NDC/PCode/UPC Mfr.
Item #
Description
AWP Pkg
J
Ͳ
Code
00007Ͳ4643Ͳ13 GLA 39011 Promacta 12.5Mg Tab 30
3482.64
00007Ͳ4640Ͳ13 GLA 33374 Promacta 25Mg Tab 30
3482.64
00007Ͳ4641Ͳ13 GLA 33378 Promacta 50Mg Tab 30
6803.29
00007Ͳ4642Ͳ13 GLA 35704 Promacta 75Mg Tab 30
10204.94
00008Ͳ0923Ͳ55 HEM 25449 Protonix Iv 40Mg Vl 10/Pk
60.00
J3490
30237Ͳ8900Ͳ06 DEN 38849* Provenge 250Ml Sus ( R )
44162.40
Q2043
00008Ͳ1041Ͳ05 PFI
30667 Rapamune 1Mg Tab 100
2271.78
J7520
00008Ͳ1042Ͳ05 PFI
33465 Rapamune 2Mg Tab 100
4543.55
J7520
32909Ͳ0725Ͳ03 BRA 35357 ReadiͲCat Banana 24X450Ml
108.67
32909Ͳ0715Ͳ03 BRA 35354 ReadiͲCat Berry 24X450Ml
108.67
32909Ͳ0755Ͳ03 BRA 35358 ReadiͲCat Creamy Van 24X450Ml
0.00
32909Ͳ0775Ͳ03 BRA 35360 ReadiͲCat Mochaccino 24X450Ml
0.00
32909Ͳ0723Ͳ01 BRA 35361 ReadiͲCat2 Barium2.1% 24X450Ml
124.85
00078Ͳ0435Ͳ61 NOV 30069 Reclast 5Mg Vl 100Ml
1300.60
J3489
00944Ͳ2843Ͳ10 BAX 43977 Recombinate Pds 1100Iu 5Ml Vl ( R )
1.75
J7192
00006Ͳ4981Ͳ00 MER 13770 Recombivax 5Mcg P/F Sdv 10/Pk ( R )
278.45
90744
28400Ͳ0105Ͳ41 THE 34279 Recothrom 5000Iu Kit
103.20
00023Ͳ9205Ͳ15 ALL 30960 Refresh Liq Gel Drp 15 Ml
8.81
00023Ͳ0798Ͳ15 ALL 30961 Refresh Tears Drp 15 Ml
8.81
65649Ͳ0551Ͳ02 SAL 38795 Relistor 12Mg Vl
78.61
65649Ͳ0552Ͳ04 SAL 43984 Relistor 8Mg/0.4Ml Syr 7/Pk
550.28
57894Ͳ0030Ͳ01 JOM 10026 Remicade 100Mg 20Ml Vl ( R )
1113.89
J1745
00062Ͳ0275Ͳ01 VAL 34942 Retin A 0.1% Crm 45Gm Ea
403.96
59572Ͳ0410Ͳ00 CEL 27937* Revlimid 10Mg 100/Btl
56313.39
59572Ͳ0410Ͳ28 CEL 33877* Revlimid 10Mg Cap 28/Btl
15767.75
59572Ͳ0415Ͳ00 CEL 28335* Revlimid 15Mg Cap 100
56313.39
59572Ͳ0415Ͳ21 CEL 28334* Revlimid 15Mg Cap 21
11825.81
59572Ͳ0402Ͳ00 CEL 39486* Revlimid 2.5Mg Cap 100/Btl
56313.39
59572Ͳ0402Ͳ28 CEL 39485* Revlimid 2.5Mg Cap 28/Btl
15767.75
59572Ͳ0420Ͳ00 CEL 41259* Revlimid 20Mg Cap 100
56313.39
59572Ͳ0420Ͳ21 CEL 41258* Revlimid 20Mg Cap 21
11825.81
59572Ͳ0425Ͳ00 CEL 28330* Revlimid 25Mg Cap 100
56313.39
59572Ͳ0425Ͳ21 CEL 33878* Revlimid 25Mg Cap 21/Btl
11825.81
59572Ͳ0405Ͳ00 CEL 27935* Revlimid 5Mg 100/Btl
56313.39
59572Ͳ0405Ͳ28 CEL 33876* Revlimid 5Mg Cap 28/Btl
15767.75
67457Ͳ0177Ͳ50 MYL 30224 RimsoͲ50 Vl 50Ml Ea
136.13
J1212
50458Ͳ0306Ͳ11 JOM 24316 Risperdal Consta 25Mg Syg 2Ml ( R )
409.66
J2794
50458Ͳ0308Ͳ11 JOM 26832 Risperdal Consta 50Mg Syg 2Ml ( R )
819.36
J2794
50242Ͳ0051Ͳ21 GEN 10152 Rituxan 100Mg Vl 10Ml ( R )
869.22
J9310
50242Ͳ0053Ͳ06 GEN 10151 Rituxan 500Mg Vl 50Ml ( R )
4346.10
J9310
42747Ͳ0726Ͳ01 PRO 33561 Sancuso 3.1Mg Patch
488.40
00078Ͳ0340Ͳ61 NOV 25195 Sandostat Lar 10Mg Dil Pfs Kit ( R )
2799.91
J2353
00078Ͳ0341Ͳ61 NOV 25260 Sandostat Lar 20Mg Dil Pfs Kit ( R )
3668.38
J2353
00078Ͳ0342Ͳ61 NOV 25143 Sandostat Lar 30Mg Dil Pfs Kit ( R )
5493.12
J2353
00078Ͳ0181Ͳ01 NOV 23329 Sandostatin 0.1Mg/Ml Amp10X1Ml ( R )
306.80
J2354
00078Ͳ0183Ͳ25 NOV 10900 Sandostatin 200Mcg/Ml Mdv 5Ml ( R )
316.28
J2354
00310Ͳ0280Ͳ60 AST 37107 Seroquel Xr 50Mg Tab 60
547.46
57894Ͳ0350Ͳ01 JOM 41463 Simponi Aria 50Mg/4Ml Vl Ea ( R )
1518.55
J1602
25682Ͳ0001Ͳ01 ALE 29525* Soliris 300Mg/30Ml NonͲReturn ( R )
7196.40
J1300
00009Ͳ0825Ͳ01 PFI
10671 Solu Cortef 100Mg Vl
6.61
J1720
( R ) Ͳ Indicates Refrigerated Drug Item / *Indicates Dropship Drug Item
PRICES ARE SUBJECT TO CHANGE
BRANDED DRUGS
