Drug IndexGammaplex (IVIG)
Billing
Code: J1557
Description: Gammaplex injection
Unit: 500 MG
Payment: $55.009
Pay quarter: Q2 2024
Covered in Part D: Yes
Avg tier level: 4
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
$6,162.90Total Reimbursement:
$3,300.54(ASP: $3,113.72, Margin: $186.82)
.
.# Units to bill:
60Dosage & Frequency
Billable NDCs
64208-8234-06
GAMMAPLEX (BIO PRODUCTS LABORATORY, LTD)
5000 MG
64208-8234-07
GAMMAPLEX (BIO PRODUCTS LABORATORY, LTD)
10000 MG
64208-8234-08
GAMMAPLEX (BIO PRODUCTS LABORATORY, LTD)
20000 MG
64208-8235-05
GAMMAPLEX (BIO PRODUCTS LABORATORY, LTD)
5000 MG
64208-8235-06
GAMMAPLEX (BIO PRODUCTS LABORATORY, LTD)
10000 MG
64208-8235-07
GAMMAPLEX (BIO PRODUCTS LABORATORY, LTD)
20000 MG
Prior Authorization
Resources