S E N HYPERIMMUNE I C A GLLOBULOBULINSIGIM V FLU G I ... · the products you s c i flu g vaccine product coagulatio hyperimmune albumin/pllasma proteiiasma proteivin fractig v gllobulobulins

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. . . .actionrotein Fr / Plasma P... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Product Size Manufacturer NDC# Code*

ANTI-INHIBITOR (HUMAN PLASMA-DERIVED) FEIBA NF 500 IU VIAL W/BAXJECT II SHIRE 64193-0423-02 J7198 1000 IU VIAL W/BAXJECT II 64193-0424-02 J7198 2500 IU VIAL W/BAXJECT II 64193-0425-02 J7198 FACTOR VIIa (RECOMBINANT) NOVOSEVEN RT 1000 MCG VIAL NOVO NORDISK 00169-7201-01 J7189 WITH MIXPRO 2000 MCG VIAL 00169-7202-01 J7189 5000 MCG VIAL 00169-7205-01 J7189 8000 MCG VIAL 00169-7208-01 J7189 FACTOR VIII (HUMAN PLASMA-DERIVED) KOATE DVI 250 IU VIAL KEDRION 76125-0250-20 J7190 500 IU VIAL 76125-0667-30 J7190 1000 IU VIAL 76125-0672-50 J7190

VON WILLEBRAND FACTOR / FACTOR VIII COMPLEX (HUMAN PLASMA-DERIVED) ALPHANATE 250 IU VIAL+ GRIFOLS 68516-4601-01 J7186 500 IU VIAL+ 68516-4602-01 J7186 1000 IU VIAL+ 68516-4603-02 J7186 1500 IU VIAL+ 68516-4604-02 J7186 2000 IU VIAL+ 68516-4609-02 J7186HUMATE-P 600 IU VWF:RCO AND 250 IU FVIII CSL BEHRING 63833-0615-02 J7187 1200 IU VWF:RCO AND 500 IU FVIII 63833-0616-02 J7187 2400 IU VWF:RCO AND 1000 IU FVIII 68516-4609-02 J7186 WILATE 500 IU VIAL+ OCTAPHARMA 67467-0182-01 J7183 1000 IU VIAL+ 67467-0182-02 J7183

FACTOR VIII (RECOMBINANT) ADVATE 2 ML 250 IU VIAL SHIRE 00944-3051-02 J7192 500 IU VIAL 00944-3052-02 J7192 1000 IU VIAL 00944-3053-02 J7192 1500 IU VIAL 00944-3054-02 J7192 ADVATE 5 ML 2000 IU VIAL SHIRE 00944-3045-10 J7192 3000 IU VIAL 00944-3046-10 J7192 4000 IU VIAL 00944-3047-10 J7192 ADYNOVATE 250 IU VIAL SHIRE 00944-4252-02 J7192 500 IU VIAL 00944-4254-02 J7192 1000 IU VIAL 00944-4256-02 J7192 2000 IU VIAL 00944-4258-02 J7192AFSTYLA 250 IU CSL BEHRING 69911-0474-02 J7199/C9399 500 IU 69911-0475-02 J7199/C9399 1000 IU 69911-0476-02 J7199/C9399 2000 IU 69911-0477-02 J7199/C9399 3000 IU 69911-0478-02 J7199/C9399ELOCTATE 250 IU VIAL BIOGEN 64406-0801-01 J7205 500 IU VIAL 64406-0802-01 J7205 750 IU VIAL 64406-0803-01 J7205 1000 IU VIAL 64406-0804-01 J7205 1500 IU VIAL 64406-0805-01 J7205 2000 IU VIAL 64406-0806-01 J7205 3000 IU VIAL 64406-0807-01 J7205 HELIXATE FS 250 IU VIAL CSL BEHRING 00053-8131-02 J7192 500 IU VIAL 00053-8132-02 J7192 1000 IU VIAL 00053-8133-02 J7192 2000 IU VIAL 00053-8134-02 J7192 3000 IU VIAL 00053-8135-02 J7192 KOGENATE FS 250 IU VIAL W/BIOSET BAYER 00026-3792-20 J7192KOGENATE FS VIAL ADAPTER 250 IU VIAL W/VIAL ADAPTER BAYER 00026-3782-25 J7192 500 IU VIAL W/VIAL ADAPTER 00026-3783-35 J7192 1000 IU VIAL W/VIAL ADAPTER 00026-3785-55 J7192 2000 IU VIAL W/VIAL ADAPTER 00026-3786-65 J7192 3000 IU VIAL W/VIAL ADAPTER 00026-3787-75 J7192KOVALTRY 250 IU VIAL BAYER 00026-3821-25 TBD 500 IU VIAL 00026-3822-25 TBD 1000 IU VIAL 00026-3824-25 TBD 2000 IU VIAL 00026-3826-50 TBD 3000 IU VIAL 00026-3828-50 TBD

Coagulation Products

Continued*All codes should be verified between the provider and the payer. +Call (800) 843-7477 or check ordering screen for RCo values.

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc

VIPc340B

VIPc340B

VIPc

340B

VIPc

VIPc

VIPc

VIPc Verified Inventory Program-Consignment (VIPc™)

Public Health Services 340B pricing available.340B

6

Continued


FACTOR VIII (RECOMBINANT) CONTINUED

NOVOEIGHT 500 IU VIAL NOVO NORDISK 00169-7850-01 J7182 1000 IU VIAL 00169-7810-01 J7182 3000 IU VIAL 00169-7830-01 J7182

NUWIQ 250 IU VIAL OCTAPHARMA 68982-0139-01 J7192 500 IU VIAL 68982-0141-01 J7192 1000 IU VIAL 68982-0143-01 J7192 2000 IU VIAL 68982-0145-01 J7192 RECOMBINATE 220-400 IU VIAL SHIRE 00944-2841-10 J7192 401-800 IU VIAL 00944-2842-10 J7192 801-1240 IU VIAL 00944-2843-10 J7192 1241-1800 IU VIAL 00944-2844-10 J7192 1801-2400 IU VIAL 00944-2845-10 J7192

XYNTHA 250 IU VIAL PFIZER 58394-0012-01 J7185 500 IU VIAL 58394-0013-01 J7185 1000 IU VIAL 58394-0014-01 J7185 2000 IU VIAL 58394-0015-01 J7185

XYNTHA SOLOFUSE 250 IU/4ML DCS PFIZER 58394-0022-03 J7185 500 IU/4ML DCS 58394-0023-03 J7185 2000 IU/4ML DCS 58394-0025-03 J7185 3000 IU/4ML DCS 58394-0016-03 J7185

FACTOR VIII (MONOCLONAL PURIFIED)

HEMOFIL M 250 IU VIAL SHIRE 00944-3940-02 J7190 500 IU VIAL 00944-3942-02 J7190 1000 IU VIAL 00944-3944-02 J7190 1700 IU VIAL 00944-3946-02 J7190

MONOCLATE-P 1000 IU VIAL CSL BEHRING 00053-7633-02 J7190

FACTOR IX (HUMAN PLASMA-DERIVED)

ALPHANINE SD 500 IU VIAL GRIFOLS 68516-3601-02 J7193 1000 IU VIAL 68516-3602-02 J7193 1500 IU VIAL 68516-3603-02 J7193

BEBULIN 500 IU VIAL SHIRE 64193-0445-02 J7194

PROFILNINE SD 500 IU VIAL GRIFOLS 68516-3201-01 J7194 1000 IU VIAL 68516-3202-02 J7194 1500 IU VIAL 68516-3203-02 J7194

FACTOR IX (MONOCLONAL PURIFIED)

MONONINE 1000 IU VIAL CSL BEHRING 00053-6233-02 J7193

FACTOR IX (RECOMBINANT)

ALPROLIX 500 IU VIAL BIOGEN 64406-0911-01 J7199 1000 IU VIAL 64406-0922-01 J7199 2000 IU VIAL 64406-0933-01 J7199 3000 IU VIAL 64406-0944-01 J7199

BENEFIX RT 250 IU VIAL PFIZER 58394-0633-03 J7195 500 IU VIAL 58394-0634-03 J7195 1000 IU VIAL 58394-0635-03 J7195 2000 IU VIAL 58394-0636-03 J7195 3000 IU VIAL 58394-0637-03 J7195

IDELVION 250 IU VIAL CSL BEHRING 69911-0864-02 TBD 500 IU VIAL 69911-0865-02 TBD 1000 IU VIAL 69911-0866-02 TBD 2000 IU VIAL 69911-0867-02 TBD

RIXUBIS 250 IU VIAL SHIRE 00944-3026-02 J7195 500 IU VIAL 00944-3028-02 J7195 1000 IU VIAL 00944-3030-02 J7195 2000 IU VIAL 00944-3032-02 J7195 3000 IU VIAL 00944-3034-02 J7195

Coagulation Products (CONTINUED)

*All codes should be verified between the provider and the payer.


VIPc

VIPc

VIPc

VIPc

VIPc

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B



7

COAGUALATIONIM

MUNE

GLOBULINSHYPERIM

MUNES

INFLUENZA VACCINES& ANCILLARIES

ALBUMIN / PLASM

APROTEIN FRACTION

ONCOLOGY & BIOSURGERY



IMMUNE GLOBULINS SUBCUTANEOUS (SCIG)

HIZENTRA 1 GM VIAL CSL BEHRING 44206-0451-01 J1559 2 GM VIAL 44206-0452-02 J1559 4 GM VIAL 44206-0454-04 J1559 10 GM VIAL 44206-0455-10 J1559

HYQVIA 2.5 GM VIAL SHIRE 00944-2510-02 5 GM VIAL 00944-2511-02 10 GM VIAL 00944-2512-02 20 GM VIAL 00944-2513-02 30 GM VIAL 00944-2514-02

GAMUNEX-C 1 GM VIAL GRIFOLS 13533-0800-12 J1561 2.5 GM VIAL 13533-0800-15 J1561 5 GM VIAL 13533-0800-20 J1561 10 GM VIAL 13533-0800-71 J1561 20 GM VIAL 13533-0800-24 J1561 40 GM VIAL 13533-0800-40 J1561

GAMMAGARD LIQUID 1 GM VIAL SHIRE 00944-2700-02 J1569 2.5 GM VIAL 00944-2700-03 J1569 5 GM VIAL 00944-2700-04 J1569 10 GM VIAL 00944-2700-05 J1569 20 GM VIAL 00944-2700-06 J1569 30 GM VIAL 00944-2700-07 J1569

GAMMAKED 1 GM VIAL KEDRION 76125-0900-01 J1561 2.5 GM VIAL 76125-0900-25 J1561 5 GM VIAL 76125-0900-50 J1561 10 GM VIAL 76125-0900-10 J1561 20 GM VIAL 76125-0900-20 J1561

OTHER COAGULATION PRODUCTS

CORIFACT 1000-1600 IU VIAL CSL BEHRING 63833-0518-02 J7180

KCENTRA 500 IU VIAL CSL BEHRING 63833-0386-02 J3590 1000 IU VIAL 63833-0387-02 J3590 RIASTAP 1000 MG VIAL CSL BEHRING 63833-0891-51 J1680

STIMATE NASAL SPRAY 1.5 ML CSL BEHRING 00053-6871-00 J3490

Immune Globulins Subcutaneous (SCIG)


IMMUNE GLOBULIN INTRAMUSCULAR (IGIM) GAMASTAN S/D 2 ML VIAL GRIFOLS 13533-0635-04 J1460 10 ML VIAL 13533-0635-12 J1460

Immune Globulin Intramuscular (IGIM)


**Call Baxalta Reimbursement at (888) 229-8379 for the most up-to-date billing code.

J3490 or J3590** J3490 or J3590** J3490 or J3590** J3490 or J3590** J3490 or J3590**


Coagulation Products (CONTINUED)

VIPc

VIPc

VIPc

340B

VIPc340B

VIPc

340B

VIPc340B



Fax (800) 418-4333 | FFFenterprises.com | MyFluVaccine.com | biosupply.fffenterprises.com

C 6 GM VIAL CSL BEHRING 44206-0417-06 J1566 12 GM VIAL 44206-0418-12 J1566

G 5 GM VIAL SHIRE 00944-2656-03 J1566( 10 GM VIAL 00944-2658-04 J1566

I

B 5 GM VIAL KEDRION 59730-6502-01 J1556 10 GM VIAL 59730-6503-01 J1556

F 2.5 GM VIAL GRIFOLS 61953-0004-02 J1572 5 GM VIAL 61953-0004-03 J1572 10 GM VIAL 61953-0004-04 J1572 20 GM VIAL 61953-0004-05 J1572

F 5 GM VIAL GRIFOLS 61953-0005-01 J1572 10 GM VIAL 61953-0005-02 J1572 20 GM VIAL 61953-0005-03 J1572

G 1 GM VIAL SHIRE 00944-2700-02 J1569 2.5 GM VIAL 00944-2700-03 J1569 5 GM VIAL 00944-2700-04 J1569 10 GM VIAL 00944-2700-05 J1569 20 GM VIAL 00944-2700-06 J1569 30 GM VIAL 00944-2700-07 J1569

G 1 GM VIAL KEDRION 76125-0900-01 J1561 5 GM VIAL 76125-0900-50 J1561 10 GM VIAL 76125-0900-10 J1561 20 GM VIAL 76125-0900-20 J1561

G 5 GM VIAL BPL 64208-8234-06 J1557 10 GM VIAL 64208-8234-07 J1557 20 GM VIAL 64208-8234-08 J1557

G 1 GM VIAL GRIFOLS 13533-0800-12 J1561 2.5 GM VIAL 13533-0800-15 J1561 5 GM VIAL 13533-0800-20 J1561 10 GM VIAL 13533-0800-71 J1561 20 GM VIAL 13533-0800-24 J1561 40 GM VIAL 13533-0800-40 J1561

O 1 GM VIAL OCTAPHARMA 68982-0840-01 J1568 2.5 GM VIAL 68982-0840-02 J1568 5 GM VIAL 68982-0840-03 J1568 10 GM VIAL 68982-0840-04 J1568

O 2 GM VIAL OCTAPHARMA 68982-0850-01 J1568 5 GM VIAL 68982-0850-02 J1568 10 GM VIAL 68982-0850-03 J1568 20 GM VIAL 68982-0850-04 J1568

P 5 GM VIAL CSL BEHRING 44206-0436-05 J1459 10 GM VIAL 44206-0437-10 J1459 20 GM VIAL 44206-0438-20 J1459 40 GM VIAL 44206-0439-40 J1459

I

V

P

8

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H 1 GM VIAL CSL BEHRING 44206-0451-01 J1559 2 GM VIAL 44206-0452-02 J1559 4 GM VIAL 44206-0454-04 J1559 10 GM VIAL 44206-0455-10 J1559

H 2.5 GM VIAL SHIRE 00944-2510-02 5 GM VIAL 00944-2511-02 10 GM VIAL 00944-2512-02 20 GM VIAL 00944-2513-02 30 GM VIAL 00944-2514-02

G 1 GM VIAL GRIFOLS 13533-0800-12 J1561 2.5 GM VIAL 13533-0800-15 J1561 5 GM VIAL 13533-0800-20 J1561 10 GM VIAL 13533-0800-71 J1561 20 GM VIAL 13533-0800-24 J1561 40 GM VIAL 13533-0800-40 J1561

G 1 GM VIAL SHIRE 00944-2700-02 J1569 2.5 GM VIAL 00944-2700-03 J1569 5 GM VIAL 00944-2700-04 J1569 10 GM VIAL 00944-2700-05 J1569 20 GM VIAL 00944-2700-06 J1569 30 GM VIAL 00944-2700-07 J1569

G 1 GM VIAL KEDRION 76125-0900-01 J1561 2.5 GM VIAL 76125-0900-25 J1561 5 GM VIAL 76125-0900-50 J1561 10 GM VIAL 76125-0900-10 J1561 20 GM VIAL 76125-0900-20 J1561

O

C

63833-0387-02 J3590

G J1460 13533-0635-12 J1460

I

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IMMUNE GLOBULINS (HUMAN) LYOPHILIZED

CARIMUNE NF 6 GM VIAL CSL BEHRING 44206-0417-06 J1566 12 GM VIAL 44206-0418-12 J1566

GAMMAGARD S/D 5 GM VIAL SHIRE 00944-2656-03 J1566(IGA<1 MCG/ML) 10 GM VIAL 00944-2658-04 J1566

IMMUNE GLOBULINS (HUMAN) LIQUID

BIVIGAM 5 GM VIAL KEDRION 59730-6502-01 J1556 10 GM VIAL 59730-6503-01 J1556

FLEBOGAMMA 5% DIF 2.5 GM VIAL GRIFOLS 61953-0004-02 J1572 5 GM VIAL 61953-0004-03 J1572 10 GM VIAL 61953-0004-04 J1572 20 GM VIAL 61953-0004-05 J1572

FLEBOGAMMA 10% DIF 5 GM VIAL GRIFOLS 61953-0005-01 J1572 10 GM VIAL 61953-0005-02 J1572 20 GM VIAL 61953-0005-03 J1572

GAMMAGARD LIQUID 1 GM VIAL SHIRE 00944-2700-02 J1569 2.5 GM VIAL 00944-2700-03 J1569 5 GM VIAL 00944-2700-04 J1569 10 GM VIAL 00944-2700-05 J1569 20 GM VIAL 00944-2700-06 J1569 30 GM VIAL 00944-2700-07 J1569

GAMMAKED 1 GM VIAL KEDRION 76125-0900-01 J1561 5 GM VIAL 76125-0900-50 J1561 10 GM VIAL 76125-0900-10 J1561 20 GM VIAL 76125-0900-20 J1561

GAMMAPLEX 5 GM VIAL BPL 64208-8234-06 J1557 10 GM VIAL 64208-8234-07 J1557 20 GM VIAL 64208-8234-08 J1557

GAMUNEX-C 1 GM VIAL GRIFOLS 13533-0800-12 J1561 2.5 GM VIAL 13533-0800-15 J1561 5 GM VIAL 13533-0800-20 J1561 10 GM VIAL 13533-0800-71 J1561 20 GM VIAL 13533-0800-24 J1561 40 GM VIAL 13533-0800-40 J1561

OCTAGAM 5% 1 GM VIAL OCTAPHARMA 68982-0840-01 J1568 2.5 GM VIAL 68982-0840-02 J1568 5 GM VIAL 68982-0840-03 J1568 10 GM VIAL 68982-0840-04 J1568

OCTAGAM 10% 2 GM VIAL OCTAPHARMA 68982-0850-01 J1568 5 GM VIAL 68982-0850-02 J1568 10 GM VIAL 68982-0850-03 J1568 20 GM VIAL 68982-0850-04 J1568

PRIVIGEN 5 GM VIAL CSL BEHRING 44206-0436-05 J1459 10 GM VIAL 44206-0437-10 J1459 20 GM VIAL 44206-0438-20 J1459 40 GM VIAL 44206-0439-40 J1459

Immune Globulins Intravenous (IVIG)


VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc340B

340B

340B

VIPc340B

340B

340B

340B

340B

340B

340B



9

COAGUALATIONIM

MUNE GLOBULINS

HYPERIMM

UNESINFLUENZA VACCINES

& ANCILLARIESALBUM

IN / PLASMA

PROTEIN FRACTIONONCOLOGY & BIOSURGERY


BOTULISM IGIV (HUMAN) (BIG-IV)

BABYBIG 100 MG VIAL CA DEPT. OF PUBLIC HEALTH 68403-1100-06 —

CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN)

CYTOGAM 2.5 GM VIAL CSL BEHRING 44206-0532-11 J0850

HEPATITIS B IMMUNE GLOBULIN

HEPAGAM B 1 ML VIAL APTEVO THERAPEUTICS 53270-0052-01 J1571 or J1573 5 ML VIAL 53270-0051-01 J1571 or J1573

HYPERHEP B S/D 0.5 ML SYRINGE GRIFOLS 13533-0636-03 90371 1 ML SYRINGE 13533-0636-02 90371 5 ML VIAL 13533-0636-05 90371

NABI-HB 1 ML SDV BIOTEST PHARMACEUTICALS 59730-4202-01 90371 5 ML SDV 59730-4203-01 90371

RABIES IMMUNE GLOBULIN

HYPERRAB S/D 2 ML 150 IU/ML VIAL GRIFOLS 13533-0618-02 90375 10 ML 150 IU/ML VIAL 13533-0618-10 90375

IMOGAM RABIES-HT 2 ML VIAL SANOFI PASTEUR 49281-0190-20 90376

RHO(D) IMMUNE GLOBULIN

HYPERRHO S/D 50 MCG/0.17 ML SYRINGE GRIFOLS 13533-0661-06 J2788 300 MCG 1 ML SYRINGE 13533-0631-02 J2790 300 MCG 1 ML SYRINGE/10-PK 13533-0631-10 J2790

MICRHOGAM 50 MCG 1 ML SYRINGE KEDRION 00562-7806-01 J2788 50 MCG 1 ML SYRINGE/5-PK 00562-7806-05 J2788 50 MCG 1 ML SYRINGE/25-PK 00562-7806-25 J2788

RHOGAM 300 MCG 1 ML SYRINGE KEDRION 00562-7805-01 J2790 300 MCG 1 ML SYRINGE/5-PK 00562-7805-05 J2790 300 MCG 1 ML SYRINGE/25-PK 00562-7805-25 J2790

RHOPHYLAC 300 MCG SYRINGE CSL BEHRING 44206-0300-01 J2791 300 MCG SYRINGE/10-PK 44206-0300-10 J2791

WINRHO SDF 1500 IU 300 MCG VIAL APTEVO THERAPEUTICS 53270-3300-01 J2792 2500 IU 500 MCG VIAL 53270-3500-01 J2792 5000 IU 1000 MCG VIAL 53270-3100-01 J2792 15,000 IU 3000 MCG VIAL 53270-3000-01 J2792

TETANUS IMMUNE GLOBULIN

HYPERTET S/D 250 UNIT SYRINGE GRIFOLS 13533-0634-02 J1670

VARICELLA ZOSTER IMMUNE GLOBULIN

VARIZIG LIQUID 125 UNIT VIAL APTEVO THERAPEUTICS 53270-0126-02 90396



VIPc

VIPc

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B

VIPc340B




ANTI-THYMOCYTE GLOBULIN

THYMOGLOBULIN 25 MG VIAL SANOFI AVENTIS 58468-0080-01 J7511 VIPc

VIPc340B

VIPc340B

10

11TO ORDER (800) 843-7477 | Fax (800) 418-4333 | FFFenterprises.com | MyFluVaccine.com | biosupply.fffenterprises.com

Antithrombin VIPc Verified Inventory Program-Consignment (VIPc™)


11

COAGUALATIONIM

MUNE

GLOBULINSANTITHROM

BININFLUENZA VACCINES

& ANCILLARIESALBUM

IN / PLASMA

PROTEIN FRACTIONONCOLOGY & BIOSURGERY

A 250 ML KEDRION 76125-0790-25 P9045

A 100 ML KEDRION 76125-0784-10 P9047

A 50 ML CSL BEHRING 00053-7680-32 P9047

A 250 ML CSL BEHRING 44206-0310-25 P9045 500 ML 44206-0310-50 P9045

A 50 ML CSL BEHRING 44206-0251-05 P9047 100 ML 44206-0251-10 P9047

A 250 ML GRIFOLS 68516-5214-01 P9045 500 ML 68516-5214-02 P9045

A 50 ML GRIFOLS 68516-5216-01 P9047 100 ML 68516-5216-02 P9047

A 250 ML OCTAPHARMA 68982-0623-02 P9045 500 ML 68982-0623-03 P9045

A 50 ML OCTAPHARMA 68209-0643-01 P9047 50 ML 68982-0643-01 P9047 100 ML 68209-0643-02 P9047 100 ML 68982-0643-02 P9047

B 500 ML SHIRE 00944-0491-02 P9045

F 250 ML SHIRE 00944-0495-05 P9045

F 50 ML SHIRE 00944-0493-01 P9047 100 ML 00944-0493-02 P9047

K 50 ML KEDRION 76179-0025-01 P9047 50 ML 76179-0025-02 P9047 100 ML 76179-0025-04 P9047 100 ML 76179-0025-03 P9047

P 50 ML GRIFOLS 13533-0690-20 — 250 ML 13533-0690-25 —

P 20 ML GRIFOLS 13533-0692-16 — 50 ML 13533-0692-20 —

A

Fax (800) 418-4333 | FFFenterprises.com | MyFluVaccine.com | biosupply.fffenterprises.com

P

12

OTHER VACCINES

ACTHIB 10 MCG W/DILUENT SANOFI PASTEUR 49281-0545-05 90648ADACEL (TDAP) 5 PFS/BX SANOFI PASTEUR 49281-0400-15 90715 10 SDV/BX 49281-0400-10 90715DAPTACEL 10 SDV/BX SANOFI PASTEUR 49281-0286-10 90700DIPHTHERIA AND TETANUS TOXOID 10 SDV PF PEDS SANOFI PASTEUR 49281-0225-10 90714GARDASIL HPV 0.5 ML PFS/10-PK MERCK 00006-4109-02 90649GARDASIL 9 HPV 10 - 0.5 ML PFS MERCK 00006-4121-02 90651IMOVAX IM 1 SDV W/DILUENT SANOFI PASTEUR 49281-0250-51 90675IPOL POLIO VIRUS 5 ML MDV SANOFI PASTEUR 49281-0860-10 90713MENACTRA SDV/5-PK SANOFI PASTEUR 49281-0589-05 90734MENOMUNE SDV SANOFI PASTEUR 49281-0489-01 90733MMR II MEASLES MUMPS 0.5 ML SDV/10-PK MERCK 00006-4681-00 90707PEDVAX HIB 0.5 ML SDV/10-PK MERCK 00006-4897-00 90647PENTACEL SDV/5-PK SANOFI PASTEUR 49281-0510-05 90698PNEUMOVAX 23 0.5 ML PFS/10-PK MERCK 00006-4837-03 90732 0.5 ML PFS 00006-4837-02 90732PREVNAR 13 1 PFS/10-PK PFIZER 00005-1971-02 90670PROQUAD 0.5 ML SDV/10-PK MERCK 00006-4999-00 90710RECOMBIVAX HB ADULT 10 MCG/SDV MERCK 00006-4995-00 90746 10 MCG VIAL/10-PK 00006-4995-41 90743/90746 10 MCG PFS/6-PK 00006-4094-09 90743/90746RECOMBIVAX HB PED/ADOLESC 5 MCG/6-PK PFS MERCK 00006-4093-09 90744 5 MCG/0.5 ML 10-PK 00006-4981-00 90744RECOMBIVAX HB DIALYSIS 40 MCG SDV MERCK 00006-4992-00 90740/90747ROTATEQ ROTAVIRUS 2 ML TUBES/25-PK MERCK 00006-4047-20 90680 TENIVAC 10 SDV/BX SANOFI PASTEUR 49281-0215-10 90714 10 PFS/BX 49281-0215-15 90714TETANUS AND DIPHTHERIA 0.5 ML VIAL/10-PK GRIFOLS 13533-0131-01 90714TOXOIDS ADSORBEDTRUMENBA 0.5 ML SDV PFS/5-PK PFIZER 00005-0100-05 90621 0.5 ML SDV PFS/10-PK 00005-0100-10 90621TUBERSOL 1 ML VIAL 10 TEST SANOFI PASTEUR 49281-0752-21 86580 5 ML VIAL 50 TEST 49281-0752-22 86580TYPHIM VI TYPHOID 0.5 ML/PFS SANOFI PASTEUR 49281-0790-51 90691VAQTA 25 U/1 ML PFS/10-PK MERCK 00006-4095-02 90633VARIVAX 0.5 ML SDV/10-PK MERCK 00006-4827-00 90716VIVOTIF BLISTER PK OF 4 CAPSULES PAXVAX 69401-0000-01 90690ZOSTAVAX SDV/10-PK MERCK 00006-4963-41 90736 SDV 00006-4963-00 90736

Other Vaccines




VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

VIPc

12

13

ALBUMIN / PLASMA PROTEIN FRACTION

ALBUKED 5% 250 ML KEDRION 76125-0790-25 P9045

ALBUKED 25% 100 ML KEDRION 76125-0784-10 P9047

ALBUMINAR 25% 50 ML CSL BEHRING 00053-7680-32 P9047

ALBURX 5% 250 ML CSL BEHRING 44206-0310-25 P9045 500 ML 44206-0310-50 P9045

ALBURX 25% 50 ML CSL BEHRING 44206-0251-05 P9047 100 ML 44206-0251-10 P9047

ALBUTEIN 5% 250 ML GRIFOLS 68516-5214-01 P9045 500 ML 68516-5214-02 P9045

ALBUTEIN 25% 50 ML GRIFOLS 68516-5216-01 P9047 100 ML 68516-5216-02 P9047

ALBUMIN 5% 250 ML OCTAPHARMA 68982-0623-02 P9045 500 ML 68982-0623-03 P9045

ALBUMIN 25% 50 ML OCTAPHARMA 68209-0643-01 P9047 50 ML 68982-0643-01 P9047 100 ML 68209-0643-02 P9047 100 ML 68982-0643-02 P9047

BUMINATE 5% 500 ML SHIRE 00944-0491-02 P9045

FLEXBUMIN 5% 250 ML SHIRE 00944-0495-05 P9045

FLEXBUMIN 25% 50 ML SHIRE 00944-0493-01 P9047 100 ML 00944-0493-02 P9047

KEDBUMIN 25% 50 ML KEDRION 76179-0025-01 P9047 50 ML 76179-0025-02 P9047 100 ML 76179-0025-04 P9047 100 ML 76179-0025-03 P9047

PLASBUMIN AFP 5% 50 ML GRIFOLS 13533-0690-20 — 250 ML 13533-0690-25 —

PLASBUMIN AFP 25% 20 ML GRIFOLS 13533-0692-16 — 50 ML 13533-0692-20 —

Albumin / Plasma Protein Fraction


*All codes should be verified between the provider and the payer.TO ORDER (800) 843-7477 | Fax (800) 418-4333 | FFFenterprises.com | MyFluVaccine.com | biosupply.fffenterprises.com


340B

340B

340B

340B

340B

340B

340B

340B

340B

340B

13

COAGUALATIONIM

MUNE

GLOBULINSHYPERIM

MUNES


ALBUMIN /

PLASMA PROTEIN FRACTION

ONCOLOGY & BIOSURGERY


PHARMACEUTICALSACTIVASE 50 MG/50 ML VIAL GENENTECH 50242-0044-13 J2997 100 MG/100 ML VIAL 50242-0085-27 J2997BERINERT 500 IU VIAL CSL BEHRING 63833-0825-02 J0597CROFAB 2 VIAL PK BTG INTERNATIONAL 50633-0110-12 J0840CUBICIN 500 MG SDV MERCK 67919-0011-01 J0878DIGIFAB 40 MG VIAL BTG INTERNATIONAL 50633-0120-11 J1162

ENTYVIO 300 MG SDV TAKEDA PHARMACEUTICALS 64764-0300-20 J3380

EPIPEN 0.3 MG/0.3 ML 2-PK MYLAN 49502-0500-02 J3490EPIPEN JR 0.15 MG/0.3 ML 2-PK MYLAN 49502-0501-02 J3490FOLLISTIM AQ 75 IU SDV MERCK 00052-0308-02 J3490 300 IU CARTRIDGE 00052-0313-01 J3490 600 IU CARTRIDGE 00052-0316-01 J3490 900 IU CARTRIDGE 00052-0326-01 J3490GANIRELIX ACETATE 250 MCG/0.5 ML PFS MERCK 00052-0301-51 S0132HEMABATE 250 MCG/1 ML-10PK PFIZER 00009-0856-08 J3490INTEGRILIN 75 MG/ML 100 ML VIAL MERCK 00085-1136-01 J1327 2 MG/ML 10 ML VIAL 00085-1177-01 J1327 2 MG/ML 100 ML VIAL 00085-1177-02 J1327

MIACALCIN 2 ML MDV MYLAN 54766-0149-23 J0630

MOZOBIL 20 MG/1.2 ML VIAL SANOFI AVENTIS 58468-0140-01 J2562NAFCILLIN** 10 GM SDV AURO MEDICS 55150-0124-99 S0032SIVEXTRO TEDIZOLID PHOSPHATE 200 MG IV VIALS X 6 MERCK 67919-0041-02 P0300 200 MG IV VIALS X 10 67919-0040-01 P0300 200 MG IV VIALS X 30 67919-0041-01 P0300

TNKASE 50 MG VIAL GENENTECH 50242-0120-01 J3101

ZERBAXA 1.5 GM/10-VL MERCK 67919-0030-01 J3490/C9452

Biopharmaceuticals & Pharmaceuticals


VIPcVIPc

VIPc

VIPc

VIPc340B

VIPc340B

VIPc340B

VIPc340B



Generics

GENERICSARIPIPRAZOLE** 2 MG TAB 100-BX APOTEX 48433-0120-10 J3490 5MG TAB 100-BX 48433-0119-10 J3490 10MG TAB 100-BX 48433-0118-10 J3490 15MG TAB 100-BX 48433-0117-10 J3490 20MG TAB 100-BX 48433-0116-10 J3490 30MG TAB 100-BX 48433-0115-10 J3490CEFEPIME** 1 GM / 20 ML WG CRITICAL CARE 44567-0240-10 J0692 2 GM / 20 ML 44567-0241-10 J0692MEROPENEM** 20 ML/500 MG 25/PK FRESENIUS KABI 63323-0507-25 J2185 30 ML/1 GM 25/PK 63323-0508-25 J2185 PIPERACILLIN & TAZOBACTAM** 2.25 GM 10-PK AUROMEDICS 55150-0119-30 J2543 3.375 GM 10-PK 55150-0120-30 J2543 4.5 GM 10-PK 55150-0121-50 J2543PIPERACILLIN & TAZOBACTAM** 2.25 GM 10-PK FRESENIUS KABI 63323-0309-20 J2543 3.375 GM 10-PK 63323-0300-30 J2543 4.5 GM 10-PK 63323-0320-50 J2543PIPERACILLIN & TAZOBACTAM** 2.25 GM 10-PK SANDOZ 00781-3110-95 J2543 3.375 GM 10-PK 00781-3113-95 J2543 4.5 GM 10-PK 00781-3114-95 J2543

340B

340B

340B

340B

340B

* All codes should be verified between the provider and the payer. ** Call for eligibility through your GPO affiliation.

14

50242-0085-27 J2997B J0597C J0840C J0878D J1162

E

00052-0313-01 J3490 00052-0316-01 J3490 00052-0326-01 J3490G S0132H J3490I J1327 00085-1177-01 J1327 00085-1177-02 J1327

M

J2562N

67919-0040-01 P0300 67919-0041-01 P0300

T

67919-0030-01 J

| FFFenterprises.com | MyFluVaccine.com | biosupply.fffenterprises.com

V

48433-0119-10 J3490 48433-0118-10 J3490 48433-0117-10 J3490 48433-0116-10 J3490 48433-0115-10 J3490C 44567-0241-10 J0692M 63323-0508-25 J2185

55150-0120-30 J2543 55150-0121-50 J2543P 63323-0300-30 J2543 63323-0320-50 J2543P 00781-3113-95 J2543 00781-3114-95 J2543

3

** Call for eligibility through your GPO affiliation.

*All codes should be verified between the provider and the payer.TO ORDER (800) 843-7477 | Fax (800) 418-4333 | FFFenterprises.com | MyFluVaccine.com | biosupply.fffenterprises.com

* All codes should be verified between the provider and the payer. ** Call for eligibility through your GPO affiliation.

BioSurgical and Surgical

ARTISS (FROZEN) 2 ML BAXTER BIOSURGERY 00944-8503-02 — 4 ML 00944-8503-04 — 10 ML 00944-8503-10 — COSEAL 2 ML BAXTER BIOSURGERY 01376-5404-61 — 4 ML 01376-5404-62 — 8 ML 01376-5404-63 — FLOSEAL 5 ML BAXTER BIOSURGERY 08541-2096-10 — 10 ML 08541-2096-12 — OMIDRIA 4 ML VIAL 4-CTN OMEROS 62225-0600-04 J3490/C9447 SOTRADECOL 1% 20 MG/2 ML VIAL MYLAN 67457-0162-02 J3490 3% 60 MG/2 ML VIAL 67457-0163-02 J3490 TISSEEL VHSD KIT 2 ML BAXTER BIOSURGERY 00944-4301-02 J3590/C9399 VHSD KIT 4 ML 00944-4302-04 J3590/C9399 VHSD KIT 10 ML 00944-4303-10 J3590/C9399 VHSD KIT 10 ML 00944-4201-12 J3590/C9399 2 ML VHSD VALUPAK 00944-4210-02 J3590/C9399 4 ML VHSD VALUPAK 00944-4211-04 J3590/C9399 10 ML VHSD VALUPAK 00944-4212-10 J3590/C9399

TISSEEL (FROZEN) 2 ML BAXTER BIOSURGERY 00944-8402-02 — 4 ML 00944-8402-04 — 10 ML 00944-8402-10 —

ONCOLOGY (GENERICS)CLOLAR 20 MG/20 ML SDV SANOFI AVENTIS 58468-0100-01 J9027TICE BCG 50 MG SDV MERCK 00052-0602-02 J9031/90586ONCASPAR 3750 IU/5 ML SHIRE 54482-0301-01 J9266ZOLINZA 100 MG ORAL CAPSULE MERCK 00006-0568-40 J8999

ONCOLOGY (BIOSIMILARS)ZARXIO** 300 MCG/0.5 ML PFS SANDOZ 61314-0304-01 Q5101 300 MCG/0.5 ML PFS 10-BX 61314-0304-10 Q5101 480 MCG/0.8 ML PFS 61314-0312-01 Q5101 480 MCG/0.8 ML PFS 10-BX 61314-0312-10 Q5101

Oncology

VIPc


340B

340B

340B

340B

Generics (CONTINUED)

GENERICS

SODIUM PHENYLACETATE 50 ML SDV ZYDUS PHARMACEUTICALS 68382-0396-01 J3490& SODIUM BENZOATEPIPERACILLIN & TAZOBACTAM** 2.25 GM 10-PK SANDOZ 00781-3110-95 J2543 3.375 GM 10-PK 00781-3113-95 J2543 4.5 GM 10-PK 00781-3114-95 J2543VANCOMYCIN** 10 GM 1-PK FRESENIUS KABI 63323-0314-61 J3370 1 GM 10-PK 63323-0284-20 J3370 500 MG 25-PK 63323-0221-10 J3370 5 GM SDV 1-PK 63323-0295-61 J3370VERAPAMIL** 2 ML EXELA PHARMA SCIENCES 51754-0203-02 J3490

340B

15

COAGUALATIONIM

MUNE

GLOBULINSHYPERIM

MUNES


ALBUMIN / PLASM

APROTEIN FRACTION

ONCOLOGY & BIOSURGERY / SURGERY

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Documents

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