Drug IndexElaprase (Idursulfase)



Billing

Code: J1743

Description: Idursulfase injection

Unit: 1 MG

Payment: $542.894

Pay quarter: Q2 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

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

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# Units to bill:

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Billable NDCs

54092-0700-01

ELAPRASE (Takeda Pharmaceuticals America, Inc.)

1 VIAL, GLASS in 1 BOX (54092-700-01) / 3 mL in 1 VIAL, GLASS



Prior Authorization


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