OPFOLDA J Code: J1202

Drug & Product Overview

HCPCS Descriptor Miglustat, oral, 65 mg

HCPCS Added Date April 1, 2024

Manufacturer Amicus Therapeutics

Route of Administration Oral

Generic Status Single-Source; Branded

Dosage Form Capsule

About OPFOLDA

Opfolda is a medication aligned to the HCPCS J Code: J1202 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the oral route and manufactured by Amicus Therapeutics.

Manufacturers, reach out to us to add more information.

NDC Code Information

3 NDC packages are crosswalked to J1202. Package detail is available to logged-in subscribers.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
•••••-••••-•• Log in to view	OPFOLDA
	OPFOLDA
	OPFOLDA

Login to view 3 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

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OPFOLDA Pricing & Reimbursement

J1202 Private Payer Reimbursement

$33.94 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Miglustat 505(b)(2) Information:

HCPCS Code	Manufacturer	Active Ingredient	HCPCS Description
J1202	Amicus Therapeutics	Miglustat	Miglustat, oral, 65 mg

OPFOLDA Medically Unlikely Edits (MUE)

The most billing units of J1202 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 65 mg.

Practitioner Office & Hospital Outpatient

4 units / day

= 260 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

OPFOLDA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

late-onset Pompe disease (lysosomal acid alpha-glucosidase [GAA] deficiency)

Drug Class

Enzyme Stabilizer [EPC]Enzyme Stabilizers [MoA]Glucosylceramide Synthase Inhibitor [EPC]Glucosylceramide Synthase Inhibitors [MoA]

Frequently Asked Questions

Is an Opfolda billing and coding guide available?

Our team has not identified a manufacturer-published source of billing and coding information for OPFOLDA.

Is Opfolda patient assistance information available?

OPFOLDA patient assistance information can be found through Amicus Therapeutics. Visit Here →

Where can I find Opfolda prescribing information?

Opfolda prescribing information can be found at the link below: Visit Here →

Where can I find Opfolda side effect information?

Information regarding Opfolda's potential side effects can be found at MedlinePlus

Does billing OPFOLDA require JZ/JW wastage modifiers?

CMS does not include OPFOLDA (J1202) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1202. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.