Tools
Workflow tools for infusion pharmacists, billers, and directors. Every number comes from a public CMS or FDA file shown on the page; nothing you enter is stored.
Billing-unit calculator
Pharmacists and billersDose to HCPCS units with the formula shown, plus the CMS MUE check, JW/JZ claim lines with the NDC segment, a vial optimizer with dose-rounding options, and a printable worksheet.Vial barcode scanner
Pharmacists and techniciansScan the 2D barcode on a vial or carton with your phone camera, a photo, or a USB scanner: NDC, HCPCS code, billable units, container type, Medicaid unit type, lot, and expiry — straight into the calculator.Chargemaster & formulary audit
Revenue integrity and pharmacy directorsPaste or upload HCPCS codes and NDCs (or code–NDC pairs) and see terminated codes, NDCs missing from the CMS crosswalk, mismatched pairs, FDA listing problems, payment limits, and MUEs. Export to CSV.Margin analyzer
Directors and financeCompare your own acquisition cost with the Medicare Part B payment (ASP-based limit, net of sequestration) per billing unit and per package, and find drugs that are underwater. Your costs never leave your browser.Site of care: HOPD vs home
Infusion and pharmacy directorsMonthly revenue for one therapy in your hospital outpatient department versus your home infusion pharmacy (no Medicare HIT certification), for Medicare, Washington Apple Health, and your commercial contracts — from CMS OPPS rates, the HCA schedule, and terms you enter.Part B vs Part D
Pharmacists, billers, and intakeWhich Medicare benefit pays for a drug in each setting, with the CMS source for every answer: Noridian's self-administered drug list, DME policies, Washington Part D plan coverage, and the dollars for each lawful pathway.MultiCare price benchmark
Contracting and financeWhat MultiCare's Washington hospitals have negotiated for a drug, per CMS billing unit and as a percent of the Medicare payment limit, by plan type — from their federally required price transparency files. No payer names.Biosimilar comparator
Formulary and P&T committeesReference biologics side by side with their FDA-licensed biosimilars, plus a switch simulator: annual Medicare payment, patient coinsurance, and margin when part of the volume moves to a biosimilar.What changed this quarter
Everyone who maintains a chargemasterPayment-limit movers, new and terminated drug codes, codes added to or dropped from the payment file, and NDCs added to or removed from the CMS crosswalk — with a personal watchlist and an RSS feed.Referral intake card
Intake and prior-authorization staffOne printable page per drug code: billing unit, MUEs, NDCs with claim unit qualifiers, the Medicare hospital and home payment path, Washington Apple Health prior authorization, and related biologics. No patient fields.
Disclaimer. This application provides informational coding and reimbursement reference data. It does not constitute legal, clinical, coding, or billing advice. Codes, payment amounts, payer rules, and coverage policies can change. Verify all information with current CMS publications, the applicable payer, and your organization’s compliance policies before submitting a claim. CodeRx is not affiliated with or endorsed by CMS, FDA, Medicare, or any payer.