HCPCS Q5105
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
HCPCS Information
- HCPCS Code: Q5105
- The Healthcare Common Procedure Coding System (HCPCS) is a set of unique alphanumeric codes used to report medical procedures and services to healthcare programs like Medicare and Medicaid. HCPCS codes are used in conjunction with NDC codes for billing and medical documentation puporses. For instance, HCPCS Q5105 identifies the type of service or supply used while any of the 13 NDC codes below could be used to specify the exact drug used.
- Short Description
- Inj retacrit esrd on dialysi
- Long Description
- Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
- Pricing Indicator
- Other carrier priced
- Multiple Pricing Indicator
- Not applicable as HCPCS priced under one methodology
- Coverage Description
- Special coverage instructions apply
- BETOS Type of Service
- Other drugs
- Medicare Payment Limit
- $0.76
- Medicare Co-Insurance Percentage
- 20.000%
- Medicare Pricing Notes
- 8% of reference add-on applied
- HCPCS Classification
- List of HCPCS codes for: Temporary Codes (Q-codes)
HCPCS Crossover to NDC Codes
The NDC codes below allow precise billing based on the specific manufacturer and medication used:
| NDC | Proprietary Name | Non-Proprietary Name | Dosage Form | Route Name | Company Name | Status | |
|---|---|---|---|---|---|---|---|
| 0069-1305 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 0069-1306 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 0069-1307 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 0069-1308 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 0069-1309 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 0069-1311 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 0069-1318 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Pfizer Laboratories Div Pfizer Inc | ACTIVE | |
| 59353-002 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Vifor (international) Inc. | ACTIVE | |
| 59353-003 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Vifor (international) Inc. | ACTIVE | |
| 59353-004 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Vifor (international) Inc. | ACTIVE | |
| 59353-010 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Vifor (international) Inc. | ACTIVE | |
| 59353-120 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Vifor (international) Inc. | ACTIVE | |
| 59353-220 | Retacrit | Epoetin Alfa-epbx | Injection, Solution | Intravenous; Subcutaneous | Vifor (international) Inc. | ACTIVE |
