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:

$47,760.90

Total Reimbursement:

$50,010.15

(ASP: $47,179.39, Margin: $2,830.76)

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# Units to bill:

150

Dosage & Frequency

Thyroid Eye Disease

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

Aetna

United Healthcare

Anthem

Cigna


Resources

Website