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Aldurazyme (laronidase)


Billing

Code: J1931

Description: Laronidase injection

Unit: 0.1 mg

Payment: $36.091

Pay quarter: Q1 2023


Medicare history

Dosage and Frequency

Mucopolysaccharidosis I (MPS I)

• 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:

464

Prior 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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