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Y Extended 681.45 $ 670.32 $ 608.32 $ 543.30 $ 535.53 $ 530.40 $ 530.26 $ 518.31 $ 486.52 $ 461.97 $ 435.53 $ 429.14 $ 381.48 $ 354.80 $ 352.25 $ 331.84 $ 322.22 $ 281.04 $ 281.00 $ 280.03 $ 271.20 $ 267.76 $ 254.4
Unit Cost 20.65 15.96 152.08 181.10 267.76 7.27 265.13 129.58 48.65 461.97 25.62 6.81 31.79 14.78 25.16 27.65 53.70 28.10 12.22 3.89 22.60 267.76 25.45 13.78 33.72 109.03 2.96 4.63 4.21 17.50 18.45 2.96 41.43 16.88 2.96 11.97 13.78 43.72 3.89 4.77 6.89 6.04 6.28
X $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
Package Cost 20.65 159.60 4,562.36 181.10 267.76 181.65 265.13 129.58 486.52 461.97 256.19 68.12 317.90 177.40 25.16 829.61 537.03 281.04 122.17 38.89 271.20 267.76 254.48 137.78 33.72 1,090.26 29.59 46.27 42.11 350.06 184.53 29.59 165.72 168.78 29.59 119.70 137.78 43.72 97.23 119.14 82.69 6.04 62.80
W $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
SOURCE UPDATED PRICE UPDATED PRICE 7300011693 7300011120 7300006345 7300000922 7300005307 7300009198 7300006753 7300000818 7300019361 7300010440 7300006336 7300011960 7300011334 7300018884 MIS NADAC 7300000079 7300006674 7300006675 UPDATED PRICE 7300006345 7300000970 7300005503 7300011465 7300000841 7300000577 7300006676 7300005199 7300005428 7300000093 7300000577 7300011124 7300019360 7300000577 7300005655 7300005503 7300011047 73000
V
AHFS 28080492-OTHER NONSTEROIDAL ANTI-INFLAM 20122000-THROMBOLYTIC AGENTS 80040000-ANTITOXINS AND IMMUNE GLOBULIN 20160000-HEMATOPOIETIC AGENTS 24289200-CALCIUM-CHANNEL BLOCKING AGEN 40181800-POTASSIUM-REMOVING AGENTS 68290400-SOMATOSTATIN AGONISTS 68290400-SOMATOSTATIN AGONISTS 12202000-NEUROMUSCULAR BLOCKING AGENT 12202000-NEUROMUSCULAR BLOCKING AGENT 68290400-SOMATOSTATIN AGONISTS
U 68200816-INSULINS, LONG-ACTING 68280000-PITUITARY 28121200-HYDANTOINS 68160400-ESTROGENS 80120000-VACCINES 68280000-PITUITARY 68200808-INSULINS, SHORT-ACTING 68200812-INSULINS, INTERMEDIATE-ACTING 80080000-TOXOIDS 68280000-PITUITARY 28121200-HYDANTOIN
081228 081228
DEA
T CLASS
GENERIC 20240 13072 10260 99384 10890 13922 98442 26601 44765 2641 10860 46567 11660 40065 99414 21766 21767 10260 99385 5679 32770 37201 24220 41301 16778 89471 37201 26665 44764 37201 99309 21767 25428 15001 89699
S CODE
MANUFACTURER West-Ward Pharmaceuticals Baxter Healthcare Corporatio GlaxoSmithKline Biologicals Mallinckrodt Hospital Produc Cosette Pharmaceuticals, In X-GEN Pharmaceuticals, Inc
R SCA Pharmaceuticals, Inc. Egalet US Inc. sanofi-aventis U.S. LLC Teva Parenteral Medicines, Amring Pharmaceuticals Inc Relypsa, Inc. QUVA PHARMA INC Amring Pharmaceuticals Inc AbbVie Inc. AuroMedics Pharma LLC Hospira, Inc. Halozyme, Inc. Hospira, Inc. INTRAMUSCULAR/INTRAVENOUS INJECTIO SOMERSET THERAPEUTICS LLC Hospira, Inc. SCA Pharmaceuticals, Inc.
Q DOSE FORM SUBCUTANEOUS INJECTION, SOLUTION INTRAMUSCULAR/INTRAVENOUS INJECTIO Mylan Institutional LLC INTRAMUSCULAR/INTRAVENOUS INJECTIO Wyeth Pharmaceuticals LLC INTRAVENOUS INJECTION, POWDER, LYOPGenentech, Inc. INTRAMUSCULAR INJECTION, SUSPENSION GlaxoSmithKline Biologicals INTRAMUSCULAR; INTRAVENOUS INJECTIOSaol Therapeutics Inc. INTRAVENOUS; SUBCUTANEOUS INJECTIO Pfizer Laboratories Div Pfize INTRAVENOUS INJECTION, SOLUTION SUBCUTANEOUS INJECTION, SUSPENSIONEli Lil
PLASTIC BAG SYRN RECTAL SUPPOSITORY INTRAVENOUS INJECTION INTRAVENOUS INJECTION INTRAVENOUS SOLUTION SYRN IV BAG INTRAVENOUS SOLUTION INTRAVENOUS INJECTION RECTAL SUPPOSITORY PLASTIC BAG IRRIGATION SOLUTION
1 1636 1637 1638 1639 1640 1641 1642 1643 1644 1645 1646 1647 1648 1649 1650 1651 1652 1653 1654 1655 1656 1657 1658 1659 1660 1661 1662 1663 1664 1665 1666 1667 1668 1669 1670 1671 1672 KIT 1673 1674 1675 1676 1677 1678
