Drug IndexTrogarzo (Ibalizumab)



Billing

Code: J1746

Description: Inj., ibalizumab-uiyk, 10 mg

Unit: 10 MG

Payment: $74.645

Pay quarter: Q2 2024


Covered in Part D: No


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

62064-0122-02

TROGARZO (Theratechnologies Inc.)

2 VIAL, SINGLE-USE in 1 CARTON (62064-122-02) / 1.33 mL in 1 VIAL, SINGLE-USE (62064-122-01)



Prior Authorization


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