healthcosts.net

Drugs costs at US hospitals

Procedure Code Lowest cash National median Highest Hospitals
Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 $83.20 $361.60 $5,313.35 14
Abciximab injection HCPCS J0130 $3,955.80 $6,244.80 $6,244.80 3
Abobotulinumtoxina HCPCS J0586 $2,911.20 $3,255.66 $4,582.80 6
Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 $2.40 $47.40 $160.80 9
Acetazolamide 500 mg solution for injection HCPCS J1120 $25.80 $256.80 $1,307.40 13
Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 $81.60 $648.00 $2,785.80 12
Acetylcysteine non-comp unit HCPCS J7608 $42.80 $87.97 $438.00 12
Acyclovir 400 mg tablet HCPCS J8499 $13.20 $100,424.10 $100,424.10 5
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 $6.00 $77.65 $427.20 11
Adenosine 3 mg/250 ml bag for osm HCPCS J0153 $55.20 $528.78 $3,166.80 13
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 $44.40 $450.00 $5,046.43 14
Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 $102.60 $139.20 $6,328.80 7
Afamelanotide implant, 1 mg HCPCS J7352 $6,227.40 $6,529.20 $140,689.80 6
Aflibercept injection HCPCS J0178 $6,024.00 $6,024.00 $6,024.00 1
Agalsidase beta 35 mg intravenous solution HCPCS J0180 $4,783.20 $27,295.80 $28,942.08 8
Albuterol ipratrop non-comp HCPCS J7620 $2.43 $13.80 $38.25 12
Albuterol non-comp con HCPCS J7611 $0.80 $5.00 $44.56 12
Albuterol non-comp unit HCPCS J7613 $2.43 $7.20 $18.00 12
Aldesleukin injection HCPCS J9015 $3,330.60 $6,538.20 $8,184.00 7
Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 $8,173.80 $16,540.80 $112,036.08 7
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 $29.80 $40.40 $378.00 10
Alprostadil for injection HCPCS J0270 $12.00 $550.20 $800.48 8
Alteplase 100 mg infusion from pyxis vial HCPCS J2997 $540.80 $31,563.16 $40,758.00 11
Altuviiio per factor viii iu HCPCS J7214 $13.80 $13.80 $13.80 1
Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 $3.60 $27.00 $79.87 14
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 $8.00 $9.15 $35.21 12
Aminolevulinic acid, 10% gel HCPCS J7345 $3.00 $3.00 $3.00 1
Aminolevulinic acid hcl top HCPCS J7308 $725.40 $725.40 $725.40 1
Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 $7.80 $65.64 $92.80 13
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 $119.07 $119.07 $119.07 3
Amiodarone 50 mg/ml intravenous solution HCPCS J0282 $42.80 $96.80 $224.40 11
Amitriptyline injection HCPCS J1320 — — — 0
Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 $32.40 $14,075.19 $14,075.19 5
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 $28.80 $146.40 $176.40 13
Amphotericin b lipid complex HCPCS J0287 $87.60 $272.40 $360.00 6
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 $109.80 $592.80 $2,961.60 14
Ampicillin 1 gram solution for injection HCPCS J0290 $16.20 $110.40 $316.80 13
Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 $18.87 $61.20 $246.60 13
Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 — — — 0
Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 $1,346.40 $22,037.40 $99,634.80 13
Anidulafungin injection HCPCS J0348 $8.40 $116.22 $2,876.40 8
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 $11.40 $15.20 $30.60 9
Antihemophilic viii/vwf comp HCPCS J7186 $10.20 $10.20 $10.20 2
Anti-inhibitor HCPCS J7198 $2.40 $11.60 $18,764.82 9
Antithrombin iii injection HCPCS J7197 $15.20 $70.20 $6,858.87 7
Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 $3,726.60 $3,726.60 $17,349.88 6
Antithymocyte globuln rabbit HCPCS J7511 $639.60 $4,139.25 $4,183.80 8
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 $4.20 $9.20 $13.80 9
Argatroban nonesrd (accord) HCPCS J0891 — — — 0
Argatroban nonesrd (auromed) HCPCS J0898 $668.52 $668.52 $668.52 3
Argatroban nonesrd use 1mg HCPCS J0883 $64.80 $881.10 $3,121.80 9
Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 $9.60 $579.60 $11,842.72 9
Aripiprazole injection HCPCS J0400 $4.80 $4.80 $4.80 1
Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 $35.40 $292.80 $2,751.00 10
Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 $273.60 $311.20 $450.40 7
Atropine 0.1 mg/ml injection syringe HCPCS J0461 $2.70 $39.35 $227.40 13
Avelumab 20 mg/ml intravenous solution HCPCS J9023 $112.20 $231.00 $2,189.40 8
Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 $99.60 $100.20 $100.20 4
Azacitidine injection HCPCS J9025 $237.60 $2,163.93 $2,860.20 11
Azathioprine 50 mg tablet HCPCS J7500 $10.40 $14.40 $29.25 9
Azathioprine parenteral HCPCS J7501 $250.80 $771.30 $2,562.00 5
Azithromycin 500 mg intravenous solution HCPCS J0456 $22.93 $186.40 $1,063.80 12
Aztreonam 1 gram solution for injection HCPCS J0457 $11.80 $21.60 $203.80 14
Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 $1,134.00 $3,464.00 $7,524.60 9
Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 $43.80 $420.00 $3,171.60 9
Basiliximab HCPCS J0480 $2,629.20 $7,420.80 $15,941.19 7
Bcg live 50 mg intravesical suspension HCPCS J9030 $22.20 $605.43 $732.60 6
Belatacept 250 mg intravenous solution HCPCS J0485 $581.40 $3,406.85 $5,053.80 8
Belimumab 120 mg intravenous solution HCPCS J0490 $1,225.80 $7,881.60 $7,979.25 8
Bendamustine 100 mg intravenous powder for solution HCPCS J9033 $53.40 $214.20 $19,878.00 5
Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 — — — 0
Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 $24.00 $87.00 $370.80 10
Bendamustine 25 mg/ml intravenous solution (vivimusta) HCPCS J9056 — — — 0
Benztropine 1 mg/ml injection solution HCPCS J0515 $43.80 $115.80 $277.80 13
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 $39.00 $149.68 $287.40 13
Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 $398.40 $2,946.69 $25,358.40 13
Bivalirudin HCPCS J0583 $585.00 $5,267.40 $18,344.51 10
Bleomycin 15 unit solution for injection HCPCS J9040 $34.20 $306.40 $2,601.60 14
Blinatumomab 35 mcg intravenous solution HCPCS J9039 $311.40 $417.00 $20,544.09 8
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 $241.20 $3,308.40 $11,202.60 11
Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 $843.20 $31,641.60 $46,868.78 9
Budesonide non-comp unit HCPCS J7626 $32.78 $463.20 $1,982.40 12
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 $0.60 $9.00 $58.80 11
Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 $0.40 $1.40 $2.00 10
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 $15.40 $20.25 $89.40 9
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 $25.00 $36.60 $64.40 9
Buprenorphine hydrochloride HCPCS J0592 $9.00 $14.40 $52.01 12
Buprenorphine oral 1mg HCPCS J0571 $2.40 $715.66 $715.66 4
Busulfan injection HCPCS J0594 $40.80 $783.10 $2,442.60 6
Butorphanol tartrate 1 mg HCPCS J0595 $4.80 $90.60 $133.20 11
C-1 esterase, berinert HCPCS J0597 $156.00 $168.60 $8,429.40 9
C-1 esterase, cinryze HCPCS J0598 $5,831.40 $5,831.40 $12,877.20 2
Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 $367.20 $495.60 $1,397.40 8
Cabergoline, oral 0.25mg HCPCS J8515 $70.80 $173.02 $242.40 9
Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er HCPCS J0741 — — — 0
Caffeine citrate 20 mg/ml inj for po HCPCS J0706 $7.20 $106.71 $276.00 11
Calaspargase pegol-mknl 750 unit/ml intravenous solution HCPCS J9118 $279.00 $279.00 $279.00 1
Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 $939.60 $9,437.60 $20,030.40 13
Calcium acetate(phosphate binders) 667 mg tablet HCPCS J0615 — — — 0
Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 $71.82 $71.82 $71.82 3
Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 $0.60 $0.80 $3.00 10
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 $0.60 $0.80 $0.80 9
Canakinumab injection HCPCS J0638 $257.40 $79,068.64 $79,068.64 5
Cantharidin top, applicator HCPCS J7354 — — — 0
Capecitabine, oral, 50 mg HCPCS J8522 $7.80 $20,888.96 $20,888.96 5
Capsaicin 8% patch HCPCS J7336 $9.75 $9.75 $19.20 4
Carbidopa levodopa ent 100ml HCPCS J7340 — — — 0
Carboplatin 10 mg/ml desensitization HCPCS J9045 $45.78 $500.40 $1,696.00 12
Carboprost tromethamine 250 mcg/ml intramuscular solution HCPCS J0675 $334.92 $334.92 $334.92 3
Carfilzomib 10 mg intravenous solution HCPCS J9047 $102.00 $1,876.80 $13,992.87 13
Carmustine 100 mg intravenous powder for solution HCPCS J9050 $287.40 $2,713.80 $21,846.60 11
Caspofungin acetate HCPCS J0637 $240.00 $1,752.00 $4,123.80 12
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 $7.78 $16.40 $78.60 13
Cefepime 1 gram solution for injection HCPCS J0692 $6.00 $51.00 $186.60 14
Cefotaxime sodium injection HCPCS J0698 $10.20 $43.10 $298.20 10
Cefoxitin 1 gram intravenous solution HCPCS J0694 $6.00 $94.59 $324.60 14
Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 $147.00 $552.60 $814.20 13
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 $6.60 $93.60 $422.40 13
Ceftazidime and avibactam HCPCS J0714 $237.00 $1,248.60 $1,516.80 13
Ceftriaxone 1 gram solution for injection HCPCS J0696 $18.00 $123.72 $1,013.40 14
Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 $3.60 $30.60 $93.60 13
Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 $497.40 $527.40 $882.60 7
Centruroides immune f(ab) HCPCS J0716 — — — 0
Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 $34.60 $34.80 $37.80 7
Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 $210.60 $2,809.20 $7,483.80 11
Chloramphenicol sodium injec HCPCS J0720 $143.40 $143.40 $143.40 3
Chloroprocaine hcl injection HCPCS J2401 $0.60 $1.20 $1.80 9
Chloroprocaine opht gel, 1mg HCPCS J2403 — — — 0
Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 $178.20 $1,236.80 $2,846.40 13
Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 $16.80 $91.92 $238.40 13
Chorionic gonadotropin/1000u HCPCS J0725 $66.00 $788.58 $788.58 4
Cidofovir injection HCPCS J0740 $118.20 $1,615.67 $27,738.00 8
Cilastatin sodium injection HCPCS J0743 $11.40 $36.62 $1,249.80 10
Cinacalcet 30 mg tablet HCPCS J0604 $93.60 $5,641.98 $5,641.98 4
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 $1.20 $23.67 $129.60 10
Ciprofloxacin otic susp 6 mg HCPCS J7342 $128.80 $876.00 $963.20 6
Cisplatin 1 mg/ml desensitization HCPCS J9060 $83.40 $700.00 $1,042.40 7
Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 $25.80 $355.41 $2,014.80 12
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 $6.00 $47.40 $76.20 13
Clofarabine 1 mg/ml intravenous solution HCPCS J9027 $879.00 $11,963.49 $11,963.49 4
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 $348.60 $361.14 $729.60 9
Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 $4,809.00 $16,994.46 $34,168.20 8
Codeine 15 mg/ml inj 2 ml HCPCS J0745 $55.80 $55.80 $58.80 2
Colistimethate sodium inj HCPCS J0770 $12.00 $129.00 $1,284.60 11
Collagenase, clost hist inj HCPCS J0775 $26,281.91 $26,281.91 $26,281.91 3
Conjugated estrogens 25 mg solution for injection HCPCS J1410 $220.80 $1,291.95 $1,431.00 11
Copper intrauterine device HCPCS J7300 $651.00 $2,606.40 $4,211.46 10
Cosyntropin 0.25 mg solution for injection HCPCS J0834 $63.60 $542.40 $891.00 13
Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 $147.00 $436.20 $9,069.75 8
Cromolyn sodium noncomp unit HCPCS J7631 $15.00 $48.14 $48.14 4
Crotalidae poly immune fab HCPCS J0840 $3,408.60 $6,805.20 $14,450.40 5
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 $2.40 $15.00 $54.00 14
Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 $1.40 $3.75 $39.00 8
Cyclophosphamide 25 mg capsule HCPCS J8530 $7.80 $43.20 $133.20 8
Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 $29.00 $243.99 $268.20 9
Cyclosporine modified 25 mg capsule HCPCS J7515 $2.40 $10.80 $51.45 10
Cyclosporine oral 100 mg HCPCS J7502 $10.20 $34.00 $198.60 8
Cytarabine 20 mg/ml injection solution HCPCS J9100 $8.40 $66.20 $320.40 11
Cytomegalovirus imm IV /vial HCPCS J0850 $5,413.80 $5,413.80 $6,333.64 6
Dacarbazine 100 mg intravenous solution HCPCS J9130 $10.80 $67.40 $198.60 14
Dactinomycin 0.5 mg intravenous solution HCPCS J9120 $166.20 $2,879.40 $10,014.84 9
Dalbavancin 500 mg intravenous solution HCPCS J0875 $1,067.40 $6,061.91 $7,113.00 8
Dalteparin sodium HCPCS J1645 $126.00 $126.00 $478.20 2
Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 $267.00 $1,138.20 $2,063.40 9
Daptomycin (xellia) unrefrig HCPCS J0872 — — — 0
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 $104.40 $109.20 $387.60 8
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 $2,322.00 $5,546.48 $17,923.80 10
Darbepoetin alfa, esrd use HCPCS J0882 $2,151.00 $2,151.00 $2,171.40 3
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 $483.00 $29,942.40 $38,568.63 7
Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 $107.40 $413.60 $1,617.60 10
Decitabine 50 mg intravenous solution HCPCS J0894 $82.80 $292.80 $1,026.60 11
Deferoxamine 500 mg solution for injection HCPCS J0895 $20.40 $102.84 $234.40 11
Degarelix 120 mg subcutaneous solution HCPCS J9155 $78.60 $2,262.60 $4,902.00 9
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 $1,127.40 $10,269.00 $12,371.55 10
Depo-estradiol cypionate inj HCPCS J1000 — — — 0
Desmopressin 4 mcg/ml injection solution HCPCS J2597 $39.40 $172.46 $765.60 11
Device intraute mirena HCPCS J7298 $693.60 $3,052.80 $4,491.10 13
Dexametha opth insert 0.1 mg HCPCS J1096 $354.00 $505.80 $2,022.60 10
Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 $1,738.20 $1,738.20 $1,738.20 1
Dexamethasone 4 mg tablet HCPCS J8540 $0.60 $5.40 $18.00 9
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 $1.80 $7.60 $16.28 11
Dexamethasone intra implant HCPCS J7312 $521.40 $521.40 $3,437.40 2
Dexmedetomidine film, 1 mcg HCPCS J1105 — — — 0
Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 $307.20 $1,087.80 $4,341.60 13
Dextran 40 infusion HCPCS J7100 $225.55 $225.55 $645.60 6
Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 $22.19 $37.20 $159.00 12
Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 $22.19 $29.00 $140.00 12
Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 $36.98 $60.40 $119.40 12
Dextrose 5 % IV bolus HCPCS J7070 $22.19 $26.80 $76.40 12
Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 $9.60 $35.40 $333.00 14
Dicyclomine injection HCPCS J0500 $25.20 $425.60 $691.20 13
Difelikefalin, esrd on dialy HCPCS J0879 $1.20 $1.20 $1.20 1
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 $3.60 $29.85 $85.80 11
Digoxin immune fab 40 mg intravenous solution HCPCS J1162 $2,869.80 $11,176.80 $17,050.66 13
Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 $89.40 $518.40 $1,414.20 12
Diltiazem 5 mg/ml intravenous solution HCPCS J1163 $12.60 $107.23 $107.23 4
Dimecaprol injection HCPCS J0470 — — — 0
Dimenhydrinate injection HCPCS J1240 $6.60 $14.40 $33.90 13
Dimethyl sulfoxide 50% 50 ml HCPCS J1212 $7.80 $2,501.55 $3,160.80 9
Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 $1.80 $13.80 $19.00 13
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 $31.20 $138.60 $556.80 13
Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 $35.40 $94.40 $6,111.60 10
Docetaxel (docivyx), 1 mg HCPCS J9172 — — — 0
Dolasetron mesylate HCPCS J1260 $91.20 $91.20 $138.60 2
Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 $22.80 $56.40 $98.91 12
Doripenem 50 mg/ml inj 10 ml HCPCS J1267 $3.00 $8.40 $162.00 7
Dornase alfa non-comp unit HCPCS J7639 $30.60 $380.80 $571.80 13
Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 $279.00 $565.80 $679.80 5
Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 $157.80 $358.40 $901.65 13
Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 $0.40 $1.20 $15.60 10
Droperidol 2.5 mg/ml injection solution HCPCS J1790 $2.40 $39.60 $126.60 11
Durvalumab 50 mg/ml intravenous solution HCPCS J9173 $200.40 $241.20 $1,036.80 7
Ecallantide injection HCPCS J1290 $14,223.60 $14,223.60 $14,223.60 1
Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 $130.20 $268.80 $657.60 8
Edetate calcium disodium inj HCPCS J0600 $20,833.61 $20,833.61 $20,833.61 3
Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 $67.20 $85.60 $185.40 9
Elosulfase alfa, injection HCPCS J1322 — — — 0
Elotuzumab 300 mg intravenous solution HCPCS J9176 $16.80 $1,749.60 $11,443.25 8
Elranatamab-bcmm 40 mg/ml subcutaneous solution HCPCS J1323 $463.20 $463.20 $463.20 3
Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 $36.60 $67.20 $89.40 7
Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 $7.60 $69.60 $136.00 13
Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution HCPCS J9321 $100.80 $102.60 $11,590.20 6
Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 $831.94 $831.94 $831.94 3
Epinephrine 1 mg/ml im kit - adult HCPCS J0169 $1.20 $424.18 $424.18 5
Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 $106.40 $441.60 $1,009.20 9
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 $1.80 $3.00 $46.16 8
Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 $8.40 $161.59 $293.40 10
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 $98.40 $255.20 $667.20 11
Epoetin beta non esrd HCPCS J0888 — — — 0
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 $31.20 $253.20 $759.00 9
Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 $62.40 $350.40 $2,520.60 13
Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 $1,060.20 $3,637.20 $7,173.42 10
Ergonovine 0.2 mg/ml inj HCPCS J1330 — — — 0
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 $277.80 $509.40 $5,213.48 10
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 $55.80 $227.20 $1,000.80 14
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 $28.60 $120.00 $460.00 12
Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 — — — 0
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 $3.00 $11.80 $81.60 11
Estradiol valerate 10 mg inj HCPCS J1380 $51.00 $51.40 $390.60 5
Etanercept injection HCPCS J1438 $1,119.00 $1,801.80 $7,314.47 8
Ethanolamine oleate 100 mg HCPCS J1430 $697.20 $1,605.00 $1,622.73 7
Etonogestrel implant system HCPCS J7307 $693.60 $4,715.65 $5,044.00 11
Etoposide 20 mg/ml intravenous solution HCPCS J9181 $44.40 $213.17 $1,867.20 13
Etoposide 50 mg cap HCPCS J8560 $45.00 $285.60 $5,934.05 9
Euflexxa inj per dose HCPCS J7323 $752.40 $1,186.77 $2,039.40 8
Factor ix alprolix recomb HCPCS J7201 $7.80 $38,712.83 $38,712.83 4
Factor ix complex HCPCS J7194 $7.80 $8.40 $4,991.63 9
Factor ix idelvion inj HCPCS J7202 $36,235.50 $36,235.50 $36,235.50 3
Factor ix non-recombinant HCPCS J7193 — — — 0
Factor ix recomb gly rebinyn HCPCS J7203 — — — 0
Factor ix recombinant nos HCPCS J7195 $1.20 $34.65 $7,321.05 9
Factor viii HCPCS J7190 — — — 0
Factor viii fc fusion recomb HCPCS J7205 $5.40 $17,969.85 $17,969.85 4
Factor viii nuwiq recomb 1iu HCPCS J7209 — — — 0
Factor viii pegylated recomb HCPCS J7207 $11.10 $11.10 $11.10 3
Factor viii recombinant nos HCPCS J7192 $4.20 $11.10 $21.60 9
Factor viii recomb novoeight HCPCS J7182 $3.15 $3.40 $2,592.00 8
Factor viii recomb obizur HCPCS J7188 $16.20 $5,435.33 $5,435.33 4
Factor xiii anti-hem factor HCPCS J7180 — — — 0
Factor xiii recomb a-subunit HCPCS J7181 $68.26 $68.26 $68.26 3
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 $0.30 $0.40 $0.40 9
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 $31.20 $55.20 $1,620.60 7
Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 — — — 0
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 $16.20 $144.00 $451.20 13
Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 $2,680.20 $3,736.68 $5,580.60 8
Fiasp for insulin pump use HCPCS J1811 — — — 0
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 $188.40 $1,964.97 $2,461.20 13
Flebogamma injection HCPCS J1572 $3,562.92 $3,562.92 $6,922.20 4
Floxuridine injection HCPCS J9200 $555.60 $8,522.40 $14,923.11 9
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 $2.40 $24.41 $42.00 8
Fludarabine 50 mg intravenous solution HCPCS J9185 $81.00 $601.96 $2,164.80 10
Fluocinol acet intravit imp HCPCS J7313 — — — 0
Fluocinolone acetonide implt HCPCS J7311 $34,587.60 $70,344.94 $70,344.94 4
Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 $31.80 $152.80 $1,062.00 12
Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 $276.00 $380.85 $1,498.80 12
Folic acid 5 mg/ml injection solution HCPCS J1808 $0.80 $1.05 $3.00 10
Fomepizole 1 gram/ml intravenous solution HCPCS J1451 $600.00 $5,244.60 $16,285.80 12
Fondaparinux sodium HCPCS J1652 $34.20 $490.80 $1,206.60 14
Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 $200.40 $1,233.17 $1,549.20 12
Foscarnet sodium injection HCPCS J1455 $215.20 $1,101.86 $2,358.00 10
Furosemide 10 mg/ml injection solution HCPCS J1938 $0.40 $0.60 $2.40 10
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 $0.60 $12.00 $32.40 7
Gamma globulin > 10 cc inj HCPCS J1560 — — — 0
Gamma globulin 1 cc inj HCPCS J1460 $31.20 $189.60 $381.00 5
Gammaplex injection HCPCS J1557 $6.00 $6.00 $6.00 1
Gamunex-c/gammaked HCPCS J1561 $259.20 $345.60 $8,519.04 10
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 $94.28 $415.20 $1,251.60 12
Gel-one HCPCS J7326 $2,173.80 $2,173.80 $2,173.80 1
Gel-syn injection 0.1 mg HCPCS J7328 $3.00 $1,330.04 $1,330.04 5
Gemcitabine 1 gram intravenous solution HCPCS J9201 $168.02 $365.40 $2,500.80 10
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 $844.20 $37,698.54 $37,978.20 7
Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 $3.60 $49.60 $85.57 12
Genvisc 850, inj, 1mg HCPCS J7320 — — — 0
Glassia injection HCPCS J0257 $34.80 $384.00 $2,551.28 7
Glucagon 1 mg solution for injection HCPCS J1610 $95.40 $1,053.60 $2,251.20 11
Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 $167.40 $509.06 $509.06 4
Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 $8.40 $11.70 $102.50 13
Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 $81.00 $104.80 $299.40 7
Goserelin 10.8 mg subcutaneous implant HCPCS J9202 $392.40 $1,886.40 $11,433.78 13
Graft axiofill 1000mg HCPCS J3590 $2,287.80 $3,597.00 $15,289.20 7
Granisetron hcl injection HCPCS J1626 $27.00 $181.80 $1,434.00 7
Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 $22.80 $160.00 $1,022.40 13
Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 $8.58 $9.00 $48.20 10
Hemin 350 mg intravenous powder for solution HCPCS J1640 $85.20 $28,532.40 $41,382.91 7
Hepagam b im injection HCPCS J1571 $165.60 $2,543.59 $2,543.59 5
Hepagam b intravenous, inj HCPCS J1573 — — — 0
Heparin bolus from bag HCPCS J1644 $6.00 $39.40 $57.46 13
Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 $1.20 $5.40 $12.00 11
HIV prep, ftc/taf 200/25mg HCPCS J0751 — — — 0
HIV prep, ftc/tdf 200/300mg HCPCS J0750 $36.60 $36.60 $36.60 1
HIV prep, inj, cabotegravir HCPCS J0739 — — — 0
Hizentra injection HCPCS J1559 $25.80 $4,991.26 $4,991.26 5
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 — — — 0
Hyaluronidase 150 unit/ml injection solution HCPCS J3470 $43.80 $60.00 $259.20 4
Hyaluronidase 200 units/ml inj HCPCS J3471 $0.60 $414.18 $414.18 5
Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 $33.00 $316.80 $419.40 8
Hydralazine 20 mg/ml injection solution HCPCS J0360 $25.20 $92.80 $236.40 13
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 $22.20 $121.20 $583.20 14
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 $4.40 $12.75 $72.63 13
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 $277.32 $654.40 $2,847.60 12
Hydroxocobalamin im 10mcg HCPCS J3425 $83.64 $83.64 $83.64 3
Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 $7.20 $17.55 $87.60 9
Hymovis injection 1 mg HCPCS J7322 $70.20 $2,459.97 $2,459.97 4
Hyoscyamine sulfate inj HCPCS J1980 $73.20 $308.52 $308.52 5
Hyqvia 100mg immuneglobulin HCPCS J1575 — — — 0
Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 $105.00 $839.85 $2,088.60 5
Ibuprofen injection HCPCS J1741 $86.20 $86.20 $150.00 4
Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 $279.60 $1,022.55 $2,792.80 10
Icatibant injection HCPCS J1744 $1,016.40 $3,697.02 $35,979.60 9
Idarubicin hcl injection HCPCS J9211 $249.51 $555.60 $7,371.00 9
Idursulfase injection HCPCS J1743 $6,966.00 $11,942.56 $11,942.56 4
Ifosfamide 1 gram intravenous solution HCPCS J9208 $64.20 $294.81 $1,083.60 14
Imetelstat 188 mg intravenous solution HCPCS J0870 $98.40 $99.00 $99.00 3
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 $476.00 $629.40 $2,613.77 13
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 $191.40 $2,778.42 $12,597.00 9
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 $920.40 $1,080.00 $5,101.20 8
Imuglucerase injection HCPCS J1786 $343.20 $343.20 $1,903.20 4
Incobotulinumtoxin a HCPCS J0588 $45.00 $1,317.00 $1,889.43 6
Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 $24.00 $24.00 $586.73 7
Infliximab 100 mg intravenous solution HCPCS J1745 $380.80 $700.20 $5,408.40 14
Inj, abilify asimtufii, 1 mg HCPCS J0402 — — — 0
Inj, abilify maintena, 1 mg HCPCS J0401 $2,848.80 $7,107.60 $13,261.20 9
Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 — — — 0
Inj, adstiladrin, per tx dos HCPCS J9029 — — — 0
Inj, aducanumab-avwa, 2 mg HCPCS J0172 $25.80 $25.80 $25.80 1
Inj, adzynma, 10 iu HCPCS J7171 — — — 0
Inj, aflibercept hd, 1 mg HCPCS J0177 — — — 0
Inj, afstyla, 1 i.u HCPCS J7210 — — — 0
Inj allopurinol sodium 1 mg HCPCS J0206 $155.40 $5,937.23 $5,937.23 4
Inj, alyglo, 500 mg HCPCS J1552 — — — 0
Inj, amisulpride, 1 mg HCPCS J0184 — — — 0
Inj andexxa, 10 mg HCPCS J7169 $751.80 $13,381.20 $20,052.60 6
Inj anifrolumab-fnia 1mg HCPCS J0491 $1,522.80 $11,192.40 $20,116.77 7
Inj., aristada initio, 1 mg HCPCS J1943 — — — 0
Inj, artesunate, 1mg HCPCS J0391 $109.80 $39,774.01 $39,774.01 4
Inj. asceniv HCPCS J1554 — — — 0
Inj, aspara, rylaze, 0.1 mg HCPCS J9021 $96.60 $96.60 $99.60 2
Inj avacincaptad pegol 0.1mg HCPCS J2782 — — — 0
Inj aval alfa-nqpt 4mg HCPCS J0219 $5,052.80 $5,052.80 $5,248.20 6
Inj., benralizumab, 1 mg HCPCS J0517 $568.00 $5,853.00 $19,707.27 12
Inj, bezlotoxumab, 10 mg HCPCS J0565 $156.00 $11,671.20 $17,599.20 9
Inj bimatoprost itc imp1mcg HCPCS J7351 $7,487.44 $7,487.44 $7,487.44 3
Inj, bortezomib, dr. reddy's HCPCS J9046 — — — 0
Inj, bortezomib freseniuskab HCPCS J9048 — — — 0
Inj, brixadi, 7 days or less HCPCS J0577 $533.40 $1,086.00 $1,086.40 7
Inj brixadi, more than 7 day HCPCS J0578 $2,846.40 $4,345.20 $4,345.20 5
Inj, brolucizumab-dbll, 1 mg HCPCS J0179 — — — 0
Inj, bupivacaine liposome HCPCS J0666 $2.40 $7.20 $13.20 10
Inj calcitriol per 0.1 mcg HCPCS J0636 $5.40 $25.20 $190.20 11
Inj, carmustine (accord) HCPCS J9052 — — — 0
Inj cefazolin sodium, hikma HCPCS J0688 $4.80 $4.80 $4.80 1
Inj cefazolin (wg crit care) HCPCS J0687 $3.00 $3.00 $3.00 1
Inj, cefepime hcl (b braun) HCPCS J0703 $17.40 $43.40 $85.20 8
Inj, cefiderocol, 10 mg HCPCS J0699 $131.40 $596.40 $846.06 6
Inj ceftolozane tazobactam HCPCS J0695 $19.00 $286.20 $597.69 14
Inj. cetirizine hcl 0.5mg HCPCS J1201 — — — 0
Inj, cipaglucosidase, 5 mg HCPCS J1203 $229.20 $229.20 $229.20 3
Inj crotalidae im f(ab')2 eq HCPCS J0841 $792.00 $1,134.60 $3,968.40 3
Inj, crovalimab-akkz, 10 mg HCPCS J1307 — — — 0
Inj cuvitru, 100 mg HCPCS J1555 — — — 0
Inj cyclophos dr.reddy's 5mg HCPCS J9072 — — — 0
Inj cyclophosphamd auromedic HCPCS J9071 — — — 0
Inj cyclophosphamd (ingenus) HCPCS J9073 $2.40 $3.75 $87.60 7
Inj, cyclophosphamd, sandoz HCPCS J9074 — — — 0
Inj, daptomycin (hospira) HCPCS J0877 — — — 0
Inj daptomycin (xellia) HCPCS J0873 — — — 0
Inj daxibotulinumtoxina-lanm HCPCS J0589 — — — 0
Inj delandistrogene mox rokl HCPCS J1413 $2,056,320.00 $2,056,320.00 $2,056,320.00 1
Inj, donanemab-azbt, 2 mg HCPCS J0175 $7.20 $7.20 $7.20 4
Inj, durolane 1 mg HCPCS J7318 $22.80 $106.40 $4,122.72 6
Injection, belinostat, 10mg HCPCS J9032 $95.40 $9,355.72 $9,355.72 4
Injection, burosumab-twza 1m HCPCS J0584 $1,120.20 $1,120.20 $1,120.20 1
Injection, daratumumab 10 mg HCPCS J9145 $85.20 $198.60 $3,195.00 7
Injection, doxercalciferol HCPCS J1270 $23.86 $95.20 $395.40 7
Injection, edaravone, 1 mg HCPCS J1301 $1,484.40 $1,485.00 $2,098.80 3
Injection, fulvestrant HCPCS J9395 $589.60 $3,584.82 $9,219.60 12
Injection glatiramer acetate HCPCS J1595 $318.40 $1,207.20 $1,749.29 8
Injection, inclisiran, 1 mg HCPCS J1306 $22.80 $39.20 $1,348.80 9
Injection, isavuconazonium HCPCS J1833 $229.20 $1,350.22 $1,378.20 9
Injection, necitumumab, 1 mg HCPCS J9295 $15.60 $15.60 $15.60 1
Injection,onabotulinumtoxina HCPCS J0585 $380.40 $2,876.40 $6,946.80 13
Injection, peramivir HCPCS J2547 $6.75 $7.40 $1,257.68 9
Injection, ruconest HCPCS J0596 — — — 0
Injection, siltuximab HCPCS J2860 $404.40 $3,603.00 $23,535.37 8
Injection torsemide 10 mg/ml HCPCS J3265 $69.60 $69.60 $69.60 1
Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 $79.80 $79.80 $1,723.20 4
Inj eflapegrastim-xnst 0.1mg HCPCS J1449 — — — 0
Inj., emapalumab-lzsg, 1 mg HCPCS J9210 $1,790.40 $1,929.00 $4,497.60 4
Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 $98.40 $58,842.17 $58,842.17 5
Inj, evinacumab-dgnb, 5mg HCPCS J1305 — — — 0
Inj., evomela, 1 mg HCPCS J9246 $105.60 $105.60 $105.60 1
Inj, factor x, (human), 1iu HCPCS J7175 $6.60 $33.28 $40.20 11
Inj, faricimab-svoa, 0.1mg HCPCS J2777 $100.00 $100.00 $106.40 2
Inj. fe derisomaltose 10 mg HCPCS J1437 $141.60 $181.20 $194.40 7
Inj fensolvi 0.25 mg HCPCS J1951 — — — 0
Inj., fibryga, 1 mg HCPCS J7177 $5.40 $5.40 $5.40 1
Inj fluphenazine hcl 1.25 mg HCPCS J2679 — — — 0
Inj, focinvez, 1mg HCPCS J1434 $5.40 $5.40 $5.40 3
Inj, fosaprepitant (teva) HCPCS J1456 — — — 0
Inj fosnetupitant, palonoset HCPCS J1454 — — — 0
Inj, fulvestrant (fresenius) HCPCS J9394 $1,713.99 $1,713.99 $1,713.99 3
Inj, fulvestrant (teva) HCPCS J9393 — — — 0
Inj givosiran 0.5 mg HCPCS J0223 $235.20 $119,349.60 $162,298.07 6
Inj glofitamab gxbm, 2.5 mg HCPCS J9286 $612.60 $6,717.00 $6,717.00 4
Inj glycopyrrolate fres kabi HCPCS J1598 — — — 0
Inj, granisetron, xr, 0.1 mg HCPCS J1627 — — — 0
Inj., guselkumab, 1 mg HCPCS J1628 $675.00 $675.00 $695.20 4
Inj, hemgenix, per tx dose HCPCS J1411 — — — 0
Inj heparin, pfizer, 1000u HCPCS J1643 $3.00 $3.00 $3.00 1
Inj. herceptin hylecta, 10mg HCPCS J9356 $37.20 $561.00 $17,286.71 7
Inj human fibrinogen con nos HCPCS J7178 $9.00 $4,326.08 $4,326.08 4
Inj hydroxocobalamin IV 25mg HCPCS J3424 $1,125.60 $1,125.60 $1,125.60 1
Inj hydroxyprogst capoat nos HCPCS J1729 — — — 0
Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 — — — 0
Inj imip 4 cilas 4 releb 2mg HCPCS J0742 $5.40 $7.35 $7.40 7
Inj, immphentiv, 20 mcg HCPCS J2373 — — — 0
Inj. inebilizumab-cdon, 1 mg HCPCS J1823 $864.00 $871.80 $172,856.28 7
Inj, invega hafyera/trinza HCPCS J2427 $32.40 $32.40 $32.40 1
Inj ivig privigen 500 mg HCPCS J1459 $4,194.45 $4,345.80 $6,144.00 8
Inj, ixinity, 1 i.u HCPCS J7213 — — — 0
Inj. jivi 1 iu HCPCS J7208 — — — 0
Inj, kovaltry, 1 i.u HCPCS J7211 — — — 0
Inj, lanreotide, (cipla) 1mg HCPCS J1932 $96.60 $8,487.60 $10,671.00 3
Inj, lecanemab-irmb, 1 mg HCPCS J0174 — — — 0
Inj, lenacapavir, 1 mg HCPCS J1961 — — — 0
Inj levocarnitine per 1 gm HCPCS J1955 $16.20 $205.60 $1,039.80 13
Inj, levothyroxine, freskabi HCPCS J0651 $10.20 $244.63 $244.63 4
Inj, levothyroxine, hikma HCPCS J0652 — — — 0
Inj. lumasiran, 0.5 mg HCPCS J0224 $763.20 $763.20 $763.20 1
Inj., lumoxiti, 0.01 mg HCPCS J9313 $31.20 $52.80 $52.80 3
Inj luxturna 1 billion vec g HCPCS J3398 — — — 0
Inj melpha hydroch nos 50 mg HCPCS J9245 $1,156.20 $1,713.99 $6,460.20 7
Inj melphalan (hepzato) 1 mg HCPCS J9248 — — — 0
Inj mepivacaine hcl/10 ml HCPCS J0670 $8.60 $28.41 $105.00 11
Inj., meropenem, vaborbactam HCPCS J2186 $129.60 $991.20 $3,622.20 11
Inj meropenem (wg crit care) HCPCS J2183 $34.20 $34.20 $34.20 1
Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 $138.60 $138.60 $138.60 1
Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 $540.60 $691.20 $691.20 9
Inj, motixafortide, 0.25 mg HCPCS J2277 — — — 0
Inj, moxifloxacin 100 mg HCPCS J2280 $85.80 $249.60 $442.20 3
Inj. mycophenolate mofetil HCPCS J7519 $64.20 $387.27 $387.27 4
Inj. naxitamab-gqgk, 1 mg HCPCS J9348 $96,378.67 $96,378.67 $96,378.67 3
Inj, nithiodote, 3mg / 125mg HCPCS J0211 $3.60 $3.60 $4.80 6
Inj, nogapendekin pmln, 1mcg HCPCS J9028 — — — 0
Inj olipudase alfa-rpcp 1mg HCPCS J0218 — — — 0
Inj., omadacycline, 1 mg HCPCS J0121 $21.60 $21.60 $21.60 1
Inj onase abepar-xioi treat HCPCS J3399 — — — 0
Inj, palonosetron (posfrea) HCPCS J2468 — — — 0
Inj pantoprazole(hikma) 40mg HCPCS J2471 — — — 0
Inj, panzyga, 500 mg HCPCS J1576 — — — 0
Inj, pasireotide long acting HCPCS J2502 — — — 0
Inj., patisiran, 0.1 mg HCPCS J0222 $36,180.04 $36,180.04 $36,180.04 3
Inj, pedmark, 100 mg HCPCS J0208 — — — 0
Inj, pegcetacoplan, 1mg HCPCS J2781 — — — 0
Inj. pemetrexed, 10 mg HCPCS J9304 $152.40 $156.60 $156.60 5
Inj pemetrexed (accord) 10mg HCPCS J9296 — — — 0
Inj, pemetrexed (avyxa) 10mg HCPCS J9292 — — — 0
Inj pemetrexed ditromethamin HCPCS J9323 — — — 0
Inj pemetrexed, hospira 10mg HCPCS J9294 — — — 0
Inj pemetrexed (teva) 10mg HCPCS J9314 — — — 0
Inj, pemrydi rtu, 10 mg HCPCS J9324 — — — 0
Inj., perseris, 0.5 mg HCPCS J2798 — — — 0
Inj plasminogen tvmh 1mg HCPCS J2998 — — — 0
Inj., plazomicin, 5 mg HCPCS J0291 $85.80 $85.80 $115.20 5
Inj progesterone per 50 mg HCPCS J2675 $1.80 $12.60 $123.09 9
Inj recombin esperoct per iu HCPCS J7204 — — — 0
Inj, rimabotulinumtoxinb HCPCS J0587 $2,348.22 $2,348.22 $2,348.22 3
Inj roctavian ml 2x10^13vc g HCPCS J1412 — — — 0
Inj romidepsin non-lyo 0.1mg HCPCS J9318 — — — 0
Inj, rykindo, 0.5 mg HCPCS J2801 — — — 0
Inj sebelipase alfa 1 mg HCPCS J2840 — — — 0
Inj secretin synthetic human HCPCS J2850 $43.80 $630.00 $2,715.60 9
Inj secukinumab intrav 1mg HCPCS J3247 $31.80 $43.50 $253.80 7
Inj, sezaby, 1 mg HCPCS J2561 $79.80 $79.80 $79.80 1
Inj, spesolimab-sbzo, 1 mg HCPCS J1747 $109.20 $109.20 $109.20 1
Inj, susvimo 0.1 mg HCPCS J2779 $242.40 $242.40 $242.40 1
Inj, sutimlimab-jome, 10 mg HCPCS J1302 $34.80 $34.80 $2,256.00 4
Inj. tagraxofusp-erzs 10 mcg HCPCS J9269 $540.00 $560.40 $124,816.51 9
Inj, taliglucerace alfa 10 u HCPCS J3060 — — — 0
Inj teclistamab cqyv 0.5 mg HCPCS J9380 $58.20 $85.20 $3,345.00 5
Inj tedizolid phosphate HCPCS J3090 $184.20 $1,081.80 $1,282.20 6
Inj teplizumab mzwv 5 mcg HCPCS J9381 — — — 0
Inj. teprotumumab-trbw 10 mg HCPCS J3241 $9,829.20 $38,425.20 $66,625.08 8
Inj testostero enanthate 1mg HCPCS J3121 $0.60 $0.60 $20.40 4
Inj testosterone cypionate HCPCS J1071 $12.60 $72.60 $473.66 10
Inj thiotepa nos 1 mg HCPCS J9342 $53.40 $450.00 $8,689.13 6
Inj., tildrakizumab, 1 mg HCPCS J3245 $313.20 $424.00 $31,450.80 7
Inj, tislelizumab-jsgr HCPCS J9329 $64.20 $103.20 $103.20 5
Inj tofersen intrathec 1 mg HCPCS J1304 $288.00 $288.00 $288.00 1
Inj triamcinolone ace X-ray 1mg HCPCS J3304 — — — 0
Inj., triluron, 1 mg HCPCS J7332 — — — 0
Inj., triptorelin X-ray 3.75 mg HCPCS J3316 — — — 0
Inj, trivisc 1 mg HCPCS J7329 — — — 0
Inj, uzedy, 1 mg HCPCS J2799 $59.40 $59.40 $59.40 1
Inj, vancomycin hcl (mylan) HCPCS J3371 — — — 0
Inj, vasopressin (baxter) HCPCS J2601 — — — 0
Inj velmanase alfa-tycv 1 mg HCPCS J0217 — — — 0
Inj. xembify, 100 mg HCPCS J1558 — — — 0
Inj xipere 1 mg HCPCS J3299 — — — 0
Inj., yutiq, 0.01 mg HCPCS J7314 — — — 0
Inj zanidatamab-hrii, 2 mg HCPCS J9276 $44.40 $44.40 $44.40 2
Inj zenocutuzumab-zbco 1 mg HCPCS J9382 — — — 0
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 $3.00 $8,027.40 $88,429.23 8
Inst tauro 1.35mg/hep 100u HCPCS J0911 — — — 0
Interferon alfa-2b inj HCPCS J9214 $108.00 $1,111.20 $4,544.40 7
Interferon beta-1a inj HCPCS J1826 $4,373.40 $4,373.40 $4,373.40 1
Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 $200.40 $495.00 $664.80 7
Ipratropium bromide non-comp HCPCS J7644 $2.43 $7.20 $55.40 12
Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 $378.32 $1,091.20 $7,858.80 12
Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 $78.00 $210.60 $11,014.86 9
Iron dextran 50 mg/ml injection solution HCPCS J1750 $10.20 $99.00 $239.40 12
Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 $35.40 $315.00 $682.20 12
Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 $92.40 $156.60 $15,760.97 7
Ixabepilone 15 mg intravenous solution HCPCS J9207 $272.40 $680.40 $16,246.20 10
Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 $3.60 $24.60 $126.60 12
Kyleena, 19.5 mg HCPCS J7296 $2,036.40 $2,489.60 $4,491.10 8
Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 $4.50 $7.80 $22.19 7
Lactated ringers intravenous solution HCPCS J7120 $22.19 $32.40 $108.00 12
Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 $11,474.40 $33,573.60 $35,355.50 7
Lanthanum carbonate oral 5mg HCPCS J0607 $6.60 $2,066.54 $2,066.54 5
Laronidase injection HCPCS J1931 $181.80 $4,116.73 $4,116.73 4
Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 $4.80 $83.13 $797.40 14
Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 $2,789.60 $6,209.40 $30,791.46 14
Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 $1,045.80 $4,568.40 $42,325.47 13
Leuprolide depot cipla 7.5mg HCPCS J1954 — — — 0
Leuprolide inj, camcevi, 1mg HCPCS J1952 — — — 0
Levalbuterol non-comp unit HCPCS J7614 $5.40 $5.40 $66.00 5
Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 $97.62 $276.00 $1,195.80 11
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 $2.40 $47.70 $356.40 10
Levonorgestrel implant sys HCPCS J7306 — — — 0
Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 $19.80 $24.00 $652.50 9
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 $0.16 $0.20 $4.20 10
Liletta, 52 mg HCPCS J7297 $3,445.08 $3,445.08 $3,445.08 3
Lincomycin injection HCPCS J2010 — — — 0
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 $37.80 $253.60 $883.80 13
Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 $394.80 $15,780.00 $104,719.60 6
Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 $4.80 $49.14 $96.00 9
Lumizyme injection HCPCS J0221 $966.60 $3,672.96 $4,834.80 6
Lurbinectedin 4 mg intravenous solution HCPCS J9223 $234.60 $380.40 $423.60 6
Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 $44.40 $87.60 $313.20 8
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 $7.80 $74.40 $239.40 12
Makena, 10 mg HCPCS J1726 — — — 0
Mannitol 12.5 gm/50 ml inj HCPCS J2150 $20.40 $88.80 $241.20 8
Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 $91.20 $138.00 $9,885.94 9
Mechlorethamine hcl inj HCPCS J9230 $690.00 $690.00 $690.00 2
Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 $20.40 $252.10 $597.60 12
Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 $50,047.20 $235,134.00 $308,663.40 7
Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 $5.40 $16.40 $28.20 14
Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 $3,571.80 $8,127.60 $11,523.04 9
Meropenem 1 gram intravenous solution HCPCS J2185 $6.60 $77.20 $470.40 14
Mesna 100 mg/ml intravenous solution HCPCS J9209 $40.80 $153.60 $1,001.60 9
Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 $197.40 $463.20 $2,776.62 10
Methadone injection HCPCS J1230 $12.60 $55.95 $725.09 9
Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 $38.39 $78.20 $155.40 10
Methotrexate sodium 2.5 mg tablet HCPCS J8610 $1.80 $28.65 $38.60 11
Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 $19.80 $284.80 $441.60 13
Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 $18.00 $42.45 $76.59 12
Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 $150.00 $504.60 $582.48 12
Methylprednisolone 4 mg tablet HCPCS J7509 $1.20 $10.80 $114.60 10
Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 $0.60 $1.20 $11.40 10
Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 $2.20 $6.80 $45.00 11
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 $0.60 $10.35 $16.40 11
Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 $1.20 $4.80 $9.00 11
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 $0.20 $3.15 $11.84 13
Micafungin 100 mg intravenous solution HCPCS J2248 $5.80 $26.20 $112.20 11
Midazolam 1 mg/ml injection solution HCPCS J2250 $7.80 $36.60 $97.25 13
Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 $102.80 $102.80 $102.80 3
Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 $15.20 $73.20 $1,179.60 12
Minocycline hydrochloride HCPCS J2265 $104.40 $403.80 $884.76 8
Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 $77.40 $131.40 $190.20 5
Mitomycin 40 mg intravenous solution HCPCS J9280 $596.00 $1,714.80 $6,847.80 14
Mitomycin instillation HCPCS J9281 $818.40 $858.00 $54,580.80 8
Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 $145.20 $1,254.00 $2,986.80 11
Mometasone sinus sinuva HCPCS J7402 — — — 0
Monovisc inj per dose HCPCS J7327 $2,155.28 $2,155.28 $2,835.00 4
Morphine 4 mg/ml injection (wrapper) HCPCS J2270 $1.80 $27.20 $324.00 12
Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 $1.80 $8.37 $8.37 4
Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 $10.20 $102.60 $1,132.55 14
Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 $924.00 $924.00 $924.00 2
Mycophenolate mofetil 250 mg capsule HCPCS J7517 $10.20 $79.60 $273.60 10
Mycophenolic acid HCPCS J7518 $2.40 $21.60 $46.20 7
Nafcillin 2 gram solution for injection HCPCS J2290 $1.80 $2.00 $5.55 7
Nalbuphine 10 mg/ml injection solution HCPCS J2300 $2.40 $22.20 $178.93 13
Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 $0.60 $1.20 $116.48 9
Naltrexone, depot form HCPCS J2315 $5,101.20 $5,794.40 $12,768.00 8
Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 $76.20 $28,621.80 $32,830.92 9
Nelarabine injection HCPCS J9261 $748.80 $2,265.28 $3,741.60 6
Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 $8.40 $99.51 $213.00 13
Nesiritide injection HCPCS J2325 $168.00 $168.00 $441.00 2
Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 $2.80 $3.80 $17.55 10
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 $0.60 $4.00 $26.40 11
Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 $82.80 $104.40 $186.60 7
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 $291.00 $375.60 $435.60 4
Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 $2,820.00 $492,978.44 $492,978.44 4
Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 $123.60 $236.00 $898.20 9
Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 $1,182.60 $52,712.40 $76,319.96 6
Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 $29.40 $558.60 $1,059.00 13
Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 $1,515.00 $23,098.20 $30,309.60 13
Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 $72.00 $201.60 $5,899.80 8
Olanzapine 10 mg intramuscular solution HCPCS J2359 $6.40 $30.00 $172.31 13
Olanzapine long-acting inj HCPCS J2358 $76.20 $76.20 $23,003.40 3
Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 $131.40 $830.40 $6,151.20 11
Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 $27.40 $34.32 $138.60 11
Ophthalmic mitomycin HCPCS J7315 $1,327.41 $1,663.20 $1,930.20 11
Oprelvekin injection HCPCS J2355 — — — 0
Oral aprepitant HCPCS J8501 $52.20 $1,012.80 $3,616.34 13
Oral busulfan HCPCS J8510 $24.60 $24.60 $24.60 2
Oral everolimus HCPCS J7527 $115.20 $1,208.40 $2,255.34 11
Oral methotrexate (jylamvo) HCPCS J8611 — — — 0
Oral methotrexate (xatmep) HCPCS J8612 — — — 0
Oral netupitant, palonosetro HCPCS J8655 $2,044.20 $2,044.20 $2,044.20 1
Oritavancin 1,200 mg intravenous solution HCPCS J2406 — — — 0
Oritavancin 400 mg intravenous solution HCPCS J2407 $99.20 $105.60 $696.00 6
Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 $31.68 $61.00 $366.00 11
Orthovisc inj per dose HCPCS J7324 $443.85 $443.85 $903.60 4
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 $13.80 $125.40 $552.00 7
Oxaliplatin 5 mg/ml desensitization HCPCS J9263 $13.20 $97.20 $1,965.00 11
Oxytocin 10 unit/ml injection solution HCPCS J2590 $6.60 $29.00 $60.60 14
Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 $2.40 $47.20 $300.60 11
Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 $51.00 $963.60 $6,166.20 12
Palifermin injection HCPCS J2425 $11,767.98 $11,767.98 $11,767.98 3
Paliperidone 117 mg/0.75 ml inj HCPCS J2426 $84.00 $6,272.41 $9,557.40 9
Palonosetron hcl HCPCS J2469 $24.00 $378.60 $3,325.80 13
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 $31.80 $200.00 $2,828.80 11
Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 $197.40 $364.20 $652.80 6
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 $18.49 $30.80 $201.00 12
Papaverin hcl injection HCPCS J2440 $11.00 $123.60 $264.80 13
Paricalcitol HCPCS J2501 $9.00 $35.52 $268.80 12
Pegaspargase injection HCPCS J9266 $19,415.40 $62,371.80 $82,241.50 8
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 $901.20 $6,417.60 $28,812.00 13
Pegloticase 8 mg/ml intravenous solution HCPCS J2507 $6,349.20 $94,586.40 $113,672.22 8
Pegunigalsidase alfa-iwxj HCPCS J2508 $526.20 $526.20 $548.00 6
Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 $850.20 $21,534.00 $21,806.82 8
Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 $205.60 $3,134.40 $23,822.40 12
Peng benzathine/procaine inj HCPCS J0558 $7.20 $251.40 $1,641.00 6
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 $96.00 $1,422.60 $2,592.13 12
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 $16.20 $192.60 $552.60 13
Penicillin g procaine inj HCPCS J2510 — — — 0
Pentamidine 300 mg solution for injection HCPCS J2516 $572.10 $572.10 $572.10 3
Pentamidine non-comp unit HCPCS J2545 $99.60 $396.65 $1,608.80 8
Pentobarbital sodium inj HCPCS J2515 $8.00 $63.60 $115.20 7
Pentostatin 10 mg intravenous solution HCPCS J9268 $1,609.20 $8,715.64 $10,218.00 7
Pertuzumab 30 mg/ml desensitization HCPCS J9306 $7,603.80 $22,539.60 $25,218.78 7
Pertuzu, trastuzu, 10 mg HCPCS J9316 $285.60 $523.20 $51,456.39 7
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 $13.60 $42.15 $203.37 14
Phentolaine mesylate inj HCPCS J2760 $293.40 $1,028.40 $1,968.60 13
Phenylephrine 10 mg/ml injection solution HCPCS J2371 $0.03 $0.14 $2.40 10
Phenylep ketorolac opth soln HCPCS J1097 — — — 0
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 $15.00 $417.00 $883.20 9
Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 $21.00 $52.80 $272.40 14
Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 $9.00 $115.20 $660.00 14
Plerixafor injection HCPCS J2562 $1,570.80 $1,570.80 $36,856.95 6
Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 $10,525.80 $36,544.20 $68,815.70 8
Porfimer sodium injection HCPCS J9600 $13,787.40 $75,528.84 $105,045.60 8
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 $5.40 $70.80 $171.00 13
Pralatrexate injection HCPCS J9307 $723.60 $5,614.80 $46,709.38 9
Pralidoxime 1 gram solution for injection HCPCS J2730 $51.60 $297.18 $399.60 7
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 $10.80 $13.80 $739.20 8
Prednisone 1 mg tablet HCPCS J7512 $0.60 $3.00 $14.80 10
Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 $36.00 $225.00 $1,611.15 12
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 $5.40 $63.42 $115.20 13
Promethazine hcl injection HCPCS J2550 $1.80 $10.99 $39.75 13
Propofol infusion 10 mg/ml HCPCS J2704 $1.80 $21.45 $174.00 12
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 $4.80 $16.46 $120.80 10
Protamine 10 mg/ml intravenous solution HCPCS J2720 $6.15 $112.23 $149.40 12
Protein c concentrate HCPCS J2724 $123.00 $123.00 $3,840.00 2
Prothrombin complex kcentra HCPCS J7168 $1.80 $8.25 $32.40 11
Pyridoxine hcl 100 mg HCPCS J3415 $12.60 $29.11 $70.20 13
Quinupristin/dalfopristin HCPCS J2770 $279.60 $279.60 $279.60 1
Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 $85.20 $187.20 $8,319.60 9
Ranibizumab injection HCPCS J2778 $844.80 $1,641.00 $7,078.80 3
Rasburicase 1.5 mg intravenous solution HCPCS J2783 $644.40 $9,544.20 $20,465.52 14
Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 $14,859.00 $71,857.80 $88,558.68 9
Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 $231.60 $698.06 $2,544.60 10
Remdesivir 100 mg intravenous powder for solution HCPCS J0248 $16.00 $16.80 $17.00 9
Reslizumab 10 mg/ml intravenous solution HCPCS J2786 $34.05 $34.40 $64.20 6
Reteplase injection HCPCS J2993 $2,774.40 $2,774.40 $9,565.80 2
Retifanlimab-dlwr 500 mg/20 ml intravenous solution HCPCS J9345 — — — 0
Rezafungin 200 mg intravenous solution HCPCS J0349 $25.40 $26.25 $26.25 4
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 $48.00 $172.80 $224.40 10
Rho d immune globulin 50 mcg HCPCS J2788 — — — 0
Rho(d) immune globulin h, sd HCPCS J2792 $210.60 $1,551.00 $5,242.06 8
Rho d immune globulin inj HCPCS J2790 $70.80 $622.40 $2,785.80 14
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 $0.60 $4.20 $4.20 5
Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 $20.25 $26.40 $588.00 9
Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 $1,204.20 $4,199.40 $6,465.00 11
Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 $55.80 $433.20 $4,351.20 9
Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 $117.60 $337.20 $27,790.74 7
Rolapitant, oral, 1mg HCPCS J8670 $12.00 $12.00 $12.00 1
Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 $87.60 $197.60 $1,918.80 7
Romiplostim 125 mcg subcutaneous solution HCPCS J2802 $25.95 $34.60 $44.60 9
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 $641.40 $8,372.44 $12,093.00 10
Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 $9.00 $178.80 $1,503.60 12
Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 — — — 0
Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 $1,441.80 $5,043.00 $9,478.55 10
Sargramostim injection HCPCS J2820 $820.80 $1,092.15 $21,867.60 5
Sevelamer carbonate 800 mg tablet HCPCS J0601 $3.60 $3.60 $3.60 1
Sevelamer carbonate pdr 20mg HCPCS J0602 $10.20 $638.94 $638.94 4
Sincalide 5 mcg solution for injection HCPCS J2805 $81.60 $475.20 $753.00 13
Sirolimus, oral HCPCS J7520 $20.40 $180.00 $1,122.00 9
Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 $153.00 $153.00 $153.00 1
Skyla, 13.5 mg HCPCS J7301 $532.80 $2,343.60 $3,739.59 8
Sodium chloride 0.9 % intravenous solution HCPCS J7030 $26.00 $33.28 $76.80 12
Sodium chloride 0.9 % IV bolus HCPCS J7040 $20.34 $22.20 $78.80 12
Sodium chloride 0.9 % IV bolus HCPCS J7050 $19.42 $32.40 $78.80 13
Sodium chloride 3 % ivpb HCPCS J7131 $11.10 $21.60 $80.40 11
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 $3.60 $43.20 $374.40 14
Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 $480.00 $651.32 $2,860.80 7
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 — — — 0
Somatropin injection HCPCS J2941 $1,512.00 $2,111.40 $2,600.83 6
Streptokinase 1.5 m-units inj HCPCS J2995 — — — 0
Streptomycin injection HCPCS J3000 — — — 0
Streptozocin injection HCPCS J9320 $209.40 $1,286.99 $2,809.80 8
Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 $4.20 $22.19 $73.20 13
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 $0.20 $0.40 $0.60 10
Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 $105.60 $167.98 $1,520.40 13
Supprelin la implant HCPCS J9226 $185,546.55 $185,546.55 $185,546.55 3
Synvisc or synvisc-one HCPCS J7325 $50.40 $198.00 $1,696.83 7
Tacrol astagraf ex rel oral HCPCS J7508 $1.60 $3.15 $2,970.47 8
Tacrol envarsus ex rel oral HCPCS J7503 $3.20 $3.40 $15.60 8
Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 $21.00 $29.40 $119.40 10
Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 $148.20 $1,588.00 $2,712.00 10
Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 $27.60 $28.80 $5,161.23 8
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 $101.40 $25,827.38 $25,827.38 5
Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 $123.60 $175.20 $6,216.00 5
Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 $2,801.40 $2,828.40 $9,000.00 4
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 $3.60 $357.60 $959.55 6
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 $418.80 $457.20 $24,312.00 3
Telavancin injection HCPCS J3095 $7.20 $748.80 $2,428.05 9
Temozolomide HCPCS J8700 $350.40 $1,918.68 $3,327.00 5
Temozolomide 100 mg intravenous solution HCPCS J9328 $601.80 $3,438.61 $3,438.61 5
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 $77.40 $539.40 $8,196.60 8
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 $4,559.40 $14,427.60 $29,758.74 13
Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 $11.40 $102.00 $455.20 13
Teriparatide injection HCPCS J3110 $36.75 $67.80 $6,598.80 5
Testosterone undecanoate 1mg HCPCS J3145 — — — 0
Tetanus immune globulin inj HCPCS J1670 $389.40 $1,524.00 $2,306.40 14
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 $47.25 $48.80 $1,269.00 8
Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 $2.40 $38.20 $64.80 14
Thiotepa 15 mg solution for injection HCPCS J9341 — — — 0
Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 $1,186.20 $7,476.81 $19,696.80 8
Tigecycline injection HCPCS J3243 $6.00 $58.20 $724.80 14
Tirofiban 12.5 mg/50 ml HCPCS J3246 $43.80 $43.80 $43.80 1
Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 $190.20 $334.80 $27,364.47 8
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 $49.80 $97.60 $612.00 11
Tobramycin non-comp unit HCPCS J7682 $1.80 $124.14 $533.40 5
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 $783.00 $5,861.40 $9,652.20 9
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 $17.40 $130.80 $517.65 10
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 $70.20 $70.80 $889.20 3
Trabectedin 1 mg intravenous solution HCPCS J9352 $386.40 $2,068.20 $13,641.34 12
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 $77.65 $77.65 $77.65 3
Trastuzumab 150 mg intravenous solution HCPCS J9355 $276.00 $5,762.28 $7,527.60 11
Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 $156.00 $263.40 $1,560.00 7
Treprostinil injection HCPCS J3285 $253.20 $9,431.40 $21,186.46 7
Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 $10.80 $45.00 $162.88 13
Triamcinolone a inj prs-free HCPCS J3300 $351.00 $696.00 $3,235.98 10
Trilaciclib 300 mg intravenous solution HCPCS J1448 $928.80 $928.80 $928.80 1
Trimethobenzamide hcl inj HCPCS J3250 $77.60 $99.20 $191.20 12
Triptorelin pamoate HCPCS J3315 $2,681.40 $16,454.18 $16,454.18 5
Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 $133.20 $133.20 $1,047.00 2
Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 $46.20 $55.80 $76.00 8
Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 $57.00 $16,705.20 $109,781.59 7
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 $22.29 $22.29 $22.29 3
Valrubicin injection HCPCS J9357 $168.60 $6,841.31 $6,841.31 4
Vancomycin 1,000 mg intravenous injection HCPCS J3373 $0.60 $0.60 $8.40 8
Vancomycin 750 mg intravenous solution HCPCS J3374 $303.13 $303.13 $303.13 3
Vancomycin hcl injection HCPCS J3370 $25.80 $42.00 $280.20 8
Vasopressin 20 unit/ml intravenous solution HCPCS J2598 $7.95 $42.00 $201.60 13
Vedolizumab 300 mg intravenous solution HCPCS J3380 $5,199.60 $27,154.80 $34,608.27 10
Velaglucerase alfa 400 unit intravenous solution HCPCS J3385 $876.00 $5,564.78 $7,060.20 5
Verteporfin injection HCPCS J3396 — — — 0
Vinblastine 1 mg/ml intravenous solution HCPCS J9360 $19.80 $159.60 $699.00 12
Vincristine 1 mg/ml intravenous solution HCPCS J9370 $10.20 $111.30 $530.40 14
Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 $115.80 $417.00 $1,020.60 11
Vonvendi inj 1 iu vwf:rco HCPCS J7179 $0.60 $10.80 $15.20 7
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 $43.80 $690.60 $2,734.80 13
Vutrisiran 25 mg/0.5 ml subcutaneous syringe HCPCS J0225 $9,373.80 $13,248.60 $143,221.20 4
Vyjuvek 5x10^9pfu/ml, 0.1 ml HCPCS J3401 — — — 0
Wilate injection HCPCS J7183 $9.60 $9.60 $9.60 1
Xyntha inj HCPCS J7185 $1.80 $1.80 $1.80 1
Ziconotide injection HCPCS J2278 $76.20 $4,530.00 $5,752.20 6
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 $6.60 $100.06 $135.00 9
Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 $32.46 $229.80 $592.20 13
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 $74.40 $74.40 $1,920.00 2
Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 $45.60 $46.20 $948.00 6
Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 $110.40 $3,207.00 $4,651.80 13