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Extended 159.16 $ 141.92 $ 139.52 $ 136.83 $ 133.54 $ 129.36 $ 121.44 $ 118.27 $ 113.19 $ 98.53 $ 93.91 $ 93.21 $ 87.82 $ 86.56 $ 84.10 $ 79.76 $ 76.25 $ 69.57 $ 69.12 $ 57.66 $ 51.20 $ 50.85 $ 50.63 $

Unit Cost 159.16 $ 11.83 $ 8.21 $ 6.84 $ 5.81 $ 64.68 $ 60.72 $ 14.78 $ 10.29 $ 98.53 $ 6.26 $ 13.32 $ 43.91 $ 43.28 $ 6.47 $ 39.88 $ 5.08 $ 23.19 $ 8.64 $ 57.66 $ 6.40 $ 50.85 $ 4.60 $

Package Cost 159.16 $ 118.27 $ 82.07 $ 82.10 $ 145.15 $ 64.68 $ 60.72 $ 147.84 $ 10.29 $ 985.27 $ 156.52 $ 133.15 $ 43.91 $ 43.28 $ 64.69 $ 39.88 $ 182.99 $ 23.19 $ 8.64 $ 57.66 $ 6.40 $ 50.85 $ 55.23 $

B: SMITH NORTHVIEW HOSP Purchase History 387496 B: SMITH NORTHVIEW HOSP Purchase History 387496 C: McKesson Catalog SMITH NORTHVIEW HOSP 387496 C: McKesson Catalog SMITH B: SMITH NORTHVIEW HOSP Purchase History 387496 C: McKesson Catalog SMITH B: SMITH NORTHVIEW HOSP B: SMITH NORTHVIEW HOSP Purchase History 387496 B: SMITH NORTHVIEW HOSP Purchase History 387496 B: SMITH NORTHVIEW HOSP Purchase History 387496 B: SMITH NORTHVIEW HOSP B: SMITH NORTHVIEW HOSP C: McKesson Catalog SMITH C: McKesson Catalog SMITH C: McKesson Catalog SMITH B: SMITH NORTHVIEW HOSP C: McKesson

SOURCE

AHFS GLYCOGENOLYTIC AGENTS ANTIBACTERIALS (SKIN & MUCOUS MEMBRANE) 72000000-LOCAL (PARENTERAL) 940000 - DEVICES NORTHVIEW HOSP 387496 72000000-LOCAL (PARENTERAL) 16000000-BLOOD DERIVATIVES NORTHVIEW HOSP 387496 940000 - DEVICES Purchase History 387496 ANTIBACTERIALS, GLYCOPEPTIDES ANTIBACTERIALS, FUNCTION 52160000-LOCAL ANESTHETICS (EENT) Purchase History 387496 ROENTGENOGRAPHY Purchase History 387496 68040000-ADRENALS NORTHVIEW HOSP 387496 20281600-HEMOSTAT

68221200- 84040400- ANESTHETICS ANESTHETICS 08122816- 08122808- BACITRACINS 36340000- GALLBLADDER 36680000- 52040400- 84080000-

DEA CLASS

Inventory Date 9/16/20 MANUFACTURER Boehringer Ingelheim Pharmaceuticals, Inc. Actavis Pharma, Inc. ETHICON Fresenius Kabi USA, LLC CSL Behring LLC ALCON SURGICAL Mylan Institutional LLC Pharmacia and Upjohn Company LLC Bracco Diagnostics Inc. International Medication Systems, Limited GE Healthcare Inc. E.R. Squibb & Sons, L.L.C. Pfizer Laboratories Div Pfizer Inc Akorn, Inc. ALCON SURGICAL Alcon Laboratories, SAFECOR HEALTH Sandoz Inc Bausch & Lomb Incorporated Pharmacia and Upjohn Company LLC .028; .004; .00 Cetylite Industries, Inc. Alcon Laboratories, Inc.

STRENGTH 1MG 40; 200000mg 2.5; .0091mg/Hospira, Inc. 12-7MM 5mg/mL 25g/100mL 40-30MG/ML 1g/20mL 50000iU/1 5ug/5mL 20mg/mL 300mg/mL 40mg/mL 5MU 20mg/mL 10MG/ML 6.4; .75; .48; .Inc. 5% 3.5; 10000; 1m 10mg/ml 40mg/mL 5mg/mL

SGMC Smith Northview Med Desc glucagon (human recombinant) 1mg SOLN neomycin-polymyxin B GU 1mL SOLN bupivacaine-EPINEPHrine PF 0.25% 30mL gelatin adsorbable 12-7MM sponge ropivacaine 5mg/1mL 30mL SOLN albumin human 25% 25g/100mL 100mL IV sodium chondroitin sulfate-sodium hyaluronate 40-30mg/1mL 0.5mL SOLN vancomycin 1000mg SOLR bacitracin 50000Units SOLN sincalide 5mcg SOLN lidocaine UROJECT 2% 20mL JELLY iohexol 300mg/1mL 10mL SOLN triamcinolone acetonide 40mg/1mL 5mL SUSP thrombin 5000Units SOLN lidocaine 2% 5mL ex gel sodium hyaluronate 10/1mL .55mL SOLN balanced salt solution 15mL irrg

Meridian Divisor 1 10 SOLN 10 12 25 SOLN 1 1 10 1 10 25 10 1 1 10 1 36 1 1 1 SUSP 1 1 12

QTY 1.00 12.00 17.00 20.00 23.00 2.00 2.00 8.00 11.00 1.00 15.00 7.00 2.00 2.00 13.00 2.00 15.00 3.00 8.00 1.00 8.00 1.00 11.00

00597026010 00591219045 00409174630 63713001972 63323028635 00053768033 08065183905 67457034001 00009023301 00270055615 76329301505 00407141310 00003029320 60793021505 17478071131 08065183055 00065079515 48433023015 61314063136 24208053920 00009307301 10223020103 00065074114

NDC

LOC

0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO 0112 - SN6SO