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  • Immune Globulins

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)

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Product
Size
ManufacturerMfgr
NDC#
Code*
VIP
340B
Intravenous Immune Globulin (IVIG)
Product: Flebogamma® 5% DIF
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Grifols
NDC#: 61953-0004-02
Code*: J1572
VIPNo
340BYes
Product: Flebogamma® 5% DIF
Prescribing Information
Size: 5 gm Vial
Manufacturer: Grifols
NDC#: 61953-0004-03
Code*: J1572
VIPNo
340BYes
Product: Flebogamma® 10% DIF
Prescribing Information
Size: 5 gm Vial
Manufacturer: Grifols
NDC#: 61953-0005-01
Code*: J1572
VIPVIP
340BYes
Product: Flebogamma® 10% DIF
Prescribing Information
Size: 10 gm Vial
Manufacturer: Grifols
NDC#: 61953-0005-02
Code*: J1572
VIPVIP
340BYes
Product: Flebogamma® 10% DIF
Prescribing Information
Size: 20 gm Vial
Manufacturer: Grifols
NDC#: 61953-0005-03
Code*: J1572
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 1 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-02
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-03
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-04
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-05
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-06
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 30 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-07
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD® S/D 5%
<1 μg/mL IgA

Prescribing Information
Size: 5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2656-03
Code*: J1566
VIPVIP
340BNo
Product: GAMMAGARD® S/D 5%
<1 μg/mL IgA

Prescribing Information
Size: 10 gm Vial
Manufacturer: Takeda
NDC#: 00944-2658-04
Code*: J1566
VIPVIP
340BNo
Product: GAMMAKED™ 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Kedrion
NDC#: 76125-0900-50
Code*: J1561
VIPNo
340BYes
Product: GAMMAKED™ 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Kedrion
NDC#: 76125-0900-10
Code*: J1561
VIPNo
340BYes
Product: GAMMAKED™ 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Kedrion
NDC#: 76125-0900-20
Code*: J1561
VIPNo
340BYes
Product: Gammaplex® 5% 2
Prescribing Information
Size: 5 gm Vial
Manufacturer: BPL
NDC#: 64208-8234-06
Code*: J1557
VIPNo
340BNo
Product: Gammaplex® 5% 2
Prescribing Information
Size: 10 gm Vial
Manufacturer: BPL
NDC#: 64208-8234-07
Code*: J1557
VIPNo
340BNo
Product: Gammaplex® 5% 2
Prescribing Information
Size: 20 gm Vial
Manufacturer: BPL
NDC#: 64208-8234-08
Code*: J1557
VIPNo
340BNo
Product: Gammaplex® 10% 2
Prescribing Information
Size: 5 gm Vial
Manufacturer: BPL
NDC#: 64208-8235-05
Code*: J1557
VIPNo
340BNo
Product: Gammaplex® 10% 2
Prescribing Information
Size: 10 gm Vial
Manufacturer: BPL
NDC#: 64208-8235-06
Code*: J1557
VIPNo
340BNo
Product: Gammaplex® 10% 2
Prescribing Information
Size: 20 gm Vial
Manufacturer: BPL
NDC#: 64208-8235-07
Code*: J1557
VIPNo
340BNo
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 1 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-12
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-15
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-20
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-71
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-24
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 40 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-40
Code*: J1561
VIPVIP
340BYes
Product: Octagam® 5%
Prescribing Information
Size: 1 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0840-01
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 5%
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0840-02
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 5%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0840-03
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 5%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0840-04
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 10%
Prescribing Information
Size: 2 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0850-01
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0850-02
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0850-03
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0850-04
Code*: J1568
VIPVIP
340BYes
Product: Octagam® 10%
Prescribing Information
Size: 30 gm Vial
Manufacturer: Octapharma
NDC#: 68982-0850-05
Code*: J1568
VIPVIP
340BYes
Product: Panzyga® 10% 2
Prescribing Information
Size: 10% Liquid Prep. 2.5 gm 25 mL Vial
Manufacturer: Octapharma
NDC#: 00069-1109-02
Code*: 90283/J1599
VIPNo
340BNo
Product: Panzyga® 10% 2
Prescribing Information
Size: 10% Liquid Prep. 5 gm 50 mL Vial
Manufacturer: Octapharma
NDC#: 00069-1224-02
Code*: 90283/J1599
VIPNo
340BNo
Product: Panzyga® 10% 2
Prescribing Information
Size: 10% Liquid Prep. 10 gm 100 mL Vial
Manufacturer: Octapharma
NDC#: 00069-1312-02
Code*: 90283/J1599
VIPNo
340BNo
Product: Panzyga® 10% 2
Prescribing Information
Size: 10% Liquid Prep. 20 gm 200 mL Vial
Manufacturer: Octapharma
NDC#: 00069-1415-02
Code*: 90283/J1599
VIPNo
340BNo
Product: Panzyga® 10% 2
Prescribing Information
Size: 10% Liquid Prep. 30 gm 300 mL Vial
Manufacturer: Octapharma
NDC#: 00069-1558-02
Code*: 90283/J1599
VIPNo
340BNo
Product: Privigen® 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: CSL Behring
NDC#: 44206-0436-05
Code*: J1459
VIPVIP
340BYes
Product: Privigen® 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: CSL Behring
NDC#: 44206-0437-10
Code*: J1459
VIPVIP
340BYes
Product: Privigen® 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: CSL Behring
NDC#: 44206-0438-20
Code*: J1459
VIPVIP
340BYes
Product: Privigen® 10%
Prescribing Information
Size: 40 gm Vial
Manufacturer: CSL Behring
NDC#: 44206-0439-40
Code*: J1459
VIPVIP
340BYes
Subcutaneous Immune Globulin (SCIG)
Product: CUTAQUIG® 16.5% 2
Prescribing Information
Size: 1 gm 6 mL Single-dose Vial
Manufacturer: Octapharma
NDC#: 68982-0810-01
Code*: 90284 /J3590
VIPNo
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
VIPNo
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
VIPNo
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
VIPNo
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
VIPNo
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
VIPNo
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
VIPNo
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
VIPNo
340BNo
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 1 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-02
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-03
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-04
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-05
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-06
Code*: J1569
VIPVIP
340BYes
Product: GAMMAGARD LIQUID® 10%
Prescribing Information
Size: 30 gm Vial
Manufacturer: Takeda
NDC#: 00944-2700-07
Code*: J1569
VIPVIP
340BYes
Product: GAMMAKED™ 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Kedrion
NDC#: 76125-0900-50
Code*: J1561
VIPNo
340BYes
Product: GAMMAKED™ 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Kedrion
NDC#: 76125-0900-10
Code*: J1561
VIPNo
340BYes
Product: GAMMAKED™ 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Kedrion
NDC#: 76125-0900-20
Code*: J1561
VIPNo
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 1 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-12
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-15
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-20
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-71
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-24
Code*: J1561
VIPVIP
340BYes
Product: GAMUNEX®-C 10%
Prescribing Information
Size: 40 gm Vial
Manufacturer: Grifols
NDC#: 13533-0800-40
Code*: J1561
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 4 gm 20 mL Pre-filled Syringe
Manufacturer: CSL Behring
NDC#: 44206-0458-24
Code*: J1559
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 2 gm 10 mL Pre-filled Syringe
Manufacturer: CSL Behring
NDC#: 44206-0457-22
Code*: J1559
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 1 gm 5 mL Pre-filled Syringe
Manufacturer: CSL Behring
NDC#: 44206-0456-21
Code*: J1559
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 1 gm 5 mL Vial
Manufacturer: CSL Behring
NDC#: 44206-0451-01
Code*: J1559
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 2 gm 10 mL Vial
Manufacturer: CSL Behring
NDC#: 44206-0452-02
Code*: J1559
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 4 gm 20 mL Vial
Manufacturer: CSL Behring
NDC#: 44206-0454-04
Code*: J1559
VIPVIP
340BYes
Product: HIZENTRA® 20%
Prescribing Information
Size: 10 gm 50 mL Vial
Manufacturer: CSL Behring
NDC#: 44206-0455-10
Code*: J1559
VIPVIP
340BYes
Product: HYQVIA® 10%
Prescribing Information
Size: 2.5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2510-02
Code*: J1575
VIPNo
340BYes
Product: HYQVIA® 10%
Prescribing Information
Size: 5 gm Vial
Manufacturer: Takeda
NDC#: 00944-2511-02
Code*: J1575
VIPNo
340BYes
Product: HYQVIA® 10%
Prescribing Information
Size: 10 gm Vial
Manufacturer: Takeda
NDC#: 00944-2512-02
Code*: J1575
VIPNo
340BYes
Product: HYQVIA® 10%
Prescribing Information
Size: 20 gm Vial
Manufacturer: Takeda
NDC#: 00944-2513-02
Code*: J1575
VIPNo
340BYes
Product: HYQVIA® 10%
Prescribing Information
Size: 30 gm Vial
Manufacturer: Takeda
NDC#: 00944-2514-02
Code*: J1575
VIPNo
340BYes
Product: XEMBIFY® 20% †
Prescribing Information
Size: 1 gm Vial
Manufacturer: Grifols
NDC#: 13533-0810-05
Code*: 90284 /J1558
VIPNo
340BYes
Product: XEMBIFY® 20% †
Prescribing Information
Size: 2 gm Vial
Manufacturer: Grifols
NDC#: 13533-0810-10
Code*: 90284 /J1558
VIPNo
340BYes
Product: XEMBIFY® 20% †
Prescribing Information
Size: 4 gm Vial
Manufacturer: Grifols
NDC#: 13533-0810-20
Code*: 90284 /J1558
VIPNo
340BYes
Product: XEMBIFY® 20% †
Prescribing Information
Size: 10 gm Vial
Manufacturer: Grifols
NDC#: 13533-0810-50
Code*: 90284 /J1558
VIPNo
340BYes
Intramuscular Immune Globulin (IMIG)
Product: GamaSTAN®
Prescribing Information
Size: 2 mL Vial
Manufacturer: Grifols
NDC#: 13533-0335-04
Code*: 90281 /J1460
VIPNo
340BYes
Product: GamaSTAN®
Prescribing Information
Size: 10 mL Vial
Manufacturer: Grifols
NDC#: 13533-0335-12
Code*: 90281 /J1460
VIPNo
340BYes
* All codes should be verified between the provider and the payer.
1 Call for eligibility through your GPO affiliation.
2 Call for eligibility.
VIP - Verified Inventory Program™ (VIPc)® | 340B - Public Health Services 340B Pricing Available.

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