Elaprase (idursulfase)
Billing
Code: J1743
Description: Idursulfase injection
Unit: 1 mg
Payment: $542.876
Pay quarter: Q1 2023
Dosage and Frequency
Hunter syndrome (Mucopolysaccharidosis II, MPS II)
• 0.5mg/kg IV every 1 week
• 0.5mg/kg IV every 1 week
Calculate drug reimbursement
Total Reimbursement:
$23,017.94(ASP: $21,715.04, Margin: $1,302.90)
Code:
J1743# Units to bill:
40Prior Authorization
Prior auth criteria for Elaprase may include but is not limited to:
Insurance prior auth guidelines:
Billable NDCs
54092-0700-01
ELAPRASE (TAKEDA PHARMACEUTICALS AMERICA, INC.)
6 MG
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