Effective April 1, 2023 through June 30, 2023
HCPCS | Description | Labeler name | NDC | Drug name | Dosage | Package size | Package quantity | Billable units | Billable units / pkg |
---|---|---|---|---|---|---|---|---|---|
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-01 | Clariscan | 0.1 ML | 10 | 10 | 100 | 1000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-02 | Clariscan | 0.1 ML | 15 | 10 | 150 | 1500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-05 | Clariscan | 0.1 ML | 20 | 10 | 200 | 2000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2000-00 | Dotarem | 0.1 ML | 5 | 10 | 50 | 500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2000-01 | Dotarem | 0.1 ML | 10 | 10 | 100 | 1000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2000-05 | Dotarem | 0.1 ML | 10 | 5 | 100 | 500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2000-06 | Dotarem | 0.1 ML | 15 | 5 | 150 | 750 |
A9575 |
Inj gadoterate meglumi 0.1ml | Guerbet, Llc | 67684-2001-00 | Dotarem | 0.1 ML | 5 | 10 | 50 | 500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2001-01 | Dotarem | 0.1 ML | 10 | 10 | 100 | 1000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2001-02 | Dotarem | 0.1 ML | 15 | 10 | 150 | 1500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2001-03 | Dotarem | 0.1 ML | 20 | 10 | 200 | 2000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-2001-04 | Dotarem | 0.1 ML | 100 | 6 | 1000 | 6000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-3001-01 | Dotarem | 0.1 ML | 10 | 10 | 100 | 1000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-3001-02 | Dotarem | 0.1 ML | 15 | 10 | 150 | 1500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GUERBET LLC | 67684-3001-03 | Dotarem | 0.1 ml | 20 mL 10 EA | 10 | 200 | 2000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-06 | Gadoterate Meglumine | 0.1 ML | 5 | 10 | 50 | 500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-12 | Gadoterate Meglumine | 0.1 ML | 10 | 10 | 100 | 1000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-17 | Gadoterate Meglumine | 0.1 ML | 15 | 10 | 150 | 1500 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-22 | Gadoterate Meglumine | 0.1 ML | 20 | 10 | 200 | 2000 |
A9575 |
Inj gadoterate meglumi 0.1ml | GE HEALTHCARE | 00407-2943-70 | Gadoterate Meglumine | 0.1 ML | 100 | 10 | 1000 | 10000 |
A9575 |
Inj gadoterate meglumi 0.1ml | FRESENIUS KABI USA, LLC | 65219-0080-05 | GADOTERATE MEGLUMINE | 0.1 ML | 5 | 10 | 50 | 500 |
A9575 |
Inj gadoterate meglumi 0.1ml | FRESENIUS KABI USA, LLC | 65219-0082-10 | GADOTERATE MEGLUMINE | 0.1 ML | 10 | 10 | 100 | 1000 |
A9575 |
Inj gadoterate meglumi 0.1ml | FRESENIUS KABI USA, LLC | 65219-0084-15 | GADOTERATE MEGLUMINE | 0.1 ML | 15 | 10 | 150 | 1500 |
A9575 |
Inj gadoterate meglumi 0.1ml | FRESENIUS KABI USA, LLC | 65219-0086-20 | GADOTERATE MEGLUMINE | 0.1 ML | 20 | 10 | 200 | 2000 |
A9575 |
Inj gadoterate meglumi 0.1ml | FRESENIUS KABI USA, LLC | 65219-0088-50 | GADOTERATE MEGLUMINE | 0.1 ML | 100 | 6 | 1000 | 6000 |
A9576 |
Inj prohance multipack | BRACCO DIAGNOSTICS | 00270-1111-70 | Prohance Multipack | 1 ML | 50 | 5 | 50 | 250 |
A9577 |
Inj multihance | BRACCO DIAGNOSTICS | 00270-5164-12 | Multihance | 1 ML | 5 | 5 | 5 | 25 |
A9577 |
Inj multihance | BRACCO DIAGNOSTICS | 00270-5164-13 | Multihance | 1 ML | 10 | 5 | 10 | 50 |
A9577 |
Inj multihance | BRACCO DIAGNOSTICS | 00270-5164-14 | Multihance | 1 ML | 15 | 5 | 15 | 75 |
A9577 |
Inj multihance | BRACCO DIAGNOSTICS | 00270-5164-15 | Multihance | 1 ML | 20 | 5 | 20 | 100 |
A9578 |
Inj multihance multipack | BRACCO DIAGNOSTICS | 00270-5264-16 | Multihance Multipack | 1 ML | 50 | 5 | 50 | 250 |
A9578 |
Inj multihance multipack | BRACCO DIAGNOSTICS | 00270-5264-17 | Multihance Multipack | 1 ML | 100 | 5 | 100 | 500 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-05 | Omniscan | 1 ML | 5 | 10 | 5 | 50 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-10 | Omniscan | 1 ML | 10 | 10 | 10 | 100 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-12 | Omniscan | 1 ML | 10 | 10 | 10 | 100 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-15 | Omniscan | 1 ML | 15 | 10 | 15 | 150 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-17 | Omniscan | 1 ML | 15 | 10 | 15 | 150 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-20 | Omniscan | 1 ML | 20 | 10 | 20 | 200 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-22 | Omniscan | 1 ML | 20 | 10 | 20 | 200 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0690-70 | Omniscan | 1 ML | 100 | 10 | 100 | 1000 |
A9579 |
Gad-base mr contrast nos,1ml | GE HEALTHCARE | 00407-0691-62 | Omniscan | 1 ML | 15 | 10 | 15 | 150 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-01 | Magnevist 46.9% | 1 ML | 10 | 20 | 10 | 200 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-02 | Magnevist 46.9% | 1 ML | 20 | 20 | 20 | 400 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-05 | Magnevist 46.9% | 1 ML | 5 | 20 | 5 | 100 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-11 | Magnevist 46.9% | 1 ML | 100 | 10 | 100 | 1000 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-15 | Magnevist 46.9% | 1 ML | 15 | 20 | 15 | 300 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-36 | Magnevist 46.9% | 1 ML | 10 | 5 | 10 | 50 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-37 | Magnevist 46.9% | 1 ML | 15 | 5 | 15 | 75 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-38 | Magnevist 46.9% | 1 ML | 20 | 5 | 20 | 100 |
A9579 |
Gad-base mr contrast nos,1ml | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0188-58 | Magnevist 46.9% | 1 ML | 50 | 10 | 50 | 500 |
HCPCS | Description | Labeler name | NDC | Drug name | Dosage | Package size | Package quantity | Billable units | Billable units / pkg |
---|---|---|---|---|---|---|---|---|---|
P9041 |
Albumin (human),5%, 50ml | Octapharma USA | 68982-0623-01 | Albumin (Human) | 50 ML | 100 | 1 | 2 | 2 |
P9041 |
Albumin (human),5%, 50ml | Grifols | 68516-5214-05 | Albutein 5% | 50 ML | 50 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Grifols | 68516-5214-02 | Albutein® 5% Albumin 500 ml | 250 ML | 500 | 1 | 2 | 2 |
P9045 |
Albumin (human), 5%, 250 ml | Kedrion Biopharma | 76125-0790-25 | Albuked 5 | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Talecris | 13533-0685-20 | Plasbumin-5 | 250 ML | 50 | 1 | 0.2 | 0.2 |
P9045 |
Albumin (human), 5%, 250 ml | Talecris | 13533-0685-25 | Plasbumin-5 | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Talecris | 13533-0690-20 | Plasbumin-5 | 250 ML | 50 | 1 | 0.2 | 0.2 |
P9045 |
Albumin (human), 5%, 250 ml | Talecris | 13533-0690-25 | Plasbumin-5 | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Octapharma USA | 68982-0623-02 | Albumin (Human) | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Octapharma USA | 68982-0623-03 | Albumin (Human) | 250 ML | 500 | 1 | 2 | 2 |
P9045 |
Albumin (human), 5%, 250 ml | CSL Behring | 00053-7670-31 | Albuminar-5 | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | CSL Behring | 00053-7670-32 | Albuminar-5 | 250 ML | 500 | 1 | 2 | 2 |
P9045 |
Albumin (human), 5%, 250 ml | Bio Products Laboratory USA, Inc. | 64208-2510-01 | ALBUMINEX 5% | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Bio Products Laboratory USA, Inc. | 64208-2510-05 | ALBUMINEX 5% | 250 ML | 500 | 1 | 2 | 2 |
P9045 |
Albumin (human), 5%, 250 ml | CSL Behring | 44206-0310-25 | Alburx | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | CSL Behring | 44206-0310-50 | Alburx | 250 ML | 500 | 1 | 2 | 2 |
P9045 |
Albumin (human), 5%, 250 ml | Grifols | 68516-5214-01 | Albutein® 5% | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Baxter | 00944-0491-01 | Buminate | 250 ML | 250 | 1 | 1 | 1 |
P9045 |
Albumin (human), 5%, 250 ml | Baxter | 00944-0491-02 | Buminate | 250 ML | 500 | 1 | 2 | 2 |
P9046 |
Albumin (human), 25%, 20 ml | Grifols | 68516-5216-05 | Albutein 25% | 20 ML | 20 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Kedrion Biopharma | 76125-0784-10 | Albuked 25 | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Kedrion Biopharma | 76125-0784-25 | Albuked 25 | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Grifols | 68516-5216-01 | Albutein® 25% | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Grifols | 68516-5216-02 | Albutein® 25% Albumin 100 ml | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Baxter | 00944-0490-01 | Buminate | 50 ML | 20 | 1 | 0.4 | 0.4 |
P9047 |
Albumin (human), 25%, 50ml | Baxter | 00944-0493-01 | Flexbumin | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Baxter | 00944-0493-02 | Flexbumin | 50 ML | 100 | 1 | 1 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Grifols | 61953-0002-01 | Human Albumin Grifols | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Grifols | 61953-0002-02 | Human Albumin Grifols | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Kedrion Biopharma | 76179-0025-01 | Kedbumin | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Kedrion Biopharma | 76179-0025-02 | Kedbumin | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Kedrion Biopharma | 76179-0025-04 | Kedbumin | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Talecris | 13533-0684-16 | Plasbumin-25 | 50 ML | 20 | 1 | 0.4 | 0.4 |
P9047 |
Albumin (human), 25%, 50ml | Talecris | 13533-0684-20 | Plasbumin-25 | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Talecris | 13533-0684-71 | Plasbumin-25 | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Talecris | 13533-0692-16 | Plasbumin-25 | 50 ML | 20 | 1 | 0.4 | 0.4 |
P9047 |
Albumin (human), 25%, 50ml | Talecris | 13533-0692-20 | Plasbumin-25 | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Talecris | 13533-0692-71 | Plasbumin-25 | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | CSL Behring | 44206-0251-05 | Alburx | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | CSL Behring | 44206-0251-10 | Alburx | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Grifols | 68516-5216-07 | Albutein | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Grifols | 68516-5216-08 | Albutein | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Bio Products Laboratory USA, Inc. | 64208-2512-03 | ALBUMINEX 25% | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Bio Products Laboratory USA, Inc. | 64208-2512-07 | ALBUMINEX 25% | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | Octapharma USA | 68982-0643-01 | Albumin (Human) | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | Octapharma USA | 68982-0643-02 | Albumin (Human) | 50 ML | 100 | 1 | 2 | 2 |
P9047 |
Albumin (human), 25%, 50ml | CSL Behring | 00053-7680-32 | Albuminar-25 | 50 ML | 50 | 1 | 1 | 1 |
P9047 |
Albumin (human), 25%, 50ml | CSL Behring | 00053-7680-33 | Albuminar-25 | 50 ML | 100 | 1 | 2 | 2 |
Description | Labeler name | NDC | Drug name | Dosage | Package size | Package quantity | Billable units | Billable units / pkg |
---|---|---|---|---|---|---|---|---|
Alfentanil Hcl | AKORN | 17478-0067-02 | ALFENTA | 500 MCG | 2 | 10 | 2 | 20 |
Alfentanil Hcl | AKORN | 17478-0067-05 | Alfenta | 500 MCG | 5 | 10 | 5 | 50 |
Allopurinol Sodium | FRESENIUS KABI USA, LLC | 65219-0380-30 | Allopurinol | 500 MG | 1 | 1 | 1 | 1 |
Allopurinol Sodium | HIKMA PHARMACEUTICALS USA INC. | 00143-9533-01 | Allopurinol Sodium | 500 MG | 1 | 1 | 1 | 1 |
Allopurinol Sodium | MYLAN INSTITUTIONAL LLC | 67457-0187-50 | Aloprim | 500 MG | 1 | 1 | 1 | 1 |
Allopurinol Sodium | MYLAN INSTITUTIONAL LLC | 67457-0978-50 | Aloprim | 500 MG | 1 | 1 | 1 | 1 |
Aminocaproic acid | AMERICAN REGENT | 00517-9191-25 | Aminocaproic Acid | 250 MG | 20 | 25 | 20 | 500 |
Aminocaproic acid | CIVICA INC | 72572-0015-25 | Aminocaproic Acid | 250 MG | 20 | 25 | 20 | 500 |
Aminocaproic acid | PFIZER INC. | 00409-4346-73 | AMINOCAPROIC ACID INJ | 250 MG | 20 | 25 | 20 | 500 |
Aztreonam | BRISTOL-MYERS SQUIBB COMPANY | 00003-2560-16 | AZACTAM | 500 MG | 1 | 10 | 2 | 20 |
Aztreonam | BRISTOL-MYERS SQUIBB COMPANY | 00003-2570-16 | AZACTAM | 500 MG | 1 | 10 | 4 | 40 |
Aztreonam | FRESENIUS KABI | 63323-0401-20 | Aztreonam | 500 MG | 1 | 10 | 2 | 20 |
Aztreonam | FRESENIUS KABI | 63323-0401-24 | Aztreonam | 500 MG | 1 | 10 | 2 | 20 |
Aztreonam | FRESENIUS KABI | 63323-0401-26 | Aztreonam | 500 MG | 1 | 10 | 2 | 20 |
Aztreonam | FRESENIUS KABI | 63323-0402-20 | Aztreonam | 500 MG | 1 | 10 | 4 | 40 |
Aztreonam | FRESENIUS KABI | 63323-0402-24 | Aztreonam | 500 MG | 1 | 10 | 4 | 40 |
Aztreonam | FRESENIUS KABI | 63323-0402-30 | Aztreonam | 500 MG | 1 | 10 | 4 | 40 |
Esmolol Hydrochloride | BAXTER | 10019-0075-87 | Brevibloc | 10 MG | 100 | 1 | 200 | 200 |
Esmolol Hydrochloride | BAXTER | 10019-0115-01 | Brevibloc | 10 MG | 10 | 25 | 10 | 250 |
Esmolol Hydrochloride | BAXTER | 10019-0666-10 | BREVIBLOC | 10 MG | 100 | 10 | 200 | 2000 |
Esmolol Hydrochloride | BAXTER | 10019-0668-10 | BREVIBLOC | 10 MG | 100 | 10 | 200 | 2000 |
Esmolol Hydrochloride | BAXTER | 10019-0670-10 | BREVIBLOC | 10 MG | 250 | 10 | 250 | 2500 |
Esmolol Hydrochloride | BAXTER | 10019-0672-10 | BREVIBLOC | 10 MG | 250 | 10 | 250 | 2500 |
Esmolol Hydrochloride | BAXTER | 10019-0055-61 | Brevibloc In Nacl | 10 MG | 250 | 1 | 250 | 250 |
Bumetanide | PFIZER INC. | 00409-1412-04 | Bumetanide | 0.25 MG | 4 | 10 | 4 | 40 |
Bumetanide | PFIZER INC. | 00409-1412-10 | Bumetanide | 0.25 MG | 10 | 10 | 10 | 100 |
Bumetanide | HIKMA PHARMACEUTICALS USA INC. | 00641-6007-10 | Bumetanide | 0.25 MG | 10 | 10 | 10 | 100 |
Bumetanide | HIKMA PHARMACEUTICALS USA INC. | 00641-6008-10 | Bumetanide | 0.25 MG | 4 | 10 | 4 | 40 |
Bumetanide | HIKMA PHARMACEUTICALS USA INC. | 00641-6161-10 | Bumetanide | 0.25 MG | 4 | 10 | 4 | 40 |
Bumetanide | HIKMA PHARMACEUTICALS USA INC. | 00641-6162-10 | Bumetanide | 0.25 MG | 10 | 10 | 10 | 100 |
Bumetanide | ATHENEX PHARMACEUTICAL | 70860-0405-04 | Bumetanide | 0.25 MG | 4 | 10 | 4 | 40 |
Bumetanide | ATHENEX PHARMACEUTICAL | 70860-0406-10 | Bumetanide | 0.25 MG | 10 | 10 | 10 | 100 |
Bumetanide | CIVICA, INC. | 72572-0040-10 | Bumetanide | 0.25 MG | 4 | 10 | 4 | 40 |
Bumetanide | CIVICA, INC. | 72572-0041-10 | Bumetanide | 0.25 MG | 10 | 10 | 10 | 100 |
Bupivacaine | Hikma Pharmaceuticals Usa | 00143-9328-10 | Bupivacaine HCl | 1 ML | 50 | 10 | 50 | 500 |
Bupivacaine | HIKMA PHARMACEUTICALS USA INC. | 00143-9330-10 | BUPIVACAINE HCL | 1 ML | 10 | 10 | 10 | 100 |
Bupivacaine | HIKMA PHARMACEUTICALS USA INC. | 00143-9331-10 | BUPIVACAINE HCL | 1 ML | 10 | 10 | 10 | 100 |
Bupivacaine | AUROMEDICS PHARMA, LLC | 00143-9332-10 | BUPIVACAINE HCL | 1 ML | 10 | 10 | 10 | 100 |
Bupivacaine | HIKMA PHARMACEUTICALS USA INC. | 00143-9333-10 | Bupivacaine HCl | 1 ML | 30 | 10 | 30 | 300 |
Bupivacaine | HIKMA PHARMACEUTICALS USA INC. | 00143-9334-10 | Bupivacaine HCl | 1 ML | 30 | 10 | 30 | 300 |
Bupivacaine | HIKMA PHARMACEUTICALS USA INC. | 00143-9335-10 | Bupivacaine HCl | 1 ML | 30 | 10 | 30 | 300 |
Bupivacaine | PFIZER INC. | 00409-1159-01 | Bupivacaine Hcl | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | PFIZER INC. | 00409-1159-10 | Bupivacaine HCl | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | PFIZER INC. | 00409-1160-01 | Bupivacaine Hcl | 1 ML | 50 | 25 | 50 | 1250 |
Bupivacaine | PFIZER INC. | 00409-1162-01 | Bupivacaine Hcl | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | PFIZER INC. | 00409-1162-10 | Bupivacaine Hcl | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | PFIZER INC. | 00409-1163-01 | Bupivacaine Hcl | 1 ML | 50 | 25 | 50 | 1250 |
Bupivacaine | PFIZER INC. | 00409-1165-02 | Bupivacaine Hcl | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | PFIZER INC. | 00409-1582-10 | Bupivacaine HCl | 1 ML | 10 | 10 | 5 | 50 |
Bupivacaine | BAXTER | 36000-0092-10 | Bupivacaine Hcl | 1 ML | 2 | 10 | 2 | 20 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0167-10 | Bupivacaine HCl | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0168-30 | Bupivacaine HCl | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0169-10 | Bupivacaine HCl | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0170-30 | Bupivacaine HCl | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0171-10 | Bupivacaine HCl | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0172-30 | Bupivacaine HCl | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0249-50 | Bupivacaine Hcl | 1 ML | 50 | 25 | 50 | 1250 |
Bupivacaine | AUROMEDICS PHARMA LLC | 55150-0250-50 | Bupivacaine Hcl | 1 ML | 50 | 25 | 50 | 1250 |
Bupivacaine | PFIZER INC. | 00409-1159-02 | BUPIVICAINE HCL | 1 ML | 30 | 25 | 30 | 750 |
Carmustine (Accord) | ACCORD HEALTHCARE INC. | 16729-0545-63 | Carmustine | 100 MG | 1 | 1 | 0.5 | 0.5 |
Carmustine (Accord) | ACCORD HEALTHCARE | 16729-0548-63 | CARMUSTINE | 100 MG | 1 | 1 | 3 | 3 |
Clindamycin Phosphate | PFIZER INC. | 00009-0728-09 | Cleocin | 150 MG | 60 | 5 | 1 | 5 |
Clindamycin Phosphate | PFIZER INC. | 00009-0775-26 | Cleocin | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | PFIZER INC. | 00009-0870-26 | Cleocin | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | PFIZER INC. | 00009-0902-18 | Cleocin | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | PFIZER INC. | 00009-3051-02 | Cleocin | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | PFIZER INC. | 00009-4073-04 | Cleocin | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | PFIZER INC. | 00009-5095-06 | Cleocin | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | BAXTER | 00338-3616-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 4 | 96 |
Clindamycin Phosphate | BAXTER | 00338-4114-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 6 | 144 |
Clindamycin Phosphate | BAXTER | 00338-9545-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 2 | 48 |
Clindamycin Phosphate | BAXTER | 00338-9549-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 4 | 96 |
Clindamycin Phosphate | BAXTER | 00338-9553-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 6 | 144 |
Clindamycin Phosphate | SANDOZ | 00781-9220-09 | Clindamycin in D5W | 150 MG | 50 | 24 | 2 | 48 |
Clindamycin Phosphate | SANDOZ | 00781-9221-09 | Clindamycin in D5W | 150 MG | 50 | 24 | 4 | 96 |
Clindamycin Phosphate | SANDOZ | 00781-9222-09 | Clindamycin in D5W | 150 MG | 50 | 24 | 6 | 144 |
Clindamycin Phosphate | Civica | 72572-0074-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 4 | 96 |
Clindamycin Phosphate | Civica | 72572-0076-24 | Clindamycin in D5W | 150 MG | 50 | 24 | 6 | 144 |
Clindamycin Phosphate | PFIZER INC. | 00009-0302-25 | Clindamycin Phosphate | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | PFIZER INC. | 00009-0602-25 | Clindamycin Phosphate | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | PFIZER INC. | 00009-0901-25 | Clindamycin Phosphate | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | BAXTER | 00338-3410-24 | Clindamycin Phosphate | 150 MG | 50 | 24 | 2 | 48 |
Clindamycin Phosphate | BAXTER | 00338-3612-24 | Clindamycin Phosphate | 150 MG | 50 | 24 | 4 | 96 |
Clindamycin Phosphate | BAXTER | 00338-3814-24 | Clindamycin Phosphate | 150 MG | 50 | 24 | 6 | 144 |
Clindamycin Phosphate | SANDOZ | 00781-3288-09 | Clindamycin Phosphate | 150 MG | 50 | 24 | 2 | 48 |
Clindamycin Phosphate | SANDOZ | 00781-3289-09 | Clindamycin Phosphate | 150 MG | 50 | 24 | 4 | 96 |
Clindamycin Phosphate | SANDOZ | 00781-3290-09 | Clindamycin Phosphate | 150 MG | 50 | 24 | 6 | 144 |
Clindamycin Phosphate | SAGENT PHARMACEUTICALS INC | 25021-0115-02 | Clindamycin Phosphate | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | SAGENT PHARMACEUTICALS INC | 25021-0115-04 | Clindamycin Phosphate | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | SAGENT PHARMACEUTICALS INC | 25021-0115-06 | Clindamycin Phosphate | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | SAGENT PHARMACEUTICALS INC | 25021-0115-51 | Clindamycin Phosphate | 150 MG | 60 | 1 | 60 | 60 |
Clindamycin Phosphate | ALVOGEN | 47781-0459-68 | Clindamycin Phosphate | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | ALVOGEN | 47781-0460-68 | Clindamycin Phosphate | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | ALVOGEN | 47781-0461-68 | Clindamycin Phosphate | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | ALVOGEN | 47781-0465-70 | Clindamycin Phosphate | 150 MG | 60 | 1 | 60 | 60 |
Clindamycin Phosphate | ALVOGEN | 47781-0619-69 | Clindamycin Phosphate | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | ALVOGEN | 47781-0620-69 | Clindamycin Phosphate | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | ALVOGEN | 47781-0621-69 | Clindamycin Phosphate | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | MYLAN INSTITUTIONAL LLC | 67457-0814-02 | Clindamycin Phosphate | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | MYLAN INSTITUTIONAL LLC | 67457-0815-04 | Clindamycin Phosphate | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | MYLAN INSTITUTIONAL LLC | 67457-0816-06 | Clindamycin Phosphate | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | ALMAJECT | 72611-0634-25 | Clindamycin Phosphate | 150 MG | 2 | 25 | 2 | 50 |
Clindamycin Phosphate | ALMAJECT | 72611-0639-25 | Clindamycin Phosphate | 150 MG | 4 | 25 | 4 | 100 |
Clindamycin Phosphate | ALMAJECT | 72611-0642-25 | Clindamycin Phosphate | 150 MG | 6 | 25 | 6 | 150 |
Clindamycin Phosphate | ALMAJECT | 72611-0645-55 | Clindamycin Phosphate | 150 MG | 60 | 5 | 60 | 300 |
Diltiazem Hydrochloride | HIKMA PHARMACEUTICALS USA INC. | 00641-6013-10 | Diltiazem Hcl | 5 MG | 5 | 10 | 5 | 50 |
Diltiazem Hydrochloride | HIKMA PHARMACEUTICALS USA INC. | 00641-6014-10 | Diltiazem Hcl | 5 MG | 10 | 10 | 10 | 100 |
Diltiazem Hydrochloride | HIKMA PHARMACEUTICALS USA INC. | 00641-6015-10 | Diltiazem Hcl | 5 MG | 25 | 10 | 25 | 250 |
Diltiazem Hydrochloride | HIKMA PHARMACEUTICALS USA INC. | 00641-9217-10 | Diltiazem Hcl | 5 MG | 5 | 10 | 5 | 50 |
Diltiazem Hydrochloride | HIKMA PHARMACEUTICALS USA INC. | 00641-9218-10 | Diltiazem Hcl | 5 MG | 10 | 10 | 10 | 100 |
Diltiazem Hydrochloride | HIKMA PHARMACEUTICALS USA INC. | 00641-9219-10 | Diltiazem Hcl | 5 MG | 25 | 10 | 25 | 250 |
Diltiazem Hydrochloride | AKORN | 17478-0937-05 | Diltiazem Hcl | 5 MG | 5 | 10 | 5 | 50 |
Diltiazem Hydrochloride | AKORN | 17478-0937-10 | Diltiazem Hcl | 5 MG | 10 | 10 | 10 | 100 |
Diltiazem Hydrochloride | AKORN | 17478-0937-25 | Diltiazem Hcl | 5 MG | 25 | 10 | 25 | 25 |
Diltiazem Hydrochloride | AKORN | 17478-0937-26 | Diltiazem Hcl | 5 MG | 25 | 10 | 25 | 250 |
Diltiazem Hydrochloride | ATHENEX | 70860-0301-05 | Diltiazem HCl | 5 MG | 5 | 10 | 5 | 50 |
Diltiazem Hydrochloride | ATHENEX | 70860-0301-10 | Diltiazem HCl | 5 MG | 10 | 10 | 10 | 100 |
Diltiazem Hydrochloride | ATHENEX | 70860-0301-25 | Diltiazem HCl | 5 MG | 25 | 10 | 25 | 250 |
Doxycycline Hyclate | HIKMA PHARMACEUTICALS USA INC. | 00143-9381-10 | Doxycycline Hyclate | 100 MG | 1 | 10 | 1 | 10 |
Doxycycline Hyclate | FRESENIUS KABI | 63323-0130-11 | Doxycycline Hyclate | 100 MG | 1 | 10 | 1 | 10 |
Doxycycline Hyclate | FRESENIUS KABI | 63323-0130-13 | Doxycycline Hyclate | 100 MG | 1 | 10 | 1 | 10 |
Doxycycline Hyclate | FRESENIUS KABI | 63323-0130-17 | Doxycycline Hyclate | 100 MG | 1 | 10 | 1 | 10 |
Doxycycline Hyclate | MYLAN INSTITUTIONAL LLC | 67457-0437-10 | Doxycycline Hyclate | 100 MG | 1 | 10 | 1 | 10 |
Doxycycline Hyclate | ZYDUS PHARMACEUTICALS | 68382-0910-10 | Doxycycline Hyclate | 100 MG | 1 | 10 | 1 | 10 |
Esmolol Hydrochloride | BAXTER | 10019-0120-01 | Esmolol HCl | 10 MG | 10 | 25 | 10 | 250 |
Esmolol Hydrochloride | SAGENT PHARMACEUTICALS INC | 25021-0308-84 | Esmolol HCl | 10 MG | 250 | 10 | 250 | 2500 |
Esmolol Hydrochloride | SAGENT PHARMACEUTICALS INC | 25021-0309-82 | Esmolol HCl | 10 MG | 100 | 10 | 200 | 2000 |
Esmolol Hydrochloride | SAGENT PHARMACEUTICALS INC | 25021-0314-10 | Esmolol HCl | 10 MG | 10 | 10 | 10 | 100 |
Esmolol Hydrochloride | WG CRITICAL CARE | 44567-0811-10 | Esmolol HCl | 10 MG | 250 | 10 | 250 | 2500 |
Esmolol Hydrochloride | WG CRITICAL CARE | 44567-0812-10 | Esmolol Hcl | 10 MG | 100 | 10 | 200 | 2000 |
Esmolol Hydrochloride | AUROMEDICS PHARMA LLC | 55150-0194-10 | Esmolol Hcl | 10 MG | 10 | 25 | 10 | 250 |
Esmolol Hydrochloride | AUROMEDICS PHARMA | 55150-0420-10 | Esmolol HCl | 10 MG | 250 | 10 | 250 | 2500 |
Esmolol Hydrochloride | AUROMEDICS PHARMA | 55150-0421-10 | Esmolol HCl | 10 MG | 100 | 10 | 200 | 2000 |
Esmolol Hydrochloride | FRESENIUS KABI | 63323-0652-10 | Esmolol Hcl | 10 MG | 10 | 25 | 10 | 250 |
Esmolol Hydrochloride | MYLAN INSTITUTIONAL LLC | 67457-0182-10 | Esmolol Hcl | 10 MG | 10 | 10 | 10 | 100 |
Esmolol Hydrochloride | MYLAN INSTITUTIONAL LLC | 67457-0657-25 | Esmolol HCl | 10 MG | 250 | 10 | 250 | 2500 |
Esmolol Hydrochloride | MYLAN INSTITUTIONAL LLC | 67457-0658-10 | Esmolol Hcl | 10 MG | 100 | 10 | 200 | 2000 |
Famotidine | HIKMA PHARMACEUTICALS USA INC. | 00641-6021-10 | Famotidine | 10 MG | 20 | 10 | 20 | 200 |
Famotidine | HIKMA PHARMACEUTICALS USA INC. | 00641-6022-25 | Famotidine | 10 MG | 2 | 25 | 2 | 50 |
Famotidine | HIKMA PHARMACEUTICALS USA INC. | 00641-6023-25 | Famotidine | 10 MG | 4 | 25 | 4 | 100 |
Famotidine | FRESENIUS KABI | 63323-0738-09 | Famotidine | 10 MG | 4 | 10 | 4 | 40 |
Famotidine | FRESENIUS KABI | 63323-0738-20 | Famotidine | 10 MG | 20 | 10 | 20 | 200 |
Famotidine | FRESENIUS KABI | 63323-0739-12 | Famotidine | 10 MG | 2 | 25 | 2 | 50 |
Famotidine | FRESENIUS KABI | 63323-0739-16 | Famotidine | 10 MG | 2 | 25 | 2 | 50 |
Famotidine | MYLAN INSTITUTIONAL LLC | 67457-0448-43 | Famotidine | 10 MG | 4 | 10 | 4 | 40 |
Famotidine | MYLAN INSTITUTIONAL LLC | 67457-0457-20 | Famotidine | 10 MG | 20 | 10 | 20 | 200 |
Famotidine | ATHENEX | 70860-0751-02 | Famotidine | 10 MG | 2 | 25 | 2 | 50 |
Famotidine | ATHENEX | 70860-0753-20 | Famotidine | 10 MG | 20 | 10 | 20 | 200 |
Famotidine | BAXTER | 00338-5197-41 | Famotidine Premixed | 10 MG | 50 | 12 | 2 | 24 |
Insulin aspart (Fiasp) administration through dme (i.e., insulin pump) | NOVO NORDISK INC | 00169-3201-11 | Fiasp | 50 UNITS | 10 | 1 | 20 | 20 |
Insulin aspart (Fiasp) administration through dme (i.e., insulin pump) | NOVO NORDISK INC | 00169-3204-15 | Fiasp FlexTouch | 50 UNITS | 3 | 5 | 6 | 30 |
Insulin aspart (Fiasp) administration through dme (i.e., insulin pump) | NOVO NORDISK INC | 00169-3205-15 | Fiasp Penfill | 50 UNITS | 3 | 5 | 6 | 30 |
Flumazenil | HIKMA PHARMACEUTICALS USA INC. | 00143-9683-10 | Flumazenil | 0.1 MG | 10 | 10 | 10 | 100 |
Flumazenil | HIKMA PHARMACEUTICALS USA INC. | 00143-9684-10 | Flumazenil | 0.1 MG | 5 | 10 | 5 | 50 |
Flumazenil | HIKMA PHARMACEUTICALS USA INC. | 00143-9783-10 | Flumazenil | 0.1 MG | 10 | 10 | 10 | 100 |
Flumazenil | HIKMA PHARMACEUTICALS USA INC. | 00143-9784-10 | Flumazenil | 0.1 MG | 5 | 10 | 5 | 50 |
Flumazenil | BAXTER | 36000-0148-10 | Flumazenil | 0.1 MG | 5 | 10 | 5 | 50 |
Flumazenil | BAXTER | 36000-0149-10 | Flumazenil | 0.1 MG | 10 | 10 | 10 | 100 |
Flumazenil | FRESENIUS KABI | 63323-0424-05 | Flumazenil | 0.1 MG | 5 | 10 | 5 | 50 |
Flumazenil | FRESENIUS KABI | 63323-0424-10 | Flumazenil | 0.1 MG | 10 | 1 | 10 | 10 |
Folic Acid | X-GEN PHARMACEUTICALS INC | 39822-1100-01 | Folic Acid | 5 MG | 10 | 1 | 10 | 10 |
Folic Acid | FRESENIUS KABI | 63323-0184-10 | Folic Acid | 5 MG | 10 | 1 | 10 | 10 |
Furosemide (Phlow Corporation) | PHLOW CORPORATION | 81565-0201-02 | Furosemide | 20 MG | 2 | 25 | 1 | 25 |
Glycopyrrolate injection | AMERICAN REGENT | 00517-4601-25 | Glycopyrrolate | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | AMERICAN REGENT | 00517-4602-25 | Glycopyrrolate | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | AMERICAN REGENT | 00517-4605-25 | Glycopyrrolate | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | AMERICAN REGENT | 00517-4620-25 | Glycopyrrolate | 0.2 MG | 20 | 25 | 20 | 500 |
Glycopyrrolate injection (Fresenius Kabi) | Fresenius Kabi USA, LLC | 76045-0023-30 | Glycopyrrolate | 0.2 MG | 3 | 10 | 3 | 30 |
Glycopyrrolate injection | FRESENIUS KABI | 63323-0578-11 | Glycopyrrolate (injection) | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | FRESENIUS KABI | 63323-0578-12 | Glycopyrrolate (injection) | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9584-10 | Glycopyrrolate INJECTION | 0.2 MG | 20 | 10 | 20 | 200 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9585-25 | Glycopyrrolate INJECTION | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9586-25 | Glycopyrrolate INJECTION | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9587-25 | Glycopyrrolate INJECTION | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9679-10 | Glycopyrrolate INJECTION | 0.2 MG | 20 | 10 | 20 | 200 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9680-25 | Glycopyrrolate INJECTION | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9681-25 | Glycopyrrolate INJECTION | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9682-25 | Glycopyrrolate INJECTION | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | SANDOZ | 00781-3825-96 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | SANDOZ | 00781-3827-96 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | SANDOZ | 00781-3829-96 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | SANDOZ | 00781-3831-95 | Glycopyrrolate Injection | 0.2 MG | 20 | 10 | 20 | 200 |
Glycopyrrolate injection | A-S MEDICATION SOLUTIONS | 50090-5226-00 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | AUROMEDICS PHARMA LLC | 55150-0292-01 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | AUROMEDICS PHARMA LLC | 55150-0293-02 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | AUROMEDICS PHARMA LLC | 55150-0294-05 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | AUROMEDICS PHARMA LLC | 55150-0295-20 | Glycopyrrolate Injection | 0.2 MG | 20 | 25 | 20 | 500 |
Glycopyrrolate injection | APOTEX CORP. | 60505-6179-05 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | APOTEX CORP. | 60505-6180-05 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | APOTEX CORP. | 60505-6181-05 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | APOTEX CORP. | 60505-6182-04 | Glycopyrrolate Injection | 0.2 MG | 20 | 10 | 20 | 200 |
Glycopyrrolate injection | FRESENIUS KABI | 63323-0578-01 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | FRESENIUS KABI | 63323-0578-02 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | FRESENIUS KABI | 63323-0578-05 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | PIRAMAL CRITICAL CARE | 66794-0202-42 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | PIRAMAL CRITICAL CARE | 66794-0203-42 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | PIRAMAL CRITICAL CARE | 66794-0204-42 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | PIRAMAL CRITICAL CARE | 66794-0205-41 | Glycopyrrolate Injection | 0.2 MG | 20 | 10 | 20 | 200 |
Glycopyrrolate injection | AMERICAN HEALTH PACKAGING | 68001-0351-60 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | AMERICAN HEALTH PACKAGING | 68001-0352-71 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | AMERICAN HEALTH PACKAGING | 68001-0353-72 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | AMNEAL BIOSCIENCES | 70121-1394-05 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | AMNEAL BIOSCIENCES | 70121-1395-05 | Glycopyrrolate Injection | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | AMNEAL BIOSCIENCES | 70121-1396-05 | Glycopyrrolate Injection | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | AMNEAL BIOSCIENCES | 70121-1397-07 | Glycopyrrolate Injection | 0.2 MG | 20 | 10 | 20 | 200 |
Glycopyrrolate injection | BE PHARMACEUTICALS, INC. | 71839-0123-25 | Glycopyrrolate INJECTION | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | BE PHARMACEUTICALS, INC. | 71839-0124-25 | Glycopyrrolate INJECTION | 0.2 MG | 2 | 25 | 2 | 50 |
Glycopyrrolate injection | BE PHARMACEUTICALS, INC. | 71839-0125-25 | Glycopyrrolate INJECTION | 0.2 MG | 5 | 25 | 5 | 125 |
Glycopyrrolate injection | CIVICA INC | 72572-0225-25 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | CIVICA INC | 72572-0226-25 | Glycopyrrolate Injection | 0.2 MG | 1 | 25 | 1 | 25 |
Glycopyrrolate injection | FRESENIUS KABI | 76045-0203-10 | Glycopyrrolate Injection | 0.2 MG | 1 | 24 | 1 | 24 |
Glycopyrrolate injection | FRESENIUS KABI | 76045-0203-20 | Glycopyrrolate Injection | 0.2 MG | 2 | 24 | 2 | 48 |
Paliperidone Palmitate (Invega Trinza) | JANSSEN PHARMACEUTICALS, INC. | 50458-0606-01 | INVEGA TRINZA | 1 MG | 0.875 | 1 | 273 | 273 |
Paliperidone Palmitate (Invega Trinza) | JANSSEN PHARMACEUTICALS, INC. | 50458-0607-01 | INVEGA TRINZA | 1 MG | 1.315 | 1 | 410 | 410 |
Paliperidone Palmitate (Invega Trinza) | JANSSEN PHARMACEUTICALS, INC. | 50458-0608-01 | INVEGA TRINZA | 1 MG | 1.75 | 1 | 546 | 546 |
Paliperidone Palmitate (Invega Trinza) | JANSSEN PHARMACEUTICALS, INC. | 50458-0609-01 | INVEGA TRINZA | 1 MG | 2.625 | 1 | 819 | 819 |
Coagulation Factor IX, Recombinant (Ixinity) | MEDEXUS PHARMA, INC. | 59137-0282-05 | Ixinity | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | MEDEXUS PHARMA, INC. | 59137-0283-05 | Ixinity | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | MEDEXUS PHARMA, INC. | 59137-0284-05 | Ixinity | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | MEDEXUS PHARMA, INC. | 59137-0289-05 | Ixinity | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | APTEVO BIOTHERAPEUTICS, LLC. | 70504-0282-05 | IXINITY | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | APTEVO BIOTHERAPEUTICS, LLC. | 70504-0283-05 | IXINITY | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | APTEVO BIOTHERAPEUTICS, LLC. | 70504-0284-05 | IXINITY | 1 IU | 1 | 1 | 1 | 1 |
Coagulation Factor IX, Recombinant (Ixinity) | APTEVO BIOTHERAPEUTICS, LLC. | 70504-0289-05 | IXINITY | 1 IU | 1 | 1 | 1 | 1 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9320-01 | Labetalol HCl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9363-10 | Labetalol HCl | 5 MG | 100 | 10 | 20 | 200 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9364-10 | Labetalol HCl | 5 MG | 200 | 10 | 40 | 400 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9365-10 | Labetalol HCl | 5 MG | 300 | 10 | 60 | 600 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9366-10 | Labetalol HCl | 5 MG | 200 | 10 | 40 | 400 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9622-01 | Labetalol Hcl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | HIKMA PHARMACEUTICALS USA INC. | 00143-9623-01 | Labetalol Hcl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | AKORN | 17478-0420-20 | Labetalol Hcl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | AKORN | 17478-0420-40 | Labetalol Hcl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | SAGENT PHARMACEUTICALS, INC. | 25021-0317-20 | Labetalol HCl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | SAGENT PHARMACEUTICALS, INC. | 25021-0317-40 | Labetalol HCl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | BAXTER | 36000-0320-10 | Labetalol Hcl | 5 MG | 4 | 1 | 4 | 40 |
Labetalol Hcl | BAXTER | 36000-0322-02 | Labetalol Hcl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | BAXTER | 36000-0324-02 | Labetalol Hcl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | ALVOGEN | 47781-0586-29 | Labetalol Hcl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | ALVOGEN | 47781-0586-56 | Labetalol Hcl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | FOSUN PHARMA | 72266-0102-01 | Labetalol Hcl | 5 MG | 20 | 1 | 20 | 20 |
Labetalol Hcl | FOSUN PHARMA | 72266-0103-01 | Labetalol Hcl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | FOSUN PHARMA | 72266-0103-41 | Labetalol HCl | 5 MG | 40 | 1 | 40 | 40 |
Labetalol Hcl | CIVICA INC | 72572-0350-01 | Labetalol HCl | 5 MG | 20 | 1 | 20 | 20 |
Insulin lispro-aabc (Lyumjev) administration through dme (i.e., insulin pump) | ELI LILLY AND COMPANY | 00002-8207-05 | Lyumjev Kwikpen U-100 | 50 UNITS | 3 | 5 | 6 | 30 |
Insulin lispro-aabc (Lyumjev) administration through dme (i.e., insulin pump) | ELI LILLY AND COMPANY | 00002-8228-27 | Lyumjev Kwikpen U-200 | 50 UNITS | 3 | 2 | 12 | 24 |
Insulin lispro-aabc (Lyumjev) administration through dme (i.e., insulin pump) | Lilly, Eli & Company | 00002-8235-05 | Lyumjev Tempo Pen | 50 UNITS | 3 | 5 | 6 | 30 |
Insulin lispro-aabc (Lyumjev) administration through dme (i.e., insulin pump) | ELI LILLY AND COMPANY | 00002-7728-01 | Lyumjev U-100 | 50 UNITS | 10 | 1 | 20 | 20 |
Bupivacaine | PFIZER INC. | 00409-1559-10 | MARCAINE | 1 ML | 10 | 10 | 10 | 100 |
Bupivacaine | PFIZER INC. | 00409-1559-30 | MARCAINE | 1 ML | 30 | 10 | 30 | 300 |
Bupivacaine | PFIZER INC. | 00409-1560-10 | MARCAINE | 1 ML | 10 | 10 | 10 | 100 |
Bupivacaine | PFIZER INC. | 00409-1560-29 | MARCAINE | 1 ML | 30 | 10 | 30 | 300 |
Bupivacaine | HOSPIRA, INC. | 00409-1761-10 | MARCAINE SPINAL | 1 ML | 2 | 10 | 15 | 150 |
Bupivacaine | PFIZER INC. | 00409-1761-62 | MARCAINE SPINAL | 1 ML | 2 | 800 | 2 | 1600 |
Bupivacaine | PFIZER INC. | 00409-1582-29 | MARCAINE WITHOUT EPI | 1 ML | 30 | 10 | 30 | 300 |
Metoprolol Tartrate | HIKMA PHARMACEUTICALS USA INC. | 00143-9873-25 | METOPROLOL INJ | 1 MG | 5 | 25 | 5 | 125 |
Metoprolol Tartrate | HIKMA PHARMACEUTICALS USA INC. | 00143-9660-10 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | PFIZER INC. | 00409-1778-05 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | HOSPIRA, INC. | 00409-2016-10 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | BAXTER | 36000-0033-10 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | ALVOGEN | 47781-0587-17 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | FRESENIUS KABI | 63323-0660-05 | METOPROLOL TARTRATE | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | FOSUN PHARMA USA | 72266-0122-05 | Metoprolol Tartrate | 1 MG | 5 | 5 | 5 | 25 |
Metoprolol Tartrate | FOSUN PHARMA | 72266-0122-25 | Metoprolol Tartrate | 1 MG | 5 | 25 | 5 | 125 |
Metoprolol Tartrate | CIVICA INC | 72572-0420-10 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metoprolol Tartrate | ALMAJECT | 72611-0740-10 | Metoprolol Tartrate | 1 MG | 5 | 10 | 5 | 50 |
Metronidazole inj | PFIZER INC. | 00409-7811-24 | METRONIDAZL 500MG | 500 MG | 100 | 24 | 1 | 24 |
Metronidazole inj | BAXTER | 00338-9541-24 | METRONIDAZOLE | 500 MG | 100 | 24 | 1 | 24 |
Metronidazole inj | SAGENT PHARMACEUTICALS INC | 25021-0131-82 | Metronidazole | 500 MG | 100 | 24 | 1 | 24 |
Metronidazole inj | PFIZER INC. | 00409-7811-37 | METRONIDAZOLE 500 MG INJ USP LIFECARE 100ML FILL | 500 MG | 100 | 80 | 1 | 80 |
Metronidazole inj | B. BRAUN MEDICAL INC. | 00264-5535-32 | Metronidazole In Nacl | 500 MG | 100 | 24 | 1 | 24 |
Metronidazole inj | BAXTER | 00338-1055-48 | Metronidazole In Nacl | 500 MG | 100 | 24 | 1 | 24 |
Metronidazole inj | Hospira, Inc. | 00409-0152-24 | Metronidazole In NaCl | 500 MG | 100 | 24 | 1 | 24 |
Nitroglycerin | AMERICAN REGENT | 00517-4810-25 | Nitroglycerin | 5 MG | 10 | 25 | 10 | 250 |
Nitroglycerin | BAXTER | 00338-1047-02 | Nitroglycerin In D5W | 5 MG | 250 | 12 | 5 | 60 |
Nitroglycerin | BAXTER | 00338-1049-02 | Nitroglycerin In D5W | 5 MG | 250 | 12 | 10 | 120 |
Nitroglycerin | BAXTER | 00338-1051-02 | Nitroglycerin In D5W | 5 MG | 250 | 12 | 20 | 240 |
Olanzapine short acting intramuscular injection | AMERICAN REGENT | 00517-0955-01 | Olanzapine (Immediate Release) | 0.5 MG | 1 | 1 | 20 | 20 |
Olanzapine short acting intramuscular injection | SANDOZ | 00781-3159-72 | Olanzapine (Immediate Release) | 0.5 MG | 1 | 1 | 20 | 20 |
Olanzapine short acting intramuscular injection | SANDOZ | 00781-9105-72 | Olanzapine (Immediate Release) | 0.5 MG | 1 | 1 | 20 | 20 |
Olanzapine short acting intramuscular injection | AUROMEDICS PHARMA LLC | 55150-0308-01 | Olanzapine (Immediate Release) | 0.5 MG | 1 | 1 | 20 | 20 |
Immune Globulin (Panzyga) | PFIZER INC. | 00069-1109-02 | PANZYGA | 500 MG | 25 | 1 | 5 | 5 |
Immune Globulin (Panzyga) | PFIZER INC. | 00069-1224-02 | PANZYGA | 500 MG | 50 | 1 | 10 | 10 |
Immune Globulin (Panzyga) | PFIZER INC. | 00069-1312-02 | PANZYGA | 500 MG | 100 | 1 | 20 | 20 |
Immune Globulin (Panzyga) | PFIZER INC. | 00069-1415-02 | PANZYGA | 500 MG | 200 | 1 | 40 | 40 |
Immune Globulin (Panzyga) | PFIZER INC. | 00069-1558-02 | PANZYGA | 500 MG | 300 | 1 | 60 | 60 |
Immune Globulin (Panzyga) | PFIZER INC. | 68982-0820-02 | PANZYGA | 500 MG | 25 | 1 | 5 | 5 |
Immune Globulin (Panzyga) | PFIZER INC. | 68982-0820-04 | PANZYGA | 500 MG | 100 | 1 | 20 | 20 |
Immune Globulin (Panzyga) | PFIZER INC. | 68982-0820-05 | PANZYGA | 500 MG | 200 | 1 | 40 | 40 |
Immune Globulin (Panzyga) | PFIZER INC. | 68982-0820-06 | PANZYGA | 500 MG | 300 | 1 | 60 | 60 |
Immune Globulin (Panzyga) | OCTAPHARMA | 68982-0822-02 | PANZYGA | 500 MG | 25 | 1 | 5 | 5 |
Immune Globulin (Panzyga) | OCTAPHARMA | 68982-0822-03 | PANZYGA | 500 MG | 50 | 1 | 10 | 10 |
Immune Globulin (Panzyga) | OCTAPHARMA | 68982-0822-04 | PANZYGA | 500 MG | 100 | 1 | 20 | 20 |
Immune Globulin (Panzyga) | OCTAPHARMA | 68982-0822-05 | PANZYGA | 500 MG | 200 | 1 | 40 | 40 |
Immune Globulin (Panzyga) | OCTAPHARMA | 68982-0822-06 | PANZYGA | 500 MG | 300 | 1 | 60 | 60 |
Rifampin | FRESENIUS KABI | 63323-0351-20 | Rifampin | 600 MG | 1 | 1 | 1 | 1 |
Rifampin | MYLAN INSTITUTIONAL LLC | 67457-0445-60 | Rifampin | 600 MG | 1 | 1 | 1 | 1 |
Bupivacaine | FRESENIUS KABI | 63323-0465-57 | Sensorcaine | 1 ML | 50 | 25 | 50 | 1250 |
Bupivacaine | FRESENIUS KABI | 63323-0467-57 | Sensorcaine | 1 ML | 50 | 25 | 50 | 1250 |
Bupivacaine | FRESENIUS KABI | 63323-0472-17 | Sensorcaine | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | FRESENIUS KABI | 63323-0464-17 | SENSORCAINE-MPF | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | FRESENIUS KABI | 63323-0464-37 | SENSORCAINE-MPF | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | FRESENIUS KABI | 63323-0466-17 | Sensorcaine-MPF | 1 ML | 10 | 25 | 10 | 250 |
Bupivacaine | FRESENIUS KABI | 63323-0466-37 | SENSORCAINE-MPF | 1 ML | 30 | 25 | 30 | 750 |
Bupivacaine | FRESENIUS KABI | 63323-0472-37 | SENSORCAINE-MPF | 1 ML | 30 | 25 | 30 | 750 |
Sodium Chloride, Hypertonic (3% - 5% infusion) | B. BRAUN MEDICAL INC. | 00264-7805-10 | Sodium Chloride | 250 CC | 500 | 24 | 2 | 48 |
Sodium Chloride, Hypertonic (3% - 5% infusion) | B. BRAUN MEDICAL INC. | 00264-7806-10 | Sodium Chloride | 250 CC | 500 | 24 | 2 | 48 |
Sodium Chloride, Hypertonic (3% - 5% infusion) | BAXTER | 00338-0054-03 | Sodium Chloride | 250 CC | 500 | 1 | 2 | 2 |
Sodium Chloride, Hypertonic (3% - 5% infusion) | BAXTER | 00338-0056-03 | Sodium Chloride | 250 CC | 500 | 1 | 2 | 2 |
Sulfamethoxazole-Trimethoprim | SICOR PHARMACEUTICALS, INC. | 00703-9503-03 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 50 | 10 | 10 | 100 |
Sulfamethoxazole-Trimethoprim | SICOR PHARMACEUTICALS, INC. | 00703-9514-03 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 100 | 10 | 20 | 200 |
Sulfamethoxazole-Trimethoprim | SICOR PHARMACEUTICALS, INC. | 00703-9514-93 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 10 | 10 | 2 | 20 |
Sulfamethoxazole-Trimethoprim | SICOR PHARMACEUTICALS, INC. | 00703-9526-01 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 30 | 1 | 6 | 6 |
Sulfamethoxazole-Trimethoprim | MYLAN INSTITUTIONAL LLC | 67457-0778-05 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 5 | 10 | 1 | 10 |
Sulfamethoxazole-Trimethoprim | MYLAN INSTITUTIONAL LLC | 67457-0779-30 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 30 | 1 | 6 | 6 |
Sulfamethoxazole-Trimethoprim | MYLAN INSTITUTIONAL LLC | 67457-0921-05 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 5 | 10 | 1 | 10 |
Sulfamethoxazole-Trimethoprim | MYLAN INSTITUTIONAL LLC | 67457-0922-30 | Sulfamethoxazole-Trimethoprim | 400-80 MG | 30 | 1 | 6 | 6 |
Vasopressin | Amphastar Pharmaceuticals, Inc. | 00548-9701-00 | Vasopressin | 20 UNITS | 1 | 10 | 1 | 10 |
Vasopressin | PAR PHARMACEUTICAL, INC | 42023-0164-25 | Vasopressin | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | EAGLE PHARMACEUTICALS INC. | 42367-0570-87 | Vasopressin | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | DR. REDDY'S LABORATORIES, INC. | 43598-0085-25 | Vasopressin | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | AUROMEDICS PHARMA | 55150-0370-25 | VASOPRESSIN | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | AUROMEDICS PHARMA | 55150-0371-25 | Vasopressin | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | AMNEAL BIOSCIENCES | 70121-1642-05 | VASOPRESSIN | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | AMNEAL BIOSCIENCES | 70121-1642-07 | Vasopressin | 20 UNITS | 1 | 10 | 1 | 10 |
Vasopressin (American Regent) | AMERICAN REGENT | 00517-1020-25 | Vasopressin | 20 UNITS | 1 | 25 | 1 | 25 |
Vasopressin | PAR PHARMACEUTICAL, INC | 42023-0164-10 | VASOSTRICT | 20 UNITS | 1 | 10 | 1 | 10 |
Vasopressin | PAR PHARMACEUTICAL, INC | 42023-0190-01 | VASOSTRICT | 20 UNITS | 10 | 1 | 10 | 10 |
Vasopressin | PAR PHARMACEUTICAL | 42023-0219-10 | VASOSTRICT | 20 UNITS | 100 | 10 | 2 | 20 |
Vasopressin | PAR PHARMACEUTICAL | 42023-0237-10 | VASOSTRICT | 20 UNITS | 100 | 10 | 1 | 10 |
Glucarpidase | BTG INTERNATIONAL INC. | 50633-0210-11 | Voraxaze | 10 UNITS | 1 | 1 | 100 | 100 |
HCPCS | Description | Labeler name | NDC | Drug name | Dosage | Package size | Package quantity | Billable units | Billable units / pkg |
---|---|---|---|---|---|---|---|---|---|
A9513 |
Lutetium Lu 177 dotatat ther | ADVANCED ACCELERATOR APPLICATIONS | 69488-0003-01 | LUTATHERA | 1 MCI | 20 | 1 | 200 | 200 |
A9543 |
Y90 ibritumomab, rx | SPECTRUM PHARMACEUTICALS | 68152-0103-03 | ZEVALIN Y-90 | UP TO 40 millicuries | 1 | 1 | 1 | 1 |
A9543 |
Y90 ibritumomab, rx | ACROTECH BIOPHARMA | 72893-0007-04 | ZEVALIN Y-90 | UP TO 40 millicuries | 1 | 1 | 1 | 1 |
A9590 |
Iodine i-131 therapeutic | PROGENICS PHARMACEUTICALS, INC. | 71258-0015-22 | AZEDRA therapeutic | 1 mCi | 1 | 1 | 1 | 1 |
A9591 |
Fluoroestradiol F 18 | ZIONEXA US CORPORATION | 72874-0001-01 | Cerianna | 1 mCi | 50 | 1 | 6 | 6 |
A9592 |
Copper cu 64 dotatate diag | CURIUM US LLC | 69945-0064-01 | Detectnet | 1 mCi | 4 | 1 | 4 | 4 |
A9593 |
Gallium ga-68 psma-11 ucsf | UCSF RADIOPHARMACEUTICAL FACILITY | 24275-0525-01 | Gallium Ga 68 PSMA (UCSF) | 1 mCi | 11 | 1 | 1 | 1 |
A9594 |
Gallium ga-68 psma-11, ucla | UCLA BIOMEDICAL CYCLOTRON | 76394-2642-03 | Gallium Ga 68 PSMA (UCLA) | 1 mCi | 12 | 1 | 1 | 1 |
A9595 |
Piflu f-18, dia 1 millicurie | PROGENICS PHARMACEUTICALS, INC | 71258-0022-00 | Pylarify | 1 millicurie | 1 | 1 | 9 | 9 |
A9596 |
Gallium illuccix 1 millicure | TELIX PHARMACEUTICALS, INC. | 74725-0100-25 | ILLUCCIX | 1 mCi | 1 | 1 | 1 | 1 |
A9596 |
Gallium illuccix 1 millicure | TELIX PHARMACEUTICALS, INC. | 74725-0100-64 | ILLUCCIX | 1 mCi | 1 | 1 | 1 | 1 |
A9600 |
Sr89 strontium | QBIOMED INC | 72928-0089-01 | Strontium Chloride Sr 89 | PER MILLICURIE | 4 | 1 | 1 | 4 |
A9602 |
Fluorodopa f-18 diag per mci | THE FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH | 13267-0346-57 | Fluorodopa F18 | 1 mCi | 1 | 1 | 1 | 1 |
A9604 |
Sm 153 lexidronam | LANTHEUS MEDICAL IMAGING, INC. | 11994-0016-01 | QUADRAMET | up to 150 millicuries | 3 | 1 | 1 | 1 |
A9606 |
Radium Ra223 dichloride ther | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0208-01 | Xofigo | 1 mCi | 6 | 1 | 1 | 1 |
A9607 |
Lutetium lu 177 vipivotide | ADVANCED ACCELERATOR APPLICATIONS USA, INC | 69488-0010-61 | PLUVICTO | 1 mCi | 1 | 1 | 1 | 1 |
A9800 |
Gallium locametz 1 millicuri | ADVANCED ACCELERATOR APPLICATIONS USA, INC | 69488-0017-61 | LOCAMETZ | 1 mCi | 1 | 1 | 1 | 1 |
C9047 |
Injection, caplacizumab-yhdp | GENZYME CORPORATION | 58468-0225-01 | Cablivi | 1 MG | 1 | 1 | 11 | 11 |
C9067 |
Gallium ga-68 Dotatoc | UIHC-PET IMAGING CENTER | 24417-0681-30 | Dotatoc Ga 68 | 0.01 mCi | 14 | 1 | 400 | 400 |
C9088 |
Instill, bupivac and meloxic | HERON THERAPEUTICS | 47426-0301-02 | Zynrelef | 1 mg - 0.03 mg | 14 ML | 1 | 400 | 400 |
C9088 |
Instill, bupivac and meloxic | HERON THERAPEUTICS, INC. | 47426-0302-02 | Zynrelef | 1 mg - 0.03 mg | 10.5 ML | 1 | 300 | 300 |
C9088 |
Instill, bupivac and meloxic | HERON THERAPEUTICS | 47426-0303-01 | Zynrelef | 1 mg - 0.03 mg | 7 ML | 1 | 200 | 200 |
C9088 |
Instill, bupivac and meloxic | HERON THERAPEUTICS, INC. | 47426-0304-01 | Zynrelef | 1 mg - 0.03 mg | 2.3 ML | 1 | 60 | 60 |
C9089 |
Bupivacaine implant, 1 mg | INNOCOLL PHARMACEUTICALS LIMITED | 51715-0100-04 | Xaracoll | 1 mg | 1 | 12 | 100 | 1200 |
C9089 |
Bupivacaine implant, 1 mg | INNOCOLL PHARMACEUTICALS LIMITED | 51715-0100-10 | Xaracoll | 1 mg | 1 | 30 | 100 | 3000 |
C9101 |
Inj, oliceridine 0.1 mg | TREVENA, INC. | 71308-0011-10 | Olinvyk | 0.1 MG | 1 | 10 | 10 | 100 |
C9101 |
Inj, oliceridine 0.1 mg | TREVENA, INC. | 71308-0021-10 | Olinvyk | 0.1 MG | 2 | 10 | 20 | 200 |
C9101 |
Inj, oliceridine 0.1 mg | TREVENA, INC. | 71308-0301-10 | Olinvyk | 0.1 MG | 30 | 10 | 300 | 3000 |
C9144 |
Inj, bupivacaine (posimir) | INNOCOLL PHARMACEUTICALS | 51715-0660-10 | Posimir | 1 MG | 5 | 10 | 660 | 6600 |
C9145 |
Inj, aponvie, 1 mg | HERON THERAPEUTICS, INC. | 47426-0401-10 | APONVIE | 1 MG | 4.4 | 10 | 32 | 320 |
C9146 |
Inj, elahere, 1 mg | Immunogen, Inc. | 72903-0853-01 | ELAHERE | 1 MG | 20 | 1 | 100 | 100 |
C9147 |
Inj, tremelimumab-actl, 1 mg | Astrazeneca Pharmaceuticals, Lp | 00310-4505-25 | IMJUDO | 1 MG | 1.25 | 1 | 25 | 25 |
C9147 |
Inj, tremelimumab-actl, 1 mg | Astrazeneca Pharmaceuticals, Lp | 00310-4535-30 | IMJUDO | 1 MG | 15 | 1 | 300 | 300 |
C9148 |
Inj, teclistamab-cqyv, 0.5mg | Janssen Biotech, Inc. | 57894-0449-01 | TECVAYLI | 0.5 MG | 3 | 1 | 60 | 60 |
C9148 |
Inj, teclistamab-cqyv, 0.5mg | Janssen Biotech, Inc. | 57894-0450-01 | TECVAYLI | 0.5 MG | 1.7 | 1 | 306 | 306 |
C9149 |
Inj, teplizumab-mzwv, 5 mcg | Provention Bio, Inc. | 73650-0316-01 | TZIELD | 5 MCG | 2 | 1 | 400 | 400 |
C9149 |
Inj, teplizumab-mzwv, 5 mcg | Provention Bio, Inc. | 73650-0316-10 | TZIELD | 5 MCG | 2 | 10 | 400 | 4000 |
C9149 |
Inj, teplizumab-mzwv, 5 mcg | Provention Bio, Inc. | 73650-0316-14 | TZIELD | 5 MCG | 2 | 14 | 400 | 5600 |
C9248 |
Inj, clevidipine butyrate | CHIESI USA, INC. | 10122-0610-10 | CLEVIPREX | 1 MG | 50 | 10 | 25 | 250 |
C9248 |
Inj, clevidipine butyrate | CHIESI USA, INC. | 10122-0611-10 | CLEVIPREX | 1 MG | 100 | 10 | 50 | 500 |
C9257 |
Bevacizumab injection | GENENTECH, INC. | 50242-0060-01 | Avastin | 0.25 MG | 4 | 1 | 400 | 400 |
C9257 |
Bevacizumab injection | GENENTECH, INC. | 50242-0060-10 | Avastin | 0.25 MG | 4 | 10 | 400 | 4000 |
C9257 |
Bevacizumab injection | GENENTECH, INC. | 50242-0061-01 | Avastin | 0.25 MG | 16 | 1 | 1600 | 1600 |
C9257 |
Bevacizumab injection | GENENTECH, INC. | 50242-0061-10 | Avastin | 0.25 MG | 16 | 10 | 1600 | 16000 |
C9290 |
Inj, bupivacaine liposome | PACIRA PHARMACEUTICALS | 65250-0133-04 | EXPAREL | 1 MG | 10 | 4 | 133 | 532 |
C9290 |
Inj, bupivacaine liposome | PACIRA PHARMACEUTICALS | 65250-0133-09 | EXPAREL | 1 MG | 10 | 10 | 133 | 1330 |
C9290 |
Inj, bupivacaine liposome | PACIRA PHARMACEUTICALS | 65250-0266-04 | EXPAREL | 1 MG | 20 | 4 | 266 | 1064 |
C9290 |
Inj, bupivacaine liposome | PACIRA PHARMACEUTICALS | 65250-0266-09 | EXPAREL | 1 MG | 20 | 10 | 266 | 2660 |
C9460 |
Injection, cangrelor | CHIESI USA, INC. | 10122-0620-10 | KENGREAL | 1 MG | 1 | 10 | 50 | 500 |
C9482 |
Sotalol hydrochloride IV | ALTATHERA PHARMACEUTICALS | 69724-0112-10 | Sotalol | 1MG | 10 | 1 | 150 | 150 |
C9488 |
Conivaptan HCL | CUMBERLAND PHARMACEUTICALS | 66220-0160-10 | VAPRISOL | 1 MG | 100 | 1 | 20 | 20 |
J0135 |
Adalimumab injection | ABBVIE US, LLC | 00074-3799-02 | Humira | 20 MG | 0.8 | 2 | 2 | 4 |
J0135 |
Adalimumab injection | ABBVIE US, LLC | 00074-4339-02 | Humira | 20 MG | 0.8 | 2 | 2 | 4 |
J0135 |
Adalimumab injection | ABBVIE US, LLC | 00074-4339-06 | Humira | 20 MG | 0.8 | 6 | 2 | 12 |
J0135 |
Adalimumab injection | ABBVIE US, LLC | 00074-4339-07 | Humira | 20 MG | 0.8 | 4 | 2 | 8 |
J0208 |
Inj sodium thiosulfate 100mg | FENNEC PHARMACEUTICALS INC. | 73077-0010-01 | Sodium Thiosulfate | 100 MG | 100 | 1 | 125 | 125 |
J0470 |
Dimecaprol injection | AKORN | 17478-0526-03 | Bal In Oil | 100 MG | 3 | 10 | 3 | 30 |
J0570 |
Buprenorphine implant 74.2mg | TITAN PHARMACEUTICALS | 52440-0100-14 | PROBUPHINE SYSTEM KIT | 74.2 MG | 1 | 4 | 1 | 4 |
J0641 |
Levoleucovorin injection | HIKMA PHARMACEUTICALS USA INC. | 00143-9558-01 | Levoleucovorin Calcium | 0.5 MG | 1 | 1 | 100 | 100 |
J0641 |
Levoleucovorin injection | SANDOZ | 00781-3201-94 | Levoleucovorin Calcium | 0.5 MG | 17.5 | 1 | 350 | 350 |
J0641 |
Levoleucovorin injection | NORTHSTAR RX LLC | 16714-0890-01 | Levoleucovorin Calcium | 0.5 MG | 17.5 | 1 | 350 | 350 |
J0641 |
Levoleucovorin injection | NORTHSTAR RX LLC | 16714-0915-01 | Levoleucovorin Calcium | 0.5 MG | 25 | 1 | 500 | 500 |
J0641 |
Levoleucovorin injection | DR. REDDY'S LABORATORIES, INC. | 43598-0771-11 | Levoleucovorin Calcium | 0.5 MG | 17.5 | 1 | 350 | 350 |
J0641 |
Levoleucovorin injection | DR. REDDY'S LABORATORIES, INC. | 43598-0773-11 | Levoleucovorin Calcium | 0.5 MG | 25 | 1 | 500 | 500 |
J0641 |
Levoleucovorin injection | INGENUS PHARMACEUTICALS, LLC | 50742-0494-17 | Levoleucovorin Calcium | 0.5 MG | 17.5 | 1 | 350 | 350 |
J0641 |
Levoleucovorin injection | INGENUS PHARMACEUTICALS, LLC | 50742-0495-25 | Levoleucovorin Calcium | 0.5 MG | 25 | 1 | 500 | 500 |
J0641 |
Levoleucovorin injection | AMNEAL BIOSCIENCES | 70121-1099-01 | Levoleucovorin Calcium | 0.5 MG | 1 | 1 | 100 | 100 |
J0641 |
Levoleucovorin injection | AMNEAL BIOSCIENCES | 70121-1572-01 | Levoleucovorin Calcium | 0.5 MG | 17.5 | 1 | 350 | 350 |
J0641 |
Levoleucovorin injection | FOSUN PHARMA | 72266-0120-01 | Levoleucovorin Calcium | 0.5 MG | 17.5 | 1 | 350 | 350 |
J0699 |
Inj, cefiderocol, 10 mg | SHIONOGI INC | 59630-0266-10 | Fetroja | 10 MG | 1 | 10 | 100 | 1000 |
J0716 |
Centruroides immune f(ab) | RARE DISEASE THERAPEUTICS, INC. | 66621-0150-02 | ANASCORP | UP TO 120MG | 1 | 1 | 1 | 1 |
J0879 |
Difelikefalin, esrd on dialy | Vifor | 59353-0065-01 | Korsuva | 0.1 mcg | 1.3 | 1 | 65 | 650 |
J0879 |
Difelikefalin, esrd on dialy | Vifor | 59353-0065-12 | Korsuva | 0.1 mcg | 1.3 | 1 | 65 | 7800 |
J0884 |
Argatroban esrd dialysis 1mg | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0930-61 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J0884 |
Argatroban esrd dialysis 1mg | HIKMA PHARMACEUTICALS USA INC. | 00143-9288-01 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J0884 |
Argatroban esrd dialysis 1mg | HIKMA PHARMACEUTICALS USA INC. | 00143-9377-01 | Argatroban | 1 MG | 50 | 1 | 50 | 50 |
J0884 |
Argatroban esrd dialysis 1mg | HIKMA PHARMACEUTICALS USA INC. | 00143-9559-01 | ARGATROBAN | 1 MG | 50 | 1 | 50 | 50 |
J0884 |
Argatroban esrd dialysis 1mg | HIKMA PHARMACEUTICALS USA INC. | 00143-9674-01 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J0884 |
Argatroban esrd dialysis 1mg | PFIZER INC. | 00409-1140-01 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J0884 |
Argatroban esrd dialysis 1mg | SAGENT PHARMACEUTICALS INC | 25021-0414-50 | ARGATROBAN | 1 MG | 50 | 1 | 50 | 50 |
J0884 |
Argatroban esrd dialysis 1mg | PAR PHARMACEUTICAL, INC | 42023-0182-01 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J0884 |
Argatroban esrd dialysis 1mg | FRESENIUS KABI | 63323-0526-03 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J0884 |
Argatroban esrd dialysis 1mg | FRESENIUS KABI | 65219-0429-50 | ARGATROBAN | 1 MG | 50 | 1 | 50 | 50 |
J0884 |
Argatroban esrd dialysis 1mg | MYLAN INSTITUTIONAL LLC | 67457-0212-02 | Argatroban | 1 MG | 2.5 | 1 | 250 | 250 |
J1096 |
Dexametha opth insert 0.1 mg | OCULAR THERAPEUTIX | 70382-0204-01 | Dextenza | 0.1 MG | 1 | 1 | 4 | 4 |
J1096 |
Dexametha opth insert 0.1 mg | OCULAR THERAPEUTIX | 70382-0204-10 | Dextenza | 0.1 MG | 1 | 10 | 4 | 40 |
J1097 |
Phenylep ketorolac opth soln | OMEROS CORPORATION | 62225-0600-04 | Omidria (phenylephrine 1% + ketorolac 0.3% irrigation) | 1 ML | 4 | 4 | 4 | 16 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0100-10 | Hemgenix | Per Therapeutic Dose | 10 | 10 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0110-11 | Hemgenix | Per Therapeutic Dose | 10 | 11 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0120-12 | Hemgenix | Per Therapeutic Dose | 10 | 12 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0130-13 | Hemgenix | Per Therapeutic Dose | 10 | 13 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0140-14 | Hemgenix | Per Therapeutic Dose | 10 | 14 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0150-15 | Hemgenix | Per Therapeutic Dose | 10 | 15 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0160-16 | Hemgenix | Per Therapeutic Dose | 10 | 16 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0170-17 | Hemgenix | Per Therapeutic Dose | 10 | 17 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0180-18 | Hemgenix | Per Therapeutic Dose | 10 | 18 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0190-19 | Hemgenix | Per Therapeutic Dose | 10 | 19 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0200-20 | Hemgenix | Per Therapeutic Dose | 10 | 20 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0210-21 | Hemgenix | Per Therapeutic Dose | 10 | 21 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0220-22 | Hemgenix | Per Therapeutic Dose | 10 | 22 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0230-23 | Hemgenix | Per Therapeutic Dose | 10 | 23 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0240-24 | Hemgenix | Per Therapeutic Dose | 10 | 24 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0250-25 | Hemgenix | Per Therapeutic Dose | 10 | 25 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0260-26 | Hemgenix | Per Therapeutic Dose | 10 | 26 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0270-27 | Hemgenix | Per Therapeutic Dose | 10 | 27 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0280-28 | Hemgenix | Per Therapeutic Dose | 10 | 28 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0290-29 | Hemgenix | Per Therapeutic Dose | 10 | 29 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0300-30 | Hemgenix | Per Therapeutic Dose | 10 | 30 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0310-31 | Hemgenix | Per Therapeutic Dose | 10 | 31 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0320-32 | Hemgenix | Per Therapeutic Dose | 10 | 32 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0330-33 | Hemgenix | Per Therapeutic Dose | 10 | 33 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0340-34 | Hemgenix | Per Therapeutic Dose | 10 | 34 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0350-35 | Hemgenix | Per Therapeutic Dose | 10 | 35 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0360-36 | Hemgenix | Per Therapeutic Dose | 10 | 36 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0370-37 | Hemgenix | Per Therapeutic Dose | 10 | 37 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0380-38 | Hemgenix | Per Therapeutic Dose | 10 | 38 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0390-39 | Hemgenix | Per Therapeutic Dose | 10 | 39 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0400-40 | Hemgenix | Per Therapeutic Dose | 10 | 40 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0410-41 | Hemgenix | Per Therapeutic Dose | 10 | 41 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0420-42 | Hemgenix | Per Therapeutic Dose | 10 | 42 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0430-43 | Hemgenix | Per Therapeutic Dose | 10 | 43 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0440-44 | Hemgenix | Per Therapeutic Dose | 10 | 44 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0450-45 | Hemgenix | Per Therapeutic Dose | 10 | 45 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0460-46 | Hemgenix | Per Therapeutic Dose | 10 | 46 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0470-47 | Hemgenix | Per Therapeutic Dose | 10 | 47 | 1 | 1 |
J1411 |
Inj, hemgenix, per tx dose | CSL Behring | 0053-0480-48 | Hemgenix | Per Therapeutic Dose | 10 | 48 | 1 | 1 |
J1426 |
Injection, casimersen, 10 mg | SAREPTA | 60923-0227-02 | Amondys 45 | 10 MG | 2 | 1 | 10 | 10 |
J1427 |
Inj. viltolarsen | NS PHARMA INC | 73292-0011-01 | Viltepso | 10 MG | 5 | 1 | 25 | 25 |
J1429 |
Inj golodirsen 10 mg | SAREPTA | 60923-0465-02 | Vyondys 53 | 10 MG | 2 | 1 | 10 | 10 |
J1438 |
Etanercept injection | AMGEN USA, INC. | 58406-0425-34 | Enbrel | 25 MG | 1 | 4 | 1 | 4 |
J1438 |
Etanercept injection | AMGEN USA, INC. | 58406-0445-04 | Enbrel | 25 MG | 1 | 4 | 2 | 8 |
J1438 |
Etanercept injection | AMGEN USA, INC. | 58406-0455-04 | Enbrel | 25 MG | 0.5 | 4 | 1 | 4 |
J1438 |
Etanercept injection | AMGEN USA, INC. | 58406-0435-04 | Enbrel (Etanercept) | 25 MG | 1 | 4 | 2 | 8 |
J1449 |
Inj eflapegrastim-xnst 0.1mg | Spectrum Pharmaceuticals, Inc. | 76961-0101-01 | ROLVEDON | 0.1 MG | 0.6 | 1 | 132 | 132 |
J1451 |
Fomepizole, 15 mg | AMERICAN REGENT | 00517-0710-01 | FOMEPIZOLE | 15 MG | 1.5 | 1 | 100 | 100 |
J1451 |
Fomepizole, 15 mg | MYLAN INSTITUTIONAL LLC | 67457-0211-02 | FOMEPIZOLE | 15 MG | 1.5 | 1 | 100 | 100 |
J1451 |
Fomepizole, 15 mg | ZYDUS PHARMACEUTICALS | 70710-1478-01 | Fomepizole | 15 MG | 1.5 | 1 | 100 | 100 |
J1455 |
Foscarnet sodium injection | SAGENT PHARMACEUTICALS INC | 25021-0189-84 | FOSCARNET SODIUM | 1000 MG | 250 | 10 | 6 | 60 |
J1455 |
Foscarnet sodium injection | FRESENIUS KABI | 63323-0875-50 | Foscarnet Sodium | 1000 MG | 250 | 1 | 6 | 6 |
J1573 |
Hepagam b intravenous, inj | SAOL THERAPEUTICS | 70257-0051-51 | Hepagam B | 0.5 ML | 5 | 1 | 10 | 10 |
J1573 |
Hepagam b intravenous, inj | SAOL THERAPEUTICS | 70257-0052-51 | HEPAGAM B | 0.5 ML | 1 | 1 | 2 | 2 |
J1573 |
Hepagam b intravenous, inj | SAOL THERAPEUTICS | 70257-0053-51 | Hepagam B | 0.5 ML | 1 | 1 | 2 | 2 |
J1573 |
Hepagam b intravenous, inj | SAOL THERAPEUTICS | 70257-0054-51 | Hepagam B | 0.5 ML | 5 | 1 | 10 | 10 |
J1595 |
Injection glatiramer acetate | TEVA NEUROSCIENCE, INC. | 68546-0317-30 | Copaxone | 20 MG | 1 | 30 | 1 | 30 |
J1595 |
Injection glatiramer acetate | TEVA NEUROSCIENCE, INC. | 68546-0325-12 | Copaxone | 20 MG | 1 | 12 | 2 | 24 |
J1628 |
Inj., guselkumab, 1 mg | JANSSEN BIOTECH, INC. | 57894-0640-01 | Tremfya | 1 MG | 1 | 1 | 100 | 100 |
J1628 |
Inj., guselkumab, 1 mg | JANSSEN BIOTECH, INC. | 57894-0640-11 | Tremfya | 1 MG | 1 | 1 | 100 | 100 |
J1632 |
Inj, brexanolone | SAGE THERAPEUTICS | 72152-0547-20 | Zulresso | 1 MG | 20 | 1 | 100 | 100 |
J1726 |
Inj, Makena | AMERICAN REGENT | 00517-1767-01 | MAKENA | 10 MG | 1 | 1 | 25 | 25 |
J1726 |
Inj, Makena | AMAG PHARMACEUTICALS, INC. | 64011-0247-02 | MAKENA | 10 MG | 1 | 1 | 25 | 25 |
J1726 |
Inj, Makena | AMAG PHARMACEUTICALS, INC. | 64011-0301-03 | Makena Auto Injector | 10 MG | 1.1 | 1 | 27.5 | 27.5 |
J1726 |
Inj, Makena | AMERICAN REGENT | 00517-1791-01 | Hydroxyprogesterone Caproate | 10 MG | 1 | 1 | 25 | 25 |
J1726 |
Inj, Makena | AUROMEDICS PHARMA LLC | 55150-0309-01 | Hydroxyprogesterone Caproate | 10 MG | 1 | 1 | 25 | 25 |
J1726 |
Inj, Makena | AUROMEDICS PHARMA LLC | 55150-0310-01 | Hydroxyprogesterone Caproate | 10 MG | 5 | 1 | 125 | 125 |
J1726 |
Inj, Makena | MYLAN INSTITUTIONAL LLC | 67457-0886-05 | Hydroxyprogesterone Caproate | 10 MG | 1 | 1 | 125 | 125 |
J1726 |
Inj, Makena | MYLAN INSTITUTIONAL LLC | 67457-0967-01 | Hydroxyprogesterone Caproate | 10 MG | 1 | 1 | 25 | 25 |
J1726 |
Inj, Makena | AMNEAL PHARMACEUTICALS, LLC | 69238-1797-01 | Hydroxyprogesterone Caproate | 10 MG | 1 | 1 | 25 | 25 |
J1726 |
Inj, Makena | SLAYBACK PHARMA | 71225-0104-01 | Hydroxyprogesterone Caproate | 10 MG | 5 | 1 | 125 | 125 |
J1726 |
Inj, Makena | SLAYBACK PHARMA | 71225-0105-01 | Hydroxyprogesterone Caproate | 10 MG | 1 | 1 | 25 | 25 |
J1742 |
Ibutilide fumarate injection | MYLAN INSTITUTIONAL LLC | 67457-0366-10 | IBUTILIDE FUMARATE | 1 MG | 10 | 1 | 1 | 1 |
J1742 |
Ibutilide fumarate injection | PFIZER INC. | 00009-3794-01 | Corvert | 1 MG | 10 | 1 | 1 | 1 |
J1742 |
Ibutilide fumarate injection | PFIZER INC. | 00009-3794-22 | Corvert | 1 MG | 10 | 1 | 1 | 1 |
J1744 |
Icatibant injection | LEUCADIA PHARMACEUTICALS | 24201-0207-01 | ICATIBANT | 1 MG | 3 | 1 | 30 | 30 |
J1744 |
Icatibant injection | LEUCADIA PHARMACEUTICALS | 24201-0207-03 | ICATIBANT | 1 MG | 3 | 3 | 30 | 90 |
J1744 |
Icatibant injection | TAKEDA PHARMACEUTICALS AMERICA, INC. | 54092-0702-02 | ICATIBANT | 1 MG | 3 | 1 | 30 | 30 |
J1744 |
Icatibant injection | TAKEDA PHARMACEUTICALS AMERICA, INC. | 54092-0702-03 | ICATIBANT | 1 MG | 3 | 3 | 30 | 90 |
J1744 |
Icatibant injection | FRESENIUS KABI | 63323-0574-86 | ICATIBANT | 1 MG | 3 | 1 | 30 | 30 |
J1744 |
Icatibant injection | FRESENIUS KABI | 63323-0574-93 | ICATIBANT | 1 MG | 3 | 3 | 30 | 90 |
J1744 |
Icatibant injection | CIPLA USA INC. | 69097-0664-34 | ICATIBANT | 1 MG | 3 | 1 | 30 | 30 |
J1744 |
Icatibant injection | CIPLA USA INC. | 69097-0664-68 | ICATIBANT | 1 MG | 3 | 3 | 30 | 90 |
J1833 |
Inj, isavuconazonium sulfate | ASTELLAS PHARMA US INC. | 00469-0420-99 | CRESEMBA injection | 1mg (as sulfate) | 1 | 10 | 372 | 3720 |
J1954 |
Injection, leuprolide acetate for depot suspension (cipla), 7.5 mg | Cipla Usa, Inc. | 69097-0909-50 | Leuprolide Acetate | 7.5 MG | 1 | 1 | 3 | 3 |
J2186 |
Inj., meropenem, vaborbactam | MELINTA THERAPEUTICS, INC. | 70842-0120-06 | Vabomere (meropenem-vaborbactam) | (10 MG/10MG) 20 MG | 1 | 6 | 100 | 600 |
J2265 |
Minocycline hydrochloride | MELINTA THERAPEUTICS, INC. | 70842-0160-10 | MINOCIN | 1 MG | 1 | 10 | 100 | 1000 |
J2326 |
Injection, nusinersen | BIOGEN | 64406-0058-01 | Spinraza | 0.1 MG | 5 | 1 | 120 | 120 |
J2403 |
Chloroprocaine opht gel, 1mg | Harrow Eye, Llc. | 82667-0300-01 | IHEEZO | 1 MG | 1 | 1 | 800 | 800 |
J2403 |
Chloroprocaine opht gel, 1mg | Harrow Eye, Llc. | 82667-0300-10 | IHEEZO | 1 MG | 1 | 10 | 800 | 8000 |
J2502 |
Inj, pasireotide long acting | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0641-81 | Signifor LAR | 1 MG | 1 | 1 | 20 | 20 |
J2502 |
Inj, pasireotide long acting | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0642-81 | Signifor LAR | 1 MG | 1 | 1 | 40 | 40 |
J2502 |
Inj, pasireotide long acting | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0643-81 | Signifor LAR | 1 MG | 1 | 1 | 60 | 60 |
J2502 |
Inj, pasireotide long acting | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0741-81 | Signifor LAR | 1 MG | 1 | 1 | 30 | 30 |
J2502 |
Inj, pasireotide long acting | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0748-81 | Signifor LAR | 1 MG | 1 | 1 | 10 | 10 |
J2502 |
Inj, pasireotide long acting | RECORDATI RARE DISEASES | 55292-0139-01 | Signifor Lar | 1 MG | 1 | 1 | 10 | 10 |
J2502 |
Inj, pasireotide long acting | RECORDATI RARE DISEASES | 55292-0140-01 | Signifor Lar | 1 MG | 1 | 1 | 20 | 20 |
J2502 |
Inj, pasireotide long acting | RECORDATI RARE DISEASES | 55292-0141-01 | Signifor Lar | 1 MG | 1 | 1 | 30 | 30 |
J2502 |
Inj, pasireotide long acting | RECORDATI RARE DISEASES | 55292-0142-01 | Signifor Lar | 1 MG | 1 | 1 | 40 | 40 |
J2502 |
Inj, pasireotide long acting | RECORDATI RARE DISEASES | 55292-0143-01 | Signifor Lar | 1 MG | 1 | 1 | 60 | 60 |
J2515 |
Pentobarbital sodium inj | AKORN | 17478-0181-20 | Pentobarbital | 50 MG | 20 | 1 | 20 | 20 |
J2515 |
Pentobarbital sodium inj | AKORN | 17478-0181-50 | Pentobarbital | 50 MG | 50 | 1 | 50 | 50 |
J2515 |
Pentobarbital sodium inj | LEUCADIA PHARMACEUTICALS | 24201-0010-20 | Pentobarbital | 50 MG | 20 | 1 | 20 | 20 |
J2515 |
Pentobarbital sodium inj | LEUCADIA PHARMACEUTICALS | 24201-0010-50 | Pentobarbital | 50 MG | 50 | 1 | 50 | 50 |
J2515 |
Pentobarbital sodium inj | SAGENT PHARMACEUTICALS INC | 25021-0676-20 | Pentobarbital | 50 MG | 20 | 1 | 20 | 20 |
J2515 |
Pentobarbital sodium inj | SAGENT PHARMACEUTICALS INC | 25021-0676-50 | Pentobarbital | 50 MG | 50 | 1 | 50 | 50 |
J2515 |
Pentobarbital sodium inj | OAK | 76478-0501-20 | Nembutal | 50 MG | 20 | 1 | 20 | 20 |
J2515 |
Pentobarbital sodium inj | OAK | 76478-0501-50 | Nembutal | 50 MG | 50 | 1 | 50 | 50 |
J2547 |
Injection, peramivir | BIOCRYST | 72769-0181-03 | Rapivab | 1 MG | 20 | 3 | 200 | 600 |
J2770 |
Quinupristin/dalfopristin | PFIZER INC. | 61570-0260-10 | Synercid | 500 MG | 1 | 10 | 1 | 10 |
J2840 |
Injection, sebelipase alfa | ALEXION PHARMACEUTICALS | 25682-0007-01 | Kanuma | 1 MG | 10 | 1 | 20 | 20 |
J2850 |
Inj secretin synthetic human | CHIRHOCLIN, INC. | 67066-0005-01 | CHIRHOSTIM | 1 MCG | 1 | 1 | 16 | 16 |
J2993 |
Reteplase injection | CHIESI USA, INC. | 10122-0141-02 | RETAVASE KIT | 18.1 MG | 1 | 2 | 1 | 2 |
J2998 |
Inj plasminogen tvmh 1mg | Prometic | 70573-0099-01 | Ryplazim | 1 mg | 1 | 1 | 68.8 | 68.8 |
J2998 |
Inj plasminogen tvmh 1mg | Prometic | 70573-0099-02 | Ryplazim | 1 mg | 1 | 1 | 68.8 | 68.8 |
J3031 |
Inj., fremanezumab-vfrm 1 mg | NUPATHE INC | 51759-0202-10 | Ajovy | 1 MG | 1.5 | 1 | 225 | 225 |
J3031 |
Inj., fremanezumab-vfrm 1 mg | NUPATHE INC | 51759-0202-22 | Ajovy | 1 MG | 1.5 | 3 | 225 | 675 |
J3031 |
Inj., fremanezumab-vfrm 1 mg | NUPATHE INC | 51759-0204-10 | Ajovy | 1 MG | 1.5 | 1 | 225 | 225 |
J3316 |
Inj., triptorelin xr 3.75 mg | ARBOR PHARMACEUTICAL | 24338-0150-20 | Triptodur | 3.75 MG | 1 | 1 | 6 | 6 |
J3398 |
Inj luxturna 1 billion vec g | SPARK THERAPEUTICS, INC. | 71394-0415-01 | LUXTURNA | 1 billion vector genomes | 0.5 | 1 | 150 | 150 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0122-03 | Zolgensma 1x5.5 mL vial and 2x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 22.1 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0125-04 | Zolgensma 1x5.5 mL vial and 3x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 30.4 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0128-05 | Zolgensma 1x5.5 mL vial and 4x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 38.7 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0131-06 | Zolgensma 1x5.5 mL vial and 5x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 47 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0134-07 | Zolgensma 1x5.5 mL vial and 6x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 55.3 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0137-08 | Zolgensma 1x5.5 mL vial and 7x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 63.6 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0140-09 | Zolgensma 1x5.5 mL vial and 9x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 71.9 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0121-03 | Zolgensma 2x5.5 mL vial and 1x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 19.3 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0124-04 | Zolgensma 2x5.5 mL vial and 2x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 27.6 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0127-05 | Zolgensma 2x5.5 mL vial and 3x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 35.9 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0130-06 | Zolgensma 2x5.5 mL vial and 4x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 44.2 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0133-07 | Zolgensma 2x5.5 mL vial and 5x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 52.5 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0136-08 | Zolgensma 2x5.5 mL vial and 6x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 60.8 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0139-09 | Zolgensma 2x5.5 mL vial and 7x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 69.1 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0120-02 | Zolgensma 2x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 16.6 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0123-03 | Zolgensma 3x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 24.9 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0126-04 | Zolgensma 4x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 33.2 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0129-05 | Zolgensma 5x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 41.5 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0132-06 | Zolgensma 6x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 49.8 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0135-07 | Zolgensma 7x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 58.1 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0138-08 | Zolgensma 8x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 66.4 | 1 | 1 | 1 |
J3399 |
Inj onase abepar-xioi treat | AVEXIS | 71894-0141-09 | Zolgensma 9x8.3 mL vial Kit | per tx dose (up to 5 x10^15 vg?) | 74.7 | 1 | 1 | 1 |
J7168 |
Prothrombin complex kcentra | CSL BEHRING LLC | 63833-0386-02 | Kcentra | 1 IU | 1 | 1 | 1 | 1 |
J7168 |
Prothrombin complex kcentra | CSL BEHRING LLC | 63833-0387-02 | Kcentra | 1 IU | 1 | 1 | 1 | 1 |
J7169 |
Inj andexxa, 10 mg | ALEXION PHARMACEUTICALS | 69853-0102-01 | Andexxa | 10 MG | 1 | 4 | 20 | 80 |
J7352 |
Afamelanotide implant, 1 mg | CLINUVEL | 73372-0116-01 | Scenesse | 1 MG | 1 | 1 | 16 | 16 |
J7501 |
Azathioprine parenteral | HIKMA PHARMACEUTICALS USA INC. | 00143-9566-01 | AZATHIOPRINE INJECTION | 100 MG | 1 | 1 | 1 | 1 |
J9019 |
Erwinaze injection | JAZZ PHARMACEUTICALS, INC. | 57902-0249-05 | ERWINAZE | 1,000 IU | 1 | 5 | 10 | 50 |
J9048 |
Inj, bortezomib freseniuskab | FRESENIUS KABI | 63323-0721-10 | Bortezomib | 0.1 MG | 1 | 1 | 35 | 35 |
J9057 |
Inj., copanlisib, 1 mg | BAYER HEALTHCARE PHARMACEUTICALS INC. | 50419-0385-01 | ALIQOPA | 1 MG | 1 | 1 | 60 | 60 |
J9225 |
Vantas implant | ENDO PHARMACEUTICALS VALERA INC. | 67979-0500-01 | Vantas implant | 50 MG | 1 | 1 | 1 | 1 |
J9247 |
Inj, melphalan flufenami 1mg | ONCOPEPTIDES, INC. | 73657-0020-01 | Pepaxto | 1 MG | 1 | 1 | 20 | 20 |
J9318 |
Inj romidepsin non-lyo 0.1mg | SICOR PHARMACEUTICALS, INC. | 00703-4004-01 | Romidepsin non-lyophilized | 0.1 MG | 5.5 | 1 | 275 | 275 |
J9348 |
Inj. naxitamab-gqgk, 1 mg | Y-MABS THERAPEUTICS | 73042-0201-01 | Danyelza | 1 MG | 10 | 1 | 40 | 40 |
J9371 |
Inj, Vincristine sul lip 1mg | SPECTRUM PHARMACEUTICALS | 20536-0322-01 | Vincristine Sulfate | 1 MG | 1 | 1 | 5 | 5 |
J9371 |
Inj, Vincristine sul lip 1mg | ACROTECH BIOPHARMA | 72893-0008-03 | Vincristine Sulfate | 1 MG | 1 | 1 | 5 | 5 |
J9600 |
Porfimer sodium injection | PINNACLE BIOLOGICS, INC. | 76128-0155-75 | Photofrin | 75 MG | 1 | 1 | 1 | 1 |
Q2042 |
Tisagenlecleucel car-pos t | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0958-19 | Kymriah (adult dose) | up to 600 million CAR-positive viable T cells | 1 | 1 | 1 | 1 |
Q2042 |
Tisagenlecleucel car-pos t | NOVARTIS PHARMACEUTICALS CORPORATION | 00078-0846-19 | Kymriah (pediatric dose) | up to 600 million CAR-positive viable T cells | 1 | 1 | 1 | 1 |
Q2054 |
lisocabtagene car pos t | JUNO THERAPEUTICS, INC. WHOLLY OWNED SUBSIDIARIES OF BRISTOL MYERS SQUIBB | 73153-0900-01 | Breyanzi | Up to 110 million CAR-positive viable T cells, per therapeutic d | 1 | 1 | 1 | 1 |
Q2055 |
Idecabtagene car pos t | CELGENE CORPORATION | 59572-0515-01 | Abecma | UP TO 460 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CEL | 1 | 1 | 1 | 1 |
Q2055 |
Idecabtagene car pos t | CELGENE CORPORATION | 59572-0515-02 | Abecma | UP TO 460 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CEL | 1 | 1 | 1 | 1 |
Q2055 |
Idecabtagene car pos t | CELGENE CORPORATION | 59572-0515-03 | Abecma | UP TO 460 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CEL | 1 | 1 | 1 | 1 |
Q2056 |
Ciltacabtagene car-pos t | Janssen Biotech, Inc. | 57894-0111-01 | Carvykti | up to 100 million autologous b-cell maturation antigen (bcma) di | 1 | 1 | 1 | 1 |
Q2056 |
Ciltacabtagene car-pos t | Janssen Biotech, Inc. | 57894-0111-02 | Carvykti | up to 100 million autologous b-cell maturation antigen (bcma) di | 1 | 1 | 1 | 1 |
Q5128 |
Inj, cimerli, 0.1 mg | Coherus Biosciences, Inc. | 70114-0440-01 | Cimerli | 0.1 MG | 0.05 | 1 | 3 | 3 |
Q5128 |
Inj, cimerli, 0.1 mg | Coherus Biosciences, Inc. | 70114-0441-01 | Cimerli | 0.1 MG | 0.05 | 1 | 5 | 5 |
Q9968 |
Visualization adjunct | MYLAN INSTITUTIONAL LLC | 67457-0220-05 | ISOSULFAN BLUE INJECTION | 1 MG | 5 | 6 | 50 | 300 |
Q9968 |
Visualization adjunct | AMERICAN REGENT | 00517-0374-05 | Provayblue | 1 MG | 10 | 5 | 50 | 250 |