Default Fee Schedules Part 4
Default Fee Schedules Part 4
Code | Price | Type | Description |
G9659 | 0 | HCPCS / CPT® | >85Y NO HX COLO CA/RSN SCOPE |
G9660 | 0 | HCPCS / CPT® | DOC MED RSN SCOPE PT >85Y |
G9661 | 0 | HCPCS / CPT® | >85Y SCOPE OTHR RSN |
G9662 | 0 | HCPCS / CPT® | PRIOR DX/ACTIVE CLIN ASCVD |
G9663 | 0 | HCPCS / CPT® | FAST/DIR LDL = 190 MG/DL |
G9664 | 0 | HCPCS / CPT® | TAKING STATIN OR REC’D ORDER |
G9665 | 0 | HCPCS / CPT® | NO STATIN/NO ORDER STATIN |
G9666 | 0 | HCPCS / CPT® | FAS/DIR LDL 70-189MG/DL MST |
G9674 | 0 | HCPCS / CPT® | PT W/CLIN ASCVD DX |
G9675 | 0 | HCPCS / CPT® | PT W/FAST/DIR LAB LDL-C >190 |
G9676 | 0 | HCPCS / CPT® | 40-75Y W/TYPE 1/2 W/LDL-C RS |
G9678 | 0 | HCPCS / CPT® | ONCOLOGY CARE MODEL SERVICE |
G9679 | 0 | HCPCS / CPT® | ACUTE CARE PNEUMONIA |
G9680 | 0 | HCPCS / CPT® | ACUTE CARE CONGESTIVE HEART |
G9681 | 0 | HCPCS / CPT® | ACUTE CARE CHRONIC OBSTRUCT |
G9682 | 0 | HCPCS / CPT® | ACUTE CARE SKIN INFECTION |
G9683 | 0 | HCPCS / CPT® | ACUTE CARE FLUID OR ELECTROL |
G9684 | 0 | HCPCS / CPT® | ACUTE CARE URINARY TRACT INF |
G9685 | 0 | HCPCS / CPT® | ACUTE NURSING FACILITY CARE |
G9686 | 0 | HCPCS / CPT® | NURSING FACILITY CONFERENCE |
G9687 | 0 | HCPCS / CPT® | HOSPICE ANYTIME MSMT PER |
G9688 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9689 | 0 | HCPCS / CPT® | INPT ELECT CAROTID INTERVENT |
G9690 | 0 | HCPCS / CPT® | PT REC HOSPICE DUR MSMT PER |
G9691 | 0 | HCPCS / CPT® | PT HOSP DUR MSMT PERIOD |
G9692 | 0 | HCPCS / CPT® | HOSP RECD BY PT DUR MSMT PER |
G9693 | 0 | HCPCS / CPT® | PT USE HOSP DURING MSMT PER |
G9694 | 0 | HCPCS / CPT® | HOSP SRV USED PT IN MSMT PER |
G9695 | 0 | HCPCS / CPT® | LONG ACT INHAL BRONCHDIL PRE |
G9696 | 0 | HCPCS / CPT® | MED RSN NO PRESC BRONCHDIL |
G9697 | 0 | HCPCS / CPT® | PT RSN NO PRESC BRONCHDIL |
G9698 | 0 | HCPCS / CPT® | SYS RSN NO PRESC BRONCHDIL |
G9699 | 0 | HCPCS / CPT® | LONG INHAL BRONCHDIL NO PRES |
G9700 | 0 | HCPCS / CPT® | PT IS W/HOSP DURING MSMT PER |
G9701 | 0 | HCPCS / CPT® | CHILD ANBX 30 PRIOR DX ESTAB |
G9702 | 0 | HCPCS / CPT® | PT USE HOSP DURING MSMT PER |
G9703 | 0 | HCPCS / CPT® | CHILD ANBX 30 PRIOR DX PHARY |
G9704 | 0 | HCPCS / CPT® | AJCC BR CA STG I: T1 MIC/T1A |
G9705 | 0 | HCPCS / CPT® | AJCC BR CA STG IB |
G9706 | 0 | HCPCS / CPT® | LOW RECUR PROST CA |
G9707 | 0 | HCPCS / CPT® | PT HAD HOSP DUR MSMT PER |
G9708 | 0 | HCPCS / CPT® | BILAT MAST/HX BI /UNILAT MAS |
G9709 | 0 | HCPCS / CPT® | HOSP SRV USED PT IN MSMT PER |
G9710 | 0 | HCPCS / CPT® | PT PROV HOSP SRV MSMT PER |
G9711 | 0 | HCPCS / CPT® | PT HX TOT COL OR COLON CA |
G9712 | 0 | HCPCS / CPT® | DOC MED RSN PRESC ANBX |
G9713 | 0 | HCPCS / CPT® | PT USE HOSP DURING MSMT PER |
G9714 | 0 | HCPCS / CPT® | PT IS W/HOSP DURING MSMT PER |
G9715 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9716 | 0 | HCPCS / CPT® | BMI NOT NORM, NO FOLLOW, DOC |
G9717 | 0 | HCPCS / CPT® | DOC DX DEPR/DX BIPOL, NO SCR |
G9718 | 0 | HCPCS / CPT® | HOSPICE ANYTIME MSMT PER |
G9719 | 0 | HCPCS / CPT® | PT NOT AMBUL/IMMOB/WC |
G9720 | 0 | HCPCS / CPT® | HOSPICE ANYTIME MSMT PER |
G9721 | 0 | HCPCS / CPT® | PT NOT AMBUL/IMMOB/WC |
G9722 | 0 | HCPCS / CPT® | DOC HX RENAL FAIL OR CR+ >4 |
G9723 | 0 | HCPCS / CPT® | HOSP RECD BY PT DUR MSMT PER |
G9724 | 0 | HCPCS / CPT® | PT W/DOC USE ANTICOAG MST YR |
G9725 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9726 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9727 | 0 | HCPCS / CPT® | NO KNEE INTAKE PROM, NO PROX |
G9728 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9729 | 0 | HCPCS / CPT® | NO HIP INTAKE PROM, NO PROXY |
G9730 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9731 | 0 | HCPCS / CPT® | NO FOOT PROM, NO PROXY |
G9732 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9733 | 0 | HCPCS / CPT® | NO BACK INTAKE PROM, NO PROX |
G9734 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9735 | 0 | HCPCS / CPT® | PT NO FOTO KNEE AND NO PROXY |
G9736 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9737 | 0 | HCPCS / CPT® | PT NO FOTO ELBOW, NO PROXY |
G9738 | 0 | HCPCS / CPT® | REFUSED TO PARTICIPATE |
G9739 | 0 | HCPCS / CPT® | PT NO FOTO ORTH, NO PROXY |
G9740 | 0 | HCPCS / CPT® | HOSP SRV TO PT DUR MSMT PER |
G9741 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9742 | 0 | HCPCS / CPT® | PSYCH SYMPT ASSESSED |
G9743 | 0 | HCPCS / CPT® | PSYCH SYMP NOT ASSESSED, RNS |
G9744 | 0 | HCPCS / CPT® | PT NOT ELIG, DX HTN |
G9745 | 0 | HCPCS / CPT® | DOC RSN NO SCR HIGH BP |
G9746 | 0 | HCPCS / CPT® | MIT STEN, VALVE OR TRANS AF |
G9747 | 0 | HCPCS / CPT® | PALL DIALYSIS WITH CATHETER |
G9748 | 0 | HCPCS / CPT® | APP TRANSPL LVG KIDNEY DONOR |
G9749 | 0 | HCPCS / CPT® | PALL DIALYSIS WITH CATHETER |
G9750 | 0 | HCPCS / CPT® | APP TRANSPL LVG KIDNEY DONOR |
G9751 | 0 | HCPCS / CPT® | PT DIED W/IN 24 MOS RPT TIME |
G9752 | 0 | HCPCS / CPT® | URGENT SURGERY |
G9753 | 0 | HCPCS / CPT® | DOC NO DICOM, CT OTHER FAC |
G9754 | 0 | HCPCS / CPT® | INCID PULM NODULE |
G9755 | 0 | HCPCS / CPT® | DOC MED RSN FOR IMAGING |
G9756 | 0 | HCPCS / CPT® | SURG PROC W/SILICONE OIL |
G9757 | 0 | HCPCS / CPT® | SURG PROC W/SILICONE OIL |
G9758 | 0 | HCPCS / CPT® | HOSPICE OR TERM PHASE |
G9759 | 0 | HCPCS / CPT® | HX PREOP POST CAP RUP |
G9760 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9761 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9762 | 0 | HCPCS / CPT® | PT HAD HPV B/T 9-13 YR |
G9763 | 0 | HCPCS / CPT® | PT NO HPV B/T 9-13 YR |
G9764 | 0 | HCPCS / CPT® | PT TX ORAL SYST/BIO MED PSOR |
G9765 | 0 | HCPCS / CPT® | PT DECL CHAN/CONIND OR <6M |
G9766 | 0 | HCPCS / CPT® | CVA STROKE DX TX TRANSF FAC |
G9767 | 0 | HCPCS / CPT® | HOSP NEW DX CVA CONSID EVST |
G9768 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9769 | 0 | HCPCS / CPT® | BN DEN 2YR/GOT OST MED/THER |
G9770 | 0 | HCPCS / CPT® | PERIP NERVE BLOCK |
G9771 | 0 | HCPCS / CPT® | ANES END, 1 TEMP >35.5(95.9) |
G9772 | 0 | HCPCS / CPT® | DOC TEMP >35.5(95.9), ANEST |
G9773 | 0 | HCPCS / CPT® | NO TEMP >35.5(95.9), ANES |
G9774 | 0 | HCPCS / CPT® | PT HAD HYST |
G9775 | 0 | HCPCS / CPT® | RECD 2 ANTI-EMET PRE/INTRAOP |
G9776 | 0 | HCPCS / CPT® | DOC MED RSN NO PROPH ANTIEM |
G9777 | 0 | HCPCS / CPT® | PT NO ANTIEMET PRE/INTRAOP |
G9778 | 0 | HCPCS / CPT® | PTS DX W/PREGN |
G9779 | 0 | HCPCS / CPT® | PTS BREASTFEEDING |
G9780 | 0 | HCPCS / CPT® | PTS DX W/RHABDOMYOLYSIS |
G9781 | 0 | HCPCS / CPT® | DOC RSN NO STATIN |
G9782 | 0 | HCPCS / CPT® | HX DX FAM/PURE HYPERCHOLES |
G9783 | 0 | HCPCS / CPT® | DOC DX DM, FAST <70, NO STAT |
G9784 | 0 | HCPCS / CPT® | PATH/DERM 2ND OPIN BX |
G9785 | 0 | HCPCS / CPT® | PATH RPT SNT PATH/DERM IN 7D |
G9786 | 0 | HCPCS / CPT® | NO PATH RPT SENT IN 7D |
G9787 | 0 | HCPCS / CPT® | PT ALIVE LST DAY MSMT YR |
G9788 | 0 | HCPCS / CPT® | MOST RCT BP </= 140/90 |
G9789 | 0 | HCPCS / CPT® | RECORD BP IP, ER, URG/SELF |
G9790 | 0 | HCPCS / CPT® | MOST RCT BP >/= 140/90 |
G9791 | 0 | HCPCS / CPT® | MOST RCT TOB STAT FREE |
G9792 | 0 | HCPCS / CPT® | MOST RCT TOB STAT NOT FREE |
G9793 | 0 | HCPCS / CPT® | PT ON DAILY ASA/ANTIPLAT |
G9794 | 0 | HCPCS / CPT® | DOC MED RSN NO ASA/ANTIPLAT |
G9795 | 0 | HCPCS / CPT® | PT NO DAILY ASA/ANTIPLAT |
G9796 | 0 | HCPCS / CPT® | PT NOT CURRENTLY ON STATIN |
G9797 | 0 | HCPCS / CPT® | PT CURRENTLY ON STATIN |
G9798 | 0 | HCPCS / CPT® | D/C AMI BTW 7/1-6/30 MST PER |
G9799 | 0 | HCPCS / CPT® | MED DISP EVT INDIC HX ASTH |
G9800 | 0 | HCPCS / CPT® | PT ID INTOL/ALLEG BETA-BLOCK |
G9801 | 0 | HCPCS / CPT® | NONACUT TRANSF FROM INPT |
G9802 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9803 | 0 | HCPCS / CPT® | POST D/C 180D TX BETA-BL AMI |
G9804 | 0 | HCPCS / CPT® | NO POST D/C 180D TX BB AMI |
G9805 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9806 | 0 | HCPCS / CPT® | PT RECD CERV CYTO/HPV |
G9807 | 0 | HCPCS / CPT® | PT NO RECD CERV CYTO/HPV |
G9808 | 0 | HCPCS / CPT® | PT NO ASTHM CONT MED MST PER |
G9809 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9810 | 0 | HCPCS / CPT® | PDC 75% W/ASTH CONT MED |
G9811 | 0 | HCPCS / CPT® | NO PDC 75% W/ASTH CONT MED |
G9812 | 0 | HCPCS / CPT® | PT DIED DURING INPT/30D AFT |
G9813 | 0 | HCPCS / CPT® | PT NOT DIED W/IN 30D OF PROC |
G9814 | 0 | HCPCS / CPT® | DEATH OCC DUR HOSPITALIZ |
G9815 | 0 | HCPCS / CPT® | NO DEATH OCC DUR HOSPITALIZ |
G9816 | 0 | HCPCS / CPT® | DEATH OCC 30D POST PROC |
G9817 | 0 | HCPCS / CPT® | NO DEATH OCC 30D POST PROC |
G9818 | 0 | HCPCS / CPT® | DOC SEX ACTIVITY |
G9819 | 0 | HCPCS / CPT® | PT W/HOSP ANYTIME MSMT PER |
G9820 | 0 | HCPCS / CPT® | DOC CHLAM SCR TEST W/FOLLOW |
G9821 | 0 | HCPCS / CPT® | NO DOC CHLAM SCR TS W/FOLLOW |
G9822 | 0 | HCPCS / CPT® | ENDO ABL PROC YR PREV IND DT |
G9823 | 0 | HCPCS / CPT® | ENDO SMPL/HYST BX RES DOC |
G9824 | 0 | HCPCS / CPT® | ENDO SMPL/HYST BX RES NO DOC |
G9825 | 0 | HCPCS / CPT® | HER-2 NEG,UNDOC/UNKN |
G9826 | 0 | HCPCS / CPT® | TRANSF PRACT AFT INIT CHEMO |
G9827 | 0 | HCPCS / CPT® | HER-2 TARG THER NO INIT TX |
G9828 | 0 | HCPCS / CPT® | HER-2 TARG THER DUR INIT TX |
G9829 | 0 | HCPCS / CPT® | BREAST ADJ CHEMO ADMIN |
G9830 | 0 | HCPCS / CPT® | HER-2 POS |
G9831 | 0 | HCPCS / CPT® | AJCC STG BRT CA DX II OR III |
G9832 | 0 | HCPCS / CPT® | BRT CA DX I, NO T1/T1A/T1B |
G9833 | 0 | HCPCS / CPT® | TRANSF PRACT AFT INIT CHEMO |
G9834 | 0 | HCPCS / CPT® | PT MET DIS AT DX |
G9835 | 0 | HCPCS / CPT® | TRASTUZ GIVEN W/IN 12 MOS DX |
G9836 | 0 | HCPCS / CPT® | RSN NO TRAST GIVEN DOC |
G9837 | 0 | HCPCS / CPT® | TRASTUZ NOT IN 12 MOS DX |
G9838 | 0 | HCPCS / CPT® | PT MET DIS AT DX |
G9839 | 0 | HCPCS / CPT® | ANTI-EGFR MON ANTI THER |
G9840 | 0 | HCPCS / CPT® | KRAS TST BFR BEG ANTI MOAB |
G9841 | 0 | HCPCS / CPT® | NO KRAS TST BFR BEG ANT MOAB |
G9842 | 0 | HCPCS / CPT® | PT MET DIS AT DX |
G9843 | 0 | HCPCS / CPT® | KRAS GENE MUT |
G9844 | 0 | HCPCS / CPT® | PT NO RECD ANTI-EGFR THER |
G9845 | 0 | HCPCS / CPT® | PT RECD ANTI-EGFR THER |
G9846 | 0 | HCPCS / CPT® | PT DIED FROM CANCER |
G9847 | 0 | HCPCS / CPT® | PT RECD CHEMO LAST 14D LIFE |
G9848 | 0 | HCPCS / CPT® | PT NO CHEMO LAST 14D LIFE |
G9849 | 0 | HCPCS / CPT® | PT DIED FROM CANCER |
G9850 | 0 | HCPCS / CPT® | 1/MORE ED LAST 30D LIFE |
G9851 | 0 | HCPCS / CPT® | 1/NO ED VISIT LAST 30D LIFE |
G9852 | 0 | HCPCS / CPT® | PT DIED FROM CANCER |
G9853 | 0 | HCPCS / CPT® | ICU STAY LAST 30D LIFE |
G9854 | 0 | HCPCS / CPT® | NO ICU STAY LAST 30D LIFE |
G9855 | 0 | HCPCS / CPT® | PT DIED FROM CANCER |
G9856 | 0 | HCPCS / CPT® | PT NO HOSPICE |
G9857 | 0 | HCPCS / CPT® | PT ADMIT HOSPICE |
G9858 | 0 | HCPCS / CPT® | PT ENROLL HOSPICE |
G9859 | 0 | HCPCS / CPT® | PT DIED FROM CANCER |
G9860 | 0 | HCPCS / CPT® | PT LESS 3D HOSPICE |
G9861 | 0 | HCPCS / CPT® | PT MORE THAN 3D HOSPICE |
G9862 | 0 | HCPCS / CPT® | DOC RSN NO 10 YR FOLLOW |
H0001 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG ASSESS |
H0002 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SCREENIN |
H0003 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SCREENIN |
H0004 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0005 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0006 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0007 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0008 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0009 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0010 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0011 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0012 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0013 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0014 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0015 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0016 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0017 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0018 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0019 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0020 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG SERVICES |
H0021 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG TRAINING |
H0022 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG INTERVEN |
H0023 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG OUTREACH |
H0024 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG PREVENTI |
H0025 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG PREVENTI |
H0026 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG PREVENTI |
H0027 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG PREVENTI |
H0028 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG PREVENTI |
H0029 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG PREVENTI |
H0030 | 0 | HCPCS / CPT® | ALCOHOL AND/OR DRUG HOTLINE |
H0031 | 0 | HCPCS / CPT® | MH HEALTH ASSESS BY NON-MD |
H0032 | 0 | HCPCS / CPT® | MH SVC PLAN DEV BY NON-MD |
H0033 | 0 | HCPCS / CPT® | ORAL MED ADM DIRECT OBSERVE |
H0034 | 0 | HCPCS / CPT® | MED TRNG & SUPPORT PER 15MIN |
H0035 | 0 | HCPCS / CPT® | MH PARTIAL HOSP TX UNDER 24H |
H0036 | 0 | HCPCS / CPT® | COMM PSY FACE-FACE PER 15MIN |
H0037 | 0 | HCPCS / CPT® | COMM PSY SUP TX PGM PER DIEM |
H0038 | 0 | HCPCS / CPT® | SELF-HELP/PEER SVC PER 15MIN |
H0039 | 0 | HCPCS / CPT® | ASSER COM TX FACE-FACE/15MIN |
H0040 | 0 | HCPCS / CPT® | ASSERT COMM TX PGM PER DIEM |
H0041 | 0 | HCPCS / CPT® | FOS C CHLD NON-THER PER DIEM |
H0042 | 0 | HCPCS / CPT® | FOS C CHLD NON-THER PER MON |
H0043 | 0 | HCPCS / CPT® | SUPPORTED HOUSING, PER DIEM |
H0044 | 0 | HCPCS / CPT® | SUPPORTED HOUSING, PER MONTH |
H0045 | 0 | HCPCS / CPT® | RESPITE NOT-IN-HOME PER DIEM |
H0046 | 0 | HCPCS / CPT® | MENTAL HEALTH SERVICE, NOS |
H0047 | 0 | HCPCS / CPT® | ALCOHOL/DRUG ABUSE SVC NOS |
H0048 | 0 | HCPCS / CPT® | SPEC COLL NON-BLOOD:A/D TEST |
H0049 | 0 | HCPCS / CPT® | ALCOHOL/DRUG SCREENING |
H0050 | 0 | HCPCS / CPT® | ALCOHOL/DRUG SERVICE 15 MIN |
H1000 | 0 | HCPCS / CPT® | PRENATAL CARE ATRISK ASSESSM |
H1001 | 0 | HCPCS / CPT® | ANTEPARTUM MANAGEMENT |
H1002 | 0 | HCPCS / CPT® | CARECOORDINATION PRENATAL |
H1003 | 0 | HCPCS / CPT® | PRENATAL AT RISK EDUCATION |
H1004 | 0 | HCPCS / CPT® | FOLLOW UP HOME VISIT/PRENTAL |
H1005 | 0 | HCPCS / CPT® | PRENATALCARE ENHANCED SRV PK |
H1010 | 0 | HCPCS / CPT® | NONMED FAMILY PLANNING ED |
H1011 | 0 | HCPCS / CPT® | FAMILY ASSESSMENT |
H2000 | 0 | HCPCS / CPT® | COMP MULTIDISIPLN EVALUATION |
H2001 | 0 | HCPCS / CPT® | REHABILITATION PROGRAM 1/2 D |
H2010 | 0 | HCPCS / CPT® | COMPREHENSIVE MED SVC 15 MIN |
H2011 | 0 | HCPCS / CPT® | CRISIS INTERVEN SVC, 15 MIN |
H2012 | 0 | HCPCS / CPT® | BEHAV HLTH DAY TREAT, PER HR |
H2013 | 0 | HCPCS / CPT® | PSYCH HLTH FAC SVC, PER DIEM |
H2014 | 0 | HCPCS / CPT® | SKILLS TRAIN AND DEV, 15 MIN |
H2015 | 0 | HCPCS / CPT® | COMP COMM SUPP SVC, 15 MIN |
H2016 | 0 | HCPCS / CPT® | COMP COMM SUPP SVC, PER DIEM |
H2017 | 0 | HCPCS / CPT® | PSYSOC REHAB SVC, PER 15 MIN |
H2018 | 0 | HCPCS / CPT® | PSYSOC REHAB SVC, PER DIEM |
H2019 | 0 | HCPCS / CPT® | THER BEHAV SVC, PER 15 MIN |
H2020 | 0 | HCPCS / CPT® | THER BEHAV SVC, PER DIEM |
H2021 | 0 | HCPCS / CPT® | COM WRAP-AROUND SV, 15 MIN |
H2022 | 0 | HCPCS / CPT® | COM WRAP-AROUND SV, PER DIEM |
H2023 | 0 | HCPCS / CPT® | SUPPORTED EMPLOY, PER 15 MIN |
H2024 | 0 | HCPCS / CPT® | SUPPORTED EMPLOY, PER DIEM |
H2025 | 0 | HCPCS / CPT® | SUPP MAINT EMPLOY, 15 MIN |
H2026 | 0 | HCPCS / CPT® | SUPP MAINT EMPLOY, PER DIEM |
H2027 | 0 | HCPCS / CPT® | PSYCHOED SVC, PER 15 MIN |
H2028 | 0 | HCPCS / CPT® | SEX OFFEND TX SVC, 15 MIN |
H2029 | 0 | HCPCS / CPT® | SEX OFFEND TX SVC, PER DIEM |
H2030 | 0 | HCPCS / CPT® | MH CLUBHOUSE SVC, PER 15 MIN |
H2031 | 0 | HCPCS / CPT® | MH CLUBHOUSE SVC, PER DIEM |
H2032 | 0 | HCPCS / CPT® | ACTIVITY THERAPY, PER 15 MIN |
H2033 | 0 | HCPCS / CPT® | MULTISYS THER/JUVENILE 15MIN |
H2034 | 0 | HCPCS / CPT® | A/D HALFWAY HOUSE, PER DIEM |
H2035 | 0 | HCPCS / CPT® | A/D TX PROGRAM, PER HOUR |
H2036 | 0 | HCPCS / CPT® | A/D TX PROGRAM, PER DIEM |
H2037 | 0 | HCPCS / CPT® | DEV DELAY PREV DP CH, 15 MIN |
J0120 | 65 | HCPCS / CPT® | TETRACYCLIN INJECTION |
J0129 | 65 | HCPCS / CPT® | ABATACEPT INJECTION |
J0130 | 65 | HCPCS / CPT® | ABCIXIMAB INJECTION |
J0131 | 65 | HCPCS / CPT® | ACETAMINOPHEN INJECTION |
J0132 | 65 | HCPCS / CPT® | ACETYLCYSTEINE INJECTION |
J0133 | 65 | HCPCS / CPT® | ACYCLOVIR INJECTION |
J0135 | 65 | HCPCS / CPT® | ADALIMUMAB INJECTION |
J0153 | 10 | HCPCS / CPT® | ADENOSINE INJ 1MG |
J0171 | 10 | HCPCS / CPT® | ADRENALIN EPINEPHRINE INJECT |
J0178 | 65 | HCPCS / CPT® | AFLIBERCEPT INJECTION |
J0180 | 65 | HCPCS / CPT® | AGALSIDASE BETA INJECTION |
J0190 | 65 | HCPCS / CPT® | INJ BIPERIDEN LACTATE/5 MG |
J0200 | 65 | HCPCS / CPT® | ALATROFLOXACIN MESYLATE |
J0202 | 65 | HCPCS / CPT® | INJECTION, ALEMTUZUMAB |
J0205 | 65 | HCPCS / CPT® | ALGLUCERASE INJECTION |
J0207 | 65 | HCPCS / CPT® | AMIFOSTINE |
J0210 | 65 | HCPCS / CPT® | METHYLDOPATE HCL INJECTION |
J0215 | 65 | HCPCS / CPT® | ALEFACEPT |
J0220 | 65 | HCPCS / CPT® | ALGLUCOSIDASE ALFA INJECTION |
J0221 | 65 | HCPCS / CPT® | LUMIZYME INJECTION |
J0256 | 65 | HCPCS / CPT® | ALPHA 1 PROTEINASE INHIBITOR |
J0257 | 65 | HCPCS / CPT® | GLASSIA INJECTION |
J0270 | 65 | HCPCS / CPT® | ALPROSTADIL FOR INJECTION |
J0275 | 65 | HCPCS / CPT® | ALPROSTADIL URETHRAL SUPPOS |
J0278 | 65 | HCPCS / CPT® | AMIKACIN SULFATE INJECTION |
J0280 | 65 | HCPCS / CPT® | AMINOPHYLLIN 250 MG INJ |
J0282 | 12 | HCPCS / CPT® | AMIODARONE HCL |
J0285 | 65 | HCPCS / CPT® | AMPHOTERICIN B |
J0287 | 65 | HCPCS / CPT® | AMPHOTERICIN B LIPID COMPLEX |
J0288 | 65 | HCPCS / CPT® | AMPHO B CHOLESTERYL SULFATE |
J0289 | 65 | HCPCS / CPT® | AMPHOTERICIN B LIPOSOME INJ |
J0290 | 22 | HCPCS / CPT® | AMPICILLIN 500 MG INJ |
J0295 | 49 | HCPCS / CPT® | AMPICILLIN SODIUM PER 1.5 GM |
J0300 | 65 | HCPCS / CPT® | AMOBARBITAL 125 MG INJ |
J0330 | 157 | HCPCS / CPT® | SUCCINYCHOLINE CHLORIDE INJ |
J0348 | 65 | HCPCS / CPT® | ANIDULAFUNGIN INJECTION |
J0350 | 65 | HCPCS / CPT® | INJECTION ANISTREPLASE 30 U |
J0360 | 65 | HCPCS / CPT® | HYDRALAZINE HCL INJECTION |
J0364 | 65 | HCPCS / CPT® | APOMORPHINE HYDROCHLORIDE |
J0365 | 65 | HCPCS / CPT® | APROTONIN, 10,000 KIU |
J0380 | 65 | HCPCS / CPT® | INJ METARAMINOL BITARTRATE |
J0390 | 65 | HCPCS / CPT® | CHLOROQUINE INJECTION |
J0395 | 65 | HCPCS / CPT® | ARBUTAMINE HCL INJECTION |
J0400 | 65 | HCPCS / CPT® | ARIPIPRAZOLE INJECTION |
J0401 | 65 | HCPCS / CPT® | INJ ARIPIPRAZOLE EXT REL 1MG |
J0456 | 74 | HCPCS / CPT® | AZITHROMYCIN |
J0461 | 65 | HCPCS / CPT® | ATROPINE SULFATE INJECTION |
J0470 | 65 | HCPCS / CPT® | DIMECAPROL INJECTION |
J0475 | 65 | HCPCS / CPT® | BACLOFEN 10 MG INJECTION |
J0476 | 65 | HCPCS / CPT® | BACLOFEN INTRATHECAL TRIAL |
J0480 | 65 | HCPCS / CPT® | BASILIXIMAB |
J0485 | 65 | HCPCS / CPT® | BELATACEPT INJECTION |
J0490 | 65 | HCPCS / CPT® | BELIMUMAB INJECTION |
J0500 | 22 | HCPCS / CPT® | DICYCLOMINE INJECTION |
J0515 | 65 | HCPCS / CPT® | INJ BENZTROPINE MESYLATE |
J0520 | 65 | HCPCS / CPT® | BETHANECHOL CHLORIDE INJECT |
J0558 | 68 | HCPCS / CPT® | PENG BENZATHINE/PROCAINE INJ |
J0561 | 56 | HCPCS / CPT® | PENICILLIN G BENZATHINE INJ |
J0570 | 65 | HCPCS / CPT® | BUPRENORPHINE IMPLANT 74.2MG |
J0571 | 65 | HCPCS / CPT® | BUPRENORPHINE ORAL 1MG |
J0572 | 65 | HCPCS / CPT® | BUPREN/NAL UP TO 3MG BUPRENO |
J0573 | 65 | HCPCS / CPT® | BUPREN/NAL 3.1 TO 6MG BUPREN |
J0574 | 65 | HCPCS / CPT® | BUPREN/NAL 6.1 TO 10MG BUPRE |
J0575 | 65 | HCPCS / CPT® | BUPREN/NAL OVER 10MG BUPRENO |
J0583 | 65 | HCPCS / CPT® | BIVALIRUDIN |
J0585 | 65 | HCPCS / CPT® | INJECTION,ONABOTULINUMTOXINA |
J0586 | 65 | HCPCS / CPT® | ABOBOTULINUMTOXINA |
J0587 | 65 | HCPCS / CPT® | INJ, RIMABOTULINUMTOXINB |
J0588 | 65 | HCPCS / CPT® | INCOBOTULINUMTOXIN A |
J0592 | 65 | HCPCS / CPT® | BUPRENORPHINE HYDROCHLORIDE |
J0594 | 65 | HCPCS / CPT® | BUSULFAN INJECTION |
J0595 | 65 | HCPCS / CPT® | BUTORPHANOL TARTRATE 1 MG |
J0596 | 65 | HCPCS / CPT® | INJECTION, RUCONEST |
J0597 | 65 | HCPCS / CPT® | C-1 ESTERASE, BERINERT |
J0598 | 65 | HCPCS / CPT® | C-1 ESTERASE, CINRYZE |
J0600 | 65 | HCPCS / CPT® | EDETATE CALCIUM DISODIUM INJ |
J0610 | 65 | HCPCS / CPT® | CALCIUM GLUCONATE INJECTION |
J0620 | 65 | HCPCS / CPT® | CALCIUM GLYCER & LACT/10 ML |
J0630 | 65 | HCPCS / CPT® | CALCITONIN SALMON INJECTION |
J0636 | 65 | HCPCS / CPT® | INJ CALCITRIOL PER 0.1 MCG |
J0637 | 65 | HCPCS / CPT® | CASPOFUNGIN ACETATE |
J0638 | 65 | HCPCS / CPT® | CANAKINUMAB INJECTION |
J0640 | 65 | HCPCS / CPT® | LEUCOVORIN CALCIUM INJECTION |
J0641 | 6 | HCPCS / CPT® | LEVOLEUCOVORIN INJECTION |
J0670 | 65 | HCPCS / CPT® | INJ MEPIVACAINE HCL/10 ML |
J0690 | 22 | HCPCS / CPT® | CEFAZOLIN SODIUM INJECTION |
J0692 | 42 | HCPCS / CPT® | CEFEPIME HCL FOR INJECTION |
J0694 | 65 | HCPCS / CPT® | CEFOXITIN SODIUM INJECTION |
J0695 | 65 | HCPCS / CPT® | INJ CEFTOLOZANE TAZOBACTAM |
J0696 | 63 | HCPCS / CPT® | Rocephin/Ceftriaxone Sodium 250 mg |
J0697 | 65 | HCPCS / CPT® | STERILE CEFUROXIME INJECTION |
J0698 | 65 | HCPCS / CPT® | CEFOTAXIME SODIUM INJECTION |
J0702 | 65 | HCPCS / CPT® | BETAMETHASONE ACET&SOD PHOSP |
J0706 | 65 | HCPCS / CPT® | CAFFEINE CITRATE INJECTION |
J0710 | 65 | HCPCS / CPT® | CEPHAPIRIN SODIUM INJECTION |
J0712 | 65 | HCPCS / CPT® | CEFTAROLINE FOSAMIL INJ |
J0713 | 65 | HCPCS / CPT® | INJ CEFTAZIDIME PER 500 MG |
J0714 | 65 | HCPCS / CPT® | CEFTAZIDIME AND AVIBACTAM |
J0715 | 65 | HCPCS / CPT® | CEFTIZOXIME SODIUM / 500 MG |
J0716 | 65 | HCPCS / CPT® | CENTRUROIDES IMMUNE F(AB) |
J0717 | 65 | HCPCS / CPT® | CERTOLIZUMAB PEGOL INJ 1MG |
J0720 | 65 | HCPCS / CPT® | CHLORAMPHENICOL SODIUM INJEC |
J0725 | 65 | HCPCS / CPT® | CHORIONIC GONADOTROPIN/1000U |
J0735 | 17 | HCPCS / CPT® | CLONIDINE HYDROCHLORIDE |
J0740 | 65 | HCPCS / CPT® | CIDOFOVIR INJECTION |
J0743 | 65 | HCPCS / CPT® | CILASTATIN SODIUM INJECTION |
J0744 | 66 | HCPCS / CPT® | CIPROFLOXACIN IV |
J0745 | 65 | HCPCS / CPT® | INJ CODEINE PHOSPHATE /30 MG |
J0770 | 65 | HCPCS / CPT® | COLISTIMETHATE SODIUM INJ |
J0775 | 65 | HCPCS / CPT® | COLLAGENASE, CLOST HIST INJ |
J0780 | 11 | HCPCS / CPT® | PROCHLORPERAZINE INJECTION |
J0795 | 65 | HCPCS / CPT® | CORTICORELIN OVINE TRIFLUTAL |
J0800 | 65 | HCPCS / CPT® | CORTICOTROPIN INJECTION |
J0833 | 65 | HCPCS / CPT® | COSYNTROPIN INJECTION NOS |
J0834 | 65 | HCPCS / CPT® | COSYNTROPIN CORTROSYN INJ |
J0840 | 65 | HCPCS / CPT® | CROTALIDAE POLY IMMUNE FAB |
J0850 | 65 | HCPCS / CPT® | CYTOMEGALOVIRUS IMM IV /VIAL |
J0875 | 65 | HCPCS / CPT® | INJECTION, DALBAVANCIN |
J0878 | 65 | HCPCS / CPT® | DAPTOMYCIN INJECTION |
J0881 | 65 | HCPCS / CPT® | DARBEPOETIN ALFA, NON-ESRD |
J0882 | 65 | HCPCS / CPT® | DARBEPOETIN ALFA, ESRD USE |
J0883 | 0 | HCPCS / CPT® | ARGATROBAN NONESRD USE 1MG |
J0884 | 65 | HCPCS / CPT® | ARGATROBAN ESRD DIALYSIS 1MG |
J0885 | 65 | HCPCS / CPT® | EPOETIN ALFA, NON-ESRD |
J0887 | 65 | HCPCS / CPT® | EPOETIN BETA ESRD USE |
J0888 | 65 | HCPCS / CPT® | EPOETIN BETA NON ESRD |
J0890 | 65 | HCPCS / CPT® | PEGINESATIDE INJECTION |
J0894 | 65 | HCPCS / CPT® | DECITABINE INJECTION |
J0895 | 65 | HCPCS / CPT® | DEFEROXAMINE MESYLATE INJ |
J0897 | 65 | HCPCS / CPT® | DENOSUMAB INJECTION |
J0945 | 65 | HCPCS / CPT® | BROMPHENIRAMINE MALEATE INJ |
J1000 | 65 | HCPCS / CPT® | DEPO-ESTRADIOL CYPIONATE INJ |
J1020 | 6 | HCPCS / CPT® | METHYLPREDNISOLONE 20 MG INJ |
J1030 | 15 | HCPCS / CPT® | METHYLPREDNISOLONE 40 MG INJ |
J1040 | 9 | HCPCS / CPT® | METHYLPREDNISOLONE 80 MG INJ |
J1050 | 65 | HCPCS / CPT® | MEDROXYPROGESTERONE ACETATE |
J1071 | 65 | HCPCS / CPT® | INJ TESTOSTERONE CYPIONATE |
J1094 | 22 | HCPCS / CPT® | INJ DEXAMETHASONE ACETATE |
J1100 | 34 | HCPCS / CPT® | DECADRON 1MG |
J1110 | 65 | HCPCS / CPT® | INJ DIHYDROERGOTAMINE MESYLT |
J1120 | 65 | HCPCS / CPT® | ACETAZOLAMID SODIUM INJECTIO |
J1130 | 65 | HCPCS / CPT® | INJ DICLOFENAC SODIUM 0.5MG |
J1160 | 65 | HCPCS / CPT® | DIGOXIN INJECTION |
J1162 | 65 | HCPCS / CPT® | DIGOXIN IMMUNE FAB (OVINE) |
J1165 | 37 | HCPCS / CPT® | PHENYTOIN SODIUM INJECTION |
J1170 | 31 | HCPCS / CPT® | HYDROMORPHONE INJECTION |
J1180 | 65 | HCPCS / CPT® | DYPHYLLINE INJECTION |
J1190 | 65 | HCPCS / CPT® | DEXRAZOXANE HCL INJECTION |
J1200 | 22 | HCPCS / CPT® | BENADRYL-DIPHENHYDRAMINE HCL INJECTIO |
J1205 | 65 | HCPCS / CPT® | CHLOROTHIAZIDE SODIUM INJ |
J1212 | 65 | HCPCS / CPT® | DIMETHYL SULFOXIDE 50% 50 ML |
J1230 | 65 | HCPCS / CPT® | METHADONE INJECTION |
J1240 | 30 | HCPCS / CPT® | DIMENHYDRINATE INJECTION |
J1245 | 65 | HCPCS / CPT® | DIPYRIDAMOLE INJECTION |
J1250 | 0 | HCPCS / CPT® | INJ DOBUTAMINE HCL/250 MG |
J1260 | 65 | HCPCS / CPT® | DOLASETRON MESYLATE |
J1265 | 65 | HCPCS / CPT® | DOPAMINE INJECTION |
J1267 | 65 | HCPCS / CPT® | DORIPENEM INJECTION |
J1270 | 65 | HCPCS / CPT® | INJECTION, DOXERCALCIFEROL |
J1290 | 65 | HCPCS / CPT® | ECALLANTIDE INJECTION |
J1300 | 65 | HCPCS / CPT® | ECULIZUMAB INJECTION |
J1320 | 65 | HCPCS / CPT® | AMITRIPTYLINE INJECTION |
J1322 | 65 | HCPCS / CPT® | ELOSULFASE ALFA, INJECTION |
J1324 | 65 | HCPCS / CPT® | ENFUVIRTIDE INJECTION |
J1325 | 65 | HCPCS / CPT® | EPOPROSTENOL INJECTION |
J1327 | 65 | HCPCS / CPT® | EPTIFIBATIDE INJECTION |
J1330 | 65 | HCPCS / CPT® | ERGONOVINE MALEATE INJECTION |
J1335 | 65 | HCPCS / CPT® | ERTAPENEM INJECTION |
J1364 | 65 | HCPCS / CPT® | ERYTHRO LACTOBIONATE /500 MG |
J1380 | 65 | HCPCS / CPT® | ESTRADIOL VALERATE 10 MG INJ |
J1410 | 65 | HCPCS / CPT® | INJ ESTROGEN CONJUGATE 25 MG |
J1430 | 65 | HCPCS / CPT® | ETHANOLAMINE OLEATE 100 MG |
J1435 | 65 | HCPCS / CPT® | INJECTION ESTRONE PER 1 MG |
J1436 | 65 | HCPCS / CPT® | ETIDRONATE DISODIUM INJ |
J1438 | 65 | HCPCS / CPT® | ETANERCEPT INJECTION |
J1439 | 65 | HCPCS / CPT® | INJ FERRIC CARBOXYMALTOS 1MG |
J1442 | 65 | HCPCS / CPT® | INJ FILGRASTIM EXCL BIOSIMIL |
J1443 | 65 | HCPCS / CPT® | INJ FERRIC PYROPHOSPHATE CIT |
J1447 | 65 | HCPCS / CPT® | INJ TBO FILGRASTIM 1 MICROG |
J1450 | 65 | HCPCS / CPT® | FLUCONAZOLE |
J1451 | 65 | HCPCS / CPT® | FOMEPIZOLE, 15 MG |
J1452 | 65 | HCPCS / CPT® | INTRAOCULAR FOMIVIRSEN NA |
J1453 | 65 | HCPCS / CPT® | FOSAPREPITANT INJECTION |
J1455 | 65 | HCPCS / CPT® | FOSCARNET SODIUM INJECTION |
J1457 | 65 | HCPCS / CPT® | GALLIUM NITRATE INJECTION |
J1458 | 0 | HCPCS / CPT® | GALSULFASE INJECTION |
J1459 | 65 | HCPCS / CPT® | INJ IVIG PRIVIGEN 500 MG |
J1460 | 65 | HCPCS / CPT® | GAMMA GLOBULIN 1 CC INJ |
J1556 | 65 | HCPCS / CPT® | INJ, IMM GLOB BIVIGAM, 500MG |
J1557 | 65 | HCPCS / CPT® | GAMMAPLEX INJECTION |
J1559 | 65 | HCPCS / CPT® | HIZENTRA INJECTION |
J1560 | 65 | HCPCS / CPT® | GAMMA GLOBULIN > 10 CC INJ |
J1561 | 65 | HCPCS / CPT® | GAMUNEX-C/GAMMAKED |
J1562 | 65 | HCPCS / CPT® | VIVAGLOBIN, INJ |
J1566 | 65 | HCPCS / CPT® | IMMUNE GLOBULIN, POWDER |
J1568 | 65 | HCPCS / CPT® | OCTAGAM INJECTION |
J1569 | 65 | HCPCS / CPT® | GAMMAGARD LIQUID INJECTION |
J1570 | 65 | HCPCS / CPT® | GANCICLOVIR SODIUM INJECTION |
J1571 | 65 | HCPCS / CPT® | HEPAGAM B IM INJECTION |
J1572 | 65 | HCPCS / CPT® | FLEBOGAMMA INJECTION |
J1573 | 65 | HCPCS / CPT® | HEPAGAM B INTRAVENOUS, INJ |
J1575 | 65 | HCPCS / CPT® | HYQVIA 100MG IMMUNEGLOBULIN |
J1580 | 65 | HCPCS / CPT® | GARAMYCIN GENTAMICIN INJ |
J1595 | 65 | HCPCS / CPT® | INJECTION GLATIRAMER ACETATE |
J1599 | 65 | HCPCS / CPT® | IVIG NON-LYOPHILIZED, NOS |
J1600 | 65 | HCPCS / CPT® | GOLD SODIUM THIOMALEATE INJ |
J1602 | 65 | HCPCS / CPT® | GOLIMUMAB FOR IV USE 1MG |
J1610 | 16 | HCPCS / CPT® | GLUCAGON HYDROCHLORIDE/1 MG |
J1620 | 65 | HCPCS / CPT® | GONADORELIN HYDROCH/ 100 MCG |
J1626 | 65 | HCPCS / CPT® | GRANISETRON HCL INJECTION |
J1630 | 65 | HCPCS / CPT® | HALOPERIDOL INJECTION |
J1631 | 65 | HCPCS / CPT® | HALOPERIDOL DECANOATE INJ |
J1640 | 65 | HCPCS / CPT® | HEMIN, 1 MG |
J1642 | 12 | HCPCS / CPT® | INJ HEPARIN SODIUM PER 10 U |
J1644 | 79 | HCPCS / CPT® | INJ HEPARIN SODIUM PER 1000U |
J1645 | 65 | HCPCS / CPT® | DALTEPARIN SODIUM |
J1650 | 65 | HCPCS / CPT® | INJ ENOXAPARIN SODIUM |
J1652 | 65 | HCPCS / CPT® | FONDAPARINUX SODIUM |
J1655 | 65 | HCPCS / CPT® | TINZAPARIN SODIUM INJECTION |
J1670 | 65 | HCPCS / CPT® | TETANUS IMMUNE GLOBULIN INJ |
J1675 | 65 | HCPCS / CPT® | HISTRELIN ACETATE |
J1700 | 65 | HCPCS / CPT® | HYDROCORTISONE ACETATE INJ |
J1710 | 65 | HCPCS / CPT® | HYDROCORTISONE SODIUM PH INJ |
J1720 | 0 | HCPCS / CPT® | HYDROCORTISONE SODIUM SUCC I |
J1725 | 0 | HCPCS / CPT® | HYDROXYPROGESTERONE CAPROATE |
J1730 | 0 | HCPCS / CPT® | DIAZOXIDE INJECTION |
J1740 | 0 | HCPCS / CPT® | IBANDRONATE SODIUM INJECTION |
J1741 | 0 | HCPCS / CPT® | IBUPROFEN INJECTION |
J1742 | 0 | HCPCS / CPT® | IBUTILIDE FUMARATE INJECTION |
J1743 | 0 | HCPCS / CPT® | IDURSULFASE INJECTION |
J1744 | 0 | HCPCS / CPT® | ICATIBANT INJECTION |
J1745 | 0 | HCPCS / CPT® | INFLIXIMAB NOT BIOSIMIL 10MG |
J1750 | 0 | HCPCS / CPT® | INJ IRON DEXTRAN |
J1756 | 0 | HCPCS / CPT® | IRON SUCROSE INJECTION |
J1786 | 0 | HCPCS / CPT® | IMUGLUCERASE INJECTION |
J1790 | 0 | HCPCS / CPT® | DROPERIDOL INJECTION |
J1800 | 0 | HCPCS / CPT® | PROPRANOLOL INJECTION |
J1810 | 7 | HCPCS / CPT® | DROPERIDOL/FENTANYL INJ |
J1815 | 32 | HCPCS / CPT® | INSULIN INJECTION |
J1817 | 0 | HCPCS / CPT® | INSULIN FOR INSULIN PUMP USE |
J1826 | 0 | HCPCS / CPT® | INTERFERON BETA-1A INJ |
J1830 | 0 | HCPCS / CPT® | INTERFERON BETA-1B / .25 MG |
J1833 | 0 | HCPCS / CPT® | INJECTION, ISAVUCONAZONIUM |
J1835 | 0 | HCPCS / CPT® | ITRACONAZOLE INJECTION |
J1840 | 0 | HCPCS / CPT® | KANAMYCIN SULFATE 500 MG INJ |
J1850 | 0 | HCPCS / CPT® | KANAMYCIN SULFATE 75 MG INJ |
J1885 | 22 | HCPCS / CPT® | KETOROLAC TROMETHAMINE INJ |
J1890 | 0 | HCPCS / CPT® | CEPHALOTHIN SODIUM INJECTION |
J1930 | 0 | HCPCS / CPT® | LANREOTIDE INJECTION |
J1931 | 0 | HCPCS / CPT® | LARONIDASE INJECTION |
J1940 | 2000 | HCPCS / CPT® | FUROSEMIDE INJECTION |
J1942 | 0 | HCPCS / CPT® | ARIPIPRAZOLE LAUROXIL 1MG |
J1945 | 0 | HCPCS / CPT® | LEPIRUDIN |
J1950 | 0 | HCPCS / CPT® | LEUPROLIDE ACETATE /3.75 MG |
J1953 | 0 | HCPCS / CPT® | LEVETIRACETAM INJECTION |
J1955 | 0 | HCPCS / CPT® | INJ LEVOCARNITINE PER 1 GM |
J1956 | 86 | HCPCS / CPT® | LEVOFLOXACIN INJECTION |
J1960 | 0 | HCPCS / CPT® | LEVORPHANOL TARTRATE INJ |
J1980 | 0 | HCPCS / CPT® | HYOSCYAMINE SULFATE INJ |
J1990 | 0 | HCPCS / CPT® | CHLORDIAZEPOXIDE INJECTION |
J2001 | 32 | HCPCS / CPT® | LIDOCAINE INJECTION |
J2010 | 0 | HCPCS / CPT® | LINCOMYCIN INJECTION |
J2020 | 0 | HCPCS / CPT® | LINEZOLID INJECTION |
J2060 | 54 | HCPCS / CPT® | LORAZEPAM INJECTION |
J2150 | 0 | HCPCS / CPT® | MANNITOL INJECTION |
J2170 | 0 | HCPCS / CPT® | MECASERMIN INJECTION |
J2175 | 27 | HCPCS / CPT® | DEMOROL/ MEPERIDINE HYDROCHL /100 MG |
J2180 | 0 | HCPCS / CPT® | MEPERIDINE/PROMETHAZINE INJ |
J2182 | 0 | HCPCS / CPT® | INJECTION, MEPOLIZUMAB, 1MG |
J2185 | 0 | HCPCS / CPT® | MEROPENEM |
J2210 | 0 | HCPCS / CPT® | METHYLERGONOVIN MALEATE INJ |
J2212 | 0 | HCPCS / CPT® | METHYLNALTREXONE INJECTION |
J2248 | 0 | HCPCS / CPT® | MICAFUNGIN SODIUM INJECTION |
J2250 | 12 | HCPCS / CPT® | INJ MIDAZOLAM HYDROCHLORIDE |
J2260 | 0 | HCPCS / CPT® | INJ MILRINONE LACTATE / 5 MG |
J2265 | 0 | HCPCS / CPT® | MINOCYCLINE HYDROCHLORIDE |
J2270 | 15.1 | HCPCS / CPT® | INJECTION, MORPHINE SULFATE, UP TO 10 MG |
J2274 | 65 | HCPCS / CPT® | IN MORPHINE PRESERVATIV FREE |
J2278 | 65 | HCPCS / CPT® | ZICONOTIDE INJECTION |
J2280 | 0 | HCPCS / CPT® | INJ, MOXIFLOXACIN 100 MG |
J2300 | 0 | HCPCS / CPT® | INJ NALBUPHINE HYDROCHLORIDE |
J2310 | 0 | HCPCS / CPT® | INJ NALOXONE HYDROCHLORIDE |
J2315 | 0 | HCPCS / CPT® | NALTREXONE, DEPOT FORM |
J2320 | 0 | HCPCS / CPT® | NANDROLONE DECANOATE 50 MG |
J2323 | 0 | HCPCS / CPT® | NATALIZUMAB INJECTION |
J2325 | 0 | HCPCS / CPT® | NESIRITIDE INJECTION |
J2353 | 0 | HCPCS / CPT® | OCTREOTIDE INJECTION, DEPOT |
J2354 | 0 | HCPCS / CPT® | OCTREOTIDE INJ, NON-DEPOT |
J2355 | 0 | HCPCS / CPT® | OPRELVEKIN INJECTION |
J2357 | 0 | HCPCS / CPT® | OMALIZUMAB INJECTION |
J2358 | 0 | HCPCS / CPT® | OLANZAPINE LONG-ACTING INJ |
J2360 | 0 | HCPCS / CPT® | ORPHENADRINE INJECTION |
J2370 | 0 | HCPCS / CPT® | PHENYLEPHRINE HCL INJECTION |
J2400 | 0 | HCPCS / CPT® | CHLOROPROCAINE HCL INJECTION |
J2405 | 20 | HCPCS / CPT® | ONDANSETRON HCL INJECTION |
J2407 | 0 | HCPCS / CPT® | INJECTION, ORITAVANCIN |
J2410 | 0 | HCPCS / CPT® | OXYMORPHONE HCL INJECTION |
J2425 | 0 | HCPCS / CPT® | PALIFERMIN INJECTION |
J2426 | 0 | HCPCS / CPT® | PALIPERIDONE PALMITATE INJ |
J2430 | 0 | HCPCS / CPT® | PAMIDRONATE DISODIUM /30 MG |
J2440 | 0 | HCPCS / CPT® | PAPAVERIN HCL INJECTION |
J2460 | 0 | HCPCS / CPT® | OXYTETRACYCLINE INJECTION |
J2469 | 0 | HCPCS / CPT® | PALONOSETRON HCL |
J2501 | 0 | HCPCS / CPT® | PARICALCITOL |
J2502 | 0 | HCPCS / CPT® | INJ, PASIREOTIDE LONG ACTING |
J2503 | 0 | HCPCS / CPT® | PEGAPTANIB SODIUM INJECTION |
J2504 | 0 | HCPCS / CPT® | PEGADEMASE BOVINE, 25 IU |
J2505 | 0 | HCPCS / CPT® | INJECTION, PEGFILGRASTIM 6MG |
J2507 | 0 | HCPCS / CPT® | PEGLOTICASE INJECTION |
J2510 | 0 | HCPCS / CPT® | PENICILLIN G PROCAINE INJ |
J2513 | 0 | HCPCS / CPT® | PENTASTARCH 10% SOLUTION |
J2515 | 0 | HCPCS / CPT® | PENTOBARBITAL SODIUM INJ |
J2540 | 0 | HCPCS / CPT® | PENICILLIN G POTASSIUM INJ |
J2543 | 0 | HCPCS / CPT® | PIPERACILLIN/TAZOBACTAM |
J2545 | 0 | HCPCS / CPT® | PENTAMIDINE NON-COMP UNIT |
J2547 | 0 | HCPCS / CPT® | INJECTION, PERAMIVIR |
J2550 | 20.8 | HCPCS / CPT® | INJECTION, PROMETHAZINE HCL, UP TO 50 MG |
J2560 | 0 | HCPCS / CPT® | PHENOBARBITAL SODIUM INJ |
J2562 | 0 | HCPCS / CPT® | PLERIXAFOR INJECTION |
J2590 | 0 | HCPCS / CPT® | OXYTOCIN INJECTION |
J2597 | 0 | HCPCS / CPT® | INJ DESMOPRESSIN ACETATE |
J2650 | 0 | HCPCS / CPT® | PREDNISOLONE ACETATE INJ |
J2670 | 0 | HCPCS / CPT® | TOTAZOLINE HCL INJECTION |
J2675 | 0 | HCPCS / CPT® | INJ PROGESTERONE PER 50 MG |
J2680 | 0 | HCPCS / CPT® | FLUPHENAZINE DECANOATE 25 MG |
J2690 | 0 | HCPCS / CPT® | PROCAINAMIDE HCL INJECTION |
J2700 | 0 | HCPCS / CPT® | OXACILLIN SODIUM INJECITON |
J2704 | 65 | HCPCS / CPT® | INJ, PROPOFOL, 10 MG |
J2710 | 65 | HCPCS / CPT® | NEOSTIGMINE METHYLSLFTE INJ |
J2720 | 0 | HCPCS / CPT® | INJ PROTAMINE SULFATE/10 MG |
J2724 | 0 | HCPCS / CPT® | PROTEIN C CONCENTRATE |
J2725 | 0 | HCPCS / CPT® | INJ PROTIRELIN PER 250 MCG |
J2730 | 0 | HCPCS / CPT® | PRALIDOXIME CHLORIDE INJ |
J2760 | 0 | HCPCS / CPT® | PHENTOLAINE MESYLATE INJ |
J2765 | 65 | HCPCS / CPT® | METOCLOPRAMIDE HCL INJECTION |
J2770 | 0 | HCPCS / CPT® | QUINUPRISTIN/DALFOPRISTIN |
J2778 | 0 | HCPCS / CPT® | RANIBIZUMAB INJECTION |
J2780 | 65 | HCPCS / CPT® | RANITIDINE HYDROCHLORIDE INJ |
J2783 | 0 | HCPCS / CPT® | RASBURICASE |
J2785 | 0 | HCPCS / CPT® | REGADENOSON INJECTION |
J2786 | 0 | HCPCS / CPT® | INJECTION, RESLIZUMAB, 1MG |
J2788 | 0 | HCPCS / CPT® | RHO D IMMUNE GLOBULIN 50 MCG |
J2790 | 65 | HCPCS / CPT® | RHO D IMMUNE GLOBULIN INJ |
J2791 | 0 | HCPCS / CPT® | RHOPHYLAC INJECTION |
J2792 | 0 | HCPCS / CPT® | RHO(D) IMMUNE GLOBULIN H, SD |
J2793 | 0 | HCPCS / CPT® | RILONACEPT INJECTION |
J2794 | 0 | HCPCS / CPT® | RISPERIDONE, LONG ACTING |
J2795 | 0 | HCPCS / CPT® | ROPIVACAINE HCL INJECTION |
J2796 | 0 | HCPCS / CPT® | ROMIPLOSTIM INJECTION |
J2800 | 0 | HCPCS / CPT® | METHOCARBAMOL INJECTION |
J2805 | 0 | HCPCS / CPT® | SINCALIDE INJECTION |
J2810 | 0 | HCPCS / CPT® | INJ THEOPHYLLINE PER 40 MG |
J2820 | 0 | HCPCS / CPT® | SARGRAMOSTIM INJECTION |
J2840 | 0 | HCPCS / CPT® | INJ SEBELIPASE ALFA 1 MG |
J2850 | 0 | HCPCS / CPT® | INJ SECRETIN SYNTHETIC HUMAN |
J2860 | 0 | HCPCS / CPT® | INJECTION, SILTUXIMAB |
J2910 | 0 | HCPCS / CPT® | AUROTHIOGLUCOSE INJECITON |
J2916 | 0 | HCPCS / CPT® | NA FERRIC GLUCONATE COMPLEX |
J2920 | 19 | HCPCS / CPT® | METHYLPREDNISOLONE INJECTION |
J2930 | 17 | HCPCS / CPT® | METHYLPREDNISOLONE INJECTION |
J2940 | 0 | HCPCS / CPT® | SOMATREM INJECTION |
J2941 | 0 | HCPCS / CPT® | SOMATROPIN INJECTION |
J2950 | 0 | HCPCS / CPT® | PROMAZINE HCL INJECTION |
J2993 | 0 | HCPCS / CPT® | RETEPLASE INJECTION |
J2995 | 0 | HCPCS / CPT® | INJ STREPTOKINASE /250000 IU |
J2997 | 0 | HCPCS / CPT® | ALTEPLASE RECOMBINANT |
J3000 | 0 | HCPCS / CPT® | STREPTOMYCIN INJECTION |
J3010 | 6 | HCPCS / CPT® | FENTANYL CITRATE INJECITON |
J3030 | 11 | HCPCS / CPT® | SUMATRIPTAN SUCCINATE / 6 MG |
J3060 | 0 | HCPCS / CPT® | INJ, TALIGLUCERACE ALFA 10 U |
J3070 | 0 | HCPCS / CPT® | PENTAZOCINE INJECTION |
J3090 | 0 | HCPCS / CPT® | INJ TEDIZOLID PHOSPHATE |
J3095 | 0 | HCPCS / CPT® | TELAVANCIN INJECTION |
J3101 | 0 | HCPCS / CPT® | TENECTEPLASE INJECTION |
J3105 | 0 | HCPCS / CPT® | TERBUTALINE SULFATE INJ |
J3110 | 0 | HCPCS / CPT® | TERIPARATIDE INJECTION |
J3121 | 0 | HCPCS / CPT® | INJ TESTOSTERO ENANTHATE 1MG |
J3145 | 0 | HCPCS / CPT® | TESTOSTERONE UNDECANOATE 1MG |
J3230 | 0 | HCPCS / CPT® | CHLORPROMAZINE HCL INJECTION |
J3240 | 0 | HCPCS / CPT® | THYROTROPIN INJECTION |
J3243 | 0 | HCPCS / CPT® | TIGECYCLINE INJECTION |
J3246 | 0 | HCPCS / CPT® | TIROFIBAN HCL |
J3250 | 0 | HCPCS / CPT® | TRIMETHOBENZAMIDE HCL INJ |
J3260 | 0 | HCPCS / CPT® | TOBRAMYCIN SULFATE INJECTION |
J3262 | 0 | HCPCS / CPT® | TOCILIZUMAB INJECTION |
J3265 | 0 | HCPCS / CPT® | INJECTION TORSEMIDE 10 MG/ML |
J3280 | 0 | HCPCS / CPT® | THIETHYLPERAZINE MALEATE INJ |
J3285 | 0 | HCPCS / CPT® | TREPROSTINIL INJECTION |
J3300 | 0 | HCPCS / CPT® | TRIAMCINOLONE A INJ PRS-FREE |
J3301 | 0 | HCPCS / CPT® | TRIAMCINOLONE ACET INJ NOS |
J3302 | 0 | HCPCS / CPT® | TRIAMCINOLONE DIACETATE INJ |
J3303 | 0 | HCPCS / CPT® | TRIAMCINOLONE HEXACETONL INJ |
J3305 | 0 | HCPCS / CPT® | INJ TRIMETREXATE GLUCORONATE |
J3310 | 0 | HCPCS / CPT® | PERPHENAZINE INJECITON |
J3315 | 0 | HCPCS / CPT® | TRIPTORELIN PAMOATE |
J3320 | 0 | HCPCS / CPT® | SPECTINOMYCN DI-HCL INJ |
J3350 | 0 | HCPCS / CPT® | UREA INJECTION |
J3355 | 0 | HCPCS / CPT® | UROFOLLITROPIN, 75 IU |
J3357 | 0 | HCPCS / CPT® | USTEKINUMAB SUB CU INJ, 1 MG |
J3360 | 11 | HCPCS / CPT® | DIAZEPAM INJECTION |
J3364 | 0 | HCPCS / CPT® | UROKINASE 5000 IU INJECTION |
J3365 | 0 | HCPCS / CPT® | UROKINASE 250,000 IU INJ |
J3370 | 118 | HCPCS / CPT® | VANCOMYCIN HCL INJECTION |
J3380 | 0 | HCPCS / CPT® | INJECTION, VEDOLIZUMAB |
J3385 | 0 | HCPCS / CPT® | VELAGLUCERASE ALFA |
J3396 | 0 | HCPCS / CPT® | VERTEPORFIN INJECTION |
J3400 | 0 | HCPCS / CPT® | TRIFLUPROMAZINE HCL INJ |
J3410 | 0 | HCPCS / CPT® | HYDROXYZINE HCL INJECTION |
J3411 | 0 | HCPCS / CPT® | THIAMINE HCL 100 MG |
J3415 | 0 | HCPCS / CPT® | PYRIDOXINE HCL 100 MG |
J3420 | 0 | HCPCS / CPT® | VITAMIN B12 INJECTION |
J3430 | 17 | HCPCS / CPT® | VITAMIN K PHYTONADIONE INJ |
J3465 | 0 | HCPCS / CPT® | INJECTION, VORICONAZOLE |
J3470 | 0 | HCPCS / CPT® | HYALURONIDASE INJECTION |
J3471 | 0 | HCPCS / CPT® | OVINE, UP TO 999 USP UNITS |
J3472 | 0 | HCPCS / CPT® | OVINE, 1000 USP UNITS |
J3473 | 0 | HCPCS / CPT® | HYALURONIDASE RECOMBINANT |
J3475 | 27 | HCPCS / CPT® | INJ MAGNESIUM SULFATE |
J3480 | 7 | HCPCS / CPT® | INJ POTASSIUM CHLORIDE |
J3485 | 0 | HCPCS / CPT® | ZIDOVUDINE |
J3486 | 0 | HCPCS / CPT® | ZIPRASIDONE MESYLATE |
J3489 | 0 | HCPCS / CPT® | ZOLEDRONIC ACID 1MG |
J3490 | 65 | HCPCS / CPT® | DRUGS UNCLASSIFIED INJECTION |
J3499 | 65 | HCPCS / CPT® | Unclassified Drugs |
J3520 | 0 | HCPCS / CPT® | EDETATE DISODIUM PER 150 MG |
J3530 | 0 | HCPCS / CPT® | NASAL VACCINE INHALATION |
J3535 | 0 | HCPCS / CPT® | METERED DOSE INHALER DRUG |
J3570 | 0 | HCPCS / CPT® | LAETRILE AMYGDALIN VIT B17 |
J3590 | 0 | HCPCS / CPT® | UNCLASSIFIED BIOLOGICS |
J7030 | 68 | HCPCS / CPT® | NORMAL SALINE SOLUTION INFUS |
J7040 | 36 | HCPCS / CPT® | NORMAL SALINE SOLUTION INFUS |
J7042 | 32 | HCPCS / CPT® | 5% DEXTROSE/NORMAL SALINE |
J7050 | 28 | HCPCS / CPT® | NORMAL SALINE SOLUTION INFUS |
J7060 | 38 | HCPCS / CPT® | 5% DEXTROSE/WATER |
J7070 | 87 | HCPCS / CPT® | D5W INFUSION |
J7100 | 0 | HCPCS / CPT® | DEXTRAN 40 INFUSION |
J7110 | 0 | HCPCS / CPT® | DEXTRAN 75 INFUSION |
J7120 | 96 | HCPCS / CPT® | RINGERS LACTATE INFUSION |
J7121 | 98 | HCPCS / CPT® | 5% DEXTROSE IN LAC RINGERS |
J7131 | 77 | HCPCS / CPT® | HYPERTONIC SALINE SOL |
J7175 | 0 | HCPCS / CPT® | INJ, FACTOR X, (HUMAN), 1IU |
J7178 | 0 | HCPCS / CPT® | HUMAN FIBRINOGEN CONC INJ |
J7179 | 0 | HCPCS / CPT® | VONVENDI INJ 1 IU VWF:RCO |
J7180 | 0 | HCPCS / CPT® | FACTOR XIII ANTI-HEM FACTOR |
J7181 | 0 | HCPCS / CPT® | FACTOR XIII RECOMB A-SUBUNIT |
J7182 | 0 | HCPCS / CPT® | FACTOR VIII RECOMB NOVOEIGHT |
J7183 | 0 | HCPCS / CPT® | WILATE INJECTION |
J7185 | 0 | HCPCS / CPT® | XYNTHA INJ |
J7186 | 0 | HCPCS / CPT® | ANTIHEMOPHILIC VIII/VWF COMP |
J7187 | 0 | HCPCS / CPT® | HUMATE-P, INJ |
J7188 | 0 | HCPCS / CPT® | FACTOR VIII RECOMB OBIZUR |
J7189 | 0 | HCPCS / CPT® | FACTOR VIIA |
J7190 | 0 | HCPCS / CPT® | FACTOR VIII |
J7191 | 0 | HCPCS / CPT® | FACTOR VIII (PORCINE) |
J7192 | 0 | HCPCS / CPT® | FACTOR VIII RECOMBINANT NOS |
J7193 | 0 | HCPCS / CPT® | FACTOR IX NON-RECOMBINANT |
J7194 | 0 | HCPCS / CPT® | FACTOR IX COMPLEX |
J7195 | 0 | HCPCS / CPT® | FACTOR IX RECOMBINANT NOS |
J7196 | 0 | HCPCS / CPT® | ANTITHROMBIN RECOMBINANT |
J7197 | 0 | HCPCS / CPT® | ANTITHROMBIN III INJECTION |
J7198 | 0 | HCPCS / CPT® | ANTI-INHIBITOR |
J7199 | 0 | HCPCS / CPT® | HEMOPHILIA CLOT FACTOR NOC |
J7200 | 0 | HCPCS / CPT® | FACTOR IX RECOMBINAN RIXUBIS |
J7201 | 0 | HCPCS / CPT® | FACTOR IX ALPROLIX RECOMB |
J7202 | 0 | HCPCS / CPT® | FACTOR IX IDELVION INJ |
J7205 | 0 | HCPCS / CPT® | FACTOR VIII FC FUSION RECOMB |
J7207 | 0 | HCPCS / CPT® | FACTOR VIII PEGYLATED RECOMB |
J7209 | 0 | HCPCS / CPT® | FACTOR VIII NUWIQ RECOMB 1IU |
J7297 | 0 | HCPCS / CPT® | LILETTA, 52 MG |
J7298 | 0 | HCPCS / CPT® | MIRENA, 52 MG |
J7300 | 0 | HCPCS / CPT® | INTRAUT COPPER CONTRACEPTIVE |
J7301 | 0 | HCPCS / CPT® | SKYLA, 13.5 MG |
J7303 | 0 | HCPCS / CPT® | CONTRACEPTIVE VAGINAL RING |
J7304 | 0 | HCPCS / CPT® | CONTRACEPTIVE HORMONE PATCH |
J7306 | 0 | HCPCS / CPT® | LEVONORGESTREL IMPLANT SYS |
J7307 | 0 | HCPCS / CPT® | ETONOGESTREL IMPLANT SYSTEM |
J7308 | 0 | HCPCS / CPT® | AMINOLEVULINIC ACID HCL TOP |
J7309 | 0 | HCPCS / CPT® | METHYL AMINOLEVULINATE, TOP |
J7310 | 0 | HCPCS / CPT® | GANCICLOVIR LONG ACT IMPLANT |
J7311 | 0 | HCPCS / CPT® | FLUOCINOLONE ACETONIDE IMPLT |
J7312 | 65 | HCPCS / CPT® | DEXAMETHASONE INTRA IMPLANT |
J7313 | 0 | HCPCS / CPT® | FLUOCINOL ACET INTRAVIT IMP |
J7315 | 0 | HCPCS / CPT® | OPHTHALMIC MITOMYCIN |
J7316 | 0 | HCPCS / CPT® | INJ, OCRIPLASMIN, 0.125 MG |
J7320 | 0 | HCPCS / CPT® | GENVISC 850, INJ, 1MG |
J7321 | 0 | HCPCS / CPT® | HYALGAN/SUPARTZ INJ PER DOSE |
J7322 | 0 | HCPCS / CPT® | HYMOVIS INJECTION 1 MG |
J7323 | 0 | HCPCS / CPT® | EUFLEXXA INJ PER DOSE |
J7324 | 0 | HCPCS / CPT® | ORTHOVISC INJ PER DOSE |
J7325 | 0 | HCPCS / CPT® | SYNVISC OR SYNVISC-ONE |
J7326 | 0 | HCPCS / CPT® | GEL-ONE |
J7327 | 0 | HCPCS / CPT® | MONOVISC INJ PER DOSE |
J7328 | 0 | HCPCS / CPT® | GEL-SYN INJECTION 0.1 MG |
J7330 | 0 | HCPCS / CPT® | CULTURED CHONDROCYTES IMPLNT |
J7336 | 0 | HCPCS / CPT® | CAPSAICIN 8% PATCH |
J7340 | 0 | HCPCS / CPT® | CARBIDOPA LEVODOPA ENT 100ML |
J7342 | 0 | HCPCS / CPT® | CIPROFLOXACIN OTIC SUSP 6 MG |
J7500 | 0 | HCPCS / CPT® | AZATHIOPRINE ORAL 50MG |
J7501 | 0 | HCPCS / CPT® | AZATHIOPRINE PARENTERAL |
J7502 | 65 | HCPCS / CPT® | CYCLOSPORINE ORAL 100 MG |
J7503 | 0 | HCPCS / CPT® | TACROL ENVARSUS EX REL ORAL |
J7504 | 0 | HCPCS / CPT® | LYMPHOCYTE IMMUNE GLOBULIN |
J7505 | 0 | HCPCS / CPT® | MONOCLONAL ANTIBODIES |
J7507 | 65 | HCPCS / CPT® | TACROLIMUS IMME REL ORAL 1MG |
J7508 | 0 | HCPCS / CPT® | TACROL ASTAGRAF EX REL ORAL |
J7509 | 0 | HCPCS / CPT® | METHYLPREDNISOLONE ORAL |
J7510 | 11 | HCPCS / CPT® | PREDNISOLONE ORAL PER 5 MG |
J7511 | 0 | HCPCS / CPT® | ANTITHYMOCYTE GLOBULN RABBIT |
J7512 | 11 | HCPCS / CPT® | PREDNISONE IR OR DR ORAL 1MG |
J7513 | 0 | HCPCS / CPT® | DACLIZUMAB, PARENTERAL |
J7515 | 0 | HCPCS / CPT® | CYCLOSPORINE ORAL 25 MG |
J7516 | 0 | HCPCS / CPT® | CYCLOSPORIN PARENTERAL 250MG |
J7517 | 0 | HCPCS / CPT® | MYCOPHENOLATE MOFETIL ORAL |
J7518 | 0 | HCPCS / CPT® | MYCOPHENOLIC ACID |
J7520 | 0 | HCPCS / CPT® | SIROLIMUS, ORAL |
J7525 | 0 | HCPCS / CPT® | TACROLIMUS INJECTION |
J7527 | 0 | HCPCS / CPT® | ORAL EVEROLIMUS |
J7599 | 0 | HCPCS / CPT® | IMMUNOSUPPRESSIVE DRUG NOC |
J7604 | 0 | HCPCS / CPT® | ACETYLCYSTEINE COMP UNIT |
J7605 | 0 | HCPCS / CPT® | ARFORMOTEROL NON-COMP UNIT |
J7606 | 0 | HCPCS / CPT® | FORMOTEROL FUMARATE, INH |
J7607 | 16 | HCPCS / CPT® | LEVALBUTEROL COMP CON |
J7608 | 0 | HCPCS / CPT® | ACETYLCYSTEINE NON-COMP UNIT |
J7609 | 0 | HCPCS / CPT® | ALBUTEROL COMP UNIT |
J7610 | 17 | HCPCS / CPT® | ALBUTEROL COMP CON |
J7611 | 17 | HCPCS / CPT® | ALBUTEROL NON-COMP CON |
J7612 | 0 | HCPCS / CPT® | LEVALBUTEROL NON-COMP CON |
J7613 | 65 | HCPCS / CPT® | ALBUTEROL NON-COMP UNIT |
J7614 | 19 | HCPCS / CPT® | LEVALBUTEROL NON-COMP UNIT |
J7615 | 16 | HCPCS / CPT® | LEVALBUTEROL COMP UNIT |
J7620 | 65 | HCPCS / CPT® | ALBUTEROL IPRATROP NON-COMP |
J7622 | 0 | HCPCS / CPT® | BECLOMETHASONE COMP UNIT |
J7624 | 0 | HCPCS / CPT® | BETAMETHASONE COMP UNIT |
J7626 | 0 | HCPCS / CPT® | BUDESONIDE NON-COMP UNIT |
J7627 | 0 | HCPCS / CPT® | BUDESONIDE COMP UNIT |
J7628 | 0 | HCPCS / CPT® | BITOLTEROL MESYLATE COMP CON |
J7629 | 0 | HCPCS / CPT® | BITOLTEROL MESYLATE COMP UNT |
J7631 | 0 | HCPCS / CPT® | CROMOLYN SODIUM NONCOMP UNIT |
J7632 | 0 | HCPCS / CPT® | CROMOLYN SODIUM COMP UNIT |
J7633 | 0 | HCPCS / CPT® | BUDESONIDE NON-COMP CON |
J7634 | 0 | HCPCS / CPT® | BUDESONIDE COMP CON |
J7635 | 0 | HCPCS / CPT® | ATROPINE COMP CON |
J7636 | 0 | HCPCS / CPT® | ATROPINE COMP UNIT |
J7637 | 65 | HCPCS / CPT® | DEXAMETHASONE COMP CON |
J7638 | 65 | HCPCS / CPT® | DEXAMETHASONE COMP UNIT |
J7639 | 0 | HCPCS / CPT® | DORNASE ALFA NON-COMP UNIT |
J7640 | 0 | HCPCS / CPT® | FORMOTEROL COMP UNIT |
J7641 | 0 | HCPCS / CPT® | FLUNISOLIDE COMP UNIT |
J7642 | 0 | HCPCS / CPT® | GLYCOPYRROLATE COMP CON |
J7643 | 0 | HCPCS / CPT® | GLYCOPYRROLATE COMP UNIT |
J7644 | 28 | HCPCS / CPT® | IPRATROPIUM BROMIDE NON-COMP |
J7645 | 0 | HCPCS / CPT® | IPRATROPIUM BROMIDE COMP |
J7647 | 0 | HCPCS / CPT® | ISOETHARINE COMP CON |
J7648 | 0 | HCPCS / CPT® | ISOETHARINE NON-COMP CON |
J7649 | 0 | HCPCS / CPT® | ISOETHARINE NON-COMP UNIT |
J7650 | 0 | HCPCS / CPT® | ISOETHARINE COMP UNIT |
J7657 | 0 | HCPCS / CPT® | ISOPROTERENOL COMP CON |
J7658 | 0 | HCPCS / CPT® | ISOPROTERENOL NON-COMP CON |
J7659 | 0 | HCPCS / CPT® | ISOPROTERENOL NON-COMP UNIT |
J7660 | 0 | HCPCS / CPT® | ISOPROTERENOL COMP UNIT |
J7665 | 0 | HCPCS / CPT® | MANNITOL FOR INHALER |
J7667 | 0 | HCPCS / CPT® | METAPROTERENOL COMP CON |
J7668 | 0 | HCPCS / CPT® | METAPROTERENOL NON-COMP CON |
J7669 | 0 | HCPCS / CPT® | METAPROTERENOL NON-COMP UNIT |
J7670 | 0 | HCPCS / CPT® | METAPROTERENOL COMP UNIT |
J7674 | 0 | HCPCS / CPT® | METHACHOLINE CHLORIDE, NEB |
J7676 | 0 | HCPCS / CPT® | PENTAMIDINE COMP UNIT DOSE |
J7680 | 0 | HCPCS / CPT® | TERBUTALINE SULF COMP CON |
J7681 | 0 | HCPCS / CPT® | TERBUTALINE SULF COMP UNIT |
J7682 | 0 | HCPCS / CPT® | TOBRAMYCIN NON-COMP UNIT |
J7683 | 0 | HCPCS / CPT® | TRIAMCINOLONE COMP CON |
J7684 | 0 | HCPCS / CPT® | TRIAMCINOLONE COMP UNIT |
J7685 | 0 | HCPCS / CPT® | TOBRAMYCIN COMP UNIT |
J7686 | 0 | HCPCS / CPT® | TREPROSTINIL, NON-COMP UNIT |
J7699 | 7 | HCPCS / CPT® | INHALATION SOLUTION FOR DME |
J7799 | 65 | HCPCS / CPT® | NON-INHALATION DRUG FOR DME |
J7999 | 65 | HCPCS / CPT® | COMPOUNDED DRUG, NOC |
J8498 | 0 | HCPCS / CPT® | ANTIEMETIC RECTAL/SUPP NOS |
J8499 | 65 | HCPCS / CPT® | ORAL PRESCRIP DRUG NON CHEMO |
J8501 | 65 | HCPCS / CPT® | ORAL APREPITANT |
J8510 | 0 | HCPCS / CPT® | ORAL BUSULFAN |
J8515 | 65 | HCPCS / CPT® | CABERGOLINE, ORAL 0.25MG |
J8520 | 65 | HCPCS / CPT® | CAPECITABINE, ORAL, 150 MG |
J8521 | 65 | HCPCS / CPT® | CAPECITABINE, ORAL, 500 MG |
J8530 | 65 | HCPCS / CPT® | CYCLOPHOSPHAMIDE ORAL 25 MG |
J8540 | 18 | HCPCS / CPT® | ORAL DEXAMETHASONE |
J8560 | 65 | HCPCS / CPT® | ETOPOSIDE ORAL 50 MG |
J8562 | 65 | HCPCS / CPT® | ORAL FLUDARABINE PHOSPHATE |
J8565 | 65 | HCPCS / CPT® | GEFITINIB ORAL |
J8597 | 65 | HCPCS / CPT® | ANTIEMETIC DRUG ORAL NOS |
J8600 | 65 | HCPCS / CPT® | MELPHALAN ORAL 2 MG |
J8610 | 65 | HCPCS / CPT® | METHOTREXATE ORAL 2.5 MG |
J8650 | 65 | HCPCS / CPT® | NABILONE ORAL |
J8655 | 65 | HCPCS / CPT® | NETUPITANT PALONOSETRON ORAL |
J8670 | 65 | HCPCS / CPT® | ROLAPITANT, ORAL, 1MG |
J8700 | 65 | HCPCS / CPT® | TEMOZOLOMIDE |
J8705 | 0 | HCPCS / CPT® | TOPOTECAN ORAL |
J8999 | 0 | HCPCS / CPT® | ORAL PRESCRIPTION DRUG CHEMO |
J9000 | 65 | HCPCS / CPT® | DOXORUBICIN HCL INJECTION |
J9015 | 65 | HCPCS / CPT® | ALDESLEUKIN INJECTION |
J9017 | 65 | HCPCS / CPT® | ARSENIC TRIOXIDE INJECTION |
J9019 | 65 | HCPCS / CPT® | ERWINAZE INJECTION |
J9020 | 65 | HCPCS / CPT® | ASPARAGINASE, NOS |
J9025 | 65 | HCPCS / CPT® | AZACITIDINE INJECTION |
J9027 | 128 | HCPCS / CPT® | CLOFARABINE INJECTION |
J9031 | 65 | HCPCS / CPT® | BCG LIVE INTRAVESICAL VAC |
J9032 | 65 | HCPCS / CPT® | INJECTION, BELINOSTAT, 10MG |
J9033 | 65 | HCPCS / CPT® | INJ., TREANDA 1 MG |
J9034 | 65 | HCPCS / CPT® | INJ., BENDEKA 1 MG |
J9035 | 65 | HCPCS / CPT® | BEVACIZUMAB INJECTION |
J9039 | 65 | HCPCS / CPT® | INJECTION, BLINATUMOMAB |
J9040 | 65 | HCPCS / CPT® | BLEOMYCIN SULFATE INJECTION |
J9041 | 65 | HCPCS / CPT® | BORTEZOMIB INJECTION |
J9042 | 65 | HCPCS / CPT® | BRENTUXIMAB VEDOTIN INJ |
J9043 | 65 | HCPCS / CPT® | CABAZITAXEL INJECTION |
J9045 | 65 | HCPCS / CPT® | CARBOPLATIN INJECTION |
J9047 | 65 | HCPCS / CPT® | INJECTION, CARFILZOMIB, 1 MG |
J9050 | 65 | HCPCS / CPT® | CARMUSTINE INJECTION |
J9055 | 65 | HCPCS / CPT® | CETUXIMAB INJECTION |
J9060 | 65 | HCPCS / CPT® | CISPLATIN 10 MG INJECTION |
J9065 | 65 | HCPCS / CPT® | INJ CLADRIBINE PER 1 MG |
J9070 | 65 | HCPCS / CPT® | CYCLOPHOSPHAMIDE 100 MG INJ |
J9098 | 65 | HCPCS / CPT® | CYTARABINE LIPOSOME INJ |
J9100 | 65 | HCPCS / CPT® | CYTARABINE HCL 100 MG INJ |
J9120 | 65 | HCPCS / CPT® | DACTINOMYCIN INJECTION |
J9130 | 65 | HCPCS / CPT® | DACARBAZINE 100 MG INJ |
J9145 | 65 | HCPCS / CPT® | INJECTION, DARATUMUMAB 10 MG |
J9150 | 65 | HCPCS / CPT® | DAUNORUBICIN INJECTION |
J9151 | 65 | HCPCS / CPT® | DAUNORUBICIN CITRATE INJ |
J9155 | 65 | HCPCS / CPT® | DEGARELIX INJECTION |
J9160 | 65 | HCPCS / CPT® | DENILEUKIN DIFTITOX INJ |
J9165 | 65 | HCPCS / CPT® | DIETHYLSTILBESTROL INJECTION |
J9171 | 65 | HCPCS / CPT® | DOCETAXEL INJECTION |
J9175 | 65 | HCPCS / CPT® | ELLIOTTS B SOLUTION PER ML |
J9176 | 65 | HCPCS / CPT® | INJECTION, ELOTUZUMAB, 1MG |
J9178 | 65 | HCPCS / CPT® | INJ, EPIRUBICIN HCL, 2 MG |
J9179 | 65 | HCPCS / CPT® | ERIBULIN MESYLATE INJECTION |
J9181 | 65 | HCPCS / CPT® | ETOPOSIDE INJECTION |
J9185 | 65 | HCPCS / CPT® | FLUDARABINE PHOSPHATE INJ |
J9190 | 65 | HCPCS / CPT® | FLUOROURACIL INJECTION |
J9200 | 65 | HCPCS / CPT® | FLOXURIDINE INJECTION |
J9201 | 65 | HCPCS / CPT® | GEMCITABINE HCL INJECTION |
J9202 | 65 | HCPCS / CPT® | GOSERELIN ACETATE IMPLANT |
J9205 | 65 | HCPCS / CPT® | INJ IRINOTECAN LIPOSOME 1 MG |
J9206 | 65 | HCPCS / CPT® | IRINOTECAN INJECTION |
J9207 | 65 | HCPCS / CPT® | IXABEPILONE INJECTION |
J9208 | 65 | HCPCS / CPT® | IFOSFAMIDE INJECTION |
J9209 | 65 | HCPCS / CPT® | MESNA INJECTION |
J9211 | 65 | HCPCS / CPT® | IDARUBICIN HCL INJECTION |
J9212 | 65 | HCPCS / CPT® | INTERFERON ALFACON-1 INJ |
J9213 | 65 | HCPCS / CPT® | INTERFERON ALFA-2A INJ |
J9214 | 65 | HCPCS / CPT® | INTERFERON ALFA-2B INJ |
J9215 | 65 | HCPCS / CPT® | INTERFERON ALFA-N3 INJ |
J9216 | 65 | HCPCS / CPT® | INTERFERON GAMMA 1-B INJ |
J9217 | 65 | HCPCS / CPT® | LEUPROLIDE ACETATE SUSPNSION |
J9218 | 65 | HCPCS / CPT® | LEUPROLIDE ACETATE INJECITON |
J9219 | 65 | HCPCS / CPT® | LEUPROLIDE ACETATE IMPLANT |
J9225 | 65 | HCPCS / CPT® | VANTAS IMPLANT |
J9226 | 65 | HCPCS / CPT® | SUPPRELIN LA IMPLANT |
J9228 | 65 | HCPCS / CPT® | IPILIMUMAB INJECTION |
J9230 | 65 | HCPCS / CPT® | MECHLORETHAMINE HCL INJ |
J9245 | 65 | HCPCS / CPT® | INJ MELPHALAN HYDROCHL 50 MG |
J9250 | 65 | HCPCS / CPT® | METHOTREXATE SODIUM INJ |
J9260 | 65 | HCPCS / CPT® | METHOTREXATE SODIUM INJ |
J9261 | 65 | HCPCS / CPT® | NELARABINE INJECTION |
J9262 | 65 | HCPCS / CPT® | INJ, OMACETAXINE MEP, 0.01MG |
J9263 | 65 | HCPCS / CPT® | OXALIPLATIN |
J9264 | 65 | HCPCS / CPT® | PACLITAXEL PROTEIN BOUND |
J9266 | 65 | HCPCS / CPT® | PEGASPARGASE INJECTION |
J9267 | 65 | HCPCS / CPT® | PACLITAXEL INJECTION |
J9268 | 65 | HCPCS / CPT® | PENTOSTATIN INJECTION |
J9270 | 65 | HCPCS / CPT® | PLICAMYCIN (MITHRAMYCIN) INJ |
J9271 | 65 | HCPCS / CPT® | INJ PEMBROLIZUMAB |
J9280 | 65 | HCPCS / CPT® | MITOMYCIN INJECTION |
J9293 | 65 | HCPCS / CPT® | MITOXANTRONE HYDROCHL / 5 MG |
J9295 | 65 | HCPCS / CPT® | INJECTION, NECITUMUMAB, 1 MG |
J9299 | 65 | HCPCS / CPT® | INJECTION, NIVOLUMAB |
J9300 | 65 | HCPCS / CPT® | GEMTUZUMAB OZOGAMICIN INJ |
J9301 | 65 | HCPCS / CPT® | OBINUTUZUMAB INJ |
J9302 | 65 | HCPCS / CPT® | OFATUMUMAB INJECTION |
J9303 | 65 | HCPCS / CPT® | PANITUMUMAB INJECTION |
J9305 | 65 | HCPCS / CPT® | PEMETREXED INJECTION |
J9306 | 65 | HCPCS / CPT® | INJECTION, PERTUZUMAB, 1 MG |
J9307 | 65 | HCPCS / CPT® | PRALATREXATE INJECTION |
J9308 | 65 | HCPCS / CPT® | INJECTION, RAMUCIRUMAB |
J9310 | 65 | HCPCS / CPT® | RITUXIMAB INJECTION |
J9315 | 65 | HCPCS / CPT® | ROMIDEPSIN INJECTION |
J9320 | 65 | HCPCS / CPT® | STREPTOZOCIN INJECTION |
J9325 | 65 | HCPCS / CPT® | INJ TALIMOGENE LAHERPAREPVEC |
J9328 | 65 | HCPCS / CPT® | TEMOZOLOMIDE INJECTION |
J9330 | 65 | HCPCS / CPT® | TEMSIROLIMUS INJECTION |
J9340 | 65 | HCPCS / CPT® | THIOTEPA INJECTION |
J9351 | 65 | HCPCS / CPT® | TOPOTECAN INJECTION |
J9352 | 65 | HCPCS / CPT® | INJECTION TRABECTEDIN 0.1MG |
J9354 | 65 | HCPCS / CPT® | INJ, ADO-TRASTUZUMAB EMT 1MG |
J9355 | 65 | HCPCS / CPT® | TRASTUZUMAB INJECTION |
J9357 | 65 | HCPCS / CPT® | VALRUBICIN INJECTION |
J9360 | 65 | HCPCS / CPT® | VINBLASTINE SULFATE INJ |
J9370 | 65 | HCPCS / CPT® | VINCRISTINE SULFATE 1 MG INJ |
J9371 | 65 | HCPCS / CPT® | INJ, VINCRISTINE SUL LIP 1MG |
J9390 | 65 | HCPCS / CPT® | VINORELBINE TARTRATE INJ |
J9395 | 65 | HCPCS / CPT® | INJECTION, FULVESTRANT |
J9400 | 65 | HCPCS / CPT® | INJ, ZIV-AFLIBERCEPT, 1MG |
J9600 | 65 | HCPCS / CPT® | PORFIMER SODIUM INJECTION |
J9999 | 65 | HCPCS / CPT® | CHEMOTHERAPY DRUG |
K0001 | 0 | HCPCS / CPT® | STANDARD WHEELCHAIR |
K0002 | 0 | HCPCS / CPT® | STND HEMI (LOW SEAT) WHLCHR |
K0003 | 0 | HCPCS / CPT® | LIGHTWEIGHT WHEELCHAIR |
K0004 | 0 | HCPCS / CPT® | HIGH STRENGTH LTWT WHLCHR |
K0005 | 0 | HCPCS / CPT® | ULTRALIGHTWEIGHT WHEELCHAIR |
K0006 | 0 | HCPCS / CPT® | HEAVY DUTY WHEELCHAIR |
K0007 | 0 | HCPCS / CPT® | EXTRA HEAVY DUTY WHEELCHAIR |
K0008 | 0 | HCPCS / CPT® | CSTM MANUAL WHEELCHAIR/BASE |
K0009 | 0 | HCPCS / CPT® | OTHER MANUAL WHEELCHAIR/BASE |
K0010 | 0 | HCPCS / CPT® | STND WT FRAME POWER WHLCHR |