| |
|
|
2009 |
2009 |
|
| J
Code |
Dscription |
|
4th
Qtr |
3rd
Qtr |
Change |
| J0207 |
Amifostine |
500
MG |
356.806 |
$367.76 |
$0.00 |
| J0287 |
Amphotericin
b lipid complex |
10
MG |
9.845 |
$9.90 |
$0.05 |
| J0460 |
Atropine
sulfate injection |
0.3
MG |
0.514 |
$0.45 |
$0.06 |
| J0610 |
Calcium
gluconate injection |
10
ML |
0.297 |
$0.30 |
$0.00 |
| J0640 |
Leucovorin
calcium injection |
50
MG |
1.006 |
$0.87 |
$0.14 |
| J0641 |
Levoleucovorin
injection |
0.5
MG |
0.992 |
$1.28 |
$0.29 |
| J0696 |
Ceftriaxone
sodium injection |
250
MG |
1.054 |
$1.07 |
$0.02 |
| J0713 |
Inj
ceftazidime per 500 mg |
500
MG |
2.432 |
$2.86 |
$0.43 |
| J0780 |
Prochlorperazine
injection |
10
MG |
2.108 |
$2.05 |
$0.06 |
| J0881 |
Darbepoetin
alfa, non-esrd |
1
MCG |
2.812 |
$2.98 |
$0.17 |
| J0885 |
Epoetin
alfa, non-esrd |
1000
UNITS |
9.583 |
$9.46 |
$0.12 |
| J0894 |
Decitabine,
inj |
1
MG |
28.967 |
$28.43 |
$0.54 |
| J1100 |
Dexamethasone
sodium phos |
1
MG |
0.088 |
$0.09 |
$0.00 |
| J1190 |
Dexrazoxane
HCl injection |
250
MG |
346.569 |
$272.91 |
$73.66 |
| J1200 |
Diphenhydramine
hcl injectio |
50
MG |
0.857 |
$0.78 |
$0.08 |
| J1260 |
Dolasetron
mesylate |
10
MG |
4.408 |
$4.84 |
$0.43 |
| J1440 |
Filgrastim
300 mcg injection |
300
MCG |
212.548 |
$208.59 |
$3.96 |
| J1441 |
Filgrastim
480 mcg injection |
480
MCG |
330.684 |
$322.76 |
$7.92 |
| J1566 |
Immune
globulin, powder |
500
MG |
30.405 |
$30.89 |
$0.48 |
| J1569 |
Gammagard
Liquid injection |
500
MG |
38.581 |
$38.61 |
$0.03 |
| J1626 |
Granisetron
HCl injection |
100
MCG |
2.004 |
$2.34 |
$0.34 |
| J1642 |
Inj
heparin sodium per 10 u |
10
UNITS |
0.156 |
$0.12 |
$0.04 |
| J1644 |
Inj
heparin sodium per 1000u |
1000
UNITS |
0.268 |
$0.27 |
$0.00 |
| J1650 |
Inj
enoxaparin sodium |
10
MG |
6.452 |
$6.36 |
$0.09 |
| J1720 |
Hydrocortisone
sodium succ i |
100
MG |
2.918 |
$2.97 |
$0.05 |
| J1740 |
Ibandronate
sodium, inj |
1
MG |
141.902 |
$141.40 |
$0.50 |
| J1745 |
Infliximab
injection |
10
MG |
58.712 |
$56.63 |
$2.08 |
| J1750 |
Iron
dextran inj |
50
MG |
14.377 |
$11.76 |
$2.62 |
| J1815 |
Insulin
injection |
5
UNITS |
0.446 |
$0.43 |
$0.02 |
| J1940 |
Furosemide
injection |
20
MG |
0.207 |
$0.21 |
$0.00 |
| J1950 |
Leuprolide
acetate /3.75 MG |
3.75
MG |
489.43 |
$480.49 |
$8.94 |
| J2060 |
Lorazepam
injection |
2
MG |
0.796 |
$0.80 |
$0.00 |
| J2150 |
Mannitol
injection |
50
ML |
0.939 |
$0.92 |
$0.02 |
| J2175 |
Meperidine
hydrochl /100 MG |
100
MG |
1.654 |
$1.51 |
$0.14 |
| J2275 |
Morphine
sulfate injection |
10
MG |
2.813 |
$2.67 |
$0.14 |
| J2353 |
Octreotide
injection, depot |
1
MG |
107.297 |
$107.26 |
$0.04 |
| J2354 |
Octreotide
inj, non-depot |
25
MCG |
1.364 |
$1.52 |
$0.16 |
| J2355 |
Oprelvekin
injection |
5
MG |
246.821 |
$247.30 |
$0.48 |
| J2405 |
Ondansetron
hcl injection |
1
MG |
0.247 |
$0.19 |
$0.06 |
| J2430 |
Pamidronate
disodium /30 MG |
30
MG |
18.773 |
$20.53 |
$1.76 |
| J2469 |
Palonosetron
hcl |
25
MCG |
17.516 |
$17.63 |
$0.11 |
| J2505 |
Injection,
pegfilgrastim 6mg |
6
MG |
2264.807 |
$2,243.64 |
$21.17 |
| J2780 |
Ranitidine
hydrochloride inj |
25
MG |
1.078 |
$1.22 |
$0.14 |
| J2792 |
Rho(D)
immune globulin h, sd |
100
IU |
18.742 |
$17.22 |
$1.52 |
| J2820 |
Sargramostim
injection |
50
MCG |
23.754 |
$24.11 |
$0.36 |
| J2920 |
Methylprednisolone
injection |
40
MG |
2.56 |
$2.73 |
$0.17 |
| J2930 |
Methylprednisolone
injection |
125
MG |
3.446 |
$3.71 |
$0.26 |
| J2997 |
Alteplase
recombinant |
1
MG |
35.7 |
$35.48 |
$0.22 |
| J3370 |
Vancomycin
hcl injection |
500
MG |
3.008 |
$3.05 |
$0.04 |
| J3420 |
Vitamin
b12 injection |
1000
MCG |
0.248 |
$0.27 |
$0.02 |
| J3430 |
Vitamin
k phytonadione inj |
1
MG |
1.215 |
$4.24 |
$3.03 |
| J3475 |
Inj
magnesium sulfate |
500
MG |
0.05 |
$0.05 |
$0.00 |
| J3480 |
Inj
potassium chloride |
2
MEQ |
0.015 |
$0.01 |
$0.01 |
| J3487 |
Zoledronic
acid |
1
MG |
219.07 |
$217.37 |
$1.70 |
| J3488 |
Reclast
injection |
1
MG |
222.789 |
$220.54 |
$2.25 |
| J7030 |
Normal
saline solution infus |
1000
CC |
0.449 |
$0.45 |
$0.00 |
| J7040 |
Normal
saline solution infus |
500
ML |
0.543 |
$0.54 |
$0.00 |
| J7042 |
5%
dextrose/normal saline |
500
ML |
0.321 |
$0.31 |
$0.01 |
| J7050 |
Normal
saline solution infus |
250
CC |
0.272 |
$0.27 |
$0.00 |
| J7070 |
D5W
infusion |
1000
CC |
2.256 |
$2.20 |
$0.06 |
| J7120 |
Ringers
lactate infusion |
1000
CC |
0.987 |
$0.97 |
$0.02 |
| J8501 |
Oral
aprepitant |
5
MG |
5.523 |
$5.49 |
$0.03 |
| J9000 |
Doxorubic
hcl 10 MG vl chemo |
10
MG |
3.69 |
$3.58 |
$0.11 |
| J9001 |
Doxorubicin
hcl liposome inj |
10
MG |
459.175 |
$456.99 |
$2.19 |
| J9010 |
Alemtuzumab
injection |
10
MG |
570.215 |
$569.84 |
$0.38 |
| J9015 |
Aldesleukin/single
use vial |
1
EA |
847.481 |
$844.07 |
$3.41 |
| J9017 |
Arsenic
trioxide |
1
MG |
37.441 |
$37.55 |
$0.11 |
| J9020 |
Asparaginase
injection |
10000
UNITS |
58.014 |
$58.02 |
$0.01 |
| J9031 |
Bcg
live intravesical vac |
1
EA |
113.213 |
$117.81 |
$4.60 |
| J9035 |
Bevacizumab
injection |
10
MG |
57.479 |
$57.42 |
$0.06 |
| J9040 |
Bleomycin
sulfate injection |
15
UNITS |
29.663 |
$30.89 |
$1.23 |
| J9041 |
Bortezomib
injection |
0.1
MG |
37.239 |
$37.24 |
$0.00 |
| J9045 |
Carboplatin
injection |
50
MG |
4.601 |
$5.22 |
$0.62 |
| J9050 |
Carmus
bischl nitro inj |
100
MG |
177.073 |
$176.92 |
$0.15 |
| J9055 |
Cetuximab
injection |
10
MG |
49.729 |
$49.73 |
$0.00 |
| J9060 |
Cisplatin
10 MG injection |
10
MG |
2.068 |
$2.32 |
$0.25 |
| J9065 |
Inj
cladribine per 1 MG |
1
MG |
25.637 |
$27.06 |
$1.42 |
| J9070 |
Cyclophosphamide
100 MG inj |
100
MG |
4.303 |
$4.02 |
$0.28 |
| J9090 |
Cyclophosphamide
500 MG inj |
500
MG |
21.514 |
$20.09 |
$1.42 |
| J9130 |
Dacarbazine
100 mg inj |
100
MG |
4.254 |
$4.00 |
$0.25 |
| J9140 |
Dacarbazine
200 MG inj |
200
MG |
8.359 |
$7.89 |
$0.47 |
| J9170 |
Docetaxel |
20
MG |
345.536 |
$344.65 |
$0.89 |
| J9178 |
Inj,
epirubicin hcl, 2 mg |
2
MG |
2.594 |
$2.90 |
$0.31 |
| J9181 |
Etoposide
10 MG inj |
10
MG |
0.542 |
$0.45 |
$0.09 |
| J9185 |
Fludarabine
phosphate inj |
50
MG |
154.274 |
$163.26 |
$8.99 |
| J9190 |
Fluorouracil
injection |
500
MG |
1.519 |
$1.45 |
$0.07 |
| J9201 |
Gemcitabine
HCl |
200
MG |
141.77 |
$141.29 |
$0.48 |
| J9202 |
Goserelin
acetate implant |
3.6
MG |
196.728 |
$196.05 |
$0.68 |
| J9206 |
Irinotecan
injection |
20
MG |
13.433 |
$14.95 |
$1.52 |
| J9207 |
Ixabepilone
injection |
1
MG |
63.74 |
$63.74 |
$0.00 |
| J9208 |
Ifosfamide
injection |
1
GM |
29.958 |
$30.03 |
$0.07 |
| J9209 |
Mesna
injection |
200
MG |
4.42 |
$4.17 |
$0.25 |
| J9214 |
Interferon
alfa-2b inj |
1
MIL UNITS |
15.836 |
$15.41 |
$0.43 |
| J9216 |
Interferon
gamma 1-b inj |
3
MIL UNITS |
299.685 |
$299.39 |
$0.30 |
| J9217 |
Leuprolide
acetate suspnsion |
7.5
MG |
214.569 |
$198.87 |
$15.70 |
| J9260 |
Methotrexate
sodium inj |
50
MG |
2.122 |
$2.06 |
$0.06 |
| J9263 |
Oxaliplatin |
0.5
MG |
9.73 |
$9.61 |
$0.12 |
| J9264 |
Paclitaxel
protein bound |
1
MG |
9.261 |
$9.22 |
$0.04 |
| J9265 |
Paclitaxel
injection |
30
MG |
9.11 |
$7.72 |
$1.39 |
| J9268 |
Pentostatin
injection |
10
MG |
1426.472 |
$1,388.20 |
$38.27 |
| J9280 |
Mitomycin
5 MG inj |
5
MG |
18.085 |
$14.27 |
$3.82 |
| J9293 |
Mitoxantrone
hydrochl / 5 MG |
5
MG |
66.772 |
$68.36 |
$1.59 |
| J9305 |
Pemetrexed
injection |
10
MG |
49.435 |
$49.46 |
$0.02 |
| J9310 |
Rituximab
cancer treatment |
100
MG |
563.334 |
$550.00 |
$13.33 |
| J9320 |
Streptozocin
injection |
1
GM |
283.698 |
$282.38 |
$1.32 |
| J9330 |
Temsirolimus
injection |
1
MG |
48.854 |
$48.79 |
$0.06 |
| J9340 |
Thiotepa
injection |
15
MG |
99.566 |
$97.35 |
$2.22 |
| J9350 |
Topotecan |
4
MG |
1007.896 |
$981.07 |
$26.83 |
| J9355 |
Trastuzumab |
10
MG |
64.731 |
$63.17 |
$1.56 |
| J9360 |
Vinblastine
sulfate inj |
1
MG |
0.962 |
$1.00 |
$0.04 |
| J9370 |
Vincristine
sulfate 1 MG inj |
1
MG |
5.718 |
$5.70 |
$0.02 |
| J9375 |
Vincristine
sulfate 2 MG inj |
2
MG |
11.435 |
$11.40 |
$0.04 |
| J9390 |
Vinorelbine
tartrate/10 mg |
10
MG |
12.176 |
$13.14 |
$0.96 |
| J9395 |
Injection,
Fulvestrant |
25
MG |
82.18 |
$82.13 |
$0.05 |
