Glassia (A1-PI)
Billing
Code: J0257
Description: Glassia injection
Unit: 10 mg
Payment: $5.099
Pay quarter: Q1 2023
Dosage and Frequency
Alpha-1 Antitrypsin Deficiency
• 60mg/kg IV every 1 week
• 60mg/kg IV every 1 week
Calculate drug reimbursement
Total Reimbursement:
$2,594.37(ASP: $2,447.52, Margin: $146.85)
Code:
J0257# Units to bill:
480Prior Authorization
Prior auth criteria for Glassia may include but is not limited to:
Insurance prior auth guidelines:
Billable NDCs
00944-2884-01
GLASSIA (TAKEDA PHARMACEUTICALS AMERICA, INC.)
1 MG
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