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In the same manner as Sublocade, and as explained in the coding announcement for HCPCS codes J0577 and J0578, [502] because all versions of a single source drug or biological product (or NDCs) marketed under the same FDA approval number are considered the same drug or biological for purposes of payments made under section 1847A of the Act, the payment limits for both J0577 and J0578 are calculated using all the NDCs marketed under the applicable FDA approval

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Peptide Vials (Tesamorelin, 5 mg each): 8 weeks 23 vials (112 mg total) 12 weeks 34 vials (168 mg total) 16 weeks 45 vials (224 mg total) Insulin Syringes (U-100, 1 mL capacity): Per week: 7 syringes (1/day) 8 weeks: 56 syringes 12 weeks: 84 syringes 16 weeks: 112 syringes Bacteriostatic Water (10 mL bottles): Use 2.5 mL per vial for reconstitution

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