J2151, Injection, mannitol, 250 mg
HCPCS/CPT
Prior Authorization
Prior Auth Required
Conditional coverage; review criteria to confirm PA need (medium confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
2 Active Policies
BCBSLA-00734-0E394E34EC, 00734 mannitol (Bronchitol)
LA
HEALTHNET_OR-HNOR-MANNITOL-BRONCHITOL-CP-PHAR-518-B535DE2B08, Mannitol (Bronchitol); CP.PHAR.518
OR
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