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Ilumya (tildrakizumab-asmn)


Billing

Code: J3245

Description: Inj., tildrakizumab, 1 mg

Unit: 1 mg

Payment: $142.222

Pay quarter: Q4 2023


Medicare history

Dosage and Frequency

Calculate drug reimbursement


Total Reimbursement:

$14,222.20

(ASP: $13,417.17, Margin: $805.03)


Code:

J3245

# Units to bill:

100

Prior Authorization

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





Insurance prior auth guidelines:


Billable NDCs

47335-0177-95

Ilumya (SUN PHARMACEUTICAL GLOBAL FZE.)

100 MG



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