Table of content for "Inj ogivri 10 mg" (HCPCS Q5114)
General information on the “Q5114” code
HCPCS Code: Q5114
Long Description: Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
Short Description: Inj ogivri 10 mg
Original information is taken from Q5114 page
Pricing indicators
Pricing Indicator Code 1: 51 – Drugs
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 1 – Medical care
Type Of Service 2: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20190701
Code Effective Date: 20190701
Action Code: N – No maintenance for this code