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)
Wisconsin
Hospital Address Code Price Last Updated
Ascension Calumet Hospital 614 Memorial Dr, Chilton Q5106 $16 [source] 3 years ago
Midwest Orthopedic Specialty Hospital, Llc 10101 S 27Th St, Franklin Q5106 $21 [source] 3 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee Q5106 $28 [source] 3 years ago
Aspirus Medford Hospital 135 S Gibson St, Medford Q5106 $36 [source] 3 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau Q5106 $36 [source] 3 years ago
Aspirus Langlade Hospital 110 E 5Th Ave, Antigo Q5106 $36 [source] 3 years ago
Aspirus Riverview Hospital 410 Dewey St, Wisconsin Rapids Q5106 $36 [source] 3 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette Q5106 $63 [source] 3 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay Q5106 $64 [source] 3 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers Q5106 $65 [source] 3 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q5106 $86 [source] 3 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton Q5106 $88 [source] 3 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee Q5106 $90 [source] 3 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh Q5106 $96 [source] 3 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q5106 $97 [source] 3 years ago
Aurora Lakeland Medical Center W3930 County Road Nn, Elkhorn Q5106 $97 [source] 3 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington Q5106 $98 [source] 3 years ago
Aurora Sheboygan Memorial Medical Center 2629 N 7Th St, Sheboygan Q5106 $103 [source] 3 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q5106 $111 [source] 3 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee Q5106 $113 [source] 3 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q5106 $115 [source] 3 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford Q5106 $148 [source] 3 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand Q5106 $267 [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.