NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
00517-0130-05 AME 23774 Cyanoco 1000Mcg/Ml Vl 30Ml5/Pk
62.50
J3420
59746-0177-06 CAD 32488 Cyclobenz 10Mg Tab 100
115.78
59746-0211-06 CAD 41133 Cyclobenz 5Mg Tab 100
172.89
00054-4129-25 ROX 27188 Cyclophospham 25Mg Tab 100
209.32
J8530
00054-4130-25 ROX 27186 Cyclophospham 50Mg Tab 100
384.15
J8530
10019-0956-01 BAX 24822 Cyclophosphamide Sdv 1Gm
678.54
J9070 , J9080 , J9090-92
10019-0957-01 BAX 24824 Cyclophosphamide Sdv 2Gm
1357.09
J9070 , J9080 , J9090-92
10019-0955-01 BAX 24823 Cyclophosphamide Sdv 500Mg
339.28
J9070 , J9080 , J9090-92
00172-7312-46 TEV 31923 Cyclospor Mic 100Mg Sgc Ud 30
164.89
J7502
00172-7310-46 TEV 32990 Cyclospor Mic 25Mg Sgc 30Ud
41.25
J7515
00002-3240-30 ELI
30860 Cymbalta 30Mg Cap 30
261.72
00002-3270-30 ELI
35602 Cymbalta 60Mg Cap 30
261.72
60258-0850-01 CYP 37338 Cyprohept 4Mg Tab 100
106.73
63323-0120-20 FRE 24778 Cytarabine 2G/20Ml Sdv Sol
25.08
J9100 , J9110
61703-0304-36 HOS 23386 Cytarabine 500Mg/25Ml Mdv Sol
14.14
J9100 , J9110
63323-0127-10 FRE 18725 Dacarbazine 100Mg Sdpwd 10/Pk ( R )
13.35
J9130 , J9140
63323-0128-20 FRE 18726 Dacarbazine 200Mg Sdpwd 10/Pk ( R )
144.00
J9130 , J9140
62856-0600-01 EIS 35216 Dacogen Inj 50Mg
2053.20
J0894
00527-1368-01 LAN 39121 Danazol 100Mg Cap 100
239.40
00527-1369-06 LAN 39072 Danazol 200Mg Cap 60
324.86
49938-0102-30 JAC 33093 Dapsone 25Mg Bp Tab 2X15
31.80
00703-5233-13 TEV 20150 Daunorubicin 20Mg/4Mlsdv 10/Pk ( R )
946.74
J9150
10885-0001-01 GAL 39058 Daunoxome Inj 50Mg Vl ( R )
1380.00
00075-2451-53 AVE 18897 Ddavp 4Mcg/Ml 10Ml ( R )
666.26
J2597
00075-2451-01 AVE 18896 Ddavp 4Mcg/Ml Amps 10X1Ml ( R )
658.09
J2597
55111-0556-10 DR 41359 Decitabine Inj 50Mg Pwd Sdv
1950.54
J0894
00409-2337-25 HOS 26101 Deferoxamine 2Gm Vl 4/Pk
148.70
J0895
00409-2336-10 HOS 26217 Deferoxamine 500Mg Vl 4/Pk
37.54
J0895
00430-0753-27 WAR 41648 Delzicol 400Mg Cap 180
454.16
00009-0271-01 PFI
10656 Depo Estradiol 5Mg/Ml Vl 5Ml
51.07
J1000
00009-0280-03 PFI
14452 Depo Medrol 40Mg/Ml Mdv 10Ml
58.36
J1030
00009-0280-02 PFI
10654 Depo Medrol 40Mg/Ml Mdv 5Ml
32.04
J1030
00009-3073-01 PFI
14453 Depo Medrol 40Mg/Ml Sdv 1Ml
9.04
J1030
00009-0306-02 PFI
14460 Depo Medrol 80Mg/Ml Mdv 5Ml
58.36
J1040
00009-3475-01 PFI
14457 Depo Medrol 80Mg/Ml Sdv 1Ml
15.67
J1040
00009-7376-11 PFI
39766 Depo Provera 150Mg/Ml Syg
128.41
J1051
00009-0746-30 PFI
10650 Depo Provera 150Mg/Ml Vlinj1Ml
134.22
00009-0626-01 PFI
10655 Depo Provera 400Mg/Ml Vl 2.5Ml
288.01
J1050
57665-0331-01 SIG 23733 Depocyt Inj 50Mg ( R )
3145.20
J9098
00054-3177-63 ROX 25140 Dexameth 0.5Mg/5Ml Sol 16Oz
23.91
00054-3177-57 ROX 41106 Dexameth 0.5Mg/5Ml Sol 240Ml
63.69
63323-0516-10 FRE 26931 Dexameth 10Mg/Ml Mdv10X10Ml Lf
79.92
J1100
00054-4183-25 ROX 35763 Dexameth 2Mg Tab 100
62.31
00054-8175-25 ROX 30550 Dexameth 4Mg Tab Ud 100
62.05
00069-4545-02 PFI
38313 Dexameth 4Mg/Ml Mdv 25X30Ml
315.00
J1100
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
97.50
J1100
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE
1...,19,20,21,22,23,24,25,26,27,28 30,31,32,33,34,35,36,37,38,39,...112