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Y Extended 35.50 $ 35.19 $ 33.62 $ 33.57 $ 32.15 $ 30.97 $ 30.94 $ 30.63 $ 30.38 $ 29.34 $ 28.95 $ 28.66 $ 27.87 $ 27.68 $ 27.35 $ 26.57 $ 26.09 $ 25.74 $ 25.18 $ 25.16 $ 24.22 $ 24.10
Unit Cost 7.10 1.76 3.06 1.68 4.02 1.15 1.47 7.66 3.38 7.34 3.62 4.09 27.87 3.46 3.04 2.66 5.22 1.51 1.68 83.87 3.46 1.51 4.75 23.23 4.51 3.07 1.78 10.43 10.12 1.17 9.51 0.98 0.73 5.99 2.21 1.43 5.62 2.22 1.72 1.51 0.79 1.25 7.38
X $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
Package Cost 213.00 17.60 30.56 16.79 120.55 114.70 123.77 76.58 33.76 7.34 90.48 122.85 334.41 86.49 30.39 159.39 313.03 96.90 16.79 83.87 83.05 21.09 118.73 232.30 451.31 30.70 17.80 52.16 10.12 105.58 28.53 29.41 7.33 59.91 55.27 128.94 56.24 110.99 42.94 36.21 79.38 62.45 73.75
W $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
SOURCE 7300009563 7300011746 7300002914 7300010869 7300011272 7300003712 MIS NADAC 7300005250 7300000368 7300002818 7300008768 7300011005 7300011815 7300010060 7300005882 7300003649 7300011911 MIS NADAC 7300010869 7300011334 MIS NADAC 7300009336 7300009516 7300009195 7300001433 7300000988 7300001155 7300011253 7300010044 7300001968 7300005961 7300019457 7300005781 7300001429 7300005988 7300002077 7300005650 7300011660 7300008718 7300
V
28080800-OPIATE AGONISTS 28080800-OPIATE AGONISTS 92160000-ANTIGOUT AGENTS 40200000-CALORIC AGENTS 24082000-DIRECT VASODILATORS 28080800-OPIATE AGONISTS 48160000-EXPECTORANTS 48240000-MUCOLYTIC AGENTS 28080800-OPIATE AGONISTS 28080800-OPIATE AGONISTS 68360400-THYROID AGENTS 40200000-CALORIC AGENTS 40280800-LOOP DIURETICS 28100000-OPIATE ANTAGONISTS 40280800-LOOP DIURETICS 68040000-ADRENALS
AHFS 24060500-CHOLESTEROL ABSORPTION INHIBIT 52401200-CARBONIC ANHYDRASE INHIBITORS 12120812-ALPHA- & BETA-ADRENERGIC AGONI 24040420-ANTIARRHYTHMIC AGENTS, CLASS II 28160808-BUTYROPHENONES ANTIPSYCHOTIC 08120608-CEPHALOSPORINS, SECOND GENER 20120414-ANTICOAGULANTS, DIRECT FACTOR 28160824-PHENOTHIAZINES ANTIPSYCHOTIC A 08120604-CEPHALOSPORINS, FIRST GENERATI 24320400-ANGIOTENSIN-CONVERTING ENZYME 24069200-ANTILIPEMIC AGENTS, MISCELLANEO 08309200-ANTIPROTOZOALS, MISCEL
U 56283600-PROTON-PUMP INHIBITORS 40120000-REPLACEMENT PREPARATIONS 08121616-EXTENDED-SPECTRUM PENICILLINS 08122820-ANTIBACTERIALS, LINCOMYCINS 56281200-HISTAMINE H2-ANTAGONISTS 40120000-REPLACEMENT PREPARATIONS 68200812-INSULINS, INTERMEDIATE-ACTING 40120000-REPLACEMENT PREPARATIONS 28160804-ATYPICAL ANTIPSYCHOTIC AGENTS 20120416-ANTICOAGULANTS, HEPARINS 56120000-CATHARTICS AND LAXATIVES 56920000-GI DRUGS, MISCELLANEOUS 20120416-ANTICOAGULANTS, HEPARINS 201204
DEA
T CLASS II II II II II V
GENERIC 18387 34707 13025 33308 35674 34722 2962 6771 53281 40822 1225 98776 30039 15490 47281 30239 2962 33308 11660 2840 98863 2400 17037 14432 70022 33309 24635 98433 26322 36349 39908 62772 34940 47262 45132 23929 34940 43025 23047 62773
S CODE
MANUFACTURER Wyeth Pharmaceuticals LLC Heritage Pharmaceuticals In Patriot Pharmaceuticals, LLC Baxter Healthcare Corporatio Upsher-Smith Laboratories, Dr. Reddy's Laboratories, Inc
R Major Pharmaceuticals, Inc Hospira, Inc. American Health Packaging B. Braun Medical Inc. Hospira, Inc. Akorn, Inc. Mylan Specialty L.P. Amerisource Bergen Ascend Laboratories, LLC E.R. Squibb & Sons, L.L.C. B. Braun Medical Inc. RB Health (US) LLC Sanofi-Aventis U.S. LLC SpecGx LLC Meda Pharmaceuticals Inc. AbbVie Inc. VALEANT/BAUSCH i-Health, Inc. Sanofi-Aventis U.S. LLC Almatica Pharma Inc. Hospira, Inc. American Health Packaging Sagent Pharmaceutic
Q DOSE FORM INTRAMUSCULAR/INTRAVENOUS; SUBCUTA INTRAVENOUS INJECTION, POWDER, FOR S INTRAMUSCULAR/INTRAVENOUS INJECTIO Hospira, Inc. ORAL TABLET, FILM COATED INTRAVENOUS INJECTION, SOLUTION INTRAVENOUS INJECTION, SOLUTION INTRAVENOUS; PARENTERAL INJECTION, PHospira, Inc INTRAMUSCULAR/INTRAVENOUS INJECTIO Mylan Institutional Inc. RESPIRATORY (INHALATION) SOLUTION INTRAVENOUS INJECTION, SOLUTION, BAGBaxter Healthcare Corporatio INTRAMUSCULAR INJECTION ORAL TABLET, FILM COATED
ORAL TABLET ORAL TABLET INTRAVENOUS INJECTION ORAL TABLET ORAL TABLET GEL (GRAM) POWDER PACK ORAL TABLET ORAL TABLET ORAL CAPSULE
1 5420 5421 5422 5423 5424 5425 5426 5427 5428 5429 5430 5431 5432 5433 5434 5435 5436 5437 5438 5439 5440 5441 5442 5443 5444 5445 5446 5447 5448 5449 5450 5451 5452 5453 5454 5455 5456 5457 5458 5459 5460 5461 5462
