|
Sodium chloride 0.9 % IV bolus
|
HCPCS J7050 |
$2.93 |
$37.64
|
$329.25 |
564 |
|
Sodium chloride 3 % ivpb
|
HCPCS J7131 |
$2.28 |
$40.61
|
$325.99 |
483 |
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
HCPCS J2916 |
$4.04 |
$80.14
|
$803.00 |
655 |
|
Sodium hyaluronate 20 mg/2 ml syringe
|
HCPCS J7321 |
$40.50 |
$410.40
|
$3,619.18 |
310 |
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
HCPCS J0209 |
$8.34 |
$177.52
|
$1,399.00 |
364 |
|
Somatropin injection
|
HCPCS J2941 |
$64.06 |
$2,111.40
|
$11,877.38 |
159 |
|
Streptokinase 1.5 m-units inj
|
HCPCS J2995 |
$635.54 |
$917.47
|
$917.47 |
9 |
|
Streptomycin injection
|
HCPCS J3000 |
$8.40 |
$138.30
|
$877.50 |
257 |
|
Streptozocin injection
|
HCPCS J9320 |
$131.76 |
$785.95
|
$4,963.00 |
172 |
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
HCPCS J0330 |
$3.41 |
$54.80
|
$505.68 |
689 |
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
HCPCS J2865 |
$7.00 |
$82.46
|
$592.37 |
326 |
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
HCPCS J3030 |
$8.23 |
$129.89
|
$1,460.12 |
658 |
|
Supprelin la implant
|
HCPCS J9226 |
$22,556.05 |
$80,935.72
|
$363,354.00 |
187 |
|
Synojoynt, inj., 1 mg
|
HCPCS J7331 |
$4.30 |
$4.30
|
$32.36 |
7 |
|
Synvisc or synvisc-one
|
HCPCS J7325 |
$44.92 |
$1,242.63
|
$7,149.42 |
356 |
|
Tacrol astagraf ex rel oral
|
HCPCS J7508 |
$3.15 |
$62.32
|
$400.58 |
89 |
|
Tacrol envarsus ex rel oral
|
HCPCS J7503 |
$1.77 |
$15.60
|
$249.13 |
213 |
|
Tacrolimus 1 mg capsule, immediate-release
|
HCPCS J7507 |
$0.63 |
$9.93
|
$119.40 |
482 |
|
Tacrolimus 5 mg/ml intravenous solution
|
HCPCS J7525 |
$33.16 |
$596.76
|
$4,636.44 |
386 |
|
Tafasitamab-cxix 200 mg intravenous solution
|
HCPCS J9349 |
$565.20 |
$2,762.00
|
$14,807.39 |
240 |
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
HCPCS J9325 |
$101.40 |
$1,223.36
|
$16,658.82 |
117 |
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
HCPCS J3055 |
$3,575.07 |
$21,745.13
|
$72,338.87 |
167 |
|
Tarlatamab-dlle 10 mg intravenous solution
|
HCPCS J9026 |
$1,545.00 |
$24,217.20
|
$127,800.00 |
246 |
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
HCPCS J1447 |
$42.80 |
$937.50
|
$7,553.49 |
395 |
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
HCPCS J9274 |
$1,801.80 |
$40,114.80
|
$141,820.00 |
146 |
|
Telavancin injection
|
HCPCS J3095 |
$61.10 |
$1,191.80
|
$6,203.12 |
201 |
|
Temozolomide
|
HCPCS J8700 |
$23.87 |
$540.06
|
$3,858.00 |
243 |
|
Temozolomide 100 mg intravenous solution
|
HCPCS J9328 |
$291.00 |
$1,867.28
|
$9,000.00 |
168 |
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
HCPCS J9330 |
$171.98 |
$3,723.60
|
$27,862.04 |
341 |
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
HCPCS J3101 |
$715.65 |
$14,951.87
|
$133,419.96 |
532 |
|
Terbutaline 1 mg/ml subcutaneous solution
|
HCPCS J3105 |
$2.34 |
$39.33
|
$382.01 |
697 |
|
Teriparatide injection
|
HCPCS J3110 |
$794.40 |
$7,403.20
|
$22,530.95 |
81 |
|
Testosterone undecanoate 1mg
|
HCPCS J3145 |
$216.33 |
$3,528.08
|
$15,920.24 |
75 |
|
Tetanus immune globulin inj
|
HCPCS J1670 |
$76.72 |
$1,285.36
|
$10,438.68 |
650 |
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
HCPCS J2356 |
$1,002.11 |
$8,737.05
|
$71,015.50 |
267 |
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
HCPCS J3411 |
$1.80 |
$25.54
|
$258.00 |
745 |
|
Thiethylperazine maleate inj
|
HCPCS J3280 |
$3.71 |
$3.71
|
$3.71 |
1 |
|
Thiotepa 15 mg solution for injection
|
HCPCS J9341 |
$1,090.00 |
$1,090.00
|
$7,200.00 |
15 |
|
Thiotepa injection
|
HCPCS J9340 |
$209.02 |
$1,485.00
|
$7,452.36 |
101 |
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
HCPCS J3240 |
$321.51 |
$4,152.21
|
$25,911.00 |
462 |
|
Tigecycline injection
|
HCPCS J3243 |
$12.17 |
$235.29
|
$2,142.00 |
418 |
|
Tinzaparin sodium injection
|
HCPCS J1655 |
$5.44 |
$5.44
|
$153.41 |
2 |
|
Tirofiban 12.5 mg/50 ml
|
HCPCS J3246 |
$21.15 |
$458.85
|
$2,796.30 |
290 |
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
HCPCS J9273 |
$708.50 |
$13,339.20
|
$77,127.29 |
227 |
|
Tobramycin comp unit
|
HCPCS J7685 |
$54.97 |
$810.40
|
$1,426.80 |
16 |
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
HCPCS J3260 |
$7.22 |
$152.36
|
$1,372.70 |
624 |
|
Tobramycin non-comp unit
|
HCPCS J7682 |
$6.56 |
$108.42
|
$958.75 |
207 |
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
HCPCS J3262 |
$387.65 |
$5,258.52
|
$27,604.21 |
454 |
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
HCPCS J9351 |
$17.26 |
$316.84
|
$3,358.00 |
451 |
|
Topotecan oral
|
HCPCS J8705 |
$172.62 |
$851.05
|
$1,656.75 |
41 |
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
HCPCS J3263 |
$889.20 |
$15,383.12
|
$81,131.94 |
125 |
|
Trabectedin 1 mg intravenous solution
|
HCPCS J9352 |
$362.82 |
$6,684.23
|
$35,935.00 |
352 |
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
HCPCS J3290 |
$6.50 |
$56.38
|
$512.00 |
283 |
|
Trastuzumab 150 mg intravenous solution
|
HCPCS J9355 |
$155.24 |
$3,141.85
|
$17,779.54 |
440 |
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
HCPCS J9347 |
$3,883.65 |
$73,346.25
|
$404,153.26 |
220 |
|
Treprostinil injection
|
HCPCS J3285 |
$469.53 |
$19,071.84
|
$74,489.22 |
246 |
|
Treprostinil, non-comp unit
|
HCPCS J7686 |
$271.77 |
$2,970.72
|
$14,196.00 |
69 |
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
HCPCS J3301 |
$3.00 |
$43.09
|
$427.50 |
711 |
|
Triamcinolone a inj prs-free
|
HCPCS J3300 |
$15.37 |
$223.56
|
$2,749.74 |
233 |
|
Triamcinolone diacetate inj
|
HCPCS J3302 |
$0.27 |
$3.60
|
$33.48 |
27 |
|
Triamcinolone hexacetonl inj
|
HCPCS J3303 |
$1.33 |
$21.36
|
$123.23 |
94 |
|
Trilaciclib 300 mg intravenous solution
|
HCPCS J1448 |
$729.11 |
$4,043.12
|
$14,226.96 |
81 |
|
Trimethobenzamide hcl inj
|
HCPCS J3250 |
$8.47 |
$117.49
|
$1,129.76 |
377 |
|
Triptorelin pamoate
|
HCPCS J3315 |
$275.33 |
$4,619.39
|
$44,595.34 |
272 |
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
HCPCS J2329 |
$872.71 |
$21,992.26
|
$107,599.30 |
179 |
|
Urofollitropin, 75 iu
|
HCPCS J3355 |
โ |
โ
|
โ |
0 |
|
Urokinase 250,000 iu inj
|
HCPCS J3365 |
$522.40 |
$522.40
|
$905.51 |
17 |
|
Urokinase 5000 iu injection
|
HCPCS J3364 |
$8.48 |
$199.82
|
$199.82 |
6 |
|
Ustekinumab 130 mg/26 ml intravenous solution
|
HCPCS J3358 |
$247.46 |
$5,205.00
|
$40,509.34 |
365 |
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
HCPCS J3357 |
$12,940.35 |
$51,633.07
|
$154,889.53 |
243 |
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
HCPCS J3379 |
$1.90 |
$24.12
|
$237.00 |
194 |
|
Valrubicin injection
|
HCPCS J9357 |
$153.72 |
$2,813.49
|
$14,856.00 |
177 |
|
Vancomycin 1,000 mg intravenous injection
|
HCPCS J3373 |
$12.40 |
$259.05
|
$2,454.96 |
376 |
|
Vancomycin 750 mg intravenous solution
|
HCPCS J3374 |
$14.12 |
$90.33
|
$438.54 |
303 |
|
Vancomycin hcl injection
|
HCPCS J3370 |
$8.36 |
$149.49
|
$1,449.84 |
318 |
|
Vantas implant
|
HCPCS J9225 |
$3,178.60 |
$12,207.65
|
$17,084.76 |
18 |
|
Vasopressin 20 unit/ml intravenous solution
|
HCPCS J2598 |
$17.10 |
$325.80
|
$2,584.52 |
583 |
|
Vedolizumab 300 mg intravenous solution
|
HCPCS J3380 |
$1,273.42 |
$18,732.33
|
$150,507.36 |
455 |
|
Velaglucerase alfa 400 unit intravenous solution
|
HCPCS J3385 |
$370.20 |
$2,632.35
|
$25,166.74 |
162 |
|
Verteporfin injection
|
HCPCS J3396 |
$2,357.63 |
$3,077.48
|
$27,653.75 |
115 |
|
Vinblastine 1 mg/ml intravenous solution
|
HCPCS J9360 |
$7.15 |
$165.00
|
$1,350.56 |
523 |
|
Vincristine 1 mg/ml intravenous solution
|
HCPCS J9370 |
$4.44 |
$87.15
|
$613.48 |
564 |
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
HCPCS J9390 |
$15.00 |
$223.55
|
$2,233.00 |
486 |
|
Vonvendi inj 1 iu vwf:rco
|
HCPCS J7179 |
$0.60 |
$5.42
|
$22.50 |
169 |
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
HCPCS J3465 |
$7.26 |
$165.81
|
$1,406.40 |
509 |
|
Vutrisiran 25 mg/0.5 ml subcutaneous syringe
|
HCPCS J0225 |
$9,373.80 |
$177,291.55
|
$835,457.00 |
168 |
|
Vyjuvek 5x10^9pfu/ml, 0.1 ml
|
HCPCS J3401 |
$2,067.27 |
$40,693.74
|
$54,500.55 |
34 |
|
Wilate injection
|
HCPCS J7183 |
$0.46 |
$4.58
|
$48.76 |
194 |
|
Xyntha inj
|
HCPCS J7185 |
$0.53 |
$6.65
|
$48.76 |
169 |
|
Ziconotide injection
|
HCPCS J2278 |
$251.40 |
$7,216.02
|
$31,609.84 |
161 |
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
HCPCS J3485 |
$4.12 |
$83.25
|
$772.00 |
348 |
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
HCPCS J3486 |
$7.56 |
$123.21
|
$1,151.00 |
662 |
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
HCPCS J9400 |
$675.08 |
$5,215.08
|
$22,364.00 |
206 |
|
Zolbetuximab-clzb 100 mg intravenous solution
|
HCPCS J1326 |
$334.39 |
$7,810.92
|
$48,000.00 |
141 |
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
HCPCS J3489 |
$23.64 |
$432.92
|
$4,582.80 |
661 |