Drug IndexAvsola (Infliximab-Axxq)



Billing

Code: Q5121

Description: Inj. avsola, 10 mg

Unit: 10 MG

Payment: $21.290

Pay quarter: Q4 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

55513-0670-01

AVSOLA (Amgen Inc)

1 VIAL, SINGLE-DOSE in 1 CARTON (55513-670-01) / 10 mL in 1 VIAL, SINGLE-DOSE



Prior Authorization


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