HCPCS Level IIdrugActive
J0750
Hiv prep, ftc/tdf 200/300mg
BETOS: O1E
Effective: 2025-01-01
Referenced in 1 policies
Description
Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
Medicare Part B Drug Pricing
Average Sales Price (ASP) data for Q1 2026
Drug Name
Emtricitabine/Tenofovir disoproxil fumarate
Manufacturer
A-S Medication Solutions
HCPCS Dosage
200 MG/300 MG
Billing Units
30.0000
32
NDC Products
prep
Pricing Source