Medicare ᏗᎾᏓᏁᏢᏍᎩ

J0585

INJECTION, ONABOTULINUMOTXINA, 1 UNIT

J0587

INJECTION, RIMABOTULINUMTOXINB, 100 UNITS

STEP THERAPY

J0588

INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT

STEP THERAPY

J1437

INJECTION, FERRIC DERISOMALTOSE, 10 MG

STEP THERAPY

J1439

INJECTION, FERRIC CARBOXYMALTOSE, 1 MG

STEP THERAPY

J1443

INJECTION, FERRIC PYROPHOSPHATE CITRATE SOLUTION (TRIFERIC), 0.1 MG OF IRON

STEP THERAPY

J1444

INJECTION, FERRIC PYROPHOSPHATE CITRATE POWDER, 0.1 MG OF IRON

STEP THERAPY

J1445

INJECTION, FERRIC PYROPHOSPHATE CITRATE SOLUTION (TRIFERIC AVNU), 0.1 MG OF IRON

STEP THERAPY

J1449

INJECTION, EFLAPEGRASTIM-XNST (ROLVEDON), 0.1 MG

STEP THERAPY

J1460

INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC

STEP THERAPY

J1560

INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC

STEP THERAPY

Q0138

INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1MG (NON-ESRD USE)

STEP THERAPY

Q0139

INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1MG (FOR ESRD ON DIALYSIS)

STEP THERAPY

Q5126

INJECTION, BEVACIZUMAB-MALY, BIOSIMILAR, (ALYMSYS), 10 MG

STEP THERAPY

Q5127

INJECTION, PEGFILGRASTIM-FPGK (STIMUFEND), BIOSIMILAR, 0.5 MG

STEP THERAPY

Q5128

INJECTION, RANIBIZUMAB-EQRN (CIMERLI), BIOSIMIAR, 0.1 MG

STEP THERAPY

Q5129

INJECTION, BEVACIZUMAB-ADCD (VEGZELMA), BIOSIMILAR, 10 MG

STEP THERAPY

Q5130

INJECTION, PEGFILGRASTIM-PBBK (FYLNETRA), BIOSIMILAR, 0.5 MG

STEP THERAPY