Drug IndexCuvitru (SCIG)



Billing

Code: J1555

Description: Inj cuvitru, 100 mg

Unit: 100 MG

Payment: $15.827

Pay quarter: Q2 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$6,734.10

Total Reimbursement:

$4,748.10

(ASP: $4,479.34, Margin: $268.76)

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# Units to bill:

300

Dosage & Frequency


Billable NDCs

00944-2850-01

CUVITRU (TAKEDA PHARMACEUTICALS AMERICA, INC.)

1000 MG


00944-2850-03

CUVITRU (TAKEDA PHARMACEUTICALS AMERICA, INC.)

2000 MG


00944-2850-05

CUVITRU (TAKEDA PHARMACEUTICALS AMERICA, INC.)

4000 MG


00944-2850-07

CUVITRU (TAKEDA PHARMACEUTICALS AMERICA, INC.)

8000 MG


00944-2850-09

Cuvitru (TAKEDA PHARMACEUTICALS AMERICA, INC.)

10000 MG



Prior Authorization

Aetna

United Healthcare

Anthem

Cigna


Resources

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