Dermatology Medications and Treatment

Pharmaceutical Products

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Product
Size
ManufacturerMfgr
NDC#
Code*
VIP
340B
Acne Vulgaris
Product: AKLIEF® Cream 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5935-45
Code*: J3490
VIPTBD
340BYes
Product: DIFFERIN® Lotion 0.1% 2
Prescribing Information
Size: 2 fl oz (59 mL) Pump Bottle
Manufacturer: Galderma
NDC#: 00299-5912-02
Code*: TBD
VIPTBD
340BYes
Product: DIFFERIN® Cream 0.1% 2
Prescribing Information
Size: 45 gm Tube
Manufacturer: Galderma
NDC#: 00299-5915-45
Code*: TBD
VIPTBD
340BYes
Product: EPIDUO® FORTE Gel 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5906-45
Code*: TBD
VIPTBD
340BYes
Dermatosis
Product: CLOBEX® Lotion 0.05% 2
Prescribing Information
Size: 4 fl oz (118 mL) Bottle
Manufacturer: Galderma
NDC#: 00299-3848-04
Code*: TBD
VIPTBD
340BYes
Melasma
Product: TRI-LUMA® Cream 2
Prescribing Information
Size: 30 gm Aluminum Tube (0.01%/4%/0.05%)
Manufacturer: Galderma
NDC#: 00299-5950-30
Code*: TBD
VIPTBD
340BYes
Plaque Psoriasis
Product: CLOBEX® Spray 0.05% 2
Prescribing Information
Size: 4.25 fl oz (125 mL) Bottle
Manufacturer: Galderma
NDC#: 00299-3849-04
Code*: TBD
VIPTBD
340BYes
Product: DIFFERIN® Gel 0.3% 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5918-25
Code*: TBD
VIPTBD
340BYes
Product: VECTICAL® Ointment 2
Prescribing Information
Size: 3 mcg/1 gm 100 gm Tube
Manufacturer: Galderma
NDC#: 00299-2012-10
Code*: TBD
VIPTBD
340BYes
Rosacea
Product: Doxycycline 2
Prescribing Information
Size: 40 mg Capsule Bottle of 30
Manufacturer: Prasco Laboratories
NDC#: 66993-0815-30
Code*: TBD
VIPTBD
340BYes
Product: ORACEA® 2
Prescribing Information
Size: 40 mg Capsule Bottle of 30
Manufacturer: Galderma
NDC#: 00299-3822-30
Code*: TBD
VIPTBD
340BYes
Product: SOOLANTRA® Cream 2
Prescribing Information
Size: 45 gm Tube
Manufacturer: Galderma
NDC#: 00299-3823-45
Code*: TBD
VIPTBD
340BYes
Scalp Psoriasis
Product: CLOBEX® Shampoo 0.05% 2
Prescribing Information
Size: 4 fl oz (118 mL) Bottle
Manufacturer: Galderma
NDC#: 00299-3847-04
Code*: TBD
VIPTBD
340BYes
* All codes should be verified between the provider and the payer.
1 Call for eligibility through your GPO affiliation.
2 Call for eligibility.
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