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Cerezyme (imiglucerase)


Billing

Code: J1786

Description: Imuglucerase injection

Unit: 10 units

Payment: $44.397

Pay quarter: Q1 2023


Medicare history

Dosage and Frequency

Type 1 Gaucher disease

Dosage is based on disease severity ranging from:
• 2.5 units/kg IV 3 times a week
• 60 units/kg IV every 2 weeks

Calculate drug reimbursement


Total Reimbursement:

$11,294.60

(ASP: $10,655.28, Margin: $639.32)


Code:

J1786

# Units to bill:

240

Prior Authorization

Prior auth criteria for Cerezyme may include but is not limited to:





Insurance prior auth guidelines:


Billable NDCs

58468-4663-01

Cerezyme (GENZYME CORPORATION)

400 UNITS



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