HCPCS Level IIdrugActive
J7504
Lymphocyte immune globulin
BETOS: O1E
Effective: 2002-01-01
Referenced in 2 policies
Description
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
Medicare Part B Drug Pricing
Average Sales Price (ASP) data for Q1 2026
Drug Name
Atgam
Manufacturer
Pfizer Inc
HCPCS Dosage
250 MG
Billing Units
1.0000
1
NDC Products
asp
Pricing Source
Medicare Part B drugs are reimbursed at ASP + 6%. Pricing updates quarterly based on manufacturer-reported data.