BioCareSD January 2023 Product Catalog

January 2023 PRODUCT CATALOG

We have extremely agile and wide-reaching distribution capabilities to support our partners and their patients when they need it most.

We are dedicated to helping our customers save lives —one patient, one product and one promise at a time. BioCareSD, a BioCare Company, is one of the nation’s leading specialty distributors, known for our unparalleled customer service. Our customer support team and local, field-based account management teams are available 24 hours a day, 7 days a week, 365 days a year. We feature an ever-expanding portfolio of specialty products for hematology, thrombophilia, immunology, neurology, ophthalmology, orphan and other ultra-rare diseases. BioCareSD is an Authorized Distributor of Record for all the manufacturers we represent, so you can depend on the quality of our products. We believe that trusted partnerships are pivotal to supporting patients needs. We are proud to support our partners in their mission to save lives.

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Westbury

Dayton

Denver

Kansas City

Las Vegas

Olive Branch

Tempe

El Paso

Dallas

Lafayette

We will do whatever it takes to provide our partners with unmatched service-levels.

There is always a live BioCareSD® Team member to answer your calls 24/7/365

We are always at your service.

Our distribution network is within a 6 hour delivery window

Celebrating Over

Outstanding customer service is who we are. We are people who care

in Specialty Distribution

3

BioCareSD In the News...

January 2023

The BioCare team celebrates and recognizes the following holidays and events this month.

The Intricacies of the Pharma Cold Chain

Tom Hart, Chief Operating Officer of BioCare, discusses how extreme temperatures affect cold chains and what supply chain players can do to minimize impacts and delays caused by weather.

January 1 NEW YEAR’S DAY

We partner with our customers to deliver the best possible care to patients all over the country. We spare no effort to ensure every customer has, on hand, the inventory they need, when they need it and that there is always a live voice at the other end of the line when duty calls. It is our promise to deliver unparalleled service to our partners and their patients. At the end of every journey there is a patient waiting for life-saving therapeutics.

January 16 MARTIN LUTHER KING DAY

Read More

Creating A Sense Of Togetherness For Your Team In A Remote Work Environment

Andrew Kirk, Chief Revenue Officer of BioCare, details tips and strategies that leaders can implement to bring their teams together and build connection despite being physically apart.

Read More

We are people who care.

Visit our News & Insights page for the latest BioCare case studies, news stories, and industry insights.

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Always at your service.

Product Catalog

ASCENIV™ is the only IVIG produced from blending RSV plasma and normal source plasma 1

Learn More About ASCENIV and the ADvantage Ig Patient Support Program at ASCENIV.com

Indication ASCENIV (immune globulin intravenous, human – slra) is a 10% immune globulin liquid for intravenous injection, indicated for the treatment of primary humoral immunodeficiency (PI) in adults and adolescents (12 to 17 years of age). PI includes, but is not limited to, the humoral immune defect in congenital agammaglobulinemia, common variable immunodeficiency (CVID), X linked agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies (SCID). Contraindications ASCENIV is contraindicated in: • Patients who have had an anaphylactic or severe systemic reaction to the administration of human immune globulin. • IgA-deficiency patients with antibodies to IgA and a history of hypersensitivity. Warnings and Precautions Severe hypersensitivity reactions may occur with IGIV products, including ASCENIV. In case of hypersensitivity, discontinue ASCENIV infusion immediately and institute appropriate treatment. Patients with known antibodies to IgA may have a greater risk of developing potentially severe hypersensitivity and anaphylactic reactions. Thrombosis may occur following treatment with immunoglobulin products and in the absence of known risk factors. Consider baseline assessment of blood viscosity in patients at risk for hyperviscosity and ensure adequate hydration before administration. For patients at risk of thrombosis, administer ASCENIV at the minimum dose and infusion rate practicable. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity. Acute renal dysfunction/failure, osmotic nephrosis, and death may occur upon use of human IGIV products. Ensure that patients are not volume depleted before administering ASCENIV. Periodic monitoring of renal function and urine output is particularly important in patients judged to be at increased risk of developing acute renal failure. Assess renal function, including measurement of blood urea nitrogen (BUN) and serum creatinine, before the initial infusion of ASCENIV and at appropriate intervals thereafter. Discontinue ASCENIV if renal function deteriorates. In at risk patients, administer ASCENIV at the minimum infusion rate practicable. Hyperproteinemia, increased serum viscosity, and hyponatremia or pseudohyponatremia may occur in patients receiving IGIV treatment, including ASCENIV. It is critical to clinically distinguish true hyponatremia from a pseudohyponatremia that is associated with or causally related to hyperproteinemia. Treatment aimed at decreasing serum free water in patients with pseudohyponatremia may lead to volume depletion, a further increase in serum viscosity, and a possible predisposition to thrombotic events. Aseptic meningitis syndrome (AMS) may occur with IGIV treatments, including ASCENIV. AMS usually begins within several hours to 2 days following IGIV treatment. AMS may occur more frequently in association with high doses (2 g/kg) and/or rapid infusion of IGIV. Conduct a thorough neurological examination on patients exhibiting signs and symptoms of AMS, including cerebrospinal fluid (CSF) studies, to rule out other causes of meningitis. IGIV products, including ASCENIV, may contain blood group antibodies that can act as hemolysins and induce in vivo coating of red blood cells (RBCs) with immunoglobulin, causing a positive direct antiglobulin reaction and hemolysis. Monitor patients for clinical signs and symptoms of hemolysis, including appropriate confirmatory laboratory testing. Non-cardiogenic pulmonary edema may occur with IV administered IG. Monitor patients for pulmonary adverse reactions. If suspected, perform appropriate tests for presence of anti-neutrophil in both product and patient serum. May be managed using oxygen therapy with adequate ventilatory support. Because ASCENIV is made from human blood, it may carry a risk of transmitting infectious agents, e.g., viruses, the variant Creutzfeldt-Jakob disease (vCJD) and theoretically, the Creutzfeldt-Jakob disease (CJD) agent. All infections suspected by a physician to possibly have been transmitted by this product should be reported to ADMA Biologics at (1-800-458-4244) . After infusion of immunoglobulin, the transitory rise of the various passively transferred antibodies in the patient’s blood may yield positive serological testing results, with the potential for misleading interpretation. Passive transmission of antibodies to erythrocyte antigens (e.g., A, B, and D) may cause a positive direct or indirect antiglobulin (Coombs’) test. Adverse Reactions The most common adverse reactions to ASCENIV ( ≥ 5% of study subjects) were headache, sinusitis, diarrhea, gastroenteritis viral, nasopharyngitis, upper respiratory tract infection, bronchitis, and nausea.

1. Data on File, ADMA Biologics. IT’S WHAT’S INSIDE THAT COUNTS For patients with primary humoral immunodeficiency (PI)

www.asceniv.com

Focused on what matters most: safety, quality, and efficacy

Important Safety Information for ASCENIV™ WARNING: THROMBOSIS, RENAL DYSFUNCTION AND ACUTE RENAL FAILURE

Thrombosis may occur with immune globulin intravenous (IGIV) products, including ASCENIV. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors. Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur with the administration of Immune Globulin Intravenous (Human) (IGIV) products in predisposed patients. Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV products containing sucrose. ASCENIV does not contain sucrose. For patients at risk of thrombosis, renal dysfunction or renal failure, administer ASCENIV at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.

You are encouraged to report side effects of prescription drugs to ADMA Biologics @ 1-800-458-4244 or the FDA. Visit www.fda.gov/MedWatch or call 1-800-FDA-1088. For additional safety information about ASCENIV, please see full Prescribing Information.

© 2023 ADMA Biologics. All rights reserved. ASCENIV™ is a trademark of ADMA Biologics. Visit admabiologics.com

AP ALBUMIN PRODUCTS Product Name Package Size NDC #

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

Product Category

Product Category

Presentation

Subcategory Derivation

Manufacturer

Presentation

Subcategory

Derivation

Manufacturer

ALBUMIN/PLASMA PROTEIN FRACTION

ANTI-INHIBITOR COAGULANT COMPLEX

ANTI-INHIBITOR COAGULANT COMPL ANTI-INHIBITOR COAGULANT COMPL ANTI-INHIBITOR COAGULANT COMPL ANTI-INHIBITOR COAGULANT COMPL ANTI-INHIBITOR COAGULANT COMPL ANTI-INHIBITOR COAGULANT COMPL ANTI-INHIBITOR COAGULANT COMPL

ALBURX

25% 50mL 44206-0251-05

VIAL

ALBUMIN

PLASMA

CSL BEHRING LLC

TAKEDA PHARMACEUTICALS AMERICAS, INC.

FEIBA

1000 IU 64193-0424-02

VIAL

INHIBITORS

PLASMA

ALBURX

25% 100mL 44206-0251-10

VIAL

ALBUMIN

PLASMA

CSL BEHRING LLC

TAKEDA PHARMACEUTICALS AMERICAS, INC.

FEIBA

2000 IU 64193-0425-02

VIAL

INHIBITORS

PLASMA

ALBURX

5% 250mL 44206-0310-25

VIAL

ALBUMIN

PLASMA

CSL BEHRING LLC

ALBURX

5% 500mL 44206-0310-50

VIAL

ALBUMIN

PLASMA

CSL BEHRING LLC

TAKEDA PHARMACEUTICALS AMERICAS, INC.

FEIBA

500 IU 64193-0426-02

VIAL

INHIBITORS

PLASMA

ALBUTEIN

5% 250mL

68516-5214-01

VIAL

ALBUMIN

PLASMA

GRIFOLS USA, LLC

MONOCLONAL ANTIBODY

ALBUTEIN

5% 500mL

68516-5214-02

VIAL

ALBUMIN

PLASMA

GRIFOLS USA, LLC

HEMLIBRA

30 MG 50242-0920-01

VIAL

NONFACTOR

GENENTECH USA, INC.

ALBUTEIN

5% 50mL

68516-5214-05

VIAL

ALBUMIN

PLASMA

GRIFOLS USA, LLC

MONOCLONAL ANTIBODY

HEMLIBRA

60 MG 50242-0921-01

VIAL

NONFACTOR

GENENTECH USA, INC.

ALBUTEIN

25% 50mL

68516-5216-01

VIAL

ALBUMIN

PLASMA

GRIFOLS USA, LLC

ALBUTEIN

25% 100mL 68516-5216-02

VIAL

ALBUMIN

PLASMA

GRIFOLS USA, LLC

MONOCLONAL ANTIBODY

HEMLIBRA

105 MG 50242-0922-01

VIAL

NONFACTOR

GENENTECH USA, INC.

ALBUTEIN

25% 20mL

68516-5216-05

VIAL

ALBUMIN

PLASMA

GRIFOLS USA, LLC

MONOCLONAL ANTIBODY

25% 25 GM / 100 ML

HEMLIBRA

150 MG 50242-0923-01

VIAL

NONFACTOR

GENENTECH USA, INC.

ALBUTEIN FLEXBAG

68516-5216-00

5 PACK

ALBUMIN

PLASMA

GRIFOLS USA, LLC

ALBUTEIN FLEXBAG

5% 500mL 68516-5214-00

2 PACK

ALBUMIN

PLASMA

GRIFOLS USA, LLC

ANTITHROMBIN

ALBUTEIN FLEXBAG

5% 250mL

68516-5214-09

4 PACK

ALBUMIN

PLASMA

GRIFOLS USA, LLC

THROMBATE III

500 IU

13533-0606-12

VIAL

COAGULANT ANTITHROMBIN PLASMA

GRIFOLS USA, LLC

25% 12.5 GM / 50 ML

ALBUTEIN FLEXBAG

68516-5216-09

5 PACK

ALBUMIN

PLASMA

GRIFOLS USA, LLC

FACTOR I

ALBUKED

5% 250mL

76125-0790-25

VIAL

ALBUMIN

PLASMA

KEDRION BIOPHARMA

FIBRYGA

1 GRAM 68982-0347-01

VIAL

COAGULANT

FACTOR I

PLASMA

OCTAPHARMA USA

ALBUKED

5% 50mL

76125-0790-05

VIAL

ALBUMIN

PLASMA

KEDRION BIOPHARMA

RIASTAP

1000 IU 63833-0891-51

VIAL

COAGULANT

FACTOR I

PLASMA

CSL BEHRING LLC

ALBUKED

25% 100 mL 76125-0792-10

VIAL

ALBUMIN

PLASMA

KEDRION BIOPHARMA

FACTOR IX

ALBUKED

25% 20mL

76125-0792-20

VIAL

ALBUMIN

PLASMA

KEDRION BIOPHARMA

ALPHANINE

500 IU

68516-3610-02

VIAL

COAGULANT FACTOR IX

PLASMA

GRIFOLS USA, LLC

ALBUKED

25% 50 mL 76125-0792-25

VIAL

ALBUMIN

PLASMA

KEDRION BIOPHARMA

ALBUMIN

5% 250mL 68982-0623-02

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALPHANINE

1000 IU

68516-3611-02

VIAL

COAGULANT FACTOR IX

PLASMA

GRIFOLS USA, LLC

ALBUMIN

5% 500mL 68982-0623-03

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALPHANINE

1500 IU 68516-3612-02

VIAL

COAGULANT FACTOR IX

PLASMA

GRIFOLS USA, LLC

ALBUMIN

5% 100mL 68982-0623-01

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALPROLIX

500 IU

71104-0911-01

VIAL

COAGULANT FACTOR IX RECOMBINANT

SANOFI GENZYME

ALBUMIN

20% 50mL 68982-0633-01

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALPROLIX

1000 IU 71104-0922-01

VIAL

COAGULANT FACTOR IX RECOMBINANT

SANOFI GENZYME

ALBUMIN

20% 100mL 68982-0633-02

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALPROLIX

2000 IU 71104-0933-01

VIAL

COAGULANT FACTOR IX RECOMBINANT

SANOFI GENZYME

ALBUMIN

25% 50mL

68982-0643-01

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALBUMIN

25% 100mL 68982-0643-02

VIAL

ALBUMIN

PLASMA

OCTAPHARMA USA

ALPROLIX

3000 IU 71104-0944-01

VIAL

COAGULANT FACTOR IX RECOMBINANT

SANOFI GENZYME

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

FLEXBUMIN

25% 50mL 00944-0493-01

BAG

ALBUMIN

PLASMA

ALPROLIX

250 IU

71104-0966-01

VIAL

COAGULANT FACTOR IX RECOMBINANT

SANOFI GENZYME

FLEXBUMIN

25% 100mL 00944-0493-02

BAG

ALBUMIN

PLASMA

ALPROLIX

4000 IU 71104-0977-01

VIAL

COAGULANT FACTOR IX RECOMBINANT

SANOFI GENZYME

FLEXBUMIN

5% 250mL 00944-0495-05

BAG

ALBUMIN

PLASMA

11

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

Product Category

Product Category

Presentation

Subcategory

Derivation

Manufacturer

Presentation

Subcategory

Derivation

Manufacturer

FACTOR IX COM- PLEX FACTOR IX COM- PLEX FACTOR IX COM- PLEX

BENEFIX RT

250 IU 58394-0633-03

VIAL

COAGULANT FACTOR IX RECOMBINANT

PFIZER, INC.

PROFILNINE

500 IU

68516-3210-01

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

BENEFIX RT

500 IU 58394-0634-03

VIAL

COAGULANT FACTOR IX RECOMBINANT

PFIZER, INC.

PROFILNINE

1000 IU

68516-3211-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

BENEFIX RT

1000 IU 58394-0635-03

VIAL

COAGULANT FACTOR IX RECOMBINANT

PFIZER, INC.

PROFILNINE

1500 IU 68516-3212-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

FACTOR VIIA

BENEFIX RT

2000 IU 58394-0636-03

VIAL

COAGULANT FACTOR IX RECOMBINANT

PFIZER, INC.

BENEFIX RT

3000 IU 58394-0637-03

VIAL

COAGULANT FACTOR IX RECOMBINANT

PFIZER, INC.

NOVOSEVEN RT

1 MG

00169-7201-01

VIAL

INHIBITORS FACTOR VIIA RECOMBINANT NOVO NORDISK INC.

IDELVION

250 IU

69911-0864-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

CSL BEHRING LLC

NOVOSEVEN RT

2 MG

00169-7202-01

VIAL

INHIBITORS FACTOR VIIA RECOMBINANT NOVO NORDISK INC.

IDELVION

500 IU

69911-0865-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

CSL BEHRING LLC

NOVOSEVEN RT

5 MG

00169-7205-01

VIAL

INHIBITORS FACTOR VIIA RECOMBINANT NOVO NORDISK INC.

IDELVION

1000 IU 69911-0866-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

CSL BEHRING LLC

NOVOSEVEN RT

8 MG

00169-7208-01

VIAL

INHIBITORS FACTOR VIIA RECOMBINANT NOVO NORDISK INC.

IDELVION

2000 IU 69911-0867-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

CSL BEHRING LLC

SEVENFACT

1MG

71127-1000-01

VIAL

INHIBITORS FACTOR VIIA RECOMBINANT

HEMA BIOLOGICS

IDELVION

3500 IU 69911-0869-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

CSL BEHRING LLC

SEVENFACT

5MG

71127-5000-01

VIAL

INHIBITORS FACTOR VIIA RECOMBINANT

HEMA BIOLOGICS

FACTOR VIII

REBINYN

1000 IU 00169-7901-01

VIAL

COAGULANT FACTOR IX RECOMBINANT NOVO NORDISK INC.

1801 IU - 2400 IU 2401 IU - 3600 IU 3601 IU - 4800 IU

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

REBINYN

2000 IU 00169-7902-01

VIAL

COAGULANT FACTOR IX RECOMBINANT NOVO NORDISK INC.

ADVATE

00944-3045-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

REBINYN

500 IU

00169-7905-01

VIAL

COAGULANT FACTOR IX RECOMBINANT NOVO NORDISK INC.

ADVATE

00944-3046-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

RIXUBIS

250 IU 00944-3026-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

ADVATE

00944-3047-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

RIXUBIS

500 IU 00944-3028-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

ADVATE

200 IU - 400 IU 00944-3051-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

RIXUBIS

1000 IU 00944-3030-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

ADVATE

401 IU - 800 IU 00944-3052-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

801 IU - 1200 IU 1201 IU - 1800 IU

RIXUBIS

2000 IU 00944-3032-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

ADVATE

00944-3053-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

RIXUBIS

3000 IU 00944-3034-02

VIAL

COAGULANT FACTOR IX RECOMBINANT

ADVATE

00944-3054-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

FACTOR IX COMPLEX

ADYNOVATE

401 IU - 800 IU 00944-4623-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

FACTOR IX COM- PLEX FACTOR IX COM- PLEX FACTOR IX COM- PLEX FACTOR IX COM- PLEX FACTOR IX COM- PLEX

KCENTRA

500 IU 63833-0386-02

VIAL

COAGULANT

PLASMA

CSL BEHRING LLC

ADYNOVATE

801 IU - 1250 IU 00944-4624-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

KCENTRA

1000 IU 63833-0387-02

VIAL

COAGULANT

PLASMA

CSL BEHRING LLC

ADYNOVATE

1801-2500 IU 00944-4625-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PROFILNINE

500 IU

68516-3207-01

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

ADYNOVATE

750 IU 00944-4626-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PROFILNINE

1000 IU 68516-3208-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

ADYNOVATE

1500 IU 00944-4627-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PROFILNINE

1500 IU 68516-3209-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

ADYNOVATE

3000 IU 00944-4628-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

13

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

Product Category

Product Category

Presentation

Subcategory

Derivation

Manufacturer

Presentation

Subcategory

Derivation

Manufacturer

801 IU – 1200 IU 1201 IU – 2000 IU

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

AFSTYLA

250 IU

69911-0474-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

HEMOFIL

00944-3944-02

VIAL

COAGULANT FACTOR VIII

PLASMA

AFSTYLA

500 IU

69911-0475-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

HEMOFIL

00944-3946-02

VIAL

COAGULANT FACTOR VIII

PLASMA

AFSTYLA

1000 IU 69911-0476-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

JIVI

500 IU 00026-3942-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

AFSTYLA

2000 IU 69911-0477-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

JIVI

1000 IU 00026-3944-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

AFSTYLA

3000 IU 69911-0478-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

JIVI

2000 IU 00026-3946-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

AFSTYLA

1500 IU 69911-0480-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

JIVI

3000 IU 00026-3948-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

AFSTYLA

2500 IU 69911-0481-02

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

CSL BEHRING LLC

KOATE

250 IU

76125-0257-25

VIAL

COAGULANT FACTOR VIII

PLASMA

KEDRION BIOPHARMA

ELOCTATE

250 IU

71104-0801-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOATE

500 IU

76125-0663-50

VIAL

COAGULANT FACTOR VIII

PLASMA

KEDRION BIOPHARMA

ELOCTATE

500 IU

71104-0802-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOATE

1000 IU 76125-0676-50

VIAL

COAGULANT FACTOR VIII

PLASMA

KEDRION BIOPHARMA

ELOCTATE

700 IU

71104-0803-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOGENATE

250 IU 00026-3782-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

1000 IU 71104-0804-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOGENATE

500 IU 00026-3783-35

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

1500 IU 71104-0805-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOGENATE

1000 IU 00026-3785-55

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

2000 IU 71104-0806-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOGENATE

2000 IU 00026-3786-65

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

3000 IU 71104-0807-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOGENATE

3000 IU 00026-3787-75

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

4000 IU 71104-0808-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOVALTRY

250 IU

00026-3821-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

KOVALTRY

500 IU 00026-3822-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

5000 IU 71104-0809-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOVALTRY

1000 IU 00026-3824-25

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ELOCTATE

6000 IU 71104-0810-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

SANOFI GENZYME

KOVALTRY

2000 IU 00026-3826-50

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ESPEROCT

1000 IU 00169-8100-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

KOVALTRY

3000 IU 00026-3828-50

VIAL

COAGULANT FACTOR VIII

RECOMBINANT BAYER CORPORATION

ESPEROCT

1500 IU 00169-8150-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

NOVOEIGHT

1000 IU 00169-7810-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

ESPEROCT

2000 IU 00169-8200-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

NOVOEIGHT

1500 IU

00169-7815-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

NOVOEIGHT

2000 IU 00169-7820-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

ESPEROCT

3000 IU 00169-8300-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

NOVOEIGHT

250 IU

00169-7825-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

ESPEROCT

500 IU 00169-8500-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

NOVOEIGHT

3000 IU 00169-7830-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

HEMOFIL

220 IU – 400 IU 00944-3940-02

VIAL

COAGULANT FACTOR VIII

PLASMA

NOVOEIGHT

500 IU

00169-7850-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

HEMOFIL

401 IU – 800 IU 00944-3942-02

VIAL

COAGULANT FACTOR VIII

PLASMA

NUWIQ

250 IU

68982-0139-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

15

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

HP HEMATOLOGY PRODUCTS Product Name Package Size NDC #

Product Category

Product Category

Presentation

Subcategory

Derivation

Manufacturer

Presentation

Subcategory

Derivation

Manufacturer

XYNTHA SOLOFUSE

2000 IU 58394-0025-03

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

NUWIQ

500 IU

68982-0141-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

XYNTHA SOLOFUSE

250 IU 58394-0022-03

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

NUWIQ

1000 IU 68982-0143-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

XYNTHA SOLOFUSE

500 IU 58394-0023-03

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

NUWIQ

1500 IU 68982-0153-01

Vial

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

FACTOR VIII WITH VON WILLEBRAND FACTOR

FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF FACTOR VIII WITH VWF

NUWIQ

2000 IU 68982-0145-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

ALPHANATE

250 IU

68516-4611-01

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

ALPHANATE

250 IU

68516-4616-01

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

NUWIQ

2500 IU 68982-0147-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

ALPHANATE

500 IU

68516-4617-01

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

NUWIQ

3000 IU 68982-0149-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

ALPHANATE

1000 IU 68516-4618-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

NUWIQ

4000 IU 68982-0151-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

OCTAPHARMA USA

ALPHANATE

1500 IU 68516-4619-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

TAKEDA PHARMACEUTICALS AMERICAS, INC.

OBIZUR

1-PACK 500 AU 00944-5001-01

VIAL

INHIBITORS

FACTOR VIII

RECOMBINANT

ALPHANATE

2000 IU 68516-4620-02

VIAL

COAGULANT

PLASMA

GRIFOLS USA, LLC

OBIZUR-RECOMBI- NANT FACTOR VIII SUBSTRATE

1 CARTON = 1 VIAL

TAKEDA PHARMACEUTICALS AMERICAS, INC.

1505746

VIAL

INHIBITORS

FACTOR VIII

RECOMBINANT

HUMATE-P

600 RCOF

63833-0615-02

VIAL

COAGULANT

PLASMA

CSL BEHRING LLC

HUMATE-P

1200 RCOF

63833-0616-02

VIAL

COAGULANT

PLASMA

CSL BEHRING LLC

2000 IU - 3125 IU

TRETTEN

00169-7013-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT NOVO NORDISK INC.

HUMATE-P

2400 RCOF

63833-0617-02

VIAL

COAGULANT

PLASMA

CSL BEHRING LLC

TAKEDA PHARMACEUTICALS AMERICAS, INC.

RECOMBINATE

220 IU – 400 IU 00944-2841-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

WILATE

500 RCOF

68982-0182-01

VIAL

COAGULANT

PLASMA

OCTAPHARMA USA

TAKEDA PHARMACEUTICALS AMERICAS, INC.

RECOMBINATE

401 IU – 800 IU 00944-2842-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

WILATE

1000 RCOF

68982-0182-02

VIAL

COAGULANT

PLASMA

OCTAPHARMA USA

801 IU – 1240 IU

TAKEDA PHARMACEUTICALS AMERICAS, INC.

RECOMBINATE

00944-2843-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

FACTOR X

BIO PRODUCTS LABORATORIES BIO PRODUCTS LABORATORIES

TAKEDA PHARMACEUTICALS AMERICAS, INC.

COAGADEX

250 IU

64208-7752-01

VIAL

COAGULANT FACTOR X

PLASMA

RECOMBINATE

1241-1800 IU 00944-2844-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

COAGADEX

500 IU

64208-7753-01

VIAL

COAGULANT FACTOR X

PLASMA

TAKEDA PHARMACEUTICALS AMERICAS, INC.

RECOMBINATE

1801 – 2400 IU 00944-2845-10

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

FACTOR XA

XYNTHA

250 IU

58394-0012-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

CARTON: 4 VIALS/CTN

ANDEXXA

200 MG VIAL 69853-0102-01

COAGULANT FACTOR XA RECOMBINANT

ALEXION

XYNTHA

500 IU

58394-0013-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

FACTOR XIII

XYNTHA

1000 IU 58394-0014-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

CORIFACT

1000 IU 63833-0518-02

VIAL

COAGULANT FACTOR XIII

PLASMA

CSL BEHRING LLC

VON WILLEBRAND FACTOR

XYNTHA

2000 IU 58394-0015-01

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

VON WILLE- BRAND FACTOR VON WILLE- BRAND FACTOR

CABLIVI

11 MG

58468-0225-01

VIAL

COAGULANT

RECOMBINANT

SANOFI GENZYME

XYNTHA SOLOFUSE

3000 IU 58394-0016-03

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

TAKEDA PHARMACEUTICALS AMERICAS, INC.

VONVENDI

450 – 850 IU 00944-7551-02

VIAL

COAGULANT

RECOMBINANT

XYNTHA SOLOFUSE

1000 IU 58394-0024-03

VIAL

COAGULANT FACTOR VIII

RECOMBINANT

PFIZER, INC.

17

HG IMMUNOLOGY PRODUCTS - HYPERIMMUNE GLOBULIN Product Name Package Size NDC # Presentation Product Category Subcategory Derivation

Manufacturer

CYTOMEGALOVIRUS IMMUNE GLOBULIN

CYTOGAM

2.5 GRAMS 70257-0532-51

VIAL

HYPER IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

INTRAMUSCULAR IMMUNE GLOBULIN

GAMASTAN

2 ML

13533-0335-04

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

GAMASTAN

10 ML

13533-0335-12

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

HEPATITIS B IMMUNE GLOBULIN

HEPAGAM

5 ML

70257-0051-51

VIAL

HYPER IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

Simplify access to ASCENIV ™ & BIVIGAM ® for your patients When you decide that IVIG treatment is right for your patient, enroll them in the support program that can help connect them with potential financial assistance.

HEPAGAM

1 ML

70257-0052-51

VIAL

HYPER IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

HYPERHEP B

0.5ML VIAL 13533-0636-03

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

HYPERHEP B

1 ML VIAL

13533-0636-02

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

HYPERHEP B

5 ML VIAL

13533-0636-05

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

NABI-HB

1ML

69800-4202-01

VIAL

HYPER IMMUNE

IG

PLASMA

ADMA BIOLOGICS

NABI-HB

5ML

69800-4203-01

VIAL

HYPER IMMUNE

IG

PLASMA

ADMA BIOLOGICS

RABIES IMMUNE GLOBULIN

HYPERRAB

1 ML

13533-0318-01

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

ADMA ADvantage Ig TM is a dedicated patient support program created for eligible patients who have been prescribed ADMA Biologics treatment.

HYPERRAB

3 ML

13533-0318-03

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

HYPERRAB

5 ML

13533-0318-05

VIAL

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

Comprehensive Support for Your Practice

Financial Assistance for Your Patients

Prescription Triage

Coverage and Reimbursement Support

HYPERRHO S/D FULL DOSE SYRINGE HYPERRHO S/D FULL DOSE SYRINGE 10PK HYPERRHO S/D MINI- DOSE SYRINGE 10PK

SINGLE

13533-0631-02

SYRINGE

RH IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

10 PACK

13533-0631-11

SYRINGE

RH IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

10 PACK 13533-0661-06

SYRINGE

RH IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

KEDRAB

2 ML

76125-0150-02

VIAL

SPECIALTY

IG

PLASMA

KEDRION BIOPHARMA

KEDRAB

10 ML

76125-0150-10

VIAL

SPECIALTY

IG

PLASMA

KEDRION BIOPHARMA

TETANUS IMMUNE GLOBULIN

HYPERTET

250 IU 13533-0634-02

SYRINGE

HYPER IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

VARICELLA ZOSTER IMMUNE GLOBULIN

Enroll Your Patients Today!

VARIZIG

125 IU

70257-0126-51

VIAL

HYPER IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

RHO(D) IMMUNE GLOBULIN

HYPERRHO S/D FULL DOSE SYRINGE 10PK HYPERRHO S/D MINI- DOSE SYRINGE 10PK

Click here for the ASCENIV Enrollment Form

Click here for the BIVIGAM Enrollment Form

10 PACK

13533-0631-11

SYRINGE

RH IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

10 PACK 13533-0661-06

SYRINGE

RH IMMUNE

IG

PLASMA

GRIFOLS USA, LLC

© 2022 ADMA Biologics. All rights reserved. ASCENIV™ is a trademark of ADMA Biologics.

MICRHOGAM

1 PACK

00562-7806-01

SYRINGE

RH IMMUNE

IG

PLASMA

KEDRION BIOPHARMA

BIVIGAM ® is a registered trademark of ADMA Biologics. ADvantage Ig TM is a trademark of ADMA Biologics. Visit admabiologics.com

19

HG IMMUNOLOGY PRODUCTS - HYPERIMMUNE GLOBULIN Product Name Package Size NDC # Presentation Product Category Subcategory Derivation

IG IMMUNOLOGY PRODUCTS - IMMUNOGLOBULIN Product Name Package Size NDC # Presentation Product Category

Manufacturer

Subcategory Derivation

Manufacturer

BIO PRODUCTS LABORATORIES BIO PRODUCTS LABORATORIES

RHOGAM

1 PACK

00562-7805-01

SYRINGE

RH IMMUNE

IG

PLASMA

KEDRION BIOPHARMA

GAMMAPLEX 5%

5% 10 GRAM 64208-8234-07

VIAL

IVIG

IG

PLASMA

RHOGAM

5 PACK 00562-7805-05 SYRINGE

RH IMMUNE

IG

PLASMA

KEDRION BIOPHARMA

GAMMAPLEX 5%

5% 20 GRAM 64208-8234-08

VIAL

IVIG

IG

PLASMA

RHOGAM

25 PACK 00562-7805-25

SYRINGE

RH IMMUNE

IG

PLASMA

KEDRION BIOPHARMA

GAMUNEX

1 GRAM 13533-0800-12

VIAL

IVIG

IG

PLASMA

GRIFOLS USA, LLC

PACK, 10 SYRINGES

RHOPHYLAC

300 MCG 44206-0300-10

RH IMMUNE

IG

PLASMA

CSL BEHRING LLC

GAMUNEX

2.5 GRAM 13533-0800-15

VIAL

IVIG

IG

PLASMA

GRIFOLS USA, LLC

1000 UG (5000 IU) 300 UG (1500 IU) 500 UG (2500 IU)

WINRHO

70257-0310-51

VIAL

RH IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

GAMUNEX

5 GRAM 13533-0800-20

VIAL

IVIG

IG

PLASMA

GRIFOLS USA, LLC

WINRHO

70257-0330-51

VIAL

RH IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

GAMUNEX

20 GRAM 13533-0800-24

VIAL

IVIG

IG

PLASMA

GRIFOLS USA, LLC

GAMUNEX

40 GRAM 13533-0800-40

VIAL

IVIG

IG

PLASMA

GRIFOLS USA, LLC

WINRHO

70257-0350-51

VIAL

RH IMMUNE

IG

PLASMA SAOL THERAPEUTICS, INC.

GAMUNEX

10 GRAM 13533-0800-71

VIAL

IVIG

IG

PLASMA

GRIFOLS USA, LLC

OCTAGAM 10%

10% 2 GRAM 68982-0850-01

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

IG IMMUNOLOGY PRODUCTS - IMMUNOGLOBULIN Product Name Package Size NDC # Presentation Product Category

OCTAGAM 10%

10% 5 GRAM 68982-0850-02

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

Subcategory Derivation

Manufacturer

OCTAGAM 10%

10% 10 GRAM 68982-0850-03

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

OCTAGAM 10%

10% 20 GRAM 68982-0850-04

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

INTRAVENOUS IMMUNE GLOBULIN

OCTAGAM 10%

10% 30 GRAM 68982-0850-05

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

ASCENIV

5 GRAM 69800-0250-01

VIAL

IVIG

IG

PLASMA

ADMA BIOLOGICS

OCTAGAM 5%

5% 1 GRAM 68982-0840-01

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

BIVIGAM

5 GRAM 69800-6502-01

VIAL

IVIG

IG

PLASMA

ADMA BIOLOGICS

OCTAGAM 5%

5% 2.5 GRAM 68982-0840-02

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

BIVIGAM

10 GRAM 69800-6503-01

VIAL

IVIG

IG

PLASMA

ADMA BIOLOGICS

OCTAGAM 5%

5% 5 GRAM 68982-0840-03

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

GAMMAGARD - LIQUID

1 GRAM 00944-2700-02

VIAL

IVIG

IG

PLASMA

OCTAGAM 5%

5% 10 GRAM 68982-0840-04

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

PANZYGA

2.5 GRAM 00069-1109-02

VIAL

IVIG

IG

PLASMA

PFIZER, INC.

GAMMAGARD - LIQUID 2.5 GRAM 00944-2700-03

VIAL

IVIG

IG

PLASMA

PANZYGA

5 GRAM 00069-1224-02

VIAL

IVIG

IG

PLASMA

PFIZER, INC.

GAMMAGARD - LIQUID

5 GRAM 00944-2700-04

VIAL

IVIG

IG

PLASMA

PANZYGA

10 GRAM 00069-1312-02

VIAL

IVIG

IG

PLASMA

PFIZER, INC.

PANZYGA

20 GRAM 00069-1415-02

VIAL

IVIG

IG

PLASMA

PFIZER, INC.

GAMMAGARD - LIQUID

10 GRAM 00944-2700-05

VIAL

IVIG

IG

PLASMA

PANZYGA

30 GRAM 00069-1558-02

VIAL

IVIG

IG

PLASMA

PFIZER, INC.

GAMMAGARD - LIQUID 20 GRAM 00944-2700-06

VIAL

IVIG

IG

PLASMA

PANZYGA

2.5 GRAM 68982-0820-02

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

PANZYGA

5 GRAM 68982-0820-03

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

GAMMAGARD - LIQUID 30 GRAM 00944-2700-07

VIAL

IVIG

IG

PLASMA

PANZYGA

10 GRAM 68982-0820-04

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

GAMMAGARD - S/D

5 GRAM 00944-2656-03

VIAL

IVIG

IG

PLASMA

PANZYGA

20 GRAM 68982-0820-05

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

GAMMAGARD - S/D

10 GRAM 00944-2658-04

VIAL

IVIG

IG

PLASMA

PANZYGA

30 GRAM 68982-0820-06

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

GAMMAKED

1 GRAM 76125-0900-01

VIAL

IVIG

IG

PLASMA

KEDRION BIOPHARMA

PRIVIGEN

5 GRAM 44206-0436-05

VIAL

IVIG

IG

PLASMA

CSL BEHRING LLC

GAMMAKED

10 GRAM 76125-0900-10

VIAL

IVIG

IG

PLASMA

KEDRION BIOPHARMA

PRIVIGEN

10 GRAM 44206-0437-10

VIAL

IVIG

IG

PLASMA

CSL BEHRING LLC

GAMMAKED

20 GRAM 76125-0900-20

VIAL

IVIG

IG

PLASMA

KEDRION BIOPHARMA

PRIVIGEN

20 GRAM 44206-0438-20

VIAL

IVIG

IG

PLASMA

CSL BEHRING LLC

GAMMAKED

5 GRAM 76125-0900-50

VIAL

IVIG

IG

PLASMA

KEDRION BIOPHARMA

PRIVIGEN

40 GRAM 44206-0439-40

VIAL

IVIG

IG

PLASMA

CSL BEHRING LLC

BIO PRODUCTS LABORATORIES BIO PRODUCTS LABORATORIES BIO PRODUCTS LABORATORIES BIO PRODUCTS LABORATORIES

GAMMAPLEX 10%

10% 5 GRAM 64208-8235-05

VIAL

IVIG

IG

PLASMA

SUBCUTANEOUS IMMUNE GLOBULIN

CUTAQUIG

1 GRAM 00069-1061-02

VIAL

SUBQ

IG

PLASMA

PFIZER, INC.

GAMMAPLEX 10%

10% 10 GRAM 64208-8235-06

VIAL

IVIG

IG

PLASMA

CUTAQUIG

2 GRAM 00069-1476-02

VIAL

SUBQ

IG

PLASMA

PFIZER, INC.

GAMMAPLEX 10%

10% 20 GRAM 64208-8235-07

VIAL

IVIG

IG

PLASMA

CUTAQUIG

4 GRAM 00069-1509-02

VIAL

SUBQ

IG

PLASMA

PFIZER, INC.

CUTAQUIG

8 GRAM 00069-1965-02

VIAL

SUBQ

IG

PLASMA

PFIZER, INC.

GAMMAPLEX 5%

5% 5 GRAM 64208-8234-06

VIAL

IVIG

IG

PLASMA

CUTAQUIG

1 GRAM 68982-0810-01

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

21

IG IMMUNOLOGY PRODUCTS - IMMUNOGLOBULIN Product Name Package Size NDC # Presentation Product Category

NP NEUROLOGY PRODUCTS Product Name Package Size NDC #

Product Category

Subcategory Derivation

Manufacturer

Presentation

Subcategory

Derivation

Manufacturer

BRIVIACT ORAL SOLUTION

CUTAQUIG

2 GRAM 68982-0810-03

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

10 MG / ML 50474-0870-15

BOTTLE

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

CUTAQUIG

4 GRAM 68982-0810-05

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

BRIVIACT INJECTION 50 MG / 5 ML 50474-0970-75

VIAL

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

CUTAQUIG

8 GRAM 68982-0810-06

VIAL

IVIG

IG

PLASMA

OCTAPHARMA USA

HIZENTRA

1 GRAM 44206-0451-01

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

NAYZILAM

5 MG 50474-0500-15 NASAL SPRAY SPECIALTY SPECIALTY BENZODIAZEPINES

UCB, INC.

HIZENTRA

2 GRAM 44206-0452-02

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

KEPPRA ORAL SOLUTION

100 MG / ML 50474-0001-48

BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HIZENTRA

4 GRAM 44206-0454-04

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

HIZENTRA

10 GRAM 44206-0455-10

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

KEPPRA INJECTION 500 MG / 5ML 50474-0002-63

VIAL

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HIZENTRA PFS

1 GRAM 44206-0456-21

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

KEPPRA

250 MG 50474-0594-40 BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HIZENTRA PFS

2 GRAM 44206-0457-22

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

KEPPRA

500 MG 50474-0595-40 BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HIZENTRA PFS

4 GRAM 44206-0458-24

VIAL

SUBQ

IG

PLASMA

CSL BEHRING LLC

TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC. TAKEDA PHARMACEUTICALS AMERICAS, INC.

KEPPRA

750 MG 50474-0596-40 BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HYQVIA

2.5 GRAM 00944-2510-02

VIAL

SUBQ

IG

PLASMA

KEPPRA

1000 MG 50474-0597-66

BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HYQVIA

5 GRAM 00944-2511-02

VIAL

SUBQ

IG

PLASMA

KEPPRA XR

500 MG 50474-0598-66

BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

HYQVIA

10 GRAM 00944-2512-02

VIAL

SUBQ

IG

PLASMA

KEPPRA XR

750 MG 50474-0599-66

BOTTLE

SPECIALTY SPECIALTY LEVETIRACETAM UCB, INC.

LEQEMBI

200 MG / 2 ML 62856-0212-01

VIAL

SPECIALTY SPECIALTY LECANEMAB

EISAI INC.

HYQVIA

20 GRAM 00944-2513-02

VIAL

SUBQ

IG

PLASMA

LEQEMBI

500 MG / 5 ML 62856-0215-01

VIAL

SPECIALTY SPECIALTY LECANEMAB

EISAI INC.

HYQVIA

30 GRAM 00944-2514-02

VIAL

SUBQ

IG

PLASMA

200 MG / 20 ML

VIMPAT INJECTION

00131-1810-67

VIAL

SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

XEMBIFY

1 GRAM 13533-0810-05

VIAL

SUBQ

IG

PLASMA

GRIFOLS USA, LLC

VIMPAT

50 MG 00131-2477-35

BOTTLE

SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

XEMBIFY

2 GRAM 13533-0810-10

VIAL

SUBQ

IG

PLASMA

GRIFOLS USA, LLC

VIMPAT

50 MG 00131-2477-60 UNIT DOSE PACK SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

XEMBIFY

4 GRAM 13533-0810-20

VIAL

SUBQ

IG

PLASMA

GRIFOLS USA, LLC

VIMPAT

100 MG 00131-2478-35

BOTTLE

SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

XEMBIFY

10 GRAM 13533-0810-50

VIAL

SUBQ

IG

PLASMA

GRIFOLS USA, LLC

VIMPAT

100 MG 00131-2478-60 UNIT DOSE PACK SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

NP NEUROLOGY PRODUCTS Product Name Package Size NDC #

VIMPAT

150 MG 00131-2479-35

BOTTLE

SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

Product Category

VIMPAT

150 MG 00131-2479-60 UNIT DOSE PACK SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

Presentation

Subcategory

Derivation

Manufacturer

VIMPAT

200 MG 00131-2480-35

BOTTLE

SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

AMYOTROPHIC LATERAL SCLEROSIS (ALS)

VIMPAT

200 MG 00131-2480-60 UNIT DOSE PACK SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

MITSUBISHI TANABE PHARMA AMERICA, INC.

RADICAVA_ CATEGORY

RADICAVA

30MG/100 ML 70510-2171-02

CARTON

SPECIALTY RECOMBINANT

VIMPAT ORAL SOLUTION

10 MG / ML 00131-5410-72

BOTTLE

SPECIALTY SPECIALTY LACOSAMIDE

UCB, INC.

SEIZURE DISORDERS

PARKINSON’S DISEASE

BRIVIACT

10 MG 50474-0370-66

BOTTLE

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

DOPAMINE AGONISTS DOPAMINE AGONISTS DOPAMINE AGONISTS DOPAMINE AGONISTS DOPAMINE AGONISTS DOPAMINE AGONISTS

NEUPRO

30 X 1 MG 50474-0801-03

EACH

SPECIALTY SPECIALTY

UCB, INC.

BRIVIACT

25 MG 50474-0470-09 UNIT DOSE PACK SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

BRIVIACT

25 MG 50474-0470-66

BOTTLE

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

NEUPRO

30 X 2 MG 50474-0802-03

EACH

SPECIALTY SPECIALTY

UCB, INC.

BRIVIACT

50 MG 50474-0570-09 UNIT DOSE PACK SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

NEUPRO

30 X 3 MG 50474-0803-03

EACH

SPECIALTY SPECIALTY

UCB, INC.

BRIVIACT

50 MG 50474-0570-66

BOTTLE

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

NEUPRO

30 X 4 MG 50474-0804-03

EACH

SPECIALTY SPECIALTY

UCB, INC.

BRIVIACT

75 MG 50474-0670-66

BOTTLE

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

NEUPRO

30 X 6 MG 50474-0805-03

EACH

SPECIALTY SPECIALTY

UCB, INC.

BRIVIACT

100 MG 50474-0770-09 UNIT DOSE PACK SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

NEUPRO

30 X 8 MG 50474-0806-03

EACH

SPECIALTY SPECIALTY

UCB, INC.

BRIVIACT

100 MG 50474-0770-66

BOTTLE

SPECIALTY SPECIALTY BRIVARACETAM UCB, INC.

23

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