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Y Extended 20.83 $ 20.80 $ 20.33 $ 20.26 $ 20.16 $ 20.00 $ 19.98 $ 19.94 $ 19.70 $ 19.49 $ 19.42 $ 19.33 $ 19.29 $ 19.14 $ 18.94 $ 18.58 $ 18.45 $ 18.38 $ 18.25 $ 18.19 $ 18.12 $ 17.84
Unit Cost 4.17 1.60 4.07 1.69 1.26 5.00 2.22 0.71 0.43 3.90 0.41 4.83 2.76 1.74 2.37 4.65 83.87 4.59 0.70 0.61 0.79 1.78 8.91 3.56 1.08 3.41 0.99 0.79 0.98 5.48 4.08 1.63 4.07 4.07 0.98 0.49 1.19 1.17 2.53 1.01 3.78 2.50 1.25
X $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
Package Cost 4.17 16.00 40.67 16.88 31.50 150.00 110.99 17.80 12.84 116.94 4.13 115.95 27.56 174.02 23.67 23.23 83.87 110.27 17.55 30.31 787.84 17.84 89.12 85.33 108.31 3.41 98.97 79.38 24.38 136.95 4.08 22.80 101.73 40.67 97.98 48.79 107.41 105.12 63.23 10.12 90.83 25.03 12.50
W $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
SOURCE 6770000011 7300007867 7300006236 7300007411 7300007392 7300018860 7300011660 7300006438 7300019655 7300011305 7300000445 6770009805 7300008761 7300001895 7300002447 7300007752 7300011334 6770006446 7300008748 7300001060 7300000619 7300006633 7300011079 7300001866 7300003700 6770000223 7300011131 7300002951 7300005782 7300000807 7300010064 7300007878 7300007697 7300006236 7300002048 7300011641 7300001970 7300001967 7300008855 7
V
24060600-FIBRIC ACID DERIVATIVES
40280800-LOOP DIURETICS 28080800-OPIATE AGONISTS 28080800-OPIATE AGONISTS 28080800-OPIATE AGONISTS 68040000-ADRENALS 48240000-MUCOLYTIC AGENTS 68360400-THYROID AGENTS 68360400-THYROID AGENTS 40280800-LOOP DIURETICS 28080800-OPIATE AGONISTS
AHFS 24289200-CALCIUM-CHANNEL BLOCKING AGEN 28049200-GENERAL ANESTHETICS, MISCELLAN 28240800-BENZODIAZEPINES (ANXIOLYTIC,SED 28240800-BENZODIAZEPINES (ANXIOLYTIC,SED 28049200-GENERAL ANESTHETICS, MISCELLAN 24069200-ANTILIPEMIC AGENTS, MISCELLANEO 28129200-ANTICONVULSANTS, MISCELLANEOU 28049200-GENERAL ANESTHETICS, MISCELLAN 28129200-ANTICONVULSANTS, MISCELLANEOU 24040408-ANTIARRHYTHMIC AGENTS, CLASS Ib 24320800-ANGIOTENSIN II RECEPTOR ANTAGO 12121200-ALPHA- AND BETA-ADRE
U 40120000-REPLACEMENT PREPARATIONS 56281200-HISTAMINE H2-ANTAGONISTS 40120000-REPLACEMENT PREPARATIONS 56222000-5-HT3 RECEPTOR ANTAGONISTS 68200812-INSULINS, INTERMEDIATE-ACTING 04040400-ETHANOLAMINE DERIVATIVES 12120400-ALPHA-ADRENERGIC AGONISTS 40120000-REPLACEMENT PREPARATIONS 52160000-LOCAL ANESTHETICS (EENT) 52080800-CORTICOSTEROIDS (EENT) 56120000-CATHARTICS AND LAXATIVES 56120000-CATHARTICS AND LAXATIVES 40120000-REPLACEMENT PREPARATIONS
DEA
T CLASS IV IV III III II II II II
GENERIC 2641 12831 33820 33823 23929 99002 98806 93437 99097 12852 18040 34810 19201 11660 26899 46013 34853 97790 3282 25792 20091 25519 9614 62263 3421 2401 12831 25793 9131 26327 26321 34940 86211 41321 39963 34855
S CODE
MANUFACTURER Athenex Pharmaceutical Div Nephron Pharmaceuticals Corporation West-Ward Pharmaceuticals Heritage Pharmaceuticals Inc. Baxter Healthcare Corporatio Bristol-Myers Squibb Pharma International Medication Sys West-Ward Pharmaceuticals Athenex Pharmaceutical Div Bristol-Myers Squibb Pharma Pharmaceutical Associates, Baxter Healthcare Corporatio
R ICU Medical Inc. Hospira, Inc. American Health Packaging Nomax Inc. American Health Packaging Hospira, Inc. Mylan Pharmaceuticals Inc. B. Braun Medical Inc. AvKare, Inc. Lupin Pharmaceuticals, Inc. Hospira, Inc. SpecGx LLC Fera Pharmaceuticals, LLC Hospira, Inc Rugby Laboratories Inc. AbbVie Inc. AbbVie Inc. Bayer HealthCare LLC. Hospira, Inc.
Q DOSE FORM INTRAVENOUS INJECTION, SOLUTION INTRAVENOUS INJECTION, SOLUTION INTRAMUSCULAR/INTRAVENOUS INJECTIO Fresenius Kabi USA, LLC INTRAMUSCULAR/INTRAVENOUS INJECTIO Fresenius Kabi USA, LLC ORAL CAPSULE, LIQUID FILLED INTRAVENOUS INJECTION ORAL TABLET, EFFERVESCENT INTRAVENOUS INJECTION, SOLUTION INTRAVENOUS INJECTION, SOLUTION INTRAMUSCULAR; INTRAVENOUS INJECTIOWest-Ward Pharmaceuticals ORAL TABLET, FILM COATED, EXTENDED RAmerican Health Packaging INTRAMUSCULAR/INTRAVE
SYRINGE ORAL CAPSULE TRANSDERMAL PATCH ORAL TABLET ORAL TABLET ORAL TABLET ORAL TABLET ORAL TABLET TOPICAL JELLY NASAL SPRAY, METERED ORAL TABLET ORAL LIQUID ORAL TABLET ORAL TABLET
IS
1 6452 6453 6454 6455 6456 6457 6458 6459 6460 6461 6462 6463 6464 6465 6466 6467 6468 6469 6470 6471 6472 6473 6474 6475 6476 6477 6478 6479 6480 6481 6482 6483 6484 6485 6486 6487 6488 6489 6490 6491 6492 6493 6494
