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Product
Size
ManufacturerMfgr
NDC#
Code*
VIP
340B
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
VIPNo
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
VIPNo
340BYes
Product: AKLIEF® Cream 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5935-45
Code*: J3490
VIPTBD
340BYes
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: ANAVIP®
Prescribing Information
Size: 12 mg/20 mL Single-dose Vial
Manufacturer: Rare Disease Therapeutics
NDC#: 66621-0790-02
Code*: J0841
VIPVIP
340BYes
Product: Atropine Sulfate 1
Prescribing Information
Size: 1 mg/mL 10 mL Luer-Jet™ Luer-Lock Pre-Filled Syringe 10 Pack
Manufacturer: International Medication Systems
NDC#: 76329-3340-01
Code*: J0461
VIPNo
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: Cefazolin 1
Prescribing Information
Size: 1 gm/10 mL Single-dose Vial 25 Pack
Manufacturer: Apotex
NDC#: 60505-6142-05
Code*: J0690
VIPNo
340BYes
Product: Cefazolin 1
Prescribing Information
Size: 10 gm/100 mL Single-dose Vial 10 Pack
Manufacturer: Apotex
NDC#: 60505-6143-04
Code*: J0690
VIPNo
340BYes
Product: Cefepime 1
Prescribing Information
Size: 1 gm/20 mL Single-dose Vial
Manufacturer: Apotex
NDC#: 60505-6146-00
Code*: J0692
VIPNo
340BYes
Product: Cefepime 1
Prescribing Information
Size: 2 gm/20 mL Single-dose Vial
Manufacturer: Apotex
NDC#: 60505-6147-00
Code*: J0692
VIPNo
340BYes
Product: Cefepime 1
Prescribing Information
Size: 1 gm/20 mL Single-dose Vial Box of 10
Manufacturer: Apotex
NDC#: 60505-6146-04
Code*: J0692
VIPNo
340BYes
Product: Cefepime 1
Prescribing Information
Size: 2 gm/20 mL Single-dose Vial Box of 10
Manufacturer: Apotex
NDC#: 60505-6147-04
Code*: J0692
VIPNo
340BYes
Product: Ceftriaxone 1
Prescribing Information
Size: 1 gm/20 mL Single-dose Vial 10 Pack
Manufacturer: Apotex
NDC#: 60505-6148-04
Code*: J0696
VIPNo
340BYes
Product: Ceftriaxone 1
Prescribing Information
Size: 2 gm/20 mL Single-dose Vial 10 Pack
Manufacturer: Apotex
NDC#: 60505-6149-04
Code*: J0696
VIPNo
340BYes
Product: Ceftriaxone 1
Prescribing Information
Size: 250 mg/10 mL Single-dose Vial
Manufacturer: Apotex
NDC#: 60505-6151-04
Code*: J0696
VIPNo
340BYes
Product: Ceftriaxone 1
Prescribing Information
Size: 250 mg/10 mL Single-dose Vial 10 Pack
Manufacturer: Apotex
NDC#: 60505-6151-01
Code*: J0696
VIPNo
340BYes
Product: Ceftriaxone 1
Prescribing Information
Size: 500 mg/10 mL Single-dose Vial
Manufacturer: Apotex
NDC#: 60505-6152-04
Code*: J0696
VIPNo
340BYes
Product: Ceftriaxone 1
Prescribing Information
Size: 500 mg/10 mL Single-dose Vial 10 Pack
Manufacturer: Apotex
NDC#: 60505-6152-01
Code*: J0696
VIPNo
340BYes
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: 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: Doxycycline
Prescribing Information
Size: 40 mg Capsule Bottle of 30
Manufacturer: Presco Laboratories
NDC#: 66993-0815-30
Code*: TBD
VIPNo
340BYes
Product: Dehydrated Alcohol
Prescribing Information
Size: 5 mL (0.98 mL/1 mL) Multi-dose Vial Box of 10
Manufacturer: Akorn Pharmaceuticals
NDC#: 17478-0503-05
Code*: J3490
VIPNo
340BYes
Product: Dextrose
Prescribing Information
Size: 50% 25 gm/50 mL Pre-filled Syringe
Manufacturer: International Medication Systems
NDC#: 76329-3301-01
Code*: J3490
VIPNo
340BYes
Product: Diazepam 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 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: Dilaudid® Injection 1
Prescribing Information
Size: 0.2 mg/1 mL Single-dose Pre-filled Syringe 10 Box
Manufacturer: Fresenius Kabi
NDC#: 76045-0121-11
Code*: J1170
VIPNo
340BYes
Product: Docetaxel Injection
Prescribing Information
Size: 20 mg/1 mL Single-dose Vial
Manufacturer: Hospira
NDC#: 00409-0366-01
Code*: J9171
VIPNo
340BYes
Product: Docetaxel Injection
Prescribing Information
Size: 160 mg/8 mL Single-dose Vial
Manufacturer: Hospira
NDC#: 00409-0368-01
Code*: J9171
VIPNo
340BYes
Product: EPIDUO FORTE Gel 2
Prescribing Information
Size: 45 gm Pump
Manufacturer: Galderma
NDC#: 00299-5906-45
Code*: TBD
VIPTBD
340BYes
Product: ESPEROCT®
Prescribing Information
Size: 500 mcg (4 mL) Syringe
Manufacturer: Novo Nordisk
NDC#: 00169-8500-01
Code*: J7199
VIPNo
340BYes
Product: ESPEROCT®
Prescribing Information
Size: 1000 mcg (4 mL) Syringe
Manufacturer: Novo Nordisk
NDC#: 00169-8100-01
Code*: J7199
VIPNo
340BYes
Product: ESPEROCT®
Prescribing Information
Size: 1500 mcg (4 mL) Syringe
Manufacturer: Novo Nordisk
NDC#: 00169-8150-01
Code*: J7199
VIPNo
340BYes
Product: ESPEROCT®
Prescribing Information
Size: 2000 mcg (4 mL) Syringe
Manufacturer: Novo Nordisk
NDC#: 00169-8200-01
Code*: J7199
VIPNo
340BYes
Product: ESPEROCT®
Prescribing Information
Size: 3000 mcg (4 mL) Syringe
Manufacturer: Novo Nordisk
NDC#: 00169-8300-01
Code*: J7199
VIPNo
340BYes
Product: EVKEEZA™
Prescribing Information
Size: 345 mg/2.3 mL (150 mg/mL) Single-dose Vial
Manufacturer: Regeneron
NDC#: 61755-0013-01
Code*: TBD
VIPNo
340BYes
Product: EVKEEZA™
Prescribing Information
Size: 1200 mg/8 mL (150 mg/mL) Single-dose Vial
Manufacturer: Regeneron
NDC#: 61755-0010-01
Code*: TBD
VIPNo
340BYes
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#: 70461-0120-03
Code*: 90653
VIPNo
340BTBD
Product: GEL-FLOW™
Prescribing Information
Size: JMI 5000 IU Spray Kit (With Thrombin)
Manufacturer: Pfizer
NDC#: 00009-1040-06
Code*: J3490
VIPNo
340BNo
Product: GEL-FLOW™ NT
Prescribing Information
Size: 6 mL (Box/6 Kits) (No Thrombin)
Manufacturer: Pfizer
NDC#: 00009-2250-01
Code*: J3590
VIPNo
340BNo
Product: Imovax® Rabies
Prescribing Information
Size: 1 mL Single-dose Vial w/diluent
Manufacturer: Sanofi Pasteur
NDC#: 49281-0252-51
Code*: 90675
VIPVIP
340BNo
Product: IXINITY®
Prescribing Information
Size: 500 IU Range Single-dose Vial
Manufacturer: Medexus
NDC#: 70504-0282-05
Code*: J7195
VIPVIP
340BYes
Product: IXINITY®
Prescribing Information
Size: 1000 IU Range Single-dose Vial
Manufacturer: Medexus
NDC#: 70504-0283-05
Code*: J7195
VIPVIP
340BYes
Product: IXINITY®
Prescribing Information
Size: 1500 IU Range Single-dose Vial
Manufacturer: Medexus
NDC#: 70504-0284-05
Code*: J7195
VIPVIP
340BYes
Product: IXINITY®
Prescribing Information
Size: 3000 IU Range Single-dose Vial
Manufacturer: Medexus
NDC#: 70504-0289-05
Code*: J7195
VIPVIP
340BYes
Product: Lidocaine HCL
Prescribing Information
Size: 2% Hydrochloride 100 mg 5 mL (20 mg/mL) Pre-filled Syringe
Manufacturer: International Medication Systems
NDC#: 76329-3390-01
Code*: J3490
VIPNo
340BYes
Product: Labetalol 1
Prescribing Information
Size: 20 mg/4 mL Single-dose Carpuject™ Syringe Pack of 10
(250 mg/mL)
Manufacturer: Pfizer
NDC#: 00409-2339-04
Code*: J3490
VIPNo
340BYes
Product: Lorazepam 1
Prescribing Information
Size: 2 mg/1 mL Single-dose CARPUJECT™ Syringe System 10 Pack
Manufacturer: Pfizer
NDC#: 00409-1985-03
Code*: J2060
VIPNo
340BYes
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: Novoeight® †
Prescribing Information
Size: 2000 IU Vial
Manufacturer: Novo Nordisk
NDC#: 00169-7820-01
Code*: J7182
VIPVIP
340BYes
Product: NUWIQ® †
Prescribing Information
Size: 2500 IU Single-dose Vial
Manufacturer: Octapharma
NDC#: 68982-0147-01
Code*: J7209
VIPVIP
340BYes
Product: NUWIQ® †
Prescribing Information
Size: 3000 IU Single-dose Vial
Manufacturer: Octapharma
NDC#: 68982-0149-01
Code*: J7209
VIPVIP
340BYes
Product: NUWIQ® †
Prescribing Information
Size: 4000 IU Single-dose Vial
Manufacturer: Octapharma
NDC#: 68982-0151-01
Code*: J7209
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: 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: Sodium Chloride
Prescribing Information
Size: 0.9% 20 mL Single-dose Vial Box of 25
Manufacturer: Pfizer
NDC#: 00409-4888-20
Code*: A4216
VIPNo
340BYes
Product: Sodium Chloride
Prescribing Information
Size: 0.9% 50 mL Single-dose Vial Box of 25
Manufacturer: Pfizer
NDC#: 00409-4888-50
Code*: A4216
VIPNo
340BYes
Product: Sodium Tetradecyl Sulfate 3%
Prescribing Information
Size: 60 mg/2 mL (30 mg/mL) Vial 5 Box
Manufacturer: Leucadia Pharmaceuticals
NDC#: 24201-0201-05
Code*: J3490
VIPVIP
340BYes
Product: SOOLANTRA 2
Prescribing Information
Size: 45 gm Tube
Manufacturer: Galderma
NDC#: 00299-3823-45
Code*: TBD
VIPTBD
340BYes
Product: Tamiflu®
Prescribing Information
Size: 30 mg Capsules 10 Pack
Manufacturer: Genentech
NDC#: 00004-0802-85
Code*: G9035/G9019
VIPNo
340BYes
Product: Tamiflu®
Prescribing Information
Size: 45 mg Capsules 10 Pack
Manufacturer: Genentech
NDC#: 00004-0801-85
Code*: G9035/G9019
VIPNo
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: VECTICAL® Ointment 2
Prescribing Information
Size: 3 mcg/1 gm 100 gm Tube
Manufacturer: Galderma
NDC#: 00299-2012-10
Code*: J3490
VIPNo
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: XERAVA™
Prescribing Information
Size: 100 mg/10 mL Single-dose Vial 12 Pack
Manufacturer: Tetraphase Pharmaceuticals
NDC#: 71773-0100-12
Code*: J0122
VIPVIP
340BYes
Product: YUTIQ™
Prescribing Information
Size: YUTIQ 0.18 mg Intravitreal Injection
Manufacturer: Eyepoint Pharmaceuticals
NDC#: 71879-0136-01
Code*: J7314
VIPNo
340BYes
Product: ZILRETTA®
Prescribing Information
Size: 32 mg Single-dose Kit
Manufacturer: Flexion Therapeutics
NDC#: 70801-0003-01
Code*: J3304
VIPVIP
340BYes
* 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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