Table III: 2013 Medicare Drug Fee Schedule*
CY 2013 2nd Quarter Average Sales Price (ASP) Data Plus 6 Percent
*The Medicare payments allowance limits are effective April 1 - June 30, 2013.
| Code | Description | Dosage | CY 2013 Effective Jan 1 Through Mar 31 ASP plus |
CY 2013 Effective April 1 Through June 31 ASP plus |
||
|---|---|---|---|---|---|---|
| J0129 | Abatacept | 10mg | $22.40 | $22.62 | ||
| J0130 | Abciximab injection | 10mg | $577.27 | $574.85 | ||
| J0133 | Acyclovir, 5 mg | 5mg | $0.03 | $0.02 | ||
| J0150 | Injection adenosine 6 MG | 6mg | $7.14 | $6.18 | ||
| J0152 | Adenosine injection | 30mg | $109.01 | $109.01 | ||
| J0171 | Adrenalin epinephrin inject | 0.1mg | $0.06 | $0.06 | ||
| J0205 | Alglucerase injection | 10units | $42.03 | $42.03 | ||
| J0207 | Amifostine | 500mg | $306.16 | $312.76 | ||
| J0210 | Methyldopate hcl injection | 250mg | $42.40 | $42.40 | ||
| J0215 | Alefacept | 0.5mg | $41.64 | $41.64 | ||
| J0256 | Alpha 1 proteinase inhibitor | 10mg | $3.95 | $3.92 | ||
| J0280 | Aminophyllin 250 MG inj | 250mg | $0.72 | $0.92 | ||
| J0289 | Amphotericin b liposome inj | 10mg | $14.46 | $15.23 | ||
| J0295 | Ampicillin sodium per 1.5 gm | 1.5gm | $2.30 | $1.90 | ||
| J0360 | Hydralazine hcl injection | 20mg | $3.18 | $2.89 | ||
| J0456 | Azithromycin | 500mg | $4.35 | $2.14 | ||
| J0461 | Atropine sulfate injection | 0.01mg | $0.02 | $0.03 | ||
| J0475 | Baclofen 10 MG injection | 10mg | $175.88 | $175.16 | ||
| J0476 | Baclofen intrathecal trial | 50mcg | $76.51 | $75.91 | ||
| J0480 | Basiliximab | 20mg | $2,516.73 | $2,321.25 | ||
| J0490 | Belimumab | 10mg | $38.27 | $38.29 | ||
| J0500 | Dicyclomine injection | 20mg | $32.25 | $30.46 | ||
| J0515 | Inj benztropine mesylate | 1mg | $25.74 | $23.36 | ||
| J0583 | Bivalirudin | 1mg | $2.99 | $2.99 | ||
| J0585 | Botulinum toxin a per unit | 1unit | $5.47 | $5.47 | ||
| J0587 | Botulinum toxin type B | 100units | $10.89 | $10.82 | ||
| J0592 | Buprenorphine hydrochloride | 0.1mg | $0.75 | $0.99 | ||
| J0595 | Butorphanol tartrate 1 mg | 1mg | $1.05 | $0.93 | ||
| J0600 | Edetate calcium disodium inj | 1000mg | $201.40 | $201.40 | ||
| J0610 | Calcium gluconate injection | 10ml | $0.70 | $0.72 | ||
| J0630 | Calcitonin salmon injection | 400units | $62.75 | $62.79 | ||
| J0636 | Inj calcitriol per 0.1 mcg | 0.1mcg | $0.45 | $0.38 | ||
| J0637 | Caspofungin acetate | 5mg | $12.83 | $13.08 | ||
| J0640 | Leucovorin calcium injection | 50mg | $2.71 | $5.11 | ||
| J0690 | Cefazolin sodium injection | 500mg | $0.75 | $0.78 | ||
| J0692 | Cefepime HCl for injection | 500mg | $2.38 | $2.56 | ||
| J0694 | Cefoxitin sodium injection | 1gm | $5.60 | $5.35 | ||
| J0696 | Ceftriaxone sodium injection | 250mg | $0.73 | $0.74 | ||
| J0697 | Sterile cefuroxime injection | 750mg | $3.02 | $3.28 | ||
| J0698 | Cefotaxime sodium injection | 1gm | $1.76 | $1.76 | ||
| J0702 | Betamethasone acet&sod phosp | 3mg | $5.57 | $5.70 | ||
| J0706 | Caffeine citrate injection | 5mg | $0.41 | $0.31 | ||
| J0713 | Inj ceftazidime per 500 mg | 500mg | $2.48 | $2.32 | ||
| J0718 | Certolizum | 1mg | $4.89 | $5.15 | ||
| J0720 | Chloramphenicol sodium injec | 1gm | $23.42 | $26.16 | ||
| J0725 | Chorionic gonadotropin/1000u | 1,000units | $12.64 | $13.09 | ||
| J0740 | Cidofovir injection | 375mg | $756.64 | $757.16 | ||
| J0743 | Cilastatin sodium injection | 250mg | $7.75 | $6.91 | ||
| J0745 | Inj codeine phosphate /30 MG | 30mg | $1.35 | $1.35 | ||
| J0760 | Colchicine injection | 1mg | $6.57 | $6.57 | ||
| J0770 | Colistimethate sodium inj | 150mg | $12.91 | $12.35 | ||
| J0780 | Prochlorperazine injection | 10mg | $1.40 | $4.55 | ||
| J0800 | Corticotropin injection | 1-40units | $3,014.33 | $3,012.76 | ||
| J0882 | Darbepoetin alfa, non-esrd | 1mcg | $3.45 | $3.33 | ||
| J0885 | Non esrd epoetin alpha inj | 1,000units | $10.26 | $10.39 | ||
| J0895 | Deferoxamine mesylate inj | 500mg | $8.24 | $8.25 | ||
| J0897 | Denosumab injection | 1 mg | $14.27 | $14.22 | ||
| J1000 | Depo-estradiol cypionate inj | 5mg | $7.40 | $7.44 | ||
| J1020 | Methylprednisolone 20 MG inj | 20mg | $3.11 | $3.16 | ||
| J1030 | Methylprednisolone 40 MG inj | 40mg | $2.89 | $2.96 | ||
| J1040 | Methylprednisolone 80 MG inj | 80mg | $5.60 | $5.73 | ||
| J1070 | Testosterone cypionat 100 MG | 100mg | $5.07 | $12.35 | ||
| J1080 | Testosterone cypionat 200 MG | 1cc_200mg | $5.78 | $4.55 | ||
| J1100 | Dexamethasone sodium phos | 1mg | $0.10 | $0.10 | ||
| J1110 | Inj dihydroergotamine mesylt | 1mg | $39.31 | $39.32 | ||
| J1120 | Acetazolamid sodium injectio | 50mg | $28.40 | $28.82 | ||
| J1160 | Digoxin injection | 0.5mg | $1.35 | $1.60 | ||
| J1165 | Phenytoin sodium injection | 50mg | $0.33 | $0.52 | ||
| J1190 | Dexrazoxane HCl injection | 250mg | $165.93 | $153.07 | ||
| J1200 | Diphenhydramine hcl injectio | 1-50mg | $0.84 | $0.79 | ||
| J1205 | Chlorothiazide sodium inj | 500mg | $227.14 | $205.85 | ||
| J1230 | Methadone injection | 10mg | $7.08 | $7.99 | ||
| J1245 | Dipyridamole injection | 10mg | $0.95 | $0.84 | ||
| J1250 | Inj dobutamine HCL/250 mg | 250mg | $5.44 | $7.99 | ||
| J1260 | Dolasetron mesylate | 10mg | $7.54 | $4.68 | ||
| J1265 | DopAMIne injection | 40mg | $0.40 | $0.47 | ||
| J1270 | Injection, doxercalciferol | 1mcg | $0.98 | $1.73 | ||
| J1325 | Epoprostenol injection | 0.5mg | $14.15 | $14.17 | ||
| J1327 | Eptifibatide injection | 5mg | $25.06 | $25.95 | ||
| J1335 | Ertapenem injection | 500mg | $31.54 | $31.58 | ||
| J1364 | Erythro lactobionate /500 MG | 500mg | $10.60 | $14.85 | ||
| J1410 | Inj estrogen conjugate 25 MG | 25mg | $139.45 | $136.72 | ||
| J1430 | Ethanolamine oleate 100 mg | 100mg | $299.94 | $299.94 | ||
| J1440 | Filgrastim 300 mcg injection | 300mcg | $275.69 | $277.25 | ||
| J1441 | Filgrastim 480 mcg injection | 480mcg | $435.92 | $439.90 | ||
| J1450 | Fluconazole | 200mg | $4.29 | $4.04 | ||
| J1451 | Fomepizole, 15 mg | 15mg | $6.25 | $6.23 | ||
| J1455 | Foscarnet sodium injection | 1000mg | $3.50 | $3.50 | ||
| J1566 | Inj immune globulin, lyophilzed 500mg | 500mg | $34.74 | $33.12 | ||
| J1570 | Ganciclovir sodium injection | 500mg | $72.47 | $64.49 | ||
| J1580 | Garamycin gentamicin inj | 80mg | $1.04 | $1.19 | ||
| J1610 | Glucagon hydrochloride/1 MG | 1mg | $118.18 | $115.04 | ||
| J1626 | Granisetron HCl injection | 100mcg | $0.63 | $0.44 | ||
| J1630 | Haloperidol injection | 5mg | $2.11 | $1.52 | ||
| J1631 | Haloperidol decanoate inj | 50mg | $19.16 | $19.39 | ||
| J1642 | Inj heparin sodium per 10 u | 10units | $0.17 | $0.18 | ||
| J1644 | Inj heparin sodium per 1000u | 1000units | $0.20 | $0.21 | ||
| J1645 | Dalteparin sodium | 2500I.U. | $10.76 | $11.05 | ||
| J1650 | Inj enoxaparin sodium | 10mg | $3.43 | $2.91 | ||
| J1652 | Fondaparinux sodium | 0.5mg | $4.25 | $4.10 | ||
| J1720 | Hydrocortisone sodium succ i | 100mg | $4.39 | $4.81 | ||
| J1740 | Ibandronate sodium | 1mg | $151.51 | $151.50 | ||
| J1742 | Ibutilide fumarate injection | 1mg | $114.39 | $164.73 | ||
| J1745 | Infliximab injection | 10mg | $66.41 | $67.68 | ||
| J1756 | Iron sucrose injection | 1mg | $0.28 | $0.29 | ||
| J1786 | Imuglucerase injection | 10units | $41.86 | $41.87 | ||
| J1790 | Droperidol injection | 5mg | $3.29 | $3.31 | ||
| J1800 | Propranolol injection | 1mg | $3.73 | $2.95 | ||
| J1815 | Insulin injection | 5units | $0.53 | $0.54 | ||
| J1817 | Insulin for insulin pump use | 50units | $5.32 | $5.37 | ||
| J1940 | Furosemide injection | 20mg | $2.13 | $2.32 | ||
| J1945 | Lepirudin | 50mg | $570.54 | $570.54 | ||
| J1950 | Leuprolide acetate /3.75 MG | 3.75mg | $672.89 | $680.67 | ||
| J1955 | Inj levocarnitine per 1 gm | 1gm | $6.29 | $7.66 | ||
| J1956 | Levofloxacin injection | 250mg | $3.65 | $2.92 | ||
| J1980 | Hyoscyamine sulfate inj | 0.25mg | $16.04 | $16.19 | ||
| J2001 | Lidocaine injection | 10mg | $0.02 | $0.02 | ||
| J2010 | Lincomycin injection | 300mg | $7.39 | $7.39 | ||
| J2020 | Linezolid injection | 200mg | $38.95 | $39.10 | ||
| J2060 | Lorazepam injection | 2mg | $0.81 | $0.76 | ||
| J2150 | Mannitol injection | 50ml | $1.90 | $1.66 | ||
| J2185 | Meropenem | 100mg | $1.36 | $1.23 | ||
| J2210 | Methylergonovin maleate inj | 0.2mg | $4.03 | $4.02 | ||
| J2250 | Inj midazolam hydrochloride | 1mg | $0.18 | $0.16 | ||
| J2260 | Inj milrinone lactate / 5 MG | 5mg | $2.68 | $4.82 | ||
| J2300 | Inj nalbuphine hydrochloride | 10mg | $0.97 | $1.29 | ||
| J2310 | Inj naloxone hydrochloride | 1mg | $12.18 | $15.30 | ||
| J2353 | Octreotide injection, depot | 1mg | $129.66 | $131.13 | ||
| J2354 | Octreotide inj, non-depot | 25mcg | $1.41 | $1.27 | ||
| J2355 | Oprelvekin injection | 5mg | $262.88 | $256.80 | ||
| J2370 | Phenylephrine hcl injection | 1ml | $1.15 | $1.44 | ||
| J2400 | Chloroprocaine hcl injection | 30ml | $22.25 | $22.67 | ||
| J2405 | Ondansetron hcl injection | 1mg | $0.17 | $0.15 | ||
| J2410 | Oxymorphone hcl injection | 1mg | $2.32 | $2.34 | ||
| J2430 | Pamidronate disodium /30 MG | 30mg | $9.72 | $10.75 | ||
| J2440 | Papaverin hcl injection | 60mg | $1.28 | $1.28 | ||
| J2501 | Paricalcitol | 1mcg | $1.80 | $1.82 | ||
| J2505 | Injection, pegfilgrastim 6mg | 6mg | $2,921.12 | $2,940.20 | ||
| J2507 | Pegloticase injection 1mg | 1mg | $356.54 | $365.79 | ||
| J2510 | Penicillin g procaine inj | 600,000units | $13.52 | $13.72 | ||
| J2515 | Pentobarbital sodium inj | 50mg | $33.02 | $35.56 | ||
| J2543 | Piperacillin/tazobactam | 1.125gm | $2.98 | $2.35 | ||
| J2550 | Promethazine hcl injection | 1-50mg | $1.63 | $1.59 | ||
| J2560 | Phenobarbital sodium inj | 120mg | $13.95 | $10.86 | ||
| J2590 | Oxytocin injection | 10units | $0.61 | $0.64 | ||
| J2597 | Inj desmopressin acetate | 1mcg | $5.63 | $5.60 | ||
| J2675 | Inj progesterone per 50 MG | 50mg | $1.56 | $1.39 | ||
| J2680 | Fluphenazine decanoate 25 MG | 25mg | $15.37 | $15.88 | ||
| J2690 | Procainamide hcl injection | 1gm | $13.66 | $16.30 | ||
| J2700 | Oxacillin sodium injection | 250mg | $2.26 | $2.25 | ||
| J2730 | Pralidoxime chloride inj | 1gm | $89.99 | $89.52 | ||
| J2760 | Phentolaine mesylate inj | 5mg | $105.99 | $132.52 | ||
| J2765 | Metoclopramide hcl injection | 10mg | $0.44 | $0.62 | ||
| J2770 | Quinupristin/dalfopristin | 500mg | $187.32 | $188.54 | ||
| J2780 | Ranitidine hydrochloride inj | 25mg | $1.17 | $1.64 | ||
| J2783 | Rasburicase | 0.5mg | $208.19 | $208.17 | ||
| J2788 | Rho d immune globulin 50 mcg | 50mcg | $24.54 | $24.97 | ||
| J2792 | Rho(D) immune globulin h, sd | 100IU | $18.33 | $18.59 | ||
| J2795 | Ropivacaine HCl injection | 1mg | $0.09 | $0.10 | ||
| J2810 | Inj theophylline per 40 MG | 40mg | $0.23 | $0.19 | ||
| J2820 | Sargramostim injection | 50mcg | $29.69 | $26.90 | ||
| J2916 | Na ferric gluconate complex | 12.5mg | $3.10 | $2.95 | ||
| J2920 | Methylprednisolone injection | 40mg | $1.63 | $1.90 | ||
| J2930 | Methylprednisolone injection | 125mg | $2.60 | $2.67 | ||
| J2993 | Reteplase injection | 18.1mg | $2,301.90 | $2,301.90 | ||
| J2997 | Alteplase recombinant | 1mg | $51.91 | $52.19 | ||
| J3010 | Fentanyl citrate injection | 0.1mg | $0.47 | $0.59 | ||
| J3030 | Sumatriptan succinate / 6 MG | 6mg | $51.89 | $51.89 | ||
| J3101 | Tenecteplase injection | 1mg | $70.77 | $72.44 | ||
| J3105 | Terbutaline sulfate inj | 1mg | $3.81 | $2.36 | ||
| J3120 | Testosterone enanthate inj | 100mg | $4.63 | $4.49 | ||
| J3130 | Testosterone enanthate inj | 1-200mg | $9.26 | $8.99 | ||
| J3230 | Chlorpromazine hcl injection | 50mg | $17.86 | $17.77 | ||
| J3240 | Thyrotropin injection | 0.9mg_1.1mg | $1,051.90 | $1,053.98 | ||
| J3246 | Tirofiban hydrochloride | 0.25mg | $7.90 | $8.20 | ||
| J3250 | Trimethobenzamide hcl inj | 200mg | $10.38 | $10.17 | ||
| J3260 | Tobramycin sulfate injection | 80mg | $2.55 | $2.62 | ||
| J3262 | Tocilizumab injection | 1mg | $3.56 | $3.69 | ||
| J3285 | Treprostinil, 1 mg | 1mg | $61.24 | $61.24 | ||
| J3301 | Triamcinolone acetonide inj | 10mg | $1.80 | $1.78 | ||
| J3315 | Triptorelin pamoate | 3.75mg | $175.79 | $172.30 | ||
| J3360 | Diazepam injection | 5mg | $3.34 | $3.08 | ||
| J3365 | Urokinase 250,000 IU inj | 250,000I.U. | $457.73 | $457.73 | ||
| J3370 | Vancomycin hcl injection | 500mg | $2.42 | $2.38 | ||
| J3396 | Verteporfin injection | 0.1mg | $10.28 | $10.30 | ||
| J3410 | Hydroxyzine hcl injection | 25mg | $1.31 | $0.95 | ||
| J3420 | Vitamin b12 injection | 1000mcg | $0.56 | $1.43 | ||
| J3430 | Vitamin k phytonadione inj | 1mg | $1.43 | $1.54 | ||
| J3465 | Injection, voriconazole | 10mg | $4.92 | $4.87 | ||
| J3475 | Inj magnesium sulfate | 500mg | $0.15 | $0.19 | ||
| J3480 | Inj potassium chloride | 2meq | $0.01 | $0.01 | ||
| J3485 | Zidovudine | 10mg | $1.51 | $1.50 | ||
| J3486 | Ziprasidone mesylate | 10mg | $8.76 | $8.76 | ||
| J3488 | Zoledronic acid (Reclast) | 1mg | $224.70 | $224.68 | ||
| J7030 | Normal saline solution infus | 1000cc | $1.07 | $1.08 | ||
| J7040 | Normal saline solution infus | 500ML | $0.53 | $0.54 | ||
| J7042 | 5% dextrose/normal saline | 500ML | $0.49 | $0.47 | ||
| J7050 | Normal saline solution infus | 250cc | $0.27 | $0.27 | ||
| J7060 | 5% dextrose/water | 500ML | $1.03 | $1.05 | ||
| J7070 | D5w infusion | 1000cc | $2.05 | $2.10 | ||
| J7100 | Dextran 40 infusion | 500ml | $21.93 | $22.47 | ||
| J7110 | Dextran 75 infusion | 500ml | $14.52 | $14.52 | ||
| J7120 | Ringers lactate infusion | 1000cc | $0.99 | $0.98 | ||
| J7189 | Factor viia recombinant | 1mcg | $1.61 | $1.62 | ||
| J7190 | Factor viii | 1I.U. | $0.92 | $0.91 | ||
| J7192 | Factor viii recombinant | 1I.U. | $1.13 | $1.13 | ||
| J7193 | Factor IX non-recombinant | 1I.U. | $0.96 | $0.95 | ||
| J7194 | Factor ix complex | 1I.U. | $1.06 | $1.09 | ||
| J7195 | Factor IX recombinant | 1I.U. | $1.25 | $1.26 | ||
| J7197 | Antithrombin iii injection | 1I.U. | $3.04 | $3.04 | ||
| J7198 | Anti-inhibitor | 1I.U. | $1.63 | $1.64 | ||
| J7308 | Aminolevulinic acid hcl top | 354mg | $160.72 | $160.03 | ||
| J7310 | Ganciclovir long act implant | 4.5mg | $16,960.00 | $16,960.00 | ||
| J7321 | Hyalgan or Supartz, inj | PER DOSE | $89.98 | $88.84 | ||
| J7323 | Euflexxa, inj | PER DOSE | $151.34 | $163.96 | ||
| J7324 | Orthovisc, inj | PER DOSE | $167.46 | $167.50 | ||
| J7325 | Synvisc and Synvisc-One | 1mg | $12.06 | $12.20 | ||
| J7330 | Cultured chondrocytes implnt | 1dose | $29,193.23 | $29,193.23 | ||
| J7500 | Azathioprine oral 50mg | 50mg | $0.12 | $0.11 | ||
| J7501 | Azathioprine parenteral | 100mg | $161.37 | $162.95 | ||
| J7502 | Cyclosporine oral 100 mg | 100mg | $3.59 | $3.35 | ||
| J7504 | Lymphocyte immune globulin | 250mg | $671.43 | $705.82 | ||
| J7505 | Monoclonal antibodies | 5mg | $1,156.08 | $1,156.08 | ||
| J7506 | Prednisone oral | 5mg | $0.02 | $0.05 | ||
| J7507 | Tacrolimus oral per 1 MG | 1mg | $1.80 | $1.70 | ||
| J7509 | Methylprednisolone oral | 4mg | $0.72 | $0.77 | ||
| J7511 | Antithymocyte globuln rabbit | 25mg | $538.68 | $529.73 | ||
| J7513 | Daclizumab, parenteral | 25mg | $526.34 | $526.34 | ||
| J7515 | Cyclosporine oral 25 mg | 25mg | $0.98 | $0.88 | ||
| J7516 | Cyclosporin parenteral 250mg | 250mg | $33.58 | $33.80 | ||
| J7517 | Mycophenolate mofetil oral | 250mg | $1.25 | $1.27 | ||
| J7520 | Sirolimus, oral | 1mg | $12.37 | $12.13 | ||
| J7525 | Tacrolimus injection | 5mg | $138.89 | $138.00 | ||
| J7608 | Acetylcysteine inh sol u d | 1gm | $1.55 | $2.05 | ||
| J7626 | Budesonide inhalation sol | 0.25-0.50mg | $5.26 | $4.76 | ||
| J7631 | Cromolyn sodium inh sol u d | 10mg | $0.61 | $0.55 | ||
| J7639 | Dornase alpha inhal sol u d | 1mg | $30.64 | $30.64 | ||
| J7644 | Ipratropium brom inh sol u d | 1mg | $0.24 | $0.24 | ||
| J7669 | Metaproterenol inh sol u d | 10mg | $0.25 | $0.25 | ||
| J7682 | Tobramycin inhalation sol | 300mg | $94.05 | $101.28 | ||
| J8510 | Oral busulfan | 2mg | $5.56 | $6.57 | ||
| J8520 | Capecitabine, oral, 150 mg | 150mg | $8.87 | $8.92 | ||
| J8521 | Capecitabine, oral, 500 mg | 500mg | $29.51 | $29.67 | ||
| J8530 | Cyclophosphamide oral 25 MG | 25mg | $0.93 | $0.92 | ||
| J8560 | Etoposide oral 50 MG | 50mg | $52.36 | $52.29 | ||
| J8610 | Methotrexate oral 2.5 MG | 2.5mg | $0.21 | $0.30 | ||
| J8700 | Temozolomide | 5mg | $10.67 | $11.19 | ||
| J9000 | Doxorubic hcl 10 MG vl chemo | 10mg | $3.41 | $4.23 | ||
| J9002 | 'Injection, doxorubicin hydrochloride, liposomal, doxil, 10mg | 10mg | $543.06 | $543.06 | ||
| J9010 | Alemtuzumab injection | 10mg | $611.45 | $623.63 | ||
| J9015 | Aldesleukin/single use vial | pervial | $1,246.98 | $1,246.98 | ||
| J9017 | Arsenic trioxide | 1mg | $45.13 | $45.07 | ||
| J9020 | Asparaginase injection | 10,000units | $63.20 | $63.21 | ||
| J9031 | Bcg live intravesical vac | perinstallation | $120.87 | $117.45 | ||
| J9040 | Bleomycin sulfate injection | 15units | $21.39 | $21.83 | ||
| J9045 | Carboplatin injection | 50mg | $3.29 | $3.44 | ||
| J9050 | Carmus bischl nitro inj | 200mg | $175.75 | $175.81 | ||
| J9060 | Cisplatin 10 MG injection | 10mg | $2.12 | $2.04 | ||
| J9065 | Inj cladribine per 1 MG | 1mg | $29.17 | $26.67 | ||
| J9070 | Cyclophosphamide 500 MG inj | 100mg | $23.37 | $35.42 | ||
| J9100 | Cytarabine hcl 100 MG inj | 100mg | $0.96 | $0.95 | ||
| J9120 | Dactinomycin actinomycin d | 0.5mg | $577.60 | $592.43 | ||
| J9150 | Daunorubicin | 10mg | $22.05 | $26.08 | ||
| J9160 | Denileukin diftitox, 300 mcg | 300mcg | $1,646.18 | $1,646.18 | ||
| J9171 | Docetaxel injection | 1mg | $6.37 | $6.15 | ||
| J9175 | Elliotts b solution per ml | 1ml | $4.07 | $4.07 | ||
| J9178 | Inj, epirubicin hcl, 2 mg | 2mg | $1.58 | $1.41 | ||
| J9181 | Etoposide 10 MG inj | 10mg | $0.74 | $0.76 | ||
| J9185 | Fludarabine phosphate inj | 50mg | $86.66 | $83.74 | ||
| J9190 | Fluorouracil injection | 500mg | $1.82 | $2.10 | ||
| J9200 | Floxuridine injection | 500mg | $65.32 | $57.68 | ||
| J9201 | Gemcitabine HCl | 200mg | $10.86 | $8.04 | ||
| J9202 | Goserelin acetate implant | 3.6mg | $178.39 | $193.19 | ||
| J9206 | Irinotecan injection | 20mg | $4.70 | $3.40 | ||
| J9208 | Ifosfomide injection | 1gm | $29.16 | $29.83 | ||
| J9209 | Mesna injection | 200mg | $3.60 | $2.97 | ||
| J9211 | Idarubicin hcl injection | 5mg | $97.96 | $62.71 | ||
| J9214 | Interferon alfa-2b inj | 1millionunits | $19.29 | $17.39 | ||
| J9217 | Leuprolide acetate suspnsion | 7.5mg | $215.13 | $207.81 | ||
| J9218 | Leuprolide acetate injection | 1mg | $7.46 | $8.87 | ||
| J9219 | Leuprolide acetate implant | 65mg | $4,819.82 | $4,819.82 | ||
| J9230 | Mechlorethamine hcl inj | 10mg | $157.86 | $154.70 | ||
| J9245 | Inj melphalan hydrochl 50 MG | 50mg | $1,314.21 | $1,301.51 | ||
| J9250 | Methotrexate sodium inj | 5mg | $0.20 | $0.19 | ||
| J9260 | Methotrexate sodium inj | 50mg | $1.95 | $1.95 | ||
| J9263 | Oxaliplatin | 0.5mg | $4.08 | $1.06 | ||
| J9265 | Paclitaxel injection | 30mg | $5.40 | $4.98 | ||
| J9268 | Pentostatin injection | 10mg | $1,290.39 | $1,390.65 | ||
| J9280 | Mitomycin 5 MG inj | 5mg | $24.03 | $22.25 | ||
| J9293 | Mitoxantrone hydrochl / 5 MG | 5mg | $36.88 | $37.32 | ||
| J9300 | Gemtuzumab ozogamicin | 5mg | $2,742.59 | $2,742.59 | ||
| J9310 | Rituximab cancer treatment | 100mg | $660.78 | $677.94 | ||
| J9320 | Streptozocin injection | 1gm | $271.16 | $273.31 | ||
| J9340 | Thiotepa injection | 15mg | $175.48 | $265.00 | ||
| J9355 | Trastuzumab | 10mg | $76.54 | $78.55 | ||
| J9360 | Vinblastine sulfate inj | 1mg | $1.17 | $1.34 | ||
| J9370 | Vincristine sulfate 1 MG inj | 1mg | $3.78 | $4.03 | ||
| J9390 | Vinorelbine tartrate/10 mg | 20mg | $11.06 | $9.83 | ||
| J9395 | Injection, Fulvestrant | 25mg | $88.34 | $88.33 | ||
| Q0167 | Dronabinol 2.5mg oral | 2.5mg | $3.42 | $3.10 | ||
| Q0168 | Dronabinol 5mg oral | 5mg | $6.63 | $14.24 | ||
| This information is from the CMS website dated March 13, 2013. | ||||||
