Code: Q5103

Description:
Description: Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
INFLECTRA BS 100 MG INJ
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
INFLIXIMAB-DYYB INFLECT (PER 10MG) JW
INFLIXIMAB BIO 10MG JWMOD
INFLIXIMAB BIOSIM 10 MG
INFLIXIMAB BIOSIMIL 10 MG
INFLECTRA BS 10 MG INJJW
Related codes:
Code: Q5101
ZARXIO BS 480 MCG INJ
Code: Q5102
Description: Injection, infliximab, biosimilar, 10 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q5104
RENFLEXIS BS 100 MG INJ
Code: Q5105
RETACRIT BS 100U ESRD
Code: Q5106
RETACRIT BS 3000U NESRD
Code: Q5107
MVASI BS 100 MG INJ
Code: Q5108
FULPHILA BS 6 MG INJ
Code: Q5109
Description: Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Massachusetts
Hospital Address Code Price Last Updated
Saint Vincent Hospital 123 Summer St., Worcester Q5103 $275 [source] 3 years ago
Massachusetts Eye And Ear 243 Charles St, Boston Q5103 $745 [source] 3 years ago
Martha's Vineyard Hospital One Hospital Road, Oak Bluffs Q5103 $1,475 [source] 3 years ago
Nantucket Cottage Hospital 57 Prospect St, Nantucket Q5103 $1,489 [source] 3 years ago
Newton Wellesley Hospital 2014 Washington St, Newton Lower Falls Q5103 $2,065 [source] 3 years ago
Cooley Dickinson Health Care 30 Locust St, Northampton Q5103 $2,065 [source] 3 years ago
North Shore Medical Center Hospital 81 Highland Ave, Salem Q5103 $2,065 [source] 3 years ago
Brigham & Women Faulkner Hospital 1153 Centre St, Jamaica Plain Q5103 $2,085 [source] 3 years ago
Massachusetts General Hospital 55 Fruit St, Boston Q5103 $2,090 [source] 3 years ago
Brigham & Womens Hospital, Inc. 75 Francis St, Boston Q5103 $2,090 [source] 3 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.