|
Q5111 |
 |
Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg
| short | Injection, udenyca 0.5 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 12.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 12.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q5112 |
|
Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg
| short | Inj ontruzant 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
Q5113 |
|
Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg
| short | Inj herzuma 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 120.0 | 3 Date of Service Edit: Clinical | Clinical: Society Comment | | OPH | 120.0 | 3 Date of Service Edit: Clinical | Clinical: Society Comment |
|
|
|
|
Q5114 |
|
Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
| short | Inj ogivri 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
Q5115 |
|
Injection, rituximab-abbs, biosimilar, (truxima), 10 mg
| short | Inj truxima 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
Q5116 |
|
Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
| short | Inj., trazimera, 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
|
|
|
Q5117 |
|
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
| short | Inj., kanjinti, 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
|
|
|
Q5118 |
|
Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg
| short | Inj., zirabev, 10 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
|
|