Drug IndexCimerli (Ranibizumab-Eqrn)



Billing

Code: Q5128

Description: Inj, cimerli, 0.1 mg

Unit: 0.1 MG

Payment: $204.567

Pay quarter: Q3 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

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Total Reimbursement:

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

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# Units to bill:

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Billable NDCs

70114-0440-01

CIMERLI (Coherus BioSciences Inc)

1 VIAL, SINGLE-DOSE in 1 CARTON (70114-440-01) / .05 mL in 1 VIAL, SINGLE-DOSE


70114-0441-01

CIMERLI (Coherus BioSciences Inc)

1 VIAL, SINGLE-DOSE in 1 CARTON (70114-441-01) / .05 mL in 1 VIAL, SINGLE-DOSE



Prior Authorization


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