Drugs: Contract Drugs List Part 5drugs cdl p5
Authorized Drug Manufacturer Labeler Codes1
GENERAL PROVISIONS
(1)Reimbursement of drugs made by manufacturers whose labeler codes are marked with a symbol (♦)was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
(2)Providers will not be reimbursed for any drugs made by manufacturers identified with a symbol (), on the following pages, unless they have an approved Treatment Authorization Request (TAR). There are two exceptions to this policy:
- Drugs from affected manufacturers do not require a TAR if they are marked with a symbol (ƒ) on the Contract Drugs List. See paragraph (6), “General Provisions,” in the Drugs: Contract Drugs Introduction section of the Part 2 Pharmacy manual for more information.
- A patient who has been receiving one of the affected drugs may continue to receive it withoutauthorization. Affected drugs are lined out and marked with a symbol (§) on the Contract DrugsList. See paragraph (7), “General Provisions,” in the Drugs: Contract Drugs Introduction section of the Part 2 Pharmacy manual for more information.
Note: Non-Pharmacy providers may view the Pharmacy manual on the Medi-Cal Web site ().
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
September 2008
Drugs: Contract Drugs List Part 5drugs cdl p5
Authorized Drug Manufacturer Labeler Codes1
NDC Labeler Code / Contracting Company’s Name00002 / ELI LILLY AND COMPANY
00003 ♦ / E. R. SQUIBB & SONS, INC.
00004 / HOFFMAN-LA ROCHE INC.
† / 00005 ♦ / LEDERLE LABORATORIES
00006 ♦ / MERCK & COMPANY, INC.
00007 / GLAXOSMITHKLINE
00008 ♦ / WYETH LABORATORIES
00009 ♦ / PFIZER, INC.
00013 / PFIZER, INC.
00015 / MEAD JOHNSON & COMPANY
00023 / ALLERGAN, INC.
00024 / SANOFI-AVENTIS, US LLC.
00025 / PFIZER, INC.
00026 / BAYER CORPORATION PHARMACEUTICAL DIV.
00029 / GLAXOSMITHKLINE
† / 00031 / A. H. ROBINS
00032 / SOLVAY PHARMACEUTICALS
00037 / MEDA PHARMACEUTICALS, INC.
†Effective October 1, 2015
00039 / SANOFI-AVENTIS, US LLC.
00046 ♦ / AYERST LABORATORIES, INC.
00049 ♦ / PFIZER, INC.
00051 / UNIMED PHARMACEUTICALS, INC.
00052 / ORGANON INC.
00053 / CSL BEHRING
00054 / ROXANE LABORATORIES, INC.
00056 / DUPONT PHARMACEUTICALS
00062 / ORTHO PHARMACEUTICAL CORPORATION
00064 / HEALTHPOINT, LTD.
00065 / ALCON LABORATORIES INC.
00066 / AVENTIS PHARMACEUTICALS
00067 / NOVARTIS CONSUMER HEALTH, INC.
00068 / AVENTIS PHARMACEUTICALS
00069 ♦ / PFIZER, INC.
00071 ♦ / PFIZER, INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
September 2008
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1
NDC Labeler Code / Contracting Company’s Name00074 / ABBOTT LABORATORIES
00075 / AVENTIS PHARMACEUTICALS
00078 / NOVARTIS PHARMACEUTICALS CORPORATION
00085 / SCHERING CORPORATION
00087 / BRISTOL-MYERS SQUIBB COMPANY
00088 / AVENTIS PHARMACEUTICALS
00091 / SCHWARZ PHARMA, INC.
00093 / TEVA PHARMACEUTICALS USA, INC.
00095 / ECR PHARMACEUTICALS
00096 / PERSON & COVEY INC.
00113 / GEISS, DESTIN & DUNN, INC.
00115 / GLOBAL PHARMACEUTICAL CORPORATION
00116 / XTTRIUM LABORATORIES, INC.
00121 / PHARMACEUTICAL ASSOCIATES, INC.
† / 00126 / COLGATE ORAL PHARMACEUTICALS
†Effective July 1, 2013
NDC Labeler Code / Contracting Company’s Name00131 / SCHWARZ PHARMA MANUFACTURING
00132 / C.B. FLEET COMPANY, INC.
00135 / GLAXOSMITHKLINE
00143 / WEST-WARD PHARMACEUTICAL CORP
00145 / STIEFEL LABORATORIES, INC.
00149 / PROCTOR & GAMBLE PHARMACEUTICALS
00168 / E. FOUGERA & CO., DIVISION OF ALTANA
00169 / NOVO NORDISK PHARMACEUTICALS, INC.
00172 / IVAX PHARMACEUTICALS, INC.
00173 / GLAXOSMITHKLINE
00178 / MISSION PHARMACAL COMPANY
00182 / GOLDLINE LABORATORIES INC.
00185 / EON LABS MANUFACTURING, INC.
00186 / ASTRAZENECA LP
00187 / VALEANT PHARMACEUTICALS NORTH AMERICA
00206 / LEDERLE PIPERACILLIN, INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
June 2015
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NDC Labeler Code / Contracting Company’s Name00224 / KONSYL PHARMACEUTICALS, INC.
00225 / B.F. ASCHER COMPANY INC.
00228 / ACTAVIS ELIZABETH LLC.
00245 / UPSHER-SMITH LABORATORIES, INC.
00258 / INWOOD LABORATORIES, INC.
00259 / MERZ PHARMACEUTICALS
00264 / B. BRAUN MEDICAL INC.
00281 / SAVAGE LABORATORIES, DIV. OF ALTANA
00299 / GALDERMA LABORATORIES, L.P.
00300 / TAP PHARMACEUTICAL INC.
00310 / ASTRAZENECA LP
† / 00316 / CROWN LABORATORIES, INC.
00327 / GUARDIAN LABS DIV
UNITED-GUARDIAN INC.
†Effective April 1, 2018
NDC Labeler Code / Contracting Company’s Name00338 / BAXTER HEALTHCARE CORPORATION
00378 / MYLAN PHARMACEUTICALS INC.
00406 / MALLINC.KRODT INC.
00407 / GE HEALTHCARE, INC.
00409 / HOSPIRA, INC.
00430 / WARNER CHILCOTT LABORATORIES
00456 / FOREST PHARMACEUTICALS, INC.
00469 / ASTELLAS PHARMA US, INC.
00472 / ACTAVIS
00485 / EDWARDS PHARMACEUTICALS, INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
June 2015
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NDC Labeler Code / Contracting Company’s Name00486 / BEACH PRODUCTS, INC.
00487 / NEPHRON PHARMACEUTICALS CORPORATION
00517 / AMERICAN REGENT LABORATORIES, INC.
00527 / LANNETT COMPANY, INC.
00535 / GILBERT LABORATORIES
00536 / WATSON PHARMACEUTICALS
00548 / AMPHASTAR PHARMACEUTICALS, INC.
00555 / BARR LABORATORIES, INC.
00562 / KEDRION MELVILLE, INC.
00574 / PADDOCK LABORATORIES, INC.
00575 / IVAX RESEARCH, INC.
00590 / DUPONT PHARMACEUTICALS
00591 / WATSON PHARMA, INC.
00597 / BOEHRINGER INGELHEIM PHARMACEUTICALS
00603 / QUALITEST PHARMACEUTICALS, INC.
00641 / BAXTER HEALTHCARE CORPORATION
00642 / EVERETT LABORATORIES, INC.
00682 / MARNEL PHARMACEUTICALS, INC.
†Effective October 1, 2018
NDC Labeler Code / Contracting Company’s Name00703 / SICOR PHARMACEUTICALS, INC.
00713 / G & W LABORATORIES, INC.
00777 / DISTA PRODUCTS CO DIV. OF ELI LILLY & CO.
00781 / SANDOZ
00813 / PHARMICS, INC.
00832 / UPSHER-SMITH LABORATORIES, INC.
00884 / PEDINOL PHARMACAL INC.
00904 / MAJOR PHARMACEUTICALS
00941 / BAXTER HEALTHCARE CORPORATION
00944 / BAXTER HEALTHCARE
00955 / SANOFI-SYNTHELABO INC.
† / 00990 / ICU MEDICAL INC.
00998 / ALCON LABORATORIES, INC.
10019 / BAXTER HEALTHCARE CORPORATION
10122 / CORNERSTONE BIOPHARMA, INC.
10144 / ACORDA THERAPEUTICS, INC.
10147 / PATRIOT PHARMACEUTICALS, LLC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
September 2018
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NDC Labeler Code / Contracting Company’s Name10158 / GLAXOSMITHKLINE
10267 / CONTRACT PHARMACAL CORP.
10337 / DOAK DERMATOLOGICS
10370 / ANCHEN PHARMACEUTICALS, INC.
10454 / SOLSTICE NEUROSCIENCES, INC.
10511 / PHOTOCURE, INC.
10542 / HILLESTAD PHARMACEUTICALS
10572 / AFFORDABLE PHARMACEUTICALS, LLC.
† / 10599 / INTERSECT ENT, INC.
10631 / RANBAXY LABORATORIES INC.
10702 / KVK-TECH, INC.
10885 / GALEN US INC.ORPORATED
10888 / BANNER PHARMACAPS INC.
10922 / INTENDIS, INC.
11534 / SUNRISE PHARMACEUTICAL, INC.
†Effective April 1, 2018
NDC Labeler Code / Contracting Company’s Name11701 / COLOPLAST CORP.
11980 / ALLERGAN, INC.
11994 / LANTHEUS MEDICAL IMAGING, INC.
12496 / RECKITT BENCKISER PHARMACEUTICALS, INC.
12830 / R. A. MC NEIL COMPANY
13107 / AUROBINDO PHARMA USA, INC.
13310 / AR SCIENTIFIC, INC.
13517 / E5 PHARMA, LLC.
13533 / TALECRIS BIOTHERAPEUTICS, INC.
13548 / CORIA LABORATORIES, LTD.
13551 / FSC LABORATORIES, INC.
13632 / ROSEMONT PHARMACEUTICALS, LTD.
13668 / TORRENT PHARMA, INC.
13811 / TRIGEN LABORATORIES, INC.
13845 / PURDUE GMP CENTER LLC.
DBA THE CHAO CENTER
13913 / DEPOMED, INC.
13925 / SETON
PHARMACEUTICALS, LLC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions" on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
__ 2009
drugs cdl p5
1
NDC Labeler Code / Contracting Company’s Name14550 / ACTAVIS PHARMA MFGING PRIVATE LTD
15054 / TERCICA, INC.
15127 / SELECT BRANDS DISTRIBUTORS
† / 15310 / CREEKWOOD PHARMACEUTICAL, INC.
15370 / CARWIN ASSOCIATES, INC.
15584 / BRISTOL-MYERS SQUIBB AND GILEAD SCIENCES, LLC.
15749 / AMERICAN ANTIBIOTICS, INC.
15821 / FOCUS LABORATORIES, INC.
16103 / PHARBEST PHARMACEUTICALS, INC.
16252 / COBALT LABORATORIES, INC.
16477 / LASER PHARMACEUTICALS, INC.
16571 / PACK PHARMACEUTICALS, LLC.
16714 / NORTHSTAR RX, LLC.
16729 / ACCORD HEALTHCARE INC.ORPORATED
17433 / SUMMIT PHARMACEUTICALS DBA ENEMEEZ, INC.
17478 / AKORN, INC.
17772 / SUPERNUS PHARMACEUTICALS, INC.
18657 / HALOZYME THERAPEUTICS, INC.
18860 / JAZZ PHARMACEUTICALS, INC.
20482 / INSYS THERAPEUTICS, INC.
20536 / TALON THERAPEUTICS, INC.
†Effective October 1, 2018
NDC Labeler Code / Contracting Company’s Name21724 / INDEPENDENCE PHARMACEUTICALS, LLC.
23155 / HERITAGE PHARMACEUTICALS, INC.
23359 / CENTURION LABS, LLC.
23594 / Zylera Pharmaceuticals, LLC.
23635 / MALLINC.KRODT BRAND PHARMACEUTICALS, INC.
24090 / AKRIMAX PHARMACEUTICALS LLC.
24201 / CUSTOPHARM, INC. DBA LEUCADIA PHARMA
24208 / BAUSCH & LOMB PHARMACEUTICALS, INC.
24338 / ARBOR PHARMACEUTICALS, INC.
24385 / BERGEN BRUNSWIG DRUG COMPANY
† / 24477 / EKR THERAPEUTICS, INC.
24478 / NEXTWAVE PHARMACEUTICALS, INC.
† / 24486 / ARISTOS PHARMACEUTICALS, INC.
24492 / PARI RESPIRATORY EQUIPMENT, INC.
24510 / COLLEGIUM PHARMACEUTICALS, INC.
24658 / BLU PHARMACEUTICALS
24856 / THROMBOGENICS, INC.
24979 / TWI PHARMACEUTICALS, INC.
24987 / COVIS PHARMECEUTICALS, INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
September 2018
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1
NDC Labeler Code / Contracting Company’s Name25010 / ATON PHARMA, INC.
25021 / SAGENT PHARMACEUTICALS, INC.
25208 / MEDICURE PHARMA, INC.
25682 / ALEXION PHARMACEUTICALS
27241 / AJANTA PHARMA LIMITED
27437 / LUPIN PHARMACEUTICALS, INC.
27505 / US WORLDMEDS, LLC.
27808 / TRIS PHARMA, INC.
28105 / HILL DERMACEUTICALS, INC.
28595 / ALLEGIS PHARMACEUTICALS, LLC.
29033 / NOSTRUM LABORATORIES
29300 / UNICHEM PHARMACEUTICALS, INC.
29978 / CAPITAL PHARMACEUTICAL, LLC.
30237 / DENDREON CORPORATION
30698 / VALIDUS PHARMACEUTICALS, INC.
31357 / INSPIRE PHARMACEUTICALS, INC.
31722 / CAMBER PHARMACEUTICALS, INC.
33342 / MACLEODS PHARMA USA, INC.
35573 / BUREL PHARMACEUTICALS
† / 36000 / BAXTER HEALTHCARE CORPORATION
36800 / TOPCO ASSOCIATES LLC.
37205 / LEADER
39328 / PATRIN PHARMA, INC.
†Effective October 1, 2018
NDC Labeler Code / Contracting Company’s Name39822 / X-GEN PHARMACEUTICALS
40076 / PRESTIUM PHARMA, INC.
40085 / RENAISSANCE PHARMA, INC.
41616 / SUN PHARMA GLOBAL, INC.
42023 / JHP PHARMACEUTICALS, LLC.
42043 / KARALEX PHARMA, LLC.
42195 / XSPIRE PHARMA
42211 / IROKO PHARMACEUTICALS
LLC.
42227 / LEV PHARMACEUTICALS
42238 / VIDARA THERAPEUTICS INC.
42292 / MYLAN INSTITUTIONAL INC.
42358 / SENTYNL THERAPEUTICS
42367 / EAGLE PHARMACEUTICALS, INC.
42385 / LAURUS LABS LIMITED
42388 / EXELIXIS, INC.
42457 / EMMAUS MEDICAL, INC.
42494 / CAMERON PHARMACEUTICALS, LLC.
42543 / VENSUN PHARMACEUTICALS, INC.
42571 / MICRO LABS LIMITED
42702 / PARAGON BIOTEK, INC.
42747 / PROSTRAKAN, INC.
42794 / SIGNAPHARM LABORATORIES, LLC.
42799 / EDENBRIDGE PHARMACEUTICALS LLC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
June 2012
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1
NDC Labeler Code / Contracting Company’s Name42806 / EPIC PHARMA LLC.
42847 / SOMAXON PHARMACEUTICALS, INC.
42858 / RHODES PHARMACEUTICALS, L.P.
42865 / EURAND PHARMACEUTICALS, INC.
42998 / MARATHON PHARMACEUTICALS, LLC.
43066 / BAXTER HEALTHCARE CORPORATION
43068 / VANDA PHARMACEUTICALS, INC.
43199 / COUNTY LINE PHARMACEUTICALS, LLC.
43376 / ZOGENIX, INC.
43386 / GAVIS PHARMACEUTICALS, LLC.
43393 / GENBIOPRO, INC.
43469 / ZARS PHARMA, INC.
43478 / ROUSES POINT PHARMACEUTICALS, LLC.
43485 / APRECIA PHARMACEUTICALS COMPANY
43538 / MEDIMETRIKS PHARMACEUTICALS, INC.
43547 /
SOLCO HEALTHCARE US, LLC.
43553 /convatec INC.
43595 / LABOPHARM PHARMACEUTICALS, LLC.43598 / DR. REDDY’S LABORATORIES, INC.
43773 / SLATE PHARMACEUTICALS, INC.
†Effective January 1, 2017
NDC Labeler Code / Contracting Company’s Name43975 / AMERIGEN PHARMACEUTICALS, INC.
44087 / SERONO INC.
44183 / MACOVEN PHARMACEUTICALS, LLC.
44206 / CSL BEHRING, LLC.
44523 / BIOCOMP PHARMA, INC.
44567 / WG CRITICAL CARE, LLC.
44946 / SANCILIO & COMPANY, INC.
45043 / MANCHESTER PHARMACEUTICALS, INC.
45802 / PERRIGO PHARMACEUTICALS
45945 / CNS THERAPEUTICS INC.
45963 / ACTAVIS, INC.
46026 / GLOUCESTER PHARMACEUTICAL INC.
46122 / AMERISOURCE BERGEN DRUG COMPANY
46287 / CAROLINA MEDICAL PRODUCTS COMPANY
46672 / MIKART, INC.
46783 / MERZ AESTHETICS, INC.
46987 / ACTAVIS KADIAN LLC.
47335 / SUN PHARMA GLOBAL FZE
† / 47426 / HERON THERAPEUTICS, INC.
47781 / ALVOGEN INC.
47783 / DYAX CORP
† / 47918 / MANNKIND CORPORATION
48102 / FERA PHARMACEUTICALS, LLC.
48818 / ALLOS THERAPEUTICS INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
December 2016
drugs cdl p5
1
NDC Labeler Code / Contracting Company’s Name49158 / THAMES PHARMACEUTICALS, INC.
49230 / FRESENIUS MEDICAL CARE NORTH AMERICA
49281 / AVENTIS PASTEUR, INC.
49348 / MC KESSON CORP.-VALU-RITE
49483 / TIME-CAP LABS, INC.
49401 / HUMAN GENOME SCIENCES, INC.
49411 / CLOVER PHARMACEUTICALS CORPORATION
49502 / DEY L.P.
49663 / RAPTOR THERAPEUTICS, INC.
49685 / NEUROGESX, INC.
49702 / VIIV HEALTHCARE
49708 / CARACO PHARMA INC.
49730 / HERCON PHARMACEUTICALS, LLC.
49808 / METACON LABS
49884 / PAR PHARMACEUTICAL INC.
49908 / ROCHESTER PHARMACEUTICALS
49909 / EDGEMONT PHARMACEUTICALS, LLC.
49938 / JACOBUS PHARMACEUTICAL CO., INC.
50102 / AFAXYS, INC.
50111 / PLIVA, INC.
50192 / NAUTILUS NEUROSCIENCES, INC.
†Effective January 1, 2018
NDC Labeler Code / Contracting Company’s Name50222 / LEO PHARMA INC.
50236 / QLT OPHTHALMICS INC.
50242 / GENENTECH, INC.
† / 50268 / AVPAK
50383 / HI-TECH PHARMACAL CO., INC.
50419 / BAYER HEALTHCARE PHARMACEUTICALS
50458 / JANSSEN PHARMACEUTICALS, INC.
50474 / UCB PHARMA, INC.
50484 / SMITH & NEPHEW, INC.
50742 / INGENUS PHARMACEUTICALS, LLC.
50816 / NEW AMERICAN THERAPEUTICS
50844 / LNK INTERNATIONAL, INC.
50881 / INC.YTE CORPORATION
50967 / WOMEN'S CHOICE PHARMACEUTICALS, LLC.
50991 / POLY PHARMACEUTICAL CO., INC.
51021 / SIRCLE LABORATORIES, LLC.
51079 / UDL LABORATORIES, INC.
51144 / SEATTLE GENETICS INC.
51167 / VERTEX PHARMACEUTICALS, INC.
51224 / TAGI PHARMA, INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions" on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler CodesPharmacy 653
April 2007
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1
NDC Labeler Code / Contracting Company’s Name51248 / ASTELLAS
† / 51267 / OREXIGEN
THERAPEUTICS, INC.
51285 / TEVA WOMENS HEALTH INC
51293 / ECI PHARMACEUTICALS LLC
51477 / NESHER PHARMACEUTICALS, INC.
51525 / WALLACE PHARMACEUTICALS
51645 / GEMINI PHARMACEUTICALS, INC.
51660 / OHM LABORATORIES, INC.
51672 / TARO PHARMACEUTICALS, INC.
51754 / EXELA PHARMA SCIENCES
51759 / NUPATHE INC.
51801 / NOMAX, INC.
51862 / LIBERTAS PHARMA, INC.
51991 / BRECKENRIDGE PHARMACEUTICAL, INC.
52015 / OPTIMER PHARMACEUTICALS, INC.
52054 / AMEDRA PHARMACEUTICALS, LLC
52118 / THERAVANCE, INC.
52244 / ACTIENT PHARMACEUTICALS
52246 / PARAPRO, LLC
52268 / BRAINTREE LABORATORIES INC.
52276 / ORPHAN EUROPE, SARL
52427 / ALMATICA INC.
52536 / WILSHIRE PHARMACEUTICALS, INC.
52544 / WATSON LABORATORIES, INC.
†Effective April 1, 2017
NDC Labeler Code / Contracting Company’s Name52565 / IGI LABORATORIES, INC.
52609 / APO-PHARMA USA, INC.
52652 / SILVERGATE PHARMACEUTICALS, INC.
52747 / U.S. PHARMACEUTICAL CORPORATION
52796 / BON GEO PHARMACEUTICALS, INC.
52817 / TRUPHARMA, LLC
52937 / AMARIN PHARMACEUTICALS, IRELAND LTD
53014 / CELLTECH PHARMACEUTICALS
53097 / THE PHARMA NETWORK, LLC
53150 / AMNEAL-AGILA, LLC
53270 / CANGENE BIO PHARMA
53329 / MEDLINE INDUSTRIES, INC.
53436 / RELYPSA, INC.
53451 / XENOPORT, INC.
53489 / MUTUAL PHARMACEUTICAL COMPANY, INC.
53746 / AMNEAL PHARMACEUTICALS
54092 / SHIRE US INC.
54123 / OREXO US, INC.
54295 / TRINITY PHARMACEUTICALS LLC
54436 / ANTARES PHARMA, INC.
54458 / INTERNATIONAL LABS, INC.
54482 / SIGMA-TAU PHARMACEUTICALS, INC.
54505 / LINEAGE THERAPEUTICS INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
March 2017
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1
NDC Labeler Code / Contracting Company’s Name54643 / BAXTER HEALTHCARE CORPORATION
54766 / SEBELA PHARMACEUTICALS, INC.
54838 / SILARX PHARMACEUTICALS, INC.
54859 / LLORENS PHARMACEUTICAL INTERNATIONAL DIV.
54879 / STI PHARMA, LLC
55111 / DR. REDDY’S LABORATORIES, INC.
55150 / AUROMEDICS PHARMA LLC
55253 / CIMA LABS
55292 / RECORDATI RARE DISEASES, INC.
55390 / BEDFORD LABORATORIES
55466 / NEOLPHARMA, INC.
55494 / DUCHESNAY USA, INC.
55513 / AMGEN INC.
55566 / FERRING PHARMACEUTICALS, INC.
55607 / HEALTH SCIENCE FUNDING, LLC
55724 / ANACOR PHARMACEUTICALS
57237 / CITRON PHARMA, LLC
57278 / ROCKWELL MEDICAL, INC.
57664 / CARACO PHARMACEUTICAL LABORATORIES LTD.
57665 / ENZON, INC.
57782 / BAUSCH & LOMB PHARMACEUTICALS, INC.
57844 / GATE PHARMACEUTICALS
57881 / GALENA BIOPHARMA, INC.
†Effective October 1, 2018
NDC Labeler Code / Contracting Company’s Name57894 / CENTOCOR, INC.
57902 / EUSA PHARMA (USA), INC.
57962 / PHARMACYCLICS, INC.
57970 / DURATA THERAPEUTICS, INC.
† / 58181 / NEXTSOURCE BIOTECHNOLOGY, LLC
58281 / MEDTRONIC, INC.
58284 / BRAEBURN PHARMACEUTICALS, INC.
58394 / GENETICS INSTITUTE, INC.
58406 / AMGEN/IMMUNEX
58407 / MAGNA PHARMACEUTICALS, INC.
58463 / PRAGMA PHARMACEUTICALS, LLC
58468 / GENZYME CORPORATION
58487 / NEW HAVEN PHARMACEUTICALS, INC.
58517 / NEW HORIZON RX GROUP, LLC
† / 58604 / SPROUT PHARMACEUTICALS, INC.
58605 / MCR-AMERICAN PHARMACEUTICALS, INC.
58657 / METHOD PHARMACEUTICALS
58809 / GM PHARMACEUTICALS, INC.
58914 / AXCAN SCANDIPHARM, INC.
59011 / PURDUE PHARMA L.P.
59075 / ELAN PHARMACEUTICALS, INC./ATHENA NEURO
59088 / puretek corporation
59137 / MEDAC PHARMA, INC.
59148 / OTSUKA AMERICA PHARMACEUTICALS, INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes
March 2017
drugs cdl p5
1
NDC Labeler Code / Contracting Company’s Name59212 / CONCORDIA PHARMACEUTICALS, INC.
59310 / IVAX LABS, INC.
59338 / AMAG PHARMACEUTICALS, INC.
59353 / VIFOR (INTERNATIONAL) INC.
† / 59365 / COOPERSURGICAL INC.
59385 / BIODELIVERY SCIENCES INTERNATIONAL, INC.
59417 / SHIRE US, INC.
59467 / HIKMA AMERICAS
59528 / NEPHRO-TECH, INC.
59572 / CELGENE CORPORATION
59617 / GREER LABORATORIES, INC.
59627 / BIOGEN, INC.
59630 / SCIELE PHARMA, INC.
59651 / AUROBINDO PHARMA USA, INC.
59676 / JANSSEN PRODUCTS, LP.
59730 / BIOTEST PHARMACEUTICALS CORPORATION
59746 / CADISTA PHARMACEUTICALS INC.
59762 / PFIZER, INC.
59767 / DIGESTIVE CARE, INC
† / 59917 / ADARE PHARMACEUTICALS, INC.
59922 / KERYX BIOPHARMACEUTICALS, INC.
59923 / AREVA PHARMACEUTICALS
60219 / AMNEAL PHARMACEUTICALS
60258 / CYPRESS PHARMACEUTICAL, INC.
†Effective July 1, 2018
NDC Labeler Code / Contracting Company’s Name60432 / MORTON GROVE PHARMACEUTICALS, INC.
60505 / APOTEX CORP.
60574 / MEDIMMUNE, INC.
60631 / ARBOR PHARMACEUTICALS IRELAND LIMITED
60687 / AMERICAN HEALTH PACKAGING
60758 / PACIFIC PHARMA
60793 / KING PHARMACEUTICALS, INC.
60846 / GEMINI LABORATORIES, LLC
60923 / SAREPTA THERAPEUTICS INC.
60951 / ENDO PHARMACEUTICALS, INC.
60977 / BAXTER HEALTHCARE CORPORATION
61269 / H2-PHARMA, LLC
61314 / FALCON PHARMACEUTICALS LTD.
61364 / BIOCRYST PHARMACEUTICALS, INC.
61442 / CARLSBAD TECHNOLOGY, INC.
61570 / MONARCH PHARMACEUTICAL CORPORATION
61703 / MAYNE PHARMA (USA), INC.
61748 / VERSAPHARM, INC.
61755 / REGENERON PHARMACEUTICALS, INC.
61874 / ACTAVIS PHARMA, INC.
61894 / SYMPLMED PHARMACEUTICALS
61953 / GRIFOLS BIOLOGICALS, INC.
61958 / GILEAD SCIENCES, INC.
61971 / VISTA PHARMACEUTICALS,
INC.
♦Reimbursement for drug products was based on the direct price of this manufacturer for dates of service prior to December 1, 2002.
Drugs made by this manufacturer require a TAR. See “General Provisions” on a previous page for exceptions to this policy.
2 – Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes