Page 31 - ecatalogJan14.indd

NDC/PCode/UPC Mfr. Item # Description AWP Pkg J-Code
63323-0883-10 FRE 18730 Doxorubicin 20Mg/10Ml Sdv Sol ( R ) 31.20 J9000
00069-3031-20 PFI 37911 Doxorubicin 20Mg/10Ml Sdv Sol ( R ) 24.00 J9000
00069-3032-20 PFI 37912 Doxorubicin 50Mg/25Ml Sdv Sol ( R ) 42.00 J9000
00703-5046-01 TEV 10758 Doxorubicin 50Mg/25Ml Sdv Sol ( R ) 56.40 J9000
63323-0883-30 FRE 10222 Doxorubicin 50Mg/25Ml Sdv Sol ( R ) 40.00 J9000
00143-2112-50 WES 34698 Doxycycline 100Mg Tab 50 276.61
00527-1336-01 LAN 40846 Doxycycline 20Mg Tab 100 115.14
53489-0119-02 MUT 20664 Doxycyline 100Mg Cap 50/Btl 307.35
00024-0222-05 AVE 24476 Eligard 22.5Mg 3 Mo Kit Pfs ( R ) 1479.60 J9217
00024-0610-30 AVE 23310 Eligard 30Mg 4 Month Kit ( R ) 1972.80 J9217
00024-0605-45 AVE 25857 Eligard 45Mg 6 Month Kit ( R ) 2959.20 J9217
00024-0793-75 AVE 24242 Eligard 7.5Mg 1 Month Kit ( R ) 493.20 J9217
00003-0893-21 BRI 41688 Eliquis 2.5Mg Tab 60 318.47
00003-0894-21 BRI 41689 Eliquis 5Mg Tab 60 318.47
00024-5150-10 AVE 25197 Elitek 1.5Mg Sdv W/Dil 3/Pk ( R ) 2293.74 J2783
00024-5151-75 AVE 34297 Elitek 7.5Mg Vl ( R ) 3823.00 J2783
00009-5091-01 PFI 19061 Ellence 50Mg/25Ml Sdv ( R ) 67.20 J9178
00024-0591-20 AVE 26299 Eloxatin 100Mg/20Ml Sdv Sol 2896.76 J9263
00024-0590-10 AVE 26298 Eloxatin 50Mg/10Ml Sdv Sol 1448.38 J9263
00013-0132-02 PFI 19063 Emcyt 140Mg Cap 100 ( R ) 917.70
00006-3941-32 MER 37123 Emend 150Mg Sdv 10Ml ( R ) 308.35 J1453
00006-0461-02 MER 31335 Emend 80Mg Cap 2/Pk 274.30 J8501
00006-3862-03 MER 23321 Emend Trifold 125/80Mg Cap 3 485.44 J8501
64679-0923-02 WOC 31890 Enalapril 2.5Mg Tab 100/Btl 88.33
58406-0425-34 AMG 10514 Enbrel 25Mg Vl 4/Bx ( R ) 1418.06 J1438
58406-0435-04 AMG 25479 Enbrel 50Mg/Ml Pref Syg 4/Ctn ( R ) 2836.13 J1438
58406-0445-04 AMG 28356 Enbrel Sureclick 50Mg/Ml 4/Pk ( R ) 2836.13 J1438
58160-0821-11 GLA 30326 Engerix Adt20Mcg P/F Sdv10X1Ml ( R ) 628.50 90740 , 90746 , 90747
00955-1010-10 WIN 40331 Enoxaparin 100Mg Pfs 10X1Ml 893.11 J1650
00781-3500-69 SAN 38660 Enoxaparin 100Mg Pfs 10X1Ml 812.79 J1650
00781-3612-68 SAN 38661 Enoxaparin 120Mg Pfs 10X.8Ml 975.69 J1650
00955-1012-10 WIN 40332 Enoxaparin 120Mg Pfs 10X.8Ml 1072.08 J1650
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
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 2 257.03
49502-0500-02 MYL 34632 Epipen Adult 0.3Mg 2/Pk 364.69
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE