| J1554 | |
| J1556 | |
| J3590 | |
J1561 | |
J1569 | |
| J1561 | |
J1559 | |
| J1568 | |
| J1568 | |
| J1599 | |
J1459 |
| Actemra | J3262 |
| Actemra | J3262 |
| Actemra | J3262 |
| Aduhelm | J3590 |
| Aduhelm | J3590 |
| Avastin | J9035 |
| Avastin | J9035 |
| Avsola | Q5121 |
| Benlysta | J0490 |
| Benlysta | J0490 |
| Botox 100U (Allergan) | J0585 |
| Botox 200U (Allergan) | J0585 |
| Cimzia | J0717 |
| Cinrize 500U | J0598 |
| Dysport 300U | J0586 |
| Dysport 500U | J0586 |
| Entyvio | J3380 |
| Fabrazyme | J0180 |
| Fabrazyme | J0180 |
| Fasenra | J0517 |
| Inflectra | Q5103 |
| Keytruda | J9271 |
| Krystexxa | J2507 |
| Novoseven | J7189 |
| Nucala | J2182 |
| Ocrevus | J2350 |
| Orencia | J0129 |
| Prolia | J0897 |
| Radicava (per carton) | J1301 |
| Radicava (per carton) - Direct Contract | J1301 |
| Remicade | J1745 |
| Renflexis | Q5104 |
| Rituxan | J9312 |
| Rituxan | J9312 |
| Simponi | J1602 |
| Soliris | J1300 |
| Spinraza | J2326 |
| Stelara IV | J3358 |
| Stelara | J3357 |
| Trogarzo | J1746 |
| Truxima | Q5115 |
| Tysabri DRPSHP | J2323 |
| Xolair | J2357 |
| Volumat MC Agila Infusion Pump | |
| VL ST10-0 | |
| VL ST10-X0 | |
| VL ST02-0 | |
| VL ST02-X0 | |
| VL PN02-1 | |
| VL SP22-0 | |
| VL SP62-1 | |
| VL ON72-1 | |
| VL ON72-X1 | |
| VL PA92-1 | |
| VL PA92-2 | |
| VL PR40-11 | |
| VL SP40-11 | |
| VL PR42-11 | |
| VL PR42-12 | |
| VL PR44-12 | |
| VL PR72-11 | |
| VL SL00-X0 | |
| VL SL00-XP | |
| Sodium Chloride 0.45% Freeflex Inj. Solution 50mL | J7030 |
| Sodium Chloride 0.45% Freeflex Inj. Solution 100mL | J7030 |
| Sodium Chloride 0.45% Freeflex Inj. Solution 250mL | J7030 |
| Sodium Chloride 0.45% Freeflex Inj. Solution 500mL | J7030 |
| Sodium Chloride 0.45% Freeflex Inj. Solution 1000mL | J7030 |
| Sodium Chloride 0.9% Freeflex Inj. Solution 50mL | J7040 |
| Sodium Chloride 0.9% Freeflex Inj. Solution 100mL | J7040 |
| Sodium Chloride 0.9% Freeflex Inj. Solution 250mL | J7040 |
| Sodium Chloride 0.9% Freeflex Inj. Solution 500mL | J7040 |
| Sodium Chloride 0.9% Freeflex Inj. Solution 1000mL | J7040 |
| Sodium Chloride 3.0% Injection, USP 500mL Freeflex | J7050 |
| Dextrose 5% Freeflex Inj, USP 50mL (2.5g) | J7060 |
| Dextrose 5% Freeflex Inj, USP 100mL (5g) | J7060 |
| Dextrose 5% Freeflex Inj, USP 250mL (12.5g) | J7060 |
| Dextrose 5% Freeflex Inj, USP 500mL (25g) | J7060 |
| Dextrose 5% Freeflex Inj, USP 1000mL (50g) | J7060 |
| Dextrose 10% Freeflex Inj, USP 250mL (25g) | J7070 |
| Dextrose 10% Freeflex Inj, USP 500mL (50g) | J7070 |
| Dextrose 10% Freeflex Inj, USP 1000mL (100g) | J7070 |
| Lactated Ringer's Injection, USP 250mL | J7120 |
| Lactated Ringer's Injection, USP 500mL | J7120 |
| Lactated Ringer's Injection, USP 1000mL | J7120 |
| Water Sterile Freeflex Inj, USP 1000 mL |
