Drug IndexGlassia (Alpha1-Proteinase Inhibitor (Human))
Billing
Code: J0257
Description: Glassia injection
Unit: 10 MG
Payment: $5.576
Pay quarter: Q4 2024
Covered in Part D: Yes
Avg tier level: 4
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
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.# Units to bill:
N/ABillable NDCs
00944-2884-01
GLASSIA (Takeda Pharmaceuticals America, Inc.)
1 VIAL, GLASS in 1 CARTON (0944-2884-01) / 50 mL in 1 VIAL, GLASS (0944-2884-02)
Prior Authorization
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