| 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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January 2019 |
February 2019 |
March 2019 |
April 2019 |
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Total NDC's Aligned to this HCPCS Code
|
2 | 2 | 2 | 2 | 2 | ||
| Average Sales Price: ASP | $.00 | $.00 | $.00 | $.00 | $.00 | ||
Effective Payment Limit: ASP+4.3%
|
$.00 | $.00 | $.00 | $.00 | $.00 | ||
| Medicare Payment Limit ASP+6% | N/A | N/A | N/A | N/A | N/A | ||
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| HCPCS Code | HCPCS Unit | HCPCS Code Descriptor |
| J9035 | 10 MG | INJECTION, BEVACIZUMAB, 10 MG |
| Manufacturer | Brand Name | Short Description |
| Genentech, Inc. | AVASTIN | Bevacizumab injection |
| < | December 2018 |
January 2019 |
February 2019 |
March 2019 |
April 2019 |
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Total NDC's Aligned to this HCPCS Code
|
2 | 2 | 2 | 2 | 2 | ||
| Average Sales Price: ASP | $74.77 | $76.58 | $76.58 | $76.58 | $76.62 | ||
Effective Payment Limit: ASP+4.3%
|
$77.98 | $79.88 | $79.88 | $79.88 | $79.92 | ||
| Medicare Payment Limit ASP+6% | $79.25 | $81.18 | $81.18 | $81.18 | $81.22 | ||
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