NDC/PCode/UPC Mfr.
Item # Description
AWP Pkg
J-Code
00555-0485-27 TEV 40070 Leucovorin 25Mg Tab 25
600.00
55390-0054-01 BED 21155 Leucovorin 350Mg Sdv Lyo
37.20
J0640
63323-0711-00 FRE 18728 Leucovorin 500Mg Sdv Lyo
48.60
J0640
25021-0814-30 SAG 40138 Leucovorin P/F 100Mg Sdv Lyo
24.00
J0640
25021-0815-30 SAG 40139 Leucovorin P/F 200Mg Sdv Lyo
48.00
J0640
25021-0816-30 SAG 40140 Leucovorin P/F 350Mg Sdv Lyo
84.00
J0640
25021-0813-10 SAG 40137 Leucovorin P/F 50Mg 10/Pk Lyo
120.00
J0640
76388-0635-50 PRA 39954 Leukeran 2Mg Tab 50 ( R )
556.80
00024-5843-05 AVE 41962 Leukine 250Mcg 5X1Ml ( R )
1311.10
J2820
66993-0022-27 PRA 40208 Levalbuterol 0.63Mg Sol 24X3Ml
160.79
J7614
66993-0023-27 PRA 40207 Levalbuterol 1.25Mg Sol 24X3Ml
160.79
J7614
68180-0113-16 LUP 34874 Levetiracetam 500 Mg Tab 120
421.71
00781-3342-09 SAN 38339 Levofloxac 500Mg Bag 24X100Ml
396.86
J1956
68180-0240-08 LUP 38129 Levofloxacin 250Mg Tab 50
841.48
17478-0107-20 AKO 38513 Levofloxacin 500Mg Sdv 20Ml
44.74
J1956
68180-0241-08 LUP 38131 Levofloxacin 500Mg Tab 50
964.40
68180-0242-20 LUP 38130 Levofloxacin 750Mg Tab 20
722.36
00781-5184-92 SAN 40562 Levothyroxine 100Mcg Tab 90
45.46
00781-5187-92 SAN 40690 Levothyroxine 150Mcg Tab 90
54.86
00527-1341-01 LAN 40053 Levothyroxine 25Mcg Tab 100
19.40
00527-1342-01 LAN 32856 Levothyroxine 50Mcg Tab 100
22.06
00527-1343-01 LAN 40192 Levothyroxine 75Mcg Tab 100
24.38
00409-4713-02 HOS 27359 Lido 1% P/F Amp 25X5Ml
34.20
00409-4277-02 HOS 26659 Lido 2% Ftv 25X50Ml
91.50
76329-3012-05 INT 39478 Lido 2% Jelly Urojet 25X5Ml
191.19
00409-4903-34 HOS 27319 Lido 2% Lfs Syg 10X5Ml
30.84
00409-4277-01 HOS 26553 Lido 2% Vl 25X20Ml
51.90
00409-1323-05 HOS 27452 Lido Ansyr 2% Syg 10X5Ml
32.76
00264-9594-10 B.B 28571 Lido/Dext 0.4/5% Sol 24X500Ml
8.00
J2001
50383-0667-30 HI-
37309 Lido/Priloc 2.5% Crm 30Gm
45.95
00409-4713-32 HOS 27154 Lidocaine 1% Amp P/F 50X2Ml
57.00
00409-4276-01 HOS 26663 Lidocaine 1% Ftv 25X20Ml
36.30
00409-4279-02 HOS 27155 Lidocaine 1% T/Tp Vl 25X30Ml
72.90
00409-3178-03 HOS 26828 Lidocaine 1% W/Epi Mdv 25X50Ml
88.50
17478-0711-30 AKO 27622 Lidocaine 2% Jelly 30Ml
16.67
00409-3182-01 HOS 27213 Lidocaine 2% W/Epi Ftv 25X20Ml
74.40
00409-3182-03 HOS 26824 Lidocaine 2% W/Epi Ftv 25X50Ml
105.90
51672-3008-03 TAR 36066 Lidocaine 5% Ont 50Gm
98.89
00591-3525-30 ACT 41974 Lidocaine 5% Patch 30/Bx
269.58
63323-0208-05 FRE 11490 Lidocaine Hcl P/F 2% Sdv25X5Ml
2.10
J3490
50383-0775-04 HI-
28170 Lidocaine Vis 2% Sol 100Ml
5.99
63481-0687-06 END 22080 Lidoderm Patch 5% Pat 30/Bx
312.01
00071-0155-23 PFI
17684 Lipitor 10Mg Tab 90
504.95
47335-0049-40 CAR 40984 Liposome Doxo 20Mg/10Ml Sdv ( R )
1162.80
Q2050
47335-0050-40 CAR 40985 Liposome Doxo 50Mg/25Ml Sdv ( R )
2907.10
Q2050
68180-0518-01 LUP 36958 Lisino/Hctz 10/12.5Mg Tab 100
112.04
68180-0519-01 LUP 31839 Lisinop/Hctz 20/12.5Mg Tab 100
121.28
00185-0101-01 SAN 29972 Lisinopril 10Mg Tab 100
100.42
00185-0102-01 SAN 28173 Lisinopril 20Mg Tab 100
107.51
( R ) - Indicates Refrigerated Drug Item
PRICES ARE SUBJECT TO CHANGE
1...,28,29,30,31,32,33,34,35,36,37 39,40,41,42,43,44,45,46,47,48,...112