Searchable Medical Pharmacy Benefit HCPCS Listing

How to use the searchable tool

Definitions

  • Drug Name: Brand or Common Name of the HCPCS code
  • Authorization Required: If there is a check mark in this column, then this medication requires authorization prior to administration
  • Covered (No PA Required): If there is a check mark in this column, then there is No Authorization Required
  • Not Covered: If there is a check mark in this column, then this HCPCS code is not a covered benefit
  • Auth Required if Prescribed for an Oncology/Hematology Indication
    • If there is a check mark in this column, the corresponding HCPCS code will require authorization if prescribed for an Oncology/Hematology ICD-10 diagnosis code found on the ICD-10 Codes listing.
      • If not prescribed for an Oncology/Hematology Indication, the HCPCS Code is No Authorization Required.
  • Medicaid Listing
    • Medicaid Medical Pharmacy Benefit HCPCS
  • Commercial Listing
    • Commercial Medical Pharmacy Benefit HCPCS
  • INTEGRITY (MMP) Listing
    • Integrity (MMP) Medical Pharmacy Benefit HCPCS
  • EFP (Extended Family Planning) Listing
    • EFP Medical Pharmacy Benefit Covered HCPCS
  • ICD-10 Codes Listing
    • Listing of indications that require prior authorization for a designated HCPCS code that has a check mark in Auth Required if Prescribed for an Oncology/Hematology Indication.
  • Medical Pharmacy Benefit Authorization Criteria
  • Medicare Part B Step Therapy Document

Last Updated 7/2/2022

MEDICAIDINTEGRITY (MMP)CommercialEFP FormularyICD10 Codes
HCPCS CODEHCPCS CODE DESCRIPTIONDRUG NAMEMEDICAID - Authorization RequiredMEDICAID - Covered (No PA Required)MEDICAID- Not CoveredAuth Required if Prescribed for an Oncology/Hematology Related Indication
90378Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular useSynagisYes
A9513Lutetium lu 177, dotatate, therapeutic, 1 millicurieLutatheraYes
A9517Iodine- i-131 sodium iodide capsule(s), therapeutic, per millicurieHiconYes
A9543Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuriesZevalin Y-90Yes
A9590Iodine i-131, iobenguane, 1 millicurieAzedraYes
A9600Strontium sr-89 chloride, therapeutic, per millicurieMetastronYes
A9604Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuriesQuadrametYes
A9606Radium ra-223 dichloride, therapeutic, per microcurieXofigoYes
C9046COCAINE HCL NASAL SOLUTION Goprelto Yes
C9047Injection, caplacizumab-yhdp, 1 mg (Cablivi)CabliviYes
C9113INJECTION, PANTOPRAZOLE SODIUM, PER VIAL ProtonixYes
C9248Inj, clevidipine butyrate CleviprexYes
C9250Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 mlArtissYes
C9254Injection, lacosamide VimpatYes
C9257Bevacizumab injection AvastinYes
C9285Patch, lidocaine/tetracaine SyneraYes
C9290INJ, BUPIVACAINE LIPOSOME ExparelYes
C9293INJECTION, GLUCARPIDASE VoraxazeYes
C9460INJECTION, CANGRELOR KengrealYes
C9462INJECTION, DELAFLOXACIN BaxdelaYes
C9482SOTALOL HYDROCHLORIDE IV Sotalol HclYes
C9488CONIVAPTAN HCL VaprisolYes
J0121Injection, omadacycline, 1 mgNuzyraYes
J0122Injection, eravacycline, 1 mgXeravaYes
J0129INJECTION ABATACEPT 10 MG Orencia ClickjectYes
J0130INJECTION ABCIXIMAB, 10 MG ReoproYes
J0131Acetaminophen injection OfirmevYes
J0132INJECTION, ACETYLCYSTEINE, 100 MG AcetadoteYes
J0133INJECTION, ACYCLOVIR, 5 MG Acyclovir SodiumYes
J0135INJECTION, ADALIMUMAB, 20 MG Humira PenYes
J0153ADENOSINE INJ 1MG AdenoscanYes
J0171Adrenalin epinephrine inject Epinephrine PfYes
J0178Injection, aflibercept, 1 mgEyleaYes
J0179Injection, brolucizumab-dbll, 1 mgBeovuYes
J0180INJECTION, AGALSIDASE BETA, 1 MG FabrazymeYes
J0185INJ., APREPITANT, 1 MG CinvantiYes
J0202INJECTION, ALEMTUZUMAB LemtradaYes
J0207INJECTION, AMIFOSTINE, 500 MG EthyolYes
J0210INJECTION, METHYLDOPATE HCL, UP TO 250 MG Methyldopate HclYes
J0221Injection, alglucosidase alfa, 10 mg Lumizyme Yes
J0222Injection, patisiran, 0.1 mgOnpattroYes
J0223Injection, givosiran, 0.5 mgGivlaariYes
J0256INJECTION, ALPHA 1 - PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG Prolastin-cYes
J0257INJECTION, ALPHA 1 - PROTEINASE INHIBITOR (HUMAN), (GLASSIA), 10 MG GlassiaYes
J0270ALPROSTADIL, PER 1.25MCG CaverjectYes
J0275ALPROSTADIL URETHRAL SUPPOSITORY (CODE MAY BE USED FOR MEDICARE WHEN DRUMuseYes
J0278INJECTION, AMIKACIN SULFATE, 100 MG Amikacin SulfateYes
J0280INJECTION, AMINOPHYLLIN, UP TO 250 MG AminophyllineYes
J0282INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG Amiodarone HclYes
J0285INJECTION, AMPHOTERICIN B, 50 MG Amphotericin BYes
J0287INJECTION, AMPHOTERICIN B LIPID COMPLEX, 10 MG AbelcetYes
J0289INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG AmbisomeYes
J0290INJECTION, AMPICILLIN SODIUM, UP TO 500MG Ampicillin SodiumYes
J0291Injection, plazomicin, 5 mgZemdriYes
J0295INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM UnasynYes
J0300INJECTION, AMOBARBITAL, UP TO 125 MG Amytal SodiumYes
J0330INJECTION, SUCCINYCHOLINE CHLORIDE, UP TO 20 MG QuelicinYes
J0348INJECTION, ANIDULAFUNGIN, 1 MG EraxisYes
J0360INJECTION, HYDRALAZINE HCL, UP TO 20 MG Hydralazine HclYes
J0364INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG ApokynYes
J0401INJ ARIPIPRAZOLE EXT REL 1MG Abilify MaintenaYes
J0456INJECTION, AZITHROMYCIN, 500 MG ZithromaxYes
J0461Atropine sulfate injection Atropine SulfateYes
J0470INJECTION, DIMECAPROL, UP TO 100 MG Bal In OilYes
J0475INJECTION, BACLOFEN, 10 MG BaclofenYes
J0476INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL LioresalYes
J0480INJECTION, BASILIXIMAB, 20 MG SimulectYes
J0485BELATACEPT INJECTION NulojixYes
J0490Belimumab injection BenlystaYes
J0500INJECTION, DICYCLOMINE, UP TO 20 MG BentylYes
J0515INJECTION, BENZTROPINE CogentinYes
J0517INJ., BENRALIZUMAB, 1 MG Fasenra yes
J0558PenG benzathine/procaine inj Bicillin C-RYes
J0561Penicillin g benzathine inj Bicillin L-AYes
J0565INJ, BEZLOTOXUMAB, 10 MG ZinplavaYes
J0567INJ., CERLIPONASE ALFA 1 MG BrineuraYes
J0570BUPRENORPHINE IMPLANT, 74.2 MG Probuphine Implant KitYes
J0571BUPRENORPHINE ORAL 1MG SubutexYes
J0572BUPRENORPHIN/NALOX UP TO 3MG Suboxone, Bunavail, ZubsolvYes
J0573BUPRENORPH/NALOX 3.1 TO 6MG Suboxone, Bunavail, ZubsolvYes
J0574BUPRENORPH/NALOX 6.1 TO 10MG Suboxone, Bunavail, ZubsolvYes
J0575BUPRENORPH/NALOX OVER 10MG Suboxone, Bunavail, ZubsolvYes
J0583INJECTION, BIVALIRUDIN, 1 MG AngiomaxYes
J0584INJECTION, BUROSUMAB-TWZA 1M CrysvitaYes
J0585BOTULINUM TOXIN TYPE A, PER UNIT Botox Yes
J0586AbobotulinumtoxinA Dysport Yes
J0587RimabotulinumtoxinBMyobloc Yes
J0588IncobotulinumtoxinA Xeomin Yes
J0591Injection, deoxycholic acid, 1 mgKybellaYes
J0592INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG BuprenexYes
J0593Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)TakhzyroYes
J0594INJECTION BUSULFAN 1 MG BusulfexYes
J0595INJECTION, BUTORPHANOL TARTRATE, 1 MG Butorphanol TartrateYes
J0596Injection, C1 esterase inhibitor (recombinant), ruconest, 10 units RuconestYes
J0597Injection, c-1 esterase inhibitor (human), berinert, 10 units BerinertYes
J0598Injection, c-1 esterase inhibitor (human), cinryze, 10 units CinryzeYes
J0599Injection, c-1 esterase inhibitor (human), haegarda, 10 units HaegardaYes
J0600INJECTION, EDETATE CALCIUM DISODIUM, UP TO 200 MG Calcium Disodium VersenateYes
J0604CINACALCET, ORAL, ESRD ON DIALYSIS SensiparYes
J0606INJ, ETELCALCETIDE, 0.1 MG ParsabivYes
J0610INJECTION, CALCIUM GLUCONATE, UP TO 10 ML Calcium GluconateYes
J0630INJECTION, CALCITONIN SALMON, UP TO 400 UNITS MiacalcinYes
J0636INJECTION, CALCITRIOL, 0.1 MCG CalcitriolYes
J0637INJECTION, CASPOFUNGIN ACETATE, 5 MG CancidasYes
J0638Canakinumab injection IlarisYes
J0640INJECTION, LEUCOVORIN CALCIUM, PER 50 MG Leucovorin CalciumYes
J0641Levoleucovorin injection Levoleucovorin Calcium PfYes
J0642Injection, levoleucovorin (Khapzory), 0.5 mgKhapzoryYes
J0670INJECTION, MEPIVACAINE Polocaine-mpfYes
J0690INJECTION, CEFAZOLIN SODIUM, UP TO 500 MG Cefazolin SodiumYes
J0691Injection, lefamulin, 1 mgXenletaYes
J0692INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG Cefepime HclYes
J0694INJECTION, CEFOXITIN SODIUM, 1 GM Cefoxitin SodiumYes
J0695INJ CEFTOLOZANE AND TAZOBACTAM ZerbaxaYes
J0696INJECTION, CEFTRIAXONE SODIUM, PER 250 MG (ROCEPHIN) Ceftriaxone SodiumYes
J0697INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG ZinacefYes
J0698CEFOTAXIME SODIUM, PER GM Cefotaxime SodiumYes
J0702INJECTION; BETAMETHASONE ACETATE & SODIUM PHOSPHATE Betamethasone Sod Phos & AcetYes
J0706INJECTION, CAFFEINE CITRATE, 5MG Caffeine CitrateYes
J0712Ceftaroline fosamil inj TeflaroYes
J0713INJ CEFTAZIDIME PER 500 MG CeftazidimeYes
J0714CEFTAZIDIME AND AVIBACTAM AvycazYes
J0716CENTRUROIDES IMMUNE F(AB) AnascorpYes
J0717CERTOLIZUMAB PEGOL INJ 1MG Cimzia Starter KitYes
J0720INJECTION, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 GM Chloramphenicol Sod SuccinateYes
J0725INJECTION, CHORIONIC GONADOTROPIN NovarelYes
J0735INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG DuraclonYes
J0740INJECTION, CIDOFOVIR, 375 MG CidofovirYes
J0742Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mgRecarbrioYes
J0743INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG PrimaxinYes
J0744INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG Cipro IVYes
J0770INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG Coly-Mycin MYes
J0775Collagenase, clost hist inj XiaflexYes
J0780INJECTION, PROCHLORPERAZINE, UP TO 10 MG Prochlorperazine EdisylateYes
J0791Injection, crizanlizumab-tmca, 5 mgAdakveoYes
J0795INJECTION, CORTICORELIN OVINE TRIFLUTATE, 1 MICROGRAM ActhrelYes
J0800INJECTION, CORTICOTROPIN, UP TO 40 UNITS ActharYes
J0834Cosyntropin cortrosyn inj CosyntropinYes
J0840Crotalidae poly immune fab CrofabYes
J0841INJ CROTALIDAE IM F(AB')2 EQ AnavipYes
J0850Injection, cytomegalovirus immune globulin IVCytogamYes
J0875INJECTION, DALBAVANCIN DalvanceYes
J0878INJECTION, DAPTOMYCIN, 1 MG CubicinYes
J0881INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE) AranespYes
J0882INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (FOR ESRD ON DIALYSIS) AranespYes
J0883ARGATROBAN NONESRD USE 1MG ArgatrobanYes
J0884ARGATROBAN ESRD DIALYSIS 1MG ArgatrobanYes
J0885INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS Epogen, ProcritYes
J0887EPOETIN BETA ESRD USE MirceraYes
J0888EPOETIN BETA NON ESRD MirceraYes
J0894INJECTION DECITABINE 1 MG DecitabineYes
J0895INJECTION, DEFEROXAMINE MESYLATE, 500 MG PER 5 CC DesferalYes
J0896Injection, luspatercept-aamt, 0.25 mgReblozylYes
J0897Denosumab injection Prolia, XgevaYes
J1000INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG Depo-estradiolYes
J1020INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG Depo-medrolYes
J1030INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG Methylprednisolone AcetateYes
J1040INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG Methylprednisolone AcetateYes
J1050INJECTION, MEDROXYPROGESTERONE ACETATE, 100 MG(DEPO PROVERA) Depo-proveraYes
J1071INJ TESTOSTERONE CYPIONATE Testosterone CypionateYes
J1095INJECTION, DEXAMETHASONE 9 PERCENT, INTRAOCULAR, 1 DexycuYes
J1096Dexamethasone, lacrimal ophthalmic insert, 0.1 mgDextenzaYes
J1097Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 mlOmidriaYes
J1100INJECTION, DEXAMETHOSONE SODIUM PHOSPHATE, UP TO 4MG/ML Dexamethasone Sodium PhosphateYes
J1110INJECTION, DEHYDROERGOTAMINE, UP TO 1 MG Dihydroergotamine MesylateYes
J1120INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG Acetazolamide SodiumYes
J1130INJ DICLOFENAC SODIUM 0.5MG DylojectYes
J1160INJECTION, DIGOXIN, UP TO 0.5 MG LanoxinYes
J1162INJECTION, DIGOXIN IMMUNE FAB (OVINE), PER VIAL DigifabYes
J1165INJECTION, PHENYTOIN SODIUM Phenytoin SodiumYes
J1170INJECTION, HYDROMORPHONE, UP TO 4 MG DilaudidYes
J1190INJECTION, DEXRAZOXANE HCL, PER 250 MG Dexrazoxane HclYes
J1200INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG Diphenhydramine HclYes
J1201Injection, cetirizine hydrochloride, 0.5 mgQuzyttirYes
J1205INJECTION, CHLOROTHIAZIDE SODIUM DiurilYes
J1212INJECTION, DMSO, DIMETHYL SULFOXIDE Rimso-50Yes
J1230INJECTION, METHADONE HCL, UP TO 10 MG Methadone HclYes
J1240INJECTION, DIMENHYDRINATE, UP TO 50 MG DimenhydrinateYes
J1245INJECTION, DIPYRIDAMOLE, PER 10 MG DipyridamoleYes
J1250INJ DOBUTAMINE HCL/250 MG Dobutamine HclYes
J1260INJECTION, DOLASETRON MESYLATE, 10 MG AnzemetYes
J1265INJECTION, DOPAMINE HCL, 40 MG Dopamine HclYes
J1267Doripenem injection DoribaxYes
J1270INJECTION, DOXERCALCIFEROL, 1 MCG HectorolYes
J1290Ecallantide injection KalbitorYes
J1300Eculizumab injection SolirisYes
J1301INJECTION, EDARAVONE, 1 MG RadicavaYes
J1303Injection, ravulizumab-cwvz, 10 mgUltomirisYes
J1322ELOSULFASE ALFA, INJECTION VimizimYes
J1324Enfuvirtide injection FuzeonYes
J1325INJECTION, EPOPROSTENOL, 0.5 MG Flolan, VeletriYes
J1327INJECTION, EPTIFIBATIDE, 5 MG IntegrilinYes
J1335INJECTION, ERTAPENEM SODIUM, 500 MG InvanzYes
J1364INJECTION; ERYTHROMYCIN LACTOBIONA Erythrocin LactobionateYes
J1380INJECTION, ESTRADIOL VALERATE, UP TO 10 MG Estradiol ValerateYes
J1410INJECTION, ESTROGEN CONJUGATED, UP TO 2 MG OR 20,000 UNITS PremarinYes
J1428INJ, ETEPLIRSEN, 10 MG Exondys 51Yes
J1429Injection, golodirsen, 10 mgVyondys 53Yes
J1430INJECTION, ETHANOLAMINE OLEATE, 100 MG EthamolinYes
J1437Injection, ferric derisomaltose, 10 mgMonoferricYes
J1438INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)EnbrelYes
J1439INJ FERRIC CARBOXYMALTOSE 1MG InjectaferYes
J1442INJ, FILGRASTIM G-CSF 1MCG NeupogenYes
J1443Injection, ferric pyrophosphate citrate solution, 0.1 mg of ironTrifericYes
J1444Injection, ferric pyrophosphate citrate powder, 0.1 mg of ironTrifericYes
J1447INJ TBO FILGRASTIM 1 MICROG GranixYes
J1450INJECTION FLUCONAZOLE, 200 MG Fluconazole In Sodium ChlorideYes
J1451INJECTION, FOMEPIZOLE, 15 MG FomepizoleYes
J1453Fosaprepitant injection EmendYes
J1454INJ FOSNETUPITANT AND PALONOSETRON AkynzeoYes
J1455INJECTION, FOSCARNET SODIUM, PER 1000 MG FoscavirYes
J1458INJECTION GALSULFASE 1 MG NaglazymeYes
J1459Inj IVIG privigen 500 mg PrivigenYes
J1460INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC GamastanYes
J1555INJ, IMMUNE GLOBULIN, CUVITRU, 100 MG CuvitruYes
J1556INJ, IMM GLOB BIVIGAM, 500MG BivigamYes
J1557Inj, immune globulin, Gammaplex, 500 mg GammaplexYes
J1558Injection, immune globulin (xembify), 100 mgXembifyYes
J1559Inj, immune globulin, Hizentra, 100 mg HizentraYes
J1560INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC GamastanYes
J1561INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, PER 500 MG. Gammaked, Gamunex-CYes
J1566INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. P Carimune NfYes
J1568Octagam injection OctagamYes
J1569Gammagard liquid injection Gammagard LiquidYes
J1570INJECTION, GANCICLOVIR SODIUM, 500 MG Ganciclovir SodiumYes
J1571HepaGam B IM injection Hepagam BYes
J1572Flebogamma injection Flebogamma DifYes
J1573Hepagam B intravenous, inj Hepagam BYes
J1575HYQVIA 100MG IMMUNEGLOBULIN HyqviaYes
J1580INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG Gentamicin SulfateYes
J1595INJECTION, GLATIRAMER ACETATE, 20 MG CopaxoneYes
J1599Ivig non-lyophilized, NOS Panzyga, AscenivYes
J1602GOLIMUMAB FOR IV USE 1MG Simponi AriaYes
J1610INJECTION; GLUCAGON HYDROCHLORIDE Glucagon EmergencyYes
J1626INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG Granisetron HclYes
J1627INJ, GRANISETRON, XR, 0.1 MG SustolYes
J1628INJ., GUSELKUMAB, 1 MG TremfyaYes
J1630INJECTION, HALOPERIDOL, UP TO 5 MG Haldol LactateYes
J1631INJECTION, HALOPERIDOL DECANOATE, PER 50 MG Haldol DecanoateYes
J1632Injection, brexanolone, 1 mgZulressoYes
J1640INJECTION, HEMIN, 1 MG PanhematinYes
J1642HEPARIN SODIUM PER 10 UNITS Heparin Lock FlushYes
J1644INJECTION, HEPARIN SODIUM, PER 1000 units Heparin Sodium (porcine)Yes
J1645INJECTION, DALTEPARIN SODIUM, PER 2500 IU FragminYes
J1650INJ ENOXAPARIN SODIUM 30 MG LovenoxYes
J1652INJECTION, FONDAPARINUX SODIUM, 0.5 MG ArixtraYes
J1670INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS Hypertet S/DYes
J1675INJECTION, HISTRELIN ACETATE, 10 MICROGRAMS VantasYes
J1720INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG Solu-cortefYes
J1726Injection, hydroxyprogesterone caproate, (makena), 10 mg MakenaYes
J1729Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg Hydroxyprogesterone CaproateYes
J1730INJECTION, DIAZOXIDE, UP TO 300 MG Yes
J1738Injection, meloxicam, 1 mgAnjesoYes
J1740INJECTION IBANDRONATE SODIUM 1 MG BonivaYes
J1741INJECTION, IBUPROFEN, 100 MGCaldolorYes
J1742INJECTION, IBUTILIDE FUMARATE, 1 MG CorvertYes
J1743Idursulfase injection ElapraseYes
J1744ICATIBANT INJECTION Firazyr Yes
J1745INJECTION INFLIXIMAB, 10 MG RemicadeYes
J1746INJ., IBALIZUMAB-UIYK, 10 MG TrogarzoYes
J1750INJECTION, IRON DEXTRAN, 50 MG InfedYes
J1756INJECTION, IRON SUCROSE, 1 MG VenoferYes
J1786Injection, imiglucerase, 10 unitsCerezymeYes
J1790INJECTION, DROPERIDOL, UP TO 5 MG DroperidolYes
J1800INJECTION, PROPRANOLOL HCL, UP TO 1 MG Propranolol HclYes
J1815INJECTION, INSULIN, PER 5 UNITS MultipleYes
J1817INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITSMultipleYes
J1826Interferon Beta-1A inj Avonex PenYes
J1830INJECTION; INTERFERON BETA-1B BetaseronYes
J1833INJECTION, ISAVUCONAZONIUM CresembaYes
J1885INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG ToradolYes
J1930Injection, lanreotide, 1 mg Somatuline Depot Yes
J1931INJECTION, LARONIDASE, 0.1 MG AldurazymeYes
J1940INJECTION, FUROSEMIDE, UP TO 20 MG LasixYes
J1943Injection, aripiprazole lauroxil, (Aristada Initio), 1 mgAristada InitioYes
J1944Injection, aripiprazole lauroxil, (Aristada), 1 mgAristadaYes
J1950Injection, leuprolide acetate, per 3.75mg Lupron DepotYes
J1953Levetiracetam injection KeppraYes
J1955INJ LEVOCARNITINE PER 1 GM CarnitorYes
J1956INJECTION, LEVOFLOXACIN, 250 MG LevaquinYes
J1980INJECTION, HYOSCYAMINE SULFATE, UP TO 0.25 MG LevsinYes
J2001INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG XylocaineYes
J2010INJECTION, LINCOMYCIN HCL, UP TO 300 MG LincocinYes
J2020INJECTION, LINEZOLID, 200MG ZyvoxYes
J2060INJECTION, LORAZEPAM, 2 MG AtivanYes
J2062LOXAPINE FOR INHALATION 1 MG AdasuveYes
J2150INJECTION, MANNITOL, 25% IN 50 ML OsmitrolYes
J2170 Mecasermin injection IncrelexYes
J2175INJECTION, MEPERIDINE; PER 100MG DemerolYes
J2182INJECTION, MEPOLIZUMAB, 1MG NucalaYes
J2185INJECTION, MEROPENEM, 100 MG MerremYes
J2186INJECTION, MEROPENEM AND VABORBACTAM, 10MG/10MG, (20 MG)VabomereYes
J2210INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG MethergineYes
J2212METHYLNALTREXONE INJECTION RelistorYes
J2248INJECTION MICAFUNGIN SODIUM 1 MG MycamineYes
J2250INJ MIDAZOLAM HYDROCHLORIDE (VERSED) VersedYes
J2260INJECTION; MILRIONONE LACTATE Milrinone LactateYes
J2265Minocycline hydrochloride MinocinYes
J2270INJECTION, MORPHINE SULFATE, UP TO 10 MG Morphine SulfateYes
J2274IN MORPHINE PRESERVATIV FREE Morphine Sulfate (pf)Yes
J2278INJECTION, ZICONOTIDE, 1 MICROGRAM PrialtYes
J2280INJECTION, MOXIFLOXACIN, 100 MG AveloxYes
J2300INJ NALBUPHINE HYDROCHLORIDE Nalbuphine HclYes
J2310INJ NALOXONE HYDROCHLORIDE NarcanYes
J2315INJECTION NALTREXONE DEPOT FORM 1 MG VivitrolYes
J2323Natalizumab injection TysabriYes
J2325INJECTION, NESIRITIDE, 0.1 MG NatrecorYes
J2326INJ, NUSINERSEN, 0.1MG SpinrazaYes
J2350Injection, ocrelizumab, 1 mg OcrevusYes
J2353INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG Sandostatin LAR DepotYes
J2354INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJ, 25 MCGSandostatinYes
J2357INJECTION, OMALIZUMAB, 5 MG XolairYes
J2358Olanzapine long-acting inj Zyprexa RelprevvYes
J2360INJECTION, ORPHENADRINE, UP TO 60 MG OrphenateYes
J2370INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML Phenylephrine HclYes
J2400INJECTION, CHLOROPROCAINE HCL Chloroprocaine Hcl (pf)Yes
J2405INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG ZofranYes
J2407INJECTION, ORITAVANCIN OrbactivYes
J2410INJECTION, OXYMORPHONE HCL, UP TO 1 MG OpanaYes
J2425INJECTION, PALIFERMIN, 50 MICROGRAMS KepivanceYes
J2426Inj, paliperidone palmitate extended release, 1 mg Invega Sustenna, Invega TrinzaYes
J2430INJECTION; PAMIDRONATE DISODIUM ArediaYes
J2440INJECTION, PAPAVERINE HCL, UP TO 60 MG Papaverine HclYes
J2469INJECTION, PALONOSETRON HCL, 25 MCG AloxiYes
J2501INJECTION, PARICALCITOL, 1 MCG ZemplarYes
J2502INJ, PASIREOTIDE LONG ACTING Signifor LARYes
J2503INJECTION, PEGAPTANIB SODIUM, 0.3 MG MacugenYes
J2504INJECTION, PEGADEMASE BOVINE, 25 IU AdagenYes
J2507Pegloticase injection KrystexxaYes
J2510INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS Penicillin G ProcaineYes
J2515INJECTION, PENTOBARBITAL SODIUM NembutalYes
J2540INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS PfizerpenYes
J2543INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)ZosynYes
J2545Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mgNebupentYes
J2547INJECTION, PERAMIVIR RapivabYes
J2550INJECTION, PROMETHAZINE HCL, UP TO 50 MG PhenerganYes
J2560INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG Phenobarbital SodiumYes
J2562Plerixafor injection MozobilYes
J2590INJECTION, OXYTOCIN, UP TO 10 UNITS PitocinYes
J2597INJECTION DESMOPRESSIN ACETATE, PER 1 MCG DDAVPYes
J2675INJECTION, PROGESTERONE, PER 50MG Progesterone in OilYes
J2680INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG Prolixin DecanoateYes
J2690INJECTION, PROCAINAMIDE HCL, UP TO 1 GM PronestylYes
J2700INJECTION, OXACILLIN SODIUM, UP TO 250 MG BactocillYes
J2704INJ, PROPOFOL, 10 MG DiprivanYes
J2710INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG BloxiverzYes
J2720INJECTION, PROTAMINE SULFATE, UP TO 5 ML Protamine SulfateYes
J2724Injection, protein c concentrate, intravenous, human, 10 iu CeprotinYes
J2730INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM ProtopamYes
J2760INJECTION, PHENTOLAINE MESYLATE, UP TO 5 MG(REGITINE) Phentolamine MesylateYes
J2765INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG ReglanYes
J2770INJECTION, QUINUPRISTIN/DALFOPRISTIN, 500 MG (150/350) SynercidYes
J2778Ranibizumab injection LucentisYes
J2780INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG ZantacYes
J2783INJECTION, RASBURICASE, 0.5 MG ElitekYes
J2785Regadenoson injection LexiscanYes
J2786INJECTION, RESLIZUMAB, 1MG CinqairYes
J2787Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml Photrexa ViscousYes
J2788Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)HyperRHO S/DYes
J2790Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) HyperRHO S/D, Rhogam Ultra-filtered PlusYes
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu RhophylacYes
J2792Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iuWinRho SDFYes
J2793Rilonacept injection ArcalystYes
J2794Injection, risperidone (Risperdal CONSTA), 0.5 mgRisperdal ConstaYes
J2795INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG NaropinYes
J2796Romiplostim injection NplateYes
J2797INJ., ROLAPITANT, 0.5 MG VarubiYes
J2798Injection, risperidone, (Perseris), 0.5 mgPerserisYes
J2800INJECTION, METHOCARBAMOL, UP TO 10 ML RobaxinYes
J2805INJECTION, SINCALIDE, 5 MICROGRAMS KinevacYes
J2810INJECTION, THEOPHYLLINE, UP TO 2 ML TheophyllineYes
J2820INJECTION, SARGRAMOSTIM (CM-CSF), 50 MCG LeukineYes
J2840INJECTION, SEBELIPASE ALFA, 1 MG KanumaYes
J2850INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM ChiRhoStimYes
J2860INJECTION, SILTUXIMAB SylvantYes
J2916INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MGFerrlecitYes
J2920INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG Solu-medrolYes
J2930INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG Solu-medrolYes
J2941INJECTION, SOMATROPIN, 1 MG Serostim, Humatrope, Genotropin,Norditropin,Nutropin,Omnitrope,Saizen,Zomacton,ZorbtiveYes
J2993INJECTION, RETEPLASE, 18.1 MG RetavaseYes
J2997INJECTION, ALTEPLASE RECOMBINANT, 1 MG ActivaseYes
J3000INJECTION, STREPTOMYCIN, UP TO 1 GM Streptomycin SulfateYes
J3010INJECTION, FENTANYL CITRATE, 0.1 MG SublimazeYes
J3030INJECTION; SUMATRIPTAN SUCCINATE; 6MG Imitrex, SumavelYes
J3031Injection, fremanezumab-vfrm, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)AjovyYes
J3032Injection, eptinezumab-jjmr, 1 mgVyeptiYes
J3060Injection, taliglucerase alfa, 10 unitsElelysoYes
J3070INJECTION, PENTAZOCINE HCL, UP TO 30 MG TalwinYes
J3090INJ TEDIZOLID PHOSPHATE SivextroYes
J3095Televancin injection VibativYes
J3101Tenecteplase injection TNKaseYes
J3105INJECTION, TERBUTALINE SULFATE, UP TO 1 MG Terbutaline SulfateYes
J3110INJECTION, TERIPARATIDE, 10 MCG ForteoYes
J3111Injection, romosozumab-aqqg, 1 mgEvenityYes
J3121INJ TESTOSTERO ENANTHATE 1MG DelatestrylYes
J3145TESTOSTERONE UNDECANOATE 1MG AveedYes
J3230INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG ThorazineYes
J3240INJECTION, THYROTROPIN, UP TO 10 I.U. ThyrogenYes
J3241Injection, teprotumumab-trbw, 10 mgTepezzaYes
J3243INJECTION TIGECYCLINE 1 MG TygacilYes
J3245INJ., TILDRAKIZUMAB, 1 MG IlumyaYes
J3246INJECTION, TIROFIBAN HCL, 0.25MG AggrastatYes
J3250INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG TiganYes
J3260INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG NebcinYes
J3262Tocilizumab injection ActemraYes
J3285INJECTION, TREPROSTINIL, 1 MG RemodulinYes
J3300Triamcinolone A inj PRS-free TriesenceYes
J3301INJECTION TRIAMCINOLONE ACETONIDE, PER 10MG KenalogYes
J3303INJECTION TRIAMCINOLONE HEXACETONIDE, PER 5MG AristospanYes
J3304INJ TRIAMCINOLONE ACE XR 1MG ZilrettaYes
J3315INJECTION, TRIPTORELIN PAMOATE, 3.75 MG TrelstarYes
J3316INJ., TRIPTORELIN XR 3.75 MG TriptodurYes
J3355INJECTION, UROFOLLITROPIN, 75 IU BravelleYes
J3357Ustekinumab, for subcutaneous injection, 1 mgStelaraYes
J3358Ustekinumab, for intravenous injection, 1 mg StelaraYes
J3360INJECTION, DIAZEPAM, UP TO 5 MG ValiumYes
J3370INJECTION, VANCOMYCIN HCL, UP TO 500 MG VancocinYes
J3380INJECTION, VEDOLIZUMAB EntyvioYes
J3385Velaglucerase alfa VprivYes
J3396INJECTION, VERTEPORFIN, 0.1 MG VisudyneYes
J3397INJ., VESTRONIDASE ALFA-VJBK MepseviiYes
J3398Injection, voretigene neparvovec-rzyl, 1 billion vector genomesLuxturnaYes
J3399Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomesZolgensmaYes
J3410INJECTION, HYDROXYZINE HCL, UP TO 25 MG VistarilYes
J3411INJECTION, THIAMINE HCL, 100 MG Thiamine HclYes
J3415INJECTION, PYRIDOXINE HCL, 100 MG Pyridoxine HclYes
J3420INJECTION, VITAMIN B- 12 CYANOCOBALAMIN, UP TO 1000 MCG CyanocobalaminYes
J3430Injection, phytonadione (vitamin k), per 1 mgAqua-MephytonYes
J3465INJECTION, VORICONAZOLE, 10 MG Vfend IVYes
J3470INJECTION, HYALURONIDASE, UP TO 150 UNITS AmphadaseYes
J3471INJECTION, HYALURONIDASE, OVINE, PRESERVATIVE FREE, PER 1 US VitraseYes
J3473INJECTION HYALURONIDASE RECOMBINANT 1 USP UNIT HylenexYes
J3475INJ MAGNESIUM SULFATE Magnesium SulfateYes
J3480INJ POTASSIUM CHLORIDE-2 MEQ Potassium ChlorideYes
J3485INJECTION, ZIDOVUDINE, 10 MG RetrovirYes
J3486INJECTION, ZIPRASIDONE MESYLATE, 10 MG GeodonYes
J3489ZOLEDRONIC ACID 1MG Reclast, ZometaYes
J3490Unclassified drugsUnclassified drugsYes
J3590Unclassified biologicsUnclassified biologicsYes
J7030INFUSION, NORMAL SALINE SOLUTION , 1000 CC Sodium ChlorideYes
J7040INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) Sodium ChlorideYes
J70425% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT) Dextrose 5%-0.9% NaClYes
J7050INFUSION, NORMAL SALINE SOLUTION , 250 CC Sodium ChlorideYes
J70605% DEXTROSE/WATER (500 ML = 1 UNIT) Dextrose in waterYes
J7070INFUSION, D5W, 1000 CC Dextrose in waterYes
J7100INFUSION, DEXTRAN 40, 500 ML LMDYes
J7120RINGERS LACTATE INFUSION, UP TO 1000 CC Lactated RingersYes
J71215% DEXTROSE IN LAC RINGERS Dextrose In Lactated RingersYes
J7169Injection, coagulation Factor Xa (recombinant), inactivated-zhzo (Andexxa), 10 mgAndexxaYes
J7170INJ., EMICIZUMAB-KXWH 0.5 MG HemlibraYes
J7175INJ, FACTOR X, (HUMAN), 1IU CoagadexYes
J7177Injection, human fibrinogen concentrate (fibryga), 1 mgFibrygaYes
J7178HUMAN FIBRINOGEN CONC INJ RiastapYes
J7179Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco VonvendiYes
J7180Factor XIII anti-hem factor CorifactYes
J7181FACTOR XIII RECOMB A-SUBUNIT TrettenYes
J7182FACTOR VIII RECOMB NOVOEIGHT NovoeightYes
J7183Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco WilateYes
J7185Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.XynthaYes
J7186Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.Alphanate/VWF Complex/HumanYes
J7187INJECTION VON WILLEBRAND FACTOR COMPLEX HUMAN RISTOCETIN COFACTOR PER IVHumate-pYes
J7188FACTOR VIII RECOMB OBIZUR ObizurYes
J7189Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram NovoSeven RTYes
J7190FACTOR VIII, (ANTI-HEMOPHILIC FACTOR (HUMAN)), PER I.U. Hemofil M, KoateYes
J7192FACTOR VIII (ANTIHEMOPHILIC FACTOR (RECOMBINANT)), PER I.U. Recombinate, Advate, Kogenate, Helixate FSYes
J7193FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT) PER I.U. Mononine, AlphanineYes
J7194FACTOR IX, COMPLEX, PER I.U. Profilnine SDYes
J7195FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U. Ixinity, BeneFIXYes
J7196Antithrombin recombinant AtrynYes
J7197ANTITHROMBIN III (HUMAN), PER I.U. Thrombate IIIYes
J7198ANTI-INHIBITOR, PER I.U. Feiba NFYes
J7200FACTOR IX RECOMBINAN RIXUBIS RixubisYes
J7201FACTOR IX FC FUSION RECOMB AlprolixYes
J7202FACTOR IX IDELVION INJ IdelvionYes
J7203FACTOR IX RECOMB GLY REBINYN RebinynYes
J7204Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IUEsperoctYes
J7205FACTOR VIII FC FUSION RECOMB EloctateYes
J7207FACTOR VIII PEGYLATED RECOMB AdynovateYes
J7208Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.JiviYes
J7209FACTOR VIII NUWIQ RECOMB 1IU NuwiqYes
J7210INJ, AFSTYLA, 1 I.U. AfstylaYes
J7211INJ, KOVALTRY, 1 I.U. KovaltryYes
J7296LEVONORGESTREL IU, KYLEENA, 19.5 MG KyleenaYes
J7297LEVONORGESTREL IU 52MG 3 YR Liletta (52 Mg)Yes
J7298LEVONORGESTREL IU 52MG 5 YR Mirena (52 Mg)Yes
J7300IUD COPPER Paragard Intrauterine CopperYes
J7301LEVONORGESTREL IU, SKYLA, 13.5MG SkylaYes
J7304CONTRACEPTIVE SUPPLY, HORMONE CONTAINING PATCH, EACH XulaneYes
J7307Etonogestrel implant system NexplanonYes
J7308AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSLevulan KerastickYes
J7311FLUOCINOLONE ACETONIDE INTRAVITREAL IMPLANT RetisertYes
J7312Dexamethasone intravitreal implant OzurdexYes
J7313FLUOCINOL ACET INTRAVITREAL IMPLANT IluvienYes
J7314Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mgYutiqYes
J7315OPTHALMIC MITOMYCIN MitosolYes
J7316INJ, OCRIPLASMIN, 0.125 MG JetreaYes
J7318INJ, DUROLANE 1 MG DurolaneYes
J7320HYALURONAN OR DERIVITIVE, GENVISC 850, FOR INTRA-ARTICULAR INJ, 1 MG Genvisc 850Yes
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose Hyalgan; Supartz;Visco-3Yes
J7322HYALURONAN OR DERIVATIVE, HYMOVIS, FOR INTRA-ARTICULAR INJECTION, 1 MG HymovisYes
J7323Euflexxa inj per dose EuflexxaYes
J7324Orthovisc inj per dose OrthoviscYes
J7325Synvisc or Synvisc-One Synvisc, Synvisc-OneYes
J7326Gel-one Gel-oneYes
J7327MONOVISC INJ PER DOSE MonoviscYes
J7328GEL-SYN INJECTION 0.1 MG Gelsyn-3Yes
J7329INJ, TRIVISC 1 MG TriviscYes
J7330AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT MACIYes
J7331Hyaluronan or derivative, SYNOJOYNT, for intra-articular injection, 1 mgSynojoyntYes
J7332Hyaluronan or derivative, Triluron, for intra-articular injection, 1 mgTriluronYes
J7336CAPSAICIN 8% PATCH QutenzaYes
J7340CARBIDOPA LEVODOPA ENTERAL DuopaYes
J7342Instillation, ciprofloxacin otic suspension, 6 mgOtiprioYes
J7345Aminolevulinic acid HCl for topical administration, 10% gel, 10mgAmeluzYes
J7351Injection, bimatoprost, intracameral implant, 1 mcgDurystaYes
J7500Azathioprine, oral, 50 mg ImuranYes
J7501Azathioprine, parenteral, 100 mgAzathioprine SodiumYes
J7502CYCLOSPORINE, ORAL, 100 MG Sandimmune; Gengraf; NeoralYes
J7503TACROL ENVARSUS EXT REL ORAL Envarsus XRYes
J7504LYMPHOCYTE IMMUNE GLOBULIN, ANTITYMOCYTE GLOBULIN - PARENTERAL, AMP, 5 AtgamYes
J7507TACROLIMUS, ORAL PrografYes
J7508TACROLIMUS EXT REL ORAL 0.1MG Astagraf XLYes
J7509METHYLPREDNISOLONE ORAL MedrolYes
J7510PREDNISOLONE ORAL PER 5 MG PrednisoloneYes
J7511LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, ThymoglobulinYes
J7512PREDNISONE IR OR DR ORAL 1MG DeltasoneYes
J7513DACLIZUMAB, PARENTERAL, 25 MG ZinbrytaYes
J7515CYCLOSPORINE, ORAL, 25 MG Sandimmune; Gengraf, NeoralYes
J7516CYCLOSPORIN, PARENTERAL, 250 MG SandIMMUNEYes
J7517MYCOPHENOLATE MOFETIL, ORAL, 250 MG CellCeptYes
J7518MYCOPHENOLIC ACID, ORAL, 180 MG MyforticYes
J7520SIROLIMUS, ORAL, 1 MG RapamuneYes
J7525TACROLIMUS, PARENTERAL, 5 MG PrografYes
J7527ORAL EVEROLIMUS ZortressYes
J7605Arformoterol non-comp unit BrovanaYes
J7606Formoterol fumarate, inh PerforomistYes
J7608ACETYLCYSTEINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE AcetylcysteineYes
J7611ALBUTEROL, INHALATION SOLUTION, ADMINISTERED THROUGH DME, CO Albuterol SulfateYes
J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mgXopenexYes
J7613ALBUTEROL, INHALATION SOLUTION, ADMINISTERED THROUGH DME, UN Albuterol SulfateYes
J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg XopenexYes
J7620ALBUTEROL AND IPRATROPIUM INHAL.SOLUTION ADMIN. VIA DME Ipratropium-albuterolYes
J7626BUDESONIDE INHALATION SOLUTION, ADMINISTERED THROUGH DME, UNIT DOSE FORMPulmicort RespulesYes
J7631CROMOLYN SODIUM, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSECromolyn SodiumYes
J7639DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FPulmozymeYes
J7644IPRATROPIUM BROMIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT AtroventYes
J7665Mannitol for inhaler AridolYes
J7674METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION TH ProvocholineYes
J7677revefenacin inhalation solutionYupelriYes
J7682TOBRAMYCIN, UNIT DOSE FORM, 300 MG, INHALATION SOLUTION, ADMINISTERED THROUGH DMETobi; Bethkis; KitabisYes
J7686Treprostinil, non-comp unit TyvasoYes
J8499Prescription drug, oral, non chemotherapeutic, nosPrescription drug, oral, non chemotherapeutic, nosYes
J8501APREPITANT, ORAL, 5 MG EmendYes
J8510BUSULFAN; ORAL, 2 MG MyleranYes
J8515CABERGOLINE, ORAL, 0.25 MG CabergolineYes
J8520CAPECITABINE, ORAL, 150 MG XelodaYes
J8521CAPECITABINE, ORAL, 500 MG XelodaYes
J8530CYCLOPHOSPHAMIDE, ORAL CyclophosphamideYes
J8540DEXAMETHASONE, ORAL, 0.25 MG DexamethasoneYes
J8560ETOPOSIDE, ORAL VePesidYes
J8565GEFITINIB, ORAL, 250 MG IressaYes
J8600MELPHALAN AlkeranYes
J8610METHOTREXATE, ORAL MethotrexateYes
J8650Nabilone oral CesametYes
J8655NETUPITANT AND PALONOSETRON, ORAL AkynzeoYes
J8670ROLAPITANT, ORAL, 1MG VarubiYes
J8700TEMOZOLOMIDE, ORAL, 5 MG TemodarYes
J8705Topotecan oral HycamtinYes
J8999Prescription drug, oral, chemotherapeutic, NOSPrescription drug, oral, chemotherapeutic, NOSYes
J9000DOXORUBICIN HCL, 10 MG AdriamycinYes
J9015ALDESLEUKIN/SINGLE USE VIAL ProleukinYes
J9017ARSENIC TRIOXIDE, 1MG TrisenoxYes
J9019Injection, asparaginase (erwinaze), 1,000 iuErwinazeYes
J9022INJ, ATEZOLIZUMAB,10 MG TecentriqYes
J9023INJECTION, AVELUMAB, 10 MG BavencioYes
J9025INJECTION, AZACITIDINE, 1 MG VidazaYes
J9027INJECTION, CLOFARABINE, 1 MG ClolarYes
J9030Bcg live intravesical instillation, 1 mgTice BCGYes
J9032INJECTION, BELINOSTAT, 10MG BeleodaqYes
J9033Bendamustine injection TreandaYes
J9034Inj., bendamustine hcl (bendeka), 1 mgBendekaYes
J9035INJECTION, BEVACIZUMAB, 10 MG AvastinYes
J9036Injection, bendamustine hydrochloride, (Belrapzo/bendamustine), 1 mgBelrapzoYes
J9039INJECTION, BLINATUMOMAB BlincytoYes
J9040BLEOMYCIN SULFATE, 15 UNITS Bleomycin SulfateYes
J9041INJECTION, BORTEZOMIB, 0.1 MG VelcadeYes
J9042BRENTUXIMAB VEDOTIN INJ AdcetrisYes
J9043Cabazitaxel injection JevtanaYes
J9044INJ, BORTEZOMIB, NOS, 0.1 MG BortezomibYes
J9045CARBOPLATIN, 50 MG ParaplatinYes
J9047INJECTION, CARFILZOMIB, 1 MG KyprolisYes
J9050CARMUSTINE, 100 MG BiCNUYes
J9055INJECTION, CETUXIMAB, 10 MG ErbituxYes
J9057INJ., COPANLISIB, 1 MG AliqopaYes
J9060CISPLATIN, POWDER OR S0LUTION, PER 10 MG Platinol AQYes
J9065INJECTION; CLADRIBINE LeustatinYes
J9070CYCLOPHOSPHAMIDE, 100 MG CytoxanYes
J9098CYTARABINE LIPOSOME, 10 MG DepocytYes
J9100CYTARABINE 100 MG Cytarabine (pf)Yes
J9118Injection, calaspargase pegol-mknl, 10 unitsAsparlasYes
J9119Injection, cemiplimab-rwlc, 1 mgLibtayoYes
J9120DACTINOMYCIN, 0.5 MG CosmegenYes
J9130DACARBAZINE, 100 MG DTIC-DOME IVYes
J9145INJECTION, DARATUMUMAB 10 MG DarzalexYes
J9150DAUNORUBICIN HYDROCHLORIDE, 10 MG CerubidineYes
J9151DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG Daunoxome Yes
J9153INJ, LIPOSOMAL, DAUNORUBICIN AND CYTARABINE VyxeosYes
J9155Degarelix injection FirmagonYes
J9171Docetaxel injection TaxotereYes
J9173INJ., DURVALUMAB, 10 MG ImfinziYes
J9175INJECTION, ELLIOTTS' B SOLUTION, 1 ML Elliotts BYes
J9176INJECTION, ELOTUZUMAB, 1MG EmplicitiYes
J9177Injection, enfortumab vedotin-ejfv, 0.25 mgPadcevYes
J9178INJECTION, EPIRUBICIN HCL, 2 MG EllenceYes
J9179Eribulin mesylate injection HalavenYes
J9181ETOPOSIDE, 10 MG EtoposideYes
J9185FLUDARABINE PHOSPHATE, 50 MG FludaraYes
J9190FLUOROURACIL, 500 MG AdrucilYes
J9198Injection, gemcitabine hydrochloride, (Infugem), 100 mgInfugemYes
J9200FLOXURIDINE, 500 MG FloxuridineYes
J9201GEMCITABINE HCL, 200 MG GemzarYes
J9202GOSERELIN ACETATE IMPLANT, PER 3.6 MG ZoladexYes
J9203GEMTUZUMAB OZOGAMICIN 0.1 MG MylotargYes
J9204Injection, mogamulizumab-kpkc, 1 mgPoteligeoYes
J9205INJ IRINOTECAN LIPOSOME 1 MG OnivydeYes
J9206IRINOTECAN, 20 MG CamptosarYes
J9207Ixabepilone injection Ixempra KitYes
J9208IFOSFAMIDE, 1 GM IfexYes
J9209MESNA, 200 MG MesnexYes
J9210Injection, emapalumab-lzsg, 1 mgGamifantYes
J9211IDARUBICIN HYDROCHLORIDE, 5 MG Idamycin PFSYes
J9214INTERFERON, ALFA-2B, RECOMBINANT, 1 MILLION UNITS Intron AYes
J9215INTERFERON, ALFA-N3, (HUMAN LEUKOCYTE DERIVED), 250,000 IU Alferon NYes
J9216INTERFERON, GAMMA 1-B, 3 MILLION UNITS ActimmuneYes
J9217LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG Eligard, Lupron DepotYes
J9218LEUPROLIDE ACETATE, PER 1 MG Leuprolide AcetateYes
J9225HISTRELIN IMPLANT, 50 MG VantasYes
J9226Supprelin LA implant Supprelin LAYes
J9227Injection, isatuximab-irfc, 10 mgSarclisaYes
J9228Ipilimumab injection YervoyYes
J9229INJ INOTUZUMAB OZOGAM 0.1 MG BesponsaYes
J9230MECHLORETHAMINE HYDROCHLORIDE, (NITROGEN MUSTARD), 10 MG MustargenYes
J9245INJECTION; MELPHALAN HCL AlkeranYes
J9246Injection, melphalan (Evomela), 1 mgEvomelaYes
J9250METHOTREXATE SODIUM, 5 MG Methotrexate SodiumYes
J9260METHOTREXATE SODIUM, 50 MG Methotrexate SodiumYes
J9261INJECTION NELARABINE 50 MG ArranonYes
J9262INJ, OMACETAXINE MEP, 0.01MG SynriboYes
J9263INJECTION, OXALIPLATIN, 0.5 MG EloxatinYes
J9264INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG AbraxaneYes
J9266PEGASPARGASE/SINGL DOSE VIAL OncasparYes
J9267PACLITAXEL INJECTION TaxolYes
J9268PENTOSTATIN, PER 10 MG (NIPENT) NipentYes
J9269Injection, tagraxofusp-erzs, 10 mcgElzonrisYes
J9271INJ PEMBROLIZUMAB KeytrudaYes
J9280MITOMYCIN, 5 MG MutamycinYes
J9285INJ, OLARATUMAB, 10 MG LartruvoYes
J9293MITOXANTRONE HYDROCHLORIDE, 20 MG-1994,1995=5MG NovantroneYes
J9295INJECTION, NECITUMUMAB, 1 MG PortrazzaYes
J9299INJECTION, NIVOLUMAB OpdivoYes
J9301OBINUTUZUMAB INJ GazyvaYes
J9302Ofatumumab injection ArzerraYes
J9303Panitumumab injection VectibixYes
J9304Injection, pemetrexed (Pemfexy), 10 mgPemfexyYes
J9305INJECTION, PEMETREXED, not otherwise specified, 10 MG AlimtaYes
J9306INJECTION, PERTUZUMAB, 1 MG PerjetaYes
J9307Pralatrexate injection FolotynYes
J9308INJECTION, RAMUCIRUMAB CyramzaYes
J9309Injection, polatuzumab vedotin-piiq, 1 mgPolivyYes
J9311INJ RITUXIMAB, HYALURONIDASE Rituxan HycelaYes
J9312INJ., RITUXIMAB, 10 MG RituxanYes
J9313Injection, moxetumomab pasudotox-tdfk, 0.01 mgLumoxitiYes
J9320STREPTOZOCIN, 1 GM ZanosarYes
J9325INJ TALIMOGENE LAHERPAREPVEC ImlygicYes
J9328Temozolomide injection TemodarYes
J9330Temsirolimus injection ToriselYes
J9340THIOTEPA, 15 MG TepadinaYes
J9351Topotecan injection HycamtinYes
J9352INJECTION TRABECTEDIN 0.1MG YondelisYes
J9354INJ, ADO-TRASTUZUMAB EMT 1MG KadcylaYes
J9355TRASTUZUMAB, 10 MG HerceptinYes
J9356Injection, trastuzumab, 10 mg and Hyaluronidase-oyskHerceptin HylectaYes
J9357VALRUBICIN, INTRAVESICAL, 200 MG ValstarYes
J9358Injection, fam-trastuzumab deruxtecan-nxki, 1 mgEnhertuYes
J9360VINBLASTINE SULFATE, 1 MG Vinblastine SulfateYes
J9370VINCRISTINE SULFATE, 1 MG Vincasar PFSYes
J9371INJ, VINCRISTINE SUL LIP 1MG MarqiboYes
J9390VINORELBINE TARTRATE/10 MG NavelbineYes
J9395INJECTION, FULVESTRANT, 25 MG FaslodexYes
J9400INJ, ZIV-AFLIBERCEPT, 1MG ZaltrapYes
J9600PORFIMER SODIUM, 75 MG PhotofrinYes
P9045INFUSION, ALBUMIN (HUMAN), 5%, 250 ML Plasbumin-5Yes
P9046INFUSION, ALBUMIN (HUMAN), 25%, 20 ML AlbuteinYes
P9047INFUSION, ALBUMIN (HUMAN), 25%, 50 ML Albuminar-25Yes
Q0138Ferumoxytol, non-esrd FerahemeYes
Q0139Ferumoxytol, esrd use FerahemeYes
Q0144AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM ZithromaxYes
Q0162Ondansetron oral ZofranYes
Q0163DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANBenadrylYes
Q0164PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMCompazineYes
Q0166GRANISETRON HYDROCHLORIDE, 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMKytrilYes
Q0167DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USEMarinolYes
Q0169PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTPhenerganYes
Q0175PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USEPerphenazineYes
Q0177HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC,VistarilYes
Q2004Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 mlRenacidinYes
Q2009INJECTION, FOSPHENYTOIN, 50 MG CerebyxYes
Q2028INJ, SCULPTRA, 0.5MG SculptraYes
Q2041Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseYescartaYes
Q2042Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseKymriahYes
Q2043Sipuleucel-T auto CD54+ ProvengeYes
Q2050Inj, doxorubicin, liposomal, not otherwise specified, 10 mgDoxilYes
Q3027INJ BETA INTERFERON IM 1 MCG AvonexYes
Q3028INJ BETA INTERFERON SQ 1 MCG RebifYes
Q4074Iloprost non-comp unit dose VentavisYes
Q4081INJECTION EPOETIN ALFA 100 UNITS (FOR ESRD ON DIALYSIS) Epogen, ProcritYes
Q5101INJ FILGRASTIM G-CSF BIOSIM ZarxioYes
Q5103Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mgInflectraYes
Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg RenflexisYes
Q5105Inj, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units RetacritYes
Q5106Inj, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units RetacritYes
Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg MvasiYes
Q5108Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mgFulphilaYes
Q5109Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg IxifiYes
Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 mcg NivestymYes
Q5111Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mgUdenycaYes
Q5112Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mgOntruzantYes
Q5113Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mgHerzumaYes
Q5114Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mgOgivriYes
Q5115Injection, rituximab-abbs, biosimilar, 10 mgTruximaYes
Q5116Injection, trastuzumab-qyyp, biosimilar, (Trazimera), 10 mgTrazimeraYes
Q5117Injection, trastuzumab-anns, biosimilar, (Kanjinti), 10 mgKanjintiYes
Q5118Injection, bevacizumab-bvcr, biosimilar, (Zirabev), 10 mgZirabevYes
Q5119Injection, rituximab-pvvr, biosimilar, (RUXIENCE), 10 mgRuxienceYes
Q5120Injection, pegfilgrastim-bmez, biosimilar, (ZIEXTENZO), 0.5 mgZiextenzoYes
Q5121Injection, infliximab-axxq, biosimilar, (AVSOLA), 10 mgAvsolaYes
Q9991BUPRENORPH XR 100 MG OR LESS SublocadeYes
Q9992BUPRENORPHINE XR OVER 100 MG SublocadeYes
S0012BUTORPHANOL TARTRATE, NASAL SPRAY, 25 MG Butorphanol TartrateYes
S0017INJECTION, AMINOCAPROIC ACID, 5 GRAMS Aminocaproic AcidYes
S0020INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML Marcaine; SensorcaineYes
S0028INJECTION, FAMOTIDINE, 20 MG PepcidYes
S0030INJECTION, METRONIDAZOLE, 500 MG FlagylYes
S0032INJECTION, NAFCILLIN SODIUM, 2 GRAMS Nafcillin SodiumYes
S0039INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 ML Sulfamethoxazole-trimethoprimYes
S0073INJECTION, AZTREONAM, 500 MG AzactamYes
S0074INJECTION, CEFOTETAN DISODIUM, 500 MG CefotanYes
S0077INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG Cleocin PhosphateYes
S0078INJECTION, FOSPHENYTOIN SODIUM, 750 MG CerebyxYes
S0080INJECTION, PENTAMIDINE ISETHIONATE, 300 MG PentamYes
S0088Imatinib, 100 mgGleevecYes
S0090SILDENAFIL CITRATE, 25 MG ViagraYes
S0091Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)KytrilYes
S0092Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)DilaudidYes
S0093INJECTION, MORPHINE SULFATE, 500 MG (LOADING DOSE FOR INFUSION PUMP) Morphine SulfateYes
S0104ZIDOVUDINE, ORAL, 100 MG RetrovirYes
S0106BUPROPION HCL SUSTAINED RELEASE TABLET, 150 MG, PER BOTTLE OF 60 TABLETSWellbutrin SRYes
S0108MERCAPTOPURINE, ORAL, 50 MG PurixanYes
S0109METHADONE, ORAL, 5MG Dolophine; MethadoseYes
S0117TRETINOIN, TOPICAL, 5 GRAMS Retin-A; AltrenoYes
S0119Ondansetron 4 mg ZofranYes
S0122INJECTION, MENOTROPINS, 75 IU MenopurYes
S0126INJECTION, FOLLITROPIN ALFA, 75 IU Gonal-f RffYes
S0128INJECTION, FOLLITROPIN BETA, 75 IU Follistim AQYes
S0132INJECTION, GANIRELIX ACETATE, 250 MCG Ganirelix AcetateYes
S0136CLOZAPINE, 25 MG ClozarilYes
S0137DIDANOSINE (DDI), 25 MG Videx; Videx ECYes
S0138FINASTERIDE, 5 MG ProscarYes
S0139MINOXIDIL, 10 MG MinoxidilYes
S0140SAQUINAVIR, 200 MG InviraseYes
S0145INJECTION, PEGYLATED INTERFERON ALFA-2A, 180 MCG PER ML PegasysYes
S0148Peg interferon alfa-2b, 10 mcg PegIntron; SylatronYes
S0155STERILE DILUTANT FOR EPOPROSTENOL, 50ML Diluent For EpoprostenolYes
S0156EXEMESTANE, 25 MG AromasinYes
S0157BECAPLERMIN GEL 0.01%, 0.5 GM RegranexYes
S0160DEXTROAMPHETAMINE SULFATE, 5 MG DexedrineYes
S0164INJECTION, PANTOPRAZOLE SODIUM, 40 MG ProtonixYes
S0166INJECTION, OLANZAPINE, 2.5 MG ZyprexaYes
S0169Calcitrol, 0.25 mcgRocaltrolYes
S0170ANASTROZOLE, ORAL, 1MG ArimidexYes
S0171INJECTION, BUMETANIDE, 0.5MG BumexYes
S0172CHLORAMBUCIL, ORAL, 2MG LeukeranYes
S0174DOLASETRON MESYLATE, ORAL 50MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDIAnzemetYes
S0175FLUTAMIDE, ORAL, 125MG EulexinYes
S0176HYDROXYUREA, ORAL, 500MG HydreaYes
S0178LOMUSTINE, ORAL, 10MG GleostineYes
S0179MEGESTROL ACETATE, ORAL, 20MG Megace ESYes
S0182PROCARBAZINE HYDROCHLORIDE, ORAL, 50MG MatulaneYes
S0183PROCHLORPERAZINE MALEATE, ORAL, 5MG (FOR CIRCUMSTANCES FALLING UNDER THECompazineYes
S0187TAMOXIFEN CITRATE, ORAL, 10MG Tamoxifen CitrateYes
S0189TESTOSTERONE PELLET, 75MG TestopelYes
S0190MIFEPRISTONE, ORAL, 200 MG MifeprexYes
S0191MISOPROSTOL, ORAL, 200 MCG CytotecYes
S0197Prenatal vitamins, 30-day supplyPrenatal Vitamin And MineralYes
S4991Nicotine patches, non-legendNicoderm CQYes
S4993Contraceptive pills for birth controlMultipleYes
S4995Smoking cessation gumNicoretteYes
S50105% dextrose and 0.45% normal saline, 1000 mlDextrose-sodium chlorideYes
S5550Insulin, rapid onset, 5 unitsApidraYes
S5551Insulin, most rapid onset (lispro or aspart); 5 unitsMultipleYes
S5552Insulin, intermediate acting (nph or lente); 5 unitsHumulin N; Novolin NYes
S5553Insulin, long acting; 5 unitsMultipleYes
S5561Insulin delivery device, reusable pen; 3 ml sizeYes
S5566Insulin cartridge for use in insulin delivery device other than pump; 300 unitsYes
S5570Insulin delivery device, disposable pen (including insulin); 1.5 ml sizeToujeo SolostarYes
S5571Insulin delivery device, disposable pen (including insulin); 3 ml sizeMultipleYes
S8490Insulin syringes (100 syringes, any size)Insulin syringes (100 syringes, any size)Yes
C1052HEMOSTATIC AGT GASTROINTESTINAL TOPHEMOSTATIC AGT GASTROINTESTINAL TOPYes
J1823Injection, inebilizumab-cdon, 1 mgUpliznaYes
J7212Factor viia (antihemophilic factor, recombinant)- jncw (sevenfact), 1 microgramSevenfactYes
J7352Afamelanotide implant, 1 mgScenesseYes
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihjDarzalex FasproYes
J9223Injection, lurbinectedin, 0.1 mgZepzelcaYes
J9281Mitomycin pyelocalyceal instillation, 1 mgJelmytoYes
J9316Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mgPhesgoYes
J9317Injection, sacituzumab govitecan-hziy, 2.5 mgTrodelvyYes
M0243IV INFUSION CASIRIVIMAB & IMDEVIMAB MONITORINGIV INFUSION CASIRIVIMAB & IMDEVIMAB MONITORINGYes
Q0239INJECTION BAMLANIVIMAB-XXXX 700 MGINJECTION BAMLANIVIMAB-XXXX 700 MGYes
Q0243INJ CASIRIVIMAB & IMDEVIMAB 2400 MGINJ CASIRIVIMAB & IMDEVIMAB 2400 MGYes
Q5122Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mgNyvepriaYes
S0013Esketamine, nasal spray, 1 mgSpravatoYes
M0245IV INF Bamlanivimab and etesevimab, monitoringIV INF Bamlanivimab and etesevimab, monitoringYes
Q0245INJ Bamlanivimab and etesevimabBamlanivimab and etesevimabYes
J1427Injection, viltolarsen, 10 mgViltepsoYes
J1554Injection, immune globulin (Asceniv), 500 mgAscenivYes
J9037Injection, belantamab mafodontin-blmf, 0.5 mgBlenrepYes
J9349Injection, tafasitamab-cxix, 2 mgMonjuviYes
Q2053Brexucabtagene autoleucel, up to 200 million autologous anti-CD19 CAR positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic doseTecartusYes
J7402Mometasone furoate sinus implant, (Sinuva), 10 mcgSinuvaYes
S1091Stent, non-coronary, temporary, with delivery system(propel)PropelYes
M0244Intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring in the home or residencen/aYes
M0246Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residencen/aYes
J0224INJECTION LUMASIRAN 0.5 MGOxlumoYes
J1951INJ LEU AC FOR DEP SUSP 0.25 MGFensolviYes
J7168PRT CMPLX CONC KCNTRA PR IU FIX ACTKecentraYes
J9348INJECTION NAXITAMAB-GQGK 1 MGDanyelzaYes
J9353INJECTION MARGETUXIMAB-CMKB 5 MGMargenzaYes
Q5123INJ RITUXIMAB-ARRX BIOSIMILAR 10 MGRiabniYes
Q0247injection, sotrovimab 500mgn/aYes
M0247Intravenous infusion, sotrovimab, includes infusion and post administration monitoringn/aYes
Q0244injection, casirivimab and imdevimab, 1200mgn/aYes
Q0249INJ TOCILIZUMAB HP PT 2 YRS & > COVID-19 1 MGn/aYes
M0249IV TCZ HP PT 2 & > COVID-19 INC INF & PA MON FDn/aYes
M0250IV TCZ HP 2 & > COVID-19 INC INF & PA MON 2ND Dn/aYes
Q0240Injection, casirivimab and imdevimab, 600 mgcasirivimab and imdevimabYes
M0240Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat dosesn/aYes
M0241ntravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residencen/aYes
J1305Injection, evinacumab-dgnb, 5mgEvkeezaYes
J1426Injection, casimersen, 10 mgAmondys 45Yes
J1448Injection, trilaciclib, 1mgCoselaYes
J9318Injection, romidepsin, non-lyophilized, 0.1 mgn/aYes
J9319Injection, romidepsin, lyophilized, 0.1 mgIstodaxYes
Q2054Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseBreyanziYes
J0699Injection, cefiderocol, 10 mgFetrojaYes
J0741Injection, cabotegravir and rilpivirine, 2mg/3mgCabenuvaYes
J1445Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of ironTriferic AVNUYes
J2406Injection, oritavancin (kimyrsa), 10 mgKimyrsaYes
J7294Segesterone acetate and ethinyl estradiol 0.15 mg, 0.013 mg per 24 hours; yearly vaginal system, eachAnnoveraYes
J7295Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, eachNuvaringYes
J1952Leuprolide injectable, camcevi, 1 mgCamceviYes
J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mgNeulastaYes
J9021Injection, asparaginase, recombinant, (Rylaze), 0.1 mgRylazeYes
J9061Injection, amivantamab-vmjw, 2 mgRybrevantYes
J9272Injection, dostarlimab-gxly, 10 mgJemperliYes
Q2055Idecabtagene vicleucel, up to 460 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic doseAbecmaYes
C9088Instillation, bupivacaine and meloxicam, 1 mg/0.03 mgZynrelefYes
C9089Bupivacaine, collagen-matrix implant, 1 mgXaracollYes
J0172Injection, aducanumab-avwa, 2 mgAduhelmYes
Q0220tixagevimab and cilgavimabEvusheldYes
M0220tixagevimab and cilgavimab administration codeEvusheld (administration code)Yes
M0221tixagevimab and cilgavimab home administration codeEvusheld ( home administration code)Yes
J0248injection, remdesivirVekluryYes
Q0222injection, bebtelovimab, 175mgbebtelovimabyes
M0222Intravenous injection, bebtelovimab, includes injection and post administration monitoringIntravenous injection, bebtelovimab, includes injection and post administration monitoringYes
J0219Injection, avalglucosidase alfa-ngpt, 4 mg Nexviazyme Yes
J0491Injection, anifrolumab-fnia, 1 mg SaphneloYes
J0879Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis) KorsuvaYes
J9273Injection, tisotumab vedotin-tftv, 1 mg TivdakYes
J9359Injection, loncastuximab tesirine-lpyl, 0.075 mg ZynlontaYes
Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg ByoovizYes
J9071Injection, cyclophosphamide, (auromedics), 5 mg cyclophosphamide Yes
Q0221 Injection, tixagevimab and cilgavimab, for pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mgEvusheldYes
J2998Injection, plasminogen, human-tvmh, 1 mg Ryplazim Yes
J9331Injection, sirolimus protein-bound particles, 1 mg Fyarro Yes
J3299Injection, triamcinolone acetonide (xipere), 1 mgXipere Yes
J2779Injection, ranibizumab, via sustained release intravitreal implant Susvimo Yes
J0739Injection, cabotegravir, 1 mgApretudeYes
J1306Injection, inclisiran, 1 mgLeqvioYes
J1551Injection, immune globulin (cutaquig), 100 mgCutaquigYes
J2356Injection, tezepelumab-ekko, 1 mgTezspireYes
J9332Injection, efgartigimod alfa-fcab, 2 mgVyvgartYes
Q2017injection, teniposide, 50mgVumonYes
J9999not otherwise classified, antineoplastic drugsn/aYes
J7599immunosuppressive drugs, not otherwise classified,Yes
C9399unclassified drugs or biologicals Yes
C9101Injection, oliceridine, 0.1 mgOlinvykYes
C9142Injection, bevacizumab-maly, biosimilar, (Alymsys), 10 mgAlymsysYes
J1302Injection, sutimlimab-jome, 10 mgEnjaymoYes
J1932Injection, lanreotide, (Cipla), 1 mgCiplaYes
J2777Injection, faricimab-svoa, 0.1 mgVabysmoYes
J9274Injection, tebentafusp-tebn, 1 mcgkimmtrakYes
J9298Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mgOpdualagYes
Q2056Ciltacabtagene autoleucel, up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic doseCarvyktiYes
Q5125Injection, filgrastim-ayow, biosimilar, (Releuko), 1 mcgReleukoYes
A9607Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicuriePluvictoYes
HCPCS CODEHCPCS CODE DESCRIPTIONDRUG NAMEINTEGRITY - Authorization RequiredINTEGRITY - COVERED (No PA Required)INTEGRITY-Not CoveredAuth Required if Prescribed for an Oncology/Hematology Related Indication
90378Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular useSynagisYes
A9513Lutetium lu 177, dotatate, therapeutic, 1 millicurieLutatheraYes
A9517Iodine- i-131 sodium iodide capsule(s), therapeutic, per millicurieHiconYes
A9543Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuriesZevalin Y-90Yes
A9590Iodine i-131, iobenguane, 1 millicurieAzedraYes
A9600Strontium sr-89 chloride, therapeutic, per millicurieMetastronYes
A9604Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuriesQuadrametYes
A9606Radium ra-223 dichloride, therapeutic, per microcurieXofigoYes
C9046COCAINE HCL NASAL SOLUTION GopreltoYes
C9047Injection, caplacizumab-yhdp, 1 mg (Cablivi)CabliviYes
C9113INJECTION, PANTOPRAZOLE SODIUM, PER VIAL ProtonixYes
C9248Inj, clevidipine butyrate CleviprexYes
C9250Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 mlArtissYes
C9254Injection, lacosamide VimpatYes
C9257Bevacizumab injection AvastinYes
C9285Patch, lidocaine/tetracaine SyneraYes
C9290INJ, BUPIVACAINE LIPOSOME ExparelYes
C9293INJECTION, GLUCARPIDASE VoraxazeYes
C9460INJECTION, CANGRELOR KengrealYes
C9462INJECTION, DELAFLOXACIN BaxdelaYes
C9482SOTALOL HYDROCHLORIDE IV Sotalol HclYes
C9488CONIVAPTAN HCL VaprisolYes
J0121Injection, omadacycline, 1 mgNuzyraYes
J0122Injection, eravacycline, 1 mgXeravaYes
J0129INJECTION ABATACEPT 10 MG Orencia ClickjectYes
J0130INJECTION ABCIXIMAB, 10 MG ReoproYes
J0131Acetaminophen injection OfirmevYes
J0132INJECTION, ACETYLCYSTEINE, 100 MG AcetadoteYes
J0133INJECTION, ACYCLOVIR, 5 MG Acyclovir SodiumYes
J0135INJECTION, ADALIMUMAB, 20 MG Humira PenYes
J0153ADENOSINE INJ 1MG AdenoscanYes
J0171Adrenalin epinephrine inject Epinephrine PfYes
J0178Injection, aflibercept, 1 mgEyleaYes
J0179Injection, brolucizumab-dbll, 1 mgBeovuYes
J0180INJECTION, AGALSIDASE BETA, 1 MG FabrazymeYes
J0185INJ., APREPITANT, 1 MG CinvantiYes
J0202INJECTION, ALEMTUZUMAB LemtradaYes
J0207INJECTION, AMIFOSTINE, 500 MG EthyolYes
J0210INJECTION, METHYLDOPATE HCL, UP TO 250 MG Methyldopate HclYes
J0221Injection, alglucosidase alfa, 10 mg LumizymeYes
J0222Injection, patisiran, 0.1 mgOnpattroYes
J0223Injection, givosiran, 0.5 mgGivlaariYes
J0256INJECTION, ALPHA 1 - PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG Prolastin-cYes
J0257INJECTION, ALPHA 1 - PROTEINASE INHIBITOR (HUMAN), (GLASSIA), 10 MG GlassiaYes
J0270ALPROSTADIL, PER 1.25MCG CaverjectYes
J0275ALPROSTADIL URETHRAL SUPPOSITORY (CODE MAY BE USED FOR MEDICARE WHEN DRUMuseYes
J0278INJECTION, AMIKACIN SULFATE, 100 MG Amikacin SulfateYes
J0280INJECTION, AMINOPHYLLIN, UP TO 250 MG AminophyllineYes
J0282INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG Amiodarone HclYes
J0285INJECTION, AMPHOTERICIN B, 50 MG Amphotericin BYes
J0287INJECTION, AMPHOTERICIN B LIPID COMPLEX, 10 MG AbelcetYes
J0289INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG AmbisomeYes
J0290INJECTION, AMPICILLIN SODIUM, UP TO 500MG Ampicillin SodiumYes
J0291Injection, plazomicin, 5 mgZemdriYes
J0295INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM UnasynYes
J0300INJECTION, AMOBARBITAL, UP TO 125 MG Amytal SodiumYes
J0330INJECTION, SUCCINYCHOLINE CHLORIDE, UP TO 20 MG QuelicinYes
J0348INJECTION, ANIDULAFUNGIN, 1 MG EraxisYes
J0360INJECTION, HYDRALAZINE HCL, UP TO 20 MG Hydralazine HclYes
J0364INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG ApokynYes
J0401INJ ARIPIPRAZOLE EXT REL 1MG Abilify MaintenaYes
J0456INJECTION, AZITHROMYCIN, 500 MG ZithromaxYes
J0461Atropine sulfate injection Atropine SulfateYes
J0470INJECTION, DIMECAPROL, UP TO 100 MG Bal In OilYes
J0475INJECTION, BACLOFEN, 10 MG BaclofenYes
J0476INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL LioresalYes
J0480INJECTION, BASILIXIMAB, 20 MG SimulectYes
J0485BELATACEPT INJECTION NulojixYes
J0490Belimumab injection BenlystaYes
J0500INJECTION, DICYCLOMINE, UP TO 20 MG BentylYes
J0515INJECTION, BENZTROPINE CogentinYes
J0517INJ., BENRALIZUMAB, 1 MG FasenraYes
J0558PenG benzathine/procaine inj Bicillin C-RYes
J0561Penicillin g benzathine inj Bicillin L-AYes
J0565INJ, BEZLOTOXUMAB, 10 MG ZinplavaYes
J0567INJ., CERLIPONASE ALFA 1 MG BrineuraYes
J0570BUPRENORPHINE IMPLANT, 74.2 MG Probuphine Implant KitYes
J0571BUPRENORPHINE ORAL 1MG SubutexYes
J0572BUPRENORPHIN/NALOX UP TO 3MG Suboxone, Bunavail, ZubsolvYes
J0573BUPRENORPH/NALOX 3.1 TO 6MG Suboxone, Bunavail, ZubsolvYes
J0574BUPRENORPH/NALOX 6.1 TO 10MG Suboxone, Bunavail, ZubsolvYes
J0575BUPRENORPH/NALOX OVER 10MG Suboxone, Bunavail, ZubsolvYes
J0583INJECTION, BIVALIRUDIN, 1 MG AngiomaxYes
J0584INJECTION, BUROSUMAB-TWZA 1M CrysvitaYes
J0585BOTULINUM TOXIN TYPE A, PER UNIT BotoxYes
J0586AbobotulinumtoxinA DysportYes
J0587RimabotulinumtoxinBMyoblocYes
J0588IncobotulinumtoxinA XeominYes
J0591Injection, deoxycholic acid, 1 mgKybellaYes
J0592INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG BuprenexYes
J0593Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)TakhzyroYes
J0594INJECTION BUSULFAN 1 MG BusulfexYes
J0595INJECTION, BUTORPHANOL TARTRATE, 1 MG Butorphanol TartrateYes
J0596Injection, C1 esterase inhibitor (recombinant), ruconest, 10 units RuconestYes
J0597Injection, c-1 esterase inhibitor (human), berinert, 10 units BerinertYes
J0598Injection, c-1 esterase inhibitor (human), cinryze, 10 units CinryzeYes
J0599Injection, c-1 esterase inhibitor (human), haegarda, 10 units HaegardaYes
J0600INJECTION, EDETATE CALCIUM DISODIUM, UP TO 200 MG Calcium Disodium VersenateYes
J0604CINACALCET, ORAL, ESRD ON DIALYSIS SensiparYes
J0606INJ, ETELCALCETIDE, 0.1 MG ParsabivYes
J0610INJECTION, CALCIUM GLUCONATE, UP TO 10 ML Calcium GluconateYes
J0630INJECTION, CALCITONIN SALMON, UP TO 400 UNITS MiacalcinYes
J0636INJECTION, CALCITRIOL, 0.1 MCG CalcitriolYes
J0637INJECTION, CASPOFUNGIN ACETATE, 5 MG CancidasYes
J0638Canakinumab injection IlarisYes
J0640INJECTION, LEUCOVORIN CALCIUM, PER 50 MG Leucovorin CalciumYes
J0641Levoleucovorin injection Levoleucovorin Calcium PfYes
J0642Injection, levoleucovorin (Khapzory), 0.5 mgKhapzoryYes
J0670INJECTION, MEPIVACAINE Polocaine-mpfYes
J0690INJECTION, CEFAZOLIN SODIUM, UP TO 500 MG Cefazolin SodiumYes
J0691Injection, lefamulin, 1 mgXenletaYes
J0692INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG Cefepime HclYes
J0694INJECTION, CEFOXITIN SODIUM, 1 GM Cefoxitin SodiumYes
J0695INJ CEFTOLOZANE AND TAZOBACTAM ZerbaxaYes
J0696INJECTION, CEFTRIAXONE SODIUM, PER 250 MG (ROCEPHIN) Ceftriaxone SodiumYes
J0697INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG ZinacefYes
J0698CEFOTAXIME SODIUM, PER GM Cefotaxime SodiumYes
J0702INJECTION; BETAMETHASONE ACETATE & SODIUM PHOSPHATE Betamethasone Sod Phos & AcetYes
J0706INJECTION, CAFFEINE CITRATE, 5MG Caffeine CitrateYes
J0712Ceftaroline fosamil inj TeflaroYes
J0713INJ CEFTAZIDIME PER 500 MG CeftazidimeYes
J0714CEFTAZIDIME AND AVIBACTAM AvycazYes
J0716CENTRUROIDES IMMUNE F(AB) AnascorpYes
J0717CERTOLIZUMAB PEGOL INJ 1MG Cimzia Starter KitYes
J0720INJECTION, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 GM Chloramphenicol Sod SuccinateYes
J0725INJECTION, CHORIONIC GONADOTROPIN NovarelYes
J0735INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG DuraclonYes
J0740INJECTION, CIDOFOVIR, 375 MG CidofovirYes
J0742Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mgRecarbrioYes
J0743INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG PrimaxinYes
J0744INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG Cipro IVYes
J0770INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG Coly-Mycin MYes
J0775Collagenase, clost hist inj XiaflexYes
J0780INJECTION, PROCHLORPERAZINE, UP TO 10 MG Prochlorperazine EdisylateYes
J0791Injection, crizanlizumab-tmca, 5 mgAdakveoYes
J0795INJECTION, CORTICORELIN OVINE TRIFLUTATE, 1 MICROGRAM ActhrelYes
J0800INJECTION, CORTICOTROPIN, UP TO 40 UNITS ActharYes
J0834Cosyntropin cortrosyn inj CosyntropinYes
J0840Crotalidae poly immune fab CrofabYes
J0841INJ CROTALIDAE IM F(AB')2 EQ AnavipYes
J0850Injection, cytomegalovirus immune globulin IVCytogamYes
J0875INJECTION, DALBAVANCIN DalvanceYes
J0878INJECTION, DAPTOMYCIN, 1 MG CubicinYes
J0881INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE) AranespYes
J0882INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (FOR ESRD ON DIALYSIS) AranespYes
J0883ARGATROBAN NONESRD USE 1MG ArgatrobanYes
J0884ARGATROBAN ESRD DIALYSIS 1MG ArgatrobanYes
J0885INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS Epogen, ProcritYes
J0887EPOETIN BETA ESRD USE MirceraYes
J0888EPOETIN BETA NON ESRD MirceraYes
J0894INJECTION DECITABINE 1 MG DecitabineYes
J0895INJECTION, DEFEROXAMINE MESYLATE, 500 MG PER 5 CC DesferalYes
J0896Injection, luspatercept-aamt, 0.25 mgReblozylYes
J0897Denosumab injection Prolia, XgevaYes
J1000INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG Depo-estradiolYes
J1020INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG Depo-medrolYes
J1030INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG Methylprednisolone AcetateYes
J1040INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG Methylprednisolone AcetateYes
J1050INJECTION, MEDROXYPROGESTERONE ACETATE, 100 MG(DEPO PROVERA) Depo-proveraYes
J1071INJ TESTOSTERONE CYPIONATE Testosterone CypionateYes
J1095INJECTION, DEXAMETHASONE 9 PERCENT, INTRAOCULAR, 1 DexycuYes
J1096Dexamethasone, lacrimal ophthalmic insert, 0.1 mgDextenzaYes
J1097Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 mlOmidriaYes
J1100INJECTION, DEXAMETHOSONE SODIUM PHOSPHATE, UP TO 4MG/ML Dexamethasone Sodium PhosphateYes
J1110INJECTION, DEHYDROERGOTAMINE, UP TO 1 MG Dihydroergotamine MesylateYes
J1120INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG Acetazolamide SodiumYes
J1130INJ DICLOFENAC SODIUM 0.5MG DylojectYes
J1160INJECTION, DIGOXIN, UP TO 0.5 MG LanoxinYes
J1162INJECTION, DIGOXIN IMMUNE FAB (OVINE), PER VIAL DigifabYes
J1165INJECTION, PHENYTOIN SODIUM Phenytoin SodiumYes
J1170INJECTION, HYDROMORPHONE, UP TO 4 MG DilaudidYes
J1190INJECTION, DEXRAZOXANE HCL, PER 250 MG Dexrazoxane HclYes
J1200INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG Diphenhydramine HclYes
J1201Injection, cetirizine hydrochloride, 0.5 mgQuzyttirYes
J1205INJECTION, CHLOROTHIAZIDE SODIUM DiurilYes
J1212INJECTION, DMSO, DIMETHYL SULFOXIDE Rimso-50Yes
J1230INJECTION, METHADONE HCL, UP TO 10 MG Methadone HclYes
J1240INJECTION, DIMENHYDRINATE, UP TO 50 MG DimenhydrinateYes
J1245INJECTION, DIPYRIDAMOLE, PER 10 MG DipyridamoleYes
J1250INJ DOBUTAMINE HCL/250 MG Dobutamine HclYes
J1260INJECTION, DOLASETRON MESYLATE, 10 MG AnzemetYes
J1265INJECTION, DOPAMINE HCL, 40 MG Dopamine HclYes
J1267Doripenem injection DoribaxYes
J1270INJECTION, DOXERCALCIFEROL, 1 MCG HectorolYes
J1290Ecallantide injection KalbitorYes
J1300Eculizumab injection SolirisYes
J1301INJECTION, EDARAVONE, 1 MG RadicavaYes
J1303Injection, ravulizumab-cwvz, 10 mgUltomirisYes
J1322ELOSULFASE ALFA, INJECTION VimizimYes
J1324Enfuvirtide injection FuzeonYes
J1325INJECTION, EPOPROSTENOL, 0.5 MG Flolan, VeletriYes
J1327INJECTION, EPTIFIBATIDE, 5 MG IntegrilinYes
J1335INJECTION, ERTAPENEM SODIUM, 500 MG InvanzYes
J1364INJECTION; ERYTHROMYCIN LACTOBIONA Erythrocin LactobionateYes
J1380INJECTION, ESTRADIOL VALERATE, UP TO 10 MG Estradiol ValerateYes
J1410INJECTION, ESTROGEN CONJUGATED, UP TO 2 MG OR 20,000 UNITS PremarinYes
J1428INJ, ETEPLIRSEN, 10 MG Exondys 51Yes
J1429Injection, golodirsen, 10 mgVyondys 53Yes
J1430INJECTION, ETHANOLAMINE OLEATE, 100 MG EthamolinYes
J1437Injection, ferric derisomaltose, 10 mgMonoferricYes
J1438INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)EnbrelYes
J1439INJ FERRIC CARBOXYMALTOSE 1MG InjectaferYes
J1442INJ, FILGRASTIM G-CSF 1MCG NeupogenYes
J1443Injection, ferric pyrophosphate citrate solution, 0.1 mg of ironTrifericYes
J1444Injection, ferric pyrophosphate citrate powder, 0.1 mg of ironTrifericYes
J1447INJ TBO FILGRASTIM 1 MICROG GranixYes
J1450INJECTION FLUCONAZOLE, 200 MG Fluconazole In Sodium ChlorideYes
J1451INJECTION, FOMEPIZOLE, 15 MG FomepizoleYes
J1453Fosaprepitant injection EmendYes
J1454INJ FOSNETUPITANT AND PALONOSETRON AkynzeoYes
J1455INJECTION, FOSCARNET SODIUM, PER 1000 MG FoscavirYes
J1458INJECTION GALSULFASE 1 MG NaglazymeYes
J1459Inj IVIG privigen 500 mg PrivigenYes
J1460INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC GamastanYes
J1555INJ, IMMUNE GLOBULIN, CUVITRU, 100 MG CuvitruYes
J1556INJ, IMM GLOB BIVIGAM, 500MG BivigamYes
J1557Inj, immune globulin, Gammaplex, 500 mg GammaplexYes
J1558Injection, immune globulin (xembify), 100 mgXembifyYes
J1559Inj, immune globulin, Hizentra, 100 mg HizentraYes
J1560INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC GamastanYes
J1561INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, PER 500 MG. Gammaked, Gamunex-CYes
J1566INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. P Carimune NfYes
J1568Octagam injection OctagamYes
J1569Gammagard liquid injection Gammagard LiquidYes
J1570INJECTION, GANCICLOVIR SODIUM, 500 MG Ganciclovir SodiumYes
J1571HepaGam B IM injection Hepagam BYes
J1572Flebogamma injection Flebogamma DifYes
J1573Hepagam B intravenous, inj Hepagam BYes
J1575HYQVIA 100MG IMMUNEGLOBULIN HyqviaYes
J1580INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG Gentamicin SulfateYes
J1595INJECTION, GLATIRAMER ACETATE, 20 MG CopaxoneYes
J1599Ivig non-lyophilized, NOS Panzyga, AscenivYes
J1602GOLIMUMAB FOR IV USE 1MG Simponi AriaYes
J1610INJECTION; GLUCAGON HYDROCHLORIDE Glucagon EmergencyYes
J1626INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG Granisetron HclYes
J1627INJ, GRANISETRON, XR, 0.1 MG SustolYes
J1628INJ., GUSELKUMAB, 1 MG TremfyaYes
J1630INJECTION, HALOPERIDOL, UP TO 5 MG Haldol LactateYes
J1631INJECTION, HALOPERIDOL DECANOATE, PER 50 MG Haldol DecanoateYes
J1632Injection, brexanolone, 1 mgZulressoYes
J1640INJECTION, HEMIN, 1 MG PanhematinYes
J1642HEPARIN SODIUM PER 10 UNITS Heparin Lock FlushYes
J1644INJECTION, HEPARIN SODIUM, PER 1000 units Heparin Sodium (porcine)Yes
J1645INJECTION, DALTEPARIN SODIUM, PER 2500 IU FragminYes
J1650INJ ENOXAPARIN SODIUM 30 MG LovenoxYes
J1652INJECTION, FONDAPARINUX SODIUM, 0.5 MG ArixtraYes
J1670INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS Hypertet S/DYes
J1675INJECTION, HISTRELIN ACETATE, 10 MICROGRAMS VantasYes
J1720INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG Solu-cortefYes
J1726Injection, hydroxyprogesterone caproate, (makena), 10 mg MakenaYes
J1729Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg Hydroxyprogesterone CaproateYes
J1730INJECTION, DIAZOXIDE, UP TO 300 MG Yes
J1738Injection, meloxicam, 1 mgAnjesoYes
J1740INJECTION IBANDRONATE SODIUM 1 MG BonivaYes
J1741INJECTION, IBUPROFEN, 100 MGCaldolorYes
J1742INJECTION, IBUTILIDE FUMARATE, 1 MG CorvertYes
J1743Idursulfase injection ElapraseYes
J1744ICATIBANT INJECTION FirazyrYes
J1745INJECTION INFLIXIMAB, 10 MG RemicadeYes
J1746INJ., IBALIZUMAB-UIYK, 10 MG TrogarzoYes
J1750INJECTION, IRON DEXTRAN, 50 MG InfedYes
J1756INJECTION, IRON SUCROSE, 1 MG VenoferYes
J1786Injection, imiglucerase, 10 unitsCerezymeYes
J1790INJECTION, DROPERIDOL, UP TO 5 MG DroperidolYes
J1800INJECTION, PROPRANOLOL HCL, UP TO 1 MG Propranolol HclYes
J1815INJECTION, INSULIN, PER 5 UNITS MultipleYes
J1817INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITSMultipleYes
J1826Interferon Beta-1A inj Avonex PenYes
J1830INJECTION; INTERFERON BETA-1B BetaseronYes
J1833INJECTION, ISAVUCONAZONIUM CresembaYes
J1885INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG ToradolYes
J1930Injection, lanreotide, 1 mg Somatuline DepotYes
J1931INJECTION, LARONIDASE, 0.1 MG AldurazymeYes
J1940INJECTION, FUROSEMIDE, UP TO 20 MG LasixYes
J1943Injection, aripiprazole lauroxil, (Aristada Initio), 1 mgAristada InitioYes
J1944Injection, aripiprazole lauroxil, (Aristada), 1 mgAristadaYes
J1950Injection, leuprolide acetate, per 3.75mg Lupron DepotYes
J1953Levetiracetam injection KeppraYes
J1955INJ LEVOCARNITINE PER 1 GM CarnitorYes
J1956INJECTION, LEVOFLOXACIN, 250 MG LevaquinYes
J1980INJECTION, HYOSCYAMINE SULFATE, UP TO 0.25 MG LevsinYes
J2001INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG XylocaineYes
J2010INJECTION, LINCOMYCIN HCL, UP TO 300 MG LincocinYes
J2020INJECTION, LINEZOLID, 200MG ZyvoxYes
J2060INJECTION, LORAZEPAM, 2 MG AtivanYes
J2062LOXAPINE FOR INHALATION 1 MG AdasuveYes
J2150INJECTION, MANNITOL, 25% IN 50 ML OsmitrolYes
J2170 Mecasermin injection IncrelexYes
J2175INJECTION, MEPERIDINE; PER 100MG DemerolYes
J2182INJECTION, MEPOLIZUMAB, 1MG NucalaYes
J2185INJECTION, MEROPENEM, 100 MG MerremYes
J2186INJECTION, MEROPENEM AND VABORBACTAM, 10MG/10MG, (20 MG)VabomereYes
J2210INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG MethergineYes
J2212METHYLNALTREXONE INJECTION RelistorYes
J2248INJECTION MICAFUNGIN SODIUM 1 MG MycamineYes
J2250INJ MIDAZOLAM HYDROCHLORIDE (VERSED) VersedYes
J2260INJECTION; MILRIONONE LACTATE Milrinone LactateYes
J2265Minocycline hydrochloride MinocinYes
J2270INJECTION, MORPHINE SULFATE, UP TO 10 MG Morphine SulfateYes
J2274IN MORPHINE PRESERVATIV FREE Morphine Sulfate (pf)Yes
J2278INJECTION, ZICONOTIDE, 1 MICROGRAM PrialtYes
J2280INJECTION, MOXIFLOXACIN, 100 MG AveloxYes
J2300INJ NALBUPHINE HYDROCHLORIDE Nalbuphine HclYes
J2310INJ NALOXONE HYDROCHLORIDE NarcanYes
J2315INJECTION NALTREXONE DEPOT FORM 1 MG VivitrolYes
J2323Natalizumab injection TysabriYes
J2325INJECTION, NESIRITIDE, 0.1 MG NatrecorYes
J2326INJ, NUSINERSEN, 0.1MG SpinrazaYes
J2350Injection, ocrelizumab, 1 mg OcrevusYes
J2353INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG Sandostatin LAR DepotYes
J2354INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJ, 25 MCGSandostatinYes
J2357INJECTION, OMALIZUMAB, 5 MG XolairYes
J2358Olanzapine long-acting inj Zyprexa RelprevvYes
J2360INJECTION, ORPHENADRINE, UP TO 60 MG OrphenateYes
J2370INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML Phenylephrine HclYes
J2400INJECTION, CHLOROPROCAINE HCL Chloroprocaine Hcl (pf)Yes
J2405INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG ZofranYes
J2407INJECTION, ORITAVANCIN OrbactivYes
J2410INJECTION, OXYMORPHONE HCL, UP TO 1 MG OpanaYes
J2425INJECTION, PALIFERMIN, 50 MICROGRAMS KepivanceYes
J2426Inj, paliperidone palmitate extended release, 1 mg Invega Sustenna, Invega TrinzaYes
J2430INJECTION; PAMIDRONATE DISODIUM ArediaYes
J2440INJECTION, PAPAVERINE HCL, UP TO 60 MG Papaverine HclYes
J2469INJECTION, PALONOSETRON HCL, 25 MCG AloxiYes
J2501INJECTION, PARICALCITOL, 1 MCG ZemplarYes
J2502INJ, PASIREOTIDE LONG ACTING Signifor LARYes
J2503INJECTION, PEGAPTANIB SODIUM, 0.3 MG MacugenYes
J2504INJECTION, PEGADEMASE BOVINE, 25 IU AdagenYes
J2507Pegloticase injection KrystexxaYes
J2510INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS Penicillin G ProcaineYes
J2515INJECTION, PENTOBARBITAL SODIUM NembutalYes
J2540INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS PfizerpenYes
J2543INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)ZosynYes
J2545Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mgNebupentYes
J2547INJECTION, PERAMIVIR RapivabYes
J2550INJECTION, PROMETHAZINE HCL, UP TO 50 MG PhenerganYes
J2560INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG Phenobarbital SodiumYes
J2562Plerixafor injection MozobilYes
J2590INJECTION, OXYTOCIN, UP TO 10 UNITS PitocinYes
J2597INJECTION DESMOPRESSIN ACETATE, PER 1 MCG DDAVPYes
J2675INJECTION, PROGESTERONE, PER 50MG Progesterone in OilYes
J2680INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG Prolixin DecanoateYes
J2690INJECTION, PROCAINAMIDE HCL, UP TO 1 GM PronestylYes
J2700INJECTION, OXACILLIN SODIUM, UP TO 250 MG BactocillYes
J2704INJ, PROPOFOL, 10 MG DiprivanYes
J2710INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG BloxiverzYes
J2720INJECTION, PROTAMINE SULFATE, UP TO 5 ML Protamine SulfateYes
J2724Injection, protein c concentrate, intravenous, human, 10 iu CeprotinYes
J2730INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM ProtopamYes
J2760INJECTION, PHENTOLAINE MESYLATE, UP TO 5 MG(REGITINE) Phentolamine MesylateYes
J2765INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG ReglanYes
J2770INJECTION, QUINUPRISTIN/DALFOPRISTIN, 500 MG (150/350) SynercidYes
J2778Ranibizumab injection LucentisYes
J2780INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG ZantacYes
J2783INJECTION, RASBURICASE, 0.5 MG ElitekYes
J2785Regadenoson injection LexiscanYes
J2786INJECTION, RESLIZUMAB, 1MG CinqairYes
J2787Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml Photrexa ViscousYes
J2788Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)HyperRHO S/DYes
J2790Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) HyperRHO S/D, Rhogam Ultra-filtered PlusYes
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu RhophylacYes
J2792Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iuWinRho SDFYes
J2793Rilonacept injection ArcalystYes
J2794Injection, risperidone (Risperdal CONSTA), 0.5 mgRisperdal ConstaYes
J2795INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG NaropinYes
J2796Romiplostim injection NplateYes
J2797INJ., ROLAPITANT, 0.5 MG VarubiYes
J2798Injection, risperidone, (Perseris), 0.5 mgPerserisYes
J2800INJECTION, METHOCARBAMOL, UP TO 10 ML RobaxinYes
J2805INJECTION, SINCALIDE, 5 MICROGRAMS KinevacYes
J2810INJECTION, THEOPHYLLINE, UP TO 2 ML TheophyllineYes
J2820INJECTION, SARGRAMOSTIM (CM-CSF), 50 MCG LeukineYes
J2840INJECTION, SEBELIPASE ALFA, 1 MG KanumaYes
J2850INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM ChiRhoStimYes
J2860INJECTION, SILTUXIMAB SylvantYes
J2916INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MGFerrlecitYes
J2920INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG Solu-medrolYes
J2930INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG Solu-medrolYes
J2941INJECTION, SOMATROPIN, 1 MG Serostim, Humatrope, Genotropin,Norditropin,Nutropin,Omnitrope,Saizen,Zomacton,ZorbtiveYes
J2993INJECTION, RETEPLASE, 18.1 MG RetavaseYes
J2997INJECTION, ALTEPLASE RECOMBINANT, 1 MG ActivaseYes
J3000INJECTION, STREPTOMYCIN, UP TO 1 GM Streptomycin SulfateYes
J3010INJECTION, FENTANYL CITRATE, 0.1 MG SublimazeYes
J3030INJECTION; SUMATRIPTAN SUCCINATE; 6MG Imitrex, SumavelYes
J3031Injection, fremanezumab-vfrm, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)AjovyYes
J3032Injection, eptinezumab-jjmr, 1 mgVyeptiYes
J3060Injection, taliglucerase alfa, 10 unitsElelysoYes
J3070INJECTION, PENTAZOCINE HCL, UP TO 30 MG TalwinYes
J3090INJ TEDIZOLID PHOSPHATE SivextroYes
J3095Televancin injection VibativYes
J3101Tenecteplase injection TNKaseYes
J3105INJECTION, TERBUTALINE SULFATE, UP TO 1 MG Terbutaline SulfateYes
J3110INJECTION, TERIPARATIDE, 10 MCG ForteoYes
J3111Injection, romosozumab-aqqg, 1 mgEvenityYes
J3121INJ TESTOSTERO ENANTHATE 1MG DelatestrylYes
J3145TESTOSTERONE UNDECANOATE 1MG AveedYes
J3230INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG ThorazineYes
J3240INJECTION, THYROTROPIN, UP TO 10 I.U. ThyrogenYes
J3241Injection, teprotumumab-trbw, 10 mgTepezzaYes
J3243INJECTION TIGECYCLINE 1 MG TygacilYes
J3245INJ., TILDRAKIZUMAB, 1 MG IlumyaYes
J3246INJECTION, TIROFIBAN HCL, 0.25MG AggrastatYes
J3250INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG TiganYes
J3260INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG NebcinYes
J3262Tocilizumab injection ActemraYes
J3285INJECTION, TREPROSTINIL, 1 MG RemodulinYes
J3300Triamcinolone A inj PRS-free TriesenceYes
J3301INJECTION TRIAMCINOLONE ACETONIDE, PER 10MG KenalogYes
J3303INJECTION TRIAMCINOLONE HEXACETONIDE, PER 5MG AristospanYes
J3304INJ TRIAMCINOLONE ACE XR 1MG ZilrettaYes
J3315INJECTION, TRIPTORELIN PAMOATE, 3.75 MG TrelstarYes
J3316INJ., TRIPTORELIN XR 3.75 MG TriptodurYes
J3355INJECTION, UROFOLLITROPIN, 75 IU BravelleYes
J3357Ustekinumab, for subcutaneous injection, 1 mgStelaraYes
J3358Ustekinumab, for intravenous injection, 1 mg StelaraYes
J3360INJECTION, DIAZEPAM, UP TO 5 MG ValiumYes
J3370INJECTION, VANCOMYCIN HCL, UP TO 500 MG VancocinYes
J3380INJECTION, VEDOLIZUMAB EntyvioYes
J3385Velaglucerase alfa VprivYes
J3396INJECTION, VERTEPORFIN, 0.1 MG VisudyneYes
J3397INJ., VESTRONIDASE ALFA-VJBK MepseviiYes
J3398Injection, voretigene neparvovec-rzyl, 1 billion vector genomesLuxturnaYes
J3399Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomesZolgensmaYes
J3410INJECTION, HYDROXYZINE HCL, UP TO 25 MG VistarilYes
J3411INJECTION, THIAMINE HCL, 100 MG Thiamine HclYes
J3415INJECTION, PYRIDOXINE HCL, 100 MG Pyridoxine HclYes
J3420INJECTION, VITAMIN B- 12 CYANOCOBALAMIN, UP TO 1000 MCG CyanocobalaminYes
J3430Injection, phytonadione (vitamin k), per 1 mgAqua-MephytonYes
J3465INJECTION, VORICONAZOLE, 10 MG Vfend IVYes
J3470INJECTION, HYALURONIDASE, UP TO 150 UNITS AmphadaseYes
J3471INJECTION, HYALURONIDASE, OVINE, PRESERVATIVE FREE, PER 1 US VitraseYes
J3473INJECTION HYALURONIDASE RECOMBINANT 1 USP UNIT HylenexYes
J3475INJ MAGNESIUM SULFATE Magnesium SulfateYes
J3480INJ POTASSIUM CHLORIDE-2 MEQ Potassium ChlorideYes
J3485INJECTION, ZIDOVUDINE, 10 MG RetrovirYes
J3486INJECTION, ZIPRASIDONE MESYLATE, 10 MG GeodonYes
J3489ZOLEDRONIC ACID 1MG Reclast, ZometaYes
J3490Unclassified drugsUnclassified drugsYes
J3590Unclassified biologicsUnclassified biologicsYes
J7030INFUSION, NORMAL SALINE SOLUTION , 1000 CC Sodium ChlorideYes
J7040INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) Sodium ChlorideYes
J70425% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT) Dextrose 5%-0.9% NaClYes
J7050INFUSION, NORMAL SALINE SOLUTION , 250 CC Sodium ChlorideYes
J70605% DEXTROSE/WATER (500 ML = 1 UNIT) Dextrose in waterYes
J7070INFUSION, D5W, 1000 CC Dextrose in waterYes
J7100INFUSION, DEXTRAN 40, 500 ML LMDYes
J7120RINGERS LACTATE INFUSION, UP TO 1000 CC Lactated RingersYes
J71215% DEXTROSE IN LAC RINGERS Dextrose In Lactated RingersYes
J7169Injection, coagulation Factor Xa (recombinant), inactivated-zhzo (Andexxa), 10 mgAndexxaYes
J7170INJ., EMICIZUMAB-KXWH 0.5 MG HemlibraYes
J7175INJ, FACTOR X, (HUMAN), 1IU CoagadexYes
J7177Injection, human fibrinogen concentrate (fibryga), 1 mgFibrygaYes
J7178HUMAN FIBRINOGEN CONC INJ RiastapYes
J7179Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco VonvendiYes
J7180Factor XIII anti-hem factor CorifactYes
J7181FACTOR XIII RECOMB A-SUBUNIT TrettenYes
J7182FACTOR VIII RECOMB NOVOEIGHT NovoeightYes
J7183Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco WilateYes
J7185Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.XynthaYes
J7186Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.Alphanate/VWF Complex/HumanYes
J7187INJECTION VON WILLEBRAND FACTOR COMPLEX HUMAN RISTOCETIN COFACTOR PER IVHumate-pYes
J7188FACTOR VIII RECOMB OBIZUR ObizurYes
J7189Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram NovoSeven RTYes
J7190FACTOR VIII, (ANTI-HEMOPHILIC FACTOR (HUMAN)), PER I.U. Hemofil M, KoateYes
J7192FACTOR VIII (ANTIHEMOPHILIC FACTOR (RECOMBINANT)), PER I.U. Recombinate, Advate, Kogenate, Helixate FSYes
J7193FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT) PER I.U. Mononine, AlphanineYes
J7194FACTOR IX, COMPLEX, PER I.U. Profilnine SDYes
J7195FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U. Ixinity, BeneFIXYes
J7196Antithrombin recombinant AtrynYes
J7197ANTITHROMBIN III (HUMAN), PER I.U. Thrombate IIIYes
J7198ANTI-INHIBITOR, PER I.U. Feiba NFYes
J7200FACTOR IX RECOMBINAN RIXUBIS RixubisYes
J7201FACTOR IX FC FUSION RECOMB AlprolixYes
J7202FACTOR IX IDELVION INJ IdelvionYes
J7203FACTOR IX RECOMB GLY REBINYN RebinynYes
J7204Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IUEsperoctYes
J7205FACTOR VIII FC FUSION RECOMB EloctateYes
J7207FACTOR VIII PEGYLATED RECOMB AdynovateYes
J7208Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.JiviYes
J7209FACTOR VIII NUWIQ RECOMB 1IU NuwiqYes
J7210INJ, AFSTYLA, 1 I.U. AfstylaYes
J7211INJ, KOVALTRY, 1 I.U. KovaltryYes
J7296LEVONORGESTREL IU, KYLEENA, 19.5 MG KyleenaYes
J7297LEVONORGESTREL IU 52MG 3 YR Liletta (52 Mg)Yes
J7298LEVONORGESTREL IU 52MG 5 YR Mirena (52 Mg)Yes
J7300IUD COPPER Paragard Intrauterine CopperYes
J7301LEVONORGESTREL IU, SKYLA, 13.5MG SkylaYes
J7304CONTRACEPTIVE SUPPLY, HORMONE CONTAINING PATCH, EACH XulaneYes
J7307Etonogestrel implant system NexplanonYes
J7308AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSLevulan KerastickYes
J7311FLUOCINOLONE ACETONIDE INTRAVITREAL IMPLANT RetisertYes
J7312Dexamethasone intravitreal implant OzurdexYes
J7313FLUOCINOL ACET INTRAVITREAL IMPLANT IluvienYes
J7314Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mgYutiqYes
J7315OPTHALMIC MITOMYCIN MitosolYes
J7316INJ, OCRIPLASMIN, 0.125 MG JetreaYes
J7318INJ, DUROLANE 1 MG DurolaneYes
J7320HYALURONAN OR DERIVITIVE, GENVISC 850, FOR INTRA-ARTICULAR INJ, 1 MG Genvisc 850Yes
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose Hyalgan; Supartz;Visco-3Yes
J7322HYALURONAN OR DERIVATIVE, HYMOVIS, FOR INTRA-ARTICULAR INJECTION, 1 MG HymovisYes
J7323Euflexxa inj per dose EuflexxaYes
J7324Orthovisc inj per dose OrthoviscYes
J7325Synvisc or Synvisc-One Synvisc, Synvisc-OneYes
J7326Gel-one Gel-oneYes
J7327MONOVISC INJ PER DOSE MonoviscYes
J7328GEL-SYN INJECTION 0.1 MG Gelsyn-3Yes
J7329INJ, TRIVISC 1 MG TriviscYes
J7330AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT MACIYes
J7331Hyaluronan or derivative, SYNOJOYNT, for intra-articular injection, 1 mgSynojoyntYes
J7332Hyaluronan or derivative, Triluron, for intra-articular injection, 1 mgTriluronYes
J7336CAPSAICIN 8% PATCH QutenzaYes
J7340CARBIDOPA LEVODOPA ENTERAL DuopaYes
J7342Instillation, ciprofloxacin otic suspension, 6 mgOtiprioYes
J7345Aminolevulinic acid HCl for topical administration, 10% gel, 10mgAmeluzYes
J7351Injection, bimatoprost, intracameral implant, 1 mcgDurystaYes
J7500Azathioprine, oral, 50 mg ImuranYes
J7501Azathioprine, parenteral, 100 mgAzathioprine SodiumYes
J7502CYCLOSPORINE, ORAL, 100 MG Sandimmune; Gengraf; NeoralYes
J7503TACROL ENVARSUS EXT REL ORAL Envarsus XRYes
J7504LYMPHOCYTE IMMUNE GLOBULIN, ANTITYMOCYTE GLOBULIN - PARENTERAL, AMP, 5 AtgamYes
J7507TACROLIMUS, ORAL PrografYes
J7508TACROLIMUS EXT REL ORAL 0.1MG Astagraf XLYes
J7509METHYLPREDNISOLONE ORAL MedrolYes
J7510PREDNISOLONE ORAL PER 5 MG PrednisoloneYes
J7511LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, ThymoglobulinYes
J7512PREDNISONE IR OR DR ORAL 1MG DeltasoneYes
J7513DACLIZUMAB, PARENTERAL, 25 MG ZinbrytaYes
J7515CYCLOSPORINE, ORAL, 25 MG Sandimmune; Gengraf, NeoralYes
J7516CYCLOSPORIN, PARENTERAL, 250 MG SandIMMUNEYes
J7517MYCOPHENOLATE MOFETIL, ORAL, 250 MG CellCeptYes
J7518MYCOPHENOLIC ACID, ORAL, 180 MG MyforticYes
J7520SIROLIMUS, ORAL, 1 MG RapamuneYes
J7525TACROLIMUS, PARENTERAL, 5 MG PrografYes
J7527ORAL EVEROLIMUS ZortressYes
J7605Arformoterol non-comp unit BrovanaYes
J7606Formoterol fumarate, inh PerforomistYes
J7608ACETYLCYSTEINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE AcetylcysteineYes
J7611ALBUTEROL, INHALATION SOLUTION, ADMINISTERED THROUGH DME, CO Albuterol SulfateYes
J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mgXopenexYes
J7613ALBUTEROL, INHALATION SOLUTION, ADMINISTERED THROUGH DME, UN Albuterol SulfateYes
J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg XopenexYes
J7620ALBUTEROL AND IPRATROPIUM INHAL.SOLUTION ADMIN. VIA DME Ipratropium-albuterolYes
J7626BUDESONIDE INHALATION SOLUTION, ADMINISTERED THROUGH DME, UNIT DOSE FORMPulmicort RespulesYes
J7631CROMOLYN SODIUM, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSECromolyn SodiumYes
J7639DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FPulmozymeYes
J7644IPRATROPIUM BROMIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT AtroventYes
J7665Mannitol for inhaler AridolYes
J7674METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION TH ProvocholineYes
J7677revefenacin inhalation solutionYupelriYes
J7682TOBRAMYCIN, UNIT DOSE FORM, 300 MG, INHALATION SOLUTION, ADMINISTERED THROUGH DMETobi; Bethkis; KitabisYes
J7686Treprostinil, non-comp unit TyvasoYes
J8499Prescription drug, oral, non chemotherapeutic, nosPrescription drug, oral, non chemotherapeutic, nosYes
J8501APREPITANT, ORAL, 5 MG EmendYes
J8510BUSULFAN; ORAL, 2 MG MyleranYes
J8515CABERGOLINE, ORAL, 0.25 MG CabergolineYes
J8520CAPECITABINE, ORAL, 150 MG XelodaYes
J8521CAPECITABINE, ORAL, 500 MG XelodaYes
J8530CYCLOPHOSPHAMIDE, ORAL CyclophosphamideYes
J8540DEXAMETHASONE, ORAL, 0.25 MG DexamethasoneYes
J8560ETOPOSIDE, ORAL VePesidYes
J8565GEFITINIB, ORAL, 250 MG IressaYes
J8600MELPHALAN AlkeranYes
J8610METHOTREXATE, ORAL MethotrexateYes
J8650Nabilone oral CesametYes
J8655NETUPITANT AND PALONOSETRON, ORAL AkynzeoYes
J8670ROLAPITANT, ORAL, 1MG VarubiYes
J8700TEMOZOLOMIDE, ORAL, 5 MG TemodarYes
J8705Topotecan oral HycamtinYes
J8999Prescription drug, oral, chemotherapeutic, NOSPrescription drug, oral, chemotherapeutic, NOSYes
J9000DOXORUBICIN HCL, 10 MG AdriamycinYes
J9015ALDESLEUKIN/SINGLE USE VIAL ProleukinYes
J9017ARSENIC TRIOXIDE, 1MG TrisenoxYes
J9019Injection, asparaginase (erwinaze), 1,000 iuErwinazeYes
J9022INJ, ATEZOLIZUMAB,10 MG TecentriqYes
J9023INJECTION, AVELUMAB, 10 MG BavencioYes
J9025INJECTION, AZACITIDINE, 1 MG VidazaYes
J9027INJECTION, CLOFARABINE, 1 MG ClolarYes
J9030Bcg live intravesical instillation, 1 mgTice BCGYes
J9032INJECTION, BELINOSTAT, 10MG BeleodaqYes
J9033Bendamustine injection TreandaYes
J9034Inj., bendamustine hcl (bendeka), 1 mgBendekaYes
J9035INJECTION, BEVACIZUMAB, 10 MG AvastinYes
J9036Injection, bendamustine hydrochloride, (Belrapzo/bendamustine), 1 mgBelrapzoYes
J9039INJECTION, BLINATUMOMAB BlincytoYes
J9040BLEOMYCIN SULFATE, 15 UNITS Bleomycin SulfateYes
J9041INJECTION, BORTEZOMIB, 0.1 MG VelcadeYes
J9042BRENTUXIMAB VEDOTIN INJ AdcetrisYes
J9043Cabazitaxel injection JevtanaYes
J9044INJ, BORTEZOMIB, NOS, 0.1 MG BortezomibYes
J9045CARBOPLATIN, 50 MG ParaplatinYes
J9047INJECTION, CARFILZOMIB, 1 MG KyprolisYes
J9050CARMUSTINE, 100 MG BiCNUYes
J9055INJECTION, CETUXIMAB, 10 MG ErbituxYes
J9057INJ., COPANLISIB, 1 MG AliqopaYes
J9060CISPLATIN, POWDER OR S0LUTION, PER 10 MG Platinol AQYes
J9065INJECTION; CLADRIBINE LeustatinYes
J9070CYCLOPHOSPHAMIDE, 100 MG CytoxanYes
J9098CYTARABINE LIPOSOME, 10 MG DepocytYes
J9100CYTARABINE 100 MG Cytarabine (pf)Yes
J9118Injection, calaspargase pegol-mknl, 10 unitsAsparlasYes
J9119Injection, cemiplimab-rwlc, 1 mgLibtayoYes
J9120DACTINOMYCIN, 0.5 MG CosmegenYes
J9130DACARBAZINE, 100 MG DTIC-DOME IVYes
J9145INJECTION, DARATUMUMAB 10 MG DarzalexYes
J9150DAUNORUBICIN HYDROCHLORIDE, 10 MG CerubidineYes
J9151DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG Daunoxome Yes
J9153INJ, LIPOSOMAL, DAUNORUBICIN AND CYTARABINE VyxeosYes
J9155Degarelix injection FirmagonYes
J9171Docetaxel injection TaxotereYes
J9173INJ., DURVALUMAB, 10 MG ImfinziYes
J9175INJECTION, ELLIOTTS' B SOLUTION, 1 ML Elliotts BYes
J9176INJECTION, ELOTUZUMAB, 1MG EmplicitiYes
J9177Injection, enfortumab vedotin-ejfv, 0.25 mgPadcevYes
J9178INJECTION, EPIRUBICIN HCL, 2 MG EllenceYes
J9179Eribulin mesylate injection HalavenYes
J9181ETOPOSIDE, 10 MG EtoposideYes
J9185FLUDARABINE PHOSPHATE, 50 MG FludaraYes
J9190FLUOROURACIL, 500 MG AdrucilYes
J9198Injection, gemcitabine hydrochloride, (Infugem), 100 mgInfugemYes
J9200FLOXURIDINE, 500 MG FloxuridineYes
J9201GEMCITABINE HCL, 200 MG GemzarYes
J9202GOSERELIN ACETATE IMPLANT, PER 3.6 MG ZoladexYes
J9203GEMTUZUMAB OZOGAMICIN 0.1 MG MylotargYes
J9204Injection, mogamulizumab-kpkc, 1 mgPoteligeoYes
J9205INJ IRINOTECAN LIPOSOME 1 MG OnivydeYes
J9206IRINOTECAN, 20 MG CamptosarYes
J9207Ixabepilone injection Ixempra KitYes
J9208IFOSFAMIDE, 1 GM IfexYes
J9209MESNA, 200 MG MesnexYes
J9210Injection, emapalumab-lzsg, 1 mgGamifantYes
J9211IDARUBICIN HYDROCHLORIDE, 5 MG Idamycin PFSYes
J9214INTERFERON, ALFA-2B, RECOMBINANT, 1 MILLION UNITS Intron AYes
J9215INTERFERON, ALFA-N3, (HUMAN LEUKOCYTE DERIVED), 250,000 IU Alferon NYes
J9216INTERFERON, GAMMA 1-B, 3 MILLION UNITS ActimmuneYes
J9217LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG Eligard, Lupron DepotYes
J9218LEUPROLIDE ACETATE, PER 1 MG Leuprolide AcetateYes
J9225HISTRELIN IMPLANT, 50 MG VantasYes
J9226Supprelin LA implant Supprelin LAYes
J9227Injection, isatuximab-irfc, 10 mgSarclisaYes
J9228Ipilimumab injection YervoyYes
J9229INJ INOTUZUMAB OZOGAM 0.1 MG BesponsaYes
J9230MECHLORETHAMINE HYDROCHLORIDE, (NITROGEN MUSTARD), 10 MG MustargenYes
J9245INJECTION; MELPHALAN HCL AlkeranYes
J9246Injection, melphalan (Evomela), 1 mgEvomelaYes
J9250METHOTREXATE SODIUM, 5 MG Methotrexate SodiumYes
J9260METHOTREXATE SODIUM, 50 MG Methotrexate SodiumYes
J9261INJECTION NELARABINE 50 MG ArranonYes
J9262INJ, OMACETAXINE MEP, 0.01MG SynriboYes
J9263INJECTION, OXALIPLATIN, 0.5 MG EloxatinYes
J9264INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG AbraxaneYes
J9266PEGASPARGASE/SINGL DOSE VIAL OncasparYes
J9267PACLITAXEL INJECTION TaxolYes
J9268PENTOSTATIN, PER 10 MG (NIPENT) NipentYes
J9269Injection, tagraxofusp-erzs, 10 mcgElzonrisYes
J9271INJ PEMBROLIZUMAB KeytrudaYes
J9280MITOMYCIN, 5 MG MutamycinYes
J9285INJ, OLARATUMAB, 10 MG LartruvoYes
J9293MITOXANTRONE HYDROCHLORIDE, 20 MG-1994,1995=5MG NovantroneYes
J9295INJECTION, NECITUMUMAB, 1 MG PortrazzaYes
J9299INJECTION, NIVOLUMAB OpdivoYes
J9301OBINUTUZUMAB INJ GazyvaYes
J9302Ofatumumab injection ArzerraYes
J9303Panitumumab injection VectibixYes
J9304Injection, pemetrexed (Pemfexy), 10 mgPemfexyYes
J9305INJECTION, PEMETREXED, not otherwise specified, 10 MG AlimtaYes
J9306INJECTION, PERTUZUMAB, 1 MG PerjetaYes
J9307Pralatrexate injection FolotynYes
J9308INJECTION, RAMUCIRUMAB CyramzaYes
J9309Injection, polatuzumab vedotin-piiq, 1 mgPolivyYes
J9311INJ RITUXIMAB, HYALURONIDASE Rituxan HycelaYes
J9312INJ., RITUXIMAB, 10 MG RituxanYes
J9313Injection, moxetumomab pasudotox-tdfk, 0.01 mgLumoxitiYes
J9320STREPTOZOCIN, 1 GM ZanosarYes
J9325INJ TALIMOGENE LAHERPAREPVEC ImlygicYes
J9328Temozolomide injection TemodarYes
J9330Temsirolimus injection ToriselYes
J9340THIOTEPA, 15 MG TepadinaYes
J9351Topotecan injection HycamtinYes
J9352INJECTION TRABECTEDIN 0.1MG YondelisYes
J9354INJ, ADO-TRASTUZUMAB EMT 1MG KadcylaYes
J9355TRASTUZUMAB, 10 MG HerceptinYes
J9356Injection, trastuzumab, 10 mg and Hyaluronidase-oyskHerceptin HylectaYes
J9357VALRUBICIN, INTRAVESICAL, 200 MG ValstarYes
J9358Injection, fam-trastuzumab deruxtecan-nxki, 1 mgEnhertuYes
J9360VINBLASTINE SULFATE, 1 MG Vinblastine SulfateYes
J9370VINCRISTINE SULFATE, 1 MG Vincasar PFSYes
J9371INJ, VINCRISTINE SUL LIP 1MG MarqiboYes
J9390VINORELBINE TARTRATE/10 MG NavelbineYes
J9395INJECTION, FULVESTRANT, 25 MG FaslodexYes
J9400INJ, ZIV-AFLIBERCEPT, 1MG ZaltrapYes
J9600PORFIMER SODIUM, 75 MG PhotofrinYes
P9045INFUSION, ALBUMIN (HUMAN), 5%, 250 ML Plasbumin-5Yes
P9046INFUSION, ALBUMIN (HUMAN), 25%, 20 ML AlbuteinYes
P9047INFUSION, ALBUMIN (HUMAN), 25%, 50 ML Albuminar-25Yes
Q0138Ferumoxytol, non-esrd FerahemeYes
Q0139Ferumoxytol, esrd use FerahemeYes
Q0144AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM ZithromaxYes
Q0162Ondansetron oral ZofranYes
Q0163DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANBenadrylYes
Q0164PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMCompazineYes
Q0166GRANISETRON HYDROCHLORIDE, 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMKytrilYes
Q0167DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USEMarinolYes
Q0169PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTPhenerganYes
Q0175PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USEPerphenazineYes
Q0177HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC,VistarilYes
Q2004Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 mlRenacidinYes
Q2009INJECTION, FOSPHENYTOIN, 50 MG CerebyxYes
Q2028INJ, SCULPTRA, 0.5MG SculptraYes
Q2041Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseYescartaYes
Q2042Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseKymriahYes
Q2043Sipuleucel-T auto CD54+ ProvengeYes
Q2050Inj, doxorubicin, liposomal, not otherwise specified, 10 mgDoxilYes
Q3027INJ BETA INTERFERON IM 1 MCG AvonexYes
Q3028INJ BETA INTERFERON SQ 1 MCG RebifYes
Q4074Iloprost non-comp unit dose VentavisYes
Q4081INJECTION EPOETIN ALFA 100 UNITS (FOR ESRD ON DIALYSIS) Epogen, ProcritYes
Q5101INJ FILGRASTIM G-CSF BIOSIM ZarxioYes
Q5103Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mgInflectraYes
Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg RenflexisYes
Q5105Inj, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units RetacritYes
Q5106Inj, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units RetacritYes
Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg MvasiYes
Q5108Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mgFulphilaYes
Q5109Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg IxifiYes
Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 mcg NivestymYes
Q5111Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mgUdenycaYes
Q5112Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mgOntruzantYes
Q5113Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mgHerzumaYes
Q5114Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mgOgivriYes
Q5115Injection, rituximab-abbs, biosimilar, 10 mgTruximaYes
Q5116Injection, trastuzumab-qyyp, biosimilar, (Trazimera), 10 mgTrazimeraYes
Q5117Injection, trastuzumab-anns, biosimilar, (Kanjinti), 10 mgKanjintiYes
Q5118Injection, bevacizumab-bvcr, biosimilar, (Zirabev), 10 mgZirabevYes
Q5119Injection, rituximab-pvvr, biosimilar, (RUXIENCE), 10 mgRuxienceYes
Q5120Injection, pegfilgrastim-bmez, biosimilar, (ZIEXTENZO), 0.5 mgZiextenzoYes
Q5121Injection, infliximab-axxq, biosimilar, (AVSOLA), 10 mgAvsolaYes
Q9991BUPRENORPH XR 100 MG OR LESS SublocadeYes
Q9992BUPRENORPHINE XR OVER 100 MG SublocadeYes
S0012BUTORPHANOL TARTRATE, NASAL SPRAY, 25 MG Butorphanol TartrateYes
S0017INJECTION, AMINOCAPROIC ACID, 5 GRAMS Aminocaproic AcidYes
S0020INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML Marcaine; SensorcaineYes
S0028INJECTION, FAMOTIDINE, 20 MG PepcidYes
S0030INJECTION, METRONIDAZOLE, 500 MG FlagylYes
S0032INJECTION, NAFCILLIN SODIUM, 2 GRAMS Nafcillin SodiumYes
S0039INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 ML Sulfamethoxazole-trimethoprimYes
S0073INJECTION, AZTREONAM, 500 MG AzactamYes
S0074INJECTION, CEFOTETAN DISODIUM, 500 MG CefotanYes
S0077INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG Cleocin PhosphateYes
S0078INJECTION, FOSPHENYTOIN SODIUM, 750 MG CerebyxYes
S0080INJECTION, PENTAMIDINE ISETHIONATE, 300 MG PentamYes
S0088Imatinib, 100 mgGleevecYes
S0090SILDENAFIL CITRATE, 25 MG ViagraYes
S0091Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)KytrilYes
S0092Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)DilaudidYes
S0093INJECTION, MORPHINE SULFATE, 500 MG (LOADING DOSE FOR INFUSION PUMP) Morphine SulfateYes
S0104ZIDOVUDINE, ORAL, 100 MG RetrovirYes
S0106BUPROPION HCL SUSTAINED RELEASE TABLET, 150 MG, PER BOTTLE OF 60 TABLETSWellbutrin SRYes
S0108MERCAPTOPURINE, ORAL, 50 MG PurixanYes
S0109METHADONE, ORAL, 5MG Dolophine; MethadoseYes
S0117TRETINOIN, TOPICAL, 5 GRAMS Retin-A; AltrenoYes
S0119Ondansetron 4 mg ZofranYes
S0122INJECTION, MENOTROPINS, 75 IU MenopurYes
S0126INJECTION, FOLLITROPIN ALFA, 75 IU Gonal-f RffYes
S0128INJECTION, FOLLITROPIN BETA, 75 IU Follistim AQYes
S0132INJECTION, GANIRELIX ACETATE, 250 MCG Ganirelix AcetateYes
S0136CLOZAPINE, 25 MG ClozarilYes
S0137DIDANOSINE (DDI), 25 MG Videx; Videx ECYes
S0138FINASTERIDE, 5 MG ProscarYes
S0139MINOXIDIL, 10 MG MinoxidilYes
S0140SAQUINAVIR, 200 MG InviraseYes
S0145INJECTION, PEGYLATED INTERFERON ALFA-2A, 180 MCG PER ML PegasysYes
S0148Peg interferon alfa-2b, 10 mcg PegIntron; SylatronYes
S0155STERILE DILUTANT FOR EPOPROSTENOL, 50ML Diluent For EpoprostenolYes
S0156EXEMESTANE, 25 MG AromasinYes
S0157BECAPLERMIN GEL 0.01%, 0.5 GM RegranexYes
S0160DEXTROAMPHETAMINE SULFATE, 5 MG DexedrineYes
S0164INJECTION, PANTOPRAZOLE SODIUM, 40 MG ProtonixYes
S0166INJECTION, OLANZAPINE, 2.5 MG ZyprexaYes
S0169Calcitrol, 0.25 mcgRocaltrolYes
S0170ANASTROZOLE, ORAL, 1MG ArimidexYes
S0171INJECTION, BUMETANIDE, 0.5MG BumexYes
S0172CHLORAMBUCIL, ORAL, 2MG LeukeranYes
S0174DOLASETRON MESYLATE, ORAL 50MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDIAnzemetYes
S0175FLUTAMIDE, ORAL, 125MG EulexinYes
S0176HYDROXYUREA, ORAL, 500MG HydreaYes
S0178LOMUSTINE, ORAL, 10MG GleostineYes
S0179MEGESTROL ACETATE, ORAL, 20MG Megace ESYes
S0182PROCARBAZINE HYDROCHLORIDE, ORAL, 50MG MatulaneYes
S0183PROCHLORPERAZINE MALEATE, ORAL, 5MG (FOR CIRCUMSTANCES FALLING UNDER THECompazineYes
S0187TAMOXIFEN CITRATE, ORAL, 10MG Tamoxifen CitrateYes
S0189TESTOSTERONE PELLET, 75MG TestopelYes
S0190MIFEPRISTONE, ORAL, 200 MG MifeprexYes
S0191MISOPROSTOL, ORAL, 200 MCG CytotecYes
S0197Prenatal vitamins, 30-day supplyPrenatal Vitamin And MineralYes
S4991Nicotine patches, non-legendNicoderm CQYes
S4993Contraceptive pills for birth controlMultipleYes
S4995Smoking cessation gumNicoretteYes
S50105% dextrose and 0.45% normal saline, 1000 mlDextrose-sodium chlorideYes
S5550Insulin, rapid onset, 5 unitsApidraYes
S5551Insulin, most rapid onset (lispro or aspart); 5 unitsMultipleYes
S5552Insulin, intermediate acting (nph or lente); 5 unitsHumulin N; Novolin NYes
S5553Insulin, long acting; 5 unitsMultipleYes
S5561Insulin delivery device, reusable pen; 3 ml sizeYes
S5566Insulin cartridge for use in insulin delivery device other than pump; 300 unitsYes
S5570Insulin delivery device, disposable pen (including insulin); 1.5 ml sizeToujeo SolostarYes
S5571Insulin delivery device, disposable pen (including insulin); 3 ml sizeMultipleYes
S8490Insulin syringes (100 syringes, any size)Insulin syringes (100 syringes, any size)Yes
C1052HEMOSTATIC AGT GASTROINTESTINAL TOPHEMOSTATIC AGT GASTROINTESTINAL TOPYes
J1823Injection, inebilizumab-cdon, 1 mgUpliznaYes
J7212Factor viia (antihemophilic factor, recombinant)- jncw (sevenfact), 1 microgramSevenfactYes
J7352Afamelanotide implant, 1 mgScenesseYes
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihjDarzalex FasproYes
J9223Injection, lurbinectedin, 0.1 mgZepzelcaYes
J9281Mitomycin pyelocalyceal instillation, 1 mgJelmytoYes
J9316Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mgPhesgoYes
J9317Injection, sacituzumab govitecan-hziy, 2.5 mgTrodelvyYes
M0243IV INFUSION CASIRIVIMAB & IMDEVIMAB MONITORINGIV INFUSION CASIRIVIMAB & IMDEVIMAB MONITORINGYes
Q0239INJECTION BAMLANIVIMAB-XXXX 700 MGINJECTION BAMLANIVIMAB-XXXX 700 MGYes
Q0243INJ CASIRIVIMAB & IMDEVIMAB 2400 MGINJ CASIRIVIMAB & IMDEVIMAB 2400 MGYes
Q5122Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mgNyvepriaYes
S0013Esketamine, nasal spray, 1 mgSpravatoYes
M0245IV INF Bamlanivimab and etesevimab, monitoringIV INF Bamlanivimab and etesevimab, monitoringYes
Q0245INJ Bamlanivimab and etesevimabBamlanivimab and etesevimabYes
J1427Injection, viltolarsen, 10 mgViltepsoYes
J1554Injection, immune globulin (Asceniv), 500 mgAscenivYes
J9037Injection, belantamab mafodontin-blmf, 0.5 mgBlenrepYes
J9349Injection, tafasitamab-cxix, 2 mgMonjuviYes
Q2053Brexucabtagene autoleucel, up to 200 million autologous anti-CD19 CAR positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic doseTecartusYes
J7402Mometasone furoate sinus implant, (Sinuva), 10 mcgSinuvaYes
S1091Stent, non-coronary, temporary, with delivery system(propel)PropelYes
M0244Intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring in the home or residencen/aYes
M0246Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residencen/aYes
J0224INJECTION LUMASIRAN 0.5 MGOxlumoYes
J1951INJ LEU AC FOR DEP SUSP 0.25 MGFensolviYes
J7168PRT CMPLX CONC KCNTRA PR IU FIX ACTKecentraYes
J9348INJECTION NAXITAMAB-GQGK 1 MGDanyelzaYes
J9353INJECTION MARGETUXIMAB-CMKB 5 MGMargenzaYes
Q5123INJ RITUXIMAB-ARRX BIOSIMILAR 10 MGRiabniYes
Q0247injection, sotrovimab 500mgn/aYes
M0247Intravenous infusion, sotrovimab, includes infusion and post administration monitoringn/aYes
Q0244injection, casirivimab and imdevimab, 1200mgn/aYes
Q0249INJ TOCILIZUMAB HP PT 2 YRS & > COVID-19 1 MGn/aYes
M0249IV TCZ HP PT 2 & > COVID-19 INC INF & PA MON FDn/aYes
M0250IV TCZ HP 2 & > COVID-19 INC INF & PA MON 2ND Dn/aYes
Q0240Injection, casirivimab and imdevimab, 600 mgcasirivimab and imdevimabYes
M0240Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat dosesn/aYes
M0241ntravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residencen/aYes
J1305Injection, evinacumab-dgnb, 5mgEvkeezaYes
J1426Injection, casimersen, 10 mgAmondys 45Yes
J1448Injection, trilaciclib, 1mgCoselaYes
J9318Injection, romidepsin, non-lyophilized, 0.1 mgn/aYes
J9319Injection, romidepsin, lyophilized, 0.1 mgIstodaxYes
Q2054Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseBreyanziYes
J0699Injection, cefiderocol, 10 mgFetrojaYes
J0741Injection, cabotegravir and rilpivirine, 2mg/3mgCabenuvaYes
J1445Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of ironTriferic AVNUYes
J2406Injection, oritavancin (kimyrsa), 10 mgKimyrsaYes
J7294Segesterone acetate and ethinyl estradiol 0.15 mg, 0.013 mg per 24 hours; yearly vaginal system, eachAnnoveraYes
J7295Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, eachNuvaringYes
J1952Leuprolide injectable, camcevi, 1 mgCamceviYes
J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mgNeulastaYes
J9021Injection, asparaginase, recombinant, (Rylaze), 0.1 mgRylazeYes
J9061Injection, amivantamab-vmjw, 2 mgRybrevantYes
J9272Injection, dostarlimab-gxly, 10 mgJemperliYes
Q2055Idecabtagene vicleucel, up to 460 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic doseAbecmaYes
C9088Instillation, bupivacaine and meloxicam, 1 mg/0.03 mgZynrelefYes
C9089Bupivacaine, collagen-matrix implant, 1 mgXaracollYes
J0172Injection, aducanumab-avwa, 2 mgAduhelmYes
Q0220tixagevimab and cilgavimabEvusheldYes
M0220tixagevimab and cilgavimab administration codeEvusheld (administration code)Yes
M0221tixagevimab and cilgavimab home administration codeEvusheld ( home administration code)Yes
J0248injection, remdesivirVekluryYes
Q0222injection, bebtelovimab, 175mgbebtelovimabyes
M0222Intravenous injection, bebtelovimab, includes injection and post administration monitoringIntravenous injection, bebtelovimab, includes injection and post administration monitoringYes
J0219Injection, avalglucosidase alfa-ngpt, 4 mg NexviazymeYes
J0491Injection, anifrolumab-fnia, 1 mg SaphneloYes
J0879Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis) KorsuvaYes
J9273Injection, tisotumab vedotin-tftv, 1 mg TivdakYes
J9359Injection, loncastuximab tesirine-lpyl, 0.075 mg ZynlontaYes
Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg ByoovizYes
J9071Injection, cyclophosphamide, (auromedics), 5 mg cyclophosphamide Yes
Q0221 Injection, tixagevimab and cilgavimab, for pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mgEvusheldYes
J2998Injection, plasminogen, human-tvmh, 1 mg Ryplazim Yes
J9331Injection, sirolimus protein-bound particles, 1 mg Fyarro Yes
J3299Injection, triamcinolone acetonide (xipere), 1 mgXipere Yes
J2779Injection, ranibizumab, via sustained release intravitreal implant Susvimo Yes
J0739Injection, cabotegravir, 1 mgApretudeYes
J1306Injection, inclisiran, 1 mgLeqvioYes
J1551Injection, immune globulin (cutaquig), 100 mgCutaquigYes
J2356Injection, tezepelumab-ekko, 1 mgTezspireYes
J9332Injection, efgartigimod alfa-fcab, 2 mgVyvgartYes
Q2017injection, teniposide, 50mgVumonYes
J9999not otherwise classified, antineoplastic drugsn/aYes
J7599immunosuppressive drugs, not otherwise classified,Yes
C9399unclassified drugs or biologicals Yes
C9101Injection, oliceridine, 0.1 mgOlinvykYes
C9142Injection, bevacizumab-maly, biosimilar, (Alymsys), 10 mgAlymsysYes
J1302Injection, sutimlimab-jome, 10 mgEnjaymoYes
J1932Injection, lanreotide, (Cipla), 1 mgCiplaYes
J2777Injection, faricimab-svoa, 0.1 mgVabysmoYes
J9274Injection, tebentafusp-tebn, 1 mcgkimmtrakYes
J9298Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mgOpdualagYes
Q2056Ciltacabtagene autoleucel, up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic doseCarvyktiYes
Q5125Injection, filgrastim-ayow, biosimilar, (Releuko), 1 mcgReleukoYes
A9607Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicuriePluvictoYes
HCPCS CODEHCPCS CODE DESCRIPTIONDRUG NAMECommercial - Authorization Required Commercial - COVERED (No PA Required) Commercial - Not CoveredAuth Required if Prescribed for an Oncology/Hematology Related Indication
90378Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular useSynagisYes
A9513Lutetium lu 177, dotatate, therapeutic, 1 millicurieLutatheraYes
A9517Iodine- i-131 sodium iodide capsule(s), therapeutic, per millicurieHiconYes
A9543Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuriesZevalin Y-90Yes
A9590Iodine i-131, iobenguane, 1 millicurieAzedraYes
A9600Strontium sr-89 chloride, therapeutic, per millicurieMetastronYes
A9604Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuriesQuadrametYes
A9606Radium ra-223 dichloride, therapeutic, per microcurieXofigoYes
C9046COCAINE HCL NASAL SOLUTION GopreltoYes
C9047Injection, caplacizumab-yhdp, 1 mg (Cablivi)CabliviYes
C9113INJECTION, PANTOPRAZOLE SODIUM, PER VIAL ProtonixYes
C9248Inj, clevidipine butyrate CleviprexYes
C9250Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 mlArtissYes
C9254Injection, lacosamide VimpatYes
C9257Bevacizumab injection AvastinYes
C9285Patch, lidocaine/tetracaine SyneraYes
C9290INJ, BUPIVACAINE LIPOSOME ExparelYes
C9293INJECTION, GLUCARPIDASE VoraxazeYes
C9460INJECTION, CANGRELOR KengrealYes
C9462INJECTION, DELAFLOXACIN BaxdelaYes
C9482SOTALOL HYDROCHLORIDE IV Sotalol HclYes
C9488CONIVAPTAN HCL VaprisolYes
J0121Injection, omadacycline, 1 mgNuzyraYes
J0122Injection, eravacycline, 1 mgXeravaYes
J0129INJECTION ABATACEPT 10 MG Orencia ClickjectYes
J0130INJECTION ABCIXIMAB, 10 MG ReoproYes
J0131Acetaminophen injection OfirmevYes
J0132INJECTION, ACETYLCYSTEINE, 100 MG AcetadoteYes
J0133INJECTION, ACYCLOVIR, 5 MG Acyclovir SodiumYes
J0135INJECTION, ADALIMUMAB, 20 MG Humira PenYes
J0153ADENOSINE INJ 1MG AdenoscanYes
J0171Adrenalin epinephrine inject Epinephrine PfYes
J0178Injection, aflibercept, 1 mgEyleaYes
J0179Injection, brolucizumab-dbll, 1 mgBeovuYes
J0180INJECTION, AGALSIDASE BETA, 1 MG FabrazymeYes
J0185INJ., APREPITANT, 1 MG CinvantiYes
J0202INJECTION, ALEMTUZUMAB LemtradaYes
J0207INJECTION, AMIFOSTINE, 500 MG EthyolYes
J0210INJECTION, METHYLDOPATE HCL, UP TO 250 MG Methyldopate HclYes
J0221Injection, alglucosidase alfa, 10 mg LumizymeYes
J0222Injection, patisiran, 0.1 mgOnpattroYes
J0223Injection, givosiran, 0.5 mgGivlaariYes
J0256INJECTION, ALPHA 1 - PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG Prolastin-cYes
J0257INJECTION, ALPHA 1 - PROTEINASE INHIBITOR (HUMAN), (GLASSIA), 10 MG GlassiaYes
J0270ALPROSTADIL, PER 1.25MCG CaverjectYes
J0275ALPROSTADIL URETHRAL SUPPOSITORY (CODE MAY BE USED FOR MEDICARE WHEN DRUMuseYes
J0278INJECTION, AMIKACIN SULFATE, 100 MG Amikacin SulfateYes
J0280INJECTION, AMINOPHYLLIN, UP TO 250 MG AminophyllineYes
J0282INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG Amiodarone HclYes
J0285INJECTION, AMPHOTERICIN B, 50 MG Amphotericin BYes
J0287INJECTION, AMPHOTERICIN B LIPID COMPLEX, 10 MG AbelcetYes
J0289INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG AmbisomeYes
J0290INJECTION, AMPICILLIN SODIUM, UP TO 500MG Ampicillin SodiumYes
J0291Injection, plazomicin, 5 mgZemdriYes
J0295INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM UnasynYes
J0300INJECTION, AMOBARBITAL, UP TO 125 MG Amytal SodiumYes
J0330INJECTION, SUCCINYCHOLINE CHLORIDE, UP TO 20 MG QuelicinYes
J0348INJECTION, ANIDULAFUNGIN, 1 MG EraxisYes
J0360INJECTION, HYDRALAZINE HCL, UP TO 20 MG Hydralazine HclYes
J0364INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG ApokynYes
J0401INJ ARIPIPRAZOLE EXT REL 1MG Abilify MaintenaYes
J0456INJECTION, AZITHROMYCIN, 500 MG ZithromaxYes
J0461Atropine sulfate injection Atropine SulfateYes
J0470INJECTION, DIMECAPROL, UP TO 100 MG Bal In OilYes
J0475INJECTION, BACLOFEN, 10 MG BaclofenYes
J0476INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL LioresalYes
J0480INJECTION, BASILIXIMAB, 20 MG SimulectYes
J0485BELATACEPT INJECTION NulojixYes
J0490Belimumab injection BenlystaYes
J0500INJECTION, DICYCLOMINE, UP TO 20 MG BentylYes
J0515INJECTION, BENZTROPINE CogentinYes
J0517INJ., BENRALIZUMAB, 1 MG FasenraYes
J0558PenG benzathine/procaine inj Bicillin C-RYes
J0561Penicillin g benzathine inj Bicillin L-AYes
J0565INJ, BEZLOTOXUMAB, 10 MG ZinplavaYes
J0567INJ., CERLIPONASE ALFA 1 MG BrineuraYes
J0570BUPRENORPHINE IMPLANT, 74.2 MG Probuphine Implant KitYes
J0571BUPRENORPHINE ORAL 1MG SubutexYes
J0572BUPRENORPHIN/NALOX UP TO 3MG Suboxone, Bunavail, ZubsolvYes
J0573BUPRENORPH/NALOX 3.1 TO 6MG Suboxone, Bunavail, ZubsolvYes
J0574BUPRENORPH/NALOX 6.1 TO 10MG Suboxone, Bunavail, ZubsolvYes
J0575BUPRENORPH/NALOX OVER 10MG Suboxone, Bunavail, ZubsolvYes
J0583INJECTION, BIVALIRUDIN, 1 MG AngiomaxYes
J0584INJECTION, BUROSUMAB-TWZA 1M CrysvitaYes
J0585BOTULINUM TOXIN TYPE A, PER UNIT BotoxYes
J0586AbobotulinumtoxinA DysportYes
J0587RimabotulinumtoxinBMyoblocYes
J0588IncobotulinumtoxinA XeominYes
J0591Injection, deoxycholic acid, 1 mgKybellaYes
J0592INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG BuprenexYes
J0593Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)TakhzyroYes
J0594INJECTION BUSULFAN 1 MG BusulfexYes
J0595INJECTION, BUTORPHANOL TARTRATE, 1 MG Butorphanol TartrateYes
J0596Injection, C1 esterase inhibitor (recombinant), ruconest, 10 units RuconestYes
J0597Injection, c-1 esterase inhibitor (human), berinert, 10 units BerinertYes
J0598Injection, c-1 esterase inhibitor (human), cinryze, 10 units CinryzeYes
J0599Injection, c-1 esterase inhibitor (human), haegarda, 10 units HaegardaYes
J0600INJECTION, EDETATE CALCIUM DISODIUM, UP TO 200 MG Calcium Disodium VersenateYes
J0604CINACALCET, ORAL, ESRD ON DIALYSIS SensiparYes
J0606INJ, ETELCALCETIDE, 0.1 MG ParsabivYes
J0610INJECTION, CALCIUM GLUCONATE, UP TO 10 ML Calcium GluconateYes
J0630INJECTION, CALCITONIN SALMON, UP TO 400 UNITS MiacalcinYes
J0636INJECTION, CALCITRIOL, 0.1 MCG CalcitriolYes
J0637INJECTION, CASPOFUNGIN ACETATE, 5 MG CancidasYes
J0638Canakinumab injection IlarisYes
J0640INJECTION, LEUCOVORIN CALCIUM, PER 50 MG Leucovorin CalciumYes
J0641Levoleucovorin injection Levoleucovorin Calcium PfYes
J0642Injection, levoleucovorin (Khapzory), 0.5 mgKhapzoryYes
J0670INJECTION, MEPIVACAINE Polocaine-mpfYes
J0690INJECTION, CEFAZOLIN SODIUM, UP TO 500 MG Cefazolin SodiumYes
J0691Injection, lefamulin, 1 mgXenletaYes
J0692INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG Cefepime HclYes
J0694INJECTION, CEFOXITIN SODIUM, 1 GM Cefoxitin SodiumYes
J0695INJ CEFTOLOZANE AND TAZOBACTAM ZerbaxaYes
J0696INJECTION, CEFTRIAXONE SODIUM, PER 250 MG (ROCEPHIN) Ceftriaxone SodiumYes
J0697INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG ZinacefYes
J0698CEFOTAXIME SODIUM, PER GM Cefotaxime SodiumYes
J0702INJECTION; BETAMETHASONE ACETATE & SODIUM PHOSPHATE Betamethasone Sod Phos & AcetYes
J0706INJECTION, CAFFEINE CITRATE, 5MG Caffeine CitrateYes
J0712Ceftaroline fosamil inj TeflaroYes
J0713INJ CEFTAZIDIME PER 500 MG CeftazidimeYes
J0714CEFTAZIDIME AND AVIBACTAM AvycazYes
J0716CENTRUROIDES IMMUNE F(AB) AnascorpYes
J0717CERTOLIZUMAB PEGOL INJ 1MG Cimzia Starter KitYes
J0720INJECTION, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 GM Chloramphenicol Sod SuccinateYes
J0725INJECTION, CHORIONIC GONADOTROPIN NovarelYes
J0735INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG DuraclonYes
J0740INJECTION, CIDOFOVIR, 375 MG CidofovirYes
J0742Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mgRecarbrioYes
J0743INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG PrimaxinYes
J0744INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG Cipro IVYes
J0770INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG Coly-Mycin MYes
J0775Collagenase, clost hist inj XiaflexYes
J0780INJECTION, PROCHLORPERAZINE, UP TO 10 MG Prochlorperazine EdisylateYes
J0791Injection, crizanlizumab-tmca, 5 mgAdakveoYes
J0795INJECTION, CORTICORELIN OVINE TRIFLUTATE, 1 MICROGRAM ActhrelYes
J0800INJECTION, CORTICOTROPIN, UP TO 40 UNITS ActharYes
J0834Cosyntropin cortrosyn inj CosyntropinYes
J0840Crotalidae poly immune fab CrofabYes
J0841INJ CROTALIDAE IM F(AB')2 EQ AnavipYes
J0850Injection, cytomegalovirus immune globulin IVCytogamYes
J0875INJECTION, DALBAVANCIN DalvanceYes
J0878INJECTION, DAPTOMYCIN, 1 MG CubicinYes
J0881INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE) AranespYes
J0882INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (FOR ESRD ON DIALYSIS) AranespYes
J0883ARGATROBAN NONESRD USE 1MG ArgatrobanYes
J0884ARGATROBAN ESRD DIALYSIS 1MG ArgatrobanYes
J0885INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS Epogen, ProcritYes
J0887EPOETIN BETA ESRD USE MirceraYes
J0888EPOETIN BETA NON ESRD MirceraYes
J0894INJECTION DECITABINE 1 MG DecitabineYes
J0895INJECTION, DEFEROXAMINE MESYLATE, 500 MG PER 5 CC DesferalYes
J0896Injection, luspatercept-aamt, 0.25 mgReblozylYes
J0897Denosumab injection Prolia, XgevaYes
J1000INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG Depo-estradiolYes
J1020INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG Depo-medrolYes
J1030INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG Methylprednisolone AcetateYes
J1040INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG Methylprednisolone AcetateYes
J1050INJECTION, MEDROXYPROGESTERONE ACETATE, 100 MG(DEPO PROVERA) Depo-proveraYes
J1071INJ TESTOSTERONE CYPIONATE Testosterone CypionateYes
J1095INJECTION, DEXAMETHASONE 9 PERCENT, INTRAOCULAR, 1 DexycuYes
J1096Dexamethasone, lacrimal ophthalmic insert, 0.1 mgDextenzaYes
J1097Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 mlOmidriaYes
J1100INJECTION, DEXAMETHOSONE SODIUM PHOSPHATE, UP TO 4MG/ML Dexamethasone Sodium PhosphateYes
J1110INJECTION, DEHYDROERGOTAMINE, UP TO 1 MG Dihydroergotamine MesylateYes
J1120INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG Acetazolamide SodiumYes
J1130INJ DICLOFENAC SODIUM 0.5MG DylojectYes
J1160INJECTION, DIGOXIN, UP TO 0.5 MG LanoxinYes
J1162INJECTION, DIGOXIN IMMUNE FAB (OVINE), PER VIAL DigifabYes
J1165INJECTION, PHENYTOIN SODIUM Phenytoin SodiumYes
J1170INJECTION, HYDROMORPHONE, UP TO 4 MG DilaudidYes
J1190INJECTION, DEXRAZOXANE HCL, PER 250 MG Dexrazoxane HclYes
J1200INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG Diphenhydramine HclYes
J1201Injection, cetirizine hydrochloride, 0.5 mgQuzyttirYes
J1205INJECTION, CHLOROTHIAZIDE SODIUM DiurilYes
J1212INJECTION, DMSO, DIMETHYL SULFOXIDE Rimso-50Yes
J1230INJECTION, METHADONE HCL, UP TO 10 MG Methadone HclYes
J1240INJECTION, DIMENHYDRINATE, UP TO 50 MG DimenhydrinateYes
J1245INJECTION, DIPYRIDAMOLE, PER 10 MG DipyridamoleYes
J1250INJ DOBUTAMINE HCL/250 MG Dobutamine HclYes
J1260INJECTION, DOLASETRON MESYLATE, 10 MG AnzemetYes
J1265INJECTION, DOPAMINE HCL, 40 MG Dopamine HclYes
J1267Doripenem injection DoribaxYes
J1270INJECTION, DOXERCALCIFEROL, 1 MCG HectorolYes
J1290Ecallantide injection KalbitorYes
J1300Eculizumab injection SolirisYes
J1301INJECTION, EDARAVONE, 1 MG RadicavaYes
J1303Injection, ravulizumab-cwvz, 10 mgUltomirisYes
J1322ELOSULFASE ALFA, INJECTION VimizimYes
J1324Enfuvirtide injection FuzeonYes
J1325INJECTION, EPOPROSTENOL, 0.5 MG Flolan, VeletriYes
J1327INJECTION, EPTIFIBATIDE, 5 MG IntegrilinYes
J1335INJECTION, ERTAPENEM SODIUM, 500 MG InvanzYes
J1364INJECTION; ERYTHROMYCIN LACTOBIONA Erythrocin LactobionateYes
J1380INJECTION, ESTRADIOL VALERATE, UP TO 10 MG Estradiol ValerateYes
J1410INJECTION, ESTROGEN CONJUGATED, UP TO 2 MG OR 20,000 UNITS PremarinYes
J1428INJ, ETEPLIRSEN, 10 MG Exondys 51Yes
J1429Injection, golodirsen, 10 mgVyondys 53Yes
J1430INJECTION, ETHANOLAMINE OLEATE, 100 MG EthamolinYes
J1437Injection, ferric derisomaltose, 10 mgMonoferricYes
J1438INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)EnbrelYes
J1439INJ FERRIC CARBOXYMALTOSE 1MG InjectaferYes
J1442INJ, FILGRASTIM G-CSF 1MCG NeupogenYes
J1443Injection, ferric pyrophosphate citrate solution, 0.1 mg of ironTrifericYes
J1444Injection, ferric pyrophosphate citrate powder, 0.1 mg of ironTrifericYes
J1447INJ TBO FILGRASTIM 1 MICROG GranixYes
J1450INJECTION FLUCONAZOLE, 200 MG Fluconazole In Sodium ChlorideYes
J1451INJECTION, FOMEPIZOLE, 15 MG FomepizoleYes
J1453Fosaprepitant injection EmendYes
J1454INJ FOSNETUPITANT AND PALONOSETRON AkynzeoYes
J1455INJECTION, FOSCARNET SODIUM, PER 1000 MG FoscavirYes
J1458INJECTION GALSULFASE 1 MG NaglazymeYes
J1459Inj IVIG privigen 500 mg PrivigenYes
J1460INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC GamastanYes
J1555INJ, IMMUNE GLOBULIN, CUVITRU, 100 MG CuvitruYes
J1556INJ, IMM GLOB BIVIGAM, 500MG BivigamYes
J1557Inj, immune globulin, Gammaplex, 500 mg GammaplexYes
J1558Injection, immune globulin (xembify), 100 mgXembifyYes
J1559Inj, immune globulin, Hizentra, 100 mg HizentraYes
J1560INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC GamastanYes
J1561INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, PER 500 MG. Gammaked, Gamunex-CYes
J1566INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. P Carimune NfYes
J1568Octagam injection OctagamYes
J1569Gammagard liquid injection Gammagard LiquidYes
J1570INJECTION, GANCICLOVIR SODIUM, 500 MG Ganciclovir SodiumYes
J1571HepaGam B IM injection Hepagam BYes
J1572Flebogamma injection Flebogamma DifYes
J1573Hepagam B intravenous, inj Hepagam BYes
J1575HYQVIA 100MG IMMUNEGLOBULIN HyqviaYes
J1580INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG Gentamicin SulfateYes
J1595INJECTION, GLATIRAMER ACETATE, 20 MG CopaxoneYes
J1599Ivig non-lyophilized, NOS Panzyga, AscenivYes
J1602GOLIMUMAB FOR IV USE 1MG Simponi AriaYes
J1610INJECTION; GLUCAGON HYDROCHLORIDE Glucagon EmergencyYes
J1626INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG Granisetron HclYes
J1627INJ, GRANISETRON, XR, 0.1 MG SustolYes
J1628INJ., GUSELKUMAB, 1 MG TremfyaYes
J1630INJECTION, HALOPERIDOL, UP TO 5 MG Haldol LactateYes
J1631INJECTION, HALOPERIDOL DECANOATE, PER 50 MG Haldol DecanoateYes
J1632Injection, brexanolone, 1 mgZulressoYes
J1640INJECTION, HEMIN, 1 MG PanhematinYes
J1642HEPARIN SODIUM PER 10 UNITS Heparin Lock FlushYes
J1644INJECTION, HEPARIN SODIUM, PER 1000 units Heparin Sodium (porcine)Yes
J1645INJECTION, DALTEPARIN SODIUM, PER 2500 IU FragminYes
J1650INJ ENOXAPARIN SODIUM 30 MG LovenoxYes
J1652INJECTION, FONDAPARINUX SODIUM, 0.5 MG ArixtraYes
J1670INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS Hypertet S/DYes
J1675INJECTION, HISTRELIN ACETATE, 10 MICROGRAMS VantasYes
J1720INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG Solu-cortefYes
J1726Injection, hydroxyprogesterone caproate, (makena), 10 mg MakenaYes
J1729Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg Hydroxyprogesterone CaproateYes
J1730INJECTION, DIAZOXIDE, UP TO 300 MG Yes
J1738Injection, meloxicam, 1 mgAnjesoYes
J1740INJECTION IBANDRONATE SODIUM 1 MG BonivaYes
J1741INJECTION, IBUPROFEN, 100 MGCaldolorYes
J1742INJECTION, IBUTILIDE FUMARATE, 1 MG CorvertYes
J1743Idursulfase injection ElapraseYes
J1744ICATIBANT INJECTION FirazyrYes
J1745INJECTION INFLIXIMAB, 10 MG RemicadeYes
J1746INJ., IBALIZUMAB-UIYK, 10 MG TrogarzoYes
J1750INJECTION, IRON DEXTRAN, 50 MG InfedYes
J1756INJECTION, IRON SUCROSE, 1 MG VenoferYes
J1786Injection, imiglucerase, 10 unitsCerezymeYes
J1790INJECTION, DROPERIDOL, UP TO 5 MG DroperidolYes
J1800INJECTION, PROPRANOLOL HCL, UP TO 1 MG Propranolol HclYes
J1815INJECTION, INSULIN, PER 5 UNITS MultipleYes
J1817INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITSMultipleYes
J1826Interferon Beta-1A inj Avonex PenYes
J1830INJECTION; INTERFERON BETA-1B BetaseronYes
J1833INJECTION, ISAVUCONAZONIUM CresembaYes
J1885INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG ToradolYes
J1930Injection, lanreotide, 1 mg Somatuline DepotYes
J1931INJECTION, LARONIDASE, 0.1 MG AldurazymeYes
J1940INJECTION, FUROSEMIDE, UP TO 20 MG LasixYes
J1943Injection, aripiprazole lauroxil, (Aristada Initio), 1 mgAristada InitioYes
J1944Injection, aripiprazole lauroxil, (Aristada), 1 mgAristadaYes
J1950Injection, leuprolide acetate, per 3.75mg Lupron DepotYes
J1953Levetiracetam injection KeppraYes
J1955INJ LEVOCARNITINE PER 1 GM CarnitorYes
J1956INJECTION, LEVOFLOXACIN, 250 MG LevaquinYes
J1980INJECTION, HYOSCYAMINE SULFATE, UP TO 0.25 MG LevsinYes
J2001INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG XylocaineYes
J2010INJECTION, LINCOMYCIN HCL, UP TO 300 MG LincocinYes
J2020INJECTION, LINEZOLID, 200MG ZyvoxYes
J2060INJECTION, LORAZEPAM, 2 MG AtivanYes
J2062LOXAPINE FOR INHALATION 1 MG AdasuveYes
J2150INJECTION, MANNITOL, 25% IN 50 ML OsmitrolYes
J2170 Mecasermin injection IncrelexYes
J2175INJECTION, MEPERIDINE; PER 100MG DemerolYes
J2182INJECTION, MEPOLIZUMAB, 1MG NucalaYes
J2185INJECTION, MEROPENEM, 100 MG MerremYes
J2186INJECTION, MEROPENEM AND VABORBACTAM, 10MG/10MG, (20 MG)VabomereYes
J2210INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG MethergineYes
J2212METHYLNALTREXONE INJECTION RelistorYes
J2248INJECTION MICAFUNGIN SODIUM 1 MG MycamineYes
J2250INJ MIDAZOLAM HYDROCHLORIDE (VERSED) VersedYes
J2260INJECTION; MILRIONONE LACTATE Milrinone LactateYes
J2265Minocycline hydrochloride MinocinYes
J2270INJECTION, MORPHINE SULFATE, UP TO 10 MG Morphine SulfateYes
J2274IN MORPHINE PRESERVATIV FREE Morphine Sulfate (pf)Yes
J2278INJECTION, ZICONOTIDE, 1 MICROGRAM PrialtYes
J2280INJECTION, MOXIFLOXACIN, 100 MG AveloxYes
J2300INJ NALBUPHINE HYDROCHLORIDE Nalbuphine HclYes
J2310INJ NALOXONE HYDROCHLORIDE NarcanYes
J2315INJECTION NALTREXONE DEPOT FORM 1 MG VivitrolYes
J2323Natalizumab injection TysabriYes
J2325INJECTION, NESIRITIDE, 0.1 MG NatrecorYes
J2326INJ, NUSINERSEN, 0.1MG SpinrazaYes
J2350Injection, ocrelizumab, 1 mg OcrevusYes
J2353INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG Sandostatin LAR DepotYes
J2354INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJ, 25 MCGSandostatinYes
J2357INJECTION, OMALIZUMAB, 5 MG XolairYes
J2358Olanzapine long-acting inj Zyprexa RelprevvYes
J2360INJECTION, ORPHENADRINE, UP TO 60 MG OrphenateYes
J2370INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML Phenylephrine HclYes
J2400INJECTION, CHLOROPROCAINE HCL Chloroprocaine Hcl (pf)Yes
J2405INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG ZofranYes
J2407INJECTION, ORITAVANCIN OrbactivYes
J2410INJECTION, OXYMORPHONE HCL, UP TO 1 MG OpanaYes
J2425INJECTION, PALIFERMIN, 50 MICROGRAMS KepivanceYes
J2426Inj, paliperidone palmitate extended release, 1 mg Invega Sustenna, Invega TrinzaYes
J2430INJECTION; PAMIDRONATE DISODIUM ArediaYes
J2440INJECTION, PAPAVERINE HCL, UP TO 60 MG Papaverine HclYes
J2469INJECTION, PALONOSETRON HCL, 25 MCG AloxiYes
J2501INJECTION, PARICALCITOL, 1 MCG ZemplarYes
J2502INJ, PASIREOTIDE LONG ACTING Signifor LARYes
J2503INJECTION, PEGAPTANIB SODIUM, 0.3 MG MacugenYes
J2504INJECTION, PEGADEMASE BOVINE, 25 IU AdagenYes
J2507Pegloticase injection KrystexxaYes
J2510INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS Penicillin G ProcaineYes
J2515INJECTION, PENTOBARBITAL SODIUM NembutalYes
J2540INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS PfizerpenYes
J2543INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)ZosynYes
J2545Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mgNebupentYes
J2547INJECTION, PERAMIVIR RapivabYes
J2550INJECTION, PROMETHAZINE HCL, UP TO 50 MG PhenerganYes
J2560INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG Phenobarbital SodiumYes
J2562Plerixafor injection MozobilYes
J2590INJECTION, OXYTOCIN, UP TO 10 UNITS PitocinYes
J2597INJECTION DESMOPRESSIN ACETATE, PER 1 MCG DDAVPYes
J2675INJECTION, PROGESTERONE, PER 50MG Progesterone in OilYes
J2680INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG Prolixin DecanoateYes
J2690INJECTION, PROCAINAMIDE HCL, UP TO 1 GM PronestylYes
J2700INJECTION, OXACILLIN SODIUM, UP TO 250 MG BactocillYes
J2704INJ, PROPOFOL, 10 MG DiprivanYes
J2710INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG BloxiverzYes
J2720INJECTION, PROTAMINE SULFATE, UP TO 5 ML Protamine SulfateYes
J2724Injection, protein c concentrate, intravenous, human, 10 iu CeprotinYes
J2730INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM ProtopamYes
J2760INJECTION, PHENTOLAINE MESYLATE, UP TO 5 MG(REGITINE) Phentolamine MesylateYes
J2765INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG ReglanYes
J2770INJECTION, QUINUPRISTIN/DALFOPRISTIN, 500 MG (150/350) SynercidYes
J2778Ranibizumab injection LucentisYes
J2780INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG ZantacYes
J2783INJECTION, RASBURICASE, 0.5 MG ElitekYes
J2785Regadenoson injection LexiscanYes
J2786INJECTION, RESLIZUMAB, 1MG CinqairYes
J2787Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml Photrexa ViscousYes
J2788Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)HyperRHO S/DYes
J2790Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) HyperRHO S/D, Rhogam Ultra-filtered PlusYes
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu RhophylacYes
J2792Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iuWinRho SDFYes
J2793Rilonacept injection ArcalystYes
J2794Injection, risperidone (Risperdal CONSTA), 0.5 mgRisperdal ConstaYes
J2795INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG NaropinYes
J2796Romiplostim injection NplateYes
J2797INJ., ROLAPITANT, 0.5 MG VarubiYes
J2798Injection, risperidone, (Perseris), 0.5 mgPerserisYes
J2800INJECTION, METHOCARBAMOL, UP TO 10 ML RobaxinYes
J2805INJECTION, SINCALIDE, 5 MICROGRAMS KinevacYes
J2810INJECTION, THEOPHYLLINE, UP TO 2 ML TheophyllineYes
J2820INJECTION, SARGRAMOSTIM (CM-CSF), 50 MCG LeukineYes
J2840INJECTION, SEBELIPASE ALFA, 1 MG KanumaYes
J2850INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM ChiRhoStimYes
J2860INJECTION, SILTUXIMAB SylvantYes
J2916INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MGFerrlecitYes
J2920INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG Solu-medrolYes
J2930INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG Solu-medrolYes
J2941INJECTION, SOMATROPIN, 1 MG Serostim, Humatrope, Genotropin,Norditropin,Nutropin,Omnitrope,Saizen,Zomacton,ZorbtiveYes
J2993INJECTION, RETEPLASE, 18.1 MG RetavaseYes
J2997INJECTION, ALTEPLASE RECOMBINANT, 1 MG ActivaseYes
J3000INJECTION, STREPTOMYCIN, UP TO 1 GM Streptomycin SulfateYes
J3010INJECTION, FENTANYL CITRATE, 0.1 MG SublimazeYes
J3030INJECTION; SUMATRIPTAN SUCCINATE; 6MG Imitrex, SumavelYes
J3031Injection, fremanezumab-vfrm, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)AjovyYes
J3032Injection, eptinezumab-jjmr, 1 mgVyeptiYes
J3060Injection, taliglucerase alfa, 10 unitsElelysoYes
J3070INJECTION, PENTAZOCINE HCL, UP TO 30 MG TalwinYes
J3090INJ TEDIZOLID PHOSPHATE SivextroYes
J3095Televancin injection VibativYes
J3101Tenecteplase injection TNKaseYes
J3105INJECTION, TERBUTALINE SULFATE, UP TO 1 MG Terbutaline SulfateYes
J3110INJECTION, TERIPARATIDE, 10 MCG ForteoYes
J3111Injection, romosozumab-aqqg, 1 mgEvenityYes
J3121INJ TESTOSTERO ENANTHATE 1MG DelatestrylYes
J3145TESTOSTERONE UNDECANOATE 1MG AveedYes
J3230INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG ThorazineYes
J3240INJECTION, THYROTROPIN, UP TO 10 I.U. ThyrogenYes
J3241Injection, teprotumumab-trbw, 10 mgTepezzaYes
J3243INJECTION TIGECYCLINE 1 MG TygacilYes
J3245INJ., TILDRAKIZUMAB, 1 MG IlumyaYes
J3246INJECTION, TIROFIBAN HCL, 0.25MG AggrastatYes
J3250INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG TiganYes
J3260INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG NebcinYes
J3262Tocilizumab injection ActemraYes
J3285INJECTION, TREPROSTINIL, 1 MG RemodulinYes
J3300Triamcinolone A inj PRS-free TriesenceYes
J3301INJECTION TRIAMCINOLONE ACETONIDE, PER 10MG KenalogYes
J3303INJECTION TRIAMCINOLONE HEXACETONIDE, PER 5MG AristospanYes
J3304INJ TRIAMCINOLONE ACE XR 1MG ZilrettaYes
J3315INJECTION, TRIPTORELIN PAMOATE, 3.75 MG TrelstarYes
J3316INJ., TRIPTORELIN XR 3.75 MG TriptodurYes
J3355INJECTION, UROFOLLITROPIN, 75 IU BravelleYes
J3357Ustekinumab, for subcutaneous injection, 1 mgStelaraYes
J3358Ustekinumab, for intravenous injection, 1 mg StelaraYes
J3360INJECTION, DIAZEPAM, UP TO 5 MG ValiumYes
J3370INJECTION, VANCOMYCIN HCL, UP TO 500 MG VancocinYes
J3380INJECTION, VEDOLIZUMAB EntyvioYes
J3385Velaglucerase alfa VprivYes
J3396INJECTION, VERTEPORFIN, 0.1 MG VisudyneYes
J3397INJ., VESTRONIDASE ALFA-VJBK MepseviiYes
J3398Injection, voretigene neparvovec-rzyl, 1 billion vector genomesLuxturnaYes
J3399Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomesZolgensmaYes
J3410INJECTION, HYDROXYZINE HCL, UP TO 25 MG VistarilYes
J3411INJECTION, THIAMINE HCL, 100 MG Thiamine HclYes
J3415INJECTION, PYRIDOXINE HCL, 100 MG Pyridoxine HclYes
J3420INJECTION, VITAMIN B- 12 CYANOCOBALAMIN, UP TO 1000 MCG CyanocobalaminYes
J3430Injection, phytonadione (vitamin k), per 1 mgAqua-MephytonYes
J3465INJECTION, VORICONAZOLE, 10 MG Vfend IVYes
J3470INJECTION, HYALURONIDASE, UP TO 150 UNITS AmphadaseYes
J3471INJECTION, HYALURONIDASE, OVINE, PRESERVATIVE FREE, PER 1 US VitraseYes
J3473INJECTION HYALURONIDASE RECOMBINANT 1 USP UNIT HylenexYes
J3475INJ MAGNESIUM SULFATE Magnesium SulfateYes
J3480INJ POTASSIUM CHLORIDE-2 MEQ Potassium ChlorideYes
J3485INJECTION, ZIDOVUDINE, 10 MG RetrovirYes
J3486INJECTION, ZIPRASIDONE MESYLATE, 10 MG GeodonYes
J3489ZOLEDRONIC ACID 1MG Reclast, ZometaYes
J3490Unclassified drugsUnclassified drugsYes
J3590Unclassified biologicsUnclassified biologicsYes
J7030INFUSION, NORMAL SALINE SOLUTION , 1000 CC Sodium ChlorideYes
J7040INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) Sodium ChlorideYes
J70425% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT) Dextrose 5%-0.9% NaClYes
J7050INFUSION, NORMAL SALINE SOLUTION , 250 CC Sodium ChlorideYes
J70605% DEXTROSE/WATER (500 ML = 1 UNIT) Dextrose in waterYes
J7070INFUSION, D5W, 1000 CC Dextrose in waterYes
J7100INFUSION, DEXTRAN 40, 500 ML LMDYes
J7120RINGERS LACTATE INFUSION, UP TO 1000 CC Lactated RingersYes
J71215% DEXTROSE IN LAC RINGERS Dextrose In Lactated RingersYes
J7169Injection, coagulation Factor Xa (recombinant), inactivated-zhzo (Andexxa), 10 mgAndexxaYes
J7170INJ., EMICIZUMAB-KXWH 0.5 MG HemlibraYes
J7175INJ, FACTOR X, (HUMAN), 1IU CoagadexYes
J7177Injection, human fibrinogen concentrate (fibryga), 1 mgFibrygaYes
J7178HUMAN FIBRINOGEN CONC INJ RiastapYes
J7179Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco VonvendiYes
J7180Factor XIII anti-hem factor CorifactYes
J7181FACTOR XIII RECOMB A-SUBUNIT TrettenYes
J7182FACTOR VIII RECOMB NOVOEIGHT NovoeightYes
J7183Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco WilateYes
J7185Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.XynthaYes
J7186Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.Alphanate/VWF Complex/HumanYes
J7187INJECTION VON WILLEBRAND FACTOR COMPLEX HUMAN RISTOCETIN COFACTOR PER IVHumate-pYes
J7188FACTOR VIII RECOMB OBIZUR ObizurYes
J7189Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram NovoSeven RTYes
J7190FACTOR VIII, (ANTI-HEMOPHILIC FACTOR (HUMAN)), PER I.U. Hemofil M, KoateYes
J7192FACTOR VIII (ANTIHEMOPHILIC FACTOR (RECOMBINANT)), PER I.U. Recombinate, Advate, Kogenate, Helixate FSYes
J7193FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT) PER I.U. Mononine, AlphanineYes
J7194FACTOR IX, COMPLEX, PER I.U. Profilnine SDYes
J7195FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U. Ixinity, BeneFIXYes
J7196Antithrombin recombinant AtrynYes
J7197ANTITHROMBIN III (HUMAN), PER I.U. Thrombate IIIYes
J7198ANTI-INHIBITOR, PER I.U. Feiba NFYes
J7200FACTOR IX RECOMBINAN RIXUBIS RixubisYes
J7201FACTOR IX FC FUSION RECOMB AlprolixYes
J7202FACTOR IX IDELVION INJ IdelvionYes
J7203FACTOR IX RECOMB GLY REBINYN RebinynYes
J7204Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IUEsperoctYes
J7205FACTOR VIII FC FUSION RECOMB EloctateYes
J7207FACTOR VIII PEGYLATED RECOMB AdynovateYes
J7208Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.JiviYes
J7209FACTOR VIII NUWIQ RECOMB 1IU NuwiqYes
J7210INJ, AFSTYLA, 1 I.U. AfstylaYes
J7211INJ, KOVALTRY, 1 I.U. KovaltryYes
J7296LEVONORGESTREL IU, KYLEENA, 19.5 MG KyleenaYes
J7297LEVONORGESTREL IU 52MG 3 YR Liletta (52 Mg)Yes
J7298LEVONORGESTREL IU 52MG 5 YR Mirena (52 Mg)Yes
J7300IUD COPPER Paragard Intrauterine CopperYes
J7301LEVONORGESTREL IU, SKYLA, 13.5MG SkylaYes
J7304CONTRACEPTIVE SUPPLY, HORMONE CONTAINING PATCH, EACH XulaneYes
J7307Etonogestrel implant system NexplanonYes
J7308AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSLevulan KerastickYes
J7311FLUOCINOLONE ACETONIDE INTRAVITREAL IMPLANT RetisertYes
J7312Dexamethasone intravitreal implant OzurdexYes
J7313FLUOCINOL ACET INTRAVITREAL IMPLANT IluvienYes
J7314Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mgYutiqYes
J7315OPTHALMIC MITOMYCIN MitosolYes
J7316INJ, OCRIPLASMIN, 0.125 MG JetreaYes
J7318INJ, DUROLANE 1 MG DurolaneYes
J7320HYALURONAN OR DERIVITIVE, GENVISC 850, FOR INTRA-ARTICULAR INJ, 1 MG Genvisc 850Yes
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose Hyalgan; Supartz;Visco-3Yes
J7322HYALURONAN OR DERIVATIVE, HYMOVIS, FOR INTRA-ARTICULAR INJECTION, 1 MG HymovisYes
J7323Euflexxa inj per dose EuflexxaYes
J7324Orthovisc inj per dose OrthoviscYes
J7325Synvisc or Synvisc-One Synvisc, Synvisc-OneYes
J7326Gel-one Gel-oneYes
J7327MONOVISC INJ PER DOSE MonoviscYes
J7328GEL-SYN INJECTION 0.1 MG Gelsyn-3Yes
J7329INJ, TRIVISC 1 MG TriviscYes
J7330AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT MACIYes
J7331Hyaluronan or derivative, SYNOJOYNT, for intra-articular injection, 1 mgSynojoyntYes
J7332Hyaluronan or derivative, Triluron, for intra-articular injection, 1 mgTriluronYes
J7336CAPSAICIN 8% PATCH QutenzaYes
J7340CARBIDOPA LEVODOPA ENTERAL DuopaYes
J7342Instillation, ciprofloxacin otic suspension, 6 mgOtiprioYes
J7345Aminolevulinic acid HCl for topical administration, 10% gel, 10mgAmeluzYes
J7351Injection, bimatoprost, intracameral implant, 1 mcgDurystaYes
J7500Azathioprine, oral, 50 mg ImuranYes
J7501Azathioprine, parenteral, 100 mgAzathioprine SodiumYes
J7502CYCLOSPORINE, ORAL, 100 MG Sandimmune; Gengraf; NeoralYes
J7503TACROL ENVARSUS EXT REL ORAL Envarsus XRYes
J7504LYMPHOCYTE IMMUNE GLOBULIN, ANTITYMOCYTE GLOBULIN - PARENTERAL, AMP, 5 AtgamYes
J7507TACROLIMUS, ORAL PrografYes
J7508TACROLIMUS EXT REL ORAL 0.1MG Astagraf XLYes
J7509METHYLPREDNISOLONE ORAL MedrolYes
J7510PREDNISOLONE ORAL PER 5 MG PrednisoloneYes
J7511LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, ThymoglobulinYes
J7512PREDNISONE IR OR DR ORAL 1MG DeltasoneYes
J7513DACLIZUMAB, PARENTERAL, 25 MG ZinbrytaYes
J7515CYCLOSPORINE, ORAL, 25 MG Sandimmune; Gengraf, NeoralYes
J7516CYCLOSPORIN, PARENTERAL, 250 MG SandIMMUNEYes
J7517MYCOPHENOLATE MOFETIL, ORAL, 250 MG CellCeptYes
J7518MYCOPHENOLIC ACID, ORAL, 180 MG MyforticYes
J7520SIROLIMUS, ORAL, 1 MG RapamuneYes
J7525TACROLIMUS, PARENTERAL, 5 MG PrografYes
J7527ORAL EVEROLIMUS ZortressYes
J7605Arformoterol non-comp unit BrovanaYes
J7606Formoterol fumarate, inh PerforomistYes
J7608ACETYLCYSTEINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE AcetylcysteineYes
J7611ALBUTEROL, INHALATION SOLUTION, ADMINISTERED THROUGH DME, CO Albuterol SulfateYes
J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mgXopenexYes
J7613ALBUTEROL, INHALATION SOLUTION, ADMINISTERED THROUGH DME, UN Albuterol SulfateYes
J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg XopenexYes
J7620ALBUTEROL AND IPRATROPIUM INHAL.SOLUTION ADMIN. VIA DME Ipratropium-albuterolYes
J7626BUDESONIDE INHALATION SOLUTION, ADMINISTERED THROUGH DME, UNIT DOSE FORMPulmicort RespulesYes
J7631CROMOLYN SODIUM, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSECromolyn SodiumYes
J7639DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FPulmozymeYes
J7644IPRATROPIUM BROMIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT AtroventYes
J7665Mannitol for inhaler AridolYes
J7674METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION TH ProvocholineYes
J7677revefenacin inhalation solutionYupelriYes
J7682TOBRAMYCIN, UNIT DOSE FORM, 300 MG, INHALATION SOLUTION, ADMINISTERED THROUGH DMETobi; Bethkis; KitabisYes
J7686Treprostinil, non-comp unit TyvasoYes
J8499Prescription drug, oral, non chemotherapeutic, nosPrescription drug, oral, non chemotherapeutic, nosYes
J8501APREPITANT, ORAL, 5 MG EmendYes
J8510BUSULFAN; ORAL, 2 MG MyleranYes
J8515CABERGOLINE, ORAL, 0.25 MG CabergolineYes
J8520CAPECITABINE, ORAL, 150 MG XelodaYes
J8521CAPECITABINE, ORAL, 500 MG XelodaYes
J8530CYCLOPHOSPHAMIDE, ORAL CyclophosphamideYes
J8540DEXAMETHASONE, ORAL, 0.25 MG DexamethasoneYes
J8560ETOPOSIDE, ORAL VePesidYes
J8565GEFITINIB, ORAL, 250 MG IressaYes
J8600MELPHALAN AlkeranYes
J8610METHOTREXATE, ORAL MethotrexateYes
J8650Nabilone oral CesametYes
J8655NETUPITANT AND PALONOSETRON, ORAL AkynzeoYes
J8670ROLAPITANT, ORAL, 1MG VarubiYes
J8700TEMOZOLOMIDE, ORAL, 5 MG TemodarYes
J8705Topotecan oral HycamtinYes
J8999Prescription drug, oral, chemotherapeutic, NOSPrescription drug, oral, chemotherapeutic, NOSYes
J9000DOXORUBICIN HCL, 10 MG AdriamycinYes
J9015ALDESLEUKIN/SINGLE USE VIAL ProleukinYes
J9017ARSENIC TRIOXIDE, 1MG TrisenoxYes
J9019Injection, asparaginase (erwinaze), 1,000 iuErwinazeYes
J9022INJ, ATEZOLIZUMAB,10 MG TecentriqYes
J9023INJECTION, AVELUMAB, 10 MG BavencioYes
J9025INJECTION, AZACITIDINE, 1 MG VidazaYes
J9027INJECTION, CLOFARABINE, 1 MG ClolarYes
J9030Bcg live intravesical instillation, 1 mgTice BCGYes
J9032INJECTION, BELINOSTAT, 10MG BeleodaqYes
J9033Bendamustine injection TreandaYes
J9034Inj., bendamustine hcl (bendeka), 1 mgBendekaYes
J9035INJECTION, BEVACIZUMAB, 10 MG AvastinYes
J9036Injection, bendamustine hydrochloride, (Belrapzo/bendamustine), 1 mgBelrapzoYes
J9039INJECTION, BLINATUMOMAB BlincytoYes
J9040BLEOMYCIN SULFATE, 15 UNITS Bleomycin SulfateYes
J9041INJECTION, BORTEZOMIB, 0.1 MG VelcadeYes
J9042BRENTUXIMAB VEDOTIN INJ AdcetrisYes
J9043Cabazitaxel injection JevtanaYes
J9044INJ, BORTEZOMIB, NOS, 0.1 MG BortezomibYes
J9045CARBOPLATIN, 50 MG ParaplatinYes
J9047INJECTION, CARFILZOMIB, 1 MG KyprolisYes
J9050CARMUSTINE, 100 MG BiCNUYes
J9055INJECTION, CETUXIMAB, 10 MG ErbituxYes
J9057INJ., COPANLISIB, 1 MG AliqopaYes
J9060CISPLATIN, POWDER OR S0LUTION, PER 10 MG Platinol AQYes
J9065INJECTION; CLADRIBINE LeustatinYes
J9070CYCLOPHOSPHAMIDE, 100 MG CytoxanYes
J9098CYTARABINE LIPOSOME, 10 MG DepocytYes
J9100CYTARABINE 100 MG Cytarabine (pf)Yes
J9118Injection, calaspargase pegol-mknl, 10 unitsAsparlasYes
J9119Injection, cemiplimab-rwlc, 1 mgLibtayoYes
J9120DACTINOMYCIN, 0.5 MG CosmegenYes
J9130DACARBAZINE, 100 MG DTIC-DOME IVYes
J9145INJECTION, DARATUMUMAB 10 MG DarzalexYes
J9150DAUNORUBICIN HYDROCHLORIDE, 10 MG CerubidineYes
J9151DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG Daunoxome Yes
J9153INJ, LIPOSOMAL, DAUNORUBICIN AND CYTARABINE VyxeosYes
J9155Degarelix injection FirmagonYes
J9171Docetaxel injection TaxotereYes
J9173INJ., DURVALUMAB, 10 MG ImfinziYes
J9175INJECTION, ELLIOTTS' B SOLUTION, 1 ML Elliotts BYes
J9176INJECTION, ELOTUZUMAB, 1MG EmplicitiYes
J9177Injection, enfortumab vedotin-ejfv, 0.25 mgPadcevYes
J9178INJECTION, EPIRUBICIN HCL, 2 MG EllenceYes
J9179Eribulin mesylate injection HalavenYes
J9181ETOPOSIDE, 10 MG EtoposideYes
J9185FLUDARABINE PHOSPHATE, 50 MG FludaraYes
J9190FLUOROURACIL, 500 MG AdrucilYes
J9198Injection, gemcitabine hydrochloride, (Infugem), 100 mgInfugemYes
J9200FLOXURIDINE, 500 MG FloxuridineYes
J9201GEMCITABINE HCL, 200 MG GemzarYes
J9202GOSERELIN ACETATE IMPLANT, PER 3.6 MG ZoladexYes
J9203GEMTUZUMAB OZOGAMICIN 0.1 MG MylotargYes
J9204Injection, mogamulizumab-kpkc, 1 mgPoteligeoYes
J9205INJ IRINOTECAN LIPOSOME 1 MG OnivydeYes
J9206IRINOTECAN, 20 MG CamptosarYes
J9207Ixabepilone injection Ixempra KitYes
J9208IFOSFAMIDE, 1 GM IfexYes
J9209MESNA, 200 MG MesnexYes
J9210Injection, emapalumab-lzsg, 1 mgGamifantYes
J9211IDARUBICIN HYDROCHLORIDE, 5 MG Idamycin PFSYes
J9214INTERFERON, ALFA-2B, RECOMBINANT, 1 MILLION UNITS Intron AYes
J9215INTERFERON, ALFA-N3, (HUMAN LEUKOCYTE DERIVED), 250,000 IU Alferon NYes
J9216INTERFERON, GAMMA 1-B, 3 MILLION UNITS ActimmuneYes
J9217LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG Eligard, Lupron DepotYes
J9218LEUPROLIDE ACETATE, PER 1 MG Leuprolide AcetateYes
J9225HISTRELIN IMPLANT, 50 MG VantasYes
J9226Supprelin LA implant Supprelin LAYes
J9227Injection, isatuximab-irfc, 10 mgSarclisaYes
J9228Ipilimumab injection YervoyYes
J9229INJ INOTUZUMAB OZOGAM 0.1 MG BesponsaYes
J9230MECHLORETHAMINE HYDROCHLORIDE, (NITROGEN MUSTARD), 10 MG MustargenYes
J9245INJECTION; MELPHALAN HCL AlkeranYes
J9246Injection, melphalan (Evomela), 1 mgEvomelaYes
J9250METHOTREXATE SODIUM, 5 MG Methotrexate SodiumYes
J9260METHOTREXATE SODIUM, 50 MG Methotrexate SodiumYes
J9261INJECTION NELARABINE 50 MG ArranonYes
J9262INJ, OMACETAXINE MEP, 0.01MG SynriboYes
J9263INJECTION, OXALIPLATIN, 0.5 MG EloxatinYes
J9264INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG AbraxaneYes
J9266PEGASPARGASE/SINGL DOSE VIAL OncasparYes
J9267PACLITAXEL INJECTION TaxolYes
J9268PENTOSTATIN, PER 10 MG (NIPENT) NipentYes
J9269Injection, tagraxofusp-erzs, 10 mcgElzonrisYes
J9271INJ PEMBROLIZUMAB KeytrudaYes
J9280MITOMYCIN, 5 MG MutamycinYes
J9285INJ, OLARATUMAB, 10 MG LartruvoYes
J9293MITOXANTRONE HYDROCHLORIDE, 20 MG-1994,1995=5MG NovantroneYes
J9295INJECTION, NECITUMUMAB, 1 MG PortrazzaYes
J9299INJECTION, NIVOLUMAB OpdivoYes
J9301OBINUTUZUMAB INJ GazyvaYes
J9302Ofatumumab injection ArzerraYes
J9303Panitumumab injection VectibixYes
J9304Injection, pemetrexed (Pemfexy), 10 mgPemfexyYes
J9305INJECTION, PEMETREXED, not otherwise specified, 10 MG AlimtaYes
J9306INJECTION, PERTUZUMAB, 1 MG PerjetaYes
J9307Pralatrexate injection FolotynYes
J9308INJECTION, RAMUCIRUMAB CyramzaYes
J9309Injection, polatuzumab vedotin-piiq, 1 mgPolivyYes
J9311INJ RITUXIMAB, HYALURONIDASE Rituxan HycelaYes
J9312INJ., RITUXIMAB, 10 MG RituxanYes
J9313Injection, moxetumomab pasudotox-tdfk, 0.01 mgLumoxitiYes
J9320STREPTOZOCIN, 1 GM ZanosarYes
J9325INJ TALIMOGENE LAHERPAREPVEC ImlygicYes
J9328Temozolomide injection TemodarYes
J9330Temsirolimus injection ToriselYes
J9340THIOTEPA, 15 MG TepadinaYes
J9351Topotecan injection HycamtinYes
J9352INJECTION TRABECTEDIN 0.1MG YondelisYes
J9354INJ, ADO-TRASTUZUMAB EMT 1MG KadcylaYes
J9355TRASTUZUMAB, 10 MG HerceptinYes
J9356Injection, trastuzumab, 10 mg and Hyaluronidase-oyskHerceptin HylectaYes
J9357VALRUBICIN, INTRAVESICAL, 200 MG ValstarYes
J9358Injection, fam-trastuzumab deruxtecan-nxki, 1 mgEnhertuYes
J9360VINBLASTINE SULFATE, 1 MG Vinblastine SulfateYes
J9370VINCRISTINE SULFATE, 1 MG Vincasar PFSYes
J9371INJ, VINCRISTINE SUL LIP 1MG MarqiboYes
J9390VINORELBINE TARTRATE/10 MG NavelbineYes
J9395INJECTION, FULVESTRANT, 25 MG FaslodexYes
J9400INJ, ZIV-AFLIBERCEPT, 1MG ZaltrapYes
J9600PORFIMER SODIUM, 75 MG PhotofrinYes
P9045INFUSION, ALBUMIN (HUMAN), 5%, 250 ML Plasbumin-5Yes
P9046INFUSION, ALBUMIN (HUMAN), 25%, 20 ML AlbuteinYes
P9047INFUSION, ALBUMIN (HUMAN), 25%, 50 ML Albuminar-25Yes
Q0138Ferumoxytol, non-esrd FerahemeYes
Q0139Ferumoxytol, esrd use FerahemeYes
Q0144AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM ZithromaxYes
Q0162Ondansetron oral ZofranYes
Q0163DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANBenadrylYes
Q0164PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMCompazineYes
Q0166GRANISETRON HYDROCHLORIDE, 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMKytrilYes
Q0167DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USEMarinolYes
Q0169PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTPhenerganYes
Q0175PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USEPerphenazineYes
Q0177HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC,VistarilYes
Q2004Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 mlRenacidinYes
Q2009INJECTION, FOSPHENYTOIN, 50 MG CerebyxYes
Q2028INJ, SCULPTRA, 0.5MG SculptraYes
Q2041Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseYescartaYes
Q2042Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseKymriahYes
Q2043Sipuleucel-T auto CD54+ ProvengeYes
Q2050Inj, doxorubicin, liposomal, not otherwise specified, 10 mgDoxilYes
Q3027INJ BETA INTERFERON IM 1 MCG AvonexYes
Q3028INJ BETA INTERFERON SQ 1 MCG RebifYes
Q4074Iloprost non-comp unit dose VentavisYes
Q4081INJECTION EPOETIN ALFA 100 UNITS (FOR ESRD ON DIALYSIS) Epogen, ProcritYes
Q5101INJ FILGRASTIM G-CSF BIOSIM ZarxioYes
Q5103Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mgInflectraYes
Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg RenflexisYes
Q5105Inj, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units RetacritYes
Q5106Inj, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units RetacritYes
Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg MvasiYes
Q5108Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mgFulphilaYes
Q5109Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg IxifiYes
Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 mcg NivestymYes
Q5111Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mgUdenycaYes
Q5112Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mgOntruzantYes
Q5113Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mgHerzumaYes
Q5114Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mgOgivriYes
Q5115Injection, rituximab-abbs, biosimilar, 10 mgTruximaYes
Q5116Injection, trastuzumab-qyyp, biosimilar, (Trazimera), 10 mgTrazimeraYes
Q5117Injection, trastuzumab-anns, biosimilar, (Kanjinti), 10 mgKanjintiYes
Q5118Injection, bevacizumab-bvcr, biosimilar, (Zirabev), 10 mgZirabevYes
Q5119Injection, rituximab-pvvr, biosimilar, (RUXIENCE), 10 mgRuxienceYes
Q5120Injection, pegfilgrastim-bmez, biosimilar, (ZIEXTENZO), 0.5 mgZiextenzoYes
Q5121Injection, infliximab-axxq, biosimilar, (AVSOLA), 10 mgAvsolaYes
Q9991BUPRENORPH XR 100 MG OR LESS SublocadeYes
Q9992BUPRENORPHINE XR OVER 100 MG SublocadeYes
S0012BUTORPHANOL TARTRATE, NASAL SPRAY, 25 MG Butorphanol TartrateYes
S0017INJECTION, AMINOCAPROIC ACID, 5 GRAMS Aminocaproic AcidYes
S0020INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML Marcaine; SensorcaineYes
S0028INJECTION, FAMOTIDINE, 20 MG PepcidYes
S0030INJECTION, METRONIDAZOLE, 500 MG FlagylYes
S0032INJECTION, NAFCILLIN SODIUM, 2 GRAMS Nafcillin SodiumYes
S0039INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 ML Sulfamethoxazole-trimethoprimYes
S0073INJECTION, AZTREONAM, 500 MG AzactamYes
S0074INJECTION, CEFOTETAN DISODIUM, 500 MG CefotanYes
S0077INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG Cleocin PhosphateYes
S0078INJECTION, FOSPHENYTOIN SODIUM, 750 MG CerebyxYes
S0080INJECTION, PENTAMIDINE ISETHIONATE, 300 MG PentamYes
S0088Imatinib, 100 mgGleevecYes
S0090SILDENAFIL CITRATE, 25 MG ViagraYes
S0091Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)KytrilYes
S0092Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)DilaudidYes
S0093INJECTION, MORPHINE SULFATE, 500 MG (LOADING DOSE FOR INFUSION PUMP) Morphine SulfateYes
S0104ZIDOVUDINE, ORAL, 100 MG RetrovirYes
S0106BUPROPION HCL SUSTAINED RELEASE TABLET, 150 MG, PER BOTTLE OF 60 TABLETSWellbutrin SRYes
S0108MERCAPTOPURINE, ORAL, 50 MG PurixanYes
S0109METHADONE, ORAL, 5MG Dolophine; MethadoseYes
S0117TRETINOIN, TOPICAL, 5 GRAMS Retin-A; AltrenoYes
S0119Ondansetron 4 mg ZofranYes
S0122INJECTION, MENOTROPINS, 75 IU MenopurYes
S0126INJECTION, FOLLITROPIN ALFA, 75 IU Gonal-f RffYes
S0128INJECTION, FOLLITROPIN BETA, 75 IU Follistim AQYes
S0132INJECTION, GANIRELIX ACETATE, 250 MCG Ganirelix AcetateYes
S0136CLOZAPINE, 25 MG ClozarilYes
S0137DIDANOSINE (DDI), 25 MG Videx; Videx ECYes
S0138FINASTERIDE, 5 MG ProscarYes
S0139MINOXIDIL, 10 MG MinoxidilYes
S0140SAQUINAVIR, 200 MG InviraseYes
S0145INJECTION, PEGYLATED INTERFERON ALFA-2A, 180 MCG PER ML PegasysYes
S0148Peg interferon alfa-2b, 10 mcg PegIntron; SylatronYes
S0155STERILE DILUTANT FOR EPOPROSTENOL, 50ML Diluent For EpoprostenolYes
S0156EXEMESTANE, 25 MG AromasinYes
S0157BECAPLERMIN GEL 0.01%, 0.5 GM RegranexYes
S0160DEXTROAMPHETAMINE SULFATE, 5 MG DexedrineYes
S0164INJECTION, PANTOPRAZOLE SODIUM, 40 MG ProtonixYes
S0166INJECTION, OLANZAPINE, 2.5 MG ZyprexaYes
S0169Calcitrol, 0.25 mcgRocaltrolYes
S0170ANASTROZOLE, ORAL, 1MG ArimidexYes
S0171INJECTION, BUMETANIDE, 0.5MG BumexYes
S0172CHLORAMBUCIL, ORAL, 2MG LeukeranYes
S0174DOLASETRON MESYLATE, ORAL 50MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDIAnzemetYes
S0175FLUTAMIDE, ORAL, 125MG EulexinYes
S0176HYDROXYUREA, ORAL, 500MG HydreaYes
S0178LOMUSTINE, ORAL, 10MG GleostineYes
S0179MEGESTROL ACETATE, ORAL, 20MG Megace ESYes
S0182PROCARBAZINE HYDROCHLORIDE, ORAL, 50MG MatulaneYes
S0183PROCHLORPERAZINE MALEATE, ORAL, 5MG (FOR CIRCUMSTANCES FALLING UNDER THECompazineYes
S0187TAMOXIFEN CITRATE, ORAL, 10MG Tamoxifen CitrateYes
S0189TESTOSTERONE PELLET, 75MG TestopelYes
S0190MIFEPRISTONE, ORAL, 200 MG MifeprexYes
S0191MISOPROSTOL, ORAL, 200 MCG CytotecYes
S0197Prenatal vitamins, 30-day supplyPrenatal Vitamin And MineralYes
S4991Nicotine patches, non-legendNicoderm CQYes
S4993Contraceptive pills for birth controlMultipleYes
S4995Smoking cessation gumNicoretteYes
S50105% dextrose and 0.45% normal saline, 1000 mlDextrose-sodium chlorideYes
S5550Insulin, rapid onset, 5 unitsApidraYes
S5551Insulin, most rapid onset (lispro or aspart); 5 unitsMultipleYes
S5552Insulin, intermediate acting (nph or lente); 5 unitsHumulin N; Novolin NYes
S5553Insulin, long acting; 5 unitsMultipleYes
S5561Insulin delivery device, reusable pen; 3 ml sizeYes
S5566Insulin cartridge for use in insulin delivery device other than pump; 300 unitsYes
S5570Insulin delivery device, disposable pen (including insulin); 1.5 ml sizeToujeo SolostarYes
S5571Insulin delivery device, disposable pen (including insulin); 3 ml sizeMultipleYes
S8490Insulin syringes (100 syringes, any size)Insulin syringes (100 syringes, any size)Yes
C1052HEMOSTATIC AGT GASTROINTESTINAL TOPHEMOSTATIC AGT GASTROINTESTINAL TOPYes
J1823Injection, inebilizumab-cdon, 1 mgUpliznaYes
J7212Factor viia (antihemophilic factor, recombinant)- jncw (sevenfact), 1 microgramSevenfactYes
J7352Afamelanotide implant, 1 mgScenesseYes
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihjDarzalex FasproYes
J9223Injection, lurbinectedin, 0.1 mgZepzelcaYes
J9281Mitomycin pyelocalyceal instillation, 1 mgJelmytoYes
J9316Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mgPhesgoYes
J9317Injection, sacituzumab govitecan-hziy, 2.5 mgTrodelvyYes
M0243IV INFUSION CASIRIVIMAB & IMDEVIMAB MONITORINGIV INFUSION CASIRIVIMAB & IMDEVIMAB MONITORINGYes
Q0239INJECTION BAMLANIVIMAB-XXXX 700 MGINJECTION BAMLANIVIMAB-XXXX 700 MGYes
Q0243INJ CASIRIVIMAB & IMDEVIMAB 2400 MGINJ CASIRIVIMAB & IMDEVIMAB 2400 MGYes
Q5122Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mgNyvepriaYes
S0013Esketamine, nasal spray, 1 mgSpravatoYes
M0245IV INF Bamlanivimab and etesevimab, monitoringIV INF Bamlanivimab and etesevimab, monitoringYes
Q0245INJ Bamlanivimab and etesevimabBamlanivimab and etesevimabYes
J1427Injection, viltolarsen, 10 mgViltepsoYes
J1554Injection, immune globulin (Asceniv), 500 mgAscenivYes
J9037Injection, belantamab mafodontin-blmf, 0.5 mgBlenrepYes
J9349Injection, tafasitamab-cxix, 2 mgMonjuviYes
Q2053Brexucabtagene autoleucel, up to 200 million autologous anti-CD19 CAR positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic doseTecartusYes
J7402Mometasone furoate sinus implant, (Sinuva), 10 mcgSinuvaYes
S1091Stent, non-coronary, temporary, with delivery system(propel)PropelYes
M0244Intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring in the home or residencen/aYes
M0246Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residencen/aYes
J0224INJECTION LUMASIRAN 0.5 MGOxlumoYes
J1951INJ LEU AC FOR DEP SUSP 0.25 MGFensolviYes
J7168PRT CMPLX CONC KCNTRA PR IU FIX ACTKecentraYes
J9348INJECTION NAXITAMAB-GQGK 1 MGDanyelzaYes
J9353INJECTION MARGETUXIMAB-CMKB 5 MGMargenzaYes
Q5123INJ RITUXIMAB-ARRX BIOSIMILAR 10 MGRiabniYes
Q0247injection, sotrovimab 500mgn/aYes
M0247Intravenous infusion, sotrovimab, includes infusion and post administration monitoringn/aYes
Q0244injection, casirivimab and imdevimab, 1200mgn/aYes
Q0249INJ TOCILIZUMAB HP PT 2 YRS & > COVID-19 1 MGn/aYes
M0249IV TCZ HP PT 2 & > COVID-19 INC INF & PA MON FDn/aYes
M0250IV TCZ HP 2 & > COVID-19 INC INF & PA MON 2ND Dn/aYes
Q0240Injection, casirivimab and imdevimab, 600 mgcasirivimab and imdevimabYes
M0240Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat dosesn/aYes
M0241ntravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residencen/aYes
J1305Injection, evinacumab-dgnb, 5mgEvkeezaYes
J1426Injection, casimersen, 10 mgAmondys 45Yes
J1448Injection, trilaciclib, 1mgCoselaYes
J9318Injection, romidepsin, non-lyophilized, 0.1 mgn/aYes
J9319Injection, romidepsin, lyophilized, 0.1 mgIstodaxYes
Q2054Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic doseBreyanziYes
J0699Injection, cefiderocol, 10 mgFetrojaYes
J0741Injection, cabotegravir and rilpivirine, 2mg/3mgCabenuvaYes
J1445Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of ironTriferic AVNUYes
J2406Injection, oritavancin (kimyrsa), 10 mgKimyrsaYes
J7294Segesterone acetate and ethinyl estradiol 0.15 mg, 0.013 mg per 24 hours; yearly vaginal system, eachAnnoveraYes
J7295Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, eachNuvaringYes
J1952Leuprolide injectable, camcevi, 1 mgCamceviYes
J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mgNeulastaYes
J9021Injection, asparaginase, recombinant, (Rylaze), 0.1 mgRylazeYes
J9061Injection, amivantamab-vmjw, 2 mgRybrevantYes
J9272Injection, dostarlimab-gxly, 10 mgJemperliYes
Q2055Idecabtagene vicleucel, up to 460 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic doseAbecmaYes
C9088Instillation, bupivacaine and meloxicam, 1 mg/0.03 mgZynrelefYes
C9089Bupivacaine, collagen-matrix implant, 1 mgXaracollYes
J0172Injection, aducanumab-avwa, 2 mgAduhelmYes
Q0220tixagevimab and cilgavimabEvusheldYes
M0220tixagevimab and cilgavimab administration codeEvusheld (administration code)Yes
M0221tixagevimab and cilgavimab home administration codeEvusheld ( home administration code)Yes
J0248injection, remdesivirVekluryYes
Q0222injection, bebtelovimab, 175mgbebtelovimabyes
M0222Intravenous injection, bebtelovimab, includes injection and post administration monitoringIntravenous injection, bebtelovimab, includes injection and post administration monitoringYes
J0219Injection, avalglucosidase alfa-ngpt, 4 mg NexviazymeYes
J0491Injection, anifrolumab-fnia, 1 mg SaphneloYes
J0879Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis) KorsuvaYes
J9273Injection, tisotumab vedotin-tftv, 1 mg TivdakYes
J9359Injection, loncastuximab tesirine-lpyl, 0.075 mg ZynlontaYes
Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg ByoovizYes
J9071Injection, cyclophosphamide, (auromedics), 5 mg cyclophosphamide Yes
Q0221 Injection, tixagevimab and cilgavimab, for pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mgEvusheldYes
J2998Injection, plasminogen, human-tvmh, 1 mg Ryplazim Yes
J9331Injection, sirolimus protein-bound particles, 1 mg Fyarro Yes
J3299Injection, triamcinolone acetonide (xipere), 1 mgXipere Yes
J2779Injection, ranibizumab, via sustained release intravitreal implant Susvimo Yes
J0739Injection, cabotegravir, 1 mgApretudeYes
J1306Injection, inclisiran, 1 mgLeqvioYes
J1551Injection, immune globulin (cutaquig), 100 mgCutaquigYes
J2356Injection, tezepelumab-ekko, 1 mgTezspireYes
J9332Injection, efgartigimod alfa-fcab, 2 mgVyvgartYes
Q2017injection, teniposide, 50mgVumonYes
J9999not otherwise classified, antineoplastic drugsn/aYes
J7599immunosuppressive drugs, not otherwise classified,Yes
C9399unclassified drugs or biologicals Yes
C9101Injection, oliceridine, 0.1 mgOlinvykYes
C9142Injection, bevacizumab-maly, biosimilar, (Alymsys), 10 mgAlymsysYes
J1302Injection, sutimlimab-jome, 10 mgEnjaymoYes
J1932Injection, lanreotide, (Cipla), 1 mgCiplaYes
J2777Injection, faricimab-svoa, 0.1 mgVabysmoYes
J9274Injection, tebentafusp-tebn, 1 mcgkimmtrakYes
J9298Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mgOpdualagYes
Q2056Ciltacabtagene autoleucel, up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic doseCarvyktiYes
Q5125Injection, filgrastim-ayow, biosimilar, (Releuko), 1 mcgReleukoYes
A9607Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicuriePluvictoYes
HCPCS CODEDESCRIPTION
A4261Cervical Cap
A4266Diaphram for contraceptive use
A4269Contraceptive Supply, Spermicide
J0278INJECTION, AMIKACIN SULFATE, 100 MG
J0290INJECTION, AMPICILLIN SODIUM, UP TO 500MG
J0295INJECTION; AMPICILLIN
J0456INJECTION, AZITHROMYCIN, 500 MG
J0558PenG benzathine/procaine inj
J0561Penicillin g benzathine inj
J0690INJECTION, CEFAZOLIN SODIUM, UP TO 500 MG
J0692INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG
J0694INJECTION, CEFOXITIN SODIUM, 1 GM
J0695INJ CEFTOLOZANE TAZOBACTAM
J0696INJECTION, CEFTRIAXONE SODIUM, PER 250 MG (ROCEPHIN)
J0697INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG
J0698CEFOTAXIME SODIUM, PER GM
J0713INJ CEFTAZIDIME PER 500 MG
J0714CEFTAZIDIME AND AVIBACTAM
J0744INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG
J1000INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG
J1050INJECTION, MEDROXYPROGESTERONE ACETATE, 100 MG(DEPO PROVERA)
J1364INJECTION; ERYTHROMYCIN LACTOBIONA
J1450INJECTION FLUCONAZOLE, 200 MG
J1580INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG
J1956INJECTION, LEVOFLOXACIN, 250 MG
J2265Minocycline hydrochloride
J2280INJECTION, MOXIFLOXACIN, 100 MG
J2510INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS
J2540INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS
J2543INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.
J3260INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG
J7296Levonorgestrel-releasing intrauterine contraceptive system (Kyleena) 19.5mg
J7297LEVONORGESTREL IU 52MG 3 YR
J7298LEVONORGESTREL IU 52MG 5 YR
J7300IUD COPPER
J7301SKYLA 13.5MG
J7303CONTRACEPTIVE SUPPLY, HORMONE CONTAINING VAGINAL RING, EACH
J7304CONTRACEPTIVE SUPPLY, HORMONE CONTAINING PATCH, EACH
J7307Etonogestrel implant system
Q0144AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM
S0030INJECTION, METRONIDAZOLE, 500 MG
S0032INJECTION, NAFCILLIN SODIUM, 2 GRAMS
S0039INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 ML
S0073INJECTION, AZTREONAM, 500 MG
S0074INJECTION, CEFOTETAN DISODIUM, 500 MG
S0077INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG
<
ICD-10 CodeICD-10 Code Description
C00.0Malignant neoplasm of external upper lip
C00.1Malignant neoplasm of external lower lip
C00.2Malignant neoplasm of external lip, unspecified
C00.3Malignant neoplasm of upper lip, inner aspect
C00.4Malignant neoplasm of lower lip, inner aspect
C00.5Malignant neoplasm of lip, unspecified, inner aspect
C00.6Malignant neoplasm of commissure of lip, unspecified
C00.8Malignant neoplasm of overlapping sites of lip
C00.9Malignant neoplasm of lip, unspecified
C01Malignant neoplasm of base of tongue
C02.0Malignant neoplasm of dorsal surface of tongue
C02.1Malignant neoplasm of border of tongue
C02.2Malignant neoplasm of ventral surface of tongue
C02.3Malignant neoplasm of anterior two-thirds of tongue, part unspecified
C02.4Malignant neoplasm of lingual tonsil
C02.8Malignant neoplasm of overlapping sites of tongue
C02.9Malignant neoplasm of tongue, unspecified
C03.0Malignant neoplasm of upper gum
C03.1Malignant neoplasm of lower gum
C03.9Malignant neoplasm of gum, unspecified
C04.0Malignant neoplasm of anterior floor of mouth
C04.1Malignant neoplasm of lateral floor of mouth
C04.8Malignant neoplasm of overlapping sites of floor of mouth
C04.9Malignant neoplasm of floor of mouth, unspecified
C05.0Malignant neoplasm of hard palate
C05.1Malignant neoplasm of soft palate
C05.2Malignant neoplasm of uvula
C05.8Malignant neoplasm of overlapping sites of palate
C05.9Malignant neoplasm of palate, unspecified
C06.0Malignant neoplasm of cheek mucosa
C06.1Malignant neoplasm of vestibule of mouth
C06.2Malignant neoplasm of retromolar area
C06.80Malignant neoplasm of overlapping sites of unspecified parts of mouth
C06.89Malignant neoplasm of overlapping sites of other parts of mouth
C06.9Malignant neoplasm of mouth, unspecified
C07Malignant neoplasm of parotid gland
C08.0Malignant neoplasm of submandibular gland
C08.1Malignant neoplasm of sublingual gland
C08.9Malignant neoplasm of major salivary gland, unspecified
C09.0Malignant neoplasm of tonsillar fossa
C09.1Malignant neoplasm of tonsillar pillar (anterior) (posterior)
C09.8Malignant neoplasm of overlapping sites of tonsil
C09.9Malignant neoplasm of tonsil, unspecified
C10.0Malignant neoplasm of vallecula
C10.1Malignant neoplasm of anterior surface of epiglottis
C10.2Malignant neoplasm of lateral wall of oropharynx
C10.3Malignant neoplasm of posterior wall of oropharynx
C10.4Malignant neoplasm of branchial cleft
C10.8Malignant neoplasm of overlapping sites of oropharynx
C10.9Malignant neoplasm of oropharynx, unspecified
C11.0Malignant neoplasm of superior wall of nasopharynx
C11.1Malignant neoplasm of posterior wall of nasopharynx
C11.2Malignant neoplasm of lateral wall of nasopharynx
C11.3Malignant neoplasm of anterior wall of nasopharynx
C11.8Malignant neoplasm of overlapping sites of nasopharynx
C11.9Malignant neoplasm of nasopharynx, unspecified
C12Malignant neoplasm of pyriform sinus
C13.0Malignant neoplasm of postcricoid region
C13.1Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect
C13.2Malignant neoplasm of posterior wall of hypopharynx
C13.8Malignant neoplasm of overlapping sites of hypopharynx
C13.9Malignant neoplasm of hypopharynx, unspecified
C14.0Malignant neoplasm of pharynx, unspecified
C14.2Malignant neoplasm of Waldeyer's ring
C14.8Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx
C15.3Malignant neoplasm of upper third of esophagus
C15.4Malignant neoplasm of middle third of esophagus
C15.5Malignant neoplasm of lower third of esophagus
C15.8Malignant neoplasm of overlapping sites of esophagus
C15.9Malignant neoplasm of esophagus, unspecified
C16.0Malignant neoplasm of cardia
C16.1Malignant neoplasm of fundus of stomach
C16.2Malignant neoplasm of body of stomach
C16.3Malignant neoplasm of pyloric antrum
C16.4Malignant neoplasm of pylorus
C16.5Malignant neoplasm of lesser curvature of stomach, unspecified
C16.6Malignant neoplasm of greater curvature of stomach, unspecified
C16.8Malignant neoplasm of overlapping sites of stomach
C16.9Malignant neoplasm of stomach, unspecified
C17.0Malignant neoplasm of duodenum
C17.1Malignant neoplasm of jejunum
C17.2Malignant neoplasm of ileum
C17.3Meckel's diverticulum, malignant
C17.8Malignant neoplasm of overlapping sites of small intestine
C17.9Malignant neoplasm of small intestine, unspecified
C18.0Malignant neoplasm of cecum
C18.1Malignant neoplasm of appendix
C18.2Malignant neoplasm of ascending colon
C18.3Malignant neoplasm of hepatic flexure
C18.4Malignant neoplasm of transverse colon
C18.5Malignant neoplasm of splenic flexure
C18.6Malignant neoplasm of descending colon
C18.7Malignant neoplasm of sigmoid colon
C18.8Malignant neoplasm of overlapping sites of colon
C18.9Malignant neoplasm of colon, unspecified
C19Malignant neoplasm of rectosigmoid junction
C20Malignant neoplasm of rectum
C21.0Malignant neoplasm of anus, unspecified
C21.1Malignant neoplasm of anal canal
C21.2Malignant neoplasm of cloacogenic zone
C21.8Malignant neoplasm of overlapping sites of rectum, anus and anal canal
C22.0Liver cell carcinoma
C22.1Intrahepatic bile duct carcinoma
C22.2Hepatoblastoma
C22.3Angiosarcoma of liver
C22.4Other sarcomas of liver
C22.7Other specified carcinomas of liver
C22.8Malignant neoplasm of liver, primary, unspecified as to type
C22.9Malignant neoplasm of liver, not specified as primary or secondary
C23Malignant neoplasm of gallbladder
C24.0Malignant neoplasm of extrahepatic bile duct
C24.1Malignant neoplasm of ampulla of Vater
C24.8Malignant neoplasm of overlapping sites of biliary tract
C24.9Malignant neoplasm of biliary tract, unspecified
C25.0Malignant neoplasm of head of pancreas
C25.1Malignant neoplasm of body of pancreas
C25.2Malignant neoplasm of tail of pancreas
C25.3Malignant neoplasm of pancreatic duct
C25.4Malignant neoplasm of endocrine pancreas
C25.7Malignant neoplasm of other parts of pancreas
C25.8Malignant neoplasm of overlapping sites of pancreas
C25.9Malignant neoplasm of pancreas, unspecified
C26.0Malignant neoplasm of intestinal tract, part unspecified
C26.1Malignant neoplasm of spleen
C26.9Malignant neoplasm of ill-defined sites within the digestive system
C30.0Malignant neoplasm of nasal cavity
C30.1Malignant neoplasm of middle ear
C31.0Malignant neoplasm of maxillary sinus
C31.1Malignant neoplasm of ethmoidal sinus
C31.2Malignant neoplasm of frontal sinus
C31.3Malignant neoplasm of sphenoid sinus
C31.8Malignant neoplasm of overlapping sites of accessory sinuses
C31.9Malignant neoplasm of accessory sinus, unspecified
C32.0Malignant neoplasm of glottis
C32.1Malignant neoplasm of supraglottis
C32.2Malignant neoplasm of subglottis
C32.3Malignant neoplasm of laryngeal cartilage
C32.8Malignant neoplasm of overlapping sites of larynx
C32.9Malignant neoplasm of larynx, unspecified
C33Malignant neoplasm of trachea
C34.00Malignant neoplasm of unspecified main bronchus
C34.01Malignant neoplasm of right main bronchus
C34.02Malignant neoplasm of left main bronchus
C34.10Malignant neoplasm of upper lobe, unspecified bronchus or lung
C34.11Malignant neoplasm of upper lobe, right bronchus or lung
C34.12Malignant neoplasm of upper lobe, left bronchus or lung
C34.2Malignant neoplasm of middle lobe, bronchus or lung
C34.30Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31Malignant neoplasm of lower lobe, right bronchus or lung
C34.32Malignant neoplasm of lower lobe, left bronchus or lung
C34.80Malignant neoplasm of overlapping sites of unspecified bronchus and lung
C34.81Malignant neoplasm of overlapping sites of right bronchus and lung
C34.82Malignant neoplasm of overlapping sites of left bronchus and lung
C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
C34.91Malignant neoplasm of unspecified part of right bronchus or lung
C34.92Malignant neoplasm of unspecified part of left bronchus or lung
C37Malignant neoplasm of thymus
C38.0Malignant neoplasm of heart
C38.1Malignant neoplasm of anterior mediastinum
C38.2Malignant neoplasm of posterior mediastinum
C38.3Malignant neoplasm of mediastinum, part unspecified
C38.4Malignant neoplasm of pleura
C38.8Malignant neoplasm of overlapping sites of heart, mediastinum and pleura
C39.0Malignant neoplasm of upper respiratory tract, part unspecified
C39.9Malignant neoplasm of lower respiratory tract, part unspecified
C40.00Malignant neoplasm of scapula and long bones of unspecified upper limb
C40.01Malignant neoplasm of scapula and long bones of right upper limb
C40.02Malignant neoplasm of scapula and long bones of left upper limb
C40.10Malignant neoplasm of short bones of unspecified upper limb
C40.11Malignant neoplasm of short bones of right upper limb
C40.12Malignant neoplasm of short bones of left upper limb
C40.20Malignant neoplasm of long bones of unspecified lower limb
C40.21Malignant neoplasm of long bones of right lower limb
C40.22Malignant neoplasm of long bones of left lower limb
C40.30Malignant neoplasm of short bones of unspecified lower limb
C40.31Malignant neoplasm of short bones of right lower limb
C40.32Malignant neoplasm of short bones of left lower limb
C40.80Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb
C40.81Malignant neoplasm of overlapping sites of bone and articular cartilage of right limb
C40.82Malignant neoplasm of overlapping sites of bone and articular cartilage of left limb
C40.90Malignant neoplasm of unspecified bones and articular cartilage of unspecified limb
C40.91Malignant neoplasm of unspecified bones and articular cartilage of right limb
C40.92Malignant neoplasm of unspecified bones and articular cartilage of left limb
C41.0Malignant neoplasm of bones of skull and face
C41.1Malignant neoplasm of mandible
C41.2Malignant neoplasm of vertebral column
C41.3Malignant neoplasm of ribs, sternum and clavicle
C41.4Malignant neoplasm of pelvic bones, sacrum and coccyx
C41.9Malignant neoplasm of bone and articular cartilage, unspecified
C43.0Malignant melanoma of lip
C43.10Malignant melanoma of unspecified eyelid, including canthus
C43.111Malignant melanoma of right upper eyelid, including canthus
C43.112Malignant melanoma of right lower eyelid, including canthus
C43.121Malignant melanoma of left upper eyelid, including canthus
C43.122Malignant melanoma of left lower eyelid, including canthus
C43.20Malignant melanoma of unspecified ear and external auricular canal
C43.21Malignant melanoma of right ear and external auricular canal
C43.22Malignant melanoma of left ear and external auricular canal
C43.30Malignant melanoma of unspecified part of face
C43.31Malignant melanoma of nose
C43.39Malignant melanoma of other parts of face
C43.4Malignant melanoma of scalp and neck
C43.51Malignant melanoma of anal skin
C43.52Malignant melanoma of skin of breast
C43.59Malignant melanoma of other part of trunk
C43.60Malignant melanoma of unspecified upper limb, including shoulder
C43.61Malignant melanoma of right upper limb, including shoulder
C43.62Malignant melanoma of left upper limb, including shoulder
C43.70Malignant melanoma of unspecified lower limb, including hip
C43.71Malignant melanoma of right lower limb, including hip
C43.72Malignant melanoma of left lower limb, including hip
C43.8Malignant melanoma of overlapping sites of skin
C43.9Malignant melanoma of skin, unspecified
C44.00Unspecified malignant neoplasm of skin of lip
C44.01Basal cell carcinoma of skin of lip
C44.02Squamous cell carcinoma of skin of lip
C44.09Other specified malignant neoplasm of skin of lip
C44.101Unspecified malignant neoplasm of skin of unspecified eyelid, including canthus
C44.1021Unspecified malignant neoplasm of skin of right upper eyelid, including canthus
C44.1022Unspecified malignant neoplasm of skin of right lower eyelid, including canthus
C44.1091Unspecified malignant neoplasm of skin of left upper eyelid, including canthus
C44.1092Unspecified malignant neoplasm of skin of left lower eyelid, including canthus
C44.111Basal cell carcinoma of skin of unspecified eyelid, including canthus
C44.1121Basal cell carcinoma of skin of right upper eyelid, including canthus
C44.1122Basal cell carcinoma of skin of right lower eyelid, including canthus
C44.1191Basal cell carcinoma of skin of left upper eyelid, including canthus
C44.1192Basal cell carcinoma of skin of left lower eyelid, including canthus
C44.121Squamous cell carcinoma of skin of unspecified eyelid, including canthus
C44.1221Squamous cell carcinoma of skin of right upper eyelid, including canthus
C44.1222Squamous cell carcinoma of skin of right lower eyelid, including canthus
C44.1291Squamous cell carcinoma of skin of left upper eyelid, including canthus
C44.1292Squamous cell carcinoma of skin of left lower eyelid, including canthus
C44.131Sebaceous cell carcinoma of skin of unspecified eyelid, including canthus
C44.1321Sebaceous cell carcinoma of skin of right upper eyelid, including canthus
C44.1322Sebaceous cell carcinoma of skin of right lower eyelid, including canthus
C44.1391Sebaceous cell carcinoma of skin of left upper eyelid, including canthus
C44.1392Sebaceous cell carcinoma of skin of left lower eyelid, including canthus
C44.191Other specified malignant neoplasm of skin of unspecified eyelid, including canthus
C44.1921Other specified malignant neoplasm of skin of right upper eyelid, including canthus
C44.1922Other specified malignant neoplasm of skin of right lower eyelid, including canthus
C44.1991Other specified malignant neoplasm of skin of left upper eyelid, including canthus
C44.1992Other specified malignant neoplasm of skin of left lower eyelid, including canthus
C44.201Unspecified malignant neoplasm of skin of unspecified ear and external auricular canal
C44.202Unspecified malignant neoplasm of skin of right ear and external auricular canal
C44.209Unspecified malignant neoplasm of skin of left ear and external auricular canal
C44.211Basal cell carcinoma of skin of unspecified ear and external auricular canal
C44.212Basal cell carcinoma of skin of right ear and external auricular canal
C44.219Basal cell carcinoma of skin of left ear and external auricular canal
C44.221Squamous cell carcinoma of skin of unspecified ear and external auricular canal
C44.222Squamous cell carcinoma of skin of right ear and external auricular canal
C44.229Squamous cell carcinoma of skin of left ear and external auricular canal
C44.291Other specified malignant neoplasm of skin of unspecified ear and external auricular canal
C44.292Other specified malignant neoplasm of skin of right ear and external auricular canal
C44.299Other specified malignant neoplasm of skin of left ear and external auricular canal
C44.300Unspecified malignant neoplasm of skin of unspecified part of face
C44.301Unspecified malignant neoplasm of skin of nose
C44.309Unspecified malignant neoplasm of skin of other parts of face
C44.310Basal cell carcinoma of skin of unspecified parts of face
C44.311Basal cell carcinoma of skin of nose
C44.319Basal cell carcinoma of skin of other parts of face
C44.320Squamous cell carcinoma of skin of unspecified parts of face
C44.321Squamous cell carcinoma of skin of nose
C44.329Squamous cell carcinoma of skin of other parts of face
C44.390Other specified malignant neoplasm of skin of unspecified parts of face
C44.391Other specified malignant neoplasm of skin of nose
C44.399Other specified malignant neoplasm of skin of other parts of face
C44.40Unspecified malignant neoplasm of skin of scalp and neck
C44.41Basal cell carcinoma of skin of scalp and neck
C44.42Squamous cell carcinoma of skin of scalp and neck
C44.49Other specified malignant neoplasm of skin of scalp and neck
C44.500Unspecified malignant neoplasm of anal skin
C44.501Unspecified malignant neoplasm of skin of breast
C44.509Unspecified malignant neoplasm of skin of other part of trunk
C44.510Basal cell carcinoma of anal skin
C44.511Basal cell carcinoma of skin of breast
C44.519Basal cell carcinoma of skin of other part of trunk
C44.520Squamous cell carcinoma of anal skin
C44.521Squamous cell carcinoma of skin of breast
C44.529Squamous cell carcinoma of skin of other part of trunk
C44.590Other specified malignant neoplasm of anal skin
C44.591Other specified malignant neoplasm of skin of breast
C44.599Other specified malignant neoplasm of skin of other part of trunk
C44.601Unspecified malignant neoplasm of skin of unspecified upper limb, including shoulder
C44.602Unspecified malignant neoplasm of skin of right upper limb, including shoulder
C44.609Unspecified malignant neoplasm of skin of left upper limb, including shoulder
C44.611Basal cell carcinoma of skin of unspecified upper limb, including shoulder
C44.612Basal cell carcinoma of skin of right upper limb, including shoulder
C44.619Basal cell carcinoma of skin of left upper limb, including shoulder
C44.621Squamous cell carcinoma of skin of unspecified upper limb, including shoulder
C44.622Squamous cell carcinoma of skin of right upper limb, including shoulder
C44.629Squamous cell carcinoma of skin of left upper limb, including shoulder
C44.691Other specified malignant neoplasm of skin of unspecified upper limb, including shoulder
C44.692Other specified malignant neoplasm of skin of right upper limb, including shoulder
C44.699Other specified malignant neoplasm of skin of left upper limb, including shoulder
C44.701Unspecified malignant neoplasm of skin of unspecified lower limb, including hip
C44.702Unspecified malignant neoplasm of skin of right lower limb, including hip
C44.709Unspecified malignant neoplasm of skin of left lower limb, including hip
C44.711Basal cell carcinoma of skin of unspecified lower limb, including hip
C44.712Basal cell carcinoma of skin of right lower limb, including hip
C44.719Basal cell carcinoma of skin of left lower limb, including hip
C44.721Squamous cell carcinoma of skin of unspecified lower limb, including hip
C44.722Squamous cell carcinoma of skin of right lower limb, including hip
C44.729Squamous cell carcinoma of skin of left lower limb, including hip
C44.791Other specified malignant neoplasm of skin of unspecified lower limb, including hip
C44.792Other specified malignant neoplasm of skin of right lower limb, including hip
C44.799Other specified malignant neoplasm of skin of left lower limb, including hip
C44.80Unspecified malignant neoplasm of overlapping sites of skin
C44.81Basal cell carcinoma of overlapping sites of skin
C44.82Squamous cell carcinoma of overlapping sites of skin
C44.89Other specified malignant neoplasm of overlapping sites of skin
C44.90Unspecified malignant neoplasm of skin, unspecified
C44.91Basal cell carcinoma of skin, unspecified
C44.92Squamous cell carcinoma of skin, unspecified
C44.99Other specified malignant neoplasm of skin, unspecified
C45.0Mesothelioma of pleura
C45.1Mesothelioma of peritoneum
C45.2Mesothelioma of pericardium
C45.7Mesothelioma of other sites
C45.9Mesothelioma, unspecified
C46.0Kaposi's sarcoma of skin
C46.1Kaposi's sarcoma of soft tissue
C46.2Kaposi's sarcoma of palate
C46.3Kaposi's sarcoma of lymph nodes
C46.4Kaposi's sarcoma of gastrointestinal sites
C46.50Kaposi's sarcoma of unspecified lung
C46.51Kaposi's sarcoma of right lung
C46.52Kaposi's sarcoma of left lung
C46.7Kaposi's sarcoma of other sites
C46.9Kaposi's sarcoma, unspecified
C47.0Malignant neoplasm of peripheral nerves of head, face and neck
C47.10Malignant neoplasm of peripheral nerves of unspecified upper limb, including shoulder
C47.11Malignant neoplasm of peripheral nerves of right upper limb, including shoulder
C47.12Malignant neoplasm of peripheral nerves of left upper limb, including shoulder
C47.20Malignant neoplasm of peripheral nerves of unspecified lower limb, including hip
C47.21Malignant neoplasm of peripheral nerves of right lower limb, including hip
C47.22Malignant neoplasm of peripheral nerves of left lower limb, including hip
C47.3Malignant neoplasm of peripheral nerves of thorax
C47.4Malignant neoplasm of peripheral nerves of abdomen
C47.5Malignant neoplasm of peripheral nerves of pelvis
C47.6Malignant neoplasm of peripheral nerves of trunk, unspecified
C47.8Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system
C47.9Malignant neoplasm of peripheral nerves and autonomic nervous system, unspecified
C48.0Malignant neoplasm of retroperitoneum
C48.1Malignant neoplasm of specified parts of peritoneum
C48.2Malignant neoplasm of peritoneum, unspecified
C48.8Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
C49.0Malignant neoplasm of connective and soft tissue of head, face and neck
C49.10Malignant neoplasm of connective and soft tissue of unspecified upper limb, including shoulder
C49.11Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder
C49.12Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder
C49.20Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip
C49.21Malignant neoplasm of connective and soft tissue of right lower limb, including hip
C49.22Malignant neoplasm of connective and soft tissue of left lower limb, including hip
C49.3Malignant neoplasm of connective and soft tissue of thorax
C49.4Malignant neoplasm of connective and soft tissue of abdomen
C49.5Malignant neoplasm of connective and soft tissue of pelvis
C49.6Malignant neoplasm of connective and soft tissue of trunk, unspecified
C49.8Malignant neoplasm of overlapping sites of connective and soft tissue
C49.9Malignant neoplasm of connective and soft tissue, unspecified
C49.A0Gastrointestinal stromal tumor, unspecified site
C49.A1Gastrointestinal stromal tumor of esophagus
C49.A2Gastrointestinal stromal tumor of stomach
C49.A3Gastrointestinal stromal tumor of small intestine
C49.A4Gastrointestinal stromal tumor of large intestine
C49.A5Gastrointestinal stromal tumor of rectum
C49.A9Gastrointestinal stromal tumor of other sites
C4A.0Merkel cell carcinoma of lip
C4A.10Merkel cell carcinoma of unspecified eyelid, including canthus
C4A.111Merkel cell carcinoma of right upper eyelid, including canthus
C4A.112Merkel cell carcinoma of right lower eyelid, including canthus
C4A.121Merkel cell carcinoma of left upper eyelid, including canthus
C4A.122Merkel cell carcinoma of left lower eyelid, including canthus
C4A.20Merkel cell carcinoma of unspecified ear and external auricular canal
C4A.21Merkel cell carcinoma of right ear and external auricular canal
C4A.22Merkel cell carcinoma of left ear and external auricular canal
C4A.30Merkel cell carcinoma of unspecified part of face
C4A.31Merkel cell carcinoma of nose
C4A.39Merkel cell carcinoma of other parts of face
C4A.4Merkel cell carcinoma of scalp and neck
C4A.51Merkel cell carcinoma of anal skin
C4A.52Merkel cell carcinoma of skin of breast
C4A.59Merkel cell carcinoma of other part of trunk
C4A.60Merkel cell carcinoma of unspecified upper limb, including shoulder
C4A.61Merkel cell carcinoma of right upper limb, including shoulder
C4A.62Merkel cell carcinoma of left upper limb, including shoulder
C4A.70Merkel cell carcinoma of unspecified lower limb, including hip
C4A.71Merkel cell carcinoma of right lower limb, including hip
C4A.72Merkel cell carcinoma of left lower limb, including hip
C4A.8Merkel cell carcinoma of overlapping sites
C4A.9Merkel cell carcinoma, unspecified
C50.011Malignant neoplasm of nipple and areola, right female breast
C50.012Malignant neoplasm of nipple and areola, left female breast
C50.019Malignant neoplasm of nipple and areola, unspecified female breast
C50.021Malignant neoplasm of nipple and areola, right male breast
C50.022Malignant neoplasm of nipple and areola, left male breast
C50.029Malignant neoplasm of nipple and areola, unspecified male breast
C50.111Malignant neoplasm of central portion of right female breast
C50.112Malignant neoplasm of central portion of left female breast
C50.119Malignant neoplasm of central portion of unspecified female breast
C50.121Malignant neoplasm of central portion of right male breast
C50.122Malignant neoplasm of central portion of left male breast
C50.129Malignant neoplasm of central portion of unspecified male breast
C50.211Malignant neoplasm of upper-inner quadrant of right female breast
C50.212Malignant neoplasm of upper-inner quadrant of left female breast
C50.219Malignant neoplasm of upper-inner quadrant of unspecified female breast
C50.221Malignant neoplasm of upper-inner quadrant of right male breast
C50.222Malignant neoplasm of upper-inner quadrant of left male breast
C50.229Malignant neoplasm of upper-inner quadrant of unspecified male breast
C50.311Malignant neoplasm of lower-inner quadrant of right female breast
C50.312Malignant neoplasm of lower-inner quadrant of left female breast
C50.319Malignant neoplasm of lower-inner quadrant of unspecified female breast
C50.321Malignant neoplasm of lower-inner quadrant of right male breast
C50.322Malignant neoplasm of lower-inner quadrant of left male breast
C50.329Malignant neoplasm of lower-inner quadrant of unspecified male breast
C50.411Malignant neoplasm of upper-outer quadrant of right female breast
C50.412Malignant neoplasm of upper-outer quadrant of left female breast
C50.419Malignant neoplasm of upper-outer quadrant of unspecified female breast
C50.421Malignant neoplasm of upper-outer quadrant of right male breast
C50.422Malignant neoplasm of upper-outer quadrant of left male breast
C50.429Malignant neoplasm of upper-outer quadrant of unspecified male breast
C50.511Malignant neoplasm of lower-outer quadrant of right female breast
C50.512Malignant neoplasm of lower-outer quadrant of left female breast
C50.519Malignant neoplasm of lower-outer quadrant of unspecified female breast
C50.521Malignant neoplasm of lower-outer quadrant of right male breast
C50.522Malignant neoplasm of lower-outer quadrant of left male breast
C50.529Malignant neoplasm of lower-outer quadrant of unspecified male breast
C50.611Malignant neoplasm of axillary tail of right female breast
C50.612Malignant neoplasm of axillary tail of left female breast
C50.619Malignant neoplasm of axillary tail of unspecified female breast
C50.621Malignant neoplasm of axillary tail of right male breast
C50.622Malignant neoplasm of axillary tail of left male breast
C50.629Malignant neoplasm of axillary tail of unspecified male breast
C50.811Malignant neoplasm of overlapping sites of right female breast
C50.812Malignant neoplasm of overlapping sites of left female breast
C50.819Malignant neoplasm of overlapping sites of unspecified female breast
C50.821Malignant neoplasm of overlapping sites of right male breast
C50.822Malignant neoplasm of overlapping sites of left male breast
C50.829Malignant neoplasm of overlapping sites of unspecified male breast
C50.911Malignant neoplasm of unspecified site of right female breast
C50.912Malignant neoplasm of unspecified site of left female breast
C50.919Malignant neoplasm of unspecified site of unspecified female breast
C50.921Malignant neoplasm of unspecified site of right male breast
C50.922Malignant neoplasm of unspecified site of left male breast
C50.929Malignant neoplasm of unspecified site of unspecified male breast
C51.0Malignant neoplasm of labium majus
C51.1Malignant neoplasm of labium minus
C51.2Malignant neoplasm of clitoris
C51.8Malignant neoplasm of overlapping sites of vulva
C51.9Malignant neoplasm of vulva, unspecified
C52Malignant neoplasm of vagina
C53.0Malignant neoplasm of endocervix
C53.1Malignant neoplasm of exocervix
C53.8Malignant neoplasm of overlapping sites of cervix uteri
C53.9Malignant neoplasm of cervix uteri, unspecified
C54.0Malignant neoplasm of isthmus uteri
C54.1Malignant neoplasm of endometrium
C54.2Malignant neoplasm of myometrium
C54.3Malignant neoplasm of fundus uteri
C54.8Malignant neoplasm of overlapping sites of corpus uteri
C54.9Malignant neoplasm of corpus uteri, unspecified
C55Malignant neoplasm of uterus, part unspecified
C56.1Malignant neoplasm of right ovary
C56.2Malignant neoplasm of left ovary
C56.9Malignant neoplasm of unspecified ovary
C57.00Malignant neoplasm of unspecified fallopian tube
C57.01Malignant neoplasm of right fallopian tube
C57.02Malignant neoplasm of left fallopian tube
C57.10Malignant neoplasm of unspecified broad ligament
C57.11Malignant neoplasm of right broad ligament
C57.12Malignant neoplasm of left broad ligament
C57.20Malignant neoplasm of unspecified round ligament
C57.21Malignant neoplasm of right round ligament
C57.22Malignant neoplasm of left round ligament
C57.3Malignant neoplasm of parametrium
C57.4Malignant neoplasm of uterine adnexa, unspecified
C57.7Malignant neoplasm of other specified female genital organs
C57.8Malignant neoplasm of overlapping sites of female genital organs
C57.9Malignant neoplasm of female genital organ, unspecified
C58Malignant neoplasm of placenta
C60.0Malignant neoplasm of prepuce
C60.1Malignant neoplasm of glans penis
C60.2Malignant neoplasm of body of penis
C60.8Malignant neoplasm of overlapping sites of penis
C60.9Malignant neoplasm of penis, unspecified
C61Malignant neoplasm of prostate
C62.00Malignant neoplasm of unspecified undescended testis
C62.01Malignant neoplasm of undescended right testis
C62.02Malignant neoplasm of undescended left testis
C62.10Malignant neoplasm of unspecified descended testis
C62.11Malignant neoplasm of descended right testis
C62.12Malignant neoplasm of descended left testis
C62.90Malignant neoplasm of unspecified testis, unspecified whether descended or undescended
C62.91Malignant neoplasm of right testis, unspecified whether descended or undescended
C62.92Malignant neoplasm of left testis, unspecified whether descended or undescended
C63.00Malignant neoplasm of unspecified epididymis
C63.01Malignant neoplasm of right epididymis
C63.02Malignant neoplasm of left epididymis
C63.10Malignant neoplasm of unspecified spermatic cord
C63.11Malignant neoplasm of right spermatic cord
C63.12Malignant neoplasm of left spermatic cord
C63.2Malignant neoplasm of scrotum
C63.7Malignant neoplasm of other specified male genital organs
C63.8Malignant neoplasm of overlapping sites of male genital organs
C63.9Malignant neoplasm of male genital organ, unspecified
C64.1Malignant neoplasm of right kidney, except renal pelvis
C64.2Malignant neoplasm of left kidney, except renal pelvis
C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
C65.1Malignant neoplasm of right renal pelvis
C65.2Malignant neoplasm of left renal pelvis
C65.9Malignant neoplasm of unspecified renal pelvis
C66.1Malignant neoplasm of right ureter
C66.2Malignant neoplasm of left ureter
C66.9Malignant neoplasm of unspecified ureter
C67.0Malignant neoplasm of trigone of bladder
C67.1Malignant neoplasm of dome of bladder
C67.2Malignant neoplasm of lateral wall of bladder
C67.3Malignant neoplasm of anterior wall of bladder
C67.4Malignant neoplasm of posterior wall of bladder
C67.5Malignant neoplasm of bladder neck
C67.6Malignant neoplasm of ureteric orifice
C67.7Malignant neoplasm of urachus
C67.8Malignant neoplasm of overlapping sites of bladder
C67.9Malignant neoplasm of bladder, unspecified
C68.0Malignant neoplasm of urethra
C68.1Malignant neoplasm of paraurethral glands
C68.8Malignant neoplasm of overlapping sites of urinary organs
C68.9Malignant neoplasm of urinary organ, unspecified
C69.00Malignant neoplasm of unspecified conjunctiva
C69.01Malignant neoplasm of right conjunctiva
C69.02Malignant neoplasm of left conjunctiva
C69.10Malignant neoplasm of unspecified cornea
C69.11Malignant neoplasm of right cornea
C69.12Malignant neoplasm of left cornea
C69.20Malignant neoplasm of unspecified retina
C69.21Malignant neoplasm of right retina
C69.22Malignant neoplasm of left retina
C69.30Malignant neoplasm of unspecified choroid
C69.31Malignant neoplasm of right choroid
C69.32Malignant neoplasm of left choroid
C69.40Malignant neoplasm of unspecified ciliary body
C69.41Malignant neoplasm of right ciliary body
C69.42Malignant neoplasm of left ciliary body
C69.50Malignant neoplasm of unspecified lacrimal gland and duct
C69.51Malignant neoplasm of right lacrimal gland and duct
C69.52Malignant neoplasm of left lacrimal gland and duct
C69.60Malignant neoplasm of unspecified orbit
C69.61Malignant neoplasm of right orbit
C69.62Malignant neoplasm of left orbit
C69.80Malignant neoplasm of overlapping sites of unspecified eye and adnexa
C69.81Malignant neoplasm of overlapping sites of right eye and adnexa
C69.82Malignant neoplasm of overlapping sites of left eye and adnexa
C69.90Malignant neoplasm of unspecified site of unspecified eye
C69.91Malignant neoplasm of unspecified site of right eye
C69.92Malignant neoplasm of unspecified site of left eye
C70.0Malignant neoplasm of cerebral meninges
C70.1Malignant neoplasm of spinal meninges
C70.9Malignant neoplasm of meninges, unspecified
C71.0Malignant neoplasm of cerebrum, except lobes and ventricles
C71.1Malignant neoplasm of frontal lobe
C71.2Malignant neoplasm of temporal lobe
C71.3Malignant neoplasm of parietal lobe
C71.4Malignant neoplasm of occipital lobe
C71.5Malignant neoplasm of cerebral ventricle
C71.6Malignant neoplasm of cerebellum
C71.7Malignant neoplasm of brain stem
C71.8Malignant neoplasm of overlapping sites of brain
C71.9Malignant neoplasm of brain, unspecified
C72.0Malignant neoplasm of spinal cord
C72.1Malignant neoplasm of cauda equina
C72.20Malignant neoplasm of unspecified olfactory nerve
C72.21Malignant neoplasm of right olfactory nerve
C72.22Malignant neoplasm of left olfactory nerve
C72.30Malignant neoplasm of unspecified optic nerve
C72.31Malignant neoplasm of right optic nerve
C72.32Malignant neoplasm of left optic nerve
C72.40Malignant neoplasm of unspecified acoustic nerve
C72.41Malignant neoplasm of right acoustic nerve
C72.42Malignant neoplasm of left acoustic nerve
C72.50Malignant neoplasm of unspecified cranial nerve
C72.59Malignant neoplasm of other cranial nerves
C72.9Malignant neoplasm of central nervous system, unspecified
C73Malignant neoplasm of thyroid gland
C74.00Malignant neoplasm of cortex of unspecified adrenal gland
C74.01Malignant neoplasm of cortex of right adrenal gland
C74.02Malignant neoplasm of cortex of left adrenal gland
C74.10Malignant neoplasm of medulla of unspecified adrenal gland
C74.11Malignant neoplasm of medulla of right adrenal gland
C74.12Malignant neoplasm of medulla of left adrenal gland
C74.90Malignant neoplasm of unspecified part of unspecified adrenal gland
C74.91Malignant neoplasm of unspecified part of right adrenal gland
C74.92Malignant neoplasm of unspecified part of left adrenal gland
C75.0Malignant neoplasm of parathyroid gland
C75.1Malignant neoplasm of pituitary gland
C75.2Malignant neoplasm of craniopharyngeal duct
C75.3Malignant neoplasm of pineal gland
C75.4Malignant neoplasm of carotid body
C75.5Malignant neoplasm of aortic body and other paraganglia
C75.8Malignant neoplasm with pluriglandular involvement, unspecified
C75.9Malignant neoplasm of endocrine gland, unspecified
C76.0Malignant neoplasm of head, face and neck
C76.1Malignant neoplasm of thorax
C76.2Malignant neoplasm of abdomen
C76.3Malignant neoplasm of pelvis
C76.40Malignant neoplasm of unspecified upper limb
C76.41Malignant neoplasm of right upper limb
C76.42Malignant neoplasm of left upper limb
C76.50Malignant neoplasm of unspecified lower limb
C76.51Malignant neoplasm of right lower limb
C76.52Malignant neoplasm of left lower limb
C76.8Malignant neoplasm of other specified ill-defined sites
C77.0Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck
C77.1Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes
C77.2Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes
C77.3Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes
C77.4Secondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes
C77.5Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes
C77.8Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions
C77.9Secondary and unspecified malignant neoplasm of lymph node, unspecified
C78.00Secondary malignant neoplasm of unspecified lung
C78.01Secondary malignant neoplasm of right lung
C78.02Secondary malignant neoplasm of left lung
C78.1Secondary malignant neoplasm of mediastinum
C78.2Secondary malignant neoplasm of pleura
C78.30Secondary malignant neoplasm of unspecified respiratory organ
C78.39Secondary malignant neoplasm of other respiratory organs
C78.4Secondary malignant neoplasm of small intestine
C78.5Secondary malignant neoplasm of large intestine and rectum
C78.6Secondary malignant neoplasm of retroperitoneum and peritoneum
C78.7Secondary malignant neoplasm of liver and intrahepatic bile duct
C78.80Secondary malignant neoplasm of unspecified digestive organ
C78.89Secondary malignant neoplasm of other digestive organs
C79.00Secondary malignant neoplasm of unspecified kidney and renal pelvis
C79.01Secondary malignant neoplasm of right kidney and renal pelvis
C79.02Secondary malignant neoplasm of left kidney and renal pelvis
C79.10Secondary malignant neoplasm of unspecified urinary organs
C79.11Secondary malignant neoplasm of bladder
C79.19Secondary malignant neoplasm of other urinary organs
C79.2Secondary malignant neoplasm of skin
C79.31Secondary malignant neoplasm of brain
C79.32Secondary malignant neoplasm of cerebral meninges
C79.40Secondary malignant neoplasm of unspecified part of nervous system
C79.49Secondary malignant neoplasm of other parts of nervous system
C79.51Secondary malignant neoplasm of bone
C79.52Secondary malignant neoplasm of bone marrow
C79.60Secondary malignant neoplasm of unspecified ovary
C79.61Secondary malignant neoplasm of right ovary
C79.62Secondary malignant neoplasm of left ovary
C79.70Secondary malignant neoplasm of unspecified adrenal gland
C79.71Secondary malignant neoplasm of right adrenal gland
C79.72Secondary malignant neoplasm of left adrenal gland
C79.81Secondary malignant neoplasm of breast
C79.82Secondary malignant neoplasm of genital organs
C79.89Secondary malignant neoplasm of other specified sites
C79.9Secondary malignant neoplasm of unspecified site
C7A.00Malignant carcinoid tumor of unspecified site
C7A.010Malignant carcinoid tumor of the duodenum
C7A.011Malignant carcinoid tumor of the jejunum
C7A.012Malignant carcinoid tumor of the ileum
C7A.019Malignant carcinoid tumor of the small intestine, unspecified portion
C7A.020Malignant carcinoid tumor of the appendix
C7A.021Malignant carcinoid tumor of the cecum
C7A.022Malignant carcinoid tumor of the ascending colon
C7A.023Malignant carcinoid tumor of the transverse colon
C7A.024Malignant carcinoid tumor of the descending colon
C7A.025Malignant carcinoid tumor of the sigmoid colon
C7A.026Malignant carcinoid tumor of the rectum
C7A.029Malignant carcinoid tumor of the large intestine, unspecified portion
C7A.090Malignant carcinoid tumor of the bronchus and lung
C7A.091Malignant carcinoid tumor of the thymus
C7A.092Malignant carcinoid tumor of the stomach
C7A.093Malignant carcinoid tumor of the kidney
C7A.094Malignant carcinoid tumor of the foregut, unspecified
C7A.095Malignant carcinoid tumor of the midgut, unspecified
C7A.096Malignant carcinoid tumor of the hindgut, unspecified
C7A.098Malignant carcinoid tumors of other sites
C7A.1Malignant poorly differentiated neuroendocrine tumors
C7A.8Other malignant neuroendocrine tumors
C7B.00Secondary carcinoid tumors, unspecified site
C7B.01Secondary carcinoid tumors of distant lymph nodes
C7B.02Secondary carcinoid tumors of liver
C7B.03Secondary carcinoid tumors of bone
C7B.04Secondary carcinoid tumors of peritoneum
C7B.09Secondary carcinoid tumors of other sites
C7B.1Secondary Merkel cell carcinoma
C7B.8Other secondary neuroendocrine tumors
C80.0Disseminated malignant neoplasm, unspecified
C80.1Malignant (primary) neoplasm, unspecified
C80.2Malignant neoplasm associated with transplanted organ
C81.00Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site
C81.01Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck
C81.02Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes
C81.03Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes
C81.04Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of axilla and upper limb
C81.05Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C81.06Nodular lymphocyte predominant Hodgkin lymphoma, intrapelvic lymph nodes
C81.07Nodular lymphocyte predominant Hodgkin lymphoma, spleen
C81.08Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of multiple sites
C81.09Nodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites
C81.10Nodular sclerosis Hodgkin lymphoma, unspecified site
C81.11Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck
C81.12Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes
C81.13Nodular sclerosis Hodgkin lymphoma, intra-abdominal lymph nodes
C81.14Nodular sclerosis Hodgkin lymphoma, lymph nodes of axilla and upper limb
C81.15Nodular sclerosis Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C81.16Nodular sclerosis Hodgkin lymphoma, intrapelvic lymph nodes
C81.17Nodular sclerosis Hodgkin lymphoma, spleen
C81.18Nodular sclerosis Hodgkin lymphoma, lymph nodes of multiple sites
C81.19Nodular sclerosis Hodgkin lymphoma, extranodal and solid organ sites
C81.20Mixed cellularity Hodgkin lymphoma, unspecified site
C81.21Mixed cellularity Hodgkin lymphoma, lymph nodes of head, face, and neck
C81.22Mixed cellularity Hodgkin lymphoma, intrathoracic lymph nodes
C81.23Mixed cellularity Hodgkin lymphoma, intra-abdominal lymph nodes
C81.24Mixed cellularity Hodgkin lymphoma, lymph nodes of axilla and upper limb
C81.25Mixed cellularity Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C81.26Mixed cellularity Hodgkin lymphoma, intrapelvic lymph nodes
C81.27Mixed cellularity Hodgkin lymphoma, spleen
C81.28Mixed cellularity Hodgkin lymphoma, lymph nodes of multiple sites
C81.29Mixed cellularity Hodgkin lymphoma, extranodal and solid organ sites
C81.30Lymphocyte depleted Hodgkin lymphoma, unspecified site
C81.31Lymphocyte depleted Hodgkin lymphoma, lymph nodes of head, face, and neck
C81.32Lymphocyte depleted Hodgkin lymphoma, intrathoracic lymph nodes
C81.33Lymphocyte depleted Hodgkin lymphoma, intra-abdominal lymph nodes
C81.34Lymphocyte depleted Hodgkin lymphoma, lymph nodes of axilla and upper limb
C81.35Lymphocyte depleted Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C81.36Lymphocyte depleted Hodgkin lymphoma, intrapelvic lymph nodes
C81.37Lymphocyte depleted Hodgkin lymphoma, spleen
C81.38Lymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites
C81.39Lymphocyte depleted Hodgkin lymphoma, extranodal and solid organ sites
C81.40Lymphocyte-rich Hodgkin lymphoma, unspecified site
C81.41Lymphocyte-rich Hodgkin lymphoma, lymph nodes of head, face, and neck
C81.42Lymphocyte-rich Hodgkin lymphoma, intrathoracic lymph nodes
C81.43Lymphocyte-rich Hodgkin lymphoma, intra-abdominal lymph nodes
C81.44Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb
C81.45Lymphocyte-rich Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C81.46Lymphocyte-rich Hodgkin lymphoma, intrapelvic lymph nodes
C81.47Lymphocyte-rich Hodgkin lymphoma, spleen
C81.48Lymphocyte-rich Hodgkin lymphoma, lymph nodes of multiple sites
C81.49Lymphocyte-rich Hodgkin lymphoma, extranodal and solid organ sites
C81.70Other Hodgkin lymphoma, unspecified site
C81.71Other Hodgkin lymphoma, lymph nodes of head, face, and neck
C81.72Other Hodgkin lymphoma, intrathoracic lymph nodes
C81.73Other Hodgkin lymphoma, intra-abdominal lymph nodes
C81.74Other Hodgkin lymphoma, lymph nodes of axilla and upper limb
C81.75Other Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C81.76Other Hodgkin lymphoma, intrapelvic lymph nodes
C81.77Other Hodgkin lymphoma, spleen
C81.78Other Hodgkin lymphoma, lymph nodes of multiple sites
C81.79Other Hodgkin lymphoma, extranodal and solid organ sites
C81.90Hodgkin lymphoma, unspecified, unspecified site
C81.91Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck
C81.92Hodgkin lymphoma, unspecified, intrathoracic lymph nodes
C81.93Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes
C81.94Hodgkin lymphoma, unspecified, lymph nodes of axilla and upper limb
C81.95Hodgkin lymphoma, unspecified, lymph nodes of inguinal region and lower limb
C81.96Hodgkin lymphoma, unspecified, intrapelvic lymph nodes
C81.97Hodgkin lymphoma, unspecified, spleen
C81.98Hodgkin lymphoma, unspecified, lymph nodes of multiple sites
C81.99Hodgkin lymphoma, unspecified, extranodal and solid organ sites
C82.00Follicular lymphoma grade I, unspecified site
C82.01Follicular lymphoma grade I, lymph nodes of head, face, and neck
C82.02Follicular lymphoma grade I, intrathoracic lymph nodes
C82.03Follicular lymphoma grade I, intra-abdominal lymph nodes
C82.04Follicular lymphoma grade I, lymph nodes of axilla and upper limb
C82.05Follicular lymphoma grade I, lymph nodes of inguinal region and lower limb
C82.06Follicular lymphoma grade I, intrapelvic lymph nodes
C82.07Follicular lymphoma grade I, spleen
C82.08Follicular lymphoma grade I, lymph nodes of multiple sites
C82.09Follicular lymphoma grade I, extranodal and solid organ sites
C82.10Follicular lymphoma grade II, unspecified site
C82.11Follicular lymphoma grade II, lymph nodes of head, face, and neck
C82.12Follicular lymphoma grade II, intrathoracic lymph nodes
C82.13Follicular lymphoma grade II, intra-abdominal lymph nodes
C82.14Follicular lymphoma grade II, lymph nodes of axilla and upper limb
C82.15Follicular lymphoma grade II, lymph nodes of inguinal region and lower limb
C82.16Follicular lymphoma grade II, intrapelvic lymph nodes
C82.17Follicular lymphoma grade II, spleen
C82.18Follicular lymphoma grade II, lymph nodes of multiple sites
C82.19Follicular lymphoma grade II, extranodal and solid organ sites
C82.20Follicular lymphoma grade III, unspecified, unspecified site
C82.21Follicular lymphoma grade III, unspecified, lymph nodes of head, face, and neck
C82.22Follicular lymphoma grade III, unspecified, intrathoracic lymph nodes
C82.23Follicular lymphoma grade III, unspecified, intra-abdominal lymph nodes
C82.24Follicular lymphoma grade III, unspecified, lymph nodes of axilla and upper limb
C82.25Follicular lymphoma grade III, unspecified, lymph nodes of inguinal region and lower limb
C82.26Follicular lymphoma grade III, unspecified, intrapelvic lymph nodes
C82.27Follicular lymphoma grade III, unspecified, spleen
C82.28Follicular lymphoma grade III, unspecified, lymph nodes of multiple sites
C82.29Follicular lymphoma grade III, unspecified, extranodal and solid organ sites
C82.30Follicular lymphoma grade IIIa, unspecified site
C82.31Follicular lymphoma grade IIIa, lymph nodes of head, face, and neck
C82.32Follicular lymphoma grade IIIa, intrathoracic lymph nodes
C82.33Follicular lymphoma grade IIIa, intra-abdominal lymph nodes
C82.34Follicular lymphoma grade IIIa, lymph nodes of axilla and upper limb
C82.35Follicular lymphoma grade IIIa, lymph nodes of inguinal region and lower limb
C82.36Follicular lymphoma grade IIIa, intrapelvic lymph nodes
C82.37Follicular lymphoma grade IIIa, spleen
C82.38Follicular lymphoma grade IIIa, lymph nodes of multiple sites
C82.39Follicular lymphoma grade IIIa, extranodal and solid organ sites
C82.40Follicular lymphoma grade IIIb, unspecified site
C82.41Follicular lymphoma grade IIIb, lymph nodes of head, face, and neck
C82.42Follicular lymphoma grade IIIb, intrathoracic lymph nodes
C82.43Follicular lymphoma grade IIIb, intra-abdominal lymph nodes
C82.44Follicular lymphoma grade IIIb, lymph nodes of axilla and upper limb
C82.45Follicular lymphoma grade IIIb, lymph nodes of inguinal region and lower limb
C82.46Follicular lymphoma grade IIIb, intrapelvic lymph nodes
C82.47Follicular lymphoma grade IIIb, spleen
C82.48Follicular lymphoma grade IIIb, lymph nodes of multiple sites
C82.49Follicular lymphoma grade IIIb, extranodal and solid organ sites
C82.50Diffuse follicle center lymphoma, unspecified site
C82.51Diffuse follicle center lymphoma, lymph nodes of head, face, and neck
C82.52Diffuse follicle center lymphoma, intrathoracic lymph nodes
C82.53Diffuse follicle center lymphoma, intra-abdominal lymph nodes
C82.54Diffuse follicle center lymphoma, lymph nodes of axilla and upper limb
C82.55Diffuse follicle center lymphoma, lymph nodes of inguinal region and lower limb
C82.56Diffuse follicle center lymphoma, intrapelvic lymph nodes
C82.57Diffuse follicle center lymphoma, spleen
C82.58Diffuse follicle center lymphoma, lymph nodes of multiple sites
C82.59Diffuse follicle center lymphoma, extranodal and solid organ sites
C82.60Cutaneous follicle center lymphoma, unspecified site
C82.61Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck
C82.62Cutaneous follicle center lymphoma, intrathoracic lymph nodes
C82.63Cutaneous follicle center lymphoma, intra-abdominal lymph nodes
C82.64Cutaneous follicle center lymphoma, lymph nodes of axilla and upper limb
C82.65Cutaneous follicle center lymphoma, lymph nodes of inguinal region and lower limb
C82.66Cutaneous follicle center lymphoma, intrapelvic lymph nodes
C82.67Cutaneous follicle center lymphoma, spleen
C82.68Cutaneous follicle center lymphoma, lymph nodes of multiple sites
C82.69Cutaneous follicle center lymphoma, extranodal and solid organ sites
C82.80Other types of follicular lymphoma, unspecified site
C82.81Other types of follicular lymphoma, lymph nodes of head, face, and neck
C82.82Other types of follicular lymphoma, intrathoracic lymph nodes
C82.83Other types of follicular lymphoma, intra-abdominal lymph nodes
C82.84Other types of follicular lymphoma, lymph nodes of axilla and upper limb
C82.85Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb
C82.86Other types of follicular lymphoma, intrapelvic lymph nodes
C82.87Other types of follicular lymphoma, spleen
C82.88Other types of follicular lymphoma, lymph nodes of multiple sites
C82.89Other types of follicular lymphoma, extranodal and solid organ sites
C82.90Follicular lymphoma, unspecified, unspecified site
C82.91Follicular lymphoma, unspecified, lymph nodes of head, face, and neck
C82.92Follicular lymphoma, unspecified, intrathoracic lymph nodes
C82.93Follicular lymphoma, unspecified, intra-abdominal lymph nodes
C82.94Follicular lymphoma, unspecified, lymph nodes of axilla and upper limb
C82.95Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb
C82.96Follicular lymphoma, unspecified, intrapelvic lymph nodes
C82.97Follicular lymphoma, unspecified, spleen
C82.98Follicular lymphoma, unspecified, lymph nodes of multiple sites
C82.99Follicular lymphoma, unspecified, extranodal and solid organ sites
C83.00Small cell B-cell lymphoma, unspecified site
C83.01Small cell B-cell lymphoma, lymph nodes of head, face, and neck
C83.02Small cell B-cell lymphoma, intrathoracic lymph nodes
C83.03Small cell B-cell lymphoma, intra-abdominal lymph nodes
C83.04Small cell B-cell lymphoma, lymph nodes of axilla and upper limb
C83.05Small cell B-cell lymphoma, lymph nodes of inguinal region and lower limb
C83.06Small cell B-cell lymphoma, intrapelvic lymph nodes
C83.07Small cell B-cell lymphoma, spleen
C83.08Small cell B-cell lymphoma, lymph nodes of multiple sites
C83.09Small cell B-cell lymphoma, extranodal and solid organ sites
C83.10Mantle cell lymphoma, unspecified site
C83.11Mantle cell lymphoma, lymph nodes of head, face, and neck
C83.12Mantle cell lymphoma, intrathoracic lymph nodes
C83.13Mantle cell lymphoma, intra-abdominal lymph nodes
C83.14Mantle cell lymphoma, lymph nodes of axilla and upper limb
C83.15Mantle cell lymphoma, lymph nodes of inguinal region and lower limb
C83.16Mantle cell lymphoma, intrapelvic lymph nodes
C83.17Mantle cell lymphoma, spleen
C83.18Mantle cell lymphoma, lymph nodes of multiple sites
C83.19Mantle cell lymphoma, extranodal and solid organ sites
C83.30Diffuse large B-cell lymphoma, unspecified site
C83.31Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck
C83.32Diffuse large B-cell lymphoma, intrathoracic lymph nodes
C83.33Diffuse large B-cell lymphoma, intra-abdominal lymph nodes
C83.34Diffuse large B-cell lymphoma, lymph nodes of axilla and upper limb
C83.35Diffuse large B-cell lymphoma, lymph nodes of inguinal region and lower limb
C83.36Diffuse large B-cell lymphoma, intrapelvic lymph nodes
C83.37Diffuse large B-cell lymphoma, spleen
C83.38Diffuse large B-cell lymphoma, lymph nodes of multiple sites
C83.39Diffuse large B-cell lymphoma, extranodal and solid organ sites
C83.50Lymphoblastic (diffuse) lymphoma, unspecified site
C83.51Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck
C83.52Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes
C83.53Lymphoblastic (diffuse) lymphoma, intra-abdominal lymph nodes
C83.54Lymphoblastic (diffuse) lymphoma, lymph nodes of axilla and upper limb
C83.55Lymphoblastic (diffuse) lymphoma, lymph nodes of inguinal region and lower limb
C83.56Lymphoblastic (diffuse) lymphoma, intrapelvic lymph nodes
C83.57Lymphoblastic (diffuse) lymphoma, spleen
C83.58Lymphoblastic (diffuse) lymphoma, lymph nodes of multiple sites
C83.59Lymphoblastic (diffuse) lymphoma, extranodal and solid organ sites
C83.70Burkitt lymphoma, unspecified site
C83.71Burkitt lymphoma, lymph nodes of head, face, and neck
C83.72Burkitt lymphoma, intrathoracic lymph nodes
C83.73Burkitt lymphoma, intra-abdominal lymph nodes
C83.74Burkitt lymphoma, lymph nodes of axilla and upper limb
C83.75Burkitt lymphoma, lymph nodes of inguinal region and lower limb
C83.76Burkitt lymphoma, intrapelvic lymph nodes
C83.77Burkitt lymphoma, spleen
C83.78Burkitt lymphoma, lymph nodes of multiple sites
C83.79Burkitt lymphoma, extranodal and solid organ sites
C83.80Other non-follicular lymphoma, unspecified site
C83.81Other non-follicular lymphoma, lymph nodes of head, face, and neck
C83.82Other non-follicular lymphoma, intrathoracic lymph nodes
C83.83Other non-follicular lymphoma, intra-abdominal lymph nodes
C83.84Other non-follicular lymphoma, lymph nodes of axilla and upper limb
C83.85Other non-follicular lymphoma, lymph nodes of inguinal region and lower limb
C83.86Other non-follicular lymphoma, intrapelvic lymph nodes
C83.87Other non-follicular lymphoma, spleen
C83.88Other non-follicular lymphoma, lymph nodes of multiple sites
C83.89Other non-follicular lymphoma, extranodal and solid organ sites
C83.90Non-follicular (diffuse) lymphoma, unspecified, unspecified site
C83.91Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of head, face, and neck
C83.92Non-follicular (diffuse) lymphoma, unspecified, intrathoracic lymph nodes
C83.93Non-follicular (diffuse) lymphoma, unspecified, intra-abdominal lymph nodes
C83.94Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of axilla and upper limb
C83.95Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of inguinal region and lower limb
C83.96Non-follicular (diffuse) lymphoma, unspecified, intrapelvic lymph nodes
C83.97Non-follicular (diffuse) lymphoma, unspecified, spleen
C83.98Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites
C83.99Non-follicular (diffuse) lymphoma, unspecified, extranodal and solid organ sites
C84.00Mycosis fungoides, unspecified site
C84.01Mycosis fungoides, lymph nodes of head, face, and neck
C84.02Mycosis fungoides, intrathoracic lymph nodes
C84.03Mycosis fungoides, intra-abdominal lymph nodes
C84.04Mycosis fungoides, lymph nodes of axilla and upper limb
C84.05Mycosis fungoides, lymph nodes of inguinal region and lower limb
C84.06Mycosis fungoides, intrapelvic lymph nodes
C84.07Mycosis fungoides, spleen
C84.08Mycosis fungoides, lymph nodes of multiple sites
C84.09Mycosis fungoides, extranodal and solid organ sites
C84.40Peripheral T-cell lymphoma, not classified, unspecified site
C84.41Peripheral T-cell lymphoma, not classified, lymph nodes of head, face, and neck
C84.42Peripheral T-cell lymphoma, not classified, intrathoracic lymph nodes
C84.43Peripheral T-cell lymphoma, not classified, intra-abdominal lymph nodes
C84.44Peripheral T-cell lymphoma, not classified, lymph nodes of axilla and upper limb
C84.45Peripheral T-cell lymphoma, not classified, lymph nodes of inguinal region and lower limb
C84.46Peripheral T-cell lymphoma, not classified, intrapelvic lymph nodes
C84.47Peripheral T-cell lymphoma, not classified, spleen
C84.48Peripheral T-cell lymphoma, not classified, lymph nodes of multiple sites
C84.49Peripheral T-cell lymphoma, not classified, extranodal and solid organ sites
C84.60Anaplastic large cell lymphoma, ALK-positive, unspecified site
C84.61Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck
C84.62Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes
C84.63Anaplastic large cell lymphoma, ALK-positive, intra-abdominal lymph nodes
C84.64Anaplastic large cell lymphoma, ALK-positive, lymph nodes of axilla and upper limb
C84.65Anaplastic large cell lymphoma, ALK-positive, lymph nodes of inguinal region and lower limb
C84.66Anaplastic large cell lymphoma, ALK-positive, intrapelvic lymph nodes
C84.67Anaplastic large cell lymphoma, ALK-positive, spleen
C84.68Anaplastic large cell lymphoma, ALK-positive, lymph nodes of multiple sites
C84.69Anaplastic large cell lymphoma, ALK-positive, extranodal and solid organ sites
C84.70Anaplastic large cell lymphoma, ALK-negative, unspecified site
C84.71Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neck
C84.72Anaplastic large cell lymphoma, ALK-negative, intrathoracic lymph nodes
C84.73Anaplastic large cell lymphoma, ALK-negative, intra-abdominal lymph nodes
C84.74Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb
C84.75Anaplastic large cell lymphoma, ALK-negative, lymph nodes of inguinal region and lower limb
C84.76Anaplastic large cell lymphoma, ALK-negative, intrapelvic lymph nodes
C84.77Anaplastic large cell lymphoma, ALK-negative, spleen
C84.78Anaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites
C84.79Anaplastic large cell lymphoma, ALK-negative, extranodal and solid organ sites
C84.90Mature T/NK-cell lymphomas, unspecified, unspecified site
C84.91Mature T/NK-cell lymphomas, unspecified, lymph nodes of head, face, and neck
C84.92Mature T/NK-cell lymphomas, unspecified, intrathoracic lymph nodes
C84.93Mature T/NK-cell lymphomas, unspecified, intra-abdominal lymph nodes
C84.94Mature T/NK-cell lymphomas, unspecified, lymph nodes of axilla and upper limb
C84.95Mature T/NK-cell lymphomas, unspecified, lymph nodes of inguinal region and lower limb
C84.96Mature T/NK-cell lymphomas, unspecified, intrapelvic lymph nodes
C84.97Mature T/NK-cell lymphomas, unspecified, spleen
C84.98Mature T/NK-cell lymphomas, unspecified, lymph nodes of multiple sites
C84.99Mature T/NK-cell lymphomas, unspecified, extranodal and solid organ sites
C84.A0Cutaneous T-cell lymphoma, unspecified, unspecified site
C84.A1Cutaneous T-cell lymphoma, unspecified lymph nodes of head, face, and neck
C84.A2Cutaneous T-cell lymphoma, unspecified, intrathoracic lymph nodes
C84.A3Cutaneous T-cell lymphoma, unspecified, intra-abdominal lymph nodes
C84.A4Cutaneous T-cell lymphoma, unspecified, lymph nodes of axilla and upper limb
C84.A5Cutaneous T-cell lymphoma, unspecified, lymph nodes of inguinal region and lower limb
C84.A6Cutaneous T-cell lymphoma, unspecified, intrapelvic lymph nodes
C84.A7Cutaneous T-cell lymphoma, unspecified, spleen
C84.A8Cutaneous T-cell lymphoma, unspecified, lymph nodes of multiple sites
C84.A9Cutaneous T-cell lymphoma, unspecified, extranodal and solid organ sites
C84.Z0Other mature T/NK-cell lymphomas, unspecified site
C84.Z1Other mature T/NK-cell lymphomas, lymph nodes of head, face, and neck
C84.Z2Other mature T/NK-cell lymphomas, intrathoracic lymph nodes
C84.Z3Other mature T/NK-cell lymphomas, intra-abdominal lymph nodes
C84.Z4Other mature T/NK-cell lymphomas, lymph nodes of axilla and upper limb
C84.Z5Other mature T/NK-cell lymphomas, lymph nodes of inguinal region and lower limb
C84.Z6Other mature T/NK-cell lymphomas, intrapelvic lymph nodes
C84.Z7Other mature T/NK-cell lymphomas, spleen
C84.Z8Other mature T/NK-cell lymphomas, lymph nodes of multiple sites
C84.Z9Other mature T/NK-cell lymphomas, extranodal and solid organ sites
C85.10Unspecified B-cell lymphoma, unspecified site
C85.11Unspecified B-cell lymphoma, lymph nodes of head, face, and neck
C85.12Unspecified B-cell lymphoma, intrathoracic lymph nodes
C85.13Unspecified B-cell lymphoma, intra-abdominal lymph nodes
C85.14Unspecified B-cell lymphoma, lymph nodes of axilla and upper limb
C85.15Unspecified B-cell lymphoma, lymph nodes of inguinal region and lower limb
C85.16Unspecified B-cell lymphoma, intrapelvic lymph nodes
C85.17Unspecified B-cell lymphoma, spleen
C85.18Unspecified B-cell lymphoma, lymph nodes of multiple sites
C85.19Unspecified B-cell lymphoma, extranodal and solid organ sites
C85.20Mediastinal (thymic) large B-cell lymphoma, unspecified site
C85.21Mediastinal (thymic) large B-cell lymphoma, lymph nodes of head, face, and neck
C85.22Mediastinal (thymic) large B-cell lymphoma, intrathoracic lymph nodes
C85.23Mediastinal (thymic) large B-cell lymphoma, intra-abdominal lymph nodes
C85.24Mediastinal (thymic) large B-cell lymphoma, lymph nodes of axilla and upper limb
C85.25Mediastinal (thymic) large B-cell lymphoma, lymph nodes of inguinal region and lower limb
C85.26Mediastinal (thymic) large B-cell lymphoma, intrapelvic lymph nodes
C85.27Mediastinal (thymic) large B-cell lymphoma, spleen
C85.28Mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites
C85.29Mediastinal (thymic) large B-cell lymphoma, extranodal and solid organ sites
C85.80Other specified types of non-Hodgkin lymphoma, unspecified site
C85.81Other specified types of non-Hodgkin lymphoma, lymph nodes of head, face, and neck
C85.82Other specified types of non-Hodgkin lymphoma, intrathoracic lymph nodes
C85.83Other specified types of non-Hodgkin lymphoma, intra-abdominal lymph nodes
C85.84Other specified types of non-Hodgkin lymphoma, lymph nodes of axilla and upper limb
C85.85Other specified types of non-Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
C85.86Other specified types of non-Hodgkin lymphoma, intrapelvic lymph nodes
C85.87Other specified types of non-Hodgkin lymphoma, spleen
C85.88Other specified types of non-Hodgkin lymphoma, lymph nodes of multiple sites
C85.89Other specified types of non-Hodgkin lymphoma, extranodal and solid organ sites
C85.90Non-Hodgkin lymphoma, unspecified, unspecified site
C85.91Non-Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck
C85.92Non-Hodgkin lymphoma, unspecified, intrathoracic lymph nodes
C85.93Non-Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes
C85.94Non-Hodgkin lymphoma, unspecified, lymph nodes of axilla and upper limb
C85.95Non-Hodgkin lymphoma, unspecified, lymph nodes of inguinal region and lower limb
C85.96Non-Hodgkin lymphoma, unspecified, intrapelvic lymph nodes
C85.97Non-Hodgkin lymphoma, unspecified, spleen
C85.98Non-Hodgkin lymphoma, unspecified, lymph nodes of multiple sites
C85.99Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites
C86.0Extranodal NK/T-cell lymphoma, nasal type
C86.1Hepatosplenic T-cell lymphoma
C86.2Enteropathy-type (intestinal) T-cell lymphoma
C86.3Subcutaneous panniculitis-like T-cell lymphoma
C86.4Blastic NK-cell lymphoma
C86.5Angioimmunoblastic T-cell lymphoma
C86.6Primary cutaneous CD30-positive T-cell proliferations
C88.2Heavy chain disease
C88.3Immunoproliferative small intestinal disease
C88.4Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma]
C88.8Other malignant immunoproliferative diseases
C88.9Malignant immunoproliferative disease, unspecified
C90.00Multiple myeloma not having achieved remission
C90.01Multiple myeloma in remission
C90.02Multiple myeloma in relapse
C90.10Plasma cell leukemia not having achieved remission
C90.11Plasma cell leukemia in remission
C90.12Plasma cell leukemia in relapse
C90.20Extramedullary plasmacytoma not having achieved remission
C90.21Extramedullary plasmacytoma in remission
C90.22Extramedullary plasmacytoma in relapse
C90.30Solitary plasmacytoma not having achieved remission
C90.31Solitary plasmacytoma in remission
C90.32Solitary plasmacytoma in relapse
C91.00Acute lymphoblastic leukemia not having achieved remission
C91.01Acute lymphoblastic leukemia, in remission
C91.02Acute lymphoblastic leukemia, in relapse
C91.10Chronic lymphocytic leukemia of B-cell type not having achieved remission
C91.11Chronic lymphocytic leukemia of B-cell type in remission
C91.12Chronic lymphocytic leukemia of B-cell type in relapse
C91.30Prolymphocytic leukemia of B-cell type not having achieved remission
C91.31Prolymphocytic leukemia of B-cell type, in remission
C91.32Prolymphocytic leukemia of B-cell type, in relapse
C91.40Hairy cell leukemia not having achieved remission
C91.41Hairy cell leukemia, in remission
C91.42Hairy cell leukemia, in relapse
C91.50Adult T-cell lymphoma/leukemia (HTLV-1-associated) not having achieved remission
C91.51Adult T-cell lymphoma/leukemia (HTLV-1-associated), in remission
C91.52Adult T-cell lymphoma/leukemia (HTLV-1-associated), in relapse
C91.60Prolymphocytic leukemia of T-cell type not having achieved remission
C91.61Prolymphocytic leukemia of T-cell type, in remission
C91.62Prolymphocytic leukemia of T-cell type, in relapse
C91.90Lymphoid leukemia, unspecified not having achieved remission
C91.91Lymphoid leukemia, unspecified, in remission
C91.92Lymphoid leukemia, unspecified, in relapse
C91.A0Mature B-cell leukemia Burkitt-type not having achieved remission
C91.A1Mature B-cell leukemia Burkitt-type, in remission
C91.A2Mature B-cell leukemia Burkitt-type, in relapse
C91.Z0Other lymphoid leukemia not having achieved remission
C91.Z1Other lymphoid leukemia, in remission
C91.Z2Other lymphoid leukemia, in relapse
C92.00Acute myeloblastic leukemia, not having achieved remission
C92.01Acute myeloblastic leukemia, in remission
C92.02Acute myeloblastic leukemia, in relapse
C92.10Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission
C92.11Chronic myeloid leukemia, BCR/ABL-positive, in remission
C92.12Chronic myeloid leukemia, BCR/ABL-positive, in relapse
C92.20Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission
C92.21Atypical chronic myeloid leukemia, BCR/ABL-negative, in remission
C92.22Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse
C92.30Myeloid sarcoma, not having achieved remission
C92.31Myeloid sarcoma, in remission
C92.32Myeloid sarcoma, in relapse
C92.40Acute promyelocytic leukemia, not having achieved remission
C92.41Acute promyelocytic leukemia, in remission
C92.42Acute promyelocytic leukemia, in relapse
C92.50Acute myelomonocytic leukemia, not having achieved remission
C92.51Acute myelomonocytic leukemia, in remission
C92.52Acute myelomonocytic leukemia, in relapse
C92.60Acute myeloid leukemia with 11q23-abnormality not having achieved remission
C92.61Acute myeloid leukemia with 11q23-abnormality in remission
C92.62Acute myeloid leukemia with 11q23-abnormality in relapse
C92.90Myeloid leukemia, unspecified, not having achieved remission
C92.91Myeloid leukemia, unspecified in remission
C92.92Myeloid leukemia, unspecified in relapse
C92.A0Acute myeloid leukemia with multilineage dysplasia, not having achieved remission
C92.A1Acute myeloid leukemia with multilineage dysplasia, in remission
C92.A2Acute myeloid leukemia with multilineage dysplasia, in relapse
C92.Z0Other myeloid leukemia not having achieved remission
C92.Z1Other myeloid leukemia, in remission
C92.Z2Other myeloid leukemia, in relapse
C93.00Acute monoblastic/monocytic leukemia, not having achieved remission
C93.01Acute monoblastic/monocytic leukemia, in remission
C93.02Acute monoblastic/monocytic leukemia, in relapse
C93.10Chronic myelomonocytic leukemia not having achieved remission
C93.11Chronic myelomonocytic leukemia, in remission
C93.12Chronic myelomonocytic leukemia, in relapse
C93.30Juvenile myelomonocytic leukemia, not having achieved remission
C93.31Juvenile myelomonocytic leukemia, in remission
C93.32Juvenile myelomonocytic leukemia, in relapse
C93.90Monocytic leukemia, unspecified, not having achieved remission
C93.91Monocytic leukemia, unspecified in remission
C93.92Monocytic leukemia, unspecified in relapse
C93.Z0Other monocytic leukemia, not having achieved remission
C93.Z1Other monocytic leukemia, in remission
C93.Z2Other monocytic leukemia, in relapse
C94.00Acute erythroid leukemia, not having achieved remission
C94.01Acute erythroid leukemia, in remission
C94.02Acute erythroid leukemia, in relapse
C94.20Acute megakaryoblastic leukemia not having achieved remission
C94.21Acute megakaryoblastic leukemia, in remission
C94.22Acute megakaryoblastic leukemia, in relapse
C94.30Mast cell leukemia not having achieved remission
C94.31Mast cell leukemia, in remission
C94.32Mast cell leukemia, in relapse
C94.40Acute panmyelosis with myelofibrosis not having achieved remission
C94.41Acute panmyelosis with myelofibrosis, in remission
C94.42Acute panmyelosis with myelofibrosis, in relapse
C94.6Myelodysplastic disease, not classified
C94.80Other specified leukemias not having achieved remission
C94.81Other specified leukemias, in remission
C94.82Other specified leukemias, in relapse
C95.00Acute leukemia of unspecified cell type not having achieved remission
C95.01Acute leukemia of unspecified cell type, in remission
C95.02Acute leukemia of unspecified cell type, in relapse
C95.10Chronic leukemia of unspecified cell type not having achieved remission
C95.11Chronic leukemia of unspecified cell type, in remission
C95.12Chronic leukemia of unspecified cell type, in relapse
C95.90Leukemia, unspecified not having achieved remission
C95.91Leukemia, unspecified, in remission
C95.92Leukemia, unspecified, in relapse
C96.0Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis
C96.20Malignant mast cell neoplasm, unspecified
C96.21Aggressive systemic mastocytosis
C96.22Mast cell sarcoma
C96.29Other malignant mast cell neoplasm
C96.4Sarcoma of dendritic cells (accessory cells)
C96.6Unifocal Langerhans-cell histiocytosis
C96.9Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified
C96.AHistiocytic sarcoma
C96.ZOther specified malignant neoplasms of lymphoid, hematopoietic and related tissue
D00.00Carcinoma in situ of oral cavity, unspecified site
D00.01Carcinoma in situ of labial mucosa and vermilion border
D00.02Carcinoma in situ of buccal mucosa
D00.03Carcinoma in situ of gingiva and edentulous alveolar ridge
D00.04Carcinoma in situ of soft palate
D00.05Carcinoma in situ of hard palate
D00.06Carcinoma in situ of floor of mouth
D00.07Carcinoma in situ of tongue
D00.08Carcinoma in situ of pharynx
D00.1Carcinoma in situ of esophagus
D00.2Carcinoma in situ of stomach
D01.0Carcinoma in situ of colon
D01.1Carcinoma in situ of rectosigmoid junction
D01.2Carcinoma in situ of rectum
D01.3Carcinoma in situ of anus and anal canal
D01.40Carcinoma in situ of unspecified part of intestine
D01.49Carcinoma in situ of other parts of intestine
D01.5Carcinoma in situ of liver, gallbladder and bile ducts
D01.7Carcinoma in situ of other specified digestive organs
D01.9Carcinoma in situ of digestive organ, unspecified
D02.0Carcinoma in situ of larynx
D02.1Carcinoma in situ of trachea
D02.20Carcinoma in situ of unspecified bronchus and lung
D02.21Carcinoma in situ of right bronchus and lung
D02.22Carcinoma in situ of left bronchus and lung
D02.3Carcinoma in situ of other parts of respiratory system
D02.4Carcinoma in situ of respiratory system, unspecified
D03.0Melanoma in situ of lip
D03.10Melanoma in situ of unspecified eyelid, including canthus
D03.111Melanoma in situ of right upper eyelid, including canthus
D03.112Melanoma in situ of right lower eyelid, including canthus
D03.121Melanoma in situ of left upper eyelid, including canthus
D03.122Melanoma in situ of left lower eyelid, including canthus
D03.20Melanoma in situ of unspecified ear and external auricular canal
D03.21Melanoma in situ of right ear and external auricular canal
D03.22Melanoma in situ of left ear and external auricular canal
D03.30Melanoma in situ of unspecified part of face
D03.39Melanoma in situ of other parts of face
D03.4Melanoma in situ of scalp and neck
D03.51Melanoma in situ of anal skin
D03.52Melanoma in situ of breast (skin) (soft tissue)
D03.59Melanoma in situ of other part of trunk
D03.60Melanoma in situ of unspecified upper limb, including shoulder
D03.61Melanoma in situ of right upper limb, including shoulder
D03.62Melanoma in situ of left upper limb, including shoulder
D03.70Melanoma in situ of unspecified lower limb, including hip
D03.71Melanoma in situ of right lower limb, including hip
D03.72Melanoma in situ of left lower limb, including hip
D03.8Melanoma in situ of other sites
D03.9Melanoma in situ, unspecified
D04.0Carcinoma in situ of skin of lip
D04.10Carcinoma in situ of skin of unspecified eyelid, including canthus
D04.111Carcinoma in situ of skin of right upper eyelid, including canthus
D04.112Carcinoma in situ of skin of right lower eyelid, including canthus
D04.121Carcinoma in situ of skin of left upper eyelid, including canthus
D04.122Carcinoma in situ of skin of left lower eyelid, including canthus
D04.20Carcinoma in situ of skin of unspecified ear and external auricular canal
D04.21Carcinoma in situ of skin of right ear and external auricular canal
D04.22Carcinoma in situ of skin of left ear and external auricular canal
D04.30Carcinoma in situ of skin of unspecified part of face
D04.39Carcinoma in situ of skin of other parts of face
D04.4Carcinoma in situ of skin of scalp and neck
D04.5Carcinoma in situ of skin of trunk
D04.60Carcinoma in situ of skin of unspecified upper limb, including shoulder
D04.61Carcinoma in situ of skin of right upper limb, including shoulder
D04.62Carcinoma in situ of skin of left upper limb, including shoulder
D04.70Carcinoma in situ of skin of unspecified lower limb, including hip
D04.71Carcinoma in situ of skin of right lower limb, including hip
D04.72Carcinoma in situ of skin of left lower limb, including hip
D04.8Carcinoma in situ of skin of other sites
D04.9Carcinoma in situ of skin, unspecified
D05.00Lobular carcinoma in situ of unspecified breast
D05.01Lobular carcinoma in situ of right breast
D05.02Lobular carcinoma in situ of left breast
D05.10Intraductal carcinoma in situ of unspecified breast
D05.11Intraductal carcinoma in situ of right breast
D05.12Intraductal carcinoma in situ of left breast
D05.80Other specified type of carcinoma in situ of unspecified breast
D05.81Other specified type of carcinoma in situ of right breast
D05.82Other specified type of carcinoma in situ of left breast
D05.90Unspecified type of carcinoma in situ of unspecified breast
D05.91Unspecified type of carcinoma in situ of right breast
D05.92Unspecified type of carcinoma in situ of left breast
D06.0Carcinoma in situ of endocervix
D06.1Carcinoma in situ of exocervix
D06.7Carcinoma in situ of other parts of cervix
D06.9Carcinoma in situ of cervix, unspecified
D07.0Carcinoma in situ of endometrium
D07.1Carcinoma in situ of vulva
D07.2Carcinoma in situ of vagina
D07.30Carcinoma in situ of unspecified female genital organs
D07.39Carcinoma in situ of other female genital organs
D07.4Carcinoma in situ of penis
D07.5Carcinoma in situ of prostate
D07.60Carcinoma in situ of unspecified male genital organs
D07.61Carcinoma in situ of scrotum
D07.69Carcinoma in situ of other male genital organs
D09.0Carcinoma in situ of bladder
D09.10Carcinoma in situ of unspecified urinary organ
D09.19Carcinoma in situ of other urinary organs
D09.20Carcinoma in situ of unspecified eye
D09.21Carcinoma in situ of right eye
D09.22Carcinoma in situ of left eye
D09.3Carcinoma in situ of thyroid and other endocrine glands
D09.8Carcinoma in situ of other specified sites
D09.9Carcinoma in situ, unspecified
D10.0Benign neoplasm of lip
D10.1Benign neoplasm of tongue
D10.2Benign neoplasm of floor of mouth
D10.30Benign neoplasm of unspecified part of mouth
D10.39Benign neoplasm of other parts of mouth
D10.4Benign neoplasm of tonsil
D10.5Benign neoplasm of other parts of oropharynx
D10.6Benign neoplasm of nasopharynx
D10.7Benign neoplasm of hypopharynx
D10.9Benign neoplasm of pharynx, unspecified
D11.0Benign neoplasm of parotid gland
D11.7Benign neoplasm of other major salivary glands
D11.9Benign neoplasm of major salivary gland, unspecified
D12.0Benign neoplasm of cecum
D12.1Benign neoplasm of appendix
D12.2Benign neoplasm of ascending colon
D12.3Benign neoplasm of transverse colon
D12.4Benign neoplasm of descending colon
D12.5Benign neoplasm of sigmoid colon
D12.6Benign neoplasm of colon, unspecified
D12.7Benign neoplasm of rectosigmoid junction
D12.8Benign neoplasm of rectum
D12.9Benign neoplasm of anus and anal canal
D13.0Benign neoplasm of esophagus
D13.1Benign neoplasm of stomach
D13.2Benign neoplasm of duodenum
D13.30Benign neoplasm of unspecified part of small intestine
D13.39Benign neoplasm of other parts of small intestine
D13.4Benign neoplasm of liver
D13.5Benign neoplasm of extrahepatic bile ducts
D13.6Benign neoplasm of pancreas
D13.7Benign neoplasm of endocrine pancreas
D13.9Benign neoplasm of ill-defined sites within the digestive system
D14.0Benign neoplasm of middle ear, nasal cavity and accessory sinuses
D14.1Benign neoplasm of larynx
D14.2Benign neoplasm of trachea
D14.30Benign neoplasm of unspecified bronchus and lung
D14.31Benign neoplasm of right bronchus and lung
D14.32Benign neoplasm of left bronchus and lung
D14.4Benign neoplasm of respiratory system, unspecified
D15.0Benign neoplasm of thymus
D15.1Benign neoplasm of heart
D15.2Benign neoplasm of mediastinum
D15.7Benign neoplasm of other specified intrathoracic organs
D15.9Benign neoplasm of intrathoracic organ, unspecified
D16.00Benign neoplasm of scapula and long bones of unspecified upper limb
D16.01Benign neoplasm of scapula and long bones of right upper limb
D16.02Benign neoplasm of scapula and long bones of left upper limb
D16.10Benign neoplasm of short bones of unspecified upper limb
D16.11Benign neoplasm of short bones of right upper limb
D16.12Benign neoplasm of short bones of left upper limb
D16.20Benign neoplasm of long bones of unspecified lower limb
D16.21Benign neoplasm of long bones of right lower limb
D16.22Benign neoplasm of long bones of left lower limb
D16.30Benign neoplasm of short bones of unspecified lower limb
D16.31Benign neoplasm of short bones of right lower limb
D16.32Benign neoplasm of short bones of left lower limb
D16.4Benign neoplasm of bones of skull and face
D16.5Benign neoplasm of lower jaw bone
D16.6Benign neoplasm of vertebral column
D16.7Benign neoplasm of ribs, sternum and clavicle
D16.8Benign neoplasm of pelvic bones, sacrum and coccyx
D16.9Benign neoplasm of bone and articular cartilage, unspecified
D17.0Benign lipomatous neoplasm of skin and subcutaneous tissue of head, face and neck
D17.1Benign lipomatous neoplasm of skin and subcutaneous tissue of trunk
D17.20Benign lipomatous neoplasm of skin and subcutaneous tissue of unspecified limb
D17.21Benign lipomatous neoplasm of skin and subcutaneous tissue of right arm
D17.22Benign lipomatous neoplasm of skin and subcutaneous tissue of left arm
D17.23Benign lipomatous neoplasm of skin and subcutaneous tissue of right leg
D17.24Benign lipomatous neoplasm of skin and subcutaneous tissue of left leg
D17.30Benign lipomatous neoplasm of skin and subcutaneous tissue of unspecified sites
D17.39Benign lipomatous neoplasm of skin and subcutaneous tissue of other sites
D17.4Benign lipomatous neoplasm of intrathoracic organs
D17.5Benign lipomatous neoplasm of intra-abdominal organs
D17.6Benign lipomatous neoplasm of spermatic cord
D17.71Benign lipomatous neoplasm of kidney
D17.72Benign lipomatous neoplasm of other genitourinary organ
D17.79Benign lipomatous neoplasm of other sites
D17.9Benign lipomatous neoplasm, unspecified
D18.00Hemangioma unspecified site
D18.01Hemangioma of skin and subcutaneous tissue
D18.02Hemangioma of intracranial structures
D18.03Hemangioma of intra-abdominal structures
D18.09Hemangioma of other sites
D18.1Lymphangioma, any site
D19.0Benign neoplasm of mesothelial tissue of pleura
D19.1Benign neoplasm of mesothelial tissue of peritoneum
D19.7Benign neoplasm of mesothelial tissue of other sites
D19.9Benign neoplasm of mesothelial tissue, unspecified
D20.0Benign neoplasm of soft tissue of retroperitoneum
D20.1Benign neoplasm of soft tissue of peritoneum
D21.0Benign neoplasm of connective and other soft tissue of head, face and neck
D21.10Benign neoplasm of connective and other soft tissue of unspecified upper limb, including shoulder
D21.11Benign neoplasm of connective and other soft tissue of right upper limb, including shoulder
D21.12Benign neoplasm of connective and other soft tissue of left upper limb, including shoulder
D21.20Benign neoplasm of connective and other soft tissue of unspecified lower limb, including hip
D21.21Benign neoplasm of connective and other soft tissue of right lower limb, including hip
D21.22Benign neoplasm of connective and other soft tissue of left lower limb, including hip
D21.3Benign neoplasm of connective and other soft tissue of thorax
D21.4Benign neoplasm of connective and other soft tissue of abdomen
D21.5Benign neoplasm of connective and other soft tissue of pelvis
D21.6Benign neoplasm of connective and other soft tissue of trunk, unspecified
D21.9Benign neoplasm of connective and other soft tissue, unspecified
D22.0Melanocytic nevi of lip
D22.10Melanocytic nevi of unspecified eyelid, including canthus
D22.111Melanocytic nevi of right upper eyelid, including canthus
D22.112Melanocytic nevi of right lower eyelid, including canthus
D22.121Melanocytic nevi of left upper eyelid, including canthus
D22.122Melanocytic nevi of left lower eyelid, including canthus
D22.20Melanocytic nevi of unspecified ear and external auricular canal
D22.21Melanocytic nevi of right ear and external auricular canal
D22.22Melanocytic nevi of left ear and external auricular canal
D22.30Melanocytic nevi of unspecified part of face
D22.39Melanocytic nevi of other parts of face
D22.4Melanocytic nevi of scalp and neck
D22.5Melanocytic nevi of trunk
D22.60Melanocytic nevi of unspecified upper limb, including shoulder
D22.61Melanocytic nevi of right upper limb, including shoulder
D22.62Melanocytic nevi of left upper limb, including shoulder
D22.70Melanocytic nevi of unspecified lower limb, including hip
D22.71Melanocytic nevi of right lower limb, including hip
D22.72Melanocytic nevi of left lower limb, including hip
D22.9Melanocytic nevi, unspecified
D23.0Other benign neoplasm of skin of lip
D23.10Other benign neoplasm of skin of unspecified eyelid, including canthus
D23.111Other benign neoplasm of skin of right upper eyelid, including canthus
D23.112Other benign neoplasm of skin of right lower eyelid, including canthus
D23.121Other benign neoplasm of skin of left upper eyelid, including canthus
D23.122Other benign neoplasm of skin of left lower eyelid, including canthus
D23.20Other benign neoplasm of skin of unspecified ear and external auricular canal
D23.21Other benign neoplasm of skin of right ear and external auricular canal
D23.22Other benign neoplasm of skin of left ear and external auricular canal
D23.30Other benign neoplasm of skin of unspecified part of face
D23.39Other benign neoplasm of skin of other parts of face
D23.4Other benign neoplasm of skin of scalp and neck
D23.5Other benign neoplasm of skin of trunk
D23.60Other benign neoplasm of skin of unspecified upper limb, including shoulder
D23.61Other benign neoplasm of skin of right upper limb, including shoulder
D23.62Other benign neoplasm of skin of left upper limb, including shoulder
D23.70Other benign neoplasm of skin of unspecified lower limb, including hip
D23.71Other benign neoplasm of skin of right lower limb, including hip
D23.72Other benign neoplasm of skin of left lower limb, including hip
D23.9Other benign neoplasm of skin, unspecified
D24.1Benign neoplasm of right breast
D24.2Benign neoplasm of left breast
D24.9Benign neoplasm of unspecified breast
D25.0Submucous leiomyoma of uterus
D25.1Intramural leiomyoma of uterus
D25.2Subserosal leiomyoma of uterus
D25.9Leiomyoma of uterus, unspecified
D26.0Other benign neoplasm of cervix uteri
D26.1Other benign neoplasm of corpus uteri
D26.7Other benign neoplasm of other parts of uterus
D26.9Other benign neoplasm of uterus, unspecified
D27.0Benign neoplasm of right ovary
D27.1Benign neoplasm of left ovary
D27.9Benign neoplasm of unspecified ovary
D28.0Benign neoplasm of vulva
D28.1Benign neoplasm of vagina
D28.2Benign neoplasm of uterine tubes and ligaments
D28.7Benign neoplasm of other specified female genital organs
D28.9Benign neoplasm of female genital organ, unspecified
D29.0Benign neoplasm of penis
D29.1Benign neoplasm of prostate
D29.20Benign neoplasm of unspecified testis
D29.21Benign neoplasm of right testis
D29.22Benign neoplasm of left testis
D29.30Benign neoplasm of unspecified epididymis
D29.31Benign neoplasm of right epididymis
D29.32Benign neoplasm of left epididymis
D29.4Benign neoplasm of scrotum
D29.8Benign neoplasm of other specified male genital organs
D29.9Benign neoplasm of male genital organ, unspecified
D30.00Benign neoplasm of unspecified kidney
D30.01Benign neoplasm of right kidney
D30.02Benign neoplasm of left kidney
D30.10Benign neoplasm of unspecified renal pelvis
D30.11Benign neoplasm of right renal pelvis
D30.12Benign neoplasm of left renal pelvis
D30.20Benign neoplasm of unspecified ureter
D30.21Benign neoplasm of right ureter
D30.22Benign neoplasm of left ureter
D30.3Benign neoplasm of bladder
D30.4Benign neoplasm of urethra
D30.8Benign neoplasm of other specified urinary organs
D30.9Benign neoplasm of urinary organ, unspecified
D31.00Benign neoplasm of unspecified conjunctiva
D31.01Benign neoplasm of right conjunctiva
D31.02Benign neoplasm of left conjunctiva
D31.10Benign neoplasm of unspecified cornea
D31.11Benign neoplasm of right cornea
D31.12Benign neoplasm of left cornea
D31.20Benign neoplasm of unspecified retina
D31.21Benign neoplasm of right retina
D31.22Benign neoplasm of left retina
D31.30Benign neoplasm of unspecified choroid
D31.31Benign neoplasm of right choroid
D31.32Benign neoplasm of left choroid
D31.40Benign neoplasm of unspecified ciliary body
D31.41Benign neoplasm of right ciliary body
D31.42Benign neoplasm of left ciliary body
D31.50Benign neoplasm of unspecified lacrimal gland and duct
D31.51Benign neoplasm of right lacrimal gland and duct
D31.52Benign neoplasm of left lacrimal gland and duct
D31.60Benign neoplasm of unspecified site of unspecified orbit
D31.61Benign neoplasm of unspecified site of right orbit
D31.62Benign neoplasm of unspecified site of left orbit
D31.90Benign neoplasm of unspecified part of unspecified eye
D31.91Benign neoplasm of unspecified part of right eye
D31.92Benign neoplasm of unspecified part of left eye
D32.0Benign neoplasm of cerebral meninges
D32.1Benign neoplasm of spinal meninges
D32.9Benign neoplasm of meninges, unspecified
D33.0Benign neoplasm of brain, supratentorial
D33.1Benign neoplasm of brain, infratentorial
D33.2Benign neoplasm of brain, unspecified
D33.3Benign neoplasm of cranial nerves
D33.4Benign neoplasm of spinal cord
D33.7Benign neoplasm of other specified parts of central nervous system
D33.9Benign neoplasm of central nervous system, unspecified
D34Benign neoplasm of thyroid gland
D35.00Benign neoplasm of unspecified adrenal gland
D35.01Benign neoplasm of right adrenal gland
D35.02Benign neoplasm of left adrenal gland
D35.1Benign neoplasm of parathyroid gland
D35.2Benign neoplasm of pituitary gland
D35.3Benign neoplasm of craniopharyngeal duct
D35.4Benign neoplasm of pineal gland
D35.5Benign neoplasm of carotid body
D35.6Benign neoplasm of aortic body and other paraganglia
D35.7Benign neoplasm of other specified endocrine glands
D35.9Benign neoplasm of endocrine gland, unspecified
D36.0Benign neoplasm of lymph nodes
D36.10Benign neoplasm of peripheral nerves and autonomic nervous system, unspecified
D36.11Benign neoplasm of peripheral nerves and autonomic nervous system of face, head, and neck
D36.12Benign neoplasm of peripheral nerves and autonomic nervous system, upper limb, including shoulder
D36.13Benign neoplasm of peripheral nerves and autonomic nervous system of lower limb, including hip
D36.14Benign neoplasm of peripheral nerves and autonomic nervous system of thorax
D36.15Benign neoplasm of peripheral nerves and autonomic nervous system of abdomen
D36.16Benign neoplasm of peripheral nerves and autonomic nervous system of pelvis
D36.17Benign neoplasm of peripheral nerves and autonomic nervous system of trunk, unspecified
D36.7Benign neoplasm of other specified sites
D36.9Benign neoplasm, unspecified site
D37.01Neoplasm of uncertain behavior of lip
D37.02Neoplasm of uncertain behavior of tongue
D37.030Neoplasm of uncertain behavior of the parotid salivary glands
D37.031Neoplasm of uncertain behavior of the sublingual salivary glands
D37.032Neoplasm of uncertain behavior of the submandibular salivary glands
D37.039Neoplasm of uncertain behavior of the major salivary glands, unspecified
D37.04Neoplasm of uncertain behavior of the minor salivary glands
D37.05Neoplasm of uncertain behavior of pharynx
D37.09Neoplasm of uncertain behavior of other specified sites of the oral cavity
D37.1Neoplasm of uncertain behavior of stomach