Emergency: 119
AMDA-IMIC

Section Q: Miscellaneous Services

589 procedure codes. CMS quarterly release — October 2026.

HCPCS Level II codes are updated quarterly by CMS. This listing reflects the October 2026 quarterly release.
Code Description Pricing
Q0035 Cardiokymography 11
Q0081 Infusion ther other than che 00
Q0083 Chemo by other than infusion 00
Q0084 Chemotherapy by infusion 00
Q0085 Chemo by both infusion and o 00
Q0091 Obtaining screen pap smear 11
Q0092 Set up port xray equipment 11
Q0111 Wet mounts/ w preparations 21
Q0112 Potassium hydroxide preps 21
Q0113 Pinworm examinations 21
Q0114 Fern test 21
Q0115 Post-coital mucous exam 21
Q0138 Ferumoxytol, non-esrd 51
Q0139 Ferumoxytol, esrd use 51
Q0144 Azithromycin dihydrate, oral 00
Q0155 Dronabinol (syndros) 0.1 mg 51
Q0161 Chlorpromazine hcl 5mg oral 51
Q0162 Ondansetron oral 51
Q0163 Diphenhydramine hcl 50mg 51
Q0164 Prochlorperazine maleate 5mg 51
Q0166 Granisetron hcl 1 mg oral 51
Q0167 Dronabinol 2.5mg oral 51
Q0169 Promethazine hcl 12.5mg oral 51
Q0173 Trimethobenzamide hcl 250mg 51
Q0175 Perphenazine 4mg oral 51
Q0177 Hydroxyzine pamoate 25mg 51
Q0180 Dolasetron mesylate oral 51
Q0181 Unspecified oral anti-emetic 51
Q0224 Inj, pemivibart, 4500 mg 54
Q0234 Inj, tocilizumab-bavi, 1mg 54
Q0235 Inj, monoclon antibody, 1 mg 54
Q0237 Inj, tocilizumab-anoh, hospi 54
Q0238 Inj, tocilizumab-aazg, hospi 54
Q0249 Tocilizumab for covid-19 54
Q0477 Pwr module pt cable lvad rpl 38
Q0478 Power adapter, combo vad 38
Q0479 Power module combo vad, rep 38
Q0480 Driver pneumatic vad, rep 38
Q0481 Microprcsr cu elec vad, rep 38
Q0482 Microprcsr cu combo vad, rep 38
Q0483 Monitor elec vad, rep 38
Q0484 Monitor elec or comb vad rep 38
Q0485 Monitor cable elec vad, rep 38
Q0486 Mon cable elec/pneum vad rep 38
Q0487 Leads any type vad, rep only 38
Q0488 Pwr pack base elec vad, rep 38
Q0489 Pwr pck base combo vad, rep 38
Q0490 Emr pwr source elec vad, rep 38
Q0491 Emr pwr source combo vad rep 38
Q0492 Emr pwr cbl elec vad, rep 38
Q0493 Emr pwr cbl combo vad, rep 38
Q0494 Emr hd pmp elec/combo, rep 38
Q0495 Charger elec/combo vad, rep 38
Q0496 Battery elec/combo vad, rep 38
Q0497 Bat clps elec/comb vad, rep 38
Q0498 Holster elec/combo vad, rep 38
Q0499 Belt/vest elec/combo vad rep 38
Q0500 Filters elec/combo vad, rep 38
Q0501 Shwr cov elec/combo vad, rep 38
Q0502 Mobility cart pneum vad, rep 38
Q0503 Battery pneum vad replacemnt 38
Q0504 Pwr adpt pneum vad, rep veh 38
Q0506 Lith-ion batt elec/pneum vad 38
Q0507 Misc sup/acc ext vad 46
Q0508 Mis sup/acc imp vad 46
Q0509 Mis sup/ac imp vad nopay med 46
Q0510 Dispens fee immunosupressive 46
Q0511 Sup fee antiem,antica,immuno 46
Q0512 Px sup fee anti-can sub pres 46
Q0513 Disp fee inhal drugs/30 days 46
Q0514 Disp fee inhal drugs/90 days 46
Q0515 Sermorelin acetate injection 51
Q0521 Supply fee hiv prep fda appr 46
Q1004 Ntiol category 4 57
Q1005 Ntiol category 5 57
Q2004 Bladder calculi irrig sol 51
Q2009 Fosphenytoin inj pe 51
Q2026 Radiesse injection 51
Q2028 Inj, sculptra, 0.5mg 51
Q2034 Agriflu vaccine 54
Q2035 Afluria vacc, 3 yrs & >, im 54
Q2036 Flulaval vacc, 3 yrs & >, im 54
Q2037 Fluvirin vacc, 3 yrs & >, im 54
Q2038 Fluzone vacc, 3 yrs & >, im 54
Q2039 Influenza virus vaccine, nos 54
Q2041 Axicabtagene ciloleucel car+ 51
Q2042 Tisagenlecleucel car-pos t 51
Q2043 Sipuleucel-t auto cd54+ 53
Q2049 Imported lipodox inj 51
Q2050 Doxorubicin inj 10mg 51
Q2052 Home ivig, services/supplies 57
Q2053 Brexucabtagene car pos t 51
Q2054 Lisocabtagene mara car pos t 51
Q2055 Idecabtagene vicleucel car 51
Q2056 Ciltacabtagene car-pos t 51
Q2057 Afamitresgene autoleucel 51
Q2058 Obecbtge autol up to 400 mil 51
Q3001 Brachytherapy radioelements 57
Q3014 Telehealth facility fee 53
Q3027 Inj beta interferon im 1 mcg 51
Q3028 Inj beta interferon sq 1 mcg 00
Q3031 Collagen skin test 11
Q4001 Cast sup body cast plaster 55
Q4002 Cast sup body cast fiberglas 55
Q4003 Cast sup shoulder cast plstr 55
Q4004 Cast sup shoulder cast fbrgl 55
Q4005 Cast sup long arm adult plst 55
Q4006 Cast sup long arm adult fbrg 55
Q4007 Cast sup long arm ped plster 55
Q4008 Cast sup long arm ped fbrgls 55
Q4009 Cast sup sht arm adult plstr 55
Q4010 Cast sup sht arm adult fbrgl 55
Q4011 Cast sup sht arm ped plaster 55
Q4012 Cast sup sht arm ped fbrglas 55
Q4013 Cast sup gauntlet plaster 55
Q4014 Cast sup gauntlet fiberglass 55
Q4015 Cast sup gauntlet ped plster 55
Q4016 Cast sup gauntlet ped fbrgls 55
Q4017 Cast sup lng arm splint plst 55
Q4018 Cast sup lng arm splint fbrg 55
Q4019 Cast sup lng arm splnt ped p 55
Q4020 Cast sup lng arm splnt ped f 55
Q4021 Cast sup sht arm splint plst 55
Q4022 Cast sup sht arm splint fbrg 55
Q4023 Cast sup sht arm splnt ped p 55
Q4024 Cast sup sht arm splnt ped f 55
Q4025 Cast sup hip spica plaster 55
Q4026 Cast sup hip spica fiberglas 55
Q4027 Cast sup hip spica ped plstr 55
Q4028 Cast sup hip spica ped fbrgl 55
Q4029 Cast sup long leg plaster 55
Q4030 Cast sup long leg fiberglass 55
Q4031 Cast sup lng leg ped plaster 55
Q4032 Cast sup lng leg ped fbrgls 55
Q4033 Cast sup lng leg cylinder pl 55
Q4034 Cast sup lng leg cylinder fb 55
Q4035 Cast sup lngleg cylndr ped p 55
Q4036 Cast sup lngleg cylndr ped f 55
Q4037 Cast sup shrt leg plaster 55
Q4038 Cast sup shrt leg fiberglass 55
Q4039 Cast sup shrt leg ped plster 55
Q4040 Cast sup shrt leg ped fbrgls 55
Q4041 Cast sup lng leg splnt plstr 55
Q4042 Cast sup lng leg splnt fbrgl 55
Q4043 Cast sup lng leg splnt ped p 55
Q4044 Cast sup lng leg splnt ped f 55
Q4045 Cast sup sht leg splnt plstr 55
Q4046 Cast sup sht leg splnt fbrgl 55
Q4047 Cast sup sht leg splnt ped p 55
Q4048 Cast sup sht leg splnt ped f 55
Q4049 Finger splint, static 55
Q4050 Cast supplies unlisted 57
Q4051 Splint supplies misc 57
Q4074 Iloprost non-comp unit dose 51
Q4081 Epoetin alfa, 100 units esrd 57
Q4082 Drug/bio noc part b drug cap 51
Q4101 Apligraf 11
Q4102 Oasis wound matrix 11
Q4103 Oasis burn matrix 11
Q4104 Integra bmwd 11
Q4105 Integra drt or omnigraft 11
Q4107 Graftjacket 11
Q4108 Integra matrix 11
Q4110 Primatrix 11
Q4111 Gammagraft 11
Q4112 Cymetra injectable 13
Q4113 Graftjacket xpress 13
Q4114 Integra flowable wound matri 13
Q4115 Alloskin 11
Q4116 Alloderm 11
Q4117 Hyalomatrix 11
Q4118 Matristem micromatrix 13
Q4121 Theraskin 11
Q4122 Dermacell, awm, porous sq cm 11
Q4123 Alloskin 11
Q4124 Oasis tri-layer wound matrix 11
Q4125 Arthroflex 11
Q4126 Memoderm/derma/tranz/integup 11
Q4127 Talymed 11
Q4128 Flexhd/allopatchhd/sq cm 11
Q4130 Strattice tm 11
Q4132 Grafix core, grafixpl core 11
Q4133 Grafix stravix prime pl sqcm 11
Q4134 Hmatrix 11
Q4135 Mediskin 11
Q4136 Ezderm 11
Q4137 Amnioexcel biodexcel 1sq cm 11
Q4138 Biodfence dryflex, 1cm 11
Q4139 Amnio or biodmatrix, inj 1cc 13
Q4140 Biodfence 1cm 11
Q4141 Alloskin ac, 1 cm 11
Q4142 Xcm biologic tiss matrix 1cm 11
Q4143 Repriza, 1cm 11
Q4145 Epifix, inj, 1mg 13
Q4146 Tensix, 1cm 11
Q4147 Architect ecm px fx 1 sq cm 11
Q4148 Neox neox rt or clarix cord 11
Q4149 Excellagen, 0.1 cc 13
Q4150 Allowrap ds or dry 1 sq cm 11
Q4151 Amnioband, guardian 1 sq cm 11
Q4152 Dermapure 1 square cm 11
Q4153 Dermavest, plurivest sq cm 11
Q4154 Biovance 1 square cm 11
Q4155 Neoxflo or clarixflo 1 mg 13
Q4156 Neox 100 or clarix 100 11
Q4157 Revitalon 1 square cm 11
Q4158 Kerecis omega3, per sq cm 11
Q4159 Affinity1 square cm 11
Q4160 Nushield 1 square cm 11
Q4161 Bio-connekt per square cm 11
Q4162 Wndex flw, bioskn flw, 0.5cc 13
Q4163 Woundex, bioskin, per sq cm 11
Q4164 Helicoll, per square cm 11
Q4165 Keramatrix, kerasorb sq cm 11
Q4166 Cytal, per square centimeter 11
Q4167 Truskin, per sq centimeter 11
Q4168 Amnioband, 1 mg 13
Q4169 Artacent wound, per sq cm 11
Q4170 Cygnus, per sq cm 11
Q4171 Interfyl, 1 mg 13
Q4173 Palingen or palingen xplus 11
Q4174 Palingen or promatrx 13
Q4175 Miroderm 11
Q4176 Neopatch or therion, 1 sq cm 11
Q4177 Floweramnioflo, 0.1 cc 13
Q4178 Floweramniopatch, per sq cm 11
Q4179 Flowerderm, per sq cm 11
Q4180 Revita, per sq cm 11
Q4181 Amnio wound, per square cm 11
Q4182 Transcyte, per sq centimeter 11
Q4183 Surgigraft, 1 sq cm 11
Q4184 Cellesta or duo per sq cm 11
Q4185 Cellesta flowab amnion 0.5cc 13
Q4186 Epifix 1 sq cm 11
Q4187 Epicord 1 sq cm 11
Q4188 Amnioarmor 1 sq cm 11
Q4189 Artacent ac, 1 mg 13
Q4190 Artacent ac 1 sq cm 11
Q4191 Restorigin 1 sq cm 11
Q4192 Restorigin, 1 cc 13
Q4193 Coll-e-derm 1 sq cm 11
Q4194 Novachor 1 sq cm 11
Q4195 Puraply 1 sq cm 11
Q4196 Puraply am 1 sq cm 11
Q4197 Puraply xt 1 sq cm 11
Q4198 Genesis amnio membrane 1sqcm 11
Q4199 Cygnus matrix, per sq cm 11
Q4200 Skin te 1 sq cm 11
Q4201 Matrion 1 sq cm 11
Q4202 Keroxx (2.5g/cc), 1cc 13
Q4203 Derma-gide, 1 sq cm 11
Q4204 Xwrap 1 sq cm 11
Q4205 Membrane graft or wrap sq cm 11
Q4206 Fluid flow or fluid gf 1 cc 13
Q4207 Carbon life, per sq cm 11
Q4208 Novafix per sq cm 11
Q4209 Surgraft per sq cm 11
Q4211 Amnion bio or axobio sq cm 11
Q4212 Allogen, per cc 13
Q4213 Ascent, 0.5 mg 13
Q4214 Cellesta cord per sq cm 11
Q4215 Axolotl ambient, cryo 0.1 mg 13
Q4216 Artacent cord per sq cm 11
Q4217 Woundfix biowound plus xplus 11
Q4218 Surgicord per sq cm 11
Q4219 Surgigraft dual per sq cm 11
Q4220 Bellacell hd, surederm sq cm 11
Q4221 Amniowrap2 per sq cm 11
Q4222 Progenamatrix, per sq cm 11
Q4223 Dermabind sl optic per sq cm 11
Q4224 Hhf10-p per sq cm 11
Q4225 Amnio or derma tl, per sq cm 11
Q4226 Myown harv prep proc sq cm 51
Q4227 Amniocore per sq cm 11
Q4229 Cogenex amnio memb per sq cm 11
Q4230 Cogenex flow amnion 0.5 cc 13
Q4232 Corplex, per sq cm 11
Q4233 Surfactor /nudyn per 0.5 cc 13
Q4234 Xcellerate, per sq cm 11
Q4235 Amniorepair or altiply sq cm 11
Q4236 Carepatch per sq cm 11
Q4237 Cryo-cord, per sq cm 11
Q4238 Derm-maxx, per sq cm 11
Q4239 Amnio-maxx or lite per sq cm 11
Q4240 Corecyte topical only 0.5 cc 13
Q4241 Polycyte, topical only 0.5cc 13
Q4242 Amniocyte plus, per 0.5 cc 13
Q4243 Amchomatrix, per sq cm 11
Q4245 Amniotext, per cc 13
Q4246 Coretext or protext, per cc 13
Q4247 Amniotext patch, per sq cm 11
Q4248 Dermacyte amn mem allo sq cm 11
Q4249 Amniply, per sq cm 11
Q4250 Amnioamp-mp per sq cm 11
Q4251 Vim, per square centimeter 11
Q4252 Vendaje, per square centimet 11
Q4253 Zenith amniotic membrane psc 11
Q4254 Novafix dl per sq cm 11
Q4255 Reguard, topical use per sq 11
Q4256 Mlg complet, per sq cm 11
Q4257 Relese, per sq cm 11
Q4258 Enverse, per sq cm 11
Q4259 Celera per sq cm 11
Q4260 Signature apatch, per sq cm 11
Q4261 Tag, per square centimeter 11
Q4262 Dual layer impax, per sq cm 11
Q4263 Surgraft tl, per sq cm 11
Q4264 Cocoon membrane, per sq cm 11
Q4265 Neostim tl per sq cm 11
Q4266 Neostim per sq cm 11
Q4267 Neostim dl per sq cm 11
Q4268 Surgraft ft per sq cm 11
Q4269 Surgraft xt per sq cm 11
Q4270 Complete sl per sq cm 11
Q4271 Complete ft per sq cm 11
Q4272 Esano a, per sq cm 11
Q4273 Esano aaa, per sq cm 11
Q4274 Esano ac, per sq cm 11
Q4275 Esano aca, per sq cm 11
Q4276 Orion, per sq cm 11
Q4278 Epieffect, per sq cm 11
Q4279 Vendaje ac, per sq cm 11
Q4280 Xcell amnio matrix per sq cm 11
Q4281 Barrera slor dl per sq cm 11
Q4282 Cygnus dual per sq cm 11
Q4283 Biovance tri or 3l, sq cm 11
Q4284 Dermabind sl, per sq cm 11
Q4285 Nudyn dl or dl mesh pr sq cm 11
Q4286 Nudyn sl or slw, per sq cm 11
Q4287 Dermabind dl, per sq cm 11
Q4288 Dermabind ch, per sq cm 11
Q4289 Revoshield+ amnio, per sq cm 11
Q4290 Membrane wrap hydr per sq cm 11
Q4291 Lamellas xt, per sq cm 11
Q4292 Lamellas, per sq cm 11
Q4293 Acesso dl, per sq cm 11
Q4294 Amnio quad-core, per sq cm 11
Q4295 Amnio tri-core, per sq cm 11
Q4296 Rebound matrix, per sq cm 11
Q4297 Emerge matrix, per sq cm 11
Q4298 Amniocore pro, per sq cm 11
Q4299 Amniocore pro+, per sq cm 11
Q4300 Acesso tl, per sq cm 11
Q4301 Activate matrix, per sq cm 11
Q4302 Complete aca, per sq cm 11
Q4303 Complete aa, per sq cm 11
Q4304 Grafix plus, per sq cm 11
Q4305 Amer am ac tri-lay per sq cm 11
Q4306 Americ amnion ac per sq cm 11
Q4307 American amnion, per sq cm 11
Q4308 Sanopellis, per sq cm 11
Q4309 Via matrix, per sq cm 11
Q4310 Procenta, per 100 mg 13
Q4311 Acesso, per sq cm 11
Q4312 Acesso ac, per sq cm 11
Q4313 Dermabind fm, per sq cm 11
Q4314 Reeva, per sq cm 11
Q4315 Regenelink amniotic mem allo 11
Q4316 Amchoplast, per sq cm 11
Q4317 Vitograft, per sq cm 11
Q4318 E-graft, per sq cm 11
Q4319 Sanograft, per sq cm 11
Q4320 Pellograft, per sq cm 11
Q4321 Renograft, per sq cm 11
Q4322 Caregraft, per sq cm 11
Q4323 Alloply, per sq cm 11
Q4324 Amniotx, per sq cm 11
Q4325 Acapatch, per sq cm 11
Q4326 Woundplus, per sq cm 11
Q4327 Duoamnion, per sq cm 11
Q4328 Most, per sq cm 11
Q4329 Singlay, per sq cm 11
Q4330 Total, per sq cm 11
Q4331 Axolotl graft, per sq cm 11
Q4332 Axolotl dualgraft, per sq cm 11
Q4333 Ardeograft, per sq cm 11
Q4334 Amnioplast 1, per sq cm 11
Q4335 Amnioplast 2, per sq cm 11
Q4336 Artecent c, per sq cm 11
Q4337 Artecent trident, per sq cm 11
Q4338 Artacent velos, per sq cm 11
Q4339 Artacent vericlen, per sq cm 11
Q4340 Simpligraft, per sq cm 11
Q4341 Simplimax, per sq cm 11
Q4342 Theramend, per sq cm 11
Q4343 Dermacyte ac matrx per sq cm 11
Q4344 Tri membrane wrap, per sq cm 11
Q4345 Matrix hd allogrft per sq cm 11
Q4346 Shelter dm matrix per sq cm 11
Q4347 Rampart dl matrix per sq cm 11
Q4348 Sentry sl matrix per sq cm 11
Q4349 Mantle dl matrix per sq cm 11
Q4350 Palisade dm matrix per sq cm 11
Q4351 Enclose tl matrix, per sq cm 11
Q4352 Overlay sl matrix, per sq cm 11
Q4353 Xceed tl matrix per sq cm 11
Q4354 Palingen dl-palingen dl-x 11
Q4355 Abio xpl abio xpl hy p sq cm 11
Q4356 Abio mem abio hyd per sq cm 11
Q4357 Xwrap plus, per sq cm 11
Q4358 Xwrap dual, per sq cm 11
Q4359 Choriply, per sq cm 11
Q4360 Amchoplast fd per sq cm 11
Q4361 Epixpress, per sq cm 11
Q4362 Cygnus disk, per sq cm 11
Q4363 Am bur mem hydro per sq cm 11
Q4364 Am bur xp mem xpl hy p sq cm 11
Q4365 Amnio bur dl mem per sq cm 11
Q4366 Dl amnio bur x-mem per sq cm 11
Q4367 Amniocore sl, per sq cm 11
Q4368 Amchothick per sq cm 11
Q4369 Amnioplast 3 per sq cm 11
Q4370 Aeroguard per sq cm 11
Q4371 Neoguard per sq cm 11
Q4372 Amchoplast excl per sq cm 11
Q4373 Membrane wrp lt per sq cm 11
Q4375 Duograft ac per sq cm 11
Q4376 Duograft aa per sq cm 11
Q4377 Trigraft ft per sq cm 11
Q4378 Renew ft matrix per sq cm 11
Q4379 Amniodefend ft per sq cm 11
Q4380 Advograft one per sq cm 11
Q4382 Advograft dual per sq cm 11
Q4383 Axolotl graft ult per sq cm 11
Q4384 Axolotl dual ult per sq cm 11
Q4385 Apollo ft per sq cm 11
Q4386 Acesso trifaca per sq cm 11
Q4387 Neothelium ft per sq cm 11
Q4388 Neothelium 4l per sq cm 11
Q4389 Neothelium 4l+ per sq cm 11
Q4390 Ascendion per sq cm 11
Q4391 Amnioplast double per sq cm 11
Q4392 Grafix duo per sq cm 11
Q4393 Surgraft ac per sq cm 11
Q4394 Surgraft aca per sq cm 11
Q4395 Acelagraft per sq cm 11
Q4396 Natalin per sq cm 11
Q4397 Summit aaa per sq cm 11
Q4398 Summit ac per sq cm 11
Q4399 Summit fx per sq cm 11
Q4400 Polygon3 per sq cm 11
Q4401 Absolv3 per sq cm 11
Q4402 Xwrap 2.0 per sq cm 11
Q4403 Xwrap dual plus per sq cm 11
Q4404 Xwrap hydro plus per sq cm 11
Q4405 Xwrap fenestra plus sq cm 11
Q4406 Xwrap fenestra per sq cm 11
Q4407 Xwrap tribus per sq cm 11
Q4408 Xwrap hydro per sq cm 11
Q4409 Amniomatrixf3x per sq cm 11
Q4410 Amchomatrixdl per sq cm 11
Q4411 Amniomatrixf4x per sq cm 11
Q4412 Choriofix per sq cm 11
Q4413 Cygnus solo per sq cm 11
Q4414 Simplichor per sq cm 11
Q4415 Alexiguard st-l per sq cm 11
Q4416 Alexiguard tl-t per sq cm 11
Q4417 Alexiguard dl-t per sq cm 11
Q4418 Biolab wrap flow per sq cm 11
Q4419 Biolab wrap flw lt per sq cm 11
Q4420 Nuform per sq cm 11
Q4421 Biolab wrap solo per sq cm 11
Q4422 Ac wrap per sq cm 11
Q4423 Biolab tri wrap fl per sq cm 11
Q4424 Revive ft per sq cm 11
Q4425 Revive tl per sq cm 11
Q4426 Dermbnd tl+, tlx per sq cm 11
Q4427 Dermbnd dln dl+ dlx sq cm 11
Q4428 Dermbnd sln sl+ slx sq cm 11
Q4429 Dermbnd chn, chx per sq cm 11
Q4431 Pma skin substitute, nos 13
Q4432 510(k) skin subs, nos 13
Q4433 361 hct/p skin subs, nos 13
Q4435 Renati membrane per sq cm 11
Q4436 Renati ac membrane per sq cm 11
Q4437 Revival ac per sq cm 11
Q4438 Pretect per sq cm 11
Q4439 Instagraft per sq cm 11
Q4440 Curamatrix per sq cm 11
Q5001 Hospice or home hlth in home 00
Q5002 Hospice/home hlth in asst lv 00
Q5003 Hospice in lt/non-skilled nf 00
Q5004 Hospice in snf 00
Q5005 Hospice, inpatient hospital 00
Q5006 Hospice in hospice facility 00
Q5007 Hospice in ltch 00
Q5008 Hospice in inpatient psych 00
Q5009 Hospice/home hlth, place nos 00
Q5010 Hospice home care in hospice 00
Q5098 Inj ustekinumab-srlf, 1 mg 51
Q5099 Inj ustekinumab-stba, 1 mg 51
Q5100 Inj ustekinumab-kfce, 1 mg 51
Q5101 Injection, zarxio 51
Q5103 Injection, inflectra 51
Q5104 Injection, renflexis 51
Q5105 Inj retacrit esrd on dialysi 57
Q5106 Inj retacrit non-esrd use 51
Q5107 Inj mvasi 10 mg 51
Q5108 Injection, fulphila 51
Q5110 Nivestym 51
Q5111 Injection, udenyca 0.5 mg 51
Q5112 Inj ontruzant 10 mg 51
Q5113 Inj herzuma 10 mg 51
Q5114 Inj ogivri 10 mg 51
Q5115 Inj truxima 10 mg 51
Q5116 Inj., trazimera, 10 mg 51
Q5117 Inj., kanjinti, 10 mg 51
Q5118 Inj., zirabev, 10 mg 51
Q5119 Inj ruxience, 10 mg 51
Q5120 Inj pegfilgrastim-bmez 0.5mg 51
Q5121 Inj. avsola, 10 mg 51
Q5122 Inj, nyvepria 51
Q5123 Inj. riabni, 10 mg 51
Q5124 Inj. byooviz, 0.1 mg 51
Q5125 Inj, releuko 1 mcg 51
Q5126 Inj alymsys 10 mg 51
Q5127 Inj, stimufend, 0.5 mg 51
Q5128 Inj, cimerli, 0.1 mg 51
Q5129 Inj, vegzelma, 10 mg 51
Q5130 Inj, fylnetra, 0.5 mg 51
Q5133 Inj, tofidence, 1 mg 51
Q5134 Inj, tyruko, 1 mg 51
Q5135 Inj, tyenne, 1 mg 51
Q5136 Inj. denosumab-bbdz, 1 mg 51
Q5137 Inj, wezlana, sub cu, 1 mg 51
Q5138 Inj, wezlana, iv, 1 mg 51
Q5140 Inj adalimumab-fkjp, 1 mg 51
Q5141 Inj adalimumab-aaty, 1 mg 51
Q5142 Inj adalimumab-ryvk, 1 mg 51
Q5143 Inj adalimumab-adbm, 1 mg 51
Q5144 Inj, idacio, 1 mg 51
Q5145 Inj, abrilada, 1 mg 51
Q5146 Inj, hercessi, 10 mg 51
Q5147 Inj, aflibercept-ayyh, 1 mg 51
Q5148 Inj, nyposi 1 mcg 51
Q5149 Inj, aflibercept-abzv, 1 mg 51
Q5150 Inj, aflibercept-mrbb, 1 mg 51
Q5151 Inj, eculizumab-aagh, 2 mg 51
Q5152 Inj, eculizumab-aeeb, 2 mg 51
Q5153 Inj, aflibercept-yszy, 1 mg 51
Q5154 Inj, omlyclo, 5 mg 51
Q5155 Inj, aflibercept-jbvf, 1 mg 51
Q5156 Inj, tocilizumab-anoh, 1 mg 51
Q5157 Inj, denosumab-bmwo, 1 mg 51
Q5158 Inj, denosumab-bnht, 1 mg 51
Q5159 Inj, denosumab-dssb, 1 mg 51
Q5160 Inj, jobevne, 10 mg 51
Q5161 Inj, denosumab-kyqq, 1 mg 51
Q5162 Inj, denosumab-nxxp, 1 mg 51
Q5164 Ustekinumab-hmny, 1 mg 51
Q5165 Inj, denosumab-mobz, 1 mg 51
Q5166 Inj, denosumab-desu, 1 mg 51
Q5167 Inj, denosumab-qbde, 1 mg 51
Q5168 Inj. nufymco, 0.1 mg 51
Q5169 Inj, armlupeg, 0.5 mg 51
Q5170 Inj, aflibercept-boav, 1 mg 51
Q5171 Inj, den (boncres), bio, 1mg 51
Q5172 Inj, filkri, 1 mcg 51
Q5173 Inj, denosumab-adet, 1 mg 51
Q9001 Chaplain assessment 99
Q9002 Chaplain counsel individu 99
Q9003 Chaplain counsel group 99
Q9004 Va whole health partner serv 99
Q9950 Inj sulf hexa lipid microsph 57
Q9951 Locm >= 400 mg/ml iodine,1ml 51
Q9953 Inj fe-based mr contrast,1ml 57
Q9954 Oral mr contrast, 100 ml 57
Q9955 Inj perflexane lip micros,ml 57
Q9956 Inj octafluoropropane mic,ml 57
Q9957 Inj perflutren lip micros,ml 57
Q9958 Hocm <=149 mg/ml iodine, 1ml 51
Q9959 Hocm 150-199mg/ml iodine,1ml 51
Q9960 Hocm 200-249mg/ml iodine,1ml 51
Q9961 Hocm 250-299mg/ml iodine,1ml 51
Q9962 Hocm 300-349mg/ml iodine,1ml 51
Q9963 Hocm 350-399mg/ml iodine,1ml 51
Q9964 Hocm>= 400mg/ml iodine, 1ml 51
Q9965 Locm 100-199mg/ml iodine,1ml 51
Q9966 Locm 200-299mg/ml iodine,1ml 51
Q9967 Locm 300-399mg/ml iodine,1ml 51
Q9968 Visualization adjunct 51
Q9982 Flutemetamol f18 diagnostic 00
Q9983 Florbetaben f18 diagnostic 00
Q9991 Buprenorph xr 100 mg or less 51
Q9992 Buprenorphine xr over 100 mg 51
Q9996 Ustekinumab- ttwe sub cu inj 51
Q9997 Ustekinumab-ttwe iv inj 1 mg 51
Q9998 Inj ustekinumab-aekn, 1 mg 51
Q9999 Inj ustekinumab-aauz 1 mg 51

Last reviewed: September 2026