HCPCS Level IIdrugActive
J1413
Inj delandistrogene mox rokl
BETOS: O1E
Effective: 2024-01-01
Referenced in 2 policies
Description
Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose
Medicare Part B Drug Pricing
Average Sales Price (ASP) data for Q1 2026
Drug Name
Elevidys
Manufacturer
Sarepta Therapeutics, Inc.
HCPCS Dosage
Per Therapeutic Dose
Billing Units
1.0000
58
NDC Products
opps
Pricing Source
Medicare Part B drugs are reimbursed at ASP + 6%. Pricing updates quarterly based on manufacturer-reported data.