|
Abatacept (with maltose) 250 mg intravenous solution
|
HCPCS J0129 |
$141.66 |
$3,138.72
|
$24,924.00 |
419 |
|
Abciximab injection
|
HCPCS J0130 |
$354.77 |
$2,443.52
|
$18,769.74 |
101 |
|
Abobotulinumtoxina
|
HCPCS J0586 |
$51.15 |
$1,541.21
|
$8,805.00 |
171 |
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
HCPCS J0131 |
$3.00 |
$72.74
|
$501.00 |
492 |
|
Acetazolamide 500 mg solution for injection
|
HCPCS J1120 |
$6.30 |
$122.55
|
$1,207.00 |
681 |
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
HCPCS J0132 |
$12.60 |
$218.79
|
$1,958.00 |
596 |
|
Acetylcysteine non-comp unit
|
HCPCS J7608 |
$2.52 |
$31.21
|
$296.67 |
289 |
|
Acyclovir 400 mg tablet
|
HCPCS J8499 |
$4.10 |
$54.77
|
$762.47 |
147 |
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
HCPCS J0133 |
$3.29 |
$64.45
|
$567.00 |
575 |
|
Adalimumab injection
|
HCPCS J0135 |
$779.10 |
$6,853.40
|
$18,236.97 |
45 |
|
Adenosine 3 mg/250 ml bag for osm
|
HCPCS J0153 |
$10.92 |
$271.98
|
$2,089.74 |
588 |
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
HCPCS J1815 |
$10.37 |
$193.40
|
$1,967.15 |
489 |
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
HCPCS J9354 |
$857.54 |
$11,350.31
|
$54,386.58 |
355 |
|
Adrenalin epinephrine inject
|
HCPCS J0171 |
$6.71 |
$231.47
|
$1,236.25 |
249 |
|
Afamelanotide implant, 1 mg
|
HCPCS J7352 |
$4,061.92 |
$78,638.30
|
$145,182.24 |
75 |
|
Aflibercept injection
|
HCPCS J0178 |
$790.04 |
$2,738.00
|
$28,307.80 |
136 |
|
Agalsidase beta 35 mg intravenous solution
|
HCPCS J0180 |
$955.20 |
$14,475.20
|
$92,980.16 |
274 |
|
Albuterol comp con
|
HCPCS J7610 |
$2.27 |
$12.80
|
$14.98 |
15 |
|
Albuterol comp unit
|
HCPCS J7609 |
$0.13 |
$0.80
|
$1.20 |
18 |
|
Albuterol ipratrop non-comp
|
HCPCS J7620 |
$0.33 |
$5.67
|
$63.79 |
341 |
|
Albuterol non-comp con
|
HCPCS J7611 |
$0.36 |
$6.07
|
$63.00 |
227 |
|
Albuterol non-comp unit
|
HCPCS J7613 |
$0.32 |
$5.40
|
$45.00 |
298 |
|
Aldesleukin injection
|
HCPCS J9015 |
$1,156.91 |
$9,030.11
|
$47,400.38 |
250 |
|
Alefacept
|
HCPCS J0215 |
$37.63 |
$37.63
|
$214.20 |
2 |
|
Alemtuzumab 12 mg/1.2 ml intravenous solution
|
HCPCS J0202 |
$2,337.69 |
$47,974.31
|
$157,560.18 |
202 |
|
Alglucerase injection
|
HCPCS J0205 |
โ |
โ
|
โ |
0 |
|
Alglucosidase alfa injection
|
HCPCS J0220 |
$1,034.01 |
$2,010.58
|
$10,517.33 |
17 |
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
HCPCS J0256 |
$3.25 |
$13.14
|
$378.00 |
218 |
|
Alprostadil for injection
|
HCPCS J0270 |
$29.02 |
$511.41
|
$3,766.75 |
346 |
|
Alprostadil urethral suppos
|
HCPCS J0275 |
$67.20 |
$150.04
|
$245.26 |
47 |
|
Alteplase 100 mg infusion from pyxis vial
|
HCPCS J2997 |
$556.56 |
$15,857.45
|
$102,964.26 |
530 |
|
Altuviiio per factor viii iu
|
HCPCS J7214 |
$4.67 |
$13.32
|
$25.75 |
93 |
|
Amifostine
|
HCPCS J0207 |
$346.64 |
$2,121.39
|
$18,453.00 |
238 |
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
HCPCS J0278 |
$1.94 |
$39.84
|
$366.00 |
524 |
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
HCPCS J0281 |
$1.96 |
$37.33
|
$350.00 |
362 |
|
Aminolevulinic acid, 10% gel
|
HCPCS J7345 |
$1.72 |
$1.81
|
$3.00 |
25 |
|
Aminolevulinic acid hcl top
|
HCPCS J7308 |
$325.60 |
$640.56
|
$1,629.27 |
134 |
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
HCPCS J0280 |
$2.61 |
$47.06
|
$360.69 |
650 |
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
HCPCS J0283 |
$5.41 |
$108.13
|
$1,017.00 |
498 |
|
Amiodarone 50 mg/ml intravenous solution
|
HCPCS J0282 |
$2.59 |
$55.86
|
$471.47 |
627 |
|
Amitriptyline injection
|
HCPCS J1320 |
$31.10 |
$31.10
|
$31.10 |
5 |
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
HCPCS J9061 |
$451.37 |
$9,084.45
|
$62,670.60 |
232 |
|
Amobarbital 125 mg inj
|
HCPCS J0300 |
$75.60 |
$1,283.59
|
$5,184.41 |
134 |
|
Ampho b cholesteryl sulfate
|
HCPCS J0288 |
$123.99 |
$438.23
|
$864.00 |
6 |
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
HCPCS J0285 |
$8.75 |
$123.53
|
$1,208.09 |
513 |
|
Amphotericin b lipid complex
|
HCPCS J0287 |
$11.37 |
$226.80
|
$1,948.50 |
174 |
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
HCPCS J0289 |
$23.79 |
$519.03
|
$4,399.53 |
553 |
|
Ampicillin 1 gram solution for injection
|
HCPCS J0290 |
$3.00 |
$56.70
|
$534.79 |
680 |
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
HCPCS J0295 |
$3.44 |
$54.57
|
$536.57 |
685 |
|
Anacaulase-bcdb 8.8% gel 1 g
|
HCPCS J7353 |
$58.32 |
$58.34
|
$200.46 |
27 |
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
HCPCS J3490 |
$133.62 |
$2,979.43
|
$26,215.20 |
472 |
|
Anidulafungin injection
|
HCPCS J0348 |
$18.27 |
$312.30
|
$2,876.40 |
236 |
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
HCPCS J7187 |
$1.09 |
$6.10
|
$190.18 |
305 |
|
Antihemophilic viii/vwf comp
|
HCPCS J7186 |
$0.36 |
$3.67
|
$44.89 |
163 |
|
Anti-inhibitor
|
HCPCS J7198 |
$1.35 |
$8.33
|
$217.62 |
228 |
|
Antithrombin iii injection
|
HCPCS J7197 |
$1.61 |
$11.85
|
$166.69 |
254 |
|
Antithrombin recombinant
|
HCPCS J7196 |
$8.56 |
$9.22
|
$14.00 |
34 |
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
HCPCS J7504 |
$427.95 |
$8,214.07
|
$79,307.67 |
320 |
|
Antithymocyte globuln rabbit
|
HCPCS J7511 |
$374.04 |
$2,111.00
|
$10,031.28 |
301 |
|
Apomorphine hydrochloride
|
HCPCS J0364 |
$109.03 |
$174.99
|
$626.31 |
49 |
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
HCPCS J0185 |
$34.20 |
$955.43
|
$5,269.54 |
247 |
|
Aprotonin, 10,000 kiu
|
HCPCS J0365 |
$18.60 |
$18.60
|
$595.98 |
2 |
|
Arformoterol non-comp unit
|
HCPCS J7605 |
$3.08 |
$24.24
|
$224.00 |
150 |
|
Argatroban dialysis (accord)
|
HCPCS J0892 |
$38.00 |
$196.11
|
$640.32 |
4 |
|
Argatroban dialysis, auromed
|
HCPCS J0899 |
$25.78 |
$374.54
|
$1,096.87 |
21 |
|
Argatroban esrd dialysis 1mg
|
HCPCS J0884 |
$55.47 |
$934.80
|
$5,612.04 |
117 |
|
Argatroban nonesrd (accord)
|
HCPCS J0891 |
$7.64 |
$218.25
|
$1,271.16 |
51 |
|
Argatroban nonesrd (auromed)
|
HCPCS J0898 |
$4.97 |
$40.30
|
$394.27 |
53 |
|
Argatroban nonesrd use 1mg
|
HCPCS J0883 |
$36.00 |
$881.10
|
$6,148.16 |
343 |
|
Aripiprazole 441 mg/1.6 ml inj
|
HCPCS J1944 |
$418.67 |
$6,387.85
|
$32,136.47 |
183 |
|
Aripiprazole injection
|
HCPCS J0400 |
$4.80 |
$90.50
|
$234.36 |
24 |
|
Arsenic trioxide 2 mg/ml intravenous solution
|
HCPCS J9017 |
$69.21 |
$1,303.25
|
$9,061.62 |
418 |
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
HCPCS J9022 |
$1,019.90 |
$22,528.65
|
$107,949.97 |
420 |
|
Atropine 0.1 mg/ml injection syringe
|
HCPCS J0461 |
$2.44 |
$53.24
|
$448.13 |
586 |
|
Avelumab 20 mg/ml intravenous solution
|
HCPCS J9023 |
$199.80 |
$3,721.71
|
$20,102.59 |
277 |
|
Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial
|
HCPCS J9038 |
$15,592.21 |
$23,112.50
|
$67,410.35 |
75 |
|
Azacitidine injection
|
HCPCS J9025 |
$48.20 |
$1,047.73
|
$7,903.00 |
470 |
|
Azathioprine 50 mg tablet
|
HCPCS J7500 |
$0.25 |
$3.44
|
$43.34 |
499 |
|
Azathioprine parenteral
|
HCPCS J7501 |
$30.00 |
$465.00
|
$3,465.00 |
222 |
|
Azithromycin 500 mg intravenous solution
|
HCPCS J0456 |
$2.82 |
$37.53
|
$369.19 |
713 |
|
Aztreonam 1 gram solution for injection
|
HCPCS J0457 |
$7.94 |
$157.30
|
$977.37 |
537 |
|
Baclofen 2,000 mcg/ml intrathecal solution (wrapper)
|
HCPCS J0475 |
$80.74 |
$1,639.90
|
$15,030.00 |
393 |
|
Baclofen 50 mcg/ml intrathecal solution (wrapper)
|
HCPCS J0476 |
$11.70 |
$158.07
|
$1,555.00 |
296 |
|
Basiliximab
|
HCPCS J0480 |
$1,744.05 |
$8,127.89
|
$51,618.90 |
270 |
|
Bcg live 50 mg intravesical suspension
|
HCPCS J9030 |
$22.20 |
$404.04
|
$2,438.10 |
243 |
|
Belatacept 250 mg intravenous solution
|
HCPCS J0485 |
$408.78 |
$2,036.75
|
$16,778.25 |
321 |
|
Belimumab 120 mg intravenous solution
|
HCPCS J0490 |
$202.40 |
$4,047.32
|
$22,244.00 |
339 |
|
Bendamustine 100 mg intravenous powder for solution
|
HCPCS J9033 |
$214.20 |
$5,145.52
|
$34,023.00 |
337 |
|
Bendamustine 25 mg/ml intravenous solution (belrapzo)
|
HCPCS J9036 |
$238.00 |
$4,107.38
|
$14,805.71 |
118 |
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
HCPCS J9034 |
$231.00 |
$4,898.13
|
$29,120.93 |
355 |
|
Bendamustine 25 mg/ml intravenous solution (vivimusta)
|
HCPCS J9056 |
$339.81 |
$9,029.40
|
$27,892.20 |
81 |
|
Benztropine 1 mg/ml injection solution
|
HCPCS J0515 |
$7.58 |
$108.90
|
$1,074.08 |
678 |
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
HCPCS J0702 |
$3.44 |
$65.00
|
$610.00 |
731 |
|
Bethanechol chloride inject
|
HCPCS J0520 |
$20.72 |
$20.72
|
$20.72 |
1 |
|
Bevacizumab 25 mg/ml intravenous solution
|
HCPCS J9035 |
$275.40 |
$5,737.97
|
$31,792.80 |
458 |
|
Bivalirudin
|
HCPCS J0583 |
$50.36 |
$1,086.92
|
$9,866.94 |
433 |
|
Bleomycin 15 unit solution for injection
|
HCPCS J9040 |
$14.37 |
$220.56
|
$2,192.00 |
493 |
|
Blinatumomab 35 mcg intravenous solution
|
HCPCS J9039 |
$499.92 |
$10,187.42
|
$58,340.21 |
254 |
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
HCPCS J9041 |
$124.89 |
$2,915.40
|
$23,659.00 |
445 |
|
Brentuximab vedotin 50 mg intravenous solution
|
HCPCS J9042 |
$1,158.95 |
$22,383.57
|
$107,997.84 |
375 |