Drug IndexLumizyme (alglucosidase alfa)


Billing

Code: J0221

Description: Lumizyme injection

Unit: 10 MG

Payment: $197.303

Pay quarter: Q2 2024

Covered in Part D: No

Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$29,962.88

Total Reimbursement:

$31,568.48

(ASP: $29,781.58, Margin: $1,786.90)

.

.

# Units to bill:

160

Dosage & Frequency

Pompe disease

• 20mg/kg IV every 2 weeks

Billable NDCs

58468-0160-01

Lumizyme (GENZYME CORPORATION)

50 MG


58468-0160-02

Lumizyme (GENZYME CORPORATION)

500 MG


Prior Authorization

Aetna

United Healthcare

Anthem

Cigna

Resources

Website