Page 32 - ecatalogJuly14.indd
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NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
00054-4183-25 ROX 35763 Dexameth 2Mg Tab 100
62.31
00054-8175-25 ROX 30550 Dexameth 4Mg Tab Ud 100
62.05
00641-0367-25 WES 11173 Dexameth Pho 10Mg/1Ml Sdv25/Pk
39.00
J1100
63323-0165-05 FRE 20182 Dexameth Pho 20Mg/5Ml Mdv25/Pk
121.80
J1100
63323-0165-01 FRE 19790 Dexameth Pho 4Mg/1Ml Sdv 25/Pk
50.70
J1100
63323-0165-30 FRE 12733 Dexameth Phos 4Mg/Ml Vl 30Ml
26.26
J1100
63323-0506-01 FRE 23457 Dexameth Phos Pf10Mg/Ml 25X1Ml
121.20
J1100
61314-0294-05 SAN 41817 Dexamethasone 0.1% Drp 5Ml
21.10
00054-4184-25 ROX 23813 Dexamethasone 4Mg Tab 100
58.41
00054-8183-25 ROX 42579 Dexamethasone 6Mg Tab Ud 100
97.34
00517-0234-10 AME 10743 Dexferrum Iv 50Mg/Ml Sdv10X2Ml
450.00
J1750
64764-0171-30 TAK 42444 Dexilant 30Mg Cap 30
220.66
64764-0175-30 TAK 36410 Dexilant 60Mg Cap 30
220.66
00409-7922-25 HOS 34745 Dext Viv 5% 24X250Ml
132.77
J7060
00409-7926-02 HOS 36941 Dext/Sod Lc 5%/.45%Sol24X250Ml
92.45
J7042
00409-7517-16 HOS 27419 Dextrose 50% Ansyr Syg 10X50Ml
67.68
00409-4902-34 HOS 27423 Dextrose 50% Lfs Syg 10X50Ml
114.12
16571-0201-06 PAC 41702 Diclofenac 75Mg Ec Tab 60
106.43
00591-0794-01 ACT 24765 Dicyclomine 10Mg Cap 100/Btl
7.08
00641-1410-35 WES 13434 Digoxin 500Mcg/2Ml Amp 25X2Ml
165.00
J1160
00093-0318-01 TEV 41347 Diltiazem 30Mg Tab 100
52.59
00093-5117-98 TEV 41610 Diltiazem Cd 180Mg Cap 90
130.12
00093-5118-98 TEV 28150 Diltiazem Er 240Mg Cap 90
184.60
00904-5306-60 MAJ 19079 Diphen/Banophen 25Mg Cap 100
4.10
00185-0648-10 SAN 28110 Diphenhyd 25Mg Cap 1000
45.50
00904-5306-61 MAJ 38759 Diphenhyd 25Mg Cap Ud 100/Pk
12.50
00185-0649-01 SAN 28111 Diphenhyd 50Mg Cap 100
9.04
Q0163
00409-2290-31 HOS 26722 Diphenhyd 50Mg/Ml C/J 10X1Ml
19.08
J1200
51672-2066-02 TAR 37673 Diphenhydram 2% Crm 1Oz
4.13
67457-0124-10 MYL 38222 Diphenhydram 50Mg/Ml Mdv 10Ml
143.70
J1200
00185-0648-01 SAN 10704 Diphenhydramin 25Mgcap 100/Btl
8.26
63323-0664-01 FRE 22253 Diphenhydramine 50Mg 25X1Ml
82.50
J1200
00641-0376-25 WES 11153 Diphenhydramne 50Mg Vl 25X1Ml
24.60
J1200
68382-0189-01 ZYD 42681 Dipyridamole 75Mg Tab 100
125.90
16729-0267-65 ACC 41119 Docetaxel 160Mg/8Ml Rtu Mdv
2921.20
J9171
00955-1020-01 WIN 37176 Docetaxel 20Mg Vl 1Ml
444.76
J9171
16729-0267-63 ACC 41846 Docetaxel 20Mg/1Ml Rtu Mdv
365.15
J9171
25021-0222-01 SAG 41975 Docetaxel 20Mg/1Ml Sdv
240.00
J9171
00955-1021-04 WIN 37177 Docetaxel 80Mg Vl 4Ml
1779.00
J9171
16729-0267-64 ACC 41468 Docetaxel 80Mg/4Ml Rtu Mdv
1460.60
J9171
25021-0222-04 SAG 41976 Docetaxel 80Mg/4Ml Sdv
960.00
J9171
00409-0201-20 HOS 37031 Docetaxel Inj 160Mg/16Ml Mdv
1583.00
J9171
66758-0050-03 SAN 38424 Docetaxel Inj 160Mg/16Ml Mdv
3036.35
J9171
66758-0050-01 SAN 38422 Docetaxel Inj 20Mg/2Ml Mdv
379.54
J9171
00409-0201-02 HOS 37029 Docetaxel Inj 20Mg/2Ml Sdv
199.84
J9171
00409-0201-10 HOS 37030 Docetaxel Inj 80Mg/8Ml Mdv
799.48
J9171
66758-0050-02 SAN 38423 Docetaxel Inj 80Mg/8Ml Mdv
1518.17
J9171
57896-0401-01 AME 28163 Docusate Sod 100Mg Cap 100
1.00
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE
