Drug IndexFerrlecit (Sodium Ferric Gluconate Complex)



Billing

Code: J2916

Description: Na ferric gluconate complex

Unit: 12.5 MG

Payment: $2.137

Pay quarter: Q3 2024


Covered in Part D: No


Drug Cost

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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

00024-2792-10

Ferrlecit (sanofi-aventis U.S. LLC)

10 VIAL, SINGLE-USE in 1 CARTON (0024-2792-10) / 5 mL in 1 VIAL, SINGLE-USE (0024-2792-01)


00024-2794-10

Ferrlecit (sanofi-aventis U.S. LLC)

10 VIAL, SINGLE-USE in 1 CARTON (0024-2794-10) / 5 mL in 1 VIAL, SINGLE-USE (0024-2794-01)



Prior Authorization


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