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2008 Table of Drugs

2008 Table of Drugs IA - Intra-arterial administration IV - Intravenous administration IM - Intramuscular administration IT - Intrathecal SC - Subcutaneous ...

Clinical Coverage Guideline

Supprelin LA (histrelin acetate) Subcutaneous Implant for the Treatment of Central Precocious Puberty (CPP)

Ultrasound Measurements in Pregnancy

Code 02SPO . Special Projects Officer for the ... Alternatively, you may discontinue the injections and ... you could start the patient on DMPA (depot ...

Medical Therapy and Health Maintenance for Transgender Men: A ...

... are able to make testosterone (including depot ... more even levels of testosterone release with injections ... Depo-Lupron , the most frequently used GnRH agonist ...

Health Choice of Arizona PRIOR AUTHORIZATION GUIDELINES

Prior Authorization Guidelines Last update: June, 2010 Page 1 Health Choice of Arizona PRIOR AUTHORIZATION GUIDELINES It is with great pleasure that Health Choice provides ...

Provider Administered Injectable Drug Program Quick Reference Guide

... must be authorized by ICORE before being administered in the office: Table 1 J-Code ... Intron-A Supprelin LA Lupron Depot Synagis Neumega Tysabri Nplate ...

Policy Name Self-Administered Drugs

... joints), intrathecal injections, limited subcutaneous injections ... 07/01/2009 Updated codes 06/01/2009 Removed Lupron Depot, added Affinitor to code list 06/01 ...

Affiliated Computer Services

Lupron Depot. ACS Technical Call Center: PDL - Non-Preferred ... capsules HIC3=M0E Antihemophilic factors IV injections ... Code Level Code Values Drug Code Oral Chemotherapy ...

Clearance #4942 Title: Health Plan Providers: Therapeutic ...

Title: Health Plan Providers: Therapeutic Injections and ... (v) Lupron depot. (a) Lupron depot for the treament of ... made only when billed with an injection code (J code ...

National Drug Code (NDC) Billing Reference

NDC Billing Reference for Nevada Medicaid and Nevada Check Up Claims 09/16/08 Page 1 National Drug Code (NDC) Billing Reference (for Nevada Medicaid and Nevada Check Up ...

Presented below draft document during meeting with AUSA Michael ...

The Code of Federal Regulations (320.22) state ... Yet, it is the daily lupron injections which are mostly ... Depot lupron (long acting formulation) is also used in ...

www.medicaid.state.ar.us

Lupron-DEPOT (leuprolide acetate) injections (including Lupron-DEPOT PED): Lupron-DEPOT ... Point-of-sale claims will deny if there is a billed J-code for ...

Medical Injection Prior Authorization List Coventry Health Care of ...

Effective 01/01/2012 Drug Name Code Code Drug Name Abraxane J9264 90283 Immune ... Koate-DVI/HP J7190 J1950 Lupron Depot Kogenate/FS J7192 J2020 Zyvok (linezolid)

WOMENS INTERVIEW STUDY OF HEALTH

(if any, circle code for daughter for each one in l12.) ... lupron depot (inj.) 3.75mg 880. lupron depot (inj.) 7.5mg 881 ... injections / norplant: deladroxate injection 450

National Drug Code (NDC) Billing Reference

NDC Billing Reference for Nevada Medicaid and Nevada Check Up Claims 09/16/08 Page 1 National Drug Code (NDC) Billing Reference (for Nevada Medicaid and Nevada Check Up ...

Health Choice of Arizona PRIOR AUTHORIZATION GUIDELINES

... the Pharmacy section of this guideline for injections ... with authorization: Medication description J Code ... FOR DEPOT SUSPENSION), 7.5 MG (ELIGARD/LUPRON DEPOT) J9217 ...

www.nj.gov

... are related to therapeutic or diagnostic injections. At recodified N.J.A ... found in the New Jersey Administrative Code at N.J ... Injection, octreotide depot, 1 mg: 104.36 ...

Clinical Coverage Guideline

Supprelin LA (histrelin acetate) Subcutaneous Implant for the Treatment of Central Precocious Puberty (CPP)

HCPCS REQUIRING CORRESPONDING NDC CODES

The list of procedure codes affected by the J Code NDC Requirements is now available ... NALBUPHINE HCL PER 10 MG J2310 INJ NALOXONE HCL PER 1 MG J2315 INJ NALTREXONE DEPOT ...

NDC Billing Reference

National Drug Code (NDC) Billing Reference Revised ... Two 1.5ml injections of Lidocaine 1% are NDC quantity 3 ... One Lupron depot 7.5mg kit is NDC quantity 1 Transdermal ...

National Drug Code (NDC) Billing Reference

... December 31 will be processed with current J Code ... 1000mcg/ml is NDC quantity 1 - Two 1.5ml injections of ... ACETATE (FOR DEPOT SUSPENSION), 7.5MG KIT LUPRON DEPOT (SRN ...

2008 Table of Drugs

2008 Table of Drugs IA - Intra-arterial administration IV - Intravenous administration IM - Intramuscular administration IT - Intrathecal SC - Subcutaneous ...

home.cc.umanitoba.ca/~mtennen/AntiVirals/ACYLOVIR.doc

RID:150: Abraham AM, Kavitha S, Joseph P, George R, Pillay D, Malathi J, et al ... can be successfully used to determine the content of ganciclovir in injections.

Rx only

1 LUPRON INJECTION (leuprolide acetate) Rx only DESCRIPTION Leuprolide acetate is a synthetic nonapeptide analog of naturally occurring gonadotropin releasing hormone (GnRH or ...

Affiliated Computer Services

Lupron Depot. ACS Technical Call Center: PDL - Non-Preferred ... capsules HIC3=M0E Antihemophilic factors IV injections ... Code Level Code Values Drug Code Oral Chemotherapy ...

HCPCS 2001 TABLE OF DRUGS

HCPCS 2001 TABLE OF DRUGS J Jenamicin, see Garamycin ... Leuprolide acetate (for depot suspension) 3 ... Lupron, see Leuprolide acetate. Lymphocyte immune globulin,

Physicians Injectable Medications Fee Schedule (Update effective ...

new j code january 2012 : j1051 injection, medroxyprogesterone acetate, 50 mg (depo ... j9217 leuprolide acetate, for depot suspension, 7.5 mg (lupron : depot, eligard) ***men ...

National Drug Code (NDC) Billing Reference

NDC Billing Reference for Nevada Medicaid and Nevada Check Up Claims Updated nl 07/14/10 pv 09/16/08 Page 1 National Drug Code (NDC) Billing Reference (for Nevada Medicaid and ...

MORTAR MIXER

Page 2 SKU 95906 For technical questions, please call 1-800-444-3353. sPECIFICATIOns Drum Capacity 6 Cubic Feet Batch Capacity 1-1/2 to 2 Bags of cement Wheel to ...

Specialty Injectable Drug Program

... Blue Shield Association 06/10/03 1 of 3 HCPCS Billing Code ... NUTROPIN AQ NUTROPIN DEPOT SAIZEN SEROSTIM AWP- 15% J3240 ... AWP- 15% J9217 LUPRON AWP- 15% J9218 LEUPROLIDE LUPRON AWP- 15% ...