G0513 Emergency Medical Outpatient Services Labs, X-Rays and Other Tests Preventive Dental Care for Children Maternity Services Medical Care Outpatient Visits Mental Health and Substance Use Treatment - Biologically Based Mental Conditions Mental Health and Substance Use Treatment - Non-Biologically Based Mental Conditions Mental Health and Substance Use Treatment - Alcoholism Treatment Routine Vision Care TMJ Disorder Treatment PROLONG PREV SVCS, FIRST 30M PROLONG PREV SVCS, FIRST 30M
J1568 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy OCTAGAM INJECTION OCTAGAM INJECTION
J1569 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy GAMMAGARD LIQUID INJECTION GAMMAGARD LIQUID INJECTION
J1575 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy HYQVIA 100MG IMMUNEGLOBULIN HYQVIA 100MG IMMUNEGLOBULIN
J1602 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy GOLIMUMAB FOR IV USE 1MG GOLIMUMAB FOR IV USE 1MG
J1610 Ambulance Services Home Health Care Labs, X-Rays and Other Tests Medical Care Outpatient Visits GLUCAGON HYDROCHLORIDE/1 MG GLUCAGON HYDROCHLORIDE/1 MG
J1620 Home Health Care Medical Care Outpatient Visits GONADORELIN HYDROCH/ 100 MCG GONADORELIN HYDROCH/ 100 MCG
J7199 Home Health Care Medical Care Outpatient Visits HEMOPHILIA CLOT FACTOR NOC HEMOPHILIA CLOT FACTOR NOC
J7205 Home Health Care Medical Care Outpatient Visits Prescription Drugs FACTOR VIII FC FUSION RECOMB FACTOR VIII FC FUSION RECOMB