HCPCS Q5114

Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg

HCPCS Information

HCPCS Code: Q5114
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 Q5114 identifies the type of service or supply used while any of the 4 NDC codes below could be used to specify the exact drug used.
Short Description
Inj ogivri 10 mg
Long Description
Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg
Pricing Indicator
Drugs
Multiple Pricing Indicator
Not applicable as HCPCS priced under one methodology
Coverage Description
Carrier judgment
BETOS Type of Service
Other drugs
Medicare Payment Limit
$44.59
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
67457-847Ogivri TrastuzumabKitMylan Institutional LlcACTIVE
67457-991Ogivri TrastuzumabInjection, Powder, Lyophilized, For SolutionIntravenousMylan Institutional LlcACTIVE
83257-001Ogivri Trastuzumab-dkstInjection, Powder, Lyophilized, For SolutionIntravenousBiocon Biologics Inc.ACTIVE
83257-004Ogivri Trastuzumab-dkstKitBiocon Biologics Inc.ACTIVE