Drug IndexOrencia (Abatacept)


Billing

Code: J0129

Description: Abatacept injection

Unit: 10 MG

Payment: $43.437

Pay quarter: Q4 2024

Covered in Part D: Yes

Avg tier level: 4

Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

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

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# Units to bill:

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Billable NDCs

00003-2187-10

ORENCIA (E.R. Squibb & Sons, L.L.C.)

1 VIAL, SINGLE-USE in 1 CELLO PACK (0003-2187-10) / 15 mL in 1 VIAL, SINGLE-USE


00003-2187-13

ORENCIA (E.R. Squibb & Sons, L.L.C.)

1 VIAL, SINGLE-USE in 1 CARTON (0003-2187-13) / 15 mL in 1 VIAL, SINGLE-USE


00003-2188-11

ORENCIA (E.R. Squibb & Sons, L.L.C.)

4 SYRINGE, GLASS in 1 CARTON (0003-2188-11) / 1 mL in 1 SYRINGE, GLASS


00003-2188-21

ORENCIA (E.R. Squibb & Sons, L.L.C.)

1 SYRINGE, GLASS in 1 CARTON (0003-2188-21) / 1 mL in 1 SYRINGE, GLASS


00003-2188-50

ORENCIA (E.R. Squibb & Sons, L.L.C.)

1 SYRINGE, GLASS in 1 CARTON (0003-2188-50) / 1 mL in 1 SYRINGE, GLASS


00003-2188-51

ORENCIA (E.R. Squibb & Sons, L.L.C.)

4 SYRINGE, GLASS in 1 CARTON (0003-2188-51) / 1 mL in 1 SYRINGE, GLASS


00003-2188-90

ORENCIA (E.R. Squibb & Sons, L.L.C.)

1 SYRINGE, GLASS in 1 CARTON (0003-2188-90) / 1 mL in 1 SYRINGE, GLASS


00003-2188-91

ORENCIA (E.R. Squibb & Sons, L.L.C.)

1 SYRINGE, GLASS in 1 CARTON (0003-2188-91) / 1 mL in 1 SYRINGE, GLASS


00003-2814-11

ORENCIA (E.R. Squibb & Sons, L.L.C.)

4 SYRINGE, GLASS in 1 CARTON (0003-2814-11) / .4 mL in 1 SYRINGE, GLASS


00003-2818-11

ORENCIA (E.R. Squibb & Sons, L.L.C.)

4 SYRINGE, GLASS in 1 CARTON (0003-2818-11) / .7 mL in 1 SYRINGE, GLASS


Prior Authorization

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