Drug IndexEntyvio (Vedolizumab)
Billing
Code: N/A
Description: N/A
Unit: N/A
Payment: Claims must be manually adjudicated
Pay quarter: N/A
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
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.# Units to bill:
N/ABillable NDCs
64764-0107-11
ENTYVIO (Takeda Pharmaceuticals America, Inc.)
1 TRAY in 1 CARTON (64764-107-11) / 1 SYRINGE in 1 TRAY (64764-107-10) / .68 mL in 1 SYRINGE
64764-0108-21
ENTYVIO (Takeda Pharmaceuticals America, Inc.)
1 TRAY in 1 CARTON (64764-108-21) / 1 SYRINGE in 1 TRAY (64764-108-20) / .68 mL in 1 SYRINGE
Prior Authorization
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