Alberta Blue Cross Drug Price List

Transcription

Products and Pricing on the Alberta Blue Cross Drug Price List (ABCDPL)
Effective September 14, 2016
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002192691
3TC 10 MG/ML ORAL LIQUID
ORL
LIQ
GSK
ML
0.3272
00002192683
3TC 150 MG TABLET
ORL
TAB
GSK
TAB
5.0507
00002247825
3TC 300 MG TABLET
ORL
TAB
GSK
TAB
9.8070
00002162113
5 BENZAGEL 5% TOPICAL (ALCOHOL) GEL
TOP
ALCGEL
CLC
G
0.2080
00002166607
5 BENZAGEL 5% TOPICAL LOTION
TOP
LOT
NVC
ML
0.1984
00000437999
5% DEXTROSE & 0.45% NACL W 0.15% KCL 20 MEQ INJ
INJ
DEFAUL
BAX
ML
0.0030
00080013172
5-HTP 100 MG CAPSULE
ORL
CAP
VTH
CAP
0.2000
00002414570
ABBOTT-CITALOPRAM 10 MG TABLET
ORL
TAB
ABB
TAB
0.1432
00002414589
ORL
TAB
ABB
TAB
0.2397
00002414597
ORL
TAB
ABB
TAB
0.2397
00002412942
ABBOTT-CLOPIDOGREL 75 MG TABLET
ORL
TAB
ABB
TAB
0.4735
00002414805
ABBOTT-LEVETIRACETAM 250 MG TABLET
ORL
TAB
ABB
TAB
0.8000
00002414791
ORL
TAB
ABB
TAB
0.9750
00002414783
ORL
TAB
ABB
TAB
1.3500
00002414546
ABBOTT-OLANZAPINE ODT 10 MG TABLET
ORL
DISNTAB
ABB
TAB
1.2857
00002414538
ABBOTT-OLANZAPINE ODT 5 MG TABLET
ORL
DISNTAB
ABB
TAB
0.6434
00002412969
ABBOTT-PANTOPRAZOLE 40 MG ENTERIC-COATED TABLET
ORL
ECT
ABB
TAB
0.3628
00002412985
ABBOTT-QUETIAPINE 100 MG TABLET
ORL
TAB
ABB
TAB
0.3295
00002412993
ORL
TAB
ABB
TAB
0.6617
00002412977
ORL
TAB
ABB
TAB
0.1235
This document is for pricing use only and should not be used to determine benefit status information.
Pricing is applicable to a Drug Product regardless of the package size for each Drug Product.
Pg 1 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002413000
ORL
TAB
ABB
TAB
0.9656
00002422638
ABBOTT-RABEPRAZOLE 10 MG ENTERIC-COATED TABLET
ORL
ECT
ABB
TAB
0.1204
00002422646
ABBOTT-RABEPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
ABB
TAB
0.2408
00002414619
ABBOTT-TOPIRAMATE 100 MG TABLET
ORL
TAB
ABB
TAB
0.5928
00002414627
ORL
TAB
ABB
TAB
0.8853
00002414600
ORL
TAB
ABB
TAB
0.3128
00002231590
ABELCET 5MG/ML LIPID COMPLEX INJECTION
INJ
DEFAUL
SGM
ML
9.3000
00001919385
ABENOL 120 MG RECTAL SUPPOSITORY
RT
SUP
PPH
SUP
0.5417
00001919393
RT
SUP
PPH
SUP
0.6692
00001919407
RT
SUP
PPH
SUP
0.7683
00002281066
ABRAXANE 100 MG/VIAL INJECTION
INJ
DEFAUL
CLG
VIAL
971.0000
00002245677
ABREVA 10% TOPICAL CREAM
TOP
CRM
GKC
G
7.0000
00002364174
ABSTRAL 100 MCG SUBLINGUAL TABLET
SLG
SLT
PAL
TAB
11.0060
00002364182
SLG
SLT
PAL
TAB
12.4590
00002364190
SLG
SLT
PAL
TAB
14.9410
00002364204
SLG
SLT
PAL
TAB
16.9760
00002364212
SLG
SLT
PAL
TAB
22.6450
00002364220
SLG
SLT
PAL
TAB
28.3030
00001922246
AC & C 8 MG TABLET
ORL
TAB
PPH
TAB
0.0510
00002401126
ACCEL-ALENDRONATE 10 MG TABLET
ORL
TAB
ACP
TAB
0.3989
Pg 2 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002401134
ACCEL-ALENDRONATE 70 MG TABLET
ORL
TAB
ACP
TAB
1.9000
00002341107
ACCEL-AMLODIPINE 10 MG TABLET
ORL
TAB
ACP
TAB
0.3587
00002341093
ACCEL-AMLODIPINE 5 MG TABLET
ORL
TAB
ACP
TAB
0.2417
00002419874
ACCEL-DONEPEZIL 10 MG TABLET
ORL
TAB
ACP
TAB
0.8145
00002419866
ACCEL-DONEPEZIL 5 MG TABLET
ORL
TAB
ACP
TAB
0.8145
00002400391
ACCEL-FLUOXETINE 10 MG CAPSULE
ORL
CAP
ACP
CAP
0.3300
00002400405
ACCEL-FLUOXETINE 20 MG CAPSULE
ORL
CAP
ACP
CAP
0.3300
00002400359
ACCEL-QUETIAPINE 100 MG TABLET
ORL
TAB
ACP
TAB
0.2100
00002400375
ORL
TAB
ACP
TAB
0.4300
00002400340
ORL
TAB
ACP
TAB
0.0800
00002400383
ORL
TAB
ACP
TAB
0.6300
00002435349
ACCEL-TOPIRAMATE 100 MG TABLET
ORL
TAB
ACP
TAB
0.4400
00002435357
ORL
TAB
ACP
TAB
0.6600
00002435330
ORL
TAB
ACP
TAB
0.2300
00002164396
ACEBUTOLOL-100 100 MG TABLET
ORL
TAB
PDL
TAB
0.0787
00002164418
ORL
TAB
PDL
TAB
0.1177
00002164426
ORL
TAB
PDL
TAB
0.2466
00002230435
ACET 160 MG RECTAL SUPPOSITORY
RT
SUP
PPH
SUP
0.6242
00001999648
ACET CODEINE 30 TABLET
ORL
TAB
PMS
TAB
0.1655
00002154234
ACETAMINOPHEN 300MG/15MG CAFFEINE/8MG COD. CAPLET
ORL
TAB
VTH
TAB
0.0348
Pg 3 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00001977415
ACETAMINOPHEN 325 MG CAPLET
ORL
TAB
TLI
TAB
0.0592
00000789801
ACETAMINOPHEN 325 MG TABLET
ORL
TAB
TLI
TAB
0.0592
00000605751
ORL
TAB
VTH
TAB
0.0272
00000374148
ORL
TAB
WAM
TAB
0.0184
00001938088
ORL
TAB
JPC
TAB
0.0120
00000789798
ORL
TAB
TLI
TAB
0.0243
00001905864
ACETAMINOPHEN 80 MG/ML ORAL DROPS
ORL
DPS
TLI
ML
0.1300
00002272482
ACETAMINOPHEN ARTHRITIS PAIN 650 MG EXT.REL TABLET
ORL
ERT
PRI
TAB
0.0755
00000706221
ACETAMINOPHEN CAFFEINE & CODEINE 8 MG TABLET
ORL
TAB
WTR
TAB
0.0258
00002028174
ACETAMINOPHEN COMPOUND WITH CODEINE CAPLET
ORL
TAB
PPH
TAB
0.0398
00001905856
ACETAMINOPHEN COMPRIME A CROQUER 80 MG
ORL
TAB
TLI
TAB
0.1000
00002255251
ACETAMINOPHEN EXT STR EASY TO SWALLOW 500 MG TAB
ORL
TAB
PMT
TAB
0.0660
00000605778
ACETAMINOPHEN EXTRA STRENGTH 500 MG TABLET
ORL
TAB
WTR
TAB
0.0306
00002252813
ORL
TAB
PMT
TAB
0.0621
00002285797
ORL
TAB
VTH
TAB
0.0600
00001904132
ACETAMINOPHEN EXTRA-STRENGTH 500 MG TABLET
ORL
TAB
TAN
TAB
0.0179
00001958836
ACETAMINOPHEN ORAL SOLUTION FOR CHILDREN USP
ORL
SOL
TLI
ML
0.0296
00002143933
ACETAMINOPHEN WITH CODEINE CAPLET
ORL
TAB
ROG
TAB
0.0460
00002025337
ACETAMINOPHEN WITH CODEINE TABLET
ORL
TAB
PMS
TAB
0.0398
00002251914
ACETAMINOPHEN, CAFFEINE & 8 MG CODEINE PHOS. TAB
ORL
TAB
PMT
TAB
0.0396
Pg 4 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002362228
ACETAMINOPHENE 500 MG CAPLET
ORL
TAB
RIV
TAB
0.0149
00002017458
ACETAMINOPHENE 80MGCO.CROQUABLE POUR ENFANT
ORL
CTB
RIV
TAB
0.1000
00000834319
ACETAZONE FORTE C-8 TABLET
ORL
TAB
RPH
TAB
0.4495
00000834300
ACETAZONE FORTE TABLET
ORL
TAB
RPH
TAB
0.3399
00001999656
ACET-CODEINE 60 MG TABLET
ORL
TAB
PMS
TAB
0.2640
00002300435
ACETYLCYSTEINE 20% INHALATION SOLUTION
INH
SOL
ALV
ML
1.9500
00000718831
ACETYLSALICYLIC ACID 325 MG TABLET
ORL
TAB
PHH
TAB
0.0621
00002426757
ACH-CAPECITABINE 150 MG TABLET
ORL
TAB
AHI
TAB
1.4640
00002426765
ACH-CAPECITABINE 500 MG TABLET
ORL
TAB
AHI
TAB
4.8800
00002247551
ACID REDUCER 75 MG TABLET
ORL
TAB
PMS
TAB
0.1067
00080042609
ACIDOPHILUS PROBIOTIC COMPLETE CAPSULE
ORL
CAP
WNP
CAP
0.2892
00080011789
ACIDOPHILUS WITH BIFIDUS CAPSULE
ORL
CAP
WNP
CAP
0.1082
00002439247
ACT AMPHETAMINE XR 10 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
APH
CAP
2.0758
00002439255
ORL
ERC
APH
CAP
2.3250
00002439263
ORL
ERC
APH
CAP
2.5743
00002439271
ORL
ERC
APH
CAP
2.8235
00002439298
ORL
ERC
APH
CAP
3.0729
00002439239
ORL
ERC
APH
CAP
1.8266
00002394898
ACT ANASTROZOLE 1 MG TABLET
ORL
TAB
APH
TAB
2.5459
00002374765
ACT BETAHISTINE 24 MG TABLET
ORL
TAB
APH
TAB
0.4983
Pg 5 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002376520
ACT CANDESARTAN 4 MG TABLET
ORL
TAB
APH
TAB
0.3400
00002244816
ACT CLOMIPRAMINE 10 MG TABLET
ORL
TAB
APH
TAB
0.1290
00002244817
ORL
TAB
APH
TAB
0.1758
00002244818
ORL
TAB
APH
TAB
0.3237
00002397145
ACT DICLO-MISO 50 MG/200 MCG ENTERIC-COATED TABLET
ORL
ECT
APH
TAB
0.4541
00002397153
ACT DICLO-MISO 75 MG/200 MCG ENTERIC-COATED TABLET
ORL
ECT
APH
TAB
0.6179
00002397625
ACT DONEPEZIL ODT 10 MG ORALLY DISINT. TABLET
ORL
DISNTAB
APH
TAB
3.6176
00002397617
ACT DONEPEZIL ODT 5 MG ORALLY DISINT. TABLET
ORL
DISNTAB
APH
TAB
3.6176
00002423855
ACT ESOMEPRAZOLE 20 MG DELAYED-RELEASE TABLET
ORL
DRT
APH
TAB
1.8690
00002423863
ACT ESOMEPRAZOLE 40 MG DELAYED-RELEASE TABLET
ORL
DRT
APH
TAB
1.8690
00002305682
ACT FAMCICLOVIR 125 MG TABLET
ORL
TAB
APH
TAB
2.0240
00002305690
ORL
TAB
APH
TAB
2.7200
00002305704
ORL
TAB
APH
TAB
4.2281
00002397285
ACT IMATINIB 100 MG TABLET
ORL
TAB
COB
TAB
20.4557
00002397293
ACT IMATINIB 400 MG TABLET
ORL
TAB
COB
TAB
81.8228
00002250020
ACT MELOXICAM 15 MG TABLET
ORL
TAB
APH
TAB
0.5670
00002250012
ACT MELOXICAM 7.5 MG TABLET
ORL
TAB
APH
TAB
0.4914
00002404656
ACT MOXIFLOXACIN 0.5% OPHTHALMIC SOLUTION
OPH
SOL
APH
ML
3.7567
00002325713
ACT OLANZAPINE 20 MG TABLET
ORL
TAB
APH
TAB
10.3093
00002327589
ACT OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
APH
TAB
5.3553
Pg 6 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002327597
ACT OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
APH
TAB
7.5977
00002404095
ACT OLAPATADINE 0.2% OPHTHALMIC SOLUTION
OPH
SOL
APH
ML
10.4520
00002403986
ACT OLOPATADINE 0.1% OPH SOLUTION
OPH
SOL
APH
ML
5.2260
00002394189
ACT OXYCODONE CR 10 MG CONTROLLED-RELEASE TABLET
ORL
CRT
APH
TAB
0.4390
00002394197
ORL
CRT
APH
TAB
0.6585
00002394200
ORL
CRT
APH
TAB
1.1413
00002394170
ORL
CRT
APH
TAB
0.3150
00002394219
ORL
CRT
APH
TAB
2.1080
00002262746
ACT PAROXETINE 10 MG TABLET
ORL
TAB
APH
TAB
1.0430
00002297310
ACT PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
APH
TAB
1.3860
00002402955
ACT PREGABALIN 150 MG CAPSULE
ORL
CAP
APH
CAP
1.7270
00002402971
ORL
CAP
APH
CAP
1.7270
00002402912
ORL
CAP
APH
CAP
0.6173
00002402998
ORL
CAP
APH
CAP
1.7270
00002402920
ORL
CAP
APH
CAP
0.9683
00002402939
ORL
CAP
APH
CAP
1.2528
00002446820
ACT PROGESTERONE INJECTION 50 MG/ML INJECTION
INJ
DEFAUL
APH
ML
5.8610
00002437961
ACT PROPOFOL 10 MG/ML INJECTION
INJ
DEFAUL
APH
ML
0.4600
00002372088
ACT SILDENAFIL 100 MG TABLET
ORL
TAB
APH
TAB
9.2000
00002372053
ORL
TAB
APH
TAB
8.2900
Pg 7 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002372061
ORL
TAB
APH
TAB
8.8475
00002257882
ACT SUMATRIPTAN 25 MG TABLET
ORL
TAB
APH
TAB
8.9900
00002428644
ACT TADALAFIL 10 MG TABLET
ORL
TAB
APH
TAB
11.9255
00002428628
ACT TADALAFIL 2.5 MG TABLET
ORL
TAB
APH
TAB
3.6471
00002428652
ORL
TAB
APH
TAB
12.3569
00002428636
ORL
TAB
APH
TAB
3.6471
00002395282
ACT TEMOZOLOMIDE 100 MG CAPSULE
ORL
CAP
APH
CAP
113.5966
00002395290
ORL
CAP
APH
CAP
159.0358
00002395274
ORL
CAP
APH
CAP
22.7194
00002395312
ORL
CAP
APH
CAP
283.9834
00002441160
ORL
CAP
APH
CAP
6.6300
00002337487
ACT VALSARTAN 40 MG TABLET
ORL
TAB
APH
TAB
0.5823
00002454297
ACT-ESCITALOPRAM ODT 10 MG ORAL DISINTEGRATING TAB
ORL
DISNTAB
APH
TAB
1.4959
00002454300
ACT-ESCITALOPRAM ODT 20 MG ORAL DISINTEGRATING TAB
ORL
DISNTAB
APH
TAB
1.5926
00002238302
ACTIFED 60 MG/2.5 MG TABLET
ORL
TAB
MCL
TAB
0.3246
00002249405
ACTIVELLE 1 MG/0.5 MG TABLET
ORL
TAB
NNA
TAB
2.3014
00002309009
ACTIVELLE LD 0.5 MG/0.1 MG TABLET
ORL
TAB
NNA
TAB
2.3014
00002316838
ACTONEL 150 MG TABLET
ORL
TAB
ASC
TAB
55.8000
00002370417
ACTONEL DR 35 MG DELAYED-RELEASE TABLET
ORL
DRT
ASC
TAB
13.1875
00002248722
ACULAR LS 0.4% OPH SOLUTION
OPH
SOL
ALL
ML
3.3940
Pg 8 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002286556
ACYCLOVIR 200 MG TABLET
ORL
TAB
SNS
TAB
0.6397
00002286564
ORL
TAB
SNS
TAB
1.2700
00002286572
ORL
TAB
SNS
TAB
1.2673
00002236916
ACYCLOVIR SODIUM 25 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
4.8620
00002236926
ACYCLOVIR SODIUM 50 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
12.5840
00002281074
ACZONE 5% TOPICAL GEL
TOP
GEL
VCL
G
1.0590
00002240255
ADACEL INJECTION
INJ
DEFAUL
SFP
ML
58.0000
00002352044
ADACEL-POLIO INJECTION
INJ
DEFAUL
SFP
ML
79.9000
00002313766
ADALAT XL PLUS 20 MG/81 MG TABLET
ORL
ERT
BAI
TAB
0.6555
00002313774
ORL
ERT
BAI
TAB
0.6170
00002313782
ORL
ERT
BAI
TAB
0.9373
00000266507
ADASEPT 0.5% TOPICAL LIQUID
TOP
LIQ
ODN
ML
0.0290
00002290081
ADASEPT BP5 ACNE GEL 5% TOPICAL GEL
TOP
GEL
ODN
ML
0.1700
00002401347
ADCETRIS 50MG/VIAL INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
STG
VIAL
4,840.0000
00002338327
ADCIRCA 20 MG TABLET
ORL
TB
LIL
TAB
13.4970
00002248809
ADDERALL XR 10 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
SHB
CAP
2.4421
00002248810
ORL
ERC
SHB
CAP
2.7353
00002248811
ORL
ERC
SHB
CAP
3.0286
00002248812
ORL
ERC
SHB
CAP
3.3218
00002248813
ORL
ERC
SHB
CAP
3.6152
Pg 9 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002248808
ORL
ERC
SHB
CAP
2.1489
00002412764
ADEMPAS 0.5 MG TABLET
ORL
TAB
BAI
TAB
42.7500
00002412772
ADEMPAS 1 MG TABLET
ORL
TAB
BAI
TAB
42.7500
00002412799
ORL
TAB
BAI
TAB
42.7500
00002412802
ADEMPAS 2 MG TABLET
ORL
TAB
BAI
TAB
42.7500
00002412810
ORL
TAB
BAI
TAB
42.7500
00002071002
ADRIAMYCIN PFS 2 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
11.2080
00002296462
ADVAGRAF 0.5 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
ASP
CAP
1.9700
00002296470
ADVAGRAF 1 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
ASP
CAP
2.5200
00002331667
ORL
ERC
ASP
CAP
7.5600
00002296489
ORL
ERC
ASP
CAP
12.6200
00080025646
ADVANCED B COMPLEX
ORL
CAP
AOR
CAP
0.2941
00002270447
ADVICOR 1000 MG/20 MG TABLET
ORL
TAB
SUN
TAB
1.3900
00002270439
ADVICOR 500 MG/20 MG TABLET
ORL
TAB
SUN
TAB
1.2400
00001933558
ADVIL 200 MG TABLET
ORL
TAB
PDH
TAB
0.1870
00002036312
ADVIL COLD AND SINUS CAPLET
ORL
TAB
PDH
TAB
0.3750
00002248645
ADVIL COLD AND SINUS PLUS CAPLET
ORL
TAB
PDH
TAB
0.4120
00002244577
ADVIL EXTRA STRENGTH 400 MG CAPLET
ORL
TAB
PDH
TAB
0.2706
00002248231
ADVIL EXTRA STRENGTH LIQUI-GEL 400 MG CAPSULE
ORL
CAP
PDH
CAP
0.3608
00001933531
ADVIL IBUPROFEN 200 MG CAPLET
ORL
TAB
PDH
TAB
0.1433
Pg 10 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002246403
ADVIL JUNIOR STRENGTH CHEWABLE TABLET
ORL
CTB
PDH
TAB
0.3070
00002241769
ADVIL LIQUI-GELS 200 MG CAPSULE
ORL
CAP
PDH
CAP
0.2469
00002242522
ADVIL PEDIATRIC 40 MG/ML SUSPENSION DROPS
ORL
DPS
PDH
ML
0.3160
00002243919
AERIUS 5 MG TABLET
ORL
TAB
SCH
TAB
0.9560
00002339528
AFINITOR 10 MG TABLET
ORL
TAB
NOV
TAB
192.1880
00002369257
AFINITOR 2.5 MG TABLET
ORL
TAB
NOV
TAB
192.1880
00002339501
AFINITOR 5 MG TABLET
ORL
TAB
NOV
TAB
192.1880
00002425645
AFINITOR DISPERZ 2 MG TABLET FOR SUSPENSION
ORL
DTS
NOV
TAB
191.3940
00002425653
ORL
DTS
NOV
TAB
191.3940
00002425661
ORL
DTS
NOV
TAB
191.3940
00002432692
AG-DONEPEZIL 10 MG TABLET
ORL
TAB
AGP
TAB
0.8752
00002432684
AG-DONEPEZIL 5 MG TABLET
ORL
TAB
AGP
TAB
0.8752
00002243542
AGENERASE 150 MG CAPSULE
ORL
CAP
GSK
CAP
1.9200
00002346850
AGRIFLU INJECTION SYRINGE
INJ
DEFAUL
NVD
SYR
9.3000
00002428881
AGRIFLU MULTI-DOSE VIAL INJECTION
INJ
DEFAUL
NOV
ML
16.2000
00002236859
AGRYLIN 0.5 MG CAPSULE
ORL
CAP
SHB
CAP
5.9748
00002410265
AHI-MONTELUKAST 4 MG CHEWABLE TABLET
ORL
CTB
AHI
TAB
0.3646
00002410273
AHI-MONTELUKAST 5 MG CHEWABLE TABLET
ORL
CTB
AHI
TAB
0.5565
00000888230
A-HYDROCORT 100 MG/VIAL INJECTION
INJ
DEFAUL
HSP
VIAL
3.4500
00002408848
AJ-CISATRACURIUM 2MG/ML WITH PRESERVATIVE INJ
INJ
DEFAUL
AJP
ML
2.1652
Pg 11 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000001147
ALBALON 0.1% OPH SOLUTION
OPH
SOL
ALL
ML
0.5933
00000180408
ALDACTAZIDE-25 TABLET
ORL
TAB
PFI
TAB
0.2233
00000594377
ALDACTAZIDE-50 TABLET
ORL
TAB
PFI
TAB
0.4734
00000285455
ALDACTONE 100 MG TABLET
ORL
TAB
PFI
TAB
0.3467
00000028606
ALDACTONE 25 MG TABLET
ORL
TAB
PFI
TAB
0.1471
00002254506
ALDURAZYME 0.58 MG/ML INJECTION
INJ
DEFAUL
GZM
ML
209.0000
00002381478
ALENDRONATE SODIUM 5 MG TABLET
ORL
TAB
AHI
TAB
1.0371
00002301733
ALEVE 220 MG TABLET
ORL
TAB
BAI
TAB
0.2240
00002414759
ALFUZOSIN 10 MG PROLONGED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.4966
00080014418
ALIGN PROBIOTIC CAPSULE
ORL
CAP
PGI
CAP
0.9007
00002253437
ALIMTA 500 MG/VIAL INJECTION
INJ
DEFAUL
LIL
VIAL
2,750.0000
00000004715
ALKERAN 2 MG TABLET
ORL
TAB
ASN
TAB
1.7182
00002231462
ALLEGRA 12 HOUR 60 MG TABLET
ORL
TAB
SAV
TAB
0.3792
00002242819
ALLEGRA 24 HOUR 120 MG TABLET
ORL
TAB
SAV
TAB
0.7417
00002239853
ALLEGRA-D SUSTAINED-RELEASE TABLET
ORL
SRT
SAV
TAB
0.5080
00002146142
ALLER-AIDE 2.5 MG/ML ORAL ELIXIR
ORL
ELX
ROG
ML
0.0342
00002176483
ALLER-AIDE 25 MG CAPLET
ORL
TAB
ROG
TAB
0.2198
00000271411
ALLERDRYL 50 MG CAPSULE
ORL
CAP
VCL
CAP
0.1303
00000299987
ALLERGENIC EXTRACT POLLENS 100000 UNIT/ML INJ
INJ
DEFAUL
ALK
ML
7.5000
00001949454
ALLERGY 25 MG TABLET
ORL
TAB
TAN
TAB
0.0938
Pg 12 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000764647
ALLERGY DROPS 0.012% OPH SOLUTION
OPH
SOL
BSH
ML
0.1773
00000833266
ALLERGY ELIXIR 2.5 MG/ML ORAL ELIXIR
ORL
ELX
TAN
ML
0.0180
00002141728
ALLERGY FORMULA 25 MG CAPLET
ORL
TAB
PRI
TAB
0.1200
00002240266
ALLERGY RELIEF 10 MG TABLET
ORL
TAB
APX
TAB
0.4083
00002230398
ALLERGY TABLETS EXTRA STRENGTH 50 MG TABLET
ORL
TAB
TAN
TAB
0.1625
00000804193
ALLERNIX 2.5 MG/ML ORAL ELIXIR
ORL
ELX
ROG
ML
0.0499
00002097583
ALLERNIX 25 MG CAPLET
ORL
TAB
ROG
TAB
0.2413
00002097575
ALLERNIX EXTRA STRENGTH 50 MG CAPLET
ORL
TAB
ROG
TAB
0.4400
00002369656
ALLERNIX MULTI SYMPTOM 5 MG TABLET
ORL
TAB
ROG
TAB
0.5120
00002240265
ALLER-RELIEF 10 MG TABLET
ORL
TAB
APX
TAB
0.4083
00002364689
ALLER-RELIEF 10 MG TABLET
ORL
TAB
PMS
TAB
0.4080
00000555681
ALLOPURINOL 100 MG TABLET
ORL
TAB
PDL
TAB
0.0780
00002130157
ORL
TAB
PDL
TAB
0.1300
00000555703
ORL
TAB
PDL
TAB
0.2125
00000569801
ALMAGEL 200 ORAL LIQUID
ORL
LIQ
ATL
ML
0.0179
00002424029
ALMOTRIPTAN 12.5 MG TABLET
ORL
TAB
PDL
TAB
7.0433
00002241407
ALOCRIL 2% OPH SOLUTION
OPH
SOL
ALL
ML
6.4900
00000893560
ALOMIDE 0.1% (BASE) OPH SOLUTION
OPH
SOL
ALC
ML
1.1910
00002381710
ALOXI 0.05 MG/ML INJECTION
INJ
DEFAUL
EIS
ML
18.0000
00002381729
ALOXI 0.5 MG CAPSULE
ORL
CAP
EIS
CAP
66.0000
Pg 13 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080005881
ALPHA LIPOIC ACID 100MG CAPSULE
ORL
CAP
WNP
CAP
0.1055
00002248151
ALPHAGAN P 0.15% OPHTHALMIC SOLUTION
OPH
SOL
ALL
ML
3.5680
00001908189
ALPRAZOLAM-0.25 MG TABLET
ORL
TAB
PDL
TAB
0.0609
00001908170
ALPRAZOLAM-0.5 MG TABLET
ORL
TAB
PDL
TAB
0.0728
00002248706
ALPRAZOLAM-1 1 MG TABLET
ORL
TAB
PDL
TAB
0.3099
00002320924
ALREX 0.2% OPHTHALMIC SUSPENSION
OPH
SUS
BSH
ML
5.5620
00002281112
ALTACE 15 MG CAPSULE
ORL
CAP/TAB
VCL
CAP
1.1920
00002245272
AMARYL 1 MG TABLET
ORL
TAB
SAV
TAB
0.9400
00002245273
AMARYL 2 MG TABLET
ORL
TAB
SAV
TAB
1.0230
00002245274
AMARYL 4 MG TABLET
ORL
TAB
SAV
TAB
1.0950
00002241630
AMBISOME 50 MG/VIAL INJECTION
INJ
DEFAUL
ASP
VIAL
121.0000
00002230575
AMETOP 4% TOPICAL GEL
TOP
GEL
SNE
G
2.6511
00000870943
AMI-HYDRO 50 MG/5 MG TABLET
ORL
TAB
PDL
TAB
0.0838
00002242971
AMIKACIN SULFATE 250 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
33.5570
00002374684
AMIODARONE SYRINGE 50 MG/ML INJECTION
INJ
NDL
SDZ
SYR
66.4500
00000370991
AMITRIPTYLINE 10 MG TABLET
ORL
TAB
PDL
TAB
0.0435
00002451786
ORL
TAB
SIV
TAB
0.0664
00002451794
ORL
TAB
SIV
TAB
0.1211
00000371009
ORL
TAB
PDL
TAB
0.0829
00002451808
ORL
TAB
SIV
TAB
0.2347
Pg 14 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000456349
ORL
TAB
PDL
TAB
0.1540
00002326817
AMLODIPINE 10 MG TABLET
ORL
TAB
PDL
TAB
0.3587
00002326795
AMLODIPINE 2.5 MG TABLET
ORL
TAB
PDL
TAB
0.1380
00002326809
AMLODIPINE 5 MG TABLET
ORL
TAB
PDL
TAB
0.2417
00002378779
AMLODIPINE-ODAN 10 MG TABLET
ORL
TAB
ODN
TAB
0.3587
00002378760
AMLODIPINE-ODAN 5 MG TABLET
ORL
TAB
ODN
TAB
0.2417
00000638064
AMOSAN 68.6% MOUTHWASH
ORL
MWH
OLB
ML
0.3340
00002401576
AMOXICILLIN SUGAR-REDUCED 50 MG/ML ORAL SUSPENSION
ORL
SUS
SIV
ML
0.0540
00002326515
AMOXI-CLAV 500 MG/125 MG TABLET
ORL
TAB
PDL
TAB
0.6673
00002326523
AMOXI-CLAV 875 MG/125 MG TABLET
ORL
TAB
PDL
TAB
1.0008
00002125862
AMPHOJEL 320 MG/5ML ORAL LIQUID
ORL
LIQ
AXC
ML
0.0179
00002124971
AMPHOJEL 600 MG TABLET
ORL
TAB
AUP
TAB
0.1250
00080006771
A-MULSION ORAL LIQUID
ORL
LIQ
SRL
ML
0.4000
00002221861
ANANDRON 50 MG TABLET
ORL
TAB
SAV
TAB
2.3173
00002442736
ANASTROZOLE 1 MG TABLET
ORL
TAB
SNS
TAB
2.5457
00002245345
ANDROGEL (2.5 G/PACKET) 1% TOPICAL GEL
TOP
GEL
BGP
G
0.8920
00002245346
ANDROGEL (5 G/PACKET) 1% TOPICAL GEL
TOP
GEL
BGP
G
0.7887
00002249499
ANDROGEL (75 G/PUMP) 1% TOPICAL GEL
TOP
GEL
BGP
G
0.9013
00000874019
ANEXATE 0.1 MG/ ML INJECTION
INJ
DEFAUL
HLR
ML
5.6956
00002268825
ANGELIQ 1 MG/1 MG TABLET
ORL
TAB
BAI
TAB
0.7821
Pg 15 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002280361
ANTHELIOS XL SPF 60 TOPICAL CREAM
TOP
CRM
LRP
G
0.1688
00000566756
ANTHRAFORTE 1 1% TOPICAL OINTMENT
TOP
ONT
MPQ
G
0.3696
00000566748
ANTHRAFORTE 2 2% TOPICAL OINTMENT
TOP
ONT
MPQ
G
0.8066
00000695351
ANTHRASCALP 0.4% TOPICAL LOTION
TOP
LOT
STI
ML
0.7000
00002230251
ANTIBIOTIC TOPICAL OINTMENT USP
TOP
ONT
TAR
G
0.1500
00002241532
ANTI-NAUSEANT 50 MG TABLET
ORL
TAB
VTH
TAB
0.0790
00002222132
ANTIPHLOGISTINE RUB A-535 NO ODOUR 13.3% TOP OINT
TOP
ONT
CHD
G
0.0570
00000990104
ANTI-STATIC COMPACT SPACE CHAMBER PLUS MOUTHPIECE
DEFAUL
DEV
MPI
DEV
23.5500
00000990107
ANTI-STATIC COMPACT SPACE CHAMBER PLUS W/ LG MASK
DEFAUL
ADUDEV
MPI
DEV
39.8600
00000990106
ANTI-STATIC COMPACT SPACE CHAMBER PLUS W/ MED MASK
DEFAUL
PEDDEV
MPI
DEV
37.6700
00000990105
ANTI-STATIC COMPACT SPACE CHAMBER PLUS W/ SM MASK
DEFAUL
INFDEV
MPI
DEV
37.6700
00001945939
ANUSOL 0.5% RECTAL OINTMENT
RT
ONT
MCL
G
0.1530
00001945920
ANUSOL 10 MG RECTAL SUPPOSITORY
RT
SUP
MCL
SUP
0.4183
00001945912
ANUSOL PLUS RECTAL OINTMENT
RT
ONT
MCL
G
0.1917
00001945904
ANUSOL PLUS RECTAL SUPPOSITORY
RT
SUP
MCL
SUP
0.5592
00000621439
ANUZINC 10 MG RECTAL SUPPOSITORY
RT
SUP
SDZ
SUP
0.4083
00002248424
ANUZINC PLUS RECTAL OINTMENT
RT
ONT
SDZ
G
0.1173
00080017904
AOR CHROMIUM PICOLINATE 600 MCG CAPSULE
ORL
CAP
AOR
CAP
0.1333
00080005832
AOR N.A.C. 500 MG CAPSULE
ORL
CAP
AOR
CAP
0.1375
00002396769
APO-ABACAVIR 300 MG TABLET
ORL
TAB
APX
TAB
5.9207
Pg 16 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002399539
APO-ABACAVIR-LAMIVUDINE 600 MG/300 MG TABLET
ORL
TAB
APX
TAB
20.3573
00002416255
APO-ABACAVIR-LAMIVUDINE-ZIDOVUDINE TABLET
ORL
TAB
APX
TAB
15.4613
00002229873
APO-ACETAMINOPHEN 325 MG CAPLET
ORL
TAB
APX
TAB
0.0326
00000544981
APO-ACETAMINOPHEN 325 MG TABLET
ORL
TAB
APX
TAB
0.0326
00002248727
APO-ALENDRONATE 5 MG TABLET
ORL
TAB
APX
TAB
1.0370
00002454467
APO-ALENDRONATE/VITAMIN D3 70 MG/2800 UNIT TABLET
ORL
TAB
APX
TAB
3.7300
00002454475
APO-ALENDRONATE/VITAMIN D3 70 MG/5600 UNIT TABLET
ORL
TAB
APX
TAB
1.2174
00002243611
APO-ALPRAZ 1 MG TABLET
ORL
TAB
APX
TAB
0.3099
00002243612
APO-ALPRAZ TS 2 MG TABLET
ORL
TAB
APX
TAB
0.5508
00002411318
APO-AMLODIPINE-ATORVASTATIN 10 MG/10 MG TABLET
ORL
TAB
APX
TAB
0.9194
00002411326
ORL
TAB
APX
TAB
1.0234
00002411334
ORL
TAB
APX
TAB
1.0624
00002411342
ORL
TAB
APX
TAB
1.0624
00002411253
ORL
TAB
APX
TAB
0.7551
00002411261
ORL
TAB
APX
TAB
0.8591
00002411288
ORL
TAB
APX
TAB
0.8981
00002411296
ORL
TAB
APX
TAB
0.8981
00002288559
APO-AMOXI CLAV 80 MG/11.4 MG/ML ORAL SUSPENSION
ORL
SUS
APX
ML
0.1969
00002374420
APO-ANASTROZOLE 1 MG TABLET
ORL
TAB
APX
TAB
2.5460
00000510696
APO-ASEN ECT 325 MG ENTERIC-COATED TABLET
ORL
ECT
APX
TAB
0.0304
Pg 17 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000472476
APO-ASEN ECT 650 MG ENTERIC-COATED TABLET
ORL
ECT
APX
TAB
0.2500
00002318024
APO-ATOMOXETINE 10 MG CAPSULE
ORL
CAP
APX
CAP
2.3140
00002318083
ORL
CAP
APX
CAP
4.3520
00002318032
ORL
CAP
APX
CAP
2.6523
00002318040
ORL
CAP
APX
CAP
2.9281
00002318059
ORL
CAP
APX
CAP
3.3377
00002318067
ORL
CAP
APX
CAP
3.7024
00002318075
ORL
CAP
APX
CAP
3.9960
00002247423
APO-AZITHROMYCIN 250 MG TABLET
ORL
TAB
APX
TAB
1.2317
00002296063
APO-BICALUTAMIDE 50 MG TABLET
ORL
TAB
APX
TAB
4.0573
00002399210
APO-BOSENTAN 125 MG TABLET
ORL
TAB
APX
TAB
22.4625
00002399202
APO-BOSENTAN 62.5 MG TABLET
ORL
TAB
APX
TAB
22.4625
00000682047
APO-CAL 250 625 MG TABLET
ORL
TAB
APX
TAB
0.0266
00000682039
APO-CAL 500 MG TABLET
ORL
TAB
APX
TAB
0.0645
00002365340
APO-CANDESARTAN 4 MG TABLET
ORL
TAB
APX
TAB
0.3400
00001999559
APO-CAPTO 6.25 MG TABLET
ORL
TAB
APX
TAB
0.1237
00002293943
APO-CEFPROZIL 25 MG/ML ORAL SUSPENSION
ORL
SUS
APX
ML
0.1455
00002293951
APO-CEFPROZIL 50 MG/ML ORAL SUSPENSION
ORL
SUS
APX
ML
0.2907
00002231603
APO-CETIRIZINE 10 MG TABLET
ORL
TAB
APX
TAB
0.4083
00002453363
APO-CETIRIZINE 20 MG TABLET
ORL
TAB
APX
TAB
0.7535
Pg 18 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000399302
APO-CHLORPROPAMIDE 100 MG TABLET
ORL
TAB
APX
TAB
0.0803
00000312711
APO-CHLORPROPAMIDE 250 MG TABLET
ORL
TAB
APX
TAB
0.1624
00002298953
APO-CICLOPIROX 8% TOPICAL SOLUTION
TOP
SOL
APX
G
7.7433
00002452693
APO-CINACALCET 30 MG TABLET
ORL
TAB
APX
TAB
10.1946
00002452707
ORL
TAB
APX
TAB
18.5901
00002452715
ORL
TAB
APX
TAB
27.0515
00002263130
APO-CIPROFLOX 0.3% OPHTHALMIC SOL.
OPH
SOL
APX
ML
1.7600
00002274744
APO-CLARITHROMYCIN 250 MG TABLET
ORL
TAB
APX
TAB
0.4209
00002274752
APO-CLARITHROMYCIN 500 MG TABLET
ORL
TAB
APX
TAB
1.6293
00002040786
APO-CLOMIPRAMINE 10 MG TABLET
ORL
TAB
APX
TAB
0.1290
00002040778
ORL
TAB
APX
TAB
0.1758
00002040751
ORL
TAB
APX
TAB
0.3237
00002243433
APO-DICLO RAPIDE 50 MG TABLET
ORL
TAB
APX
TAB
0.3937
00002354403
APO-DICLOFENAC 1.5% TOPICAL SOLUTION
TOP
SOL
APX
ML
0.5165
00002291037
APO-DILTIAZ TZ 120 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
APX
CAP
0.2133
00002291045
ORL
ERC
APX
CAP
0.2889
00002291053
ORL
ERC
APX
CAP
0.3832
00002291061
ORL
ERC
APX
CAP
0.4720
00002291088
ORL
ERC
APX
CAP
0.5778
00002296055
APO-DORZOLAMIDE 2% OPHTHALMIC SOLUTION
OPH
SOL
APX
ML
1.6880
Pg 19 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002386054
APO-ELETRIPTAN 20 MG TABLET
ORL
TAB
APX
TAB
10.0850
00002386062
APO-ELETRIPTAN 40 MG TABLET
ORL
TAB
APX
TAB
10.0850
00002339099
APO-ESOMEPRAZOLE 20 MG DELAYED-RELEASE TABLET
ORL
DRT
APX
TAB
1.8690
00002339102
APO-ESOMEPRAZOLE 40 MG DELAYED-RELEASE TABLET
ORL
DRT
APX
TAB
1.8690
00002419726
APO-EXEMESTANE 25 MG TABLET
ORL
TAB
APX
TAB
3.9008
00002292025
APO-FAMCICLOVIR 125 MG TABLET
ORL
TAB
APX
TAB
2.0240
00002292041
ORL
TAB
APX
TAB
2.7200
00002292068
ORL
TAB
APX
TAB
4.2280
00000545031
APO-FERROUS GLUCONATE 300 MG TABLET
ORL
TAB
APX
TAB
0.0404
00001912518
APO-FERROUS SULFATE-FC 300 MG TABLET
ORL
TAB
APX
TAB
0.0353
00002294745
APO-FLUTICASONE 50 MCG/DOSE AQUEOUS NASAL SPRAY
NAS
SPM
APX
DOSE
0.1831
00002426471
APO-FROVATRIPTAN 2.5 MG TABLET
ORL
TAB
APX
TAB
12.5033
00002293358
APO-GABAPENTIN 600 MG TABLET
ORL
TAB
APX
TAB
1.3045
00002293366
APO-GABAPENTIN 800 MG TABLET
ORL
TAB
APX
TAB
1.7393
00000885754
APO-GAIN 2% TOPICAL SOLUTION
TOP
SOL
APX
ML
0.4956
00002295377
APO-GLIMEPIRIDE 1 MG TABLET
ORL
TAB
APX
TAB
0.4900
00002295385
ORL
TAB
APX
TAB
0.4900
00002295393
ORL
TAB
APX
TAB
0.4900
00002327856
APO-HYDRO 12.5 MG TABLET
ORL
TAB
APX
TAB
0.0341
00000441643
APO-IBUPROFEN 200 MG TABLET
ORL
TAB
APX
TAB
0.0528
Pg 20 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002355337
APO-IMATINIB 100 MG TABLET
ORL
TAB
APX
TAB
20.4557
00002355345
APO-IMATINIB 400 MG TABLET
ORL
TAB
APX
TAB
81.8228
00002369052
APO-LAMIVUDINE 150 MG TABLET
ORL
TAB
APX
TAB
3.6269
00002369060
APO-LAMIVUDINE 300 MG TABLET
ORL
TAB
APX
TAB
7.2538
00002375540
APO-LAMIVUDINE-ZIDOVUDINE 150 MG/300 MG TABLET
ORL
TAB
APX
TAB
7.8309
00002358514
APO-LETROZOLE 2.5 MG TABLET
ORL
TAB
APX
TAB
2.7560
00002261979
APO-LISINOPRIL/HCTZ 10 MG/12.5 MG TABLET
ORL
TAB
APX
TAB
0.2083
00002261987
APO-LISINOPRIL/HCTZ 20 MG/12.5 MG TABLET
ORL
TAB
APX
TAB
0.2503
00002261995
APO-LISINOPRIL/HCTZ 20 MG/25 MG TABLET
ORL
TAB
APX
TAB
0.3506
00002243880
APO-LORATADINE 10 MG TABLET
ORL
TAB
APX
TAB
0.6267
00002248974
APO-MELOXICAM 15 MG TABLET
ORL
TAB
APX
TAB
0.5670
00002248973
APO-MELOXICAM 7.5 MG TABLET
ORL
TAB
APX
TAB
0.4914
00002366487
APO-MEMANTINE 10 MG TABLET
ORL
TAB
APX
TAB
1.6357
00002273950
APO-METHYLPHENIDATE 5 MG TABLET
ORL
TAB
APX
TAB
0.1004
00002452731
APO-METHYLPHENIDATE ER 18 MG EXTENDED REL. TABLET
ORL
ERT
APX
TAB
1.4276
00002452758
ORL
ERT
APX
TAB
1.6475
00002452766
ORL
ERT
APX
TAB
1.8674
00002330377
ORL
ERT
APX
TAB
2.3072
00002286610
APO-MIRTAZAPINE 15 MG TABLET
ORL
TAB
APX
TAB
0.3750
00002286637
APO-MIRTAZAPINE 45 MG TABLET
ORL
TAB
APX
TAB
1.1250
Pg 21 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002406373
APO-MOXIFLOXACIN 0.5 % OPHTHALMIC SOLUTION
OPH
SOL
APX
ML
3.7570
00002352559
APO-MYCOPHENOLATE 250 MG CAPSULE
ORL
CAP
APX
CAP
1.0310
00002352567
APO-MYCOPHENOLATE 500 MG TABLET
ORL
TAB
APX
TAB
2.0620
00002372738
APO-MYCOPHENOLIC ACID 180 MG ENTERIC-COATED TAB
ORL
ECT
APX
TAB
1.6980
00002372746
APO-MYCOPHENOLIC ACID 360 MG ENTERIC-COATED TAB
ORL
ECT
APX
TAB
3.3960
00002444275
APO-NALTREXONE 50 MG TABLET
ORL
TAB
APX
TAB
7.3025
00002246699
APO-NAPROXEN EC 250 MG ENTERIC-COATED TABLET
ORL
ECT
APX
TAB
0.2087
00002365499
APO-NARATRIPTAN 1 MG TABLET
ORL
TAB
APX
TAB
8.4338
00002365502
APO-NARATRIPTAN 2.5 MG TABLET
ORL
TAB
APX
TAB
6.1437
00002427931
APO-NEVIRAPINE XR 400 MG EXTENDED-RELEASE TABLET
ORL
ERT
APX
TAB
2.0987
00002333015
APO-OLANZAPINE 20 MG TABLET
ORL
TAB
APX
TAB
10.3093
00002360632
APO-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
APX
TAB
5.3553
00002360640
APO-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
APX
TAB
7.5977
00002305054
APO-OLOPATADINE 0.1% OPH SOLUTION
OPH
SOL
APX
ML
5.2261
00002402823
APO-OLOPATADINE 0.2% OPHTHALMIC SOLUTION
OPH
SOL
APX
ML
10.4522
00002243661
APO-OXAPROZIN 600 MG TABLET
ORL
TAB
APX
TAB
0.6892
00002284294
APO-OXCARBAZEPINE 150 MG TABLET
ORL
TAB
APX
TAB
0.6209
00002284308
ORL
TAB
APX
TAB
0.9102
00002284316
ORL
TAB
APX
TAB
1.8204
00002366754
APO-OXYCODONE CR 10 MG CONTROLLED-RELEASE TABLET
ORL
CRT
APX
TAB
0.4390
Pg 22 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002394766
ORL
CRT
APX
TAB
0.5300
00002366762
ORL
CRT
APX
TAB
0.6585
00002394774
ORL
CRT
APX
TAB
0.8700
00002306530
ORL
CRT
APX
TAB
1.1413
00002366746
ORL
CRT
APX
TAB
0.3150
00002394782
ORL
CRT
APX
TAB
1.5750
00002366789
ORL
CRT
APX
TAB
2.1080
00002292912
APO-PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
APX
TAB
1.2750
00002240907
APO-PAROXETINE 10 MG TABLET
ORL
TAB
APX
TAB
1.0430
00000755885
APO-PINDOL 10 MG TABLET
ORL
TAB
APX
TAB
0.2323
00000755893
ORL
TAB
APX
TAB
0.3370
00000755877
ORL
TAB
APX
TAB
0.1361
00002292386
APO-PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
APX
TAB
1.3860
00002394278
APO-PREGABALIN 150 MG CAPSULE
ORL
CAP
APX
CAP
1.7270
00002394286
ORL
CAP
APX
CAP
1.7270
00002394235
ORL
CAP
APX
CAP
0.6173
00002394294
ORL
CAP
APX
CAP
1.7270
00002394243
ORL
CAP
APX
CAP
0.9683
00002394251
ORL
CAP
APX
CAP
1.2529
00000504335
APO-PROPRANOLOL 120 MG TABLET
ORL
TAB
APX
TAB
0.3091
Pg 23 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002325381
APO-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
APX
CAP
0.8550
00002404680
APO-RASAGILINE 0.5 MG TABLET
ORL
TAB
APX
TAB
6.1285
00002404699
APO-RASAGILINE 1 MG TABLET
ORL
TAB
APX
TAB
6.1285
00002377721
APO-RISEDRONATE 150 MG TABLET
ORL
TAB
APX
TAB
40.9500
00002248203
APO-SILDENAFIL 100 MG TABLET
ORL
TAB
APX
TAB
9.2006
00002248201
ORL
TAB
APX
TAB
8.2894
00002248202
ORL
TAB
APX
TAB
8.8481
00002418118
APO-SILDENAFIL R 20 MG TABLET
ORL
TAB
APX
TAB
7.2940
00000778354
APO-SULIN 150 MG TABLET
ORL
TAB
APX
TAB
0.3824
00000778362
APO-SULIN 200 MG TABLET
ORL
TAB
APX
TAB
0.3920
00002422107
APO-TADALAFIL 10 MG TABLET
ORL
TAB
APX
TAB
11.9250
00002422085
APO-TADALAFIL 2.5 MG TABLET
ORL
TAB
APX
TAB
3.6470
00002422115
ORL
TAB
APX
TAB
12.3575
00002422093
ORL
TAB
APX
TAB
3.6470
00002421933
APO-TADALAFIL PAH 20 MG TABLET
ORL
TB
APX
TAB
11.4725
00000812404
APO-TAMOX 10 MG TABLET
ORL
TAB
APX
TAB
0.1750
00000812390
APO-TAMOX 20 MG TABLET
ORL
TAB
APX
TAB
0.3500
00002413094
APO-TEMOZOLOMIDE 100 MG CAPSULE
ORL
CAP
APX
CAP
113.5960
00002413116
ORL
CAP
APX
CAP
159.0360
00002413124
ORL
CAP
APX
CAP
253.6726
Pg 24 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002413043
ORL
CAP
APX
CAP
22.7200
00002413132
ORL
CAP
APX
CAP
283.9840
00002413035
ORL
CAP
APX
CAP
5.8500
00000755850
APO-TIMOL 10 MG TABLET
ORL
TAB
APX
TAB
0.3239
00000755869
ORL
TAB
APX
TAB
0.6304
00000755842
ORL
TAB
APX
TAB
0.2077
00002290812
APO-TIMOP GEL 0.5% OPHTHALMIC SOLUTION
OPH
LAS
APX
ML
2.7300
00002369680
APO-TOLTERODINE 1 MG TABLET
ORL
TAB
APX
TAB
0.8838
00002369699
APO-TOLTERODINE 2 MG TABLET
ORL
TAB
APX
TAB
0.8838
00002426153
APO-TRAMADOL 50 MG TABLET
ORL
TAB
APX
TAB
0.6386
00002336790
APO-TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
APX
TAB
0.6264
00002147653
APO-TRAZODONE 150 MG TABLET
ORL
TAB
APX
TAB
0.4613
00002437635
APO-TRIAMCINOLONE AQ 55 MCG METERED DOSE SPRAY
NAS
SPM
APX
DOSE
0.1700
00002371510
APO-VALSARTAN 40 MG TABLET
ORL
TAB
APX
TAB
0.5823
00001946323
APO-ZIDOVUDINE 100 MG CAPSULE
ORL
CAP
APX
CAP
1.3977
00002381575
APO-ZOLMITRIPTAN RAPID 2.5 MG ORALLY DISP. TABLET
ORL
DISPTAB
APX
TAB
3.5383
00002434946
APO-ZOLPIDEM ODT 10 MG SUBLINGUAL DISINT TABLET
SLG
DISNTAB
APX
TAB
1.1884
00002436159
APO-ZOLPIDEM ODT 5 MG SUBLINGUAL DISINT. TABLET
SLG
DISNTAB
APX
TAB
1.1825
00002375885
APPRILON 40 MG MODIFIED RELEASE CAPSULE
ORL
MRC
GAL
CAP
2.6071
00000723754
APRESOLINE 20 MG/VIAL INJECTION
INJ
DEFAUL
STM
VIAL
11.6500
Pg 25 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002273322
APTIVUS 250 MG CAPSULE
ORL
CAP
BOE
CAP
8.2500
00002162075
AQUASOL E 50 UNIT/ML ORAL DROPS
ORL
DPS
NOV
ML
0.8488
00002059762
AREDIA 30 MG/VIAL INJECTION
INJ
DEFAUL
NOV
ML
16.6930
00002059789
AREDIA 90 MG/VIAL INJECTION
INJ
DEFAUL
NOV
ML
50.0790
00002269465
ARICEPT RDT 10 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
PFI
TAB
5.0132
00002269457
ARICEPT RDT 5 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
PFI
TAB
5.0132
00002224135
ARIMIDEX 1 MG TABLET
ORL
TAB
AZC
TAB
5.2900
00080008677
ARNICA 7% GEL
TOP
GEL
BCI
G
0.1314
00080015109
ARNICA GEL-CREAM RUB A535 TOPICAL GEL
TOP
GEL
CHD
G
0.0971
00002446561
ARNUITY ELLIPTA 100 MCG/DOSE POWDER FOR INHALATION
INH
MIP
GSK
DOSE
1.2683
00002446588
ARNUITY ELLIPTA 200 MCG/DOSE POWDER FOR INHALATION
INH
MIP
GSK
DOSE
2.5367
00002242705
AROMASIN 25 MG TABLET
ORL
TAB
PFI
TAB
5.3847
00002286653
ARTHRITIS PAIN 650 MG EXTENDED RELIEF TABLET
ORL
ERT
VTH
TAB
0.0792
00002371146
ARTHRITIS PAIN RELIEF 650 MG EXTENDED-RELEASE TAB
ORL
ERT
VTH
TAB
0.0498
00002229632
ARTIFICIAL TEARS EXTRA OPH SOLUTION
OPH
SOL
PMS
ML
0.3033
00002229570
ARTIFICIAL TEARS OPH SOLUTION
OPH
SOL
PPH
ML
0.2927
00002381559
ARZERRA 100 MG/5 ML VIAL INJECTION
INJ
DEFAUL
NOV
VIAL
336.0000
00002381567
ARZERRA 1000 MG/50 ML VIAL INJECTION
INJ
DEFAUL
NOV
VIAL
3,360.0000
00000180041
ASA & CODEINE 8 MG TABLET
ORL
TAB
SDR
TAB
0.0396
00000230324
ASA 325 MG TABLET
ORL
TAB
TEV
TAB
0.0621
Pg 26 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000036145
ASA 325 MG TABLET
ORL
TAB
WAM
TAB
0.0136
00000530336
ASA 325 MG TABLET
ORL
TAB
VTH
TAB
0.0215
00002244993
ASA 81 MG ENTERIC-COATED TABLET
ORL
ECT
PMS
TAB
0.0361
00002433044
ORL
ECT
PMS
TAB
0.0560
00002372177
ORL
ECT
VTH
TAB
0.0530
00002427176
ASA EC 80 MG TABLET
ORL
TAB
SNS
TAB
0.0560
00002426811
ASA EC 81 MG ENTERIC-COATED TABLET
ORL
ECT
SNS
TAB
0.0530
00002046253
ASADOL 325 MG ENTERIC-COATED TABLET
ORL
ECT
PPH
TAB
0.0125
00002009013
ASAPHEN 80 MG TABLET
ORL
TAB
PMS
TAB
0.0560
00002243974
ASAPHEN 81 MG CHEWABLE TABLET
ORL
CTB
PMS
TAB
0.0749
00002238545
ASAPHEN E.C. 80 MG ENTERIC-COATED TABLET
ORL
ECT
PMS
TAB
0.0560
00002242281
ASAPHEN E.C. 81 MG ENTERIC-COATED TABLET
ORL
ECT
PMS
TAB
0.0749
00002280167
ASATAB 80 MG CHEWABLE TABLET
ORL
CTB
ODN
TAB
0.0580
00002352427
ASATAB EC 325 MG ENTERIC-COATED TABLET
ORL
ECT
ODN
TAB
0.0295
00000266086
ASCORBIC ACID 500 MG TABLET
ORL
TAB
PMT
TAB
0.0300
00002074710
ASPERCREME CREME RUB 10% TOPICAL CREAM
TOP
CRM
SAH
G
0.0581
00002150328
ASPIRIN 325 MG TABLET
ORL
TAB
BAI
TAB
0.0929
00002289970
ASPIRIN 81 MG QUICK CHEWS CHEWABLE TABLET
ORL
CTB
BIC
TAB
0.1159
00002316897
ASPIRIN STOMACH GUARD EXTRA STRENGTH 500 MG CAPLET
ORL
TAB
BIC
TAB
0.0960
00002239090
ATACAND 4 MG TABLET
ORL
TAB
AZC
TAB
0.7233
Pg 27 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000013668
ATASOL FORTE 500 MG TABLET
ORL
TAB
CHD
TAB
0.0543
00000293504
ATASOL-15 TABLET
ORL
TAB
CHD
TAB
0.0910
00000293512
ATASOL-30 TABLET
ORL
TAB
CHD
TAB
0.1338
00000293490
ATASOL-8 TABLET
ORL
TAB
CHD
TAB
0.0703
00002326701
ATENOLOL 25 MG TABLET
ORL
TAB
PDL
TAB
0.0676
00000828793
ATENOLOL-100 MG TABLET
ORL
TAB
PDL
TAB
0.2362
00000828807
ATENOLOL-50 MG TABLET
ORL
TAB
PDL
TAB
0.1437
00002396904
ATOMOXETINE 10 MG CAPSULE
ORL
CAP
PDL
CAP
1.4040
00002445883
ORL
CAP
SIV
CAP
2.3140
00002445905
ORL
CAP
SIV
CAP
2.6523
00002396912
ORL
CAP
PDL
CAP
1.6093
00002396920
ORL
CAP
PDL
CAP
1.7767
00002445913
ORL
CAP
SIV
CAP
2.9280
00002396939
ORL
CAP
PDL
CAP
2.0250
00002445948
ORL
CAP
SIV
CAP
3.3373
00002396947
ORL
CAP
PDL
CAP
2.2463
00002445956
ORL
CAP
SIV
CAP
3.7023
00002387891
ATORVASTATIN 10 MG TABLET
ORL
TAB
SIV
TAB
0.3138
00002396424
ORL
TAB
APX
TAB
0.3138
00002346486
ORL
TAB
PDL
TAB
0.3138
Pg 28 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002396432
ORL
TAB
APX
TAB
0.3922
00002387905
ORL
TAB
SIV
TAB
0.3923
00002346494
ORL
TAB
PDL
TAB
0.3922
00002396440
ORL
TAB
APX
TAB
0.4216
00002346508
ORL
TAB
PDL
TAB
0.4216
00002387913
ORL
TAB
SIV
TAB
0.4217
00002396459
ORL
TAB
APX
TAB
0.4216
00002387921
ORL
TAB
SIV
TAB
0.4217
00002346516
ORL
TAB
PDL
TAB
0.4216
00002421429
ATOVAQUONE PROGUANIL 250 MG/100 MG TABLET
ORL
TAB
SNS
TAB
4.1308
00002299925
ATRIANCE 5 MG/ML INJECTION
INJ
DEFAUL
NOV
ML
9.9799
00002300699
ATRIPLA TABLET
ORL
TAB
BMG
TAB
42.3340
00002094703
ATROPINE 0.6 MG/ML INJECTION
INJ
DEFAUL
ALV
ML
2.5000
00002148358
ATROPINE SULFATE 1% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00002163713
ATROVENT 0.06% NASAL SPRAY
NAS
SPR
BOE
ML
2.0453
00002332477
AURALGAN OTIC SOLUTION
OT
SOL
PAL
ML
0.5236
00002449161
AURO-BETAHISTINE 24 MG TABLET
ORL
TAB
AUR
TAB
0.4983
00002445808
AURO-CANDESARTAN 16 MG TABLET
ORL
TAB
AUR
TAB
0.3008
00002445816
ORL
TAB
AUR
TAB
0.3008
00002445786
ORL
TAB
AUR
TAB
0.1808
Pg 29 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002445794
ORL
TAB
AUR
TAB
0.3008
00002347261
AURO-CEFPROZIL 25 MG/ML ORAL SUSPENSION
ORL
SUS
AUR
ML
0.0593
00002347245
AURO-CEFPROZIL 250 MG TABLET
ORL
TAB
AUR
TAB
0.4332
00002347288
AURO-CEFPROZIL 50 MG/ML ORAL SUSPENSION
ORL
SUS
AUR
ML
0.1185
00002347253
AURO-CEFPROZIL 500 MG TABLET
ORL
TAB
AUR
TAB
0.8494
00002381931
AURO-CIPROFLOXACIN 750 MG TABLET
ORL
TAB
AUR
TAB
1.2780
00002418428
AURO-EFAVIRENZ 600 MG TABLET
ORL
TAB
AUR
TAB
11.2103
00002448777
AURO-ENTECAVIR 0.5 MG TABLET
ORL
TAB
AUR
TAB
5.5000
00002385627
AURO-FLUOXETINE 10 MG CAPSULE
ORL
CAP
AUR
CAP
0.4595
00002447878
AURO-IRBESARTAN HCT 150/12.5 MG TABLET
ORL
TAB
AUR
TAB
0.3024
00002447886
AURO-IRBESARTAN HCT 300/12.5 MG TABLET
ORL
TAB
AUR
TAB
0.3024
00002447894
AURO-IRBESARTAN HCT 300/25 MG TABLET
ORL
TAB
AUR
TAB
0.3052
00002414414
AURO-LAMIVUDINE/ZIDOVUDINE 150 MG/300 MG TABLET
ORL
TAB
AUR
TAB
7.8308
00002423650
AURO-LOSARTAN HCT 100 MG/12.5 MG TABLET
ORL
TAB
AUR
TAB
0.3082
00002423669
AURO-LOSARTAN HCT 100 MG/25 MG TABLET
ORL
TAB
AUR
TAB
0.3146
00002423642
AURO-LOSARTAN HCT 50 MG/12.5 MG TABLET
ORL
TAB
AUR
TAB
0.3146
00002390892
AURO-MELOXICAM 15 MG TABLET
ORL
TAB
AUR
TAB
0.4623
00002390884
AURO-MELOXICAM 7.5 MG TABLET
ORL
TAB
AUR
TAB
0.4007
00002411695
AURO-MIRTAZAPINE 15 MG TABLET
ORL
TAB
AUR
TAB
0.3750
00002299801
AURO-MIRTAZAPINE OD 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
AUR
TAB
0.2730
Pg 30 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002299828
ORL
DISNTAB
AUR
TAB
0.5460
00002299836
ORL
DISNTAB
AUR
TAB
0.8190
00002430487
AURO-MODAFINIL 100 MG TABLET
ORL
TAB
AUR
TAB
0.9293
00002318601
AURO-NEVIRAPINE 200 MG TABLET
ORL
TAB
AUR
TAB
2.4690
00002448742
AURO-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
AUR
TAB
1.9280
00002448750
AURO-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
AUR
TAB
2.5447
00002422212
AURO-OMEPRAZOLE 10 MG DELAYED-RELEASE CAPSULE
ORL
CAP/SRT
AUR
CAP
0.8166
00002384906
AURO-PIOGLITAZONE 15 MG TABLET
ORL
TAB
AUR
TAB
0.5809
00002384914
ORL
TAB
AUR
TAB
0.8139
00002384922
ORL
TAB
AUR
TAB
1.2237
00002424061
AURO-PRAMIPEXOLE 0.25 MG TABLET
ORL
TAB
AUR
TAB
0.2628
00002424096
AURO-PRAMIPEXOLE 1 MG TABLET
ORL
TAB
AUR
TAB
0.5257
00002424118
AURO-PRAMIPEXOLE 1.5 MG TABLET
ORL
TAB
AUR
TAB
0.5257
00002433907
AURO-PREGABALIN 150 MG CAPSULE
ORL
CAP
AUR
CAP
1.7270
00002433869
ORL
CAP
AUR
CAP
0.6172
00002433877
ORL
CAP
AUR
CAP
0.9682
00002433885
ORL
CAP
AUR
CAP
1.2528
00002405156
AURO-SIMVASTATIN 10 MG TABLET
ORL
TAB
AUR
TAB
0.5057
00002405164
ORL
TAB
AUR
TAB
0.6250
00002405172
ORL
TAB
AUR
TAB
0.6250
Pg 31 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002405148
ORL
TAB
AUR
TAB
0.2556
00002405180
ORL
TAB
AUR
TAB
0.4501
00002435934
AURO-TADALAFIL 10 MG TABLET
ORL
TAB
AUR
TAB
11.9250
00002435896
AURO-TADALAFIL 2.5 MG TABLET
ORL
TAB
AUR
TAB
3.6470
00002435942
ORL
TAB
AUR
TAB
12.3575
00002435926
ORL
TAB
AUR
TAB
3.6470
00002439050
AURO-TRAMADOL/ACETAMINOPHEN 37.5 MG/325 MG TABLET
ORL
TAB
AUR
TAB
0.6264
00002414201
AURO-VALSARTAN 40 MG TABLET
ORL
TAB
AUR
TAB
0.5240
00002363798
AVA-ACEBUTOLOL 100 MG TABLET
ORL
TAB
AVA
TAB
0.1630
00002363801
ORL
TAB
AVA
TAB
0.2440
00002363828
ORL
TAB
AVA
TAB
0.4848
00002360969
AVA-ATENOLOL 25 MG TABLET
ORL
TAB
AVA
TAB
0.1730
00002363364
AVA-AZITHROMYCIN 250 MG TABLET
ORL
TAB
AVA
TAB
2.9650
00002371413
AVA-BACLOFEN 10 MG TABLET
ORL
TAB
AVA
TAB
0.2911
00002371421
AVA-BACLOFEN 20 MG TABLET
ORL
TAB
AVA
TAB
0.5667
00002360993
AVA-BICALUTAMIDE 50 MG TABLET
ORL
TAB
AVA
TAB
4.0573
00002363895
AVA-BISOPROLOL 10 MG TABLET
ORL
TAB
AVA
TAB
0.3654
00002363887
AVA-BISOPROLOL 5 MG TABLET
ORL
TAB
AVA
TAB
0.2205
00002363399
AVA-BUPROPION SR 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AVA
TAB
0.3365
00002363402
AVA-BUPROPION SR 150 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AVA
TAB
0.5040
Pg 32 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002370751
AVA-CARVEDILOL 12.5 MG TABLET
ORL
TAB
AVA
TAB
0.7564
00002370786
AVA-CARVEDILOL 25 MG TABLET
ORL
TAB
AVA
TAB
0.7564
00002370735
ORL
TAB
AVA
TAB
0.7564
00002370743
ORL
TAB
AVA
TAB
0.7564
00002362864
AVA-CEFPROZIL 25 MG/ML ORAL SUSPENSION
ORL
SUS
AVA
ML
0.0948
00002362848
AVA-CEFPROZIL 250 MG TABLET
ORL
TAB
AVA
TAB
0.9703
00002362872
AVA-CEFPROZIL 50 MG/ML ORAL SUSPENSION
ORL
SUS
AVA
ML
0.1896
00002362856
AVA-CEFPROZIL 500 MG TABLET
ORL
TAB
AVA
TAB
1.9025
00002364255
AVA-CITALOPRAM 10 MG TABLET
ORL
TAB
AVA
TAB
0.4464
00002366371
AVA-CLARITHROMYCIN 250 MG TABLET
ORL
TAB
AVA
TAB
1.1001
00002366398
AVA-CLARITHROMYCIN 500 MG TABLET
ORL
TAB
AVA
TAB
1.8249
00002364719
AVA-CLINDAMYCIN 150 MG CAPSULE
ORL
CAP
AVA
CAP
0.4890
00002364727
AVA-CLINDAMYCIN 300 MG CAPSULE
ORL
CAP
AVA
CAP
0.9780
00002360861
AVA-CLONIDINE 0.025 MG TABLET
ORL
TAB
AVA
TAB
0.1523
00002366665
AVA-DICLOFENAC 25 MG ENTERIC-COATED TABLET
ORL
ECT
AVA
TAB
0.1902
00002366673
AVA-DICLOFENAC 50 MG ENTERIC-COATED TABLET
ORL
ECT
AVA
TAB
0.3804
00002366703
AVA-DICLOFENAC SR 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AVA
TAB
0.7608
00002366681
AVA-DICLOFENAC SR 75 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AVA
TAB
0.5706
00002364271
AVA-DOMPERIDONE 10 MG TABLET
ORL
TAB
AVA
TAB
0.1418
00002363488
AVA-ENALAPRIL 10 MG TABLET
ORL
TAB
AVA
TAB
0.5932
Pg 33 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002363453
AVA-ENALAPRIL 2.5 MG TABLET
ORL
TAB
AVA
TAB
0.4172
00002363496
ORL
TAB
AVA
TAB
0.7156
00002363461
ORL
TAB
AVA
TAB
0.4935
00002373920
AVA-FAMOTIDINE 20 MG TABLET
ORL
TAB
AVA
TAB
0.5896
00002373939
AVA-FAMOTIDINE 40 MG TABLET
ORL
TAB
AVA
TAB
1.0612
00002364409
AVA-FENOFIBRATE MICRO 200 MG CAPSULE
ORL
CAP
AVA
CAP
1.0890
00002364530
AVA-FLUOXETINE 20 MG CAPSULE
ORL
CAP
AVA
CAP
1.0112
00002363771
AVA-FLUVOXAMINE 100 MG TABLET
ORL
TAB
AVA
TAB
0.8902
00002363763
AVA-FLUVOXAMINE 50 MG TABLET
ORL
TAB
AVA
TAB
0.4952
00002364573
AVA-FUROSEMIDE 20 MG TABLET
ORL
TAB
AVA
TAB
0.0445
00002364581
ORL
TAB
AVA
TAB
0.0670
00002364603
ORL
TAB
AVA
TAB
0.1220
00002363518
AVA-GLICLAZIDE 80 MG TABLET
ORL
TAB
AVA
TAB
0.2242
00002363704
AVA-GLYBURIDE 2.5 MG TABLET
ORL
TAB
AVA
TAB
0.0393
00002363712
AVA-GLYBURIDE 5 MG TABLET
ORL
TAB
AVA
TAB
0.0683
00002363968
AVA-HYDROCHLOROTHIAZIDE 25 MG TABLET
ORL
TAB
AVA
TAB
0.0395
00002363976
AVA-HYDROCHLOROTHIAZIDE 50 MG TABLET
ORL
TAB
AVA
TAB
0.0551
00002373327
AVA-IRBESARTAN 150 MG TABLET
ORL
TAB
AVA
TAB
0.5444
00002373335
ORL
TAB
AVA
TAB
0.5444
00002373319
ORL
TAB
AVA
TAB
0.5444
Pg 34 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002373343
AVA-IRBESARTAN/HCTZ 150/12.5 MG TABLET
ORL
TAB
AVA
TAB
0.3024
00002373351
AVA-IRBESARTAN/HCTZ 300/12.5 MG TABLET
ORL
TAB
AVA
TAB
0.3024
00002373378
AVA-IRBESARTAN/HCTZ 300/25 MG TABLET
ORL
TAB
AVA
TAB
0.3004
00002371677
AVA-LEVETIRACETAM 250 MG TABLET
ORL
TAB
AVA
TAB
0.9632
00002371685
ORL
TAB
AVA
TAB
1.1739
00002371693
ORL
TAB
AVA
TAB
1.6254
00002361027
AVA-LEVOFLOXACIN 250 MG TABLET
ORL
TAB
AVA
TAB
2.8494
00002361035
AVA-LEVOFLOXACIN 500 MG TABLET
ORL
TAB
AVA
TAB
3.2153
00002362880
AVA-LISINOPRIL HCT 10 MG/12.5 MG TABLET
ORL
TAB
AVA
TAB
0.2083
00002362899
AVA-LISINOPRIL HCT 20 MG/12.5 MG TABLET
ORL
TAB
AVA
TAB
0.6030
00002362902
AVA-LISINOPRIL HCT 20 MG/25 MG TABLET
ORL
TAB
AVA
TAB
0.6030
00002364239
AVA-LOVASTATIN 20 MG TABLET
ORL
TAB
AVA
TAB
1.0907
00002364247
AVA-LOVASTATIN 40 MG TABLET
ORL
TAB
AVA
TAB
2.0117
00002364506
AVA-METFORMIN 500 MG TABLET
ORL
TAB
AVA
TAB
0.1216
00002364514
AVA-METFORMIN 850 MG TABLET
ORL
TAB
AVA
TAB
0.2040
00002364859
AVA-METOPROLOL (TYPE L) 100 MG TABLET
ORL
TAB
AVA
TAB
0.2223
00002364840
AVA-METOPROLOL (TYPE L) 50 MG TABLET
ORL
TAB
AVA
TAB
0.1225
00002364832
AVA-METOPROLOL 100 MG TABLET
ORL
TAB
AVA
TAB
0.2223
00002364824
AVA-METOPROLOL 50 MG TABLET
ORL
TAB
AVA
TAB
0.1225
00002362937
AVA-MIRTAZAPINE 30 MG TABLET
ORL
TAB
AVA
TAB
0.6944
Pg 35 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002298589
AVAMYS 27.5 MCG/DOSE NASAL SPRAY
NAS
SPM
GSK
DOSE
0.2157
00002365820
AVA-NAPROXEN 375 MG TABLET
ORL
TAB
AVA
TAB
0.1458
00002365839
AVA-NAPROXEN 500 MG TABLET
ORL
TAB
AVA
TAB
0.2110
00002365847
AVA-NAPROXEN EC 250 MG ENTERIC-COATED TABLET
ORL
ECT
AVA
TAB
0.2467
00002365855
ORL
ECT
AVA
TAB
0.3234
00002365863
ORL
ECT
AVA
TAB
0.5842
00002366304
AVA-NORFLOXACIN 400 MG TABLET
ORL
TAB
AVA
TAB
1.2204
00002364301
AVA-NORTRIPTYLINE 10 MG CAPSULE
ORL
CAP
AVA
CAP
0.1260
00002364328
AVA-NORTRIPTYLINE 25 MG CAPSULE
ORL
CAP
AVA
CAP
0.2546
00002373467
AVA-OLANZAPINE 10 MG TABLET
ORL
TAB
AVA
TAB
4.2270
00002373432
AVA-OLANZAPINE 2.5 MG TABLET
ORL
TAB
AVA
TAB
1.0568
00002373440
AVA-OLANZAPINE 5 MG TABLET
ORL
TAB
AVA
TAB
2.1135
00002373459
AVA-OLANZAPINE 7.5 MG TABLET
ORL
TAB
AVA
TAB
3.1703
00002363429
AVA-PANTOPRAZOLE 40 MG ENTERIC-COATED TABLET
ORL
ECT
AVA
TAB
1.2135
00002363305
AVA-PRAMIPEXOLE 0.25 MG TABLET
ORL
TAB
AVA
TAB
0.5887
00002363321
AVA-PRAMIPEXOLE 1 MG TABLET
ORL
TAB
AVA
TAB
1.1776
00002363348
AVA-PRAMIPEXOLE 1.5 MG TABLET
ORL
TAB
AVA
TAB
1.1776
00002363267
AVA-RAMIPRIL 1.25 MG TABLET
ORL
CAP/TAB
AVA
TAB
0.1274
00002363291
AVA-RAMIPRIL 10 MG TABLET
ORL
CAP/TAB
AVA
TAB
0.1862
00002363275
AVA-RAMIPRIL 2.5 MG TABLET
ORL
CAP/TAB
AVA
TAB
0.1470
Pg 36 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002363283
AVA-RAMIPRIL 5 MG TABLET
ORL
CAP/TAB
AVA
TAB
0.1470
00002364816
AVA-RISEDRONATE 35 MG TABLET
ORL
TAB
AVA
TAB
4.8169
00002367173
AVA-RISPERIDONE 0.25 MG TABLET
ORL
TAB
AVA
TAB
0.2615
00002367181
AVA-RISPERIDONE 0.5 MG TABLET
ORL
TAB
AVA
TAB
0.4379
00002367203
AVA-RISPERIDONE 1 MG TABLET
ORL
TAB
AVA
TAB
0.6048
00002364344
AVA-RISPERIDONE 1 MG/ML ORAL SOLUTION
ORL
SOL
AVA
ML
0.7727
00002367211
ORL
TAB
AVA
TAB
1.2075
00002367238
ORL
TAB
AVA
TAB
1.8113
00002367246
ORL
TAB
AVA
TAB
2.4150
00002363682
AVA-SOTALOL 160 MG TABLET
ORL
TAB
AVA
TAB
0.5771
00002363674
AVA-SOTALOL 80 MG TABLET
ORL
TAB
AVA
TAB
0.4922
00002270994
AVASTIN 25 MG/ML INJECTION
INJ
DEFAUL
HLR
ML
127.5000
00002366266
AVA-SUMATRIPTAN 100 MG TABLET
ORL
TAB
AVA
TAB
9.8433
00002366258
AVA-SUMATRIPTAN 50 MG TABLET
ORL
TAB
AVA
TAB
8.9350
00002366231
AVA-TAMSULOSIN CR 0.4 MG EXTENDED-RELEASE TABLET
ORL
ERT
AVA
TAB
0.2700
00002370980
AVA-TOPIRAMATE 100 MG TABLET
ORL
TAB
AVA
TAB
1.2537
00002370999
ORL
TAB
AVA
TAB
1.9845
00002370972
ORL
TAB
AVA
TAB
0.6615
00002367130
AVA-VALSARTAN 160 MG TABLET
ORL
TAB
AVA
TAB
0.2957
00002367149
ORL
TAB
AVA
TAB
0.2843
Pg 37 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002367114
ORL
TAB
AVA
TAB
0.5240
00002367122
ORL
TAB
AVA
TAB
0.2957
00002367084
AVA-VALSARTAN HCT 160 MG/ 25 MG TABLET
ORL
TAB
AVA
TAB
0.2957
00002367076
AVA-VALSARTAN HCT 160 MG/12.5 MG TABLET
ORL
TAB
AVA
TAB
0.2957
00002367092
ORL
TAB
AVA
TAB
0.2910
00002367106
AVA-VALSARTAN HCT 320 MG/25 MG TABLET
ORL
TAB
AVA
TAB
0.2910
00002367068
ORL
TAB
AVA
TAB
0.2957
00002237792
AVAXIM 160 U/0.5 ML INJECTION SYRINGE
INJ
NDL
SFP
SYR
42.4500
00002243741
AVAXIM-PEDIATRIC 80 UNIT/0.5 ML INJECTION SYRINGE
INJ
NDL
SFP
SYR
21.2300
00002363534
AVA-ZOPICLONE 5 MG TABLET
ORL
TAB
AVA
TAB
0.2231
00002363542
AVA-ZOPICLONE 7.5 MG TABLET
ORL
TAB
AVA
TAB
0.4685
00002317508
AVEENO CREAM
TOP
CRM
JJI
G
0.0219
00002241416
AVEENO MOISTURIZING BATH
TOP
PWR
JJI
G
0.0461
00002382369
AXIRON 2% TOPICAL SOLUTION
TOP
SOL
LIL
ML
1.5259
00002284642
AZILECT 0.5 MG TABLET
ORL
TAB
TMP
TAB
7.3543
00002284650
AZILECT 1 MG TABLET
ORL
TAB
TMP
TAB
7.3543
00002274388
AZITHROMYCIN 20 MG/ML ORAL SUSPENSION
ORL
SUS
PMS
ML
0.3727
00002274396
AZITHROMYCIN 40 MG/ML ORAL SUSPENSION
ORL
SUS
PMS
ML
0.5280
00002330911
AZITHROMYCIN 600 MG TABLET
ORL
TAB
SNS
TAB
6.0000
00000598577
B COMPLEX 50 TABLET
ORL
TAB
JAM
TAB
0.0810
Pg 38 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000598569
B COMPLEX 75 TABLET
ORL
TAB
JAM
TAB
0.1616
00000123803
B COMPLEX PLUS C TABLET
ORL
TAB
JAM
TAB
0.0810
00080007498
B&C VITAMINS TABLET
ORL
TAB
WBP
TAB
0.0631
00080002409
B12 1000 MCG TABLET
ORL
TAB
WNP
TAB
0.0850
00002245512
B50 COMPLEX CAPSULE
ORL
CAP
WNP
CAP
0.0895
00001927906
BACID 1 B CAPSULE
ORL
CAP
ERF
CAP
0.6598
00000876488
BACIMYXIN TOPICAL OINTMENT
TOP
ONT
PMS
G
0.2433
00000584908
BACITIN 500 UNIT/G TOPICAL OINTMENT
TOP
ONT
PPH
G
0.1993
00000030708
BACITRACIN 50,000 U/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
11.7500
00002433532
BACKUP PLAN ONESTEP 1.5 MG TABLET
ORL
TAB
APX
TAB
14.8200
00002152584
BACLOFEN 10 MG TABLET
ORL
TAB
PDL
TAB
0.1595
00002152592
BACLOFEN 20 MG TABLET
ORL
TAB
PDL
TAB
0.3104
00000037818
BACTERIOSTATIC SODIUM CHLORIDE 0.9% INJECTION
INJ
DEFAUL
HSP
ML
0.2160
00002243425
BALANCED B COMPLEX 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PMT
TAB
0.0850
00002244010
BALMINIL CODEINE NIGHT TIME + EXPECTORANT
ORL
SYR
ROG
ML
0.0295
00000436895
BALMINIL DM 3 MG/ML ORAL SYRUP
ORL
SYR
ROG
ML
0.0332
00001908855
BALNETAR 2.5% TOPICAL SOLUTION
TOP
SOL
WSD
ML
0.0496
00002060841
BARRIERE 20% TOPICAL CREAM
TOP
CRM
WSP
G
0.0660
00002444844
BASAGLAR 100 UNIT/ML INJECTION CARTRIDGE
INJ
DEFAUL
LIL
ML
5.2613
00002444852
BASAGLAR 100 UNIT/ML INJECTION KWIKPEN
INJ
DEFAUL
LIL
ML
5.2613
Pg 39 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002135620
BASALJEL 500 MG CAPSULE
ORL
CAP
AUP
CAP
0.1500
00000658413
BAXEDIN 20% SOLUTION
TOP
SOL
OMG
ML
0.0520
00002243966
BAZA CLEANSE & PROTECT 2% TOPICAL LOTION
TOP
LOT
COC
ML
0.0485
00000075124
BCG VACCINE (FREEZE-DRIED) 1 MG INJECTION
INJ
DEFAUL
SFP
VIAL
193.3000
00000498815
B-COMPLEX 100 SUSTAINED-RELEASE TABLET
ORL
SRT
JAM
TAB
0.2158
00002237567
BEANO 150 UNIT TABLET
ORL
TAB
GSK
TAB
0.1800
00080043158
BEDUZIL 1500 1500 MCG TABLET
ORL
ERT
ORI
TAB
0.1158
00002019736
BENADRYL 12.5 MG/5 ML ORAL ELIXIR
ORL
ELX
MCL
ML
0.0540
00002019701
BENADRYL 2% TOPICAL CREAM
TOP
CRM
MCL
G
0.2703
00002017849
BENADRYL 25 MG CAPLET
ORL
TAB
MCL
TAB
0.3883
00002019671
BENADRYL 50 MG CAPSULE
ORL
CAP
MCL
CAP
0.2514
00002061287
BENADRYL ALLERGY JUNIOR STRENGTH CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.4483
00002229367
BENADRYL ALLERGY SINUS HEADACHE CAPLET
ORL
TAB
MCL
TAB
0.3175
00002019698
BENADRYL CHILDREN'S 1.25 MG/ML ORAL LIQUID
ORL
LIQ
MCL
ML
0.0540
00002239138
BENADRYL EXTRA STRENGTH 50 MG CAPLET
ORL
TAB
MCL
TAB
0.4096
00002280876
BENADRYL SPRAY
TOP
SPR
MCL
ML
0.0822
00002370050
BENLYSTA 120 MG /VIAL INJECTION
INJ
DEFAUL
GSK
VIAL
293.5700
00002370069
BENLYSTA 400 MG /VIAL INJECTION
INJ
DEFAUL
GSK
VIAL
978.5600
00002245709
BENYLIN 2 COLD AND FLU WITH CODEINE ORAL SYRUP
ORL
SYR
MCL
ML
0.0570
00002003317
BENYLIN COUGH AND CHEST CONGESTION WARMING SYRUP
ORL
SYR
MCL
ML
0.0366
Pg 40 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00001944738
BENYLIN DM 3 MG/ML ORAL SYRUP
ORL
SYR
MCL
ML
0.0494
00002215268
BENYLIN DM FOR CHILDREN 1.5 MG/ML ORAL SYRUP
ORL
SYR
MCL
ML
0.0494
00002245383
BENYLIN DM FREEZER POPS 7.5 MG/ PACKET ORAL LIQUID
ORL
LIQ
MCL
PCKT
0.5925
00001944746
BENYLIN DM-D FOR CHILDREN ORAL SYRUP
ORL
SYR
MCL
ML
0.0494
00001944711
BENYLIN DM-D ORAL SYRUP
ORL
SYR
MCL
ML
0.0474
00001944673
BENYLIN DM-D-E ORAL SYRUP
ORL
SYR
MCL
ML
0.0494
00001944762
BENYLIN DM-E ORAL SYRUP
ORL
SYR
MCL
ML
0.0494
00002265427
BENYLIN E EXTRA STR W/ MENTHACTIN 40/3MG/ML SYR
ORL
SYR
MCL
ML
0.0366
00001912437
BENZAC AC 10% TOPICAL COPOLYMER GEL
TOP
COPGEL
GAL
G
0.3333
00001925199
BENZAC W10 10% TOPICAL WASH
TOP
WAS
GAL
G
0.3351
00002162121
BENZAGEL 5 5% WASH
TOP
WAS
NVC
ML
0.0584
00002225271
BENZAMYCIN TOPICAL GEL
TOP
GEL
VCL
G
1.1292
00002336847
BESIVANCE 0.6% OPHTHALMIC SOLUTION
OPH
SOL
BSH
ML
2.6780
00000716634
BETADERM 0.1% SCALP LOTION
SCP
LOT
TAR
ML
0.0852
00000158348
BETADINE 10% TOPICAL SOLUTION
TOP
SOL
PUR
ML
0.0293
00002237835
BETAJECT INJECTION
INJ
DEFAUL
SDZ
ML
10.4830
00002449773
BETEFLAM 2.25 MG TOPICAL PATCH
TOP
PTH
CIP
PTH
3.1581
00002417030
BEXSERO 0.5 ML INJECTION SYRINGE
INJ
NDL
NOV
SYR
101.0000
00002359685
BIACNA 1.2%/0.025% TOPICAL GEL
TOP
GEL
VCL
G
1.0582
00002382423
BICALUTAMIDE 50 MG TABLET
ORL
TAB
SIV
TAB
4.0573
Pg 41 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002325985
BICALUTAMIDE 50 MG TABLET
ORL
TAB
AHI
TAB
4.0572
00002291924
BICILLIN L-A 1,200,000 IU/2 ML INJ SYR
INJ
NDL
PFI
SYR
44.6390
00000297763
BICNU 100 MG/VIAL INJECTION
INJ
DEFAUL
BMS
VIAL
120.0400
00002230897
BILTRICIDE 600 MG TABLET
ORL
TAB
BAI
TAB
6.2900
00080026265
BIO K 20 POTASSIUM 20 MEQ TABLET
ORL
TAB
BMD
TAB
0.1995
00002392143
BIO-AMLODIPINE 10 MG TABLET
ORL
TAB
BMD
TAB
0.3587
00002392127
BIO-AMLODIPINE 2.5 MG TABLET
ORL
TAB
BMD
TAB
0.1380
00002392135
BIO-AMLODIPINE 5 MG TABLET
ORL
TAB
BMD
TAB
0.2417
00002392186
BIO-ATENOLOL 100 MG TABLET
ORL
TAB
BMD
TAB
0.2362
00002392194
ORL
TAB
BMD
TAB
0.0676
00002392178
ORL
TAB
BMD
TAB
0.1437
00002448475
BIO-CITALOPRAM 10 MG TABLET
ORL
TAB
BMD
TAB
0.1432
00002448491
ORL
TAB
BMD
TAB
0.2397
00002448513
ORL
TAB
BMD
TAB
0.2397
00000621366
BIODERM TOPICAL OINTMENT
TOP
ONT
ODN
G
0.3600
00002425211
BIO-EZETIMIBE 10 MG TABLET
ORL
TAB
BMD
TAB
0.4549
00002448424
BIO-FLUOXETINE 10 MG CAPSULE
ORL
CAP
BMD
CAP
0.4595
00002247371
BIO-FUROSEMIDE 20 MG TABLET
ORL
TAB
BMD
TAB
0.0373
00002247372
BIO-FUROSEMIDE 40 MG TABLET
ORL
TAB
BMD
TAB
0.0558
00080012473
BIOGAIA DROPS
ORL
DPS
FEI
ML
4.2800
Pg 42 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080062995
BIOGAIA ORAL DROPS
ORL
SUS
FEI
ML
4.6800
00002247170
BIO-HYDROCHLOROTHIAZIDE 25 MG TABLET
ORL
TAB
PMS
TAB
0.0157
00002247171
BIO-HYDROCHLOROTHIAZIDE 50 MG TABLET
ORL
TAB
PMS
TAB
0.0217
00080015104
BIO-K EXTRA STRENGTH PROBIOTIC CAPSULE
ORL
CAP
BKP
CAP
1.5627
00000989995
BIO-K PLUS RICE PROBIOTIC DRINK
ORL
LIQ
BKP
G
0.0536
00080006533
BIOMEDIC MULTIVITAMIN
ORL
CAP
VTH
CAP
0.0607
00002216051
BION TEARS OPH SOLUTION
OPH
SOL
ALC
ML
0.9604
00000116785
BIONET TABLET
ORL
TAB
CHD
TAB
0.1938
00080003128
BIONUTRITION FORMULA 3 CAPSULE
ORL
CAP
BNI
CAP
1.1666
00080023605
BIOSIL CAPSULE
ORL
CAP
PRN
CAP
0.4000
00000999776
BIOTENE ORAL BALANCE GEL
ORL
GEL
GSK
G
0.1715
00000999782
BIOTENE ORAL RINSE
ORL
MWH
GSK
ML
0.0153
00000999777
BIOTENE SPRAY
ORL
SPR
GSK
ML
0.1637
00000437522
BIOTIN 250 MCG TABLET
ORL
TAB
JAM
TAB
0.0567
00002326302
BI-PEGLYTE KIT
ORL
ECT/PWR
PPH
KIT
19.9900
00002361450
BISACODYL 10 MG RECTAL SUPPOSITORY
RT
SUP
JPC
SUP
0.4681
00002273411
BISACODYL-ODAN 5 MGENTERIC-COATED TABLET
ORL
ECT
ODN
TAB
0.0550
00002131692
BLEOMYCIN SULFATE 15 UNIT/VIAL INJECTION
INJ
DEFAUL
MNP
VIAL
421.3800
00000999809
BLINK CONTACTS LUBRICATING EYE DROP
OPH
DPS
AMO
ML
0.3890
00080053068
BLOOD PRESSURE FORMULATION COMBO CAPSULE
ORL
CAP
BEL
CAP
0.3483
Pg 43 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002247600
BOOSTRIX INJECTION SYRINGE
INJ
DEFAUL
GSK
SYR
28.6220
00002423405
BORTEZOMIB FOR INJECTION 3.5 MG/VIAL INJECTION
INJ
DEFAUL
TEV
VIAL
1,402.4200
00002419149
BOSULIF 100 MG TABLET
ORL
TAB
PFI
TAB
37.6511
00002419157
BOSULIF 500 MG TABLET
ORL
TAB
PFI
TAB
150.5839
00002268140
BRAVELLE 75 UNIT/VIAL POWDER FOR INJECTION
INJ
DEFAUL
FEI
VIAL
74.0000
00002444186
BREO ELLIPTA 200 MCG/25 MCG POWDER FOR INHALATION
INH
MIP
GSK
DOSE
4.2913
00002187086
BREVICON 0.5/35 (21 DAY) TABLET
ORL
TAB
PFI
TAB
0.6295
00002187094
BREVICON 0.5/35 (28 DAY) TABLET
ORL
TB
PFI
TAB
0.4721
00002189054
BREVICON 1/35 (21 DAY) TABLET
ORL
TAB
PFI
TAB
0.6295
00002189062
BREVICON 1/35 (28 DAY) TABLET
ORL
TB
PFI
TAB
0.4721
00002455005
BRILINTA 60 MG TABLET
ORL
TAB
AZC
TAB
1.4800
00002301334
BRIMONIDINE P 0.15% OPHTHALMIC SOLUTION
OPH
SOL
AAP
ML
1.7330
00002452936
BRIVLERA 10 MG TABLET
ORL
TAB
UCB
TAB
4.3200
00002452979
ORL
TAB
UCB
TAB
4.3200
00002452944
ORL
TAB
UCB
TAB
4.3200
00002452952
ORL
TAB
UCB
TAB
4.3200
00002452960
ORL
TAB
UCB
TAB
4.3200
00002220520
BROMAZEPAM 3 MG TABLET
ORL
TAB
PDL
TAB
0.0815
00002220539
BROMAZEPAM 6 MG TABLET
ORL
TAB
PDL
TAB
0.1191
00000522791
BRONCHOPHAN FORTE DM ORAL SYRUP
ORL
SYR
ATL
ML
0.0275
Pg 44 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000512990
BSS BALANCED SALT OPH SOLUTION
OPH
SOL
ALC
ML
0.4387
00000729655
BUCKLEY'S DM ORAL LIQUID
ORL
LIQ
BUA
ML
0.0489
00080022907
BUGS BUNNY AND FRIENDS COMPLETE MULTI VIT CHEW TAB
ORL
CTB
BIC
TAB
0.0869
00002331616
BUPROPION SR 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.2667
00000728284
BURINEX 1 MG TABLET
ORL
TAB
LEO
TAB
0.7906
00000728276
BURINEX 5 MG TABLET
ORL
TAB
LEO
TAB
3.0183
00000579947
BURO-SOL TOPICAL POWDER
TOP
PWR
GSK
G
0.7510
00002223163
BUSPIRONE 10 MG TABLET
ORL
TAB
PDL
TAB
0.3517
00002242504
BUTORPHANOL 10 MG/ML NASAL SPRAY
NAS
SPR
AAP
ML
22.6120
00002341212
BUTRANS 10 (10 MCG/HR) TRANSDERMAL PATCH
TRD
PTH
PUR
PTH
23.1500
00002450771
TRD
PTH
PUR
PTH
32.6100
00002341220
TRD
PTH
PUR
PTH
42.0700
00002341174
TRD
PTH
PUR
PTH
12.6000
00002448610
BYDUREON 2 MG/DOSE INJECTION PEN
INJ
DEFAUL
AZC
SYR
47.9400
00002361817
BYETTA 10 MCG/DOSE (2.4 ML) INJECTION SYRINGE
INJ
NDL
AZC
SYR
143.6700
00002361809
BYETTA 5 MCG/DOSE (1.2 ML) INJECTION SYRINGE
INJ
NDL
AZC
SYR
143.6700
00002399016
BYSTOLIC 10 MG TABLET
ORL
TAB
FLC
TAB
1.2600
00002398990
BYSTOLIC 2.5 MG TABLET
ORL
TAB
FLC
TAB
1.2600
00002399024
ORL
TAB
FLC
TAB
1.2600
00002399008
ORL
TAB
FLC
TAB
1.2600
Pg 45 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002273284
CADUET 10 MG/10 MG TABLET
ORL
TAB
PFI
TAB
2.5236
00002273292
ORL
TAB
PFI
TAB
3.1461
00002273306
ORL
TAB
PFI
TAB
3.2960
00002273314
ORL
TAB
PFI
TAB
3.2960
00002273233
ORL
TAB
PFI
TAB
2.3902
00002273241
ORL
TAB
PFI
TAB
2.8187
00002273268
ORL
TAB
PFI
TAB
2.9793
00002273276
ORL
TAB
PFI
TAB
2.9793
00002238389
CAELYX 2 MG/ML PEGYLATED LIPOSOME INJECTION
INJ
DEFAUL
JAI
ML
71.3340
00002241460
CAL MAG 2:1 WITH D TABLET
ORL
TAB
WNP
TAB
0.0536
00080000159
CALCIA 500 MG/400 IU ORANGE TABLET
ORL
TAB
MDX
TAB
0.1498
00000730602
CALCIUM & MAGNESIUM WITH VITAMIN D CAPSULE
ORL
CAP
SIS
CAP
0.2442
00002240973
CALCIUM (CARBONATE) W/ VITAMIN D 500 MG/125 U TAB
ORL
TAB
WNP
TAB
0.0750
00002240240
CALCIUM 500 MG TABLET
ORL
TAB
PMT
TAB
0.0850
00000621722
ORL
TAB
HAL
TAB
0.0274
00002240977
ORL
TAB
WNP
TAB
0.0449
00080003658
ORL
TAB
WNP
TAB
0.0243
00080000248
ORL
TAB
JAM
TAB
0.0609
00080009369
ORL
TAB
PMT
TAB
0.0342
00080007105
CALCIUM 650 MG WITH VITAMIN D 400 IU CAPLET
ORL
TAB
JMS
TAB
0.0609
Pg 46 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002040875
CALCIUM AND MAGNESIUM CAPLET
ORL
TAB
JAM
TAB
0.0345
00002245170
CALCIUM AND MAGNESIUM CITRATE WITH VITAMIN D TAB
ORL
TAB
WNP
TAB
0.0467
00080006568
CALCIUM AND MAGNESIUM TABLET
ORL
TAB
GFR
TAB
0.1140
00002244861
CALCIUM AND MAGNESIUM WITH VITAMIN D TAB
ORL
TAB
PMT
TAB
0.0345
00002048965
CALCIUM AND MAGNESIUM WITH ZINC CAPLET
ORL
TAB
JAM
TAB
0.0335
00002243418
CALCIUM BONE SOLUTION
ORL
LIQ
ULT
ML
0.0343
00000730599
CALCIUM CARBONATE & VITAMIN D3 500 MG/125 U TABLET
ORL
TAB
PMT
TAB
0.0345
00000644684
CALCIUM CARBONATE 500 MG (BASE) TABLET
ORL
TAB
WBP
TAB
0.0245
00001922238
CALCIUM CARBONATE 500 MG CHEWABLE TABLET
ORL
CTB
WAM
TAB
0.0988
00080003855
CALCIUM CITRATE 300 MG TABLET
ORL
TAB
WNP
TAB
0.0642
00002243766
ORL
TAB
PMT
TAB
0.0791
00002158728
ORL
TAB
SWS
TAB
0.0945
00080003662
CALCIUM CITRATE W/ VITAMIN D 300 MG/200 IU TABLET
ORL
TAB
WNP
TAB
0.0669
00002237590
CALCIUM CITRATE WITH VITAMIN D TABLET
ORL
TAB
JAM
TAB
0.0677
00002243669
CALCIUM CITRATE WITH VITAMIN D TABLET
ORL
TAB
WNP
TAB
0.0833
00002141019
CALCIUM GLUCONATE 94 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
1.3474
00080007103
CALCIUM MAGNESIUM WITH VITAMIN D CAPLET
ORL
TAB
JMS
TAB
0.0345
00002040905
CALCIUM MAGNESIUM WITH VITAMIN D TABLET
ORL
TAB
JAM
TAB
0.0685
00080007265
CALCIUM SOFT CHEWS WITH VITAMIN D
ORL
CAP
JAM
CAP
0.1787
00001906828
CAL-MAG WITH ZINC & VITAMIN D CAPLET
ORL
TAB
SWS
TAB
0.0902
Pg 47 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080027151
CALMOSEPTINE OINTMENT
TOP
ONT
CAL
G
0.0619
00002198630
CALMYLIN ACE 2 MG/ML SYRUP
ORL
SYR
RPH
ML
0.0960
00000535230
CALMYLIN WITH CODEINE COUGH ORAL LIQUID
ORL
LIQ
RPH
ML
0.0515
00002172917
CALMYLIN WITH CODEINE ORAL SYRUP
ORL
SYR
ROG
ML
0.0549
00002242997
CALTRATE 600 MG WITH VITAMIN D SOFT CHEWS TABLET
ORL
CTB
WCH
TAB
0.1825
00002231948
CALTRATE 600 MG WITH VITAMIN D TABLET
ORL
TAB
WCH
TAB
0.1738
00080003751
CALTRATE 600 TABLET
ORL
TAB
PDH
TAB
0.1738
00002240959
CALTRATE PLUS CHEWABLE TABLET
ORL
CTB
WCH
TAB
0.2190
00080009423
CALTRATE PLUS CHEWABLES 400 IU
ORL
TAB
PDH
TAB
0.2221
00080009761
CALTRATE PLUS TABLET
ORL
TAB
PDH
TAB
0.1922
00080023065
CALTRATE SELECT 600 MG/400 IU TABLET
ORL
TAB
PDH
TAB
0.2198
00080033741
CALTRATE WITH VITAMIN D 600 MG/800 IU TABLET
ORL
TAB
PDH
TAB
0.1738
00080012593
CALTRATE WITH VITAMIN D SOFT CHEWS
ORL
CTB
WAY
TAB
0.1922
00002381680
CAMBIA 50 MG ORAL POWDER PACKET
ORL
PWDPKT
TRI
PCKT
10.0389
00002293269
CAMPRAL 333 MG DELAYED-RELEASE TABLET
ORL
DRT
MYP
TAB
0.8000
00002231622
CAMPTOSAR 20 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
111.1980
00002377942
CANDESARTAN 16 MG TABLET
ORL
TAB
PDL
TAB
0.2850
00002422069
ORL
TAB
PDL
TAB
0.2850
00002388901
ORL
TAB
SNS
TAB
0.3400
00002388693
ORL
TAB
SIV
TAB
0.3400
Pg 48 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002377934
ORL
TAB
PDL
TAB
0.2850
00002379260
CANDESARTAN CILEXETIL 4 MG TABLET
ORL
TAB
AHI
TAB
0.3400
00002392275
CANDESARTAN-HCTZ 16 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.2993
00080038188
CANDIBACTIN BR TABLET
ORL
TAB
MTG
TAB
0.3033
00080050373
CANDIBACTIN-AR CAPSULE
ORL
CAP
MTG
CAP
0.4550
00002311690
CANESORAL 150 MG CAPSULE
ORL
CAP
BIC
CAP
15.4200
00002311739
CANESORAL COMBI-PAK KIT
ORL/VAG
CAP/CRM
BIC
KIT
17.6300
00002311720
CANESTEN 1% EXTERNAL CREAM
TOP
CRM
BIC
G
13.3100
00002150867
CANESTEN 1% TOPICAL CREAM
TOP
CRM
BAI
G
0.3693
00080028872
CANTHACUR 0.7% TOPICAL SOLUTION
TOP
SOL
PMS
ML
7.1320
00000589500
CANTHACUR-PS TOPICAL SOLUTION
TOP
SOL
PMS
ML
8.5600
00000619035
CANTHARONE 0.7% TOPICAL SOLUTION
TOP
SOL
BAK
ML
6.6600
00080023975
CANTHARONE 0.7% TOPICAL SOLUTION
TOP
SOL
DLX
ML
6.6600
00000772011
CANTHARONE PLUS TOPICAL SOLUTION
TOP
SOL
DLX
ML
7.9933
00000619027
CANTHARONE PLUS TOPICAL SOLUTION
TOP
SOL
BAK
ML
7.9930
00002157101
CAPSAICIN 0.025% TOPICAL CREAM
TOP
CRM
VCL
G
0.1917
00002157128
CAPSAICIN 0.075% TOPICAL CREAM
TOP
CRM
VCL
G
0.2325
00002060043
CARBACHOL 2 MG TABLET
ORL
TAB
BNQ
TAB
0.5900
00002413590
CARBAMAZEPINE CR 200 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.0930
00002413604
CARBAMAZEPINE CR 400 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.1859
Pg 49 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002241999
CARBOCAINE 10 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
0.6313
00002242001
CARBOCAINE 20 MG/ ML INJECTION
INJ
DEFAUL
HSP
ML
1.3890
00002245511
CARBOCAL D 400 TABLET
ORL
TAB
EUP
TAB
0.1200
00002011239
CARBOLITH 600 MG CAPSULE
ORL
CAP
VCL
CAP
0.1848
00002126680
CARBOPLATIN 10 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
20.2124
00001958100
CARDURA-1 1 MG TABLET
ORL
TAB
PFI
TAB
0.6548
00001958097
ORL
TAB
PFI
TAB
0.7855
00001958119
ORL
TAB
PFI
TAB
1.0214
00002397447
CARIPUL 0.5 MG/VIAL INJECTION
INJ
DEFAUL
ACT
VIAL
17.1760
00002397455
CARIPUL 1.5 MG/VIAL INJECTION
INJ
DEFAUL
ACT
VIAL
34.4470
00002324520
CARVEDILOL 12.5 MG TABLET
ORL
TAB
PDL
TAB
0.6350
00002324539
CARVEDILOL 25 MG TABLET
ORL
TAB
PDL
TAB
0.6350
00002324504
ORL
TAB
PDL
TAB
0.6350
00002324512
ORL
TAB
PDL
TAB
0.6350
00002184478
CASODEX 50 MG TABLET
ORL
TAB
AZC
TAB
6.9733
00000259527
CATAPRES 0.1 MG TABLET
ORL
TAB
BOE
TAB
0.1853
00002245859
CATHFLO 1 MG/ML POWDER FOR SOLUTION
INJ
DEFAUL
HLR
ML
32.9340
00002215756
CAVERJECT 20 MCG INJECTION
INJ
DEFAUL
PFI
VIAL
30.3760
00000465208
CECLOR 25 MG/ML ORAL SUSPENSION
ORL
SUS
PPH
ML
0.1183
00000465186
CECLOR 250 MG CAPSULE
ORL
CAP
PPH
CAP
1.1092
Pg 50 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000832804
CECLOR 375 MG/5ML ORAL SUSPENSION
ORL
SUS
PHH
ML
0.2872
00000465216
CECLOR 50 MG/ML ORAL SUSPENSION
ORL
SUS
PPH
ML
0.2166
00000465194
CECLOR 500 MG CAPSULE
ORL
CAP
PPH
CAP
2.1777
00000360430
CEENU 10 MG CAPSULE
ORL
CAP
BMS
CAP
7.5150
00000360414
CEENU 100 MG CAPSULE
ORL
CAP
BMS
CAP
21.3850
00000360422
CEENU 40 MG CAPSULE
ORL
CAP
BMS
CAP
12.9550
00002237138
CEFAZOLIN 1 G/VIAL USP INJECTION
INJ
DEFAUL
FKC
VIAL
6.9000
00002437120
CEFAZOLIN 10 G/VIAL INJECTION
INJ
DEFAUL
STM
VIAL
30.1500
00002237137
CEFAZOLIN 500 MG/VIAL USP INJECTION
INJ
DEFAUL
FKC
VIAL
2.5000
00002437112
CEFAZOLIN FOR INJECTION 1 G/VIAL INJECTION
INJ
DEFAUL
STM
VIAL
3.2300
00002437104
CEFAZOLIN FOR INJECTION 500 MG/VIAL INJECTION
INJ
DEFAUL
STM
VIAL
2.5000
00002319039
CEFEPIME 2G/VIAL INJECTION
INJ
DEFAUL
APX
VIAL
30.1960
00002036274
CEFOTAN 1 G/VIAL INJECTION
INJ
DEFAUL
WAY
VIAL
15.0000
00002240773
CEFOXITIN 10 G/VIAL USP INJECTION
INJ
DEFAUL
TEV
VIAL
105.9500
00002332027
CEFPROZIL 50 MG/ML ORAL SUSPENSION
ORL
SUS
RAN
ML
0.2366
00002437848
CEFTAZIDIME 1 G/VIAL INJECTION
INJ
DEFAUL
STM
VIAL
22.9270
00000886971
INJ
DEFAUL
FKC
VIAL
31.9700
00000886955
INJ
DEFAUL
FKC
VIAL
60.8100
00002437856
INJ
DEFAUL
STM
VIAL
45.0770
00002439522
INJ
DEFAUL
STM
VIAL
67.5000
Pg 51 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000886963
INJ
DEFAUL
FKC
VIAL
190.9900
00002437864
INJ
DEFAUL
STM
VIAL
135.3000
00002212307
CEFTIN 125 MG/5ML ORAL SUSPENSION
ORL
SUS
GSK
ML
0.1722
00002409968
CEFTRIAXONE 100 G/SMARTPAK BULK PACKAGE INJECTION
INJ
DEFAUL
FKC
G
21.4200
00002292262
CEFTRIAXONE FOR INJECTION BP 0.25G/VIAL INJECTION
INJ
DEFAUL
SDZ
VIAL
7.5250
00002287668
CEFTRIAXONE SODIUM FOR INJECTION 10 G/VIAL INJ
INJ
DEFAUL
TEV
VIAL
214.2000
00002250292
CEFTRIAXONE SODIUM FOR INJECTION BP 1 G/VIAL INJ
INJ
DEFAUL
HSP
VIAL
36.3100
00002422301
CEFUROXIME 1.5 G/VIAL INJECTION USP
INJ
DEFAUL
STM
VIAL
39.7900
00002241639
INJ
DEFAUL
FKC
VIAL
39.7900
00002241640
INJ
DEFAUL
FKC
VIAL
149.2000
00002422328
INJ
DEFAUL
STM
VIAL
149.2000
00002422298
CEFUROXIME 750 MG/VIAL INJECTION USP
INJ
DEFAUL
STM
VIAL
19.8900
00002241638
CEFUROXIME 750 MG/VIAL INJECTION USP
INJ
DEFAUL
FKC
VIAL
19.8900
00002424371
CELECOXIB 100 MG CAPSULE
ORL
CAP
PDL
CAP
0.1776
00002424398
CELECOXIB 200 MG CAPSULE
ORL
CAP
PDL
CAP
0.3553
00002357844
CELESTODERM-V 0.1% TOPICAL CREAM
TOP
CRM
VCL
G
0.0911
00002357852
CELESTODERM-V 0.1% TOPICAL OINTMENT
TOP
ONT
VCL
G
0.0911
00002357860
CELESTODERM-V/2 0.05% TOPICAL CREAM
TOP
CRM
VCL
G
0.0611
00002357879
CELESTODERM-V/2 0.05% TOPICAL OINTMENT
TOP
ONT
VCL
G
0.0611
00002242145
CELLCEPT 200 MG/ ML ORAL SUSPENSION
ORL
SUS
HLR
ML
1.8536
Pg 52 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002192748
CELLCEPT 250 MG CAPSULE
ORL
CAP
HLR
CAP
2.0806
00002237484
CELLCEPT 500 MG TABLET
ORL
TAB
HLR
TAB
4.1612
00002240347
CELLCEPT I.V. 500 MG/VIAL INJECTION POWDER FOR SOL
INJ
DEFAUL
HLR
VIAL
32.0000
00000870153
CELLUVISC 1% OPH SOLUTION
OPH
SOL
ALL
ML
0.8217
00002299844
CELSENTRI 150 MG TABLET
ORL
TAB
PFI
TAB
16.6485
00002299852
CELSENTRI 300 MG TABLET
ORL
TAB
PFI
TAB
16.9815
00080013657
CENTRUM ADVANTAGE TABLET
ORL
TAB
PDH
TAB
0.1863
00080022930
CENTRUM CARDIO TABLET
ORL
TAB
PDH
TAB
0.2226
00080024482
CENTRUM FOR WOMEN
ORL
TAB
PDH
TAB
0.1440
00080005174
CENTRUM FORTE TABLET
ORL
TAB
PDH
TAB
0.1700
00080020794
CENTRUM JUNIOR COMPLETE CHEWABLE TABLET
ORL
CTB
PDH
TAB
0.1238
00002246440
CENTRUM SELECT CHEWABLE TABLET
ORL
CTB
WCH
TAB
0.2223
00080005153
CENTRUM SELECT TABLET
ORL
TAB
WCH
TAB
0.1563
00002246362
CENTRUM TABLET
ORL
TAB
PDH
TAB
0.0919
00080021452
CENTRUM TABLET
ORL
TAB
PDH
TAB
0.0919
00002099365
CEPACOL MINT WITH FLUORIDE MOUTHWASH
ORL
MWH
RBC
ML
0.0040
00000828866
CEPHALEXIN 500 MG TABLET
ORL
TAB
PDL
TAB
0.4500
00002410923
CERAVE TOPICAL LOTION
TOP
LOT
VCL
ML
0.1010
00002230988
CEREBYX 75 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
7.6000
00002230694
CEREZYME 200 U/VIAL INJECTION
INJ
DEFAUL
GZM
VIAL
1,230.0000
Pg 53 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002241751
CEREZYME 400 U/VIAL INJECTION
INJ
DEFAUL
GZM
VIAL
2,460.0000
00001926683
CERUBIDINE 20 MG/VIAL INJECTION
INJ
DEFAUL
ERF
VIAL
92.0000
00000158356
CERUMENEX 10% OTIC DROPS
OT
DPS
PUR
ML
0.5740
00000221570
CERUMOL OTIC DROPS
OT
DPS
PAL
ML
0.4900
00002342227
CERVARIX 0.5 ML INJECTION
INJ
DEFAUL
GSK
ML
187.0600
00002312263
CESAMET 0.25 MG ORAL CAPSULE
ORL
CAP
VCL
CAP
1.7384
00002450526
CETIRIZINE 20 MG TABLET
ORL
TAB
PDL
TAB
0.7535
00002247766
CETROTIDE 0.25 MG/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
90.0000
00002247767
CETROTIDE 3 MG/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
340.0000
00000496685
CHELATED CHROMIUM 200 MCG TABLET
ORL
TAB
JAM
TAB
0.0721
00080009742
CHEWABLE PEPPERMINT VITAMIN D 1000 IU
ORL
TAB
SWS
TAB
0.0479
00002248435
CHILDREN'S ADVIL COLD ORAL SUSPENSION
ORL
SUS
PDH
ML
0.0590
00002354799
CHILDREN'S EUROPROFEN 20 MG/ML ORAL SUSPENSION
ORL
SUS
PPH
ML
0.0541
00002238626
CHILDREN'S MOTRIN 40 MG/ML SUSPENSION DROPS
ORL
DPS
MCL
ML
0.1907
00002238295
CHILDRENS TYLENOL 80 MG CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.1708
00000870455
CHILDRENS TYLENOL COLD DM CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.1763
00002039990
CHILDREN'S TYLENOL COLD DM ORAL SUSPENSION
ORL
SUS
MCL
ML
0.0540
00002229538
CHILDRENS TYLENOL DECONGESTANT LIQUID
ORL
LIQ
MCL
ML
0.0540
00002046040
CHILDREN'S TYLENOL GRAPE 32 MG/ML ORAL SUSPENSION
ORL
SUS
MCL
ML
0.0540
00002247621
CHLORAL HYDRATE-ODAN 100 MG/ML ORAL SYRUP
ORL
SYR
ODN
ML
0.0433
Pg 54 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000743518
CHLORPROMAZINE HCL 25 MG/ML (BASE) INJECTION
INJ
DEFAUL
SDZ
ML
1.8350
00000738972
CHLOR-TRIPOLON 4 MG TABLET
ORL
TAB
SCH
TAB
0.2117
00001970399
CHLOR-TRIPOLON N.D. SUSTAINED-RELEASE TABLET
ORL
TAB
SCH
TAB
0.4342
00080015373
CHONDROCARE TABLET
ORL
TAB
MTG
TAB
0.4500
00002247459
CHORIONIC GONADOTROPIN 10,000 UNIT/VIAL INJECTION
INJ
DEFAUL
FKC
VIAL
126.0000
00080005091
CHROMIUM GTF TABLET
ORL
TAB
WNP
TAB
0.0412
00002248088
CIALIS 10 MG TABLET
ORL
TAB
LIL
TAB
11.9575
00002296888
CIALIS 2.5 MG TABLET
ORL
TAB
LIL
TAB
3.6568
00002248089
CIALIS 20 MG TABLET
ORL
TAB
LIL
TAB
12.3900
00002296896
CIALIS 5 MG TABLET
ORL
TAB
LIL
TAB
3.6568
00002238273
CI-CAL 250 MG TABLET
ORL
TAB
EUP
TAB
0.1368
00002410346
CICLOPIROX 8% TOPICAL SOLUTION
TOP
SOL
STM
G
7.7433
00002350963
CILAZAPRIL 1 MG TABLET
ORL
TAB
SNS
TAB
0.1557
00002350998
CILAZAPRIL 5 MG TABLET
ORL
TAB
SNS
TAB
0.2085
00002200864
CILOXAN 0.3% OPH OINTMENT
OPH
ONT
ALC
G
3.1743
00080005972
CINNAMON 500 MG CAPSULE
ORL
CAP
VTH
CAP
0.0600
00002391449
CIPRALEX MELTZ 10 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
LBC
TAB
1.7600
00002391457
CIPRALEX MELTZ 20 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
LBC
TAB
1.8737
00002251787
CIPRO XL 1000 MG EXTENDED-RELEASE TABLET
ORL
ERT
BAI
TAB
3.1120
00002247916
CIPRO XL 500 MG EXTENDED-RELEASE TABLET
ORL
ERT
BAI
TAB
3.1120
Pg 55 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002353334
CIPROFLOXACIN 750 MG TABLET
ORL
TAB
SNS
TAB
1.2780
00002304759
CIPROFLOXACIN INTRAVENOUS INFUSION BP 2 MG/ML INJ
INJ
DEFAUL
SDZ
ML
0.1540
00002403188
CISPLATIN 1 MG/ML INJECTION
INJ
DEFAUL
TEV
ML
6.1524
00002126613
CISPLATIN 1 MG/ML INJECTION
INJ
DEFAUL
MNP
ML
6.4600
00002301822
CITALOPRAM 10 MG TABLET
ORL
TAB
MEL
TAB
0.4464
00002301830
ORL
TAB
MEL
TAB
0.8750
00002301849
ORL
TAB
MEL
TAB
0.8750
00002325047
CITALOPRAM-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.1432
00002306247
CITALOPRAM-ODAN 40 MG TABLET
ORL
TAB
ODN
TAB
0.2397
00002257521
CITALOPROM-40 40 MG TABLET
ORL
TAB
PDL
TAB
0.3329
00000519235
CITANEST PLAIN 4% INJECTION
INJ
DEFAUL
DSC
ML
0.8658
00002150220
CITRACAL MG TABLET
ORL
TAB
BAI
TAB
0.1535
00002150158
CITRACAL PLUS D CAPLET
ORL
TAB
SFD
TAB
0.1548
00000701416
CITRAMINS CAPSULE
ORL
CAP
XXX
CAP
0.1856
00080007797
CITRAMINS II CAPSULE
ORL
CAP
XXX
CAP
0.1856
00000262609
CITRO MAG 50 MG ORAL LIQUID
ORL
LIQ
ROG
ML
0.0146
00002324482
CLARITHROMYCIN 250 MG TABLET
ORL
TAB
PDL
TAB
0.4122
00002324490
ORL
TAB
PDL
TAB
1.6297
00002442485
ORL
TAB
SIV
TAB
1.6292
00002237734
CLARITIN 10 MG RAPID DISSOLVE TONGUE TABLET
ORL
DISPTAB
BIC
TAB
0.6700
Pg 56 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000782696
CLARITIN 10 MG TABLET
ORL
TAB
BIC
TAB
0.8356
00001945157
CLARITIN EXTRA SUSTAINED-RELEASE TABLET
ORL
SRT
BIC
TAB
0.6700
00000442968
CLEARASIL BP PLUS 5% TOPICAL LOTION
TOP
LOT
RBC
ML
0.1707
00002324989
CLEARLAX ORAL POWDER
ORL
PWR
PRI
G
0.0275
00002250616
CLIMARA PRO 4.40 MG/1.39 MG TRANSDERMAL PATCH
TRD
PTH
BAI
PTH
6.6950
00002408511
CLINDAMYCIN IV INFUSION 12 MG/ML MINIBAG INJECTION
INJ
DEFAUL
SDZ
ML
0.3724
00002408538
CLINDAMYCIN IV INFUSION 18 MG/ML MINIBAG INJECTION
INJ
DEFAUL
SDZ
ML
0.5186
00002248525
CLINDAMYCINE-150 150 MG TABLET
ORL
TAB
PDL
TAB
0.2217
00002248526
CLINDAMYCINE-300 300 MG CAPSULE
ORL
CAP
PDL
CAP
0.4434
00002243659
CLINDA-T 1% (BASE) TOPICAL SOLUTION
TOP
SOL
VCL
ML
0.2163
00002243050
CLINDETS PLEDGET 1% TOPICAL PAD
TOP
PAD
GSK
PAD
0.6698
00080007070
CLINIDERM GENTLE SPF 45 LOTION
TOP
LOT
SAH
ML
0.2415
00002248454
CLOBAZAM-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.1097
00002256398
CLOBEX 0.05% TOPICAL LOTION
TOP
LOT
GAL
ML
0.8763
00002256371
CLOBEX 0.05% TOPICAL SHAMPOO
TOP
SHP
GAL
ML
0.9376
00002299739
CLOBEX 0.05% TOPICAL SPRAY
TOP
SPR
GAL
ML
1.9069
00002442027
CLONAZEPAM 0.25 MG TABLET
ORL
TAB
SIV
TAB
0.0774
00002442043
CLONAZEPAM 1 MG TABLET
ORL
TAB
SIV
TAB
0.1487
00001910396
CLONIDINE 0.1 MG TABLET
ORL
TAB
PDL
TAB
0.1358
00002394820
CLOPIDOGREL 75 MG TABLET
ORL
TAB
PDL
TAB
0.6577
Pg 57 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000812382
CLOTRIMADERM 1% TOPICAL CREAM
TOP
CRM
TAR
G
0.3065
00002229380
CLOTRIMAZOLE 1% TOPICAL CREAM USP
TOP
CRM
TAR
G
0.2100
00002274337
CO BICALUTAMIDE 50 MG TABLET
ORL
TAB
APH
TAB
4.0573
00002390183
CO EXEMESTANE 25 MG TABLET
ORL
TAB
APH
TAB
3.9008
00080006266
CO Q10 100 MG CAPSULE
ORL
CAP
SIS
CAP
0.1666
00080007078
CO Q10 LIQUID
ORL
LIQ
INN
ML
0.7941
00002244814
CO TEMAZEPAM 15 MG CAPSULE
ORL
CAP
APH
CAP
0.0438
00002244815
CO TEMAZEPAM 30 MG CAPSULE
ORL
CAP
APH
CAP
0.0526
00002383209
CO TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
APH
TAB
0.6264
00000068594
COACTIFED ORAL SYRUP
ORL
SYR
GSK
ML
0.1643
00000068608
COACTIFED TABLET
ORL
TAB
GSK
TAB
1.0012
00002150417
COATED ASPIRIN 325 MG CAPLET
ORL
ECT
BAI
TAB
0.0802
00002237726
COATED ASPIRIN DAILY LOW DOSE 81 MG ECT
ORL
ECT
BIC
TAB
0.1087
00002150425
COATED ASPIRIN EXTRA STRENGTH 500 MG CAPLET
ORL
ECT
BAI
TAB
0.0755
00002243897
COATED DAILY LOW-DOSE ASA 81 MG TABLET
ORL
ECT
PMS
TAB
0.0433
00002009757
CODEINE 30 MG TABLET
ORL
TAB
RIV
TAB
0.0773
00002163748
CODEINE CONTIN 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PUR
TAB
0.6780
00002163780
ORL
SRT
PUR
TAB
1.0170
00002163799
ORL
SRT
PUR
TAB
1.3560
00002230302
ORL
SRT
PUR
TAB
0.3390
Pg 58 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000050024
CODEINE PHOSPHATE 5 MG/ML ORAL SYRUP
ORL
SYR
ATL
ML
0.0569
00002248644
COENZYME Q10 100 MG CAPSULE
ORL
CAP
VTH
CAP
0.3266
00002246219
ORL
CAP
WNP
CAP
0.1403
00080010367
COENZYME Q10 150 MG SOFTGEL
ORL
CAP
WBP
CAP
0.3887
00080006827
ORL
CAP
WNP
CAP
0.1237
00080006674
ORL
CAP
WNP
CAP
0.2473
00002231735
ORL
CAP
WNP
CAP
0.3000
00002245926
ORL
CAP
WNP
CAP
0.2540
00080006505
COENZYME Q10 SOFTGEL
ORL
TAB
WNP
TAB
0.1390
00000287873
COLCHICINE 0.6 MG TABLET
ORL
TAB
EUP
TAB
0.2565
00000642975
COLESTID ORAL POWDER PACKET
ORL
PWDPKT
PFI
PCKT
1.0997
00002132699
COLESTID ORANGE 7.5 G ORAL POWDER PACKET
ORL
PWDPKT
PFI
PCKT
1.0997
00000476420
COLY-MYCIN M 150 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
39.5000
00001944363
COMBANTRIN 125 MG TABLET
ORL
TAB
MCL
TAB
1.1083
00001944355
COMBANTRIN 50 MG/ML ORAL SUSPENSION
ORL
SUS
MCL
ML
0.2789
00002419106
COMBIVENT RESPIMAT 20 MCG/100 MCG INH SOLUTION
INH
SOL
BOE
DOSE
0.2392
00002239213
COMBIVIR 150 MG/300 TABLET
ORL
TAB
GSK
TAB
10.9050
00002374129
COMPLERA 200 MG/25 MG/300 MG TABLET
ORL
TAB
GIL
TAB
41.5741
00002229633
COMPLETE MULTI-ADULT TABLET
ORL
TAB
WAM
TAB
0.0607
00000999760
COMPLEX 15 DAILY FACE CREAM
TOP
CRM
MFC
ML
0.0632
Pg 59 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002247732
CONCERTA 18 MG EXTENDED-RELEASE TABLET
ORL
ERT
JAI
TAB
2.1887
00002250241
ORL
ERT
JAI
TAB
2.5259
00002247733
ORL
ERT
JAI
TAB
2.8631
00002247734
ORL
ERT
JAI
TAB
3.5373
00001945149
CONDYLINE 0.5% TOPICAL SOLUTION
TOP
SOL
SAV
ML
11.8086
00002417162
CONSTELLA 145 MCG CAPSULE
ORL
CAP
FLC
CAP
3.3000
00002417170
CONSTELLA 290 MCG CAPSULE
ORL
CAP
FLC
CAP
5.3000
00002224577
COPHYLAC ORAL SOLUTION
ORL
SOL
VCL
ML
2.2687
00002176955
COQ10 30 MG CAPSULE
ORL
CAP
JAM
CAP
0.2248
00080012965
COQ10 MRB 60 MG SOFTGEL CAPSULE
ORL
CAP
INN
CAP
0.7950
00002036282
CORDARONE 200 MG TABLET
ORL
TAB
PFI
TAB
2.0589
00000513288
CORTATE 0.5% TOPICAL CREAM
TOP
CRM
MFC
G
0.1333
00000022381
CORTROSYN 0.25 MG/VIAL INJECTION
INJ
DEFAUL
LYN
VIAL
98.7600
00002181215
COTAZYM ECS 4 CAPSULE (ENTERIC-COATED PELLET)
ORL
CAP/ENCP
ORG
CAP
0.1795
00002452340
COTELLIC 20 MG TABLET
ORL
TAB
HLR
TAB
120.1111
00002099748
COUGH SYRUP WITH CODEINE
ORL
SYR
ROG
ML
0.0162
00002240206
COUMADIN 6 MG TABLET
ORL
TAB
BMS
TAB
0.5010
00002243063
COVAN ORAL SYRUP
ORL
SYR
PMS
ML
0.0573
00002246568
COVERSYL PLUS LD 2 MG/0.625 MG TABLET
ORL
TAB
SEV
TAB
0.8477
00080018683
CRANBERRY 500 MG CAPSULE
ORL
CAP
VCL
CAP
0.0516
Pg 60 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080027158
CRANBERRY COMPLEX 500 MG CAPSULE
ORL
CAP
JAM
CAP
0.1965
00002415194
CREON MINIMICROSPHERES 6 CAPSULE
ORL
CAP/ENCP
BGP
CAP
0.1703
00002445158
CREON MINIMICROSPHERES MICRO GRANULES
ORL
GRNUL
BGP
G
1.7030
00000299561
CREO-RECTAL ADULT RECTAL SUPPOSITORY
RT
SUP
SDZ
SUP
0.7500
00000299588
CREO-RECTAL INFANT RECTAL SUPPOSITORY
RT
SUP
SDZ
SUP
0.6020
00000299596
CREO-RECTAL INFANT RECTAL SUPPOSITORY
RT
SUP
SDZ
SUP
0.7500
00002241013
CRINONE 8% VAGINAL GEL
VAG
GEL
SRO
G
8.2759
00002277778
CRITIC-AID CLEAR OINTMENT
TOP
ONT
COC
G
0.0885
00002229161
CRIXIVAN 200 MG CAPSULE
ORL
CAP
MFC
CAP
1.3467
00002229196
CRIXIVAN 400 MG CAPSULE
ORL
CAP
MFC
CAP
2.6933
00002089912
CUTIVATE 0.05% TOPICAL CREAM
TOP
CRM
GKC
G
0.7250
00002424584
CYCLOBENZAPRINE 10 MG TABLET
ORL
TAB
SIV
TAB
0.3727
00002220644
CYCLOBENZAPRINE 10 MG TABLET
ORL
TAB
PDL
TAB
0.3727
00002148331
CYCLOPENTOLATE HCL 0.5% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00002148382
CYCLOPENTOLATE HCL 1% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00002290308
CYESTRA-35 TABLET
ORL
TAB
PMS
TAB
1.1114
00002064405
CYKLOKAPRON 500 MG TABLET
ORL
TAB
PFI
TAB
1.3054
00002443805
CYRAMZA 10 MG/ ML INJECTION
INJ
DEFAUL
LIL
ML
8.4858
00002238526
CYSTADANE 1 G/SCOOP ORAL POWDER
ORL
PWR
ORP
G
4.5524
00080038525
CYSTA-Q CAPSULE
ORL
CAP
SLP
CAP
0.4900
Pg 61 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002126656
CYTARABINE 100MG/ ML INJECTION
INJ
DEFAUL
MNP
ML
12.6700
00000386715
CYTOSAR 100 MG/5 ML INJECTION
INJ
DEFAUL
PFI
VIAL
10.7240
00002444747
DAKLINZA 30 MG TABLET
ORL
TAB
BMS
TAB
428.5700
00002444755
DAKLINZA 60 MG TABLET
ORL
TAB
BMS
TAB
428.5700
00002060604
DALACIN 2% VAGINAL CREAM
VAG
CRM
PAL
G
0.7997
00000030570
DALACIN C 150 MG CAPSULE
ORL
CAP
PFI
CAP
1.3482
00002182866
DALACIN C 300 MG CAPSULE
ORL
CAP
PFI
CAP
2.6961
00000582301
DALACIN T 1% (BASE) TOPICAL SOLUTION
TOP
SOL
PFI
ML
0.4757
00000507415
DAN-GARD 2% TOPICAL SHAMPOO
TOP
SHP
VLP
ML
0.0400
00001997653
DANTRIUM 100 MG CAPSULE
ORL
CAP
PAR
CAP
0.7684
00002455951
DARZALEX 100 MG/5 ML INJECTION
INJ
DEFAUL
JAI
ML
119.6040
00002455978
DARZALEX 400 MG/20 ML INJECTION
INJ
DEFAUL
JAI
ML
119.6040
00002359456
DAXAS 500 MCG TABLET
ORL
TAB
TAK
TAB
2.1000
00002027860
DAYPRO 600 MG TABLET
ORL
TAB
PFI
TAB
0.7255
00002285002
DDAVP MELT 120 MCG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
FEI
TAB
1.9823
00002285010
ORL
DISNTAB
FEI
TAB
3.5683
00002284995
ORL
DISNTAB
FEI
TAB
0.9910
00080001791
DDROPS 1,000 IU/DROP ORAL LIQUID
ORL
LIQ
DDR
ML
1.3800
00002389282
DECAPEPTYL 0.1 MG/ML INJECTION SYRINGE
INJ
DEFAUL
FEI
SYR
12.0000
00000791172
DECONGEST 0.1 MG NASAL SOLUTION
NAS
SOL
RPH
ML
0.1510
Pg 62 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002236796
DEEP PORE ACNE VANISHING TREATMENT 5% LOTION
TOP
LOT
MNT
ML
0.1964
00002018403
DELSYM 6 MG/ML CONTROLLED-RELEASE SUSPENSION
ORL
CRSUS
NVC
ML
0.0634
00000030848
DEPO-PROVERA 50 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
6.7720
00000681989
DERMAFLEX HC 1% CREAM
TOP
CRM
PAL
G
0.1833
00000681997
DERMAFLEX HC 1% TOPICAL LOTION
TOP
LOT
PAL
ML
0.1833
00002247093
DERMAL THERAPY- HEEL CARE CREAM
TOP
CRM
DTR
ML
0.0792
00002239903
DERMALAC 12% CREAM
TOP
CRM
TAR
G
0.0571
00000873292
DERMA-SMOOTHE/FS 0.01% TOPICAL OIL
TOP
OIL
HDI
ML
0.2809
00002230642
DERMATOP 0.1% EMOLLIENT CREAM
TOP
EMCRM
VCL
G
1.7635
00002227517
DERMATOP 0.1% TOPICAL OINTMENT
TOP
ONT
VCL
G
1.5547
00002238407
DERMAZINC 0.25% TOPICAL SPRAY
TOP
SPR
DPI
ML
0.2333
00002300559
DERMOTIC OIL EAR DROPS 0.01% OTIC SOLUTION
OT
SOL
HDI
ML
1.6000
00002454416
DESCOVY 200 MG/10 MG TABLET
ORL
TAB
GIL
TAB
28.5700
00002454424
DESCOVY 200 MG/25 MG TABLET
ORL
TAB
GIL
TAB
28.5700
00002216280
DESIPRAMINE 100 MG TABLET
ORL
TAB
AAP
TAB
0.9093
00001942417
DESITIN DIAPER RASH OINTMENT
TOP
ONT
JJI
G
0.0588
00002298155
DESLORATADINE ALLERGY CONTROL 5 MG TABLET
ORL
TAB
PMS
TAB
0.5193
00002239064
DETROL 1 MG TABLET
ORL
TAB
PFI
TAB
1.0217
00002239065
DETROL 2 MG TABLET
ORL
TAB
PFI
TAB
1.0217
00002204274
DEXAMETHASONE OMEGA 10 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
1.2830
Pg 63 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002204266
DEXAMETHASONE OMEGA 4 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
1.6060
00000489158
DEXASONE 4 MG TABLET
ORL
TAB
VCL
TAB
0.8140
00000832030
DEXIDIN 20 MG TOPICAL SOLUTION
TOP
LIQ
ATL
ML
0.0383
00000832111
DEXIDIN 4 % TOPICAL LIQUID
TOP
LIQ
ATL
ML
0.0261
00002354950
DEXILANT 30 MG DELAYED-RELEASE CAPSULE
ORL
DRC
TAK
CAP
2.2000
00002354969
DEXILANT 60 MG DELAYED-RELEASE CAPSULE
ORL
DRC
TAK
CAP
2.2000
00000833231
DEXTROMETHORPHAN 15 MG/5 ML COUGH SYRUP
ORL
SYR
TAN
ML
0.0199
00000060348
DEXTROSE 5% 5 G/100 ML USP INJECTION
INJ
DEFAUL
BAX
ML
0.0857
00002058235
DEY-PAK SODIUM CHLORIDE 0.9% INHALATION SOLUTION
INH
SOL
MYP
ML
0.0567
00002237450
D-FORTE 50000 IU CAPSULE
ORL
CAP
EUP
CAP
0.1986
00002398982
DIACOMIT 500 MG ORAL POWDER PACKET
ORL
PWDPKT
BCF
PCKT
11.7783
00080028781
DIAMINE TABLET
ORL
TAB
EUP
TAB
0.0631
00002245391
DIAMINE TABLET
ORL
TAB
EUP
TAB
0.0631
00002233542
DIANE-35 2 MG/0.035 MG TABLET
ORL
TAB
BHP
TAB
1.7200
00002337452
DIAPER RASH 15% TOPICAL CREAM
TOP
CRM
HJS
G
0.0093
00002229552
DIARR-EZE 2 MG CAPLET
ORL
TAB
PMS
TAB
0.3000
00002248994
DIARRHEA RELIEF 2 MG TABLET
ORL
TAB
PMS
TAB
0.1778
00002238162
DIASTAT RECTAL DELIVERY SYS 5 MG/ML RECTAL GEL
RT
GEL
VCL
SYS
79.0900
00002065614
DIAZEMULS 5 MG/ML EMULSION INJECTION
INJ
EML
PFI
ML
1.1520
00000434388
DIAZEPAM 10 MG TABLET
ORL
TAB
PDL
TAB
0.0867
Pg 64 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000313580
DIAZEPAM 5 TABLET
ORL
TAB
PDL
TAB
0.0650
00002434571
DICLOFENAC 1.5% TOPICAL SOLUTION
TOP
SOL
STM
ML
0.6226
00000870978
DICLOFENAC 50 MG ENTERIC-COATED TABLET
ORL
ECT
PDL
TAB
0.2024
00002351684
DICLOFENAC POTASSIUM 50 MG TABLET
ORL
TAB
SNS
TAB
0.3937
00002352400
DICLOFENAC SODIUM SR 75 MG TABLET
ORL
SRT
SNS
TAB
0.2320
00002224127
DICLOFENAC-SR 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.4048
00002224119
DICLOFENAC-SR 75 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.2320
00002231592
DIFFERIN 0.1% TOPICAL CREAM
TOP
CRM
GAL
G
1.9940
00002148749
DIFFERIN 0.1% TOPICAL GEL
TOP
GEL
GAL
G
1.9940
00002274000
DIFFERIN XP 0.3% TOPICAL GEL
TOP
GEL
GAL
G
2.2287
00002039486
DIFLUNISAL 250 MG TABLET
ORL
TAB
AAP
TAB
0.5646
00002039494
DIFLUNISAL 500 MG TABLET
ORL
TAB
AAP
TAB
0.7150
00080056878
DIGEST GOLD CAPSULE
ORL
CAP
EMI
CAP
0.4291
00002048264
DIGOXIN 0.25 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
6.6820
00002048272
DIGOXIN PEDIATRIC 0.05 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
11.1700
00002325306
DILTIAZEM TZ 120 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
PDL
CAP
0.2133
00002325314
ORL
ERC
PDL
CAP
0.2889
00002325322
ORL
ERC
PDL
CAP
0.3832
00002325330
ORL
ERC
PDL
CAP
0.4719
00002325349
ORL
ERC
PDL
CAP
0.5778
Pg 65 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002231472
DILTIAZEM-CD 120 MG CONTROLLED-DELIVERY CAPSULE
ORL
CDC
PDL
CAP
0.4061
00002231474
ORL
CDC
PDL
CAP
0.5392
00002231475
ORL
CDC
PDL
CAP
0.7151
00002231057
ORL
CDC
PDL
CAP
0.8939
00002300648
DIMENHYDRINATE 50 MG/ML INJECTION
INJ
DEFAUL
ALV
ML
2.5000
00002244079
DIMETANE EXPECTORANT C ORAL SYRUP
ORL
SYR
PDH
ML
0.0919
00002244080
DIMETANE EXPECTORANT DC ORAL SYRUP
ORL
SYR
PDH
ML
0.1242
00002243969
DIMETAPP DM COUGH & COLD ORAL LIQUID
ORL
LIQ
PDH
ML
0.0513
00002243091
DIMETAPP NIGHTTIME COLD EXTRA STRENGTH CAPLET
ORL
TAB
WCH
TAB
0.3125
00002244078
DIMETAPP-C ORAL SYRUP
ORL
SYR
PDH
ML
0.1111
00001997769
DIODOQUIN 210 MG TABLET
ORL
TAB
GLE
TAB
0.7533
00001997750
DIODOQUIN 650 MG TABLET
ORL
TAB
GLE
TAB
0.9347
00002027100
DIONEPHRINE 2.5% OPH SOLUTION
OPH
SOL
DIO
ML
0.7180
00002270528
DIOVAN 40 MG TABLET
ORL
TAB
NOV
TAB
1.2021
00002157624
DIOVOL PLUS AF CHEWABLE TABLET
ORL
CTB
CHD
TAB
0.1188
00002157616
DIOVOL PLUS AF-SUSPENSION
ORL
SUS
CHD
ML
0.0170
00000116815
DIOVOL PLUS ORAL SUSPENSION
ORL
SUS
CHD
ML
0.0170
00000116882
DIOVOL PLUS TABLET
ORL
TAB
CHD
TAB
0.1188
00002257548
DIPHENHYDRAMINE HYDROCHLORIDE 25 MG CAPLET
ORL
TAB
JPC
TAB
0.1379
00002257556
DIPHENHYDRAMINE HYDROCHLORIDE 50 MG CAPLET
ORL
TAB
JPC
TAB
0.1659
Pg 66 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002369567
DIPHENHYDRAMINE HYDROCHLORIDE 50 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
4.3900
00002219336
DIPHENIST 50 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
4.1500
00002018950
DIPRIVAN EML IV 10 MG/ML INJECTION
INJ
DEFAUL
AZC
ML
0.5200
00000417262
DIPROGEN TOPICAL CREAM
TOP
CRM
SCH
G
0.8556
00002243961
DITROPAN XL 10 MG EXTENDED-RELEASE TABLET
ORL
ERT
JAI
TAB
2.3292
00002243960
DITROPAN XL 5 MG EXTENDED-RELEASE TABLET
ORL
ERT
JAI
TAB
2.3292
00002240341
DIVALPROEX-125 MG ENTERIC-COATED TABLET
ORL
ECT
PDL
TAB
0.0724
00002240342
ORL
ECT
PDL
TAB
0.1301
00002240343
ORL
TAB
PDL
TAB
0.2604
00002228335
DOBUTAMINE HYDROCHLORIDE 12.5 MG/ML INJECTION
INJ
DEFAUL
TEV
VIAL
23.2500
00002412225
DOCETAXEL 28 MG/ML (20 MG/0.72 ML) INJECTION
INJ
DEFAUL
TEV
ML
317.3194
00002412233
DOCETAXEL 28 MG/ML (80 MG/2.88 ML) INJECTION
INJ
DEFAUL
TEV
ML
317.3194
00002246741
DOCUSATE CALCIUM 240 MG CAPSULE
ORL
CAP
ROG
CAP
0.1283
00000870218
DOCUSATE SODIUM 10 MG/ML ORAL DROPS
ORL
DPS
ROG
ML
0.1996
00002326086
DOCUSATE SODIUM 100 MG CAPSULE
ORL
CAP
PDL
CAP
0.0250
00000830267
ORL
CAP
TLI
CAP
0.0338
00002246036
ORL
CAP
ROG
CAP
0.0405
00002245946
ORL
CAP
JPC
CAP
0.0250
00000794406
ORL
CAP
VTH
CAP
0.0334
00002246854
DOCUSATE SODIUM 4 MG/ML ORAL SYRUP
ORL
SYR
ROG
ML
0.0245
Pg 67 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000614491
DOLORAL 1 MG ORAL SYRUP
ORL
SYR
ATL
ML
0.0335
00000614505
DOLORAL 5 MG/ML ORAL SYRUP
ORL
SYR
ATL
ML
0.0573
00002130963
DOM-AMANTADINE 100 MG CAPSULE
ORL
CAP
DPC
CAP
0.5179
00002246331
DOM-AMIODARONE 200 MG TABLET
ORL
TAB
DPC
TAB
0.6177
00002326841
DOM-AMLODIPINE 10 MG TABLET
ORL
TAB
DPC
TAB
0.3587
00002326825
DOM-AMLODIPINE 2.5 MG TABLET
ORL
TAB
DPC
TAB
0.1380
00002326833
DOM-AMLODIPINE 5 MG TABLET
ORL
TAB
DPC
TAB
0.2417
00002229468
DOM-ATENOLOL 100 MG TABLET
ORL
TAB
DPC
TAB
0.2362
00002229467
DOM-ATENOLOL 50 MG TABLET
ORL
TAB
DPC
TAB
0.1437
00002399482
DOM-ATORVASTATIN 10 MG TABLET
ORL
TAB
DPC
TAB
0.3137
00002399490
ORL
TAB
DPC
TAB
0.3922
00002399504
ORL
TAB
DPC
TAB
0.4216
00002278499
DOM-AZITHROMYCIN 250 MG TABLET
ORL
TAB
DPC
TAB
1.2317
00002138271
DOM-BACLOFEN 10 MG TABLET
ORL
TAB
DPC
TAB
0.1595
00002232564
DOM-BUSPIRONE 10 MG TABLET
ORL
TAB
DPC
TAB
0.3521
00002238222
DOM-CARBAMAZEPINE CR 200 MG SUSTAINED-RELEASE TAB
ORL
SRT
DPC
TAB
0.1301
00002238223
DOM-CARBAMAZEPINE CR 400 MG SUSTAINED-RELEASE TAB
ORL
SRT
DPC
TAB
0.2602
00002251280
DOM-CIPROFLOXACIN 500 MG TABLET
ORL
TAB
DPC
TAB
0.6979
00002273055
DOM-CITALOPRAM 10 MG TABLET
ORL
TAB
DPC
TAB
0.1432
00002351005
DOM-CLARITHROMYCIN 500 MG TABLET
ORL
TAB
DPC
TAB
1.6293
Pg 68 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002247230
DOM-CLOBAZAM 10 MG TABLET
ORL
TAB
DPC
TAB
0.1538
00002130998
DOM-CLONAZEPAM 0.5 MG TABLET
ORL
TAB
DPC
TAB
0.0554
00002131013
DOM-CLONAZEPAM 2 MG TABLET
ORL
TAB
DPC
TAB
0.0954
00002224100
DOM-CLONAZEPAM-R 0.5 MG TABLET
ORL
TAB
DPC
TAB
0.0694
00002238633
DOM-CYCLOBENZAPRINE 10 MG TABLET
ORL
TAB
DPC
TAB
0.3727
00002130092
DOM-DESIPRAMINE 25 MG TABLET
ORL
TAB
DPC
TAB
0.2723
00002231662
DOM-DICLOFENAC 25 MG ENTERIC-COATED TABLET
ORL
ECT
DPC
TAB
0.1094
00002231664
DOM-DICLOFENAC-SR 75 MG SUSTAINED-RELEASE TABLET
ORL
SRT
DPC
TAB
0.2320
00002238315
DOM-DOMPERIDONE 10 MG TABLET
ORL
TAB
DPC
TAB
0.0831
00002376709
DOM-FINASTERIDE 5 MG TABLET
ORL
TAB
DPC
TAB
0.4633
00002246109
DOM-FLUCONAZOLE 100 MG TABLET
ORL
TAB
DPC
TAB
3.2047
00002246108
DOM-FLUCONAZOLE 50 MG TABLET
ORL
TAB
DPC
TAB
1.8065
00002177617
DOM-FLUOXETINE 10 MG CAPSULE
ORL
CAP
DPC
CAP
0.8650
00002177625
DOM-FLUOXETINE 20 MG CAPSULE
ORL
CAP
DPC
CAP
0.6438
00002241348
DOM-FLUVOXAMINE 100 MG TABLET
ORL
TAB
DPC
TAB
0.5297
00002241347
DOM-FLUVOXAMINE 50 MG TABLET
ORL
TAB
DPC
TAB
0.2947
00002243743
DOM-GABAPENTIN 100 MG CAPSULE
ORL
CAP
DPC
CAP
0.1456
00002243744
ORL
CAP
DPC
CAP
0.3542
00002243745
ORL
CAP
DPC
CAP
0.4221
00002241608
DOM-GEMFIBROZIL 300 MG CAPSULE
ORL
CAP
DPC
CAP
0.1803
Pg 69 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002234514
DOM-GLYBURIDE 5 MG TABLET
ORL
TAB
DPC
TAB
0.0683
00002239913
DOM-INDAPAMIDE 1.25 MG TABLET
ORL
TAB
DPC
TAB
0.0745
00002239917
DOM-INDAPAMIDE 2.5 MG TABLET
ORL
TAB
DPC
TAB
0.1182
00002372193
DOM-IRBESARTAN 150 MG TABLET
ORL
TAB
DPC
TAB
0.3025
00002414775
DOM-LANSOPRAZOLE 30 MG DELAYED-RELEASE CAPSULE
ORL
DRC
DPC
CAP
0.5000
00002245784
DOM-LORAZEPAM 0.5 MG TABLET
ORL
TAB
DPC
TAB
0.0359
00002245785
DOM-LORAZEPAM 1 MG TABLET
ORL
TAB
DPC
TAB
0.0447
00002247232
DOM-LOVASTATIN 40 MG TABLET
ORL
TAB
DPC
TAB
1.2579
00002242726
DOM-METFORMIN 850 MG TABLET
ORL
TAB
DPC
TAB
0.1186
00002231122
DOM-METOPROLOL-L 100 MG TABLET
ORL
TAB
DPC
TAB
0.1714
00002231121
DOM-METOPROLOL-L 50 MG TABLET
ORL
TAB
DPC
TAB
0.0786
00002376695
DOM-MONTELUKAST FC 10 MG TABLET
ORL
TAB
DPC
TAB
0.8195
00002178729
DOM-NORTRIPTYLINE 10 MG CAPSULE
ORL
CAP
DPC
CAP
0.0772
00002178737
DOM-NORTRIPTYLINE 25 MG CAPSULE
ORL
CAP
DPC
CAP
0.1560
00002125145
DOM-NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION
ORL
SUS
DPC
ML
0.0521
00002333430
DOM-OMEPRAZOLE DR 20 MG DELAYED-RELEASE TABLET
ORL
CAP/SRT
DPC
TAB
0.4117
00002241285
DOM-OXYBUTYNIN 5 MG TABLET
ORL
TAB
DPC
TAB
0.1508
00002248447
DOM-PAROXETINE 10 MG TABLET
ORL
TAB
DPC
TAB
0.8210
00002248448
ORL
TAB
DPC
TAB
0.6320
00002248449
ORL
TAB
DPC
TAB
0.6714
Pg 70 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002236857
DOMPERIDONE-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.0594
00002238046
DOM-PINDOLOL 10 MG TABLET
ORL
TAB
DPC
TAB
0.2323
00002238047
ORL
TAB
DPC
TAB
0.3370
00002231650
ORL
TAB
DPC
TAB
0.1905
00002249723
DOM-PRAVASTATIN 10 MG TABLET
ORL
TAB
DPC
TAB
0.4050
00002249731
ORL
TAB
DPC
TAB
0.4778
00002249758
ORL
TAB
DPC
TAB
0.8057
00002299003
DOM-QUETIAPINE 100 MG TABLET
ORL
TAB
DPC
TAB
0.3295
00002299038
ORL
TAB
DPC
TAB
0.6617
00002298996
ORL
TAB
DPC
TAB
0.1235
00002299046
ORL
TAB
DPC
TAB
0.9656
00002320460
DOM-RABEPRAZOLE EC 20 MG ENTERIC-COATED TABLET
ORL
ECT
DPC
TAB
0.2407
00002287986
DOM-RAMIPRIL 10 MG CAPSULE
ORL
CAP/TAB
DPC
CAP
0.1862
00002287951
DOM-RAMIPRIL 2.5 MG CAPSULE
ORL
CAP/TAB
DPC
CAP
0.1470
00002287978
DOM-RAMIPRIL 5 MG CAPSULE
ORL
CAP/TAB
DPC
CAP
0.1470
00002243038
DOM-RANITIDINE 150 MG TABLET
ORL
TAB
DPC
TAB
0.1800
00002309831
DOM-RISEDRONATE 35 MG TABLET
ORL
TAB
DPC
TAB
2.4275
00002396203
DOM-RIZATRIPTAN RDT 10 MG ORALLY DISINT. TABLET
ORL
DISNTAB
DPC
TAB
3.7050
00002216949
DOM-SALBUTAMOL 1 MG/ML INHALATION SOLUTION
INH
SOL
DPC
ML
0.3618
00002245750
DOM-SERTRALINE 100 MG CAPSULE
ORL
CAP
DPC
CAP
0.4200
Pg 71 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002245748
ORL
CAP
DPC
CAP
0.2004
00002245749
ORL
CAP
DPC
CAP
0.4000
00002238635
DOM-SOTALOL 160 MG TABLET
ORL
TAB
DPC
TAB
0.1623
00002238634
DOM-SOTALOL 80 MG TABLET
ORL
TAB
DPC
TAB
0.2966
00002270765
DOM-SUMATRIPTAN 100 MG TABLET
ORL
TAB
DPC
TAB
7.8600
00002243749
DOM-TERAZOSIN 10 MG TABLET
ORL
TAB
DPC
TAB
0.6183
00002128969
DOM-TRAZODONE 100 MG TABLET
ORL
TAB
DPC
TAB
0.0989
00002128950
DOM-TRAZODONE 50 MG TABLET
ORL
TAB
DPC
TAB
0.0554
00002414147
DOM-VALSARTAN 80 MG TABLET
ORL
TAB
DPC
TAB
0.2957
00002299313
DOM-VENLAFAXINE XR 150 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
DPC
CAP
0.3469
00002299291
DOM-VENLAFAXINE XR 37.5 MG EXTENDED-RELEASE CAP
ORL
ERC
DPC
CAP
0.1643
00002299305
DOM-VENLAFAXINE XR 75 MG EXTENDED-RELEASE CAP
ORL
ERC
DPC
CAP
0.3285
00002240321
DOM-VERAPAMIL SR 240 MG SUSTAINED-RELEASE TABLET
ORL
SRT
DPC
TAB
0.6767
00002389525
DOM-ZOLMITRIPTAN 2.5 MG TABLET
ORL
TAB
DPC
TAB
3.5375
00002246317
DOM-ZOPICLONE 5 MG TABLET
ORL
TAB
DPC
TAB
0.1782
00002240823
DOM-ZOPICLONE 7.5 MG TABLET
ORL
TAB
DPC
TAB
0.2250
00002416425
DONEPEZIL 10 MG TABLET
ORL
TAB
PDL
TAB
1.2340
00002416417
DONEPEZIL 5 MG TABLET
ORL
TAB
PDL
TAB
1.2340
00002194341
DOVONEX 50 MCG/ML SCALP SOLUTION
SCP
SOL
LEO
ML
0.7777
00002240978
DOXAZOSIN-1 1MG TABLET
ORL
TAB
PDL
TAB
0.1416
Pg 72 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002240979
DOXAZOSIN-2 2 MG TABLET
ORL
TAB
PDL
TAB
0.1699
00002240980
DOXAZOSIN-4 4 MG TABLET
ORL
TAB
PDL
TAB
0.2209
00002375710
DOXORUBICIN HYDROCHLORIDE 2 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
13.0420
00002413973
DOXORUBICIN HYDROCHLORIDE 2MG/ML INJECTION USP
INJ
DEFAUL
MYP
ML
11.4000
00000817120
DOXYCIN 100 MG CAPSULE
ORL
CAP
RIV
CAP
0.5860
00000860751
DOXYCIN 100 MG TABLET
ORL
TAB
RIV
TAB
0.5860
00000887064
DOXYTAB 100 MG TABLET
ORL
TAB
PDL
TAB
0.5860
00001974335
DR SCHOLL'S CLEAR AWAY WART REMOVER SYSTEM 40% PTH
TOP
PTH
BAI
PTH
0.3356
00001929313
DRISTAN DECONGESTANT NASAL MIST SOLUTION
NAS
SOL
PDH
ML
0.3173
00001929372
DRISTAN LONG LASTING 0.05% NASAL MIST SOLUTION
NAS
SOL
PDH
ML
0.3173
00001929380
DRISTAN LONG LASTING MENTHOLATED 0.05% NASAL SPRAY
NAS
SPR
PDH
ML
0.3173
00000740861
DRIXORAL DESCONGESTANT 0.05% NASAL SOLUTION
NAS
SOL
SCH
ML
0.1593
00000298433
DRIXORAL SUSTAINED-RELEASE TABLET
ORL
SRT
SCH
TAB
0.4020
00000342742
DRYSOL 20% TOPICAL SOLUTION
TOP
SOL
SFD
ML
0.4203
00000821772
D-TAB 10,000 UNIT TABLET
ORL
TAB
RIV
TAB
0.2100
00002247208
DUKORAL ORAL SUSPENSION
ORL
SUS
AVE
DOSE
35.9900
00002452650
DULOXETINE 30 MG DELAYED-RELEASE CAPSULE
ORL
DRC
PDL
CAP
0.4814
00002452669
DULOXETINE 60 MG DELAYED-RELEASE CAPSULE
ORL
DRC
PDL
CAP
0.9769
00002292165
DUODOPA 20 MG/ML / 5MG/ML (100 ML) INTESTINAL GEL
INTRA
GEL
ABV
CAS
166.0000
00002239299
DUOFILM 40% TOPICAL PATCH
TOP
PTH
MMH
PTH
0.4633
Pg 73 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000370576
DUOFILM TOPICAL SOLUTION
TOP
SOL
GSK
ML
0.5413
00002125706
DUOLUBE OPH OINTMENT
OPH
ONT
BSH
G
1.4771
00000656747
DUONALC E (MILD) 20% TOPICAL SOLUTION
TOP
SOL
VCL
ML
0.2196
00000490156
DUONALC E 47.5% TOPICAL SOLUTION
TOP
SOL
VCL
ML
0.2196
00002148633
DUOVENT UDV INHALATION SOLUTION
INH
SOL
BOE
ML
0.8264
00002275848
DURAGESIC MAT 75 (75 MCG/HR) TRANSDERMAL PATCH
TRD
PTH
JAI
PTH
41.0940
00002275856
TRD
PTH
JAI
PTH
51.1500
00002334186
TRD
PTH
JAI
PTH
6.0220
00002275813
TRD
PTH
JAI
PTH
15.5260
00002275821
TRD
PTH
JAI
PTH
29.2220
00002373017
DURELA 100 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
CIP
CAP
1.1400
00002373025
ORL
ERC
CIP
CAP
2.0800
00002373033
ORL
ERC
CIP
CAP
2.8800
00002415534
DUREZOL 0.05% OPHTHALMIC EMULSION
OPH
EML
ALC
ML
5.4000
00000999010
DUROLANE
DEFAUL
DEV
QMD
ML
143.3300
00002421712
DUTASTERIDE 0.5 MG CAPSULE
ORL
CAP
PDL
CAP
0.9624
00001947958
DUVOID 10 MG TABLET
ORL
TAB
PAL
TAB
0.3137
00001947931
DUVOID 25 MG TABLET
ORL
TAB
PAL
TAB
0.5081
00001947923
DUVOID 50 MG TABLET
ORL
TAB
PAL
TAB
0.6693
00002432889
DYMISTA 50 MCG/137 MCG METERED DOSE NASAL SPRAY
NAS
SPM
MDP
DOSE
0.7875
Pg 74 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002260638
EBIXA 10 MG TABLET
ORL
TAB
LBC
TAB
2.4403
00002381389
EDARBI 40 MG TABLET
ORL
TAB
VCL
TAB
1.2090
00002381397
EDARBI 80 MG TABLET
ORL
TAB
VCL
TAB
1.2090
00002397749
EDARBYCLOR 40 MG/12.5 MG TABLET
ORL
TAB
TAK
TAB
1.2090
00002397765
EDARBYCLOR 40 MG/25 MG TABLET
ORL
TAB
TAK
TAB
1.2090
00002397757
EDARBYCLOR 80 MG/12.5 MG TABLET
ORL
TAB
TAK
TAB
1.2090
00002370603
EDURANT 25 MG TABLET
ORL
TAB
JAI
TAB
15.0153
00080009719
EFAMOL 1000 MG CAPSULE
ORL
CAP
FMD
CAP
0.1667
00002349124
EFFIENT 10 MG TABLET
ORL
TAB
LIL
TAB
2.7377
00002209764
EGOZINC-HC RECTAL OINTMENT
RT
ONT
PMS
G
0.4160
00002210517
EGOZINC-HC RECTAL SUPPOSITORY
RT
SUP
PMS
SUP
0.6075
00002438712
EGRIFTA 1 MG/VIAL INJECTION
INJ
DEFAUL
THE
VIAL
51.4170
00002425637
ELELYSO 200 UNIT/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
648.3600
00002247238
ELIDEL 1 % TOPICAL CREAM
TOP
CRM
VCL
G
00002248239
ELIGARD 10.2 MG/SYR INJECTION
INJ
NDL
SAV
SYR
310.7200
00002248240
INJ
NDL
SAV
SYR
891.0000
00002248999
INJ
NDL
SAV
SYR
1,285.2000
00002268892
INJ
NDL
SAV
SYR
1,450.0000
00000627410
ELIXIR DE THEOPHYLLINE
ORL
ELX
ATL
ML
0.0052
00002436329
ELLA 30 MG TABLET
ORL
TAB
ASC
TAB
25.0000
2.3223
Pg 75 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002296284
ELOXATIN 5 MG/ML INJECTION
INJ
DEFAUL
SAV
ML
51.8160
00002103109
ELTOR-120 120 MG SUSTAINED-RELEASE TABLET
ORL
SRT
SAV
TAB
0.2742
00002298805
EMEND 125 MG CAPSULE
ORL
CAP
MFC
CAP
31.7433
00002324679
EMEND IV 115 MG/VIAL
INJ
DEFAUL
MFC
VIAL
30.1800
00000886858
EMLA TOPICAL CREAM
TOP
CRM
AZC
G
1.9500
00002057794
EMLA TOPICAL PATCH
TOP
PTH
AZC
PTH
2.7500
00080008611
EMPOWER 18 PLUS CAPSULE
ORL
CAP
TRU
CAP
0.3025
00002248209
ENCA 100 MG CAPSULE
ORL
CAP
PRP
CAP
1.0332
00002248208
ENCA 50 MG CAPSULE
ORL
CAP
PRP
CAP
0.5350
00002334992
ENDOMETRIN 100 MG VAGINAL EFFERVESCENT TABLET
VAG
EVT
FEI
TAB
4.0000
00002296454
ENGERIX-B 10 MCG/0.5 ML SUSPENSION
INJ
DEFAUL
GSK
ML
21.3200
00002010526
ENTERIC COATED ASA 325 MG TABLET
ORL
ECT
WTR
TAB
0.0280
00000794244
ENTERIC COATED ASA 650 MG TABLET
ORL
ECT
VTH
TAB
0.0550
00002246971
ENTEX LA SUSTAINED-RELEASE TABLET
ORL
SRT
PUR
TAB
0.4425
00002446928
ENTRESTO 24.3 MG/25.7 MG TABLET
ORL
TAB
NOV
TAB
3.6200
00002446936
ORL
TAB
NOV
TAB
3.6200
00002446944
ORL
TAB
NOV
TAB
3.6200
00000010340
ENTROPHEN 10 650 MG ENTERIC-COATED TABLET
ORL
ECT
PPH
TAB
0.0843
00001905392
ENTROPHEN 10 SUPER EXTRA STRENGTH 650 MG ECCPT
ORL
ECT
PPH
TAB
0.0705
00000852015
ENTROPHEN 500 MG ENTERIC-COATED TABLET
ORL
ECT
PPH
TAB
0.0686
Pg 76 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002050161
ENTROPHEN REGULAR STRENGTH (CAPLET) 325 MG ECCPT
ORL
ECT
PPH
TAB
0.0549
00000010332
ENTROPHEN REGULAR STRENGTH 325 MG ECT
ORL
ECT
PPH
TAB
0.0549
00002436841
ENTYVIO 300 MG/VIAL INJECTION
INJ
DEFAUL
TAK
VIAL
3,290.0000
00000880183
EPI-LYT
TOP
LOT
VCL
ML
0.1127
00000721891
EPINEPHRINE 1 MG/ML INJECTION USP
INJ
NDL
HSP
SYR
3.9700
00002264927
EPIRUBICIN HYDROCHLORIDE 2 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
13.3196
00002396971
EPURIS 10 MG CAPSULE
ORL
CAP
CIP
CAP
1.0710
00002396998
ORL
CAP
CIP
CAP
1.4423
00002397005
ORL
CAP
CIP
CAP
1.8140
00002397013
ORL
CAP
CIP
CAP
2.1853
00002243801
EQUATE DAILY LOW-DOSE 81 MG ENTERIC-COATED TABLET
ORL
ECT
PMS
TAB
0.1096
00002271249
ERBITUX 2 MG/ML INJECTION
INJ
DEFAUL
LIL
ML
7.2924
00002409267
ERIVEDGE 150 MG CAPSULE
ORL
CAP
HLR
CAP
294.2238
00000607142
ERYC 250 MG CAPSULE (ENTERIC-COATED PELLET)
ORL
CAP/ENCP
PFI
CAP
0.2764
00000726672
ERYTHRO-EC 250 MG ENTERIC-COATED CAPSULE
ORL
CAP/ENCP
AAP
CAP
0.3900
00001925938
ERYTHRO-EC 333 MG ENTERIC-COATED CAPSULE
ORL
CAP/ENCP
AAP
CAP
0.4332
00002393751
ESBRIET 267 MG CAPSULE
ORL
CAP
HLR
CAP
13.0302
00002424401
ESCITALOPRAM 10 MG TABLET
ORL
TAB
PDL
TAB
1.4680
00002424428
ESCITALOPRAM 20 MG TABLET
ORL
TAB
PDL
TAB
1.5630
00002394839
ESOMEPRAZOLE 20 MG DELAYED-RELEASE TABLET
ORL
DRT
PDL
TAB
1.5887
Pg 77 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002442493
ORL
DRT
SIV
TAB
1.8690
00002394847
ORL
DRT
PDL
TAB
1.4298
00002431173
ORL
DRT
SNS
TAB
1.8690
00002442507
ORL
DRT
SIV
TAB
1.8690
00002244990
ESSENTIAL VITAMINS AND MINERALS TABLET
ORL
TAB
WNP
TAB
0.0214
00002237515
ESTER C 1000 MG TABLET
ORL
TAB
SIS
TAB
0.1598
00002247480
ESTER-C 250 MG CHEWABLE TABLET
ORL
CTB
WNP
TAB
0.0799
00080003499
ESTER-C CAPSULE
ORL
CAP
BPC
CAP
0.1496
00000727369
ESTRAGYN 1MG/G VAGINAL CREAM
VAG
CRM
SLP
G
0.6873
00002403404
ESTROGEL PROPAK 0.06% TRANSDERM. GEL/100MG CAPSULE
TRD/ORL
GEL/CAP
MFC
KIT
51.0000
00000247960
ETIBI 100 MG TABLET
ORL
TAB
VCL
TAB
0.2058
00000247979
ETIBI 400 MG TABLET
ORL
TAB
VCL
TAB
0.6175
00002353210
ETIDROCAL 400 MG/500 MG TABLET
ORL
TAB
SNS
TAB
0.2221
00002080036
ETOPOSIDE 20 MG/ML INJECTION
INJ
DEFAUL
TEV
ML
15.0000
00000999330
EUFLEXXA
DEFAUL
DEV
FEI
ML
56.8333
00080013021
EUPHORBIUM COMPOSITUM SN ORAL DROPS
ORL
DPS
HEE
ML
0.7650
00000623377
EURAX 10% TOPICAL CREAM
TOP
CRM
CLC
G
0.3584
00080003010
EURO D 800 IU CAPSULE
ORL
CAP
EUP
CAP
0.0600
00002303825
EURO DOCUSATE C 100 MG CAPSULE
ORL
CAP
EUP
CAP
0.0328
00080011428
EURO K 975 975 MG (25 MEQ) EFFERVESCENT TABLET
ORL
EVT
EUP
TAB
0.5550
Pg 78 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002245668
EURO-CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP
ORL
SYR
EUP
ML
0.0624
00002242651
EURO-D VITAMIN D3 400 IU CAPSULE
ORL
CAP
EUP
CAP
0.0300
00002247385
EURO-DOCUSATE 100 MG CAPSULE
ORL
CAP
EUP
CAP
0.0328
00002246590
EURO-FER 20 MG/ML ORAL SUSPENSION
ORL
SUS
EUP
ML
0.0780
00002237556
EURO-FER 300 MG CAPSULE
ORL
CAP
EUP
CAP
0.1397
00002241802
EURO-FER CF CAPSULE
ORL
CAP
EUP
CAP
0.2330
00002246733
EURO-FERROUS SULFATE 300 MG TABLET
ORL
TAB
EUP
TAB
0.0157
00002412926
EURO-HYDROCORTISONE 1% CREAM
TOP
CRM
EUP
G
0.2000
00002247389
EURO-SENNA 8.6 MG TABLET
ORL
TAB
EUP
TAB
0.0464
00002247390
EURO-SENNA S 8.6 MG/50 MG TABLET
ORL
TAB
EUP
TAB
0.1135
00002264374
EUTHYROX 100 MCG TABLET
ORL
TAB
SRO
TAB
0.0306
00002264390
ORL
TAB
SRO
TAB
0.0644
00002264404
ORL
TAB
SRO
TAB
0.0654
00002264412
ORL
TAB
SRO
TAB
0.1148
00002264420
ORL
TAB
SRO
TAB
0.0339
00002264439
ORL
TAB
SRO
TAB
0.0699
00002264447
ORL
TAB
SRO
TAB
0.0359
00002264323
ORL
TAB
SRO
TAB
0.0564
00002264455
ORL
TAB
SRO
TAB
0.0785
00002264331
ORL
TAB
SRO
TAB
0.0249
Pg 79 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002264358
ORL
TAB
SRO
TAB
0.0610
00002264366
ORL
TAB
SRO
TAB
0.0610
00080005494
EVENING PRIMROSE OIL SOFTGEL CAPSULE
ORL
CAP
WNP
CAP
0.0644
00002248297
EVRA 6 MG/0.6 MG TRANSDERMAL PATCH
TRD
PTH
JAI
PTH
5.6700
00002377179
EXACT ANTI-NAUSEANT 50 MG TABLET
ORL
TAB
APX
TAB
0.0627
00002243896
EXACT DAILY LOW-DOSE ASA 81 MG ENTERIC-COATED TAB
ORL
ECT
PMS
TAB
0.1330
00001990675
EXCEDRIN EXTRA-STRENGTH CAPLET
ORL
TAB
NVC
TAB
0.0588
00002302853
EXELON PATCH 10 (9.5 MG/24 H)
TRD
PTH
NOV
PTH
4.6747
00002432803
TRD
PTH
NOV
PTH
4.4753
00002302845
TRD
PTH
NOV
PTH
4.6747
00002226030
EX-LAX CHOCOLATED TABLET
ORL
TAB
NVC
TAB
0.2006
00002237524
EX-LAX EXTRA STRENGHT 25 MG TABLET
ORL
TAB
NVC
TAB
0.2354
00002184672
EXOREX 1% TOPICAL GEL
TOP
GEL
YNG
ML
0.2250
00002184680
EXOREX 2% TOPICAL GEL
TOP
GEL
YNG
ML
0.2250
00000813095
EXPECTORANT COUGH FORMULA 100 MG/5 ML ORAL SYRUP
ORL
SYR
TAN
ML
0.0199
00002315955
EXTRA STRENGTH ALLERGY RELIEF 10 MG TABLET
ORL
TAB
PMS
TAB
0.1730
00002242632
EXTRA STRENGTH MOTRIN IB 300 MG TABLET
ORL
TAB
MCL
TAB
0.1307
00002244142
EXTRA STRENGTH NIGHTTIME COLD RELIEF TABLET
ORL
TAB
PPH
TAB
0.1283
00000889806
EYELUBE .5% OPH DROPS
OPH
DPS
SDZ
ML
0.3093
00000874965
EYELUBE 1% OPH DROPS
OPH
DPS
SDZ
ML
0.3840
Pg 80 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
OPH
LIQ
ALC
ML
Base Price
00000707937
EYE-STREAM EYE LIQUID
00002415992
EYLEA 2 MG/VIAL INJECTION
INJ
DEFAUL
BHP
VIAL
1,418.0000
00002422549
EZETIMIBE 10 MG TABLET
ORL
TAB
PDL
TAB
0.4612
00002248968
FACTIVE 320 MG TABLET
ORL
TAB
ABB
TAB
7.0000
00002324865
FAMCICLOVIR 125 MG TABLET
ORL
TAB
PDL
TAB
0.1394
00002247745
FAMOTIDINE OMEGA-(W PRES,BENZYL ALC) 10 MG/ML INJ
INJ
DEFAUL
OMG
ML
1.4000
00002247735
FAMOTIDINE OMEGA-(W/O PRESERVATIVE) 10 MG/ML INJ
INJ
DEFAUL
OMG
ML
2.3500
00002379910
FAMPYRA 10 MG SUSTAINED-RELEASE TABLET
ORL
SRT
BIO
TAB
9.3570
00002229110
FAMVIR 125 MG TABLET
ORL
TAB
NOV
TAB
3.0170
00002229129
ORL
TAB
NOV
TAB
4.0927
00002177102
ORL
TAB
NOV
TAB
7.2905
00002248624
FASLODEX 250 MG/5 ML INJECTION
INJ
NDL
AZC
SYR
576.5550
00002231384
FEMARA 2.5 MG TABLET
ORL
TAB
NOV
TAB
6.4113
00002242531
FEMHRT 1/5 TABLET
ORL
TAB
PFI
TAB
0.8400
00002286092
FENOFIBRATE MICRO 200 MG CAPSULE
ORL
CAP
SNS
CAP
0.2723
00002240360
FENO-MICRO-200 MG CAPSULE
ORL
CAP
PDL
CAP
0.2723
00002395703
FENTANYL 100 MCG/HR TRANSDERMAL PATCH
TRD
PTH
PDL
PTH
12.0520
00002395657
TRD
PTH
PDL
PTH
2.3480
00002395665
TRD
PTH
PDL
PTH
3.6600
00002395673
TRD
PTH
PDL
PTH
6.8840
0.0930
Pg 81 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002395681
TRD
PTH
PDL
PTH
9.6820
00002384124
FENTANYL CITRATE SDZ 50 MCG/ML INJECTION
INJ
DEFAUL
SDZ
ML
2.5988
00002408007
FENTORA 100 MCG EFFERVESCENT TABLET
BUC/SLG
EVT
TMP
TAB
10.8968
00002408015
BUC/SLG
EVT
TMP
TAB
10.8968
00002408023
BUC/SLG
EVT
TMP
TAB
10.8968
00002408031
BUC/SLG
EVT
TMP
TAB
10.8968
00002408058
BUC/SLG
EVT
TMP
TAB
10.8968
00002377217
FERAHEME 30 MG/ML INJECTION
INJ
DEFAUL
TAK
ML
11.0294
00080033717
FERAMAX 15/1/4 TSP POWDER
ORL
PWR
BIS
G
0.2169
00080013210
FERAMAX 150 150 MG CAPSULE
ORL
CAP
BIS
CAP
0.4633
00000232599
FERMALAC VAGINAL CAPSULE
VAG
CAP
ROG
CAP
1.9310
00002248699
FERODAN 300 MG TABLET
ORL
TAB
ODN
TAB
0.0199
00002436558
FERRIPROX 1000 MG TABLET
ORL
TAB
APP
TAB
30.3600
00002243333
FERRLECIT 12.5 MG/ ML INJECTION
INJ
DEFAUL
SAV
ML
5.2720
00002138751
FERROUS FUMARATE 200 MG TABLET
ORL
TAB
VTH
TAB
0.0209
00000031089
FERROUS FUMARATE 300 MG TABLET
ORL
TAB
WAM
TAB
0.0625
00000041157
FERROUS GLUCONATE 300 MG TABLET
ORL
TAB
ADA
TAB
0.0371
00000031097
ORL
TAB
JPC
TAB
0.0212
00080009681
ORL
TAB
WAM
TAB
0.0625
00002244532
ORL
TAB
PMT
TAB
0.0400
Pg 82 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000582727
ORL
TAB
VTH
TAB
0.0231
00002245389
ORL
TAB
WNP
TAB
0.0785
00000782114
FERROUS SULFATE 300 MG TABLET
ORL
TAB
WTR
TAB
0.0346
00000346918
FERROUS SULFATE 300 MG TABLET
ORL
TAB
PMT
TAB
0.0385
00002441004
FETZIMA 120 MG EXTENDED RELEASE CAPSULE
ORL
ERC
ASC
CAP
4.1000
00002440970
ORL
ERC
ASC
CAP
3.4500
00002440989
ORL
ERC
ASC
CAP
3.5800
00002440997
ORL
ERC
ASC
CAP
3.8400
00080005803
FIBER PLUS CAPSULE
ORL
CAP
PLT
CAP
0.2000
00002207230
FIBRE LAXATIVE 3.4 G/12 G ORAL POWDER
ORL
PWR
PRI
G
0.0060
00080009650
FIBRE LAXATIVE SMOOTH TEXTURE ORANGE FLAVOUR
ORL
PWR
ACV
G
0.0103
00080009651
FIBRE LAXATIVE UNFLAVOURED ORAL POWDER
ORL
PWR
APH
G
0.0109
00002447568
FINASTERIDE 1 MG TABLET
ORL
TAB
SIV
TAB
1.1453
00002350270
FINASTERIDE 5 MG TABLET
ORL
TAB
PDL
TAB
0.4633
00002337037
FIRMAGON 120 MG/VIAL INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
FEI
VIAL
405.5000
00002337029
FIRMAGON 80 MG/VIAL INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
FEI
VIAL
300.0000
00001926853
FLAGYL 500 MG CAPSULE
ORL
CAP
SAV
CAP
1.0957
00080000193
FLAX SEED OIL
ORL
LIQ
WNP
CAP
0.0410
00002149133
FLAX SEED OIL 500 MG CAPSULE
ORL
CAP
JAM
CAP
0.0622
00080000580
FLAXSEED OIL 1000 MG SOFTGEL
ORL
CAP
PMT
CAP
0.0937
Pg 83 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080000840
FLAXSEED OIL LIQUID
ORL
LIQ
VML
ML
0.0422
00002206218
FLEET PHOSPO-SODA ORAL LIQUID
ORL
LIQ
JJM
ML
0.0838
00000999052
FLEXI-T +300 IUD 1
DEFAUL
DEFAUL
TSN
DEV
76.1300
00000999053
FLEXI-T +380 IUD 1
DEFAUL
DEFAUL
TSN
DEV
76.1300
00000999051
FLEXI-T 300 IUD 1
DEFAUL
DEFAUL
TSN
DEV
67.6000
00080021934
FLINTSTONES MULTI VITAMINS COMPLETE CHEWABLE TAB
ORL
CTB
BAI
TAB
0.1370
00002230845
FLOLAN 0.5 MG/VIAL INJECTION
INJ
DEFAUL
GLA
VIAL
18.6400
00002230848
FLOLAN 1.5 MG/VIAL INJECTION
INJ
DEFAUL
GLA
VIAL
37.2700
00002213672
FLONASE 50 MCG/DOSE AQUEOUS NASAL SPRAY
NAS
SPM
GSK
DOSE
0.2589
00080011335
FLORASMART TABLET
ORL
TAB
RLC
TAB
0.5421
00080013321
FLORASTOR 250 MG CAPSULE
ORL
CAP
BCX
CAP
1.0150
00002237245
FLOVENT DISKUS 100 MCG/DOSE PWDR FOR INHAL
INH
MIP
GSK
DOSE
0.3988
00002237244
FLOVENT DISKUS 50 MCG/DOSE PWDR FOR INHAL
INH
MIP
GSK
DOSE
0.2522
00002434881
FLUAD PEDIATRIC INJECTION SYRINGE
INJ
DEFAUL
NOV
SYR
12.4500
00002261472
FLUCONAZOLE 2 MG/ML INJECTION
INJ
DEFAUL
BAX
ML
0.1794
00002248443
FLUCONAZOLE 2 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
0.4695
00002388448
FLUCONAZOLE INJECTION SDZ 2 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
0.4695
00002247749
FLUCONAZOLE OMEGA 2 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
0.3660
00002246226
FLUDARA 10 MG TABLET
ORL
TAB
SAV
TAB
40.0760
00002249561
FLUMAZENIL 0.1 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
5.0400
Pg 84 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002352621
FLUMIST INFLUENZA VACCINE NASAL SPRAY
NAS
SPR
AZC
ML
72.0000
00002426544
FLUMIST QUADRIVALENT NASAL SPRAY
NAS
SPR
AZC
ML
90.0000
00001977857
FLUOR A DAY 1.1 MG CHEWABLE TABLET
ORL
CTB
PMS
TAB
0.0849
00002090139
FLUOR-A-DAY 0.56 MG CHEWABLE TABLET
ORL
CTB
PMS
TAB
0.0849
00000610100
FLUOR-A-DAY 5.56 MG/ML ORAL DROPS
ORL
DPS
PMS
ML
0.1760
00002182742
FLUOROURACIL 50 MG/ML INJECTION
INJ
DEFAUL
MNP
ML
2.0376
00000012882
FLUOROURACIL 50 MG/ML INJECTION
INJ
DEFAUL
VCL
ML
1.4630
00002331721
FLUPENTIXOL DECANOATE 100 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
26.7500
00000578479
FLURAZEPAM 15 MG CAPSULE
ORL
CAP
PDL
CAP
0.0675
00000578487
FLURAZEPAM 30 MG CAPSULE
ORL
CAP
PDL
CAP
0.0775
00002015986
FLUVIRAL S/F SPLIT-VIRION INFLUENZA VACCINE INJ
INJ
DEFAUL
IAF
ML
16.0000
00002420686
FLUVIRAL SUSPENSION FOR INJECTION
INJ
DEFAUL
IAF
ML
16.0000
00002236754
FLUVOXAMINE 100 MG TABLET
ORL
TAB
PDL
TAB
0.3783
00002236753
FLUVOXAMINE 50 MG TABLET
ORL
TAB
PDL
TAB
0.2105
00002420643
FLUZONE QUADRIVALENT 0.5 ML/SYRINGE INJECTION
INJ
DEFAUL
SFP
SYR
12.9500
00002432730
FLUZONE QUADRIVALENT 5 ML MULTIDOSE VIAL INJECTION
INJ
DEFAUL
SFP
ML
20.0000
00000707511
FML FORTE 0.25% OPH SUSPENSION
OPH
SUS
ALL
ML
2.6880
00000247855
FML LIQUIFILM 0.1% OPH SUSPENSION
OPH
SUS
ALL
ML
3.2120
00080000549
FOLAPRO 0.8 MG TABLET
ORL
TAB
MTG
TAB
0.1916
00080000273
FOLIC ACID 1 MG TABLET
ORL
TAB
WNP
TAB
0.0298
Pg 85 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000647039
ORL
TAB
VTH
TAB
0.0079
00000318973
ORL
TAB
JAM
TAB
0.0404
00002048841
FOLIC ACID USP 1 MG TABLET
ORL
TAB
PMT
TAB
0.0171
00002435667
FOMEPIZOLE FOR INJECTION 1 G/ML INJ
INJ
DEFAUL
STM
ML
820.6233
00002254689
FORTEO 250 MCG/ML INJECTION
INJ
DEFAUL
LIL
ML
373.8542
00002435470
FORXIGA 10 MG TABLET
ORL
TAB
AZC
TAB
2.6200
00002435462
FORXIGA 5 MG TABLET
ORL
TAB
AZC
TAB
2.6200
00002241568
FORZA-10 TABLET
ORL
TAB
EUP
TAB
0.1628
00002276429
FOSAVANCE 70 MG/2800 UNIT TABLET
ORL
TAB
MFC
TAB
4.8275
00002303000
FOSINOPRIL-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.2178
00002303019
FOSINOPRIL-20 20 MG TABLET
ORL
TAB
PDL
TAB
0.2619
00002287188
FOSRENOL 1000 MG CHEWABLE TABLET
ORL
CTB
SHB
TAB
4.6148
00002287145
ORL
CTB
SHB
TAB
1.1564
00002287153
ORL
CTB
SHB
TAB
2.3131
00002287161
ORL
CTB
SHB
TAB
3.4808
00002377454
FRAGMIN 2,500 IU/ML INJECTION
INJ
DEFAUL
PFI
ML
4.0785
00002221799
FRISIUM 10 MG TABLET
ORL
TAB
LUI
TAB
0.4393
00002257084
FROVA 2.5 MG TABLET
ORL
TAB
TMP
TAB
14.3300
00000989993
FRUCTOSE USP POWDER
ORL
PWR
GNA
G
0.0693
00002238578
FUCIDIN H TOPICAL CREAM
TOP
CRM
LEO
G
1.3813
Pg 86 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002243862
FUCITHALMIC 1% VISCOUS OPH DROPS (PRESERVED)
OPH
GEL
AMD
G
2.2200
00002243861
FUCITHALMIC 1% VISCOUS OPH DROPS (UNPRESERVED)
OPH
GEL
AMD
G
4.7790
00002360365
FUROSEMIDE 10MG/ML INJECTION
INJ
DEFAUL
OMG
ML
1.0500
00000496723
FUROSEMIDE 20 TABLET
ORL
TAB
PDL
TAB
0.0373
00000397792
FUROSEMIDE 40 MG TABLET
ORL
TAB
PDL
TAB
0.0558
00000667080
FUROSEMIDE-80 MG TABLET
ORL
TAB
PDL
TAB
0.1220
00002247725
FUZEON 108 MG/VIAL INJECTION
INJ
DEFAUL
HLR
VIAL
40.9202
00002388200
GABAPENTIN 600 MG TABLET
ORL
TAB
SIV
TAB
1.3045
00002410990
ORL
TAB
GLM
TAB
1.3045
00002431289
ORL
TAB
SNS
TAB
1.3045
00002392526
GABAPENTIN 600 MG TABLET USP
ORL
TAB
AHI
TAB
0.3256
00002411008
ORL
TAB
GLM
TAB
1.7393
00002388219
ORL
TAB
SIV
TAB
1.7393
00002431297
ORL
TAB
SNS
TAB
1.7393
00002392534
GABAPENTIN 800 MG TABLET USP
ORL
TAB
AHI
TAB
0.4341
00002416581
GALANTAMINE ER 16 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
PDL
CAP
1.2467
00002416603
ORL
ERC
PDL
CAP
1.2467
00002416573
ORL
ERC
PDL
CAP
1.2467
00002404761
GANCICLOVIR 500 MG/VIAL INJECTION USP
INJ
DEFAUL
FKC
VIAL
48.3344
00002283190
GARDASIL 0.5 ML INJECTION
INJ
DEFAUL
MFC
ML
287.4600
Pg 87 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002437058
GARDASIL 9 0.5 ML INJECTION
INJ
DEFAUL
MFC
ML
310.5000
00000896675
GAS X EXTRA STRENGTH TABLET
ORL
TAB
NVC
TAB
0.2361
00002300761
GAS X ULTRA STRENGTH 180 MG CAPSULE
ORL
CAP
NVC
CAP
0.2093
00002159791
GAVISCON HEARTBURN RELIEF CHEWABLE TABLET
ORL
CTB
SKB
TAB
0.1455
00002231538
GAVISCON HEARTBURN RELIEF EXTRA STRENGTH TABLET
ORL
TAB
SKB
TAB
0.2328
00002159775
GAVISCON HEARTBURN RELIEF ORAL LIQUID - FRUIT
ORL
LIQ
SKB
ML
0.0214
00002434806
GAZYVA 25 MG/ML INJECTION
INJ
DEFAUL
HLR
ML
5,381.0100
00002362791
GD-AMLODIPINE/ATORVASTATIN 10 MG/10 MG TABLET
ORL
TAB
GMD
TAB
0.9194
00002362805
ORL
TAB
GMD
TAB
1.0234
00002362813
ORL
TAB
GMD
TAB
1.0624
00002362821
ORL
TAB
GMD
TAB
1.0624
00002362759
ORL
TAB
GMD
TAB
0.7551
00002362767
ORL
TAB
GMD
TAB
0.8591
00002362775
ORL
TAB
GMD
TAB
0.8981
00002362783
ORL
TAB
GMD
TAB
0.8981
00002342235
GD-ELETRIPTAN 20 MG TABLET
ORL
TAB
GMD
TAB
10.0850
00002342243
GD-ELETRIPTAN 40 MG TABLET
ORL
TAB
GMD
TAB
10.0850
00002285843
GD-GABAPENTIN 600 MG TABLET
ORL
TAB
GMD
TAB
1.3045
00002285851
GD-GABAPENTIN 800 MG TABLET
ORL
TAB
GMD
TAB
1.7393
00002360179
GD-PREGABALIN 150 MG CAPSULE
ORL
CAP
GMD
CAP
1.7270
Pg 88 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002360195
ORL
CAP
GMD
CAP
1.7270
00002360136
ORL
CAP
GMD
CAP
0.6173
00002360209
ORL
CAP
GMD
CAP
1.7270
00002360144
ORL
CAP
GMD
CAP
0.9683
00002360152
ORL
CAP
GMD
CAP
1.2528
00002273705
GD-SERTRALINE 100 MG CAPSULE
ORL
CAP
GMD
CAP
0.4200
00002273683
ORL
CAP
GMD
CAP
0.2004
00002273691
ORL
CAP
GMD
CAP
0.4008
00002028107
GEL-KAM 0.4% DENTAL GEL
DEN
GEL
COL
G
0.0705
00002366150
GELNIQUE 100 MG/G TOPICAL GEL
TOP
GEL
ASC
G
1.9760
00001945831
GELUSIL EXTRA STRENGTH CHEWABLE TABLET
ORL
CTB
WLA
TAB
0.1484
00001933906
GELUSIL TABLET
ORL
TAB
WSP
TAB
0.0598
00002324210
GEMCITABINE 1 G/VIAL INJECTION
INJ
DEFAUL
AHI
VIAL
265.0000
00002412292
GEMCITABINE 40 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
10.8120
00002136058
GEMFIBROZIL-600 MG TABLET
ORL
TAB
PDL
TAB
0.5157
00002230309
GEMZAR 1 G/VIAL INJECTION
INJ
DEFAUL
LIL
VIAL
308.3500
00002230308
GEMZAR 200 MG/VIAL INJECTION
INJ
DEFAUL
LIL
VIAL
61.0900
00080020663
GENESTRA BRAND HMF INTENSIVE PROBIOTIC
ORL
CAP
SRL
CAP
1.7166
00080034399
GENESTRA BRANDS DIGEST GLUTEN PLUS CAPSULE
ORL
CAP
SRL
CAP
0.3143
00080008885
GENESTRA BRANDS D-MULSION
ORL
LIQ
SRL
ML
0.5663
Pg 89 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080012475
GENESTRA BRANDS D-MULSION 400
ORL
LIQ
SRL
ML
0.2367
00002246047
GEN-NIZATIDINE 300 MG CAPSULE
ORL
CAP
MYP
CAP
0.9580
00002082144
GENTAMICIN (E) 1.2 MG/ML INJECTION
INJ
DEFAUL
BAX
ML
0.0794
00002082152
GENTAMICIN (E) 1.6 MG/ML INJECTION
INJ
DEFAUL
BAX
ML
0.0890
00002268531
GENTAMICIN 10 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
5.2785
00002148404
GENTAMICIN SULFATE 0.3% (BASE) OPH SOL (MINIMS)
OPH
SOL
NVO
ML
6.3483
00002082136
GENTAMICINE (E) 1 MG/ML INJECTION
INJ
DEFAUL
BAX
ML
0.0467
00002231289
GENTEAL 0.3% OPHTHALMIC DROPS
OPH
DPS
ALC
ML
0.4327
00002242977
GENTEAL 0.3% OPHTHALMIC GEL
OPH
GEL
ALC
ML
0.8110
00080014125
GENTLE IRON CAPSULE
ORL
CAP
VTH
CAP
0.0622
00002449498
GENVOYA TABLET
ORL
TAB
GIL
TAB
46.3893
00080044443
GI SUSTAIN ORAL POWDER
ORL
PWR
MTG
G
0.0676
00002415666
GIOTRIF 20 MG TABLET
ORL
TAB
BOE
TAB
73.3000
00002415674
ORL
TAB
BOE
TAB
73.3000
00002415682
ORL
TAB
BOE
TAB
73.3000
00080003490
GLA 130 PRIMROSE OIL CAPSULE
ORL
CAP
SRL
CAP
0.4438
00002244725
GLEEVEC 100 MG CAPSULE
ORL
CAP
NOV
CAP
25.3240
00002253275
GLEEVEC 100 MG TABLET
ORL
TAB
NOV
TAB
28.4584
00002253283
GLEEVEC 400 MG TABLET
ORL
TAB
NOV
TAB
113.8337
00002248453
GLICLAZIDE-80 MG TABLET
ORL
TAB
PDL
TAB
0.0931
Pg 90 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080000015
GLUCOSAMINE SULFATE 500 MG CAPLET
ORL
TAB
JAM
TAB
0.0448
00080000082
GLUCOSAMINE SULFATE 500 MG CAPSULE
ORL
CAP
WBP
CAP
0.0432
00080000083
GLUCOSAMINE SULFATE 500 MG TABLET
ORL
TAB
WBP
TAB
0.0360
00002300451
GLUMETZA 1000 MG EXTENDED-RELEASE TABLET
ORL
ERT
VCL
TAB
1.1769
00002268493
GLUMETZA 500 MG EXTENDED-RELEASE TABLET
ORL
ERT
VCL
TAB
0.5861
00080009026
GLUTAMINE MAXX ORAL POWDER
ORL
PWR
IHS
G
0.0600
00001959352
GLYBURIDE-2.5 MG TABLET
ORL
TAB
PDL
TAB
0.0321
00001926039
GLYCERIN RECTAL SUPPOSITORY
RT
SUP
WSP
SUP
0.1517
00000873462
GLYCERINE 90% RECTAL SUPPOSITORY USP
RT
SUP
MCO
SUP
0.0850
00080006852
GLYCINE ORAL POWDER
ORL
PWR
AOR
G
0.0639
00002229516
GLYCON 500 MG TABLET
ORL
TAB
VCL
TAB
0.0444
00002239214
GLYCON 850 MG TABLET
ORL
TAB
VCL
TAB
0.0610
00002382857
GLYCOPYRROLATE 0.2 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
3.9750
00002382849
GLYCOPYRROLATE 0.2 MG/ML MULTIDOSE INJECTION
INJ
DEFAUL
OMG
ML
3.1125
00002247884
GLYQUIN XM TOPICAL CREAM
TOP
CRM
VCL
G
1.2500
00000652512
GOLYTELY POWDER FOR ORAL LAVAGE SOLUTION
ORL
PWR
BAX
G
0.0034
00002248156
GONAL-F 33 MCG/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
425.2500
00002248154
GONAL-F 5.5 MCG/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
70.8800
00002248157
GONAL-F 77 MCG/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
992.2500
00002270404
GONAL-F PEN 300 IU/0.5 ML INJECTION SYRINGE
INJ
NDL
SRO
SYR
283.5000
Pg 91 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002270390
INJ
NDL
SRO
SYR
425.2500
00002270382
INJ
NDL
SRO
SYR
850.5000
00000999546
GOOD START INFANT FORMULA
ORL
LIQ
NES
ML
0.0085
00000999578
GOOD START STAGE 2 INFANT FORMULA
ORL
PWR
NHN
G
0.0404
00002232483
GRAMCAL 1000 MG EFFERVESCENT TABLET
ORL
EVT
NVC
TAB
0.7295
00080006061
GRAPE SEED CAPLET
ORL
TAB
JAM
TAB
0.3122
00002418304
GRASTEK 2800 UNIT SUBLINGUAL TABLET
SLG
DISNTAB
MFC
TAB
3.9103
00002441489
GRASTOFIL 300 MCG/0.5 ML INJECTION SYRINGE
INJ
DEFAUL
APX
SYR
144.3135
00000116858
GRAVERGOL CAPSULE
ORL
CAP
AXS
CAP
1.0108
00002254409
GRAVOL 100 MG LONG ACTING SUSTAINED-RELEASE CAPLET
ORL
SRT
CHD
TAB
0.4688
00000511196
GRAVOL 15 MG CHEWABLE TABLET
ORL
CTB
CHD
TAB
0.2433
00000230197
GRAVOL 3 MG/ML ORAL LIQUID
ORL
SYR
CHD
ML
0.0708
00000013803
GRAVOL 50 MG TABLET
ORL
TAB
CHD
TAB
0.2220
00000013609
GRAVOL ADULT 100 MG RECTAL SUPPOSITORY
RT
SUP
CHD
SUP
0.5630
00000783595
GRAVOL CHILDREN 25 MG RECTAL SUPPOSITORIES
RT
SUP
CHD
SUP
0.4960
00002248180
GRAVOL GINGER LOZENGE
ORL
LOZ
CHD
LOZ
0.2275
00000013579
GRAVOL I.M. 50 MG/ML INJECTION
INJ
DEFAUL
CHD
ML
1.1510
00002245718
GRAVOL NATURAL SOURCE 500 MG TABLET
ORL
TAB
CHD
TAB
0.2275
00002384132
GRAVOL QUICK DISSOLVE CHEWABLE 50 MG TABLET
ORL
CTB
CHD
TAB
0.3763
00080014526
GREEN TEA PHYTOSOME COMPLEX CAPSULE
ORL
CAP
JAM
CAP
0.2143
Pg 92 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080012417
GREENS+ BONE BUILDER ORAL POWDER
ORL
PWR
GNH
G
0.0948
00002384272
GUM PAROEX 0.12% ORAL RINSE
ORL
MWH
SUA
ML
0.0153
00080003089
HAIR & NAILS CAPSULE
ORL
CAP
VTH
CAP
0.0933
00002377438
HALAVEN 0.5 MG/ML INJECTION
INJ
DEFAUL
EIS
ML
00000271691
HALIBUT LIVER OIL SUPER CAPSULE
ORL
CAP
SWS
CAP
0.0329
00000202061
HALIBUT LIVER OIL WITH VITAMIN D CAPSULE
ORL
CAP
WAM
CAP
0.0268
00002366010
HALOPERIDOL (PRESERVATIVE FREE) 5 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
4.9000
00000587796
HALOPERIDOL 0.5 MG TABLET
ORL
TAB
PDL
TAB
0.0360
00002130297
HALOPERIDOL LA 50 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
8.4640
00002187078
HAVRIX 1,440 U/ML INJECTION
INJ
DEFAUL
GSK
ML
45.9400
00002231056
HAVRIX JUNIOR 720 U/0.5 ML INJECTION SYRINGE
INJ
NDL
GSK
SYR
22.7500
00000740578
HEPALEAN-LOK 100 IU/ML LOCK FLUSH INJECTION USP
INJ
LOCFLUSH
ORG
ML
0.3275
00000579718
HEPARIN LEO 10,000 IU/ML INJECTION
INJ
DEFAUL
LEO
ML
1.1000
00000640468
HEPARIN LOCK FLUSH SOLUTION 10 UNIT/ML INJECTION
INJ
LOCFLUSH
HSP
ML
1.2056
00002264315
HEPARIN SODIUM 1,000 IU/ML INJECTION USP
INJ
DEFAUL
FKC
ML
3.0744
00002303086
INJ
DEFAUL
SDZ
ML
0.5650
00002382296
HEPARIN SODIUM 1,000 UNIT/ML INJECTION
INJ
DEFAUL
PFI
ML
0.5160
00002264307
INJ
DEFAUL
FKC
ML
6.4912
00002382326
INJ
DEFAUL
PFI
ML
5.1604
00002382334
INJ
DEFAUL
PFI
ML
1.2470
270.0000
Pg 93 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002303094
HEPARIN SODIUM(PRESERVAT FREE)10,000 IU/ML INJ USP
INJ
DEFAUL
SDZ
ML
5.2700
00002303108
HEPARIN SODIUM(WITH PRESERVAT)10,000 IU/ML INJ USP
INJ
DEFAUL
SDZ
ML
3.7160
00002239194
HEPTOVIR 5 MG/ML ORAL SOLUTION
ORL
SOL
GSK
ML
0.2300
00002175622
HERBAL WATER TABLET
ORL
TAB
VCL
TAB
0.0621
00002240692
HERCEPTIN 440 MG/VIAL INJECTION
INJ
DEFAUL
HLR
VIAL
2,778.7900
00002244784
HILL-VITE TABLET
ORL
TAB
HIL
TAB
0.1320
00000575178
HISTANTIL 25 MG TABLET
ORL
TAB
PMS
TAB
0.1158
00000575186
HISTANTIL 50 MG TABLET
ORL
TAB
PMS
TAB
0.1849
00001948903
HONEY BEE VENOM 1.1 MG
INJ
DEFAUL
ALG
VIAL
30.8667
00001948911
HONEY BEE VENOM 120 MCG
INJ
DEFAUL
ALG
VIAL
30.8667
00002078759
HUMATIN 250 MG CAPSULE
ORL
CAP
PFI
CAP
2.7000
00000745626
HUMATROPE 1 MG/ML INJECTION
INJ
DEFAUL
LIL
VIAL
233.3500
00002243079
HUMATROPE 24 MG INJECTION
INJ
DEFAUL
LIL
VIAL
1,120.0800
00002415089
HUMULIN R 100 UNIT/ML INJECTION KWIKPEN
INJ
DEFAUL
LIL
ML
2.9307
00000999015
HYALGAN
DEFAUL
DEV
MDX
ML
25.0000
00001916580
HYCODAN 1 MG/ML ORAL SYRUP
ORL
SYR
BMS
ML
0.1328
00001916599
HYCODAN 5 MG TABLET
ORL
TAB
BMS
TAB
1.1120
00002231476
HYDRASENSE NASAL SOLUTION
NAS
SOL
SCH
ML
0.0598
00000465283
HYDREA 500 MG CAPSULE
ORL
CAP
BMS
CAP
1.0203
00000341975
HYDROCHLOROTHIAZIDE 25 MG TABLET
ORL
TAB
PDL
TAB
0.0157
Pg 94 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002242930
HYDROCORTISONE ACETATE 0.5% TOPICAL CREAM
TOP
CRM
TAR
G
0.0846
00002244797
HYDROMORPHONE HP FORTE 100 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
67.6200
00000564281
HYDROSONE 0.5% CREAM
TOP
CRM
RPH
G
0.1267
00002343096
HYDROXYUREA 500 MG CAPSULE
ORL
CAP
SNS
CAP
1.0203
00000742813
HYDROXYZINE HCL 50 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
8.9630
00002229868
HYOSCINE BUTYLBROMIDE 20 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
4.5200
00002230697
HYPERTET S/D 250 IU/SYR INJECTION
INJ
DEFAUL
GRL
SYR
78.0000
00002133253
HYPOTEARS 1% OPH SOLUTION
OPH
SOL
ALC
ML
0.4147
00002133288
HYPOTEARS 85%/15% EYE OINTMENT
OPH
ONT
ALC
G
1.5886
00002275864
HYPURIN NPH INSULIN ISOPHANE PORK 100 UNIT/ML INJ
INJ
DEFAUL
NTI
ML
9.9000
00002275872
HYPURIN REGULAR INSULIN PORK 100 UNIT/ML INJ
INJ
DEFAUL
NTI
ML
9.9000
00080022866
IBEROGAST ORAL SOLUTION
ORL
SOL
STA
ML
0.1951
00002453169
IBRANCE 100 MG CAPSULE
ORL
CAP
PFI
CAP
297.6190
00002453177
ORL
CAP
PFI
CAP
297.6190
00002453150
ORL
CAP
PFI
CAP
297.6190
00002357275
IBUPROFEN 200 MG LIQUID CAPSULE
ORL
CAP
VTH
CAP
0.0681
00002257912
IBUPROFEN 200 MG TABLET
ORL
TAB
PMT
TAB
0.0498
00002317338
IBUPROFEN 400 MG CAPLET
ORL
TAB
PMT
TAB
0.0392
00000636533
IBUPROFEN 400 MG TABLET
ORL
TAB
PDL
TAB
0.0372
00002437333
ICLUSIG 15 MG TABLET
ORL
TAB
ARI
TAB
142.8446
Pg 95 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002437341
ICLUSIG 45 MG TABLET
ORL
TAB
ARI
TAB
331.6398
00002344939
ILARIS 150 MG/VIAL INJECTION
INJ
DEFAUL
NOV
VIAL
16,000.0000
00002411393
ILEVRO 0.3% OPHTHALMIC SUSPENSION
OPH
SUS
ALC
ML
7.4933
00002434407
IMBRUVICA 140 MG CAPSULE
ORL
CAP
JAI
CAP
90.6500
00002358336
IMIPENEM & CILASTATIN 250 MG/250 MG/VIAL INJ USP
INJ
DEFAUL
SDZ
VIAL
11.7400
00002358344
IMIPENEM & CILASTATIN 500 MG/500 MG/VIAL INJ USP
INJ
DEFAUL
SDZ
VIAL
21.9400
00002376016
IMODIUM 2 MG CAPSULE
ORL
CAP
MCL
CAP
0.8200
00002245185
IMODIUM ADVANCED CAPLET
ORL
TAB
MCL
TAB
0.6345
00002237297
IMODIUM ADVANCED CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.9280
00002230542
IMODIUM QUICK DISSOLVE 2 MG TABLET
ORL
TAB
MCL
TAB
0.8200
00001959042
IMOVAX POLIO INJECTION SYRINGE
INJ
NDL
SFP
SYR
44.3200
00001908286
IMOVAX RABIES VACCINE 2.5 UNIT/VIAL INJECTION
INJ
DEFAUL
SFP
VIAL
194.3900
00002240713
IMUNOVIR 500 MG TABLET
ORL
TAB
RIP
TAB
1.9507
00002244895
IMURAN 50 MG/VIAL INJECTION
INJ
DEFAUL
ASN
VIAL
100.2400
00002371553
INCIVEK 375 MG TABLET
ORL
TAB
VER
TAB
69.3810
00002042266
INDERAL-LA 120 MG SUSTAINED-RELEASE CAPSULE
ORL
SRC
PFI
CAP
1.0932
00002042274
ORL
SRC
PFI
CAP
1.2928
00002042231
ORL
SRC
PFI
CAP
0.6296
00002042258
ORL
SRC
PFI
CAP
0.7101
00000558079
INFANTOL ORAL LIQUID
ORL
LIQ
CHD
ML
0.0191
Pg 96 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002046059
INFANTS' TYLENOL 80 MG/ML ORAL SUSPENSION DROPS
ORL
DPS
MCL
ML
0.2893
00002269562
INFLUVAC VACCINE INJECTION SYRINGE
INJ
DEFAUL
ABB
SYR
7.4400
00002389630
INLYTA 1 MG TABLET
ORL
TAB
PFI
TAB
19.1580
00002389649
INLYTA 5 MG TABLET
ORL
TAB
PFI
TAB
95.7900
00080013031
INNO-Q-NOL 100 MG SOFT GEL CAPSULE
ORL
CAP
INN
CAP
1.1325
00080026628
INSTAFLEX JOINT SUPPORT CAPSULE
ORL
CAP
DDI
CAP
0.3332
00000762040
INSTA-GLUCOSE (1 DOSE PER TUBE) ORAL LIQUID
ORL
LIQ
VCL
DOSE
3.8300
00002294990
INSTILLAGEL 2% /0.05% TOPICAL GEL
TOP
GEL
PPH
ML
0.9667
00002348756
INTANZA INJECTION SYRINGE
INJ
DEFAUL
SFP
SYR
12.0000
00002306778
INTELENCE 100 MG TABLET
ORL
TAB
JAI
TAB
5.9330
00002375931
INTELENCE 200 MG TABLET
ORL
TAB
JAI
TAB
11.6253
00002238675
INTRON A 10 MIU/ML INJECTION - HUMAN ALBUMIN FREE
INJ
DEFAUL
MFC
ML
120.9400
00002223406
INTRON A 10,000,000 UNIT/VIAL INJECTION
INJ
DEFAUL
MFC
ML
125.2000
00002238674
INTRON A 6 MIU/ML INJECTION - HUMAN ALBUMIN FREE
INJ
DEFAUL
MFC
ML
72.5633
00002240693
INTRON A MULTI-DOSE PEN 15 MIU/ML INJECTION SYR
INJ
NDL
MFC
SYR
217.6900
00002240694
INJ
NDL
MFC
SYR
362.7800
00002240695
INJ
NDL
MFC
SYR
725.6100
00002409100
INTUNIV XR 1 MG EXTENDED-RELEASE TABLET
ORL
ERT
SHB
TAB
3.0000
00002409119
ORL
ERT
SHB
TAB
3.6500
00002409127
ORL
ERT
SHB
TAB
4.3000
Pg 97 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002409135
ORL
ERT
SHB
TAB
4.9500
00002216965
INVIRASE 200 MG CAPSULE
ORL
CAP
HLR
CAP
1.9021
00002279320
INVIRASE 500 MG TABLET
ORL
TAB
HLR
TAB
4.4773
00002455455
INVOKAMET 150 MG/1000 MG TABLET
ORL
TAB
JAI
TAB
1.5338
00002455439
ORL
TAB
JAI
TAB
1.5338
00002455447
ORL
TAB
JAI
TAB
1.5338
00002455420
ORL
TAB
JAI
TAB
1.5338
00002455404
ORL
TAB
JAI
TAB
1.5338
00002455412
ORL
TAB
JAI
TAB
1.5338
00000888354
IOPIDINE 1% OPH SOLUTION (UNIT DOSE)
OPH
SOL
ALC
ML
62.3667
00002246084
IPRAVENT 0.06% NASAL SPRAY
NAS
SPR
AAP
ML
1.4900
00002365200
IRBESARTAN 150 MG TABLET
ORL
TAB
PDL
TAB
0.3025
00002365219
ORL
TAB
PDL
TAB
0.3025
00002365197
ORL
TAB
PDL
TAB
0.3025
00002365162
IRBESARTAN-HCTZ 150 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.3024
00002365170
IRBESARTAN-HCTZ 300 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.3024
00002365189
IRBESARTAN-HCTZ 300 MG/25 MG TABLET
ORL
TAB
PDL
TAB
0.3004
00002248676
IRESSA 250 MG TABLET
ORL
TAB
AZC
TAB
73.3000
00002392437
ISENTRESS 100 MG CHEWABLE TABLET
ORL
CTB
MFC
TAB
3.9483
00002392429
ISENTRESS 25 MG CHEWABLE TABLET
ORL
CTB
MFC
TAB
0.9870
Pg 98 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002301881
ISENTRESS 400 MG TABLET
ORL
TAB
MFC
TAB
13.9050
00000897639
ISOPROTERENOL HYDROCHLORIDE 0.2 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
8.8180
00000000809
ISOPTO TEARS 0.5% OPH DROPS
OPH
DPS
ALC
ML
0.5147
00000000817
ISOPTO TEARS 1.0% OPH DROPS
OPH
DPS
ALC
ML
0.5147
00000272655
ISOTAMINE 300 MG TABLET
ORL
TAB
VCL
TAB
0.0899
00002414295
ISTODAX 10 MG/VIAL INJECTION
INJ
DEFAUL
CLG
VIAL
2,582.0000
00002333279
IXIARO 6 MCG/0.5ML INJECTION SYRINGE
INJ
NDL
NOV
SYR
193.2500
00002452227
JADENU 180 MG TABLET
ORL
TAB
NOV
TAB
20.4928
00002452235
JADENU 360 MG TABLET
ORL
TAB
NOV
TAB
40.9871
00002452219
JADENU 90 MG TABLET
ORL
TAB
NOV
TAB
10.2460
00002434814
JAKAVI 10 MG TABLET
ORL
TAB
NOV
TAB
83.8355
00002388014
JAKAVI 15 MG TABLET
ORL
TAB
NOV
TAB
83.8355
00002388022
JAKAVI 20 MG TABLET
ORL
TAB
NOV
TAB
83.8355
00002388006
JAKAVI 5 MG TABLET
ORL
TAB
NOV
TAB
83.8355
00002372010
JALYN 0.5 MG/0.4 MG MODIFIED RELEASE CAPSULE
ORL
MRC
GSK
CAP
1.6570
00002246040
JAMP CALCIUM 500 MG TABLET
ORL
TAB
JPC
TAB
0.0216
00002417308
JAMP OLANZAPINE FC 20 MG TABLET
ORL
TAB
JPC
TAB
10.3093
00002388308
JAMP-ACET-TRAMADOL 37.5 MG/325 MG TABLET
ORL
TAB
JPC
TAB
0.6264
00080037789
JAMP-AD 5000 IU/ 400 IU CHEWABLE TABLET
ORL
CTB
JPC
TAB
0.1053
00002421593
JAMP-ALLOPURINOL 100 MG TABLET
ORL
TAB
JPC
TAB
0.0780
Pg 99 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002421607
ORL
TAB
JPC
TAB
0.1300
00002421615
ORL
TAB
JPC
TAB
0.2125
00002400154
JAMP-ALPRAZOLAM 2 MG TABLET
ORL
TAB
JPC
TAB
0.5508
00002435527
JAMP-AMITRIPTYLINE 10 MG TABLET
ORL
TAB
JPC
TAB
0.0435
00002435535
ORL
TAB
JPC
TAB
0.0829
00002435543
ORL
TAB
JPC
TAB
0.1540
00002435551
ORL
TAB
JPC
TAB
0.3634
00002331098
JAMP-AMLODIPINE 10 MG TABLET
ORL
TAB
JPC
TAB
0.3587
00002331071
JAMP-AMLODIPINE 5 MG TABLET
ORL
TAB
JPC
TAB
0.2417
00002433060
JAMP-AMOXICILLIN 250 MG CAPSULE
ORL
CAP
JPC
CAP
0.1750
00002433079
JAMP-AMOXICILLIN 500 MG CAPSULE
ORL
CAP
JPC
CAP
0.3417
00002339080
JAMP-ANASTROZOLE 1 MG TABLET
ORL
TAB
JPC
TAB
2.5458
00002283905
JAMP-ASA 80 MG TABLET
ORL
DRT
JPC
TAB
0.0560
00002453312
JAMP-BEZAFIBRATE 400 MG SUSTAINED-RELEASE TABLET
ORL
SRT
JPC
TAB
1.7460
00002357216
JAMP-BICALUTAMIDE 50 MG TABLET
ORL
TAB
JPC
TAB
4.0573
00002410893
JAMP-BISACODYL 5 MG SUPPOSITORY
RT
SUP
JPC
SUP
0.4367
00002246039
JAMP-BISACODYL 5 MG TABLET
ORL
TAB
JPC
TAB
0.0426
00080028892
JAMP-CALCIUM CITRATE 250 MG + VIT D 1000 IU TABLET
ORL
TAB
JPC
TAB
0.1224
00002451778
JAMP-CETIRIZINE 10 MG TABLET
ORL
TAB
JPC
TAB
0.4083
00002373823
JAMP-COLCHICINE 0.6 MG TABLET
ORL
TAB
JPC
TAB
0.2565
Pg 100 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002391619
JAMP-DICYCLOMINE HCL 10 MG TABLET
ORL
TAB
JPC
TAB
0.4200
00002366088
JAMP-DICYCLOMINE HCL 20 MG TABLET
ORL
TAB
JPC
TAB
0.2207
00002283220
JAMP-DOCUSATE SODIUM 50 MG/ML ORAL SYRUP
ORL
SYR
JPC
ML
0.9203
00080036242
JAMP-E 200 IU CHEWABLE TABLET
ORL
CTB
JPC
TAB
0.1474
00080024232
JAMP-FER 300 MG CAPSULE
ORL
CAP
JPC
CAP
0.1300
00080025200
JAMP-FER FC 100 MG/ 0.5 MG/ 200 MG CAPSULE
ORL
CAP
JPC
CAP
0.2281
00080047569
JAMP-FERROUS POLYSACCHARIDE 150 MG CAPSULE
ORL
CAP
JPC
CAP
0.3997
00000031100
JAMP-FERROUS SULFATE 300 MG TABLET
ORL
TAB
JPC
TAB
0.0165
00080053274
JAMP-FOLIC ACID 1 MG TABLET
ORL
TAB
JPC
TAB
0.0152
00002366061
JAMP-FOLIC ACID 5 MG TABLET
ORL
TAB
JPC
TAB
0.0404
00002402289
JAMP-GABAPENTIN 600 MG TABLET
ORL
TAB
JPC
TAB
1.3045
00002402297
JAMP-GABAPENTIN 800 MG TABLET
ORL
TAB
JPC
TAB
1.7393
00080057189
JAMP-HYDROCORTISONE CREAM 1% TOPICAL CREAM
TOP
CRM
JPC
G
0.1251
00002401290
JAMP-IBUPROFEN 400 MG TABLET
ORL
TAB
JPC
TAB
0.0372
00080047136
JAMP-IRON POLYPEPTIDE 11 MG TABLET
ORL
TAB
JPC
TAB
0.6420
00080023817
JAMP-K-CITRATE 10 MEQ TABLET
ORL
SRT
JPC
TAB
0.1626
00002280078
JAMP-LACTULOSE 667 MG/ML ORAL SYRUP
ORL
SYR
JPC
ML
0.0145
00002373009
JAMP-LETROZOLE 2.5 MG TABLET
ORL
TAB
JPC
TAB
2.7560
00002386836
JAMP-LIDOCAINE 5% TOPICAL OINTMENT
TOP
ONT
JPC
G
0.2800
00080041590
JAMP-MAGNESIUM 100 MG TABLET
ORL
TAB
JPC
TAB
0.2632
Pg 101 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080009357
JAMP-MAGNESIUM 25 MG ORAL LIQUID
ORL
LIQ
JPC
ML
0.0210
00080043440
JAMP-MAGNESIUM 250 MG TABLET
ORL
TAB
JPC
TAB
0.1026
00002419173
JAMP-METHOTREXATE (UNPRESERVED) 25 MG/ML INJECTION
INJ
DEFAUL
JPC
ML
5.6250
00002442353
JAMP-MONTELUKAST 4 MG CHEWABLE TABLET
ORL
CTB
JPC
TAB
0.3865
00002442361
JAMP-MONTELUKAST 5 MG CHEWABLE TABLET
ORL
CTB
JPC
TAB
0.4280
00002427745
JAMPOCAINE 2% VISCOUS TOPICAL SOLUTION
TOP
SOL
JPC
ML
0.0525
00002406640
JAMP-OLANZAPINE 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
JPC
TAB
5.3553
00002406659
JAMP-OLANZAPINE 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
JPC
TAB
7.5977
00002440717
JAMP-OXCARBAZEPINE 150 MG TABLET
ORL
TAB
JPC
TAB
0.6209
00002440725
ORL
TAB
JPC
TAB
0.9102
00002440733
ORL
TAB
JPC
TAB
1.4484
00002408414
JAMP-PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
JPC
TAB
1.2750
00002420430
JAMP-PIP/TAZ 4 G/500 MG/VIAL INJECTION
INJ
DEFAUL
JPC
VIAL
12.1100
00002436000
JAMP-PREGABALIN 150 MG CAPSULE
ORL
CAP
JPC
CAP
1.7270
00002435977
ORL
CAP
JPC
CAP
0.6173
00002436019
ORL
CAP
JPC
CAP
1.7270
00002435985
ORL
CAP
JPC
CAP
0.9683
00002435993
ORL
CAP
JPC
CAP
1.2529
00002380617
JAMP-PYRANTEL PAMOATE 125 MG TABLET
ORL
TAB
JPC
TAB
0.9410
00080040279
JAMP-QUININE 200 MG CAPSULE
ORL
CAP
JPC
CAP
0.2390
Pg 102 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002445190
ORL
CAP
JPC
CAP
0.2390
00080040277
ORL
CAP
JPC
CAP
0.3750
00002445204
ORL
CAP
JPC
CAP
0.3750
00002440334
JAMP-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
JPC
CAP
0.8550
00002405687
JAMP-SILDENAFIL 100 MG TABLET
ORL
TAB
JPC
TAB
9.2000
00002405660
ORL
TAB
JPC
TAB
8.2900
00002405679
ORL
TAB
JPC
TAB
8.8475
00080034416
JAMP-SODIUM PHOSPHATE 0.891 G -2.4 G/5 ML SOLUTION
ORL
SOL
JPC
ML
0.0947
00002451840
JAMP-TADALAFIL 10 MG TABLET
ORL
TAB
JPC
TAB
11.9250
00002451824
JAMP-TADALAFIL 2.5 MG TABLET
ORL
TAB
JPC
TAB
3.6471
00002451859
ORL
TAB
JPC
TAB
12.3575
00002451832
ORL
TAB
JPC
TAB
3.6471
00002435616
JAMP-TOPIRAMATE 100 MG TABLET
ORL
TAB
JPC
TAB
0.5929
00002435624
ORL
TAB
JPC
TAB
0.8854
00002435608
ORL
TAB
JPC
TAB
0.3128
00002420309
JAMP-VANCOMYCIN 1 G/VIAL INJECTION
INJ
DEFAUL
JPC
VIAL
58.9900
00002420325
INJ
DEFAUL
JPC
VIAL
589.9000
00002420317
INJ
DEFAUL
JPC
VIAL
509.7900
00002420295
JAMP-VANCOMYCIN 500 MG/VIAL INJECTION
INJ
DEFAUL
JPC
VIAL
31.0500
00080054130
JAMP-VITAMIN A 10, 000 IU CAPSULE
ORL
CAP
JPC
CAP
0.0431
Pg 103 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080028902
JAMP-VITAMIN B12 1000 MCG RAPID DISSOLVE TABLET
ORL
TAB
JPC
TAB
0.0884
00002449099
JAMP-VITAMIN D 10,000 UNIT CAPSULE
ORL
CAP
JPC
CAP
0.2100
00002379007
JAMP-VITAMIN D 10000 UNIT TABLET
ORL
TAB
JPC
TAB
0.2100
00002449110
JAMP-VITAMIN D 50,000 IU CAPSULE
ORL
CAP
JPC
CAP
0.9162
00080054585
JAMP-VITAMIN K + VITAMIN D TABLET
ORL
TAB
JPC
TAB
0.0627
00080055096
JAMP-VITAMIN K 100 MCG TABLET
ORL
TAB
JPC
TAB
0.0627
00002356805
JAMP-ZOPICLONE 7.5 MG TABLET
ORL
TAB
JPC
TAB
0.3125
00002416808
JANUMET XR 100 MG/1000 MG EXTENDED-RELEASE TABLET
ORL
ERT
MFC
TAB
3.2038
00002416794
ORL
ERT
MFC
TAB
1.6020
00002416786
ORL
ERT
MFC
TAB
1.6019
00002369524
JEVTANA 40 MG/ML INJECTION
INJ
DEFAUL
SAV
VIAL
5,800.0000
00002437503
JINARC 45 MG/15 MG COMBINATION PACK
ORL
TAB
OTS
TAB
45.2057
00002437511
ORL
TAB
OTS
TAB
45.2057
00002437538
ORL
TAB
OTS
TAB
45.2057
00002413388
JUBLIA 10% TOPICAL SOLUTION
TOP
SOL
VCL
ML
10.9767
00002247344
JUNIOR STRENGTH MOTRIN 100 MG CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.2250
00002337282
JURNISTA 16 MG EXTENDED-RELEASE TABLET
ORL
ERT
JAI
TAB
5.3183
00002337290
ORL
ERT
JAI
TAB
10.6360
00002337266
ORL
ERT
JAI
TAB
1.3290
00002337274
ORL
ERT
JAI
TAB
2.6587
Pg 104 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002420376
JUXTAPID 10 MG CAPSULE
ORL
CAP
AEP
CAP
1,040.0000
00002420384
ORL
CAP
AEP
CAP
1,040.0000
00002420341
ORL
CAP
AEP
CAP
1,040.0000
00002412365
KADCYLA 20 MG/ML INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
HLR
ML
411.6725
00002312301
KALETRA 100 MG/25 MG TABLET
ORL
TAB
ABV
TAB
2.8427
00002285533
KALETRA 200 MG/50 MG TABLET
ORL
TAB
ABV
TAB
5.6853
00002243644
KALETRA 80 MG/ML/20MG/ML ORAL SOLUTION
ORL
SOL
ABV
ML
2.2746
00002442612
KALYDECO 50 MG GRANULES
ORL
GRNUL
VER
PCKT
420.0000
00002442620
KALYDECO 75 MG GRANULES
ORL
GRNUL
VER
PCKT
420.0000
00002417235
KAZANO 12.5 MG/1000 MG TABLET
ORL
TAB
TAK
TAB
1.3700
00002417219
ORL
TAB
TAK
TAB
1.3700
00002417227
ORL
TAB
TAK
TAB
1.3700
00080011529
K-CITRA 2 MEQ/ML SOLUTION
ORL
LIQ
SFD
ML
0.0349
00002243768
K-CITRA POTASSIUM CITRATE 10 MEQ SRT
ORL
SRT
SFD
TAB
0.2699
00000376167
KEMSOL 70% TOPICAL SOLUTION
TOP
SOL
AXS
ML
0.2786
00000224391
KETALAR 10 MG/ML INJECTION
INJ
DEFAUL
ERF
ML
1.6000
00000224405
KETALAR 50 MG/ML INJECTION
INJ
DEFAUL
ERF
ML
5.3000
00002246796
KETAMINE 50 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
4.9500
00002246795
KETAMINE HYDROCHLORIDE 10 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
1.6450
00002443376
KETOROLAC TROMETHAMINE 30 MG/ML INJECTION
INJ
DEFAUL
MDA
ML
4.4100
Pg 105 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
INJ
DEFAUL
FKC
ML
5.1452
OPH
SOL
STM
ML
4.2340
00002244947
KETOROLAC TROMETHAMINE 30 MG/ML INJECTION
00002400871
KETOTIFEN 0.25 MG/ML OPH SOLUTION
00002441152
KEYTRUDA 50 MG/VIAL INJECTION
INJ
DEFAUL
MFC
VIAL
00080020666
KID'S LIQUID VITAMIN D 400 IU
ORL
LIQ
WBP
ML
0.1306
00002269341
KIVEXA 600 MG/300 MG TABLET
ORL
TAB
GSK
TAB
24.3037
00001928783
KOFFEX SIROP 3 MG/ML ORAL SYRUP
ORL
SYR
ROG
ML
0.0190
00002389185
KOMBOGLYZE 2.5 MG/1000 MG TABLET
ORL
TAB
AZC
TAB
1.2700
00002389169
ORL
TAB
AZC
TAB
1.2700
00002389177
ORL
TAB
AZC
TAB
1.2700
00080052499
KRILL OIL CAPSULE
ORL
CAP
WNP
CAP
0.4383
00080022006
KRILL OIL SOFTGEL CAPSULE
ORL
CAP
WBP
CAP
0.2192
00002350580
KUVAN 100 MG TABLET
ORL
TAB
BMI
TAB
33.0000
00080004073
KYOLIC AGED GARLIC EXTRACT ORAL CAPLET
ORL
TAB
WKG
TAB
0.5991
00002451034
KYPROLIS 60 MG/VIAL INJECTION
INJ
DEFAUL
AMG
VIAL
1,533.3300
00002387468
LABETALOL HYDROCHLORIDE 5 MG/ML INJECTION
INJ
DEFAUL
MYP
ML
1.2930
00002231689
LABETALOL HYDROCHLORIDE 5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
1.3900
00000210889
LACRI-LUBE OPH OINTMENT
OPH
ONT
ALL
G
2.0543
00002250624
LACRISERT 5 MG OPHTHALMIC INSERT
OPH
INS
ATP
DEV
3.2823
00080012831
LACTOBACILLUS ACIDOPHILUS & BIFIDUS
ORL
CAP
SWS
CAP
0.1123
00000468401
LAIT DE MAGNESIE ORL SUSP (MILK OF MAGNESIA)
ORL
SUS
ATL
ML
0.0068
2,200.0000
Pg 106 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002243803
LAMICTAL 2 MG CHEWABLE TABLET
ORL
CTB
GSK
TAB
0.1700
00002366282
LANSOPRAZOLE 30 MG DELAYED-RELEASE CAPSULE
ORL
DRC
PDL
CAP
0.6000
00002385775
LANSOPRAZOLE 30 MG DELAYED-RELEASE CAPSULE
ORL
DRC
SIV
CAP
0.5000
00000608734
LANSOYL JELLY 78%
ORL
GEL
AUP
G
0.0467
00002186926
LANSOYL SUGAR FREE JELLY 78%
ORL
GEL
AUP
G
0.0467
00000282081
LANVIS 40 MG TABLET
ORL
TAB
ASN
TAB
4.6288
00002375508
LATANOPROST 0.005% OPHTHALMIC SOLUTION
OPH
SOL
RIV
ML
3.6320
00002415828
LEFLUNOMIDE 10 MG TABLET
ORL
TAB
PDL
TAB
2.6433
00002415836
LEFLUNOMIDE 20 MG TABLET
ORL
TAB
PDL
TAB
2.6433
00002450321
LENVIMA (10 MG DAILY DOSE) 10 MG CAPSULE
ORL
CAP
EIS
CAP
71.6400
00002450313
LENVIMA (14 MG DAILY DOSE) 10 MG / 4 MG CAPSULE
ORL
CAP
EIS
CAP
55.2100
00002450305
LENVIMA (20 MG DAILY DOSE) 10 MG CAPSULE
ORL
CAP
EIS
CAP
82.8200
00002450291
LENVIMA (24 MG DAILY DOSE) 10 MG / 4 MG CAPSULE
ORL
CAP
EIS
CAP
73.6133
00002061562
LESCOL 20 MG CAPSULE
ORL
CAP
NOV
CAP
0.9003
00002061570
LESCOL 40 MG CAPSULE
ORL
CAP
NOV
CAP
1.2642
00002338459
LETROZOLE 2.5 MG TABLET
ORL
TAB
AHI
TAB
3.0617
00002347997
ORL
TAB
TEV
TAB
2.7560
00002402025
ORL
TAB
PDL
TAB
1.3780
00002348969
ORL
TAB
APH
TAB
2.7560
00002183005
LEUCOVORIN CALCIUM 10 MG/ML INJECTION
INJ
DEFAUL
MNP
ML
14.0080
Pg 107 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000004626
LEUKERAN 2 MG TABLET
ORL
TAB
ASN
TAB
1.4972
00002236840
LEVAQUIN 25 MG/ML INJECTION
INJ
DEFAUL
JAI
ML
2.2895
00002236841
LEVAQUIN 250 MG TABLET
ORL
TAB
JAI
TAB
5.0324
00002236839
LEVAQUIN 5 MG/ML INJECTION
INJ
DEFAUL
JAI
ML
0.4578
00002236842
ORL
TAB
JAI
TAB
5.6784
00002246804
ORL
TAB
JAI
TAB
10.0474
00002442531
LEVETIRACETAM 250 MG TABLET
ORL
TAB
SIV
TAB
0.8000
00002442558
ORL
TAB
SIV
TAB
0.9750
00002442566
ORL
TAB
SIV
TAB
1.3500
00002250470
LEVITRA 10 MG TABLET
ORL
TAB
BAI
TAB
12.2325
00002250489
LEVITRA 20 MG TABLET
ORL
TAB
BAI
TAB
13.4450
00002250462
LEVITRA 5 MG TABLET
ORL
TAB
BAI
TAB
10.9650
00002415879
LEVOFLOXACIN 500 MG TABLET
ORL
TAB
PDL
TAB
1.3718
00002245948
LEVOTHYROXINE SODIUM 0.5 MG/VIAL INJECTION
INJ
DEFAUL
FKC
VIAL
330.1600
00002243933
LEVULAN KERASTICK 20% TOPICAL SOLUTION
TOP
SOL
DSP
ML
166.0000
00000999056
LIBERTE COPPER IUD TT380 STANDARD 10 YEARS
DEFAUL
DEFAUL
MDI
DEV
59.0000
00000999054
LIBERTE UT380 COPPER IUD 380MG SHORT
DEFAUL
DEFAUL
MDI
DEV
51.0000
00000999055
LIBERTE UT380 COPPER IUD 380MG STANDARD
DEFAUL
DEFAUL
MDI
DEV
51.0000
00002296187
LIDOCAINE HCL 2% INJECTION (BLOCK OR INFILTRATION)
INJ
LIQ
ALV
ML
1.0500
00000436208
LIDOCAINE HYDROCHLORIDE 2% INJECTION
INJ
DEFAUL
HSP
ML
5.8420
Pg 108 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002143879
LIDODAN 2% TOPICAL JELLY
TOP
JEL
ODN
ML
0.4067
00002231147
LIDODAN ENDOTRACHEAL 10 MG/DOSE NON-AEROSOL SPRAY
TOP
SPR
ODN
DOSE
0.2225
00000874949
LIDOMYXIN OTIC LIQUID
OT
LIQ
SDZ
ML
0.5960
00002243101
LIFE BRAND DAILY LOW DOSE ASA 81 MG ECT
ORL
ECT
PMS
TAB
0.1597
00080003212
LIFE BRAND ORAL LAXATIVE
ORL
LIQ
HJS
ML
0.0920
00000030732
LINCOCIN 300 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
3.0190
00002402637
LINEZOLID 2 MG/ML INJECTION
INJ
DEFAUL
TEV
ML
0.2958
00002269082
LIPIDIL EZ 145 MG TABLET
ORL
TAB
BGP
TAB
1.0977
00002269074
LIPIDIL EZ 48 MG TABLET
ORL
TAB
BGP
TAB
0.4287
00002146959
LIPIDIL MICRO 200 MG CAPSULE
ORL
CAP
FAB
CAP
1.0890
00002241601
LIPIDIL SUPRA 100 MG TABLET
ORL
TAB
BGP
TAB
1.1130
00000999813
LIPISTART FORMULA ORAL POWDER
ORL
PWR
VTF
G
0.0945
00080006893
LIQUID CALCIUM WITH VITAMIN D
ORL
LIQ
WBP
ML
0.0168
00080001853
LIQUID GLUCOSAMINE
ORL
LIQ
JAM
ML
0.0310
00080001800
LIQUID GLUCOSAMINE/CHONDROITIN & MSM LIQUID
ORL
LIQ
WBP
ML
0.0334
00080007222
LIQUID OMEGA-3 PLUS VITAMIN A & D
ORL
LIQ
WNP
ML
0.0939
00002266695
LITHMAX 300 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AAP
TAB
0.2545
00002020017
LIVOSTIN 50 MCG PER DOSE NASAL SPRAY
NAS
SPR
JAI
ML
1.9667
00080027321
LIVRELIEF EXTRA STRENGTH NERVE PAIN RELIEF
TOP
CRM
DVI
G
0.3154
00080022837
LIVRELIEF PAIN RELIEF CREAM
TOP
CRM
DVI
G
0.1792
Pg 109 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000074462
LOCACORTEN VIOFORM TOPICAL CREAM
TOP
CRM
PAL
G
0.9603
00002417456
LOLO (28 DAY) TABLET
ORL
TB
ASC
TAB
0.6110
00000590819
LOPRESOR 1.0 MG/ML INJECTION
INJ
DEFAUL
NOV
ML
1.2660
00002221810
LOPROX 1% TOPICAL LOTION
TOP
LOT
VCL
ML
0.3022
00002244692
LORATADINE 10 MG TABLET
ORL
TAB
VTH
TAB
0.4442
00002280159
LORATADINE 10 MG TABLET
ORL
TAB
VTH
TAB
0.1540
00002429810
LORAZEPAM 1 MG TABLET
ORL
TAB
SIV
TAB
0.0447
00002429829
LORAZEPAM 2 MG TABLET
ORL
TAB
SIV
TAB
0.0699
00002243278
LORAZEPAM 4 MG INJECTION USP
INJ
DEFAUL
SDZ
ML
21.2000
00002394383
LOSARTAN 100 MG TABLET
ORL
TAB
PDL
TAB
0.3025
00002394367
ORL
TAB
PDL
TAB
0.3025
00002394375
ORL
TAB
PDL
TAB
0.3025
00002394405
LOSARTAN-HCTZ 100 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.3083
00002394413
LOSARTAN-HCTZ 100 MG/25 MG TABLET
ORL
TAB
PDL
TAB
0.3146
00002394391
LOSARTAN-HCTZ 50 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.3146
00002435853
LOTEMAX 0.5% OPHTHALMIC GEL
OPH
GEL
BSH
G
4.4000
00002421941
LOTEMAX 0.5% OPHTHALMIC OINTMENT
OPH
ONT
BSH
G
6.2857
00002321114
LOTEMAX 0.5% OPHTHALMIC SUSPENSION
OPH
SUS
BSH
ML
4.4000
00002169991
LOXAPAC 50 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
16.7590
00002179709
LOZIDE 1.25 MG TABLET
ORL
TAB
SEV
TAB
0.2980
Pg 110 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002425629
LUCENTIS 1.65 MG/SYRINGE INJECTION
INJ
DEFAUL
NOV
SYR
1,575.0000
00002239833
LUPRON DEPOT 30 MG/VIAL INJECTION
INJ
DEFAUL
ABV
VIAL
1,428.0000
00002242934
LUSTRA-AF TOPICAL CREAM
TOP
CRM
MEI
G
00002046210
LUTREPULSE 0.8 MG/VIAL INJECTION
INJ
DEFAUL
FEI
VIAL
115.0000
00002269066
LUVERIS 75 IU/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
26.4900
00002366924
LUXIQ 0.12% TOPICAL FOAM
TOP
FOA
GSK
G
0.7531
00002454408
LYNPARZA 50 MG CAPSULE
ORL
CAP
AZC
CAP
16.7411
00002268450
LYRICA 150 MG CAPSULE
ORL
CAP
PFI
CAP
2.3717
00002268477
ORL
CAP
PFI
CAP
2.3717
00002268418
ORL
CAP
PFI
CAP
0.8477
00002268485
ORL
CAP
PFI
CAP
2.3717
00002268426
ORL
CAP
PFI
CAP
1.3297
00002268434
ORL
CAP
PFI
CAP
1.7207
00000463221
LYSODREN 500 MG TABLET
ORL
TAB
BMS
TAB
4.7745
00002009765
M.O.S. SULPHATE 10 MG TABLET
ORL
TAB
VCL
TAB
0.1751
00002009749
ORL
TAB
VCL
TAB
0.2317
00002009773
ORL
TAB
VCL
TAB
0.1133
00002009706
ORL
TAB
VCL
TAB
0.3553
00000776181
M.O.S.-SR 30 MG SUSTAINED-RELEASE TABLET
ORL
SRT
VCL
TAB
0.4670
00000776203
M.O.S.-SR 60 MG SUSTAINED-RELEASE TABLET
ORL
SRT
VCL
TAB
0.8232
1.1972
Pg 111 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002244690
MAALOX ANTACID WITH ANTI-GAS EXTRA STRENGTH SUSP
ORL
SUS
NVC
ML
0.0211
00002244689
MAALOX ANTACID WITH ANTI-GAS ORAL SUSPENSION
ORL
SUS
NVC
ML
0.0181
00002238291
MAALOX QUICK DISSOVE EXTRA STR. CHEWABLE TABLET
ORL
TAB
NVC
TAB
0.1031
00002267225
MACUGEN 0.3 MG/SYR INJECTION SYRINGE
INJ
NDL
PFI
SYR
995.0000
00002068400
MAGNESIUM 100 MG TABLET
ORL
TAB
JAM
TAB
0.0697
00080025339
ORL
TAB
WNP
TAB
0.0306
00002040921
ORL
TAB
JAM
TAB
0.0542
00080005581
MAGNESIUM CITRATE 150 MG CAPSULE
ORL
CAP
WBP
CAP
0.0755
00080005079
MAGNESIUM COMPLEX 250 MG CAPLET
ORL
TAB
JAM
TAB
0.0892
00002247017
MAGNESIUM COMPLEX 250 MG TABLET
ORL
TAB
JAM
TAB
0.0450
00080013414
MAGNESIUM EXTRA STRENGTH 500 MG TABLET
ORL
TAB
WNP
TAB
0.0755
00000299448
MAGNESIUM OXIDE 420 MG TABLET
ORL
TAB
VCL
TAB
0.0328
00080014800
MAGNESIUM PLUS CALCIUM POWDER FOR SUSPENSION
ORL
PWRSUS
NCC
G
0.0973
00000392618
MAGNESIUM SULFATE 20% INJECTION
INJ
DEFAUL
SDZ
ML
1.1101
00000602264
MAGNESIUM SULFATE 50% INJECTION USP
INJ
DEFAUL
BAX
ML
1.4890
00002139499
MAGNESIUM SULFATE 500 MG/ML INJECTION USP
INJ
DEFAUL
FKC
ML
0.5603
00000202045
MAGNOLAX ORAL EMULSION
ORL
EML
PPH
ML
0.0140
00002264935
MALARONE PEDIATRIC TABLET
ORL
TAB
GSK
TAB
1.5983
00002238151
MALARONE TABLET
ORL
TAB
GSK
TAB
4.6592
00002243459
MALTLEVOL-12 ORAL LIQUID
ORL
LIQ
CHD
ML
0.0206
Pg 112 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000499013
MANDELAMINE 500 MG TABLET
ORL
TAB
ERF
TAB
0.4599
00000899356
MANERIX 150 MG TABLET
ORL
TAB
MED
TAB
0.6612
00002166747
MANERIX 300 MG TABLET
ORL
TAB
MED
TAB
1.2985
00002429861
MAR-AMITRIPTYLINE 10 MG TABLET
ORL
TAB
MAR
TAB
0.0664
00002429888
ORL
TAB
MAR
TAB
0.1211
00002429896
ORL
TAB
MAR
TAB
0.2347
00002429918
ORL
TAB
MAR
TAB
0.3634
00002371707
MAR-AMLODIPINE 2.5 MG TABLET
ORL
TAB
MAR
TAB
0.1726
00002379562
MAR-ANASTROZOLE 1 MG TABLET
ORL
TAB
MAR
TAB
3.3280
00002241918
MARCAINE 2.5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
0.7730
00002305909
MARCAINE 5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
0.9368
00002241919
MARCAINE 5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
0.9200
00002241917
MARCAINE 7.5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
1.9050
00002241915
MARCAINE E 2.5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
0.8015
00002241914
MARCAINE SPINAL 7.5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
12.4250
00002427133
MAR-CETIRIZINE 10 MG TABLET
ORL
TAB
MAR
TAB
0.4083
00002427141
MAR-CETIRIZINE 20 MG TABLET
ORL
TAB
MAR
TAB
0.7535
00000611190
MARINOL 2.5 MG CAPSULE
ORL
CAP
ABB
CAP
2.0310
00000611204
MARINOL 5 MG CAPSULE
ORL
CAP
ABB
CAP
4.0618
00002373424
MAR-LETROZOLE 2.5 MG TABLET
ORL
TAB
MAR
TAB
3.0617
Pg 113 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002432560
MAR-MODAFINIL 100 MG TABLET
ORL
TAB
MAR
TAB
0.9293
00002389118
MAR-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
MAR
TAB
6.9623
00002389126
MAR-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
MAR
TAB
7.5900
00002416557
MAR-PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
MAR
TAB
1.2750
00002411946
MAR-PAROXETINE 10 MG TABLET
ORL
TAB
MAR
TAB
1.0430
00002417561
MAR-PREGABALIN 150 MG CAPSULE
ORL
CAP
MAR
CAP
1.8652
00002417529
ORL
CAP
MAR
CAP
0.6667
00002417537
ORL
CAP
MAR
CAP
1.0458
00002417545
ORL
CAP
MAR
CAP
1.3532
00002420503
MAR-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
MAR
CAP
0.8550
00002452251
MAR-TADALAFIL 10 MG TABLET
ORL
TAB
MAR
TAB
11.9250
00002452286
MAR-TADALAFIL 2.5 MG TABLET
ORL
TAB
MAR
TAB
3.6471
00002452243
ORL
TAB
MAR
TAB
12.3575
00002452278
ORL
TAB
MAR
TAB
3.6471
00002432102
MAR-TOPIRAMATE 100 MG TABLET
ORL
TAB
MAR
TAB
0.5928
00002432110
ORL
TAB
MAR
TAB
0.8853
00002432099
ORL
TAB
MAR
TAB
0.3128
00002388324
MAR-TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
MAR
TAB
0.6264
00000012750
MATULANE 50 MG CAPSULE
ORL
CAP
SGM
CAP
56.7958
00002244533
MAXILENE 4% TOPICAL CREAM
TOP
CRM
RGR
G
1.7800
Pg 114 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002245939
MAXILENE 5 % TOPICAL CREAM
TOP
CRM
RGR
G
1.6200
00002163632
MAXIPIME 1 G/VIAL INJECTION
INJ
DEFAUL
BMS
VIAL
17.7650
00002163640
MAXIPIME 2 G/VIAL INJECTION
INJ
DEFAUL
BMS
VIAL
35.5250
00002379104
MED-ANASTROZOLE 1 MG TABLET
ORL
TAB
GMP
TAB
3.3280
00002426935
MED-LATANOPROST 0.005% OPHTHALMIC SOLUTION
OPH
SOL
GMP
ML
3.6320
00002253550
MEDROXY-2.5 2.5 MG TABLET
ORL
TAB
PDL
TAB
0.0416
00002253577
MEDROXY-5 5MG TABLET
ORL
TAB
PDL
TAB
0.0823
00002244366
MEFLOQUINE 250 MG TABLET
ORL
TAB
AAP
TAB
3.6950
00002040891
MEGA-CAL CALCIUM W/ VITAMIN D 650 MG/200 UNIT CPT
ORL
TAB
JAM
TAB
0.1028
00002242594
MEGA-VIM CAPLET
ORL
TAB
JAM
TAB
0.1893
00002409623
MEKINIST 0.5 MG TABLET
ORL
TAB
NOV
TAB
74.6750
00002409658
MEKINIST 2 MG TABLET
ORL
TAB
NOV
TAB
298.7000
00080006449
MELATONIN TIMED RELEASED
ORL
TAB
PLH
TAB
0.0556
00002353156
MELOXICAM 15 MG TABLET
ORL
TAB
SNS
TAB
0.5670
00002353148
MELOXICAM 7.5 MG TABLET
ORL
TAB
SNS
TAB
0.4913
00002443082
MEMANTINE 10 MG TABLET
ORL
TAB
SNS
TAB
1.6357
00002446049
MEMANTINE 10 MG TABLET
ORL
TAB
SIV
TAB
1.6357
00002279924
MENACTRA A/C/Y/W-135 (0.5ML SINGLE-DOSE) INJECTION
INJ
DEFAUL
SFP
ML
220.0000
00002248649
MENINGITEC (10 MCG/15 MCG) 0.5 ML INJECTION
INJ
DEFAUL
NBV
ML
130.0400
00002243820
MENJUGATE VACCINE (10 MCG/25 MCG) .5 ML INJECTION
INJ
DEFAUL
NOV
VIAL
89.0000
Pg 115 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000588490
MENOMUNE A/C/Y/W-135 (MULTI-DOSE) INJECTION
INJ
DEFAUL
SFP
VIAL
157.2900
00001959018
MENOMUNE A/C/Y/W-135 (SINGLE-DOSE) INJECTION
INJ
DEFAUL
SFP
VIAL
184.5100
00002283093
MENOPUR 75 IU/VIAL INJECTION
INJ
DEFAUL
FEI
VIAL
74.0000
00002347393
MENVEO 0.5 ML INJECTION
INJ
DEFAUL
NOV
ML
202.0000
00002415275
MERCAPTOPURINE 50 MG TABLET
ORL
TAB
STM
TAB
2.8612
00002378795
MEROPENEM 1G/VIAL INJECTION
INJ
DEFAUL
SDZ
VIAL
47.9900
00002378787
MEROPENEM 500 MG/VIAL INJECTION
INJ
DEFAUL
SDZ
VIAL
23.9950
00002047667
MERSYNDOL WITH CODEINE TABLET
ORL
TAB
SAV
TAB
0.2113
00002244931
MESNA 100 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
10.7966
00002241615
METAMUCIL FIBRE APPLE CRISP 3.4 G/2 WAFERS
ORL
WAF
PGI
WAF
0.1717
00002241614
METAMUCIL FIBRE CINNAMON SPICE 3.4 G/2 WAFERS
ORL
WAF
PGI
WAF
0.2120
00002174812
METAMUCIL FIBRE THERAPY 3.4 G/TSP ORAL POWDER
ORL
PWR
PGI
G
0.0246
00002247034
METAMUCIL FIBRE THERAPY CAPSULE
ORL
CAP
PGI
CAP
0.1220
00002174782
METAMUCIL FIBRE THERAPY-SMOOTH TEXTURE-ORANGE S.F.
ORL
PWR
PGI
G
0.0686
00002174790
METAMUCIL SMOOTH TEXTURE-ORANGE 3 G/TBSP ORAL PWDR
ORL
PWR
PGI
G
0.0157
00002174804
METAMUCIL SMOOTH UNFLAVORED SUGAR FREE POWDER
ORL
PWR
PGI
G
0.0320
00002182971
METHOTREXATE (UNPRESERVED) 25 MG/ML INJECTION
INJ
DEFAUL
MNP
ML
7.8755
00002422174
METHOTREXATE 10 MG/0.4ML INJECTION SYRINGE BP
INJ
NDL
PMS
SYR
7.0000
00002422182
METHOTREXATE 15 MG/0.6 ML INJECTION SYRINGE BP
INJ
NDL
PMS
SYR
8.4000
00002422190
METHOTREXATE 20 MG/0.8 ML INJECTION SYRINGE BP
INJ
NDL
PMS
SYR
11.2000
Pg 116 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002417626
METHOTREXATE 25 MG/ML INJECTION (UNPRESERVED)
INJ
DEFAUL
MYP
ML
6.2500
00002327236
METHOTREXATE 25 MG/ML INJECTION BP (UNPRESERVED)
INJ
DEFAUL
AHI
ML
8.0000
00002422204
METHOTREXATE 25 MG/ML INJECTION SYRINGE BP
INJ
NDL
PMS
SYR
14.0000
00002422166
METHOTREXATE 7.5 ML/0.3 ML INJECTION SYRINGE BP
INJ
NDL
PMS
SYR
5.6000
00002182947
METHOTREXATE SODIUM (UNPRESERVED) 10 MG/ML INJ
INJ
DEFAUL
MNP
ML
9.5050
00002230521
METHOXACET CAPLET
ORL
TAB
RPH
TAB
0.1583
00002236872
METHOXACET-C 1/8 CAPLET
ORL
TAB
RPH
TAB
0.5828
00000868868
METHOXISAL CAPLET
ORL
TAB
RPH
TAB
0.2772
00001966375
METHOXISAL-C 1/2 TABLET
ORL
TAB
RPH
TAB
0.9525
00001966367
METHOXISAL-C 1/4 TABLET
ORL
TAB
RPH
TAB
0.8208
00001941895
METHOXISAL-C 1/8 CAPLET
ORL
TAB
RPH
TAB
0.5272
00002326248
METHYLPHENIDATE 10 MG TABLET
ORL
TAB
PDL
TAB
0.0816
00002326256
ORL
TAB
PDL
TAB
0.2326
00002326221
ORL
TAB
PDL
TAB
0.1004
00002245407
METHYLPREDNISOLONE ACETATE (PRES.) 40 MG/ML INJ
INJ
DEFALT
SDZ
ML
4.1000
00002245408
METHYLPREDNISOLONE ACETATE (PRES.) 80 MG/ML INJ.
INJ
DEFALT
SDZ
ML
6.9900
00002245400
METHYLPREDNISOLONE ACETATE 40 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
4.1000
00002245406
METHYLPREDNISOLONE ACETATE 80 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
8.2000
00002243563
METOCLOPRAMIDE OMEGA 5MG/ML INJECTION
INJ
DEFAUL
OMG
ML
2.9450
00002320037
METOJECT 10 MG/1 ML INJECTION SYRINGE
INJ
NDL
MDX
SYR
49.4000
Pg 117 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002320045
METOJECT 15 MG/1.5 ML INJECTION SYRINGE
INJ
NDL
MDX
SYR
54.6000
00002304767
METOJECT 20 MG/2 ML INJECTION SYRINGE
INJ
NDL
MDX
SYR
59.8000
00002320053
METOJECT 25 MG/2.5 ML INJECTION SYRINGE
INJ
NDL
MDX
SYR
65.0000
00002320029
METOJECT 7.5 MG/0.75 ML INJECTION SYRINGE
INJ
NDL
MDX
SYR
46.8000
00002296713
METOPROLOL - 25 25 MG TABLET
ORL
TAB
PDL
TAB
0.0643
00002351404
METOPROLOL SR 100 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.1871
00002351412
METOPROLOL SR 200 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.3396
00002267853
METOPROLOL TARTRATE 1 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
1.4162
00000648027
METOPROLOL-100 MG TABLET
ORL
TAB
PDL
TAB
0.1714
00000648019
METOPROLOL-50 MG TABLET
ORL
TAB
PDL
TAB
0.0786
00002442116
METOPROLOL-L 25 MG TABLET
ORL
TAB
SIV
TAB
0.0643
00002092832
METROGEL 0.75% TOPICAL GEL
TOP
GEL
GAL
G
1.4400
00002248562
METRONIDAZOLE 500 MG CAPSULE
ORL
CAP
AAP
CAP
0.7028
00002323273
METVIX 16.8% TOPICAL CREAM
TOP
CRM
GAL
G
162.8200
00002085852
MICATIN 2% TOPICAL CREAM
TOP
CRM
WSP
G
0.3840
00002171775
MICONAZOLE 3 DAY OVULE TREATMENT
VAG
OVL
VTH
OVL
1.6966
00002091143
MICRO PLUS 4 CONCENTRATE INJECTION
INJ
DEFAUL
SDZ
ML
2.5276
00002091135
MICRO PLUS 4 REGULAR STRENGTH INJECTION
INJ
DEFAUL
SDZ
ML
0.9090
00002063905
MICROLAX MICRO RECTAL ENEMA
RT
ENM
JJM
ENM
1.5000
00000787000
MICRO-ZN 5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
2.4042
Pg 118 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000487805
MIDAMOR 5 MG TABLET
ORL
TAB
OPI
TAB
0.2860
00002423758
MIDAZOLAM 1 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
0.8200
00002242904
INJ
DEFAUL
FKC
ML
1.3170
00002240285
INJ
DEFAUL
SDZ
ML
0.7800
00002242905
INJ
DEFAUL
FKC
ML
4.7150
00002423766
INJ
DEFAUL
PFI
ML
4.1000
00002382873
MIDAZOLAM INJECTION SDZ 1 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
0.7800
00002244622
MILRINONE LACTATE 1 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
5.9061
00001935348
MINERAL OIL (HEAVY)
ORL
LIQ
RBW
ML
0.0092
00000485802
MINERAL OIL 100% ORAL LIQUID
ORL
LIQ
RPH
ML
0.0122
00002246500
MINIRIN 0.1 MG TABLET
ORL
TAB
FEI
TAB
1.3216
00002042320
MIN-OVRAL (21 DAY) TABLET
ORL
TAB
PFI
TAB
0.7800
00002042339
MIN-OVRAL (28 DAY) TABLET
ORL
TB
PFI
TAB
0.5850
00002394863
MINT-ALENDRONATE 10 MG TABLET
ORL
TAB
MPI
TAB
0.4986
00002393573
MINT-ANASTROZOLE 1 MG TABLET
ORL
TAB
MPI
TAB
1.7821
00002317427
MINT-CIPROFLOXACIN 250 MG TABLET
ORL
TAB
MPI
TAB
0.6186
00002317435
MINT-CIPROFLOXACIN 500 MG TABLET
ORL
TAB
MPI
TAB
0.6979
00002425947
MINT-HYDROCHLOROTHIAZIDE 12.5 MG TABLET
ORL
TAB
MPI
TAB
0.0341
00002426196
MINT-HYDROCHLOROTHIAZIDE 25 MG TABLET
ORL
TAB
MPI
TAB
0.0157
00002426218
MINT-HYDROCHLOROTHIAZIDE 50 MG TABLET
ORL
TAB
MPI
TAB
0.0217
Pg 119 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002388766
MINT-METFORMIN 500 MG TABLET
ORL
TAB
MPI
TAB
0.0444
00002388774
MINT-METFORMIN 850 MG TABLET
ORL
TAB
MPI
TAB
0.0610
00002436981
MINT-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
MPI
TAB
1.9280
00002437007
MINT-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
MPI
TAB
7.5977
00002422727
MINT-OLOPATADINE 0.1% OPHTHALMIC SOLUTION
OPH
SOL
MPI
ML
5.2260
00002424207
MINT-PREGABALIN 150 MG CAPSULE
ORL
CAP
MPI
CAP
1.7270
00002423804
ORL
CAP
MPI
CAP
0.6173
00002423812
ORL
CAP
MPI
CAP
0.9683
00002424185
ORL
CAP
MPI
CAP
1.2529
00002421348
MINT-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
MPI
CAP
0.8551
00002393085
MINT-SILDENAFIL 100 MG TABLET
ORL
TAB
MPI
TAB
9.2000
00002393069
ORL
TAB
MPI
TAB
8.2900
00002393077
ORL
TAB
MPI
TAB
8.8475
00002423308
MINT-TOLTERODINE 1 MG TABLET
ORL
TAB
MPI
TAB
0.4910
00002423316
MINT-TOLTERODINE 2 MG TABLET
ORL
TAB
MPI
TAB
0.4910
00002389800
MINT-TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
MPI
TAB
0.6264
00000042544
MIOSTAT 0.01% OPH SOLUTION
OPH
SOL
ALC
ML
13.3822
00002297256
MIRAPEX 0.125 MG TABLET
ORL
TAB
BOE
TAB
1.1160
00002241594
MIRAPEX 0.5 MG TABLET
ORL
TAB
BOE
TAB
2.2322
00002312786
MIRTAZAPINE-30 30 MG TABLET
ORL
TAB
PDL
TAB
0.1950
Pg 120 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002248846
MISOPROSTOL-200 200 MCG TABLET
ORL
TAB
PDL
TAB
0.4389
00002230451
MITOMYCIN 20 MG/VIAL INJECTION
INJ
DEFAUL
TEV
VIAL
377.2000
00002230450
MITOMYCIN 5 MG/VIAL INJECTION
INJ
DEFAUL
TEV
VIAL
94.3000
00001948873
MIXED VESPID VENOM PROTEIN 1.1 MG VIAL INJ
INJ
DEFAUL
ALK
ML
71.3833
00001948881
MIXED VESPID VENOM PROTEIN 120 MCG
INJ
DEFAUL
ALG
VIAL
71.3833
00080025624
MK 20 A LIBERATION PROLONGEE 20 MEQ TABLET
ORL
TAB
MTR
TAB
0.1995
00080035346
MK 8 8 MEQ TABLET
ORL
TAB
MTR
TAB
0.2250
00000466085
M-M-R II VIRUS VACCINE LIVE ATTENUATED INJECTION
INJ
DEFAUL
MSD
VIAL
30.4980
00002242786
MOBICOX 15 MG TABLET
ORL
TAB
BOE
TAB
0.9520
00002242785
MOBICOX 7.5 MG TABLET
ORL
TAB
BOE
TAB
0.8251
00002238696
MOI-STIR SPRAY ORAL LIQUID
ORL
LIQ
PMS
ML
0.0637
00001909142
MOISTUREL TOPICAL CREAM
TOP
CRM
WSD
G
0.0567
00001909169
MOISTUREL TOPICAL LOTION
TOP
LOT
WSD
ML
0.0208
00000999058
MONA LISA 10 IUD COPPER STERILE
DEFAUL
DEFAUL
BSN
DEV
61.5000
00000999057
MONA LISA 5 IUD COPPER STERILE
DEFAUL
DEFAUL
BSN
DEV
48.0000
00002239601
MONISTAT 1 1200 MG VAGINAL OVULE
VAG
OVL
MCL
OVL
12.0200
00002244005
MONISTAT 3 4% VAGINAL CREAM
VAG
CRM
MCL
G
0.8013
00002126605
MONISTAT 3 400 MG VAGINAL OVULE
VAG
OVL
MCL
OVL
4.0067
00002126249
MONISTAT 3 DUAL-PAK KIT
VAG/TOP
OVL/CRM
MCL
KIT
13.7600
00002084309
MONISTAT 7 2% VAGINAL CREAM
VAG
CRM
MCL
G
0.3434
Pg 121 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
VAG/TOP
OVL/CRM
MCL
KIT
13.7600
TOP
CRM
MCL
G
0.3933
00002126257
MONISTAT 7 DUAL-PAK VAGINAL OVULE/TOPICAL CREAM
00002126567
MONISTAT DERM 2% TOPICAL CREAM
00002239600
MONISTAT-1 COMBINATION PACK VAG OVULE/TOP CREAM
VAG/TOP
OVL/CRM
MCL
KIT
13.7600
00000999332
MONOVISC
DEFAUL
DEV
PMS
ML
75.0000
00002379856
MONTELUKAST 10 MG TABLET
ORL
TAB
PDL
TAB
0.9460
00002379821
ORL
TAB
PDL
TAB
0.9460
00002379848
ORL
TAB
PDL
TAB
0.9460
00002021056
MORPHINE LP EPIDURAL 0.5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
2.6187
00001964437
MORPHINE SULFATE 2 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
0.2528
00001964429
INJ
DEFAUL
SDZ
ML
0.4153
00001980696
INJ
DEFAUL
SDZ
ML
0.3726
00002242484
MORPHINE SULFATE 2 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
2.1440
00002382997
MORPHINE SULFATE INJECTION SDZ 10 MG/ML INJ
INJ
DEFAUL
SDZ
ML
2.2720
00080028360
MOTION MEDICINE TOPICAL CREAM
TOP
CRM
NDP
G
0.1212
00002186934
MOTRIN IB 200 MG TABLET
ORL
TAB
MCL
TAB
0.1229
00002442167
MOVANTIK 12.5 MG TABLET
ORL
TAB
AZC
TAB
5.9500
00002442175
MOVANTIK 25 MG TABLET
ORL
TAB
AZC
TAB
5.9500
00002359499
MOVIPREP POWDER FOR ORAL LAVAGE SOLUTION
ORL
PWDPKT
MFI
PCKT
5.8600
00002430037
M-SILDENAFIL 100 MG TABLET
ORL
TAB
MTR
TAB
0.3680
00080001844
MSM 1000 MG
ORL
TAB
WNP
TAB
0.0654
Pg 122 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002125013
MUCAINE ORAL SUSPENSION
ORL
SUS
AXC
ML
0.0243
00000599875
MUCILLIUM 500 MG/G ORAL POWDER
ORL
PWR
PMS
G
0.0175
00002091526
MUCOMYST 20% INHALATION SOLUTION
INH
SOL
WSP
ML
0.7200
00002330989
MULTAQ 400 MG TABLET
ORL
TAB
SAV
TAB
2.1817
00080050211
MULTI COMPLETE DYE FREE MULTIVITAMINS
ORL
TAB
WNP
TAB
0.0556
00000782203
MULTI VITAMIN PLUS IRON TABLET
ORL
TAB
VTH
TAB
0.0600
00000782211
MULTI VITAMIN TABLET
ORL
TAB
VTH
TAB
0.0270
00000586315
MULTI-1000 INJECTION
INJ
DEFAUL
SDZ
ML
1.2296
00002100606
MULTI-12 INJECTION
INJ
DEFAUL
SDZ
ML
1.3288
00002244898
MULTIPLE VITAMIN TABLET
ORL
TAB
PMT
TAB
0.0700
00000374083
MULTIPLE VITAMIN WITH MINERAL TABLET
ORL
TAB
ADA
TAB
0.1100
00002248775
MULTISURE FOR WOMEN
ORL
CAP
WNP
CAP
0.0850
00002248778
MULTISURE FOR WOMEN OVER 50 GELATIN CAPSULE
ORL
CAP
WBP
CAP
0.0850
00002240942
MULTI-TAR PLUS REGULAR TOPICAL SHAMPOO
TOP
SHP
VCL
ML
0.0381
00000233498
MULTIVITAMIN TABLET
ORL
TAB
WAM
TAB
0.2226
00080005483
MULTI-VITAMIN TABLET
ORL
TAB
WNP
TAB
0.0351
00002242779
MULTIVITAMINS & MULTIMINERALS FORMULA FORTE SR.TAB
ORL
TAB
PMT
TAB
0.0800
00002242939
MULTIVITAMINS + MULTIMINERALS 50+ FORMULA TAB.
ORL
TAB
PMT
TAB
0.0665
00002242780
MULTIVITAMINS AND MULTIMINERALS FORMULA FORTE TAB
ORL
TAB
PMT
TAB
0.0678
00002244864
MULTIVITAMINS FOR ADULTS TABLET
ORL
TAB
PMT
TAB
0.0300
Pg 123 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000750816
MURO-128 5% OPH OINTMENT
OPH
ONT
BSH
G
2.9486
00000750824
MURO-128 5% OPH SOLUTION
OPH
SOL
BSH
ML
0.6880
00002238595
MUSE 1000 MCG URETHRAL SUPPOSITORY
URH
SUP
PAL
SUP
38.0900
00002238593
URH
SUP
PAL
SUP
38.0900
00002238594
URH
SUP
PAL
SUP
38.0900
00000016063
MUSTARGEN HCL TRITURATION 10 MG/VIAL INJECTION
INJ
DEFAUL
LUI
VIAL
7.9500
00002415380
MYA 28 TABLET
ORL
TB
APX
TAB
0.4229
00002311054
MYCAMINE 100 MG/VIAL INJECTION
INJ
DEFAUL
ASP
VIAL
196.0000
00002294222
MYCAMINE 50 MG/VIAL INJECTION
INJ
DEFAUL
ASP
VIAL
98.0000
00002264560
MYFORTIC 180 MG ENTERIC-COATED TABLET
ORL
ECT
NOV
TAB
1.9977
00002264579
MYFORTIC 360 MG ENTERIC-COATED TABLET
ORL
ECT
NOV
TAB
3.9953
00002450682
MYLAN-ABACAVIR/LAMIVUDINE 600 MG/300 MG TABLET
ORL
TAB
MYP
TAB
20.3573
00002270129
MYLAN-ALENDRONATE 10 MG TABLET
ORL
TAB
MYP
TAB
0.5134
00002270110
MYLAN-ALENDRONATE 5 MG TABLET
ORL
TAB
MYP
TAB
1.0370
00002229813
MYLAN-ALPRAZOLAM 1 MG TABLET
ORL
TAB
MYP
TAB
0.3099
00002229814
MYLAN-ALPRAZOLAM 2 MG TABLET
ORL
TAB
MYP
TAB
0.5508
00002253054
MYLAN-ANAGRELIDE 0.5 MG CAPSULE
ORL
CAP
MYP
CAP
3.3491
00002361418
MYLAN-ANASTROZOLE 1 MG TABLET
ORL
TAB
MYP
TAB
2.7497
00002378981
MYLAN-ATOMOXETINE 100 MG CAPSULE
ORL
CAP
MYP
CAP
4.3520
00002378930
ORL
CAP
MYP
CAP
2.6500
Pg 124 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002378949
ORL
CAP
MYP
CAP
2.9281
00002378957
ORL
CAP
MYP
CAP
3.3375
00002378965
ORL
CAP
MYP
CAP
3.7024
00002378973
ORL
CAP
MYP
CAP
3.9960
00002373203
MYLAN-ATORVASTATIN 10 MG TABLET
ORL
TAB
MYP
TAB
0.3138
00002373211
ORL
TAB
MYP
TAB
0.3922
00002373238
ORL
TAB
MYP
TAB
0.4216
00002373246
ORL
TAB
MYP
TAB
0.4216
00002402165
MYLAN-ATOVAQUONE/PROGUANIL 250 MG/ 100 MG TABLET
ORL
TAB
MYP
TAB
4.1308
00002302403
MYLAN-BICALUTAMIDE 50 MG TABLET
ORL
TAB
MYP
TAB
4.0573
00002383500
MYLAN-BOSENTAN 125 MG TABLET
ORL
TAB
MYP
TAB
22.4625
00002383497
MYLAN-BOSENTAN 62.5 MG TABLET
ORL
TAB
MYP
TAB
22.4625
00002241003
MYLAN-BUDESONIDE AQ 64 MCG/DOSE MET DOSE NAS SPRAY
NAS
SPM
MYP
DOSE
0.0843
00002379120
MYLAN-CANDESARTAN 4 MG TABLET
ORL
TAB
MYP
TAB
0.3400
00002163594
MYLAN-CAPTOPRIL 100 MG TABLET
ORL
TAB
MYP
TAB
0.5198
00002163551
MYLAN-CAPTOPRIL 12.5 MG TABLET
ORL
TAB
MYP
TAB
0.1060
00002163578
ORL
TAB
MYP
TAB
0.1500
00002163586
ORL
TAB
MYP
TAB
0.2795
00002241882
MYLAN-CARBAMAZEPINE CR 200 MG SUSTAIN RELEASE TAB
ORL
SRT
MYP
TAB
0.0930
00002241883
MYLAN-CARBAMAZEPINE CR 400 MG SUSTAIN RELEASE TAB
ORL
SRT
MYP
TAB
0.1859
Pg 125 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002227444
MYLAN-CIMETIDINE 300 MG TABLET
ORL
TAB
MYP
TAB
0.0860
00002434539
MYLAN-CINACALCET 30 MG TABLET
ORL
TAB
MYP
TAB
10.1947
00002278669
MYLAN-DOMPERIDONE 10 MG TABLET
ORL
TAB
MYP
TAB
0.0594
00002240498
MYLAN-DOXAZOSIN 1 MG TABLET
ORL
TAB
MYP
TAB
0.1416
00002240499
ORL
TAB
MYP
TAB
0.1699
00002240500
ORL
TAB
MYP
TAB
0.2209
00002381524
MYLAN-EFAVIRENZ 600 MG TABLET
ORL
TAB
MYP
TAB
11.2103
00002383039
MYLAN-ESOMEPRAZOLE 20 MG DELAYED-RELEASE TABLET
ORL
DRT
MYP
TAB
1.8690
00002383047
MYLAN-ESOMEPRAZOLE 40 MG DELAYED-RELEASE TABLET
ORL
DRT
MYP
TAB
1.8690
00002245330
MYLAN-ETIDRONATE 200 MG TABLET
ORL
TAB
MYP
TAB
0.3568
00002392631
MYLAN-FINASTERIDE HG 1 MG TABLET
ORL
TAB
MYP
TAB
1.1453
00002397471
MYLAN-GABAPENTIN 600 MG TABLET
ORL
TAB
MYP
TAB
1.3045
00002397498
MYLAN-GABAPENTIN 800 MG TABLET
ORL
TAB
MYP
TAB
1.7393
00000808733
MYLAN-GLYBE 2.5 MG TABLET
ORL
TAB
MYP
TAB
0.0321
00000808741
MYLAN-GLYBE 5 MG TABLET
ORL
TAB
MYP
TAB
0.0573
00002242920
MYLAN-HYDROXYUREA 500 MG CAPSULE
ORL
CAP
MYP
CAP
1.0203
00002319225
MYLAN-LEFLUNOMIDE 10 MG TABLET
ORL
TAB
MYP
TAB
6.0417
00002319233
MYLAN-LEFLUNOMIDE 20 MG TABLET
ORL
TAB
MYP
TAB
6.0417
00002297736
MYLAN-LISINOPRIL HCTZ 10 MG/12.5 MG TABLET
ORL
TAB
MYP
TAB
0.2083
00002297744
MYLAN-LISINOPRIL HCTZ 20 MG/12.5 MG TABLET
ORL
TAB
MYP
TAB
0.2503
Pg 126 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002297752
MYLAN-LISINOPRIL HCTZ 20 MG/25 MG TABLET
ORL
TAB
MYP
TAB
0.2503
00002255995
MYLAN-MELOXICAM 15 MG TABLET
ORL
TAB
MYP
TAB
0.5670
00002255987
MYLAN-MELOXICAM 7.5 MG TABLET
ORL
TAB
MYP
TAB
0.4914
00002430371
MYLAN-MEMANTINE 10 MG TABLET
ORL
TAB
MYP
TAB
1.6357
00002371154
MYLAN-MYCOPHENOLATE 250 MG CAPSULE
ORL
CAP
MYP
CAP
1.0310
00002370549
MYLAN-MYCOPHENOLATE 500 MG TABLET
ORL
TAB
MYP
TAB
2.0620
00002244563
MYLAN-NABUMETONE 500 MG TABLET
ORL
TAB
MYP
TAB
0.3625
00002387727
MYLAN-NEVIRAPINE 200 MG TABLET
ORL
TAB
MYP
TAB
1.7285
00002382725
MYLAN-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
MYP
TAB
4.1240
00002382733
MYLAN-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
MYP
TAB
7.5977
00002248012
MYLAN-PAROXETINE 10 MG TABLET
ORL
TAB
MYP
TAB
1.0430
00002298279
MYLAN-PIOGLITAZONE 15 MG TABLET
ORL
TAB
MYP
TAB
0.5809
00002298287
ORL
TAB
MYP
TAB
0.8139
00002298295
ORL
TAB
MYP
TAB
1.2237
00002376369
MYLAN-PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
MYP
TAB
1.0514
00002245372
MYLAN-PROPAFENONE 150 MG TABLET
ORL
TAB
MYP
TAB
0.2965
00002245373
MYLAN-PROPAFENONE 300 MG TABLET
ORL
TAB
MYP
TAB
0.5227
00002397773
MYLAN-RISEDRONATE 150 MG TABLET
ORL
TAB
MYP
TAB
40.9500
00002229779
MYLAN-SOTALOL 160 MG TABLET
ORL
TAB
MYP
TAB
0.1623
00002229778
MYLAN-SOTALOL 80 MG TABLET
ORL
TAB
MYP
TAB
0.2966
Pg 127 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002268906
MYLAN-SUMATRIPTAN 25 MG TABLET
ORL
TAB
MYP
TAB
8.9900
00002019795
MYLANTA REGULAR STRENGTH CHEWABLE TABLET
ORL
CTB
WLA
TAB
0.1062
00002410656
MYLAN-TADALAFIL 10 MG TABLET
ORL
TAB
MYP
TAB
11.9250
00002410621
MYLAN-TADALAFIL 2.5 MG TABLET
ORL
TAB
MYP
TAB
3.6471
00002410664
ORL
TAB
MYP
TAB
12.3569
00002410648
ORL
TAB
MYP
TAB
3.6471
00002088428
MYLAN-TAMOXIFEN 10 MG TABLET
ORL
TAB
MYP
TAB
0.1750
00002089858
MYLAN-TAMOXIFEN 20 MG TABLET
ORL
TAB
MYP
TAB
0.3500
00002298570
MYLAN-TAMSULOSIN 0.4 MG EXTENDED-RELEASE CAPSULE
ORL
SRC
MYP
CAP
0.2375
00002396289
MYLAN-TERAZOSIN 1 MG TABLET
ORL
TAB
MYP
TAB
0.1835
00002396319
ORL
TAB
MYP
TAB
0.4637
00002396297
ORL
TAB
MYP
TAB
0.2333
00002396300
ORL
TAB
MYP
TAB
0.3168
00002242503
MYLAN-TERBINAFINE 250 MG TABLET
ORL
TAB
MYP
TAB
1.8525
00002239744
MYLAN-TICLOPIDINE 250 MG TABLET
ORL
TAB
MYP
TAB
0.3139
00002272059
MYLAN-TIZANIDINE 4 MG TABLET
ORL
TAB
MYP
TAB
0.3686
00002425599
MYLAN-TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
MYP
TAB
0.6264
00002231684
MYLAN-TRAZODONE 100 MG TABLET
ORL
TAB
MYP
TAB
0.0989
00002231683
MYLAN-TRAZODONE 50 MG TABLET
ORL
TAB
MYP
TAB
0.0554
00002383527
MYLAN-VALSARTAN 40 MG TABLET
ORL
TAB
MYP
TAB
0.5239
Pg 128 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002450488
MYLAN-VERAPAMIL SR 180 MG SUSTAINED-RELEASE TABLET
ORL
SRT
MYP
TAB
0.5204
00002287501
MYLAN-WARFARIN 6 MG TABLET
ORL
TAB
MYP
TAB
0.2805
00002287528
MYLAN-WARFARIN 7.5 MG TABLET
ORL
TAB
MYP
TAB
0.3014
00000004618
MYLERAN 2 MG TABLET
ORL
TAB
ASN
TAB
1.5888
00002372169
MYL-LETROZOLE 2.5 MG TABLET
ORL
TAB
MYP
TAB
2.7560
00002408694
MYL-PREGABALIN 150 MG CAPSULE
ORL
CAP
MYP
CAP
1.7270
00002408651
ORL
CAP
MYP
CAP
0.6173
00002408708
ORL
CAP
MYP
CAP
1.7270
00002408678
ORL
CAP
MYP
CAP
0.9683
00002408686
ORL
CAP
MYP
CAP
1.2529
00002367378
MYL-RANITIDINE 150 MG TABLET
ORL
TAB
MYP
TAB
0.1800
00002367386
MYL-RANITIDINE 300 MG TABLET
ORL
TAB
MYP
TAB
0.3600
00002392593
MYL-SILDENAFIL 100 MG TABLET
ORL
TAB
MYP
TAB
9.2007
00002392577
ORL
TAB
MYP
TAB
8.2900
00002392585
ORL
TAB
MYP
TAB
8.8475
00001927612
MYOCHRYSINE 25 MG/ML INJECTION
INJ
DEFAUL
AVE
ML
15.3000
00002226022
MYOFLEX EXTRA STRENGTH 15% CREAM
TOP
CRM
BIC
G
0.0598
00000828815
NADOLOL-40 MG TABLET
ORL
TAB
PDL
TAB
0.2465
00000818704
NADOLOL-80 MG TABLET
ORL
TAB
PDL
TAB
0.3515
00002412683
NAGLAZYME 1 MG/ML INJECTION
INJ
DEFAUL
BMI
ML
307.0000
Pg 129 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002382601
NALOXONE HYDROCHLORIDE (PRES. FREE) 0.4 MG/ML INJ
INJ
DEFAUL
SDZ
ML
13.7450
00002382482
NALOXONE HYDROCHLORIDE 0.4 MG/ML INJ USP
INJ
DEFAUL
ALV
ML
15.0000
00002148706
NALOXONE HYDROCHLORIDE 0.4 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
13.7450
00002148714
NALOXONE HYDROCHLORIDE 1 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
20.1475
00002393034
NALOXONE HYDROCHLORIDE INJECTION 0.4 MG/ML INJ
INJ
DEFAUL
OMG
ML
13.7500
00000390283
NAPHCON FORTE 0.1% OPH SOLUTION
OPH
SOL
ALC
ML
0.5060
00000481408
NAPHCON-A OPH SOLUTION
OPH
SOL
ALC
ML
0.4747
00002242505
NAPRELAN 375 MG CONTROLLED-RELEASE TABLET
ORL
CRT
SUN
TAB
0.9604
00002242506
NAPRELAN 500 MG CONTROLLED-RELEASE TABLET
ORL
CRT
SUN
TAB
1.5790
00000618721
NAPROXEN 500 MG TABLET
ORL
TAB
PDL
TAB
0.2110
00002362430
ORL
TAB
PMS
TAB
0.0696
00000590762
ORL
TAB
PDL
TAB
0.1068
00000655686
NAPROXEN-375 375 MG TABLET
ORL
TAB
PDL
TAB
0.1458
00000887056
NAPROXEN-NA 275 MG TABLET
ORL
TAB
PDL
TAB
0.3422
00002153386
NAPROXEN-NA DF 550 MG TABLET
ORL
TAB
PDL
TAB
0.6667
00002229415
NAROPIN 5 MG/ML INJECTION
INJ
DEFAUL
AZC
ML
0.3798
00002213834
NASACORT AQ 55 MCG NASAL METERED DOSE SPRAY
NAS
SPM
SAV
DOSE
0.1700
00002192799
NASAL + SINUS DECONGESTANT RELIEF 60 MG TABLET
ORL
TAB
VTH
TAB
0.1242
00000788503
NASAL DECONGESTANT SPRAY 0.1%
NAS
LIQ
CNF
ML
0.0920
00002417855
NAT-ANASTROZOLE 1 MG TABLET
ORL
TAB
NTP
TAB
2.9000
Pg 130 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002421585
NAT-LETROZOLE 2.5 MG TABLET
ORL
TAB
NTP
TAB
3.1300
00002440229
NAT-LEVETIRACETAM 750 MG TABLET
ORL
TAB
NTP
TAB
1.3500
00000024430
NAVANE 2 MG CAPSULE
ORL
CAP
ERF
CAP
0.3171
00080029758
NEBUSAL 7% INHALATION SOLUTION
MIS
DEFAUL
STM
ML
0.2431
00080027142
NEILMED NASAL SINUS RINSE
NAS
PWS
NPI
PCKT
0.2350
00002245057
NEISVAC-C 10 MCG/20 MCG INJECTION SYRINGE
INJ
NDL
PFI
SYR
80.1850
00000147680
NEO-BEX (LIDOCAINE HCL) INJECTION VIAL
INJ
DEFAUL
BRO
ML
5.5850
00000999808
NEOCATE NUTRA ORAL POWDER
ORL
PWR
NUN
G
0.1113
00000874957
NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
0.8844
00000885282
NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
0.9690
00001915436
NEOSTIGMINE METHYLSULFATE 2.5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
3.4342
00002230593
NEOSTIGMINE OMEGA 0.5 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
0.9600
00002230592
NEOSTIGMINE OMEGA 1 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
1.0700
00001958690
NEOSTRATA HQ 2% GEL
TOP
GEL
CDX
G
0.7667
00000999459
NEOVISC
DEFAUL
DEV
STL
ML
47.7400
00000587826
NERISONE 0.1% TOPICAL CREAM
TOP
CRM
GSK
G
0.3943
00080007796
NERVOHEEL N TABLET
ORL
TAB
HEE
TAB
0.2858
00002417197
NESINA 12.5 MG TABLET
ORL
TAB
TAK
TAB
2.6177
00002417200
NESINA 25 MG TABLET
ORL
TAB
TAK
TAB
2.6177
00002417189
NESINA 6.25 MG TABLET
ORL
TAB
TAK
TAB
2.6177
Pg 131 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000999799
NESTLE GOOD START 1 GOS OMEGA 3+6 INF FORMULA PWD
ORL
PWR
NES
G
0.0490
00000999801
NESTLE GOOD START 1 GOS OMEGA 3+6 LIQ CONCENTRATE
ORL
LIQ
NES
ML
0.0060
00000999800
NESTLE GOOD START 1 GOS OMEGA 3+6 READY-T-F NURSER
ORL
LIQ
NES
ML
0.0280
00000999802
NESTLE GOOD START 1 INFANT FORMULA POWDER
ORL
PWR
NES
G
0.0290
00000999804
NESTLE GOOD START 1 LIQ CONCENTRATE INFANT FORMULA
ORL
LIQ
NES
ML
0.0050
00000999798
NESTLE GOOD START 1 PROBIOTIC DHA & ARA INFANT PWR
ORL
PWR
NES
G
0.0500
00000999803
NESTLE GOOD START 1 READY-TO-FEED TETRA LIQUID
ORL
LIQ
NES
ML
0.0120
00000999806
NESTLE GOOD START 2 ALSOY OMEGA 3+6 INF FORM PWR
ORL
PWR
NES
G
0.0400
00000999805
NESTLE GOOD START ALSOY OMEGA 3+6 INF FORM POWDER
ORL
PWR
NES
G
0.0400
00002420104
NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE
INJ
NDL
AMG
SYR
173.1890
00002420112
NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE
INJ
NDL
AMG
SYR
277.1020
00002403897
NEUPRO 1 MG/24 HOUR TRANSDERMAL PATCH
TRD
PTH
UCB
PTH
3.5400
00002403900
TRD
PTH
UCB
PTH
3.5400
00002403919
TRD
PTH
UCB
PTH
6.5000
00002403927
TRD
PTH
UCB
PTH
6.5000
00002403935
TRD
PTH
UCB
PTH
7.2700
00002403943
TRD
PTH
UCB
PTH
7.2700
00002239717
NEURONTIN 600 MG TABLET
ORL
TAB
PFI
TAB
1.9426
00002239718
NEURONTIN 800 MG TABLET
ORL
TAB
PFI
TAB
2.5926
00080006269
NEUTROGENA BODY CLEAR BODY WASH PINK GRAPEFRUIT
TOP
GEL
JJI
ML
0.0270
Pg 132 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002308983
NEVANAC 0.1% OPHTHALMIC SUSPENSION
OPH
SUS
ALC
ML
4.1380
00080039670
NEW NORDIC HAIR VOLUME TABLET
ORL
TAB
NNO
TAB
0.9313
00002284227
NEXAVAR 200 MG TABLET
ORL
TAB
BAI
TAB
46.0088
00002300524
NEXIUM 10 MG/DOSE DEL REL GRANULES FOR ORAL SUSP
ORL
DRGRNUL
AZC
PCKT
2.2000
00002244521
NEXIUM 20 MG DELAYED-RELEASE TABLET
ORL
DRT
AZC
TAB
2.2000
00002244522
NEXIUM 40 MG DELAYED-RELEASE TABLET
ORL
DRT
AZC
TAB
2.2000
00000232459
NIACIN 100 MG TABLET
ORL
TAB
ADA
TAB
0.0830
00000779806
NIACIN 500 MG SUSTAINED-RELEASE CAPSULE
ORL
SRC
VTH
CAP
0.8500
00000309737
NIACIN 500 MG TABLET
ORL
TAB
JAM
TAB
0.0567
00002244702
NIACIN AND INOSITOL 500 MG/150 MG TABLET
ORL
TAB
JAM
TAB
0.1962
00002242138
NIACIN AND INOSITOL 500 MG/150 MG TABLET
ORL
TAB
QVS
TAB
0.1277
00002262339
NIASPAN 1000 MG EXTENDED-RELEASE TABLET
ORL
ERT
SUN
TAB
1.2303
00002262347
ORL
ERT
SUN
TAB
1.2837
00002262355
ORL
ERT
SUN
TAB
1.4180
00002309289
NIASPAN FCT 1000 MG EXTENDED-RELEASE TABLET
ORL
ERT
SUN
TAB
1.3433
00002309254
ORL
ERT
SUN
TAB
1.3433
00002309262
ORL
ERT
SUN
TAB
1.3433
00002247347
NICORETTE MINI LOZENGE 2 MG
ORL
LOZ
MCL
LOZ
0.4714
00002247348
NICORETTE MINI LOZENGE 4 MG
ORL
LOZ
MCL
LOZ
0.4714
00002065762
NICORETTE PATCH 15MG; NICORETTE COMBOQUIT
TOP
PTH
MCL
PTH
3.4771
Pg 133 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080007461
NICOTINE LOZENGES; THRIVE LOZENGES 1 MG
ORL
LOZ
NOV
LOZ
0.2542
00080007464
NICOTINE LOZENGES; THRIVE LOZENGES 2 MG
ORL
LOZ
NOV
LOZ
0.2889
00080000117
NICOTINE POLACRILEX; NIC-ASSIST 2 MG GUM
ORL
GUM
PRI
PIECE
0.2104
00080000118
NICOTINE POLACRILEX; NIC-ASSIST 4 MG GUM
ORL
GUM
PER
PIECE
0.2539
00080000396
NICOTINELL; THRIVE 2 MG ORAL GUM
ORL
GUM
NOV
PIECE
0.2542
00080000402
NICOTINELL; THRIVE 4 MG ORAL GUM
ORL
GUM
NVC
PIECE
0.2889
00002125226
NIDAGEL 0.75% VAGINAL GEL
VAG
GEL
VCL
G
0.3017
00002421631
NIFEDIPINE 30 MG EXTENDED RELEASE TABLET
ORL
ERT
PDL
TAB
0.6171
00002421658
NIFEDIPINE 60 MG EXTENDED RELEASE TABLET
ORL
ERT
PDL
TAB
0.9374
00002442930
NIFEDIPINE ER 30 MG EXTENDED-RELEASE TABLET
ORL
ERT
SIV
TAB
0.6171
00002442949
NIFEDIPINE ER 60 MG EXTENDED-RELEASE TABLET
ORL
ERT
SIV
TAB
0.9374
00002325926
NIMOTOP 30 MG TABLET
ORL
TAB
BAI
TAB
10.0776
00002182920
NIZORAL 2% TOPICAL SHAMPOO
TOP
SHP
MCL
ML
0.0970
00002397927
NOCDURNA 25 MCG SL ORALLY DISINTEGRATING TABLET
SLG
DISNTAB
FEI
TAB
1.3200
00002431076
NOCDURNA 50 MCG SL ORALLY DISINTEGRATING TABLET
SLG
DISNTAB
FEI
TAB
1.3200
00002048485
NOLVADEX-D 20 MG (BASE) TABLET
ORL
TAB
AZC
TAB
0.3867
00080016396
NON-FLUSH/FLUSH FREE NIACIN CAPSULE
ORL
CAP
PLH
CAP
0.1560
00080008766
NORDIC NATURALS ARCTIC COD LIVER OIL
ORL
LIQ
NRD
ML
0.1105
00080007895
NORDIC NATURALS ARCTIC COD LIVER OIL LIQUID
ORL
LIQ
NRD
ML
0.0827
00080002913
NORDIC NATURALS OMEGA-3 LIQUID
ORL
LIQ
NRD
ML
0.0827
Pg 134 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002334860
NORDITROPIN NORDIFLEX 10 MG PEN INJECTION SYRINGE
INJ
DEFAUL
NNA
SYR
389.4000
00002334879
INJ
DEFAUL
NNA
SYR
584.1000
00002334852
INJ
DEFAUL
NNA
SYR
194.7000
00001966162
NORFLEX 30 MG/ML INJECTION
INJ
DEFAUL
GRC
ML
5.6642
00002285576
NORLEVO 0.75 MG TABLET
ORL
TAB
BAI
TAB
8.6000
00000023760
NORLUTATE 5 MG TABLET
ORL
TAB
PFI
TAB
1.4167
00002357593
NORVIR 100 MG FILM-COATED TABLET
ORL
TAB
ABV
TAB
1.5037
00002229145
NORVIR 80 MG/ML ORAL SOLUTION
ORL
SOL
ABV
ML
1.2316
00002241480
NORVIR SEC 100 MG CAPSULE
ORL
CAP
ABB
CAP
1.4671
00002049481
NOVAHISTEX DH ADULT ORAL LIQUID
ORL
LIQ
SAV
ML
0.1774
00002049473
NOVAHISTINE DH CHILDREN ORAL LIQUID
ORL
LIQ
SAV
ML
0.1461
00000216666
NOVASEN 325 MG ENTERIC-COATED TABLET
ORL
ECT
TEV
TAB
0.0304
00000229296
NOVASEN 650 MG ENTERIC COATED TABLET
ORL
ECT
NOP
TAB
0.0650
00002270226
NOVO-BICALUTAMIDE 50 MG TABLET
ORL
TAB
TEV
TAB
4.0573
00002266377
NOVO-CILAZAPRIL 5 MG TABLET
ORL
TAB
TEV
TAB
0.2085
00000582417
NOVO-CIMETINE 300 MG TABLET
ORL
TAB
TEV
TAB
0.0860
00000603678
ORL
TAB
TEV
TAB
0.1350
00000603686
ORL
TAB
TEV
TAB
0.1720
00002309556
NOVO-CYPROTERONE/ETHINYL ESTRADIOL 2MG/0.035MG TAB
ORL
TAB
TEV
TAB
1.1114
00000842044
NOVO-DOCUSATE CALCIUM 240 MG CAPSULE
ORL
CAP
TEV
CAP
0.0886
Pg 135 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002020084
NOVO-DOCUSATE SODIUM 100 MG CAPSULE
ORL
CAP
TEV
CAP
0.0481
00000021458
NOVOFERROGLUC 300 MG TABLET
ORL
TAB
TEV
TAB
0.0254
00080000435
NOVO-FERROGLUC 300 MG TABLET
ORL
TAB
XXX
TAB
0.0360
00000595829
NOVO-FIBER 469 MG TABLET
ORL
TAB
TEV
TAB
0.0979
00080042720
NOVO-FIBRE 469 MG TABLET
ORL
TAB
TEV
TAB
0.0979
00000389218
NOVO-GESIC 325 MG TABLET
ORL
TAB
TEV
TAB
0.0326
00002273756
NOVO-GLIMEPIRIDE 1 MG TABLET
ORL
TAB
TEV
TAB
0.4900
00002273764
ORL
TAB
TEV
TAB
0.4900
00002273772
ORL
TAB
TEV
TAB
0.4900
00002265435
NOVOMIX 30 100 UNIT/ML INJECTION
INJ
DEFAUL
NNA
ML
3.6913
00002265443
NOVOMIX 30 FLEXPEN 100 UNIT/ML INJECTION
INJ
DEFAUL
NNA
ML
3.1833
00002364883
NOVO-MYCOPHENOLATE 250 MG CAPSULE
ORL
CAP
TEV
CAP
1.0310
00002348675
NOVO-MYCOPHENOLATE 500 MG TABLET
ORL
TAB
TEV
TAB
2.0620
00002240868
NOVO-NABUMETONE 750 MG TABLET
ORL
TAB
TEV
TAB
0.9192
00000021288
NOVO-PHENIRAM 4 MG TABLET
ORL
TAB
TEV
TAB
0.0645
00000021695
NOVO-PREDNISONE 5 MG TABLET
ORL
TAB
TEV
TAB
0.0401
00000232378
NOVO-PREDNISONE 50 MG TABLET
ORL
TAB
TEV
TAB
0.1735
00002283891
NOVO-RAMIPRIL 1.25 MG CAPSULE
ORL
CAP/TAB
TEV
CAP
0.1274
00002326450
NOVO-SALBUTAMOL HFA 100 MCG/DOSE MDA
INH
AEM
TEV
DOSE
0.0325
00002230095
NOVO-TEMAZEPAM 15 MG CAPSULE
ORL
CAP
TEV
CAP
0.0438
Pg 136 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002211920
NOVO-VERAMIL SR 240MG SUSTAINED-RELEASE TABLET
ORL
SRT
TEV
TAB
0.5075
00002251469
NOVO-ZOPICLONE 7.5 MG TABLET
ORL
TAB
TEV
TAB
0.3125
00080041987
NOW GABA 750 MG VEGGIE CAPS CAPSULE
ORL
CAP
NWF
CAP
0.2495
00002322854
NPLATE 250 MCG/0.5 ML VIAL INJECTION
INJ
DEFAUL
AMG
VIAL
970.8000
00002322862
NPLATE 500 MCG/1 ML VIAL INJECTION
INJ
DEFAUL
AMG
VIAL
1,941.6100
00001913980
NUBAIN 10 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
12.2230
00001913972
NUBAIN 20 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
6.0850
00002449781
NUCALA 100 MG/ML (144 MG/VIAL) RECONSTITUTED INJ
INJ
DEFAUL
GSK
VIAL
1,938.4600
00002415585
NUCYNTA 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
JAI
TAB
1.5388
00002415593
ORL
ERT
JAI
TAB
2.0595
00002415607
ORL
ERT
JAI
TAB
2.6698
00002415615
ORL
ERT
JAI
TAB
3.6972
00002415577
ORL
ERT
JAI
TAB
1.0263
00002360381
NUCYNTA CR 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
JAI
TAB
1.4730
00002360403
ORL
ERT
JAI
TAB
1.9720
00002360411
ORL
ERT
JAI
TAB
2.5565
00002360438
ORL
ERT
JAI
TAB
3.5895
00002360373
ORL
ERT
JAI
TAB
0.9830
00002378299
NUCYNTA IR 100 MG TABLET
ORL
TAB
JAI
TAB
1.5121
00002378272
ORL
TAB
JAI
TAB
1.0092
Pg 137 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
ORL
TAB
JAI
TAB
1.2604
RT
ONT
NVC
G
0.1407
00002378280
00000623385
NUPERCAINAL ANESTHETIC 1% RECTAL OINTMENT
00000999817
NUTRAMIGEN A+ WITH LGG ORAL POWDER
ORL
PWR
MJO
G
0.0624
00002249002
NUTROPIN AQ 5 MG/ML PEN CARTRIDGE
INJ
CTG
HLR
ML
197.7350
00002376393
NUTROPIN AQ NUSPIN 10 10 MG/2ML PEN CARTRIDGE
INJ
CTG
HLR
ML
197.7350
00002399083
NUTROPIN AQ NUSPIN 20 20 MG/2 ML SOLUTION
INJ
DEFAUL
HLR
ML
395.4700
00002399091
NUTROPIN AQ NUSPIN 5 5 MG/2 ML SOLUTION
INJ
DEFAUL
HLR
ML
98.8700
00002253186
NUVARING 11.4 MG/2.6 MG SLOW-RELEASE VAGINAL RING
VAG
SDE
MFC
RNG
15.4533
00000716901
NYADERM 25,000 U/G VAGINAL CREAM
VAG
CRM
TAR
G
0.1250
00000999812
OASIS NUTRISOLUTION ORAL LIQUID
ORL
LIQ
OAS
ML
0.0057
00002239742
OBUSFORME EXTRA STRENGTH (W ACETAMINOPHEN) CAPLET
ORL
TAB
WAM
TAB
0.3611
00002237577
OBUSFORME METHOCARBAMOL & ACETAMINOPHEN CAPLET
ORL
TAB
WAM
TAB
0.3306
00000687766
O-CALCIUM 250 MG AND VITAMIN D TABLET
ORL
TAB
WTR
TAB
0.0620
00000622443
O-CALCIUM 500 MG (BASE) TABLET
ORL
TAB
VTH
TAB
0.0257
00002024179
OCTOSTIM 15 MCG INJECTION
INJ
DEFAUL
FEI
ML
36.2880
00002299445
OCTREOTIDE 200 MCG/ML INJECTION
INJ
DEFAUL
TEV
ML
15.5840
00002299453
OCTREOTIDE 500 MCG/ML INJECTION
INJ
DEFAUL
TEV
ML
38.0720
00002248640
OCTREOTIDE ACETATE OMEGA 100 MCG/ML INJECTION
INJ
DEFAUL
OMG
ML
11.2000
00002248642
INJ
DEFAUL
OMG
ML
23.4000
00002248639
INJ
DEFAUL
OMG
ML
5.9500
Pg 138 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002248641
INJ
DEFAUL
OMG
ML
52.3000
00080038562
OCUVITE ADULT 50+
ORL
CAP
BSH
CAP
0.2644
00080053047
ODAN POLYSACCHARIDE IRON COMPLEX 150 150 MG CAP
ORL
CAP
ODN
CAP
0.3900
00000358495
ODANS LIQUOR CARBONIS DETERGENS
TOP
LIQ
ODN
ML
0.0890
00080046696
ODAN-SODIUM CHLORIDE 5% OPHTHALMIC OINTMENT
OPH
ONT
ODN
G
2.5686
00080046737
ODAN-SODIUM CHLORIDE 5% OPHTHALMIC SOLUTION
OPH
SOL
ODN
ML
0.5993
00002443066
OFEV 100 MG CAPSULE
ORL
CAP
BOE
CAP
27.1800
00002443074
OFEV 150 MG CAPSULE
ORL
CAP
BOE
CAP
54.3600
00002231529
OFLOXACIN 200 MG TABLET
ORL
TAB
AAP
TAB
1.3693
00002231531
ORL
TAB
AAP
TAB
1.6089
00002231532
ORL
TAB
AAP
TAB
1.6089
00002311992
OLANZAPINE 10 MG TABLET
ORL
TAB
PDL
TAB
1.7857
00002312018
ORL
TAB
PDL
TAB
2.6775
00002311968
OLANZAPINE 2.5 MG TABLET
ORL
TAB
PDL
TAB
0.4493
00002421704
ORL
TAB
PDL
TAB
5.9377
00002311976
ORL
TAB
PDL
TAB
0.8936
00002311984
OLANZAPINE 7.5 MG TABLET
ORL
TAB
PDL
TAB
1.3479
00002416522
OLANZAPINE FOR INJECTION 10MG/VIAL INJ
INJ
DEFAUL
SDZ
VIAL
24.0800
00002338653
OLANZAPINE ODT 10 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
PDL
TAB
1.7857
00002343681
ORL
DISNTAB
SIV
TAB
5.3553
Pg 139 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002352990
ORL
DISNTAB
SNS
TAB
5.3553
00002338661
ORL
DISNTAB
PDL
TAB
2.6777
00002343703
ORL
DISNTAB
SIV
TAB
7.5977
00002425114
ORL
DISNTAB
PDL
TAB
5.9377
00002338645
ORL
DISNTAB
PDL
TAB
0.8937
00002365677
OLEX 20 MG DELAYED-RELEASE TABLET
ORL
DRT
PPH
TAB
0.6636
00002344408
OLUX-E 0.05% TOPICAL FOAM
TOP
FOA
GSK
G
1.4449
00002239144
OMBRELLE ECRAN SPF 60 TOPICAL CREAM
TOP
CRM
COS
G
0.0991
00002241277
OMBRELLE EXTREME SPF 30 TOPICAL LOTION
TOP
LOT
COS
ML
0.0875
00002303639
OMBRELLE SPF 60 TOPICAL LOTION
TOP
LOT
OMB
ML
0.1049
00002239016
OMBRELLE VAPO SPORT SPF 15 TOPICAL LOTION
TOP
LOT
COS
ML
0.0868
00080003480
OMEGA 3 CAPSULE
ORL
CAP
PMT
CAP
0.0990
00080008273
OMEGA 3 CAPSULE
ORL
CAP
WNP
CAP
0.2587
00080044844
OMEGA 3 KRILL OIL 500 MG CAPSULE
ORL
CAP
JMS
CAP
0.3078
00080015284
OMEGA 3 LIQUID
ORL
LIQ
WNP
ML
0.0261
00080002435
OMEGA 3 PREMIUM FISH OIL 1000 MG CAPSULE
ORL
CAP
WNP
CAP
0.0593
00080002596
OMEGA 3 SELECT CAPSULE
ORL
CAP
JAM
CAP
0.1131
00080019234
OMEGA 3 TRIPLE STRENGTH 900 MG SOFTGEL
ORL
CAP
WBP
CAP
0.2552
00002240743
OMEGA 3-6-9 CAPSULE
ORL
CAP
JAM
CAP
0.1647
00080000884
OMEGA 3-6-9 CAPSULE
ORL
CAP
JMS
CAP
0.1608
Pg 140 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080003127
OMEGA-3 ELITE SOFTGEL
ORL
CAP
WBP
CAP
0.0511
00080003179
OMEGA-3 TABLET
ORL
TAB
JAM
TAB
0.1542
00002385384
OMEPRAZOLE 20 MG DELAYED-RELEASE CAPSULE
ORL
CAP/SRT
SIV
CAP
0.5500
00002339927
OMEPRAZOLE 20 MG DELAYED-RELEASE CAPSULE
ORL
CAP/SRT
PDL
CAP
0.4117
00002303671
OMNARIS 50 MCG/DOSE METERED DOSE NASAL SPRAY
NAS
SPM
TAK
DOSE
0.2148
00002153513
ONCOTICE 800 M UNIT/VIAL FOR BLADDER INSTILLATION
BLDIR
PWS
MFC
VIAL
273.1400
00002325160
ONDANSETRON 8 MG TABLET
ORL
TAB
PDL
TAB
4.9930
00002271761
ONDANSETRON OMEGA (PRESERVATIVE FREE) 2 MG/ML INJ
INJ
DEFAUL
OMG
ML
8.1750
00002271788
ONDANSETRON OMEGA (WITH PRESERVATIVE) 2 MG/ML INJ
INJ
DEFALT
OMG
ML
8.1250
00002306212
ONDANSETRON-ODAN 4 MG TABLET
ORL
TAB
ODN
TAB
3.3500
00002306220
ONDANSETRON-ODAN 8 MG TABLET
ORL
TAB
ODN
TAB
4.9930
00080020211
ONE A DAY FRUITI-SSENTIAL GUMMIES
ORL
CTB
BAI
TAB
0.1563
00002248292
ONE A DAY MEN 50 PLUS TABLET
ORL
TAB
BIC
TAB
0.1037
00002248319
ONE A DAY WEIGHTSMART TABLET
ORL
TAB
BAI
TAB
0.1213
00002375842
ONGLYZA 2.5 MG TABLET
ORL
TAB
AZC
TAB
2.3650
00002421208
ONRELTEA 0.33 % TOPICAL GEL
TOP
GEL
GAL
G
3.5180
00000750794
OPCON-A OPH SOLUTION
OPH
SOL
BSH
ML
0.2800
00002446634
OPDIVO (100 MG/10 ML) 10 MG/ML INJECTION
INJ
DEFAUL
BMS
ML
195.5560
00002446626
OPDIVO (40 MG/4 ML) 10 MG/ML INJECTION
INJ
DEFAUL
BMS
ML
195.5550
00002415690
OPSUMIT 10 MG FILM COATED TABLET
ORL
TAB
ACT
TAB
132.0550
Pg 141 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000990059
OPTICHAMBER DEVICE
DEFAUL
DEV
ACM
DEV
30.7200
00000990061
OPTICHAMBER LARGE FACE MASK DEVICE
DEFAUL
ADUDEV
ACM
DEV
35.3400
00000990062
OPTICHAMBER MEDIUM FACE MASK DEVICE
DEFAUL
PEDDEV
ACM
DEV
28.5300
00000990063
OPTICHAMBER SMALL FACE MASK DEVICE
DEFAUL
INFDEV
ACM
DEV
29.4300
00000999420
OPTIMENTAL ORAL LIQUID
ORL
LIQ
ABN
ML
0.0278
00000355666
OPTIMINE 1 MG TABLET
ORL
TAB
SCH
TAB
0.4216
00002160889
OPTIMYXIN OPHTHALMIC OINTMENT
OPH
ONT
SDZ
G
1.4543
00000701785
OPTIMYXIN OTIC OPH DROPS
OT/OPH
DPS
SDZ
ML
0.9250
00002371189
OPTION 2 0.75 MG TABLET
ORL
TAB
PRI
TAB
7.7950
00080027592
OPUS D-1000 SOFTGEL
ORL
CAP
OPU
CAP
0.0700
00002035286
ORABASE PASTE
ORL
PST
CVO
G
1.1560
00001985396
ORAJEL MAXIMUM STRENGTH GEL
ORL
GEL
CHD
G
0.4063
00002381885
ORALAIR 100 UNIT SUBLINGUAL TABLET
SLG
TAB
PAL
TAB
1.2600
00002381893
ORALAIR 300 UNIT SUBLINGUAL TABLET
SLG
TAB
PAL
TAB
3.9000
00002047535
ORFENACE 100 MG TABLET
ORL
TAB
STM
TAB
0.4700
00002245641
ORGALUTRAN 250 MCG/ 0.5 ML INJECTION SYRINGE
INJ
NDL
MFC
SYR
94.7100
00002451379
ORKAMBI 125 MG/200 MG TABLET
ORL
TAB
VER
TAB
170.5357
00002209055
ORO-CLENSE 0.12% ORAL RINSE
ORL
MWH
GER
ML
0.0165
00002240336
ORO-MIN REMINERALIZING SOL W FLUORIDE ORAL RINSE
ORL
RNS
XXX
ML
0.0225
00080023808
ORTHO BONE CAPSULE
ORL
CAP
AOR
CAP
0.1565
Pg 142 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
ORL
TB
JAI
TAB
0.7850
00002042533
ORTHO-CEPT (28 DAY) TABLET
00000999460
ORTHOVISC
DEFAUL
DEV
PMS
ML
50.0000
00000999490
OSTENIL
DEFAUL
DEV
TRB
ML
50.2600
00002247548
OSTEOCIT D PLUS TABLET
ORL
TAB
SFD
TAB
0.1683
00002301911
OSTO-D2 50000 IU CAPSULE
ORL
CAP
TPI
CAP
0.2137
00002434318
OTEZLA 10 MG/20 MG/30 MG TABLET STARTER PACK
ORL
TAB
CLG
TAB
19.2822
00002434334
OTEZLA 30 MG TABLET
ORL
TAB
CLG
TAB
19.2821
00002238867
OTRIVIN 0.05% DECONGESTANT NASAL SPRAY
NAS
SPR
NVC
ML
0.2340
00000653330
OTRIVIN 0.1% DECONGESTANT NASAL SPRAY
NAS
SPR
NVC
ML
0.2340
00002331403
OTRIVIN MOIST 0.1% NASAL SPRAY
NAS
SPR
NVC
ML
0.3075
00000857777
OTRIVIN-SALINE 0.7% NASAL DROPS
NAS
SOL
NVC
ML
0.1348
00000810436
OTRIVIN-SALINE 0.7% NASAL SPRAY
NAS
SPR
NVC
ML
0.1187
00002262088
OVIDREL 250 MCG INJECTION SYRINGE
INJ
NDL
SRO
SYR
72.0000
00002371588
OVIDREL 250 MCG/0.5 ML PEN CARTRIDGE INJECTION
INJ
DEFAUL
SRO
ML
72.0000
00000013617
OVOL 40 MG/ML ORAL DROPS
ORL
DPS
CHD
ML
0.3393
00002239298
OVOL-180 ULTRA STRENGTH 180 MG CAPSULE
ORL
CAP
CHD
CAP
0.1850
00000292990
OVOL-80 80 MG TABLET
ORL
TAB
CHD
TAB
0.1300
00002435071
OXALIPLATIN 5 MG/ML INJECTION
INJ
DEFAUL
TEV
ML
46.6344
00002436957
OXALIPLATIN INJECTION 5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
46.6350
00000497754
OXAZEPAM 10 MG TABLET
ORL
TAB
PDL
TAB
0.0420
Pg 143 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000497762
ORL
TAB
PDL
TAB
0.0660
00000497770
ORL
TAB
PDL
TAB
0.0900
00002220636
OXYBUTYNINE-5 5 MG TABLET
ORL
TAB
PDL
TAB
0.0986
00002231934
OXY-IR 5 MG TABLET
ORL
TAB
PUR
TAB
0.2715
00002139561
OXYTOCIN 10 UNIT/ML INJECTION
INJ
DEFAUL
FKC
ML
6.8640
00002254735
OXYTROL 36 MG TRANSDERMAL PATCH
TRD
PTH
ASC
PTH
6.9463
00080001408
OYSTER SHELL CALCIUM 500 MG CAPLET
ORL
TAB
NCI
TAB
0.0290
00002248374
OYSTER SHELL CALCIUM WITH VIT D 500 MG TABLET
ORL
TAB
VTH
TAB
0.0266
00002363445
OZURDEX 0.7 MG INTRAVITREAL IMPLANT
OPH
IMP
ALL
SYS
1,352.5000
00002130947
PACIS 120 MG INJECTION
INJ
DEFAUL
IAF
VIAL
113.6000
00002320150
PACLITAXEL 6 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
74.8000
00001923420
PALAFER 300 MG CAPSULE
ORL
CAP
GKC
CAP
0.2293
00001923455
PALAFER-CF CAPSULE
ORL
CAP
GKC
CAP
0.3133
00002246597
PAMIDRONATE DISODIUM 30 MG/10 ML VIAL INJECTION
INJ
DEFAUL
FKC
ML
15.7500
00002246598
PAMIDRONATE DISODIUM 60 MG/10 ML INJECTION
INJ
DEFAUL
FKC
ML
29.9000
00002246599
PAMIDRONATE DISODIUM 90 MG/10 ML VIAL INJECTION
INJ
DEFAUL
FKC
ML
44.8000
00002249677
PAMIDRONATE DISODIUM OMEGA 60 MG/10 ML VIAL INJ
INJ
DEFAUL
OMG
ML
17.6700
00002188708
PANOXYL 4% CREAMY WASH
TOP
WAS
GSK
G
0.0671
00000483184
PANOXYL 5 5% TOPICAL BAR
TOP
BAR
GSK
G
0.0853
00002239616
PANTO IV 40 MG/VIAL INJECTION
INJ
DEFAUL
TAK
VIAL
13.7000
Pg 144 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002241804
PANTOLOC 20 MG ENTERIC-COATED TABLET
ORL
ECT
TAK
TAB
1.8089
00002385740
PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
SIV
TAB
1.2750
00002309866
ORL
ECT
MEL
TAB
0.3628
00002439107
ORL
ECT
DPC
TAB
0.3628
00002431327
ORL
ECT
RIV
TAB
0.3628
00002318695
ORL
ECT
PDL
TAB
0.9785
00002306727
PANTOPRAZOLE SODIUM FOR INJECTION 40 MG/VIAL INJ
INJ
DEFAUL
SDZ
VIAL
10.9600
00002428172
PANTOPRAZOLE-20 20 MG ENTERIC-COATED TABLET
ORL
ECT
SIV
TAB
1.2750
00000009881
PAPAVERINE HCL 32.5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
4.4230
00002388227
PAROXETINE 10 MG TABLET
ORL
TAB
SIV
TAB
1.0430
00002282844
PAROXETINE 10 MG TABLET
ORL
TAB
SNS
TAB
1.0430
00002248913
PAROXETINE-10 MG TABLET
ORL
TAB
PDL
TAB
0.8210
00002248914
ORL
TAB
PDL
TAB
0.4513
00002248915
ORL
TAB
PDL
TAB
0.4796
00002362171
PATADAY 0.2% OPHTHALMIC SOLUTION
OPH
SOL
ALC
ML
12.4080
00002233143
PATANOL 0.1% OPH SOLUTION
OPH
SOL
ALC
ML
6.2040
00000886327
PATE D'IHLE ZINC OXIDE 25% PASTE
TOP
PST
ATL
G
0.0234
00000532576
PATE D'IHLE ZINC OXIDE PASTE
TOP
PST
ROG
G
0.0306
00002381737
PAT-RABEPRAZOLE 10 MG ENTERIC-COATED TABLET
ORL
ECT
PAT
TAB
0.1204
00002381745
PAT-RABEPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
PAT
TAB
0.2408
Pg 145 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002389274
PAT-TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
PAT
TAB
0.6263
00002027887
PAXIL 10 MG TABLET
ORL
TAB
GSK
TAB
1.6920
00002248503
PAXIL CR 12.5 MG SUSTAINED-RELEASE TABLET
ORL
SRT
GSK
TAB
1.7540
00002248504
PAXIL CR 25 MG SUSTAINED-RELEASE TABLET
ORL
SRT
GSK
TAB
1.9163
00000577790
PDP-ISONIAZID 100 MG TABLET
ORL
TAB
PPH
TAB
0.7314
00000577804
PDP-ISONIAZID 300 MG TABLET
ORL
TAB
PPH
TAB
0.7533
00000577812
PDP-ISONIAZID 50 MG/5ML ORAL LIQUID
ORL
LIQ
PPH
ML
0.2369
00002242863
PEDIAFER 30 MG/ML ORAL SOLUTION USP
ORL
SYR
EUP
ML
0.0272
00002232202
PEDIAFER 75 MG/ML ORAL SOLUTION USP
ORL
SYR
EUP
ML
0.1432
00002162431
PEDIAPHARM NAPROXEN 25 MG/ML ORAL SUSPENSION
ORL
SUS
PPI
ML
0.0949
00080004595
PEDIAVIT D DROPS 400 IU
ORL
LIQ
EUP
ML
0.1100
00002358034
PEG 3350 ORAL POWDER
ORL
PWR
MES
G
0.0668
00002328232
PEGALAX ORAL POWDER
ORL
PWR
MFI
G
0.0387
00002246030
PEGETRON 200 MG CAP/150 MCG/0.5 ML INJ KIT
INJ
VIAL/CAP
MFC
KIT
851.2300
00002246026
PEGETRON 200 MG CAP/50 MCG/0.5ML INJ KIT
INJ
VIAL/CAP
MFC
KIT
770.3500
00000468029
PENICILLINE V 300 TABLET
ORL
TAB
PDL
TAB
0.0710
00002250535
PENLAC NAIL LACQUER 8% TOPICAL SOLUTION
TOP
SOL
VCL
G
13.3667
00002247265
PENNSAID 1.5% TOPICAL SOLUTION
TOP
SOL
PAL
ML
0.8890
00001980602
PENTA-3B PLUS VITAMIN C TABLET
ORL
TAB
SDZ
TAB
0.5820
00001980599
PENTA-3B TABLET
ORL
TAB
SDZ
TAB
0.4780
Pg 146 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002183080
PENTAMIDINE ISETHIONATE 300 MG/VIAL INJECTION BP
INJ
DEFAUL
HSP
VIAL
130.9300
00002185938
PEPCID AC 10 MG TABLET
ORL
TAB
MCL
TAB
0.3217
00000728128
PEPCID IV 10 MG/ML INJECTION
INJ
DEFAUL
MFC
ML
1.9955
00002097079
PEPTO-BISMOL 17.6 MG/ML ORAL LIQUID
ORL
LIQ
PGI
ML
0.0223
00002177994
PEPTO-BISMOL CAPLET
ORL
TAB
PGI
TAB
0.1521
00002237315
PEPTO-BISMOL CHEWABLES CHEWABLE TABLET
ORL
CTB
PGI
TAB
0.1521
00000999423
PERATIVE ORAL LIQUID
ORL
LIQ
ABN
ML
0.0113
00000254916
PERGONAL 75 UNIT/75 UNIT INJECTION
INJ
DEFAUL
SRO
VIAL
46.0000
00002240433
PERICHLOR 0.12% ORAL RINSE
ORL
MWH
PMS
ML
0.0181
00002237452
PERIDEX 0.12% ORAL RINSE
ORL
MWH
ZIL
ML
0.0238
00002207796
PERIOGARD 0.12% ORAL RINSE
ORL
MWH
COL
ML
0.0164
00002247104
PERIOSTAT 20 MG CAPSULE
ORL
CAP
PPH
CAP
1.2500
00002229501
PERI-WASH II ANTISEPTIC 0.1% CLEANSER
TOP
WAS
COC
ML
0.0147
00080017389
PGX 750 DAILY CAPSULE
ORL
CAP
NFN
CAP
0.0805
00080001122
PHARMA-CAL 500 MG
ORL
CAP
PPH
CAP
0.0216
00080004281
PHARMA-CAL D 500 MG/125 IU TABLET
ORL
TAB
PMS
TAB
0.0680
00002371499
PHARMA-D 10,000 UNIT CAPSULE
ORL
CAP
PMS
CAP
0.2100
00080001145
PHARMA-D 400 IU GELCAP
ORL
CAP
PPH
CAP
0.0300
00002371502
PHARMA-D 50,000 UNIT CAPSULE
ORL
CAP
PMS
CAP
0.9500
00080040416
PHARMA-K20 20 MEQ SUSTAINED-RELEASE TABLET
ORL
TAB/SRT
PMS
TAB
0.1995
Pg 147 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002247383
PHARMA-LACTULOSE 667 MG/ML SOLUTION
ORL
SOL
PMS
ML
0.0145
00080038071
PHARMANAC TM ACETYLCYSTEINE 900 MG TABLET
ORL
TAB
BAP
TAB
0.7653
00002436663
PHEBURANE 483 MG/G ORAL GRANULES
ORL
GRNUL
MDK
G
9.2690
00002304090
PHENOBARBITAL SODIUM 120 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
14.2730
00002304082
PHENOBARBITAL SODIUM 30 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
12.8170
00002148455
PHENYLEPHRINE HCL 10% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00002148447
PHENYLEPHRINE HYDROCHLORIDE OPH SOLUTION (MINIMS)
OPH
SOL
OPT
ML
6.6667
00000780626
PHENYTOIN 50 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
6.0785
00002431378
PHENYTOIN SODIUM 50 MG/ML INJECTION USP
INJ
DEFAUL
STM
ML
5.2856
00002150638
PHILLIPS MAGNESIA 300 MG CHEWABLE TABLET
ORL
CTB
BAI
TAB
0.0487
00002150646
PHILLIPS MILK OF MAGNESIA 80 MG/ML ORAL LIQUID
ORL
LIQ
BAI
ML
0.0139
00002243578
PHISODERM FACIAL CLEANSER
TOP
WAS
MNT
G
0.0225
00002017733
PHISOHEX 3% TOPICAL CLEANSER
TOP
CLR
SAV
ML
0.0714
00002245781
PHL-AMIODARONE 200 MG TABLET
ORL
TAB
PHH
TAB
1.2971
00002326787
PHL-AMLODIPINE 10 MG TABLET
ORL
TAB
PHH
TAB
0.3587
00002326760
PHL-AMLODIPINE 2.5 MG TABLET
ORL
TAB
PHH
TAB
0.1380
00002326779
PHL-AMLODIPINE 5 MG TABLET
ORL
TAB
PHH
TAB
0.2417
00002278588
PHL-AZITHROMYCIN 250 MG TABLET
ORL
TAB
PHH
TAB
1.2313
00002236964
PHL-BACLOFEN 20 MG TABLET
ORL
TAB
PHH
TAB
0.3104
00002273543
PHL-CITALOPRAM 10 MG TABLET
ORL
TAB
PHH
TAB
0.1432
Pg 148 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002248944
ORL
TAB
PHH
TAB
0.2397
00002248945
ORL
TAB
PHH
TAB
0.2397
00002145227
PHL-CLONAZEPAM 0.5 MG TABLET
ORL
TAB
PHH
TAB
0.0495
00002145235
PHL-CLONAZEPAM 1 MG TABLET
ORL
TAB
PHH
TAB
0.1487
00002236948
PHL-CLONAZEPAM-R 0.5 MG TABLET
ORL
TAB
PHH
TAB
0.0495
00002249359
PHL-CYCLOBENZAPRINE 10 MG TABLET
ORL
TAB
PHH
TAB
0.3765
00002223481
PHL-FLUOXETINE 10 MG CAPSULE
ORL
CAP
PHH
CAP
0.4595
00002223503
PHL-FLUOXETINE 20 MG CAPSULE
ORL
CAP
PHH
CAP
0.4598
00002248608
PHL-MELOXICAM 15 MG TABLET
ORL
TAB
PHH
TAB
0.5670
00002248607
PHL-MELOXICAM 7.5 MG TABLET
ORL
TAB
PHH
TAB
0.4914
00002281732
PHL-MIRTAZAPINE 15 MG TABLET
ORL
TAB
PHH
TAB
0.3750
00002278618
PHL-ONDANSETRON 4 MG TABLET
ORL
TAB
PHH
TAB
3.2720
00002278626
PHL-ONDANSETRON 8 MG TABLET
ORL
TAB
PHH
TAB
4.9930
00002307669
PHL-PIOGLITAZONE 15 MG TABLET
ORL
TAB
PHH
TAB
1.5716
00002307677
ORL
TAB
PHH
TAB
0.2017
00002307723
ORL
TAB
PHH
TAB
3.3105
00002249766
PHL-PRAVASTATIN 10 MG TABLET
ORL
TAB
PHH
TAB
0.5670
00002249774
ORL
TAB
PHH
TAB
0.6689
00002249782
ORL
TAB
PHH
TAB
0.8057
00002299062
PHL-QUETIAPINE 100 MG TABLET
ORL
TAB
PHH
TAB
0.9226
Pg 149 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002299089
ORL
TAB
PHH
TAB
1.8527
00002299054
ORL
TAB
PHH
TAB
0.3458
00002299097
ORL
TAB
PHH
TAB
2.7038
00002245782
PHL-RANITIDINE 150 MG TABLET
ORL
TAB
PHH
TAB
0.1800
00002245783
PHL-RANITIDINE 300 MG TABLET
ORL
TAB
PHH
TAB
0.3600
00002258439
PHL-RISPERIDONE 0.25 MG TABLET
ORL
TAB
PHH
TAB
0.1252
00002258447
PHL-RISPERIDONE 0.5 MG TABLET
ORL
TAB
PHH
TAB
0.2097
00002258455
PHL-RISPERIDONE 1 MG TABLET
ORL
TAB
PHH
TAB
0.2896
00002258463
ORL
TAB
PHH
TAB
0.5782
00002258471
ORL
TAB
PHH
TAB
0.8673
00002258498
ORL
TAB
PHH
TAB
1.1565
00002245826
PHL-SERTRALINE 100 MG CAPSULE
ORL
CAP
PHH
CAP
0.4200
00002245824
ORL
CAP
PHH
CAP
0.2004
00002245825
ORL
CAP
PHH
CAP
0.4000
00002281554
PHL-SIMVASTATIN 10 MG TABLET
ORL
TAB
PHH
TAB
0.3642
00002281562
ORL
TAB
PHH
TAB
0.4501
00002281570
ORL
TAB
PHH
TAB
0.4501
00002281546
ORL
TAB
PHH
TAB
0.1841
00002281589
ORL
TAB
PHH
TAB
0.4501
00002271192
PHL-TOPIRAMATE 100 MG TABLET
ORL
TAB
PHH
TAB
0.5928
Pg 150 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002271206
ORL
TAB
PHH
TAB
0.8853
00002271184
ORL
TAB
PHH
TAB
0.3128
00002236942
PHL-TRAZODONE 100 MG TABLET
ORL
TAB
PHH
TAB
0.3956
00002236941
PHL-TRAZODONE 50 MG TABLET
ORL
TAB
PHH
TAB
0.2214
00002294052
PHL-ZOPICLONE 5 MG TABLET
ORL
TAB
PHH
TAB
0.1782
00002294060
PHL-ZOPICLONE 7.5 MG TABLET
ORL
TAB
PHH
TAB
0.2250
00002230399
PHOSPHATES SOLUTION ORAL LIQUID
ORL
LIQ
PPH
ML
0.0856
00002019876
PHOTOFRIN 75MG/ VIAL INJECTION
INJ
DEFAUL
AXC
VIAL
00002400987
PICATO 0.015% TOPICAL GEL
TOP
GEL
LEO
DOSE
127.6667
00002400995
PICATO 0.05% TOPICAL GEL
TOP
GEL
LEO
DOSE
191.5000
00002254794
PICO SALAX ORAL POWDER
ORL
PWR
FEI
PCKT
7.0000
00002300583
PICODAN
ORL
PWDPKT
ODN
PCKT
3.6000
00002402483
PILOCARPINE HYDROCHLORIDE 5 MG TABLET
ORL
TAB
STM
TAB
0.7805
00002148463
PILOCARPINE NITRATE 2% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00000828424
PINDOLOL-10 MG TABLET
ORL
TAB
PDL
TAB
0.2323
00000828416
PINDOLOL-5 MG TABLET
ORL
TAB
PDL
TAB
0.1361
00002374013
PIOGLITAZONE HCL 15 MG TABLET
ORL
TAB
SIV
TAB
0.9295
00002374021
ORL
TAB
SIV
TAB
1.3022
00002374048
ORL
TAB
SIV
TAB
1.9580
00002391600
PIOGLITAZONE HYDROCHLORIDE 15 MG TABLET
ORL
TAB
AHI
TAB
0.8718
19,255.1000
Pg 151 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002339587
ORL
TAB
AHI
TAB
0.8139
00002339595
ORL
TAB
AHI
TAB
1.2237
00002246640
PIPERACILLIN 2 G/VIAL INJECTION
INJ
DEFAUL
HSP
VIAL
9.5000
00002248939
PIPERACILLIN 2 G/VIAL INJECTION USP
INJ
DEFAUL
FKC
VIAL
15.2800
00002246641
INJ
DEFAUL
HSP
VIAL
23.9600
00002248940
INJ
DEFAUL
FKC
VIAL
22.9300
00002246642
INJ
DEFAUL
HSP
VIAL
19.0000
00002248941
INJ
DEFAUL
FKC
VIAL
30.5500
00002330547
PIPERACILLIN SOD/TAZOBACTAM SOD 12G/1500 MG VL INJ
INJ
DEFAUL
SDZ
VIAL
67.5000
00002439131
PIPERACILLIN SOD/TAZOBACTAM SOD 36G/4500 MG VL INJ
INJ
DEFAUL
STM
VIAL
202.5000
00002391511
PIPERACILLIN/TAZOBACTAM 2 G/250 MG/VIAL INJECTION
INJ
DEFAUL
MYP
VIAL
9.6120
00002391538
INJ
DEFAUL
MYP
VIAL
9.0800
00002391546
INJ
DEFAUL
MYP
VIAL
12.1100
00001926667
PIPORTIL L4 25 MG/ML INJECTION
INJ
DEFAUL
SAV
ML
16.4400
00000501190
PLACEBO 100 MG TABLET
ORL
TAB
ODN
TAB
0.0750
00002293854
PLAN B 1.5 MG TABLET
ORL
TAB
TEP
TAB
17.2000
00002237405
PLANTE GUMMI BEAR MULTIPLE VITAMINS ORAL GUM
ORL
GUM
PLI
PIECE
0.1566
00002444399
PLEGRIDY 125 MCG/0.5 ML PS/PEN INJECTION
INJ
NDL
BIO
SYR
846.7550
00002444402
PLEGRIDY 63 MCG/94 MCG PS/PEN INJ STARTER PACK
INJ
NDL
BIO
SYR
846.7550
00001946897
PMS DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR
ORL
ELX
PMS
ML
0.3899
Pg 152 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000792691
PMS-ACETAMINOPHEN 32 MG/ML ORAL SOLUTION
ORL
SOL
PPH
ML
0.0260
00002243435
PMS-ADENOSINE 3 MG/ML INJECTION
INJ
DEFAUL
PMS
ML
19.5000
00000654523
PMS-AMITRIPTYLINE 10 MG TABLET
ORL
TAB
PMS
TAB
0.0664
00000654515
ORL
TAB
PMS
TAB
0.1211
00000654507
ORL
TAB
PMS
TAB
0.2347
00002247304
ORL
TAB
PMS
TAB
0.2346
00002274949
PMS-ANAGRELIDE 0.5 MG CAPSULE
ORL
CAP
PMS
CAP
3.3491
00002320738
PMS-ANASTROZOLE 1 MG TABLET
ORL
TAB
PMS
TAB
2.5460
00002284529
PMS-ASA EC 325 MG ENTERIC-COATED TABLET
ORL
ECT
PMS
TAB
0.0309
00002283700
PMS-ASA EC 81 MG ENTERIC-COATED TABLET
ORL
ECT
PMS
TAB
0.0538
00002381028
PMS-ATOMOXETINE 10 MG CAPSULE
ORL
CAP
PMS
CAP
2.3140
00002381036
ORL
CAP
PMS
CAP
2.6522
00002381044
ORL
CAP
PMS
CAP
2.9281
00002381052
ORL
CAP
PMS
CAP
3.3375
00002381060
ORL
CAP
PMS
CAP
3.7024
00002330237
PMS-BETAHISTINE 24 MG TABLET
ORL
TAB
PMS
TAB
0.4983
00002275589
PMS-BICALUTAMIDE 50 MG TABLET
ORL
TAB
PMS
TAB
4.0573
00002383020
PMS-BOSENTAN 125 MG TABLET
ORL
TAB
PMS
TAB
48.1340
00002383012
PMS-BOSENTAN 62.5 MG TABLET
ORL
TAB
PMS
TAB
48.1340
00002391171
PMS-CANDESARTAN 4 MG TABLET
ORL
TAB
PMS
TAB
0.3400
Pg 153 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002185830
PMS-CEFACLOR 250 MG CAPSULE
ORL
CAP
PMS
CAP
0.6430
00002185857
PMS-CEFACLOR 25MG/ML ORAL SUSPENSION
ORL
SUS
PMS
ML
0.0762
00002185865
PMS-CEFACLOR 50 MG/ML ORAL SUSPENSION
ORL
SUS
PMS
ML
0.1395
00002185849
PMS-CEFACLOR 500 MG CAPSULE
ORL
CAP
PMS
CAP
1.2625
00002185873
PMS-CEFACLOR 75 MG/ML ORAL SUSPENSION
ORL
SUS
PMS
ML
0.2010
00002315963
PMS-CETIRIZINE 20 MG TABLET
ORL
TAB
PMS
TAB
0.7535
00002413574
PMS-CICLOPIROX NAIL LACQUER 8% TOPICAL SOLUTION
TOP
SOL
PMS
G
7.7433
00002416433
PMS-CIPROFLOXACIN XL 500 MG EXTENDED-RELEASE TAB
ORL
ERT
PMS
TAB
2.3110
00002244474
PMS-CLOBAZAM 10 MG TABLET
ORL
TAB
PMS
TAB
0.1097
00002232195
PMS-CLOBETASOL 0.05% SCALP LOTION
SCP
LOT
PMS
ML
0.2273
00002232191
PMS-CLOBETASOL 0.05% TOPICAL CREAM
TOP
CRM
PMS
G
0.3648
00002309548
PMS-CLOBETASOL 0.05% TOPICAL OINTMENT
TOP
ONT
PMS
G
0.2606
00002232193
PMS-CLOBETASOL 0.05% TOPICAL OINTMENT
TOP
ONT
PMS
G
0.4068
00000891797
PMS-DIAZEPAM 1 MG/ML ORAL SOLUTION
ORL
SOL
PMS
ML
0.1106
00002247492
PMS-DIAZEPAM 10 MG TABLET
ORL
TAB
PMS
TAB
0.0867
00002247490
ORL
TAB
PMS
TAB
0.0508
00002247491
ORL
TAB
PMS
TAB
0.0650
00000721344
PMS-DICITRATE ORAL SOLUTION
ORL
SOL
PMS
ML
0.0474
00002356783
PMS-DICLOFENAC 1.5% TOPICAL SOLUTION
TOP
SOL
PMS
ML
0.6227
00002239753
PMS-DICLOFENAC-K 50 MG TABLET
ORL
TAB
PMS
TAB
0.3937
Pg 154 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000757683
PMS-DIPHENHYDRAMINE 25 MG CAPSULE
ORL
CAP
PPH
CAP
0.0899
00000757691
PMS-DIPHENHYDRAMINE 50 MG CAPSULE
ORL
CAP
PPH
CAP
0.1099
00002434342
PMS-ELETRIPTAN 20 MG TABLET
ORL
TAB
PMS
TAB
10.0850
00002434350
PMS-ELETRIPTAN 40 MG TABLET
ORL
TAB
PMS
TAB
10.0850
00002379171
PMS-ESOMEPRAZOLE 40 MG DELAYED-RELEASE CAPSULE
ORL
DRC
PMS
CAP
1.8690
00002278081
PMS-FAMCICLOVIR 125 MG TABLET
ORL
TAB
PMS
TAB
2.0240
00002278103
ORL
TAB
PMS
TAB
2.7200
00002278111
ORL
TAB
PMS
TAB
4.2281
00000586323
PMS-FERROUS SULFATE 300 MG TABLET
ORL
TAB
PPH
TAB
0.0296
00002222574
PMS-FERROUS SULFATE INFANT DROPS 75 MG/ML
ORL
DPS
PMS
ML
0.1900
00002320169
PMS-FINASTERIDE 1 MG TABLET
ORL
TAB
PMS
TAB
1.1455
00000726354
PMS-FLUPHENAZINE 5 MG TABLET
ORL
TAB
PMS
TAB
0.1720
00002247493
PMS-FUROSEMIDE 20 MG TABLET
ORL
TAB
PMS
TAB
0.0373
00002247494
PMS-FUROSEMIDE 40 MG TABLET
ORL
TAB
PMS
TAB
0.0746
00002255898
PMS-GABAPENTIN 600 MG TABLET
ORL
TAB
PMS
TAB
1.3045
00002255901
PMS-GABAPENTIN 800 MG TABLET
ORL
TAB
PMS
TAB
1.7393
00002247386
PMS-HYDROCHLOROTHIAZIDE 25 MG TABLET
ORL
TAB
PMS
TAB
0.0474
00002247387
PMS-HYDROCHLOROTHIAZIDE 50 MG TABLET
ORL
TAB
PMS
TAB
0.0551
00002324253
PMS-HYDROCODONE 1 MG/ML ORAL SYRUP
ORL
SYR
PMS
ML
0.1224
00000836133
PMS-IBUPROFEN 400 MG TABLET
ORL
TAB
PMS
TAB
0.1010
Pg 155 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002431114
PMS-IMATINIB 100 MG TABLET
ORL
TAB
PMS
TAB
20.4557
00002431122
PMS-IMATINIB 400 MG TABLET
ORL
TAB
PMS
TAB
81.8227
00002239620
PMS-INDAPAMIDE 2.5 MG TABLET
ORL
TAB
PMS
TAB
0.1183
00002395258
PMS-LANSOPRAZOLE 15 MG DELAYED-RELEASE CAPSULE
ORL
DRC
PMS
CAP
0.5000
00002395266
PMS-LANSOPRAZOLE 30 MG DELAYED-RELEASE CAPSULE
ORL
DRC
PMS
CAP
0.5000
00002288265
PMS-LEFLUNOMIDE 10 MG TABLET
ORL
TAB
PMS
TAB
6.0417
00002288273
PMS-LEFLUNOMIDE 20 MG TABLET
ORL
TAB
PMS
TAB
6.0417
00002309114
PMS-LETROZOLE 2.5 MG TABLET
ORL
TAB
PMS
TAB
2.7560
00000811874
PMS-LIDOCAINE VISCOUS 2% ORAL LIQUID
ORL
LIQ
PMS
ML
0.0950
00002074834
PMS-LITHIUM CITRATE 8 MMO/5ML ORAL SYRUP
ORL
SYR
PMS
ML
0.0708
00002248268
PMS-MELOXICAM 15 MG TABLET
ORL
TAB
PMS
TAB
0.5670
00002248267
PMS-MELOXICAM 7.5 MG TABLET
ORL
TAB
PMS
TAB
0.4914
00002321130
PMS-MEMANTINE 10 MG TABLET
ORL
TAB
PMS
TAB
1.6357
00002382830
PMS-MEMANTINE 5 MG TABLET
ORL
TAB
PMS
TAB
1.6357
00002413728
PMS-METHYLPHENIDATE 18 MG EXTENDED RELEASE TABLET
ORL
ERT
PMS
TAB
1.4276
00002413736
ORL
ERT
PMS
TAB
1.6475
00002413744
ORL
ERT
PMS
TAB
1.8674
00002413752
ORL
ERT
PMS
TAB
2.3072
00000783137
PMS-METRONIDAZOLE 500 MG CAPSULE
ORL
CAP
PMS
CAP
0.7028
00002432218
PMS-MOXIFLOXACIN 0.5% OPHTHALMIC SOLUTION
OPH
SOL
PMS
ML
3.7567
Pg 156 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002405776
PMS-NEVIRAPINE 200 MG TABLET
ORL
TAB
PMS
TAB
2.4692
00002418630
PMS-NIFEDIPINE ER 30 MG EXTENDED-RELEASE TABLET
ORL
ERT
PMS
TAB
0.6171
00002416301
PMS-NIFEDIPINE ER 60 MG EXTENDED-RELEASE TABLET
ORL
ERT
PMS
TAB
0.9374
00002177714
PMS-NIZATIDINE 150 MG CAPSULE
ORL
CAP
PMS
CAP
0.2098
00002177722
PMS-NIZATIDINE 300 MG CAPSULE
ORL
CAP
PMS
CAP
0.3802
00002177692
PMS-NORTRIPTYLINE 10 MG CAPSULE
ORL
CAP
PMS
CAP
0.0500
00002177706
PMS-NORTRIPTYLINE 25 MG CAPSULE
ORL
CAP
PMS
CAP
0.1011
00002367483
PMS-OLANZAPINE 20 MG TABLET
ORL
TAB
PMS
TAB
10.3093
00002303213
PMS-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
PMS
TAB
5.3553
00002423944
PMS-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
PMS
TAB
7.5977
00002309882
PMS-OXYCODONE CR 10 MG CONTROLLED-RELEASE TABLET
ORL
CRT
PMS
TAB
0.4390
00002309890
ORL
CRT
PMS
TAB
0.6585
00002309904
ORL
CRT
PMS
TAB
1.1413
00002309912
ORL
CRT
PMS
TAB
2.1080
00002247750
PMS-PAROXETINE 10 MG TABLET
ORL
TAB
PMS
TAB
1.0430
00002231537
PMS-PINDOLOL 10 MG TABLET
ORL
TAB
PMS
TAB
0.2323
00002231539
ORL
TAB
PMS
TAB
0.3370
00002231536
ORL
TAB
PMS
TAB
0.1361
00002154463
PMS-PIROXICAM 20 MG RECTAL SUPPOSITORY
RT
SUP
PMS
SUP
2.2117
00002240363
PMS-POLYTRIMETHOPRIM OPHTHALMIC SOLUTION
OPH
SOL
PMS
ML
2.3880
Pg 157 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002290138
PMS-PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
PMS
TAB
1.3860
00002359634
PMS-PREGABALIN 150 MG CAPSULE
ORL
CAP
PMS
CAP
1.7270
00002398079
ORL
CAP
PMS
CAP
1.7270
00002359596
ORL
CAP
PMS
CAP
0.6173
00002359642
ORL
CAP
PMS
CAP
1.7270
00002359618
ORL
CAP
PMS
CAP
0.9683
00002359626
ORL
CAP
PMS
CAP
1.2529
00000753661
PMS-PROCHLORPERAZINE 5 MG TABLET
ORL
TAB
PMS
TAB
0.1659
00002294559
PMS-PROPAFENONE 150 MG TABLET
ORL
TAB
PMS
TAB
0.4275
00002294575
PMS-PROPAFENONE 300 MG TABLET
ORL
TAB
PMS
TAB
0.7537
00000815993
PMS-PSEUDOEPHEDRINE HCL 6 MG/ML ORAL SYRUP
ORL
SYR
PMS
ML
0.0443
00000618810
PMS-PYRAZINAMIDE 500 MG TABLET
ORL
TAB
PMS
TAB
1.2408
00002340569
PMS-QUINAPRIL 10 MG TABLET
ORL
TAB
PMS
TAB
0.6867
00002340577
ORL
TAB
PMS
TAB
0.6867
00002340585
ORL
TAB
PMS
TAB
0.6867
00002340550
ORL
TAB
PMS
TAB
0.6867
00002343932
PMS-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
PMS
CAP
0.8133
00002424177
PMS-RISEDRONATE 150 MG TABLET
ORL
TAB
PMS
TAB
40.9500
00002069571
PMS-SALBUTAMOL 5 MG/ML INHALATION SOLUTION
INH
SOL
PMS
ML
0.3510
00002371642
PMS-SILDENAFIL 100 MG TABLET
ORL
TAB
PMS
TAB
9.2006
Pg 158 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002371626
ORL
TAB
PMS
TAB
8.2894
00002371634
ORL
TAB
PMS
TAB
8.8481
00002412179
PMS-SILDENAFIL R 20 MG TABLET
ORL
TAB
PMS
TAB
7.2940
00002256428
PMS-SUMATRIPTAN 25 MG TABLET
ORL
TAB
PMS
TAB
8.9900
00002409437
PMS-TADALAFIL 10 MG TABLET
ORL
TAB
PMS
TAB
11.9255
00002409410
PMS-TADALAFIL 2.5 MG TABLET
ORL
TAB
PMS
TAB
3.6471
00002409445
ORL
TAB
PMS
TAB
12.3569
00002409429
ORL
TAB
PMS
TAB
3.6471
00002237460
PMS-TAMOXIFEN 20 MG TABLET
ORL
TAB
PMS
TAB
0.3500
00002391236
PMS-TELMISARTAN 40 MG TABLET
ORL
TAB
PMS
TAB
0.2821
00002391244
PMS-TELMISARTAN 80 MG TABLET
ORL
TAB
PMS
TAB
0.2821
00002401665
PMS-TELMISARTAN-HCTZ 80 MG/12.5 MG TABLET
ORL
TAB
PMS
TAB
0.2821
00002083353
PMS-TIMOLOL 0.25% (BASE) OPH SOLUTION
OPH
SOL
PMS
ML
0.9680
00002401657
PMS-TRAMADOL-ACET 37.5 MG/325 MG TABLET
ORL
TAB
PMS
TAB
0.6264
00002312999
PMS-VALSARTAN 40 MG TABLET
ORL
TAB
PMS
TAB
0.5240
00002241821
PMS-VANCOMYCIN 1 G/VIAL INJECTION
INJ
DEFAUL
PMS
VIAL
58.9900
00002241820
PMS-VANCOMYCIN 500 MG/VIAL INJECTION
INJ
DEFAUL
PMS
VIAL
31.0500
00001954504
PMS-YOHIMBINE 2 MG TABLET
ORL
TAB
PMS
TAB
0.2063
00001954342
PMS-YOHIMBINE 5.4 MG TABLET
ORL
TAB
PMS
TAB
0.4395
00001985604
PMS-YOHIMBINE 6 MG TABLET
ORL
TAB
PMS
TAB
0.7850
Pg 159 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
INJ
DEFAUL
MSD
VIAL
18.3600
00000431648
PNEUMOVAX 23 25 MCG/VIAL INJECTION
00000990067
POCKET CHAMBER DEVICE
DEFAUL
DEV
MMS
DEV
15.9900
00000990069
POCKET CHAMBER PEDIATRIC MEDIUM MASK DEVICE
DEFAUL
PEDDEV
MMS
DEV
49.9900
00000598208
PODOFILM 250 MG/ML TOPICAL LIQUID
TOP
LIQ
PMS
ML
1.5168
00000464988
POLLINEX R INJECTION
INJ
VIAL/SYR
BEE
VL/SYR
96.4700
00000999389
POLYCAL ORAL POWDER
ORL
PWR
XXX
G
0.0224
00000999928
POLYCOSE ORAL POWDER
ORL
PWR
ABN
G
0.0253
00002230844
POLYSPORIN 10,000 U/0.25 MG ANTIBIOTIC TOPICAL CRM
TOP
CRM
JJI
G
0.3633
00002237227
POLYSPORIN ANTIBIOTIC TOPICAL OINTMENT
TOP
ONT
JJI
G
0.3633
00002239155
POLYSPORIN PLUS PAIN RELIEF EAR DROPS
OT
SOL
JJI
ML
0.6967
00002239201
POLYSPORIN PLUS PAIN RELIEF TOPICAL CREAM
TOP
CRM
JJI
G
0.3940
00002239157
POLYSPORIN STERILE OPHTHALMIC OINTMENT
OPH
ONT
JJI
G
1.6886
00002239156
POLYSPORIN STERILE OTIC OPH DROPS
OT/OPH
DPS
JJI
ML
0.6967
00002237226
POLYSPORIN TRIPLE ANTIBIOTIC TOPICAL OINTMENT
TOP
ONT
JJI
G
0.3940
00001981021
POLYTAR AF TOPICAL SHAMPOO
TOP
SHP
GSK
ML
0.0623
00000249866
POLYTAR REGULAR 1% TOPICAL SHAMPOO
TOP
SHP
GSK
ML
0.0403
00001942921
POLYTOPIC TOPICAL OINTMENT
TOP
ONT
SDZ
G
0.3333
00002011956
POLYTRIM OPH SOLUTION
OPH
SOL
ALL
ML
3.2900
00002419580
POMALYST 1 MG CAPSULE
ORL
CAP
CLG
CAP
500.0000
00002419599
ORL
CAP
CLG
CAP
500.0000
Pg 160 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002419602
ORL
CAP
CLG
CAP
500.0000
00002419610
ORL
CAP
CLG
CAP
500.0000
00002424622
POSANOL 100 MG DELAYED-RELEASE TABLET
ORL
DRT
MFC
TAB
46.7230
00002293404
POSANOL 40 MG/ML ORAL SUSPENSION
ORL
SUS
MFC
ML
9.3446
00000611271
POTABA 0.5 G CAPSULE
ORL
CAP
GLE
CAP
0.3311
00000550175
POTABA 0.5 G TABLET
ORL
TAB
GLE
TAB
0.4319
00000316121
POTASSIUM 50 MG TABLET
ORL
TAB
JAM
TAB
0.0563
00080028233
POTASSIUM CHLORIDE 20 MEQ TABLET
ORL
TAB/SRT
OPU
TAB
0.1995
00080026332
POTASSIUM CITRATE 10 MMOL 10 MEQ TABLET
ORL
TAB
MTR
TAB
0.1545
00000804789
POTASSIUM PHOSPHATE 224 MG/ML/ 236 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
1.1869
00002139545
POTASSIUM PHOSPHATES 224 MG/ML/236 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
0.5302
00002312433
PRADAXA 75 MG CAPSULE
ORL
CAP
BOE
CAP
1.6480
00002309130
PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
SIV
TAB
1.3860
00002367610
PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
SNS
TAB
1.3860
00000770957
PRAMOX H.C. TOPICAL CREAM
TOP
CRM
DPT
G
0.4444
00001954210
PRAMOX H.C. TOPICAL LOTION
TOP
LOT
DPT
ML
0.1833
00002243824
PRAVASTATIN-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.4050
00002243825
ORL
TAB
PDL
TAB
0.4777
00002243826
ORL
TAB
PDL
TAB
0.5755
00002148498
PREDNISOLONE SOD PHOS 0.5% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
Pg 161 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000156876
PREDNISONE 5 MG TABLET
ORL
TAB
PDL
TAB
0.0401
00000607517
PREDNISONE-50 50 MG TABLET
ORL
TAB
PDL
TAB
0.1735
00002403722
PREGABALIN 150 MG CAPSULE
ORL
CAP
SIV
CAP
1.7270
00002405563
ORL
CAP
SNS
CAP
1.7270
00002396521
ORL
CAP
PDL
CAP
1.1698
00002403749
ORL
CAP
SIV
CAP
1.1698
00002405539
ORL
CAP
SNS
CAP
0.6173
00002396483
ORL
CAP
PDL
CAP
0.4181
00002403692
ORL
CAP
SIV
CAP
0.6173
00002405598
ORL
CAP
SNS
CAP
1.7270
00002403730
ORL
CAP
SIV
CAP
1.7270
00002396548
ORL
CAP
PDL
CAP
1.1698
00002396505
ORL
CAP
PDL
CAP
0.6558
00002405547
ORL
CAP
SNS
CAP
0.9683
00002403706
ORL
CAP
SIV
CAP
0.9683
00002396513
ORL
CAP
PDL
CAP
0.8486
00002405555
ORL
CAP
SNS
CAP
1.2528
00002403714
ORL
CAP
SIV
CAP
1.2529
00002411768
PREGABALIN-150 150 MG CAPSULE
ORL
CAP
SIV
CAP
1.7270
00002411725
ORL
CAP
SIV
CAP
0.6173
Pg 162 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002411733
ORL
CAP
SIV
CAP
0.9683
00002411741
ORL
CAP
SIV
CAP
1.2529
00002182904
PREGNYL 10,000 UNIT INJECTION
INJ
DEFAUL
MFC
VIAL
72.0000
00002276194
PREGVIT FOLIC 5 TABLET
ORL
TAB
DUI
TAB
0.5312
00002451581
PREGVIT FOLIC 5 TABLET
ORL
TAB
DUI
TAB
0.5312
00002451573
PREGVIT TABLET
ORL
TAB
DUI
TAB
0.4167
00002246067
PREGVIT TABLET
ORL
TAB
DUI
TAB
0.4167
00002043394
PREMARIN 0.3 MG TABLET
ORL
TAB
PFI
TAB
0.3027
00002043408
ORL
TAB
PFI
TAB
0.3027
00002043424
ORL
TAB
PFI
TAB
0.3027
00002043386
PREMARIN 25 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
43.4100
00002244574
PRENATAL VITAMIN AND MINERAL SUPPLEMENT CAPLET
ORL
TAB
WNP
TAB
0.0766
00000886750
PREPARATION H TOPICAL CREAM
TOP
CRM
PDH
G
0.2544
00001926217
PREPARATION H TOPICAL OINTMENT
TOP
ONT
PDH
G
0.2208
00000999899
PRESIDENT'S CHOICE ORAL LIQUID
ORL
LIQ
XXX
ML
0.0071
00000693820
PRESSYN 20 U/ML INJECTION
INJ
DEFAUL
FEI
ML
7.9000
00002246133
PRESSYN AR 20U/ML INJECTION
INJ
DEFAUL
FEI
ML
10.0000
00002249464
PREVACID FASTAB 15 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
BGP
TAB
2.0000
00002249472
PREVACID FASTAB 30 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
BGP
TAB
2.0000
00000635189
PREVEX 67% TOPICAL CREAM
TOP
CRM
GSK
G
0.1565
Pg 163 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
DEN
CRM
COL
G
0.2013
00002210754
PREVIDENT 5000 PLUS DENTAL CREAM
00002335204
PREVNAR 13 SUSPENSION 0.5 ML SYRINGE INJECTION
INJ
NDL
PFI
SYR
91.3500
00002244081
PREVNAR VACCINE 0.5 ML INJECTION
INJ
DEFAUL
PFI
ML
180.1800
00002426501
PREZCOBIX 800 MG/150 MG TABLET
ORL
TAB
JAI
TAB
23.8670
00002369753
PREZISTA 150 MG TABLET
ORL
TAB
JAI
TAB
3.7860
00002324016
ORL
TAB
JAI
TAB
10.8580
00002324024
ORL
TAB
JAI
TAB
15.7848
00002338432
ORL
TAB
JAI
TAB
1.8930
00002393050
ORL
TAB
JAI
TAB
21.7160
00080033655
PRIMADOPHILUS OPTIMA MAX BIFIDO 90 BILLION CAPSULE
ORL
CAP
ENT
CAP
1.4283
00000839388
PRINIVIL 5 MG TABLET
ORL
TAB
MFC
TAB
0.6073
00002239208
PRIORIX VIAL INJECTION
INJ
DEFAUL
GSK
VIAL
27.7760
00002321106
PRISTIQ 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
PFI
TAB
2.7250
00002321092
PRISTIQ 50 MG EXTENDED-RELEASE TABLET
ORL
ERT
PFI
TAB
2.7250
00002426366
PRIVA-CELECOXIB 100 MG CAPSULE
ORL
CAP
PMI
CAP
0.1730
00002426374
PRIVA-CELECOXIB 200 MG CAPSULE
ORL
CAP
PMI
CAP
0.3497
00002446677
PRIVA-DONEPEZIL 10 MG TABLET
ORL
TAB
PMI
TAB
0.7875
00002446669
PRIVA-DONEPEZIL 5 MG TABLET
ORL
TAB
PMI
TAB
0.7875
00002425238
PRIVA-EZETIMIBE 10 MG TABLET
ORL
TAB
PMI
TAB
0.4612
00002446715
PRIVA-LOSARTAN 100 MG TABLET
ORL
TAB
PMI
TAB
0.2321
Pg 164 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002446693
ORL
TAB
PMI
TAB
0.2321
00002446707
ORL
TAB
PMI
TAB
0.2321
00002425378
PRIVA-PANTOPRAZOLE 40 MG ENTERIC-COATED TABLET
ORL
ECT
PMI
TAB
0.3628
00002425874
PRIVA-ZOPICLONE 5 MG TABLET
ORL
TAB
PMI
TAB
0.1782
00002425882
PRIVA-ZOPICLONE 7.5 MG TABLET
ORL
TAB
PMI
TAB
0.2250
00000644315
PRO AMOX-500 MG CAPSULE
ORL
CAP
PDL
CAP
0.3417
00002311518
PRO-AAS (CROQUABLE) 80 MG CHEWABLE TABLET
ORL
CTB
PDL
TAB
0.0560
00002311496
PRO-AAS EC 80 MG TABLET
ORL
ECT
PDL
TAB
0.5600
00002309661
PRO-AMIODARONE-200 200 MG TABLET
ORL
TAB
PDL
TAB
0.5147
00000644331
PRO-AMOX 250 MG/5 ML POWDER FOR ORAL SUSPENSION
ORL
SUS
PDL
ML
0.0540
00080026419
PROARGI-9 PLUS ORAL POWDER
ORL
PWR
NHP
G
0.1252
00002310600
PRO-AZITHROMYCINE 250 MG TABLET
ORL
TAB
PDL
TAB
2.4667
00002311038
PRO-BICALUTAMIDE-50 50 MG TABLET
ORL
TAB
PDL
TAB
1.6100
00080014464
PROBIOTIC 10 BILLION
ORL
CAP
JAM
CAP
0.2398
00002184486
PROCAINAMIDE HYDROCHLORIDE 100 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
3.2384
00080008566
PRO-CAL-D 400 IU ORAL CAPLET
ORL
DEFAUL
PDL
TAB
0.1200
00002311062
PRO-CEFADROXIL-500 500 MG CAPSULE
ORL
CAP
PDL
CAP
0.8421
00002311453
PRO-CEFUROXIME-500 500 MG TABLET
ORL
TAB
PDL
TAB
1.4337
00002232658
PROCET-30 TABLET
ORL
TAB
PDL
TAB
0.1300
00000789747
PROCHLORPERAZINE 5 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
1.5020
Pg 165 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002317796
PRO-CIPROFLOXACIN 250 MG TABLET
ORL
TAB
PDL
TAB
0.6186
00002317818
PRO-CIPROFLOXACIN 500 MG TABLET
ORL
TAB
PDL
TAB
0.6979
00002311593
PRO-CLONAZEPAM 0.5 MG TABLET
ORL
TAB
PDL
TAB
0.0554
00002311607
PRO-CLONAZEPAM 1 MG TABLET
ORL
TAB
PDL
TAB
0.1487
00002311615
PRO-CLONAZEPAM 2 MG TABLET
ORL
TAB
PDL
TAB
0.0954
00002223260
PROCTOSEDYL RECTAL SUPPOSITORY
RT
SUP
AXC
SUP
1.2108
00002241799
PROCYTOX 1,000 MG/VIAL INJECTION
INJ
DEFAUL
ASM
VIAL
87.5700
00002241797
PROCYTOX 200 MG/VIAL INJECTION
INJ
DEFAUL
ASM
VIAL
51.8700
00002241795
PROCYTOX 25 MG TABLET
ORL
TAB
ASM
TAB
0.5002
00002241796
PROCYTOX 50 MG TABLET
ORL
TAB
ASM
TAB
0.6690
00002241800
PROCYTOX INJECTION
INJ
DEFAUL
ASM
VIAL
152.3500
00002311267
PRO-DEXAMETHASONE-4 4 MG TABLET
ORL
TAB
PDL
TAB
0.3046
00002246645
PRODIEM BULK FIBRE THERAPY 625 MG TABLET
ORL
TAB
NVC
TAB
0.1614
00002246576
PRODIEM OVERNIGHT RELIEF THERAPY 15 MG TABLET
ORL
TAB
NVC
TAB
0.2030
00002311429
PRO-ENALAPRIL-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.3252
00002311402
PRO-ENALAPRIL-2.5 2.5 MG TABLET
ORL
TAB
PDL
TAB
0.2288
00002311437
ORL
TAB
PDL
TAB
0.3924
00002311410
ORL
TAB
PDL
TAB
0.2706
00002310228
PRO-FENO-SUPER-100 100 MG TABLET
ORL
TAB
PDL
TAB
0.5406
00002310236
PRO-FENO-SUPER-160 160 MG TABLET
ORL
CAP/TAB
PDL
TAB
0.2723
Pg 166 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002247909
PROFERRIN 11 MG TABLET
ORL
TAB
CBI
TAB
0.6990
00002310686
PRO-FLUCONAZOLE 100 MG TABLET
ORL
TAB
PDL
TAB
2.2890
00002310694
PRO-FLUCONAZOLE 150 MG CAPSULE
ORL
CAP
PDL
CAP
3.9400
00002314991
PRO-FLUOXETINE 10 MG CAPSULE
ORL
CAP
PDL
CAP
0.4595
00002315009
PRO-FLUOXETINE 20 MG CAPSULE
ORL
CAP
PDL
CAP
0.4598
00002310449
PRO-GABAPENTIN 100 MG CAPSULE
ORL
CAP
PDL
CAP
0.1040
00002310457
ORL
CAP
PDL
CAP
0.2530
00002310465
ORL
CAP
PDL
CAP
0.3015
00002310473
PRO-GABAPENTIN 600 MG TABLET
ORL
TAB
PDL
TAB
0.9580
00002310481
PRO-GABAPENTIN 800 MG TABLET
ORL
TAB
PDL
TAB
1.2773
00000503347
PROGLYCEM 100 MG CAPSULE
ORL
CAP
MFC
CAP
1.6802
00002243144
PROGRAF 0.5 MG CAPSULE
ORL
CAP
ASP
CAP
1.9700
00002175991
PROGRAF 1 MG CAPSULE
ORL
CAP
ASP
CAP
2.5200
00002175983
PROGRAF 5 MG CAPSULE
ORL
CAP
ASP
CAP
12.6200
00080060497
PROGRESSIVE HARMONIZED VEGAN PROTEIN POWDER
ORL
PWR
BPN
G
0.0582
00002311011
PRO-HYDROXYQUINE-200 200 MG TABLET
ORL
TAB
PDL
TAB
0.2620
00002312530
PRO-INDAPAMIDE 1.25 MG TABLET
ORL
TAB
PDL
TAB
0.0745
00002312549
PRO-INDAPAMIDE 2.5 MG TABLET
ORL
TAB
PDL
TAB
0.1182
00000646261
PRO-INDO 25 MG CAPSULE
ORL
CAP
PDL
CAP
0.0871
00000646288
PRO-INDO 50 MG CAPSULE
ORL
CAP
PDL
CAP
0.1511
Pg 167 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080053887
PRO-K 20 20 MEQ SUSTAINED-RELEASE TABLET
ORL
TAB
PDL
TAB
0.1995
00002204606
PROLASTIN-C 1 G/VIAL INJECTION
INJ
DEFAUL
GRL
VIAL
429.0600
00002439123
PROLENSA 0.07% OPHTHALMIC SOLUTION
OPH
SOL
BSH
ML
7.6700
00002310988
PRO-LISINOPRIL-10 10 MG TABLET
ORL
TAB
PDL
TAB
0.1619
00002310996
ORL
TAB
PDL
TAB
0.1945
00002310961
ORL
TAB
PDL
TAB
0.1347
00000655643
PRO-LORAZEPAM 0.5 MG TABLET
ORL
TAB
PDL
TAB
0.0359
00000655651
PRO-LORAZEPAM 1.0 MG TABLET
ORL
TAB
PDL
TAB
0.0447
00000655678
PRO-LORAZEPAM 2 MG TABLET
ORL
TAB
PDL
TAB
0.0699
00002314908
PRO-METFORMIN 500 MG TABLET
ORL
TAB
PDL
TAB
0.0444
00002314894
PRO-METFORMIN 850 MG TABLET
ORL
TAB
PDL
TAB
0.0610
00000567434
PROMETHAZINE HCL 25 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
1.6540
00002310953
PRO-NAPROXEN EC - 500 500 MG ENTERIC-COATED TABLET
ORL
ECT
PDL
TAB
0.2110
00002343053
PROPAFENONE 150 MG TABLET
ORL
TAB
SNS
TAB
0.4303
00002343061
PROPAFENONE 300 MG TABLET
ORL
TAB
SNS
TAB
0.7537
00002243783
PROPAFENONE-150 150 MG TABLET
ORL
TAB
PDL
TAB
0.2965
00002243784
PROPAFENONE-300 300 MG TABLET
ORL
TAB
PDL
TAB
0.5227
00002238213
PROPECIA 1 MG TABLET
ORL
TAB
MFC
TAB
1.8529
00002317354
PRO-QUETIAPINE 100 MG TABLET
ORL
TAB
PDL
TAB
0.3295
00002317362
ORL
TAB
PDL
TAB
0.6617
Pg 168 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002317346
ORL
TAB
PDL
TAB
0.1235
00002317370
ORL
TAB
PDL
TAB
0.9656
00002311224
PRO-QUININE-300 300 MG CAPSULE
ORL
CAP
PDL
CAP
0.3750
00002315181
PRO-RABEPRAZOLE 10 MG ENTERIC-COATED TABLET
ORL
ECT
PDL
TAB
0.1204
00002315203
PRO-RABEPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
PDL
TAB
0.2408
00002310023
PRO-RAMIPRIL-1.25 1.25 MG CAPSULE
ORL
CAP/TAB
PDL
CAP
0.1274
00002310104
PRO-RAMIPRIL-10 10 MG CAPSULE
ORL
CAP/TAB
PDL
CAP
0.1862
00002310066
PRO-RAMIPRIL-2.5 2.5 MG CAPSULE
ORL
CAP/TAB
PDL
CAP
0.1470
00002310074
PRO-RAMIPRIL-5 5 MG CAPSULE
ORL
CAP/TAB
PDL
CAP
0.1470
00002316536
PRO-SOTALOL 160 MG TABLET
ORL
TAB
PDL
TAB
0.1623
00002316528
PRO-SOTALOL 80 MG TABLET
ORL
TAB
PDL
TAB
0.2966
00000519367
PRO-TRIAZIDE 50/25 MG TABLET
ORL
TAB
PDL
TAB
0.0608
00000512524
PROTRIN DF 800 MG/160 MG TABLET
ORL
TAB
PDL
TAB
0.1221
00000287709
PROTYLOL 10 MG CAPSULE
ORL
CAP
PDL
CAP
0.0609
00000513059
PROTYLOL 20 MG TABLET
ORL
TAB
PDL
TAB
0.1690
00000729973
PROVERA 10 MG TABLET
ORL
TAB
PFI
TAB
0.8563
00000708917
PROVERA 2.5 MG TABLET
ORL
TAB
PFI
TAB
0.2135
00000030937
PROVERA 5 MG TABLET
ORL
TAB
PFI
TAB
0.4220
00002324156
PRO-VERAPAMIL SR 120 MG SUSTAINED-RELEASE TABLET
ORL
SRT
PDL
TAB
0.5078
00002324164
ORL
SRT
PDL
TAB
0.5204
Pg 169 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002312697
ORL
SRT
PDL
TAB
0.5075
00002239656
PROVOCHOLINE 100 MG/VIAL INHALATION PWD FOR SOL
INH
PWS
MTP
VIAL
40.0000
00002243834
INH
PWS
MTP
VIAL
487.0000
00002246492
INH
PWS
MTP
VIAL
64.0000
00002246493
INH
PWS
MTP
VIAL
128.0000
00002313065
PRO-ZOPICLONE 5 MG TABLET
ORL
TAB
PDL
TAB
0.1782
00002313073
PRO-ZOPICLONE 7.5 MG TABLET
ORL
TAB
PDL
TAB
0.2250
00080002201
PSN 056 CAPSULE
ORL
CAP
PSN
CAP
0.0750
00000999412
PULMOCARE ORAL LIQUID
ORL
LIQ
ABN
ML
0.0137
00000466409
PULMOPHYLLINE 5.3 MG/ML ORAL ELIXIR
ORL
ELX
RIV
ML
0.0086
00002046733
PULMOZYME 1 ML AMPOULE INHALATION SOLUTION
INH
SOL
HLR
ML
15.7557
00002242439
PUREGON 100 IU/ML INJECTION
INJ
DEFAUL
MFC
ML
97.0000
00002242441
PUREGON 200 IU/ML INJECTION
INJ
DEFAUL
MFC
ML
194.0000
00002243948
PUREGON 833 IU/ML INJECTION CARTRIDGE
INJ
CTG
MFC
ML
808.3333
00080056141
PUREPALEO PROTEIN ORAL POWDER
ORL
PWR
DFH
G
0.0549
00080039387
PURFEM VAGINAL OVULE
VAG
OVL
MFI
OVL
2.0690
00002317966
PURG-ODAN ORL POWDER
ORL
PWDPKT
ODN
PCKT
5.3000
00000004723
PURINETHOL 50 MG TABLET
ORL
TAB
TEV
TAB
2.8610
00080009682
PYCNOGENOL 25 MG ORAL CASPULE
ORL
CAP
NFN
CAP
0.5665
00000497517
PYRIDOXINE HCL 100 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
1.9500
Pg 170 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002245215
PYRIDOXINE HYDROCHLORIDE 100 MG/ML INJECTION
INJ
DEFAUL
BNQ
ML
1.1663
00080015945
QUEST TABLET
ORL
TAB
PLH
TAB
0.3943
00002417367
QUETIAPINE XR 150 MG EXTENDED-RELEASE TABLET
ORL
ERT
SIV
TAB
0.7780
00002417790
ORL
ERT
PDL
TAB
0.8753
00002417804
ORL
ERT
PDL
TAB
1.1882
00002417375
ORL
ERT
SIV
TAB
1.0520
00002417812
ORL
ERT
PDL
TAB
1.7505
00002417383
ORL
ERT
SIV
TAB
1.5440
00002417391
ORL
ERT
SIV
TAB
2.0960
00002417820
ORL
ERT
PDL
TAB
2.3763
00002417782
ORL
ERT
PDL
TAB
0.4445
00002417359
ORL
ERT
SIV
TAB
0.3950
00002415925
QUINAPRIL 10 MG TABLET
ORL
TAB
PDL
TAB
0.5329
00002415933
ORL
TAB
PDL
TAB
0.5329
00002415941
ORL
TAB
PDL
TAB
0.5329
00002415917
ORL
TAB
PDL
TAB
0.5329
00000695440
QUININE-ODAN 200 MG CAPSULE
ORL
CAP
ODN
CAP
0.2390
00000695459
QUININE-ODAN 300 MG CAPSULE
ORL
CAP
ODN
CAP
0.3750
00000695432
QUININE-ODAN 300 MG TABLET
ORL
TAB
ODN
TAB
0.3750
00080039114
Q-UROL TABLET
ORL
TAB
SLP
TAB
0.7415
Pg 171 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002267667
RABAVERT VACCINE 2.5 UNIT/VIAL INJECTION
INJ
DEFAUL
MFC
VIAL
171.8800
00002423723
RAGWITEK 12 UNIT SUBLINGUAL TABLET
SLG
TAB
MFC
TAB
3.9103
00002299194
RALIVIA 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
VCL
TAB
1.2546
00002299208
ORL
ERT
VCL
TAB
2.2888
00002299216
ORL
ERT
VCL
TAB
3.3160
00002415852
RALOXIFENE 60 MG TABLET
ORL
TAB
PDL
TAB
0.4585
00002415895
RAMIPRIL-HCTZ 10 MG/ 12.5 MG TABLET
ORL
TAB
PDL
TAB
0.2633
00002415909
RAMIPRIL-HCTZ 10 MG/25 MG TABLET
ORL
TAB
PDL
TAB
0.2633
00002415887
RAMIPRIL-HCTZ 5 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.2067
00002384701
RAN-ALENDRONATE 10 MG TABLET
ORL
TAB
RAN
TAB
0.4986
00002384698
RAN-ALENDRONATE 5 MG TABLET
ORL
TAB
RAN
TAB
1.0370
00002398877
RAN-AMLODIPINE 2.5 MG TABLET
ORL
TAB
RAN
TAB
0.1380
00002328690
RAN-ANASTROZOLE 1 MG TABLET
ORL
TAB
RAN
TAB
2.5457
00002371324
RAN-BICALUTAMIDE 50 MG TABLET
ORL
TAB
RAN
TAB
4.0573
00002380684
RAN-CANDESARTAN 4 MG TABLET
ORL
TAB
RAN
TAB
0.3400
00002268043
RAN-CARVEDILOL 12.5 MG TABLET
ORL
TAB
RAN
TAB
0.3377
00002268051
RAN-CARVEDILOL 25 MG TABLET
ORL
TAB
RAN
TAB
0.3377
00002268027
ORL
TAB
RAN
TAB
0.3377
00002268035
ORL
TAB
RAN
TAB
0.3377
00002361434
RAN-CLARITHROMYCIN 500 MG TABLET
ORL
TAB
RAN
TAB
1.6293
Pg 172 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002423979
RAN-ESOMEPRAZOLE 20 MG DELAYED-RELEASE TABLET
ORL
DRT
RAN
TAB
1.8690
00002423987
RAN-ESOMEPRAZOLE 40 MG DELAYED-RELEASE TABLET
ORL
DRT
RAN
TAB
1.8690
00002405695
RAN-FLUOXETINE 10 MG CAPSULE
ORL
CAP
RAN
CAP
0.4595
00002405709
RAN-FLUOXETINE 20 MG CAPSULE
ORL
CAP
RAN
CAP
0.4728
00002351706
RAN-IMIPENEM-CILASTATIN 500 MG/500 MG/VIAL INJ
INJ
DEFAUL
RAN
VIAL
21.9400
00002363208
RAN-IRBESARTAN HCTZ 150/12.5 MG TABLET
ORL
TAB
RAN
TAB
0.3024
00002363216
RAN-IRBESARTAN HCTZ 300/12.5 MG TABLET
ORL
TAB
RAN
TAB
0.3024
00002363224
RAN-IRBESARTAN HCTZ 300/25 MG TABLET
ORL
TAB
RAN
TAB
0.3004
00000740748
RANITIDINE 150 MG TABLET
ORL
TAB
PDL
TAB
0.1800
00000740756
RANITIDINE 300 MG TABLET
ORL
TAB
PDL
TAB
0.3600
00002372282
RAN-LETROZOLE 2.5 MG TABLET
ORL
TAB
RAN
TAB
2.7560
00002404486
RAN-LOSARTAN 100 MG TABLET
ORL
TAB
RAN
TAB
0.3025
00002404451
ORL
TAB
RAN
TAB
0.3025
00002404478
ORL
TAB
RAN
TAB
0.3025
00002421364
RAN-MEMANTINE 10 MG TABLET
ORL
TAB
RAN
TAB
1.6357
00002358077
RAN-NABILONE 0.25 MG CAPSULE
ORL
CAP
RAN
CAP
1.3962
00002403102
RAN-OLANZAPINE 15 MG TABLET
ORL
TAB
RAN
TAB
1.9136
00002414112
RAN-OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
RAN
TAB
5.3554
00002414120
RAN-OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
RAN
TAB
7.5979
00002403617
RAN-OMEPRAZOLE 20 MG DELAYED-RELEASE CAPSULE
ORL
CAP/SRT
RAN
CAP
0.4117
Pg 173 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002305038
RAN-PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
RAN
TAB
1.2750
00002375850
RAN-PIOGLITAZONE 15 MG TABLET
ORL
TAB
RAN
TAB
0.5809
00002375869
ORL
TAB
RAN
TAB
0.8139
00002375877
ORL
TAB
RAN
TAB
1.2237
00002392844
RAN-PREGABALIN 150 MG CAPSULE
ORL
CAP
RAN
CAP
1.7270
00002392852
ORL
CAP
RAN
CAP
1.7270
00002392801
ORL
CAP
RAN
CAP
0.6173
00002392860
ORL
CAP
RAN
CAP
1.7270
00002392828
ORL
CAP
RAN
CAP
0.9683
00002392836
ORL
CAP
RAN
CAP
1.2528
00002425548
RAN-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
RAN
CAP
0.8550
00002383136
RAN-SILDENAFIL 100 MG TABLET
ORL
TAB
RAN
TAB
9.2000
00002383101
ORL
TAB
RAN
TAB
8.2900
00002383128
ORL
TAB
RAN
TAB
8.8477
00002452103
RAN-TADALAFIL 10 MG TABLET
ORL
TAB
RAN
TAB
11.9255
00002452081
RAN-TADALAFIL 2.5 MG TABLET
ORL
TAB
RAN
TAB
3.6471
00002452111
ORL
TAB
RAN
TAB
12.3569
00002452073
ORL
TAB
RAN
TAB
3.6471
00002396084
RAN-TOPIRAMATE 100 MG TABLET
ORL
TAB
RAN
TAB
0.5928
00002396092
ORL
TAB
RAN
TAB
0.8853
Pg 174 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002396076
ORL
TAB
RAN
TAB
0.3128
00002388197
RAN-TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
RAN
TAB
0.6264
00002363062
RAN-VALSARTAN 40 MG TABLET
ORL
TAB
RAN
TAB
0.5239
00002361663
RAPAFLO 4 MG CAPSULE
ORL
CAP
ASC
CAP
1.8966
00002361671
RAPAFLO 8 MG CAPSULE
ORL
CAP
ASC
CAP
1.8968
00002247111
RAPAMUNE 1 MG TABLET
ORL
TAB
PFI
TAB
8.1435
00002243237
RAPAMUNE 1 MG/ML ORAL LIQUID
ORL
LIQ
PFI
ML
8.1435
00002302063
RASILEZ 150 MG TABLET
ORL
TAB
NOV
TAB
1.2954
00002302071
RASILEZ 300 MG TABLET
ORL
TAB
NOV
TAB
1.2954
00002332728
RASILEZ HCT 150 MG/12.5 MG TABLET
ORL
TAB
NOV
TAB
1.3007
00002332736
RASILEZ HCT 150 MG/25 MG TABLET
ORL
TAB
NOV
TAB
1.3007
00002332744
RASILEZ HCT 300 MG/12.5 MG TABLET
ORL
TAB
NOV
TAB
1.3007
00002332752
RASILEZ HCT 300 MG/25 MG TABLET
ORL
TAB
NOV
TAB
1.3007
00002244646
RATIO-ACLAVULANATE 125F 25 MG/6.25 MG ORAL SUSP
ORL
SUS
RPH
ML
0.0543
00002244647
RATIO-ACLAVULANATE 250F 50 MG/12.5 MG ORAL SUSP
ORL
SUS
RPH
ML
0.1830
00002259613
RATIO-AMLODIPINE 10 MG TABLET
ORL
TAB
RPH
TAB
0.3587
00002259605
RATIO-AMLODIPINE 5 MG TABLET
ORL
TAB
RPH
TAB
0.2417
00002275287
RATIO-AZITHROMYCIN 250 MG TABLET
ORL
TAB
RPH
TAB
1.2317
00002277700
RATIO-BICALUTAMIDE 50 MG TABLET
ORL
TAB
RPH
TAB
4.0573
00000404802
RATIO-BISACODYL 10 MG RECTAL SUPPOSITORY
RT
SUP
RPH
SUP
0.7199
Pg 175 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002243026
RATIO-BRIMONIDINE 0.2% OPHTHALMIC SOLUTION
OPH
SOL
RPH
ML
1.1560
00000550477
RATIO-CALMYDONE ORAL SYRUP
ORL
SYR
RPH
ML
0.0596
00002242657
RATIO-CEFUROXIME 500 MG TABLET
ORL
TAB
RPH
TAB
1.4337
00002252120
RATIO-CITALOPRAM 40 MG TABLET
ORL
TAB
RPH
TAB
0.2397
00002053403
RATIO-COTRIDIN EXPECTORANT ORAL SYRUP
ORL
SYR
RPH
ML
0.0610
00002169126
RATIO-COTRIDIN ORAL SYRUP
ORL
SYR
RPH
ML
0.0550
00002306905
RATIO-FINASTERIDE 5 MG TABLET
ORL
TAB
RPH
TAB
0.4633
00002241371
RATIO-FLUOXETINE HYDROCHLORIDE 10 MG CAPSULE
ORL
CAP
RPH
CAP
0.4595
00002241374
RATIO-FLUOXETINE HYDROCHLORIDE 20 MG CAPSULE
ORL
CAP
RPH
CAP
0.4598
00002296071
RATIO-FLUTICASONE 50 MCG/DOSE AQUEOUS NASAL SPRAY
NAS
SPM
RPH
DOSE
0.1831
00002218461
RATIO-FLUVOXAMINE 100 MG TABLET
ORL
TAB
RPH
TAB
0.3783
00002218453
RATIO-FLUVOXAMINE 50 MG TABLET
ORL
TAB
RPH
TAB
0.2105
00002275252
RATIO-FOSINOPRIL 10 MG TABLET
ORL
TAB
RPH
TAB
0.4977
00002275260
RATIO-FOSINOPRIL 20 MG TABLET
ORL
TAB
RPH
TAB
0.5985
00002260883
RATIO-GABAPENTIN 100 MG CAPSULE
ORL
CAP
RPH
CAP
0.0749
00002260905
RATIO-GABAPENTIN 400 MG CAPSULE
ORL
CAP
RPH
CAP
0.2171
00002273101
RATIO-GLIMEPIRIDE 1 MG TABLET
ORL
TAB
RPH
TAB
0.4900
00002273128
ORL
TAB
RPH
TAB
0.4900
00002273136
ORL
TAB
RPH
TAB
0.4900
00001934139
RATIO-INDOMETHACIN 100 MG RECTAL SUPPOSITORY
RT
SUP
RPH
SUP
0.8910
Pg 176 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000653233
RATIO-LENOLTEC NO.1 TABLET
ORL
TAB
RPH
TAB
0.0517
00002031159
RATIO-LEVOBUNOLOL 0.25% OPH SOLUTION
OPH
SOL
RPH
ML
3.9000
00002031167
RATIO-LEVOBUNOLOL 0.5% OPH SOLUTION
OPH
SOL
RPH
ML
1.1520
00002248031
RATIO-MELOXICAM 15 MG TABLET
ORL
TAB
RPH
TAB
0.5670
00002247889
RATIO-MELOXICAM 7.5 MG TABLET
ORL
TAB
RPH
TAB
0.4914
00002320908
RATIO-MEMANTINE 10 MG TABLET
ORL
TAB
RPH
TAB
1.6357
00002244798
RATIO-METHOTREXATE SODIUM 2.5 MG TABLET
ORL
TAB
RPH
TAB
0.6325
00002194163
RATIO-NYSTATIN 100,000 UNIT/G VAGINAL CREAM
VAG
CRM
RPH
G
0.3191
00002278529
RATIO-ONDANSETRON 4 MG TABLET
ORL
TAB
RPH
TAB
3.3500
00002278537
RATIO-ONDANSETRON 8 MG TABLET
ORL
TAB
RPH
TAB
5.1877
00002308681
RATIO-PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
RPH
TAB
1.2750
00002247810
RATIO-PAROXETINE 10 MG TABLET
ORL
TAB
RPH
TAB
1.0430
00002301423
RATIO-PIOGLITAZONE 15 MG TABLET
ORL
TAB
RPH
TAB
0.5809
00002301431
ORL
TAB
RPH
TAB
0.8139
00002301458
ORL
TAB
RPH
TAB
1.2237
00002311194
RATIO-RAMIPRIL 15 MG CAPSULE
ORL
CAP/TAB
RPH
CAP
0.8133
00002311291
RATIO-RIVASTIGMINE 3 MG CAPSULE
ORL
CAP
RPH
CAP
0.6514
00002311305
RATIO-RIVASTIGMINE 4.5 MG CAPSULE
ORL
CAP
RPH
CAP
0.6514
00001986864
RATIO-SALBUTAMOL SULFATE U.D. P.F. 1 MG/ML INH SOL
INH
SOL
RPH
ML
0.1446
00002239366
RATIO-SALBUTAMOL SULFATE U.D. P.F. 2MG/ML INH SOL
INH
UDSOL
RPH
ML
0.2748
Pg 177 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002319500
RATIO-SILDENAFIL R 20 MG TABLET
ORL
TAB
RPH
TAB
7.2940
00000550507
RATIO-TRIACOMB REGULAR TOPICAL CREAM
TOP
CRM
RPH
G
0.4027
00000989994
RCF SOY FREE FORMULA
ORL
LIQ
ABN
ML
0.0211
00002223554
REACTINE 10 MG TABLET
ORL
TAB
MCL
TAB
0.7040
00001900978
ORL
TAB
MCL
TAB
0.8595
00002223546
ORL
TAB
MCL
TAB
0.4981
00002246162
REACTINE ALLERGY & SINUS EXTENDED-RELEASE TABLET
ORL
ERT
MCL
TAB
0.7040
00002368064
REACTINE ALLERGY LIQUID GELS 10 MG CAPSULE
ORL
CAP
MCL
CAP
0.7172
00002358352
REACTINE FAST MELT 10 MG ODT
ORL
ODT
MCL
TAB
0.6367
00002243676
RECOMBIVAX HB (PRESERVATIVE FREE) 5MCG/0.5ML INJ
INJ
DEFAUL
MFC
ML
22.8000
00000897221
REDOXON (LEMON) 1,000 MG EFFERVESCENT TABLET
ORL
EVT
HLR
TAB
0.2640
00000897256
REDOXON (ORANGE) 1,000 MG EFFERVESCENT TABLET
ORL
EVT
HLR
TAB
0.2367
00002138670
REFRESH 1.4% OPH SOLUTION
OPH
SOL
ALL
ML
0.8533
00002244650
REFRESH LIQUIGEL 1% OPH SOLUTION
OPH
SOL
ALL
ML
0.5140
00002399148
REFRESH OPTIVE ADVANCED
NAS
SOL
ALL
ML
0.8950
00002435578
REFRESH OPTIVE FUSION OPH SOLUTION
OPH
SOL
ALL
ML
0.9500
00002049260
REFRESH PLUS 0.5% OPH SOLUTION
OPH
SOL
ALL
ML
0.7592
00002231008
REFRESH TEARS 0.5% OPH SOLUTION
OPH
SOL
ALL
ML
0.4167
00002239405
REGRANEX TOPICAL GEL
TOP
GEL
JAI
G
35.3333
00002242592
REGULAR VITA-VIM CAPLET
ORL
TAB
JAM
TAB
0.1012
Pg 178 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002192640
REJUVA-A 0.025% TOPICAL CREAM
TOP
CRM
GSK
G
1.8410
00002240863
RELENZA 5 MG/DOSE INHALATION DISK
INH
DSK
GSK
DISC
7.3080
00002308215
RELISTOR 20 MG/ML INJECTION
INJ
DEFAUL
SLX
ML
63.3333
00002256290
RELPAX 20 MG TABLET
ORL
TAB
PFI
TAB
14.2967
00002256304
RELPAX 40 MG TABLET
ORL
TAB
PFI
TAB
14.2967
00002248542
REMERON RD 15 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
MFC
TAB
0.4370
00002248543
ORL
DISNTAB
MFC
TAB
0.8737
00002248544
ORL
DISNTAB
MFC
TAB
1.3110
00002246552
REMODULIN 1 MG/ML INJECTION
INJ
DEFAUL
NTH
ML
45.0000
00002246555
INJ
DEFAUL
NTH
ML
450.0000
00002246553
REMODULIN 2.5 MG/ML INJECTION
INJ
DEFAUL
NTH
ML
112.5000
00002246554
INJ
DEFAUL
NTH
ML
225.0000
00002244310
RENAGEL 800 MG TABLET
ORL
TAB
SAV
TAB
1.6426
00002354586
RENVELA 800 MG TABLET
ORL
TAB
SAV
TAB
1.5503
00002415968
REPAGLINIDE 0.5 MG TABLET
ORL
TAB
PDL
TAB
0.0996
00002415976
REPAGLINIDE 1 MG TABLET
ORL
TAB
PDL
TAB
0.1036
00002415984
REPAGLINIDE 2 MG TABLET
ORL
TAB
PDL
TAB
0.1075
00002446057
REPATHA 140 MG/ML INJECTION SYRINGE/AUTOINJECTOR
INJ
NDL
AMG
SYR
279.3600
00002249057
REPLAGAL 1 MG/ML INJECTION
INJ
DEFAUL
PAL
ML
657.1429
00002247790
REPRONEX 75 UNIT/VIAL INJECTION
INJ
DEFAUL
FEI
VIAL
74.0000
Pg 179 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002377012
RESOTRAN 1 MG FILM-COATED TABLET
ORL
TAB
JAI
TAB
2.2700
00002377020
RESOTRAN 2 MG FILM-COATED TABLET
ORL
TAB
JAI
TAB
3.4850
00002355655
RESTASIS 0.05% OPH EMULSION
OPH
EML
ALL
ML
8.4833
00002318164
RESTORALAX ORAL POWDER
ORL
PWR
SPL
G
0.0603
00000443816
RETIN-A 0.025% TOPICAL GEL
TOP
GEL
VCL
G
0.4070
00000443794
RETIN-A 0.05% TOPICAL CREAM
TOP
CRM
VCL
G
0.4070
00002264633
RETIN-A MICRO 0.04% TOPICAL GEL
TOP
GEL
VCL
G
1.1305
00002243914
RETIN-A MICRO 0.1% GEL
TOP
GEL
VCL
G
1.1305
00002306980
RETISERT 0.59 MG INTRAVITREAL IMPLANT
OPH
IMP
BSH
SYS
00002008726
RETISOL-A 0.01% TOPICAL CREAM
TOP
CRM
GSK
G
0.7353
00002008696
TOP
CRM
GSK
G
0.7116
00002008718
TOP
CRM
GSK
G
0.7116
00002008688
RETISOL-A O.1% TOPICAL CREAM
TOP
CRM
GSK
G
0.7116
00001902660
RETROVIR 100 MG CAPSULE
ORL
CAP
GSK
CAP
1.9464
00001902652
RETROVIR 50 MG/5ML ORAL SYRUP
ORL
SYR
GSK
ML
0.1975
00002279401
REVATIO 20 MG TABLET
ORL
TAB
PFI
TAB
11.4557
00002445727
REVESTIVE 5 MG/VIAL INJECTION
INJ
DEFAUL
NPS
VIAL
904.0000
00002213826
REVIA 50 MG TABLET
ORL
TAB
BAR
TAB
7.3028
00002035871
REVITONUS C-1000 ORAL LIQUID
ORL
LIQ
SDZ
AMP
0.7875
00002304902
REVLIMID 10 MG CAPSULE
ORL
CAP
CLG
CAP
361.0000
16,000.0000
Pg 180 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002317699
ORL
CAP
CLG
CAP
382.0000
00002440601
ORL
CAP
CLG
CAP
403.0000
00002317710
ORL
CAP
CLG
CAP
424.0000
00002304899
ORL
CAP
CLG
CAP
340.0000
00002361825
REVOLADE 25 MG TABLET
ORL
TAB
NOV
TAB
64.3121
00002361833
REVOLADE 50 MG TABLET
ORL
TAB
NOV
TAB
128.6250
00002248610
REYATAZ 150 MG CAPSULE
ORL
CAP
BMS
CAP
11.0587
00002248611
ORL
CAP
BMS
CAP
11.0587
00002294176
ORL
CAP
BMS
CAP
22.1173
00002220806
RHINARIS LUBRICATING NASAL GEL
NAS
GEL
PMS
G
0.2689
00000732230
RHINARIS NASAL AEROSOL
NAS
AER
PMS
DOSE
0.1933
00080058002
RHINARIS NOZOIL NASAL SPRAY
NAS
SPR
PPH
ML
1.7990
00001950541
RHINARIS-CS 2% NASAL SOLUTION
NAS
SOL
PPH
ML
0.7677
00002231923
RHINOCORT AQUA 64 MCG/DOSE METERED DOSE NAS. SPRAY
NAS
SPM
AZC
DOSE
0.0920
00080026370
RHODIOLA ROSEA CAPSULE
ORL
CAP
AOR
CAP
0.2546
00002260107
RHOXAL-ANAGRELIDE 0.5 MG CAPSULE
ORL
CAP
SDZ
CAP
3.3491
00002269589
RHOXAL-GLIMEPIRIDE 1 MG TABLET
ORL
TAB
SDZ
TAB
0.4900
00002269597
ORL
TAB
SDZ
TAB
0.4900
00002269619
ORL
TAB
SDZ
TAB
0.4900
00002243559
RHOXAL-ORPHENADRINE 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
SDZ
TAB
0.9856
Pg 181 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000309702
RIBOFLAVINE 100 MG TABLET
ORL
TAB
JAM
TAB
0.0647
00002091887
RIFADIN 150 MG CAPSULE
ORL
CAP
SAV
CAP
0.8395
00002092808
RIFADIN 300 MG CAPSULE
ORL
CAP
SAV
CAP
1.3211
00002347474
RISEDRONATE 35 MG TABLET
ORL
TAB
PDL
TAB
2.4275
00002352141
RISEDRONATE 35 MG TABLET
ORL
TAB
SIV
TAB
2.4893
00002298465
RISPERDAL CONSTA 12.5 MG/VIAL INJECTION
INJ
DEFAUL
JAI
VIAL
80.9500
00002247217
RIVA-AMIODARONE 200 MG TABLET
ORL
TAB
RIV
TAB
0.5147
00002331500
RIVA-AMLODIPINE 10 MG TABLET
ORL
TAB
RIV
TAB
0.3587
00002331489
RIVA-AMLODIPINE 2.5 MG TABLET
ORL
TAB
RIV
TAB
0.1380
00002331497
RIVA-AMLODIPINE 5 MG TABLET
ORL
TAB
RIV
TAB
0.2417
00002242093
RIVA-ATENOLOL 100 MG TABLET
ORL
TAB
RIV
TAB
0.2362
00002242094
RIVA-ATENOLOL 50 MG TABLET
ORL
TAB
RIV
TAB
0.1437
00002422751
RIVA-ATORVASTATIN 10 MG TABLET
ORL
TAB
RIV
TAB
0.3138
00002422778
ORL
TAB
RIV
TAB
0.3922
00002422786
ORL
TAB
RIV
TAB
0.4216
00002422794
ORL
TAB
RIV
TAB
0.4216
00002242077
RIVA-CLONAZEPAM 0.5 MG TABLET
ORL
TAB
RIV
TAB
0.0554
00002388529
RIVA-CLOPIDOGREL 75 MG TABLET
ORL
TAB
RIV
TAB
0.4735
00002242468
RIVACOCET 5 MG/325 MG TABLET
ORL
TAB
RIV
TAB
0.1285
00002424436
RIVA-EZETIMIBE 10 MG TABLET
ORL
TAB
RIV
TAB
0.4549
Pg 182 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002247306
RIVA-FENOFIBRATE MICRO 200 MG CAPSULE
ORL
CAP
RIV
CAP
0.2723
00002251167
RIVA-GABAPENTIN 100 MG CAPSULE
ORL
CAP
RIV
CAP
0.1040
00002251175
ORL
CAP
RIV
CAP
0.2530
00002251183
ORL
CAP
RIV
CAP
0.3015
00002239081
RIVA-METFORMIN 500 MG TABLET
ORL
TAB
RIV
TAB
0.0586
00002242783
RIVA-METFORMIN 850 MG TABLET
ORL
TAB
RIV
TAB
0.0610
00002265265
RIVA-MIRTAZAPINE 30 MG TABLET
ORL
TAB
RIV
TAB
0.2338
00002240788
RIVA-NAPROXEN 500 MG TABLET
ORL
TAB
RIV
TAB
0.2110
00002228300
RIVANASE AQ 50 MCG/DOSE METER DOSE NASAL SPRAY
NAS
SPM
RIV
DOSE
0.0613
00002337150
RIVA-OLANZAPINE 10 MG TABLET
ORL
TAB
RIV
TAB
1.2757
00002337169
ORL
TAB
RIV
TAB
1.9136
00002337126
RIVA-OLANZAPINE 2.5 MG TABLET
ORL
TAB
RIV
TAB
0.3189
00002337134
ORL
TAB
RIV
TAB
0.6379
00002337142
RIVA-OLANZAPINE 7.5 MG TABLET
ORL
TAB
RIV
TAB
0.9568
00002339838
RIVA-OLANZAPINE ODT 10 MG ORALLY DISINT. TABLET
ORL
DISNTAB
RIV
TAB
1.2757
00002339846
ORL
DISNTAB
RIV
TAB
1.9137
00002392399
ORL
DISNTAB
RIV
TAB
2.5447
00002339811
ORL
DISNTAB
RIV
TAB
0.6380
00002402416
RIVA-OMEPRAZOLE DR 20 MG DELAYED-RELEASE TABLET
ORL
CAP/SRT
RIV
TAB
0.4117
00002316463
RIVA-PANTOPRAZOLE 40 MG ENTERIC-COATED TABLET
ORL
ECT
RIV
TAB
0.5054
Pg 183 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002330083
RIVA-RABEPRAZOLE EC 10 MG ENTERIC-COATED TABLET
ORL
ECT
RIV
TAB
0.1203
00002330091
RIVA-RABEPRAZOLE EC 20 MG ENTERIC-COATED TABLET
ORL
ECT
RIV
TAB
0.2407
00002380056
RIVA-ROSUVASTATIN 10 MG TABLET
ORL
TAB
RIV
TAB
0.2437
00002380064
ORL
TAB
RIV
TAB
0.3046
00002380102
ORL
TAB
RIV
TAB
0.3582
00002202352
RIVASA CROQUABLE 80 MG TABLET
ORL
CTB
RIV
TAB
0.0560
00002240112
RIVASOL-HC RECTAL SUPPOSITORY
RT
SUP
RIV
SUP
0.5833
00001940112
RIVASONE SCALP 0.1% TOPICAL LOTION
TOP
LOT
RIV
ML
0.0853
00002242157
RIVA-SOTALOL 160 MG TABLET
ORL
TAB
RIV
TAB
0.1623
00002416999
RIVASTIGMINE 1.5 MG CAPSULE
ORL
CAP
PDL
CAP
0.6514
00002417006
RIVASTIGMINE 3 MG CAPSULE
ORL
CAP
PDL
CAP
0.6514
00002417014
RIVASTIGMINE 4.5 MG CAPSULE
ORL
CAP
PDL
CAP
0.6514
00002417022
RIVASTIGMINE 6 MG CAPSULE
ORL
CAP
PDL
CAP
0.6514
00002307790
RIVA-VENLAFAXINE XR 150 MG EXTENDED-RELEASE CAP
ORL
ERC
RIV
CAP
0.3469
00002307774
RIVA-VENLAFAXINE XR 37.5 MG EXTENDED-RELEASE CAP
ORL
ERC
RIV
CAP
0.1643
00002307782
RIVA-VENLAFAXINE XR 75 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
RIV
CAP
0.3285
00002248082
RIVA-VERAPAMIL SR 240 MG SUSTAINED-RELEASE TABLET
ORL
SRT
RIV
TAB
0.5075
00002278030
RIVA-ZOPICLONE 5 MG TABLET
ORL
TAB
RIV
TAB
0.1782
00002278049
RIVA-ZOPICLONE 7.5 MG TABLET
ORL
TAB
RIV
TAB
0.2250
00002415801
RIZATRIPTAN ODT 10 MG ORALLY DISINT. TABLET
ORL
DISNTAB
PDL
TAB
3.7050
Pg 184 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002415798
RIZATRIPTAN ODT 5 MG ORALLY DISINT. TABLET
ORL
DISNTAB
PDL
TAB
3.7050
00002247147
ROBAX PLATINUM TABLET
ORL
TAB
PDH
TAB
0.6361
00002026805
ROBAXACET CAPLET
ORL
TAB
PDH
TAB
0.4689
00002231176
ROBAXACET EXTRA STRENGTH CAPLET
ORL
TAB
PDH
TAB
0.5150
00001934767
ROBAXACET-8 TABLET
ORL
TAB
PDH
TAB
0.7081
00001930990
ROBAXIN 500 MG TABLET
ORL
TAB
PDH
TAB
0.4826
00001932187
ROBAXIN-750 750 MG TABLET
ORL
TAB
PDH
TAB
0.7966
00002026783
ROBAXISAL CAPLET
ORL
TAB
WCH
TAB
0.4022
00002230949
ROBAXISAL EXTRA STRENGTH CAPLET
ORL
TAB
PDH
TAB
0.5150
00001934791
ROBAXISAL-C 1/2 TABLET
ORL
TAB
PDH
TAB
1.1788
00001934783
ROBAXISAL-C 1/4 TABLET
ORL
TAB
PDH
TAB
0.9867
00001931032
ROBITUSSIN 20 MG ORAL SYRUP
ORL
SYR
PDH
ML
0.0508
00002142783
ROBITUSSIN 200 MG/5 ML EXTRA STRENGTH ORAL SYRUP
ORL
SYR
PDH
ML
0.0508
00001934740
ROBITUSSIN A-C ORAL SYRUP
ORL
SYR
PDH
ML
0.1019
00002068419
ROBITUSSIN COUGH AND COLD ORAL SYRUP
ORL
SYR
PDH
ML
0.0508
00002142775
ROBITUSSIN DM EXTRA STRENGTH ORAL SYRUP
ORL
SYR
PDH
ML
0.0508
00001931024
ROBITUSSIN DM ORAL SYRUP
ORL
SYR
PDH
ML
0.0508
00002318415
ROCURONIUM BROMIDE 10MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
1.0260
00000393444
ROFACT 150 MG CAPSULE
ORL
CAP
VCL
CAP
0.6765
00000343617
ROFACT 300 MG CAPSULE
ORL
CAP
VCL
CAP
1.0649
Pg 185 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000708925
ROGAINE 20 MG/ML TOPICAL SOLUTION
TOP
SOL
JJI
ML
0.6102
00002368684
ROGAINE FOAM 50 MG/G AEROSOL FOAM
TOP
FOA
JJI
G
0.4926
00002242979
ROGITINE 10 MG/ML INJECTION
INJ
DEFAUL
PAL
ML
46.9960
00002353067
ROPINIROLE 2 MG TABLET
ORL
TAB
SNS
TAB
0.3122
00002353075
ROPINIROLE 5 MG TABLET
ORL
TAB
SNS
TAB
0.8596
00002440342
ROSIVER 1% TOPICAL CREAM
TOP
CRM
GAL
G
2.7198
00002381184
ROSUVASTATIN 10 MG TABLET
ORL
TAB
PDL
TAB
0.3400
00002389045
ORL
TAB
SIV
TAB
0.3400
00002389053
ORL
TAB
SIV
TAB
0.4250
00002381192
ORL
TAB
PDL
TAB
0.4250
00002389061
ORL
TAB
SIV
TAB
0.4977
00002381206
ORL
TAB
PDL
TAB
0.4977
00002381176
ORL
TAB
PDL
TAB
0.3227
00002389037
ORL
TAB
SIV
TAB
0.3227
00002300591
ROTARIX 1 000 000 CCID50/DOSE (1.5ML) ORAL SUSP
ORL
SUS
GSK
DOSE
81.2600
00002284413
ROTATEQ (2 ML/DOSE) ORAL SOLUTION
ORL
SOL
MFC
ML
29.0250
00000466425
ROUGIER CALCIUM ORAL LIQUID
ORL
LIQ
ROG
ML
0.0210
00002248563
RUB A535 DUAL ACTION
TOP
CRM
CHD
G
0.0570
00002222116
RUB A-535 EXTRA STRENGTH
TOP
CRM
CHD
G
0.0570
00080015240
RUGBY NICOTINE POLACRILEX; NIC-ASSIST 2 MG GUM
ORL
GUM
APH
PIECE
0.1650
Pg 186 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
INJ
DEFAUL
SDZ
ML
13.7450
00002453258
S.O.S. NALOXONE HYDROCHLORIDE INJ 0.4 MG/ML INJ
00002245735
SAB-SODIUM CHLORIDE 5% OPTHALMIC SOLUTION USP
OPH
SOL
SDZ
ML
0.5633
00002064480
SALAZOPYRIN 500 MG TABLET
ORL
TAB
PFI
TAB
0.3157
00002064472
SALAZOPYRIN EN-TABS 500 MG ENTERIC-COATED TABLET
ORL
ECT
PFI
TAB
0.4846
00000623571
SALIJECT 570 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
1.8000
00080024381
SALINEX 9 MG/ML NASAL SPRAY
NAS
SPR
SDZ
ML
0.1307
00000779296
SALINEX NASAL LUBRICANT GEL
NAS
GEL
SDZ
G
0.1407
00001910701
SALINEX NASAL LUBRICANT SPRAY
NAS
SPR
SDZ
ML
0.1697
00080004542
SALMON & FISH OILS 1000 MG SOFTGEL
ORL
TAB
WNP
TAB
0.0568
00080003356
SALMON AND FISH OILS ORAL CAPSULE
ORL
CAP
JAM
CAP
0.0923
00002370468
SAMSCA 15 MG TABLET
ORL
TAB
OTS
TAB
90.4110
00002370476
SAMSCA 30 MG TABLET
ORL
TAB
OTS
TAB
90.4110
00000593257
SANDIMMUNE I.V. 50 MG/ML INJECTION
INJ
DEFAUL
NOV
ML
4.5490
00002288079
SANDOZ ALENDRONATE 5 MG TABLET
ORL
TAB
SDZ
TAB
1.0370
00002338467
SANDOZ ANASTROZOLE 1 MG TABLET
ORL
TAB
SDZ
TAB
2.5457
00002386410
SANDOZ ATOMOXETINE 10 MG CAPSULE
ORL
CAP
SDZ
CAP
2.3140
00002386429
ORL
CAP
SDZ
CAP
2.6523
00002386437
ORL
CAP
SDZ
CAP
2.9280
00002386445
ORL
CAP
SDZ
CAP
3.3373
00002386453
ORL
CAP
SDZ
CAP
3.7023
Pg 187 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002386461
ORL
CAP
SDZ
CAP
3.9963
00002276089
SANDOZ BICALUTAMIDE 50 MG TABLET
ORL
TAB
SDZ
TAB
4.0573
00002386283
SANDOZ BOSENTAN 125 MG TABLET
ORL
TAB
SDZ
TAB
48.1340
00002386275
SANDOZ BOSENTAN 62.5 MG TABLET
ORL
TAB
SDZ
TAB
48.1340
00002392267
SANDOZ CANDESARTAN 32 MG TABLET
ORL
TAB
SDZ
TAB
0.3009
00002326957
SANDOZ CANDESARTAN 4 MG TABLET
ORL
TAB
SDZ
TAB
0.3400
00002421917
SANDOZ CAPECITABINE 150 MG TABLET
ORL
TAB
SDZ
TAB
1.4640
00002421925
SANDOZ CAPECITABINE 500 MG TABLET
ORL
TAB
SDZ
TAB
4.8800
00002261855
SANDOZ CARBAMAZEPINE 100 MG CHEWABLE TABLET
ORL
CTB
SDZ
TAB
0.0380
00002261863
SANDOZ CARBAMAZEPINE 200 MG CHEWABLE TABLET
ORL
CTB
SDZ
TAB
0.0749
00002387131
SANDOZ CIPROFLOXACIN 0.3% OPHTHALMIC SOLUTION
OPH
SOL
SDZ
ML
1.8600
00002233960
SANDOZ CLONAZEPAM 0.5 MG TABLET
ORL
TAB
SDZ
TAB
0.0495
00002233982
SANDOZ CLONAZEPAM 1 MG TABLET
ORL
TAB
SDZ
TAB
0.1487
00002233985
SANDOZ CLONAZEPAM 2 MG TABLET
ORL
TAB
SDZ
TAB
0.0854
00002230386
SANDOZ CORTIMYXIN OTIC SOLUTION
OT
SOL
SDZ
ML
1.1400
00002400596
SANDOZ DICLOFENAC MISOPROSTOL 50 MG/200 MCG ECT
ORL
ECT
SDZ
TAB
0.4541
00002400618
SANDOZ DICLOFENAC MISOPROSTOL 75 MG/200 MCG ECT
ORL
ECT
SDZ
TAB
0.6179
00002261774
SANDOZ DICLOFENAC RAPIDE 50 MG TABLET
ORL
TAB
SDZ
TAB
0.3937
00002367696
SANDOZ DONEPEZIL ODT 10 MG ORALLY DISINT. TABLET
ORL
DISNTAB
SDZ
TAB
3.6177
00002367688
SANDOZ DONEPEZIL ODT 5 MG ORALLY DISINT. TABLET
ORL
DISNTAB
SDZ
TAB
3.6177
Pg 188 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002278634
SANDOZ FAMCICLOVIR 125 MG TABLET
ORL
TAB
SDZ
TAB
2.0240
00002278642
ORL
TAB
SDZ
TAB
2.7200
00002278650
ORL
TAB
SDZ
TAB
4.2281
00002390701
SANDOZ FENOFIBRATE E 145 MG TABLET
ORL
TAB
SDZ
TAB
0.9113
00002390698
SANDOZ FENOFIBRATE E 48 MG TABLET
ORL
TAB
SDZ
TAB
0.3560
00002327139
SANDOZ FENTANYL PATCH 37 MCG/HR TRANSDERMAL PATCH
TRD
PTH
SDZ
PTH
8.5000
00002339471
SANDOZ FINASTERIDE A 1 MG TABLET
ORL
TAB
SDZ
TAB
1.1455
00002243487
SANDOZ FLUOXETINE 20 MG CAPSULE
ORL
CAP
SDZ
CAP
0.4598
00002400243
SANDOZ FLUVASTATIN 40 MG CAPSULE
ORL
CAP
SDZ
CAP
0.3092
00002248009
SANDOZ GLYBURIDE 5 MG TABLET
ORL
TAB
SDZ
TAB
0.0573
00002344815
SANDOZ LETROZOLE 2.5 MG TABLET
ORL
TAB
SDZ
TAB
2.7560
00002241716
SANDOZ LEVOBUNOLOL 0.5% OPH SOLUTION
OPH
SOL
SDZ
ML
1.1520
00002247056
SANDOZ LOVASTATIN 20 MG TABLET
ORL
TAB
SDZ
TAB
0.4919
00002344807
SANDOZ MEMANTINE 10 MG TABLET
ORL
TAB
SDZ
TAB
1.6357
00002375532
SANDOZ MEMANTINE FCT 10 MG TABLET
ORL
TAB
SDZ
TAB
1.6357
00002237314
SANDOZ MINOCYCLINE 100 MG CAPSULE
ORL
CAP
SDZ
CAP
0.5912
00002237313
SANDOZ MINOCYCLINE 50 MG CAPSULE
ORL
CAP
SDZ
CAP
0.3064
00002250594
SANDOZ MIRTAZAPINE 15 MG TABLET
ORL
TAB
SDZ
TAB
0.3750
00002449811
SANDOZ MOMETASONE 50 MCG/DOSE AQUEOUS NASAL SPRAY
NAS
SPM
SDZ
DOSE
0.1549
00002411520
SANDOZ MOXIFLOXACIN 0.5% OPHTHALMIC SOLUTION
OPH
SOL
SDZ
ML
3.7567
Pg 189 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002320630
SANDOZ MYCOPHENOLATE MOFETIL 250 MG CAPSULE
ORL
CAP
SDZ
CAP
1.0310
00002313855
SANDOZ MYCOPHENOLATE MOFETIL 500 MG TABLET
ORL
TAB
SDZ
TAB
2.0620
00002247189
SANDOZ OFLOXACIN 0.3% OPHTHALMIC SOLUTION
OPH
SOL
SDZ
ML
1.4680
00002327791
SANDOZ OLANZAPINE ODT 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
SDZ
TAB
5.3553
00002327805
SANDOZ OLANZAPINE ODT 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
SDZ
TAB
7.5977
00002358913
SANDOZ OLOPATADINE 0.1% OPH SOLUTION
OPH
SOL
SDZ
ML
5.2260
00002420171
SANDOZ OLOPATADINE 0.2% OPHTHALMIC SOLUTION
OPH
SOL
SDZ
ML
10.4520
00002301075
SANDOZ PANTOPRAZOLE 20 MG ENTERIC-COATED TABLET
ORL
ECT
SDZ
TAB
1.2750
00002269422
SANDOZ PAROXETINE 10 MG TABLET
ORL
TAB
SDZ
TAB
1.0430
00002431777
ORL
TAB
SDZ
TAB
1.0430
00002269449
ORL
TAB
SDZ
TAB
0.4796
00002261790
SANDOZ PINDOLOL 10 MG TABLET
ORL
TAB
SDZ
TAB
0.2323
00002261804
SANDOZ PINDOLOL 15 MG TABLET
ORL
TAB
SDZ
TAB
0.3370
00002239234
SANDOZ POLYTRIMETHOPRIM OPH SOLUTION
OPH
SOL
SDZ
ML
2.9040
00002315270
SANDOZ PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
SDZ
TAB
1.3860
00002247856
SANDOZ PRAVASTATIN 10 MG TABLET
ORL
TAB
SDZ
TAB
0.4050
00002247857
SANDOZ PRAVASTATIN 20 MG TABLET
ORL
TAB
SDZ
TAB
0.4777
00002390841
SANDOZ PREGABALIN 150 MG CAPSULE
ORL
CAP
SDZ
CAP
1.7270
00002390817
ORL
CAP
SDZ
CAP
0.6172
00002390868
ORL
CAP
SDZ
CAP
1.7270
Pg 190 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002390825
ORL
CAP
SDZ
CAP
0.9682
00002390833
ORL
CAP
SDZ
CAP
1.2528
00002154412
SANDOZ SALBUTAMOL 5 MG/ML INHALATION SOLUTION
INH
SOL
SDZ
ML
0.3510
00002089645
SANDOZ SENNOSIDES 12 MG TABLET
ORL
TAB
SDZ
TAB
0.0604
00002318822
SANDOZ SILDENAFIL 100 MG TABLET
ORL
TAB
SDZ
TAB
9.2006
00002318806
ORL
TAB
SDZ
TAB
8.2894
00002318814
ORL
TAB
SDZ
TAB
8.8481
00002257831
SANDOZ SOTALOL 80 MG TABLET
ORL
TAB
SDZ
TAB
0.2966
00002416816
SANDOZ TACROLIMUS 0.5 MG CAPSULE
ORL
CAP
SDZ
CAP
1.4775
00002416824
SANDOZ TACROLIMUS 1 MG CAPSULE
ORL
CAP
SDZ
CAP
1.8900
00002416832
SANDOZ TACROLIMUS 5 MG CAPSULE
ORL
CAP
SDZ
CAP
9.4650
00002295121
SANDOZ TAMSULOSIN 0.4 MG SUSTAINED-RELEASE CAPSULE
ORL
SRC
SDZ
CAP
0.1500
00002262177
SANDOZ TERBINAFINE 250 MG TABLET
ORL
TAB
SDZ
TAB
1.8525
00002260069
SANDOZ TOPIRAMATE 100 MG TABLET
ORL
TAB
SDZ
TAB
0.6235
00002267837
ORL
TAB
SDZ
TAB
0.8853
00002260050
ORL
TAB
SDZ
TAB
0.3128
00002413817
SANDOZ TRAVOPROST/TIMOLOL PQ 0.004%/0.5% OPH SOL
OPH
SOL
SDZ
ML
11.2880
00002356740
SANDOZ VALSARTAN 40 MG TABLET
ORL
TAB
SDZ
TAB
0.5240
00000578541
SARNA HC 1% TOPICAL LOTION
TOP
LOT
GSK
ML
0.0938
00000856711
SARNA HC 2.5% TOPICAL LOTION
TOP
LOT
GSK
ML
0.1813
Pg 191 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
BUC
SPR
BHP
ML
20.9900
00002266121
SATIVEX BUCCAL SPRAY
00002437899
SAXENDA 6 MG/ML PEN INJECTION SYRINGE
INJ
DEFAUL
NNA
ML
23.2860
00080041540
SCHINOUSSA PROBIOTIC WHEY ISOLATE ORAL POWDER
ORL
PWR
QUA
G
0.0357
00001919245
SCHOLL ATHLETE'S FOOT SPRAY 1% TOPICAL POWDER
TOP
PWR
SCH
G
0.0462
00002020939
SCLERODEX INJECTION
INJ
DEFAUL
OMG
ML
1.6500
00002020793
SCLERODINE 6 INJECTION
INJ
DEFAUL
OMG
ML
3.1800
00000541869
SCOPOLAMINE HYDROBROMIDE 0.4 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
5.0400
00000541877
INJ
DEFAUL
HSP
ML
5.5200
00002242811
INJ
DEFAUL
OMG
ML
5.4500
00002296659
SEASONALE (91 DAY) TABLET
ORL
TAB
ASC
TAB
0.6426
00002346176
SEASONIQUE (91 DAY) TABLET
ORL
TAB
ASC
TAB
0.6426
00000666106
SEBCUR 4% TOPICAL SHAMPOO
TOP
SHP
DPT
ML
0.0575
00000666114
SEBCUR-T TOPICAL SHAMPOO
TOP
SHP
DPT
ML
0.0667
00002288389
SEBIVO 600 MG TABLET
ORL
TAB
NOV
TAB
18.2629
00000551805
SECARIS NASAL GEL
NAS
GEL
PMS
G
0.3240
00002197502
SELECT 1/35 (21 DAY) TABLET
ORL
TAB
PFI
TAB
0.4676
00002199297
SELECT 1/35 (28 DAY) TABLET
ORL
TB
PFI
TAB
0.3507
00000633380
SELENIUM 100 MCG TABLET
ORL
TAB
JAM
TAB
0.0721
00000554987
SELENIUM 50 MCG TABLET
ORL
TAB
JAM
TAB
0.0641
00000243000
SELSUN 2.5% TOPICAL SOLUTION
TOP
SOL
ABB
ML
0.0448
Pg 192 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000483796
SELSUN BLUE 1% TOPICAL LOTION
TOP
LOT
ABB
ML
0.0236
00000709069
SELSUN BLUE EXTRA CONDITIONING 1% TOPICAL SHAMPOO
TOP
SHP
ABB
ML
0.0236
00002247134
SENNA LAXATIVE & DOCUSATE SODIUM 8.6MG/50MG TABLET
ORL
TAB
VTH
TAB
0.1152
00002237105
SENNA LAXATIVE 8.6 MG TABLET
ORL
TAB
SDR
TAB
0.0249
00002257130
SENSIPAR 30 MG TABLET
ORL
TAB
AMG
TAB
12.0053
00002257149
ORL
TAB
AMG
TAB
21.8913
00002257157
ORL
TAB
AMG
TAB
31.8557
00002357704
SEPTA-AMLODIPINE 2.5 MG TABLET
ORL
TAB
SEP
TAB
0.1380
00002368633
SEPTA-ATENOLOL 25 MG TABLET
ORL
TAB
SEP
TAB
0.0676
00002247998
SERC 24 MG TABLET
ORL
TAB
BGP
TAB
0.7000
00002239046
SEROSTIM 5 MG/VIAL INJECTION
INJ
DEFAUL
SRO
VIAL
1,633.0000
00002241304
SERTRALINE 100 MG CAPSULE
ORL
CAP
PDL
CAP
0.4200
00002241302
ORL
CAP
PDL
CAP
0.2004
00002241303
ORL
CAP
PDL
CAP
0.4000
00002240344
SIALOR 25 MG TABLET
ORL
TAB
PMS
TAB
0.9082
00080039305
SIERRASIL JOINT FORMULA 14 CAPSULE
ORL
CAP
SMM
CAP
0.2127
00002413299
SIGNIFOR 0.3 MG/ML INJECTION
INJ
DEFAUL
NOV
ML
78.8183
00002413302
SIGNIFOR 0.6 MG /ML INJECTION
INJ
DEFAUL
NOV
ML
87.9018
00002413310
SIGNIFOR 0.9 MG /ML INJECTION
INJ
DEFAUL
NOV
ML
87.9018
00002437252
SIGNIFOR LAR 20 MG/VIAL INJECTION
INJ
DEFAUL
NOV
VIAL
4,840.0000
Pg 193 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002437260
INJ
DEFAUL
NOV
VIAL
4,840.0000
00002437279
INJ
DEFAUL
NOV
VIAL
4,840.0000
00002424320
SILDENAFIL 100 MG TABLET
ORL
TAB
PDL
TAB
9.2000
00002406160
ORL
TAB
SNS
TAB
9.2000
00002317583
ORL
TAB
PMS
TAB
9.2007
00002317559
ORL
TAB
PMS
TAB
8.2900
00002317575
ORL
TAB
PMS
TAB
8.8480
00002424312
ORL
TAB
PDL
TAB
8.8475
00002406152
ORL
TAB
SNS
TAB
8.8475
00002398257
SILENOR 3 MG TABLET
ORL
TAB
PAL
TAB
0.6000
00002398265
SILENOR 6 MG TABLET
ORL
TAB
PAL
TAB
1.2010
00080012979
SILICA WITH ZINC CAPLET
ORL
TAB
JAM
TAB
0.1937
00002338572
SILKIS 3 MCG/G TOPICAL OINTMENT
TOP
ONT
GAL
G
1.2500
00000999793
SIMILAC ADVANCE OMEGA 3 & 6 READY-TO-FEED BOTTLE
ORL
LIQ
ABN
ML
0.0099
00000999794
SIMILAC ADVANCE OMEGA 3 & 6 READY-TO-FEED CAN
ORL
LIQ
ABN
ML
0.0117
00000999792
SIMILAC ADVANCE OMEGA-3 & 6 CONCENTRATED LIQUID
ORL
LIQ
ABN
ML
0.0104
00000999791
SIMILAC ADVANCE OMEGA-3 & 6 INFANT FORMULA PWR
ORL
PWR
ABN
G
0.0415
00000999788
SIMILAC ALIMENTUM OMEGA-3 & 6 INFANT FORMULA PWR
ORL
PWR
ABN
G
0.0381
00000999789
SIMILAC ISOMIL OMEGA-3 & 6 INFANT FORMULA POWDER
ORL
PWR
ABN
G
0.0306
00000999790
SIMILAC ISOMIL STEP 2 INFANT FORMULA POWDER
ORL
PWR
ABN
G
0.0306
Pg 194 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000999797
SIMILAC PARTIALLY BROKEN DOWN PROTEIN POWDER
ORL
PWR
ABN
G
0.0057
00000999796
SIMILAC SENSITIVE INFANT FORMULA CONCENTRATED LIQ
ORL
LIQ
ABN
ML
0.0104
00000999795
SIMILAC SENSITIVE INFANT FORMULA POWDER
ORL
PWR
ABN
G
0.0375
00002239548
SIMPLY SLEEP 25 MG CAPLET
ORL
TAB
MCL
TAB
0.2015
00002413183
SIMPONI 100 MG/1 ML INJECTION AUTO INJECTOR
INJ
NDL
JAI
SYR
1,516.0000
00002413175
SIMPONI 100 MG/1 ML INJECTION SYRINGE
INJ
NDL
JAI
SYR
1,516.0000
00002417472
SIMPONI I.V. 50 MG/4.0 ML VIAL INJECTION
INJ
DEFAUL
JAI
ML
212.2750
00002247224
SIMVASTATIN-80 80 MG TABLET
ORL
TAB
PDL
TAB
0.4501
00002378892
SIMVASTATIN-ODAN 10 MG TABLET
ORL
TAB
ODN
TAB
0.3642
00002378906
ORL
TAB
ODN
TAB
0.4501
00002378914
ORL
TAB
ODN
TAB
0.4501
00002378884
ORL
TAB
ODN
TAB
0.1841
00002378922
ORL
TAB
ODN
TAB
0.4501
00001926055
SINUTAB N.D. REGULAR STRENGTH TABLET
ORL
TAB
MCL
TAB
0.1808
00001938371
SINUTAB NO DROWSINESS EXTRA STRENGTH TABLET
ORL
TAB
MCL
TAB
0.2629
00001926004
SINUTAB REGULAR STRENGTH TABLET
ORL
TAB
MCL
TAB
0.1988
00001938363
SINUTAB WITH CODEINE TABLET
ORL
TAB
MCL
TAB
0.4063
00001994247
SLEEP AID (REGULAR STRENGTH) 25 MGTABLET
ORL
TAB
TAN
TAB
0.0950
00000074225
SLOW K 8 MEQ SUSTAINED-RELEASE TABLET
ORL
SRT
NOV
TAB
0.1475
00000481912
SODIUM BICARBONATE 325 MG TABLET
ORL
TAB
SLW
TAB
0.0304
Pg 195 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080022194
SODIUM BICARBONATE 500 MG TABLET
ORL
TAB
SDZ
TAB
0.0754
00000261998
SODIUM BICARBONATE 8.4 % INJECTION
INJ
DEFAUL
HSP
ML
0.5842
00000037842
SODIUM CHLORIDE 0.9% INJECTION
INJ
DEFAUL
HSP
ML
0.0994
00000060208
SODIUM CHLORIDE 0.9% INJECTION USP
INJ
DEFAUL
BAX
ML
0.0202
00000851388
SODIUM CHLORIDE 0.9% NASAL SPRAY
NAS
SPR
SFY
ML
0.0357
00000999807
SODIUM CHLORIDE 1 G CAPSULE
ORL
CAP
GLN
CAP
0.1525
00002139510
SODIUM CHLORIDE 234 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
0.3860
00000392499
INJ
DEFAUL
SDZ
ML
4.2790
00000402230
SODIUM CHLORIDE 234 MG/ML INJECTION USP
INJ
DEFAUL
OMG
ML
0.3667
00002150204
INJ
DEFAUL
OMG
ML
0.3350
00000037834
SODIUM CHLORIDE 9 MG/ML IRRIGATION SOLUTION
IR
SOL
HSP
ML
0.0280
00000402249
SODIUM CHLORIDE BACTERIOSTATIC 9 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
0.1650
00000268313
SODIUM EDECRIN 50 MG/VIAL INJECTION
INJ
DEFAUL
VCL
VIAL
00000896187
SODIUM PHOSPHATE INJECTION
INJ
DEFAUL
SDZ
ML
1.4299
00000028053
SODIUM SULAMYD 10% OPH SOLUTION
OPH
SOL
SDZ
ML
0.4933
00002006758
SOFLAX 4 MG/ML ORAL SYRUP
ORL
SYR
PMS
ML
0.0232
00002224887
SOFRAMYCIN 0.5% OPH SOLUTION
OPH
SOL
ERF
ML
1.3663
00002224879
SOFRAMYCIN 15 MG/50 MCG TOPICAL OINTMENT
TOP
ONT
ERF
G
1.0893
00002224860
SOFRAMYCIN NASAL SPRAY
NAS
SPR
ERF
ML
2.8667
00001988840
SOFRA-TULLE (10 X 10 CM) TOPICAL GAUZE
TOP
GAU
ERF
DRE
1.5500
494.6400
Pg 196 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002243257
SOLAGE 0.01%/ 2% TOPICAL SOLUTION
TOP
SOL
GAL
ML
1.6933
00001923986
SOLARCAINE FIRST AID LIDOCAINE 0.5% TOPICAL AEROSO
TOP
AER
SCH
G
0.0385
00001975382
SOLUGEL 4% TOPICAL GEL
TOP
GEL
GSK
G
0.2269
00002019825
SOLUGEL 8% TOPICAL GEL
TOP
GEL
GSK
G
0.3480
00002230211
SOLU-MEDROL 40 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
5.2672
00000690333
SOLUVER 20% TOPICAL SOLUTION
TOP
SOL
DPT
ML
0.7500
00000837733
SOLUVER PLUS LIQ 27%
TOP
SOL
DPT
ML
1.2000
00002272199
SOMAVERT 10 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
118.4000
00002272202
INJ
DEFAUL
PFI
VIAL
177.4200
00002272210
INJ
DEFAUL
PFI
VIAL
236.4400
00002448831
INJ
DEFAUL
PFI
VIAL
295.5500
00002448858
INJ
DEFAUL
PFI
VIAL
354.6600
00000483818
SOMNOL 30 MG TABLET
ORL
TAB
AXS
TAB
0.1145
00002237578
SPASMHALT-8 CAPLET
ORL
TAB
PPH
TAB
0.3433
00002237580
SPASMHALT-ASA-8 CAPLET
ORL
TAB
WAM
TAB
0.3300
00000999811
SPECIAL ACCESS DRUG - CELONTIN
ORL
CAP
XXX
CAP
2.3287
00000999031
SPECIAL ACCESS DRUG - DEFLAZACORT
ORL
TAB
XXX
TAB
0.3158
00000999810
SPECIAL ACCESS DRUG - MVW COMPLETE D1500 SOFTGEL
ORL
CAP
MVW
CAP
0.4705
00000999034
SPECIAL ACCESS DRUG - MVW COMPLETE D3000 CHEW TAB
ORL
CTB
MVW
TAB
0.5168
00000999033
SPECIAL ACCESS DRUG - MVW COMPLETE D3000 SOFTGEL
ORL
CAP
MVW
CAP
0.4705
Pg 197 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
ORL
DPS
MVW
ML
DEFAUL
DEFAUL
XXX
Base Price
00000999035
SPECIAL ACCESS DRUG - MVW COMPLETE FORMULATION DRP
00000999036
SPECIAL ACCESS DRUG - OSPOLOT
00000999037
SPECIAL ACCESS DRUG - STEROGYL 15 INJECTION
INJ
DEFAUL
XXX
ML
48.3533
00002214415
SPECTRO ECZEMACARE MEDICATED CREAM
TOP
CRM
GKC
G
0.4400
00002320193
SPRYCEL 100 MG TABLET
ORL
TAB
BMS
TAB
152.9553
00002293129
ORL
TAB
BMS
TAB
38.4053
00002293137
ORL
TAB
BMS
TAB
77.2943
00002293145
ORL
TAB
BMS
TAB
84.7605
00001938991
STANHEXIDINE 2% SOL WITH 4% ISOPROPYL ALCOHOL
TOP
SOL
OMG
ML
0.0097
00001938983
STANHEXIDINE 4% WITH 4% ISOPROPYL ALCOHOL SOLUTION
TOP
SOL
OMG
ML
0.0153
00002245439
STARLIX 120 MG TABLET
ORL
TAB
NOV
TAB
0.5582
00002245438
STARLIX 60 MG TABLET
ORL
TAB
NOV
TAB
0.5582
00002372436
STAXYN 10 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
BAI
TAB
6.7650
00002139383
STERILE VANCOMYCIN HCL 1 G/VIAL INJECTION
INJ
DEFAUL
FKC
VIAL
95.1660
00002230192
INJ
DEFAUL
HSP
VIAL
81.2600
00002139243
INJ
DEFAUL
FKC
VIAL
509.7900
00002139375
STERILE VANCOMYCIN HCL 500 MG/VIAL INJ USP
INJ
DEFAUL
FKC
VIAL
47.7040
00002230191
STERILE VANCOMYCIN HCL 500 MG/VIAL INJECTION
INJ
DEFAUL
HSP
VIAL
42.7700
00000038245
STERILE WATER FOR INJECTION
DEFAUL
INJ
HSP
ML
0.0950
00002142546
DEFAUL
INJ
HSP
ML
0.1910
0.8757
0.4221
Pg 198 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
DEFAUL
INJ
OMG
ML
0.3500
00000402257
00002247228
STIEPROX 1.5 % TOPICAL SHAMPOO
TOP
SHP
GSK
ML
0.1347
00001945262
STIEVAMYCIN FORTE TOPICAL GEL
TOP
GEL
GSK
G
0.8427
00002015994
STIEVAMYCIN MILD TOPICAL GEL
TOP
GEL
GSK
G
0.8427
00001905112
STIEVAMYCIN REGULAR TOPICAL GEL
TOP
GEL
GSK
G
0.8427
00002125277
STILAMIN 3 MG/AMPOULE INJECTION
INJ
DEFAUL
SRO
VIAL
210.0000
00002403390
STIVARGA 40 MG TABLET
ORL
TAB
BAI
TAB
72.6200
00002262800
STRATTERA 10 MG CAPSULE
ORL
CAP
LIL
CAP
2.8364
00002279355
ORL
CAP
LIL
CAP
5.3529
00002262819
ORL
CAP
LIL
CAP
3.1936
00002262827
ORL
CAP
LIL
CAP
3.5664
00002262835
ORL
CAP
LIL
CAP
4.0939
00002262843
ORL
CAP
LIL
CAP
4.4954
00002279347
ORL
CAP
LIL
CAP
4.8771
00002444615
STRENSIQ 18 MG/VIAL INJECTION
INJ
DEFAUL
APG
VIAL
1,836.0000
00002444623
INJ
DEFAUL
APG
VIAL
2,856.0000
00002444631
INJ
DEFAUL
APG
VIAL
4,080.0000
00002444658
INJ
DEFAUL
APG
VIAL
8,160.0000
00002243660
STREPTOMYCIN 1 G/VIAL INJECTION
INJ
DEFAUL
STM
VIAL
89.0000
00000613959
STRESS FORMULA VITAMIN WITH ZINC CAPSULE
ORL
CAP
WAM
CAP
0.0617
Pg 199 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002174383
STRESSEASE MULTIVITAMIN AND MINERAL CAPLET
ORL
TAB
JAM
TAB
0.1080
00002166615
STRESSTABS + ZINC-COPPER TABLET
ORL
TAB
WCH
TAB
0.1017
00080009625
STRESSTABS FOR WOMEN TABLET
ORL
TAB
PDH
TAB
0.1042
00002167948
STRESSTABS PLUS IRON TABLET
ORL
TAB
WCH
TAB
0.1017
00002397137
STRIBILD TABLET
ORL
TAB
GIL
TAB
46.3894
00002370433
SUBLINOX 10 MG SUBLINGUAL DISINTEGRATING TABLET
SLG
DISNTAB
MED
TAB
1.3537
00002391678
SUBLINOX 5 MG SUBLINGUAL DISINTEGRATING TAB
SLG
DISNTAB
MED
TAB
1.3537
00002130939
SUCRALFATE-1 1 G TABLET
ORL
TAB
PDL
TAB
0.3089
00002238099
SUDAFED DECONGESTANT 12-HOUR 120 MG CAPLET
ORL
TAB
MCL
TAB
0.4850
00002237793
SUDAFED DECONGESTANT EXTRA STRENGTH 60 MG TABLET
ORL
TAB
MCL
TAB
0.2908
00002250217
SUDAFED PE DECONGESTANT 10 MG TABLET
ORL
TAB
MCL
TAB
0.3000
00001951319
SUFENTA 50 MCG/ML INJECTION
INJ
DEFAUL
JAI
ML
6.4480
00002244147
SUFENTANIL CITRATE USP 50 MCG/ML INJECTION
INJ
DEFAUL
SDZ
ML
13.5500
00002220407
SULFACET-R TOPICAL LOTION
TOP
LOT
VCL
G
1.0300
00000187534
SULFUR TOPICAL SOAP
TOP
SOP
VCL
G
0.0733
00002324660
SUMATRIPTAN 100 MG TABLET
ORL
TAB
PDL
TAB
7.8600
00002324652
SUMATRIPTAN 50 MG TABLET
ORL
TAB
PDL
TAB
7.1350
00000678996
SUPER B COMPLEX CAPSULE
ORL
CAP
SIS
CAP
0.2581
00080002944
SUPER CALCIUM 600 MG WITH VITAMIN D 400 IU
ORL
TAB
JAM
TAB
0.1251
00080011269
SUPER MULTI IRON FREE TABLET
ORL
TAB
NFN
TAB
0.2143
Pg 200 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080023127
SUPER STRAIN ACIDOPHILUS PROBIOTIC 2 BILLION
ORL
CAP
JAM
CAP
0.1258
00002242658
SUPER STRENGTH MOTRIN IB 400 MG TABLET
ORL
TAB
MCL
TAB
0.1844
00080017929
SUPER VITA VIM CAPLET
ORL
TAB
JMS
TAB
0.1283
00002242595
SUPER VITA-VIM CAPLET
ORL
TAB
JAM
TAB
0.1334
00000999816
SUPLASYN
DEFAUL
DEV
MYP
ML
37.5000
00002240749
SUPREFACT DEPOT 9.45 MG IMPLANT INJECTION
INJ
IMP
SAV
SYS
1,177.4000
00002239888
SUSTIVA 200 MG CAPSULE
ORL
CAP
BMS
CAP
4.9823
00002239886
SUSTIVA 50 MG CAPSULE
ORL
CAP
BMS
CAP
1.2457
00002246045
SUSTIVA 600 MG TABLET
ORL
TAB
BMS
TAB
14.9470
00002280795
SUTENT 12.5 MG CAPSULE
ORL
CAP
PFI
CAP
63.7207
00002280809
SUTENT 25 MG CAPSULE
ORL
CAP
PFI
CAP
127.4411
00002280817
SUTENT 50 MG CAPSULE
ORL
CAP
PFI
CAP
254.8825
00000253952
SYNACTHEN DEPOT 1 MG/ML INJECTION
INJ
DEFAUL
QST
VIAL
680.0000
00002245890
SYNAGIS 100 MG/VIAL INJECTION
INJ
DEFAUL
ABV
VIAL
1,504.5100
00002245889
SYNAGIS 50 MG/VIAL INJECTION
INJ
DEFAUL
ABV
VIAL
752.2600
00002162504
SYNALAR 0.01% TOPICAL SOLUTION
TOP
SOL
VCL
ML
0.4128
00002162512
SYNALAR 0.025% TOPICAL OINTMENT
TOP
ONT
VCL
G
0.4433
00000990010
SYNVISC
DEFAUL
DEV
GZB
ML
67.9100
00000999331
SYNVISC ONE
DEFAUL
DEV
GZB
ML
69.0117
00002444062
SYSTANE OPHTHALMIC OINTMENT
OPH
ONT
ALC
G
1.5457
Pg 201 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002248967
SYSTANE OPHTHALMIC SOLUTION
OPH
SOL
ALC
ML
0.5267
00000999333
SYSTANE ULTRA
OPH
DPS
ALC
ML
0.9598
00080032792
SYSTANE VITAMIN- OMEGA 3 CAPSULE
ORL
CAP
ALC
CAP
0.2197
00002239122
T.R. SWISS ONE 50 MULTIVITAMIN & MINERAL TABLET
ORL
TAB
SWS
TAB
0.2048
00002365871
TACTUPUMP 0.1%/2.5% TOPICAL GEL
TOP
GEL
GAL
G
1.4129
00002446235
TACTUPUMP FORTE 0.3%/2.5% TOPICAL GEL
TOP
GEL
GAL
G
2.3428
00002455374
TADALAFIL 20 MG TABLET
ORL
TAB
PDL
TAB
12.3575
00002455358
TADALAFIL 5 MG TABLET
ORL
TAB
PDL
TAB
3.6470
00002409607
TAFINLAR 50 MG CAPSULE
ORL
CAP
NOV
CAP
43.4889
00002409615
TAFINLAR 75 MG CAPSULE
ORL
CAP
NOV
CAP
65.2333
00002456214
TAGRISSO 40 MG TABLET
ORL
TAB
AZC
TAB
294.6764
00002456222
TAGRISSO 80 MG TABLET
ORL
TAB
AZC
TAB
294.6764
00002304848
TAMIFLU 30 MG CAPSULE
ORL
CAP
HLR
CAP
2.0370
00002304856
ORL
CAP
HLR
CAP
3.1980
00002381842
TAMIFLU 6 MG/ML ORAL SUSPENSION
ORL
SUS
HLR
ML
0.3197
00002241472
ORL
CAP
HLR
CAP
4.1570
00001926624
TAMOFEN 10 MG TABLET
ORL
TAB
SAV
TAB
0.1750
00002413612
TAMSULOSIN CR 0.4 MG EXTENDED-RELEASE TABLET
ORL
ERT
PDL
TAB
0.1500
00001962353
TANTAPHEN EXTRA STRENGTH 500 MG CAPLET
ORL
TAB
TAN
TAB
0.0214
00002296039
TAPAZOLE 10 MG TABLET
ORL
TAB
PAL
TAB
0.5609
Pg 202 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002269015
TARCEVA 100 MG TABLET
ORL
TAB
HLR
TAB
54.8897
00002269023
ORL
TAB
HLR
TAB
82.3343
00002269007
ORL
TAB
HLR
TAB
13.3333
00000510335
TARGEL SA TOPICAL LIQUID
TOP
LIQ
ODN
G
0.1880
00000344508
TARGEL TOPICAL GEL
TOP
GEL
ODN
G
0.1680
00002339609
TARGIN 10 MG/ 5 MG EXTENDED-RELEASE TABLET
ORL
ERT
PUR
TAB
0.9940
00002339617
ORL
ERT
PUR
TAB
1.4910
00002339625
ORL
ERT
PUR
TAB
2.5830
00002387425
TARGIN 5 MG/ 2.5 MG EXTENDED-RELEASE TABLET
ORL
ERT
PUR
TAB
0.7130
00002240945
TARKA 1 MG/ 240 MG TABLET
ORL
TAB
ABB
TAB
1.5400
00002238096
ORL
TAB
ABB
TAB
1.5500
00002240946
ORL
TAB
BGP
TAB
1.7698
00002238097
ORL
TAB
BGP
TAB
1.9640
00002365650
TARO-ANASTROZOLE 1 MG TABLET
ORL
TAB
TAR
TAB
1.2730
00002244403
TARO-CARBAMAZEPINE 100 MG CHEWABLE TABLET
ORL
CTB
TAR
TAB
0.1188
00002244404
TARO-CARBAMAZEPINE 200 MG CHEWABLE TABLET
ORL
CTB
TAR
TAB
0.2354
00002353288
TARO-CICLOPIROX 8% TOPICAL SOLUTION
TOP
SOL
TAR
G
7.7433
00002266938
TARO-CLINDAMYCIN 1% (BASE) TOPICAL SOLUTION
TOP
SOL
TAR
ML
0.2613
00002420988
TARO-DICLOFENAC 1.5% TOPICAL SOLUTION
TOP
SOL
TAR
ML
0.6227
00002264749
TARO-MOMETASONE 0.1% OINTMENT
TOP
ONT
TAR
G
0.2720
Pg 203 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00001925350
TARO-SONE 0.05% TOPICAL CREAM
TOP
CRM
TAR
G
00002443511
TARO-TEMOZOLOMIDE 100 MG CAPSULE
ORL
CAP
TAR
CAP
113.5965
00002443538
ORL
CAP
TAR
CAP
159.0360
00002443481
ORL
CAP
TAR
CAP
22.7200
00002443554
ORL
CAP
TAR
CAP
283.9840
00002443473
ORL
CAP
TAR
CAP
6.6300
00002247651
TARO-TERCONAZOLE 0.4% VAGINAL CREAM
VAG
CRM
TAR
G
0.5296
00002450429
TARO-TRAMADOL ER 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
TAR
TAB
1.0374
00002450437
ORL
ERT
TAR
TAB
1.8915
00002450445
ORL
ERT
TAR
TAB
2.7485
00002368250
TASIGNA 150 MG CAPSULE
ORL
CAP
NOV
CAP
28.7703
00002315874
TASIGNA 200 MG CAPSULE
ORL
CAP
NOV
CAP
40.4741
00002177099
TAXOTERE 40 MG/ML (20 MG/0.5 ML) INJECTION
INJ
DEFAUL
SAV
ML
456.9400
00002177080
TAXOTERE 40 MG/ML (80 MG/2 ML) INJECTION
INJ
DEFAUL
SAV
ML
456.9400
00002170817
TAZOCIN 2 G/250 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
11.9220
00002170795
INJ
DEFAUL
PFI
VIAL
17.8830
00002170809
INJ
DEFAUL
PFI
VIAL
23.8450
00002243894
TAZORAC 0.05% TOPICAL CREAM
TOP
CRM
ALL
G
1.3600
00002243895
TAZORAC 0.1% TOPICAL CREAM
TOP
CRM
ALL
G
1.3600
00000615358
TD POLIO ADSORBED FOR ADULT INJECTION
INJ
DEFAUL
SFP
VIAL
60.2240
0.2048
Pg 204 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00001950010
TEARS ENCORE 1.4% OPH SOLUTION
OPH
SOL
AKN
ML
0.9710
00002246397
TEARS NATURAL FORTE OPH SOLUTION
OPH
SOL
ALC
ML
0.4087
00001943308
TEARS NATURALE FREE OPH SOLUTION
OPH
SOL
ALC
ML
0.4944
00000743445
TEARS NATURALE II OPH SOLUTION
OPH
SOL
ALC
ML
0.4220
00000390291
TEARS NATURALE OPH DROPS
OPH
DPS
ALC
ML
0.4220
00002082519
TEARS NATURALE P.M. OPH OINTMENT
OPH
ONT
ALC
G
1.5457
00000579408
TEARS PLUS 1.4% OPH SOLUTION
OPH
SOL
ALL
ML
0.4800
00000283991
TEBRAZID 500 MG TABLET
ORL
TAB
VCL
TAB
0.4980
00002420201
TECFIDERA 240 MG DELAYED-RELEASE CAPSULE
ORL
DRC
BIO
CAP
33.0329
00002447711
TECHNIVIE TABLET
ORL
TAB
ABV
TAB
332.5000
00002395223
TELMISARTAN 40 MG TABLET
ORL
TAB
PDL
TAB
0.2824
00002395231
TELMISARTAN 80 MG TABLET
ORL
TAB
PDL
TAB
0.2824
00002395525
TELMISARTAN-HCTZ 80 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.2824
00002395533
TELMISARTAN-HCTZ 80 MG/25 MG TABLET
ORL
TAB
PDL
TAB
0.2824
00002261553
TELZIR 50 MG/ML ORAL SUSPENSION
ORL
SUS
GSK
ML
0.5912
00002261545
TELZIR 700 MG TABLET
ORL
TAB
GSK
TAB
8.0863
00002241095
TEMODAL 100 MG CAPSULE
ORL
CAP
MFC
CAP
153.4045
00002321262
TEMODAL 100 MG/VIAL INJECTION
INJ
DEFAUL
MFC
VIAL
411.2600
00002312794
ORL
CAP
MFC
CAP
214.7680
00002312816
ORL
CAP
MFC
CAP
264.3805
Pg 205 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002241094
ORL
CAP
MFC
CAP
30.6820
00002241096
ORL
CAP
MFC
CAP
383.5000
00002241093
ORL
CAP
MFC
CAP
7.6705
00000875988
TEMPRA INFANT 80 MG/ML ORAL DROPS
ORL
DPS
PAL
ML
0.2500
00000894710
TERAZOL 3 80 MG VAGINAL OVULE
VAG
OVL
JAI
OVL
6.3767
00002130874
TERAZOL 3 DUAL PAK KIT
VAG/TOP
OVL/CRM
JAI
KIT
30.4000
00000894729
TERAZOL 7 0.4% VAGINAL CREAM
VAG
CRM
JAI
G
0.7060
00002242735
TERBINAFINE-250 MG TABLET
ORL
TAB
PDL
TAB
1.8527
00000632317
TERSASEPTIC 0.5% TOPICAL SHAMPOO
TOP
SHP
GSK
ML
0.0273
00000632295
TERSA-TAR MILD 1% TOPICAL SHAMPOO
TOP
SHP
GSK
ML
0.0367
00002280248
TESTIM 1% TOPICAL GEL
TOP
GEL
PAL
G
0.7444
00002246063
TESTOSTERONE CYPIONATE 100 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
2.3580
00000514462
TETANUS & DIPHTHERIA TOXOIDS ADULT INJECTION
INJ
LIQ
CNG
ML
43.3800
00002148528
TETRACAINE 0.5% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00002416662
TEVA-ABACAVIR/LAMIVUDINE 600 MG/300 MG TABLET
ORL
TAB
TEV
TAB
20.3573
00002248251
TEVA-ALENDRONATE 5 MG TABLET
ORL
TAB
TEV
TAB
1.0370
00002403633
TEVA-ALENDRONATE/CHOLECALCIFEROL 70 MG/2800 U TAB
ORL
TAB
TEV
TAB
3.7300
00002326043
TEVA-AMITRIPTYLINE 10 MG TABLET
ORL
TAB
TEV
TAB
0.0664
00002326051
ORL
TAB
TEV
TAB
0.1211
00002326078
ORL
TAB
TEV
TAB
0.2347
Pg 206 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002313049
TEVA-ANASTROZOLE 1 MG TABLET
ORL
TAB
TEV
TAB
2.5460
00001912054
TEVA-ATENOLOL 100 MG TABLET
ORL
TAB
TEV
TAB
0.2363
00001912062
TEVA-ATENOLOL 50 MG TABLET
ORL
TAB
TEV
TAB
0.1437
00002314541
TEVA-ATOMOXETINE 10 MG CAPSULE
ORL
CAP
TEV
CAP
2.3140
00002362538
ORL
CAP
TEV
CAP
4.3520
00002314568
ORL
CAP
TEV
CAP
2.6523
00002314576
ORL
CAP
TEV
CAP
2.9280
00002314584
ORL
CAP
TEV
CAP
3.3377
00002314592
ORL
CAP
TEV
CAP
3.7023
00002362511
ORL
CAP
TEV
CAP
3.9960
00002380927
TEVA-ATOVAQUONE PROGUANIL 250 MG/100 MG TABLET
ORL
TAB
TEV
TAB
4.1310
00002280205
TEVA-BETAHISTINE 24 MG TABLET
ORL
TAB
TEV
TAB
0.4983
00002280183
TEVA-BETAHISTINE 8 MG TABLET
ORL
TAB
TEV
TAB
0.2259
00002398419
TEVA-BOSENTAN 125 MG TABLET
ORL
TAB
TEV
TAB
48.1340
00002398400
TEVA-BOSENTAN 62.5 MG TABLET
ORL
TAB
TEV
TAB
48.1340
00002395576
TEVA-CANDESARTAN/HCTZ 32 MG/25 MG TABLET
ORL
TAB
TEV
TAB
0.8985
00002400022
TEVA-CAPECITABINE 150 MG TABLET
ORL
TAB
TEV
TAB
1.4640
00002400030
TEVA-CAPECITABINE 500 MG TABLET
ORL
TAB
TEV
TAB
4.8800
00002239355
TEVA-DIFENAC-K 50 MG TABLET
ORL
TAB
TEV
TAB
0.3937
00002389762
TEVA-EFAVIRENZ 600 MG TABLET
ORL
TAB
TEV
TAB
11.2103
Pg 207 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002382091
TEVA-ELETRIPTAN 20 MG TABLET
ORL
TAB
TEV
TAB
10.0850
00002382105
TEVA-ELETRIPTAN 40 MG TABLET
ORL
TAB
TEV
TAB
10.0850
00002300680
TEVA-ENALAPRIL 2.5 MG TABLET
ORL
TAB
TEV
TAB
0.1863
00002330601
TEVA-ENALAPRIL 40 MG TABLET
ORL
TAB
TEV
TAB
1.2560
00002377705
TEVA-ERLOTINIB 100 MG TABLET
ORL
TAB
TEV
TAB
47.4667
00002377713
ORL
TAB
TEV
TAB
71.2000
00002377691
ORL
TAB
TEV
TAB
11.8667
00002408473
TEVA-EXEMESTANE 25 MG TABLET
ORL
TAB
TEV
TAB
3.9007
00002289091
TEVA-FENOFIBRATE-S 160 MG TABLET
ORL
CAP/TAB
TEV
TAB
0.2723
00002230089
TEVA-FLUTAMIDE 250 MG TABLET
ORL
TAB
TEV
TAB
1.3530
00002415844
TEVA-FROVATRIPTAN 2.5 MG TABLET
ORL
TAB
TEV
TAB
12.5029
00002248457
TEVA-GABAPENTIN 600 MG TABLET
ORL
TAB
TEV
TAB
1.3045
00002247346
TEVA-GABAPENTIN 800 MG TABLET
ORL
TAB
TEV
TAB
1.7393
00002377969
TEVA-GALANTAMINE ER 16 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
TEV
CAP
1.2467
00002377977
ORL
ERC
TEV
CAP
1.2467
00002377950
ORL
ERC
TEV
CAP
1.2467
00002399806
TEVA-IMATINIB 100 MG TABLET
ORL
TAB
TEV
TAB
20.4557
00002399814
TEVA-IMATINIB 400 MG TABLET
ORL
TAB
TEV
TAB
81.8228
00002316005
TEVA-IRBESARTAN 300 MG TABLET
ORL
TAB
TEV
TAB
0.3025
00002316013
TEVA-IRBESARTAN/HCTZ 150/12.5 MG TABLET
ORL
TAB
TEV
TAB
0.3024
Pg 208 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002316021
TEVA-IRBESARTAN/HCTZ 300/12.5 MG TABLET
ORL
TAB
TEV
TAB
0.3024
00002316048
TEVA-IRBESARTAN/HCTZ 300/25 MG TABLET
ORL
TAB
TEV
TAB
0.3004
00002387247
TEVA-LAMIVUDINE/ZIDOVUDINE 150 MG/300 MG TABLET
ORL
TAB
TEV
TAB
7.8309
00002343657
TEVA-LETROZOLE 2.5 MG TABLET
ORL
TAB
TEV
TAB
2.7560
00002246542
TEVA-LOVASTATIN 20 MG TABLET
ORL
TAB
TEV
TAB
0.4919
00002246543
TEVA-LOVASTATIN 40 MG TABLET
ORL
TAB
TEV
TAB
0.8985
00002258323
TEVA-MELOXICAM 15 MG TABLET
ORL
TAB
TEV
TAB
0.5670
00002258315
TEVA-MELOXICAM 7.5 MG TABLET
ORL
TAB
TEV
TAB
0.4914
00002315068
TEVA-METHYLPHENIDATE ER-C 18 MG EXTEND REL. TABLET
ORL
ERT
TEV
TAB
1.4276
00002315076
TEVA-METHYLPHENIDATE ER-C 27 MG EXTEND RELEASE TAB
ORL
ERT
TEV
TAB
1.6475
00002315084
ORL
ERT
TEV
TAB
1.8674
00002315092
ORL
ERT
TEV
TAB
2.3072
00002261898
TEVA-METOPROL 25 MG TABLET
ORL
TAB
TEV
TAB
0.0643
00002279894
TEVA-MIRTAZAPINE OD 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
TEV
TAB
0.2730
00002279908
TEVA-MIRTAZAPINE OD 30MG ORALLY DISINT. TABLET
ORL
DISNTAB
TEV
TAB
0.5460
00002279916
TEVA-MIRTAZAPINE OD 45MG ORALLY DISINT. TABLET
ORL
DISNTAB
TEV
TAB
0.8190
00002239747
TEVA-MOCLOBEMIDE 150 MG TABLET
ORL
TAB
TEV
TAB
0.3120
00002239748
TEVA-MOCLOBEMIDE 300 MG TABLET
ORL
TAB
TEV
TAB
0.6126
00002420260
TEVA-MODAFINIL 100 MG TABLET
ORL
TAB
TEV
TAB
0.9293
00002392925
TEVA-NABILONE 0.25 MG CAPSULE
ORL
CAP
TEV
CAP
1.3962
Pg 209 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002352893
TEVA-NEVIRAPINE 200 MG TABLET
ORL
TAB
TEV
TAB
2.4692
00002359707
TEVA-OLANZAPINE 20 MG TABLET
ORL
TAB
TEV
TAB
10.3093
00002321378
TEVA-OLANZAPINE OD 15 MG ORALLY DISINT. TABLET
ORL
DISNTAB
TEV
TAB
5.3553
00002321386
TEVA-OLANZAPINE OD 20 MG ORALLY DISINT. TABLET
ORL
DISNTAB
TEV
TAB
7.5977
00002285479
TEVA-PANTOPRAZOLE 20MG ENTERIC-COATED ORAL TAB
ORL
ECT
TEV
TAB
1.2750
00002248556
TEVA-PAROXETINE 10 MG TABLET
ORL
TAB
TEV
TAB
1.0430
00000869015
TEVA-PINDOLOL 10 MG TABLET
ORL
TAB
TEV
TAB
0.2323
00000869023
ORL
TAB
TEV
TAB
0.3370
00000869007
ORL
TAB
TEV
TAB
0.1361
00002274914
TEVA-PIOGLITAZONE 15 MG TABLET
ORL
TAB
TEV
TAB
0.5809
00002274922
ORL
TAB
TEV
TAB
0.8139
00002274930
ORL
TAB
TEV
TAB
1.2237
00002269317
TEVA-PRAMIPEXOLE 0.5 MG TABLET
ORL
TAB
TEV
TAB
1.3860
00002361205
TEVA-PREGABALIN 150 MG CAPSULE
ORL
CAP
TEV
CAP
1.7270
00002361221
ORL
CAP
TEV
CAP
1.7270
00002361159
ORL
CAP
TEV
CAP
0.6173
00002361248
ORL
CAP
TEV
CAP
1.7270
00002361175
ORL
CAP
TEV
CAP
0.9683
00002361183
ORL
CAP
TEV
CAP
1.2529
00002312298
TEVA-RALOXIFENE 60 MG TABLET
ORL
TAB
TEV
TAB
0.4583
Pg 210 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002388359
TEVA-RAMIPRIL/HCTZ 10 MG/12.5 MG TABLET
ORL
TAB
TEV
TAB
0.2633
00002388375
TEVA-RAMIPRIL/HCTZ 10 MG/25 MG TABLET
ORL
TAB
TEV
TAB
0.2633
00002388332
TEVA-RAMIPRIL/HCTZ 2.5 MG/12.5 MG TABLET
ORL
TAB
TEV
TAB
0.1694
00002388340
TEVA-RAMIPRIL/HCTZ 5 MG/12.5 MG TABLET
ORL
TAB
TEV
TAB
0.2070
00002388367
TEVA-RAMIPRIL/HCTZ 5 MG/25 MG TABLET
ORL
TAB
TEV
TAB
0.2070
00002418436
TEVA-RASAGILINE 0.5 MG TABLET
ORL
TAB
TEV
TAB
6.1285
00002418444
TEVA-RASAGILINE 1 MG TABLET
ORL
TAB
TEV
TAB
6.1285
00002413809
TEVA-RISEDRONATE 150 MG TABLET
ORL
TAB
TEV
TAB
40.9500
00002308754
TEVA-SILDENAFIL 100 MG TABLET
ORL
TAB
TEV
TAB
9.2006
00002308738
ORL
TAB
TEV
TAB
8.2900
00002308746
ORL
TAB
TEV
TAB
8.8475
00002286815
TEVA-SUMATRIPTAN DF 25 MG TABLET
ORL
TAB
TEV
TAB
8.9900
00002440164
TEVA-TADALAFIL 10 MG TABLET
ORL
TAB
TEV
TAB
11.9250
00002440148
TEVA-TADALAFIL 2.5 MG TABLET
ORL
TAB
TEV
TAB
3.6470
00002440172
ORL
TAB
TEV
TAB
12.3569
00002440156
ORL
TAB
TEV
TAB
3.6470
00000851965
TEVA-TAMOXIFEN 10 MG TABLET
ORL
TAB
TEV
TAB
0.1750
00000851973
TEVA-TAMOXIFEN 20 MG TABLET
ORL
TAB
TEV
TAB
0.3500
00002230102
TEVA-TEMAZEPAM 30 MG CAPSULE
ORL
CAP
TEV
CAP
0.0526
00002230085
TEVA-THEOPHYLLINE SR 100 MG EXTENDED RELEASE TAB
ORL
SRT
TEV
TAB
0.1300
Pg 211 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002230086
ORL
SRT
TEV
TAB
0.1350
00002230087
ORL
SRT
TEV
TAB
0.1400
00002236848
TEVA-TICLOPIDINE 250 MG TABLET
ORL
TAB
TEV
TAB
0.3139
00001947818
TEVA-TIMOLOL 10 MG TABLET
ORL
TAB
TEV
TAB
0.2572
00001947826
ORL
TAB
TEV
TAB
0.5005
00001947796
ORL
TAB
TEV
TAB
0.1649
00002299593
TEVA-TOLTERODINE 1 MG TABLET
ORL
TAB
TEV
TAB
0.8838
00002299607
TEVA-TOLTERODINE 2 MG TABLET
ORL
TAB
TEV
TAB
0.8838
00002347180
TEVA-TRAMADOL/ACETAMINOPHEN 37.5 MG/325 MG TABLET
ORL
TAB
TEV
TAB
0.6264
00002357542
TEVA-VALACYCLOVIR 1000 MG TABLET (CAPLET)
ORL
TAB
TEV
TAB
3.0531
00002356643
TEVA-VALSARTAN 40 MG TABLET
ORL
TAB
TEV
TAB
0.5240
00002355205
THALOMID 100 MG CAPSULE
ORL
CAP
CLG
CAP
58.9400
00002355221
ORL
CAP
CLG
CAP
117.8800
00002355191
ORL
CAP
CLG
CAP
29.4700
00002360101
THEO ER 400 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AAP
TAB
0.3362
00002360128
THEO ER 600 MG SUSTAINED-RELEASE TABLET
ORL
SRT
AAP
TAB
0.4072
00080015438
THERA TEARS NUTRITION CAPSULE
ORL
CAP
AVR
CAP
0.1056
00002242082
THERATEARS (PRESERVATIVE-FREE) 0.25% OPH SOLUTION
OPH
SOL
AVR
ML
0.6417
00002248854
THERATEARS 0.25% OPH SOLUTION
OPH
SOL
AVR
ML
0.4900
00002343045
TICLOPIDINE 250 MG TABLET
ORL
TAB
SNS
TAB
0.3139
Pg 212 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002409356
TIGECYCLINE 50 MG/VIAL INJECTION
INJ
DEFAUL
APX
VIAL
71.4225
00001916939
TIMENTIN 3.1G INJECTION
INJ
DEFAUL
GSK
VIAL
10.7520
00002242275
TIMOLOL MALEATE-EX 0.25% OPHTHALMIC SOLUTION
OPH
LAS
ALC
ML
3.2160
00002242276
TIMOLOL MALEATE-EX 0.5% OPHTHALMIC SOLUTION
OPH
LAS
ALC
ML
3.8480
00000576050
TINACTIN 1% TOPICAL AEROSOL
TOP
AER
SCH
G
0.0523
00000576034
TINACTIN 1% TOPICAL CREAM
TOP
CRM
SCH
G
0.3487
00000576042
TINACTIN 1% TOPICAL POWDER
TOP
PWR
SCH
G
0.0649
00002414945
TIVICAY 50 MG TABLET
ORL
TAB
VIV
TAB
19.0400
00002259893
TIZANIDINE 4 MG TABLET
ORL
TAB
AAP
TAB
0.6884
00002244826
TNKASE 50 MG/VIAL INJECTION
INJ
DEFAUL
HLR
VIAL
2,778.7900
00000533688
TOBRAMYCIN 1.2 G/VIAL INJECTION
INJ
DEFAUL
FKC
VIAL
199.0000
00002241209
TOBRAMYCIN 10 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
5.1585
00002230640
TOBRAMYCIN 40 MG/ML INJECTION
INJ
DEFAUL
FKC
ML
3.5310
00002337630
TOCTINO 10 MG CAPSULE
ORL
CAP
GST
CAP
21.9900
00002337649
TOCTINO 30 MG CAPSULE
ORL
CAP
GST
CAP
21.9900
00000312762
TOLBUTAMIDE 500 MG TABLET
ORL
TAB
AAP
TAB
0.1111
00002229566
TOMUDEX 2 MG/VIAL INJECTION
INJ
DEFAUL
AZC
VIAL
324.6200
00002221926
TOPICORT 0.05% TOPICAL GEL
TOP
GEL
VCL
G
0.5037
00002221934
TOPICORT 0.25% TOPICAL OINTMENT
TOP
ONT
VCL
G
0.6493
00000749834
TOPIDERM HC 2% TOPICAL CREAM
TOP
CRM
PAL
G
0.3317
Pg 213 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002390981
TOPOTECAN 4 MG / VIAL INJECTION
INJ
DEFAUL
SDZ
VIAL
567.0000
00002304104
TORISEL 25 MG/ML INJECTION
INJ
DEFAUL
PFI
VIAL
1,309.6000
00002441829
TOUJEO SOLOSTAR 300 UNIT/ML INJECTION
INJ
DEFAUL
SAV
ML
17.6227
00002244982
TRACLEER 125 MG TABLET
ORL
TAB
ACT
TAB
64.1786
00002244981
TRACLEER 62.5 MG TABLET
ORL
TAB
ACT
TAB
64.1786
00002264846
TRAMACET 37.5 MG/325 MG TABLET
ORL
TAB
JAI
TAB
0.7640
00002426803
TRAMADOL/ACET 37.5 MG/325 MG TABLET
ORL
TAB
SNS
TAB
0.6264
00002429969
TRAMADOL/ACETAMINOPHEN 37.5 MG/325 MG TABLET
ORL
TAB
SIV
TAB
0.6264
00002417502
TRAMADOL-ACET 37.5 MG/325 MG TABLET
ORL
TAB
PDL
TAB
0.6264
00002388294
TRAMAPHEN-ODAN 37.5 MG/325 MG TABLET
ORL
TAB
ODN
TAB
0.6264
00002246365
TRANEXAMIC ACID 100 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
3.8860
00080044392
TRANSDERMAL NICOTINE PATCH; NICOTINE PATCH 14 MG
TRD
PTH
APH
PTH
2.1500
00080044389
TRD
PTH
APH
PTH
2.1500
00080044393
TRD
PTH
APH
PTH
2.2857
00080024336
TRANSDERM-V 1.5 MG TOPICAL PATCH
TOP
PTH
NOV
PTH
3.9250
00000605786
TRAVEL AID 50 MG TABLET
ORL
TAB
WTR
TAB
0.0488
00002164361
TRAZODONE-100 100 MG TABLET
ORL
TAB
PDL
TAB
0.0989
00002164388
TRAZODONE-150 D 150 MG TABLET
ORL
TAB
PDL
TAB
0.1453
00002164353
TRAZODONE-50 50 MG TABLET
ORL
TAB
PDL
TAB
0.0554
00002230285
TRAZOREL 100 MG TABLET
ORL
TAB
ICN
TAB
0.3956
Pg 214 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002230284
TRAZOREL 50 MG TABLET
ORL
TAB
ICN
TAB
0.2214
00002392569
TREANDA 100 MG/VIAL INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
LUI
VIAL
1,250.0000
00002392550
TREANDA 25 MG/VIAL INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
LUI
VIAL
312.5000
00002412322
TRELSTAR 22.5 MG/VIAL INJECTION
INJ
DEFAUL
ASC
VIAL
1,650.0000
00002240000
TRELSTAR 3.75 MG/VIAL INJECTION
INJ
DEFAUL
ASC
VIAL
347.3300
00002243856
TRELSTAR LA 11.25 MG/VIAL INJECTION
INJ
DEFAUL
ASC
VIAL
1,042.0300
00002229540
TRIAMCINOLONE ACETONIDE 10 MG/ML INJ.
INJ
DEFAUL
SDZ
ML
2.8600
00002229550
TRIAMCINOLONE ACETONIDE 40MG/ML INJ.
INJ
DEFAUL
SDZ
ML
5.5000
00080015032
TRIAMEG H OMEGA 3 500 MG CAPSULE
ORL
CAP
LLN
CAP
0.3000
00000896179
TRIAMINIC DM NIGHTIME ORAL SYRUP
ORL
SYR
NVC
ML
0.0474
00000789828
TRIATEC-30 TABLET
ORL
TAB
TLI
TAB
0.1300
00000852163
TRIATEC-8 TABLET
ORL
TAB
TLI
TAB
0.0473
00000808563
TRIAZO 0.125 MG TABLET
ORL
TAB
AAP
TAB
0.1496
00002296381
TRIDURAL 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
PAL
TAB
1.2205
00002296403
ORL
ERT
PAL
TAB
2.2253
00002296411
ORL
ERT
PAL
TAB
3.2335
00002242067
TRILEPTAL 150 MG TABLET
ORL
TAB
NOV
TAB
0.8526
00002242068
ORL
TAB
NOV
TAB
0.9374
00002244673
TRILEPTAL 60 MG/ML ORAL SUSPENSION
ORL
SUS
NOV
ML
0.3409
00002242069
ORL
TAB
NOV
TAB
1.8750
Pg 215 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000517895
TRINALIN REPETABS SUSTAINED-RELEASE TABLET
ORL
SRT
SCH
TAB
0.6535
00002432927
TRINTELLIX 10 MG TABLET
ORL
TAB
LBC
TAB
2.8339
00002432943
ORL
TAB
LBC
TAB
3.0768
00002432919
ORL
TAB
LBC
TAB
2.7054
00080002067
TRIPLE STRENGTH ODOURLESS GARLIC SOFTGEL CAPSULE
ORL
CAP
VCL
CAP
0.0460
00002407833
TRISENOX 1 MG/ML AMPOULE INJECTION
INJ
DEFAUL
LBC
ML
53.0000
00002430932
TRIUMEQ TABLET
ORL
TAB
VIV
TAB
42.5007
00002244757
TRIZIVIR TABLET
ORL
TAB
GSK
TAB
18.4588
00000511234
TROMBOJECT 10 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
6.2500
00000511226
TROMBOJECT 30 MG/ML INJECTION
INJ
DEFAUL
OMG
ML
8.5000
00080015078
TROPHIC KRILL OIL CAPSULE
ORL
CAP
MTA
CAP
0.4237
00002148536
TROPICAMIDE 1% OPH SOLUTION (MINIMS)
OPH
SOL
BSH
ML
6.6667
00080000383
TRUEHOPE EMP CAPSULE
ORL
CAP
TRU
CAP
0.2087
00002448599
TRULICITY 0.75 MG/0.5 ML INJECTION PEN
INJ
DEFAUL
LIL
ML
95.9000
00002448602
TRULICITY 1.5 MG/0.5 ML INJECTION PEN
INJ
DEFAUL
LIL
ML
95.9000
00002274906
TRUVADA 200 MG/300 MG TABLET
ORL
TAB
GIL
TAB
27.3870
00000317268
TUBERSOL TUBERCULIN PPD 5 TUB INJECTION
INJ
DEFAUL
AVE
ML
177.7100
00001967932
TUMS EXTRA STRENGTH 750 MG CHEWABLE TABLET
ORL
CTB
SKB
TAB
0.0442
00001970240
TUMS REGULAR 500 MG CHEWABLE TABLET
ORL
CTB
SKB
TAB
0.0311
00002151138
TUMS ULTRA STRENGTH 1G CHEWABLE TABLET
ORL
CTB
SKB
TAB
0.0496
Pg 216 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00001916971
TUSSIONEX ORAL SUSTAINED-RELEASE SUSPENSION
ORL
SRSUS
SAV
ML
0.3369
00001916963
TUSSIONEX TABLET
ORL
SRT
SAV
TAB
1.6843
00080019103
TUZEN CAPSULE
ORL
CAP
FEI
CAP
0.7600
00002268205
TWINJECT 1:1000 (0.15 MG) INJECTION AUTO INJECTOR
INJ
NDL
PAL
SYR
82.4600
00002247310
TWINJECT 1:1000 (0.3 MG) INJECTION AUTO INJECTOR
INJ
NDL
PAL
SYR
82.4600
00002230578
TWINRIX INJECTION SYRINGE
INJ
NDL
GSK
SYR
48.8800
00002237548
TWINRIX JUNIOR 0.5 ML INJECTION SYRINGE
INJ
NDL
GSK
SYR
24.4400
00002285401
TYGACIL 50 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
83.0010
00002326442
TYKERB 250 MG TABLET
ORL
TAB
NOV
TAB
23.5000
00002246060
TYLENOL 8 HOUR 650 MG EXTENDED-RELIEF CAPLET
ORL
ERT
MCL
TAB
0.1663
00001933728
TYLENOL ALLERGY SINUS EXTRA STRENGTH CAPLET
ORL
TAB
MCL
TAB
0.2850
00002238885
TYLENOL ARTHRITIS PAIN 650 MG EXT-RELIEF CAPLET
ORL
ERT
MCL
TAB
0.1567
00000743224
TYLENOL CHILDRENS COLD CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.1763
00000890677
TYLENOL COLD DM JUNIOR STRENGTH CHEWABLE TABLET
ORL
CTB
MCL
TAB
0.2590
00000743275
TYLENOL COLD EXTRA STRENGTH CAPLET
ORL
TAB
MCL
TAB
0.2850
00000743267
TYLENOL COLD EXTRA STRENGTH N.D. CAPLET
ORL
TAB
MCL
TAB
0.2850
00002276259
TYLENOL COLD EXTRA STRENGTH NIGHTTIME TABLET
ORL
TAB
MCL
TAB
0.3000
00000574007
TYLENOL COLD REGULAR STRENGTH CAPLET
ORL
TAB
MCL
TAB
0.2004
00000743283
TYLENOL COLD REGULAR STRENGTH N.D. CAPLET
ORL
TAB
MCL
TAB
0.2012
00002290510
TYLENOL EXTRA STR. BACK PAIN 400 MG/500 MG TABLET
ORL
TAB
MCL
TAB
0.4811
Pg 217 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000863270
TYLENOL EXTRA-STRENGTH GELCAPS 500 MG CAPSULE
ORL
CAP
MCL
CAP
0.1383
00000663980
TYLENOL EXTRA-STRENGTH SINUS MEDICATION CAPLET
ORL
TAB
MCL
TAB
0.4783
00002347792
TYLENOL FASTMELTS JUNIOR STRENGTH 160 MG CHEW TAB
ORL
CTB
MCL
TAB
0.2700
00002241361
TYLENOL JUNIOR STRENGTH 160 MG SOFT CHEW TABLET
ORL
CTB
MCL
TAB
0.2700
00002181061
TYLENOL NO.1 WITH CODEINE TABLET
ORL
TAB
MCL
TAB
0.1396
00000559393
TYLENOL REGULAR STRENGTH 325 MG TABLET
ORL
TAB
MCL
TAB
0.1417
00000723894
TYLENOL REGULAR STRENGTH 325 MG TABLET
ORL
TAB
MCL
TAB
0.1208
00000778400
TYLENOL SINUS CAPLET
ORL
TAB
MCL
TAB
0.2004
00002242727
TYPHERIX 25 MCG/0.5 ML INJECTION SYRINGE
INJ
NDL
GSK
SYR
22.1400
00002130955
TYPHIM VI 50 MCG/ML INJECTION
INJ
DEFAUL
CNG
ML
48.5000
00080022377
UDO'S CHOICE SUPER 8 PLUS PROBIOTIC
ORL
CAP
FMD
CAP
0.9900
00001966294
ULONE 5 MG ORAL SYRUP
ORL
SYR
MMH
ML
0.1406
00080015173
ULTIMATE FLORA CRITICAL CARE 50 BILLION
ORL
CAP
RLC
CAP
1.1665
00080040326
ULTIMATE FLORA ULTRA POTENT 100 BILLION CAPSULE
ORL
CAP
RLC
CAP
1.2000
00080006259
ULTIMATE OMEGA FACTORS 3-6-9 SOFT GEL CAPSULE
ORL
CAP
NFN
CAP
0.2387
00080033880
ULTRA C 1000 TABLET
ORL
TAB
MTG
TAB
0.3135
00080032885
ULTRA C TM 500 500 MG TABLET
ORL
TAB
MTG
TAB
0.2817
00080011779
ULTRA FLORA PLUS CAPSULE
ORL
CAP
MTG
CAP
0.4116
00080011780
ULTRA FLORA PLUS; ULTRA FLORA BALANCE
ORL
CAP
MTG
CAP
0.4167
00002237698
ULTRA STRENGTH PHAZYME 180 MG CAPSULE
ORL
CAP
CBF
CAP
0.2221
Pg 218 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080025550
ULTRA-FIBER BALANCED CAPLET
ORL
TAB
AAM
TAB
0.0802
00080004965
ULTRA-FIBER SUPPLEMENT CHEWABLE TABLET
ORL
TAB
AAM
TAB
0.0917
00002349469
ULTRAM 50 MG TABLET
ORL
TAB
JAI
TAB
0.7493
00002324113
ULTRAQUIN 4% HYDROQUINONE CREAM WITH SUNSCREENS
TOP
CRM
SAH
G
1.0000
00000626724
ULTRAQUIN 4% TOPICAL GEL
TOP
GEL
SAH
G
1.0000
00000632783
ULTRAQUIN PLAIN 4% CREAM
TOP
CRM
SAH
G
0.8667
00001962728
ULTRAVATE 0.05% TOPICAL OINTMENT
TOP
ONT
VCL
G
0.9102
00001946994
UNISOM-2 NIGHTTIME SLEEP AID TAB 25 MG
ORL
TAB
PDH
TAB
0.2040
00002451190
UPTRAVI 1000 MCG TABLET
ORL
TAB
ACT
TAB
64.1667
00002451204
ORL
TAB
ACT
TAB
64.1667
00002451212
ORL
TAB
ACT
TAB
64.1667
00002451220
ORL
TAB
ACT
TAB
64.1667
00002451158
ORL
TAB
ACT
TAB
64.1667
00002451166
ORL
TAB
ACT
TAB
64.1667
00002451174
ORL
TAB
ACT
TAB
64.1667
00002451182
ORL
TAB
ACT
TAB
64.1667
00000116866
URASAL GRANULES ORAL EFFERVESCENT POWDER
ORL
EVP
AXS
G
0.1138
00001946099
UREMOL 10 10% TOPICAL CREAM
TOP
CRM
GKC
G
0.0769
00000398179
UREMOL 20% TOPICAL CREAM
TOP
CRM
GKC
G
0.0811
00001946102
UREMOL-10 10% TOPICAL LOTION
TOP
LOT
GKC
ML
0.0430
Pg 219 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000503134
UREMOL-HC TOPICAL CREAM
TOP
CRM
GSK
G
0.1746
00000560022
UREMOL-HC TOPICAL LOTION
TOP
LOT
GSK
ML
0.0982
00080005531
URISEC 40 40% TOPICAL CREAM
TOP
CRM
ODN
G
1.2500
00002353997
UROCIT-K 10 MEQ EXTENDED-RELEASE TABLET
ORL
ERT
PAL
TAB
0.5355
00001914022
UROCIT-K 5 MEQ TABLET
ORL
SRT
SFD
TAB
0.3588
00002241411
UROMITEXAN 100 MG/ML INJECTION
INJ
DEFAUL
AST
ML
6.6198
00080030062
UTI CLEANSE TABLET
ORL
TAB
AOR
TAB
0.4416
00080046888
UXOR 7.5% GEL
TOP
GEL
JPC
G
0.1787
00000990079
VAGINAL PESSARY
DEFAUL
DEV
XXX
DEV
00000027944
VALISONE 0.1% SCALP LOTION
SCP
LOT
PMS
ML
0.0853
00000177016
VALISONE-G TOPICAL CREAM
TOP
CRM
VCL
G
1.0253
00000232351
VALISONE-G TOPICAL OINTMENT
TOP
ONT
VCL
G
1.0253
00000013285
VALIUM 5 MG TABLET
ORL
TAB
HLR
TAB
0.1750
00002367742
VALSARTAN 160 MG TABLET
ORL
TAB
PDL
TAB
0.2957
00002367750
ORL
TAB
PDL
TAB
0.2843
00002384523
ORL
TAB
SIV
TAB
0.5240
00002366940
ORL
TAB
SNS
TAB
0.5239
00002367726
ORL
TAB
PDL
TAB
0.4080
00002367734
ORL
TAB
PDL
TAB
0.2957
00002384760
VALSARTAN HCT 320 MG/12.5 MG TABLET
ORL
TAB
SIV
TAB
0.2910
141.9500
Pg 220 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002384779
VALSARTAN HCT 320 MG/25 MG TABLET
ORL
TAB
SIV
TAB
0.2910
00002367777
VALSARTAN-HCTZ 160 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.2957
00002367785
VALSARTAN-HCTZ 160 MG/25 MG TABLET
ORL
TAB
PDL
TAB
0.2957
00002367769
VALSARTAN-HCTZ 80 MG/12.5 MG TABLET
ORL
TAB
PDL
TAB
0.2957
00002246559
VALTREX 1000 MG CAPLET
ORL
TAB
GSK
TAB
6.8867
00002394634
VANCOMYCIN HYDROCHLORIDE 1 G/VIAL INJ USP
INJ
DEFAUL
SDZ
VIAL
58.9900
00002407922
VANCOMYCIN HYDROCHLORIDE 1 G/VIAL INJECTION
INJ
DEFAUL
MYP
VIAL
58.9900
00002407930
VANCOMYCIN HYDROCHLORIDE 5 G/VIAL INJECTION
INJ
DEFAUL
MYP
VIAL
509.7900
00002394626
VANCOMYCIN HYDROCHLORIDE 500 MG/VIAL INJ USP
INJ
DEFAUL
SDZ
VIAL
31.0500
00002407914
VANCOMYCIN HYDROCHLORIDE 500 MG/VIAL INJECTION
INJ
DEFAUL
MYP
VIAL
31.0500
00002432544
VAN-GABAPENTIN 600 MG TABLET
ORL
TAB
VAN
TAB
1.3045
00002432552
VAN-GABAPENTIN 800 MG TABLET
ORL
TAB
VAN
TAB
1.7393
00002243837
VANIQA 13.9% TOPICAL CREAM
TOP
CRM
ALM
G
2.3917
00002229702
VAQTA 50 U/ML INJECTION
INJ
DEFAUL
MSD
ML
45.5400
00002241047
VARILRIX 2000 UNITS/(0.5 ML) VIAL INJECTION
INJ
DEFAUL
GSK
VIAL
62.7900
00002246081
VARIVAX III VACCINE 1350 U/VIAL INJECTION
INJ
DEFAUL
MFC
VIAL
72.7200
00002139502
VASOPRESSIN 20 UNIT/ML INJECTION
INJ
DEFAUL
FKC
ML
19.8300
00002223929
VAXIGRIP INFLUENZA VACCINE INJECTION
INJ
DEFAUL
CNG
ML
8.3500
00002308487
VECTIBIX 20 MG/ML (5 ML VIAL) INJECTION
INJ
DEFAUL
AMG
ML
128.3640
00002339269
VENLAFAXINE XR 150 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
PDL
CAP
0.8868
Pg 221 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002339242
VENLAFAXINE XR 37.5 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
PDL
CAP
0.4200
00002339250
VENLAFAXINE XR 75 MG EXTENDED-RELEASE CAPSULE
ORL
ERC
PDL
CAP
0.8399
00002243716
VENOFER 20 MG/ML INJECTION
INJ
DEFAUL
LPI
ML
7.5000
00002226286
VENOMIL YELLOW JACKET VENOM PROTEIN 120 MCG INJ
INJ
DEFAUL
BAI
VIAL
00002243115
VENTOLIN DISKUS 200 MCG/DOSE POWDER FOR INHALATION
INH
MIP
GSK
DOSE
0.1928
00000616192
VEPESID 50 MG CAPSULE
ORL
CAP
BMS
CAP
39.6050
00080033844
VERALAC HYDROSOLUBLE NAIL LACQUER
TOP
SOL
VCL
ML
3.6606
00000839299
VERAPAMIL HYDROCHLORIDE 2.5 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
19.7250
00002166739
VERAPAMIL HYDROCHLORIDE USP 2.5 MG/ML INJECTION
INJ
DEFAUL
SDZ
ML
19.1000
00002348489
VERDESO 0.05% TOPICAL FOAM
TOP
FOA
GSK
G
0.2944
00002411849
VEREGEN 10% TOPICAL OINTMENT
TOP
ONT
PAL
G
4.0153
00000594601
VERSEL 2.5% TOPICAL LOTION
TOP
LOT
VCL
ML
0.0716
00002145839
VESANOID 10 MG CAPSULE
ORL
CAP
CAG
CAP
16.3863
00002163691
VEXOL 1% OPH SOLUTION
OPH
SUS
ALC
ML
3.5620
00002451557
VIACORAM 14 MG/10 MG TABLET
ORL
TAB
SEV
TAB
1.1500
00002451530
VIACORAM 3.5 MG/2.5 MG TABLET
ORL
TAB
SEV
TAB
0.9500
00002451549
VIACORAM 7 MG/5 MG TABLET
ORL
TAB
SEV
TAB
1.0500
00000717002
VIADERM K.C. TOPICAL CREAM
TOP
CRM
TAR
G
0.4233
00000717029
VIADERM K.C. TOPICAL OINTMENT
TOP
ONT
TAR
G
0.6233
00002239768
VIAGRA 100 MG TABLET
ORL
TAB
PFI
TAB
9.2000
195.0000
Pg 222 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002239766
VIAGRA 25 MG TABLET
ORL
TAB
PFI
TAB
8.2900
00002239767
VIAGRA 50 MG TABLET
ORL
TAB
PFI
TAB
8.8475
00002330725
VIBATIV 750 MG/VIAL INJECTION POWDER FOR SOLUTION
INJ
DEFAUL
PPH
VIAL
179.0000
00000024368
VIBRAMYCIN 100 MG CAPSULE
ORL
CAP
PFI
CAP
1.7810
00002273330
VICKS CHILDREN'S NYQUIL COLD & COUGH ORAL LIQUID
ORL
LIQ
PGI
ML
0.0265
00001938959
VICKS FORMULA 44 ORAL LIQUID
ORL
LIQ
PGI
ML
0.0341
00002050684
VICKS NYQUIL ADULT NIGHTTIME COLD MEDICINE ORL LIQ
ORL
LIQ
PGI
ML
0.0276
00001935747
VICKS VAPORUB TOPICAL OINTMENT
TOP
ONT
PGI
G
0.0704
00002351064
VICTOZA 6 MG/ML PEN INJECTION SYRINGE
INJ
DEFAUL
NNA
ML
27.7000
00002370816
VICTRELIS 200 MG CAPSULE
ORL
CAP
MFC
CAP
12.5000
00002371456
VICTRELIS TRIPLE 200MG/200MG/100MCG/0.5ML INJ KIT
INJ
SYR/CAP
MFC
KIT
2,652.5500
00002371464
VICTRELIS TRIPLE 200MG/200MG/120MCG/0.5MLINJ KIT
INJ
SYR/CAP
MFC
KIT
2,726.0000
00002371472
INJ
SYR/CAP
MFC
KIT
2,726.0000
00002371448
INJ
SYR/CAP
MFC
KIT
2,652.5500
00002336707
VIDAZA 100 MG/VIAL INJECTION
INJ
DEFAUL
CLG
VIAL
628.0000
00002244596
VIDEX EC 125 MG CAPSULE (ENTERIC-COATED BEADLETS)
ORL
CAP/ENCP
BMS
CAP
3.8967
00002244597
ORL
CAP/ENCP
BMS
CAP
6.2350
00002244598
ORL
CAP/ENCP
BMS
CAP
7.7233
00002244599
ORL
CAP/ENCP
BMS
CAP
12.4950
00002417685
VIDEXTRA 10,000 UNIT TABLET
ORL
TAB
ORI
TAB
0.2500
Pg 223 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
OPH
SOL
ALC
ML
Base Price
00002252260
VIGAMOX 0.5% OPHTHALMIC SOLUTION
00002427184
VIMIZIM 5MG/5ML (SINGLE-USE) VIAL INJECTION
INJ
DEFAUL
BMI
VIAL
1,199.0000
00002361701
VIMOVO 375 MG/20 MG TABLET
ORL
TAB
AZC
TAB
1.0950
00002361728
VIMOVO 500 MG/20 MG TABLET
ORL
TAB
AZC
TAB
1.0910
00002183056
VINBLASTINE SULPHATE 1 MG/ML INJECTION
INJ
DEFAUL
MNP
ML
18.5630
00002401460
VINBLASTINE SULPHATE 1 MG/ML INJECTION
INJ
DEFAUL
TEV
ML
17.6790
00002183013
VINCRISTINE SULFATE 1 MG/ML INJECTION
INJ
DEFAUL
HSP
ML
63.3650
00002143305
VINCRISTINE SULPHATE 1 MG/ML INJECTION
INJ
DEFAUL
TEV
ML
31.0000
00000074500
VIOFORM HC TOPICAL CREAM
TOP
CRM
PAL
G
0.9103
00002238617
VIRACEPT 250 MG TABLET
ORL
TAB
AGR
TAB
1.9370
00002248761
VIRACEPT 625 MG TABLET
ORL
TAB
PFI
TAB
4.7106
00002238748
VIRAMUNE 200 MG TABLET
ORL
TAB
BOE
TAB
5.0865
00002367289
VIRAMUNE XR 400 MG EXTENDED-RELEASE TABLET
ORL
ERT
BOE
TAB
2.5430
00080030855
VISION CARE CAPSULE
ORL
CAP
PLT
CAP
0.8991
00000568627
VISKAZIDE 10/25 MG TABLET
ORL
TAB
TRI
TAB
1.1007
00000568635
VISKAZIDE 10/50 MG TABLET
ORL
TAB
TRI
TAB
1.1007
00000443174
VISKEN 10 MG TABLET
ORL
TAB
TRI
TAB
1.2262
00000417289
VISKEN 15 MG TABLET
ORL
TAB
TRI
TAB
1.7788
00000417270
VISKEN 5 MG TABLET
ORL
TAB
TRI
TAB
0.7182
00002429063
VISTITAN 0.03% OPHTHALMIC SOLUTION
OPH
SOL
SDZ
ML
9.5200
4.5300
Pg 224 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002242367
VISUDYNE 15 MG/VIAL INJECTION
INJ
DEFAUL
VCL
VIAL
1,703.1000
00080044606
VITALUX ADVANCED CAPLET
ORL
TAB
ALC
TAB
0.2083
00080016590
VITALUX CAPLET
ORL
TAB
ALC
TAB
0.2353
00080016683
VITALUX PLUS OMEGA 3 CAPSULE
ORL
CAP
ALC
CAP
0.2100
00002245911
VITALUX TABLET
ORL
TAB
NOV
TAB
0.2398
00002240199
VITALUX TR MULTIVITAMIN/MULTIMINERAL TABLET
ORL
TAB
NCI
TAB
0.2398
00080028004
VITALUX-S PLUS OMEGA-3 CAPSULE
ORL
CAP
ALC
CAP
0.2100
00080016576
VITALUX-S TABLET
ORL
TAB
ALC
TAB
0.2374
00000123137
VITAMIN A & D FORTIFIED CAPSULE
ORL
CAP
JAM
CAP
0.0482
00000297720
VITAMIN A 10,000 IU CAPSULE
ORL
CAP
JAM
CAP
0.0444
00002245311
VITAMIN A 10,000 IU CAPSULE
ORL
CAP
WNP
CAP
0.0260
00080035590
VITAMIN B 100 MG TIME RELEASE TABLET
ORL
TAB
WNP
TAB
0.1575
00000487082
VITAMIN B CMPD 100 SUSTAINED-RELEASE TABLET
ORL
SRT
SWS
TAB
0.1732
00000294853
VITAMIN B1 100 MG TABLET
ORL
TAB
VCL
TAB
0.0900
00000407011
ORL
TAB
JAM
TAB
0.0567
00002239350
ORL
TAB
PMT
TAB
0.0214
00000816078
VITAMIN B1 100 MG/ML INJECTION USP
INJ
DEFAUL
SDZ
ML
2.5370
00000610267
ORL
TAB
LEA
TAB
0.0740
00080009633
ORL
TAB
JPC
TAB
0.0737
00002247479
VITAMIN B100 COMPLEX TABLET
ORL
TAB
WBP
TAB
0.1082
Pg 225 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000450642
VITAMIN B12 100 MCG TABLET
ORL
TAB
VTH
TAB
0.0700
00002023598
ORL
TAB
PMT
TAB
0.0568
00000331015
ORL
TAB
JAM
TAB
0.0567
00002241500
VITAMIN B12 100 MCG/ML INJECTION
INJ
DEFAUL
SDZ
ML
2.3240
00002237736
ORL
TAB
SWS
TAB
0.0420
00080012952
ORL
TAB
JAM
TAB
0.0893
00080006939
ORL
TAB
WNP
TAB
0.0974
00080003575
VITAMIN B12 1000 MCG TIME RELEASE TABLET
ORL
ERT
PMT
TAB
0.0470
00000502758
ORL
TAB
SWS
TAB
0.1397
00000335940
ORL
TAB
JAM
TAB
0.0647
00000305243
ORL
TAB
JAM
TAB
0.0525
00002243767
ORL
TAB
VTH
TAB
0.0465
00000689726
ORL
TAB
SNS
TAB
0.0741
00000329185
ORL
TAB
JAM
TAB
0.0647
00000528846
ORL
TAB
HAL
TAB
0.0300
00002239348
ORL
TAB
PMT
TAB
0.0228
00000122645
ORL
TAB
JAM
TAB
0.0336
00000331031
ORL
TAB
JAM
TAB
0.1051
00000305227
ORL
TAB
JAM
TAB
0.0485
00000341207
VITAMIN C 1000 MG SUSTAINED-RELEASE TABLET
ORL
SRT
JAM
TAB
0.1087
Pg 226 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000305235
VITAMIN C 1000 MG TABLET
ORL
TAB
JAM
TAB
0.0818
00080040321
VITAMIN C 125 MG GUMMY
ORL
DEFAUL
JAM
PIECE
0.1250
00001922378
ORL
TAB
SWS
TAB
0.0479
00001994336
VITAMIN C 500 MG CHEWABLE TABLET
ORL
CTB
JAM
TAB
0.0604
00002243893
VITAMIN C 500 MG CHEWABLE TABLET
ORL
CTB
PMT
TAB
0.0333
00000237116
VITAMIN C 500 MG ORANGE FLAVORED CHEWABLE TABLET
ORL
CTB
TEV
TAB
0.0257
00000373699
VITAMIN C 500 MG SUSTAINED-RELEASE CAPSULE
ORL
SRC
JAM
CAP
0.0967
00002163268
ORL
TAB
JAM
TAB
0.0403
00002240883
ORL
TAB
WNP
TAB
0.0359
00000036188
ORL
TAB
WAM
TAB
0.0400
00080020803
VITAMIN C 500 MG TIMED RELEASE CAPLET
ORL
SRT
JAM
TAB
0.0804
00000463108
VITAMIN C CHEWABLE TABLET
ORL
TAB
GAH
TAB
0.0970
00080001870
VITAMIN D 1,000 IU TAB
ORL
TAB
SIS
TAB
0.0440
00080017530
VITAMIN D 1000 IU CAPSULE
ORL
CAP
JAM
CAP
0.0351
00080000436
VITAMIN D 1000 IU TABLET
ORL
TAB
JAM
TAB
0.0444
00080006264
ORL
TAB
GFR
TAB
0.0500
00000323179
VITAMIN D 1000 UNIT TABLET
ORL
TAB
SWS
TAB
0.0305
00080009578
ORL
TAB
VCL
TAB
0.0236
00002229879
ORL
TAB
SWS
TAB
0.0398
00000765384
ORL
TAB
LCO
TAB
0.0400
Pg 227 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002242175
ORL
TAB
JAM
TAB
0.0433
00080002452
ORL
TAB
WNP
TAB
0.0180
00002240858
ORL
TAB
PMT
TAB
0.0117
00002240624
ORL
TAB
WAM
TAB
0.0161
00080018025
VITAMIN D DROPS 400 IU
ORL
LIQ
JAM
ML
0.9316
00080015280
VITAMIN D3 1000 IU CAPSULE
ORL
GEL
VTH
CAP
0.0415
00080012124
VITAMIN D3 1000 IU ORAL LIQUID
ORL
LIQ
WBP
ML
0.1948
00002245842
VITAMIN D3 1000 IU TABLET
ORL
TAB
PMT
TAB
0.0178
00080003663
VITAMIN D3 1000 IU TABLET
ORL
TAB
WNP
TAB
0.0327
00080027799
VITAMIN D3 DROPS 1000 IU ORAL LIQUID
ORL
DPS
JMS
ML
0.9360
00000480924
VITAMIN E 100 IU NATURAL SOURCE CAPSULE
ORL
CAP
VTH
CAP
0.0468
00000122823
VITAMIN E 100 IU OBLONG AMBER CAPSULE
ORL
CAP
JAM
CAP
0.0638
00000332348
VITAMIN E 200 IU CAPSULE (NATURAL)
ORL
CAP
LDL
CAP
0.0629
00000122831
ORL
CAP
JAM
CAP
0.0821
00000266108
VITAMIN E 400 IU CAPSULE
ORL
CAP
PMT
CAP
0.0542
00000782181
ORL
CAP
VTH
CAP
0.0816
00002240967
ORL
CAP
WNP
CAP
0.0541
00000480940
ORL
CAP
VTH
CAP
0.0741
00000332356
VITAMIN E 400 IU CAPSULE (NATURAL)
ORL
CAP
LDL
CAP
0.0539
00000122858
ORL
CAP
JAM
CAP
0.1058
Pg 228 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00080013178
VITAMIN E 400 IU SOFTGEL CAPSULE
ORL
CAP
JMS
CAP
0.1058
00000330191
ORL
CAP
JAM
CAP
0.2814
00002015293
VITAMIN E NATURAL SOURCE 400 UNIT CAPSULE
ORL
CAP
QVS
CAP
0.0592
00000201995
VITAMIN E NF NATURAL SOURCE 400 IU CAPSULE
ORL
CAP
WAM
CAP
0.1165
00080030153
VITAMIN K2 100 MCG CAPSULE
ORL
CAP
NFN
CAP
0.1248
00000480878
VITAMINE B12 1200 MCG SUSTAINED-RELEASE TABLET
ORL
SRT
JAM
TAB
0.1013
00000816175
VITAMINE C 600 MG CAPSULE
ORL
CAP
SIS
CAP
0.2112
00002417995
VITAMINE D 10 000 10000 UNIT TABLET
ORL
TAB
PDL
TAB
0.2100
00002248361
VIVAXIM INJECTION
INJ
DEFAUL
SFP
SYR
80.7000
00080028217
VIVISCAL MAXIMUM STRENGTH TABLET
ORL
TAB
IRI
TAB
0.9998
00000013765
VIVOL 5 MG TABLET
ORL
TAB
AXS
TAB
0.0858
00000885975
VIVOTIF BERNA 6 B CAPSULE
ORL
CAP
SSV
CAP
5.8600
00002307073
VOLIBRIS 10 MG TABLET
ORL
TAB
GSK
TAB
122.5200
00002307065
VOLIBRIS 5 MG TABLET
ORL
TAB
GSK
TAB
122.5200
00002290375
VOLTAREN EMULGEL 1.16% TOPICAL GEL
TOP
GEL
NVC
G
0.1297
00002393190
VOLTAREN EMULGEL EXTRA STRENGTH 2.32% TOPICAL GEL
TOP
GEL
GKC
G
0.1073
00002338580
VOLTAREN EMULGEL JOINT PAIN 1.16% TOPICAL GEL
TOP
GEL
NVC
G
0.1124
00000881635
VOLTAREN RAPIDE 50 MG TABLET
ORL
TAB
NOV
TAB
0.9286
00002381966
VORICONAZOLE 200 MG/VIAL INJECTION
INJ
DEFAUL
SDZ
VIAL
130.0800
00002352303
VOTRIENT 200 MG TABLET
ORL
TAB
NOV
TAB
34.4100
Pg 229 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002357119
VPRIV 400 UNIT/VIAL INJECTION
INJ
DEFAUL
SHG
VIAL
1,955.0000
00080037590
VSL #3 ORAL POWDER
ORL
PWR
FEI
PCKT
3.1000
00002365561
VYLOMA 3.75% TOPICAL CREAM
TOP
CRM
VCL
G
38.6667
00002439603
VYVANSE 10 MG CAPSULE
ORL
CAP
SHB
CAP
2.1839
00080006877
WAMPOLE MINERAL CALCIUM ORAL LIQUID
ORL
LIQ
JPC
ML
0.0350
00080008041
WAMPOLE MULTIVITAMIN LIQUID
ORL
LIQ
WAM
ML
0.0350
00002344025
WARFARIN 1 MG TABLET
ORL
TAB
SNS
TAB
0.0780
00002344114
ORL
TAB
SNS
TAB
0.1187
00002344033
ORL
TAB
SNS
TAB
0.0825
00002344041
WARFARIN 2.5 MG TABLET
ORL
TAB
SNS
TAB
0.0660
00002344068
ORL
TAB
SNS
TAB
0.1023
00002344076
ORL
TAB
SNS
TAB
0.1023
00002344084
ORL
TAB
SNS
TAB
0.0662
00001948970
WASP VENOM PROTEIN 1.1 MG
INJ
DEFAUL
ALG
VIAL
41.4833
00001910787
WEBBER OINTMENT VITAMIN E 30 IU/G TOPICAL OINTMENT
TOP
ONT
JLF
G
0.1116
00080002343
WELLESSE JOINT MOVEMENT GLUCOSAMINE LIQUID
ORL
LIQ
BOT
ML
0.0284
00080024468
WESTCOAST NATURALS CALCIUM MAGNES. PHOS. VIT D LIQ
ORL
LIQ
WES
ML
0.0347
00080018599
WESTCOAST NATURALS VITAMIN B12 1000 MCG TABLET
ORL
TAB
WES
TAB
0.1277
00001949004
WHITE FACED HORNET VENOM 120 MCG
INJ
DEFAUL
ALG
VIAL
35.6833
00002136740
WOBENZYM N TABLET
ORL
TAB
MUC
TAB
0.3497
Pg 230 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002424703
WOMEN'S ROGAINE FOAM 5% AEROSOL FOAM
TOP
FOA
JJI
G
00002384256
XALKORI 200 MG CAPSULE
ORL
CAP
PFI
CAP
130.0000
00002384264
XALKORI 250 MG CAPSULE
ORL
CAP
PFI
CAP
130.0000
00000548359
XANAX 0.25 MG TABLET
ORL
TAB
PFI
TAB
0.2814
00000548367
XANAX 0.5 MG TABLET
ORL
TAB
PFI
TAB
0.3366
00000723770
XANAX 1 MG TABLET
ORL
TAB
PFI
TAB
0.6117
00000813958
XANAX TS 2 MG TABLET
ORL
TAB
PFI
TAB
1.0871
00002441535
XARELTO 15 MG / 20 MG TABLET STARTER PACK
ORL
TAB
BAI
TAB
2.8400
00002238453
XELODA 150 MG TABLET
ORL
TAB
HLR
TAB
1.8833
00002238454
XELODA 500 MG TABLET
ORL
TAB
HLR
TAB
6.2780
00002240325
XENICAL 120 MG CAPSULE
ORL
CAP
HLR
CAP
1.6574
00002404044
XERESE 5%/1% TOPICAL CREAM
TOP
CRM
VCL
G
7.1480
00002368153
XGEVA 120 MG/VIAL INJECTION
INJ
DEFAUL
AMG
VIAL
567.3300
00002388316
XIAFLEX 0.9 MG/VIAL INJECTION
INJ
DEFAUL
ACT
VIAL
1,169.7000
00002449943
XIGDUO 5 MG/1000 MG TABLET
ORL
TAB
AZC
TAB
1.3100
00002449935
XIGDUO 5 MG/850 MG TABLET
ORL
TAB
AZC
TAB
1.3100
00080036707
X-PUR 100% XYLITOL GUM 1.06 G ORAL GUM
ORL
GUM
ORS
PIECE
0.1422
00000866598
X-SEB PLUS CONDITIONING TOPICAL SHAMPOO
TOP
SHP
BAK
ML
0.0639
00000866601
X-SEB T PLUS CONDITIONING TOPICAL SHAMPOO
TOP
SHP
BAK
ML
0.0639
00000509906
X-SEB T TOPICAL SHAMPOO
TOP
SHP
PMS
ML
0.0639
0.7697
Pg 231 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002407329
XTANDI 40 MG CAPSULE
ORL
CAP
ASP
CAP
28.3450
00000001791
XYLOCAINE 1% W EPINEPHRINE 1:100,000 INJ
INJ
DEFAUL
AZC
ML
0.3820
00000385484
XYLOCAINE 2% TOPICAL JELLY
URH
JEL
AZC
ML
0.9170
00002373130
XYLOCAINE 2% W EPINEPHRINE 1:200,000 INJECTION
ORL
DEFAUL
AZC
VIAL
0.3820
00000001732
XYLOCAINE HCL 1% LIQUID (BLOCK OR INFILTRATION)
INJ
LIQ
AZC
ML
0.9720
00000036641
XYLOCAINE HCL 2% PLAIN LIQ (BLOCK OR INFILTRATION)
INJ
LIQ
AZC
ML
1.1640
00002268272
XYREM 500 MG/ML ORAL SOLUTION
ORL
SOL
VCL
ML
2.6868
00002321157
YAZ 28 TABLET
ORL
TB
BAI
TAB
0.5771
00002387433
YAZ PLUS 28 TABLET
ORL
TB
BAI
TAB
0.4229
00001948954
YELLOW JACKET VENOM PROTEIN 1.1 MG
INJ
DEFAUL
ALG
VIAL
35.6833
00001948962
YELLOW JACKET VENOM PROTEIN 120 MCG
INJ
DEFAUL
ALG
VIAL
35.6833
00002379384
YERVOY INTRAVENOUS INFUSION 5 MG/ML INJECTION
INJ
DEFAUL
BMS
ML
580.0000
00000428833
YF-VAX 109648 U/0.5 ML INJECTION
INJ
DEFAUL
SFP
VIAL
128.2080
00000795283
YOCON 5.4 MG TABLET
ORL
TAB
GLE
TAB
0.5568
00000885533
YOHIMBINE-ODAN 2 MG TABLET
ORL
TAB
ODN
TAB
0.5010
00001901885
YOHIMBINE-ODAN 5.4 MG TABLET
ORL
TAB
ODN
TAB
0.7650
00000600784
ZADITEN 0.2 MG/ML ORAL SYRUP
ORL
SYR
TEV
ML
0.4961
00002279223
ZADITOR (PRESERVATIVE FREE) 0.25 MG/ML OPH SOL
OPH
SOL
NOV
ML
3.5283
00002242324
ZADITOR 0.25 MG/ML OPH SOLUTION
OPH
SOL
LTH
ML
5.2920
00002239170
ZANAFLEX 4 MG TABLET
ORL
TAB
PAL
TAB
0.7862
Pg 232 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002230287
ZANTAC 75 MG TABLET
ORL
TAB
GSK
TAB
0.4060
00000568392
ZAPEX 10 MG TABLET
ORL
TAB
RIV
TAB
0.0420
00000568406
ZAPEX 15 MG TABLET
ORL
TAB
RIV
TAB
0.0660
00000568414
ZAPEX 30 MG TABLET
ORL
TAB
RIV
TAB
0.0900
00002250519
ZAVESCA 100 MG CAPSULE
ORL
CAP
ACT
CAP
108.5500
00002246740
Z-BEC STRESSTABS TABLET
ORL
TAB
WCH
TAB
0.1653
00000237213
ZEASORB MEDICATED TOPICAL POWDER
TOP
PWR
GSK
G
0.1450
00002380242
ZELBORAF 240 MG FILM-COATED TABLET
ORL
TAB
HLR
TAB
34.1355
00002108208
ZEMURON 10 MG/ML INJECTION
INJ
DEFAUL
MFC
ML
1.0260
00002361752
ZENHALE 100 MCG/5 MCG/DOSE METERED DOSE AEROSOL
INH
AEM
MFC
DOSE
0.7443
00002361760
INH
AEM
MFC
DOSE
0.9020
00002361744
INH
AEM
MFC
DOSE
0.5762
00002451131
ZEPATIER 50 MG/100 MG TABLET
ORL
TAB
MFC
TAB
717.8571
00002216086
ZERIT 15 MG CAPSULE
ORL
CAP
BMS
CAP
4.7508
00002216094
ZERIT 20 MG CAPSULE
ORL
CAP
BMS
CAP
4.9400
00002216108
ZERIT 30 MG CAPSULE
ORL
CAP
BMS
CAP
5.1525
00002216116
ZERIT 40 MG CAPSULE
ORL
CAP
BMS
CAP
5.3417
00002240358
ZIAGEN 20 MG/ML ORAL SOLUTION
ORL
SOL
GSK
ML
0.4568
00002240357
ZIAGEN 300 MG TABLET
ORL
TAB
GSK
TAB
6.9655
00000297666
ZINC 10 MG TABLET
ORL
TAB
JAM
TAB
0.0473
Pg 233 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00000441589
ZINC 25 MG TABLET
ORL
TAB
JAM
TAB
0.0631
00000505463
ZINC 50 MG TABLET
ORL
TAB
JAM
TAB
0.0711
00001922351
ZINC 50 MG TABLET
ORL
TAB
SWS
TAB
0.0466
00000480886
ZINC 50 MG TIMED RELEASE TABLET
ORL
TAB
JAM
TAB
0.0877
00080012983
ZINC COPPER BALANCE 15 MG/2 MG CAPSULE
ORL
CAP
AOR
CAP
0.1550
00002244744
ZINC OXIDE 15 % TOPICAL OINTMENT
TOP
ONT
RWP
G
0.0270
00002239162
ZINCOFAX 15% TOPICAL OINTMENT
TOP
ONT
PAL
G
0.0748
00002239160
ZINCOFAX EXTRA STRENGTH 40% TOPICAL OINTMENT
TOP
ONT
PDH
G
0.0595
00002153432
ZINECARD 250 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
137.0600
00002153440
ZINECARD 500 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
274.1400
00002239952
ZITHROMAX 500 MG/VIAL INJECTION
INJ
DEFAUL
PFI
VIAL
22.1810
00002354802
ZMAX SR 27 MG/ML ORAL SUPENSION
ORL
SUS
PFI
ML
0.5322
00000884324
ZOCOR 5 MG TABLET
ORL
TAB
MFC
TAB
1.0839
00002421550
ZOLEDRONIC ACID 4 MG/5 ML INJECTION
INJ
DEFAUL
HSP
ML
415.5600
00002413701
ZOLEDRONIC ACID CONCENTRATE 4 MG/5 ML INJECTION
INJ
DEFAUL
OMG
ML
38.7856
00002327619
ZOLINZA 100 MG CAPSULE
ORL
CAP
MFC
CAP
76.1795
00002379929
ZOLMITRIPTAN 2.5 MG TABLET
ORL
TAB
PDL
TAB
3.5375
00002379988
ZOLMITRIPTAN ODT 2.5 MG ORALLY DISPERSIBLE TABLET
ORL
DISPTAB
PDL
TAB
3.5375
00002248992
ZOMIG 2.5 MG NASAL SPRAY
NAS
SPU
AZC
DOSE
14.6100
00002315939
ZOSTAVAX 19,400 UNITS/(0.65 ML) VIAL INJECTION
INJ
DEFAUL
MFC
VIAL
157.5000
Pg 234 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002375516
ZOSTAVAX II 19,400 UNITS/(0.65 ML) VIAL INJECTION
INJ
DEFAUL
MFC
VIAL
00000740306
ZOSTRIX 0.025% TOPICAL CREAM
TOP
CRM
GEU
G
0.2192
00002004240
ZOSTRIX H.P. 0.075% TOPICAL CREAM
TOP
CRM
GEU
G
0.2800
00000634506
ZOVIRAX 200 MG TABLET
ORL
TAB
GSK
TAB
1.3259
00002039524
ZOVIRAX 5% TOPICAL CREAM
TOP
CRM
VCL
G
13.5620
00000569771
ZOVIRAX 5% TOPICAL OINTMENT
TOP
ONT
VCL
G
13.5640
00000800686
Z-PLUS TOPICAL SHAMPOO
TOP
SHP
DLX
ML
0.0956
00002354772
ZUACTA 0.075% TOPICAL CREAM
TOP
CRM
SAV
G
1.8478
00002340445
ZYCLARA 3.75% TOPICAL CREAM
TOP
CRM
VCL
G
39.8267
00002438798
ZYDELIG 100 MG TABLET
ORL
TAB
GIL
TAB
85.3500
00002438801
ZYDELIG 150 MG TABLET
ORL
TAB
GIL
TAB
85.3500
00002436779
ZYKADIA 150 MG CAPSULE
ORL
CAP
NOV
CAP
67.4666
00002342804
ZYM-AMLODIPINE 10 MG TABLET
ORL
TAB
ZMC
TAB
0.3587
00002342790
ZYM-AMLODIPINE 5 MG TABLET
ORL
TAB
ZMC
TAB
0.2417
00002257270
ZYMAR 0.3% OPHTHALMIC SOLUTION
OPH
SOL
ALL
ML
2.7100
00002338106
ZYM-CARVEDILOL 12.5 MG TABLET
ORL
TAB
ZMC
TAB
0.8001
00002338114
ZYM-CARVEDILOL 25 MG TABLET
ORL
TAB
ZMC
TAB
0.8001
00002338068
ORL
TAB
ZMC
TAB
0.8001
00002338092
ORL
TAB
ZMC
TAB
0.8001
00002345676
ZYM-CLONAZEPAM 0.5 MG TABLET
ORL
TAB
ZMC
TAB
0.1166
173.3000
Pg 235 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002303329
ZYM-CLONAZEPAM 1 MG TABLET
ORL
TAB
ZMC
TAB
0.1860
00002303337
ZYM-CLONAZEPAM 2 MG TABLET
ORL
TAB
ZMC
TAB
0.2010
00002302659
ZYM-FLUOXETINE 10 MG CAPSULE
ORL
CAP
ZMC
CAP
1.1773
00002302667
ZYM-FLUOXETINE 20 MG CAPSULE
ORL
CAP
ZMC
CAP
1.0112
00002325179
ZYM-MIRTAZAPINE 15 MG TABLET
ORL
TAB
ZMC
TAB
0.3750
00002325187
ZYM-MIRTAZAPINE 30 MG TABLET
ORL
TAB
ZMC
TAB
0.7800
00002344440
ZYM-ONDANSETRON 4 MG TABLET
ORL
TAB
ZMC
TAB
7.5453
00002344459
ZYM-ONDANSETRON 8 MG TABLET
ORL
TAB
ZMC
TAB
11.5170
00002320754
ZYM-PIOGLITAZONE 15 MG TABLET
ORL
TAB
ZMC
TAB
1.5716
00002320762
ORL
TAB
ZMC
TAB
2.2017
00002320770
ORL
TAB
ZMC
TAB
3.3105
00002303817
ZYM-SERTRALINE 100 MG (BASE) CAPSULE
ORL
CAP
ZMC
CAP
1.1025
00002303779
ORL
CAP
ZMC
CAP
0.5040
00002303809
ORL
CAP
ZMC
CAP
1.0080
00002325144
ZYM-TOPIRAMATE 100 MG TABLET
ORL
TAB
ZMC
TAB
1.2537
00002325152
ORL
TAB
ZMC
TAB
1.9845
00002325136
ORL
TAB
ZMC
TAB
0.6615
00002238851
ZYPREXA 20 MG TABLET
ORL
TAB
LIL
TAB
14.3775
00002243088
ZYPREXA ZYDIS 15 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
LIL
TAB
10.7111
00002243089
ZYPREXA ZYDIS 20 MG ORALLY DISINTEGRATING TABLET
ORL
DISNTAB
LIL
TAB
14.2643
Pg 236 of 237
DIN/ PIN/ NPN
Product Description
Route
Form
MFR
Unit of Issue
Base Price
00002371065
ZYTIGA 250 MG TABLET
ORL
TAB
JAI
TAB
29.5910
00002360349
ZYTRAM XL 100 MG EXTENDED-RELEASE TABLET
ORL
ERT
PUR
TAB
1.1660
00002286424
ZYTRAM XL 150 MG CONTROLLED-RELEASE TABLET
ORL
CRT
PUR
TAB
1.7130
00002286432
ORL
CRT
PUR
TAB
2.2490
00002286440
ORL
CRT
PUR
TAB
3.2640
00002286459
ORL
CRT
PUR
TAB
4.2840
00002360322
ZYTRAM XL 75 MG EXTENDED-RELEASE TABLET
ORL
ERT
PUR
TAB
0.8990
00002243685
ZYVOXAM 2 MG/ML INJECTION
INJ
DEFAUL
PFI
ML
0.3515
00002243686
ZYVOXAM 20 MG/ML ORAL SUSPENSION
ORL
SUS
PFI
ML
2.5793
Pg 237 of 237

Alberta Blue Cross Drug Price List

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