J3371 Inj, vancomycin hcl (mylan)

Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg

Payer policies and prior authorization for J3371

Payer coverage policies that name J3371

J3371 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaInjectable Medications (0020)listed, no stance (range J2550-J3520)Mar 5, 2026payer document

Medicaid fee-for-service

  • KY: $0.00 (asc), effective Jan 1, 2026
  • MA: $5.05 (dme_rates), effective Mar 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.