NDC/PCode/UPC Mfr.
Item #
Description
AWP Pkg
J
Ͳ
Code
68982Ͳ0850Ͳ02 OCT 43756* Octagam 10% 5Gm 50Ml Vl Ion ( R )
774.60
J1568
67467Ͳ0843Ͳ02 OCT 39265* Octagam 5% 2.5M 50Ml Nr Ion ( R )
380.02
J1568
67467Ͳ0843Ͳ03 OCT 39266* Octagam 5% 5Gm 100Ml Nr Ion ( R )
760.02
J1568
68209Ͳ0843Ͳ04 OCT 39269* Octagam 5%10Gm 200Ml Nr Ion ( R )
1520.04
J1568
67467Ͳ0843Ͳ04 OCT 39268* Octagam 5%10Gm 200Ml Nr Ion ( R )
1520.04
J1568
43825Ͳ0102Ͳ01 CAD 38007 Ofirmev Acetamin 1000Mg Inj 24
1019.52
54482Ͳ0301Ͳ01 SIG 38687* Oncaspar 750Iu/Ml Sdvpf 5Ml
7182.49
J9266
00003Ͳ3774Ͳ12 BRI
44118 Opdivo 100Mg 10Ml Vl ( R )
2877.60
00003Ͳ3772Ͳ11 BRI
44117 Opdivo 40Mg 4Ml Vl ( R )
1151.04
00003Ͳ2187Ͳ10 BRI
28321 Orencia 250Mg Vl15Ml Nonreturn ( R )
874.69
J0129
59011Ͳ0410Ͳ10 PUR 36641 Oxycontin 10Mg Tab 100/Btl
323.00
00386Ͳ0008Ͳ03 GEB 26843 Pain Ease 3.5Oz Spray
27.50
00386Ͳ0008Ͳ02 GEB 32320 Pain Ease Spray Mist 3.5 Oz
27.50
00004Ͳ0357Ͳ30 GEN 38837 Pegasys 180Mcg Pfs 4X.5Ml ( R )
4159.30
00004Ͳ0350Ͳ09 GEN 22862 Pegasys 180Mcg/Ml Vl 1Ml ( R )
1039.82
00085Ͳ4355Ͳ01 MER 43927 PegͲIntron 120Ug/.5Ml Pwdw/Dil
995.06
00085Ͳ4353Ͳ01 MER 43925 PegͲIntron 50Ug/0.5Ml Pwdw/Dil
902.60
00085Ͳ4354Ͳ01 MER 43926 PegͲIntron 80Ug/0.5Ml Pwdw/Dil
947.63
50242Ͳ0145Ͳ01 GEN 39679 Perjeta 420Mg/14Ml Sdv ( R )
4890.79
J9306
24385Ͳ0092Ͳ27 BIR 42888 Petroleum Jelly Jel 13Oz
0.00
00006Ͳ4943Ͳ00 MER 10355 Pneumovax 23 Vl 10X0.5Ml ( R )
868.61
90732
59572Ͳ0501Ͳ00 CEL 40662* Pomalyst 1Mg Cap 100
65222.70
59572Ͳ0501Ͳ21 CEL 40661* Pomalyst 1Mg Cap 21
13696.76
59572Ͳ0502Ͳ00 CEL 40664* Pomalyst 2Mg Cap 100
65222.70
59572Ͳ0502Ͳ21 CEL 40663* Pomalyst 2Mg Cap 21
13696.76
59572Ͳ0503Ͳ00 CEL 40666* Pomalyst 3Mg Cap 100
65222.70
59572Ͳ0503Ͳ21 CEL 40665* Pomalyst 3Mg Cap 21
13696.76
59572Ͳ0504Ͳ00 CEL 40668* Pomalyst 4Mg Cap 100
65222.70
59572Ͳ0504Ͳ21 CEL 40667* Pomalyst 4Mg Cap 21
13696.76
00597Ͳ0135Ͳ54 BOE 37190 Pradaxa 150Mg Cap 60
377.64
00597Ͳ0149Ͳ54 BOE 38864 Pradaxa 75Mg Cap 60
377.64
00126Ͳ0072Ͳ92 COL 43700 Prevident Pls T/P Fruit 3.4Oz
11.05
00126Ͳ0074Ͳ92 COL 43699 Prevident Pls T/P Sprmnt 3.4Oz
11.05
00005Ͳ1971Ͳ05 PFI
41022 PrevnarͲ13 Pfs 0.5Ml Ea ( R )
187.95
90670
00005Ͳ1971Ͳ02 PFI
38983 PrevnarͲ13 Pfs 10X0.5Ml ( R )
1822.64
90670
59676Ͳ0566Ͳ30 JOM 42948 Prezista 800 Mg Tab 30
1509.79
37000Ͳ0455Ͳ04 AME 30138 Prilosec Otc Tab 42/Pk
27.07
00024Ͳ1596Ͳ01 AVE 21224 Primaquine 26.3Mg Tab 100
202.14
44206Ͳ0437Ͳ10 CSL 31316 Privigen 10Gm Sdv
1560.00
J1459
44206Ͳ0438Ͳ20 CSL 31317 Privigen 20Gm Sdv
3120.00
J1459
44206Ͳ0436Ͳ05 CSL 31315 Privigen 5Gm Sdv
780.00
J1459
59310Ͳ0579Ͳ22 TEV 40430 Proair Hfa 90Mcg Inh 8.5Gm
60.02
QOL112
THO 42764 Probioqol 30/Btl
0.00
59676Ͳ0312Ͳ04 ORT 31310 Procrit 10M Un/Ml 2Ml Mdv 4/Pk ( R )
2041.92
J0885, J0886, Q4081
59676Ͳ0310Ͳ01 ORT 10510 Procrit 10M Un/Ml Vl 6X1Ml ( R )
1531.44
J0885, J0886, Q4081
59676Ͳ0340Ͳ01 ORT 10982 Procrit 40M Un/Ml Vl 4X1Ml ( R )
4083.84
J0885, J0886, Q4081
59676Ͳ0320Ͳ04 ORT 30696 Procrit20M Un/Ml Mdv 4X1Ml ( R )
2041.92
J0885, J0886, Q4081
68516Ͳ3201Ͳ01 GRI
39918 Profilnine Sd Pds 480Iu Vl ( R )
1.32
J7194
65483Ͳ0116Ͳ07 PRO 39000 Proleukin 22Mm Iu Vl ( R )
2936.78
J9015
55513Ͳ0710Ͳ01 AMG 38610 Prolia Uro Onc 60Mg Syg ( R )
1057.86
J0897
( R ) Ͳ Indicates Refrigerated Drug Item / *Indicates Dropship Drug Item
PRICES ARE SUBJECT TO CHANGE
BRANDED DRUGS
