All HCPCS and CPT Drug Codes

This is the complete list of codes on BuyandBill.com, spanning HCPCS J, A, C, P, Q, S, and NOC codes alongside CPT vaccine and drug administration codes.

Q5126

Sponsored

HCPCS Descriptor: Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg
Manufacturer: Amneal Pharmaceuticals
Class: Oncology
NDCs: 4

Q5169

Sponsored

HCPCS Descriptor: Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg
Manufacturer: Valorum Biologics
Class: Oncology Colony Stimulating Factor
NDC: 1

0.5 mg per unit

J9184

Sponsored

HCPCS Descriptor: Injection, gemcitabine hydrochloride (avyxa), 200 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

200 mg per unit

J9186

Sponsored

HCPCS Descriptor: Injection, etoposide (avyxa), 1 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

J9292

Sponsored

HCPCS Descriptor: Injection, pemetrexed dipotassium, 10 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

J1952

Sponsored

HCPCS Descriptor: Leuprolide injectable, camcevi, 1 mg
Manufacturer: Accord
Class: Oncology
NDCs: 2

J9072

CYCLOPHOSPHAMIDE (AVYXA)

Sponsored

HCPCS Descriptor: Injection, cyclophosphamide (frindovyx), 5 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 6

J9172

Sponsored

HCPCS Descriptor: Injection, docetaxel (docivyx), 1 mg
Manufacturer: Avyxa Pharma
Class: Antibiotic
NDCs: 3

J2789

Epioxa HD/Epioxa

Sponsored

HCPCS Descriptor: Riboflavin 5'-phosphate, ophthalmic solution (epioxahd/epioxa), up to 2 ml
Manufacturer: Glaukos
Class: Ophthalmology
NDC: 1

up to 2 ml per unit

J9191

Sponsored

HCPCS Descriptor: Injection, fluorouracil (avyxa), 10 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

Q5172

Sponsored

HCPCS Descriptor: Injection, filgrastim-laha (filkri), biosimilar, 1 microgram
Manufacturer: Accord
Class: Oncology Colony Stimulating Factor
NDCs: 4

Q5146

Sponsored

HCPCS Descriptor: Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg
Manufacturer: Accord
Class: Oncology
NDCs: 3

Q5098

Sponsored

HCPCS Descriptor: Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg
Manufacturer: Accord
Class: Immunology
NDCs: 3

J1439

Sponsored

HCPCS Descriptor: Injection, ferric carboxymaltose, 1 mg
Manufacturer: American Regent
Class: Anti-Anemia
NDCs: 4

Q5136

Sponsored

HCPCS Descriptor: Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg
Manufacturer: Sandoz
Class: Osteoporosis
NDCs: 2

J9278

Sponsored

HCPCS Descriptor: Injection, carboplatin (avyxa), 1 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

J1954

Sponsored

HCPCS Descriptor: Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

7.5 mg per unit

J9601

Sponsored

HCPCS Descriptor: Injection, linvoseltamab-gcpt, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Oncology
NDCs: 2

J3490

Fosaprepitant

Sponsored

Manufacturer: Avyxa Pharma
NDC: 1

J9038

Sponsored

HCPCS Descriptor: Injection, axatilimab-csfr, 0.1 mg
Manufacturer: Incyte
Class: Oncology
NDCs: 4

0.1 mg per unit

Q5148

Sponsored

HCPCS Descriptor: Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram
Manufacturer: Cipla
Class: Oncology Colony Stimulating Factor
NDCs: 8

Q5154

Sponsored

HCPCS Descriptor: Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg
Manufacturer: Celltrion USA
Class: Immunology
NDCs: 3

Q5166

Sponsored

HCPCS Descriptor: Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mg
Manufacturer: Accord
Class: Osteoporosis
NDCs: 2

J7300

Sponsored

HCPCS Descriptor: Intrauterine copper contraceptive (paragard)
Manufacturer: Cooper Surgical
Class: Contraceptive
NDCs: 2

per dose per unit

J2468

Sponsored

HCPCS Descriptor: Injection, palonosetron hydrochloride (posfrea), 25 micrograms
Manufacturer: Avyxa Pharma
Class: Anti-Emetic
NDC: 1

25 mcg per unit

J9318

Sponsored

HCPCS Descriptor: Injection, romidepsin, non-lyophilized, 0.1 mg
Manufacturer: Amneal Pharmaceuticals
Class: Oncology
NDCs: 2

0.1 mg per unit

J9361

Sponsored

HCPCS Descriptor: Injection, efbemalenograstim alfa-vuxw, 0.5 mg
Manufacturer: Acrotech Biopharma
Class: Oncologic Supportive Care
NDC: 1

0.5 mg per unit

Q5134

Sponsored

HCPCS Descriptor: Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg
Manufacturer: Sandoz
Class: Immunology
NDC: 1

Q5111

Sponsored

HCPCS Descriptor: Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
Manufacturer: Accord
Class: Oncology Colony Stimulating Factor
NDCs: 6

0.5 mg per unit

J1756

Sponsored

HCPCS Descriptor: Injection, iron sucrose, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Anemia
NDCs: 26

J0644

Sponsored

HCPCS Descriptor: Injection, leucovorin calcium (avyxa), 1 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 3

Q5136

Sponsored

HCPCS Descriptor: Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg
Manufacturer: Sandoz
Class: Osteoporosis
NDCs: 2

J9202

Sponsored

HCPCS Descriptor: Goserelin acetate implant, per 3.6 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 2

3.6 mg per unit

J0130

HCPCS Descriptor: Injection abciximab, 10 mg
Class: Cardiology

Q2055

HCPCS Descriptor: Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: BMS
Class: Oncology
NDCs: 3

up to 510 million autologous anti-bcma car-positive viable t cells per unit

J0287

HCPCS Descriptor: Injection, amphotericin b lipid complex, 10 mg
Manufacturer: Leadiant
Class: Anti-Fungal
NDC: 1

J0402

ABILIFY ASIMTUFII

HCPCS Descriptor: Injection, aripiprazole (abilify asimtufii), 1 mg
Manufacturer: Otsuka
Class: Psychiatric
NDCs: 2

J0401

ABILIFY MAINTENA

HCPCS Descriptor: Injection, aripiprazole (abilify maintena), 1 mg
Manufacturer: Otsuka
Class: Psychiatric
NDCs: 8

J9264

HCPCS Descriptor: Injection, paclitaxel protein-bound particles, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 10

Q5145

HCPCS Descriptor: Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg
Manufacturer: Pfizer
Class: Immunology: Anti-TNF
NDCs: 4

90678

HCPCS Descriptor: Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use
Manufacturer: Pfizer
Class: Vaccine
NDCs: 3

per dose per unit

Q4118

ACELL MICROMATRIX 20MG

HCPCS Descriptor: Matristem micromatrix, 1 mg
Manufacturer: Acell
Class: Wound Care
NDCs: 8

J0132

HCPCS Descriptor: Injection, acetylcysteine, 100 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 13

100 mg per unit

J0134

HCPCS Descriptor: Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg
Manufacturer: Fresenius Kabi
Class: Non-Opioid Analgesic
NDCs: 2

J0136

HCPCS Descriptor: Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg
Manufacturer: Multiple Manufacturers
Class: Non-Opioid Analgesic
NDCs: 4

J0137

HCPCS Descriptor: Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg
Manufacturer: Hikma
Class: Non-Opioid Analgesic
NDCs: 2

J1120

HCPCS Descriptor: Injection, acetazolamide sodium, up to 500 mg
Manufacturer: Multiple Manufacturers
Class: Ophthalmology
NDCs: 7

500 mg per unit

J7608

HCPCS Descriptor: Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 24

J3262

HCPCS Descriptor: Injection, tocilizumab, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunology: Anti-TNF
NDCs: 5

Q0249

HCPCS Descriptor: Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Manufacturer: Multiple Manufacturers
Class: COVID-19
NDCs: 5

90648

HCPCS Descriptor: Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 2

per dose per unit

J9216

HCPCS Descriptor: Injection, interferon, gamma 1-b, 3 million units
Manufacturer: Amgen
Class: Oncology
NDCs: 2

3 million units per unit

J2997

HCPCS Descriptor: Injection, alteplase recombinant, 1 mg
Manufacturer: Genentech
Class: Cardiology
NDCs: 4

J0133

ACYCLOVIR SODIUM

HCPCS Descriptor: Injection, acyclovir, 5 mg
Manufacturer: Multiple Manufacturers
Class: Antiviral
NDCs: 14

90715

HCPCS Descriptor: Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 9

0.5 ml per unit

J0791

HCPCS Descriptor: Injection, crizanlizumab-tmca, 5 mg
Manufacturer: Novartis
Class: Anti-Emetic
NDC: 1

J2062

HCPCS Descriptor: Loxapine for inhalation, 1 mg
Manufacturer: Galen Pharma
Class: Psychiatric
NDCs: 2

J9042

HCPCS Descriptor: Injection, brentuximab vedotin, 1 mg
Manufacturer: Pfizer
Class: Oncology
NDC: 1

J0153

HCPCS Descriptor: Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 31

20610

Administration Code

HCPCS Descriptor: Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance

J0163

HCPCS Descriptor: Injection, epinephrine in sodium chloride (endo), 0.1 mg
Manufacturer: Endo USA
Class: Cardiology
NDCs: 10

0.1 mg per unit

J0169

HCPCS Descriptor: Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg
Manufacturer: Endo USA
Class: Cardiology
NDCs: 2

0.1 mg per unit

A9582

HCPCS Descriptor: Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

up to 15 millicuries per unit

J9000

HCPCS Descriptor: Injection, doxorubicin hydrochloride, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 46

J9029

HCPCS Descriptor: Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose
Manufacturer: Ferring Pharmaceuticals
Class: Oncology
NDCs: 2

per therapeutic dose per unit

J7192

HCPCS Descriptor: Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 17

J7207

HCPCS Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDCs: 14

J7171

HCPCS Descriptor: Injection, adamts13, recombinant-krhn, 10 iu
Manufacturer: Takeda Pharmaceuticals
Class: Anti-Eosinophil Asthma
NDCs: 2

10 units per unit

Q4159

HCPCS Descriptor: Affinity, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Organogenesis
Class: Wound Care
NDCs: 2

1 sq cm per unit

J7527

HCPCS Descriptor: Everolimus, oral, 0.25 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 104

0.25 mg per unit

90655

Afluria Preservative Free

HCPCS Descriptor: Trivalent, split-virus, preservative-free influenza vaccine (IIV3), IM use
Manufacturer: Seqirus
Class: Vaccine
NDC: 1

per dose per unit

90687

AFLURIA QUADRIVALENT 0.25ML (2019/2020)

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use
Manufacturer: Seqirus
Class: Vaccine
NDCs: 2

0.25 ml per unit

90685

AFLURIA QUADRIVALENT 2023-2024 FORMULA PF

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use
Manufacturer: Seqirus Inc
Class: Vaccine
NDC: 1

0.25 ml per unit

90673

AFLURIA TRIVALENT (2024/2025)

HCPCS Descriptor: Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 3

0.5 ml per unit

J7210

HCPCS Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.
Manufacturer: CSL Behring
Class: Hematology
NDCs: 8

J3246

HCPCS Descriptor: Injection, tirofiban hcl, 0.25 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 12

0.25 mg per unit

Q5150

HCPCS Descriptor: Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg
Manufacturer: Formycon AG
Class: Ophthalmology

J3031

HCPCS Descriptor: Injection, 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)
Manufacturer: Teva
Class: Neurology
NDCs: 3

J1454

HCPCS Descriptor: Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
Manufacturer: Helsinn Therapeutics US
Class: Anti-Emetic
NDCs: 3

0.25 mg per unit

J8655

HCPCS Descriptor: Netupitant 300 mg and palonosetron 0.5 mg, oral
Manufacturer: Helsinn Therapeutics US
Class: Anti-Emetic
NDC: 1

300 mg/0.5 mg per unit

P9046

HCPCS Descriptor: Infusion, albumin (human), 25%, 20 ml
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 17

P9047

HCPCS Descriptor: Infusion, albumin (human), 25%, 50 ml
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 18

P9045

HCPCS Descriptor: Infusion, albumin (human), 5%, 250 ml
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 13

250 ml per unit

P9041

Albumin (Human)

HCPCS Descriptor: Infusion, albumin (human), 5%, 50 ml
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 14

J7609

HCPCS Descriptor: Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg
Class: Respiratory

J7610

HCPCS Descriptor: Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg
Class: Respiratory

J7620

Albuterol ipratropium

HCPCS Descriptor: Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 26

2.5 mg/0.5 mg per unit

J7611

ALBUTEROL SULFATE

HCPCS Descriptor: Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 4

J7613

ALBUTEROL SULFATE

HCPCS Descriptor: Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 46

J1931

HCPCS Descriptor: Injection, laronidase, 0.1 mg
Manufacturer: Sanofi
Class: Enzyme Replacement Therapy
NDC: 1

0.1 mg per unit

J0216

HCPCS Descriptor: Injection, alfentanil hydrochloride, 500 micrograms
Manufacturer: AKORN
Class: Opioid Analgesic
NDCs: 2

500 mcg per unit

NOC ALFENTANIL H

HCPCS Descriptor: Alfentanil Hcl 500 MCG
Manufacturer: Akorn

500 mcg per unit

J9215

HCPCS Descriptor: Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu
Manufacturer: HEMISPHERX BIOPHARMA, INC.
Class: Immunology
NDC: 1

250,000 iu per unit

J0220

ALGLUCOSIDASE ALFA

HCPCS Descriptor: Injection, alglucosidase alfa, 10 mg, not otherwise specified
Class: Enzyme Replacement Therapy

J7173

HCPCS Descriptor: Injection, concizumab-mtci, 0.5 mg
Manufacturer: Novo Nordisk
Class: Hematology
NDCs: 3

0.5 mg per unit

J9305

HCPCS Descriptor: Injection, pemetrexed, not otherwise specified, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 46

J9057

HCPCS Descriptor: Injection, copanlisib, 1 mg
Manufacturer: Bayer
Class: Oncology
NDC: 1

J8600

HCPCS Descriptor: Melphalan; oral, 2 mg
Manufacturer: ApoPharma
Class: Oncology
NDC: 1

J9245

HCPCS Descriptor: Injection, melphalan hydrochloride, not otherwise specified, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 18

J0206

HCPCS Descriptor: Injection, allopurinol sodium, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 3

NOC ALLOPURINOL

Allopurinol Sodium

HCPCS Descriptor: Allopurinol Sodium,500 MG
Manufacturer: Hikma Pharmaceuticals

500 mg per unit

J7186

HCPCS Descriptor: Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.
Manufacturer: Grifols
Class: Hematology
NDCs: 10

per factor viii iu per unit

J7190

HCPCS Descriptor: Factor viii (antihemophilic factor, human) per i.u.
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 16

J7193

HCPCS Descriptor: Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.
Manufacturer: Grifols
Class: Hematology
NDCs: 3

J7201

HCPCS Descriptor: Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.
Manufacturer: Sanofi
Class: Hematology
NDCs: 6

J7214

HCPCS Descriptor: Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
Manufacturer: Sanofi
Class: Hematology
NDCs: 12

J1552

HCPCS Descriptor: Injection, immune globulin (alyglo), 500 mg
Manufacturer: GC Biopharma
Class: Hematology
NDCs: 6

500 mg per unit

J0289

HCPCS Descriptor: Injection, amphotericin b liposome, 10 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 5

J7345

HCPCS Descriptor: Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg
Manufacturer: Biofrontera
Class: Misc.
NDCs: 3

J0278

AMIKACIN SULFATE

HCPCS Descriptor: Injection, amikacin sulfate, 100 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 17

100 mg per unit

J0281

AMINOCAPROIC ACID

HCPCS Descriptor: Injection, aminocaproic acid, 1 gram
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 7

NOC AMINOCAPROIC

Aminocaproic Acid

HCPCS Descriptor: Aminocaproic acid, 250 MG
Manufacturer: Multiple Manufacturers

250 mg per unit

J0280

HCPCS Descriptor: Injection, aminophyllin, up to 250 mg
Manufacturer: Pfizer
Class: Respiratory
NDCs: 4

250 mg per unit

J0282

HCPCS Descriptor: Injection, amiodarone hydrochloride, 30 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 20

J1320

AMITRIPTYLINE HCL

HCPCS Descriptor: Injection, amitriptyline hcl, up to 20 mg
Class: Psychiatric

J1426

HCPCS Descriptor: Injection, casimersen, 10 mg
Manufacturer: Sarepta Therapeutics
Class: Genetic Disorder
NDC: 1

J3470

HCPCS Descriptor: Injection, hyaluronidase, up to 150 units
Manufacturer: Amphastar Pharmaceuticals
Class: Misc.
NDC: 1

150 units per unit

J0285

HCPCS Descriptor: Injection, amphotericin b, 50 mg
Manufacturer: XGen Pharmaceuticals DJB
Class: Anti-Fungal
NDC: 1

J0290

HCPCS Descriptor: Injection, ampicillin sodium, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 102

500 mg per unit

J0295

Ampicillin-Sulbactam

HCPCS Descriptor: Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 72

1.5 gm per unit

J0225

HCPCS Descriptor: Injection, vutrisiran, 1 mg
Manufacturer: Alnylam Pharmaceuticals
Class: Genetic Disorder
NDC: 1

J0300

HCPCS Descriptor: Injection, amobarbital, up to 125 mg
Manufacturer: BAUSCH HEALTH US
Class: Sedative
NDC: 1

125 mg per unit

A9586

HCPCS Descriptor: Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
Manufacturer: Eli Lilly and Company
Class: Imaging/Radiopharmaceutical
NDC: 1

up to 10 mci per unit

J0716

HCPCS Descriptor: Injection, centruroides immune f(ab)2, up to 120 milligrams
Manufacturer: Rare Disease Therapeutics
Class: Immunology
NDC: 1

up to 120 mg per unit

J0841

HCPCS Descriptor: Injection, crotalidae immune f(ab')2 (equine), 120 mg
Manufacturer: Rare Disease Therapeutics
Class: Immunology
NDCs: 2

120 mg per unit

J7169

HCPCS Descriptor: Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg
Manufacturer: AstraZeneca
Class: Hematology
NDCs: 2

J0583

HCPCS Descriptor: Injection, bivalirudin, 1 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 21

J1738

HCPCS Descriptor: Injection, meloxicam, 1 mg
Manufacturer: Baudax Bio, Inc.
Class: Non-Opioid Analgesic

J9028

HCPCS Descriptor: Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram
Manufacturer: ImmunityBio
Class: Oncology
NDC: 1

J7294

HCPCS Descriptor: Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each
Manufacturer: TherapeuticsMD
Class: Contraceptive
NDC: 1

66030

Anterior Chamber Eye Injection

HCPCS Descriptor: Injection, anterior chamber of eye (separate procedure); medication

J7196

ANTITHROMBIN RECOMBINANT

HCPCS Descriptor: Injection, antithrombin recombinant, 50 i.u.
Class: Hematology

50 i.u. per unit

J1260

HCPCS Descriptor: Injection, dolasetron mesylate, 10 mg
Manufacturer: Sanofi
Class: Anti-Emetic
NDCs: 3

Q0180

HCPCS Descriptor: Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Manufacturer: Sanofi
Class: Anti-Emetic
NDCs: 2

100 mg per unit

J2277

HCPCS Descriptor: Injection, motixafortide, 0.25 mg
Manufacturer: BioLineRx
Class: Oncology
NDCs: 2

0.25 mg per unit

J1815

HCPCS Descriptor: Injection, insulin, per 5 units
Manufacturer: Multiple Manufacturers
Class: Insulin
NDCs: 12

5 units per unit

Q4101

HCPCS Descriptor: Apligraf, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Organogenesis
Class: Wound Care
NDC: 1

1 sq cm per unit

J0364

HCPCS Descriptor: Injection, apomorphine hydrochloride, 1 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 4

J8502

HCPCS Descriptor: Injection, aprepitant (aponvie), 1 mg
Manufacturer: Heron Therapeutics
Class: Anti-Emetic
NDCs: 2

96377

Application Of On-Body Injector

HCPCS Descriptor: Application of on-body injector (includes cannula insertion) for timed subcutaneous injection

J2374

Apraclonidine HCL

HCPCS Descriptor: Apraclonidine hydrochloride ophthalmic, 1% solution, 0.1 ml
Manufacturer: Harrow Eye
Class: Ophthalmology
NDCs: 2

0.1 ml per unit

J8501

HCPCS Descriptor: Aprepitant, oral, 5 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 33

J0739

HCPCS Descriptor: Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Manufacturer: GlaxoSmithKline
Class: Anti-HIV
NDC: 1

J0256

HCPCS Descriptor: Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg
Manufacturer: Multiple Manufacturers
Class: Enzyme Replacement Therapy
NDCs: 8

J0881

HCPCS Descriptor: Injection, darbepoetin alfa, 1 microgram (non-esrd use)
Manufacturer: Amgen
Class: Oncology Colony Stimulating Factor
NDCs: 25

J0882

HCPCS Descriptor: Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)
Manufacturer: Amgen
Class: Oncology
NDCs: 25

J2793

HCPCS Descriptor: Injection, rilonacept, 1 mg
Manufacturer: Kiniksa Pharmaceuticals
Class: Immunology
NDC: 1

90679

HCPCS Descriptor: Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

J0883

HCPCS Descriptor: Injection, argatroban, 1 mg (for non-esrd use)
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 12

J0884

HCPCS Descriptor: Injection, argatroban, 1 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 12

J0891

HCPCS Descriptor: Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)
Manufacturer: Accord
Class: Hematology
NDC: 1

J0892

HCPCS Descriptor: Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)
Manufacturer: Accord
Class: Hematology
NDC: 1

J0898

HCPCS Descriptor: Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)
Manufacturer: Eugia US
Class: Hematology
NDCs: 2

J0899

HCPCS Descriptor: Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)
Manufacturer: Eugia US
Class: Hematology
NDCs: 2

J7665

HCPCS Descriptor: Mannitol, administered through an inhaler, 5 mg
Manufacturer: Methapharm
Class: Respiratory
NDC: 1

J0400

HCPCS Descriptor: Injection, aripiprazole, intramuscular, 0.25 mg
Class: Psychiatric

0.25 mg per unit

J1944

HCPCS Descriptor: Injection, aripiprazole lauroxil, (aristada), 1 mg
Manufacturer: Alkermes
Class: Psychiatric
NDCs: 4

J1943

ARISTADA INITIO

HCPCS Descriptor: Injection, aripiprazole lauroxil, (aristada initio), 1 mg
Manufacturer: Alkermes
Class: Psychiatric
NDC: 1

J1652

HCPCS Descriptor: Injection, fondaparinux sodium, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 44

0.5 mg per unit

J9261

HCPCS Descriptor: Injection, nelarabine, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 24

J9017

ARSENIC TRIOXIDE

HCPCS Descriptor: Injection, arsenic trioxide, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 34

J0391

HCPCS Descriptor: Injection, artesunate, 1 mg
Manufacturer: Amivas
Class: Antimalarial
NDC: 1

C9250

HCPCS Descriptor: Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml
Manufacturer: Baxter Healthcare
Class: Wound Care
NDCs: 3

J9302

HCPCS Descriptor: Injection, ofatumumab, 10 mg
Manufacturer: Novartis
Class: Oncology
NDCs: 3

J1554

HCPCS Descriptor: Injection, immune globulin (asceniv), 500 mg
Manufacturer: Adma Biologics
Class: Immunoglobulin
NDC: 1

500 mg per unit

J9118

HCPCS Descriptor: Injection, calaspargase pegol-mknl, 10 units
Manufacturer: Servier Pharmaceuticals
Class: Oncology
NDC: 1

10 units per unit

J7508

HCPCS Descriptor: Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
Manufacturer: Astellas Pharma
Class: Immunosuppressant
NDCs: 3

0.1 mg per unit

J7504

HCPCS Descriptor: Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
Manufacturer: Pfizer
Class: Immunology
NDCs: 2

250 mg per unit

J2060

HCPCS Descriptor: Injection, lorazepam, 2 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 26

J7635

HCPCS Descriptor: Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7636

HCPCS Descriptor: Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J0461

ATROPINE SULFATE

HCPCS Descriptor: Injection, atropine sulfate, 0.01 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 17

0.01 mg per unit

J0462

ATROPINE SULFATE

HCPCS Descriptor: Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 12

0.01 mg per unit

J0463

Atropine Sulfate

HCPCS Descriptor: Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 8

0.01 mg per unit

Q2058

HCPCS Descriptor: Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
Manufacturer: Autolus
Class: Oncology
NDC: 1

per therapeutic dose per unit

Q5161

Aukelso and Bosaya

HCPCS Descriptor: Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg
Manufacturer: Biocon Biologics
Class: Osteoporosis
NDCs: 2

J1749

HCPCS Descriptor: Injection, iloprost, 0.1 mcg
Manufacturer: BTG International
Class: Cardiology
NDCs: 2

0.1 mcg per unit

J0609

HCPCS Descriptor: Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)
Manufacturer: Akebia Therapeutics
Class: Endocrinology
NDCs: 2

27412

Autologous Chondrocyte Implantation, Knee

C9257

HCPCS Descriptor: Injection, bevacizumab, 0.25 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

0.25 mg per unit

J9035

HCPCS Descriptor: Injection, bevacizumab, 10 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

J3145

HCPCS Descriptor: Injection, testosterone undecanoate, 1 mg
Manufacturer: Endo USA
Class: Hormone Replacement
NDC: 1

J2280

HCPCS Descriptor: Injection, moxifloxacin, 100 mg
Manufacturer: Viatris
Class: Antibiotic
NDC: 1

100 mg per unit

J1757

HCPCS Descriptor: Injection, tividenofusp alfa-eknm, 1 mg
Manufacturer: Denali Therapeutics
Class: Enzyme Replacement Therapy
NDC: 1

J1826

HCPCS Descriptor: Injection, interferon beta-1a, 30 mcg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 5

30 mcg per unit

Q3027

HCPCS Descriptor: Injection, interferon beta-1a, 1 mcg for intramuscular use
Manufacturer: Biogen
Class: Neurology
NDCs: 2

Q5121

HCPCS Descriptor: Injection, infliximab-axxq, biosimilar, (avsola), 10 mg
Manufacturer: Amgen
Class: Immunology: Anti-TNF
NDCs: 2

Q0237

HCPCS Descriptor: Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Manufacturer: Celltrion USA
Class: COVID-19
NDCs: 3

Q5156

HCPCS Descriptor: Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunology: Anti-TNF
NDCs: 5

J0714

HCPCS Descriptor: Injection, ceftazidime and avibactam, 0.5 g/0.125 g
Manufacturer: AbbVie
Class: Antibiotic
NDCs: 2

.625 gm per unit

Q4215

AXOLOTL AMBIENT FLOWABLE ALLOGRAFT

HCPCS Descriptor: Axolotl ambient or axolotl cryo, 0.1 mg
Manufacturer: Axolotl Biologix
Class: Wound Care
NDCs: 3

0.1 mg per unit

A9588

HCPCS Descriptor: Fluciclovine f-18, diagnostic, 1 millicurie
Manufacturer: Blue Earth Diagnostics
Class: Imaging/Radiopharmaceutical
NDC: 1

J9025

HCPCS Descriptor: Injection, azacitidine, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 23

NOC AZTREONAM

Aztreonam

Manufacturer: Fresenius Kabi
Class: Antibiotic
NDCs: 6

500 mg per unit

J7500

HCPCS Descriptor: Azathioprine, oral, 50 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 17

J7501

AZATHIOPRINE SODIUM

HCPCS Descriptor: Azathioprine, parenteral, 100 mg
Manufacturer: Hikma
Class: Immunosuppressant
NDC: 1

100 mg per unit

J0456

HCPCS Descriptor: Injection, azithromycin, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 16

500 mg per unit

J1072

HCPCS Descriptor: Injection, testosterone cypionate (azmiro), 1 mg
Manufacturer: Azurity Pharmaceuticals
Class: Hormone Replacement
NDC: 1

J0457

HCPCS Descriptor: Injection, aztreonam, 100 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 15

100 mg per unit

J0475

HCPCS Descriptor: Injection, baclofen, 10 mg
Manufacturer: Multiple Manufacturers
Class: Muscle Relaxant
NDCs: 24

J0476

HCPCS Descriptor: Injection, baclofen, 50 mcg for intrathecal trial
Manufacturer: Multiple Manufacturers
Class: Muscle Relaxant
NDCs: 3

50 mcg per unit

J0470

HCPCS Descriptor: Injection, dimercaprol, per 100 mg
Manufacturer: Akorn
Class: Imaging/Radiopharmaceutical
NDC: 1

100 mg per unit

J7165

HCPCS Descriptor: Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
Manufacturer: Octapharma
Class: Hematology
NDCs: 4

per factor ix iu per unit

J0184

HCPCS Descriptor: Injection, amisulpride, 1 mg
Manufacturer: Acacia Pharma
Class: Anti-Emetic
NDCs: 4

J9023

HCPCS Descriptor: Injection, avelumab, 10 mg
Manufacturer: EMD Serono
Class: Oncology
NDC: 1

J3268

HCPCS Descriptor: Injection, delafloxacin, 1 mg
Manufacturer: Melinta Therapeutics
Class: Antibiotic
NDC: 1

90585

BCG (TICE STRAIN)

HCPCS Descriptor: Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use
Manufacturer: Merck
Class: Vaccine
NDC: 1

90586

BCG (TICE STRAIN)

HCPCS Descriptor: Bcg vaccine intravesical
Manufacturer: Merck
Class: Vaccine
NDCs: 2

1 each per unit

J9030

BCG (TICE STRAIN)

HCPCS Descriptor: Bcg live intravesical instillation, 1 mg
Manufacturer: Merck
Class: Oncology
NDC: 1

J7622

HCPCS Descriptor: Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J9174

HCPCS Descriptor: Injection, docetaxel (beizray), 1 mg
Manufacturer: Zydus Pharmaceuticals
Class: Oncology
NDCs: 4

J9032

HCPCS Descriptor: Injection, belinostat, 10 mg
Manufacturer: Acrotech Biopharma
Class: Oncology
NDC: 1

J9036

HCPCS Descriptor: Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 3

J9066

Bendamustine Hydrochloride (Avyxa)

HCPCS Descriptor: Injection, bendamustine hydrochloride (avyxa), 1 mg
Manufacturer: AVYXA Pharma, LLC
Class: Oncology

J9034

HCPCS Descriptor: Injection, bendamustine hcl (bendeka), 1 mg
Manufacturer: Teva
Class: Oncology
NDC: 1

J7195

HCPCS Descriptor: Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified
Manufacturer: Pfizer
Class: Hematology
NDCs: 5

J0490

HCPCS Descriptor: Injection, belimumab, 10 mg
Manufacturer: GlaxoSmithKline
Class: Immunology
NDCs: 2

J0515

BENZTROPINE MESYLATE

HCPCS Descriptor: Injection, benztropine mesylate, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 6

J0179

HCPCS Descriptor: Injection, brolucizumab-dbll, 1 mg
Manufacturer: Novartis
Class: Ophthalmology
NDC: 1

J1414

HCPCS Descriptor: Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose
Manufacturer: Pfizer
Class: Hematology
NDCs: 4

per therapeutic dose per unit

J0597

HCPCS Descriptor: Injection, c-1 esterase inhibitor (human), berinert, 10 units
Manufacturer: CSL Behring
Class: Immunology
NDC: 1

10 units per unit

J9229

HCPCS Descriptor: Injection, inotuzumab ozogamicin, 0.1 mg
Manufacturer: Pfizer
Class: Oncology
NDC: 1

0.1 mg per unit

J7624

HCPCS Descriptor: Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J0702

BETAMETHASONE SOD PHOS-ACETATE

HCPCS Descriptor: Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 4

3 mg & 3 mg per unit

J1830

HCPCS Descriptor: Injection, interferon beta-1b, 0.25 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)
Manufacturer: Bayer Pharmaceutical
Class: Neurology
NDCs: 3

0.25 mg per unit

J0520

BETHANECHOL CHLORIDE

HCPCS Descriptor: Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg
Class: Misc.

J7682

HCPCS Descriptor: Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 26

300 mg per unit

90620

HCPCS Descriptor: Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

90380

HCPCS Descriptor: Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

0.5 ml per unit

90381

HCPCS Descriptor: Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

J0558

HCPCS Descriptor: Injection, penicillin g benzathine and penicillin g procaine, 100,000 units
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 3

100,000 units per unit

J0561

HCPCS Descriptor: Injection, penicillin g benzathine, 100,000 units
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 6

100,000 units per unit

J9050

HCPCS Descriptor: Injection, carmustine, 100 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 13

100 mg per unit

Q5162

HCPCS Descriptor: Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg
Manufacturer: Organon
Class: Osteoporosis
NDCs: 2

Q4138

HCPCS Descriptor: Biodfence dryflex, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: BioDLogics LLC
Class: Wound Care
NDCs: 5

1 sq cm per unit

Q4140

BioDfence Sentry

HCPCS Descriptor: Biodfence, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: BioDLogics LLC
Class: Wound Care
NDCs: 15

1 sq cm per unit

J2372

HCPCS Descriptor: Injection, phenylephrine hydrochloride (biorphen), 20 micrograms
Manufacturer: Dr. Reddy's Laboratories
Class: Cardiology
NDCs: 5

20 mcg per unit

J7628

BITOLTEROL MESYLATE

HCPCS Descriptor: Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7629

BITOLTEROL MESYLATE

HCPCS Descriptor: Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J0582

HCPCS Descriptor: Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg
Manufacturer: Endo USA
Class: Cardiology
NDCs: 2

J1556

HCPCS Descriptor: Injection, immune globulin (bivigam), 500 mg
Manufacturer: Adma Biologics
Class: Immunoglobulin
NDCs: 3

500 mg per unit

J9382

HCPCS Descriptor: Injection, zenocutuzumab-zbco, 1 mg
Manufacturer: Partner Therapeutics
Class: Oncology
NDCs: 2

Q5152

HCPCS Descriptor: Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg
Manufacturer: Amgen
Class: Immunology
NDC: 1

51720

Bladder Instillation Of Anticarcinogenic Agent

HCPCS Descriptor: Bladder instillation of anticarcinogenic agent, including retention time

J9053

HCPCS Descriptor: Injection, belantamab mafodotin-blmf, 0.1 mg
Manufacturer: GlaxoSmithKline
Class: Oncology
NDC: 1

0.1 mg per unit

J9040

BLEOMYCIN SULFATE

HCPCS Descriptor: Injection, bleomycin sulfate, 15 units
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 12

15 units per unit

J9039

HCPCS Descriptor: Injection, blinatumomab, 1 microgram
Manufacturer: Amgen
Class: Oncology
NDCs: 3

J9220

HCPCS Descriptor: Injection, indigotindisulfonate sodium, 1 mg
Manufacturer: Provepharm
Class: Imaging/Radiopharmaceutical
NDCs: 3

Q5171

HCPCS Descriptor: Injection, denosumab-mobz (boncresa), biosimilar, 1 mg
Manufacturer: Amneal Pharmaceuticals
Class: Osteoporosis
NDC: 1

J1740

HCPCS Descriptor: Injection, ibandronate sodium, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 5

J9041

HCPCS Descriptor: Injection, bortezomib, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 22

0.1 mg per unit

J9046

HCPCS Descriptor: Injection, bortezomib (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg
Manufacturer: Dr. Reddy's Laboratories
Class: Oncology
NDC: 1

0.1 mg per unit

J9048

HCPCS Descriptor: Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg
Manufacturer: Fresenius Kabi
Class: Oncology
NDC: 1

0.1 mg per unit

J9049

HCPCS Descriptor: Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 2

0.1 mg per unit

J9054

HCPCS Descriptor: Injection, bortezomib (boruzu), 0.1 mg
Manufacturer: Amneal Pharmaceuticals
Class: Oncology
NDC: 1

0.1 mg per unit

J0585

HCPCS Descriptor: Injection, onabotulinumtoxina, 1 unit
Manufacturer: AbbVie
Class: Neurology
NDCs: 4

1 unit per unit

NOC ESMOLOL HYDR

HCPCS Descriptor: Esmolol Hydrochloride, 10 MG
Manufacturer: Baxter Healthcare

J1805

BREVIBLOC IN NACL

HCPCS Descriptor: Injection, esmolol hydrochloride, 10 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 26

Q2054

HCPCS Descriptor: Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: BMS
Class: Oncology
NDC: 1

up to 110 million car-positive viable t cells, per therapeutic dose per unit

J0567

HCPCS Descriptor: Injection, cerliponase alfa, 1 mg
Manufacturer: Biomarin Pharmaceuticals
Class: Enzyme Replacement Therapy
NDC: 1

J2329

HCPCS Descriptor: Injection, ublituximab-xiiy, 1mg
Manufacturer: TG Therapeutics
Class: Neurology
NDC: 1

J0578

BRIXADI (MONTHLY DOSING)

HCPCS Descriptor: Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy
Manufacturer: Braeburn Pharmaceutical
Class: Anti-Addiction
NDCs: 3

greater than 7 days and up to 28 days of therapy per unit

J0577

BRIXADI (WEEKLY DOSING)

HCPCS Descriptor: Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
Manufacturer: Braeburn Pharmaceutical
Class: Anti-Addiction
NDCs: 4

less than or equal to 7 days of therapy per unit

J0945

BROMPHENIRAMINE MALEATE

HCPCS Descriptor: Injection, brompheniramine maleate, per 10 mg
Class: Antihistamine

94070

Bronchospasm Provocation Evaluation

HCPCS Descriptor: Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (e.g., antigen[s], cold air, methacholine)

J7605

HCPCS Descriptor: Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 45

15 mcg per unit

J7626

HCPCS Descriptor: Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 46

up to 0.50 mg per unit

J7627

HCPCS Descriptor: Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg
Class: Respiratory

0.5 mg per unit

J7633

HCPCS Descriptor: Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram
Class: Respiratory

0.25 milligram per unit

J7634

HCPCS Descriptor: Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram
Class: Respiratory

0.25 milligram per unit

J1939

HCPCS Descriptor: Injection, bumetanide, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 36

0.5 mg per unit

NOC BUMETANIDE

Manufacturer: Hikma
Class: Diuretic
NDCs: 6

0.25 mg per unit

J0665

BUPIVACAINE HCL

HCPCS Descriptor: Injection, bupivicaine, not otherwise specified, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 115

0.5 mg per unit

NOC BUPIVACAINE

Bupivacaine HCl

HCPCS Descriptor: Bupivacaine,1 ML
Manufacturer: Auromedics Pharma

J0592

HCPCS Descriptor: Injection, buprenorphine hydrochloride, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Addiction
NDCs: 4

0.1 mg per unit

J0571

HCPCS Descriptor: Buprenorphine, oral, 1 mg
Manufacturer: Hikma
Class: Anti-Addiction
NDCs: 4

J0572

BUPRENORPHINE-NALOXONE

HCPCS Descriptor: Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 14

J0573

BUPRENORPHINE-NALOXONE

HCPCS Descriptor: Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 7

J0574

BUPRENORPHINE-NALOXONE

HCPCS Descriptor: Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 14

J0575

BUPRENORPHINE-NALOXONE

HCPCS Descriptor: Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 6

61210

Burr Hole(S); For Implanting Ventricular Catheter

HCPCS Descriptor: Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure)

J0594

HCPCS Descriptor: injection, busulfan, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 10

J0595

BUTORPHANOL TARTRATE

HCPCS Descriptor: Injection, butorphanol tartrate, 1 mg
Manufacturer: Pfizer
Class: Opioid Analgesic
NDCs: 3

J2249

HCPCS Descriptor: Injection, remimazolam, 1 mg
Manufacturer: Acacia Pharma
Class: Sedative
NDCs: 2

Q5124

HCPCS Descriptor: Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg
Manufacturer: Biogen
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

J0741

HCPCS Descriptor: Injection, cabotegravir and rilpivirine, 2mg/3mg
Manufacturer: GlaxoSmithKline
Class: Anti-HIV
NDCs: 2

2 mg - 3 mg per unit

J8515

HCPCS Descriptor: Cabergoline, oral, 0.25 mg
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 7

0.25 mg per unit

C9047

HCPCS Descriptor: Injection, caplacizumab-yhdp, 1 mg
Manufacturer: Sanofi
Class: Hematology
NDC: 1

J0706

CAFFEINE CITRATE

HCPCS Descriptor: Injection, caffeine citrate, 5 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 8

J0636

HCPCS Descriptor: Injection, calcitriol, 0.1 mcg
Manufacturer: Fosun Pharma
Class: Endocrinology
NDCs: 2

0.1 mcg per unit

S0169

HCPCS Descriptor: Calcitrol, oral, 0.25 microgram
Manufacturer: Multiple Manufacturers
Class: Endocrinology

J0615

Calcium acetate

HCPCS Descriptor: Calcium acetate, oral, 23 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 11

J0618

CALCIUM CHLORIDE

HCPCS Descriptor: Injection, calcium chloride, 2 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 16

J0600

CALCIUM DISODIUM VERSENATE

HCPCS Descriptor: Injection, edetate calcium disodium, up to 1000 mg
Manufacturer: Rising Pharmaceuticals
Class: Misc.
NDCs: 2

1000 mg per unit

J0620

CALCIUM GLUCEPTATE

HCPCS Descriptor: Injection, calcium glycerophosphate and calcium lactate, per 10 ml
Class: Misc.

J0612

Calcium Gluconate

HCPCS Descriptor: Injection, calcium gluconate, not otherwise specified, 10 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 30

J0613

Calcium Gluconate

HCPCS Descriptor: Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg
Manufacturer: WG Critical Care
Class: Cardiology
NDCs: 10

J1741

HCPCS Descriptor: Injection, ibuprofen, 100 mg
Manufacturer: Cumberland Pharmaceuticals
Class: Non-Opioid Analgesic
NDCs: 2

100 mg per unit

J9003

HCPCS Descriptor: Leuprolide injectable (camcevi etm), 1 mg
Manufacturer: Accord BioPharma, Inc.
Class: Oncology

J9206

HCPCS Descriptor: Injection, irinotecan, 20 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 36

J0637

HCPCS Descriptor: Injection, caspofungin acetate, 5 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 15

90684

HCPCS Descriptor: Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use
Manufacturer: Merck
Class: Vaccine
NDC: 1

38225

HCPCS Descriptor: Chimeric antigen receptor T cell (CAR T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR T cells, per day

J9045

HCPCS Descriptor: Injection, carboplatin, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 37

J2404

HCPCS Descriptor: Injection, nicardipine, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 43

0.1 mg per unit

J9052

HCPCS Descriptor: Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg
Manufacturer: ACCORD HEALTHCARE
Class: Oncology
NDC: 1

100 mg per unit

NOC CARMUSTINE (

HCPCS Descriptor: NOC Carmustine (Accord)
Manufacturer: ACCORD HEALTHCARE INC.

100 mg per unit

J1955

HCPCS Descriptor: Injection, levocarnitine, per 1 gm
Manufacturer: Multiple Manufacturers
Class: Genetic Disorder
NDCs: 6

Q2056

HCPCS Descriptor: Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: Janssen
Class: Oncology
NDCs: 2

up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells per unit

J3392

HCPCS Descriptor: Injection, exagamglogene autotemcel, per treatment
Manufacturer: Vertex Pharmaceuticals
Class: Oncology
NDC: 1

per treatment per unit

66984

Cataract Surgery

HCPCS Descriptor: Uncomplicated cataract surgery

J0687

HCPCS Descriptor: Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg
Manufacturer: WG Critical Care
Class: Antibiotic
NDCs: 4

500 mg per unit

J0688

HCPCS Descriptor: Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg
Manufacturer: Hikma
Class: Antibiotic
NDCs: 4

500 mg per unit

J0690

HCPCS Descriptor: Injection, cefazolin sodium, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 46

500 mg per unit

J0689

Cefazolin Sodium

HCPCS Descriptor: Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg
Manufacturer: Baxter Healthcare
Class: Antibiotic
NDCs: 3

500 mg per unit

J0692

HCPCS Descriptor: Injection, cefepime hydrochloride, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 29

500 mg per unit

J0701

HCPCS Descriptor: Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg
Manufacturer: Baxter Healthcare
Class: Antibiotic
NDCs: 2

500 mg per unit

J0703

Cefepime HCL in Dextrose

HCPCS Descriptor: Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg
Manufacturer: B. Braun Medical
Class: Antibiotic
NDCs: 2

500 mg per unit

J0698

CEFOTAXIME SODIUM

HCPCS Descriptor: Injection, cefotaxime sodium, per gm
Manufacturer: HOSPIRA
Class: Antibiotic
NDC: 1

per gm per unit

J0525

CEFOTETAN DISODIUM

HCPCS Descriptor: Injection, cefotetan disodium, 10 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 5

J0694

HCPCS Descriptor: Injection, cefoxitin sodium, 1 gm
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 19

J0713

HCPCS Descriptor: Injection, ceftazidime, per 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 15

500 mg per unit

J0696

HCPCS Descriptor: Injection, ceftriaxone sodium, per 250 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 80

250 mg per unit

J0697

CEFUROXIME SODIUM

HCPCS Descriptor: Injection, sterile cefuroxime sodium, per 750 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 6

750 mg per unit

J2724

HCPCS Descriptor: Injection, protein c concentrate, intravenous, human, 10 iu
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDCs: 2

10 units per unit

Q2009

HCPCS Descriptor: Injection, fosphenytoin, 50 mg phenytoin equivalent
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 16

50 mg pe/ml per unit

A9521

HCPCS Descriptor: Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDCs: 2

up to 25 millicuries per unit

J1786

HCPCS Descriptor: Injection, imiglucerase, 10 units
Manufacturer: Sanofi
Class: Enzyme Replacement Therapy
NDC: 1

10 units per unit

A9591

HCPCS Descriptor: Fluoroestradiol f 18, diagnostic, 1 millicurie
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

64616

Chemodenervation Of Muscle

HCPCS Descriptor: Chemodenervation of muscle(s), cervical spinal muscle(s); 50 modifier for bilateral injections

96401

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic

96402

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic

96405

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration; intralesional, up to and including 7 lesions

96409

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration; intravenous, push technique, single or initial substance/drug

96411

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)

96413

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

96415

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

96416

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, IV infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours) requiring use of a portable or implantable pump

96417

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug) up to 1 hour (List separately in addition to code for primary procedure)

96450

Chemotherapy Administration

HCPCS Descriptor: Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture

J2850

HCPCS Descriptor: Injection, secretin, synthetic, human, 1 microgram
Manufacturer: ChiRhoClin
Class: Misc.
NDC: 1

J0720

CHLORAMPHENICOL SOD SUCCINATE

HCPCS Descriptor: Injection, chloramphenicol sodium succinate, up to 1 gm
Manufacturer: Fresenius Kabi
Class: Antibiotic
NDC: 1

J1990

CHLORDIAZEPOXIDE HCL

HCPCS Descriptor: Injection, chlordiazepoxide hcl, up to 100 mg
Class: Sedative

100 mg per unit

J2401

CHLOROPROCAINE HCL

HCPCS Descriptor: Injection, chloroprocaine hydrochloride, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 12

J0390

CHLOROQUINE HYDROCHLORIDE

HCPCS Descriptor: Injection, chloroquine hydrochloride, up to 250 mg
Class: Antimalarial

250 mg per unit

J1205

CHLOROTHIAZIDE SODIUM

HCPCS Descriptor: Injection, chlorothiazide sodium, per 500 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 7

500 mg per unit

J3230

CHLORPROMAZINE HCL

HCPCS Descriptor: Injection, chlorpromazine hcl, up to 50 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 13

J0725

CHORIONIC GONADOTROPIN

HCPCS Descriptor: Injection, chorionic gonadotropin, per 1,000 usp units
Manufacturer: Multiple Manufacturers
Class: Fertility
NDCs: 6

1000 units per unit

J0740

HCPCS Descriptor: Injection, cidofovir, 375 mg
Manufacturer: Multiple Manufacturers
Class: Antiviral
NDCs: 2

375 mg per unit

Q5128

HCPCS Descriptor: Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg
Manufacturer: Coherus Biosciences
Class: Ophthalmology
NDCs: 4

0.1 mg per unit

J0717

HCPCS Descriptor: Injection, certolizumab pegol, 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)
Manufacturer: UCB Pharma
Class: Immunology: Anti-TNF
NDCs: 4

J0604

HCPCS Descriptor: Cinacalcet, oral, 1 mg, (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 36

J2786

HCPCS Descriptor: Injection, reslizumab, 1 mg
Manufacturer: Teva
Class: Anti-Eosinophil Asthma
NDC: 1

J0598

HCPCS Descriptor: Injection, c-1 esterase inhibitor (human), cinryze, 10 units
Manufacturer: Takeda Pharmaceuticals
Class: Immunology
NDC: 1

10 units per unit

J0185

HCPCS Descriptor: Injection, aprepitant, 1 mg
Manufacturer: Heron Therapeutics
Class: Anti-Emetic
NDC: 1

J0744

HCPCS Descriptor: Injection, ciprofloxacin for intravenous infusion, 200 mg
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 9

200 mg per unit

J9060

HCPCS Descriptor: Injection, cisplatin, powder or solution, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 24

J9065

HCPCS Descriptor: Injection, cladribine, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 4

A9575

HCPCS Descriptor: Injection, gadoterate meglumine, 0.1 ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 34

0.1 ml per unit

J0736

HCPCS Descriptor: Injection, clindamycin phosphate, 300 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 33

300 mg per unit

NOC CLINDAMYCIN

HCPCS Descriptor: Clindamycin Phosphate,150 MG
Manufacturer: Pfizer

150 mg per unit

J0759

HCPCS Descriptor: Injection, clevidipine butyrate, 1 mg
Manufacturer: Chiesi USA
Class: Cardiology
NDCs: 4

J0737

CLINDAMYCIN PHOSPHATE IN NACL

HCPCS Descriptor: Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg
Manufacturer: Baxter Healthcare
Class: Antibiotic
NDCs: 6

300 mg per unit

J9027

HCPCS Descriptor: Injection, clofarabine, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 8

J0735

HCPCS Descriptor: Injection, clonidine hydrochloride, 1 mg
Manufacturer: Multiple Manufacturers
Class: Non-Opioid Analgesic
NDCs: 6

J2402

HCPCS Descriptor: Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg
Manufacturer: B. Braun
Class: Anesthetic
NDCs: 2

S0136

HCPCS Descriptor: Clozapine, 25 mg
Manufacturer: Sun Pharma
Class: Psychiatric
NDC: 1

J7175

HCPCS Descriptor: Injection, factor x, (human), 1 i.u.
Manufacturer: Bio Products Laboratory
Class: Hematology
NDCs: 4

J0014

Cocaine Hydrochloride

HCPCS Descriptor: Cocaine hydrochloride nasal solution (goprelto), 1 mg
Manufacturer: LXO US
Class: Anesthetic
NDC: 1

J0745

CODEINE PHOSPHATE

HCPCS Descriptor: Injection, codeine phosphate, per 30 mg
Class: Opioid Analgesic

J0770

HCPCS Descriptor: Injection, colistimethate sodium, up to 150 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 10

up to 150 mg per unit

J9286

HCPCS Descriptor: Injection, glofitamab-gxbm, 2.5 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

2.5 mg per unit

J0138

HCPCS Descriptor: Injection, acetaminophen 10 mg and ibuprofen 3 mg
Manufacturer: Hikma
Class: Non-Opioid Analgesic
NDCs: 2

10 mg/3mg per unit

91320

COMIRNATY 2023-2024 AGE 12 AND OLDER

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
Manufacturer: Pfizer
Class: Vaccine
NDCs: 3

0.3 ml per unit

Q5158

HCPCS Descriptor: Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg
Manufacturer: Fresenius Kabi
Class: Osteoporosis
NDCs: 3

Q9961

HCPCS Descriptor: High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
Manufacturer: Guerbet
Class: Imaging/Radiopharmaceutical
NDCs: 3

J0528

HCPCS Descriptor: Injection, fosfomycin disodium, 20 mg
Manufacturer: Meitheal Pharmaceuticals
Class: Antibiotic
NDCs: 2

J1595

HCPCS Descriptor: Injection, glatiramer acetate, 20 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 11

J7180

HCPCS Descriptor: Injection, factor xiii (antihemophilic factor, human), 1 i.u.
Manufacturer: CSL Behring
Class: Hematology
NDC: 1

J0834

HCPCS Descriptor: Injection, cosyntropin, 0.25 mg
Manufacturer: Multiple Manufacturers
Class: Growth Disorder
NDCs: 2

0.25 mg per unit

J1742

HCPCS Descriptor: Injection, ibutilide fumarate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 4

J1448

HCPCS Descriptor: Injection, trilaciclib, 1mg
Manufacturer: Pharmacosmos
Class: Oncology
NDCs: 2

J3247

HCPCS Descriptor: Injection, secukinumab, intravenous, 1 mg
Manufacturer: Novartis
Class: Immunology
NDC: 1

J9120

HCPCS Descriptor: Injection, dactinomycin, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 9

0.5 mg per unit

91318

COVID-19 VACCINE 2023-2024

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
Manufacturer: Pfizer
Class: COVID-19
NDC: 1

0.3 ml per unit

91321

COVID-19 VACCINE 2023-2024

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use
Manufacturer: Moderna
Class: Vaccine
NDCs: 4

0.25 ml per unit

J1833

HCPCS Descriptor: Injection, isavuconazonium, 1 mg
Manufacturer: Astellas Pharma
Class: Anti-Fungal
NDC: 1

J0840

HCPCS Descriptor: Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram
Manufacturer: BTG International
Class: Immunology
NDC: 1

up to 1 gm per unit

J7631

CROMOLYN SODIUM

HCPCS Descriptor: Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 3

J7632

CROMOLYN SODIUM

HCPCS Descriptor: Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams
Class: Respiratory

10 milligrams per unit

J0584

HCPCS Descriptor: Injection, burosumab-twza 1 mg
Manufacturer: Kyowa Kirin
Class: Genetic Disorder
NDCs: 3

J0878

HCPCS Descriptor: Injection, daptomycin, 1 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 38

J1551

HCPCS Descriptor: Injection, immune globulin (cutaquig), 100 mg
Manufacturer: Octapharma
Class: Immunoglobulin
NDCs: 20

100 mg per unit

J1555

HCPCS Descriptor: Injection, immune globulin (cuvitru), 100 mg
Manufacturer: Takeda Pharmaceuticals
Class: Immunoglobulin
NDCs: 6

100 mg per unit

J3420

HCPCS Descriptor: Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 47

1000 mcg per unit

J3424

HCPCS Descriptor: Injection, hydroxocobalamin, intravenous, 25 mg
Manufacturer: BTG International
Class: Hematology
NDCs: 2

J8530

CYCLOPHOSPHAMIDE

HCPCS Descriptor: Cyclophosphamide; oral, 25 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 12

J9071

Cyclophosphamide

HCPCS Descriptor: Injection, cyclophosphamide (auromedics), 5 mg
Manufacturer: Eugia US
Class: Oncology
NDCs: 5

J9075

CYCLOPHOSPHAMIDE

HCPCS Descriptor: Injection, cyclophosphamide, not otherwise specified, 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 47

J9076

Cyclophosphamide (Baxter)

HCPCS Descriptor: Injection, cyclophosphamide (baxter), 5 mg
Manufacturer: Baxter Healthcare
Class: Oncology
NDCs: 2

J9073

CYCLOPHOSPHAMIDE (INGENUS)

HCPCS Descriptor: Injection, cyclophosphamide (dr. reddy's), 5 mg
Manufacturer: Athenex
Class: Oncology
NDCs: 11

J9074

Cyclophosphamide (Sandoz)

HCPCS Descriptor: Injection, cyclophosphamide (sandoz), 5 mg
Manufacturer: Sandoz
Class: Oncology
NDCs: 6

J7515

HCPCS Descriptor: Cyclosporine, oral, 25 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 11

J7502

CYCLOSPORINE MODIFIED

HCPCS Descriptor: Cyclosporine, oral, 100 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 15

100 mg per unit

J1098

HCPCS Descriptor: Articaine ophthalmic, 8% solution, 0.4 ml
Manufacturer: American Genomics, LLC
Class: Ophthalmology

0.4 ml per unit

Q5143

HCPCS Descriptor: Injection, adalimumab-adbm, biosimilar, 1 mg
Manufacturer: Boehringer Ingelheim
Class: Immunology: Anti-TNF
NDCs: 23

J9308

HCPCS Descriptor: Injection, ramucirumab, 5 mg
Manufacturer: Eli Lilly
Class: Oncology
NDCs: 2

Q9958

HCPCS Descriptor: High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 4

A9589

HCPCS Descriptor: Instillation, hexaminolevulinate hydrochloride, 100 mg
Manufacturer: Photocure
Class: Imaging/Radiopharmaceutical
NDC: 1

100 mg per unit

Q4166

CYTAL WOUND MATRIX

HCPCS Descriptor: Cytal, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Multiple Manufacturers
Class: Wound Care
NDCs: 16

1 sq cm per unit

J9100

HCPCS Descriptor: Injection, cytarabine, 100 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 10

100 mg per unit

J0850

HCPCS Descriptor: Injection, cytomegalovirus immune globulin intravenous (human), per vial
Manufacturer: Kamada
Class: Immunoglobulin
NDC: 1

per vial per unit

J9130

HCPCS Descriptor: Dacarbazine, 100 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 7

100 mg per unit

J0894

HCPCS Descriptor: Injection, decitabine, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 22

J0875

HCPCS Descriptor: Injection, dalbavancin, 5 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 5

J9348

HCPCS Descriptor: Injection, naxitamab-gqgk, 1 mg
Manufacturer: Y-mAbs Therapeutics
Class: Oncology
NDC: 1

90700

HCPCS Descriptor: Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 3

per dose per unit

J0871

HCPCS Descriptor: Injection, daptomycin (endo), not therapeutically equivalent to j0878, 1 mg
Manufacturer: Endo USA
Class: Antibiotic
NDC: 1

J0872

HCPCS Descriptor: Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg
Manufacturer: Hikma
Class: Antibiotic
NDCs: 5

J0873

HCPCS Descriptor: Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg
Manufacturer: Civica
Class: Antibiotic
NDCs: 3

J0877

HCPCS Descriptor: Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 2

J0874

DAPTOMYCIN IN SODIUM CHLORIDE

HCPCS Descriptor: Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg
Manufacturer: Baxter Healthcare
Class: Antibiotic
NDCs: 4

J9145

HCPCS Descriptor: Injection, daratumumab, 10 mg
Manufacturer: Janssen
Class: Oncology
NDCs: 2

J9144

DARZALEX FASPRO

HCPCS Descriptor: Injection, daratumumab, 10 mg and hyaluronidase-fihj
Manufacturer: Janssen
Class: Oncology
NDC: 1

J9011

HCPCS Descriptor: Injection, datopotamab deruxtecan-dlnk, 1 mg
Manufacturer: Daiichi Sankyo
Class: Oncology
NDC: 1

A9584

HCPCS Descriptor: Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

per study dose, up to 5 millicuries per unit

J9150

DAUNORUBICIN HCL

HCPCS Descriptor: Injection, daunorubicin, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 10

J0589

HCPCS Descriptor: Injection, daxibotulinumtoxina-lanm, 1 unit
Manufacturer: Revance Therapeutics
Class: Neurology
NDC: 1

1 unit per unit

J2597

HCPCS Descriptor: Injection, desmopressin acetate, per 1 mcg
Manufacturer: Multiple Manufacturers
Class: Hormone Replacement
NDCs: 28

J0893

HCPCS Descriptor: Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg
Manufacturer: Sun Pharma
Class: Oncology
NDC: 1

C9313

HCPCS Descriptor: Injection, pivekimab sunirine-pvzy, 0.01 mg
Manufacturer: AbbVie
Class: Oncology
NDC: 1

0.01 mg per unit

J0911

HCPCS Descriptor: Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)
Manufacturer: CorMedix
Class: Antibiotic
NDCs: 2

taurolidine 1.35 mg and heparin sodium 100 units per unit

J0895

DEFEROXAMINE MESYLATE

HCPCS Descriptor: Injection, deferoxamine mesylate, 500 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 12

500 mg per unit

Q9957

HCPCS Descriptor: Injection, perflutren lipid microspheres, per ml
Manufacturer: Lantheus Medical Imaging
Class: Imaging/Radiopharmaceutical
NDCs: 4

J1380

HCPCS Descriptor: Injection, estradiol valerate, up to 10 mg
Manufacturer: Multiple Manufacturers
Class: Hormone Replacement
NDCs: 10

J2175

HCPCS Descriptor: Injection, meperidine hydrochloride, per 100 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 10

100 mg per unit

90587

HCPCS Descriptor: Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use
Manufacturer: Sanofi
Class: Vaccine
NDC: 1

per dose per unit

J1000

HCPCS Descriptor: Injection, depo-estradiol cypionate, up to 5 mg
Manufacturer: Pfizer
Class: Hormone Replacement
NDC: 1

J1050

HCPCS Descriptor: Injection, medroxyprogesterone acetate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Contraceptive/ Long Acting Reversible
NDCs: 13

J1071

DEPO-TESTOSTERONE

HCPCS Descriptor: Injection, testosterone cypionate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Hormone Replacement
NDCs: 37

64620

Destruction By Neurolytic Agent

HCPCS Descriptor: Destruction by neurolytic agent, intercostal nerve

A9592

HCPCS Descriptor: Copper cu-64, dotatate, diagnostic, 1 millicurie
Manufacturer: Curium US
Class: Imaging/Radiopharmaceutical
NDC: 1

J7637

HCPCS Descriptor: Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

j7620 1 mg per unit

J7638

HCPCS Descriptor: Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

j7620, 1 mg per unit

J8540

HCPCS Descriptor: Dexamethasone, oral, 0.25 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 62

0.25 mg per unit

J1100

Dexamethasone Sodium Phosphate

HCPCS Descriptor: Injection, dexamethasone sodium phosphate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 47

J1190

HCPCS Descriptor: Injection, dexrazoxane hydrochloride, per 250 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 11

250 mg per unit

J1096

HCPCS Descriptor: Dexamethasone, lacrimal ophthalmic insert, 0.1 mg
Manufacturer: Ocular Therapeutix
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

S0160

DEXTROAMPHETAMINE SULFATE

HCPCS Descriptor: Dextroamphetamine sulfate, 5 mg
Manufacturer: Sunrise Pharmaceutical
Class: Psychiatric
NDC: 1

J7060

HCPCS Descriptor: 5% dextrose/water (500 ml = 1 unit)
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 21

500 ml per unit

J7070

HCPCS Descriptor: Infusion, d5w, 1000 cc
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 21

1000 cc per unit

J7042

DEXTROSE 5%-0.9% NACL

HCPCS Descriptor: 5% dextrose/normal saline (500 ml = 1 unit)
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 4

500 ml per unit

J3480

DEXTROSE 5%-POTASSIUM CHLORIDE

HCPCS Descriptor: Injection, potassium chloride, per 2 meq
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 57

J7121

DEXTROSE IN LACTATED RINGERS

HCPCS Descriptor: 5% dextrose in lactated ringers infusion, up to 1000 cc
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 4

1000 cc per unit

J1095

HCPCS Descriptor: Injection, dexamethasone 9 percent, intraocular, 1 microgram
Manufacturer: ANI Pharmaceuticals
Class: Ophthalmology
NDC: 1

78227

Diagnostic Nuclear Medicine Procedures

HCPCS Descriptor: Diagnostic Nuclear Medicine Procedures on the Gastrointestinal System

J3360

HCPCS Descriptor: Injection, diazepam, up to 5 mg
Manufacturer: Multiple Manufacturers
Class: Sedative
NDCs: 13

J1730

HCPCS Descriptor: Injection, diazoxide, up to 300 mg
Class: Endocrinology

300 mg per unit

J1130

DICLOFENAC SODIUM

HCPCS Descriptor: Injection, diclofenac sodium, 0.5 mg
Class: Non-Opioid Analgesic

0.5 mg per unit

J0500

DICYCLOMINE HCI

HCPCS Descriptor: Injection, dicyclomine hcl, up to 20 mg
Manufacturer: Multiple Manufacturers
Class: Muscle Relaxant
NDCs: 15

J1162

HCPCS Descriptor: Injection, digoxin immune fab (ovine), per vial
Manufacturer: Salvagenix
Class: Cardiology
NDCs: 3

per vial per unit

J1160

HCPCS Descriptor: Injection, digoxin, up to 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 8

0.5 mg per unit

J1110

Dihydroergotamine Mesylate

HCPCS Descriptor: Injection, dihydroergotamine mesylate, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 7

J1163

HCPCS Descriptor: Injection, diltiazem hydrochloride, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 19

0.5 mg per unit

NOC DILTIAZEM HY

HCPCS Descriptor: Diltiazem Hydrochloride 5 MG
Manufacturer: Multiple Manufacturers

J1164

Diltiazem in NaCl

HCPCS Descriptor: Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg
Manufacturer: WG Critical Care
Class: Cardiology
NDCs: 2

0.5 mg per unit

J1240

HCPCS Descriptor: Injection, dimenhydrinate, up to 50 mg
Manufacturer: Fresenius Kabi
Class: Antihistamine
NDCs: 2

J1200

DIPHENHYDRAMINE HCL

HCPCS Descriptor: Injection, diphenhydramine hcl, up to 50 mg
Manufacturer: Multiple Manufacturers
Class: Antihistamine
NDCs: 17

90702

DIPHTHERIA AND TETANUS TOXOIDS ADSORBED

HCPCS Descriptor: Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

J2704

HCPCS Descriptor: Injection, propofol, 10 mg
Manufacturer: Multiple Manufacturers
Class: Sedative
NDCs: 70

J1245

HCPCS Descriptor: Injection, dipyridamole, per 10 mg
Manufacturer: Hikma
Class: Hematology
NDCs: 2

J1250

HCPCS Descriptor: Injection, dobutamine hydrochloride, per 250 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 17

250 mg per unit

J9171

HCPCS Descriptor: Injection, docetaxel, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 38

J9232

HCPCS Descriptor: Injection, docetaxel (hospira), not therapeutically equivalent to j9171, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 34

J1265

HCPCS Descriptor: Injection, dopamine hcl, 40 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 20

J1270

DOXERCALCIFEROL

HCPCS Descriptor: Injection, doxercalciferol, 1 mcg
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 9

Q2050

HCPCS Descriptor: Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 32

J0591

DOXYCHOLIC ACID

HCPCS Descriptor: Injection, deoxycholic acid, 1 mg
Manufacturer: AbbVie
Class: Misc.
NDC: 1

J1271

DOXYCYCLINE HYCLATE

HCPCS Descriptor: Injection, doxycycline hyclate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 24

NOC DOXYCYCLINE

Doxycycline Hyclate

HCPCS Descriptor: Doxycycline Hyclate,100 MG
Manufacturer: Multiple Manufacturers

100 mg per unit

Q0167

HCPCS Descriptor: Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 12

2.5 mg per unit

J1790

HCPCS Descriptor: Injection, droperidol, up to 5 mg
Manufacturer: Multiple Manufacturers
Class: Sedative
NDCs: 6

up to 5 mg per unit

96372

HCPCS Descriptor: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular

96374

HCPCS Descriptor: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug), IV push, single, or initial substance/drug

J7340

HCPCS Descriptor: Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml
Manufacturer: AbbVie
Class: Neurology
NDC: 1

5 mg/20 mg 100 ml per unit

J2274

HCPCS Descriptor: Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 11

J7318

HCPCS Descriptor: Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg
Manufacturer: Bioventus
Class: Orthopedic
NDC: 1

J7351

HCPCS Descriptor: Injection, bimatoprost, intracameral implant, 1 microgram
Manufacturer: AbbVie
Class: Orthopedic
NDC: 1

J1180

HCPCS Descriptor: Injection, dyphylline, up to 500 mg
Class: Respiratory

500 mg per unit

J0586

HCPCS Descriptor: Injection, abobotulinumtoxina, 5 units
Manufacturer: Ipsen Biopharma
Class: Neurology
NDCs: 3

5 units per unit

81235

Egfr Gene Analysis

HCPCS Descriptor: EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q)

J9063

HCPCS Descriptor: Injection, mirvetuximab soravtansine-gynx, 1 mg
Manufacturer: AbbVie
Class: Misc.
NDC: 1

J1743

HCPCS Descriptor: Injection, idursulfase, 1 mg
Manufacturer: Takeda Pharmaceuticals
Class: Enzyme Replacement Therapy
NDC: 1

62369

Electronic Analysis Of Implanted Pump

HCPCS Descriptor: Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill

J3060

HCPCS Descriptor: Injection, taliglucerase alfa, 10 units
Manufacturer: Pfizer
Class: Enzyme Replacement Therapy
NDC: 1

10 units per unit

J1413

HCPCS Descriptor: Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose
Manufacturer: Sarepta Therapeutics
Class: Genetic Disorder
NDCs: 61

per therapeutic dose per unit

J2508

HCPCS Descriptor: Injection, pegunigalsidase alfa-iwxj, 1 mg
Manufacturer: Chiesi USA
Class: Enzyme Replacement Therapy
NDCs: 4

J9217

HCPCS Descriptor: Leuprolide acetate (for depot suspension), 7.5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 16

7.5 mg per unit

J2783

HCPCS Descriptor: Injection, rasburicase, 0.5 mg
Manufacturer: Sanofi
Class: Oncology
NDCs: 2

0.5 mg per unit

J9178

HCPCS Descriptor: Injection, epirubicin hcl, 2 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 4

J9175

HCPCS Descriptor: Injection, elliotts' b solution, 1 ml
Manufacturer: Lukare Medical
Class: Misc.
NDC: 1

J7205

HCPCS Descriptor: Injection, factor viii fc fusion protein (recombinant), per iu
Manufacturer: Sanofi
Class: Hematology
NDCs: 10

J1323

HCPCS Descriptor: Injection, elranatamab-bcmm, 1 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 4

A9573

HCPCS Descriptor: Injection, gadopiclenol, 1 ml
Manufacturer: Guerbet
Class: Imaging/Radiopharmaceutical
NDCs: 26

J9269

HCPCS Descriptor: Injection, tagraxofusp-erzs, 10 micrograms
Manufacturer: Stemline Therapeutics
Class: Oncology
NDC: 1

10 mcg per unit

J0458

HCPCS Descriptor: Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)
Manufacturer: AbbVie
Class: Antibiotic
NDCs: 2

J1453

HCPCS Descriptor: Injection, fosaprepitant, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 24

J9176

HCPCS Descriptor: Injection, elotuzumab, 1 mg
Manufacturer: BMS
Class: Oncology
NDCs: 2

J9326

HCPCS Descriptor: Injection, telisotuzumab vedotin-tllv, 1 mg
Manufacturer: AbbVie
Class: Oncology
NDCs: 2

J1438

HCPCS Descriptor: Injection, 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)
Manufacturer: Amgen
Class: Immunology: Anti-TNF
NDCs: 11

J3403

HCPCS Descriptor: Revakinagene taroretcel-lwey, per implant
Manufacturer: Neurotech Pharmaceuticals
Class: Ophthalmology
NDC: 1

per implant per unit

90382

HCPCS Descriptor: Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 mL, for intramuscular use
Manufacturer: Merck
Class: Vaccine
NDCs: 2

per dose per unit

90740

HCPCS Descriptor: Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 8

40 mcg per unit

90746

HCPCS Descriptor: Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 9

1 dose per unit

90747

HCPCS Descriptor: Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 8

40 mcg per unit

90744

Engerix-B Pediatric

HCPCS Descriptor: Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 7

1 dose per unit

J9358

HCPCS Descriptor: Injection, fam-trastuzumab deruxtecan-nxki, 1 mg
Manufacturer: Daiichi Sankyo
Class: Oncology
NDC: 1

J1302

HCPCS Descriptor: Injection, sutimlimab-jome, 10 mg
Manufacturer: Recordati Rare Diseases
Class: Hematology
NDCs: 2

Q5167

HCPCS Descriptor: Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg
Manufacturer: Hikma
Class: Osteoporosis
NDCs: 2

J1650

ENOXAPARIN SODIUM

HCPCS Descriptor: Injection, enoxaparin sodium, 10 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 174

J3380

HCPCS Descriptor: Injection, vedolizumab, intravenous, 1 mg
Manufacturer: Takeda Pharmaceuticals
Class: Immunology
NDC: 1

J7503

HCPCS Descriptor: Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
Manufacturer: Veloxis Pharmaceuticals
Class: Immunosuppressant
NDCs: 6

0.25 mg per unit

Q5149

HCPCS Descriptor: Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg
Manufacturer: Sandoz
Class: Ophthalmology
NDC: 1

A9581

HCPCS Descriptor: Injection, gadoxetate disodium, 1 ml
Manufacturer: Bayer Pharmaceutical
Class: Imaging/Radiopharmaceutical
NDCs: 3

J0164

EPINEPHRINE (BAXTER)

HCPCS Descriptor: Injection, epinephrine in sodium chloride (baxter), 0.1 mg
Manufacturer: Baxter Healthcare
Class: Cardiology
NDCs: 2

0.1 mg per unit

J0162

EPINEPHRINE HCL

HCPCS Descriptor: Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg
Manufacturer: Fresenius Kabi
Class: Cardiology
NDC: 1

0.1 mg per unit

J0165

EPINEPHRINE HCL

HCPCS Descriptor: Injection, epinephrine, not otherwise specified, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 13

0.1 mg per unit

J0167

EPINEPHRINE HCL

HCPCS Descriptor: Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 2

0.1 mg per unit

J0168

EPINEPHRINE HCL

HCPCS Descriptor: Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg
Manufacturer: A-S Medication Solutions
Class: Cardiology
NDCs: 2

0.1 mg per unit

J0166

EPINEPHRINE HCL (BELCHER)

HCPCS Descriptor: Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 16

0.1 mg per unit

J9321

HCPCS Descriptor: Injection, epcoritamab-bysp, 0.16 mg
Manufacturer: Genmab
Class: Oncology
NDCs: 2

0.16 mg per unit

J0885

HCPCS Descriptor: Injection, epoetin alfa, (for non-esrd use), 1000 units
Manufacturer: Amgen
Class: Oncology Colony Stimulating Factor
NDCs: 26

1000 units per unit

Q4081

HCPCS Descriptor: Injection, epoetin alfa, 100 units (for esrd on dialysis)
Manufacturer: Amgen
Class: Oncology Colony Stimulating Factor
NDCs: 20

100 units per unit

J1325

EPOPROSTENOL SODIUM

HCPCS Descriptor: Injection, epoprostenol, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 8

0.5 mg per unit

J1327

HCPCS Descriptor: Injection, eptifibatide, 5 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 21

Q5151

HCPCS Descriptor: Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg
Manufacturer: Teva
Class: Immunology
NDC: 1

J0348

ERAXIS (WATER DILUENT)

HCPCS Descriptor: Injection, anidulafungin, 1 mg
Manufacturer: Pfizer
Class: Anti-Fungal
NDCs: 3

J9055

HCPCS Descriptor: Injection, cetuximab, 10 mg
Manufacturer: Eli Lilly
Class: Oncology
NDCs: 2

J1335

HCPCS Descriptor: Injection, ertapenem sodium, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 21

500 mg per unit

J1364

ERYTHROCIN LACTOBIONATE

HCPCS Descriptor: Injection, erythromycin lactobionate, per 500 mg
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 3

500 mg per unit

J2428

HCPCS Descriptor: Injection, paliperidone palmitate extended release (erzofri), 1 mg
Manufacturer: Shandong Luye Pharmaceuticals
Class: Psychiatric
NDCs: 6

J1806

HCPCS Descriptor: Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg
Manufacturer: WG Critical Care
Class: Cardiology
NDCs: 2

J1370

ESOMEPRAZOLE SODIUM

HCPCS Descriptor: Injection, esomeprazole sodium, 1 mg
Manufacturer: Multiple Manufacturers
Class: Gastroenterology
NDCs: 3

J7204

HCPCS Descriptor: Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu
Manufacturer: Novo Nordisk
Class: Hematology
NDCs: 11

J1435

HCPCS Descriptor: Injection, estrone, per 1 mg
Class: Hormone Replacement

J1807

ETHACRYNATE SODIUM

HCPCS Descriptor: Injection, ethacrynate sodium, 1 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 2

J1430

HCPCS Descriptor: Injection, ethanolamine oleate, 100 mg
Manufacturer: Qol Medical
Class: Cardiology
NDC: 1

100 mg per unit

J0207

HCPCS Descriptor: Injection, amifostine, 500 mg
Manufacturer: Legacy Pharma
Class: Anti-Emetic
NDCs: 3

500 mg per unit

J1436

ETIDRONATE DISODIUM

HCPCS Descriptor: Injection, etidronate disodium, per 300 mg
Class: Osteoporosis

300 mg per unit

J8560

HCPCS Descriptor: Etoposide; oral, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 2

J9187

HCPCS Descriptor: Injection, etoposide, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 20

J7323

HCPCS Descriptor: Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose
Manufacturer: Ferring Pharmaceuticals
Class: Orthopedic
NDC: 1

per dose per unit

C9312

HCPCS Descriptor: Injection, trabectedin (apotex), not therapeutically equivalent to j9362, 0.01 mg
Manufacturer: Apotex
Class: Oncology
NDC: 1

0.01 mg per unit

J3111

HCPCS Descriptor: Injection, romosozumab-aqqg, 1 mg
Manufacturer: Amgen
Class: Osteoporosis
NDCs: 4

J1305

HCPCS Descriptor: Injection, evinacumab-dgnb, 5mg
Manufacturer: Regeneron Pharmaceuticals
Class: Cardiology
NDCs: 2

J9246

HCPCS Descriptor: Injection, melphalan (evomela), 1 mg
Manufacturer: Acrotech Biopharma
Class: Oncology
NDC: 1

J2361

HCPCS Descriptor: Injection, depemokimab-ulaa, 1 mg
Manufacturer: GlaxoSmithKline
Class: Anti-Eosinophil Asthma
NDCs: 2

J1428

HCPCS Descriptor: Injection, eteplirsen, 10 mg
Manufacturer: Sarepta Therapeutics
Class: Genetic Disorder
NDCs: 2

J0666

HCPCS Descriptor: Injection, bupivacaine liposome, 1 mg
Manufacturer: Pacira Pharmaceuticals
Class: Non-Opioid Analgesic
NDCs: 6

Q5170

HCPCS Descriptor: Injection, aflibercept-boav (eydenzelt), biosimilar, 1 mg
Class: Ophthalmology

J0178

HCPCS Descriptor: Injection, aflibercept, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Ophthalmology
NDCs: 2

J0177

HCPCS Descriptor: Injection, aflibercept hd, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Ophthalmology
NDC: 1

J0180

HCPCS Descriptor: Injection, agalsidase beta, 1 mg
Manufacturer: Sanofi
Class: Enzyme Replacement Therapy
NDCs: 2

NOC FAMOTIDINE

Manufacturer: Multiple Manufacturers
Class: Gastroenterology
NDCs: 10

J1308

FAMOTIDINE PREMIXED

HCPCS Descriptor: Injection, famotidine, 0.25 mg
Manufacturer: Multiple Manufacturers
Class: Antihistamine
NDCs: 24

0.25 mg per unit

J0517

HCPCS Descriptor: Injection, benralizumab, 1 mg
Manufacturer: AstraZeneca
Class: Anti-Eosinophil Asthma
NDCs: 3

J9395

HCPCS Descriptor: Injection, fulvestrant, 25 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 30

J7198

HCPCS Descriptor: Anti-inhibitor, per i.u.
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDCs: 3

J1951

HCPCS Descriptor: Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg
Manufacturer: Tolmar Pharmaceuticals
Class: Growth Disorder
NDCs: 2

0.25 mg per unit

J3010

FENTANYL CITRATE

HCPCS Descriptor: Injection, fentanyl citrate, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 32

0.1 mg per unit

A9574

HCPCS Descriptor: Injection, ferumoxytol, 1 mg
Manufacturer: Azurity Pharmaceuticals
Class: Imaging/Radiopharmaceutical
NDCs: 2

Q0138

HCPCS Descriptor: Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
Manufacturer: Multiple Manufacturers
Class: Anti-Anemia
NDCs: 2

Q0139

HCPCS Descriptor: Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Anti-Anemia
NDCs: 2

J2916

HCPCS Descriptor: Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Anemia
NDCs: 4

12.5 mg per unit

J7176

HCPCS Descriptor: Injection, human fibrinogen - chmt (fesilty), 1 mg
Manufacturer: Grifols
Class: Hematology
NDCs: 2

J0699

HCPCS Descriptor: Injection, cefiderocol, 10 mg
Manufacturer: Shionogi Pharma
Class: Antibiotic
NDCs: 2

J1811

HCPCS Descriptor: Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units
Manufacturer: Novo Nordisk
Class: Insulin
NDCs: 2

50 units per unit

J1812

HCPCS Descriptor: Insulin (fiasp), per 5 units
Manufacturer: Novo Nordisk
Class: Insulin
NDCs: 3

5 units per unit

J7177

HCPCS Descriptor: Injection, human fibrinogen concentrate (fibryga), 1 mg
Manufacturer: Octapharma
Class: Hematology
NDCs: 4

J1744

HCPCS Descriptor: Injection, icatibant, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 15

J9155

HCPCS Descriptor: Injection, degarelix, 1 mg
Manufacturer: Ferring Pharmaceuticals
Class: Oncology
NDCs: 2

J1572

FLEBOGAMMA 10% DIF

HCPCS Descriptor: Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 7

500 mg per unit

J9200

HCPCS Descriptor: Injection, floxuridine, 500 mg
Manufacturer: JND Therapeutics
Class: Oncology
NDC: 1

500 mg per unit

90694

FLUAD QUADRIVALENT 2022-2023 FORMULA

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use
Manufacturer: Seqirus
Class: Vaccine
NDC: 1

0.5 ml per unit

90653

FLUAD TRIVALENT (2024/2025) PRESERVATIVE FREE

HCPCS Descriptor: Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use
Manufacturer: Seqirus
Class: Vaccine
NDCs: 3

0.5 ml per unit

90686

Fluarix Quadrivalent (2021/2022) (Pres free)

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 3

0.5 ml per unit

90682

FLUBLOK QUADRIVALENT 2022-2023 FORMULA

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDC: 1

0.5 ml per unit

90756

Flucelvax Quadrivalent (2021/2022)

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use
Manufacturer: Seqirus
Class: Vaccine
NDC: 1

0.5 ml per unit

90674

FLUCELVAX QUADRIVALENT 2022-2023 FORMULA PF

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
Manufacturer: Seqirus
Class: Vaccine
NDC: 1

0.5 ml per unit

90661

FLUCELVAX TRIVALENT (2024/2025)

HCPCS Descriptor: Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use
Manufacturer: Seqirus
Class: Vaccine
NDCs: 5

0.5 ml per unit

J1450

Fluconazole In Sodium Chloride

HCPCS Descriptor: Injection fluconazole, 200 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 16

200 mg per unit

J9185

FLUDARABINE PHOSPHATE

HCPCS Descriptor: Injection, fludarabine phosphate, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 6

A9609

FLUDEOXYGLUCOSE F18

HCPCS Descriptor: Fludeoxyglucose f18 up to 15 millicuries
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 4

15 millicuries per unit

90688

FLULAVAL QUADRIVALENT (2019/2020)

HCPCS Descriptor: Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use
Manufacturer: Sanofi Pasteur
Class: Vaccine
NDCs: 2

0.5 ml per unit

NOC FLUMAZENIL

Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 9

0.1 mg per unit

90672

FluMist Quadrivalent (2021/2022)

HCPCS Descriptor: Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use
Manufacturer: MedImmune
Class: Vaccine
NDC: 1

0.2 ml per unit

90660

FLUMIST QUADRIVALENT (2023/2024)

HCPCS Descriptor: Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use
Manufacturer: AstraZeneca
Class: Vaccine
NDCs: 3

0.2 ml per unit

J7641

HCPCS Descriptor: Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram
Class: Respiratory

A9612

HCPCS Descriptor: Injection, fluorescein, 1 mg
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 2

A9602

HCPCS Descriptor: Fluorodopa f-18, diagnostic, per millicurie
Manufacturer: The Feinstein Institute for Medical Research
Class: Imaging/Radiopharmaceutical
NDC: 1

J9192

HCPCS Descriptor: Injection, fluorouracil, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 28

J2680

FLUPHENAZINE DECANOATE

HCPCS Descriptor: Injection, fluphenazine decanoate, up to 25 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 8

J2679

FLUPHENAZINE HCL

HCPCS Descriptor: Injection, fluphenazine hcl, 1.25 mg
Manufacturer: Fresenius Kabi
Class: Psychiatric
NDC: 1

1.25 mg per unit

90656

FLUVARIX TRIVALENT (2024/2025) PRESERVATIVE FREE

HCPCS Descriptor: Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 11

0.5 ml per unit

90657

FLUZONE HIGH-DOSE (2024/2025) PRESERVATIVE FREE

HCPCS Descriptor: Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 4

0.25 ml per unit

90658

FLUZONE HIGH-DOSE (2024/2025) PRESERVATIVE FREE

HCPCS Descriptor: Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 5

0.5 ml per unit

90662

FLUZONE HIGH-DOSE QUADRIVALENT (2020/2021)

HCPCS Descriptor: Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 3

0.5 ml per unit

A9611

HCPCS Descriptor: Flurpiridaz f 18, diagnostic, 1 millicurie
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

J1434

HCPCS Descriptor: Injection, fosaprepitant (focinvez), 1 mg
Manufacturer: Amneal Pharmaceuticals
Class: Antiviral
NDC: 1

J1808

HCPCS Descriptor: Injection, folic acid, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Anemia
NDCs: 2

0.1 mg per unit

NOC FOLIC ACID

Manufacturer: Fresenius Kabi
Class: Anti-Anemia
NDC: 1

S0128

HCPCS Descriptor: Injection, follitropin beta, 75 iu
Manufacturer: Merck
Class: Fertility
NDC: 1

J9307

HCPCS Descriptor: Injection, pralatrexate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 8

J1451

HCPCS Descriptor: Injection, fomepizole, 15 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 4

J7640

HCPCS Descriptor: Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms
Class: Respiratory

12 micrograms per unit

J3110

HCPCS Descriptor: Injection, teriparatide, 10 mcg
Manufacturer: Multiple Manufacturers
Class: Osteoporosis
NDCs: 8

10 mcg per unit

J1456

HCPCS Descriptor: Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg
Manufacturer: Teva
Class: Anti-Emetic
NDC: 1

J1455

FOSCARNET SODIUM

HCPCS Descriptor: Injection, foscarnet sodium, per 1000 mg
Manufacturer: Multiple Manufacturers
Class: Antiviral
NDCs: 8

1000 mg per unit

J1645

HCPCS Descriptor: Injection, dalteparin sodium, per 2500 iu
Manufacturer: Pfizer
Class: Hematology
NDCs: 17

2500 iu per unit

Q5108

HCPCS Descriptor: Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg
Manufacturer: Biocon Biologics
Class: Oncology Colony Stimulating Factor
NDCs: 2

0.5 mg per unit

J9393

HCPCS Descriptor: Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDC: 1

J9394

HCPCS Descriptor: Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg
Manufacturer: Fresenius Kabi
Class: Oncology
NDC: 1

J1947

HCPCS Descriptor: Injection, furosemide (furoscix), 1 mg
Manufacturer: scPharmaceuticals
Class: Diuretic
NDC: 1

J1938

HCPCS Descriptor: Injection, furosemide, 1 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 64

NOC FUROSEMIDE (

HCPCS Descriptor: NOC Furosemide (Phlow Corporation)
Manufacturer: PHLOW CORPORATION

J0641

HCPCS Descriptor: Injection, levoleucovorin, not otherwise specified, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 8

0.5 mg per unit

J1324

HCPCS Descriptor: Injection, enfuvirtide, 1 mg
Manufacturer: Genentech
Class: Anti-HIV
NDC: 1

J9331

HCPCS Descriptor: Injection, sirolimus protein-bound particles, 1 mg
Manufacturer: Aadi Bioscience
Class: Oncology
NDC: 1

Q5130

HCPCS Descriptor: Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg
Manufacturer: Amneal Pharmaceuticals
Class: Oncology Colony Stimulating Factor
NDC: 1

0.5 mg per unit

A9585

HCPCS Descriptor: Injection, gadobutrol, 0.1 ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 23

0.1 ml per unit

J1460

HCPCS Descriptor: Injection, gamma globulin, intramuscular, 1 cc
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 4

J1560

HCPCS Descriptor: Injection, gamma globulin, intramuscular, over 10 cc
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 3

J9210

HCPCS Descriptor: Injection, emapalumab-lzsg, 1 mg
Manufacturer: Sobi
Class: Oncology
NDCs: 3

J1569

GAMMAGARD LIQUID

HCPCS Descriptor: Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg
Manufacturer: Takeda Pharmaceuticals
Class: Immunoglobulin
NDCs: 9

500 mg per unit

J1566

HCPCS Descriptor: Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
Manufacturer: Takeda Pharmaceuticals
Class: Immunoglobulin
NDCs: 2

500 mg per unit

J1561

HCPCS Descriptor: Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 12

500 mg per unit

J1557

HCPCS Descriptor: Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg
Manufacturer: Bio Products Laboratory
Class: Immunoglobulin
NDCs: 12

500 mg per unit

J1570

HCPCS Descriptor: Injection, ganciclovir sodium, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antiviral
NDCs: 9

500 mg per unit

J1574

HCPCS Descriptor: Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg
Manufacturer: EXELA PHARMA SCIENCES
Class: Antiviral
NDCs: 2

500 mg per unit

S0132

GANIRELIX ACETATE

HCPCS Descriptor: Injection, ganirelix acetate, 250 mcg
Manufacturer: Multiple Manufacturers
Class: Fertility
NDCs: 3

250 mcg per unit

90651

HCPCS Descriptor: Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 2 or 3 dose schedule, for intramuscular use
Manufacturer: Merck
Class: Vaccine
NDCs: 3

per dose per unit

Q9963

HCPCS Descriptor: High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 3

J9301

HCPCS Descriptor: Injection, obinutuzumab, 10 mg
Manufacturer: Genentech
Class: Oncology
NDC: 1

J7326

HCPCS Descriptor: Hyaluronan or derivative, gel-one, for intra-articular injection, per dose
Manufacturer: Zimmer
Class: Orthopedic
NDC: 1

per dose per unit

J7328

HCPCS Descriptor: Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg
Manufacturer: Bioventus
Class: Orthopedic
NDC: 1

0.1 mg per unit

J9196

HCPCS Descriptor: Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg
Manufacturer: Accord
Class: Oncology
NDCs: 4

200 mg per unit

J9201

HCPCS Descriptor: Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 51

200 mg per unit

J1580

GENTAMICIN SULFATE

HCPCS Descriptor: Injection, garamycin, gentamicin, up to 80 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 26

J7320

HCPCS Descriptor: Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
Manufacturer: Orthogenrx
Class: Orthopedic
NDC: 1

J3486

HCPCS Descriptor: Injection, ziprasidone mesylate, 10 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 11

J0223

HCPCS Descriptor: Injection, givosiran, 0.5 mg
Manufacturer: Alnylam Pharmaceuticals
Class: Genetic Disorder
NDC: 1

0.5 mg per unit

J0257

HCPCS Descriptor: Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg
Manufacturer: Takeda Pharmaceuticals
Class: Enzyme Replacement Therapy
NDCs: 6

J1610

HCPCS Descriptor: Injection, glucagon hydrochloride, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 4

J1611

Glucagon Emergency

HCPCS Descriptor: Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg
Manufacturer: Fresenius Kabi
Class: Endocrinology
NDCs: 7

J1598

HCPCS Descriptor: Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg
Manufacturer: Fresenius Kabi
Class: Misc.
NDCs: 4

0.1 mg per unit

J7642

HCPCS Descriptor: Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7643

HCPCS Descriptor: Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

NOC GLYCOPYRROLA

HCPCS Descriptor: Glycopyrrolate injection, 0.2 MG
Manufacturer: American Regent

0.2 mg per unit

NOC GLYCOPYRROLA

HCPCS Descriptor: NOC Glycopyrrolate injection (Fresenius Kabi)
Manufacturer: Fresenius Kabi USA, LLC

0.1 mg per unit

J1596

GLYCOPYRROLATE INJECTION

HCPCS Descriptor: Injection, glycopyrrolate, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 124

0.1 mg per unit

J1597

HCPCS Descriptor: Injection, glycopyrrolate (glyrx-pf), 0.1 mg
Manufacturer: Exela Pharma Sciences
Class: Anesthetic
NDCs: 6

0.1 mg per unit

J1600

GOLD SODIUM THIOMALATE

HCPCS Descriptor: Injection, gold sodium thiomalate, up to 50 mg
Class: Misc.

S0126

GONAL-F RFF REDI-JECT

HCPCS Descriptor: Injection, follitropin alfa, 75 iu
Manufacturer: Multiple Manufacturers
Class: Fertility
NDCs: 4

A9616

HCPCS Descriptor: Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie
Manufacturer: Telix Pharmaceuticals US
Class: Imaging/Radiopharmaceutical
NDCs: 2

J0614

HCPCS Descriptor: Injection, treosulfan, 50 mg
Manufacturer: Medexus Pharma
Class: Oncology
NDCs: 4

Q4132

HCPCS Descriptor: Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Osiris Therapeutics
Class: Wound Care
NDCs: 3

1 sq cm per unit

J1626

GRANISETRON HCL

HCPCS Descriptor: Injection, granisetron hydrochloride, 100 mcg
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 6

100 mcg per unit

Q0166

Granisetron HCl

HCPCS Descriptor: Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Manufacturer: Breckenridge
Class: Anti-Emetic
NDCs: 2

J1447

HCPCS Descriptor: Injection, tbo-filgrastim, 1 microgram
Manufacturer: Teva
Class: Oncology Colony Stimulating Factor
NDCs: 12

J1612

HCPCS Descriptor: Injection, glucagon (gvoke), 0.01 mg
Manufacturer: Xeris Pharmaceuticals
Class: Endocrinology
NDCs: 9

0.01 mg per unit

J0801

HCPCS Descriptor: Injection, corticotropin (acthar gel), up to 40 units
Manufacturer: Mallinckrodt Pharmaceuticals
Class: Immunosuppressant
NDCs: 5

up to 40 units per unit

J0599

HCPCS Descriptor: Injection, c-1 esterase inhibitor (human), (haegarda), 10 units
Manufacturer: CSL Behring
Class: Immunology
NDCs: 2

10 units per unit

J9179

HCPCS Descriptor: Injection, eribulin mesylate, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 12

0.1 mg per unit

J1631

HALDOL DECANOATE 100

HCPCS Descriptor: Injection, haloperidol decanoate, per 50 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 65

J1630

HALOPERIDOL LACTATE

HCPCS Descriptor: Injection, haloperidol, up to 5 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 8

90632

HCPCS Descriptor: Hepatitis A vaccine (HepA), adult dosage, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 8

90633

HAVRIX PEDIATRIC

HCPCS Descriptor: Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 2

per dose per unit

Q4164

HCPCS Descriptor: Helicoll, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: ENCOLL CORP
Class: Wound Care
NDCs: 7

1 sq cm per unit

J0675

HCPCS Descriptor: Injection, carboprost tromethamine, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Women's Health
NDCs: 31

0.1 mg per unit

J8541

HCPCS Descriptor: Dexamethasone (hemady), oral, 0.25 mg
Manufacturer: Acrotech Biopharma
Class: Oncology
NDCs: 4

0.25 mg per unit

38241

Hematopoietic Progenitor Cell Transplantation

HCPCS Descriptor: Hematopoietic progenitor cell (HPC); autologous transplantation

J1411

HCPCS Descriptor: Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
Manufacturer: CSL Behring
Class: Hematology
NDCs: 39

per therapeutic dose per unit

J7170

HCPCS Descriptor: Injection, emicizumab-kxwh, 0.5 mg
Manufacturer: Genentech
Class: Hematology
NDCs: 6

0.5 mg per unit

90935

Hemodialysis Procedure

HCPCS Descriptor: Hemodialysis procedure with single evaluation by a physician or other qualified healthcare professional

J1571

HCPCS Descriptor: Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml
Manufacturer: Kamada
Class: Immunoglobulin
NDCs: 4

0.5 ml per unit

J1573

HCPCS Descriptor: Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml
Manufacturer: Kamada
Class: Immunoglobulin
NDCs: 2

0.5 ml per unit

J1642

HCPCS Descriptor: Injection, heparin sodium, (heparin lock flush), per 10 units
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 14

10 units per unit

J1644

Heparin (Porcine) In NaCl

HCPCS Descriptor: Injection, heparin sodium, per 1000 units
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 172

1000 units per unit

J1643

HCPCS Descriptor: Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units
Manufacturer: Pfizer
Class: Hematology
NDCs: 2

1000 units per unit

80076

Hepatic Function Panel Test

HCPCS Descriptor: Hepatic function panel test in which the blood levels of protein, albumin, alkaline phosphatase, bilirubin, and liver enzymes are measured

90739

HCPCS Descriptor: Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use
Manufacturer: Dynavax
Class: Vaccine
NDCs: 2

1 dose per unit

J9248

HCPCS Descriptor: Injection, melphalan (hepzato), 1 mg
Manufacturer: Delcath Systems
Class: Oncology
NDCs: 2

J9355

HCPCS Descriptor: Injection, trastuzumab, excludes biosimilar, 10 mg
Manufacturer: Genentech
Class: Oncology
NDC: 1

J9356

HERCEPTIN HYLECTA

HCPCS Descriptor: Injection, trastuzumab, 10 mg and hyaluronidase-oysk
Manufacturer: Genentech
Class: Oncology
NDC: 1

Q5113

HCPCS Descriptor: Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg
Manufacturer: Teva
Class: Oncology
NDCs: 2

J3303

HCPCS Descriptor: Injection, triamcinolone hexacetonide, per 5 mg
Manufacturer: Medexus Pharma
Class: Immunosuppressant
NDC: 1

J9225

HCPCS Descriptor: Histrelin implant (vantas), 50 mg
Manufacturer: Endo Pharmaceuticals
Class: Oncology

J1675

HISTRELIN ACETATE

HCPCS Descriptor: Injection, histrelin acetate, 10 micrograms
Class: Endocrinology

10 micrograms per unit

J1559

HCPCS Descriptor: Injection, immune globulin (hizentra), 100 mg
Manufacturer: CSL Behring
Class: Immunoglobulin
NDCs: 10

100 mg per unit

Q5140

HCPCS Descriptor: Injection, adalimumab-fkjp, biosimilar, 1 mg
Manufacturer: Biocon Biologics
Class: Immunology: Anti-TNF
NDCs: 6

J1817

HCPCS Descriptor: Insulin for administration through dme (i.e., insulin pump) per 50 units
Manufacturer: Multiple Manufacturers
Class: Insulin
NDCs: 24

50 units per unit

J7187

HCPCS Descriptor: Injection, von willebrand factor complex (humate-p), per iu vwf:rco
Manufacturer: CSL Behring
Class: Hematology
NDCs: 4

J0139

HCPCS Descriptor: Injection, adalimumab, 1 mg
Manufacturer: AbbVie
Class: Immunology: Anti-TNF
NDCs: 12

S5550

HUMULIN R U-500

HCPCS Descriptor: Insulin, rapid onset, 5 units
Manufacturer: Eli Lilly
Class: Insulin
NDC: 1

5 units per unit

J7321

HCPCS Descriptor: Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose
Manufacturer: Multiple Manufacturers
Class: Orthopedic
NDCs: 3

per dose per unit

J3472

HCPCS Descriptor: Injection, hyaluronidase, ovine, preservative free, per 1000 usp units
Class: Enzyme Replacement Therapy

1000 usp units per unit

J8705

HCPCS Descriptor: Topotecan, oral, 0.25 mg
Manufacturer: Sandoz
Class: Oncology
NDCs: 4

0.25 mg per unit

J9351

HCPCS Descriptor: Injection, topotecan, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 9

0.1 mg per unit

J0360

HYDRALAZINE HCL

HCPCS Descriptor: Injection, hydralazine hcl, up to 20 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 16

J1700

HYDROCORTISONE ACETATE

HCPCS Descriptor: Injection, hydrocortisone acetate, up to 25 mg
Class: Misc.

J1171

HYDROMORPHONE HCL

HCPCS Descriptor: Injection, hydromorphone, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 53

0.1 mg per unit

J3425

HYDROXOCOBALAMIN

HCPCS Descriptor: Injection, hydroxocobalamin, intramuscular, 10 mcg
Manufacturer: Teva
Class: Hematology
NDC: 1

10 mcg per unit

J1729

HYDROXYPROGESTERONE CAPROATE

HCPCS Descriptor: Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
Manufacturer: Slayback Pharma
Class: Women's Health
NDCs: 2

J3410

Hydroxyzine Hcl

HCPCS Descriptor: Injection, hydroxyzine hcl, up to 25 mg
Manufacturer: American Regent
Class: Antihistamine
NDCs: 3

J3473

HCPCS Descriptor: Injection, hyaluronidase, recombinant, 1 usp unit
Manufacturer: Antares Pharma
Class: Misc.
NDC: 1

1 usp unit per unit

J7322

HCPCS Descriptor: Hyaluronan or derivative, hymovis or hymovis one, for intra-articular injection, 1 mg
Manufacturer: Fidia Pharma
Class: Orthopedic
NDCs: 3

J7172

HCPCS Descriptor: Injection, marstacimab-hncq, 0.5 mg
Manufacturer: Pfizer
Class: Hematology
NDC: 1

0.5 mg per unit

90371

HCPCS Descriptor: Hepatitis B immune globulin (HBIg), human, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 8

90375

HCPCS Descriptor: Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use
Manufacturer: Grifols
Class: Vaccine
NDCs: 6

150 iu per unit

J2788

HCPCS Descriptor: Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)
Manufacturer: Grifols
Class: Hematology
NDCs: 2

50 mcg per unit

J2790

HCPCS Descriptor: Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 6

300 mcg (1500 iu) per unit

J1670

HCPCS Descriptor: Injection, tetanus immune globulin, human, up to 250 units
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 2

250 units per unit

J1575

HCPCS Descriptor: Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
Manufacturer: Takeda Pharmaceuticals
Class: Immunoglobulin
NDCs: 5

100 mg per unit

Q5144

HCPCS Descriptor: Injection, adalimumab-aacf (idacio), biosimilar, 1 mg
Manufacturer: Fresenius Kabi
Class: Immunology: Anti-TNF
NDCs: 4

J9211

HCPCS Descriptor: Injection, idarubicin hydrochloride, 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 18

J7202

HCPCS Descriptor: Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.
Manufacturer: CSL Behring
Class: Hematology
NDCs: 5

J7355

HCPCS Descriptor: Injection, travoprost, intracameral implant, 1 microgram
Manufacturer: Glaukos
Class: Imaging/Radiopharmaceutical
NDC: 1

J9208

HCPCS Descriptor: Injection, ifosfamide, 1 gram
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 8

J1105

HCPCS Descriptor: Dexmedetomidine, oral, 1 mcg
Manufacturer: BioXcel Therapeutics
Class: Psychiatric
NDCs: 2

J2403

HCPCS Descriptor: Chloroprocaine hcl ophthalmic, 3% gel, 1 mg
Manufacturer: Harrow Eye
Class: Ophthalmology
NDCs: 2

J0638

HCPCS Descriptor: Injection, canakinumab, 1 mg
Manufacturer: Novartis
Class: Immunology: Anti-TNF
NDC: 1

A9596

HCPCS Descriptor: Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
Manufacturer: Telix Pharmaceuticals US
Class: Imaging/Radiopharmaceutical
NDCs: 2

J3245

HCPCS Descriptor: Injection, tildrakizumab, 1 mg
Manufacturer: Sun Pharma
Class: Immunology: Anti-TNF
NDC: 1

J7313

HCPCS Descriptor: Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg
Manufacturer: ANI Pharmaceuticals
Class: Ophthalmology
NDC: 1

0.01 mg per unit

J9256

HCPCS Descriptor: Injection, nipocalimab-aahu, 3 mg
Manufacturer: Janssen
Class: Immunology
NDCs: 2

J9026

HCPCS Descriptor: Injection, tarlatamab-dlle, 1 mg
Manufacturer: Amgen
Class: Anti-Emetic
NDCs: 4

J9173

HCPCS Descriptor: Injection, durvalumab, 10 mg
Manufacturer: AstraZeneca
Class: Oncology
NDCs: 2

J0743

IMIPENEM-CILASTATIN SODIUM

HCPCS Descriptor: Injection, cilastatin sodium; imipenem, per 250 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 11

250 mg per unit

J9347

HCPCS Descriptor: Injection, tremelimumab-actl, 1 mg
Manufacturer: AstraZeneca
Class: Misc.
NDCs: 2

J9325

HCPCS Descriptor: Injection, talimogene laherparepvec, per 1 million plaque forming units
Manufacturer: Amgen
Class: Oncology
NDCs: 2

1 million pfu per unit

J2373

HCPCS Descriptor: Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms
Manufacturer: Hikma
Class: Antiviral
NDCs: 4

20 mcg per unit

90460

Immunization Administration

HCPCS Descriptor: Immunization administration via any route, first vaccine/toxoid component

90471

Immunization Administration

HCPCS Descriptor: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), one vaccine (single or combination vaccine/toxoid)

90376

IMOGAM RABIES-HT

HCPCS Descriptor: Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

150 iu per unit

90675

HCPCS Descriptor: Rabies vaccine, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 5

11981

Implant Administration

HCPCS Descriptor: Insertion of single non-biodegradable implant

J2170

HCPCS Descriptor: Injection, mecasermin, 1 mg
Manufacturer: Eton Pharmaceuticals
Class: Growth Disorder
NDCs: 2

A9548

Indium In 111 DTPA

HCPCS Descriptor: Indium in-111 pentetate, diagnostic, per 0.5 millicurie
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

0.5 millicuries per unit

A9547

Indium In 111 Oxyquinoline

HCPCS Descriptor: Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

0.5 millicuries per unit

J1750

HCPCS Descriptor: Injection, iron dextran, 50 mg
Manufacturer: AbbVie
Class: Anti-Anemia
NDCs: 2

Q5103

HCPCS Descriptor: Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
Manufacturer: Pfizer
Class: Immunology: Anti-TNF
NDC: 1

Q2038

Influenza Virus Vaccine

HCPCS Descriptor: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)
Manufacturer: Sanofi
Class: Vaccine
NDCs: 6

per therapeutic dose per unit

J9198

HCPCS Descriptor: Injection, gemcitabine hydrochloride, (infugem), 100 mg
Manufacturer: Sun Pharma
Class: Oncology
NDCs: 10

100 mg per unit

64455

Injection Of Anesthetic Agent

HCPCS Descriptor: Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves

62322

Injection Of Diagnostic Substance

HCPCS Descriptor: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance

J9183

HCPCS Descriptor: Gemcitabine intravesical system, 225 mg
Manufacturer: Janssen
Class: Oncology
NDC: 1

225 mg per unit

68841

Insertion Of Drug-Eluting Implant

HCPCS Descriptor: the insertion of a drug-eluting implant into the lacrimal caliculus, including punctal dilation

Q4104

Integra Bilayer Wound Matrix

HCPCS Descriptor: Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Integra Lifesciences
Class: Wound Care
NDCs: 8

1 sq cm per unit

Q4114

Integra Flowable Wound Matrix

HCPCS Descriptor: Integra flowable wound matrix, injectable, 1 cc
Manufacturer: Integra Lifesciences
Class: Wound Care
NDC: 1

Q4105

Integra Omnigraft Dermal Regeneration Matrix

HCPCS Descriptor: Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Multiple Manufacturers
Class: Wound Care
NDCs: 11

1 sq cm per unit

Q4108

Integra Wound Matrix

HCPCS Descriptor: Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Integra Lifesciences
Class: Wound Care
NDCs: 6

1 sq cm per unit

J9213

HCPCS Descriptor: Injection, interferon, alfa-2a, recombinant, 3 million units
Class: Immunology

3 million units per unit

58300

Intrauterine Device Administration

HCPCS Descriptor: Insertion, intrauterine device

96360

Intravenous Infusion

HCPCS Descriptor: Intravenous infusion, hydration; initial, 31 minutes to 1 hour

96361

Intravenous Infusion

HCPCS Descriptor: Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)

96365

Intravenous Infusion

HCPCS Descriptor: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

96366

Intravenous Infusion

HCPCS Descriptor: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

96367

Intravenous Infusion

HCPCS Descriptor: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)

96368

Intravenous Infusion

HCPCS Descriptor: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)

67027

Intravitreal Implant

HCPCS Descriptor: Implantation of intravitreal drug delivery system, includes concomitant removal of vitreous

67028

Intravitreal Injection

HCPCS Descriptor: Intravitreal injection of a pharmacologic agent (separate procedure) 67028

J9214

HCPCS Descriptor: Injection, interferon, alfa-2b, recombinant, 1 million units
Manufacturer: Merck
Class: Immunology
NDCs: 3

1 mil units per unit

J2426

INVEGA SUSTENNA

HCPCS Descriptor: Injection, paliperidone palmitate extended release (invega sustenna), 1 mg
Manufacturer: Janssen
Class: Psychiatric
NDCs: 5

J2427

HCPCS Descriptor: Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg
Manufacturer: Janssen
Class: Psychiatric
NDCs: 6

NOC PALIPERIDONE

HCPCS Descriptor: Paliperidone Palmitate (Invega Trinza),1 MG
Manufacturer: Janssen

90713

HCPCS Descriptor: Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

per dose per unit

J7644

IPRATROPIUM BROMIDE

HCPCS Descriptor: Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 23

J7645

IPRATROPIUM BROMIDE

HCPCS Descriptor: Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J8565

HCPCS Descriptor: Gefitinib, oral, 250 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 4

250 mg per unit

J7647

ISOETHARINE HCL

HCPCS Descriptor: Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7648

ISOETHARINE HCL

HCPCS Descriptor: Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram
Class: Respiratory

J7649

ISOETHARINE HCL

HCPCS Descriptor: Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Class: Respiratory

J7650

ISOETHARINE HCL

HCPCS Descriptor: Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J1834

ISONIAZID INJECTION

HCPCS Descriptor: Injection, isoniazid, 1 mg
Manufacturer: Sandoz
Class: Antibiotic
NDC: 1

J7657

ISOPROTERENOL HCL

HCPCS Descriptor: Isoproterenol hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7658

ISOPROTERENOL HCL

HCPCS Descriptor: Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram
Class: Respiratory

J7659

ISOPROTERENOL HCL

HCPCS Descriptor: Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Class: Respiratory

J7660

ISOPROTERENOL HCL

HCPCS Descriptor: Isoproterenol hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

Q9966

HCPCS Descriptor: Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 21

Q9967

HCPCS Descriptor: Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 114

J9319

HCPCS Descriptor: Injection, romidepsin, lyophilized, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 3

0.1 mg per unit

J1835

HCPCS Descriptor: Injection, itraconazole, 50 mg
Class: Anti-Fungal

J3405

HCPCS Descriptor: Injection, onasemnogene abeparvovec-brve, per treatment
Manufacturer: Novartis
Class: Genetic Disorder
NDCs: 2

per treatment per unit

J9207

HCPCS Descriptor: Injection, ixabepilone, 1 mg
Manufacturer: R-Pharm US
Class: Oncology
NDCs: 2

90738

HCPCS Descriptor: Japanese encephalitis virus vaccine, inactivated, for intramuscular use
Manufacturer: Valneva
Class: Vaccine
NDC: 1

per dose per unit

J7213

HCPCS Descriptor: Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.
Manufacturer: Aptevo BioTherapeutics
Class: Hematology
NDCs: 10

NOC COAGULATION

HCPCS Descriptor: Coagulation Factor IX, Recombinant (Ixinity),1 IU
Manufacturer: Aptevo Biotherapeutics

J2782

HCPCS Descriptor: Injection, avacincaptad pegol, 0.1 mg
Manufacturer: Astellas Pharma
Class: Ophthalmology
NDC: 1

0.1 mg per unit

J9281

HCPCS Descriptor: Mitomycin pyelocalyceal instillation, 1 mg
Manufacturer: UroGen Pharma
Class: Oncology
NDC: 1

J9272

HCPCS Descriptor: Injection, dostarlimab-gxly, 10 mg
Manufacturer: GlaxoSmithKline
Class: Oncology
NDC: 1

J9043

HCPCS Descriptor: Injection, cabazitaxel, 1 mg
Manufacturer: Sanofi
Class: Oncology
NDC: 1

J7208

HCPCS Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.
Manufacturer: Bayer Pharmaceutical
Class: Hematology
NDCs: 5

Q5160

HCPCS Descriptor: Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg
Manufacturer: Biocon Biologics
Class: Oncology
NDCs: 2

C9818

HCPCS Descriptor: Suzetrigine, oral, 1 mg
Manufacturer: Vertex Pharmaceuticals
Class: Non-Opioid Analgesic
NDCs: 3

J8611

HCPCS Descriptor: Methotrexate (jylamvo), oral, 2.5 mg
Manufacturer: Shorla Oncology
Class: Oncology
NDC: 1

2.5 mg per unit

J9354

HCPCS Descriptor: Injection, ado-trastuzumab emtansine, 1 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

J1290

HCPCS Descriptor: Injection, ecallantide, 1 mg
Manufacturer: Takeda Pharmaceuticals
Class: Immunology
NDC: 1

Q5117

HCPCS Descriptor: Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
Manufacturer: Amgen
Class: Oncology
NDCs: 5

J2840

HCPCS Descriptor: Injection, sebelipase alfa, 1 mg
Manufacturer: AstraZeneca
Class: Enzyme Replacement Therapy
NDC: 1

J7168

HCPCS Descriptor: Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity
Manufacturer: CSL Behring
Class: Hematology
NDCs: 2

90377

HCPCS Descriptor: Rabies ig ht&sol human im/sc
Manufacturer: Kedrion Biopharma
Class: Vaccine
NDCs: 3

150 iu per unit

NOC RABIES IMMUN

HCPCS Descriptor: Rabies Immune Globulin (Kedrab),150 IU
Manufacturer: Kedrion Biopharma

150 iu per unit

J3301

HCPCS Descriptor: Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Manufacturer: Multiple Manufacturers
Class: Orthopedic
NDCs: 44

C9460

HCPCS Descriptor: Injection, cangrelor, 1 mg
Manufacturer: Chiesi USA
Class: Hematology
NDC: 1

J2425

HCPCS Descriptor: Injection, palifermin, 50 micrograms
Manufacturer: Sobi
Class: Oncology
NDCs: 3

50 mcg per unit

J1885

KETOROLAC TROMETHAMINE

HCPCS Descriptor: Injection, ketorolac tromethamine, per 15 mg
Manufacturer: Multiple Manufacturers
Class: Non-Opioid Analgesic
NDCs: 88

J9271

HCPCS Descriptor: Injection, pembrolizumab, 1 mg
Manufacturer: Merck
Class: Oncology
NDCs: 2

J9277

HCPCS Descriptor: Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph
Manufacturer: Merck
Class: Oncology
NDCs: 4

J0642

HCPCS Descriptor: Injection, levoleucovorin (khapzory), 0.5 mg
Manufacturer: Acrotech Biopharma
Class: Oncology
NDC: 1

0.5 mg per unit

J9274

HCPCS Descriptor: Injection, tebentafusp-tebn, 1 microgram
Manufacturer: Immunocore Commercial
Class: Oncology
NDC: 1

J2406

HCPCS Descriptor: Injection, oritavancin (kimyrsa), 10 mg
Manufacturer: Melinta Therapeutics
Class: Antibiotic
NDC: 1

J2805

HCPCS Descriptor: Injection, sincalide, 5 micrograms
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 5

J0175

HCPCS Descriptor: Injection, donanemab-azbt, 2 mg
Manufacturer: Eli Lilly
Class: Neurology
NDC: 1

J0879

HCPCS Descriptor: Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)
Manufacturer: Vifor International
Class: Non-Opioid Analgesic
NDCs: 2

0.1 mcg per unit

J7211

HCPCS Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
Manufacturer: Bayer Pharmaceutical
Class: Hematology
NDCs: 5

J2507

HCPCS Descriptor: Injection, pegloticase, 1 mg
Manufacturer: Amgen
Class: Immunology
NDCs: 2

J7296

HCPCS Descriptor: Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg
Manufacturer: Bayer Pharmaceutical
Class: Contraceptive
NDC: 1

19.5 mg per unit

Q2042

HCPCS Descriptor: Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: Novartis
Class: Oncology
NDCs: 2

up to 600 million car-positive viable t cells per unit

J9047

HCPCS Descriptor: Injection, carfilzomib, 1 mg
Manufacturer: Amgen
Class: Oncology
NDCs: 6

J1920

HCPCS Descriptor: Injection, labetalol hydrochloride, 5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 24

J1921

HCPCS Descriptor: Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg
Manufacturer: Hikma
Class: Cardiology
NDCs: 4

NOC LABETALOL HC

HCPCS Descriptor: Labetalol Hcl,5 MG
Manufacturer: Alvogen

J7120

LACTATED RINGERS

HCPCS Descriptor: Ringers lactate infusion, up to 1000 cc
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 20

up to 1000 cc per unit

J0217

HCPCS Descriptor: Injection, velmanase alfa-tycv, 1 mg
Manufacturer: Chiesi USA
Class: Enzyme Replacement Therapy
NDCs: 2

J1932

HCPCS Descriptor: Injection, lanreotide, (cipla), 1 mg
Manufacturer: Cipla
Class: Oncology
NDC: 1

J0607

Lanthanum carbonate

HCPCS Descriptor: Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 38

J0608

Lanthanum carbonate

HCPCS Descriptor: Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)
Manufacturer: Takeda Pharmaceuticals
Class: Endocrinology
NDCs: 4

S5553

LANTUS SOLOSTAR PEN

HCPCS Descriptor: Insulin, long acting; 5 units
Manufacturer: Sanofi
Class: Insulin
NDC: 1

5 units per unit

J9285

HCPCS Descriptor: Injection, olaratumab, 10 mg
Manufacturer: Eli Lilly and Company
Class: Oncology
NDCs: 2

J1946

HCPCS Descriptor: Injection, furosemide (lasix onyu), 1 mg
Manufacturer: SQ Innovation, Inc.
Class: Diuretic
NDC: 1

J0202

HCPCS Descriptor: Injection, alemtuzumab, 1 mg
Manufacturer: Sanofi
Class: Neurology
NDC: 1

J3391

HCPCS Descriptor: Injection, atidarsagene autotemcel, per treatment
Manufacturer: Orchard Therapeutics
Class: Genetic Disorder
NDC: 1

per treatment dose per unit

J0174

HCPCS Descriptor: Lecanemab-irmb, for intravenous injection, 1 mg
Manufacturer: Eisai
Class: Neurology
NDCs: 2

J1306

HCPCS Descriptor: Injection, inclisiran, 1 mg
Manufacturer: Novartis
Class: Cardiology
NDC: 1

J0643

Leucovorin Calcium

HCPCS Descriptor: Injection, leucovorin calcium, not otherwise specified, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 35

J2820

HCPCS Descriptor: Injection, sargramostim (gm-csf), 50 mcg
Manufacturer: Partner Therapeutics
Class: Oncology Colony Stimulating Factor
NDC: 1

50 mcg per unit

J9218

LEUPROLIDE ACETATE

HCPCS Descriptor: Leuprolide acetate, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 7

J9219

LEUPROLIDE ACETATE

HCPCS Descriptor: Leuprolide acetate implant, 65 mg
Class: Oncology

J7607

HCPCS Descriptor: Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg
Class: Respiratory

0.5 mg per unit

J7614

HCPCS Descriptor: Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 26

0.5 mg per unit

J7615

HCPCS Descriptor: Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg
Class: Respiratory

0.5 mg per unit

J7612

LEVALBUTEROL CONCENTRATE

HCPCS Descriptor: Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 2

0.5 mg per unit

J1957

HCPCS Descriptor: Injection, levetiracetam, 5 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 15

J1958

Levetiracetam in Sodium Chloride

HCPCS Descriptor: Injection, levetiracetam in sodium chloride, 5 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 43

J1956

HCPCS Descriptor: Injection, levofloxacin, 250 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 26

250 mg per unit

J1960

LEVORPHANOL TARTRATE

HCPCS Descriptor: Injection, levorphanol tartrate, up to 2 mg
Class: Opioid Analgesic

J0650

Levothyroxine Sodium

HCPCS Descriptor: Injection, levothyroxine sodium, not otherwise specified, 10 mcg
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 18

10 mcg per unit

J0651

LEVOTHYROXINE SODIUM

HCPCS Descriptor: Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg
Manufacturer: Fresenius Kabi
Class: Hormone Replacement
NDCs: 5

10 mcg per unit

J0652

LEVOTHYROXINE SODIUM

HCPCS Descriptor: Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg
Manufacturer: Hikma
Class: Hormone Replacement
NDC: 1

10 mcg per unit

J1980

HCPCS Descriptor: Injection, hyoscyamine sulfate, up to 0.25 mg
Manufacturer: Mylan
Class: Gastroenterology
NDC: 1

0.25 mg per unit

J7308

HCPCS Descriptor: Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)
Manufacturer: Sun Pharma
Class: Misc.
NDCs: 2

354 mg per unit

J2785

HCPCS Descriptor: Injection, regadenoson, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 13

0.1 mg per unit

J9119

HCPCS Descriptor: Injection, cemiplimab-rwlc, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Oncology
NDC: 1

J2003

HCPCS Descriptor: Injection, lidocaine hydrochloride, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 152

J2002

LIDOCAINE IN D5W

HCPCS Descriptor: Injection, lidocaine hcl in 5% dextrose, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 7

J7297

HCPCS Descriptor: Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg
Manufacturer: AbbVie
Class: Contraceptive
NDC: 1

J2010

HCPCS Descriptor: Injection, lincomycin hcl, up to 300 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 11

up to 300 mg per unit

J2020

HCPCS Descriptor: Injection, linezolid, 200 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 15

200 mg per unit

J2021

HCPCS Descriptor: Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 3

200 mg per unit

J0654

LIOTHYRONINE SODIUM

HCPCS Descriptor: Injection, liothyronine, 1 mcg
Manufacturer: XGen Pharmaceuticals DJB
Class: Endocrinology
NDC: 1

J7100

LMD IN DEXTROSE

HCPCS Descriptor: Infusion, dextran 40, 500 ml
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 4

500 ml per unit

J1818

HCPCS Descriptor: Injection, pegzilarginase-nbln, 0.05 mg
Manufacturer: Immedica Pharma
Class: Enzyme Replacement Therapy
NDC: 1

0.05 mg per unit

A9800

HCPCS Descriptor: Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie
Manufacturer: Novartis
Class: Imaging/Radiopharmaceutical
NDCs: 2

J3263

HCPCS Descriptor: Injection, toripalimab-tpzi, 1 mg
Manufacturer: Coherus Biosciences
Class: Antibiotic
NDC: 1

J2778

HCPCS Descriptor: Injection, ranibizumab, 0.1 mg
Manufacturer: Genentech
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

Q9950

HCPCS Descriptor: Injection, sulfur hexafluoride lipid microspheres, per ml
Manufacturer: Bracco Diagnostics
Class: Imaging/Radiopharmaceutical
NDCs: 4

A9615

HCPCS Descriptor: Injection, pegulicianine, 1 mg
Manufacturer: Lumicell
Class: Imaging/Radiopharmaceutical
NDC: 1

J0221

HCPCS Descriptor: Injection, alglucosidase alfa, (lumizyme), 10 mg
Manufacturer: Sanofi
Class: Enzyme Replacement Therapy
NDC: 1

J9313

HCPCS Descriptor: Injection, moxetumomab pasudotox-tdfk, 0.01 mg
Manufacturer: Astrazeneca
Class: Oncology
NDC: 1

0.01 mg per unit

J9350

HCPCS Descriptor: Injection, mosunetuzumab-axgb, 1 mg
Manufacturer: Genentech
Class: Misc.
NDCs: 4

J1950

HCPCS Descriptor: Injection, leuprolide acetate (for depot suspension), per 3.75 mg
Manufacturer: Multiple Manufacturers
Class: Growth Disorder
NDCs: 8

3.75 mg per unit

A9513

HCPCS Descriptor: Lutetium lu 177, dotatate, therapeutic, 1 millicurie
Manufacturer: Novartis
Class: Imaging/Radiopharmaceutical
NDC: 1

J3398

HCPCS Descriptor: Injection, voretigene neparvovec-rzyl, 1 billion vector genomes
Manufacturer: Spark Therapeutics
Class: Ophthalmology
NDC: 1

1 billion vector genomes per unit

J3394

HCPCS Descriptor: Injection, lovotibeglogene autotemcel, per treatment
Manufacturer: Genetix Biotherapeutics
Class: Genetic Disorder
NDC: 1

per treatment per unit

J9161

HCPCS Descriptor: Injection, denileukin diftitox-cxdl, 1 mcg
Manufacturer: Citius Pharmaceuticals
Class: Oncology
NDC: 1

A9520

HCPCS Descriptor: Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
Manufacturer: Cardinal Health
Class: Imaging/Radiopharmaceutical
NDCs: 2

0.5 millicuries per unit

J1814

HCPCS Descriptor: Insulin (lyumjev), per 5 units
Manufacturer: Eli Lilly
Class: Endocrinology
NDCs: 2

5 units per unit

J1813

HCPCS Descriptor: Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units
Manufacturer: A-S Medication Solutions
Class: Insulin
NDCs: 2

50 units per unit

90707

HCPCS Descriptor: Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 3

per dose per unit

J7330

HCPCS Descriptor: Autologous cultured chondrocytes, implant
Manufacturer: Vericel
Class: Orthopedic
NDCs: 2

1 implant per unit

J3475

MAGNESIUM SULFATE

HCPCS Descriptor: Injection, magnesium sulfate, per 500 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 65

500 mg per unit

J1726

HCPCS Descriptor: Injection, hydroxyprogesterone caproate, (makena), 10 mg
Manufacturer: Multiple Manufacturers
Class: Fertility
NDC: 1

J2151

HCPCS Descriptor: Injection, mannitol, 250 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 7

250 mg per unit

J9353

HCPCS Descriptor: Injection, margetuximab-cmkb, 5 mg
Manufacturer: MacroGenics
Class: Oncology
NDCs: 2

J9230

MECHLORETHAMINE HYDROCHLORIDE

HCPCS Descriptor: Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg
Class: Oncology

J7509

HCPCS Descriptor: Methylprednisolone oral, per 4 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 28

J1736

Meloxicam injection

HCPCS Descriptor: Injection, meloxicam (delova), 1 mg
Manufacturer: Nanjing Delova Biotech Co., Ltd.
Class: Non-Opioid Analgesic

J9249

Melphalan (Apotex)

HCPCS Descriptor: Injection, melphalan (apotex), 1 mg
Manufacturer: Apotex
Class: Oncology
NDC: 1

90734

HCPCS Descriptor: Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenACWY-D) or CRM197 carrier (MenACWY-CRM), for intramuscular use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

S0122

HCPCS Descriptor: Injection, menotropins, 75 iu
Manufacturer: Ferring Pharmaceuticals
Class: Fertility
NDC: 1

90619

HCPCS Descriptor: Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 3

per dose per unit

J2180

HCPCS Descriptor: Injection, meperidine and promethazine hcl, up to 50 mg
Class: Anesthetic

J3397

HCPCS Descriptor: Injection, vestronidase alfa-vjbk, 1 mg
Manufacturer: Ultragenyx Pharmaceutical
Class: Enzyme Replacement Therapy
NDC: 1

J2183

HCPCS Descriptor: Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 3

100 mg per unit

J2184

HCPCS Descriptor: Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg
Manufacturer: B. Braun Medical
Class: Antibiotic
NDCs: 2

100 mg per unit

J2185

HCPCS Descriptor: Injection, meropenem, 100 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 46

100 mg per unit

J9209

HCPCS Descriptor: Injection, mesna, 200 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 8

200 mg per unit

J7667

METAPROTERENOL SULFATE

HCPCS Descriptor: Metaproterenol sulfate, inhalation solution, compounded product, concentrated form, per 10 milligrams
Class: Respiratory

10 milligrams per unit

J7668

METAPROTERENOL SULFATE

HCPCS Descriptor: Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 10 milligrams
Class: Respiratory

10 milligrams per unit

J7669

METAPROTERENOL SULFATE

HCPCS Descriptor: Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
Class: Respiratory

10 milligrams per unit

J7670

METAPROTERENOL SULFATE

HCPCS Descriptor: Metaproterenol sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams
Class: Respiratory

10 milligrams per unit

J1230

HCPCS Descriptor: Injection, methadone hcl, up to 10 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 4

S0109

HCPCS Descriptor: Methadone, oral, 5 mg
Manufacturer: Ascend Laboratories
Class: Anti-Addiction
NDC: 1

J2800

HCPCS Descriptor: Injection, methocarbamol, up to 10 ml
Manufacturer: Multiple Manufacturers
Class: Muscle Relaxant
NDCs: 13

J8610

HCPCS Descriptor: Methotrexate; oral, 2.5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 23

2.5 mg per unit

J9255

HCPCS Descriptor: Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg
Manufacturer: ACCORD HEALTHCARE
Class: Oncology

J9260

HCPCS Descriptor: Injection, methotrexate sodium, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 20

J0210

METHYLDOPATE HCL

HCPCS Descriptor: Injection, methyldopate hcl, up to 250 mg
Manufacturer: American Regent
Class: Cardiology
NDC: 1

250 mg per unit

J2210

METHYLERGONOVINE MALEATE

HCPCS Descriptor: Injection, methylergonovine maleate, up to 0.2 mg
Manufacturer: Multiple Manufacturers
Class: Hormone Replacement
NDCs: 3

0.2 mg per unit

J1010

METHYLPREDNISOLONE ACETATE

HCPCS Descriptor: Injection, methylprednisolone acetate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 43

J2919

METHYLPREDNISOLONE SODIUM SUCCINATE

HCPCS Descriptor: Injection, methylprednisolone sodium succinate, 5 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 34

J2765

METOCLOPRAMIDE HCL

HCPCS Descriptor: Injection, metoclopramide hcl, up to 10 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 10

NOC METOPROLOL T

HCPCS Descriptor: Metoprolol Tartrate,1 MG
Manufacturer: Multiple Manufacturers

J0616

METOPROLOL TARTRATE

HCPCS Descriptor: Injection, metoprolol tartrate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 18

NOC METRONIDAZOL

METRONIDAZL 500MG

HCPCS Descriptor: Metronidazole inj,500 MG
Manufacturer: Pfizer

500 mg per unit

J1836

HCPCS Descriptor: Injection, metronidazole, 10 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 9

90616

HCPCS Descriptor: Influenza virus vaccine, trivalent (tIRV), mRNA, 37.5 mcg/0.38 mL dosage, for intramuscular use
Manufacturer: Moderna
Class: Vaccine
NDCs: 2

0.38 ml per unit

J0630

HCPCS Descriptor: Injection, calcitonin salmon, up to 400 units
Manufacturer: Multiple Manufacturers
Class: Osteoporosis
NDCs: 9

400 units per unit

J2247

HCPCS Descriptor: Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
Manufacturer: Endo USA
Class: Anti-Fungal
NDCs: 4

J2246

Micafungin Sodium

HCPCS Descriptor: Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg
Manufacturer: Baxter Healthcare
Class: Anti-Fungal
NDCs: 6

J2248

MICAFUNGIN SODIUM

HCPCS Descriptor: Injection, micafungin sodium, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 41

J2250

HCPCS Descriptor: Injection, midazolam hydrochloride, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Sedative
NDCs: 62

J2251

HCPCS Descriptor: Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
Manufacturer: Multiple Manufacturers
Class: Sedative
NDCs: 10

J2252

MIDAZOLAM-SODIUM CHLORIDE (PF)

HCPCS Descriptor: Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
Manufacturer: B. Braun Medical
Class: Sedative
NDCs: 3

J2260

MILRINONE IN 5% DEXTROSE

HCPCS Descriptor: Injection, milrinone lactate, 5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 38

J2265

HCPCS Descriptor: Injection, minocycline hydrochloride, 1 mg
Manufacturer: Melinta Therapeutics
Class: Antibiotic
NDC: 1

J0887

HCPCS Descriptor: Injection, epoetin beta, 1 microgram, (for esrd on dialysis)
Manufacturer: Vifor International
Class: Oncology Colony Stimulating Factor
NDCs: 7

J0888

HCPCS Descriptor: Injection, epoetin beta, 1 microgram, (for non esrd use)
Manufacturer: Vifor International
Class: Oncology
NDCs: 7

J7298

HCPCS Descriptor: Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg
Manufacturer: Bayer Pharmaceutical
Class: Contraceptive
NDC: 1

J9280

HCPCS Descriptor: Injection, mitomycin, 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 29

J7315

HCPCS Descriptor: Mitomycin, ophthalmic, 0.2 mg
Manufacturer: Mobius Therapeutics
Class: Ophthalmology
NDCs: 2

0.2 mg per unit

J9293

MITOXANTRONE HCL

HCPCS Descriptor: Injection, mitoxantrone hydrochloride, per 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 8

J7299

HCPCS Descriptor: Intrauterine copper contraceptive (miudella)
Manufacturer: Organon
Class: Contraceptive/ Long Acting Reversible
NDC: 1

per therapeutic dose per unit

91323

mNEXSPIKE 2025-26 (12Y UP)

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 10 mcg/0.2 mL dosage, for intramuscular use
Manufacturer: Moderna
Class: COVID-19
NDCs: 6

0.2 ml per unit

J9349

HCPCS Descriptor: Injection, tafasitamab-cxix, 2 mg
Manufacturer: Incyte
Class: Oncology
NDCs: 2

J1437

HCPCS Descriptor: Injection, ferric derisomaltose, 10 mg
Manufacturer: Pharmacosmos
Class: Anti-Anemia
NDC: 1

J7327

HCPCS Descriptor: Hyaluronan or derivative, monovisc, for intra-articular injection, per dose
Manufacturer: Depuy Mitek
Class: Orthopedic
NDC: 1

per dose per unit

J2270

Morphine Sulfate

HCPCS Descriptor: Injection, morphine sulfate, up to 10 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 22

J2272

Morphine Sulfate

HCPCS Descriptor: Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg
Manufacturer: Fresenius Kabi
Class: Opioid Analgesic
NDCs: 13

J2281

MOXIFLOXACIN HCL

HCPCS Descriptor: Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg
Manufacturer: Fresenius Kabi
Class: Antibiotic
NDCs: 2

100 mg per unit

J2562

HCPCS Descriptor: Injection, plerixafor, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology Colony Stimulating Factor
NDCs: 9

90683

HCPCS Descriptor: Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use
Manufacturer: Moderna
Class: Vaccine
NDCs: 4

per dose per unit

A9577

HCPCS Descriptor: Injection, gadobenate dimeglumine (multihance), per ml
Manufacturer: Bracco Diagnostics
Class: Imaging/Radiopharmaceutical
NDCs: 4

A9578

MULTIHANCE MULTIPACK

HCPCS Descriptor: Injection, gadobenate dimeglumine (multihance multipack), per ml
Manufacturer: Bracco Diagnostics
Class: Imaging/Radiopharmaceutical
NDCs: 2

Q5107

HCPCS Descriptor: Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg
Manufacturer: Amgen
Class: Oncology
NDCs: 4

J7526

Mycophenolate Mofetil IV

HCPCS Descriptor: Injection, mycophenolate mofetil, 5 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 6

J7524

Mycophenolate Mofetil Oral

HCPCS Descriptor: Mycophenolate mofetil, oral, 5 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 33

J7529

Mycophenolate Mofetil Oral Suspension

HCPCS Descriptor: Mycophenolate mofetil, for suspension, oral, 5 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 6

J7518

MYCOPHENOLIC ACID

HCPCS Descriptor: Mycophenolic acid, oral, 180 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 29

180 mg per unit

J7530

HCPCS Descriptor: Mycophenolate mofetil (myhibbin), oral suspension, 5 mg
Manufacturer: Azurity Pharmaceuticals
Class: Immunosuppressant
NDC: 1

J8510

HCPCS Descriptor: Busulfan; oral, 2 mg
Manufacturer: Waylis Therapeutics
Class: Oncology
NDC: 1

J9203

HCPCS Descriptor: Injection, gemtuzumab ozogamicin, 0.1 mg
Manufacturer: Pfizer
Class: Oncology
NDC: 1

0.1 mg per unit

J0587

HCPCS Descriptor: Injection, rimabotulinumtoxinb, 100 units
Manufacturer: Solstice Neurosciences
Class: Neurology
NDCs: 3

100 units per unit

A9502

HCPCS Descriptor: Technetium tc-99m tetrofosmin, diagnostic, per study dose
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDCs: 2

per study dose per unit

J2291

HCPCS Descriptor: Injection, nafcillin sodium (baxter), 20 mg
Manufacturer: Baxter Healthcare
Class: Antibiotic
NDC: 1

J2290

Nafcillin sodium

HCPCS Descriptor: Injection, nafcillin sodium, 20 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 31

J1458

HCPCS Descriptor: Injection, galsulfase, 1 mg
Manufacturer: Biomarin Pharmaceuticals
Class: Enzyme Replacement Therapy
NDC: 1

J2300

HCPCS Descriptor: Injection, nalbuphine hydrochloride, per 10 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Addiction
NDCs: 13

J2312

HCPCS Descriptor: Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Addiction
NDCs: 47

0.01 mg per unit

J2320

NANDROLONE DECANOATE

HCPCS Descriptor: Injection, nandrolone decanoate, up to 50 mg
Class: Endocrinology

J2795

HCPCS Descriptor: Injection, ropivacaine hydrochloride, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 131

J9390

HCPCS Descriptor: Injection, vinorelbine tartrate, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 6

J2545

HCPCS Descriptor: Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 4

300 mg per unit

J2515

NEMBUTAL SODIUM

HCPCS Descriptor: Injection, pentobarbital sodium, per 50 mg
Manufacturer: Multiple Manufacturers
Class: Sedative
NDCs: 6

J2710

NEOSTIGMINE METHYLSULFATE

HCPCS Descriptor: Injection, neostigmine methylsulfate, up to 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 32

0.5 mg per unit

J2325

HCPCS Descriptor: Injection, nesiritide, 0.1 mg
Class: Cardiology

0.1 mg per unit

A9587

HCPCS Descriptor: Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
Manufacturer: Novartis
Class: Imaging/Radiopharmaceutical
NDC: 1

0.1 mci per unit

J2506

HCPCS Descriptor: Injection, pegfilgrastim, excludes biosimilar, 0.5 mg
Manufacturer: Amgen
Class: Oncology Colony Stimulating Factor
NDCs: 3

0.5 mg per unit

J1442

HCPCS Descriptor: Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram
Manufacturer: Amgen
Class: Oncology Colony Stimulating Factor
NDCs: 14

Q9983

HCPCS Descriptor: Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries
Manufacturer: Lantheus Medical Imaging
Class: Imaging/Radiopharmaceutical
NDC: 1

per study dose, upto 8 mci per unit

J7353

HCPCS Descriptor: Anacaulase-bcdb, 8.8% gel, 1 gram
Manufacturer: Vericel
Class: Wound Care
NDC: 1

1 gm (of 8.8% gel) per unit

J7307

HCPCS Descriptor: Etonogestrel (contraceptive) implant system, including implant and supplies
Manufacturer: Organon
Class: Contraceptive
NDC: 1

singular implant per unit

J0283

HCPCS Descriptor: Injection, amiodarone hydrochloride (nexterone), 30 mg
Manufacturer: Baxter Healthcare
Class: Cardiology
NDCs: 2

J0219

HCPCS Descriptor: Injection, avalglucosidase alfa-ngpt, 4 mg
Manufacturer: Sanofi
Class: Enzyme Replacement Therapy
NDC: 1

J9268

HCPCS Descriptor: Injection, pentostatin, 10 mg
Manufacturer: Pfizer
Class: Oncology
NDC: 1

J0211

HCPCS Descriptor: Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)
Manufacturer: Hope Pharmaceuticals
Class: Misc.
NDC: 1

3 mg and 125 mg per unit

NOC NITROGLYCERI

HCPCS Descriptor: Nitroglycerin, 5 MG
Manufacturer: American Regent

J2305

NITROGLYCERIN IN D5W

HCPCS Descriptor: Injection, nitroglycerin, 5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 4

Q5110

HCPCS Descriptor: Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram
Manufacturer: Pfizer
Class: Oncology Colony Stimulating Factor
NDCs: 6

J0799

Not Otherwise Classified

HCPCS Descriptor: Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified
Class: Anti-HIV

Q4194

HCPCS Descriptor: Novachor, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Organogenesis, Inc.
Class: Wound Care
NDC: 1

1 sq cm per unit

91304

NOVAVAX COVID-19 VACCINE, 2023-2024 ADJUVANTED

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use
Manufacturer: Sanofi
Class: COVID-19
NDCs: 3

0.5 ml per unit

J7182

HCPCS Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu
Manufacturer: Novo Nordisk
Class: Hematology
NDCs: 6

J7189

HCPCS Descriptor: Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram
Manufacturer: Novo Nordisk
Class: Hematology
NDCs: 4

J2802

HCPCS Descriptor: Injection, romiplostim, 1 microgram
Manufacturer: Amgen
Class: Hematology
NDCs: 5

J2182

HCPCS Descriptor: Injection, mepolizumab, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Eosinophil Asthma
NDCs: 4

Q5168

HCPCS Descriptor: Injection, ranibizumab-leyk (nufymco), biosimilar, 0.1 mg
Manufacturer: Zydus Pharmaceuticals
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

J1809

HCPCS Descriptor: Injection, fosdenopterin, 0.1 mg
Manufacturer: Sentynl Therapeutics
Class: Genetic Disorder
NDC: 1

0.1 mg per unit

J0485

HCPCS Descriptor: Injection, belatacept, 1 mg
Manufacturer: BMS
Class: Immunosuppressant
NDC: 1

C9143

HCPCS Descriptor: Cocaine hydrochloride nasal solution (numbrino), 1 mg
Manufacturer: Omnivium Pharmaceuticals
Class: Anesthetic
NDC: 1

Q4160

HCPCS Descriptor: Nushield, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Organogenesis
Class: Wound Care
NDCs: 9

1 sq cm per unit

J7295

HCPCS Descriptor: Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each
Manufacturer: Multiple Manufacturers
Class: Contraceptive
NDCs: 6

J7209

HCPCS Descriptor: Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.
Manufacturer: Octapharma
Class: Hematology
NDCs: 16

J0121

HCPCS Descriptor: Injection, omadacycline, 1 mg
Manufacturer: Paratek Pharmaceuticals
Class: Antibiotic
NDC: 1

Q5122

HCPCS Descriptor: Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg
Manufacturer: Pfizer
Class: Oncology Colony Stimulating Factor
NDC: 1

0.5 mg per unit

Q4124

OASIS ULTRA TRI-LAYER MATRIX

HCPCS Descriptor: Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Smith & Nephew
Class: Wound Care
NDCs: 5

1 sq cm per unit

Q4102

Oasis Wound Matrix Sheet

HCPCS Descriptor: Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Healthpoint
Class: Wound Care
NDCs: 2

1 sq cm per unit

Q4103

OASIS WOUND MATRIX SHEET

HCPCS Descriptor: Oasis burn matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: SMITH & NEPHEW BIOTHERAPEUTICS
Class: Wound Care
NDCs: 5

1 sq cm per unit

J7188

HCPCS Descriptor: Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDC: 1

J2350

HCPCS Descriptor: Injection, ocrelizumab, 1 mg
Manufacturer: Genentech
Class: Neurology
NDC: 1

J2351

HCPCS Descriptor: Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq
Manufacturer: Genentech
Class: Immunology
NDC: 1

J7316

HCPCS Descriptor: Injection, ocriplasmin, 0.125 mg
Class: Ophthalmology

0.125 mg per unit

J1568

HCPCS Descriptor: Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg
Manufacturer: Pfizer
Class: Immunoglobulin
NDCs: 28

500 mg per unit

J2354

OCTREOTIDE ACETATE

HCPCS Descriptor: Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg
Manufacturer: Multiple Manufacturers
Class: Growth Disorder
NDCs: 51

25 mcg per unit

J0131

HCPCS Descriptor: Injection, acetaminophen, not otherwise specified,10 mg
Manufacturer: Multiple Manufacturers
Class: Non-Opioid Analgesic
NDCs: 18

Q5114

HCPCS Descriptor: Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
Manufacturer: Biocon Biologics
Class: Oncology
NDCs: 4

J7601

HCPCS Descriptor: Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg
Manufacturer: Merck
Class: Respiratory
NDC: 1

J2359

HCPCS Descriptor: Injection, olanzapine, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 12

0.5 mg per unit

NOC OLANZAPINE S

Olanzapine (Immediate Release)

HCPCS Descriptor: Olanzapine short acting intramuscular injection, 0.5 MG
Manufacturer: American Regent

0.5 mg per unit

C9101

HCPCS Descriptor: Injection, oliceridine, 0.1 mg
Manufacturer: Trevena
Class: Opioid Analgesic
NDCs: 3

0.1 mg per unit

J1097

HCPCS Descriptor: Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
Manufacturer: Rayner Surgical
Class: Ophthalmology
NDCs: 3

J3406

HCPCS Descriptor: Injection, omidubicel-onlv, per therapeutic dose
Manufacturer: Gamida Cell
Class: Hematology
NDC: 1

per therapeutic dose per unit

Q9965

HCPCS Descriptor: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDCs: 3

A9579

HCPCS Descriptor: Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 18

J2267

HCPCS Descriptor: Injection, mirikizumab-mrkz, 1 mg
Manufacturer: Eli Lilly
Class: Anti-Fungal
NDCs: 11

J9266

HCPCS Descriptor: Injection, pegaspargase, per single dose vial
Manufacturer: Servier Pharmaceuticals
Class: Oncology
NDC: 1

1 each per unit

Q0162

HCPCS Descriptor: Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 130

J2405

ONDANSETRON HCL

HCPCS Descriptor: Injection, ondansetron hydrochloride, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 39

J9205

HCPCS Descriptor: Injection, irinotecan liposome, 1 mg
Manufacturer: Ipsen Biopharma
Class: Oncology
NDC: 1

J0222

HCPCS Descriptor: Injection, patisiran, 0.1 mg
Manufacturer: Alnylam Pharmaceuticals
Class: Genetic Disorder
NDC: 1

0.1 mg per unit

Q5112

HCPCS Descriptor: Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg
Manufacturer: Organon
Class: Oncology
NDCs: 2

J9299

HCPCS Descriptor: Injection, nivolumab, 1 mg
Manufacturer: BMS
NDCs: 4

J9289

HCPCS Descriptor: Injection, nivolumab, 2 mg and hyaluronidase-nvhy
Manufacturer: BMS
NDCs: 2

J9298

HCPCS Descriptor: Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg
Manufacturer: BMS
Class: Oncology
NDC: 1

3 mg - 1 mg per unit

J1202

HCPCS Descriptor: Miglustat, oral, 65 mg
Manufacturer: Amicus Therapeutics
Class: Oncology
NDCs: 3

J2355

HCPCS Descriptor: Injection, oprelvekin, 5 mg
Class: Oncology Colony Stimulating Factor

Q9956

HCPCS Descriptor: Injection, octafluoropropane microspheres, per ml
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDCs: 2

Q5153

HCPCS Descriptor: Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg
Manufacturer: Biogen Inc.
Class: Ophthalmology

J2407

HCPCS Descriptor: Injection, oritavancin (orbactiv), 10 mg
Manufacturer: Melinta Therapeutics
Class: Antibiotic
NDC: 1

J0129

HCPCS Descriptor: Injection, abatacept, 10 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)
Manufacturer: BMS
Class: Immunology: Anti-TNF
NDCs: 5

J2360

ORPHENADRINE CITRATE

HCPCS Descriptor: Injection, orphenadrine citrate, up to 60 mg
Manufacturer: Multiple Manufacturers
Class: Muscle Relaxant
NDCs: 3

J7324

HCPCS Descriptor: Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose
Manufacturer: Depuy Mitek
Class: Orthopedic
NDC: 1

per dose per unit

Q5159

OSPOMYV AND XBRYK

HCPCS Descriptor: Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg
Manufacturer: Cordavis
Class: Osteoporosis
NDC: 1

J7342

HCPCS Descriptor: Instillation, ciprofloxacin otic suspension, 6 mg
Manufacturer: Otonomy
Class: Antibiotic
NDC: 1

Q9999

HCPCS Descriptor: Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg
Manufacturer: Fresenius Kabi
Class: Immunology
NDCs: 6

J2700

HCPCS Descriptor: Injection, oxacillin sodium, up to 250 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 15

250 mg per unit

J9263

HCPCS Descriptor: Injection, oxaliplatin, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 51

0.5 mg per unit

J0224

HCPCS Descriptor: Injection, lumasiran, 0.5 mg
Manufacturer: Alnylam Pharmaceuticals
Class: Genetic Disorder
NDC: 1

0.5 mg per unit

J2410

OXYMORPHONE HCL

HCPCS Descriptor: Injection, oxymorphone hcl, up to 1 mg
Class: Opioid Analgesic

J2460

OXYTETRACYCLINE HCL

HCPCS Descriptor: Injection, oxytetracycline hcl, up to 50 mg
Class: Antibiotic

J2590

HCPCS Descriptor: Injection, oxytocin, up to 10 units
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 13

10 units per unit

Q5165

HCPCS Descriptor: Injection, denosumab-mobz (oziltus), biosimilar, 1 mg
Manufacturer: Amneal Pharmaceuticals
Class: Osteoporosis
NDC: 1

J7312

HCPCS Descriptor: Injection, dexamethasone, intravitreal implant, 0.1 mg
Manufacturer: AbbVie
Class: Ophthalmology
NDC: 1

0.1 mg per unit

J9267

HCPCS Descriptor: Injection, paclitaxel, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 41

J9177

HCPCS Descriptor: Injection, enfortumab vedotin-ejfv, 0.25 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 2

0.25 mg per unit

J2469

HCPCS Descriptor: Injection, palonosetron hcl, 25 mcg
Manufacturer: Multiple Manufacturers
Class: Anti-Emetic
NDCs: 24

25 mcg per unit

J2430

PAMIDRONATE DISODIUM

HCPCS Descriptor: Injection, pamidronate disodium, per 30 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 7

J1640

HCPCS Descriptor: Injection, hemin, 1 mg
Manufacturer: Recordati Rare Diseases
Class: Hematology
NDC: 1

J2472

Pantoprazole sodium - NaCl (Baxter)

HCPCS Descriptor: Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg
Manufacturer: Baxter Healthcare
Class: Gastroenterology
NDCs: 6

J2470

Pantoprazole Sodium

HCPCS Descriptor: Injection, pantoprazole sodium, 40 mg
Manufacturer: Multiple Manufacturers
Class: Gastroenterology
NDCs: 36

J2471

Pantoprazole Sodium

HCPCS Descriptor: Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg
Manufacturer: Civica
Class: Gastroenterology
NDCs: 5

J1576

HCPCS Descriptor: Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg
Manufacturer: Octapharma
Class: Immunoglobulin
NDCs: 24

500 mg per unit

J1599

HCPCS Descriptor: Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg
Manufacturer: Octapharma
Class: Immunoglobulin
NDCs: 12

500 mg per unit

NOC IMMUNE GLOBU

HCPCS Descriptor: Immune Globulin (Panzyga),500 MG
Manufacturer: Pfizer

500 mg per unit

J2440

HCPCS Descriptor: Injection, papaverine hcl, up to 60 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 7

up to 60 mg per unit

J3404

HCPCS Descriptor: Injection, zopapogene imadenovec-drba suspension, per therapeutic dose
Manufacturer: Precigen
Class: Oncology
NDC: 1

per therapeutic dose per unit

J2501

HCPCS Descriptor: Injection, paricalcitol, 1 mcg
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 14

J0606

HCPCS Descriptor: Injection, etelcalcetide, 0.1 mg
Manufacturer: Amgen
Class: Endocrinology
NDCs: 9

0.1 mg per unit

Q5147

HCPCS Descriptor: Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg
Manufacturer: Amgen
Class: Ophthalmology
NDCs: 2

90723

HCPCS Descriptor: Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for intramuscular use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

90647

HCPCS Descriptor: Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use
Manufacturer: Merck
Class: Vaccine
NDC: 1

per dose per unit

J0890

HCPCS Descriptor: Injection, peginesatide, 0.1 mg (for esrd on dialysis)
Class: Anti-Anemia

0.1 mg per unit

J9294

HCPCS Descriptor: Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 6

J9296

HCPCS Descriptor: Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg
Manufacturer: Accord
Class: Oncology
NDC: 1

J9297

HCPCS Descriptor: Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg
Manufacturer: Sandoz
Class: Oncology
NDCs: 2

J9314

HCPCS Descriptor: Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg
Manufacturer: Teva
Class: Oncology
NDCs: 3

J9323

PEMETREXED (HOSPIRA)

HCPCS Descriptor: Injection, pemetrexed ditromethamine, 10 mg
Manufacturer: Hospira, Inc.
Class: Oncology
NDCs: 2

J9322

PEMETREXED DISODIUM

HCPCS Descriptor: Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg
Manufacturer: BluePoint Lab Injectables
Class: Oncology
NDCs: 2

J9304

HCPCS Descriptor: Injection, pemetrexed (pemfexy), 10 mg
Manufacturer: Acacia Pharma
Class: Oncology
NDCs: 2

Q0224

HCPCS Descriptor: Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg
Manufacturer: Invivyd
Class: Anti-Anemia
NDC: 1

4500 mg per unit

J9324

HCPCS Descriptor: Injection, pemetrexed (pemrydi rtu), 10 mg
Manufacturer: Amneal Pharmaceuticals
Class: Anesthetic
NDCs: 2

90623

HCPCS Descriptor: Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use
Manufacturer: Pfizer
Class: Vaccine
NDCs: 3

per dose per unit

J2540

PENICILLIN G POTASSIUM

HCPCS Descriptor: Injection, penicillin g potassium, up to 600,000 units
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 21

600000 units per unit

J2510

PENICILLIN G PROCAINE

HCPCS Descriptor: Injection, penicillin g procaine, aqueous, up to 600,000 units
Manufacturer: Pfizer
Class: Antibiotic
NDCs: 2

up to 600000 units per unit

90624

HCPCS Descriptor: Meningococcal pentavalent vaccine, Men B-4C recombinant proteins and outer membrane vesicle and conjugated Men A, C, W, Y-diphtheria toxoid carrier, for intramuscular use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

90698

HCPCS Descriptor: Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDC: 1

per dose per unit

J2516

PENTAMIDINE ISETHIONATE

HCPCS Descriptor: Injection, pentamidine isethionate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 6

J7676

PENTAMIDINE ISETHIONATE

HCPCS Descriptor: Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg
Class: Anti-Fungal

300 mg per unit

J3070

HCPCS Descriptor: Injection, pentazocine, 30 mg
Class: Opioid Analgesic

J7606

HCPCS Descriptor: Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 31

20 mcg per unit

J9306

HCPCS Descriptor: Injection, pertuzumab, 1 mg
Manufacturer: Genentech
Class: Oncology
NDC: 1

J2798

HCPCS Descriptor: Injection, risperidone, (perseris), 0.5 mg
Manufacturer: Indivior
Class: Psychiatric
NDCs: 2

0.5 mg per unit

78811

HCPCS Descriptor: Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck)

78812

HCPCS Descriptor: Positron emission tomography (PET) imaging; skull base to mid-thigh

91319

PFIZER-BIONTECH COVID-19 VACCINE 2023-2024 AGE5<12

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
Manufacturer: Pfizer
Class: COVID-19
NDCs: 3

0.3 ml per unit

J2550

HCPCS Descriptor: Injection, promethazine hcl, up to 50 mg
Manufacturer: Multiple Manufacturers
Class: Antihistamine
NDCs: 17

J2560

PHENOBARBITAL SODIUM

HCPCS Descriptor: Injection, phenobarbital sodium, up to 120 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 15

120 mg per unit

J2760

PHENTOLAMINE MESYLATE

HCPCS Descriptor: Injection, phentolamine mesylate, up to 5 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 3

J2371

PHENYLEPHRINE HCL

HCPCS Descriptor: Injection, phenylephrine hydrochloride, 20 micrograms
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 85

20 mcg per unit

J1165

PHENYTOIN SODIUM

HCPCS Descriptor: Injection, phenytoin sodium, per 50 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 10

J9316

HCPCS Descriptor: Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

67221

Photodynamic Therapy

HCPCS Descriptor: Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)

96567

Photodynamic Therapy

HCPCS Descriptor: Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa (eg, lip) by activation of photosensitive drug(s), per day

J9600

HCPCS Descriptor: Injection, porfimer sodium, 75 mg
Manufacturer: Pinnacle Biologics
Class: Oncology
NDC: 1

J2787

PHOTREXA CROSS-LINKING

HCPCS Descriptor: Riboflavin 5'-phosphate, ophthalmic solution (photrexa viscous/photrexa), up to 3 ml
Manufacturer: Glaukos
Class: Ophthalmology
NDCs: 2

J3430

HCPCS Descriptor: Injection, phytonadione (vitamin k), per 1 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 17

J1307

HCPCS Descriptor: Injection, crovalimab-akkz, 10 mg
Manufacturer: Genentech
Class: Hematology
NDC: 1

J2543

PIPERACILLIN AND TAZOBACTAM

HCPCS Descriptor: Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 114

1.125 gm per unit

A9607

HCPCS Descriptor: Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
Manufacturer: Novartis
Class: Imaging/Radiopharmaceutical
NDCs: 2

90732

HCPCS Descriptor: Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
Manufacturer: Merck
Class: Vaccine
NDCs: 3

0.5 ml per unit

J9309

HCPCS Descriptor: Injection, polatuzumab vedotin-piiq, 1 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

J0670

HCPCS Descriptor: Injection, mepivacaine hydrochloride, per 10 ml
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 8

J1203

HCPCS Descriptor: Injection, cipaglucosidase alfa-atga, 5 mg
Manufacturer: Amicus Therapeutics
Class: Genetic Disorder
NDCs: 3

G0138

POMBILITI and OPFOLDA

HCPCS Descriptor: Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga
Manufacturer: Amicus

Q5173

HCPCS Descriptor: Injection, denosumab-adet (ponlimsi), biosimilar, 1 mg
Class: Osteoporosis

J9295

HCPCS Descriptor: Injection, necitumumab, 1 mg
Manufacturer: Eli Lilly and Company
Class: Oncology
NDC: 1

J1837

HCPCS Descriptor: Injection, posaconazole, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 7

C9144

HCPCS Descriptor: Injection, bupivacaine (posimir), 1 mg
Manufacturer: Innocoll Pharmaceuticals
Class: Anesthetic
NDC: 1

A9608

HCPCS Descriptor: Flotufolastat f 18, diagnostic, 1 millicurie
Manufacturer: Blue Earth Diagnostics
Class: Imaging/Radiopharmaceutical
NDCs: 2

J9204

HCPCS Descriptor: Injection, mogamulizumab-kpkc, 1 mg
Manufacturer: Kyowa Kirin
Class: Oncology
NDC: 1

J7510

HCPCS Descriptor: Prednisolone oral, per 5 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 38

J2650

PREDNISOLONE ACETATE

HCPCS Descriptor: Injection, prednisolone acetate, up to 1 ml
Class: Ophthalmology

up to 1 ml per unit

J7531

Prednisolone sodium phosphate

HCPCS Descriptor: Prednisolone sodium phosphate, orally disintegrating tablet, 1 mg
Manufacturer: Advanz Pharma (US) Corp.
Class: Immunosuppressant

J7512

HCPCS Descriptor: Prednisone, immediate release or delayed release, oral, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 283

90759

HCPCS Descriptor: Hepatitis B vaccine (HepB), 3-antigen (S, Pre-S1, Pre-S2), 10 mcg dosage, 3 dose schedule, for intramuscular use
Manufacturer: VBI Vaccines
Class: Vaccine
NDC: 1

10 mcg per unit

J1410

HCPCS Descriptor: Injection, estrogen conjugated, per 25 mg
Manufacturer: Pfizer
Class: Hormone Replacement
NDC: 1

J2711

HCPCS Descriptor: Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg
Manufacturer: Endo USA
Class: Anesthetic
NDCs: 2

0.1 mg and 0.02 mg per unit

90670

HCPCS Descriptor: Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use
Manufacturer: Pfizer
Class: Vaccine
NDCs: 2

0.5 ml per unit

90677

HCPCS Descriptor: Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use
Manufacturer: Pfizer
Class: Vaccine
NDCs: 3

J2278

HCPCS Descriptor: Injection, ziconotide, 1 microgram
Manufacturer: TerSera Therapeutics
Class: Non-Opioid Analgesic
NDCs: 3

Q4110

HCPCS Descriptor: Primatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Manufacturer: Multiple Manufacturers
Class: Wound Care
NDCs: 36

1 sq cm per unit

J1459

HCPCS Descriptor: Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg
Manufacturer: CSL Behring
Class: Immunoglobulin
NDCs: 4

500 mg per unit

J2690

PROCAINAMIDE HCL

HCPCS Descriptor: Injection, procainamide hcl, up to 1 gm
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 8

J0780

PROCHLORPERAZINE EDISYLATE

HCPCS Descriptor: Injection, prochlorperazine, up to 10 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 26

Q0164

PROCHLORPERAZINE MALEATE

HCPCS Descriptor: Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 23

J7194

HCPCS Descriptor: Factor ix, complex, per i.u.
Manufacturer: Grifols
Class: Hematology
NDCs: 3

J2675

HCPCS Descriptor: Injection, progesterone, per 50 mg
Manufacturer: Multiple Manufacturers
Class: Fertility
NDCs: 5

J7507

HCPCS Descriptor: Tacrolimus, immediate release, oral, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 47

J7525

HCPCS Descriptor: Tacrolimus, parenteral, 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 2

J7521

PROGRAF GRANULES

HCPCS Descriptor: Tacrolimus, granules, oral suspension, 0.1 mg
Manufacturer: Astellas Pharma
Class: Immunosuppressant
NDCs: 2

0.1 mg per unit

A9576

PROHANCE MULTIPACK

HCPCS Descriptor: Injection, gadoteridol, (prohance multipack), per ml
Manufacturer: Bracco Diagnostics
Class: Imaging/Radiopharmaceutical
NDC: 1

J9015

HCPCS Descriptor: Injection, aldesleukin, per single use vial
Manufacturer: Iovance Biotherapeutics
Class: Oncology
NDC: 1

per single use vial per unit

J0897

HCPCS Descriptor: Injection, denosumab, 1 mg
Manufacturer: Amgen
Class: Osteoporosis
NDCs: 4

J2950

HCPCS Descriptor: Injection, promazine hcl, up to 25 mg
Class: Sedative

Q0169

PROMETHAZINE HCL

HCPCS Descriptor: Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Manufacturer: Multiple Manufacturers
Class: Antihistamine
NDCs: 21

12.5 mg per unit

S1091

HCPCS Descriptor: Stent, non-coronary, temporary, with delivery system (propel)
Manufacturer: Intersect ENT
Class: Ophthalmology
NDCs: 4

370 mcg per unit

J1800

PROPRANOLOL HCL

HCPCS Descriptor: Injection, propranolol hcl, up to 1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 4

90710

HCPCS Descriptor: Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use
Manufacturer: Merck
Class: Vaccine
NDC: 1

per dose per unit

J0270

PROSTIN VR PEDIATRIC

HCPCS Descriptor: Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 14

1.25 mcg per unit

J2720

PROTAMINE SULFATE

HCPCS Descriptor: Injection, protamine sulfate, per 10 mg
Manufacturer: Fresenius Kabi
Class: Hematology
NDCs: 6

J2725

HCPCS Descriptor: Injection, protirelin, per 250 mcg
Class: Endocrinology

250 mcg per unit

J2730

PROTOPAM CHLORIDE

HCPCS Descriptor: Injection, pralidoxime chloride, up to 1 gm
Manufacturer: Baxter Healthcare
Class: Misc.
NDC: 1

Q9968

HCPCS Descriptor: Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 9

Q2043

HCPCS Descriptor: Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion
Manufacturer: Dendreon Pharmaceuticals
Class: Oncology
NDC: 1

per infusion (minimum 50 million cells) per unit

J7674

HCPCS Descriptor: Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg
Manufacturer: Methapharm
Class: Respiratory
NDCs: 2

J7639

HCPCS Descriptor: Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Manufacturer: Genentech
Class: Respiratory
NDCs: 2

J0802

PURIFIED CORTROPHIN GEL

HCPCS Descriptor: Injection, corticotropin (ani), up to 40 units
Manufacturer: ANI Pharmaceuticals
Class: Immunosuppressant
NDCs: 4

up to 40 units per unit

A9595

HCPCS Descriptor: Piflufolastat f 18 (pylarify), diagnostic, 1 millicurie
Manufacturer: Lantheus Medical Imaging
Class: Imaging/Radiopharmaceutical
NDCs: 2

1 millicurie per unit

J3415

HCPCS Descriptor: Injection, pyridoxine hcl, 100 mg
Manufacturer: Fresenius Kabi
Class: Misc.
NDCs: 2

100 mg per unit

Q9996

HCPCS Descriptor: Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg
Manufacturer: Cordavis
Class: Immunology
NDCs: 6

Q9997

HCPCS Descriptor: Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg
Manufacturer: Quallent Pharmaceuticals
Class: Immunology
NDCs: 2

J1304

HCPCS Descriptor: Injection, tofersen, 1 mg
Manufacturer: Biogen
Class: Neurology
NDC: 1

J7174

HCPCS Descriptor: Injection, fitusiran, 0.04 mg
Manufacturer: Sanofi
Class: Hematology
NDCs: 2

0.04 mg per unit

J1577

HCPCS Descriptor: Injection, immune globulin (qivigy), 100 mg
Manufacturer: Kedrion Biopharma
Class: Immunoglobulin
NDCs: 4

100 mg per unit

90696

HCPCS Descriptor: Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), when administered to children 4 through 6 years of age, for intramuscular use
Manufacturer: Multiple Manufacturers
Class: Vaccine
NDCs: 7

per dose per unit

A9604

HCPCS Descriptor: Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
Manufacturer: Lantheus
Class: Imaging/Radiopharmaceutical
NDC: 1

up to 150 millicuries per unit

J7336

HCPCS Descriptor: Capsaicin 8% patch, per square centimeter
Manufacturer: Averitas Pharma
Class: Non-Opioid Analgesic
NDCs: 3

1 sq cm per unit

J1201

HCPCS Descriptor: Injection, cetirizine hydrochloride, 0.5 mg
Manufacturer: TerSera Therapeutics
Class: Antihistamine
NDCs: 3

0.5 mg per unit

J1301

HCPCS Descriptor: Injection, edaravone, 1 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 7

79101

Radiopharmaceutical Therapy

HCPCS Descriptor: Radiopharmaceutical therapy, by intravenous administration

J7520

HCPCS Descriptor: Sirolimus, oral, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 29

J2547

HCPCS Descriptor: Injection, peramivir, 1 mg
Manufacturer: BioCryst Pharmaceuticals
Class: Antiviral
NDCs: 2

Q3028

HCPCS Descriptor: Injection, interferon beta-1a, 1 mcg for subcutaneous use
Manufacturer: EMD Serono
Class: Neurology
NDCs: 5

J7203

HCPCS Descriptor: Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu
Manufacturer: Novo Nordisk
Class: Hematology
NDCs: 5

J0896

HCPCS Descriptor: Injection, luspatercept-aamt, 0.25 mg
Manufacturer: BMS
Class: Anti-Anemia
NDCs: 2

0.25 mg per unit

J1440

HCPCS Descriptor: Fecal microbiota, live - jslm, 1 ml
Manufacturer: Ferring Pharmaceuticals
Class: Misc.
NDCs: 2

J0742

HCPCS Descriptor: Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg
Manufacturer: Merck
Class: Antibiotic
NDCs: 2

4 mg-4 mg-2 mg per unit

J3489

HCPCS Descriptor: Injection, zoledronic acid, 1 mg
Manufacturer: Multiple Manufacturers
Class: Osteoporosis
NDCs: 35

90743

HCPCS Descriptor: Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use
Manufacturer: Merck
Class: Vaccine
NDCs: 3

1 dose per unit

S0157

HCPCS Descriptor: Becaplermin gel 0.01%, 0.5 gm
Manufacturer: Smith & Nephew
Class: Misc.
NDC: 1

0.5 gm per unit

J2212

HCPCS Descriptor: Injection, methylnaltrexone, 0.1 mg
Manufacturer: Bausch Health
Class: Gastroenterology
NDCs: 4

0.1 mg per unit

B4105

HCPCS Descriptor: In-line cartridge containing digestive enzyme(s) for enteral feeding, each
Manufacturer: Alcresta Therapeutics
Class: Enzyme Replacement Therapy
NDC: 1

Q5125

HCPCS Descriptor: Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram
Manufacturer: Amneal Pharmaceuticals
Class: Oncology Colony Stimulating Factor
NDCs: 4

J1745

HCPCS Descriptor: Injection, infliximab, excludes biosimilar, 10 mg
Manufacturer: Janssen
Class: Immunology: Anti-TNF
NDCs: 2

J3285

HCPCS Descriptor: Injection, treprostinil, 1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 21

Q5104

HCPCS Descriptor: Injection, infliximab-abda, biosimilar, (renflexis), 10 mg
Manufacturer: Organon
Class: Immunology: Anti-TNF
NDCs: 2

Q5105

HCPCS Descriptor: Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
Manufacturer: Vifor International
Class: Oncology Colony Stimulating Factor
NDCs: 19

100 units per unit

Q5106

HCPCS Descriptor: Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
Manufacturer: Vifor International
Class: Oncology Colony Stimulating Factor
NDCs: 15

1000 units per unit

J2993

HCPCS Descriptor: Injection, reteplase, 18.1 mg
Manufacturer: Chiesi
Class: Cardiology
NDC: 1

18.1 mg per unit

J7311

HCPCS Descriptor: Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
Manufacturer: Bausch Health
Class: Ophthalmology
NDC: 1

0.01 mg per unit

J3485

HCPCS Descriptor: Injection, zidovudine, 10 mg
Manufacturer: GlaxoSmithKline
Class: Anti-HIV
NDC: 1

J0349

HCPCS Descriptor: Injection, rezafungin, 1 mg
Manufacturer: Melinta Therapeutics
Class: Anti-Fungal
NDC: 1

J2791

HCPCS Descriptor: Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu
Manufacturer: CSL Behring
Class: Immunology
NDCs: 2

100 iu per unit

Q5123

HCPCS Descriptor: Injection, rituximab-arrx, biosimilar, (riabni), 10 mg
Manufacturer: Amgen
Class: Oncology
NDCs: 2

J7178

HCPCS Descriptor: Injection, human fibrinogen concentrate, not otherwise specified, 1 mg
Manufacturer: CSL Behring
Class: Hematology
NDC: 1

J2804

HCPCS Descriptor: Injection, rifampin, 1 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 3

NOC RIFAMPIN

Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 2

600 mg per unit

J1212

HCPCS Descriptor: Injection, dmso, dimethyl sulfoxide, 50%, 50 ml
Manufacturer: Viatris
Class: Misc.
NDC: 1

J2794

RISPERDAL CONSTA

HCPCS Descriptor: Injection, risperidone (risperdal consta), 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 14

0.5 mg per unit

J9312

HCPCS Descriptor: Injection, rituximab, 10 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

J9311

HCPCS Descriptor: Injection, rituximab 10 mg and hyaluronidase
Manufacturer: Genentech
Class: Oncology
NDCs: 2

10 mg (rituximab) per unit

J7200

HCPCS Descriptor: Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDCs: 5

J1412

HCPCS Descriptor: Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
Manufacturer: BioMarin Pharmaceutical Inc.
Class: Hematology
NDCs: 2

J2797

HCPCS Descriptor: Injection, rolapitant, 0.5 mg
Class: Anti-Emetic

0.5 mg per unit

J1449

HCPCS Descriptor: Injection, eflapegrastim-xnst, 0.1 mg
Manufacturer: Assertio Pharmaceuticals
Class: Oncology Colony Stimulating Factor
NDCs: 2

0.1 mg per unit

90681

HCPCS Descriptor: Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

90680

HCPCS Descriptor: Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use
Manufacturer: Merck
Class: Vaccine
NDCs: 2

per dose per unit

J0596

HCPCS Descriptor: Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units
Manufacturer: Pharming Healthcare
Class: Immunology
NDCs: 2

10 units per unit

Q5119

HCPCS Descriptor: Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 2

J9061

HCPCS Descriptor: Injection, amivantamab-vmjw, 2 mg
Manufacturer: Janssen
Class: Oncology
NDCs: 2

J9062

Rybrevant Faspro

HCPCS Descriptor: Injection, amivantamab 5 mg and hyaluronidase-lpuj
Manufacturer: Janssen
Class: Oncology
NDCs: 4

J2801

HCPCS Descriptor: Injection, risperidone (rykindo), 0.5 mg
Manufacturer: Shandong Luye Pharmaceuticals
Class: Neurology
NDCs: 6

0.5 mg per unit

J9021

HCPCS Descriptor: Injection, asparaginase, recombinant, (rylaze), 0.1 mg
Manufacturer: Jazz Pharmaceuticals
Class: Oncology
NDCs: 2

0.1 mg per unit

J3402

HCPCS Descriptor: Injection, remestemcel-l-rknd, per therapeutic dose
Manufacturer: Mesoblast
Class: Misc.
NDCs: 12

per therapeutic dose per unit

J2998

HCPCS Descriptor: Injection, plasminogen, human-tvmh, 1 mg
Manufacturer: Kedrion Biopharma
Class: Hematology
NDCs: 2

J9333

HCPCS Descriptor: Injection, rozanolixizumab-noli, 1 mg
Manufacturer: UCB Pharma
Class: Neurology
NDCs: 4

J0870

HCPCS Descriptor: Injection, imetelstat, 1 mg
Manufacturer: Geron
Class: Hematology
NDCs: 2

J7516

HCPCS Descriptor: Injection, cyclosporine, 250 mg
Manufacturer: Novartis
Class: Immunosuppressant
NDCs: 2

250 mg per unit

J2353

SANDOSTATIN LAR DEPOT

HCPCS Descriptor: Injection, octreotide, depot form for intramuscular injection, 1 mg
Manufacturer: Multiple Manufacturers
Class: Growth Disorder
NDCs: 12

J0491

HCPCS Descriptor: Injection, anifrolumab-fnia, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 2

J9227

HCPCS Descriptor: Injection, isatuximab-irfc, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 3

J7352

HCPCS Descriptor: Afamelanotide implant, 1 mg
Manufacturer: Clinuvel
Class: Misc.
NDC: 1

J2253

HCPCS Descriptor: Injection, midazolam (seizalam), 1 mg
Manufacturer: Meridian Medical Technologies, Inc
Class: Sedative

Q9998

HCPCS Descriptor: Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg
Manufacturer: Teva
Class: Immunology
NDCs: 8

J2941

HCPCS Descriptor: Injection, somatropin, 1 mg
Manufacturer: Multiple Manufacturers
Class: Growth Disorder
NDCs: 27

J0601

Sevelamer carbonate

HCPCS Descriptor: Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 13

J0602

Sevelamer carbonate

HCPCS Descriptor: Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 27

J0603

Sevelamer hydrochloride

HCPCS Descriptor: Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 12

J7212

HCPCS Descriptor: Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram
Manufacturer: Hema
Class: Hematology
NDCs: 3

J2561

HCPCS Descriptor: Injection, phenobarbital sodium (sezaby), 1 mg
Manufacturer: Sun Pharma
Class: Misc.
NDC: 1

J2502

HCPCS Descriptor: Injection, pasireotide long acting, 1 mg
Manufacturer: Recordati Rare Diseases
Class: Growth Disorder
NDCs: 5

Q5142

HCPCS Descriptor: Injection, adalimumab-ryvk biosimilar, 1 mg
Manufacturer: Teva
Class: Immunology: Anti-TNF
NDCs: 11

J1602

HCPCS Descriptor: Injection, golimumab, 1 mg, for intravenous use
Manufacturer: Janssen
Class: Immunology: Anti-TNF
NDC: 1

J0480

HCPCS Descriptor: Injection, basiliximab, 20 mg
Manufacturer: Novartis
Class: Immunosuppressant
NDCs: 2

J7402

HCPCS Descriptor: Mometasone furoate sinus implant, (sinuva), 10 micrograms
Manufacturer: Intersect ENT
Class: Misc.
NDC: 1

10 mcg per unit

J3090

HCPCS Descriptor: Injection, tedizolid phosphate, 1 mg
Manufacturer: Merck
Class: Antibiotic
NDCs: 2

J7301

HCPCS Descriptor: Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
Manufacturer: Bayer Pharmaceutical
Class: Contraceptive
NDC: 1

13.5 mg per unit

J2327

HCPCS Descriptor: Injection, risankizumab-rzaa, intravenous, 1 mg
Manufacturer: AbbVie
Class: Immunology: Anti-TNF
NDC: 1

J3387

HCPCS Descriptor: Injection, elivaldogene autotemcel, per treatment
Manufacturer: Genetix Biotherapeutics
Class: Genetic Disorder
NDC: 1

per therapeutic dose per unit

J7030

SODIUM CHLORIDE

HCPCS Descriptor: Infusion, normal saline solution , 1000 cc
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 35

1000 cc per unit

J7040

SODIUM CHLORIDE

HCPCS Descriptor: Infusion, normal saline solution, sterile (500 ml = 1 unit)
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 35

500 ml per unit

J7050

SODIUM CHLORIDE

HCPCS Descriptor: Infusion, normal saline solution, 250 cc
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 35

250 cc per unit

J7131

SODIUM CHLORIDE

HCPCS Descriptor: Hypertonic saline solution, 1 ml
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 5

NOC SODIUM CHLOR

Sodium Chloride

HCPCS Descriptor: Sodium Chloride, Hypertonic (3% - 5% infusion), 250 CC
Manufacturer: Baxter Healthcare

250 cc per unit

A4216

Sodium Chloride Flush

HCPCS Descriptor: Sterile water, saline and/or dextrose, diluent/flush, 10 ml
Manufacturer: Guerbet
Class: Misc.
NDC: 1

J0208

Sodium Thiosulfate

HCPCS Descriptor: Injection, sodium thiosulfate (pedmark), 100 mg
Manufacturer: Fennec Pharmaceuticals
Class: Misc.
NDC: 1

100 mg per unit

J0209

Sodium Thiosulfate

HCPCS Descriptor: Injection, sodium thiosulfate (hope), 100 mg
Manufacturer: Hope Pharmaceuticals
Class: Misc.
NDC: 1

100 mg per unit

J1299

HCPCS Descriptor: Injection, eculizumab, 2 mg
Manufacturer: AstraZeneca
Class: Immunology
NDC: 1

J1720

HCPCS Descriptor: Injection, hydrocortisone sodium succinate, up to 100 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 10

up to 100 mg per unit

J1930

SOMATULINE DEPOT

HCPCS Descriptor: Injection, lanreotide, 1 mg
Manufacturer: Multiple Manufacturers
Class: Growth Disorder
NDCs: 6

C9482

HCPCS Descriptor: Injection, sotalol hydrochloride, 1 mg
Manufacturer: Altathera Pharmaceuticals
Class: Cardiology
NDC: 1

J1747

HCPCS Descriptor: Injection, spesolimab-sbzo, 1 mg
Manufacturer: Boehringer Ingelheim
Class: Misc.
NDCs: 5

91322

SPIKEVAX 2023-2024 FORMULA

HCPCS Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use
Manufacturer: Moderna
Class: COVID-19
NDCs: 4

0.5 ml per unit

J2326

HCPCS Descriptor: Injection, nusinersen, 0.1 mg
Manufacturer: Biogen
Class: Genetic Disorder
NDCs: 3

0.1 mg per unit

J0013

HCPCS Descriptor: Esketamine, nasal spray, 1 mg
Manufacturer: Janssen
Class: Psychiatric
NDCs: 3

Q5164

HCPCS Descriptor: Injection, ustekinumab-hmny (starjemza), biosimilar, 1 mg
Manufacturer: Hikma
Class: Immunology
NDCs: 4

J3357

HCPCS Descriptor: Ustekinumab, for subcutaneous injection, 1 mg
Manufacturer: Janssen
Class: Immunology: Anti-TNF
NDCs: 6

J3358

HCPCS Descriptor: Ustekinumab, for intravenous injection, 1 mg
Manufacturer: Janssen
Class: Immunology
NDCs: 2

Q5099

HCPCS Descriptor: Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg
Manufacturer: Celltrion USA
Class: Immunology
NDCs: 4

Q5127

HCPCS Descriptor: Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg
Manufacturer: Fresenius Kabi
Class: Oncology Colony Stimulating Factor
NDCs: 2

0.5 mg per unit

Q5157

STOBOCLO AND OSENVELT

HCPCS Descriptor: Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg
Manufacturer: Celltrion USA
Class: Osteoporosis
NDCs: 2

J3000

STREPTOMYCIN SULFATE

HCPCS Descriptor: Injection, streptomycin, up to 1 gm
Manufacturer: XGen Pharmaceuticals DJB
Class: Antibiotic
NDC: 1

A9600

STRONTIUM CHLORIDE SR 89

HCPCS Descriptor: Strontium sr-89 chloride, therapeutic, per millicurie
Manufacturer: QBIOMED INC
Class: Imaging/Radiopharmaceutical
NDC: 1

per millicurie per unit

96369

Subcutaneous Infusion

HCPCS Descriptor: Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)

Q9991

HCPCS Descriptor: Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
Manufacturer: Indivior
Class: Anti-Addiction
NDCs: 3

less than or equal to 100 mg per unit

Q9992

HCPCS Descriptor: Injection, buprenorphine extended-release (sublocade), greater than 100 mg
Manufacturer: Indivior
Class: Anti-Addiction
NDCs: 3

greater than 100 mg per unit

J0330

SUCCINYLCHOLINE CHLORIDE

HCPCS Descriptor: Injection, succinylcholine chloride, up to 20 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 30

J2865

SULFAMETHOXAZOLE-TRIMETHOPRIM

HCPCS Descriptor: Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 14

5mg-1mg per unit

NOC SULFAMETHOXA

Sulfamethoxazole-Trimethoprim

HCPCS Descriptor: Sulfamethoxazole-Trimethoprim,400-80 MG
Manufacturer: Multiple Manufacturers

400-80 mg per unit

J3030

SUMATRIPTAN SUCCINATE

HCPCS Descriptor: Injection, sumatriptan succinate, 6 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)
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 19

J1961

HCPCS Descriptor: Injection, lenacapavir (only for use as hiv treatment), 1 mg
Manufacturer: Gilead Sciences
Class: Misc.
NDCs: 2

J9226

HCPCS Descriptor: Histrelin implant (supprelin la), 50 mg
Manufacturer: Endo USA
Class: Growth Disorder
NDC: 1

67516

Suprachoroidal Injection

HCPCS Descriptor: Suprachoroidal injection of a pharmacologic agent; does not include supply of medication

J1627

HCPCS Descriptor: Injection, granisetron, extended-release, 0.1 mg
Manufacturer: Heron Therapeutics
Class: Anti-Emetic
NDC: 1

0.1 mg per unit

J2779

HCPCS Descriptor: Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg
Manufacturer: Genentech
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

J2781

HCPCS Descriptor: Injection, pegcetacoplan, intravitreal, 1 mg
Manufacturer: Apellis Pharmaceuticals
Class: Ophthalmology
NDCs: 2

S0148

HCPCS Descriptor: Injection, pegylated interferon alfa-2b, 10 mcg
Manufacturer: Merck
Class: Oncology
NDC: 1

10 mcg per unit

J2860

HCPCS Descriptor: Injection, siltuximab, 10 mg
Manufacturer: Recordati Rare Diseases
Class: Anti-HIV
NDCs: 2

90378

HCPCS Descriptor: Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each
Manufacturer: Sobi
Class: Vaccine
NDCs: 2

Q0155

HCPCS Descriptor: Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Manufacturer: Benuvia Therapeutics
Class: Anti-Emetic
NDC: 1

0.1 mg per unit

J2770

HCPCS Descriptor: Injection, quinupristin/dalfopristin, 500 mg (150/350)
Manufacturer: Pfizer
Class: Antibiotic
NDC: 1

500 mg per unit

J7331

HCPCS Descriptor: Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg
Manufacturer: Arthrex
Class: Orthopedic
NDC: 1

J9262

HCPCS Descriptor: Injection, omacetaxine mepesuccinate, 0.01 mg
Manufacturer: Cephalon
Class: Oncology
NDC: 1

0.01 mg per unit

J7325

HCPCS Descriptor: Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg
Manufacturer: Genzyme
Class: Orthopedic
NDCs: 2

J0593

HCPCS Descriptor: Injection, 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)
Manufacturer: Takeda Pharmaceuticals
Class: Immunology
NDCs: 2

J3055

HCPCS Descriptor: Injection, talquetamab-tgvs, 0.25 mg
Manufacturer: Janssen
Class: Oncology
NDCs: 2

0.25 mg per unit

A9601

HCPCS Descriptor: Flortaucipir f 18 injection, diagnostic, 1 millicurie
Manufacturer: ELI LILLY AND COMPANY
Class: Imaging/Radiopharmaceutical
NDC: 1

90714

HCPCS Descriptor: Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 6

0.5 ml per unit

Q2053

HCPCS Descriptor: Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: Gilead Sciences
Class: Oncology
NDCs: 4

up to 200 million autologous anti-cd19 car positive viable t cells per unit

Q2057

HCPCS Descriptor: Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: Supernus Pharmaceuticals
Class: Oncology
NDC: 1

per therapeutic dose per unit

J9022

HCPCS Descriptor: Injection, atezolizumab, 10 mg
Manufacturer: Genentech
Class: Oncology
NDCs: 2

J9024

TECENTRIQ HYBREZA

HCPCS Descriptor: Injection, atezolizumab, 5 mg and hyaluronidase-tqjs
Manufacturer: Genentech
Class: Oncology
NDC: 1

A9506

HCPCS Descriptor: Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible
Manufacturer: Cyclomedica Australia Pty Limited
Class: Imaging/Radiopharmaceutical
NDC: 1

A9512

HCPCS Descriptor: Technetium tc-99m pertechnetate, diagnostic, per millicurie
Manufacturer: Lantheus Medical Imaging
Class: Imaging/Radiopharmaceutical
NDCs: 13

per millicurie per unit

A9537

TECHNETIUM TC 99M MEBROFENIN

HCPCS Descriptor: Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries
Manufacturer: Multiple Manufacturers
Class: Imaging/Radiopharmaceutical
NDCs: 3

up to 15 millicuries per unit

A9500

TECHNETIUM TC 99M SESTAMIBI

HCPCS Descriptor: Technetium tc-99m sestamibi, diagnostic, per study dose
Manufacturer: Lantheus Medical Imaging
Class: Imaging/Radiopharmaceutical
NDCs: 5

per study dose per unit

J9380

HCPCS Descriptor: Injection, teclistamab-cqyv, 0.5 mg
Manufacturer: Janssen
Class: Misc.
NDCs: 2

0.5 mg per unit

J0712

HCPCS Descriptor: Injection, ceftaroline fosamil, 10 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 6

J8700

HCPCS Descriptor: Temozolomide, oral, 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 60

J9328

HCPCS Descriptor: Injection, temozolomide, 1 mg
Manufacturer: Merck
Class: Oncology
NDC: 1

J9330

HCPCS Descriptor: Injection, temsirolimus, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 4

J3241

HCPCS Descriptor: Injection, teprotumumab-trbw, 10 mg
Manufacturer: Amgen
Class: Ophthalmology
NDC: 1

J9341

HCPCS Descriptor: Injection, thiotepa (tepylute), 1 mg
Manufacturer: Shorla Oncology
Class: Oncology
NDCs: 2

J3105

TERBUTALINE SULFATE

HCPCS Descriptor: Injection, terbutaline sulfate, up to 1 mg
Manufacturer: Multiple Manufacturers
Class: Respiratory
NDCs: 6

J7680

TERBUTALINE SULFATE

HCPCS Descriptor: Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7681

TERBUTALINE SULFATE

HCPCS Descriptor: Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

1 milligram per unit

J1073

HCPCS Descriptor: Testosterone pellet, implant, 75 mg
Manufacturer: Endo USA
Class: Hormone Replacement
NDCs: 2

J3121

TESTOSTERONE ENANTHATE

HCPCS Descriptor: Injection, testosterone enanthate, 1 mg
Manufacturer: Multiple Manufacturers
Class: Hormone Replacement
NDCs: 4

J0120

TETRACYCLINE HCL

HCPCS Descriptor: Injection, tetracycline, up to 250 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic

250 mg per unit

J9329

HCPCS Descriptor: Injection, tislelizumab-jsgr, 1mg
Manufacturer: Beigene USA
Class: Oncology
NDCs: 2

J2356

HCPCS Descriptor: Injection, tezepelumab-ekko, 1 mg
Manufacturer: Amgen
Class: Anti-Eosinophil Asthma
NDCs: 2

J2810

THEOPHYLLINE IN 5% DEXTROSE

HCPCS Descriptor: Injection, theophylline, per 40 mg
Manufacturer: B. Braun
Class: Respiratory
NDCs: 2

J3411

HCPCS Descriptor: Injection, thiamine hcl, 100 mg
Manufacturer: Multiple Manufacturers
Class: Misc.
NDCs: 21

100 mg per unit

J9342

HCPCS Descriptor: Injection, thiotepa, not otherwise specified, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 15

J7197

HCPCS Descriptor: Antithrombin iii (human), per i.u.
Manufacturer: Grifols
Class: Hematology
NDCs: 2

37195

Thrombolysis By Intravenous Infusion

HCPCS Descriptor: Thrombolysis, cerebral, by intravenous infusion

J7511

HCPCS Descriptor: Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
Manufacturer: Sanofi
Class: Immunosuppressant
NDC: 1

J3240

HCPCS Descriptor: Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
Manufacturer: Sanofi
Class: Endocrinology
NDC: 1

0.9 mg per unit

J3250

HCPCS Descriptor: Injection, trimethobenzamide hcl, up to 200 mg
Manufacturer: Endo USA
Class: Anti-Emetic
NDC: 1

200 mg per unit

J3243

HCPCS Descriptor: Injection, tigecycline, 1 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 11

J3244

HCPCS Descriptor: Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg
Manufacturer: Accord Healthcare
Class: Antibiotic
NDC: 1

J9273

HCPCS Descriptor: Injection, tisotumab vedotin-tftv, 1 mg
Manufacturer: Pfizer
Class: Oncology
NDC: 1

J3101

HCPCS Descriptor: Injection, tenecteplase, 1 mg
Manufacturer: Genentech
Class: Cardiology
NDCs: 3

J7685

HCPCS Descriptor: Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams
Class: Antibiotic

300 milligrams per unit

J3260

TOBRAMYCIN SULFATE

HCPCS Descriptor: Injection, tobramycin sulfate, up to 80 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 24

Q0234

HCPCS Descriptor: Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, 1 mg
Manufacturer: Biogen
Class: COVID-19
NDCs: 6

Q5133

HCPCS Descriptor: Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg
Manufacturer: Biogen
Class: Antibiotic
NDCs: 6

J2670

HCPCS Descriptor: Injection, tolazoline hcl, up to 25 mg
Class: Cardiology

J3265

HCPCS Descriptor: Injection, torsemide, 10 mg/ml
Class: Diuretic

J3290

TRANEXAMIC ACID

HCPCS Descriptor: Injection, tranexamic acid, 5 mg
Manufacturer: Multiple Manufacturers
Class: Hematology
NDCs: 29

J3291

Tranexamic Acid

HCPCS Descriptor: Injection, tranexamic acid in sodium chloride, 5 mg
Manufacturer: Exela Pharma Sciences
Class: Hematology
NDCs: 2

Q5116

HCPCS Descriptor: Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 2

J9033

HCPCS Descriptor: Injection, bendamustine hydrochloride, not otherwise specified, 1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 11

J3315

HCPCS Descriptor: Injection, triptorelin pamoate, 3.75 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 6

3.75 mg per unit

J1628

HCPCS Descriptor: Injection, guselkumab, 1 mg
Manufacturer: Janssen
Class: Immunology: Anti-TNF
NDCs: 10

J7181

HCPCS Descriptor: Injection, factor xiii a-subunit, (recombinant), per iu
Manufacturer: Novo Nordisk
Class: Hematology
NDC: 1

J7683

HCPCS Descriptor: Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Class: Respiratory

J7684

HCPCS Descriptor: Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Class: Respiratory

J3302

TRIAMCINOLONE DIACETATE

HCPCS Descriptor: Injection, triamcinolone diacetate, per 5 mg
Class: Misc.

J3300

HCPCS Descriptor: Injection, triamcinolone acetonide (triesence), preservative free, 1 mg
Manufacturer: Harrow Eye
Class: Ophthalmology
NDCs: 2

J7332

HCPCS Descriptor: Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg
Manufacturer: Fidia Pharma
Class: Orthopedic
NDC: 1

J3316

HCPCS Descriptor: Injection, triptorelin, extended-release, 3.75 mg
Manufacturer: Azurity Pharmaceuticals
Class: Growth Disorder
NDC: 1

3.75 mg per unit

J7329

HCPCS Descriptor: Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg
Manufacturer: Orthogenrx
Class: Orthopedic
NDC: 1

J9317

HCPCS Descriptor: Injection, sacituzumab govitecan-hziy, 2.5 mg
Manufacturer: Gilead Sciences
Class: Oncology
NDC: 1

2.5 mg per unit

J1746

HCPCS Descriptor: Injection, ibalizumab-uiyk, 10 mg
Manufacturer: Theratechnologies
Class: Anti-HIV
NDCs: 2

90621

HCPCS Descriptor: Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use
Manufacturer: Pfizer
Class: Vaccine
NDCs: 2

per dose per unit

J0750

HCPCS Descriptor: Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
Manufacturer: Multiple Manufacturers
Class: Anti-HIV
NDCs: 22

200 mg/300 mg per unit

J0751

HCPCS Descriptor: Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
Manufacturer: Gilead Sciences
Class: Anti-HIV
NDCs: 2

200/25 mg per unit

Q5115

HCPCS Descriptor: Injection, rituximab-abbs, biosimilar, (truxima), 10 mg
Manufacturer: Teva
Class: Oncology
NDCs: 2

90636

HCPCS Descriptor: Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use
Manufacturer: GlaxoSmithKline
Class: Vaccine
NDC: 1

per dose per unit

Q0238

HCPCS Descriptor: Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Manufacturer: Fresenius Kabi
Class: COVID-19
NDCs: 3

Q5135

HCPCS Descriptor: Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 7

90691

HCPCS Descriptor: Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

per dose per unit

J2323

HCPCS Descriptor: Injection, natalizumab, 1 mg
Manufacturer: Biogen
Class: Neurology
NDC: 1

J7686

HCPCS Descriptor: Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg
Manufacturer: United Therapeutics
Class: Cardiology
NDCs: 4

1.74 mg per unit

J9381

HCPCS Descriptor: Injection, teplizumab-mzwv, 5 mcg
Manufacturer: Sanofi
Class: Misc.
NDCs: 3

J1303

HCPCS Descriptor: Injection, ravulizumab-cwvz, 10 mg
Manufacturer: AstraZeneca
Class: Immunology
NDCs: 2

J1246

HCPCS Descriptor: 0
Manufacturer: UNITED THERAPEUTICS
Class: Oncology

0.1 mg per unit

J9275

HCPCS Descriptor: Injection, cosibelimab-ipdl, 2 mg
Manufacturer: Sun Pharma
Class: Oncology
NDC: 1

J1823

HCPCS Descriptor: Injection, inebilizumab-cdon, 1 mg
Manufacturer: Amgen
Class: Neurology
NDCs: 2

J3350

HCPCS Descriptor: Injection, urea, up to 40 gm
Class: Wound Care

J2799

HCPCS Descriptor: Injection, risperidone (uzedy), 1 mg
Manufacturer: Teva
Class: Psychiatric
NDCs: 7

J2186

HCPCS Descriptor: Injection, meropenem and vaborbactam, 10mg/10mg (20mg)
Manufacturer: Melinta Therapeutics
Class: Antibiotic
NDCs: 2

(10 mg/10mg) 20 mg per unit

J2777

HCPCS Descriptor: Injection, faricimab-svoa, 0.1 mg
Manufacturer: Genentech
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

J0901

HCPCS Descriptor: Vadadustat, oral, 1 mg (for esrd on dialysis)
Manufacturer: Akebia Therapeutics
Class: Anti-Anemia
NDCs: 2

J3379

VALPROATE SODIUM

HCPCS Descriptor: Injection, valproate sodium, 5 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 5

J9357

HCPCS Descriptor: Injection, valrubicin, intravesical, 200 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 2

200 mg per unit

J3373

HCPCS Descriptor: Injection, vancomycin hydrochloride, 10 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 101

J3374

HCPCS Descriptor: Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 24

J3375

HCPCS Descriptor: Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg
Manufacturer: Hikma
Class: Antibiotic
NDCs: 23

J3376

HCPCS Descriptor: Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg
Manufacturer: Hikma
Class: Antibiotic
NDCs: 7

C9488

VAPRISOL-5% DEXTROSE

HCPCS Descriptor: Injection, conivaptan hydrochloride, 1 mg
Manufacturer: Cumberland Pharmacy
Class: Diuretic
NDC: 1

90716

HCPCS Descriptor: Varicella virus vaccine (VAR), live, for subcutaneous use
Manufacturer: Merck
Class: Vaccine
NDC: 1

per dose per unit

90396

HCPCS Descriptor: Varicella-zoster immune globulin, human, for intramuscular use
Manufacturer: Kamada
Class: Vaccine
NDC: 1

125 iu per unit

J8670

HCPCS Descriptor: Rolapitant, oral, 1 mg
Manufacturer: TerSera Therapeutics
Class: Anti-Emetic
NDC: 1

J2596

HCPCS Descriptor: Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit
Manufacturer: Long Grove Pharmaceuticals
Class: Hormone Replacement
NDCs: 4

1 unit per unit

J2598

HCPCS Descriptor: Injection, vasopressin, 1 unit
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 23

1 unit per unit

J2601

HCPCS Descriptor: Injection, vasopressin (baxter), 1 unit
Manufacturer: Baxter Healthcare
Class: Endocrinology
NDCs: 2

1 unit per unit

NOC VASOPRESSIN

Manufacturer: Par Pharmaceuticals
Class: Endocrinology
NDCs: 2

20 units per unit

NOC VASOPRESSIN

Manufacturer: LONG GROVE PHARMACEUTICALS, LLC
Class: Endocrinology
NDCs: 2

20 units per unit

J2599

VASOPRESSIN (AMERICAN REGENT)

HCPCS Descriptor: Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit
Manufacturer: American Regent
Class: Cardiology
NDCs: 5

1 unit per unit

90697

HCPCS Descriptor: Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use
Manufacturer: MSP Vaccine Company
Class: Vaccine
NDCs: 4

per dose per unit

90671

HCPCS Descriptor: Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use
Manufacturer: Merck
Class: Vaccine
NDC: 1

J9303

HCPCS Descriptor: Injection, panitumumab, 10 mg
Manufacturer: Amgen
Class: Oncology
NDCs: 4

Q5129

HCPCS Descriptor: Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg
Manufacturer: Celltrion USA
Class: Oncology
NDCs: 2

J0248

HCPCS Descriptor: Injection, remdesivir, 1 mg
Manufacturer: Gilead Sciences
Class: COVID-19
NDC: 1

J0605

HCPCS Descriptor: Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)
Manufacturer: Fresenius Kabi
Class: Endocrinology
NDC: 1

Q4074

HCPCS Descriptor: Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms
Manufacturer: Actelion
Class: Cardiology
NDCs: 3

up to 20 mcg per unit

J9376

HCPCS Descriptor: Injection, pozelimab-bbfg, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Hematology
NDC: 1

J3465

HCPCS Descriptor: Injection, voriconazole, 10 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Fungal
NDCs: 10

J3095

HCPCS Descriptor: Injection, telavancin, 10 mg
Manufacturer: Cumberland Pharmaceuticals
Class: Antibiotic
NDCs: 3

J1427

HCPCS Descriptor: Injection, viltolarsen, 10 mg
Manufacturer: NS Pharma
Class: Genetic Disorder
NDC: 1

J1322

HCPCS Descriptor: Injection, elosulfase alfa, 1 mg
Manufacturer: Biomarin Pharmaceuticals
Class: Enzyme Replacement Therapy
NDC: 1

90593

HCPCS Descriptor: Chikungunya virus vaccine, recombinant, for intramuscular use
Manufacturer: Bavarian Nordic
Class: Vaccine
NDCs: 2

per dose per unit

C9254

HCPCS Descriptor: Injection, lacosamide, 1 mg
Manufacturer: UCB Pharma
Class: Neurology
NDC: 1

J9360

VINBLASTINE SULFATE

HCPCS Descriptor: Injection, vinblastine sulfate, 1 mg
Manufacturer: Fresenius Kabi
Class: Oncology
NDC: 1

J9370

VINCRISTINE SULFATE

HCPCS Descriptor: Vincristine sulfate, 1 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 6

J3396

HCPCS Descriptor: Injection, verteporfin, 0.1 mg
Manufacturer: Bausch Health
Class: Ophthalmology
NDCs: 2

0.1 mg per unit

J3471

HCPCS Descriptor: Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)
Manufacturer: Bausch Health
Class: Misc.
NDC: 1

1 usp unit per unit

67036

HCPCS Descriptor: Vitrectomy, mechanical, pars plana approach

J9056

HCPCS Descriptor: Injection, bendamustine hydrochloride (vivimusta), 1 mg
Manufacturer: Azurity Pharmaceuticals
Class: Oncology
NDCs: 2

J2315

HCPCS Descriptor: Injection, naltrexone, depot form, 1 mg
Manufacturer: Alkermes
Class: Anti-Addiction
NDC: 1

90690

HCPCS Descriptor: Typhoid vaccine, live, oral
Manufacturer: Bavarian Nordic
Class: Vaccine
NDCs: 2

per dose per unit

Q9982

HCPCS Descriptor: Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries
Manufacturer: GE Healthcare
Class: Imaging/Radiopharmaceutical
NDC: 1

per study dose, up to 5 millicuries per unit

J7179

HCPCS Descriptor: Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDCs: 2

C9293

HCPCS Descriptor: Injection, glucarpidase, 10 units
Manufacturer: BTG International
Class: Oncology
NDC: 1

10 units per unit

NOC GLUCARPIDASE

HCPCS Descriptor: NOC Glucarpidase
Manufacturer: BTG INTERNATIONAL INC.

10 units per unit

J3385

HCPCS Descriptor: Injection, velaglucerase alfa, 100 units
Manufacturer: Takeda Pharmaceuticals
Class: Enzyme Replacement Therapy
NDC: 1

100 units per unit

J7356

HCPCS Descriptor: Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg
Manufacturer: AbbVie
Class: Neurology
NDC: 1

0.25 mg - 5 mg per unit

J3032

HCPCS Descriptor: Injection, eptinezumab-jjmr, 1 mg
Manufacturer: Lundbeck Pharmaceuticals
Class: Neurology
NDC: 1

J3401

HCPCS Descriptor: Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
Manufacturer: Krystal Biotech
Class: Genetic Disorder
NDC: 1

0.1 ml per unit

J1326

HCPCS Descriptor: Injection, zolbetuximab-clzb, 2 mg
Manufacturer: Astellas Pharma
Class: Oncology
NDCs: 2

J1429

HCPCS Descriptor: Injection, golodirsen, 10 mg
Manufacturer: Sarepta Therapeutics
Class: Genetic Disorder
NDC: 1

J9332

HCPCS Descriptor: Injection, efgartigimod alfa-fcab, 2mg
Manufacturer: Argenx US
Class: Oncology
NDC: 1

J9334

VYVGART HYTRULO

HCPCS Descriptor: Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc
Manufacturer: Argenx US
Class: Neurology
NDCs: 3

J9153

HCPCS Descriptor: Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
Manufacturer: Jazz Pharmaceuticals
Class: Oncology
NDCs: 2

1 mg/2.27 mg per unit

C9311

HCPCS Descriptor: Injection, eplontersen, 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)
Manufacturer: AstraZeneca
Class: Genetic Disorder
NDCs: 2

J3386

HCPCS Descriptor: Injection, etuvetidigene autotemcel, per treatment
Manufacturer: Fondazione Telethon ETS
Class: Genetic Disorder

Q5137

HCPCS Descriptor: Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg
Manufacturer: Nuvaila
Class: Immunology
NDCs: 6

Q5138

HCPCS Descriptor: Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg
Manufacturer: Nuvaila
Class: Oncology
NDC: 1

J7183

HCPCS Descriptor: Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco
Manufacturer: Octapharma
Class: Hematology
NDCs: 2

1 i.u. vwf:rco per unit

J2792

HCPCS Descriptor: Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu
Manufacturer: Kamada
Class: Hematology
NDCs: 5

100 iu per unit

J8612

HCPCS Descriptor: Methotrexate (xatmep), oral, 2.5 mg
Manufacturer: Azurity Pharmaceuticals
Class: Anti-Anemia
NDCs: 2

2.5 mg per unit

A2004

XCelliStem Wound Powder

HCPCS Descriptor: Xcellistem, 1 mg
Manufacturer: STEMSYS, LLC
Class: Imaging/Radiopharmaceutical
NDC: 1

J8522

HCPCS Descriptor: Capecitabine, oral, 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 37

J1558

HCPCS Descriptor: Injection, immune globulin (xembify), 100 mg
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 4

100 mg per unit

J0691

HCPCS Descriptor: Injection, lefamulin, 1 mg
Manufacturer: Nabriva Therapeutics Us, Inc
Class: Antibiotic
NDC: 1

J0218

HCPCS Descriptor: Injection, olipudase alfa-rpcp, 1 mg
Manufacturer: Sanofi
Class: Enzyme Replacement Therapy
NDCs: 2

J0588

HCPCS Descriptor: Injection, incobotulinumtoxin a, 1 unit
Manufacturer: Merz Pharmaceuticals
Class: Neurology
NDCs: 3

1 unit per unit

J0122

HCPCS Descriptor: Injection, eravacycline, 1 mg
Manufacturer: Tetraphase Pharmaceuticals
Class: Antibiotic
NDCs: 3

J0775

HCPCS Descriptor: Injection, collagenase, clostridium histolyticum, 0.01 mg
Manufacturer: Endo USA
Class: Orthopedic
NDC: 1

0.01 mg per unit

J1737

HCPCS Descriptor: Injection, meloxicam (azurity), 1 mg
Manufacturer: Azurity Pharmaceuticals
Class: Non-Opioid Analgesic
NDCs: 2

J3299

HCPCS Descriptor: Injection, triamcinolone acetonide (xipere), 1 mg
Manufacturer: Bausch Health
Class: Ophthalmology
NDC: 1

A9606

HCPCS Descriptor: Radium ra-223 dichloride, therapeutic, per microcurie
Manufacturer: Bayer Pharmaceutical
Class: Imaging/Radiopharmaceutical
NDC: 1

J2357

HCPCS Descriptor: Injection, omalizumab, 5 mg
Manufacturer: Genentech
Class: Anti-Eosinophil Asthma
NDCs: 9

J7304

HCPCS Descriptor: Contraceptive supply, hormone containing patch, each
Manufacturer: Multiple Manufacturers
Class: Contraceptive
NDCs: 6

J2004

XYLOCAINE-MPF/EPINEPHRINE

HCPCS Descriptor: Injection, lidocaine hcl with epinephrine, 1 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 54

J7185

HCPCS Descriptor: Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.
Manufacturer: Pfizer
Class: Hematology
NDCs: 9

J1289

HCPCS Descriptor: Injection, narsoplimab-wuug, 1 mg
Manufacturer: Rayner Surgical
Class: Immunology
NDC: 1

J7354

HCPCS Descriptor: Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
Manufacturer: Verrica Pharmaceuticals
Class: Misc.
NDCs: 3

per 3.2 mg single-use applicator per unit

J9228

HCPCS Descriptor: Injection, ipilimumab, 1 mg
Manufacturer: BMS
Class: Oncology
NDCs: 2

Q5155

HCPCS Descriptor: Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg
Manufacturer: Biocon Biologics
Class: Ophthalmology
NDC: 1

Q2041

HCPCS Descriptor: Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: Kite Pharma
Class: Oncology
NDC: 1

up to 200 million car t cells per unit

Q5100

HCPCS Descriptor: Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg
Manufacturer: Biocon Biologics
Class: Immunology
NDCs: 4

J0738

HCPCS Descriptor: Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Manufacturer: Gilead Sciences
Class: Anti-HIV
NDC: 1

J0752

HCPCS Descriptor: Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Manufacturer: Gilead Sciences
Class: Anti-HIV
NDC: 1

300 mg per unit

90717

HCPCS Descriptor: Yellow fever vaccine, live, for subcutaneous use
Manufacturer: Sanofi
Class: Vaccine
NDCs: 2

per dose per unit

J1553

HCPCS Descriptor: Injection, immune globulin (yimmugo), 100 mg
Manufacturer: Grifols
Class: Immunoglobulin
NDCs: 6

100 mg per unit

J9362

HCPCS Descriptor: Injection, trabectedin, 0.01 mg
Manufacturer: Janssen
Class: Oncology
NDC: 1

0.01 mg per unit

Q5141

HCPCS Descriptor: Injection, adalimumab-aaty, biosimilar, 1 mg
Manufacturer: Celltrion USA
Class: Immunology: Anti-TNF
NDCs: 12

J7677

HCPCS Descriptor: Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram
Manufacturer: Viatris
Class: Respiratory
NDC: 1

J7314

HCPCS Descriptor: Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg
Manufacturer: ANI Pharmaceuticals
Class: Ophthalmology
NDCs: 2

0.01 mg per unit

J9400

HCPCS Descriptor: Injection, ziv-aflibercept, 1 mg
Manufacturer: Sanofi
Class: Oncology
NDCs: 2

J9320

HCPCS Descriptor: Injection, streptozocin, 1 gram
Manufacturer: Teva
Class: Oncology
NDC: 1

Q5101

HCPCS Descriptor: Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram
Manufacturer: Sandoz
Class: Oncology Colony Stimulating Factor
NDCs: 4

J0291

HCPCS Descriptor: Injection, plazomicin, 5 mg
Manufacturer: Cipla
Class: Antibiotic
NDCs: 4

J9223

HCPCS Descriptor: Injection, lurbinectedin, 0.1 mg
Manufacturer: Jazz Pharmaceuticals
Class: Oncology
NDC: 1

0.1 mg per unit

J0695

HCPCS Descriptor: Injection, ceftolozane 50 mg and tazobactam 25 mg
Manufacturer: Merck
Class: Antibiotic
NDC: 1

75mg (50mg cft/25mg taz) per unit

A9543

HCPCS Descriptor: Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries
Manufacturer: Acrotech Biopharma
Class: Imaging/Radiopharmaceutical
NDC: 1

up to 40 millicuries per unit

J3389

HCPCS Descriptor: Topical administration, prademagene zamikeracel, per treatment
Manufacturer: Abeona Therapeutics
Class: Genetic Disorder
NDC: 1

per therapeutic dose per unit

J0681

HCPCS Descriptor: Injection, ceftobiprole medocaril sodium, 3 mg
Manufacturer: La Jolla Pharmaceutical
Class: Antibiotic
NDCs: 2

Q5120

HCPCS Descriptor: Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg
Manufacturer: Sandoz
Class: Oncology Colony Stimulating Factor
NDCs: 2

0.5 mg per unit

J9276

HCPCS Descriptor: Injection, zanidatamab-hrii, 2 mg
Manufacturer: Jazz Pharmaceuticals
Class: Oncology
NDCs: 2

J3304

HCPCS Descriptor: Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
Manufacturer: Pacira Pharmaceuticals
Class: Orthopedic
NDC: 1

J2313

HCPCS Descriptor: Injection, naloxone hydrochloride (zimhi), 0.01 mg
Manufacturer: USWM, LLC
Class: Anti-Addiction
NDCs: 2

0.01 mg per unit

J0565

HCPCS Descriptor: Injection, bezlotoxumab, 10 mg
Manufacturer: Merck
Class: Antibiotic
NDCs: 2

Q5118

HCPCS Descriptor: Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 2

J3399

HCPCS Descriptor: Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes
Manufacturer: Novartis
Class: Genetic Disorder
NDCs: 37

per tx dose (up to 5 x10^15 vg?) per unit

J1632

HCPCS Descriptor: Injection, brexanolone, 1 mg
Manufacturer: Sage Therapeutics
Class: Psychiatric
NDC: 1

J9282

HCPCS Descriptor: Mitomycin, intravesical instillation, 1 mg
Manufacturer: UroGen Pharma
Class: Oncology
NDC: 1

J1748

HCPCS Descriptor: Injection, infliximab-dyyb (zymfentra), 10 mg
Manufacturer: Celltrion USA
Class: Immunology: Anti-TNF
NDCs: 3

J9359

HCPCS Descriptor: Injection, loncastuximab tesirine-lpyl, 0.075 mg
Manufacturer: ADC Therapeutics
Class: Oncology
NDC: 1

0.075 mg per unit

J0668

HCPCS Descriptor: Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg
Manufacturer: Heron Therapeutics
Class: Anesthetic
NDCs: 4

1 mg - 0.03 mg per unit

J3393

HCPCS Descriptor: Injection, betibeglogene autotemcel, per treatment
Manufacturer: Genetix Biotherapeutics
Class: Genetic Disorder
NDC: 1

per therapeutic dose per unit

J9345

HCPCS Descriptor: Injection, retifanlimab-dlwr, 1 mg
Manufacturer: Incyte
Class: Oncology
NDC: 1

J2358

ZYPREXA RELPREVV

HCPCS Descriptor: Injection, olanzapine, long-acting, 1 mg
Manufacturer: Eli Lilly
Class: Psychiatric
NDCs: 6

C9152

ABILIFY ASIMTUFII

HCPCS Descriptor: Injection, aripiprazole, (abilify asimtufii), 1 mg
Manufacturer: Otsuka
Class: Psychiatric
NDCs: 2

Inactive December 31, 2023

Q5132

HCPCS Descriptor: Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg
Manufacturer: PFIZER INC.
Class: Immunology: Anti-TNF
NDCs: 4

Inactive December 31, 2024

J0800

HCPCS Descriptor: Injection, corticotropin, up to 40 units
Manufacturer: Multiple Manufacturers
Class: Endocrinology
NDCs: 3

Inactive September 30, 2023

J0795

HCPCS Descriptor: Injection, corticorelin ovine triflutate, 1 microgram
Manufacturer: Ferring Pharmaceuticals
Class: Endocrinology
NDC: 1

Inactive December 31, 2025

J0171

HCPCS Descriptor: Injection, adrenalin, epinephrine, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 23

Inactive June 30, 2025

J0172

HCPCS Descriptor: Injection, aducanumab-avwa, 2 mg
Manufacturer: Biogen
Class: Neurology
NDCs: 2

Inactive December 31, 2025

C9167

HCPCS Descriptor: Injection, adamts13, recombinant-krhn, 10 iu
Manufacturer: Takeda Pharmaceuticals
Class: Hematology
NDCs: 2

Inactive June 30, 2024

J0200

ALATROFLOXACIN MESYLATE

HCPCS Descriptor: Injection, alatrofloxacin mesylate, 100 mg
Class: Antibiotic

Inactive December 31, 2025

J0215

HCPCS Descriptor: Injection, alefacept, 0.5 mg
Class: Immunology

Inactive December 31, 2025

J0205

HCPCS Descriptor: Injection, alglucerase, per 10 units
Class: Enzyme Replacement Therapy

Inactive December 31, 2025

C9142

HCPCS Descriptor: Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg
Manufacturer: Amneal Pharmaceuticals
Class: Oncology
NDCs: 2

Inactive December 31, 2022

J0288

AMPHOTERICIN B CHOLESTERYL SULFATE

HCPCS Descriptor: Injection, amphotericin b cholesteryl sulfate complex, 10 mg
Class: Anti-Fungal

Inactive December 31, 2025

J0350

HCPCS Descriptor: Injection, anistreplase, per 30 units
Class: Cardiology

Inactive December 31, 2025

C9169

HCPCS Descriptor: Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram
Manufacturer: ImmunityBio
Class: Oncology
NDC: 1

Inactive December 31, 2024

C9145

HCPCS Descriptor: Injection, aprepitant, (aponvie), 1 mg
Manufacturer: Heron Therapeutics
Class: Anti-Emetic
NDC: 1

Inactive March 31, 2026

J0365

HCPCS Descriptor: Injection, aprotonin, 10,000 kiu
Class: Hematology

Inactive December 31, 2025

J0395

HCPCS Descriptor: Injection, arbutamine hcl, 1 mg
Class: Cardiology

Inactive December 31, 2025

C9301

HCPCS Descriptor: Obecabtagene autoleucel, up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Manufacturer: Autolus
Class: Oncology
NDC: 1

Inactive June 30, 2025

J2910

AUROTHIOGLUCOSE

HCPCS Descriptor: Injection, aurothioglucose, up to 50 mg
Class: Misc.

Inactive December 31, 2025

S0073

HCPCS Descriptor: Injection, aztreonam, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 4

Inactive June 30, 2023

C9159

HCPCS Descriptor: Injection, prothrombin complex concentrate (human), balfaxar, per i.u. of factor ix activity
Manufacturer: Octapharma
Class: Hematology
NDCs: 2

Inactive March 31, 2024

C9153

HCPCS Descriptor: Injection, amisulpride, 1 mg
Manufacturer: Acacia Pharma
Class: Anti-Emetic
NDCs: 2

Inactive December 31, 2023

C9462

HCPCS Descriptor: Injection, delafloxacin, 1 mg
Manufacturer: Melinta Therapeutics
Class: Antibiotic
NDC: 1

Inactive September 30, 2026

Q0222

HCPCS Descriptor: Injection, bebtelovimab, 175 mg
Manufacturer: Eli Lilly and Company
Class: COVID-19
NDC: 1

Inactive December 12, 2024

J9058

BENDAMUSTINE (APOTEX)

HCPCS Descriptor: Injection, bendamustine hydrochloride (apotex), 1 mg
Manufacturer: Apotex
Class: Oncology
NDC: 1

Inactive December 31, 2024

J9059

BENDAMUSTINE HYDROCHLORIDE

HCPCS Descriptor: Injection, bendamustine hydrochloride (baxter), 1 mg
Manufacturer: Baxter Healthcare
Class: Oncology
NDC: 1

Inactive December 31, 2024

C9172

HCPCS Descriptor: Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose
Manufacturer: Pfizer
Class: Genetic Disorder
NDCs: 4

Inactive December 31, 2024

J2370

HCPCS Descriptor: Injection, phenylephrine hcl, up to 1 ml
Manufacturer: Multiple Manufacturers
Class: Cardiology
NDCs: 23

Inactive June 30, 2023

J0190

BIPERIDEN LACTATE

HCPCS Descriptor: Injection, biperiden lactate, per 5 mg
Class: Neurology

Inactive December 31, 2025

Q5139

HCPCS Descriptor: Injection, eculizumab-aeeb (bkemv), biosimilar, 10 mg
Manufacturer: Amgen Inc
Class: Hematology

Inactive March 31, 2025

J9037

HCPCS Descriptor: Injection, belantamab mafodotin-blmf, 0.5 mg
Manufacturer: GSK
Class: Oncology
NDC: 1

Inactive March 31, 2025

C9300

HCPCS Descriptor: Injection, indigotindisulfonate sodium, 1 mg
Manufacturer: Provepharm
Class: Imaging/Radiopharmaceutical
NDC: 1

Inactive June 30, 2025

J9044

HCPCS Descriptor: Injection, bortezomib, not otherwise specified, 0.1 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 5

Inactive December 31, 2022

J9051

BORTEZOMIB (MAIA)

HCPCS Descriptor: Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg
Manufacturer: MAIA Pharma
Class: Oncology
NDC: 1

C9154

HCPCS Descriptor: Injection, buprenorphine extended-release (brixadi), 1 mg
Manufacturer: Braeburn Pharmaceutical
Class: Anti-Addiction
NDCs: 7

Inactive December 31, 2023

J0576

HCPCS Descriptor: Injection, buprenorphine extended-release (brixadi), 1 mg
Manufacturer: Braeburn Pharmaceutical
Class: Anti-Addiction
NDCs: 7

Inactive March 31, 2024

S0171

HCPCS Descriptor: Injection, bumetanide, 0.5 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 8

Inactive December 31, 2023

S0020

BUPIVACAINE HCL

HCPCS Descriptor: Injection, bupivicaine hydrochloride, 30 ml
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 5

Inactive June 30, 2023

J9064

CABAZITAXEL (SANDOZ)

HCPCS Descriptor: Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg
Manufacturer: SANDOZ

J8520

HCPCS Descriptor: Capecitabine, oral, 150 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 12

Inactive September 30, 2024

J8521

HCPCS Descriptor: Capecitabine, oral, 500 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 13

Inactive September 30, 2024

J0715

CEFTIZOXIME SODIUM

HCPCS Descriptor: Injection, ceftizoxime sodium, per 500 mg
Class: Antibiotic

Inactive December 31, 2025

J7519

HCPCS Descriptor: Injection, mycophenolate mofetil, 10 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 8

Inactive September 30, 2026

J7517

HCPCS Descriptor: Mycophenolate mofetil, oral, 250 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 55

Inactive September 30, 2026

J0710

CEPHAPIRIN SODIUM

HCPCS Descriptor: Injection, cephapirin sodium, up to 1 gm
Class: Antibiotic

Inactive December 31, 2025

J2400

CHLOROPROCAINE HCL

HCPCS Descriptor: Injection, chloroprocaine hydrochloride, per 30 ml
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 7

Inactive December 31, 2022

C9248

HCPCS Descriptor: Injection, clevidipine butyrate, 1 mg
Manufacturer: Chiesi USA
Class: Cardiology
NDCs: 2

Inactive September 30, 2025

C9046

HCPCS Descriptor: Cocaine hydrochloride nasal solution (goprelto), 1 mg
Manufacturer: Genus Lifesciences
Class: Anesthetic
NDC: 1

Inactive September 30, 2026

C9166

HCPCS Descriptor: Injection, secukinumab, intravenous, 1 mg
Manufacturer: Novartis
Class: Immunology
NDC: 1

Inactive June 30, 2024

J9070

Cyclophosphamide

HCPCS Descriptor: Cyclophosphamide, 100 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 41

Inactive March 31, 2024

J9098

CYTARABINE LIPOSOME

HCPCS Descriptor: Injection, cytarabine liposome, 10 mg
Class: Oncology

Inactive December 31, 2025

J0889

HCPCS Descriptor: Daprodustat, oral, 1 mg, (for esrd on dialysis)
Class: Anti-Anemia

Inactive December 31, 2025

C9174

HCPCS Descriptor: Injection, datopotamab deruxtecan-dlnk, 1 mg
Manufacturer: Daiichi Sankyo
Class: Oncology
NDC: 1

Inactive September 30, 2025

J9151

HCPCS Descriptor: Injection, daunorubicin citrate, liposomal formulation, 10 mg
Class: Oncology

Inactive December 31, 2025

C9160

HCPCS Descriptor: Injection, daxibotulinumtoxina-lanm, 1 unit
Manufacturer: Revance Therapeutics
Class: Neurology
NDC: 1

Inactive March 31, 2024

J1020

HCPCS Descriptor: Injection, methylprednisolone acetate, 20 mg
Manufacturer: Pfizer
Class: Immunology
NDC: 1

Inactive March 31, 2024

J1030

HCPCS Descriptor: Injection, methylprednisolone acetate, 40 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 21

Inactive March 31, 2024

J1040

HCPCS Descriptor: Injection, methylprednisolone acetate, 80 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 15

Inactive March 31, 2024

Q4106

Dermagraft 2"x3" Sheet

HCPCS Descriptor: Dermagraft, per square centimeter
Manufacturer: Organogenesis
Class: Wound Care
NDC: 1

Inactive December 31, 2025

J9165

DIETHYLSTILBESTROL DIPHOSPHATE

HCPCS Descriptor: Injection, diethylstilbestrol diphosphate, 250 mg
Class: Oncology

Inactive December 31, 2025

J1170

HCPCS Descriptor: Injection, hydromorphone, up to 4 mg
Manufacturer: Multiple Manufacturers
Class: Opioid Analgesic
NDCs: 32

Inactive September 30, 2024

J1267

HCPCS Descriptor: Injection, doripenem, 10 mg
Class: Antibiotic

Inactive December 31, 2025

C9146

HCPCS Descriptor: Injection, mirvetuximab soravtansine-gynx, 1 mg
Manufacturer: AbbVie
Class: Oncology
NDC: 1

Inactive June 30, 2023

C9165

HCPCS Descriptor: Injection, elranatamab-bcmm, 1 mg
Manufacturer: Pfizer
Class: Oncology
NDCs: 2

Inactive March 31, 2024

C9306

HCPCS Descriptor: Injection, telisotuzumab vedotin-tllv, 1 mg
Manufacturer: AbbVie
Class: Oncology
NDCs: 2

Inactive December 31, 2025

C9094

HCPCS Descriptor: Inj, sutimlimab-jome, 10 mg
Manufacturer: Bioverativ
Class: Hematology
NDC: 1

Inactive September 30, 2022

J0173

HCPCS Descriptor: Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg
Manufacturer: Belcher
Class: Cardiology
NDC: 1

Inactive June 30, 2025

C9155

HCPCS Descriptor: Injection, epcoritamab-bysp, 0.16 mg
Manufacturer: Genmab
Class: Oncology
NDCs: 2

Inactive December 31, 2023

J1330

ERGONOVINE MALEATE

HCPCS Descriptor: Injection, ergonovine maleate, up to 0.2 mg
Class: Misc.

Inactive December 31, 2025

J9019

HCPCS Descriptor: Injection, asparaginase (erwinaze), 1,000 iu
Manufacturer: Clinigen Group
Class: Oncology
NDC: 1

Inactive December 31, 2025

J9181

HCPCS Descriptor: Injection, etoposide, 10 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 21

Inactive September 30, 2026

C9290

HCPCS Descriptor: Injection, bupivacaine liposome, 1 mg
Manufacturer: Pacira Pharmaceuticals
Class: Anesthetic
NDCs: 4

Inactive December 31, 2024

C9161

HCPCS Descriptor: Injection, aflibercept hd, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Ophthalmology
NDC: 1

Inactive March 31, 2024

J8562

HCPCS Descriptor: Fludarabine phosphate, oral, 10 mg
Class: Oncology

Inactive December 31, 2025

J9190

HCPCS Descriptor: Injection, fluorouracil, 500 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 33

Inactive September 30, 2026

J1452

FOMIVIRSEN SODIUM

HCPCS Descriptor: Injection, fomivirsen sodium, intraocular, 1.65 mg
Class: Ophthalmology

Inactive December 31, 2025

J1941

HCPCS Descriptor: Injection, furosemide (furoscix), 20 mg
Manufacturer: scPharmaceuticals
Class: Diuretic
NDC: 1

Inactive September 30, 2026

J1940

HCPCS Descriptor: Injection, furosemide, up to 20 mg
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 45

Inactive March 31, 2025

J1457

GALLIUM NITRATE

HCPCS Descriptor: Injection, gallium nitrate, 1 mg
Class: Oncology

Inactive December 31, 2025

J1620

GONADORELIN HYDROCHLORIDE

HCPCS Descriptor: Injection, gonadorelin hydrochloride, per 100 mcg
Class: Fertility

Inactive December 31, 2025

C9175

HCPCS Descriptor: Injection, treosulfan, 50 mg
Manufacturer: Medexus Pharma
Class: Oncology
NDCs: 2

Inactive September 30, 2025

J0135

HCPCS Descriptor: Injection, adalimumab, 20 mg
Manufacturer: AbbVie
Class: Immunology: Anti-TNF
NDCs: 16

Inactive December 31, 2024

J1710

HCPCS Descriptor: Injection, hydrocortisone sodium phosphate, up to 50 mg
Class: Misc.

Inactive December 31, 2025

C9304

HCPCS Descriptor: Injection, marstacimab-hncq, 0.5 mg
Manufacturer: Pfizer
Class: Hematology
NDC: 1

Inactive June 30, 2025

C9305

HCPCS Descriptor: Injection, nipocalimab-aahu, 3 mg
Manufacturer: Janssen
Class: Immunology
NDC: 1

Inactive December 31, 2025

C9170

HCPCS Descriptor: Injection, tarlatamab-dlle, 1 mg
Manufacturer: Amgen
Class: Oncology
NDCs: 2

Inactive December 31, 2024

C9147

HCPCS Descriptor: Injection, tremelimumab-actl, 1 mg
Manufacturer: AstraZeneca
Class: Oncology
NDCs: 2

Inactive June 30, 2023

J9212

INTERFERON ALFACON-1

HCPCS Descriptor: Injection, interferon alfacon-1, recombinant, 1 microgram
Class: Immunology

Inactive December 31, 2025

C9309

HCPCS Descriptor: Injection, onasemnogene abeparvovec-brve, per treatment
Manufacturer: Novartis Gene Therapies
Class: Genetic Disorder

Inactive June 30, 2026

Q5109

HCPCS Descriptor: Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg
Manufacturer: Pfizer
Class: Immunology: Anti-TNF

Inactive December 31, 2025

C9162

HCPCS Descriptor: Injection, avacincaptad pegol, 0.1 mg
Manufacturer: Astellas Pharma
Class: Ophthalmology
NDC: 1

Inactive March 31, 2024

J1953

HCPCS Descriptor: Injection, levetiracetam, 10 mg
Manufacturer: Multiple Manufacturers
Class: Neurology
NDCs: 75

Inactive September 30, 2026

C9308

HCPCS Descriptor: Injection, carboplatin (avyxa), 1 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 2

Inactive March 31, 2026

J1945

HCPCS Descriptor: Injection, lepirudin, 50 mg
Class: Misc.

Inactive December 31, 2025

J0640

LEUCOVORIN CALCIUM

HCPCS Descriptor: Injection, leucovorin calcium, per 50 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 39

Inactive September 30, 2026

J2001

LIDOCAINE HCL IN 5% DEXTROSE

HCPCS Descriptor: Injection, lidocaine hcl for intravenous infusion, 10 mg
Manufacturer: Multiple Manufacturers
Class: Anesthetic
NDCs: 6

Inactive September 30, 2024

C9171

HCPCS Descriptor: Injection, pegulicianine, 1 mg
Manufacturer: Lumicell
Class: Imaging/Radiopharmaceutical
NDC: 1

Inactive December 31, 2024

C9307

HCPCS Descriptor: Injection, linvoseltamab-gcpt, 1 mg
Manufacturer: Regeneron Pharmaceuticals
Class: Oncology
NDCs: 2

Inactive March 31, 2026

J2150

HCPCS Descriptor: Injection, mannitol, 25% in 50 ml
Manufacturer: Multiple Manufacturers
Class: Diuretic
NDCs: 3

Inactive September 30, 2025

J9371

HCPCS Descriptor: Injection, vincristine sulfate liposome, 1 mg
Manufacturer: Acrotech Biopha
Class: Oncology
NDC: 1

Inactive June 30, 2024

J0380

METARAMINOL BITARTRATE

HCPCS Descriptor: Injection, metaraminol bitartrate, per 10 mg
Class: Cardiology

Inactive December 31, 2025

J9250

HCPCS Descriptor: Methotrexate sodium, 5 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 19

Inactive March 31, 2024

J2920

METHYLPREDNISOLONE SODIUM SUCC

HCPCS Descriptor: Injection, methylprednisolone sodium succinate, up to 40 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 8

Inactive March 31, 2024

J2930

METHYLPREDNISOLONE SODIUM SUCC

HCPCS Descriptor: Injection, methylprednisolone sodium succinate, up to 125 mg
Manufacturer: Multiple Manufacturers
Class: Immunology
NDCs: 20

Inactive March 31, 2024

J7528

MYCOPHENOLATE MOFETIL ORAL

HCPCS Descriptor: Mycophenolate mofetil, for suspension, oral, 100 mg
Manufacturer: Multiple Manufacturers
Class: Immunosuppressant
NDCs: 8

Inactive September 30, 2026

J7514

HCPCS Descriptor: Mycophenolate mofetil (myhibbin), oral suspension, 100 mg
Manufacturer: Azurity Pharmaceuticals
Class: Immunosuppressant
NDC: 1

Inactive September 30, 2026

J8650

HCPCS Descriptor: Nabilone, oral, 1 mg
Class: Anti-Emetic

Inactive December 31, 2025

J2310

HCPCS Descriptor: Injection, naloxone hydrochloride, per 1 mg
Manufacturer: Multiple Manufacturers
Class: Anti-Addiction
NDCs: 38

Inactive June 30, 2025

J2796

HCPCS Descriptor: Injection, romiplostim, 10 micrograms
Manufacturer: Amgen
Class: Oncology Colony Stimulating Factor
NDCs: 3

Inactive December 31, 2024

C9173

HCPCS Descriptor: Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram
Manufacturer: Tanvex Biopharma USA
Class: Oncology
NDCs: 4

Inactive June 30, 2025

S0166

HCPCS Descriptor: Injection, olanzapine, 2.5 mg
Manufacturer: Multiple Manufacturers
Class: Psychiatric
NDCs: 2

Inactive September 30, 2023

C9168

HCPCS Descriptor: Injection, mirikizumab-mrkz, 1 mg
Manufacturer: Eli Lilly
Class: Gastroenterology
NDCs: 2

Inactive June 30, 2024

J9259

PACLITAXEL PROTEIN-BOUND (AMERICAN REGENT)

HCPCS Descriptor: Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mg
Manufacturer: American Regent
Class: Oncology
NDC: 1

Inactive December 31, 2024

J9258

PACLITAXEL PROTEIN-BOUND PARTICLES

HCPCS Descriptor: Injection, paclitaxel protein-bound particles (teva), not therapeutically equivalent to j9264, 1 mg
Manufacturer: Teva
Class: Oncology
NDC: 1

Inactive September 30, 2024

J2504

PEGADEMASE BOVINE

HCPCS Descriptor: Injection, pegademase bovine, 25 iu
Class: Genetic Disorder

Inactive December 31, 2025

J2513

HCPCS Descriptor: Injection, pentastarch, 10% solution, 100 ml
Class: Hematology

Inactive December 31, 2025

J3310

HCPCS Descriptor: Injection, perphenazine, up to 5 mg
Class: Psychiatric

Inactive December 31, 2025

J9270

HCPCS Descriptor: Injection, plicamycin, 2.5 mg
Class: Oncology

Inactive December 31, 2025

J0570

HCPCS Descriptor: Buprenorphine implant, 74.2 mg
Manufacturer: Titan Pharmaceuticals
Class: Anti-Addiction
NDC: 1

S0164

HCPCS Descriptor: Injection, pantoprazole sodium, 40 mg
Manufacturer: Multiple Manufacturers
Class: Gastroenterology
NDCs: 4

Inactive June 30, 2024

C9157

HCPCS Descriptor: Injection, tofersen, 1 mg
Manufacturer: Biogen
Class: Neurology
NDC: 1

Inactive December 31, 2023

J2806

HCPCS Descriptor: Injection, sincalide (maia), not therapeutically equivalent to j2805, 5 micrograms
Manufacturer: Fosun Pharma
Class: Misc.
NDCs: 2

Inactive December 31, 2024

J1300

HCPCS Descriptor: Injection, eculizumab, 10 mg
Manufacturer: AstraZeneca
Class: Immunology
NDC: 1

Inactive March 31, 2025

J2940

HCPCS Descriptor: Injection, somatrem, 1 mg
Class: Growth Disorder

Inactive December 31, 2025

Q0247

Sotrovimab Injection

HCPCS Descriptor: Injection, sotrovimab, 500 mg
Manufacturer: GSK
Class: Anti-HIV
NDC: 1

Inactive December 12, 2024

J3320

SPECTINOMYCIN DIHYDROCHLORIDE

HCPCS Descriptor: Injection, spectinomycin dihydrochloride, up to 2 gm
Class: Antibiotic

Inactive December 31, 2025

J2995

HCPCS Descriptor: Injection, streptokinase, per 250,000 iu
Class: Cardiology

Inactive December 31, 2025

C9151

HCPCS Descriptor: Injection, pegcetacoplan, 1 mg
Manufacturer: Apellis Pharmaceuticals
Class: Ophthalmology
NDC: 1

Inactive September 30, 2023

C9163

HCPCS Descriptor: Injection, talquetamab-tgvs, 0.25 mg
Manufacturer: Janssen
Class: Oncology
NDCs: 2

Inactive March 31, 2024

C9148

HCPCS Descriptor: Injection, teclistamab-cqyv, 0.5 mg
Manufacturer: Janssen
Class: Oncology
NDCs: 2

Inactive June 30, 2023

Q2017

HCPCS Descriptor: Injection, teniposide, 50 mg
Manufacturer: WG Critical Care
Class: Oncology
NDC: 1

Inactive December 31, 2025

J9340

HCPCS Descriptor: Injection, thiotepa, 15 mg
Manufacturer: Multiple Manufacturers
Class: Oncology
NDCs: 16

Inactive June 30, 2025

J3280

THIETHYLPERAZINE MALEATE

HCPCS Descriptor: Injection, thiethylperazine maleate, up to 10 mg
Class: Anti-Emetic

Inactive December 31, 2025

J1655

TINZAPARIN SODIUM

HCPCS Descriptor: Injection, tinzaparin sodium, 1000 iu
Class: Hematology

Inactive December 31, 2025

J1443

HCPCS Descriptor: Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron
Manufacturer: Rockwell Medical
Class: Anti-Anemia
NDCs: 2

Inactive December 31, 2025

J1444

HCPCS Descriptor: Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron
Manufacturer: ROCKWELL MEDICAL
Class: Hematology
NDCs: 2

Inactive December 31, 2025

J1445

HCPCS Descriptor: Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron
Manufacturer: Rockwell Medical
Class: Anti-Anemia

Inactive December 31, 2025

J3400

TRIFLUPROMAZINE HCL

HCPCS Descriptor: Injection, triflupromazine hcl, up to 20 mg
Class: Psychiatric

Inactive December 31, 2025

J3305

TRIMETREXATE GLUCURONATE

HCPCS Descriptor: Injection, trimetrexate glucuronate, per 25 mg
Class: Oncology

Inactive December 31, 2025

C9149

HCPCS Descriptor: Injection, teplizumab-mzwv, 5 mcg
Manufacturer: Sanofi
Class: Immunology
NDCs: 3

Inactive June 30, 2023

J3355

HCPCS Descriptor: Injection, urofollitropin, 75 iu
Class: Fertility

Inactive December 31, 2025

J3364

HCPCS Descriptor: Injection, urokinase, 5000 iu vial
Class: Hematology

Inactive December 31, 2025

J3365

HCPCS Descriptor: Injection, iv, urokinase, 250,000 i.u. vial
Class: Hematology

Inactive December 31, 2025

C9158

HCPCS Descriptor: Injection, risperidone, (uzedy), 1 mg
Manufacturer: Teva
Class: Psychiatric
NDCs: 7

Inactive December 31, 2023

J3370

HCPCS Descriptor: Injection, vancomycin hcl, 500 mg
Manufacturer: Multiple Manufacturers
Class: Antibiotic
NDCs: 115

Inactive June 30, 2025

J3371

HCPCS Descriptor: Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg
Manufacturer: Viatris
Class: Antibiotic
NDCs: 9

Inactive June 30, 2025

J3372

HCPCS Descriptor: Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg
Manufacturer: Xellia Pharmaceuticals USA
Class: Antibiotic
NDCs: 14

Inactive June 30, 2025

J1562

HCPCS Descriptor: Injection, immune globulin (vivaglobin), 100 mg
Manufacturer: CSL Behring
Class: Immunoglobulin

Inactive December 31, 2025

C9310

HCPCS Descriptor: Injection, leucovorin calcium (avyxa), 1 mg
Manufacturer: Avyxa Pharma
Class: Oncology
NDCs: 3

Inactive September 30, 2026

C9303

HCPCS Descriptor: Injection, zolbetuximab-clzb, 1 mg
Manufacturer: Astellas Pharma
Class: Oncology
NDC: 1

Inactive June 30, 2025

C9089

HCPCS Descriptor: Bupivacaine, collagen-matrix implant, 1 mg
Manufacturer: Innocoll Pharmaceuticals
Class: Anesthetic
NDCs: 2

Inactive December 31, 2025

C9150

HCPCS Descriptor: Xenon xe-129 hyperpolarized gas, diagnostic, per study dose
Manufacturer: Polarean, Inc.
Class: Imaging/Radiopharmaceutical
NDC: 1

Inactive September 30, 2024

C9164

HCPCS Descriptor: Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
Manufacturer: Verrica Pharmaceuticals
Class: Dermatology
NDCs: 3

Inactive March 31, 2024

J9352

HCPCS Descriptor: Injection, trabectedin, 0.1 mg
Manufacturer: Janssen
Class: Oncology
NDC: 1

Inactive September 30, 2026

C9302

HCPCS Descriptor: Injection, zanidatamab-hrii, 2 mg
Manufacturer: Jazz Pharmaceuticals
Class: Oncology
NDC: 1

Inactive June 30, 2025

J2311

HCPCS Descriptor: Injection, naloxone hydrochloride (zimhi), 1 mg
Manufacturer: US Worldmeds
Class: Opioid Analgesic
NDCs: 2

Inactive June 30, 2025

C9088

HCPCS Descriptor: Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg
Manufacturer: Heron Therapeutics
Class: Anesthetic
NDCs: 3

Inactive September 30, 2025