Drug IndexFerrlecit (Sodium ferric gluconate complex)
Billing
Code: J2916
Description: Na ferric gluconate complex
Unit: 12.5 MG
Payment: $2.184
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$63.60Total Reimbursement:
$21.84(ASP: $20.60, Margin: $1.24)
.
.# Units to bill:
10Dosage & Frequency
Iron Deficiency Anemia (IDA)
• 125mg IV
• 1.5mg/kg IV for pediatric patients
• 125mg IV
• 1.5mg/kg IV for pediatric patients
Billable NDCs
00024-2792-10
Ferrlecit (SANOFI-AVENTIS)
625 MG
00024-2794-10
Ferrlecit (SANOFI-AVENTIS)
625 MG
00143-9298-10
SODIUM FERRIC GLUCONATE (HIKMA PHARMACEUTICALS USA INC.)
625 MG
00143-9570-10
SODIUM FERRIC GLUCONATE (HIKMA PHARMACEUTICALS USA INC.)
625 MG
Prior Authorization
Resources