APC Status Codes and Titles Effective 10-01-2005 Source: CMS OCE/APC V 6.3 Module, October 2005 Notes: 1) There are 820 APC Titles as of October 2005. APC Status Description ----- - ----------------------------------------------------- 00001 S LEVEL I PHOTOCHEMOTHERAPY 00002 T LEVEL I FINE NEEDLE BIOPSY/ASPIRATION 00003 T BONE MARROW BIOPSY/ASPIRATION 00004 T LEVEL I NEEDLE BIOPSY/ ASPIRATION EXCEPT BONE MARROW 00005 T LEVEL II NEEDLE BIOPSY/ASPIRATION EXCEPT BONE MARROW 00006 T LEVEL I INCISION & DRAINAGE 00007 T LEVEL II INCISION & DRAINAGE 00008 T LEVEL III INCISION AND DRAINAGE 00009 T NAIL PROCEDURES 00010 T LEVEL I DESTRUCTION OF LESION 00011 T LEVEL II DESTRUCTION OF LESION 00012 T LEVEL I DEBRIDEMENT & DESTRUCTION 00013 T LEVEL II DEBRIDEMENT & DESTRUCTION 00015 T LEVEL III DEBRIDEMENT & DESTRUCTION 00016 T LEVEL IV DEBRIDEMENT & DESTRUCTION 00017 T LEVEL VI DEBRIDEMENT & DESTRUCTION 00018 T BIOPSY OF SKIN/PUNCTURE OF LESION 00019 T LEVEL I EXCISION/ BIOPSY 00020 T LEVEL II EXCISION/ BIOPSY 00021 T LEVEL III EXCISION/ BIOPSY 00022 T LEVEL IV EXCISION/ BIOPSY 00023 T EXPLORATION PENETRATING WOUND 00024 T LEVEL I SKIN REPAIR 00025 T LEVEL II SKIN REPAIR 00027 T LEVEL IV SKIN REPAIR 00028 T LEVEL I BREAST SURGERY 00029 T LEVEL II BREAST SURGERY 00030 T LEVEL III BREAST SURGERY 00032 T INSERTION OF CENTRAL VENOUS/ARTERIAL CATHETER 00033 P PARTIAL HOSPITALIZATION 00034 P DAILY MENTAL HEALTH SERVICES 00035 T PLACEMENT OF ARTERIAL OR CENTRAL VENOUS CATHETER 00036 T LEVEL II FINE NEEDLE BIOPSY/ASPIRATION 00037 T LEVEL IV NEEDLE BIOPSY/ASPIRATION EXCEPT BONE MARROW 00039 S LEVEL I IMPLANTATION OF NEUROSTIMULATOR 00040 S LEVEL II IMPLANTATION OF NEUROSTIMULATOR ELECTRODES 00041 T LEVEL I ARTHROSCOPY 00042 T LEVEL II ARTHROSCOPY 00043 T CLOSED TREATMENT FRACTURE FINGER/TOE/TRUNK 00045 T BONE/JOINT MANIPULATION UNDER ANESTHESIA 00046 T OPEN/PERCUTANEOUS TREATMENT FRACTURE OR DISLOCATION 00047 T ARTHROPLASTY WITHOUT PROSTHESIS 00048 T LEVEL I ARTHROPLASTY WITH PROSTHESIS 00049 T LEVEL I MUSCULOSKELETAL PROCEDURES EXCEPT HAND AND FOOT 00050 T LEVEL II MUSCULOSKELETAL PROCEDURES EXCEPT HAND AND FOOT 00051 T LEVEL III MUSCULOSKELETAL PROCEDURES EXCEPT HAND AND FOOT 00052 T LEVEL IV MUSCULOSKELETAL PROCEDURES EXCEPT HAND AND FOOT 00053 T LEVEL I HAND MUSCULOSKELETAL PROCEDURES 00054 T LEVEL II HAND MUSCULOSKELETAL PROCEDURES 00055 T LEVEL I FOOT MUSCULOSKELETAL PROCEDURES 00056 T LEVEL II FOOT MUSCULOSKELETAL PROCEDURES 00057 T BUNION PROCEDURES 00058 S LEVEL I STRAPPING AND CAST APPLICATION 00060 S MANIPULATION THERAPY 00068 S CPAP INITIATION 00069 T THORACOSCOPY 00070 T THORACENTESIS/LAVAGE PROCEDURES 00071 T LEVEL I ENDOSCOPY UPPER AIRWAY 00072 T LEVEL II ENDOSCOPY UPPER AIRWAY 00073 T LEVEL III ENDOSCOPY UPPER AIRWAY 00074 T LEVEL IV ENDOSCOPY UPPER AIRWAY 00075 T LEVEL V ENDOSCOPY UPPER AIRWAY 00076 T LEVEL I ENDOSCOPY LOWER AIRWAY 00077 S LEVEL I PULMONARY TREATMENT 00078 S LEVEL II PULMONARY TREATMENT 00079 S VENTILATION INITIATION AND MANAGEMENT 00080 T DIAGNOSTIC CARDIAC CATHETERIZATION 00081 T NON-CORONARY ANGIOPLASTY OR ATHERECTOMY 00082 T CORONARY ATHERECTOMY 00083 T CORONARY ANGIOPLASTY AND PERCUTANEOUS VALVULOPLASTY 00084 S LEVEL I ELECTROPHYSIOLOGIC EVALUATION 00085 T LEVEL II ELECTROPHYSIOLOGIC EVALUATION 00086 T ABLATE HEART DYSRHYTHM FOCUS 00087 T CARDIAC ELECTROPHYSIOLOGIC RECORDING/MAPPING 00088 T THROMBECTOMY 00089 T INSERTION/REPLACEMENT OF PERMANENT PACEMAKER AND ELECTRODES 00090 T INSERTION/REPLACEMENT OF PACEMAKER PULSE GENERATOR 00091 T LEVEL II VASCULAR LIGATION 00092 T LEVEL I VASCULAR LIGATION 00093 T VASCULAR RECONSTRUCTION/FISTULA REPAIR WITHOUT DEVICE 00094 S LEVEL I RESUSCITATION AND CARDIOVERSION 00095 S CARDIAC REHABILITATION 00096 S NON-INVASIVE VASCULAR STUDIES 00097 X CARDIAC AND AMBULATORY BLOOD PRESSURE MONITORING 00098 T INJECTION OF SCLEROSING SOLUTION 00099 S ELECTROCARDIOGRAMS 00100 X CARDIAC STRESS TESTS 00101 S TILT TABLE EVALUATION 00103 T MISCELLANEOUS VASCULAR PROCEDURES 00104 T TRANSCATHETER PLACEMENT OF INTRACORONARY STENTS 00105 T REVISION/REMOVAL OF PACEMAKERS, AICD, OR VASCULAR 00106 T INSERTION/REPLACEMENT/REPAIR OF PACEMAKER AND/OR ELECTRODES 00107 T INSERTION OF CARDIOVERTER-DEFIBRILLATOR 00108 T INSERTION/REPLACEMENT/REPAIR OF CARDIOVERTER-DEFIBRILLATOR LEADS 00109 T REMOVAL OF IMPLANTED DEVICES 00110 S TRANSFUSION 00111 S BLOOD PRODUCT EXCHANGE 00112 S APHERESIS, PHOTOPHERESIS, AND PLASMAPHERESIS 00113 T EXCISION LYMPHATIC SYSTEM 00114 T THYROID/LYMPHADENECTOMY PROCEDURES 00115 T CANNULA/ACCESS DEVICE PROCEDURES 00116 S CHEMOTHERAPY ADMINISTRATION BY OTHER TECHNIQUE EXCEPT INFUSION 00117 S CHEMOTHERAPY ADMINISTRATION BY INFUSION ONLY 00119 T IMPLANTATION OF INFUSION PUMP 00120 T INFUSION THERAPY EXCEPT CHEMOTHERAPY 00121 T LEVEL I TUBE CHANGES AND REPOSITIONING 00122 T LEVEL II TUBE CHANGES AND REPOSITIONING 00123 S BONE MARROW HARVESTING AND BONE MARROW/STEM CELL TRANSPLANT 00124 T REVISION OF IMPLANTED INFUSION PUMP 00125 T REFILLING OF INFUSION PUMP 00130 T LEVEL I LAPAROSCOPY 00131 T LEVEL II LAPAROSCOPY 00132 T LEVEL III LAPAROSCOPY 00140 T ESOPHAGEAL DILATION WITHOUT ENDOSCOPY 00141 T LEVEL I UPPER GI PROCEDURES 00142 T SMALL INTESTINE ENDOSCOPY 00143 T LOWER GI ENDOSCOPY 00146 T LEVEL I SIGMOIDOSCOPY 00147 T LEVEL II SIGMOIDOSCOPY 00148 T LEVEL I ANAL/RECTAL PROCEDURE 00149 T LEVEL III ANAL/RECTAL PROCEDURE 00150 T LEVEL IV ANAL/RECTAL PROCEDURE 00151 T ENDOSCOPIC RETROGRADE CHOLANGIO-PANCREATOGRAPHY (ERCP) 00152 T LEVEL I PERCUTANEOUS ABDOMINAL AND BILIARY PROCEDURES 00153 T PERITONEAL AND ABDOMINAL PROCEDURES 00154 T HERNIA/HYDROCELE PROCEDURES 00155 T LEVEL II ANAL/RECTAL PROCEDURE 00156 T LEVEL II URINARY AND ANAL PROCEDURES 00157 S COLORECTAL CANCER SCREENING: BARIUM ENEMA 00158 T COLORECTAL CANCER SCREENING: COLONOSCOPY 00159 S COLORECTAL CANCER SCREENING: FLEXIBLE SIGMOIDOSCOPY 00160 T LEVEL I CYSTOURETHROSCOPY AND OTHER GENITOURINARY PROCEDURES 00161 T LEVEL II CYSTOURETHROSCOPY AND OTHER GENITOURINARY PROCEDURES 00162 T LEVEL III CYSTOURETHROSCOPY AND OTHER GENITOURINARY PROCEDURES 00163 T LEVEL IV CYSTOURETHROSCOPY AND OTHER GENITOURINARY PROCEDURES 00164 T LEVEL I URINARY AND ANAL PROCEDURES 00165 T LEVEL III URINARY AND ANAL PROCEDURES 00166 T LEVEL I URETHRAL PROCEDURES 00167 T LEVEL III URETHRAL PROCEDURES 00168 T LEVEL II URETHRAL PROCEDURES 00169 T LITHOTRIPSY 00170 S DIALYSIS 00180 T CIRCUMCISION 00181 T PENILE PROCEDURES 00183 T TESTES/EPIDIDYMIS PROCEDURES 00184 T PROSTATE BIOPSY 00187 T MISCELLANEOUS PLACEMENT/REPOSITIONING 00188 T LEVEL II FEMALE REPRODUCTIVE PROC 00189 T LEVEL III FEMALE REPRODUCTIVE PROC 00190 T LEVEL I HYSTEROSCOPY 00191 T LEVEL I FEMALE REPRODUCTIVE PROC 00192 T LEVEL IV FEMALE REPRODUCTIVE PROC 00193 T LEVEL V FEMALE REPRODUCTIVE PROC 00194 T LEVEL VIII FEMALE REPRODUCTIVE PROC 00195 T LEVEL IX FEMALE REPRODUCTIVE PROC 00196 T DILATION AND CURETTAGE 00197 T INFERTILITY PROCEDURES 00198 T PREGNANCY AND NEONATAL CARE PROCEDURES 00200 T LEVEL VII FEMALE REPRODUCTIVE PROC 00201 T LEVEL VI FEMALE REPRODUCTIVE PROC 00202 T LEVEL X FEMALE REPRODUCTIVE PROC 00203 T LEVEL IV NERVE INJECTIONS 00204 T LEVEL I NERVE INJECTIONS 00206 T LEVEL II NERVE INJECTIONS 00207 T LEVEL III NERVE INJECTIONS 00208 T LAMINOTOMIES AND LAMINECTOMIES 00209 S EXTENDED EEG STUDIES AND SLEEP STUDIES, LEVEL II 00212 T NERVOUS SYSTEM INJECTIONS 00213 S EXTENDED EEG STUDIES AND SLEEP STUDIES, LEVEL I 00214 S ELECTROENCEPHALOGRAM 00215 S LEVEL I NERVE AND MUSCLE TESTS 00216 S LEVEL III NERVE AND MUSCLE TESTS 00218 S LEVEL II NERVE AND MUSCLE TESTS 00220 T LEVEL I NERVE PROCEDURES 00221 T LEVEL II NERVE PROCEDURES 00222 T IMPLANTATION OF NEUROLOGICAL DEVICE 00223 T IMPLANTATION OR REVISION OF PAIN MANAGEMENT CATHETER 00224 T IMPLANTATION OF RESERVOIR/PUMP/SHUNT 00225 S LEVEL I IMPLANTATION OF NEUROSTIMULATOR ELECTRODES 00226 T IMPLANTATION OF DRUG INFUSION RESERVOIR 00227 T IMPLANTATION OF DRUG INFUSION DEVICE 00228 T CREATION OF LUMBAR SUBARACHNOID SHUNT 00229 T TRANSCATHERTER PLACEMENT OF INTRAVASCULAR SHUNTS 00230 S LEVEL I EYE TESTS & TREATMENTS 00231 S LEVEL III EYE TESTS & TREATMENTS 00232 T LEVEL I ANTERIOR SEGMENT EYE PROCEDURES 00233 T LEVEL II ANTERIOR SEGMENT EYE PROCEDURES 00234 T LEVEL III ANTERIOR SEGMENT EYE PROCEDURES 00235 T LEVEL I POSTERIOR SEGMENT EYE PROCEDURES 00236 T LEVEL II POSTERIOR SEGMENT EYE PROCEDURES 00237 T LEVEL III POSTERIOR SEGMENT EYE PROCEDURES 00238 T LEVEL I REPAIR AND PLASTIC EYE PROCEDURES 00239 T LEVEL II REPAIR AND PLASTIC EYE PROCEDURES 00240 T LEVEL III REPAIR AND PLASTIC EYE PROCEDURES 00241 T LEVEL IV REPAIR AND PLASTIC EYE PROCEDURES 00242 T LEVEL V REPAIR AND PLASTIC EYE PROCEDURES 00243 T STRABISMUS/MUSCLE PROCEDURES 00244 T CORNEAL TRANSPLANT 00245 T LEVEL I CATARACT PROCEDURES WITHOUT IOL INSERT 00246 T CATARACT PROCEDURES WITH IOL INSERT 00247 T LASER EYE PROCEDURES EXCEPT RETINAL 00248 T LASER RETINAL PROCEDURES 00249 T LEVEL II CATARACT PROCEDURES WITHOUT IOL INSERT 00250 T NASAL CAUTERIZATION/PACKING 00251 T LEVEL I ENT PROCEDURES 00252 T LEVEL II ENT PROCEDURES 00253 T LEVEL III ENT PROCEDURES 00254 T LEVEL IV ENT PROCEDURES 00256 T LEVEL V ENT PROCEDURES 00258 T TONSIL AND ADENOID PROCEDURES 00259 T LEVEL VI ENT PROCEDURES 00260 X LEVEL I PLAIN FILM EXCEPT TEETH 00261 X LEVEL II PLAIN FILM EXCEPT TEETH INCLUDING BONE DENSITY MEASUREMENT 00262 X PLAIN FILM OF TEETH 00263 X LEVEL I MISCELLANEOUS RADIOLOGY PROCEDURES 00264 X LEVEL II MISCELLANEOUS RADIOLOGY PROCEDURES 00265 S LEVEL I DIAGNOSTIC ULTRASOUND 00266 S LEVEL II DIAGNOSTIC ULTRASOUND 00267 S LEVEL III DIAGNOSTIC ULTRASOUND 00268 S ULTRASOUND GUIDANCE PROCEDURES 00269 S LEVEL III ECHOCARDIOGRAM EXCEPT TRANSESOPHAGEAL 00270 S TRANSESOPHAGEAL ECHOCARDIOGRAM 00272 X LEVEL I FLUOROSCOPY 00274 S MYELOGRAPHY 00275 S ARTHROGRAPHY 00276 S LEVEL I DIGESTIVE RADIOLOGY 00277 S LEVEL II DIGESTIVE RADIOLOGY 00278 S DIAGNOSTIC UROGRAPHY 00279 S LEVEL II ANGIOGRAPHY AND VENOGRAPHY EXCEPT EXTREMITY 00280 S LEVEL III ANGIOGRAPHY AND VENOGRAPHY EXCEPT EXTREMITY 00281 S VENOGRAPHY OF EXTREMITY 00282 S MISCELLANEOUS COMPUTERIZED AXIAL TOMOGRAPHY 00283 S COMPUTERIZED AXIAL TOMOGRAPHY WITH CONTRAST MATERIAL 00284 S MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAS 00285 S MYOCARDIAL POSITRON EMISSION TOMOGRAPHY (PET) 00287 S COMPLEX VENOGRAPHY 00288 S BONE DENSITY:AXIAL SKELETON 00289 X NEEDLE LOCALIZATION FOR BREAST BIOPSY 00296 S LEVEL I THERAPEUTIC RADIOLOGIC PROCEDURES 00297 S LEVEL II THERAPEUTIC RADIOLOGIC PROCEDURES 00299 S MISCELLANEOUS RADIATION TREATMENT 00300 S LEVEL I RADIATION THERAPY 00301 S LEVEL II RADIATION THERAPY 00302 S LEVEL III RADIATION THERAPY 00303 X TREATMENT DEVICE CONSTRUCTION 00304 X LEVEL I THERAPEUTIC RADIATION TREATMENT PREPARATION 00305 X LEVEL II THERAPEUTIC RADIATION TREATMENT PREPARATION 00310 X LEVEL III THERAPEUTIC RADIATION TREATMENT PREPARATION 00312 S RADIOELEMENT APPLICATIONS 00313 S BRACHYTHERAPY 00314 S HYPERTHERMIC THERAPIES 00315 T LEVEL II IMPLANTATION OF NEUROSTIMULATOR 00320 S ELECTROCONVULSIVE THERAPY 00321 S BIOFEEDBACK AND OTHER TRAINING 00322 S BRIEF INDIVIDUAL PSYCHOTHERAPY 00323 S EXTENDED INDIVIDUAL PSYCHOTHERAPY 00324 S FAMILY PSYCHOTHERAPY 00325 S GROUP PSYCHOTHERAPY 00330 S DENTAL PROCEDURES 00332 S COMPUTERIZED AXIAL TOMOGRAPHY AND COMPUTERIZED ANGIOGRAPHY WITHOUT CONTRAS 00333 S COMPUTERIZED AXIAL TOMOGRAPHY AND COMPUTERIZED ANGIO W/O CONTRAST MATERIAL 00335 S MAGNETIC RESONANCE IMAGING, MISCELLANEOUS 00336 S MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONT 00337 S MRI AND MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST MATERIAL FOLLOWED 00339 S OBSERVATION 00340 X MINOR ANCILLARY PROCEDURES 00341 X SKIN TESTS 00342 X LEVEL I PATHOLOGY 00343 X LEVEL II PATHOLOGY 00344 X LEVEL III PATHOLOGY 00345 X LEVEL I TRANSFUSION LABORATORY PROCEDURES 00346 X LEVEL II TRANSFUSION LABORATORY PROCEDURES 00347 X LEVEL III TRANSFUSION LABORATORY PROCEDURES 00348 X FERTILITY LABORATORY PROCEDURES 00352 X LEVEL I INJECTIONS 00353 X LEVEL II ALLERGY INJECTIONS 00355 K LEVEL I IMMUNIZATIONS 00356 K LEVEL II IMMUNIZATIONS 00359 X LEVEL II INJECTIONS 00360 X LEVEL I ALIMENTARY TESTS 00361 X LEVEL II ALIMENTARY TESTS 00362 X CONTACT LENS AND SPECTACLE SERVICES 00363 X LEVEL I OTORHINOLARYNGOLOGIC FUNCTION TESTS 00364 X LEVEL I AUDIOMETRY 00365 X LEVEL II AUDIOMETRY 00366 X LEVEL III AUDIOMETRY 00367 X LEVEL I PULMONARY TEST 00368 X LEVEL II PULMONARY TESTS 00369 X LEVEL III PULMONARY TESTS 00370 X ALLERGY TESTS 00371 X LEVEL I ALLERGY INJECTIONS 00372 X THERAPEUTIC PHLEBOTOMY 00373 X NEUROPSYCHOLOGICAL TESTING 00374 X MONITORING PSYCHIATRIC DRUGS 00375 T ANCILLARY OUTPATIENT SERVICES WHEN PATIENT EXPIRES 00376 S LEVEL II CARDIAC IMAGING 00377 S LEVEL III CARDIAC IMAGING 00378 S LEVEL II PULMONARY IMAGING 00380 K DIPYRIDAMOLE INJECTION 00384 T GI PROCEDURES WITH STENTS 00385 S LEVEL I PROSTHETIC UROLOGICAL PROCEDURES 00386 S LEVEL II PROSTHETIC UROLOGICAL PROCEDURES 00387 T LEVEL II HYSTEROSCOPY 00388 S DISCOGRAPHY 00389 S NON-IMAGING NUCLEAR MEDICINE 00390 S LEVEL I ENDOCRINE IMAGING 00391 S LEVEL II ENDOCRINE IMAGING 00393 S RED CELL/PLASMA STUDIES 00394 S HEPATOBILIARY IMAGING 00395 S GI TRACT IMAGING 00396 S BONE IMAGING 00397 S VASCULAR IMAGING 00398 S LEVEL I CARDIAC IMAGING 00399 S NUCLEAR MEDICINE ADD-ON IMAGING 00400 S HEMATOPOIETIC IMAGING 00401 S LEVEL I PULMONARY IMAGING 00402 S BRAIN IMAGING 00403 S CSF IMAGING 00404 S RENAL AND GENITOURINARY STUDIES LEVEL I 00405 S RENAL AND GENITOURINARY STUDIES LEVEL II 00406 S TUMOR/INFECTION IMAGING 00407 S RADIONUCLIDE THERAPY 00409 X RED BLOOD CELL TESTS 00411 S RESPIRATORY PROCEDURES 00412 S IMRT TREATMENT DELIVERY 00415 T LEVEL II ENDOSCOPY LOWER AIRWAY 00416 S LEVEL I INTRAVASCULAR AND INTRACARDIAC ULTRASOUND AND FLOW RESERVE 00417 S COMPUTERIZED RECONSTRUCTION 00418 T INSERTION OF LEFT VENTRICULAR PACING ELECT. 00421 X PROLONGED PHYSIOLOGIC MONITORING 00422 T LEVEL II UPPER GI PROCEDURES 00423 T LEVEL II PERCUTANEOUS ABDOMINAL AND BILIARY PROCEDURES 00425 T LEVEL II ARTHROPLASTY WITH PROSTHESIS 00426 S LEVEL II STRAPPING AND CAST APPLICATION 00600 V LOW LEVEL CLINIC VISITS 00601 V MID LEVEL CLINIC VISITS 00602 V HIGH LEVEL CLINIC VISITS 00610 V LOW LEVEL EMERGENCY VISITS 00611 V MID LEVEL EMERGENCY VISITS 00612 V HIGH LEVEL EMERGENCY VISITS 00620 S CRITICAL CARE 00648 T BREAST RECONSTRUCTION WITH PROSTHESIS 00651 S COMPLEX INTERSTITIAL RADIATION SOURCE APPLICATION 00652 T INSERTION OF INTRAPERITONEAL CATHETERS 00653 T VASCULAR RECONSTRUCTION/FISTULA REPAIR WITH DEVICE 00654 T INSERTION/REPLACEMENT OF A PERMANENT DUAL CHAMBER PACEMAKER 00655 T INSERTION/REPLACEMENT/CONVERSION OF A PERMANENT DUAL CHAMBER PACEMAKER 00656 T TRANSCATHETER PLACEMENT OF INTRACORONARY DRUG-ELUTING STENTS 00657 S PLACEMENT OF TISSUE CLIPS 00658 T PERCUTANEOUS BREAST BIOPSIES 00659 S HYPERBARIC OXYGEN 00660 X LEVEL II OTORHINOLARYNGOLOGIC FUNCTION TESTS 00661 X LEVEL IV PATHOLOGY 00662 S CT ANGIOGRAPHY 00664 S LEVEL I PROTON BEAM RADIATION THERAPY 00665 S BONE DENSITY:APPENDICULARSKELETON 00668 S LEVEL I ANGIOGRAPHY AND VENOGRAPHY EXCEPT EXTREMITY 00670 S LEVEL II INTRAVASCULAR AND INTRACARDIAC ULTRASOUND AND FLOW RESERVE 00671 S LEVEL II ECHOCARDIOGRAM EXCEPT TRANSESOPHAGEAL 00672 T LEVEL IV POSTERIOR SEGMENT PROCEDURES 00673 T LEVEL IV ANTERIOR SEGMENT EYE PROCEDURES 00674 T PROSTATE CRYOABLATION 00675 T PROSTATIC THERMOTHERAPY 00676 T LEVEL II THROMBOLYSIS AND THROMBECTOMY 00677 T LEVEL I THROMBOLYSIS AND THROMBECTOMY 00678 T EXTERNAL COUNTERPULSATION 00679 S LEVEL II RESUSCITATION AND CARDIOVERSION 00680 S INSERTION OF PATIENT ACTIVATED EVENT RECORDERS 00681 T KNEE ARTHROPLASTY 00682 T LEVEL V DEBRIDEMENT & DESTRUCTION 00683 S LEVEL II PHOTOCHEMOTHERAPY 00685 T LEVEL III NEEDLE BIOPSY/ASPIRATION EXCEPT BONE MARROW 00686 T LEVEL III SKIN REPAIR 00687 T REVISION/REMOVAL OF NEUROSTIMULATOR ELECTRODES 00688 T REVISION/REMOVAL OF NEUROSTIMULATOR PULSE GENERATOR RECEIVER 00689 S ELECTRONIC ANALYSIS OF CARDIOVERTER-DEFIBRILLATORS 00690 S ELECTRONIC ANALYSIS OF PACEMAKERS AND OTHER CARDIAC DEVICES 00691 S ELECTRONIC ANALYSIS OF PROGRAMMABLE SHUNTS/PUMPS 00692 S ELECTRONIC ANALYSIS OF NEUROSTIMULATOR PULSE GENERATORS 00693 T LEVEL II BREAST RECONSTRUCTION 00694 T MOHS SURGERY 00695 T LEVEL VII DEBRIDEMENT & DESTRUCTION 00697 S LEVEL I ECHOCARDIOGRAM EXCEPT TRANSESOPHAGEAL 00698 S LEVEL II EYE TESTS & TREATMENTS 00699 T LEVEL IV EYE TESTS & TREATMENTS 00700 T ANTEPARTUM MANIPULATION 00701 K SR 89 CHLORIDE, PER MCI 00702 K SM 153 LEXIDRONAM 00703 K BUTORPHANOL TARTRATE 00704 K IN 111 SATUMOMAB PENDETIDE PER DOSE 00705 K TECHNETIUM TC99M TETROFOSMIN 00726 K DEXRAZOXANE HCL INJECTION 00728 K FILGRASTIM INJECTION 00729 K INJECTION, MEROPENEM 00730 K PAMIDRONATE DISODIUM 00731 K SARGRAMOSTIM INJECTION 00732 K MESNA INJECTION 00733 K NON ESRD EPOETIN ALPHA INJ 00734 K INJECTION, DARBEPOETIN ALFA (FOR NON-ESRD), PER 1 MCG 00735 K AMPHO B CHOLESTERYL SULFATE 00736 K AMPHOTERICIN B LIPOSOME INJ 00737 K AMMONIA N-13, PER DOSE 00738 G RASBURICASE 00750 K DOLASETRON MESYLATE 00763 K DOLASETRON MESYLATE ORAL 00764 K GRANISETRON HCL INJECTION 00765 K GRANISETRON HCL ORAL 00768 K ONDANSETRON HCL INJECTION 00769 K ONDANSETRON HCL ORAL 00800 K LEUPROLIDE ACETATE 00802 K ETOPOSIDE ORAL 00807 K ALDESLEUKIN/SINGLE USE VIAL 00809 K BCG LIVE INTRAVESICAL VAC 00810 K GOSERELIN ACETATE IMPLANT 00811 K CARBOPLATIN INJECTION 00812 K CARMUS BISCHL NITRO INJ 00813 K CISPLATIN INJECTION 00814 K ASPARAGINASE INJECTION 00815 K CYCLOPHOSPHAMIDE INJ 00816 K CYCLOPHOSPHAMIDE LYOPHILIZED 00817 K CYTARABINE HCL INJ 00819 K DACARBAZINE INJ 00820 K DAUNORUBICIN 00821 K DAUNORUBICIN CITRATE LIPOSOM 00822 K DIETHYLSTILBESTROL INJECTION 00823 K DOCETAXEL 00824 K ETOPOSIDE INJ 00827 K FLOXURIDINE INJECTION 00828 K GEMCITABINE HCL 00830 K IRINOTECAN INJECTION 00831 K IFOSFOMIDE INJECTION 00832 K IDARUBICIN HCL INJECTION 00834 K INTERFERON ALFA-2A INJ 00836 K INTERFERON ALFA-2B INJ RECOMBINANT, 1 MILLION 00838 K INTERFERON GAMMA 1-B INJ 00840 K MELPHALAN HYDROCHL 00842 K FLUDARABINE PHOSPHATE INJ 00843 K PEGASPARGASE 00844 K PENTOSTATIN INJECTION 00845 K PHENTOLAINE MESYLATE INJ 00846 K CILASTATIN SODIUM INJECTION 00847 K DOXORUBIC HCL CHEMO 00848 K TESTOSTERONE ENANTHATE INJ 00849 K RITUXIMAB 00851 K THIOTEPA INJECTION 00852 K TOPOTECAN 00855 K VINORELBINE TARTRATE 00856 K PORFIMER SODIUM 00857 K BLEOMYCIN SULFATE INJECTION 00858 K CLADRIBINE 00860 K PLICAMYCIN (MITHRAMYCIN) INJ 00861 K LEUPROLIDE ACETATE INJECTION 00862 K MITOMYCIN 00863 K PACLITAXEL INJECTION 00864 K MITOXANTRONE HCL 00865 K INTERFERON ALFA-N3 INJ, HUMAN LEUKOCYTE DERIVED, 2 00866 K FOSCARNET SODIUM INJECTION 00867 K METHACHOLINE CHLORIDE, NEB 00868 G ORAL APREPITANT 00869 K IVIG LYOPHIL 1G 00870 K IVIG LYOPHIL 10 MG 00871 K IVIG NON-LYOPHIL 1G 00872 K IVIG NON-LYOPHIL 10 MG 00887 K AZATHIOPRINE PARENTERAL 00888 K CYCLOSPORINE ORAL 00890 K LYMPHOCYTE IMMUNE GLOBULIN 00891 K TACROLIMUS ORAL 00900 K ALGLUCERASE INJECTION 00901 K ALPHA 1 PROTEINASE INHIBITOR 00902 K BOTULINUM TOXIN A, PER UNIT 00903 K CYTOMEGALOVIRUS IMM IV/VIAL 00906 K RSV-IVIG 00910 K INTERFERON BETA-1B 00911 K STREPTOKINASE 00916 K INJECTION IMIGLUCERASE /UNIT 00925 K FACTOR VIII 00926 K FACTOR VIII (PORCINE) 00927 K FACTOR VIII RECOMBINANT 00928 K FACTOR IX COMPLEX 00929 K ANTI-INHIBITOR PER IU 00931 K FACTOR IX NON-RECOMBINANT 00932 K FACTOR IX RECOMBINANT 00949 K PLASMA, POOLED MULTIPLE DONOR, SOLVENT/DETERGENT T 00950 K BLOOD (WHOLE) FOR TRANSFUSION 00952 K CRYOPRECIPITATE 00954 K RBC LEUKOCYTES REDUCED 00955 K PLASMA, FRESH FROZEN 00956 K PLASMA PROTEIN FRACTION 00957 K PLATELET CONCENTRATE 00958 K PLATELET RICH PLASMA 00959 K RED BLOOD CELLS 00960 K WASHED RED BLOOD CELLS 00961 K INFUSION, ALBUMIN (HUMAN) 5%, 50 ML 00963 K ALBUMIN (HUMAN), 5% 00964 K ALBUMIN (HUMAN), 25% 00965 K ALBUMIN (HUMAN), 25% 00966 K PLASMAPROTEIN FRACT,5% 00967 K SPLIT UNIT OF BLOOD 00968 K PLATELETS LEUKOCYTE REDUCED IRRADIATED 00969 K RED BLOOD CELL LEUKOCYTE REDUCED IRRADIATED 01009 K CRYOPRECIP REDUCED PLASMA 01010 K BLOOD, L/R, CMV-NEG 01011 K PLATELETS, HLA-M, L/R, UNIT 01013 K PLATELET CONCENTRATE, L/R, UNIT 01016 K BLOOD, L/R, FROZ/DEGLYCEROL/WASHED 01017 K PLATELETS, APH/PHER, L/R, CMV-NEG, UNIT 01018 K BLOOD, L/R, IRRADIATED 01019 K PLATELETS, APH/PHER, L/R, IRRADIATED, UNIT 01020 K PIT, PHER,L/R,CMV,IRRAD 01021 K RBC, FRZ/DEG/WSH, L/R, IRRAD 01022 K RBC, L/R, CMV NEG, IRRAD 01045 K IOBENGUANE SULFATE I-131 01046 K INJ, MOXIFLOXACIN 01049 K THIAMINE HCL 01050 K PYRIDOXINE HCL 01052 K INJECTION, VORICONAZOLE 01062 K ACYCLOVIR 01064 K I-131 SODIUM IODIDE CAPSULE 01065 K I-131 SODIUM IODIDE SOLUTION 01070 K DOPAMINE HCL 01079 K CO 57/58 01080 K I-131 TOSITUMOMAB, DX 01081 K I-131 TOSITUMOMAB, TX 01082 K TREPROSTINIL 01083 K INJECTION, ADALIMUMAB 01084 K DENILEUKIN DIFTITOX 01085 K INJECTION, GALLIUM NITRATE 01086 K TEMOZOLOMIDE,ORAL 01089 K CYANOCOBALAMIN COBALT CO57 01091 K IN 111 OXYQUINOLINE 01092 K IN 111 PENTETATE 01093 K TC99M FANOLESOMAB 01095 K TECHNETIUM TC 99M DEPREOTIDE 01096 K TC 99M EXAMETAZIME, PER DOSE 01122 K TC 99M ARCITUMOMAB, PER VIAL 01167 K EPIRUBICIN HCL 01178 K BUSULFAN IV 01201 K TC 99M SUCCIMER, PER VIAL 01203 K VERTEPORFIN FOR INJECTION 01207 K OCTREOTIDE INJECTION, DEPOT 01305 K APLIGRAF 01409 K FACTOR VIIA RECOMBINANT 01501 S NEW TECHNOLOGY - LEVEL I ($0 - $50) 01502 S NEW TECHNOLOGY - LEVEL II ($50 - $100) 01503 S NEW TECHNOLOGY - LEVEL III ($100 - $200) 01504 S NEW TECHNOLOGY - LEVEL IV ($200 - $300) 01505 S NEW TECHNOLOGY - LEVEL V ($300 - $400) 01506 S NEW TECHNOLOGY - LEVEL VI ($400 - $500) 01507 S NEW TECHNOLOGY - LEVEL VII ($500 - $600) 01508 S NEW TECHNOLOGY - LEVEL VIII ($600 - $700) 01509 S NEW TECHNOLOGY - LEVEL IX ($700 - $800) 01510 S NEW TECHNOLOGY - LEVEL X ($800 - $900) 01511 S NEW TECHNOLOGY - LEVEL XI ($900 - $1000) 01512 S NEW TECHNOLOGY - LEVEL XII ($1000 - $1100) 01513 S NEW TECHNOLOGY - LEVEL XIII ($1100 - $1200) 01514 S NEW TECHNOLOGY - LEVEL XIV ($1200- $1300) 01515 S NEW TECHNOLOGY - LEVEL XV ($1300 - $1400) 01516 S NEW TECHNOLOGY - LEVEL XVI ($1400 - $1500) 01517 S NEW TECHNOLOGY - LEVEL XVII ($1500-$1600) 01518 S NEW TECHNOLOGY - LEVEL XVIII ($1600-$1700) 01519 S NEW TECHNOLOGY - LEVEL IXX ($1700-$1800) 01520 S NEW TECHNOLOGY - LEVEL XX ($1800-$1900) 01521 S NEW TECHNOLOGY - LEVEL XXI ($1900-$2000) 01522 S NEW TECHNOLOGY - LEVEL XXII ($2000-$2500) 01523 S NEW TECHNOLOGY - LEVEL XXIII ($2500-$3000) 01524 S NEW TECHNOLOGY - LEVEL XIV ($3000-$3500) 01525 S NEW TECHNOLOGY - LEVEL XXV ($3500-$4000) 01526 S NEW TECHNOLOGY - LEVEL XXVI ($4000-$4500) 01527 S NEW TECHNOLOGY - LEVEL XXVII ($4500-$5000) 01528 S NEW TECHNOLOGY - LEVEL XXVIII ($5000-$5500) 01529 S NEW TECHNOLOGY - LEVEL XXIX ($5500-$6000) 01530 S NEW TECHNOLOGY - LEVEL XXX ($6000-$6500) 01531 S NEW TECHNOLOGY - LEVEL XXXI ($6500-$7000) 01532 S NEW TECHNOLOGY - LEVEL XXXII ($7000-$7500) 01533 S NEW TECHNOLOGY - LEVEL XXXIII ($7500-$8000) 01534 S NEW TECHNOLOGY - LEVEL XXXIV ($8000-$8500) 01535 S NEW TECHNOLOGY - LEVEL XXXV ($8500-$9000) 01536 S NEW TECHNOLOGY - LEVEL XXXVI ($9000-$9500) 01537 S NEW TECHNOLOGY - LEVEL XXXVII ($9500-$10000) 01538 T NEW TECHNOLOGY - LEVEL I ($0 - $50) 01539 T NEW TECHNOLOGY - LEVEL II ($50 - $100) 01540 T NEW TECHNOLOGY - LEVEL III ($100 - $200) 01541 T NEW TECHNOLOGY - LEVEL IV ($200 - $300) 01542 T NEW TECHNOLOGY - LEVEL V ($300 - $400) 01543 T NEW TECHNOLOGY - LEVEL VI ($400 - $500) 01544 T NEW TECHNOLOGY - LEVEL VII ($500 - $600) 01545 T NEW TECHNOLOGY - LEVEL VIII ($600 - $700) 01546 T NEW TECHNOLOGY - LEVEL IX ($700 - $800) 01547 T NEW TECHNOLOGY - LEVEL X ($800 - $900) 01548 T NEW TECHNOLOGY - LEVEL XI ($900 - $1000) 01549 T NEW TECHNOLOGY - LEVEL XII ($1000 - $1100) 01550 T NEW TECHNOLOGY - LEVEL XIII ($1100 - $1200) 01551 T NEW TECHNOLOGY - LEVEL XIV ($1200- $1300) 01552 T NEW TECHNOLOGY - LEVEL XV ($1300 - $1400) 01553 T NEW TECHNOLOGY - LEVEL XVI ($1400 - $1500) 01554 T NEW TECHNOLOGY - LEVEL XVII ($1500-$1600) 01555 T NEW TECHNOLOGY - LEVEL XVIII ($1600-$1700) 01556 T NEW TECHNOLOGY - LEVEL XIX ($1700-$1800) 01557 T NEW TECHNOLOGY - LEVEL XX ($1800-$1900) 01558 T NEW TECHNOLOGY - LEVEL XXI ($1900-$2000) 01559 T NEW TECHNOLOGY - LEVEL XXII ($2000-$2500) 01560 T NEW TECHNOLOGY - LEVEL XXIII ($2500-$3000) 01561 T NEW TECHNOLOGY - LEVEL XXIV ($3000-$3500) 01562 T NEW TECHNOLOGY - LEVEL XXV ($3500-$4000) 01563 T NEW TECHNOLOGY - LEVEL XXVI ($4000-$4500) 01564 T NEW TECHNOLOGY - LEVEL XXVII ($4500-$5000) 01565 T NEW TECHNOLOGY - LEVEL XXVIII ($5000-$5500) 01566 T NEW TECHNOLOGY - LEVEL XXIX ($5500-$6000) 01567 T NEW TECHNOLOGY - LEVEL XXX ($6000-$6500) 01568 T NEW TECHNOLOGY - LEVEL XXXI ($6500-$7000) 01569 T NEW TECHNOLOGY - LEVEL XXXII ($7000-$7500) 01570 T NEW TECHNOLOGY - LEVEL XXXIII ($7500-$8000) 01571 T NEW TECHNOLOGY - LEVEL XXXIV ($8000-$8500) 01572 T NEW TECHNOLOGY - LEVEL XXXV ($8500-$9000) 01573 T NEW TECHNOLOGY - LEVEL XXXVI ($9000-$9500) 01574 T NEW TECHNOLOGY - LEVEL XXXVII ($9500-$10000) 01600 K TECHNETIUM TC 99M SESTAMIBI 01602 K TECHNETIUM TC 99M APCITIDE 01603 K THALLOUS CHLORIDE TL 201 01604 K IN 111 CAPROMAB PENDETIDE, PER DOSE 01605 K ABCIXIMAB INJECTION 01606 K ANISTREPLASE 01607 K EPTIFIBATIDE INJECTION 01608 K ETANERCEPT INJECTION 01609 K RHO(D) IMMUNE GLOBULIN H, SD 01611 K HYLAN G-F 20 INJECTION 01612 K DACLIZUMAB, PARENTERAL 01613 K TRASTUZUMAB 01615 K BASILIXIMAB 01618 K VONWILLEBRANDFACTRCMPLX, PER IU 01619 K GALLIUM GA 67 01620 K TECHNETIUM TC99M BICISATE 01622 K TECHNETIUM TC99M MERTIATIDE 01624 K SODIUM PHOSPHATE P32 01625 K INDIUM 111-IN PENTETREOTIDE 01628 K CHROMIC PHOSPHATE P32 01716 H BRACHYTX SOURCE, GOLD 198 01717 H BRACHYTX SOURCE, HDR IR-192 01718 H BRACHYTX SOURCE, IODINE 125 01719 H BRACHYTX SOUR,NON-HDR IR-192 01720 H BRACHYTX SOUR, PALLADIUM 103 01775 K FDG, PER DOSE (4-40 MCI/ML) 01814 H RETINAL TAMP, SILICONE OIL 01818 H INTEGRATED KERATOPROSTHESIS 01819 H TISSUE LOCALIZATION-EXCISION DEV 02616 H BRACHYTX SOURCE, YTTRIUM-90 02632 H BRACHYTX SOL, I-125, PER MCI 02633 H BRACHYTX SOURCE, CESIUM-131 02634 H BRACHYTX SOURCE, HA, I-125 02635 H BRACHYTX SOURCE, HA, P-103 02636 H BRACHYTX LINEAR SOURCE, P-103 02637 H BRACHYTX, YTTERBIUM-169 07000 K AMIFOSTINE 07003 K EPOPROSTENOL INJECTION 07005 K GONADORELIN HYDROCH 07007 K INJ MILRINONE LACTATE 07011 K OPRELVEKIN INJECTION 07015 K BUSULFAN, ORAL 07019 K APROTININ 07022 K ELLIOTTS B SOLUTION PER ML 07024 K CORTICORELIN OVINE TRIFLUTAT 07025 K DIGOXIN IMMUNE FAB (OVINE) 07026 K ETHANOLAMINE OLEATE 07027 K FOMEPIZOLE 07028 K FOSPHENYTOIN 07030 K HEMIN 07031 K OCTREOTIDE ACETATE INJECTION 07034 K SOMATROPIN INJECTION 07035 K TENIPOSIDE 07036 K UROKINASE INJ 07037 K UROFOLLITROPIN 07038 K MONOCLONAL ANTIBODIES 07040 K PENTASTARCH 10% SOLUTION 07041 K TIROFIBAN HCL 07042 K CAPECITABINE, ORAL 07043 K INFLIXIMAB INJECTION 07045 K TRIMETREXATE GLUCORONATE 07046 K DOXORUBICIN HCL LIPOSOME INJ 07048 K ALTEPLASE RECOMBINANT 07049 K FILGRASTIM INJECTION 07051 K LEUPROLIDE ACETATE IMPLANT 07308 K AMINOLEVULINIC ACID HCL TOP 07316 K SODIUM HYALURONATE INJECTION 09001 K LINEZOLID INJECTION 09002 K TENECTEPLASE 09003 K PALIVIZUMAB 09004 K GEMTUZUMAB OZOGAMICIN 09005 K RETEPLASE INJECTION 09008 K BACLOFEN REFILL KIT-500MCG 09009 K BACLOFEN REFILL KIT - PER 2000 MCG 09012 K ARSENIC TRIOXIDE 09013 K CO 57 COBALTOUS CHLORIDE 09015 K MYCOPHENOLATE MOFETIL ORAL 09018 K BOTULINUM TOXIN B 09019 K CASPOFUNGIN ACETATE 09020 K SIROLIMUS TABLET 09022 K IM INJ INTERFERON BETA 1-A 09023 K RHO D IMMUNE GLOBULIN 09024 K AMPHOTERICIN B LIPID COMPLEX 09025 K RUBIDIUM-RB-82 09026 K HIGH DOSE CONTRAST MRI 09027 K SUPP-PARAMAGNETIC CONTRAST MATERIAL 09028 K TETRACYCLIN INJECTION 09029 K AMIODARONE HCL 09030 K AMPHOTERICIN B 09031 K ARBUTAMINE HCL INJECTION 09032 K BACLOFEN 10 MG INJECTION 09033 K CIDOFOVIR INJECTION 09034 K BROMPHENIRAMINE MALEATE INJ 09035 K MEDROXYPROGESTERONE INJECTION 09036 K DIMETHYL SULFOXIDE 50% 09037 K METHADONE INJECTION 09038 K INJ ESTROGEN CONJUGATE 09040 K INTRAOCULAR FOMIVIRSEN NA 09041 K GAMMA GLOBULIN INJ 09042 K GLUCAGON HYDROCHLORIDE 09044 K IBUTILIDE FUMARATE INJECTION 09045 K IRON DEXTRAN 09046 K IRON SUCROSE INJECTION 09047 K ITRACONAZOLE INJECTION 09048 K INJ DESMOPRESSIN ACETATE 09049 K INJ PROTIRELIN 09050 K NA FERRIC GLUCONATE COMPLEX 09051 K UREA INJECTION 09053 K NASAL VACCINE INHALATION 09054 K METABOLICALLY ACTIVE TISSUE 09055 K INJECTABLE HUMAN TISSUE 09057 K LEPIRUDIN 09104 K ANTI-THYMOCYCTE GLOBULIN RABBIT 09105 K HEP B IMM GLOB 09108 K THYROTROPIN ALFA 09110 K ALEMTUZUMAB INJECTION 09111 K INJ, BIVALIRUDIN 09112 K PERFLUTREN LIPID MICRO 09114 K NESIRITIDE 09115 K INJ, ZOLEDRONIC ACID 09117 K YTTRIUM 90 IBRITUMOMAB TIUXETAN 09118 K IN-111 IBRITUMOMAB TIUXETAN 09119 K PEGFILGRASTIM 09120 K INJ, FULVESTRANT 09121 K INJ, ARGATROBAN 09122 K TRIPTORELIN PAMOATE 09123 G TRANSCYTE 09124 G INJECTION, DAPTOMYCIN 09125 G RISPERIDONE, LONG ACTING 09126 G INJECTION, NATALIZUMAB 09127 G PACLITAXEL PROTEIN PR 09128 G INJ PEGAPTAMIB SODIUM 09129 G INJ CLOFARABINE 09200 K ORCEL 09201 K DERMAGRAFT 09202 K OCTAFLUOROPROPANE 09203 G PERFLEXANE LIPID MICRO 09204 G ZIPRASIDONE MESYLATE 09205 G OXALIPLATIN 09206 K INTEGRA 09207 G INJECTION, BORTEZOMIB 09208 G INJECTION, AGALSIDASE BETA 09209 G INJECTION, LARONIDASE 09210 G INJECTION, PALONOSETRON HCL 09211 G INJ, ALEFACEPT, IV 09212 G INJ, ALEFACEPT, IM 09213 G INJECTION, PEMETREXED 09214 G INJECTION, BEVACIZUMAB 09215 G INJECTION, CETUXIMAB 09216 G ABARELIX INJECTION 09217 K LEUPROLIDE ACETATE SUSPNSION 09218 K INJECTION, AZACITIDINE 09219 G MYCOPHENOLIC ACID 09220 G SODIUM HYALURONATE 09221 G GRAFTJACKET REG MATRIX 09222 G GRAFTJACKET SFTTIS 09223 K INJ ADENOSINE, TX DX 09224 K INJECTION, GALSULFASE 09225 G FLUOCINOLONE ACETONIDE 09226 G ZICONOTIDE INTRATHECAL INF 09300 G INJECTION, OMALIZUMAB 09400 K THALLOUS CHLORIDE, BRAND 09401 K STRONTIUM-89 CHLORIDE, BRAND 09402 K TH I131 SO IODIDE CAP, BRAND 09403 K DX I131 SO IODIDE CAP, BRAND 09404 K DX I131 SO IODIDE SOL, BRAND 09405 K TH I131 SO IODIDE SOL, BRAND 09410 K DEXRAZOXANE HCL INJ, BRAND 09411 K PAMIDRONATE DISODIUM, BRAND 09413 K SODIUM HYALURONATE INJ, BRAND 09414 K ETOPOSIDE ORAL, BRAND 09415 K DOXORUBIC HCL CHEMO, BRAND 09417 K BLEOMYCIN SULFATE INJ, BRAND 09418 K CISPLATIN INJ, BRAND 09419 K INJ CLADRIBINE, BRAND 09420 K CYCLOPHOSPHAMIDE INJ, BRAND 09421 K CYCLOPHOSPHAMIDE LYO, BRAND 09422 K CYTARABINE HCL INJ, BRAND 09423 K DACARBAZINE INJ, BRAND 09424 K DAUNORUBICIN, BRAND 09425 K ETOPOSIDE INJ, BRAND 09426 K FLOXURIDINE INJ, BRAND 09427 K IFOSFOMIDE INJ, BRAND 09428 K MESNA INJECTION, BRAND 09429 K IDARUBICIN HCL INJ, BRAND 09430 K LEUPROLIDE ACETATE INJ, BRAN 09431 K PACLITAXEL INJ, BRAND 09432 K MITOMYCIN INJ, BRAND 09433 K THIOTEPA INJ, BRAND 09435 K GONADORELIN HYDROCH, BRAND 09436 K AZATHIOPRINE PARENTERAL,BRAND 09437 K CARMUS BISCHL NITRO INJ 09438 K CYCLOSPORINE ORAL, BRAND 09439 K DIETHYLSTILBESTROL INJECTION 09440 K VINORELBINE TAR,BRAND 09500 K PLATELETS, IRRADIATED 09501 K PLATELETS, PHERESIS, LEUKOCYTES REDUCED 09502 K PLATELET PHERESIS IRRADIATED 09503 K FRESH FROZEN PLASMA, EA UNIT 09504 K RBC DEGLYCEROLIZED 09505 K RBC IRRADIATED 09506 K GRANULOCYTES, PHERESIS 09507 K PLATELETS, PHERESIS 09508 K PLASMA, FROZEN W/IN 8 HOURS
