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| Generic Name(s) | Strength | Dosage Form | ICD Code |
| Autologous Cultured Chondrocytes | 12 million cells/Vial | ||
| Botulinum Toxin Type A | 50 Units, 100 Units, or 200 Units/Vials | Injection | |
| Onabotulinumtoxina | 50Units, 100Unit | Injection |
| Generic Name(s) | Strength | Dosage Form | ICD Code |
| Autologous Cultured Chondrocytes | 12 million cells/Vial | ||
| Botulinum Toxin Type A | 50 Units, 100 Units, or 200 Units/Vials | Injection | |
| Onabotulinumtoxina | 50Units, 100Unit | Injection |
