Drug IndexVabysmo (Faricimab)


Billing

Code: J2777

Description: Inj, faricimab-svoa, 0.1mg

Unit: 0.1 MG

Payment: $34.247

Pay quarter: Q4 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

50242-0096-01

VABYSMO (Genentech, Inc.)

1 VIAL in 1 CARTON (50242-096-01) / .05 mL in 1 VIAL (50242-096-03)


50242-0096-06

VABYSMO (Genentech, Inc.)

1 SYRINGE in 1 CARTON (50242-096-06) / .05 mL in 1 SYRINGE


50242-0096-45

VABYSMO (Genentech, Inc.)

1 SYRINGE in 1 CARTON (50242-096-45) / .05 mL in 1 SYRINGE


50242-0096-86

VABYSMO (Genentech, Inc.)

1 VIAL in 1 CARTON (50242-096-86) / .05 mL in 1 VIAL (50242-096-77)


Prior Authorization

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