|
Factor xiii anti-hem factor
|
HCPCS J7180 |
$8.77 |
$23.98
|
$146.89 |
89 |
|
Factor xiii recomb a-subunit
|
HCPCS J7181 |
$17.26 |
$46.05
|
$68.26 |
89 |
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
HCPCS J1308 |
$1.05 |
$22.20
|
$199.41 |
496 |
|
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution
|
HCPCS J9358 |
$309.17 |
$5,894.50
|
$46,584.62 |
317 |
|
Fecal microbiota, live-jslm 150 ml rectal suspension enema
|
HCPCS J1440 |
$3,252.85 |
$14,956.68
|
$54,717.60 |
132 |
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
HCPCS J3010 |
$5.17 |
$101.40
|
$985.25 |
648 |
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
HCPCS J1439 |
$149.99 |
$2,590.25
|
$18,814.07 |
456 |
|
Fiasp for insulin pump use
|
HCPCS J1811 |
$7.41 |
$7.41
|
$10.91 |
24 |
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
HCPCS J1442 |
$53.84 |
$1,197.83
|
$9,449.05 |
435 |
|
Flebogamma injection
|
HCPCS J1572 |
$135.28 |
$3,438.30
|
$19,307.68 |
158 |
|
Floxuridine injection
|
HCPCS J9200 |
$248.28 |
$5,871.79
|
$20,583.60 |
201 |
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
HCPCS J1450 |
$3.21 |
$64.22
|
$634.20 |
627 |
|
Fludarabine 50 mg intravenous solution
|
HCPCS J9185 |
$47.34 |
$493.35
|
$5,022.00 |
434 |
|
Fluocinol acet intravit imp
|
HCPCS J7313 |
$700.26 |
$14,359.80
|
$36,457.38 |
100 |
|
Fluocinolone acetonide implt
|
HCPCS J7311 |
$10,939.05 |
$30,686.32
|
$132,209.70 |
125 |
|
Fluorouracil 50 mg/ml intravenous solution (wrapper)
|
HCPCS J9190 |
$7.35 |
$107.00
|
$971.82 |
541 |
|
Fluphenazine decanoate 25 mg/ml injection solution
|
HCPCS J2680 |
$5.10 |
$72.52
|
$806.94 |
484 |
|
Folic acid 5 mg/ml injection solution
|
HCPCS J1808 |
$1.81 |
$45.00
|
$355.19 |
452 |
|
Fomepizole 1 gram/ml intravenous solution
|
HCPCS J1451 |
$103.60 |
$2,511.73
|
$19,661.38 |
529 |
|
Fondaparinux sodium
|
HCPCS J1652 |
$9.45 |
$186.20
|
$1,446.58 |
559 |
|
Formoterol comp unit
|
HCPCS J7640 |
$2.40 |
$2.40
|
$2.40 |
12 |
|
Formoterol fumarate, inh
|
HCPCS J7606 |
$3.03 |
$59.40
|
$339.87 |
194 |
|
Fosaprepitant 150 mg intravenous powder for solution
|
HCPCS J1453 |
$22.53 |
$490.67
|
$3,612.00 |
479 |
|
Foscarnet sodium injection
|
HCPCS J1455 |
$50.32 |
$988.21
|
$5,617.92 |
324 |
|
Furosemide 10 mg/ml injection solution
|
HCPCS J1938 |
$1.07 |
$19.53
|
$168.87 |
440 |
|
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr
|
HCPCS J1940 |
$2.32 |
$26.40
|
$260.01 |
221 |
|
Gallium nitrate injection
|
HCPCS J1457 |
$1,315.20 |
$1,315.20
|
$1,315.20 |
1 |
|
Galsulfase injection
|
HCPCS J1458 |
$709.13 |
$4,037.51
|
$6,386.40 |
69 |
|
Gamma globulin > 10 cc inj
|
HCPCS J1560 |
$144.24 |
$498.52
|
$1,911.07 |
43 |
|
Gamma globulin 1 cc inj
|
HCPCS J1460 |
$21.60 |
$407.60
|
$3,746.75 |
266 |
|
Gammaplex injection
|
HCPCS J1557 |
$2,795.10 |
$7,464.29
|
$14,349.50 |
46 |
|
Gamunex-c/gammaked
|
HCPCS J1561 |
$259.20 |
$7,435.88
|
$45,033.03 |
388 |
|
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr
|
HCPCS J1570 |
$18.60 |
$197.40
|
$1,945.97 |
504 |
|
Ganciclovir long act implant
|
HCPCS J7310 |
$5,768.70 |
$68,716.05
|
$68,716.05 |
14 |
|
Gefitinib oral
|
HCPCS J8565 |
$25.67 |
$423.82
|
$1,173.85 |
78 |
|
Gel-one
|
HCPCS J7326 |
$400.20 |
$1,561.21
|
$5,750.00 |
178 |
|
Gel-syn injection 0.1 mg
|
HCPCS J7328 |
$135.02 |
$680.71
|
$1,862.40 |
118 |
|
Gemcitabine 1 gram intravenous solution
|
HCPCS J9201 |
$10.50 |
$207.51
|
$2,034.00 |
586 |
|
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln
|
HCPCS J9203 |
$1,020.50 |
$19,305.62
|
$86,867.22 |
262 |
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
HCPCS J1580 |
$2.81 |
$52.54
|
$413.92 |
665 |
|
Genvisc 850, inj, 1mg
|
HCPCS J7320 |
$5.90 |
$6.02
|
$28.80 |
25 |
|
Glassia injection
|
HCPCS J0257 |
$2.10 |
$20.32
|
$384.00 |
124 |
|
Glucagon 1 mg solution for injection
|
HCPCS J1610 |
$31.57 |
$613.79
|
$5,666.63 |
626 |
|
Glucagon hcl 1 mg/ml solution for injection
|
HCPCS J1611 |
$88.52 |
$491.67
|
$4,593.78 |
484 |
|
Glycopyrrolate 0.2 mg/ml injection solution
|
HCPCS J1596 |
$2.07 |
$37.40
|
$358.18 |
555 |
|
Gold sodium thiomaleate inj
|
HCPCS J1600 |
$13.78 |
$27.20
|
$62.81 |
15 |
|
Golimumab 12.5 mg/ml intravenous solution
|
HCPCS J1602 |
$221.65 |
$5,009.45
|
$32,147.04 |
407 |
|
Goserelin 10.8 mg subcutaneous implant
|
HCPCS J9202 |
$230.70 |
$4,417.13
|
$26,346.42 |
508 |
|
Graft axiofill 1000mg
|
HCPCS J3590 |
$234.75 |
$5,125.68
|
$28,466.18 |
322 |
|
Granisetron hcl injection
|
HCPCS J1626 |
$3.00 |
$45.03
|
$466.21 |
333 |
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
HCPCS J1631 |
$5.44 |
$91.09
|
$825.48 |
531 |
|
Haloperidol lactate 5 mg/ml injection solution
|
HCPCS J1630 |
$1.31 |
$24.30
|
$247.00 |
760 |
|
Hemin 350 mg intravenous powder for solution
|
HCPCS J1640 |
$3,519.41 |
$20,618.46
|
$179,297.94 |
281 |
|
Hepagam b im injection
|
HCPCS J1571 |
$68.66 |
$1,118.05
|
$4,218.32 |
149 |
|
Hepagam b intravenous, inj
|
HCPCS J1573 |
$68.66 |
$386.40
|
$3,630.50 |
86 |
|
Heparin bolus from bag
|
HCPCS J1644 |
$3.91 |
$66.06
|
$544.30 |
669 |
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
HCPCS J1642 |
$0.58 |
$12.00
|
$104.49 |
593 |
|
HIV prep, ftc/taf 200/25mg
|
HCPCS J0751 |
$25.55 |
$88.39
|
$541.79 |
94 |
|
HIV prep, ftc/tdf 200/300mg
|
HCPCS J0750 |
$1.74 |
$31.80
|
$283.32 |
111 |
|
HIV prep, inj, cabotegravir
|
HCPCS J0739 |
$593.25 |
$7,320.13
|
$66,343.68 |
122 |
|
Hizentra injection
|
HCPCS J1559 |
$107.16 |
$3,912.58
|
$6,107.68 |
76 |
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
HCPCS J7165 |
$302.30 |
$5,568.57
|
$27,717.23 |
177 |
|
Hyaluronidase 150 unit/ml injection solution
|
HCPCS J3470 |
$14.44 |
$126.37
|
$1,167.45 |
361 |
|
Hyaluronidase 200 units/ml inj
|
HCPCS J3471 |
$16.85 |
$245.00
|
$1,753.60 |
191 |
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
HCPCS J3473 |
$8.37 |
$142.40
|
$1,041.37 |
488 |
|
Hydralazine 20 mg/ml injection solution
|
HCPCS J0360 |
$3.16 |
$48.00
|
$454.30 |
756 |
|
Hydrocortisone acetate inj
|
HCPCS J1700 |
$7.80 |
$78.81
|
$78.81 |
5 |
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
HCPCS J1720 |
$9.73 |
$140.54
|
$1,466.15 |
661 |
|
Hydrocortisone sodium ph inj
|
HCPCS J1710 |
$4.24 |
$4.24
|
$4.24 |
1 |
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
HCPCS J1171 |
$5.38 |
$112.66
|
$1,049.50 |
547 |
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
HCPCS J7999 |
$14.39 |
$294.92
|
$2,532.32 |
347 |
|
Hydromorphone injection
|
HCPCS J1170 |
$6.00 |
$80.38
|
$521.50 |
161 |
|
Hydroxocobalamin im 10mcg
|
HCPCS J3425 |
$0.34 |
$4.86
|
$50.70 |
79 |
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
HCPCS J3410 |
$4.03 |
$72.65
|
$717.05 |
632 |
|
Hymovis injection 1 mg
|
HCPCS J7322 |
$17.44 |
$28.00
|
$1,282.37 |
69 |
|
Hyoscyamine sulfate inj
|
HCPCS J1980 |
$12.03 |
$123.83
|
$1,361.73 |
221 |
|
Hyqvia 100mg immuneglobulin
|
HCPCS J1575 |
$830.16 |
$13,494.15
|
$31,504.14 |
63 |
|
Ibandronate 3 mg/3 ml intravenous syringe
|
HCPCS J1740 |
$36.59 |
$684.45
|
$6,758.00 |
417 |
|
Ibuprofen injection
|
HCPCS J1741 |
$20.07 |
$256.76
|
$1,867.30 |
183 |
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
HCPCS J1742 |
$69.68 |
$980.94
|
$9,220.39 |
560 |
|
Icatibant injection
|
HCPCS J1744 |
$321.84 |
$8,695.05
|
$55,665.00 |
254 |
|
Idarubicin hcl injection
|
HCPCS J9211 |
$25.30 |
$447.02
|
$4,432.00 |
355 |
|
Idursulfase injection
|
HCPCS J1743 |
$420.59 |
$5,646.08
|
$28,487.76 |
147 |
|
Ifosfamide 1 gram intravenous solution
|
HCPCS J9208 |
$18.82 |
$246.95
|
$1,752.00 |
488 |
|
Imetelstat 188 mg intravenous solution
|
HCPCS J0870 |
$4,403.25 |
$20,373.55
|
$88,689.66 |
155 |
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
HCPCS J1569 |
$259.29 |
$6,106.32
|
$32,583.07 |
437 |
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
HCPCS J1566 |
$147.00 |
$2,900.11
|
$15,186.40 |
315 |
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
HCPCS J1568 |
$200.72 |
$3,846.15
|
$32,830.74 |
325 |
|
Imuglucerase injection
|
HCPCS J1786 |
$161.00 |
$3,399.59
|
$18,180.26 |
143 |
|
Incobotulinumtoxin a
|
HCPCS J0588 |
$127.50 |
$1,339.57
|
$5,446.00 |
211 |
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
HCPCS J9220 |
$38.88 |
$766.66
|
$3,985.00 |
245 |
|
Infliximab 100 mg intravenous solution
|
HCPCS J1745 |
$102.10 |
$2,047.13
|
$18,708.48 |
586 |
|
Inj, abilify asimtufii, 1 mg
|
HCPCS J0402 |
$733.17 |
$9,426.91
|
$21,783.26 |
92 |
|
Inj, abilify maintena, 1 mg
|
HCPCS J0401 |
$973.93 |
$5,355.30
|
$27,060.87 |
238 |
|
Inj acetaminoph 10mg/ibu 3mg
|
HCPCS J0138 |
$0.13 |
$0.22
|
$0.22 |
12 |
|
Inj, acetaminophen (b braun)
|
HCPCS J0136 |
$3.27 |
$32.79
|
$214.84 |
214 |
|
Inj acetaminophen -fresenius
|
HCPCS J0134 |
$2.57 |
$36.60
|
$340.00 |
252 |
|
Inj, acetaminophen (hikma)
|
HCPCS J0137 |
$2.18 |
$56.70
|
$326.96 |
157 |
|
Inj. acthar gel to 40 units
|
HCPCS J0801 |
$2,625.63 |
$7,918.32
|
$59,796.00 |
79 |
|
Inj, adalimumab, 1 mg
|
HCPCS J0139 |
$503.94 |
$12,098.05
|
$49,791.96 |
168 |