|
Inj., perseris, 0.5 mg
|
HCPCS J2798 |
$2,262.24 |
$5,146.85
|
$39,395.24 |
99 |
|
Inj plasminogen tvmh 1mg
|
HCPCS J2998 |
$1,292.93 |
$4,456.80
|
$6,428.08 |
38 |
|
Inj., plazomicin, 5 mg
|
HCPCS J0291 |
$81.00 |
$607.16
|
$4,047.06 |
72 |
|
Inj pozelimab-bbfg, 1 mg
|
HCPCS J9376 |
$126.59 |
$126.59
|
$126.59 |
4 |
|
Inj progesterone per 50 mg
|
HCPCS J2675 |
$0.99 |
$13.76
|
$153.81 |
354 |
|
Inj protirelin per 250 mcg
|
HCPCS J2725 |
$16.43 |
$24.00
|
$24.00 |
15 |
|
Inj recombin esperoct per iu
|
HCPCS J7204 |
$2.17 |
$6.63
|
$22.50 |
54 |
|
Inj, rimabotulinumtoxinb
|
HCPCS J0587 |
$28.00 |
$714.24
|
$3,734.28 |
166 |
|
Inj roctavian ml 2x10^13vc g
|
HCPCS J1412 |
$12,007.81 |
$130,068.54
|
$187,598.85 |
58 |
|
Inj., rolapitant, 0.5 mg
|
HCPCS J2797 |
$1.80 |
$1.80
|
$2.40 |
13 |
|
Inj romidepsin non-lyo 0.1mg
|
HCPCS J9318 |
$3,312.93 |
$9,892.69
|
$18,083.74 |
73 |
|
Inj, rykindo, 0.5 mg
|
HCPCS J2801 |
$13.03 |
$13.03
|
$17.98 |
24 |
|
Inj sebelipase alfa 1 mg
|
HCPCS J2840 |
$156.62 |
$539.69
|
$1,261.96 |
36 |
|
Inj secretin synthetic human
|
HCPCS J2850 |
$53.12 |
$1,253.09
|
$7,266.00 |
255 |
|
Inj secukinumab intrav 1mg
|
HCPCS J3247 |
$253.80 |
$4,413.21
|
$35,708.30 |
163 |
|
Inj, sezaby, 1 mg
|
HCPCS J2561 |
$13.46 |
$235.85
|
$659.06 |
87 |
|
Inj, spesolimab-sbzo, 1 mg
|
HCPCS J1747 |
$11,044.80 |
$90,007.62
|
$792,082.77 |
135 |
|
Inj, susvimo 0.1 mg
|
HCPCS J2779 |
$137.60 |
$2,598.44
|
$15,320.00 |
54 |
|
Inj, sutimlimab-jome, 10 mg
|
HCPCS J1302 |
$191.31 |
$3,453.73
|
$28,688.40 |
88 |
|
Inj. tagraxofusp-erzs 10 mcg
|
HCPCS J9269 |
$24,871.24 |
$67,538.30
|
$221,035.72 |
107 |
|
Inj, taliglucerace alfa 10 u
|
HCPCS J3060 |
$612.45 |
$1,573.27
|
$3,505.56 |
57 |
|
Inj teclistamab cqyv 0.5 mg
|
HCPCS J9380 |
$2,468.79 |
$17,517.56
|
$65,417.10 |
176 |
|
Inj tedizolid phosphate
|
HCPCS J3090 |
$184.20 |
$664.72
|
$2,458.64 |
102 |
|
Inj teplizumab mzwv 5 mcg
|
HCPCS J9381 |
$2,491.21 |
$22,340.08
|
$139,703.02 |
69 |
|
Inj. teprotumumab-trbw 10 mg
|
HCPCS J3241 |
$3,762.84 |
$35,034.78
|
$113,475.30 |
196 |
|
Inj testostero enanthate 1mg
|
HCPCS J3121 |
$8.29 |
$123.09
|
$311.84 |
129 |
|
Inj, testosterone, azmiro
|
HCPCS J1072 |
$1.33 |
$1.33
|
$1.83 |
12 |
|
Inj testosterone cypionate
|
HCPCS J1071 |
$2.98 |
$64.96
|
$503.88 |
494 |
|
Inj theophylline per 40 mg
|
HCPCS J2810 |
$2.85 |
$31.90
|
$67.20 |
80 |
|
Inj thiotepa nos 1 mg
|
HCPCS J9342 |
$165.66 |
$3,170.16
|
$27,516.22 |
154 |
|
Inj. tigecycline (accord)
|
HCPCS J3244 |
$10.14 |
$188.03
|
$1,110.00 |
97 |
|
Inj., tildrakizumab, 1 mg
|
HCPCS J3245 |
$1,296.41 |
$26,635.60
|
$86,430.45 |
114 |
|
Inj, tislelizumab-jsgr
|
HCPCS J9329 |
$551.62 |
$9,764.09
|
$89,613.26 |
97 |
|
Inj tofersen intrathec 1 mg
|
HCPCS J1304 |
$153.66 |
$293.34
|
$22,881.85 |
64 |
|
Inj travoprost intra impl
|
HCPCS J7355 |
$195.25 |
$197.16
|
$270.79 |
24 |
|
Inj triamcinolone ace X-ray 1mg
|
HCPCS J3304 |
$39.00 |
$1,090.75
|
$3,104.00 |
122 |
|
Inj triferic avnu 0.1mg iron
|
HCPCS J1445 |
โ |
โ
|
โ |
0 |
|
Inj., triluron, 1 mg
|
HCPCS J7332 |
$10.16 |
$10.36
|
$13.96 |
24 |
|
Inj., triptorelin X-ray 3.75 mg
|
HCPCS J3316 |
$2,131.07 |
$33,416.39
|
$139,616.05 |
90 |
|
Inj, trivisc 1 mg
|
HCPCS J7329 |
$4.98 |
$6.67
|
$74.02 |
46 |
|
Inj, uzedy, 1 mg
|
HCPCS J2799 |
$698.58 |
$11,475.96
|
$31,407.80 |
109 |
|
Inj, vancomycin hcl (mylan)
|
HCPCS J3371 |
$9.02 |
$72.33
|
$730.33 |
177 |
|
Inj, vancomycin hcl (xellia)
|
HCPCS J3372 |
$5.85 |
$85.20
|
$736.93 |
161 |
|
Inj vancomycin (xellia) 10mg
|
HCPCS J3375 |
$13.80 |
$76.59
|
$458.40 |
159 |
|
Inj vasopressin (am reg) 1 u
|
HCPCS J2599 |
$4.93 |
$41.79
|
$390.42 |
97 |
|
Inj, vasopressin (baxter)
|
HCPCS J2601 |
$16.22 |
$202.50
|
$763.46 |
99 |
|
Inj velmanase alfa-tycv 1 mg
|
HCPCS J0217 |
$442.00 |
$7,123.31
|
$10,578.36 |
73 |
|
Inj., vestronidase alfa-vjbk
|
HCPCS J3397 |
$386.53 |
$386.53
|
$386.53 |
4 |
|
Inj. viltolarsen
|
HCPCS J1427 |
$1,446.70 |
$2,466.35
|
$3,303.15 |
34 |
|
Inj. xembify, 100 mg
|
HCPCS J1558 |
$2,021.13 |
$3,451.77
|
$4,622.91 |
34 |
|
Inj xipere 1 mg
|
HCPCS J3299 |
$48.00 |
$93.00
|
$2,479.41 |
82 |
|
Inj., yutiq, 0.01 mg
|
HCPCS J7314 |
$722.80 |
$14,458.60
|
$36,706.62 |
90 |
|
Inj zanidatamab-hrii, 2 mg
|
HCPCS J9276 |
$3,634.60 |
$8,532.00
|
$62,133.77 |
72 |
|
Inj zenocutuzumab-zbco 1 mg
|
HCPCS J9382 |
$1,993.78 |
$19,177.20
|
$64,089.64 |
63 |
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
HCPCS J9229 |
$2,540.29 |
$41,083.73
|
$219,309.26 |
247 |
|
Inst tauro 1.35mg/hep 100u
|
HCPCS J0911 |
$7.68 |
$8.58
|
$21.23 |
28 |
|
Insulin for insulin pump use
|
HCPCS J1817 |
$9.50 |
$67.93
|
$1,707.26 |
70 |
|
Interferon alfa-2a inj
|
HCPCS J9213 |
$30.24 |
$31.80
|
$497.15 |
13 |
|
Interferon alfa-2b inj
|
HCPCS J9214 |
$75.08 |
$1,409.92
|
$9,837.62 |
152 |
|
Interferon alfacon-1 inj
|
HCPCS J9212 |
$351.00 |
$382.15
|
$537.43 |
7 |
|
Interferon alfa-n3 inj
|
HCPCS J9215 |
$23.85 |
$59.64
|
$244.23 |
23 |
|
Interferon beta-1a inj
|
HCPCS J1826 |
$270.05 |
$1,851.20
|
$15,311.69 |
94 |
|
Interferon beta-1b / .25 mg
|
HCPCS J1830 |
$91.44 |
$1,662.71
|
$13,879.85 |
142 |
|
Interferon gamma 1-b inj
|
HCPCS J9216 |
$613.46 |
$9,879.00
|
$49,676.36 |
66 |
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
HCPCS J9228 |
$2,825.08 |
$62,692.46
|
$226,783.20 |
391 |
|
Ipratropium bromide comp
|
HCPCS J7645 |
$1.05 |
$2.40
|
$7.34 |
27 |
|
Ipratropium bromide non-comp
|
HCPCS J7644 |
$0.29 |
$4.06
|
$47.81 |
338 |
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
HCPCS J9206 |
$9.32 |
$173.98
|
$1,591.20 |
525 |
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
HCPCS J9205 |
$302.90 |
$5,517.12
|
$25,381.08 |
319 |
|
Iron dextran 50 mg/ml injection solution
|
HCPCS J1750 |
$4.76 |
$80.67
|
$800.06 |
602 |
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
HCPCS J1756 |
$9.58 |
$187.06
|
$1,495.72 |
605 |
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
HCPCS J9227 |
$427.70 |
$8,273.35
|
$37,559.57 |
223 |
|
Ivig non-lyophilized, nos
|
HCPCS J1599 |
$157.60 |
$402.40
|
$3,603.23 |
4 |
|
Ixabepilone 15 mg intravenous solution
|
HCPCS J9207 |
$573.00 |
$10,695.32
|
$62,733.40 |
298 |
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
HCPCS J1885 |
$1.20 |
$23.52
|
$223.93 |
710 |
|
Kyleena, 19.5 mg
|
HCPCS J7296 |
$184.31 |
$2,125.00
|
$12,724.40 |
292 |
|
Labetalol 5 mg/ml IV (wrapper)
|
HCPCS J1920 |
$1.95 |
$33.60
|
$322.75 |
594 |
|
Lactated ringers intravenous solution
|
HCPCS J7120 |
$2.38 |
$43.74
|
$408.48 |
635 |
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
HCPCS J1930 |
$2,786.43 |
$19,124.00
|
$130,195.75 |
362 |
|
Lanthanum carbonate oral 5mg
|
HCPCS J0607 |
$5.15 |
$14.53
|
$97.15 |
84 |
|
Laronidase injection
|
HCPCS J1931 |
$131.01 |
$1,927.01
|
$8,478.00 |
114 |
|
Lepirudin
|
HCPCS J1945 |
$175.32 |
$1,259.22
|
$7,035.43 |
13 |
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
HCPCS J0640 |
$8.39 |
$163.62
|
$1,545.09 |
607 |
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
HCPCS J9217 |
$298.42 |
$6,360.76
|
$49,431.22 |
561 |
|
Leuprolide 3.75 mg intramuscular syringe kit
|
HCPCS J1950 |
$476.58 |
$8,348.12
|
$57,839.58 |
499 |
|
Leuprolide acetate implant
|
HCPCS J9219 |
$137.40 |
$4,516.13
|
$13,625.30 |
5 |
|
Leuprolide acetate injeciton
|
HCPCS J9218 |
$118.67 |
$1,322.50
|
$11,840.50 |
171 |
|
Leuprolide depot cipla 7.5mg
|
HCPCS J1954 |
$220.74 |
$623.81
|
$5,302.35 |
44 |
|
Leuprolide inj, camcevi, 1mg
|
HCPCS J1952 |
$51.41 |
$55.00
|
$78.71 |
24 |
|
Levalbuterol comp unit
|
HCPCS J7615 |
$2.40 |
$2.40
|
$2.40 |
12 |
|
Levalbuterol non-comp con
|
HCPCS J7612 |
$1.99 |
$20.06
|
$189.61 |
122 |
|
Levalbuterol non-comp unit
|
HCPCS J7614 |
$0.67 |
$6.48
|
$66.00 |
196 |
|
Levetiracetam 500 mg/5 ml intravenous solution
|
HCPCS J1953 |
$3.90 |
$97.62
|
$686.27 |
617 |
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
HCPCS J1956 |
$2.98 |
$55.69
|
$513.18 |
641 |
|
Levonorgestrel implant sys
|
HCPCS J7306 |
$333.90 |
$933.60
|
$1,254.70 |
18 |
|
Levothyroxine 100 mcg intravenous powder for solution
|
HCPCS J0650 |
$19.58 |
$420.60
|
$3,075.10 |
392 |
|
Lidocaine injection
|
HCPCS J2001 |
$2.52 |
$44.76
|
$440.76 |
124 |
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
HCPCS J2003 |
$2.59 |
$46.02
|
$418.95 |
491 |
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
HCPCS J2002 |
$2.47 |
$39.75
|
$360.56 |
446 |
|
Lifileucel til/dose 7.5b-72b snij
|
HCPCS J9999 |
$1,953.87 |
$30,744.64
|
$180,128.02 |
110 |