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L8603 |
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Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies
| short | Collagen imp urinary 2.5 ml |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
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L8604 |
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Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
| short | Dextranomer/hyaluronic acid |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 3.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 3.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
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L8605 |
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Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies
| short | Inj bulking agent anal canal |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 4.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 4.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
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L8606 |
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Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies
| short | Synthetic implnt urinary 1ml |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 5.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 5.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
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L8607 |
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Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies
| short | Inj vocal cord bulking agent |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 20.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 20.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
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