APC Status Codes and Titles Effective 01-01-2007 Source: CMS OCE/APC V 8.0 Module, January 2007 Notes: 1) There are 868 APC Titles as of January 2007 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 00031 X SMOKING CESSATION SERVICES 00033 P PARTIAL HOSPITALIZATION 00034 P DAILY MENTAL HEALTH SERVICES 00035 T ARTERIAL/VENOUS PUNCTURE 00036 T LEVEL II FINE NEEDLE BIOPSY/ASPIRATION 00037 T LEVEL IV NEEDLE BIOPSY/ASPIRATION EXCEPT BONE MARROW 00038 S SPONTANEOUS MEG 00039 S LEVEL I IMPLANTATION OF NEUROSTIMULATOR 00040 S PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, EXCLUDING CRANIAL NERV 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 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 00061 S LAMINECTOMY OR INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, EXCLUDI 00062 T LEVEL I TREATMENT FRACTURE/DISLOCATION 00063 T LEVEL II TREATMENT FRACTURE/DISLOCATION 00064 T LEVEL III TREATMENT FRACTURE/DISLOCATION 00065 S LEVEL I STEREOTACTIC RADIOSURGERY 00066 S LEVEL II STEREOTACTIC RADIOSURGERY 00067 S LEVEL III STEREOTACTIC RADIOSURGERY 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 REPAIR/REVISION/REMOVAL OF PACEMAKERS, AICDS, OR VASCULAR DEVICES 00106 T INSERTION/REPLACEMENT OF PACEMAKER LEADS 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 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 00125 T REFILLING OF INFUSION PUMP 00126 T LEVEL I URINARY AND ANAL PROCEDURES 00127 S LEVEL IV STEREOTACTIC RADIOSURGERY 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 AND ANOSCOPY 00147 T LEVEL II SIGMOIDOSCOPY AND ANOSCOPY 00148 T LEVEL I ANAL/RECTAL PROCEDURES 00149 T LEVEL III ANAL/RECTAL PROCEDURES 00150 T LEVEL IV ANAL/RECTAL PROCEDURES 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 PROCEDURES 00156 T LEVEL III 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 II URINARY AND ANAL PROCEDURES 00165 T LEVEL IV URINARY AND ANAL PROCEDURES 00166 T LEVEL I URETHRAL PROCEDURES 00168 T LEVEL II URETHRAL PROCEDURES 00169 T LITHOTRIPSY 00170 S DIALYSIS 00171 T LEVEL V ANAL/RECTAL PROCEDURES 00180 T CIRCUMCISION 00181 T PENILE PROCEDURES 00183 T TESTES/EPIDIDYMIS PROCEDURES 00184 T PROSTATE BIOPSY 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 LEVEL II MEG, EXTENDED EEG STUDIES AND SLEEP STUDIES 00212 T NERVOUS SYSTEM INJECTIONS 00213 S LEVEL I MEG, EXTENDED EEG STUDIES AND SLEEP STUDIES 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 IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CRANIAL NERVE 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 00257 S LEVEL I THERAPEUTIC RADIOLOGIC 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 AND SCREENING ULTRASOUND 00266 S LEVEL II DIAGNOSTIC AND SCREENING ULTRASOUND 00267 S LEVEL III DIAGNOSTIC AND SCREENING ULTRASOUND 00268 S LEVEL I ULTRASOUND GUIDANCE PROCEDURES 00269 S LEVEL II ECHOCARDIOGRAM EXCEPT TRANSESOPHAGEAL 00270 S TRANSESOPHAGEAL ECHOCARDIOGRAM 00272 X 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 00280 S LEVEL III ANGIOGRAPHY AND VENOGRAPHY 00282 S MISCELLANEOUS COMPUTERIZED AXIAL TOMOGRAPHY 00283 S COMPUTED TOMOGRAPHY WITH CONTRAST 00284 S MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST 00288 S BONE DENSITY:AXIAL SKELETON 00293 T LEVEL V ANTERIOR SEGMENT EYE PROCEDURES 00296 S LEVEL II THERAPEUTIC RADIOLOGIC PROCEDURES 00297 S LEVEL III THERAPEUTIC RADIOLOGIC PROCEDURES 00298 S LEVEL IV THERAPEUTIC RADIOLOGIC PROCEDURES 00299 S MISCELLANEOUS RADIATION TREATMENT 00300 S LEVEL I RADIATION THERAPY 00301 S LEVEL II RADIATION THERAPY 00302 S COMPUTER ASSISTED NAVIGATIONAL PROCEDURES 00303 X TREATMENT DEVICE CONSTRUCTION 00304 X LEVEL I THERAPEUTIC RADIATION TREATMENT PREPARATION 00305 X LEVEL II THERAPEUTIC RADIATION TREATMENT PREPARATION 00307 S MYOCARDIAL POSITRON EMISSION TOMOGRAPHY (PET) IMAGING 00308 S NON-MYOCARDIAL POSITRON EMISSION TOMOGRAPHY (PET) IMAGING 00309 S LEVEL II ULTRASOUND GUIDANCE PROCEDURES 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 COMPUTED TOMOGRAPHY WITHOUT CONTRAST 00333 S COMPUTED TOMOGRAPHY WITHOUT CONTRAST FOLLOWED BY CONTRAST) 00335 S MAGNETIC RESONANCE IMAGING, MISCELLANEOUS 00336 S MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST 00337 S MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST 00339 S OBSERVATION 00340 X MINOR ANCILLARY PROCEDURES 00341 X SKIN TESTS 00342 X LEVEL I PATHOLOGY 00343 X LEVEL III PATHOLOGY 00344 X LEVEL IV 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 00350 S ADMINISTRATION OF FLU AND PPV VACCINE 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 00372 X THERAPEUTIC PHLEBOTOMY 00373 X LEVEL I NEUROPSYCHOLOGICAL TESTING 00374 X MONITORING PSYCHIATRIC DRUGS 00375 S ANCILLARY OUTPATIENT SERVICES WHEN PATIENT EXPIRES 00376 S LEVEL II CARDIAC IMAGING 00377 S LEVEL III CARDIAC IMAGING 00378 S LEVEL II PULMONARY IMAGING 00379 K INJECTION ADENOSINE 6 MG 00381 X SINGLE ALLERGY TESTS 00382 X LEVEL II NEUROPSYCHOLOGICAL TESTING 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 LEVEL I NON-IMAGING NUCLEAR MEDICINE 00390 S LEVEL I ENDOCRINE IMAGING 00391 S LEVEL II ENDOCRINE IMAGING 00392 S LEVEL II NON-IMAGING NUCLEAR MEDICINE 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 LEVEL I TUMOR/INFECTION IMAGING 00407 S LEVEL I RADIONUCLIDE THERAPY 00408 S LEVEL II TUMOR/INFECTION IMAGING 00409 X RED BLOOD CELL TESTS 00411 S RESPIRATORY PROCEDURES 00412 S IMRT TREATMENT DELIVERY 00413 S LEVEL II RADIONUCLIDE THERAPY 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 00427 T LEVEL III TUBE CHANGES AND REPOSITIONING 00428 T LEVEL III SIGMOIDOSCOPY AND ANOSCOPY 00429 T LEVEL V CYSTOURETHROSCOPY AND OTHER GENITOURINARY PROCEDURES 00432 S HEALTH AND BEHAVIOR SERVICES 00433 X LEVEL II PATHOLOGY 00434 T CARDIAC DEFECT REPAIR 00436 S LEVEL I DRUG ADMINISTRATION 00437 S LEVEL II DRUG ADMINISTRATION 00438 S LEVEL III DRUG ADMINISTRATION 00439 S LEVEL IV DRUG ADMINISTRATION 00440 S LEVEL V DRUG ADMINISTRATION 00441 S LEVEL VI DRUG ADMINISTRATION 00442 S DOSIMETRIC DRUG ADMINISTRATION 00443 X OVERNIGHT PULSE OXIMETRY 00604 V LEVEL 1 HOSPITAL CLINIC VISITS 00605 V LEVEL 2 HOSPITAL CLINIC VISITS 00606 V LEVEL 3 HOSPITAL CLINIC VISITS 00607 V LEVEL 4 HOSPITAL CLINIC VISITS 00608 V LEVEL 5 HOSPITAL CLINIC VISITS 00609 V LEVEL 1 EMERGENCY VISITS 00613 V LEVEL 2 EMERGENCY VISITS 00614 V LEVEL 3 EMERGENCY VISITS 00615 V LEVEL 4 EMERGENCY VISITS 00616 V LEVEL 5 EMERGENCY VISITS 00617 S CRITICAL CARE 00618 S TRAUMA RESPONSE WITH CRITICAL CARE 00621 T LEVEL I VASCULAR ACCESS PROCEDURES 00622 T LEVEL II VASCULAR ACCESS PROCEDURES 00623 T LEVEL III VASCULAR ACCESS PROCEDURES 00624 X MINOR VASCULAR ACCESS DEVICE PROCEDURES 00625 T LEVEL IV VASCULAR ACCESS PROCEDURES 00648 T LEVEL IV BREAST SURGERY 00651 S COMPLEX INTERSTITIAL RADIATION SOURCE APPLICATION 00652 T INSERTION OF INTRAPERITONEAL AND PLEURAL 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 V PATHOLOGY 00662 S CT ANGIOGRAPHY 00663 S LEVEL I ELECTRONIC ANALYSIS OF NEUROSTIMULATOR PULSE GENERATORS 00664 S LEVEL I PROTON BEAM RADIATION THERAPY 00665 S BONE DENSITY:APPENDICULARSKELETON 00667 S LEVEL II PROTON BEAM RADIATION THERAPY 00668 S LEVEL I ANGIOGRAPHY AND VENOGRAPHY 00670 S LEVEL II INTRAVASCULAR AND INTRACARDIAC ULTRASOUND AND FLOW RESERVE 00672 T LEVEL IV POSTERIOR SEGMENT EYE PROCEDURES 00673 T LEVEL IV ANTERIOR SEGMENT EYE PROCEDURES 00674 T PROSTATE CRYOABLATION 00675 T PROSTATIC THERMOTHERAPY 00676 T 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 LEVEL II ELECTRONIC ANALYSIS OF NEUROSTIMULATOR PULSE GENERATORS 00693 T 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 H SR89 STRONTIUM 00702 H SM 153 LEXIDRONM 00704 H IN111 SATUMOMAB 00705 H TC99M TETROFOSMIN 00722 H TC99M PENTETATE 00723 H CO57/58 00724 H CO57 CYANO 00726 K DEXRAZOXANE HCL INJECTION 00728 K FILGRASTIM 300 MCG INJECTION 00730 K PAMIDRONATE DISODIUM /30 MG 00731 K SARGRAMOSTIM INJECTION 00732 K MESNA INJECTION 00735 K AMPHO B CHOLESTERYL SULFATE 00736 K AMPHOTERICIN B LIPOSOME INJ 00737 H NITROGEN N-13 AMMONIA 00738 K RASBURICASE 00739 H TC99M DEPREOTIDE 00740 H TC99M GLUCEPTATE 00741 H CR51 CHROMATE 00742 H TC99M LABELED RBC 00743 H TC99M MERTIATIDE 00744 K PLAGUE VACCINE, IM 00746 K DACARBAZINE 100 MG INJ 00747 K CHLOROTHIAZIDE SODIUM INJ 00748 K BLEOMYCIN SULFATE INJECTION 00750 K DOLASETRON MESYLATE 00751 K MECHLORETHAMINE HCL INJ 00752 K DACTINOMYCIN ACTINOMYCIN D 00753 K SPECTINOMYCN DI-HCL INJ 00759 K NALTREXONE, DEPOT FORM 00760 G ANADULAFUNGIN INJECTION 00763 K DOLASETRON MESYLATE ORAL 00764 K GRANISETRON HCL INJECTION 00765 K GRANISETRON HCL 1 MG ORAL 00766 K APOMORPHINE HYDROCHLORIDE 00767 K ENFUVIRTIDE INJECTION 00768 K ONDANSETRON HCL INJECTION 00769 K ONDANSETRON HCL 8MG ORAL 00800 K LEUPROLIDE ACETATE /3.75 MG 00802 K ETOPOSIDE ORAL 50 MG 00804 K IMMUNE GLOBULIN SUBCUTANEOUS 00805 K MECASERMIN INJECTION 00806 G HYALURONIDASE RECOMBINANT 00807 K ALDESLEUKIN/SINGLE USE VIAL 00808 K NABILONE ORAL 00809 K BCG LIVE INTRAVESICAL VAC 00810 K GOSERELIN ACETATE IMPLANT 00811 K CARBOPLATIN INJECTION 00812 K CARMUS BISCHL NITRO INJ 00814 K ASPARAGINASE INJECTION 00820 K DAUNORUBICIN 00821 K DAUNORUBICIN CITRATE LIPOSOM 00823 K DOCETAXEL 00825 K NELARABINE INJECTION 00827 K FLOXURIDINE INJECTION 00828 K GEMCITABINE HCL 00829 H TECHNETIUM TC-99M AEROSOL 00830 K IRINOTECAN INJECTION 00831 K IFOSFOMIDE INJECTION 00832 K IDARUBICIN HCL INJECTION 00834 K INTERFERON ALFA-2A INJ 00835 K INJ COSYNTROPIN PER 0.25 MG 00836 K INTERFERON ALFA-2B INJ 00837 K NON-HUMAN, NON-METAB TISSUE 00838 K INTERFERON GAMMA 1-B INJ 00840 K INJ MELPHALAN HYDROCHL 50 MG 00842 K FLUDARABINE PHOSPHATE INJ 00843 K PEGASPARGASE/SINGL DOSE VIAL 00844 K PENTOSTATIN INJECTION 00849 K RITUXIMAB CANCER TREATMENT 00850 K STREPTOZOCIN INJECTION 00851 K THIOTEPA INJECTION 00852 K TOPOTECAN 00855 K VINORELBINE TARTRATE/10 MG 00856 K PORFIMER SODIUM 00858 K INJ CLADRIBINE PER 1 MG 00860 K PLICAMYCIN (MITHRAMYCIN) INJ 00861 K LEUPROLIDE ACETATE INJECTION 00862 K MITOMYCIN 5 MG INJ 00863 K PACLITAXEL INJECTION 00864 K MITOXANTRONE HYDROCHL / 5 MG 00865 K INTERFERON ALFA-N3 INJ 00868 G ORAL APREPITANT 00873 K HYALGAN/SUPARTZ INJ PER DOSE 00874 K SYNVISC INJ PER DOSE 00875 K EUFLEXXA INJ PER DOSE 00876 K CAFFEINE CITRATE INJECTION 00877 K ORTHOVISC INJ PER DOSE 00884 K RHO D IMMUNE GLOBULIN INJ 00887 K AZATHIOPRINE PARENTERAL 00888 K CYCLOSPORINE ORAL 100 MG 00890 K LYMPHOCYTE IMMUNE GLOBULIN 00891 K TACROLIMUS ORAL PER 1 MG 00892 K EDETATE CALCIUM DISODIUM INJ 00895 K DEFEROXAMINE MESYLATE INJ 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 / .25 MG 00911 K INJ STREPTOKINASE /250000 IU 00912 K INTERFERON ALFACON-1 00913 K GANCICLOVIR LONG ACT IMPLANT 00916 K INJECTION IMIGLUCERASE /UNIT 00917 K ADENOSINE INJECTION 00925 K FACTOR VIII 00926 K FACTOR VIII (PORCINE) 00927 K FACTOR VIII RECOMBINANT 00928 K FACTOR IX COMPLEX 00929 K ANTI-INHIBITOR 00930 K ANTITHROMBIN III INJECTION 00931 K FACTOR IX NON-RECOMBINANT 00932 K FACTOR IX RECOMBINANT 00935 K CLONIDINE HYDROCHLORIDE 00949 K FROZEN PLASMA, POOLED, SD 00950 K WHOLE BLOOD FOR TRANSFUSION 00952 K CRYOPRECIPITATE EACH UNIT 00954 K RBC LEUKOCYTES REDUCED 00955 K PLASMA, FRZ BETWEEN 8-24HOUR 00956 K PLASMA PROTEIN FRACT,5%,50ML 00957 K PLATELETS, EACH UNIT 00958 K PLATELET RICH PLASMA UNIT 00959 K RED BLOOD CELLS UNIT 00960 K WASHED RED BLOOD CELLS UNIT 00961 K ALBUMIN (HUMAN),5%, 50ML 00963 K ALBUMIN (HUMAN), 5%, 250 ML 00964 K ALBUMIN (HUMAN), 25%, 20 ML 00965 K ALBUMIN (HUMAN), 25%, 50ML 00966 K PLASMAPROTEIN FRACT,5%,250ML 00967 K BLOOD SPLIT UNIT 00968 K PLATELETS LEUKOREDUCED IRRAD 00969 K RBC LEUKOREDUCED IRRADIATED 01009 K CRYOPRECIPITATEREDUCEDPLASMA 01010 K BLOOD, L/R, CMV-NEG 01011 K PLATELETS, HLA-M, L/R, UNIT 01013 K PLATELETS LEUKOCYTES REDUCED 01016 K BLOOD, L/R, FROZ/DEGLY/WASH 01017 K PLT, APH/PHER, L/R, CMV-NEG 01018 K BLOOD, L/R, IRRADIATED 01019 K PLATE PHERES LEUKOREDU IRRAD 01020 K PLT, PHER, L/R CMV-NEG, IRR 01021 K RBC, FRZ/DEG/WSH, L/R, IRRAD 01022 K RBC, L/R, CMV-NEG, IRRAD 01032 H AUD OSSEO DEV, INT/EXT COMP 01045 H I131 IODOBENGUATE, DX 01052 K INJECTION, VORICONAZOLE 01064 H I131 IODIDE CAP, RX 01083 K ADALIMUMAB INJECTION 01084 K DENILEUKIN DIFTITOX, 300 MCG 01086 K TEMOZOLOMIDE 01088 H IODINE I-131 IODIDE CAP, DX 01096 H TC99M EXAMETAZIME 01150 H I131 IODIDE SOL, RX 01166 K CYTARABINE LIPOSOME 01167 K INJ, EPIRUBICIN HCL, 2 MG 01178 K BUSULFAN INJECTION 01203 K VERTEPORFIN INJECTION 01207 K OCTREOTIDE INJECTION, DEPOT 01280 K CORTICOTROPIN INJECTION 01330 K ERGONOVINE MALEATE INJECTION 01436 K ETIDRONATE DISODIUM INJ 01491 S NEW TECHNOLOGY - LEVEL IA ($0-$10) 01492 S NEW TECHNOLOGY - LEVEL IB ($10-$20) 01493 S NEW TECHNOLOGY - LEVEL IC ($20-$30) 01494 S NEW TECHNOLOGY - LEVEL ID ($30-$40) 01495 S NEW TECHNOLOGY - LEVEL IE ($40-$50) 01496 T NEW TECHNOLOGY - LEVEL IA ($0-$10) 01497 T NEW TECHNOLOGY - LEVEL IB($10-$20) 01498 T NEW TECHNOLOGY - LEVEL IC ($20-$30) 01499 T NEW TECHNOLOGY - LEVEL ID($30-$40) 01500 T NEW TECHNOLOGY - LEVEL IE ($40-$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 XXIV ($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) 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 H TC99M SESTAMIBI 01603 H TL201 THALLIUM 01604 H IN111 CAPROMAB 01605 K ABCIXIMAB INJECTION 01606 K INJECTION ANISTREPLASE 30 U 01607 K EPTIFIBATIDE INJECTION 01608 K ETANERCEPT INJECTION 01609 K RHO(D) IMMUNE GLOBULIN H, SD 01612 K DACLIZUMAB, PARENTERAL 01613 K TRASTUZUMAB 01629 K NONMETABOLIC ACT D/E TISSUE 01630 K HEP B IG, IM 01631 K BACLOFEN INTRATHECAL TRIAL 01632 K METABOLIC ACTIVE D/E TISSUE 01633 K ALEFACEPT 01642 H IN111 IBRITUMOMAB, DX 01643 H Y90 IBRITUMOMAB, RX 01644 H I131 TOSITUMOMAB, DX 01645 H I131 TOSITUMOMAB, RX 01646 H IN111 OXYQUINOLINE 01647 H IN111 PENTETATE 01648 H TECHNETIUM TC99M ARCITUMOMAB 01650 H TC99M SUCCIMER 01651 H F18 FDG 01654 H RB82 RUBIDIUM 01655 K TINZAPARIN SODIUM INJECTION 01670 K TETANUS IMMUNE GLOBULIN INJ 01671 H GA67 GALLIUM 01672 H TC99M BICISATE 01675 H P32 NA PHOSPHATE 01676 H P32 CHROMIC PHOSPHATE 01677 H IN111 PENTETREOTIDE 01678 H TC99M FANOLESOMAB 01680 K ACETYLCYSTEINE INJECTION 01682 K APROTONIN, 10,000 KIU 01683 K BASILIXIMAB 01684 K CORTICORELIN OVINE TRIFLUTAL 01685 K DARBEPOETIN ALFA, NON-ESRD 01686 K EPOETIN ALFA, NON-ESRD 01687 K DIGOXIN IMMUNE FAB (OVINE) 01688 K ETHANOLAMINE OLEATE 100 MG 01689 K FOMEPIZOLE, 15 MG 01690 K HEMIN, 1 MG 01691 K IRON DEXTRAN 165 INJECTION 01692 K IRON DEXTRAN 267 INJECTION 01693 K LEPIRUDIN 01694 G ZICONOTIDE INJECTION 01695 K NESIRITIDE INJECTION 01696 K PALIFERMIN INJECTION 01697 G PEGAPTANIB SODIUM INJECTION 01700 K INJ SECRETIN SYNTHETIC HUMAN 01701 K TREPROSTINIL INJECTION 01703 K OVINE, 1000 USP UNITS 01704 K INJ VONWILLEBRAND FACTOR IU 01705 K FACTOR VIIA 01707 K NON-HUMAN, METABOLIC TISSUE 01709 K AZACITIDINE INJECTION 01710 G CLOFARABINE INJECTION 01711 K HISTRELIN IMPLANT 01712 G PACLITAXEL PROTEIN BOUND 01713 K INJ FE-BASED MR CONTRAST,1ML 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 01738 K OXALIPLATIN 01739 K PEGADEMASE BOVINE, 25 IU 01740 K DIAZOXIDE INJECTION 01741 K UROFOLLITROPIN, 75 IU 01820 H GENERATOR NEURO RECHG BAT SYS 01821 H INTERSPINOUS IMPLANT 02210 K METHYLDOPATE HCL INJECTION 02616 H BRACHYTX SOURCE, YTTRIUM-90 02632 H IODINE I-125 SODIUM IODIDE 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 02731 K IMMUNE GLOBULIN, POWDER 02732 K IMMUNE GLOBULIN, LIQUID 02770 K QUINUPRISTIN/DALFOPRISTIN 02940 K SOMATREM INJECTION 03030 K SUMATRIPTAN SUCCINATE / 6 MG 03032 K DTP/HIB VACCINE, IM 03038 K INJ BIPERIDEN LACTATE/5 MG 03039 K INJ METARAMINOL BITARTRATE 03041 K BIVALIRUDIN 03042 K FOSCARNET SODIUM INJECTION 03043 K GAMMA GLOBULIN 1 CC INJ 03045 K MEROPENEM 03048 K DOXORUBIC HCL 10 MG VL CHEMO 03049 K CYCLOPHOSPHAMIDE LYOPHILIZED 03050 K SERMORELIN ACETATE INJECTION 07000 K AMIFOSTINE 07005 K GONADORELIN HYDROCH/ 100 MCG 07011 K OPRELVEKIN INJECTION 07015 K ORAL BUSULFAN 07028 K FOSPHENYTOIN, 50 MG 07034 K SOMATROPIN INJECTION 07035 K TENIPOSIDE, 50 MG 07036 K UROKINASE 250,000 IU INJ 07038 K MONOCLONAL ANTIBODIES 07041 K TIROFIBAN HCL 07042 K CAPECITABINE, ORAL, 150 MG 07043 K INFLIXIMAB INJECTION 07045 K INJ TRIMETREXATE GLUCORONATE 07046 K DOXORUBICIN HCL LIPOSOME INJ 07048 K ALTEPLASE RECOMBINANT 07049 K FILGRASTIM 480 MCG INJECTION 07051 K LEUPROLIDE ACETATE IMPLANT 07308 K AMINOLEVULINIC ACID HCL TOP 09001 K LINEZOLID INJECTION 09002 K TENECTEPLASE INJECTION 09003 K PALIVIZUMAB, PER 50 MG 09004 K GEMTUZUMAB OZOGAMICIN 09005 K RETEPLASE INJECTION 09006 K TACROLIMUS INJECTION 09012 K ARSENIC TRIOXIDE 09015 K MYCOPHENOLATE MOFETIL ORAL 09018 K BOTULINUM TOXIN TYPE B 09019 K CASPOFUNGIN ACETATE 09020 K SIROLIMUS, ORAL 09022 K IM INJ INTERFERON BETA 1-A 09023 K RHO D IMMUNE GLOBULIN 50 MCG 09024 K AMPHOTERICIN B LIPID COMPLEX 09031 K ARBUTAMINE HCL INJECTION 09032 K BACLOFEN 10 MG INJECTION 09033 K CIDOFOVIR INJECTION 09038 K INJ ESTROGEN CONJUGATE 25 MG 09040 K INTRAOCULAR FOMIVIRSEN NA 09042 K GLUCAGON HYDROCHLORIDE/1 MG 09044 K IBUTILIDE FUMARATE INJECTION 09046 K IRON SUCROSE INJECTION 09047 K ITRACONAZOLE INJECTION 09051 K UREA INJECTION 09054 K METABOLICALLY ACTIVE TISSUE 09100 H I131 SERUM ALBUMIN, DX 09104 K ANTITHYMOCYTE GLOBULN RABBIT 09108 K THYROTROPIN INJECTION 09110 K ALEMTUZUMAB INJECTION 09112 K INJ PERFLUTREN LIP MICROS,ML 09115 K ZOLEDRONIC ACID 09119 K INJECTION, PEGFILGRASTIM 6MG 09120 K INJECTION, FULVESTRANT 09121 K INJECTION, ARGATROBAN 09122 K TRIPTORELIN PAMOATE 09124 K DAPTOMYCIN INJECTION 09125 K RISPERIDONE, LONG ACTING 09126 G NATALIZUMAB INJECTION 09133 K RABIES IG, IM/SC 09134 K RABIES IG, HEAT TREATED 09135 K VARICELLA-ZOSTER IG, IM 09137 K BCG VACCINE, PERCUT 09139 K RABIES VACCINE, IM 09140 K RABIES VACCINE, ID 09141 K MEASLES-RUBELLA VACCINE, SC 09143 K MENINGOCOCCAL VACCINE, SC 09144 K ENCEPHALITIS VACCINE, SC 09145 K MENINGOCOCCAL VACCINE, IM 09148 H I123 IODIDE CAP, DX 09156 K NONMETABOLIC ACTIVE TISSUE 09157 K LOCM <=149 MG/ML IODINE, 1ML 09158 K LOCM 150-199MG/ML IODINE,1ML 09159 K LOCM 200-249MG/ML IODINE,1ML 09160 K LOCM 250-299MG/ML IODINE,1ML 09161 K LOCM 300-349MG/ML IODINE,1ML 09162 K LOCM 350-399MG/ML IODINE,1ML 09163 K LOCM >= 400 MG/ML IODINE,1ML 09164 K INJ GAD-BASE MR CONTRAST,1ML 09165 K ORAL MR CONTRAST, 100 ML 09167 K VALRUBICIN, 200 MG 09202 K INJ OCTAFLUOROPROPANE MIC,ML 09203 K INJ PERFLEXANE LIP MICROS,ML 09207 K BORTEZOMIB INJECTION 09208 K AGALSIDASE BETA INJECTION 09209 K LARONIDASE INJECTION 09210 K PALONOSETRON HCL 09213 K PEMETREXED INJECTION 09214 K BEVACIZUMAB INJECTION 09215 K CETUXIMAB INJECTION 09216 K ABARELIX INJECTION 09217 K LEUPROLIDE ACETATE SUSPNSION 09219 K MYCOPHENOLIC ACID 09222 K INJECTION HUMAN TISSUE 09224 K GALSULFASE INJECTION 09225 G FLUOCINOLONE ACETONIDE IMPLT 09227 G MICAFUNGIN SODIUM INJECTION 09228 G TIGECYCLINE INJECTION 09229 G IBANDRONATE SODIUM INJECTION 09230 G ABATACEPT INJECTION 09231 G DECITABINE INJECTION 09232 G INJECTION, IDURSULFASE 09233 G INJECTION, RANIBIZUMAB 09234 K INJ, ALGLUCOSIDASE ALFA 09235 G INJECTION, PANITUMUMAB 09300 K OMALIZUMAB INJECTION 09350 G POROUS COLLAGEN TUBE PER CM 09351 G ACELLULAR DERM TISSUE PERCM2 09500 K PLATELETS, IRRADIATED 09501 K PLATELET PHERES LEUKOREDUCED 09502 K PLATELET PHERESIS IRRADIATED 09503 K FR FRZ PLASMA DONOR RETESTED 09504 K RBC DEGLYCEROLIZED 09505 K RBC IRRADIATED 09506 K GRANULOCYTES, PHERESIS UNIT 09507 K PLATELETS, PHERESIS 09508 K PLASMA 1 DONOR FRZ W/IN 8 HR

