Hydroxyzine hcl injection
Products billed under this code include Hydroxyzine HCl.
Payment limit per 25 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 J3410
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 |
|---|---|---|---|---|
| Hydroxyzine HCl | Henry Schein Inc. | 00404-9877-01 | 2 | $28.226 |
| Hydroxyzine HCl | Henry Schein Inc. | 00404-9878-02 | 4 | $56.452 |
| Hydroxyzine HCl | American Regent, Inc. | 00517-4201-25 | 25 | $352.825 |
| Hydroxyzine HCl | American Regent, Inc. | 00517-5601-25 | 50 | $705.65 |
| Hydroxyzine HCl | American Regent, Inc. | 00517-5602-25 | 100 | $1,411.30 |
| Hydroxyzine HCl | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1649-03 | 25 | $352.825 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $14.113 | −$1.096 | 25 MG | Hydroxyzine hcl injection | v1, posted September 17, 2026 |
| 3Q26 | $15.209 | +$0.044 | 25 MG | Hydroxyzine hcl injection | v1, posted September 15, 2026 |
| 2Q26 | $15.165 | +$2.165 | 25 MG | Hydroxyzine hcl injection | v1, posted September 15, 2026 |
| 1Q26 | $13.00 | −$2.297 | 25 MG | Hydroxyzine hcl injection | v1, posted September 15, 2026 |
| 4Q25 | $15.297 | −$1.631 | 25 MG | Hydroxyzine hcl injection | v1, posted September 8, 2026 |
| 3Q25 | $16.928 | −$0.832 | 25 MG | Hydroxyzine hcl injection | v1, posted March 10, 2026 |
| 2Q25 | $17.76 | +$5.45 | 25 MG | Hydroxyzine hcl injection | v1, posted March 10, 2026 |
| 1Q25 | $12.31 | −$0.095 | 25 MG | Hydroxyzine hcl injection | v1, posted December 19, 2025 |
| 4Q24 | $12.405 | −$2.098 | 25 MG | Hydroxyzine hcl injection | v1, posted June 11, 2025 |
| 3Q24 | $14.503 | +$0.634 | 25 MG | Hydroxyzine hcl injection | v1, posted June 11, 2025 |
| 2Q24 | $13.869 | +$3.961 | 25 MG | Hydroxyzine hcl injection | v1, posted March 11, 2025 |
| 1Q24 | $9.908 | −$3.242 | 25 MG | Hydroxyzine hcl injection | v1, posted December 19, 2024 |
| 4Q23 | $13.15 | −$0.472 | 25 MG | Hydroxyzine hcl injection | v1, posted October 10, 2024 |
| 3Q23 | $13.622 | +$0.517 | 25 MG | Hydroxyzine hcl injection | v1, posted June 5, 2024 |
| 2Q23 | $13.105 | +$2.429 | 25 MG | Hydroxyzine hcl injection | v1, posted February 23, 2024 |
| 1Q23 | $10.676 | −$0.66 | 25 MG | Hydroxyzine hcl injection | v1, posted December 6, 2023 |
| 4Q22 | $11.336 | +$0.561 | 25 MG | Hydroxyzine hcl injection | v1, posted June 22, 2023 |
| 3Q22 | $10.775 | +$1.025 | 25 MG | Hydroxyzine hcl injection | v1, posted June 9, 2023 |
| 2Q22 | $9.75 | +$1.32 | 25 MG | Hydroxyzine hcl injection | v1, posted December 14, 2022 |
| 1Q22 | $8.43 | −$0.598 | 25 MG | Hydroxyzine hcl injection | v1, posted June 8, 2022 |
| 4Q21 | $9.028 | −$0.651 | 25 MG | Hydroxyzine hcl injection | v1, posted June 2, 2022 |
| 3Q21 | $9.679 | +$1.331 | 25 MG | Hydroxyzine hcl injection | v1, posted June 2, 2022 |
| 2Q21 | $8.348 | +$0.049 | 25 MG | Hydroxyzine hcl injection | v1, posted March 1, 2022 |
| 1Q21 | $8.299 | – | 25 MG | Hydroxyzine hcl 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.
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