NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
63323-0738-20 FRE 38362 Famotidine 200Mg Mdv 10X20Ml ( R )
413.00
NEW03
63323-0739-12 FRE 22115 Famotidine 20Mg Sdv 25X2Ml ( R )
102.50
NEW03
00172-5728-60 TEV 42321 Famotidine 20Mg Tab 100
173.00
63739-0484-10 MCK 42080 Famotidine 20Mg Tab Ud 100
8.64
00172-5729-60 TEV 34699 Famotidine 40Mg Tab 100
334.40
00078-0598-20 NOV 41944 Fanapt 6Mg Tab 60
919.04
42747-0327-30 PRO 40617 Fareston 60Mg Tab 30
1177.44
00310-0720-10 AST 36987 Faslodex 500Mg Pf Syr 2X5.0Ml ( R )
2148.86
J9395
00378-5012-01 MYL 31974 Felodipine 5Mg Er Tab 100
151.09
00078-0249-15 NOV 20960 Femara 2.5Mg Tabs 30/Btl
730.10
59338-0775-01 AMA 34408 Feraheme 510 Mg/17Ml Sdv
614.76
Q0138 , Q0139
59338-0775-10 AMA 34409 Feraheme 510 Mg/17Ml Sdv 10/Pk
6147.60
Q0138 , Q0139
00178-0089-90 MIS 42844 Ferralet 90 Mg Tab 90
135.48
51991-0203-11 AME 30088 Ferrex 150Mg Caps Ud 100/Bx
27.50
51991-0588-28 BRE 37415 Ferrex 28 Tab 28
28.95
00024-2792-10 AVE 37769 Ferrlecit 62.5Mg/5Ml Vl 10X5Ml
381.60
J2916
50383-0778-16 AME 31018 Ferrous Sul 220Mg/5Ml Elx 16Oz
6.85
00536-5890-01 WAT 27170 Ferrous Sul 325Mg Red Tab 100
4.04
45802-0571-78 PER 38217 Fexofenadine 180Mg Tab 100
41.82
45802-0425-78 PER 38865 Fexofenadine 60Mg Tab 100
71.93
31722-0525-30 CAM 38921 Finasteride 5Mg Tab 30
93.39
31722-0525-90 CAM 38838 Finasteride 5Mg Tab 90
280.14
55566-8403-01 FER 41326 Firmagon 240Mg Kit
1620.24
J9155
55566-8303-01 FER 41325 Firmagon 80Mg Kit
540.00
J9155
65628-0053-01 CUT 37395 First Mary'S M/Wsh Sus 8Oz
57.70
65628-0051-01 CUT 37394 First-Bxn M/Wsh Kit 237Ml
50.00
61953-0004-04 GRI
29505 Flebogamma Dif5% 10Gm 200Ml Vl ( R )
1006.56
J1572
61953-0004-05 GRI
29506 Flebogamma Dif5% 20Gm 400Ml Vl ( R )
2013.12
J1572
61953-0004-03 GRI
29504 Flebogamma Dif5% 5Gm 100Ml Vl ( R )
503.28
J1572
63323-0145-07 FRE 19717 Floxuridine 500Mg Vl Lyo
150.00
J9200
00409-4688-23 HOS 37969 Fluconaz/Sal 200Mg Bag 6X100Ml
70.06
J1450
68001-0252-04 AME 42919 Fluconazole 100Mg Tab 30
264.09
68001-0253-20 AME 42918 Fluconazole 150Mg Tab 12
168.12
68001-0254-04 AME 42853 Fluconazole 200Mg Tab 30
432.14
25021-0205-05 SAG 36343 Fludarabine 50Mg Sdv Lyo
132.00
J9185
00703-5854-01 TEV 23881 Fludarabine 50Mg Sdv Lyo ( R )
113.40
J9185
66758-0046-01 SAN 30651 Fludarabine 50Mg/2Ml Sdv Sol ( R )
350.00
J9185
63323-0192-02 FRE 34398 Fludarabine 50Mg/2Ml Sdv Sol ( R )
326.26
J9185
00143-9784-10 WES 40606 Flumazenil 0.1Mg/Ml Vl 10X5Ml
81.25
J3490
51672-1253-01 TAR 24982 Fluocinonide 0.05% Crm 15Gm
45.55
51672-1253-02 TAR 41138 Fluocinonide 0.05% Crm 30Gm
91.10
16729-0276-67 ACC 42398 Fluorouracil 1Gm/20Ml 10/Pk
J9190
63323-0117-20 FRE 18715 Fluorouracil 1Gm/20Ml Sd 10/Pk
72.00
J9190
16729-0276-11 ACC 42399 Fluorouracil 2.5Gm/50Ml Pbp
J9190
63323-0117-51 FRE 18716 Fluorouracil 2.5Gm/50Ml Pbp
16.06
J9190
51672-4118-06 TAR 37189 Fluorouracil 5% Crm 40 Gm
384.94
16729-0276-68 ACC 42397 Fluorouracil 500Mg/10Ml 10/Pk
J9190
63323-0117-10 FRE 10753 Fluorouracil 500Mg/10Ml 10/Pk
36.00
J9190
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE
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