Drug IndexKrystexxa (Pegloticase)



Billing

Code: J2507

Description: Pegloticase injection

Unit: 1 MG

Payment: $3391.914

Pay quarter: Q2 2024


Covered in Part D: No


Drug Cost

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Total WAC:

N/A

Total Reimbursement:

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(ASP: N/A, Margin: N/A)

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# Units to bill:

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Billable NDCs

75987-0080-10

Krystexxa (Horizon Therapeutics USA, Inc.)

1 VIAL in 1 CARTON (75987-080-10) / 1 mL in 1 VIAL



Prior Authorization


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