HCPCS Level IIdrugActive
J3375
Inj vancomycin (xellia) 10mg
BETOS: O1E
Effective: 2025-07-01
Description
Injection, vancomycin hydrochloride (xellia), not therapeutically equivalent to j3373, 10 mg
Medicare Part B Drug Pricing
Average Sales Price (ASP) data for Q1 2026
Drug Name
Vancomycin HCl
Manufacturer
Xellia Pharmaceuticals USA, LLC.
HCPCS Dosage
10 MG
Billing Units
50.0000
7
NDC Products
asp
Pricing Source
Medicare Part B drugs are reimbursed at ASP + 6%. Pricing updates quarterly based on manufacturer-reported data.