ASP Changes July 2023

[et_pb_section fb_built=”1″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.21.0″ _module_preset=”default” width=”100%” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text _builder_version=”4.21.0″ _module_preset=”default” text_font=”Arial||||||||” text_font_size=”18px” global_colors_info=”{}” theme_builder_area=”post_content”]

July 2023 ASP Changes: Quarter 3 ASP

[/et_pb_text][et_pb_text _builder_version=”4.21.0″ _module_preset=”default” text_text_color=”#000000″ text_font_size=”18px” custom_margin=”||-10px||false|false” custom_padding=”||1px|||” global_colors_info=”{}” theme_builder_area=”post_content”]

 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.

 

[/et_pb_text][et_pb_button button_url=”https://pricing.buyandbill.com/login/” url_new_window=”on” button_text=”Login to View Pricing Data” button_alignment=”center” _builder_version=”4.21.0″ _module_preset=”default” custom_button=”on” button_text_color=”#FFFFFF” button_bg_color=”gcid-4d0edd0e-a305-4c46-8fd3-eaa616197869″ button_icon=”5||divi||400″ button_icon_color=”#FFFFFF” locked=”off” global_colors_info=”{%22gcid-4d0edd0e-a305-4c46-8fd3-eaa616197869%22:%91%22button_bg_color%22%93}” theme_builder_area=”post_content”][/et_pb_button][/et_pb_column][/et_pb_row][et_pb_row _builder_version=”4.21.0″ _module_preset=”default” width=”100%” custom_margin=”-24px||||false|false” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_code _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”]

HCPCS CodeShort DescriptionPayment Limit
90371Hep b ig im136.744
90375Rabies ig im/sc284.678
90376Rabies ig heat treated250.093
90377Rabies ig ht&sol human im/sc234.090
90586Bcg vaccine intravesical144.714
90632Hepa vaccine adult im71.853
90662Iiv no prsv increased ag im69.941
90670Pcv13 vaccine im257.989
90671PCV15 vaccine IM246.195
90672Laiv4 vaccine intranasal26.876
90674Cciiv4 vac no prsv 0.5 ml im32.278
90675Rabies vaccine im329.989
90677Pcv20 vaccine im288.664
90682Riv4 vacc recombinant dna im69.941
90686Iiv4 vacc no prsv 0.5 ml im21.518
90687Iiv4 vaccine splt 0.25 ml im10.241
90688Iiv4 vaccine splt 0.5 ml im20.482
90694Vacc AIIV4 no prsrv 0.5ML IM71.682
90714Td vacc no presv 7 yrs+ im31.045
90715Tdap vaccine 7 yrs/> im38.745
90732Ppsv23 vacc 2 yrs+ subq/im133.472
90739Hepb vacc 2 dose adult im160.284
90740Hepb vacc 3 dose immunsup im152.124
90743Hep b vacc, adol, 2 dose, im73.847
90744Hepb vacc 3 dose ped/adol im29.895
90746Hepb vaccine 3 dose adult im70.376
90747Hepb vacc 4 dose immunsup im140.752
90756Cciiv4 vacc abx free im30.581
90759Hep b vac 3ag 10mcg 3 dos im73.815
A9575Inj gadoterate meglumi 0.1ml0.135
A9576Inj prohance multipack1.451
A9577Inj multihance1.813
A9578Inj multihance multipack1.833
A9579Gad-base mr contrast nos,1ml1.547
A9581Gadoxetate disodium inj14.730
A9585Gadobutrol injection0.345
A9589Insti hexaminolevulinate hcl1244.440
A9606Radium ra223 dichloride therN/A
J0121Inj., omadacycline, 1 mg3.683
J0122Inj., eravacycline, 1 mg1.133
J0129Abatacept injection43.271
J0131Inj, acetaminophen (nos)0.086
J0132Acetylcysteine injection0.779
J0133Acyclovir injection0.047
J0134Inj acetaminophen -fresenius0.069
J0136Inj, acetaminophen (b braun)0.054
J0137Inj, acetaminophen (hikma)0.075
J0153Adenosine inj 1mg0.540
J0171Adrenalin epinephrine inject0.733
J0172Inj, aducanumab-avwa, 2 mg5.978
J0173Inj, epinephrine (belcher)1.614
J0178Aflibercept injection875.670
J0179Inj, brolucizumab-dbll, 1 mg319.946
J0180Agalsidase beta injection215.378
J0185Inj., aprepitant, 1 mg1.731
J0202Injection, alemtuzumab2283.728
J0206Inj allopurinol sodium 1 mg5.805
J0216Inj, alfentanil hcl, 500mcg2.565
J0218Inj olipudase alfa-rpcp 1mg377.508
J0219Inj aval alfa-nqpt 4mg75.038
J0221Lumizyme injection194.915
J0222Inj., patisiran, 0.1 mg100.472
J0223Inj givosiran 0.5 mg112.486
J0224Inj. lumasiran, 0.5 mg318.998
J0225Inj, vutrisiran, 1 mg4940.950
J0248Inj, remdesivir, 1 mg6.058
J0256Alpha 1 proteinase inhibitor4.878
J0257Glassia injection5.311
J0278Amikacin sulfate injection0.936
J0280Aminophyllin 250 mg inj4.508
J0285Amphotericin b41.673
J0287Amphotericin b lipid complex11.130
J0289Amphotericin b liposome inj27.871
J0290Ampicillin 500 mg inj0.782
J0291Inj., plazomicin, 5 mg3.356
J0295Ampicillin sulbactam 1.5 gm1.890
J0348Anidulafungin injection0.479
J0360Hydralazine hcl injection5.714
J0401Inj aripiprazole ext rel 1mg6.723
J0456Azithromycin2.778
J0461Atropine sulfate injection0.089
J0475Baclofen 10 mg injection182.487
J0476Baclofen intrathecal trial44.966
J0480Basiliximab4389.082
J0485Belatacept injection3.781
J0490Belimumab injection50.927
J0491Inj anifrolumab-fnia 1mg16.656
J0500Dicyclomine injection25.436
J0515Inj benztropine mesylate16.211
J0517Inj., benralizumab, 1 mg170.925
J0558Peng benzathine/procaine inj15.673
J0561Penicillin g benzathine inj20.168
J0565Inj, bezlotoxumab, 10 mg39.853
J0583Bivalirudin0.238
J0584Injection, burosumab-twza 1m426.072
J0585Injection,onabotulinumtoxina6.394
J0586Abobotulinumtoxina8.246
J0587Inj, rimabotulinumtoxinb12.721
J0588Incobotulinumtoxin a5.196
J0592Buprenorphine hydrochloride4.063
J0594Busulfan injection1.383
J0595Butorphanol tartrate 1 mg5.049
J0596Injection, ruconest33.020
J0597C-1 esterase, berinert64.445
J0598C-1 esterase, cinryze60.727
J0612Calcium glucon (fresenius)0.055
J0613Calcium glucon (wg critical)0.083
J0630Calcitonin salmon injection1366.440
J0636Inj calcitriol per 0.1 mcg0.795
J0637Caspofungin acetate8.621
J0638Canakinumab injection121.513
J0640Leucovorin calcium injection4.698
J0642Injection, khapzory, 0.5 mg1.483
J0665Inj, bupivacaine, nos, 0.5mg0.021
J0670Inj mepivacaine hcl/10 ml3.077
J0689Inj cefazolin sodium, baxter1.224
J0690Cefazolin sodium injection0.869
J0691Inj lefamulin 1 mg0.724
J0692Cefepime hcl for injection1.226
J0694Cefoxitin sodium injection5.001
J0695Inj ceftolozane tazobactam7.540
J0696Ceftriaxone sodium injection0.569
J0697Sterile cefuroxime injection2.236
J0699Inj, cefiderocol, 10 mg2.163
J0701Inj. cefepime hcl (baxter)5.718
J0702Betamethasone acet&sod phosp6.956
J0703Inj, cefepime hcl (b braun)5.103
J0712Ceftaroline fosamil inj3.887
J0713Inj ceftazidime per 500 mg1.836
J0714Ceftazidime and avibactam92.479
J0717Certolizumab pegol inj 1mg5.073
J0720Chloramphenicol sodium injec50.261
J0725Chorionic gonadotropin/1000u23.077
J0735Clonidine hydrochloride21.036
J0736Inj, clindamycin phosp 300mg1.606
J0740Cidofovir injection577.031
J0741Inj, cabote rilpivir 2mg 3mg21.842
J0742Inj imip 4 cilas 4 releb 2mg2.488
J0743Cilastatin sodium injection7.145
J0744Ciprofloxacin iv1.955
J0770Colistimethate sodium inj12.282
J0775Collagenase, clost hist inj65.148
J0780Prochlorperazine injection3.014
J0791Inj crizanlizumab-tmca 5mg126.606
J0800Corticotropin injection3819.780
J0834Inj., cosyntropin, 0.25 mg27.881
J0840Crotalidae poly immune fab2056.352
J0841Inj crotalidae im f(ab')2 eq1019.456
J0850Cytomegalovirus imm iv /vial1814.195
J0875Injection, dalbavancin14.703
J0877Inj, daptomycin (hospira)0.071
J0878Daptomycin injection0.078
J0881Darbepoetin alfa, non-esrd2.936
J0882Darbepoetin alfa, esrd use2.936
J0885Epoetin alfa, non-esrd6.876
J0887Epoetin beta esrd use1.647
J0888Epoetin beta non esrd1.647
J0891Argatroban nonesrd (accord)0.460
J0892Argatroban dialysis (accord)0.460
J0893Inj, decitabine (sun pharma)2.240
J0894Decitabine injection2.000
J0895Deferoxamine mesylate inj8.592
J0896Inj luspatercept-aamt 0.25mg39.181
J0897Denosumab injection24.192
J0898Argatroban nonesrd (auromed)1.642
J0899Argatroban dialysis, auromed1.642
J1000Depo-estradiol cypionate inj30.682
J1020Methylprednisolone 20 mg inj7.167
J1030Methylprednisolone 40 mg inj7.613
J1040Methylprednisolone 80 mg inj11.910
J1071Inj testosterone cypionate0.029
J1100Dexamethasone sodium phos0.122
J1110Inj dihydroergotamine mesylt50.588
J1120Acetazolamid sodium injectio29.702
J1160Digoxin injection10.814
J1162Digoxin immune fab (ovine)4593.574
J1165Phenytoin sodium injection0.630
J1170Hydromorphone injection4.347
J1190Dexrazoxane hcl injection113.897
J1200Diphenhydramine hcl injectio1.062
J1201Inj. cetirizine hcl 0.5mg15.065
J1205Chlorothiazide sodium inj61.567
J1212Dimethyl sulfoxide 50% 50 ml682.516
J1230Methadone injection17.143
J1240Dimenhydrinate injection8.977
J1245Dipyridamole injection3.777
J1250Inj dobutamine hcl/250 mg8.825
J1265Dopamine injection0.699
J1270Injection, doxercalciferol0.443
J1290Ecallantide injection530.720
J1300Eculizumab injection225.791
J1301Injection, edaravone, 1 mg21.402
J1302Inj, sutimlimab-jome, 10 mg17.754
J1303Inj., ravulizumab-cwvz 10 mg221.875
J1305Inj, evinacumab-dgnb, 5mg175.777
J1306Injection, inclisiran, 1 mg12.059
J1322Elosulfase alfa, injection280.126
J1325Epoprostenol injection15.999
J1335Ertapenem injection13.322
J1364Erythro lactobionate /500 mg87.328
J1380Estradiol valerate 10 mg inj10.782
J1410Inj estrogen conjugate 25 mg371.893
J1430Ethanolamine oleate 100 mg481.062
J1437Inj. fe derisomaltose 10 mg20.613
J1439Inj ferric carboxymaltos 1mg1.125
J1442Inj filgrastim excl biosimil0.985
J1447Inj tbo filgrastim 1 microg0.426
J1448Injection, trilaciclib, 1mg5.102
J1449Inj eflapegrastim-xnst 0.1mg31.771
J1450Fluconazole2.680
J1453Fosaprepitant injection0.142
J1454Inj fosnetupitant, palonoset371.999
J1456Inj, fosaprepitant (teva)0.098
J1458Galsulfase injection461.919
J1459Inj ivig privigen 500 mg47.992
J1460Gamma globulin 1 cc inj48.465
J1551Inj cutaquig 100 mg14.386
J1554Inj. asceniv491.405
J1555Inj cuvitru, 100 mg16.275
J1556Inj, imm glob bivigam, 500mg72.963
J1557Gammaplex injection59.483
J1558Inj. xembify, 100 mg13.999
J1559Hizentra injection12.803
J1560Gamma globulin > 10 cc inj484.648
J1561Gamunex-c/gammaked50.640
J1566Immune globulin, powder77.766
J1568Octagam injection44.118
J1569Gammagard liquid injection46.031
J1570Ganciclovir sodium injection39.494
J1571Hepagam b im injection66.257
J1572Flebogamma injection56.116
J1575Hyqvia 100mg immuneglobulin16.655
J1576Inj, panzyga, 500 mg65.741
J1580Garamycin gentamicin inj2.992
J1602Golimumab for iv use 1mg13.287
J1610Glucagon hydrochloride/1 mg195.175
J1611Inj glucagon hcl, fresenius101.412
J1626Granisetron hcl injection0.389
J1627Inj, granisetron, xr, 0.1 mg5.877
J1630Haloperidol injection1.383
J1631Haloperidol decanoate inj8.325
J1640Hemin, 1 mg31.081
J1642Inj heparin sodium per 10 u0.069
J1643Inj heparin, pfizer, 1000u6.094
J1644Inj heparin sodium per 1000u0.263
J1645Dalteparin sodium16.601
J1650Inj enoxaparin sodium0.677
J1652Fondaparinux sodium1.071
J1670Tetanus immune globulin inj540.989
J1720Hydrocortisone sodium succ i17.514
J1738Inj. meloxicam 1 mg3.321
J1740Ibandronate sodium injection29.314
J1743Idursulfase injection542.918
J1745Infliximab not biosimil 10mg32.907
J1746Inj., ibalizumab-uiyk, 10 mg74.292
J1747Inj, spesolimab-sbzo, 1 mg60.223
J1750Inj iron dextran17.176
J1756Iron sucrose injection0.206
J1786Imuglucerase injection44.250
J1805Inj, esmolol hcl, 10mg0.250
J1806Inj esmolol hcl wg crit care0.486
J1811Fiasp for insulin pump use7.195
J1813Lyumjev for insulin pump use15.730
J1817Insulin for insulin pump use8.395
J1823Inj. inebilizumab-cdon, 1 mg472.303
J1836Inj, metronidazole, 10 mg0.024
J1885Ketorolac tromethamine inj0.546
J1920Inj, labetalol hcl, 5mg0.244
J1921Inj labetalol hcl hikma, 5mg1.237
J1930Lanreotide injection54.182
J1931Laronidase injection37.043
J1932Inj, lanreotide, (cipla) 1mg51.378
J1940Furosemide injection0.495
J1943Inj., aristada initio, 1 mg3.060
J1944Aripiprazole lauroxil 1 mg3.067
J1950Leuprolide acetate /3.75 mg1543.516
J1951Inj fensolvi 0.25 mg138.807
J1952Leuprolide inj, camcevi, 1mg78.308
J1953Levetiracetam injection0.073
J1954Leuprolide depot cipla 7.5mg425.478
J1955Inj levocarnitine per 1 gm35.415
J1956Levofloxacin injection0.917
J1980Hyoscyamine sulfate inj33.233
J2001Lidocaine injection0.030
J2010Lincomycin injection9.991
J2020Linezolid injection3.471
J2021Inj, linezolid (hospira)9.480
J2060Lorazepam injection0.852
J2150Mannitol injection4.930
J2175Meperidine hydrochl /100 mg7.309
J2182Injection, mepolizumab, 1mg29.747
J2184Inj, meropenem (b. braun)2.101
J2185Meropenem0.518
J2210Methylergonovin maleate inj20.893
J2247Inj, micafungin (par pharm)0.291
J2248Micafungin sodium injection0.830
J2250Inj midazolam hydrochloride0.140
J2251Inj midazolam (wg crit care)0.288
J2260Inj milrinone lactate / 5 mg1.874
J2270Morphine sulfate injection4.600
J2272Inj, morphine (fresenius)6.929
J2274Inj morphine pf epid ithc15.701
J2278Ziconotide injection9.078
J2280Inj, moxifloxacin 100 mg9.845
J2281Inj moxifloxacin (fres kabi)4.495
J2300Inj nalbuphine hydrochloride2.716
J2305Inj, nitroglycerin, 5 mg1.296
J2310Inj naloxone hydrochloride9.450
J2311Inj, naloxone hcl (zimhi)8.508
J2315Naltrexone, depot form3.940
J2323Natalizumab injection24.863
J2327Inj risankizumab-rzaa 1 mg15.519
J2350Injection, ocrelizumab, 1 mg61.417
J2353Octreotide injection, depot208.117
J2354Octreotide inj, non-depot1.314
J2356Inj tezepelumab-ekko, 1mg18.729
J2357Omalizumab injection39.383
J2358Olanzapine long-acting inj2.917
J2360Orphenadrine injection16.536
J2372Inj, biorphen, 20 micrograms0.188
J2401Chloroprocaine hcl injection0.039
J2405Ondansetron hcl injection0.111
J2406Injection, oritavancin 10 mg41.734
J2407Injection, oritavancin26.894
J2426Inj, invega sustenna, 1 mgj14.217
J2427Inj, invega hafyera/trinza12.108
J2430Pamidronate disodium /30 mg10.316
J2469Palonosetron hcl1.001
J2501Paricalcitol0.498
J2506Inj pegfilgrast ex bio 0.5mg85.710
J2507Pegloticase injection3268.450
J2510Penicillin g procaine inj43.376
J2540Penicillin g potassium inj1.070
J2543Piperacillin/tazobactam1.359
J2545Pentamidine non-comp unit93.857
J2550Promethazine hcl injection3.147
J2560Phenobarbital sodium inj39.383
J2562Plerixafor injection429.363
J2597Inj desmopressin acetate7.271
J2598Inj, vasopressin, 1 unit2.919
J2599Inj vasopressin (am reg) 1 u2.098
J2675Inj progesterone per 50 mg0.970
J2680Fluphenazine decanoate 25 mg10.952
J2690Procainamide hcl injection307.989
J2700Oxacillin sodium injeciton1.173
J2704Inj, propofol, 10 mg0.098
J2720Inj protamine sulfate/10 mg0.947
J2724Protein c concentrate15.112
J2760Phentolaine mesylate inj458.182
J2765Metoclopramide hcl injection1.235
J2777Inj, faricimab-svoa, 0.1mg37.089
J2778Ranibizumab injection236.583
J2779Inj, susvimo 0.1 mg81.018
J2783Rasburicase357.364
J2785Regadenoson injection62.275
J2786Injection, reslizumab, 1mg10.198
J2788Rho d immune globulin 50 mcg26.918
J2790Rho d immune globulin inj81.831
J2791Rhophylac injection4.901
J2792Rho(d) immune globulin h, sd33.710
J2794Inj risperdal consta, 0.5 mg12.023
J2795Ropivacaine hcl injection0.074
J2796Romiplostim injection95.468
J2798Inj., perseris, 0.5 mg11.669
J2800Methocarbamol injection6.650
J2805Sincalide injection133.543
J2820Sargramostim injection58.311
J2860Injection, siltuximab139.218
J2916Na ferric gluconate complex2.123
J2920Methylprednisolone injection4.237
J2930Methylprednisolone injection5.725
J2997Alteplase recombinant89.146
J2998Inj plasminogen tvmh 1mg30.095
J3000Streptomycin injection31.568
J3010Fentanyl citrate injection0.837
J3032Inj. eptinezumab-jjmr 1 mg17.443
J3060Inj, taliglucerase alfa 10 u44.561
J3090Inj tedizolid phosphate1.709
J3095Telavancin injection6.826
J3101Tenecteplase injection152.696
J3105Terbutaline sulfate inj2.290
J3111Inj. romosozumab-aqqg 1 mg10.367
J3121Inj testostero enanthate 1mg0.047
J3145Testosterone undecanoate 1mg1.904
J3230Chlorpromazine hcl injection35.950
J3240Thyrotropin injection2001.485
J3241Inj. teprotumumab-trbw 10 mg327.998
J3243Tigecycline injection0.743
J3245Inj., tildrakizumab, 1 mg143.265
J3250Trimethobenzamide hcl inj45.041
J3260Tobramycin sulfate injection2.652
J3262Tocilizumab injection5.910
J3285Treprostinil injection55.196
J3299Inj xipere 1 mg48.486
J3300Triamcinolone a inj prs-free4.269
J3301Triamcinolone acet inj nos1.005
J3304Inj triamcinolone ace xr 1mg17.114
J3315Triptorelin pamoate382.392
J3357Ustekinumab sub cu inj, 1 mg147.647
J3358Ustekinumab, iv inject, 1 mg12.594
J3360Diazepam injection5.250
J3370Vancomycin hcl injection2.409
J3371Inj, vancomycin hcl (mylan)6.298
J3372Inj, vancomycin hcl (xellia)6.578
J3380Injection, vedolizumab22.677
J3385Velaglucerase alfa367.181
J3396Verteporfin injection11.416
J3410Hydroxyzine hcl injection13.622
J3411Thiamine hcl 100 mg2.502
J3415Pyridoxine hcl 100 mg15.897
J3420Vitamin b12 injection1.310
J3430Vitamin k phytonadione inj2.872
J3465Injection, voriconazole1.223
J3471Ovine, up to 999 usp units0.494
J3473Hyaluronidase recombinant0.359
J3475Inj magnesium sulfate0.934
J3480Inj potassium chloride0.101
J3485Zidovudine1.512
J3486Ziprasidone mesylate9.603
J3489Zoledronic acid 1mg9.085
J7030Normal saline solution infus2.539
J7040Normal saline solution infus1.270
J70425% dextrose/normal saline1.178
J7050Normal saline solution infus0.635
J70605% dextrose/water1.812
J7070D5w infusion3.623
J7120Ringers lactate infusion2.389
J7170Inj., emicizumab-kxwh 0.5 mg51.005
J7175Inj, factor x, (human), 1iu9.091
J7177Inj., fibryga, 1 mg1.098
J7178Inj human fibrinogen con nos1.383
J7179Vonvendi inj 1 iu vwf:rco1.781
J7180Factor xiii anti-hem factor9.683
J7181Factor xiii recomb a-subunit16.886
J7182Factor viii recomb novoeight1.283
J7183Wilate injection1.259
J7185Xyntha inj1.376
J7186Antihemophilic viii/vwf comp1.216
J7187Humate-p, inj1.347
J7188Factor viii recomb obizur3.217
J7189Factor viia recomb novoseven2.412
J7190Factor viii1.029
J7192Factor viii recombinant nos1.506
J7193Factor ix non-recombinant1.297
J7194Factor ix complex1.615
J7195Factor ix recombinant nos1.756
J7197Antithrombin iii injection3.350
J7198Anti-inhibitor2.232
J7200Factor ix recombinan rixubis1.614
J7201Factor ix alprolix recomb3.460
J7202Factor ix idelvion inj4.932
J7203Factor ix recomb gly rebinyn4.414
J7204Inj recombin esperoct per iu2.108
J7205Factor viii fc fusion recomb2.173
J7207Factor viii pegylated recomb2.106
J7208Inj. jivi 1 iu2.354
J7209Factor viii nuwiq recomb 1iu1.358
J7210Inj, afstyla, 1 i.u.1.436
J7211Inj, kovaltry, 1 i.u.1.436
J7212Factor viia recomb sevenfact2.013
J7213Inj, ixinity, 1 i.u.1.746
J7308Aminolevulinic acid hcl top391.230
J7311Inj., retisert, 0.01 mg322.381
J7312Dexamethasone intra implant204.677
J7313Inj., iluvien, 0.01 mg490.947
J7314Inj., yutiq, 0.01 mg529.269
J7318Inj, durolane 1 mg6.061
J7320Genvisc 850, inj, 1mg6.105
J7321Hyalgan supartz visco-3 dose73.480
J7322Hymovis injection 1 mg17.019
J7323Euflexxa inj per dose131.420
J7324Orthovisc inj per dose117.377
J7325Synvisc or synvisc-one9.617
J7326Gel-one516.727
J7327Monovisc inj per dose692.752
J7328Gelsyn-3 injection 0.1 mg0.615
J7329Inj, trivisc 1 mg8.795
J7331Synojoynt, inj., 1 mg13.250
J7332Inj., triluron, 1 mg10.055
J7336Capsaicin 8% patch3.274
J7340Carbidopa levodopa ent 100ml226.831
J7342Ciprofloxacin otic susp 6 mg30.019
J7345Aminolevulinic acid, 10% gel1.649
J7351Inj bimatoprost itc imp1mcg206.406
J7402Mometasone sinus sinuva11.345
J7500Azathioprine oral 50mg13.701
J7502Cyclosporine oral 100 mg1.759
J7503Tacrol envarsus ex rel oral1.673
J7504Lymphocyte immune globulin2989.437
J7507Tacrolimus imme rel oral 1mg0.287
J7508Tacrol astagraf ex rel oral0.549
J7509Methylprednisolone oral0.261
J7510Prednisolone oral per 5 mg0.248
J7511Antithymocyte globuln rabbit920.534
J7512Prednisone ir or dr oral 1mg0.006
J7515Cyclosporine oral 25 mg0.754
J7517Mycophenolate mofetil oral0.212
J7518Mycophenolic acid0.672
J7520Sirolimus, oral3.107
J7525Tacrolimus injection246.085
J7527Oral everolimus3.201
J7605Arformoterol non-comp unit3.286
J7606Formoterol fumarate, inh5.189
J7608Acetylcysteine non-comp unit6.844
J7611Albuterol non-comp con0.133
J7612Levalbuterol non-comp con0.254
J7613Albuterol non-comp unit0.030
J7614Levalbuterol non-comp unit0.035
J7620Albuterol ipratrop non-comp0.131
J7626Budesonide non-comp unit0.878
J7631Cromolyn sodium noncomp unit1.658
J7639Dornase alfa non-comp unit52.234
J7644Ipratropium bromide non-comp0.258
J7674Methacholine chloride, neb0.863
J7677Revefenacin inh non-com 1mcg0.196
J7682Tobramycin non-comp unit29.624
J7686Treprostinil, non-comp unit737.376
J8501Oral aprepitant3.119
J8520Capecitabine, oral, 150 mg0.796
J8521Capecitabine, oral, 500 mg22.876
J8530Cyclophosphamide oral 25 mg0.953
J8540Oral dexamethasone0.103
J8560Etoposide oral 50 mg77.388
J8610Methotrexate oral 2.5 mg0.232
J8655Oral netupitant, palonosetro461.255
J8670Rolapitant, oral, 1mg1.625
J8700Temozolomide0.189
J8705Topotecan oral112.300
J9000Doxorubicin hcl injection2.501
J9017Arsenic trioxide injection12.966
J9021Inj, aspara, rylaze, 0.1 mg49.530
J9022Inj, atezolizumab,10 mg82.678
J9023Injection, avelumab, 10 mg90.569
J9025Azacitidine injection0.402
J9027Clofarabine injection29.424
J9030Bcg live intravesical 1mg2.894
J9032Injection, belinostat, 10mg47.622
J9033Inj., treanda 1 mg12.282
J9034Inj., bendeka 1 mg16.508
J9035Bevacizumab injection73.579
J9036Inj. belrapzo/bendamustine16.716
J9039Injection, blinatumomab144.683
J9040Bleomycin sulfate injection24.533
J9041Injection, bortezomib, 0.1mg3.031
J9042Brentuximab vedotin inj221.964
J9043Cabazitaxel injection206.032
J9045Carboplatin injection2.408
J9046Inj, bortezomib, dr. reddy's48.547
J9047Injection, carfilzomib, 1 mg47.040
J9049Inj, bortezomib, hospira3.892
J9050Carmustine injection410.962
J9055Cetuximab injection72.078
J9056Inj, bendamustine, 1 mg33.325
J9059Inj bendamustine, baxter 1mg23.958
J9060Cisplatin 10 mg injection3.172
J9061Inj, amivantamab-vmjw19.631
J9063Inj, elahere, 1 mg65.802
J9065Inj cladribine per 1 mg18.296
J9070Cyclophosphamide 100 mg inj17.087
J9071Inj cyclophosphamd auromedic3.869
J9100Cytarabine hcl 100 mg inj0.917
J9118Inj. calaspargase pegol-mknl72.869
J9119Inj., cemiplimab-rwlc, 1 mg26.923
J9120Dactinomycin injection594.546
J9130Dacarbazine 100 mg inj4.050
J9144Daratumumab, hyaluronidase49.120
J9145Injection, daratumumab 10 mg61.783
J9150Daunorubicin injection45.622
J9153Inj daunorubicin, cytarabine227.232
J9155Degarelix injection4.194
J9171Docetaxel injection0.937
J9173Inj., durvalumab, 10 mg79.763
J9176Injection, elotuzumab, 1mg7.191
J9177Inj enfort vedo-ejfv 0.25mg33.818
J9178Inj, epirubicin hcl, 2 mg1.344
J9179Eribulin mesylate injection128.777
J9181Etoposide injection0.704
J9185Fludarabine phosphate inj604.748
J9190Fluorouracil injection1.830
J9196Inj gemcitabine hcl (accord)3.715
J9198Inj. infugem, 100 mg40.280
J9200Floxuridine injection3551.000
J9201In gemcitabine hcl nos 200mg3.706
J9202Goserelin acetate implant613.565
J9203Gemtuzumab ozogamicin 0.1 mg221.843
J9204Inj mogamulizumab-kpkc, 1 mg226.706
J9205Inj irinotecan liposome 1 mg61.964
J9206Irinotecan injection3.003
J9207Ixabepilone injection122.548
J9208Ifosfamide injection25.384
J9209Mesna injection1.669
J9210Inj., emapalumab-lzsg, 1 mg393.723
J9211Idarubicin hcl injection33.898
J9214Interferon alfa-2b inj32.574
J9217Leuprolide acetate suspnsion165.863
J9218Leuprolide acetate injeciton10.057
J9223Inj. lurbinectedin, 0.1 mg197.177
J9226Supprelin la implant43270.018
J9227Inj. isatuximab-irfc 10 mg74.349
J9228Ipilimumab injection167.933
J9229Inj inotuzumab ozogam 0.1 mg2529.553
J9245Inj melpha hydroch nos 50 mg154.188
J9246Inj., evomela, 1 mg16.441
J9250Methotrexate sodium inj0.274
J9260Methotrexate sodium inj2.710
J9261Nelarabine injection128.994
J9262Inj, omacetaxine mep, 0.01mg4.007
J9263Oxaliplatin0.068
J9264Paclitaxel protein bound12.056
J9266Pegaspargase injection25762.460
J9267Paclitaxel injection0.122
J9268Pentostatin injection2387.725
J9269Inj. tagraxofusp-erzs 10 mcg322.596
J9271Inj pembrolizumab54.811
J9272Inj, dostarlimab-gxly, 10 mg226.925
J9273Inj tisotu vedotin-tftv, 1mg162.051
J9274Inj, tebentafusp-tebn, 1 mcg203.827
J9280Mitomycin injection79.024
J9281Mitomycin instillation296.173
J9293Mitoxantrone hydrochl / 5 mg29.060
J9294Inj pemetrexed, hospira 10mg9.997
J9295Injection, necitumumab, 1 mg5.737
J9296Inj pemetrexed (accord) 10mg9.656
J9297Inj pemetrexed (sandoz) 10mg1.731
J9298Inj nivol relatlimab 3mg/1mg183.630
J9299Injection, nivolumab30.457
J9301Obinutuzumab inj70.546
J9303Panitumumab injection149.709
J9304Inj. pemetrexed, 10 mg64.476
J9305Inj. pemetrexed nos 10mg7.933
J9306Injection, pertuzumab, 1 mg15.366
J9307Pralatrexate injection356.512
J9308Injection, ramucirumab68.870
J9309Inj, polatuzumab vedotin 1mg121.252
J9311Inj rituximab, hyaluronidase37.458
J9312Inj., rituximab, 10 mg81.037
J9313Inj., lumoxiti, 0.01 mg23.394
J9314Inj pemetrexed (teva) 10mg12.300
J9316Pertuzu, trastuzu, 10 mg68.210
J9317Sacituzumab govitecan-hziy33.315
J9319Inj romidepsin lyophil 0.1mg30.370
J9320Streptozocin injection370.184
J9325Inj talimogene laherparepvec66.054
J9328Temozolomide injection10.410
J9330Temsirolimus injection33.637
J9331Inj sirolimus prot part 1 mg107.606
J9332Inj efgartigimod 2mg31.811
J9340Thiotepa injection259.563
J9347Inj, tremelimumab-actl, 1 mg136.560
J9348Inj. naxitamab-gqgk, 1 mg579.649
J9349Inj., tafasitamab-cxix13.302
J9351Topotecan injection0.499
J9352Injection trabectedin 0.1mg337.279
J9353Inj. margetuximab-cmkb, 5 mg45.881
J9354Inj, ado-trastuzumab emt 1mg38.325
J9355Inj trastuzumab excl biosimi81.079
J9356Inj. herceptin hylecta, 10mg65.583
J9357Valrubicin injection1391.799
J9358Inj fam-trastu deru-nxki 1mg26.235
J9359Inj lon tesirin-lpyl 0.075mg196.449
J9360Vinblastine sulfate inj3.952
J9370Vincristine sulfate 1 mg inj7.486
J9380Inj teclistamab cqyv 0.5 mg30.935
J9381Inj teplizumab mzwv 5 mcg36.273
J9390Vinorelbine tartrate inj8.268
J9393Inj, fulvestrant (teva)21.200
J9394Inj, fulvestrant (fresenius)1.653
J9395Injection, fulvestrant9.470
J9400Inj, ziv-aflibercept, 1mg6.812
P9041Albumin (human),5%, 50ml10.615
P9045Albumin (human), 5%, 250 ml53.077
P9046Albumin (human), 25%, 20 ml21.231
P9047Albumin (human), 25%, 50ml53.077
Q0138Ferumoxytol, non-esrd0.503
Q0139Ferumoxytol, esrd use0.503
Q0162Ondansetron oral0.014
Q0167Dronabinol 2.5mg oral0.733
Q0222Bebtelovimab 175 mg#N/A
Q2041Axicabtagene ciloleucel car+449440.000
Q2043Sipuleucel-t auto cd54+53062.441
Q2050Doxorubicin inj 10mg87.978
Q2053Brexucabtagene car pos t449440.000
Q2054Lisocabtagene mara car pos t454489.310
Q2056Ciltacabtagene car-pos t492900.000
Q3027Inj beta interferon im 1 mcg53.147
Q4074Iloprost non-comp unit dose144.425
Q4081Epoetin alfa, 100 units esrd0.688
Q4101Apligraf30.420
Q4102Oasis wound matrix12.826
Q4103Oasis burn matrix12.938
Q4104Integra bmwd48.961
Q4105Integra drt or omnigraft26.023
Q4106Dermagraft34.478
Q4108Integra matrix47.499
Q4110Primatrix42.867
Q4111Gammagraft7.524
Q4114Integra flowable wound matri1530.311
Q4115Alloskin15.323
Q4117Hyalomatrix22.701
Q4118Matristem micromatrix2.499
Q4121Theraskin46.984
Q4123Alloskin23.844
Q4124Oasis tri-layer wound matrix10.037
Q4126Memoderm/derma/tranz/integup93.598
Q4127Talymed86.750
Q4128Flexhd/allopatchhd/sq cm31.213
Q4132Grafix core, grafixpl core285.745
Q4133Grafix stravix prime pl sqcm137.374
Q4134Hmatrix162.078
Q4137Amnioexcel biodexcel 1sq cm104.346
Q4143Repriza, 1cm27.823
Q4150Allowrap ds or dry 1 sq cm77.145
Q4151Amnioband, guardian 1 sq cm136.184
Q4152Dermapure 1 square cm50.179
Q4153Dermavest, plurivest sq cm133.825
Q4154Biovance 1 square cm130.411
Q4159Affinity1 square cm420.539
Q4160Nushield 1 square cm92.907
Q4161Bio-connekt per square cm134.825
Q4163Woundex, bioskin, per sq cm165.168
Q4166Cytal, per square centimeter18.900
Q4168Amnioband, 1 mg17.486
Q4169Artacent wound, per sq cm264.413
Q4170Cygnus, per sq cm42.753
Q4171Interfyl, 1 mg12.991
Q4173Palingen or palingen xplus367.452
Q4175Miroderm63.480
Q4176Neopatch or therion, 1 sq cm65.919
Q4178Floweramniopatch, per sq cm89.468
Q4180Revita, per sq cm103.693
Q4186Epifix 1 sq cm148.822
Q4187Epicord 1 sq cm242.712
Q4190Artacent ac 1 sq cm584.125
Q4196Puraply am 1 sq cm102.279
Q4197Puraply xt 1 sq cm147.163
Q4199Cygnus matrix, per sq cm284.653
Q4201Matrion 1 sq cm131.424
Q4203Derma-gide, 1 sq cm229.804
Q4210Axolotl graf dualgraf sq cm826.800
Q4222Progenamatrix, per sq cm115.690
Q4227Amniocore per sq cm148.902
Q4229Cogenex amnio memb per sq cm170.015
Q4232Corplex, per sq cm204.833
Q4234Xcellerate, per sq cm856.664
Q4235Amniorepair or altiply sq cm165.147
Q4246Coretext or protext, per cc2968.000
Q4247Amniotext patch, per sq cm530.000
Q4248Dermacyte amn mem allo sq cm1107.700
Q4252Vendaje, per square centimet175.091
Q4253Zenith amniotic membrane psc614.800
Q4258Enverse, per sq cm73.787
Q4259Celera per sq cm995.341
Q5101Injection, zarxio0.181
Q5103Injection, inflectra18.427
Q5104Injection, renflexis35.547
Q5105Inj retacrit esrd on dialysi0.750
Q5106Inj retacrit non-esrd use7.495
Q5107Inj mvasi 10 mg28.398
Q5108Injection, fulphila111.145
Q5110Nivestym0.326
Q5111Injection, udenyca 0.5 mg124.782
Q5112Inj ontruzant 10 mg46.927
Q5113Inj herzuma 10 mg29.870
Q5114Inj ogivri 10 mg40.405
Q5115Inj truxima 10 mg39.791
Q5116Inj., trazimera, 10 mg23.154
Q5117Inj., kanjinti, 10 mg23.960
Q5118Inj., zirabev, 10 mg28.191
Q5119Inj ruxience, 10 mg27.509
Q5120Inj pegfilgrastim-bmez 0.5mg30.049
Q5121Inj. avsola, 10 mg28.334
Q5122Inj, nyvepria101.891
Q5123Inj. riabni, 10 mg44.579
Q5124Inj. byooviz, 0.1 mg220.828
Q5125Inj, releuko 1 mcg0.586
Q5126Inj alymsys 10 mg72.518
Q5128Inj, cimerli, 0.1 mg279.498
Q9950Inj sulf hexa lipid microsph18.997
Q9956Inj octafluoropropane mic,ml42.720
Q9957Inj perflutren lip micros,ml42.720
Q9958Hocm <=149 mg/ml iodine, 1ml0.077
Q9961Hocm 250-299mg/ml iodine,1ml0.110
Q9963Hocm 350-399mg/ml iodine,1ml0.212
Q9965Locm 100-199mg/ml iodine,1ml1.308
Q9966Locm 200-299mg/ml iodine,1ml0.369
Q9967Locm 300-399mg/ml iodine,1ml0.126
Q9991Buprenorph xr 100 mg or less1886.367
Q9992Buprenorphine xr over 100 mg1886.367
[/et_pb_code][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.19.4″ _module_preset=”default” global_colors_info=”{}” theme_builder_area=”post_content”][/et_pb_section]