|
Inj, adstiladrin, per tx dos
|
HCPCS J9029 |
$11,921.18 |
$63,354.77
|
$249,373.80 |
147 |
|
Inj, aducanumab-avwa, 2 mg
|
HCPCS J0172 |
$5.98 |
$5.98
|
$25.80 |
34 |
|
Inj, adzynma, 10 iu
|
HCPCS J7171 |
$7.92 |
$34.60
|
$103.89 |
50 |
|
Inj, aflibercept hd, 1 mg
|
HCPCS J0177 |
$319.74 |
$2,794.18
|
$11,816.00 |
96 |
|
Inj, afstyla, 1 i.u
|
HCPCS J7210 |
$1.12 |
$6.76
|
$22.50 |
77 |
|
Inj, alfentanil hcl, 500mcg
|
HCPCS J0216 |
$6.69 |
$35.94
|
$197.55 |
129 |
|
Inj allopurinol sodium 1 mg
|
HCPCS J0206 |
$502.79 |
$6,968.99
|
$43,290.00 |
217 |
|
Inj, alyglo, 500 mg
|
HCPCS J1552 |
$131.12 |
$169.86
|
$170.90 |
24 |
|
Inj, amisulpride, 1 mg
|
HCPCS J0184 |
$9.06 |
$91.89
|
$673.52 |
92 |
|
Inj andexxa, 10 mg
|
HCPCS J7169 |
$246.00 |
$4,370.80
|
$20,193.00 |
108 |
|
Inj anifrolumab-fnia 1mg
|
HCPCS J0491 |
$1,038.87 |
$10,052.58
|
$34,066.55 |
231 |
|
Inj. (ani), up to 40 units
|
HCPCS J0802 |
$4,901.40 |
$4,901.40
|
$4,901.40 |
4 |
|
Inj., aristada initio, 1 mg
|
HCPCS J1943 |
$604.14 |
$4,052.45
|
$11,871.55 |
118 |
|
Inj, artesunate, 1mg
|
HCPCS J0391 |
$2,034.83 |
$14,460.21
|
$93,943.00 |
146 |
|
Inj. asceniv
|
HCPCS J1554 |
$491.40 |
$7,833.92
|
$11,298.93 |
58 |
|
Inj, aspara, rylaze, 0.1 mg
|
HCPCS J9021 |
$790.20 |
$10,458.00
|
$71,236.50 |
126 |
|
Inj atezolizumb 5mg hya-tqjs
|
HCPCS J9024 |
$6,720.00 |
$18,716.52
|
$109,041.45 |
67 |
|
Inj avacincaptad pegol 0.1mg
|
HCPCS J2782 |
$236.50 |
$3,409.64
|
$9,460.00 |
45 |
|
Inj aval alfa-nqpt 4mg
|
HCPCS J0219 |
$201.91 |
$3,907.30
|
$21,034.66 |
117 |
|
Inj belantamab mafodot blmf
|
HCPCS J9037 |
$5,295.60 |
$21,726.12
|
$33,801.60 |
21 |
|
Inj., benralizumab, 1 mg
|
HCPCS J0517 |
$538.18 |
$11,310.00
|
$97,345.10 |
363 |
|
Inj, betibeglogene autotemce
|
HCPCS J3393 |
$2,950,686.67 |
$4,057,157.07
|
$14,973,577.00 |
48 |
|
Inj, bezlotoxumab, 10 mg
|
HCPCS J0565 |
$332.50 |
$7,612.43
|
$63,921.37 |
251 |
|
Inj bimatoprost itc imp1mcg
|
HCPCS J7351 |
$175.50 |
$3,287.96
|
$11,754.76 |
110 |
|
Inj, biorphen, 20 micrograms
|
HCPCS J2372 |
$0.86 |
$17.33
|
$134.16 |
155 |
|
Inj bortezomib boruzu 0.1 mg
|
HCPCS J9054 |
$26.21 |
$26.21
|
$35.37 |
12 |
|
Inj, bortezomib, dr. reddy's
|
HCPCS J9046 |
$4.77 |
$48.55
|
$660.72 |
48 |
|
Inj, bortezomib freseniuskab
|
HCPCS J9048 |
$114.56 |
$2,624.08
|
$7,941.80 |
98 |
|
Inj, bortezomib, hospira
|
HCPCS J9049 |
$10.87 |
$175.35
|
$1,630.00 |
70 |
|
Inj., brexanolone, 1 mg
|
HCPCS J1632 |
$1,303.75 |
$13,019.44
|
$33,055.65 |
56 |
|
Inj, brixadi, 7 days or less
|
HCPCS J0577 |
$72.00 |
$748.85
|
$6,244.88 |
93 |
|
Inj brixadi, more than 7 day
|
HCPCS J0578 |
$1,691.31 |
$2,858.76
|
$22,204.01 |
95 |
|
Inj, brolucizumab-dbll, 1 mg
|
HCPCS J0179 |
$332.57 |
$3,382.69
|
$4,878.89 |
61 |
|
Inj, bupivacaine liposome
|
HCPCS J0666 |
$58.79 |
$699.38
|
$4,785.63 |
273 |
|
Inj calcitriol per 0.1 mcg
|
HCPCS J0636 |
$1.20 |
$22.69
|
$221.12 |
342 |
|
Inj, carmustine (accord)
|
HCPCS J9052 |
$5,758.78 |
$9,875.08
|
$13,225.56 |
34 |
|
Inj cefazolin sodium, baxter
|
HCPCS J0689 |
$1.76 |
$27.38
|
$175.74 |
195 |
|
Inj cefazolin sodium, hikma
|
HCPCS J0688 |
$1.96 |
$27.38
|
$268.22 |
428 |
|
Inj cefazolin (wg crit care)
|
HCPCS J0687 |
$1.00 |
$18.43
|
$175.74 |
239 |
|
Inj. cefepime hcl (baxter)
|
HCPCS J0701 |
$8.24 |
$86.84
|
$472.86 |
106 |
|
Inj, cefepime hcl (b braun)
|
HCPCS J0703 |
$6.84 |
$69.85
|
$319.48 |
212 |
|
Inj, cefiderocol, 10 mg
|
HCPCS J0699 |
$24.47 |
$544.85
|
$4,233.06 |
343 |
|
Inj ceftolozane tazobactam
|
HCPCS J0695 |
$17.06 |
$364.86
|
$3,169.92 |
495 |
|
Inj., cerliponase alfa 1 mg
|
HCPCS J0567 |
$60.52 |
$167.25
|
$339.19 |
7 |
|
Inj. cetirizine hcl 0.5mg
|
HCPCS J1201 |
$14.87 |
$159.98
|
$1,235.04 |
65 |
|
Inj, cipaglucosidase, 5 mg
|
HCPCS J1203 |
$214.48 |
$3,278.80
|
$5,433.20 |
64 |
|
Inj, clindamycin (baxter)
|
HCPCS J0737 |
$3.24 |
$48.30
|
$342.00 |
393 |
|
Inj., copanlisib, 1 mg
|
HCPCS J9057 |
$746.20 |
$9,204.29
|
$54,532.37 |
119 |
|
Inj crotalidae im f(ab')2 eq
|
HCPCS J0841 |
$203.16 |
$2,613.60
|
$17,124.69 |
328 |
|
Inj, crovalimab-akkz, 10 mg
|
HCPCS J1307 |
$535.90 |
$535.90
|
$761.09 |
24 |
|
Inj cutaquig 100 mg
|
HCPCS J1551 |
$20.46 |
$348.81
|
$503.09 |
38 |
|
Inj cuvitru, 100 mg
|
HCPCS J1555 |
$2,437.55 |
$4,163.61
|
$38,292.96 |
35 |
|
Inj, cyclophos (baxter) 5mg
|
HCPCS J9076 |
$321.02 |
$2,584.85
|
$5,277.64 |
86 |
|
Inj cyclophos dr.reddy's 5mg
|
HCPCS J9072 |
$1,575.00 |
$5,460.00
|
$8,400.00 |
27 |
|
Inj cyclophosphamd auromedic
|
HCPCS J9071 |
$8.92 |
$249.68
|
$1,455.00 |
79 |
|
Inj cyclophosphamd (ingenus)
|
HCPCS J9073 |
$25.70 |
$742.72
|
$4,426.75 |
167 |
|
Inj, cyclophosphamd, sandoz
|
HCPCS J9074 |
$63.60 |
$735.20
|
$4,505.34 |
89 |
|
Inj, daptomycin (baxter)
|
HCPCS J0874 |
$0.15 |
$1.83
|
$1.83 |
17 |
|
Inj, daptomycin (hospira)
|
HCPCS J0877 |
$10.00 |
$128.08
|
$411.05 |
95 |
|
Inj daptomycin (xellia)
|
HCPCS J0873 |
$3.25 |
$56.04
|
$401.07 |
129 |
|
Inj daxibotulinumtoxina-lanm
|
HCPCS J0589 |
$436.90 |
$736.62
|
$1,774.50 |
50 |
|
Inj, decitabine (sun pharma)
|
HCPCS J0893 |
$16.25 |
$310.09
|
$1,648.85 |
106 |
|
Inj delandistrogene mox rokl
|
HCPCS J1413 |
$2,056,320.00 |
$3,325,454.76
|
$8,000,000.00 |
40 |
|
Inj diclofenac sodium 0.5mg
|
HCPCS J1130 |
$109.44 |
$109.44
|
$120.33 |
4 |
|
Inj, docetaxel (beizray) 1mg
|
HCPCS J9174 |
$52.47 |
$52.47
|
$65.46 |
12 |
|
Inj, donanemab-azbt, 2 mg
|
HCPCS J0175 |
$82.41 |
$1,233.44
|
$6,339.24 |
113 |
|
Inj, durolane 1 mg
|
HCPCS J7318 |
$100.50 |
$1,950.93
|
$12,314.18 |
189 |
|
Injection, belinostat, 10mg
|
HCPCS J9032 |
$226.20 |
$4,446.10
|
$14,422.60 |
162 |
|
Injection, burosumab-twza 1m
|
HCPCS J0584 |
$1,075.10 |
$20,002.09
|
$70,110.39 |
86 |
|
Injection, casimersen, 10 mg
|
HCPCS J1426 |
$181.00 |
$2,598.44
|
$7,400.25 |
58 |
|
Injection, daratumumab 10 mg
|
HCPCS J9145 |
$240.51 |
$5,324.34
|
$35,666.83 |
350 |
|
Injection, doxercalciferol
|
HCPCS J1270 |
$1.47 |
$23.86
|
$190.85 |
237 |
|
Injection, edaravone, 1 mg
|
HCPCS J1301 |
$149.85 |
$1,136.59
|
$10,458.72 |
114 |
|
Injection estrone per 1 mg
|
HCPCS J1435 |
$0.80 |
$0.80
|
$0.80 |
12 |
|
Injection, fulvestrant
|
HCPCS J9395 |
$88.11 |
$1,719.16
|
$16,199.22 |
509 |
|
Injection glatiramer acetate
|
HCPCS J1595 |
$67.65 |
$830.51
|
$6,668.64 |
282 |
|
Injection, inclisiran, 1 mg
|
HCPCS J1306 |
$1,036.97 |
$6,679.35
|
$57,085.56 |
314 |
|
Injection, isavuconazonium
|
HCPCS J1833 |
$47.84 |
$787.67
|
$3,197.15 |
281 |
|
Injection, khapzory, 0.5 mg
|
HCPCS J0642 |
$1,269.47 |
$2,162.76
|
$2,896.56 |
34 |
|
Injection, necitumumab, 1 mg
|
HCPCS J9295 |
$4,424.85 |
$8,572.91
|
$45,140.55 |
96 |
|
Injection,onabotulinumtoxina
|
HCPCS J0585 |
$131.04 |
$2,277.65
|
$11,423.53 |
487 |
|
Injection, peramivir
|
HCPCS J2547 |
$37.05 |
$744.75
|
$3,146.12 |
214 |
|
Injection, ruconest
|
HCPCS J0596 |
$8,245.00 |
$14,111.44
|
$44,089.27 |
42 |
|
Injection, siltuximab
|
HCPCS J2860 |
$467.40 |
$11,502.35
|
$48,713.66 |
161 |
|
Injection torsemide 10 mg/ml
|
HCPCS J3265 |
$4.00 |
$16.02
|
$69.60 |
42 |
|
Inj efgart-alfa 2mg hya-qvfc
|
HCPCS J9334 |
$1,295.64 |
$32,176.93
|
$239,553.76 |
171 |
|
Inj eflapegrastim-xnst 0.1mg
|
HCPCS J1449 |
$13.68 |
$22.75
|
$88.37 |
26 |
|
Inj., emapalumab-lzsg, 1 mg
|
HCPCS J9210 |
$378.03 |
$3,181.80
|
$40,644.12 |
116 |
|
Inj., emicizumab-kxwh 0.5 mg
|
HCPCS J7170 |
$6,452.03 |
$54,322.53
|
$118,063.22 |
87 |
|
Inj, epinephrine (belcher)
|
HCPCS J0173 |
$1.20 |
$6.55
|
$96.92 |
51 |
|
Inj., eravacycline, 1 mg
|
HCPCS J0122 |
$13.00 |
$206.64
|
$1,295.04 |
214 |
|
Inj, erzofri, 1 mg
|
HCPCS J2428 |
$3,331.02 |
$10,213.70
|
$13,679.07 |
38 |
|
Inj, etelcalcetide, 0.1 mg
|
HCPCS J0606 |
$75.21 |
$343.35
|
$2,291.64 |
119 |
|
Inj, eteplirsen, 10 mg
|
HCPCS J1428 |
$230.96 |
$2,598.44
|
$17,427.80 |
56 |
|
Inj, evinacumab-dgnb, 5mg
|
HCPCS J1305 |
$19,268.91 |
$20,751.13
|
$163,496.87 |
58 |
|
Inj., evomela, 1 mg
|
HCPCS J9246 |
$17.35 |
$17.37
|
$1,475.98 |
39 |
|
Inj, exagamglogene autotem
|
HCPCS J3392 |
$1,320,000.00 |
$3,218,160.00
|
$11,764,953.00 |
49 |
|
Inj, factor x, (human), 1iu
|
HCPCS J7175 |
$4.23 |
$26.74
|
$52.80 |
133 |
|
Inj, faricimab-svoa, 0.1mg
|
HCPCS J2777 |
$2,250.00 |
$4,103.29
|
$10,080.00 |
51 |
|
Inj. fe derisomaltose 10 mg
|
HCPCS J1437 |
$138.68 |
$3,221.52
|
$18,516.57 |
155 |