HCPCS Level IIdrugActive
J0133
Acyclovir injection
BETOS: O1E
Effective: 2006-01-01
Referenced in 3 policies
Description
Injection, acyclovir, 5 mg
Medicare Part B Drug Pricing
Average Sales Price (ASP) data for Q1 2026
Drug Name
Acyclovir Sodium
Manufacturer
Eugia US LLC
HCPCS Dosage
5 MG
Billing Units
100.0000
9
NDC Products
asp
Pricing Source
Medicare Part B drugs are reimbursed at ASP + 6%. Pricing updates quarterly based on manufacturer-reported data.