Drug IndexAsceniv (Immune Globulin Intravenous, Human - Slra)



Billing

Code: J1554

Description: Inj. asceniv

Unit: 500 MG

Payment: $491.404

Pay quarter: Q4 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

(ASP: N/A, Margin: N/A)

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# Units to bill:

N/A

Billable NDCs

69800-0250-01

ASCENIV (ADMA Biologics, Inc.)

1 VIAL, SINGLE-USE in 1 CARTON (69800-0250-1) / 50 mL in 1 VIAL, SINGLE-USE (69800-0250-2)



Prior Authorization


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