Px Code Generic Name NDC Unit Price

2580001 phenylephrine 1 mg/10 mL (100 mcg/mL) in 0.9 % sod.chloride IV syringe 69374095710 136.29

2580001 phenylephrine 1 mg/10 mL (100 mcg/mL) in 0.9 % sod.chloride IV syringe 71019026315 136.29

2580001 dextrose 10 % in water (D10W) intravenous solution 264752000 58.65

2580001 dextrose 5 % in water (D5W) intravenous solution 264751000 58.65

2580001 electrolyte-P in dextrose 5 % intravenous solution 264773010 59.15

2580001 dextrose 5 % in water (D5W) IV 264751000 56.65

2580001 dextrose 5 % and 0.45 % sodium chloride IV 264761210 56.65

2580001 dextrose 10% in water (D10W) IV Soln 264752000 56.65

2580001 dextrose 5 % in water (D5W) intravenous solution 264751000 58.65

2500002 etoposide 20 mg/mL intravenous solution 68001026522 145.66

2500002 ofatumumab 100 mg/5 mL intravenous solution 173082133 1,844.38

2500002 filgrastim 300 mcg/mL injection solution 55513053001 1,149.13

2500002 fluconazole 200 mg/100 mL in sod. chloride (iso) intravenous piggyback 25021018482 176.89

2500002 fluconazole 200 mg/100 mL in sod. chloride (iso) intravenous piggyback 70655000210 172.39

2500002 heparin (porcine) 1,000 unit/mL injection solution 69005802 139.18

2500002 heparin (porcine) 1,000 unit/mL injection solution 641039137 137.65

2500002 heparin (porcine) 1,000 unit/mL injection solution 409272030 137.88

2500002 heparin (porcine) 1,000 unit/mL injection solution 409272031 139.18

2500002 heparin (porcine) 10,000 unit/mL injection solution 69006202 142.49

2500002 heparin (porcine) 10,000 unit/mL injection solution 409272130 139.11

2500002 heparin (porcine) 10,000 unit/mL injection solution 67457060202 140.29

2500002 heparin (porcine) 5,000 unit/mL injection solution 641040037 137.51

2500002 ifosfamide 1 gram intravenous solution 10019092582 173.03

2500002 ifosfamide 3 gram intravenous solution 10019092616 392.52

2500002 interferon alfa-2b 50 million unit (1 mL) solution for injection 85053901 4,380.40

2500002 LORazepam 2 mg/mL injection solution 17478004001 139.54

2500002 LORazepam 2 mg/mL injection solution 641600101 138.19

2500002 LORazepam 2 mg/mL injection solution 641600125 138.19

2500002 LORazepam 2 mg/mL injection solution 641604401 137.27

2500002 LORazepam 2 mg/mL injection solution 641604801 137.04

2500002 LORazepam 2 mg/mL injection solution 76329826100 146.29

2500002 triptorelin pamoate 22.5 mg/2 mL intramuscular syringe 23590623 17,809.96

2500002 cabazitaxel 10 mg/mL (first dilution) intravenous solution 24582411 38,243.86

2500002 methylergonovine 0.2 mg/mL (1 mL) injection solution 517074001 160.99

2500002 enoxaparin 100 mg/mL subcutaneous syringe 63323056895 146.33

2500002 midazolam 5 mg/mL injection solution 641606001 143.19

2500002 ondansetron HCl (PF) 4 mg/2 mL injection solution 641607801 137.24

2500002 ondansetron HCl (PF) 4 mg/2 mL injection solution 409475518 137.44

2500002 ondansetron HCl (PF) 4 mg/2 mL injection solution 23155054731 136.75

2500002 ondansetron HCl (PF) 4 mg/2 mL injection solution 23155054831 136.75

2500002 ondansetron HCl (PF) 4 mg/2 mL injection solution 70860077602 138.25

2500002 ondansetron HCl 2 mg/mL intravenous solution 25021078220 19.52

2500002 DOCEtaxel 20 mg/mL (1 mL) intravenous solution 75800301 2,100.94

2500002 DOCEtaxel 20 mg/mL (1 mL) intravenous solution 25021022201 730

2500002 DOCEtaxel 20 mg/mL (1 mL) intravenous solution 25021024501 161.29

2500002 fosaprepitant 150 mg intravenous solution 6306100 1,221.40

2500002 fosaprepitant 150 mg intravenous solution 6306101 1,221.40

2500002 ceftaroline fosamil 600 mg intravenous solution 456060001 342.77

2500002 fondaparinux 5 mg/0.4 mL subcutaneous solution syringe 7323201 434.68

2500002 fondaparinux 5 mg/0.4 mL subcutaneous solution syringe 55111067911 396.54

2500002 fondaparinux 7.5 mg/0.6 mL subcutaneous solution syringe 7323401 360.26

2500002 fondaparinux 7.5 mg/0.6 mL subcutaneous solution syringe 60505608000 375.55

2500002 fondaparinux 7.5 mg/0.6 mL subcutaneous solution syringe 55111068011 396.54

2500002 fondaparinux 10 mg/0.8 mL subcutaneous solution syringe 60505608100 375.55

2500002 darbepoetin alfa 25 mcg/0.42 mL in polysorbate injection syringe 55513005701 706.27

2500002 darbepoetin alfa 40 mcg/0.4 mL in polysorbate injection syringe 55513002101 1,130.04

2500002 darbepoetin alfa 60 mcg/0.3 mL in polysorbate injection syringe 55513002301 1,695.06

2500002 darbepoetin alfa 100 mcg/0.5 mL in polysorbate injection syringe 55513002501 2,825.10

2500002 darbepoetin alfa 150 mcg/0.3 mL in polysorbate injection syringe 55513002701 4,237.65

2500002 penicillin G benzathine 1,200,000 unit/2 mL intramuscular syringe 60793070102 574.39

2500002 bevacizumab 25 mg/mL intravenous solution 50242006001 2,908.83

2500002 bevacizumab 25 mg/mL intravenous solution 50242006101 11,635.32

2500002 filgrastim 480 mcg/1.6 mL injection solution 55513054601 1,829.85

2500002 levoFLOXacin 250 mg/50 mL in 5 % dextrose intravenous piggyback 781334152 175.09

2500002 levoFLOXacin 250 mg/50 mL in 5 % dextrose intravenous piggyback 143972201 173.89

2500002 levoFLOXacin 500 mg/100 mL in 5 % dextrose intravenous piggyback 781334246 181.69

2500002 levoFLOXacin 750 mg/150 mL in 5 % dextrose intravenous piggyback 781334355 180.94

2500002 DOCEtaxel 80 mg/4 mL (20 mg/mL) intravenous solution 25021024504 310.25

2500002 poliovirus vaccine 40 unit-8 unit-32 unit/0.5 mL injection suspension 49281086078 72.46

2500002 ketorolac 30 mg/mL (1 mL) injection solution 641604201 137.87

2500002 ketorolac 30 mg/mL (1 mL) injection solution 409379519 142.04

2500002 ketorolac 30 mg/mL (1 mL) injection solution 47781058493 137.41

2500002 topotecan 4 mg/4 mL (1 mg/mL) intravenous solution 703471471 390.11

2500002 topotecan 4 mg/4 mL (1 mg/mL) intravenous solution 67457066205 547.5

2500002 belimumab 120 mg intravenous solution 49401010101 1,863.51

2500002 belimumab 400 mg intravenous solution 49401010201 6,211.50

2500002 penicillin G benzathine 600,000 unit/mL intramuscular syringe 60793070001 331.64

2500002 ibandronate 3 mg/3 mL intravenous syringe 25021082273 912.5

2500002 brentuximab vedotin 50 mg intravenous solution 51144005001 25,907.70

2500002 rifAMPin 600 mg intravenous solution 23155034031 394.2

2500002 digoxin 250 mcg/mL injection solution 641141031 136.29

2500002 digoxin 250 mcg/mL injection solution 781305972 136.29

2500002 acetaZOLAMIDE 500 mg solution for injection 143950301 176.29

2500002 fluoride 0.25 mg (0.55 mg sodium fluoride)/drop oral drops 58223068424 19.52

2500002 terbutaline 1 mg/mL subcutaneous solution 143974601 140.29

2500002 HYDROmorphone 2 mg/mL injection syringe 76045001010 136.29

2500002 HYDROmorphone 2 mg/mL injection syringe 409131203 136.29

2500002 pneumococcal 23 polyvalent vaccine 25 mcg/0.5 mL injection syringe 6483701 148.42

2500002 linezolid in 5% dextrose in water 600 mg/300 mL intravenous piggyback 9514001 227.89

2500002 linezolid in 5% dextrose in water 600 mg/300 mL intravenous piggyback 703906031 401.96

2500002 HYDROmorphone 1 mg/mL injection syringe 409128303 138.85

2500002 HYDROmorphone 1 mg/mL injection syringe 409128309 138.85

2500002 HYDROmorphone 1 mg/mL injection syringe 76045000910 139.41

2500002 oxytocin 20 unit/1000 mL in 0.9 % sodium chloride intravenous 61553074004 179.89

2500002 oxytocin 20 unit/1000 mL in 0.9 % sodium chloride intravenous 99999000622 179.89

2500002 oxytocin 20 unit/1000 mL in 0.9 % sodium chloride intravenous 71019025102 179.91

2500002 meperidine (PF) 25 mg/mL injection syringe 409117603 142.24

2500002 meperidine (PF) 50 mg/mL injection syringe 409117803 142.44

2500002 meperidine (PF) 100 mg/mL injection syringe 409118059 142.05

2500002 BCG live 50 mg intravesical suspension 52060201 573.31

2500002 h papillomavirus vac,qval(PF) 20mcg-40mcg-40mcg-20mcg/0.5mL IM susp 6404541 226.3

2500002 h papillomavirus vac,qval(PF) 20mcg-40mcg-40mcg-20mcg/0.5mL IM susp 6404501 226.7

2500002 etanercept 50 mg/mL (0.98 mL) subcutaneous pen injector 58406044501 3,970.68

2500002 hepatitis B immune globulin 220 unit/mL intramuscular solution 13533063601 608.78

2500002 hepatitis B immune globulin 110 unit/0.5 mL intramuscular syringe 13533063603 1,937.06

2500002 hepatitis A virus vaccine (PF) 720 ELISA unit/0.5 mL IM suspension 58160082501 72.44

2500002 hepatitis A vaccine (PF) 1,440 ELISA unit/mL intramuscular syringe 58160082643 115.16

2500002 hepatitis A virus vaccine (PF) 50 unit/mL intramuscular syringe 6409601 114.39

2500002 hepatitis A virus vaccine (PF) 50 unit/mL intramuscular syringe 6409609 114.39

2500002 hepatitis A virus vaccine (PF) 1,440 ELISA unit/mL IM suspension 58160082601 115.16

2500002 triptorelin pamoate 11.25 mg/2 mL intramuscular syringe 23590412 8,904.98

2500002 methylPREDNISolone sod succ (PF) 40 mg/mL solution for injection 9003930 142.31

2500002 methylPREDNISolone sod succ (PF) 125 mg/2 mL solution for injection 9004725 145.98

2500002 amikacin 500 mg/2 mL injection solution 23155029031 144.46

2500002 glucagon (human recombinant) 1 mg/mL solution for injection 597005301 307.89

2500002 succinylcholine chloride 140 mg/7 mL (20 mg/mL) intravenous syringe 61553036145 170.73

2500002 succinylcholine chloride 140 mg/7 mL (20 mg/mL) intravenous syringe 71019034116 164.34

2500002 octreotide acetate 100 mcg/mL (1 mL) injection syringe 67457024500 136.29

2500002 EPINEPHrine 1 mg/mL (1 mL) injection solution 409724161 136.29

2500002 EPINEPHrine 1 mg/mL (1 mL) injection solution 409724110 136.29

2500002 EPINEPHrine 1 mg/mL (1 mL) injection solution 409724160 136.29

2500002 ropivacaine (PF) 5 mg/mL (0.5 %) injection solution 63323028630 136.29

2500002 calcium gluconate 100 mg/mL (10 %) intravenous solution 63323036001 136.29

2500002 calcium gluconate 100 mg/mL (10 %) intravenous solution 63323036003 136.29

2500002 calcium gluconate 100 mg/mL (10 %) intravenous solution 63323031110 141.69

2500002 calcium gluconate 100 mg/mL (10 %) intravenous solution 63323031150 136.29

2500002 ceFAZolin 1 gram solution for injection 25021010110 137.89

2500002 ceFAZolin 1 gram solution for injection 781345170 142.29

2500002 ceFAZolin 1 gram solution for injection 63323023710 137.88

2500002 ceFAZolin 10 gram solution for injection 143998391 144.79

2500002 ceFAZolin 10 gram solution for injection 409080611 144.71

2500002 cytomegalovirus immune globulin 50 mg/mL intravenous solution 44206053211 4,690.25

2500002 epoetin alfa 20,000 unit/mL injection solution 55513047801 1,210.34

2500002 prochlorperazine Edisylate 10 mg/2 mL (5 mg/mL) injection solution 55390007710 140.89

2500002 prochlorperazine Edisylate 10 mg/2 mL (5 mg/mL) injection solution 23155029431 154.79

2500002 bupivacaine liposome(PF) 1.3 %(13.3 mg/mL) suspension for infiltration 65250026620 136.29

2500002 HYDROmorphone 0.5 mg/mL in 0.9 % sodium chloride intravenous syringe 61553035240 140.65

2500002 pertuzumab 420 mg/14 mL (30 mg/mL) intravenous solution 50242014501 18,295.84

2500002 hepatitis A virus vaccine (PF) 25 unit/0.5 mL intramuscular syringe 6409501 72.54

2500002 morphine (PF) 1 mg/mL injection solution 641601901 153.61

2500002 carfilzomib 60 mg intravenous solution 76075010101 8,227.25

2500002 ziv-aflibercept 100 mg/4 mL (25 mg/mL) intravenous solution 24584001 5,840.00

2500002 ziv-aflibercept 200 mg/8 mL (25 mg/mL) intravenous solution 24584101 11,680.00

2500002 morphine 2 mg/mL intravenous cartridge 409189003 136.29

2500002 morphine 2 mg/mL intravenous cartridge 99999000702 136.29

2500002 morphine 4 mg/mL intravenous cartridge 409189103 136.29

2500002 morphine 4 mg/mL intravenous cartridge 99999000703 136.29

2500002 levonorgestrel 14 mcg/24 hour (3 years) intrauterine device 50419042201 1,040.47

2500002 baclofen 40,000 mcg/20 mL (2,000 mcg/mL) intrathecal syringe 45945015701 3,015.50

2500002 baclofen 40,000 mcg/20 mL (2,000 mcg/mL) intrathecal syringe 66794015701 3,314.05

2500002 goserelin 10.8 mg subcutaneous implant 70720095130 6,624.75

2500002 ado-trastuzumab emtansine 100 mg intravenous solution 50242008801 10,905.87

2500002 ado-trastuzumab emtansine 160 mg intravenous solution 50242008701 17,449.41

2500002 cefepime 1 gram solution for injection 781322280 143.41

2500002 cefepime 1 gram solution for injection 60505083401 143.41

2500002 cefepime 2 gram solution for injection 60505614700 150.42

2500002 cefepime 2 gram solution for injection 63323034021 148.17

2500002 HYDROmorphone 0.5 mg/0.5 mL injection syringe 409128304 138.99

2500002 HYDROmorphone 0.5 mg/0.5 mL injection syringe 76045000905 139.59

2500002 neostigmine methylsulfate 1 mg/mL intravenous solution 76014000333 154.65

2500002 neostigmine methylsulfate 1 mg/mL intravenous solution 641614901 182.29

2500002 neostigmine methylsulfate 1 mg/mL intravenous solution 42023018901 177.79

2500002 chlorproMAZINE 25 mg/mL injection solution 641139831 165

2500002 DOCEtaxel 140 mg/7 mL (20 mg/mL) intravenous solution 25021022207 4,744.99

2500002 copper 380 square mm intrauterine device 51285020401 1,102.43

2500002 tbo-filgrastim 300 mcg/0.5 mL subcutaneous syringe 63459091012 911.99

2500002 diph,pertus(acel),tet,polio(PF) 15 Lf-48 mcg-5 Lf unit/0.5 mL IM susp 49281056005 141.6

2500002 vedolizumab 300 mg intravenous solution 64764030020 22,256.13

2500002 oritavancin 400 mg intravenous solution 65293001501 3,528.33

2500002 bendamustine 180 mg/2 mL intravenous solution 63459039602 15,507.32

2500002 bendamustine 45 mg/0.5 mL intravenous solution 63459039502 3,876.85

2500002 human papillomavirus vaccine,9-valent (PF) 0.5 mL IM suspension 6411901 279.94

2500002 human papillomavirus vaccine,9-valent(PF) 0.5 mL intramuscular syringe 6412101 279.94

2500002 ceftolozane-tazobactam 1.5 gram intravenous solution 67919003001 384.86

2500002 nivolumab 40 mg/4 mL intravenous solution 3377211 3,828.24

2500002 nivolumab 100 mg/10 mL intravenous solution 3377412 9,570.59

2500002 pegfilgrastim 6 mg/0.6 mL (deliverable) wearable subcutaneous injector 55513019201 22,743.37

2500002 pembrolizumab 25 mg/mL intravenous solution 6302602 16,971.19

2500002 octreotide,microspheres ER 20 mg intramuscular susp, extended release 78064781 12,904.54

2500002 octreotide,microspheres ER 30 mg intramuscular susp, extended release 78064881 19,323.65

2500002 octreotide,microspheres ER 10 mg intramuscular susp, extended release 78081181 11,369.49

2500002 trabectedin 1 mg intravenous solution 59676061001 10,458.20

2500002 morphine 4 mg/mL intravenous solution 641612501 136.29

2500002 topotecan 4 mg intravenous solution 25021020606 1,095.00

2500002 meropenem 500 mg intravenous solution 409350511 150.79

2500002 meropenem 1 gram intravenous solution 409350611 136.29

2500002 idaruCIZUmab 2.5 gram/50 mL intravenous solution 597019705 6,387.50

2500002 neostigmine methylsulfate 3 mg/3 mL (1 mg/mL) intravenous syringe 61553055134 168.39

2500002 neostigmine methylsulfate 3 mg/3 mL (1 mg/mL) intravenous syringe 71019020507 166.37

2500002 neostigmine methylsulfate 3 mg/3 mL (1 mg/mL) intravenous syringe 69374093203 155.79

2500002 succinylcholine(PF)200 mg/10 mL(20 mg/mL)-NaCl,iso intravenous syringe 69374091910 156.04

2500002 infliximab-dyyb 100 mg intravenous solution 69080901 3,453.92

2500002 levonorgestrel 17.5 mcg/24 hour (5 years) intrauterine device 50419042401 1,222.99

2500002 trastuzumab 150 mg intravenous solution 50242013201 5,688.23

2500002 hemin 350 mg intravenous powder for solution 55292070254 27,187.03

2500002 varicella-zoster glycoE vacc-AS01B adj(PF) 50 mcg/0.5 mL IM susp, kit 58160081912 203

2500002 varicella-zoster glycoE vacc-AS01B adj(PF) 50 mcg/0.5 mL IM susp, kit 58160082311 203

2500002 varicella-zoster glycop E vaccine (vial 2 of 2) 50 mcg IM suspension 58160082801 203

2500002 varicella-zoster glycop E vaccine (vial 2 of 2) 50 mcg IM suspension 58160082803 203

2500002 nivolumab 240 mg/24 mL intravenous solution 3373413 22,969.42

2500002 piperacillin-tazobactam 4.5 gram intravenous solution 781311491 150.02

2500002 piperacillin-tazobactam 4.5 gram intravenous solution 781336794 150.02

2500002 piperacillin-tazobactam 4.5 gram intravenous solution 67457052300 154.78

2500002 piperacillin-tazobactam 4.5 gram intravenous solution 64679001202 150.89

2500002 piperacillin-tazobactam 4.5 gram intravenous solution 64679001201 150.89

2500002 piperacillin-tazobactam 3.375 gram intravenous solution 206885408 146.59

2500002 piperacillin-tazobactam 3.375 gram intravenous solution 781311390 146.59

2500002 piperacillin-tazobactam 3.375 gram intravenous solution 60505068701 146.07

2500002 piperacillin-tazobactam 3.375 gram intravenous solution 44567080210 147.29

2500002 piperacillin-tazobactam 3.375 gram intravenous solution 781335094 146.59

2500002 piperacillin-tazobactam 3.375 gram intravenous solution 67457052200 150.16

2500002 piperacillin-tazobactam 2.25 gram intravenous solution 206885208 143.16

2500002 piperacillin-tazobactam 2.25 gram intravenous solution 781311090 143.16

2500002 piperacillin-tazobactam 2.25 gram intravenous solution 60505068601 142.81

2500002 piperacillin-tazobactam 2.25 gram intravenous solution 781334494 143.16

2500002 piperacillin-tazobactam 2.25 gram intravenous solution 67457052100 145.54

2500002 cyanocobalamin (vit B-12) 1,000 mcg/mL injection solution 143962101 136.29

2500002 azithromycin 500 mg intravenous solution 69315084 142.29

2500002 fomepizole 1 gram/mL intravenous solution 781318273 3,910.64

2500002 morphine (PF) 30 mg/30 mL PCA intravenous solution 99999-0006-30 141.93

2500002 morphine (PF) 30 mg/30 mL PCA intravenous solution 99999-0006-30 141.93

2500002 morphine (PF) 30 mg/30 mL PCA intravenous solution 99999-0006-30 141.93

2500002 morphine (PF) 30 mg/30 mL PCA intravenous solution 99999-0006-30 141.93

2500002 ketorolac 15 mg/mL injection solution 641604101 137.77

2500002 ketorolac 15 mg/mL injection solution 409379319 138.94

2500002 dexamethasone 10 mg/mL injection solution 641036721 137.59

2500002 dexamethasone 4 mg/mL injection solution 67457042300 136.29

2500002 dexamethasone 4 mg/mL injection solution 63323016503 136.29

2500002 dicyclomine 10 mg/mL intramuscular solution 641617301 184.77

2500002 dicyclomine 20 mg tablet 51079011901 20.02

2500002 thyrotropin alfa 1.1 mg intramuscular solution 58468003001 2,026.43

2500002 sodium ferric gluconate complex in sucrose 62.5 mg/5 mL intravenous 591014926 199.69

2500002 sodium ferric gluconate complex in sucrose 62.5 mg/5 mL intravenous 143957001 199.69

2500002 diphenhydrAMINE 50 mg/mL injection solution 641037621 137.11

2500002 methacholine chloride 100 mg solution for inhalation 64281010000 116.95

2500002 morphine 10 mg/mL intravenous solution 641612701 138.21

2500002 DOXOrubicin, pegylated liposomal 2 mg/mL intravenous suspension 43598054125 8,842.31

2500002 EPINEPHrine 0.1 mg/mL injection syringe 409492120 140.85

2500002 DACTINomycin 0.5 mg intravenous solution 55292081155 6,166.53

2500002 typhoid vaccine,live,attenuated 2 billion unit capsule,delayed release 69401000002 58.32

2500002 typhoid vaccine,live,attenuated 2 billion unit capsule,delayed release 58337000301 54.46

2500002 levonorgestrel 20 mcg/24 hr (5 years) intrauterine device 50419042301 1,222.99

2500002 levonorgestrel 20 mcg/24 hr (5 years) intrauterine device 50419042101 1,222.99

2500002 bivalirudin 250 mg intravenous solution 409830020 762.23

2500002 fentaNYL (PF) 50 mcg/mL injection solution 641602701 137.89

2500002 fentaNYL (PF) 50 mcg/mL injection solution 641602801 139.29

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909412 137.55

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909416 142.65

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909345 138.24

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909337 137.75

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909409 137.09

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909418 138.18

2500002 fentaNYL (PF) 50 mcg/mL injection solution 409909417 139.08

2500002 ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL nebulization soln 378967131 20.02

2500002 alteplase 2 mg intra-catheter solution 50242004163 315.9

2500002 fondaparinux 2.5 mg/0.5 mL subcutaneous solution syringe 60505607800 180.02

2500002 fondaparinux 2.5 mg/0.5 mL subcutaneous solution syringe 55111067811 182.45

2500002 pegfilgrastim 6 mg/0.6 mL subcutaneous syringe 55513019001 22,743.37

2500002 ampicillin-sulbactam 1.5 gram solution for injection 641611601 139.79

2500002 ampicillin-sulbactam 1.5 gram solution for injection 49001381 143.89

2500002 ampicillin-sulbactam 3 gram solution for injection 641611701 142.64

2500002 ampicillin-sulbactam 3 gram solution for injection 67457022600 141.59

2500002 ampicillin-sulbactam 3 gram solution for injection 49001481 150.64

2500002 ampicillin-sulbactam 3 gram solution for injection 67457034903 139.89

2500002 ampicillin-sulbactam 3 gram solution for injection 25021018730 145.29

2500002 onabotulinumtoxinA 100 unit solution for injection 23114501 853.43

2500002 furosemide 10 mg/mL injection solution 23155047331 138.49

2500002 furosemide 10 mg/mL injection solution 23155047333 136.29

2500002 furosemide 10 mg/mL injection solution 409610218 136.29

2500002 furosemide 10 mg/mL injection solution 409610219 140.41

2500002 furosemide 10 mg/mL injection solution 409610220 136.29

2500002 furosemide 10 mg/mL injection solution 63323028005 136.29

2500002 rasburicase 1.5 mg intravenous solution 24515011 3,021.48

2500002 midazolam 1 mg/mL in 0.9 % sodium chloride intravenous 61553029041 183.19

2500002 bortezomib 3.5 mg solution for injection 63020004901 5,850.95

2500002 haloperidol lactate 5 mg/mL injection solution 67457042600 137.17

2500002 omalizumab 150 mg subcutaneous solution 50242004062 3,959.01

2500002 alpha-1-proteinase inhibitor (human) 1,000 mg intravenous solution 13533070002 708.23

2500002 alpha-1-proteinase inhibitor (human) 1,000 mg intravenous solution 13533070211 708.23

2500002 palonosetron 0.25 mg/5 mL intravenous solution 63323094241 832.2

2500002 palonosetron 0.25 mg/5 mL intravenous solution 781331275 992.07

2500002 hydrALAZINE 20 mg/mL injection solution 63323061455 140.68

2500002 hydrALAZINE 20 mg/mL injection solution 17478093401 140.38

2500002 hydrALAZINE 20 mg/mL injection solution 67457029100 148.29

2500002 DAPTOmycin 500 mg intravenous solution 7030012501 1,625.89

2500002 DAPTOmycin 500 mg intravenous solution 703012501 1,625.89

2500002 DAPTOmycin 500 mg intravenous solution 409010601 1,625.86

2500002 sodium hyaluronate 30 mg/2 mL intra-articular syringe 9999000662 950.46

2500002 rho(D) immune globulin 1,500 unit (300 mcg)/2 mL injection syringe 44206030001 585.39

2500002 9999-4089903 302.58

2500002 99994089913 135.11

2500002 99994089918 191.85

2500002 99994089919 214.38

2500002 99994089920 176.99

2500002 99999000642 137.91

2500002 fludarabine 50 mg/2 mL intravenous solution 25021024202 793.88

2500002 tigecycline 50 mg intravenous solution 8499019 571.23

2500002 measles,mumps,rubel,varicel liv(PF)10e3-4.3-3-3.99TCID50/0.5 mL subcut 6499900 274.29

2500002 measles,mumps,rubel,varicel liv(PF)10e3-4.3-3-3.99TCID50/0.5 mL subcut 6417101 274.29

2500002 lidocaine 10 mg/mL (1 %) injection solution 409427616 137.71

2500002 ampicillin 1 gram solution for injection 781340485 143.2

2500002 ampicillin 2 gram solution for injection 781340880 149.69

2500002 magnesium sulfate 4 mEq/mL (50 %) injection solution 63323006404 136.29

2500002 ampicillin 250 mg solution for injection 781340278 139.64

2500002 ampicillin 250 mg solution for injection 409371910 138.09

2500002 ampicillin 500 mg solution for injection 781340778 139.81

2500002 mannitol 25 % intravenous solution 409403116 136.29

2500002 meperidine (PF) 25 mg/mL injection solution 641605201 138.39

2500002 meperidine (PF) 50 mg/mL injection solution 641605301 138.48

2500002 metoclopramide 5 mg/mL injection solution 703450201 139.64

2500002 metoclopramide 5 mg/mL injection solution 409341418 137.4

2500002 99999000691 139.29

2500002 oxacillin 2 gram solution for injection 64679069902 152.87

2500002 99999000433 3,212.13

2500002 99999000580 144.27

2500002 99999000581 150.64

2500002 99999000595 145.52

2500002 99999000597 150.14

2500002 99999000599 153.83

2500002 99999000601 152.33

2500002 99999000582 142.29

2500002 99999000578 143.2

2500002 99999000579 149.69

2500002 99999000576 396.03

2500002 99999000586 165.43

2500002 99999000588 150.86

2500002 penicillin G potassium 5 million unit solution for injection 49052084 148.95

2500002 PHENobarbital sodium 130 mg/mL injection solution 641047721 190.28

2500002 PHENobarbital sodium 65 mg/mL injection solution 641047621 157.09

2500002 phenylephrine 10 mg/mL injection solution 641614201 148.29

2500002 phenytoin sodium 50 mg/mL intravenous solution 641049321 137.55

2500002 phenytoin sodium 50 mg/mL intravenous solution 641255541 138.11

2500002 phenytoin sodium 50 mg/mL intravenous solution 39822405002 138.49

2500002 potassium chloride 2 mEq/mL intravenous solution 409665119 139.26

2500002 potassium chloride 2 mEq/mL intravenous solution 409665318 140.43

2500002 potassium chloride 2 mEq/mL intravenous solution 69374095805 139.79

2500002 pralidoxime 1 gram solution for injection 60977014127 316.46

2500002 promethazine 25 mg/mL injection solution 641092821 137.61

2500002 promethazine 25 mg/mL injection solution 641095521 137.15

2500002 promethazine 25 mg/mL injection solution 641149531 137.61

2500002 promethazine 12.5 mg tablet 68084015411 19.97

2500002 antihemophilic factor-vWF 500 unit-1,200 unit intravenous solution 63833061602 4,861.80

2500002 antihemophilic factor-vWF 1,000 unit-2,400 unit intravenous solution 63833061702 9,723.60

2500002 atropine 0.4 mg/mL injection solution 641600601 171.39

2500002 succinylcholine chloride 20 mg/mL injection solution 781300970 139.31

2500002 alglucosidase alfa 50 mg intravenous solution 58468016001 2,865.25

2500002 decitabine 50 mg intravenous solution 47335036140 5,614.25

2500002 zoster vaccine live (PF) 19,400 unit/0.65 mL subcutaneous suspension 6496301 302.74

2500002 darbepoetin alfa 25 mcg/mL in polysorbate injection 55513000201 706.28

2500002 etonogestrel 68 mg subdermal implant 52433001 1,200.59

2500002 levETIRAcetam 500 mg/5 mL intravenous solution 62756051340 169.51

2500002 levETIRAcetam 500 mg/5 mL intravenous solution 143967310 146.79

2500002 levETIRAcetam 500 mg/5 mL intravenous solution 143967301 146.79

2500002 levETIRAcetam 500 mg/5 mL intravenous solution 67457079000 146.79

2500002 arformoterol 15 mcg/2 mL solution for nebulization 63402091101 53.07

2500002 thiamine HCl (vitamin B1) 100 mg/mL injection solution 67457019600 136.29

2500002 fluorouracil 2.5 gram/50 mL intravenous solution 703301811 155.69

2500002 fluorouracil 500 mg/10 mL intravenous solution 16729027603 149.04

2500002 fluorouracil 500 mg/10 mL intravenous solution 703301511 141.84

2500002 fluorouracil 1 gram/20 mL intravenous solution 16729027605 159.25

2500002 temsirolimus 30 mg/3 mL (10 mg/mL) (first dilution) intravenous soln 8117901 4,665.64

2500002 vancomycin 1,000 mg intravenous injection 67457034000 136.29

2500002 vancomycin 1,000 mg intravenous injection 70860010520 136.29

2500002 vancomycin 1,000 mg intravenous injection 51991094199 136.29

2500002 vancomycin 1,000 mg intravenous injection 47781059707 136.29

2500002 vancomycin 1,000 mg intravenous injection 55150020420 136.29

2500002 vancomycin 500 mg intravenous solution 67457033900 144.33

2500002 lanreotide 120 mg/0.5 mL subcutaneous syringe 15054112003 26,458.85

2500002 fosphenytoin 500 mg PE/10 mL injection solution 69600110 363.25

2500002 fosphenytoin 100 mg PE/2 mL injection solution 63323040302 141.09

2500002 fosphenytoin 100 mg PE/2 mL injection solution 69600102 169.46

2500002 methotrexate sodium (PF) 25 mg/mL injection solution 703367101 146.64

2500002 methotrexate sodium (PF) 25 mg/mL injection solution 69014601 140.69

2500002 methotrexate sodium (PF) 25 mg/mL injection solution 67457046721 140.69

2500002 yellow fever vaccine live(PF) 10 exp4.74 unit/0.5 mL subcutaneous susp 49281091501 203.79

2500002 ixabepilone 15 mg intravenous solution 15191012 4,184.07

2500002 ixabepilone 45 mg intravenous solution 15191113 12,552.17

2500002 albumin, human 25 % intravenous solution 944049302 271.07

2500002 albumin, human 25 % intravenous solution 68516521602 242.63

2500002 alteplase 100 mg intravenous solution 50242008525 32,121.31

2500002 alteplase 50 mg intravenous solution 50242004406 16,060.66

2500002 hepatitis A virus vaccine (PF) 720 ELISA unit/0.5 mL IM syringe 58160082543 72.44

2500002 hepatitis A virus vaccine (PF) 25 unit/0.5 mL intramuscular suspension 6483101 72.54

2500002 secretin (human) 16 mcg intravenous solution 67066000501 1,514.75

2500002 ketorolac 60 mg/2 mL intramuscular solution 409379619 139.17

2500002 ketorolac 60 mg/2 mL intramuscular solution 47781058546 137.53

2500002 azaTHIOprine 50 mg tablet 68084022911 19.52

2500002 azaTHIOprine 50 mg tablet 54808425 19.52

2500002 benztropine 2 mg/2 mL injection solution 17478001202 183.29

2500002 benztropine 2 mg/2 mL injection solution 143972901 196.29

2500002 betamethasone acetate and sodium phos 6 mg/mL suspension for injection 85432001 173.69

2500002 amiodarone 50 mg/mL intravenous solution 67457015300 139.78

2500002 amiodarone 50 mg/mL intravenous solution 143987501 138.29

2500002 amiodarone 50 mg/mL intravenous solution 67457015399 143.34

2500002 midazolam 1 mg/mL injection solution 641605601 136.29

2500002 midazolam 1 mg/mL injection solution 641605701 136.29

2500002 midazolam 1 mg/mL injection solution 641605901 136.29

2500002 C1 esterase inhibitor 500 unit (5 mL) intravenous solution 42227008105 6,753.33

2500002 C1 esterase inhibitor 500 unit (5 mL) intravenous solution 42227008101 6,753.33

2500002 cefotaxime 1 gram solution for injection 39001810 138.14

2500002 cefotaxime 500 mg solution for injection 143993001 137.79

2500002 cefTRIAXone 1 gram solution for injection 781320885 140.96

2500002 cefTRIAXone 1 gram solution for injection 143985701 138.79

2500002 cefTRIAXone 1 gram solution for injection 409733211 137.79

2500002 cefTRIAXone 250 mg solution for injection 143985901 137.49

2500002 cefTRIAXone 250 mg solution for injection 409733711 137.04

2500002 cefTRIAXone 10 gram solution for injection 409733420 153.35

2500002 cosyntropin 0.25 mg solution for injection 67457022700 238.03

2500002 cycloSPORINE 100 mg capsule 78024161 46.22

2500002 cycloSPORINE 25 mg capsule 78024061 92.32

2500002 desmopressin 4 mcg/mL injection solution 69918089901 195.08

2500002 desmopressin 4 mcg/mL injection solution 75245101 241.1

2500002 tobramycin 40 mg/mL injection solution 69008802 138.27

2500002 dextrose 5 % and 0.2 % sodium chloride intravenous solution 264761600 58.65

2500002 dextrose 5 % and 0.2 % sodium chloride intravenous solution 264761610 58.65

2500002 fluorouracil 5 gram/100 mL intravenous solution 703301911 169.59

2500002 digoxin 100 mcg/mL injection solution 70515026210 336.4

2500002 DOBUTamine 250 mg/20 mL (12.5 mg/mL) intravenous solution 409234401 142.19

2500002 epoetin alfa 10,000 unit/mL injection solution 59676031000 938.85

2500002 epoetin alfa 10,000 unit/mL injection solution 55513014401 605.17

2500002 epoetin alfa 2,000 unit/mL injection solution 55513012601 169.45

2500002 epoetin alfa 3,000 unit/mL injection solution 55513026701 186.03

2500002 epoetin alfa 4,000 unit/mL injection solution 55513014801 242.07

2500002 oxaliplatin 50 mg/10 mL (5 mg/mL) intravenous solution 69007401 365

2500002 oxaliplatin 100 mg/20 mL intravenous solution 781331780 365

2500003 famotidine 20 mg tablet 51079096601 19.52

2500003 famotidine 20 mg tablet 16714036105 19.52

2500003 famotidine 20 mg tablet 50268030311 19.52

2500003 fat emulsion 20 % intravenous 338051903 172.79

2500003 fat emulsion 20 % intravenous 338051948 163.19

2500003 finasteride 5 mg tablet 51079052001 20.78

2500003 finasteride 5 mg tablet 68084039911 20.81

2500003 fluconazole 200 mg tablet 68084073511 19.52

2500003 EPINEPHrine 0.3 mg/0.3 mL injection, auto-injector 54505010201 721.24

2500003 EPINEPHrine 0.3 mg/0.3 mL injection, auto-injector 49502050002 554.64

2500003 fludrocortisone 0.1 mg tablet 50268033011 19.52

2500003 FLUoxetine 10 mg capsule 16714035103 19.58

2500003 FLUoxetine 10 mg capsule 50268033311 19.66

2500003 FLUoxetine 20 mg capsule 16714035203 19.52

2500003 FLUoxetine 20 mg capsule 68084060511 19.52

2500003 glipiZIDE 10 mg tablet 51079081101 19.52

2500003 glipiZIDE 5 mg tablet 904663761 19.85

2500003 glipiZIDE 5 mg tablet 51079081001 19.84

2500003 hydroxychloroquine 200 mg tablet 68084026911 22.57

2500003 hydroxychloroquine 200 mg tablet 42292001101 22.43

2500003 hydroxyurea 500 mg capsule 68084028411 20.44

2500003 labetalol 5 mg/mL intravenous solution 143962201 142.29

2500003 labetalol 200 mg tablet 51079092901 19.52

2500003 lidocaine (PF) 10 mg/mL (1 %) injection solution 409471365 138.32

2500003 lidocaine (PF) 10 mg/mL (1 %) injection solution 409427916 139.23

2500003 lidocaine (PF) 10 mg/mL (1 %) injection solution 143959501 138.75

2500003 lidocaine (PF) 20 mg/mL (2 %) injection solution 143959401 138.5

2500003 tamsulosin 0.4 mg capsule 51079029401 20.1

2500003 levothyroxine 88 mcg tablet 42292003801 22.71

2500003 levothyroxine 175 mcg tablet 378181701 19.52

2500003 lidocaine 20 mg/mL (2 %)-epinephrine 1:100,000 injection solution 99999000424 136.29

2500003 lidocaine-prilocaine 2.5 %-2.5 % topical cream 115146853 55.98

2500003 lidocaine-prilocaine 2.5 %-2.5 % topical cream 115146853 55.98

2500003 lidocaine-prilocaine 2.5 %-2.5 % topical cream 168035705 58.22

2500003 lisinopril 40 mg tablet 172376160 19.52

2500003 lisinopril 40 mg tablet 904581061 19.52

2500003 lisinopril 5 mg tablet 51079098101 19.52

2500003 lisinopril 5 mg tablet 904581161 19.52

2500003 lisinopril 5 mg tablet 43547035210 19.52

2500003 lisinopril 5 mg tablet 185060501 19.52

2500003 metFORMIN 500 mg tablet 51079017201 19.64

2500003 metFORMIN 500 mg tablet 67877056101 19.55

2500003 methIMAzole 5 mg tablet 68084027511 19.89

2500003 bupivacaine-epinephrine (PF) 0.25 %-1:200,000 injection solution 409174670 139.9

2500003 bupivacaine-epinephrine (PF) 0.25 %-1:200,000 injection solution 409174671 145.32

2500003 bupivacaine-epinephrine (PF) 0.25 %-1:200,000 injection solution 409904211 140.28

2500003 bupivacaine-epinephrine (PF) 0.5 %-1:200,000 injection solution 409174970 140.2

2500003 bupivacaine-epinephrine (PF) 0.5 %-1:200,000 injection solution 409174971 140.91

2500003 bupivacaine-epinephrine (PF) 0.5 %-1:200,000 injection solution 409904516 138.72

2500003 lidocaine (PF) 5 mg/mL (0.5 %) injection solution 409427816 140.14

2500003 bupivacaine (PF) 0.5 % (5 mg/mL) injection solution 409116219 138.12

2500003 bupivacaine (PF) 0.5 % (5 mg/mL) injection solution 409116218 138.17

2500003 methylergonovine 0.2 mg tablet 43386014028 176.31

2500003 metOLazone 5 mg tablet 51079002401 19.52

2500003 midodrine 2.5 mg tablet 68084024011 20.5

2500003 midodrine 5 mg tablet 51079045301 19.52

2500003 midodrine 5 mg tablet 68084024111 19.52

2500003 miSOPROStol 100 mcg tablet 68084004011 20.88

2500003 miSOPROStol 200 mcg tablet 68084004111 19.52

2500003 niMODipine 30 mg capsule 23155010811 30.18

2500003 niMODipine 30 mg capsule 63739079733 22.39

2500003 nitrofurantoin monohydrate/macrocrystals 100 mg capsule 51079034801 23.38

2500003 norepinephrine bitartrate 1 mg/mL intravenous solution 703115301 154.31

2500003 norepinephrine bitartrate 1 mg/mL intravenous solution 36000016201 145.04

2500003 balanced salt solution combination no.2 intraocular irrigation 264251410 60.45

2500003 electrolytes-dextrose oral solution 70074011133 51.13

2500003 oxyCODONE 5 mg/5 mL oral solution 66689040101 56.85

2500003 oxyCODONE 5 mg tablet 406055223 19.97

2500003 PARoxetine 20 mg tablet 51079077401 19.52

2500003 sodium nitrite-sodium thiosulfate 300 mg/10 mL-12.5 gram/50 mL IV soln 60267081200 665.04

2500003 phenytoin 50 mg chewable tablet 51079012901 20.15

2500003 fidaxomicin 200 mg tablet 52015008001 603.78

2500003 iodine-potassium iodide 5 %-10 % topical solution 10481011108 34.85

2500003 prochlorperazine 25 mg rectal suppository 713013506 32.17

2500003 promethazine 12.5 mg rectal suppository 591216039 31.97

2500003 promethazine 25 mg rectal suppository 45802075900 19.52

2500003 promethazine 25 mg rectal suppository 591216139 19.52

2500003 propafenone 150 mg tablet 51079099601 20.28

2500003 argatroban 50 mg/50 mL (1 mg/mL) in sodium chloride (iso-osmotic) IV 42367020307 828.55

2500003 argatroban 50 mg/50 mL (1 mg/mL) in sodium chloride (iso-osmotic) IV 42367020284 828.55

2500003 argatroban 50 mg/50 mL (1 mg/mL) in sodium chloride (iso-osmotic) IV 781331491 803

2500003 propofol 10 mg/mL intravenous emulsion 63323026967 148.29

2500003 propofol 10 mg/mL intravenous emulsion 703285801 150.89

2500003 propofol 10 mg/mL intravenous emulsion 63323026937 138.69

2500003 pyridostigmine bromide 5 mg/mL injection solution 781304072 167.01

2500003 pyridostigmine bromide 60 mg tablet 64720012810 19.52

2500003 pyridostigmine bromide 60 mg tablet 68084049411 19.52

2500003 iodine strong (Lugols) 5 % oral solution 395277516 121.37

2500003 acetaZOLAMIDE 250 mg tablet 68084054111 23.01

2500003 ostomy supplies powder 68455010826 56.01

2500003 bupivacaine 0.25 % (2.5 mg/mL) injection solution 409116018 136.29

2500003 bupivacaine 0.25 % (2.5 mg/mL) injection solution 55150024950 136.29

2500003 indigotindisulfonate sodium 8 mg/mL (0.8 %) injection solution 517037501 602.25

2500003 indigotindisulfonate sodium 8 mg/mL (0.8 %) injection solution 517037505 602.25

2500003 dexamethasone 1 mg/mL drops (concentrate) 99999000485 23.5

2500003 sertraline 100 mg tablet 68084018211 19.52

2500003 sertraline 100 mg tablet 51079015101 19.52

2500003 sertraline 100 mg tablet 60687025311 19.52

2500003 sertraline 50 mg tablet 60687024211 19.52

2500003 silver nitrate applicators 75 %-25 % topical stick 12165010003 19.76

2500003 sodium bicarbonate 4.2 % intravenous solution 63323008305 155.14

2500003 sodium bicarbonate 4.2 % intravenous solution 63323002605 138.84

2500003 phenylephrine 1 % nasal spray 24135202 53.51

2500003 sodium bicarbonate 4 % intravenous solution 409660925 142.46

2500003 sodium chloride 0.9 % irrigation solution 264220150 58.65

2500003 lidocaine 2 % mucosal solution 603139364 19.52

2500003 lidocaine 2 % mucosal solution 50383077515 20.42

2500003 lidocaine 2 % mucosal solution 63739069457 20.48

2500003 sotalol 80 mg tablet 68084065411 20.79

2500003 sucralfate 100 mg/mL oral suspension 68094017159 19.52

2500003 sucralfate 1 gram tablet 68084059311 19.93

2500003 sucralfate 1 gram tablet 51079075301 19.84

2500003 iodoform 1/2" X 5 yard bandage 8080783200 136.64

2500003 iodoform 1" X 5 yard bandage 8080783300 137.27

2500003 terbutaline 5 mg tablet 115262201 19.52

2500003 timolol maleate 0.5 % eye drops 99999000431 50.14

2500003 verapamil ER (SR) 120 mg tablet,extended release 68084066501 19.91

2500003 verapamil ER (SR) 120 mg tablet,extended release 68084066511 19.91

2500003 verapamil ER (SR) 120 mg tablet,extended release 51079089401 21.45

2500003 verapamil ER (SR) 180 mg tablet,extended release 68084067411 19.52

2500003 verapamil ER (SR) 180 mg tablet,extended release 51079089901 19.52

2500003 warfarin 1 mg tablet 56016901 21.58

2500003 zolpidem 10 mg tablet 51079072501 19.52

2500003 zolpidem 5 mg tablet 51079072401 19.52

2500003 zolpidem 5 mg tablet 904608261 19.52

2500003 ostomy adhesive paste 68455010690 141.48

2500003 paraben-cetyl alcohol-stearyl alcohol-propy glycol-sls topical cleaner 10939010833 57.99

2500003 benzethonium chloride 0.13 % topical cleanser 50484049200 67.89

2500003 candida albicans skin test FDA STANDARD intradermal 49643013801 136.29

2500003 dilTIAZem 125 mg/125 mL (1 mg/mL) in dextrose 5 % IV 71019005501 184.64

2500003 modified lanolin topical ointment 44677010020 132.59

2500003 famotidine (PF) 20 mg/2 mL intravenous solution 641602201 137.08

2500003 venlafaxine 37.5 mg tablet 68084084411 19.52

2500003 dornase alfa 1 mg/mL solution for inhalation 50242010039 376.94

2500003 bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution 409155918 139.57

2500003 bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution 409115909 137.7

2500003 bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution 409115919 137.94

2500003 bupivacaine (PF) 0.25 % (2.5 mg/mL) injection solution 409115918 137.9

2500003 bupivacaine 0.5 % (5 mg/mL) injection solution 409116318 136.29

2500003 lidocaine HCl (bulk) 100 % powder 62991109502 174.03

2500003 ePHEDrine (PF) 25 mg/5 mL (5 mg/mL) in 0.9% sodium chloride IV syringe 61553030133 136.29

2500003 ePHEDrine (PF) 25 mg/5 mL (5 mg/mL) in 0.9% sodium chloride IV syringe 71030000302 136.29

2500003 ePHEDrine (PF) 25 mg/5 mL (5 mg/mL) in 0.9% sodium chloride IV syringe 69374090105 136.29

2500003 rocuronium 50 mg/5 mL (10 mg/mL) intravenous syringe 61553032133 144.07

2500003 rocuronium 50 mg/5 mL (10 mg/mL) intravenous syringe 61553049233 173.54

2500003 rocuronium 50 mg/5 mL (10 mg/mL) intravenous syringe 69374092405 148.29

2500003 rocuronium 50 mg/5 mL (10 mg/mL) intravenous syringe 71019032110 144.09

2500003 lipase-protease-amylase 5,000-17,000-27,000 unit capsule,delayed rel 39822020501 20.24

2500003 carbidopa ER 25 mg-levodopa 100 mg tablet,extended release 51079097801 19.9

2500003 midazolam 10 mg/5 mL (2 mg/mL) syrup 68094071659 23.59

2500003 midazolam 10 mg/5 mL (2 mg/mL) syrup 68094076459 25.63

2500003 tetracaine HCl (PF) 0.5 % eye drops 99999000413 50.83

2500003 tetracaine HCl (PF) 0.5 % eye drops 65074112 59.14

2500003 ketamine 50 mg/mL (1 mL) intravenous syringe 61553034878 136.29

2500003 ketamine 50 mg/mL (1 mL) intravenous syringe 99999000647 136.29

2500003 benzocaine-menthol 15 mg-2.6 mg lozenges 63824073116 6.7

2500003 triamterene 37.5 mg-hydrochlorothiazide 25 mg capsule 51079093501 19.88

2500003 lisinopril 2.5 mg tablet 68084076511 20.07

2500003 carBAMazepine 100 mg chewable tablet 51079087001 20.07

2500003 carBAMazepine 200 mg tablet 68084044411 20.9

2500003 carBAMazepine 200 mg tablet 51079038501 20.42

2500003 fluconazole 150 mg tablet 172541279 19.52

2500003 carbamide peroxide 6.5 % ear drops 78112073623 53.93

2500003 carbamide peroxide 6.5 % ear drops 904662735 51.35

2500003 lamoTRIgine 25 mg tablet 51079049801 19.64

2500003 lamoTRIgine 25 mg tablet 68084031811 19.71

2500003 lamoTRIgine 100 mg tablet 51079049901 19.52

2500003 lamoTRIgine 100 mg tablet 68084031911 19.52

2500003 traMADol 50 mg tablet 51079099101 19.6

2500003 traMADol 50 mg tablet 68084080811 19.65

2500003 metFORMIN 850 mg tablet 62584033211 19.52

2500003 metFORMIN 850 mg tablet 60687014311 19.52

2500003 tiZANidine 4 mg tablet 185440051 19.52

2500003 losartan 25 mg tablet 68084034611 20.03

2500003 losartan 50 mg tablet 68084034711 19.52

2500003 fosfomycin tromethamine 3 gram oral packet 456430008 198.46

2500003 SUMAtriptan 25 mg tablet 68084033996 20.77

2500003 labetalol 20 mg/4 mL (5 mg/mL) intravenous syringe 69374094604 136.29

2500003 valproic acid (as sodium salt) 250 mg/5 mL (5 mL) oral solution 68094019359 20.14

2500003 tranexamic acid 1,000 mg/10 mL (100 mg/mL) intravenous solution 67457019700 165.5

2500003 tranexamic acid 1,000 mg/10 mL (100 mg/mL) intravenous solution 13111420 178.29

2500003 morphine (PF) 30 mg/30 mL(1 mg/mL) in 0.9% sod.chloride IV PCA Syringe 99999-0006-30 141.93

2500003 sodium citrate-citric acid 500 mg-334 mg/5 mL oral solution 121119030 19.52

2500003 calcitonin (salmon) 200 unit/actuation nasal spray 245000835 109.46

2500003 bicalutamide 50 mg tablet 68084061211 20.89

2500003 carvedilol 6.25 mg tablet 51079093001 19.52

2500003 carvedilol 12.5 mg tablet 51079093101 19.52

2500003 carvedilol 12.5 mg tablet 68084086511 19.52

2500003 heparin (porcine) 25,000 unit/500 mL in 0.45 % sodium chloride IV soln 409765113 174.39

2500003 morphine concentrate 20 mg/mL oral syringe (FOR ORAL USE ONLY) 99999000509 19.52

2500003 isopropyl alcohol 70 % solution 395124928 76.83

2500003 megestrol 400 mg/10 mL (10 mL) oral suspension 66689002001 23.06

2500003 glucose 4 gram chewable tablet 49348091409 78.6

2500003 melatonin 1 mg/mL oral liquid 30768016836 19.52

2500003 cisatracurium 2 mg/mL intravenous solution 781315270 161.59

2500003 cisatracurium 2 mg/mL intravenous solution 781903870 161.59

2500003 chlordiazePOXIDE 25 mg capsule 51079014101 19.52

2500003 chlordiazePOXIDE 5 mg capsule 51079037401 20.16

2500003 glimepiride 2 mg tablet 51079042501 19.52

2500003 glimepiride 4 mg tablet 51079042601 19.52

2500003 ferric subsulfate 0.2 gram to 0.22 gram/mL topical soln and applicator 48783011208 63.7

2500003 chlorproMAZINE 25 mg tablet 51079051901 19.52

2500003 chlorthalidone 25 mg tablet 51079005801 21.43

2500003 factor IX recomb, Fc fusion protein 3,000 unit intravenous solution 64406094401 30,112.50

2500003 vasopressin 20 unit/mL intravenous solution 42023016401 303.54

2500003 saliva stimulant combination no.5 lozenges 51137000028 50.02

2500003 glycopyrrolate 0.4 mg/2 mL (0.2 mg/mL) intravenous syringe 61553032928 162.19

2500003 glycopyrrolate 0.4 mg/2 mL (0.2 mg/mL) intravenous syringe 71019010304 162.9

2500003 clorazepate dipotassium 7.5 mg tablet 63304055301 19.65

2500003 ePHEDrine sulfate 50 mg/mL intravenous solution 76014000530 172.5

2500003 ePHEDrine sulfate 50 mg/mL intravenous solution 42023021601 171.29

2500003 methylene blue (antidote) 5 mg/mL (0.5 %) intravenous solution 517037401 653.28

2500003 glycopyrrolate (PF) 1 mg/5 mL (0.2 mg/mL) in sterile water IV syringe 69374090305 160.29

2500003 torsemide 20 mg tablet 60505023401 19.52

2500003 torsemide 20 mg tablet 68084053911 19.52

2500003 torsemide 5 mg tablet 50268075411 39.75

2500003 lipase-protease-amylase 5,000-17,000-24,000 unit capsule, delayed rel 23611501 21.07

2500003 gabapentin 400 mg capsule 63739037610 19.52

2500003 gabapentin 400 mg capsule 68084077411 19.52

2500003 gabapentin 400 mg capsule 63739069310 19.52

2500003 gabapentin 300 mg capsule 63739037510 19.52

2500003 gabapentin 300 mg capsule 63739068910 19.52

2500003 gabapentin 300 mg capsule 68084076211 19.52

2500003 gabapentin 100 mg capsule 63739037410 19.78

2500003 gabapentin 100 mg capsule 16714066101 19.62

2500003 gabapentin 100 mg capsule 63739067510 19.64

2500003 gabapentin 100 mg capsule 68084078311 19.65

2500003 gabapentin 100 mg capsule 904666561 19.64

2500003 sterile talc 3 gram intrapleural aerosol powder 62327033303 456.25

2500003 sterile talc 3 gram intrapleural aerosol powder 62327033343 456.25

2500003 buPROPion HCl SR 150 mg tablet,12 hr sustained-release 51079039201 19.52

2500003 carvedilol 3.125 mg tablet 51079077101 19.65

2500003 diphenhydrAMINE 25 mg-acetaminophen 500 mg tablet 10939033044 0.6

2500003 sodium nitroprusside 25 mg/mL intravenous solution 42998030202 1,189.29

2500003 topiramate 25 mg tablet 68084034211 19.69

2500003 topiramate 100 mg tablet 68084034411 19.52

2500003 hydroCHLOROthiazide 12.5 mg capsule 51079077601 19.68

2500003 atorvastatin 10 mg tablet 68084009711 19.89

2500003 atorvastatin 10 mg tablet 51079020801 19.83

2500003 atorvastatin 20 mg tablet 68084009811 19.52

2500003 atorvastatin 20 mg tablet 51079020901 19.52

2500003 warfarin 3 mg tablet 56018801 19.52

2500003 ofloxacin 0.3 % eye drops 24208043405 70.39

2500003 ofloxacin 0.3 % eye drops 99999000430 50.7

2500003 sertraline 25 mg tablet 68084018011 19.68

2500003 sertraline 25 mg tablet 51079014901 19.73

2500003 sertraline 25 mg tablet 60687023111 19.78

2500003 cyclobenzaprine 10 mg tablet 51079064401 19.52

2500003 cyproheptadine 4 mg tablet 93292901 20.18

2500003 etomidate 2 mg/mL intravenous solution 143950601 142.51

2500003 etomidate 2 mg/mL intravenous solution 55150022110 141.79

2500003 valproate sodium 500 mg/5 mL (100 mg/mL) intravenous solution 143978501 153.58

2500003 morphine ER 15 mg tablet,extended release 68084040311 20.17

2500003 morphine ER 15 mg tablet,extended release 406831523 20.36

2500003 morphine ER 30 mg tablet,extended release 406833023 21.11

2500003 azithromycin 250 mg tablet 50111078710 21.65

2500003 azithromycin 250 mg tablet 68084065611 21.26

2500003 azithromycin 250 mg tablet 68084090601 21.26

2500003 azithromycin 250 mg tablet 60687028211 21.26

2500003 citalopram 20 mg tablet 68084074411 19.52

2500003 QUEtiapine 25 mg tablet 904663861 19.81

2500003 QUEtiapine 100 mg tablet 904664061 19.99

2500003 montelukast 10 mg tablet 68084062011 19.52

2500003 montelukast 10 mg tablet 50268057511 19.52

2500003 montelukast 10 mg tablet 68084087511 19.52

2500003 diazePAM 10 mg tablet 51079028601 19.52

2500003 diazePAM 2 mg tablet 51079028401 19.58

2500003 diazePAM 5 mg tablet 51079028501 19.52

2500003 dicloxacillin 250 mg capsule 781224801 19.82

2500003 dicloxacillin 500 mg capsule 781225801 19.52

2500003 dicyclomine 10 mg capsule 51079011801 20.02

2500003 isosorbide mononitrate ER 60 mg tablet,extended release 24 hr 68084059211 19.52

2500003 digoxin 125 mcg tablet 68084036611 20.97

2500003 digoxin 250 mcg tablet 24987024956 34.24

2500003 celecoxib 100 mg capsule 68084096911 21.87

2500003 celecoxib 200 mg capsule 68084097611 19.52

2500003 isosorbide mononitrate ER 30 mg tablet,extended release 24 hr 68084059111 20.05

2500003 ciprofloxacin 250 mg tablet 68084006911 19.52

2500003 ciprofloxacin 500 mg tablet 51079018201 19.52

2500003 divalproex 250 mg tablet,delayed release 51079047401 19.52

2500003 divalproex 250 mg tablet,delayed release 68084077611 19.52

2500003 risperiDONE 0.5 mg tablet 51079046101 19.52

2500003 pioglitazone 15 mg tablet 51079051301 21.14

2500003 pioglitazone 15 mg tablet 68084087811 20.45

2500003 doxapram 20 mg/mL intravenous solution 641601801 182.45

2500003 doxepin 10 mg capsule 51079043601 20.05

2500003 doxepin 25 mg capsule 51079043701 20.22

2500003 doxepin 50 mg capsule 51079043801 19.52

2500003 pantoprazole 40 mg tablet,delayed release 904623561 19.82

2500003 pantoprazole 40 mg tablet,delayed release 51079005101 19.81

2500003 pantoprazole 40 mg tablet,delayed release 66993006851 19.9

2500003 pantoprazole 40 mg intravenous solution 8092351 141.29

2500003 pantoprazole 40 mg intravenous solution 8200101 141.29

2500003 pantoprazole 40 mg intravenous solution 55150020200 141.29

2500003 doxycycline hyclate 100 mg tablet 62584069311 19.52

2500003 doxycycline hyclate 100 mg tablet 904043006 19.52

2500003 levETIRAcetam 250 mg tablet 50268046711 19.8

2500003 levETIRAcetam 500 mg tablet 51079082101 19.52

2500003 levETIRAcetam 500 mg tablet 68084033711 19.52

2500003 levETIRAcetam 500 mg tablet 68084087011 19.52

2500003 dofetilide 125 mcg capsule 69580043 34.09

2500003 nitroglycerin 400 mcg/spray translingual 24338030065 325.05

2500003 nitroglycerin 400 mcg/spray translingual 52536030065 237.01

2500003 dexmedetomidine 100 mcg/mL intravenous solution 16729023930 149.29

2500003 dexmedetomidine 100 mcg/mL intravenous solution 16729023993 149.29

2500003 dexmedetomidine 100 mcg/mL intravenous solution 70860060502 154.29

2500003 montelukast 4 mg chewable tablet 603465316 20.4

2500003 montelukast 4 mg chewable tablet 50268057311 20.57

2500003 NIFEdipine ER 30 mg tablet,extended release 24 hr 51079040001 20.7

2500003 NIFEdipine ER 30 mg tablet,extended release 24 hr 68084059711 20.53

2500003 NIFEdipine ER 90 mg tablet,extended release 24 hr 69267066 19.52

2500003 estradiol 0.05 mg/24 hr semiweekly transdermal patch 52544047154 46.31

2500003 estradiol 0.1 mg/24 hr semiweekly transdermal patch 52544047354 48.35

2500003 estradiol 0.1 mg/24 hr semiweekly transdermal patch 378464016 29.79

2500003 dextrose 40 % oral gel 574006915 19.52

2500003 dinoprostone ER 10 mg vaginal insert,controlled release 456412363 1,004.57

2500003 dinoprostone ER 10 mg vaginal insert,controlled release 55566280000 1,229.90

2500003 nitroglycerin 0.1 mg/hr transdermal 24 hour patch 378910216 20.13

2500003 nitroglycerin 0.2 mg/hr transdermal 24 hour patch 378910416 20.23

2500003 nitroglycerin 0.3 mg/hr transdermal 24 hour patch 85331504 25.08

2500003 nitroglycerin 0.3 mg/hr transdermal 24 hour patch 85331503 25.08

2500003 nitroglycerin 0.4 mg/hr transdermal 24 hour patch 378911216 20.34

2500003 nitroglycerin 0.6 mg/hr transdermal 24 hour patch 378911616 20.56

2500003 nitroglycerin 0.8 mg/hr transdermal 24 hour patch 85081904 25.21

2500003 dilTIAZem CD 120 mg capsule,extended release 24 hr 60687019511 19.85

2500003 dilTIAZem CD 120 mg capsule,extended release 24 hr 63739001410 19.84

2500003 cloNIDine 0.1 mg/24 hr weekly transdermal patch 378087116 86.91

2500003 cloNIDine 0.2 mg/24 hr weekly transdermal patch 378087216 146.33

2500003 cloNIDine 0.3 mg/24 hr weekly transdermal patch 555101101 203.22

2500003 cloNIDine 0.3 mg/24 hr weekly transdermal patch 378087316 203

2500003 aspirin 25 mg-dipyridamole 200 mg capsule,ext.release 12 hr multiphase 65162059606 24.51

2500003 aspirin 25 mg-dipyridamole 200 mg capsule,ext.release 12 hr multiphase 60687030533 34.44

2500003 trolamine salicylate 10 % topical cream 10939023644 55.48

2500003 scopolamine 1 mg over 3 days transdermal patch 10019055388 69.85

2500003 scopolamine 1 mg over 3 days transdermal patch 67434509 58.52

2500003 scopolamine 1 mg over 3 days transdermal patch 10019055390 69.85

2500003 scopolamine 1 mg over 3 days transdermal patch 66758020858 58.49

2500003 ondansetron 4 mg disintegrating tablet 781523806 20.16

2500003 ondansetron 4 mg disintegrating tablet 68462015740 19.98

2500003 ondansetron 4 mg disintegrating tablet 62756024060 20.59

2500003 ondansetron 8 mg disintegrating tablet 781523906 19.52

2500003 ondansetron 8 mg disintegrating tablet 68462015840 19.52

2500003 iopamidol 41 % (410 mg/mL) intravenous solution 270131415 447.49

2500003 venlafaxine ER 37.5 mg capsule,extended release 24 hr 59762018003 19.93

2500003 venlafaxine ER 37.5 mg capsule,extended release 24 hr 68084069811 20.02

2500003 venlafaxine ER 37.5 mg capsule,extended release 24 hr 904646861 20.03

2500003 venlafaxine ER 150 mg capsule,extended release 24 hr 904624861 19.52

2500003 venlafaxine ER 150 mg capsule,extended release 24 hr 59762018203 19.52

2500003 fentaNYL 25 mcg/hr transdermal patch 591319854 26.65

2500003 fentaNYL 25 mcg/hr transdermal patch 60505700600 24.09

2500003 fentaNYL 25 mcg/hr transdermal patch 47781042447 26.65

2500003 fentaNYL 25 mcg/hr transdermal patch 47781042411 26.65

2500003 fentaNYL 50 mcg/hr transdermal patch 591321254 41.54

2500003 fentaNYL 50 mcg/hr transdermal patch 60505700700 32.14

2500003 fentaNYL 50 mcg/hr transdermal patch 47781042611 41.54

2500003 fentaNYL 75 mcg/hr transdermal patch 591321354 65.67

2500003 fentaNYL 75 mcg/hr transdermal patch 60505700800 40.57

2500003 fentaNYL 100 mcg/hr transdermal patch 591321454 90.39

2500003 fentaNYL 100 mcg/hr transdermal patch 60505700900 63.63

2500003 fentaNYL 100 mcg/hr transdermal patch 47781042811 90.39

2500003 sodium polystyrene sulfonate 15 gram/60 mL oral suspension 99999000721 43.57

2500003 benzocaine-menthol 20 %-0.5 % topical aerosol 63029085001 54.79

2500003 benzocaine-menthol 20 %-0.5 % topical aerosol 75137085520 54.79

2500003 camphor-menthol topical ointment 99999000427 135.23

2500003 OLANZapine 5 mg disintegrating tablet 55111026279 24.46

2500003 OLANZapine 10 mg disintegrating tablet 49884032152 19.52

2500003 OLANZapine 10 mg disintegrating tablet 65862065710 19.52

2500003 lidocaine 5 % topical patch 63481068701 51.82

2500003 lidocaine 5 % topical patch 591352511 27.01

2500003 linezolid 600 mg tablet 9513502 557.82

2500003 ePHEDrine sulfate 50 mg/mL injection solution 66758000801 146.7

2500003 ePHEDrine sulfate 50 mg/mL injection solution 14789001401 151.29

2500003 HYDROcodone 10 mg-acetaminophen 325 mg tablet 406036701 19.84

2500003 HYDROcodone 10 mg-acetaminophen 325 mg tablet 406036723 20.23

2500003 HYDROcodone 10 mg-acetaminophen 325 mg tablet 406012523 20.3

2500003 water for injection, sterile intravenous solution 338001306 142.29

2500003 ergocalciferol (vitamin D2) 50,000 unit capsule 68084046311 20.79

2500003 ergocalciferol (vitamin D2) 50,000 unit capsule 50111099001 20.73

2500003 atorvastatin 80 mg tablet 68084059095 19.52

2500003 atorvastatin 80 mg tablet 50268009611 19.52

2500003 hydrocortisone 1 %-pramoxine 1 % rectal foam 68220014210 143.23

2500003 erythromycin 5 mg/gram (0.5 %) eye ointment 574402411 57.2

2500003 EPINEPHrine 0.15 mg/0.3 mL injection,auto-injector 49502050102 554.64

2500003 dilTIAZem CD 180 mg capsule,extended release 24 hr 60687020611 19.52

2500003 dilTIAZem CD 180 mg capsule,extended release 24 hr 63739001510 19.52

2500003 dilTIAZem CD 240 mg capsule,extended release 24 hr 63739001610 19.52

2500003 dilTIAZem CD 300 mg capsule,extended release 24 hr 68084005511 19.52

2500003 dilTIAZem CD 300 mg capsule,extended release 24 hr 60687022811 19.52

2500003 mirtazapine 15 mg disintegrating tablet 93730318 21.47

2500003 mirtazapine 15 mg disintegrating tablet 115165351 21.47

2500003 esmolol 2,500 mg/250 mL (10 mg/mL) in sodium chloride (iso-osmotic) IV 67457065725 1,316.23

2500003 metoprolol succinate ER 25 mg tablet,extended release 24 hr 68084030311 20.49

2500003 metoprolol succinate ER 25 mg tablet,extended release 24 hr 68084065911 20.49

2500003 metoprolol succinate ER 50 mg tablet,extended release 24 hr 186109039 19.52

2500003 metoprolol succinate ER 50 mg tablet,extended release 24 hr 51079017001 19.52

2500003 metoprolol succinate ER 50 mg tablet,extended release 24 hr 51079017020 19.52

2500003 metoprolol succinate ER 50 mg tablet,extended release 24 hr 68084066611 19.52

2500003 doxycycline monohydrate 50 mg tablet 70710112101 19.99

2500003 fentaNYL (PF) 2 mcg/mL-bupivacaine 0.1 %-NaCl injection solution 61553012348 187.39

2500003 calcium acetate 667 mg capsule 68084047911 20.76

2500003 allopurinol 100 mg tablet 63739041010 19.77

2500003 allopurinol 100 mg tablet 51079020501 19.83

2500003 allopurinol 300 mg tablet 62584071311 20.26

2500003 allopurinol 300 mg tablet 51079020601 20.15

2500003 oxyCODONE-acetaminophen 10 mg-325 mg tablet 406052323 21.41

2500003 oxyCODONE-acetaminophen 10 mg-325 mg tablet 68084071011 21.24

2500003 folic acid 1 mg tablet 62584089711 19.65

2500003 ALPRAZolam 0.25 mg tablet 68084064711 19.65

2500003 ALPRAZolam 0.25 mg tablet 51079078801 19.6

2500003 ALPRAZolam 0.5 mg tablet 51079078901 19.52

2500003 olmesartan 20 mg tablet 93761198 19.52

2500003 furosemide 20 mg tablet 378020801 19.52

2500003 furosemide 20 mg tablet 51079007201 19.52

2500003 furosemide 40 mg tablet 904579761 19.52

2500003 furosemide 40 mg tablet 51079007301 19.52

2500003 amoxicillin 500 mg-potassium clavulanate 125 mg tablet 16714029601 20.81

2500003 amoxicillin 875 mg-potassium clavulanate 125 mg tablet 16714029702 21.03

2500003 gemfibrozil 600 mg tablet 68084047311 19.52

2500003 gemfibrozil 600 mg tablet 50268035011 19.52

2500003 gemfibrozil 600 mg tablet 60687022411 19.52

2500003 amoxicillin-potassium clavulanate 1,000 mg-62.5 mg tablet,ext.rel 12hr 781194339 25.11

2500003 amoxicillin-potassium clavulanate 1,000 mg-62.5 mg tablet,ext.rel 12hr 43598022040 25.11

2500003 ezetimibe 10 mg tablet 66582041429 37.72

2500003 ezetimibe 10 mg tablet 60687028411 33.88

2500003 HYDROcodone 5 mg-acetaminophen 325 mg tablet 406036523 19.82

2500003 HYDROcodone 5 mg-acetaminophen 325 mg tablet 63739070410 20.07

2500003 HYDROcodone 5 mg-acetaminophen 325 mg tablet 406012323 19.96

2500003 HYDROcodone 7.5 mg-acetaminophen 325 mg tablet 406036623 19.86

2500003 HYDROcodone 7.5 mg-acetaminophen 325 mg tablet 406012423 20.01

2500003 buprenorphine HCl 2 mg sublingual tablet 42858050103 20.05

2500003 neomycin-polymyxin-hydrocort 3.5 mg/mL-10,000 unit/mL-1 % ear solution 24208063110 133.85

2500003 glycopyrrolate 0.2 mg/mL injection solution 641603501 138.85

2500003 glycopyrrolate 0.2 mg/mL injection solution 143968101 150.29

2500003 rosuvastatin 10 mg tablet 42292003001 19.52

2500003 rosuvastatin 10 mg tablet 60687024511 19.52

2500003 guaiFENesin 100 mg/5 mL oral liquid 121148810 19.52

2500003 esmolol 2,000 mg/100 mL (20 mg/mL) in sodium chloride (iso-osmotic) IV 67457065810 1,417.77

2500003 haloperidol 0.5 mg tablet 51079073301 19.81

2500003 haloperidol 1 mg tablet 51079073401 19.93

2500003 haloperidol 5 mg tablet 51079073601 19.52

2500003 potassium chloride ER 20 mEq tablet,extended release(part/cryst) 66758019006 19.52

2500003 ciprofloxacin 0.3 %-dexamethasone 0.1 % ear drops,suspension 65853302 225.45

2500003 hydrALAZINE 10 mg tablet 51079007401 19.75

2500003 hydrALAZINE 25 mg tablet 51079007501 19.74

2500003 hydrocortisone 20 mg tablet 68084093095 19.52

2500003 hydrocortisone acetate 25 mg rectal suppository 713050306 19.52

2500003 metoprolol tartrate 25 mg tablet 51079025501 19.62

2500003 metoprolol tartrate 25 mg tablet 62584026511 19.6

2500003 glipiZIDE ER 2.5 mg tablet, extended release 24 hr 68084029511 20.51

2500003 NIFEdipine ER 90 mg tablet,extended release 60687029133 21.86

2500003 hydrOXYzine HCl 10 mg tablet 68084025311 19.79

2500003 hydrOXYzine HCl 10 mg tablet 51079079601 19.75

2500003 hydrOXYzine HCl 25 mg tablet 51079080601 19.52

2500003 hydrOXYzine HCl 50 mg tablet 68084025511 19.52

2500003 hydrOXYzine HCl 50 mg tablet 51079081601 19.52

2500003 HYDROcodone 7.5 mg-acetaminophen 325 mg/15 mL oral solution 66689002301 19.52

2500003 HYDROcodone 7.5 mg-acetaminophen 325 mg/15 mL oral solution 121231615 19.52

2500003 propranolol ER 80 mg capsule,24 hr,extended release 62559053101 19.52

2500003 lactulose 10 gram/15 mL oral solution 66689003801 19.52

2500003 ibuprofen 400 mg tablet 63739044210 19.52

2500003 ibuprofen 800 mg tablet 63739044401 19.52

2500003 ibuprofen 800 mg tablet 63739044410 19.52

2500003 indomethacin 25 mg capsule 51079019001 19.74

2500003 indomethacin 50 mg capsule 93403001 19.52

2500003 indomethacin 50 mg capsule 51079019101 19.52

2500003 DULoxetine 20 mg capsule,delayed release 68084067511 21.29

2500003 DULoxetine 30 mg capsule,delayed release 68084068311 19.52

2500003 levalbuterol concentrate 1.25 mg/0.5 mL solution for nebulization 93414719 24.88

2500003 levalbuterol concentrate 1.25 mg/0.5 mL solution for nebulization 17478017101 26.35

2500003 levalbuterol concentrate 1.25 mg/0.5 mL solution for nebulization 378699331 24.88

2500003 flumazenil 0.1 mg/mL intravenous solution 143978401 142.79

2500003 aminocaproic acid 250 mg/mL intravenous solution 409434609 142.73

2500003 aminocaproic acid 250 mg/mL intravenous solution 409434610 142.73

2500003 isosorbide dinitrate 10 mg tablet 904634661 20.2

2500003 isosorbide dinitrate 10 mg tablet 50268044811 20.34

2500003 isosorbide dinitrate 20 mg tablet 68084008311 19.52

2500003 propfol 10 mg/mL IV 703285801 150.89

2500003 99999000373 136.3

2500003 99999000426 136.29

2500003 99999000687 435.26

2500003 99999000360 21.13

2500003 99999000361 21.13

2500003 99999000362 13.37

2500003 99999000363 20.13

2500003 fentaNYL 12 mcg/hr transdermal patch 378911916 53.27

2500003 fentaNYL 12 mcg/hr transdermal patch 47781042311 53.27

2500003 sildenafil (antihypertensive) 20 mg tablet 68084062221 20.5

2500003 ketamine 50 mg/mL injection solution 67457000100 136.29

2500003 ketamine 50 mg/mL injection solution 143950801 136.29

2500003 amitriptyline 10 mg tablet 51079013101 19.66

2500003 amitriptyline 100 mg tablet 51079056301 19.52

2500003 amitriptyline 25 mg tablet 51079010701 19.52

2500003 amitriptyline 50 mg tablet 51079013301 19.52

2500003 levothyroxine 25 mcg tablet 51079044401 79.69

2500003 levothyroxine 50 mcg tablet 51079044001 19.98

2500003 levothyroxine 75 mcg tablet 51079044101 26.7

2500003 levothyroxine 100 mcg tablet 51079044201 20.04

2500003 levothyroxine 125 mcg tablet 51079044301 19.52

2500003 levothyroxine 150 mcg tablet 51079044501 19.52

2500003 lidocaine 2 % mucosal jelly 50383078105 54.6

2500003 lidocaine 2 % mucosal jelly 50383078130 60.36

2500003 lidocaine 20 mg/mL (2 %) injection solution 409427716 138.39

2500003 lidocaine (PF) 40 mg/mL (4 %) injection solution 409428311 140.62

2500003 99999000396 46.51

2500003 99999000398 151

2500003 LORazepam 0.5 mg tablet 51079041701 19.72

2500003 LORazepam 1 mg tablet 69315090501 19.52

2500003 LORazepam 2 mg tablet 51079038701 19.52

2500003 mannitol 20 % intravenous solution 264757810 168.92

2500003 methadone 10 mg tablet 406577123 19.85

2500003 methadone 5 mg tablet 406575523 19.81

2500003 methocarbamol 750 mg tablet 68084005711 19.52

2500003 methyldopa 250 mg tablet 51079020001 19.7

2500003 methyldopa 250 mg tablet 93293101 19.75

2500003 methyldopa 500 mg tablet 93293201 19.52

2500003 methylene blue (antidote) 1 % (10 mg/mL) intravenous solution 17478050410 653.28

2500003 methylphenidate 10 mg tablet 53014053007 19.52

2500003 methylphenidate 5 mg tablet 53014053107 20.05

2500003 metoclopramide 10 mg tablet 63739048210 19.52

2500003 metoclopramide 10 mg tablet 68084000911 19.52

2500003 metoprolol tartrate 5 mg/5 mL intravenous solution 781307175 139.51

2500003 metoprolol tartrate 5 mg/5 mL intravenous solution 70860030005 138.09

2500003 metoprolol tartrate 5 mg/5 mL intravenous solution 409177815 137.34

2500003 metoprolol tartrate 100 mg tablet 51079080201 19.52

2500003 metoprolol tartrate 50 mg tablet 51079080101 19.52

2500003 metoprolol tartrate 50 mg tablet 93073301 19.52

2500003 metroNIDAZOLE 250 mg tablet 51079021601 19.91

2500003 metroNIDAZOLE 500 mg tablet 51079021701 19.52

2500003 metroNIDAZOLE 500 mg tablet 68084096601 19.52

2500003 metroNIDAZOLE 500 mg tablet 68084096611 19.52

2500003 metroNIDAZOLE 500 mg tablet 42292000101 19.52

2500003 99999000634 31.47

2500003 morphine 10 mg/5 mL oral solution 54023755 20.16

2500003 morphine 10 mg/5 mL oral solution 66689003201 21.42

2500003 morphine 10 mg/5 mL oral solution 68094000159 20.88

2500003 nadolol 40 mg tablet 378117110 19.52

2500003 nadolol 40 mg tablet 68084076311 19.52

2500003 nadolol 40 mg tablet 51079081301 19.52

2500003 naphazoline 0.1 % eye drops 17478021612 54.71

2500003 naproxen 250 mg tablet 50268059411 19.78

2500003 naproxen 250 mg tablet 53746018801 19.59

2500003 naproxen 500 mg tablet 68084012711 19.52

2500003 naproxen 500 mg tablet 53746019001 19.52

2500003 neomycin 500 mg tablet 39822031007 19.52

2500003 NIFEdipine 10 mg capsule 68084002211 20.67

2500003 nitrofurantoin macrocrystal 50 mg capsule 51079058401 21.82

2500003 nitroglycerin 0.4 mg sublingual tablet 68462063925 50.77

2500003 nortriptyline 25 mg capsule 68084003211 19.94

2500003 nystatin 100,000 unit/mL oral suspension 68094059959 19.52

2500003 nystatin 100,000 unit/mL oral suspension 121478505 19.52

2500003 nystatin 100,000 unit/mL oral suspension 66689003701 19.52

2500003 nystatin 100,000 unit/mL oral suspension 121481005 19.52

2500003 oxybutynin chloride 5 mg tablet 68084040011 19.52

2500003 oxyCODONE-acetaminophen 5 mg-325 mg tablet 406051223 19.93

2500003 cisatracurium 2 mg/mL intravenous solution 781315270 161.59

2500003 cisatracurium 2 mg/mL intravenous solution 99999000467 923.45

2500003 99999000454 50.23

2500003 99999000436 132.97

2500003 99999000416 73.58

2500003 99999000446 50.79

2500003 99999000422 19.52

2500003 99999000591 150.86

2500003 99999000425 53.27

2500003 99999000445 63.25

2500003 99999000420 19.52

2500003 99999000421 19.52

2500003 99999000429 19.52

2500003 penicillin V potassium 250 mg tablet 781120501 20.07

2500003 phenazopyridine 100 mg tablet 68084029211 20.69

2500003 phenazopyridine 100 mg tablet 69367016204 20.37

2500003 phenazopyridine 200 mg tablet 68084029311 19.52

2500003 phenazopyridine 200 mg tablet 51293080201 19.52

2500003 PHENobarbital 32.4 mg tablet 68084081411 19.52

2500003 PHENobarbital 32.4 mg tablet 904657561 19.52

2500003 phenylephrine 0.5 % nasal spray 24135301 53.12

2500003 phenylephrine 1 % nasal drops 10939044333 3.99

2500003 potassium chloride 20 mEq oral packet 76439034330 24.35

2500003 potassium chloride 20 mEq oral packet 66758012081 31.67

2500003 potassium chloride 20 mEq oral packet 66758012094 31.66

2500003 potassium chloride 20 mEq oral packet 603155410 26.73

2500003 potassium chloride 20 mEq oral packet 245036089 27.11

2500003 predniSONE 5 mg/5 mL oral solution 54872216 20.64

2500003 probenecid 500 mg tablet 68084094595 20.88

2500003 prochlorperazine maleate 10 mg tablet 51079054201 19.52

2500003 proparacaine 0.5 % eye drops 99999000412 50.18

2500003 propranolol 20 mg tablet 16714002210 19.52

2500003 propranolol 20 mg tablet 60687030611 19.52

2500003 propranolol 20 mg tablet 51079027801 19.52

2500003 propranolol 60 mg tablet 23155011301 19.52

2500003 pseudoephedrine 30 mg tablet 904505360 19.54

2500003 raNITIdine 15 mg/mL syrup 68094020459 26.28

2500003 potassium, sodium phosphates 280 mg-160 mg-250 mg oral powder packet 60258000615 19.96

2500003 fluticasone 50 mcg/actuation nasal spray,suspension 54327099 1,154.56

2500003 fluticasone 50 mcg/actuation nasal spray,suspension 60505082901 72.16

2500003 neomycin 40 mg-polymyxin B 200,000 unit/mL GU irrigation solution 591219054 149.04

2500003 neomycin 40 mg-polymyxin B 200,000 unit/mL GU irrigation solution 39822120101 147.22

2500003 atenolol 25 mg tablet 51079075901 19.52

2500003 atenolol 50 mg tablet 51079068401 19.52

2500003 sodium acetate 2 mEq/mL intravenous solution 409729983 139.45

2500003 sodium bicarbonate 8.4 % (1 mEq/mL) intravenous syringe 69374091450 148.29

2500003 sodium chloride 2.5 mEq/mL intravenous solution 409665701 137.53

2500003 sodium chloride 2.5 mEq/mL intravenous solution 409666001 137.65

2500003 atropine 1 % eye drops 24208075060 63.41

2500003 atropine 1 % eye drops 61314030301 65.55

2500003 sodium thiosulfate 12.5 gram/50 mL (250 mg/mL) intravenous solution 60267070550 136.29

2500003 spironolactone 25 mg tablet 16729022501 19.65

2500003 sulfamethoxazole 400 mg-trimethoprim 80 mg/5 mL intravenous solution 703951401 180.43

2500003 sulfamethoxazole 400 mg-trimethoprim 80 mg/5 mL intravenous solution 67457077930 205.51

2500003 sulfamethoxazole 400 mg-trimethoprim 80 mg tablet 50268072811 19.82

2500003 hyaluronidase, human recombinant 150 unit/mL injection solution 18657010204 192.09

2500003 hyaluronidase, human recombinant 150 unit/mL injection solution 18657010201 192.09

2500003 omeprazole 40 mg-sodium bicarbonate 1,680 mg oral packet 68012005401 361.54

2500003 omeprazole 40 mg-sodium bicarbonate 1,680 mg oral packet 27241003062 286.55

2500003 ethyl alcohol 70 % topical solution 10939013633 82.11

2500003 camphor-eucalyptus oil-menthol 4.8 %-1.2 %-2.6 % topical ointment 23900000361 136.49

2500003 camphor-eucalyptus oil-menthol 4.8 %-1.2 %-2.6 % topical ointment 23900000015 143.25

2500003 temazepam 15 mg capsule 63739087710 19.65

2500003 temazepam 15 mg capsule 51079041801 19.63

2500003 theophylline 80 mg/15 mL oral elixir 49708064490 1,034.81

2500003 theophylline 80 mg/15 mL oral elixir 99999000239 32.82

2500003 tobramycin 0.3 % eye drops 99999000414 50.42

2500003 tobramycin 0.3 % eye drops 70069013101 61.5

2500003 traZODone 100 mg tablet 904399161 19.52

2500003 traZODone 50 mg tablet 68084012401 19.59

2500003 traZODone 50 mg tablet 68084012411 19.59

2500003 traZODone 50 mg tablet 904399061 19.64

2500003 triamterene 75 mg-hydrochlorothiazide 50 mg tablet 51079043301 20.23

2500003 trimethoprim 100 mg tablet 93215801 19.83

2500003 clindamycin 150 mg/mL injection solution 9077520 136.29

2500003 tropicamide 1 % eye drops 99999000432 50.15

2500003 tuberculin PPD 5 tub. unit/0.1 mL intradermal injection solution 49281075278 136.29

2500003 valproic acid 250 mg capsule 51079029801 19.9

2500003 vasopressin 20 unit/mL injection solution 63323030201 173.29

2500003 bacitracin 50,000 unit intramuscular solution 39822027801 142.79

2500003 verapamil 2.5 mg/mL intravenous solution 51754020301 168.44

2500003 baclofen 10 mg tablet 68084085511 19.52

2500003 warfarin 2 mg tablet 56017001 19.52

2500003 warfarin 2.5 mg tablet 56017601 19.52

2500003 warfarin 5 mg tablet 56017201 19.52

2500003 oxyCODONE 10 mg tablet 68084004811 19.52

2500003 budesonide 1 mg/2 mL suspension for nebulization 69097032186 34.16

2500003 trypan blue 0.06 % intraocular syringe 68803061210 186.84

2500003 nebivolol 5 mg tablet 456140511 19.52

2500003 nebivolol 2.5 mg tablet 456140211 23.96

2500003 clopidogrel 300 mg tablet 55111067106 68.13

2500003 clopidogrel 300 mg tablet 68084075295 62.39

2500003 thrombin (recombinant) 5,000 unit topical solution 28400010541 152.87

2500003 thrombin (recombinant) 5,000 unit topical solution 28400010501 152.87

2500003 thrombin (recombinant) 5,000 unit topical solution 43825060641 152.87

2500003 butalbital-acetaminophen-caffeine 50 mg-325 mg-40 mg tablet 68084039611 21.15

2500003 acyclovir 200 mg capsule 93894001 19.64

2500003 acyclovir 800 mg tablet 50268006211 20.66

2500003 alprostadil 500 mcg/mL injection solution 9316901 432.8

2500003 amiodarone 200 mg tablet 245014789 19.52

2500003 amLODIPine 10 mg tablet 51079045201 19.52

2500003 amLODIPine 10 mg tablet 31722023990 19.52

2500003 amLODIPine 10 mg tablet 59762154005 19.52

2500003 amLODIPine 2.5 mg tablet 68084049811 19.73

2500003 amLODIPine 2.5 mg tablet 68084025811 19.73

2500003 amLODIPine 5 mg tablet 51079045101 19.52

2500003 amLODIPine 5 mg tablet 68084025911 19.52

2500003 hepatitis A virus vaccine (PF) 50 unit/mL intramuscular suspension 6484101 241.47

2500003 alvimopan 12 mg capsule 67919002010 516.17

2500003 benzoin topical spray 54162010504 56.91

2500003 bumetanide 0.25 mg/mL injection solution 641600701 139.01

2500003 bumetanide 0.25 mg/mL injection solution 641600801 138.79

2500003 buPROPion HCl 100 mg tablet 51079094401 19.52

2500003 buPROPion HCl 75 mg tablet 51079094301 19.52

2500003 busPIRone 10 mg tablet 51079098601 19.52

2500003 busPIRone 5 mg tablet 51079098501 19.62

2500003 butamben-tetracaine-benzocaine 2 %-2 %-14 % (200 mg/sec) topical spray 10223020101 101.3

2500003 carbidopa 25 mg-levodopa 100 mg tablet 63739001710 19.52

2500003 carboprost tromethamine 250 mcg/mL intramuscular solution 9085605 557.55

2500003 niCARdipine 20 mg/200 mL in sodium chloride(iso) intravenous piggyback 10122031301 370.84

2500003 cefoTEtan 1 gram solution for injection 52565005201 175.79

2500003 cefoTEtan 1 gram solution for injection 143967001 155.52

2500003 cefoTEtan 1 gram solution for injection 143967010 155.52

2500003 cefpodoxime 100 mg/5 mL oral suspension 781616952 226.16

2500003 cephalexin 250 mg capsule 50268015111 19.92

2500003 cephalexin 500 mg capsule 60687016311 19.52

2500003 cephalexin 500 mg capsule 50268015211 19.52

2500003 cephalexin 250 mg/5 mL oral suspension 68180044101 75.44

2500003 cetirizine 10 mg tablet 51079059701 19.52

2500003 chlorhexidine gluconate 0.12 % mouthwash 17856200205 19.52

2500003 rocuronium 10 mg/mL intravenous solution 781322070 158.94

2500003 rocuronium 10 mg/mL intravenous solution 781322075 148.09

2500003 cholestyramine (with sugar) 4 gram powder for susp in a packet 49884046564 21.57

2500003 clindamycin HCl 300 mg capsule 68084024411 19.52

2500003 clindamycin 300 mg/50 mL in 5 % dextrose intravenous piggyback 781328891 175.74

2500003 clindamycin 600 mg/50 mL in 5 % dextrose intravenous piggyback 781328991 179.74

2500003 clindamycin 600 mg/50 mL in 5 % dextrose intravenous piggyback 9337501 185.34

2500003 clindamycin 900 mg/50 mL in 5 % dextrose intravenous piggyback 9338201 189.19

2500003 clindamycin 900 mg/50 mL in 5 % dextrose intravenous piggyback 781329091 182.39

2500003 clonazePAM 0.5 mg tablet 16714075201 19.52

2500003 clonazePAM 1 mg tablet 51079088201 19.52

2500003 collagenase clostridium histolyticum 250 unit/gram topical ointment 64501030 254.76

2500003 mesalamine 800 mg tablet,delayed release 68382064928 25.73

2500003 dantrolene 20 mg intravenous solution 27505000367 255.5

2500003 dantrolene 25 mg capsule 68084030011 21.15

2500003 dilTIAZem 5 mg/mL intravenous solution 641601301 138.69

2500003 dilTIAZem 5 mg/mL intravenous solution 641601501 142.67

2500003 desflurane 100 % inhalation liquid 10019064164 324.61

2500003 desflurane 100 % inhalation liquid 10019064464 324.61

2500003 menthol-zinc oxide 0.2 %-20 % topical paste 80196030615 64.08

2500003 furosemide 40 mg/4 mL oral solution 68094075659 19.52

2500003 dextrose 5 % and 0.45 % sodium chloride intravenous solution 264761210 58.65

2500003 prasugrel 10 mg tablet 2512301 50.18

2500003 prasugrel 10 mg tablet 60505464303 20.35

2500003 benzonatate 100 mg capsule 68084021411 19.98

2500003 benzonatate 100 mg capsule 60687011511 19.98

2500003 benzonatate 100 mg capsule 63739002910 19.98

2500003 benzonatate 100 mg capsule 60687034611 19.98

2500003 doxazosin 1 mg tablet 51079095701 22.66

2500003 doxazosin 2 mg tablet 51079095801 19.52

2500003 doxazosin 4 mg tablet 51079095901 19.52

2500003 dronabinol 5 mg capsule 68084017511 19.52

2500003 enalaprilat 1.25 mg/mL intravenous solution 143978601 141.79

2500003 levonorgestrel 1.5 mg tablet 68180085211 95.94

2500003 ethambutol 400 mg tablet 54879000200 41.64

2500003 benztropine 1 mg tablet 68084038811 19.52

2500003 benztropine 1 mg tablet 603243821 19.52

2500003 benztropine 1 mg tablet 60687036801 19.52

2500003 benztropine 1 mg tablet 60687036811 19.52

6360001 pneumococcal 13-val conj vaccine-dip crm (PF) 0.5 mL IM syringe 5197101 250.16

6360001 measles,mumps,rubella vaccine live(PF)1,000-12,500TCID50/0.5 mL subcut 6468101 117.4

6360001 eriBULin 1 mg/2 mL (0.5 mg/mL) intravenous solution 62856038901 4,073.40

6360001 penicillin G benzathine and procaine 1,200,000 unit/2 mL IM syringe 60793060002 457.86

6360001 sodium hyaluronate 10 mg/mL intra-articular solution 89122072412 693.5

6360001 ipilimumab 200 mg/40 mL (5 mg/mL) intravenous solution 3232822 104,736.17

6360001 pneumococcal 23 polyvalent vaccine 25 mcg/0.5 mL injection solution 6494301 148.42

6360001 rabies immune globulin (PF) 150 unit/mL intramuscular solution 13533061802 2,591.94

6360001 rabies immune globulin (PF) 150 unit/mL intramuscular solution 13533061810 11,830.31

6360001 rabies immune globulin (PF) 150 unit/mL intramuscular solution 13533061820 2,591.94

6360001 vecuronium bromide 20 mg intravenous solution 67457047500 146.29

6360001 vecuronium bromide 20 mg intravenous solution 63323078220 147.29

6360001 haemophilus B polysaccharid conj-tetanus tox(PF) 10 mcg/0.5 mL IM soln 49281054515 141.6

6360001 haemophilus B polysaccharid conj-tetanus tox(PF) 10 mcg/0.5 mL IM soln 49281054758 53.36

6360001 haemophilus B polysaccharid conj-tetanus tox(PF) 10 mcg/0.5 mL IM soln 58160081601 46.76

6360001 hepatitis B immune globulin 220 unit/mL (5 mL) intramuscular solution 13533063605 1,752.50

6360001 hepatitis B virus vaccine recomb (PF) 20 mcg/mL intramuscular syringe 58160082143 102.8

6360001 hepatitis B virus vaccine recomb (PF) 10 mcg/0.5 mL IM syringe 58160082043 61.76

6360001 hepatitis A and B virus vaccine(PF)720 ELISA unit-20 mcg/mL IM syringe 58160081543 154.4

6360001 hepatitis A and B virus vaccine(PF) 720 ELISA unit-20 mcg/mL IM susp 58160081501 150.92

6360001 diph,pertus(acel),tet pedi (PF) 15 Lf unit-10 mcg-5 Lf/0.5 mL IM susp 49281028658 68.3

6360001 tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf unit/0.5 mL IM syringe 49281021588 72.67

6360001 tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf unit/0.5 mL IM susp 49281021558 72.67

6360001 diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe 49281040088 85.39

6360001 diphth,pertus(ac)tetanus(PF)2 Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM syringe 49281040089 85.39

6360001 tetanus immune globulin (PF) 250 unit intramuscular syringe 13533063402 1,817.81

6360001 diph,pertus(acel),tet,polio(PF) 25 Lf-58 mcg-10 Lf/0.5 mL IM susp 58160081201 92.24

6360001 cytarabine (PF) 100 mg/5 mL (20 mg/mL) injection solution 69015201 141.04

6360001 immune glob G 10 gram/100 mL(10%)-gly-IgA ave 46 mcg/mL injection soln 13533080071 4,101.51

6360001 varicella virus vaccine live (PF) 1,350 unit/0.5 mL subcutaneous susp 6482700 180.53

6360001 varicella virus vaccine live (PF) 1,350 unit/0.5 mL subcutaneous susp 6482701 180.53

6360001 C1 esterase inhibitor 500 unit (10 mL) intravenous solution 63833083501 20,549.50

6360001 obinutuzumab 1,000 mg/40 mL intravenous solution 50242007001 23,557.83

6360001 ramucirumab 10 mg/mL intravenous solution 2766901 4,050.41

6360001 ramucirumab 10 mg/mL intravenous solution 2767801 20,252.03

6360001 hum prothrombin cplx (PCC) 4factor 500 unit (400-620 unit) IV solution 63833039601 17,428.75

6360001 hum prothrombin cplx(PCC)4fact 1,000 unit (800-1,240 unit) IV solution 63833039701 13,505.00

6360001 immune glob,gamm(IgG)10 %-malt-IgA over 50 mcg/mL intravenous solution 68982085002 2,427.25

6360001 immune glob,gamm(IgG)10 %-malt-IgA over 50 mcg/mL intravenous solution 68982085003 4,858.15

6360001 immune glob,gamm(IgG)10 %-malt-IgA over 50 mcg/mL intravenous solution 68982085004 9,716.30

6360001 N.meningitidis group B,lipid fHBP 120 mcg/0.5 mL intramuscular syringe 5010001 194.45

6360001 meningococcal B vac,4-cmp 50 mcg-50 mcg-50 mcg-25 mcg/0.5mL IM syringe 58160097602 233

6360001 meningococcal B vac,4-cmp 50 mcg-50 mcg-50 mcg-25 mcg/0.5mL IM syringe 58160097606 233

6360001 immune glob,gamm(IgG) 5 %-malt-IgA over 50 mcg/mL intravenous solution 67467084303 2,356.08

6360001 immune glob,gamm(IgG) 5 %-malt-IgA over 50 mcg/mL intravenous solution 67467084304 4,712.15

6360001 immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270004 2,431.63

6360001 immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270005 4,863.26

6360001 immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270006 9,726.52

6360001 immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270012 9,726.52

6360001 immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270010 2,431.63

6360001 immune glob,gamm(IgG) 10 %-pro-IgA 0 to 50 mcg/mL intravenous solution 44206043605 2,536.75

6360001 immune glob,gamm(IgG) 10 %-pro-IgA 0 to 50 mcg/mL intravenous solution 44206043710 5,073.50

6360001 immune glob,gamm(IgG) 10 %-pro-IgA 0 to 50 mcg/mL intravenous solution 44206043820 10,147.00

6360001 immune glob,gamm(IgG) 10 %-pro-IgA 0 to 50 mcg/mL intravenous solution 44206043940 20,294.00

6360001 immune glob,gamm(IgG) 10 %-pro-IgA 0 to 50 mcg/mL intravenous solution 44206043892 10,147.00

6360001 immune glob,gamm(IgG) 10 %-pro-IgA 0 to 50 mcg/mL intravenous solution 44206043993 20,294.00

6360001 irinotecan liposomal 4.3 mg/mL intravenous 69171039801 7,146.70

6360001 irinotecan liposomal 4.3 mg/mL intravenous 15054004301 7,146.70

6360001 daratumumab 20 mg/mL intravenous solution 57894050205 1,860.92

6360001 daratumumab 20 mg/mL intravenous solution 57894050220 7,443.66

6360001 atezolizumab 1,200 mg/20 mL (60 mg/mL) intravenous solution 50242091701 32,413.97

6360001 ustekinumab 130 mg/26 mL intravenous solution 57894005427 5,839.96

6360001 ocrelizumab 30 mg/mL intravenous solution 50242015001 59,312.50

6360001 rabies immune globulin (PF) 300 unit/mL intramuscular solution 13533031801 2,591.94

6360001 rabies immune globulin (PF) 300 unit/mL intramuscular solution 13533031805 11,830.31

6360001 rabies immune globulin (PF) 300 unit/mL intramuscular solution 13533031810 2,591.94

6360001 rabies immune globulin (PF) 300 unit/mL intramuscular solution 13533031850 11,830.31

6360001 flu vaccine qs 2018-19(6 mos up)(PF)60 mcg(15 mcgx4)/0.5 mL IM syringe 58160089841 26.19

6360001 flu vaccine qs 2018-19(6 mos up)(PF)60 mcg(15 mcgx4)/0.5 mL IM syringe 58160089852 26.19

6360001 flu vaccine qv2018(18yr up)rcmb(PF)180 mcg(45 mcgx4)/0.5 mL IM syringe 49281071810 75.29

6360001 flu vaccine qv2018(18yr up)rcmb(PF)180 mcg(45 mcgx4)/0.5 mL IM syringe 49281071888 75.29

6360001 flu vacc qs 2018-19(6-35 mos)(PF) 30 mcg(7.5 mcgx4)/0.25 mL IM syringe 49281051800 30.17

6360001 flu vacc qs 2018-19(6-35 mos)(PF) 30 mcg(7.5 mcgx4)/0.25 mL IM syringe 49281051825 30.17

6360001 flu vaccine ts2018-19(65yr up)(PF)180 mcg/0.5 mL intramuscular syringe 49281040365 75.29

6360001 flu vaccine ts2018-19(65yr up)(PF)180 mcg/0.5 mL intramuscular syringe 49281040388 75.29

6360001 flu vacc qs2018-19 (36 mos up)(PF)60 mcg (15 mcg x4)/0.5 mL IM syringe 49281041850 28.07

6360001 flu vacc qs2018-19 (36 mos up)(PF)60 mcg (15 mcg x4)/0.5 mL IM syringe 49281041888 28.07

6360001 diph,pertus(acel),tet ped(PF) 25 Lf unit-58 mcg-10 Lf/0.5mL IM syringe 58160081043 61.16

6360001 rabies vaccine, purified chicken embryo cell (PF) 2.5 unit IM susp 58160096412 515.61

6360001 rabies vaccine, purified chicken embryo cell (PF) 2.5 unit IM susp 58160096601 515.61

6360001 aminolevulinic acid HCl 20 % topical solution 67308010101 504.9

6360001 triptorelin pamoate 11.25 mg intramuscular suspension 23590411 8,904.98

6360001 hep B-DP(a)T-polio vacc (PF) 10 mcg-25Lf-25 mcg-10Lf/0.5 mL IM syringe 58160081143 122.84

6360001 tetanus-diphtheria toxoids-Td 2 Lf unit-2 Lf unit/0.5 mL IM suspension 13533013100 63.71

6360001 natalizumab 300 mg/15 mL intravenous solution 64406000801 22,557.00

6360001 meningoc vac A,C,Y,W-135 dip (PF) 4 mcg/0.5 mL intramuscular solution 49281058958 173.66

6360001 diphth,pertus(acel)tetanus(PF)2Lf-(2.5-5-3-5mcg)-5 Lf/0.5 mL IM susp 49281040058 85.39

6360001 immune glob,gamm(IgG) 5 %-malt-IgA over 50 mcg/mL intravenous solution 67467084303 2,356.08

6360001 immune glob,gamm(IgG) 5 %-malt-IgA over 50 mcg/mL intravenous solution 67467084304 4,712.15

6360001 immune globulin (human) (IgG) 10 % IV,immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270004 2,431.63

6360001 immune globulin (human) (IgG) 10 % IV,immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270005 4,863.26

6360001 immune globulin (human) (IgG) 10 % IV,immune glob,gamma (IgG) 10 %-gly-IgA over 50 mcg/mL injection solution 944270006 9,726.52

6360001 immune globulin (human) (IgG) 10 % IV 44206043605 2,536.75

6360001 immune globulin (human) (IgG) 10 % IV 44206043710 5,073.50

6360001 immune globulin (human) (IgG) 10 % IV 44206043820 10,147.00

6360001 immune globulin (human) (IgG) 10 % IV 44206043940 20,294.00

6360001 immune glob,gamm(IgG) 10%-sorb-IgA 0 to 50 mcg/mL intravenous solution 61953000501 1,685.57

6360001 immune glob,gamm(IgG) 10%-sorb-IgA 0 to 50 mcg/mL intravenous solution 61953000502 3,371.14

6360001 immune glob,gamm(IgG) 10%-sorb-IgA 0 to 50 mcg/mL intravenous solution 61953000503 6,742.28

6360001 1 g,2.5 g,5 g,10 g,20 g,40 g 13533080021 2,050.57

6360001 1 g,2.5 g,5 g,10 g,20 g,40 g 13533080024 8,203.01

6360001 1 g,2.5 g,5 g,10 g,20 g,40 g 13533080071 4,101.51

6360001 1 g,2.5 g,5 g,10 g,20 g,40 g 13533080021 1,957.68

6360001 1 g,2.5 g,5 g,10 g,20 g,40 g 13533-0800-21 2,050.57

6360001 immune glob,gamm(IgG)10 %-malt-IgA over 50 mcg/mL intravenous solution 68982085002 2,427.25

6360001 immune glob,gamm(IgG)10 %-malt-IgA over 50 mcg/mL intravenous solution 68982085003 4,858.15

6360001 immune glob,gamm(IgG)10 %-malt-IgA over 50 mcg/mL intravenous solution 68982085004 9,716.30

6360001 rotavirus vaccine live, pentavalent 2 mL oral solution 6404701 132.09

6360001 eculizumab 300 mg/30 mL intravenous solution 25682000101 47,617.83

6360001 rotavirus vac,live att, 89-12 strain G1P(8) 10exp6 CCID50/mL oral susp 58160085101 175.04

6360001 diph,pertus(acell),tet,polio (PF) 25 Lf-58 mcg-10 Lf/0.5 mL IM syringe 58160081243 92.24

6360001 romiPLOStim 250 mcg subcutaneous solution 55513022101 2,297.57

6360001 romiPLOStim 500 mcg subcutaneous solution 55513022201 4,462.91

6370001 phentolamine 5 mg injection solution 55390011301 547.5

6370001 SUMAtriptan 6 mg/0.5 mL subcutaneous solution 781317471 248.68

6370001 SUMAtriptan 6 mg/0.5 mL subcutaneous solution 143963801 160.29

2530001 99999000386 80.43

2530001 99999000096 43

2530001 99999000392 91.22

2530001 99999000223 67.36