Trogarzo (ibalizumab-uiyk)
Billing
Code: J1746
Description: Inj., ibalizumab-uiyk, 10 mg
Unit: 10 mg
Payment: $69.614
Pay quarter: Q1 2023
Dosage and Frequency
Human Immunodeficiency Virus Type 1 (HIV-1)
Loading dose:
• 2000mg IV
Maintenance:
• 800 mg every 2 weeks
Loading dose:
• 2000mg IV
Maintenance:
• 800 mg every 2 weeks
Calculate drug reimbursement
Total Reimbursement:
$5,903.27(ASP: $5,569.12, Margin: $334.15)
Code:
J1746# Units to bill:
80Prior Authorization
Prior auth criteria for Trogarzo may include but is not limited to:
Insurance prior auth guidelines:
Billable NDCs
62064-0122-02
Trogarzo (THERATECHNOLOGIES INC.)
400 MG
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