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Elaprase (idursulfase)


Billing

Code: J1743

Description: Idursulfase injection

Unit: 1 mg

Payment: $542.876

Pay quarter: Q1 2023


Medicare history

Dosage and Frequency

Hunter syndrome (Mucopolysaccharidosis II, MPS II)

• 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:

40

Prior 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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