Medications that will require a PA as of 9/3/19
C9399 ANTINEOPLASTIC ENZYME INHIBITORS (IMATINIB)
J8501 APREPITANT ORAL 5 MG
J9017 ARSENIC TRIOXIDE 1 MG
J9025 AZACITIDINE 1 MG INJECTION
J9031 BCG PER INSTILLATION
J9999 BENDAMUSTINE 25MG/ML 4ML
J9040 BLEOMYCIN SULFATE INJECTION
J0594 BUSULFAN 1 MG INJECTION
J0630 CALCITONIN SALMON INJECTION TO 400 UNITS
J9045 CARBOPLATIN INJECTION
J9050 CARMUSTINE INJECTION
J9999 CEMIPLIMAB-RWLC, LIBTAYO INJECTION
J9060 CISPLATIN 10 MG INJECTION
J9065 CLADRIBINE PER 1 MG INJECTION
J9027 CLOFARABINE 1 MG INJECTION
J9100 CYTARABINE 100 MG INJECTION
J9098 CYTARABINE LIPOSOME INJECTION
J9130 DACARBAZINE 100 MG
J9120 DACTINOMYCIN INJECTION
J9150 DAUNORUBICIN INJECTION
J0894 DECITABINE 1 MG INJECTION
J8499 DEFERASIROX ORAL
J0407 DEFERASIROX ORAL DISPERSIBLE
J3490 DEFERIPRONE ORAL
J1190 DEXRAZOXANE HYDROCHLORIDE PER 250 MG INJECTION
J9171 DOCETAXEL INJECTION
J9000 DOXORUBICIN HCL INJECTION
J8597 DRONABINOL ORAL SOLUTION J1790 DROPERIDOL INJECTION
J9176 ELOTUZUMAB INJ 1MG
J9178 EPIRUBICIN HCL 2MG INJECTION
J9179 ERIBULIN MESYLATE INJECTION
J9019 ERWINAZE INJECTION
J9181 ETOPOSIDE 10 MG INJECTION
J3490 FAMOTIDINE INJECTION
J1439 FERRIC CARBOXYMALTOSE INJECTION
Q5110 FILGRASTIM-AAFI, NIVESTYM
J9200 FLOXURIDINE INJECTION
J9185 FLUDARABINE PHOSPHATE INJECTION
J9190 FLUOROURACIL INJECTION
J1453 FOSAPREPITANT INJECTION
J9395 FULVESTRANT 25 MG INJECTION
J9201 GEMCITABINE HCL INJECTION
J1626 GRANISETRON HYDROCHLORIDE 100 MCG INJECTION
J3490 GRANISETRON TRANSDERMAL PATCH (3.1 MG/24 HOURS)
J1720 HYDROCORTISONE SODIUM SUCCINATE TO 100 MG INJECTION
J9211 IDARUBICIN HCL INJECTION
J9208 IFOSFAMIDE INJECTION
Q2049 IMPORTED LIPODOX INJECTION
J9206 IRINOTECAN INJECTION
J9205 IRINOTECAN LIPOSOME 1MG INJECTION
J1750 IRON DEXTRAN INJECTION
J1756 IRON SUCROSE 1 MG INJECTION
J1599 IVIG NON-LYOPHILIZED, NOS
J9207 IXABEPILONE INJECTION
J0640 LEUCOVORIN CALCIUM PER 50 MG INJECTION
J3490 LEVOLEUCOVORIN, KHAPZORY INJECTION J8499 L-GLUTAMINE ORAL POWDER
Q2050 LIPOSOMAL DOXORUBICIN INJ
J3490 MECHLORETHAMINE 0.016% TOPICAL GEL
J9230 MECHLORETHAMINE HCL INJECTION
J9245 MELPHALAN HCL 50 MG INJECTION
J9209 MESNA INJECTION
J8999 MESNA ORAL
J9250 METHOTREXATE SODIUM INJECTION 5 MG
J9260 METHOTREXATE SODIUM INJECTION 50 MG
J9999 METHOXSALEN INJECTION
J2930 METHYLPREDNISOLONE SODIUM SUCCNAT TO 125 MG INJECTION
J2920 METHYLPREDNISOLONE SODIUM SUCCNAT TO 40 MG INJECTION
J9280 MITOMYCIN INJECTION
J9293 MITOXANTRONE HCL PER 5 MG INJECTION
C9038 MOGAMULIZUMAB - KPKC, POTELIGEO
J9999 MOXETUMOMAB PASUDOTOX-TDFK, LUMOXITI INJECTION
J9295 NECITUMUMAB 1MG INJECTION
J9261 NELARABINE 50 MG INJECTION
J2405 ONDANSETRON HCL PER 1 MG INJECTION
J9263 OXALIPLATIN 0.5 MG INJECTION
J9267 PACLITAXEL INJECTION
J2469 PALONOSETRON HCL 25 MCG INJECTION
J2430 PAMIDRONATE DISODIUM PER 30 MG INJECTION
J3490 PEGINTERFERON ALFA-2A, PEGASYS
J9999 PEGINTERFERON ALFA-2B, PEGINTRON
J9999 PEGINTERFERON ALFA-2B, SYLATRON
J9268 PENTOSTATIN INJECTION
J9600 PORFIMER SODIUM INJECTION
J0780 PROCHLORPERAZINE TO 10 MG INJECTION J9999 RITUXIMAB-ABBS, RITUXIN HYCELA
J8670 ROLAPITANT, ORAL, 1 MG
J2820 SARGRAMOSTIM (GM-CSF)/50 MCG INJECTION
J2860 SILTUXIMAB 10MG INJECTION
J2916 SODIUM FERRIC GLUCONATE 12.5MG INJECTION
J9320 STREPTOZOCIN INJECTION
J9999 TAGRAXOFUSP-ERZS, ELZONRIS
J9325 TALIMOGENE LAHERPAREPVEC INJECTION
J9328 TEMOZOLOMIDE INJECTION
Q2017 TENIPOSIDE 50 MG INJECTION
J3490 TESTOSTERONE PELLET
J9340 THIOTEPA INJECTION
J9351 TOPOTECAN INJECTION
J9352 TRABECTEDIN 0.1MG INJECTION
J9999 TRASTUZUMAB/HYALURONIDASE-OYSK INJECTION
Q5114 TRASTUZUMAB-DKST, OGIVRI
J9999 TRASTUZUMAB-DTTB, ONTRUZANT
J9999 TRASTUZUMAB-PKRB INJECTION
J9357 VALRUBICIN INTRAVESICAL INJECTION
J9360 VINBLASTINE SULFATE INJECTION
J9370 VINCRISTINE SULFATE 1 MG INJECTION
J9390 VINORELBINE TARTRATE INJECTION