Vitamin k phytonadione inj
Products billed under this code include Phytonadione, Vitamin K1.
Payment limit per 1 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 Phytonadione, Vitamin K1.
Payment limit per 1 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 |
|---|---|---|---|---|
| Phytonadione | Henry Schein Inc. | 00404-9935-05 | 1 | $3.989 |
| Phytonadione | Henry Schein Inc. | 00404-9969-01 | 10 | $39.89 |
| Phytonadione | Baxter Healthcare Corp. | 43066-0132-10 | 10 | $39.89 |
| Phytonadione | Dr. Reddy's Laboratories Inc. | 43598-0405-16 | 250 | $997.25 |
| Phytonadione | FreseniUS Kabi USA, LLC | 65219-0635-01 | 100 | $398.90 |
| Phytonadione | Glenmark Pharmaceuticals Inc., USA | 68462-0758-25 | 250 | $997.25 |
| Phytonadione | Cipla USA, Inc. | 69097-0003-96 | 10 | $39.89 |
| Phytonadione | Cipla USA, Inc. | 69097-0708-96 | 100 | $398.90 |
| Phytonadione | Cipla USA, Inc. | 69097-0709-96 | 10 | $39.89 |
| Phytonadione | Amneal Pharmaceuticals, LLC | 70121-1682-07 | 10 | $39.89 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Phytonadione | Xiromed, LLC | 70700-0331-25 | 250 | $997.25 |
| Vitamin K1 | Pfizer Inc | 00409-9157-01 | 25 | $99.725 |
| Vitamin K1 | Pfizer Inc | 00409-9158-01 | 250 | $997.25 |
| Vitamin K1 | Pfizer Inc | 00409-9158-25 | 250 | $997.25 |
| Vitamin K1 | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1536-03 | 250 | $997.25 |
| Vitamin K1 | HF Acquisition Co. LLC, DBA HealthFirst | 51662-1537-03 | 25 | $99.725 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $3.989 | +$0.736 | 1 MG | Vitamin k phytonadione inj | v1, posted September 17, 2026 |
| 3Q26 | $3.253 | +$0.097 | 1 MG | Vitamin k phytonadione inj | v1, posted September 15, 2026 |
| 2Q26 | $3.156 | +$0.348 | 1 MG | Vitamin k phytonadione inj | v1, posted September 15, 2026 |
| 1Q26 | $2.808 | +$0.081 | 1 MG | Vitamin k phytonadione inj | v1, posted September 15, 2026 |
| 4Q25 | $2.727 | −$0.117 | 1 MG | Vitamin k phytonadione inj | v1, posted September 8, 2026 |
| 3Q25 | $2.844 | +$0.399 | 1 MG | Vitamin k phytonadione inj | v1, posted March 10, 2026 |
| 2Q25 | $2.445 | +$0.239 | 1 MG | Vitamin k phytonadione inj | v1, posted March 10, 2026 |
| 1Q25 | $2.206 | −$0.305 | 1 MG | Vitamin k phytonadione inj | v1, posted December 19, 2025 |
| 4Q24 | $2.511 | −$0.343 | 1 MG | Vitamin k phytonadione inj | v1, posted June 11, 2025 |
| 3Q24 | $2.854 | +$0.051 | 1 MG | Vitamin k phytonadione inj | v1, posted June 11, 2025 |
| 2Q24 | $2.803 | −$0.096 | 1 MG | Vitamin k phytonadione inj | v1, posted March 11, 2025 |
| 1Q24 | $2.899 | −$0.083 | 1 MG | Vitamin k phytonadione inj | v1, posted December 19, 2024 |
| 4Q23 | $2.982 | +$0.11 | 1 MG | Vitamin k phytonadione inj | v1, posted October 10, 2024 |
| 3Q23 | $2.872 | −$0.123 | 1 MG | Vitamin k phytonadione inj | v1, posted June 5, 2024 |
| 2Q23 | $2.995 | −$0.195 | 1 MG | Vitamin k phytonadione inj | v1, posted February 23, 2024 |
| 1Q23 | $3.19 | −$0.116 | 1 MG | Vitamin k phytonadione inj | v1, posted December 6, 2023 |
| 4Q22 | $3.306 | +$0.091 | 1 MG | Vitamin k phytonadione inj | v1, posted June 22, 2023 |
| 3Q22 | $3.215 | −$0.273 | 1 MG | Vitamin k phytonadione inj | v1, posted June 9, 2023 |
| 2Q22 | $3.488 | +$0.065 | 1 MG | Vitamin k phytonadione inj | v1, posted December 14, 2022 |
| 1Q22 | $3.423 | −$0.139 | 1 MG | Vitamin k phytonadione inj | v1, posted June 8, 2022 |
| 4Q21 | $3.562 | −$0.12 | 1 MG | Vitamin k phytonadione inj | v1, posted June 2, 2022 |
| 3Q21 | $3.682 | −$0.055 | 1 MG | Vitamin k phytonadione inj | v1, posted June 2, 2022 |
| 2Q21 | $3.737 | −$0.122 | 1 MG | Vitamin k phytonadione inj | v1, posted March 1, 2022 |
| 1Q21 | $3.859 | – | 1 MG | Vitamin k phytonadione inj | 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.