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Acute Care Hospitals
Centennial Hills Hospital Medical Center
3.0
Financial Assistance
You May Qualify for Free or Discounted Care
- Free care reviewed case by case — call to apply
- Discount reviewed case by case — call to apply
- Processing Time: Typically 21–30 days from a complete application.
- Required Documents: 6
ProcedureScout is independent — we are not paid by hospitals, financial assistance programs, applications, or referrals. Whether you qualify depends on each hospital's rules and a final review.
All Procedure Prices
Insurance:
| Procedure | CPT | Price |
|---|---|---|
| CT CEREBRL PERFUSION WCON | 0042T | $2,396 |
| FNA BX W/FLUOR GDN 1ST LES | 10007 | $1,473 |
| FNA BX W/CT GDN 1ST LES | 10009 | $5,964 |
| FNA BX W/CT GDN EA ADDL | 10010 | $2,145 |
| IMAGE CATH FLUID SOFT TIS | 10030 | $7,558 |
| PERQ DEV SOFT TISS 1ST IMAG | 10035 | $919 |
| I D HEMATOMA/SEROMA/FLUID | 10140 | $3,607 |
| ASP ABSC/HEMA/CYST/BULLA | 10160 | $1,274 |
| BX MUSCLE NEEDLE PERC | 20206 | $3,104 |
| SCREW AUTO-DRIVE OSTEOMED 1.6MM X 5MM | 20610 | $462 |
| ROD LEGACY 5.5MM X 500MM | 27130 | $24,264 |
| APPLY FOREARM SPLINT | 29125 | $276 |
| PLATE VARIAX CLAV SUP MIDSHAFT TI STD 10H 122MM RT | 29881 | $5,315 |
| Intubation, endotracheal, emergency procedure | 31500 | $1,131 |
| Tracheotomy tube change prior to establishment of fistula tract | 31502 | $484 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate pr | 31622 | $2,035 |
| STENT PROTEGE GPS 6F .035 14X30 80CM | 31720 | $294 |
| DILATOR PULMONARY BALLOON CRE 3.0CM 12-15MM | 32408 | $7,948 |
| IMPLANT ENDOSKELETON TL 7DEG LORDOTIC 55X22X12MM | 32550 | $7,681 |
| HC ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX | 36600 | $159 |
| CATH PACIFIC EXTREME PTA BLN 130CM 5X200MM | 36620 | $396 |
| Diagnostic bone marrow; aspiration(s) Non-Facility Wound Care | 38220 | $2,662 |
| HC BONE MARROW BX; NEEDLE/TROCAR | 38221 | $2,284 |
| VALVE POLARIS ADJ 30-200 INLINE RESERVR SOPHYSA | 38222 | $1,083 |
| SCREW ASNIS III TI CANN P/T 5.0X55MM | 38505 | $3,174 |
| TEMPLATE PLT STRT 20H | 42400 | $919 |
| CANNULATED SCREW ACUMED 4.0-4.2 | 47490 | $5,173 |
| CLAMP 5MM PIN X 5MM ROD | 49082 | $1,579 |
| THREADED HALF PIN 2.0MM X 20MM X 75MM | 49083 | $4,153 |
| THREADED HALF PIN 3.0MM X 15MM X 100MM | 49084 | $4,153 |
| SCREW EX FIX 160MM 6MM SCHNZ SS SPD PNT LG XTRNFXTR NS | 49185 | $2,443 |
| SCREW WORKHORSE 3.5MM X 36MM | 49406 | $6,106 |
| HC CRYOTHERAPY PERC RNL TUMOR ABLAT | 50593 | $5,458 |
| Aspiration of bladder; with insertion of suprapubic catheter Non-Facility Colon and Rectal Surgery | 51102 | $6,578 |
| CT EXT UP WO/W CON LT | 53411203 | $4,692 |
| CT EXT UP WO/W CON RT | 53411302 | $4,692 |
| CT EXT LOW W/O CON LT | 53411401 | $3,156 |
| CT EXT LOW W/O CON RT | 53411500 | $3,156 |
| CT EXT LOW W/CON LT | 53411609 | $3,821 |
| CT EXT LOW W/CON RT | 53411708 | $3,821 |
| CT EXT LOW WO/W CON LT | 53411807 | $4,103 |
| CT EXT LOW WO/W CON RT | 53411906 | $4,103 |
| CT EXT UP W/O CON BIL | 53413209 | $5,456 |
| CT EXT UP W/ CON BIL | 53413308 | $7,101 |
| CT EXT UP WO/W CON BIL | 53413407 | $8,731 |
| CT EXT LOW W/O CON BIL | 53413506 | $5,914 |
| CT EXT LOW W/CON BIL | 53413605 | $6,691 |
| CT EXT LOW WO/W CON BIL | 53413704 | $8,712 |
| CTA HEAD W/WO CON | 53413803 | $4,863 |
| CTA HEAD W/WO CON LTD | 53413852 | $3,852 |
| CTA NECK W/WO CON | 53413902 | $4,863 |
| CTA NECK W/WO CON LTD | 53413951 | $3,852 |
| CTA CHEST W/WO CON | 53414009 | $7,681 |
| CTA CHEST W/WO CON LTD | 53414058 | $4,160 |
| CTA PELVIS W/WO CON | 53414108 | $7,262 |
| CTA EXT UP W/WO LT | 53414256 | $7,697 |
| CTA EXT UP W/WO RT | 53414355 | $7,697 |
| CTA EXT LOW WO/W BIL | 53414454 | $8,967 |
| CTA EXT LOW WO/W LT | 53414504 | $7,681 |
| CTA EXT LOW WO/W LT LTD | 53414553 | $4,151 |
| CTA EXT LOW WO/W RT | 53414603 | $7,681 |
| CTA EXT LOW WO/W RT LTD | 53414652 | $4,151 |
| CTA ABD WO/W CONT | 53414702 | $7,262 |
| CTA AAA ILIO RUNOFF | 53414751 | $8,967 |
| CTA AAA ILIO RUNOFF LTD | 53414801 | $7,262 |
| CT GUIDE NDL PLACEMENT S/I | 53414850 | $3,047 |
| CT EXT UP W/O CON LT LTD | 53470001 | $2,461 |
| CT EXT UP W/O CON RT LTD | 53470100 | $2,461 |
| CT EXT LOW W/O CON LT LTD | 53470605 | $2,416 |
| CT EXT LOW W/O CON RT LTD | 53470704 | $2,461 |
| CT EXT LOW W/CON LT LTD | 53470803 | $2,520 |
| CT EXT LOW W/CON RT LTD | 53470902 | $2,520 |
| CT HEART W/O CON W/CALCIUM | 53471116 | $6,080 |
| CT GUIDE FOR TISSUE ABLATION | 53471223 | $2,504 |
| I AND D APPENDIX ABSCESS PERC | 53471355 | $6,106 |
| FNA W/IMAGING GUIDANCE | 53471363 | $5,964 |
| I AND D HEMATOMA | 53471371 | $3,607 |
| BX SOFT TISSUE NECK/THORAX | 53471397 | $3,104 |
| 3D CT RENDER W/O POSTPROCESS | 53471694 | $2,776 |
| 3D CT RENDER W/ POSTPROCESS | 53471702 | $3,113 |
| MODERATE SEDATION EA ADD 15MIN | 53472148 | $133 |
| BX LYMPH NODES SUPERFICIAL | 53472189 | $3,174 |
| PUNCT/ASP ABCESS HEMAT CYST | 53472288 | $1,274 |
| ABLATE CRYOTHERPY RENAL UNILAT | 53472304 | $5,458 |
| CHOLECYSTOSTOMY PERC | 53472411 | $5,173 |
| ASPIRATION PERQ INTERDISC DX | 53472973 | $1,366 |
| INJ/ASPIR JNT/BURSA MAJOR LT | 53472981 | $462 |
| INJ/ASPIR JNT/BURSA MAJOR RT | 53472999 | $462 |
| INSERT PLEURAL TUNNEL CATH | 53473278 | $7,681 |
| BX THYROID PERC CORE NEEDLE | 53473328 | $1,347 |
| CT ABD PELVIS W/O CON | 53473518 | $6,250 |
| CT ABD PELVIS W/CON | 53473526 | $8,750 |
| CT ABD PELVIS AND OR WO/W CON | 53473534 | $9,083 |
| CT PERFUSION W/CON CBF/VOLUME | 53473625 | $2,396 |
| PARACENTESIS ABD W/O IMAGE | 53473641 | $1,579 |
| PARACENTESIS ABD W/IMAGE | 53473658 | $4,153 |
| PERITONEAL LAVAGE W/WO IMAGE | 53473666 | $4,153 |
| CTA ABD AND PELVIS W/WO CON | 53473674 | $16,286 |
| INSERT SUPRAPUBIC CATH | 53473716 | $6,578 |
| BX PELVIS SOFT TISS SUPERFCL | 53473781 | $2,002 |
| BX PELVIS SOFT TISSUE DEEP | 53473799 | $3,104 |
| BONE MARROW BX NDL/TROCAR | 53474029 | $2,284 |
| BX NDLE SALIVARY GLAND | 53474037 | $919 |
| ASPIRATE AND BX BONE MARROW | 53474045 | $1,083 |
| ASPIRATION ONLY BONE MARROW | 53474052 | $2,662 |
| CT DRAIN ABSC HEMAT/CYST | 53474060 | $7,558 |
| INJ ANES CELIAC PLEXUS | 53474078 | $2,133 |
| SCLERO TX FLUID COLLECTION | 53474227 | $2,443 |
| RENAL CYST STUDY LT S/I | 53474235 | $1,452 |
| RENAL CYST STUDY RT S/I | 53474243 | $1,452 |
| BX ADRENAL PERC NDL RT | 53474284 | $3,174 |
| BX ADRENAL PERC NDL LT | 53474292 | $2,400 |
| BX ADRENAL PERC NDL BIL | 53474300 | $3,600 |
| PLACE SOFT TIS DEV 1ST LESION | 53474318 | $919 |
| MODERATE SEDATION >5YRS 15MIN | 53474334 | $153 |
| FNA W/CT GUIDE EA ADDL | 53474441 | $2,145 |
| FNA W/FLUORO GUIDANCE | 53474458 | $1,473 |
| BX LUNG/MED CORE W/IMAGE LT | 53474748 | $7,948 |
| BX LUNG/MED CORE W/IMAGE RT | 53474755 | $7,948 |
| BX LUNG/MED NDL FNA EA ADDL | 53474763 | $2,145 |
| CTA HEAD W/WO CON W/ AI | 53474797 | $4,863 |
| BX LUNG/MED CORE W/IMAGE | 53474896 | $3,577 |
| INJ EPIDURAL BLOOD/CLOT PATCH | 53475166 | $1,983 |
| CT HEART WCON 3D/FX EVAL | 53475174 | $5,270 |
| CT HEART W/CON 3D/FX CONGENTIL | 53475182 | $5,217 |
| CTA HEART W/CON 3D/FX EVAL | 53475190 | $8,680 |
| CARDIOVERSION EXTERNAL | 53500039 | $1,431 |
| EKG TRACING | 53500047 | $638 |
| STRESS TEST TRACING | 53500062 | $1,396 |
| RHYTHM ECG 1-3 LEAD TRACING | 53500096 | $515 |
| HOLTER HOOK UP W/RECORD | 53500104 | $1,630 |
| DOPPLER ECHO COMP ADDON | 53500237 | $516 |
| DOPPLER COLOR FLOW ADDON | 53500245 | $576 |
| STRESS TEST WITH PHARM | 53500625 | $1,396 |
| 2-D ECHO TTE COMP NO CONTRST | 53501490 | $2,151 |
| STRESS ECHO TTE NO CONTRST | 53501540 | $1,339 |
| 2-D ECHO TTE COMP W/CONTRST | 53501573 | $2,279 |
| STRESS ECHO TTE W/CONTRST | 53501623 | $1,339 |
| EEG 41-60 MIN | 53600029 | $1,896 |
| EEG AWAKE AND ASLEEP | 53600052 | $1,580 |
| EEG COMA OR SLEEP ONLY | 53600060 | $1,799 |
| EEG BRAIN DEATH | 53600078 | $2,192 |
| SOMAT TEST UPPER LIMBS | 53600342 | $1,821 |
| SOMAT TEST LOWER LIMBS | 53600359 | $1,821 |
| VISUAL EVOKED POTENTIAL TEST | 53600375 | $1,316 |
| NEUROMUSC JUNC TEST EACH NERV | 53600417 | $292 |
| EEG NONINTRACRANIAL SURGERY | 53600466 | $3,000 |
| NERVE CONDUCTION STUDY 5-6 | 53601480 | $650 |
| NERVE CONDUCTION STUDY 7-8 | 53601498 | $866 |
| NERVE CONDUCTION STUDY 9-10 | 53601506 | $1,731 |
| NERVE CONDUCTION STUDY 11-12 | 53601514 | $1,922 |
| NERVE CONDUCTION STUDY 13+ | 53601522 | $3,462 |
| EEG 61-119 MINUTES | 53601886 | $1,799 |
| EEG W/VIDEO 2-12HR REALTIME | 53601928 | $1,793 |
| EEG W/VIDEO 12-26HR REALTIME | 53601951 | $3,585 |
| TEE PROBE PLACE ONLY 483 | 53800090 | $4,144 |
| TEE ANOMALY PROBE PLACE 483 | 53800124 | $6,662 |
| DOPPLER ECHO COMP ADDON | 53800157 | $580 |
| DOPPLER COLOR FLOW ADDON | 53800173 | $671 |
| PHYSIO ART EXT LOW BIL SNGL | 53800256 | $2,818 |
| PHYSIO ART EXT UP BIL SNGL | 53800264 | $2,818 |
| PHYSIO ART EXT LOW BIL MUL | 53800298 | $4,798 |
| PHYSIO ART EXT UP BIL MUL | 53800306 | $4,798 |
| PHYSIO ART EXT LOW BIL MUL 52 | 53800314 | $2,001 |
| PHYSIO ART EXT UP BIL MUL 52 | 53800322 | $2,001 |
| DUPLEX ARTERIAL EXT LOW BIL | 53800348 | $1,685 |
| DUPLEX ARTERIAL EXT UP BIL | 53800389 | $1,880 |
| IV PUSH INITIAL DRUG | 53800769 | $169 |
| IV PUSH ADDL NEW DRUG | 53800777 | $172 |
| TTE CONG ABN COMP NO CONTRST | 53800785 | $2,279 |
| 2-D ECHO TTE COMP NO CONTRST | 53800793 | $2,856 |
| 2-D ECHO TTE NO CONTRST LTD | 53800801 | $1,930 |
| TEE PROBE PLACE I/RPT NO CON | 53800819 | $4,690 |
| STRESS ECHO TTE NO CONTRST | 53800843 | $1,339 |
| TTE CONG ABN COMP W/CONTRST | 53800850 | $2,279 |
| 2-D ECHO TTE COMP W/CONTRST | 53800868 | $2,893 |
| 2-D ECHO TTE W/CONTRST LTD | 53800876 | $2,581 |
| TEE PROBE PLACE I/RPT W/CON | 53800884 | $4,824 |
| STRESS ECHO TTE W/CONTRST | 53800918 | $1,339 |
| TTE W/DOPPLER COMPLETE | 53800942 | $4,238 |
| TTE W/DOPPLER COMPLETE W/CON | 53800959 | $1,898 |
| STRESS TTE COMPLETE W/CONTRAST | 53800967 | $1,898 |
| STRESS TTE COMPLETE | 53800975 | $4,238 |
| DOPPLER TCD ARTERY COMPLETE | 53801049 | $2,905 |
| MYOCRD STRAIN SPECKL TRCK ADD | 53801247 | $233 |
| RAD TX SIMULAT SIMPLE | 53900106 | $2,119 |
| RAD TX SIMULAT INTERM | 53900205 | $2,119 |
| RAD TX SIMULAT COMP | 53900304 | $2,119 |
| RAD TX 3-D | 53900403 | $2,119 |
| RAD TX MISC | 53900502 | $2,310 |
| BASIC RADIATION DOSIMETRY | 53900601 | $2,119 |
| ISODOSE PLAN SIMP | 53900700 | $2,119 |
| ISODOSE PLAN COMP | 53900908 | $2,119 |
| SPECIAL PORT PLAN | 53901005 | $2,119 |
| SPECIAL DOSIMETRY | 53901401 | $2,119 |
| TRX DEVICE SIMPLE | 53901500 | $2,119 |
| TRX DEVICE INTERM | 53901609 | $2,119 |
| TRX DEVICE COMP | 53901708 | $2,119 |
| CONTINUING PHYSICS | 53901807 | $2,119 |
| SPECIAL PHYSICS | 53901906 | $2,119 |
| UNLISTED PHYSICS/DOSIM/TRX DEV | 53902003 | $2,310 |
| RAD TX SUPERF/ORTHO VOLT | 53902102 | $2,119 |
| RAD TX PORT FILMS | 53903407 | $2,119 |
| RAD TX SPECIAL TREATMENT | 53903605 | $2,119 |
| PROTON TRX SIMPLE NO COMP | 53903803 | $2,119 |
| PROTON TRX COMPLEX | 53903902 | $2,647 |
| HYPERTHERMIA S/F | 53904009 | $2,119 |
| HYPERTHERMIA DEEP | 53904108 | $2,119 |
| HYPERTHERMIA <5 INTERSTIT | 53904207 | $2,119 |
| HYPERTHERMIA >5 INTERSTIT | 53904306 | $2,119 |
| HYPERTHERMIA INTRACAV PROBES | 53904405 | $2,119 |
| INTRACAV RAD APPL SIMPLE | 53904603 | $2,119 |
| INTRACAV RAD APPL INTER | 53904702 | $2,119 |
| INTRACAV RAD APPL COMP | 53904801 | $2,119 |
| INTERSTIT RAD ELEMENT COMP | 53905105 | $2,119 |
| SURFACE APPL RAD ELEM | 53905600 | $2,119 |
| RADIATION ELEMENT HANDLING | 53905709 | $2,119 |
| BRACHY UNLISTED PROC | 53905808 | $2,310 |
| RAD TX SIMULAT SIMPLE LTD | 53906004 | $1,412 |
| TRX DEVICE SIMPLE LTD | 53906301 | $1,412 |
| CONTINUING PHYSICS LTD | 53906400 | $1,412 |
| SPECIAL PHYSICS LTD | 53906509 | $1,412 |
| RAD TX SUPERF/ORTHO VOLT LTD | 53906608 | $1,412 |
| PROTON TRX SIMPLE NO COMP LTD | 53906806 | $2,216 |
| HYPERTHERMIA S/F LTD | 53906905 | $1,412 |
| INTRACAV RAD APPL SIMPLE LTD | 53907200 | $1,412 |
| SURFACE APPL RAD ELEM LTD | 53907408 | $1,412 |
| INFUSE RADIO SOL 3MTH F/UP | 53912283 | $1,961 |
| INFUSE RADIO SOL 3MTH F/UP LTD | 53912291 | $1,306 |
| ACETAZOLAMIDE UP TO 500MG | 54000930 | $610 |
| ACYCLOVIR PER 5MG INJ | 54001532 | $352 |
| ACYCLOVIR PER 5MG INJ | 54001599 | $1,078 |
| ACYCLOVIR PER 5MG INJ | 54001615 | $2,132 |
| ALBUMIN HUMAN 5% 250 ML | 54001813 | $2,443 |
| ALBUMIN HUMAN 5% PER 50ML | 54001839 | $668 |
| ALBUMIN HUMAN 25% 50ML | 54001854 | $2,096 |
| ALBUMIN HUMAN 5% PER 50ML | 54001870 | $1,184 |
| ALPHA 1 PROT INHIBIT PER 10MG | 54002498 | $4,644 |
| AMIKACIN SULF PER 100MG | 54003215 | $4,831 |
| AMIKACIN SULF PER 100MG | 54003231 | $1,526 |
| AMINOPHYLLINE UP TO 250MG | 54003579 | $188 |
| AMINOPHYLLINE UP TO 250MG | 54003595 | $116 |
| AMOBARBITAL SOD UP TO 125MG | 54004213 | $176 |
| AMPHOTERICIN B 50MG VIAL | 54004817 | $971 |
| AMPICILLIN SOD 500MG INJ | 54004932 | $28 |
| AMPICILLIN SOD 500MG INJ | 54004957 | $44 |
| AMPICILLIN SOD PER 500MG | 54004973 | $187 |
| AMPICILLIN SOD PER 500MG | 54005012 | $267 |
| AMPICILLIN SOD 500MG VIAL | 54005053 | $175 |
| AMP SOD/SULBACT PER 1.5GM | 54005111 | $310 |
| AMP SOD/SULBACT 1.5GM INJ | 54005137 | $294 |
| AMP SOD/SULBACT PER 1.5GM | 54005152 | $446 |
| ASPARAGINASE INJ 10000 UNITS | 54006259 | $1,373 |
| AZATHIOPRINE 50MG TAB | 54007232 | $38 |
| AZITHROMYCIN 500MG VIAL | 54007372 | $475 |
| BENZTROPINE MESYL PER 1MG | 54009113 | $554 |
| CELESTONE SOLSPN PER 3MG | 54009238 | $1,175 |
| BUPRENORPHINE PER 0.1MG | 54010954 | $47 |
| BUTORPHANOL 1MG/ML 1ML VIAL | 54011291 | $136 |
| BUTORPHANOL TAR PER 1MG | 54011317 | $284 |
| CAFFEINE CITRATED PER 5MG INJ | 54011390 | $954 |
| CALC/SAL/SYN UP TO 400UNITS | 54011630 | $1,442 |
| CALCITRIOL PER 0.1MCG | 54011713 | $373 |
| CALCIUM GLUC INJ PER 10MG | 54012455 | $58 |
| CARMUSTINE 100MG VIAL | 54013610 | $1,561 |
| CEFAZOLIN SODIUM PER 500MG | 54014311 | $120 |
| CEFAZOLIN SODIUM PER 500MG | 54014337 | $391 |
| CEFAZOLIN SODIUM 500MG VIAL | 54014352 | $28 |
| CEFAZOLIN PER 500MG | 54014378 | $112 |
| CEFEPIME HCL PER 500MG | 54014451 | $562 |
| CEFEPIME HCL PER 500MG | 54014477 | $1,173 |
| CEFOTAXIME PER 1GM | 54014691 | $453 |
| CEFOTAXIME PER 1GM | 54014717 | $373 |
| CEFOTAXIME PER 1GM | 54014774 | $247 |
| CEFOTAXIME PER 1GM | 54014790 | $426 |
| CEFOXITIN SODIUM PER 1GM | 54014972 | $352 |
| CEFOXITIN SODIUM PER 1GM | 54014998 | $709 |
| CEFOXITIN SODIUM PER 1GM | 54015037 | $445 |
| CEFTAZIDIME PER 500MG | 54015433 | $392 |
| CEFTAZIDIME PER 500MG | 54015474 | $680 |
| CEFTAZIDIME PER 500MG | 54015573 | $310 |
| CEFTRIAXONE PER 250MG | 54015714 | $1,447 |
| CEFTRIAXONE INJ PER 250MG | 54015730 | $126 |
| CEFTRIAXONE INJ PER 250MG | 54015771 | $1,495 |
| CEFTRIAXONE INJ PER 250MG | 54015797 | $286 |
| CEFTRIAXONE INJ PER 250MG | 54015813 | $538 |
| CEFTRIAXONE PER 250MG | 54015839 | $759 |
| CEFTRIAXONE PER 250MG | 54015870 | $666 |
| CEFTRIAXONE PER 250MG | 54015896 | $1,082 |
| CEFUROXIME SOD PER 750MG | 54016035 | $124 |
| CEFUROXIME SOD PER 750MG | 54016050 | $236 |
| CEFUROXIME SOD PER 750MG | 54016092 | $537 |
| CEFUROXIME SOD PER 750MG | 54016118 | $150 |
| CEFUROXIME PER 750MG | 54016134 | $160 |
| CEFUROXIME PER 750MG | 54016159 | $276 |
| CHLORAMPHENICOL NA UP TO 1GM | 54017074 | $227 |
| CHLOROTHIAZIDE SOD PER 500MG | 54017652 | $2,377 |
| CHLORPROMAZINE INJ PER 50MG | 54018130 | $120 |
| CIPROFLAXIN PER 200MG | 54019138 | $324 |
| CIPROFLOX PER 200MG | 54019153 | $1,050 |
| CIPRO/D5W 200MG/100ML IVPB | 54019195 | $282 |
| CIPROFLAXIN PER 200MG | 54019211 | $1,520 |
| CODEINE PHOS PER 30MG | 54021399 | $21 |
| CODEINE PHOS PER 30MG | 54021415 | $22 |
| CODEINE PHOS PER 30MG | 54021456 | $23 |
| COLISTIMETHATE PER 150MG VIAL | 54022074 | $971 |
| COSYNTROPIN 0.25MG VIAL | 54022314 | $430 |
| CYCLOPHOSPHAMIDE ORAL PER 25MG | 54022751 | $58 |
| CYCLOSPORINE 100MG CAP (GN) | 54022892 | $141 |
| CYCLOSPORINE 25MG CAP | 54022918 | $42 |
| CYCLOSPORIN PAREN PER 250MG | 54022959 | $731 |
| CYCLOSPORINE MOD 100MG CAP(GN) | 54022991 | $95 |
| CYCLOSPORINE 25MG CAP | 54023015 | $34 |
| CYCLOSPORINE ORAL PER 100MG GN | 54023072 | $4,876 |
| CYTARABINE HCL PER 100MG (GN) | 54023197 | $390 |
| CYTARABINE HCL PER 100MG GN | 54023213 | $602 |
| CYTARABINE HCL PER 100MG GN | 54023239 | $858 |
| CYTARABINE HCL PER 100MG GN | 54023296 | $1,515 |
| DACARBAZINE PER 100MG VIAL GN | 54023312 | $551 |
| DACARBAZINE PER 100MG VIAL GN | 54023338 | $201 |
| DACTINOMYCIN PER 0.5MG | 54023353 | $2,243 |
| FRAGMIN PER 2500 UNITS | 54023379 | $346 |
| FRAGMIN PER 2500 UNITS | 54023395 | $646 |
| DAUNORUBICIN PER 10MG BRAND | 54023676 | $1,964 |
| DAUNORUBICIN PER 10MG GN | 54023692 | $2,444 |
| DEFEROXAMINE MESYL 500MG VL | 54023718 | $373 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024179 | $1 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024195 | $2 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024211 | $1 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024237 | $2 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024252 | $1 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024278 | $2 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024294 | $31 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024310 | $36 |
| DEXAMETHASONE PER 0.25MG ORAL | 54024450 | $298 |
| DEXAMETHASONE INJ PER 1MG | 54024518 | $2 |
| DEXAMETHASONE INJ PER 1MG | 54024559 | $453 |
| DEXAMETHASONE INJ PER 1MG | 54024575 | $1 |
| DIAZEPAM TO 5MG INJ | 54025499 | $66 |
| DIAZEPAM UP TO 5MG INJ | 54025515 | $62 |
| DIAZEPAM UP TO 5MG INJ | 54025531 | $136 |
| DICYCLOMINE UP TO 20MG INJ | 54025978 | $168 |
| DIGOXIN UP TO 0.5MG INJ | 54026455 | $84 |
| DIGOXIN UP TO 0.5MG INJ | 54026471 | $31 |
| DIHYDROERGOTAMINE 1MG/ML AMP | 54026539 | $169 |
| DIMETHYL SULFOX DMSO 50% 50ML | 54027032 | $1,103 |
| DIPHENHYDRAMINE 50MG CAP OP CH | 54027156 | $1 |
| DIPHENHYDRAMINE 50MG/ML VIAL | 54027255 | $116 |
| DIP/PERT/TET 28-58-10 0.5ML VL | 54027495 | $87 |
| DIPYRIDAMOLE PER 10MG | 54027651 | $1,857 |
| DOBUTAMINE PER 250MG INJ | 54028550 | $1,818 |
| DOLASETRON MESYLATE PER 10MG | 54028873 | $532 |
| DOPAMINE HCL PER 40MG INJ | 54028931 | $265 |
| DOPAMINE HCL PER 40MG | 54028956 | $276 |
| DOPAMINE HCL PER 40MG | 54028998 | $141 |
| DOPAMINE HCL PER 40MG INJ | 54029012 | $592 |
| DOPAMINE HCL PER 40MG | 54029038 | $262 |
| DOPAMINE HCL PER 40MG | 54029079 | $781 |
| DOPAMINE HCL PER 40MG | 54029111 | $228 |
| DOPAMINE HCL PER 40MG INJ | 54029152 | $239 |
| DOXORUBICIN PER 10MG GN | 54029657 | $1,148 |
| DOXORUBICIN PER 10MG GN | 54029673 | $4,562 |
| DRONABINOL PER 2.5MG OP CH | 54029913 | $104 |
| DROPERIDOL INJ UP TO 5MG | 54029939 | $257 |
| DROPERIDOL UP TO 5MG | 54029954 | $71 |
| EPOPROSTENOL NA 0.5MG VIAL | 54031372 | $466 |
| ERYTHRO LACTOB PER 500MG | 54032313 | $735 |
| ERYTHRO LACTOB PER 500MG | 54032339 | $607 |
| ESTRADIOL PER 10MG | 54032719 | $935 |
| ESTROGENS CONJ 25MG VIAL | 54033055 | $1,202 |
| ETHANOLAMINE OLEATE 100MG AMP | 54033311 | $651 |
| ETOPOSIDE PER 10MG GN | 54033774 | $1,984 |
| FENTANYL CITRATE PER 0.1MG | 54034533 | $71 |
| FENTANYL CITRATE PER 0.1MG | 54034558 | $35 |
| FENTANYL CITRATE PER 0.1MG | 54034574 | $959 |
| FENTANYL CITRATE PER 0.1MG | 54034590 | $1,554 |
| FLUCONAZOLE PER 200MG | 54035639 | $1,709 |
| FLUCONAZOLE 200MG INJ | 54035670 | $3,558 |
| FLUCONAZOLE 200MG INJ | 54035696 | $2,570 |
| FLUOROURACIL INJ PER 500MG | 54036439 | $229 |
| FLUPHENAZINE DECAN UP TO 25MG | 54036637 | $612 |
| FOSPHENYTOIN PER 50MG | 54037411 | $459 |
| FOSPHENYTOIN PER 50MG | 54037437 | $1,306 |
| FUROSEMIDE PER 20MG | 54037650 | $76 |
| GANCICLOVIR SODIUM PER 500MG | 54037858 | $1,338 |
| GENTAMICIN SULF UP TO 80MG | 54038179 | $189 |
| GENTAMICIN SULF UP TO 80MG | 54038211 | $215 |
| GENTAMICIN SULF UP TO 80MG | 54038237 | $206 |
| GENTAMICIN SULF UP TO 80MG | 54038252 | $90 |
| GENTAMICIN SULF UP TO 80MG | 54038278 | $236 |
| GENTAMICIN SULF UP TO 80MG | 54038435 | $125 |
| GLUCAGON HUMAN F KABI 1MG VIAL | 54038658 | $1,565 |
| GLUCAGON 1MG F KABI KIT | 54038674 | $1,237 |
| GRANISETRON HCL PER 100MCG | 54039276 | $3,529 |
| PEDVAXHIB 7.5MCG/0.5ML VL | 54041850 | $422 |
| HIB PRP-T VACCINE | 54041876 | $560 |
| HALOPERIDOL DEC PER 50MG | 54042072 | $1,012 |
| HALOPERIDOL DECAN PER 50MG | 54042114 | $968 |
| HALOPERIDOL INJ PER 5MG | 54042197 | $181 |
| HEP B VIR VAC 5MCG/0.5ML VL | 54042619 | $408 |
| HEP B VIR VAC 10MCG/ML 1ML VL | 54042650 | $1,091 |
| HEP B VIR VAC 20MCG/ML 1ML VL | 54042676 | $1,117 |
| HEP B VIR VAC 10MCG/0.5ML VL | 54042718 | $184 |
| HEP B VACC REC 10MCG/0.5ML SYR | 54042775 | $367 |
| HEPARIN SOD PER 10 UNITS | 54042890 | $42 |
| HEPARIN SOD PER 1000 UNITS | 54042916 | $71 |
| HEPARIN LOCK PER 10 UNITS | 54042932 | $62 |
| HEPARIN LOC PER 10 UNITS | 54042957 | $70 |
| HEPARIN PER 1000 UNITS | 54042973 | $86 |
| HEPARIN PER 1000 UNITS | 54042999 | $217 |
| HEPARIN PER 1000 UNITS | 54043013 | $56 |
| HEP B IMM GLOB 0.5ML SYR | 54043112 | $4,002 |
| HEPATITIS B IMMUNE GLOB 1ML VL | 54043138 | $2,184 |
| HEP B IMM GLOB 5ML | 54043153 | $5,780 |
| HYDRALAZINE PER 20MG | 54043559 | $222 |
| HYDRO SOD SUCC 100MG VL | 54044896 | $161 |
| HYDRO SOD SUCC PER 100MG | 54044912 | $724 |
| HYDROCO SOD SUCC UP TO 100MG | 54044938 | $210 |
| HYDRO SOD SUCC PER 100MG | 54044953 | $614 |
| HYDROXYZINE UP TO 25MG | 54045653 | $8 |
| HYOSCYAMINE UP TO 0.25MG | 54045976 | $242 |
| IDARUBICIN INJ PER 5MG GN | 54046271 | $5,428 |
| IDARUBICIN PER 5MG GN | 54046297 | $10,856 |
| IDARUBICIN PER 5MG GN | 54046313 | $17,061 |
| IFOSFAMIDE PER 1GM | 54046339 | $2,970 |
| IMIPENEM/CILAS PER 250MG | 54046370 | $287 |
| IMIPENEM/CILAS PER 250MG | 54046396 | $1,216 |
| KETOROLAC TROM PER 15MG | 54049713 | $214 |
| KETOROLAC TROM PER 15MG | 54049812 | $195 |
| KETOROLAC 15MG/ML 1ML VIAL | 54049838 | $166 |
| KETOROLAC TROM PER 15MG | 54049853 | $361 |
| LEUCOVORIN CALCIUM 50MG VIAL | 54050976 | $2,958 |
| LEUCOVORIN CAL INJ PER 50 MG | 54050992 | $900 |
| LEUCOVORIN CAL INJ PER 50 MG | 54051016 | $2,112 |
| LEVOFLOXACIN PER 250MG | 54051339 | $686 |
| LEVOFLOXACIN PER 250MG | 54051354 | $742 |
| LEVOFLOXACIN PER 250MG | 54051370 | $1,508 |
| LINCOMYCIN UP TO 300MG | 54052717 | $156 |
| LINEZOLID PER 200MG | 54052816 | $1,622 |
| LORAZEPAM PER 2MG | 54053731 | $212 |
| LORAZEPAM INJ PER 2MG | 54053756 | $453 |
| LORAZEPAM INJ PER 2MG | 54053798 | $1,804 |
| MAG SULFATE PER 500MG | 54055058 | $27 |
| MAG SULFATE PER 500MG | 54055074 | $33 |
| MAG SULPHATE PER 500MG INJ | 54055116 | $52 |
| MAG SULFATE PER 500MG | 54055173 | $250 |
| MAG SULFATE PER 500MG | 54055199 | $305 |
| MAG SULFATE PER 500MG | 54055215 | $332 |
| MAG SULFATE PER 500MG | 54055231 | $399 |
| MAG SULPHATE PER 500MG INJ | 54055272 | $80 |
| MANNITOL 25% 50 ML | 54055397 | $162 |
| M-M-R II VAC VL | 54055496 | $284 |
| MEDROXYPROG ACET PER 1MG | 54055751 | $1,808 |
| MEDROXYPROG ACET PER 1MG | 54055777 | $816 |
| MELPHALAN HCL PER 50MG | 54056015 | $5,332 |
| MENINGOCOCCAL A C Y W-135 | 54056031 | $1,558 |
| MEPERIDINE HCL PER 100MG | 54056338 | $24 |
| MEPERIDINE HCL PER 100MG | 54056395 | $408 |
| MEPERIDINE HCL PER 100MG | 54056411 | $10 |
| MEPERIDINE HCL INJ PER 100MG | 54056494 | $422 |
| MEPERIDINE 100MG/ML 1 ML | 54056510 | $22 |
| MEPIVACAINE HCL PER 10ML | 54056718 | $284 |
| MEPIVACAINE HCL PER 10ML | 54056734 | $298 |
| MEPIVACAINE HCL PER 10ML | 54056759 | $362 |
| MEROPENEM PER 100MG | 54056858 | $785 |
| MEROPENEM PER 100MG | 54056874 | $10 |
| MESNA INJ PER 200MG/GN | 54056999 | $2,688 |
| METHOCARBAMOL UP TO 10ML INJ | 54057930 | $104 |
| METHOTREXATE 2.5 MG TAB | 54057997 | $90 |
| METHYLERGONOV MAL UP TO 0.2MG | 54058599 | $64 |
| METHYLPREDNISOLONE 4MG TAB | 54058714 | $13 |
| METHYLPREDNISOLONE PER 4MG | 54058730 | $32 |
| METHYLPREDNISOLONE PER 4MG | 54058797 | $22 |
| METHYLPREDNISOLONE 4MGDSPK | 54058813 | $350 |
| METOCLOPRAMIDE UP TO 10MG | 54059134 | $21 |
| METOCLOPRAMIDE INJ UP TO 10MG | 54059159 | $90 |
| METOCLOPRAMIDE PER 10MG | 54059175 | $282 |
| MIDAZOLAM INJ PER 1MG | 54060132 | $298 |
| MIDAZOLAM INJ PER 1MG | 54060157 | $696 |
| MIDAZOLAM INJ PER 1MG | 54060173 | $274 |
| MIDAZOLAM PER 1MG INJ | 54060199 | $274 |
| MIDAZOLAM INJ PER 1MG | 54060215 | $649 |
| MIDAZOLAM PER 1MG INJ | 54060231 | $1,442 |
| MITOMYCIN PER 5MG INJ/GN | 54061130 | $2,284 |
| MORPHINE SULF PF PER 10 MG | 54061833 | $1 |
| MORPHINE SULF UP TO 10MG | 54061973 | $28 |
| MORPHINE SULF UP TO 10MG | 54062039 | $261 |
| MORPHINE SULF UP TO 10MG | 54062054 | $250 |
| MORPHINE SULF UP TO 10MG | 54062112 | $505 |
| MORPHINE SULF UP TO 10MG | 54062153 | $21 |
| MORPHINE SULF UP TO 10MG | 54062179 | $13 |
| MORPHINE SULF UP TO 10MG | 54062211 | $13 |
| MORPHINE SULF PER 10MG | 54062252 | $479 |
| MYCOPHENOLATE MOFET 250MG CAP | 54063276 | $58 |
| MYCOPHEN MOF PER 250MG ORAL | 54063292 | $86 |
| NALBUPHINE 10MG/ML 1ML AMP | 54063839 | $101 |
| NALBUPHINE PER 10MG | 54063854 | $116 |
| NALOXONE HCL PER 1MG | 54063953 | $95 |
| NALOXONE HCL PER 1MG | 54063995 | $212 |
| NEOSTIGMINE UP TO 0.5MG | 54065255 | $321 |
| NEOSTIGMINE METHY UP TO 0.5MG | 54065271 | $96 |
| ONDANSETRON INJ PER 1MG | 54067996 | $760 |
| ORPHENADRINE CIT UP TO 60MG | 54068176 | $120 |
| OXACILLIN SODIUM UP TO 250MG | 54068390 | $48 |
| OXACILLIN SODIUM UP TO 250MG | 54068432 | $250 |
| OXYTOCIN UP TO 10UNITS | 54069315 | $71 |
| OXYTOCIN UP TO 10 UNITS | 54069356 | $72 |
| PAPAVERINE HCL UP TO 60MG | 54069554 | $128 |
| PAPAVERINE UP TO 60MG | 54069570 | $310 |
| PARICALCITOL PER 1MCG | 54069679 | $619 |
| PEN G POT UP TO 600000U INJ | 54070131 | $242 |
| PEN G POT UP TO 600MU INJ | 54070313 | $92 |
| PEN G POT UP TO 600MU INJ | 54070354 | $12 |
| PEN G POT UP TO 600MU INJ | 54070370 | $74 |
| PENTAZOCINE PER 30MG | 54070693 | $71 |
| PENTOBARBITAL 50MG/ML 50ML VL | 54070834 | $514 |
| PERPHENAZINE 4MG TAB OP CH | 54071691 | $24 |
| PHENOBARB SOD UP TO 120MG | 54072178 | $76 |
| PHENOBARB SOD UP TO 120MG | 54072236 | $41 |
| PHENOBARB SOD UP TO 120MG | 54072251 | $26 |
| PHENTOLAMINE MES UP TO 5MG | 54072434 | $1,028 |
| PHENYTOIN PER 50MG | 54073630 | $76 |
| PHENYTOIN SOD PER 50MG | 54073697 | $79 |
| PHYTONADIONE PER 1MG INJ | 54073895 | $156 |
| PHYTONADIONE PER 1MG INJ | 54073911 | $90 |
| PHYTONADIONE PER 1MG | 54073937 | $87 |
| PIPER/TAZO PER 1.125GM | 54074414 | $381 |
| ZOSYN INJ PER 1.0GM/0.125GM | 54074430 | $180 |
| ZOSYN INJ PER 1.0GM/0.125GM | 54074455 | $528 |
| ZOSYN INJ PER 1.0GM/0.125GM | 54074471 | $755 |
| PNEUM 23 25MCG/0.5 0.5ML SYR | 54074737 | $602 |
| PNEUMO 23 VACCINE 2.5ML VL | 54074752 | $1,228 |
| POT CHL PER 2MEQ INJ | 54075411 | $54 |
| POT CHL PER 2MEQ INJ | 54075478 | $518 |
| POT CHL PER 2MEQ INJ | 54075494 | $674 |
| POT CHL PER 2MEQ INJ | 54075510 | $1 |
| POT CHL PER 2MEQ INJ | 54075536 | $410 |
| POTASSIUM PER 2MEQ | 54075551 | $484 |
| PREDNISOLONE 5MG TAB | 54077037 | $1 |
| PREDNISOLONE PER 5MG ORAL | 54077052 | $29 |
| PREDNISOLONE PER 5MG ORAL | 54077078 | $10 |
| PREDNISOLONE PER 5MG ORAL | 54077094 | $152 |
| PREDNISOLONE PER 5MG ORAL | 54077151 | $1,134 |
| PREDNISOLONE 6.7MG/5ML 5ML | 54077235 | $10 |
| PROCAINAMIDE UP TO 1G INJ | 54078134 | $474 |
| PROCAINAMIDE UP TO 1G INJ | 54078159 | $319 |
| PROCHLORPERAZINE 5MG/ML 2ML VL | 54078316 | $177 |
| PROCHLORPERAZINE PER 5MG OP CH | 54078373 | $10 |
| PROGESTERONE PER 50MG INJ | 54078530 | $147 |
| PROMETHAZINE INJ UP TO 50MG | 54078811 | $50 |
| PROMETHAZINE UP TO 50MG | 54078837 | $63 |
| PROPRANOLOL UP TO 1MG | 54079496 | $128 |
| PROPRANOLOL 1MG/ML 1ML AMP | 54079512 | $98 |
| PROTAMINE SULF PER 10MG INJ | 54079611 | $123 |
| PROTAMINE SULF PER 10MG INJ | 54079652 | $897 |
| PYRIDOXINE 100MG/ML 1ML VL | 54080478 | $66 |
| QUINUPRISTIN/DALFOPR PER 500MG | 54080890 | $2,420 |
| ROPIVACAINE PER 1MG | 54082250 | $156 |
| ROPIVACAINE PER 1MG | 54082276 | $58 |
| ROPIVACAINE PER 1MG | 54082292 | $518 |
| ROPIVACAINE PER 1MG | 54082318 | $385 |
| ROPIVACAINE PER 1MG | 54082391 | $304 |
| SINCALIDE 5MCG VIAL | 54083811 | $877 |
| SOD FER GLUC COMP PER 12.5MG | 54083951 | $1,002 |
| STREPTOMYCIN SULF 1GM VIAL | 54085659 | $98 |
| SUCCINYLCHOLIN CHL UP TO 20MG | 54085774 | $171 |
| SUCCINYLCHOLINE UP TO 20MG | 54085790 | $156 |
| SUMATRIPTAN 6MG/0.5ML KIT | 54086517 | $1,679 |
| TACROLIMUS ORAL PER 1 MG | 54086632 | $79 |
| TERBUTALINE 1MG/ML 1ML VIAL | 54087077 | $712 |
| TETANUS IMM GLOBULIN TO 250U | 54087416 | $888 |
| TET/DIP/TOX 5-2LF UNITS 0.5ML | 54087515 | $330 |
| TET/DIP/TOX 5-2LFU 5ML | 54087572 | $324 |
| TET/DIP PED 5-6.6LFU 5ML | 54087630 | $16 |
| THIOTEPA PER 15MG | 54089271 | $1,732 |
| TOBRAMYCIN UP TO 80MG INJ | 54090170 | $107 |
| TOBRAMYCIN UP TO 80MG | 54090238 | $232 |
| TOBRAMYCIN UP TO 80MG INJ | 54090253 | $4,378 |
| TOBRAMYCIN UP TO 80MG | 54090352 | $190 |
| TRIAMCINOLONE PER 10MG | 54091475 | $161 |
| TRIAMCINOLONE PER 10MG | 54091517 | $614 |
| TRIMTHBNZAMID UP TO 200MG | 54092317 | $39 |
| TRIMTHOBNZAMIDE UP TO 200MG | 54092333 | $56 |
| VANCOMYCIN HCL PER 500MG INJ | 54093471 | $8 |
| VANCOMYCIN PER 500MG | 54093497 | $2,940 |
| VANCOMYCIN HCL PER 500MG INJ | 54093513 | $895 |
| VARICELLA VIRUS VACCINE VIAL | 54093554 | $1,043 |
| VINBLASTINE SULF PER 1MG | 54094172 | $665 |
| VINCRISTINE PER 1MG | 54094214 | $1,148 |
| ZIDOVUDINE PER 10MG INJ | 54095252 | $430 |
| HEPARIN PER 1000 UNITS | 54095815 | $82 |
| FUROSEMIDE PER 20MG | 54095831 | $44 |
| FUROSEMIDE UP TO 20MG | 54095856 | $73 |
| CYANOCOBALAMIN TO 1000MCG | 54096094 | $73 |
| GENTAMICIN SULF UP TO 80MG | 54096433 | $265 |
| HYDROXYZINE UP TO 25MG INJ | 54096557 | $49 |
| PENTOBARB SOD PER 50MG | 54096953 | $8 |
| SUCCINYLCHOLIN CHL UP TO 20MG | 54097258 | $54 |
| MIDAZOLAM INJ PER 1MG | 54098579 | $4 |
| MIDAZOLAM INJ PER 1MG | 54098595 | $160 |
| POT CHL PER 2MEQ INJ | 54098850 | $62 |
| POT CHL PER 2MEQ INJ | 54098876 | $42 |
| POT CHL PER 2MEQ INJ | 54098892 | $71 |
| CALCIUM GLUCONATE 10% 10ML | 54099148 | $44 |
| HEPARIN LOC PER 10 UNITS | 54099155 | $1 |
| HEPARIN PER 1000 UNITS | 54099171 | $58 |
| LORAZEPAM PER 2MG | 54099429 | $1,490 |
| DEXTRAN 40/D5W 10% 500ML BAG | 54101506 | $2,423 |
| DEXTRAN 40/NS 10-0.9% 500ML BA | 54101555 | $2,423 |
| D5NS PER 500ML | 54102751 | $291 |
| D5NS 500ML BAG | 54102801 | $188 |
| D5W 1000ML BAG | 54103155 | $270 |
| D5W 500ML BAG | 54103205 | $250 |
| DOBUTAMINE PER 250MG INJ | 54104005 | $2,052 |
| DOBUTAMINE PER 250MG INJ 636 | 54104054 | $2,189 |
| HEPARIN PER 1000UNITS | 54105507 | $275 |
| HEPARIN PER 1000 UNITS | 54105655 | $23 |
| HEPARIN PER 1000 UNITS | 54105705 | $779 |
| HEPARIN PER 1000 UNITS | 54105754 | $158 |
| HEPARIN SOD PER 1000 UNITS | 54105804 | $434 |
| POT CHL PER 2MEQ INJ | 54107206 | $628 |
| POT CHL PER 2MEQ INJ | 54107354 | $506 |
| RINGERS LACTATED 1000ML BAG | 54107503 | $304 |
| RINGERS LACTATED 500 ML BAG | 54107552 | $250 |
| SODIUM CHL 0.9% 1000ML BAG | 54108055 | $318 |
| SODIUM CHL 0.9% 500ML BAG | 54108105 | $319 |
| SODIUM CHL 0.9% 250ML BAG | 54108154 | $220 |
| RINGERS LACTATED 250ML BAG | 54109756 | $194 |
| DOPAMINE HCL PER 40MG | 54110150 | $260 |
| DEXTROSE 5%-WATER 500ML BAG | 54111182 | $170 |
| PIPERACIL/TAZO PER 1.125GM | 54111497 | $265 |
| POT CHL PER 2MEQ INJ | 54111521 | $265 |
| MOXIFLOXACIN PER 100MG | 54111661 | $562 |
| VWF PER UNIT (HUMATE-P)>600 VL | 54111711 | $8 |
| VORICONAZOLE PER 10MG | 54111729 | $368 |
| POTASSIUM CHL PER 2MEQ | 54111760 | $619 |
| RASBURICASE PER 0.5MG | 54111778 | $6,151 |
| AMIODARONE HCL PER 30MG | 54111893 | $198 |
| PAMIDRONATE DISOD 30MG VL/GN | 54111950 | $898 |
| ARSENIC TRIOXIDE PER 1MG | 54111968 | $944 |
| VANCOMYCIN HCL PER 500MG | 54111984 | $84 |
| VANCOMYCIN HCL PER 500MG INJ | 54111992 | $87 |
| LEVOFLOXACIN PER 250MG | 54112024 | $979 |
| CEFTAZIDIME PER 500MG | 54112032 | $96 |
| DAPTOMYCIN PER 1MG | 54112149 | $3,479 |
| AZITHROMYCIN 500MG/NS 250ML BD | 54112206 | $81 |
| AZITHROMYCIN PER 500MG | 54112214 | $95 |
| VANCOMYCIN PER 500MG | 54112222 | $222 |
| VANCOMYCIN PER 500MG | 54112230 | $222 |
| IBUTILIDE FUM PER 1MG | 54112248 | $686 |
| CILASTATIN IMIP PER 250MG | 54112255 | $146 |
| VANCOMYCIN PER 500MG | 54112289 | $84 |
| VANCOMYCIN PER 500MG | 54112297 | $76 |
| AMPICILLIN SOD PER 500MG INJ | 54112305 | $100 |
| AMPICILLIN SOD PER 500MG INJ | 54112313 | $102 |
| AMPICILLIN/SULBACTAM PER 1.5G | 54112321 | $116 |
| AMPICILLIN/SULBACTAM PER 1.5G | 54112339 | $152 |
| CEFTAZIDIME PER 500MG | 54112362 | $128 |
| CEFTRIAXONE SOD 250MG INJ | 54112370 | $180 |
| CEFTRIAXONE PER 250MG | 54112388 | $295 |
| CEFUROXIME 750MG/NS 50ML | 54112396 | $81 |
| PEN G POT UP TO 600MU | 54112438 | $148 |
| AMPICILLIN SOD 500MG INJ | 54112446 | $172 |
| CEFOTAXIME PER 1GM | 54112453 | $174 |
| CEFOTAXIME PER 1GM | 54112461 | $228 |
| CEFEPIME HCL PER 500MG | 54112479 | $212 |
| IMIPEN/CILAS PER 250MG | 54112487 | $208 |
| CEFTAZIDIME PER 500MG | 54112495 | $211 |
| CEFOXITIN PER 1GM | 54112503 | $193 |
| PIPERACIL/TAZO PER 1.125G | 54112511 | $189 |
| PIPERAC/TAZO PER 1.125GM | 54112529 | $224 |
| OXACILLIN SODIUM UP TO 250MG | 54112545 | $190 |
| CEFTRIAXONE PER 250MG | 54112552 | $313 |
| CEFAZOLIN SOD 500MG INJ | 54112560 | $110 |
| CEFEPIME HCL PER 500MG | 54112586 | $361 |
| PIPERACIL/TAZO PER 1.125GM | 54112602 | $212 |
| AMP SOD/SULBACT PER 1.5GM | 54112610 | $162 |
| PIPERACIL/TAZO PER 1.125GM | 54112651 | $189 |
| CEFTAZIDIME PER 500MG | 54112677 | $123 |
| CEFTAZIDIME PER 500MG | 54112685 | $295 |
| CEFEPIME HCL PER 500MG | 54112693 | $219 |
| CEFEPIME HCL PER 500MG | 54112701 | $394 |
| MEROPENEM PER 100MG | 54112719 | $324 |
| MEROPENEM PER 100MG | 54112727 | $593 |
| OXACILLIN SODIUM UP TO 250MG | 54112974 | $167 |
| MORPHINE SULF UP TO 10MG | 54113014 | $92 |
| OXYTOCIN UP TO 10 UNITS | 54113063 | $136 |
| OXYTOCIN UP TO 10 UNITS | 54113071 | $108 |
| AMIODARONE HCL PER 30MG | 54113147 | $253 |
| AMIODARONE HCL PER 30MG | 54113154 | $132 |
| FLUCONAZOLE PER 200MG | 54113162 | $1,610 |
| PAMIDRONATE DISOD PER 30MG GN | 54113188 | $5,187 |
| OXYTOCIN UP TO 10 UNITS | 54113220 | $76 |
| OXYTOCIN UP TO 10 UNITS | 54113238 | $76 |
| MEPERIDINE HCL PER 100MG | 54113253 | $352 |
| MIDAZOLAM PER 1MG | 54113287 | $188 |
| LARONIDASE PER 0.1MG | 54113303 | $3,731 |
| CEFOTAXIME PER 1G 636 | 54113337 | $212 |
| CEFUROXIME PER 750MG | 54113352 | $316 |
| MAGNESIUM SULPHATE PER 500MG | 54113360 | $47 |
| AMPICILLIN/NS 500MG/50ML IVPB | 54113428 | $47 |
| METOCLOPRAMIDE 10MG/NS 50ML PB | 54113436 | $58 |
| CEFTRIAXONE PER 250MG | 54113444 | $150 |
| ERTAPENEM SOD PER 500MG | 54113451 | $390 |
| ONDANSETRON PER 1MG | 54113469 | $206 |
| PHENYTOIN PER 50MG | 54113477 | $30 |
| PIPERACIL/TAZO PER 1.125G | 54113550 | $292 |
| LORAZEPAM PER 2MG | 54113600 | $640 |
| LORAZEPAM PER 2MG | 54113618 | $637 |
| MIDAZOLAM PER 1MG INJ | 54113626 | $304 |
| DOPAMINE HCL PER 40MG | 54113642 | $152 |
| OXYTOCIN UP TO 10 UNITS | 54113675 | $135 |
| OXYTOCIN UP TO 10 UNITS | 54113683 | $422 |
| OXYTOCIN UP TO 10 UNITS | 54113741 | $176 |
| MEROPENEM PER 100MG | 54113824 | $393 |
| CEFOXITIN SODIUM PER 1GM | 54113832 | $244 |
| LORAZEPAM PER 2MG | 54113865 | $187 |
| MIDAZOLAM PER 1MG | 54113881 | $100 |
| AMIODARONE PER 30MG | 54113907 | $256 |
| CEFTRIAXONE SOD PER 250MG | 54113915 | $828 |
| CEFTRIAXONE SOD PER 250MG | 54113923 | $43 |
| OXYTOCIN UP TO 10 UNITS | 54114012 | $493 |
| FENTANYL CITRATE PER 0.1MG | 54114095 | $115 |
| HEPARIN PER 1000 UNITS | 54114269 | $66 |
| LORAZEPAM PER 2MG | 54114335 | $548 |
| AZITHROMYCIN/NS 500MG/250ML GN | 54114368 | $239 |
| AZITHROMYCN/D5W 500MG/250ML GN | 54114376 | $263 |
| CEFOXITIN DUPLEX 1GM/50ML IVPB | 54114590 | $185 |
| CEFOXITIN SODIUM PER 1GM | 54114616 | $230 |
| VANCOMYCIN PER 500MG | 54114632 | $146 |
| MAG SULFATE PER 500MG | 54114699 | $65 |
| HEPARIN PER 1000 UNITS | 54114715 | $65 |
| MIDAZOLAM PER 1MG | 54114723 | $212 |
| OXYTOCIN UP TO 10 UNITS | 54114772 | $60 |
| POTASSIUM CHL PER 2MEQ | 54114806 | $87 |
| POTASSIUM CHL PER 2MEQ | 54114814 | $87 |
| MAG SULFATE PER 500MG | 54114871 | $128 |
| ACYCLOVIR PER 5MG | 54114889 | $169 |
| CEFAZOLIN PER 500MG | 54114905 | $136 |
| MAG SULFATE PER 500MG | 54114947 | $60 |
| AMIODARONE HCL PER 30MG | 54114988 | $150 |
| CASPOFUNGIN ACET PER 5MG | 54114996 | $2,472 |
| CASPOFUNGIN ACET PER 5MG | 54115001 | $1,931 |
| CEFAZOLIN SOD PER 500MG | 54115027 | $118 |
| FLUCONAZOLE PER 200MG | 54115043 | $1,622 |
| OXYTOCIN UP TO 10 UNITS | 54115050 | $140 |
| CEFTRIAXONE SOD PER 250MG | 54115076 | $242 |
| CEFAZOLIN PER 500MG | 54115084 | $159 |
| LORAZEPAM PER 2MG | 54115100 | $292 |
| MIDAZOLAM PER 1MG | 54115118 | $361 |
| SOD CHL 0.9% ADD-VANT 250ML | 54115126 | $60 |
| DAPTOMYCIN PER 1MG | 54115159 | $60 |
| PEN G POT UP TO 600MU | 54115167 | $124 |
| ZOLEDRONC ACID/RECLAST PER 1MG | 54115175 | $5,952 |
| PITOCIN/NS 10UNITS/500ML | 54115183 | $86 |
| DOPAMINE HCL PER 40MG | 54115217 | $71 |
| INSULIN PER 5 UNITS | 54115233 | $68 |
| ONDANSETRON PER 1MG | 54115241 | $172 |
| MILRINONE LACT PER 5MG | 54115266 | $1,351 |
| CALCIUM GLUC INJ PER 10MG | 54115274 | $84 |
| OXYTOCIN UP TO 10 UNITS | 54115282 | $110 |
| CIPROFLOXACIN 200MG/100ML FLEX | 54115308 | $358 |
| CIPROFLAXACIN PER 200MG | 54115316 | $188 |
| DOBUTAMINE PER 250MG INJ | 54115332 | $601 |
| DOPAMINE HCL PER 40MG | 54115340 | $285 |
| GENTAMICIN SULF UP TO 80MG | 54115373 | $70 |
| HEPARIN PER 1000 UNITS | 54115381 | $70 |
| HEPARIN/NS 1000U/500ML PF | 54115399 | $60 |
| POTASSIUM CHL PER 2MEQ | 54115456 | $100 |
| POTASSIUM CHL PER 2MEQ | 54115464 | $100 |
| DEXTRAN/NS 10% 500ML | 54115514 | $2,665 |
| FENTANYL CITRATE PER 0.1MG | 54115563 | $84 |
| FENTANYL CITRATE PER 0.1MG | 54115571 | $86 |
| FENTANYL CITRATE PER 0.1MG | 54115589 | $87 |
| FENTANYL CITRATE PER 0.1MG | 54115597 | $92 |
| MORPHINE SULF PF PER 10 MG | 54115605 | $98 |
| MORPHINE SULF PF PER 10MG | 54115613 | $98 |
| CALCIUM GLUC INJ PER 10MG | 54115639 | $98 |
| HEPARIN PER 10 UNITS | 54116108 | $95 |
| IMIPENEM/CILAS PER 250MG | 54116132 | $579 |
| LEVETIRACETAM PER 10MG | 54116140 | $688 |
| ERTAPENEM SOD PER 500MG | 54116157 | $844 |
| PEN G POT UP TO 600MU | 54116199 | $123 |
| ONDANSETRON PER 1MG | 54116223 | $95 |
| FENTANYL CITRATE PER 0.1MG | 54116249 | $70 |
| ROPIVACAINE PER 1MG | 54116272 | $180 |
| ROPIVACAINE PER 1MG | 54116348 | $275 |
| CEFTAZIDIME PER 500MG | 54116355 | $324 |
| ROPIVACAINE PER 1MG | 54116363 | $271 |
| OXYTOCIN UP TO 10 UNITS | 54116413 | $60 |
| CEFTRIAXONE PER 250MG | 54116421 | $54 |
| BIVALIRUDIN PER 1MG | 54116439 | $3,262 |
| ALBUMIN HUMAN 25% 50ML BAG | 54116454 | $458 |
| FLUCONAZOLE PER 200MG | 54116462 | $373 |
| DOPAMINE HCL PER 40MG | 54116512 | $134 |
| AMIKACIN SULF PER 100MG | 54116520 | $146 |
| MAG SULFATE PER 500MG | 54116546 | $36 |
| TIGECYCLINE PER 1MG | 54116678 | $751 |
| CEFEPIME PER 500MG | 54116686 | $441 |
| BIVALIRUDIN PER 1MG | 54116694 | $2,817 |
| OCTREOTIDE ACET PER 25 MCG | 54116728 | $1,332 |
| FOSPHENYTOIN PER 50MG | 54116736 | $84 |
| OXYTOCIN UP TO 10 UNITS | 54116777 | $358 |
| IRINOTECAN PER 20MG | 54116827 | $141 |
| IRINOTECAN PER 20MG | 54116835 | $318 |
| IRINOTECAN PER 20MG | 54116843 | $1,263 |
| MIDAZOLAM INJ PER 1MG | 54116900 | $355 |
| INSULIN PER 5 UNITS | 54116918 | $100 |
| PROMETHAZINE/NS 25MG/50ML | 54116926 | $60 |
| HEPARIN PER 10 UNITS | 54116959 | $62 |
| HEPARIN PER 10 UNITS | 54116967 | $58 |
| MAG SULFATE PER 500MG | 54116975 | $105 |
| CEFAZOLIN PER 500MG | 54116983 | $63 |
| MORPHINE SULF UP TO 10MG | 54116991 | $58 |
| CEFAZOLIN PER 500MG | 54117007 | $168 |
| MICAFUNGIN SOD PER 1MG | 54117031 | $458 |
| MICAFUNGIN SOD PER 1MG | 54117049 | $1,122 |
| TIGECYCLINE PER 1MG | 54117056 | $437 |
| CEFAZOLIN PER 500MG | 54117064 | $71 |
| CEFOXITIN/NS 1GM/100ML | 54117072 | $136 |
| ONDANSETRON PER 1MG | 54117114 | $194 |
| LORAZEPAM PER 2MG | 54117130 | $304 |
| HEPARIN LOC PER 10 UNITS | 54117163 | $65 |
| BANANA BAG ER 1000ML | 54117189 | $430 |
| FENTANYL CITRATE PER 0.1MG | 54117205 | $76 |
| FENTANYL CITRATE PER 0.1MG | 54117213 | $132 |
| ADRENAL EPINEPH INJ PER 0.1MG | 54117221 | $71 |
| HEPARIN LOC PER 10 UNITS | 54117239 | $110 |
| HEPARIN LOC PER 10 UNITS | 54117247 | $110 |
| PIPER/TAZO PER 1.125GM | 54117254 | $88 |
| PIPER/TAZO PER 1.125GM | 54117262 | $116 |
| PIPER/TAZO PER 1.125GM | 54117270 | $146 |
| DOBUTAMINE PER 250MG INJ | 54117288 | $118 |
| CEFUROXIME SOD PER 750MG | 54117346 | $136 |
| LORAZEPAM PER 2MG | 54117387 | $331 |
| MAG SULFATE PER 500MG | 54117429 | $27 |
| CEFAZOLIN/D5W 500MG/50ML | 54117460 | $42 |
| CEFAZOLIN SOD PER 500MG | 54117551 | $49 |
| FENTANYL CITRATE PER 0.1MG | 54117585 | $50 |
| MIDAZOLAM PER 1MG | 54117593 | $38 |
| MIDAZOLAM PER 1MG | 54117601 | $43 |
| FENTANYL CITRATE PER 0.1MG | 54117619 | $34 |
| VANCOMYCIN PER 500MG | 54117791 | $18 |
| TIROFIBAN HCL INJ PER 0.25MG | 54117981 | $2,232 |
| VANCOMYCIN PER 500MG | 54118013 | $198 |
| CEFAZOLIN PER 500MG | 54118047 | $15 |
| MORPHINE SULF PER 10MG INJ | 54118054 | $27 |
| MORPHINE SULF PER 10MG INJ | 54118062 | $118 |
| MORPHINE SULF PER 10MG INJ | 54118070 | $242 |
| MORPHINE SULF PER 10MG INJ | 54118088 | $286 |
| MORPHINE SULF PER 10MG INJ | 54118096 | $62 |
| CEFTRIAXONE PER 250MG | 54118195 | $26 |
| CEFTRIAXONE PER 250MG | 54118203 | $42 |
| VANCOMYCIN HCL 500MG INJ | 54118302 | $276 |
| VANCOMYCIN PER 500MG | 54118369 | $263 |
| LEVETIRACETAM PER 10MG | 54118385 | $35 |
| LEVETIRACETAM PER 10MG | 54118393 | $227 |
| LEVETIRACETAM PER 10MG | 54118401 | $325 |
| VANCOMYCIN PER 500MG | 54118534 | $36 |
| LINEZOLID PER 200MG | 54118708 | $283 |
| VANCOMYCIN PER 500MG | 54118740 | $45 |
| VANCOMYCIN PER 500MG | 54118765 | $43 |
| VANCOMYCIN PER 500MG | 54118872 | $20 |
| VANCOMYCIN PER 500MG | 54118880 | $22 |
| CONIVAPTAN PER 1MG | 54118948 | $2,383 |
| CANGRELOR PER 1MG | 54118963 | $3,148 |
| AMIODARONE HCL PER 30MG | 54119029 | $160 |
| ARGATROBAN PER 1MG NONESRD | 54119292 | $2,273 |
| ARGATROBAN PER 1MG ESRD | 54119300 | $2,273 |
| ABCIXIMAB INJ 2MG/ML 5ML VIAL | 54200050 | $10,025 |
| ALTEPLASE PER 1MG | 54200456 | $35,794 |
| ALTEPLASE PER 1MG | 54200506 | $17,582 |
| AMIODARONE HCL PER 30MG | 54200605 | $117 |
| AMPHO B LIPID COMP PER 10MG | 54200803 | $3,383 |
| FACTOR VIII (ADVATE) PER UNIT | 54201058 | $22 |
| FACTOR VIII (MONO-P) PER UNIT | 54201207 | $21 |
| BACLOFEN PER 50MCG FOR TRIAL | 54201405 | $1,287 |
| BLEOMYCIN SUL 15 UNIT VL BRAND | 54201801 | $5,368 |
| BLEOMYCIN SULFATE PER 15U GN | 54201900 | $6,999 |
| BLEOMYCIN SULFATE PER 15U GN | 54201959 | $2,033 |
| BOTULINUM TOXIN PER UNIT | 54202056 | $12,225 |
| CARBOPLATIN INJ PER 50MG | 54202106 | $1,823 |
| CARBOPLATIN INJ PER 50MG | 54202155 | $4,735 |
| CARBOPLATIN INJ PER 50MG | 54202205 | $12,099 |
| CIDOFOVIR PER 375MG | 54202304 | $2,360 |
| CISPLATIN PER 10MG INJ GN | 54202403 | $3,201 |
| CISPLATIN PER 10MG GN | 54202650 | $10,038 |
| CISPLATIN PER 10MG INJ GN | 54202700 | $102 |
| CLADRIBINE PER 1MG | 54202809 | $7,272 |
| DESMOPRESSIN PER 1MCG | 54203351 | $679 |
| DESMOPRESSIN PER 1MCG | 54203401 | $473 |
| DESMOPRESSIN PER 1MCG | 54203450 | $3,277 |
| DIGOXIN IMMUNE FAB PER VIAL | 54204052 | $6,022 |
| DOXORUBICIN HCL LIPO PER 10MG | 54204250 | $19,963 |
| DOXORUBICIN HCL LIPO PER 10MG | 54204300 | $7,986 |
| ENOXAPARIN SOD PER 10MG INJ | 54204409 | $608 |
| ENOXAPARIN SOD INJ PER 10MG | 54204458 | $1,281 |
| ENOXAPARIN SOD INJ PER 10MG | 54204508 | $950 |
| ENOXAPARIN SOD INJ PER 10MG | 54204557 | $1,837 |
| ENOXAPARIN SOD INJ PER 10MG | 54204607 | $894 |
| EPTIFIBATIDE INJ PER 5MG | 54204656 | $3,853 |
| EPTIFIBATIDE INJ PER 5MG | 54204706 | $6,976 |
| EPTIFIBATIDE INJ PER 5MG | 54204755 | $1,158 |
| ETANERCEPT 25MG KIT INJ | 54204805 | $2,184 |
| FLUDARABINE PHOS 50MG VIAL | 54205158 | $3,304 |
| FOMEPIZOLE PER 15MG | 54205208 | $23,290 |
| FOSCARNET SODIUM PER 1000MG | 54205307 | $2,175 |
| GEMCITABINE HCL PER 200MG | 54205406 | $6,079 |
| GEMCITABINE HCL PER 200MG | 54205455 | $1,649 |
| GOSERELIN IMPLANT PER 3.6MG | 54205604 | $15,942 |
| HEMIN PER 1MG | 54205653 | $5,972 |
| IBUTILIDE FUM PER 1MG | 54206354 | $4,039 |
| INFLIXIMAB INJECTION PER 10MG | 54207204 | $10,302 |
| IRINOTECAN INJ PER 20MG | 54207402 | $7,667 |
| IRINOTECAN INJ PER 20MG | 54207451 | $3,650 |
| LEPIRUDIN 50MG VIAL | 54207808 | $4,245 |
| LEUPROLIDE ACETATE PER 3.75MG | 54207956 | $10,961 |
| LEUPROLIDE ACETATE PER 3.75MG | 54208004 | $12,521 |
| LEUPROLIDE ACE DEPOT PER 7.5MG | 54208152 | $28,538 |
| LEUPROLIDE ACE DEPOT PER 7.5MG | 54208202 | $32,440 |
| LEUPROLIDE ACE SUSP 7.5MG KIT | 54208251 | $4,019 |
| LYMPH IMMUNE GLOB PER 250MG | 54208509 | $2,881 |
| MILRINONE LACT PER 5MG | 54208608 | $2,908 |
| MILRINONE LACT PER 5MG | 54208806 | $1,569 |
| MILRNONE PER 5MG | 54208855 | $2,118 |
| MILRINONE PER 5MG | 54208905 | $490 |
| MITOXANTRONE HCL PER 5MG | 54209101 | $13,275 |
| OPRELVEKIN 5MG VL | 54209655 | $3,494 |
| PALIVIZUMAB PER 50MG | 54209853 | $18,374 |
| PALIVIZUMAB PER 50MG | 54209903 | $9,354 |
| PAMIDRONATE DISOD PER 30MG BRD | 54209952 | $4,897 |
| PAMIDRONATE DISOD PER 30MG GN | 54210000 | $9,583 |
| RABIES IMM GLOB 150U/ML 10ML | 54210208 | $2,463 |
| RABIES IG-HT 150UNITS/ML 2ML V | 54210257 | $2,273 |
| BAYRAB 150UNITS/ML(GN) 2ML | 54210307 | $2,463 |
| RABAVERT 2.5 UNIT KIT | 54210406 | $3,080 |
| RABIES VACC HUMAN 2.5U/ML VL | 54210455 | $2,276 |
| RETEPLASE PER 18.1MG | 54210703 | $16,476 |
| RHO(D) IMM GLOB PER 50MCG | 54210851 | $655 |
| RHO(D)IMM GLOB H/SD/PER100IU | 54211156 | $4,755 |
| RHO(D)IMM GLOB H/SD/PER 100 IU | 54211206 | $12,961 |
| SARGRAMOSTIM PER 50MCG | 54211750 | $8,766 |
| SARGRAMOSTIM PER 50MCG | 54211800 | $4,480 |
| SOMATROPIN PER 1MG | 54212006 | $3,076 |
| VINORELBINE TART PER 10MG | 54213459 | $1,129 |
| VINORELBINE TART PER 10MG/BD | 54213509 | $4,505 |
| ALTEPLASE PER 1MG | 54213608 | $1,916 |
| ALTEPLASE PER 1MG | 54214077 | $514 |
| EPOETIN ALFA PER 1000U NONESRD | 54214119 | $522 |
| EPOETIN ALFA PER 1000U NONESRD | 54214127 | $863 |
| EPOETIN ALFA PER 1000U NONESRD | 54214135 | $649 |
| EPOETIN ALFA PER 1000U NONESRD | 54214168 | $2,305 |
| EPOETIN ALFA PER 1000U NONESRD | 54214184 | $4,748 |
| EPOETIN ALFA PER 1000U NONESRD | 54214192 | $7,321 |
| AMPHO B LIPOSOME PER 10MG | 54214218 | $3,854 |
| MYCOPHENOLATE ORAL PER 250MG | 54214366 | $5,977 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54214374 | $2,052 |
| EPIRUBICIN HCL PER 2MG | 54214382 | $4,530 |
| THYROTROPIN 1.1MG VIAL | 54214416 | $4,080 |
| CYTARABINE LIPSOME PER 10MG | 54214424 | $4,722 |
| FULVESTRANT F KABI PER 25MG | 54214549 | $2,092 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54214606 | $2,189 |
| BEVACIZUMAB PER 10MG | 54214630 | $6,664 |
| BEVACIZUMAB PER 10MG | 54214648 | $15,204 |
| PEMETREXED PER 10MG | 54214671 | $13,477 |
| OCTREOTIDE NONDEP PER 25MCG | 54214697 | $1,376 |
| OCTREOTIDE NONDEP PER 25MCG | 54214705 | $7,274 |
| CETUXIMAB PER 10MG | 54214739 | $5,386 |
| MESNA PER 200MG | 54300819 | $224 |
| AMIKACIN SULF PER 100MG | 54301957 | $464 |
| HYDROXYZINE INJ UP TO 25MG | 54302039 | $10 |
| DEXAMETHASONE INJ PER 1MG | 54302096 | $26 |
| DEXAMETHASONE INJ PER 1MG | 54302112 | $31 |
| MORPHINE SULF PF PER 10MG | 54302179 | $2,285 |
| NALOXONE HCL PER 1MG | 54302195 | $109 |
| TRIAMCINOLONE PER 10MG | 54302799 | $197 |
| BUTORPHANOL TART PER 1MG | 54303821 | $100 |
| PEGASPARGASE PER SGLE DOSE VL | 54304183 | $62,108 |
| CYCLOSPORINE ORAL 100MG GN | 54304282 | $144 |
| VINCRISTINE PER 1MG | 54304662 | $551 |
| MORPHINE SULF UP TO 10MG | 54304688 | $11 |
| FLUROROURACIL PER 500MG | 54304704 | $70 |
| MEPIVACAINE PER 10ML | 54305305 | $168 |
| MEPERIDINE PER 100MG | 54305446 | $531 |
| TOBRAMYCIN UP TO 80MG INJ | 54306329 | $384 |
| HEP-LOCK 10 UNITS/ML 1ML VL | 54306584 | $2 |
| TEMOZOLOMIDE PER 5MG ORAL | 54306907 | $1,990 |
| TEMOZOLOMIDE PER 5MG ORAL | 54306923 | $4,760 |
| MEPIVACAINE PER 10ML | 54307020 | $58 |
| ONDANSETRON PER 1MG | 54307764 | $1,796 |
| HEPARIN PER 1000 UNITS | 54308002 | $44 |
| DROPERIDOL UP TO 5MG | 54308143 | $81 |
| CASPOFUNGIN ACET PER 5MG | 54308622 | $7,776 |
| CASPOFUNGIN ACET PER 5MG | 54308630 | $6,036 |
| HEPARIN PER 10 UNITS | 54308721 | $52 |
| MDRXYPRGSTRN ACET PER 50MG | 54309133 | $752 |
| MORPHINE SULF UP TO 10MG | 54309489 | $168 |
| IRON SUCROSE CPLX PER 1MG | 54309901 | $1,335 |
| ZOLEDRONIC ACID PER 1MG | 54310073 | $12,987 |
| SIROLIMUS 1MG TAB | 54310255 | $162 |
| METHADONE PER 10MG | 54310412 | $13 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54311006 | $1,910 |
| PROCHLORPER 5MG TAB/OP CH | 54311063 | $2 |
| PROMETHAZINE PER 12.5MG OP CH | 54311097 | $1 |
| HYDROXYZINE 25MG CAP (OP CH) | 54311147 | $34 |
| CELESTONE PER 3MG | 54312236 | $56 |
| BETAMETHASONE PER 3MG | 54312244 | $116 |
| DOXORUBICIN PER 10MG | 54312830 | $792 |
| CHLORPROMAZINE UP TO 50MG | 54313002 | $51 |
| PEN G PROCAINE UP TO 600MU | 54313028 | $168 |
| VANCOMYCIN PER 500MG | 54313135 | $144 |
| HEPARIN PER 10 UNITS | 54313416 | $10 |
| MORPHINE SULF UP TO 10MG | 54313556 | $242 |
| VANCOMYCIN PER 500MG | 54313747 | $246 |
| MORPHINE SULF UP TO 10MG | 54315114 | $8 |
| HEPARIN/NA PER 1000 UNITS | 54315460 | $24 |
| ALTEPLASE PER 1MG | 54315478 | $2,448 |
| FENTANYL CITRATE PER 0.1MG | 54315585 | $1 |
| HEPARIN SOD PER 1000 UNITS | 54315643 | $1 |
| ROPIVACAINE HCL PER 1MG | 54315908 | $52 |
| CYCLOPHOSPHAMIDE PER 25MG TAB | 54316070 | $2 |
| TET/DIPH TOX 2-2LFU/0.5ML | 54316229 | $113 |
| ENOXAPARIN SOD INJ PER 10MG | 54316260 | $633 |
| ENOXAPARIN SOD PER 10MG | 54316278 | $762 |
| DIAZEPAM UP TO 5MG INJ | 54316484 | $24 |
| DIGOXIN IMMUNE FAB PER VIAL | 54316518 | $4,665 |
| TACROLIMUS PARENTERAL PER 5MG | 54316526 | $1,504 |
| FONDAPARINUX PER 0.5MG | 54316716 | $568 |
| ZIPRASIDONE MESYL INJ PER 10MG | 54316872 | $176 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54316971 | $1,392 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54317235 | $1,966 |
| DARBTN ALFA PER 1MCG NON ESRD | 54317250 | $2,239 |
| LORAZEPAM PER 2MG | 54317284 | $2 |
| PAPAVERINE UP TO 60MG | 54317656 | $340 |
| NEOSTIGMINE METHY UP TO 0.5MG | 54317680 | $321 |
| PIPER/TAZO/D5W 4.5GM/100ML PB | 54317938 | $512 |
| FUROSEMIDE PER 20MG | 54318415 | $96 |
| EPOETIN ALFA PER 1000U NONESRD | 54319561 | $687 |
| PREDNISOLONE PER 5MG ORAL | 54319595 | $1 |
| FLUCONAZOLE PER 200MG | 54319702 | $362 |
| PEN G POT UP TO 600MU INJ | 54319934 | $44 |
| HEP B VACC/DP(A)T-POLIO 0.5ML | 54320171 | $52 |
| TEMOZOLOMIDE PER 5MG ORAL | 54320213 | $81 |
| EPOETIN ALFA PER 1000U NONESRD | 54320296 | $32 |
| DRONABINOL ORAL PER 2.5MG OPCH | 54320544 | $156 |
| PROMETHAZINE PER 12.5MG OPCH | 54320593 | $1 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54320676 | $4,636 |
| HEPARIN PER 10 UNITS | 54320833 | $1 |
| BIVALIRUDIN PER 1MG | 54320866 | $7,904 |
| ERTAPENEM SOD PER 500MG | 54320874 | $150 |
| GLATIRAMER ACETATE 20MG KIT | 54320916 | $830 |
| HEPARIN PER 1000 UNITS | 54321013 | $2 |
| MORPHINE SULF UP TO 10MG | 54321047 | $239 |
| AMIODARONE HCL PER 30MG | 54321104 | $171 |
| APREPITANT PER 5MG | 54321195 | $228 |
| APREPITANT PER 5MG | 54321203 | $1,392 |
| INSULIN PER 5 UNITS | 54321351 | $60 |
| CAFFEINE CITRATED PER 5MG | 54321542 | $140 |
| GENTAMICIN UP TO 80MG | 54321641 | $1 |
| MORPHINE SULF UP TO 10MG | 54321740 | $1 |
| ACYCLOVIR PER 5MG INJ | 54321823 | $1 |
| GENTAMICIN UP TO 80MG | 54321963 | $1 |
| CAFFEINE CITRATE PER 5MG | 54322102 | $70 |
| PAMIDRONATE DISOD PER 30MG BRD | 54322169 | $4,920 |
| CYCLOSPOR ORAL PER 100MG/BD | 54322201 | $76 |
| CYCLOSPOR ORAL PER 100MG/BD | 54322227 | $1,975 |
| CYCLOSPORINE 100MG CAP BRAND | 54322235 | $81 |
| CYCLOSPORINE ORAL PER 100MG | 54322243 | $198 |
| CYCLOSPOR ORAL PER 100MG/BD | 54322268 | $1,950 |
| CYCLOSPOR ORAL PER 100MG/BD | 54322276 | $102 |
| DOXORUBICIN PER 10MG BRAND | 54322292 | $1,257 |
| DOXORUBICIN PER 10MG BRAND | 54322300 | $188 |
| DOXORUBICIN PER 10MG | 54322326 | $380 |
| DACARBAZINE PER 100MG BRAND | 54322615 | $313 |
| IFOSFOMIDE PER 1GM BRAND | 54322672 | $1,978 |
| IFOSFOMIDE PER 1GM BRAND | 54322680 | $2,820 |
| MESNA INJ PER 200MG BRAND | 54322698 | $1,233 |
| MITOMYCIN 5MG VIAL BRAND | 54322805 | $588 |
| MITOMYCIN PER 5MG INJ BRAND | 54322813 | $2,546 |
| MITOMYCIN PER 5MG INJ BRAND | 54322821 | $5,589 |
| OCTREOTIDE NONDEP PER 25MCG | 54322896 | $87 |
| OCTREOTIDE NONDEP PER 25MCG | 54322904 | $182 |
| OCTREOTIDE NONDEP PER 25MCG | 54322912 | $1,382 |
| ETOPOSIDE PER 10MG BRAND | 54322961 | $226 |
| CEFAZOLIN PER 500MG | 54323084 | $10 |
| CEFEPIME PER 500MG | 54323092 | $84 |
| CEFTAZIDIME PER 500MG | 54323100 | $63 |
| METOCLOPRAMIDE UP TO 10MG | 54323142 | $1 |
| ROPIVACAINE PER 1MG | 54323373 | $87 |
| PALONSETRON HCL PER 25MCG | 54323639 | $1,898 |
| DIPH PERT TET 15-10-5 0.5ML VL | 54324074 | $208 |
| MORPHINE SULF UP TO 10MG | 54324389 | $8 |
| OXACILLIN SODIUM UP TO 250MG | 54324603 | $87 |
| CEFAZOLIN PER 500MG | 54324777 | $136 |
| AZACITIDINE PER 1MG | 54324827 | $4,944 |
| FUROSEMIDE INJ UP TO 20MG | 54325048 | $24 |
| HYDRALAZINE UP TO 20MG | 54325055 | $24 |
| THIAMINE INJ PER 100MG | 54325071 | $24 |
| ZIDOVUDINE PER 10MG | 54325089 | $24 |
| AMPHO B LIPOSOME PER 10MG | 54325220 | $63 |
| DEXAMETHASONE INJ PER 1MG | 54325279 | $24 |
| MEROPENEM PER 100MG | 54325303 | $34 |
| OXACILLIN SODIUM TO 250MG | 54325311 | $27 |
| CEFAZOLIN PER 500MG | 54325568 | $171 |
| RISPERIDONE LONG ACT PER 0.5MG | 54325725 | $2,067 |
| RISPERIDONE LONG ACT PER 0.5MG | 54325733 | $3,508 |
| OMALIZUMAB PER 5MG | 54325857 | $3,332 |
| GRANISETRON PER 100MCG | 54325881 | $98 |
| LEVOFLOXACIN 250MG/10ML SOLN | 54326004 | $60 |
| HEP B IMMUNE GLOB (>3121IU) VL | 54326277 | $2,184 |
| HEP B IMMUNE GLOB (>1560IU) VL | 54326285 | $4,367 |
| FONDAPARINUX SOD PER 0.5MG | 54326293 | $1,697 |
| FONDAPARINUX SOD PER 0.5MG | 54326301 | $579 |
| FONDAPARINUX SOD PER 0.5MG | 54326319 | $579 |
| TET DIP TOX PED 5-6.7LFU 0.5ML | 54326327 | $135 |
| LORAZEPAM INJ PER 2MG | 54326707 | $91 |
| THIAMINE INJ PER 100MG | 54326814 | $59 |
| AMIODARONE HCL PER 30MG | 54326921 | $95 |
| NATALIZUMAB PER 1MG INJ | 54326988 | $10,327 |
| MAGNESIUM SULF PER 500MG | 54327077 | $29 |
| PROPRANOLOL UP TO 1MG | 54327085 | $162 |
| AMIODARONE HCL PER 30MG | 54327341 | $269 |
| RISPERIDONE LONG ACT PER 0.5MG | 54327663 | $3,089 |
| DIGOXIN UP TO 0.5MG | 54328042 | $1 |
| DARBEPOETIN ALFA PER 1MCG ESRD | 54328174 | $1,181 |
| PNEUMOVAX 25MCG/0.5ML SYR | 54328232 | $175 |
| ETANERCEPT PER 25MG | 54328315 | $2,144 |
| DOXERCALCIFEROL PER 1 MCG | 54328356 | $115 |
| TIGECYCLINE PER 1MG | 54328414 | $922 |
| OCTREOTIDE ACET PER 25MCG | 54328489 | $243 |
| OCTREOTIDE ACET PER 25 MCG | 54328497 | $1,749 |
| HEPARIN LOC PER 10 UNITS | 54328554 | $2 |
| FACTOR VIII (RECOMB) PER UNIT | 54328596 | $22 |
| PARICALCITOL PER 1MCG | 54328604 | $97 |
| AMINOPHYLLINE UP TO 250MG | 54328653 | $23 |
| DEFEROXAMINE MESYL 500MG VL | 54328679 | $480 |
| PEN G PROCAINE UP TO 600MU | 54328737 | $100 |
| MAG SULPHATE 500MG INJ | 54328836 | $23 |
| MAG SULPHATE 500MG INJ | 54328844 | $31 |
| MIDAZOLAM PF 1MG/1ML SYRINGE | 54329297 | $23 |
| MIDAZOLAM 1MG/ML 1ML | 54329305 | $23 |
| AMIODARONE PER 30MG | 54329404 | $140 |
| AMPICILLIN SOD PER 500MG | 54329412 | $206 |
| AMPICILLIN SOD PER 500MG | 54329438 | $766 |
| AMPICILLIN SOD 500MG VIAL | 54329446 | $193 |
| AMP SOD/SULBACT 1.5GM VL | 54329453 | $516 |
| AMP SOD/SULBACT PER 1.5GM | 54329461 | $152 |
| AZATHIOPRINE 100MG VL | 54329487 | $558 |
| CEFTRIAXONE SOD PER 250MG | 54329495 | $324 |
| CEFTRIAXONE SODIUM 250MG VIAL | 54329503 | $344 |
| CEFTRIAXONE SOD PER 250MG | 54329511 | $562 |
| MICAFUNGIN SOD PER 1MG | 54329636 | $775 |
| DIGOXIN UP TO 0.5MG | 54329693 | $30 |
| DIPHENHYDRAMINE UP TO 50MG | 54329701 | $1 |
| MIDAZOLAM PER 1MG | 54329776 | $1 |
| OCTREOTIDE PER 25MCG | 54329784 | $50 |
| TOBRAMYCIN UP TO 80MG | 54329800 | $15 |
| PENTOBARBITAL PER 50MG | 54329818 | $842 |
| MORPHINE UP TO 10MG | 54329826 | $10 |
| METOCLOPRAMIDE UP TO 10MG | 54330147 | $23 |
| DEXAMETHASONE INJ 1MG | 54330154 | $23 |
| CALCIUM GLUC INJ PER 10MG | 54330162 | $23 |
| METOCLOPRAMIDE INJ UP TO 10MG | 54330519 | $34 |
| ACYCLOVIR PER 5MG | 54330584 | $250 |
| POLIOMYELITIS VAC KILLED 0.5ML | 54330659 | $380 |
| HEP A VACC 50UNITS/1ML VIAL | 54330667 | $518 |
| FUROSEMIDE UP TO 20MG | 54330691 | $24 |
| MIDAZOLAM PER 1MG | 54330725 | $23 |
| ACYCLOVIR PER 5MG | 54330733 | $24 |
| HYDRALAZINE UP TO 20MG | 54330774 | $23 |
| AMINOPHYLLINE UP TO 250MG | 54330881 | $23 |
| GENTAMICIN UP TO 80MG | 54330915 | $27 |
| HYDROCORTISONE UP TO 100MG | 54330964 | $24 |
| BACLOFEN KIT PER 10MG | 54331087 | $1,298 |
| OXALIPLATIN PER 0.5MG | 54331103 | $17,697 |
| OXALIPLATIN PER 0.5MG | 54331111 | $4,902 |
| OXALIPLATIN PER 0.5MG | 54331129 | $9,804 |
| NESIRITIDE PER 0.1MG | 54331152 | $5,421 |
| SODIUM CL 0.9% FLUSH 10ML SYRN | 54331186 | $47 |
| IVIG LYOPHILIZED PER 500MG | 54331251 | $5,327 |
| IVIG LYOPHILIZED PER 500MG | 54331269 | $1,524 |
| IVIG LYOPHILIZED PER 500MG | 54331277 | $6,092 |
| IVIG LYOPHILIZED PER 500MG | 54331285 | $5,658 |
| IVIG LYOPHILIZED PER 500MG | 54331368 | $2,661 |
| HYALURON OVINE PER USP UNIT | 54331673 | $100 |
| HYALURON OVINE PER USP UNIT | 54331681 | $226 |
| ACETYLCYSTEIN PER 100MG | 54331723 | $2,149 |
| BACLOFEN KIT PER 10MG | 54331764 | $5,540 |
| RHO(D) IMMU GLOB 300MCG SYR | 54331863 | $597 |
| ALBUMIN HUMAN 25% PER 20ML | 54332036 | $1,830 |
| HYDRALAZINE 1MG/1ML SYR | 54332051 | $23 |
| PEN G POT 100000U/1ML SYR | 54332069 | $23 |
| ROPIVACAINE PER 1MG | 54332200 | $51 |
| MIDAZOLAM PER 1MG | 54332275 | $10 |
| MORPHINE SULF 1MG/ML 10ML PF | 54332341 | $52 |
| IVIG NONLYOPHILIZED PER 500MG | 54332580 | $3,233 |
| POLIO VAC KILLED 0.5ML SYR | 54332614 | $380 |
| PHENYTOIN PER 50MG | 54332648 | $22 |
| METOCLOPRAMIDE UP TO 10MG | 54332705 | $22 |
| NALOXONE HCL PER 1MG | 54332721 | $22 |
| ONDANSETRON HCL PER 1MG | 54332739 | $100 |
| PHENOBARB SOD UP TO 120MG | 54332754 | $22 |
| MORPHINE SULF UP TO 10MG | 54332812 | $22 |
| POT CHL PER 2MEQ INJ | 54332820 | $22 |
| MAG SULFATE PER 500MG | 54332838 | $22 |
| AZITHROMYCIN 500MG/10ML VL GEN | 54333117 | $601 |
| IVIG NONLYOPHILIZED PER 500MG | 54333125 | $538 |
| TOBRAMYCIN UP TO 80MG | 54333521 | $1,699 |
| DOLASETRON MESYLATE PER 10MG | 54333562 | $147 |
| DOPAMINE HCL PER 40MG | 54333968 | $28 |
| DOPAMINE HCL PER 40MG | 54333976 | $95 |
| IVIG NONLYOPHILIZED PER 500MG | 54334016 | $5,557 |
| CAFFEINE CITRATE PER 5MG | 54334115 | $71 |
| DOPAMINE PER 40MG | 54334123 | $95 |
| MITOMYCIN OPHTH SOLN 3ML | 54334156 | $70 |
| FENTANYL CITRATE PER 0.1MG | 54334164 | $62 |
| IBANDRONATE SOD PER 1MG | 54334263 | $1,782 |
| DECITABINE PER 1MG | 54334271 | $7,402 |
| FENTANYL CITRATE PER 0.1MG | 54334461 | $212 |
| A-THYMOCYTE GLOB (RABBIT) 25MG | 54334479 | $2,314 |
| ABATACEPT PER 10MG | 54334560 | $2,047 |
| ANIDULAFUNGIN PER 1MG | 54334701 | $548 |
| HEPARIN LOC PER 10 UNITS | 54334735 | $22 |
| DIP/PERT(ACELL)/TET 0.5ML VL | 54334958 | $341 |
| EPOETIN ALFA PER 100UNITS ESRD | 54334974 | $101 |
| EPOETIN ALFA PER 100UNITS ESRD | 54334982 | $172 |
| EPOETIN ALFA PER 100UNITS ESRD | 54334990 | $308 |
| EPOETIN ALFA PER 100UNITS ESRD | 54335005 | $342 |
| EPOETIN ALFA PER 100UNITS ESRD | 54335013 | $436 |
| EPOETIN ALFA PER 100UNITS ESRD | 54335021 | $1,622 |
| EPOETIN ALFA PER 100UNITS ESRD | 54335039 | $111 |
| EPOETIN ALFA PER 100UNITS ESRD | 54335047 | $3,009 |
| MENINGOCOCCAL/DIPH 16MCG/0.5ML | 54335070 | $438 |
| FENTANYL CITRATE PER 0.1MG | 54335211 | $90 |
| FENTANYL CITRATE PER 0.1MG | 54335229 | $42 |
| HEPARIN LOC PER 10 UNITS | 54335419 | $23 |
| HEPARIN LOC PER 10 UNITS | 54335427 | $26 |
| HEPARIN LOC PER 10 UNITS | 54335781 | $28 |
| HYALURONIDASE PER 1 USP UNIT | 54335799 | $997 |
| DEXAMETHASONE PER 0.25MG | 54335815 | $1 |
| HEPARIN/0.2NS 10U/20ML SYR | 54335930 | $21 |
| CYCLOSPORINE 250MG/5ML VIAL | 54336086 | $168 |
| INSULIN PER 5 UNITS | 54336128 | $224 |
| INSULIN PER 5 UNITS | 54336136 | $262 |
| DARBPTN ALFA PER 1MCG NON ESRD | 54336425 | $1,585 |
| PHYTONADIONE 1MG/0.5ML SYR | 54336698 | $21 |
| HEPARIN LOC PER 10 UNITS | 54336706 | $21 |
| CEFEPIME HCL PER 500MG | 54336763 | $140 |
| CEFEPIME HCL PER 500MG | 54336771 | $243 |
| ONDANSETRON PER 1MG | 54336789 | $30 |
| ONDANSETRON PER 1MG | 54336797 | $158 |
| CAFFEINE CITRATE PER 5MG | 54336896 | $177 |
| CAFFEINE CITRATE PER 5MG | 54336904 | $52 |
| CEFOXITIN (GN) 1GM/20ML VL | 54336912 | $95 |
| CEFOXITIN SODIUM PER 1GM | 54336920 | $168 |
| MILRINONE LACT PER 5MG | 54336938 | $160 |
| DEXAMETHASONE INJ PER 1MG | 54336979 | $120 |
| HEPARIN LOC PER 10 UNITS | 54336987 | $21 |
| DICYCLOMINE (GN) 20MG/2ML VL | 54337019 | $213 |
| FONDAPARINUX SOD PER 0.5MG | 54337126 | $343 |
| HYDROCORTISONE 100MG/2ML ACT V | 54337142 | $21 |
| HEPARIN PER 1000 UNITS | 54337175 | $21 |
| ALBUMIN 5% PER 50ML | 54337183 | $2,902 |
| ALBUMIN 25% 12.5GM/50ML | 54337209 | $2,651 |
| DIHYDROERGOTAMINE (GN) 1MG/1ML | 54337225 | $214 |
| HALOPERIDOL DEC (GN) 50MG/1ML | 54337316 | $52 |
| HALOPERIDOL LAC (GN) 5MG/1ML | 54337332 | $208 |
| HALOPERIDOL INJ PER 5MG | 54337340 | $417 |
| MORPHINE SULF PF PER 10MG | 54337530 | $479 |
| METHACHOLINE CL PER 1MG | 54337548 | $276 |
| ONDANSETRON/NS (GN) 1MG/1ML | 54337555 | $21 |
| HEPARIN LOC PER 10 UNITS | 54337563 | $51 |
| CARBOPLATIN INJ PER 50MG | 54337589 | $340 |
| CARBOPLATIN INJ PER 50MG | 54337597 | $538 |
| CARBOPLATIN (GN) 50MG/5ML VL | 54337605 | $136 |
| CARBOPLATIN INJ PER 50MG | 54337613 | $1,080 |
| CYTARABINE (GN) 100MG/5ML VL | 54337639 | $44 |
| CYTARABINE HCL PER 100MG | 54337647 | $287 |
| FLUOROURACIL (GN) 500MG/10ML V | 54337654 | $24 |
| MITOXANTRONE HCL PER 5MG | 54337688 | $6,411 |
| BLEOMYCIN SULF (GN) 15 UNIT VL | 54337712 | $470 |
| DACARBAZINE PER 100MG VIAL | 54337720 | $158 |
| DOXORUBICIN PER 10MG | 54337738 | $387 |
| FLUDARABINE PHOS (GN) 50MG/2ML | 54337746 | $1,571 |
| VINCRISTINE PFS 1MG/1ML VL | 54337753 | $128 |
| ETOPOSIDE PER 10MG | 54337779 | $352 |
| HEPARIN PER 1000 UNITS | 54337910 | $21 |
| LEVETIRACETAM PER 10MG | 54337951 | $244 |
| ARIPIPRAZOLE PER 0.25MG | 54337969 | $92 |
| IXABEPILONE INJECTION 1MG | 54337993 | $4,601 |
| IXABEPILONE INJECTION 1MG | 54338009 | $13,804 |
| RHO(D)IMM GLOB H/SD/PER 100 IU | 54338223 | $2,594 |
| RHO(D)IMM GLOB H/SD/PER 100 IU | 54338231 | $15,570 |
| HEPARIN PER 1000 UNITS | 54338249 | $81 |
| TEMSIROLIMUS PER 1MG | 54338306 | $5,754 |
| HEPARIN PER 10 UNITS | 54338348 | $60 |
| MEDROXYPROG ACET PER 1MG | 54338496 | $329 |
| MEDROXYPROG ACET PER 1MG | 54338504 | $554 |
| FOSPHENYTOIN PER 50MG | 54338678 | $27 |
| FOSPHENYTOIN PER 50MG | 54338694 | $57 |
| AGALSIDASE BETA PER 1MG | 54338827 | $22,216 |
| VWF PER UNIT (HUMATE-P)<600 VL | 54338868 | $14 |
| ALBUMIN HUMAN 12.5MG/50ML VIAL | 54339072 | $459 |
| FACTOR VIII(HELI250) PER UNIT | 54339080 | $2 |
| FACTOR VIII (HELI500) PER UNIT | 54339098 | $2 |
| FACTOR VIII(HELI1000) PER UNIT | 54339106 | $2 |
| FACTOR VIII(HELI2000) PER UNIT | 54339114 | $2 |
| RHO(D) IMMUNE GLOB PER 100IU | 54339122 | $499 |
| IFOSFAMIDE PER 1GM | 54339155 | $382 |
| IFOSFAMIDE PER 1GM | 54339163 | $948 |
| TREPROSTINIL PER 1MG | 54339197 | $13,816 |
| TEMOZOLOMIDE PER 5MG ORAL | 54339205 | $1,164 |
| BENDAMUSTINE PER 1MG | 54339320 | $8,722 |
| DIPYRIDAMOLE 5MG/ML 2ML AMP | 54339403 | $21 |
| MICAFUNGIN SOD PER 1MG | 54339429 | $1,384 |
| DORIPENEM PER 10MG | 54339502 | $275 |
| ENOXAPARIN/NS 10MG/1ML SYRINGE | 54339593 | $70 |
| SUCCINYLCHOLIN CHL UP TO 20MG | 54339684 | $183 |
| BASILIXIMAB 20MG VIAL | 54339700 | $8,740 |
| IVIG NONLYOPHILIZED PER 500MG | 54339775 | $5,293 |
| FENTANYL CITRATE PER 0.1MG | 54339825 | $105 |
| NALBUPHINE PER 10MG | 54339874 | $79 |
| FENTANYL CITRATE PER 0.1MG | 54339940 | $71 |
| DIHYDROERGOTAMINE 1MG/1ML VIAL | 54339965 | $188 |
| INS R/0.45 SOD CHL 5UNITS/50ML | 54340005 | $127 |
| REGADENOSAN PER 0.1MG | 54340054 | $1,731 |
| TENECTEPLASE PER 1MG | 54340062 | $41,997 |
| LEVOLEUCOVORIN PER 0.5MG | 54340161 | $470 |
| FOSAPREPITANT PER 1MG | 54340179 | $832 |
| CLEVIDIPINE BUTYRATE PER 1MG | 54340237 | $1,974 |
| INFLUENZA PEDI 22.5MCG/0.25ML | 54340245 | $105 |
| METHYLDOPATE 250MG/5ML 5ML VL | 54340823 | $165 |
| MIDAZOLAM 1MG/1ML SYR | 54341201 | $16 |
| LEUPROLIDE ACE DEPOT PER 7.5MG | 54341433 | $6,190 |
| TREPROSTINIL PER 1MG | 54341466 | $25,583 |
| METHYLERGONOVINE TO 0.2MG | 54341482 | $76 |
| VANCOMYCIN PER 500MG | 54341508 | $50 |
| MYCOPHENOLATE 250MG CAP UD | 54341581 | $79 |
| ALTEPLASE PER 1MG | 54341623 | $420 |
| ALTEPLASE PER 1MG | 54341631 | $3,470 |
| VARIZIG 125 IU/1ML VIAL | 54341839 | $489 |
| ZOSTER VACC LIVE 19400 UNIT | 54341870 | $766 |
| HEPARIN LOC PER 10 UNITS | 54341912 | $20 |
| DRONABINOL ORAL PER 2.5MG OPCH | 54341946 | $128 |
| INFLUENZA VACC 45MCG/0.5ML SYR | 54342043 | $56 |
| PRALIDOXIME UP TO 1GM | 54342068 | $410 |
| OCTREOTIDE DEPOT PER 1MG | 54342076 | $9,834 |
| INSULIN PER 5 UNITS | 54342092 | $144 |
| MAG SULFATE PER 500MG | 54342134 | $83 |
| IVIG PRIVIGEN PER 500MG | 54342142 | $2,056 |
| IVIG PRIVIGEN PER 500MG | 54342159 | $4,110 |
| IVIG PRIVIGEN PER 500MG | 54342167 | $8,222 |
| INFLUENZA VACC 45MCG/0.5ML SYR | 54342191 | $69 |
| TREPROSTINIL PER 1MG | 54342217 | $5,117 |
| ENOXAPARIN SOD INJ PER 10MG | 54342274 | $260 |
| ENOXAPARIN SOD INJ PER 10MG | 54342282 | $300 |
| ENOXAPARIN SOD INJ PER 10MG | 54342290 | $371 |
| ENOXAPARIN SOD INJ PER 10MG | 54342308 | $453 |
| ENOXAPARIN SOD INJ PER 10MG | 54342316 | $444 |
| ENOXAPARIN SOD INJ PER 10MG | 54342324 | $476 |
| ENOXAPARIN SOD INJ PER 10MG | 54342332 | $546 |
| ENOXAPARIN SOD INJ PER 10MG | 54342340 | $579 |
| ENOXAPARIN SOD INJ PER 10MG | 54342357 | $614 |
| ENOXAPARIN SOD INJ PER 10MG | 54342365 | $646 |
| ENOXAPARIN SOD INJ PER 10MG | 54342373 | $682 |
| IRON DEX COMPLEX PER 50MG | 54342381 | $150 |
| SODIUM HYALURONATE PER DOSE | 54342399 | $618 |
| INFLUENZA VAC 45MCG/0.5ML SYR | 54342431 | $96 |
| DEXRAZOXANE PER 250MG | 54342563 | $2,967 |
| NELARABINE PER 50MG | 54342571 | $2,156 |
| APREPITANT PER 5MG | 54342647 | $254 |
| ELLIOTS B SOLUTION PER 1ML | 54342662 | $236 |
| FENTANYL CITRATE PER 0.1MG | 54342670 | $28 |
| FENTANYL CITRATE PER 0.1MG | 54342688 | $16 |
| METHYLENE BLUE PER 1MG | 54342985 | $66 |
| METHYLENE BLUE PER 1MG | 54342993 | $38 |
| METHYLENE BLUE PER 1MG | 54343009 | $56 |
| ATROPINE SULF INJ PER 0.01MG | 54343017 | $16 |
| ATROPINE SULF INJ PER 0.01MG | 54343025 | $69 |
| ATROPINE SULF INJ PER 0.01MG | 54343033 | $16 |
| ATROPINE SULF INJ PER 0.01MG | 54343041 | $291 |
| ATROPINE SULF INJ PER 0.01MG | 54343058 | $24 |
| ATROPINE SULF INJ PER 0.01MG | 54343066 | $18 |
| ATROPINE SULF INJ PER 0.01MG | 54343074 | $1 |
| ATROPINE SULF INJ PER 0.01MG | 54343082 | $39 |
| ATROPINE SULF INJ PER 0.01MG | 54343090 | $16 |
| ATROPINE SULF INJ PER 0.01MG | 54343108 | $21 |
| HYALURONAN INJ PER 1MG | 54343140 | $1,071 |
| HYALURONAN INJ PER 1MG | 54343157 | $3,213 |
| DOCETAXEL PER 1MG | 54343165 | $6,669 |
| DOCETAXEL PER 1MG | 54343173 | $1,767 |
| LACOSAMIDE INJ PER 1MG | 54343181 | $267 |
| PACLITAXEL PROTEIN-BND PER 1MG | 54343363 | $3,982 |
| ANTI-INHIBITOR(FEIBA VH)PER IU | 54343389 | $12 |
| LEVETIRACETAM/NS 10MG/2ML SYR | 54343454 | $16 |
| ETOPOSIDE 50MG CAP | 54343520 | $238 |
| LEUPROLIDE ACE DEPOT PER 7.5MG | 54343538 | $5,310 |
| TELAVANCIN PER 10MG | 54343645 | $287 |
| TELAVANCIN PER 10MG | 54343652 | $1,689 |
| DEGARELIX PER 1MG | 54343686 | $4,018 |
| DEGARELIX PER 1MG | 54343694 | $1,422 |
| PALIPERIDONE PALMITATE PER 1MG | 54343702 | $1,129 |
| PALIPERIDONE PALMITATE PER 1MG | 54343710 | $2,254 |
| PALIPERIDONE PALMITATE PER 1MG | 54343728 | $3,384 |
| OXALIPLATIN PER 0.5MG | 54343777 | $2,572 |
| OXALIPLATIN PER 0.5MG | 54343785 | $5,146 |
| ENFUVIRTIDE PER 1MG | 54343959 | $11,652 |
| PENTOSTATIN PER 10MG | 54344007 | $8,183 |
| HUMAN SECRETIN PER 1MCG | 54344155 | $1,891 |
| HEPARIN LOC PER 10 UNITS | 54344163 | $16 |
| PREVNAR 13 VALENT 0.5ML SYR | 54344221 | $1,217 |
| FERUMOXYTOL PER 1MG NONESRD | 54344288 | $1,811 |
| EPOPROSTENOL PER 0.5MG | 54344379 | $213 |
| EPOPROSTENOL 0.5MG VIAL | 54344395 | $79 |
| FACTOR IX COMPLEX PER UNIT | 54344403 | $2 |
| DACLIZUMAB PER 25MG | 54344437 | $2,267 |
| DIMERCAPROL PER 100MG | 54344478 | $456 |
| HEP A VACC 1440 UNITS/1ML VIAL | 54344486 | $360 |
| TETANUS/DIPTH/PERT 0.5ML SYR | 54344668 | $268 |
| CYTOMEGALOVIRUS PER VIAL | 54344684 | $4,829 |
| DEXAMETHASONE 0.5MG/5ML | 54344924 | $16 |
| MORPHINE SULF UP TO 10MG | 54344999 | $15 |
| CLOFARABINE PER 1MG | 54345046 | $8,810 |
| MINOCYCLINE PER 1MG | 54345111 | $560 |
| CLONIDINE 1MG/10ML VIAL | 54345160 | $265 |
| INSULIN PER 5 UNITS | 54345343 | $30 |
| MORPHINE SULF UP TO 10MG | 54345467 | $126 |
| TRIAMCINOLONE ACET PER 1MG | 54345509 | $516 |
| ADRENAL EPINEPH INJ PER 0.1MG | 54345673 | $613 |
| ADRENAL EPINEPH INJ PER 0.1MG | 54345681 | $503 |
| ADRENAL EPINEPH INJ PER 0.1MG | 54345731 | $306 |
| ADRENAL EPINEPH INJ PER 0.1MG | 54345756 | $738 |
| ADRENAL EPINEPH INJ PER 0.1MG | 54345764 | $1 |
| PEN G BENZ/PROC PER 100000 | 54345772 | $269 |
| PEN G BENZ INJ PER 100000U | 54345806 | $208 |
| PEN G BENZ INJ PER 100000U | 54345814 | $797 |
| PEN G BENZ INJ PER 100000U | 54345822 | $886 |
| ESTADIOL VALERATE PER 10MG | 54345830 | $1,167 |
| TOPOTECAN PER 0.1MG | 54345848 | $7,526 |
| ANTITHROMBIN RECOM PER 50IU | 54345855 | $15,578 |
| CROTALIDAE IMMUNE FAB TO 1MG | 54345863 | $13,166 |
| IMMUNE GLOB/HIZENTRA PER 100MG | 54345939 | $2,091 |
| EPOETIN ALFA PER 1000U NONESRD | 54345954 | $1,060 |
| EPOETIN ALFA PER 100UNITS ESRD | 54345962 | $1,060 |
| DOCETAXEL PER 1MG | 54345970 | $5,972 |
| DOCETAXEL PER 1MG | 54345988 | $1,583 |
| IRON SUCROSE CPLX PER 1MG | 54346028 | $422 |
| PROMETHAZINE 25MG/1ML VIAL | 54346051 | $14 |
| OCTREOTIDE NONDEP PER 25MCG | 54346093 | $29 |
| CEFTAROLINE FOSAMIL PER 10MG | 54346127 | $262 |
| DORIPENEM PER 10MG | 54346143 | $106 |
| RHO(D) IMM GLOB 50MCG MINI SYR | 54346184 | $164 |
| INTERFERON A2B PER 1 MILL UNIT | 54346267 | $594 |
| MIDAZOLAM PER 1MG | 54346283 | $14 |
| MIDAZOLAM PER 1MG | 54346291 | $2 |
| IBUPROFEN INJ PER 100MG | 54346325 | $42 |
| FLUOROURACIL INJ PER 500MG | 54346333 | $35 |
| LEVOFLOXACIN PER 250MG | 54346366 | $236 |
| PLERIXAFOR INJ PER 1MG | 54346416 | $25,219 |
| BENZTROPINE MESYL PER 1MG | 54346499 | $702 |
| IMIGLUCERASE PER 10 UNITS | 54346531 | $6,094 |
| PLASMA PROT (HUMAN) 5% 250ML | 54346549 | $185 |
| SUCCINYLCHOLIN CHL UP TO 20MG | 54346887 | $95 |
| NEOSTIGMINE METHY UP TO 0.5MG | 54346895 | $61 |
| IVIG NONLYOPHILIZED PER 500MG | 54346945 | $3,098 |
| IVIG NONLYOPHILIZED PER 500MG | 54346952 | $1,550 |
| OXYMORPHONE 1MG/1ML AMP | 54346994 | $15 |
| BUPRENORPHINE PER 0.1MG | 54347075 | $23 |
| RETEPLASE PER 18.1MG | 54347083 | $16,690 |
| HYDROCORT SOD SUC PF 100MG/2ML | 54347109 | $24 |
| DENOSUMAB PER 1MG | 54347257 | $3,172 |
| CEFTAROLINE FOSAMIL PER 10MG | 54347265 | $262 |
| ECALLANTIDE PER 1MG | 54347281 | $32,087 |
| GEMCITABINE HCL PER 200MG | 54347315 | $2,062 |
| GEMCITABINE 200MG/5.26ML VIAL | 54347323 | $412 |
| DOCETAXEL PER 1MG | 54347331 | $4,586 |
| DOCETAXEL PER 1MG | 54347349 | $1,217 |
| FOSAPREPITANT PER 1MG | 54347414 | $984 |
| ACETAMINOPHEN INJ PER 10MG | 54347539 | $83 |
| LIDOCAINE/TETRA 70-70MG PATCH | 54347547 | $101 |
| ROTAVIRUS VACCINE SUSP 1ML | 54347588 | $392 |
| KINRIX VACCINE 0.5ML SYRINGE | 54347596 | $218 |
| HUMAN PAPILOMVIRUS VACC 0.5ML | 54347604 | $504 |
| MIDAZOLAM INJ PER 1MG | 54347638 | $19 |
| RASBURICASE PER 0.5MG | 54347695 | $11,088 |
| HYDROCORTISONE PF TO 100MG | 54347802 | $66 |
| HPV VACCINE 2-VALENT 0.5ML | 54347836 | $492 |
| DIMENHYDRINATE 50MG/1ML VIAL | 54347893 | $28 |
| HYDRO SOD SUCC PER 100MG | 54348057 | $110 |
| ROPIVACAINE PER 1MG | 54348081 | $306 |
| ROPIVACAINE PER 1MG | 54348099 | $1,756 |
| FENTANYL CITRATE PER 0.1MG | 54348115 | $23 |
| MORPHINE SULF PF PER 10MG | 54348156 | $63 |
| TRASTUZUMAB PER 10MG | 54348271 | $574 |
| PAMIDRONATE DISORD PER 30MG | 54348297 | $122 |
| TRASTUZUMAB PER 10MG | 54348339 | $331 |
| NULECIT 12.5MG/5ML | 54348354 | $14 |
| MELPHALAN 2MG TAB | 54348388 | $28 |
| ROPIVACAINE HCL PER 1MG | 54348412 | $39 |
| SIROLIMUS ORAL PER 1 MG | 54348479 | $49 |
| BRENTUXIMAB VEDOTIN PER 1MG | 54348628 | $15,720 |
| ANASCORP UP TO 120MG | 54348669 | $13,946 |
| ACYCLOVIR PER 5MG INJ | 54348727 | $66 |
| ALBUMIN HUMAN 5% PER 50ML | 54348735 | $120 |
| GENTAMICIN UP TO 80MG | 54348784 | $15 |
| HYDROCORTISONE UP TO 100MG | 54348792 | $23 |
| IVIG NONLYOPHILIZED PER 500MG | 54348982 | $7,005 |
| IVIG NONLYOPHILIZED PER 500MG | 54349089 | $464 |
| IVIG NONLYOPHILIZED PER 500MG | 54349097 | $1,018 |
| BUPIVACAINE LIPOSOME PER 1MG | 54349311 | $1,468 |
| CYCLOSPORINE ORAL PER 100MG | 54349360 | $17 |
| METHYLNAL TREXONE PER 0.1 MG | 54349618 | $472 |
| EVEROLIMUS PER 0.25 MG | 54349626 | $933 |
| PEN G POT UP TO 600000U INJ | 54350947 | $23 |
| TOCILIZUMAB INJ PER 1MG | 54351234 | $5,587 |
| ICATIBANT INJ PER 1MG | 54351283 | $9,782 |
| INFLUENZA QUAD 60MCG/0.5ML SYR | 54351291 | $116 |
| INJ FILGRASTIM G-CSF PER 1MCG | 54351549 | $3,222 |
| INJ FILGRASTIM G-CSF PER 1MCG | 54351556 | $1,117 |
| INJ FILGRASTIM G-CSF PER 1MCG | 54351564 | $5,831 |
| INJ BETA INTERFERON PER 1MCG | 54351580 | $2,736 |
| INJ BETA INTERFERON PER 1MCG | 54351598 | $2,021 |
| NEOSTIGMINE METHY UP TO 0.5MG | 54351804 | $62 |
| DENOSUMAB PER 1MG | 54351838 | $7,290 |
| DEFINITY RT PER 1ML | 54352141 | $816 |
| POTASSIUM CHL PER 2MEQ | 54352372 | $18 |
| IVIG NONLYOPHILIZED PER 500MG | 54352471 | $3,134 |
| MORPHINE SULF PER 10MG INJ | 54352786 | $263 |
| TESTOSTERON CYP PER 1MG INJ | 54352794 | $398 |
| TESTOSTERONE ENANTH PER 1MG | 54352802 | $1,151 |
| PACLITAXEL PER 1MG INJ | 54352810 | $3,838 |
| PACLITAXEL PER 1MG INJ | 54352828 | $8,176 |
| MORPHINE SULF PER 10MG INJ | 54352836 | $438 |
| PACLITAXEL PER 1MG INJ | 54352844 | $1,966 |
| PACLITAXEL PER 1MG INJ | 54352851 | $9,694 |
| PROPOFOL INJ PER 10MG | 54352869 | $357 |
| PROPOFOL INJ PER 10MG | 54352877 | $432 |
| PROPOFOL INJ PER 10MG | 54352885 | $86 |
| PACLITAXEL PER 1MG INJ | 54352901 | $715 |
| PACLITAXEL PER 1MG INJ | 54352919 | $2,001 |
| PROPOFOL INJ PER 10MG | 54352927 | $21 |
| PROPOFOL INJ PER 10MG | 54352935 | $52 |
| PROPOFOL INJ PER 10MG | 54352943 | $118 |
| PROPOFOL INJ PER 10MG | 54352950 | $21 |
| PROPOFOL INJ PER 10MG | 54352968 | $14 |
| PROPOFOL INJ PER 10MG | 54352976 | $36 |
| PROPOFOL INJ PER 10MG | 54352984 | $58 |
| PROPOFOL INJ PER 10MG | 54352992 | $33 |
| PROPOFOL INJ PER 10MG | 54353008 | $81 |
| PROPOFOL INJ PER 10MG | 54353016 | $140 |
| PROPOFOL INJ PER 10MG | 54353024 | $109 |
| PROPOFOL INJ PER 10MG | 54353032 | $66 |
| PROPOFOL INJ PER 10MG | 54353040 | $519 |
| ADENOSINE PER 1MG INJ | 54353065 | $546 |
| ADENOSINE PER 1MG INJ | 54353073 | $1,112 |
| ADENOSINE PER 1MG INJ | 54353198 | $183 |
| ADENOSINE PER 1MG INJ | 54353206 | $661 |
| ADENOSINE PER 1MG INJ | 54353214 | $50 |
| ADENOSINE PER 1MG INJ | 54353222 | $846 |
| PROTHROMBIN CMPLEX PER IU | 54353230 | $10 |
| CYCLOPHOSPHAMIDE ORAL PER 25MG | 54353263 | $23 |
| CYCLOPHOSPHAMIDE ORAL PER 25MG | 54353271 | $102 |
| FACTOR VIIA PER 1MCG | 54353404 | $12 |
| FACTOR VIIA PER 1MCG | 54353412 | $12 |
| FACTOR VIIA PER 1MCG | 54353420 | $12 |
| FACTOR IX(PROFILNINE)PER UNIT | 54353446 | $4 |
| FACTOR IX(BENEFIX)PER UNIT | 54353479 | $8 |
| ANTITHROMBIN III PER IU | 54353495 | $22 |
| SUMATRIPTAN 6MG/0.5ML INJ | 54353644 | $1,294 |
| LORAZEPAM PER 2MG | 54353800 | $39 |
| CEFTOLOZANE/TAZOBACTAM 50/25MG | 54353842 | $530 |
| RHO(D) IMMUNE GLOB 300MCG SYR | 54353909 | $1,790 |
| TBO-FILGRASTIM PER 1MCG | 54354089 | $1,839 |
| TBO-FILGRASTIM PER 1MCG | 54354097 | $2,928 |
| ALEMTUZUMAB PER 1MG | 54354105 | $7,960 |
| PREDNISONE IR ORAL PER 1MG | 54354295 | $1 |
| PREDNISONE IR ORAL 1MG | 54354303 | $1 |
| PREDNISONE IR ORAL 1MG | 54354311 | $1 |
| PREDNISONE IR ORAL 1MG | 54354329 | $24 |
| PREDNISONE IR ORAL 1MG | 54354345 | $1 |
| PREDNISONE IR ORAL 1MG | 54354352 | $81 |
| FILGRASTIM G-CSF BIO PER 1MCG | 54354659 | $876 |
| NEOSTIGMINE METHY UP TO 0.5MG | 54354733 | $190 |
| PERAMIVIR PER 1MG | 54354824 | $1,157 |
| GENTAMICIN SULF UP TO 80MG | 54354857 | $12 |
| GENTAMICIN SULF UP TO 80MG | 54354865 | $1 |
| GENTAMICIN UP TO 80MG | 54354873 | $176 |
| GENTAMICIN UP TO 80MG | 54354881 | $237 |
| ORITAVANCIN PER 10MG | 54355359 | $8,289 |
| ISAVUCONAZONIUM PER 1MG | 54355391 | $1,224 |
| BELATACEPT PER 1MG | 54355433 | $2,358 |
| ARGATROBAN PER 1MG NONESRD | 54355607 | $13,008 |
| ARGATROBAN PER 1MG ESRD | 54355615 | $11,825 |
| METHYLENE BLUE PER 1MG | 54355847 | $834 |
| IVIG NONLYOPHILIZED PER 500MG | 54356076 | $3,210 |
| CANGRELOR PER 1MG | 54356092 | $3,206 |
| CONIVAPTAN PER 1MG | 54356100 | $504 |
| HEMIN PER 1MG | 54356761 | $21,461 |
| INSULIN PER 5 UNITS | 54356993 | $12 |
| DALBAVANCIN PER 5MG | 54357009 | $3,616 |
| SUCCINYLCHOLIN CHL UP TO 20MG | 54357090 | $56 |
| CEFAZOLIN PER 500MG | 54357116 | $16 |
| CEFEPIME HCL PER 500MG | 54357124 | $37 |
| CEFEPIME HCL PER 500MG | 54357132 | $69 |
| CEFOXITIN SODIUM PER 1GM | 54357157 | $34 |
| CEFTAZIDIME PER 500MG | 54357165 | $32 |
| CEFTRIAXONE PER 250MG | 54357173 | $16 |
| CEFTRIAXONE PER 250MG | 54357181 | $26 |
| CEFUROXIME SOD PER 750MG | 54357199 | $16 |
| MEROPENEM PER 100MG | 54357207 | $118 |
| CEFAZOLIN PER 500MG | 54357280 | $23 |
| MEROPENEM PER 100MG | 54357314 | $34 |
| AMPICILLIN SOD PER 500MG | 54357322 | $34 |
| AMPICILLIN SOD PER 500MG | 54357330 | $73 |
| OXACILLIN SODIUM UP TO 250MG | 54357348 | $53 |
| OXACILLIN SODIUM UP TO 250MG | 54357355 | $122 |
| DAPTOMYCIN PER 1MG | 54357371 | $251 |
| ERTAPENEM SOD PER 500MG | 54357553 | $90 |
| DAPTOMYCIN PER 1MG | 54357785 | $2,081 |
| FACTOR VIII(WILATE1000)PERUNIT | 54357819 | $6 |
| C1 ESTERASE BERINERT PER 10U | 54357868 | $7,158 |
| GLIADEL WAFER 7.7-192.3 | 54357900 | $14,824 |
| IVIG NONLYOPHILIZED PER 500MG | 54357975 | $1,266 |
| ARGATROBAN PER 1MG NONESRD | 54358171 | $606 |
| RABIES IG PER 150IU | 54358247 | $10,893 |
| INJ FILGRASTIM G-CSF PER 1MCG | 54358502 | $1,109 |
| RITUXIMAB PER 10 MG | 54358775 | $28,318 |
| RITUXIMAB PER 10 MG | 54358783 | $6,920 |
| MEROPENEM/VABOR PER 10MG/10MG | 54358916 | $644 |
| VANCOMYCIN PER 500MG | 54358924 | $95 |
| EPO ALFA EPBX PER 1000U | 54359005 | $384 |
| EPO ALFA EPBX PER 100U ESRD | 54359047 | $384 |
| VANCOMYCIN PER 500MG | 54359070 | $66 |
| METHYLNAL TREXONE PER 0.1 MG | 54359252 | $411 |
| COCAINE HCL NASAL PER 1MG | 54359294 | $518 |
| COCAINE HCL NASAL PER 1MG | 54359302 | $458 |
| COCAINE HCL NASAL PER 1MG | 54359310 | $186 |
| MENB-FHBP VACC 2/3 DOSE IM | 54359351 | $492 |
| EPO ALFA EPBX PER 1000U | 54359484 | $94 |
| EPO ALFA EPBX PER 100U ESRD | 54359492 | $94 |
| EPO ALFA EPBX PER 1000U | 54359500 | $130 |
| EPO ALFA EPBX PER 100U ESRD | 54359518 | $130 |
| TREPROSTINIL PER 1MG | 54359609 | $40,095 |
| BCG LIVE INTRAVESICAL PER 1MG | 54359815 | $2,424 |
| BCG LIVE INTRAVESICAL PER 1MG | 54359823 | $542 |
| TOCILIZUMAB PER 1MG | 54360094 | $2,794 |
| ERAVACYCLINE PER 1MG | 54360128 | $202 |
| EPINEPHRINE PER 0.1MG | 54360235 | $54 |
| RITUXIMAB-ABBS PER 10MG | 54361118 | $1,453 |
| RITUXIMAB-ABBS PER 10MG | 54361126 | $4,582 |
| CAPLACIZUMAB PER 1MG INJ | 54361928 | $18,189 |
| REMDESIVIR PER 1MG | 54363288 | $1,354 |
| HEP B VAC 20MCG/0.5ML 1ML | 54363460 | $316 |
| MENINGOC/DIPH OLIGO 0.5ML VL | 54364468 | $435 |
| VISAPAQUE 320 PER 1ML | 54365671 | $349 |
| FIBRINOGEN PER 1MG | 54365770 | $5 |
| ISOVUE 250 100ML PER 1ML | 54366232 | $4 |
| ERAVACYCLINE PER 1MG | 54366992 | $309 |
| PEGFILGRASTIM PER 0.5MG | 54367008 | $28,498 |
| CEFIDEROCOL PER 10MG | 54367156 | $583 |
| PNEUMO 20 VALENT VACC 0.5ML | 54369269 | $653 |
| BORTEZOMIB NOS PER 0.1MG | 54370903 | $10,428 |
| ERTAPENEM/SWFI 0.5 GM/5 ML | 54371042 | $62 |
| FLUARIX QUAD 0.5ML SYR | 54371729 | $68 |
| TENECTEPLASE PER 1MG | 54372057 | $16,015 |
| CHLOROPROCAINE PER 1MG | 54372065 | $72 |
| CHLOROPROCAINE PER 1MG | 54372073 | $355 |
| CHLOROPROCAINE PER 1MG | 54372081 | $328 |
| CHLOROPROCAINE PER 1MG | 54372099 | $352 |
| CEFEPIME HCL PER 500MG | 54372271 | $465 |
| VANCOMYCIN PER 500MG | 54372503 | $580 |
| CALCIUM GLUC INJ PER 10MG | 54373014 | $26 |
| CEFEPIME PER 500MG | 54373378 | $708 |
| SOD FER GLUC COMP PER 12.5MG | 54373592 | $51 |
| MEROPENEM PER 100MG | 54373683 | $153 |
| ISOVUE M 200 PER 1ML | 54373717 | $357 |
| ISOVUE M 200 PER 1ML | 54373725 | $389 |
| ISOVUE 200 PER 1ML | 54373733 | $403 |
| ISOVUE 200 200ML PER 1ML | 54373741 | $2 |
| ISOVUE 250 PER 1ML | 54373758 | $403 |
| ISOVUE 250 150ML PER 1ML | 54373766 | $3 |
| ISOVUE 250 200ML PER 1ML | 54373774 | $2 |
| VISIPAQUE 270 PER 1ML | 54373782 | $403 |
| VISIPAQUE 270 100ML PER 1ML | 54373790 | $4 |
| VISIPAQUE 270 150ML PER 1ML | 54373808 | $3 |
| VISIPAQUE 270 200ML PER 1ML | 54373816 | $2 |
| IODIXANOL 270 F-K PER 1ML | 54373832 | $410 |
| IODIXANOL 270 150ML FK PER 1ML | 54373840 | $3 |
| ISOVUE M 300 PER 1ML | 54373857 | $98 |
| ISOVUE 300 PER 1ML | 54373865 | $195 |
| ISOVUE 300 PER 1ML | 54373873 | $349 |
| ISOVUE 300 PER 1ML | 54373881 | $460 |
| ISOVUE 300 100ML PER 1ML | 54373899 | $4 |
| ISOVUE 300 150ML PER 1ML | 54373907 | $3 |
| ISOVUE 300 200ML PER 1ML | 54373915 | $2 |
| ISOVUE 370 PER 1ML | 54373923 | $349 |
| ISOVUE 370 75ML PER 1ML | 54373931 | $6 |
| ISOVUE 370 100ML PER 1ML | 54373949 | $4 |
| ISOVUE 370 125ML PER 1ML | 54373956 | $3 |
| ISOVUE 370 150ML PER 1ML | 54373964 | $3 |
| ISOVUE 370 200ML PER 1ML | 54373972 | $2 |
| ISOVUE 370 500ML PER 1ML | 54373980 | $1 |
| VISIPAQUE 320 PER 1ML | 54374004 | $406 |
| VISIPAQUE 320 150ML PER 1ML | 54374012 | $3 |
| VISIPAQUE 320 200ML PER 1ML | 54374020 | $2 |
| VISIPAQUE 320 500ML PER 1ML | 54374038 | $1 |
| IODIXANOL 320 F-K PER 1ML | 54374046 | $349 |
| IODIXANOL 320 F-K PER 1ML | 54374053 | $406 |
| IODIXANOL320 150ML FK PER 1ML | 54374061 | $3 |
| IODIXANOL320 200ML FK PER 1ML | 54374079 | $2 |
| GADIVIST PER 0.1ML | 54374095 | $147 |
| GADIVIST PER 0.1ML | 54374103 | $207 |
| GADIVIST PER 0.1ML | 54374111 | $311 |
| EOVIST PER 1ML | 54374129 | $310 |
| LUMASON PER 1ML | 54374145 | $40 |
| CYSTOGRAFIN PER 1ML | 54374186 | $182 |
| GASTROGRAFIN PER 1ML | 54374194 | $23 |
| GASTROGRAFIN PER 1ML | 54374202 | $93 |
| CYSTOGRAFIN PER 1ML | 54374517 | $182 |
| ALLOPURINOL SODIUM 1MG | 54374624 | $4,151 |
| ALFENTANIL HYDROCHLORID 500MCG | 54374632 | $546 |
| ALFENTANIL HYDROCHLORID 500MCG | 54374640 | $691 |
| AZTREONAM PER 100MG | 54374657 | $16 |
| AZTREONAM PER 100MG | 54374665 | $456 |
| AZTREONAM PER 100MG | 54374673 | $562 |
| AZTREONAM PER 100MG | 54374681 | $171 |
| AZTREONAM PER 100MG | 54374699 | $143 |
| AZTREONAM PER 100MG | 54374707 | $1,083 |
| AZTREONAM PER 100MG | 54374715 | $782 |
| AZTREONAM PER 100MG | 54374731 | $430 |
| AZTREONAM PER 100MG | 54374749 | $300 |
| BUPIVICAINE PER 0.5MG | 54374764 | $52 |
| BUPIVICAINE PER 0.5MG | 54374772 | $157 |
| BUPIVICAINE PER 0.5MG | 54374806 | $157 |
| BUPIVICAINE PER 0.5MG | 54374814 | $157 |
| BUPIVICAINE PER 0.5MG | 54374822 | $14 |
| BUPIVICAINE PER 0.5MG | 54374830 | $21 |
| BUPIVICAINE PER 0.5MG | 54374848 | $172 |
| BUPIVICAINE PER 0.5MG | 54374855 | $9 |
| BUPIVICAINE PER 0.5MG | 54374889 | $34 |
| BUPIVICAINE PER 0.5MG | 54374897 | $2 |
| BUPIVICAINE PER 0.5MG | 54374905 | $118 |
| BUPIVICAINE PER 0.5MG | 54374913 | $128 |
| BUPIVICAINE PER 0.5MG | 54374939 | $35 |
| BUPIVICAINE PER 0.5MG | 54374947 | $282 |
| BUPIVICAINE PER 0.5MG | 54374954 | $228 |
| BUPIVICAINE PER 0.5MG | 54374962 | $233 |
| BUPIVICAINE PER 0.5MG | 54374970 | $134 |
| BUPIVICAINE PER 0.5MG | 54374988 | $136 |
| BUPIVICAINE PER 0.5MG | 54374996 | $340 |
| BUPIVICAINE PER 0.5MG | 54375001 | $332 |
| BUPIVICAINE PER 0.5MG | 54375019 | $239 |
| BUPIVICAINE PER 0.5MG | 54375043 | $63 |
| BUPIVICAINE PER 0.5MG | 54375050 | $73 |
| BUPIVICAINE PER 0.5MG | 54375068 | $340 |
| BUPIVICAINE PER 0.5MG | 54375076 | $186 |
| BUPIVICAINE PER 0.5MG | 54375084 | $134 |
| BUPIVICAINE PER 0.5MG | 54375118 | $488 |
| BUPIVICAINE PER 0.5MG | 54375126 | $528 |
| BUPIVICAINE PER 0.5MG | 54375167 | $1,458 |
| BUPIVICAINE PER 0.5MG | 54375175 | $480 |
| BUPIVICAINE PER 0.5MG | 54375191 | $858 |
| BUPIVICAINE PER 0.5MG | 54375209 | $757 |
| METRONIDAZOLE PER 10MG | 54375225 | $684 |
| METRONIDAZOLE PER 10MG | 54375233 | $1 |
| METRONIDAZOLE PER 10MG | 54375241 | $1 |
| METRONIDAZOLE PER 10MG | 54375266 | $152 |
| METRONIDAZOLE PER 10MG | 54375274 | $23 |
| METRONIDAZOLE PER 10MG | 54375282 | $168 |
| NITROGLYCERIN PER 5MG | 54375308 | $401 |
| NITROGLYCERIN PER 5MG | 54375316 | $369 |
| NITROGLYCERIN PER 5MG | 54375324 | $473 |
| NITROGLYCERIN PER 5MG | 54375332 | $1,452 |
| NITROGLYCERIN PER 5MG | 54375357 | $98 |
| NITROGLYCERIN PER 5MG | 54375399 | $507 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375415 | $110 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375431 | $66 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375456 | $172 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375464 | $177 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375472 | $101 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375480 | $95 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375514 | $916 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375522 | $199 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375548 | $150 |
| CLINDAMYCIN PHOSPHATE 300MG | 54375589 | $277 |
| VASOPRESSIN PER 1 UNIT | 54375597 | $16 |
| VASOPRESSIN PER 1 UNIT | 54375621 | $112 |
| VASOPRESSIN PER 1 UNIT | 54375639 | $709 |
| VASOPRESSIN PER 1 UNIT | 54375647 | $652 |
| VASOPRESSIN PER 1 UNIT | 54375662 | $1,178 |
| VASOPRESSIN PER 1 UNIT | 54375670 | $686 |
| VASOPRESSIN PER 1 UNIT | 54375746 | $193 |
| VASOPRESSIN PER 1 UNIT | 54375753 | $2,188 |
| ESMOLOL HYDROCHLORIDE PER 10MG | 54375795 | $59 |
| ESMOLOL HYDROCHLORIDE PER 10MG | 54375829 | $206 |
| ESMOLOL HYDROCHLORIDE PER 10MG | 54375837 | $2,086 |
| ESMOLOL HYDROCHLORIDE PER 10MG | 54375845 | $1,171 |
| LABETALOL HYDROCHLORIDE 5MG | 54375860 | $14 |
| LABETALOL HYDROCHLORIDE 5MG | 54375878 | $24 |
| LABETALOL HYDROCHLORIDE 5MG | 54375894 | $145 |
| LABETALOL HYDROCHLORIDE 5MG | 54375910 | $938 |
| LABETALOL HYDROCHLORIDE 5MG | 54375936 | $484 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54375944 | $16 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376009 | $71 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376017 | $15 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376058 | $105 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376074 | $146 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376090 | $70 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376124 | $58 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376140 | $101 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376157 | $173 |
| PHENYLEPHRINE HYDROCHLOR 20MCG | 54376199 | $52 |
| ISOVUE 300 500ML PER 1ML | 54376967 | $1 |
| OLANZAPINE INJ PER 0.5MG | 54377056 | $453 |
| MYCOPHENOLATE MOF PER 10MG | 54377072 | $282 |
| GLYCOPYROLATE INJ PER 0.1MG | 54377569 | $110 |
| GLYCOPYROLATE INJ PER 0.1MG | 54377577 | $31 |
| GLYCOPYROLATE INJ PER 0.1MG | 54377601 | $62 |
| GLYCOPYROLATE INJ PER 0.1MG | 54377619 | $79 |
| BUMETAMIDE PER 0.5MG | 54377635 | $262 |
| BUMETAMIDE PER 0.5MG | 54377643 | $38 |
| BUMETAMIDE PER 0.5MG | 54377650 | $91 |
| NICARDIPIN INJ PER 0.1MG | 54377692 | $815 |
| NICARDIPIN INJ PER 0.1MG | 54377718 | $143 |
| NICARDIPIN INJ PER 0.1MG | 54377742 | $182 |
| NICARDIPIN INJ PER 0.1MG | 54377767 | $1,681 |
| NICARDIPIN INJ PER 0.1MG | 54377783 | $576 |
| NICARDIPIN INJ PER 0.1MG | 54377791 | $30 |
| NICARDIPIN INJ PER 0.1MG | 54377809 | $2,761 |
| FLUPHENAZINE HCL PER 1.25MG | 54377825 | $208 |
| FLUPHENAZINE HCL PER 1.25MG | 54377833 | $46 |
| NICARDIPIN INJ PER 0.1MG | 54377932 | $1,068 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378252 | $39 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378260 | $147 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378278 | $196 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378294 | $20 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378302 | $20 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378310 | $20 |
| GADOBUTROL CONTRAST PER 0.1ML | 54378328 | $20 |
| BALFAXAR PER IU 20ML | 54378435 | $4 |
| BALFAXAR PER IU 40ML | 54378443 | $4 |
| METHYLPREDNISOLONE ACETATE 1MG | 54378633 | $213 |
| METHYLPREDNISOLONE ACETATE 1MG | 54378641 | $140 |
| METHYLPREDNISOLONE ACETATE 1MG | 54378658 | $83 |
| METHYLPREDNISOLONE ACETATE 1MG | 54378666 | $147 |
| METHPRED SOD SUCCINATE 5MG | 54378682 | $13 |
| METHPRED SOD SUCCINATE 5MG | 54378690 | $89 |
| METHPRED SOD SUCCINATE 5MG | 54378708 | $56 |
| METHPRED SOD SUCCINATE 5MG | 54378716 | $36 |
| METHPRED SOD SUCCINATE 5MG | 54378724 | $271 |
| METHPRED SOD SUCCINATE 5MG | 54378732 | $140 |
| METHPRED SOD SUCCINATE 5MG | 54378740 | $631 |
| METHPRED SOD SUCCINATE 5MG | 54378757 | $101 |
| METHPRED SOD SUCCINATE 5MG | 54378773 | $753 |
| METHPRED SOD SUCCINATE 5MG | 54378781 | $1,558 |
| HYDROXOCOBALAMIN PER 25MG | 54378799 | $1,799 |
| CYCLOPHOSPHAMIDE PER 5MG | 54378807 | $856 |
| CYCLOPHOSPHAMIDE PER 5MG | 54378815 | $304 |
| CYCLOPHOSPHAMIDE PER 5MG | 54378831 | $384 |
| METHOTREXATE SOD PER 50MG | 54378849 | $310 |
| METHOTREXATE SOD PER 50MG | 54378856 | $760 |
| METHOTREXATE SOD PER 50MG | 54378872 | $388 |
| METHOTREXATE SOD PER 50MG | 54378880 | $36 |
| METHOTREXATE SOD PER 50MG | 54378898 | $701 |
| LEVOTHYROXINE PER 10MCG | 54378906 | $1,369 |
| LEVOTHYROXINE PER 10MCG | 54378914 | $538 |
| LEVOTHYROXINE PER 10MCG | 54378930 | $28 |
| LEVOTHYROXINE PER 10MCG | 54378948 | $1,261 |
| CEFTRIAXONE PER 250MG | 54379151 | $5 |
| PANTOPRAZOLE SOD PER 40MG | 54379375 | $579 |
| PANTOPRAZOLE SOD PER 40MG | 54379383 | $424 |
| PANTOPRAZOLE SOD PER 40MG | 54379391 | $444 |
| PANTOPRAZOLE SOD PER 40MG | 54379425 | $324 |
| PANTOPRAZOLE SOD PER 40MG | 54379441 | $91 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380142 | $262 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380159 | $440 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380175 | $626 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380183 | $426 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380191 | $426 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380209 | $436 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380217 | $98 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380233 | $436 |
| POTASSIUM CHLORIDE PER 2MEQ | 54380241 | $437 |
| INFLUENZA VAC FLUARIX 0.5ML | 54380266 | $53 |
| CAPECITABINE ORAL PER 50MG | 54380753 | $136 |
| LIDOCAINE/EPI PER 1MG | 54380761 | $182 |
| LIDOCAINE/EPI PER 1MG | 54380779 | $274 |
| LIDOCAINE/EPI PER 1MG | 54380803 | $81 |
| LIDOCAINE/EPI PER 1MG | 54380829 | $28 |
| LIDOCAINE/EPI PER 1MG | 54380852 | $73 |
| LIDOCAINE/EPI PER 1MG | 54380860 | $134 |
| LIDOCAINE/EPI PER 1MG | 54380878 | $176 |
| LIDOCAINE/EPI PER 1MG | 54380894 | $230 |
| LIDOCAINE/EPI PER 1MG | 54380902 | $304 |
| LIDOCAINE/EPI PER 1MG | 54380910 | $28 |
| LIDOCAINE D5W PER 1MG | 54380928 | $390 |
| LIDOCAINE D5W PER 1MG | 54380936 | $97 |
| LIDOCAINE D5W PER 1MG | 54380944 | $189 |
| LIDOCAINE HCL PER 1MG | 54380969 | $16 |
| LIDOCAINE HCL PER 1MG | 54380985 | $28 |
| LIDOCAINE HCL PER 1MG | 54380993 | $16 |
| LIDOCAINE HCL PER 1MG | 54381017 | $38 |
| LIDOCAINE HCL PER 1MG | 54381025 | $14 |
| LIDOCAINE HCL PER 1MG | 54381041 | $8 |
| LIDOCAINE HCL PER 1MG | 54381058 | $208 |
| LIDOCAINE HCL PER 1MG | 54381066 | $52 |
| LIDOCAINE HCL PER 1MG | 54381074 | $27 |
| LIDOCAINE HCL PER 1MG | 54381082 | $71 |
| LIDOCAINE HCL PER 1MG | 54381090 | $144 |
| LIDOCAINE HCL PER 1MG | 54381116 | $236 |
| LIDOCAINE HCL PER 1MG | 54381124 | $8 |
| LIDOCAINE HCL PER 1MG | 54381132 | $23 |
| LIDOCAINE HCL PER 1MG | 54381140 | $116 |
| LIDOCAINE HCL PER 1MG | 54381181 | $12 |
| LIDOCAINE HCL PER 1MG | 54381199 | $60 |
| LIDOCAINE HCL PER 1MG | 54381207 | $69 |
| LIDOCAINE HCL PER 1MG | 54381215 | $37 |
| LIDOCAINE HCL PER 1MG | 54381223 | $150 |
| LIDOCAINE HCL PER 1MG | 54381264 | $184 |
| LIDOCAINE HCL PER 1MG | 54381272 | $116 |
| LIDOCAINE HCL PER 1MG | 54381280 | $185 |
| LIDOCAINE HCL PER 1MG | 54381298 | $255 |
| LIDOCAINE HCL PER 1MG | 54381306 | $38 |
| LIDOCAINE HCL PER 1MG | 54381314 | $72 |
| LIDOCAINE HCL PER 1MG | 54381322 | $78 |
| LIDOCAINE HCL PER 1MG | 54381330 | $327 |
| HYDROMORPHONE PER 0.1MG | 54381355 | $7 |
| HYDROMORPHONE PER 0.1MG | 54381363 | $19 |
| HYDROMORPHONE PER 0.1MG | 54381371 | $27 |
| HYDROMORPHONE PER 0.1MG | 54381389 | $28 |
| HYDROMORPHONE PER 0.1MG | 54381397 | $92 |
| HYDROMORPHONE PER 0.1MG | 54381405 | $78 |
| HYDROMORPHONE PER 0.1MG | 54381413 | $184 |
| HYDROMORPHONE PER 0.1MG | 54381421 | $71 |
| HYDROMORPHONE PER 0.1MG | 54381439 | $198 |
| HYDROMORPHONE PER 0.1MG | 54381447 | $160 |
| HYDROMORPHONE PER 0.1MG | 54381454 | $496 |
| HYDROMORPHONE PER 0.1MG | 54381462 | $86 |
| HYDROMORPHONE PER 0.1MG | 54381470 | $91 |
| HYDROMORPHONE PER 0.1MG | 54381488 | $63 |
| HYDROMORPHONE PER 0.1MG | 54381496 | $116 |
| HYDROMORPHONE PER 0.1MG | 54381504 | $71 |
| HYDROMORPHONE PER 0.1MG | 54381553 | $27 |
| HYDROMORPHONE PER 0.1MG | 54381561 | $160 |
| HYDROMORPHONE PER 0.1MG | 54381579 | $62 |
| HYDROMORPHONE PER 0.1MG | 54381587 | $124 |
| HYDROMORPHONE PER 0.1MG | 54381595 | $38 |
| HYDROMORPHONE PER 0.1MG | 54381603 | $105 |
| HYDROMORPHONE PER 0.1MG | 54381611 | $490 |
| HYDROMORPHONE PER 0.1MG | 54381629 | $120 |
| HYDROMORPHONE PER 0.1MG | 54381652 | $285 |
| MRI ORBIT/FACE/NCK W/CON | 54600101 | $4,976 |
| MRI ORBIT/FACE/NCK W/O CON | 54600200 | $4,307 |
| MRI ORBIT/FACE/NCK WO/W CON | 54600309 | $4,162 |
| MRI BRAIN W/O CON | 54600507 | $4,585 |
| MRI BRAIN W/CON | 54600606 | $5,510 |
| MRI BRAIN WO/W CON | 54600705 | $5,786 |
| MRI CHEST W/CON | 54600804 | $5,212 |
| MRI CHEST W/O CON | 54600903 | $5,412 |
| MRI CHEST W/WO CON | 54601000 | $7,207 |
| MRA CHEST W/CON | 54601109 | $5,101 |
| MRI C-SPINE W/O CON | 54601208 | $4,770 |
| MRI C-SPINE W/CON | 54601307 | $6,201 |
| MRI T-SPINE W/O CON | 54601406 | $3,728 |
| MRI T-SPINE W/CON | 54601505 | $6,201 |
| MRI L-SPINE W/O CON | 54601604 | $4,770 |
| MRI L-SPINE W/CON | 54601703 | $6,201 |
| MRI C-SPINE WO/W CON | 54601802 | $6,828 |
| MRI T-SPINE WO/W CON | 54601901 | $6,828 |
| MRI L-SPINE WO/W CON | 54602008 | $6,828 |
| MRA SPINAL CONTENTS | 54602107 | $5,407 |
| MRI PELVIS W/CON | 54602206 | $5,473 |
| MRI PELVIS W/O CON | 54602305 | $4,770 |
| MRI PELVIS WO/W CON | 54602404 | $5,743 |
| MRI ABD W/CON | 54602602 | $4,270 |
| MRI ABD W/O CON | 54602701 | $4,144 |
| MRI ABD W0/W CON | 54602800 | $4,528 |
| MRA ABD W/CON | 54602909 | $5,809 |
| MRI BREAST W/CON BIL | 54603501 | $2,720 |
| MRI SPECTROSCOPY | 54603709 | $6,155 |
| MRI BONE MARROW | 54603808 | $2,681 |
| MRI ORBIT/FACE/NCK W/CON LTD | 54603907 | $2,681 |
| MRI ORBIT/FACE/NCK W/O CON LTD | 54604004 | $3,218 |
| MRI ORBIT/FACE/NCK WO/W LTD | 54604103 | $2,681 |
| MRI BRAIN W/O CON LTD | 54604301 | $3,268 |
| MRI BRAIN W/CON LTD | 54604400 | $2,590 |
| MRI BRAIN WO/W CON LTD | 54604509 | $4,078 |
| MRI CHEST W/O CON LTD | 54604707 | $2,874 |
| MRI C-SPINE W/O CON LTD | 54605001 | $3,132 |
| MRI C-SPINE W/CONTRAST LTD | 54605100 | $2,438 |
| MRI T-SPINE W/O CON LTD | 54605209 | $2,681 |
| MRI T-SPINE W/CON LTD | 54605308 | $4,002 |
| MRI L-SPINE W/O CON LTD | 54605407 | $3,077 |
| MRI L-SPINE W/CON LTD | 54605506 | $3,696 |
| MRI T-SPINE WO/W CON LTD | 54605704 | $4,180 |
| MRI L-SPINE WO/W CON LTD | 54605803 | $4,430 |