These codes are used to report injectable drugs that ordinarily cannot be self-administered; chemotherapy, immunosuppressive drugs and inhalation solutions as well as some orally administered drugs.
Etonogestrel (contraceptive) implant system, including implant and supplies
Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)
Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram
Ganciclovir, 4.5 mg, long-acting implant
Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
Injection, dexamethasone, intravitreal implant, 0.1 mg
Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg
Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg
Mitomycin, ophthalmic, 0.2 mg
Injection, ocriplasmin, 0.125 mg
Continued
Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg
Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose
Hyaluronan or derivative, hymovis or hymovis one, for intra-articular injection, 1 mg
Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose
Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg
Hyaluronan or derivative, gel-one, for intra-articular injection, per dose
Hyaluronan or derivative, monovisc, for intra-articular injection, per dose
Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg
Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg
Autologous cultured chondrocytes, implant
Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg
Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg
Hyaluronan or derivative, visco-3, for intra-articular injection, per dose
Capsaicin 8% patch, per 10 square centimeters
Capsaicin 8% patch, per square centimeter
Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml
Instillation, ciprofloxacin otic suspension, 6 mg
Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg
Continued
Injection, bimatoprost, intracameral implant, 1 microgram
Afamelanotide implant, 1 mg
Anacaulase-bcdb, 8.8% gel, 1 gram
Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
Injection, travoprost, intracameral implant, 1 microgram
Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg
Mometasone furoate sinus implant, 10 micrograms
Mometasone furoate sinus implant, (sinuva), 10 micrograms
Azathioprine, oral, 50 mg
Azathioprine, parenteral, 100 mg
Cyclosporine, oral, 100 mg
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
Muromonab-cd3, parenteral, 5 mg
Prednisone, oral, per 5 mg
Tacrolimus, immediate release, oral, 1 mg
Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
Methylprednisolone oral, per 4 mg
Prednisolone oral, per 5 mg
Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg