Drug IndexReclast (zoledronic acid)
Billing
Code: J3489
Description: Zoledronic acid 1mg
Unit: 1 MG
Payment: $6.935
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$1,191.13Total Reimbursement:
$34.68(ASP: $32.71, Margin: $1.96)
.
.# Units to bill:
5Dosage & Frequency
• 5mg IV every 1 year
Billable NDCs
00078-0435-61
Reclast (NOVARTIS PHARMACEUTICALS CORPORATION)
5 MG
00409-4215-01
ZOLEDRONIC ACID (PFIZER INC.)
4 MG
16714-0815-01
ZOLEDRONIC ACID (NORTHSTAR RX LLC)
4 MG
16729-0242-31
ZOLEDRONIC ACID (ACCORD HEALTHCARE INC.)
4 MG
25021-0801-66
ZOLEDRONIC ACID (SAGENT PHARMACEUTICALS INC)
4 mg
25021-0826-67
ZOLEDRONIC ACID (SAGENT PHARMACEUTICALS INC)
4 MG
25021-0826-82
ZOLEDRONIC ACID (SAGENT PHARMACEUTICALS INC)
4 MG
25021-0830-82
ZOLEDRONIC ACID (SAGENT PHARMACEUTICALS INC)
5 MG
43598-0233-11
ZOLEDRONIC ACID (DR.REDDY'S LABORATORIES, INC.)
4 MG
50742-0416-05
ZOLEDRONIC ACID (INGENUS PHARMACEUTICALS, LLC)
4 MG
51991-0064-98
ZOLEDRONIC ACID (BRECKENRIDGE PHARMACEUTICAL)
5 MG
51991-0065-98
ZOLEDRONIC ACID (BRECKENRIDGE PHARMACEUTICAL)
4 MG
55111-0685-07
ZOLEDRONIC ACID (DR. REDDY'S LABORATORIES, INC.)
4 mg
55111-0688-52
ZOLEDRONIC ACID (DR. REDDY'S LABORATORIES, INC.)
5 MG
63323-0961-98
ZOLEDRONIC ACID (FRESENIUS KABI)
4 MG
63323-0966-00
ZOLEDRONIC ACID (FRESENIUS KABI)
5 MG
67457-0390-54
ZOLEDRONIC ACID (MYLAN INSTITUTIONAL LLC)
4 MG
67457-0619-10
ZOLEDRONIC ACID (MYLAN INSTITUTIONAL LLC)
5 MG
67457-0794-10
ZOLEDRONIC ACID (MYLAN INSTITUTIONAL LLC)
5 MG
67457-0920-05
ZOLEDRONIC ACID (MYLAN INSTITUTIONAL LLC)
4 MG
68001-0437-25
ZOLEDRONIC ACID (BLUEPOINT LABORATORIES)
4 MG
70860-0210-51
ZOLEDRONIC ACID (ATHENEX)
4 MG
70860-0802-82
ZOLEDRONIC ACID (ATHENEX)
5 MG
71288-0806-51
ZOLEDRONIC ACID (MEITHEAL PHARMACEUTICALS, INC.)
5 MG
72266-0152-01
Zoledronic Acid (FOSUN PHARMA USA INC.)
5 MG
Prior Authorization
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