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Product
Size
ManufacturerMfgr
NDC#
Code*
VIP
340B
Product: Ablysinol
Prescribing Information
Size: 5 mL Single-dose Ampule 10 Box
Manufacturer: BPI Labs
NDC#: 54288-0105-15
Code*: J3490
VIPNo
340BNo
Product: Acetaminophen Injection IV 2
Prescribing Information
Size: 500 mg/50 mL (10 mg/mL) Container 24 Case
Manufacturer: B. Braun Medical
NDC#: 00264-4050-80
Code*: J0131
VIPVIP
340BYes
Product: Acetaminophen Injection IV 2
Prescribing Information
Size: 1000 mg/100 mL (10 mg/mL) Container 24 Per Case
Manufacturer: B. Braun Medical
NDC#: 00264-4100-90
Code*: J0131
VIPVIP
340BYes
Product: Acthar® Gel 2
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe 10 Box
Manufacturer: Mallinckrodt
NDC#: 63004-8710-01
Code*: J0800
VIPNo
340BYes
Product: Afluria® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe 10 Box
Manufacturer: Seqirus
NDC#: 33332-0322-03
Code*: 90685
VIPNo
340BNo
Product: Afluria® Quadrivalent
Prescribing Information
Size: 5 mL Multi-Dose Vial
Manufacturer: Seqirus
NDC#: 33332-0422-10
Code*: 90685
VIPNo
340BNo
Product: Adapalene and Benzoyl Peroxide Gel 0.3%/2.5% 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: TEVA
NDC#: 00093-6303-45
Code*: J3490
VIPTBD
340BNo
Product: AKLIEF® Cream 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5935-45
Code*: J3490
VIPTBD
340BYes
Product: Albutein® 5% FlexBag™
Prescribing Information
Size: 12.5 gm/250 mL Liquid Bag
Manufacturer: Grifols
NDC#: 68516-5214-09
Code*: P9045
VIPNo
340BNo
Product: Albutein® 5% FlexBag™
Prescribing Information
Size: 12.5 gm/500 mL Liquid Bag
Manufacturer: Grifols
NDC#: 68516-5214-00
Code*: P9045
VIPNo
340BNo
Product: Albutein® 25% FlexBag™
Prescribing Information
Size: 12.5 gm/50 mL Liquid Bag
Manufacturer: Grifols
NDC#: 68516-5216-07
Code*: P9047
VIPNo
340BYes
Product: Albutein® 25% FlexBag™
Prescribing Information
Size: 25 gm/100 mL Liquid Bag
Manufacturer: Grifols
NDC#: 68516-5216-08
Code*: P9047
VIPNo
340BYes
Product: Caffeine Citrate Oral Solution 2
Prescribing Information
Size: 60 mg/3 mL Single-Use Vial 10 Pack
Manufacturer: Exela Pharma Sciences
NDC#: 51754-0501-03
Code*: J8499
VIPTBD
340BYes
Product: Calcitonin Salmon
Prescribing Information
Size: 2 mL (400 USP) Multi-dose Vial
Manufacturer: Leucadia Pharmaceuticals
NDC#: 24201-0400-02
Code*: J0630
VIPVIP
340BNo
Product: Cetaphil® Moisturizing Lotion 2
Prescribing Information
Size: 4 oz
Manufacturer: Galderma
NDC#: 00299-0241-31
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Moisturizing Cream 2
Prescribing Information
Size: 3 oz
Manufacturer: Galderma
NDC#: 00299-3917-53
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Gentle Cleanser 2
Prescribing Information
Size: 4 oz
Manufacturer: Galderma
NDC#: 00299-0110-24
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Daily Facial Cleanser 2
Prescribing Information
Size: 4 oz
Manufacturer: Galderma
NDC#: 00299-3927-38
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Gentle Skin Cleansing Cloths 2
Prescribing Information
Size: (25 Count) Case of 12
Manufacturer: Galderma
NDC#: 00299-3934-05
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Sheer Mineral Sunscreen Stick SPF 50 (Broad Spectrum) 2
Prescribing Information
Size: 0.5 oz
Manufacturer: Galderma
NDC#: 00299-4108-00
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Sheer Mineral Sunscreen SPF 50 (Broad Spectrum) 2
Prescribing Information
Size: 1 oz
Manufacturer: Galderma
NDC#: 00299-4110-00
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Sheer Mineral Sunscreen SPF 50 (Broad Spectrum) 2
Prescribing Information
Size: 3 oz
Manufacturer: Galderma
NDC#: 00299-4112-00
Code*: TBD
VIPTBD
340BNo
Product: Cetaphil® Dermacontrol Oil Absorbing Moisturizer (w/ Sunscreen SPF 30) 2
Prescribing Information
Size: 4 oz
Manufacturer: Galderma
NDC#: 00299-4313-04
Code*: TBD
VIPTBD
340BNo
Product: Clindamycin Phosphate and Tretinoin Gel
Prescribing Information
Size: (1.2%/0.025%) 30 gm
Manufacturer: Prasco Laboratories
NDC#: 66993-0959-31
Code*: J3490
VIPNo
340BNo
Product: Clindamycin Phosphate and Tretinoin Gel
Prescribing Information
Size: (1.2%/0.025%) 60 gm
Manufacturer: Prasco Laboratories
NDC#: 66993-0959-61
Code*: J3490
VIPNo
340BNo
Product: CLOBEX® Lotion 0.05% 2
Prescribing Information
Size: 4 fl oz (118 mL) Bottle
Manufacturer: Galderma
NDC#: 00299-3848-04
Code*: J3490
VIPNo
340BYes
Product: CLOBEX® Shampoo 0.05% 2
Prescribing Information
Size: 4 fl oz (118 mL) Bottle
Manufacturer: Galderma
NDC#: 00299-3847-04
Code*: J3490
VIPNo
340BYes
Product: CLOBEX® Spray 0.05% 2
Prescribing Information
Size: 4.25 fl oz (125 mL) Bottle
Manufacturer: Galderma
NDC#: 00299-3849-04
Code*: J3490
VIPNo
340BYes
Product: CYANOKIT® 2
Prescribing Information
Size: 5 gm Single Dose Vial 1 Carton
Manufacturer: BTG International
NDC#: 50633-0310-11
Code*: J3490
VIPNo
340BNo
Product: Doxycycline
Prescribing Information
Size: 40 mg Capsule Bottle of 30
Manufacturer: Prasco Laboratories
NDC#: 66993-0815-30
Code*: TBD
VIPNo
340BYes
Product: Diazepam Injection 1
Prescribing Information
Size: 10 mg/2 mL Single-dose Carpuject™ Syringe Pack of 10
Manufacturer: Pfizer
NDC#: 00409-1273-32
Code*: J3360
VIPNo
340BYes
Product: Diazepam Injection 1
Prescribing Information
Size: 50 mg/10 mL Multi-dose Fliptop Vial Box of 10
Manufacturer: Pfizer
NDC#: 00409-3213-12
Code*: J3360
VIPNo
340BYes
Product: DIFFERIN® Lotion 0.1% 2
Prescribing Information
Size: 2 fl oz (59 mL) Pump Bottle
Manufacturer: Galderma
NDC#: 00299-5912-02
Code*: J3490
VIPNo
340BYes
Product: DIFFERIN® Cream 0.1% 2
Prescribing Information
Size: 45 gm Tube
Manufacturer: Galderma
NDC#: 00299-5915-45
Code*: J3490
VIPNo
340BYes
Product: DIFFERIN® Gel 0.3% 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5918-25
Code*: J3490
VIPNo
340BYes
Product: EPIDUO FORTE Gel 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5906-45
Code*: TBD
VIPTBD
340BYes
Product: EpinephrineSnap™-V Kit
Prescribing Information
Instructions for Use
Size: 1 mg/1 mL Single-dose Vial
Manufacturer: Snap Medical Industries
NDC#: 71923-0200-20
Code*: J0171
VIPNo
340BNo
Product: EpinephrineSnap™-EMS Kit
Prescribing Information
Instructions for Use
Size: 1 mg/1 mL Single-dose Vial
Manufacturer: Snap Medical Industries
NDC#: 71923-0100-20
Code*: J0171
VIPNo
340BNo
Product: Fentanyl Citrate Injection 1
Prescribing Information
Size: 100 mcg/2 mL Single-dose Fliptop Vial Box of 25
Manufacturer: Pfizer
NDC#: 00409-9094-22
Code*: J3010
VIPNo
340BYes
Product: Fentanyl Citrate Injection 1
Prescribing Information
Size: 500 mcg/10 mL Single-dose Fliptop Vial Box of 25
Manufacturer: Pfizer
NDC#: 00409-9094-28
Code*: J3010
VIPNo
340BYes
Product: Fentanyl Citrate Injection 1
Prescribing Information
Size: 1000 mcg/20 mL Single-dose Fliptop Vial Box of 25
Manufacturer: Pfizer
NDC#: 00409-9094-31
Code*: J3010
VIPNo
340BYes
Product: Fentanyl Citrate Injection 1
Prescribing Information
Size: 2500 mcg/50 mL Single-dose Fliptop Vial Box of 25
Manufacturer: Pfizer
NDC#: 00409-9094-61
Code*: J3010
VIPNo
340BYes
Product: Fluad® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Seqirus
NDC#: 33332-0322-03
Code*: 90694
VIPNo
340BNo
Product: FLUARIX® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: GlaxoSmithKline
NDC#: 58160-0890-52
Code*: 90686
VIPNo
340BNo
Product: Flublok® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Sanofi Pasteur
NDC#: 49281-0722-10
Code*: 90682
VIPNo
340BNo
Product: Flucelvax® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Seqirus
NDC#: 70461-0322-03
Code*: 90674
VIPNo
340BNo
Product: Flucelvax® Quadrivalent
Prescribing Information
Size: 5 mL Multi-Dose Vial 10 Doses
Manufacturer: Seqirus
NDC#: 70461-0422-10
Code*: 90756
VIPNo
340BNo
Product: FLULAVAL® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: GlaxoSmithKline
NDC#: 19515-0808-52
Code*: 90686
VIPNo
340BNo
Product: FluMist® Quadrivalent
Prescribing Information
Size: 0.2 mL Single-use Intranasal Spray Box of 10
Manufacturer: AstraZeneca
NDC#: 66019-0309-10
Code*: 90672
VIPNo
340BNo
Product: Fluzone®Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Sanofi Pasteur
NDC#: 49281-0422-50
Code*: 90686
VIPNo
340BNo
Product: Fluzone® Quadrivalent
Prescribing Information
Size: 0.5 mL Single-Dose Vial Box of 10
Manufacturer: Sanofi Pasteur
NDC#: 49281-0422-10
Code*: 90686
VIPNo
340BNo
Product: Fluzone® Quadrivalent
Prescribing Information
Size: 5 mL Multi-Dose Vial Box of 10
Manufacturer: Sanofi Pasteur
NDC#: 49281-0637-15
Code*: 90688
VIPNo
340BNo
Product: Fluzone® Quadrivalent High-Dose
Prescribing Information
Size: 0.7 mL Pre-Filled Syringe Box of 10
Manufacturer: Sanofi Pasteur
NDC#: 49281-0122-65
Code*: 90662
VIPNo
340BNo
Product: Fosfomycin Tromethamine
Prescribing Information
Size: 5.631 gm Single-dose Sachet [Packet]
Manufacturer: Zambon
NDC#: 82036-4274-01
Code*: TBD
VIPNo
340BNo
Product: GLYRX-PF™ 2
Prescribing Information
Size: 0.2 mg/1 mL Single-dose Vial 25 Pack
Manufacturer: Exela Pharma Sciences
NDC#: 51754-6000-04
Code*: J3490
VIPTBD
340BYes
Product: GLYRX-PF™ 2
Prescribing Information
Size: 0.4 mg/2 mL Single-dose Vial 25 Pack
Manufacturer: Exela Pharma Sciences
NDC#: 51754-6001-04
Code*: J3490
VIPTBD
340BYes
Product: HyperHEP® B
Prescribing Information
Size: 1 mL Vial
Manufacturer: Grifols
NDC#: 13533-0636-01
Code*: 90371
VIPNo
340BYes
Product: Ketorolac Tromethamine
Prescribing Information
Size: 30 mg/1 mL Single-dose Vial 25 Carton
Manufacturer: Almaject
NDC#: 72611-0722-25
Code*: J1885
VIPNo
340BNo
Product: Lanreotide Injection 1
Prescribing Information
Size: 120 mg/0.5 mL Pre-filled Syringe
Manufacturer: Cipla USA
NDC#: 69097-0870-67
Code*: J1930
VIPTBD
340BTBD
Product: Methylene Blue
Prescribing Information
Size: 100 mg/10 mL Single-dose Vial
Manufacturer: BPI Labs
NDC#: 54288-0147-01
Code*: J3490
VIPNo
340BNo
Product: MIRVASO® Gel 0.33% 2
Prescribing Information
Size: 30 gm Pump
Manufacturer: Galderma
NDC#: 00299-5980-35
Code*: J3490
VIPNo
340BYes
Product: Nabi-HB®
Prescribing Information
Size: 1 mL Single-dose Vial
Manufacturer: ADMA Biologics
NDC#: 69800-4202-01
Code*: 90371
VIPVIP
340BYes
Product: Nabi-HB®
Prescribing Information
Size: 5 mL Single-dose Vial
Manufacturer: ADMA Biologics
NDC#: 69800-4203-01
Code*: 90371
VIPVIP
340BYes
Product: ORACEA 2
Prescribing Information
Size: 40 mg Capsule Bottle of 30
Manufacturer: Galderma
NDC#: 00299-3822-30
Code*: TBD
VIPTBD
340BYes
Product: Paclitaxel
Prescribing Information
Size: 100 mg Single-dose Vial
Manufacturer: TWi Pharmaceuticals
NDC#: 24979-0710-51
Code*: J9264
VIPNo
340BYes
Product: Pentacel®
Prescribing Information
Size: 48 mcg/0.5 mL Single-dose Vial 5 Box
Manufacturer: Sanofi Pasteur
NDC#: 49281-0511-05
Code*: 90698
VIPNo
340BNo
Product: PreHevbrio
Prescribing Information
Size: 10 mcg Single-dose Vial Box of 10
Manufacturer: VBI Vaccines
NDC#: 75052-0001-10
Code*: 90759
VIPVIP
340BTBD
Product: PREVNAR 20™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe
Manufacturer: Pfizer
NDC#: 00005-2000-02
Code*: 90677
VIPVIP
340BNo
Product: PREVNAR 20™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe 10 Pack
Manufacturer: Pfizer
NDC#: 00005-2000-10
Code*: 90677
VIPVIP
340BNo
Product: Pyrimethamine
Prescribing Information
Size: 25 mg Tablet 100 Bottle
Manufacturer: Alvogen
NDC#: 47781-0925-01
Code*: J3490
VIPTBD
340BTBD
Product: Quadracel®
Prescribing Information
Size: 0.5 mL Single-dose Vial 10 Box
Manufacturer: Sanofi Pasteur
NDC#: 49281-0564-15
Code*: 90696
VIPVIP
340BNo
Product: Rocuronium Bromide
Prescribing Information
Size: 50 mg/5 mL Multi-dose Vial 10 Carton
Manufacturer: Almaject
NDC#: 72611-0756-10
Code*: J3490
VIPNo
340BNo
Product: Rocuronium Bromide
Prescribing Information
Size: 100 mg/10 mL Multi-dose Vial 10 Carton
Manufacturer: Almaject
NDC#: 72611-0757-10
Code*: J3490
VIPNo
340BNo
Product: RYPLAZIM® 1
Prescribing Information
Size: 40 mg Single-dose Vial 25 Pack
Manufacturer: Kedrion
NDC#: 70573-0099-02
Code*: J3590
VIPNo
340BNo
Product: Sensorcaine® MPF 1
Prescribing Information
Size: 0.25% 10 mL Single-dose Vial 25 Pack
Manufacturer: Fresenius Kabi
NDC#: 63323-0464-17
Code*: J3490
VIPNo
340BYes
Product: Sensorcaine® MPF 1
Prescribing Information
Size: 0.25% 30 mL Single-dose Vial 25 Pack
Manufacturer: Fresenius Kabi
NDC#: 63323-0464-37
Code*: J3490
VIPNo
340BYes
Product: Sensorcaine® MPF 1
Prescribing Information
Size: 0.5% 10 mL Single-dose Vial 25 Pack
Manufacturer: Fresenius Kabi
NDC#: 63323-0466-17
Code*: J3490
VIPNo
340BYes
Product: Sensorcaine® MPF 1
Prescribing Information
Size: 0.5% 30 mL Single-dose Vial 25 Pack
Manufacturer: Fresenius Kabi
NDC#: 63323-0466-37
Code*: J3490
VIPNo
340BYes
Product: Sensorcaine® MPF w/Epinephrine 1
Prescribing Information
Size: 0.25% 30 mL Single-dose Vial 25 Pack
Manufacturer: Fresenius Kabi
NDC#: 63323-0468-37
Code*: J3490
VIPNo
340BYes
Product: Sensorcaine® MPF w/Epinephrine 1
Prescribing Information
Size: 0.5% 30 mL Single-dose Vial 25 Pack
Manufacturer: Fresenius Kabi
NDC#: 63323-0462-37
Code*: J3490
VIPNo
340BYes
Product: SOOLANTRA 2
Prescribing Information
Size: 45 gm Tube
Manufacturer: Galderma
NDC#: 00299-3823-45
Code*: TBD
VIPTBD
340BYes
Product: TICOVAC™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe
Manufacturer: Pfizer
NDC#: 00069-0411-02
Code*: TBD
VIPVIP
340BTBD
Product: TICOVAC™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe 10 Pack
Manufacturer: Pfizer
NDC#: 00069-0411-10
Code*: TBD
VIPNo
340BTBD
Product: Tranexamic Acid in 0.7% Sodium Chloride 2
Prescribing Information
Size: 1000 mg/100 mL Single-dose (IV) Bag
Manufacturer: Exela Pharma Sciences
NDC#: 51754-0108-03
Code*: J3490
VIPTBD
340BYes
Product: TRI-LUMA® Cream 2
Prescribing Information
Size: 30 gm Aluminum Tube (0.01%/4%/0.05%)
Manufacturer: Galderma
NDC#: 00299-5950-30
Code*: J3490
VIPNo
340BYes
Product: TWYNEO® Cream 1
Prescribing Information
Size: 30 gm Bottle w/ Pump (0.1%/3%)
Manufacturer: Galderma
NDC#: 00299-5945-30
Code*: TBD
VIPNo
340BNo
Product: VECTICAL® Ointment 2
Prescribing Information
Size: 3 mcg/1 gm 100 gm Tube
Manufacturer: Galderma
NDC#: 00299-2012-10
Code*: J3490
VIPNo
340BYes
Product: VAZCULEP® 2
Prescribing Information
Size: 50 mg/5 mL Single-dose Vial 10 Pack
Manufacturer: Exela Pharma Sciences
NDC#: 51754-4000-03
Code*: J2370
VIPTBD
340BYes
Product: VAZCULEP® 2
Prescribing Information
Size: 100 mg/10 mL Single-dose Vial
Manufacturer: Exela Pharma Sciences
NDC#: 51754-4020-01
Code*: J2370
VIPTBD
340BYes
Product: VAXELIS™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe 10 Pack
Manufacturer: Sanofi Pasteur
NDC#: 63361-0243-15
Code*: 90697
VIPTBD
340BTBD
Product: VAXELIS™
Prescribing Information
Size: 0.5 mL Single-dose Vial 10 Pack
Manufacturer: Sanofi Pasteur
NDC#: 63361-0243-10
Code*: 90697
VIPTBD
340BTBD
Product: VAXNEUVANCE™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe
Manufacturer: Merck
NDC#: 00006-4329-02
Code*: 90671
VIPNo
340BNo
Product: VAXNEUVANCE™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe 10 Box
Manufacturer: Merck
NDC#: 00006-4329-03
Code*: 90671
VIPNo
340BNo
Product: Verapamil 2
Prescribing Information
Size: 5 mg 2 mL Single-dose Vial 5 Carton
Manufacturer: Exela Pharma Sciences
NDC#: 51754-0203-02
Code*: J3490
VIPTBD
340BYes
Product: Verapamil 2
Prescribing Information
Size: 5 mg 2 mL Single-dose Vial 25 Carton
Manufacturer: Exela Pharma Sciences
NDC#: 51754-0203-04
Code*: J3490
VIPTBD
340BYes
Product: Verapamil 2
Prescribing Information
Size: 5 mg 2 mL Single-dose Vial 25 Carton
Manufacturer: Exela Pharma Sciences
NDC#: 51754-0204-04
Code*: J3490
VIPTBD
340BYes
Product: Vincristine
Prescribing Information
Size: 1 mg/1 mL Single Dose Vial
Manufacturer: Pfizer
NDC#: 61703-0309-06
Code*: J9370
VIPNo
340BNo
* All codes should be verified between the provider and the payer.
1 Call for eligibility through your GPO affiliation.
2 Call for eligibility.
+Call (800) 843-7477 or check ordering screen for RCo values.
VIP - Verified Inventory Program™ (VIPc)® | 340B - Public Health Services 340B Pricing Available.

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