Drug IndexSimponi Aria (golimumab)
Billing
Code: J1602
Description: Golimumab for iv use 1mg
Unit: 1 MG
Payment: $11.801
Pay quarter: Q2 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$1,499.40Total Reimbursement:
$1,770.15(ASP: $1,669.95, Margin: $100.20)
.
.# Units to bill:
150Dosage & Frequency
Rheumatoid Arthritis (RA)
Psoriatic Arthritis (PsA)
Ankylosing Spondylitis (AS)
Induction:
• 2mg/kg IV at weeks 0 and 4
Maintenance:
• 2mg/kg IV every 8 weeks
Psoriatic Arthritis (PsA)
Ankylosing Spondylitis (AS)
Induction:
• 2mg/kg IV at weeks 0 and 4
Maintenance:
• 2mg/kg IV every 8 weeks
Billable NDCs
57894-0350-01
SIMPONI ARIA (JANSSEN BIOTECH, INC.)
50 MG
Prior Authorization
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