ASP Changes July 2023

July 2023 ASP Changes: Quarter 3 ASP

Every quarter, the Centers for Medicare and Medicaid Services (CMS) publish a file mapping HCPCS coded drugs to their Medicare reimbursement rates. This reimbursement rate is referred to as the ‘Payment Limit’ and is calculated based on ASP, or the real average selling price of a drug. The CMS file can be found here: https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/2023-asp-drug-pricing-files

Significant increases were seen in Fulvestrant (J9393) and Bortezomib (J9046) with spikes of 590.78% and 461.11%, respectively. Others such as Pyridoxine HCL (J3415) and Anavip (J0841) also saw substantial uplifts. However, not all ASPs moved upward. Pemetrexed by Sandoz (J9297) saw the largest drop at 81.10%, closely followed by Fosaprepitant by Teva (J1456), and Ziextenzo (Q5120).

Lots of sharp increases and declines were visible in 505(b)(2) drugs that were recently assigned HCPCS codes separate from the generic codes.

Below, you will find a graph displaying Medicare Payment Limits for July, 1st 2023. You can filter and search the graph for a HCPCS code or drug of choice.

HCPCS Code	Short Description	Payment Limit
90371	Hep b ig im	136.744
90375	Rabies ig im/sc	284.678
90376	Rabies ig heat treated	250.093
90377	Rabies ig ht&sol human im/sc	234.090
90586	Bcg vaccine intravesical	144.714
90632	Hepa vaccine adult im	71.853
90662	Iiv no prsv increased ag im	69.941
90670	Pcv13 vaccine im	257.989
90671	PCV15 vaccine IM	246.195
90672	Laiv4 vaccine intranasal	26.876
90674	Cciiv4 vac no prsv 0.5 ml im	32.278
90675	Rabies vaccine im	329.989
90677	Pcv20 vaccine im	288.664
90682	Riv4 vacc recombinant dna im	69.941
90686	Iiv4 vacc no prsv 0.5 ml im	21.518
90687	Iiv4 vaccine splt 0.25 ml im	10.241
90688	Iiv4 vaccine splt 0.5 ml im	20.482
90694	Vacc AIIV4 no prsrv 0.5ML IM	71.682
90714	Td vacc no presv 7 yrs+ im	31.045
90715	Tdap vaccine 7 yrs/> im	38.745
90732	Ppsv23 vacc 2 yrs+ subq/im	133.472
90739	Hepb vacc 2 dose adult im	160.284
90740	Hepb vacc 3 dose immunsup im	152.124
90743	Hep b vacc, adol, 2 dose, im	73.847
90744	Hepb vacc 3 dose ped/adol im	29.895
90746	Hepb vaccine 3 dose adult im	70.376
90747	Hepb vacc 4 dose immunsup im	140.752
90756	Cciiv4 vacc abx free im	30.581
90759	Hep b vac 3ag 10mcg 3 dos im	73.815
A9575	Inj gadoterate meglumi 0.1ml	0.135
A9576	Inj prohance multipack	1.451
A9577	Inj multihance	1.813
A9578	Inj multihance multipack	1.833
A9579	Gad-base mr contrast nos,1ml	1.547
A9581	Gadoxetate disodium inj	14.730
A9585	Gadobutrol injection	0.345
A9589	Insti hexaminolevulinate hcl	1244.440
A9606	Radium ra223 dichloride ther	N/A
J0121	Inj., omadacycline, 1 mg	3.683
J0122	Inj., eravacycline, 1 mg	1.133
J0129	Abatacept injection	43.271
J0131	Inj, acetaminophen (nos)	0.086
J0132	Acetylcysteine injection	0.779
J0133	Acyclovir injection	0.047
J0134	Inj acetaminophen -fresenius	0.069
J0136	Inj, acetaminophen (b braun)	0.054
J0137	Inj, acetaminophen (hikma)	0.075
J0153	Adenosine inj 1mg	0.540
J0171	Adrenalin epinephrine inject	0.733
J0172	Inj, aducanumab-avwa, 2 mg	5.978
J0173	Inj, epinephrine (belcher)	1.614
J0178	Aflibercept injection	875.670
J0179	Inj, brolucizumab-dbll, 1 mg	319.946
J0180	Agalsidase beta injection	215.378
J0185	Inj., aprepitant, 1 mg	1.731
J0202	Injection, alemtuzumab	2283.728
J0206	Inj allopurinol sodium 1 mg	5.805
J0216	Inj, alfentanil hcl, 500mcg	2.565
J0218	Inj olipudase alfa-rpcp 1mg	377.508
J0219	Inj aval alfa-nqpt 4mg	75.038
J0221	Lumizyme injection	194.915
J0222	Inj., patisiran, 0.1 mg	100.472
J0223	Inj givosiran 0.5 mg	112.486
J0224	Inj. lumasiran, 0.5 mg	318.998
J0225	Inj, vutrisiran, 1 mg	4940.950
J0248	Inj, remdesivir, 1 mg	6.058
J0256	Alpha 1 proteinase inhibitor	4.878
J0257	Glassia injection	5.311
J0278	Amikacin sulfate injection	0.936
J0280	Aminophyllin 250 mg inj	4.508
J0285	Amphotericin b	41.673
J0287	Amphotericin b lipid complex	11.130
J0289	Amphotericin b liposome inj	27.871
J0290	Ampicillin 500 mg inj	0.782
J0291	Inj., plazomicin, 5 mg	3.356
J0295	Ampicillin sulbactam 1.5 gm	1.890
J0348	Anidulafungin injection	0.479
J0360	Hydralazine hcl injection	5.714
J0401	Inj aripiprazole ext rel 1mg	6.723
J0456	Azithromycin	2.778
J0461	Atropine sulfate injection	0.089
J0475	Baclofen 10 mg injection	182.487
J0476	Baclofen intrathecal trial	44.966
J0480	Basiliximab	4389.082
J0485	Belatacept injection	3.781
J0490	Belimumab injection	50.927
J0491	Inj anifrolumab-fnia 1mg	16.656
J0500	Dicyclomine injection	25.436
J0515	Inj benztropine mesylate	16.211
J0517	Inj., benralizumab, 1 mg	170.925
J0558	Peng benzathine/procaine inj	15.673
J0561	Penicillin g benzathine inj	20.168
J0565	Inj, bezlotoxumab, 10 mg	39.853
J0583	Bivalirudin	0.238
J0584	Injection, burosumab-twza 1m	426.072
J0585	Injection,onabotulinumtoxina	6.394
J0586	Abobotulinumtoxina	8.246
J0587	Inj, rimabotulinumtoxinb	12.721
J0588	Incobotulinumtoxin a	5.196
J0592	Buprenorphine hydrochloride	4.063
J0594	Busulfan injection	1.383
J0595	Butorphanol tartrate 1 mg	5.049
J0596	Injection, ruconest	33.020
J0597	C-1 esterase, berinert	64.445
J0598	C-1 esterase, cinryze	60.727
J0612	Calcium glucon (fresenius)	0.055
J0613	Calcium glucon (wg critical)	0.083
J0630	Calcitonin salmon injection	1366.440
J0636	Inj calcitriol per 0.1 mcg	0.795
J0637	Caspofungin acetate	8.621
J0638	Canakinumab injection	121.513
J0640	Leucovorin calcium injection	4.698
J0642	Injection, khapzory, 0.5 mg	1.483
J0665	Inj, bupivacaine, nos, 0.5mg	0.021
J0670	Inj mepivacaine hcl/10 ml	3.077
J0689	Inj cefazolin sodium, baxter	1.224
J0690	Cefazolin sodium injection	0.869
J0691	Inj lefamulin 1 mg	0.724
J0692	Cefepime hcl for injection	1.226
J0694	Cefoxitin sodium injection	5.001
J0695	Inj ceftolozane tazobactam	7.540
J0696	Ceftriaxone sodium injection	0.569
J0697	Sterile cefuroxime injection	2.236
J0699	Inj, cefiderocol, 10 mg	2.163
J0701	Inj. cefepime hcl (baxter)	5.718
J0702	Betamethasone acet&sod phosp	6.956
J0703	Inj, cefepime hcl (b braun)	5.103
J0712	Ceftaroline fosamil inj	3.887
J0713	Inj ceftazidime per 500 mg	1.836
J0714	Ceftazidime and avibactam	92.479
J0717	Certolizumab pegol inj 1mg	5.073
J0720	Chloramphenicol sodium injec	50.261
J0725	Chorionic gonadotropin/1000u	23.077
J0735	Clonidine hydrochloride	21.036
J0736	Inj, clindamycin phosp 300mg	1.606
J0740	Cidofovir injection	577.031
J0741	Inj, cabote rilpivir 2mg 3mg	21.842
J0742	Inj imip 4 cilas 4 releb 2mg	2.488
J0743	Cilastatin sodium injection	7.145
J0744	Ciprofloxacin iv	1.955
J0770	Colistimethate sodium inj	12.282
J0775	Collagenase, clost hist inj	65.148
J0780	Prochlorperazine injection	3.014
J0791	Inj crizanlizumab-tmca 5mg	126.606
J0800	Corticotropin injection	3819.780
J0834	Inj., cosyntropin, 0.25 mg	27.881
J0840	Crotalidae poly immune fab	2056.352
J0841	Inj crotalidae im f(ab')2 eq	1019.456
J0850	Cytomegalovirus imm iv /vial	1814.195
J0875	Injection, dalbavancin	14.703
J0877	Inj, daptomycin (hospira)	0.071
J0878	Daptomycin injection	0.078
J0881	Darbepoetin alfa, non-esrd	2.936
J0882	Darbepoetin alfa, esrd use	2.936
J0885	Epoetin alfa, non-esrd	6.876
J0887	Epoetin beta esrd use	1.647
J0888	Epoetin beta non esrd	1.647
J0891	Argatroban nonesrd (accord)	0.460
J0892	Argatroban dialysis (accord)	0.460
J0893	Inj, decitabine (sun pharma)	2.240
J0894	Decitabine injection	2.000
J0895	Deferoxamine mesylate inj	8.592
J0896	Inj luspatercept-aamt 0.25mg	39.181
J0897	Denosumab injection	24.192
J0898	Argatroban nonesrd (auromed)	1.642
J0899	Argatroban dialysis, auromed	1.642
J1000	Depo-estradiol cypionate inj	30.682
J1020	Methylprednisolone 20 mg inj	7.167
J1030	Methylprednisolone 40 mg inj	7.613
J1040	Methylprednisolone 80 mg inj	11.910
J1071	Inj testosterone cypionate	0.029
J1100	Dexamethasone sodium phos	0.122
J1110	Inj dihydroergotamine mesylt	50.588
J1120	Acetazolamid sodium injectio	29.702
J1160	Digoxin injection	10.814
J1162	Digoxin immune fab (ovine)	4593.574
J1165	Phenytoin sodium injection	0.630
J1170	Hydromorphone injection	4.347
J1190	Dexrazoxane hcl injection	113.897
J1200	Diphenhydramine hcl injectio	1.062
J1201	Inj. cetirizine hcl 0.5mg	15.065
J1205	Chlorothiazide sodium inj	61.567
J1212	Dimethyl sulfoxide 50% 50 ml	682.516
J1230	Methadone injection	17.143
J1240	Dimenhydrinate injection	8.977
J1245	Dipyridamole injection	3.777
J1250	Inj dobutamine hcl/250 mg	8.825
J1265	Dopamine injection	0.699
J1270	Injection, doxercalciferol	0.443
J1290	Ecallantide injection	530.720
J1300	Eculizumab injection	225.791
J1301	Injection, edaravone, 1 mg	21.402
J1302	Inj, sutimlimab-jome, 10 mg	17.754
J1303	Inj., ravulizumab-cwvz 10 mg	221.875
J1305	Inj, evinacumab-dgnb, 5mg	175.777
J1306	Injection, inclisiran, 1 mg	12.059
J1322	Elosulfase alfa, injection	280.126
J1325	Epoprostenol injection	15.999
J1335	Ertapenem injection	13.322
J1364	Erythro lactobionate /500 mg	87.328
J1380	Estradiol valerate 10 mg inj	10.782
J1410	Inj estrogen conjugate 25 mg	371.893
J1430	Ethanolamine oleate 100 mg	481.062
J1437	Inj. fe derisomaltose 10 mg	20.613
J1439	Inj ferric carboxymaltos 1mg	1.125
J1442	Inj filgrastim excl biosimil	0.985
J1447	Inj tbo filgrastim 1 microg	0.426
J1448	Injection, trilaciclib, 1mg	5.102
J1449	Inj eflapegrastim-xnst 0.1mg	31.771
J1450	Fluconazole	2.680
J1453	Fosaprepitant injection	0.142
J1454	Inj fosnetupitant, palonoset	371.999
J1456	Inj, fosaprepitant (teva)	0.098
J1458	Galsulfase injection	461.919
J1459	Inj ivig privigen 500 mg	47.992
J1460	Gamma globulin 1 cc inj	48.465
J1551	Inj cutaquig 100 mg	14.386
J1554	Inj. asceniv	491.405
J1555	Inj cuvitru, 100 mg	16.275
J1556	Inj, imm glob bivigam, 500mg	72.963
J1557	Gammaplex injection	59.483
J1558	Inj. xembify, 100 mg	13.999
J1559	Hizentra injection	12.803
J1560	Gamma globulin > 10 cc inj	484.648
J1561	Gamunex-c/gammaked	50.640
J1566	Immune globulin, powder	77.766
J1568	Octagam injection	44.118
J1569	Gammagard liquid injection	46.031
J1570	Ganciclovir sodium injection	39.494
J1571	Hepagam b im injection	66.257
J1572	Flebogamma injection	56.116
J1575	Hyqvia 100mg immuneglobulin	16.655
J1576	Inj, panzyga, 500 mg	65.741
J1580	Garamycin gentamicin inj	2.992
J1602	Golimumab for iv use 1mg	13.287
J1610	Glucagon hydrochloride/1 mg	195.175
J1611	Inj glucagon hcl, fresenius	101.412
J1626	Granisetron hcl injection	0.389
J1627	Inj, granisetron, xr, 0.1 mg	5.877
J1630	Haloperidol injection	1.383
J1631	Haloperidol decanoate inj	8.325
J1640	Hemin, 1 mg	31.081
J1642	Inj heparin sodium per 10 u	0.069
J1643	Inj heparin, pfizer, 1000u	6.094
J1644	Inj heparin sodium per 1000u	0.263
J1645	Dalteparin sodium	16.601
J1650	Inj enoxaparin sodium	0.677
J1652	Fondaparinux sodium	1.071
J1670	Tetanus immune globulin inj	540.989
J1720	Hydrocortisone sodium succ i	17.514
J1738	Inj. meloxicam 1 mg	3.321
J1740	Ibandronate sodium injection	29.314
J1743	Idursulfase injection	542.918
J1745	Infliximab not biosimil 10mg	32.907
J1746	Inj., ibalizumab-uiyk, 10 mg	74.292
J1747	Inj, spesolimab-sbzo, 1 mg	60.223
J1750	Inj iron dextran	17.176
J1756	Iron sucrose injection	0.206
J1786	Imuglucerase injection	44.250
J1805	Inj, esmolol hcl, 10mg	0.250
J1806	Inj esmolol hcl wg crit care	0.486
J1811	Fiasp for insulin pump use	7.195
J1813	Lyumjev for insulin pump use	15.730
J1817	Insulin for insulin pump use	8.395
J1823	Inj. inebilizumab-cdon, 1 mg	472.303
J1836	Inj, metronidazole, 10 mg	0.024
J1885	Ketorolac tromethamine inj	0.546
J1920	Inj, labetalol hcl, 5mg	0.244
J1921	Inj labetalol hcl hikma, 5mg	1.237
J1930	Lanreotide injection	54.182
J1931	Laronidase injection	37.043
J1932	Inj, lanreotide, (cipla) 1mg	51.378
J1940	Furosemide injection	0.495
J1943	Inj., aristada initio, 1 mg	3.060
J1944	Aripiprazole lauroxil 1 mg	3.067
J1950	Leuprolide acetate /3.75 mg	1543.516
J1951	Inj fensolvi 0.25 mg	138.807
J1952	Leuprolide inj, camcevi, 1mg	78.308
J1953	Levetiracetam injection	0.073
J1954	Leuprolide depot cipla 7.5mg	425.478
J1955	Inj levocarnitine per 1 gm	35.415
J1956	Levofloxacin injection	0.917
J1980	Hyoscyamine sulfate inj	33.233
J2001	Lidocaine injection	0.030
J2010	Lincomycin injection	9.991
J2020	Linezolid injection	3.471
J2021	Inj, linezolid (hospira)	9.480
J2060	Lorazepam injection	0.852
J2150	Mannitol injection	4.930
J2175	Meperidine hydrochl /100 mg	7.309
J2182	Injection, mepolizumab, 1mg	29.747
J2184	Inj, meropenem (b. braun)	2.101
J2185	Meropenem	0.518
J2210	Methylergonovin maleate inj	20.893
J2247	Inj, micafungin (par pharm)	0.291
J2248	Micafungin sodium injection	0.830
J2250	Inj midazolam hydrochloride	0.140
J2251	Inj midazolam (wg crit care)	0.288
J2260	Inj milrinone lactate / 5 mg	1.874
J2270	Morphine sulfate injection	4.600
J2272	Inj, morphine (fresenius)	6.929
J2274	Inj morphine pf epid ithc	15.701
J2278	Ziconotide injection	9.078
J2280	Inj, moxifloxacin 100 mg	9.845
J2281	Inj moxifloxacin (fres kabi)	4.495
J2300	Inj nalbuphine hydrochloride	2.716
J2305	Inj, nitroglycerin, 5 mg	1.296
J2310	Inj naloxone hydrochloride	9.450
J2311	Inj, naloxone hcl (zimhi)	8.508
J2315	Naltrexone, depot form	3.940
J2323	Natalizumab injection	24.863
J2327	Inj risankizumab-rzaa 1 mg	15.519
J2350	Injection, ocrelizumab, 1 mg	61.417
J2353	Octreotide injection, depot	208.117
J2354	Octreotide inj, non-depot	1.314
J2356	Inj tezepelumab-ekko, 1mg	18.729
J2357	Omalizumab injection	39.383
J2358	Olanzapine long-acting inj	2.917
J2360	Orphenadrine injection	16.536
J2372	Inj, biorphen, 20 micrograms	0.188
J2401	Chloroprocaine hcl injection	0.039
J2405	Ondansetron hcl injection	0.111
J2406	Injection, oritavancin 10 mg	41.734
J2407	Injection, oritavancin	26.894
J2426	Inj, invega sustenna, 1 mgj	14.217
J2427	Inj, invega hafyera/trinza	12.108
J2430	Pamidronate disodium /30 mg	10.316
J2469	Palonosetron hcl	1.001
J2501	Paricalcitol	0.498
J2506	Inj pegfilgrast ex bio 0.5mg	85.710
J2507	Pegloticase injection	3268.450
J2510	Penicillin g procaine inj	43.376
J2540	Penicillin g potassium inj	1.070
J2543	Piperacillin/tazobactam	1.359
J2545	Pentamidine non-comp unit	93.857
J2550	Promethazine hcl injection	3.147
J2560	Phenobarbital sodium inj	39.383
J2562	Plerixafor injection	429.363
J2597	Inj desmopressin acetate	7.271
J2598	Inj, vasopressin, 1 unit	2.919
J2599	Inj vasopressin (am reg) 1 u	2.098
J2675	Inj progesterone per 50 mg	0.970
J2680	Fluphenazine decanoate 25 mg	10.952
J2690	Procainamide hcl injection	307.989
J2700	Oxacillin sodium injeciton	1.173
J2704	Inj, propofol, 10 mg	0.098
J2720	Inj protamine sulfate/10 mg	0.947
J2724	Protein c concentrate	15.112
J2760	Phentolaine mesylate inj	458.182
J2765	Metoclopramide hcl injection	1.235
J2777	Inj, faricimab-svoa, 0.1mg	37.089
J2778	Ranibizumab injection	236.583
J2779	Inj, susvimo 0.1 mg	81.018
J2783	Rasburicase	357.364
J2785	Regadenoson injection	62.275
J2786	Injection, reslizumab, 1mg	10.198
J2788	Rho d immune globulin 50 mcg	26.918
J2790	Rho d immune globulin inj	81.831
J2791	Rhophylac injection	4.901
J2792	Rho(d) immune globulin h, sd	33.710
J2794	Inj risperdal consta, 0.5 mg	12.023
J2795	Ropivacaine hcl injection	0.074
J2796	Romiplostim injection	95.468
J2798	Inj., perseris, 0.5 mg	11.669
J2800	Methocarbamol injection	6.650
J2805	Sincalide injection	133.543
J2820	Sargramostim injection	58.311
J2860	Injection, siltuximab	139.218
J2916	Na ferric gluconate complex	2.123
J2920	Methylprednisolone injection	4.237
J2930	Methylprednisolone injection	5.725
J2997	Alteplase recombinant	89.146
J2998	Inj plasminogen tvmh 1mg	30.095
J3000	Streptomycin injection	31.568
J3010	Fentanyl citrate injection	0.837
J3032	Inj. eptinezumab-jjmr 1 mg	17.443
J3060	Inj, taliglucerase alfa 10 u	44.561
J3090	Inj tedizolid phosphate	1.709
J3095	Telavancin injection	6.826
J3101	Tenecteplase injection	152.696
J3105	Terbutaline sulfate inj	2.290
J3111	Inj. romosozumab-aqqg 1 mg	10.367
J3121	Inj testostero enanthate 1mg	0.047
J3145	Testosterone undecanoate 1mg	1.904
J3230	Chlorpromazine hcl injection	35.950
J3240	Thyrotropin injection	2001.485
J3241	Inj. teprotumumab-trbw 10 mg	327.998
J3243	Tigecycline injection	0.743
J3245	Inj., tildrakizumab, 1 mg	143.265
J3250	Trimethobenzamide hcl inj	45.041
J3260	Tobramycin sulfate injection	2.652
J3262	Tocilizumab injection	5.910
J3285	Treprostinil injection	55.196
J3299	Inj xipere 1 mg	48.486
J3300	Triamcinolone a inj prs-free	4.269
J3301	Triamcinolone acet inj nos	1.005
J3304	Inj triamcinolone ace xr 1mg	17.114
J3315	Triptorelin pamoate	382.392
J3357	Ustekinumab sub cu inj, 1 mg	147.647
J3358	Ustekinumab, iv inject, 1 mg	12.594
J3360	Diazepam injection	5.250
J3370	Vancomycin hcl injection	2.409
J3371	Inj, vancomycin hcl (mylan)	6.298
J3372	Inj, vancomycin hcl (xellia)	6.578
J3380	Injection, vedolizumab	22.677
J3385	Velaglucerase alfa	367.181
J3396	Verteporfin injection	11.416
J3410	Hydroxyzine hcl injection	13.622
J3411	Thiamine hcl 100 mg	2.502
J3415	Pyridoxine hcl 100 mg	15.897
J3420	Vitamin b12 injection	1.310
J3430	Vitamin k phytonadione inj	2.872
J3465	Injection, voriconazole	1.223
J3471	Ovine, up to 999 usp units	0.494
J3473	Hyaluronidase recombinant	0.359
J3475	Inj magnesium sulfate	0.934
J3480	Inj potassium chloride	0.101
J3485	Zidovudine	1.512
J3486	Ziprasidone mesylate	9.603
J3489	Zoledronic acid 1mg	9.085
J7030	Normal saline solution infus	2.539
J7040	Normal saline solution infus	1.270
J7042	5% dextrose/normal saline	1.178
J7050	Normal saline solution infus	0.635
J7060	5% dextrose/water	1.812
J7070	D5w infusion	3.623
J7120	Ringers lactate infusion	2.389
J7170	Inj., emicizumab-kxwh 0.5 mg	51.005
J7175	Inj, factor x, (human), 1iu	9.091
J7177	Inj., fibryga, 1 mg	1.098
J7178	Inj human fibrinogen con nos	1.383
J7179	Vonvendi inj 1 iu vwf:rco	1.781
J7180	Factor xiii anti-hem factor	9.683
J7181	Factor xiii recomb a-subunit	16.886
J7182	Factor viii recomb novoeight	1.283
J7183	Wilate injection	1.259
J7185	Xyntha inj	1.376
J7186	Antihemophilic viii/vwf comp	1.216
J7187	Humate-p, inj	1.347
J7188	Factor viii recomb obizur	3.217
J7189	Factor viia recomb novoseven	2.412
J7190	Factor viii	1.029
J7192	Factor viii recombinant nos	1.506
J7193	Factor ix non-recombinant	1.297
J7194	Factor ix complex	1.615
J7195	Factor ix recombinant nos	1.756
J7197	Antithrombin iii injection	3.350
J7198	Anti-inhibitor	2.232
J7200	Factor ix recombinan rixubis	1.614
J7201	Factor ix alprolix recomb	3.460
J7202	Factor ix idelvion inj	4.932
J7203	Factor ix recomb gly rebinyn	4.414
J7204	Inj recombin esperoct per iu	2.108
J7205	Factor viii fc fusion recomb	2.173
J7207	Factor viii pegylated recomb	2.106
J7208	Inj. jivi 1 iu	2.354
J7209	Factor viii nuwiq recomb 1iu	1.358
J7210	Inj, afstyla, 1 i.u.	1.436
J7211	Inj, kovaltry, 1 i.u.	1.436
J7212	Factor viia recomb sevenfact	2.013
J7213	Inj, ixinity, 1 i.u.	1.746
J7308	Aminolevulinic acid hcl top	391.230
J7311	Inj., retisert, 0.01 mg	322.381
J7312	Dexamethasone intra implant	204.677
J7313	Inj., iluvien, 0.01 mg	490.947
J7314	Inj., yutiq, 0.01 mg	529.269
J7318	Inj, durolane 1 mg	6.061
J7320	Genvisc 850, inj, 1mg	6.105
J7321	Hyalgan supartz visco-3 dose	73.480
J7322	Hymovis injection 1 mg	17.019
J7323	Euflexxa inj per dose	131.420
J7324	Orthovisc inj per dose	117.377
J7325	Synvisc or synvisc-one	9.617
J7326	Gel-one	516.727
J7327	Monovisc inj per dose	692.752
J7328	Gelsyn-3 injection 0.1 mg	0.615
J7329	Inj, trivisc 1 mg	8.795
J7331	Synojoynt, inj., 1 mg	13.250
J7332	Inj., triluron, 1 mg	10.055
J7336	Capsaicin 8% patch	3.274
J7340	Carbidopa levodopa ent 100ml	226.831
J7342	Ciprofloxacin otic susp 6 mg	30.019
J7345	Aminolevulinic acid, 10% gel	1.649
J7351	Inj bimatoprost itc imp1mcg	206.406
J7402	Mometasone sinus sinuva	11.345
J7500	Azathioprine oral 50mg	13.701
J7502	Cyclosporine oral 100 mg	1.759
J7503	Tacrol envarsus ex rel oral	1.673
J7504	Lymphocyte immune globulin	2989.437
J7507	Tacrolimus imme rel oral 1mg	0.287
J7508	Tacrol astagraf ex rel oral	0.549
J7509	Methylprednisolone oral	0.261
J7510	Prednisolone oral per 5 mg	0.248
J7511	Antithymocyte globuln rabbit	920.534
J7512	Prednisone ir or dr oral 1mg	0.006
J7515	Cyclosporine oral 25 mg	0.754
J7517	Mycophenolate mofetil oral	0.212
J7518	Mycophenolic acid	0.672
J7520	Sirolimus, oral	3.107
J7525	Tacrolimus injection	246.085
J7527	Oral everolimus	3.201
J7605	Arformoterol non-comp unit	3.286
J7606	Formoterol fumarate, inh	5.189
J7608	Acetylcysteine non-comp unit	6.844
J7611	Albuterol non-comp con	0.133
J7612	Levalbuterol non-comp con	0.254
J7613	Albuterol non-comp unit	0.030
J7614	Levalbuterol non-comp unit	0.035
J7620	Albuterol ipratrop non-comp	0.131
J7626	Budesonide non-comp unit	0.878
J7631	Cromolyn sodium noncomp unit	1.658
J7639	Dornase alfa non-comp unit	52.234
J7644	Ipratropium bromide non-comp	0.258
J7674	Methacholine chloride, neb	0.863
J7677	Revefenacin inh non-com 1mcg	0.196
J7682	Tobramycin non-comp unit	29.624
J7686	Treprostinil, non-comp unit	737.376
J8501	Oral aprepitant	3.119
J8520	Capecitabine, oral, 150 mg	0.796
J8521	Capecitabine, oral, 500 mg	22.876
J8530	Cyclophosphamide oral 25 mg	0.953
J8540	Oral dexamethasone	0.103
J8560	Etoposide oral 50 mg	77.388
J8610	Methotrexate oral 2.5 mg	0.232
J8655	Oral netupitant, palonosetro	461.255
J8670	Rolapitant, oral, 1mg	1.625
J8700	Temozolomide	0.189
J8705	Topotecan oral	112.300
J9000	Doxorubicin hcl injection	2.501
J9017	Arsenic trioxide injection	12.966
J9021	Inj, aspara, rylaze, 0.1 mg	49.530
J9022	Inj, atezolizumab,10 mg	82.678
J9023	Injection, avelumab, 10 mg	90.569
J9025	Azacitidine injection	0.402
J9027	Clofarabine injection	29.424
J9030	Bcg live intravesical 1mg	2.894
J9032	Injection, belinostat, 10mg	47.622
J9033	Inj., treanda 1 mg	12.282
J9034	Inj., bendeka 1 mg	16.508
J9035	Bevacizumab injection	73.579
J9036	Inj. belrapzo/bendamustine	16.716
J9039	Injection, blinatumomab	144.683
J9040	Bleomycin sulfate injection	24.533
J9041	Injection, bortezomib, 0.1mg	3.031
J9042	Brentuximab vedotin inj	221.964
J9043	Cabazitaxel injection	206.032
J9045	Carboplatin injection	2.408
J9046	Inj, bortezomib, dr. reddy's	48.547
J9047	Injection, carfilzomib, 1 mg	47.040
J9049	Inj, bortezomib, hospira	3.892
J9050	Carmustine injection	410.962
J9055	Cetuximab injection	72.078
J9056	Inj, bendamustine, 1 mg	33.325
J9059	Inj bendamustine, baxter 1mg	23.958
J9060	Cisplatin 10 mg injection	3.172
J9061	Inj, amivantamab-vmjw	19.631
J9063	Inj, elahere, 1 mg	65.802
J9065	Inj cladribine per 1 mg	18.296
J9070	Cyclophosphamide 100 mg inj	17.087
J9071	Inj cyclophosphamd auromedic	3.869
J9100	Cytarabine hcl 100 mg inj	0.917
J9118	Inj. calaspargase pegol-mknl	72.869
J9119	Inj., cemiplimab-rwlc, 1 mg	26.923
J9120	Dactinomycin injection	594.546
J9130	Dacarbazine 100 mg inj	4.050
J9144	Daratumumab, hyaluronidase	49.120
J9145	Injection, daratumumab 10 mg	61.783
J9150	Daunorubicin injection	45.622
J9153	Inj daunorubicin, cytarabine	227.232
J9155	Degarelix injection	4.194
J9171	Docetaxel injection	0.937
J9173	Inj., durvalumab, 10 mg	79.763
J9176	Injection, elotuzumab, 1mg	7.191
J9177	Inj enfort vedo-ejfv 0.25mg	33.818
J9178	Inj, epirubicin hcl, 2 mg	1.344
J9179	Eribulin mesylate injection	128.777
J9181	Etoposide injection	0.704
J9185	Fludarabine phosphate inj	604.748
J9190	Fluorouracil injection	1.830
J9196	Inj gemcitabine hcl (accord)	3.715
J9198	Inj. infugem, 100 mg	40.280
J9200	Floxuridine injection	3551.000
J9201	In gemcitabine hcl nos 200mg	3.706
J9202	Goserelin acetate implant	613.565
J9203	Gemtuzumab ozogamicin 0.1 mg	221.843
J9204	Inj mogamulizumab-kpkc, 1 mg	226.706
J9205	Inj irinotecan liposome 1 mg	61.964
J9206	Irinotecan injection	3.003
J9207	Ixabepilone injection	122.548
J9208	Ifosfamide injection	25.384
J9209	Mesna injection	1.669
J9210	Inj., emapalumab-lzsg, 1 mg	393.723
J9211	Idarubicin hcl injection	33.898
J9214	Interferon alfa-2b inj	32.574
J9217	Leuprolide acetate suspnsion	165.863
J9218	Leuprolide acetate injeciton	10.057
J9223	Inj. lurbinectedin, 0.1 mg	197.177
J9226	Supprelin la implant	43270.018
J9227	Inj. isatuximab-irfc 10 mg	74.349
J9228	Ipilimumab injection	167.933
J9229	Inj inotuzumab ozogam 0.1 mg	2529.553
J9245	Inj melpha hydroch nos 50 mg	154.188
J9246	Inj., evomela, 1 mg	16.441
J9250	Methotrexate sodium inj	0.274
J9260	Methotrexate sodium inj	2.710
J9261	Nelarabine injection	128.994
J9262	Inj, omacetaxine mep, 0.01mg	4.007
J9263	Oxaliplatin	0.068
J9264	Paclitaxel protein bound	12.056
J9266	Pegaspargase injection	25762.460
J9267	Paclitaxel injection	0.122
J9268	Pentostatin injection	2387.725
J9269	Inj. tagraxofusp-erzs 10 mcg	322.596
J9271	Inj pembrolizumab	54.811
J9272	Inj, dostarlimab-gxly, 10 mg	226.925
J9273	Inj tisotu vedotin-tftv, 1mg	162.051
J9274	Inj, tebentafusp-tebn, 1 mcg	203.827
J9280	Mitomycin injection	79.024
J9281	Mitomycin instillation	296.173
J9293	Mitoxantrone hydrochl / 5 mg	29.060
J9294	Inj pemetrexed, hospira 10mg	9.997
J9295	Injection, necitumumab, 1 mg	5.737
J9296	Inj pemetrexed (accord) 10mg	9.656
J9297	Inj pemetrexed (sandoz) 10mg	1.731
J9298	Inj nivol relatlimab 3mg/1mg	183.630
J9299	Injection, nivolumab	30.457
J9301	Obinutuzumab inj	70.546
J9303	Panitumumab injection	149.709
J9304	Inj. pemetrexed, 10 mg	64.476
J9305	Inj. pemetrexed nos 10mg	7.933
J9306	Injection, pertuzumab, 1 mg	15.366
J9307	Pralatrexate injection	356.512
J9308	Injection, ramucirumab	68.870
J9309	Inj, polatuzumab vedotin 1mg	121.252
J9311	Inj rituximab, hyaluronidase	37.458
J9312	Inj., rituximab, 10 mg	81.037
J9313	Inj., lumoxiti, 0.01 mg	23.394
J9314	Inj pemetrexed (teva) 10mg	12.300
J9316	Pertuzu, trastuzu, 10 mg	68.210
J9317	Sacituzumab govitecan-hziy	33.315
J9319	Inj romidepsin lyophil 0.1mg	30.370
J9320	Streptozocin injection	370.184
J9325	Inj talimogene laherparepvec	66.054
J9328	Temozolomide injection	10.410
J9330	Temsirolimus injection	33.637
J9331	Inj sirolimus prot part 1 mg	107.606
J9332	Inj efgartigimod 2mg	31.811
J9340	Thiotepa injection	259.563
J9347	Inj, tremelimumab-actl, 1 mg	136.560
J9348	Inj. naxitamab-gqgk, 1 mg	579.649
J9349	Inj., tafasitamab-cxix	13.302
J9351	Topotecan injection	0.499
J9352	Injection trabectedin 0.1mg	337.279
J9353	Inj. margetuximab-cmkb, 5 mg	45.881
J9354	Inj, ado-trastuzumab emt 1mg	38.325
J9355	Inj trastuzumab excl biosimi	81.079
J9356	Inj. herceptin hylecta, 10mg	65.583
J9357	Valrubicin injection	1391.799
J9358	Inj fam-trastu deru-nxki 1mg	26.235
J9359	Inj lon tesirin-lpyl 0.075mg	196.449
J9360	Vinblastine sulfate inj	3.952
J9370	Vincristine sulfate 1 mg inj	7.486
J9380	Inj teclistamab cqyv 0.5 mg	30.935
J9381	Inj teplizumab mzwv 5 mcg	36.273
J9390	Vinorelbine tartrate inj	8.268
J9393	Inj, fulvestrant (teva)	21.200
J9394	Inj, fulvestrant (fresenius)	1.653
J9395	Injection, fulvestrant	9.470
J9400	Inj, ziv-aflibercept, 1mg	6.812
P9041	Albumin (human),5%, 50ml	10.615
P9045	Albumin (human), 5%, 250 ml	53.077
P9046	Albumin (human), 25%, 20 ml	21.231
P9047	Albumin (human), 25%, 50ml	53.077
Q0138	Ferumoxytol, non-esrd	0.503
Q0139	Ferumoxytol, esrd use	0.503
Q0162	Ondansetron oral	0.014
Q0167	Dronabinol 2.5mg oral	0.733
Q0222	Bebtelovimab 175 mg	#N/A
Q2041	Axicabtagene ciloleucel car+	449440.000
Q2043	Sipuleucel-t auto cd54+	53062.441
Q2050	Doxorubicin inj 10mg	87.978
Q2053	Brexucabtagene car pos t	449440.000
Q2054	Lisocabtagene mara car pos t	454489.310
Q2056	Ciltacabtagene car-pos t	492900.000
Q3027	Inj beta interferon im 1 mcg	53.147
Q4074	Iloprost non-comp unit dose	144.425
Q4081	Epoetin alfa, 100 units esrd	0.688
Q4101	Apligraf	30.420
Q4102	Oasis wound matrix	12.826
Q4103	Oasis burn matrix	12.938
Q4104	Integra bmwd	48.961
Q4105	Integra drt or omnigraft	26.023
Q4106	Dermagraft	34.478
Q4108	Integra matrix	47.499
Q4110	Primatrix	42.867
Q4111	Gammagraft	7.524
Q4114	Integra flowable wound matri	1530.311
Q4115	Alloskin	15.323
Q4117	Hyalomatrix	22.701
Q4118	Matristem micromatrix	2.499
Q4121	Theraskin	46.984
Q4123	Alloskin	23.844
Q4124	Oasis tri-layer wound matrix	10.037
Q4126	Memoderm/derma/tranz/integup	93.598
Q4127	Talymed	86.750
Q4128	Flexhd/allopatchhd/sq cm	31.213
Q4132	Grafix core, grafixpl core	285.745
Q4133	Grafix stravix prime pl sqcm	137.374
Q4134	Hmatrix	162.078
Q4137	Amnioexcel biodexcel 1sq cm	104.346
Q4143	Repriza, 1cm	27.823
Q4150	Allowrap ds or dry 1 sq cm	77.145
Q4151	Amnioband, guardian 1 sq cm	136.184
Q4152	Dermapure 1 square cm	50.179
Q4153	Dermavest, plurivest sq cm	133.825
Q4154	Biovance 1 square cm	130.411
Q4159	Affinity1 square cm	420.539
Q4160	Nushield 1 square cm	92.907
Q4161	Bio-connekt per square cm	134.825
Q4163	Woundex, bioskin, per sq cm	165.168
Q4166	Cytal, per square centimeter	18.900
Q4168	Amnioband, 1 mg	17.486
Q4169	Artacent wound, per sq cm	264.413
Q4170	Cygnus, per sq cm	42.753
Q4171	Interfyl, 1 mg	12.991
Q4173	Palingen or palingen xplus	367.452
Q4175	Miroderm	63.480
Q4176	Neopatch or therion, 1 sq cm	65.919
Q4178	Floweramniopatch, per sq cm	89.468
Q4180	Revita, per sq cm	103.693
Q4186	Epifix 1 sq cm	148.822
Q4187	Epicord 1 sq cm	242.712
Q4190	Artacent ac 1 sq cm	584.125
Q4196	Puraply am 1 sq cm	102.279
Q4197	Puraply xt 1 sq cm	147.163
Q4199	Cygnus matrix, per sq cm	284.653
Q4201	Matrion 1 sq cm	131.424
Q4203	Derma-gide, 1 sq cm	229.804
Q4210	Axolotl graf dualgraf sq cm	826.800
Q4222	Progenamatrix, per sq cm	115.690
Q4227	Amniocore per sq cm	148.902
Q4229	Cogenex amnio memb per sq cm	170.015
Q4232	Corplex, per sq cm	204.833
Q4234	Xcellerate, per sq cm	856.664
Q4235	Amniorepair or altiply sq cm	165.147
Q4246	Coretext or protext, per cc	2968.000
Q4247	Amniotext patch, per sq cm	530.000
Q4248	Dermacyte amn mem allo sq cm	1107.700
Q4252	Vendaje, per square centimet	175.091
Q4253	Zenith amniotic membrane psc	614.800
Q4258	Enverse, per sq cm	73.787
Q4259	Celera per sq cm	995.341
Q5101	Injection, zarxio	0.181
Q5103	Injection, inflectra	18.427
Q5104	Injection, renflexis	35.547
Q5105	Inj retacrit esrd on dialysi	0.750
Q5106	Inj retacrit non-esrd use	7.495
Q5107	Inj mvasi 10 mg	28.398
Q5108	Injection, fulphila	111.145
Q5110	Nivestym	0.326
Q5111	Injection, udenyca 0.5 mg	124.782
Q5112	Inj ontruzant 10 mg	46.927
Q5113	Inj herzuma 10 mg	29.870
Q5114	Inj ogivri 10 mg	40.405
Q5115	Inj truxima 10 mg	39.791
Q5116	Inj., trazimera, 10 mg	23.154
Q5117	Inj., kanjinti, 10 mg	23.960
Q5118	Inj., zirabev, 10 mg	28.191
Q5119	Inj ruxience, 10 mg	27.509
Q5120	Inj pegfilgrastim-bmez 0.5mg	30.049
Q5121	Inj. avsola, 10 mg	28.334
Q5122	Inj, nyvepria	101.891
Q5123	Inj. riabni, 10 mg	44.579
Q5124	Inj. byooviz, 0.1 mg	220.828
Q5125	Inj, releuko 1 mcg	0.586
Q5126	Inj alymsys 10 mg	72.518
Q5128	Inj, cimerli, 0.1 mg	279.498
Q9950	Inj sulf hexa lipid microsph	18.997
Q9956	Inj octafluoropropane mic,ml	42.720
Q9957	Inj perflutren lip micros,ml	42.720
Q9958	Hocm <=149 mg/ml iodine, 1ml	0.077
Q9961	Hocm 250-299mg/ml iodine,1ml	0.110
Q9963	Hocm 350-399mg/ml iodine,1ml	0.212
Q9965	Locm 100-199mg/ml iodine,1ml	1.308
Q9966	Locm 200-299mg/ml iodine,1ml	0.369
Q9967	Locm 300-399mg/ml iodine,1ml	0.126
Q9991	Buprenorph xr 100 mg or less	1886.367
Q9992	Buprenorphine xr over 100 mg	1886.367

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