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Feraheme (ferumoxytol)


Billing

Code: Q0138

Description: Ferumoxytol, non-esrd

Unit: 1 mg

Payment: $0.556

Pay quarter: Q1 2023


Medicare history

Dosage and Frequency

Iron Deficiency Anemia (IDA)

Initial:
• Two doses of 510mg IV 3-8 days apart

Calculate drug reimbursement


Total Reimbursement:

$300.57

(ASP: $283.56, Margin: $17.01)


Code:

Q0138

# Units to bill:

510

Prior Authorization

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





Insurance prior auth guidelines:


Billable NDCs

00781-3154-01

FERUMOXYTOL (SANDOZ)

510 MG


59338-0775-01

Feraheme (AMAG PHARMACEUTICALS, INC.)

510 MG



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