Drug IndexActemra (Tocilizumab)



Billing

Code: J3262

Description: Tocilizumab injection

Unit: 1 MG

Payment: $5.950

Pay quarter: Q3 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

(ASP: N/A, Margin: N/A)

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# Units to bill:

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Billable NDCs

50242-0135-01

ACTEMRA (Genentech, Inc.)

1 VIAL, SINGLE-USE in 1 BOX (50242-135-01) / 4 mL in 1 VIAL, SINGLE-USE


50242-0136-01

ACTEMRA (Genentech, Inc.)

1 VIAL, SINGLE-USE in 1 BOX (50242-136-01) / 10 mL in 1 VIAL, SINGLE-USE


50242-0137-01

ACTEMRA (Genentech, Inc.)

1 VIAL, SINGLE-USE in 1 BOX (50242-137-01) / 20 mL in 1 VIAL, SINGLE-USE



Prior Authorization


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