Drug IndexByooviz (Ranibizumab-Nuna)


Billing

Code: Q5124

Description: Inj. byooviz, 0.1 mg

Unit: 0.1 MG

Payment: $157.712

Pay quarter: Q3 2024

Covered in Part D: No

Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

(ASP: N/A, Margin: N/A)

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# Units to bill:

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Billable 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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