Inj levetirac sodi chlo 5 mg
Products billed under this code include Levetiracetam.
Payment limit per 5 MG, by effective quarter, 4Q26 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J1958
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 |
|---|---|---|---|---|
| Levetiracetam | Hikma Pharmaceuticals USA Inc. | 00143-9281-10 | 1000 | $33.00 |
| Levetiracetam | Hikma Pharmaceuticals USA Inc. | 00143-9282-10 | 2000 | $66.00 |
| Levetiracetam | Hikma Pharmaceuticals USA Inc. | 00143-9283-10 | 3000 | $99.00 |
| Levetiracetam | B. Braun Medical Inc. | 00264-1009-90 | 4800 | $158.40 |
| Levetiracetam | B. Braun Medical Inc. | 00264-1509-90 | 7200 | $237.60 |
| Levetiracetam | B. Braun Medical Inc. | 00264-5009-90 | 2400 | $79.20 |
| Levetiracetam | Nexus Pharmaceuticals, LLC | 14789-0110-05 | 1000 | $33.00 |
| Levetiracetam | Nexus Pharmaceuticals, LLC | 14789-0220-10 | 2000 | $66.00 |
| Levetiracetam | Nexus Pharmaceuticals, LLC | 14789-0330-15 | 3000 | $99.00 |
| Levetiracetam | Sagent Pharmaceuticals | 25021-0793-82 | 1000 | $33.00 |
Show all 40 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Levetiracetam | Sagent Pharmaceuticals | 25021-0794-82 | 2000 | $66.00 |
| Levetiracetam | Sagent Pharmaceuticals | 25021-0795-82 | 3000 | $99.00 |
| Levetiracetam | Baxter Healthcare Corporation | 36000-0352-40 | 2400 | $79.20 |
| Levetiracetam | Baxter Healthcare Corporation | 36000-0354-40 | 7200 | $237.60 |
| Levetiracetam | Baxter Healthcare Corporation | 36000-0356-40 | 4800 | $158.40 |
| Levetiracetam | Dr. Reddy's Laboratories Inc. | 43598-0635-10 | 1000 | $33.00 |
| Levetiracetam | Dr. Reddy's Laboratories Inc. | 43598-0636-10 | 2000 | $66.00 |
| Levetiracetam | Dr. Reddy's Laboratories Inc. | 43598-0637-10 | 3000 | $99.00 |
| Levetiracetam | Dr. Reddy's Laboratories Inc. | 43598-0755-10 | 1000 | $33.00 |
| Levetiracetam | Dr. Reddy's Laboratories Inc. | 43598-0757-10 | 2000 | $66.00 |
| Levetiracetam | Dr. Reddy's Laboratories Inc. | 43598-0759-10 | 3000 | $99.00 |
| Levetiracetam | WG Critical Care, LLC | 44567-0501-10 | 1000 | $33.00 |
| Levetiracetam | WG Critical Care, LLC | 44567-0501-90 | 1000 | $33.00 |
| Levetiracetam | WG Critical Care, LLC | 44567-0502-10 | 2000 | $66.00 |
| Levetiracetam | WG Critical Care, LLC | 44567-0503-10 | 3000 | $99.00 |
| Levetiracetam | Eugia US LLC | 55150-0246-47 | 1000 | $33.00 |
| Levetiracetam | Eugia US LLC | 55150-0247-47 | 2000 | $66.00 |
| Levetiracetam | Eugia US LLC | 55150-0248-47 | 3000 | $99.00 |
| Levetiracetam | Caplin Steriles USA Inc. | 65145-0173-10 | 1000 | $33.00 |
| Levetiracetam | Caplin Steriles USA Inc. | 65145-0174-10 | 2000 | $66.00 |
| Levetiracetam | Caplin Steriles USA Inc. | 65145-0175-10 | 3000 | $99.00 |
| Levetiracetam | FreseniUS Kabi USA, LLC | 65219-0042-71 | 2400 | $79.20 |
| Levetiracetam | FreseniUS Kabi USA, LLC | 65219-0044-71 | 4800 | $158.40 |
| Levetiracetam | FreseniUS Kabi USA, LLC | 65219-0046-71 | 7200 | $237.60 |
| Levetiracetam | Mylan Institutional LLC | 67457-0255-10 | 1000 | $33.00 |
| Levetiracetam | Mylan Institutional LLC | 67457-0265-10 | 2000 | $66.00 |
| Levetiracetam | Mylan Institutional LLC | 67457-0266-10 | 3000 | $99.00 |
| Levetiracetam | Somerset Pharma, LLC | 70069-0845-10 | 1000 | $33.00 |
| Levetiracetam | Somerset Pharma, LLC | 70069-0846-10 | 2000 | $66.00 |
| Levetiracetam | Somerset Pharma, LLC | 70069-0847-10 | 3000 | $99.00 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $0.033 | – | 5 MG | Inj levetirac sodi chlo 5 mg | v1, posted September 17, 2026 |
“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