Description - DE Medical Assistance Program

J2001 LIDOCAINE INJECTION 3 $0.02
J2010 LINCOMYCIN INJECTION 5 $0.00
J2020 LINEZOLID INJECTION 5 $0.00
J2050 INJECTION, LIVER, UP TO 20 MCG O $0.00
J2060 LORAZEPAM INJECTION 3 $0.75
J2100 INJECTION, LUMINAL SODIUM, UP TO 12 O $0.00
J2150 MANNITOL INJECTION 3 $0.91
J2160 INJECTION, CYCLIZINE LACTATE, UP TO O $0.00
J2170 MECASERMIN INJECTION 3 $18.78
J2175 MEPERIDINE HYDROCHL /100 MG 3 $0.54
J2180 MEPERIDINE/PROMETHAZINE INJ 6 $0.00
J2185 MEROPENEM 6 $0.00
J2190 INJECTION, MERSALYL WITH THEOPHYLLI O $0.00
J2210 METHYLERGONOVIN MALEATE INJ 5 $0.00
J2220 INJECTION, METHYLANDROSTENEDIOL, AL O $0.00
J2240 METOCURINE IODIDE INJECTION O $0.00
J2248 MICAFUNGIN SODIUM INJECTION 3 $1.12
J2250 INJ MIDAZOLAM HYDROCHLORIDE 3 $0.11
J2260 INJ MILRINONE LACTATE / 5 MG 5 $0.00
J2270 MORPHINE SULFATE INJECTION 3 $0.26
J2271 MORPHINE SO4 INJECTION 100MG 5 $0.00
J2275 MORPHINE SULFATE INJECTION 5 $0.00
J2278 ZICONOTIDE INJECTION 3 $6.50
J2280 INJ, MOXIFLOXACIN 100 MG 6 $0.00
J2300 INJ NALBUPHINE HYDROCHLORIDE 3 $1.55
J2310 INJ NALOXONE HYDROCHLORIDE 3 $4.99
J2315 NALTREXONE, DEPOT FORM 3 $2.14
J2320 NANDROLONE DECANOATE 50 MG 5 $0.00
J2321 NANDROLONE DECANOATE 100 MG 5 $0.00
J2322 NANDROLONE DECANOATE 200 MG 5 $0.00
J2323 NATALIZUMAB INJECTION 3 $8.24
J2324 NESIRITIDE O $0.00
J2325 NESIRITIDE INJECTION 3 $37.97
J2330 THIOTHIXENE INJECTION O $0.00
J2350 NIACINAMIDE/NIACIN INJECTION O $0.00
J2352 OCTREOTIDE ACETATE INJECTION O $0.00
J2353 OCTREOTIDE INJECTION, DEPOT 6 $0.00
J2354 OCTREOTIDE INJ, NON-DEPOT 6 $0.00
J2355 OPRELVEKIN INJECTION 5 $0.00
J2357 OMALIZUMAB INJECTION 3 $19.22
J2360 ORPHENADRINE INJECTION 5 $0.00
J2370 PHENYLEPHRINE HCL INJECTION 5 $0.00
J2400 CHLOROPROCAINE HCL INJECTION 5 $0.00
J2405 ONDANSETRON HCL INJECTION 3 $0.24
J2410 OXYMORPHONE HCL INJECTION 5 $0.00
J2425 PALIFERMIN INJECTION 3 $11.29
J2430 PAMIDRONATE DISODIUM /30 MG 3 $20.36
J2440 PAPAVERIN HCL INJECTION 5 $0.00
J2460 OXYTETRACYCLINE INJECTION 5 $0.00