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Immune Globulins Intravenous (IVIG, SCIG, IGIM)

Immune globulin (IG) is made from pooled plasma collected from thousands of donors. Immune globulin contains antibodies against a broad spectrum of bacteria and viruses, and is used primarily to treat three categories of illnesses: primary immune deficiencies, autoimmune neuromuscular disorders, and certain rheumatologic conditions. Immune globulin therapy may be administered intravenously (IVIG), subcutaneously (SCIG), or intramuscularly (IGIM)

IVIG Reimbursement Calculator

Product Catalog [PDF]

Product

Size

ManufacturerMfgr

NDC#

Code*

RNI

340B

Intravenous Immune Globulin (IVIG)

Product: ASCENIV™ 10%
Prescribing Information

Size: 5 gm/50 mL Single-dose Vial

Manufacturer: ADMA Biologics

NDC#: 69800-0250-01

Code*: J1569

RNINo

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 1 gm/10 mL Ref Wide Neck Single-dose Vial 40 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-02

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 2.5 gm/25 mL Ref Wide Neck Single-dose Vial 60 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-03

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 5 gm/50 mL Ref Wide Neck Single-dose Vial 60 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-04

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 10 gm/100 mL Ref Wide Neck Single-dose Vial 24 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-05

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 20 gm/200 mL Ref Wide Neck Single-dose Vial 24 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-06

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 30 gm/300 mL Ref Wide Neck Single-dose Vial 24 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-07

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD^® S/D 5%
<1 μg/mL IgA
Prescribing Information

Size: 5 gm Single-use Vial LOW IgA

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2656-03

Code*: J1566

RNIRNI

340BNo

Product: GAMMAGARD^® S/D 5%
<1 μg/mL IgA
Prescribing Information

Size: 10 gm Single-use Vial LOW IgA

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2658-04

Code*: J1566

RNIRNI

340BNo

Product: GAMMAKED™ 10%
Prescribing Information

Size: 5 gm 50 mL Single-dose Vial

Manufacturer: Kedrion Biopharma

NDC#: 76125-0900-50

Code*: J1561

RNINo

340BYes

Product: GAMMAKED™ 10%
Prescribing Information

Size: 10 gm 100 mL Single-dose Vial

Manufacturer: Kedrion Biopharma

NDC#: 76125-0900-10

Code*: J1561

RNINo

340BYes

Product: GAMMAKED™ 10%
Prescribing Information

Size: 20 gm 200 mL Single-dose Vial

Manufacturer: Kedrion Biopharma

NDC#: 76125-0900-20

Code*: J1561

RNINo

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 1 gm/10 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-12

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 2.5 gm/25 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-15

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 5 gm/50 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-20

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 10 gm/100 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-71

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 20 gm/200 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-24

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 40 gm/400 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-40

Code*: J1561

RNIRNI

340BYes

Product: octagam^® 5%
Prescribing Information

Size: 1 gm 20 mL Single-dose Vial 12/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0840-01

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 5%
Prescribing Information

Size: 2.5 gm 50 mL Single-dose Vial 12/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0840-02

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 5%
Prescribing Information

Size: 5 gm 100 mL Single-use Vial 12/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0840-03

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 5%
Prescribing Information

Size: 10 gm 200 mL Single-use Vial 6/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0840-04

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 10%
Prescribing Information

Size: 2 gm 20 mL Single-use Vial 144/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0850-01

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 10%
Prescribing Information

Size: 5 gm 50 mL Single-use Vial 72/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0850-02

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 10%
Prescribing Information

Size: 10 gm 100 mL Single-use Vial 48/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0850-03

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 10%
Prescribing Information

Size: 20 gm 200 mL Single-use Vial 24/Case/Box

Manufacturer: Octapharma

NDC#: 68982-0850-04

Code*: J1568

RNIRNI

340BYes

Product: octagam^® 10%
Prescribing Information

Size: 30 gm 300 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0850-05

Code*: J1568

RNIRNI

340BYes

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 2.5 gm 25 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0822-02

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 5 gm 50 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0822-03

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 10 gm 100 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0822-04

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 20 gm 200 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0822-05

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 30 gm 300 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0822-06

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 2.5 gm 25 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1109-02

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 5 gm 50 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1224-02

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 10 gm 100 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1312-02

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 20 gm 200 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1415-02

Code*: J1576

RNINo

340BNo

Product: Panzyga® 10% ²
Prescribing Information

Size: 10% Liquid Prep. 30 gm 300 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1558-02

Code*: J1576

RNINo

340BNo

Product: Privigen^® 10%
Prescribing Information

Size: 5 mg/50 mL Single-dose Vial 10 Per Case

Manufacturer: CSL Behring

NDC#: 44206-0436-05

Code*: J1459

RNIRNI

340BYes

Product: Privigen^® 10%
Prescribing Information

Size: 10 mg/100 mL Single-dose Vial 10 Per Case

Manufacturer: CSL Behring

NDC#: 44206-0437-10

Code*: J1459

RNIRNI

340BYes

Product: Privigen^® 10%
Prescribing Information

Size: 20 mg/200 mL Single-dose Vial 10 Per Case

Manufacturer: CSL Behring

NDC#: 44206-0438-20

Code*: J1459

RNIRNI

340BYes

Product: Privigen^® 10%
Prescribing Information

Size: 40 mg/400 mL Single-dose Vial

Manufacturer: CSL Behring

NDC#: 44206-0439-40

Code*: J1459

RNIRNI

340BYes

Subcutaneous Immune Globulin (SCIG)

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 1 gm/6 mL Single-use Vial

Manufacturer: Octapharma

NDC#: 68982-0810-01

Code*: 90284 /J3590

RNINo

340BYes

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 2 gm/12 mL Single-dose Vial

Manufacturer: Octapharma

NDC#: 68982-0810-03

Code*: 90284 /J3590

RNINo

340BYes

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 4 gm/12 mL Single-dose Vial

Manufacturer: Octapharma

NDC#: 68982-0810-05

Code*: 90284 /J3590

RNINo

340BYes

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 8 gm/48 mL Single-dose Vial

Manufacturer: Octapharma

NDC#: 68982-0810-06

Code*: 90284 /J3590

RNINo

340BYes

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 1 gm/6 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1061-02

Code*: 90284 /J3590

RNINo

340BNo

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 2 gm/12 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1476-02

Code*: 90284 /J3590

RNINo

340BNo

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 4 gm/24 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1509-02

Code*: 90284 /J3590

RNINo

340BNo

Product: CUTAQUIG^® 16.5% ²
Prescribing Information

Size: 8 gm/48 mL Single-dose Vial

Manufacturer: Pfizer

NDC#: 00069-1965-02

Code*: 90284 /J3590

RNINo

340BNo

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 1 gm/10 mL Ref Wide Neck Single-dose Vial 40 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-02

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 2.5 gm/25 mL Ref Wide Neck Single-dose Vial 60 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-03

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 5 gm/50 mL Ref Wide Neck Single-dose Vial 60 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-04

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 10 gm/100 mL Ref Wide Neck Single-dose Vial 24 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-05

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 20 gm/200 mL Ref Wide Neck Single-dose Vial 24 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-06

Code*: J1569

RNIRNI

340BYes

Product: GAMMAGARD LIQUID^® 10%
Prescribing Information

Size: 30 gm/300 mL Ref Wide Neck Single-dose Vial 24 Per Case

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2700-07

Code*: J1569

RNIRNI

340BYes

Product: GAMMAKED™ 10%
Prescribing Information

Size: 5 gm 50 mL Single-dose Vial

Manufacturer: Kedrion Biopharma

NDC#: 76125-0900-50

Code*: J1561

RNINo

340BYes

Product: GAMMAKED™ 10%
Prescribing Information

Size: 10 gm 100 mL Single-dose Vial

Manufacturer: Kedrion Biopharma

NDC#: 76125-0900-10

Code*: J1561

RNINo

340BYes

Product: GAMMAKED™ 10%
Prescribing Information

Size: 20 gm 200 mL Single-dose Vial

Manufacturer: Kedrion Biopharma

NDC#: 76125-0900-20

Code*: J1561

RNINo

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 1 gm/10 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-12

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 2.5 gm/25 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-15

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 5 gm/50 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-20

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 10 gm/100 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-71

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 20 gm/200 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-24

Code*: J1561

RNIRNI

340BYes

Product: GAMUNEX^®-C 10%
Prescribing Information

Size: 40 gm/400 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0800-40

Code*: J1561

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 4 gm/20 mL Pre-filled Syringe

Manufacturer: CSL Behring

NDC#: 44206-0458-24

Code*: J1559

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 2 gm/10 mL Pre-filled Syringe

Manufacturer: CSL Behring

NDC#: 44206-0457-22

Code*: J1559

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 1 gm/5 mL Pre-filled Syringe

Manufacturer: CSL Behring

NDC#: 44206-0456-21

Code*: J1559

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 1 gm/5 mL Single-dose Vial

Manufacturer: CSL Behring

NDC#: 44206-0451-01

Code*: J1559

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 2 gm/10 mL Single-dose Vial

Manufacturer: CSL Behring

NDC#: 44206-0452-02

Code*: J1559

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 4 gm/20 mL Single-dose Vial

Manufacturer: CSL Behring

NDC#: 44206-0454-04

Code*: J1559

RNIRNI

340BYes

Product: HIZENTRA^® 20%
Prescribing Information

Size: 10 gm/50 mL Single-dose Vial

Manufacturer: CSL Behring

NDC#: 44206-0455-10

Code*: J1559

RNIRNI

340BYes

Product: HYQVIA^® 10%
Prescribing Information

Size: 2.5 gm 25 mL Single-dose Vial Kit

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2510-02

Code*: J1575

RNINo

340BYes

Product: HYQVIA^® 10%
Prescribing Information

Size: 5 gm 50 mL Single-dose Vial Kit

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2511-02

Code*: J1575

RNINo

340BYes

Product: HYQVIA^® 10%
Prescribing Information

Size: 10 gm 100 mL Single-dose Vial Kit

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2512-02

Code*: J1575

RNINo

340BYes

Product: HYQVIA^® 10%
Prescribing Information

Size: 20 gm 200 mL Single-dose Vial Kit

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2513-02

Code*: J1575

RNINo

340BYes

Product: HYQVIA^® 10%
Prescribing Information

Size: 30 gm 300 mL Single-dose Vial Kit

Manufacturer: Takeda Pharmaceuticals

NDC#: 00944-2514-02

Code*: J1575

RNINo

340BYes

Product: XEMBIFY^® 20%
Prescribing Information

Size: 1 mg/5 mL Single Dose Vial

Manufacturer: Grifols

NDC#: 13533-0810-05

Code*: 90284 /J1558

RNINo

340BYes

Product: XEMBIFY^® 20%
Prescribing Information

Size: 2 mg/10 mL Single Dose Vial

Manufacturer: Grifols

NDC#: 13533-0810-10

Code*: 90284 /J1558

RNINo

340BYes

Product: XEMBIFY^® 20%
Prescribing Information

Size: 4 mg/20 mL Single Dose Vial

Manufacturer: Grifols

NDC#: 13533-0810-20

Code*: 90284 /J1558

RNINo

340BYes

Product: XEMBIFY^® 20%
Prescribing Information

Size: 10 mg/50 mL Single Dose Vial

Manufacturer: Grifols

NDC#: 13533-0810-50

Code*: 90284 /J1558

RNINo

340BYes

Intramuscular Immune Globulin (IMIG)

Product: GamaSTAN^®
Prescribing Information

Size: 2 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0335-04

Code*: 90281 /J1460

RNINo

340BYes

Product: GamaSTAN^®
Prescribing Information

Size: 10 mL Single-dose Vial

Manufacturer: Grifols

NDC#: 13533-0335-12

Code*: 90281 /J1460

RNINo

340BYes

^* All codes should be verified between the provider and the payer.
¹ Call for eligibility through your GPO affiliation.
² Call for eligibility.
RNI - RightNow Inventory™ Eligible Products | 340B - Public Health Services 340B Pricing Available.

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