Drug IndexHizentra (SCIG)
Billing
Code: J1559
Description: Hizentra injection
Unit: 100 MG
Payment: $12.907
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$6,597.30Total Reimbursement:
$3,872.10(ASP: $3,652.92, Margin: $219.18)
.
.# Units to bill:
300Dosage & Frequency
Billable NDCs
44206-0451-01
Hizentra (CSL BEHRING LLC)
1000 MG
44206-0452-02
Hizentra (CSL BEHRING LLC)
2000 MG
44206-0454-04
Hizentra (CSL BEHRING LLC)
4000 MG
44206-0455-10
Hizentra (CSL BEHRING LLC)
10000 MG
44206-0456-21
Hizentra (CSL BEHRING LLC)
1000 MG
44206-0457-22
Hizentra (CSL BEHRING LLC)
2000 MG
44206-0458-24
Hizentra (CSL BEHRING LLC)
4000 MG
Prior Authorization
Resources