HCPCS Code	HCPCS Unit	HCPCS Code Descriptor
C9257	0.25 MG
Manufacturer	Brand Name	Short Description
Genentech, Inc.	Avastin	Bevacizumab injection

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	<	September 2019	October 2019	November 2019	December 2019	January 2020	>
Total NDC's Aligned to this HCPCS Code (?)		2	2	2	2	2
ASP: Average Sales Price		$.00	$.00	$.00	$.00	$.00
ASP+4.3%: Effective Payment Limit (?)		$.00	$.00	$.00	$.00	$.00
ASP+6%: Medicare Payment Limit		N/A	N/A	N/A	N/A	N/A
APC: Ambulatory Procedure Code Payment Limit			$2.03	$2.03	$2.03	$2.02
Lowest HCPCS Unit WAC Price (?)	Please click here to view this data.
Highest HCPCS Unit WAC Price (?)
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Highest HCPCS Unit AWP Price (?)

HCPCS Code	HCPCS Unit	HCPCS Code Descriptor
J9035	10 MG	INJECTION, BEVACIZUMAB, 10 MG
Manufacturer	Brand Name	Short Description
Genentech, Inc.	AVASTIN	Bevacizumab injection

	<	September 2019	October 2019	November 2019	December 2019	January 2020	>
Total NDC's Aligned to this HCPCS Code (?)		2	2	2	2	2
ASP: Average Sales Price		$76.68	$76.59	$76.59	$76.59	$76.08
ASP+4.3%: Effective Payment Limit (?)		$79.98	$79.88	$79.88	$79.88	$79.35
ASP+6%: Medicare Payment Limit		$81.28	$81.18	$81.18	$81.18	$80.64
APC: Ambulatory Procedure Code Payment Limit			$81.18	$81.18	$81.18	$80.64
Lowest HCPCS Unit WAC Price (?)	Please click here to view this data.
Highest HCPCS Unit WAC Price (?)
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Highest HCPCS Unit AWP Price (?)