Drug IndexByooviz (Ranibizumab-Nuna)
Billing
Code: Q5124
Description: Inj. byooviz, 0.1 mg
Unit: 0.1 MG
Payment: $170.799
Pay quarter: Q4 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
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.# Units to bill:
N/ABillable NDCs
64406-0019-01
Byooviz (Biogen Inc.)
1 VIAL, SINGLE-DOSE in 1 CARTON (64406-019-01) / .05 mL in 1 VIAL, SINGLE-DOSE (64406-019-07)
64406-0019-08
Byooviz (Biogen Inc.)
1 VIAL, SINGLE-DOSE in 1 CARTON (64406-019-08) / .05 mL in 1 VIAL, SINGLE-DOSE (64406-019-09)
Prior Authorization
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