Ambulatory Payment Classifications
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Drugs and Biologicals (Excluding Cancer/Chemotherapy)
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Injection(s)
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Injections 9000–9999
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9002   Tenecteplase injection
9004   Injection, inclisiran, 1 mg
9005   Reteplase injection
9006   Tacrolimus injection
9007   Inj cutaquig 100 mg
9008   Inj tezepelumab-ekko, 1mg
9009   Inj, vutrisiran, 1 mg
9010   Inj efgartigimod 2mg
9012   Arsenic trioxide injection
9013   Inj risankizumab-rzaa 1 mg
9016   Inj., triptorelin xr 3.75 mg
9017   Inj. byooviz, 0.1 mg
9018   Inj, rimabotulinumtoxinB
9025   Inj glucagon hcl, fresenius
9028   Inj inotuzumab ozogam 0.1 mg
9029   Inj., guselkumab, 1 mg
9030   Inj., copanlisib, 1 mg
9032   Baclofen 10 MG injection
9033   Cidofovir injection
9034   Inj cuvitru, 100 mg
9036   Injection, renflexis
9038   Inj estrogen conjugate
9039   Dimecaprol injection
9043   Inj, afstyla, 1 i.u.
9044   Ibutilide fumarate injection
9046   Inj., fibryga, 1 mg
9047   Leuprolide acetate injeciton
9049   Inj, oliceridine 0.1 mg
9051   Inj, lanreotide, (cipla) 1mg
9059   Vonvendi inj 1 iu vwf:rco
9070   Inj luxturna 1 billion vec g
9073   Buprenorph xr 100 mg or less
9075   Inj, kovaltry, 1 i.u.
9079   Genvisc 850, inj, 1mg
9088   Peng benzathine/procaine inj
9094   Radiesse injection
9095   Inj, sculptra, 0.5mg
9097   Inj retacrit non-esrd use
9099   Inj fosnetupitant, palonoset
9108   Thyrotropin injection
9125   Risperidone, long acting
9126   Natalizumab injection
9130   Inj, Imm Glob Bivigam, 500mg
9173   Injection, fulphila
9174   Inj, durolane 1 mg
9178   Inj., meropenem, vaborbactam
9179   Inj., aristada initio, 1 mg
9180   Inj., patisiran, 0.1 mg
9181   Inj., perseris, 0.5 mg
9182   Inj mogamulizumab-kpkc, 1 mg
9183   Inj., plazomicin, 5 mg
9186   Inj., rituximab, 10 mg
9187   Injection, burosumab-twza 1m
9188   Inj crotalidae im f(ab')2 eq
9189   Inj., ibalizumab-uiyk, 10 mg
9195   Injection, udenyca 0.5 mg
9196   Inj, trivisc 1 mg
9197   Inj., fremanezumab-vfrm 1 mg
9198   Inj andexxa, 10 mg
9199   Injection, caplacizumab-yhdp
9200   Inj, remdesivir, 1 mg
9208   Agalsidase beta injection
9209   Laronidase injection
9215   Cetuximab injection
9225   Fluocinolone acetonide implt
9230   Abatacept injection
9233   Ranibizumab injection
9234   Alglucosidase alfa injection
9236   Eculizumab injection
9237   Inj, lanreotide acetate
9239   Buprenorphine xr over 100 mg
9240   Injection, ixabepilone
9243   Inj., treanda 1 mg
9245   Romiplostim injection
9251   C1 esterase inhibitor inj
9252   Plerixafor injection
9255   Inj, invega sustenna, 1 mg
9257   Inj., emicizumab-kxwh 0.5 mg
9258   Telavancin injection
9261   Ustekinumab sub cu inj, 1 mg
9263   Ecallantide injection
9264   Tocilizumab injection
9272   Inj, denosumab
9276   Cabazitaxel injection
9281   Injection, pegloticase
9284   Ipilimumab injection
9286   Belatacept injection
9287   Brentuximab vedotin inj
9294   Inj, taliglucerase alfa 10 u
9295   Injection, Carfilzomib, 1 mg
9297   Inj, Omacetaxine Mep, 0.01mg
9299   Inj. jivi 1 iu
9300   Omalizumab injection
9302   Inj daunorubicin, cytarabine
9304   Inj., cemiplimab-rwlc, 1 mg
9305   Inj., lumoxiti, 0.01 mg
9306   Inj., tildrakizumab, 1 mg
9309   Inj. tagraxofusp-erzs 10 mcg
9310   Inj., emapalumab-lzsg, 1 mg
9311   Inj., omadacycline, 1 mg
9312   Inj., ravulizumab-cwvz 10 mg
9313   Inj. belrapzo/bendamustine
9314   Inj. herceptin hylecta, 10mg
9318   Inj hydroxyprogst capoat nos
9319   Somatropin injection
9327   Inj. romosozumab-aqqg 1 mg
9328   Inj., yutiq, 0.01 mg
9329   Inj mvasi 10 mg
9330   Inj., kanjinti, 10 mg
9331   Inj, polatuzumab vedotin 1mg
9333   Inj., brexanolone, 1 mg
9336   Inj truxima 10 mg
9337   Synojoynt, inj., 1 mg
9340   Inj, brolucizumab-dbll, 1 mg
9341   Inj ogivri 10 mg
9343   Inj givosiran 0.5 mg
9345   Inj pegfilgrastim-bmez 0.5mg
9347   Inj luspatercept-aamt 0.25mg
9348   Inj., zirabev, 10 mg
9349   Inj herzuma 10 mg
9350   Inj., trazimera, 10 mg
9351   Inj bimatoprost itc imp 1mcg
9353   Inj fam-trastu deru-nxki 1mg
9354   Inj recombin esperoct per iu
9355   Inj. teprotumumab-trbw 10 mg
9356   Inj golodirsen 10 mg
9357   Inj. eptinezumab-jjmr 1 mg
9358   Inj xipere 1 mg
9359   Inj crizanlizumab-tmca 5mg
9361   Inj. cetirizine hcl 0.5mg
9362   Inj imip 4 cilas 4 releb 2mg
9364   Inj enfort vedo-ejfv 0.25mg
9367   Inj ruxience, 10 mg
9372   Inj. xembify, 100 mg
9375   Inj., evomela, 1 mg
9376   Sacituzumab govitecan-hziy
9377   Inj. isatuximab-irfc 10 mg
9378   Daratumumab, hyaluronidase
9381   Inj. avsola, 10 mg
9382   Inj ontruzant 10 mg
9384   Inj belantamab mafodot blmf
9385   Inj., tafasitamab-cxix
9386   Inj. viltolarsen
9387   Inj. infugem, 100 mg
9388   Inj. fe derisomaltose 10 mg
9389   Inj. lurbinectedin, 0.1 mg
9392   Inj. asceniv
9394   Inj. inebilizumab-cdon, 1 mg
9401   Bebtelovimab 175 mg
9406   Inj, nyvepria
9407   Inj. lumasiran, 0.5 mg
9408   Inj. naxitamab-gqgk, 1 mg
9411   Inj. riabni, 10 mg
9412   Injection, casimersen, 10 mg
9414   Inj, cabote rilpivir 2mg 3mg
9415   Injection, trilaciclib, 1mg
9416   Inj, evinacumab-dgnb, 5 mg
9418   Inj. margetuximab-cmkb, 5 mg
9419   Inj fensolvi 0.25 mg
9421   Inj, granisetron, xr, 0.1 mg
9426   Inj, cefiderocol, 10 mg
9427   Injection, oritavancin 10 mg
9433   Inj aval alfa-nqpt 4mg
9434   Inj anifrolumab-fnia 1mg
9438   Injection, aducanumab-avwa, 2 mg
9439   Inj, susvimo 0.1 mg
9441   Inj ferric carboxymaltos 1mg
9444   Inj, sutimlimab-jome, 10 mg
9445   Injection, ruconest
9449   Injection, blinatumomab
9450   Fluocinol acet intravit imp
9451   Injection, peramivir
9452   Inj ceftolozane tazobactam
9453   Injection, nivolumab
9454   Inj, pasireotide long acting
9455   Injection, siltuximab
9456   Injection, isavuconazonium
9463   Inj., aprepitant, 1 mg
9466   Inj., benralizumab, 1 mg
9467   Inj rituximab, hyaluronidase
9469   Inj triamcinolone ace xr 1mg
9471   Hymovis injection 1 mg
9473   Injection, mepolizumab, 1mg
9474   Inj irinotecan liposome 1 mg
9475   Injection, necitumumab, 1 mg
9476   Injection, daratumumab 10 mg
9477   Injection, elotuzumab, 1mg
9478   Inj sebelipase alfa 1 mg
9481   Injection, reslizumab
9487   Ustekinumab, iv inject,1 mg
9488   Conivaptan hcl
9489   Inj, nusinersen, 0.1mg
9490   Inj, bezlotoxumab, 10 mg
9491   Injection, avelumab, 10 mg
9492   Inj., durvalumab, 10 mg
9493   Injection, edaravone, 1 mg
9494   Injection, ocrelizumab
9495   Gemtuzumab ozogamicin inj
9496   Inj, faricimab-svoa, 0.1mg
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