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Product
Size
ManufacturerMfgr
NDC#
Code*
RNI
340B
Product: Acthar® Gel 2
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe 10 Box
Manufacturer: Mallinckrodt
NDC#: 63004-8710-01
Code*: J0800
RNINo
340BYes
Product: Afluria® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe 10 Box
Manufacturer: Seqirus
NDC#: 33332-0323-03
Code*: 90685
RNINo
340BNo
Product: Afluria® Quadrivalent
Prescribing Information
Size: 5 mL Multi-Dose Vial
Manufacturer: Seqirus
NDC#: 33332-0423-10
Code*: 90685
RNINo
340BNo
Product: Aminocaproic Acid
Prescribing Information
Size: 5 gm/20 mL Single-dose Fliptop Vial 25 Pack
Manufacturer: Pfizer
NDC#: 00409-4346-73
Code*: J3490
RNINo
340BTBD
Product: Argatroban Injection
Prescribing Information
Size: 250 mg/2.5 mL Single-dose Vial
Manufacturer: Par Pharmaceutical
NDC#: 42023-0182-01
Code*: J0883
RNINo
340BNo
Product: Artesunate for Injection
Prescribing Information
Size: 110 mg Single-dose Vial 2 Pack
Manufacturer: Amivas
NDC#: 73607-0011-11
Code*: J3490
RNIRNI
340BNo
Product: BRIVIACT®
Prescribing Information
Size: 10 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0370-66
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 25 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0470-66
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 50 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0570-66
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 75 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0670-66
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 100 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0770-66
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 50 mg/5 mL Single-dose Vial Carton of 10
Manufacturer: UCB
NDC#: 50474-0970-75
Code*: J3490
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 10 mg/mL 300 mL Oral Solution Bottle
Manufacturer: UCB
NDC#: 50474-0870-15
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 25 mg Tablet Unit Dose Carton of 100 Tablets
Manufacturer: UCB
NDC#: 50474-0470-09
Code*: TBD
RNINo
340BYes
Product: BRIVIACT®
Prescribing Information
Size: 100 mg Tablet Unit Dose Carton of 100 Tablets
Manufacturer: UCB
NDC#: 50474-0770-09
Code*: TBD
RNINo
340BYes
Product: CIMZIA®
Prescribing Information
Size: 200 mg Single-dose Pre-filled Syringe
Manufacturer: UCB
NDC#: 50474-0710-79
Code*: J0717
RNINo
340BYes
Product: CIMZIA®
Prescribing Information
Size: 200 mg Single-dose Pre-filled Syringe Pack of 6
Manufacturer: UCB
NDC#: 50474-0710-81
Code*: J0717
RNINo
340BYes
Product: CIMZIA®
Prescribing Information
Size: 200 mg Single-dose Vial
Manufacturer: UCB
NDC#: 50474-0700-62
Code*: J0717
RNINo
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
RNINo
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
RNINo
340BNo
Product: EPSOLAY® Cream 5% 2
Prescribing Information
Size: 30 gm Pump
Manufacturer: Galderma
NDC#: 00299-5890-30
Code*: TBD
RNINo
340BNo
Product: Fentanyl Citrate Injection 1
Prescribing Information
Size: 50 mcg/1 mL Single-dose Pre-filled Syringe
Manufacturer: Fresenius Kabi
NDC#: 63323-0808-11
Code*: J3010
RNINo
340BYes
Product: Fentanyl Citrate Injection 1
Prescribing Information
Size: 50 mcg/1 mL Single-dose Vial Carton of 25
Manufacturer: Fresenius Kabi
NDC#: 63323-0806-01
Code*: J3010
RNINo
340BYes
Product: Fluad® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Seqirus
NDC#: 70461-0123-03
Code*: 90694
RNINo
340BNo
Product: FLUARIX® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: GlaxoSmithKline
NDC#: 58160-0909-52
Code*: 90686
RNINo
340BNo
Product: Flublok® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Sanofi
NDC#: 49281-0723-10
Code*: 90682
RNINo
340BNo
Product: Flucelvax® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Seqirus
NDC#: 70461-0323-03
Code*: 90674
RNINo
340BNo
Product: Flucelvax® Quadrivalent
Prescribing Information
Size: 5 mL Multi-Dose Vial 10 Doses
Manufacturer: Seqirus
NDC#: 70461-0423-10
Code*: 90756
RNINo
340BNo
Product: FLULAVAL® Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: GlaxoSmithKline
NDC#: 19515-0814-52
Code*: 90686
RNINo
340BNo
Product: FluMist® Quadrivalent
Prescribing Information
Size: 0.2 mL Single-use Intranasal Spray Box of 10
Manufacturer: AstraZeneca
NDC#: 66019-0310-10
Code*: 90672
RNINo
340BNo
Product: Fluzone®Quadrivalent
Prescribing Information
Size: 0.5 mL Pre-Filled Syringe Box of 10
Manufacturer: Sanofi
NDC#: 49281-0423-50
Code*: 90686
RNINo
340BNo
Product: Fluzone® Quadrivalent
Prescribing Information
Size: 5 mL Multi-Dose Vial Box of 10
Manufacturer: Sanofi
NDC#: 49281-0639-15
Code*: 90688
RNINo
340BNo
Product: Fluzone® Quadrivalent High-Dose
Prescribing Information
Size: 0.7 mL Pre-Filled Syringe Box of 10
Manufacturer: Sanofi
NDC#: 49281-0123-65
Code*: 90662
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 1,000U/1 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0112-06
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 2,000U/2 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0115-07
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 5,000U/1 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0111-06
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 10,000U/1 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0113-06
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 10,000U/10 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0112-09
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 20,000U/1 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0116-06
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 30,000U/30 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0112-10
Code*: J1644
RNINo
340BNo
Product: Heparin Sodium
Prescribing Information
Size: 50,000U/5 mL Multiple-dose Vial Carton of 25
Manufacturer: Techdow
NDC#: 81952-0113-08
Code*: J1644
RNINo
340BNo
Product: Iodixanol
Prescribing Information
Size: 270 mg/100 mL Single-dose Bottle 10 Box
Manufacturer: Fresenius Kabi
NDC#: 65219-0381-10
Code*: TBD
RNINo
340BNo
Product: Iodixanol
Prescribing Information
Size: 270 mg/200 mL Single-dose Bottle 10 Box
Manufacturer: Fresenius Kabi
NDC#: 65219-0381-50
Code*: TBD
RNINo
340BNo
Product: Iodixanol
Prescribing Information
Size: 320 mg/50 mL Single-dose Bottle 10 Box
Manufacturer: Fresenius Kabi
NDC#: 65219-0383-05
Code*: TBD
RNINo
340BNo
Product: Iodixanol
Prescribing Information
Size: 320 mg/100 mL Single-dose Bottle 10 Box
Manufacturer: Fresenius Kabi
NDC#: 65219-0383-10
Code*: TBD
RNINo
340BNo
Product: Iodixanol
Prescribing Information
Size: 320 mg/150 mL Single-dose Bottle 10 Box
Manufacturer: Fresenius Kabi
NDC#: 65219-0383-50
Code*: TBD
RNINo
340BNo
Product: Iodixanol
Prescribing Information
Size: 320 mg/200 mL Single-dose Bottle 10 Box
Manufacturer: Fresenius Kabi
NDC#: 65219-0383-70
Code*: TBD
RNINo
340BNo
Product: Ivermectin Cream 1%
Prescribing Information
Size: 45 gm Tube
Manufacturer: Padagis
NDC#: 00574-2107-45
Code*: TBD
RNINo
340BNo
Product: KEPPRA®
Prescribing Information
Size: 250 mg Tablet Bottle of 120
Manufacturer: UCB
NDC#: 50474-0594-40
Code*: J8499
RNINo
340BYes
Product: KEPPRA®
Prescribing Information
Size: 500 mg Tablet Bottle of 120
Manufacturer: UCB
NDC#: 50474-0595-40
Code*: J8499
RNINo
340BYes
Product: KEPPRA®
Prescribing Information
Size: 750 mg Tablet Bottle of 120
Manufacturer: UCB
NDC#: 50474-0596-40
Code*: J8499
RNINo
340BYes
Product: KEPPRA®
Prescribing Information
Size: 1000 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0597-66
Code*: J3490
RNINo
340BYes
Product: KEPPRA®
Prescribing Information
Size: 100 mg/1 mL Oral Solution
Manufacturer: UCB
NDC#: 50474-0001-48
Code*: J8499
RNINo
340BYes
Product: KEPPRA®
Prescribing Information
Size: 500 mg/5 mL Single-use Vial Carton of 10
Manufacturer: UCB
NDC#: 50474-0002-63
Code*: J1953
RNINo
340BYes
Product: KEPPRA XR®
Prescribing Information
Size: 500 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0598-66
Code*: J8499
RNINo
340BYes
Product: KEPPRA XR®
Prescribing Information
Size: 750 mg Tablet Bottle of 60
Manufacturer: UCB
NDC#: 50474-0599-66
Code*: J8499
RNINo
340BYes
Product: KETALAR® 2
Prescribing Information
Size: 200 mg/20 mL Multi-dose Vial 10 Pack
Manufacturer: Par Pharmaceutical
NDC#: 42023-0113-10
Code*: J3490
RNINo
340BYes
Product: KETALAR® 2
Prescribing Information
Size: 500 mg/5 mL Multi-dose Vial 10 Pack
Manufacturer: Par Pharmaceutical
NDC#: 42023-0115-10
Code*: J3490
RNINo
340BYes
Product: KETALAR® 2
Prescribing Information
Size: 500 mg/10 mL Multi-dose Vial 10 Pack
Manufacturer: Par Pharmaceutical
NDC#: 42023-0114-10
Code*: J3490
RNINo
340BYes
Product: Mafenide Acetate 5% 2
Prescribing Information
Size: 50 gm Pack Carton of 5 Packs
Manufacturer: Par Pharmaceutical
NDC#: 49884-0902-78
Code*: TBD
RNINo
340BTBD
Product: MenQuadfi®
Prescribing Information
Size: 0.5 mL Single-dose Vial 5 Pack
Manufacturer: Sanofi
NDC#: 49281-0590-05
Code*: 90734
RNIRNI
340BNo
Product: Methylene Blue
Prescribing Information
Size: 100 mg/10 mL Single-dose Vial
Manufacturer: BPI Labs
NDC#: 54288-0147-01
Code*: J3490
RNINo
340BNo
Product: Methylprednisolone Acetate
Prescribing Information
Size: 40 mg/1 mL Single-dose Vial
Manufacturer: Amneal Pharmaceuticals
NDC#: 70121-1573-01
Code*: J1030
RNINo
340BNo
Product: Methylprednisolone Acetate
Prescribing Information
Size: 40 mg/1 mL Single-dose Vial Carton of 25
Manufacturer: Amneal Pharmaceuticals
NDC#: 70121-1573-05
Code*: J1030
RNINo
340BNo
Product: Methylprednisolone Acetate
Prescribing Information
Size: 80 mg/1 mL Single-dose Vial
Manufacturer: Amneal Pharmaceuticals
NDC#: 70121-1574-01
Code*: J1040
RNINo
340BNo
Product: Methylprednisolone Acetate
Prescribing Information
Size: 80 mg/1 mL Single-dose Vial Carton of 25
Manufacturer: Amneal Pharmaceuticals
NDC#: 70121-1574-05
Code*: J1040
RNINo
340BNo
Product: NAYZILAM®
Prescribing Information
Size: 5 mg/0.1 mL Single-dose Nasal Spray Unit
Manufacturer: UCB
NDC#: 50474-0500-15
Code*: J3490
RNINo
340BYes
Product: NEUPRO®
Prescribing Information
Size: 1 mg/24 hours Patch 30 Carton
Manufacturer: UCB
NDC#: 50474-0801-03
Code*: J3490
RNINo
340BYes
Product: NEUPRO®
Prescribing Information
Size: 2 mg/24 hours Patch 30 Carton
Manufacturer: UCB
NDC#: 50474-0802-03
Code*: J3490
RNINo
340BYes
Product: NEUPRO®
Prescribing Information
Size: 3 mg/24 hours Patch 30 Carton
Manufacturer: UCB
NDC#: 50474-0803-03
Code*: J3490
RNINo
340BYes
Product: NEUPRO®
Prescribing Information
Size: 4 mg/24 hours Patch 30 Carton
Manufacturer: UCB
NDC#: 50474-0804-03
Code*: J3490
RNINo
340BYes
Product: NEUPRO®
Prescribing Information
Size: 6 mg/24 hours Patch 30 Carton
Manufacturer: UCB
NDC#: 50474-0805-03
Code*: J3490
RNINo
340BYes
Product: NEUPRO®
Prescribing Information
Size: 8 mg/24 hours Patch 30 Carton
Manufacturer: UCB
NDC#: 50474-0806-03
Code*: J3490
RNINo
340BYes
Product: NIPRIDE® RTU 2
Prescribing Information
Size: 20 mg/100 mL Single-dose Fliptop Vial
Manufacturer: Exela
NDC#: 51754-1029-01
Code*: J3490
RNITBD
340BTBD
Product: Pitocin® 2
Prescribing Information
Size: 10 mL Multi-dose Vial Carton of 25
Manufacturer: Par Pharmaceutical
NDC#: 42023-0116-02
Code*: J2590
VIPNo
340BNo
Product: PreHevbrio
Prescribing Information
Size: 10 mcg Single-dose Vial Box of 10
Manufacturer: VBI Vaccines
NDC#: 75052-0001-10
Code*: 90759
RNIRNI
340BTBD
Product: Quadracel®
Prescribing Information
Size: 0.5 mL Single-dose Vial 10 Box
Manufacturer: Sanofi
NDC#: 49281-0564-15
Code*: 90696
RNIRNI
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
RNINo
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
RNINo
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
RNINo
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
RNINo
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
RNINo
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
RNINo
340BYes
Product: SEVENFACT®
Prescribing Information
Size: 1 mg Single-dose Vial
Manufacturer: HEMA Biologics
NDC#: 71127-1000-01
Code*: J7212
RNINo
340BYes
Product: SEVENFACT®
Prescribing Information
Size: 5 mg Single-dose Vial
Manufacturer: HEMA Biologics
NDC#: 71127-5000-01
Code*: J7212
RNINo
340BYes
Product: TERLIVAZ®
Prescribing Information
Size: 0.85 mg Single-dose Vial
Manufacturer: Mallinckrodt
NDC#: 43825-0200-01
Code*: TBD
RNINo
340BNo
Product: TICOVAC™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe
Manufacturer: Pfizer
NDC#: 00069-0411-02
Code*: TBD
RNIRNI
340BTBD
Product: TICOVAC™
Prescribing Information
Size: 0.5 mL Pre-filled Syringe 10 Pack
Manufacturer: Pfizer
NDC#: 00069-0411-10
Code*: TBD
RNINo
340BTBD
Product: VIMPAT®
Prescribing Information
Size: 10 mg/200 mL Glass Bottle
Manufacturer: UCB
NDC#: 00131-5410-72
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 200 mg/20 mL Single-dose Vial 10 Pack
Manufacturer: UCB
NDC#: 00131-1810-67
Code*: C9254/ J3490
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 50 mg Tablet Unit Dose Carton of 60
Manufacturer: UCB
NDC#: 00131-2477-60
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 100 mg Tablet Unit Dose Carton of 60
Manufacturer: UCB
NDC#: 00131-2478-60
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 150 mg Tablet Unit Dose Carton of 60
Manufacturer: UCB
NDC#: 00131-2479-60
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 200 mg Tablet Unit Dose Carton of 60
Manufacturer: UCB
NDC#: 00131-2480-60
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 50 mg Tablet Bottle of 60 Tablets
Manufacturer: UCB
NDC#: 00131-2477-35
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 100 mg Tablet Bottle of 60 Tablets
Manufacturer: UCB
NDC#: 00131-2478-35
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 150 mg Tablet Bottle of 60 Tablets
Manufacturer: UCB
NDC#: 00131-2479-35
Code*: J8499
RNINo
340BYes
Product: VIMPAT®
Prescribing Information
Size: 200 mg Tablet Bottle of 60 Tablets
Manufacturer: UCB
NDC#: 00131-2480-35
Code*: J8499
RNINo
340BYes
Product: VTAMA® Cream 1%
Prescribing Information
Size: 60 gm Laminated Tube
Manufacturer: Dermavant Sciences
NDC#: 81672-5051-01
Code*: TBD
RNINo
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.
RNI - RightNow Inventory™ Eligible Products | 340B - Public Health Services 340B Pricing Available.

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