A9575 - Injection, gadoterate meglumine, 0.1 ml |
0.1 ML |
0.123 |
20% |
- |
- |
- |
- |
- |
|
|
A9576 - Injection, gadoteridol, (prohance multipack), per ml |
1 ML |
1.403 |
20% |
- |
- |
- |
- |
- |
|
|
A9577 - Injection, gadobenate dimeglumine (multihance), per ml |
1 ML |
1.819 |
20% |
- |
- |
- |
- |
- |
|
|
A9578 - Injection, gadobenate dimeglumine (multihance multipack), per ml |
1 ML |
1.821 |
20% |
- |
- |
- |
- |
- |
|
|
A9579 - Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1 ML |
1.531 |
20% |
- |
- |
- |
- |
- |
|
|
A9581 - Injection, gadoxetate disodium, 1 ml |
1 ML |
14.75 |
20% |
- |
- |
- |
- |
- |
|
|
A9585 - Injection, gadobutrol, 0.1 ml |
0.1 ML |
0.324 |
20% |
- |
- |
- |
- |
- |
|
|
A9589 - Instillation, hexaminolevulinate hydrochloride, 100 mg |
100 MG |
1265.417 |
20% |
- |
- |
- |
- |
- |
|
|
A9606 - Radium ra-223 dichloride, therapeutic, per microcurie |
1 microCurie |
N/A |
20% |
- |
- |
- |
- |
- |
|
|
J0121 - Injection, omadacycline, 1 mg |
1 MG |
3.604 |
20% |
- |
- |
- |
- |
- |
|
|
J0122 - Injection, eravacycline, 1 mg |
1 MG |
1.126 |
20% |
- |
- |
- |
- |
- |
|
|
J0129 - 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) |
10 MG |
42.7 |
20% |
- |
- |
- |
- |
- |
|
|
J0131 - Injection, acetaminophen, not otherwise specified,10 mg |
10 MG |
0.072 |
20% |
- |
- |
- |
- |
- |
|
|
J0132 - Injection, acetylcysteine, 100 mg |
100 MG |
0.653 |
20% |
- |
- |
- |
- |
- |
|
|
J0133 - Injection, acyclovir, 5 mg |
5 MG |
0.051 |
20% |
- |
- |
- |
- |
- |
|
|
J0134 - Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
10 MG |
0.05085316 |
20% |
- |
- |
- |
- |
- |
|
|
J0136 - Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
10 MG |
0.054 |
20% |
- |
- |
- |
- |
- |
|
|
J0137 - Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
10 MG |
0.067 |
20% |
- |
- |
- |
- |
- |
|
|
J0153 - Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
1 MG |
0.536 |
20% |
- |
- |
- |
- |
- |
|
|
J0171 - Injection, adrenalin, epinephrine, 0.1 mg |
0.1 MG |
0.78 |
20% |
- |
- |
- |
- |
- |
|
|
J0172 - Injection, aducanumab-avwa, 2 mg |
2 MG |
5.978 |
20% |
- |
- |
- |
- |
- |
|
|
J0173 - Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg |
0.1 MG |
1.706 |
20% |
- |
- |
- |
- |
- |
|
|
J0174 - Injection, lecanemab-irmb, 1 mg |
1 MG |
1.35 |
20% |
- |
- |
- |
- |
- |
|
|
J0178 - Injection, aflibercept, 1 mg |
1 MG |
868.241 |
20% |
- |
- |
- |
- |
- |
|
|
J0179 - Injection, brolucizumab-dbll, 1 mg |
1 MG |
319.249 |
20% |
- |
- |
- |
- |
- |
|
|