Important Safety Information
Full Prescribing Information
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About
OMIDRIA
Schedule an in-service with your OMIDRIA Field Reimbursement Manager by emailing omidriafrms@rayner.com or by calling 1-844-RAYNER1 (1-844-729-6371).
Contact Us about access and reimbursement.
‡Based on your Medicare or commercial plan selection, your coverage may require a copay for OMIDRIA.
PA=prior authorization; VA=United States Department of Veterans Affairs.
The OMIDRIAssure® program offers patients options to assist with the cost of OMIDRIA:
Dedicated access to comprehensive reimbursement programs for your cataract procedures:
OMIDRIA is on the VA National Formulary with no PA required.
We Pay the Difference patient reimbursement program for commercially insured patients‡
Equal Access patient assistance program for government-insured, underinsured, or uninsured patients (based on financial need and eligibility requirements)
Field Reimbursement Managers to help you navigate through the reimbursement pathway
OMIDRIA has a unique billing code: J1097†
Phenylephrine 10.16 mg/mL and ketorolac 2.88 mg/mL ophthalmic irrigation solution, 1 mL.¹
OMIDRIA is reimbursed per mL; therefore, providers should always use 1 mL as the billing unit and bill for 4 units when OMIDRIA is utilized.
*Section 4135(b) CAA provides for both a transitional period (December 29, 2022, to December 31, 2024) and a specified period (January 1, 2025, to January 1, 2028) during which nonopioid pain management drugs such as OMIDRIA will qualify for separate payment in the ASC setting.
†ASCs use this unique permanent HCPCS code to bill CMS and other payers for separate payment. HOPDs use this unique HCPCS code to bill commercial payers and Med Advantage.
ASC=ambulatory surgical center; HCPCS=Healthcare Common Procedure Coding System; HOPD=hospital outpatient department.
DEDICATED ACCESS AND SUPPORT FOR YOUR PATIENTS
Passage of the Consolidated Appropriations Act 2023 has secured separate payment status in ASCs for OMIDRIA through January 1, 2028.
HOPD separate payment status is secured for OMIDRIA starting January 2025 through January 1, 2028.*
REFERENCE:
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Centers for Medicare & Medicaid Services. HCPCS January 2024 Index. Accessed February 15th, 2024. https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/addendum-a-b-updates
Indications and Usage
OMIDRIA® is added to ophthalmic irrigating solution used during cataract surgery or intraocular lens replacement and is indicated for maintaining pupil size by preventing intraoperative miosis and reducing postoperative ocular pain.
Important Safety Information
OMIDRIA must be added to irrigating solution prior to intraocular use.
OMIDRIA is contraindicated in patients with a known hypersensitivity to any of its ingredients.
Systemic exposure to phenylephrine may cause elevations in blood pressure.
Use OMIDRIA with caution in individuals who have previously exhibited sensitivities to acetylsalicylic acid, phenylacetic acid derivatives, and other nonsteroidal anti-inflammatory drugs (NSAIDs), or have a past medical history of asthma.
The most commonly reported adverse reactions at ≥ 2% are eye irritation, posterior capsule opacification, increased intraocular pressure, and anterior chamber inflammation.
Please see the Full Prescribing Information for OMIDRIA.
You are encouraged to report Suspected Adverse Reactions to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Indications and Usage
OMIDRIA® is added to ophthalmic irrigating solution used during cataract surgery or intraocular lens replacement and is indicated for maintaining pupil size by preventing intraoperative miosis and reducing postoperative ocular pain.
Important Safety Information
OMIDRIA must be added to irrigating solution prior to intraocular use.
OMIDRIA is contraindicated in patients with a known hypersensitivity to any of its ingredients.
Systemic exposure to phenylephrine may cause elevations in blood pressure.
Use OMIDRIA with caution in individuals who have previously exhibited sensitivities to acetylsalicylic acid, phenylacetic acid derivatives, and other nonsteroidal anti-inflammatory drugs (NSAIDs), or have a past medical history of asthma.
The most commonly reported adverse reactions at ≥ 2% are eye irritation, posterior capsule opacification, increased intraocular pressure, and anterior chamber inflammation.
Please see the Full Prescribing Information for OMIDRIA.
You are encouraged to report Suspected Adverse Reactions to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.