DURING MSMT PER
G97030HCPCS / CPT®CHILD ANBX 30 PRIOR DX PHARY
G97040HCPCS / CPT®AJCC BR CA STG I: T1 MIC/T1A
G97050HCPCS / CPT®AJCC BR CA STG IB
G97060HCPCS / CPT®LOW RECUR PROST CA
G97070HCPCS / CPT®PT HAD HOSP DUR MSMT PER
G97080HCPCS / CPT®BILAT MAST/HX BI /UNILAT MAS
G97090HCPCS / CPT®HOSP SRV USED PT IN MSMT PER
G97100HCPCS / CPT®PT PROV HOSP SRV MSMT PER
G97110HCPCS / CPT®PT HX TOT COL OR COLON CA
G97120HCPCS / CPT®DOC MED RSN PRESC ANBX
G97130HCPCS / CPT®PT USE HOSP DURING MSMT PER
G97140HCPCS / CPT®PT IS W/HOSP DURING MSMT PER
G97150HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G97160HCPCS / CPT®BMI NOT NORM, NO FOLLOW, DOC
G97170HCPCS / CPT®DOC DX DEPR/DX BIPOL, NO SCR
G97180HCPCS / CPT®HOSPICE ANYTIME MSMT PER
G97190HCPCS / CPT®PT NOT AMBUL/IMMOB/WC
G97200HCPCS / CPT®HOSPICE ANYTIME MSMT PER
G97210HCPCS / CPT®PT NOT AMBUL/IMMOB/WC
G97220HCPCS / CPT®DOC HX RENAL FAIL OR CR+ >4
G97230HCPCS / CPT®HOSP RECD BY PT DUR MSMT PER
G97240HCPCS / CPT®PT W/DOC USE ANTICOAG MST YR
G97250HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G97260HCPCS / CPT®REFUSED TO PARTICIPATE
G97270HCPCS / CPT®NO KNEE INTAKE PROM, NO PROX
G97280HCPCS / CPT®REFUSED TO PARTICIPATE
G97290HCPCS / CPT®NO HIP INTAKE PROM, NO PROXY
G97300HCPCS / CPT®REFUSED TO PARTICIPATE
G97310HCPCS / CPT®NO FOOT PROM, NO PROXY
G97320HCPCS / CPT®REFUSED TO PARTICIPATE
G97330HCPCS / CPT®NO BACK INTAKE PROM, NO PROX
G97340HCPCS / CPT®REFUSED TO PARTICIPATE
G97350HCPCS / CPT®PT NO FOTO KNEE AND NO PROXY
G97360HCPCS / CPT®REFUSED TO PARTICIPATE
G97370HCPCS / CPT®PT NO FOTO ELBOW, NO PROXY
G97380HCPCS / CPT®REFUSED TO PARTICIPATE
G97390HCPCS / CPT®PT NO FOTO ORTH, NO PROXY
G97400HCPCS / CPT®HOSP SRV TO PT DUR MSMT PER
G97410HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G97420HCPCS / CPT®PSYCH SYMPT ASSESSED
G97430HCPCS / CPT®PSYCH SYMP NOT ASSESSED, RNS
G97440HCPCS / CPT®PT NOT ELIG, DX HTN
G97450HCPCS / CPT®DOC RSN NO SCR HIGH BP
G97460HCPCS / CPT®MIT STEN, VALVE OR TRANS AF
G97470HCPCS / CPT®PALL DIALYSIS WITH CATHETER
G97480HCPCS / CPT®APP TRANSPL LVG KIDNEY DONOR
G97490HCPCS / CPT®PALL DIALYSIS WITH CATHETER
G97500HCPCS / CPT®APP TRANSPL LVG KIDNEY DONOR
G97510HCPCS / CPT®PT DIED W/IN 24 MOS RPT TIME
G97520HCPCS / CPT®URGENT SURGERY
G97530HCPCS / CPT®DOC NO DICOM, CT OTHER FAC
G97540HCPCS / CPT®INCID PULM NODULE
G97550HCPCS / CPT®DOC MED RSN FOR IMAGING
G97560HCPCS / CPT®SURG PROC W/SILICONE OIL
G97570HCPCS / CPT®SURG PROC W/SILICONE OIL
G97580HCPCS / CPT®HOSPICE OR TERM PHASE
G97590HCPCS / CPT®HX PREOP POST CAP RUP
G97600HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G97610HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G97620HCPCS / CPT®PT HAD HPV B/T 9-13 YR
G97630HCPCS / CPT®PT NO HPV B/T 9-13 YR
G97640HCPCS / CPT®PT TX ORAL SYST/BIO MED PSOR
G97650HCPCS / CPT®PT DECL CHAN/CONIND OR <6M
G97660HCPCS / CPT®CVA STROKE DX TX TRANSF FAC
G97670HCPCS / CPT®HOSP NEW DX CVA CONSID EVST
G97680HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G97690HCPCS / CPT®BN DEN 2YR/GOT OST MED/THER
G97700HCPCS / CPT®PERIP NERVE BLOCK
G97710HCPCS / CPT®ANES END, 1 TEMP >35.5(95.9)
G97720HCPCS / CPT®DOC TEMP >35.5(95.9), ANEST
G97730HCPCS / CPT®NO TEMP >35.5(95.9), ANES
G97740HCPCS / CPT®PT HAD HYST
G97750HCPCS / CPT®RECD 2 ANTI-EMET PRE/INTRAOP
G97760HCPCS / CPT®DOC MED RSN NO PROPH ANTIEM
G97770HCPCS / CPT®PT NO ANTIEMET PRE/INTRAOP
G97780HCPCS / CPT®PTS DX W/PREGN
G97790HCPCS / CPT®PTS BREASTFEEDING
G97800HCPCS / CPT®PTS DX W/RHABDOMYOLYSIS
G97810HCPCS / CPT®DOC RSN NO STATIN
G97820HCPCS / CPT®HX DX FAM/PURE HYPERCHOLES
G97830HCPCS / CPT®DOC DX DM, FAST <70, NO STAT
G97840HCPCS / CPT®PATH/DERM 2ND OPIN BX
G97850HCPCS / CPT®PATH RPT SNT PATH/DERM IN 7D
G97860HCPCS / CPT®NO PATH RPT SENT IN 7D
G97870HCPCS / CPT®PT ALIVE LST DAY MSMT YR
G97880HCPCS / CPT®MOST RCT BP </= 140/90
G97890HCPCS / CPT®RECORD BP IP, ER, URG/SELF
G97900HCPCS / CPT®MOST RCT BP >/= 140/90
G97910HCPCS / CPT®MOST RCT TOB STAT FREE
G97920HCPCS / CPT®MOST RCT TOB STAT NOT FREE
G97930HCPCS / CPT®PT ON DAILY ASA/ANTIPLAT
G97940HCPCS / CPT®DOC MED RSN NO ASA/ANTIPLAT
G97950HCPCS / CPT®PT NO DAILY ASA/ANTIPLAT
G97960HCPCS / CPT®PT NOT CURRENTLY ON STATIN
G97970HCPCS / CPT®PT CURRENTLY ON STATIN
G97980HCPCS / CPT®D/C AMI BTW 7/1-6/30 MST PER
G97990HCPCS / CPT®MED DISP EVT INDIC HX ASTH
G98000HCPCS / CPT®PT ID INTOL/ALLEG BETA-BLOCK
G98010HCPCS / CPT®NONACUT TRANSF FROM INPT
G98020HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G98030HCPCS / CPT®POST D/C 180D TX BETA-BL AMI
G98040HCPCS / CPT®NO POST D/C 180D TX BB AMI
G98050HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G98060HCPCS / CPT®PT RECD CERV CYTO/HPV
G98070HCPCS / CPT®PT NO RECD CERV CYTO/HPV
G98080HCPCS / CPT®PT NO ASTHM CONT MED MST PER
G98090HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G98100HCPCS / CPT®PDC 75% W/ASTH CONT MED
G98110HCPCS / CPT®NO PDC 75% W/ASTH CONT MED
G98120HCPCS / CPT®PT DIED DURING INPT/30D AFT
G98130HCPCS / CPT®PT NOT DIED W/IN 30D OF PROC
G98140HCPCS / CPT®DEATH OCC DUR HOSPITALIZ
G98150HCPCS / CPT®NO DEATH OCC DUR HOSPITALIZ
G98160HCPCS / CPT®DEATH OCC 30D POST PROC
G98170HCPCS / CPT®NO DEATH OCC 30D POST PROC
G98180HCPCS / CPT®DOC SEX ACTIVITY
G98190HCPCS / CPT®PT W/HOSP ANYTIME MSMT PER
G98200HCPCS / CPT®DOC CHLAM SCR TEST W/FOLLOW
G98210HCPCS / CPT®NO DOC CHLAM SCR TS W/FOLLOW
G98220HCPCS / CPT®ENDO ABL PROC YR PREV IND DT
G98230HCPCS / CPT®ENDO SMPL/HYST BX RES DOC
G98240HCPCS / CPT®ENDO SMPL/HYST BX RES NO DOC
G98250HCPCS / CPT®HER-2 NEG,UNDOC/UNKN
G98260HCPCS / CPT®TRANSF PRACT AFT INIT CHEMO
G98270HCPCS / CPT®HER-2 TARG THER NO INIT TX
G98280HCPCS / CPT®HER-2 TARG THER DUR INIT TX
G98290HCPCS / CPT®BREAST ADJ CHEMO ADMIN
G98300HCPCS / CPT®HER-2 POS
G98310HCPCS / CPT®AJCC STG BRT CA DX II OR III
G98320HCPCS / CPT®BRT CA DX I, NO T1/T1A/T1B
G98330HCPCS / CPT®TRANSF PRACT AFT INIT CHEMO
G98340HCPCS / CPT®PT MET DIS AT DX
G98350HCPCS / CPT®TRASTUZ GIVEN W/IN 12 MOS DX
G98360HCPCS / CPT®RSN NO TRAST GIVEN DOC
G98370HCPCS / CPT®TRASTUZ NOT IN 12 MOS DX
G98380HCPCS / CPT®PT MET DIS AT DX
G98390HCPCS / CPT®ANTI-EGFR MON ANTI THER
G98400HCPCS / CPT®KRAS TST BFR BEG ANTI MOAB
G98410HCPCS / CPT®NO KRAS TST BFR BEG ANT MOAB
G98420HCPCS / CPT®PT MET DIS AT DX
G98430HCPCS / CPT®KRAS GENE MUT
G98440HCPCS / CPT®PT NO RECD ANTI-EGFR THER
G98450HCPCS / CPT®PT RECD ANTI-EGFR THER
G98460HCPCS / CPT®PT DIED FROM CANCER
G98470HCPCS / CPT®PT RECD CHEMO LAST 14D LIFE
G98480HCPCS / CPT®PT NO CHEMO LAST 14D LIFE
G98490HCPCS / CPT®PT DIED FROM CANCER
G98500HCPCS / CPT®1/MORE ED LAST 30D LIFE
G98510HCPCS / CPT®1/NO ED VISIT LAST 30D LIFE
G98520HCPCS / CPT®PT DIED FROM CANCER
G98530HCPCS / CPT®ICU STAY LAST 30D LIFE
G98540HCPCS / CPT®NO ICU STAY LAST 30D LIFE
G98550HCPCS / CPT®PT DIED FROM CANCER
G98560HCPCS / CPT®PT NO HOSPICE
G98570HCPCS / CPT®PT ADMIT HOSPICE
G98580HCPCS / CPT®PT ENROLL HOSPICE
G98590HCPCS / CPT®PT DIED FROM CANCER
G98600HCPCS / CPT®PT LESS 3D HOSPICE
G98610HCPCS / CPT®PT MORE THAN 3D HOSPICE
G98620HCPCS / CPT®DOC RSN NO 10 YR FOLLOW
H00010HCPCS / CPT®ALCOHOL AND/OR DRUG ASSESS
H00020HCPCS / CPT®ALCOHOL AND/OR DRUG SCREENIN
H00030HCPCS / CPT®ALCOHOL AND/OR DRUG SCREENIN
H00040HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00050HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00060HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00070HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00080HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00090HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00100HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00110HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00120HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00130HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00140HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00150HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00160HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00170HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00180HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00190HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00200HCPCS / CPT®ALCOHOL AND/OR DRUG SERVICES
H00210HCPCS / CPT®ALCOHOL AND/OR DRUG TRAINING
H00220HCPCS / CPT®ALCOHOL AND/OR DRUG INTERVEN
H00230HCPCS / CPT®ALCOHOL AND/OR DRUG OUTREACH
H00240HCPCS / CPT®ALCOHOL AND/OR DRUG PREVENTI
H00250HCPCS / CPT®ALCOHOL AND/OR DRUG PREVENTI
H00260HCPCS / CPT®ALCOHOL AND/OR DRUG PREVENTI
H00270HCPCS / CPT®ALCOHOL AND/OR DRUG PREVENTI
H00280HCPCS / CPT®ALCOHOL AND/OR DRUG PREVENTI
H00290HCPCS / CPT®ALCOHOL AND/OR DRUG PREVENTI
H00300HCPCS / CPT®ALCOHOL AND/OR DRUG HOTLINE
H00310HCPCS / CPT®MH HEALTH ASSESS BY NON-MD
H00320HCPCS / CPT®MH SVC PLAN DEV BY NON-MD
H00330HCPCS / CPT®ORAL MED ADM DIRECT OBSERVE
H00340HCPCS / CPT®MED TRNG & SUPPORT PER 15MIN
H00350HCPCS / CPT®MH PARTIAL HOSP TX UNDER 24H
H00360HCPCS / CPT®COMM PSY FACE-FACE PER 15MIN
H00370HCPCS / CPT®COMM PSY SUP TX PGM PER DIEM
H00380HCPCS / CPT®SELF-HELP/PEER SVC PER 15MIN
H00390HCPCS / CPT®ASSER COM TX FACE-FACE/15MIN
H00400HCPCS / CPT®ASSERT COMM TX PGM PER DIEM
H00410HCPCS / CPT®FOS C CHLD NON-THER PER DIEM
H00420HCPCS / CPT®FOS C CHLD NON-THER PER MON
H00430HCPCS / CPT®SUPPORTED HOUSING, PER DIEM
H00440HCPCS / CPT®SUPPORTED HOUSING, PER MONTH
H00450HCPCS / CPT®RESPITE NOT-IN-HOME PER DIEM
H00460HCPCS / CPT®MENTAL HEALTH SERVICE, NOS
H00470HCPCS / CPT®ALCOHOL/DRUG ABUSE SVC NOS
H00480HCPCS / CPT®SPEC COLL NON-BLOOD:A/D TEST
H00490HCPCS / CPT®ALCOHOL/DRUG SCREENING
H00500HCPCS / CPT®ALCOHOL/DRUG SERVICE 15 MIN
H10000HCPCS / CPT®PRENATAL CARE ATRISK ASSESSM
H10010HCPCS / CPT®ANTEPARTUM MANAGEMENT
H10020HCPCS / CPT®CARECOORDINATION PRENATAL
H10030HCPCS / CPT®PRENATAL AT RISK EDUCATION
H10040HCPCS / CPT®FOLLOW UP HOME VISIT/PRENTAL
H10050HCPCS / CPT®PRENATALCARE ENHANCED SRV PK
H10100HCPCS / CPT®NONMED FAMILY PLANNING ED
H10110HCPCS / CPT®FAMILY ASSESSMENT
H20000HCPCS / CPT®COMP MULTIDISIPLN EVALUATION
H20010HCPCS / CPT®REHABILITATION PROGRAM 1/2 D
H20100HCPCS / CPT®COMPREHENSIVE MED SVC 15 MIN
H20110HCPCS / CPT®CRISIS INTERVEN SVC, 15 MIN
H20120HCPCS / CPT®BEHAV HLTH DAY TREAT, PER HR
H20130HCPCS / CPT®PSYCH HLTH FAC SVC, PER DIEM
H20140HCPCS / CPT®SKILLS TRAIN AND DEV, 15 MIN
H20150HCPCS / CPT®COMP COMM SUPP SVC, 15 MIN
H20160HCPCS / CPT®COMP COMM SUPP SVC, PER DIEM
H20170HCPCS / CPT®PSYSOC REHAB SVC, PER 15 MIN
H20180HCPCS / CPT®PSYSOC REHAB SVC, PER DIEM
H20190HCPCS / CPT®THER BEHAV SVC, PER 15 MIN
H20200HCPCS / CPT®THER BEHAV SVC, PER DIEM
H20210HCPCS / CPT®COM WRAP-AROUND SV, 15 MIN
H20220HCPCS / CPT®COM WRAP-AROUND SV, PER DIEM
H20230HCPCS / CPT®SUPPORTED EMPLOY, PER 15 MIN
H20240HCPCS / CPT®SUPPORTED EMPLOY, PER DIEM
H20250HCPCS / CPT®SUPP MAINT EMPLOY, 15 MIN
H20260HCPCS / CPT®SUPP MAINT EMPLOY, PER DIEM
H20270HCPCS / CPT®PSYCHOED SVC, PER 15 MIN
H20280HCPCS / CPT®SEX OFFEND TX SVC, 15 MIN
H20290HCPCS / CPT®SEX OFFEND TX SVC, PER DIEM
H20300HCPCS / CPT®MH CLUBHOUSE SVC, PER 15 MIN
H20310HCPCS / CPT®MH CLUBHOUSE SVC, PER DIEM
H20320HCPCS / CPT®ACTIVITY THERAPY, PER 15 MIN
H20330HCPCS / CPT®MULTISYS THER/JUVENILE 15MIN
H20340HCPCS / CPT®A/D HALFWAY HOUSE, PER DIEM
H20350HCPCS / CPT®A/D TX PROGRAM, PER HOUR
H20360HCPCS / CPT®A/D TX PROGRAM, PER DIEM
H20370HCPCS / CPT®DEV DELAY PREV DP CH, 15 MIN
J012065HCPCS / CPT®TETRACYCLIN INJECTION
J012965HCPCS / CPT®ABATACEPT INJECTION
J013065HCPCS / CPT®ABCIXIMAB INJECTION
J013165HCPCS / CPT®ACETAMINOPHEN INJECTION
J013265HCPCS / CPT®ACETYLCYSTEINE INJECTION
J013365HCPCS / CPT®ACYCLOVIR INJECTION
J013565HCPCS / CPT®ADALIMUMAB INJECTION
J015310HCPCS / CPT®ADENOSINE INJ 1MG
J017110HCPCS / CPT®ADRENALIN EPINEPHRINE INJECT
J017865HCPCS / CPT®AFLIBERCEPT INJECTION
J018065HCPCS / CPT®AGALSIDASE BETA INJECTION
J019065HCPCS / CPT®INJ BIPERIDEN LACTATE/5 MG
J020065HCPCS / CPT®ALATROFLOXACIN MESYLATE
J020265HCPCS / CPT®INJECTION, ALEMTUZUMAB
J020565HCPCS / CPT®ALGLUCERASE INJECTION
J020765HCPCS / CPT®AMIFOSTINE
J021065HCPCS / CPT®METHYLDOPATE HCL INJECTION
J021565HCPCS / CPT®ALEFACEPT
J022065HCPCS / CPT®ALGLUCOSIDASE ALFA INJECTION
J022165HCPCS / CPT®LUMIZYME INJECTION
J025665HCPCS / CPT®ALPHA 1 PROTEINASE INHIBITOR
J025765HCPCS / CPT®GLASSIA INJECTION
J027065HCPCS / CPT®ALPROSTADIL FOR INJECTION
J027565HCPCS / CPT®ALPROSTADIL URETHRAL SUPPOS
J027865HCPCS / CPT®AMIKACIN SULFATE INJECTION
J028065HCPCS / CPT®AMINOPHYLLIN 250 MG INJ
J028212HCPCS / CPT®AMIODARONE HCL
J028565HCPCS / CPT®AMPHOTERICIN B
J028765HCPCS / CPT®AMPHOTERICIN B LIPID COMPLEX
J028865HCPCS / CPT®AMPHO B CHOLESTERYL SULFATE
J028965HCPCS / CPT®AMPHOTERICIN B LIPOSOME INJ
J029022HCPCS / CPT®AMPICILLIN 500 MG INJ
J029549HCPCS / CPT®AMPICILLIN SODIUM PER 1.5 GM
J030065HCPCS / CPT®AMOBARBITAL 125 MG INJ
J0330157HCPCS / CPT®SUCCINYCHOLINE CHLORIDE INJ
J034865HCPCS / CPT®ANIDULAFUNGIN INJECTION
J035065HCPCS / CPT®INJECTION ANISTREPLASE 30 U
J036065HCPCS / CPT®HYDRALAZINE HCL INJECTION
J036465HCPCS / CPT®APOMORPHINE HYDROCHLORIDE
J036565HCPCS / CPT®APROTONIN, 10,000 KIU
J038065HCPCS / CPT®INJ METARAMINOL BITARTRATE
J039065HCPCS / CPT®CHLOROQUINE INJECTION
J039565HCPCS / CPT®ARBUTAMINE HCL INJECTION
J040065HCPCS / CPT®ARIPIPRAZOLE INJECTION
J040165HCPCS / CPT®INJ ARIPIPRAZOLE EXT REL 1MG
J045674HCPCS / CPT®AZITHROMYCIN
J046165HCPCS / CPT®ATROPINE SULFATE INJECTION
J047065HCPCS / CPT®DIMECAPROL INJECTION
J047565HCPCS / CPT®BACLOFEN 10 MG INJECTION
J047665HCPCS / CPT®BACLOFEN INTRATHECAL TRIAL
J048065HCPCS / CPT®BASILIXIMAB
J048565HCPCS / CPT®BELATACEPT INJECTION
J049065HCPCS / CPT®BELIMUMAB INJECTION
J050022HCPCS / CPT®DICYCLOMINE INJECTION
J051565HCPCS / CPT®INJ BENZTROPINE MESYLATE
J052065HCPCS / CPT®BETHANECHOL CHLORIDE INJECT
J055868HCPCS / CPT®PENG BENZATHINE/PROCAINE INJ
J056156HCPCS / CPT®PENICILLIN G BENZATHINE INJ
J057065HCPCS / CPT®BUPRENORPHINE IMPLANT 74.2MG
J057165HCPCS / CPT®BUPRENORPHINE ORAL 1MG
J057265HCPCS / CPT®BUPREN/NAL UP TO 3MG BUPRENO
J057365HCPCS / CPT®BUPREN/NAL 3.1 TO 6MG BUPREN
J057465HCPCS / CPT®BUPREN/NAL 6.1 TO 10MG BUPRE
J057565HCPCS / CPT®BUPREN/NAL OVER 10MG BUPRENO
J058365HCPCS / CPT®BIVALIRUDIN
J058565HCPCS / CPT®INJECTION,ONABOTULINUMTOXINA
J058665HCPCS / CPT®ABOBOTULINUMTOXINA
J058765HCPCS / CPT®INJ, RIMABOTULINUMTOXINB
J058865HCPCS / CPT®INCOBOTULINUMTOXIN A
J059265HCPCS / CPT®BUPRENORPHINE HYDROCHLORIDE
J059465HCPCS / CPT®BUSULFAN INJECTION
J059565HCPCS / CPT®BUTORPHANOL TARTRATE 1 MG
J059665HCPCS / CPT®INJECTION, RUCONEST
J059765HCPCS / CPT®C-1 ESTERASE, BERINERT
J059865HCPCS / CPT®C-1 ESTERASE, CINRYZE
J060065HCPCS / CPT®EDETATE CALCIUM DISODIUM INJ
J061065HCPCS / CPT®CALCIUM GLUCONATE INJECTION
J062065HCPCS / CPT®CALCIUM GLYCER & LACT/10 ML
J063065HCPCS / CPT®CALCITONIN SALMON INJECTION
J063665HCPCS / CPT®INJ CALCITRIOL PER 0.1 MCG
J063765HCPCS / CPT®CASPOFUNGIN ACETATE
J063865HCPCS / CPT®CANAKINUMAB INJECTION
J064065HCPCS / CPT®LEUCOVORIN CALCIUM INJECTION
J06416HCPCS / CPT®LEVOLEUCOVORIN INJECTION
J067065HCPCS / CPT®INJ MEPIVACAINE HCL/10 ML
J069022HCPCS / CPT®CEFAZOLIN SODIUM INJECTION
J069242HCPCS / CPT®CEFEPIME HCL FOR INJECTION
J069465HCPCS / CPT®CEFOXITIN SODIUM INJECTION
J069565HCPCS / CPT®INJ CEFTOLOZANE TAZOBACTAM
J069663HCPCS / CPT®Rocephin/Ceftriaxone Sodium 250 mg
J069765HCPCS / CPT®STERILE CEFUROXIME INJECTION
J069865HCPCS / CPT®CEFOTAXIME SODIUM INJECTION
J070265HCPCS / CPT®BETAMETHASONE ACET&SOD PHOSP
J070665HCPCS / CPT®CAFFEINE CITRATE INJECTION
J071065HCPCS / CPT®CEPHAPIRIN SODIUM INJECTION
J071265HCPCS / CPT®CEFTAROLINE FOSAMIL INJ
J071365HCPCS / CPT®INJ CEFTAZIDIME PER 500 MG
J071465HCPCS / CPT®CEFTAZIDIME AND AVIBACTAM
J071565HCPCS / CPT®CEFTIZOXIME SODIUM / 500 MG
J071665HCPCS / CPT®CENTRUROIDES IMMUNE F(AB)
J071765HCPCS / CPT®CERTOLIZUMAB PEGOL INJ 1MG
J072065HCPCS / CPT®CHLORAMPHENICOL SODIUM INJEC
J072565HCPCS / CPT®CHORIONIC GONADOTROPIN/1000U
J073517HCPCS / CPT®CLONIDINE HYDROCHLORIDE
J074065HCPCS / CPT®CIDOFOVIR INJECTION
J074365HCPCS / CPT®CILASTATIN SODIUM INJECTION
J074466HCPCS / CPT®CIPROFLOXACIN IV
J074565HCPCS / CPT®INJ CODEINE PHOSPHATE /30 MG
J077065HCPCS / CPT®COLISTIMETHATE SODIUM INJ
J077565HCPCS / CPT®COLLAGENASE, CLOST HIST INJ
J078011HCPCS / CPT®PROCHLORPERAZINE INJECTION
J079565HCPCS / CPT®CORTICORELIN OVINE TRIFLUTAL
J080065HCPCS / CPT®CORTICOTROPIN INJECTION
J083365HCPCS / CPT®COSYNTROPIN INJECTION NOS
J083465HCPCS / CPT®COSYNTROPIN CORTROSYN INJ
J084065HCPCS / CPT®CROTALIDAE POLY IMMUNE FAB
J085065HCPCS / CPT®CYTOMEGALOVIRUS IMM IV /VIAL
J087565HCPCS / CPT®INJECTION, DALBAVANCIN
J087865HCPCS / CPT®DAPTOMYCIN INJECTION
J088165HCPCS / CPT®DARBEPOETIN ALFA, NON-ESRD
J088265HCPCS / CPT®DARBEPOETIN ALFA, ESRD USE
J08830HCPCS / CPT®ARGATROBAN NONESRD USE 1MG
J088465HCPCS / CPT®ARGATROBAN ESRD DIALYSIS 1MG
J088565HCPCS / CPT®EPOETIN ALFA, NON-ESRD
J088765HCPCS / CPT®EPOETIN BETA ESRD USE
J088865HCPCS / CPT®EPOETIN BETA NON ESRD
J089065HCPCS / CPT®PEGINESATIDE INJECTION
J089465HCPCS / CPT®DECITABINE INJECTION
J089565HCPCS / CPT®DEFEROXAMINE MESYLATE INJ
J089765HCPCS / CPT®DENOSUMAB INJECTION
J094565HCPCS / CPT®BROMPHENIRAMINE MALEATE INJ
J100065HCPCS / CPT®DEPO-ESTRADIOL CYPIONATE INJ
J10206HCPCS / CPT®METHYLPREDNISOLONE 20 MG INJ
J103015HCPCS / CPT®METHYLPREDNISOLONE 40 MG INJ
J10409HCPCS / CPT®METHYLPREDNISOLONE 80 MG INJ
J105065HCPCS / CPT®MEDROXYPROGESTERONE ACETATE
J107165HCPCS / CPT®INJ TESTOSTERONE CYPIONATE
J109422HCPCS / CPT®INJ DEXAMETHASONE ACETATE
J110034HCPCS / CPT®DECADRON 1MG
J111065HCPCS / CPT®INJ DIHYDROERGOTAMINE MESYLT
J112065HCPCS / CPT®ACETAZOLAMID SODIUM INJECTIO
J113065HCPCS / CPT®INJ DICLOFENAC SODIUM 0.5MG
J116065HCPCS / CPT®DIGOXIN INJECTION
J116265HCPCS / CPT®DIGOXIN IMMUNE FAB (OVINE)
J116537HCPCS / CPT®PHENYTOIN SODIUM INJECTION
J117031HCPCS / CPT®HYDROMORPHONE INJECTION
J118065HCPCS / CPT®DYPHYLLINE INJECTION
J119065HCPCS / CPT®DEXRAZOXANE HCL INJECTION
J120022HCPCS / CPT®BENADRYL-DIPHENHYDRAMINE HCL INJECTIO
J120565HCPCS / CPT®CHLOROTHIAZIDE SODIUM INJ
J121265HCPCS / CPT®DIMETHYL SULFOXIDE 50% 50 ML
J123065HCPCS / CPT®METHADONE INJECTION
J124030HCPCS / CPT®DIMENHYDRINATE INJECTION
J124565HCPCS / CPT®DIPYRIDAMOLE INJECTION
J12500HCPCS / CPT®INJ DOBUTAMINE HCL/250 MG
J126065HCPCS / CPT®DOLASETRON MESYLATE
J126565HCPCS / CPT®DOPAMINE INJECTION
J126765HCPCS / CPT®DORIPENEM INJECTION
J127065HCPCS / CPT®INJECTION, DOXERCALCIFEROL
J129065HCPCS / CPT®ECALLANTIDE INJECTION
J130065HCPCS / CPT®ECULIZUMAB INJECTION
J132065HCPCS / CPT®AMITRIPTYLINE INJECTION
J132265HCPCS / CPT®ELOSULFASE ALFA, INJECTION
J132465HCPCS / CPT®ENFUVIRTIDE INJECTION
J132565HCPCS / CPT®EPOPROSTENOL INJECTION
J132765HCPCS / CPT®EPTIFIBATIDE INJECTION
J133065HCPCS / CPT®ERGONOVINE MALEATE INJECTION
J133565HCPCS / CPT®ERTAPENEM INJECTION
J136465HCPCS / CPT®ERYTHRO LACTOBIONATE /500 MG
J138065HCPCS / CPT®ESTRADIOL VALERATE 10 MG INJ
J141065HCPCS / CPT®INJ ESTROGEN CONJUGATE 25 MG
J143065HCPCS / CPT®ETHANOLAMINE OLEATE 100 MG
J143565HCPCS / CPT®INJECTION ESTRONE PER 1 MG
J143665HCPCS / CPT®ETIDRONATE DISODIUM INJ
J143865HCPCS / CPT®ETANERCEPT INJECTION
J143965HCPCS / CPT®INJ FERRIC CARBOXYMALTOS 1MG
J144265HCPCS / CPT®INJ FILGRASTIM EXCL BIOSIMIL
J144365HCPCS / CPT®INJ FERRIC PYROPHOSPHATE CIT
J144765HCPCS / CPT®INJ TBO FILGRASTIM 1 MICROG
J145065HCPCS / CPT®FLUCONAZOLE
J145165HCPCS / CPT®FOMEPIZOLE, 15 MG
J145265HCPCS / CPT®INTRAOCULAR FOMIVIRSEN NA
J145365HCPCS / CPT®FOSAPREPITANT INJECTION
J145565HCPCS / CPT®FOSCARNET SODIUM INJECTION
J145765HCPCS / CPT®GALLIUM NITRATE INJECTION
J14580HCPCS / CPT®GALSULFASE INJECTION
J145965HCPCS / CPT®INJ IVIG PRIVIGEN 500 MG
J146065HCPCS / CPT®GAMMA GLOBULIN 1 CC INJ
J155665HCPCS / CPT®INJ, IMM GLOB BIVIGAM, 500MG
J155765HCPCS / CPT®GAMMAPLEX INJECTION
J155965HCPCS / CPT®HIZENTRA INJECTION
J156065HCPCS / CPT®GAMMA GLOBULIN > 10 CC INJ
J156165HCPCS / CPT®GAMUNEX-C/GAMMAKED
J156265HCPCS / CPT®VIVAGLOBIN, INJ
J156665HCPCS / CPT®IMMUNE GLOBULIN, POWDER
J156865HCPCS / CPT®OCTAGAM INJECTION
J156965HCPCS / CPT®GAMMAGARD LIQUID INJECTION
J157065HCPCS / CPT®GANCICLOVIR SODIUM INJECTION
J157165HCPCS / CPT®HEPAGAM B IM INJECTION
J157265HCPCS / CPT®FLEBOGAMMA INJECTION
J157365HCPCS / CPT®HEPAGAM B INTRAVENOUS, INJ
J157565HCPCS / CPT®HYQVIA 100MG IMMUNEGLOBULIN
J158065HCPCS / CPT®GARAMYCIN GENTAMICIN INJ
J159565HCPCS / CPT®INJECTION GLATIRAMER ACETATE
J159965HCPCS / CPT®IVIG NON-LYOPHILIZED, NOS
J160065HCPCS / CPT®GOLD SODIUM THIOMALEATE INJ
J160265HCPCS / CPT®GOLIMUMAB FOR IV USE 1MG
J161016HCPCS / CPT®GLUCAGON HYDROCHLORIDE/1 MG
J162065HCPCS / CPT®GONADORELIN HYDROCH/ 100 MCG
J162665HCPCS / CPT®GRANISETRON HCL INJECTION
J163065HCPCS / CPT®HALOPERIDOL INJECTION
J163165HCPCS / CPT®HALOPERIDOL DECANOATE INJ
J164065HCPCS / CPT®HEMIN, 1 MG
J164212HCPCS / CPT®INJ HEPARIN SODIUM PER 10 U
J164479HCPCS / CPT®INJ HEPARIN SODIUM PER 1000U
J164565HCPCS / CPT®DALTEPARIN SODIUM
J165065HCPCS / CPT®INJ ENOXAPARIN SODIUM
J165265HCPCS / CPT®FONDAPARINUX SODIUM
J165565HCPCS / CPT®TINZAPARIN SODIUM INJECTION
J167065HCPCS / CPT®TETANUS IMMUNE GLOBULIN INJ
J167565HCPCS / CPT®HISTRELIN ACETATE
J170065HCPCS / CPT®HYDROCORTISONE ACETATE INJ
J171065HCPCS / CPT®HYDROCORTISONE SODIUM PH INJ
J17200HCPCS / CPT®HYDROCORTISONE SODIUM SUCC I
J17250HCPCS / CPT®HYDROXYPROGESTERONE CAPROATE
J17300HCPCS / CPT®DIAZOXIDE INJECTION
J17400HCPCS / CPT®IBANDRONATE SODIUM INJECTION
J17410HCPCS / CPT®IBUPROFEN INJECTION
J17420HCPCS / CPT®IBUTILIDE FUMARATE INJECTION
J17430HCPCS / CPT®IDURSULFASE INJECTION
J17440HCPCS / CPT®ICATIBANT INJECTION
J17450HCPCS / CPT®INFLIXIMAB NOT BIOSIMIL 10MG
J17500HCPCS / CPT®INJ IRON DEXTRAN
J17560HCPCS / CPT®IRON SUCROSE INJECTION
J17860HCPCS / CPT®IMUGLUCERASE INJECTION
J17900HCPCS / CPT®DROPERIDOL INJECTION
J18000HCPCS / CPT®PROPRANOLOL INJECTION
J18107HCPCS / CPT®DROPERIDOL/FENTANYL INJ
J181532HCPCS / CPT®INSULIN INJECTION
J18170HCPCS / CPT®INSULIN FOR INSULIN PUMP USE
J18260HCPCS / CPT®INTERFERON BETA-1A INJ
J18300HCPCS / CPT®INTERFERON BETA-1B / .25 MG
J18330HCPCS / CPT®INJECTION, ISAVUCONAZONIUM
J18350HCPCS / CPT®ITRACONAZOLE INJECTION
J18400HCPCS / CPT®KANAMYCIN SULFATE 500 MG INJ
J18500HCPCS / CPT®KANAMYCIN SULFATE 75 MG INJ
J188522HCPCS / CPT®KETOROLAC TROMETHAMINE INJ
J18900HCPCS / CPT®CEPHALOTHIN SODIUM INJECTION
J19300HCPCS / CPT®LANREOTIDE INJECTION
J19310HCPCS / CPT®LARONIDASE INJECTION
J19402000HCPCS / CPT®FUROSEMIDE INJECTION
J19420HCPCS / CPT®ARIPIPRAZOLE LAUROXIL 1MG
J19450HCPCS / CPT®LEPIRUDIN
J19500HCPCS / CPT®LEUPROLIDE ACETATE /3.75 MG
J19530HCPCS / CPT®LEVETIRACETAM INJECTION
J19550HCPCS / CPT®INJ LEVOCARNITINE PER 1 GM
J195686HCPCS / CPT®LEVOFLOXACIN INJECTION
J19600HCPCS / CPT®LEVORPHANOL TARTRATE INJ
J19800HCPCS / CPT®HYOSCYAMINE SULFATE INJ
J19900HCPCS / CPT®CHLORDIAZEPOXIDE INJECTION
J200132HCPCS / CPT®LIDOCAINE INJECTION
J20100HCPCS / CPT®LINCOMYCIN INJECTION
J20200HCPCS / CPT®LINEZOLID INJECTION
J206054HCPCS / CPT®LORAZEPAM INJECTION
J21500HCPCS / CPT®MANNITOL INJECTION
J21700HCPCS / CPT®MECASERMIN INJECTION
J217527HCPCS / CPT®DEMOROL/ MEPERIDINE HYDROCHL /100 MG
J21800HCPCS / CPT®MEPERIDINE/PROMETHAZINE INJ
J21820HCPCS / CPT®INJECTION, MEPOLIZUMAB, 1MG
J21850HCPCS / CPT®MEROPENEM
J22100HCPCS / CPT®METHYLERGONOVIN MALEATE INJ
J22120HCPCS / CPT®METHYLNALTREXONE INJECTION
J22480HCPCS / CPT®MICAFUNGIN SODIUM INJECTION
J225012HCPCS / CPT®INJ MIDAZOLAM HYDROCHLORIDE
J22600HCPCS / CPT®INJ MILRINONE LACTATE / 5 MG
J22650HCPCS / CPT®MINOCYCLINE HYDROCHLORIDE
J227015.1HCPCS / CPT®INJECTION, MORPHINE SULFATE, UP TO 10 MG
J227465HCPCS / CPT®IN MORPHINE PRESERVATIV FREE
J227865HCPCS / CPT®ZICONOTIDE INJECTION
J22800HCPCS / CPT®INJ, MOXIFLOXACIN 100 MG
J23000HCPCS / CPT®INJ NALBUPHINE HYDROCHLORIDE
J23100HCPCS / CPT®INJ NALOXONE HYDROCHLORIDE
J23150HCPCS / CPT®NALTREXONE, DEPOT FORM
J23200HCPCS / CPT®NANDROLONE DECANOATE 50 MG
J23230HCPCS / CPT®NATALIZUMAB INJECTION
J23250HCPCS / CPT®NESIRITIDE INJECTION
J23530HCPCS / CPT®OCTREOTIDE INJECTION, DEPOT
J23540HCPCS / CPT®OCTREOTIDE INJ, NON-DEPOT
J23550HCPCS / CPT®OPRELVEKIN INJECTION
J23570HCPCS / CPT®OMALIZUMAB INJECTION
J23580HCPCS / CPT®OLANZAPINE LONG-ACTING INJ
J23600HCPCS / CPT®ORPHENADRINE INJECTION
J23700HCPCS / CPT®PHENYLEPHRINE HCL INJECTION
J24000HCPCS / CPT®CHLOROPROCAINE HCL INJECTION
J240520HCPCS / CPT®ONDANSETRON HCL INJECTION
J24070HCPCS / CPT®INJECTION, ORITAVANCIN
J24100HCPCS / CPT®OXYMORPHONE HCL INJECTION
J24250HCPCS / CPT®PALIFERMIN INJECTION
J24260HCPCS / CPT®PALIPERIDONE PALMITATE INJ
J24300HCPCS / CPT®PAMIDRONATE DISODIUM /30 MG
J24400HCPCS / CPT®PAPAVERIN HCL INJECTION
J24600HCPCS / CPT®OXYTETRACYCLINE INJECTION
J24690HCPCS / CPT®PALONOSETRON HCL
J25010HCPCS / CPT®PARICALCITOL
J25020HCPCS / CPT®INJ, PASIREOTIDE LONG ACTING
J25030HCPCS / CPT®PEGAPTANIB SODIUM INJECTION
J25040HCPCS / CPT®PEGADEMASE BOVINE, 25 IU
J25050HCPCS / CPT®INJECTION, PEGFILGRASTIM 6MG
J25070HCPCS / CPT®PEGLOTICASE INJECTION
J25100HCPCS / CPT®PENICILLIN G PROCAINE INJ
J25130HCPCS / CPT®PENTASTARCH 10% SOLUTION
J25150HCPCS / CPT®PENTOBARBITAL SODIUM INJ
J25400HCPCS / CPT®PENICILLIN G POTASSIUM INJ
J25430HCPCS / CPT®PIPERACILLIN/TAZOBACTAM
J25450HCPCS / CPT®PENTAMIDINE NON-COMP UNIT
J25470HCPCS / CPT®INJECTION, PERAMIVIR
J255020.8HCPCS / CPT®INJECTION, PROMETHAZINE HCL, UP TO 50 MG
J25600HCPCS / CPT®PHENOBARBITAL SODIUM INJ
J25620HCPCS / CPT®PLERIXAFOR INJECTION
J25900HCPCS / CPT®OXYTOCIN INJECTION
J25970HCPCS / CPT®INJ DESMOPRESSIN ACETATE
J26500HCPCS / CPT®PREDNISOLONE ACETATE INJ
J26700HCPCS / CPT®TOTAZOLINE HCL INJECTION
J26750HCPCS / CPT®INJ PROGESTERONE PER 50 MG
J26800HCPCS / CPT®FLUPHENAZINE DECANOATE 25 MG
J26900HCPCS / CPT®PROCAINAMIDE HCL INJECTION
J27000HCPCS / CPT®OXACILLIN SODIUM INJECITON
J270465HCPCS / CPT®INJ, PROPOFOL, 10 MG
J271065HCPCS / CPT®NEOSTIGMINE METHYLSLFTE INJ
J27200HCPCS / CPT®INJ PROTAMINE SULFATE/10 MG
J27240HCPCS / CPT®PROTEIN C CONCENTRATE
J27250HCPCS / CPT®INJ PROTIRELIN PER 250 MCG
J27300HCPCS / CPT®PRALIDOXIME CHLORIDE INJ
J27600HCPCS / CPT®PHENTOLAINE MESYLATE INJ
J276565HCPCS / CPT®METOCLOPRAMIDE HCL INJECTION
J27700HCPCS / CPT®QUINUPRISTIN/DALFOPRISTIN
J27780HCPCS / CPT®RANIBIZUMAB INJECTION
J278065HCPCS / CPT®RANITIDINE HYDROCHLORIDE INJ
J27830HCPCS / CPT®RASBURICASE
J27850HCPCS / CPT®REGADENOSON INJECTION
J27860HCPCS / CPT®INJECTION, RESLIZUMAB, 1MG
J27880HCPCS / CPT®RHO D IMMUNE GLOBULIN 50 MCG
J279065HCPCS / CPT®RHO D IMMUNE GLOBULIN INJ
J27910HCPCS / CPT®RHOPHYLAC INJECTION
J27920HCPCS / CPT®RHO(D) IMMUNE GLOBULIN H, SD
J27930HCPCS / CPT®RILONACEPT INJECTION
J27940HCPCS / CPT®RISPERIDONE, LONG ACTING
J27950HCPCS / CPT®ROPIVACAINE HCL INJECTION
J27960HCPCS / CPT®ROMIPLOSTIM INJECTION
J28000HCPCS / CPT®METHOCARBAMOL INJECTION
J28050HCPCS / CPT®SINCALIDE INJECTION
J28100HCPCS / CPT®INJ THEOPHYLLINE PER 40 MG
J28200HCPCS / CPT®SARGRAMOSTIM INJECTION
J28400HCPCS / CPT®INJ SEBELIPASE ALFA 1 MG
J28500HCPCS / CPT®INJ SECRETIN SYNTHETIC HUMAN
J28600HCPCS / CPT®INJECTION, SILTUXIMAB
J29100HCPCS / CPT®AUROTHIOGLUCOSE INJECITON
J29160HCPCS / CPT®NA FERRIC GLUCONATE COMPLEX
J292019HCPCS / CPT®METHYLPREDNISOLONE INJECTION
J293017HCPCS / CPT®METHYLPREDNISOLONE INJECTION
J29400HCPCS / CPT®SOMATREM INJECTION
J29410HCPCS / CPT®SOMATROPIN INJECTION
J29500HCPCS / CPT®PROMAZINE HCL INJECTION
J29930HCPCS / CPT®RETEPLASE INJECTION
J29950HCPCS / CPT®INJ STREPTOKINASE /250000 IU
J29970HCPCS / CPT®ALTEPLASE RECOMBINANT
J30000HCPCS / CPT®STREPTOMYCIN INJECTION
J30106HCPCS / CPT®FENTANYL CITRATE INJECITON
J303011HCPCS / CPT®SUMATRIPTAN SUCCINATE / 6 MG
J30600HCPCS / CPT®INJ, TALIGLUCERACE ALFA 10 U
J30700HCPCS / CPT®PENTAZOCINE INJECTION
J30900HCPCS / CPT®INJ TEDIZOLID PHOSPHATE
J30950HCPCS / CPT®TELAVANCIN INJECTION
J31010HCPCS / CPT®TENECTEPLASE INJECTION
J31050HCPCS / CPT®TERBUTALINE SULFATE INJ
J31100HCPCS / CPT®TERIPARATIDE INJECTION
J31210HCPCS / CPT®INJ TESTOSTERO ENANTHATE 1MG
J31450HCPCS / CPT®TESTOSTERONE UNDECANOATE 1MG
J32300HCPCS / CPT®CHLORPROMAZINE HCL INJECTION
J32400HCPCS / CPT®THYROTROPIN INJECTION
J32430HCPCS / CPT®TIGECYCLINE INJECTION
J32460HCPCS / CPT®TIROFIBAN HCL
J32500HCPCS / CPT®TRIMETHOBENZAMIDE HCL INJ
J32600HCPCS / CPT®TOBRAMYCIN SULFATE INJECTION
J32620HCPCS / CPT®TOCILIZUMAB INJECTION
J32650HCPCS / CPT®INJECTION TORSEMIDE 10 MG/ML
J32800HCPCS / CPT®THIETHYLPERAZINE MALEATE INJ
J32850HCPCS / CPT®TREPROSTINIL INJECTION
J33000HCPCS / CPT®TRIAMCINOLONE A INJ PRS-FREE
J33010HCPCS / CPT®TRIAMCINOLONE ACET INJ NOS
J33020HCPCS / CPT®TRIAMCINOLONE DIACETATE INJ
J33030HCPCS / CPT®TRIAMCINOLONE HEXACETONL INJ
J33050HCPCS / CPT®INJ TRIMETREXATE GLUCORONATE
J33100HCPCS / CPT®PERPHENAZINE INJECITON
J33150HCPCS / CPT®TRIPTORELIN PAMOATE
J33200HCPCS / CPT®SPECTINOMYCN DI-HCL INJ
J33500HCPCS / CPT®UREA INJECTION
J33550HCPCS / CPT®UROFOLLITROPIN, 75 IU
J33570HCPCS / CPT®USTEKINUMAB SUB CU INJ, 1 MG
J336011HCPCS / CPT®DIAZEPAM INJECTION
J33640HCPCS / CPT®UROKINASE 5000 IU INJECTION
J33650HCPCS / CPT®UROKINASE 250,000 IU INJ
J3370118HCPCS / CPT®VANCOMYCIN HCL INJECTION
J33800HCPCS / CPT®INJECTION, VEDOLIZUMAB
J33850HCPCS / CPT®VELAGLUCERASE ALFA
J33960HCPCS / CPT®VERTEPORFIN INJECTION
J34000HCPCS / CPT®TRIFLUPROMAZINE HCL INJ
J34100HCPCS / CPT®HYDROXYZINE HCL INJECTION
J34110HCPCS / CPT®THIAMINE HCL 100 MG
J34150HCPCS / CPT®PYRIDOXINE HCL 100 MG
J34200HCPCS / CPT®VITAMIN B12 INJECTION
J343017HCPCS / CPT®VITAMIN K PHYTONADIONE INJ
J34650HCPCS / CPT®INJECTION, VORICONAZOLE
J34700HCPCS / CPT®HYALURONIDASE INJECTION
J34710HCPCS / CPT®OVINE, UP TO 999 USP UNITS
J34720HCPCS / CPT®OVINE, 1000 USP UNITS
J34730HCPCS / CPT®HYALURONIDASE RECOMBINANT
J347527HCPCS / CPT®INJ MAGNESIUM SULFATE
J34807HCPCS / CPT®INJ POTASSIUM CHLORIDE
J34850HCPCS / CPT®ZIDOVUDINE
J34860HCPCS / CPT®ZIPRASIDONE MESYLATE
J34890HCPCS / CPT®ZOLEDRONIC ACID 1MG
J349065HCPCS / CPT®DRUGS UNCLASSIFIED INJECTION
J349965HCPCS / CPT®Unclassified Drugs
J35200HCPCS / CPT®EDETATE DISODIUM PER 150 MG
J35300HCPCS / CPT®NASAL VACCINE INHALATION
J35350HCPCS / CPT®METERED DOSE INHALER DRUG
J35700HCPCS / CPT®LAETRILE AMYGDALIN VIT B17
J35900HCPCS / CPT®UNCLASSIFIED BIOLOGICS
J703068HCPCS / CPT®NORMAL SALINE SOLUTION INFUS
J704036HCPCS / CPT®NORMAL SALINE SOLUTION INFUS
J704232HCPCS / CPT®5% DEXTROSE/NORMAL SALINE
J705028HCPCS / CPT®NORMAL SALINE SOLUTION INFUS
J706038HCPCS / CPT®5% DEXTROSE/WATER
J707087HCPCS / CPT®D5W INFUSION
J71000HCPCS / CPT®DEXTRAN 40 INFUSION
J71100HCPCS / CPT®DEXTRAN 75 INFUSION
J712096HCPCS / CPT®RINGERS LACTATE INFUSION
J712198HCPCS / CPT®5% DEXTROSE IN LAC RINGERS
J713177HCPCS / CPT®HYPERTONIC SALINE SOL
J71750HCPCS / CPT®INJ, FACTOR X, (HUMAN), 1IU
J71780HCPCS / CPT®HUMAN FIBRINOGEN CONC INJ
J71790HCPCS / CPT®VONVENDI INJ 1 IU VWF:RCO
J71800HCPCS / CPT®FACTOR XIII ANTI-HEM FACTOR
J71810HCPCS / CPT®FACTOR XIII RECOMB A-SUBUNIT
J71820HCPCS / CPT®FACTOR VIII RECOMB NOVOEIGHT
J71830HCPCS / CPT®WILATE INJECTION
J71850HCPCS / CPT®XYNTHA INJ
J71860HCPCS / CPT®ANTIHEMOPHILIC VIII/VWF COMP
J71870HCPCS / CPT®HUMATE-P, INJ
J71880HCPCS / CPT®FACTOR VIII RECOMB OBIZUR
J71890HCPCS / CPT®FACTOR VIIA
J71900HCPCS / CPT®FACTOR VIII
J71910HCPCS / CPT®FACTOR VIII (PORCINE)
J71920HCPCS / CPT®FACTOR VIII RECOMBINANT NOS
J71930HCPCS / CPT®FACTOR IX NON-RECOMBINANT
J71940HCPCS / CPT®FACTOR IX COMPLEX
J71950HCPCS / CPT®FACTOR IX RECOMBINANT NOS
J71960HCPCS / CPT®ANTITHROMBIN RECOMBINANT
J71970HCPCS / CPT®ANTITHROMBIN III INJECTION
J71980HCPCS / CPT®ANTI-INHIBITOR
J71990HCPCS / CPT®HEMOPHILIA CLOT FACTOR NOC
J72000HCPCS / CPT®FACTOR IX RECOMBINAN RIXUBIS
J72010HCPCS / CPT®FACTOR IX ALPROLIX RECOMB
J72020HCPCS / CPT®FACTOR IX IDELVION INJ
J72050HCPCS / CPT®FACTOR VIII FC FUSION RECOMB
J72070HCPCS / CPT®FACTOR VIII PEGYLATED RECOMB
J72090HCPCS / CPT®FACTOR VIII NUWIQ RECOMB 1IU
J72970HCPCS / CPT®LILETTA, 52 MG
J72980HCPCS / CPT®MIRENA, 52 MG
J73000HCPCS / CPT®INTRAUT COPPER CONTRACEPTIVE
J73010HCPCS / CPT®SKYLA, 13.5 MG
J73030HCPCS / CPT®CONTRACEPTIVE VAGINAL RING
J73040HCPCS / CPT®CONTRACEPTIVE HORMONE PATCH
J73060HCPCS / CPT®LEVONORGESTREL IMPLANT SYS
J73070HCPCS / CPT®ETONOGESTREL IMPLANT SYSTEM
J73080HCPCS / CPT®AMINOLEVULINIC ACID HCL TOP
J73090HCPCS / CPT®METHYL AMINOLEVULINATE, TOP
J73100HCPCS / CPT®GANCICLOVIR LONG ACT IMPLANT
J73110HCPCS / CPT®FLUOCINOLONE ACETONIDE IMPLT
J731265HCPCS / CPT®DEXAMETHASONE INTRA IMPLANT
J73130HCPCS / CPT®FLUOCINOL ACET INTRAVIT IMP
J73150HCPCS / CPT®OPHTHALMIC MITOMYCIN
J73160HCPCS / CPT®INJ, OCRIPLASMIN, 0.125 MG
J73200HCPCS / CPT®GENVISC 850, INJ, 1MG
J73210HCPCS / CPT®HYALGAN/SUPARTZ INJ PER DOSE
J73220HCPCS / CPT®HYMOVIS INJECTION 1 MG
J73230HCPCS / CPT®EUFLEXXA INJ PER DOSE
J73240HCPCS / CPT®ORTHOVISC INJ PER DOSE
J73250HCPCS / CPT®SYNVISC OR SYNVISC-ONE
J73260HCPCS / CPT®GEL-ONE
J73270HCPCS / CPT®MONOVISC INJ PER DOSE
J73280HCPCS / CPT®GEL-SYN INJECTION 0.1 MG
J73300HCPCS / CPT®CULTURED CHONDROCYTES IMPLNT
J73360HCPCS / CPT®CAPSAICIN 8% PATCH
J73400HCPCS / CPT®CARBIDOPA LEVODOPA ENT 100ML
J73420HCPCS / CPT®CIPROFLOXACIN OTIC SUSP 6 MG
J75000HCPCS / CPT®AZATHIOPRINE ORAL 50MG
J75010HCPCS / CPT®AZATHIOPRINE PARENTERAL
J750265HCPCS / CPT®CYCLOSPORINE ORAL 100 MG
J75030HCPCS / CPT®TACROL ENVARSUS EX REL ORAL
J75040HCPCS / CPT®LYMPHOCYTE IMMUNE GLOBULIN
J75050HCPCS / CPT®MONOCLONAL ANTIBODIES
J750765HCPCS / CPT®TACROLIMUS IMME REL ORAL 1MG
J75080HCPCS / CPT®TACROL ASTAGRAF EX REL ORAL
J75090HCPCS / CPT®METHYLPREDNISOLONE ORAL
J751011HCPCS / CPT®PREDNISOLONE ORAL PER 5 MG
J75110HCPCS / CPT®ANTITHYMOCYTE GLOBULN RABBIT
J751211HCPCS / CPT®PREDNISONE IR OR DR ORAL 1MG
J75130HCPCS / CPT®DACLIZUMAB, PARENTERAL
J75150HCPCS / CPT®CYCLOSPORINE ORAL 25 MG
J75160HCPCS / CPT®CYCLOSPORIN PARENTERAL 250MG
J75170HCPCS / CPT®MYCOPHENOLATE MOFETIL ORAL
J75180HCPCS / CPT®MYCOPHENOLIC ACID
J75200HCPCS / CPT®SIROLIMUS, ORAL
J75250HCPCS / CPT®TACROLIMUS INJECTION
J75270HCPCS / CPT®ORAL EVEROLIMUS
J75990HCPCS / CPT®IMMUNOSUPPRESSIVE DRUG NOC
J76040HCPCS / CPT®ACETYLCYSTEINE COMP UNIT
J76050HCPCS / CPT®ARFORMOTEROL NON-COMP UNIT
J76060HCPCS / CPT®FORMOTEROL FUMARATE, INH
J760716HCPCS / CPT®LEVALBUTEROL COMP CON
J76080HCPCS / CPT®ACETYLCYSTEINE NON-COMP UNIT
J76090HCPCS / CPT®ALBUTEROL COMP UNIT
J761017HCPCS / CPT®ALBUTEROL COMP CON
J761117HCPCS / CPT®ALBUTEROL NON-COMP CON
J76120HCPCS / CPT®LEVALBUTEROL NON-COMP CON
J761365HCPCS / CPT®ALBUTEROL NON-COMP UNIT
J761419HCPCS / CPT®LEVALBUTEROL NON-COMP UNIT
J761516HCPCS / CPT®LEVALBUTEROL COMP UNIT
J762065HCPCS / CPT®ALBUTEROL IPRATROP NON-COMP
J76220HCPCS / CPT®BECLOMETHASONE COMP UNIT
J76240HCPCS / CPT®BETAMETHASONE COMP UNIT
J76260HCPCS / CPT®BUDESONIDE NON-COMP UNIT
J76270HCPCS / CPT®BUDESONIDE COMP UNIT
J76280HCPCS / CPT®BITOLTEROL MESYLATE COMP CON
J76290HCPCS / CPT®BITOLTEROL MESYLATE COMP UNT
J76310HCPCS / CPT®CROMOLYN SODIUM NONCOMP UNIT
J76320HCPCS / CPT®CROMOLYN SODIUM COMP UNIT
J76330HCPCS / CPT®BUDESONIDE NON-COMP CON
J76340HCPCS / CPT®BUDESONIDE COMP CON
J76350HCPCS / CPT®ATROPINE COMP CON
J76360HCPCS / CPT®ATROPINE COMP UNIT
J763765HCPCS / CPT®DEXAMETHASONE COMP CON
J763865HCPCS / CPT®DEXAMETHASONE COMP UNIT
J76390HCPCS / CPT®DORNASE ALFA NON-COMP UNIT
J76400HCPCS / CPT®FORMOTEROL COMP UNIT
J76410HCPCS / CPT®FLUNISOLIDE COMP UNIT
J76420HCPCS / CPT®GLYCOPYRROLATE COMP CON
J76430HCPCS / CPT®GLYCOPYRROLATE COMP UNIT
J764428HCPCS / CPT®IPRATROPIUM BROMIDE NON-COMP
J76450HCPCS / CPT®IPRATROPIUM BROMIDE COMP
J76470HCPCS / CPT®ISOETHARINE COMP CON
J76480HCPCS / CPT®ISOETHARINE NON-COMP CON
J76490HCPCS / CPT®ISOETHARINE NON-COMP UNIT
J76500HCPCS / CPT®ISOETHARINE COMP UNIT
J76570HCPCS / CPT®ISOPROTERENOL COMP CON
J76580HCPCS / CPT®ISOPROTERENOL NON-COMP CON
J76590HCPCS / CPT®ISOPROTERENOL NON-COMP UNIT
J76600HCPCS / CPT®ISOPROTERENOL COMP UNIT
J76650HCPCS / CPT®MANNITOL FOR INHALER
J76670HCPCS / CPT®METAPROTERENOL COMP CON
J76680HCPCS / CPT®METAPROTERENOL NON-COMP CON
J76690HCPCS / CPT®METAPROTERENOL NON-COMP UNIT
J76700HCPCS / CPT®METAPROTERENOL COMP UNIT
J76740HCPCS / CPT®METHACHOLINE CHLORIDE, NEB
J76760HCPCS / CPT®PENTAMIDINE COMP UNIT DOSE
J76800HCPCS / CPT®TERBUTALINE SULF COMP CON
J76810HCPCS / CPT®TERBUTALINE SULF COMP UNIT
J76820HCPCS / CPT®TOBRAMYCIN NON-COMP UNIT
J76830HCPCS / CPT®TRIAMCINOLONE COMP CON
J76840HCPCS / CPT®TRIAMCINOLONE COMP UNIT
J76850HCPCS / CPT®TOBRAMYCIN COMP UNIT
J76860HCPCS / CPT®TREPROSTINIL, NON-COMP UNIT
J76997HCPCS / CPT®INHALATION SOLUTION FOR DME
J779965HCPCS / CPT®NON-INHALATION DRUG FOR DME
J799965HCPCS / CPT®COMPOUNDED DRUG, NOC
J84980HCPCS / CPT®ANTIEMETIC RECTAL/SUPP NOS
J849965HCPCS / CPT®ORAL PRESCRIP DRUG NON CHEMO
J850165HCPCS / CPT®ORAL APREPITANT
J85100HCPCS / CPT®ORAL BUSULFAN
J851565HCPCS / CPT®CABERGOLINE, ORAL 0.25MG
J852065HCPCS / CPT®CAPECITABINE, ORAL, 150 MG
J852165HCPCS / CPT®CAPECITABINE, ORAL, 500 MG
J853065HCPCS / CPT®CYCLOPHOSPHAMIDE ORAL 25 MG
J854018HCPCS / CPT®ORAL DEXAMETHASONE
J856065HCPCS / CPT®ETOPOSIDE ORAL 50 MG
J856265HCPCS / CPT®ORAL FLUDARABINE PHOSPHATE
J856565HCPCS / CPT®GEFITINIB ORAL
J859765HCPCS / CPT®ANTIEMETIC DRUG ORAL NOS
J860065HCPCS / CPT®MELPHALAN ORAL 2 MG
J861065HCPCS / CPT®METHOTREXATE ORAL 2.5 MG
J865065HCPCS / CPT®NABILONE ORAL
J865565HCPCS / CPT®NETUPITANT PALONOSETRON ORAL
J867065HCPCS / CPT®ROLAPITANT, ORAL, 1MG
J870065HCPCS / CPT®TEMOZOLOMIDE
J87050HCPCS / CPT®TOPOTECAN ORAL
J89990HCPCS / CPT®ORAL PRESCRIPTION DRUG CHEMO
J900065HCPCS / CPT®DOXORUBICIN HCL INJECTION
J901565HCPCS / CPT®ALDESLEUKIN INJECTION
J901765HCPCS / CPT®ARSENIC TRIOXIDE INJECTION
J901965HCPCS / CPT®ERWINAZE INJECTION
J902065HCPCS / CPT®ASPARAGINASE, NOS
J902565HCPCS / CPT®AZACITIDINE INJECTION
J9027128HCPCS / CPT®CLOFARABINE INJECTION
J903165HCPCS / CPT®BCG LIVE INTRAVESICAL VAC
J903265HCPCS / CPT®INJECTION, BELINOSTAT, 10MG
J903365HCPCS / CPT®INJ., TREANDA 1 MG
J903465HCPCS / CPT®INJ., BENDEKA 1 MG
J903565HCPCS / CPT®BEVACIZUMAB INJECTION
J903965HCPCS / CPT®INJECTION, BLINATUMOMAB
J904065HCPCS / CPT®BLEOMYCIN SULFATE INJECTION
J904165HCPCS / CPT®BORTEZOMIB INJECTION
J904265HCPCS / CPT®BRENTUXIMAB VEDOTIN INJ
J904365HCPCS / CPT®CABAZITAXEL INJECTION
J904565HCPCS / CPT®CARBOPLATIN INJECTION
J904765HCPCS / CPT®INJECTION, CARFILZOMIB, 1 MG
J905065HCPCS / CPT®CARMUSTINE INJECTION
J905565HCPCS / CPT®CETUXIMAB INJECTION
J906065HCPCS / CPT®CISPLATIN 10 MG INJECTION
J906565HCPCS / CPT®INJ CLADRIBINE PER 1 MG
J907065HCPCS / CPT®CYCLOPHOSPHAMIDE 100 MG INJ
J909865HCPCS / CPT®CYTARABINE LIPOSOME INJ
J910065HCPCS / CPT®CYTARABINE HCL 100 MG INJ
J912065HCPCS / CPT®DACTINOMYCIN INJECTION
J913065HCPCS / CPT®DACARBAZINE 100 MG INJ
J914565HCPCS / CPT®INJECTION, DARATUMUMAB 10 MG
J915065HCPCS / CPT®DAUNORUBICIN INJECTION
J915165HCPCS / CPT®DAUNORUBICIN CITRATE INJ
J915565HCPCS / CPT®DEGARELIX INJECTION
J916065HCPCS / CPT®DENILEUKIN DIFTITOX INJ
J916565HCPCS / CPT®DIETHYLSTILBESTROL INJECTION
J917165HCPCS / CPT®DOCETAXEL INJECTION
J917565HCPCS / CPT®ELLIOTTS B SOLUTION PER ML
J917665HCPCS / CPT®INJECTION, ELOTUZUMAB, 1MG
J917865HCPCS / CPT®INJ, EPIRUBICIN HCL, 2 MG
J917965HCPCS / CPT®ERIBULIN MESYLATE INJECTION
J918165HCPCS / CPT®ETOPOSIDE INJECTION
J918565HCPCS / CPT®FLUDARABINE PHOSPHATE INJ
J919065HCPCS / CPT®FLUOROURACIL INJECTION
J920065HCPCS / CPT®FLOXURIDINE INJECTION
J920165HCPCS / CPT®GEMCITABINE HCL INJECTION
J920265HCPCS / CPT®GOSERELIN ACETATE IMPLANT
J920565HCPCS / CPT®INJ IRINOTECAN LIPOSOME 1 MG
J920665HCPCS / CPT®IRINOTECAN INJECTION
J920765HCPCS / CPT®IXABEPILONE INJECTION
J920865HCPCS / CPT®IFOSFAMIDE INJECTION
J920965HCPCS / CPT®MESNA INJECTION
J921165HCPCS / CPT®IDARUBICIN HCL INJECTION
J921265HCPCS / CPT®INTERFERON ALFACON-1 INJ
J921365HCPCS / CPT®INTERFERON ALFA-2A INJ
J921465HCPCS / CPT®INTERFERON ALFA-2B INJ
J921565HCPCS / CPT®INTERFERON ALFA-N3 INJ
J921665HCPCS / CPT®INTERFERON GAMMA 1-B INJ
J921765HCPCS / CPT®LEUPROLIDE ACETATE SUSPNSION
J921865HCPCS / CPT®LEUPROLIDE ACETATE INJECITON
J921965HCPCS / CPT®LEUPROLIDE ACETATE IMPLANT
J922565HCPCS / CPT®VANTAS IMPLANT
J922665HCPCS / CPT®SUPPRELIN LA IMPLANT
J922865HCPCS / CPT®IPILIMUMAB INJECTION
J923065HCPCS / CPT®MECHLORETHAMINE HCL INJ
J924565HCPCS / CPT®INJ MELPHALAN HYDROCHL 50 MG
J925065HCPCS / CPT®METHOTREXATE SODIUM INJ
J926065HCPCS / CPT®METHOTREXATE SODIUM INJ
J926165HCPCS / CPT®NELARABINE INJECTION
J926265HCPCS / CPT®INJ, OMACETAXINE MEP, 0.01MG
J926365HCPCS / CPT®OXALIPLATIN
J926465HCPCS / CPT®PACLITAXEL PROTEIN BOUND
J926665HCPCS / CPT®PEGASPARGASE INJECTION
J926765HCPCS / CPT®PACLITAXEL INJECTION
J926865HCPCS / CPT®PENTOSTATIN INJECTION
J927065HCPCS / CPT®PLICAMYCIN (MITHRAMYCIN) INJ
J927165HCPCS / CPT®INJ PEMBROLIZUMAB
J928065HCPCS / CPT®MITOMYCIN INJECTION
J929365HCPCS / CPT®MITOXANTRONE HYDROCHL / 5 MG
J929565HCPCS / CPT®INJECTION, NECITUMUMAB, 1 MG
J929965HCPCS / CPT®INJECTION, NIVOLUMAB
J930065HCPCS / CPT®GEMTUZUMAB OZOGAMICIN INJ
J930165HCPCS / CPT®OBINUTUZUMAB INJ
J930265HCPCS / CPT®OFATUMUMAB INJECTION
J930365HCPCS / CPT®PANITUMUMAB INJECTION
J930565HCPCS / CPT®PEMETREXED INJECTION
J930665HCPCS / CPT®INJECTION, PERTUZUMAB, 1 MG
J930765HCPCS / CPT®PRALATREXATE INJECTION
J930865HCPCS / CPT®INJECTION, RAMUCIRUMAB
J931065HCPCS / CPT®RITUXIMAB INJECTION
J931565HCPCS / CPT®ROMIDEPSIN INJECTION
J932065HCPCS / CPT®STREPTOZOCIN INJECTION
J932565HCPCS / CPT®INJ TALIMOGENE LAHERPAREPVEC
J932865HCPCS / CPT®TEMOZOLOMIDE INJECTION
J933065HCPCS / CPT®TEMSIROLIMUS INJECTION
J934065HCPCS / CPT®THIOTEPA INJECTION
J935165HCPCS / CPT®TOPOTECAN INJECTION
J935265HCPCS / CPT®INJECTION TRABECTEDIN 0.1MG
J935465HCPCS / CPT®INJ, ADO-TRASTUZUMAB EMT 1MG
J935565HCPCS / CPT®TRASTUZUMAB INJECTION
J935765HCPCS / CPT®VALRUBICIN INJECTION
J936065HCPCS / CPT®VINBLASTINE SULFATE INJ
J937065HCPCS / CPT®VINCRISTINE SULFATE 1 MG INJ
J937165HCPCS / CPT®INJ, VINCRISTINE SUL LIP 1MG
J939065HCPCS / CPT®VINORELBINE TARTRATE INJ
J939565HCPCS / CPT®INJECTION, FULVESTRANT
J940065HCPCS / CPT®INJ, ZIV-AFLIBERCEPT, 1MG
J960065HCPCS / CPT®PORFIMER SODIUM INJECTION
J999965HCPCS / CPT®CHEMOTHERAPY DRUG
K00010HCPCS / CPT®STANDARD WHEELCHAIR
K00020HCPCS / CPT®STND HEMI (LOW SEAT) WHLCHR
K00030HCPCS / CPT®LIGHTWEIGHT WHEELCHAIR
K00040HCPCS / CPT®HIGH STRENGTH LTWT WHLCHR
K00050HCPCS / CPT®ULTRALIGHTWEIGHT WHEELCHAIR
K00060HCPCS / CPT®HEAVY DUTY WHEELCHAIR
K00070HCPCS / CPT®EXTRA HEAVY DUTY WHEELCHAIR
K00080HCPCS / CPT®CSTM MANUAL WHEELCHAIR/BASE
K00090HCPCS / CPT®OTHER MANUAL WHEELCHAIR/BASE
K00100HCPCS / CPT®STND WT FRAME POWER WHLCHR