Ambulatory Payment Classifications →
section notes
Drugs and Biologicals (Excluding Cancer/Chemotherapy) →
section notes
0702‑9468   Hemophilia Products
0703‑9496   Injection(s)
0707   Cantharidin top, applicator
0722   Dexmedetomidine film, 1 mcg
0738   Rasburicase
0742   Anacaulase-bcdb 8.8% gel 1 g
0744   Inst tauro 1.35mg/hep 100u
0754   Daptomycin (xellia) unrefrig
0755   Oral methotrexate (jylamvo)
0756   Oral methotrexate (xatmep)
0763‑9396   Implants
0800   Leuprolide acetate
0805‑0808   HIV PreP
0864   Mitoxantrone hydrochl
0874   Synvisc or synvisc-one
0887   Azathioprine parenteral
0901   Alpha 1 proteinase inhibitor
0903   Cytomegalovirus imm IV /vial
0929   Anti-inhibitor
0948   Gamunex-C/Gammaked
0963‑9541   Blood Products
0890‑9135   Immune Globulins, Serum or Recombinant Products
1139   Protein c concentrate
1289   AbobotulinumtoxinA
1417   Gel-one
1475   Golimumab for iv use 1mg
1482   Darbepoetin alfa, esrd use
1683   Basiliximab
1685   Darbepoetin alfa, non-esrd
1686   Epoetin alfa, non-esrd
1688   Ethanolamine oleate
1689   Fomepizole
1690   Hemin
1712   Paclitaxel protein bound
1825   Ceftazidime and avibactam
1832   Dimethyl sulfoxide 50% 50 ml
1853   Minocycline hydrochloride
1859   Argatroban nonesrd use 1mg
2770   Quinupristin/dalfopristin
5691‑5694   Drug Administration
7043   Infliximab not biosimil 10mg
7048   Alteplase recombinant
7308   Aminolevulinic acid hcl top
9020‑9022   Argatroban
9024   Amphotericin b lipid complex
9042   Glucagon hydrochloride
9071   Capsaicin 8% patch
9074   Makena, 10 mg
9077   Epoetin beta non esrd
9078   Testosterone undecanoate 1mg
9104   Antithymocyte globuln rabbit
9116   Chloroprocaine opht gel, 1mg
9122   Triptorelin pamoate
9132   Prothrombin complex kcentra
9142   Fecal˙microbiota jslm 1 ml
9202   Difelikefalin, esrd on dialy
9217   Leuprolide acetate suspnsion
9269   C-1 esterase, berinert
9270   Gammaplex IVIG
9271   Velaglucerase alfa
9274   Crotalidae Poly Immune Fab
9278   Incobotulinumtoxin A
9301   Aminolevulinic acid, 10% gel
9308   Dexametha opth insert 0.1 mg
9320   Carbidopa levodopa ent 100ml
9324   Phenylep ketorolac opth soln
9335   Oral busulfan
9346   Mometasone sinus sinuva
9366   Fiasp for insulin pump use
9374   Mitomycin instillation
9440   Instill, bupivac and meloxic
9448   Oral netupitant, palonosetro
9470   Aripirazole lauroxil 1 mg
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