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/A

Total Reimbursement:

N/A

(ASP: N/A, Margin: N/A)

.

.

# Units to bill:

N/A

Billable 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


Resources