Aldurazyme (laronidase)
Billing
Code: J1931
Description: Laronidase injection
Unit: 0.1 mg
Payment: $36.091
Pay quarter: Q1 2023
Dosage and Frequency
Mucopolysaccharidosis I (MPS I)
• 0.58mg/kg IV every 1 week
• 0.58mg/kg IV every 1 week
Calculate drug reimbursement
Total Reimbursement:
$17,751.00(ASP: $16,746.22, Margin: $1,004.77)
Code:
J1931# Units to bill:
464Prior Authorization
Prior auth criteria for Aldurazyme may include but is not limited to:
Insurance prior auth guidelines:
Billable NDCs
58468-0070-01
Aldurazyme (GENZYME CORPORATION)
2.9000000000000004 MG
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