Drug IndexCimerli (Ranibizumab-Eqrn)
Billing
Code: Q5128
Description: Inj, cimerli, 0.1 mg
Unit: 0.1 MG
Payment: $201.011
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)
.
.# Units to bill:
N/ABillable 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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