NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
00781-3655-69 SAN 38662 Enoxaparin 150Mg Pfs 10X1Ml
1219.68
J1650
00955-1015-10 WIN 40333 Enoxaparin 150Mg Pfs 10X1Ml
1340.11
J1650
00955-1016-01 WIN 40338 Enoxaparin 300Mg Vl 1X3Ml Mdv
267.64
J1650
00781-3133-63 SAN 38663 Enoxaparin 30Mg Pfs 10X.3Ml
243.54
J1650
00955-1003-10 WIN 40327 Enoxaparin 30Mg Pfs 10X.3Ml
267.64
J1650
00781-3224-64 SAN 38664 Enoxaparin 40Mg Pfs 10X.4Ml
324.72
J1650
00955-1004-10 WIN 40328 Enoxaparin 40Mg Pfs 10X.4Ml
356.82
J1650
00781-3356-66 SAN 38665 Enoxaparin 60Mg Pfs 10X.6Ml
487.71
J1650
00955-1006-10 WIN 40329 Enoxaparin 60Mg Pfs 10X.6Ml
535.87
J1650
00781-3428-68 SAN 38666 Enoxaparin 80Mg Pfs 10X.8Ml
650.25
J1650
00955-1008-10 WIN 40330 Enoxaparin 80Mg Pfs 10X.8Ml
714.50
J1650
64764-0300-20 TAK 42958 Entyvio 300Mg 20Mlsdv Ea ( R )
5782.80
00409-7241-01 HOS 26815 Epinep 1:1000 Amp 25X1Ml
63.00
J0171
00409-4921-34 HOS 27478 Epinep 1:10000 20G Abj 10X10Ml
58.08
J0171
54505-0102-02 AME 41502 Epinephrine 0.3Mg Inj 2
324.56
49502-0500-02 MYL 34632 Epipen Adult 0.3Mg 2/Pk
419.03
25021-0203-51 SAG 36345 Epirubicin 200Mg Sdv 100Ml ( R )
252.00
J9178
61703-0359-59 HOS 30336 Epirubicin 200Mg/100Ml Sdv Sol ( R )
191.34
J9178
00703-3069-11 TEV 30368 Epirubicin 200Mg/100Ml Sdv Sol ( R )
457.39
J9178
25021-0203-25 SAG 36344 Epirubicin 50Mg Sdv 25Ml ( R )
72.00
J9178
61703-0359-93 HOS 30335 Epirubicin 50Mg/25Ml Sdv Sol ( R )
49.14
J9178
00703-3067-11 TEV 30367 Epirubicin 50Mg/25Ml Sdv Sol ( R )
114.35
J9178
53270-0100-10 CAN 40290 Episil Oral Liq 10Ml Btl
150.00
66733-0948-23 BRI
24544 Erbitux 100Mg/50Ml Vl ( R )
617.46
J9055
66733-0958-23 BRI
29585 Erbitux 200Mg/100Ml Vl ( R )
1234.92
J9055
50242-0140-01 GEN 39092 Erivedge 150Mg Cap 28
9922.50
THO 42761 Erythroqol 60/Btl
00093-5851-01 TEV 39403 Escitalopram 10Mg Tab 100
432.65
00093-5852-01 TEV 39404 Escitalopram 20Mg Tab 100
451.46
00591-0487-01 ACT 42497 Estradiol 1Mg Tab 100
34.50
00015-3404-20 BRI
18774 Etopophos 100Mg ( R )
159.55
J9181 , J9182
63323-0104-05 FRE 16136 Etoposide 20Mg/Ml Mdv 10X5Ml
149.28
J9181 , J9182
00378-3266-94 MYL 22971 Etoposide 50Mg Cap 20/Ud ( R )
1417.19
J8560
63323-0104-25 FRE 18713 Etoposide Inj 20Mg/Ml 25Ml Md
74.63
J9181 , J9182
63323-0104-50 FRE 18714 Etoposide Inj 20Mg/Ml 50Ml Mdv
149.26
J9181 , J9182
16729-0114-31 ACC 37616 Etoposide Inj 20Mg/Ml 5Ml Mdv
11.37
J9181
00002-4165-02 ELI
13682 Evista 60Mg Tab 100
792.00
59762-2858-01 GRE 37816 Exemestane 25Mg Tab 30
606.94
00078-0490-15 NOV 36961 Exforge 5/320Mg Tab 30
231.17
00078-0468-15 NOV 27363 Exjade 125Mg Tablets 30/Btl
844.43
00078-0469-15 NOV 27364 Exjade 250Mg Tablets 30/Btl
1688.82
00078-0470-15 NOV 27362 Exjade 500Mg Tablets 30/Btl
3377.58
58468-0040-01 GEN 25855 Fabrazyme 35Mg Vl-Non Return ( R )
6039.60
J0180
58468-0041-01 GEN 25854 Fabrazyme 5Mg Vl-Non Return ( R )
862.80
J0180
00054-0197-13 ROX 41175 Famciclovir 250Mg Tab 30
208.42
00054-0198-13 ROX 41049 Famciclovir 500Mg Tab 30
418.57
00338-5197-41 BAX 38586 Famotid Prmix 20Mg/50 Ml 24X50
4.68
NEW03
63323-0738-09 FRE 40382 Famotidine 10Mg/Ml Mdv 10X4Ml ( R )
21.60
NEW03
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE