J0120 |
Tetracyclin injection |
J0121 |
Inj., omadacycline, 1 mg |
J0122 |
Inj., eravacycline, 1 mg |
J0129 |
Abatacept injection |
J0130 |
Abciximab injection |
J0131 |
Acetaminophen injection |
J0132 |
Acetylcysteine injection |
J0133 |
Acyclovir injection |
J0135 |
Adalimumab injection |
J0153 |
Adenosine inj 1mg |
J0171 |
Adrenalin epinephrine inject |
J0178 |
Aflibercept injection |
J0179 |
Inj, brolucizumab-dbll, 1 mg |
J0180 |
Agalsidase beta injection |
J0185 |
Inj., aprepitant, 1 mg |
J0190 |
Inj biperiden lactate/5 mg |
J0200 |
Alatrofloxacin mesylate |
J0202 |
Injection, alemtuzumab |
J0205 |
Alglucerase injection |
J0207 |
Amifostine |
J0210 |
Methyldopate hcl injection |
J0215 |
Alefacept |
J0220 |
Alglucosidase alfa injection |
J0221 |
Lumizyme injection |
J0222 |
Inj., patisiran, 0.1 mg |
J0256 |
Alpha 1 proteinase inhibitor |
J0257 |
Glassia injection |
J0270 |
Alprostadil for injection |
J0275 |
Alprostadil urethral suppos |
J0278 |
Amikacin sulfate injection |
J0280 |
Aminophyllin 250 mg inj |
J0282 |
Amiodarone hcl |
J0285 |
Amphotericin b |
J0287 |
Amphotericin b lipid complex |
J0288 |
Ampho b cholesteryl sulfate |
J0289 |
Amphotericin b liposome inj |
J0290 |
Ampicillin 500 mg inj |
J0291 |
Inj., plazomicin, 5 mg |
J0295 |
Ampicillin sulbactam 1.5 gm |
J0300 |
Amobarbital 125 mg inj |
J0330 |
Succinycholine chloride inj |
J0348 |
Anidulafungin injection |
J0350 |
Injection anistreplase 30 u |
J0360 |
Hydralazine hcl injection |
J0364 |
Apomorphine hydrochloride |
J0365 |
Aprotonin, 10,000 kiu |
J0380 |
Inj metaraminol bitartrate |
J0390 |
Chloroquine injection |
J0395 |
Arbutamine hcl injection |
J0400 |
Aripiprazole injection |
J0401 |
Inj aripiprazole ext rel 1mg |
J0456 |
Azithromycin |
J0461 |
Atropine sulfate injection |
J0470 |
Dimecaprol injection |
J0475 |
Baclofen 10 mg injection |
J0476 |
Baclofen intrathecal trial |
J0480 |
Basiliximab |
J0485 |
Belatacept injection |
J0490 |
Belimumab injection |
J0500 |
Dicyclomine injection |
J0515 |
Inj benztropine mesylate |
J0517 |
Inj., benralizumab, 1 mg |
J0520 |
Bethanechol chloride inject |
J0558 |
Peng benzathine/procaine inj |
J0561 |
Penicillin g benzathine inj |
J0565 |
Inj, bezlotoxumab, 10 mg |
J0567 |
Inj., cerliponase alfa 1 mg |
J0570 |
Buprenorphine implant 74.2mg |
J0571 |
Buprenorphine oral 1mg |
J0572 |
Bupren/nal up to 3mg bupreno |
J0573 |
Bupren/nal 3.1 to 6mg bupren |
J0574 |
Bupren/nal 6.1 to 10mg bupre |
J0575 |
Bupren/nal over 10mg bupreno |
J0583 |
Bivalirudin |
J0584 |
Injection, burosumab-twza 1m |
J0585 |
Injection,onabotulinumtoxina |
J0586 |
Abobotulinumtoxina |
J0587 |
Inj, rimabotulinumtoxinb |
J0588 |
Incobotulinumtoxin a |
J0592 |
Buprenorphine hydrochloride |
J0593 |
Inj., lanadelumab-flyo, 1 mg |
J0594 |
Busulfan injection |
J0595 |
Butorphanol tartrate 1 mg |
J0596 |
Injection, ruconest |
J0597 |
C-1 esterase, berinert |
J0598 |
C-1 esterase, cinryze |
J0599 |
Inj., haegarda 10 units |
J0600 |
Edetate calcium disodium inj |
J0604 |
Cinacalcet, esrd on dialysis |
J0606 |
Inj, etelcalcetide, 0.1 mg |
J0610 |
Calcium gluconate injection |
J0620 |
Calcium glycer & lact/10 ml |
J0630 |
Calcitonin salmon injection |
J0636 |
Inj calcitriol per 0.1 mcg |
J0637 |
Caspofungin acetate |
J0638 |
Canakinumab injection |
J0640 |
Leucovorin calcium injection |
J0641 |
Inj levoleucovorin nos 0.5mg |
J0642 |
Injection, khapzory, 0.5 mg |
J0670 |
Inj mepivacaine hcl/10 ml |
J0690 |
Cefazolin sodium injection |
J0692 |
Cefepime hcl for injection |
J0694 |
Cefoxitin sodium injection |
J0695 |
Inj ceftolozane tazobactam |
J0696 |
Ceftriaxone sodium injection |
J0697 |
Sterile cefuroxime injection |
J0698 |
Cefotaxime sodium injection |
J0702 |
Betamethasone acet&sod phosp |
J0706 |
Caffeine citrate injection |
J0710 |
Cephapirin sodium injection |
J0712 |
Ceftaroline fosamil inj |
J0713 |
Inj ceftazidime per 500 mg |
J0714 |
Ceftazidime and avibactam |
J0715 |
Ceftizoxime sodium / 500 mg |
J0716 |
Centruroides immune f(ab) |
J0717 |
Certolizumab pegol inj 1mg |
J0720 |
Chloramphenicol sodium injec |
J0725 |
Chorionic gonadotropin/1000u |
J0735 |
Clonidine hydrochloride |
J0740 |
Cidofovir injection |
J0743 |
Cilastatin sodium injection |
J0744 |
Ciprofloxacin iv |
J0745 |
Inj codeine phosphate /30 mg |
J0770 |
Colistimethate sodium inj |
J0775 |
Collagenase, clost hist inj |
J0780 |
Prochlorperazine injection |
J0795 |
Corticorelin ovine triflutal |
J0800 |
Corticotropin injection |
J0834 |
Inj., cosyntropin, 0.25 mg |
J0840 |
Crotalidae poly immune fab |
J0841 |
Inj crotalidae im f(ab')2 eq |
J0850 |
Cytomegalovirus imm iv /vial |
J0875 |
Injection, dalbavancin |
J0878 |
Daptomycin injection |
J0881 |
Darbepoetin alfa, non-esrd |
J0882 |
Darbepoetin alfa, esrd use |
J0883 |
Argatroban nonesrd use 1mg |
J0884 |
Argatroban esrd dialysis 1mg |
J0885 |
Epoetin alfa, non-esrd |
J0887 |
Epoetin beta esrd use |
J0888 |
Epoetin beta non esrd |
J0890 |
Peginesatide injection |
J0894 |
Decitabine injection |
J0895 |
Deferoxamine mesylate inj |
J0897 |
Denosumab injection |
J0945 |
Brompheniramine maleate inj |
J1000 |
Depo-estradiol cypionate inj |
J1020 |
Methylprednisolone 20 mg inj |
J1030 |
Methylprednisolone 40 mg inj |
J1040 |
Methylprednisolone 80 mg inj |
J1050 |
Medroxyprogesterone acetate |
J1071 |
Inj testosterone cypionate |
J1094 |
Inj dexamethasone acetate |
J1095 |
Injection, dexamethasone 9% |
J1096 |
Dexametha opth insert 0.1 mg |
J1097 |
Phenylep ketorolac opth soln |
J1100 |
Dexamethasone sodium phos |
J1110 |
Inj dihydroergotamine mesylt |
J1120 |
Acetazolamid sodium injectio |
J1130 |
Inj diclofenac sodium 0.5mg |
J1160 |
Digoxin injection |
J1162 |
Digoxin immune fab (ovine) |
J1165 |
Phenytoin sodium injection |
J1170 |
Hydromorphone injection |
J1180 |
Dyphylline injection |
J1190 |
Dexrazoxane hcl injection |
J1200 |
Diphenhydramine hcl injectio |
J1205 |
Chlorothiazide sodium inj |
J1212 |
Dimethyl sulfoxide 50% 50 ml |
J1230 |
Methadone injection |
J1240 |
Dimenhydrinate injection |
J1245 |
Dipyridamole injection |
J1250 |
Inj dobutamine hcl/250 mg |
J1260 |
Dolasetron mesylate |
J1265 |
Dopamine injection |
J1267 |
Doripenem injection |
J1270 |
Injection, doxercalciferol |
J1290 |
Ecallantide injection |
J1300 |
Eculizumab injection |
J1301 |
Injection, edaravone, 1 mg |
J1303 |
Inj., ravulizumab-cwvz 10 mg |
J1320 |
Amitriptyline injection |
J1322 |
Elosulfase alfa, injection |
J1324 |
Enfuvirtide injection |
J1325 |
Epoprostenol injection |
J1327 |
Eptifibatide injection |
J1330 |
Ergonovine maleate injection |
J1335 |
Ertapenem injection |
J1364 |
Erythro lactobionate /500 mg |
J1380 |
Estradiol valerate 10 mg inj |
J1410 |
Inj estrogen conjugate 25 mg |
J1428 |
Inj, eteplirsen, 10 mg |
J1430 |
Ethanolamine oleate 100 mg |
J1435 |
Injection estrone per 1 mg |
J1436 |
Etidronate disodium inj |
J1438 |
Etanercept injection |
J1439 |
Inj ferric carboxymaltos 1mg |
J1442 |
Inj filgrastim excl biosimil |
J1443 |
Inj ferric pyrophosphate cit |
J1444 |
Fe pyro cit pow 0.1 mg iron |
J1447 |
Inj tbo filgrastim 1 microg |
J1450 |
Fluconazole |
J1451 |
Fomepizole, 15 mg |
J1452 |
Intraocular fomivirsen na |
J1453 |
Fosaprepitant injection |
J1454 |
Inj fosnetupitant, palonoset |
J1455 |
Foscarnet sodium injection |
J1457 |
Gallium nitrate injection |
J1458 |
Galsulfase injection |
J1459 |
Inj ivig privigen 500 mg |
J1460 |
Gamma globulin 1 cc inj |
J1555 |
Inj cuvitru, 100 mg |
J1556 |
Inj, imm glob bivigam, 500mg |
J1557 |
Gammaplex injection |
J1559 |
Hizentra injection |
J1560 |
Gamma globulin > 10 cc inj |
J1561 |
Gamunex-c/gammaked |
J1562 |
Vivaglobin, inj |
J1566 |
Immune globulin, powder |
J1568 |
Octagam injection |
J1569 |
Gammagard liquid injection |
J1570 |
Ganciclovir sodium injection |
J1571 |
Hepagam b im injection |
J1572 |
Flebogamma injection |
J1573 |
Hepagam b intravenous, inj |
J1575 |
Hyqvia 100mg immuneglobulin |
J1580 |
Garamycin gentamicin inj |
J1595 |
Injection glatiramer acetate |
J1599 |
Ivig non-lyophilized, nos |
J1600 |
Gold sodium thiomaleate inj |
J1602 |
Golimumab for iv use 1mg |
J1610 |
Glucagon hydrochloride/1 mg |
J1620 |
Gonadorelin hydroch/ 100 mcg |
J1626 |
Granisetron hcl injection |
J1627 |
Inj, granisetron, xr, 0.1 mg |
J1628 |
Inj., guselkumab, 1 mg |
J1630 |
Haloperidol injection |
J1631 |
Haloperidol decanoate inj |
J1640 |
Hemin, 1 mg |
J1642 |
Inj heparin sodium per 10 u |
J1644 |
Inj heparin sodium per 1000u |
J1645 |
Dalteparin sodium |
J1650 |
Inj enoxaparin sodium |
J1652 |
Fondaparinux sodium |
J1655 |
Tinzaparin sodium injection |
J1670 |
Tetanus immune globulin inj |
J1675 |
Histrelin acetate |
J1700 |
Hydrocortisone acetate inj |
J1710 |
Hydrocortisone sodium ph inj |
J1720 |
Hydrocortisone sodium succ i |
J1726 |
Makena, 10 mg |
J1729 |
Inj hydroxyprogst capoat nos |
J1730 |
Diazoxide injection |
J1740 |
Ibandronate sodium injection |
J1741 |
Ibuprofen injection |
J1742 |
Ibutilide fumarate injection |
J1743 |
Idursulfase injection |
J1744 |
Icatibant injection |
J1745 |
Infliximab not biosimil 10mg |
J1746 |
Inj., ibalizumab-uiyk, 10 mg |
J1750 |
Inj iron dextran |
J1756 |
Iron sucrose injection |
J1786 |
Imuglucerase injection |
J1790 |
Droperidol injection |
J1800 |
Propranolol injection |
J1810 |
Droperidol/fentanyl inj |
J1815 |
Insulin injection |
J1817 |
Insulin for insulin pump use |
J1826 |
Interferon beta-1a inj |
J1830 |
Interferon beta-1b / .25 mg |
J1833 |
Injection, isavuconazonium |
J1835 |
Itraconazole injection |
J1840 |
Kanamycin sulfate 500 mg inj |
J1850 |
Kanamycin sulfate 75 mg inj |
J1885 |
Ketorolac tromethamine inj |
J1890 |
Cephalothin sodium injection |
J1930 |
Lanreotide injection |
J1931 |
Laronidase injection |
J1940 |
Furosemide injection |
J1943 |
Inj., aristada initio, 1 mg |
J1944 |
Aripirazole lauroxil 1 mg |
J1945 |
Lepirudin |
J1950 |
Leuprolide acetate /3.75 mg |
J1953 |
Levetiracetam injection |
J1955 |
Inj levocarnitine per 1 gm |
J1956 |
Levofloxacin injection |
J1960 |
Levorphanol tartrate inj |
J1980 |
Hyoscyamine sulfate inj |
J1990 |
Chlordiazepoxide injection |
J2001 |
Lidocaine injection |
J2010 |
Lincomycin injection |
J2020 |
Linezolid injection |
J2060 |
Lorazepam injection |
J2062 |
Loxapine for inhalation 1 mg |
J2150 |
Mannitol injection |
J2170 |
Mecasermin injection |
J2175 |
Meperidine hydrochl /100 mg |
J2180 |
Meperidine/promethazine inj |
J2182 |
Injection, mepolizumab, 1mg |
J2185 |
Meropenem |
J2186 |
Inj., meropenem, vaborbactam |
J2210 |
Methylergonovin maleate inj |
J2212 |
Methylnaltrexone injection |
J2248 |
Micafungin sodium injection |
J2250 |
Inj midazolam hydrochloride |
J2260 |
Inj milrinone lactate / 5 mg |
J2265 |
Minocycline hydrochloride |
J2270 |
Morphine sulfate injection |
J2274 |
Inj morphine pf epid ithc |
J2278 |
Ziconotide injection |
J2280 |
Inj, moxifloxacin 100 mg |
J2300 |
Inj nalbuphine hydrochloride |
J2310 |
Inj naloxone hydrochloride |
J2315 |
Naltrexone, depot form |
J2320 |
Nandrolone decanoate 50 mg |
J2323 |
Natalizumab injection |
J2325 |
Nesiritide injection |
J2326 |
Inj, nusinersen, 0.1mg |
J2350 |
Injection, ocrelizumab, 1 mg |
J2353 |
Octreotide injection, depot |
J2354 |
Octreotide inj, non-depot |
J2355 |
Oprelvekin injection |
J2357 |
Omalizumab injection |
J2358 |
Olanzapine long-acting inj |
J2360 |
Orphenadrine injection |
J2370 |
Phenylephrine hcl injection |
J2400 |
Chloroprocaine hcl injection |
J2405 |
Ondansetron hcl injection |
J2407 |
Injection, oritavancin |
J2410 |
Oxymorphone hcl injection |
J2425 |
Palifermin injection |
J2426 |
Paliperidone palmitate inj |
J2430 |
Pamidronate disodium /30 mg |
J2440 |
Papaverin hcl injection |
J2460 |
Oxytetracycline injection |
J2469 |
Palonosetron hcl |
J2501 |
Paricalcitol |
J2502 |
Inj, pasireotide long acting |
J2503 |
Pegaptanib sodium injection |
J2504 |
Pegademase bovine, 25 iu |
J2505 |
Injection, pegfilgrastim 6mg |
J2507 |
Pegloticase injection |
J2510 |
Penicillin g procaine inj |
J2513 |
Pentastarch 10% solution |
J2515 |
Pentobarbital sodium inj |
J2540 |
Penicillin g potassium inj |
J2543 |
Piperacillin/tazobactam |
J2545 |
Pentamidine non-comp unit |
J2547 |
Injection, peramivir |
J2550 |
Promethazine hcl injection |
J2560 |
Phenobarbital sodium inj |
J2562 |
Plerixafor injection |
J2590 |
Oxytocin injection |
J2597 |
Inj desmopressin acetate |
J2650 |
Prednisolone acetate inj |
J2670 |
Totazoline hcl injection |
J2675 |
Inj progesterone per 50 mg |
J2680 |
Fluphenazine decanoate 25 mg |
J2690 |
Procainamide hcl injection |
J2700 |
Oxacillin sodium injeciton |
J2704 |
Inj, propofol, 10 mg |
J2710 |
Neostigmine methylslfte inj |
J2720 |
Inj protamine sulfate/10 mg |
J2724 |
Protein c concentrate |
J2725 |
Inj protirelin per 250 mcg |
J2730 |
Pralidoxime chloride inj |
J2760 |
Phentolaine mesylate inj |
J2765 |
Metoclopramide hcl injection |
J2770 |
Quinupristin/dalfopristin |
J2778 |
Ranibizumab injection |
J2780 |
Ranitidine hydrochloride inj |
J2783 |
Rasburicase |
J2785 |
Regadenoson injection |
J2786 |
Injection, reslizumab, 1mg |
J2787 |
Riboflavin 5'phos opth<=3ml |
J2788 |
Rho d immune globulin 50 mcg |
J2790 |
Rho d immune globulin inj |
J2791 |
Rhophylac injection |
J2792 |
Rho(d) immune globulin h, sd |
J2793 |
Rilonacept injection |
J2794 |
Inj risperdal consta, 0.5 mg |
J2795 |
Ropivacaine hcl injection |
J2796 |
Romiplostim injection |
J2797 |
Inj., rolapitant, 0.5 mg |
J2798 |
Inj., perseris, 0.5 mg |
J2800 |
Methocarbamol injection |
J2805 |
Sincalide injection |
J2810 |
Inj theophylline per 40 mg |
J2820 |
Sargramostim injection |
J2840 |
Inj sebelipase alfa 1 mg |
J2850 |
Inj secretin synthetic human |
J2860 |
Injection, siltuximab |
J2910 |
Aurothioglucose injeciton |
J2916 |
Na ferric gluconate complex |
J2920 |
Methylprednisolone injection |
J2930 |
Methylprednisolone injection |
J2940 |
Somatrem injection |
J2941 |
Somatropin injection |
J2950 |
Promazine hcl injection |
J2993 |
Reteplase injection |
J2995 |
Inj streptokinase /250000 iu |
J2997 |
Alteplase recombinant |
J3000 |
Streptomycin injection |
J3010 |
Fentanyl citrate injection |
J3030 |
Sumatriptan succinate / 6 mg |
J3031 |
Inj., fremanezumab-vfrm 1 mg |
J3060 |
Inj, taliglucerase alfa 10 u |
J3070 |
Pentazocine injection |
J3090 |
Inj tedizolid phosphate |
J3095 |
Telavancin injection |
J3101 |
Tenecteplase injection |
J3105 |
Terbutaline sulfate inj |
J3110 |
Teriparatide injection |
J3111 |
Inj. romosozumab-aqqg 1 mg |
J3121 |
Inj testostero enanthate 1mg |
J3145 |
Testosterone undecanoate 1mg |
J3230 |
Chlorpromazine hcl injection |
J3240 |
Thyrotropin injection |
J3243 |
Tigecycline injection |
J3245 |
Inj., tildrakizumab, 1 mg |
J3246 |
Tirofiban hcl |
J3250 |
Trimethobenzamide hcl inj |
J3260 |
Tobramycin sulfate injection |
J3262 |
Tocilizumab injection |
J3265 |
Injection torsemide 10 mg/ml |
J3280 |
Thiethylperazine maleate inj |
J3285 |
Treprostinil injection |
J3300 |
Triamcinolone a inj prs-free |
J3301 |
Triamcinolone acet inj nos |
J3302 |
Triamcinolone diacetate inj |
J3303 |
Triamcinolone hexacetonl inj |
J3304 |
Inj triamcinolone ace xr 1mg |
J3305 |
Inj trimetrexate glucoronate |
J3310 |
Perphenazine injeciton |
J3315 |
Triptorelin pamoate |
J3316 |
Inj., triptorelin xr 3.75 mg |
J3320 |
Spectinomycn di-hcl inj |
J3350 |
Urea injection |
J3355 |
Urofollitropin, 75 iu |
J3357 |
Ustekinumab sub cu inj, 1 mg |
J3358 |
Ustekinumab, iv inject, 1 mg |
J3360 |
Diazepam injection |
J3364 |
Urokinase 5000 iu injection |
J3365 |
Urokinase 250,000 iu inj |
J3370 |
Vancomycin hcl injection |
J3380 |
Injection, vedolizumab |
J3385 |
Velaglucerase alfa |
J3396 |
Verteporfin injection |
J3397 |
Inj., vestronidase alfa-vjbk |
J3398 |
Inj luxturna 1 billion vec g |
J3400 |
Triflupromazine hcl inj |
J3410 |
Hydroxyzine hcl injection |
J3411 |
Thiamine hcl 100 mg |
J3415 |
Pyridoxine hcl 100 mg |
J3420 |
Vitamin b12 injection |
J3430 |
Vitamin k phytonadione inj |
J3465 |
Injection, voriconazole |
J3470 |
Hyaluronidase injection |
J3471 |
Ovine, up to 999 usp units |
J3472 |
Ovine, 1000 usp units |
J3473 |
Hyaluronidase recombinant |
J3475 |
Inj magnesium sulfate |
J3480 |
Inj potassium chloride |
J3485 |
Zidovudine |
J3486 |
Ziprasidone mesylate |
J3489 |
Zoledronic acid 1mg |
J3490 |
Drugs unclassified injection |
J3520 |
Edetate disodium per 150 mg |
J3530 |
Nasal vaccine inhalation |
J3535 |
Metered dose inhaler drug |
J3570 |
Laetrile amygdalin vit b17 |
J3590 |
Unclassified biologics |
J3591 |
Esrd on dialysi drug/bio noc |
J7030 |
Normal saline solution infus |
J7040 |
Normal saline solution infus |
J7042 |
5% dextrose/normal saline |
J7050 |
Normal saline solution infus |
J7060 |
5% dextrose/water |
J7070 |
D5w infusion |
J7100 |
Dextran 40 infusion |
J7110 |
Dextran 75 infusion |
J7120 |
Ringers lactate infusion |
J7121 |
5% dextrose in lac ringers |
J7131 |
Hypertonic saline sol |
J7170 |
Inj., emicizumab-kxwh 0.5 mg |
J7175 |
Inj, factor x, (human), 1iu |
J7177 |
Inj., fibryga, 1 mg |
J7178 |
Inj human fibrinogen con nos |
J7179 |
Vonvendi inj 1 iu vwf:rco |
J7180 |
Factor xiii anti-hem factor |
J7181 |
Factor xiii recomb a-subunit |
J7182 |
Factor viii recomb novoeight |
J7183 |
Wilate injection |
J7185 |
Xyntha inj |
J7186 |
Antihemophilic viii/vwf comp |
J7187 |
Humate-p, inj |
J7188 |
Factor viii recomb obizur |
J7189 |
Factor viia |
J7190 |
Factor viii |
J7191 |
Factor viii (porcine) |
J7192 |
Factor viii recombinant nos |
J7193 |
Factor ix non-recombinant |
J7194 |
Factor ix complex |
J7195 |
Factor ix recombinant nos |
J7196 |
Antithrombin recombinant |
J7197 |
Antithrombin iii injection |
J7198 |
Anti-inhibitor |
J7199 |
Hemophilia clot factor noc |
J7200 |
Factor ix recombinan rixubis |
J7201 |
Factor ix alprolix recomb |
J7202 |
Factor ix idelvion inj |
J7203 |
Factor ix recomb gly rebinyn |
J7205 |
Factor viii fc fusion recomb |
J7207 |
Factor viii pegylated recomb |
J7208 |
Inj. jivi 1 iu |
J7209 |
Factor viii nuwiq recomb 1iu |
J7210 |
Inj, afstyla, 1 i.u. |
J7211 |
Inj, kovaltry, 1 i.u. |
J7296 |
Kyleena, 19.5 mg |
J7297 |
Liletta, 52 mg |
J7298 |
Mirena, 52 mg |
J7300 |
Intraut copper contraceptive |
J7301 |
Skyla, 13.5 mg |
J7303 |
Contraceptive vaginal ring |
J7304 |
Contraceptive hormone patch |
J7306 |
Levonorgestrel implant sys |
J7307 |
Etonogestrel implant system |
J7308 |
Aminolevulinic acid hcl top |
J7309 |
Methyl aminolevulinate, top |
J7310 |
Ganciclovir long act implant |
J7311 |
Inj., retisert, 0.01 mg |
J7312 |
Dexamethasone intra implant |
J7313 |
Inj., iluvien, 0.01 mg |
J7314 |
Inj., yutiq, 0.01 mg |
J7315 |
Ophthalmic mitomycin |
J7316 |
Inj, ocriplasmin, 0.125 mg |
J7318 |
Inj, durolane 1 mg |
J7320 |
Genvisc 850, inj, 1mg |
J7321 |
Hyalgan supartz visco-3 dose |
J7322 |
Hymovis injection 1 mg |
J7323 |
Euflexxa inj per dose |
J7324 |
Orthovisc inj per dose |
J7325 |
Synvisc or synvisc-one |
J7326 |
Gel-one |
J7327 |
Monovisc inj per dose |
J7328 |
Gelsyn-3 injection 0.1 mg |
J7329 |
Inj, trivisc 1 mg |
J7330 |
Cultured chondrocytes implnt |
J7331 |
Synojoynt, inj., 1 mg |
J7332 |
Inj., triluron, 1 mg |
J7336 |
Capsaicin 8% patch |
J7340 |
Carbidopa levodopa ent 100ml |
J7342 |
Ciprofloxacin otic susp 6 mg |
J7345 |
Aminolevulinic acid, 10% gel |
J7401 |
Mometasone furoate sinus imp |
J7500 |
Azathioprine oral 50mg |
J7501 |
Azathioprine parenteral |
J7502 |
Cyclosporine oral 100 mg |
J7503 |
Tacrol envarsus ex rel oral |
J7504 |
Lymphocyte immune globulin |
J7505 |
Monoclonal antibodies |
J7507 |
Tacrolimus imme rel oral 1mg |
J7508 |
Tacrol astagraf ex rel oral |
J7509 |
Methylprednisolone oral |
J7510 |
Prednisolone oral per 5 mg |
J7511 |
Antithymocyte globuln rabbit |
J7512 |
Prednisone ir or dr oral 1mg |
J7513 |
Daclizumab, parenteral |
J7515 |
Cyclosporine oral 25 mg |
J7516 |
Cyclosporin parenteral 250mg |
J7517 |
Mycophenolate mofetil oral |
J7518 |
Mycophenolic acid |
J7520 |
Sirolimus, oral |
J7525 |
Tacrolimus injection |
J7527 |
Oral everolimus |
J7599 |
Immunosuppressive drug noc |
J7604 |
Acetylcysteine comp unit |
J7605 |
Arformoterol non-comp unit |
J7606 |
Formoterol fumarate, inh |
J7607 |
Levalbuterol comp con |
J7608 |
Acetylcysteine non-comp unit |
J7609 |
Albuterol comp unit |
J7610 |
Albuterol comp con |
J7611 |
Albuterol non-comp con |
J7612 |
Levalbuterol non-comp con |
J7613 |
Albuterol non-comp unit |
J7614 |
Levalbuterol non-comp unit |
J7615 |
Levalbuterol comp unit |
J7620 |
Albuterol ipratrop non-comp |
J7622 |
Beclomethasone comp unit |
J7624 |
Betamethasone comp unit |
J7626 |
Budesonide non-comp unit |
J7627 |
Budesonide comp unit |
J7628 |
Bitolterol mesylate comp con |
J7629 |
Bitolterol mesylate comp unt |
J7631 |
Cromolyn sodium noncomp unit |
J7632 |
Cromolyn sodium comp unit |
J7633 |
Budesonide non-comp con |
J7634 |
Budesonide comp con |
J7635 |
Atropine comp con |
J7636 |
Atropine comp unit |
J7637 |
Dexamethasone comp con |
J7638 |
Dexamethasone comp unit |
J7639 |
Dornase alfa non-comp unit |
J7640 |
Formoterol comp unit |
J7641 |
Flunisolide comp unit |
J7642 |
Glycopyrrolate comp con |
J7643 |
Glycopyrrolate comp unit |
J7644 |
Ipratropium bromide non-comp |
J7645 |
Ipratropium bromide comp |
J7647 |
Isoetharine comp con |
J7648 |
Isoetharine non-comp con |
J7649 |
Isoetharine non-comp unit |
J7650 |
Isoetharine comp unit |
J7657 |
Isoproterenol comp con |
J7658 |
Isoproterenol non-comp con |
J7659 |
Isoproterenol non-comp unit |
J7660 |
Isoproterenol comp unit |
J7665 |
Mannitol for inhaler |
J7667 |
Metaproterenol comp con |
J7668 |
Metaproterenol non-comp con |
J7669 |
Metaproterenol non-comp unit |
J7670 |
Metaproterenol comp unit |
J7674 |
Methacholine chloride, neb |
J7676 |
Pentamidine comp unit dose |
J7677 |
Revefenacin inh non-com 1mcg |
J7680 |
Terbutaline sulf comp con |
J7681 |
Terbutaline sulf comp unit |
J7682 |
Tobramycin non-comp unit |
J7683 |
Triamcinolone comp con |
J7684 |
Triamcinolone comp unit |
J7685 |
Tobramycin comp unit |
J7686 |
Treprostinil, non-comp unit |
J7699 |
Inhalation solution for dme |
J7799 |
Non-inhalation drug for dme |
J7999 |
Compounded drug, noc |
J8498 |
Antiemetic rectal/supp nos |
J8499 |
Oral prescrip drug non chemo |
J8501 |
Oral aprepitant |
J8510 |
Oral busulfan |
J8515 |
Cabergoline, oral 0.25mg |
J8520 |
Capecitabine, oral, 150 mg |
J8521 |
Capecitabine, oral, 500 mg |
J8530 |
Cyclophosphamide oral 25 mg |
J8540 |
Oral dexamethasone |
J8560 |
Etoposide oral 50 mg |
J8562 |
Oral fludarabine phosphate |
J8565 |
Gefitinib oral |
J8597 |
Antiemetic drug oral nos |
J8600 |
Melphalan oral 2 mg |
J8610 |
Methotrexate oral 2.5 mg |
J8650 |
Nabilone oral |
J8655 |
Oral netupitant, palonosetro |
J8670 |
Rolapitant, oral, 1mg |
J8700 |
Temozolomide |
J8705 |
Topotecan oral |
J8999 |
Oral prescription drug chemo |
J9000 |
Doxorubicin hcl injection |
J9015 |
Aldesleukin injection |
J9017 |
Arsenic trioxide injection |
J9019 |
Erwinaze injection |
J9020 |
Asparaginase, nos |
J9022 |
Inj, atezolizumab,10 mg |
J9023 |
Injection, avelumab, 10 mg |
J9025 |
Azacitidine injection |
J9027 |
Clofarabine injection |
J9030 |
Bcg live intravesical 1mg |
J9032 |
Injection, belinostat, 10mg |
J9033 |
Inj., treanda 1 mg |
J9034 |
Inj., bendeka 1 mg |
J9035 |
Bevacizumab injection |
J9036 |
Inj. belrapzo/bendamustine |
J9039 |
Injection, blinatumomab |
J9040 |
Bleomycin sulfate injection |
J9041 |
Inj., velcade 0.1 mg |
J9042 |
Brentuximab vedotin inj |
J9043 |
Cabazitaxel injection |
J9044 |
Inj, bortezomib, nos, 0.1 mg |
J9045 |
Carboplatin injection |
J9047 |
Injection, carfilzomib, 1 mg |
J9050 |
Carmustine injection |
J9055 |
Cetuximab injection |
J9057 |
Inj., copanlisib, 1 mg |
J9060 |
Cisplatin 10 mg injection |
J9065 |
Inj cladribine per 1 mg |
J9070 |
Cyclophosphamide 100 mg inj |
J9098 |
Cytarabine liposome inj |
J9100 |
Cytarabine hcl 100 mg inj |
J9118 |
Inj. calaspargase pegol-mknl |
J9119 |
Inj., cemiplimab-rwlc, 1 mg |
J9120 |
Dactinomycin injection |
J9130 |
Dacarbazine 100 mg inj |
J9145 |
Injection, daratumumab 10 mg |
J9150 |
Daunorubicin injection |
J9151 |
Daunorubicin citrate inj |
J9153 |
Inj daunorubicin, cytarabine |
J9155 |
Degarelix injection |
J9160 |
Denileukin diftitox inj |
J9165 |
Diethylstilbestrol injection |
J9171 |
Docetaxel injection |
J9173 |
Inj., durvalumab, 10 mg |
J9175 |
Elliotts b solution per ml |
J9176 |
Injection, elotuzumab, 1mg |
J9178 |
Inj, epirubicin hcl, 2 mg |
J9179 |
Eribulin mesylate injection |
J9181 |
Etoposide injection |
J9185 |
Fludarabine phosphate inj |
J9190 |
Fluorouracil injection |
J9199 |
Injection, infugem, 200 mg |
J9200 |
Floxuridine injection |
J9201 |
In gemcitabine hcl nos 200mg |
J9202 |
Goserelin acetate implant |
J9203 |
Gemtuzumab ozogamicin 0.1 mg |
J9204 |
Inj mogamulizumab-kpkc, 1 mg |
J9205 |
Inj irinotecan liposome 1 mg |
J9206 |
Irinotecan injection |
J9207 |
Ixabepilone injection |
J9208 |
Ifosfamide injection |
J9209 |
Mesna injection |
J9210 |
Inj., emapalumab-lzsg, 1 mg |
J9211 |
Idarubicin hcl injection |
J9212 |
Interferon alfacon-1 inj |
J9213 |
Interferon alfa-2a inj |
J9214 |
Interferon alfa-2b inj |
J9215 |
Interferon alfa-n3 inj |
J9216 |
Interferon gamma 1-b inj |
J9217 |
Leuprolide acetate suspnsion |
J9218 |
Leuprolide acetate injeciton |
J9219 |
Leuprolide acetate implant |
J9225 |
Vantas implant |
J9226 |
Supprelin la implant |
J9228 |
Ipilimumab injection |
J9229 |
Inj inotuzumab ozogam 0.1 mg |
J9230 |
Mechlorethamine hcl inj |
J9245 |
Inj melphalan hydrochl 50 mg |
J9250 |
Methotrexate sodium inj |
J9260 |
Methotrexate sodium inj |
J9261 |
Nelarabine injection |
J9262 |
Inj, omacetaxine mep, 0.01mg |
J9263 |
Oxaliplatin |
J9264 |
Paclitaxel protein bound |
J9266 |
Pegaspargase injection |
J9267 |
Paclitaxel injection |
J9268 |
Pentostatin injection |
J9269 |
Inj. tagraxofusp-erzs 10 mcg |
J9270 |
Plicamycin (mithramycin) inj |
J9271 |
Inj pembrolizumab |
J9280 |
Mitomycin injection |
J9285 |
Inj, olaratumab, 10 mg |
J9293 |
Mitoxantrone hydrochl / 5 mg |
J9295 |
Injection, necitumumab, 1 mg |
J9299 |
Injection, nivolumab |
J9301 |
Obinutuzumab inj |
J9302 |
Ofatumumab injection |
J9303 |
Panitumumab injection |
J9305 |
Pemetrexed injection |
J9306 |
Injection, pertuzumab, 1 mg |
J9307 |
Pralatrexate injection |
J9308 |
Injection, ramucirumab |
J9309 |
Inj, polatuzumab vedotin 1mg |
J9311 |
Inj rituximab, hyaluronidase |
J9312 |
Inj., rituximab, 10 mg |
J9313 |
Inj., lumoxiti, 0.01 mg |
J9315 |
Romidepsin injection |
J9320 |
Streptozocin injection |
J9325 |
Inj talimogene laherparepvec |
J9328 |
Temozolomide injection |
J9330 |
Temsirolimus injection |
J9340 |
Thiotepa injection |
J9351 |
Topotecan injection |
J9352 |
Injection trabectedin 0.1mg |
J9354 |
Inj, ado-trastuzumab emt 1mg |
J9355 |
Inj trastuzumab excl biosimi |
J9356 |
Inj. herceptin hylecta, 10mg |
J9357 |
Valrubicin injection |
J9360 |
Vinblastine sulfate inj |
J9370 |
Vincristine sulfate 1 mg inj |
J9371 |
Inj, vincristine sul lip 1mg |
J9390 |
Vinorelbine tartrate inj |
J9395 |
Injection, fulvestrant |
J9400 |
Inj, ziv-aflibercept, 1mg |
J9600 |
Porfimer sodium injection |
J9999 |
Chemotherapy drug |