Drug IndexBoniva (ibandronate)
Billing
Code: J1740
Description: Ibandronate sodium injection
Unit: 1 MG
Payment: $31.713
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$250.00Total Reimbursement:
$95.14(ASP: $89.75, Margin: $5.39)
.
.# Units to bill:
3Dosage & Frequency
Postmenopausal Osteoporosis
• 3mg IV every 3 months
• 3mg IV every 3 months
Billable NDCs
25021-0827-61
IBANDRONATE SODIUM (SAGENT PHARMACEUTICALS INC)
3 MG
55150-0191-83
IBANDRONATE SODIUM (AUROMEDICS PHARMA LLC)
3 MG
60505-6097-00
IBANDRONATE SODIUM (APOTEX CORP.)
3 MG
67457-0524-33
IBANDRONATE SODIUM (MYLAN INSTITUTIONAL LLC)
3 MG
Prior Authorization
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