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October 2018
Overview of correct pharmacy benefit billing for Cimzia, Enbrel, Victoza
For accurate, quick reimbursement of your Cimzia®, Enbrel® and Victoza® prescription benefit claims, be sure to bill the strengths, quantities and days’ supply per package as follows:
Drug |
Bill by box quantity
(not syringe quantity) |
Days’ supply
per package |
Cimzia
200 mg/mL syringe kit |
1 box (2 syringes) |
28 |
2 boxes (4 syringes) |
56 |
Enbrel
50 mg/0.98 mL
(3.92 mL syringes) |
1 box (4 syringes) |
28 |
Victoza
dose per day |
Days’ supply
per pen |
Bill by package volume
(not pen quantity) |
Days’ supply per package |
0.6 mg |
30 |
6 mL (2 pens) |
60 |
9 mL (3 pens) |
90 |
1.2 mg |
15 |
6 mL (2 pens) |
30 |
9 mL (3 pens) |
45 |
1.8 mg |
10 |
6 mL (2 pens) |
20 |
9 mL (3 pens) |
30 |
If you have questions, contact our claims processor, Express Scripts®, at 1-800-922-1557. If you have any unresolved issues or other questions, contact our Pharmacy Services Clinical Help Desk at 1-800-437-3803. |
