Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump

Injection, cerliponase alfa, 1 mg

Injection, c-1 esterase inhibitor (human), haegarda, 10 units

Injection, triptorelin extended release, 3.75 mg

Injection, obinutuzumab, 10 mg

Injection, elosulfase alfa, 1mg

Injection, testosterone undecanoate, 1 mg

Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine

Injection, ramucirumab, 5 mg

Injection, vedolizumab, 1 mg

Injection, pembrolizumab, 1 mg

Injection, inotuzumab ozogamicin, 0.1 mg

Injection, guselkumab, 1 mg

Injection, copanlisib, 1 mg

Lutetium lu 177, dotatate, therapeutic, 1 mci

Injection, voretigene neparvovec-rzyl, 1 billion vector genome

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Injection, dexamethasone 9%, intraocular, 1 mcg

Injection, aripiprazole lauroxil (aristada initio), 1 mg

Injection, patisiran, 0.1 mg

Injection, risperidone (perseris), 0.5 mg

Injection, mogamulizumab-kpkc, 1 mg

Injection, plazomicin, 5 mg

Injection, fremanezumab-vfrm, 1mg

Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg

Injection, bendamustine hcl (belrapzo), 1 mg

Injection, levoleucovorin, 1 mg

Injection, cemiplimab-rwlc, 1 mg

Injection, moxetumomab pasudotox-tdfk, 0.01 mg

Cocaine hydrochloride nasal solution for topical administration, 1 mg

Injection, caplacizumab-yhdp, 1 mg

Dexamethasone, lacrimal ophthalmic insert, 0.1 mg

Injection, tagraxofusp-erzs, 10 mcg

Injection, emapalumab-lzsg, 1 mg

Injection, omadacycline, 1 mg

Injection, ravulizumab-cwvz, 10 mg

Injection, lefamulin (xenleta), 1 mg

Injection, brexanolone, 1mg

Injection, pantoprazole sodium, per vial

Injection, argatroban, per 5 mg

Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity

Factor ix (antihemophilic factor, recombinant), rixubis, per i.u.

Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u.

Factor ix (antihemophilic factor, recombinant), alprolix, per i.u.

Injection, factor viii, fc fusion protein, (recombinant), per i.u.

Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.

Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.

Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.

Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.

Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u.

Injection, clevidipine butyrate, 1 mg

Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml

Injection, lacosamide, 1 mg

Injection, bevacizumab, 0.25 mg

Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose

Lidocaine 70 mg/tetracaine 70 mg, per patch

Injection, bupivacaine liposome, 1 mg

Injection, glucarpidase, 10 units

Puraply, and puraply antimicrobial, any type, per square centimeter

Microporous collagen implantable tube (neuragen nerve guide), per centimeter length

Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length

Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter

Collagen nerve cuff (neuromatrix), per 0.5 centimeter length

Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter

Dermal substitute, native, non-denatured collagen, fetal bovine origin (surgimend collagen matrix), per 0.5 square centimeters

Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc

Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters

Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length

Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc

Skin substitute, integra meshed bilayer wound matrix, per square centimeter

Porcine implant, permacol, per square centimeter

Unclassified drugs or biologicals

Iodine i-131 iobenguane, diagnostic, 1 millicurie

Iodine i-131 iobenguane, therapeutic, 1 millicurie

Injection, ferric carboxymaltose, 1 mg

Injection, belinostat, 10 mg

Injection, dalbavancin, 10 mg

Injection, oritavancin, 10 mg

Injection, c-1 esterase inhibitor (recombinant), ruconest, 10 units

Injection, tedizolid phosphate, 1 mg

Injection, phenylephrine and ketorolac, 4 ml vial

Netupitant 300 mg and palonosetron 0.5 mg, oral

Injection, blinatumomab, 1 mcg

Injection, fluocinolone acetonide intravitreal implant, 0.01 mg

Injection, peramivir, 1 mg

Injection, ceftolozane 50 mg and tazobactam 25 mg

Injection, nivolumab, 1 mg

Injection, pasireotide long acting, 1 mg

Injection, siltuximab, 10 mg

Injection, isavuconazonium sulfate, 1 mg

Injection, sulfur hexafluoride lipid microsphere, per ml

Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries

Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries

Injection, cangrelor, 1 mg

Choline c 11, diagnostic, per study dose

Injection, delafloxacin, 1 mg

Injection, aprepitant, 1 mg

Injection, rolapitant, 0.5 mg

Hyaluronan or derivative, durolane, for intra-articular injection, per dose

Injection, benralizumab, 1 mg

Injection, rituximab and hyaluronidase, 10 mg

Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.

Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg

Injection, aripiprazole lauroxil, 1 mg

Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg

Injection, talimogene laherparepvec, 1 million plaque forming units (pfu)

Injection, mepolizumab, 1 mg

Injection, irinotecan liposome, 1 mg

Injection, necitumumab, 1 mg

Injection, daratumumab, 10 mg

Injection, elotuzumab, 1 mg

Injection, sebelipase alfa, 1 mg

Instillation, ciprofloxacin otic suspension, 6 mg

Injection, trabectedin, 0.1 mg

Injection, reslizumab, 1 mg

Injection, sotalol hydrochloride, 1 mg

Injection, atezolizumab, 10 mg

Injection, eteplirsen, 10 mg

Injection, olaratumab, 10 mg

Injection, granisetron extended release, 0.1 mg

Ustekinumab, for intravenous injection, 1 mg

Injection, conivaptan hydrochloride, 1 mg

Injection, nusinersen, 0.1 mg

Injection, bezlotoxumab, 10 mg

Injection, avelumab, 10 mg

Injection, durvalumab, 10 mg

Injection, edaravone, 1 mg

Injection, ocrelizumab, 1 mg

Loxapine, inhalation powder, 10 mg