2016 Table Of Drugs - Centers For Medicare & Medicaid Services

Transcription

2016 Table of DrugsIA - Intra-arterial administrationIV - Intravenous administrationIM - Intramuscular administrationIT - IntrathecalSC - Subcutaneous administrationINH - Administration by inhaled solutionVAR - Various routes of administrationOTH - Other routes of administrationORAL - Administered orallyIntravenous administration includes all methods, such as gravity infusion, injections, and timedpushes. The ‘VAR’ posting denotes various routes of administration and is used for drugs that arecommonly administered into joints, cavities, tissues, or topical applications, in addition to otherparenteral administrations. Listings posted with ‘OTH’ indicate other administration methods, suchas suppositories or catheter injections.AAbataceptAbbokinase, see UrokinaseAbbokinase, Open Cath, see UrokinaseAbciximabAbelcet, see Amphotericin B Lipid ComplexABLC, see Amphotericin BAbobotulinumtoxintypeAAcetaminophenAcetazolamide sodiumAcetylcysteine, injectionAcetylcysteine, unit dose formAchromycin, see TetracyclineActemra, see TocilizumabACTH, see Corticotropin10 mgIVJ012910 mgIVJ01305 units10 mgup to 500 mg100 mgper gramIMIVIM, IVIVINHJ0586J0131J1120J0132J7604,J76081

Acthar, see CorticotropinActimmune, see Interferon gamma 1-BActivase, see Alteplase recombinantAcyclovir5 mgAdalimumab20 mgAdcetis, see Brentuximab VedotinAdenocard, see AdenosineAdenoscan, see AdenosineAdenosine1 mgAdo-trastuzumab Emtansine1 mgAdrenalin Chloride, see Adrenalin, epinephrineAdrenalin, epinephrine0.1 mgAdriamycin PFS, see Doxorubicin HClAdriamycin RDF, see Doxorubicin HClAdrucil, see FluorouracilAflibercept1 mgAgalsidase beta1 mgAggrastat, see Tirofiban hydrochlorideA-hydroCort, see Hydrocortisone sodium phosphateAkineton, see BiperidenAlatrofloxacin mesylate, injection100 mgAlbuterol0.5 mgAlbuterol, concentrated form1 mgAlbuterol, unit dose form1 mgAldesleukinper single use vialAldomet, see Methyldopate HClAlefacept0.5 mgAlferon N, see Interferon alfa-n3Algluceraseper 10 unitsAlglucosidase alfa10 mgAlkaban-AQ, see Vinblastine sulfateAlkeran, see Melphalan, oralAlpha 1-proteinase inhibitor, human10 mgAlphanateAlprostadil, injection1.25 mcgAlprostadil, urethral suppositoryAlteplase recombinant1 mgAlupent, see Metaproterenol sulfate or Metaproterenol, compoundedAmcort, see Triamcinolone diacetateA-methaPred, see Methylprednisolone sodium succinateAmgen, see Interferon alphacon-1Amifostine500 mgAmikacin sulfate100 mgAminolevalinic acid Hclunit dose (354 mg)Aminolevulinate1 gm2SCJ0133J0135IVIVJ0153J9354SC, IMJ0171OTHIVJ0178J0180IVINHINHINHIM, IVJ0200J7620J7610, J7611J7609, J7613J9015IM, IVJ0215IVIVJ0205J0220, J0221IVJ0256, 8J7308J7309

Aminophylline/Aminophyllinup to 250 mgAmiodarone HCl30 mgAmitriptyline HClup to 20 mgAmobarbitalup to 125 mgAmphocin, see Amphotericin BAmphotericin B50 mgAmphotericin B, lipid complex10 mgAmpicillin sodiumup to 500 mgAmpicillin sodium/sulbactam sodiumper 1.5 gmAmygdalin, see Laetrile, Amygdalin, vitamin B-17Amytal, see AmobarbitalAnabolin LA 100, see Nandrolone decanoateAnadulafungin1 mgAnascorp, see Centruroides Immune F(ab)Ancef, see Cefazolin sodiumAndrest 90-4, see Testosterone enanthate and estradiol valerateAndro-Cyp, see Testosterone cypionateAndro-Cyp 200, see Testosterone cypionateAndro L.A. 200, see Testosterone enanthateAndro-Estro 90-4, see Testosterone enanthate and estradiol valerateAndro/Fem, see Testosterone cypionate and estradiol cypionateAndrogyn L.A., see Testosterone enanthate and estradiol valerateAndrolone-50, see Nandrolone phenpropionateAndrolone-D 100, see Nandrolone decanoateAndronaq-50, see Testosterone suspensionAndronaq-LA, see Testosterone cypionateAndronate-200, see Testosterone cypionateAndronate-100, see Testosterone cypionateAndropository 100, see Testosterone enanthateAndryl 200, see Testosterone enanthateAnectine, see Succinylcholine chlorideAnergan 25, see Promethazine HClAnergan 50, see Promethazine HClAnistreplase30 unitsAnti-Inhibitorper IUAntispas, see Dicyclomine HClAntithrombin III (human)per IUAntithrombin recombinant50 IUAnzemet, see Dolasetron mesylate injectionA.P.L., see Chorionic gonadotropinApomorphine Hydrochloride1 mgApresoline, see Hydralazine HClAprotinin10,000 kiuAquaMEPHYTON, see Vitamin K3IVIVIMIM, IVJ0280J0282J1320J0300IVIVIM, IVIM, VIVJ7197J7196SCJ0364J0365

Aralen, see Chloroquine HClAramine, see MetaraminolAranesp, see Darbepoetin AlfaArbutamine1 mgArcalyst, see RilanoceptAredia, see Pamidronate disodiumArfonad, see Trimethaphan camsylateArformoterol tartrate15 mcgAridol, see MannitolAripiprazole0.25 mgAripiprazole, extended release1 mgAristocort Forte, see Triamcinolone diacetateAristocort Intralesional, see Triamcinolone diacetateAristospan Intra-Articular, see Triamcinolone hexacetonideAristospan Intralesional, see Triamcinolone hexacetonideArrestin, see Trimethobenzamide HClArsenic trioxide1 mgArzerra, see OfatumumabAsparaginase1,000 units10,000 unitsAstramorph PF, see Morphine sulfateAtgam, see Lymphocyte immune globulinAtivan, see LorazepamAtropine, concentrated formper mgAtropine, unit dose formper mgAtropine sulfate0.01 mgAtrovent, see Ipratropium bromideAtryn, see Antithrombin recombinantAurothioglucoseup to 50 mgAutologous cultured chondrocytes implantAutoplex T, see Hemophilia clotting factorsAvonex, see Interferon beta-1aAzacitidine1 mgAzathioprine50 mgAzathioprine, parenteral100 mgAzithromycin, dihydrate1 gmAzithromycin, injection500 mgIVJ0395INHJ7605IMINJJ0400J0401IVJ9017IV, IMIV, IMJ9019J9020INHINHIV, IM, fen for intrathecal trialBactocill, see Oxacillin sodiumBAL in oil, see DimercaprolBanflex, see Orphenadrine citrate10 mg50 mcg4

BasiliximabBCG (Bacillus Calmette and Guérin), live20 mgper vialinstillationBeclomethasone inhalation solution, unit dose form per mgBelatacept1 mgBelimumab10 mgBelinostat10 mgBena-D 10, see Diphenhydramine HClBena-D 50, see Diphenhydramine HClBenadryl, see Diphenhydramine HClBenahist 10, see Diphenhydramine HClBenahist 50, see Diphenhydramine HClBen-Allergin-50, see Diphenhydramine HClBendamustine HCl1 mgBenefix, see Factor IX, recombinantBenlysta, see BelimumabBenoject-10, see Diphenhydramine HClBenoject-50, see Diphenhydramine HClBentyl, see DicyclomineBenztropine mesylateper 1 mgBerinert, see C-1 esterase inhibitorBerubigen, see Vitamin B-12 cyanocobalaminBeta amyloidper study doseBetalin 12, see Vitamin B-12 cyanocobalaminBetameth, see Betamethasone sodium phosphateBetamethasone acetate& betamethasone sodium phosphateper 3 mgBetamethasone inhalation solution, unit dose form per mgBetaseron, see Interferon beta-1bBethanechol chlorideup to 5 mgBevacizumab10 mgBicillin L-A, see Penicillin G benzathineBicillin C-R 900/300, see Penicillin G procaine and penicillin GbenzathineBicillin C-R, see Penicillin G benzathine and penicillin G procaineBiCNU, see CarmustineBiperiden lactateper 5 mgBitolterol mesylate,concentrated formper mgBitolterol mesylate,unit dose formper mgBivalirudin1 mgBlenoxane, see Bleomycin sulfateBleomycin sulfate15 unitsBlinatumomab1 microgramBortezomib0.1 mgBotox, see J0490J9032IVJ9033IM, IVJ0515OTHA9599IMINHJ0702J7624SCIVJ0520J9035IM, IVINHINHIVJ0190J7628J7629J0583IM, IV, SCIVIVJ9040J9039J9041

Brentuximab Vedotin1 mgBrethine, see Terbutaline sulfate or Terbutaline, compoundedBricanyl Subcutaneous, see Terbutaline sulfateBrompheniramine maleateper 10 mgBronkephrine, see Ethylnorepinephrine HClBronkosol, see Isoetharine HClBudesonide inhalation solution, concentrated form0.25 mgBudesonide inhalation solution, unit dose form0.5 mgBuprenorphine Hydrochloride0.1 mgBuprenorphine/Naloxone1 mg 3 mg 3 mg but 6 mg 6 mg but 10 mg 10 mgBusulfan1 mgBusulfan2 mgButorphanol tartrate1 mgIVJ9042IM, SC, IVJ0945INHINHIMORALORALORALORALORALIVORALJ7633, J7634J7626, IVIVORALJ0596-J0598J9043J8515IVJ0706SC, IMIMJ0630J0636IVIM, 40IVJ9045CC1 Esterase Inhibitor10 unitsCabazitaxel1 mgCabergoline.25 mgCafcit, see Caffeine citrateCaffeine citrate5 mgCaine-1, see Lidocaine HclCaine-2, see Lidocaine HClCalcijex, see CalcitriolCalcimar, see Calcitonin-salmonCalcitonin-salmonup to 400 unitsCalcitriol0.1 mcgCalcium Disodium Versenate, see Edetate calcium disodiumCalcium gluconateper 10 mlCalcium glycerophosphate & calcium lactateper 10 mlCaldolor, see IbuprofenCalphosan, see Calcium glycerophosphate and calcium lactateCamptosar, see IrinotecanCanakinumab1 mgCapecitabine150 mg500 mgCapsaicin patchper sq cmCarbidopa 5 mg/levodopa 20 mg enteral suspensionCarbocaine with Neo-Cobefrin, see MepivacaineCarbocaine, see MepivacaineCarboplatin50 mg6

Carfilzomib1 mgIVCarmustine100 mgIVCarnitor, see LevocarnitineCarticel, see Autologous cultured chondrocytesCaspofungin acetate5 mgIVCayston, see AztreonamCefadyl, see Cephapirin SodiumCefazolin sodium500 mgIV, IMCefepime hydrochloride500 mgIVCefizox, see Ceftizoxime sodiumCefotaxime sodiumper 1 gIV, IMCefoxitin sodium1gIV, IMCeftaroline fosamil1 mgCeftazidimeper 500 mgIM, IVCeftazidime and avibactam0.5 g/0.125 gIVCeftizoxime sodiumper 500 mgIV, IMCeftriaxone sodiumper 250 mgIV, IMCeftolozane 50 mg and tazobactam 25 mgIVCefuroxime sodium, sterileper 750 mgIM, IVCelestone Soluspan, see Betamethasone acetateand betamethasone sodium phosphateCellCept, see Mycophenolate mofetilCel-U-Jec, see Betamethasone sodium phosphateCenacort Forte, see Triamcinolone diacetateCenacort A-40, see Triamcinolone acetonideCentruroides Immune F(ab)up to 120 mgIVCephalothin sodiumup to 1 gIM, IVCephapirin sodiumup to 1 gIV, IMCeredase, see AlgluceraseCertolizumab pegol1 mgSCCerubidine, see Daunorubicin HClCetuximab10 mgIVChealamide, see Endrate ethylenediamine-tetra-acetic acidChloramphenicol sodium succinateup to 1 gIVChlordiazepoxide HClup to 100 mgIM, IVChloromycetin Sodium Succinate, see Chloramphenicol sodium succinateChloroprocaine HClper 30 mlVARChlorpromazine5 mgORALChloroquine HClup to 250 mgIMChlorothiazide sodiumper 500 mgIVChlorpromazine HClup to 50 mgIM, IVChorex-5, see Chorionic gonadotropinChorex-10, see Chorionic gonadotropinChorignon, see Chorionic gonadotropinChorionic gonadotropinper 1,000 USP 055J0720J1990J2400Q0161J0390J1205J3230J0725

Choron 10, see Chorionic gonadotropinCidofovir375 mgCilastatin sodium, imipenemper 250 mgCimzia, see Certolizumab pegolCinryze, see C1 Esterase InhibitorCipro IV, see CiprofloxacinCiprofloxacin200 mgCisplatin, powder or solutionper 10 mgCladribineper mgClaforan, see Cefotaxime sodiumClofarabine1 mgClonidine Hydrochloride1 mgCobex, see Vitamin B-12 cyanocobalaminCodeine phosphateper 30 mgCodimal-A, see Brompheniramine maleateCogentin, see Benztropine mesylateCollagenase, Clostridium Histolyticum0.01 mgColchicineper 1 mgColistimethate sodiumup to 150 mgColy-Mycin M, see Colistimethate sodiumCompa-Z, see ProchlorperazineCompazine, see ProchlorperazineCompounded drug, not otherwise classifiedCophene-B, see Brompheniramine maleateCopper contraceptive, intrauterineCordarone, see Amiodarone HClCorgonject-5, see Chorionic gonadotropinCorticorelin ovine triflutate1 mcgCorticotropinup to 40 unitsCortrosyn, see CosyntropinCosmegen, see DactinomycinCosyntropinper 0.25 mgCotranzine, see ProchlorperazineCrofab, see Crotalidae Polyvalent Immune FabCromolyn sodium, unit dose formper 10 mgCrotalidae Polyvalent Immune Fabup to 1 gramCrysticillin 300 A.S., see Penicillin G procaineCrysticillin 600 A.S., see Penicillin G procaineCyclophosphamide100 mgCyclophosphamide, oral25 mgCyclosporine, oral25 mg100 mgCyclosporine, parenteral250 mgCytarabine100 mgCytarabine liposome10 mg8IVIV, 735IM, IV, SCJ0745OTHIVIM, IVJ0775J0760J0770J7999OTHJ7300IV, IM, SCJ0795J0800IM, IVJ0833, J0834INHIVJ7631, J7632J0840IVORALORALORALIVSC, IVITJ9070J8530J7515J7502J7516J9100J9098

Cytomegalovirus immune globulin intravenous(human)per vialCytosar-U, see CytarabineCytovene, see Ganciclovir sodiumCytoxan, see Cyclophosphamide; cyclophosphamide, lyophilized; andcyclophosphamide, oralIVJ0850DD-5-W, infusion1000 ccIVJ7070Dacarbazine100 mgIVJ9130Daclizumab25 mgIVJ7513Dactinomycin0.5 mgIVJ9120Dalalone, see Dexamethasone sodium phosphateDalalone L.A., see Dexamethasone acetateDalbavancin5 mgIVJ0875Dalteparin sodiumper 2500 IUSCJ1645Daptomycin1 mgIVJ0878Darbepoetin Alfa1 mcgIV, SCJ0881, J0882Daunorubicin citrate, liposomal10 mgIVJ9151formulationDaunorubicin HCl10 mgIVJ9150Daunoxome, see Daunorubicin citrateDDAVP, see Desmopressin acetateDecadron Phosphate, see Dexamethasone sodium phosphateDecadron, see Dexamethasone sodium phosphateDecadron-LA, see Dexamethasone acetateDeca-Durabolin, see Nandrolone decanoateDecaject, see Dexamethasone sodium phosphateDecaject-L.A., see Dexamethasone acetateDecitabine1 mgIVJ0894Decolone-50, see Nandrolone decanoateDecolone-100, see Nandrolone decanoateDe-Comberol, see Testosterone cypionate and estradiol cypionateDeferoxamine mesylate500 mgIM, SC, IVJ0895Degarelix1 mgSCJ9155Dehist, see Brompheniramine maleateDeladumone OB, see Testosterone enanthate and estradiol valerateDeladumone, see Testosterone enanthate and estradiol valerateDelatest, see Testosterone enanthateDelatestadiol, see Testosterone enanthate and estradiol valerateDelatestryl, see Testosterone enanthateDelta-Cortef, see Prednisolone, oralDelestrogen, see Estradiol valerateDemadex, see TorsemideDemerol HCl, see Meperidine HClDenileukin diftitox300 mcgIVJ91609

Denosumab1 mgSCDepAndro 100, see Testosterone cypionateDepAndro 200, see Testosterone cypionateDepAndrogyn, see Testosterone cypionate and estradiol cypionateDepGynogen, see Depo-estradiol cypionateDepMedalone 40, see Methylprednisolone acetateDepMedalone 80, see Methylprednisolone acetateDepo-estradiol cypionateup to 5 mgIMDepogen, see Depo-estradiol cypionateDepoject, see Methyprednisolone acetateDepo-Medrol, see Methylprednisolone acetateDepopred-40, see Methylprednisolone acetateDepopred-80, see Methylprednisolone acetateDepo-Provera, see Medroxyprogesterone acetateDepotest, see Testosterone cypionateDepo-Testadiol, see Testosterone cypionate and estradiol cypionateDepotestogen, see Testosterone cypionate and estradiol cypionateDepo-Testosterone, see Testosterone cypionateDesferal Mesylate, see Deferoxamine mesylateDesmopressin acetate1 mcgIV, SCDexacen LA-8, see Dexamethasone acetateDexacen-4, see Dexamethasone sodium phosphateDexamethasone, concentrated formper mgINHDexamethasone,unit formper mgINHDexamethasone, intravitreal implant0.1 mgOTHDexamethasone, oral0.25 mgORALDexamethasone acetate1 mgIMDexamethasone sodium phosphate1 mgIM, IV, OTHDexasone, see Dexamethasone sodium phosphateDexasone L.A., see Dexamethasone acetateDexferrum, see Iron DextranDexone, see Dexamethasone sodium phosphateDexone LA, see Dexamethasone acetateDexrazoxane hydrochloride250 mgIVDextran 40500 mlIVDextran 75500 mlIVDextrose 5%/normal saline solution,500 ml 1 unitIVDextrose/water (5%)500 ml 1 unitIVD.H.E. 45, see DihydroergotamineDiamox, se

2016 Table of Drugs IA - Intra-arterial administration IV - Intravenous administration IM - Intramuscular administration IT - Intrathecal SC - Subcutaneous administration INH - Administration by inhaled solution VAR - Various routes of administration