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Try CasePilot| Short Descr | Inj, tebentafusp-tebn, 1 mcg | Related Drugs | KIMMTRAK | Coverage | Carrier Priced | Pricing Indicator(s) | 53 – Statute | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | O1D – Chemotherapy | TOS Code(s) | 1 – Medical care | Added Date | 7/1/2022 | Termination Date | 9/30/2022 | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
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| 2023-01-01 | Deleted | First appearance of code deletion in codebook. |
| 2022-09-30 | Deleted | Code deleted. See J9274. |
| 2022-07-01 | Added | Code added. |
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