IDHIFA® is only available through the list of contracted specialty pharmacies or through authorized distributors for in-office dispensing by community physicians, hospitals, institutions, Veterans Affairs, and Department of Defense.
Specialty Pharmacies and Authorized Distributors
National Drug Codes (NDCs) | |||
---|---|---|---|
10-digit NDC | 11-digit NDCa | Dosage strength | Description |
59572-705-30 | 59572-0705-30 | 50 mg/tablet | Bottle of 30 pale yellow-to-yellow oval-shaped tablets; each film-coated tablet is debossed “ENA” on one side and “50” on the other side. |
59572-710-30 | 59572-0710-30 | 100 mg/tablet | Bottle of 30 pale yellow-to-yellow capsule-shaped tablets; each tablet is debossed “ENA” on one side and “100” on the other side. |
National Drug Codes (NDCs) | ||
---|---|---|
10-digit NDC | 59572-705-30 | 59572-710-30 |
11-digit NDCa | 59572-0705-30 | 59572-0710-30 |
Dosage strength | 50 mg/tablet | 100 mg/tablet |
Description | Bottle of 30 pale yellow-to-yellow oval-shaped tablets; each film-coated tablet is debossed “ENA” on one side and “50” on the other side. | Bottle of 30 pale yellow-to-yellow capsule-shaped tablets; each tablet is debossed “ENA” on one side and “100” on the other side. |
aThe red zero converts the 10-digit NDC to the 11-digit NDC. Some payers may require each NDC to be listed on the claim. Payer requirements regarding the use of NDCs may vary. Electronic data exchange generally requires use of the 11-digit NDC.
How supplied
Storage
Commonly used ICD-10 Codes*
*When selecting diagnosis codes, providers should consult a current ICD-10-CM manual and always select the most appropriate diagnosis code(s) with the highest level of detail to describe a patient’s actual condition.
Eligibility
Patients must meet the following criteria to enroll:
Program Benefits
Program Timing
Additional Terms and Conditions of the Celgene Commercial Co-pay Programs
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