NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
45802-0061-01 PER 40571 Bac/Neo/Poly Ont 0.5Oz
4.25
00832-1024-00 UPS 36096 Baclofen 10Mg Tab 100
54.91
00904-5551-59 MAJ 38742 Banophen 25Mg Tab 100
5.95
604RA
MER 29982 Bcg Reconstitution Tubing
00409-4888-50 MER 29983 Bcg Sodium Chloride Sdv 50Ml
50.40 J7030 , J7040 , J7050
00052-0602-02 MER 18913 Bcg Tice Strain ( R )
174.18 90585 , 90586 , J9031
58394-0635-03 PFI
38438 Benefix-Rt Pds 1010Iu Vl ( R )
1.36
J7195
58394-0636-03 PFI
40156 Benefix-Rt Pds 1950Iu Vl ( R )
1.36
J7195
58394-0636-03 PFI
41296 Benefix-Rt Pds 1990Iu Vl ( R )
1.36
J7195
58394-0636-03 PFI
38724 Benefix-Rt Pds 2040Iu Vl ( R )
1.36
J7195
58394-0637-03 PFI
41837 Benefix-Rt Pds 3020Iu Vl ( R )
1.36
J7195
65597-0104-90 SAN 25148 Benicar 40Mg Tab 90/Btl
535.68
68382-0247-01 ZYD 35809 Benzonatate 100Mg Cap 100
101.33
00143-9729-05 WES 35269 Benztropine 1Mg/Ml Amp 5X2Ml
375.00
J0515
00168-0056-46 FOU 40793 Betameth Dip 0.05% Ont 45Gm
87.01
00062-0205-03 VAL 29168 Biafine Eml 90Gm
91.75
00093-0220-56 TEV 34413 Bicalutamide 50Mg Tab 30
556.79
60793-0701-10 PFI
28839 Bicillin La 1200Mu Pfs2Ml10/Pk ( R )
732.31
J0561 , J0580
60793-0702-10 PFI
28840 Bicillin La 2400Mu Pfs4Ml10/Pk ( R )
1500.61
J0561 , J0580
23155-0261-41 HER 41235 Bicnu 100Mg Vl ( R )
1645.52
J9050
59316-0104-20 LAB 32123 Biofreeze 4Oz Pump Spray
0.00
220
GLA 37892 Biotene Enzym T/P 4.5Oz
440
GLA 39352 Biotene M/Wash Liq 33.8Oz
320
GLA 37899 Biotene Mint Gel T/P 4.5 Oz
201
GLA 37893 Biotene Oral Balnce Gel 1.5Oz
00904-7927-17 MAJ 36149 Bisacodyl Ec 5Mg Tab 25/Btl
2.50
61703-0332-18 HOS 18883 Bleomycin 15Iu/Vl Sdv Lyo ( R )
30.16
J9040
63323-0136-10 FRE 33612 Bleomycin 15Iu/Vl Sdv Lyo ( R )
41.40
J9040
63323-0137-20 FRE 33613 Bleomycin 30Iu/Vl Sdv Lyo ( R )
91.54
J9040
61703-0323-22 HOS 18882 Bleomycin 30Iu/Vl Sdv Lyo ( R )
64.26
J9040
00004-0191-09 GEN 38471 Boniva 3Mg/3Ml Inj Pfs Ea
550.97
J1740
00069-0135-01 PFI
40062 Bosulif 100Mg Tab 120
9817.50
00069-0136-01 PFI
40063 Bosulif 500Mg Tab 30
9817.50
00093-4233-01 TEV 32183 Bumetanide 1Mg Tab 100/Btl
49.95
00641-6007-10 WES 40340 Bumetanide Inj.25Mg/Ml 10X10Ml
29.64
J3490
00409-1159-02 HOS 26683 Bupivacaine .25%Mp/F Vl25X30Ml
49.50
J3490
00378-0435-01 MYL 23527 Bupropion 100Mg Tab 100/Btl
106.01
00536-3414-10 ACT 22691 Cal Carbonate 10Gm Tab 1000
15.75
00517-2710-25 AME 17416 Cal Chl 10% Sdv 25X10Ml
101.56
J3490
00409-1631-10 HOS 27609 Cal Chl Ansyr 10% Syg 10X10Ml
55.44
00904-3233-52 MAJ 37536 Calc W/D 600Mg/400Iu Tab 60
3.45
17478-0931-01 AKO 38711 Calcitriol 1Mcg/Ml Amp 10X1Ml
7.47
J0636
51645-0731-06 BIR 30499 Calcium 600+D Mg Tab 60
00517-3900-25 AME 22029 Calcium Gluconate10% 25X100Ml
195.31
J0610
63323-0311-10 FRE 11477 Calcium Gluconate10%Sdv25X10Ml
99.60
J0610
00904-1883-52 MAJ 40451 Calcium Oyster 500Mg Tab 60
3.40
FC-CFF
AME 28800 Calif Style Rx F/Flder 100
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE