Drug IndexOnpattro (patisiran)
Billing
Code: J0222
Description: Inj., patisiran, 0.1 mg
Unit: 0.1 MG
Payment: $99.204
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$23,484.00Total Reimbursement:
$23,808.96(ASP: $22,461.28, Margin: $1,347.68)
.
.# Units to bill:
240Dosage & Frequency
Polyneuropathy of hereditary transthyretin-mediated amyloidosis
• 0.3mg/kg (max 30mg) IV every 3 weeks
• 0.3mg/kg (max 30mg) IV every 3 weeks
Billable NDCs
71336-1000-01
Onpattro (ALNYLAM PHARMACEUTICALS, INC.)
10 MG
Prior Authorization
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