Drug IndexRenflexis (infliximab-abda)



Billing

Code: Q5104

Description: Injection, renflexis

Unit: 10 MG

Payment: $30.579

Pay quarter: Q2 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$2,260.17

Total Reimbursement:

$917.37

(ASP: $865.44, Margin: $51.93)

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# Units to bill:

30

Dosage & Frequency

Crohn's Disease (CD)
Ulcerative Colitis (UC)
Ankylosing Spondylitis (AS)
Psoriatic Arthritis (PsA)
Plaque Psoriasis (Ps)

Induction:
• 5mg/kg IV at 0, 2, and 6 weeks

Maintenance:
• 5mg/kg IV every 8 weeks

Rheumatoid Arthritis (RA)

Induction:
• 3mg/kg IV at 0, 2, and 6 weeks

Maintenance:
• 3mg/kg IV every 8 weeks


Billable NDCs

00006-4305-02

Renflexis (MERCK SHARP & DOHME CORP.)

100 MG


78206-0162-01

Renflexis (ORGANON LLC)

100 MG



Prior Authorization

Aetna

United Healthcare

Anthem

Cigna


Resources

Drug Enrollment Form

Website