NDC - HCPCS Crosswalk Outpatient Prospective Payment System (OPPS)
Effective July 1, 2026 through September 30, 2026
The NDC - HCPCS crosswalks are intended to help understand which drug products -identified by NDCs- are assigned to which HCPCS billing codes. The information is based on published drug and biological pricing data and information submitted to CMS by manufacturers. The crosswalks are not intended to be a comprehensive list of all NDCs available in the United States. The NDC to HCPCS Crosswalks also include information on the NDC package size and the number of billable units.
Outpatient Prospective Payment System (OPPS)
| NDC | HCPCS Code | Labeler | Drug Name | Dosage | Package Size | Package Quantity | Billable Units | Billable Units / Pkg |
|---|---|---|---|---|---|---|---|---|
| 49591-126-51 | 90396 | Kamada Ltd. | Varicella-zoster ig im | 125 IU | 1.2 | 1 | 1 | 1 |
| 70257-126-51 | 90396 | Kamada Ltd. | Varicella-zoster ig im | 125 IU | 1.2 | 1 | 1 | 1 |
| 73814-986-20 | A9506 | Cyclomedica Australia PTY Limited | Tc-99m graphite crucible | EACH | 1 | 50 | 50 | 50 |
| 69488-003-01 | A9513 | Advanced Accelerator Applications USA, Inc. | Lutetium Lu 177 dotatat ther | 1 mCi | 20 | 1 | 200 | 200 |
| 72893-007-04 | A9543 | Acrotech Biopharma LLC | Y90 ibritumomab, rx | UP TO 40 millicuries | 1 | 1 | 1 | 1 |
| 24338-310-10 | A9574 | Azurity Pharmaceuticals Inc | Inj. ferumoxytol, 1 mg | 1 MG | 10 | 1 | 300 | 300 |
| 24338-510-17 | A9574 | Azurity Pharmaceuticals Inc | Inj. ferumoxytol, 1 mg | 1 MG | 17 | 1 | 510 | 510 |
| 17156-235-01 | A9582 | GE Healthcare Inc. | Iodine I-123 iobenguane | UP TO 15 millicuries | 5 | 1 | 1 | 1 |
| 17156-210-01 | A9584 | GE Healthcare Inc. | Iodine I-123 ioflupane | Per Study Dose, up to 5 millicuries | 2.5 | 1 | 1 | 1 |
| 69488-001-40 | A9587 | Advanced Accelerator Applications USA, Inc. | Gallium Ga-68 | 0.1 mCi | 1 | 1 | 1 | 1 |
| 72874-001-01 | A9591 | GE Healthcare Inc. | Fluoroestradiol F 18 | 1 mCi | 50 | 1 | 6 | 6 |
| 69945-064-01 | A9592 | Curium US LLC | Copper cu 64 dotatate diag | 1 mCi | 4 | 1 | 4 | 4 |
| 24275-0525-1 | A9593 | UCSF Radiopharmaceutical Facility | Gallium ga-68 psma-11 ucsf | 1 mCi | 11 | 1 | 1 | 1 |
| 76394-2642-3 | A9594 | UCLA Biomedical Cyclotron | Gallium ga-68 psma-11, ucla | 1 mCi | 12 | 1 | 1 | 1 |
| 71258-022-01 | A9595 | Progenics Pharmaceuticals, Inc. | Piflu f-18, dia 1 millicurie | 1 mCi | 50 | 1 | 1 | 1 |
| 74725-100-25 | A9596 | Telix Pharmaceuticals US Inc. | Gallium illuccix 1 millicure | 1 mCi | 1 | 1 | 1 | 1 |
| 74725-100-64 | A9596 | Telix Pharmaceuticals US Inc. | Gallium illuccix 1 millicure | 1 mCi | 1 | 1 | 1 | 1 |
| 72928-089-01 | A9600 | Q Biomed Inc | Sr89 strontium | PER MILLICURIE | 4 | 1 | 1 | 4 |
| 13267-346-57 | A9602 | The Feinstein Institute for Medical Research | Fluorodopa f-18 diag per mci | 1 mCi | 1 | 1 | 1 | 1 |
| 50419-208-01 | A9606 | Bayer HealthCare Pharmaceuticals Inc. | Radium Ra223 dichloride ther | 1 mCi | 6 | 1 | 1 | 1 |
| 0078-1217-61 | A9607 | Novartis Pharmaceuticals Corporation | Lutetium lu 177 vipivotide | 1 mCi | 1 | 1 | 1 | 1 |
| 69488-010-61 | A9607 | Advanced Accelerator Applications USA, Inc. | Lutetium lu 177 vipivotide | 1 mCi | 1 | 1 | 1 | 1 |
| 69932-002-50 | A9608 | Blue Earth Diagnostics Limited | Flotufolastat f18 diag 1 mci | 1 millicurie | 25 | 1 | 1 | 1 |
| 0407-8787-01 | A9611 | GE Healthcare Inc. | Flurpiridaz f18, diag, 1 mci | 1 mCi | 1 | 1 | 1 | 1 |
| 82292-040-10 | A9615 | Lumicell, Inc. | Inj, pegulicianine, 1 mg | 1 MG | 1 | 10 | 39 | 390 |
| 84552-500-25 | A9616 | Telix Innovations SA | Gallium gozellix 1 millicuri | 1 MCI | 1 | 1 | 1 | 1 |
| 84552-500-64 | A9616 | Telix Innovations SA | Gallium gozellix 1 millicuri | 1 MCI | 1 | 1 | 1 | 1 |
| 0078-1224-61 | A9800 | Novartis Pharmaceuticals Corporation | Gallium locametz 1 millicuri | 1 mCi | 1 | 1 | 1 | 1 |
| 69488-017-61 | A9800 | Advanced Accelerator Applications USA, Inc. | Gallium locametz 1 millicuri | 1 mCi | 1 | 1 | 1 | 1 |
| 58468-0225-1 | C9047 | Genzyme Corporation | Injection, caplacizumab-yhdp | 1 MG | 1 | 1 | 11 | 11 |
| 0338-9637-01 | C9250 | Baxter Healthcare Corporation | Artiss fibrin sealant | 2 ML | 2 | 1 | 1 | 1 |
| 0338-9639-01 | C9250 | Baxter Healthcare Corporation | Artiss fibrin sealant | 2 ML | 4 | 1 | 2 | 2 |
| 0338-9641-01 | C9250 | Baxter Healthcare Corporation | Artiss fibrin sealant | 2 ML | 10 | 1 | 5 | 5 |
| 50242-060-01 | C9257 | Genentech, Inc. | Bevacizumab injection | 0.25 MG | 4 | 1 | 400 | 400 |
| 50242-061-01 | C9257 | Genentech, Inc. | Bevacizumab injection | 0.25 MG | 16 | 1 | 1600 | 1600 |
| 50633-210-11 | C9293 | BTG International Inc. | Injection, glucarpidase | 10 UNITS | 1 | 1 | 100 | 100 |
| 83831-147-05 | C9310 | Avyxa Pharma, LLC | Inj, leucovorin cal (avyxa) | 1 MG | 5 | 1 | 50 | 50 |
| 83831-148-35 | C9310 | Avyxa Pharma, LLC | Inj, leucovorin cal (avyxa) | 1 MG | 35 | 1 | 350 | 350 |
| 83831-149-50 | C9310 | Avyxa Pharma, LLC | Inj, leucovorin cal (avyxa) | 1 MG | 50 | 1 | 500 | 500 |
| 10122-620-10 | C9460 | Chiesi USA, Inc. | Injection, cangrelor | 1 MG | 1 | 10 | 50 | 500 |
| 51167-548-30 | C9818 | Vertex Pharmaceuticals, Inc. | Suzetrigine, orl, 1mg | 1 MG | 30 | 1 | 1500 | 1500 |
| 51167-548-34 | C9818 | Vertex Pharmaceuticals, Inc. | Suzetrigine, orl, 1mg | 1 MG | 100 | 1 | 5000 | 5000 |
| 71390-125-20 | J0184 | Acacia Pharma Ltd | Inj, amisulpride, 1 mg | 1 MG | 2 | 10 | 5 | 50 |
| 71390-125-50 | J0184 | Acacia Pharma Ltd | Inj, amisulpride, 1 mg | 1 MG | 4 | 10 | 10 | 100 |
| 73077-010-01 | J0208 | Fennec Pharmaceuticals, Inc. | Inj, pedmark, 100 mg | 100 MG | 100 | 1 | 125 | 125 |
| 60267-705-50 | J0209 | Hope Pharmaceuticals | Inj, sod thiosulfate (hope) | 100 MG | 50 | 1 | 125 | 125 |
| 60267-812-00 | J0211 | Hope Pharmaceuticals | Inj, nithiodote, 3mg / 125mg | 3 MG AND 125 MG | 60 | 1 | 100 | 100 |
| 73607-011-11 | J0391 | Amivas, Inc | Inj, artesunate, 1mg | 1 MG | 1 | 2 | 110 | 220 |
| 71288-035-52 | J0528 | Meitheal Pharmaceuticals Inc. | Inj fosfomycin disodium 20mg | 20 MG | 1 | 12 | 300 | 3600 |
| 68135-811-02 | J0567 | BioMarin Pharmaceutical Inc. | Inj., cerliponase alfa 1 mg | 1 MG | 1 | 2 | 150 | 300 |
| 55513-740-10 | J0606 | Amgen Inc | Inj, etelcalcetide, 0.1 mg | 0.1 MG | 0.5 | 10 | 25 | 250 |
| 55513-740-20 | J0606 | Amgen Inc | Inj, etelcalcetide, 0.1 mg | 0.1 MG | 0.5 | 10 | 25 | 250 |
| 55513-741-10 | J0606 | Amgen Inc | Inj, etelcalcetide, 0.1 mg | 0.1 MG | 1 | 10 | 50 | 500 |
| 55513-741-20 | J0606 | Amgen Inc | Inj, etelcalcetide, 0.1 mg | 0.1 MG | 1 | 10 | 50 | 500 |
| 55513-742-10 | J0606 | Amgen Inc | Inj, etelcalcetide, 0.1 mg | 0.1 MG | 2 | 10 | 100 | 1000 |
| 55513-742-20 | J0606 | Amgen Inc | Inj, etelcalcetide, 0.1 mg | 0.1 MG | 2 | 10 | 100 | 1000 |
| 39822-0151-1 | J0654 | XGen Pharmaceuticals DJB, Inc. | Inj, liothyronine, 1 mcg | 1 MCG | 1 | 1 | 10 | 10 |
| 47426-301-02 | J0668 | Heron Therapeutics | Instill, bupivac and meloxic | 1 MG - 0.03 MG | 14 | 1 | 400 | 400 |
| 47426-303-01 | J0668 | Heron Therapeutics | Instill, bupivac and meloxic | 1 MG - 0.03 MG | 7 | 1 | 200 | 200 |
| 47426-501-02 | J0668 | Heron Therapeutics | Instill, bupivac and meloxic | 1 MG - 0.03 MG | 14 | 1 | 400 | 400 |
| 47426-503-01 | J0668 | Heron Therapeutics | Instill, bupivac and meloxic | 1 MG - 0.03 MG | 7 | 1 | 200 | 200 |
| 0009-0856-08 | J0675 | Pfizer Inc | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 0143-9442-10 | J0675 | Hikma Pharmaceuticals USA Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 0409-0064-10 | J0675 | Pfizer Inc | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 25021-477-01 | J0675 | Sagent Pharmaceuticals | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 43598-179-10 | J0675 | Dr. Reddy's Laboratories Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 43598-698-58 | J0675 | Dr. Reddy's Laboratories Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 43598-917-58 | J0675 | Dr. Reddy's Laboratories Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 43598-919-58 | J0675 | Dr. Reddy's Laboratories Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 55150-459-10 | J0675 | Eugia US LLC | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 62332-777-10 | J0675 | Alembic Pharmaceuticals Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 65219-579-01 | J0675 | FreseniUS Kabi USA, LLC | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 70121-1680-7 | J0675 | Amneal Pharmaceuticals, LLC | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 70512-859-05 | J0675 | Sola Pharmaceuticals | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 5 | 2.5 | 13 |
| 70594-112-02 | J0675 | Xellia Pharmaceuticals USA, LLC. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 71839-137-10 | J0675 | BE Pharmaceuticals Inc. | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 81298-5010-3 | J0675 | Long Grove Pharmaceuticals, LLC | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 81298-5010-5 | J0675 | Long Grove Pharmaceuticals, LLC | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 1 | 2.5 | 2.5 |
| 81665-202-10 | J0675 | Omnivium | Inj, carboprost, 0.1 mg | 0.1 MG | 1 | 10 | 2.5 | 25 |
| 16729-430-43 | J0891 | Accord Healthcare Inc | Argatroban nonesrd (accord) | 1 MG | 50 | 10 | 50 | 500 |
| 72990-103-10 | J0911 | CorMedix Inc. | Inst tauro 1.35mg/hep 100u | taurolidine 1.35 mg and heparin sodium 100 units | 3 | 10 | 30 | 300 |
| 66887-004-10 | J1073 | Endo USA, Inc. | Testosterone pellet 75 mg | 75 MG | 1 | 10 | 1 | 10 |
| 66887-004-20 | J1073 | Endo USA, Inc. | Testosterone pellet 75 mg | 75 MG | 1 | 100 | 1 | 100 |
| 62225-600-04 | J1097 | Omeros Corporation | Phenylep ketorolac opth soln | 1 ML | 4 | 4 | 4 | 16 |
| 82604-600-00 | J1097 | Rayner Surgical Inc. | Phenylep ketorolac opth soln | 1 ML | 4 | 1 | 4 | 4 |
| 82604-600-04 | J1097 | Rayner Surgical Inc. | Phenylep ketorolac opth soln | 1 ML | 4 | 4 | 4 | 16 |
| 62225-300-00 | J1289 | Omeros Corporation | Narsoplimab-wuug, 1 mg | 1 MG | 2 | 1 | 370 | 370 |
| 0338-9558-10 | J1327 | Baxter Healthcare Corporation | Eptifibatide injection | 5 MG | 100 | 12 | 15 | 180 |
| 25021-408-51 | J1327 | Sagent Pharmaceuticals | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 25021-409-10 | J1327 | Sagent Pharmaceuticals | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 55150-218-99 | J1327 | Eugia US LLC | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 55150-219-10 | J1327 | Eugia US LLC | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 55150-220-99 | J1327 | Eugia US LLC | Eptifibatide injection | 5 MG | 100 | 1 | 40 | 40 |
| 67457-629-10 | J1327 | Mylan Institutional LLC | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 67457-630-10 | J1327 | Mylan Institutional LLC | Eptifibatide injection | 5 MG | 100 | 1 | 40 | 40 |
| 67457-631-10 | J1327 | Mylan Institutional LLC | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 70436-026-80 | J1327 | Slate Run Pharmaceuticals | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 70436-027-80 | J1327 | Slate Run Pharmaceuticals | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 70436-162-80 | J1327 | Slate Run Pharmaceuticals | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 70436-163-80 | J1327 | Slate Run Pharmaceuticals | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 70860-303-10 | J1327 | Athenex Pharmaceutical Division, LLC | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 70860-305-51 | J1327 | Athenex Pharmaceutical Division, LLC | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 71288-412-10 | J1327 | Meitheal Pharmaceuticals Inc. | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 71288-413-51 | J1327 | Meitheal Pharmaceuticals Inc. | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 72078-025-10 | J1327 | Mylan Institutional LLC | Eptifibatide injection | 5 MG | 10 | 1 | 4 | 4 |
| 72078-026-10 | J1327 | Mylan Institutional LLC | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 72078-027-10 | J1327 | Mylan Institutional LLC | Eptifibatide injection | 5 MG | 100 | 1 | 40 | 40 |
| 83634-301-51 | J1327 | Avenacy Inc. | Eptifibatide injection | 5 MG | 100 | 1 | 15 | 15 |
| 0053-0100-10 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 10 | 1 | 1 |
| 0053-0110-11 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 11 | 1 | 1 |
| 0053-0120-12 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 12 | 1 | 1 |
| 0053-0130-13 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 13 | 1 | 1 |
| 0053-0140-14 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 14 | 1 | 1 |
| 0053-0150-15 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 15 | 1 | 1 |
| 0053-0160-16 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 16 | 1 | 1 |
| 0053-0170-17 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 17 | 1 | 1 |
| 0053-0180-18 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 18 | 1 | 1 |
| 0053-0190-19 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 19 | 1 | 1 |
| 0053-0200-20 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 20 | 1 | 1 |
| 0053-0210-21 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 21 | 1 | 1 |
| 0053-0220-22 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 22 | 1 | 1 |
| 0053-0230-23 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 23 | 1 | 1 |
| 0053-0240-24 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 24 | 1 | 1 |
| 0053-0250-25 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 25 | 1 | 1 |
| 0053-0260-26 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 26 | 1 | 1 |
| 0053-0270-27 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 27 | 1 | 1 |
| 0053-0280-28 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 28 | 1 | 1 |
| 0053-0290-29 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 29 | 1 | 1 |
| 0053-0300-30 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 30 | 1 | 1 |
| 0053-0310-31 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 31 | 1 | 1 |
| 0053-0320-32 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 32 | 1 | 1 |
| 0053-0330-33 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 33 | 1 | 1 |
| 0053-0340-34 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 34 | 1 | 1 |
| 0053-0350-35 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 35 | 1 | 1 |
| 0053-0360-36 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 36 | 1 | 1 |
| 0053-0370-37 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 37 | 1 | 1 |
| 0053-0380-38 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 38 | 1 | 1 |
| 0053-0390-39 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 39 | 1 | 1 |
| 0053-0400-40 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 40 | 1 | 1 |
| 0053-0410-41 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 41 | 1 | 1 |
| 0053-0420-42 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 42 | 1 | 1 |
| 0053-0430-43 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 43 | 1 | 1 |
| 0053-0440-44 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 44 | 1 | 1 |
| 0053-0450-45 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 45 | 1 | 1 |
| 0053-0460-46 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 46 | 1 | 1 |
| 0053-0470-47 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 47 | 1 | 1 |
| 0053-0480-48 | J1411 | CSL Behring L.L.C. | Inj, hemgenix, per tx dose | Per Therapeutic Dose | 10 | 48 | 1 | 1 |
| 68135-927-48 | J1412 | BioMarin Pharmaceutical Inc. | Inj roctavian ml 2x10^13vc g | 1 ML | 8 | 1 | 8 | 8 |
| 60923-503-12 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 12 | 1 | 1 |
| 60923-505-14 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 14 | 1 | 1 |
| 60923-506-15 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 15 | 1 | 1 |
| 60923-507-16 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 16 | 1 | 1 |
| 60923-508-17 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 17 | 1 | 1 |
| 60923-509-18 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 18 | 1 | 1 |
| 60923-510-19 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 19 | 1 | 1 |
| 60923-511-20 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 20 | 1 | 1 |
| 60923-512-21 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 21 | 1 | 1 |
| 60923-513-22 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 22 | 1 | 1 |
| 60923-514-23 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 23 | 1 | 1 |
| 60923-515-24 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 24 | 1 | 1 |
| 60923-516-25 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 25 | 1 | 1 |
| 60923-517-26 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 26 | 1 | 1 |
| 60923-518-27 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 27 | 1 | 1 |
| 60923-519-28 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 28 | 1 | 1 |
| 60923-520-29 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 29 | 1 | 1 |
| 60923-521-30 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 30 | 1 | 1 |
| 60923-522-31 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 31 | 1 | 1 |
| 60923-523-32 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 32 | 1 | 1 |
| 60923-524-33 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 33 | 1 | 1 |
| 60923-525-34 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 34 | 1 | 1 |
| 60923-526-35 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 35 | 1 | 1 |
| 60923-527-36 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 36 | 1 | 1 |
| 60923-528-37 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 37 | 1 | 1 |
| 60923-529-38 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 38 | 1 | 1 |
| 60923-530-39 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 39 | 1 | 1 |
| 60923-531-40 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 40 | 1 | 1 |
| 60923-532-41 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 41 | 1 | 1 |
| 60923-533-42 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 42 | 1 | 1 |
| 60923-534-43 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 43 | 1 | 1 |
| 60923-535-44 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 44 | 1 | 1 |
| 60923-536-45 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 45 | 1 | 1 |
| 60923-537-46 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 46 | 1 | 1 |
| 60923-538-47 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 47 | 1 | 1 |
| 60923-539-48 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 48 | 1 | 1 |
| 60923-540-49 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 49 | 1 | 1 |
| 60923-541-50 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 50 | 1 | 1 |
| 60923-542-51 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 51 | 1 | 1 |
| 60923-543-52 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 52 | 1 | 1 |
| 60923-544-53 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 53 | 1 | 1 |
| 60923-545-54 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 54 | 1 | 1 |
| 60923-546-55 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 55 | 1 | 1 |
| 60923-547-56 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 56 | 1 | 1 |
| 60923-548-57 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 57 | 1 | 1 |
| 60923-549-58 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 58 | 1 | 1 |
| 60923-550-59 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 59 | 1 | 1 |
| 60923-551-60 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 60 | 1 | 1 |
| 60923-552-61 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 61 | 1 | 1 |
| 60923-553-62 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 62 | 1 | 1 |
| 60923-554-63 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 63 | 1 | 1 |
| 60923-555-64 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 64 | 1 | 1 |
| 60923-556-65 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 65 | 1 | 1 |
| 60923-557-66 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 66 | 1 | 1 |
| 60923-558-67 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 67 | 1 | 1 |
| 60923-559-68 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 68 | 1 | 1 |
| 60923-560-69 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 69 | 1 | 1 |
| 60923-561-70 | J1413 | Sarepta Therapeutics, Inc. | Inj delandistrogene mox rokl | Per Therapeutic Dose | 1 | 70 | 1 | 1 |
| 60923-227-02 | J1426 | Sarepta Therapeutics, Inc. | Injection, casimersen, 10 mg | 10 MG | 2 | 1 | 10 | 10 |
| 60923-284-10 | J1428 | Sarepta Therapeutics, Inc. | Injection, eteplirsen | 10 MG | 10 | 1 | 50 | 50 |
| 60923-363-02 | J1428 | Sarepta Therapeutics, Inc. | Injection, eteplirsen | 10 MG | 2 | 1 | 10 | 10 |
| 0517-0710-01 | J1451 | American Regent, Inc. | Fomepizole, 15 mg | 15 MG | 1.5 | 1 | 100 | 100 |
| 25021-829-02 | J1451 | Sagent Pharmaceuticals | Fomepizole, 15 mg | 15 MG | 1.5 | 1 | 100 | 100 |
| 67457-211-02 | J1451 | Mylan Institutional LLC | Fomepizole, 15 mg | 15 MG | 1.5 | 1 | 100 | 100 |
| 70710-1478-1 | J1451 | Zydus Pharmaceuticals (USA) Inc. | Fomepizole, 15 mg | 15 MG | 1.5 | 1 | 100 | 100 |
| 76179-010-02 | J1577 | Kedrion Biopharma Inc | Inj, qivigy, 100mg | 100 MG | 50 | 1 | 50 | 50 |
| 76179-010-04 | J1577 | Kedrion Biopharma Inc | Inj, qivigy, 100mg | 100 MG | 100 | 1 | 100 | 100 |
| 24338-153-02 | J1737 | Azurity Pharmaceuticals, Inc. | Inj meloxicam (azurity) 1mg | 1 MG | 1 | 10 | 30 | 300 |
| 0009-3794-01 | J1742 | Pfizer Inc | Ibutilide fumarate injection | 1 MG | 10 | 1 | 1 | 1 |
| 0009-3794-01 | J1742 | Pfizer Inc | Ibutilide fumarate injection | 1 MG | 10 | 1 | 1 | 1 |
| 0009-3794-22 | J1742 | Pfizer Inc | Ibutilide fumarate injection | 1 MG | 10 | 1 | 1 | 1 |
| 0009-3794-22 | J1742 | Pfizer Inc | Ibutilide fumarate injection | 1 MG | 10 | 1 | 1 | 1 |
| 23155-326-31 | J1742 | Heritage Pharmaceuticals Inc. | Ibutilide fumarate injection | 1 MG | 10 | 1 | 1 | 1 |
| 67457-366-10 | J1742 | Mylan Institutional LLC | Ibutilide fumarate injection | 1 MG | 10 | 1 | 1 | 1 |
| 42023-157-01 | J1807 | Endo USA, Inc. | Inj, ethacrynate sod, 1 mg | 1 MG | 1 | 1 | 50 | 50 |
| 42023-157-01 | J1807 | Endo USA, Inc. | Inj, ethacrynate sod, 1 mg | 1 MG | 1 | 1 | 50 | 50 |
| 69315-701-50 | J1807 | Leading Pharma LLC | Inj, ethacrynate sod, 1 mg | 1 MG | 1 | 1 | 50 | 50 |
| 0469-0420-01 | J1833 | Astellas Pharma US, Inc. | Inj, isavuconazonium sulfate | 1 MG | 1 | 1 | 372 | 372 |
| 0781-3056-70 | J1834 | Sandoz Inc. | Inj, isoniazid, 1 mg | 1 MG | 10 | 1 | 1000 | 1000 |
| 70842-120-06 | J2186 | Melinta Therapeutics, LLC | Inj., meropenem, vaborbactam | (10 MG/10MG) 20 MG | 1 | 6 | 100 | 600 |
| 70842-160-10 | J2265 | Melinta Therapeutics, LLC | Minocycline hydrochloride | 1 MG | 1 | 10 | 100 | 1000 |
| 64406-058-01 | J2326 | Biogen Inc. | Injection, nusinersen | 0.1 MG | 5 | 1 | 120 | 120 |
| 0173-0927-42 | J2361 | GlaxoSmithKline LLC | Inj depemokimab-ulaa 1 mg | 1 MG | 1 | 1 | 100 | 100 |
| 24201-010-20 | J2515 | Hikma Pharmaceuticals USA Inc. | Pentobarbital sodium inj | 50 MG | 20 | 1 | 20 | 20 |
| 24201-010-50 | J2515 | Hikma Pharmaceuticals USA Inc. | Pentobarbital sodium inj | 50 MG | 50 | 1 | 50 | 50 |
| 25021-676-20 | J2515 | Sagent Pharmaceuticals | Pentobarbital sodium inj | 50 MG | 20 | 1 | 20 | 20 |
| 25021-676-50 | J2515 | Sagent Pharmaceuticals | Pentobarbital sodium inj | 50 MG | 50 | 1 | 50 | 50 |
| 72769-181-03 | J2547 | BioCryst Pharmaceuticals, Inc. | Injection, peramivir | 1 MG | 20 | 3 | 200 | 600 |
| 62756-301-01 | J2561 | Sun Pharmaceutical Industries, Inc. | Inj, sezaby, 1 mg | 1 MG | 1 | 1 | 100 | 100 |
| 25357-024-01 | J2789 | Glaukos Corporation | Riboflavin epioxa/hd<=2ml | UP TO 2 ML | 2 | 2 | 2 | 2 |
| 72526-101-11 | J2801 | Luye Pharma USA Ltd | Inj, rykindo, 0.5 mg | 0.5 MG | 1 | 1 | 25 | 25 |
| 72526-102-11 | J2801 | Luye Pharma USA Ltd | Inj, rykindo, 0.5 mg | 0.5 MG | 1 | 1 | 50 | 50 |
| 72526-103-11 | J2801 | Luye Pharma USA Ltd | Inj, rykindo, 0.5 mg | 0.5 MG | 1 | 1 | 75 | 75 |
| 72526-104-11 | J2801 | Luye Pharma USA Ltd | Inj, rykindo, 0.5 mg | 0.5 MG | 1 | 1 | 100 | 100 |
| 25682-007-01 | J2840 | Alexion Pharmaceuticals, Inc. | Injection, sebelipase alfa | 1 MG | 10 | 1 | 20 | 20 |
| 67066-005-01 | J2850 | ChiRhoClin, Inc | Inj secretin synthetic human | 1 MCG | 1 | 1 | 16 | 16 |
| 70573-099-02 | J2998 | Kedrion Biopharma Inc | Inj plasminogen tvmh 1mg | 1 MG | 1 | 1 | 68.8 | 69 |
| 73554-2111-1 | J3387 | Genetix Biotherapeutics Inc. | Inj elivaldogene autotemcel | Per Therapeutic Dose | 20 | 1 | 1 | 1 |
| 84103-007-01 | J3389 | Abeona Therapeutics Inc. | Topi adm prad zami per treat | Per Therapeutic Dose | 1 | 1 | 1 | 1 |
| 83222-0200-1 | J3391 | Orchard Therapeutics Europe Limited | Inj, atidarsagene autotemcel | Per Treatment Dose | 1 | 1 | 1 | 1 |
| 51167-290-09 | J3392 | Vertex Pharmaceuticals, Inc. | Inj, exagamglogene autotem | Per Treatment | 1 | 1 | 1 | 1 |
| 73554-3111-1 | J3393 | Genetix Biotherapeutics Inc. | Inj, betibeglogene autotemce | Per Therapeutic Dose | 20 | 1 | 1 | 1 |
| 73554-1111-1 | J3394 | Genetix Biotherapeutics Inc. | Inj, lovotibeglogene autotem | Per Treatment | 20 | 1 | 1 | 1 |
| 69794-001-01 | J3397 | Ultragenyx Pharmaceutical Inc. | Inj., vestronidase alfa-vjbk | 1 MG | 5 | 1 | 10 | 10 |
| 71394-415-01 | J3398 | Spark Therapeutics, Inc. | Inj luxturna 1 billion vec g | 1 billion vector genomes | 0.5 | 1 | 150 | 150 |
| 71894-120-02 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 16.6 | 1 | 1 | 1 |
| 71894-121-03 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 19.3 | 1 | 1 | 1 |
| 71894-122-03 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 22.1 | 1 | 1 | 1 |
| 71894-123-03 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 24.9 | 1 | 1 | 1 |
| 71894-124-04 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 27.6 | 1 | 1 | 1 |
| 71894-125-04 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 30.4 | 1 | 1 | 1 |
| 71894-126-04 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 33.2 | 1 | 1 | 1 |
| 71894-127-05 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 35.9 | 1 | 1 | 1 |
| 71894-128-05 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 38.7 | 1 | 1 | 1 |
| 71894-129-05 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 41.5 | 1 | 1 | 1 |
| 71894-130-06 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 44.2 | 1 | 1 | 1 |
| 71894-131-06 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 47 | 1 | 1 | 1 |
| 71894-132-06 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 49.8 | 1 | 1 | 1 |
| 71894-133-07 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 52.5 | 1 | 1 | 1 |
| 71894-134-07 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 55.3 | 1 | 1 | 1 |
| 71894-135-07 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 58.1 | 1 | 1 | 1 |
| 71894-136-08 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 60.8 | 1 | 1 | 1 |
| 71894-137-08 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 63.6 | 1 | 1 | 1 |
| 71894-138-08 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 66.4 | 1 | 1 | 1 |
| 71894-139-09 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 69.1 | 1 | 1 | 1 |
| 71894-140-09 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 71.9 | 1 | 1 | 1 |
| 71894-141-09 | J3399 | Novartis Gene Therapies, Inc. | Inj onase abepar-xioi treat | Per tx dose (up to 5 x10^15 vg?) | 74.7 | 1 | 1 | 1 |
| 82958-501-01 | J3403 | Neurotech Pharmaceuticals, Inc. | Revakinagene, per implant | PER IMPLANT | 1 | 1 | 1 | 1 |
| 84768-511-01 | J3404 | Precigen, Inc. | Inj zopapogene per ther dose | Per Therapeutic Dose | 1 | 1 | 1 | 1 |
| 71894-200-02 | J3405 | Novartis Gene Therapies, Inc. | Inj onase abepar-brve treat | Per treatment | 3 | 1 | 1 | 1 |
| 11704-370-01 | J3424 | Meridian Medical Technologies LLC | Inj hydroxocobalamin iv 25mg | 25 MG | 1 | 1 | 200 | 200 |
| 50633-310-11 | J3424 | BTG International Inc. | Inj hydroxocobalamin iv 25mg | 25 MG | 1 | 1 | 200 | 200 |
| 68982-261-01 | J7165 | Octapharma USA Inc. | Inj, human-lans, per i.u | PER FACTOR IX IU | 1 | 1 | 1 | 1 |
| 68982-261-02 | J7165 | Octapharma USA Inc. | Inj, human-lans, per i.u | PER FACTOR IX IU | 1 | 1 | 1 | 1 |
| 63833-386-02 | J7168 | CSL Behring L.L.C. | Prothrombin complex kcentra | 1 IU | 1 | 1 | 1 | 1 |
| 63833-387-02 | J7168 | CSL Behring L.L.C. | Prothrombin complex kcentra | 1 IU | 1 | 1 | 1 | 1 |
| 0310-3200-04 | J7169 | AstraZeneca Pharmaceuticals LP | Inj andexxa, 10 mg | 10 MG | 1 | 4 | 20 | 80 |
| 0310-3200-05 | J7169 | AstraZeneca Pharmaceuticals LP | Inj andexxa, 10 mg | 10 MG | 1 | 5 | 20 | 100 |
| 73372-0116-1 | J7352 | Clinuvel Inc. | Afamelanotide implant, 1 mg | 1 MG | 1 | 1 | 16 | 16 |
| 0143-9566-01 | J7501 | Hikma Pharmaceuticals USA Inc. | Azathioprine parenteral | 100 MG | 1 | 1 | 1 | 1 |
| 81284-315-05 | J9220 | Apollo Pharmaceuticals | Indigotindisulfonate sod 1mg | 1 MG | 5 | 5 | 40 | 200 |
| 70095-130-01 | J9275 | Sun Pharmaceutical Industries, Inc. | Inj cosibelimab-ipdl, 2 mg | 2 MG | 5 | 1 | 150 | 150 |
| 0002-7716-01 | J9295 | Eli Lilly and Company | Injection, necitumumab | 1 MG | 50 | 1 | 800 | 800 |
| 16729-522-05 | J9296 | Accord Healthcare Inc | Inj pemetrexed (accord) 10mg | 10 MG | 20 | 1 | 50 | 50 |
| 61755-014-01 | J9376 | Regeneron Pharmaceuticals, Inc. | Inj pozelimab-bbfg, 1 mg | 1 MG | 2 | 1 | 400 | 400 |
| 0069-5471-02 | Q2009 | Pfizer Inc | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 0069-5474-02 | Q2009 | Pfizer Inc | Fosphenytoin inj PE | 50 MG PE/ML | 10 | 10 | 10 | 100 |
| 0069-6001-21 | Q2009 | Pfizer Inc | Fosphenytoin inj PE | 50 MG PE/ML | 10 | 10 | 10 | 100 |
| 0069-6001-25 | Q2009 | Pfizer Inc | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 0641-6136-25 | Q2009 | Hikma Pharmaceuticals USA Inc. | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 25021-798-02 | Q2009 | Sagent Pharmaceuticals | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 25021-798-10 | Q2009 | Sagent Pharmaceuticals | Fosphenytoin inj PE | 50 MG PE/ML | 10 | 10 | 10 | 100 |
| 63323-403-02 | Q2009 | FreseniUS Kabi USA, LLC | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 63323-403-02 | Q2009 | FreseniUS Kabi USA, LLC | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 63323-403-10 | Q2009 | FreseniUS Kabi USA, LLC | Fosphenytoin inj PE | 50 MG PE/ML | 10 | 10 | 10 | 100 |
| 63323-403-10 | Q2009 | FreseniUS Kabi USA, LLC | Fosphenytoin inj PE | 50 MG PE/ML | 10 | 10 | 10 | 100 |
| 68462-621-54 | Q2009 | Glenmark Pharmaceuticals Inc., USA | Fosphenytoin inj PE | 50 MG PE/ML | 2 | 25 | 2 | 50 |
| 68462-622-64 | Q2009 | Glenmark Pharmaceuticals Inc., USA | Fosphenytoin inj PE | 50 MG PE/ML | 10 | 10 | 10 | 100 |
| 83047-410-04 | Q2058 | Autolus, Inc | Obecbtge autol up to 400 mil | Per Therapeutic Dose | 1 | 1 | 1 | 2 |
| 83257-029-41 | Q5161 | Biocon Biologics Inc. | Inj, den (auk/bos), bio, 1mg | 1 MG | 1 | 1 | 60 | 60 |
| 83257-030-11 | Q5161 | Biocon Biologics Inc. | Inj, den (auk/bos), bio, 1mg | 1 MG | 1.7 | 1 | 120 | 120 |
| 0143-9165-01 | Q5167 | Hikma Pharmaceuticals USA Inc. | Inj, den (eno/xtr), bio, 1mg | 1 MG | 1 | 1 | 60 | 60 |
| 0143-9166-01 | Q5167 | Hikma Pharmaceuticals USA Inc. | Inj, den (eno/xtr), bio, 1mg | 1 MG | 1.7 | 1 | 120 | 120 |
| 0517-0374-05 | Q9968 | American Regent, Inc. | Visualization adjunct | 1 MG | 10 | 5 | 50 | 250 |
| 67457-220-05 | Q9968 | Mylan Institutional LLC | Visualization adjunct | 1 MG | 5 | 6 | 50 | 300 |
| 17156-067-30 | Q9982 | GE Healthcare Inc. | Flutemetamol F18 | Per Study Dose, up to 5 millicuries | 1 | 1 | 1 | 1 |
| 54828-001-50 | Q9983 | Lantheus Medical Imaging, Inc. | Florbetaben F18 | PER STUDY DOSE, UPTO 8 mCi | 50 | 1 | 1 | 1 |
