Dalteparin sodium
Products billed under this code include Fragmin.
Payment limit per 2500 IU, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J1645
From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Fragmin | Pfizer Inc | 00069-0195-02 | 10 | $456.68 |
| Fragmin | Pfizer Inc | 00069-0196-02 | 20 | $913.36 |
| Fragmin | Pfizer Inc | 00069-0206-02 | 30 | $1,370.04 |
| Fragmin | Pfizer Inc | 00069-0217-02 | 40 | $1,826.72 |
| Fragmin | Pfizer Inc | 00069-0220-02 | 50 | $2,283.40 |
| Fragmin | Pfizer Inc | 00069-0223-02 | 60 | $2,740.08 |
| Fragmin | Pfizer Inc | 00069-0228-02 | 72 | $3,288.096 |
| Fragmin | Pfizer Inc | 00069-0232-01 | 38 | $1,735.384 |
| Fragmin | Pfizer Inc | 00069-0253-10 | 40 | $1,826.72 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $45.668 | −$2.745 | 2500 IU | Dalteparin sodium | v1, posted September 17, 2026 |
| 3Q26 | $48.413 | +$32.55 | 2500 IU | Dalteparin sodium | v1, posted September 15, 2026 |
| 2Q26 | $15.863 | +$0.959 | 2500 IU | Dalteparin sodium | v1, posted September 15, 2026 |
| 1Q26 | $14.904 | −$1.637 | 2500 IU | Dalteparin sodium | v1, posted September 15, 2026 |
| 4Q25 | $16.541 | −$1.50 | 2500 IU | Dalteparin sodium | v1, posted September 8, 2026 |
| 3Q25 | $18.041 | +$1.998 | 2500 IU | Dalteparin sodium | v1, posted March 10, 2026 |
| 2Q25 | $16.043 | +$2.179 | 2500 IU | Dalteparin sodium | v1, posted March 10, 2026 |
| 1Q25 | $13.864 | −$3.342 | 2500 IU | Dalteparin sodium | v1, posted December 19, 2025 |
| 4Q24 | $17.206 | +$0.916 | 2500 IU | Dalteparin sodium | v1, posted June 11, 2025 |
| 3Q24 | $16.29 | −$0.306 | 2500 IU | Dalteparin sodium | v1, posted June 11, 2025 |
| 2Q24 | $16.596 | −$0.803 | 2500 IU | Dalteparin sodium | v1, posted March 11, 2025 |
| 1Q24 | $17.399 | +$2.185 | 2500 IU | Dalteparin sodium | v1, posted December 19, 2024 |
| 4Q23 | $15.214 | −$1.387 | 2500 IU | Dalteparin sodium | v1, posted October 10, 2024 |
| 3Q23 | $16.601 | +$2.631 | 2500 IU | Dalteparin sodium | v1, posted June 5, 2024 |
| 2Q23 | $13.97 | +$0.662 | 2500 IU | Dalteparin sodium | v1, posted February 23, 2024 |
| 1Q23 | $13.308 | +$0.622 | 2500 IU | Dalteparin sodium | v1, posted December 6, 2023 |
| 4Q22 | $12.686 | +$0.961 | 2500 IU | Dalteparin sodium | v1, posted June 22, 2023 |
| 3Q22 | $11.725 | +$0.104 | 2500 IU | Dalteparin sodium | v1, posted June 9, 2023 |
| 2Q22 | $11.621 | +$1.609 | 2500 IU | Dalteparin sodium | v1, posted December 14, 2022 |
| 1Q22 | $10.012 | +$0.893 | 2500 IU | Dalteparin sodium | v1, posted June 8, 2022 |
| 4Q21 | $9.119 | +$0.488 | 2500 IU | Dalteparin sodium | v1, posted June 2, 2022 |
| 3Q21 | $8.631 | −$0.30 | 2500 IU | Dalteparin sodium | v1, posted June 2, 2022 |
| 2Q21 | $8.931 | −$0.542 | 2500 IU | Dalteparin sodium | v1, posted March 1, 2022 |
| 1Q21 | $9.473 | – | 2500 IU | Dalteparin sodium | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022
- 3Q21: 2022-06-02_july-2021-asp-pricing-file.zipposted June 2, 2022
- 2Q21: 2022-03-01_april-2021-asp-pricing-file.zipposted March 1, 2022
- 1Q21: 2021-12-10_january-2021-asp-pricing-file.zipposted December 10, 2021