OP OPHTHALMOLOGY / RETINA Product Name Package Size
UL ULTRA-RARE / ORPHAN Product Name Package Size
NDC # Presentation Product Category Subcategory THYROID EYE DISEASE (teprotumumab-trbw)
Derivation
Manufacturer
NDC # Presentation Product Category
Subcategory
Derivation
Manufacturer
ULTRA-RARE/ ORPHAN ULTRA-RARE/ ORPHAN ULTRA-RARE/ ORPHAN
BAXTER HEALTHCARE CORPORATION BAXTER HEALTHCARE CORPORATION BAXTER HEALTHCARE CORPORATION
TISSEEL
2 ML
00338-4301-02
EACH
BIOSURGICAL
PLASMA
OPTHALMOLOGY/ RETINA
THYROID EYE DISEASE
MONOCLONAL ANTIBODY
TEPEZZA
500 MG
75987-0130-15
VIAL
HORIZON THERAPEUTICS
TISSEEL
4 ML
00338-4302-04 EACH
BIOSURGICAL
PLASMA
NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD)
TISSEEL
10 ML
00338-4303-10
EACH
BIOSURGICAL
PLASMA
NEUROMY- ELITIS OPTICA SPECTRUM DISORDER
MONOCLONAL ANTIBODY
CHRONIC GOUT (PEGLOTICASE INJECTION)
UPLIZNA
3 PACK
72677-0551-01
EACH OPTHALMOLOGY/ RETINA
HORIZON THERAPEUTICS
ULTRA-RARE/ ORPHAN
KRYSTEXXA
2 ML
75987-0080-10
VIAL
CHRONIC GOUT
RECOMBINANT
HORIZON THERAPEUTICS
UL ULTRA-RARE / ORPHAN Product Name Package Size
GENERALIZED MYASTHENIA GRAVIS (GMG)
GENERALIZED MYASTHENIA GRAVIS GENERALIZED MYASTHENIA GRAVIS GENERALIZED MYASTHENIA GRAVIS
ULTRA RARE / ORPHAN
RYSTIGGO
280MG 50474-0980-79 EACH
UCB, INC.
NDC # Presentation Product Category
Subcategory
Derivation
Manufacturer
SNAKE ANTI-VENOM
ULTRA-RARE/ ORPHAN ULTRA RARE / ORPHAN
MONOCLONAL ANTIBODY MONOCLONAL ANTIBODY
VYVGART
20 ML
73475-3041-05
VIAL
ARGENX US, INC.
ULTRA-RARE/ ORPHAN ULTRA-RARE/ ORPHAN
SNAKE ANTI-VENOM RECOMBINANT
MCKESSON SPECIALTY CARE DISTRIBUTION
ANAVIP
1 CARTON = 1 VIAL 66621-0790-02
VIAL
VYVGART HYTRULO
5.6 ML
73475-3102-03
VIAL
ARGENX US, INC.
SNAKE ANTI-VENOM
CROFAB
2 ML
50633-0110-12 CARTON, 2 VIALS PER
BTG INTERNATIONAL, INC.
ALPHA-PROTEINASE INHIBITOR (A,PI)
HEREDITARY ANGIOEDEMA (HAE)
ULTRA-RARE/ ORPHAN
ALPHA-PROTEINASE INHIBITOR
ZEMAIRA
1000 MG 00053-7201-02
VIAL
PLASMA
CSL BEHRING LLC
ULTRA-RARE/ ORPHAN
HEREDITARY ANGIOEDEMA (HAE)
BERINERT
500 UNITS
63833-0825-02
VIAL
PLASMA
CSL BEHRING LLC
SPECIALTY
PROTEIN C DEFICIENCY
TELAVANCIN HYDROCLORIDE
CUMBERLAND PHARMACEUTICALS, INC.
VIBATIV
750 MG 66220-0315-22 Case, 12 Vials ULTRA RARE / ORPHAN
SPECIALTY
ULTRA-RARE/ ORPHAN ULTRA-RARE/ ORPHAN
PROTEIN C DEFICIENCY PROTEIN C DEFICIENCY
TAKEDA PHARMACEUTI- CALS AMERICAS, INC. TAKEDA PHARMACEUTI- CALS AMERICAS, INC.
CEPROTIN
500 IU
00944-4177-05
VIAL
PLASMA
ULTRA-RARE/ ORPHAN ULTRA RARE / ORPHAN
ULTOMIRIS
300 MG / 3 ML
25682-0025-01
Vial
SPECIALTY
RAVULIZUMAB
ASTRAZENECA
CEPROTIN
1000 IU
00944-4179-10
VIAL
PLASMA
ULTOMIRIS
1100 MG / 11 ML 25682-0028-01
Vial
SPECIALTY
RAVULIZUMAB
ASTRAZENECA
ULCERATIVE COLITIS / CROHN'S DISEASE / RHEUMATOID ARTHRITIS
ULCERATIVE COLITIS / CHRON'S DISEASE / RHEUMATOID ARTHRITIS ULCERATIVE COLITIS / CHRON'S DISEASE / RHEUMATOID ARTHRITIS ULCERATIVE COLITIS / CHRON'S DISEASE / RHEUMATOID ARTHRITIS ULCERATIVE COLITIS / CHRON’S DISEASE / RHEUMATOID ARTHRITIS ULCERATIVE COLITIS / CHRON’S DISEASE / RHEUMATOID ARTHRITIS
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ULTRA-RARE/ ORPHAN
MONOCLONAL ANTIBODY
TAKEDA PHARMACEUTI- CALS AMERICAS, INC.
ENTYVIO
300MG 20ML
64764-0300-20
VIAL
ULTRA-RARE/ ORPHAN
MONOCLONAL ANTIBODY
INFLECTRA
20 ML
00069-0809-01
VIAL
PFIZER, INC.
CIMZIA LYPHOLIZED POWDER
ULTRA-RARE/ ORPHAN
2 X 200 MG 50474-0700-62
VIAL
RECOMBINANT
UCB, INC.
ULTRA-RARE/ ORPHAN
CIMZIA
2 X 200 MG PFS 50474-0710-79 SYRINGE
RECOMBINANT
UCB, INC.
ULTRA-RARE/ ORPHAN
CIMZIA
6 X 200 MG PFS 50474-0710-81
SYRINGE
RECOMBINANT
UCB, INC.
PAROXYSMAL NOCTURNAL HEMOGLOBINURIA (PNH)
PAROXYSMAL NOCTURNAL HEMOGLOBINURIA
ULTRA-RARE/ ORPHAN
SOLIRIS
300MG/ML
25682-0001-01
VIAL
ALEXION
BIOSURGICAL
ULTRA-RARE/ ORPHAN ULTRA-RARE/ ORPHAN
BAXTER HEALTHCARE CORPORATION BAXTER HEALTHCARE CORPORATION
FLOSEAL
5ML
85412-5237-38
EACH
BIOSURGICAL
PLASMA
TISSEEL
SD VALUPAK 2 ML 00338-4210-02
EACH
BIOSURGICAL
PLASMA
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