HCPCS ‘J’ Codes (1060)

by
Drugs Administered Other Than Oral Method, Chemotherapy Drugs
CodeDescription
J0120Injection, tetracycline, up to 250 mg
J0121Injection, omadacycline, 1 mg
J0122Injection, eravacycline, 1 mg
J0129Injection, 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)
J0130Injection abciximab, 10 mg
J0131Injection, acetaminophen, not otherwise specified,10 mg
J0132Injection, acetylcysteine, 100 mg
J0133Injection, acyclovir, 5 mg
J0134Injection, acetaminophen (fresenius kabi) not therapeutically equivalent to j0131, 10 mg
J0135Injection, adalimumab, 20 mg
J0136Injection, acetaminophen (b braun) not therapeutically equivalent to j0131, 10 mg
J0137Injection, acetaminophen (hikma) not therapeutically equivalent to j0131, 10 mg
J0150Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)
Terminated December 31, 2014.
J0151Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)
Terminated December 31, 2014.
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)
J0171Injection, adrenalin, epinephrine, 0.1 mg
J0172Injection, aducanumab-avwa, 2 mg
J0173Injection, epinephrine (belcher) not therapeutically equivalent to j0171, 0.1 mg
J0174Injection, lecanemab-irmb, 1 mg
J0177Injection, aflibercept hd, 1 mg
J0178Injection, aflibercept, 1 mg
J0179Injection, brolucizumab-dbll, 1 mg
J0180Injection, agalsidase beta, 1 mg
J0184Injection, amisulpride, 1 mg
J0185Injection, aprepitant, 1 mg
J0190Injection, biperiden lactate, per 5 mg
J0200Injection, alatrofloxacin mesylate, 100 mg
J0202Injection, alemtuzumab, 1 mg
J0205Injection, alglucerase, per 10 units
J0206Injection, allopurinol sodium, 1 mg
J0207Injection, amifostine, 500 mg
J0208Injection, sodium thiosulfate (pedmark), 100 mg
J0209Injection, sodium thiosulfate (hope), 100 mg
J0210Injection, methyldopate hcl, up to 250 mg
J0215Injection, alefacept, 0.5 mg
J0216Injection, alfentanil hydrochloride, 500 micrograms
J0217Injection, velmanase alfa-tycv, 1 mg
J0218Injection, olipudase alfa-rpcp, 1 mg
J0219Injection, avalglucosidase alfa-ngpt, 4 mg
J0220Injection, alglucosidase alfa, 10 mg, not otherwise specified
J0221Injection, alglucosidase alfa, (lumizyme), 10 mg
J0222Injection, patisiran, 0.1 mg
J0223Injection, givosiran, 0.5 mg
J0224Injection, lumasiran, 0.5 mg
J0225Injection, vutrisiran, 1 mg
J0248Injection, remdesivir, 1 mg
J0256Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg
J0257Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg
J0270Injection, 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)
J0275Alprostadil 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)
J0278Injection, amikacin sulfate, 100 mg
J0280Injection, aminophyllin, up to 250 mg
J0282Injection, amiodarone hydrochloride, 30 mg
J0283Injection, amiodarone hydrochloride (nexterone), 30 mg
J0285Injection, amphotericin b, 50 mg
J0287Injection, amphotericin b lipid complex, 10 mg
J0288Injection, amphotericin b cholesteryl sulfate complex, 10 mg
J0289Injection, amphotericin b liposome, 10 mg
J0290Injection, ampicillin sodium, 500 mg
J0291Injection, plazomicin, 5 mg
J0295Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
J0300Injection, amobarbital, up to 125 mg
J0330Injection, succinylcholine chloride, up to 20 mg
J0348Injection, anidulafungin, 1 mg
J0349Injection, rezafungin, 1 mg
J0350Injection, anistreplase, per 30 units
J0360Injection, hydralazine hcl, up to 20 mg
J0364Injection, apomorphine hydrochloride, 1 mg
J0365Injection, aprotonin, 10,000 kiu
J0380Injection, metaraminol bitartrate, per 10 mg
J0390Injection, chloroquine hydrochloride, up to 250 mg
J0391Injection, artesunate, 1 mg
J0395Injection, arbutamine hcl, 1 mg
J0400Injection, aripiprazole, intramuscular, 0.25 mg
J0401Injection, aripiprazole, extended release, 1 mg
J0402Injection, aripiprazole (abilify asimtufii), 1 mg
J0456Injection, azithromycin, 500 mg
J0457Injection, aztreonam, 100 mg
J0461Injection, atropine sulfate, 0.01 mg
J0470Injection, dimercaprol, per 100 mg
J0475Injection, baclofen, 10 mg
J0476Injection, baclofen, 50 mcg for intrathecal trial
J0480Injection, basiliximab, 20 mg
J0485Injection, belatacept, 1 mg
J0490Injection, belimumab, 10 mg
J0491Injection, anifrolumab-fnia, 1 mg
J0500Injection, dicyclomine hcl, up to 20 mg
J0515Injection, benztropine mesylate, per 1 mg
J0517Injection, benralizumab, 1 mg
J0520Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg
J0558Injection, penicillin g benzathine and penicillin g procaine, 100,000 units
J0561Injection, penicillin g benzathine, 100,000 units
J0565Injection, bezlotoxumab, 10 mg
J0567Injection, cerliponase alfa, 1 mg
J0570Buprenorphine implant, 74.2 mg
J0571Buprenorphine, oral, 1 mg
J0572Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
J0573Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine
J0574Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine
J0575Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine
J0576Injection, buprenorphine extended-release (brixadi), 1 mg
Terminated March 31, 2024.
J0577Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
J0578Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy
J0583Injection, bivalirudin, 1 mg
J0584Injection, burosumab-twza 1 mg
J0585Injection, onabotulinumtoxina, 1 unit
J0586Injection, abobotulinumtoxina, 5 units
J0587Injection, rimabotulinumtoxinb, 100 units
J0588Injection, incobotulinumtoxin a, 1 unit
J0589Injection, daxibotulinumtoxina-lanm, 1 unit
J0591Injection, deoxycholic acid, 1 mg
J0592Injection, buprenorphine hydrochloride, 0.1 mg
J0593Injection, 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)
J0594injection, busulfan, 1 mg
J0595Injection, butorphanol tartrate, 1 mg
J0596Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units
J0597Injection, c-1 esterase inhibitor (human), berinert, 10 units
J0598Injection, c-1 esterase inhibitor (human), cinryze, 10 units
J0599Injection, c-1 esterase inhibitor (human), (haegarda), 10 units
J0600Injection, edetate calcium disodium, up to 1000 mg
J0604Cinacalcet, oral, 1 mg, (for esrd on dialysis)
J0606Injection, etelcalcetide, 0.1 mg
J0610Injection, calcium gluconate (fresenius kabi), per 10 ml
Terminated March 31, 2023.
J0611Injection, calcium gluconate (wg critical care), per 10 ml
Terminated March 31, 2023.
J0612Injection, calcium gluconate, not otherwise specified, 10 mg
J0613Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg
J0620Injection, calcium glycerophosphate and calcium lactate, per 10 ml
J0630Injection, calcitonin salmon, up to 400 units
J0636Injection, calcitriol, 0.1 mcg
J0637Injection, caspofungin acetate, 5 mg
J0638Injection, canakinumab, 1 mg
J0640Injection, leucovorin calcium, per 50 mg
J0641Injection, levoleucovorin, not otherwise specified, 0.5 mg
J0642Injection, levoleucovorin (khapzory), 0.5 mg
J0650Injection, levothyroxine sodium, not otherwise specified, 10 mcg
J0651Injection, levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650, 10 mcg
J0652Injection, levothyroxine sodium (hikma) not therapeutically equivalent to j0650, 10 mcg
J0665Injection, bupivicaine, not otherwise specified, 0.5 mg
J0670Injection, mepivacaine hydrochloride, per 10 ml
J0688Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg
J0689Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg
J0690Injection, cefazolin sodium, 500 mg
J0691Injection, lefamulin, 1 mg
J0692Injection, cefepime hydrochloride, 500 mg
J0693Injection, cefiderocol, 5 mg
Terminated September 30, 2021.
J0694Injection, cefoxitin sodium, 1 gm
J0695Injection, ceftolozane 50 mg and tazobactam 25 mg
J0696Injection, ceftriaxone sodium, per 250 mg
J0697Injection, sterile cefuroxime sodium, per 750 mg
J0698Injection, cefotaxime sodium, per gm
J0699Injection, cefiderocol, 10 mg
J0701Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
J0703Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg
J0706Injection, caffeine citrate, 5 mg
J0710Injection, cephapirin sodium, up to 1 gm
J0712Injection, ceftaroline fosamil, 10 mg
J0713Injection, ceftazidime, per 500 mg
J0714Injection, ceftazidime and avibactam, 0.5 g/0.125 g
J0715Injection, ceftizoxime sodium, per 500 mg
J0716Injection, centruroides immune f(ab)2, up to 120 milligrams
J0717Injection, 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)
J0720Injection, chloramphenicol sodium succinate, up to 1 gm
J0725Injection, chorionic gonadotropin, per 1,000 usp units
J0735Injection, clonidine hydrochloride, 1 mg
J0736Injection, clindamycin phosphate, 300 mg
J0737Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg
J0739Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
J0740Injection, cidofovir, 375 mg
J0741Injection, cabotegravir and rilpivirine, 2mg/3mg
J0742Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg
J0743Injection, cilastatin sodium; imipenem, per 250 mg
J0744Injection, ciprofloxacin for intravenous infusion, 200 mg
J0745Injection, codeine phosphate, per 30 mg
J0750Emtricitabine 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)
J0751Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
J0760Injection, colchicine, per 1 mg
Terminated December 31, 2016.
J0770Injection, colistimethate sodium, up to 150 mg
J0775Injection, collagenase, clostridium histolyticum, 0.01 mg
J0780Injection, prochlorperazine, up to 10 mg
J0791Injection, crizanlizumab-tmca, 5 mg
J0795Injection, corticorelin ovine triflutate, 1 microgram
J0799Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified
J0800Injection, corticotropin, up to 40 units
Terminated September 30, 2023.
J0801Injection, corticotropin (acthar gel), up to 40 units
J0802Injection, corticotropin (ani), up to 40 units
J0833Injection, cosyntropin, not otherwise specified, 0.25 mg
Terminated December 31, 2018.
J0834Injection, cosyntropin, 0.25 mg
J0840Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram
J0841Injection, crotalidae immune f(ab’)2 (equine), 120 mg
J0850Injection, cytomegalovirus immune globulin intravenous (human), per vial
J0873Injection, daptomycin (xellia) not therapeutically equivalent to j0878, 1 mg
J0874Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg
J0875Injection, dalbavancin, 5 mg
J0877Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg
J0878Injection, daptomycin, 1 mg
J0879Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)
J0883Injection, argatroban, 1 mg (for non-esrd use)
J0884Injection, argatroban, 1 mg (for esrd on dialysis)
J0885Injection, epoetin alfa, (for non-esrd use), 1000 units
J0886Injection, epoetin alfa, 1000 units (for esrd on dialysis)
Terminated December 31, 2015.
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)
J0888Injection, epoetin beta, 1 microgram, (for non esrd use)
J0889Daprodustat, oral, 1 mg, (for esrd on dialysis)
J0890Injection, peginesatide, 0.1 mg (for esrd on dialysis)
J0891Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)
J0892Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)
J0893Injection, decitabine (sun pharma) not therapeutically equivalent to j0894, 1 mg
J0894Injection, decitabine, 1 mg
J0895Injection, deferoxamine mesylate, 500 mg
J0896Injection, luspatercept-aamt, 0.25 mg
J0897Injection, denosumab, 1 mg
J0898Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)
J0899Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)
J0900Injection, testosterone enanthate and estradiol valerate, up to 1 cc
Terminated December 31, 2014.
J0945Injection, brompheniramine maleate, per 10 mg
J1000Injection, depo-estradiol cypionate, up to 5 mg
J1010Injection, methylprednisolone acetate, 1 mg
J1020Injection, methylprednisolone acetate, 20 mg
Terminated March 31, 2024.
J1030Injection, methylprednisolone acetate, 40 mg
Terminated March 31, 2024.
J1040Injection, methylprednisolone acetate, 80 mg
Terminated March 31, 2024.
J1050Injection, medroxyprogesterone acetate, 1 mg
J1060Injection, testosterone cypionate and estradiol cypionate, up to 1 ml
Terminated December 31, 2014.
J1070Injection, testosterone cypionate, up to 100 mg
Terminated December 31, 2014.
J1071Injection, testosterone cypionate, 1 mg
J1080Injection, testosterone cypionate, 1 cc, 200 mg
Terminated December 31, 2014.
J1094Injection, dexamethasone acetate, 1 mg
J1095Injection, dexamethasone 9 percent, intraocular, 1 microgram
J1096Dexamethasone, lacrimal ophthalmic insert, 0.1 mg
J1097Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
J1100Injection, dexamethasone sodium phosphate, 1 mg
J1105Dexmedetomidine, oral, 1 mcg
J1110Injection, dihydroergotamine mesylate, per 1 mg
J1120Injection, acetazolamide sodium, up to 500 mg
J1130Injection, diclofenac sodium, 0.5 mg
J1160Injection, digoxin, up to 0.5 mg
J1162Injection, digoxin immune fab (ovine), per vial
J1165Injection, phenytoin sodium, per 50 mg
J1170Injection, hydromorphone, up to 4 mg
J1180Injection, dyphylline, up to 500 mg
J1190Injection, dexrazoxane hydrochloride, per 250 mg
J1200Injection, diphenhydramine hcl, up to 50 mg
J1201Injection, cetirizine hydrochloride, 0.5 mg
J1202Miglustat, oral, 65 mg
J1203Injection, cipaglucosidase alfa-atga, 5 mg
J1205Injection, chlorothiazide sodium, per 500 mg
J1212Injection, dmso, dimethyl sulfoxide, 50%, 50 ml
J1230Injection, methadone hcl, up to 10 mg
J1240Injection, dimenhydrinate, up to 50 mg
J1245Injection, dipyridamole, per 10 mg
J1250Injection, dobutamine hydrochloride, per 250 mg
J1260Injection, dolasetron mesylate, 10 mg
J1265Injection, dopamine hcl, 40 mg
J1267Injection, doripenem, 10 mg
J1270Injection, doxercalciferol, 1 mcg
J1290Injection, ecallantide, 1 mg
J1300Injection, eculizumab, 10 mg
J1301Injection, edaravone, 1 mg
J1302Injection, sutimlimab-jome, 10 mg
J1303Injection, ravulizumab-cwvz, 10 mg
J1304Injection, tofersen, 1 mg
J1305Injection, evinacumab-dgnb, 5mg
J1306Injection, inclisiran, 1 mg
J1320Injection, amitriptyline hcl, up to 20 mg
J1322Injection, elosulfase alfa, 1 mg
J1323Injection, elranatamab-bcmm, 1 mg
J1324Injection, enfuvirtide, 1 mg
J1325Injection, epoprostenol, 0.5 mg
J1327Injection, eptifibatide, 5 mg
J1330Injection, ergonovine maleate, up to 0.2 mg
J1335Injection, ertapenem sodium, 500 mg
J1364Injection, erythromycin lactobionate, per 500 mg
J1380Injection, estradiol valerate, up to 10 mg
J1410Injection, estrogen conjugated, per 25 mg
J1411Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
J1412Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
J1413Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose
J1426Injection, casimersen, 10 mg
J1427Injection, viltolarsen, 10 mg
J1428Injection, eteplirsen, 10 mg
J1429Injection, golodirsen, 10 mg
J1430Injection, ethanolamine oleate, 100 mg
J1434Injection, fosaprepitant (focinvez), 1 mg
J1435Injection, estrone, per 1 mg
J1436Injection, etidronate disodium, per 300 mg
J1437Injection, ferric derisomaltose, 10 mg
J1438Injection, 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)
J1439Injection, ferric carboxymaltose, 1 mg
J1440Fecal microbiota, live – jslm, 1 ml
J1442Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram
J1443Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron
J1444Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron
J1445Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron
J1446Injection, tbo-filgrastim, 5 micrograms
Terminated December 31, 2015.
J1447Injection, tbo-filgrastim, 1 microgram
J1448Injection, trilaciclib, 1mg
J1449Injection, eflapegrastim-xnst, 0.1 mg
J1450Injection fluconazole, 200 mg
J1451Injection, fomepizole, 15 mg
J1452Injection, fomivirsen sodium, intraocular, 1.65 mg
J1453Injection, fosaprepitant, 1 mg
J1454Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
J1455Injection, foscarnet sodium, per 1000 mg
J1456Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg
J1457Injection, gallium nitrate, 1 mg
J1458Injection, galsulfase, 1 mg
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1460Injection, gamma globulin, intramuscular, 1 cc
J1551Injection, immune globulin (cutaquig), 100 mg
J1554Injection, immune globulin (asceniv), 500 mg
J1555Injection, immune globulin (cuvitru), 100 mg
J1556Injection, immune globulin (bivigam), 500 mg
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1558Injection, immune globulin (xembify), 100 mg
J1559Injection, immune globulin (hizentra), 100 mg
J1560Injection, gamma globulin, intramuscular, over 10 cc
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg
J1562Injection, immune globulin (vivaglobin), 100 mg
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1569Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg
J1570Injection, ganciclovir sodium, 500 mg
J1571Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1573Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml
J1574Injection, ganciclovir sodium (exela) not therapeutically equivalent to j1570, 500 mg
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1580Injection, garamycin, gentamicin, up to 80 mg
J1590Injection, gatifloxacin, 10 mg
Terminated December 31, 2016.
J1595Injection, glatiramer acetate, 20 mg
J1596Injection, glycopyrrolate, 0.1 mg
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg
J1600Injection, gold sodium thiomalate, up to 50 mg
J1602Injection, golimumab, 1 mg, for intravenous use
J1610Injection, glucagon hydrochloride, per 1 mg
J1611Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg
J1620Injection, gonadorelin hydrochloride, per 100 mcg
J1626Injection, granisetron hydrochloride, 100 mcg
J1627Injection, granisetron, extended-release, 0.1 mg
J1628Injection, guselkumab, 1 mg
J1630Injection, haloperidol, up to 5 mg
J1631Injection, haloperidol decanoate, per 50 mg
J1632Injection, brexanolone, 1 mg
J1640Injection, hemin, 1 mg
J1642Injection, heparin sodium, (heparin lock flush), per 10 units
J1643Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units
J1644Injection, heparin sodium, per 1000 units
J1645Injection, dalteparin sodium, per 2500 iu
J1650Injection, enoxaparin sodium, 10 mg
J1652Injection, fondaparinux sodium, 0.5 mg
J1655Injection, tinzaparin sodium, 1000 iu
J1670Injection, tetanus immune globulin, human, up to 250 units
J1675Injection, histrelin acetate, 10 micrograms
J1700Injection, hydrocortisone acetate, up to 25 mg
J1710Injection, hydrocortisone sodium phosphate, up to 50 mg
J1720Injection, hydrocortisone sodium succinate, up to 100 mg
J1725Injection, hydroxyprogesterone caproate, 1 mg
Terminated December 31, 2017.
J1726Injection, hydroxyprogesterone caproate, (makena), 10 mg
J1729Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
J1730Injection, diazoxide, up to 300 mg
J1738Injection, meloxicam, 1 mg
J1740Injection, ibandronate sodium, 1 mg
J1741Injection, ibuprofen, 100 mg
J1742Injection, ibutilide fumarate, 1 mg
J1743Injection, idursulfase, 1 mg
J1744Injection, icatibant, 1 mg
J1745Injection, infliximab, excludes biosimilar, 10 mg
J1746Injection, ibalizumab-uiyk, 10 mg
J1747Injection, spesolimab-sbzo, 1 mg
J1750Injection, iron dextran, 50 mg
J1756Injection, iron sucrose, 1 mg
J1786Injection, imiglucerase, 10 units
J1790Injection, droperidol, up to 5 mg
J1800Injection, propranolol hcl, up to 1 mg
J1805Injection, esmolol hydrochloride, 10 mg
J1806Injection, esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805, 10 mg
J1810Injection, droperidol and fentanyl citrate, up to 2 ml ampule
J1811Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units
J1812Insulin (fiasp), per 5 units
J1813Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units
J1814Insulin (lyumjev), per 5 units
J1815Injection, insulin, per 5 units
J1817Insulin for administration through dme (i.e., insulin pump) per 50 units
J1823Injection, inebilizumab-cdon, 1 mg
J1826Injection, interferon beta-1a, 30 mcg
J1830Injection, 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)
J1833Injection, isavuconazonium, 1 mg
J1835Injection, itraconazole, 50 mg
J1836Injection, metronidazole, 10 mg
J1840Injection, kanamycin sulfate, up to 500 mg
Terminated March 31, 2024.
J1850Injection, kanamycin sulfate, up to 75 mg
Terminated March 31, 2024.
J1885Injection, ketorolac tromethamine, per 15 mg
J1890Injection, cephalothin sodium, up to 1 gram
J1920Injection, labetalol hydrochloride, 5 mg
J1921Injection, labetalol hydrochloride (hikma) not therapeutically equivalent to j1920, 5 mg
J1930Injection, lanreotide, 1 mg
J1931Injection, laronidase, 0.1 mg
J1932Injection, lanreotide, (cipla), 1 mg
J1939Injection, bumetanide, 0.5 mg
J1940Injection, furosemide, up to 20 mg
J1941Injection, furosemide (furoscix), 20 mg
J1942Injection, aripiprazole lauroxil, 1 mg
Terminated September 30, 2019.
J1943Injection, aripiprazole lauroxil, (aristada initio), 1 mg
J1944Injection, aripiprazole lauroxil, (aristada), 1 mg
J1945Injection, lepirudin, 50 mg
J1950Injection, leuprolide acetate (for depot suspension), per 3.75 mg
J1951Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg
J1952Leuprolide injectable, camcevi, 1 mg
J1953Injection, levetiracetam, 10 mg
J1954Injection, leuprolide acetate for depot suspension (cipla), 7.5 mg
J1955Injection, levocarnitine, per 1 gm
J1956Injection, levofloxacin, 250 mg
J1960Injection, levorphanol tartrate, up to 2 mg
J1961Injection, lenacapavir, 1 mg
J1980Injection, hyoscyamine sulfate, up to 0.25 mg
J1990Injection, chlordiazepoxide hcl, up to 100 mg
J2001Injection, lidocaine hcl for intravenous infusion, 10 mg
J2010Injection, lincomycin hcl, up to 300 mg
J2020Injection, linezolid, 200 mg
J2021Injection, linezolid (hospira) not therapeutically equivalent to j2020, 200 mg
J2060Injection, lorazepam, 2 mg
J2062Loxapine for inhalation, 1 mg
J2150Injection, mannitol, 25% in 50 ml
J2170Injection, mecasermin, 1 mg
J2175Injection, meperidine hydrochloride, per 100 mg
J2180Injection, meperidine and promethazine hcl, up to 50 mg
J2182Injection, mepolizumab, 1 mg
J2184Injection, meropenem (b. braun) not therapeutically equivalent to j2185, 100 mg
J2185Injection, meropenem, 100 mg
J2186Injection, meropenem and vaborbactam, 10mg/10mg (20mg)
J2210Injection, methylergonovine maleate, up to 0.2 mg
J2212Injection, methylnaltrexone, 0.1 mg
J2247Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
J2248Injection, micafungin sodium, 1 mg
J2249Injection, remimazolam, 1 mg
J2250Injection, midazolam hydrochloride, per 1 mg
J2251Injection, midazolam hydrochloride (wg critical care) not therapeutically equivalent to j2250, per 1 mg
J2260Injection, milrinone lactate, 5 mg
J2265Injection, minocycline hydrochloride, 1 mg
J2270Injection, morphine sulfate, up to 10 mg
J2271Injection, morphine sulfate, 100mg
Terminated December 31, 2014.
J2272Injection, morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270, up to 10 mg
J2274Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg
J2275Injection, morphine sulfate (preservative-free sterile solution), per 10 mg
Terminated December 31, 2014.
J2277Injection, motixafortide, 0.25 mg
J2278Injection, ziconotide, 1 microgram
J2280Injection, moxifloxacin, 100 mg
J2281Injection, moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280, 100 mg
J2300Injection, nalbuphine hydrochloride, per 10 mg
J2305Injection, nitroglycerin, 5 mg
J2310Injection, naloxone hydrochloride, per 1 mg
J2311Injection, naloxone hydrochloride (zimhi), 1 mg
J2315Injection, naltrexone, depot form, 1 mg
J2320Injection, nandrolone decanoate, up to 50 mg
J2323Injection, natalizumab, 1 mg
J2325Injection, nesiritide, 0.1 mg
J2326Injection, nusinersen, 0.1 mg
J2327Injection, risankizumab-rzaa, intravenous, 1 mg
J2329Injection, ublituximab-xiiy, 1mg
J2350Injection, ocrelizumab, 1 mg
J2353Injection, octreotide, depot form for intramuscular injection, 1 mg
J2354Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg
J2355Injection, oprelvekin, 5 mg
J2356Injection, tezepelumab-ekko, 1 mg
J2357Injection, omalizumab, 5 mg
J2358Injection, olanzapine, long-acting, 1 mg
J2359Injection, olanzapine, 0.5 mg
J2360Injection, orphenadrine citrate, up to 60 mg
J2370Injection, phenylephrine hcl, up to 1 ml
Terminated June 30, 2023.
J2371Injection, phenylephrine hydrochloride, 20 micrograms
J2372Injection, phenylephrine hydrochloride (biorphen), 20 micrograms
J2400Injection, chloroprocaine hydrochloride, per 30 ml
Terminated December 31, 2022.
J2401Injection, chloroprocaine hydrochloride, per 1 mg
J2402Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg
J2403Chloroprocaine hcl ophthalmic, 3% gel, 1 mg
J2404Injection, nicardipine, 0.1 mg
J2405Injection, ondansetron hydrochloride, per 1 mg
J2406Injection, oritavancin (kimyrsa), 10 mg
J2407Injection, oritavancin (orbactiv), 10 mg
J2410Injection, oxymorphone hcl, up to 1 mg
J2425Injection, palifermin, 50 micrograms
J2426Injection, paliperidone palmitate extended release (invega sustenna), 1 mg
J2427Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg
J2430Injection, pamidronate disodium, per 30 mg
J2440Injection, papaverine hcl, up to 60 mg
J2460Injection, oxytetracycline hcl, up to 50 mg
J2469Injection, palonosetron hcl, 25 mcg
J2501Injection, paricalcitol, 1 mcg
J2502Injection, pasireotide long acting, 1 mg
J2503Injection, pegaptanib sodium, 0.3 mg
J2504Injection, pegademase bovine, 25 iu
J2505Injection, pegfilgrastim, 6 mg
Terminated December 31, 2021.
J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mg
J2507Injection, pegloticase, 1 mg
J2508Injection, pegunigalsidase alfa-iwxj, 1 mg
J2510Injection, penicillin g procaine, aqueous, up to 600,000 units
J2513Injection, pentastarch, 10% solution, 100 ml
J2515Injection, pentobarbital sodium, per 50 mg
J2540Injection, penicillin g potassium, up to 600,000 units
J2543Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)
J2545Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg
J2547Injection, peramivir, 1 mg
J2550Injection, promethazine hcl, up to 50 mg
J2560Injection, phenobarbital sodium, up to 120 mg
J2561Injection, phenobarbital sodium (sezaby), 1 mg
J2562Injection, plerixafor, 1 mg
J2590Injection, oxytocin, up to 10 units
J2597Injection, desmopressin acetate, per 1 mcg
J2598Injection, vasopressin, 1 unit
J2599Injection, vasopressin (american regent) not therapeutically equivalent to j2598, 1 unit
J2650Injection, prednisolone acetate, up to 1 ml
J2670Injection, tolazoline hcl, up to 25 mg
J2675Injection, progesterone, per 50 mg
J2679Injection, fluphenazine hcl, 1.25 mg
J2680Injection, fluphenazine decanoate, up to 25 mg
J2690Injection, procainamide hcl, up to 1 gm
J2700Injection, oxacillin sodium, up to 250 mg
J2704Injection, propofol, 10 mg
J2710Injection, neostigmine methylsulfate, up to 0.5 mg
J2720Injection, protamine sulfate, per 10 mg
J2724Injection, protein c concentrate, intravenous, human, 10 iu
J2725Injection, protirelin, per 250 mcg
J2730Injection, pralidoxime chloride, up to 1 gm
J2760Injection, phentolamine mesylate, up to 5 mg
J2765Injection, metoclopramide hcl, up to 10 mg
J2770Injection, quinupristin/dalfopristin, 500 mg (150/350)
J2777Injection, faricimab-svoa, 0.1 mg
J2778Injection, ranibizumab, 0.1 mg
J2779Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg
J2780Injection, ranitidine hydrochloride, 25 mg
J2781Injection, pegcetacoplan, intravitreal, 1 mg
J2782Injection, avacincaptad pegol, 0.1 mg
J2783Injection, rasburicase, 0.5 mg
J2785Injection, regadenoson, 0.1 mg
J2786Injection, reslizumab, 1 mg
J2787Riboflavin 5′-phosphate, ophthalmic solution, up to 3 ml
J2788Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)
J2790Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu
J2792Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu
J2793Injection, rilonacept, 1 mg
J2794Injection, risperidone (risperdal consta), 0.5 mg
J2795Injection, ropivacaine hydrochloride, 1 mg
J2796Injection, romiplostim, 10 micrograms
J2797Injection, rolapitant, 0.5 mg
J2798Injection, risperidone, (perseris), 0.5 mg
J2799Injection, risperidone (uzedy), 1 mg
J2800Injection, methocarbamol, up to 10 ml
J2801Injection, risperidone (rykindo), 0.5 mg
J2805Injection, sincalide, 5 micrograms
J2806Injection, sincalide (maia) not therapeutically equivalent to j2805, 5 micrograms
J2810Injection, theophylline, per 40 mg
J2820Injection, sargramostim (gm-csf), 50 mcg
J2840Injection, sebelipase alfa, 1 mg
J2850Injection, secretin, synthetic, human, 1 microgram
J2860Injection, siltuximab, 10 mg
J2910Injection, aurothioglucose, up to 50 mg
J2916Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg
J2919Injection, methylprednisolone sodium succinate, 5 mg
J2920Injection, methylprednisolone sodium succinate, up to 40 mg
Terminated March 31, 2024.
J2930Injection, methylprednisolone sodium succinate, up to 125 mg
Terminated March 31, 2024.
J2940Injection, somatrem, 1 mg
J2941Injection, somatropin, 1 mg
J2950Injection, promazine hcl, up to 25 mg
J2993Injection, reteplase, 18.1 mg
J2995Injection, streptokinase, per 250,000 iu
J2997Injection, alteplase recombinant, 1 mg
J2998Injection, plasminogen, human-tvmh, 1 mg
J3000Injection, streptomycin, up to 1 gm
J3010Injection, fentanyl citrate, 0.1 mg
J3030Injection, 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)
J3031Injection, 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)
J3032Injection, eptinezumab-jjmr, 1 mg
J3055Injection, talquetamab-tgvs, 0.25 mg
J3060Injection, taliglucerase alfa, 10 units
J3070Injection, pentazocine, 30 mg
J3090Injection, tedizolid phosphate, 1 mg
J3095Injection, telavancin, 10 mg
J3101Injection, tenecteplase, 1 mg
J3105Injection, terbutaline sulfate, up to 1 mg
J3110Injection, teriparatide, 10 mcg
J3111Injection, romosozumab-aqqg, 1 mg
J3120Injection, testosterone enanthate, up to 100 mg
Terminated December 31, 2014.
J3121Injection, testosterone enanthate, 1 mg
J3130Injection, testosterone enanthate, up to 200 mg
Terminated December 31, 2014.
J3140Injection, testosterone suspension, up to 50 mg
Terminated December 31, 2014.
J3145Injection, testosterone undecanoate, 1 mg
J3150Injection, testosterone propionate, up to 100 mg
Terminated December 31, 2014.
J3230Injection, chlorpromazine hcl, up to 50 mg
J3240Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
J3241Injection, teprotumumab-trbw, 10 mg
J3243Injection, tigecycline, 1 mg
J3244Injection, tigecycline (accord) not therapeutically equivalent to j3243, 1 mg
J3245Injection, tildrakizumab, 1 mg
J3246Injection, tirofiban hcl, 0.25 mg
J3250Injection, trimethobenzamide hcl, up to 200 mg
J3260Injection, tobramycin sulfate, up to 80 mg
J3262Injection, tocilizumab, 1 mg
J3265Injection, torsemide, 10 mg/ml
J3280Injection, thiethylperazine maleate, up to 10 mg
J3285Injection, treprostinil, 1 mg
J3299Injection, triamcinolone acetonide (xipere), 1 mg
J3300Injection, triamcinolone acetonide, preservative free, 1 mg
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg
J3302Injection, triamcinolone diacetate, per 5 mg
J3303Injection, triamcinolone hexacetonide, per 5 mg
J3304Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
J3305Injection, trimetrexate glucuronate, per 25 mg
J3310Injection, perphenazine, up to 5 mg
J3315Injection, triptorelin pamoate, 3.75 mg
J3316Injection, triptorelin, extended-release, 3.75 mg
J3320Injection, spectinomycin dihydrochloride, up to 2 gm
J3350Injection, urea, up to 40 gm
J3355Injection, urofollitropin, 75 iu
J3357Ustekinumab, for subcutaneous injection, 1 mg
J3358Ustekinumab, for intravenous injection, 1 mg
J3360Injection, diazepam, up to 5 mg
J3364Injection, urokinase, 5000 iu vial
J3365Injection, iv, urokinase, 250,000 i.u. vial
J3370Injection, vancomycin hcl, 500 mg
J3371Injection, vancomycin hcl (mylan) not therapeutically equivalent to j3370, 500 mg
J3372Injection, vancomycin hcl (xellia) not therapeutically equivalent to j3370, 500 mg
J3380Injection, vedolizumab, intravenous, 1 mg
J3385Injection, velaglucerase alfa, 100 units
J3396Injection, verteporfin, 0.1 mg
J3397Injection, vestronidase alfa-vjbk, 1 mg
J3398Injection, voretigene neparvovec-rzyl, 1 billion vector genomes
J3399Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5×10^15 vector genomes
J3400Injection, triflupromazine hcl, up to 20 mg
J3401Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
J3410Injection, hydroxyzine hcl, up to 25 mg
J3411Injection, thiamine hcl, 100 mg
J3415Injection, pyridoxine hcl, 100 mg
J3420Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
J3424Injection, hydroxocobalamin, intravenous, 25 mg
J3425Injection, hydroxocobalamin, intramuscular, 10 mcg
J3430Injection, phytonadione (vitamin k), per 1 mg
J3465Injection, voriconazole, 10 mg
J3470Injection, hyaluronidase, up to 150 units
J3471Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)
J3472Injection, hyaluronidase, ovine, preservative free, per 1000 usp units
J3473Injection, hyaluronidase, recombinant, 1 usp unit
J3475Injection, magnesium sulfate, per 500 mg
J3480Injection, potassium chloride, per 2 meq
J3485Injection, zidovudine, 10 mg
J3486Injection, ziprasidone mesylate, 10 mg
J3489Injection, zoledronic acid, 1 mg
J3490Unclassified drugs
J3520Edetate disodium, per 150 mg
J3530Nasal vaccine inhalation
J3535Drug administered through a metered dose inhaler
J3570Laetrile, amygdalin, vitamin b17
J3590Unclassified biologics
J3591Unclassified drug or biological used for esrd on dialysis
J7030Infusion, normal saline solution , 1000 cc
J7040Infusion, normal saline solution, sterile (500 ml = 1 unit)
J70425% dextrose/normal saline (500 ml = 1 unit)
J7050Infusion, normal saline solution, 250 cc
J70605% dextrose/water (500 ml = 1 unit)
J7070Infusion, d5w, 1000 cc
J7100Infusion, dextran 40, 500 ml
J7110Infusion, dextran 75, 500 ml
J7120Ringers lactate infusion, up to 1000 cc
J71215% dextrose in lactated ringers infusion, up to 1000 cc
J7131Hypertonic saline solution, 1 ml
J7165Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
J7168Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity
J7169Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg
J7170Injection, emicizumab-kxwh, 0.5 mg
J7175Injection, factor x, (human), 1 i.u.
J7177Injection, human fibrinogen concentrate (fibryga), 1 mg
J7178Injection, human fibrinogen concentrate, not otherwise specified, 1 mg
J7179Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco
J7180Injection, factor xiii (antihemophilic factor, human), 1 i.u.
J7181Injection, factor xiii a-subunit, (recombinant), per iu
J7182Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu
J7183Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco
J7185Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.
J7186Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.
J7187Injection, von willebrand factor complex (humate-p), per iu vwf:rco
J7188Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.
J7189Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram
J7190Factor viii (antihemophilic factor, human) per i.u.
J7191Factor viii (antihemophilic factor (porcine)), per i.u.
J7192Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified
J7193Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.
J7194Factor ix, complex, per i.u.
J7195Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified
J7196Injection, antithrombin recombinant, 50 i.u.
J7197Antithrombin iii (human), per i.u.
J7198Anti-inhibitor, per i.u.
J7199Hemophilia clotting factor, not otherwise classified
J7200Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu
J7201Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.
J7202Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.
J7203Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu
J7204Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu
J7205Injection, factor viii fc fusion protein (recombinant), per iu
J7207Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.
J7208Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.
J7209Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.
J7210Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.
J7211Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
J7212Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram
J7213Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.
J7214Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
J7294Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each
J7295Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each
J7296Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg
J7297Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg
J7298Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg
J7300Intrauterine copper contraceptive
J7301Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
J7302Levonorgestrel-releasing intrauterine contraceptive system, 52 mg
Terminated December 31, 2015.
J7303Contraceptive supply, hormone containing vaginal ring, each
Terminated September 30, 2021.
J7304Contraceptive supply, hormone containing patch, each
J7306Levonorgestrel (contraceptive) implant system, including implants and supplies
J7307Etonogestrel (contraceptive) implant system, including implant and supplies
J7308Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)
J7309Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram
J7310Ganciclovir, 4.5 mg, long-acting implant
J7311Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
J7312Injection, dexamethasone, intravitreal implant, 0.1 mg
J7313Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg
J7314Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg
J7315Mitomycin, ophthalmic, 0.2 mg
J7316Injection, ocriplasmin, 0.125 mg
J7318Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose
J7322Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg
J7323Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose
J7324Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose
J7325Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg
J7326Hyaluronan or derivative, gel-one, for intra-articular injection, per dose
J7327Hyaluronan or derivative, monovisc, for intra-articular injection, per dose
J7328Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg
J7329Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg
J7330Autologous cultured chondrocytes, implant
J7331Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg
J7332Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg
J7333Hyaluronan or derivative, visco-3, for intra-articular injection, per dose
Terminated March 31, 2021.
J7335Capsaicin 8% patch, per 10 square centimeters
Terminated December 31, 2014.
J7336Capsaicin 8% patch, per square centimeter
J7340Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml
J7342Instillation, ciprofloxacin otic suspension, 6 mg
J7345Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg
J7351Injection, bimatoprost, intracameral implant, 1 microgram
J7352Afamelanotide implant, 1 mg
J7353Anacaulase-bcdb, 8.8% gel, 1 gram
J7354Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)
J7401Mometasone furoate sinus implant, 10 micrograms
Terminated March 31, 2021.
J7402Mometasone furoate sinus implant, (sinuva), 10 micrograms
J7500Azathioprine, oral, 50 mg
J7501Azathioprine, parenteral, 100 mg
J7502Cyclosporine, oral, 100 mg
J7503Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
J7504Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
J7505Muromonab-cd3, parenteral, 5 mg
J7506Prednisone, oral, per 5 mg
Terminated December 31, 2015.
J7507Tacrolimus, immediate release, oral, 1 mg
J7508Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
J7509Methylprednisolone oral, per 4 mg
J7510Prednisolone oral, per 5 mg
J7511Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
J7512Prednisone, immediate release or delayed release, oral, 1 mg
J7513Daclizumab, parenteral, 25 mg
J7515Cyclosporine, oral, 25 mg
J7516Injection, cyclosporine, 250 mg
J7517Mycophenolate mofetil, oral, 250 mg
J7518Mycophenolic acid, oral, 180 mg
J7519Injection, mycophenolate mofetil, 10 mg
J7520Sirolimus, oral, 1 mg
J7525Tacrolimus, parenteral, 5 mg
J7527Everolimus, oral, 0.25 mg
J7599Immunosuppressive drug, not otherwise classified
J7604Acetylcysteine, inhalation solution, compounded product, administered through dme, unit dose form, per gram
J7605Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms
J7606Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms
J7607Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg
J7608Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram
J7609Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg
J7610Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg
J7611Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg
J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg
J7613Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg
J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg
J7615Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg
J7620Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme
J7622Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7624Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7626Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
J7627Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg
J7628Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7629Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7631Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
J7632Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams
J7633Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram
J7634Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram
J7635Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7636Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7637Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7638Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7639Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
J7640Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms
J7641Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram
J7642Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7643Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7644Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
J7645Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7647Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7648Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram
J7649Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
J7650Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7657Isoproterenol hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7658Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram
J7659Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
J7660Isoproterenol hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7665Mannitol, administered through an inhaler, 5 mg
J7667Metaproterenol sulfate, inhalation solution, compounded product, concentrated form, per 10 milligrams
J7668Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 10 milligrams
J7669Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
J7670Metaproterenol sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams
J7674Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg
J7676Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg
J7677Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram
J7680Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7681Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7682Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams
J7683Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
J7684Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
J7685Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams
J7686Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg
J7699Noc drugs, inhalation solution administered through dme
J7799Noc drugs, other than inhalation drugs, administered through dme
J7999Compounded drug, not otherwise classified
J8498Antiemetic drug, rectal/suppository, not otherwise specified
J8499Prescription drug, oral, non chemotherapeutic, nos
J8501Aprepitant, oral, 5 mg
J8510Busulfan; oral, 2 mg
J8515Cabergoline, oral, 0.25 mg
J8520Capecitabine, oral, 150 mg
J8521Capecitabine, oral, 500 mg
J8530Cyclophosphamide; oral, 25 mg
J8540Dexamethasone, oral, 0.25 mg
J8560Etoposide; oral, 50 mg
J8562Fludarabine phosphate, oral, 10 mg
J8565Gefitinib, oral, 250 mg
J8597Antiemetic drug, oral, not otherwise specified
J8600Melphalan; oral, 2 mg
J8610Methotrexate; oral, 2.5 mg
J8650Nabilone, oral, 1 mg
J8655Netupitant 300 mg and palonosetron 0.5 mg, oral
J8670Rolapitant, oral, 1 mg
J8700Temozolomide, oral, 5 mg
J8705Topotecan, oral, 0.25 mg
J8999Prescription drug, oral, chemotherapeutic, nos
J9000Injection, doxorubicin hydrochloride, 10 mg
J9010Injection, alemtuzumab, 10 mg
Terminated December 31, 2015.
J9015Injection, aldesleukin, per single use vial
J9017Injection, arsenic trioxide, 1 mg
J9019Injection, asparaginase (erwinaze), 1,000 iu
J9020Injection, asparaginase, not otherwise specified, 10,000 units
J9021Injection, asparaginase, recombinant, (rylaze), 0.1 mg
J9022Injection, atezolizumab, 10 mg
J9023Injection, avelumab, 10 mg
J9025Injection, azacitidine, 1 mg
J9027Injection, clofarabine, 1 mg
J9029Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose
J9030Bcg live intravesical instillation, 1 mg
J9031Bcg (intravesical) per instillation
Terminated June 30, 2019.
J9032Injection, belinostat, 10 mg
J9033Injection, bendamustine hcl (treanda), 1 mg
J9034Injection, bendamustine hcl (bendeka), 1 mg
J9035Injection, bevacizumab, 10 mg
J9036Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg
J9037Injection, belantamab mafodotin-blmf, 0.5 mg
J9039Injection, blinatumomab, 1 microgram
J9040Injection, bleomycin sulfate, 15 units
J9041Injection, bortezomib, 0.1 mg
J9042Injection, brentuximab vedotin, 1 mg
J9043Injection, cabazitaxel, 1 mg
J9044Injection, bortezomib, not otherwise specified, 0.1 mg
Terminated December 31, 2022.
J9045Injection, carboplatin, 50 mg
J9046Injection, bortezomib, (dr. reddy’s), not therapeutically equivalent to j9041, 0.1 mg
J9047Injection, carfilzomib, 1 mg
J9048Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg
J9049Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg
J9050Injection, carmustine, 100 mg
J9051Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg
J9052Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg
J9055Injection, cetuximab, 10 mg
J9056Injection, bendamustine hydrochloride (vivimusta), 1 mg
J9057Injection, copanlisib, 1 mg
J9058Injection, bendamustine hydrochloride (apotex), 1 mg
J9059Injection, bendamustine hydrochloride (baxter), 1 mg
J9060Injection, cisplatin, powder or solution, 10 mg
J9061Injection, amivantamab-vmjw, 2 mg
J9063Injection, mirvetuximab soravtansine-gynx, 1 mg
J9064Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg
J9065Injection, cladribine, per 1 mg
J9070Cyclophosphamide, 100 mg
Terminated March 31, 2024.
J9071Injection, cyclophosphamide (auromedics), 5 mg
J9072Injection, cyclophosphamide (dr. reddy’s), 5 mg
J9073Injection, cyclophosphamide (ingenus), 5 mg
J9074Injection, cyclophosphamide (sandoz), 5 mg
J9075Injection, cyclophosphamide, not otherwise specified, 5 mg
J9098Injection, cytarabine liposome, 10 mg
J9100Injection, cytarabine, 100 mg
J9118Injection, calaspargase pegol-mknl, 10 units
J9119Injection, cemiplimab-rwlc, 1 mg
J9120Injection, dactinomycin, 0.5 mg
J9130Dacarbazine, 100 mg
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihj
J9145Injection, daratumumab, 10 mg
J9150Injection, daunorubicin, 10 mg
J9151Injection, daunorubicin citrate, liposomal formulation, 10 mg
J9153Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
J9155Injection, degarelix, 1 mg
J9160Injection, denileukin diftitox, 300 micrograms
Terminated December 31, 2023.
J9165Injection, diethylstilbestrol diphosphate, 250 mg
J9171Injection, docetaxel, 1 mg
J9172Injection, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg
J9173Injection, durvalumab, 10 mg
J9175Injection, elliotts’ b solution, 1 ml
J9176Injection, elotuzumab, 1 mg
J9177Injection, enfortumab vedotin-ejfv, 0.25 mg
J9178Injection, epirubicin hcl, 2 mg
J9179Injection, eribulin mesylate, 0.1 mg
J9181Injection, etoposide, 10 mg
J9185Injection, fludarabine phosphate, 50 mg
J9190Injection, fluorouracil, 500 mg
J9196Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg
J9198Injection, gemcitabine hydrochloride, (infugem), 100 mg
J9199Injection, gemcitabine hydrochloride (infugem), 200 mg
Terminated June 30, 2020.
J9200Injection, floxuridine, 500 mg
J9201Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg
J9202Goserelin acetate implant, per 3.6 mg
J9203Injection, gemtuzumab ozogamicin, 0.1 mg
J9204Injection, mogamulizumab-kpkc, 1 mg
J9205Injection, irinotecan liposome, 1 mg
J9206Injection, irinotecan, 20 mg
J9207Injection, ixabepilone, 1 mg
J9208Injection, ifosfamide, 1 gram
J9209Injection, mesna, 200 mg
J9210Injection, emapalumab-lzsg, 1 mg
J9211Injection, idarubicin hydrochloride, 5 mg
J9212Injection, interferon alfacon-1, recombinant, 1 microgram
J9213Injection, interferon, alfa-2a, recombinant, 3 million units
J9214Injection, interferon, alfa-2b, recombinant, 1 million units
J9215Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu
J9216Injection, interferon, gamma 1-b, 3 million units
J9217Leuprolide acetate (for depot suspension), 7.5 mg
J9218Leuprolide acetate, per 1 mg
J9219Leuprolide acetate implant, 65 mg
J9223Injection, lurbinectedin, 0.1 mg
J9225Histrelin implant (vantas), 50 mg
J9226Histrelin implant (supprelin la), 50 mg
J9227Injection, isatuximab-irfc, 10 mg
J9228Injection, ipilimumab, 1 mg
J9229Injection, inotuzumab ozogamicin, 0.1 mg
J9230Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg
J9245Injection, melphalan hydrochloride, not otherwise specified, 50 mg
J9246Injection, melphalan (evomela), 1 mg
J9247Injection, melphalan flufenamide, 1mg
J9248Injection, melphalan (hepzato), 1 mg
J9249Injection, melphalan (apotex), 1 mg
J9250Methotrexate sodium, 5 mg
Terminated March 31, 2024.
J9255Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg
J9258Injection, paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264, 1 mg
J9259Injection, paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264, 1 mg
J9260Injection, methotrexate sodium, 50 mg
J9261Injection, nelarabine, 50 mg
J9262Injection, omacetaxine mepesuccinate, 0.01 mg
J9263Injection, oxaliplatin, 0.5 mg
J9264Injection, paclitaxel protein-bound particles, 1 mg
J9265Injection, paclitaxel, 30 mg
Terminated December 31, 2014.
J9266Injection, pegaspargase, per single dose vial
J9267Injection, paclitaxel, 1 mg
J9268Injection, pentostatin, 10 mg
J9269Injection, tagraxofusp-erzs, 10 micrograms
J9270Injection, plicamycin, 2.5 mg
J9271Injection, pembrolizumab, 1 mg
J9272Injection, dostarlimab-gxly, 10 mg
J9273Injection, tisotumab vedotin-tftv, 1 mg
J9274Injection, tebentafusp-tebn, 1 microgram
J9280Injection, mitomycin, 5 mg
J9281Mitomycin pyelocalyceal instillation, 1 mg
J9285Injection, olaratumab, 10 mg
J9286Injection, glofitamab-gxbm, 2.5 mg
J9293Injection, mitoxantrone hydrochloride, per 5 mg
J9294Injection, pemetrexed (hospira) not therapeutically equivalent to j9305, 10 mg
J9295Injection, necitumumab, 1 mg
J9296Injection, pemetrexed (accord) not therapeutically equivalent to j9305, 10 mg
J9297Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg
J9298Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg
J9299Injection, nivolumab, 1 mg
J9300Injection, gemtuzumab ozogamicin, 5 mg
Terminated December 31, 2017.
J9301Injection, obinutuzumab, 10 mg
J9302Injection, ofatumumab, 10 mg
J9303Injection, panitumumab, 10 mg
J9304Injection, pemetrexed (pemfexy), 10 mg
J9305Injection, pemetrexed, not otherwise specified, 10 mg
J9306Injection, pertuzumab, 1 mg
J9307Injection, pralatrexate, 1 mg
J9308Injection, ramucirumab, 5 mg
J9309Injection, polatuzumab vedotin-piiq, 1 mg
J9310Injection, rituximab, 100 mg
Terminated December 31, 2018.
J9311Injection, rituximab 10 mg and hyaluronidase
J9312Injection, rituximab, 10 mg
J9313Injection, moxetumomab pasudotox-tdfk, 0.01 mg
J9314Injection, pemetrexed (teva) not therapeutically equivalent to j9305, 10 mg
J9315Injection, romidepsin, 1 mg
Terminated September 30, 2021.
J9316Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg
J9317Injection, sacituzumab govitecan-hziy, 2.5 mg
J9318Injection, romidepsin, non-lyophilized, 0.1 mg
J9319Injection, romidepsin, lyophilized, 0.1 mg
J9320Injection, streptozocin, 1 gram
J9321Injection, epcoritamab-bysp, 0.16 mg
J9322Injection, pemetrexed (bluepoint) not therapeutically equivalent to j9305, 10 mg
J9323Injection, pemetrexed ditromethamine, 10 mg
J9324Injection, pemetrexed (pemrydi rtu), 10 mg
J9325Injection, talimogene laherparepvec, per 1 million plaque forming units
J9328Injection, temozolomide, 1 mg
J9330Injection, temsirolimus, 1 mg
J9331Injection, sirolimus protein-bound particles, 1 mg
J9332Injection, efgartigimod alfa-fcab, 2mg
J9333Injection, rozanolixizumab-noli, 1 mg
J9334Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc
J9340Injection, thiotepa, 15 mg
J9345Injection, retifanlimab-dlwr, 1 mg
J9347Injection, tremelimumab-actl, 1 mg
J9348Injection, naxitamab-gqgk, 1 mg
J9349Injection, tafasitamab-cxix, 2 mg
J9350Injection, mosunetuzumab-axgb, 1 mg
J9351Injection, topotecan, 0.1 mg
J9352Injection, trabectedin, 0.1 mg
J9353Injection, margetuximab-cmkb, 5 mg
J9354Injection, ado-trastuzumab emtansine, 1 mg
J9355Injection, trastuzumab, excludes biosimilar, 10 mg
J9356Injection, trastuzumab, 10 mg and hyaluronidase-oysk
J9357Injection, valrubicin, intravesical, 200 mg
J9358Injection, fam-trastuzumab deruxtecan-nxki, 1 mg
J9359Injection, loncastuximab tesirine-lpyl, 0.075 mg
J9360Injection, vinblastine sulfate, 1 mg
J9370Vincristine sulfate, 1 mg
J9371Injection, vincristine sulfate liposome, 1 mg
J9376Injection, pozelimab-bbfg, 1 mg
J9380Injection, teclistamab-cqyv, 0.5 mg
J9381Injection, teplizumab-mzwv, 5 mcg
J9390Injection, vinorelbine tartrate, 10 mg
J9393Injection, fulvestrant (teva) not therapeutically equivalent to j9395, 25 mg
J9394Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg
J9395Injection, fulvestrant, 25 mg
J9400Injection, ziv-aflibercept, 1 mg
J9600Injection, porfimer sodium, 75 mg
J9999Not otherwise classified, antineoplastic drugs