Abecma (idecabtagene vicleucel) Q2055, Abraxane (paclitaxel, protein bound) J9259, J9264,
Actimmune (interferon gamma-1b) J9216, Adakveo (crizanlizumab) J0791, Adbry
(tralokinumab) J3490, J3590, C9399, Adcetris (brentuximab vedotin) J9042, Adstiladrin
(nadofaragene firadenovec-vncg) J9029, Aduhelm (aducanumab) J0172, Adzynma
(ADAMTS13, recombinant-krhn) J3590, C9399, Agents for Hemophilia A and von Willebrand
Disease J7190, J7182, J7185, J7192, J7204, J7209, J7210, J7211, J7205, J7207, J7208,
J7214, J7188, J7191, J7183, J7186, J7187, J7179, J7170, Agents for Hemophilia B J7193,
J7194, J7195, J7200 J7201, J7202, J7203, J7213, Akynzeo (fosnetupitant and palonosetron)
for Injection J1454, Aldurazyme (laronidase) J1931, S9357, Aliqopa (copanlisib) J9057, Alpha-1
Proteinase Inhibitor Therapy J0256, J0257, Amondys 45 (casimersen) J1426, Amtagvi
(lifleucel), J3490, J3590, Amvuttra (vutrisiran) J0225, Aphexda (motixafortide) J3490, J3590,
J9999, Aristada Initio (aripiprazole lauroxil) J1943, Arzerra (ofatumumab) J9302, Asparagine
Specific Enzymes J9019, J9020, J9021, J9266, J9118, Bavencio (avelumab) J9023, Beleodaq
(belinostat) J9032, Bendamustine Agents J9036, J9033, J9034, J9056, J9058, J9059, Benlysta
(belimumab) J0490, Besponsa (inotuzumab ozogamicin) J9229, Berrimi (ropeginterferon alfa-
2b-njft) J3490, J3590, J9999, C9399, Beta Interferons and Glatiramer Acetate for Treatment of
Multiple Sclerosis (Avonex (interferon beta-1a), Plegridy (peginterferon beta-1a), Rebif
(interferon beta-1a), Betaseron (interferon beta-1b), Extavia (interferon beta-1b), Copaxone
(glatiramer acetate), Glatopa (glatiramer acetate)) C9399, J1595, J1826, J1830, J3490, Q3027,
Q3028, S9559, Bevacizumab for Non-ophthalmologic Indications (Avastin, Alymsys, Avzivi,
Mvasi, Vegzelma, Zirabev) J3490, J3590, J9035, Q5107, Q5118, Q5126, Q5129,Beyfortus
(nirsevimab) 90380, 90381, 96372, Blincyto (blinatumomab) J9039, Botulinum Toxin 31573,
46505, 52287, 64647, 67345, 46505, 64611, 64612, 64615, 64616, 64617, 64642, 64643,
64644, 64645, 64646, 64647, 64650, 64653, J0585, J0586, J0587, J0588, S2340, S2341,
J3590, C9160, Breyanzi (lisocabtagene maraleucel) Q2054, Brineura (cerliponase alfa) J0567,
Briumvi (ublituximab) J2329, Cabenuva (cabotegravir extended-release; rilpivirine extended-
release) injection J0741, Cablivi (caplacizumab-yhdp) J3590, C9047, Carvykti (ciltacabtagene
autoleucel) Q2056, Colony Stimulating Factor Agents 96377, J1442, J1447, J1449, J2506,
J2820, J3490, J3590, Q5101, Q5108, Q5110, Q5111, Q5120, Q5122, Q5125, Q5127, Q5130,
Columvi (glofitamab-gxbm) J9286, Complement C5 Inhibitors J1300, J1303, Cosela (trilaciclib)
J1448, Crysvita (burosumab-twza) J0584, Cyramza (ramucirumab) J9308, Danyelza
(naxitamab-gqgk) J9348, Darzalex (daratumumab), Darzalex Faspro (daratumumab and
hyaluronidase-fihj) J9145, J9144, Denosumab agents (Prolia, Xgeva) J0897,
Dihydroergotamine (DHE) injection J1110, Docetaxel (Taxotere) J9171, J9172, Doxorubicin
liposome (Doxil) Q2049, Q2050, Duopa (carbidopa and levodopa enteral suspension) J7340,
Dupixent (dupilumab) C9399, J3590, Durysta (bimatoprost implant) J7351, Egrifta (tesamorelin)
J3490, J3590,Elahere (mirvetuximab) J9063, Elaprase (idursulfase) J1743, S9357, Elfabrio
(pegunigalsidase alfa-iwxj) J2508, Elrexfio (elranatamab-bcmm) J3490, J3590, J9999, C9165m
Elzonris (tagraxofusp-erzs) J9269Empaveli (pegcetacoplan) J3490, C9399, Empliciti
(elotuzumab) J9176, Enhertu (fam-trastuzumab deruxtecan-nxki) J9358, Enjaymo (sutimlimab-
jome) J1302, Enspryng (satralizumab-mwge) J3490, J3590, C9399, Entyvio (vedolizumab)
J3380, Enzyme Replacement Therapy for Gaucher Disease J1786, J3060, J3385, S9357,
Epkinly (epcoritamab-bysp) J9321, Erbitux (cetuximab) J9055, Erythropoiesis Stimulating
Agents J0881, J0882, J0885, Q4081, J0887, J0888, Q4081, Q5105, Q5106, EA, EB EC, Ethyol
(amifostine) J0207, Evenity (romosozumab-aqqg) J3111, Evkeeza (evinacumab) J1305,
Exondys 51 (eteplirsen) J1428Fabrazyme (agalsidase beta) J0180, S9357, Faslodex
(fulvestrant) J9393, J9394, J9395, Fuzeon (enfuvirtide) J1324, Fyarro (sirolimus albumin bound)
J9331, GamaSTAN [(immune globulin (human)] 90281, J1460, J1560, Gamifant J9210, Gazyva
(obinutuzumab) J9301, Givlaari (givosiran) J0223 Gonadotropin Releasing Hormone Analogs
for oncologic indications J1950, J9202, J9218, S9560, J3315, J9155, J9217, J9225, J1675,
J1950, J3315, J9155, J9202, J1952, Gonadotropin Releasing Hormone Analogs for the
treatment of non-oncologic indications J1675, J3315, J3316, J9202, J9225, J9226, S9560,
J1950, J1951, J9217, J1954, Growth hormone, J2940, J2941, Q0515, S9558, J3490, J3590,
C9399, Halaven (eribulin) J9179, Hereditary Angioedema Agents J0593, J0596, J0597, J0598,
J1290, J1744, J0599, Human Parathyroid Hormone J3490, C9399, J3110, Hyaluronan
Injections J7318, J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327, J7328, J7329,
J7331, J7332, Hydroxyprogesterone caproate J1729, iDose TR (travoprost implant) J3490,
J3590, Imcivree (setmelanotide) J3590, C9399, Imfinzi (durvalumab) J9173, Imjudo
(tremelimumab-actl) J9347, Immunoglobulins 90281, 90283, 90284, J1459, J1460, J1551,
J1554, J1555, J1556, J1557, J1558, J1559, J1560, J1561, J1566, J1568, J1569, J1572, J1575,
J1576, J1599, S9338, Increlex (mecasermin) J2170, Infertility Agents and HCG Agents J0725,
J1950, J3490, J8499, S0122, S0126, S0128, S0132, Interleukin-1 Inhibitors J2793, J0638,
J3490, J3590, Intravitreal Corticosteroid Implants J7314, 67027, J7311, 08H033Z, 08H133Z,
67028, J7313, 67028, J7312, Iron Agents: Ixempra (ixabepilone) J9207, Izervay (avacincaptad
pegol) J3490, J3590, J9999, C9162, Jelmyto (mitomycin) J9281, Jemperli (dostarlimab-gxly)
J9272., Jevtana (cabazitaxel) J9043, J9064, Kadcyla (ado-trastuzumab) J9354, Kanuma
(sebelipase alfa) J2840, Kesimpta (ofatumumab) J3490, J3590, C9399, Ketamine injection
(Ketalar) J3490, Keytruda (pembrolizumab) J9271, Kimmtrak (tebentafusp-tebn) J9274,
Korsuva (difelikefalin acetate) J0879, Krystexxa (pegloticase) J2507, Kymriah (tisagenlecleucel)
0537T, 0538T, 0539T, 0540T, Q2042, Kyprolis (carfilzomib) J9047, Lamzede (velmanase alfa-
tycv) J3490, C9399, Lemtrada (alemtuzumab) for Treatment of Multiple Sclerosis J0202,
Leqembi (lecanemab) J0174, Leqvio (inclisiran) J1306, Levoleucovorin Agents J0641, J0642,
Libtayo (cemiplimab-rwlc) J9119, Loqtorzi (toripalimab-tpzi) J3490, J3590, C9399, Lumoxiti
(moxetumomab pasudotox-tdfk) J9313, Lunsumio (mosunetuzumab-axgb) J9350, Margenza
(margetuximab-cmkb) J9353, Melanoma Vaccines - Imlygic (talimogene laherparepvec), other
melanoma vaccines J9325, J3590, Mepsevii (vestronidase alfa) J3397, Monjuvi (tafasitamab-
cxix) J9349, Monoclonal Antibodies to Interleukin-17 C9399, J3490, J3590, Monoclonal
Antibodies to Interleukin-23 J1628, J3245, J2327, J3590, Monoclonal Antibodies to Interleukin-
5, J0517, J2182, J2786, Monoclonal Antibodies to Interleukin-6 J3262, C9399, J3490, J3590,
Mozobil (plerixafor) J2562, Mylotarg (gemtuzumab ozogamicin) J9203, Naglazyme (galsulfase)
J1458, S9357, Naltrexone Implantable Pellets 11981, 11983, 17999, 22999, 49999, J3490,
J7999, Natalizumab Agents (Tysabri, Tyruko) J2323, J3490, J3590, Nexobrid (anacaulase-
bcdb) J7353, Nplate (romiplostim) J2796, Nulibry (fosdenopterin) J3490, J3590, C9399, Nulojix
(belatacept) J0485, Ocrevus (ocrelizumab) J2350 Octreotide Agents J2353, J2354, Onpattro
(patisiran) J0222, Opdivo (nivolumab) J9299, Opdualag (nivolumab and relatlimab-rmbw)
J9298, Orencia (abatacept) J0129, Oxlumo (lumasiran) J0224, Padcev (enfortumab vedotin-
ejfv) J9177, Palynziq (pegvaliase-pqpz) C9399, J3590, Pedmark (sodium thiosulfate injection)
J0208, Pemetrexed Agents J9304, J9305, J9314, J9322, J9323, J9324, J9294, J9296, J9297,
Pepaxto (melphalan flufenamide; melflufen) J9247, Perjeta (pertuzumab) J9306 Phesgo
(pertuzumab/trastuzumab/hyaluronidase-zzxf) J9316, Polivy (polatuzumab vedotin-piiq) J930,
Pompe Disease J0219, J0221, J3490, J3590, S9357, Prialt (ziconotide) J2278, Proleukin
(aldesleukin) J9015, Proprotein Convertase Subtilisin Kexin 9 (PCSK9) Inhibitors C9399, J3490,
J3590Prostacyclin Infusion and Inhalation Therapy J1325, J3285, J7686, K0455, Q4074,
S0155, S9347, Provenge (sipuleucel-T) Q2043, Qalsody (tofersen) J1304, Radicava
(edaravone) J1301, Radioimmunotherapy and Somatostatin Receptor Targeted Radiotherapy
A9543, 79403, 79101, A9513, A9590, A9607 Reblozyl (luspatercept) J0896, Rebyota (fecal
microbiota, live - jslm) J1440, Relizorb (immobilized lipase) cartridge B4105, Repository
Corticotropin Injection J0800, J0801, J0802, Revcovi (elapegademase-lvlr) J3590, C9399,
Rituximab agents for Non-Oncologic Indications J9312, Q5115, Q5119, Q5123, Rituximab
agents for Oncologic Indications J9312, Q5115, Q5119, Q5123, Rivfloza (nedosiran) J3490,
Romidepsin J9318, J9319 Rybrevant (amivantamab-vmjw) J9061, Ryplazim (plasminogen,
human-tvmh) J2998, Rystiggo (rozanolixizumab-noli) J9333, Saphnelo (anifrolumab-fnia) J0491
Sarclisa (isatuximab-irfc) J9227, Scenesse (afamelanotide) J7352, Select Clotting Agents for
Bleeding Disorders J7198, J7189, J7175, J7180, J7181, J7177, J7178, J7189, J7212 Selected
Injectable 5HT3 Antiemetic Agents J2469, Selected Injectable NK-1 Antiemetic Agents J1453,
J1456, J0185, C9145, J3490 Signifor LAR (pasireotide) J2502, Somatuline Depot (lanreotide)
J1930, J1932 Spevigo (spesolimab-sbzo) J1747, Spinraza (nusinersen) 96450, J2326,
Spravato (esketamine) G2082, G2083, S0013, Strensiq (asfotase alfa) J3490, Subcutaneous
Hormonal Implants 11980, S0189, J3490 Sunlenca (lenacapavir) J1961, Syfovre
(pegcetacoplan) J2781, Sylvant (siltuximab) J2860, Synagis (palivizumab) 90378, S9562,
Synribo (omacetaxine mepesuccinate) J9262, Talvey (talquetamab-tgvs) J3490, J3590, J9999,
C9163, Tecartus (brexucabtagene autoleucel) Q2053 Tecentriq (atezolizumab) J9022, Tecvayli
(teclistamab-cqyv), J9380, Tegsedi (inotersen) J3490, C9399, Tepezza (teprotumumab-trbw)
J3241, Testosterone, Injectable (Depo-Testosterone (testosterone cypionate), Xyosted
(testosterone enanthate), Aveed (testosterone undecanoate) J1071, J3121, J3145, Tezspire
(tezepelumab-ekko) J2356, Tivdak (tisotumab vedotin-tftv) J9273, Torisel (temsirolimus) J9330,
Trastuzumab Agents J9356, J9355, Q5113, Q5117 Q5114, Q5112, Q5116, Trodelvy
(sacituzumab govitecan) J9317, Trogarzo (ibalizumab-uiyk) J1746, Tumor Necrosis Factor
Antagonists J0135, J0717, J1438, J1602, J1745, J3590, Q5103, Q5104, Q5109, Q5121,
Q5131, Q5132, S9359, J3490, Adalimumab agents (Humira, Abrilada, Amjevita, Cyltezo,
Hadlima, Hulio, Hyrimoz, Idacio, Yuflyma, Yusimry), Certolizumab pegol (Cimzia), Etanercept
agents (Enbrel, Erelzi, Eticovo), Golimumab (Simponi, Simponi Aria), Infliximab agents
(Remicade, Infliximab unbranded, Avsola, Inflectra, Ixifi, Renflexis, Zymfentra) Tzield
(teplizumab-mzwv) J9381, Uplizna (inebilizumab-cdon) J1823, Ustekinumab Agents (Stelara,
Wezlana) J3357, J3358, Vascular Endothelial Growth Factor (VEGF) Inhibitors (Avastin,
Alymsys, Mvasi, Vegzelma, Zirabev (bevacizumab, bevacizumab-maly, bevacizumab-awwb,
bevacizumab-bvzr, bevacizumab-adcd), Lucentis (ranibizumab), Byooviz (ranibizumab-nuna),
Cimerli (ranibizumab-cqrn), Eylea (aflibercept), Eylea HD (aflibercept), Beovu (brolucizumab-
dbll), Vabysmo (faricimab-svoa) Q5118, C9257, J9035, Q5107, J2778, J0177, J0178, J0179,
Q5124, J2777, Q5126, Q5128, Q5129, Vectibix (panitumumab) J9303, Velcade (bortezomib)
J9041, J9044, J9046, J9048, J9049, J9051, Veopoz (pozelimab-bbfg) J3590, C9399, Vidaza
(azacitidine) J9025, Viltepso (viltolarsen) J1427, Vimizim (elosulfase alfa) J1322, S9357,
Voxzogo (vosoritide) J3490, C9399, Vyepti (eptinezumab), J3032, Vyjuvek (beremagene
geperpavec) J3401, Vyondys 53 (golodirsen) J1429, Vyvgart (efgartigimod alfa-fcab), Vyvgart
Hytrulo (efgartigimod alfa and hyaluronidase-qvfc) J9332, J9934, Wainua (eplontersen) J3490,
C9399 Winrevair (sotatercept-csrk) J3590, C9399 Xenpozyme (olipudase alfa) J0218, Xiaflex
(clostridial collagenase histolyticum) injection 20527, 26341, J0775, Xipere (triamcinolone
acetonide injectable suspension) J3299, Xofigo (Radium Ra 223 Dichloride) A9606, 79101,
Xolair (omalizumab) J2357, Ycanth (cantharidin) J3490, C9164 Yervoy (ipilimumab) J9228,
Yescarta (axicabtagene ciloleucel) 0537T, 0538T, 0539T, 0540T, Q2041, Zaltrap (ziv-aflibercept)
J9400, Zepzelca (lurbinectedin) J9223, Zilbrysq (zilucoplan) J3490, Zilretta (triamcinolone
acetonide extended release) J3304, Zinplava (bezlotoxumab) J0565, 96413, 96365, Zoledronic
Acid Reclast, Zoledronic acid 4mg J3489, Zulresso (brexanolone) J1632, Zynlonta
(loncastuximab tesirine-lpyl) J9359, Zynyz (retifanlimab-dlwr) J9345