Drug IndexFasenra (benralizumab)
Billing
Code: J0517
Description: Inj., benralizumab, 1 mg
Unit: 1 MG
Payment: $165.247
Pay quarter: Q2 2024
Covered in Part D: Yes
Avg tier level: 4
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$5,676.75Total Reimbursement:
$4,957.41(ASP: $4,676.80, Margin: $280.61)
.
.# Units to bill:
30Dosage & Frequency
Severe asthma
Induction:
• 30mg SQ every 4 weeks for first 3 doses
Maintenance:
• 30mg SQ every 8 weeks
Induction:
• 30mg SQ every 4 weeks for first 3 doses
Maintenance:
• 30mg SQ every 8 weeks
Billable NDCs
00310-1730-30
Fasenra (ASTRAZENECA)
30 MG
00310-1830-30
Fasenra (ASTRAZENECA)
30 MG
Prior Authorization
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