| | | 4712 | Abatacept(Orencia®)forInjectionforIntravenousUseMA08.028i | Pharmacy (08) | MA08.028i | MA08.028 | 81aa888e-296c-422d-8ba8-e81243f8f744 | Abatacept (Orencia®) for Injection for Intravenous Use | Abatacept (Orencia®) for Injection for Intravenous Use | {"4713": {"Id":4713,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":7523,"PolicyAttachmentPageName":"318fe192-3131-44ee-b3d3-7f823167322c"},} | |
| | | 5258 | AbortionMA11.010b | Surgery (11) | MA11.010b | MA11.010 | 97edeed7-c66a-4637-8052-16aaf9a6fc9e | Abortion | Abortion | | |
| | | 5210 | AcupunctureMA12.004c | Miscellaneous (12) | MA12.004c | MA12.004 | 17d506eb-c5fb-4488-b959-a4e75880d2e0 | Acupuncture | Acupuncture | {"5211": {"Id":5211,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Acupuncture","MPPolicyAttachmentInternalSourceId":8418,"PolicyAttachmentPageName":"e10de614-83bd-4b63-bb20-a8345d46e2de"},} | |
| | | 4632 | AcuteCareFacilityInpatientTransfersMA12.003b | Miscellaneous (12) | MA12.003b | MA12.003 | cd466655-0ef1-4249-9599-28e5a0e0a86e | Acute Care Facility Inpatient Transfers | Acute Care Facility Inpatient Transfers | | |
| | | 5272 | Ado-TrastuzumabEmtansine(Kadcyla®)MA08.066g | Pharmacy (08) | MA08.066g | MA08.066 | db6e085d-3e46-4bde-b37c-672c6dcdba72 | Ado-Trastuzumab Emtansine (Kadcyla®) | Ado-Trastuzumab Emtansine (Kadcyla®) | {"5273": {"Id":5273,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":8440,"PolicyAttachmentPageName":"45854213-f098-424b-a721-2312eddd195d"},} | |
| | | 4316 | Agalsidasebeta(Fabrazyme®)MA08.033c | Pharmacy (08) | MA08.033c | MA08.033 | 899c9577-2cf3-4cf9-80dd-865bc7bd577d | Agalsidase beta (Fabrazyme®) | Agalsidase beta (Fabrazyme®) | | |
| | | 4546 | AirAmbulanceServicesMA12.007b | Miscellaneous (12) | MA12.007b | MA12.007 | 21b96147-07c3-431a-b6e2-54dcc732d539 | Air Ambulance Services | Air Ambulance Services | | |
| | | 4438 | Alemtuzumab(Lemtrada®)MA08.015d | Pharmacy (08) | MA08.015d | MA08.015 | 8067664a-80c3-4d44-a11e-3ced21699339 | Alemtuzumab (Lemtrada®) | Alemtuzumab (Lemtrada®) | | |
| | | 4476 | Alglucosidasealfa(e.g.,Lumizyme®),Avalglucosidasealfa-ngpt(Nexviazyme®)MA08.036f | Pharmacy (08) | MA08.036f | MA08.036 | 1ae76050-dc9f-4acc-8570-eedd1dd4bb9b | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | | |
| | | 4854 | AllergyImmunotherapyMA07.055d | Medicine (07) | MA07.055d | MA07.055 | 3e070cb9-2526-4b23-bf99-c8aba195b1b2 | Allergy Immunotherapy | Allergy Immunotherapy | | |
| | | 4383 | Alpha1-AntitrypsinTherapy(e.g.,Prolastin-C,AralastNP,Glassia,Zemaira)MA08.050b | Pharmacy (08) | MA08.050b | MA08.050 | 18476a80-146f-492a-bf5d-642fda50dc24 | Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira) | Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira) | | |
| | | 5169 | AlwaysBundledProcedureCodesMA00.026t | Administrative (00) | MA00.026t | MA00.026 | b3cf9f4b-fb97-4491-8229-7e8def8e51ec | Always Bundled Procedure Codes | Always Bundled Procedure Codes | {"5170": {"Id":5170,"MPAttachmentLetter":"B","Title":"Procedures/Services Not Eligible for Separate Reimbursement","MPPolicyAttachmentInternalSourceId":8395,"PolicyAttachmentPageName":"b66a037c-e4d7-4db2-9c08-39db8f04559c"},"5171": {"Id":5171,"MPAttachmentLetter":"C","Title":"Procedures/Services Not Eligible for Reimbursement","MPPolicyAttachmentInternalSourceId":8396,"PolicyAttachmentPageName":"e2ef32b8-5a4e-418f-8258-2b6e9c49fa46"},"5172": {"Id":5172,"MPAttachmentLetter":"A","Title":"Always Bundled Procedures (MPFSD Indicator B)","MPPolicyAttachmentInternalSourceId":8398,"PolicyAttachmentPageName":"b88cc1f0-4adb-48e0-989d-05971e3f74f1"},} | |
| | | 5245 | AmbulatoryBloodPressureMonitoring(ABPM)andHomeBloodPressureMonitoring(HBPM)DevicesMA07.005c | Medicine (07) | MA07.005c | MA07.005 | f1e90256-36b5-4258-a55d-665e0ef0f39b | Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices | Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices | | |
| | | 5058 | AmbulatoryElectrocardiography(AECG)MonitoringandMobileCardiacOutpatientTelemetry(MCOT)MonitoringMA07.026o | Medicine (07) | MA07.026o | MA07.026 | 4bdd0149-1059-400b-918d-be4fb6fd04dd | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | | |
| | | 5048 | Amivantamab-vmjw(Rybrevant™)MA08.148 | Pharmacy (08) | MA08.148 | MA08.148 | 7d71ab86-9ee6-4beb-b10a-1cf9a5c0ef99 | Amivantamab-vmjw (Rybrevant™) | Amivantamab-vmjw (Rybrevant™) | | |
| | | 4756 | AnesthesiaServicesforEpidural,ParavertebralFacetandSacroiliacJointInjectionsforSpinalJointManagementMA01.008b | Anesthesia (01) | MA01.008b | MA01.008 | 23e3aa80-5874-405c-a103-7e45fece45bd | Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management | Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management | {} | |
| | | 4539 | Anifrolumab-fnia(Saphnelo®)MA08.140b | Pharmacy (08) | MA08.140b | MA08.140 | b4d3f597-41f0-492e-b517-a8331717cee3 | Anifrolumab-fnia (Saphnelo®) | Anifrolumab-fnia (Saphnelo®) | | |
| | | 5056 | Ankle-Foot/Knee-Ankle-FootOrthosesMA05.010i | DME (05) | MA05.010i | MA05.010 | e150be66-daf8-4df2-aa35-f88e1318411e | Ankle-Foot/Knee-Ankle-Foot Orthoses | Ankle-Foot/Knee-Ankle-Foot Orthoses | {"5057": {"Id":5057,"MPAttachmentLetter":"A","Title":"HCPCS CODES FOR ANKLE-FOOT/ KNEE-ANKLE FOOT ORTHOSIS","MPPolicyAttachmentInternalSourceId":8179,"PolicyAttachmentPageName":"e433e34f-99de-4355-abab-dbe9031066b6"},} | |
| | | 4398 | AnorectalManometry,Electromyography(EMG)ofAnorectalorUrethralSphincters;BiofeedbackTrainingforPerinealMusclesandAnorectalorUrethralSphinctersMA07.018c | Medicine (07) | MA07.018c | MA07.018 | de604fb8-ee97-41c4-b98a-5bb8b7fb8a4c | Anorectal Manometry, Electromyography (EMG) of Anorectal or Urethral Sphincters; Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters | Anorectal Manometry, Electromyography (EMG) of Anorectal or Urethral Sphincters; Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters | | |
| | | 4981 | ApheresisTherapyMA06.001e | Pathology and Laboratory (06) | MA06.001e | MA06.001 | 39dcf591-f9fc-44f7-bfc4-2d1736f2fd49 | Apheresis Therapy | Apheresis Therapy | | |
| | | 5036 | Apos®biomechanicalshoesystemMA05.070 | DME (05) | MA05.070 | MA05.070 | 03291464-9bff-4c1f-84d2-71221d6cc6bd | Apos® biomechanical shoe system | Apos® biomechanical shoe system | | |
| | | 5214 | ApplicationandRemovalofTattoosMA11.072 | Surgery (11) | MA11.072 | MA11.072 | 2a27f7af-3e2a-4413-932d-11598d28a540 | Application and Removal of Tattoos | Application and Removal of Tattoos | | |
| | | 4137 | AqueousShunts,Microstents,Viscocanalostomy,andCanaloplastyfortheTreatmentofGlaucomaMA11.105j | Surgery (11) | MA11.105j | MA11.105 | df24c7d1-3b2b-41a3-ba0a-d25c9c5e7d70 | Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma | Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma | {"4138": {"Id":4138,"MPAttachmentLetter":"A","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7062,"PolicyAttachmentPageName":"bad39d3e-be8b-4144-b280-a37f967082f1"},} | |
| | | 4884 | ArtificialIntervertebralLumbarDiscInsertionMA11.114b | Surgery (11) | MA11.114b | MA11.114 | 9772efeb-a7bd-4217-ac52-ea05bc5a3d31 | Artificial Intervertebral Lumbar Disc Insertion | Artificial Intervertebral Lumbar Disc Insertion | | |
| | | 4558 | Asparaginaseerwiniachrysanthemi(Erwinaze®),asparaginaseerwiniachrysanthemi(recombinant)-rywn(Rylaze®)MA08.085g | Pharmacy (08) | MA08.085g | MA08.085 | 7d0a7b7f-0ed5-4a94-ab38-982449843b7e | Asparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze®) | Asparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze®) | | |
| | | 4272 | Atezolizumab(Tecentriq®)MA08.127c | Pharmacy (08) | MA08.127c | MA08.127 | 38d9e3e1-1b0d-4386-b60a-9b0787ca330f | Atezolizumab (Tecentriq®) | Atezolizumab (Tecentriq®) | {"4273": {"Id":4273,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":7180,"PolicyAttachmentPageName":"9eff91d7-0b43-4fb4-9ac9-6c07148a0eff"},} | |
| | | 4759 | AutomaticExternalCardioverterDefibrillators(WearableandNonwearable)MA05.005g | DME (05) | MA05.005g | MA05.005 | 50cf8ab2-c1d7-4114-bf48-301031b97b42 | Automatic External Cardioverter Defibrillators (Wearable and Nonwearable) | Automatic External Cardioverter Defibrillators (Wearable and Nonwearable) | {"4760": {"Id":4760,"MPAttachmentLetter":"B","Title":"ICD-10 codes used to represent the Nonwearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":7704,"PolicyAttachmentPageName":"ae96ccb4-e007-4b22-a35a-db16d1e26d31"},"4761": {"Id":4761,"MPAttachmentLetter":"A","Title":"ICD-10 codes used to represent the Wearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":7705,"PolicyAttachmentPageName":"e746d254-5296-4104-8d51-c36caf53222f"},} | |
| | | 4469 | AutonomicNervousSystemTestingMA07.027f | Medicine (07) | MA07.027f | MA07.027 | ff1221f9-30d9-4ac7-bbab-964e32913b1c | Autonomic Nervous System Testing | Autonomic Nervous System Testing | | |
| | | 5156 | Avelumab(Bavencio®)MA08.122c | Pharmacy (08) | MA08.122c | MA08.122 | 214619b7-9453-46b2-8e3d-0e7843183ede | Avelumab (Bavencio®) | Avelumab (Bavencio®) | {"5157": {"Id":5157,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":8158,"PolicyAttachmentPageName":"2f5eef7f-f92d-407b-8800-2152cc73ae38"},} | |
| | | 4250 | BalloonCatheterDilationofSinusOstiaforTreatmentofChronicRhinosinusitisMA11.100e | Surgery (11) | MA11.100e | MA11.100 | 6a0c5929-9fd0-40f2-8aee-a03e3c5d7160 | Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis | Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis | | |
| | | 4436 | Belimumab(Benlysta®)forIntravenousUseMA08.057d | Pharmacy (08) | MA08.057d | MA08.057 | bccd1651-281b-4398-bd5c-64d796fe33fb | Belimumab (Benlysta®) for Intravenous Use | Belimumab (Benlysta®) for Intravenous Use | | |
| | | 4502 | Bevacizumab(Avastin®)andRelatedBiosimilarsForOncologicUseMA08.072m | Pharmacy (08) | MA08.072m | MA08.072 | 46cea12e-7050-4ace-8a7f-113e18bd0426 | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | {"4503": {"Id":4503,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":7281,"PolicyAttachmentPageName":"801fe1a9-7997-4d08-9710-3e524241440b"},"4504": {"Id":4504,"MPAttachmentLetter":"B","Title":"ICD 10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":7323,"PolicyAttachmentPageName":"ad90e584-84ce-4f28-8798-8e3380ae2f1f"},} | |
| | | 4964 | BillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedwithinaFacilityoronaFacilityCampusMA00.037l | Administrative (00) | MA00.037l | MA00.037 | df2725e5-51fc-4d42-95c9-22377801776d | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | {"4965": {"Id":4965,"MPAttachmentLetter":"A","Title":"Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus - CPT/HCPCS Codes","MPPolicyAttachmentInternalSourceId":7909,"PolicyAttachmentPageName":"3471875c-7222-4749-bf82-8cc0c2280af2"},} | |
| | | 4276 | BiofeedbackTherapyMA07.010a | Medicine (07) | MA07.010a | MA07.010 | 186e43b9-48ee-4ef3-842d-adf5eef12376 | Biofeedback Therapy | Biofeedback Therapy | | |
| | | 4719 | BioimpedancefortheDetectionofLymphedemaMA07.052 | Medicine (07) | MA07.052 | MA07.052 | 1511575d-8683-46df-9aae-8fd9d97cc10d | Bioimpedance for the Detection of Lymphedema | Bioimpedance for the Detection of Lymphedema | | |
| | | 4004 | Blepharoplasty,RepairofBlepharoptosis,RepairofBrowPtosis,andCanthoplasty/CanthopexyMA11.047d | Surgery (11) | MA11.047d | MA11.047 | 471e433d-f780-4d16-882b-1406395273b3 | Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy | Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy | {"4005": {"Id":4005,"MPAttachmentLetter":"A","Title":"ICD-10 Coding","MPPolicyAttachmentInternalSourceId":6998,"PolicyAttachmentPageName":"dacc12f4-b2a3-4a21-9dd1-580964f7c079"},} | |
| | | 4269 | Blinatumomab(Blincyto®)MA08.058f | Pharmacy (08) | MA08.058f | MA08.058 | 03966d42-a58c-417b-ad2a-bd444959368a | Blinatumomab (Blincyto®) | Blinatumomab (Blincyto®) | | |
| | | 5071 | Bone-Anchored(Osseointegrated)HearingAidsandImplantableMiddleEarHearingAidsMA11.049f | Surgery (11) | MA11.049f | MA11.049 | 1bc70177-61e1-4ece-96c4-22262d4cb381 | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | | |
| | | 4820 | BotulinumToxinAgentsMA08.017j | Pharmacy (08) | MA08.017j | MA08.017 | e196fa27-34f5-4e62-98af-922a3647dd39 | Botulinum Toxin Agents | Botulinum Toxin Agents | {"4821": {"Id":4821,"MPAttachmentLetter":"A","Title":"ICD-10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":7745,"PolicyAttachmentPageName":"9bfeffe7-c2cd-4c5c-9ad0-564706dc4b78"},} | |
| | | 5145 | BrentuximabVedotin(Adcetris®)MA08.068i | Pharmacy (08) | MA08.068i | MA08.068 | dd70b2ce-1cc7-48f3-ad08-4bc652df61dc | Brentuximab Vedotin (Adcetris®) | Brentuximab Vedotin (Adcetris®) | {"5146": {"Id":5146,"MPAttachmentLetter":"A","Title":"ICD 10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":7785,"PolicyAttachmentPageName":"0182b661-bf45-4c5d-a186-2e64765891a2"},} | |
| | | 4633 | BronchialValvesMA11.020 | Surgery (11) | MA11.020 | MA11.020 | a709d47e-0945-492c-b064-7ffe02701b0c | Bronchial Valves | Bronchial Valves | | |
| | | 4477 | Burosumab-twza(Crysvita®)MA08.099b | Pharmacy (08) | MA08.099b | MA08.099 | 139fe438-ff72-40f7-98d1-4bfe79daf96e | Burosumab-twza (Crysvita®) | Burosumab-twza (Crysvita®) | | |
| | | 4484 | Canakinumab(Ilaris®)MA08.101b | Pharmacy (08) | MA08.101b | MA08.101 | e823b28a-58d2-4201-8b11-a1e4fd9480f8 | Canakinumab (Ilaris®) | Canakinumab (Ilaris®) | | |
| | | 5185 | CanesandCrutchesMA05.052b | DME (05) | MA05.052b | MA05.052 | ce3cfd1e-4c67-4ca8-817e-690ac71d2f34 | Canes and Crutches | Canes and Crutches | | |
| | | 5204 | CapsuleEndoscopyMA07.022e | Medicine (07) | MA07.022e | MA07.022 | 5fb9f4ac-c527-472a-b667-a78635412888 | Capsule Endoscopy | Capsule Endoscopy | | |
| | | 5267 | CardiacRehabilitation(CR)andIntensiveCardiacRehabilitation(ICR)ProgramsMA10.002f | Rehabilitation Services (10) | MA10.002f | MA10.002 | 0c9b7de9-21a0-4ad0-849c-9b58ef072e42 | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | {"5268": {"Id":5268,"MPAttachmentLetter":"A","Title":"Medically Necessary ICD-10 Codes","MPPolicyAttachmentInternalSourceId":8306,"PolicyAttachmentPageName":"77cc58cd-1a6f-4268-aee2-7d959cc428ab"},} | |
| | | 5173 | CareManagementandCarePlanningServicesMA00.006n | Administrative (00) | MA00.006n | MA00.006 | ef7eca15-41e7-4d18-bb82-5e9138505093 | Care Management and Care Planning Services | Care Management and Care Planning Services | | |
| | | 5054 | Carfilzomib(Kyprolis)MA08.062h | Pharmacy (08) | MA08.062h | MA08.062 | 9ae20d79-ba8d-4ced-abc5-527f69c7c997 | Carfilzomib (Kyprolis) | Carfilzomib (Kyprolis) | | |
| | | 3612 | CastandSplintApplicationsandAssociatedSuppliesMA00.012c | Administrative (00) | MA00.012c | MA00.012 | b86099e5-ed74-4f52-9ab4-c534c779cb23 | Cast and Splint Applications and Associated Supplies | Cast and Splint Applications and Associated Supplies | {"3613": {"Id":3613,"MPAttachmentLetter":"A","Title":"Procedures Related to Cast and Splint Applications and Associated Supplies","MPPolicyAttachmentInternalSourceId":6422,"PolicyAttachmentPageName":"eec4f404-030d-42ce-855c-d06522638dd4"},} | |
| | | 4010 | CataractSurgeryMA11.054d | Surgery (11) | MA11.054d | MA11.054 | 35d53c26-0c5b-4b14-b8b8-a5597e77fe0c | Cataract Surgery | Cataract Surgery | {"4011": {"Id":4011,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":6669,"PolicyAttachmentPageName":"00eafbe0-27dc-4b22-bec7-d83dddcb66d7"},} | |
| | | 4768 | CatheterAblationofCardiacArrhythmiasMA11.060g | Surgery (11) | MA11.060g | MA11.060 | e18335ca-0588-4f80-a184-297223e33223 | Catheter Ablation of Cardiac Arrhythmias | Catheter Ablation of Cardiac Arrhythmias | | |
| | | 4653 | Cemiplimab-rwlc(Libtayo®)MA08.124c | Pharmacy (08) | MA08.124c | MA08.124 | 74f40bc4-a8ec-402a-a1f7-a1329d8a66c8 | Cemiplimab-rwlc (Libtayo®) | Cemiplimab-rwlc (Libtayo®) | | |
| | | 4473 | Cerliponasealfa(Brineura®)MA08.089c | Pharmacy (08) | MA08.089c | MA08.089 | cbcee004-59ba-4f3d-ace3-5dd2bb9e1992 | Cerliponase alfa (Brineura®) | Cerliponase alfa (Brineura®) | | |
| | | 4333 | CervicalTractionDevicesforIn-homeUseMA05.009a | DME (05) | MA05.009a | MA05.009 | 758792dc-b695-4e8f-8010-624a774b081b | Cervical Traction Devices for In-home Use | Cervical Traction Devices for In-home Use | | |
| | | 5235 | Cetuximab(Erbitux®)MA08.031g | Pharmacy (08) | MA08.031g | MA08.031 | 38e8f5e0-eab4-421d-a5b3-807ff85010d8 | Cetuximab (Erbitux®) | Cetuximab (Erbitux®) | {"5236": {"Id":5236,"MPAttachmentLetter":"B","Title":"ICD-10 Codes for Cetuximab (Erbitux®)","MPPolicyAttachmentInternalSourceId":8348,"PolicyAttachmentPageName":"34a06c92-ef49-4d9f-b25f-d1a9fd32765d"},"5237": {"Id":5237,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":8349,"PolicyAttachmentPageName":"e81566f9-1b58-46db-95dc-0da78e048d74"},} | |
| | | 4980 | ChemicalPeelsMA11.103b | Surgery (11) | MA11.103b | MA11.103 | 68af371b-fdac-4133-a97a-bf73d8c4b158 | Chemical Peels | Chemical Peels | | |
| | | 4939 | ChimericAntigenReceptor(CAR)TherapyMA08.093l | Pharmacy (08) | MA08.093l | MA08.093 | d8d1be84-2787-48b6-bb3e-5777c6a2c939 | Chimeric Antigen Receptor (CAR) Therapy | Chimeric Antigen Receptor (CAR) Therapy | {"4940": {"Id":4940,"MPAttachmentLetter":"A","Title":"ICD 10 codes","MPPolicyAttachmentInternalSourceId":7612,"PolicyAttachmentPageName":"461c75c8-c8a7-4f07-86e0-93fcef2ac457"},} | |
| | | 4934 | ChiropracticServicesMA10.004i | Rehabilitation Services (10) | MA10.004i | MA10.004 | 1d244cbe-e372-44f9-ad14-62a9ee25d888 | Chiropractic Services | Chiropractic Services | {} | |
| | | 1368 | Circulating Tumor Cell (CTC) Assay | Pathology and Laboratory (06) | MA06.030 | MA06.030 | F371FB2E48AFB33885257DBE00723399 | Circulating Tumor Cell (CTC) Assay | Circulating Tumor Cell (CTC) Assay | | |
| | | 5149 | CoagulationFactorsMA08.004v | Pharmacy (08) | MA08.004v | MA08.004 | f447005e-abcc-475f-aa45-41bbaa0db95b | Coagulation Factors | Coagulation Factors | | |
| | | 4206 | Cobalamin(VitaminB12),FolicAcid,andHomocysteineTestingMA06.032a | Pathology and Laboratory (06) | MA06.032a | MA06.032 | 08299b3d-e691-4b8a-b760-476b6013cdcf | Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing | Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing | {"4207": {"Id":4207,"MPAttachmentLetter":"A","Title":"ICD 10 CODES FOR MEDICALLY NECESSARY COBALAMIN (VITAMIN B12), FOLIC ACID, AND/OR HOMOCYSTEINE TESTING (CPT CODES 82607, 82746, AND 83090)","MPPolicyAttachmentInternalSourceId":7157,"PolicyAttachmentPageName":"6730a75f-3149-47c6-90ac-aee646ce81f2"},} | |
| | | 4631 | CochlearImplantationMA11.039e | Surgery (11) | MA11.039e | MA11.039 | 4bfe53c3-a7a4-4796-9218-525f38f768ee | Cochlear Implantation | Cochlear Implantation | | |
| | | 5216 | Collagenaseclostridiumhistolyticum(Xiaflex®),collagenaseclostridiumhistolyticum-aaes(Qwo®)MA08.128 | Pharmacy (08) | MA08.128 | MA08.128 | a7b81ecf-cefa-42a8-aa7c-f728507035ba | Collagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo®) | Collagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo®) | | |
| | | 5199 | CommodeChairsMA05.036b | DME (05) | MA05.036b | MA05.036 | 6536528d-3a29-42cc-a5ba-3bdca5c484eb | Commode Chairs | Commode Chairs | | |
| | | 3614 | ComplementaryandIntegrativeHealthServicesMA12.001d | Miscellaneous (12) | MA12.001d | MA12.001 | a62fd0fa-8e7b-4ed1-bb67-fd235c1159f0 | Complementary and Integrative Health Services | Complementary and Integrative Health Services | | |
| | | 4584 | CompleteDecongestiveTherapy(CDT)MA07.042 | Medicine (07) | MA07.042 | MA07.042 | b4e4e763-9995-4651-935b-e382cd5fb5be | Complete Decongestive Therapy (CDT) | Complete Decongestive Therapy (CDT) | | |
| | | 4251 | CompositeTissueAllotransplantationoftheHand(s)andFaceMA11.112 | Surgery (11) | MA11.112 | MA11.112 | df7d7068-6c32-45da-b37f-2e979978b0d5 | Composite Tissue Allotransplantation of the Hand(s) and Face | Composite Tissue Allotransplantation of the Hand(s) and Face | | |
| | | 5196 | CompressionGarmentsMA05.045d | DME (05) | MA05.045d | MA05.045 | cc20f86e-ed64-4e9d-9dfa-9a300af2b384 | Compression Garments | Compression Garments | | |
| | | 4261 | Computer-AidedDetection(CAD)SystemforUsewithChestRadiographsMA09.014a | Radiology (09) | MA09.014a | MA09.014 | 5280f42d-aefd-4364-b335-f20bb8471cff | Computer-Aided Detection (CAD) System for Use with Chest Radiographs | Computer-Aided Detection (CAD) System for Use with Chest Radiographs | | |
| | | 5244 | Computer-AssistedMusculoskeletalSurgicalNavigationalOrthopedicProcedureMA11.088c | Surgery (11) | MA11.088c | MA11.088 | bba5081d-4c80-4f43-bdfa-e81babdc9b90 | Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure | Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure | | |
| | | 4229 | ConsultationServicesMA00.049b | Administrative (00) | MA00.049b | MA00.049 | 50f137b2-f09b-4bba-bf10-c689ad659402 | Consultation Services | Consultation Services | | |
| | | 5292 | ContinuousGlucoseMonitorsandHomeBloodGlucoseMonitorsandSuppliesMA00.002m | Administrative (00) | MA00.002m | MA00.002 | a4539a91-e46c-4779-886b-04db0fc02def | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | {"5293": {"Id":5293,"MPAttachmentLetter":"B","Title":"Implantable Continuous Glucose Monitors (I-CGM)","MPPolicyAttachmentInternalSourceId":8388,"PolicyAttachmentPageName":"98993514-89a4-43d2-9025-78add9473434"},"5294": {"Id":5294,"MPAttachmentLetter":"A","Title":"ICD10: Long-Term Interstitial CGMS (Non-Implantable)","MPPolicyAttachmentInternalSourceId":8389,"PolicyAttachmentPageName":"c34f57cb-e9d8-4cbc-9308-b29762f518b9"},} | |
| | | 4293 | ContrastAgentsUsedinConjunctionwithEchocardiographyMA09.004c | Radiology (09) | MA09.004c | MA09.004 | d647b737-a9b2-45c6-8d24-5a6b333db1e7 | Contrast Agents Used in Conjunction with Echocardiography | Contrast Agents Used in Conjunction with Echocardiography | | |
| | | 4669 | CornealPachymetryUsingUltrasoundMA07.046g | Medicine (07) | MA07.046g | MA07.046 | 8a3160e2-2cd8-48bb-8348-56066ba7c299 | Corneal Pachymetry Using Ultrasound | Corneal Pachymetry Using Ultrasound | {"4670": {"Id":4670,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes Eligible to be Reported for Corneal Pachymetry Using Ultrasound","MPPolicyAttachmentInternalSourceId":7543,"PolicyAttachmentPageName":"f61fb559-401f-4234-b72e-e10ed71b4232"},} | |
| | | 5218 | CosmeticProceduresMA12.009a | Miscellaneous (12) | MA12.009a | MA12.009 | 3d6b55b7-1271-45c2-a667-be77db0458a9 | Cosmetic Procedures | Cosmetic Procedures | | |
| | | 3048 | CoverageofMedicalDevicesMA05.040b | DME (05) | MA05.040b | MA05.040 | 69c3f8a1-1044-489c-869e-7e78dbb55b06 | Coverage of Medical Devices | Coverage of Medical Devices | | |
| | | 5072 | CranialElectrotherapyStimulationMA05.066d | DME (05) | MA05.066d | MA05.066 | 9f9f128c-59e6-472a-b922-feb5034bfe68 | Cranial Electrotherapy Stimulation | Cranial Electrotherapy Stimulation | | |
| | | 4169 | CriteriaforReimbursementofEmergencyRoomServicesMA00.044c | Administrative (00) | MA00.044c | MA00.044 | bd8724e2-053c-46e0-ad5a-4e5dbf9cf587 | Criteria for Reimbursement of Emergency Room Services | Criteria for Reimbursement of Emergency Room Services | | |
| | | 4810 | crizanlizumab-tmca(Adakveo®)MA08.109b | Pharmacy (08) | MA08.109b | MA08.109 | 15a1b743-0c2d-4f22-bb7d-c37c2d029e27 | crizanlizumab-tmca (Adakveo®) | crizanlizumab-tmca (Adakveo®) | | |
| | | 4974 | CryosurgicalAblationoftheProstateGlandMA11.022a | Surgery (11) | MA11.022a | MA11.022 | f26ae49b-8ec6-4683-aaf4-48a783faf22f | Cryosurgical Ablation of the Prostate Gland | Cryosurgical Ablation of the Prostate Gland | | |
| | | 4683 | Daratumumab(Darzalex®),Daratumumab,andHyaluronidase-fihj(DarzalexFaspro®)MA08.079k | Pharmacy (08) | MA08.079k | MA08.079 | 143087a4-01b2-4afb-a001-eb8ba9423773 | Daratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®) | Daratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®) | | |
| | | 4493 | DayRehabilitationMA10.005b | Rehabilitation Services (10) | MA10.005b | MA10.005 | ee92c759-ee9f-4de2-8688-6082eef33136 | Day Rehabilitation | Day Rehabilitation | | |
| | | 4278 | DebridementofMycoticandSymptomaticNon-MycoticHypertrophicToeNailsMA11.014g | Surgery (11) | MA11.014g | MA11.014 | 8aa69314-d990-40ec-a294-8971cc5c5e5b | Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails | Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails | {"4279": {"Id":4279,"MPAttachmentLetter":"E","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (S86.892A - Z79.01), Continued","MPPolicyAttachmentInternalSourceId":7205,"PolicyAttachmentPageName":"1957de27-3b5a-409f-b455-3f1b04cc7e46"},"4280": {"Id":4280,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (A30.0 -E10.21)","MPPolicyAttachmentInternalSourceId":7206,"PolicyAttachmentPageName":"94ee1983-7988-4fe6-a254-86aa041df790"},"4281": {"Id":4281,"MPAttachmentLetter":"D","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (I87.099 - S86.891S), Continued","MPPolicyAttachmentInternalSourceId":7207,"PolicyAttachmentPageName":"efc99947-4c38-4bd5-8a59-f023e5132f48"},"4282": {"Id":4282,"MPAttachmentLetter":"C","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (E13.3513 - I87.093), Continued","MPPolicyAttachmentInternalSourceId":7208,"PolicyAttachmentPageName":"22f0eb11-922b-4f0a-8a0b-c3b947ee5213"},"4283": {"Id":4283,"MPAttachmentLetter":"B","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (E10.22 - E13.3512), Continued","MPPolicyAttachmentInternalSourceId":7209,"PolicyAttachmentPageName":"16a5b6ea-586f-4f36-b28f-7c8b503ded37"},} | |
| | | 5122 | DeepBrainStimulation(DBS)MA11.005h | Surgery (11) | MA11.005h | MA11.005 | dd818e85-f344-4c53-a2d4-1a4aebb6fd88 | Deep Brain Stimulation (DBS) | Deep Brain Stimulation (DBS) | | |
| | | 5154 | Denosumab(Prolia®,Xgeva®),Romosozumab-aqqg(Evenity®)MA08.052l | Pharmacy (08) | MA08.052l | MA08.052 | f02a318c-a818-47ab-a614-46aa61d61896 | Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®) | Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®) | {"5155": {"Id":5155,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes","MPPolicyAttachmentInternalSourceId":8083,"PolicyAttachmentPageName":"6d69e5b4-b782-48d7-b096-7b4920b8e43e"},} | |
| | | 4751 | DermabrasionforRhinophyma,Septoplasty,Rhinoplasty,andSeptorhinoplastyMA11.099d | Surgery (11) | MA11.099d | MA11.099 | af858c6b-1475-4646-9116-3543770cabcc | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | | |
| | | 5004 | DirectAccesstoObstetrics/Gynecology(OB/GYN)ServicesMA00.032f | Administrative (00) | MA00.032f | MA00.032 | 7393357c-6383-4146-9971-34e92357c526 | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | {} | |
| | | 5263 | Dofetilide(Tikosyn®)UseintheInpatientSettingMA08.021c | Pharmacy (08) | MA08.021c | MA08.021 | 01e34de8-b7d9-453b-970c-f5e26b7b36d9 | Dofetilide (Tikosyn®) Use in the Inpatient Setting | Dofetilide (Tikosyn®) Use in the Inpatient Setting | | |
| | | 5274 | Dostarlimab-gxly(Jemperli)MA08.136e | Pharmacy (08) | MA08.136e | MA08.136 | 33c3e42b-4fa6-444d-ad2f-399988971cc5 | Dostarlimab-gxly (Jemperli) | Dostarlimab-gxly (Jemperli) | | |
| | | 4971 | Drug-ElutingBeadsandBlandEmbolizationfortheTreatmentofHepaticMalignanciesMA07.041b | Medicine (07) | MA07.041b | MA07.041 | 08ccc71e-d011-4b15-9c05-434fc1442308 | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | | |
| | | 5165 | DurableMedicalEquipment(DME)MA05.044p | DME (05) | MA05.044p | MA05.044 | a8bed8df-5615-4d27-ac24-74f702417bff | Durable Medical Equipment (DME) | Durable Medical Equipment (DME) | {"5166": {"Id":5166,"MPAttachmentLetter":"B","Title":"Items that Do Not Meet the Definition of Durable Medical Equipment (DME) or Excluded from Coverage by Medicare","MPPolicyAttachmentInternalSourceId":8380,"PolicyAttachmentPageName":"bb5ea6de-4b92-4fa4-a0f9-7aeac279ace5"},"5167": {"Id":5167,"MPAttachmentLetter":"A2","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":8381,"PolicyAttachmentPageName":"baf85e02-3932-4e33-bd89-6d2f681e721a"},"5168": {"Id":5168,"MPAttachmentLetter":"A1","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":8383,"PolicyAttachmentPageName":"d224138b-c1f8-4fde-82c2-e14dcec928b9"},} | |
| | | 4015 | DurableMedicalEquipment(DME)NotSubjecttoaRentaltoPurchaseMaximumMA05.028e | DME (05) | MA05.028e | MA05.028 | 1b12ffb5-60aa-4123-895e-6165136f7204 | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | | |
| | | 4684 | Durvalumab(Imfinzi®)andtremelimumab-act(Imjudo®)MA08.123c | Pharmacy (08) | MA08.123c | MA08.123 | 4b3152da-96b0-4cf1-8b23-032f3ac547dc | Durvalumab (Imfinzi®) and tremelimumab-act (Imjudo®) | Durvalumab (Imfinzi®) and tremelimumab-act (Imjudo®) | {"4685": {"Id":4685,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":7511,"PolicyAttachmentPageName":"b6522973-c8c2-4dff-9673-0e1321414af0"},} | |
| | | 4321 | Eculizumab(Soliris®)andRelatedBiosimilars,Ravulizumab-cwvz(Ultomiris™)MA08.044h | Pharmacy (08) | MA08.044h | MA08.044 | 75362d2f-b4f7-4f18-90c0-e39dc57aaea7 | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) | | |
| | | 5119 | Efgartigimodalfa-fcab(Vyvgart)andefgartigimodalfaandhyaluronidase-qvfc(VyvgartHytrulo)MA08.142c | Pharmacy (08) | MA08.142c | MA08.142 | 32a0494d-89f3-48ca-af9a-b4f7254ff682 | Efgartigimod alfa - fcab (Vyvgart) and efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo) | Efgartigimod alfa - fcab (Vyvgart) and efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo) | | |
| | | 5106 | Eflapegrastim-xnst(Rolvedon™),Pegfilgrastim(Neulasta®)andRelatedBiosimilarsMA08.082k | Pharmacy (08) | MA08.082k | MA08.082 | 60e97141-190f-4cc0-a5a5-3e480d5c22e0 | Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | {"5107": {"Id":5107,"MPAttachmentLetter":"A","Title":"EXAMPLES OF DISEASE SETTINGS AND CHEMOTHERAPY REGIMENS WITH A HIGH (>20%) OR INTERMEDIATE (10-20%) RISK FOR FEBRILE NEUTROPENIA","MPPolicyAttachmentInternalSourceId":7534,"PolicyAttachmentPageName":"95351c3d-c6fa-41de-a0b7-ef928f5aff6b"},} | |
| | | 5212 | ElectricalStimulationandElectromagneticStimulationfortheTreatmentofWoundsMA07.013d | Medicine (07) | MA07.013d | MA07.013 | c835851d-a3e1-4abb-b0c3-e8388227a0ac | Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds | Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds | {"5213": {"Id":5213,"MPAttachmentLetter":"A","Title":"ICD-10 Coding","MPPolicyAttachmentInternalSourceId":8448,"PolicyAttachmentPageName":"94938a3d-a163-4f16-94a9-e7458b8a1e15"},} | |
| | | 4898 | ElectroconvulsiveTherapy(ECT)MA14.001a | Behavioral Health (14) | MA14.001a | MA14.001 | b3df3c46-8422-4101-a5a0-0346f4da00f0 | Electroconvulsive Therapy (ECT) | Electroconvulsive Therapy (ECT) | | |
| | | 4886 | Electromyography(EMG)Studies:NeedleEMG,SurfaceEMG(SEMG)MA07.050k | Medicine (07) | MA07.050k | MA07.050 | f7f69693-100a-49a3-8994-a5924c2ac9e6 | Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG) | Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG) | {"4887": {"Id":4887,"MPAttachmentLetter":"J","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7802,"PolicyAttachmentPageName":"3fbacc76-cba7-4ba4-84ca-1cd751d41ffb"},"4888": {"Id":4888,"MPAttachmentLetter":"K","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7803,"PolicyAttachmentPageName":"fb0b1aaf-dd14-4509-a5ef-34771237874a"},"4889": {"Id":4889,"MPAttachmentLetter":"D","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7804,"PolicyAttachmentPageName":"a414177e-2e33-44c8-89cc-8b640c9f0c25"},"4890": {"Id":4890,"MPAttachmentLetter":"I","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7805,"PolicyAttachmentPageName":"5104fc00-e1d8-4157-b63f-ffea405c4b52"},"4891": {"Id":4891,"MPAttachmentLetter":"H","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7806,"PolicyAttachmentPageName":"11971eff-fefd-4afe-ae57-17b810269e90"},"4892": {"Id":4892,"MPAttachmentLetter":"F","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7807,"PolicyAttachmentPageName":"efdd5e31-d4d3-42d3-a55a-51b61f049b6b"},"4893": {"Id":4893,"MPAttachmentLetter":"E","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7808,"PolicyAttachmentPageName":"2c8b2de4-3e0f-4b28-a628-745bdac2806b"},"4894": {"Id":4894,"MPAttachmentLetter":"G","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7809,"PolicyAttachmentPageName":"e2fd00a1-6451-4655-9700-1cda11ec4176"},"4895": {"Id":4895,"MPAttachmentLetter":"A","Title":"Recommended Guidelines for Electrodiagnostic Studies","MPPolicyAttachmentInternalSourceId":7810,"PolicyAttachmentPageName":"8aa2e360-1288-401c-8293-9ac6d91bb32f"},"4896": {"Id":4896,"MPAttachmentLetter":"B","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7811,"PolicyAttachmentPageName":"a904cc82-fe92-49cf-8584-1a255ea3ebd6"},"4897": {"Id":4897,"MPAttachmentLetter":"C","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7812,"PolicyAttachmentPageName":"64e82729-4b62-4003-85d9-eb5ce5520f8d"},} | |
| | | 4526 | Emapalumab-lzsg(Gamifant®)MA08.104b | Pharmacy (08) | MA08.104b | MA08.104 | d93e61a3-8972-41ac-8749-41a709b851c0 | Emapalumab-lzsg (Gamifant®) | Emapalumab-lzsg (Gamifant®) | | |