NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
62856-0125-10 EIS 31731 Fragmin 12500 Iu Pfs 10X.5Ml
1063.54
J1645
62856-0150-10 EIS 30745 Fragmin 15000 Iu Pfs 10X.6Ml
1276.25
J1645
62856-0180-10 EIS 30767 Fragmin 18000 Iu Pfs 10X.72Ml
1531.46
J1645
62856-0251-01 EIS 27986 Fragmin 25000Iu/Ml Mdv 3.8Ml
731.30
J1645
62856-0500-10 EIS 27983 Fragmin 5000 Iu Pfs 10X0.2Ml
425.42
J1645
62856-0750-10 EIS 29225 Fragmin 7500 Iu Pfs 10X0.3Ml
638.16
J1645
00409-6102-02 HOS 26089 Furosemide 10Mg/Ml Ftv 25X2Ml
42.90
00409-6102-04 HOS 26110 Furosemide 10Mg/Ml Ftv 25X4Ml
50.40
00409-9631-04 HOS 28180 Furosemide 10Mg/Ml Syg 10X4Ml
78.72
J1940
50742-0104-01 ING 38707 Furosemide 20Mg Tab 100
14.30
50742-0105-01 ING 38727 Furosemide 40Mg Tab 100
16.30
68152-0101-00 SPE 32424 Fusilev Levoleuco 50Mgvl10Ml
248.40
J0641
53746-0101-01 AMN 33599 Gabapentin 100Mg Cap 100
53.69
53746-0102-01 AMN 33647 Gabapentin 300Mg Cap 100
134.18
53746-0103-01 AMN 33535 Gabapentin 400Mg Cap 100
159.71
68382-0204-01 ZYD 41277 Gabapentin 600Mg Tab 100
252.62
00944-2700-02 BAX 26746 Gammagard Liq 1Gm 10Ml Nonret ( R )
145.57
J1569
00944-2700-03 BAX 26747 Gammagard Liq 2.5Gm25Ml Nonret ( R )
363.94
J1569
00944-2700-04 BAX 26748 Gammagard Liq 5Gm 50Ml Nonret ( R )
727.86
J1569
00944-2700-05 BAX 26749 Gammagard Liq10Gm 100Ml Nonret ( R )
1455.72
J1569
00944-2700-06 BAX 26750 Gammagard Liq20Gm 200Ml Nonret ( R )
2911.44
J1569
00944-2700-07 BAX 38110 Gammagard Liq30Gm 300Ml Nonret ( R )
4367.16
J1569
00944-2658-04 BAX 41016 Gammagard S/D Low Iga 10Gm Vl
1634.04
J1566
00944-2656-03 BAX 41015 Gammagard S/D Low Iga 5Gm Vl
817.02
J1566
13533-0800-71 GRI
37282 Gamunex-C 10% 10Gm 100Ml ( R )
1215.84
J1561
13533-0800-24 GRI
37285 Gamunex-C 10% 20Gm 200Ml ( R )
2431.68
J1561
13533-0800-20 GRI
37286 Gamunex-C 10% 5Gm 50Ml ( R )
607.92
J1561
00006-4045-00 MER 28210 Gardasil Hpv Vaccine Vl Ea ( R )
169.85
50242-0070-01 GEN 41963 Gazyva Inj 1000Mg/40Ml ( R )
6192.00
16729-0117-11 ACC 38374 Gemcitabine 1Gm Sdv 50Ml
579.42
J9201
23155-0214-31 HER 41578 Gemcitabine 1Gm Sdv 50Ml
44.63
J9201
00409-0181-01 HOS 38476 Gemcitabine 1Gm Vl 26.3Ml Sol ( R )
53.56
J9201
00069-3858-10 PFI
41595 Gemcitabine 1Gm Vl 50Ml
90.00
J9201
16729-0092-03 ACC 38373 Gemcitabine 200Mg Sdv 10Ml
115.88
J9201
23155-0213-31 HER 41577 Gemcitabine 200Mg Sdv 10Ml
11.46
J9201
00069-3857-10 PFI
41594 Gemcitabine 200Mg Vl 10Ml
18.00
J9201
00409-0183-01 HOS 38475 Gemcitabine 200Mg Vl5.26Ml Sol ( R )
10.72
J9201
16729-0118-38 ACC 41443 Gemcitabine 2Gm Sdv 100Ml
1158.84
J9201
00069-3859-10 PFI
41596 Gemcitabine 2Gm Vl 100Ml
180.00
J9201
00409-0187-01 HOS 37060 Gemcitabine 2Gm Vl 100Ml
119.70
J9201
00409-0182-01 HOS 38477 Gemcitabine 2Gm Vl 52.6Ml Sol ( R )
119.70
J9201
00002-7502-01 ELI
11398 Gemzar 1Gm Vl 50Ml
889.14
J9201
00002-7501-01 ELI
11399 Gemzar 200Mg Vl 10Ml
177.83
J9201
00013-2626-81 PFI
41054 Genotropin 5Mg Syg Crt 1 ( R )
503.12
00409-1207-03 HOS 26708 Gentamicin 40Mg/Ml Ftv 25X2Ml
31.50
J1580
00078-0429-97 ALC 35335 Genteal Severe Eye Gel 3.5Ml
4.14
00597-0141-30
BOE 41631 Gilotrif 20Mg Tab 30
6660.00
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE
1...,24,25,26,27,28,29,30,31,32,33 35,36,37,38,39,40,41,42,43,44,...112