Drug IndexXembify (SCIG)
Billing
Code: J1558
Description: Inj. xembify, 100 mg
Unit: 100 MG
Payment: $14.132
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$5,286.00Total Reimbursement:
$4,239.60(ASP: $3,999.62, Margin: $239.98)
.
.# Units to bill:
300Dosage & Frequency
Billable NDCs
13533-0810-05
Xembify (GRIFOLS USA, LLC)
1000 MG
13533-0810-10
Xembify (GRIFOLS USA, LLC)
2000 MG
13533-0810-20
Xembify (GRIFOLS USA, LLC)
4000 MG
13533-0810-50
Xembify (GRIFOLS USA, LLC)
10000 MG
Prior Authorization
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