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Q5108 - HCPCS Level II | Verity

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HCPCS Level IItemporaryActive

Q5108

Injection, fulphila

BETOS: O1E

Effective: 2023-04-01

Referenced in 2 policies

Description

Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg

Drug Products

FDA-registered drug products mapped to this HCPCS code

FULPHILA (PF) 6 MG/0.6 ML

NDC: 67457-0833-06SC

Billing: ML

FULPHILA (PF) 6 MG/0.6 ML

NDC: 83257-0005-41SC

Billing: ML

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Medicare Fee Schedule

2026 Medicare Physician Fee Schedule national payment rates

Excluded

This code is excluded from the Medicare Physician Fee Schedule.

Coverage Policies

This code is referenced in 2 Medicare coverage policies

Sample Policies

AETNA-CPB-0638PayerPolicycovered

Donor Lymphocyte Infusion

AETNA-CPB-0638PayerPolicycovered

Donor Lymphocyte Infusion

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About HCPCS Level II

Healthcare Common Procedure Coding System Level II codes for supplies, equipment, and non-physician services

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