Medication HCPCS Code Price
AcetylCYSTeine 20% 4 ML Vial $71.85
AcetylCYSTeine IV 200 MG/ML 30 ML Vial J0132 $22.25
ACYClovir 400 Mg Tab $14.60
ACYClovir 800 Mg Tab $25.60
ACYClovir Sodium 500 Mg Vial J0133 $74.60
Adalimumab 40 Mg/0.8 ML Prefilled Pen J0135 $12,517.50
Adenosine 6 Mg/2 ML Vial J0153 $62.40
Adenosine 90 Mg/30 ML Vial J0153 $661.80
Albumin 25% 100 ML P9047 $926.95
Albumin 25% 50 ML P9047 $466.55