Drug IndexProvenge (Sipuleucel-T)
Billing
Code: Q2043
Description: Sipuleucel-t auto cd54+
Unit: 1 per
Payment: $55453.567
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$70,816.00Total Reimbursement:
$55,453.57(ASP: $52,314.69, Margin: $3,138.88)
.
.# Units to bill:
1Dosage & Frequency
Prostate cancer
• One dose IV every 2 weeks for 3 doses
• One dose IV every 2 weeks for 3 doses
Billable NDCs
30237-8900-06
PROVENGE (DENDREON PHARMACEUTICALS LLC)
0 Per infusion (minimum 50 million cells)
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