Drug IndexCutaquig (Immune Globulin Subcutaneous (Human))


Billing

Code: J1551

Description: Inj cutaquig 100 mg

Unit: 100 MG

Payment: $14.534

Pay quarter: Q3 2024

Covered in Part D: No

Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

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

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# Units to bill:

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Billable NDCs

00069-1061-02

CUTAQUIG (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, GLASS in 1 CARTON (0069-1061-02) / 6 mL in 1 VIAL, GLASS (0069-1061-01)


00069-1476-02

CUTAQUIG (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, GLASS in 1 CARTON (0069-1476-02) / 12 mL in 1 VIAL, GLASS (0069-1476-01)


00069-1509-02

CUTAQUIG (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, GLASS in 1 CARTON (0069-1509-02) / 24 mL in 1 VIAL, GLASS (0069-1509-01)


00069-1802-02

CUTAQUIG (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, GLASS in 1 CARTON (0069-1802-02) / 10 mL in 1 VIAL, GLASS (0069-1802-01)


00069-1960-02

CUTAQUIG (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, GLASS in 1 CARTON (0069-1960-02) / 20 mL in 1 VIAL, GLASS (0069-1960-01)


00069-1965-02

CUTAQUIG (Pfizer Laboratories Div Pfizer Inc)

1 VIAL, GLASS in 1 CARTON (0069-1965-02) / 48 mL in 1 VIAL, GLASS (0069-1965-01)


68982-0810-01

CUTAQUIG (Octapharma USA Inc)

1 VIAL, GLASS in 1 CARTON (68982-810-01) / 6 mL in 1 VIAL, GLASS (68982-810-81)


68982-0810-02

CUTAQUIG (Octapharma USA Inc)

1 VIAL, GLASS in 1 CARTON (68982-810-02) / 10 mL in 1 VIAL, GLASS (68982-810-82)


68982-0810-03

CUTAQUIG (Octapharma USA Inc)

1 VIAL, GLASS in 1 CARTON (68982-810-03) / 12 mL in 1 VIAL, GLASS (68982-810-83)


68982-0810-04

CUTAQUIG (Octapharma USA Inc)

1 VIAL, GLASS in 1 CARTON (68982-810-04) / 20 mL in 1 VIAL, GLASS (68982-810-84)


68982-0810-05

CUTAQUIG (Octapharma USA Inc)

1 VIAL, GLASS in 1 CARTON (68982-810-05) / 24 mL in 1 VIAL, GLASS (68982-810-85)


68982-0810-06

CUTAQUIG (Octapharma USA Inc)

1 VIAL, GLASS in 1 CARTON (68982-810-06) / 48 mL in 1 VIAL, GLASS (68982-810-86)


Prior Authorization

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