Drug IndexInflectra (Infliximab-Dyyb)



Billing

Code: Q5103

Description: Injection, inflectra

Unit: 10 MG

Payment: $10.663

Pay quarter: Q3 2024


Covered in Part D: No


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

00069-0809-01

INFLECTRA (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, SINGLE-USE in 1 CARTON (0069-0809-01) / 10 mL in 1 VIAL, SINGLE-USE



Prior Authorization


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