Ambulatory Payment Classifications

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Drugs Administered Other Than Oral Method

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Injection(s)

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0726 Dexrazoxane HCl injection
0731 Sargramostim injection
0736 Amphotericin b liposome inj
0751 Mechlorethamine hcl inj
0752 Dactinomycin injection
0759 Naltrexone, depot form
0807 Aldesleukin injection
0812 Carmustine injection
0820 Daunorubicin injection
0823 Docetaxel injection
0825 Nelarabine injection
0836 Interferon alfa-2b inj
0840 Inj melpha hydroch nos 50 mg
0843 Pegaspargase injection
0844 Pentostatin injection
0858 Inj cladribine
0875 Euflexxa inj per dose
0877 Orthovisc inj per dose
0902 Injection,onabotulinumtoxinA
0943 Octagam injection
0944 Gammagard liquid injection
0946 Hepagam b im injection
0947 Flebogamma injection
1015 Injection glatiramer acetate
1083 Adalimumab injection
1138 Hepagam b intravenous, inj
1166 Cytarabine liposome inj
1178 Busulfan injection
1203 Verteporfin injection
1207 Octreotide injection, depot
1214 Inj IVIG privigen 500 mg
1232 Mitomycin injection
1236 Inj levoleucovorin nos 0.5mg
1237 Inj iron dextran
1263 Antithrombin iii injection
1268 Xyntha inj
1274 Edetate calcium disodium inj
1296 Degarelix injection
1311 Canakinumab injection
1312 Hizentra injection
1327 Imiglucerase injection
1340 Collagenase, clost hist inj
1341 Amobarbital 125 MG inj
1352 Wilate injection
1353 Belimumab injection
1408 Cyclophosphamide 100 MG inj
1413 Lumizyme injection
1415 Glassia injection
1420 Aflibercept injection
1421 Imported lipodox inj
1426 Eribulin mesylate injection
1433 Calcitonin salmon injection
1440 Inj desmopressin acetate
1443 Icatibant injection
1458 Phentolaine mesylate inj
1468 Inj Aripiprazole Ext Rel 1mg
1469 Inj filgrastim excl biosimil
1474 Certolizumab pegol inj 1mg
1476 Obinutuzumab inj
1478 Inj human fibrinogen con nos
1480 Elosulfase alfa, injection
1489 Injection, vedolizumab
1490 Inj pembrolizumab
1607 Eptifibatide injection
1608 Etanercept injection
1658 Injection, belinostat, 10mg
1660 Injection, oritavancin
1662 Inj tedizolid phosphate
1694 Ziconotide injection
1695 Nesiritide injection
1696 Palifermin injection
1700 Inj secretin synthetic human
1701 Treprostinil injection
1704 Humate-P, inj
1709 Azacitidine injection
1710 Clofarabine injection
1747 Monovisc inj per dose
1748 Inj tbo filgrastim 1 microg
1809 Injection, alemtuzumab
1823 Injection, dalbavancin
1824  Ceftaroline fosamil inj
1829  Penicillin g benzathine inj
1849 Foscarnet sodium injection
1854 Pentobarbital sodium inj
1861 Inj., bendeka 1 mg
1862 Gelsyn-3 injection 0.1 mg
7011 Oprelvekin injection
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