Ambulatory Payment Classifications

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Drugs Administered Other Than Oral Method

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Injections 9000–9999

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9002 Tenecteplase injection
9006 Tacrolimus injection
9012 Arsenic trioxide injection
9014 Inj., cerliponase alfa 1 mg
9015 Inj., haegarda 10 units
9016 Inj., triptorelin xr 3.75 mg
9018 Inj, rimabotulinumtoxinB
9028 Inj inotuzumab ozogam 0.1 mg
9029 Inj., guselkumab, 1 mg
9030 Inj., copanlisib, 1 mg
9031 Inj, etelcalcetide, 0.1 mg
9032 Baclofen 10 MG injection
9033 Cidofovir injection
9034 Inj cuvitru, 100 mg
9036 Injection, renflexis
9038 Inj estrogen conjugate
9044 Ibutilide fumarate injection
9059 Vonvendi inj 1 iu vwf:rco
9070 Inj luxturna 1 billion vec g
9079 Genvisc 850, inj, 1mg
9085 Inj sulf hexa lipid microsph
9088 Peng benzathine/procaine inj
9092 Interferon alfa-2a inj
9094 Radiesse injection
9095 Inj, sculptra, 0.5mg
9096 Inj retacrit esrd on dialysi
9097 Inj retacrit non-esrd use
9099 Inj fosnetupitant, palonoset
9108 Thyrotropin injection
9119 Injection, pegfilgrastim 6mg
9124 Daptomycin injection
9125 Risperidone, long acting
9126 Natalizumab injection
9171 Factor ix idelvion inj
9172 Injection, dexamethasone 9%
9173 Injection, fulphila
9174 Inj, durolane 1 mg
9178 Inj., meropenem, vaborbactam
9179 Injection, Aristada Initio
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
9190 Inj., vestronidase alfa-vjbk
9191 Inj., fibryga, 1 mg
9192 Inj, bortezomib, nos, 0.1 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
9207 Inj., velcade 0.1 mg
9208 Agalsidase beta injection
9209 Laronidase injection
9215 Cetuximab injection
9224 Galsulfase injection
9225 Fluocinolone acetonide implt
9228 Tigecycline injection
9229 Ibandronate sodium injection
9230 Abatacept injection
9231 Decitabine injection
9232 Idursulfase injection
9233 Ranibizumab injection
9234 Alglucosidase alfa injection
9236 Eculizumab injection
9237 Inj, lanreotide acetate
9240 Injection, ixabepilone
9242 Injection, fosaprepitant
9243 Inj., treanda 1 mg
9245 Romiplostim injection
9251 C1 esterase inhibitor inj
9252 Plerixafor injection
9255 Paliperidone palmitate inj
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
9289 Erwinaze injection
9294 Inj, taliglucerase alfa 10 u
9295 Injection, Carfilzomib, 1 mg
9297 Inj, Omacetaxine Mep, 0.01mg
9298 Inj, Ocriplasmin, 0.125 mg
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
9307 Cocaine hcl nasal solution
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
9321 Fosphenytoin inj pe
9324 Phenylep ketorolac opth soln
9325 Inj., eravacycline, 1 mg
9326 Inj., lanadelumab-flyo, 1 mg
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
9332 Inj lefamulin 1 mg
9333 Inj, brexanolone
9334 Injection, khapzory, 0.5 mg
9336 Inj truxima 10 mg
9337 Synojoynt, inj., 1 mg
9338 Inj., triluron, 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
9353 Inj fam-trastu deru-nxki 1mg
9354 Inj recombin esperoct per iu
9355 Injection, teprotumumab-trbw
9356 Inj golodirsen 10 mg
9357 Injection, eptinezumab-jjmr
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
9371 Injection, meloxicam
9372 Inj. xembify, 100 mg
9373 Inj onase abepar-xioi treat
9375 Inj., evomela, 1 mg
9441 Inj ferric carboxymaltos 1mg
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
9462 Injection, delafloxacin
9463 Inj., aprepitant, 1 mg
9464 Inj., rolapitant, 0.5 mg
9466 Inj., benralizumab, 1 mg
9467 Inj rituximab, hyaluronidase
9468 Factor ix recomb gly rebinyn
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
9479 Instill, ciprofloxacin otic
9481 Injection, reslizumab
9484 Inj, eteplirsen, 10 mg
9485 Inj, olaratumab, 10 mg
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
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