Code: Q5106

Description:
Description: Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
RETACRIT BS 10000U NESRD
RETACRIT BS 1000U NESRD
RETACRIT BS 4000U NESRD
RETACRIT BS 40000U NESRD
EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION
EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION
EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION
EPOETIN ALFA-EPBX 2000 UNIT/ML INJECTION SOLUTION
EPOETIN ALFA-EPBX 10000 UNIT/ML INJECTION SOLUTION
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: Q5103
INFLECTRA BS 10 MG INJ
Code: Q5104
RENFLEXIS BS 100 MG INJ
Code: Q5105
RETACRIT BS 100U ESRD
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)
Nebraska
Hospital Address Code Price Last Updated
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln Q5106 $45 [source] 3 years ago
Chi Health Good Samaritan 10 E 31St St, Kearney Q5106 $45 [source] 3 years ago
Chi Health Lakeside 17201 Wright St, Omaha Q5106 $45 [source] 3 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler Q5106 $45 [source] 3 years ago
Chi Health Midlands 11111 S 84Th St, Papillion Q5106 $45 [source] 3 years ago
Chi Health Plainview 704 N 3Rd St, Plainview Q5106 $45 [source] 3 years ago
Chi Health St. Mary 1301 Grundman Blvd, Nebraska City Q5106 $45 [source] 3 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha Q5106 $45 [source] 3 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha Q5106 $45 [source] 3 years ago
Chi Health St. Francis 2116 W Faidley Ave, Grand Island Q5106 $45 [source] 3 years ago
Chi Health Nebraska Heart 7500 So. 91St St., Lincoln Q5106 $45 [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.