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:

$1,499.40

Total Reimbursement:

$1,770.15

(ASP: $1,669.95, Margin: $100.20)

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# Units to bill:

150

Dosage & 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


Billable NDCs

57894-0350-01

SIMPONI ARIA (JANSSEN BIOTECH, INC.)

50 MG



Prior Authorization

Aetna

United Healthcare

Cigna

Anthem


Resources

Drug Enrollment Form

Website