Drug IndexBivigam (IVIG)
Billing
Code: J1556
Description: Inj, imm glob bivigam, 500mg
Unit: 500 MG
Payment: $72.965
Pay quarter: Q2 2024
Covered in Part D: Yes
Avg tier level: 4
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$4,255.20Total Reimbursement:
$4,377.90(ASP: $4,130.09, Margin: $247.81)
.
.# Units to bill:
60Dosage & Frequency
Billable NDCs
69800-6502-01
BIVIGAM (ADMA BIOLOGICS)
5000 MG
69800-6503-01
BIVIGAM (ADMA BIOLOGICS)
10000 MG
Prior Authorization
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