Drug IndexSkyrizi (Risankizumab-Rzaa)


Billing

Code: N/A

Description: N/A

Unit: N/A

Payment: Claims must be manually adjudicated

Pay quarter: N/A

Covered in Part D: Yes

Avg tier level: 4

Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

(ASP: N/A, Margin: N/A)

.

.

# Units to bill:

N/A

Billable NDCs

00074-1050-01

Skyrizi (AbbVie Inc.)

1 SYRINGE in 1 CARTON (0074-1050-01) / 1 mL in 1 SYRINGE


00074-1050-70

Skyrizi (AbbVie Inc.)

1 SYRINGE in 1 CARTON (0074-1050-70) / 1 mL in 1 SYRINGE


00074-1065-01

Skyrizi (AbbVie Inc.)

1 KIT in 1 CARTON (0074-1065-01) * 1.2 mL in 1 CARTRIDGE (0074-1066-02) * 1.2 mL in 1 CARTRIDGE (0074-1066-01)


00074-1065-02

Skyrizi (AbbVie Inc.)

1 KIT in 1 CARTON (0074-1065-02) * 1.2 mL in 1 CARTRIDGE (0074-1066-02) * 1.2 mL in 1 CARTRIDGE (0074-1066-01)


00074-1070-01

Skyrizi (AbbVie Inc.)

1 KIT in 1 CARTON (0074-1070-01) * 2.4 mL in 1 CARTRIDGE (0074-1069-02) * 2.4 mL in 1 CARTRIDGE (0074-1069-01)


00074-1070-02

Skyrizi (AbbVie Inc.)

1 KIT in 1 CARTON (0074-1070-02) * 2.4 mL in 1 CARTRIDGE (0074-1069-02) * 2.4 mL in 1 CARTRIDGE (0074-1069-01)


00074-2100-01

Skyrizi (AbbVie Inc.)

1 SYRINGE in 1 CARTON (0074-2100-01) / 1 mL in 1 SYRINGE


00074-2100-70

Skyrizi (AbbVie Inc.)

1 SYRINGE in 1 CARTON (0074-2100-70) / 1 mL in 1 SYRINGE


00074-7034-02

Skyrizi (AbbVie Inc.)

2 CARTON in 1 CARTON (0074-7034-02) / 1 KIT in 1 CARTON * 2 SYRINGE, GLASS in 1 CARTON (0074-7032-90) / 1 mL in 1 SYRINGE, GLASS (0074-7032-01)


00074-7036-04

Skyrizi (AbbVie Inc.)

4 CARTON in 1 CARTON (0074-7036-04) / 1 KIT in 1 CARTON * 1 mL in 1 SYRINGE, GLASS (0074-7032-01)


00074-7040-02

Skyrizi (AbbVie Inc.)

2 CARTON in 1 CARTON (0074-7040-02) / 1 KIT in 1 CARTON * 1 mL in 1 SYRINGE, GLASS (0074-7032-01)


00074-7042-04

Skyrizi (AbbVie Inc.)

4 CARTON in 1 CARTON (0074-7042-04) / 1 KIT in 1 CARTON * 1 mL in 1 SYRINGE, GLASS (0074-7032-01)


Prior Authorization

Resources