Download The table below contains examples of Convenience Kits that will not

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts
no text concepts found
Transcript 
The table below contains examples of Convenience Kits that will not be reimbursed based on
Unclassified Drug Payment Policy #10-008. This is not an all-inclusive listing of the Convenience
Kits.
Kit Name
MLK F1 Kit
MLK F2 Kit
MLK F3 Kit
MLK F4 Kit
Mardex-25 Kit
Marbeta-L Kit
Marbeta-25 Kit
Lidolog Kit
Marlido Kit
Marlido-25 Kit
Dexlido Kit
Lidolog Kit
Multi-Specialty Kit
Interarticular Joint Kit
JNT/TUNNEL/ Kit Trigger
Betalido Kit
Bupivilog Kit
Dexalido Kit
Dexalido-M
DoubleDex Kit
Dyural-L
Dyural-LM
Dyural-40
Dyural-80
Ketorocaine-L
Ketorocaine-LM
Physician EZ B12
Physician EZ Joint, Tunnel, Trigger
Physician EZ MPred
Advanced DNA Mediated Collection Kit
Medicated Specimen Collection Kit
Advanced DNA Mediated Collection Kit
Lexitral PharmaPak
DermacinRx Prizopak
Xrylix
IV Infusion CPI
Surgical PharmaPak
SilaPak
Dermacinrx Silapak
NDC Code
76420-0740-01
76420-0742-01
76420-0743-01
76420-0744-01
76420-0810-01
76420-0782-01
76420-0785-01
76420-0760-01
76420-0730-01
76420-0735-01
76420-0767-01
76420-0760-01
76420-0780-01
76420-0770-01
76420-0524-01
76420-0765-01
76420-0720-01
76420-0767-01
76420-0769-01
76420-0766-01
76420-0775-01
76420-0795-01
76420-0750-01
76420-0755-01
76420-0771-01
76420-0772-01
76420-0527-01
76420-0524-01
76420-0520-01
76420-0635-01
45861-0107-01
76420-0620-01
59088-0343-00
59088-0873-00
59088-0365-00
59088-0383-00
59088-0353-00
59088-0367-00
59088-0336-00
Related documents