Drug IndexMonoferric (Ferric Derisomaltose)
Billing
Code: J1437
Description: Inj. fe derisomaltose 10 mg
Unit: 10 MG
Payment: $21.052
Pay quarter: Q4 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
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.# Units to bill:
N/ABillable NDCs
73594-9301-02
Monoferric (Pharmacosmos Therapeutics Inc.)
5 VIAL in 1 BOX (73594-9301-2) / 1 mL in 1 VIAL (73594-9301-3)
73594-9305-01
Monoferric (Pharmacosmos Therapeutics Inc.)
1 VIAL in 1 BOX (73594-9305-1) / 5 mL in 1 VIAL
73594-9310-01
Monoferric (Pharmacosmos Therapeutics Inc.)
1 VIAL in 1 BOX (73594-9310-1) / 10 mL in 1 VIAL
Prior Authorization
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