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    HCPCS Details

    HCPC Q5103
    Short Description Injection, inflectra
    Long Description Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
    Pricing indicator 51
    Coverage code D
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2018-04-01
    Date Added 2018-04-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00069080901 Q5103 Injection, inflectra Inflectra PFIZER INC. 10 MG 1 1 10 10
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 10 MG
    HCPCS/CPT Billing Units 0.1
    Total doses ordered
    Billing Units 0.1

    Drug Details

    • Infliximab injection products are used to relieve the symptoms of certain autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage) including:

      • rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) that is also being treated with methotrexate (Rheumatrex, Trexall),

      • Crohn's disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) in adults and children 6 years of age or older that has not improved when treated with other medications,

      • ulcerative colitis (condition that causes swelling and sores in the lining of the large intestine) in adults and children 6 years of age or older that has not improved when treated with other medications,

      • ankylosing spondylitis (a condition in which the body attacks the joints of the spine and other areas causing pain and joint damage),

      • plaque psoriasis (a skin disease in which red, scaly patches form on some areas of the body) in adults when other treatments are less appropriate,

      • and psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin).

    • Infliximab injection products are in a class of medications called tumor necrosis factor-alpha (TNF-alpha) inhibitors. They work by blocking the action of TNF-alpha, a substance in the body that causes inflammation.