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Official Description

Injection, obinutuzumab, 10 mg
Short Descr Injection, obinutuzumab
Related Drugs Gazyva
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(t)
BETOS O1D – Chemotherapy
TOS Code(s) 9 – Other medical items or services
Added Date 4/1/2014
Termination Date 12/31/2014
APC Status Indicator Pass-Through Drugs and Biologicals
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2015-01-01 Deleted Deleted
2014-04-01 Added Added effective 4/1/2014
Code
Description
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