HCPCS Level IIdrugActive
J0652
Inj, levothyroxine, hikma
BETOS: O1E
Effective: 2024-07-01
Description
Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg
Medicare Part B Drug Pricing
Average Sales Price (ASP) data for Q1 2026
Drug Name
Levothyroxine Sodium
Manufacturer
Hikma Pharmaceuticals USA Inc.
HCPCS Dosage
10 MCG
Billing Units
10.0000
1
NDC Products
asp
Pricing Source
Medicare Part B drugs are reimbursed at ASP + 6%. Pricing updates quarterly based on manufacturer-reported data.