Drug IndexZolgensma (Onasemnogene Abeparvovec-Xioi)


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Covered in Part D: No

Drug Cost

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Billable NDCs

71894-0120-02

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-120-02) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0121-03

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-121-03) * 5.5 mL in 1 VIAL (71894-110-01) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0122-03

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-122-03) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0123-03

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-123-03) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0124-04

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-124-04) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01) * 8.3 mL in 1 VIAL (71894-115-01)


71894-0125-04

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-125-04) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0126-04

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-126-04) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0127-05

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-127-05) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0128-05

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-128-05) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0129-05

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-129-05) * 1 mL in 1 POUCH * 8.3 mL in 1 VIAL (71894-115-01)


71894-0130-06

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-130-06) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0131-06

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-131-06) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0132-06

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-132-06) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0133-07

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-133-07) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0134-07

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-134-07) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0135-07

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-135-07) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0136-08

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-136-08) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0137-08

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-137-08) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0138-08

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-138-08) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0139-09

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-139-09) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0140-09

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-140-09) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0141-09

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-141-09) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0142-10

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-142-10) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0143-10

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-143-10) * 5.5 mL in 1 VIAL (71894-110-01) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0144-10

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-144-10) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0145-11

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-145-11) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0146-11

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-146-11) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0147-11

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-147-11) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0148-12

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-148-12) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0149-12

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-149-12) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0150-12

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-150-12) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0151-13

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-151-13) * 5.5 mL in 1 VIAL (71894-110-01) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0152-13

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-152-13) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0153-13

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-153-13) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


71894-0154-14

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-154-14) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0155-14

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-155-14) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH * 5.5 mL in 1 VIAL (71894-110-01)


71894-0156-14

ZOLGENSMA (Novartis Gene Therapies, Inc.)

1 KIT in 1 CARTON (71894-156-14) * 8.3 mL in 1 VIAL (71894-115-01) * 1 mL in 1 POUCH


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