Drug IndexCuvitru (Immune Globulin Subcutaneous (Human), 20% Solution)


Billing

Code: J1555

Description: Inj cuvitru, 100 mg

Unit: 100 MG

Payment: $16.820

Pay quarter: Q4 2024

Covered in Part D: No

Drug Cost

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Total WAC:

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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

00944-2850-01

CUVITRU (Takeda Pharmaceuticals America, Inc.)

1 VIAL, SINGLE-USE in 1 CARTON (0944-2850-01) / 5 mL in 1 VIAL, SINGLE-USE (0944-2850-02)


00944-2850-03

CUVITRU (Takeda Pharmaceuticals America, Inc.)

1 VIAL, SINGLE-USE in 1 CARTON (0944-2850-03) / 10 mL in 1 VIAL, SINGLE-USE (0944-2850-04)


00944-2850-05

CUVITRU (Takeda Pharmaceuticals America, Inc.)

1 VIAL, SINGLE-USE in 1 CARTON (0944-2850-05) / 20 mL in 1 VIAL, SINGLE-USE (0944-2850-06)


00944-2850-07

CUVITRU (Takeda Pharmaceuticals America, Inc.)

1 VIAL, SINGLE-USE in 1 CARTON (0944-2850-07) / 40 mL in 1 VIAL, SINGLE-USE (0944-2850-08)


00944-2850-09

CUVITRU (Takeda Pharmaceuticals America, Inc.)

1 BOTTLE, GLASS in 1 CARTON (0944-2850-09) / 50 mL in 1 BOTTLE, GLASS (0944-2850-10)


Prior Authorization

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