Drug IndexTezspire (Tezepelumab-Ekko)


Billing

Code: J2356

Description: Inj tezepelumab-ekko, 1mg

Unit: 1 MG

Payment: $18.109

Pay quarter: Q4 2024

Covered in Part D: No

Drug Cost

Calculate drug cost and reimbursement


Total WAC:

N/A

Total Reimbursement:

N/A

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

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# Units to bill:

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Billable NDCs

55513-0100-01

TEZSPIRE (Amgen Inc)

1 VIAL, GLASS in 1 CARTON (55513-100-01) / 1.91 mL in 1 VIAL, GLASS


55513-0100-96

TEZSPIRE (Amgen Inc)

1 VIAL, GLASS in 1 CARTON (55513-100-96) / 1.91 mL in 1 VIAL, GLASS


55513-0100-99

TEZSPIRE (Amgen Inc)

1.91 mL in 1 VIAL, GLASS (55513-100-99)


55513-0112-01

TEZSPIRE (Amgen Inc)

1 SYRINGE in 1 CARTON (55513-112-01) / 1.91 mL in 1 SYRINGE


55513-0112-96

TEZSPIRE (Amgen Inc)

1 SYRINGE in 1 CARTON (55513-112-96) / 1.91 mL in 1 SYRINGE


55513-0112-99

TEZSPIRE (Amgen Inc)

1.91 mL in 1 SYRINGE (55513-112-99)


55513-0123-01

TEZSPIRE (Amgen Inc)

1 CARTRIDGE in 1 CARTON (55513-123-01) / 1.91 mL in 1 CARTRIDGE


55513-0123-96

TEZSPIRE (Amgen Inc)

1 CARTRIDGE in 1 CARTON (55513-123-96) / 1.91 mL in 1 CARTRIDGE


Prior Authorization

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