Drug IndexIlumya (Tildrakizumab-Asmn)



Billing

Code: J3245

Description: Inj., tildrakizumab, 1 mg

Unit: 1 MG

Payment: $133.551

Pay quarter: Q3 2024


Covered in Part D: Yes

Avg tier level: 4


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

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

47335-0177-01

ILUMYA (Sun Pharmaceutical Industries, Inc.)

1 mL in 1 SYRINGE, GLASS (47335-177-01)


47335-0177-10

ILUMYA (Sun Pharmaceutical Industries, Inc.)

1 mL in 1 CARTON (47335-177-10)


47335-0177-95

ILUMYA (Sun Pharmaceutical Industries, Inc.)

1 mL in 1 CARTON (47335-177-95)


47335-0177-96

ILUMYA (Sun Pharmaceutical Industries, Inc.)

1 mL in 1 SYRINGE, GLASS (47335-177-96)



Prior Authorization


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