| Aminohippurate Sodium |
10 mL vials |
Injection |
Y57.6 |
| Corticotropin |
|
|
Y57.6 |
| Edrophonium Injection |
15 mL vials |
Injection |
Y57.6 |
| Florbetapir F 18 |
10 mL, 30 mL, or 50 mL vials |
Injection |
Y57.6 |
| Fludeoxyglucose F 18 Injection |
10 - 100 mCi/mL |
Injection |
Y57.6 |
| Hexaminolevulinate Hydrochloride |
|
|
Y57.6 |
| Insoluble Prussian blue |
0.5gm |
Capsule |
Y57.6 |
| Iobenguane I 123 Injection |
2 mCi/mL |
Injection |
Y57.6 |
| Iodixanol |
|
|
Y57.6 |
| Ioflupane I 123 |
|
|
Y57.6 |
| Ioversol Injection |
20x125 mL |
Injection |
Y57.6 |
| Ioxilan |
300mgl/mL, 350mgI/mL |
Injection |
Y57.6 |
| Loxaglate |
|
|
Y57.6 |
| Lymphazurin |
1% / 5 ml single dose Vial |
Injection |
Y57.6 |
| Macimorelin |
60 mg |
Granules for oral solution |
|
| Mangafodipir |
0.01 mmol/ml |
Injection |
Y57.6 |
| Metyrapone |
250mg |
Capsules |
Y57.6 |
| Phentolamine Mesylate |
10mg/1ml |
Injection |
Y57.6 |
| Phosphocol |
15 millicuries |
Suspension |
Y57.6 |
| Protirelin |
1 mL |
Injection |
Y57.6 |
| Regadenoson |
0.4mg/5 mL |
Injection |
Y57.6 |
| Sincalide |
5mcg/vial |
Injection |
Y57.6 |
| Technetium Tc 99m Depreotide Injection |
|
Injection |
Y57.6 |
| Technetium Tc99m Exametazime Injection |
0.45 µM |
Injection |
Y57.6 |
| Technetium Tc99m Medronate Injection |
|
|
Y57.6 |
| Technetium Tc99m sestamibi |
|
|
Y57.6 |
| Thallous Chloride Tl-201 Injection |
37 MBq (1 mCi) |
Injection |
Y57.6 |
| Tricarbocyanine |
25mg/50ml |
Injection |
Y57.6 |
Radiocontrast Agent
| Generic Name(s) |
Strength |
Dosage Form |
ICD Code |
| Diatrizoate |
|
|
Y57.6 |
