Drug IndexPrivigen (IVIG)
Billing
Code: J1459
Description: Inj ivig privigen 500 mg
Unit: 500 MG
Payment: $47.858
Pay quarter: Q2 2024
Covered in Part D: Yes
Avg tier level: 4
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$5,278.20Total Reimbursement:
$2,871.48(ASP: $2,708.94, Margin: $162.54)
.
.# Units to bill:
60Dosage & Frequency
Billable NDCs
44206-0436-05
Privigen (CSL BEHRING LLC)
5000 MG
44206-0437-10
Privigen (CSL BEHRING LLC)
10000 MG
44206-0438-20
Privigen (CSL BEHRING LLC)
20000 MG
44206-0439-40
Privigen (CSL BEHRING LLC)
40000 MG
Prior Authorization
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