Drug IndexAvsola (infliximab-axxq)
Billing
Code: Q5121
Description: Inj. avsola, 10 mg
Unit: 10 MG
Payment: $25.555
Pay quarter: Q1 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$1,500.00Total Reimbursement:
$766.65(ASP: $723.25, Margin: $43.40)
.
.# Units to bill:
30Dosage & Frequency
Crohn's Disease (CD)
Ulcerative Colitis (UC)
Ankylosing Spondylitis (AS)
Psoriatic Arthritis (PsA)
Plaque Psoriasis (Ps)
Induction:
• 5mg/kg IV at 0, 2, and 6 weeks
Maintenance:
• 5mg/kg IV every 8 weeks
Ulcerative Colitis (UC)
Ankylosing Spondylitis (AS)
Psoriatic Arthritis (PsA)
Plaque Psoriasis (Ps)
Induction:
• 5mg/kg IV at 0, 2, and 6 weeks
Maintenance:
• 5mg/kg IV every 8 weeks
Rheumatoid Arthritis (RA)
Induction:
• 3mg/kg IV at 0, 2, and 6 weeks
Maintenance:
• 3mg/kg IV every 8 weeks
Induction:
• 3mg/kg IV at 0, 2, and 6 weeks
Maintenance:
• 3mg/kg IV every 8 weeks
Billable NDCs
55513-0670-01
Avsola (AMGEN USA, INC.)
100 MG
Prior Authorization
Resources