Drug IndexElaprase (idursulfase)



Billing

Code: J1743

Description: Idursulfase injection

Unit: 1 MG

Payment: $542.917

Pay quarter: Q1 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$20,905.53

Total Reimbursement:

$21,716.68

(ASP: $20,487.43, Margin: $1,229.25)

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# Units to bill:

40

Dosage & Frequency

Hunter syndrome (Mucopolysaccharidosis II, MPS II)

• 0.5mg/kg IV every 1 week


Billable NDCs

54092-0700-01

ELAPRASE (TAKEDA PHARMACEUTICALS AMERICA, INC.)

6 MG



Prior Authorization

Aetna

United Healthcare

Anthem

Cigna


Resources

Website