PERMANENT J CODE

Effective: 10/1/2021

HCPCS Level II code1:

J1448 Injection, trilaciclib, 1 mg

A female patient
G1 to One Logo

Patient Support Program

Call us with questions at 1-833-G1toOne
(1-833-418-6663)
, or email us at Enroll@G1toOne.com

Your Single Source for Access and Affordability Solutions

G1 to One® offers a suite of solutions to common access and reimbursement hurdles, such as:

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Benefits verifications for patient coverage and out-of-pocket responsibilities

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Providing payer-specific guidance for prior authorizations and appeals to address patient needs

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Offering solutions for
insurance-related delays

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Connecting patients, regardless of insurance type, to appropriate resources that can address high deductibles, co‑pays/coinsurance, or even a lack of coverage*

*Patients must express need and meet certain income eligibility requirements.

A female patient and healthcare provider

Submitting the completed form will initiate a benefits investigation that includes coverage status, prior authorization requirements, and patient out-of-pocket costs. This information will be provided to your practice.
Enrollment does not guarantee benefits.

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Simple G1 to One Enrollment Process

Call us with questions at
1-833-G1toOne (1-833-418-6663),
or email us at Enroll@G1toOne.com

Download Patient Enrollment Form for G1 to One

Complete and submit
the form to enroll
patients in G1 to One

Download the Enrollment Form

Fax the form to
1-833-FAX-G121 (1-833-329-4121)

Resources to Make Coverage
and Reimbursement Easier

Download COSELA Coding and Billing

Coding &
Billing Guide

Download
Download COSELA Prior Authorization Checklist

Prior Authorization
Checklist

Download
Download COSELA Appeals Letter Template

Appeals Letter
Template

Download
Download COSELA Letter of Medical Necessity Template

Letter of Medical
Necessity Template

Download
Download COSELA G1 to One Health Care Provider Brochure

G1 to One Brochure
for Healthcare Providers

Download
Download COSELA G1 to One Patient Brochure

G1 to One Brochure
for Patients

Download