HCPCS 'J' Codes (1188)
Drugs Administered Other Than Oral Method, Chemotherapy Drugs
| Code | Description |
| J0120 | Injection, tetracycline, up to 250 mg |
| J0121 | Injection, omadacycline, 1 mg |
| J0122 | Injection, eravacycline, 1 mg |
| 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) |
| J0130 | Injection abciximab, 10 mg |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg |
| J0132 | Injection, acetylcysteine, 100 mg |
| J0133 | Injection, acyclovir, 5 mg |
| J0134 | Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
| J0135 | Injection, adalimumab, 20 mg Terminated: December 31, 2024 |
| J0136 | Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
| J0137 | Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
| J0138 | Injection, acetaminophen 10 mg and ibuprofen 3 mg |
| J0139 | Injection, adalimumab, 1 mg |
| J0150 | Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270) Terminated: December 31, 2014 |
| J0151 | Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270) Terminated: December 31, 2014 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
| J0163 | Injection, epinephrine in sodium chloride (endo), 0.1 mg |
| J0164 | Injection, epinephrine in sodium chloride (baxter), 0.1 mg |
| J0165 | Injection, epinephrine, not otherwise specified, 0.1 mg |
| J0166 | Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg |
| J0167 | Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg |
| J0168 | Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg |
| J0169 | Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg Terminated: June 30, 2025 |
| J0172 | Injection, aducanumab-avwa, 2 mg |
| J0173 | Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg Terminated: June 30, 2025 |
| J0174 | Injection, lecanemab-irmb, 1 mg |
| J0175 | Injection, donanemab-azbt, 2 mg |
| J0177 | Injection, aflibercept hd, 1 mg |
| J0178 | Injection, aflibercept, 1 mg |
| J0179 | Injection, brolucizumab-dbll, 1 mg |
| J0180 | Injection, agalsidase beta, 1 mg |
| J0184 | Injection, amisulpride, 1 mg |
| J0185 | Injection, aprepitant, 1 mg |
| J0190 | Injection, biperiden lactate, per 5 mg |
| J0200 | Injection, alatrofloxacin mesylate, 100 mg |
| J0202 | Injection, alemtuzumab, 1 mg |
| J0205 | Injection, alglucerase, per 10 units |
| J0206 | Injection, allopurinol sodium, 1 mg |
| J0207 | Injection, amifostine, 500 mg |
| J0208 | Injection, sodium thiosulfate (pedmark), 100 mg |
| J0209 | Injection, sodium thiosulfate (hope), 100 mg |
| J0210 | Injection, methyldopate hcl, up to 250 mg |
| J0211 | Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote) |
| J0215 | Injection, alefacept, 0.5 mg |
| J0216 | Injection, alfentanil hydrochloride, 500 micrograms |
| J0217 | Injection, velmanase alfa-tycv, 1 mg |
| J0218 | Injection, olipudase alfa-rpcp, 1 mg |
| J0219 | Injection, avalglucosidase alfa-ngpt, 4 mg |
| J0220 | Injection, alglucosidase alfa, 10 mg, not otherwise specified |
| J0221 | Injection, alglucosidase alfa, (lumizyme), 10 mg |
| J0222 | Injection, patisiran, 0.1 mg |
| J0223 | Injection, givosiran, 0.5 mg |
| J0224 | Injection, lumasiran, 0.5 mg |
| J0225 | Injection, vutrisiran, 1 mg |
| J0248 | Injection, remdesivir, 1 mg |
| J0256 | Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg |
| J0257 | Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg |
| J0270 | Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
| J0275 | Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
| J0278 | Injection, amikacin sulfate, 100 mg |
| J0280 | Injection, aminophyllin, up to 250 mg |
| J0281 | Injection, aminocaproic acid, 1 gram |
| J0282 | Injection, amiodarone hydrochloride, 30 mg |
| J0283 | Injection, amiodarone hydrochloride (nexterone), 30 mg |
| J0285 | Injection, amphotericin b, 50 mg |
| J0287 | Injection, amphotericin b lipid complex, 10 mg |
| J0288 | Injection, amphotericin b cholesteryl sulfate complex, 10 mg |
| J0289 | Injection, amphotericin b liposome, 10 mg |
| J0290 | Injection, ampicillin sodium, 500 mg |
| J0291 | Injection, plazomicin, 5 mg |
| J0295 | Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
| J0300 | Injection, amobarbital, up to 125 mg |
| J0330 | Injection, succinylcholine chloride, up to 20 mg |
| J0348 | Injection, anidulafungin, 1 mg |
| J0349 | Injection, rezafungin, 1 mg |
| J0350 | Injection, anistreplase, per 30 units |
| J0360 | Injection, hydralazine hcl, up to 20 mg |
| J0364 | Injection, apomorphine hydrochloride, 1 mg |
| J0365 | Injection, aprotonin, 10,000 kiu |
| J0380 | Injection, metaraminol bitartrate, per 10 mg |
| J0390 | Injection, chloroquine hydrochloride, up to 250 mg |
| J0391 | Injection, artesunate, 1 mg |
| J0395 | Injection, arbutamine hcl, 1 mg |
| J0400 | Injection, aripiprazole, intramuscular, 0.25 mg |
| J0401 | Injection, aripiprazole (abilify maintena), 1 mg |
| J0402 | Injection, aripiprazole (abilify asimtufii), 1 mg |
| J0456 | Injection, azithromycin, 500 mg |
| J0457 | Injection, aztreonam, 100 mg |
| J0458 | Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg) |
| J0461 | Injection, atropine sulfate, 0.01 mg |
| J0462 | Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg |
| J0470 | Injection, dimercaprol, per 100 mg |
| J0475 | Injection, baclofen, 10 mg |
| J0476 | Injection, baclofen, 50 mcg for intrathecal trial |
| J0480 | Injection, basiliximab, 20 mg |
| J0485 | Injection, belatacept, 1 mg |
| J0490 | Injection, belimumab, 10 mg |
| J0491 | Injection, anifrolumab-fnia, 1 mg |
| J0500 | Injection, dicyclomine hcl, up to 20 mg |
| J0515 | Injection, benztropine mesylate, per 1 mg |
| J0517 | Injection, benralizumab, 1 mg |
| J0520 | Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg |
| J0525 | Injection, cefotetan disodium, 10 mg |
| J0558 | Injection, penicillin g benzathine and penicillin g procaine, 100,000 units |
| J0561 | Injection, penicillin g benzathine, 100,000 units |
| J0565 | Injection, bezlotoxumab, 10 mg |
| J0567 | Injection, cerliponase alfa, 1 mg |
| J0570 | Buprenorphine implant, 74.2 mg |
| J0571 | Buprenorphine, oral, 1 mg |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
| J0573 | Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
| J0575 | Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine |
| J0576 | Injection, buprenorphine extended-release (brixadi), 1 mg Terminated: March 31, 2024 |
| J0577 | Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy |
| J0578 | Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy |
| J0582 | Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg |
| J0583 | Injection, bivalirudin, 1 mg |
| J0584 | Injection, burosumab-twza 1 mg |
| J0585 | Injection, onabotulinumtoxina, 1 unit |
| J0586 | Injection, abobotulinumtoxina, 5 units |
| J0587 | Injection, rimabotulinumtoxinb, 100 units |
| J0588 | Injection, incobotulinumtoxin a, 1 unit |
| J0589 | Injection, daxibotulinumtoxina-lanm, 1 unit |
| J0591 | Injection, deoxycholic acid, 1 mg |
| J0592 | Injection, buprenorphine hydrochloride, 0.1 mg |
| J0593 | Injection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered) |
| J0594 | injection, busulfan, 1 mg |
| J0595 | Injection, butorphanol tartrate, 1 mg |
| J0596 | Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units |
| J0597 | Injection, c-1 esterase inhibitor (human), berinert, 10 units |
| J0598 | Injection, c-1 esterase inhibitor (human), cinryze, 10 units |
| J0599 | Injection, c-1 esterase inhibitor (human), (haegarda), 10 units |
| J0600 | Injection, edetate calcium disodium, up to 1000 mg |
| J0601 | Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis) |
| J0602 | Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis) |
| J0603 | Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis) |
| J0604 | Cinacalcet, oral, 1 mg, (for esrd on dialysis) |
| J0605 | Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis) |
| J0606 | Injection, etelcalcetide, 0.1 mg |
| J0607 | Lanthanum carbonate, oral, 5 mg (for esrd on dialysis) |
| J0608 | Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis) |
| J0609 | Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis) |
| J0610 | Injection, calcium gluconate (fresenius kabi), per 10 ml Terminated: March 31, 2023 |
| J0611 | Injection, calcium gluconate (wg critical care), per 10 ml Terminated: March 31, 2023 |
| J0612 | Injection, calcium gluconate, not otherwise specified, 10 mg |
| J0613 | Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg |
| J0614 | Injection, treosulfan, 50 mg |
| J0615 | Calcium acetate, oral, 23 mg (for esrd on dialysis) |
| J0616 | Injection, metoprolol tartrate, 1 mg |
| J0618 | Injection, calcium chloride, 2 mg |
| J0620 | Injection, calcium glycerophosphate and calcium lactate, per 10 ml |
| J0630 | Injection, calcitonin salmon, up to 400 units |
| J0636 | Injection, calcitriol, 0.1 mcg |
| J0637 | Injection, caspofungin acetate, 5 mg |
| J0638 | Injection, canakinumab, 1 mg |
| J0640 | Injection, leucovorin calcium, per 50 mg |
| J0641 | Injection, levoleucovorin, not otherwise specified, 0.5 mg |
| J0642 | Injection, levoleucovorin (khapzory), 0.5 mg |
| J0650 | Injection, levothyroxine sodium, not otherwise specified, 10 mcg |
| J0651 | Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg |
| J0652 | Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg |
| J0666 | Injection, bupivacaine liposome, 1 mg |
| J0668 | Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg |
| J0670 | Injection, mepivacaine hydrochloride, per 10 ml |
| J0675 | Injection, carboprost tromethamine, 0.1 mg |
| J0681 | Injection, ceftobiprole medocaril sodium, 3 mg |
| J0687 | Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
| J0688 | Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
| J0689 | Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
| J0690 | Injection, cefazolin sodium, 500 mg |
| J0691 | Injection, lefamulin, 1 mg |
| J0692 | Injection, cefepime hydrochloride, 500 mg |
| J0693 | Injection, cefiderocol, 5 mg Terminated: September 30, 2021 |
| J0694 | Injection, cefoxitin sodium, 1 gm |
| J0695 | Injection, ceftolozane 50 mg and tazobactam 25 mg |
| J0696 | Injection, ceftriaxone sodium, per 250 mg |
| J0697 | Injection, sterile cefuroxime sodium, per 750 mg |
| J0698 | Injection, cefotaxime sodium, per gm |
| J0699 | Injection, cefiderocol, 10 mg |
| J0701 | Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
| J0703 | Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg |
| J0706 | Injection, caffeine citrate, 5 mg |
| J0710 | Injection, cephapirin sodium, up to 1 gm |
| J0712 | Injection, ceftaroline fosamil, 10 mg |
| J0713 | Injection, ceftazidime, per 500 mg |
| J0714 | Injection, ceftazidime and avibactam, 0.5 g/0.125 g |
| J0715 | Injection, ceftizoxime sodium, per 500 mg |
| J0716 | Injection, centruroides immune f(ab)2, up to 120 milligrams |
| J0717 | Injection, certolizumab pegol, 1 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) |
| J0720 | Injection, chloramphenicol sodium succinate, up to 1 gm |
| J0725 | Injection, chorionic gonadotropin, per 1,000 usp units |
| J0735 | Injection, clonidine hydrochloride, 1 mg |
| J0736 | Injection, clindamycin phosphate, 300 mg |
| J0737 | Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
| J0738 | Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) |
| J0739 | Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) |
| J0740 | Injection, cidofovir, 375 mg |
| J0741 | Injection, cabotegravir and rilpivirine, 2mg/3mg |
| J0742 | Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg |
| J0743 | Injection, cilastatin sodium; imipenem, per 250 mg |
| J0744 | Injection, ciprofloxacin for intravenous infusion, 200 mg |
| J0745 | Injection, codeine phosphate, per 30 mg |
| J0750 | Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) |
| J0751 | Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) |
| J0752 | Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) |
| J0759 | Injection, clevidipine butyrate, 1 mg |
| J0760 | Injection, colchicine, per 1 mg Terminated: December 31, 2016 |
| J0770 | Injection, colistimethate sodium, up to 150 mg |
| J0775 | Injection, collagenase, clostridium histolyticum, 0.01 mg |
| J0780 | Injection, prochlorperazine, up to 10 mg |
| J0791 | Injection, crizanlizumab-tmca, 5 mg |
| J0795 | Injection, corticorelin ovine triflutate, 1 microgram |
| J0799 | Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified |
| J0800 | Injection, corticotropin, up to 40 units Terminated: September 30, 2023 |
| J0801 | Injection, corticotropin (acthar gel), up to 40 units |
| J0802 | Injection, corticotropin (ani), up to 40 units |
| J0833 | Injection, cosyntropin, not otherwise specified, 0.25 mg Terminated: December 31, 2018 |
| J0834 | Injection, cosyntropin, 0.25 mg |
| J0840 | Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram |
| J0841 | Injection, crotalidae immune f(ab')2 (equine), 120 mg |
| J0850 | Injection, cytomegalovirus immune globulin intravenous (human), per vial |
| J0870 | Injection, imetelstat, 1 mg |
| J0872 | Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg |
| J0873 | Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg |
| J0874 | Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg |
| J0875 | Injection, dalbavancin, 5 mg |
| J0877 | Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg |
| J0878 | Injection, daptomycin, 1 mg |
| J0879 | Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis) |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) |
| J0883 | Injection, argatroban, 1 mg (for non-esrd use) |
| J0884 | Injection, argatroban, 1 mg (for esrd on dialysis) |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units |
| J0886 | Injection, epoetin alfa, 1000 units (for esrd on dialysis) Terminated: December 31, 2015 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) |
| J0889 | Daprodustat, oral, 1 mg, (for esrd on dialysis) |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) |
| J0891 | Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use) |
| J0892 | Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis) |
| J0893 | Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg |
| J0894 | Injection, decitabine, 1 mg |
| J0895 | Injection, deferoxamine mesylate, 500 mg |
| J0896 | Injection, luspatercept-aamt, 0.25 mg |
| J0897 | Injection, denosumab, 1 mg |
| J0898 | Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use) |
| J0899 | Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis) |
| J0900 | Injection, testosterone enanthate and estradiol valerate, up to 1 cc Terminated: December 31, 2014 |
| J0901 | Vadadustat, oral, 1 mg (for esrd on dialysis) |
| J0911 | Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis) |
| J0945 | Injection, brompheniramine maleate, per 10 mg |
| J1000 | Injection, depo-estradiol cypionate, up to 5 mg |
| J1010 | Injection, methylprednisolone acetate, 1 mg |
| J1020 | Injection, methylprednisolone acetate, 20 mg Terminated: March 31, 2024 |
| J1030 | Injection, methylprednisolone acetate, 40 mg Terminated: March 31, 2024 |
| J1040 | Injection, methylprednisolone acetate, 80 mg Terminated: March 31, 2024 |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg |
| J1060 | Injection, testosterone cypionate and estradiol cypionate, up to 1 ml Terminated: December 31, 2014 |
| J1070 | Injection, testosterone cypionate, up to 100 mg Terminated: December 31, 2014 |
| J1071 | Injection, testosterone cypionate, 1 mg |
| J1072 | Injection, testosterone cypionate (azmiro), 1 mg |
| J1080 | Injection, testosterone cypionate, 1 cc, 200 mg Terminated: December 31, 2014 |
| J1094 | Injection, dexamethasone acetate, 1 mg Terminated: March 31, 2025 |
| J1095 | Injection, dexamethasone 9 percent, intraocular, 1 microgram |
| J1096 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg |
| J1097 | Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg |
| J1105 | Dexmedetomidine, oral, 1 mcg |
| J1110 | Injection, dihydroergotamine mesylate, per 1 mg |
| J1120 | Injection, acetazolamide sodium, up to 500 mg |
| J1130 | Injection, diclofenac sodium, 0.5 mg |
| J1160 | Injection, digoxin, up to 0.5 mg |
| J1162 | Injection, digoxin immune fab (ovine), per vial |
| J1163 | Injection, diltiazem hydrochloride, 0.5 mg |
| J1165 | Injection, phenytoin sodium, per 50 mg |
| J1170 | Injection, hydromorphone, up to 4 mg Terminated: September 30, 2024 |
| J1171 | Injection, hydromorphone, 0.1 mg |
| J1180 | Injection, dyphylline, up to 500 mg |
| J1190 | Injection, dexrazoxane hydrochloride, per 250 mg |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg |
| J1201 | Injection, cetirizine hydrochloride, 0.5 mg |
| J1202 | Miglustat, oral, 65 mg |
| J1203 | Injection, cipaglucosidase alfa-atga, 5 mg |
| J1205 | Injection, chlorothiazide sodium, per 500 mg |
| J1212 | Injection, dmso, dimethyl sulfoxide, 50%, 50 ml |
| J1230 | Injection, methadone hcl, up to 10 mg |
| J1240 | Injection, dimenhydrinate, up to 50 mg |
| J1245 | Injection, dipyridamole, per 10 mg |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg |
| J1260 | Injection, dolasetron mesylate, 10 mg |
| J1265 | Injection, dopamine hcl, 40 mg |
| J1267 | Injection, doripenem, 10 mg |
| J1270 | Injection, doxercalciferol, 1 mcg |
| J1271 | Injection, doxycycline hyclate, 1 mg |
| J1290 | Injection, ecallantide, 1 mg |
| J1299 | Injection, eculizumab, 2 mg |
| J1300 | Injection, eculizumab, 10 mg Terminated: March 31, 2025 |
| J1301 | Injection, edaravone, 1 mg |
| J1302 | Injection, sutimlimab-jome, 10 mg |
| J1303 | Injection, ravulizumab-cwvz, 10 mg |
| J1304 | Injection, tofersen, 1 mg |
| J1305 | Injection, evinacumab-dgnb, 5mg |
| J1306 | Injection, inclisiran, 1 mg |
| J1307 | Injection, crovalimab-akkz, 10 mg |
| J1308 | Injection, famotidine, 0.25 mg |
| J1320 | Injection, amitriptyline hcl, up to 20 mg |
| J1322 | Injection, elosulfase alfa, 1 mg |
| J1323 | Injection, elranatamab-bcmm, 1 mg |
| J1324 | Injection, enfuvirtide, 1 mg |
| J1325 | Injection, epoprostenol, 0.5 mg |
| J1326 | Injection, zolbetuximab-clzb, 2 mg |
| J1327 | Injection, eptifibatide, 5 mg |
| J1330 | Injection, ergonovine maleate, up to 0.2 mg |
| J1335 | Injection, ertapenem sodium, 500 mg |
| J1364 | Injection, erythromycin lactobionate, per 500 mg |
| J1370 | Injection, esomeprazole sodium, 1 mg |
| J1380 | Injection, estradiol valerate, up to 10 mg |
| J1410 | Injection, estrogen conjugated, per 25 mg |
| J1411 | Injection, etranacogene dezaparvovec-drlb, per therapeutic dose |
| J1412 | Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes |
| J1413 | Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose |
| J1414 | Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose |
| J1426 | Injection, casimersen, 10 mg |
| J1427 | Injection, viltolarsen, 10 mg |
| J1428 | Injection, eteplirsen, 10 mg |
| J1429 | Injection, golodirsen, 10 mg |
| J1430 | Injection, ethanolamine oleate, 100 mg |
| J1434 | Injection, fosaprepitant (focinvez), 1 mg |
| J1435 | Injection, estrone, per 1 mg |
| J1436 | Injection, etidronate disodium, per 300 mg |
| J1437 | Injection, ferric derisomaltose, 10 mg |
| J1438 | Injection, etanercept, 25 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) |
| J1439 | Injection, ferric carboxymaltose, 1 mg |
| J1440 | Fecal microbiota, live - jslm, 1 ml |
| J1442 | Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram |
| J1443 | Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron |
| J1444 | Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron |
| J1445 | Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron |
| J1446 | Injection, tbo-filgrastim, 5 micrograms Terminated: December 31, 2015 |
| J1447 | Injection, tbo-filgrastim, 1 microgram |
| J1448 | Injection, trilaciclib, 1mg |
| J1449 | Injection, eflapegrastim-xnst, 0.1 mg |
| J1450 | Injection fluconazole, 200 mg |
| J1451 | Injection, fomepizole, 15 mg |
| J1452 | Injection, fomivirsen sodium, intraocular, 1.65 mg |
| J1453 | Injection, fosaprepitant, 1 mg |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg |
| J1455 | Injection, foscarnet sodium, per 1000 mg |
| J1456 | Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg |
| J1457 | Injection, gallium nitrate, 1 mg |
| J1458 | Injection, galsulfase, 1 mg |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg |
| J1460 | Injection, gamma globulin, intramuscular, 1 cc |
| J1551 | Injection, immune globulin (cutaquig), 100 mg |
| J1552 | Injection, immune globulin (alyglo), 500 mg |
| J1554 | Injection, immune globulin (asceniv), 500 mg |
| J1555 | Injection, immune globulin (cuvitru), 100 mg |
| J1556 | Injection, immune globulin (bivigam), 500 mg |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg |
| J1558 | Injection, immune globulin (xembify), 100 mg |
| J1559 | Injection, immune globulin (hizentra), 100 mg |
| J1560 | Injection, gamma globulin, intramuscular, over 10 cc |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
| J1562 | Injection, immune globulin (vivaglobin), 100 mg |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
| J1570 | Injection, ganciclovir sodium, 500 mg |
| J1571 | Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml |
| J1572 | Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg |
| J1573 | Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml |
| J1574 | Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg |
| J1575 | Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin |
| J1576 | Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg |
| J1580 | Injection, garamycin, gentamicin, up to 80 mg |
| J1590 | Injection, gatifloxacin, 10 mg Terminated: December 31, 2016 |
| J1595 | Injection, glatiramer acetate, 20 mg |
| J1596 | Injection, glycopyrrolate, 0.1 mg |
| J1597 | Injection, glycopyrrolate (glyrx-pf), 0.1 mg |
| J1598 | Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg |
| J1600 | Injection, gold sodium thiomalate, up to 50 mg |
| J1602 | Injection, golimumab, 1 mg, for intravenous use |
| J1610 | Injection, glucagon hydrochloride, per 1 mg |
| J1611 | Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg |
| J1612 | Injection, glucagon (gvoke), 0.01 mg |
| J1620 | Injection, gonadorelin hydrochloride, per 100 mcg |
| J1626 | Injection, granisetron hydrochloride, 100 mcg |
| J1627 | Injection, granisetron, extended-release, 0.1 mg |
| J1628 | Injection, guselkumab, 1 mg |
| J1630 | Injection, haloperidol, up to 5 mg |
| J1631 | Injection, haloperidol decanoate, per 50 mg |
| J1632 | Injection, brexanolone, 1 mg |
| J1640 | Injection, hemin, 1 mg |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units |
| J1643 | Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
| J1644 | Injection, heparin sodium, per 1000 units |
| J1645 | Injection, dalteparin sodium, per 2500 iu |
| J1650 | Injection, enoxaparin sodium, 10 mg |
| J1652 | Injection, fondaparinux sodium, 0.5 mg |
| J1655 | Injection, tinzaparin sodium, 1000 iu |
| J1670 | Injection, tetanus immune globulin, human, up to 250 units |
| J1675 | Injection, histrelin acetate, 10 micrograms |
| J1700 | Injection, hydrocortisone acetate, up to 25 mg |
| J1710 | Injection, hydrocortisone sodium phosphate, up to 50 mg |
| J1720 | Injection, hydrocortisone sodium succinate, up to 100 mg |
| J1725 | Injection, hydroxyprogesterone caproate, 1 mg Terminated: December 31, 2017 |
| J1726 | Injection, hydroxyprogesterone caproate, (makena), 10 mg |
| J1729 | Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg |
| J1730 | Injection, diazoxide, up to 300 mg |
| J1738 | Injection, meloxicam, 1 mg |
| J1740 | Injection, ibandronate sodium, 1 mg |
| J1741 | Injection, ibuprofen, 100 mg |
| J1742 | Injection, ibutilide fumarate, 1 mg |
| J1743 | Injection, idursulfase, 1 mg |
| J1744 | Injection, icatibant, 1 mg |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg |
| J1746 | Injection, ibalizumab-uiyk, 10 mg |
| J1747 | Injection, spesolimab-sbzo, 1 mg |
| J1748 | Injection, infliximab-dyyb (zymfentra), 10 mg |
| J1749 | Injection, iloprost, 0.1 mcg |
| J1750 | Injection, iron dextran, 50 mg |
| J1756 | Injection, iron sucrose, 1 mg |
| J1786 | Injection, imiglucerase, 10 units |
| J1790 | Injection, droperidol, up to 5 mg |
| J1800 | Injection, propranolol hcl, up to 1 mg |
| J1805 | Injection, esmolol hydrochloride, 10 mg |
| J1806 | Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg |
| J1807 | Injection, ethacrynate sodium, 1 mg |
| J1808 | Injection, folic acid, 0.1 mg |
| J1809 | Injection, fosdenopterin, 0.1 mg |
| J1810 | Injection, droperidol and fentanyl citrate, up to 2 ml ampule Terminated: March 31, 2025 |
| J1811 | Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units |
| J1812 | Insulin (fiasp), per 5 units |
| J1813 | Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units |
| J1814 | Insulin (lyumjev), per 5 units |
| J1815 | Injection, insulin, per 5 units |
| J1817 | Insulin for administration through dme (i.e., insulin pump) per 50 units |
| J1823 | Injection, inebilizumab-cdon, 1 mg |
| J1826 | Injection, interferon beta-1a, 30 mcg |
| J1830 | Injection, interferon beta-1b, 0.25 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) |
| J1833 | Injection, isavuconazonium, 1 mg |
| J1834 | Injection, isoniazid, 1 mg |
| J1835 | Injection, itraconazole, 50 mg |
| J1836 | Injection, metronidazole, 10 mg |
| J1840 | Injection, kanamycin sulfate, up to 500 mg Terminated: March 31, 2024 |
| J1850 | Injection, kanamycin sulfate, up to 75 mg Terminated: March 31, 2024 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg |
| J1890 | Injection, cephalothin sodium, up to 1 gram Terminated: March 31, 2025 |
| J1920 | Injection, labetalol hydrochloride, 5 mg |
| J1921 | Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg |
| J1930 | Injection, lanreotide, 1 mg |
| J1931 | Injection, laronidase, 0.1 mg |
| J1932 | Injection, lanreotide, (cipla), 1 mg |
| J1938 | Injection, furosemide, 1 mg |
| J1939 | Injection, bumetanide, 0.5 mg |
| J1940 | Injection, furosemide, up to 20 mg Terminated: March 31, 2025 |
| J1941 | Injection, furosemide (furoscix), 20 mg |
| J1942 | Injection, aripiprazole lauroxil, 1 mg Terminated: September 30, 2019 |
| J1943 | Injection, aripiprazole lauroxil, (aristada initio), 1 mg |
| J1944 | Injection, aripiprazole lauroxil, (aristada), 1 mg |
| J1945 | Injection, lepirudin, 50 mg |
| J1950 | Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
| J1951 | Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg |
| J1952 | Leuprolide injectable, camcevi, 1 mg |
| J1953 | Injection, levetiracetam, 10 mg |
| J1954 | Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg |
| J1955 | Injection, levocarnitine, per 1 gm |
| J1956 | Injection, levofloxacin, 250 mg |
| J1960 | Injection, levorphanol tartrate, up to 2 mg |
| J1961 | Injection, lenacapavir (only for use as hiv treatment), 1 mg |
| J1980 | Injection, hyoscyamine sulfate, up to 0.25 mg |
| J1990 | Injection, chlordiazepoxide hcl, up to 100 mg |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg Terminated: September 30, 2024 |
| J2002 | Injection, lidocaine hcl in 5% dextrose, 1 mg |
| J2003 | Injection, lidocaine hydrochloride, 1 mg |
| J2004 | Injection, lidocaine hcl with epinephrine, 1 mg |
| J2010 | Injection, lincomycin hcl, up to 300 mg |
| J2020 | Injection, linezolid, 200 mg |
| J2021 | Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg |
| J2060 | Injection, lorazepam, 2 mg |
| J2062 | Loxapine for inhalation, 1 mg |
| J2150 | Injection, mannitol, 25% in 50 ml Terminated: September 30, 2025 |
| J2151 | Injection, mannitol, 250 mg |
| J2170 | Injection, mecasermin, 1 mg |
| J2175 | Injection, meperidine hydrochloride, per 100 mg |
| J2180 | Injection, meperidine and promethazine hcl, up to 50 mg |
| J2182 | Injection, mepolizumab, 1 mg |
| J2183 | Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg |
| J2184 | Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg |
| J2185 | Injection, meropenem, 100 mg |
| J2186 | Injection, meropenem and vaborbactam, 10mg/10mg (20mg) |
| J2210 | Injection, methylergonovine maleate, up to 0.2 mg |
| J2212 | Injection, methylnaltrexone, 0.1 mg |
| J2246 | Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg |
| J2247 | Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg |
| J2248 | Injection, micafungin sodium, 1 mg |
| J2249 | Injection, remimazolam, 1 mg |
| J2250 | Injection, midazolam hydrochloride, per 1 mg |
| J2251 | Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg |
| J2252 | Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg |
| J2253 | Injection, midazolam (seizalam), 1 mg |
| J2260 | Injection, milrinone lactate, 5 mg |
| J2265 | Injection, minocycline hydrochloride, 1 mg |
| J2267 | Injection, mirikizumab-mrkz, 1 mg |
| J2270 | Injection, morphine sulfate, up to 10 mg |
| J2271 | Injection, morphine sulfate, 100mg Terminated: December 31, 2014 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
| J2275 | Injection, morphine sulfate (preservative-free sterile solution), per 10 mg Terminated: December 31, 2014 |
| J2277 | Injection, motixafortide, 0.25 mg |
| J2278 | Injection, ziconotide, 1 microgram |
| J2280 | Injection, moxifloxacin, 100 mg |
| J2281 | Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg |
| J2290 | Injection, nafcillin sodium, 20 mg |
| J2291 | Injection, nafcillin sodium (baxter), 20 mg |
| J2300 | Injection, nalbuphine hydrochloride, per 10 mg |
| J2305 | Injection, nitroglycerin, 5 mg |
| J2310 | Injection, naloxone hydrochloride, per 1 mg Terminated: June 30, 2025 |
| J2311 | Injection, naloxone hydrochloride (zimhi), 1 mg Terminated: June 30, 2025 |
| J2312 | Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg |
| J2313 | Injection, naloxone hydrochloride (zimhi), 0.01 mg |
| J2315 | Injection, naltrexone, depot form, 1 mg |
| J2320 | Injection, nandrolone decanoate, up to 50 mg |
| J2323 | Injection, natalizumab, 1 mg |
| J2325 | Injection, nesiritide, 0.1 mg |
| J2326 | Injection, nusinersen, 0.1 mg |
| J2327 | Injection, risankizumab-rzaa, intravenous, 1 mg |
| J2329 | Injection, ublituximab-xiiy, 1mg |
| J2350 | Injection, ocrelizumab, 1 mg |
| J2351 | Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg |
| J2354 | Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg |
| J2355 | Injection, oprelvekin, 5 mg |
| J2356 | Injection, tezepelumab-ekko, 1 mg |
| J2357 | Injection, omalizumab, 5 mg |
| J2358 | Injection, olanzapine, long-acting, 1 mg |
| J2359 | Injection, olanzapine, 0.5 mg |
| J2360 | Injection, orphenadrine citrate, up to 60 mg |
| J2370 | Injection, phenylephrine hcl, up to 1 ml Terminated: June 30, 2023 |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms |
| J2372 | Injection, phenylephrine hydrochloride (biorphen), 20 micrograms |
| J2373 | Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms |
| J2400 | Injection, chloroprocaine hydrochloride, per 30 ml Terminated: December 31, 2022 |
| J2401 | Injection, chloroprocaine hydrochloride, per 1 mg |
| J2402 | Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg |
| J2404 | Injection, nicardipine, 0.1 mg |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg |
| J2406 | Injection, oritavancin (kimyrsa), 10 mg |
| J2407 | Injection, oritavancin (orbactiv), 10 mg |
| J2410 | Injection, oxymorphone hcl, up to 1 mg |
| J2425 | Injection, palifermin, 50 micrograms |
| J2426 | Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
| J2427 | Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg |
| J2428 | Injection, paliperidone palmitate extended release (erzofri), 1 mg |
| J2430 | Injection, pamidronate disodium, per 30 mg |
| J2440 | Injection, papaverine hcl, up to 60 mg |
| J2460 | Injection, oxytetracycline hcl, up to 50 mg |
| J2468 | Injection, palonosetron hydrochloride (posfrea), 25 micrograms |
| J2469 | Injection, palonosetron hcl, 25 mcg |
| J2470 | Injection, pantoprazole sodium, 40 mg |
| J2471 | Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
| J2472 | Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg |
| J2501 | Injection, paricalcitol, 1 mcg |
| J2502 | Injection, pasireotide long acting, 1 mg |
| J2503 | Injection, pegaptanib sodium, 0.3 mg Terminated: September 30, 2025 |
| J2504 | Injection, pegademase bovine, 25 iu |
| J2505 | Injection, pegfilgrastim, 6 mg Terminated: December 31, 2021 |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
| J2507 | Injection, pegloticase, 1 mg |
| J2508 | Injection, pegunigalsidase alfa-iwxj, 1 mg |
| J2510 | Injection, penicillin g procaine, aqueous, up to 600,000 units |
| J2513 | Injection, pentastarch, 10% solution, 100 ml |
| J2515 | Injection, pentobarbital sodium, per 50 mg |
| J2540 | Injection, penicillin g potassium, up to 600,000 units |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
| J2545 | Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg |
| J2547 | Injection, peramivir, 1 mg |
| J2550 | Injection, promethazine hcl, up to 50 mg |
| J2560 | Injection, phenobarbital sodium, up to 120 mg |
| J2561 | Injection, phenobarbital sodium (sezaby), 1 mg |
| J2562 | Injection, plerixafor, 1 mg |
| J2590 | Injection, oxytocin, up to 10 units |
| J2597 | Injection, desmopressin acetate, per 1 mcg |
| J2598 | Injection, vasopressin, 1 unit |
| J2599 | Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit |
| J2601 | Injection, vasopressin (baxter), 1 unit |
| J2650 | Injection, prednisolone acetate, up to 1 ml |
| J2670 | Injection, tolazoline hcl, up to 25 mg |
| J2675 | Injection, progesterone, per 50 mg |
| J2679 | Injection, fluphenazine hcl, 1.25 mg |
| J2680 | Injection, fluphenazine decanoate, up to 25 mg |
| J2690 | Injection, procainamide hcl, up to 1 gm |
| J2700 | Injection, oxacillin sodium, up to 250 mg |
| J2704 | Injection, propofol, 10 mg |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg |
| J2720 | Injection, protamine sulfate, per 10 mg |
| J2724 | Injection, protein c concentrate, intravenous, human, 10 iu |
| J2725 | Injection, protirelin, per 250 mcg |
| J2730 | Injection, pralidoxime chloride, up to 1 gm |
| J2760 | Injection, phentolamine mesylate, up to 5 mg |
| J2765 | Injection, metoclopramide hcl, up to 10 mg |
| J2770 | Injection, quinupristin/dalfopristin, 500 mg (150/350) |
| J2777 | Injection, faricimab-svoa, 0.1 mg |
| J2778 | Injection, ranibizumab, 0.1 mg |
| J2779 | Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg |
| J2780 | Injection, ranitidine hydrochloride, 25 mg Terminated: June 30, 2024 |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg |
| J2782 | Injection, avacincaptad pegol, 0.1 mg |
| J2783 | Injection, rasburicase, 0.5 mg |
| J2785 | Injection, regadenoson, 0.1 mg |
| J2786 | Injection, reslizumab, 1 mg |
| J2787 | Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml |
| J2788 | Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) |
| J2790 | Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
| J2791 | Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
| J2792 | Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu |
| J2793 | Injection, rilonacept, 1 mg |
| J2794 | Injection, risperidone (risperdal consta), 0.5 mg |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg |
| J2796 | Injection, romiplostim, 10 micrograms Terminated: December 31, 2024 |
| J2797 | Injection, rolapitant, 0.5 mg |
| J2798 | Injection, risperidone, (perseris), 0.5 mg |
| J2799 | Injection, risperidone (uzedy), 1 mg |
| J2800 | Injection, methocarbamol, up to 10 ml |
| J2801 | Injection, risperidone (rykindo), 0.5 mg |
| J2802 | Injection, romiplostim, 1 microgram |
| J2804 | Injection, rifampin, 1 mg |
| J2805 | Injection, sincalide, 5 micrograms |
| J2806 | Injection, sincalide (maia), not therapeutically equivalent to j2805, 5 micrograms Terminated: December 31, 2024 |
| J2810 | Injection, theophylline, per 40 mg |
| J2820 | Injection, sargramostim (gm-csf), 50 mcg |
| J2840 | Injection, sebelipase alfa, 1 mg |
| J2850 | Injection, secretin, synthetic, human, 1 microgram |
| J2860 | Injection, siltuximab, 10 mg |
| J2865 | Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg |
| J2910 | Injection, aurothioglucose, up to 50 mg |
| J2916 | Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg Terminated: March 31, 2024 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg Terminated: March 31, 2024 |
| J2940 | Injection, somatrem, 1 mg |
| J2941 | Injection, somatropin, 1 mg |
| J2950 | Injection, promazine hcl, up to 25 mg |
| J2993 | Injection, reteplase, 18.1 mg |
| J2995 | Injection, streptokinase, per 250,000 iu |
| J2997 | Injection, alteplase recombinant, 1 mg |
| J2998 | Injection, plasminogen, human-tvmh, 1 mg |
| J3000 | Injection, streptomycin, up to 1 gm |
| J3010 | Injection, fentanyl citrate, 0.1 mg |
| J3030 | Injection, sumatriptan succinate, 6 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) |
| J3031 | Injection, fremanezumab-vfrm, 1 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) |
| J3032 | Injection, eptinezumab-jjmr, 1 mg |
| J3055 | Injection, talquetamab-tgvs, 0.25 mg |
| J3060 | Injection, taliglucerase alfa, 10 units |
| J3070 | Injection, pentazocine, 30 mg |
| J3090 | Injection, tedizolid phosphate, 1 mg |
| J3095 | Injection, telavancin, 10 mg |
| J3101 | Injection, tenecteplase, 1 mg |
| J3105 | Injection, terbutaline sulfate, up to 1 mg |
| J3110 | Injection, teriparatide, 10 mcg |
| J3111 | Injection, romosozumab-aqqg, 1 mg |
| J3120 | Injection, testosterone enanthate, up to 100 mg Terminated: December 31, 2014 |
| J3121 | Injection, testosterone enanthate, 1 mg |
| J3130 | Injection, testosterone enanthate, up to 200 mg Terminated: December 31, 2014 |
| J3140 | Injection, testosterone suspension, up to 50 mg Terminated: December 31, 2014 |
| J3145 | Injection, testosterone undecanoate, 1 mg |
| J3150 | Injection, testosterone propionate, up to 100 mg Terminated: December 31, 2014 |
| J3230 | Injection, chlorpromazine hcl, up to 50 mg |
| J3240 | Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial |
| J3241 | Injection, teprotumumab-trbw, 10 mg |
| J3243 | Injection, tigecycline, 1 mg |
| J3244 | Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg |
| J3245 | Injection, tildrakizumab, 1 mg |
| J3246 | Injection, tirofiban hcl, 0.25 mg |
| J3247 | Injection, secukinumab, intravenous, 1 mg |
| J3250 | Injection, trimethobenzamide hcl, up to 200 mg |
| J3260 | Injection, tobramycin sulfate, up to 80 mg |
| J3262 | Injection, tocilizumab, 1 mg |
| J3263 | Injection, toripalimab-tpzi, 1 mg |
| J3265 | Injection, torsemide, 10 mg/ml |
| J3280 | Injection, thiethylperazine maleate, up to 10 mg |
| J3285 | Injection, treprostinil, 1 mg |
| J3290 | Injection, tranexamic acid, 5 mg |
| J3299 | Injection, triamcinolone acetonide (xipere), 1 mg |
| J3300 | Injection, triamcinolone acetonide, preservative free, 1 mg |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
| J3302 | Injection, triamcinolone diacetate, per 5 mg |
| J3303 | Injection, triamcinolone hexacetonide, per 5 mg |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg |
| J3305 | Injection, trimetrexate glucuronate, per 25 mg |
| J3310 | Injection, perphenazine, up to 5 mg |
| J3315 | Injection, triptorelin pamoate, 3.75 mg |
| J3316 | Injection, triptorelin, extended-release, 3.75 mg |
| J3320 | Injection, spectinomycin dihydrochloride, up to 2 gm |
| J3350 | Injection, urea, up to 40 gm |
| J3355 | Injection, urofollitropin, 75 iu |
| J3357 | Ustekinumab, for subcutaneous injection, 1 mg |
| J3358 | Ustekinumab, for intravenous injection, 1 mg |
| J3360 | Injection, diazepam, up to 5 mg |
| J3364 | Injection, urokinase, 5000 iu vial |
| J3365 | Injection, iv, urokinase, 250,000 i.u. vial |
| J3370 | Injection, vancomycin hcl, 500 mg Terminated: June 30, 2025 |
| J3371 | Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg Terminated: June 30, 2025 |
| J3372 | Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg Terminated: June 30, 2025 |
| J3373 | Injection, vancomycin hydrochloride, 10 mg |
| J3374 | Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg |
| J3375 | Injection, vancomycin hydrochloride (xellia), not therapeutically equivalent to j3373, 10 mg |
| J3380 | Injection, vedolizumab, intravenous, 1 mg |
| J3385 | Injection, velaglucerase alfa, 100 units |
| J3391 | Injection, atidarsagene autotemcel, per treatment |
| J3392 | Injection, exagamglogene autotemcel, per treatment |
| J3393 | Injection, betibeglogene autotemcel, per treatment |
| J3394 | Injection, lovotibeglogene autotemcel, per treatment |
| J3396 | Injection, verteporfin, 0.1 mg |
| J3397 | Injection, vestronidase alfa-vjbk, 1 mg |
| J3398 | Injection, voretigene neparvovec-rzyl, 1 billion vector genomes |
| J3399 | Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes |
| J3400 | Injection, triflupromazine hcl, up to 20 mg |
| J3401 | Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml |
| J3402 | Injection, remestemcel-l-rknd, per therapeutic dose |
| J3403 | Revakinagene taroretcel-lwey, per implant |
| J3410 | Injection, hydroxyzine hcl, up to 25 mg |
| J3411 | Injection, thiamine hcl, 100 mg |
| J3415 | Injection, pyridoxine hcl, 100 mg |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
| J3424 | Injection, hydroxocobalamin, intravenous, 25 mg |
| J3425 | Injection, hydroxocobalamin, intramuscular, 10 mcg |
| J3430 | Injection, phytonadione (vitamin k), per 1 mg |
| J3465 | Injection, voriconazole, 10 mg |
| J3470 | Injection, hyaluronidase, up to 150 units |
| J3471 | Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units) |
| J3472 | Injection, hyaluronidase, ovine, preservative free, per 1000 usp units |
| J3473 | Injection, hyaluronidase, recombinant, 1 usp unit |
| J3475 | Injection, magnesium sulfate, per 500 mg |
| J3480 | Injection, potassium chloride, per 2 meq |
| J3485 | Injection, zidovudine, 10 mg |
| J3486 | Injection, ziprasidone mesylate, 10 mg |
| J3489 | Injection, zoledronic acid, 1 mg |
| J3490 | Unclassified drugs |
| J3520 | Edetate disodium, per 150 mg |
| J3530 | Nasal vaccine inhalation |
| J3535 | Drug administered through a metered dose inhaler |
| J3570 | Laetrile, amygdalin, vitamin b17 |
| J3590 | Unclassified biologics |
| J3591 | Unclassified drug or biological used for esrd on dialysis |
| J7030 | Infusion, normal saline solution , 1000 cc |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) |
| J7042 | 5% dextrose/normal saline (500 ml = 1 unit) |
| J7050 | Infusion, normal saline solution, 250 cc |
| J7060 | 5% dextrose/water (500 ml = 1 unit) |
| J7070 | Infusion, d5w, 1000 cc |
| J7100 | Infusion, dextran 40, 500 ml |
| J7110 | Infusion, dextran 75, 500 ml |
| J7120 | Ringers lactate infusion, up to 1000 cc |
| J7121 | 5% dextrose in lactated ringers infusion, up to 1000 cc |
| J7131 | Hypertonic saline solution, 1 ml |
| J7165 | Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity |
| J7168 | Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity |
| J7169 | Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg |
| J7170 | Injection, emicizumab-kxwh, 0.5 mg |
| J7171 | Injection, adamts13, recombinant-krhn, 10 iu |
| J7172 | Injection, marstacimab-hncq, 0.5 mg |
| J7173 | Injection, concizumab-mtci, 0.5 mg |
| J7174 | Injection, fitusiran, 0.04 mg |
| J7175 | Injection, factor x, (human), 1 i.u. |
| J7177 | Injection, human fibrinogen concentrate (fibryga), 1 mg |
| J7178 | Injection, human fibrinogen concentrate, not otherwise specified, 1 mg |
| J7179 | Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco |
| J7180 | Injection, factor xiii (antihemophilic factor, human), 1 i.u. |
| J7181 | Injection, factor xiii a-subunit, (recombinant), per iu |
| J7182 | Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu |
| J7183 | Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco |
| J7185 | Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u. |
| J7186 | Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u. |
| J7187 | Injection, von willebrand factor complex (humate-p), per iu vwf:rco |
| J7188 | Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u. |
| J7189 | Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram |
| J7190 | Factor viii (antihemophilic factor, human) per i.u. |
| J7191 | Factor viii (antihemophilic factor (porcine)), per i.u. |
| J7192 | Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified |
| J7193 | Factor ix (antihemophilic factor, purified, non-recombinant) per i.u. |
| J7194 | Factor ix, complex, per i.u. |
| J7195 | Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified |
| J7196 | Injection, antithrombin recombinant, 50 i.u. |
| J7197 | Antithrombin iii (human), per i.u. |
| J7198 | Anti-inhibitor, per i.u. |
| J7199 | Hemophilia clotting factor, not otherwise classified |
| J7200 | Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu |
| J7201 | Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u. |
| J7202 | Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u. |
| J7203 | Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu |
| J7204 | Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu |
| J7205 | Injection, factor viii fc fusion protein (recombinant), per iu |
| J7207 | Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u. |
| J7208 | Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u. |
| J7209 | Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u. |
| J7210 | Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u. |
| J7211 | Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u. |
| J7212 | Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram |
| J7213 | Injection, coagulation factor ix (recombinant), ixinity, 1 i.u. |
| J7214 | Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u. |
| J7294 | Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each |
| J7295 | Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each |
| J7296 | Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg |
| J7297 | Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
| J7298 | Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
| J7300 | Intrauterine copper contraceptive (paragard) |
| J7301 | Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg |
| J7302 | Levonorgestrel-releasing intrauterine contraceptive system, 52 mg Terminated: December 31, 2015 |
| J7303 | Contraceptive supply, hormone containing vaginal ring, each Terminated: September 30, 2021 |
| J7304 | Contraceptive supply, hormone containing patch, each |
| J7306 | Levonorgestrel (contraceptive) implant system, including implants and supplies |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies |
| J7308 | Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) |
| J7309 | Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram |
| J7310 | Ganciclovir, 4.5 mg, long-acting implant |
| J7311 | Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg |
| J7313 | Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg |
| J7314 | Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg |
| J7315 | Mitomycin, ophthalmic, 0.2 mg |
| J7316 | Injection, ocriplasmin, 0.125 mg |
| J7318 | Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
| J7322 | Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg |
| J7326 | Hyaluronan or derivative, gel-one, for intra-articular injection, per dose |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose |
| J7328 | Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg |
| J7329 | Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg |
| J7330 | Autologous cultured chondrocytes, implant |
| J7331 | Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg |
| J7332 | Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg |
| J7333 | Hyaluronan or derivative, visco-3, for intra-articular injection, per dose Terminated: March 31, 2021 |
| J7335 | Capsaicin 8% patch, per 10 square centimeters Terminated: December 31, 2014 |
| J7336 | Capsaicin 8% patch, per square centimeter |
| J7340 | Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml |
| J7342 | Instillation, ciprofloxacin otic suspension, 6 mg |
| J7345 | Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg |
| J7351 | Injection, bimatoprost, intracameral implant, 1 microgram |
| J7352 | Afamelanotide implant, 1 mg |
| J7353 | Anacaulase-bcdb, 8.8% gel, 1 gram |
| J7354 | Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg) |
| J7355 | Injection, travoprost, intracameral implant, 1 microgram |
| J7356 | Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg |
| J7401 | Mometasone furoate sinus implant, 10 micrograms Terminated: March 31, 2021 |
| J7402 | Mometasone furoate sinus implant, (sinuva), 10 micrograms |
| J7500 | Azathioprine, oral, 50 mg |
| J7501 | Azathioprine, parenteral, 100 mg |
| J7502 | Cyclosporine, oral, 100 mg |
| J7503 | Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
| J7504 | Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg |
| J7505 | Muromonab-cd3, parenteral, 5 mg |
| J7506 | Prednisone, oral, per 5 mg Terminated: December 31, 2015 |
| J7507 | Tacrolimus, immediate release, oral, 1 mg |
| J7508 | Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg |
| J7509 | Methylprednisolone oral, per 4 mg |
| J7510 | Prednisolone oral, per 5 mg |
| J7511 | Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg |
| J7513 | Daclizumab, parenteral, 25 mg |
| J7514 | Mycophenolate mofetil (myhibbin), oral suspension, 100 mg |
| J7515 | Cyclosporine, oral, 25 mg |
| J7516 | Injection, cyclosporine, 250 mg |
| J7517 | Mycophenolate mofetil, oral, 250 mg |
| J7518 | Mycophenolic acid, oral, 180 mg |
| J7519 | Injection, mycophenolate mofetil, 10 mg |
| J7520 | Sirolimus, oral, 1 mg |
| J7521 | Tacrolimus, granules, oral suspension, 0.1 mg |
| J7525 | Tacrolimus, parenteral, 5 mg |
| J7527 | Everolimus, oral, 0.25 mg |
| J7599 | Immunosuppressive drug, not otherwise classified |
| J7601 | Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg |
| J7604 | Acetylcysteine, inhalation solution, compounded product, administered through dme, unit dose form, per gram |
| J7605 | Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms |
| J7606 | Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms |
| J7607 | Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg |
| J7608 | Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram |
| J7609 | Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
| J7610 | Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
| J7611 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
| J7612 | Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
| J7614 | Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
| J7615 | Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
| J7622 | Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7624 | Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7626 | Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
| J7627 | Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg |
| J7628 | Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7629 | Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7631 | Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams |
| J7632 | Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams |
| J7633 | Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram |
| J7634 | Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram |
| J7635 | Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7636 | Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7637 | Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7638 | Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7639 | Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
| J7640 | Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms |
| J7641 | Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram |
| J7642 | Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7643 | Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7644 | Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
| J7645 | Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7647 | Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7648 | Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram |
| J7649 | Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
| J7650 | Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7657 | Isoproterenol hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7658 | Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram |
| J7659 | Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
| J7660 | Isoproterenol hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7665 | Mannitol, administered through an inhaler, 5 mg |
| J7667 | Metaproterenol sulfate, inhalation solution, compounded product, concentrated form, per 10 milligrams |
| J7668 | Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 10 milligrams |
| J7669 | Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams |
| J7670 | Metaproterenol sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams |
| J7674 | Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg |
| J7676 | Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg |
| J7677 | Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram |
| J7680 | Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7681 | Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7682 | Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams |
| J7683 | Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
| J7684 | Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
| J7685 | Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams |
| J7686 | Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg |
| J7699 | Noc drugs, inhalation solution administered through dme |
| J7799 | Noc drugs, other than inhalation drugs, administered through dme |
| J7999 | Compounded drug, not otherwise classified |
| J8498 | Antiemetic drug, rectal/suppository, not otherwise specified |
| J8499 | Prescription drug, oral, non chemotherapeutic, nos |
| J8501 | Aprepitant, oral, 5 mg |
| J8510 | Busulfan; oral, 2 mg |
| J8515 | Cabergoline, oral, 0.25 mg |
| J8520 | Capecitabine, oral, 150 mg Terminated: September 30, 2024 |
| J8521 | Capecitabine, oral, 500 mg Terminated: September 30, 2024 |
| J8522 | Capecitabine, oral, 50 mg |
| J8530 | Cyclophosphamide; oral, 25 mg |
| J8540 | Dexamethasone, oral, 0.25 mg |
| J8541 | Dexamethasone (hemady), oral, 0.25 mg |
| J8560 | Etoposide; oral, 50 mg |
| J8562 | Fludarabine phosphate, oral, 10 mg |
| J8565 | Gefitinib, oral, 250 mg |
| J8597 | Antiemetic drug, oral, not otherwise specified |
| J8600 | Melphalan; oral, 2 mg |
| J8610 | Methotrexate; oral, 2.5 mg |
| J8611 | Methotrexate (jylamvo), oral, 2.5 mg |
| J8612 | Methotrexate (xatmep), oral, 2.5 mg |
| J8650 | Nabilone, oral, 1 mg |
| J8655 | Netupitant 300 mg and palonosetron 0.5 mg, oral |
| J8670 | Rolapitant, oral, 1 mg |
| J8700 | Temozolomide, oral, 5 mg |
| J8705 | Topotecan, oral, 0.25 mg |
| J8999 | Prescription drug, oral, chemotherapeutic, nos |
| J9000 | Injection, doxorubicin hydrochloride, 10 mg |
| J9010 | Injection, alemtuzumab, 10 mg Terminated: December 31, 2015 |
| J9011 | Injection, datopotamab deruxtecan-dlnk, 1 mg |
| J9015 | Injection, aldesleukin, per single use vial |
| J9017 | Injection, arsenic trioxide, 1 mg |
| J9019 | Injection, asparaginase (erwinaze), 1,000 iu |
| J9020 | Injection, asparaginase, not otherwise specified, 10,000 units |
| J9021 | Injection, asparaginase, recombinant, (rylaze), 0.1 mg |
| J9022 | Injection, atezolizumab, 10 mg |
| J9023 | Injection, avelumab, 10 mg |
| J9024 | Injection, atezolizumab, 5 mg and hyaluronidase-tqjs |
| J9025 | Injection, azacitidine, 1 mg |
| J9026 | Injection, tarlatamab-dlle, 1 mg |
| J9027 | Injection, clofarabine, 1 mg |
| J9028 | Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram |
| J9029 | Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose |
| J9030 | Bcg live intravesical instillation, 1 mg |
| J9031 | Bcg (intravesical) per instillation Terminated: June 30, 2019 |
| J9032 | Injection, belinostat, 10 mg |
| J9033 | Injection, bendamustine hydrochloride, 1 mg |
| J9034 | Injection, bendamustine hcl (bendeka), 1 mg |
| J9035 | Injection, bevacizumab, 10 mg |
| J9036 | Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg |
| J9037 | Injection, belantamab mafodotin-blmf, 0.5 mg Terminated: March 31, 2025 |
| J9038 | Injection, axatilimab-csfr, 0.1 mg |
| J9039 | Injection, blinatumomab, 1 microgram |
| J9040 | Injection, bleomycin sulfate, 15 units |
| J9041 | Injection, bortezomib, 0.1 mg |
| J9042 | Injection, brentuximab vedotin, 1 mg |
| J9043 | Injection, cabazitaxel, 1 mg |
| J9044 | Injection, bortezomib, not otherwise specified, 0.1 mg Terminated: December 31, 2022 |
| J9045 | Injection, carboplatin, 50 mg |
| J9046 | Injection, bortezomib (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg |
| J9047 | Injection, carfilzomib, 1 mg |
| J9048 | Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg |
| J9049 | Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg |
| J9050 | Injection, carmustine, 100 mg |
| J9051 | Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg |
| J9052 | Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg |
| J9054 | Injection, bortezomib (boruzu), 0.1 mg |
| J9055 | Injection, cetuximab, 10 mg |
| J9056 | Injection, bendamustine hydrochloride (vivimusta), 1 mg |
| J9057 | Injection, copanlisib, 1 mg |
| J9058 | Injection, bendamustine hydrochloride (apotex), 1 mg Terminated: December 31, 2024 |
| J9059 | Injection, bendamustine hydrochloride (baxter), 1 mg Terminated: December 31, 2024 |
| J9060 | Injection, cisplatin, powder or solution, 10 mg |
| J9061 | Injection, amivantamab-vmjw, 2 mg |
| J9063 | Injection, mirvetuximab soravtansine-gynx, 1 mg |
| J9064 | Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg |
| J9065 | Injection, cladribine, per 1 mg |
| J9070 | Cyclophosphamide, 100 mg Terminated: March 31, 2024 |
| J9071 | Injection, cyclophosphamide (auromedics), 5 mg |
| J9072 | Injection, cyclophosphamide (frindovyx), 5 mg |
| J9073 | Injection, cyclophosphamide (dr. reddy's), 5 mg |
| J9074 | Injection, cyclophosphamide (sandoz), 5 mg |
| J9075 | Injection, cyclophosphamide, not otherwise specified, 5 mg |
| J9076 | Injection, cyclophosphamide (baxter), 5 mg |
| J9098 | Injection, cytarabine liposome, 10 mg |
| J9100 | Injection, cytarabine, 100 mg |
| J9118 | Injection, calaspargase pegol-mknl, 10 units |
| J9119 | Injection, cemiplimab-rwlc, 1 mg |
| J9120 | Injection, dactinomycin, 0.5 mg |
| J9130 | Dacarbazine, 100 mg |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj |
| J9145 | Injection, daratumumab, 10 mg |
| J9150 | Injection, daunorubicin, 10 mg |
| J9151 | Injection, daunorubicin citrate, liposomal formulation, 10 mg |
| J9153 | Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine |
| J9155 | Injection, degarelix, 1 mg |
| J9160 | Injection, denileukin diftitox, 300 micrograms Terminated: December 31, 2023 |
| J9161 | Injection, denileukin diftitox-cxdl, 1 mcg |
| J9165 | Injection, diethylstilbestrol diphosphate, 250 mg |
| J9171 | Injection, docetaxel, 1 mg |
| J9172 | Injection, docetaxel (docivyx), 1 mg |
| J9173 | Injection, durvalumab, 10 mg |
| J9174 | Injection, docetaxel (beizray), 1 mg |
| J9175 | Injection, elliotts' b solution, 1 ml |
| J9176 | Injection, elotuzumab, 1 mg |
| J9177 | Injection, enfortumab vedotin-ejfv, 0.25 mg |
| J9178 | Injection, epirubicin hcl, 2 mg |
| J9179 | Injection, eribulin mesylate, 0.1 mg |
| J9181 | Injection, etoposide, 10 mg |
| J9185 | Injection, fludarabine phosphate, 50 mg |
| J9190 | Injection, fluorouracil, 500 mg |
| J9196 | Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg |
| J9198 | Injection, gemcitabine hydrochloride, (infugem), 100 mg |
| J9199 | Injection, gemcitabine hydrochloride (infugem), 200 mg Terminated: June 30, 2020 |
| J9200 | Injection, floxuridine, 500 mg |
| J9201 | Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
| J9202 | Goserelin acetate implant, per 3.6 mg |
| J9203 | Injection, gemtuzumab ozogamicin, 0.1 mg |
| J9204 | Injection, mogamulizumab-kpkc, 1 mg |
| J9205 | Injection, irinotecan liposome, 1 mg |
| J9206 | Injection, irinotecan, 20 mg |
| J9207 | Injection, ixabepilone, 1 mg |
| J9208 | Injection, ifosfamide, 1 gram |
| J9209 | Injection, mesna, 200 mg |
| J9210 | Injection, emapalumab-lzsg, 1 mg |
| J9211 | Injection, idarubicin hydrochloride, 5 mg |
| J9212 | Injection, interferon alfacon-1, recombinant, 1 microgram |
| J9213 | Injection, interferon, alfa-2a, recombinant, 3 million units |
| J9214 | Injection, interferon, alfa-2b, recombinant, 1 million units |
| J9215 | Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu |
| J9216 | Injection, interferon, gamma 1-b, 3 million units |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg |
| J9218 | Leuprolide acetate, per 1 mg |
| J9219 | Leuprolide acetate implant, 65 mg |
| J9220 | Injection, indigotindisulfonate sodium, 1 mg |
| J9223 | Injection, lurbinectedin, 0.1 mg |
| J9225 | Histrelin implant (vantas), 50 mg |
| J9226 | Histrelin implant (supprelin la), 50 mg |
| J9227 | Injection, isatuximab-irfc, 10 mg |
| J9228 | Injection, ipilimumab, 1 mg |
| J9229 | Injection, inotuzumab ozogamicin, 0.1 mg |
| J9230 | Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg |
| J9245 | Injection, melphalan hydrochloride, not otherwise specified, 50 mg |
| J9246 | Injection, melphalan (evomela), 1 mg |
| J9247 | Injection, melphalan flufenamide, 1mg Terminated: March 31, 2025 |
| J9248 | Injection, melphalan (hepzato), 1 mg |
| J9249 | Injection, melphalan (apotex), 1 mg |
| J9250 | Methotrexate sodium, 5 mg Terminated: March 31, 2024 |
| J9255 | Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg |
| J9258 | Injection, paclitaxel protein-bound particles (teva), not therapeutically equivalent to j9264, 1 mg Terminated: September 30, 2024 |
| J9259 | Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mg Terminated: December 31, 2024 |
| J9260 | Injection, methotrexate sodium, 50 mg |
| J9261 | Injection, nelarabine, 50 mg |
| J9262 | Injection, omacetaxine mepesuccinate, 0.01 mg |
| J9263 | Injection, oxaliplatin, 0.5 mg |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg |
| J9265 | Injection, paclitaxel, 30 mg Terminated: December 31, 2014 |
| J9266 | Injection, pegaspargase, per single dose vial |
| J9267 | Injection, paclitaxel, 1 mg |
| J9268 | Injection, pentostatin, 10 mg |
| J9269 | Injection, tagraxofusp-erzs, 10 micrograms |
| J9270 | Injection, plicamycin, 2.5 mg |
| J9271 | Injection, pembrolizumab, 1 mg |
| J9272 | Injection, dostarlimab-gxly, 10 mg |
| J9273 | Injection, tisotumab vedotin-tftv, 1 mg |
| J9274 | Injection, tebentafusp-tebn, 1 microgram |
| J9275 | Injection, cosibelimab-ipdl, 2 mg |
| J9276 | Injection, zanidatamab-hrii, 2 mg |
| J9280 | Injection, mitomycin, 5 mg |
| J9281 | Mitomycin pyelocalyceal instillation, 1 mg |
| J9285 | Injection, olaratumab, 10 mg |
| J9286 | Injection, glofitamab-gxbm, 2.5 mg |
| J9289 | Injection, nivolumab, 2 mg and hyaluronidase-nvhy |
| J9292 | Injection, pemetrexed dipotassium, 10 mg |
| J9293 | Injection, mitoxantrone hydrochloride, per 5 mg |
| J9294 | Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg |
| J9295 | Injection, necitumumab, 1 mg |
| J9296 | Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg |
| J9297 | Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg |
| J9298 | Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg |
| J9299 | Injection, nivolumab, 1 mg |
| J9300 | Injection, gemtuzumab ozogamicin, 5 mg Terminated: December 31, 2017 |
| J9301 | Injection, obinutuzumab, 10 mg |
| J9302 | Injection, ofatumumab, 10 mg |
| J9303 | Injection, panitumumab, 10 mg |
| J9304 | Injection, pemetrexed (pemfexy), 10 mg |
| J9305 | Injection, pemetrexed, not otherwise specified, 10 mg |
| J9306 | Injection, pertuzumab, 1 mg |
| J9307 | Injection, pralatrexate, 1 mg |
| J9308 | Injection, ramucirumab, 5 mg |
| J9309 | Injection, polatuzumab vedotin-piiq, 1 mg |
| J9310 | Injection, rituximab, 100 mg Terminated: December 31, 2018 |
| J9311 | Injection, rituximab 10 mg and hyaluronidase |
| J9312 | Injection, rituximab, 10 mg |
| J9313 | Injection, moxetumomab pasudotox-tdfk, 0.01 mg |
| J9314 | Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg |
| J9315 | Injection, romidepsin, 1 mg Terminated: September 30, 2021 |
| J9316 | Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg |
| J9317 | Injection, sacituzumab govitecan-hziy, 2.5 mg |
| J9318 | Injection, romidepsin, non-lyophilized, 0.1 mg |
| J9319 | Injection, romidepsin, lyophilized, 0.1 mg |
| J9320 | Injection, streptozocin, 1 gram |
| J9321 | Injection, epcoritamab-bysp, 0.16 mg |
| J9322 | Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg |
| J9323 | Injection, pemetrexed ditromethamine, 10 mg |
| J9324 | Injection, pemetrexed (pemrydi rtu), 10 mg |
| J9325 | Injection, talimogene laherparepvec, per 1 million plaque forming units |
| J9328 | Injection, temozolomide, 1 mg |
| J9329 | Injection, tislelizumab-jsgr, 1mg |
| J9330 | Injection, temsirolimus, 1 mg |
| J9331 | Injection, sirolimus protein-bound particles, 1 mg |
| J9332 | Injection, efgartigimod alfa-fcab, 2mg |
| J9333 | Injection, rozanolixizumab-noli, 1 mg |
| J9334 | Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc |
| J9340 | Injection, thiotepa, 15 mg Terminated: June 30, 2025 |
| J9341 | Injection, thiotepa (tepylute), 1 mg |
| J9342 | Injection, thiotepa, not otherwise specified, 1 mg |
| J9345 | Injection, retifanlimab-dlwr, 1 mg |
| J9347 | Injection, tremelimumab-actl, 1 mg |
| J9348 | Injection, naxitamab-gqgk, 1 mg |
| J9349 | Injection, tafasitamab-cxix, 2 mg |
| J9350 | Injection, mosunetuzumab-axgb, 1 mg |
| J9351 | Injection, topotecan, 0.1 mg |
| J9352 | Injection, trabectedin, 0.1 mg |
| J9353 | Injection, margetuximab-cmkb, 5 mg |
| J9354 | Injection, ado-trastuzumab emtansine, 1 mg |
| J9355 | Injection, trastuzumab, excludes biosimilar, 10 mg |
| J9356 | Injection, trastuzumab, 10 mg and hyaluronidase-oysk |
| J9357 | Injection, valrubicin, intravesical, 200 mg |
| J9358 | Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
| J9359 | Injection, loncastuximab tesirine-lpyl, 0.075 mg |
| J9360 | Injection, vinblastine sulfate, 1 mg |
| J9361 | Injection, efbemalenograstim alfa-vuxw, 0.5 mg |
| J9370 | Vincristine sulfate, 1 mg |
| J9371 | Injection, vincristine sulfate liposome, 1 mg Terminated: June 30, 2024 |
| J9376 | Injection, pozelimab-bbfg, 1 mg |
| J9380 | Injection, teclistamab-cqyv, 0.5 mg |
| J9381 | Injection, teplizumab-mzwv, 5 mcg |
| J9382 | Injection, zenocutuzumab-zbco, 1 mg |
| J9390 | Injection, vinorelbine tartrate, 10 mg |
| J9393 | Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg |
| J9394 | Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg |
| J9395 | Injection, fulvestrant, 25 mg |
| J9400 | Injection, ziv-aflibercept, 1 mg |
| J9600 | Injection, porfimer sodium, 75 mg |
| J9999 | Not otherwise classified, antineoplastic drugs |
