Maine State Maximum Allowable Cost List as of 03/13/2015 · 3/16/2015 · Acarbose Tab 25 MG TABS...

DRUG FORM CURRENT MAC PRICE

EFFECTIVE DATE

DATE UPDATED

1ST CHOICE LANCETS SUPER (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

1ST CHOICE LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

1ST CHOICE LANCETS ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

1ST TIER UNILET COMFORTOU (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

4-N-1 (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

A & D ZINC OXIDE (Dimethicone-Zinc Oxide-Vitamin A-Vitamin D Cream 1-10%***) CREA 0.02730 04/28/2005 02/19/2013

A + D PERSONAL CARE LOTIO (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

A+D FIRST AID (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

A-SOY (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

A1C NOW (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ABSORBASE (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

Acarbose Tab 100 MG TABS 0.65500 02/22/2013 02/19/2013



ACCU-CHEK ACTIVE STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK ADVANTAGE DIABE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ACCU-CHEK AVIVA (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK AVIVA PLUS (Blood Glucose Monitoring Kit w/ Device***) KIT 17.99000 12/09/2013 02/11/2014

ACCU-CHEK AVIVA PLUS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK AVIVA PLUS (Glucose Blood Test Strip) STRP 1.18000 12/10/2013 01/08/2014

ACCU-CHEK COMFORT CURVE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK COMPACT PLUS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK COMPACT STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK COMPACT TEST DR (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK FASTCLIX LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACCU-CHEK MULTICLIX LANCE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACCU-CHEK NANO SMARTVIEW (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ACCU-CHEK SAFE-T-PRO LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACCU-CHEK SAFE-T-PRO PLUS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACCU-CHEK SMARTVIEW STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACCU-CHEK SOFT TOUCH LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACCU-CHEK SOFTCLIX LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACCU-CHEK VOICEMATE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

Of 151Last Refreshed: 03/13/2015

Maine State Maximum Allowable Cost Listas of 03/13/2015


EFFECTIVE DATE

DATE UPDATED

ACCUTREND GLUCOSE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Acebutolol HCl Cap 200 MG CAPS 0.18512 02/22/2013 02/19/2013

Acebutolol HCl Cap 400 MG CAPS 0.26985 02/22/2013 02/19/2013

ACERFLEX (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Acetaminophen Cap 500 MG CAPS 0.03450 02/22/2013 02/19/2013

Acetaminophen Chew Tab 160 MG CHEW 0.10010 02/22/2013 02/19/2013

Acetaminophen Chew Tab 80 MG CHEW 0.04180 02/22/2013 02/19/2013

Acetaminophen Elixir 160 MG/5ML ELIX 0.01230 02/22/2013 02/19/2013

Acetaminophen Liquid 160 MG/5ML LIQD 0.00772 02/22/2013 02/19/2013

Acetaminophen Liquid 167 MG/5ML LIQD 0.01930 02/22/2013 02/19/2013

Acetaminophen Soln 100 MG/ML SOLN 0.04507 02/22/2013 02/19/2013

Acetaminophen Soln 160 MG/5ML SOLN 0.01230 02/22/2013 02/19/2013

Acetaminophen Suppos 120 MG SUPP 0.25480 02/22/2013 02/19/2013

Acetaminophen Suppos 650 MG SUPP 0.26585 02/22/2013 02/19/2013

Acetaminophen Susp 160 MG/5ML SUSP 0.01509 02/22/2013 02/19/2013

Acetaminophen Susp 80 MG/0.8ML SUSP 0.02060 02/22/2013 02/19/2013

Acetaminophen Tab 325 MG TABS 0.00686 02/22/2013 02/19/2013

Acetaminophen Tab 500 MG TABS 0.01092 02/22/2013 02/19/2013

Acetaminophen Tab CR 650 MG TBCR 0.05936 02/22/2013 02/19/2013

Acetaminophen w/ Codeine Soln 120-12 MG/5ML SOLN 0.01600 02/22/2013 02/19/2013

Acetaminophen w/ Codeine Tab 300-15 MG TABS 0.15000 02/22/2013 02/19/2013



Acetaminophen w/ Hydrocodone Cap 500-5 MG CAPS 0.19430 02/22/2013 02/19/2013

Acetaminophen w/ Hydrocodone Tab 500-2.5 MG TABS 0.11650 02/22/2013 02/19/2013

Acetaminophen w/ Hydrocodone Tab 500-5 MG TABS 0.06800 01/08/2013 02/20/2013







Acetaminophen-Isometheptene-Dichloral Cap 325-65-100 MG CAPS 0.98020 02/22/2013 02/19/2013

Acetazolamide Cap SR 12HR 500 MG CP12 2.76520 01/29/2015 03/10/2015




EFFECTIVE DATE

DATE UPDATED

Acetazolamide Tab 125 MG TABS 1.63270 04/21/2014 05/02/2014

Acetazolamide Tab 250 MG TABS 2.26028 02/13/2015 02/10/2015

Acetic Acid 2% in Aluminum Acetate Otic Soln SOLN 0.09490 02/22/2013 02/19/2013

Acetic Acid Irrigation Soln 0.25% SOLN 0.03840 08/09/2013 08/06/2013

Acetic Acid Otic Soln 2% SOLN 1.55420 02/22/2013 02/19/2013

Acetylcysteine Inhal Soln 10% SOLN 0.20540 02/22/2013 02/19/2013

Acetylcysteine Inhal Soln 20% SOLN 0.24093 02/22/2013 02/19/2013

ACID BLOCKERS DEPLETION (Nutritional Supplement Therapy Pack**) MISC 8.07500 12/20/2006 02/19/2013

Acitretin Cap 25 MG CAPS 23.96208 08/08/2014 08/06/2014

ACTEMRA (Tocilizumab IV Inj 400 MG/20ML) SOLN 78.11379 01/05/2015 02/10/2015

ACTEMRA (Tocilizumab IV Inj 80 MG/4ML) SOLN 78.11338 01/05/2015 02/10/2015

ACTHAR HP (Corticotropin Inj Gel 80 Unit/ML) GEL 6426.19200 12/16/2014 01/06/2015

ACTI-LANCE LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACTI-LANCE LITE SAFETY LA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACTI-LANCE SPECIAL SAFETY (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACTI-LANCE UNIVERSAL SAFE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ACTIQ (Fentanyl Citrate Lozenge on a Handle 1200 MCG) LPOP 25.20000 01/23/2009 02/19/2013






ACURA BLOOD GLUCOSE MONIT (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ACURA BLOOD GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ACURA PLUS BLOOD GLUCOSE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

Acyclovir Cap 200 MG CAPS 0.08550 02/22/2013 02/19/2013

Acyclovir Oint 5% OINT 21.04067 03/13/2015 03/10/2015

Acyclovir Susp 200 MG/5ML SUSP 0.81250 09/16/2014 10/07/2014

Acyclovir Tab 400 MG TABS 0.20500 02/22/2013 02/19/2013

Acyclovir Tab 800 MG TABS 0.32377 08/28/2013 10/09/2013

Adapalene Cream 0.1% CREA 4.11270 04/12/2013 04/09/2013

Adapalene Gel 0.1% GEL 2.55000 04/12/2013 04/09/2013

ADCETRIS (Brentuximab Vedotin For IV Soln 50 MG) SOLR 5619.43200 12/30/2014 02/10/2015

ADEKS (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

ADULT GROWTH HORMONE SUPP (Nutritional Supplement Therapy Pack**) MISC 8.07500 12/20/2006 02/19/2013

ADULT ONE DAILY GUMMIES (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

ADVANCE INTUITION BLOOD G (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

ADVANCE INTUITION TEST ST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ADVANCE MICRO-DRAW TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ADVANCED DIABETIC MULTIVI (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ADVANTAGE INFANT FORMULA/ (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ADVATE (Antihemophilic Factor rAHF-PFM For Inj 1000 Unit) SOLR 1.03365 04/23/2010 02/19/2013







ADVERA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ADVIL (Ibuprofen Tab 200 MG) TABS 0.04570 03/20/2008 02/19/2013

ADVOCATE BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ADVOCATE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ADVOCATE REDI-CODE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ADVOCATE REDI-CODE/TALKIN (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ADVOCATE SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ADVOCATE TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

AF CAPSICUM OLEORESIN (Capsicum Oleoresin Cream 0.075%) CREA 0.16320 04/28/2005 02/19/2013

AF LANCETS SUPER THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

AFINITOR (Everolimus Tab 10 MG) TABS 374.83393 01/06/2015 02/10/2015

AGAMATRIX AMP NO CODE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

AGAMATRIX JAZZ (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

AGAMATRIX JAZZ TEST STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

AGAMATRIX KEYNOTE TEST ST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

AGAMATRIX PRESTO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

AGAMATRIX PRESTO TEST STR (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

AGAMATRIX ULTRA-THIN LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ALA DERM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) NEBU 0.04911 02/22/2013 02/19/2013

Albuterol Sulfate Soln Nebu 0.5% (5 MG/ML) NEBU 0.49000 02/22/2013 02/19/2013

Albuterol Sulfate Soln Nebu 0.63 MG/3ML (Base Equiv) NEBU 0.41150 02/22/2013 02/19/2013

Albuterol Sulfate Soln Nebu 1.25 MG/3ML (Base Equiv) NEBU 0.34691 05/09/2014 05/02/2014

Albuterol Sulfate Syrup 2 MG/5ML SYRP 0.01017 02/22/2013 02/19/2013

Albuterol Sulfate Tab 2 MG TABS 4.05000 09/17/2014 11/12/2014

Albuterol Sulfate Tab 4 MG TABS 3.86500 03/20/2014 04/09/2014

Albuterol Sulfate Tab SR 12HR 4 MG TB12 0.77520 02/22/2013 02/19/2013

Albuterol Sulfate Tab SR 12HR 8 MG TB12 1.81237 02/22/2013 02/19/2013

Alclometasone Dipropionate Cream 0.05% CREA 2.28759 01/10/2014 01/08/2014

Alclometasone Dipropionate Oint 0.05% OINT 0.68185 02/22/2013 02/19/2013

Alendronate Sodium Tab 10 MG TABS 0.16863 02/22/2013 02/19/2013





ALEVE (Naproxen Sodium Tab 220 MG) TABS 0.06800 03/20/2008 02/19/2013

ALEVE ARTHRITIS (Naproxen Sodium Tab 220 MG) TABS 0.06800 03/20/2008 02/19/2013

Alfuzosin HCl Tab SR 24HR 10 MG TB24 0.36979 02/22/2013 02/19/2013

ALIMENTUM (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ALIMENTUM (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ALITRAQ (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

ALIVE MENS ENERGY (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ALIVE ONCE DAILY WOMENS 5 (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ALIVE WOMENS 50+ (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ALIVE WOMENS ENERGY (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ALKERAN (Melphalan Tab 2 MG) TABS 10.13214 02/01/2015 03/10/2015

Allopurinol Tab 100 MG TABS 0.28000 10/22/2014 12/09/2014

Allopurinol Tab 300 MG TABS 0.53200 11/10/2014 12/09/2014

ALOE AFTERSUN LOTION (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

ALOE VESTA 2-N-1 PROTECTI (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

ALOE VESTA PROTECTIVE (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

ALOXI (Palonosetron HCl IV Soln 0.25 MG/5ML (Base Equivalent)) SOLN 81.87120 12/19/2014 02/10/2015

ALPHANATE/VON WILLEBRAND (Antihemophilic Factor/VWF (Human) For Inj 1000 Unit) SOLR 0.79520 12/24/2010 02/19/2013




EFFECTIVE DATE

DATE UPDATED




ALPHANINE SD (Coagulation Factor IX For Inj 1000 Unit) SOLR 0.74750 12/24/2010 02/19/2013



Alprazolam Orally Disintegrating Tab 0.25 MG TBDP 1.31066 02/22/2013 02/19/2013

Alprazolam Orally Disintegrating Tab 1 MG TBDP 1.87452 02/22/2013 02/19/2013

Alprazolam Orally Disintegrating Tab 2 MG TBDP 3.64684 02/22/2013 02/19/2013

Alprazolam Tab 0.25 MG TABS 0.02956 02/22/2013 02/19/2013

Alprazolam Tab 0.5 MG TABS 0.03540 02/22/2013 02/19/2013

Alprazolam Tab 1 MG TABS 0.01937 02/22/2013 02/19/2013

Alprazolam Tab 2 MG TABS 0.07527 02/22/2013 02/19/2013

Alprazolam Tab SR 24HR 0.5 MG TB24 0.36958 02/22/2013 02/19/2013

Alprazolam Tab SR 24HR 1 MG TB24 0.58341 03/11/2014 04/09/2014



ALPROLIX (Coagulation Factor IX (Recomb) (rFIXFc) For Inj 1000 Unit) SOLR 2.73000 11/14/2014 11/12/2014




ALSOY SOY FORMULA (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

ALSOY SOY FORMULA (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ALSOY SOY FORMULA (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Alum & Mag Hydroxide-Simethicone Susp 200-200-20 MG/5ML LIQD 0.00420 02/22/2013 02/19/2013

Alum & Mag Hydroxide-Simethicone Susp 200-200-20 MG/5ML SUSP 0.00420 02/22/2013 02/19/2013

Alum & Mag Hydroxide-Simethicone Susp 400-400-40 MG/5ML LIQD 0.00690 02/22/2013 02/19/2013

Alum & Mag Hydroxide-Simethicone Susp 400-400-40 MG/5ML SUSP 0.00690 02/22/2013 02/19/2013

Aluminum Chloride Soln 20% SOLN 0.15656 02/22/2013 02/19/2013

Aluminum Hydroxide Gel Susp 320 MG/5ML SUSP 0.01156 02/22/2013 02/19/2013

Aluminum Hydroxide Gel Susp 600 MG/5ML SUSP 0.01350 02/22/2013 02/19/2013

Amantadine HCl Cap 100 MG CAPS 1.07842 11/14/2014 11/12/2014

Amantadine HCl Syrup 50 MG/5ML SYRP 0.04398 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

AMBI ESSENTIALS DAILY MOI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AMBI EVEN & CLEAR DAILY M (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AMBI SOFT & EVEN CREAMY O (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AMBIEN (Zolpidem Tartrate Tab 5 MG) TABS 0.13650 04/23/2010 02/19/2013

Amcinonide Cream 0.1% CREA 0.79540 02/22/2013 02/19/2013

AMETHYST (Levonorgestrel-Ethinyl Estradiol (Continuous) Tab 90-20 MCG) TABS 1.90868 07/13/2012 02/19/2013

Amiloride & Hydrochlorothiazide Tab 5-50 MG TABS 0.23500 10/30/2013 11/05/2013

Amiloride HCl Tab 5 MG TABS 0.58131 10/11/2013 10/09/2013

Amino Acids Tab*** TABS 0.41080 02/22/2013 02/19/2013

Aminocaproic Acid Inj 250 MG/ML SOLN 0.07275 02/22/2013 02/19/2013

Aminocaproic Acid Syrup 25% SYRP 2.39000 10/08/2013 11/05/2013

Aminocaproic Acid Tab 500 MG TABS 1.80000 02/22/2013 02/19/2013

Aminophylline Tab 100 MG TABS 0.02780 02/22/2013 02/19/2013

Aminophylline Tab 200 MG TABS 0.03900 02/22/2013 02/19/2013

Amiodarone HCl Tab 100 MG TABS 3.21000 05/09/2014 05/02/2014



Amitriptyline HCl Tab 10 MG TABS 0.13520 05/21/2014 07/09/2014






AMLACTIN XL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Amlodipine Besylate Tab 10 MG TABS 0.04348 02/22/2013 02/19/2013

Amlodipine Besylate Tab 2.5 MG TABS 0.02933 02/22/2013 02/19/2013

Amlodipine Besylate Tab 5 MG TABS 0.02663 02/22/2013 02/19/2013

Amlodipine Besylate-Atorvastatin Calcium Tab 10-10 MG TABS 4.16875 10/11/2013 10/09/2013





Amlodipine Besylate-Benazepril HCl Cap 10-20 MG CAPS 0.49455 10/11/2013 10/09/2013





EFFECTIVE DATE

DATE UPDATED

Amlodipine Besylate-Benazepril HCl Cap 2.5-10 MG CAPS 0.72829 10/11/2013 10/09/2013




Amoxicillin & K Clavulanate Chew Tab 200-28.5 MG CHEW 0.97900 02/22/2013 04/09/2013

Amoxicillin & K Clavulanate Chew Tab 400-57 MG CHEW 1.11200 02/22/2013 02/19/2013

Amoxicillin & K Clavulanate For Susp 200-28.5 MG/5ML SUSR 0.11591 02/22/2013 02/19/2013


Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML SUSR 0.13183 02/13/2015 02/10/2015


Amoxicillin & K Clavulanate Tab 250-125 MG TABS 4.66000 02/22/2013 02/19/2013



Amoxicillin & K Clavulanate Tab SR 12HR 1000-62.5 MG TB12 3.84783 03/13/2015 03/10/2015

Amoxicillin (Trihydrate) Cap 250 MG CAPS 0.06500 02/22/2013 02/19/2013

Amoxicillin (Trihydrate) Cap 500 MG CAPS 0.07301 02/22/2013 02/19/2013

Amoxicillin (Trihydrate) Chew Tab 125 MG CHEW 0.09000 02/22/2013 02/19/2013

Amoxicillin (Trihydrate) Chew Tab 250 MG CHEW 0.15950 02/22/2013 02/19/2013

Amoxicillin (Trihydrate) For Susp 125 MG/5ML SUSR 0.01427 02/22/2013 02/19/2013




Amoxicillin (Trihydrate) Tab 500 MG TABS 0.18070 02/22/2013 02/19/2013

Amoxicillin (Trihydrate) Tab 875 MG TABS 0.22132 02/22/2013 02/19/2013

Amphetamine-Dextroamphetamine Cap SR 24HR 10 MG CP24 3.88635 10/10/2014 10/07/2014





Amphetamine-Dextroamphetamine Tab 10 MG TABS 1.06000 02/22/2013 02/19/2013

Amphetamine-Dextroamphetamine Tab 12.5 MG TABS 0.40500 02/22/2013 02/19/2013







EFFECTIVE DATE

DATE UPDATED


Amphetamine-Dextroamphetamine Tab 7.5 MG TABS 1.10050 02/22/2013 02/19/2013

Ampicillin & Sulbactam Sodium For Inj 1-0.5 GM SOLR 4.84900 02/22/2013 02/19/2013

Ampicillin & Sulbactam Sodium For Inj 10-5 GM SOLR 46.74800 02/22/2013 02/19/2013

Ampicillin & Sulbactam Sodium For Inj 2-1 GM SOLR 6.39600 02/22/2013 02/19/2013

Ampicillin & Sulbactam Sodium For IV Soln 1-0.5 GM SOLR 4.84900 02/22/2013 02/19/2013

Ampicillin & Sulbactam Sodium For IV Soln 10-5 GM SOLR 46.74800 02/22/2013 02/19/2013

Ampicillin & Sulbactam Sodium For IV Soln 2-1 GM SOLR 8.00800 02/22/2013 02/19/2013

Ampicillin Cap 250 MG CAPS 0.08600 02/22/2013 02/19/2013

Ampicillin Cap 500 MG CAPS 0.14613 02/22/2013 02/19/2013

Ampicillin For Susp 125 MG/5ML SUSR 0.02040 02/22/2013 02/19/2013

Ampicillin For Susp 250 MG/5ML SUSR 0.01950 02/22/2013 02/19/2013

AMPYRA (Dalfampridine Tab SR 12HR 10 MG) TB12 29.49571 01/01/2015 02/10/2015

Anagrelide HCl Cap 0.5 MG CAPS 0.16750 02/22/2013 02/19/2013

Anagrelide HCl Cap 1 MG CAPS 0.32550 02/22/2013 02/19/2013

Anastrozole Tab 1 MG TABS 0.27490 07/11/2014 07/09/2014

ANTI-SEIZURE DEPLETION (Nutritional Supplement Therapy Pack**) MISC 8.07500 12/20/2006 02/19/2013

ANTI-SEIZURE SUPPORT (Nutritional Supplement Therapy Pack**) MISC 8.07500 12/20/2006 02/19/2013

ANTIOXIDANT FORTE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ANTIOXIDANT ULTRA FORMULA (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

Antipyrine-Benzocaine Otic Soln 54-14 MG/ML (5.4-1.4%) SOLN 0.79193 02/22/2013 02/19/2013

ANTIVERT (Meclizine HCl Tab 12.5 MG) TABS 0.02920 04/23/2010 02/19/2013

ANTIVERT (Meclizine HCl Tab 25 MG) TABS 0.04090 04/23/2010 02/19/2013

ANTIVERT (Meclizine HCl Tab 25 MG) TABS 0.04203 03/20/2008 02/19/2013

AP-ZEL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

APATATE FORTE (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

APEXICON E (Diflorasone Diacetate Emollient Base Cream 0.05%) CREA 1.35900 09/27/2007 02/19/2013

APOKYN (Apomorphine Hydrochloride Inj 10 MG/ML) SOLN 330.34000 02/08/2013 02/20/2013

AQUA GLYCOLIC HAND & BODY (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AQUA LACTEN (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AQUADEKS (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

AQUADEKS (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.56000 01/14/2013 02/20/2013

AQUADERM TREATMENT/MOISTU (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AQUAMED (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

AQUAPHILIC (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

AQUAPHOR (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

AQUAPHOR ADVANCED THERAPY (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

AQUAPHOR LIP REPAIR (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

ARALAST NP (Alpha1-Proteinase Inhibitor (Human) For IV Soln 1000 MG) SOLR 0.43160 01/28/2011 02/19/2013





ARANESP ALBUMIN FREE (Darbepoetin Alfa-Polysorbate 80 Soln Inj 100 MCG/0.5ML) SOLN 1412.72640 02/19/2015 03/10/2015

ARANESP ALBUMIN FREE (Darbepoetin Alfa-Polysorbate 80 Soln Inj 100 MCG/ML) SOLN 706.36320 02/19/2015 03/10/2015














ARGINAID EXTRA (Nutritional Supplement Liquid**) LIQD 0.01420 05/28/2010 02/19/2013

ARIXTRA (Fondaparinux Sodium Inj 2.5 MG/0.5ML) SOLN 110.78342 10/02/2014 11/12/2014

Artificial Tear Ophth Ointment*** OINT 2.67460 05/10/2013 08/06/2013

Artificial Tear Ophth Solution*** SOLN 0.23859 02/22/2013 02/19/2013

ASCENSIA AUTODISC TEST ST (Glucose Blood Test Disk) DISK 0.74500 11/22/2007 02/19/2013

Ascorbic Acid Cap CR 500 MG CPCR 0.01400 02/22/2013 02/19/2013

Ascorbic Acid Chew Tab 250 MG CHEW 0.02545 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Ascorbic Acid Chew Tab 500 MG CHEW 0.04220 02/22/2013 02/19/2013

Ascorbic Acid Syrup 500 MG/5ML SYRP 0.03598 02/22/2013 02/19/2013

Ascorbic Acid Tab 1000 MG TABS 0.04950 02/22/2013 02/19/2013



Ascorbic Acid Tab CR 1000 MG TBCR 0.04950 02/22/2013 02/19/2013

Ascorbic Acid Tab CR 500 MG TBCR 0.01400 02/22/2013 02/19/2013

ASPERCREME/ALOE (Trolamine Salicylate Cream 10%) CREA 0.04250 04/28/2005 02/19/2013

Aspirin Buffered (Ca Carb-Mg Carb-Mg Ox) Tab 325 MG TABS 0.01833 02/22/2013 02/19/2013

Aspirin Chew Tab 81 MG CHEW 0.03650 02/22/2013 02/19/2013

Aspirin Tab 325 MG TABS 0.00510 02/22/2013 02/19/2013

Aspirin Tab 81 MG TABS 0.01655 02/22/2013 02/19/2013

Aspirin Tab Delayed Release 325 MG TBEC 0.01920 02/22/2013 02/19/2013

Aspirin Tab Delayed Release 81 MG TBEC 0.00780 02/22/2013 02/19/2013

Aspirin-Acetaminophen-Caffeine Tab 250-250-65 MG TABS 0.02925 02/22/2013 02/19/2013

Aspirin-Caffeine-Butalbital Tab 325-40-50 MG TABS 0.45500 04/11/2014 05/02/2014

ASSURE 3 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ASSURE 4 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ASSURE HAEMOLANCE PLUS HI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE HAEMOLANCE PLUS LO (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE HAEMOLANCE PLUS MI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE HAEMOLANCE PLUS NO (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE HAEMOLANCE PLUS PE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE II (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ASSURE II CHECK STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ASSURE II TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ASSURE LANCE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ASSURE PLATINUM TEST STRI (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ASSURE PRO TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

AT LAST LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

AT LAST TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Atenolol & Chlorthalidone Tab 100-25 MG TABS 0.47580 10/02/2014 11/12/2014

Atenolol & Chlorthalidone Tab 50-25 MG TABS 0.46500 10/26/2014 12/09/2014




EFFECTIVE DATE

DATE UPDATED

Atenolol Tab 100 MG TABS 0.03289 02/22/2013 02/19/2013



Atorvastatin Calcium Tab 10 MG (Base Equivalent) TABS 0.22040 02/22/2013 02/19/2013




Atovaquone-Proguanil HCl Tab 250-100 MG TABS 5.43035 08/09/2013 08/06/2013

Atropine Sulfate Ophth Oint 1% OINT 0.65000 02/22/2013 02/19/2013

Atropine Sulfate Ophth Soln 1% SOLN 2.51333 02/22/2013 02/19/2013

AURORA HEALTHCARE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

AURORA LANCET SUPER THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

AURORA LANCET THIN 23G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

AVEENO CONTINUOUS RADIANC (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO DAILY FIRMING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO DAILY MOISTURIZING (Dimethicone Lotion 1.3%) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO DAILY MOISTURIZING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO POSITIVELY AGELESS (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO POSITIVELY NOURISH (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO POSITIVELY RADIANT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO POSITIVELY SMOOTH (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVEENO STRESS RELIEF MOIS (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

AVONEX (Interferon Beta-1a For IM Inj Kit 30MCG (33MCG(6.6 MU)/Vial)) KIT 1188.22800 09/13/2014 11/12/2014

AVONEX (Interferon Beta-1a IM Inj Kit 30 MCG/0.5ML) KIT 4752.91200 09/13/2014 11/12/2014

AVONEX PEN (Interferon Beta-1a IM Inj Kit 30 MCG/0.5ML) KIT 4752.91200 09/13/2014 11/12/2014

Azathioprine Tab 50 MG TABS 0.35400 06/07/2014 07/09/2014

Azelastine HCl Nasal Spray 137 MCG/SPRAY (1 MG/ML) SOLN 1.23542 03/13/2015 03/10/2015

Azelastine HCl Ophth Soln 0.05% SOLN 6.87166 08/08/2014 08/06/2014

Azithromycin For Susp 100 MG/5ML SUSR 1.13500 02/18/2014 03/12/2014



Azithromycin IV For Soln 500 MG SOLR 9.47700 02/22/2013 02/19/2013

Azithromycin Tab 250 MG TABS 0.70523 02/22/2013 02/19/2013





EFFECTIVE DATE

DATE UPDATED


B-Complex Vitamin Cap** CAPS 0.03890 02/22/2013 02/19/2013

B-Complex Vitamin Tab CR** TBCR 0.02250 02/22/2013 02/19/2013

B-Complex Vitamin Tab** TABS 0.03270 02/22/2013 02/19/2013

B-Complex w/ C & E + Zn Tab*** TABS 0.02200 02/22/2013 02/19/2013

B-Complex w/ C & Folic Acid Cap 1 MG*** CAPS 0.15229 02/22/2013 02/19/2013

B-Complex w/ C & Folic Acid Tab 0.8 MG*** TABS 0.08400 02/22/2013 02/19/2013

B-Complex w/ C & Folic Acid Tab 1 MG*** TABS 0.12100 02/22/2013 02/19/2013

B-Complex w/ C & Folic Acid Tab*** TABS 0.02200 02/22/2013 02/19/2013

B-Complex w/ C Cap** CAPS 0.02200 02/22/2013 02/19/2013

B-Complex w/ C Tab CR** TBCR 0.02200 02/22/2013 02/19/2013

B-Complex w/ C Tab** TABS 0.02200 02/22/2013 02/19/2013

B-Complex w/ Folic Acid Tab CR** TBCR 0.02250 02/22/2013 02/19/2013

B-Complex w/ Folic Acid Tab** TABS 0.02250 02/22/2013 02/19/2013

B-Complex w/Biotin & Folic Acid Tab CR*** TBCR 0.02250 02/22/2013 02/19/2013

B-Complex w/Biotin & Folic Acid Tab*** TABS 0.03270 02/22/2013 02/19/2013

BABYS ONLY ORGANIC/DAIRY (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

BABYS ONLY ORGANIC/DHA & (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

BABYS ONLY ORGANIC/LACTOS (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

BABYS ONLY ORGANIC/SOY (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

BACIGUENT (Bacitracin Oint 500 Unit/GM) OINT 0.08300 03/13/2008 02/19/2013

Bacitracin Oint 500 Unit/GM OINT 0.08300 02/22/2013 02/19/2013

Bacitracin Zinc Oint 500 Unit/GM OINT 0.08300 02/22/2013 02/19/2013

Bacitracin-Polymyxin B Oint*** OINT 0.15070 02/22/2013 02/19/2013

Bacitracin-Polymyxin B Ophth Oint OINT 4.07320 02/22/2013 02/19/2013

Bacitracin-Polymyxin-Neomycin-HC Ophth Oint 1% OINT 14.65000 02/05/2015 03/10/2015

Baclofen Powder POWD 2.37120 02/22/2013 02/19/2013

Baclofen Tab 10 MG TABS 0.18794 12/19/2014 12/17/2014

Baclofen Tab 20 MG TABS 0.30450 12/19/2014 12/17/2014

BACMIN (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Balsalazide Disodium Cap 750 MG CAPS 0.58520 02/13/2015 02/10/2015

BARACLUDE (Entecavir Oral Soln 0.05 MG/ML) SOLN 4.09783 07/01/2014 08/06/2014

BARACLUDE (Entecavir Tab 0.5 MG) TABS 40.97903 07/01/2014 08/06/2014

BARACLUDE (Entecavir Tab 1 MG) TABS 40.97903 07/01/2014 08/06/2014




EFFECTIVE DATE

DATE UPDATED

BASIC AM (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

BASIC PM (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

BAYER BREEZE 2 BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

BAYER CONTOUR BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER CONTOUR BLOOD GLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

BAYER CONTOUR LINK BLOOD (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER CONTOUR NEXT BLOOD (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER CONTOUR NEXT BLOOD (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

BAYER CONTOUR NEXT EZ BLO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER CONTOUR NEXT LINK B (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER CONTOUR NEXT USB BL (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER CONTOUR USB BLOOD G (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BAYER MICROLET LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

BCAD 1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

BCAD 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

BD GLUCOSE (Glucose Chew Tab 5 GM) CHEW 0.15300 04/28/2005 02/19/2013

BD LANCET ULTRAFINE 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

BD LANCET ULTRAFINE 33G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

BD LATITUDE DIABETES MANA (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

BD LATITUDE DIABETES MANA (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

BD LOGIC BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

BD MICROTAINER LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

BD TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

BD ULTRA FINE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

BEBULIN (Factor IX Complex For Inj 200-1200 Unit) SOLR 0.94350 06/26/2009 02/19/2013

BEBULIN VH (Factor IX Complex For Inj 200-1200 Unit) SOLR 0.94350 06/26/2009 02/19/2013

BENADRYL (Diphenhydramine HCl Cap 25 MG) CAPS 0.05620 03/13/2008 02/19/2013

BENADRYL (Diphenhydramine HCl Tab 25 MG) TABS 0.05620 03/13/2008 02/19/2013

BENADRYL ALLERGY (Diphenhydramine HCl Cap 25 MG) CAPS 0.05620 03/13/2008 02/19/2013

BENADRYL ALLERGY (Diphenhydramine HCl Tab 25 MG) TABS 0.05620 03/13/2008 02/19/2013

BENADRYL ALLERGY CHILDREN (Diphenhydramine HCl Liquid 12.5 MG/5ML) LIQD 0.01872 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

BENADRYL DYE-FREE ALLERGY (Diphenhydramine HCl Cap 25 MG) CAPS 0.05620 03/13/2008 02/19/2013

Benazepril & Hydrochlorothiazide Tab 10-12.5 MG TABS 1.46157 11/14/2014 11/12/2014


Benazepril & Hydrochlorothiazide Tab 20-25 MG TABS 1.45652 11/14/2014 11/12/2014


Benazepril HCl Tab 10 MG TABS 0.06499 02/22/2013 02/19/2013




BENECALORIE (Nutritional Supplement Liquid**) LIQD 0.03350 06/02/2010 02/19/2013

BENEFIX (Coagulation Factor IX (Recombinant) For Inj 1000 Unit) SOLR 1.20100 01/01/2015 02/10/2015





BENEPROTEIN (Protein Oral Powder***) POWD 0.06700 04/28/2005 02/19/2013

BENGAY ARTHRITIS FORMULA (Menthol-Methyl Salicylate Cream***) CREA 0.02880 04/28/2005 02/19/2013

BENGAY GREASELESS (Menthol-Methyl Salicylate Cream***) CREA 0.02880 04/28/2005 02/19/2013

BENGAY ULTRA STRENGTH (Camphor-Menthol-Methyl Salicylate Cream 4-10-30%) CREA 0.02880 04/28/2005 02/19/2013

BENLYSTA (Belimumab For IV Soln 120 MG) SOLR 468.50180 12/19/2014 02/10/2015

BENLYSTA (Belimumab For IV Soln 400 MG) SOLR 1561.63670 12/19/2014 02/10/2015

BENZAMYCIN (Benzoyl Peroxide-Erythromycin Gel 5-3%) GEL 0.96550 05/28/2010 02/19/2013

Benzonatate Cap 100 MG CAPS 0.12155 02/22/2013 02/19/2013

Benzonatate Cap 200 MG CAPS 0.13572 02/22/2013 02/19/2013

Benzoyl Peroxide Cream 10% CREA 0.16940 02/22/2013 02/19/2013

Benzoyl Peroxide Gel 10% GEL 0.16089 02/22/2013 02/19/2013

Benzoyl Peroxide Gel 2.5% GEL 0.25500 02/22/2013 02/19/2013

Benzoyl Peroxide Gel 5% GEL 0.11012 02/22/2013 02/19/2013

Benzoyl Peroxide Liq 10% LIQD 0.07002 02/22/2013 02/19/2013

Benzoyl Peroxide Liq 2.5% LIQD 0.06600 02/22/2013 02/19/2013



Benzoyl Peroxide Lotion 6% LOTN 0.21965 02/22/2013 02/19/2013

Benzoyl Peroxide Pad 3% PADS 2.59177 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Benzoyl Peroxide Pad 6% PADS 2.59177 02/22/2013 02/19/2013

Benzoyl Peroxide-Erythromycin Gel 5-3% GEL 0.80625 12/19/2014 12/17/2014

Benzoyl Peroxide-Erythromycin Gel 5-3% GEL 1.12520 11/10/2014 01/06/2015

Benztropine Mesylate Tab 0.5 MG TABS 0.14500 10/28/2013 11/05/2013

Benztropine Mesylate Tab 1 MG TABS 0.16500 09/19/2013 11/05/2013

Benztropine Mesylate Tab 2 MG TABS 0.16900 12/25/2013 02/11/2014

BETA CARE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

BETADINE (Povidone-Iodine Soln 10%) SOLN 0.01751 03/20/2008 02/19/2013

Betahistine Hydrochloride (Bulk) Powder POWD 4.24550 02/22/2013 02/19/2013

Betamethasone Dipropionate Augmented Cream 0.05% CREA 0.31358 02/22/2013 02/19/2013

Betamethasone Dipropionate Augmented Gel 0.05% GEL 1.33584 02/22/2013 02/19/2013

Betamethasone Dipropionate Augmented Lotion 0.05% LOTN 1.37417 02/22/2013 02/19/2013

Betamethasone Dipropionate Augmented Oint 0.05% OINT 3.14000 06/11/2013 08/06/2013

Betamethasone Dipropionate Cream 0.05% CREA 2.37500 10/22/2014 11/12/2014

Betamethasone Dipropionate Lotion 0.05% LOTN 0.60000 12/07/2012 05/15/2013

Betamethasone Dipropionate Oint 0.05% OINT 2.20152 04/11/2014 04/09/2014

Betamethasone Dipropionate Oint 0.05% OINT 2.62000 02/11/2013 03/04/2013

Betamethasone Valerate Cream 0.1% CREA 0.86977 03/13/2015 03/10/2015

Betamethasone Valerate Cream 0.1% CREA 1.29740 09/17/2013 10/09/2013

Betamethasone Valerate Lotion 0.1% LOTN 0.73500 02/22/2013 02/19/2013

Betamethasone Valerate Oint 0.1% OINT 0.88000 02/22/2013 02/19/2013

Betaxolol HCl Ophth Soln 0.5% SOLN 11.22722 06/14/2013 06/10/2013

Betaxolol HCl Tab 10 MG TABS 0.92292 02/22/2013 02/19/2013

Bethanechol Chloride Tab 10 MG TABS 0.30751 02/14/2014 02/11/2014

Bethanechol Chloride Tab 25 MG TABS 0.52410 02/17/2015 03/10/2015

BG STAR BLOOD GLUCOSE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Bicalutamide Tab 50 MG TABS 0.48566 02/22/2013 02/19/2013

BIO-35 GLUTEN-FREE (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

BIO-35 IRON FREE (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

BIOCAL (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

Bioflavonoid Products Chew Tab** CHEW 0.04215 02/22/2013 02/19/2013

Bioflavonoid Products Tab** TABS 0.01400 02/22/2013 02/19/2013

BIOSCANNER GLUCOSE TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

BIOSUPP (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

BIOTECT PLUS (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

BIOTECT PLUS (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

Biotin Tab 5 MG TABS 0.23360 02/22/2013 02/19/2013

Bisacodyl Suppos 10 MG SUPP 0.19380 02/22/2013 02/19/2013

Bisacodyl Tab Delayed Release 5 MG TBEC 0.04600 02/22/2013 02/19/2013

Bismuth Subsalicylate Chew Tab 262 MG CHEW 0.06830 02/22/2013 02/19/2013

Bismuth Subsalicylate Susp 262 MG/15ML SUSP 0.00915 02/22/2013 02/19/2013

Bismuth Subsalicylate Susp 525 MG/15ML SUSP 0.01640 02/22/2013 02/19/2013

Bismuth Subsalicylate Tab 262 MG TABS 0.06450 02/22/2013 02/19/2013

Bisoprolol & Hydrochlorothiazide Tab 10-6.25 MG TABS 0.06619 02/22/2013 02/19/2013

Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG TABS 0.06188 02/22/2013 02/19/2013

Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG TABS 0.05530 02/22/2013 02/19/2013

Bisoprolol Fumarate Tab 10 MG TABS 0.44409 03/14/2014 03/12/2014

Bisoprolol Fumarate Tab 5 MG TABS 0.61936 02/22/2013 02/19/2013

BIVIGAM (Immune Globulin (Human) IV Soln 10 GM/100ML) SOLN 12.94800 01/01/2015 02/10/2015

BIVIGAM (Immune Globulin (Human) IV Soln 5 GM/50ML) SOLN 12.94800 01/01/2015 02/10/2015

BL TEST STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Blood Glucose Monitoring Kit w/ Device*** KIT 0.71000 02/22/2013 02/19/2013

BLUE-EMU SUPER STRENGTH (Liniments & Rubs - Cream**) CREA 0.02880 04/28/2005 02/19/2013

BONINE (Meclizine HCl Chew Tab 25 MG) CHEW 0.06215 03/20/2008 02/19/2013

BOOST (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST BREEZE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST DIABETIC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST GLUCOSE CONTROL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST HIGH PROTEIN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST KID ESSENTIALS 1.0 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




BOOST KIDS ESSENTIALS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST PUDDING (Nutritional Supplement Pudding**) PUDG 0.01090 04/28/2005 02/19/2013

BOOST SMOOTHIE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOOST VHC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

BOOST/BENEFIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

BOTOX (OnabotulinumtoxinA For Inj 100 Unit) SOLR 522.90000 01/28/2011 02/19/2013

BOTOX COSMETIC (OnabotulinumtoxinA (Cosmetic) For Inj 100 Unit) SOLR 555.76800 01/01/2015 02/10/2015

BOTOX COSMETIC (OnabotulinumtoxinA (Cosmetic) For Inj 50 Unit) SOLR 305.77200 01/01/2015 02/10/2015

BRIGHT BEGINNINGS SOY (Infant Foods Liquid**) LIQD 0.01680 04/23/2010 02/19/2013

Brimonidine Tartrate Ophth Soln 0.15% SOLN 11.94200 02/22/2013 02/19/2013

Brimonidine Tartrate Ophth Soln 0.2% SOLN 0.92981 02/22/2013 02/19/2013

Bromocriptine Mesylate Cap 5 MG CAPS 5.26000 02/01/2014 03/12/2014

Bromocriptine Mesylate Tab 2.5 MG TABS 0.66667 04/11/2014 04/09/2014

Budesonide Cap SR 24HR 3 MG CP24 10.50000 03/14/2014 03/12/2014

Budesonide Inhalation Susp 0.25 MG/2ML SUSP 2.30150 02/22/2013 02/19/2013

Budesonide Inhalation Susp 0.5 MG/2ML SUSP 4.01970 02/22/2013 02/19/2013

BUFFERIN (Aspirin Buffered (Ca Carb-Mg Carb-Mg Ox) Tab 325 MG) TABS 0.03544 03/13/2008 02/19/2013

BUFFERIN LOW DOSE (Aspirin Buffered (Ca Carb-Mg Carb-Mg Ox) Tab 81 MG) TABS 0.02030 03/13/2008 02/19/2013

BULLSEYE MINI SAFETY LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

BULLSEYE SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Bumetanide Tab 0.5 MG TABS 0.11388 02/22/2013 02/19/2013

Bumetanide Tab 1 MG TABS 0.57840 07/08/2014 08/06/2014

Bumetanide Tab 2 MG TABS 1.01000 06/13/2014 07/09/2014

BUPHENYL (Sodium Phenylbutyrate Oral Powder 3 GM/Teaspoonful) POWD 26.80751 02/17/2015 03/10/2015

BUPHENYL (Sodium Phenylbutyrate Tab 500 MG) TABS 13.40364 02/17/2015 03/10/2015

Bupivacaine HCl Inj 0.25% SOLN 0.05460 02/22/2013 02/19/2013

Bupivacaine HCl Inj 0.5% SOLN 0.06370 02/22/2013 02/19/2013

Bupivacaine HCl Preservative Free (PF) Inj 0.25% SOLN 0.05460 02/22/2013 02/19/2013

Bupivacaine HCl Preservative Free (PF) Inj 0.5% SOLN 0.06370 02/22/2013 02/19/2013

Buprenorphine HCl Inj 0.3 MG/ML (Base Equiv) SOLN 3.21100 02/22/2013 02/19/2013

Buprenorphine HCl SL Tab 2 MG (Base Equiv) SUBL 1.52029 07/11/2014 07/09/2014

Buprenorphine HCl SL Tab 8 MG (Base Equiv) SUBL 2.09110 10/10/2014 10/07/2014

Bupropion HCl (Smoking Deterrent) Tab SR 12HR 150 MG TB12 0.60159 11/14/2014 11/12/2014

Bupropion HCl Tab 100 MG TABS 0.71440 02/05/2015 03/10/2015

Bupropion HCl Tab 75 MG TABS 0.59419 01/22/2014 03/12/2014

Bupropion HCl Tab SR 12HR 100 MG TB12 0.19413 03/14/2014 03/12/2014






EFFECTIVE DATE

DATE UPDATED



Buspirone HCl Tab 10 MG TABS 0.10500 09/12/2013 10/09/2013




Buspirone HCl Tab 7.5 MG TABS 0.94249 12/19/2014 12/17/2014

Butalbital-Acetaminophen Tab 50-325 MG TABS 0.33423 02/22/2013 02/19/2013

Butalbital-Acetaminophen-Caff w/ COD Cap 50-325-40-30 MG CAPS 1.08500 08/18/2014 10/07/2014

Butalbital-Acetaminophen-Caffeine Cap 50-325-40 MG CAPS 0.26900 02/22/2013 02/19/2013

Butalbital-Acetaminophen-Caffeine Tab 50-325-40 MG TABS 0.59652 04/30/2014 06/09/2014

Butalbital-Acetaminophen-Caffeine Tab 50-500-40 MG TABS 0.09165 02/22/2013 02/19/2013

Butalbital-Aspirin-Caff w/ Codeine Cap 50-325-40-30 MG CAPS 1.58600 04/29/2014 06/09/2014

Butalbital-Aspirin-Caffeine Cap 50-325-40 MG CAPS 1.10676 03/13/2015 03/10/2015

Butorphanol Tartrate Nasal Soln 10 MG/ML SOLN 7.03500 02/22/2013 02/19/2013

Cabergoline Tab 0.5 MG TABS 10.86297 03/13/2015 03/10/2015

Caffeine Citrate Inj 60 MG/3ML (10 MG/ML Base Equiv) SOLN 11.48333 02/22/2013 02/19/2013

Caffeine Citrate Oral Soln 60 MG/3ML (10 MG/ML Base Equiv) SOLN 12.70000 02/22/2013 02/19/2013

CAL-DAY 1000 (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CALCI-MIX (Calcium Carbonate Cap 1250 MG (500 MG Elemental Ca)) CAPS 0.11650 04/28/2005 02/19/2013

CALCILO XD (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Calcipotriene Cream 0.005% CREA 5.10000 09/13/2013 09/09/2013

Calcipotriene Oint 0.005% OINT 4.83821 02/14/2014 02/11/2014

Calcipotriene Soln 0.005% (50 MCG/ML) SOLN 2.25312 02/22/2013 02/19/2013

Calcitonin (Salmon) Nasal Soln 200 Unit/ACT SOLN 10.26486 04/11/2014 04/09/2014

Calcitriol Cap 0.25 MCG CAPS 0.52976 01/09/2015 01/06/2015

Calcitriol Cap 0.5 MCG CAPS 1.06552 11/08/2013 11/05/2013

Calcitriol Oral Soln 1 MCG/ML SOLN 7.56200 09/12/2014 09/05/2014

Calcium Acetate (Phosphate Binder) Cap 667 MG (169 MG Ca) CAPS 0.44943 03/13/2015 03/10/2015

Calcium Carb-Vit D w/ Minerals Chew Tab 600 MG-400 Unit*** CHEW 0.09205 02/22/2013 02/19/2013

Calcium Carb-Vit D w/ Minerals Tabs 600 MG-200 Unit*** TABS 0.07814 02/22/2013 02/19/2013

Calcium Carb-Vit D w/ Minerals Tabs 600 MG-400 Unit*** TABS 0.09205 02/22/2013 02/19/2013

Calcium Carbonate (Antacid) Chew Tab 1000 MG CHEW 0.05450 02/22/2013 02/19/2013





EFFECTIVE DATE

DATE UPDATED



Calcium Carbonate (Antacid) Tab 648 MG TABS 0.01613 02/22/2013 02/19/2013

Calcium Carbonate Chew Tab 1250 MG (500 MG Elemental Ca) CHEW 0.06222 02/22/2013 02/19/2013

Calcium Carbonate Susp 1250 MG/5ML (500 MG/5ML Elemental Ca) SUSP 0.01800 02/22/2013 02/19/2013

Calcium Carbonate Tab 1250 MG (500 MG Elemental Ca) TABS 0.07990 02/22/2013 02/19/2013

Calcium Carbonate Tab 1500 MG (600 MG Elemental Ca) TABS 0.05700 02/22/2013 02/19/2013

Calcium Carbonate Tab 600 MG TABS 0.04575 02/22/2013 02/19/2013

Calcium Carbonate-Cholecalciferol Chew Tab 500 MG-600 Unit CHEW 0.09901 03/13/2008 02/19/2013

Calcium Carbonate-Cholecalciferol Tab 250 MG-250 Unit TABS 0.02833 02/22/2013 02/19/2013






Calcium Carbonate-Ergocalciferol Tab 500MG-200 Unit TABS 0.02087 02/22/2013 02/19/2013

Calcium Carbonate-Vitamin D Tab 250 MG-125 Unit TABS 0.03500 02/22/2013 02/19/2013







Calcium Citrate Malate-Cholecalciferol Tab 250 MG-100 Unit TABS 0.02833 02/22/2013 02/19/2013

Calcium Citrate Tab 950 MG (200 MG Elemental Ca) TABS 0.03450 02/22/2013 02/19/2013

Calcium Citrate-Vitamin D Tab 200 MG-125 Unit (Elemental Ca) TABS 0.03450 02/22/2013 02/19/2013




Calcium Gluconate Tab 500 MG TABS 0.15000 02/22/2013 02/19/2013

Calcium Gluconate Tab 650 MG TABS 0.01580 02/22/2013 02/19/2013

Calcium Lactate Tab 648 MG (84 MG Elemental Ca) TABS 0.02630 02/22/2013 02/19/2013

Calcium Lactate Tab 650 MG TABS 0.02630 02/22/2013 02/19/2013

Calcium Polycarbophil Tab 625 MG TABS 0.09185 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Calcium Tab 600 MG TABS 0.02500 02/22/2013 02/19/2013

Calcium w/ Vitamin D & K Chew Tab 500 MG-100 Unit-40 MCG CHEW 0.08476 02/22/2013 02/19/2013

Calcium w/ Vitamin D Tab 600 MG-200 Unit TABS 0.04283 02/22/2013 02/19/2013

CALPHRON (Calcium Acetate Tab 667 MG) TABS 0.08938 11/27/2010 02/19/2013

CALTRATE 600+D (Calcium Carbonate-Cholecalciferol Tab 600 MG-800 Unit) TABS 0.05900 07/18/2012 02/19/2013

CALTRATE 600+D PLUS MINER (Calcium Carb-Vit D w/ Minerals Chew Tab 600 MG-800 Unit***) CHEW 0.09210 05/28/2010 02/19/2013

CALTRATE 600+D PLUS MINER (Calcium Carb-Vit D w/ Minerals Tabs 600 MG-800 Unit***) TABS 0.09205 03/13/2008 02/19/2013

CAM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CAMINO PRO 15 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

CAMINO PRO COMPLETE/GLYTA (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

CAMINO PRO RESTORE/GLYTAC (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

CAMINO PRO RESTORE/GLYTAC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Camphor & Menthol Lotion 0.5-0.5% LOTN 0.03110 02/22/2013 02/19/2013

Camphor-Menthol-Methyl Salicylate Cream 4-10-30% CREA 0.02880 02/22/2013 02/19/2013

Candesartan Cilexetil Tab 32 MG TABS 3.94680 09/13/2013 09/09/2013

Candesartan Cilexetil Tab 4 MG TABS 2.91500 09/13/2013 09/09/2013

Candesartan Cilexetil-Hydrochlorothiazide Tab 16-12.5 MG TABS 2.02290 09/13/2013 09/09/2013

Candesartan Cilexetil-Hydrochlorothiazide Tab 32-12.5 MG TABS 2.02290 09/13/2013 09/09/2013

Candesartan Cilexetil-Hydrochlorothiazide Tab 32-25 MG TABS 3.03985 09/13/2013 09/09/2013

Capsaicin Cream 0.025% CREA 0.10050 02/22/2013 02/19/2013

Capsaicin Cream 0.075% CREA 0.06771 02/22/2013 02/19/2013

Captopril & Hydrochlorothiazide Tab 25-15 MG TABS 0.98520 09/16/2014 11/12/2014




Captopril Tab 100 MG TABS 1.25400 06/16/2014 08/06/2014

Captopril Tab 12.5 MG TABS 0.86228 08/20/2014 09/10/2014



CAPZASIN-P (Capsaicin Cream 0.035%) CREA 0.18740 04/28/2005 02/19/2013

Carbamazepine Cap SR 12HR 100 MG CP12 1.36552 08/09/2013 08/06/2013






EFFECTIVE DATE

DATE UPDATED

Carbamazepine Chew Tab 100 MG CHEW 0.35201 01/09/2015 01/06/2015

Carbamazepine Susp 100 MG/5ML SUSP 0.12949 02/22/2013 02/19/2013

Carbamazepine Tab 200 MG TABS 0.83250 06/19/2014 08/06/2014

Carbamazepine Tab SR 12HR 200 MG TB12 1.11000 11/10/2013 02/11/2014

Carbamazepine Tab SR 12HR 400 MG TB12 2.40648 03/13/2015 03/10/2015

Carbamide Peroxide 6.5% Otic Soln SOLN 0.09967 02/22/2013 02/19/2013

Carbidopa & Levodopa Orally Disintegrating Tab 25-100 MG TBDP 1.02924 02/22/2013 02/20/2013

Carbidopa & Levodopa Tab 10-100 MG TABS 0.15363 02/22/2013 02/19/2013



Carbidopa & Levodopa Tab CR 25-100 MG TBCR 0.22750 02/22/2013 02/19/2013

Carbidopa & Levodopa Tab CR 50-200 MG TBCR 0.54630 07/11/2013 08/06/2013

Carbidopa-Levodopa-Entacapone Tabs 25-100-200 MG TABS 3.06482 09/13/2013 09/09/2013

Carbidopa-Levodopa-Entacapone Tabs 37.5-150-200 MG TABS 3.06482 09/13/2013 09/09/2013

Carbidopa-Levodopa-Entacapone Tabs 50-200-200 MG TABS 2.80555 09/13/2013 09/09/2013

Carboplatin IV Soln 150 MG/15ML SOLN 1.20553 02/22/2013 02/19/2013




Carboxymethylcellulose Sodium Ophth Soln 0.5% SOLN 0.48950 02/22/2013 02/19/2013

CARDENZ (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

CARDIODAILY (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

CAREONE LANCET THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CAREONE LANCET ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CARESENS N BLOOD GLUCOSE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Carisoprodol Tab 350 MG TABS 0.05785 02/22/2013 02/19/2013

Carisoprodol w/ Aspirin Tab 200-325 MG TABS 0.31000 02/22/2013 02/19/2013

CARMOL 20 (Urea Cream 20%) CREA 0.08452 03/20/2008 02/19/2013

CARNATION INSTANT BREAKFA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

CAROMEGA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Carteolol HCl Ophth Soln 1% SOLN 1.65667 02/22/2013 02/19/2013

Carvedilol Tab 12.5 MG TABS 0.04859 02/22/2013 02/19/2013

Carvedilol Tab 25 MG TABS 0.04293 02/22/2013 02/19/2013





EFFECTIVE DATE

DATE UPDATED


CAVAN PRENATAL/EC CALCIUM (Prenatal w/o A Vit w/ Fe Fumarate-FA Tab DR 30-1 MG***) TBEC 0.18187 01/23/2009 02/19/2013

CAYSTON (Aztreonam Lysine For Inhal Soln 75 MG (Base Equivalent)) SOLR 78.46049 01/01/2015 02/10/2015

CEENU (Lomustine Cap 10 MG) CAPS 8.78721 04/13/2012 02/19/2013

CEENU (Lomustine Cap 40 MG) CAPS 26.46165 04/13/2012 02/19/2013

Cefaclor Cap 250 MG CAPS 0.36000 02/22/2013 02/19/2013

Cefaclor Cap 500 MG CAPS 0.56000 02/22/2013 02/19/2013

Cefaclor For Susp 125 MG/5ML SUSR 0.09000 02/22/2013 02/19/2013

Cefaclor For Susp 375 MG/5ML SUSR 0.18000 02/22/2013 02/19/2013

Cefadroxil Cap 500 MG CAPS 0.18125 02/22/2013 02/19/2013

Cefadroxil For Susp 250 MG/5ML SUSR 0.40300 02/22/2013 02/19/2013

Cefadroxil For Susp 500 MG/5ML SUSR 0.43578 08/09/2013 08/06/2013

Cefadroxil Tab 1 GM TABS 3.15000 02/22/2013 02/19/2013

Cefazolin Sodium For Inj 1 GM SOLR 0.92300 02/22/2013 02/19/2013

Cefazolin Sodium For Inj 10 GM SOLR 8.51282 11/08/2013 11/05/2013

Cefazolin Sodium For IV Soln 1 GM SOLR 1.36500 02/22/2013 02/19/2013

Cefdinir Cap 300 MG CAPS 1.15870 03/13/2015 03/10/2015

Cefdinir For Susp 125 MG/5ML SUSR 0.55153 09/13/2013 09/09/2013

Cefdinir For Susp 250 MG/5ML SUSR 0.71996 10/10/2014 10/07/2014

Cefepime HCl For Inj 1 GM SOLR 5.63420 02/22/2013 02/19/2013

Cefepime HCl For Inj 2 GM SOLR 13.10920 02/22/2013 02/19/2013

Cefpodoxime Proxetil For Susp 100 MG/5ML SUSR 1.16000 04/03/2013 05/06/2013

Cefpodoxime Proxetil For Susp 50 MG/5ML SUSR 0.47995 02/22/2013 02/19/2013

Cefpodoxime Proxetil Tab 100 MG TABS 3.94842 02/22/2013 02/19/2013

Cefpodoxime Proxetil Tab 200 MG TABS 6.71249 11/14/2014 11/12/2014

Cefprozil For Susp 125 MG/5ML SUSR 0.31141 03/31/2014 04/09/2014



Cefprozil Tab 250 MG TABS 1.09500 02/22/2013 02/19/2013

Cefprozil Tab 500 MG TABS 1.91723 06/13/2014 06/09/2014

Ceftazidime For Inj 1 GM SOLR 4.95300 02/22/2013 02/19/2013



Ceftazidime For IV Soln 1 GM SOLR 5.23900 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Ceftazidime For IV Soln 2 GM SOLR 13.67600 02/22/2013 02/19/2013

Ceftriaxone Sodium For Inj 1 GM SOLR 2.55450 02/22/2013 02/19/2013



Ceftriaxone Sodium For Inj 250 MG SOLR 1.65450 02/22/2013 02/19/2013

Ceftriaxone Sodium For Inj 500 MG SOLR 1.71600 02/22/2013 02/19/2013

Ceftriaxone Sodium For IV Soln 1 GM SOLR 4.14500 02/22/2013 02/19/2013

Ceftriaxone Sodium For IV Soln 2 GM SOLR 4.88800 02/22/2013 02/19/2013

Cefuroxime Axetil Tab 250 MG TABS 1.32000 05/01/2014 07/09/2014

Cefuroxime Axetil Tab 500 MG TABS 3.10000 12/19/2014 12/17/2014

CELLCEPT (Mycophenolate Mofetil For Oral Susp 200 MG/ML) SUSR 6.72180 01/03/2014 03/12/2014

CELLULAR SECURITY (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

CENTRUM (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

CENTRUM (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

CENTRUM (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM ADULTS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM CARDIO (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM FLAVOR BURST (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

CENTRUM SILVER (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

CENTRUM SILVER (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM SILVER ULTRA MENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM SILVER ULTRA WOME (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM SPECIALIST HEART (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM SPECIALIST IMMUNE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM SPECIALIST VISION (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM ULTRA MENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CENTRUM ULTRA WOMENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Cephalexin Cap 250 MG CAPS 0.10500 02/22/2013 02/19/2013

Cephalexin Cap 500 MG CAPS 0.23590 01/24/2014 03/12/2014

Cephalexin For Susp 125 MG/5ML SUSR 0.17200 10/16/2014 11/12/2014

Cephalexin For Susp 250 MG/5ML SUSR 0.20500 04/28/2014 06/09/2014

CERALYTE 70 (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

CERASPORT (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

CERASPORT EX1 (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

CERAVE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CERAVE AM SPF 30 (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CERAVE PM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CERAVE SA RENEWING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CERTAVITE SENIOR/ANTIOXID (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CETAKLENZ (Soap & Cleansers - Liquid***) LIQD 0.01940 03/13/2008 02/19/2013

CETAPHIL DAILY ADVANCE UL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CETAPHIL DAILY FACIAL MOI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CETAPHIL DERMACONTROL MOI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CETAPHIL GENTLE CLEANSER (Soap & Cleansers - Lotion***) LOTN 0.01940 03/13/2008 02/19/2013

CETAPHIL MOISTURIZING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CETAPHIL RESTORADERM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Cetirizine HCl Chew Tab 10 MG CHEW 0.57308 02/22/2013 02/19/2013

Cetirizine HCl Chew Tab 5 MG CHEW 0.57308 02/22/2013 02/19/2013

Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) SOLN 0.04100 03/24/2014 04/01/2014

Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) SYRP 0.04100 03/24/2014 04/01/2014

Cetirizine HCl Tab 10 MG TABS 0.05785 02/22/2013 02/19/2013

Cetirizine HCl Tab 5 MG TABS 0.07158 02/22/2013 02/19/2013

Cetirizine-Pseudoephedrine Tab SR 12HR 5-120 MG TB12 0.60558 02/22/2013 02/19/2013

Cevimeline HCl Cap 30 MG CAPS 2.04543 02/14/2014 02/11/2014

CHAPSTICK OVERNIGHT (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CHAPSTICK ULTRA MOISTURE (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CHAPSTICK ULTRASMOOTH FOR (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CHAPSTICK ULTRASMOOTH NOU (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CHAPSTICK ULTRASMOOTH REJ (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CHAPSTICK ULTRASMOOTH SOO (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CHEMET (Succimer Cap 100 MG) CAPS 8.20960 09/16/2013 09/17/2013

CHLOR-TRIMETON (Chlorpheniramine Maleate Syrup 2 MG/5ML) SYRP 0.01750 03/13/2008 02/19/2013

CHLOR-TRIMETON (Chlorpheniramine Maleate Tab 4 MG) TABS 0.02960 03/13/2008 02/19/2013

CHLOR-TRIMETON ALLERGY (Chlorpheniramine Maleate Tab CR 12 MG) TBCR 0.36000 04/28/2005 02/19/2013

Chlordiazepoxide HCl Cap 10 MG CAPS 0.07000 02/22/2013 02/19/2013



Chlordiazepoxide HCl-Clidinium Bromide Cap 5-2.5 MG CAPS 1.02700 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Chlordiazepoxide-Amitriptyline Tab 10-25 MG TABS 0.85530 02/22/2013 02/19/2013

Chlordiazepoxide-Amitriptyline Tab 5-12.5 MG TABS 1.02580 07/18/2013 08/06/2013

Chlorhexidine Gluconate Liquid 4% LIQD 0.03079 04/02/2014 05/02/2014

Chlorhexidine Gluconate Soln 0.12% SOLN 0.00591 02/22/2013 02/19/2013

Chloroquine Phosphate Tab 250 MG TABS 1.35637 02/22/2013 02/19/2013



Chlorothiazide Tab 250 MG TABS 0.11256 02/22/2013 02/19/2013

Chlorothiazide Tab 500 MG TABS 1.05000 05/29/2014 07/09/2014

Chlorpheniramine Maleate Syrup 2 MG/5ML SYRP 0.01750 02/22/2013 02/19/2013

Chlorpheniramine Maleate Tab 4 MG TABS 0.00599 02/22/2013 02/19/2013

Chlorpheniramine Maleate Tab CR 12 MG TBCR 0.36000 02/22/2013 02/19/2013

Chlorpromazine HCl Tab 10 MG TABS 0.79000 10/23/2013 11/05/2013





Chlorpropamide Tab 100 MG TABS 0.16000 02/22/2013 02/19/2013

Chlorpropamide Tab 250 MG TABS 0.34000 02/22/2013 02/19/2013

Chlorthalidone Tab 25 MG TABS 0.93000 05/27/2014 07/09/2014

Chlorthalidone Tab 50 MG TABS 0.86000 05/23/2014 06/09/2014

Chlorzoxazone Tab 500 MG TABS 0.25000 05/29/2013 08/06/2013

CHOICE DM (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

CHOICE DM FORA G20 TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

CHOICE DM TF (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Cholecalciferol Cap 1000 Unit CAPS 0.03550 02/22/2013 02/19/2013

Cholecalciferol Cap 400 Unit CAPS 0.03760 02/22/2013 02/19/2013

Cholecalciferol Tab 1000 Unit TABS 0.03550 02/22/2013 02/19/2013

Cholecalciferol Tab 400 Unit TABS 0.03764 02/22/2013 02/19/2013

Cholestyramine Light Powder 4 GM/DOSE POWD 0.32512 11/04/2013 12/06/2013

Cholestyramine Light Powder Packets 4 GM PACK 0.76600 02/22/2013 02/19/2013

Cholestyramine Powder 4 GM/DOSE POWD 0.23340 02/09/2014 03/12/2014

Cholestyramine Powder Packets 4 GM PACK 1.83850 02/05/2014 05/02/2014

Choline & Magnesium Salicylates Tab 1000 MG TABS 0.23000 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED



Choline Fenofibrate Cap DR 135 MG (Fenofibric Acid Equiv) CPDR 2.95939 06/13/2014 06/09/2014

Choline Fenofibrate Cap DR 45 MG (Fenofibric Acid Equiv) CPDR 1.65033 09/13/2013 09/09/2013

Chorionic Gonadotropin For Inj 10000 Unit SOLR 55.75500 02/22/2013 02/19/2013

Ciclopirox Gel 0.77% GEL 1.80899 11/14/2014 11/12/2014

Ciclopirox Olamine Cream 0.77% (Base Equiv) CREA 0.41711 02/08/2013 02/20/2013

Ciclopirox Olamine Cream 0.77% (Base Equiv) CREA 0.41711 02/22/2013 02/20/2013

Ciclopirox Olamine Susp 0.77% (Base Equiv) SUSP 0.53244 11/14/2014 11/12/2014

Ciclopirox Shampoo 1% SHAM 0.66031 03/13/2015 03/10/2015

Ciclopirox Solution 8% SOLN 1.02273 02/22/2013 02/19/2013

Cilostazol Tab 100 MG TABS 0.16597 02/22/2013 02/19/2013

Cilostazol Tab 50 MG TABS 0.16708 02/22/2013 02/19/2013

Cimetidine HCl Soln 300 MG/5ML SOLN 0.03677 02/22/2013 02/19/2013

Cimetidine Tab 200 MG TABS 0.06613 02/22/2013 02/19/2013




CIMZIA (Certolizumab Pegol For Inj Kit 2 X 200 MG) KIT 3031.12680 01/01/2015 02/10/2015

CIMZIA (Certolizumab Pegol Inj Kit 2 X 200 MG/ML) KIT 3031.12680 01/01/2015 02/10/2015

CIMZIA STARTER KIT (Certolizumab Pegol Inj Kit 6 X 200 MG/ML) KIT 3031.12404 01/01/2015 02/10/2015

CINRYZE (C1 Esterase Inhibitor (Human) For IV Inj 500 Unit) SOLR 2442.97220 01/06/2014 03/12/2014

Ciprofloxacin 400 MG/200ML in D5W SOLN 0.01428 02/22/2013 02/19/2013

Ciprofloxacin HCl Ophth Soln 0.3% SOLN 0.88205 02/22/2013 02/19/2013

Ciprofloxacin HCl Tab 100 MG (Base Equiv) TABS 0.44600 02/22/2013 02/19/2013




Citalopram Hydrobromide Oral Soln 10 MG/5ML SOLN 0.19270 02/22/2013 02/19/2013

Citalopram Hydrobromide Tab 10 MG (Base Equiv) TABS 0.03042 02/22/2013 02/19/2013



CITRUCEL (Methylcellulose Tab 500 MG) TABS 0.10545 03/20/2008 02/19/2013

CITRUCEL CLEAR-MIX (Methylcellulose Powder Laxative) POWD 0.02291 07/28/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

CITRUCEL FIBER LAXATIVE (Methylcellulose Powder Laxative) POWD 0.02291 07/28/2011 02/19/2013

CITRUCEL FIBERSHAKE (Methylcellulose Powder Laxative) POWD 0.02291 07/28/2011 02/19/2013

CLARAVIS (Isotretinoin Cap 30 MG) CAPS 13.19920 01/13/2012 02/19/2013

Clarithromycin For Susp 125 MG/5ML SUSR 0.41240 03/31/2014 05/02/2014

Clarithromycin For Susp 250 MG/5ML SUSR 0.71200 07/16/2014 09/10/2014

Clarithromycin Tab 250 MG TABS 1.82083 11/14/2014 11/12/2014

Clarithromycin Tab 500 MG TABS 1.66697 12/19/2014 12/17/2014

Clarithromycin Tab SR 24HR 500 MG TB24 2.50200 02/22/2013 02/19/2013

CLARITIN (Loratadine Syrup 5 MG/5ML) SYRP 0.03850 04/23/2010 02/19/2013

CLARITIN (Loratadine Syrup 5 MG/5ML) SYRP 0.05480 03/20/2008 02/19/2013

CLARITIN (Loratadine Tab 10 MG) TABS 0.10500 05/28/2010 02/19/2013




CLARITIN REDITABS (Loratadine Rapidly-Disintegrating Tab 10 MG) TBDP 0.10500 04/23/2010 02/19/2013

CLARITIN REDITABS (Loratadine Rapidly-Disintegrating Tab 10 MG) TBDP 0.27350 03/20/2008 02/19/2013

CLASSIC PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

CLEAN & CLEAR MORNING BUR (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CLEAN & CLEAR SOFT MOISTU (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

CLEANLET LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CLEAR EYES REDNESS RELIEF (Naphazoline-Glycerin Ophth Soln 0.012-0.2%) SOLN 0.17790 04/28/2005 02/19/2013

Clemastine Fumarate Syrup 0.67 MG/5ML (0.5 MG/5ML Base Eq) SYRP 0.04950 02/22/2013 02/19/2013

Clemastine Fumarate Tab 1.34 MG (1 MG Base Equiv) TABS 0.14420 02/22/2013 02/19/2013

Clemastine Fumarate Tab 2.68 MG TABS 0.48520 01/20/2015 02/10/2015

CLEVER CHEK AUTO CODE VOI (Blood Glucose Monitoring Devices***) DEVI 0.71000 10/01/2003 02/19/2013

CLEVER CHEK AUTO-CODE BLO (Blood Glucose Monitoring Devices***) DEVI 0.71000 10/01/2003 02/19/2013

CLEVER CHEK AUTO-CODE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

CLEVER CHEK AUTO-CODE VOI (Blood Glucose Monitoring Devices***) DEVI 0.71000 10/01/2003 02/19/2013

CLEVER CHEK AUTO-CODE VOI (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

CLEVER CHEK BLOOD GLUCOSE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

CLEVER CHEK LANCETS ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CLEVER CHEK TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

CLEVER CHOICE AUTO-CODE P (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

CLEVER CHOICE MICRO BLOOD (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

CLEVER CHOICE MICRO TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Clindamycin HCl Cap 150 MG CAPS 0.14050 04/15/2013 05/06/2013



Clindamycin Palmitate HCl For Soln 75 MG/5ML (Base Equiv) SOLR 0.42149 10/10/2014 10/07/2014

Clindamycin Phosph-Benzoyl Peroxide (Refrig) Gel 1.2 (1)-5% GEL 3.21645 05/09/2014 05/02/2014

Clindamycin Phosphate Foam 1% FOAM 3.87500 01/12/2015 02/10/2015

Clindamycin Phosphate Gel 1% GEL 1.62202 01/10/2014 01/08/2014



Clindamycin Phosphate Lotion 1% LOTN 1.55200 08/01/2014 09/10/2014

Clindamycin Phosphate Soln 1% SOLN 0.95962 03/13/2015 03/10/2015

Clindamycin Phosphate Swab 1% SWAB 0.44000 02/22/2013 02/19/2013

Clindamycin Phosphate Vaginal Cream 2% CREA 1.87600 01/14/2013 02/20/2013

Clindamycin Phosphate Vaginal Cream 2% CREA 1.87600 02/22/2013 02/20/2013

Clindamycin Phosphate-Benzoyl Peroxide Gel 1-5% GEL 3.37064 02/22/2013 02/19/2013

CLINDAREACH (Clindamycin Phosphate Swab Kit 1%) KIT 0.30900 09/27/2007 02/19/2013

CLINICAL NUTRIENTS 45-PLU (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CLINICAL NUTRIENTS 50-PLU (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CLINICAL NUTRIENTS ANTIOX (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

CLINICAL NUTRIENTS FOR FE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CLINICAL NUTRIENTS FOR MA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CLINICAL NUTRIENTS FOR ME (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CLINICAL NUTRIENTS FOR WO (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Clobetasol Propionate Cream 0.05% CREA 0.41000 02/22/2013 02/19/2013





Clobetasol Propionate Emollient Base Cream 0.05% CREA 2.14520 08/28/2014 09/10/2014

Clobetasol Propionate Foam 0.05% FOAM 4.23280 06/13/2014 06/09/2014

Clobetasol Propionate Gel 0.05% GEL 4.56000 09/02/2014 10/07/2014

Clobetasol Propionate Lotion 0.05% LOTN 3.50016 07/11/2014 07/09/2014




EFFECTIVE DATE

DATE UPDATED

Clobetasol Propionate Oint 0.05% OINT 0.34000 02/22/2013 02/19/2013





Clobetasol Propionate Shampoo 0.05% SHAM 2.65200 08/07/2014 09/10/2014

Clobetasol Propionate Soln 0.05% SOLN 3.01500 08/20/2014 09/10/2014

Clomiphene Citrate Tab 50 MG TABS 1.72970 02/22/2013 02/19/2013

Clomipramine HCl Cap 25 MG CAPS 8.63171 05/09/2014 05/02/2014



Clonazepam Orally Disintegrating Tab 0.125 MG TBDP 0.83000 11/26/2013 01/08/2014



Clonazepam Orally Disintegrating Tab 1 MG TBDP 0.99200 02/22/2013 02/19/2013

Clonazepam Orally Disintegrating Tab 2 MG TBDP 1.35500 02/22/2013 02/19/2013

Clonazepam Tab 0.5 MG TABS 0.01801 02/22/2013 02/19/2013

Clonazepam Tab 1 MG TABS 0.02930 02/22/2013 02/19/2013

Clonazepam Tab 2 MG TABS 0.04350 02/22/2013 02/19/2013

Clonidine HCl Tab 0.1 MG TABS 0.03649 02/22/2013 02/19/2013



Clonidine HCl TD Patch Weekly 0.1 MG/24HR PTWK 17.56000 04/11/2014 04/09/2014



Clopidogrel Bisulfate Tab 75 MG (Base Equiv) TABS 0.20393 03/13/2015 03/10/2015

Clorazepate Dipotassium Tab 15 MG TABS 0.42000 05/13/2013 07/09/2013

Clorazepate Dipotassium Tab 3.75 MG TABS 0.15950 02/28/2014 04/09/2014

Clorazepate Dipotassium Tab 7.5 MG TABS 0.32900 01/20/2014 03/12/2014

Clotrimazole Cream 1% CREA 0.67423 04/11/2014 04/09/2014

Clotrimazole Soln 1% SOLN 0.21209 02/22/2013 02/19/2013

Clotrimazole Troche 10 MG LOZG 0.48559 01/10/2014 01/08/2014

Clotrimazole Troche 10 MG TROC 0.48559 01/10/2014 01/08/2014

Clotrimazole Vaginal Cream 1% CREA 0.09694 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Clotrimazole Vaginal Cream 2% CREA 0.35240 02/22/2013 02/19/2013

Clotrimazole w/ Betamethasone Cream 1-0.05% CREA 1.24511 02/22/2013 02/19/2013

Clotrimazole w/ Betamethasone Lotion 1-0.05% LOTN 3.98000 07/05/2013 08/06/2013

Clozapine Tab 100 MG TABS 1.09500 05/27/2014 07/09/2014




CO-NATAL FA (Prenatal Vit w/ Fe Fumarate-FA Tab 29-1 MG***) TABS 0.15587 01/23/2009 02/19/2013

COAGUCHEK LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

COAGUCHEK XS PRO SYSTEM (PT/INR Testing Monitor - Kit***) KIT 0.71000 10/01/2003 02/19/2013

Coal Tar Shampoo 0.5% SHAM 0.02261 02/22/2013 02/19/2013

Coenzyme Q10 Cap 100 MG CAPS 0.42075 02/22/2013 02/19/2013



Coenzyme Q10 Oral Powder POWD 0.06700 02/22/2013 02/19/2013

Coenzyme Q10 Tab 200 MG TABS 1.51270 02/22/2013 02/19/2013

Coenzyme Q10 Tab 60 MG TABS 0.39217 02/22/2013 02/19/2013

COLACE (Docusate Sodium Cap 100 MG) CAPS 0.03000 03/13/2008 02/19/2013

COLACE (Docusate Sodium Cap 50 MG) CAPS 0.07520 04/28/2005 02/19/2013

COLACE (Docusate Sodium Syrup 60 MG/15ML) SYRP 0.00521 03/13/2008 02/19/2013

Colchicine Tab 0.6 MG TABS 0.53679 02/22/2013 02/19/2013

Colchicine w/ Probenecid Tab 0.5-500 MG TABS 0.82500 02/22/2013 02/19/2013

Colestipol HCl Granule Packets 5 GM PACK 1.86000 09/26/2013 10/09/2013

Colestipol HCl Granules 5 GM GRAN 0.18500 02/22/2013 02/19/2013

Colestipol HCl Tab 1 GM TABS 1.01250 02/10/2015 03/10/2015

Colistimethate Sodium For Inj 150 MG SOLR 14.87200 02/22/2013 02/19/2013

COMFORT ASSURED LANCETS M (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

COMFORT ASSURED LANCETS S (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

COMFORT LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

COMPLEAT (Nutritional Supplement Liquid**) LIQD 0.01404 04/17/2007 02/19/2013

COMPLEAT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

COMPLEAT CLOSED SYSTEM (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

COMPLEAT PEDIATRIC (Nutritional Supplement Liquid**) LIQD 0.01150 04/08/2008 02/19/2013

COMPLEAT PEDIATRIC REDUCE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

COMPLETE AMINO ACID MIX (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

COMPLETENATE (Prenatal Vit w/ Fe Fumarate-FA Chew Tab 29-1 MG***) CHEW 0.29950 08/29/2008 02/19/2013

COMPLEX 15 (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

COMPLEX ESSENTIAL MSD (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

COMPLEX JUNIOR MSD (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

COMPLEX MSUD (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

CONTROL AST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

CONTROL BLOOD GLUCOSE MON (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

CONTROL TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

COOL BOTTOMS (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

COPAXONE (Glatiramer Acetate Inj Kit 20 MG/ML) KIT 202.86860 01/01/2015 02/10/2015

COPEGUS (Ribavirin Tab 200 MG) TABS 19.40179 01/05/2015 02/10/2015

CORIFACT (Factor XIII Concentrate (Human) For Inj Kit 1000-1600 Unit) KIT 6.68000 08/08/2014 08/06/2014

CORN HUSKERS (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Cortisone Acetate Tab 25 MG TABS 0.35000 02/22/2013 02/19/2013

Cosyntropin For Inj 0.25 MG SOLR 104.26000 02/22/2013 02/19/2013

CRINONE (Progesterone Vaginal Gel 8%) GEL 17.49320 02/02/2015 03/10/2015

CRITIC-AID CLEAR MOISTURE (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

CRITICARE HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Cromolyn Sodium Nasal Aerosol Soln 5.2 MG/ACT (4%) AERS 0.38197 02/22/2013 02/19/2013

Cromolyn Sodium Ophth Soln 4% SOLN 0.62075 02/22/2013 02/19/2013

Cromolyn Sodium Soln Nebu 20 MG/2ML NEBU 0.16000 02/22/2013 02/19/2013

CRUCIAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

CVS BLOOD GLUCOSE STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

CVS LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS LANCETS MICRO THIN 33 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS LANCETS ORIGINAL (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS LANCETS THIN 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS LANCETS ULTRA THIN 30 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS MINERAL OIL (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

CVS NATURAL FIBER SUPPLEM (Psyllium Powder Packet 58.6%) PACK 0.22885 03/20/2008 02/19/2013

CVS NUTRITION LIQUID (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

CVS NUTRITION PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

CVS PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

CVS SPECTRAVITE ULTRA MEN (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

CVS ULTRA THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

CVS VITAMIN D3 (Cholecalciferol Cap 400 Unit) CAPS 0.02008 03/13/2008 02/19/2013

Cyanocobalamin Inj 1000 MCG/ML SOLN 3.86950 01/14/2015 02/10/2015

Cyanocobalamin Tab 100 MCG TABS 0.03928 02/22/2013 02/19/2013




CYCLINEX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

CYCLINEX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Cyclobenzaprine HCl Tab 10 MG TABS 0.02265 02/22/2013 02/19/2013

Cyclobenzaprine HCl Tab 5 MG TABS 0.03579 02/22/2013 02/19/2013

Cyclopentolate HCl Ophth Soln 1% SOLN 4.71034 01/10/2014 01/08/2014

Cyclophosphamide For Inj 1 GM SOLR 43.88210 02/22/2013 02/19/2013

Cyclophosphamide For Inj 2 GM SOLR 879.98500 05/28/2013 07/09/2013

Cyclophosphamide Tab 25 MG TABS 1.73470 02/22/2013 02/19/2013

Cyclophosphamide Tab 50 MG TABS 3.18720 02/22/2013 02/19/2013

Cyclosporine Cap 100 MG CAPS 5.73072 08/09/2013 08/06/2013

Cyclosporine Modified Cap 100 MG CAPS 2.42000 08/26/2014 09/10/2014

Cyclosporine Modified Cap 25 MG CAPS 0.58095 03/13/2015 03/10/2015

Cyproheptadine HCl Syrup 2 MG/5ML SYRP 0.09790 02/22/2013 02/19/2013

Cyproheptadine HCl Tab 4 MG TABS 0.62818 12/19/2014 12/17/2014

CYSTADANE (Betaine Powder For Oral Solution***) POWD 6.50655 01/01/2015 02/10/2015

Cytarabine For Inj 100 MG SOLR 3.98400 02/22/2013 02/19/2013

D.H.E. 45 (Dihydroergotamine Mesylate Inj 1 MG/ML) SOLN 806.40144 01/30/2015 03/10/2015

DAILY CONDITIONING TREATM (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

Danazol Cap 200 MG CAPS 2.91562 02/22/2013 02/19/2013

Dantrolene Sodium Cap 100 MG CAPS 1.50600 02/22/2013 02/19/2013



DEBROX (Carbamide Peroxide 6.5% Otic Soln) SOLN 0.14970 03/13/2008 02/19/2013

DECUBI-VITE (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

Deferoxamine Mesylate For Inj 2 GM SOLR 39.32000 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Deferoxamine Mesylate For Inj 500 MG SOLR 10.14000 02/22/2013 02/19/2013

Demeclocycline HCl Tab 150 MG TABS 2.72788 02/22/2013 02/20/2013

Demeclocycline HCl Tab 300 MG TABS 9.43500 09/19/2013 11/05/2013

DEPO-PROVERA CONTRACEPTIV (Medroxyprogesterone Acetate IM Susp 150 MG/ML) SUSP 144.22080 01/01/2015 02/10/2015

DEQUASINE (Amino Acids Tab***) TABS 0.41080 04/28/2005 02/19/2013

DERMADROX (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

DERMAL THERAPY EXTRA STRE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DERMAL THERAPY FACE CARE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DERMAL THERAPY FOOT MASSA (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DERMAL THERAPY HAND, ELBO (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DERMAL THERAPY HEEL CARE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DERMAVITE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Desipramine HCl Tab 10 MG TABS 0.79500 05/15/2014 06/09/2014






Desloratadine Tab 5 MG TABS 0.98507 06/13/2014 06/09/2014

Desmopressin Acetate Nasal Spray Soln 0.01% SOLN 12.56615 02/22/2013 02/19/2013

Desmopressin Acetate Nasal Spray Soln 0.01% (Refrigerated) SOLN 21.63351 11/14/2014 11/12/2014

Desmopressin Acetate Tab 0.1 MG TABS 0.99435 09/12/2014 09/05/2014

Desmopressin Acetate Tab 0.2 MG TABS 0.94728 04/11/2014 04/09/2014

Desogest-Eth Estrad & Eth Estrad Tab 0.15-0.02/0.01 MG(21/5) TABS 1.33000 02/22/2013 02/19/2013

Desogest-Ethin Est Tab 0.1-0.025/0.125-0.025/0.15-0.025MG-MG TABS 0.92600 02/22/2013 02/19/2013

Desogestrel & Ethinyl Estradiol Tab 0.15 MG-30 MCG TABS 0.56123 12/19/2014 12/17/2014

Desonide Cream 0.05% CREA 4.03030 06/13/2014 06/09/2014

Desonide Lotion 0.05% LOTN 3.46500 09/30/2013 11/05/2013

Desonide Oint 0.05% OINT 2.94350 04/11/2014 04/09/2014

Desoximetasone Cream 0.05% CREA 3.40435 02/22/2013 02/19/2013

Desoximetasone Cream 0.25% CREA 1.17465 04/11/2014 04/09/2014

Desoximetasone Gel 0.05% GEL 2.24423 02/22/2013 02/19/2013

Desoximetasone Oint 0.25% OINT 6.16250 05/13/2014 06/09/2014

Dexamethasone Elixir 0.5 MG/5ML ELIX 0.23000 07/06/2013 09/09/2013




EFFECTIVE DATE

DATE UPDATED

Dexamethasone Sodium Phosphate Ophth Soln 0.1% SOLN 2.41406 02/22/2013 02/19/2013

Dexamethasone Tab 0.5 MG TABS 0.06750 02/22/2013 02/19/2013

Dexamethasone Tab 0.75 MG TABS 0.06400 02/22/2013 02/19/2013

Dexamethasone Tab 4 MG TABS 0.10036 02/22/2013 02/19/2013

Dexamethasone Tab 6 MG TABS 0.44500 02/22/2013 02/19/2013

Dexmethylphenidate HCl Tab 10 MG TABS 1.21800 03/28/2014 05/02/2014

Dexmethylphenidate HCl Tab 2.5 MG TABS 0.47500 02/22/2013 02/19/2013

Dexmethylphenidate HCl Tab 5 MG TABS 0.66100 02/22/2013 02/19/2013

Dextroamphetamine Sulfate Cap SR 24HR 10 MG CP24 1.52500 02/22/2013 02/19/2013



Dextroamphetamine Sulfate Tab 10 MG TABS 1.75336 03/13/2015 03/10/2015

Dextroamphetamine Sulfate Tab 5 MG TABS 1.85000 01/10/2014 01/08/2014

Dextromethorphan-Guaifenesin Liquid 10-100 MG/5ML LIQD 0.00819 02/22/2013 02/19/2013

Dextromethorphan-Guaifenesin Liquid 10-100 MG/5ML SOLN 0.00819 02/22/2013 02/19/2013

Dextromethorphan-Guaifenesin Syrup 10-100 MG/5ML SYRP 0.00819 02/22/2013 02/19/2013

Dextromethorphan-Guaifenesin Tab 20-400 MG TABS 0.07778 02/22/2013 02/19/2013

Dextrose Inj 5% SOLN 0.00449 02/22/2013 02/19/2013

DHS TAR (Coal Tar Shampoo 0.5%) SHAM 0.02261 03/13/2008 02/19/2013

DHS TAR GEL (Coal Tar Shampoo 0.5%) SHAM 0.02261 03/13/2008 02/19/2013

DIABETA (Glyburide Tab 2.5 MG) TABS 0.18000 12/28/2001 02/19/2013

DIABETIC TF (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

DIABETIDERM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DIABETIDERM HAND & BODY (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

DIABETISHIELD (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

DIABETISOURCE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

DIABETISOURCE AC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Diaper Rash Products - Ointment** OINT 0.02350 02/22/2013 02/19/2013

DIASTAR EASY TEST II LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DIASTAR EASY TEST LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Diazepam Inj 5 MG/ML SOLN 0.80210 02/22/2013 02/19/2013

Diazepam Tab 10 MG TABS 0.03463 02/22/2013 02/19/2013






EFFECTIVE DATE

DATE UPDATED

Dibucaine Oint 1% OINT 0.06500 02/22/2013 02/19/2013

Diclofenac Potassium Tab 50 MG TABS 0.68000 01/29/2015 02/10/2015

Diclofenac Sodium Ophth Soln 0.1% SOLN 2.55042 02/22/2013 02/19/2013

Diclofenac Sodium Tab Delayed Release 25 MG TBEC 0.19000 02/22/2013 02/19/2013



Diclofenac Sodium Tab SR 24HR 100 MG TB24 0.42237 02/22/2013 02/19/2013

Diclofenac w/ Misoprostol Tab Delayed Release 75-0.2 MG TBEC 2.30000 11/08/2013 11/05/2013

Dicloxacillin Sodium Cap 250 MG CAPS 0.27170 02/22/2013 02/19/2013

Dicloxacillin Sodium Cap 500 MG CAPS 0.49800 02/22/2013 02/19/2013

Dicyclomine HCl Cap 10 MG CAPS 0.03810 02/22/2013 02/19/2013

Dicyclomine HCl Tab 20 MG TABS 0.09520 08/12/2013 10/09/2013

Didanosine Delayed Release Capsule 200 MG CPDR 3.64700 02/22/2013 02/19/2013



DIDGET (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

Diethylpropion HCl Tab 25 MG TABS 0.39380 02/22/2013 02/19/2013

Diethylpropion HCl Tab SR 24HR 75 MG TB24 0.67000 02/22/2013 02/19/2013

DIFICID (Fidaxomicin Tab 200 MG) TABS 164.72139 01/01/2015 02/10/2015

Diflorasone Diacetate Cream 0.05% CREA 0.99700 02/22/2013 02/19/2013

Diflorasone Diacetate Oint 0.05% OINT 4.86950 10/28/2014 11/12/2014

Diflunisal Tab 500 MG TABS 1.76000 09/05/2014 10/07/2014

Digoxin Tab 125 MCG (0.125 MG) TABS 0.98900 01/25/2014 02/11/2014

Digoxin Tab 250 MCG (0.25 MG) TABS 0.90000 11/25/2013 12/06/2013

Diltiazem HCl Cap SR 12HR 120 MG CP12 0.75000 02/22/2013 02/19/2013






Diltiazem HCl Coated Beads Cap SR 24HR 120 MG CP24 0.41775 02/22/2013 02/19/2013







EFFECTIVE DATE

DATE UPDATED


Diltiazem HCl Coated Beads Tab SR 24HR 180 MG TB24 3.10567 02/22/2013 02/19/2013



Diltiazem HCl Extended Release Beads Cap SR 24HR 120 MG CP24 0.55500 02/22/2013 02/19/2013






Diltiazem HCl Tab 120 MG TABS 0.13231 02/22/2013 02/19/2013




Dimethicone-Zinc Oxide-Vitamin A-Vitamin D Cream 1-10%*** CREA 0.02730 02/22/2013 02/19/2013

DINO-LIFE W/IRON & ZINC (Pediatric Multiple Vitamins w/ Iron Chew Tab**) CHEW 0.01450 01/01/1988 02/19/2013

Diphenhydramine HCl (Sleep) Cap 50 MG CAPS 0.05210 02/22/2013 02/19/2013

Diphenhydramine HCl Cap 25 MG CAPS 0.01105 02/22/2013 02/19/2013

Diphenhydramine HCl Cap 50 MG CAPS 0.02275 02/22/2013 02/19/2013

Diphenhydramine HCl Elixir 12.5 MG/5ML ELIX 0.01670 02/22/2013 02/19/2013

Diphenhydramine HCl Inj 50 MG/ML SOLN 0.85000 02/22/2013 02/19/2013

Diphenhydramine HCl Liquid 12.5 MG/5ML LIQD 0.00585 02/22/2013 02/19/2013

Diphenhydramine HCl Syrup 12.5 MG/5ML SYRP 0.01080 02/22/2013 02/19/2013

Diphenhydramine HCl Tab 25 MG TABS 0.01690 02/22/2013 02/19/2013

Diphenhydramine-Acetaminophen Tab 25-500 MG (sleep) TABS 0.08157 02/22/2013 02/19/2013

Diphenoxylate w/ Atropine Liq 2.5-0.025 MG/5ML LIQD 0.09100 02/22/2013 02/19/2013

Diphenoxylate w/ Atropine Tab 2.5-0.025 MG TABS 0.34500 06/05/2014 08/06/2014

Dipyridamole Tab 25 MG TABS 0.10356 02/22/2013 02/19/2013



Disopyramide Phosphate Cap 100 MG CAPS 0.34820 02/22/2013 02/19/2013

Disopyramide Phosphate Cap 150 MG CAPS 0.39866 02/22/2013 02/19/2013

Disulfiram Tab 250 MG TABS 2.03878 02/13/2015 02/10/2015

Disulfiram Tab 500 MG TABS 4.86000 02/08/2013 02/20/2013




EFFECTIVE DATE

DATE UPDATED

Divalproex Sodium Cap Sprinkle 125 MG CPSP 0.44647 02/22/2013 02/19/2013

Divalproex Sodium Tab Delayed Release 125 MG TBEC 0.06324 02/22/2013 02/19/2013



Divalproex Sodium Tab SR 24 HR 250 MG TB24 1.78683 06/13/2014 06/09/2014

Divalproex Sodium Tab SR 24 HR 500 MG TB24 2.43514 06/13/2014 06/09/2014

Docusate Calcium Cap 240 MG CAPS 0.06595 02/22/2013 02/19/2013

Docusate Sodium Cap 100 MG CAPS 0.01733 02/22/2013 02/19/2013



Docusate Sodium Liquid 150 MG/15ML LIQD 0.01010 02/22/2013 02/19/2013

Docusate Sodium Syrup 60 MG/15ML SYRP 0.00521 02/22/2013 02/19/2013

Donepezil Hydrochloride Orally Disintegrating Tab 10 MG TBDP 0.33100 03/13/2015 03/10/2015

Donepezil Hydrochloride Orally Disintegrating Tab 5 MG TBDP 1.30000 02/22/2013 02/19/2013

Donepezil Hydrochloride Tab 10 MG TABS 0.15190 02/22/2013 02/19/2013



Dorzolamide HCl Ophth Soln 2% SOLN 1.77600 02/13/2015 02/10/2015

Dorzolamide HCl-Timolol Maleate Ophth Soln 22.3-6.8 MG/ML SOLN 1.94274 07/11/2014 07/09/2014

Doxazosin Mesylate Tab 1 MG TABS 0.53068 07/11/2014 07/09/2014




Doxepin HCl Cap 10 MG CAPS 0.27850 06/02/2014 08/06/2014






Doxepin HCl Conc 10 MG/ML CONC 0.05363 02/22/2013 02/19/2013

Doxorubicin HCl Inj 2 MG/ML SOLN 1.01400 02/22/2013 02/19/2013

Doxycycline Hyclate Cap 100 MG CAPS 2.13387 12/19/2014 12/17/2014

Doxycycline Hyclate Cap 50 MG CAPS 1.26173 08/08/2014 08/06/2014

Doxycycline Hyclate Tab 100 MG TABS 3.41678 05/09/2014 05/02/2014




EFFECTIVE DATE

DATE UPDATED

Doxycycline Hyclate Tab 20 MG TABS 0.36543 02/22/2013 02/19/2013

Doxycycline Hyclate Tab Delayed Release 150 MG TBEC 12.37797 04/12/2013 04/09/2013

Doxycycline Monohydrate Cap 100 MG CAPS 0.97500 10/07/2014 11/12/2014

Doxycycline Monohydrate Cap 50 MG CAPS 0.36849 08/09/2013 08/06/2013

Doxycycline Monohydrate Tab 100 MG TABS 0.62500 03/13/2015 03/10/2015

Doxycycline Monohydrate Tab 50 MG TABS 0.72100 03/13/2015 03/10/2015

DRISDOL (Ergocalciferol Cap 50000 Unit) CAPS 1.15255 11/28/2009 02/19/2013

Dronabinol Cap 10 MG CAPS 11.01000 09/13/2013 09/09/2013

Dronabinol Cap 2.5 MG CAPS 3.24000 04/12/2013 04/09/2013

Dronabinol Cap 5 MG CAPS 6.06940 03/13/2015 03/10/2015

DROPLET LANCETS ULTRA THI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Drospirenone-Ethinyl Estradiol Tab 3-0.02 MG TABS 2.01550 02/22/2013 02/19/2013

Drospirenone-Ethinyl Estradiol Tab 3-0.03 MG TABS 1.68250 02/22/2013 02/19/2013

DROXIA (Hydroxyurea Cap 200 MG) CAPS 0.75530 07/30/2010 02/19/2013



DRUG MART LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DRUG MART LANCETS ULTRA T (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DRUG MART UNILET LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DUANE READE LANCET ALTERN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DUANE READE LANCET SUPER (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DUANE READE LANCET ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

DULCOLAX (Bisacodyl Suppos 10 MG) SUPP 0.19380 03/13/2008 02/19/2013

DULCOLAX (Bisacodyl Tab Delayed Release 5 MG) TBEC 0.04600 03/13/2008 02/19/2013

Duloxetine HCl Enteric Coated Pellets Cap 20 MG CPEP 1.32520 01/09/2015 01/06/2015



DUO-CARE TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

DUOCAL (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

DYNACIN (Minocycline HCl Tab 50 MG) TABS 0.13500 02/24/2005 02/19/2013

E-Z JECT LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

E-Z JECT LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

E-Z JECT LANCETS COLOR (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

E-Z JECT LANCETS SUPER TH (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

E-Z JECT LANCETS THIN 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

E-ZJECT LANCETS MICRO-THI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EAA SUPPLEMENT (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

EASY COMFORT LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EASY COMFORT LANCETS 30G/ (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EASY PLUS BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASY PLUS BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASY STEP BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASY STEP TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASY TALK BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASY TALK BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASY TOUCH GLUCOSE MONITO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASY TOUCH GLUCOSE TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASY TOUCH LANCETS 28G/TW (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EASY TOUCH SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EASY TRAK BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASY TRAK BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASY TWIST & CAP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EASYGLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASYMAX 15 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/28/2013

EASYMAX L BLOOD GLUCOSE S (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASYMAX N BLOOD GLUCOSE S (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASYMAX NG SELF-MONITORIN (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/28/2013

EASYMAX TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASYMAX V BLOOD GLUCOSE S (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASYMAX V2 SELF-MONITORIN (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASYPLUS BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASYPLUS R13N SELF-MONITO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013




EFFECTIVE DATE

DATE UPDATED

EASYPLUS V SELF-MONITORIN (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASYPRO BLOOD GLUCOSE MON (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

EASYPRO BLOOD GLUCOSE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASYPRO PLUS (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EASYPRO PLUS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EASYTEST II LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EASYTEST LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ECLIPSE BLOOD GLUCOSE MON (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ECLIPSE TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Econazole Nitrate Cream 1% CREA 0.52000 12/13/2013 02/11/2014

Econazole Nitrate Cream 1% CREA 5.83600 01/12/2015 02/10/2015

ECOTRIN REGULAR STRENGTH (Aspirin Tab Delayed Release 325 MG) TBEC 0.01920 03/13/2008 02/19/2013

EGG/PRO (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

EGRIFTA (Tesamorelin Acetate For Inj 1 MG (Base Equiv)) SOLR 32.60904 11/11/2011 02/19/2013

ELECARE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

ELECARE JR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

ELECARE/DHA/ARA (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

ELEMENT AUTOCODE SYSTEM (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ELEMENT PLUS TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ELEMENT TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ELOCTATE (Antihemophilic Factor (Recomb) rFVIIIFc For Inj 1000 Unit) SOLR 1.97540 09/12/2014 09/05/2014







ELOXATIN (Oxaliplatin IV Soln 100 MG/20ML) SOLN 132.23726 06/06/2014 07/09/2014



EMBRACE BLOOD GLUCOSE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EMBRACE LANCETS ULTRA THI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EMCYT (Estramustine Phosphate Sodium Cap 140 MG) CAPS 9.41818 01/01/2015 02/10/2015




EFFECTIVE DATE

DATE UPDATED

EMOLLIA-LOTION (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Emollient - Lotion** LOTN 0.01940 02/22/2013 02/19/2013

Emollient - Ointment** OINT 0.04583 02/22/2013 02/19/2013

Enalapril Maleate & Hydrochlorothiazide Tab 10-25 MG TABS 0.07806 02/22/2013 02/19/2013

Enalapril Maleate & Hydrochlorothiazide Tab 5-12.5 MG TABS 0.08242 02/22/2013 02/19/2013

Enalapril Maleate Tab 10 MG TABS 0.25420 11/07/2014 12/09/2014

Enalapril Maleate Tab 2.5 MG TABS 0.11000 11/25/2013 12/06/2013



ENBREL (Etanercept For Subcutaneous Inj Kit 25 MG) KIT 362.81375 11/14/2014 02/10/2015

ENFAGROW PREMIUM LIPIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAGROW PREMIUM NEXT STE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAGROW PREMIUM OLDER TO (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAGROW PREMIUM OLDER TO (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAGROW PREMIUM TODDLER (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAGROW TODDLER TRANSITI (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFALYTE (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

ENFAMIL AR LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL AR/SPIT-UP (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL AR/SPIT-UP (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL ENFACARE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL ENFACARE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL ENFACARE LIPIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL ENFALYTE (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

ENFAMIL GENTLEASE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL GENTLEASE FUSSINE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL GENTLEASE LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL GENTLEASE LIPIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL GENTLEASE/FUSSINE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL HUMAN MILK FORTIF (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL LACTOFREE LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL LIPIL ENFACARE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL LIPIL WITH IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL LIPIL WITH IRON (Infant Foods Liquid**) LIQD 0.02756 08/28/2013 09/09/2013




EFFECTIVE DATE

DATE UPDATED

ENFAMIL LIPIL/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL LIPIL/IRON PREMAT (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL NUTRAMIGEN AA LIP (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL NUTRAMIGEN AA LIP (Infant Foods Powder**) POWD 0.09208 06/01/2010 02/19/2013

ENFAMIL NUTRAMIGEN LIPIL (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

ENFAMIL NUTRAMIGEN LIPIL (Infant Foods Conc**) CONC 0.01908 01/03/2010 02/19/2013

ENFAMIL NUTRAMIGEN LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL NUTRAMIGEN LIPIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013




ENFAMIL PREGESTIMIL LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PREMATURE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PREMATURE LIPIL/L (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PREMIUM INFANT (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PREMIUM INFANT (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL PREMIUM LIPIL (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

ENFAMIL PREMIUM LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PREMIUM LIPIL (Infant Foods Packet**) PACK 0.04649 04/24/2008 02/19/2013

ENFAMIL PREMIUM NEWBORN (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PREMIUM NEWBORN (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL PROSOBEE LIPIL (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

ENFAMIL PROSOBEE LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL PROSOBEE SOY (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAMIL PROSOBEE/SENSITIV (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENFAMIL RESTFULL LIPIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ENFAPORT LIPIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ENGERIX-B (Hepatitis B Vaccine (Recombinant) Susp 10 MCG/0.5ML) SUSP 42.31340 04/13/2012 02/19/2013

ENGERIX-B (Hepatitis B Vaccine (Recombinant) Susp 20 MCG/ML) SUSP 52.16550 04/13/2012 02/19/2013

ENLIVE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Enoxaparin Sodium Inj 100 MG/ML SOLN 29.31600 04/11/2014 04/09/2014

Enoxaparin Sodium Inj 120 MG/0.8ML SOLN 41.52000 10/10/2014 10/07/2014

Enoxaparin Sodium Inj 150 MG/ML SOLN 47.56200 10/10/2014 10/07/2014





EFFECTIVE DATE

DATE UPDATED

Enoxaparin Sodium Inj 300 MG/3ML SOLN 66.34000 05/09/2014 05/02/2014




ENSURE (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

ENSURE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

ENSURE BONE HEALTH REVIGO (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE CLEAR (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

ENSURE CLEAR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE CLINICAL STRENGTH (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE COMPLETE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE COMPLETE NUTRITION (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

ENSURE COMPLETE NUTRITION (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE ENLIVE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE HEALTHY MOM (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

ENSURE HEALTHY MOM (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE HIGH CALCIUM (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE HIGH PROTEIN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE IMMUNE HEALTH (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE MUSCLE HEALTH REVI (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE NUTRITION SHAKE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

ENSURE NUTRITION SHAKE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE PLUS HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENSURE PUDDING (Nutritional Supplement Pudding**) PUDG 0.01090 04/28/2005 02/19/2013

ENSURE/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ENUCLENE (Tyloxapol Ophth Soln 0.25%) SOLN 0.52420 04/28/2005 02/19/2013

ENVISION AUTOCODE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ENVISION AUTOCODE TEST ST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EO28 SPLASH (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

EO28 SPLASH (Nutritional Supplement Liquid**) LIQD 0.06930 05/28/2010 02/19/2013

EPILYT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Epinastine HCl Ophth Soln 0.05% SOLN 11.80800 08/09/2013 08/06/2013




EFFECTIVE DATE

DATE UPDATED

Epinephrine HCl Inj 1 MG/ML SOLN 0.68944 02/22/2013 02/19/2013

Eplerenone Tab 25 MG TABS 2.11560 11/03/2014 12/09/2014

Eplerenone Tab 50 MG TABS 2.03500 01/28/2015 03/10/2015

EPOGEN (Epoetin Alfa Inj 10000 Unit/ML) SOLN 169.22040 04/13/2012 02/19/2013





EQL COLOR LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EQL COLOR LANCETS MICRO T (Lancets***) MISC 0.08772 06/17/2011 02/28/2013

EQL MEGA SELECT MENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

EQL MEGA SELECT WOMENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

EQL ONE DAILY DIET SUPPOR (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

EQL ONE DAILY MENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

EQL ONE DAILY MENS 50+ AD (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

EQL PEDIATRIC BALANCED NU (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

EQL PRENATAL FORMULA (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

EQL PROTECTAVISION (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

EQL SUPER THIN LANCETS 30 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EQL THIN LANCETS 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EQL TRUE2GO BLOOD GLUCOSE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

EQL TRUETEST BLOOD GLUCOS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EQL TRUETRACK TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EQUALYTE (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

EQUATE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

EQUATE PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Ergocalciferol Cap 50000 Unit CAPS 0.42332 02/22/2013 02/19/2013

Ergocalciferol Soln 8000 Unit/ML SOLN 1.47885 02/22/2013 02/19/2013

Ergoloid Mesylates Tab 1 MG TABS 0.08730 02/22/2013 02/19/2013

Ergotamine w/ Caffeine Tab 1-100 MG TABS 0.66845 02/22/2013 02/19/2013

ERIVEDGE (Vismodegib Cap 150 MG) CAPS 321.19162 02/03/2015 03/10/2015

ERYTHROCIN STEARATE (Erythromycin Stearate Tab 250 MG) TABS 1.84111 10/29/2012 02/19/2013

Erythromycin Ethylsuccinate Tab 400 MG TABS 0.23450 02/22/2013 02/19/2013

Erythromycin Gel 2% GEL 4.19500 01/22/2015 02/10/2015




EFFECTIVE DATE

DATE UPDATED

Erythromycin Ophth Oint 5 MG/GM OINT 3.68750 02/22/2013 02/19/2013

Erythromycin Pads 2% PADS 1.12000 01/17/2014 02/11/2014

Erythromycin Soln 2% SOLN 0.63534 02/22/2013 02/19/2013

Erythromycin Stearate Tab 250 MG TABS 1.84111 02/22/2013 02/19/2013

Erythromycin w/ Delayed Release Particles Cap 250 MG CPEP 0.18890 02/22/2013 02/19/2013

Erythromycin-Sulfisoxazole For Susp 200-600 MG/5ML SUSR 0.26789 02/26/2014 04/09/2014

Escitalopram Oxalate Soln 5 MG/5ML (Base Equiv) SOLN 0.49376 03/13/2015 03/10/2015

Escitalopram Oxalate Tab 10 MG (Base Equiv) TABS 0.17290 02/22/2013 02/19/2013



ESSENTIAL AMINO ACID MIX (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

Estazolam Tab 1 MG TABS 0.31700 02/22/2013 02/19/2013

Estazolam Tab 2 MG TABS 0.31754 02/22/2013 02/19/2013

Estradiol & Norethindrone Acetate Tab 1-0.5 MG TABS 1.90804 02/22/2013 02/19/2013

Estradiol Tab 0.5 MG TABS 0.09500 02/04/2014 03/12/2014

Estradiol Tab 1 MG TABS 0.14684 12/19/2014 12/17/2014

Estradiol Tab 2 MG TABS 0.15000 01/07/2014 02/11/2014

Estradiol TD Patch Weekly 0.025 MG/24HR PTWK 7.24000 02/22/2013 02/19/2013

Estradiol TD Patch Weekly 0.0375 MG/24HR (37.5 MCG/24HR) PTWK 7.85424 02/22/2013 02/19/2013





Estropipate Tab 0.75 MG TABS 0.31520 10/06/2014 01/06/2015

Estropipate Tab 1.5 MG TABS 0.33000 04/29/2013 06/11/2013

Estropipate Tab 3 MG TABS 0.69500 02/28/2014 03/12/2014

Eszopiclone Tab 1 MG TABS 0.79000 06/13/2014 06/09/2014



Ethambutol HCl Tab 400 MG TABS 1.29700 02/22/2013 02/19/2013

Ethosuximide Cap 250 MG CAPS 1.06562 03/13/2015 03/10/2015

Ethosuximide Soln 250 MG/5ML SOLN 0.30000 03/01/2013 04/09/2013

Ethynodiol Diacetate & Ethinyl Estradiol Tab 1 MG-35 MCG TABS 0.81550 02/22/2013 02/19/2013

Etodolac Cap 200 MG CAPS 1.16103 02/13/2015 02/10/2015




EFFECTIVE DATE

DATE UPDATED

Etodolac Cap 300 MG CAPS 1.34000 02/22/2013 02/19/2013

Etodolac Tab 400 MG TABS 0.90000 10/14/2014 12/09/2014

Etodolac Tab 500 MG TABS 0.98000 10/06/2014 12/09/2014

Etodolac Tab SR 24HR 400 MG TB24 0.62488 02/22/2013 02/19/2013



Etoposide Cap 50 MG CAPS 59.88000 04/22/2013 06/11/2013

EUCERIN (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

EUCERIN DAILY PROTECTION/ (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

EUCERIN ORIGINAL HEALING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

EUCERIN PLUS (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

EVENCARE + BLOOD GLUCOSE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EVENCARE BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EVENCARE G2 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EVENCARE G3 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EVOLUTION AUTOCODE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EXACTECH R-S-G TEST STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EXACTECH TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Exemestane Tab 25 MG TABS 10.35000 06/06/2014 07/09/2014

EXJADE (Deferasirox Tab For Oral Susp 125 MG) TBSO 28.21724 01/06/2015 02/10/2015



EYEAID IRRIGATING SOLUTIO (Ophthalmic Irrigation Solution***) SOLN 0.02410 04/28/2005 02/19/2013

EZ SMART BLOOD GLUCOSE LA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EZ SMART BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EZ SMART PLUS BLOOD GLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

EZ-LETS LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013


EZ-LETS LANCETS 26G SUPER (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

EZ-LETS LANCETS 28G ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013


F.A.A. (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

FABRAZYME (Agalsidase beta For IV Soln 35 MG) SOLR 5215.05600 01/01/2015 01/06/2015

FABRAZYME (Agalsidase beta For IV Soln 5 MG) SOLR 745.00800 01/01/2015 01/06/2015




EFFECTIVE DATE

DATE UPDATED

Famciclovir Tab 125 MG TABS 1.19185 02/22/2013 02/19/2013



Famotidine For Susp 40 MG/5ML SUSR 1.29000 09/13/2013 09/09/2013

Famotidine Tab 10 MG TABS 0.07732 02/22/2013 02/19/2013



FASTTAKE COMPACT MONITORI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FASTTAKE TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FEIBA (Antiinhibitor Coagulant Complex For Inj**) SOLR 1.95050 07/01/2014 07/09/2014

FEIBA NF (Antiinhibitor Coagulant Complex For Inj**) SOLR 1.95050 07/01/2014 07/09/2014

FEIBA VH IMMUNO (Antiinhibitor Coagulant Complex For Inj**) SOLR 1.95050 07/01/2014 07/09/2014

Felbamate Susp 600 MG/5ML SUSP 1.99345 02/14/2014 02/11/2014

Felbamate Tab 600 MG TABS 3.81726 03/13/2015 03/10/2015

Felodipine Tab SR 24HR 10 MG TB24 1.05076 02/22/2013 02/19/2013

Felodipine Tab SR 24HR 2.5 MG TB24 0.65400 02/22/2013 02/19/2013

Felodipine Tab SR 24HR 5 MG TB24 0.62400 02/22/2013 02/19/2013

Fenofibrate Micronized Cap 134 MG CAPS 1.16500 02/22/2013 02/19/2013



Fenofibrate Tab 145 MG TABS 1.75137 02/13/2015 02/10/2015




Fenoprofen Calcium Tab 600 MG TABS 0.24000 02/22/2013 02/19/2013

Fentanyl Citrate Lozenge on a Handle 1200 MCG LPOP 19.50000 06/14/2013 06/10/2013






Fentanyl TD Patch 72HR 100 MCG/HR PT72 12.04502 02/13/2015 02/10/2015






EFFECTIVE DATE

DATE UPDATED



FEOSOL (Ferrous Sulfate Dried Tab 200 MG (65 MG Elemental Fe)) TABS 0.06600 04/28/2005 02/19/2013

FER-IN-SOL (Ferrous Sulfate Soln 75 MG/ML (15 MG/ML Elemental Fe)) SOLN 0.06070 03/13/2008 02/19/2013

FERGON (Ferrous Gluconate Tab 240 MG (27 MG Elemental Fe)) TABS 0.04440 04/28/2005 02/19/2013

FERRIPROX (Deferiprone Tab 500 MG) TABS 41.11878 11/25/2014 01/06/2015

Ferrous Fumarate Tab 325 MG (106 MG Elemental Fe) TABS 0.01810 02/22/2013 02/19/2013

Ferrous Gluconate Tab 225 MG (27 MG Fe Equivalent) TABS 0.03610 02/22/2013 02/19/2013

Ferrous Gluconate Tab 240 MG (27 MG Elemental Fe) TABS 0.04440 02/22/2013 02/19/2013


Ferrous Gluconate Tab 324 MG (37.5 MG Elemental Iron) TABS 0.04460 02/22/2013 02/19/2013

Ferrous Gluconate Tab 324 MG (38 MG Elemental Iron) TABS 0.03727 02/22/2013 02/19/2013


Ferrous Sulfate Dried Tab CR 160 MG (50 MG Fe Equivalent) TBCR 0.12550 02/22/2013 02/19/2013

Ferrous Sulfate Elixir 220 MG/5ML (44 MG/5ML Elemental Fe) ELIX 0.00790 02/22/2013 02/19/2013

Ferrous Sulfate Soln 75 MG/ML (15 MG/ML Elemental Fe) SOLN 0.06070 02/22/2013 02/19/2013

Ferrous Sulfate Syrup 300 MG/5ML (60 MG/5ML Elemental Fe) SYRP 0.06980 02/22/2013 02/19/2013

Ferrous Sulfate Tab 28 MG (Elemental Fe) TABS 0.04120 02/22/2013 02/19/2013

Ferrous Sulfate Tab 325 MG (65 MG Elemental Fe) TABS 0.01586 02/22/2013 02/19/2013

Ferrous Sulfate Tab EC 324 MG (65 MG Fe Equivalent) TBEC 0.03390 02/22/2013 02/19/2013

Ferrous Sulfate Tab EC 325 MG (65 MG Fe Equivalent) TBEC 0.03390 02/22/2013 02/19/2013

Ferrous Sulfate-Vit C-Folic Acid Tab CR 105-500-0.8 MG TBCR 0.06610 02/22/2013 02/19/2013

FEVERALL INFANTS (Acetaminophen Suppos 80 MG) SUPP 0.68255 03/13/2008 02/19/2013

Fexofenadine HCl Tab 180 MG TABS 0.44642 12/19/2014 12/17/2014



FIBER-STAT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

FIBERCON (Calcium Polycarbophil Tab 625 MG) TABS 0.09185 03/13/2008 02/19/2013

FIBERSOURCE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

FIBERSOURCE CLOSED SYSTEM (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

FIBERSOURCE HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

FIBERSOURCE HN CLOSED SYS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

FIFTY50 GLUCOSE METER 2.0 (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FIFTY50 GLUCOSE TEST STRI (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

FIFTY50 SAFETY SEAL LANCE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Finasteride Tab 5 MG TABS 0.26000 11/08/2013 11/05/2013

FINE 30 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

FINGERSTIX LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

FIORICET (Butalbital-Acetaminophen-Caffeine Tab 50-325-40 MG) TABS 0.08870 04/23/2010 02/19/2013

FIRMAGON (Degarelix Acetate For Inj 80 MG (Base Equiv)) SOLR 338.64000 07/30/2010 02/19/2013

FITNESS TABS FOR MEN AM/P (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

FITNESS TABS FOR WOMEN A (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Flavoxate HCl Tab 100 MG TABS 0.85052 02/14/2014 02/11/2014

FLEBOGAMMA (Immune Globulin (Human) IV Soln 10 GM/200ML) SOLN 6.30817 10/01/2014 12/04/2014

FLEBOGAMMA (Immune Globulin (Human) IV Soln 2.5 GM/50ML) SOLN 6.30833 10/01/2014 12/04/2014

FLEBOGAMMA (Immune Globulin (Human) IV Soln 5 GM/100ML) SOLN 6.30817 10/01/2014 12/04/2014

FLEBOGAMMA DIF (Immune Globulin (Human) IV Soln 10 GM/100ML) SOLN 12.94800 01/01/2015 02/10/2015


FLEBOGAMMA DIF (Immune Globulin (Human) IV Soln 2.5 GM/50ML) SOLN 6.30833 10/01/2014 12/04/2014




Flecainide Acetate Tab 100 MG TABS 0.31163 02/22/2013 02/19/2013



FLEET ENEMA (Sodium Phosphates - Enema***) ENEM 0.01138 03/20/2008 02/19/2013

FLEET ENEMA SIX PACK (Sodium Phosphates - Enema***) ENEM 0.01138 03/20/2008 02/19/2013

FLEET MINERAL OIL (Mineral Oil Enema) ENEM 0.01031 03/20/2008 02/19/2013

FLEET OIL (Mineral Oil Enema) ENEM 0.01031 03/20/2008 02/19/2013

FLEET PEDIATRIC (Sodium Phosphates - Enema***) ENEM 0.01832 05/22/2012 02/19/2013

FLOMAX (Tamsulosin HCl Cap 0.4 MG) CAPS 0.21000 07/28/2005 02/19/2013

FLOMAX (Tamsulosin HCl Cap 0.4 MG) CAPS 0.21000 04/23/2010 02/19/2013

Fluconazole For Susp 10 MG/ML SUSR 0.28830 02/22/2013 02/19/2013

Fluconazole For Susp 40 MG/ML SUSR 0.64709 06/13/2014 06/09/2014

Fluconazole Tab 100 MG TABS 1.25000 12/19/2014 12/17/2014







EFFECTIVE DATE

DATE UPDATED

Fludarabine Phosphate For Inj 50 MG SOLR 180.84300 02/22/2013 02/19/2013

Fludarabine Phosphate Inj 25 MG/ML SOLN 178.92550 02/22/2013 02/19/2013

Fludrocortisone Acetate Tab 0.1 MG TABS 0.46520 05/27/2014 07/09/2014

Flunisolide Nasal Soln 25 MCG/ACT (0.025%) SOLN 0.63750 02/22/2013 02/19/2013

Fluocinolone Acetonide (Otic) Oil 0.01% OIL 9.03550 07/11/2014 07/09/2014

Fluocinolone Acetonide Cream 0.01% CREA 1.86366 02/22/2013 02/19/2013

Fluocinolone Acetonide Cream 0.025% CREA 1.37372 02/22/2013 02/19/2013

Fluocinolone Acetonide Oint 0.025% OINT 1.46840 04/17/2013 05/06/2013

Fluocinolone Acetonide Soln 0.01% SOLN 2.38538 06/13/2014 06/09/2014

Fluocinonide Cream 0.05% CREA 2.26000 08/04/2014 09/10/2014

Fluocinonide Emulsified Base Cream 0.05% CREA 1.52000 10/23/2014 11/12/2014

Fluocinonide Gel 0.05% GEL 0.27083 02/22/2013 02/19/2013

Fluocinonide Oint 0.05% OINT 0.73986 01/10/2013 02/20/2013

Fluocinonide Oint 0.05% OINT 0.73986 02/22/2013 02/20/2013

Fluocinonide Soln 0.05% SOLN 1.36000 01/10/2013 02/20/2013

Fluocinonide Soln 0.05% SOLN 1.36000 02/22/2013 02/20/2013

Fluorometholone Ophth Susp 0.1% SUSP 11.68000 12/08/2014 01/06/2015

Fluorouracil Cream 5% CREA 5.64965 02/22/2013 02/19/2013

Fluorouracil Inj 2.5 GM/50ML (50 MG/ML) SOLN 0.27000 02/22/2013 02/19/2013

Fluorouracil Inj 5 GM/100ML (50 MG/ML) SOLN 0.18163 02/22/2013 02/19/2013

Fluorouracil Soln 5% SOLN 9.30360 02/22/2013 02/19/2013

Fluoxetine HCl (PMDD) Cap 10 MG CAPS 0.04061 02/08/2013 02/20/2013

Fluoxetine HCl (PMDD) Cap 20 MG CAPS 0.05359 02/22/2013 02/19/2013

Fluoxetine HCl Cap 10 MG CAPS 0.03342 02/22/2013 02/19/2013



Fluoxetine HCl Cap Delayed Release 90 MG CPDR 25.64925 02/22/2013 02/19/2013

Fluoxetine HCl Solution 20 MG/5ML SOLN 0.04066 02/22/2013 02/19/2013

Fluoxetine HCl Tab 10 MG TABS 0.95400 10/06/2014 11/12/2014

Fluoxetine HCl Tab 20 MG TABS 1.53000 12/08/2014 02/10/2015

Fluphenazine Decanoate Inj 25 MG/ML SOLN 20.10250 11/11/2014 01/06/2015

Fluphenazine HCl Tab 1 MG TABS 0.06561 02/22/2013 02/19/2013


Fluphenazine HCl Tab 2.5 MG TABS 0.07540 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED


Flurazepam HCl Cap 15 MG CAPS 0.07500 02/22/2013 02/19/2013

Flurazepam HCl Cap 30 MG CAPS 0.35156 04/10/2014 05/02/2014

Flurbiprofen Sodium Ophth Soln 0.03% SOLN 1.86816 02/22/2013 02/19/2013

Flurbiprofen Tab 100 MG TABS 0.24380 05/28/2013 07/09/2013

Flurbiprofen Tab 50 MG TABS 0.19500 02/22/2013 02/19/2013

Flutamide Cap 125 MG CAPS 0.53767 06/13/2014 06/09/2014

Fluticasone Propionate Cream 0.05% CREA 0.53442 02/22/2013 02/19/2013

Fluticasone Propionate Nasal Susp 50 MCG/ACT SUSP 0.62314 02/13/2015 02/10/2015

Fluticasone Propionate Oint 0.005% OINT 0.51150 02/22/2013 02/19/2013

Fluvastatin Sodium Cap 20 MG CAPS 3.23686 09/13/2013 09/09/2013

Fluvastatin Sodium Cap 40 MG CAPS 3.23686 09/13/2013 09/09/2013

Fluvoxamine Maleate Tab 100 MG TABS 0.28340 02/22/2013 02/19/2013



Folic Acid Tab 1 MG TABS 0.02970 02/22/2013 02/19/2013

Folic Acid Tab 400 MCG TABS 0.01810 02/22/2013 02/19/2013

Folic Acid Tab 800 MCG TABS 0.02039 02/22/2013 02/19/2013

Folic Acid-Vit B6-Vit B12-Omega 3-Phytosterols Cap 1 MG*** CAPS 0.99840 02/22/2013 02/19/2013

Folic Acid-Vitamin B6-Vitamin B12 Tab 2.2-25-1 MG TABS 0.21409 02/22/2013 02/19/2013

FOLLOW-UP (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

FOLLOW-UP SOY (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

FOLLOW-UP W/FE (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

FOLLOW-UP W/FE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

FOLLOW-UP W/FE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Fondaparinux Sodium Inj 10 MG/0.8ML SOLN 84.68594 02/22/2013 02/19/2013

Fondaparinux Sodium Inj 2.5 MG/0.5ML SOLN 48.55750 02/22/2013 02/19/2013

Fondaparinux Sodium Inj 5 MG/0.4ML SOLN 257.34000 02/22/2013 02/19/2013

Fondaparinux Sodium Inj 7.5 MG/0.6ML SOLN 125.12000 02/22/2013 02/19/2013

FORA D10 BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA D15C BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA D15G BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA D15Z BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA D20 BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

FORA G20 BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FORA G20 BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA G30A BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA G71A BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FORA G71A BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA G90 BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA GD20 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORA LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

FORA V10 BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013



FORA V22 BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013


FORA V30A BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FORA V30A BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORACARE GD40 (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORACARE PREMIUM V10 TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

FORMULA 405 BODY SMOOTHIN (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

FORMULA 405 MOISTURIZING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

FORTA DRINK (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

FORTA SHAKE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

FORTAVIT (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

FORTAVIT (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

FORTEO (Teriparatide (Recombinant) Inj 600 MCG/2.4ML) SOLN 729.65300 12/04/2014 01/06/2015

FORTICAL (Calcitonin (Salmon) Nasal Soln 200 Unit/ACT) SOLN 13.82000 09/27/2007 02/19/2013

FOSFREE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

FOSGLUTEN REFORZADO (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Fosinopril Sodium & Hydrochlorothiazide Tab 10-12.5 MG TABS 0.88800 02/22/2013 02/19/2013

Fosinopril Sodium & Hydrochlorothiazide Tab 20-12.5 MG TABS 0.88800 02/22/2013 02/19/2013

Fosinopril Sodium Tab 10 MG TABS 0.16918 02/22/2013 02/19/2013



FRAGMIN (Dalteparin Sodium Inj 10000 Unit/ML) SOLN 64.25860 04/13/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

FRAGMIN (Dalteparin Sodium Inj 12500 Unit/0.5ML) SOLN 160.63820 04/13/2012 02/19/2013




FRAGMIN (Dalteparin Sodium Inj 25000 Unit/ML) SOLN 145.34174 04/13/2012 02/19/2013



FREEDAVITE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

FREESTYLE FREEDOM (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FREESTYLE FREEDOM LITE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FREESTYLE FREEDOM LITE (Blood Glucose Monitoring Kit w/ Device***) KIT 15.30000 07/01/2010 02/19/2013

FREESTYLE INSULINX BLOOD (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FREESTYLE INSULINX BLOOD (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013



FREESTYLE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

FREESTYLE LITE TEST STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013



FREESTYLE SIDEKICK II VAL (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

FREESTYLE TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013



FREESTYLE UNISTICK II LAN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

FULL SPECTRUM B/VITAMIN C (B-Complex w/ C & Folic Acid Tab 0.8 MG***) TABS 0.08400 03/13/2008 02/19/2013

Furosemide Inj 10 MG/ML SOLN 0.07410 02/22/2013 02/19/2013

Furosemide Oral Soln 10 MG/ML SOLN 0.07735 02/22/2013 02/19/2013

Furosemide Tab 20 MG TABS 0.01761 02/22/2013 02/19/2013



FUZEON (Enfuvirtide For Inj Kit 90 MG) KIT 2777.33770 01/03/2013 02/20/2013

GA (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

GA DIET (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

GA EXPRESS15 (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

GA GEL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

Gabapentin Cap 100 MG CAPS 0.05249 02/22/2013 02/19/2013



Gabapentin Oral Soln 250 MG/5ML SOLN 0.08995 03/13/2015 03/10/2015

Gabapentin Tab 600 MG TABS 0.21399 03/14/2014 03/12/2014

Gabapentin Tab 800 MG TABS 0.92500 01/20/2015 02/10/2015

Galantamine Hydrobromide Cap SR 24HR 16 MG CP24 2.57000 02/22/2013 02/19/2013



Galantamine Hydrobromide Tab 12 MG TABS 1.87400 02/22/2013 02/19/2013



Gamma-Aminobutyric Acid Oral Powder POWD 0.06700 02/22/2013 02/19/2013

GAMMAGARD LIQUID (Immune Globulin (Human) IV or Subcutaneous Soln 1 GM/10ML) SOLN 12.39107 01/01/2014 01/22/2014


GAMMAGARD LIQUID (Immune Globulin (Human) IV or Subcutaneous Soln 2.5 GM/25ML) SOLN 10.11770 01/01/2014 01/22/2014




GAMMAGARD S/D (Immune Globulin (Human) IV For Soln 10 GM) SOLR 1578.95880 01/01/2015 02/10/2015

GAMMAGARD S/D (Immune Globulin (Human) IV For Soln 2.5 GM) SOLR 187.50000 05/01/2005 02/19/2013

GAMMAGARD S/D (Immune Globulin (Human) IV For Soln 5 GM) SOLR 789.47940 01/01/2015 02/10/2015

GAMMAGARD S/D IGA LESS TH (Immune Globulin (Human) IV For Soln 10 GM) SOLR 1578.95880 01/01/2015 02/10/2015

GAMMAGARD S/D IGA LESS TH (Immune Globulin (Human) IV For Soln 5 GM) SOLR 789.47940 01/01/2015 02/10/2015

GAMMAKED (Immune Globulin (Human) IV or Subcutaneous Soln 1 GM/10ML) SOLN 12.39107 01/01/2014 01/22/2014


GAMMAKED (Immune Globulin (Human) IV or Subcutaneous Soln 2.5 GM/25ML) SOLN 10.11770 01/01/2014 01/22/2014



GAMMAPLEX (Immune Globulin (Human) IV Soln 10 GM/200ML) SOLN 6.30817 10/01/2014 12/04/2014




EFFECTIVE DATE

DATE UPDATED

GAMMAPLEX (Immune Globulin (Human) IV Soln 2.5 GM/50ML) SOLN 6.30833 10/01/2014 12/04/2014

GAMMAPLEX (Immune Globulin (Human) IV Soln 5 GM/100ML) SOLN 6.30817 10/01/2014 12/04/2014

GAMUNEX (Immune Globulin (Human) IV Soln 1 GM/10ML) SOLN 7.50000 04/01/2005 02/19/2013


GAMUNEX (Immune Globulin (Human) IV Soln 2.5 GM/25ML) SOLN 7.50000 04/01/2005 02/19/2013



GAMUNEX-C (Immune Globulin (Human) IV or Subcutaneous Soln 1 GM/10ML) SOLN 12.39107 01/01/2014 01/22/2014


GAMUNEX-C (Immune Globulin (Human) IV or Subcutaneous Soln 2.5 GM/25ML) SOLN 10.11770 01/01/2014 01/22/2014



GAS-X (Simethicone Chew Tab 80 MG) CHEW 0.04539 03/20/2008 02/19/2013

GAS-X EXTRA STRENGTH (Simethicone Chew Tab 125 MG) CHEW 0.07284 03/20/2008 02/19/2013

GAZYVA (Obinutuzumab Soln for IV Infusion 1000 MG/40ML (25 MG/ML)) SOLN 128.48400 03/14/2014 03/12/2014

GEL-KAM (Stannous Fluoride Gel 0.4%) GEL 0.06033 03/20/2008 02/19/2013

Gemcitabine HCl For Inj 1 GM SOLR 371.23000 02/22/2013 02/19/2013

Gemcitabine HCl For Inj 200 MG SOLR 74.85000 02/22/2013 02/19/2013

Gemfibrozil Tab 600 MG TABS 0.14453 02/22/2013 02/19/2013

GENOTROPIN (Somatropin For Inj 12 MG (13.8 MG Overfill)) SOLR 1151.69140 01/01/2015 02/10/2015

GENOTROPIN (Somatropin For Subcutaneous Inj 5 MG) SOLR 479.86450 01/01/2015 02/10/2015

GENOTROPIN MINIQUICK (Somatropin For Inj 0.2 MG) SOLR 20.92074 01/01/2015 02/10/2015




GENOTROPIN MINIQUICK (Somatropin For Inj 1 MG) SOLR 104.61083 01/01/2015 02/10/2015





GENOTROPIN MINIQUICK (Somatropin For Inj 2 MG) SOLR 209.21573 01/01/2015 02/10/2015

Gentamicin Sulfate Cream 0.1% CREA 1.75000 03/15/2014 04/09/2014

Gentamicin Sulfate Oint 0.1% OINT 1.69500 02/12/2014 03/12/2014




EFFECTIVE DATE

DATE UPDATED

Gentamicin Sulfate Ophth Oint 0.3% OINT 4.44000 12/27/2013 01/08/2014

Gentamicin Sulfate Ophth Soln 0.3% SOLN 1.52250 02/22/2013 02/19/2013

GENTEAL MILD (Hypromellose Ophth Soln 0.2%) SOLN 0.40982 03/13/2008 02/19/2013

GENTLE-LET GP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GENTLE-LET LANCETS GENERA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GENTLE-LET LANCETS SAFETY (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GERBER GOOD START 2 GENTL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START 2 PROTE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START 2 SOY/I (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START GENTLE/ (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GERBER GOOD START GENTLE/ (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GERBER GOOD START GENTLE/ (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START NOURISH (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GERBER GOOD START NOURISH (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START PREMATU (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GERBER GOOD START PROTECT (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START SOOTHE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERBER GOOD START SOY/IRO (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GERBER GOOD START SOY/IRO (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GERBER GOOD START SOY/IRO (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GERI PROTECT (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

GERI-FREEDA SENIOR FORMUL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

GERI-SOFT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GERITOL EXTEND (Multiple Vitamins w/ Iron Tab**) TABS 0.04080 03/20/2008 02/19/2013

GILENYA (Fingolimod HCl Cap 0.5 MG (Base Equiv)) CAPS 181.78067 11/14/2014 02/10/2015

GILOTRIF (Afatinib Dimaleate Tab 20 MG (Base Equivalent)) TABS 214.92076 12/19/2014 02/10/2015



GLASSIA (Alpha1-Proteinase Inhibitor (Human) Inj 1000 MG/50ML) SOLN 0.45650 01/28/2011 02/19/2013

GLEEVEC (Imatinib Mesylate Tab 100 MG (Base Equivalent)) TABS 84.86234 01/06/2015 02/10/2015

GLEEVEC (Imatinib Mesylate Tab 400 MG (Base Equivalent)) TABS 305.79136 01/06/2015 02/10/2015

GLIADEL WAFER (Carmustine in Polifeprosan Intracranial Implant Wafer 7.7 MG) WAFR 3150.97050 07/30/2010 02/19/2013

Glimepiride Tab 1 MG TABS 0.03007 02/22/2013 02/19/2013





EFFECTIVE DATE

DATE UPDATED


Glipizide Tab 10 MG TABS 0.04253 02/22/2013 02/19/2013

Glipizide Tab 5 MG TABS 0.02961 02/22/2013 02/19/2013

Glipizide Tab SR 24HR 10 MG TB24 0.36545 02/22/2013 02/19/2013

Glipizide Tab SR 24HR 2.5 MG TB24 0.18000 02/22/2013 02/19/2013

Glipizide Tab SR 24HR 5 MG TB24 0.18975 02/22/2013 02/19/2013

Glipizide-Metformin HCl Tab 2.5-250 MG TABS 0.57260 02/22/2013 02/19/2013

Glipizide-Metformin HCl Tab 2.5-500 MG TABS 0.52025 02/22/2013 02/19/2013

Glipizide-Metformin HCl Tab 5-500 MG TABS 0.67150 02/22/2013 02/19/2013

GLOBAL INJECT EASE LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GLUCERNA (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

GLUCERNA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA 1.0 CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA 1.0 CAL/FIBER (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

GLUCERNA 1.0 CAL/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013





GLUCERNA CRISPY DELIGHTS (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

GLUCERNA HUNGER SMART SHA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA MEAL (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

GLUCERNA MEAL REPLACEMENT (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

GLUCERNA MINI SNACK (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

GLUCERNA OS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA SELECT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA SHAKE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

GLUCERNA SHAKE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA SNACK (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

GLUCERNA SNACK SHAKE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCERNA WEIGHT LOSS SHAK (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCO BURST (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GLUCO PERFECT 3 TEST STRI (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/28/2013

GLUCOCARD 01 BLOOD GLUCOS (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013




EFFECTIVE DATE

DATE UPDATED

GLUCOCARD 01 SENSOR (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUCOCARD 01 TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUCOCARD 01-MINI BLOOD G (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

GLUCOCARD EXPRESSION AUDI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

GLUCOCARD EXPRESSION BLOO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUCOCARD VITAL BLOOD GLU (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

GLUCOCARD VITAL TEST STRI (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUCOCARD X-METER (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

GLUCOCARD X-SENSOR (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUCOCOM BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

GLUCOCOM LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013



GLUCOCOM TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUCOLAB TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Glucosamine Sulfate Cap 500 MG CAPS 0.13817 02/22/2013 02/19/2013

Glucosamine Sulfate Cap 750 MG CAPS 0.10633 02/22/2013 02/19/2013

Glucosamine Sulfate Tab 750 MG TABS 0.36520 06/04/2014 07/09/2014

Glucosamine-Chondroitin Cap 500-400 MG CAPS 0.17500 02/22/2013 02/19/2013

Glucosamine-Chondroitin Tab 500-400 MG TABS 0.17500 02/22/2013 02/19/2013

Glucosamine-Chondroitin Tab 750-600 MG TABS 0.18410 02/22/2013 02/19/2013

Glucosamine-Chondroitin-Vit C-Manganese Cap*** CAPS 0.15500 02/22/2013 02/19/2013

Glucosamine-Chondroitin-Vit C-Manganese Tab*** TABS 0.18410 02/22/2013 02/19/2013

Glucose Blood Test Strip STRP 0.74500 02/22/2013 02/19/2013

Glucose Gel 40% GEL 0.08970 02/22/2013 02/19/2013

GLUCOSOURCE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GLUCOSTIX (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

GLUTARADE AMINO ACID BLEN (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

GLUTARADE JUNIOR GA-1 (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

GLUTAREX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

GLUTAREX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Glyburide Micronized Tab 1.5 MG TABS 0.03659 02/22/2013 02/19/2013

Glyburide Micronized Tab 3 MG TABS 0.03081 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Glyburide Micronized Tab 6 MG TABS 0.05788 02/22/2013 02/19/2013

Glyburide Tab 1.25 MG TABS 0.09620 02/22/2013 02/19/2013

Glyburide Tab 2.5 MG TABS 0.15068 02/22/2013 02/19/2013

Glyburide Tab 5 MG TABS 0.22667 02/22/2013 02/19/2013

Glyburide-Metformin Tab 1.25-250 MG TABS 0.02988 02/22/2013 02/19/2013

Glyburide-Metformin Tab 2.5-500 MG TABS 0.07485 02/22/2013 02/19/2013

Glyburide-Metformin Tab 5-500 MG TABS 0.07738 02/22/2013 02/19/2013

Glycerin Suppos 1.2 GM SUPP 0.07360 02/22/2013 02/19/2013

Glycerin Suppos 2 GM SUPP 0.04980 02/22/2013 02/19/2013

Glycerin Suppos 2.1 GM SUPP 0.04980 02/22/2013 02/19/2013

Glycerin Suppos 80.7% SUPP 0.04980 02/22/2013 02/19/2013

Glycopyrrolate Inj 0.2 MG/ML SOLN 1.35929 02/22/2013 02/19/2013

Glycopyrrolate Tab 1 MG TABS 0.47665 03/13/2015 03/10/2015

Glycopyrrolate Tab 2 MG TABS 0.54413 02/22/2013 02/19/2013

GLYCOSADE (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

GLYTACTIN BETTERMILK 15 (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

GLYTROL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

GNP ADVANCED RECOVERY (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GNP DAIRY-RELIEF (Lactase Chew Tab 3000 Unit) CHEW 0.11500 03/20/2008 02/19/2013

GNP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP LANCETS MICRO THIN 33 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP LANCETS SUPER THIN 30 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP LANCETS THIN 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP MICRO THIN LANCETS 33 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GNP MINERAL OIL HEAVY (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

GNP PRENATAL VITAMINS (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

GNP SUPER THIN LANCETS/30 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

GOLD BOND MEDICATED BODY (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GOLD BOND ULTIMATE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GOLD BOND ULTIMATE HEALIN (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

GOLD BOND ULTIMATE PROTEC (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GOLD BOND ULTIMATE RESTOR (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

GOLD BOND ULTIMATE SHEER (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GOLD BOND ULTIMATE SOFTEN (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GOLD BOND ULTIMATE SOOTHI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

GOOD START (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START 2 ESSENTIALS S (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START 2 ESSENTIALS W (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START 2 ESSENTIALS W (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START 2 ESSENTIALS W (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START 2 SUPREME W/IR (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START 2 SUPREME W/IR (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START 2 SUPREME W/IR (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START ESSENTIALS SOY (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START ESSENTIALS SOY (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START ESSENTIALS SOY (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START ESSENTIALS W/I (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START GENTLE PLUS (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START GENTLE PLUS (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START SOY PLUS 2 (Infant Foods Powder**) POWD 0.04650 04/23/2010 02/19/2013

GOOD START SUPREME DHA/AR (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START SUPREME NATURA (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START SUPREME SOY/IR (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START SUPREME SOY/IR (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START SUPREME SOY/IR (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START SUPREME W/IRON (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START SUPREME W/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START SUPREME W/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

GOOD START W/FE (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

GOOD START W/FE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

GOOD START W/FE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Granisetron HCl Tab 1 MG TABS 6.69100 06/14/2013 06/10/2013

Griseofulvin Microsize Susp 125 MG/5ML SUSP 0.12137 02/22/2013 02/19/2013

Griseofulvin Ultramicrosize Tab 250 MG TABS 5.17000 08/09/2013 08/06/2013

GRX VITAMIN E (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Guaifenesin Liquid 100 MG/5ML LIQD 0.00585 02/22/2013 02/19/2013

Guaifenesin Liquid 100 MG/5ML SOLN 0.00585 02/22/2013 02/19/2013

Guaifenesin Syrup 100 MG/5ML SYRP 0.00585 02/22/2013 02/19/2013

Guaifenesin-Codeine Soln 100-10 MG/5ML LIQD 0.01088 02/22/2013 02/19/2013

Guaifenesin-Codeine Soln 100-10 MG/5ML SOLN 0.01088 02/22/2013 02/19/2013

Guaifenesin-Codeine Soln 100-10 MG/5ML SYRP 0.01088 02/22/2013 02/19/2013

Guanfacine HCl Tab 1 MG TABS 0.08270 02/22/2013 02/19/2013

Guanfacine HCl Tab 2 MG TABS 0.12560 02/22/2013 02/19/2013

GUARDIAN REAL-TIME STARTE (Continuous Blood Glucose Monitor/Components Kit***) KIT 0.71000 10/01/2003 02/19/2013

GYNE-LOTRIMIN (Clotrimazole Vaginal Cream 1%) CREA 0.14028 03/13/2008 02/19/2013

GYNE-LOTRIMIN 3 (Clotrimazole Vaginal Cream 2%) CREA 0.35240 03/13/2008 02/19/2013

H&H THINLET LANCETS 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

H&H THINLET SUPER THIN LA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

H-E-B INCONTROL LANCETS S (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

H-E-B INCONTROL LANCETS U (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

H.P. ACTHAR (Corticotropin Inj Gel 80 Unit/ML) GEL 6426.19200 12/16/2014 01/06/2015

HAEMOLANCE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAEMOLANCE LOW FLOW LANCE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAEMOLANCE PLUS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAEMOLANCE PLUS HIGH FLOW (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAEMOLANCE PLUS LOW FLOW (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAEMOLANCE PLUS MAX FLOW (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAEMOLANCE PLUS PEDIATRIC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HAIR-VITES (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Halobetasol Propionate Cream 0.05% CREA 4.05000 07/11/2013 09/09/2013

Halobetasol Propionate Oint 0.05% OINT 4.03000 08/15/2013 09/09/2013

Haloperidol Decanoate IM Soln 100 MG/ML SOLN 41.34240 02/22/2013 02/19/2013

Haloperidol Decanoate IM Soln 50 MG/ML SOLN 22.55000 02/22/2013 02/19/2013

Haloperidol Lactate Inj 5 MG/ML SOLN 1.43000 02/22/2013 02/19/2013

Haloperidol Lactate Oral Conc 2 MG/ML CONC 0.32150 02/11/2015 03/10/2015

Haloperidol Tab 0.5 MG TABS 0.27000 01/06/2014 03/12/2014

Haloperidol Tab 1 MG TABS 0.39500 02/03/2014 03/12/2014






EFFECTIVE DATE

DATE UPDATED



HARVONI (Ledipasvir-Sofosbuvir Tab 90-400 MG) TABS 1120.50000 01/09/2015 01/06/2015

HCU COOLER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

HCU COOLER (Nutritional Supplement Liquid**) LIQD 0.06928 10/03/2008 02/19/2013

HCU EXPRESS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

HCU GEL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

HCY 1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HCY 1 DIET (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HCY 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HEALTH SOURCE SOY PROTEIN (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HEALTHWISE LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HEALTHY ACCENTS NUTRA FIT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

HEALTHY ACCENTS UNILET LA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HEARTBAR (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

HELIXATE FS (Antihemophilic Factor (Recombinant) For Inj Kit 1000 Unit) KIT 0.88000 08/26/2011 02/19/2013





HEMOCYTE (Ferrous Fumarate Tab 325 MG (106 MG Elemental Fe)) TABS 0.17490 04/28/2005 02/19/2013

HEMOFIL M (Antihemophilic Factor (Human) For Inj 1501-2000 Unit) SOLR 0.74460 06/26/2009 02/19/2013




Heparin Sodium (Porcine) Inj 10000 Unit/ML SOLN 4.40804 02/22/2013 02/19/2013

Heparin Sodium (Porcine) Inj 5000 Unit/ML SOLN 1.88800 12/13/2013 12/06/2013

Heparin Sodium (Porcine) Lock Flush IV Soln 10 Unit/ML SOLN 0.02990 12/25/2009 02/19/2013




HEPSERA (Adefovir Dipivoxil Tab 10 MG) TABS 38.45612 01/01/2015 02/10/2015

HERCEPTIN (Trastuzumab For IV Soln 440 MG) SOLR 3702.04070 01/05/2015 02/10/2015

HI-CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

HIBICLENS (Chlorhexidine Gluconate Liquid 4%) LIQD 0.01798 03/13/2008 02/19/2013

HIZENTRA (Immune Globulin (Human) Subcutaneous Inj 1 GM/5ML) SOLN 30.07920 10/10/2014 11/12/2014



HM COMPLETE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HM COMPLETE 50+ MENS ULTI (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HM COMPLETE 50+ WOMENS UL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HM HAIR/SKIN/NAILS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HM LANCETS MICRO THIN 33G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HM LANCETS ULTRA THIN 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HM MINERAL OIL (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

HM ONE DAILY MENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HM ONE DAILY WOMENS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HOM 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HOMINEX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HOMINEX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

HONEY BEARS (Pediatric Vitamin Chew Tab**) CHEW 0.01450 01/01/1988 02/19/2013

HONEY BEARS W/IRON AND ZI (Pediatric Multiple Vitamins w/ Iron Chew Tab**) CHEW 0.01450 01/01/1988 02/19/2013

HUMATE-P (Antihemophilic Factor/VWF (Human) For Inj 1000-2400 Unit) SOLR 0.80000 12/24/2010 02/19/2013



HUMATROPE (Somatropin For Inj 12 MG (36 Unit)) SOLR 1148.23030 11/25/2014 01/06/2015

HUMATROPE (Somatropin For Inj 24 MG) SOLR 2296.46060 11/25/2014 01/06/2015

HUMATROPE (Somatropin For Inj 5 MG) SOLR 478.42860 11/25/2014 01/06/2015

HUMATROPE (Somatropin For Inj 6 MG (18 Unit)) SOLR 574.11100 11/25/2014 01/06/2015

HUMATROPE COMBO PACK (Somatropin For Inj 5 MG) SOLR 478.42860 11/25/2014 01/06/2015

HUMIRA (Adalimumab Inj Kit 40 MG/0.8ML (50 MG/ML)) KIT 1450.99350 11/14/2014 12/09/2014

HUMIRA PEDIATRIC CROHNS D (Adalimumab Inj Kit 40 MG/0.8ML (50 MG/ML)) KIT 1450.99350 11/14/2014 12/09/2014

HUMIRA PEN (Adalimumab Inj Kit 40 MG/0.8ML (50 MG/ML)) KIT 1450.99350 11/14/2014 12/09/2014

HUMIRA PEN-CROHNS DISEASE (Adalimumab Inj Kit 40 MG/0.8ML (50 MG/ML)) KIT 1450.99350 11/14/2014 12/09/2014

HUMIRA PEN-PSORIASIS STAR (Adalimumab Inj Kit 40 MG/0.8ML (50 MG/ML)) KIT 1450.99350 11/14/2014 12/09/2014

HY-VEE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

HY-VEE THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

HYALEX (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

HYCAMTIN (Topotecan HCl For Inj 4 MG) SOLR 1119.29650 04/13/2012 02/19/2013

Hydralazine HCl Tab 10 MG TABS 0.12265 02/22/2013 02/19/2013




HYDRISINOL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Hydrochlorothiazide Cap 12.5 MG CAPS 0.04878 02/22/2013 02/19/2013

Hydrochlorothiazide Tab 12.5 MG TABS 0.19400 02/22/2013 02/19/2013

Hydrochlorothiazide Tab 25 MG TABS 0.01430 02/22/2013 02/19/2013

Hydrochlorothiazide Tab 50 MG TABS 0.02834 02/22/2013 02/19/2013

Hydrocodone w/ Homatropine Syrup 5-1.5 MG/5ML SYRP 0.02800 02/22/2013 02/19/2013

Hydrocodone-Acetaminophen Soln 7.5-325 MG/15ML SOLN 0.26500 12/18/2014 01/06/2015

Hydrocodone-Acetaminophen Soln 7.5-500 MG/15ML SOLN 0.02637 02/22/2013 02/19/2013

Hydrocodone-Acetaminophen Tab 10-325 MG TABS 0.27520 11/10/2014 01/06/2015





Hydrocodone-Acetaminophen Tab 7.5-300 MG TABS 1.53889 08/09/2013 08/06/2013

Hydrocodone-Acetaminophen Tab 7.5-325 MG TABS 0.36520 11/24/2014 01/06/2015

Hydrocodone-Ibuprofen Tab 7.5-200 MG TABS 0.26042 02/22/2013 02/19/2013

Hydrocortisone Acetate Lotion 2% LOTN 1.10782 02/22/2013 02/19/2013

Hydrocortisone Acetate Powder POWD 0.94640 02/22/2013 02/19/2013

Hydrocortisone Acetate Suppos 30 MG SUPP 2.27500 02/22/2013 02/19/2013

Hydrocortisone Butyrate Cream 0.1% CREA 0.83635 02/22/2013 02/19/2013

Hydrocortisone Butyrate Oint 0.1% OINT 2.20000 05/02/2014 06/09/2014

Hydrocortisone Butyrate Soln 0.1% SOLN 2.89250 12/03/2014 03/10/2015

Hydrocortisone Cream 0.5% CREA 0.05350 02/22/2013 02/19/2013

Hydrocortisone Cream 1% CREA 0.22095 05/02/2014 06/09/2014

Hydrocortisone Cream 2.5% CREA 0.09989 02/22/2013 02/19/2013

Hydrocortisone Enema 100 MG/60ML ENEM 0.06518 02/22/2013 02/19/2013

Hydrocortisone Lotion 1% LOTN 0.05600 02/22/2013 02/19/2013

Hydrocortisone Lotion 2.5% LOTN 0.26360 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Hydrocortisone Oint 0.5% OINT 0.06780 02/22/2013 02/19/2013

Hydrocortisone Oint 1% OINT 0.04185 02/22/2013 02/19/2013

Hydrocortisone Oint 2.5% OINT 0.10022 02/22/2013 02/19/2013

Hydrocortisone Powder POWD 0.93600 02/22/2013 02/19/2013

Hydrocortisone Rectal Cream 1% CREA 0.06791 02/22/2013 02/19/2013

Hydrocortisone Rectal Cream 2.5% CREA 2.37000 11/16/2014 01/06/2015

Hydrocortisone Tab 10 MG TABS 0.44475 02/22/2013 02/19/2013



Hydrocortisone Valerate Cream 0.2% CREA 1.69500 06/11/2014 07/09/2014





Hydrocortisone Valerate Oint 0.2% OINT 2.49000 02/22/2013 02/20/2013



Hydrocortisone w/ Acetic Acid Otic Soln 1-2% SOLN 11.33520 07/12/2013 07/08/2013

Hydrocortisone-Aloe Vera Cream 0.5% CREA 0.06600 02/22/2013 02/19/2013

Hydrocortisone-Aloe Vera Cream 1% CREA 0.07497 02/22/2013 02/19/2013

Hydromorphone HCl Inj 10 MG/ML SOLN 1.80960 02/22/2013 02/19/2013

Hydromorphone HCl Inj 2 MG/ML SOLN 0.44720 02/22/2013 02/19/2013

Hydromorphone HCl Preservative Free (PF) Inj 10 MG/ML SOLN 1.80960 02/22/2013 02/19/2013

Hydromorphone HCl Preservative Free (PF) Inj 2 MG/ML SOLN 0.44720 02/22/2013 02/19/2013

Hydromorphone HCl Tab 2 MG TABS 0.18000 02/22/2013 02/20/2013



Hydroxychloroquine Sulfate Tab 200 MG TABS 2.42520 12/02/2014 01/06/2015

Hydroxyprogesterone Caproate (Bulk) Powder POWD 10.45800 02/22/2013 02/19/2013

Hydroxyurea Cap 500 MG CAPS 0.38750 02/22/2013 02/19/2013

Hydroxyzine HCl IM Soln 50 MG/ML SOLN 1.10500 02/22/2013 02/19/2013

Hydroxyzine HCl Syrup 10 MG/5ML SOLN 0.06910 02/22/2013 02/19/2013

Hydroxyzine HCl Syrup 10 MG/5ML SYRP 0.06910 02/22/2013 02/19/2013

Hydroxyzine HCl Tab 10 MG TABS 0.09194 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED



Hydroxyzine Pamoate Cap 100 MG CAPS 0.30388 02/22/2013 02/19/2013



Hyoscyamine Sulfate Elixir 0.125 MG/5ML ELIX 0.08078 02/22/2013 02/19/2013

Hyoscyamine Sulfate Soln 0.125 MG/ML SOLN 1.16667 04/11/2014 04/09/2014

Hyoscyamine Sulfate Tab 0.125 MG TABS 0.25920 03/13/2015 03/10/2015

Hyoscyamine Sulfate Tab Disp 0.125 MG TBDP 0.45500 02/22/2013 02/19/2013

Hyoscyamine Sulfate Tab SL 0.125 MG SUBL 0.15657 07/11/2014 07/09/2014

Hyoscyamine Sulfate Tab SR 12HR 0.375 MG TB12 0.74818 02/22/2013 02/19/2013

HYPERRHO S/D (Rho D Immune Globulin (Human) IM Inj 300 MCG) INJ 104.69620 06/19/2014 07/09/2014

Hypromellose Ophth Soln 0.3% SOLN 0.40323 02/22/2013 02/19/2013

Hypromellose Ophth Soln 0.4% SOLN 0.23859 02/22/2013 02/19/2013

I-VALEX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

I-VALEX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Ibandronate Sodium Tab 150 MG (Base Equivalent) TABS 39.38833 06/13/2014 06/09/2014

IBG STAR BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

Ibuprofen Chew Tab 100 MG CHEW 0.14630 02/22/2013 02/19/2013

Ibuprofen Susp 100 MG/5ML SUSP 0.05000 11/20/2013 12/06/2013

Ibuprofen Susp 40 MG/ML SUSP 0.24630 02/22/2013 02/19/2013

Ibuprofen Tab 200 MG TABS 0.04200 02/01/2014 03/12/2014




ICAPS AREDS FORMULA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ICAPS PLUS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

IMBRUVICA (Ibrutinib Cap 140 MG) CAPS 97.09894 09/08/2014 11/12/2014

Imipramine HCl Tab 10 MG TABS 0.12187 02/22/2013 02/19/2013



Imiquimod Cream 5% CREA 10.09180 07/11/2014 07/09/2014

IMMULIFE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

IMMUNOPRO RX (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

IMOVAX RABIES (H.D.C.V.) (Rabies Virus Vaccine, HDC Inj) INJ 236.06000 06/28/2013 07/09/2013

IMPACT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

IMPACT 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

IMPACT ADVANCED RECOVERY (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

IMPACT GLUTAMINE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

IMPACT PEPTIDE 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

IMPACT/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

IMPACT/FIBER (Nutritional Supplement Liquid**) LIQD 0.01420 05/28/2010 02/19/2013

IMUPLUS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

INATAL ADVANCE (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

INATAL GT (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

INATAL ULTRA (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

INCIVEK (Telaprevir Tab 375 MG) TABS 130.73400 08/01/2013 09/09/2013

INCRELEX (Mecasermin Inj 40 MG/4ML (10 MG/ML)) SOLN 662.98740 05/30/2014 07/09/2014

Indapamide Tab 1.25 MG TABS 0.03313 02/22/2013 02/19/2013

Indapamide Tab 2.5 MG TABS 0.36520 10/27/2014 12/09/2014

INDERAL LA (Propranolol HCl Cap SR 24HR 80 MG) CP24 0.77360 04/23/2010 02/19/2013

Indomethacin Cap 25 MG CAPS 0.14690 02/22/2013 02/19/2013

Indomethacin Cap 50 MG CAPS 0.17945 02/22/2013 02/19/2013

Indomethacin Cap CR 75 MG CPCR 1.56000 05/09/2014 05/02/2014

Infant Foods Liquid** LIQD 0.01680 02/22/2013 02/19/2013

INFINITY BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

INFINITY BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

INLYTA (Axitinib Tab 1 MG) TABS 59.88113 01/01/2015 02/10/2015

INLYTA (Axitinib Tab 5 MG) TABS 179.64340 01/01/2015 02/10/2015

INTROLITE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

INVEGA SUSTENNA (Paliperidone Palmitate IM Extend-Release Susp 117 MG/0.75ML) SUSP 1284.22026 01/06/2015 02/10/2015

INVEGA SUSTENNA (Paliperidone Palmitate IM Extended-Release Susp 156 MG/ML) SUSP 1284.25900 01/06/2015 02/10/2015

INVEGA SUSTENNA (Paliperidone Palmitate IM Extended-Release Susp 234 MG/1.5ML) SUSP 1284.23686 01/06/2015 02/10/2015



Iodoquinol-HC Cream 1% CREA 0.76673 02/22/2013 02/19/2013

Ipratropium Bromide Inhal Soln 0.02% SOLN 0.06850 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Ipratropium Bromide Nasal Soln 0.03% (21 MCG/SPRAY) SOLN 0.71000 01/29/2014 02/11/2014

Ipratropium Bromide Nasal Soln 0.06% (42 MCG/SPRAY) SOLN 1.25600 08/28/2014 11/12/2014

Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML SOLN 0.10750 02/22/2013 02/19/2013

Irbesartan Tab 150 MG TABS 0.35000 02/22/2013 02/19/2013



Irbesartan-Hydrochlorothiazide Tab 150-12.5 MG TABS 0.46151 11/14/2014 11/12/2014

Irbesartan-Hydrochlorothiazide Tab 300-12.5 MG TABS 0.56334 12/19/2014 12/17/2014

Irinotecan HCl Inj 100 MG/5ML (20 MG/ML) SOLN 7.88060 02/22/2013 02/19/2013



Iron Polysacch Complex-Vit B12-FA Cap 150-0.025-1 MG CAPS 0.14242 02/22/2013 02/19/2013

ISOCAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOCAL HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOCAL HN PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOMIL 2 (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ISOMIL ADVANCE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ISOMIL ADVANCE SOY FORMUL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ISOMIL DF (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ISOMIL SF (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

ISOMIL SOY FORMULA/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ISOMIL SOY W/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

ISOMIL/IRON (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

ISOMIL/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

ISOMIL/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Isoniazid Tab 100 MG TABS 0.02180 02/22/2013 02/19/2013

Isoniazid Tab 300 MG TABS 0.20286 07/12/2013 07/08/2013

ISOPTO TEARS (Hypromellose Ophth Soln 0.5%) SOLN 0.75310 04/28/2005 02/19/2013

Isosorbide Dinitrate SL Tab 2.5 MG SUBL 0.04880 02/22/2013 02/19/2013

Isosorbide Dinitrate SL Tab 5 MG SUBL 0.08940 02/22/2013 02/19/2013

Isosorbide Dinitrate Tab 10 MG TABS 0.67000 06/10/2014 07/09/2014







EFFECTIVE DATE

DATE UPDATED

Isosorbide Dinitrate Tab CR 40 MG TBCR 0.65500 02/22/2013 02/19/2013

Isosorbide Mononitrate Tab 10 MG TABS 0.21836 02/22/2013 02/19/2013

Isosorbide Mononitrate Tab 20 MG TABS 0.09695 02/22/2013 02/19/2013

Isosorbide Mononitrate Tab SR 24HR 120 MG TB24 0.58300 02/04/2014 03/12/2014



ISOSOURCE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOSOURCE 1.5 CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOSOURCE CLOSED SYSTEM (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOSOURCE HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ISOSOURCE VHN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Isotretinoin Cap 10 MG CAPS 6.52054 11/14/2014 11/12/2014



Isradipine Cap 2.5 MG CAPS 1.06200 02/22/2013 02/19/2013

Isradipine Cap 5 MG CAPS 1.50300 02/22/2013 02/19/2013

Itraconazole Cap 100 MG CAPS 5.60000 02/22/2013 02/19/2013

JEVITY (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

JEVITY 1 CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

JEVITY 1 CAL/FIBER (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

JEVITY 1 CAL/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

JEVITY 1.2 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013


JEVITY 1.2 CAL/FIBER (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013







JINTELI (Norethindrone Acetate-Ethinyl Estradiol Tab 1 MG-5 MCG) TABS 2.21976 10/12/2012 02/19/2013

JOHNSONS BODY CARE 24 HOU (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

JOHNSONS BODY CARE BE RAD (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

JOHNSONS BODY CARE DEEP H (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

JOHNSONS BODY CARE FOREVE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

JOHNSONS BODY CARE MELT A (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

JUICE PLUS FIBRE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

JUVEN (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

JUVEN (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

JUVEN REVIGOR (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

K-PAX IMMUNE BOOSTER PROT (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

K-PAX IMMUNE SUPPORT FORM (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

K-PAX IMMUNE SUPPORT FORM (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

KADCYLA (Ado-Trastuzumab Emtansine For IV Soln 100 MG) SOLR 2762.47572 03/14/2014 03/12/2014

KADCYLA (Ado-Trastuzumab Emtansine For IV Soln 160 MG) SOLR 4419.95916 03/14/2014 03/12/2014

KALBITOR (Ecallantide Inj 10 MG/ML) SOLN 3486.00000 09/13/2013 09/09/2013

KALYDECO (Ivacaftor Tab 150 MG) TABS 406.70000 04/13/2012 02/19/2013

KEPPRA (Levetiracetam Tab 500 MG) TABS 0.36560 05/28/2010 02/19/2013

KERI ADVANCED MOISTURE TH (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI NOURISHING SHEA BUTT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI ORIGINAL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI OVERNIGHT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI RENEWAL MILK BODY (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI RENEWAL SKIN FIRMING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI RENEWAL STRETCH MARK (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KERI SENSITIVE SKIN (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

KETOCAL 3:1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

KETOCAL 4:1 (Nutritional Supplement Liquid**) LIQD 0.01968 08/28/2014 10/07/2014

KETOCAL 4:1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Ketoconazole Cream 2% CREA 0.92510 02/09/2015 03/10/2015



Ketoconazole Shampoo 2% SHAM 0.10450 02/22/2013 02/19/2013

Ketoconazole Tab 200 MG TABS 1.71200 08/05/2014 09/10/2014

KETONEX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

KETONEX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Ketoprofen Cap 50 MG CAPS 0.08250 02/22/2013 02/19/2013

Ketoprofen Cap 75 MG CAPS 0.28540 08/25/2014 09/10/2014




EFFECTIVE DATE

DATE UPDATED

Ketoprofen Cap SR 24HR 200 MG CP24 5.99000 05/03/2013 07/09/2013

Ketorolac Tromethamine IM Inj 30 MG/ML SOLN 0.81555 02/22/2013 02/19/2013

Ketorolac Tromethamine IM Inj 60 MG/2ML (30 MG/ML) SOLN 0.73620 02/22/2013 02/19/2013

Ketorolac Tromethamine Inj 30 MG/ML SOLN 0.81555 02/22/2013 02/19/2013

Ketorolac Tromethamine Inj 300 MG/10ML (30 MG/ML) SOLN 0.81555 02/22/2013 02/19/2013

Ketorolac Tromethamine Ophth Soln 0.4% SOLN 7.56000 11/04/2014 12/09/2014

Ketorolac Tromethamine Ophth Soln 0.5% SOLN 2.34818 03/14/2014 03/12/2014

Ketorolac Tromethamine Tab 10 MG TABS 0.55396 09/19/2013 10/09/2013

Ketotifen Fumarate Ophth Soln 0.025% (Base Equiv) SOLN 0.88540 02/22/2013 02/19/2013

KETOVOLVE 4:1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

KINNEY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KINNEY THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KINRAY PREFERRED PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

KITABIS PAK (Tobramycin Nebu Soln 300 MG/5ML) NEBU 26.10184 04/02/2014 05/02/2014

KOATE-DVI (Antihemophilic Factor (Human) For Inj 1000 Unit) SOLR 0.68720 06/26/2009 02/19/2013



KOGENATE FS (Antihemophilic Factor (Recombinant) For Inj Kit 1000 Unit) KIT 0.88000 08/26/2011 02/19/2013





KOGENATE FS BIO-SET (Antihemophilic Factor (Recombinant) For Inj Kit 1000 Unit) KIT 0.88000 08/26/2011 02/19/2013





KONSYL (Psyllium Powder Packet 28.3%) PACK 0.22920 04/28/2005 02/19/2013

KROGER BLOOD GLUCOSE MONI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

KROGER BLOOD GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

KROGER LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KROGER LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KROGER LANCETS MICRO THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

KROGER LANCETS SUPER THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KROGER LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KROGER LANCETS THIN 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KROGER LANCETS ULTRATHIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

KROGER PREMIUM BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

KROGER PREMIUM BLOOD GLUC (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

KROGER TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

KUVAN (Sapropterin Dihydrochloride Soluble Tab 100 MG) TBSO 30.53755 11/28/2009 02/19/2013

Labetalol HCl Tab 100 MG TABS 0.31052 04/26/2013 06/11/2013




LAC-HYDRIN (Lactic Acid (Ammonium Lactate) Cream 12%) CREA 0.14965 02/05/2010 02/19/2013

LAC-HYDRIN (Lactic Acid (Ammonium Lactate) Lotion 12%) LOTN 0.04600 03/20/2008 02/19/2013

LAC-HYDRIN TWELVE (Lactic Acid (Ammonium Lactate) Lotion 12%) LOTN 0.04600 03/20/2008 02/19/2013

LACTAID (Lactase Tab 3000 Unit) TABS 0.11500 03/20/2008 02/19/2013

LACTAID FAST ACT (Lactase Chew Tab 9000 Unit) CHEW 0.11500 03/20/2008 02/19/2013

LACTAID FAST ACT (Lactase Tab 9000 Unit) TABS 0.11500 03/20/2008 02/19/2013

LACTAID ULTRA (Lactase Tab 9000 Unit) TABS 0.11500 03/20/2008 02/19/2013

Lactase Chew Tab 9000 Unit CHEW 0.11500 02/22/2013 02/19/2013

Lactase Tab 3000 Unit TABS 0.07479 02/22/2013 02/19/2013



Lactated Ringer's Solution SOLN 0.00205 02/22/2013 02/19/2013

Lactic Acid (Ammonium Lactate) Cream 12% CREA 0.07604 03/04/2014 04/09/2014

Lactic Acid (Ammonium Lactate) Lotion 10% LOTN 0.06869 02/22/2013 02/19/2013



Lactic Acid w/ Vitamin E Cream 10%-3500 Unit/30GM CREA 0.12324 02/22/2013 02/19/2013

LACTICARE (Lactic Acid (Ammonium Lactate) Lotion 5%) LOTN 0.05679 03/20/2008 02/19/2013

Lactobacillus Tab** TABS 0.03640 02/22/2013 02/19/2013

LACTRASE (Lactase Cap 250 MG) CAPS 0.35560 10/09/2008 02/19/2013

Lactulose (Encephalopathy) Solution 10 GM/15ML SOLN 0.03200 10/24/2013 11/05/2013

Lactulose Solution 10 GM/15ML SOLN 0.01775 03/25/2013 04/09/2013




EFFECTIVE DATE

DATE UPDATED

LADY LITE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Lamivudine Tab 150 MG TABS 4.21730 02/14/2014 02/11/2014

Lamivudine-Zidovudine Tab 150-300 MG TABS 8.86000 02/14/2014 02/11/2014

Lamotrigine Tab 100 MG TABS 0.07734 02/22/2013 02/19/2013




Lamotrigine Tab Chewable Dispersible 25 MG CHEW 0.28500 02/22/2013 02/19/2013

Lamotrigine Tab Chewable Dispersible 5 MG CHEW 0.28500 02/22/2013 02/19/2013

Lamotrigine Tab SR 24HR 100 MG TB24 7.56178 03/13/2015 03/10/2015





LANAFLEX (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

LANAPHILIC (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

LANAPHILIC/UREA (Emollient - Ointment**) OINT 0.04583 03/13/2008 02/19/2013

LANCETS ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Lancets*** MISC 0.08772 02/22/2013 02/19/2013

LANOXIN (Digoxin Tab 250 MCG (0.25 MG)) TABS 0.11550 04/23/2010 02/19/2013

Lansoprazole Cap Delayed Release 15 MG CPDR 0.65191 11/14/2014 11/12/2014

Lansoprazole Cap Delayed Release 30 MG CPDR 0.55286 01/09/2015 01/06/2015

Lansoprazole Tab Delayed Release Orally Disintegrating 15 MG TBDP 4.05744 02/22/2013 02/19/2013

Lansoprazole Tab Delayed Release Orally Disintegrating 30 MG TBDP 4.30000 02/22/2013 02/19/2013

LANTISEPTIC SKIN PROTECTA (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

Latanoprost Ophth Soln 0.005% SOLN 3.50000 12/19/2014 12/17/2014

Leflunomide Tab 10 MG TABS 0.44575 02/22/2013 02/19/2013

Leflunomide Tab 20 MG TABS 0.40565 02/22/2013 02/19/2013

LETAIRIS (Ambrisentan Tab 10 MG) TABS 244.64887 12/31/2014 02/10/2015

LETAIRIS (Ambrisentan Tab 5 MG) TABS 244.64887 12/31/2014 02/10/2015

Letrozole Tab 2.5 MG TABS 0.20540 02/22/2013 02/19/2013

LEU-FREE COOLER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Leucovorin Calcium For Inj 100 MG SOLR 8.14320 11/08/2013 11/05/2013





EFFECTIVE DATE

DATE UPDATED


Leucovorin Calcium Inj 10 MG/ML SOLN 0.45816 02/22/2013 02/19/2013

Leucovorin Calcium Tab 10 MG TABS 6.22673 02/22/2013 02/19/2013



LEUKERAN (Chlorambucil Tab 2 MG) TABS 3.20380 07/30/2010 02/19/2013

LEUKERAN (Chlorambucil Tab 2 MG) TABS 10.62931 07/01/2014 08/06/2014

Levalbuterol HCl Soln Nebu 0.63 MG/3ML (Base Equiv) NEBU 0.62680 04/11/2014 04/09/2014

Levalbuterol HCl Soln Nebu 1.25 MG/3ML (Base Equiv) NEBU 1.04774 07/11/2014 07/09/2014

Levalbuterol HCl Soln Nebu Conc 1.25 MG/0.5ML (Base Equiv) NEBU 3.21500 02/22/2013 02/19/2013

Levetiracetam Oral Soln 100 MG/ML SOLN 0.07256 03/13/2015 03/10/2015

Levetiracetam Tab 1000 MG TABS 0.40760 03/13/2015 03/10/2015




Levetiracetam Tab SR 24HR 500 MG TB24 0.49000 02/22/2013 02/19/2013

Levetiracetam Tab SR 24HR 750 MG TB24 0.62244 03/13/2015 03/10/2015

Levobunolol HCl Ophth Soln 0.25% SOLN 0.94000 02/22/2013 02/19/2013

Levobunolol HCl Ophth Soln 0.5% SOLN 0.48890 02/22/2013 02/19/2013

Levocarnitine Cap 250 MG CAPS 0.53818 02/22/2013 02/19/2013

Levocarnitine Oral Soln 1 GM/10ML (10%) SOLN 0.19400 02/22/2013 02/19/2013

Levocarnitine Tab 330 MG TABS 0.52366 12/22/2014 02/10/2015

Levocetirizine Dihydrochloride Soln 2.5 MG/5ML (0.5 MG/ML) SOLN 0.42546 08/09/2013 08/06/2013

Levocetirizine Dihydrochloride Tab 5 MG TABS 0.32223 07/11/2014 07/09/2014

Levofloxacin Oral Soln 25 MG/ML SOLN 0.99520 12/31/2014 02/10/2015

Levofloxacin Tab 250 MG TABS 0.22802 02/22/2013 02/19/2013



Levonorg-Eth Est Tab 0.15-0.03MG(84) & Eth Est Tab 0.01MG(7) TABS 2.40000 02/22/2013 02/19/2013

Levonorgestrel & Ethinyl Estradiol (91-Day) Tab 0.15-0.03 MG TABS 1.02914 04/11/2014 04/09/2014

Levonorgestrel & Ethinyl Estradiol Tab 0.1 MG-20 MCG TABS 0.55011 08/08/2014 08/06/2014

Levonorgestrel & Ethinyl Estradiol Tab 0.15 MG-30 MCG TABS 0.55815 02/22/2013 02/19/2013

Levonorgestrel Tab 0.75 MG TABS 15.22415 02/22/2013 02/19/2013

Levonorgestrel Tab 1.5 MG TABS 34.78789 07/09/2014 08/06/2014




EFFECTIVE DATE

DATE UPDATED

Levonorgestrel-Eth Estra Tab 0.05-30/0.075-40/0.125-30MG-MCG TABS 0.73700 02/22/2013 02/19/2013

Levothyroxine Sodium Tab 100 MCG TABS 0.46618 03/14/2013 04/09/2013


















LIBERTY NEXT GENERATION B (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

LIBERTY TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Lidocaine Anorectal Cream 5% CREA 1.50940 02/22/2013 02/19/2013

Lidocaine HCl Cream 3% CREA 1.45446 01/10/2014 01/08/2014

Lidocaine HCl Gel 2% GEL 0.27560 02/22/2013 02/19/2013

Lidocaine HCl Laryngotracheal Soln 4% SOLN 0.10019 02/22/2013 02/19/2013

Lidocaine HCl Local Inj 1% SOLN 0.02262 02/22/2013 02/19/2013

Lidocaine HCl Local Inj 2% SOLN 0.02574 02/22/2013 02/19/2013

Lidocaine HCl Local Preservative Free (PF) Inj 2% SOLN 0.02574 02/22/2013 02/19/2013

Lidocaine HCl Soln 4% SOLN 0.10019 02/22/2013 02/19/2013

Lidocaine HCl Viscous Soln 2% SOLN 0.02780 02/22/2013 02/19/2013

Lidocaine Oint 5% OINT 6.83000 01/11/2015 03/10/2015

Lidocaine Patch 5% PTCH 7.21967 08/08/2014 08/06/2014

Lidocaine-Hydrocortisone Acetate Rectal Cream 3-0.5% CREA 1.65937 02/22/2013 02/19/2013

Lidocaine-Hydrocortisone Acetate Rectal Cream Kit 3-0.5% KIT 7.69340 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Lidocaine-Prilocaine Cream 2.5-2.5% CREA 1.31200 08/26/2014 10/07/2014

Lidocaine-Prilocaine Kit 2.5-2.5% KIT 33.40800 02/22/2013 04/09/2013

LIFE PACK WOMENS (Multiple Vitamins w/ Minerals Combination Therapy Pack***) MISC 0.11230 04/01/2008 02/19/2013

LIFESCAN UNISTIK 2 DEEP P (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

LIFESCAN UNISTIK II LANCE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Lindane Lotion 1% LOTN 1.76000 02/22/2013 02/19/2013

Lindane Shampoo 1% SHAM 1.67670 02/22/2013 02/19/2013

Liniments & Rubs - Cream** CREA 0.02880 02/22/2013 02/19/2013

Liniments & Rubs - Lotion** LOTN 0.02880 02/22/2013 02/19/2013

Liniments & Rubs - Ointment** OINT 0.02880 02/22/2013 02/19/2013

Liothyronine Sodium Tab 25 MCG TABS 0.82000 02/22/2013 02/19/2013



LIPISTART (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Lisinopril & Hydrochlorothiazide Tab 10-12.5 MG TABS 0.05262 02/22/2013 02/19/2013

Lisinopril & Hydrochlorothiazide Tab 20-12.5 MG TABS 0.06211 02/22/2013 02/19/2013

Lisinopril & Hydrochlorothiazide Tab 20-25 MG TABS 0.07003 02/22/2013 02/19/2013

Lisinopril Tab 10 MG TABS 0.02809 02/22/2013 02/19/2013

Lisinopril Tab 2.5 MG TABS 0.02985 02/22/2013 02/19/2013





LITE TOUCH LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Lithium Carbonate Cap 150 MG CAPS 0.09087 02/22/2013 02/19/2013



Lithium Carbonate Tab 300 MG TABS 0.19929 02/22/2013 02/19/2013

Lithium Carbonate Tab CR 300 MG TBCR 0.24433 02/22/2013 02/19/2013

Lithium Carbonate Tab CR 450 MG TBCR 0.38900 02/22/2013 02/19/2013

LIVE BETTER LANCET SUPER (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

LIVE BETTER LANCET ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

LMD (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

LMD DIET (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

LMX 5 (Lidocaine Anorectal Cream 5%) CREA 1.50940 04/28/2005 02/19/2013

LONGS LANCETS STANDARD (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

LONGS LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

LONGS LANCETS ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Loperamide HCl Cap 2 MG CAPS 0.20641 04/11/2014 04/09/2014

Loperamide HCl Liq 1 MG/5ML (0.2 MG/ML) LIQD 0.03310 02/22/2013 02/19/2013

Loperamide HCl Liq 1 MG/7.5ML SUSP 0.03310 02/22/2013 02/19/2013

Loperamide HCl Tab 2 MG TABS 0.12000 02/22/2013 02/19/2013

LOPHLEX (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

LOPHLEX LQ 20 (Nutritional Supplement Liquid**) LIQD 0.04488 11/02/2012 02/20/2013

Loratadine Rapidly-Disintegrating Tab 10 MG TBDP 0.27000 02/22/2013 02/19/2013

Loratadine Syrup 5 MG/5ML SOLN 0.07124 02/22/2013 02/19/2013

Loratadine Syrup 5 MG/5ML SYRP 0.07124 02/22/2013 02/19/2013

Loratadine Tab 10 MG TABS 0.17590 09/12/2014 09/04/2014

Lorazepam Conc 2 MG/ML CONC 0.61448 03/14/2014 03/12/2014

Lorazepam Inj 2 MG/ML SOLN 1.04744 02/22/2013 02/19/2013

Lorazepam Tab 0.5 MG TABS 0.03809 02/22/2013 02/19/2013

Lorazepam Tab 1 MG TABS 0.03524 02/22/2013 02/19/2013

Lorazepam Tab 2 MG TABS 0.05616 02/22/2013 02/19/2013

LORTAB (Acetaminophen w/ Hydrocodone Tab 500-5 MG) TABS 0.06550 05/28/2010 02/19/2013

Losartan Potassium & Hydrochlorothiazide Tab 100-12.5 MG TABS 0.15944 02/22/2013 02/19/2013

Losartan Potassium & Hydrochlorothiazide Tab 100-25 MG TABS 0.16542 02/22/2013 02/19/2013

Losartan Potassium & Hydrochlorothiazide Tab 50-12.5 MG TABS 0.10667 02/22/2013 02/19/2013

Losartan Potassium Tab 100 MG TABS 0.12153 02/22/2013 02/19/2013



LOTRIMIN AF (Clotrimazole Cream 1%) CREA 0.16850 04/23/2010 02/19/2013

LOTRIMIN AF FOR HER (Clotrimazole Cream 1%) CREA 0.16850 04/23/2010 02/19/2013

LOTRIMIN AF JOCK ITCH (Clotrimazole Cream 1%) CREA 0.16850 04/23/2010 02/19/2013

Lovastatin Tab 10 MG TABS 0.09089 02/22/2013 02/19/2013



LOVENOX (Enoxaparin Sodium Inj 100 MG/ML) SOLN 82.45500 05/18/2012 02/19/2013

LOVENOX (Enoxaparin Sodium Inj 120 MG/0.8ML) SOLN 123.72395 05/18/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

LOVENOX (Enoxaparin Sodium Inj 150 MG/ML) SOLN 123.72600 05/18/2012 02/19/2013



LOVENOX (Enoxaparin Sodium Inj 300 MG/3ML) SOLN 74.87430 07/30/2010 02/19/2013




Loxapine Succinate Cap 10 MG CAPS 0.50164 02/22/2013 02/19/2013





Lubricant Gels - Gel*** GEL 0.01780 02/22/2013 02/19/2013

LUBRIDERM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM ADVANCED THERAP (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM DAILY MOISTURE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM DAILY MOISTURE/ (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM INTENSE SKIN RE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM MENS 3-IN-1 (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM SERIOUSLY SENSI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM SKIN NOURISHING (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRIDERM SOOTHING RELIEF (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUBRISOFT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

LUPRON DEPOT (Leuprolide Acetate (3 Month) For Inj Kit 11.25 MG) KIT 2737.64710 12/31/2014 02/10/2015

LUPRON DEPOT (Leuprolide Acetate (3 Month) For Inj Kit 22.5 MG) KIT 3262.29010 12/31/2014 02/10/2015

LUPRON DEPOT (Leuprolide Acetate (4 Month) For Inj Kit 30 MG) KIT 4349.73120 12/31/2014 02/10/2015

LUPRON DEPOT (Leuprolide Acetate For Inj Kit 3.75 MG) KIT 912.53520 12/31/2014 02/10/2015

LUPRON DEPOT-PED (Leuprolide Acetate (3 Month) For Inj Pediatric Kit 11.25 MG) KIT 5979.08760 12/31/2014 02/10/2015

LUPRON DEPOT-PED (Leuprolide Acetate (3 Month) For Inj Pediatric Kit 30 MG) KIT 6585.35280 12/31/2014 02/10/2015

LUPRON DEPOT-PED (Leuprolide Acetate For Inj Pediatric Kit 11.25 MG) KIT 1993.02920 12/31/2014 02/10/2015

LUPRON DEPOT-PED (Leuprolide Acetate For Inj Pediatric Kit 15 MG) KIT 2195.11760 12/31/2014 02/10/2015

LUPRON DEPOT-PED (Leuprolide Acetate For Inj Pediatric Kit 7.5 MG) KIT 1097.78290 12/31/2014 02/10/2015

LYSIPLEX (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

M-VIT (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

MAALOX MAX (Calcium Carbonate-Simethicone Chew Tab 1000-60 MG) CHEW 0.04240 04/28/2005 02/19/2013

MACULAR VITAMIN BENEFIT (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Magnesium Chloride Tab CR 535 MG (64 MG Elemental Mg) TBCR 0.10710 02/22/2013 02/19/2013

Magnesium Citrate Soln SOLN 0.00475 02/22/2013 02/19/2013

Magnesium Gluconate Tab 500 MG TABS 0.07837 02/22/2013 02/19/2013

Magnesium Hydroxide Susp 400 MG/5ML SUSP 0.00676 02/22/2013 02/19/2013

Magnesium Oxide Tab 250 MG TABS 0.06200 02/22/2013 02/19/2013

Magnesium Oxide Tab 250 MG (Mg Supplement) TABS 0.04317 02/22/2013 02/19/2013

Magnesium Oxide Tab 400 MG TABS 0.07476 02/22/2013 02/19/2013

Magnesium Oxide Tab 400 MG (241.3 MG Elemental Mg) TABS 0.07476 02/22/2013 02/19/2013

Magnesium Oxide Tab 500 MG (Mg Supplement) TABS 0.06187 02/22/2013 02/19/2013

Magnesium Sulfate Inj 50% SOLN 0.03848 02/22/2013 02/19/2013

Magnesium Tab 250 MG TABS 0.04990 02/22/2013 02/19/2013

Magnesium Tab 30 MG TABS 0.04070 02/22/2013 02/19/2013

MAGONATE (Magnesium Gluconate Liquid 1000 MG/5ML (54 MG/5ML Magnesium)) LIQD 0.03980 04/28/2005 02/19/2013

MAJOR COMFORT LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Malathion Lotion 0.5% LOTN 2.68358 04/29/2014 06/09/2014

Maprotiline HCl Tab 25 MG TABS 0.23970 02/22/2013 02/19/2013

MATULANE (Procarbazine HCl Cap 50 MG) CAPS 56.07928 01/01/2015 02/10/2015

MAXAM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

MAXIMA BLOOD GLUCOSE MONI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MAXIMA BLOOD GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MAXIMA METER KIT (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MAXIMA STARTER KIT (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MCT OIL (Medium Chain Triglycerides Oral Oil) OIL 0.04870 04/28/2005 02/19/2013

MCT PRO-CAL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

MCT PROCAL (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Meclizine HCl Chew Tab 25 MG CHEW 0.03939 02/22/2013 02/19/2013

Meclizine HCl Tab 12.5 MG TABS 0.19580 01/20/2015 03/10/2015

Meclizine HCl Tab 25 MG TABS 0.32000 02/22/2013 02/19/2013

MEDI-LANCE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDICHOICE PRE-SET SAFETY (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDICHOICE SAFETY LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDICINE SHOPPE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

MEDICINE SHOPPE LANCETS T (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDISENSE THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE PLUS LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE PLUS LANCETS LIT (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE PLUS SUPERLITE 3 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE PLUS UNIVERSAL L (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE PLUS/LITE 25G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE/EXTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE/LITE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEDLANCE/UNIVERSAL (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Medroxyprogesterone Acetate IM Susp 150 MG/ML SUSP 59.77000 01/30/2014 03/12/2014

Medroxyprogesterone Acetate Tab 10 MG TABS 0.06217 02/22/2013 02/19/2013

Medroxyprogesterone Acetate Tab 2.5 MG TABS 0.05125 02/22/2013 02/19/2013

Medroxyprogesterone Acetate Tab 5 MG TABS 0.08900 02/22/2013 02/19/2013

Mefenamic Acid Cap 250 MG CAPS 12.51000 11/08/2013 11/05/2013

Mefloquine HCl Tab 250 MG TABS 4.95041 02/08/2013 02/20/2013

Mefloquine HCl Tab 250 MG TABS 4.95041 02/22/2013 02/20/2013

MEGA MULTIVITAMIN FOR MEN (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

MEGA MULTIVITAMIN FOR WOM (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

MEGACE ES (Megestrol Acetate Susp 625 MG/5ML) SUSP 5.52481 01/05/2015 02/10/2015

MEGAVITE FRUITS & VEGGIES (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Megestrol Acetate Susp 40 MG/ML SUSP 0.08301 02/22/2013 02/19/2013

Megestrol Acetate Tab 20 MG TABS 0.12563 02/22/2013 02/19/2013

Megestrol Acetate Tab 40 MG TABS 0.22456 02/22/2013 02/19/2013

MEIJER BLOOD GLUCOSE MONI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MEIJER BLOOD GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MEIJER COLOR LANCETS UNIV (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEIJER LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEIJER LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEIJER LANCETS UNIVERSAL (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MEIJER PREMIUM BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MEIJER PREMIUM BLOOD GLUC (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MEIJER SUPER THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

MEIJER TRUE2GO BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MEIJER TRUERESULT BLOOD G (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MEIJER TRUETEST BLOOD GLU (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MEIJER TRUETRACK BLOOD GL (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MEIJER TRUETRACK BLOOD GL (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MEKINIST (Trametinib Dimethyl Sulfoxide Tab 0.5 MG (Base Equivalent)) TABS 83.59235 01/05/2015 02/10/2015

MEKINIST (Trametinib Dimethyl Sulfoxide Tab 2 MG (Base Equivalent)) TABS 334.36855 01/05/2015 02/10/2015

Melatonin Cap 1 MG CAPS 0.07185 02/22/2013 02/19/2013

Melatonin Cap 3 MG CAPS 0.11966 02/22/2013 02/19/2013

Melatonin Liquid 1 MG/4ML LIQD 0.06321 02/22/2013 02/19/2013

Melatonin SL Tab 5 MG SUBL 0.23194 02/22/2013 02/19/2013

Melatonin Tab 1 MG TABS 0.05950 02/22/2013 02/19/2013

Melatonin Tab 3 MG TABS 0.08271 02/22/2013 02/19/2013

Meloxicam Tab 15 MG TABS 0.03060 02/22/2013 02/19/2013

Meloxicam Tab 7.5 MG TABS 0.03065 02/22/2013 02/19/2013

MENOMUNE-A/C/Y/W-135 (Meningococcal Vaccine A, C, Y, and W-135 Inj) INJ 113.36140 04/13/2012 02/19/2013

MENS 50+ ADVANCED (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

MENS 50+ MULTI VITAMIN & (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

MENS MULTI VITAMIN & MINE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

MENS PACK (Multiple Vitamins w/ Minerals Combination Therapy Pack***) MISC 0.11230 05/28/2010 02/19/2013

Menthol-Methyl Salicylate Cream*** CREA 0.02880 02/22/2013 02/19/2013

Menthol-Methyl Salicylate Ointment*** OINT 0.02880 02/22/2013 02/19/2013

Meperidine HCl Tab 100 MG TABS 0.39700 02/22/2013 02/19/2013

Meperidine HCl Tab 50 MG TABS 0.65210 11/26/2014 12/09/2014

Meprobamate Tab 200 MG TABS 0.97563 02/22/2013 02/19/2013

Meprobamate Tab 400 MG TABS 1.19780 02/22/2013 02/19/2013

Mercaptopurine Tab 50 MG TABS 2.79900 01/20/2015 02/10/2015

MERITENE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Meropenem IV For Soln 1 GM SOLR 38.00000 02/22/2013 02/19/2013

Meropenem IV For Soln 500 MG SOLR 18.50000 02/22/2013 02/19/2013

Mesalamine Enema 4 GM ENEM 0.20927 03/21/2014 04/09/2014

Mesalamine Rectal Enema 4 GM & Cleanser Wipe Kit** KIT 120.00000 10/10/2014 10/07/2014

METAFORM (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

METAMUCIL (Psyllium Cap 0.52 GM) CAPS 0.01200 03/20/2008 02/19/2013

METAMUCIL (Psyllium Powder 48.57%) POWD 0.01620 04/28/2005 02/19/2013

METAMUCIL (Psyllium Wafer**) WAFR 0.14840 04/28/2005 02/19/2013

METAMUCIL MULTIHEALTH FIB (Psyllium Powder 63%) POWD 0.01720 04/28/2005 02/19/2013

METAMUCIL MULTIHEALTH FIB (Psyllium Powder Packet 58.12%) PACK 0.22885 03/20/2008 02/19/2013

METAMUCIL ORIGINAL TEXTUR (Psyllium Powder 48.57%) POWD 0.01620 04/28/2005 02/19/2013

METAMUCIL SMOOTH TEXTURE (Psyllium Powder 63%) POWD 0.01720 04/28/2005 02/19/2013

METAMUCIL SMOOTH TEXTURE (Psyllium Powder Packet 28%) PACK 0.22920 04/28/2005 02/19/2013

Metaproterenol Sulfate Syrup 10 MG/5ML SYRP 0.05860 02/22/2013 02/19/2013

Metaxalone Tab 800 MG TABS 3.51051 02/14/2014 02/11/2014

Metformin HCl Tab 1000 MG TABS 0.04939 02/22/2013 02/19/2013



Metformin HCl Tab SR 24HR 500 MG TB24 0.05312 02/22/2013 02/19/2013

Metformin HCl Tab SR 24HR 750 MG TB24 0.12221 02/22/2013 02/19/2013

Metformin HCl Tab SR 24HR Osmotic 1000 MG TB24 6.24179 04/11/2014 04/09/2014

Methadone HCl Conc 10 MG/ML CONC 0.07060 02/22/2013 02/19/2013

Methadone HCl Tab 10 MG TABS 0.41500 10/28/2014 12/09/2014

Methadone HCl Tab 5 MG TABS 0.25000 10/30/2014 12/09/2014

Methadone HCl Tab For Oral Susp 40 MG TBSO 0.09527 02/22/2013 02/19/2013

Methamphetamine HCl Tab 5 MG TABS 3.74673 02/22/2013 02/19/2013

Methazolamide Tab 25 MG TABS 0.31500 02/22/2013 02/19/2013

Methazolamide Tab 50 MG TABS 0.14830 02/22/2013 02/19/2013

Methenamine Hippurate Tab 1 GM TABS 1.57558 11/14/2014 11/12/2014

Methenamine Mandelate Tab 1 GM TABS 1.19180 02/14/2014 02/11/2014

Methimazole Tab 10 MG TABS 0.24988 02/22/2013 02/19/2013

Methimazole Tab 5 MG TABS 0.22816 07/11/2014 07/09/2014

METHIONAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Methocarbamol Tab 500 MG TABS 0.12300 04/05/2013 05/06/2013

Methocarbamol Tab 750 MG TABS 0.12475 02/22/2013 02/19/2013

Methotrexate Sodium Inj 25 MG/ML SOLN 3.19084 06/13/2014 06/09/2014

Methotrexate Sodium Inj PF 25 MG/ML SOLN 2.04450 02/22/2013 02/19/2013

Methotrexate Sodium Tab 2.5 MG (Base Equiv) TABS 1.70459 02/13/2015 02/10/2015

Methscopolamine Bromide Tab 2.5 MG TABS 1.73901 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Methyclothiazide Tab 5 MG TABS 0.32000 02/22/2013 02/19/2013

Methylcellulose Powder Laxative POWD 0.01324 02/22/2013 02/19/2013

Methylcellulose Tab 500 MG TABS 0.10545 02/22/2013 02/19/2013

Methyldopa & Hydrochlorothiazide Tab 250-15 MG TABS 0.42630 02/22/2013 02/19/2013

Methyldopa & Hydrochlorothiazide Tab 250-25 MG TABS 0.15690 02/22/2013 02/19/2013

Methyldopa Tab 250 MG TABS 0.11089 02/22/2013 02/19/2013

Methyldopa Tab 500 MG TABS 0.20144 02/22/2013 02/19/2013

Methylergonovine Maleate Tab 0.2 MG TABS 19.77000 08/19/2014 09/10/2014

Methylphenidate HCl Cap CR 10 MG CPCR 3.45289 07/11/2014 07/09/2014



Methylphenidate HCl Cap SR 24HR 20 MG CP24 3.95000 04/12/2013 04/09/2013



Methylphenidate HCl Tab 10 MG TABS 0.80435 02/13/2015 02/10/2015



Methylphenidate HCl Tab CR 10 MG TBCR 1.29600 05/07/2014 06/09/2014

Methylphenidate HCl Tab CR 20 MG TBCR 6.02100 01/28/2015 02/10/2015

Methylphenidate HCl Tab SA OSM 18 MG TBCR 6.25400 12/13/2014 02/10/2015



Methylprednisolone Sodium Succinate For Inj 40 MG SOLR 2.35300 02/22/2013 02/19/2013

Methylprednisolone Tab 16 MG TABS 2.27702 02/14/2014 02/11/2014


Methylprednisolone Tab 4 MG Dose Pack TABS 0.83603 02/13/2015 02/10/2015


Metoclopramide HCl Soln 5 MG/5ML (10 MG/10ML) SOLN 0.01374 02/22/2013 02/19/2013

Metoclopramide HCl Tab 10 MG TABS 0.04870 02/22/2013 02/19/2013

Metoclopramide HCl Tab 5 MG TABS 0.04653 02/22/2013 02/19/2013

Metolazone Tab 10 MG TABS 0.66462 02/22/2013 02/19/2013

Metolazone Tab 2.5 MG TABS 0.98540 07/01/2014 09/10/2014

Metolazone Tab 5 MG TABS 1.12500 07/10/2014 09/10/2014

Metoprolol Succinate Tab SR 24HR 100 MG TB24 0.56107 11/14/2014 11/12/2014




EFFECTIVE DATE

DATE UPDATED




Metoprolol Tartrate Tab 100 MG TABS 0.08900 10/10/2013 12/06/2013



Metronidazole Cream 0.75% CREA 2.60044 04/11/2014 04/09/2014

Metronidazole Gel 0.75% GEL 2.73000 12/07/2012 05/15/2013

Metronidazole Gel 1% GEL 3.95161 05/09/2014 05/02/2014

Metronidazole in NaCl 0.79% IV Soln 500 MG/100ML SOLN 0.01545 02/22/2013 02/19/2013

Metronidazole Lotion 0.75% LOTN 3.29000 06/21/2013 07/09/2013

Metronidazole Tab 250 MG TABS 0.32000 02/22/2013 02/19/2013

Metronidazole Tab 500 MG TABS 0.50200 02/22/2013 02/19/2013

Metronidazole Vaginal Gel 0.75% GEL 0.38450 02/22/2013 02/19/2013

Mexiletine HCl Cap 150 MG CAPS 0.33750 02/11/2013 03/04/2013




MICATIN (Miconazole Nitrate Cream 2%) CREA 0.09870 03/20/2008 02/19/2013

Miconazole Nitrate Cream 2% CREA 0.05542 02/22/2013 02/19/2013

Miconazole Nitrate Vaginal Cream 2% CREA 0.12930 02/22/2013 02/19/2013

Miconazole Nitrate Vaginal Cream 4% (200 MG/5GM) CREA 0.44677 02/22/2013 02/19/2013

Miconazole Nitrate Vaginal Kit KIT 8.31000 02/22/2013 02/19/2013

Miconazole Nitrate Vaginal Supp 200 MG & 2% Cream 9 GM Kit KIT 8.31000 02/22/2013 02/19/2013

Miconazole Nitrate Vaginal Suppos 100 MG SUPP 0.54786 02/22/2013 02/19/2013

MICRODOT BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MICRODOT TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MICROLET LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MICROTAINER SAFETY FLOW L (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MIDAMOR (Amiloride HCl Tab 5 MG) TABS 0.90242 03/06/2009 02/19/2013

Midazolam HCl Inj 10 MG/2ML (Base Equivalent) SOLN 0.43550 02/22/2013 02/19/2013



Midazolam HCl Inj 5 MG/ML (Base Equivalent) SOLN 0.88400 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED


Midazolam HCl Syrup 2 MG/ML (Base Equivalent) SYRP 0.71611 02/22/2013 02/19/2013

Midodrine HCl Tab 10 MG TABS 1.28000 07/08/2014 08/06/2014

Midodrine HCl Tab 2.5 MG TABS 0.30375 02/22/2013 02/19/2013

Midodrine HCl Tab 5 MG TABS 0.35324 01/09/2015 01/06/2015

MILCO-B-FORTE (B-Complex w/ C & Folic Acid Tab***) TABS 0.14060 04/28/2005 02/19/2013

MILK OF MAGNESIA CONCENTR (Magnesium Hydroxide Susp Concentrate 2400 MG/10ML) SUSP 0.01720 04/28/2005 02/19/2013

Mineral Oil OIL 0.01529 02/22/2013 02/19/2013

Mineral Oil (Bulk) OIL 0.01529 02/22/2013 02/19/2013

Mineral Oil Enema ENEM 0.01031 02/22/2013 02/19/2013

MINOCIN (Minocycline HCl Cap 100 MG) CAPS 0.30557 02/26/2010 02/19/2013

Minocycline HCl Cap 100 MG CAPS 0.28783 02/22/2013 02/19/2013



Minocycline HCl Tab 100 MG TABS 1.72432 10/11/2013 10/09/2013

Minocycline HCl Tab SR 24HR 135 MG TB24 10.48000 02/22/2013 02/19/2013



Minoxidil Tab 10 MG TABS 0.26096 02/22/2013 02/19/2013

Minoxidil Tab 2.5 MG TABS 0.15625 02/22/2013 02/19/2013

MIRALAX (Polyethylene Glycol 3350 Oral Powder) POWD 0.03350 03/20/2008 02/19/2013

MIRENA (Levonorgestrel Releasing IUD 20 MCG/24HR (52 MG Total)) IUD 807.26630 11/17/2014 02/10/2015

Mirtazapine Orally Disintegrating Tab 15 MG TBDP 1.01625 02/22/2013 02/19/2013



Mirtazapine Tab 15 MG TABS 0.35000 02/17/2014 04/09/2014



Mirtazapine Tab 7.5 MG TABS 1.16500 08/05/2014 09/10/2014

Misoprostol Tab 100 MCG TABS 0.21750 04/11/2014 04/09/2014



Mitoxantrone HCl Inj Conc 20 MG/10ML (2 MG/ML) CONC 41.73000 02/22/2013 02/19/2013

Mitoxantrone HCl Inj Conc 25 MG/12.5ML (2 MG/ML) CONC 41.73000 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Mitoxantrone HCl Inj Conc 30 MG/15ML (2 MG/ML) CONC 41.73000 02/22/2013 02/19/2013

MMA/PA COOLER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

MMA/PA GEL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

MOBISYL (Trolamine Salicylate Cream 10%) CREA 0.04250 04/28/2005 02/19/2013

Modafinil Tab 100 MG TABS 9.51170 11/14/2014 11/12/2014

Modafinil Tab 200 MG TABS 11.41250 11/14/2014 11/12/2014

MODULEN IBD (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Moexipril HCl Tab 15 MG TABS 0.29200 02/22/2013 02/19/2013

Moexipril HCl Tab 7.5 MG TABS 0.28719 02/22/2013 02/19/2013

Moexipril-Hydrochlorothiazide Tab 15-12.5 MG TABS 0.59644 02/22/2013 02/19/2013

Moexipril-Hydrochlorothiazide Tab 15-25 MG TABS 0.50412 02/22/2013 02/19/2013

Moexipril-Hydrochlorothiazide Tab 7.5-12.5 MG TABS 0.67900 02/22/2013 02/19/2013

MOISTUREL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Mometasone Furoate Cream 0.1% CREA 0.73000 03/13/2014 04/09/2014

Mometasone Furoate Oint 0.1% OINT 0.73000 01/10/2014 04/09/2014

Mometasone Furoate Solution 0.1% (Lotion) SOLN 0.33617 05/09/2014 05/02/2014

MONISTAT 3 (Miconazole Nitrate Vaginal Cream 4% (200 MG/5GM)) CREA 0.44677 03/20/2008 02/19/2013

MONISTAT 3 COMBINATION PA (Miconazole Nitrate Vaginal Supp 200 MG & 2% Cream 9 GM Kit) KIT 8.31000 03/20/2008 02/19/2013

MONISTAT 7 (Miconazole Nitrate Vaginal Suppos 100 MG) SUPP 0.54790 04/23/2010 02/19/2013

MONOCLATE-P (Antihemophilic Factor (Human) For Inj Kit 1000 Unit) KIT 0.61850 12/24/2010 02/19/2013




MONOGEN (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

MONOLET LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MONOLET OPD LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MONOLETTOR SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MONONINE (Coagulation Factor IX For Inj 1000 Unit) SOLR 0.74750 12/24/2010 02/19/2013



Montelukast Sodium Chew Tab 4 MG (Base Equiv) CHEW 0.44000 02/22/2013 02/19/2013

Montelukast Sodium Chew Tab 5 MG (Base Equiv) CHEW 0.44000 02/22/2013 02/19/2013

Montelukast Sodium Oral Granules Packet 4 MG (Base Equiv) PACK 3.42283 05/09/2014 05/02/2014

Montelukast Sodium Tab 10 MG (Base Equiv) TABS 0.29151 02/13/2015 02/10/2015




EFFECTIVE DATE

DATE UPDATED

Morphine Sulfate (Concentrate) Oral Soln 20 MG/ML SOLN 0.39879 12/19/2014 12/17/2014

Morphine Sulfate Cap SR 24HR 20 MG CP24 4.74780 02/22/2013 02/19/2013





Morphine Sulfate Inj 10 MG/ML SOLN 0.79875 02/22/2013 02/19/2013

Morphine Sulfate IV Soln 50 MG/ML SOLN 0.47996 02/22/2013 02/19/2013

Morphine Sulfate Oral Soln 10 MG/5ML SOLN 0.08714 08/09/2013 08/06/2013

Morphine Sulfate Oral Soln 20 MG/5ML SOLN 0.07870 02/22/2013 02/19/2013

Morphine Sulfate Tab 30 MG TABS 0.15000 02/22/2013 02/19/2013

Morphine Sulfate Tab CR 100 MG TBCR 2.61000 10/01/2013 11/05/2013





MOTHERS FRIEND (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Moxifloxacin HCl Tab 400 MG (Base Equiv) TABS 11.56000 03/13/2015 03/10/2015

MS CONTIN (Morphine Sulfate Tab CR 100 MG) TBCR 1.18500 05/28/2010 02/19/2013

MS CONTIN (Morphine Sulfate Tab CR 60 MG) TBCR 0.61500 04/23/2010 02/19/2013

MSUD 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

MSUD AID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

MSUD ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

MSUD COOLER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

MSUD EXPRESS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

MSUD GEL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

MSUD MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

MSUD MAXAMUM (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

MULTI PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 27-0.8 MG***) TABS 0.03965 01/23/2009 02/19/2013

MULTI-BETIC (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

MULTI-BETIC DIABETES (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

MULTI-VITAMIN MONOCAPS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Multiple Vitamin Cap** CAPS 0.01190 02/22/2013 02/19/2013

Multiple Vitamin Inj** INJ 0.70278 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Multiple Vitamin Liquid** LIQD 0.02479 02/22/2013 02/19/2013

Multiple Vitamin Tab** TABS 0.02140 02/22/2013 02/19/2013

Multiple Vitamins w/ Iron Tab** TABS 0.04080 02/22/2013 02/19/2013

Multiple Vitamins w/ Minerals Cap** CAPS 0.08138 02/22/2013 02/19/2013

Multiple Vitamins w/ Minerals Chew Tab** CHEW 0.07430 02/22/2013 02/19/2013

Multiple Vitamins w/ Minerals Liquid** LIQD 0.02464 02/22/2013 02/19/2013

Multiple Vitamins w/ Minerals Tab CR** TBCR 0.01190 02/22/2013 02/19/2013

Multiple Vitamins w/ Minerals Tab** TABS 0.07430 02/22/2013 02/19/2013

Mupirocin Oint 2% OINT 0.38562 02/22/2013 02/19/2013

MURO 128 (Sodium Chloride Hypertonic Ophth Oint 5%) OINT 2.82175 03/20/2008 02/19/2013

MURO 128 (Sodium Chloride Hypertonic Ophth Soln 5%) SOLN 0.67835 03/20/2008 02/19/2013

MYCELEX OTC (Clotrimazole Cream 1%) CREA 0.16850 04/23/2010 02/19/2013

Mycophenolate Mofetil Cap 250 MG CAPS 0.33520 10/30/2014 11/12/2014

Mycophenolate Mofetil Tab 500 MG TABS 0.46299 03/13/2015 03/10/2015

MYGLUCOHEALTH BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

MYGLUCOHEALTH BLOOD GLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

MYGLUCOHEALTH MGH SOFTLAN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

MYLANTA (Alum & Mag Hydroxide-Simethicone Susp 200-200-20 MG/5ML) SUSP 0.00530 03/13/2008 02/19/2013

MYLANTA DOUBLE-STRENGTH (Alum & Mag Hydroxide-Simethicone Susp 400-400-40 MG/5ML) SUSP 0.00690 03/13/2008 02/19/2013

MYLANTA GAS (Simethicone Chew Tab 125 MG) CHEW 0.07284 03/20/2008 02/19/2013

MYLICON (Simethicone Susp 40 MG/0.6ML) SUSP 0.12622 03/20/2008 02/19/2013

MYLICON INFANTS GAS RELIE (Simethicone Susp 40 MG/0.6ML) SUSP 0.12622 03/20/2008 02/19/2013

MYNATAL ADVANCE (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

MYNATAL PLUS (Prenatal Vit w/ Fe Fumarate-FA Tab 65-1 MG***) TABS 0.16510 08/29/2008 02/19/2013

MYNATAL ULTRACAPLET (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

MYNATAL-Z (Prenatal Vit w/ Fe Fumarate-FA Tab 65-1 MG***) TABS 0.16510 08/29/2008 02/19/2013

MYOFLEX (Trolamine Salicylate Cream 10%) CREA 0.04250 04/28/2005 02/19/2013

Nabumetone Tab 500 MG TABS 0.23322 02/22/2013 02/19/2013

Nabumetone Tab 750 MG TABS 0.23864 02/22/2013 02/19/2013

Nadolol Tab 20 MG TABS 2.13000 08/07/2013 09/09/2013







EFFECTIVE DATE

DATE UPDATED

Naltrexone HCl Tab 50 MG TABS 1.02949 12/19/2014 12/17/2014

NAN (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Naphazoline HCl Ophth Soln 0.1% SOLN 0.24500 04/15/2002 02/19/2013

Naphazoline w/ Pheniramine Ophth Soln 0.025-0.3% SOLN 0.35267 02/22/2013 02/19/2013

NAPHCON-A (Naphazoline w/ Pheniramine Ophth Soln 0.025-0.3%) SOLN 0.35267 03/20/2008 02/19/2013

Naproxen Sodium Tab 220 MG TABS 0.06800 02/22/2013 02/19/2013



Naproxen Susp 125 MG/5ML SUSP 0.07523 02/22/2013 02/19/2013

Naproxen Tab 250 MG TABS 0.05148 02/22/2013 02/19/2013



Naproxen Tab EC 375 MG TBEC 0.13650 02/22/2013 02/19/2013

Naproxen Tab EC 500 MG TBEC 0.15681 02/22/2013 02/19/2013

Naratriptan HCl Tab 1 MG (Base Equiv) TABS 5.44501 11/14/2014 11/12/2014

Naratriptan HCl Tab 2.5 MG (Base Equiv) TABS 3.84295 06/13/2014 06/09/2014

NASAL DECONGESTANT (Pseudoephedrine HCl Syrup 30 MG/5ML) SYRP 0.01848 03/20/2008 02/19/2013

NASALCROM (Cromolyn Sodium Nasal Aerosol Soln 5.2 MG/ACT (4%)) AERS 0.38197 03/13/2008 02/19/2013

Nateglinide Tab 120 MG TABS 0.95450 02/22/2013 02/19/2013

Nateglinide Tab 60 MG TABS 0.98450 02/22/2013 02/19/2013

NATRUL-CHEWS (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

NATRUL-MEGA-75 (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

NATRUL-VITES (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

NECON 10/11-28 (Norethindrone-Eth Estradiol Tab 0.5-35/1-35 MG-MCG (10/11)) TABS 0.86000 12/28/2001 02/19/2013

Nefazodone HCl Tab 100 MG TABS 0.98500 09/08/2014 11/12/2014





NEOCATE INFANT DHA/ARA (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

NEOCATE INFANT FORMULA (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

NEOCATE JUNIOR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

NEOCATE JUNIOR/PREBIOTICS (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

NEOCATE NUTRA (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

NEOCATE ONE + (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

Neomycin Sulfate Tab 500 MG TABS 0.99092 02/22/2013 02/19/2013

Neomycin-Bacitrac Zn-Polymyx 5(3.5)MG-400Unt-10000Unt Op Oin OINT 3.91990 02/22/2013 02/19/2013

Neomycin-Bacitracin-Polymyxin Oint*** OINT 0.07143 02/22/2013 02/19/2013

Neomycin-Bacitracin-Polymyxin-Pramoxine Oint 1% OINT 0.06350 02/22/2013 02/19/2013

Neomycin-Polymy-Gramicid Op Sol 1.75-10000-0.025MG-UNT-MG/ML SOLN 4.65000 04/11/2014 04/09/2014

Neomycin-Polymyxin B GU Irrigation Soln SOLN 8.06000 02/22/2013 02/19/2013

Neomycin-Polymyxin-Dexamethasone Ophth Oint 0.1% OINT 4.93660 12/27/2013 01/08/2014

Neomycin-Polymyxin-Dexamethasone Ophth Susp 0.1% SUSP 2.26600 02/22/2013 02/19/2013

Neomycin-Polymyxin-HC Ophth Susp SUSP 12.05000 02/22/2013 02/19/2013

Neomycin-Polymyxin-HC Otic Soln 1% SOLN 2.14000 08/29/2013 09/09/2013

Neomycin-Polymyxin-HC Otic Susp 3.5 MG/ML-10000 Unit/ML-1% SUSP 2.25000 01/15/2014 04/09/2014

NEORAL (Cyclosporine Modified Oral Soln 100 MG/ML) SOLN 7.05566 01/06/2015 02/10/2015

NEOSALUS (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NEOSPORIN ORIGINAL (Neomycin-Bacitracin-Polymyxin Oint***) OINT 0.14310 03/20/2008 02/19/2013

NEOSURE ADVANCE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

NEPHRO-VITE (B-Complex w/ C & Folic Acid Tab 0.8 MG***) TABS 0.08400 03/13/2008 02/19/2013

NEPRO (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NEPRO (Nutritional Supplement Liquid**) LIQD 0.06930 05/28/2010 02/19/2013

NEPRO WITH CARB STEADY (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013




NETGROUP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

NEULASTA (Pegfilgrastim Inj 6 MG/0.6ML) SOLN 7777.43200 01/15/2015 02/10/2015

NEULASTA DELIVERY KIT (Pegfilgrastim Inj 6 MG/0.6ML) SOLN 7777.43200 01/15/2015 02/10/2015

NEUPOGEN (Filgrastim Inj 300 MCG/0.5ML (600 MCG/ML)) SOLN 636.44400 01/15/2015 02/10/2015

NEUPOGEN (Filgrastim Inj 300 MCG/ML) SOLN 300.23590 01/15/2015 02/10/2015



NEUTEK 2TEK TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

NEUTRAPHOR (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

NEUTRAPHORUS REX (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

NEUTROGENA HEALTHY SKIN F (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

NEUTROGENA MOISTURE SENSI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NEUTROGENA ON-THE-SPOT AC (Benzoyl Peroxide Cream 2.5%) CREA 0.25500 08/29/2008 02/19/2013

NEUTROGENA T/GEL (Coal Tar Shampoo 0.5%) SHAM 0.02261 03/13/2008 02/19/2013

NEUTROGENA T/GEL STUBBORN (Coal Tar Shampoo 0.5%) SHAM 0.02261 03/13/2008 02/19/2013

Nevirapine Tab 200 MG TABS 0.22000 02/22/2013 02/19/2013

NEXAVAR (Sorafenib Tosylate Tab 200 MG (Base Equivalent)) TABS 102.35975 01/08/2015 02/10/2015

NEXGEN TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Niacin Cap CR 250 MG CPCR 0.05797 02/22/2013 02/19/2013

Niacin Cap CR 500 MG CPCR 0.06311 02/22/2013 02/19/2013

Niacin Tab 100 MG TABS 0.01180 02/22/2013 02/19/2013




Niacin Tab CR 1000 MG TBCR 0.06600 02/22/2013 02/19/2013

Niacin Tab CR 1000 MG (Antihyperlipidemic) TBCR 4.78467 05/09/2014 05/02/2014



Niacin Tab CR 500 MG (Antihyperlipidemic) TBCR 2.96960 07/11/2014 07/09/2014


Niacinamide Tab 500 MG TABS 0.02990 02/22/2013 02/19/2013

Nicardipine HCl Cap 20 MG CAPS 0.08520 02/22/2013 02/19/2013

Nicardipine HCl Cap 30 MG CAPS 0.32000 02/22/2013 02/19/2013

NICAZEL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

NICORETTE (Nicotine Polacrilex Gum 2 MG) GUM 0.21480 05/28/2010 02/19/2013

NICORETTE (Nicotine Polacrilex Gum 2 MG) GUM 0.24650 12/27/2008 02/19/2013

NICORETTE REFILL (Nicotine Polacrilex Gum 2 MG) GUM 0.21480 05/28/2010 02/19/2013

NICORETTE STARTER KIT (Nicotine Polacrilex Gum 2 MG) GUM 0.21480 05/28/2010 02/19/2013

Nicotine Polacrilex Gum 2 MG GUM 0.21480 02/22/2013 02/19/2013

Nicotine Polacrilex Gum 4 MG GUM 0.26720 02/22/2013 02/19/2013

Nicotine Polacrilex Lozenge 2 MG LOZG 0.42639 02/22/2013 02/19/2013

Nicotine Polacrilex Lozenge 4 MG LOZG 0.46158 02/22/2013 02/19/2013

Nicotine TD Patch 24HR 14 MG/24HR PT24 1.85620 02/22/2013 02/19/2013






EFFECTIVE DATE

DATE UPDATED

Nifedipine Cap 10 MG CAPS 0.70700 02/22/2013 02/19/2013

Nifedipine Cap 20 MG CAPS 1.25530 02/22/2013 02/19/2013

Nifedipine Tab SR 24HR 30 MG TB24 0.44435 02/13/2015 02/10/2015



Nifedipine Tab SR 24HR Osmotic 30 MG TB24 0.43472 02/22/2013 02/19/2013



Nisoldipine Tab SR 24HR 17 MG TB24 4.86558 11/08/2013 11/05/2013

Nisoldipine Tab SR 24HR 25.5 MG TB24 6.55000 02/22/2013 02/19/2013

Nisoldipine Tab SR 24HR 34 MG TB24 6.55000 02/22/2013 02/19/2013

Nisoldipine Tab SR 24HR 8.5 MG TB24 4.77000 02/22/2013 02/19/2013

Nitrofurantoin Macrocrystalline Cap 100 MG CAPS 1.34262 03/13/2015 03/10/2015

Nitrofurantoin Macrocrystalline Cap 50 MG CAPS 0.84211 08/08/2014 08/06/2014

Nitrofurantoin Monohydrate Macrocrystalline Cap 100 MG CAPS 1.77820 06/13/2014 06/09/2014

Nitrofurantoin Susp 25 MG/5ML SUSP 1.56879 05/09/2014 05/02/2014

Nitroglycerin Cap CR 2.5 MG CPCR 0.06100 02/22/2013 02/19/2013

Nitroglycerin Cap CR 6.5 MG CPCR 0.07900 02/22/2013 02/19/2013

Nitroglycerin Cap CR 9 MG CPCR 0.11300 02/22/2013 02/19/2013

Nitroglycerin TD Patch 24HR 0.1 MG/HR PT24 0.62500 02/22/2013 02/19/2013




NIVEA (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA EXTRA ENRICHED (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA EXTRA ENRICHED LOTI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA GENTLE BODY EXFOLIA (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA LIGHT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA ORIGINAL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA ORIGINAL MOISTURE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIVEA VISAGE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NIX COMPLETE LICE SYSTEM (Permethrin Creme Rinse 1%) LIQD 0.10546 03/20/2008 02/19/2013

NIX CREME RINSE (Permethrin Creme Rinse 1%) LIQD 0.10546 03/20/2008 02/19/2013

Nizatidine Cap 150 MG CAPS 0.32351 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Nizatidine Cap 300 MG CAPS 0.72724 02/22/2013 02/19/2013

Nizatidine Oral Soln 15 MG/ML SOLN 0.69823 02/22/2013 02/19/2013

NIZORAL A-D (Ketoconazole Shampoo 1%) SHAM 0.06388 03/20/2008 02/19/2013

NO IRON MULTIPLE VITAMIN/ (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

NORDITROPIN FLEXPRO (Somatropin Inj 10 MG/1.5ML) SOLN 632.52640 12/02/2014 01/06/2015



NORDITROPIN NORDIFLEX PEN (Somatropin Inj 10 MG/1.5ML) SOLN 606.22094 01/01/2015 02/10/2015

NORDITROPIN NORDIFLEX PEN (Somatropin Inj 30 MG/3ML) SOLN 948.78960 12/02/2014 01/06/2015

NORDITROPIN NORDIFLEX PEN (Somatropin Inj 5 MG/1.5ML) SOLN 303.11046 01/01/2015 02/10/2015

Norethindrone & Ethinyl Estradiol Tab 0.4 MG-35 MCG TABS 1.01310 02/08/2013 02/20/2013



Norethindrone & Ethinyl Estradiol Tab 1 MG-35 MCG TABS 0.50417 12/19/2014 12/17/2014

Norethindrone Ac-Ethinyl Estrad-Fe Tab 1-20/1-30/1-35 MG-MCG TABS 1.43244 02/22/2013 02/19/2013

Norethindrone Ace & Ethinyl Estradiol Tab 1 MG-20 MCG TABS 1.03450 02/22/2013 02/19/2013

Norethindrone Ace & Ethinyl Estradiol Tab 1.5 MG-30 MCG TABS 0.88413 02/22/2013 02/19/2013

Norethindrone Ace & Ethinyl Estradiol-FE Tab 1 MG-20 MCG TABS 0.62946 12/19/2014 12/17/2014

Norethindrone Ace & Ethinyl Estradiol-FE Tab 1.5 MG-30 MCG TABS 0.59690 02/22/2013 02/19/2013

Norethindrone Acetate Tab 5 MG TABS 1.77800 02/22/2013 02/19/2013

Norethindrone Acetate-Ethinyl Estradiol Tab 1 MG-5 MCG TABS 2.21976 02/22/2013 02/19/2013

Norethindrone Tab 0.35 MG TABS 0.62884 09/12/2014 09/05/2014

Norethindrone-Eth Estradiol Tab 0.5-35/0.75-35/1-35 MG-MCG TABS 0.73292 02/22/2013 02/19/2013

Norethindrone-Eth Estradiol Tab 0.5-35/1-35/0.5-35 MG-MCG TABS 0.73313 02/22/2013 02/19/2013

Norgestimate & Ethinyl Estradiol Tab 0.25 MG-35 MCG TABS 0.40523 02/22/2013 02/19/2013

Norgestimate-Eth Estrad Tab 0.18-35/0.215-35/0.25-35 MG-MCG TABS 0.45250 02/22/2013 02/19/2013

Norgestrel & Ethinyl Estradiol Tab 0.3 MG-30 MCG TABS 0.75023 02/10/2014 03/12/2014

NORPRAMIN (Desipramine HCl Tab 50 MG) TABS 1.44450 06/14/2010 02/19/2013

Nortriptyline HCl Cap 10 MG CAPS 0.09983 02/22/2013 02/19/2013




Nortriptyline HCl Soln 10 MG/5ML SOLN 0.21500 07/13/2013 08/06/2013

NOVA MAX BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013




EFFECTIVE DATE

DATE UPDATED

NOVA MAX GLUCOSE TEST STR (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

NOVA SAFETY LANCETS 23G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

NOVA SAFETY LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

NOVA SUREFLEX LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

NOVASOURCE PULMONARY (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NOVASOURCE RENAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NOVASOURCE RENAL (Nutritional Supplement Liquid**) LIQD 0.01423 09/15/2009 02/19/2013

NOVOSEVEN RT (Coagulation Factor VIIa (Recomb) For Inj 1 MG (1000 MCG)) SOLR 1.48600 08/08/2014 08/06/2014








NU/TASTE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRA BALANCE DIABETIC NU (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

NUTRA/SHAKE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRA/SHAKE CITRUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRA/SHAKE FIBRE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRA/SHAKE FREE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRA/SHAKE SUPREME (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRADERM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NUTRADERM ADVANCED FORMUL (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NUTRADERM-30 (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

NUTRAMENT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRAMINE (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRAMINE APPLE AMINO BIT (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRAMINE BANANA AMINO B (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRAMINE CHOCOLATE AMINO (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRAMINE MANGO AMINO BI (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRAMINE MIXED FLAVORS A (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

NUTRAMINE PEACHES & CREAM (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRAMINE PINEAPPLE AMINO (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

NUTRASENTIALS (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

NUTREN 1.0 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN 1.0/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN 1.0/FIBER/ULTRAPAK (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013


NUTREN 1.5 FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013


NUTREN GLYTROL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN JUNIOR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN JUNIOR/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN PULMONARY (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN RENAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN REPLETE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTREN REPLETE FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRICAP (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

NUTRIHEAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRIHEP (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRIRENAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Nutritional Supplement Powder** POWD 0.20315 02/22/2013 02/19/2013

NUTRIVENT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRIVENT 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

NUTRIVIR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

NUTRIVIR NSA (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

NUTROPIN (Somatropin For Inj 10 MG) SOLR 703.41670 11/11/2011 02/19/2013

NUTROPIN AQ (Somatropin Inj 10 MG/2ML) SOLN 483.50820 12/16/2014 01/06/2015

NUTROPIN AQ NUSPIN 10 (Somatropin Inj 10 MG/2ML) SOLN 483.50820 12/16/2014 01/06/2015



NUTROPIN AQ PEN (Somatropin Inj 10 MG/2ML) SOLN 483.50820 12/16/2014 01/06/2015

NUTROPIN AQ PEN (Somatropin Inj 20 MG/2ML) SOLN 967.01640 12/16/2014 01/06/2015

Nystatin Cream 100000 Unit/GM CREA 0.65007 04/11/2014 04/09/2014

Nystatin Oint 100000 Unit/GM OINT 0.62000 12/07/2012 05/15/2013




EFFECTIVE DATE

DATE UPDATED

Nystatin Susp 100000 Unit/ML SUSP 0.09562 12/19/2014 12/17/2014

Nystatin Tab 500000 Unit TABS 0.49768 03/13/2015 03/10/2015

Nystatin Topical Powder** POWD 0.90780 03/13/2015 03/10/2015

Nystatin-Triamcinolone Cream 100000-0.1 Unit/GM-% CREA 4.86500 07/29/2014 09/10/2014

Nystatin-Triamcinolone Cream 100000-0.1 Unit/GM-% CREA 5.23300 04/01/2014 05/02/2014

Nystatin-Triamcinolone Oint 100000-0.1 Unit/GM-% OINT 4.06500 09/12/2014 11/12/2014

O-CAL FA (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

OA 1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

OA 1 DIET (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

OA 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

OA 2 DIET (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

OCEAN NASAL SPRAY (Saline Nasal Spray 0.65%) SOLN 0.03390 03/20/2008 02/19/2013

OCTAGAM (Immune Globulin (Human) IV Soln 1 GM/20ML) SOLN 6.30800 10/01/2014 12/04/2014



OCTAGAM (Immune Globulin (Human) IV Soln 2.5 GM/50ML) SOLN 6.30833 10/01/2014 12/04/2014





Octreotide Acetate Inj 100 MCG/ML (0.1 MG/ML) SOLN 4.55000 02/22/2013 02/19/2013

Octreotide Acetate Inj 1000 MCG/ML (1 MG/ML) SOLN 72.80000 02/22/2013 02/19/2013




OCUVITE ADULT 50+ (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

OCUVITE ADULT FORMULA (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

OCUVITE LUTEIN (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

Ofloxacin Ophth Soln 0.3% SOLN 3.23800 03/13/2015 03/10/2015

Ofloxacin Otic Soln 0.3% SOLN 1.78000 09/25/2013 10/09/2013

Ofloxacin Tab 200 MG TABS 2.47300 02/22/2013 02/19/2013



Olanzapine Orally Disintegrating Tab 10 MG TBDP 1.74995 06/13/2014 06/09/2014




EFFECTIVE DATE

DATE UPDATED




Olanzapine Tab 10 MG TABS 0.32300 12/19/2014 12/17/2014


Olanzapine Tab 2.5 MG TABS 0.25045 02/22/2013 02/19/2013



Olanzapine Tab 7.5 MG TABS 0.34060 02/22/2013 02/19/2013

OLYSIO (Simeprevir Sodium Cap 150 MG (Base Equivalent)) CAPS 786.84000 03/14/2014 03/12/2014

Omega-3 Fatty Acids Cap 1000 MG** CAPS 0.11000 02/12/2014 03/12/2014

Omega-3 Fatty Acids Cap 500 MG** CAPS 0.11900 02/22/2013 02/19/2013

Omeprazole Cap Delayed Release 10 MG CPDR 0.34142 02/22/2013 02/19/2013



Omeprazole-Sodium Bicarbonate Cap 20-1100 MG CAPS 5.38000 02/22/2013 02/19/2013

Omeprazole-Sodium Bicarbonate Cap 40-1100 MG CAPS 8.71000 01/13/2014 02/11/2014

OMNI GEL (Stannous Fluoride Gel 0.4%) GEL 0.06033 03/20/2008 02/19/2013

OMNICAP (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

OMNITROPE (Somatropin For Inj 5.8 MG) SOLR 278.79078 07/01/2014 08/06/2014

OMNITROPE (Somatropin Inj 10 MG/1.5ML) SOLN 606.22094 01/01/2015 02/10/2015

OMNITROPE (Somatropin Inj 5 MG/1.5ML) SOLN 303.11046 01/01/2015 02/10/2015

OMSOLITE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ON CALL LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ON CALL PLUS BLOOD GLUCOS (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ON CALL PLUS BLOOD GLUCOS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ON CALL PLUS LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ON CALL VIVID BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ON CALL VIVID BLOOD GLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ONCASPAR (Pegaspargase Inj 750 Unit/ML) SOLN 1129.46400 04/13/2012 02/19/2013

ONCASPAR (Pegaspargase Inj 750 Unit/ML) SOLN 1192.29334 02/01/2014 03/12/2014

ONCOVITE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Ondansetron HCl Inj 4 MG/2ML (2 MG/ML) SOLN 0.14960 02/22/2013 02/19/2013

Ondansetron HCl Inj 40 MG/20ML (2 MG/ML) SOLN 0.14960 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Ondansetron HCl Oral Soln 4 MG/5ML SOLN 0.65000 11/14/2014 11/12/2014

Ondansetron HCl Tab 24 MG TABS 4.02100 02/22/2013 02/19/2013



Ondansetron Orally Disintegrating Tab 4 MG TBDP 0.52802 03/13/2015 03/10/2015

Ondansetron Orally Disintegrating Tab 8 MG TBDP 0.45562 02/22/2013 02/19/2013

ONE DAILY MENS FORMULA W/ (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY 50 PLUS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY ENERGY (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY ESSENTIAL (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

ONE-A-DAY MENOPAUSE FORMU (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY MENS (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

ONE-A-DAY MENS 50+ ADVANT (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY MENS HEALTH FOR (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY MENS PRO EDGE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY MENS VITACRAVES (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

ONE-A-DAY TEEN ADVANTAGE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY VITACRAVES (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

ONE-A-DAY VITACRAVES GUMM (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

ONE-A-DAY VITACRAVES SOUR (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

ONE-A-DAY WEIGHT SMART AD (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY WOMENS 50+ ADVA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY WOMENS ACTIVE M (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY WOMENS PETITES (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY WOMENS PLUS HEA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ONE-A-DAY WOMENS VITACRAV (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

ONETOUCH BASIC SYSTEM (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH BASIC/PROFILE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ONETOUCH BASIC/PROFILE/ON (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ONETOUCH CLUB LANCETS FIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ONETOUCH COMBO PACK (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ONETOUCH DELICA LANCETS E (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ONETOUCH DELICA LANCETS F (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

ONETOUCH FINEPOINT LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ONETOUCH LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ONETOUCH PROFILE SYSTEM (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH ULTRA 2 (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH ULTRA 2 (Blood Glucose Monitoring Kit w/ Device***) KIT 57.10000 05/05/2010 02/19/2013

ONETOUCH ULTRA BLUE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013




ONETOUCH ULTRA MINI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH ULTRA MINI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 04/23/2010 02/19/2013

ONETOUCH ULTRA SYSTEM KIT (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH ULTRALINK SYSTEM (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH ULTRASMART (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH ULTRASOFT LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ONETOUCH VERIO IQ BLOOD G (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ONETOUCH VERIO TEST STRIP (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ONETOUCH VERIO TEST STRIP (Glucose Blood Test Strip) STRP 1.31000 08/14/2014 09/10/2014

Ophthalmic Irrigation Solution*** SOLN 0.01334 02/22/2013 02/19/2013

Opium Tincture 1% (10 MG/ML) (Morphine Equiv) TINC 6.97250 06/24/2014 07/09/2014

OPSUMIT (Macitentan Tab 10 MG) TABS 238.54200 12/29/2014 02/10/2015

OPTI-WOMAN (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

OPTIMENTAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

OPTIMENTAL (Nutritional Supplement Liquid**) LIQD 0.02746 03/24/2010 02/19/2013

OPTIMUM AIRVITES (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

OPTISOURCE (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

OPTIUM BLOOD GLUCOSE MONI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

OPTIUM TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

OPTIUMEZ TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

OPTIVITE P.M.T. (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Oral Electrolyte Solution*** SOLN 0.00560 02/22/2013 02/19/2013

ORAMORPH SR (Morphine Sulfate Tab CR 100 MG) TBCR 1.18500 05/28/2010 02/19/2013

ORAMORPH SR (Morphine Sulfate Tab CR 60 MG) TBCR 0.61500 04/23/2010 02/19/2013




EFFECTIVE DATE

DATE UPDATED

ORENCIA (Abatacept For IV Soln 250 MG) SOLR 725.99270 01/01/2015 02/10/2015

ORFADIN (Nitisinone Cap 5 MG) CAPS 173.04033 10/01/2013 10/09/2013

ORGANIC PEDIA SMART (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Orphenadrine Citrate Tab SR 12HR 100 MG TB12 0.44788 02/22/2013 02/19/2013

ORPHENADRINE COMPOUND DS (Orphenadrine w/ Aspirin & Caffeine Tab 50-770-60 MG) TABS 0.85000 04/15/2002 02/19/2013

Orphenadrine w/ Aspirin & Caffeine Tab 25-385-30 MG TABS 0.60000 02/22/2013 02/19/2013

Orphenadrine w/ Aspirin & Caffeine Tab 50-770-60 MG TABS 0.85000 02/22/2013 02/19/2013

ORTHOVISC (Hyaluronan Intra-articular Soln Prefilled Syringe 30 MG/2ML) SOSY 136.95000 04/13/2012 02/19/2013

OS 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

OS-CAL ULTRA (Calcium Carbonate-Vit D-C-E w/ Minerals Tabs 600 MG***) TABS 0.08770 04/28/2005 02/19/2013

OSMOLITE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

OSMOLITE 1 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

OSMOLITE 1 CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

OSMOLITE 1.2 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013




OSMOLITE HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

OSMOLITE HN PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Oxaliplatin IV Soln 100 MG/20ML SOLN 60.10000 02/22/2013 02/19/2013

Oxaliplatin IV Soln 50 MG/10ML SOLN 60.10000 02/22/2013 02/19/2013

Oxaliplatin For IV Inj 100 MG SOLR 1607.58000 02/22/2013 02/19/2013

Oxaliplatin For IV Inj 50 MG SOLR 772.20000 02/22/2013 02/19/2013

Oxandrolone Tab 10 MG TABS 11.64530 02/22/2013 02/19/2013

Oxandrolone Tab 2.5 MG TABS 3.19985 02/22/2013 02/19/2013

Oxaprozin Tab 600 MG TABS 2.60000 12/07/2012 05/15/2013

Oxazepam Cap 10 MG CAPS 0.86000 02/22/2013 02/19/2013



Oxcarbazepine Susp 300 MG/5ML (60 MG/ML) SUSP 0.60859 03/14/2014 03/12/2014

Oxcarbazepine Tab 150 MG TABS 0.20263 02/22/2013 02/19/2013



OXEPA (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

OXEPA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Oxybutynin Chloride Syrup 5 MG/5ML SYRP 0.04136 11/14/2014 11/12/2014

Oxybutynin Chloride Tab 5 MG TABS 0.45000 09/12/2014 09/05/2014

Oxybutynin Chloride Tab SR 24HR 10 MG TB24 0.99420 02/13/2015 02/10/2015



Oxycodone HCl Cap 5 MG CAPS 1.34000 10/15/2014 12/09/2014

Oxycodone HCl Conc 100 MG/5ML (20 MG/ML) CONC 6.13800 05/07/2013 07/09/2013

Oxycodone HCl Powder POWD 13.11500 02/22/2013 02/19/2013

Oxycodone HCl Soln 5 MG/5ML SOLN 0.24795 05/30/2013 06/11/2013

Oxycodone HCl Tab 10 MG TABS 0.22639 02/13/2015 02/10/2015





Oxycodone w/ Acetaminophen Cap 5-500 MG CAPS 0.09425 02/22/2013 02/19/2013

Oxycodone w/ Acetaminophen Tab 10-325 MG TABS 0.84100 11/29/2013 01/08/2014


Oxycodone w/ Acetaminophen Tab 2.5-325 MG TABS 1.62188 02/22/2013 02/19/2013




Oxycodone-Aspirin Tab 4.8355-325 MG TABS 0.43950 02/22/2013 02/19/2013

OXYCONTIN (Oxycodone HCl Tab ER 12HR Deter 40 MG) T12A 4.20500 04/23/2010 02/19/2013

OXYCONTIN (Oxycodone HCl Tab ER 12HR Deter 80 MG) T12A 8.10250 05/28/2010 02/19/2013

Oxymorphone HCl Tab 10 MG TABS 4.25285 03/13/2015 03/10/2015

Oxymorphone HCl Tab 5 MG TABS 2.62000 05/27/2014 07/09/2014

Oxymorphone HCl Tab SR 12HR 10 MG TB12 2.59517 04/11/2014 04/09/2014

Oxymorphone HCl Tab SR 12HR 15 MG TB12 4.13420 02/22/2013 02/19/2013

Oxymorphone HCl Tab SR 12HR 7.5 MG TB12 2.29390 02/22/2013 02/19/2013

Oyster Shell Calcium Tab 500 MG TABS 0.03228 02/22/2013 02/19/2013

PACQUIN PLUS HAND & BODY (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

PALOMAR E (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

Pamidronate Disodium For Inj 30 MG SOLR 52.00000 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Pamidronate Disodium For Inj 90 MG SOLR 156.00000 02/22/2013 02/19/2013

Pamidronate Disodium IV Soln 3 MG/ML SOLN 3.55000 02/22/2013 02/19/2013

Pamidronate Disodium IV Soln 6 MG/ML SOLN 2.40534 02/22/2013 02/19/2013

Pantoprazole Sodium EC Tab 20 MG (Base Equiv) TBEC 0.13410 02/22/2013 02/19/2013

Pantoprazole Sodium EC Tab 40 MG (Base Equiv) TBEC 0.13290 02/22/2013 02/19/2013

PARADIGM LINK BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 101.99150 05/04/2006 02/19/2013

Paregoric 2 MG/5ML TINC 0.27073 02/22/2013 02/19/2013

Paromomycin Sulfate Cap 250 MG CAPS 3.75000 03/07/2013 05/06/2013

Paroxetine HCl Oral Susp 10 MG/5ML (Base Equiv) SUSP 0.50300 02/22/2013 02/19/2013

Paroxetine HCl Tab 10 MG TABS 0.12061 02/22/2013 02/19/2013




Paroxetine HCl Tab SR 24HR 12.5 MG TB24 4.16520 01/07/2015 02/10/2015

Paroxetine HCl Tab SR 24HR 25 MG TB24 4.34500 01/05/2015 02/10/2015

Paroxetine HCl Tab SR 24HR 37.5 MG TB24 4.56000 10/06/2014 11/12/2014

PARVA-CAL (Calcium-Ergocalciferol Tab 500 MG-200 Unit) TABS 0.02087 03/13/2008 02/19/2013

PARVLEX (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

PC LANCETS SUPER THIN 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PEDIA-LAX (Glycerin Suppos 1 GM) SUPP 0.07360 03/13/2008 02/19/2013

PEDIALYTE (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

PEDIALYTE FREEZER POPS (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

PEDIALYTE SINGLES (Oral Electrolyte Solution***) SOLN 0.00560 04/28/2005 02/19/2013

PEDIASURE (Nutritional Supplement Liquid**) LIQD 0.00840 03/09/2006 02/19/2013



PEDIASURE 1.0 CAL/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE 1.5 CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE 1.5 CAL WITH FI (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013



PEDIASURE ENTERAL FORMULA (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

PEDIASURE ENTERAL FORMULA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE NUTRIPALS (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PEDIASURE NUTRIPALS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE PEDIATRIC (Nutritional Supplement Liquid**) LIQD 0.00851 11/25/2005 02/19/2013

PEDIASURE PEPTIDE 1.0 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013




PEDIASURE SHAKE WITH FIBE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE SIDEKICKS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE SIDEKICKS CLEAR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE SIDEKICKS SHAKE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEDIASURE WITH FIBER (Nutritional Supplement Liquid**) LIQD 0.00880 03/09/2006 02/19/2013



Pediatric Multiple Vitamin w/ C & FA Chew Tab** CHEW 0.02855 02/22/2013 02/19/2013

Pediatric Multiple Vitamin w/ C Liqd 60 MG/5ML** LIQD 0.01490 02/22/2013 02/19/2013

Pediatric Multiple Vitamin w/ C Liqd 60 MG/5ML** SYRP 0.01490 02/22/2013 02/19/2013

Pediatric Multiple Vitamin w/ C Soln 35 MG/ML** SOLN 0.08669 02/22/2013 02/19/2013

Pediatric Multiple Vitamin w/ Extra C & FA Chew Tab** CHEW 0.07640 02/22/2013 02/19/2013

Pediatric Multiple Vitamin w/ Minerals & C Chew Tab 60 MG** CHEW 0.01747 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Fl-Fe Drops 0.25-10 MG/ML** SOLN 0.11440 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Fluoride Chew Tab 0.25 MG*** CHEW 0.17771 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Fluoride Chew Tab 0.5 MG*** CHEW 0.16081 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Fluoride Chew Tab 1 MG*** CHEW 0.16081 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Fluoride Soln 0.25 MG/ML*** SOLN 0.10270 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Fluoride Soln 0.5 MG/ML*** SOLN 0.28650 06/24/2014 07/09/2014

Pediatric Multiple Vitamins w/ Iron Chew Tab 15 MG** CHEW 0.03479 02/22/2013 02/19/2013

Pediatric Multiple Vitamins w/ Iron Drops 10 MG/ML** SOLN 0.08108 02/22/2013 02/19/2013

PEDIATRIC PEPTINEX DT (Nutritional Supplement Liquid**) LIQD 0.01420 05/28/2010 02/19/2013

PEDIATRIC PEPTINEX DT/FIB (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Pediatric Vitamins ACD w/ Fluoride Soln 0.25 MG/ML*** SOLN 0.18550 02/22/2013 02/19/2013

Pediatric Vitamins ACD w/ Fluoride Soln 0.5 MG/ML*** SOLN 0.10270 02/22/2013 02/19/2013

Pediatric Vitamins ADC Drops 1500 Unit-400 Unit-35 MG/ML*** SOLN 0.07766 02/22/2013 02/19/2013

PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For Soln 236 GM SOLR 0.00353 02/22/2013 02/19/2013

PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For Soln 240 GM SOLR 0.00360 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PEG 3350-KCl-Sod Bicarb-NaCl For Soln 420 GM SOLR 0.00494 02/22/2013 02/19/2013

PEG-INTRON (Peginterferon alfa-2b For Inj Kit 120 MCG/0.5ML) KIT 825.89980 08/01/2014 09/10/2014




PEG-INTRON REDIPEN (Peginterferon alfa-2b For Inj Kit 120 MCG/0.5ML) KIT 825.89980 08/01/2014 09/10/2014




PEG-INTRON REDIPEN PAK 4 (Peginterferon alfa-2b For Inj Kit 120 MCG/0.5ML) KIT 825.89980 08/01/2014 09/10/2014




PEGASYS (Peginterferon alfa-2a Inj 180 MCG/ML) SOLN 863.05060 12/16/2014 01/06/2015

PEGASYS (Peginterferon alfa-2a Inj Kit 180 MCG/0.5ML) KIT 3072.74300 11/19/2013 01/08/2014

PEGINTRON (Peginterferon alfa-2b For Inj Kit 120 MCG/0.5ML) KIT 825.89980 08/01/2014 09/10/2014




PELEVERUS (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

PELEVERUS CLEAR (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

PELEVERUS GOLD (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

Penicillin G Potassium For Inj 5000000 Unit SOLR 8.65150 02/22/2013 02/19/2013

Penicillin V Potassium For Soln 125 MG/5ML SOLR 0.02150 02/22/2013 02/19/2013

Penicillin V Potassium For Soln 250 MG/5ML SOLR 0.03749 04/02/2013 05/06/2013

Penicillin V Potassium Tab 250 MG TABS 0.08269 02/22/2013 02/19/2013

Penicillin V Potassium Tab 500 MG TABS 0.25100 02/13/2015 03/10/2015

PENTAM 300 (Pentamidine Isethionate For Soln 300 MG) SOLR 81.96250 04/13/2012 02/19/2013

Pentazocine w/ Naloxone Tab 50-0.5 MG TABS 2.31520 02/13/2015 03/10/2015

Pentoxifylline Tab CR 400 MG TBCR 0.24500 03/17/2014 04/09/2014

PEPCID AC (Famotidine Tab 10 MG) TABS 0.13640 04/23/2010 02/19/2013

PEPDITE JUNIOR (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PEPTAMEN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PEPTAMEN (Nutritional Supplement Liquid**) LIQD 0.02550 05/28/2010 02/19/2013

PEPTAMEN 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN 1.5 (Nutritional Supplement Liquid**) LIQD 0.02550 09/09/2008 02/19/2013

PEPTAMEN 1.5 CAL/PREBIO1 (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

PEPTAMEN AF (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN AF (Nutritional Supplement Liquid**) LIQD 0.02550 05/28/2010 02/19/2013

PEPTAMEN BARIATRIC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN JUNIOR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN JUNIOR (Nutritional Supplement Liquid**) LIQD 0.02550 05/28/2010 02/19/2013

PEPTAMEN JUNIOR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PEPTAMEN JUNIOR 1 CAL/PRE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/28/2013

PEPTAMEN JUNIOR 1 CAL/PRE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/28/2013

PEPTAMEN JUNIOR 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN JUNIOR 1.5 (Nutritional Supplement Liquid**) LIQD 0.03208 01/20/2012 02/19/2013

PEPTAMEN JUNIOR FIBER (Nutritional Supplement Liquid**) LIQD 0.02550 05/28/2010 02/19/2013

PEPTAMEN OS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN OS 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN VHP (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTAMEN/PREBIO1 (Nutritional Supplement Liquid**) LIQD 0.01420 05/28/2010 02/19/2013

PEPTAMEN/PREBIO1 (Nutritional Supplement Liquid**) LIQD 0.02550 05/28/2010 02/19/2013

PEPTINEX 1.0 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTINEX 1.5 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTINEX DT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTINEX DT (Nutritional Supplement Liquid**) LIQD 0.01420 05/28/2010 02/19/2013

PEPTINEX DT WITH PREBIOTI (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PEPTO BISMOL (Bismuth Subsalicylate Tab 262 MG) TABS 0.06450 03/13/2008 02/19/2013

PEPTO-BISMOL (Bismuth Subsalicylate Chew Tab 262 MG) CHEW 0.06830 03/13/2008 02/19/2013

PEPTO-BISMOL (Bismuth Subsalicylate Susp 262 MG/15ML) SUSP 0.00915 03/13/2008 02/19/2013

PEPTO-BISMOL INSTACOOL (Bismuth Subsalicylate Chew Tab 262 MG) CHEW 0.06830 03/13/2008 02/19/2013

PEPTO-BISMOL MAX STRENGTH (Bismuth Subsalicylate Susp 525 MG/15ML) SUSP 0.01640 04/28/2005 02/19/2013

PEPTO-BISMOL TO-GO (Bismuth Subsalicylate Chew Tab 262 MG) CHEW 0.06830 03/13/2008 02/19/2013

PERATIVE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

PERATIVE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PERFECT LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PERFECT PRESSURE ACTIVATE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PERIFLEX (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PERIFLEX ADVANCE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PERIFLEX INFANT (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

PERIFLEX JUNIOR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Permethrin Aerosol 0.5% AERO 0.02400 02/22/2013 02/19/2013

Permethrin Cream 5% CREA 1.14685 03/13/2015 03/10/2015

Permethrin Creme Rinse 1% LIQD 0.10546 02/22/2013 02/19/2013

Permethrin Lotion 1% LOTN 0.10978 02/22/2013 02/19/2013

Perphenazine Tab 16 MG TABS 2.24000 06/23/2014 07/09/2014




Perphenazine-Amitriptyline Tab 2-10 MG TABS 0.07040 02/22/2013 02/19/2013




PERRY PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Cap 13.5-0.4 MG***) CAPS 0.08640 07/01/1998 02/19/2013

PFD 1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PFD 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PFIZERPEN-G (Penicillin G Potassium For Inj 5000000 Unit) SOLR 9.96000 01/01/2015 02/10/2015

PHARMACIST CHOICE AUTOCOD (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PHARMACIST CHOICE AUTOCOD (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PHARMACIST CHOICE ULTRA T (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PHARMACY COUNTER LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Phenazopyridine HCl Tab 100 MG TABS 0.11050 02/22/2013 02/19/2013

Phenazopyridine HCl Tab 200 MG TABS 1.51000 06/05/2014 08/06/2014

Phenazopyridine-Butabarbital-Hyoscyamine Tab 150-15-0.3 MG TABS 0.91500 02/22/2013 02/19/2013

Phendimetrazine Tartrate Tab 35 MG TABS 0.18330 02/22/2013 02/19/2013

Phenelzine Sulfate Tab 15 MG TABS 0.86472 02/22/2013 02/19/2013

PHENEX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PHENEX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Phenobarbital Elixir 20 MG/5ML ELIX 0.14115 06/18/2013 07/09/2013

Phenobarbital Elixir 20 MG/5ML SOLN 0.14115 06/18/2013 07/09/2013




EFFECTIVE DATE

DATE UPDATED

Phenobarbital Tab 100 MG TABS 0.04005 02/22/2013 02/19/2013


Phenobarbital Tab 16.2 MG TABS 0.00380 02/22/2013 02/19/2013





Phentermine HCl Cap 30 MG CAPS 0.28366 02/22/2013 02/19/2013

Phentermine HCl Cap 37.5 MG CAPS 1.25830 02/22/2013 02/19/2013

Phentermine HCl Tab 37.5 MG TABS 0.14063 02/22/2013 02/19/2013

PHENYL-FREE 1 (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

PHENYL-FREE 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PHENYL-FREE 2HP (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PHENYLADE (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

PHENYLADE DRINK MIX (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PHENYLADE ESSENTIAL DRINK (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PHENYLADE ESSENTIAL DRINK (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PHENYLADE MTE (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

PHENYLADE PHEBLOC (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

PHENYLADE PHEBLOC (Amino Acids Tab***) TABS 0.41080 04/28/2005 02/19/2013

PHENYLADE RTD PKU 10 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PHENYLADE40 DRINK MIX (Amino Acids Pack***) PACK 0.19640 04/28/2005 02/19/2013

PHENYLADE60 DRINK MIX (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PHENYLADE60 DRINK MIX (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PHENYLENE (Dietary Management Product - Powder***) POWD 0.06700 04/28/2005 02/19/2013

PHENYLENE 75 (Dietary Management Product - Powder***) POWD 0.06700 04/28/2005 02/19/2013

Phenylephrine-Brompheniramine-DM Elixir 2.5-1-5 MG/5ML ELIX 0.01520 02/22/2013 02/19/2013

Phenytoin Chew Tab 50 MG CHEW 0.42126 08/09/2013 08/06/2013

Phenytoin Sodium Extended Cap 100 MG CAPS 0.34690 02/13/2015 02/10/2015



Phenytoin Susp 125 MG/5ML SUSP 0.11360 02/22/2013 02/19/2013

PHILLIPS MILK OF MAGNESIA (Magnesium Hydroxide Susp 800 MG/5ML) SUSP 0.01720 04/28/2005 02/19/2013

PHLEXY-10 (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PHLEXY-10 (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PHOS FLUR (Sodium Fluoride Rinse 0.044%) SOLN 0.01749 03/20/2008 02/19/2013

PHOS-NAK POWDER CONCENTRA (Potassium & Sodium Phosphates Powder Pack 280-160-250 MG) PACK 0.32980 04/28/2005 02/19/2013

PHYTOFUSION (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

Pilocarpine HCl Ophth Soln 1% SOLN 0.16000 02/22/2013 02/19/2013



Pilocarpine HCl Tab 5 MG TABS 1.25400 06/24/2014 08/06/2014

Pindolol Tab 10 MG TABS 0.13000 02/22/2013 02/19/2013

Pindolol Tab 5 MG TABS 0.89500 04/25/2013 06/11/2013

Pioglitazone HCl Tab 15 MG (Base Equiv) TABS 0.20870 04/12/2013 04/09/2013



Piroxicam Cap 10 MG CAPS 0.89300 04/04/2013 06/11/2013

Piroxicam Cap 20 MG CAPS 1.64089 11/08/2013 11/05/2013

PIVOT 1.5 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013



PKU 2 (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PKU 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PKU 3 (Nutritional Supplement Powder**) POWD 0.22070 04/29/2013 05/06/2013

PKU COOLER 10 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




PKU EXPRESS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PKU GEL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PKU LOPHLEX LQ 20 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PKU LOPHLEX LQ 20 (Nutritional Supplement Liquid**) LIQD 0.04488 11/09/2012 02/19/2013

PKU TRIO (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PNEUMOVAX 23/1 DOSE (Pneumococcal Vaccine Polyvalent Inj 25 MCG/0.5ML) INJ 128.32796 11/15/2012 02/19/2013

PNEUMOVAX 23/5 DOSE (Pneumococcal Vaccine Polyvalent Inj 25 MCG/0.5ML) INJ 128.32796 11/15/2012 02/19/2013

PNV FOLIC ACID + IRON MUL (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

POCKETCHEM EZ BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

POCKETCHEM EZ BLOOD GLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Podofilox Soln 0.5% SOLN 13.00000 04/11/2014 04/09/2014

POLY-VI-FLOR (Ped Multiple Vit w/ Fluoride Biphasic Chew Tab 0.25 MG***) CHEW 0.21493 05/27/2011 02/19/2013

POLY-VI-FLOR (Ped Multiple Vit w/ Fluoride Biphasic Chew Tab 0.5 MG***) CHEW 0.16081 12/09/2011 02/19/2013

POLY-VI-FLOR (Ped Multiple Vit w/ Fluoride Biphasic Chew Tab 1 MG***) CHEW 0.16081 12/09/2011 02/19/2013

POLY-VI-SOL (Pediatric Multiple Vitamin w/ C Soln 35 MG/ML**) SOLN 0.08669 03/20/2008 02/19/2013

POLY-VI-SOL/IRON (Pediatric Multiple Vitamins w/ Iron Drops 10 MG/ML**) SOLN 0.08108 03/20/2008 02/19/2013

POLYCAL (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Polyethylene Glycol 3350 Oral Packet PACK 1.42505 02/22/2013 02/19/2013

Polyethylene Glycol 3350 Oral Powder POWD 0.03960 02/22/2013 02/19/2013

Polymyxin B-Trimethoprim Ophth Soln 10000 Unit/ML-0.1% SOLN 0.97000 02/22/2013 02/19/2013

Polysaccharide Iron Complex Cap 150 MG (Iron Equivalent) CAPS 0.12559 02/22/2013 02/19/2013

POLYTAR (Coal Tar-Juniper Tar-Pine Tar Shampoo***) SHAM 0.04490 04/28/2005 02/19/2013

Polyvinyl Alcohol Ophth Soln 1.4% SOLN 0.14917 02/22/2013 02/19/2013

Polyvinyl Alcohol-Povidone Ophth Soln 1.4-0.6% SOLN 0.23804 02/22/2013 02/19/2013

POMALYST (Pomalidomide Cap 1 MG) CAPS 541.34841 12/22/2014 02/10/2015




PORTAGEN (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Pot Phos Monobasic w/Sod Phos Di & Monobas Tab 155-852-130MG TABS 0.17733 02/22/2013 02/19/2013

Potassium Bicarbonate Effer Tab 25 mEq TBEF 0.19875 02/22/2013 02/19/2013

Potassium Chloride Cap CR 10 mEq CPCR 0.54298 12/19/2014 12/17/2014

Potassium Chloride Cap CR 8 mEq CPCR 0.86475 02/22/2013 02/19/2013

Potassium Chloride Inj 2 mEq/ML SOLN 0.08000 02/12/2014 03/12/2014

Potassium Chloride Microencapsulated Crys CR Tab 10 mEq TBCR 0.38434 11/14/2014 11/12/2014

Potassium Chloride Microencapsulated Crys CR Tab 20 mEq TBCR 0.33615 12/19/2014 12/17/2014

Potassium Chloride Oral Liq 10% (20 MEQ/15ML) LIQD 0.07800 02/03/2014 03/12/2014

Potassium Chloride Oral Liq 10% (20 MEQ/15ML) SOLN 0.07800 02/03/2014 03/12/2014

Potassium Chloride Oral Liq 20% (40 MEQ/15ML) LIQD 0.12520 08/11/2014 10/07/2014

Potassium Chloride Oral Liq 20% (40 MEQ/15ML) SOLN 0.12520 08/11/2014 10/07/2014

Potassium Chloride Powder Packet 20 mEq PACK 1.38000 05/20/2013 07/09/2013

Potassium Chloride Tab CR 10 mEq TBCR 0.35139 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Potassium Chloride Tab CR 8 mEq (600 MG) TBCR 0.38350 02/22/2013 02/19/2013

Potassium Citrate & Citric Acid Powder Pack 3300-1002 MG PACK 1.33641 02/14/2014 02/11/2014

Potassium Citrate & Citric Acid Soln 1100-334 MG/5ML SOLN 0.03020 02/22/2013 02/19/2013

Potassium Citrate & Citric Acid Soln 1100-334 MG/5ML SOLN 0.03020 06/16/2014 02/19/2013

Potassium Citrate Tab CR 10 MEQ (1080 MG) TBCR 0.52312 02/22/2013 02/19/2013

Potassium Citrate Tab CR 5 MEQ (540 MG) TBCR 0.37687 02/22/2013 02/19/2013

Povidone-Iodine Soln 10% SOLN 0.01750 02/22/2013 02/19/2013

PPA/MMA EXPRESS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PR NATAL 400 (Prenat-Fe Bis-Fe Prot Succ-FA-Ca Tab & Omega 3 Cap 400 Pk**) MISC 0.51442 01/23/2009 02/19/2013

Pramipexole Dihydrochloride Tab 0.125 MG TABS 0.09158 02/22/2013 02/19/2013




Pramipexole Dihydrochloride Tab 1 MG TABS 0.10168 02/22/2013 02/19/2013


Pravastatin Sodium Tab 10 MG TABS 0.44000 08/12/2013 09/09/2013




Prazosin HCl Cap 1 MG CAPS 0.29500 10/29/2013 11/05/2013



PRE-NATAL FORMULA (Prenatal Multivitamins & Minerals w/Iron & FA Tab 0.8 MG***) TABS 0.08640 07/01/1998 02/19/2013

PRECISION LINK (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRECISION PCX (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRECISION PCX PLUS TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRECISION POINT OF CARE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRECISION QID TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRECISION SOF-TACT TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRECISION THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PRECISION THINS GP LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PRECISION ULTRA LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PRECISION XTRA (Ketone Blood Test Strip) STRP 4.14456 08/26/2013 10/09/2013

PRECISION XTRA BLOOD GLUC (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PRECISION XTRA BLOOD GLUC (Glucose Blood Test Strip) STRP 1.25800 01/15/2014 03/12/2014

PRED FORTE (Prednisolone Acetate Ophth Susp 1%) SUSP 1.35800 05/28/2010 02/19/2013

Prednisolone Acetate Ophth Susp 1% SUSP 9.61600 04/15/2014 05/02/2014

Prednisolone Sod Phosph Oral Soln 6.7 MG/5ML (5 MG/5ML Base) SOLN 0.59279 04/20/2013 07/09/2013

Prednisolone Sod Phosphate Oral Soln 15 MG/5ML (Base Equiv) SOLN 0.09470 02/22/2013 02/19/2013

Prednisolone Sodium Phosphate Ophth Soln 1% SOLN 1.38000 02/22/2013 02/19/2013

Prednisolone Syrup 15 MG/5ML (USP Solution Equivalent) SOLN 0.03850 02/22/2013 02/19/2013

Prednisolone Syrup 15 MG/5ML (USP Solution Equivalent) SYRP 0.03850 02/22/2013 02/19/2013

Prednisone Tab 1 MG TABS 0.15500 12/17/2013 02/11/2014


Prednisone Tab 10 MG Dose Pack TABS 0.47210 02/08/2013 02/20/2013

Prednisone Tab 2.5 MG TABS 0.03438 02/22/2013 02/19/2013



PREFERRED PLUS LANCETS CO (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PREFERRED PLUS LANCETS SU (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PREFERRED PLUS LANCETS TH (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PREGESTIMIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

PREGESTIMIL (Infant Foods Powder**) POWD 0.07700 12/28/2011 02/19/2013

PREMIUM INFANT FORMULA/IR (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

PRENACARE (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

PRENAPLUS (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

PRENATABS FA (Prenatal Vit w/ Fe Fumarate-FA Tab 29-1 MG***) TABS 0.15587 01/23/2009 02/19/2013

PRENATABS RX (Prenatal Vit w/ Iron Carbonyl-FA Tab 29-1 MG***) TABS 0.17167 05/11/2012 02/19/2013

PRENATAL (Prenatal Multivitamins & Minerals w/Iron & FA Tab 0.8 MG***) TABS 0.08640 07/01/1998 02/19/2013

PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 27-0.8 MG***) TABS 0.03965 01/23/2009 02/19/2013



PRENATAL 19 (Prenatal Vit w/ DSS-Fe Fumarate-FA Tab 29-1 MG***) TABS 0.28847 01/23/2009 02/19/2013

PRENATAL 19 (Prenatal Vit w/ Fe Fumarate-FA Chew Tab 29-1 MG***) CHEW 0.29950 08/29/2008 02/19/2013

PRENATAL AD (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

PRENATAL AND IRON (Prenatal Multivitamins & Minerals w/Iron & FA Tab 0.8 MG***) TABS 0.08640 07/01/1998 02/19/2013

PRENATAL FORMULA (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

PRENATAL FORMULA (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PRENATAL FORTE (Prenatal Multivitamins & Minerals w/Iron & FA Tab 0.8 MG***) TABS 0.08640 07/01/1998 02/19/2013

PRENATAL LOW IRON (Prenatal Vit w/ Fe Fumarate-FA Tab 27-0.8 MG***) TABS 0.03965 01/23/2009 02/19/2013

PRENATAL LOW IRON (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

PRENATAL MULTIVITAMIN-ULT (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

Prenatal Multivitamins & Minerals w/Iron & FA Tab 0.8 MG*** TABS 0.08640 02/22/2013 02/19/2013

PRENATAL ONE DAILY (Prenatal Vit w/ Fe Fumarate-FA Tab 27-0.8 MG***) TABS 0.04900 03/20/2008 02/19/2013

PRENATAL PLUS (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

PRENATAL PLUS IRON (Prenatal Vit w/ Iron Carbonyl-FA Tab 29-1 MG***) TABS 0.17167 05/11/2012 02/19/2013

PRENATAL PLUS/IRON (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG*** TABS 0.07255 02/22/2013 02/19/2013

PRENATAL VITAMINS PLUS (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

PRENATAL/FOLIC ACID (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

PRESERVISION AREDS (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PRESERVISION AREDS 2 (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PRESERVISION/LUTEIN (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PRESTIGE SMART SYSTEM CO- (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRESTIGE TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRILOSEC OTC (Omeprazole Magnesium Delayed Release Tab 20 MG (Base Equiv)) TBEC 0.57785 03/20/2008 02/19/2013

Primidone Tab 250 MG TABS 0.19519 02/22/2013 02/19/2013

Primidone Tab 50 MG TABS 0.11498 02/22/2013 02/19/2013

PRIVIGEN (Immune Globulin (Human) IV Soln 10 GM/100ML) SOLN 12.94800 01/01/2015 02/10/2015



PRO-CAL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

PRO-CAL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

PRO-CAL (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PRO-PHREE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PROBALANCE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Probenecid Tab 500 MG TABS 0.49850 10/06/2014 11/12/2014

PROCERV HP (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Prochlorperazine Maleate Tab 10 MG (Base Equivalent) TABS 0.05200 02/22/2013 02/19/2013

Prochlorperazine Maleate Tab 5 MG (Base Equivalent) TABS 0.04463 02/22/2013 02/19/2013

Prochlorperazine Suppos 25 MG SUPP 7.35600 12/26/2014 02/10/2015




EFFECTIVE DATE

DATE UPDATED

PROCRIT (Epoetin Alfa Inj 10000 Unit/ML) SOLN 169.22040 04/13/2012 02/19/2013













PROCTOCORT (Hydrocortisone Rectal Cream 1%) CREA 0.06791 03/13/2008 02/19/2013

PRODIGY AUTOCODE BLOOD GL (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRODIGY AUTOCODE BLOOD GL (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRODIGY AUTOCODE PRO BLOO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRODIGY NO CODING BLOOD G (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PRODIGY POCKET BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRODIGY POCKET PRO BLOOD (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRODIGY PREFERRED BLOOD G (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRODIGY PRESSURE ACTIVATE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PRODIGY SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PRODIGY TWIST TOP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PRODIGY VOICE BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

PRODUCT 3232A (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PROFILNINE SD (Factor IX Complex For Inj 1000 Unit) SOLR 0.62217 06/26/2009 02/19/2013



Progesterone IM in Oil 50 MG/ML OIL 2.49813 02/22/2013 02/19/2013

Progesterone Micronized Cap 100 MG CAPS 1.28063 03/13/2015 03/10/2015

Progesterone Powder POWD 0.47840 02/22/2013 02/19/2013

PROGRAF (Tacrolimus Cap 0.5 MG) CAPS 2.16945 05/20/2014 07/09/2014




EFFECTIVE DATE

DATE UPDATED

PROGRAF (Tacrolimus Cap 1 MG) CAPS 4.33899 05/20/2014 07/09/2014

PROGRAF (Tacrolimus Cap 5 MG) CAPS 21.69504 05/20/2014 07/09/2014

PROLASTIN (Alpha1-Proteinase Inhibitor (Human) For IV Soln 1000 MG) SUSR 0.37392 10/23/2009 02/19/2013

PROLASTIN (Alpha1-Proteinase Inhibitor (Human) For IV Soln 500 MG) SOLR 0.37392 01/28/2011 02/19/2013

PROLASTIN-C (Alpha1-Proteinase Inhibitor (Human) For IV Soln 1000 MG) SOLR 0.43990 07/01/2014 08/06/2014

PROLASTIN-C (Alpha1-Proteinase Inhibitor (Human) For IV Soln 1000 MG) SOLR 0.43990 08/08/2014 08/06/2014

Promethazine & Phenylephrine Syrup 6.25-5 MG/5ML SYRP 0.01558 02/22/2013 02/19/2013

Promethazine HCl (Bulk) Powder POWD 0.40664 02/22/2013 02/19/2013

Promethazine HCl Inj 25 MG/ML SOLN 1.11748 02/22/2013 02/19/2013

Promethazine HCl Suppos 12.5 MG SUPP 10.01076 04/11/2014 04/09/2014

Promethazine HCl Suppos 25 MG SUPP 10.75000 12/16/2013 01/08/2014

Promethazine HCl Suppos 50 MG SUPP 0.17000 02/22/2013 02/19/2013

Promethazine HCl Syrup 6.25 MG/5ML SOLN 0.01558 02/22/2013 02/19/2013

Promethazine HCl Syrup 6.25 MG/5ML SYRP 0.01558 02/22/2013 02/19/2013

Promethazine HCl Tab 12.5 MG TABS 0.13251 02/22/2013 02/19/2013

Promethazine HCl Tab 25 MG TABS 0.15030 06/03/2013 08/06/2013

Promethazine HCl Tab 50 MG TABS 0.18352 02/22/2013 02/19/2013

Promethazine w/ Codeine Syrup 6.25-10 MG/5ML SYRP 0.01640 02/22/2013 02/19/2013

Promethazine-DM Syrup 6.25-15 MG/5ML SYRP 0.01971 02/22/2013 02/19/2013

PROMOD (Nutritional Supplement Liquid**) LIQD 0.02445 03/23/2010 02/19/2013

PROMOD (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PROMOTE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

PROMOTE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROMOTE WITH FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROMOTE-RTU (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROMOTE/FIBER (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

PROMOTE/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PRONTO (Pyrethrins-Piperonyl Butoxide Shampoo 0.33-4%) SHAM 0.04977 03/20/2008 02/19/2013

Propafenone HCl Cap SR 12HR 225 MG CP12 5.58334 02/22/2013 02/19/2013



Propafenone HCl Tab 150 MG TABS 0.14588 02/22/2013 02/19/2013






EFFECTIVE DATE

DATE UPDATED

Proparacaine HCl Ophth Soln 0.5% SOLN 0.19507 02/22/2013 02/19/2013

PROPIMEX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PROPIMEX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Propranolol & Hydrochlorothiazide Tab 40-25 MG TABS 0.07710 02/22/2013 02/19/2013

Propranolol & Hydrochlorothiazide Tab 80-25 MG TABS 0.11700 02/22/2013 02/19/2013

Propranolol HCl Cap SR 24HR 120 MG CP24 2.08747 07/11/2014 07/09/2014




Propranolol HCl Tab 10 MG TABS 0.03186 02/22/2013 02/19/2013





Propylene Glycol-Glycerin Ophth Soln 1-0.3% SOLN 0.24650 02/22/2013 02/19/2013

Propylthiouracil Tab 50 MG TABS 0.71014 03/13/2015 03/10/2015

PROSHIELD PLUS SKIN PROTE (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

PROSOURCE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROSOURCE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PROSOURCE NO CARB (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROSOURCE PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROSOURCE ZAC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROSURE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROTAIN XL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PROTECT CARDIO AF (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PROTECT PLUS (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PROTECT PLUS (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

PROTECT PLUS AF (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PROTECT PLUS NR (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

PROTEIN FORTIFIER (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/28/2013

PROTIFAR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

PROTONIX (Pantoprazole Sodium EC Tab 40 MG (Base Equiv)) TBEC 2.07500 04/23/2010 02/19/2013

Protriptyline HCl Tab 10 MG TABS 2.12000 02/01/2014 03/12/2014

Protriptyline HCl Tab 5 MG TABS 1.43575 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

PROVIGIL (Modafinil Tab 100 MG) TABS 0.05410 04/28/2005 02/19/2013

PROVIMIN (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Pseudoeph-Chlorphen-DM w/ APAP Tab 30-2-15-500 MG TABS 0.00810 02/22/2013 02/19/2013

Pseudoephed-Bromphen-DM Syrup 30-2-10 MG/5ML SYRP 0.03580 02/22/2013 02/19/2013

Pseudoephedrine HCl Liq 15 MG/5ML LIQD 0.02380 02/22/2013 02/19/2013

Pseudoephedrine HCl Liq 30 MG/5ML LIQD 0.00841 02/22/2013 02/19/2013

Pseudoephedrine HCl Syrup 30 MG/5ML SYRP 0.01848 02/22/2013 02/19/2013

Pseudoephedrine HCl Tab 30 MG TABS 0.03500 02/22/2013 02/19/2013

Pseudoephedrine HCl Tab 60 MG TABS 0.02912 02/22/2013 02/19/2013

Pseudoephedrine HCl Tab SR 12HR 120 MG TB12 0.26920 02/22/2013 02/19/2013

Pseudoephedrine HCl Tab SR 12HR 120 MG TB12 0.27700 03/20/2008 02/19/2013

PSS SELECT GP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PSS SELECT SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Psyllium Cap 0.52 GM CAPS 0.04125 02/22/2013 02/19/2013

Psyllium Powder 28.3% POWD 0.01720 02/22/2013 02/19/2013

Psyllium Powder 30% POWD 0.01120 02/22/2013 02/19/2013






PTS PANELS GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

PULMOCARE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

PULMOCARE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

PULMOZYME (Dornase Alfa Inhal Soln 1 MG/ML) SOLN 37.38641 01/05/2015 02/10/2015

PURPOSE MOISTURIZER (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

PX LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PX LANCETS ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

PX PRENATAL MULTIVITAMINS (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

Pyrethrins-Piperonyl Butoxide Liq 0.3-3% LIQD 0.06729 02/22/2013 02/19/2013

Pyrethrins-Piperonyl Butoxide Liq 0.33-4% LIQD 0.09099 02/22/2013 02/19/2013

Pyrethrins-Piperonyl Butoxide Liq 0.33-4% SHAM 0.09099 02/22/2013 02/19/2013

Pyrethrins-Piperonyl Butoxide Shampoo 0.3-3% SHAM 0.04062 02/22/2013 02/19/2013

Pyrethrins-Piperonyl Butoxide Shampoo 0.33-4% SHAM 0.03030 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Pyridostigmine Bromide Tab 60 MG TABS 0.27263 02/22/2013 02/19/2013

Pyridoxine HCl Tab 100 MG TABS 0.02610 02/22/2013 02/19/2013



QC LANCETS SUPER THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

QC LANCETS ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

QC MINERAL OIL HEAVY (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

QC PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.03965 01/23/2009 02/19/2013

QUALAQUIN (Quinine Sulfate Cap 324 MG) CAPS 0.31000 05/26/2005 02/19/2013

QUENCH (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Quetiapine Fumarate Tab 100 MG TABS 0.26000 02/22/2013 02/19/2013






QUICKTEK (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

QUICKTEK TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

QUIN B STRONG (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Quinapril HCl Tab 10 MG TABS 0.11278 02/22/2013 02/19/2013




Quinapril-Hydrochlorothiazide Tab 20-25 MG TABS 0.73764 02/22/2013 02/19/2013

Quinidine Gluconate Tab CR 324 MG TBCR 0.52300 02/22/2013 02/19/2013

Quinidine Sulfate Tab 200 MG TABS 0.18270 02/22/2013 02/19/2013

Quinidine Sulfate Tab 300 MG TABS 0.18270 02/22/2013 02/19/2013

QUINTABS (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

QUINTABS-M (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

QUINTET AC BLOOD GLUCOSE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

QUINTET BLOOD GLUCOSE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RA BALANCED NUTRITIONAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RA BALANCED NUTRITIONAL P (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RA CALCIUM HI-CAL/VITAMIN (Calcium w/ Vitamin D Tab 500 MG-125 Unit) TABS 0.02087 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

RA CALCIUM HI-CAL/VITAMIN (Calcium-Cholecalciferol Tab 500 MG-200 Unit) TABS 0.02087 03/13/2008 02/19/2013

RA CALCIUM HI-CAL/VITAMIN (Calcium-Ergocalciferol Tab 250 MG-125 Unit) TABS 0.02833 03/13/2008 02/19/2013

RA CENTRAL-VITE UNDER 50 (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

RA E-ZJECT COLOR LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RA E-ZJECT LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RA E-ZJECT LANCETS THIN 2 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RA E-ZJECT LANCETS ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RA GENTLE INFANT FORMULA/ (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

RA IMMUNE SUPPORT INFANT (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

RA INFANT FORMULA/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

RA LOTION (Resorcinol-Alcohol Lotion***) LOTN 0.02740 04/28/2005 02/19/2013

RA MILK BASED INFANT FORM (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

RA MINERAL OIL (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

RA NUTRITIONAL SUPPLEMENT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RA NUTRITIONAL SUPPORT (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

RA OMEPRAZOLE (Omeprazole Delayed Release Tab 20 MG) TBEC 0.53640 04/28/2005 02/19/2013

RA OYSTER SHELL CALCIUM/V (Calcium Carbonate-Ergocalciferol Tab 250 MG-125 Unit) TABS 0.02833 03/13/2008 02/19/2013

RA PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

RA RENEWAL ADVANCED HEALI (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

RA RENEWAL DRY SKIN THERA (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

RA SOY INFANT FORMULA/IRO (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

RA TRUE2GO BLOOD GLUCOSE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

RA TRUERESULT BLOOD GLUCO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

RA TRUETEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RA TUGABOOS INFANT FORMUL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

RA TUGABOOS SENSITIVITY I (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Rabeprazole Sodium EC Tab 20 MG TBEC 1.03434 04/11/2014 04/09/2014

RADIAGUARD ADVANCED (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

RAGUS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Ramipril Cap 1.25 MG CAPS 0.10250 02/22/2013 02/19/2013

Ramipril Cap 10 MG CAPS 0.13322 02/22/2013 02/19/2013

Ramipril Cap 2.5 MG CAPS 0.13370 02/22/2013 02/19/2013

Ramipril Cap 5 MG CAPS 0.13142 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Ranitidine HCl Cap 150 MG CAPS 0.81000 02/13/2014 03/12/2014

Ranitidine HCl Cap 300 MG CAPS 1.42000 06/05/2014 07/09/2014

Ranitidine HCl Inj 50 MG/2ML (25 MG/ML) SOLN 2.16450 02/22/2013 02/19/2013

Ranitidine HCl Syrup 15 MG/ML (75 MG/5ML) SYRP 0.04313 02/22/2013 02/19/2013

Ranitidine HCl Tab 150 MG TABS 0.09228 10/15/2013 11/06/2013



RAPAMUNE (Sirolimus Tab 1 MG) TABS 18.85577 01/01/2015 02/10/2015

RCF (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

RE/NEPH (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RE/NEPH HP/HC (Nutritional Supplement Liquid** (Frozen)) LIQD 0.00720 04/28/2005 02/19/2013

RE/NEPH LP/HC (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RE/NEPH REDUCED SUGAR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

REALITY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

REALITY TRIGGER LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

REBIF (Interferon Beta-1a Inj 22 MCG/0.5ML (12MU/ML) (44 MCG/ML)) SOLN 859.04170 10/03/2014 11/12/2014

REBIF (Interferon Beta-1a Inj 44 MCG/0.5ML (24MU/ML) (88 MCG/ML)) SOLN 859.04170 10/03/2014 11/12/2014

REBIF REBIDOSE (Interferon Beta-1a Inj 22 MCG/0.5ML (12MU/ML) (44 MCG/ML)) SOLN 859.04170 10/03/2014 11/12/2014

REBIF REBIDOSE (Interferon Beta-1a Inj 44 MCG/0.5ML (24MU/ML) (88 MCG/ML)) SOLN 859.04170 10/03/2014 11/12/2014

REBIF REBIDOSE TITRATION (Interferon Beta-1a Inj 6 X 8.8 MCG/0.2ML & 6 X 22 MCG/0.5ML) SOLN 1227.20243 10/03/2014 11/12/2014

REBIF TITRATION PACK (Interferon Beta-1a Inj 6 X 8.8 MCG/0.2ML & 6 X 22 MCG/0.5ML) SOLN 1227.20243 10/03/2014 11/12/2014

RECOMBINATE (Antihemophilic Factor (Recombinant) For Inj 1241-1800 Unit) SOLR 0.99000 10/10/2014 10/07/2014





RECTICARE (Lidocaine Anorectal Cream 5%) CREA 1.50940 04/28/2005 02/19/2013

REFRESH (Polyvinyl Alcohol-Povidone Ophth Soln 1.4-0.6%) SOLN 0.23804 03/20/2008 02/19/2013

REFRESH CELLUVISC (Carboxymethylcellulose Sodium Ophth Soln 1%) SOLN 0.47264 04/23/2012 02/19/2013

REFRESH DRY EYE THERAPY (Glycerin-Polysorbate 80 Ophth Soln 1-1%) SOLN 0.55109 03/13/2008 02/19/2013

REFRESH ENDURA (Glycerin-Polysorbate 80 Ophth Soln 1-1%) SOLN 0.55109 03/13/2008 02/19/2013

REFRESH LIQUIGEL (Carboxymethylcellulose Sodium Ophth Soln 1%) SOLN 0.47264 04/23/2012 02/19/2013




EFFECTIVE DATE

DATE UPDATED

REFRESH PLUS (Carboxymethylcellulose Sodium Ophth Soln 0.5%) SOLN 0.21960 01/15/2009 02/19/2013

REFRESH PLUS (Carboxymethylcellulose Sodium Ophth Soln 0.5%) SOLN 0.21960 05/28/2010 02/19/2013

REFUAH PLUS BLOOD GLUCOSE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

REFUAH PLUS BLOOD GLUCOSE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RELION BLOOD GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RELION CONFIRM BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

RELION CONFIRM/MICRO TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RELION LANCETS STANDARD 2 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RELION LANCETS THIN 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RELION LANCETS ULTRA-THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RELION MICRO BLOOD GLUCOS (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

RELION PRIME BLOOD GLUCOS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RELION ULTIMA BLOOD GLUCO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RELION ULTIMA TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

RELION ULTRA THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RELION ULTRA THIN PLUS LA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RELISTOR (Methylnaltrexone Bromide Inj 12 MG/0.6ML (20 MG/ML)) SOLN 119.61684 01/31/2015 03/10/2015

RELISTOR (Methylnaltrexone Bromide Inj 8 MG/0.4ML (20 MG/ML)) SOLN 179.42821 01/31/2015 03/10/2015

RELISTOR (Methylnaltrexone Bromide Inj Kit 12 MG/0.6ML) KIT 59.31180 06/14/2013 08/06/2013

REMEDY CLEAR-AID (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

REMEDY NUTRASHIELD (Dimethicone Cream 1%) CREA 0.06060 04/28/2005 02/19/2013

REMICADE (Infliximab For IV Inj 100 MG) SOLR 924.52870 09/04/2014 10/07/2014

RENALCAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RENAPLEX-D (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

RENASTART (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

RENASTART (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

RENEW ADVANCED LANCING CA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Repaglinide Tab 0.5 MG TABS 0.58577 03/13/2015 03/10/2015

Repaglinide Tab 1 MG TABS 0.66327 03/13/2015 03/10/2015

Repaglinide Tab 2 MG TABS 2.97000 02/14/2014 02/11/2014

REPLACE (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

REPLETE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

REPLETE/FIBER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

REPLETE/FIBER/ULTRAPAK (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

REQ 49+ (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

RESOURCE 2.0 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE ARGINAID (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

RESOURCE BREEZE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE DAIRY THICK HONE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE DIABETIC TF (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE GLUTASOLVE (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

RESOURCE JUST FOR KIDS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE JUST FOR KIDS 1. (Nutritional Supplement Liquid**) LIQD 0.00972 05/21/2007 02/19/2013

RESOURCE JUST FOR KIDS WI (Nutritional Supplement Liquid**) LIQD 0.00977 05/14/2007 02/19/2013

RESOURCE JUST FOR KIDS WI (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE OPTISOURCE HIGH (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE SUPPORT (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESOURCE THICKENUP (Starch Oral Thickening Powder) POWD 0.02350 03/20/2008 02/19/2013

RESOURCE THICKENUP THICKE (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

RESOURCE THICKENUP THICKE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESPALOR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

RESURGEX (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

RESURGEX PLUS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

RESURGEX SELECT (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

REVEAL BLOOD GLUCOSE MONI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

REVEAL BLOOD GLUCOSE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

REVLIMID (Lenalidomide Cap 10 MG) CAPS 467.40122 12/22/2014 02/10/2015




RHOGAM ULTRA-FILTERED PLU (Rho D Immune Globulin (Human) IM Inj 300 MCG) INJ 104.69620 06/19/2014 07/09/2014

RIASTAP (Fibrinogen Conc (Human) Inj Approximately 1 GM (900-1300 MG)) SOLR 0.87200 12/24/2010 02/19/2013

Ribavirin Cap 200 MG CAPS 0.78500 08/18/2014 09/10/2014

Ribavirin Tab 200 MG TABS 0.60089 02/22/2013 02/19/2013

Riboflavin Tab 100 MG TABS 0.03360 02/22/2013 02/19/2013

RID (Permethrin Aerosol 0.5%) AERO 0.02400 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

RID (Pyrethrins-Piperonyl Butoxide Liq 0.3-3%) LIQD 0.06729 03/20/2008 02/19/2013

RID (Pyrethrins-Piperonyl Butoxide Liq 0.33-4%) LIQD 0.09099 03/20/2008 02/19/2013

Rifampin Cap 150 MG CAPS 0.75014 02/22/2013 02/19/2013

Rifampin Cap 300 MG CAPS 1.01798 07/11/2014 07/09/2014

RIGHT STEP PRENATAL (Prenatal Vit w/ Fe Fumarate-FA Tab 27-0.8 MG***) TABS 0.03970 04/23/2010 02/19/2013

RIGHTEST GL300 LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

RIGHTEST GM100 BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013



RIGHTEST GS100 BLOOD GLUC (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013



RILUTEK (Riluzole Tab 50 MG) TABS 37.56317 12/01/2014 01/06/2015

Riluzole Tab 50 MG TABS 3.27872 02/14/2014 02/11/2014

Rimantadine Hydrochloride Tab 100 MG TABS 1.10600 02/22/2013 02/19/2013

Risperidone Orally Disintegrating Tab 0.5 MG TBDP 1.48278 02/22/2013 02/19/2013

Risperidone Orally Disintegrating Tab 1 MG TBDP 1.88676 11/14/2014 11/12/2014




Risperidone Soln 1 MG/ML SOLN 0.47063 03/13/2015 03/10/2015

Risperidone Tab 0.25 MG TABS 0.07642 02/22/2013 02/19/2013

Risperidone Tab 0.5 MG TABS 0.13073 02/22/2013 02/19/2013

Risperidone Tab 1 MG TABS 0.16431 02/22/2013 02/19/2013




RITUXAN (Rituximab For IV Inj Conc 10 MG/ML) CONC 72.14526 01/05/2015 02/10/2015

Rivastigmine Tartrate Cap 1.5 MG CAPS 2.17690 05/10/2013 05/07/2013

Rivastigmine Tartrate Cap 3 MG CAPS 1.56508 10/10/2014 10/07/2014

Rivastigmine Tartrate Cap 4.5 MG CAPS 1.92757 10/10/2014 10/07/2014

Rivastigmine Tartrate Cap 6 MG CAPS 2.54292 02/22/2013 02/19/2013

RIXUBIS (Coagulation Factor IX (Recombinant) For Inj 1000 Unit) SOLR 1.20100 01/01/2015 02/10/2015




EFFECTIVE DATE

DATE UPDATED




Rizatriptan Benzoate Orally Disintegrating Tab 10 MG TBDP 2.00889 03/14/2014 03/12/2014

Rizatriptan Benzoate Orally Disintegrating Tab 5 MG TBDP 1.91500 07/11/2014 07/09/2014

Rizatriptan Benzoate Tab 10 MG TABS 1.85000 11/08/2013 11/05/2013

Rizatriptan Benzoate Tab 5 MG TABS 2.11559 07/12/2013 07/08/2013

ROBITUSSIN CHEST CONGESTI (Guaifenesin Syrup 100 MG/5ML) SYRP 0.01800 03/13/2008 02/19/2013

ROBITUSSIN DM (Dextromethorphan-Guaifenesin Syrup 10-100 MG/5ML) SYRP 0.02981 03/13/2008 02/19/2013

ROBITUSSIN PEAK COLD DM (Dextromethorphan-Guaifenesin Syrup 10-100 MG/5ML) SYRP 0.02981 03/13/2008 02/19/2013

ROC DEEP WRINKLE SERUM (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

ROC MULTI CORREXION LIFT (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Ropinirole Hydrochloride Tab 0.25 MG TABS 0.18177 02/22/2013 02/19/2013

Ropinirole Hydrochloride Tab 0.5 MG TABS 0.21330 02/22/2013 02/19/2013

Ropinirole Hydrochloride Tab 1 MG TABS 0.21378 02/22/2013 02/19/2013





Ropinirole Hydrochloride Tab SR 24HR 2 MG (Base Equivalent) TB24 2.05110 05/09/2014 05/02/2014

Ropinirole Hydrochloride Tab SR 24HR 4 MG (Base Equivalent) TB24 2.72000 05/09/2014 05/02/2014

S.O.S. 15 (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013



SABRIL (Vigabatrin Powd Pack 500 MG) PACK 87.71174 01/02/2015 02/10/2015

SABRIL (Vigabatrin Tab 500 MG) TABS 87.71183 01/02/2015 02/10/2015

SAFE-T-LANCE LOW FLOW 25G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFE-T-LANCE NORMAL FLOW (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFE-T-LANCE PLUS SAFETY (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFETY LANCET 2MM (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFETY LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFETY LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFETY LET LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAFETY SEAL LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

SAFETY SEAL LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SAIZEN (Somatropin (Non-Refrigerated) For Inj 5 MG) SOLR 398.89800 11/28/2012 02/19/2013

SAIZEN (Somatropin (Non-Refrigerated) For Inj 5 MG) SOLR 454.57440 01/17/2014 03/12/2014

SAIZEN (Somatropin (Non-Refrigerated) For Inj 8.8 MG) SOLR 727.32070 01/17/2014 03/12/2014

SAIZEN CLICK.EASY (Somatropin (Non-Refrigerated) For Inj 8.8 MG) SOLR 763.73280 07/10/2014 08/06/2014

Salicylic Acid Lotion 6% LOTN 0.08792 02/22/2013 02/19/2013

Salicylic Acid Shampoo 6% SHAM 0.14124 02/22/2013 02/19/2013

Saline Injection Bacteriostatic SOLN 0.11379 02/22/2013 03/04/2013

Saline Nasal Spray 0.65% SOLN 0.02275 02/22/2013 02/19/2013

Salsalate Tab 500 MG TABS 1.10250 11/08/2014 01/06/2015

Salsalate Tab 750 MG TABS 0.31000 11/20/2013 01/08/2014

SANDIMMUNE (Cyclosporine Cap 25 MG) CAPS 2.79710 01/06/2015 02/10/2015

SANDIMMUNE (Cyclosporine Oral Soln 100 MG/ML) SOLN 10.78286 01/06/2015 02/10/2015

SANDOSTATIN LAR DEPOT (Octreotide Acetate For IM Inj Kit 20 MG) KIT 3044.75540 01/06/2015 02/10/2015

SANDOSTATIN LAR DEPOT (Octreotide Acetate For IM Inj Kit 30 MG) KIT 4559.28960 01/06/2015 02/10/2015

SARNA (Camphor & Menthol Lotion 0.5-0.5%) LOTN 0.03110 04/28/2005 02/19/2013

SAVISION (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

SB LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SB LANCETS ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SCANDICAL (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

SCANDISHAKE (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

SCANDISHAKE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

SE-NATAL 19 (Prenatal Vit w/ DSS-Fe Fumarate-FA Tab 29-1 MG***) TABS 0.28847 01/23/2009 02/19/2013

SE-NATAL 19 (Prenatal Vit w/ Fe Fumarate-FA Chew Tab 29-1 MG***) CHEW 0.29950 08/29/2008 02/19/2013

Selegiline HCl Cap 5 MG CAPS 1.54500 09/10/2014 10/07/2014

Selegiline HCl Tab 5 MG TABS 1.49837 10/11/2013 10/09/2013

Selenium Sulfide Lotion 1% LOTN 0.01910 02/22/2013 02/19/2013

Selenium Sulfide Lotion 1% SHAM 0.01910 02/22/2013 02/19/2013

Selenium Sulfide Lotion 2.5% LOTN 0.07900 02/22/2013 02/19/2013

Selenium Tab 50 MCG TABS 0.02969 02/22/2013 02/19/2013

SELSUN BLUE (Selenium Sulfide Lotion 1%) LOTN 0.01910 03/20/2008 02/19/2013

SELSUN BLUE DAILY (Selenium Sulfide Lotion 1%) LOTN 0.01910 03/20/2008 02/19/2013

SELSUN BLUE MEDICATED (Selenium Sulfide Lotion 1%) LOTN 0.01910 03/20/2008 02/19/2013

SELSUN BLUE MOISTURIZING (Selenium Sulfide Lotion 1%) LOTN 0.01910 03/20/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

SENETONIC (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

Senna Tab 187 MG TABS 0.03800 02/22/2013 02/19/2013

Sennosides Syrup 8.8 MG/5ML LIQD 0.05850 02/22/2013 02/19/2013

Sennosides Syrup 8.8 MG/5ML SYRP 0.05850 02/22/2013 02/19/2013

Sennosides Tab 8.6 MG TABS 0.03800 02/22/2013 02/19/2013

Sennosides-Docusate Sodium Tab 8.6-50 MG TABS 0.05000 02/22/2013 02/19/2013

SENOKOT (Sennosides Tab 8.6 MG) TABS 0.03800 03/20/2008 02/19/2013

SENOKOT S (Sennosides-Docusate Sodium Tab 8.6-50 MG) TABS 0.09222 03/20/2008 02/19/2013

SENOKOT TO GO (Sennosides Tab 8.6 MG) TABS 0.03800 03/20/2008 02/19/2013

SEROSTIM (Somatropin (Non-Refrigerated) For Subcutaneous Inj 4 MG) SOLR 268.99944 01/09/2015 02/10/2015



Sertraline HCl Oral Conc 20 MG/ML CONC 0.70188 02/22/2013 02/19/2013

Sertraline HCl Tab 100 MG TABS 0.07562 02/22/2013 02/19/2013



SIDEROL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

Sildenafil Citrate Tab 20 MG TABS 0.93500 10/09/2014 11/12/2014

Silver Sulfadiazine Cream 1% CREA 0.25000 12/07/2012 05/15/2013

Simethicone Cap 125 MG CAPS 0.02200 02/22/2013 02/19/2013

Simethicone Chew Tab 125 MG CHEW 0.07284 02/22/2013 02/19/2013

Simethicone Chew Tab 80 MG CHEW 0.02327 02/22/2013 02/19/2013

Simethicone Susp 40 MG/0.6ML SUSP 0.05709 02/22/2013 02/19/2013

SIMILAC (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

SIMILAC (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC 2 ADVANCE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC 2/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC ADVANCE COMPLETE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ADVANCE EARLY SHI (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

SIMILAC ADVANCE EARLY SHI (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ADVANCE EARLY SHI (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC ADVANCE KOSHER (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ADVANCE ORGANIC E (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

SIMILAC ADVANCE/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ADVANCE/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC ALIMENTUM ADVANCE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ALIMENTUM-IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC EXPERT CARE ALIME (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC EXPERT CARE ALIME (Infant Foods Powder**) POWD 0.05900 02/06/2010 02/19/2013

SIMILAC EXPERT CARE NEOSU (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC EXPERT CARE NEOSU (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC EXPERT CARE/DIARR (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC FOR SPIT-UP (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC FOR SPIT-UP EARLY (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC GO & GROW EARLY S (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC HUMAN MILK FORTIF (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC ISOMIL 2 ADVANCE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC ISOMIL ADVANCE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ISOMIL SOY EARLY (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC LACTOSE FREE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC LACTOSE FREE ADVA (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC LACTOSE FREE ADVA (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC LOW IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC LOW-IRON (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

SIMILAC LOW-IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC LOW-IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC NATURAL CARE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC NEOSURE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC NEOSURE ADVANCE/I (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ORGANIC/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC ORGANIC/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC PM 60/40 (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC SENSITIVE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SENSITIVE EARLY S (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SENSITIVE EARLY S (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC SENSITIVE FOR SPI (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC SENSITIVE ISOMIL (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013




EFFECTIVE DATE

DATE UPDATED

SIMILAC SENSITIVE ISOMIL (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SENSITIVE ISOMIL (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC SENSITIVE/FUSSINE (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

SIMILAC SENSITIVE/FUSSINE (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

SIMILAC SENSITIVE/SPIT-UP (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SPECIAL CARE (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SPECIAL CARE PREM (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SPECIAL CARE/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC SPECIAL CARE/LOW (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC W/IRON (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

SIMILAC/IRON (Infant Foods Conc**) CONC 0.01190 04/28/2005 02/19/2013

SIMILAC/IRON (Infant Foods Liquid**) LIQD 0.01680 12/27/2006 02/19/2013

SIMILAC/IRON (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

Simvastatin Tab 10 MG TABS 0.03698 02/22/2013 02/19/2013





SINGLE-LET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Skin Protectants Misc - Ointment*** OINT 0.03040 02/22/2013 02/19/2013

SKIN REPAIR (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

SLO-NIACIN (Niacin Tab CR 500 MG) TBCR 0.05066 03/20/2008 02/19/2013

SLO-NIACIN (Niacin Tab CR 750 MG) TBCR 0.06310 04/28/2005 02/19/2013

SLOW-MAG (Magnesium Cl-Ca Carbonate Tab DR 71.5-119 MG (Elemental)) TBEC 0.10710 03/20/2008 02/19/2013

SM LANCETS 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SM MICRO THIN LANCETS 33G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SM MINERAL OIL (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

SM NUTRI-DRINK (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

SM NUTRI-DRINK + (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

SM PRENATAL VITAMINS (Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8 MG***) TABS 0.07255 02/27/2009 02/19/2013

SM SUPER THIN LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SM THIN LANCETS 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SMART DIABETES VANTAGE UN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

SMART DIABETES XPRES BLOO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

SMART DIABETES XPRES BLOO (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SMART SENSE COLOR LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SMART SENSE STANDARD LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SMART SENSE SUPER THIN LA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SMART SENSE THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SMARTEST BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SMARTEST EJECT STARTER KI (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

SMARTEST LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SMARTEST PERSONA STARTER (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

SMARTEST PRONTO STARTER (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

SMARTEST PROTEGE STARTER (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

Sodium Bicarbonate Inj 8.4% SOLN 0.10962 06/17/2014 08/06/2014

Sodium Bicarbonate Tab 325 MG TABS 0.02043 02/22/2013 02/19/2013

Sodium Bicarbonate Tab 650 MG TABS 0.01930 02/22/2013 02/19/2013

Sodium Chloride Aero Soln 0.9% AERS 0.02435 02/22/2013 02/19/2013

Sodium Chloride Flush IV Soln 0.9% SOLN 0.00203 02/22/2013 02/19/2013

Sodium Chloride Hypertonic Ophth Oint 5% OINT 2.82175 02/22/2013 02/19/2013

Sodium Chloride Hypertonic Ophth Soln 5% SOLN 0.67835 02/22/2013 02/19/2013

Sodium Chloride Inj 0.9% SOLN 0.04000 12/03/2013 01/08/2014

Sodium Chloride Inj 4 mEq/ML (23.4%) SOLN 0.09604 01/17/2013 03/04/2013

Sodium Chloride Inj 4 mEq/ML (23.4%) SOLN 0.09604 02/22/2013 03/04/2013

Sodium Chloride Irrigation Soln 0.9% SOLN 0.00330 04/07/2014 05/02/2014

Sodium Chloride IV Soln 0.9% SOLN 0.00203 02/22/2013 02/19/2013

Sodium Chloride Soln Nebu 0.9% NEBU 0.04639 02/22/2013 02/19/2013

Sodium Chloride Tab 1 GM TABS 0.04563 02/22/2013 02/19/2013

Sodium Citrate & Citric Acid Soln 500-334 MG/5ML SOLN 0.01646 02/22/2013 02/19/2013

Sodium Fluoride Chew Tab 0.25 MG F (from 0.55 MG NaF) CHEW 0.04095 02/22/2013 02/19/2013

Sodium Fluoride Chew Tab 0.5 MG F (from 1.1 MG NaF) CHEW 0.02599 02/22/2013 02/19/2013

Sodium Fluoride Chew Tab 1 MG F (from 2.2 MG NaF) CHEW 0.00189 02/22/2013 02/19/2013

Sodium Fluoride Cream 1.1% CREA 0.07571 02/22/2013 02/19/2013

Sodium Fluoride Gel 1.1% (0.5% F) GEL 0.06328 02/22/2013 02/19/2013

Sodium Fluoride Rinse 0.2% SOLN 0.01756 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Sodium Fluoride Soln 0.5 MG/ML F (from 1.1 MG/ML NaF) SOLN 0.16980 02/22/2013 02/19/2013

Sodium Phosphates - Enema*** ENEM 0.01138 02/22/2013 02/19/2013

Sodium Phosphates - Soln*** SOLN 0.06425 02/22/2013 02/19/2013

Sodium Polystyrene Sulfonate Oral Susp 15 GM/60ML SUSP 0.07401 02/22/2013 02/19/2013

Sodium Polystyrene Sulfonate Powder** POWD 0.23634 02/22/2013 02/19/2013

SOL CARB (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

SOLO (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

SOLUS V2 AUDIBLE BLOOD GL (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

SOLUS V2 AUDIBLE TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SOLUS V2 TWIST LANCETS 30 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SOOTHE & COOL FREE MEDSEP (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

SOOTHE & COOL FREE MOISTU (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

SOOTHE & COOL FREE SKIN P (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

SOOTHE & COOL MOISTURE BA (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

SOOTHE & COOL MOISTURIZIN (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

SOOTHE & COOL PROTECT MOI (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

SORBIDON HYDRATE (Skin Protectants Misc - Cream***) CREA 0.03040 04/28/2005 02/19/2013

Sorbitol Oral Solution 70% SOLN 0.01100 02/22/2013 02/19/2013

Sorbitol Solution (Bulk) SOLN 0.01100 02/22/2013 02/19/2013

Sotalol HCl (AFIB/AFL) Tab 120 MG TABS 0.17314 02/22/2013 02/19/2013



Sotalol HCl Tab 120 MG TABS 0.17314 02/22/2013 02/19/2013




SOURCE COOKIE BAR (Nutritional Supplement Bar**) BAR 0.46070 04/28/2005 02/19/2013

SOURCECF (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

SOURCECF (Multiple Vitamins w/ Minerals Chew Tab**) CHEW 0.29485 03/20/2008 02/19/2013

SOURCECF PEDIATRIC (Pediatric Multiple Vitamin w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

SOVALDI (Sofosbuvir Tab 400 MG) TABS 996.00000 03/14/2014 03/12/2014

SOY PROTEIN SHAKE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

SOYPRO (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

Speciality Vitamin Product Cap** CAPS 0.02150 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Speciality Vitamin Product Tab** TABS 0.01190 02/22/2013 02/19/2013

Spironolactone & Hydrochlorothiazide Tab 25-25 MG TABS 0.96000 11/13/2014 12/09/2014

Spironolactone Powder POWD 2.34000 02/22/2013 02/19/2013

Spironolactone Tab 100 MG TABS 0.50262 02/22/2013 02/19/2013



SPORTSCREME (Trolamine Salicylate Cream 10%) CREA 0.04250 04/28/2005 02/19/2013

SPRYCEL (Dasatinib Tab 100 MG) TABS 319.86098 10/13/2014 11/12/2014






ST IVES SWISS FORMULA 24 (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Stannous Fluoride Gel 0.4% GEL 0.06033 02/22/2013 02/19/2013

Starch-Maltodextrin Oral Thickening Powder POWD 0.01832 02/22/2013 02/19/2013

Stavudine Cap 15 MG CAPS 1.18500 02/22/2013 02/19/2013




STERILANCE TL (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

STROVITE ADVANCE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

STROVITE FORTE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

STROVITE ONE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

SUBDUE (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

SUBDUE PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

Sucralfate Tab 1 GM TABS 0.24562 02/19/2015 03/10/2015

SUDAFED (Pseudoephedrine HCl Tab 30 MG) TABS 0.03500 03/20/2008 02/19/2013

SUDAFED CHILDRENS (Pseudoephedrine HCl Liq 15 MG/5ML) LIQD 0.02380 04/28/2005 02/19/2013

SUDAFED CONGESTION (Pseudoephedrine HCl Tab 30 MG) TABS 0.03500 03/20/2008 02/19/2013

SUDAFED NASAL DECONGESTAN (Pseudoephedrine HCl Tab 30 MG) TABS 0.03500 03/20/2008 02/19/2013

Sulfacetamide Sodium Lotion 10% (Acne) LOTN 0.62192 02/22/2013 02/19/2013

Sulfacetamide Sodium Lotion 10% (Acne) SUSP 0.62192 02/22/2013 02/19/2013

Sulfacetamide Sodium Ophth Soln 10% SOLN 3.06600 05/09/2014 05/02/2014




EFFECTIVE DATE

DATE UPDATED

Sulfacetamide Sodium w/ Sulfur Emulsion 10-5% EMUL 0.13190 02/22/2013 02/19/2013

Sulfacetamide Sodium w/ Sulfur Lotion 10-5% LOTN 0.70410 02/22/2013 02/19/2013

Sulfacetamide Sodium-Prednisolone Ophth Soln 10-0.23(0.25)% SOLN 2.86230 02/22/2013 02/19/2013

Sulfamethoxazole-Trimethoprim Susp 200-40 MG/5ML SUSP 0.37500 07/25/2014 08/06/2014

Sulfamethoxazole-Trimethoprim Tab 400-80 MG TABS 0.08359 02/22/2013 02/19/2013

Sulfamethoxazole-Trimethoprim Tab 800-160 MG TABS 0.07372 02/22/2013 02/19/2013

Sulfasalazine Tab 500 MG TABS 0.14500 02/22/2013 02/19/2013

Sulfasalazine Tab Delayed Release 500 MG TBEC 0.25764 02/22/2013 02/19/2013

Sulindac Tab 150 MG TABS 0.14599 02/22/2013 02/19/2013

Sulindac Tab 200 MG TABS 0.16336 02/22/2013 02/19/2013

Sumatriptan Succinate Inj 4 MG/0.5ML SOLN 175.00000 02/22/2013 02/19/2013

Sumatriptan Succinate Inj 6 MG/0.5ML SOLN 136.79400 02/22/2013 02/19/2013

Sumatriptan Succinate Solution Auto-injector 6 MG/0.5ML SOAJ 127.91356 10/10/2014 10/07/2014

Sumatriptan Succinate Tab 100 MG TABS 1.03678 02/22/2013 02/19/2013



SUPER THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SUPER-AMINO 1600 (Amino Acids Tab***) TABS 0.41080 04/28/2005 02/19/2013

SUPERB NAILS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

SUPLENA (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

SUPLENA RTU (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

SUPLENA WITH CARB STEADY (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

SUPPORT (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

SUPREME TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SURE COMFORT LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURE COMFORT LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURE EDGE BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SURE-LANCE FLAT LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURE-LANCE LANCETS 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURE-LANCE THIN LANCETS 2 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURE-LANCE ULTRA THIN LAN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURE-TEST EASYPLUS MINI B (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SURE-TOUCH LANCETS UNIVER (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURECHEK BLOOD GLUCOSE MO (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013




EFFECTIVE DATE

DATE UPDATED

SURECHEK BLOOD GLUCOSE TE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SURELITE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

SURESTEP PRO TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SURESTEP TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

SUTENT (Sunitinib Malate Cap 12.5 MG (Base Equivalent)) CAPS 130.99860 01/01/2015 02/10/2015

SUTENT (Sunitinib Malate Cap 25 MG (Base Equivalent)) CAPS 261.99721 01/01/2015 02/10/2015

SUTENT (Sunitinib Malate Cap 50 MG (Base Equivalent)) CAPS 456.10041 01/01/2015 02/10/2015

SYLATRON (Peginterferon alfa-2b For Inj Kit 4 X 200 MCG) KIT 5181.10900 09/18/2014 11/12/2014

SYLATRON (Peginterferon alfa-2b For Inj Kit 4 X 300 MCG) KIT 7771.68010 09/18/2014 11/12/2014

SYNAGIS (Palivizumab IM Soln 100 MG/ML) SOLN 2363.76000 12/02/2013 11/26/2013

SYNAGIS (Palivizumab IM Soln 50 MG/0.5ML) SOLN 2503.62000 12/02/2013 11/26/2013

SYNALAR (Fluocinolone Acetonide Cream 0.025%) CREA 1.37372 06/08/2012 02/19/2013

SYNALAR (Fluocinolone Acetonide Oint 0.025%) OINT 0.42333 07/15/2010 02/28/2013

SYNALAR (Fluocinolone Acetonide Soln 0.01%) SOLN 1.52405 09/20/2012 02/19/2013

SYNDION (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

SYNDION (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

SYNDION-SF (Multiple Vitamins w/ Minerals Liquid**) LIQD 0.02464 03/20/2008 02/19/2013

SYRSPEND SF (Oral Vehicles For Susp***) SUSR 0.27000 05/16/2014 05/14/2014

SYRSPEND SF ALKA (Oral Vehicles For Susp***) SUSR 0.27000 05/16/2014 05/14/2014

T-VITES (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

TABLOID (Thioguanine Tab 40 MG) TABS 10.00000 12/17/2012 02/19/2013

Tacrolimus Cap 0.5 MG CAPS 0.76161 12/19/2014 12/17/2014

Tacrolimus Cap 1 MG CAPS 0.98888 03/13/2015 03/10/2015

Tacrolimus Cap 5 MG CAPS 14.62428 02/22/2013 02/19/2013

TAFINLAR (Dabrafenib Mesylate Cap 50 MG (Base Equivalent)) CAPS 48.68524 01/05/2015 02/10/2015

TAFINLAR (Dabrafenib Mesylate Cap 75 MG (Base Equivalent)) CAPS 73.02299 01/05/2015 02/10/2015

TAGAMET HB (Cimetidine Tab 200 MG) TABS 0.18810 04/28/2005 02/19/2013

Tamoxifen Citrate Tab 10 MG (Base Equivalent) TABS 0.13355 02/22/2013 02/19/2013

Tamoxifen Citrate Tab 20 MG (Base Equivalent) TABS 0.61000 11/12/2014 12/09/2014

Tamsulosin HCl Cap 0.4 MG CAPS 0.59580 12/05/2014 01/06/2015

TAPAZOLE (Methimazole Tab 10 MG) TABS 2.07633 01/01/2015 02/10/2015

TAPAZOLE (Methimazole Tab 5 MG) TABS 1.20176 01/01/2015 02/10/2015

TARON-EC CAL (Prenatal w/o A Vit w/ Fe Fumarate-FA Tab DR 30-1 MG***) TBEC 0.18187 01/23/2009 02/19/2013

TAVIST ALLERGY (Clemastine Fumarate Tab 1.34 MG (1 MG Base Equiv)) TABS 0.14420 03/13/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Tea Tree Oil*** OIL 0.12500 02/22/2013 02/19/2013

TEARS AGAIN NIGHT & DAY (Artificial Tear Ophth Gel***) GEL 0.74780 04/28/2005 02/19/2013

TECFIDERA (Dimethyl Fumarate Capsule Delayed Release 120 MG) CPDR 85.94057 10/10/2014 11/12/2014

TECFIDERA (Dimethyl Fumarate Capsule Delayed Release 240 MG) CPDR 85.90500 10/10/2014 11/12/2014

TECHLITE AST LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TECHLITE LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TEGRIN-LT LICE TREATMENT (Pyrethrins-Piperonyl Butoxide Shampoo 0.3-3%) SHAM 0.04062 03/20/2008 02/19/2013

TELCARE BLOOD GLUCOSE MON (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

TELCARE BLOOD GLUCOSE TES (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

Telmisartan Tab 20 MG TABS 0.70000 10/10/2014 10/07/2014



Telmisartan-Hydrochlorothiazide Tab 80-12.5 MG TABS 4.93567 05/09/2014 05/02/2014

Temazepam Cap 15 MG CAPS 0.06500 02/22/2013 02/19/2013

Temazepam Cap 30 MG CAPS 0.08710 02/22/2013 02/19/2013

TEMODAR (Temozolomide Cap 140 MG) CAPS 371.94458 09/18/2014 11/12/2014



Temozolomide Cap 100 MG CAPS 103.55000 10/11/2013 10/09/2013



Terazosin HCl Cap 1 MG CAPS 0.06656 02/22/2013 02/19/2013




Terbinafine HCl Tab 250 MG TABS 0.18014 02/22/2013 02/19/2013

Terbutaline Sulfate Tab 2.5 MG TABS 0.31374 02/22/2013 02/19/2013

Terbutaline Sulfate Tab 5 MG TABS 0.42438 02/22/2013 02/19/2013

Terconazole Vaginal Cream 0.4% CREA 0.80833 08/06/2013 10/09/2013

Terconazole Vaginal Cream 0.8% CREA 0.58381 02/22/2013 02/19/2013

Terconazole Vaginal Suppos 80 MG SUPP 10.55670 02/22/2013 02/19/2013

Tetracaine HCl Ophth Soln 0.5% SOLN 0.73147 02/22/2013 02/19/2013

Tetracycline HCl Cap 250 MG CAPS 4.26560 09/03/2014 10/07/2014

Tetracycline HCl Cap 500 MG CAPS 8.86000 01/22/2014 03/12/2014




EFFECTIVE DATE

DATE UPDATED

Tetrahydroz-Dextran-PEG-Povidone Ophth Soln 0.05-0.1-1-1% SOLN 0.16942 02/22/2013 02/19/2013

Tetrahydrozoline HCl Ophth Soln 0.05% SOLN 0.16942 02/22/2013 02/19/2013

Tetrahydrozoline w/ Polyethylene Glycol Ophth Soln 0.05-1% SOLN 0.10770 02/22/2013 02/19/2013

TEV-TROPIN (Somatropin For Subcutaneous Inj 5 MG) SOLR 479.86450 01/01/2015 02/10/2015

TGT BLOOD GLUCOSE MONITOR (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

TGT BLOOD GLUCOSE TEST ST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

TGT LANCET ALTERNATE SITE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TGT LANCET MICRO THIN 33G (Lancets***) MISC 0.08772 06/17/2011 02/28/2013

TGT LANCET SUPER THIN 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TGT LANCET THIN 23G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TGT LANCET THIN 26G (Lancets***) MISC 0.08772 06/17/2011 02/28/2013

TGT LANCET ULTRA THIN 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TGT LANCET ULTRA THIN 30G (Lancets***) MISC 0.08772 06/17/2011 02/28/2013

TH MINERAL OIL (Mineral Oil) OIL 0.01529 03/20/2008 02/19/2013

THALOMID (Thalidomide Cap 100 MG) CAPS 276.29800 07/09/2014 07/16/2014




Theophylline Tab SR 12HR 100 MG TB12 0.11840 02/22/2013 02/19/2013






THERA M PLUS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERA-M (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERA-TABS M (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERA/BETA-CAROTENE (Multiple Vitamin Tab**) TABS 0.02140 03/20/2008 02/19/2013

THERABETIC MULTI-VITAMIN (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERABETIC SKIN CARE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

THERAGRAN-M (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERAGRAN-M ADVANCED (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERAGRAN-M ADVANCED 50 P (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERAGRAN-M PREMIER (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

THERAGRAN-M PREMIER 50 PL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

THERAMILL FORTE (Multiple Vitamins w/ Minerals Cap**) CAPS 0.08140 08/27/2010 02/19/2013

THERANATAL CORE NUTRITION (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

THERAPEUTIC LIQUID (Multiple Vitamins w/ Minerals Liquid**) SOLN 0.02464 03/20/2008 02/19/2013

THERATEARS (Carboxymethylcellulose Sodium Ophth Soln 0.25%) SOLN 0.35280 04/28/2005 02/19/2013

Thiamine HCl Tab 100 MG TABS 0.02230 02/22/2013 02/19/2013

Thiamine HCl Tab 50 MG TABS 0.01370 02/22/2013 02/19/2013

Thiamine Mononitrate Tab 100 MG TABS 0.02230 02/22/2013 02/19/2013

THICK-IT #2 (Starch Oral Thickening Powder) POWD 0.02350 03/20/2008 02/19/2013

THICK-IT ORIGINAL (Starch-Maltodextrin Oral Thickening Powder Packet) PACK 0.23528 03/20/2008 02/19/2013

THICK-IT ORIGINAL (Starch-Maltodextrin Oral Thickening Powder) POWD 0.02038 03/15/2012 02/19/2013

THINLETS GP LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

THINLETS LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Thioridazine HCl Tab 10 MG TABS 0.09707 02/22/2013 02/19/2013




Thiothixene Cap 1 MG CAPS 0.07813 02/22/2013 02/19/2013




THYROGEN (Thyrotropin Alfa For Inj 1.1 MG) SOLR 1347.58800 01/01/2014 01/22/2014

Ticlopidine HCl Tab 250 MG TABS 0.58000 02/22/2013 02/19/2013

TIKOSYN (Dofetilide Cap 125 MCG (0.125 MG)) CAPS 5.01092 01/01/2015 02/10/2015



Timolol Maleate Ophth Gel Forming Soln 0.25% SOLG 5.84000 02/01/2014 03/12/2014

Timolol Maleate Ophth Gel Forming Soln 0.5% SOLG 22.86500 01/26/2015 02/10/2015

Timolol Maleate Ophth Soln 0.25% SOLN 0.55900 02/22/2013 02/19/2013

Timolol Maleate Ophth Soln 0.5% SOLN 1.10300 02/22/2013 02/19/2013

TINACTIN (Tolnaftate Aerosol Pow 1%) AERP 0.04290 03/20/2008 02/19/2013

TINACTIN (Tolnaftate Cream 1%) CREA 0.13900 03/20/2008 02/19/2013

TINACTIN DEODORANT (Tolnaftate Aerosol Pow 1%) AERP 0.04290 03/20/2008 02/19/2013

TINACTIN JOCK ITCH (Tolnaftate Aerosol Pow 1%) AERP 0.04290 03/20/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

TINACTIN JOCK ITCH (Tolnaftate Cream 1%) CREA 0.13900 03/20/2008 02/19/2013

Tinidazole Tab 500 MG TABS 6.05979 02/14/2014 02/11/2014

TIVICAY (Dolutegravir Sodium Tab 50 MG (Base Equiv)) TABS 43.75982 02/03/2015 03/10/2015

Tizanidine HCl Cap 2 MG CAPS 1.56279 11/14/2014 11/12/2014



Tizanidine HCl Tab 2 MG TABS 0.67000 12/17/2014 02/10/2015

Tizanidine HCl Tab 4 MG TABS 0.26500 01/14/2014 02/11/2014

TOBI (Tobramycin Nebu Soln 300 MG/5ML) NEBU 26.10184 04/02/2014 05/02/2014

Tobramycin Ophth Soln 0.3% SOLN 1.86780 02/22/2013 02/19/2013

Tobramycin Sulfate For Inj 1.2 GM SOLR 101.01000 02/22/2013 02/19/2013

Tobramycin Sulfate Inj 1.2 GM/30ML (40 MG/ML) SOLN 0.67297 02/22/2013 02/19/2013

Tobramycin Sulfate Inj 2 GM/50ML (40 MG/ML) SOLN 0.67297 02/22/2013 02/19/2013

Tobramycin Sulfate Inj 80 MG/2ML (40 MG/ML) SOLN 0.67297 02/22/2013 02/19/2013

Tobramycin-Dexamethasone Ophth Susp 0.3-0.1% SUSP 17.42500 10/17/2014 11/12/2014

TOBREX (Tobramycin Ophth Soln 0.3%) SOLN 0.38330 04/23/2010 02/19/2013

TODAYS HEALTH SUPER THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TODAYS HEALTH ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TOFRANIL (Imipramine HCl Tab 25 MG) TABS 8.58828 12/11/2014 01/06/2015

Tolazamide Tab 250 MG TABS 0.18640 02/22/2013 02/19/2013

Tolazamide Tab 500 MG TABS 0.72640 02/22/2013 02/19/2013

TOLEREX (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

Tolmetin Sodium Cap 400 MG CAPS 0.70300 02/22/2013 02/19/2013

Tolmetin Sodium Tab 200 MG TABS 0.66200 02/22/2013 02/19/2013

Tolmetin Sodium Tab 600 MG TABS 2.88904 02/22/2013 02/19/2013

Tolnaftate Aerosol 1% AERO 0.03540 02/22/2013 02/19/2013

Tolnaftate Aerosol Pow 1% AERP 0.04290 02/22/2013 02/19/2013

Tolnaftate Cream 1% CREA 0.13900 02/22/2013 02/19/2013

Tolterodine Tartrate Tab 2 MG TABS 1.22000 01/09/2015 01/06/2015

TOPICORT (Desoximetasone Cream 0.05%) CREA 3.40435 08/06/2012 02/19/2013

Topiramate Sprinkle Cap 15 MG CPSP 0.33250 04/11/2014 04/09/2014

Topiramate Sprinkle Cap 25 MG CPSP 0.55540 02/22/2013 02/19/2013

Topiramate Tab 100 MG TABS 0.11745 02/22/2013 02/19/2013





EFFECTIVE DATE

DATE UPDATED



TORISEL (Temsirolimus Soln For IV Infusion 25 MG/ML) SOLN 1483.27640 01/01/2015 02/10/2015

Torsemide Tab 10 MG TABS 0.10953 02/22/2013 02/19/2013




TRACLEER (Bosentan Tab 125 MG) TABS 136.45200 12/29/2014 02/10/2015

TRACLEER (Bosentan Tab 62.5 MG) TABS 136.45200 12/29/2014 02/10/2015

Tramadol HCl Tab 50 MG TABS 0.02781 02/22/2013 02/19/2013

Tramadol HCl Tab SR 24HR 100 MG TB24 2.48934 04/11/2014 04/09/2014



Tramadol HCl Tab SR 24HR Biphasic Release 300 MG TB24 4.58215 08/01/2014 07/28/2014

Tramadol-Acetaminophen Tab 37.5-325 MG TABS 0.25990 02/22/2013 02/19/2013

Trandolapril Tab 1 MG TABS 0.21365 02/22/2013 02/19/2013



Tranexamic Acid Tab 650 MG TABS 3.92874 07/11/2014 07/09/2014

TRANXENE T (Clorazepate Dipotassium Tab 7.5 MG) TABS 0.25000 07/07/2003 02/19/2013

Tranylcypromine Sulfate Tab 10 MG TABS 1.60540 09/10/2013 10/09/2013

Trazodone HCl Tab 100 MG TABS 0.05122 02/22/2013 02/19/2013




TRELSTAR (Triptorelin Pamoate For IM Susp 11.25 MG) SUSR 2166.30000 07/30/2010 02/19/2013

TRELSTAR (Triptorelin Pamoate For IM Susp 3.75 MG) SUSR 722.10000 07/30/2010 02/19/2013

TRELSTAR MIXJECT (Triptorelin Pamoate For IM Susp 11.25 MG) SUSR 2166.30000 07/30/2010 02/19/2013



TRETIN-X (Tretinoin Cream 0.025% w/ Cleanser & Moisturizer Kit) KIT 1.17000 12/28/2001 02/19/2013



TRETIN-X (Tretinoin Gel 0.025% w/ Cleanser & Moisturizer Kit) KIT 1.17000 12/28/2001 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Tretinoin Cap 10 MG CAPS 20.94000 05/23/2013 08/06/2013

Tretinoin Cream 0.025% CREA 2.93500 08/30/2014 10/07/2014









Tretinoin Gel 0.01% GEL 3.35000 07/24/2014 08/06/2014



Tretinoin Microsphere Gel 0.1% GEL 10.03971 07/11/2014 07/09/2014

TRI-VI-SOL (Pediatric Vitamins ADC Drops 750 Unit-400 Unit-35 MG/ML***) SOLN 0.07766 03/20/2008 02/19/2013

TRI-VI-SOL/IRON (Pediatric Vitamins ACD w/ Iron Drops 10 MG/ML***) SOLN 0.08108 03/20/2008 02/19/2013

TRI-VI-SOL/IRON (Pediatric Vitamins ACD w/ Iron Drops 10 MG/ML***) SOLN 0.08450 04/28/2005 02/19/2013

TRI-VIT/FLUORIDE/IRON (Pediatric Vitamins ACD Fluoride & Fe Drops 0.25-10 MG/ML***) SOLN 0.12480 05/28/2010 02/19/2013

TRI-ZEL (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

TRIADVANCE (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

Triamcinolone Acetonide Cream 0.025% CREA 0.17000 10/20/2014 12/09/2014



Triamcinolone Acetonide Dental Paste 0.1% PSTE 11.81000 08/27/2014 09/10/2014

Triamcinolone Acetonide Lotion 0.025% LOTN 0.41436 02/22/2013 02/19/2013

Triamcinolone Acetonide Lotion 0.1% LOTN 1.29000 03/21/2014 04/09/2014

Triamcinolone Acetonide Oint 0.025% OINT 0.26400 06/24/2014 08/06/2014



TRIAMINO (Amino Acids Tab***) TABS 0.41080 04/28/2005 02/19/2013

Triamterene & Hydrochlorothiazide Cap 37.5-25 MG CAPS 0.19340 03/13/2015 03/10/2015

Triamterene & Hydrochlorothiazide Cap 50-25 MG CAPS 1.74500 02/28/2014 04/09/2014

Triamterene & Hydrochlorothiazide Tab 37.5-25 MG TABS 0.16830 02/22/2013 02/19/2013

Triamterene & Hydrochlorothiazide Tab 75-50 MG TABS 0.03738 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED

Triazolam Tab 0.125 MG TABS 0.20610 02/22/2013 02/19/2013

Triazolam Tab 0.25 MG TABS 0.65168 11/08/2013 11/05/2013

TRICARE (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

Trifluoperazine HCl Tab 1 MG TABS 0.24330 02/22/2013 02/19/2013




Trifluridine Ophth Soln 1% SOLN 16.35250 02/22/2013 02/19/2013

Trihexyphenidyl HCl Elixir 0.4 MG/ML ELIX 0.04710 02/22/2013 02/19/2013

Trihexyphenidyl HCl Tab 2 MG TABS 0.05613 02/22/2013 02/19/2013

Trihexyphenidyl HCl Tab 5 MG TABS 0.12050 02/22/2013 02/19/2013

Trimethoprim Tab 100 MG TABS 0.34050 02/22/2013 02/19/2013

TRINATE (Prenatal Vit w/ Fe Fumarate-FA Tab 28-1 MG***) TABS 0.18187 01/23/2009 02/19/2013

Triprolidine & Pseudoephedrine Syrup 1.25-30 MG/5ML SYRP 0.00740 02/22/2013 02/19/2013

Triprolidine & Pseudoephedrine Tab 2.5-60 MG TABS 0.03360 02/22/2013 02/19/2013

TRIXAICIN (Capsicum Oleoresin Cream 0.025%) CREA 0.10050 04/28/2005 02/19/2013

TRIXAICIN (Capsicum Oleoresin Cream 0.025%) CREA 0.10050 03/13/2008 02/19/2013

Trolamine Salicylate Cream 10% CREA 0.04250 02/22/2013 02/19/2013

TROPAZONE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

Tropicamide Ophth Soln 0.5% SOLN 0.65500 02/22/2013 02/19/2013

Tropicamide Ophth Soln 1% SOLN 0.70000 02/22/2013 02/19/2013

TRUE2GO BLOOD GLUCOSE MON (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

TRUEPLUS LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TRUEPLUS LANCETS 28G SUPE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013


TRUEPLUS LANCETS 30G ULTR (Lancets***) MISC 0.08772 06/17/2011 02/19/2013


TRUEPLUS LANCETS 33G MICR (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TRUEPLUS SAFETY LANCETS 2 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

TRUERESULT BLOOD GLUCOSE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

TRUETEST BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

TRUETEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

TRUETRACK BLOOD GLUCOSE M (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013




EFFECTIVE DATE

DATE UPDATED

TRUETRACK BLOOD GLUCOSE T (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

TRUETRACK SMART SYSTEM (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

TRUETRACK TEST (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

TRUVADA (Emtricitabine-Tenofovir Disoproxil Fumarate Tab 200-300 MG) TABS 42.60390 01/01/2014 01/22/2014

TUMS (Calcium Carbonate (Antacid) Chew Tab 500 MG) CHEW 0.02363 03/13/2008 02/19/2013

TUMS CALCIUM FOR LIFE BON (Calcium Carbonate (Antacid) Chew Tab 750 MG) CHEW 0.04025 03/13/2008 02/19/2013

TUMS E-X 750 (Calcium Carbonate (Antacid) Chew Tab 750 MG) CHEW 0.04025 03/13/2008 02/19/2013

TUMS KIDS (Calcium Carbonate (Antacid) Chew Tab 750 MG) CHEW 0.04025 03/13/2008 02/19/2013

TUMS LASTING EFFECTS (Calcium Carbonate (Antacid) Chew Tab 500 MG) CHEW 0.02363 03/13/2008 02/19/2013

TUMS SMOOTHIES (Calcium Carbonate (Antacid) Chew Tab 750 MG) CHEW 0.04025 03/13/2008 02/19/2013

TUMS ULTRA 1000 (Calcium Carbonate (Antacid) Chew Tab 1000 MG) CHEW 0.04216 03/13/2008 02/19/2013

TWOCAL HN (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

TWOCAL HN (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

TYKERB (Lapatinib Ditosylate Tab 250 MG (Base Equiv)) TABS 35.01748 07/18/2014 09/10/2014

TYLENOL (Acetaminophen Liquid 167 MG/5ML) LIQD 0.01930 04/28/2005 02/19/2013

TYLENOL (Acetaminophen Tab 325 MG) TABS 0.01590 03/13/2008 02/19/2013

TYLENOL 8 HOUR (Acetaminophen Tab CR 650 MG) TBCR 0.05936 03/13/2008 02/19/2013

TYLENOL ARTHRITIS PAIN (Acetaminophen Tab CR 650 MG) TBCR 0.05936 03/13/2008 02/19/2013

TYLENOL EXTRA STRENGTH (Acetaminophen Liquid 167 MG/5ML) LIQD 0.01930 04/28/2005 02/19/2013

TYLENOL SORE THROAT DAYTI (Acetaminophen Liquid 167 MG/5ML) LIQD 0.01930 04/28/2005 02/19/2013

TYR 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

TYR COOLER (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

TYR EXPRESS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

TYR GEL (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

TYREX-1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

TYREX-2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

TYROS 1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

TYROS 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

TYSABRI (Natalizumab for IV Inj Conc 300 MG/15ML) CONC 329.34400 01/01/2015 02/10/2015

TYVASO (Treprostinil Inhalation Solution 0.6 MG/ML) SOLN 167.43104 01/01/2015 02/10/2015

TYVASO REFILL (Treprostinil Inhalation Solution 0.6 MG/ML) SOLN 167.43104 01/01/2015 02/10/2015

TYVASO STARTER (Treprostinil Inhalation Solution 0.6 MG/ML) SOLN 167.43104 01/01/2015 02/10/2015

UCD 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

UCD ANAMIX JUNIOR (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013




EFFECTIVE DATE

DATE UPDATED

UCD TRIO (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

ULTICARE THIN LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTILET BASIC LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTILET CLASSIC LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTILET LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTILET SAFETY LANCETS 23 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTIMA TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ULTRA NATALCARE (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

ULTRA TABS (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

ULTRA THIN LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA THIN LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA TRAK PRO BLOOD GLUC (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

ULTRA-THIN II AUTO LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA-THIN II LANCETS 28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA-THIN II LANCETS 30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA-THIN II LANCETS/28G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA-THIN II LANCETS/30G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRA-THIN II SAFETY AUTO (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

ULTRACAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ULTRACAL HN PLUS (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

ULTRACET (Tramadol-Acetaminophen Tab 37.5-325 MG) TABS 0.42000 04/23/2010 02/19/2013

ULTRAMINO SOY PROTEIN (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

ULTRATRAK PRO TEST STRIPS (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

ULTRATRAK ULTIMATE TEST S (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

UNIFIBER (Cellulose Powder) POWD 0.03614 03/13/2008 02/19/2013

UNILET COMFORTOUCH LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET EXCELITE (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET EXCELITE II (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET G.P. LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET G.P. SUPERLITE LAN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET GP 28 ULTRA THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNILET SUPERLITE LANCET (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNISTIK 2 (Lancets Misc.***) MISC 0.10000 10/01/2003 02/19/2013




EFFECTIVE DATE

DATE UPDATED

UNISTIK 3 (Lancets Misc.***) MISC 0.10000 10/01/2003 02/19/2013

UNIVERSAL 1 LANCETS THIN (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

UNIVERSAL 1 LANCETS ULTRA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Urea Cream 20% CREA 0.18000 03/04/2013 04/09/2013

Urea Cream 40% CREA 0.26520 01/19/2015 02/10/2015

Urea Gel 40% GEL 2.31531 02/08/2013 02/20/2013

Urea Gel 40% GEL 2.31531 02/22/2013 02/20/2013

Urea Lotion 40% LOTN 0.07778 02/22/2013 02/19/2013

Ursodiol (Bulk) Powder POWD 1.52880 02/22/2013 02/19/2013

Ursodiol Cap 300 MG CAPS 4.08000 07/02/2014 08/06/2014

Ursodiol Tab 250 MG TABS 1.63193 04/12/2013 04/09/2013

Ursodiol Tab 500 MG TABS 2.76000 04/12/2013 04/09/2013

UTYMAX (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

Valacyclovir HCl Tab 1 GM TABS 1.12356 11/14/2014 11/12/2014

Valacyclovir HCl Tab 500 MG TABS 0.58445 02/13/2015 02/10/2015

VALCYTE (Valganciclovir HCl Tab 450 MG) TABS 64.14140 01/03/2014 02/11/2014

Valproate Sodium Syrup 250 MG/5ML (Base Equiv) SOLN 0.02042 02/22/2013 02/19/2013

Valproate Sodium Syrup 250 MG/5ML (Base Equiv) SYRP 0.02042 02/22/2013 02/19/2013

Valproic Acid Cap 250 MG CAPS 0.14560 02/22/2013 02/19/2013

Valsartan Tab 160 MG TABS 0.54224 03/13/2015 03/10/2015




Valsartan-Hydrochlorothiazide Tab 160-12.5 MG TABS 0.35200 12/19/2014 12/17/2014

Valsartan-Hydrochlorothiazide Tab 160-25 MG TABS 0.31200 12/19/2014 12/17/2014


Valsartan-Hydrochlorothiazide Tab 320-25 MG TABS 0.45600 12/19/2014 12/17/2014


VALUE PLUS LANCETS STANDA (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VALUE PLUS LANCETS SUPER (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VALUE PLUS LANCETS THIN 2 (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VALUMARK LANCET SUPER THI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VALUMARK LANCET ULTRA THI (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Vancomycin HCl Cap 125 MG CAPS 10.56000 03/13/2015 03/10/2015




EFFECTIVE DATE

DATE UPDATED

Vancomycin HCl Cap 250 MG CAPS 24.72500 04/11/2014 04/09/2014

Vancomycin HCl For Inj 1000 MG SOLR 5.77070 02/22/2013 02/19/2013

Vancomycin HCl For Inj 5000 MG SOLR 23.61169 12/13/2013 12/06/2013

VANICREAM LITE (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

VANTAS (Histrelin Acetate Implant Kit 50 MG) KIT 4980.00000 07/30/2010 02/19/2013

VASELINE CONSTANT CARE (Skin Protectants Misc - Ointment***) OINT 0.03040 04/28/2005 02/19/2013

VASOTEC (Enalapril Maleate Tab 10 MG) TABS 0.05160 04/23/2010 02/19/2013



VELCADE (Bortezomib For Inj 3.5 MG) SOLR 1596.58800 01/01/2015 02/10/2015

Venlafaxine HCl Cap SR 24HR 150 MG (Base Equivalent) CP24 0.26612 08/08/2014 08/06/2014

Venlafaxine HCl Cap SR 24HR 37.5 MG (Base Equivalent) CP24 0.30737 02/22/2013 02/19/2013

Venlafaxine HCl Cap SR 24HR 75 MG (Base Equivalent) CP24 0.30074 08/08/2014 08/06/2014

Venlafaxine HCl Tab 100 MG TABS 0.31925 02/22/2013 02/19/2013


Venlafaxine HCl Tab 37.5 MG TABS 0.25870 02/22/2013 02/19/2013



Venlafaxine HCl Tab SR 24HR 150 MG (Base Equivalent) TB24 2.20528 02/14/2014 02/11/2014

Venlafaxine HCl Tab SR 24HR 37.5 MG (Base Equivalent) TB24 2.55183 06/14/2013 06/10/2013

Venlafaxine HCl Tab SR 24HR 75 MG (Base Equivalent) TB24 2.29000 07/12/2013 07/08/2013

VENTAVIS (Iloprost Inhalation Solution 10 MCG/ML) SOLN 106.57200 12/29/2014 02/10/2015

VENTAVIS (Iloprost Inhalation Solution 20 MCG/ML) SOLN 106.57200 12/29/2014 02/10/2015

Verapamil HCl Cap SR 24HR 100 MG CP24 1.29243 02/22/2013 02/19/2013







Verapamil HCl Tab 120 MG TABS 0.07363 02/22/2013 02/19/2013



Verapamil HCl Tab CR 120 MG TBCR 0.28542 02/22/2013 02/19/2013




EFFECTIVE DATE

DATE UPDATED



VHC 2.25 (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

VIACTIV (Calcium w/ Vitamin D & K Chew Tab 500 MG-500 Unit-40 MCG) CHEW 0.08476 03/13/2008 02/19/2013

VIAGRA (Sildenafil Citrate Tab 25 MG) TABS 34.47183 01/01/2015 02/10/2015

VIAGRA (Sildenafil Citrate Tab 50 MG) TABS 34.47183 01/01/2015 02/10/2015

VICKS BABYRUB (Liniments & Rubs - Cream**) CREA 0.02880 04/28/2005 02/19/2013

VICTORY AGM-4000 TEST STR (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

VICTRELIS (Boceprevir Cap 200 MG) CAPS 19.82134 12/31/2013 01/22/2014

VIDA MIA UNILET LANCETS S (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VIDA MIA UNILET LANCETS U (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VIEKIRA PAK (Ombitas-Paritapre-Riton & Dasab Tab Pak 12.5-75-50 & 250 MG) TBPK 246.98132 02/13/2015 02/10/2015

VINATE GT (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

VINATE M (Prenatal Vit w/ Sel-Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07800 01/23/2009 02/19/2013

VINATE ULTRA (Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab 90-1 MG***) TABS 0.16250 01/23/2009 02/19/2013

VIREAD (Tenofovir Disoproxil Fumarate Oral Powder 40 MG/GM) POWD 7.90299 01/01/2014 04/09/2014

VIREAD (Tenofovir Disoproxil Fumarate Tab 150 MG) TABS 26.86517 01/01/2014 01/22/2014




VISINE (Tetrahydrozoline HCl Ophth Soln 0.05%) SOLN 0.16942 03/20/2008 02/19/2013

VISINE ADVANCED RELIEF (Tetrahydroz-Dextran-PEG-Povidone Ophth Soln 0.05-0.1-1-1%) SOLN 0.10770 04/28/2005 02/19/2013

VISINE EXTRA (Tetrahydrozoline HCl Ophth Soln 0.05%) SOLN 0.16942 03/20/2008 02/19/2013

VITA-BOB (Multiple Vitamins w/ Minerals Cap**) CAPS 0.51325 04/27/2011 02/19/2013

VITAJOULE (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

VITAL 1.0 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013




VITAL AF 1.2 CAL (Nutritional Supplement Liquid**) LIQD 0.00720 04/28/2005 02/19/2013

VITAL AF 1.2 CAL (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

VITAL HN (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

VITAL JR (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

VITAL JR (Nutritional Supplement Liquid**) LIQD 0.06930 05/28/2010 02/19/2013




EFFECTIVE DATE

DATE UPDATED

VITALET PRO LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VITALET PRO PLUS LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

VITALINE BIOTIN FORTE (B-Complex w/ C & Folic Acid Tab 0.8 MG***) TABS 0.08400 03/13/2008 02/19/2013

VITALINE TOTAL FORMULA 2 (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

VITALINE TOTAL FORMULA 3 (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

VITAMAX (Pediatric Multiple Vitamin w/ Minerals & C Chew Tab 60 MG**) CHEW 0.01747 03/20/2008 02/19/2013

Vitamin A Cap 10000 Unit CAPS 0.04138 02/22/2013 02/19/2013

Vitamin E Cap 100 Unit CAPS 0.02990 02/22/2013 02/19/2013




Vitamins A & D Oint** OINT 0.02350 02/22/2013 02/19/2013

Vitamins w/ Lipotropics Cap** CAPS 0.02250 02/22/2013 02/19/2013

Vitamins w/ Lipotropics Tab CR** TBCR 0.02250 02/22/2013 02/19/2013

Vitamins w/ Lipotropics Tab** TABS 0.02250 02/22/2013 02/19/2013

VITAPRO (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

VITAQUICK (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

VITAROCA PLUS (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

VITASANA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

VITATRUM (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

VITRUM 50+ SENIOR MULTI (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

VIVITROL (Naltrexone For IM Extended Release Susp 380 MG) SUSR 1265.91600 12/05/2014 01/06/2015

VIVONEX PEDIATRIC (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

VIVONEX PLUS (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

VIVONEX RTF (Nutritional Supplement Liquid**) LIQD 0.01410 04/28/2005 02/19/2013

VIVONEX T.E.N. (Nutritional Supplement Pack**) PACK 9.02000 06/15/2011 02/19/2013

VOCAL POINT BLOOD GLUCOSE (Glucose Blood Test Strip) STRP 0.74500 05/11/2012 02/19/2013

VOL-PLUS (Prenatal Vit w/ Fe Fumarate-FA Tab 27-1 MG***) TABS 0.07324 03/28/2011 02/19/2013

VOL-TAB RX (Prenatal Vit w/ Iron Carbonyl-FA Tab 29-1 MG***) TABS 0.17167 05/11/2012 02/19/2013

Voriconazole Tab 200 MG TABS 23.66761 09/12/2014 09/05/2014

VOTRIENT (Pazopanib HCl Tab 200 MG (Base Equiv)) TABS 69.02979 07/18/2014 09/10/2014

W&F LANCETS 26G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

W&F LANCETS COLORED 21G (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

WAL-FLU SEVERE COLD NIGHT (Pheniramine-Phenylephrine w/ APAP Powd Pack 20-10-650 MG) PACK 0.02655 08/29/2008 02/19/2013




EFFECTIVE DATE

DATE UPDATED

WALGREENS ADVANCED TRAVEL (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

WALGREENS COMFORT ASSURED (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

WALGREENS LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

WALGREENS THIN LANCETS (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

WALGREENS ULTRA THIN LANC (Lancets***) MISC 0.08772 06/17/2011 02/19/2013

Warfarin Sodium Tab 1 MG TABS 0.16950 07/15/2014 08/06/2014



Warfarin Sodium Tab 2.5 MG TABS 0.08560 02/22/2013 02/19/2013





Warfarin Sodium Tab 7.5 MG TABS 0.08633 02/22/2013 02/19/2013

Water For Injection SOLN 0.02080 02/22/2013 02/19/2013

Water For Irrigation, Sterile Irrigation Soln SOLN 0.00340 02/22/2013 02/19/2013

Water For IV Injection SOLN 0.00356 03/14/2014 03/12/2014

WAVESENSE AMP (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

WAVESENSE KEYNOTE (Blood Glucose Monitoring Kit w/ Device***) KIT 0.71000 10/01/2003 02/19/2013

White Petrolatum-Mineral Oil Ophth Ointment*** OINT 0.94400 02/22/2013 02/19/2013

WIBI (Emollient - Lotion**) LOTN 0.01940 03/13/2008 02/19/2013

WILATE (Antihemophilic Factor/VWF (Human) For Inj 1000-1000 Unit) SOLR 0.80000 08/08/2014 08/06/2014




WND 1 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

WND 2 (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

WOMENS 50+ MULTI VITAMIN (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

WOMENS BIOMULTIPLE (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

WOMENS MULTI VITAMIN & MI (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

XALKORI (Crizotinib Cap 200 MG) CAPS 212.88531 01/01/2015 02/10/2015

XALKORI (Crizotinib Cap 250 MG) CAPS 212.88531 01/01/2015 02/10/2015

XELODA (Capecitabine Tab 150 MG) TABS 11.79845 01/05/2015 02/10/2015

XELODA (Capecitabine Tab 500 MG) TABS 39.32298 01/05/2015 02/10/2015




EFFECTIVE DATE

DATE UPDATED

XENAZINE (Tetrabenazine Tab 12.5 MG) TABS 63.75749 01/02/2015 02/10/2015

XENAZINE (Tetrabenazine Tab 25 MG) TABS 127.51483 01/02/2015 02/10/2015

XIAFLEX (Collagenase Clostridium Histolyticum For Inj 0.9 MG) SOLR 3237.00000 02/08/2013 02/20/2013

XLEU ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XLEU MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XLEU MAXAMUM (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XLYS XTRP ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XLYS-XTRP ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XLYS-XTRP MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XLYS-XTRP MAXAMUM (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XMET ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XMET MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XMET MAXAMUM (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XMET XCYS ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XMET XCYS MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XMTVI ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XMTVI MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XMTVI MAXAMUM (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XOFIGO (Radium Ra 223 Dichloride Inj 27 microcurie/ML (1000 kBq/ML)) SOLN 18365.24400 01/01/2015 02/10/2015

XOLAIR (Omalizumab For Inj 150 MG) SOLR 837.04670 10/01/2014 11/12/2014

XPHE MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XPHE MAXAMUM (Amino Acids Oral Powder***) POWD 0.20315 04/05/2011 02/19/2013

XPHE MAXAMUM (Amino Acids Oral Powder***) POWD 0.33438 06/27/2012 02/19/2013

XPHE-XTYR ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XPHE-XTYR MAXAMAID (Nutritional Supplement Powder**) POWD 0.20315 04/05/2011 02/19/2013

XPTM ANALOG (Infant Foods Powder**) POWD 0.04649 04/24/2008 02/19/2013

XTRACAL PLUS (Nutritional Supplement Liquid**) LIQD 9.02000 06/15/2011 02/19/2013

XYNTHA (Antihemophilic Factor Recombinant PAF For Inj Kit 1000 Unit) KIT 1.03750 12/24/2010 02/19/2013




XYNTHA SOLOFUSE (Antihemophilic Factor Recombinant PAF For Inj Kit 1000 Unit) KIT 1.03750 12/24/2010 02/19/2013





EFFECTIVE DATE

DATE UPDATED




XYREM (Sodium Oxybate Oral Solution 500 MG/ML) SOLN 18.76459 02/15/2015 03/10/2015

YELETS TEENAGE FORMULA (Multiple Vitamins w/ Minerals Tab**) TABS 0.07430 03/20/2008 02/19/2013

ZADITOR (Ketotifen Fumarate Ophth Soln 0.025% (Base Equiv)) SOLN 0.88540 03/20/2008 02/19/2013

Zafirlukast Tab 10 MG TABS 1.04000 03/08/2013 03/04/2013

Zafirlukast Tab 20 MG TABS 1.12500 03/08/2013 03/04/2013

Zaleplon Cap 10 MG CAPS 0.42000 01/20/2014 03/12/2014

Zaleplon Cap 5 MG CAPS 0.23946 02/22/2013 02/19/2013

ZANTAC 75 (Ranitidine HCl Tab 75 MG) TABS 0.14300 03/20/2008 02/19/2013

ZAVESCA (Miglustat Cap 100 MG) CAPS 271.90800 12/29/2014 02/10/2015

ZELBORAF (Vemurafenib Tab 240 MG (Base Equivalent)) TABS 42.48189 04/13/2012 02/19/2013

ZEMAIRA (Alpha1-Proteinase Inhibitor (Human) For IV Soln 1000 MG) SOLR 0.50630 10/01/2014 11/12/2014

Zidovudine Cap 100 MG CAPS 1.58565 02/22/2013 02/19/2013

Zidovudine Syrup 10 MG/ML SYRP 0.19555 02/22/2013 02/19/2013

Zidovudine Tab 300 MG TABS 0.32291 02/22/2013 02/19/2013

ZIKS ARTHRITIS PAIN RELIE (Capsaicin-Menthol-Methyl Salicylate Cream 0.025-1-12%) CREA 0.02880 04/28/2005 02/19/2013

Zinc Cap 50 MG CAPS 0.04950 02/22/2013 02/19/2013

Zinc Gluconate Tab 50 MG (Elemental Zn) TABS 0.02900 02/22/2013 02/19/2013

Zinc Oxide Oint 20% OINT 0.09000 02/22/2013 02/19/2013

Zinc Sulfate Cap 220 MG (50 MG Elemental Zn) CAPS 0.02990 02/22/2013 02/19/2013

Zinc Tab 50 MG TABS 0.03074 02/22/2013 02/19/2013

ZINECARD (Dexrazoxane For Inj 250 MG) SOLR 204.41240 04/13/2012 02/19/2013

Ziprasidone HCl Cap 20 MG CAPS 1.42661 01/09/2015 01/06/2015




ZOFRAN (Ondansetron HCl Inj 40 MG/20ML (2 MG/ML)) SOLN 0.14960 04/23/2010 02/19/2013

ZOLADEX (Goserelin Acetate Implant 10.8 MG) IMPL 1359.39890 10/01/2014 11/12/2014

ZOLADEX (Goserelin Acetate Implant 3.6 MG) IMPL 453.13020 10/01/2014 11/12/2014

Zolmitriptan Orally Disintegrating Tab 2.5 MG TBDP 7.56800 09/13/2013 09/09/2013

Zolmitriptan Orally Disintegrating Tab 5 MG TBDP 8.66800 09/13/2013 09/09/2013




EFFECTIVE DATE

DATE UPDATED

Zolmitriptan Tab 2.5 MG TABS 7.57163 09/13/2013 09/09/2013

Zolmitriptan Tab 5 MG TABS 7.86185 03/13/2015 03/10/2015

Zolpidem Tartrate Tab 10 MG TABS 0.02565 02/22/2013 02/19/2013

Zolpidem Tartrate Tab 5 MG TABS 0.03000 02/22/2013 02/19/2013

Zolpidem Tartrate Tab CR 12.5 MG TBCR 2.04517 09/12/2014 09/05/2014

Zolpidem Tartrate Tab CR 6.25 MG TBCR 2.64071 11/14/2014 11/12/2014

Zonisamide Cap 100 MG CAPS 0.15555 09/12/2014 09/05/2014



ZORBTIVE (Somatropin (Non-Refrigerated) For Subcutaneous Inj 8.8 MG) SOLR 1033.97724 01/09/2015 02/10/2015

ZOSTRIX (Capsaicin Cream 0.025%) CREA 0.10050 03/13/2008 02/19/2013

ZOSTRIX ARTHRITIS PAIN RE (Capsaicin Cream 0.025%) CREA 0.10050 03/13/2008 02/19/2013

ZOSTRIX DIABETIC FOOT PAI (Capsaicin Cream 0.075%) CREA 0.09360 04/23/2010 02/19/2013

ZOSTRIX FOOT PAIN RELIEF (Capsaicin Cream 0.075%) CREA 0.14160 03/13/2008 02/19/2013

ZOSTRIX HP (Capsaicin Cream 0.075%) CREA 0.09360 04/23/2010 02/19/2013

ZOSTRIX SPORTS (Capsaicin Cream 0.075%) CREA 0.09360 04/23/2010 02/19/2013

ZYPREXA RELPREVV (Olanzapine Pamoate For Extended Rel IM Susp 210 MG (Base Eq)) SUSR 587.32460 10/01/2014 12/04/2014



ZYTIGA (Abiraterone Acetate Tab 250 MG) TABS 61.22647 08/06/2014 09/10/2014

ZYVOX (Linezolid For Susp 100 MG/5ML) SUSR 5.04148 01/01/2015 02/10/2015

ZYVOX (Linezolid Tab 600 MG) TABS 151.23804 01/01/2015 02/10/2015



Maine State Maximum Allowable Cost List as of 03/13/2015 · 3/16/2015 · Acarbose Tab 25 MG TABS...

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Transcript of Maine State Maximum Allowable Cost List as of 03/13/2015 · 3/16/2015 · Acarbose Tab 25 MG TABS...