calcium chloride 100 mg/ml (10 %) intravenous solution,calcium chloride 100 mg/ml (10 %) $ 60.00

Transcription

1 Px Code Generic Name CPT(R)/ HCPCS NDC Unit Price insulin human U-100 NPH-regulr mix 100 J $ labetalol 5 mg/ml intravenous solution $ lidocaine 1 %-epinephrine 1:100,000 injection $ mepivacaine (PF) 15 mg/ml (1.5 %) injection J $ bupivacaine-epinephrine (PF) 0.5 %-1:200, $ bupivacaine (PF) 0.5 % (5 mg/ml) injection $ bupivacaine (PF) 0.5 % (5 mg/ml) injection $ balanced salt solution non-surgical no.3 eye wash $ sodium borate-boric acid-sodium chloride-water $ cefazolin 2 gram/50 ml in dextrose (iso-osmotic) J $ sodium chloride 0.9 % irrigation solution $ sodium chloride 0.9 % irrigation solution $ vecuronium bromide 10 mg intravenous solution $ vecuronium bromide 20 mg intravenous solution $ water for injection, sterile injection solution $ water for injection, sterile injection solution $ zidovudine 100 mg capsule $ lidocaine 2 % mucosal solution $ bupivacaine (PF) 0.25 % (2.5 mg/ml) injection $ famotidine (PF) 20 mg/2 ml intravenous solution S $ vasopressin 20 unit/ml intravenous solution $ norepinephrine bitartrate 1 mg/ml intravenous $ lidocaine 2 % mucosal jelly in applicator $ calcium chloride 100 mg/ml (10 %) intravenous $ mvi,adult no.4 with vit K 3300 unit-150 mcg/ $ sugammadex 100 mg/ml intravenous solution $ bacitracin zinc 500 unit/gram topical ointment $ sodium hypochlorite 0.25 % solution $ sodium nitroprusside 25 mg/ml intravenous $ sodium nitroprusside 25 mg/ml intravenous $ cyclopentolate 1 % eye drops $ cyclopentolate 1 % eye drops $ etomidate 2 mg/ml intravenous solution $ etomidate 2 mg/ml intravenous solution $ diazepam 5 mg/ml injection solution J $ ondansetron 4 mg disintegrating tablet $ insulin glargine (U-100) 100 unit/ml J $ folic acid 5 mg/ml injection solution $ flumazenil 0.1 mg/ml intravenous solution $ diphenhydramine 25 mg $ calcium chloride 100 mg/ml (10 %) intravenous solution,calcium chloride 100 mg/ml (10 %) $ metoprolol tartrate 5 mg/5 ml intravenous solution,metoprolol tartrate 5 mg/5 ml $ mg/ml intravenous cartridge,morphine 4 mg/ml intravenous solution,morphine 4 mg/ml injection solution,morphine 4 mg/ml intravenous syringe J $ $ $ sodium chloride 0.9 % injection solution $ 60.00

2 ketamine 10 mg/ml injection solution $ ketamine 50 mg/ml injection solution $ lidocaine 10 mg/ml (1 %) injection solution $ mannitol 20 % intravenous solution $ nafcillin 2 gram solution for injection S $ phenylephrine 2.5 % eye drops $ prochlorperazine maleate 5 mg tablet $ promethazine 25 mg tablet $ sodium bicarbonate 8.4 % (1 meq/ml) $ sodium bicarbonate 8.4 % (1 meq/ml) $ sodium chloride 0.9 % injection syringe $ sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) $ water for irrigation, sterile solution $ water for irrigation, sterile solution $ clindamycin 150 mg/ml injection solution $ clindamycin 150 mg/ml injection solution $ tuberculin PPD 5 tub. unit/0.1 ml intradermal $ tuberculin PPD 5 tub. unit/0.1 ml intradermal $ verapamil 2.5 mg/ml intravenous solution $ verapamil 2.5 mg/ml intravenous solution $ verapamil 2.5 mg/ml intravenous solution $ aztreonam 1 gram solution for injection S $ ceftriaxone 1 gram/50 ml in dextrose (iso- J $ ceftriaxone 2 gram/50 ml in dextrose (iso-osm) J $ diltiazem 5 mg/ml intravenous solution $ diltiazem 5 mg/ml intravenous solution $ diltiazem 5 mg/ml intravenous solution $ diltiazem 5 mg/ml intravenous solution $ dronabinol 2.5 mg capsule $ dronabinol 2.5 mg capsule $ enalaprilat 1.25 mg/ml intravenous solution $ fluconazole 200 mg/100 ml in sod. chloride (iso) J $ heparin (porcine) 1,000 unit/ml injection solution J $ heparin (porcine) 10,000 unit/ml injection J $ pneumococcal 13-val conj vaccine-dip crm (PF) $ lidocaine (PF) 10 mg/ml (1 %) injection solution J $ lidocaine (PF) 10 mg/ml (1 %) injection solution J $ lidocaine (PF) 20 mg/ml (2 %) injection solution J $ lidocaine (PF) 20 mg/ml (2 %) injection solution J $ measles,mumps,rubella vaccine live(pf)1, $ denosumab 60 mg/ml subcutaneous syringe J $ 2, methylergonovine 0.2 mg/ml (1 ml) injection J $ enoxaparin 30 mg/0.3 ml subcutaneous syringe J $ enoxaparin 40 mg/0.4 ml subcutaneous syringe J $ enoxaparin 40 mg/0.4 ml subcutaneous syringe J $ enoxaparin 60 mg/0.6 ml subcutaneous syringe J $ enoxaparin 60 mg/0.6 ml subcutaneous syringe J $ enoxaparin 100 mg/ml subcutaneous syringe J $ ondansetron HCl (PF) 4 mg/2 ml injection J $ ondansetron HCl (PF) 4 mg/2 ml injection J $ ondansetron HCl 2 mg/ml intravenous solution J $ acetaminophen 1,000 mg/100 ml (10 mg/ml) J $

3 penicillin G benzathine 1,200,000 unit/2 ml J $ filgrastim 480 mcg/1.6 ml injection solution J $ 1, levofloxacin 500 mg/100 ml in 5 % dextrose J $ levofloxacin 750 mg/150 ml in 5 % dextrose J $ ciprofloxacin 400 mg/200 ml in 5 % dextrose J $ phytonadione (vitamin K1) 10 mg/ml injection J $ ibandronate 3 mg/3 ml intravenous syringe J $ pneumococcal 23 polyvalent vaccine 25 mcg/ $ potassium chloride 10 meq/100ml in sterile J $ propofol 10 mg/ml intravenous emulsion J $ terbutaline 1 mg/ml subcutaneous solution J $ dexamethasone sodium phosphate (PF) 10 J $ digoxin 250 mcg/ml injection solution J $ hydrocortisone sodium succinate 100 mg solution J $ ferric carboxymaltose 50 mg iron/ml intravenous J $ 2, acetylcysteine 200 mg/ml (20 %) solution J $ EPINEPHrine 0.1 mg/ml injection syringe J $ ipratropium bromide 0.02 % solution for J $ ipratropium bromide 0.02 % solution for J $ heparin, porcine (PF) 100 unit/ml intravenous J $ testosterone cypionate 200 mg/ml intramuscular J $ hepatitis B virus vaccine recomb (PF) 20 mcg/ml $ hepatitis B virus vaccine recomb (PF) 10 mcg/ $ hepatitis B virus vaccine recomb (PF) 10 mcg/ $ rho(d) immune globulin 1,500 unit (300 mcg)/2 J $ tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf $ tetanus and diphtheria tox (PF) 5 Lf unit-2 Lf $ diphth,pertus(ac)tetanus(pf)2 Lf-( mcg) $ diphth,pertus(ac)tetanus(pf)2 Lf-( mcg) $ dimethyl sulfoxide 50 % intravesical solution J $ 1, methylprednisolone sod succ (PF) 125 mg/2 ml J $ methylprednisolone sod succ (PF) 125 mg/2 ml J $ methylprednisolone sod succ (PF) 500 mg/4 ml J $ methylprednisolone sod succ (PF) 1,000 mg/8 J $ filgrastim-sndz 300 mcg/0.5 ml injection syringe Q $ filgrastim-sndz 480 mcg/0.8 ml injection syringe Q $ 1, pegfilgrastim 6 mg/0.6 ml subcutaneous syringe J $ 9, chlorpromazine 25 mg/ml injection solution J $ darbepoetin alfa 25 mcg/0.42 ml in polysorbate J $ leuprolide 7.5 mg intramuscular syringe kit J $ 2, calcium gluconate 100 mg/ml (10 %) intravenous J $ methylnaltrexone 12 mg/0.6 ml subcutaneous J $ midazolam (PF) 5 mg/ml injection solution J $ hum prothrombin cplx (PCC) 4factor 500 unit C $ hum prothrombin cplx(pcc)4fact 1,000 unit (800- C $ morphine 8 mg/ml intravenous syringe J $ mepolizumab 100 mg subcutaneous solution J $ 4, cefazolin 1 gram solution for injection J $ cefazolin 1 gram solution for injection J $ lidocaine (PF) 4 mg/ml (0.4 %) in 5 % dextrose J $ morphine (PF) 1 mg/ml injection solution J $ cefepime 1 gram solution for injection J $ 70.00

4 cefepime 2 gram solution for injection J $ ocrelizumab 30 mg/ml intravenous solution J $ 24, meropenem 1 gram intravenous solution J $ flu vacc qs (36 mos up)(pf)60 mcg ( $ piperacillin-tazobactam 4.5 gram intravenous J $ piperacillin-tazobactam 4.5 gram intravenous J $ piperacillin-tazobactam gram intravenous J $ piperacillin-tazobactam gram intravenous J $ DOBUTamine 500 mg/250 ml (2,000 mcg/ml) in J $ cyanocobalamin (vit B-12) 1,000 mcg/ml J $ leuprolide 22.5 mg (3 month) intramuscular J $ 7, azithromycin 500 mg intravenous solution J $ amphotericin B liposome 50 mg intravenous J $ rabies vaccine, purified chicken embryo cell (PF) $ ketorolac 30 mg/ml (1 ml) injection solution J $ eptifibatide 0.75 mg/ml intravenous solution J $ dexamethasone 4 mg tablet J $ dexamethasone 10 mg/ml injection solution J $ dexamethasone 4 mg/ml injection solution J $ levalbuterol 1.25 mg/3 ml solution for J $ sodium ferric gluconate complex in sucrose 62.5 J $ albuterol sulfate 2.5 mg/3 ml (0.083 %) solution J $ albuterol sulfate 2.5 mg/3 ml (0.083 %) solution J $ albuterol sulfate 2.5 mg/3 ml (0.083 %) solution J $ diphenhydramine 50 mg/ml injection solution J $ diphenhydramine 50 mg/ml injection solution J $ pantoprazole 40 mg intravenous solution C $ morphine 10 mg/ml intravenous solution J $ tenecteplase 50 mg intravenous kit J $ 5, budesonide 0.5 mg/2 ml suspension for J $ budesonide 0.5 mg/2 ml suspension for J $ iron sucrose 100 mg iron/5 ml intravenous J $ prednisolone sodium phosphate 15 mg/5 ml (3 J $ crotalidae polyval immune fab solution for J $ 10, propranolol 1 mg/ml intravenous solution J $ alteplase 2 mg intra-catheter solution J $ ertapenem 1 gram solution for injection J $ ertapenem 1 gram solution for injection J $ pamidronate 30 mg/10 ml (3 mg/ml) J $ furosemide 10 mg/ml injection solution J $ ziprasidone 20 mg/ml (final concentration) J $ gentamicin 40 mg/ml injection solution J $ zoledronic acid 4 mg/5 ml intravenous solution J $ haloperidol lactate 5 mg/ml injection solution J $ heparin (porcine) 20,000 unit/500 ml (40 J $ palonosetron 0.25 mg/5 ml intravenous solution J $ 1, hydralazine 20 mg/ml injection solution J $ hydroxyzine HCl 50 mg/ml intramuscular J $ cinacalcet 60 mg tablet J $ acetylcysteine 200 mg/ml (20 %) intravenous J $ adenosine 3 mg/ml intravenous solution J $ natalizumab 300 mg/15 ml intravenous solution J $ 9,888.00

5 aminophylline 250 mg/10 ml intravenous J $ LORazepam 2 mg/ml injection solution,lorazepam 2 mg/ml injection syringe J $ LORazepam 2 mg/ml injection solution,lorazepam 2 mg/ml injection syringe J $ hydrocortisone sod succinate (PF) 100 mg/2 ml solution for injection,hydrocortisone sodium J $ fentanyl (PF) 100 mcg/2 ml (50 mcg/ml) intravenous syringe,fentanyl (PF) 50 mcg/ml J $ midazolam 1 mg/ml injection solution,midazolam (PF) 1 mg/ml injection solution J $ amiodarone 50 mg/ml intravenous solution,amiodarone 150 mg/3 ml intravenous J $ amiodarone 50 mg/ml intravenous solution,amiodarone 150 mg/3 ml intravenous J $ ceftriaxone 1 gram solution for injection J $ hepatitis B virus vaccine recomb (PF) 20 mcg/ml intramuscular susp,hepatitis B virus vaccine $ EPINEPHrine 1 mg/ml injection solution,epinephrine HCL (PF) 1 mg/ml (1 ml) J $ HYDROmorphone 2 mg/ml injection solution,hydromorphone (PF) 2 mg/ml injection J $ J $ J $ J $ diphth,pertussis(acel),tetanus 2.5 Lf unit-8 mcg $ glucagon (human recombinant) 1 mg/ml solution J $ lidocaine (PF) 40 mg/ml (4 %) injection solution J $ lidocaine (PF) 50 mg/5 ml (1 %) intravenous $ lidocaine (PF) 100 mg/5 ml (2 %) intravenous J $ ampicillin 2 gram solution for injection J $ magnesium sulfate 4 meq/ml (50 %) injection J $ magnesium sulfate 4 meq/ml (50 %) injection J $ methylprednisolone 4 mg tablet J $ methylprednisolone acetate 80 mg/ml J $ metoclopramide 5 mg/ml injection solution J $ nalbuphine 10 mg/ml injection solution J $ naloxone 1 mg/ml injection syringe J $ orphenadrine citrate 30 mg/ml injection solution J $ oxytocin 10 unit/ml injection solution J $ phenylephrine 10 mg/ml injection solution J $ phenytoin sodium 50 mg/ml intravenous solution J $ potassium chloride 2 meq/ml intravenous J $ prednisone 1 mg tablet J $ prednisone 10 mg tablet J $ prednisone 20 mg tablet J $ prednisone 5 mg tablet J $ prochlorperazine Edisylate 10 mg/2 ml (5 J $ promethazine 25 mg/ml injection solution J $ promethazine 50 mg/ml injection solution J $ protamine 10 mg/ml intravenous solution J $ atropine 0.1 mg/ml injection syringe J $ 70.00

6 succinylcholine chloride 20 mg/ml injection J $ levetiracetam 500 mg/5 ml intravenous solution J $ levetiracetam 500 mg/5 ml intravenous solution J $ arformoterol 15 mcg/2 ml solution for J $ arformoterol 15 mcg/2 ml solution for J $ thiamine HCl (vitamin B1) 100 mg/ml injection J $ triamcinolone acetonide 40 mg/ml suspension J $ zoledronic acid 5 mg/100 ml in mannitol 5 %- J $ 2, vancomycin 1,000 mg intravenous injection J $ vancomycin 1,000 mg intravenous injection J $ fosphenytoin 100 mg PE/2 ml injection solution Q $ alteplase 100 mg intravenous solution J $ 14, alteplase 100 mg intravenous solution J $ 14, ampicillin-sulbactam 1.5 gram solution for J $ ampicillin-sulbactam 3 gram solution for injection J $ ketorolac 60 mg/2 ml intramuscular solution J $ azathioprine 50 mg tablet J $ betamethasone acetate and sodium phos 6 J $ romiplostim 250 mcg subcutaneous solution J $ 3, romiplostim 500 mcg subcutaneous solution J $ 6, ipratropium-albuterol 0.5 mg-3 mg(2.5 mg J $ ipratropium-albuterol 0.5 mg-3 mg(2.5 mg J $ ipratropium-albuterol 0.5 mg-3 mg(2.5 mg J $ ipratropium-albuterol 0.5 mg-3 mg(2.5 mg J $ ipratropium-albuterol 0.5 mg-3 mg(2.5 mg J $ cefoxitin 1 gram intravenous solution J $ cefoxitin 1 gram intravenous solution J $ ceftazidime 1 gram solution for injection J $ ceftazidime 2 gram solution for injection J $ ceftriaxone 2 gram solution for injection J $ imipenem-cilastatin 500 mg intravenous solution J $ EPINEPHrine 1 mg/ml injection solution J $ famotidine 20 mg tablet $ 5.75 finasteride 5 mg tablet $ 5.75 balsam peru-castor oil 87 mg-788 mg/gram $ 5.75 flavoxate 100 mg tablet $ 5.75 fluconazole 200 mg tablet $ 5.75 fludrocortisone 0.1 mg tablet $ 5.75 diclofenac 1 % topical gel $ FLUoxetine 10 mg capsule $ 5.75 FLUoxetine 20 mg capsule $ 5.75 Lactobacil rhamnosus GG 10 billion cell-inulin $ 5.75 estradiol 10 mcg vaginal tablet $ glipizide 5 mg tablet $ 5.75 glycopyrrolate 1 mg tablet $ 5.75 hydrocortisone 5 mg tablet $ 5.75 hydroxychloroquine 200 mg tablet $ hydroxychloroquine 200 mg tablet $ insulin NPH isophane U-100 human 100 unit/ml $ insulin U-100 regular human 100 unit/ml $ iodoquinol-hc 1 %-1 % topical cream $ ketoconazole 2 % topical cream $ 5.86

7 ketoconazole 2 % topical cream $ 5.75 ketorolac 10 mg tablet $ 5.75 labetalol 100 mg tablet $ 5.75 ammonium lactate 12 % lotion $ tamsulosin 0.4 mg capsule $ 5.75 levothyroxine 88 mcg tablet $ 5.75 levothyroxine 112 mcg tablet $ 5.75 levothyroxine 175 mcg tablet $ 5.75 lidocaine-prilocaine 2.5 %-2.5 % topical cream $ 5.75 lidocaine-prilocaine 2.5 %-2.5 % topical cream $ 7.64 methyl salicylate-menthol topical ointment $ 6.34 lisinopril 10 mg tablet $ 5.75 lisinopril 40 mg tablet $ 5.75 lisinopril 5 mg tablet $ 5.75 fluticasone 100 mcg-salmeterol 50 mcg/dose $ fluticasone 250 mcg-salmeterol 50 mcg/dose $ fluticasone 250 mcg-salmeterol 50 mcg/dose $ fluticasone 500 mcg-salmeterol 50 mcg/dose $ loratadine 10 mg tablet $ 5.75 magnesium oxide 400 mg (241.3 mg magnesium) $ 5.75 magnesium oxide 400 mg (241.3 mg magnesium) $ 5.75 metformin 500 mg tablet $ 5.75 metolazone 2.5 mg tablet $ 8.33 metronidazole 0.75 % vaginal gel $ 8.07 midodrine 5 mg tablet $ 5.75 neomycin 3.5 mg/g-polymyxin B 10,000 unit/g $ misoprostol 200 mcg tablet $ 5.75 HYDROcodone 10 mg-chlorpheniramine 8 mg/5 ml oral susp extend.rel 12hr $ 5.75 dabigatran etexilate 75 mg capsule $ mupirocin 2 % topical ointment $ 5.75 mupirocin 2 % topical ointment $ NIFEdipine ER 60 mg tablet,extended release $ 5.75 nitrofurantoin monohydrate/macrocrystals $ nitrofurantoin monohydrate/macrocrystals $ omega-3 fatty acids-fish oil 300 mg-1,000 mg $ 5.75 electrolytes-dextrose oral solution $ 5.75 oxycodone 5 mg tablet $ 5.75 peg 3350-electrolytes 236 gram gram $ PARoxetine 20 mg tablet $ 5.75 PARoxetine 20 mg tablet $ 5.75 PARoxetine 30 mg tablet $ 5.75 linagliptin 5 mg tablet $ rivaroxaban 10 mg tablet $ calcium polycarbophil 625 mg tablet $ 5.75 oseltamivir 6 mg/ml oral suspension $ pravastatin 10 mg tablet $ 5.75 pravastatin 20 mg tablet $ 5.75 pravastatin 20 mg tablet $ 5.75 pravastatin 40 mg tablet $ 5.75 pravastatin 40 mg tablet $ 5.75 pravastatin 40 mg tablet $ 5.75

8 ferrous gluconate 324 mg (37.5 mg iron) tablet $ 5.75 primidone 50 mg tablet $ 5.75 prochlorperazine 25 mg rectal suppository $ promethazine 12.5 mg rectal suppository $ promethazine 25 mg rectal suppository $ quinapril 20 mg tablet $ 5.75 ramipril 1.25 mg capsule $ 5.75 ramipril 2.5 mg capsule $ 5.75 ranitidine 150 mg tablet $ 5.75 rivaroxaban 15 mg tablet $ rivaroxaban 20 mg tablet $ acetazolamide 250 mg tablet $ racepinephrine 2.25 % solution for nebulization $ 6.01 sertraline 100 mg tablet $ 5.75 sertraline 50 mg tablet $ 5.75 simvastatin 10 mg tablet $ 5.75 simvastatin 20 mg tablet $ 5.75 simvastatin 40 mg tablet $ 5.75 sodium phosphates 19 gram-7 gram/118 ml $ 5.75 sotalol 80 mg tablet $ 5.75 sucralfate 1 gram tablet $ 5.75 magnesium 64 mg (magnesium chloride) $ 5.75 tamoxifen 20 mg tablet $ 5.75 timolol maleate 0.25 % eye drops $ tobramycin 0.3 %-dexamethasone 0.1 % eye $ sulfamethoxazole 800 mg-trimethoprim 160 mg $ 5.75 vancomycin 125 mg capsule $ warfarin 1 mg tablet $ 5.75 warfarin 1 mg tablet $ 9.53 ipratropium 20 mcg-albuterol 100 mcg/actuation $ mirabegron ER 25 mg tablet,extended release $ zolpidem 5 mg tablet $ morphine ER 30 mg tablet,extended release $ 5.75 diclofenac 50 mg-misoprostol 200 mcg $ apixaban 2.5 mg tablet $ morphine ER 15 mg tablet,extended release $ 5.75 morphine ER 60 mg tablet,extended release $ 5.75 morphine ER 100 mg tablet,extended release $ 5.75 apixaban 5 mg tablet $ meclizine 12.5 mg tablet $ 5.75 memantine 14 mg capsule sprinkle,extended $ doxylamine 10 mg-pyridoxine (vit B6) 10 mg $ magnesium hydroxide 400 mg/5 ml oral $ 9.01 venlafaxine 100 mg tablet $ 5.75 venlafaxine 75 mg tablet $ 5.75 venlafaxine 37.5 mg tablet $ 5.75 oxycodone ER 10 mg tablet,crush $ oxycodone ER 10 mg tablet,crush $ oxycodone ER 20 mg tablet,crush $ cholestyramine-aspartame 4 gram oral powder $ 9.48 fluocinonide-emollient 0.05 % topical cream $ activated charcoal-sorbitol 25 gram/120 ml oral $ 53.28

9 activated charcoal 25 gram/120 ml oral $ insulin aspart U unit/ml subcutaneous $ insulin glargine (U-100) 100 unit/ml (3 ml) $ insulin glargine (U-100) 100 unit/ml (3 ml) $ insulin lispro (U-100) 100 unit/ml subcutaneous $ insulin detemir (U-100) 100 unit/ml (3 ml) $ insulin aspar prot-insulin aspart 100 unit/ml ( $ liraglutide 0.6 mg/0.1 ml (18 mg/3 ml) $ estradiol 0.5 mg tablet $ 5.75 sodium chloride-aloe vera nasal gel $ 5.75 aspirin-sod bicarb-citric acid 325 mg-1,916 mg $ 5.75 trolamine salicylate-aloe vera 10 % topical cream $ 5.75 carbidopa ER 25 mg-levodopa 100 mg $ 5.75 multivit-min-fa 100 mcg-lut 1.66 mg-zeaxanth $ 5.75 terbinafine HCl 250 mg tablet $ 5.75 tiotropium bromide 2.5 mcg/actuation mist for $ umeclidinium 62.5 mcg/actuation blister powder $ 5.75 naloxegol 25 mg tablet $ white petrolatum-mineral oil 83 %-15 % eye $ 5.75 white petrolatum-mineral oil 83 %-15 % eye $ 5.75 scopolamine 1 mg over 3 days transdermal patch $ pentosan polysulfate sodium 100 mg capsule $ thyroid (pork) 30 mg tablet $ 5.75 calcium carbonate 500 mg calcium (1,250 mg) $ 5.75 thiamine mononitrate (vitamin B1) 100 mg tablet $ 5.75 salt irrigation solution no % nasal solution $ 5.75 verapamil ER (SR) 240 mg tablet,extended release $ 5.75 lisinopril 2.5 mg tablet $ 5.75 valacyclovir 1 gram tablet $ 5.75 valacyclovir 500 mg tablet $ naproxen sodium 220 mg tablet $ 5.75 naproxen sodium 220 mg tablet $ 5.75 verapamil ER (SR) 120 mg tablet,extended release $ 8.92 methyl salicylate 15 %-menthol 1 % topical cream $ 5.75 SUMAtriptan 100 mg tablet $ 5.75 acidophilus 25 million cell-pectin, citrus 100 mg $ 5.75 carbamazepine 100 mg chewable tablet $ 5.75 carbamazepine 200 mg tablet $ 5.91 fluconazole 150 mg tablet $ 5.75 carbamide peroxide 6.5 % ear drops $ 5.75 potassium chloride ER 10 meq capsule,extended $ 5.75 potassium chloride ER 10 meq capsule,extended $ 5.75 carisoprodol 350 mg tablet $ 5.75 carisoprodol 350 mg tablet $ 5.75 lamotrigine 25 mg tablet $ 5.75 lamotrigine 100 mg tablet $ 5.75 acetaminophen 300 mg-codeine 30 mg tablet $ 5.75 acetaminophen 300 mg-codeine 30 mg tablet $ 5.75 diltiazem ER 60 mg capsule,extended release $ ketoconazole 2 % shampoo $ 5.75 terazosin 1 mg capsule $ 5.75 terazosin 2 mg capsule $ 5.75

10 terazosin 5 mg capsule $ 5.75 tramadol 50 mg tablet $ 5.75 tramadol 50 mg tablet $ 5.75 metformin 850 mg tablet $ 5.75 tizanidine 2 mg tablet $ 5.75 tizanidine 4 mg tablet $ 5.75 losartan 25 mg tablet $ 5.75 losartan 50 mg tablet $ 5.75 fosfomycin tromethamine 3 gram oral packet $ SUMAtriptan 50 mg tablet $ 5.75 diclofenac sodium 75 mg tablet,delayed release $ 5.75 calcitonin (salmon) 200 unit/actuation nasal spray $ carvedilol 6.25 mg tablet $ 5.75 carvedilol 25 mg tablet $ 5.75 carvedilol 25 mg tablet $ 5.75 carvedilol 12.5 mg tablet $ 5.75 azithromycin 200 mg/5 ml oral suspension $ azithromycin 200 mg/5 ml oral suspension $ azithromycin 200 mg/5 ml oral suspension $ ipratropium bromide 0.03 % nasal spray $ chlordiazepoxide 10 mg capsule $ 5.75 chlordiazepoxide 25 mg capsule $ 5.75 chlordiazepoxide 5 mg capsule $ 5.75 glimepiride 1 mg tablet $ 5.75 glimepiride 2 mg tablet $ 5.75 glimepiride 4 mg tablet $ 5.75 bupropion HCl 150 mg tablet,12 hr sustained $ 5.75 ferrous sulfate 220 mg (44 mg iron)/5 ml oral $ 5.75 ferrous sulfate 220 mg (44 mg iron)/5 ml oral $ 5.75 chlorthalidone 25 mg tablet $ 5.75 PARoxetine 10 mg tablet $ 5.75 PARoxetine 40 mg tablet $ 5.75 lidocaine 4 % topical patch $ 5.75 lidocaine 4 % topical patch $ theophylline ER 400 mg tablet,extended release $ 5.75 sodium polystyrene sulfonate 15 gram-sorbitol $ magnesium 70 mg (magnesium chloride) $ 5.75 melatonin 3 mg tablet $ 5.75 clindamycin HCl 150 mg capsule $ 5.75 insulin lispro (U-100) 100 unit/ml subcutaneous $ buspirone 15 mg tablet $ 5.75 mirtazapine 30 mg tablet $ 5.75 mirtazapine 15 mg tablet $ 5.75 clonidine HCl 0.1 mg tablet $ 5.75 clotrimazole 1 % topical cream $ 5.75 albuterol sulfate HFA 90 mcg/actuation aerosol $ albuterol sulfate HFA 90 mcg/actuation aerosol $ albuterol sulfate HFA 90 mcg/actuation aerosol $ brimonidine 0.2 % eye drops $ brimonidine 0.2 % eye drops $ OLANZapine 5 mg tablet $ 5.75 OLANZapine 10 mg tablet $ 5.75

11 colchicine 0.6 mg tablet $ peg-electrolyte solution 420 gram oral solution $ bisoprolol 10 mg-hydrochlorothiazide 6.25 mg $ 5.75 gabapentin 400 mg capsule $ 5.75 gabapentin 300 mg capsule $ 5.75 gabapentin 100 mg capsule $ 5.75 gabapentin 100 mg capsule $ 5.75 risperidone 1 mg tablet $ 5.75 bupropion HCl SR 100 mg tablet,12 hr sustained $ 5.75 bupropion HCl SR 150 mg tablet,12 hr sustained $ 5.75 carvedilol mg tablet $ 5.75 carvedilol mg tablet $ 5.75 latanoprost % eye drops $ 5.75 donepezil 10 mg tablet $ 5.75 levofloxacin 500 mg tablet $ 5.75 hydrochlorothiazide 12.5 mg capsule $ 5.75 hydrochlorothiazide 12.5 mg capsule $ 5.75 atorvastatin 10 mg tablet $ 5.75 atorvastatin 40 mg tablet $ 5.75 atorvastatin 20 mg tablet $ 5.75 warfarin 3 mg tablet $ 5.75 warfarin 3 mg tablet $ 5.75 calcium carbonate 500 mg (1,250 mg)-vitamin D $ 5.75 benzocaine 20 % gum/denture cream $ 5.75 clindamycin 1 % lotion $ 8.88 metronidazole 0.75 % topical gel $ ofloxacin 0.3 % eye drops $ sertraline 25 mg tablet $ 5.75 cyanocobalamin (vit B-12) 100 mcg tablet $ 5.75 cyanocobalamin (vit B-12) 500 mcg tablet $ 5.75 cyclobenzaprine 10 mg tablet $ 5.75 meloxicam 7.5 mg tablet $ 5.75 imiquimod 5 % topical cream packet $ azithromycin 250 mg tablet Q $ azithromycin 250 mg tablet Q $ 6.50 OLANZapine 2.5 mg tablet $ 5.75 citalopram 20 mg tablet $ 5.75 pramipexole mg tablet $ 5.75 pramipexole 0.25 mg tablet $ 5.75 dapsone 100 mg tablet $ 5.75 warfarin 4 mg tablet $ 5.75 warfarin 4 mg tablet $ 5.75 letrozole 2.5 mg tablet $ 5.75 ropinirole 0.25 mg tablet $ 5.75 ropinirole 0.5 mg tablet $ 5.75 QUEtiapine 25 mg tablet $ 5.75 QUEtiapine 200 mg tablet $ 5.75 clopidogrel 75 mg tablet $ 5.75 cefdinir 300 mg capsule $ 5.75 montelukast 10 mg tablet $ 5.75 sulfamethoxazole 200 mg-trimethoprim 40 mg/ $ losartan 100 mg tablet $ 5.75

12 losartan 100 mg tablet $ 5.75 ursodiol 250 mg tablet $ 9.91 tolterodine 2 mg tablet $ 6.28 camphor-menthol 0.5 %-0.5 % lotion $ 5.75 simvastatin 80 mg tablet $ 5.75 lidocaine 5 % topical cream $ 5.75 citalopram 40 mg tablet $ 5.75 diazepam 5 mg tablet $ 5.75 dicloxacillin 250 mg capsule $ 5.75 dicloxacillin 500 mg capsule $ 5.75 dicyclomine 20 mg tablet $ 5.75 isosorbide mononitrate ER 60 mg tablet,extended $ 5.75 digoxin 125 mcg tablet $ 5.75 digoxin 250 mcg tablet $ 5.75 oxybutynin chloride ER 5 mg tablet,extended $ oxybutynin chloride ER 10 mg tablet,extended $ 5.75 cilostazol 50 mg tablet $ 5.75 cilostazol 100 mg tablet $ 5.75 celecoxib 100 mg capsule $ 5.75 celecoxib 200 mg capsule $ 5.75 isosorbide mononitrate ER 30 mg tablet,extended $ 5.75 lisinopril 10 mg-hydrochlorothiazide 12.5 mg $ 5.75 diltiazem 120 mg tablet $ 5.75 diltiazem 30 mg tablet $ 5.75 diltiazem 60 mg tablet $ 5.75 dextromethorphan-guaifenesin 30 mg-600 mg $ 5.75 dimenhydrinate 50 mg tablet $ 5.75 ciprofloxacin 500 mg tablet $ 5.75 diphenoxylate-atropine 2.5 mg mg tablet $ 5.75 verapamil ER 120 mg 24 hr capsule,extended $ 6.72 amoxicillin 400 mg/5 ml oral suspension $ glucosamine-chondroitin 500 mg-400 mg tablet $ 5.75 polyethylene glycol gram oral powder $ 5.75 fexofenadine 180 mg tablet $ 5.75 risperidone 0.25 mg tablet $ 5.75 risperidone 0.25 mg tablet $ 5.75 risperidone 0.5 mg tablet $ 5.75 risperidone 0.5 mg tablet $ 5.75 pioglitazone 15 mg tablet $ 5.75 pioglitazone 45 mg tablet $ 5.75 gabapentin 600 mg tablet $ 5.75 doxepin 10 mg capsule $ 5.75 pantoprazole 40 mg tablet,delayed release $ 5.75 doxycycline hyclate 100 mg capsule $ 5.75 oseltamivir 75 mg capsule $ oseltamivir 75 mg capsule $ levetiracetam 500 mg tablet $ 5.75 ciclopirox 8 % topical solution $ theophylline ER 200 mg capsule,extended release $ nitroglycerin 0.1 mg/hr transdermal 24 hour $ 5.75 nitroglycerin 0.2 mg/hr transdermal 24 hour $ 5.75 nitroglycerin 0.4 mg/hr transdermal 24 hour $ 5.75

13 felodipine ER 5 mg tablet,extended release 24 hr $ 5.75 pseudoephedrine-guaifenesin ER 60 mg-600 mg $ 5.75 divalproex 125 mg capsule,delayed release $ 5.75 NIFEdipine ER 60 mg tablet,extended release $ 5.75 lansoprazole 15 mg capsule,delayed release $ 9.24 lansoprazole 30 mg capsule,delayed release $ 9.24 omeprazole 20 mg capsule,delayed release $ 5.75 omeprazole 40 mg capsule,delayed release $ 5.75 omeprazole 40 mg capsule,delayed release $ 5.75 venlafaxine ER 37.5 mg capsule,extended release $ 5.75 venlafaxine ER 75 mg capsule,extended release $ 5.75 fentanyl 25 mcg/hr transdermal patch $ fentanyl 50 mcg/hr transdermal patch $ fentanyl 75 mcg/hr transdermal patch $ fentanyl 100 mcg/hr transdermal patch $ carboxymethylcellulose sodium 1 % eye liquid gel $ chlorhexidine gluconate 4 % topical liquid $ 5.75 lidocaine 5 % topical patch $ linezolid 600 mg tablet $ salmeterol 50 mcg/dose blister powder for $ HYDROcodone 10 mg-acetaminophen 325 mg $ 5.75 insulin aspart U unit/ml subcutaneous $ ergocalciferol (vitamin D2) 50,000 unit capsule $ 5.75 NIFEdipine ER 30 mg tablet,extended release $ 5.75 atorvastatin 80 mg tablet $ 5.75 glyburide 5 mg-metformin 500 mg tablet $ 5.75 hydrocortisone 2.5 % topical cream with perineal $ 9.71 erythromycin 5 mg/gram (0.5 %) eye ointment $ metformin ER 500 mg tablet,extended release $ 5.75 alendronate 70 mg tablet $ 5.75 QUEtiapine 300 mg tablet $ 5.75 diltiazem ER 120 mg capsule,24 hr,extended $ 5.75 diltiazem CD 120 mg capsule,extended release $ 5.75 diltiazem CD 180 mg capsule,extended release $ 5.75 diltiazem CD 240 mg capsule,extended release $ 5.75 diltiazem ER (XR/XT) 180 mg capsule,extended $ 5.75 diltiazem ER (XR/XT) 240 mg capsule,extended $ 5.75 clotrimazole-betamethasone 1 %-0.05 % topical $ 5.75 tolterodine ER 2 mg capsule,extended release $ tolterodine ER 4 mg capsule,extended release $ sodium chloride 0.65 % nasal spray aerosol $ 5.75 esomeprazole magnesium 20 mg capsule,delayed $ esomeprazole magnesium 20 mg capsule,delayed $ esomeprazole magnesium 40 mg capsule,delayed $ esomeprazole magnesium 40 mg capsule,delayed $ metoprolol succinate ER 25 mg tablet,extended $ 5.75 metoprolol succinate ER 50 mg tablet,extended $ 5.75 metoprolol succinate ER 100 mg tablet,extended $ 5.75 metoprolol succinate ER 200 mg tablet,extended $ 5.75 citalopram 10 mg tablet $ 5.75 ferrous gluconate 324 mg (38 mg iron) tablet $ 5.75 ferrous sulfate 220 mg (44 mg iron)/5 ml oral $ 5.75

14 ferrous sulfate 325 mg (65 mg iron) tablet $ 5.75 allopurinol 100 mg tablet $ 5.75 allopurinol 300 mg tablet $ 5.75 allopurinol 300 mg tablet $ 5.75 valsartan 80 mg tablet $ 5.75 oxycodone-acetaminophen 10 mg-325 mg $ 5.75 fluorometholone 0.1 % eye drops,suspension $ folic acid 1 mg tablet $ 5.75 folic acid 1 mg tablet $ 5.75 ALPRAZolam 0.25 mg tablet $ 5.75 ALPRAZolam 0.25 mg tablet $ 5.75 ALPRAZolam 0.5 mg tablet $ 5.75 risedronate 35 mg tablet $ furosemide 10 mg/ml oral solution $ furosemide 20 mg tablet $ 5.75 furosemide 40 mg tablet $ 5.75 furosemide 80 mg tablet $ 5.75 amoxicillin 500 mg-potassium clavulanate 125 mg $ 6.52 amoxicillin 875 mg-potassium clavulanate 125 mg $ amoxicillin 400 mg-potassium clavulanate $ escitalopram 10 mg tablet $ 5.75 escitalopram 20 mg tablet $ 5.75 valsartan 40 mg tablet $ 5.75 gemfibrozil 600 mg tablet $ 5.75 dutasteride 0.5 mg capsule $ ezetimibe 10 mg tablet $ 9.67 propylene glycol 1 %-glycerin 0.3 % eye drops $ 5.75 gentian violet 1 % topical solution $ 5.75 ARIPiprazole 10 mg tablet $ 5.75 HYDROcodone 5 mg-acetaminophen 325 mg $ 5.75 HYDROcodone 5 mg-acetaminophen 325 mg $ 5.75 HYDROcodone 7.5 mg-acetaminophen 325 mg $ 5.75 HYDROcodone 7.5 mg-acetaminophen 325 mg $ 5.75 HYDROcodone 7.5 mg-acetaminophen 325 mg $ 5.75 guaifenesin 400 mg tablet $ 5.75 neomycin-polymyxin-hydrocort 3.5 mg/ml $ neomycin-polymyxin-hydrocort 3.5 mg/ml $ glyburide 5 mg tablet $ 5.75 rosuvastatin 20 mg tablet $ cyclobenzaprine 5 mg tablet $ 5.75 coenzyme Q10 50 mg capsule $ 5.75 haloperidol 1 mg tablet $ 5.75 haloperidol 2 mg tablet $ 5.75 peg 400-propylene glycol 0.4 %-0.3 % eye drops $ 5.75 potassium chloride ER 20 meq tablet,extended $ 5.75 potassium chloride ER 20 meq tablet,extended $ 5.75 menthol 5 % topical patch $ 5.75 amantadine HCl 100 mg capsule $ 7.46 ARIPiprazole 5 mg tablet $ 5.75 levetiracetam 100 mg/ml oral solution $ rosuvastatin 5 mg tablet $ 5.75 bupropion HCl XL 150 mg 24 hr tablet, extended $ 6.03

15 phenylephrine % nasal drops $ 5.75 amiodarone 100 mg tablet $ amiodarone 100 mg tablet $ memantine 10 mg tablet $ 5.75 alfuzosin ER 10 mg tablet,extended release 24 hr $ 5.75 hydralazine 25 mg tablet $ 5.75 hydrochlorothiazide 25 mg tablet $ 5.75 hydrocortisone 1 % topical cream $ 9.70 hydrocortisone 2.5 % topical cream $ 5.75 hydrocortisone 10 mg tablet $ 5.75 hydrocortisone 20 mg tablet $ 5.75 hydrocortisone acetate 25 mg rectal suppository $ HYDROmorphone 2 mg tablet $ 5.75 escitalopram 5 mg tablet $ 5.75 metoprolol tartrate 25 mg tablet $ 5.75 glipizide ER 5 mg tablet, extended release 24 hr $ 5.75 glipizide ER 10 mg tablet, extended release 24 hr $ 5.75 guaifenesin ER 600 mg tablet, extended release $ 5.75 hydroxyzine HCl 25 mg tablet $ 5.75 hydroxyzine HCl 25 mg tablet $ 5.75 HYDROcodone 7.5 mg-acetaminophen 325 mg/ $ propranolol ER 60 mg capsule,24 hr,extended $ 5.75 lactulose 10 gram/15 ml oral solution $ 5.75 tiotropium bromide 18 mcg capsule with $ ibuprofen 400 mg tablet $ 5.75 ibuprofen 600 mg tablet $ 5.75 ibuprofen 800 mg tablet $ 5.75 vitamin B complex and vitamin C no.20-folic acid $ 5.75 amiloride 5 mg tablet $ 5.75 nystatin 100,000 unit/gram topical powder $ 6.57 DULoxetine 20 mg capsule,delayed release $ 5.75 DULoxetine 30 mg capsule,delayed release $ 5.75 DULoxetine 60 mg capsule,delayed release $ 5.75 DULoxetine 60 mg capsule,delayed release $ 5.75 solifenacin 5 mg tablet $ darifenacin ER 7.5 mg tablet,extended release $ isosorbide dinitrate 10 mg tablet $ 5.75 fluticasone 110 mcg/actuation HFA aerosol $ fluticasone 220 mcg/actuation HFA aerosol $ cholecalciferol (vitamin D3) 1,000 unit tablet,cholecalciferol (vitamin D3) 1,000 unit $ 5.75 cholecalciferol (vitamin D3) 5,000 unit capsule,cholecalciferol (vitamin D3) 5,000 unit $ 5.75 cholecalciferol (vitamin D3) 400 unit tablet,cholecalciferol (vitamin D3) 400 unit $ 5.75 loperamide 2 mg capsule,loperamide 2 mg tablet $ 5.75 capsule,lactobacillus rhamnosus GG 15 billion cell sprinkle capsule,lactobacillus acidophilus 75 million cell-pectin 100 mg capsule $ $ $ $ 25.87

16 $ dextromethorphan-guaifenesin 10 mg-100 mg/5 ml syrup,dextromethorphan-guaifenesin 10 mg $ dextromethorphan-guaifenesin 10 mg-100 mg/5 ml syrup,dextromethorphan-guaifenesin 10 mg $ dextromethorphan-guaifenesin 10 mg-100 mg/5 ml syrup,dextromethorphan-guaifenesin 10 mg $ cocaine 4 % topical solution,cocaine 4 % nasal $ morphine concentrate 20 mg/ml oral syringe (FOR ORAL USE ONLY),morphine concentrate $ 5.75 polyethylene glycol gram oral powder packet,polyethylene glycol gram/dose $ polyethylene glycol gram oral powder packet,polyethylene glycol gram/dose $ polyethylene glycol gram oral powder packet,polyethylene glycol gram/dose $ 5.75 potassium chloride ER 10 meq tablet,extended release,potassium chloride ER 10 meq $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ glycerin (adult) rectal suppository $ 5.75 ibandronate 150 mg tablet $ fentanyl 12 mcg/hr transdermal patch $ mometasone 220 mcg (14 doses) breath $

17 pregabalin 25 mg capsule $ pregabalin 50 mg capsule $ pregabalin 75 mg capsule $ pregabalin 100 mg capsule $ losartan 100 mg-hydrochlorothiazide 12.5 mg $ 5.75 leucovorin calcium 5 mg tablet $ 5.75 levothyroxine 25 mcg tablet $ 5.75 levothyroxine 50 mcg tablet $ 5.75 levothyroxine 75 mcg tablet $ 5.75 levothyroxine 100 mcg tablet $ 5.75 levothyroxine 125 mcg tablet $ 5.75 levothyroxine 150 mcg tablet $ 5.75 amoxicillin 250 mg capsule $ 5.75 liothyronine 25 mcg tablet $ 5.75 amoxicillin 500 mg capsule $ 5.75 amoxicillin 250 mg chewable tablet $ 5.75 lisinopril 20 mg tablet $ 5.75 lisinopril 20 mg tablet $ 5.75 amoxicillin 250 mg/5 ml oral suspension $ loperamide 2 mg capsule $ 5.75 loperamide 2 mg capsule $ 5.75 LORazepam 2 mg/ml oral concentrate $ LORazepam 0.5 mg tablet $ 5.75 LORazepam 1 mg tablet $ 5.75 LORazepam 1 mg tablet $ 5.75 ampicillin 250 mg capsule $ 5.75 magnesium citrate oral solution $ 8.21 magnesium oxide 500 mg tablet $ 5.75 medroxyprogesterone 2.5 mg tablet $ 5.75 medroxyprogesterone 2.5 mg tablet $ $ meperidine 50 mg tablet $ 5.75 methocarbamol 750 mg tablet $ 5.75 methotrexate sodium 2.5 mg tablet $ methotrexate sodium 2.5 mg tablet $ methyldopa 250 mg tablet $ 5.75 methylphenidate 10 mg tablet $ 5.75 metoclopramide 10 mg tablet $ 5.75 metoclopramide 5 mg tablet $ 5.75 metoprolol tartrate 50 mg tablet $ 5.75 metronidazole 500 mg tablet $ 5.75 miconazole nitrate 2 % topical cream $ 5.75 morphine 15 mg immediate release tablet $ 5.75 naproxen 250 mg tablet $ 5.75 naproxen 500 mg tablet $ 5.75 niacin 100 mg tablet $ 5.75 niacin 500 mg tablet $ 5.75 nitroglycerin ER 2.5 mg capsule,extended release $ 5.75 nitroglycerin ER 6.5 mg capsule,extended release $ 5.75 nitroglycerin 0.4 mg sublingual tablet $ 5.75 nitroglycerin 2 % transdermal ointment $ 5.75 nortriptyline 25 mg capsule $ 5.75