Code: Q5108

Description:
Description: Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
FULPHILA BS 0.5 MG INJ
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE
INJECTION PEGFILGRASTIM-JMDB BIOSIMILAR 0.5 MG
FULPHILA BS 0.5 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: Q5103
INFLECTRA BS 10 MG INJ
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: Q5109
Description: Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Kansas
Hospital Address Code Price Last Updated
Ascension Via Christi Hospitals Wichita Inc. 929 N Saint Francis St, Wichita Q5108 $464 [source] 3 years ago
Mt. Carmel Regional Medical Center, Inc. 1 Mt Carmel Way, Pittsburg Q5108 $464 [source] 3 years ago
Western Plains Medical Complex 3001 Avenue A, Dodge City Q5108 $846 [source] 3 years ago
Menorah Medical Center 5721 W. 119Th Street, Shawnee Mission Q5108 $11,330 [source] 3 years ago
Overland Park Regional Medical Center 10500 Quivira Road, Shawnee Mission Q5108 $11,330 [source] 3 years ago
Adventhealth Ransom Memorial, Inc. 1301 S Main St , Ottawa Q5108 $41,466 [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.