Contrast Media

Contrast agents used in diagnostic imaging

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Product
Size
ManufacturerMfgr
NDC#
Code*
RNI
340B
Ophthalmic Disclosing Agent
Product: AK-FLUOR® (Fluorescein Injection, USP) 10%
Prescribing Information
Size: 500 mg 5 mL Single-dose Glass Vial Pack of 12
Manufacturer: Long Grove Pharmaceuticals
NDC#: 81298-8660-03
Code*: J3490
RNINo
340BYes
Paramagnetic Macrocyclic (Gadolinium-based) Contrast Media
Product: Gadobutrol Injection
Prescribing Information
Size: 7.5 mL Single-Dose Vial Carton of 20
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0212-54
Code*: A9585
RNINo
340BYes
Product: Gadobutrol Injection
Prescribing Information
Size: 15 mL Single-Dose Vial Carton of 20
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0214-54
Code*: A9585
RNINo
340BYes
Product: Gadoteridol Injection
Prescribing Information
Size: 5 mL Single-dose Vial Box of 5
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0121-31
Code*: A9579
RNINo
340BYes
Product: Gadoteridol Injection
Prescribing Information
Size: 10 mL Single-dose Vial Box of 5
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0121-33
Code*: A9579
RNINo
340BYes
Product: Gadoteridol Injection
Prescribing Information
Size: 15 mL Single-dose Vial Box of 5
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0121-34
Code*: A9579
RNINo
340BYes
Product: Gadoteridol Injection
Prescribing Information
Size: 20 mL Single-dose Vial Box of 5
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0121-35
Code*: A9579
RNINo
340BYes
Paramagnetic Macrocyclic Ionic Contrast Media
Product: Gadoterate Meglumine Injection
Prescribing Information
Size: 5 mL Single-Dose Vial Pack of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0123-31
Code*: A9575
RNINo
340BYes
Product: Gadoterate Meglumine Injection
Prescribing Information
Size: 20 mL Single-Dose Vial Pack of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0123-35
Code*: A9575
RNINo
340BYes
Product: Gadoterate Meglumine Injection
Prescribing Information
Size: 5 mmol 10 mL Solution Single-Dose Vial Box of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0123-33
Code*: A9575
RNINo
340BYes
Product: Gadoterate Meglumine Injection
Prescribing Information
Size: 7.5 mmol 15 mL Solution Single-Dose Vial Box of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0123-34
Code*: A9575
RNINo
340BYes
Product: Gadoterate Meglumine Injection
Prescribing Information
Size: 50 mmol 100 mL Solution Single-Dose Vial Box of 6 – Pharmacy Bulk Package
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0123-56
Code*: A9575
RNINo
340BYes
Nonionic Radiopaque Contrast Media
Product: Iopamidol Injection, 41%
Prescribing Information
Size: (408 mg/1 mL) 10 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0124-82
Code*: Q9966
RNINo
340BYes
Product: Iopamidol Injection, 41%
Prescribing Information
Size: (408 mg/1 mL) 20 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0124-52
Code*: Q9966
RNINo
340BYes
Product: Iopamidol Injection, 41%
Prescribing Information
Size: (408 mg/1 mL) 50 mL Single-Dose Vial Carton of 1
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0211-80
Code*: Q9966
RNINo
340BYes
Product: Iopamidol Injection, 51%
Prescribing Information
Size: (510 mg/1 mL) 50 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0125-82
Code*: Q9966
RNINo
340BYes
Product: Iopamidol Injection, 61%
Prescribing Information
Size: (612 mg/1 mL) 15 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0126-82
Code*: Q9967
RNINo
340BYes
Product: Iopamidol Injection, 61%
Prescribing Information
Size: (612 mg/1 mL) 30 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0219-52
Code*: Q9967
RNINo
340BYes
Product: Iopamidol Injection, 61%
Prescribing Information
Size: (612 mg/1 mL) 50 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0219-62
Code*: Q9967
RNINo
340BYes
Product: Iopamidol Injection, 61%
Prescribing Information
Size: (612 mg/1 mL) 100 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0219-82
Code*: Q9967
RNINo
340BYes
Product: Iopamidol Injection, 76%
Prescribing Information
Size: (755 mg/1 mL) 100 mL Single-Dose Vial Carton of 10
Manufacturer: Slate Run Pharmaceuticals
NDC#: 70436-0127-82
Code*: Q9967
RNINo
340BYes
* All codes should be verified between the provider and the payer.
1 Call for eligibility through your GPO affiliation.
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