Why is the comparison with Medicare for ORENCIA 125 MG/ML SYRINGE labelled estimated?

Beyond what the card shows, the records give these reasons: Squibb & Sons, L.L.C., is listed for HCPCS J0129 on the CMS crosswalk, but the payment limit file’s Notes for the code say “"lesser of" methodology applied”, so the limit is not worked out from that company’s own sales price alone.

Why does this page start at 4 mL?

NADAC prices this product per ML. The FDA NDC Directory’s package description gives 4 mL in one package for this product’s NDC (“4 SYRINGE, GLASS in 1 CARTON (0003-2188-11) / 1 mL in 1 SYRINGE, GLASS”), so the card starts at one package: 4 ML. Change it to match your prescription.

ORENCIA 125 MG/ML SYRINGE

FDA nonproprietary name: abatacept

For 4 mL

Pharmacies pay

$5,876.91 filed

4 × $1,469.228 per ML

CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17

Medicare Part B pays

$2,296.85 derived

4 × $574.2125 per ML, Part B limit

Medicare's price is not your price.

OpenBill calculation · october-2026-medicare-part-b-payment-limit-files-final.zip + october-2026-ndc-hcpcs-crosswalk-final.zip · Part B limit 2026-10-01 to 2026-12-31 (file of 2026-09-17, retrieved 2026-10-18) · Part B crosswalk 2026-10-01 to 2026-12-31 (file of 2026-09-17, retrieved 2026-10-18)

The spread

0.39× estimated

Medicare pays 61% less than pharmacies pay.

Only one labeler, E.R.

OpenBill calculation · october-2026-medicare-part-b-payment-limit-files-final.zip + october-2026-ndc-hcpcs-crosswalk-final.zip + nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17) · Part B limit 2026-10-01 to 2026-12-31 (file of 2026-09-17, retrieved 2026-10-18) · Part B crosswalk 2026-10-01 to 2026-12-31 (file of 2026-09-17, retrieved 2026-10-18)

Cost-plus estimate

$6,763.45 estimated

$5,876.91 + $881.54 (15%) + $5.00 fee per fill = $6,763.45

This is a model, not a price any pharmacy quoted. Shipping is not included. How it is worked out

OpenBill calculation · nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17)

Open the interactive card Change the quantity, type what you were charged, and see every record in full.

What it is

ORENCIA 125 MG/ML SYRINGE is how the CMS NADAC file names this product. The FDA NDC Directory lists it as abatacept, under the trade name “ORENCIA”.

FDA gives its dosage form as injection, solution and its route as subcutaneous.

The labeler, the company named on the label, is E.R. Squibb & Sons, L.L.C.

FDA’s Established Pharmacologic Class for it is Selective T Cell Costimulation Modulator.

The NADAC file of 2026-10-14 prices it under one NDC (National Drug Code), 00003-2188-11.

NADAC classes it as a brand-name drug (rate-setting class B), and does not mark it as sold over the counter.

What pharmacies pay

Pharmacies pay $5,876.91 for 4 mL (4 × $1,469.228 per ML, rounded to the cent), by the CMS NADAC file of 2026-10-14; that price took effect on 2026-09-23. That is what pharmacies pay their suppliers, not what they charge you.

NADAC’s explanation codes for it: 1, calculated from the most recently completed pharmacy survey; 5, calculated based on package size.

What NADAC measures · NADAC explanation codes

The NDC

00003-2188-11 · E.R. Squibb & Sons, L.L.C. · $1,469.228 per ML · eff. 2026-09-23 filed

Other strengths, forms and brands

1 other product in the NADAC file shares the FDA nonproprietary name abatacept with ORENCIA 125 MG/ML SYRINGE.

Product	Pharmacies pay per unit	Medicare per unit
ORENCIA 125 MG/ML SYRINGE this page brand · injection, solution	$1,469.228 per ML filed eff. 2026-09-23	$574.2125 per ML derived Part B limit 2026 Q4
ORENCIA CLICKJECT 125 MG/ML brand · injection, solution	$1,471.08642 per ML filed eff. 2026-09-23	$574.2125 per ML derived Part B limit 2026 Q4

CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17

What Medicare paid

Medicare Part B’s payment limit for HCPCS J0129, for 2026-10-01 to 2026-12-31, comes to $2,296.85 for 4 mL, or $574.2125 per ML once converted to NADAC’s unit for this product.

Medicare Part B pays for a drug like this only in specific settings, such as a drug given in a clinic or doctor’s office or used with certain medical equipment; most prescriptions filled at a pharmacy are paid by Part D.

The patient’s share under Part B (coinsurance, 20% of the limit, before deductibles and other coverage) is $9.1874 per 10 MG.

Medicare's price is not your price.

What the Part B payment limit is · Converting it to the NADAC unit · How the spread is worked out

What to ask at the counter

None of these figures is your price: what you pay depends on your pharmacy, your insurance, coupons and discounts.

What is your cash price for 4 mL? Is it lower than what I would pay through my insurance?
How much is in the package I am getting? This page uses 4 mL; your package may hold a different amount.
If you have Medicare Part B: is this drug covered for me in this setting, and what is my share?
These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.

Questions

Why is the comparison with Medicare for ORENCIA 125 MG/ML SYRINGE labelled estimated?: Beyond what the card shows, the records give these reasons: Squibb & Sons, L.L.C., is listed for HCPCS J0129 on the CMS crosswalk, but the payment limit file’s Notes for the code say “"lesser of" methodology applied”, so the limit is not worked out from that company’s own sales price alone.
Why does this page start at 4 mL?: NADAC prices this product per ML. The FDA NDC Directory’s package description gives 4 mL in one package for this product’s NDC (“4 SYRINGE, GLASS in 1 CARTON (0003-2188-11) / 1 mL in 1 SYRINGE, GLASS”), so the card starts at one package: 4 ML. Change it to match your prescription.

Its pharmacologic class

Selective T Cell Costimulation Modulator 2 products