Alexion Pharmaceuticals

ULTOMIRIS - Cost

Updated as of: July 1st, 2024

HCPCS:

J1303

HCPCS Code Descriptor:

Injection, ravulizumab-cwvz, 10 mg

Medicare Payment Limit:

The Ultomiris Medicare Payment Limit is $221.207.

Average Sale Price:

ULTOMIRIS ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The Ultomiris Medicare Co-Insurance percentage is 20%. Ultomiris's Medicare Co-Insurance amount is $44.241

APC Code:

The Ultomiris: APC Code is: 9312

APC Payment Limit:

The APC Payment Limit for ULTOMIRIS is available. Login to view.

Ultomiris Cost Information:

Ultomiris' HCPCS code is J1303. It was added and became effective on October 1, 2019. Both the WAC and the AWP have remained at a consistent level since the drug was added in October 2019, with no price fluctuations. The ASP began at the same price as the WAC in October 2019. Since then, the ASP has decreased slightly, but has stayed fairly close to the WAC, within 2%.

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Ultomiris’s wholesale acquisition cost (WAC) information was last updated on:
October 12, 2020
Ultomiris’s average wholesale price (AWP) information was last updated on:
October 12, 2020