LCD/NCD Portal

Medications

 

Part B

 

L29051 ABATACEPT

 

L29054 ALEFACEPT *

 

L29062 ATGAM (LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN (EQUINE)

 

L29096 CEREDASE/CEREZYME

 

L29127 CYTOMEGALOVIRUS IMMUNE GLOBULIN (HUMAN), INTRAVENOUS (CMV-IGIV) *

 

L29168 ERYTHROPOIESIS STIMULATING AGENTS

 

L29174 FERRLECIT® AND VENOFER®

 

L29180 G-CSF (FILGRASTIM, NEUPOGEN®)

 

L29181 GANCICLOVIR AND CIDOFOVIR

 

L29187 HEMOPHILIA CLOTTING FACTORS

 

L29198 INFLIXIMAB (REMICADE TM)

 

L29202 INTERFERON

 

L29205 INTRAVENOUS IMMUNE GLOBULIN

 

L29215 LUTEINIZING HORMONE-RELEASING HORMONE (LHRH) ANALOGS

 

L29216 MACUGEN (PEGAPTANIB SODIUM INJECTION)

 

L29226 METASTRON C STRONTIUM-89 CHLORIDE

 

L29240 OMALIZUMAB (XOLAIR®)

 

L29250 PAMIDRONATE (AREDIA®, APD)

 

L29266 RANIBIZUMAB (LUCENTIS ®)

 

L29270 RHO (D) IMMUNE GLOBULIN INTRAVENOUS

 

L29275 SARGRAMOSTIM (GM-CSF, LEUKINE®)

 

L29287 TESTOSTERONE CYPIONATE AND TESTOSTERONE ENANTHATE *

 

L29312 ZOLEDRONIC ACID *

 

L29959 INTRAVITREAL BEVACIZUMAB (AVASTIN®)

 

L30874 PLERIXAFOR (MOZOBIL ®)

 

L30878 ROMIPLOSTIM (NPLATE ®)

 

L32094 LABEL AND OFF-LABEL COVERAGE OF OUTPATIENT DRUGS AND BIOLOGICALS

 

L33002 TESTOSTERONE PELLETS (TESTOPEL®) *

 

Part A

 

L28754 ABATACEPT

 

L28760 ALEFACEPT *

 

L28779 ATGAM (LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN (EQUINE)

 

L28795 CEREDASE/CEREZYME

 

L28812 CYTOMEGALOVIRUS IMMUNE GLOBULIN (HUMAN), INTRAVENOUS (CMV-IGIV) *

 

L28836 ERYTHROPOIESIS STIMULATING AGENTS

 

L28840 FERRLECIT® AND VENOFER®

 

L28845 G-CSF (FILGRASTIM, NEUPOGEN®)

 

L28846 GANCICLOVIR AND CIDOFOVIR

 

L28851 HEMOPHILIA CLOTTING FACTORS

 

L28890 INFLIXIMAB (REMICADE TM)

 

L28895 INTRAVENOUS IMMUNE GLOBULIN

 

L28901 LUTEINIZING HORMONE-RELEASING HORMONE (LHRH) ANALOGS

 

L28944 PAMIDRONATE (AREDIA®, APD)

 

L28977 RANIBIZUMAB (LUCENTIS ®)

 

L28979 RHO (D) IMMUNE GLOBULIN INTRAVENOUS

 

L28981 SARGRAMOSTIM (GM-CSF, LEUKINE®)

 

L28990 TESTOSTERONE CYPIONATE AND TESTOSTERONE ENANTHATE *

 

L29007 VITAMIN D ANALOGS IN CHRONIC RENAL DISEASE *

 

L29009 ZOLEDRONIC ACID *

 

L29933 INTRAVITREAL BEVACIZUMAB (AVASTIN®)

 

L30872 PLERIXAFOR (MOZOBIL ®)

 

L30876 ROMIPLOSTIM (NPLATE ®)

 

L33004 TESTOSTERONE PELLETS (TESTOPEL®) *

 

NCDs

 

NCD30.7 LAETRILE AND RELATED SUBSTANCES

 

NCD40.7 OUTPATIENT INTRAVENOUS INSULIN TREATMENT

 

NCD80.3 PHOTOSENSITIVE DRUGS

 

NCD110.3 ANTI-INHIBITOR COAGULANT COMPLEX (AICC)

 

NCD110.9 ANTIGENS PREPARED FOR SUBLINGUAL ADMINISTRATION

 

NCD110.10 INTRAVENOUS IRON THERAPY

 

NCD110.17 ANTI-CANCER CHEMOTHERAPY FOR COLORECTAL CANCER

 

NCD110.18 APREPITANT FOR CHEMOTHERAPY-INDUCED EMESIS

 

NCD150.6 VITAMIN B12 INJECTIONS TO STRENGTHEN TENDONS, LIGAMENTS, ETC., OF THE FOOT

 

NCD160.17 L-DOPA

 

NCD200.1 NESIRITIDE FOR TREATMENT OF HEART FAILURE PATIENTS