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Cinqair (reslizumab)


Billing

Code: J2786

Description: Injection, reslizumab, 1mg

Unit: 1 mg

Payment: $10.301

Pay quarter: Q4 2023


Medicare history

Dosage and Frequency

Severe asthma

• 3mg/kg IV every 4 weeks

Calculate drug reimbursement


Total Reimbursement:

$2,163.21

(ASP: $2,040.76, Margin: $122.45)


Code:

J2786

# Units to bill:

210

Prior Authorization

Prior auth criteria for Cinqair may include but is not limited to:


1. Diagnosis of asthma or COPD
2. Documented inadequate response to an appropriate trial of at least 2 maintenance medications
3. Age 18 years or older
4. FEV1/FVC < 70% or FEV1 < 80% predicted
5. Patient must not be pregnant or breastfeeding
6. Patient must not have been previously treated with Cinqair
7. Patient must not have any contraindications to Cinqair
8. Patient must not have any active infections or malignancies


Insurance prior auth guidelines:

Aetna

United Healthcare

Anthem

Cigna


Billable NDCs

59310-0610-31

CINQAIR (IVAX LABS INC.)

100 MG



Resources

Drug Enrollment Form

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