POMBILITI
NDC 71904-200 · AMICUS THERAPEUTICS US, LLC
Generic namecipaglucosidase alfa-atga
Dosage formINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION
RouteINTRAVENOUS
Active ingredient(s)CIPAGLUCOSIDASE ALFA
Strength105 mg/1
Pharmacologic classHydrolytic Lysosomal Glycogen-specific Enzyme [EPC], alpha-Glucosidases [CS]
Marketing categoryBLA
Packages
71904-200-01 — 1 VIAL, GLASS in 1 CARTON (71904-200-01) / 105 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, GLASS
71904-200-02 — 10 VIAL, GLASS in 1 CARTON (71904-200-02) / 105 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, GLASS
71904-200-03 — 25 VIAL, GLASS in 1 CARTON (71904-200-03) / 105 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, GLASS
Billed under HCPCS
J1203 — Injection, cipaglucosidase alfa-atga, 5 mg Medicare Part B payment limit (ASP + 6%): $96.30