NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
55513-0006-01 AMG 28203 Aranesplysb 200Mcg Sdv 1.0Ml ( R )
1543.68
J0881 , J0882
55513-0057-04 AMG 28191 Aranesplysb 25Mcg Pfs4X.42Ml ( R )
771.84
J0881 , J0882
55513-0002-04 AMG 28198 Aranesplysb 25Mcg Sdv 4X1Ml ( R )
771.84
J0881 , J0882
55513-0111-01 AMG 28197 Aranesplysb 300Mcg Pfs 0.6Ml ( R )
2315.52
J0881 , J0882
55513-0110-01 AMG 28204 Aranesplysb 300Mcg Sdv 1.0Ml ( R )
2315.52
J0881 , J0882
55513-0021-04 AMG 28192 Aranesplysb 40Mcg Pfs 4X.4Ml ( R )
1235.04
J0881 , J0882
55513-0003-04 AMG 28199 Aranesplysb 40Mcg Sdv 4X1Ml ( R )
1235.04
J0881 , J0882
55513-0023-04 AMG 28193 Aranesplysb 60Mcg Pfs 4X.3Ml ( R )
1852.32
J0881 , J0882
55513-0004-04 AMG 28200 Aranesplysb 60Mcg Sdv 4X1Ml ( R )
1852.32
J0881 , J0882
00904-4215-51 MAJ 31914 Arginine Tab 50
4.60
00310-0201-30 AST 14354 Arimidex 1Mg Tab 30
520.76
00007-3236-11 GLA 26441 Arixtra 10Mg/0.8Ml Pfs 10/Pk
1429.02
J1652
00007-3230-11 GLA 26442 Arixtra 2.5Mg/0.5Ml Pfs 10/Pk
607.25
J1652
00007-3230-02 GLA 27603 Arixtra 2.5Mg/0.5Ml Pfs 2/Pk
127.51
J1652
00007-3232-11 GLA 26440 Arixtra 5Mg/0.4Ml Pfs 10/Pk
1429.02
J1652
00007-3234-11 GLA 25974 Arixtra 7.5Mg/0.6Ml Pfs 10/Pk
1429.02
J1652
00009-7663-04 PFI
23615 Aromasin 25Mg Tab 30/Btl
594.00
00007-4401-06 GLA 27565 Arranon Inj 5Mg/Ml 50Ml 6/Pk
4704.20
J9261
00173-0821-01 GLA 38168 Arzerra 1000Mg Vl 50Ml ( R )
5506.58
J9302
00173-0821-33 GLA 38167 Arzerra 100Mg Vl 3X5Ml ( R )
1651.97
J9302
67457-0118-50 MYL 38221 Ascorbic Acid 500Mg/Ml 50Ml Vl ( R )
18.43
J3490
00904-2009-60 MAJ 33423 Aspirin 325Mg Tab 100/Btl
1.55
91136
AME 32406 Aspirin 81Mg Chew Tab 36
00603-0026-22 QUA 30285 Aspirin 81Mg Ec Tab 120/Btl
5.75
00186-0032-54 AST 33343 Atacand 32Mg Tab 90
429.58
50742-0101-01 ING 38512 Atenolol 25Mg Tab 100
81.75
50742-0102-01 ING 38043 Atenolol 50Mg Tab 100
84.68
60505-2578-09 APO 40112 Atorvastatin 10Mg Tab 90
364.28
60505-2579-09 APO 40064 Atorvastatin 20Mg Tab 90
519.63
17478-0214-20 AKO 39671 Atropine Care 1% Sol 2Ml
5.98
00409-4910-34 HOS 26989 Atropine Lfs 0.5Mg Syg 10X5Ml
99.60
J0461
00641-6006-10 WES 39220 Atropine Sul 0.4Mg/Ml 10X20Ml
421.20
J0461
00597-0087-17 BOE 27230 Atrovent Hfa 17Mcg Inh 12.9Gm
258.22
50242-0060-01 GEN 24580 Avastin Vl 100Mg ( R )
761.83
C9257 , J9035
50242-0061-01 GEN 25406 Avastin Vl 400Mg ( R )
3047.33
C9257 , J9035
00085-1733-01 MER 27797 Avelox 400Mg Tab 30/Btl
825.76
00173-0712-15 GLA 33226 Avodart 0.5Mg Cap 30
154.04
59627-0002-05 BIO 23857 Avonex 30Mcg Pfs 4/Pk ( R )
5454.00
Q3025
59627-0001-03 BIO 11250 Avonex Admin Pk 30Mcg Vl 4/Bx ( R )
5454.00
Q3025
00781-3253-94 SAN 41724 Azacitidine 100Mg Vl
617.62
J9025
43598-0305-62 DR 41727 Azacitidine 100Mg Vl
592.92
J9025
00054-4084-25 ROX 21055 Azathioprine 50Mg Tab 100
131.08
J7500
59762-3140-01 GRE 38069 Azithromycin 200Mg/5Ml Sus30Ml
32.93
00781-1496-31 SAN 31390 Azithromycin 250Mg Tab 30
233.51
00781-1496-68 SAN 31424 Azithromycin 250Mg Uou Tab 3X6
140.10
00781-1941-33 SAN 31304 Azithromycin 500Mg Uou Tab 3X3
140.10
25021-0112-10 SAG 36994 Azithromycin 500Mg Vl 10/Pk
72.00
J0456
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE
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