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/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
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.# Units to bill:
N/ABillable 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
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