Levofloxacin injection
Products billed under this code include Levofloxacin.
Payment limit per 250 MG, 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 this code include Levofloxacin.
Payment limit per 250 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.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 |
|---|---|---|---|---|
| Levofloxacin | Hikma Pharmaceuticals USA Inc. | 00143-9315-24 | 24 | $61.56 |
| Levofloxacin | Hikma Pharmaceuticals USA Inc. | 00143-9316-24 | 48 | $123.12 |
| Levofloxacin | Hikma Pharmaceuticals USA Inc. | 00143-9317-24 | 72 | $184.68 |
| Levofloxacin | Hikma Pharmaceuticals USA Inc. | 00143-9720-24 | 72 | $184.68 |
| Levofloxacin | Hikma Pharmaceuticals USA Inc. | 00143-9721-24 | 48 | $123.12 |
| Levofloxacin | Hikma Pharmaceuticals USA Inc. | 00143-9722-24 | 24 | $61.56 |
| Levofloxacin | Pfizer Inc | 00409-2220-24 | 24 | $61.56 |
| Levofloxacin | Pfizer Inc | 00409-3330-24 | 48 | $123.12 |
| Levofloxacin | Pfizer Inc | 00409-4444-24 | 72 | $184.68 |
| Levofloxacin | Sagent Pharmaceuticals | 25021-0132-81 | 24 | $61.56 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Levofloxacin | Sagent Pharmaceuticals | 25021-0132-82 | 48 | $123.12 |
| Levofloxacin | Sagent Pharmaceuticals | 25021-0132-83 | 72 | $184.68 |
| Levofloxacin | WG Critical Care, LLC | 44567-0435-24 | 24 | $61.56 |
| Levofloxacin | WG Critical Care, LLC | 44567-0436-24 | 48 | $123.12 |
| Levofloxacin | WG Critical Care, LLC | 44567-0437-24 | 72 | $184.68 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $2.565 | +$0.656 | 250 MG | Levofloxacin injection | v1, posted September 17, 2026 |
| 3Q26 | $1.909 | −$0.254 | 250 MG | Levofloxacin injection | v1, posted September 15, 2026 |
| 2Q26 | $2.163 | +$0.002 | 250 MG | Levofloxacin injection | v1, posted September 15, 2026 |
| 1Q26 | $2.161 | −$0.377 | 250 MG | Levofloxacin injection | v1, posted September 15, 2026 |
| 4Q25 | $2.538 | +$0.579 | 250 MG | Levofloxacin injection | v1, posted September 8, 2026 |
| 3Q25 | $1.959 | +$0.934 | 250 MG | Levofloxacin injection | v1, posted March 10, 2026 |
| 2Q25 | $1.025 | −$0.866 | 250 MG | Levofloxacin injection | v1, posted March 10, 2026 |
| 1Q25 | $1.891 | +$0.738 | 250 MG | Levofloxacin injection | v1, posted December 19, 2025 |
| 4Q24 | $1.153 | +$0.218 | 250 MG | Levofloxacin injection | v1, posted June 11, 2025 |
| 3Q24 | $0.935 | −$0.027 | 250 MG | Levofloxacin injection | v1, posted June 11, 2025 |
| 2Q24 | $0.962 | +$0.054 | 250 MG | Levofloxacin injection | v1, posted March 11, 2025 |
| 1Q24 | $0.908 | −$0.02 | 250 MG | Levofloxacin injection | v1, posted December 19, 2024 |
| 4Q23 | $0.928 | +$0.011 | 250 MG | Levofloxacin injection | v1, posted October 10, 2024 |
| 3Q23 | $0.917 | +$0.08 | 250 MG | Levofloxacin injection | v1, posted June 5, 2024 |
| 2Q23 | $0.837 | −$0.136 | 250 MG | Levofloxacin injection | v1, posted February 23, 2024 |
| 1Q23 | $0.973 | −$0.097 | 250 MG | Levofloxacin injection | v1, posted December 6, 2023 |
| 4Q22 | $1.07 | +$0.192 | 250 MG | Levofloxacin injection | v1, posted June 22, 2023 |
| 3Q22 | $0.878 | +$0.012 | 250 MG | Levofloxacin injection | v1, posted June 9, 2023 |
| 2Q22 | $0.866 | −$0.117 | 250 MG | Levofloxacin injection | v1, posted December 14, 2022 |
| 1Q22 | $0.983 | +$0.077 | 250 MG | Levofloxacin injection | v1, posted June 8, 2022 |
| 4Q21 | $0.906 | +$0.233 | 250 MG | Levofloxacin injection | v1, posted June 2, 2022 |
| 3Q21 | $0.673 | +$0.292 | 250 MG | Levofloxacin injection | v1, posted June 2, 2022 |
| 2Q21 | $0.381 | −$0.004 | 250 MG | Levofloxacin injection | v1, posted March 1, 2022 |
| 1Q21 | $0.385 | – | 250 MG | Levofloxacin injection | 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.