Drug IndexTepezza (teprotumumab-trbw)
Billing
Code: J3241
Description: Inj. teprotumumab-trbw 10 mg
Unit: 10 MG
Payment: $333.401
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$47,760.90Total Reimbursement:
$50,010.15(ASP: $47,179.39, Margin: $2,830.76)
.
.# Units to bill:
150Dosage & Frequency
Thyroid Eye Disease
Induction:
• 10mg/kg IV
Maintenance:
• 20mg/kg IV every 3 weeks for 7 doses
Induction:
• 10mg/kg IV
Maintenance:
• 20mg/kg IV every 3 weeks for 7 doses
Billable NDCs
75987-0130-15
Tepezza (HORIZON)
500 MG
Prior Authorization
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