Drug IndexLemtrada (Alemtuzumab)
Billing
Code: J0202
Description: Injection, alemtuzumab
Unit: 1 MG
Payment: $2337.693
Pay quarter: Q4 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
.
.# Units to bill:
N/ABillable NDCs
58468-0200-01
LEMTRADA (Genzyme Corporation)
1 VIAL, SINGLE-USE in 1 CARTON (58468-0200-1) / 1.2 mL in 1 VIAL, SINGLE-USE
58468-0357-01
LEMTRADA (Genzyme Corporation)
1 VIAL, SINGLE-USE in 1 CARTON (58468-0357-1) / 1 mL in 1 VIAL, SINGLE-USE
58468-0357-03
LEMTRADA (Genzyme Corporation)
3 VIAL, SINGLE-USE in 1 CARTON (58468-0357-3) / 1 mL in 1 VIAL, SINGLE-USE
Prior Authorization
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