Current Medicare/CMS ASP fee schedule

Updated 11/30/12

I excised the CPT codes, which are copyright property of AMA. I am providing this information as a public service to the oncology community.

Short Description Dosage unit Payment Limit
Hep b ig, im 1 ML 97.154
Rabies ig, im/sc 150 IU 207.349
Rabies ig, heat treated 150 IU 194.670
Rh ig, minidose, im 50 MCG 25.726
Bcg vaccine, percut 50 MG 116.144
Bcg vaccine, intravesical 1 EACH 116.811
Hep a vaccine, adult im 1 ML 49.847
Flu vaccine, intradermal, no preserv 0.1 ML 18.981
Flu vaccine no preserv 6-35m, im 0.25 ML 16.456
Flu vaccine no preserv 3 yo & >, im 0.50 ML 12.398
Flu vaccine, 6-35 mo, im 0.25 ML 6.023
Flu vaccine, nasal 0.2 ML 23.456
Flu vacc prsv free inc antig 0.5 ML 30.923
Pneumococcal vacc, 7 val im 0.5 ML 95.481
Pneumococcal vacc, 13 val im 0.5 ML 137.028
Rabies vaccine, im 1 ML 208.725
Typhoid vaccine, im 0.5 ML 63.580
Tetanus vaccine, im 0.5 ML 34.674
Td vaccine no prsrv >/= 7 yo, im 0.5 ML 19.306
Tdap => 7 yo, im 0.5 ML 34.656
Yellow fever vaccine, sc 0.5 ML 71.486
Td vaccine >/= 7 yo, im 0.5 ML 20.354
Pneumococcal vaccine 0.5 ML 65.774
Meningococcal vaccine, sc 0.5 ML 106.492
Encephalitis vaccine, sc 1 ML 102.078
Hepb vacc, ill pat 3 dose im 40 MCG 119.415
Hep b vacc, adol, 2 dose, im 1 DOSE 24.216
Hepb vacc ped/adol 3 dose im 1 DOSE 24.216
Hep b vaccine, adult, im 20 MCG 59.708
Hepb vacc, ill pat 4 dose im 40 MCG 119.415
Inj prohance multipack 1 ML 1.949
Inj multihance 1 ML 2.330
Inj multihance multipack 1 ML 1.956
Gad-base MR contrast NOS,1ml 1 ML 1.491
Gadoxetate disodium inj 1 ML 13.447
Gadofosveset trisodium inj 1 ML 11.824
Gadobutrol injection 0.1 ML 0.514
Abatacept injection 10 MG 22.194
Abciximab injection 10 MG 575.029
Acetylcysteine injection 100 MG 3.038
Acyclovir injection 5 MG 0.046
Adalimumab injection 20 MG 456.375
Injection adenosine 6 MG 6 MG 5.949
Adenosine injection 30 MG 109.401
Adrenalin epinephrine inject 0.1 MG 0.051
Agalsidase beta injection 1 MG 140.303
Alglucerase injection 10 UNITS 41.990
Amifostine 500 MG 310.176
Methyldopate hcl injection 250 MG 42.400
Alefacept 0.5 MG 41.644
Alglucosidase alfa injection 10 MG 204.424
Lumizyme injection 10 MG 153.608
Alpha 1 proteinase inhibitor 10 MG 3.966
Glassia injection 10 MG 3.922
Amikacin sulfate injection 100 MG 0.802
Aminophyllin 250 MG inj 250 MG 0.603
Amphotericin B 50 MG 12.246
Amphotericin b lipid complex 10 MG 10.986
Ampho b cholesteryl sulfate 10 MG 14.000
Amphotericin b liposome inj 10 MG 14.831
Ampicillin 500 MG inj 500 MG 1.618
Ampicillin sodium per 1.5 gm 1.5 GM 2.242
Anidulafungin injection 1 MG 1.250
Hydralazine hcl injection 20 MG 4.038
Apomorphine hydrochloride 1 MG 32.761
Aprotonin, 10,000 kiu 10000 KIU 2.646
Aripiprazole injection 0.25 MG 0.468
Azithromycin 500 MG 4.655
Atropine sulfate injection 0.01 MG 0.029
Dimecaprol injection 100 MG 28.339
Baclofen 10 MG injection 10 MG 179.988
Baclofen intrathecal trial 50 MCG 76.465
Basiliximab 20 MG 2324.184
Belimumab injection 10 MG 38.318
Dicyclomine injection 20 MG 32.004
Inj benztropine mesylate 1 MG 26.176
PenG benzathine/procaine inj 100,000 UNITS 3.475
Penicillin g benzathine inj 100,000 UNITS 4.394
Bivalirudin 1 MG 2.980
Injection,onabotulinumtoxinA 1 UNIT 5.471
AbobotulinumtoxinA 5 Unit 6.951
Inj, rimabotulinumtoxinB 100 UNITS 10.890
Incobotulinumtoxin A 1 UNIT 4.461
Buprenorphine hydrochloride 0.1 MG 0.747
Busulfan injection 1 MG 21.902
Butorphanol tartrate 1 mg 1 MG 0.875
C-1 esterase, berinert 10 UNITS 30.229
C-1 esterase, cinryze 10 UNITS 45.702
Edetate calcium disodium inj 1000 MG 201.400
Calcium gluconate injection 10 ML 0.640
Calcitonin salmon injection 400 UNITS 62.741
Inj calcitriol per 0.1 mcg 0.1 MCG 0.398
Caspofungin acetate 5 MG 12.845
Canakinumab injection 1 MG 89.412
Leucovorin calcium injection 50 MG 2.557
Levoleucovorin injection 0.5 MG 1.907
Inj mepivacaine HCL/10 ml 10 ML 1.207
Cefazolin sodium injection 500 MG 0.739
Cefepime HCl for injection 500 MG 2.322
Cefoxitin sodium injection 1 GM 5.645
Ceftriaxone sodium injection 250 MG 0.719
Sterile cefuroxime injection 750 MG 3.801
Cefotaxime sodium injection 1 GM 2.062
Betamethasone acet&sod phosp 3 MG & 3 MG 5.584
Caffeine citrate injection 5 MG 0.477
Ceftaroline fosamil inj 10 MG 0.776
Inj ceftazidime per 500 mg 500 MG 2.621
Certolizumab pegol inj 1 MG 4.909
Chloramphenicol sodium injec 1 GM 20.611
Chorionic gonadotropin/1000u 1000 UNITS 12.758
Clonidine hydrochloride 1 MG 22.865
Cidofovir injection 375 MG 757.018
Cilastatin sodium injection 250 MG 8.109
Ciprofloxacin iv 200 MG 1.002
Inj codeine phosphate /30 MG 30 MG 1.346
Colchicine injection 1 MG 6.572
Colistimethate sodium inj 150 MG 11.579
Collagenase, clost hist inj 0.01 MG 37.512
Prochlorperazine injection 10 MG 1.402
Corticorelin ovine triflutal 1 MCG 5.821
Corticotropin injection 40 UNITS 2948.924
Cosyntropin cortrosyn inj 0.25 MG 67.365
Crotalidae poly immune fab UP TO 1 GM 2216.799
Cytomegalovirus imm IV /vial PER VIAL 1013.869
Daptomycin injection 1 MG 0.539
Darbepoetin alfa, non-esrd 1 MCG 3.322
Darbepoetin alfa, esrd use 1 MCG 3.322
Epoetin alfa, non-esrd 1000 UNITS 9.870
Epoetin alfa 1000 units ESRD 1000 UNITS 9.870
Decitabine injection 1 MG 33.401
Deferoxamine mesylate inj 500 MG 8.499
Denosumab injection 1 MG 14.321
Depo-estradiol cypionate inj 5 MG 6.829
Methylprednisolone 20 MG inj 20 MG 3.063
Methylprednisolone 40 MG inj 40 MG 4.026
Methylprednisolone 80 MG inj 80 MG 7.040
Medroxyprogesterone inj 50 MG 9.305
Testosterone cypionat 100 MG 100 MG 5.294
Testosterone cypionat 200 MG 200 MG 5.662
Dexamethasone sodium phos 1 MG 0.112
Inj dihydroergotamine mesylt 1 MG 33.413
Acetazolamid sodium injectio 500 MG 28.824
Digoxin injection 0.5 MG 4.633
Digoxin immune fab (ovine) PER VIAL 899.634
Phenytoin sodium injection 50 MG 0.356
Hydromorphone injection 4 MG 1.656
Dexrazoxane HCl injection 250 MG 158.996
Diphenhydramine hcl injectio 50 MG 0.902
Chlorothiazide sodium inj 500 MG 259.141
Dimethyl sulfoxide 50% 50 ML 50 ML 87.153
Methadone injection 10 MG 7.021
Dimenhydrinate injection 50 MG 4.327
Dipyridamole injection 10 MG 0.809
Inj dobutamine HCL/250 mg 250 MG 6.204
Dolasetron mesylate 10 MG 4.064
Dopamine injection 40 MG 0.403
Doripenem injection 10 MG 0.450
Injection, doxercalciferol 1 MCG 0.944
Ecallantide injection 1 MG 318.218
Eculizumab injection 10 MG 195.464
Epoprostenol injection 0.5 MG 14.228
Eptifibatide injection 5 MG 24.642
Ertapenem injection 500 MG 30.398
Erythro lactobionate /500 MG 500 MG 11.585
Estradiol valerate 10 MG inj 10 MG 9.420
Inj estrogen conjugate 25 MG 25 MG 125.451
Ethanolamine oleate 100 mg 100 MG 299.937
Etanercept injection 25 MG 231.102
Filgrastim 300 mcg injection 300 MCG 268.907
Filgrastim 480 mcg injection 480 MCG 426.873
Fluconazole 200 MG 5.067
Fomepizole, 15 mg 15 MG 6.511
Fosaprepitant injection 1 MG 1.717
Foscarnet sodium injection 1000 MG 3.499
Gallium nitrate injection 1 MG 2.078
Galsulfase injection 1 MG 354.354
Inj IVIG privigen 500 mg 500 MG 35.142
Gamma globulin 1 CC inj 1 CC 23.337
Gammaplex injection 500 MG 37.251
Hizentra injection 100 MG 7.286
Gamma globulin > 10 CC inj 10 CC 233.374
Gamunex, Gamunex-C, Gammaked 500 MG 38.278
Immune globulin, powder 500 MG 32.213
Octagam injection 500 MG 33.207
Gammagard liquid injection 500 MG 37.617
Ganciclovir sodium injection 500 MG 73.037
Hepagam b im injection 0.5 ML 52.140
Flebogamma injection 500 MG 34.429
Hepagam b intravenous, inj 0.5 ML 52.140
Garamycin gentamicin inj 80 MG 1.289
Gold sodium thiomaleate inj 50 MG 25.037
Glucagon hydrochloride/1 MG 1 MG 111.227
Granisetron hcl injection 100 MCG 0.437
Haloperidol injection 5 MG 2.108
Haloperidol decanoate inj 50 MG 19.514
Hemin, 1 mg 1 MG 13.264
Inj heparin sodium per 10 u 10 UNITS 0.167
Inj heparin sodium per 1000u 1000 UNITS 0.213
Dalteparin sodium 2500 IU 11.035
Inj enoxaparin sodium 10 MG 4.202
Fondaparinux sodium 0.5 MG 4.666
Tetanus immune globulin inj 250 UNITS 276.268
Hydrocortisone sodium succ i 100 MG 4.278
Ibandronate sodium injection 1 MG 151.638
Ibutilide fumarate injection 1 MG 139.240
Idursulfase injection 1 MG 455.029
Infliximab injection 10 MG 65.179
Inj iron dextran 50 MG 12.002
Iron sucrose injection 1 MG 0.285
Imuglucerase injection 10 UNITS 41.735
Droperidol injection 5 MG 3.316
Propranolol injection 1 MG 3.434
Insulin injection 5 UNITS 0.510
Insulin for insulin pump use 50 UNITS 3.092
Kanamycin sulfate 500 MG inj 500 MG 7.685
Kanamycin sulfate 75 MG inj 75 MG 1.153
Ketorolac tromethamine inj 15 MG 0.226
Lanreotide injection 1 MG 33.823
Laronidase injection 0.1 MG 26.674
Furosemide injection 20 MG 0.665
Lepirudin 50 MG 551.757
Leuprolide acetate /3.75 MG 3.75 MG 663.945
Levetiracetam injection 10 MG 0.247
Inj levocarnitine per 1 gm 1 GM 6.236
Levofloxacin injection 250 MG 3.786
Hyoscyamine sulfate inj 0.25 MG 14.739
Lidocaine injection 10 MG 0.019
Lincomycin injection 300 MG 7.048
Linezolid injection 200 MG 39.318
Lorazepam injection 2 MG 1.338
Mannitol injection 50 ML 1.471
Meperidine hydrochl /100 MG 100 MG 2.159
Meropenem 100 MG 1.424
Methylergonovin maleate inj 0.2 MG 3.798
Micafungin sodium injection 1 MG 0.943
Inj midazolam hydrochloride 1 MG 0.156
Inj milrinone lactate / 5 MG 5 MG 3.716
Morphine sulfate injection 10 MG 3.388
Morphine so4 injection 100mg 100 MG 1.196
Morphine sulfate injection 10 MG 2.707
Ziconotide injection 1 MCG 6.607
Inj, moxifloxacin 100 mg 100 MG 4.081
Inj nalbuphine hydrochloride 10 MG 0.889
Inj naloxone hydrochloride 1 MG 10.179
Naltrexone, depot form 1 MG 2.850
Natalizumab injection 1 MG 11.587
Nesiritide injection 0.1 MG 51.813
Octreotide injection, depot 1 MG 127.002
Octreotide inj, non-depot 25 MCG 1.508
Oprelvekin injection 5 MG 244.001
Omalizumab injection 5 MG 23.529
Olanzapine long-acting inj 1 MG 2.753
Orphenadrine injection 60 MG 6.484
Phenylephrine hcl injection 1 ML 0.423
Chloroprocaine hcl injection 30 ML 24.326
Ondansetron hcl injection 1 MG 0.219
Oxymorphone hcl injection 1 MG 2.284
Palifermin injection 50 MCG 12.123
Paliperidone palmitate inj 1 MG 7.023
Pamidronate disodium /30 MG 30 MG 10.503
Papaverin hcl injection 60 MG 1.080
Palonosetron hcl 25 MCG 19.016
Paricalcitol 1 MCG 1.743
Pegaptanib sodium injection 0.3 MG 1029.949
Pegademase bovine, 25 iu 25 IU 265.483
Injection, pegfilgrastim 6mg 6 MG 2838.892
Pegloticase injection 1 MG 320.767
Penicillin g procaine inj 600000 UNITS 12.615
Pentobarbital sodium inj 50 MG 26.358
Penicillin g potassium inj 600000 UNITS 0.602
Piperacillin/tazobactam 1.125 GM 2.541
Pentamidine non-comp unit 300 MG 60.780
Promethazine hcl injection 50 MG 1.895
Phenobarbital sodium inj 120 MG 16.125
Plerixafor injection 1 MG 287.450
Oxytocin injection 10 UNITS 0.685
Inj desmopressin acetate 1 MCG 6.117
Inj progesterone per 50 MG 50 MG 1.577
Fluphenazine decanoate 25 MG 25 MG 15.512
Procainamide hcl injection 1 GM 12.610
Oxacillin sodium injeciton 250 MG 2.380
Inj protamine sulfate/10 MG 10 MG 0.590
Protein c concentrate 10 UNITS 13.586
Pralidoxime chloride inj 1 GM 88.595
Phentolaine mesylate inj 5 MG 54.578
Metoclopramide hcl injection 10 MG 0.357
Quinupristin/dalfopristin 500 MG 175.051
Ranibizumab injection 0.1 mg 398.309
Ranitidine hydrochloride inj 25 MG 1.338
Rasburicase 0.5 MG 204.732
Regadenoson injection 0.1 MG 53.674
Rho d immune globulin 50 mcg 50 MCG (250 IU) 25.860
Rho d immune globulin inj 300 MCG (1500 IU) 83.769
Rhophylac injection 100 IU 5.188
Rho(D) immune globulin h, sd 100 IU 18.432
Risperidone, long acting 0.5 MG 5.452
Ropivacaine HCl injection 1 MG 0.082
Romiplostim injection 10 MCG 48.183
Methocarbamol injection 10 ML 37.100
Sincalide injection 5 MCG 67.009
Inj theophylline per 40 MG 40 MG 0.256
Sargramostim injection 50 MCG 31.586
Inj secretin synthetic human 1 MCG 27.494
Na ferric gluconate complex 12.5 MG 3.315
Methylprednisolone injection 40 MG 2.065
Methylprednisolone injection 125 MG 2.858
Reteplase injection 18.1 MG 2301.896
Alteplase recombinant 1 MG 49.219
Streptomycin injection 1 GM 11.349
Fentanyl citrate injeciton 0.1 MG 0.799
Sumatriptan succinate / 6 MG 6 MG 51.887
Pentazocine injection 30 MG 19.609
Telavancin injection 10 MG 2.646
Tenecteplase injection 1 MG 66.503
Terbutaline sulfate inj 1 MG 5.519
Testosterone enanthate inj 100 MG 4.639
Testosterone enanthate inj 200 MG 9.277
Chlorpromazine hcl injection 50 MG 25.076
Thyrotropin injection 0.9 MG 1053.789
Tigecycline injection 1 MG 1.459
Tirofiban HCl 0.25 MG 8.689
Trimethobenzamide hcl inj 200 MG 10.439
Tobramycin sulfate injection 80 MG 2.754
Tocilizumab injection 1 MG 3.572
Treprostinil injection 1 MG 61.237
Triamcinolone A inj PRS-free 1 MG 3.567
Triamcinolone acet inj NOS 10 MG 1.671
Triamcinolone diacetate inj 5 MG 0.280
Triamcinolone hexacetonl inj 5 MG 1.509
Triptorelin pamoate 3.75 MG 160.300
Urofollitropin, 75 iu 75 IU 66.693
Ustekinumab injection 1 MG 130.529
Diazepam injection 5 MG 1.420
Urokinase 250,000 IU inj 250000 IU 457.729
Vancomycin hcl injection 500 MG 2.398
Velaglucerase alfa 100 UNITS 349.313
Verteporfin injection 0.1 MG 10.160
Hydroxyzine hcl injection 25 MG 1.439
Thiamine hcl 100 mg 100 MG 3.513
Pyridoxine hcl 100 mg 100 MG 6.940
Vitamin b12 injection 1000 MCG 0.539
Vitamin k phytonadione inj 1 MG 1.430
Injection, voriconazole 10 MG 6.631
Hyaluronidase injection 150 UNITS 21.200
Ovine, up to 999 USP units 1 USP UNIT 0.240
Hyaluronidase recombinant 1 USP UNIT 0.344
Inj magnesium sulfate 500 MG 0.124
Inj potassium chloride 2 MEQ 0.012
Zidovudine 10 MG 1.505
Ziprasidone mesylate 10 MG 8.762
Zoledronic acid 1 MG 224.104
Reclast injection 1 MG 224.745
Normal saline solution infus 1000 ML 1.096
Normal saline solution infus 500 ML 0.548
5% dextrose/normal saline 500 ML 0.358
Normal saline solution infus 250 ML 0.274
5% dextrose/water 500 ML 1.050
D5w infusion 1000 CC 2.100
Dextran 40 infusion 500 ML 21.015
Dextran 75 infusion 500 ML 14.522
Ringers lactate infusion 1000 CC 1.015
Wilate injection 1 I.U. VWF:RCO 0.879
Xyntha inj 1 IU 1.100
Antihemophilic viii/vwf comp PER FACTOR VIII IU 0.925
Humate-P, inj 1 IU 0.904
Factor viia 1 MCG 1.611
Factor viii 1 IU 0.902
Factor viii recombinant NOS 1 IU 1.112
Factor IX non-recombinant 1 IU 0.942
Factor ix complex 1 IU 1.028
Factor IX recombinant 1 IU 1.241
Antithrombin iii injection 1 IU 3.042
Anti-inhibitor 1 IU 1.627
Aminolevulinic acid hcl top 354 MG 161.184
Methyl aminolevulinate, top 1 GM 75.947
Ganciclovir long act implant 4.5 MG 16960.000
Fluocinolone acetonide implt 0.59 MG 19345.000
Dexamethasone intra implant 0.1 MG 195.764
Hyalgan/supartz inj per dose per dose 92.246
Euflexxa inj per dose per dose 151.089
Orthovisc inj per dose per dose 169.905
Synvisc or Synvisc-One 1 MG 12.219
Gel-One per dose 614.906
Cultured chondrocytes implnt 1 EA 29193.230
Capsaicin 8% patch 10 SQ CM 25.554
Azathioprine oral 50mg 50 MG 0.064
Azathioprine parenteral 100 MG 144.620
Cyclosporine oral 100 mg 100 MG 3.219
Lymphocyte immune globulin 250 MG 646.104
Monoclonal antibodies 5 MG 1156.078
Prednisone oral 5 MG 0.054
Tacrolimus oral per 1 MG 1 MG 2.091
Methylprednisolone oral 4 MG 0.679
Prednisolone oral per 5 mg 5 MG 0.029
Antithymocyte globuln rabbit 25 MG 465.734
Daclizumab, parenteral 25 MG 526.343
Cyclosporine oral 25 mg 25 MG 0.884
Cyclosporin parenteral 250mg 250 MG 30.612
Mycophenolate mofetil oral 250 MG 1.272
Mycophenolic acid 180 MG 3.603
Sirolimus, oral 1 MG 11.551
Tacrolimus injection 5 MG 139.360
Arformoterol non-comp unit 15 mcg 5.223
Formoterol fumarate, inh 20 MCG 5.213
Acetylcysteine non-comp unit 1 GM 2.165
Albuterol non-comp con 1 MG 0.109
Levalbuterol non-comp con 0.5 MG 0.284
Albuterol non-comp unit 1 MG 0.053
Levalbuterol non-comp unit 0.5 MG 0.261
Albuterol ipratrop non-comp 2.5 MG/0.5 MG 0.210
Budesonide non-comp unit 0.5 MG 4.867
Cromolyn sodium noncomp unit 10 MG 0.529
Dornase alfa non-comp unit 1 MG 30.641
Ipratropium bromide non-comp 1 MG 0.253
Mannitol for inhaler 5 MG 0.631
Metaproterenol non-comp unit 10 MG 0.252
Methacholine chloride, neb 1 MG 0.498
Tobramycin non-comp unit 300 MG 92.449
Treprostinil, non-comp unit  1.74 MG 438.931
Oral aprepitant 5 MG 6.290
Oral busulfan 2 MG 5.308
Capecitabine, oral, 150 mg 150 MG 8.275
Capecitabine, oral, 500 mg 500 MG 27.551
Cyclophosphamide oral 25 MG 25 MG 0.946
Oral dexamethasone 0.25 MG 0.351
Etoposide oral 50 MG 50 MG 52.165
Oral everolimus 0.25 MG 6.179
Oral fludarabine phosphate 10 MG 81.772
Melphalan oral 2 MG 2 MG 8.220
Methotrexate oral 2.5 MG 2.5 MG 0.120
Temozolomide 5 MG 10.674
Topotecan oral 0.25 mg 83.926
Doxorubicin hcl injection 10 MG 3.546
Alemtuzumab injection 10 MG 587.780
Aldesleukin injection 1 EA 1246.984
Arsenic trioxide injection 1 MG 44.994
Asparaginase injection 10000 UNITS 63.210
Azacitidine injection 1 MG 5.523
Clofarabine injection 1 MG 125.759
Bcg live intravesical vac 1 EA 116.811
Bendamustine injection 1 MG 20.614
Bevacizumab injection 10 MG 62.319
Bleomycin sulfate injection 15 UNITS 24.163
Bortezomib injection 0.1 MG 43.473
Cabazitaxel injection 1 MG 136.071
Carboplatin injection 50 MG 3.283
Carmustine injection 100 MG 175.759
Cetuximab injection 10 MG 51.094
Cisplatin 10 MG injection 10 MG 1.899
Inj cladribine per 1 MG 1 MG 28.243
Cyclophosphamide 100 MG inj 100 MG 23.475
Cytarabine liposome inj 10 MG 523.865
Cytarabine hcl 100 MG inj 100 MG 0.950
Dactinomycin injection 0.5 MG 578.931
Dacarbazine 100 mg inj 100 MG 3.402
Daunorubicin injection 10 MG 19.187
Degarelix injection 1 MG 2.992
Denileukin diftitox inj 300 MCG 1646.180
Docetaxel injection 1 MG 6.694
Elliotts b solution per ml 1 ML 4.074
Inj, epirubicin hcl, 2 mg 2 MG 1.605
Eribulin mesylate injection 0.1 MG 92.807
Etoposide injection 10 MG 0.737
Fludarabine phosphate inj 50 MG 84.878
Fluorouracil injection 500 MG 2.340
Floxuridine injection 500 MG 52.388
Gemcitabine hcl injection 200 MG 12.246
Goserelin acetate implant 3.6 MG 166.011
Irinotecan injection 20 MG 4.378
Ixabepilone injection 1 MG 66.493
Ifosfamide injection 1 GM 30.493
Mesna injection 200 MG 3.714
Idarubicin hcl injection 5 MG 100.004
Interferon alfa-2b inj 1 MIL UNITS 19.055
Leuprolide acetate suspnsion 7.5 MG 217.017
Leuprolide acetate injeciton 1 MG 5.979
Leuprolide acetate implant 65 MG 4819.820
Vantas implant 50 MG 3016.495
Supprelin LA implant 50 MG 16172.579
Ipilimumab injection 1 MG 125.158
Mechlorethamine hcl inj 10 MG 157.855
Inj melphalan hydrochl 50 MG 50 MG 1312.538
Methotrexate sodium inj 5 MG 0.193
Methotrexate sodium inj 50 MG 1.890
Nelarabine injection 50 MG 122.645
Oxaliplatin 0.5 MG 9.245
Paclitaxel protein bound 1 MG 9.591
Paclitaxel injection 30 MG 6.244
Pegaspargase injection 1 EA 5889.996
Pentostatin injection 10 MG 946.921
Mitomycin 5 MG inj 5 MG 22.900
Mitoxantrone hydrochl / 5 MG 5 MG 36.218
Gemtuzumab ozogamicin inj 5 MG 2742.591
Ofatumumab injection 10 MG 45.442
Panitumumab injection 10 MG 89.021
Pemetrexed injection 10 MG 56.511
Pralatrexate injection 1 MG 173.936
Rituximab injection 100 MG 659.716
Romidepsin injection 1 MG 233.162
Streptozocin injection 1 GM 274.157
Temozolomide injection 1 MG 4.824
Temsirolimus injection 1 MG 53.505
Thiotepa injection 15 MG 175.301
Topotecan injection 0.1 MG 3.128
Trastuzumab injection 10 MG 76.396
Valrubicin injection 200 MG 1006.266
Vinblastine sulfate inj 1 MG 1.069
Vincristine sulfate 1 MG inj 1 MG 3.603
Vinorelbine tartrate inj 10 MG 9.157
Injection, Fulvestrant 25 MG 87.038
Albumin (human),5%, 50ml 50 ML 9.546
Plasma protein fract,5%,50ml 50 ML 8.333
Albumin (human), 5%, 250 ml 250 ML 47.728
Albumin (human), 25%, 20 ml 20 ML 19.680
Albumin (human), 25%, 50ml 50 ML 49.201
Plasmaprotein fract,5%,250ml 250 ML 41.667
Ferumoxytol, non-esrd 1 MG 0.638
Ferumoxytol, esrd use 1 MG 0.638
Ondansetron oral 1 MG 0.055
Diphenhydramine HCl 50mg 50 MG 0.020
Prochlorperazine maleate 5mg 5 MG 0.050
Prochlorperazine maleate10mg 10 MG 0.049
Granisetron hcl 1 mg oral 1 MG 1.641
Dronabinol 2.5mg oral 2.5 MG 3.584
Dronabinol 5mg oral 5 MG 7.293
Promethazine HCl 12.5mg oral 12.5 MG 0.077
Promethazine HCl 25 mg oral 25 MG 0.032
Dolasetron mesylate oral 100 MG 69.499
Sermorelin acetate injection 1 MCG 1.800
Fosphenytoin inj PE 50 MG 0.919
Teniposide, 50 mg 50 MG 321.833
Afluria vacc, 3 yrs & >, im 0.5 ml 11.543
Flulaval vacc, 3 yrs & >, im 0.5 ML 9.833
Fluvirin vacc, 3 yrs & >, im 0.5 ML 14.051
Fluzone vacc, 3 yrs & >, im 0.5 ML 12.046
Sipuleucel-T auto CD54+ Per infusion (minimum 50 million cells) 32696.247
Aflibercept injection 1 MG 980.500
Peginesatide injection 0.1 MG 11.459
Doxil injection 10 MG 532.034
Imported Lipodox inj 10 MG 498.265
IM inj interferon beta 1-a 11 MCG 287.090
Iloprost non-comp unit dose UP TO 20 MCG 73.670
Epoetin alfa, 100 units ESRD 100 UNITS 0.987
Apligraf skin sub 1 SQ CM 38.059
Oasis wound matrix skin sub 1 SQ CM 7.776
Oasis burn matrix skin sub 1 SQ CM 7.776
Integra BMWD skin sub 1 SQ CM 20.972
Integra DRT skin sub 1 SQ CM 11.397
Dermagraft skin sub 1 SQ CM 42.573
Graftjacket skin sub 1 SQ CM 98.389
Integra matrix skin sub 1 SQ CM 25.173
Primatrix skin sub 1 SQ CM 37.758
Gammagraft skin sub 1 SQ CM 6.873
Cymetra allograft 1 CC 442.203
Graftjacket express allograf 1 CC 442.203
Integra flowable wound matri 1 CC 1176.137
Alloskin 1 SQ CM 10.188
Alloderm skin sub 1 SQ CM 32.211
Theraskin 1 SQ CM 22.288
Alloskin RT 1 SQ CM 13.372
Oral MR contrast, 100 ml 100 ML 9.340
Inj octafluoropropane mic,ml 1 ML 38.608
Inj perflutren lip micros,ml 1 ML 57.913
HOCM <=149 mg/ml iodine, 1ml 1 ML 0.091
HOCM 200-249mg/ml iodine,1ml 1 ML 0.161
HOCM 250-299mg/ml iodine,1ml 1 ML 0.186
HOCM 350-399mg/ml iodine,1ml 1 ML 0.183
LOCM 100-199mg/ml iodine,1ml 1 ML 0.901
LOCM 200-299mg/ml iodine,1ml 1 ML 0.205
LOCM 300-399mg/ml iodine,1ml 1 ML 0.103