Drug IndexTzield (Teplizumab-Mzwv)
Billing
Code: J9381
Description: Inj teplizumab mzwv 5 mcg
Unit: 5 MCG
Payment: $36.945
Pay quarter: Q3 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
.
.# Units to bill:
N/ABillable NDCs
73650-0316-01
TZIELD (Provention Bio, Inc.)
1 VIAL, SINGLE-DOSE in 1 CARTON (73650-316-01) / 2 mL in 1 VIAL, SINGLE-DOSE
73650-0316-10
TZIELD (Provention Bio, Inc.)
10 VIAL, SINGLE-DOSE in 1 CARTON (73650-316-10) / 2 mL in 1 VIAL, SINGLE-DOSE
73650-0316-14
TZIELD (Provention Bio, Inc.)
14 VIAL, SINGLE-DOSE in 1 CARTON (73650-316-14) / 2 mL in 1 VIAL, SINGLE-DOSE
Prior Authorization
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