Medication . Charged Approved
Pegfilgrastim $ .7,357.00 $ 3,828.10
Bevacizumab $. 6,950.00 $. 3,542.10
Epoetin alfa $. . .960.00 $ , , 493.24
Palonostron $. . .460.00 $ . ..214.69
Fosaprepitant $. . .450.00 $ . ..259.05
Oxaliplatin $. . .440.00 $ . . 154.80
Iron Dextran $. . .240.00 $. ...121.95
Leucovorin calcium $. . .147.00 $ . . . 80.56
Fluorouracil $ . .. .44.00 $. . . .19.88
Dexamethasone $. . . . .5.60 $ . . . ..2.76
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