Byooviz (ranibizumab-nuna)
Billing
Code: Q5124
Description: Inj. byooviz, 0.1 mg
Unit: 0.1 mg
Payment: $235.950
Pay quarter: Q1 2023
Dosage and Frequency
Neovascular (Wet) Age-Related Macular Degeneration (AMD)
Macular Edema Following Retinal Vein Occlusion(RVO)
• 0.5mg IVT every 1 month
Macular Edema Following Retinal Vein Occlusion(RVO)
• 0.5mg IVT every 1 month
Myopic Choroidal Neovascularization (mCNV)
• 0.5mg IVT every 1 month for up to 3 months
• 0.5mg IVT every 1 month for up to 3 months
Calculate drug reimbursement
Total Reimbursement:
$1,250.53(ASP: $1,179.75, Margin: $70.79)
Code:
Q5124# Units to bill:
5Prior Authorization
Prior auth criteria for Byooviz may include but is not limited to:
Insurance prior auth guidelines:
Billable NDCs
64406-0019-01
Byooviz (Biogen)
0.5 mg
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