Ambulatory Payment Classifications

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Drugs and Biologicals (Excluding Cancer/Chemotherapy)

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Immune Globulins, Serum or Recombinant Products

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0890 Lymphocyte immune globulin
1431 Centruroides immune f(ab)
1609 Rho(D) immune globulin h, sd
1630 Hep b ig, im
1670 Tetanus immune globulin inj
1687 Digoxin immune fab (ovine)
1826 Hyqvia 100mg immuneglobulin
1850 Gamma globulin 1 cc inj
1851 Gamma globulin > 10 cc inj
2731 Immune globulin, powder
9003 Palivizumab
9133 Rabies ig, im/sc
9134 Rabies ig, heat treated
9135 Varicella-zoster ig, im
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