Serums

Showing 1–12 of 58 results

NAME	ALSO KNOW AS	DRUG CATEGORY	FORMULARY CATEGORY	WHAT WE COVER	COST SHARE
Cutaquig Soln 1.65 Gm/10Ml (Brand)	Immune Globulin (Human)-Hipp Soln 1.65Gm/10Ml (Generic)	Serums	3	Non-Formulary Brand	$68
Cutaquig Soln 8 Gm/48Ml (Brand)	Immune Globulin (Human)-Hipp Soln 8Gm/48Ml (Generic)	Serums	3	Non-Formulary Brand	$68
Cytomegalovirus Immune Globulin (Human) Inj 50Mg/Ml (Generic)	Cytogam Inj 50 Mg/Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Hepatitis B Immune Globulin (Human) Soln (Generic)	Nabi-Hb Soln (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Im Inj (Generic)	Gamastan Inj (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Im Inj (Generic)	Gamastan S/D Inj (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 10Gm/100Ml (Generic)	Gamunex-C Soln 10 Gm/100Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 1Gm/10Ml (Generic)	Gamunex-C Soln 1 Gm/10Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 1Gm/10Ml (Generic)	Gammaked Soln 1 Gm/10Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 2.5Gm/25Ml (Generic)	Gamunex-C Soln 2.5 Gm/25Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 2.5Gm/25Ml (Generic)	Gammagard Soln 2.5 Gm/25Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 20Gm/200Ml (Generic)	Gamunex-C Soln 20 Gm/200Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Or Subcutaneous Soln 5Gm/50Ml (Generic)	Gamunex-C Soln 5 Gm/50Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln .5Gm/10Ml (Generic)	Flebogamma Dif Soln 0.5 Gm/10Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10%(Generic)	Flebogamma Dif Soln 5 Gm/50Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10%(Generic)	Flebogamma Dif Soln 10 Gm/100Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10%(Generic)	Flebogamma Dif Soln 20 Gm/200Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10Gm/100Ml (Generic)	Bivigam Soln 10 Gm/100Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10Gm/100Ml (Generic)	Gammaplex Soln 10 Gm/100Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10Gm/200Ml (Generic)	Flebogamma Dif Soln 10 Gm/200Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 10Gm/200Ml (Generic)	Gammaplex Soln 10 Gm/200Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 1Gm/20Ml (Generic)	Octagam Soln 1 Gm/20Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 2.5Gm/50Ml (Generic)	Flebogamma Dif Soln 2.5 Gm/50Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 20Gm/200Ml (Generic)	Privigen Soln 20 Gm/200Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 20Gm/200Ml (Generic)	Gammaplex Soln 20 Gm/200Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 20Gm/400Ml (Generic)	Flebogamma Dif Soln 20 Gm/400Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 25Gm/500Ml (Generic)	Octagam Soln 25 Gm/500Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 2Gm/20Ml (Generic)	Octagam Soln 2 Gm/20Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 5Gm/100Ml (Generic)	Flebogamma Dif Soln 5 Gm/100Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 5Gm/100Ml (Generic)	Octagam Soln 5 Gm/100Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Soln 5Gm/50Ml (Generic)	Gammaplex Soln 5 Gm/50Ml (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Solr 10Gm (Generic)	Gammagard S/D Less Iga Solr 10 Gm (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Solr 5Gm (Generic)	Gammagard S/D Less Iga Solr 5 Gm (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human) Iv Solr 6Gm (Generic)	Carimune Nf Solr 6 Gm (Brand)	Serums	MA	Administered in Medical Office	N/A
Immune Globulin (Human)-Hipp Soln 1Gm/6Ml (Generic)	Cutaquig Soln 1 Gm/6Ml (Brand)	Serums	MA	Administered in Medical Office	N/A

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