Sandoz

Ampicillin-Sulbactam - Cost

Last Updated: April 1st, 2024

HCPCS:

J0295

HCPCS Code Descriptor:

Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm

Medicare Payment Limit:

The Ampicillin-Sulbactam Medicare Payment Limit is $2.123

Average Sale Price:

Ampicillin-Sulbactam ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The Ampicillin-Sulbactam Medicare Co-insurance percentage is 20%. Ampicillin-Sulbactam's Medicare Co-insurance amount is $0.42 per HCPCS unit.

APC Code:

The Ampicillin-Sulbactam APC Code is: not available

APC Payment Limit:

The APC Payment Limit for Ampicillin-Sulbactam is not available.

Ampicillin-Sulbactam Cost Information:

Ampicillin-Sulbactam, HCPCS J0295, became effective on January 1, 2019, and currently has 48 NDCs mapped to J0295. From 2020 to 2024, historic pricing trends have been highly volatile across AWP and ASP while WAC has generally remained constant.

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Ampicillin-Sulbactam’s wholesale acquisition cost (WAC) information was last updated on:
March 11, 2024
Ampicillin-Sulbactam’s average wholesale price (AWP) information was last updated on:
March 11, 2024