Drug IndexBeovu (brolucizumab-dbll)
Billing
Code: J0179
Description: Inj, brolucizumab-dbll, 1 mg
Unit: 1 MG
Payment: $325.679
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$1,924.74Total Reimbursement:
$1,954.07(ASP: $1,843.47, Margin: $110.61)
.
.# Units to bill:
6Dosage & Frequency
Neovascular (Wet) Age-related Macular Degeneration (AMD)
Induction:
• 6mg IVT every 4 weeks for the first 3 doses
Maintenance:
• 6mg IVT every 8-12 weeks
Induction:
• 6mg IVT every 4 weeks for the first 3 doses
Maintenance:
• 6mg IVT every 8-12 weeks
Diabetic Macular Edema (DME)
Induction:
• 6mg IVT every 6 weeks for the first 5 doses
Maintenance:
• 6mg IVT every 8-12 weeks
Induction:
• 6mg IVT every 6 weeks for the first 5 doses
Maintenance:
• 6mg IVT every 8-12 weeks
Billable NDCs
00078-0827-60
Beovu (NOVARTIS PHARMACEUTICALS CORP.)
6 MG
00078-0827-61
Beovu (NOVARTIS PHARMACEUTICALS CORPORATION)
6 MG
Prior Authorization
Resources