J0129

Abatacept

10mg

$19.52

$19.96

$19.83

$20.19

J0130

Abciximab injection

10mg

$463.45

$462.83

$490.29

$490.66

J0133

Acyclovir, 5 mg

5mg

$0.027

$0.03

$0.03

$0.03

J0150

Injection adenosine 6 MG

6mg

$10.20

$9.79

$11.37

$12.85

J0152

Adenosine injection

30mg

$80.92

$82.72

$84.98

$85.01

J0170

Adrenalin epinephrin inject

1ml

$0.85

$0.68

$0.74

$0.76

J0205

Alglucerase injection

10units

$41.99

$41.98

$41.97

$41.98

J0207

Amifostine

500mg

$340.11

$327.96

$340.19

$318.66

J0210

Methyldopate hcl injection

250mg

$33.23

$36.33

$38.33

$40.22

J0215

Alefacept

0.5mg

$30.72

$30.63

$30.65

$33.36

J0256

Alpha 1 proteinase inhibitor

10mg

$3.74

$3.77

$3.76

$3.76

J0270

Alprostadil for injection

1.25mcg

$0.70

$0.63

$0.66

$1.73

J0275

Alprostadil urethral suppos

1dose

$24.53

$24.35

$25.53

$25.42

J0280

Aminophyllin 250 MG inj

250mg

$0.39

$0.40

$0.39

$0.38

J0282

Amiodarone HCl

30mg

$0.29

$0.26

$0.27

$0.28

J0289

Amphotericin b liposome inj

10mg

$15.81

$15.78

$15.72

$15.67

J0295

Ampicillin sodium per 1.5 gm

1.5gm

$2.10

$2.44

$2.49

$2.65

J0300

Amobarbital 125 MG inj

125mg

$11.52

$11.52

$11.52

$11.52

J0330

Succinycholine chloride inj

20mg

$0.15

$0.17

$0.12

$0.13

J0360

Hydralazine hcl injection

20mg

$5.02

$4.82

$4.58

$4.87

J0456

Azithromycin

500mg

$6.98

$6.07

$5.90

$4.50

J0460

Atropine sulfate injection

0.3mg

$0.247

$0.25

$0.25

$0.25

J0475

Baclofen 10 MG injection

10mg

$203.26

$203.88

$205.22

$203.93

J0476

Baclofen intrathecal trial

50mcg

$74.40

$73.50

$73.37

$73.15

J0480

Basiliximab

20mg

$1728.91

$1755.72

$1995.20

$2,036.73

J0500

Dicyclomine injection

20mg

$15.82

$20.09

$21.14

$21.15

J0515

Inj benztropine mesylate

1mg

$39.27

$42.16

$46.28

$58.80

J0540

Penicillin g benzathine inj

1,200,000units

$33.85

$33.85

$33.85

$33.85

J0550

Penicillin g benzathine inj

2,400,000units

$33.85

$33.85

$33.85

$33.85

J0570

Penicillin g benzathine inj

1,200,000units

$44.59

$44.80

$46.90

$47.91

J0580

Penicillin g benzathine inj

2,4000,000units

$46.07

$46.30

$49.54

$98.76

J0583

Bivalirudin

1mg

$2.46

$2.41

$2.52

$2.55

J0585

Botulinum toxin a per unit

1unit

$5.50

$5.50

$5.49

$5.49

J0587

Botulinum toxin type B

100units

$10.58

$10.58

$10.58

$10.58

J0592

Buprenorphine hydrochloride

0.1mg

$0.68

$0.76

$0.75

$1.07

J0595

Butorphanol tartrate 1 mg

1mg

$1.01

$1.10

$1.08

$1.10

J0600

Edetate calcium disodium inj

1000mg

$80.38

$197.37

$197.37

$196.72

J0610

Calcium gluconate injection

10ml

$0.31

$0.32

$0.33

$0.23

J0630

Calcitonin salmon injection

400units

$49.27

$49.26

$52.03

$51.95

J0636

Inj calcitriol per 0.1 mcg

0.1mcg

$0.39

$0.38

$0.39

$0.42

J0637

Caspofungin acetate

5mg

$11.76

$11.59

$11.93

$12.10

J0640

Leucovorin calcium injection

50mg

$1.01

$1.02

$0.95

$1.05

J0690

Cefazolin sodium injection

500mg

$0.60

$0.63

$0.61

$0.61

J0692

Cefepime HCl for injection

500mg

$3.64

$3.35

$3.24

$2.67

J0694

Cefoxitin sodium injection

1gm

$6.11

$6.16

$5.92

$8.67

J0696

Ceftriaxone sodium injection

250mg

$1.12

$0.90

$1.03

$1.12

J0697

Sterile cefuroxime injection

750mg

$2.82

$2.94

$2.76

$2.77

J0698

Cefotaxime sodium injection

1gm

$6.69

$4.17

$4.56

$4.43

J0702

Betamethasone acet&sod phosp

3mg

$6.56

$6.55

$6.30

$6.24

J0706

Caffeine citrate injection

5mg

$0.60

$0.60

$0.49

$0.41

J0713

Inj ceftazidime per 500 mg

500mg

$2.35

$2.21

$2.22

$2.21

J0718

Certolizum

1mg

$3.72

$3.78

$3.79

$3.96

J0720

Chloramphenicol sodium injec

1gm

$15.35

$11.99

$11.99

$25.39

J0725

Chorionic gonadotropin/1000u

1,000units

$5.95

$8.14

$8.26

$9.35

J0740

Cidofovir injection

375mg

$761.23

$761.10

$766.43

$761.19

J0743

Cilastatin sodium injection

250mg

$11.52

$11.76

$11.96

$11.74

J0745

Inj codeine phosphate /30 MG

30mg

$1.26

$1.55

$1.10

$1.10

J0760

Colchicine injection

1mg

$6.572

$6.57

$6.57

$6.57

J0770

Colistimethate sodium inj

150mg

$22.79

$19.87

$16.99

$14.38

J0780

Prochlorperazine injection

10mg

$1.63

$1.80

$1.87

$1.87

J0800

Corticotropin injection

1-40units

$2440.35

$2441.70

$2441.67

$2,441.33

J0882

Darbepoetin alfa, non-esrd

1mcg

$2.83

$2.83

$2.97

$2.90

J0885

Non esrd epoetin alpha inj

1,000units

$9.54

$9.44

$9.66

$9.68

J0895

Deferoxamine mesylate inj

500mg

$11.37

$10.69

$10.82

$12.39

J1000

Depo-estradiol cypionate inj

5mg

$6.83

$6.83

$6.83

$6.83

J1020

Methylprednisolone 20 MG inj

20mg

$1.65

$1.57

$1.44

$2.48

J1030

Methylprednisolone 40 MG inj

40mg

$3.76

$3.40

$3.35

$4.72

J1040

Methylprednisolone 80 MG inj

80mg

$7.10

$6.64

$6.38

$8.60

J1051

Medroxyprogesterone inj

50mg

$7.67

$7.70

$8.80

$8.12

J1070

Testosterone cypionat 100 MG

100mg

$3.30

$3.70

$3.64

$4.02

J1080

Testosterone cypionat 200 MG

1cc_200mg

$5.10

$5

$4.46

$5.59

J1100

Dexamethasone sodium phos

1mg

$0.092

$0.09

$0.09

$0.09

J1110

Inj dihydroergotamine mesylt

1mg

$22.46

$24.26

$21.29

$22.65

J1120

Acetazolamid sodium injectio

50mg

$35.25

$30.41

$27.82

$27.86

J1160

Digoxin injection

0.5mg

$1.21

$1.16

$1.11

$1.22

J1165

Phenytoin sodium injection

50mg

$0.71

$0.78

$0.67

$0.71

J1190

Dexrazoxane HCl injection

250mg

$374.16

$261

$255.17

$209.20

J1200

Diphenhydramine hcl injectio

1-50mg

$0.82

$0.80

$0.79

$0.79

J1205

Chlorothiazide sodium inj

500mg

$310.77

$352.37

$374.14

$436.94

J1230

Methadone injection

10mg

$5.67

$5.65

$6.24

$5.95

J1245

Dipyridamole injection

10mg

$0.91

$0.83

$0.90

$1.10

J1250

Inj dobutamine HCL/250 mg

250mg

$5.72

$5.88

$5.72

$5.92

J1260

Dolasetron mesylate

10mg

$4.30

$4.29

$4.30

$4.31

J1265

DopAMIne injection

40mg

$0.49

$0.53

$0.53

$0.49

J1270

Injection, doxercalciferol

1mcg

$3.08

$3.01

$2.93

$3.14

J1325

Epoprostenol injection

0.5mg

$14.03

$13.75

$13.57

$13.98

J1327

Eptifibatide injection

5mg

$18.85

$19

$19.75

$20.10

J1335

Ertapenem injection

500mg

$26.51

$27.57

$27.56

$27.70

J1364

Erythro lactobionate /500 MG

500mg

$8.46

$7.45

$8.52

$8.75

J1410

Inj estrogen conjugate 25 MG

25mg

$88.72

$88.68

$93.10

$93.09

J1430

Ethanolamine oleate 100 mg

100mg

$149.97

$149.97

$149.97

$149.97

J1440

Filgrastim 300 mcg injection

300mcg

$219.71

$223.05

$230.10

$233.43

J1441

Filgrastim 480 mcg injection

480mcg

$342.73

$348.68

$360.88

$366.81

J1450

Fluconazole

200mg

$6.84

$6.03

$5.82

$5.67

J1451

Fomepizole, 15 mg

15mg

$7.70

$7.65

$7.58

$7.56

J1455

Foscarnet sodium injection

1000mg

$10.10

$10.38

$10.33

$10.50

J1566

Inj immune globulin, lyophilzed 500mg

500mg

$30.48

$30.86

$30.73

$29.40

J1570

Ganciclovir sodium injection

500mg

$46.56

$46.08

$52.99

$53.68

J1580

Garamycin gentamicin inj

80mg

$0.873

$0.88

$0.88

$0.90

J1595

Injection glatiramer acetate

20mg

$67.64

$67.64

$67.64

$67.64

J1610

Glucagon hydrochloride/1 MG

1mg

$84.23

$81.41

$85.36

$85.93

J1626

Granisetron HCl injection

100mcg

$1.27

$0.53

$1.04

$1.00

J1630

Haloperidol injection

5mg

$1.73

$1.56

$1.41

$1.60

J1631

Haloperidol decanoate inj

50mg

$2.68

$2.81

$2.56

$18.65

J1642

Inj heparin sodium per 10 u

10units

$0.16

$0.16

$0.16

$0.17

J1644

Inj heparin sodium per 1000u

1000units

$0.29

$0.33

$0.34

$0.43

J1645

Dalteparin sodium

2500I.U.

$11.38

$11.32

$11.82

$12.04

J1650

Inj enoxaparin sodium

10mg

$6.47

$6.39

$6.69

$6.73

J1652

Fondaparinux sodium

0.5mg

$6.16

$6.14

$5.97

$6.27

J1655

Tinzaparin sodium injection

1000I.U.

$2.65

$2.72

$2.80

$2.82

J1720

Hydrocortisone sodium succ i

100mg

$3.07

$3.14

$3.31

$3.42

J1730

Diazoxide injection

300mg

$2.466

$2.47

$2.47

$2.47

J1740

Ibandronate sodium

1mg

$141.61

$141.38

$144.01

$144.18

J1742

Ibutilide fumarate injection

1mg

$403.23

$416.61

$273.77

$190.22

J1745

Infliximab injection

10mg

$58.66

$58.74

$58.59

$60.53

J1756

Iron sucrose injection

1mg

$0.366

$0.37

$0.37

$0.36

J1785

Injection imiglucerase /unit

1unit

$4.20

$4.20

$4.20

$4.20

J1790

Droperidol injection

5mg

$1.83

$1.92

$2.20

$2.15

J1800

Propranolol injection

1mg

$3.26

$3.36

$3.18

$2.95

J1815

Insulin injection

5units

$0.44

$0.42

$0.45

$0.45

J1817

Insulin for insulin pump use

50units

$3.43

$2.05

$2.19

$2.30

J1835

Itraconazole injection

50mg

$42.281

$42.28

$42.28

$42.28

J1940

Furosemide injection

20mg

$0.23

$0.22

$0.25

$0.29

J1945

Lepirudin

50mg

$231.27

$234.37

$234.31

$280.31

J1950

Leuprolide acetate /3.75 MG

3.75mg

$492.70

$516.09

$526.35

$525.44

J1955

Inj levocarnitine per 1 gm

1gm

$6.24

$6.01

$5.01

$5.00

J1956

Levofloxacin injection

250mg

$5.62

$5.42

$5.44

$6.12

J1980

Hyoscyamine sulfate inj

0.25mg

$11.59

$10.76

$10.32

$9.95

J2001

Lidocaine injection

10mg

$0.02

$0.02

$0.02

$0.02

J2010

Lincomycin injection

1-300mg

$5.18

$5.16

$5.13

$5.21

J2020

Linezolid injection

200mg

$31.54

$32.58

$33.25

$33.36

J2060

Lorazepam injection

2mg

$0.75

$0.69

$0.73

$0.70

J2150

Mannitol injection

50ml

$0.91

$0.92

$0.92

$0.92

J2185

Meropenem

100mg

$3.88

$3.94

$4.11

$4.09

J2210

Methylergonovin maleate inj

0.2mg

$6.09

$6.08

$6.66

$5.68

J2250

Inj midazolam hydrochloride

1mg

$0.11

$0.10

$0.09

$0.09

J2260

Inj milrinone lactate / 5 MG

5mg

$3.87

$3.44

$3.35

$4.43

J2300

Inj nalbuphine hydrochloride

10mg

$0.92

$0.93

$0.99

$0.97

J2310

Inj naloxone hydrochloride

1mg

$4.99

$6.06

$5.77

$6.40

J2320

Nandrolone decanoate 50 MG

50mg

$3.20

$3.20

$3.20

$3.20

J2353

Octreotide injection, depot

1mg

$108.23

$109.01

$111.22

$112.04

J2354

Octreotide inj, non-depot

25mcg

$1.14

$1.06

$1

$1.40

J2355

Oprelvekin injection

5mg

$245.80

$245.08

$244.69

$244.60

J2370

Phenylephrine hcl injection

1ml

$0.82

$0.76

$0.69

$0.71

J2400

Chloroprocaine hcl injection

30ml

$12.28

$12.25

$12.57

$12.76

J2405

Ondansetron hcl injection

1mg

$0.24

$0.13

$0.17

$0.18

J2410

Oxymorphone hcl injection

1mg

$2.26

$2.21

$2.29

$2.31

J2430

Pamidronate disodium /30 MG

30mg

$20.36

$16.24

$14.71

$15.63

J2440

Papaverin hcl injection

60mg

$0.62

$0.76

$0.69

$0.74

J2501

Paricalcitol

1mcg

$3.53

$3.54

$3.51

$3.42

J2505

Injection, pegfilgrastim 6mg

6mg

$2364.70

$2432.50

$2470.74

$2,465.21

J2510

Penicillin g procaine inj

600,000units

$10.68

$10.89

$11.50

$11.70

J2515

Pentobarbital sodium inj

50mg

$12.24

$12.39

$12.58

$14.84

J2543

Piperacillin/tazobactam

1.125gm

$5.98

$5.91

$5.67

$5.58

J2550

Promethazine hcl injection

1-50mg

$1.56

$1.55

$1.48

$1.86

J2560

Phenobarbital sodium inj

120mg

$3.17

$3.27

$3.28

$3.16

J2590

Oxytocin injection

10units

$0.66

$0.59

$0.55

$1.06

J2597

Inj desmopressin acetate

1mcg

$1.60

$1.90

$1.11

$2.16

J2675

Inj progesterone per 50 MG

50mg

$1.57

$1.47

$1.46

$1.44

J2680

Fluphenazine decanoate 25 MG

25mg

$5.92

$6.32

$6.32

$1.70

J2690

Procainamide hcl injection

1gm

$3.41

$5.67

$5.90

$6.19

J2700

Oxacillin sodium injection

250mg

$2

$2.08

$2.11

$2.21

J2710

Neostigmine methylslfte inj

0.5mg

$0.09

$0.09

$0.09

$0.09

J2730

Pralidoxime chloride inj

1gm

$90.79

$90..79

$89.27

$90.67

J2760

Phentolaine mesylate inj

5mg

$54.95

$54.79

$54.17

$54.33

J2765

Metoclopramide hcl injection

10mg

$0.37

$0.35

$0.33

$0.35

J2770

Quinupristin/dalfopristin

500mg

$147.12

$147.07

$155.63

$159.87

J2780

Ranitidine hydrochloride inj

25mg

$1.15

$1.14

$0.90

$0.96

J2783

Rasburicase

0.5mg

$172.49

$172.52

$175.71

$179.26

J2788

Rho d immune globulin 50 mcg

50mcg

$25.96

$25.14

$27.42

$22.66

J2792

Rho(D) immune globulin h, sd

100IU

$18.57

$18.55

$19.95

$17.41

J2795

Ropivacaine HCl injection

1mg

$0.06

$0.06

$0.06

$0.09

J2810

Inj theophylline per 40 MG

40mg

$0.03

$0.02

$0.02

$0.03

J2820

Sargramostim injection

50mcg

$24.27

$25.42

$25.55

$23.88

J2916

Na ferric gluconate complex

12.5mg

$4.70

$4.57

$6.61

$5.25

J2920

Methylprednisolone injection

40mg

$2.61

$2.28

$1.92

$1.81

J2930

Methylprednisolone injection

125mg

$3.33

$3.06

$2.60

$2.54

J2993

Reteplase injection

18.1mg

$1282.93

$1555.98

$1365.75

$1,312.50

J2997

Alteplase recombinant

1mg

$36.93

$37.35

$38.87

$38.71

J3010

Fentanyl citrate injection

0.1mg

$0.34

$0.33

$0.34

$0.30

J3030

Sumatriptan succinate / 6 MG

6mg

$43.55

$46.68

$47.92

$53.90

J3101

Tenecteplase injection

1mg

$42.65

$46.74

$46.99

$47.63

J3105

Terbutaline sulfate inj

1mg

$2.09

$1.94

$1.91

$1.64

J3120

Testosterone enanthate inj

100mg

$3.46

$2.94

$3.48

$3.74

J3130

Testosterone enanthate inj

1-200mg

$7.06

$5.88

$5.82

$9.77

J3230

Chlorpromazine hcl injection

50mg

$8.28

$8.59

$8.77

$9.09

J3240

Thyrotropin injection

0.9mg_1.1mg

$1063.87

$1053.41

$1053.62

$1,053.05

J3246

Tirofiban hydrochloride

0.25mg

$7.89

$7.39

$7.88

$8.04

J3250

Trimethobenzamide hcl inj

200mg

$4.84

$4.65

$4.66

$4.49

J3260

Tobramycin sulfate injection

80mg

$1.83

$2.27

$2.20

$2.28

J3285

Treprostinil, 1 mg

1mg

$55.89

$55.89

$55.89

$60.49

J3301

Triamcinolone acetonide inj

10mg

$1.59

$1.55

$1.55

$1.55

J3315

Triptorelin pamoate

3.75mg

$156.38

$164.10

$164.59

$181.93

J3360

Diazepam injection

5mg

$1.02

$1.04

$1.07

$1.12

J3364

Urokinase 5000 IU injection

5000I.U.

$9

$9.16

$9.16

$9.16

J3365

Urokinase 250,000 IU inj

250,000I.U.

$457.73

$457.73

$457.73

$457.73

J3370

Vancomycin hcl injection

500mg

$73

$3.20

$3.23

$3.20

J3396

Verteporfin injection

0.1mg

$9.49

$9.50

$9.49

$9.58

J3410

Hydroxyzine hcl injection

25mg

$1.43

$1.08

$1.33

$1.44

J3420

Vitamin b12 injection

1000mcg

$0.27

$0.27

$0.30

$0.28

J3430

Vitamin k phytonadione inj

1mg

$1.52

$1.52

$1.83

$1.83

J3465

Injection, voriconazole

10mg

$5.66

$5.82

$5.90

$5.93

J3475

Inj magnesium sulfate

500mg

$0.051

$0.05

$0.05

$0.05

J3480

Inj potassium chloride

2meq

$0.015

$0.02

$0.02

$0.02

J3485

Zidovudine

10mg

$1.31

$1.31

$1.33

$1.39

J3486

Ziprasidone mesylate

10mg

$5.91

$6.25

$6.42

$6.48

J3488

Zoledronic acid (Reclast)

1mg

$222.69

$222.92

$222.93

$222.65

J7030

Normal saline solution infus

1000cc

$0.46

$0.47

$0.47

$0.45

J7040

Normal saline solution infus

500ML

$0.56

$0.56

$0.56

$0.56

J7042

5% dextrose/normal saline

500ML

$0.34

$0.34

$0.33

$0.33

J7050

Normal saline solution infus

250cc

$0.28

$0.28

$0.28

$0.28

J7060

5% dextrose/water

500ML

$1.13

$1.14

$1.11

$1.10

J7070

D5w infusion

1000cc

$2.26

$2.27

$2.22

$2.20

J7100

Dextran 40 infusion

500ml

$19.87

$19.92

$20.26

$20.75

J7110

Dextran 75 infusion

500ml

$12.72

$12.72

$12.72

$12.72

J7120

Ringers lactate infusion

1000cc

$1.03

$1.03

$1.04

$1.05

J7189

Factor viia recombinant

1mcg

$1.33

$1.36

$1.37

$1.37

J7190

Factor viii

1I.U.

$0.87

$0.86

$0.88

$0.88

J7192

Factor viii recombinant

1I.U.

$1.10

$1.09

$1.10

$1.10

J7193

Factor IX non-recombinant

1I.U.

$0.89

$0.91

$0.90

$0.89

J7194

Factor ix complex

1I.U.

$0.87

$0.87

$0.85

$0.89

J7195

Factor IX recombinant

1I.U.

$1.11

$1.11

$1.11

$1.12

J7197

Antithrombin iii injection

1I.U.

$2.32

$2.31

$2.56

$2.53

J7198

Anti-inhibitor

1I.U.

$1.55

$1.55

$1.59

$1.59

J7308

Aminolevulinic acid hcl top

354mg

$129.52

$134.54

$136.42

$138.96

J7310

Ganciclovir long act implant

4.5mg

$16960

$16960

$16960

$16,960.00

J7321

Hyalgan or Supartz, inj

PER DOSE

$92.28

$91.96

$89.35

$90.52

J7323

Euflexxa, inj

PER DOSE

$107.09

$113.79

$117.30

$127.17

J7324

Orthovisc, inj

PER DOSE

$176.06

$176.70

$174.48

$175.10

J7325

Synvisc and Synvisc-One

1mg

$11.74

$11.79

$11.76

$11.95

J7330

Cultured chondrocytes implnt

1dose

$25099.56

$25109.57

$25995.98

$26,004.16

J7500

Azathioprine oral 50mg

50mg

$0.17

$0.19

$0.12

$0.12

J7501

Azathioprine parenteral

100mg

$95.64

$96.29

$97.15

$103.82

J7502

Cyclosporine oral 100 mg

100mg

$3.18

$3.30

$3.37

$3.11

J7504

Lymphocyte immune globulin

250mg

$465.25

$487.88

$506.79

$496.95

J7505

Monoclonal antibodies

5mg

$1132.93

$1133.50

$1133.82

$1,133.52

J7506

Prednisone oral

5mg

$0.05

$0.04

$0.04

$0.04

J7507

Tacrolimus oral per 1 MG

1mg

$3.64

$3.29

$3.33

$3.28

J7509

Methylprednisolone oral

4mg

$0.08

$0.08

$0.08

$0.07

J7511

Antithymocyte globuln rabbit

25mg

$409.66

$386.49

$401.41

$417.51

J7513

Daclizumab, parenteral

25mg

$388.51

$351.10

$526.34

$526.34

J7515

Cyclosporine oral 25 mg

25mg

$0.83

$0.84

$0.86

$0.85

J7516

Cyclosporin parenteral 250mg

250mg

$23.82

$27.25

$24.36

$21.33

J7517

Mycophenolate mofetil oral

250mg

$2.60

$1.88

$1.33

$1.51

J7520

Sirolimus, oral

1mg

$9.65

$9.65

$10.07

$10.14

J7525

Tacrolimus injection

5mg

$139.64

$139.41

$139.45

$139.49

J7608

Acetylcysteine inh sol u d

1gm

$1.83

$1.98

$2.01

$2.10

J7626

Budesonide inhalation sol

0.25-0.50mg

$6.43

$6.42

$4.85

$4.29

J7631

Cromolyn sodium inh sol u d

10mg

$0.47

$0.45

$0.45

$0.39

J7639

Dornase alpha inhal sol u d

1mg

$23.87

$23.89

$25.51

$25.61

J7644

Ipratropium brom inh sol u d

1mg

$0.209

$0.24

$0.25

$0.25

J7669

Metaproterenol inh sol u d

10mg

$0.25

$0.25

$0.25

$0.25

J7682

Tobramycin inhalation sol

300mg

$69.21

$69.26

$75.15

$75.23

J8510

Oral busulfan

2mg

$3.31

$3.65

$3.65

$3.69

J8520

Capecitabine, oral, 150 mg

150mg

$6.22

$6.28

$6.86

$6.85

J8521

Capecitabine, oral, 500 mg

500mg

$20.43

$20.66

$22.48

$22.58

J8530

Cyclophosphamide oral 25 MG

25mg

$0.83

$0.84

$0.85

$0.83

J8560

Etoposide oral 50 MG

50mg

$30.27

$28.26

$28.33

$28.48

J8610

Methotrexate oral 2.5 MG

2.5mg

$0.13

$0.16

$0.13

$0.12

J8700

Temozolomide

5mg

$8.80

$8.83

$9.09

$9.16

J9000

Doxorubic hcl 10 MG vl chemo

10mg

$3.48

$3.03

$2.94

$3.04

J9001

Doxorubicin hcl liposome inj

10mg

$471.38

$472.01

$487.99

$486.80

J9010

Alemtuzumab injection

10mg

$566.19

$578.01

$588.45

$573.35

J9015

Aldesleukin/single use vial

pervial

$846.91

$844.43

$883.88

$922.07

J9017

Arsenic trioxide

1mg

$37.54

$37.43

$37.37

$37.25

J9020

Asparaginase injection

10,000units

$60.41

$60.94

$60.96

$63.47

J9031

Bcg live intravesical vac

perinstallation

$110.64

$114.37

$110.31

$114.93

J9040

Bleomycin sulfate injection

15units

$28.47

$26.08

$26.47

$17.35

J9045

Carboplatin injection

50mg

$4.84

$5.31

$3.98

$3.70

J9050

Carmus bischl nitro inj

200mg

$176.87

$176.41

$176.15

$175.88

J9060

Cisplatin 10 MG injection

10mg

$2.08

$1.98

$1.89

$1.50

J9062

Cisplatin 50 MG injection

50mg

$10.41

$9.91

$9.45

$7.49

J9065

Inj cladribine per 1 MG

1mg

$23.97

$28.22

$25.33

$24.33

J9090

Cyclophosphamide 500 MG inj

500mg

$21.70

$21.73

$25.30

$29.79

J9091

Cyclophosphamide 1.0 grm inj

1gm

$43.39

$43.46

$50.61

$59.59

J9092

Cyclophosphamide 2.0 grm inj

2gm

$86.78

$86.92

$101.21

$119.18

J9097

Cyclophosphamide lyophilized

2gm

$44.52

$44.52

$44.52

$44.52

J9100

Cytarabine hcl 100 MG inj

100mg

$1.80

$1.51

$1.49

$1.98

J9110

Cytarabine hcl 500 MG inj

500mg

$3.86

$3.68

$3.68

$3.67

J9120

Dactinomycin actinomycin d

0.5mg

$567.04

$570.53

$570.92

$592.41

J9140

Dacarbazine 200 MG inj

200mg

$8.11

$7.37

$7.35

$6.68

J9150

Daunorubicin

10mg

$16.97

$19.46

$31.28

$15.50

J9151

Daunorubicin citrate liposom

10mg

$56.40

$56.32

$57.66

$57.66

J9160

Denileukin diftitox, 300 mcg

300mcg

$1495.78

$1494.82

$1544.31

$1,540.98

J9170

Docetaxel

20mg

$336.944

$336.94

$336.94

$336.94

J9175

Elliotts b solution per ml

1ml

$4.074

$4.07

$4.07

$4.07

J9178

Inj, epirubicin hcl, 2 mg

2mg

$2.65

$2.48

$2.09

$1.80

J9181

Etoposide 10 MG inj

10mg

$0.45

$0.49

$0.41

$0.55

J9185

Fludarabine phosphate inj

50mg

$161.68

$205.81

$115.44

$139.57

J9190

Fluorouracil injection

500mg

$1.60

$1.47

$1.48

$1.74

J9200

Floxuridine injection

500mg

$43.68

$42.99

$43.10

$41.72

J9201

Gemcitabine HCl

200mg

$144.93

$145.10

$148.63

$148.35

J9202

Goserelin acetate implant

3.6mg

$203.87

$195.23

$198.07

$194.29

J9206

Irinotecan injection

20mg

$6.94

$9.15

$6.79

$6.12

J9208

Ifosfomide injection

1gm

$30.08

$30.76

$30.35

$34.15

J9209

Mesna injection

200mg

$4.64

$4.26

$4.31

$5.31

J9211

Idarubicin hcl injection

5mg

$102.83

$63.57

$52.62

$103.96

J9212

Interferon alfacon-1

1mcg

$4.80

$4.81

$4.80

$6.55

J9214

Interferon alfa-2b inj

1millionunits

$15.84

$15.84

$15.80

$16.06

J9216

Interferon gamma 1-b inj

3millionunits

$299.69

$430.93

$430.93

$430.93

J9217

Leuprolide acetate suspnsion

7.5mg

$206.52

$220.41

$205.44

$208.22

J9218

Leuprolide acetate injection

1mg

$4.77

$4.27

$4.10

$4.79

J9219

Leuprolide acetate implant

65mg

$4819.82

$4819.82

$4819.82

$4,819.82

J9230

Mechlorethamine hcl inj

10mg

$154.15

$154.50

$154.42

$154.47

J9245

Inj melphalan hydrochl 50 MG

50mg

$1549.47

$1500.32

$1404.67

$1,401.83

J9250

Methotrexate sodium inj

5mg

$0.25

$0.21

$0.19

$0.19

J9260

Methotrexate sodium inj

50mg

$2.46

$2.10

$1.92

$1.89

J9263

Oxaliplatin

0.5mg

$7.62

$6.83

$4.46

$4.71

J9265

Paclitaxel injection

30mg

$9.44

$11.46

$11.56

$7.45

J9268

Pentostatin injection

10mg

$1343.80

$1246.38

$1267.53

$1,228.81

J9280

Mitomycin 5 MG inj

5mg

$17.15

$20.36

$20.19

$20.77

J9290

Mitomycin 20 MG inj

20mg

$68.60

$81.43

$80.74

$83.07

J9291

Mitomycin 40 MG inj

40mg

$137.19

$162.87

$161.48

$166.15

J9293

Mitoxantrone hydrochl / 5 MG

5mg

$47.77

$45.27

$40.88

$40.83

J9300

Gemtuzumab ozogamicin

5mg

$2622.98

$2687.22

$2687.84

$2,685.35

J9310

Rituximab cancer treatment

100mg

$563.76

$578.40

$579.21

$593.88

J9320

Streptozocin injection

1gm

$284.13

$282.86

$280.55

$277.71

J9340

Thiotepa injection

15mg

$105.07

$113.53

$113.60

$114.09

J9350

Topotecan

4mg

$1031.91

$1058.90

$1058.74

$1,090.84

J9355

Trastuzumab

10mg

$64.78

$66.42

$66.56

$68.28

J9360

Vinblastine sulfate inj

1mg

$1.11

$1.02

$1.02

$1.64

J9370

Vincristine sulfate 1 MG inj

1mg

$4.77

$4.31

$4.53

$3.98

J9375

Vincristine sulfate 2 MG inj

2mg

$9.54

$8.62

$9.06

$7.96

J9380

Vincristine sulfate 5 MG inj

5mg

$23.84

$21.54

$22.65

$19.90

J9390

Vinorelbine tartrate/10 mg

20mg

$11.59

$10.05

$10.19

$11.05

J9395

Injection, Fulvestrant

25mg

$82.21

$82.22

$83.04

$83.02

J9600

Porfimer sodium

75mg

$2801.82

$2934.28

$2987.92

$2,934.92

Q0167

Dronabinol 2.5mg oral

2.5mg

$6.81

$7.17

$7.09

$7.07

Q0168

Dronabinol 5mg oral

5mg

$13.60

$14.17

$14.08

$14.28