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Under this provision, we are required to make payment for a covered outpatient drug or biological that is furnished as part of covered outpatient department services but for which a HCPCS code has not yet been assigned in an amount equal to 95 percent of average wholesale price (AWP) for the drug or biological

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[5] We define each hospital outpatient claim reporting a single unit of a single primary service assigned to status indicator J1 as a single J1 unit procedure claim (78 FR 74871 and 79 FR 66801)