德克萨斯大学MD安德森癌症中心药理表 药房表显示2019年5月至2019年10月服务日平均收费并易变Med Anderson提供此信息时,即用辅助基础向用户提供与医疗护理无关的潜在特性总体判断,而不警告获取信息时的认知性、完整性或使用性信息无关 北考虑金融或医疗咨询MDDERSON不保护信息 提供到此 weblite集合信息严格地算法 和驱动安卓无法保证 服务改编为教程 和他们的科5因 教程决策, 强制编译编译,辅助测试或服务 和个体需求IN ADDITION, ESTIMATES MAY CHANGE BASED ON YOUR CONTRACTED INSURANCE BENEFITS, INSURANCE POLICY EXCLUSIONS, MAXIMUM BENEFITS, PENDING FINANCIAL ASSISTANCE, OR PENDING STATE/FEDERAL PROGRAM OR OTHER AID.",,,, List ID,IP/OP,Revenue Code,Revenue Code Description,Average Charges per Date of Service 1,IP,0250,PHARMACY - GENERAL CLASSIFICATION,$118 2,,0251,PHARMACY - GENERIC DRUGS,$113 3,,0252,PHARMACY - NON-GENERIC DRUGS,$379 4,,0258,PHARMACY - IV SOLUTIONS,$89 5,,0637,PHARMACY - EXTENSION OF 025X - SELF-ADMINISTRABLE DRUGS,$342 6,OP,0250,PHARMACY - GENERAL CLASSIFICATION,$9 7,,0251,PHARMACY - GENERIC DRUGS,$15 8,,0252,PHARMACY - NON-GENERIC DRUGS,$893 9,,0258,PHARMACY - IV SOLUTIONS,$114 10,,0637,PHARMACY - EXTENSION OF 025X - SELF-ADMINISTRABLE DRUGS,$322 11,0636 & 0891,, PHARMACY - DRUGS REQUIRING DETAILED CODING & SPECIAL PROCESSED DRUGS , 12,IP/OP,HCPCS Code,HCPCS Code Description,Average Charges per Date of Service 13,IP,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,$166 14,,A9581,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,$230 15,,A9585,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,$279 16,,A9585,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,$195 17,,C9038,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,"$42,851" 18,,C9039,PLAZOMICIN 50 MG/ML INTRAVENOUS SOLUTION,"$4,114" 19,,C9041,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) HIGH-DOSE INFUSION 1760 MG IN 176 ML (10 MG/ML)(IP-CMPD)","$153,912" 20,,C9041,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) LOW-DOSE INFUSION 880 MG IN 88 ML (10 MG/ML)(IP-CMPD)","$76,956" 21,,C9044,CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION,"$29,004" 22,,C9049,TAGRAXOFUSP-ERZS INJECTION 100 MCG/ML (IP-CMPD),"$101,060" 23,,C9113,PANTOPRAZOLE 4 MG/ML INJECTION,$200 24,,C9113,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,$27 25,,C9113,PANTOPRAZOLE INFUSION 80 MG IN 100 ML NS (IP-CMPD),$190 26,,C9132,HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION,"$15,391" 27,,C9132,PROTHROMBIN COMPLEX CONCENTRATE - DOSE GREATER THAN 2500 UNITS,"$38,478" 28,,C9254,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,$440 29,,C9290,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,$973 30,,C9293,"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION","$473,160" 31,,C9399,DABRAFENIB 50 MG CAPSULE,$673 32,,C9399,DABRAFENIB 75 MG CAPSULE,"$1,027" 33,,C9399,DASATINIB 20 MG TABLET,"$1,035" 34,,C9399,DASATINIB 50 MG TABLET,"$1,501" 35,,C9399,DASATINIB 70 MG TABLET,$848 36,,C9399,DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,"$12,101" 37,,C9399,DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION,"$48,198" 38,,C9399,NILOTINIB 200 MG CAPSULE,$391 39,,C9399,POLATUZUMAB VEDOTIN-PIIQ INJECTION 20 MG/ML,"$43,763" 40,,C9399,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,"$1,908" 41,,C9399,SORAFENIB 200 MG TABLET,"$1,501" 42,,C9399,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,$299 43,,C9399,TAGRAXOFUSP-ERZS INJECTION 100 MCG/ML (IP-CMPD),"$74,649" 44,,C9399,TRAMETINIB 0.5 MG TABLET,$724 45,,C9399,TRAMETINIB 2 MG TABLET,"$1,259" 46,,C9399,VORINOSTAT 100 MG CAPSULE,"$4,000" 47,,C9488,CONIVAPTAN IVPB 20 MG/100 ML IN D5W (VARIABLE DOSE),$392 48,,J0131,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",$236 49,,J0131,ACETAMINOPHEN IVPB 10 MG/ML (IV PREP!DOSES NOT 1000 MG),$208 50,,J0131,ACETAMINOPHEN IVPB 10 MG/ML (MAX CONC) (PEDI < 20.5 KG),$80 51,,J0132,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,"$1,813" 52,,J0133,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,$249 53,,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,$48 54,,J0171,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,$67 55,,J0171,EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,$34 56,,J0171,EPINEPHRINE 1 MG/ML (1:1000) INJ CONTAINER,$54 57,,J0171,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,$364 58,,J0207,AMIFOSTINE 50 MG/ML INJ,"$6,029" 59,,J0256,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION","$7,824" 60,,J0278,AMIKACIN 25 MG/ML INJ CONTAINER,$15 61,,J0278,AMIKACIN 250 MG/ML INJ CONTAINER,$130 62,,J0282,"AMIODARONE 150 MG/100 ML (1.5 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",$97 63,,J0282,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",$203 64,,J0282,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,$91 65,,J0282,AMIODARONE INFUSION 450 MG IN 250 ML D5W (IP-CMPD),$178 66,,J0285,AMPHOTERICIN B DEOXYCHOLATE (FUNGIZONE) FOR INHALATION 10 MG/10 ML (IP-CMPD),$47 67,,J0285,AMPHOTERICIN B INJ 5 MG/ML,$483 68,,J0285,AMPHOTERICIN B INTRAVITREAL INJECTION 10 MCG/0.1 ML,$14 69,,J0285,AMPHOTERICIN B INTRAVITREAL INJECTION 5 MCG/0.1 ML,$14 70,,J0287,AMPHOTERICIN B LIPID COMPLEX (ABELCET) FOR NEBULIZATION 50 MG/10 ML (IP-CMPD),$483 71,,J0287,AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION,"$1,066" 72,,J0289,AMPHOTERICIN B LIPOSOMAL 4 MG/ML INJ,"$5,715" 73,,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,$281 74,,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$362 75,,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,$378 76,,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$374 77,,J0290,AMPICILLIN 250 MG/ML INJ CONTAINER,$307 78,,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$256 79,,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,$197 80,,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,$274 81,,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$284 82,,J0295,AMPICILLIN-SULBACTAM 375 MG/ML INJ CONTAINER,$286 83,,J0330,SUCCINYLCHOLINE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE CONTAINER,$83 84,,J0330,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,$36 85,,J0330,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE,$28 86,,J0348,ANIDULAFUNGIN 3.33 MG/ML INJ CONTAINER,$674 87,,J0360,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,$66 88,,J0456,AZITHROMYCIN 100 MG/ML INJ,$99 89,,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE,$33 90,,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE (CARD OSM),$32 91,,J0461,ATROPINE 0.4 MG/ML INJ CONTAINER,$19 92,,J0461,ATROPINE 0.4 MG/ML INJECTION SOLUTION,$20 93,,J0475,"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLUTION","$5,410" 94,,J0515,BENZTROPINE 2 MG/2 ML INJECTION SOLUTION,$133 95,,J0565,BEZLOTOXUMAB 25 MG/ML INTRAVENOUS SOLUTION,"$9,900" 96,,J0583,BIVALIRUDIN 50 MG/ML INJ,"$1,977" 97,,J0585,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,"$3,181" 98,,J0594,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,"$8,863" 99,,J0606,ETELCALCETIDE 5 MG/ML INTRAVENOUS SOLUTION,$520 100,,J0610,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,$117 101,,J0610,"CALCIUM GLUCONATE IVPB 1,000 MG IN 50 ML NS (IP-CMPD)",$153 102,,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,"$9,408" 103,,J0636,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,$30 104,,J0637,CASPOFUNGIN 5 MG/ML INJ,"$1,654" 105,,J0637,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION,"$1,064" 106,,J0637,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),"$1,062" 107,,J0637,CASPOFUNGIN 7 MG/ML INJ,"$1,184" 108,,J0637,CASPOFUNGIN 70 MG INTRAVENOUS SOLUTION,$898 109,,J0640,LEUCOVORIN CALCIUM 20 MG/ML INJECTION,$231 110,,J0670,MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,$19 111,,J0670,MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,$32 112,,J0690,CEFAZOLIN 1 G RECONSTITUTED IN 10 ML STERILE WATER (RN OSM),$7 113,,J0690,CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$175 114,,J0690,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,$87 115,,J0690,CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,$108 116,,J0690,CEFAZOLIN 330 MG/ML INJ,$222 117,,J0692,CEFEPIME 0.1 MG/ML IN NS INJ (DESENSITIZATION),$199 118,,J0692,CEFEPIME 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$167 119,,J0692,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,$115 120,,J0692,CEFEPIME 100 MG/ML INJ,$153 121,,J0692,CEFEPIME 160 MG/ML INJ,$218 122,,J0692,CEFEPIME 2 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$228 123,,J0692,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,$101 124,,J0692,CEFEPIME 40 MG/ML IN NS STOCK BAG (IP-CMPD),$44 125,,J0694,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,$167 126,,J0694,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$166 127,,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,$200 128,,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$161 129,,J0696,CEFTRIAXONE 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$94 130,,J0696,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,$65 131,,J0696,CEFTRIAXONE 100 MG/ML INJ CONTAINER,$99 132,,J0696,CEFTRIAXONE 2 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$100 133,,J0697,CEFUROXIME SODIUM 750 MG SOLUTION FOR INJECTION,$60 134,,J0712,CEFTAROLINE 30 MG/ML INJ,"$1,266" 135,,J0712,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,"$1,608" 136,,J0712,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),"$1,485" 137,,J0713,CEFTAZIDIME 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$140 138,,J0713,CEFTAZIDIME 100 MG/ML INJ,$114 139,,J0713,CEFTAZIDIME 170 MG/ML INJ,$259 140,,J0713,CEFTAZIDIME 2 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$259 141,,J0713,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,$90 142,,J0714,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,"$2,932" 143,,J0714,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),"$2,949" 144,,J0714,CEFTAZIDIME-AVIBACTAM 209 MG/ML INJ,"$1,431" 145,,J0735,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",$12 146,,J0740,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,"$1,384" 147,,J0743,IMIPENEM-CILASTATIN 50 MG/ML INJ,$742 148,,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,$430 149,,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$352 150,,J0744,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$93 151,,J0744,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$109 152,,J0744,CIPROFLOXACIN 400 MG/40 ML INTRAVENOUS SOLUTION,$27 153,,J0744,CIPROFLOXACIN IVPB IN D5W 2 MG/ML (MAX CONC),$169 154,,J0770,COLISTIMETHATE 75 MG/ML INJ,$173 155,,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,$80 156,,J0834,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,$339 157,,J0834,COSYNTROPIN 1 MCG/ML INJ (IP-CMPD),$73 158,,J0834,COSYNTROPIN 125 MCG/ML INJ (HIGH-DOSE),$339 159,,J0875,DALBAVANCIN INJ 20 MG/ML,"$14,081" 160,,J0878,DAPTOMYCIN INJ 50 MG/ML,"$1,852" 161,,J0881,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,"$4,551" 162,,J0881,DARBEPOETIN ALFA 300 MCG/0.6 ML IN POLYSORBATE INJECTION SYRINGE,"$4,534" 163,,J0881,DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,"$1,477" 164,,J0881,DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE,"$11,378" 165,,J0883,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,"$1,656" 166,,J0894,DECITABINE 5 MG/ML INJ,"$4,389" 167,,J0895,DEFEROXAMINE 95 MG/ML INJ CONTAINER,$347 168,,J0897,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,"$6,644" 169,,J0897,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,"$2,688" 170,,J1050,MEDROXYPROGESTERONE 150 MG/ML INJ CONTAINER,$510 171,,J1071,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,$49 172,,J1100,DEXAMETHASONE 4 MG/ML INJECTION SOLUTION,$33 173,,J1100,DEXAMETHASONE IVPB 20 MG IN 50 ML NS (IP-CMPD),$96 174,,J1100,DEXAMETHASONE IVPB 4 MG/ML (MAX CONC) (PEDI < 20.5 KG),$7 175,,J1100,DEXAMETHASONE SOD PHOS (BULK) 100 % POWDER,$11 176,,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,$28 177,,J1120,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,$155 178,,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,$31 179,,J1165,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,$31 180,,J1170,HYDROMORPHONE (PF) 1 MG/5 ML (0.2 MG/ML) IN 0.9 % NACL IV SYRINGE,$46 181,,J1170,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,$44 182,,J1170,HYDROMORPHONE 0.5 MG/0.5 ML INJ CONTAINER,$39 183,,J1170,HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE,$27 184,,J1170,HYDROMORPHONE 1 MG IN 25 ML NS (IP-CMPD),$74 185,,J1170,HYDROMORPHONE 1 MG/ML IN 0.9 % SODIUM CHLORIDE PCA SYRINGE CONTAINER,$132 186,,J1170,HYDROMORPHONE 1 MG/ML IN NS PCA SYRINGE (PREMIX) (PALLIATIVE),$153 187,,J1170,HYDROMORPHONE 1 MG/ML IN NS PCA SYRINGE (PREMIX) (PEDI),$137 188,,J1170,HYDROMORPHONE 1 MG/ML INFUSION SYRINGE (PREMIX),$137 189,,J1170,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,$61 190,,J1170,HYDROMORPHONE 50 MG/50 ML IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,$130 191,,J1170,HYDROMORPHONE PF 1 MG/5 ML SYRINGE (ANES OSM),$19 192,,J1190,DEXRAZOXANE (MYLAN) 10 MG/ML INJ CONTAINER,"$1,764" 193,,J1190,DEXRAZOXANE (PFIZER/HIKMA/ALVOGEN) 10 MG/ML INJ CONTANER,"$3,125" 194,,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,$16 195,,J1205,CHLOROTHIAZIDE SODIUM 28 MG/ML INJ,"$1,141" 196,,J1230,METHADONE 10 MG/ML INJECTION SOLUTION,$189 197,,J1250,"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",$122 198,,J1265,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",$81 199,,J1265,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN (MELANOMA)",$77 200,,J1300,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,"$62,296" 201,,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,$430 202,,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$419 203,,J1335,ERTAPENEM 100 MG/ML INJ,$317 204,,J1410,CONJUGATED ESTROGENS INJECTION 5 MG/ML,$944 205,,J1450,FLUCONAZOLE 200 MG/100 ML IN SOD.千兆瓦卡,73 206,J1450,FLUCONAZOLE 400MG/200MLCIGYBACK,77207J1450FLUCONAZOLEIVPB2MG/MLNSDS < 200MGs)67 209J1450FLUCONAZOLEIVPB400MG/200MLDOSs > 200MG)83210J1450FLUCONAZOLEIVPB400MG/200MLDOSs > 400MG)97211J1450FLUCONAZOLEIVPB400MG/200MLDOSES 201-399 MG),$78 212,,J1453,FOSAPREPITANT 30 MG/ML INJ,"$1,098" 213,,J1455,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,"$2,081" 214,,J1459,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION","$17,051" 215,,J1459,IMMUNE GLOBULIN (HUMAN (IGG) 10% (INJ FOR PO USE),"$2,408" 216,,J1561,IMMUNE GLOB G (GAMUNEX-C) (10%)-GLY-IGA AVE 46 MCG/ML INJ CONTAINER,"$12,574" 217,,J1570,GANCICLOVIR INJ 50 MG/ML,$460 218,,J1580,GENTAMICIN 40 MG/ML INJECTION SOLUTION,$41 219,,J1610,GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML SOLUTION FOR INJECTION,$585 220,,J1626,GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,$133 221,,J1626,GRANISETRON HCL 1 MG/ML INJ CONTAINER,$76 222,,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,$15 223,,J1644,"HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV",$70 224,,J1644,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IRRIGATION (IR OSM)",$65 225,,J1644,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",$24 226,,J1644,"HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION",$80 227,,J1644,"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",$71 228,,J1644,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",$24 229,,J1644,"HEPARIN 1,000 UNIT/ML INJ (EXTRACORPOREAL USE)",$8 230,,J1644,"HEPARIN INFUSION 10,000 UNITS IN 500 ML NS (APHERESIS USE ONLY) (IP-CMPD)",$101 231,,J1644,"HEPARIN INFUSION 2,500 UNITS IN 250 ML NS (IP-CMPD)",$80 232,,J1644,"HEPARIN INFUSION 5,000 UNITS IN 1,000 ML NS (IR USE ONLY) (IP-CMPD)",$89 233,,J1644,"HEPARIN TITRATABLE 25,000 UNIT/500 ML IN 0.45% NACL (PREMIX)",$73 234,,J1644,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION",$98 235,,J1645,"DALTEPARIN (PORCINE) 10,000 ANTI-XA UNIT/ML SUBCUTANEOUS SYRINGE",$203 236,,J1645,"DALTEPARIN (PORCINE) 12,500 ANTI-XA UNIT/0.5 ML SUBCUTANEOUS SYRINGE",$302 237,,J1645,"DALTEPARIN (PORCINE) 15,000 ANTI-XA UNIT/0.6 ML SUBCUTANEOUS SYRINGE",$362 238,,J1645,"DALTEPARIN (PORCINE) 18,000 ANTI-XA UNIT/0.72 ML SUBCUTANEOUS SYRINGE",$434 239,,J1645,"DALTEPARIN (PORCINE) 5,000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE",$127 240,,J1645,"DALTEPARIN (PORCINE) 7,500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRINGE",$190 241,,J1650,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,$361 242,,J1650,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,$382 243,,J1650,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,$450 244,,J1650,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,$82 245,,J1650,ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,$255 246,,J1650,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,$106 247,,J1650,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,$216 248,,J1650,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,$309 249,,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,$77 250,,J1652,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,$180 251,,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,$180 252,,J1720,HYDROCORTISONE (PF) 50 MG/ML INJ,$19 253,,J1720,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,$68 254,,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,$22 255,,J1742,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,"$1,705" 256,,J1745,INFLIXIMAB 10 MG/ML INJ,"$15,848" 257,,J1756,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,$271 258,,J1756,IRON SUCROSE 20 MG/ML INJ CONTAINER,$556 259,,J1815,INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,$151 260,,J1815,INSULIN REGULAR INFUSION 100 UNITS IN 100 ML NS (IP-CMPD),$136 261,,J1833,ISAVUCONAZONIUM SULFATE 74.4 MG/ML INTRAVEOUS SOLUTION,"$1,228" 262,,J1885,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,$22 263,,J1930,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,"$23,423" 264,,J1940,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,$44 265,,J1950,LEUPROLIDE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,"$6,694" 266,,J1950,LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,"$14,621" 267,,J1950,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,"$2,231" 268,,J1953,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,$223 269,,J1955,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,$654 270,,J1956,LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,$135 271,,J1956,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$73 272,,J1956,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$69 273,,J1956,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$70 274,,J2001,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,$18 275,,J2001,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,$63 276,,J2020,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,$215 277,,J2020,LINEZOLID IVPB 2 MG/ML (MAX CONC),$169 278,,J2060,LORAZEPAM 2 MG/ML INJ CONTAINER,$14 279,,J2060,LORAZEPAM 2 MG/ML INJECTION SYRINGE,$14 280,,J2060,LORAZEPAM IV PUSH INJECTION 2 MG/ML,$13 281,,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,$18 282,,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,$12 283,,J2175,MEPERIDINE IV PUSH INJECTION 25 MG/ML,$18 284,,J2175,MEPERIDINE IV PUSH INJECTION 50 MG/ML,$12 285,,J2182,MEPOLIZUMAB SUBCUTANEOUS INJECTION 100 MG/ML,"$28,188" 286,,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,$313 287,,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$302 288,,J2185,MEROPENEM 50 MG/ML INJ CONTAINER,$455 289,,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION,$146 290,,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$136 291,,J2186,MEROPENEM-VABORBACTAM 0.1 G/ML INTRAVENOUS SOLUTION,"$1,648" 292,,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,$152 293,,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,$316 294,,J2250,MIDAZOLAM (PF) 2 MG/2 ML (1 MG/ML) INJECTION SYRINGE,$13 295,,J2250,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,$8 296,,J2250,MIDAZOLAM 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,$126 297,,J2250,MIDAZOLAM 1 MG/ML INJ CONTAINER,$9 298,,J2250,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,$9 299,,J2250,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,$8 300,,J2250,MIDAZOLAM INFUSION 5 MG/ML,$53 301,,J2260,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,$223 302,,J2260,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,$222 303,,J2265,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,$919 304,,J2265,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$949 305,,J2265,MINOCYCLINE 20 MG/ML INJECTION,$846 306,,J2270,MORPHINE (BULK) 100 % POWDER,$8 307,,J2270,MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION,$47 308,,J2270,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,$27 309,,J2270,MORPHINE 10 MG/ML INJECTION SOLUTION,$8 310,,J2270,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,$147 311,,J2270,MORPHINE 2 MG/ML INJ CONTAINER,$35 312,,J2270,MORPHINE 2 MG/ML INJECTION SYRINGE,$8 313,,J2270,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,$46 314,,J2270,MORPHINE 50 MG/50 ML PCA SYRINGE (PREMIX) (PALLIATIVE),$49 315,,J2270,MORPHINE 50 MG/50 ML PCA SYRINGE (PREMIX) (PEDI),$45 316,,J2278,ZICONOTIDE 100 MCG/ML INTRATHECAL SOLUTION,$127 317,,J2280,MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,$112 318,,J2300,NALBUPHINE 10 MG/ML INJECTION SOLUTION,$12 319,,J2310,NALOXONE 0.4 MG/ML INJECTION SOLUTION,$74 320,,J2353,"OCTREOTIDE,MICROSPHERES ER 10 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE","$9,570" 321,,J2353,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE","$12,538" 322,,J2353,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE","$18,775" 323,,J2354,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,$109 324,,J2354,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,$37 325,,J2354,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,$412 326,,J2370,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,$29 327,,J2370,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,$352 328,,J2370,PHENYLEPHRINE 100 MCG/ML INJ CONTAINER,$22 329,,J2370,PHENYLEPHRINE 100 MG/250 ML (400 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,$109 330,,J2400,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,$61 331,,J2405,ONDANSETRON 2 MG/ML INJ CONTAINER,$9 332,,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,$10 333,,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SYRINGE,$7 334,,J2405,ONDANSETRON INFUSION 24 MG IN 250 ML NS (IP-CMPD),$80 335,,J2405,ONDANSETRON IVPB 16 MG IN 50 ML NS (IP-CMPD),$76 336,,J2425,PALIFERMIN INJ 5 MG/ML,"$6,272" 337,,J2430,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,$207 338,,J2440,PAPAVERINE 30 MG/ML INJECTION SOLUTION,$193 339,,J2469,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,$775 340,,J2505,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,"$18,319" 341,,J2505,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,"$18,319" 342,,J2540,"PENICILLIN G POTASSIUM 1,000,000 UNITS/ML INJECTION",$573 343,,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,$260 344,,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$274 345,,J2543,PIPERACILLIN-TAZOBACTAM 225 MG/ML INJ CONTAINER,$354 346,,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,$328 347,,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$330 348,,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,$352 349,,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$344 350,,J2550,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,$7 351,,J2550,PROMETHAZINE IVPB 12.5 MG IN 25 ML NS (IP-CMPD),$100 352,,J2550,PROMETHAZINE IVPB 25 MG IN 25 ML NS (IP-CMPD),$96 353,,J2550,PROMETHAZINE IVPB 25 MG/ML (MAX CONC) (PEDI < 20.5 KG),$16 354,,J2550,PROMETHAZINE IVPB 6.25 MG IN 25 ML NS (IP-CMPD),$90 355,,J2560,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,$367 356,,J2560,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,$300 357,,J2562,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,"$21,200" 358,,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,$211 359,,J2700,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,$272 360,,J2704,PROPOFOL 10 MG/ML INFUSION,$220 361,,J2704,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,$51 362,,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,$184 363,,J2720,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,$72 364,,J2765,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,$37 365,,J2783,RASBURICASE 1.5 MG/ML INJ,"$5,799" 366,,J2785,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,$714 367,,J2795,ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,$154 368,,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,$495 369,,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,$82 370,,J2796,ROMIPLOSTIM SUBCUTANEOUS 500 MCG/ML INJ CONTAINER,"$10,927" 371,,J2800,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,$219 372,,J2820,SARGRAMOSTIM 250 MCG/ML INJECTION,"$1,161" 373,,J2860,SILTUXIMAB 20 MG/ML INJ CONTAINER,"$31,701" 374,,J2916,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,$278 375,,J2920,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,$44 376,,J2930,METHYLPREDNISOLONE 62.5 MG/ML INJ CONTAINER,$190 377,,J2930,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,$47 378,,J2930,METHYLPREDNISOLONE SOD SUCC (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,$241 379,,J2930,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",$205 380,,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,$200 381,,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$199 382,,J2997,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,$708 383,,J2997,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,"$2,799" 384,,J2997,ALTEPLASE IVPB 1 MG/ML,"$20,611" 385,,J3000,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,$187 386,,J3010,"FENTANYL (PF) 2,750 MCG/55 ML (50 MCG/ML) INTRAVENOUS PCA SYRINGE (PREMIX)",$213 387,,J3010,"FENTANYL (PF) 2,750 MCG/55 ML (50 MCG/ML) PCA SYRINGE (PREMIX) (PALLIATIVE)",$214 388,,J3010,"FENTANYL (PF) 2,750 MCG/55 ML (50 MCG/ML) PCA SYRINGE (PREMIX) (PEDI)",$261 389,,J3010,"FENTANYL (PF) 2,750 MCG/55 ML INFUSION (PEDI)",$323 390,,J3010,FENTANYL (PF) 50 MCG/ML INJ CONTAINER,$9 391,,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,$12 392,,J3010,"FENTANYL INFUSION 2,000 MCG IN 100 ML NS (IP-CMPD)",$165 393,,J3010,FENTANYL IV PUSH INJECTION 50 MCG/ML,$17 394,,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,$236 395,,J3095,TELAVANCIN 15 MG/ML INJ CONTAINER,"$1,646" 396,,J3110,TERIPARATIDE 20 MCG/DOSE (600 MCG/2.4 ML) SUBCUTANEOUS PEN INJECTOR,"$10,074" 397,,J3230,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,$407 398,,J3230,CHLORPROMAZINE IVPB 25 MG IN 25 ML NS (IP-CMPD),$369 399,,J3240,THYROTROPIN ALFA 1.1 MG INTRAMUSCULAR SOLUTION,"$5,169" 400,,J3243,TIGECYCLINE 10 MG/ML INJ,$899 401,,J3243,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,$885 402,,J3243,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$947 403,,J3260,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,$131 404,,J3262,TOCILIZUMAB 20 MG/ML INJ CONTAINER,"$11,501" 405,,J3300,TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,$547 406,,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,$8 407,,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,$48 408,,J3370,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",$198 409,,J3370,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION (MBP INGREDIENT)",$189 410,,J3370,VANCOMYCIN 10 MG/ML IN NS 500 ML STOCK BAG (IP-CMPD),$226 411,,J3370,VANCOMYCIN 50 MG/ML INJ CONTAINER,$222 412,,J3370,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,$153 413,,J3370,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$148 414,,J3370,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,$155 415,,J3370,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$162 416,,J3370,VANCOMYCIN INTRAVITREAL INJECTION 1 MG/0.1 ML,$14 417,,J3370,"VANCOMYCIN IVPB 1,250 MG IN 250 ML NS (IP-CMPD)",$134 418,,J3370,"VANCOMYCIN IVPB 1,500 MG IN 250 ML NS (IP-CMPD)",$145 419,,J3380,VEDOLIZUMAB 60 MG/ML INTRAVENOUS SOLUTION,"$20,230" 420,,J3415,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,$345 421,,J3420,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",$30 422,,J3465,VORICONAZOLE 10 MG/ML INJ,$672 423,,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,$76 424,,J3475,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,$64 425,,J3475,MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION,$19 426,,J3480,POTASSIUM CHLORIDE 20 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,$103 427,,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,$91 428,,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,$96 429,,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,$93 430,,J3480,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,$82 431,,J3480,POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,$94 432,,J3480,POTASSIUM CHLORIDE IVPB 20 MEQ IN 400 ML NS (IP-CMPD),$90 433,,J3486,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,$194 434,,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,$214 435,,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION (MBP INGREDIENT),$202 436,,J3489,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,$425 437,,J3490,ALLOPURINOL 500 MG/25 ML INJ,"$16,534" 438,,J3490,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,$210 439,,J3490,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,$385 440,,J3490,AZTREONAM 1 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$463 441,,J3490,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,$725 442,,J3490,AZTREONAM 2 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$711 443,,J3490,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,$58 444,,J3490,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,$20 445,,J3490,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION (MAX DOSE 150 MG) CONTAINER,$16 446,,J3490,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,$40 447,,J3490,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,$20 448,,J3490,BUPIVACAINE 0.5 % (5 MG/ML) INJECTION SOLUTION,$18 449,,J3490,CALCIUM CHLORIDE IVPB 1.36 MEQ/ML (PEDI),$27 450,,J3490,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,$155 451,,J3490,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$148 452,,J3490,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$142 453,,J3490,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,$164 454,,J3490,ERAVACYCLINE 10 MG/ML INJECTION,$421 455,,J3490,ESMOLOL 10 MG/ML INJ CONTAINER,$25 456,,J3490,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,$28 457,,J3490,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",$967 458,,J3490,FAMOTIDINE 10 MG/ML INJ CONTAINER,$9 459,,J3490,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,$30 460,,J3490,FOLIC ACID 5 MG/ML INJECTION SOLUTION,$58 461,,J3490,GLYCOPYRROLATE 0.2 MG/ML INJ CONTAINER,$75 462,,J3490,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,$55 463,,J3490,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,$19 464,,J3490,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,$9 465,,J3490,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,$16 466,,J3490,METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,$151 467,,J3490,METRONIDAZOLE IVPB 5 MG/ML,$176 468,,J3490,METRONIDAZOLE IVPB 5 MG/ML (MAX CONC) (PEDI < 20.5 KG),$169 469,,J3490,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,$383 470,,J3490,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,$127 471,,J3490,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE BOLUS (IR OSM),$75 472,,J3490,RIFAMPIN 60 MG/ML INJ,$589 473,,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,$95 474,,J7030,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION,$70 475,,J7030,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION (FOR TTM USE ONLY),$70 476,,J7040,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,$74 477,,J7040,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION,$66 478,,J7042,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,$100 479,,J7050,BLINATUMOMAB IV STABILIZER IN 270 ML SODIUM CHLORIDE 0.9% NS (NON-PVC) (IP-CMPD),$66 480,,J7050,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION (PULM OSM),$13 481,,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,$71 482,,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,$82 483,,J7050,SODIUM CHLORIDE 0.9% (NON-PVC) (BLINATUMOMAB) IV SOLN,$66 484,,J7050,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION,$113 485,,J7050,SODIUM CHLORIDE 0.9% INJ FOR TOPICAL USE,$77 486,,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,$79 487,,J7060,DEXTROSE 5 % IV BOLUS,$77 488,,J7060,DEXTROSE 5% (NON-PVC) INTRAVENOUS SOLUTION,$66 489,,J7060,DEXTROSE 5% IV FLUSH,$80 490,,J7060,DEXTROSE 5% IV FLUSH (2017-0855),$132 491,,J7070,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,$98 492,,J7070,DEXTROSE 5 % IV BOLUS,$70 493,,J7070,DEXTROSE 5% IV FLUSH,$87 494,,J7120,LACTATED RINGERS FLUSH,$70 495,,J7120,LACTATED RINGERS INTRAVENOUS SOLUTION,$98 496,,J7120,LACTATED RINGERS IV BOLUS,$80 497,,J7120,LACTATED RINGERS IV REPLENISHMENT,$144 498,,J7121,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,$93 499,,J7131,SODIUM CHLORIDE 3 % INTRAVENOUS INJECTION SOLUTION,$93 500,,J7131,SODIUM CHLORIDE 3% IV BOLUS,$93 501,,J7131,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,$27 502,,J7187,ANTIHEMOPHILIC FACTOR VIII/VWF (HUMATE-P) INJ CONTAINER,"$2,534" 503,,J7189,COAGULATION FACTOR VIIA 1 MG/ML INJ CONTAINER,"$21,666" 504,,J7325,HYLAN G-F 20 48 MG/6 ML INTRA-ARTICULAR SYRINGE,"$3,820" 505,,J7500,AZATHIOPRINE 50 MG TABLET,$4 506,,J7502,CYCLOSPORINE 100 MG CAPSULE,$141 507,,J7502,CYCLOSPORINE 100 MG/ML ORAL SOLUTION,$53 508,,J7502,CYCLOSPORINE MODIFIED 100 MG CAPSULE (NEORAL),$76 509,,J7504,LYMPHOCYTE IMMUNE GLOBULIN SKIN TEST 1:1000,$133 510,,J7504,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION","$81,263" 511,,J7507,TACROLIMUS 0.5 MG CAPSULE,$10 512,,J7507,TACROLIMUS 1 MG CAPSULE,$15 513,,J7507,TACROLIMUS 5 MG CAPSULE,$85 514,,J7507,TACROLIMUS ORAL SUSPENSION 1 MG/ML (IP-CMPD),$56 515,,J7509,METHYLPREDNISOLONE 16 MG TABLET,$20 516,,J7509,METHYLPREDNISOLONE 4 MG TABLET,$9 517,,J7510,PREDNISOLONE 5 MG TABLET,$218 518,,J7511,ANTI-THYMOCYTE GLOBULIN (RABBIT) 5 MG/ML INJECTION,"$11,502" 519,,J7512,PREDNISONE 1 MG TABLET,$5 520,,J7512,PREDNISONE 10 MG TABLET,$2 521,,J7512,PREDNISONE 2.5 MG TABLET,$2 522,,J7512,PREDNISONE 20 MG TABLET,$2 523,,J7512,PREDNISONE 5 MG TABLET,$2 524,,J7512,PREDNISONE 5 MG/5 ML ORAL SOLUTION,$54 525,,J7512,PREDNISONE 50 MG TABLET,$3 526,,J7515,CYCLOSPORINE 25 MG CAPSULE,$61 527,,J7515,CYCLOSPORINE MODIFIED 25 MG CAPSULE (NEORAL),$19 528,,J7516,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,$139 529,,J7517,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL SUSPENSION,$231 530,,J7517,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,$28 531,,J7520,SIROLIMUS 0.5 MG TABLET,$33 532,,J7520,SIROLIMUS 1 MG TABLET,$68 533,,J7520,SIROLIMUS 1 MG/ML ORAL SOLUTION,$62 534,,J7525,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,$204 535,,J7525,TACROLIMUS INFUSION 1 MG IN 250 ML NS (IP-CMPD),$193 536,,J7525,TACROLIMUS INJ 1 MG/ML,$254 537,,J8501,APREPITANT 125 MG (25 MG/ML FINAL CONCENTRATION) ORAL SUSPENSION,$540 538,,J8501,APREPITANT 125 MG CAPSULE,$825 539,,J8501,APREPITANT 40 MG CAPSULE,$281 540,,J8501,APREPITANT 80 MG CAPSULE,$522 541,,J8515,CABERGOLINE 0.5 MG TABLET,$39 542,,J8521,CAPECITABINE 500 MG TABLET,$82 543,,J8530,CYCLOPHOSPHAMIDE 25 MG CAPSULE,$37 544,,J8530,CYCLOPHOSPHAMIDE 50 MG CAPSULE,$80 545,,J8540,DEXAMETHASONE 0.5 MG TABLET,$2 546,,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,$11 547,,J8540,DEXAMETHASONE 0.75 MG TABLET,$2 548,,J8540,DEXAMETHASONE 1 MG TABLET,$2 549,,J8540,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),$26 550,,J8540,DEXAMETHASONE 2 MG TABLET,$4 551,,J8540,DEXAMETHASONE 4 MG TABLET,$14 552,,J8560,ETOPOSIDE 50 MG CAPSULE,$250 553,,J8610,METHOTREXATE SODIUM 2.5 MG TABLET,$74 554,,J8700,TEMOZOLOMIDE 100 MG CAPSULE,$389 555,,J8700,TEMOZOLOMIDE 140 MG CAPSULE,$557 556,,J8700,TEMOZOLOMIDE 180 MG CAPSULE,$518 557,,J8700,TEMOZOLOMIDE 20 MG CAPSULE,$109 558,,J8700,TEMOZOLOMIDE 5 MG CAPSULE,$44 559,,J8999,BINIMETINIB 15 MG TABLET,"$1,045" 560,,J8999,ENCORAFENIB 75 MG CAPSULE,"$1,219" 561,,J8999,LOMUSTINE 40 MG CAPSULE,"$1,929" 562,,J8999,MERCAPTOPURINE 25 MG HALF TABLET,$12 563,,J8999,MITOTANE 500 MG TABLET,$123 564,,J9000,DOXORUBICIN 2 MG/ML INJ CONTAINER,$147 565,,J9015,ALDESLEUKIN INJ 18 MILLION UNITS/ML,"$65,637" 566,,J9015,ALDESLEUKIN INTRATHECAL INJ 4.58 MILLION UNITS/ML,$638 567,,J9015,ALDESLEUKIN SUBCUTANEOUS INJ 3.6 MILLION UNITS/ML,$191 568,,J9017,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,"$2,601" 569,,J9019,"ASPARAGINASE ERWINIA INJ 10,000 UNITS/ML","$38,189" 570,,J9022,ATEZOLIZUMAB 60 MG/ML INJECTION CONTAINER,"$27,713" 571,,J9023,AVELUMAB 20 MG/ML INTRAVENOUS SOLUTION,"$19,197" 572,,J9025,AZACITIDINE INJECTION 10 MG/ML,"$1,695" 573,,J9025,AZACITIDINE SUBCUTANEOUS SOLUTION 25 MG/ML,"$1,565" 574,,J9027,CLOFARABINE 20 MG/20 ML INTRAVENOUS SOLUTION,"$20,394" 575,,J9034,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,"$15,114" 576,,J9035,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,"$18,213" 577,,J9039,BLINATUMOMAB 12.5 MCG/ML CONTAINER,"$19,029" 578,,J9040,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,$336 579,,J9040,BLEOMYCIN 3 UNITS/ML INJ CONTAINER,$404 580,,J9040,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,$337 581,,J9041,BORTEZOMIB SUBCUTANEOUS INJ 2.5 MG/ML,"$3,685" 582,,J9042,BRENTUXIMAB VEDOTIN INJ 5 MG/ML,"$64,936" 583,,J9043,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,"$14,514" 584,,J9045,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,$299 585,,J9045,CARBOPLATIN IVPB 4 MG/ML IN 250 ML (DESENSITIZATION STOCK SOLN),$157 586,,J9047,CARFILZOMIB 2 MG/ML INJ CONTAINER,"$6,415" 587,,J9050,CARMUSTINE 3.3 MG/ML INJ,"$73,521" 588,,J9055,CETUXIMAB 2 MG/ML INJ CONTAINER,"$10,233" 589,,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,$140 590,,J9065,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,"$1,416" 591,,J9070,CYCLOPHOSPHAMIDE 20 MG/ML INJ CONTAINER,"$3,265" 592,,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,$164 593,,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IV INJECTION SOLUTION,$13 594,,J9120,DACTINOMYCIN 500 MCG/ML INJ,"$10,231" 595,,J9130,DACARBAZINE 10 MG/ML INJ CONTAINER,$304 596,,J9145,DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,"$20,598" 597,,J9150,DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,$841 598,,J9153,DAUNORUBICIN-CYTARABINE LIPOSOMAL INJECTION 2.2 MG-5 MG/ML,"$49,382" 599,,J9155,DEGARELIX 20 MG/ML SQ INJ,"$1,431" 600,,J9155,DEGARELIX 40 MG/ML SQ INJ,"$4,847" 601,,J9171,DOCETAXEL 20 MG/ML INJ CONTAINER,"$2,609" 602,,J9173,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,"$15,339" 603,,J9176,ELOTUZUMAB 25 MG/ML INJ CONTAINER,"$12,286" 604,,J9179,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,"$8,154" 605,,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,$125 606,,J9181,ETOPOSIDE PHOSPHATE INJ 20 MG/ML (MAX CONC),$322 607,,J9185,FLUDARABINE 25 MG/ML INJ,$488 608,,J9190,FLUOROURACIL 50 MG/ML INJ CONTAINER,$121 609,,J9201,GEMCITABINE 38 MG/ML INJ CONTAINER,$377 610,,J9202,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,"$1,090" 611,,J9203,GEMTUZUMAB OZOGAMICIN INJECTION 1 MG/ML,"$31,682" 612,,J9204,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,"$41,445" 613,,J9206,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,$198 614,,J9208,IFOSFAMIDE 50 MG/ML INJ CONTAINER,$535 615,,J9209,MESNA 100 MG/ML INTRAVENOUS SOLUTION,$252 616,,J9211,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,"$1,012" 617,,J9217,LEUPROLIDE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,"$15,955" 618,,J9217,LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,"$7,977" 619,,J9217,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,"$10,636" 620,,J9217,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,"$2,659" 621,,J9228,IPILIMUMAB 5 MG/ML INJ CONTAINER,"$62,554" 622,,J9229,INOTUZUMAB OZOGAMICIN INJECTION 0.25 MG/ML,"$46,826" 623,,J9245,MELPHALAN INJ 5 MG/ML,"$18,133" 624,,J9250,METHOTREXATE 25 MG/ML INJECTION,$10 625,,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,$7 626,,J9260,METHOTREXATE SODIUM 25 MG/ML INJ CONTAINER,$405 627,,J9261,NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,"$13,294" 628,,J9263,OXALIPLATIN 5 MG/ML INJ CONTAINER,$919 629,,J9264,PACLITAXEL-PROTEIN BOUND IVPB 5 MG/ML,"$12,923" 630,,J9266,PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,"$34,086" 631,,J9267,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",$379 632,,J9268,PENTOSTATIN IVPB 2 MG/ML (MAX CONC),"$3,634" 633,,J9269,TAGRAXOFUSP-ERZS INJECTION 100 MCG/ML (IP-CMPD),"$71,906" 634,,J9271,PEMBROLIZUMAB 25 MG/ML INJ CONTAINER,"$30,091" 635,,J9280,MITOMYCIN 0.5 MG/ML INJ CONTAINER,"$3,975" 636,,J9280,MITOMYCIN 2 MG/ML INTRAVESICULAR CONTAINER,"$4,019" 637,,J9280,MITOMYCIN HIPEC 0.5 MG/ML INJ CONTAINER,"$5,539" 638,,J9293,"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",$544 639,,J9299,NIVOLUMAB 10 MG/ML INJ CONTAINER,"$20,123" 640,,J9301,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION","$14,668" 641,,J9302,OFATUMUMAB 20 MG/ML INJ CONTAINER,"$27,250" 642,,J9303,PANITUMUMAB 20 MG/ML INJ CONTAINER,"$14,846" 643,,J9305,PEMETREXED 25 MG/ML INJ CONTAINER,"$19,474" 644,,J9306,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,"$24,375" 645,,J9308,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,"$26,034" 646,,J9312,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS","$21,633" 647,,J9325,TALIMOGENE LAHERPAREPVEC 10EXP8 (100 MILLION)PFU/ML SUSP FOR INJECTION,"$47,107" 648,,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,"$5,207" 649,,J9340,THIOTEPA 10 MG/ML INJ (TEPADINA US),"$54,626" 650,,J9340,THIOTEPA 10.4 MG/ML INJ (USA),"$1,909" 651,,J9351,TOPOTECAN 1 MG/ML INJECTION,$291 652,,J9352,TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,"$23,733" 653,,J9355,TRASTUZUMAB 21 MG/ML INJ CONTAINER,"$15,951" 654,,J9360,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,$163 655,,J9370,VINCRISTINE 1 MG/ML INJ CONTAINER,$81 656,,J9370,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,$92 657,,J9371,VINCRISTINE SULFATE LIPOSOMAL 5 MG/31 ML(0.16 MG/ML)(FINAL CONC)IV KIT,"$46,198" 658,,J9390,VINORELBINE 10 MG/ML INJ CONTAINER,$268 659,,J9395,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,"$5,473" 660,,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,$504 661,,Q2009,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,$733 662,,Q2041,AXICABTAGENE CILOLEUCEL INTRAVENOUS SUSPENSION,"$410,300" 663,,Q2042,TISAGENLECLEUCEL 0.2 X10EXP6 TO 2.5X10EXP8 CELL INTRAVENOUS SUSPENSION,"$522,500" 664,,Q2042,TISAGENLECLEUCEL 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,"$410,300" 665,,Q2050,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION","$13,008" 666,,Q9961,IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,$34 667,,Q9966,IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,$48 668,,Q9967,IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,$103 669,,Q9967,IOHEXOL 300 MG IODINE/ML INTRATHECAL SOLUTION,$10 670,,Q9967,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,$51 671,,Q9967,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,$127 672,OP,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,$162 673,,A9581,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,$265 674,,A9585,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,$276 675,,A9585,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,$194 676,,C9038,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,"$47,751" 677,,C9044,CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION,"$29,004" 678,,C9052,RAVULIZUMAB-CWVZ 300 MG/30 ML (10 MG/ML) INTRAVENOUS SOLUTION,"$224,082" 679,,C9113,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,$24 680,,C9113,PANTOPRAZOLE INFUSION 80 MG IN 100 ML NS (IP-CMPD),$141 681,,C9254,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,$290 682,,C9257,BEVACIZUMAB INTRAVITREAL INJECTION 2.5 MG/0.1 ML,$134 683,,C9290,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,$933 684,,C9399,ABIRATERONE 250 MG TABLET,"$10,502" 685,,C9399,ABIRATERONE 500 MG TABLET,"$22,732" 686,,C9399,DABRAFENIB 50 MG CAPSULE,"$21,118" 687,,C9399,DABRAFENIB 75 MG CAPSULE,"$27,215" 688,,C9399,DASATINIB 20 MG TABLET,"$8,809" 689,,C9399,DASATINIB 50 MG TABLET,"$19,820" 690,,C9399,DASATINIB 70 MG TABLET,"$7,239" 691,,C9399,IBRUTINIB 140 MG CAPSULE,"$36,011" 692,,C9399,PALBOCICLIB 100 MG CAPSULE,"$20,630" 693,,C9399,PALBOCICLIB 125 MG CAPSULE,"$34,384" 694,,C9399,PAZOPANIB 200 MG TABLET,"$36,411" 695,,C9399,POLATUZUMAB VEDOTIN-PIIQ INJECTION 20 MG/ML,"$47,357" 696,,C9399,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,"$5,804" 697,,C9399,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,$293 698,,C9399,TRAMETINIB 2 MG TABLET,"$25,327" 699,,C9399,VEMURAFENIB 240 MG TABLET,"$26,433" 700,,J0131,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",$111 701,,J0131,ACETAMINOPHEN IVPB 10 MG/ML (IV PREP!DOSES NOT 1000 MG),$97 702,,J0131,ACETAMINOPHEN IVPB 10 MG/ML (MAX CONC) (PEDI < 20.5 KG),$45 703,,J0133,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,$293 704,,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,$32 705,,J0171,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,$43 706,,J0171,EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,$42 707,,J0171,EPINEPHRINE 1 MG/ML (1:1000) INJ CONTAINER,$67 708,,J0256,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION","$4,151" 709,,J0278,AMIKACIN 250 MG/ML INJ CONTAINER,$162 710,,J0282,"AMIODARONE 150 MG/100 ML (1.5 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",$97 711,,J0282,AMIODARONE INFUSION 450 MG IN 250 ML D5W (IP-CMPD),$158 712,,J0285,AMPHOTERICIN B INTRAVITREAL INJECTION 10 MCG/0.1 ML,$7 713,,J0287,AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION,"$1,031" 714,,J0289,AMPHOTERICIN B LIPOSOMAL 4 MG/ML INJ,"$5,234" 715,,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,$96 716,,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,$113 717,,J0290,AMPICILLIN 250 MG/ML INJ CONTAINER,$118 718,,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$154 719,,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,$98 720,,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,$130 721,,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$140 722,,J0295,AMPICILLIN-SULBACTAM 375 MG/ML INJ CONTAINER,$120 723,,J0330,SUCCINYLCHOLINE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE CONTAINER,$80 724,,J0348,ANIDULAFUNGIN 3.33 MG/ML INJ CONTAINER,$495 725,,J0360,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,$50 726,,J0456,AZITHROMYCIN 100 MG/ML INJ,$100 727,,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE,$31 728,,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE (CARD OSM),$34 729,,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE (IR OSM),$31 730,,J0461,ATROPINE 0.4 MG/ML INJ CONTAINER,$19 731,,J0461,ATROPINE 0.4 MG/ML INJECTION SOLUTION,$38 732,,J0475,"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLUTION","$1,826" 733,,J0565,BEZLOTOXUMAB 25 MG/ML INTRAVENOUS SOLUTION,"$8,449" 734,,J0585,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,"$2,868" 735,,J0594,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,"$6,656" 736,,J0610,CALCIUM GLUCONATE 1 GRAM/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,$111 737,,J0610,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,$112 738,,J0610,"CALCIUM GLUCONATE IVPB 1,000 MG IN 50 ML NS (IP-CMPD)",$142 739,,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,"$6,231" 740,,J0637,CASPOFUNGIN 5 MG/ML INJ,"$2,749" 741,,J0637,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION,"$1,059" 742,,J0637,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),"$1,059" 743,,J0637,CASPOFUNGIN 7 MG/ML INJ,"$1,182" 744,,J0640,LEUCOVORIN CALCIUM 20 MG/ML INJECTION,$273 745,,J0670,MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,$22 746,,J0690,CEFAZOLIN 1 G RECONSTITUTED IN 10 ML STERILE WATER (RN OSM),$6 747,,J0690,CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$104 748,,J0690,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,$69 749,,J0690,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,$120 750,,J0690,CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,$82 751,,J0690,CEFAZOLIN 330 MG/ML INJ,$125 752,,J0692,CEFEPIME 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$129 753,,J0692,CEFEPIME 100 MG/ML INJ,$141 754,,J0692,CEFEPIME 160 MG/ML INJ,$95 755,,J0692,CEFEPIME 2 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$131 756,,J0692,CEFEPIME 40 MG/ML IN NS STOCK BAG (IP-CMPD),$17 757,,J0694,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,$93 758,,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,$101 759,,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$177 760,,J0696,CEFTRIAXONE 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$87 761,,J0696,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,$32 762,,J0696,CEFTRIAXONE 100 MG/ML INJ CONTAINER,$101 763,,J0696,CEFTRIAXONE 2 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$99 764,,J0696,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,$31 765,,J0713,CEFTAZIDIME 1 GRAM INTRAVENOUS SOLUTION CONTAINER (MBP INGREDIENT),$88 766,,J0713,CEFTAZIDIME 170 MG/ML INJ,"$1,074" 767,,J0713,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,$104 768,,J0735,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",$14 769,,J0740,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,$672 770,,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,$167 771,,J0744,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$82 772,,J0744,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$71 773,,J0744,CIPROFLOXACIN 400 MG/40 ML INTRAVENOUS SOLUTION,$54 774,,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,$58 775,,J0834,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,$339 776,,J0834,COSYNTROPIN 1 MCG/ML INJ (IP-CMPD),$73 777,,J0834,COSYNTROPIN 125 MCG/ML INJ (HIGH-DOSE),$385 778,,J0875,DALBAVANCIN INJ 20 MG/ML,"$12,395" 779,,J0878,DAPTOMYCIN INJ 50 MG/ML,"$1,678" 780,,J0881,DARBEPOETIN ALFA 100 MCG/ML IN POLYSORBATE INJECTION,"$2,461" 781,,J0881,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,"$4,160" 782,,J0881,DARBEPOETIN ALFA 300 MCG/0.6 ML IN POLYSORBATE INJECTION SYRINGE,"$6,802" 783,,J0881,DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION,"$1,477" 784,,J0881,DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE,"$11,378" 785,,J0894,DECITABINE 5 MG/ML INJ,"$4,353" 786,,J0894,DECITABINE SUBCUTANEOUS CHEMO INJECTION 10 MG/ML,"$2,656" 787,,J0895,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,$115 788,,J0895,DEFEROXAMINE 95 MG/ML INJ CONTAINER,$183 789,,J0897,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,"$6,711" 790,,J0897,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,"$3,584" 791,,J1030,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,$163 792,,J1050,MEDROXYPROGESTERONE 150 MG/ML INJ CONTAINER,$510 793,,J1071,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,$66 794,,J1100,DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,$6 795,,J1100,DEXAMETHASONE 4 MG/ML INJECTION SOLUTION,$29 796,,J1100,DEXAMETHASONE IVPB 20 MG IN 50 ML NS (IP-CMPD),$88 797,,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,$26 798,,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,$54 799,,J1170,HYDROMORPHONE (BULK) 100 % POWDER,$149 800,,J1170,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,$91 801,,J1170,HYDROMORPHONE 0.5 MG/0.5 ML INJ CONTAINER,$34 802,,J1170,HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE,$33 803,,J1170,HYDROMORPHONE 1 MG/ML IN 0.9 % SODIUM CHLORIDE PCA SYRINGE CONTAINER,$127 804,,J1170,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,$17 805,,J1170,HYDROMORPHONE 50 MG/50 ML IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,$122 806,,J1170,HYDROMORPHONE PF 1 MG/5 ML SYRINGE (ANES OSM),$16 807,,J1190,DEXRAZOXANE (MYLAN) 10 MG/ML INJ CONTAINER,"$4,120" 808,,J1190,DEXRAZOXANE (PFIZER/HIKMA/ALVOGEN) 10 MG/ML INJ CONTANER,"$3,821" 809,,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,$14 810,,J1230,METHADONE 10 MG/ML INJECTION SOLUTION,$85 811,,J1250,"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",$97 812,,J1265,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",$74 813,,J1300,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,"$86,002" 814,,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,$417 815,,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$416 816,,J1335,ERTAPENEM 100 MG/ML INJ,$535 817,,J1442,FILGRASTIM 300 MCG/0.5 ML INJECTION SYRINGE,$981 818,,J1450,FLUCONAZOLE 200 MG/100 ML IN SOD.千兆瓦卡71 819J1450FLUCONAZOLE400MG/200MLCHIGYBACK,77820J1450FLUCONAZOLEIVPB400MG/200ML&#20048;&#21160;&#20307;&#32946;&#76;&#68;&#115;&#112;&#111;&#114;&#116;&#115;&#20013;&#22269;DOSES 201-399 MG),$79 821,,J1453,FOSAPREPITANT 30 MG/ML INJ,"$1,127" 822,,J1455,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,"$2,225" 823,,J1459,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION","$15,384" 824,,J1561,IMMUNE GLOB G (GAMUNEX-C) (10%)-GLY-IGA AVE 46 MCG/ML INJ CONTAINER,"$13,869" 825,,J1561,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,"$14,793" 826,,J1570,GANCICLOVIR INJ 50 MG/ML,$258 827,,J1580,GENTAMICIN 40 MG/ML INJECTION SOLUTION,$35 828,,J1610,GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML SOLUTION FOR INJECTION,$509 829,,J1626,GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,$63 830,,J1626,GRANISETRON HCL 1 MG/ML INJ CONTAINER,$47 831,,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,$7 832,,J1644,"HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV",$68 833,,J1644,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IRRIGATION (IR OSM)",$65 834,,J1644,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",$25 835,,J1644,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",$13 836,,J1644,"HEPARIN 1,000 UNIT/ML INJ (EXTRACORPOREAL USE)",$7 837,,J1644,"HEPARIN INFUSION 10,000 UNITS IN 500 ML NS (APHERESIS USE ONLY) (IP-CMPD)",$101 838,,J1644,"HEPARIN INFUSION 2,500 UNITS IN 250 ML NS (IP-CMPD)",$82 839,,J1644,"HEPARIN INFUSION 5,000 UNITS IN 1,000 ML NS (IR USE ONLY) (IP-CMPD)",$89 840,,J1644,"HEPARIN TITRATABLE 25,000 UNIT/500 ML IN 0.45% NACL (PREMIX)",$63 841,,J1644,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION",$75 842,,J1645,"DALTEPARIN (PORCINE) 10,000 ANTI-XA UNIT/ML SUBCUTANEOUS SYRINGE",$253 843,,J1645,"DALTEPARIN (PORCINE) 12,500 ANTI-XA UNIT/0.5 ML SUBCUTANEOUS SYRINGE",$302 844,,J1645,"DALTEPARIN (PORCINE) 15,000 ANTI-XA UNIT/0.6 ML SUBCUTANEOUS SYRINGE",$362 845,,J1645,"DALTEPARIN (PORCINE) 18,000 ANTI-XA UNIT/0.72 ML SUBCUTANEOUS SYRINGE",$434 846,,J1650,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,$264 847,,J1650,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,$318 848,,J1650,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,$331 849,,J1650,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,$79 850,,J1650,ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION,$225 851,,J1650,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,$102 852,,J1650,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,$149 853,,J1650,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,$211 854,,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,$77 855,,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,$192 856,,J1720,HYDROCORTISONE (PF) 50 MG/ML INJ,$22 857,,J1720,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,$48 858,,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,$21 859,,J1745,INFLIXIMAB 10 MG/ML INJ,"$15,931" 860,,J1756,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,$278 861,,J1756,IRON SUCROSE 20 MG/ML INJ CONTAINER,$551 862,,J1815,INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,$139 863,,J1815,INSULIN REGULAR INFUSION 100 UNITS IN 100 ML NS (IP-CMPD),$118 864,,J1885,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,$15 865,,J1930,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,"$23,423" 866,,J1930,LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRINGE,"$14,912" 867,,J1930,LANREOTIDE 90 MG/0.3 ML SUBCUTANEOUS SYRINGE,"$19,863" 868,,J1940,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,$19 869,,J1950,LEUPROLIDE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,"$6,694" 870,,J1950,LEUPROLIDE 11.25 MG (PEDIATRIC 3 MONTH) INTRAMUSCULAR SYRINGE KIT,"$14,621" 871,,J1950,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,"$2,231" 872,,J1953,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,$146 873,,J1956,LEVOFLOXACIN 25 MG/ML INTRAVENOUS SOLUTION,$119 874,,J1956,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$67 875,,J1956,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$69 876,,J2001,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,$17 877,,J2001,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,$63 878,,J2020,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,$140 879,,J2060,LORAZEPAM 2 MG/ML INJ CONTAINER,$8 880,,J2060,LORAZEPAM 2 MG/ML INJECTION SOLUTION,$9 881,,J2060,LORAZEPAM IV PUSH INJECTION 2 MG/ML,$8 882,,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,$14 883,,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,$21 884,,J2175,MEPERIDINE IV PUSH INJECTION 25 MG/ML,$13 885,,J2175,MEPERIDINE IV PUSH INJECTION 50 MG/ML,$12 886,,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,$171 887,,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$396 888,,J2185,MEROPENEM 50 MG/ML INJ CONTAINER,$531 889,,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION,$101 890,,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,$367 891,,J2248,MICAFUNGIN 100 MG/5 ML INTRAVENOUS SOLUTION,$595 892,,J2250,MIDAZOLAM (PF) 2 MG/2 ML (1 MG/ML) INJECTION SYRINGE,$13 893,,J2250,MIDAZOLAM 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,$178 894,,J2250,MIDAZOLAM 1 MG/ML INJ CONTAINER,$8 895,,J2250,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,$9 896,,J2250,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,$8 897,,J2265,MINOCYCLINE 20 MG/ML INJECTION,$567 898,,J2270,MORPHINE (BULK) 100 % POWDER,$11 899,,J2270,MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION,$34 900,,J2270,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,$47 901,,J2270,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,$79 902,,J2270,MORPHINE 2 MG/ML INJ CONTAINER,$28 903,,J2270,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,$34 904,,J2278,ZICONOTIDE 100 MCG/ML INTRATHECAL SOLUTION,"$14,953" 905,,J2278,ZICONOTIDE 25 MCG/ML INTRATHECAL SOLUTION,"$12,141" 906,,J2278,ZICONOTIDE INJECTION 5 MCG/ML STOCK SYRINGE (IP-CMPD),$121 907,,J2300,NALBUPHINE 10 MG/ML INJECTION SOLUTION,$8 908,,J2310,NALOXONE 0.4 MG/ML INJECTION SOLUTION,$32 909,,J2353,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE","$17,200" 910,,J2353,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE","$18,829" 911,,J2354,OCTREOTIDE ACETATE 100 MCG/ML (1 ML) INJECTION SYRINGE,$46 912,,J2354,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,$79 913,,J2354,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,$83 914,,J2354,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,$19 915,,J2354,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,$202 916,,J2357,OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE,"$7,036" 917,,J2357,OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,"$1,759" 918,,J2370,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,$22 919,,J2370,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,$7 920,,J2370,PHENYLEPHRINE 100 MCG/ML INJ CONTAINER,$21 921,,J2400,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,$67 922,,J2405,ONDANSETRON 2 MG/ML INJ CONTAINER,$27 923,,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,$7 924,,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SYRINGE,$8 925,,J2405,ONDANSETRON IVPB 16 MG IN 50 ML NS (IP-CMPD),$75 926,,J2425,PALIFERMIN INJ 5 MG/ML,"$13,551" 927,,J2430,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,$165 928,,J2440,PAPAVERINE 30 MG/ML INJECTION SOLUTION,$185 929,,J2469,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,$876 930,,J2505,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,"$18,319" 931,,J2505,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,"$18,319" 932,,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,$123 933,,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$229 934,,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,$196 935,,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$191 936,,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,$182 937,,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (MBP INGREDIENT),$195 938,,J2550,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,$7 939,,J2550,PROMETHAZINE IVPB 12.5 MG IN 25 ML NS (IP-CMPD),$83 940,,J2550,PROMETHAZINE IVPB 25 MG IN 25 ML NS (IP-CMPD),$86 941,,J2550,PROMETHAZINE IVPB 25 MG/ML (MAX CONC),$9 942,,J2550,PROMETHAZINE IVPB 25 MG/ML (MAX CONC) (PEDI < 20.5 KG),$7 943,,J2550,PROMETHAZINE IVPB 6.25 MG IN 25 ML NS (IP-CMPD),$80 944,,J2562,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,"$19,621" 945,,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,"$1,159" 946,,J2704,PROPOFOL 10 MG/ML INFUSION,$56 947,,J2704,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,$43 948,,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,$268 949,,J2720,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,$32 950,,J2765,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,$20 951,,J2783,RASBURICASE 1.5 MG/ML INJ,"$5,499" 952,,J2785,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,$714 953,,J2795,ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,$71 954,,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,$134 955,,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,$79 956,,J2796,ROMIPLOSTIM SUBCUTANEOUS 500 MCG/ML INJ CONTAINER,"$7,234" 957,,J2800,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,$130 958,,J2820,SARGRAMOSTIM 250 MCG/ML INJECTION,"$1,669" 959,,J2850,SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,"$2,096" 960,,J2860,SILTUXIMAB 20 MG/ML INJ CONTAINER,"$27,934" 961,,J2916,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,$307 962,,J2920,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,$28 963,,J2930,METHYLPREDNISOLONE 62.5 MG/ML INJ CONTAINER,$229 964,,J2930,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,$35 965,,J2930,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",$205 966,,J2930,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,$150 967,,J2997,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,$607 968,,J2997,ALTEPLASE INJ 1 MG/ML,"$1,119" 969,,J2997,ALTEPLASE IVPB 1 MG/ML,"$13,755" 970,,J3010,"FENTANYL (PF) 2,750 MCG/55 ML (50 MCG/ML) INTRAVENOUS PCA SYRINGE (PREMIX)",$209 971,,J3010,FENTANYL (PF) 50 MCG/ML INJ CONTAINER,$9 972,,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,$11 973,,J3010,"FENTANYL INFUSION 2,000 MCG IN 100 ML NS (IP-CMPD)",$241 974,,J3010,FENTANYL IV PUSH INJECTION 50 MCG/ML,$13 975,,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,$210 976,,J3095,TELAVANCIN 15 MG/ML INJ CONTAINER,"$1,646" 977,,J3111,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,"$5,804" 978,,J3230,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,$56 979,,J3240,THYROTROPIN ALFA 1.1 MG INTRAMUSCULAR SOLUTION,"$5,169" 980,,J3243,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,$411 981,,J3262,TOCILIZUMAB 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,"$3,163" 982,,J3262,TOCILIZUMAB 20 MG/ML INJ CONTAINER,"$6,728" 983,,J3300,TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,$578 984,,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,$9 985,,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,$44 986,,J3358,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,"$17,808" 987,,J3370,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",$135 988,,J3370,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION (MBP INGREDIENT)",$146 989,,J3370,VANCOMYCIN 10 MG/ML IN NS 500 ML STOCK BAG (IP-CMPD),$73 990,,J3370,VANCOMYCIN 50 MG/ML INJ CONTAINER,$114 991,,J3370,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,$192 992,,J3370,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,$99 993,,J3370,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION (MBP INGREDIENT),$99 994,,J3370,VANCOMYCIN INTRAVITREAL INJECTION 1 MG/0.1 ML,$7 995,,J3370,"VANCOMYCIN IVPB 1,000 MG IN 250 ML NS (IP-CMPD)",$108 996,,J3370,"VANCOMYCIN IVPB 1,250 MG IN 250 ML NS (IP-CMPD)",$101 997,,J3370,"VANCOMYCIN IVPB 1,500 MG IN 250 ML NS (IP-CMPD)",$101 998,,J3380,VEDOLIZUMAB 60 MG/ML INTRAVENOUS SOLUTION,"$20,239" 999,,J3420,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",$30 1000,,J3471,HYALURONIDASE (OVINE) 200 UNIT/ML INJECTION SOLUTION,$42 1001,,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,$74 1002,,J3475,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,$63 1003,,J3475,MAGNESIUM SULFATE 4 MEQ/ML (50 %) INJECTION SOLUTION,$36 1004,,J3480,POTASSIUM CHLORIDE 20 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,$76 1005,,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,$75 1006,,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,$106 1007,,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,$76 1008,,J3480,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,$67 1009,,J3480,POTASSIUM CHLORIDE IVPB 20 MEQ IN 400 ML NS (IP-CMPD),$73 1010,,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,$203 1011,,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION (MBP INGREDIENT),$212 1012,,J3489,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,$365 1013,,J3490,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,$78 1014,,J3490,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,$450 1015,,J3490,AZTREONAM 2 GRAM SOLUTION FOR INJECTION (MBP INGREDIENT),$584 1016,,J3490,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,$15 1017,,J3490,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,$13 1018,,J3490,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION (MAX DOSE 150 MG) CONTAINER,$16 1019,,J3490,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,$9 1020,,J3490,BUPIVACAINE 0.5 % (5 MG/ML) INJECTION SOLUTION,$19 1021,,J3490,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,$105 1022,,J3490,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$82 1023,,J3490,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,$84 1024,,J3490,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,$10 1025,,J3490,ESMOLOL 10 MG/ML INJ CONTAINER,$35 1026,,J3490,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,$20 1027,,J3490,FAMOTIDINE 10 MG/ML INJ CONTAINER,$7 1028,,J3490,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,$29 1029,,J3490,FOLIC ACID 5 MG/ML INJECTION SOLUTION,$81 1030,,J3490,GLYCOPYRROLATE 0.2 MG/ML INJ CONTAINER,$36 1031,,J3490,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,$36 1032,,J3490,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,$12 1033,,J3490,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,$9 1034,,J3490,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,$10 1035,,J3490,METRONIDAZOLE 500 MG/100 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,$80 1036,,J3490,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,$75 1037,,J3490,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE BOLUS (IR OSM),$75 1038,,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,$79 1039,,J7030,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION,$70 1040,,J7030,SODIUM CHLORIDE 0.9% INTRAPERITONEAL SOLN,$78 1041,,J7040,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,$82 1042,,J7040,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION,$68 1043,,J7040,SODIUM CHLORIDE 0.9% INTRAPERITONEAL SOLN,$66 1044,,J7042,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,$85 1045,,J7050,BLINATUMOMAB IV STABILIZER IN 270 ML SODIUM CHLORIDE 0.9% NS (NON-PVC) (IP-CMPD),$67 1046,,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,$231 1047,,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,$83 1048,,J7050,SODIUM CHLORIDE 0.9% (NON-PVC) (BLINATUMOMAB) IV SOLN,$67 1049,,J7050,SODIUM CHLORIDE 0.9% (NON-PVC) INTRAVENOUS SOLUTION,$76 1050,,J7050,SODIUM CHLORIDE 0.9% INJ FOR TOPICAL USE,$66 1051,,J7050,SODIUM CHLORIDE 0.9% INTRAPERITONEAL SOLN,$71 1052,,J7050,SODIUM CHLORIDE 0.9% IV FLUSH (VOLUME GREATER THAN 10 ML),$66 1053,,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,$71 1054,,J7060,DEXTROSE 5 % IV BOLUS,$125 1055,,J7060,DEXTROSE 5% (NON-PVC) INTRAVENOUS SOLUTION,$66 1056,,J7060,DEXTROSE 5% IV FLUSH,$88 1057,,J7060,DEXTROSE 5% IV FLUSH (2017-0614),$66 1058,,J7060,DEXTROSE 5% IV FLUSH (2017-0855),$110 1059,,J7060,DEXTROSE 5% IV FLUSH (RESEARCH PROTOCOL USE ONLY),$66 1060,,J7070,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,$74 1061,,J7070,DEXTROSE 5 % IV BOLUS,$70 1062,,J7120,LACTATED RINGERS (NON-PVC) INTRAVENOUS SOLUTION,$70 1063,,J7120,LACTATED RINGERS FLUSH,$105 1064,,J7120,LACTATED RINGERS INTRAVENOUS SOLUTION,$80 1065,,J7120,LACTATED RINGERS IV BOLUS,$72 1066,,J7121,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,$77 1067,,J7131,SODIUM CHLORIDE 3 % INTRAVENOUS INJECTION SOLUTION,$70 1068,,J7131,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,$73 1069,,J7192,"ANTIHEMOPHILIC FACTOR (RECOMB) 1,500 (+/-) UNIT INTRAVENOUS SOLUTION","$15,541" 1070,,J7300,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,"$2,590" 1071,,J7301,LEVONORGESTREL 14 MCG/24 HRS (3 YRS) 13.5 MG INTRAUTERINE DEVICE,"$2,334" 1072,,J7308,AMINOLEVULINIC ACID HCL 20 % TOPICAL SOLUTION,"$2,035" 1073,,J7325,HYLAN G-F 20 48 MG/6 ML INTRA-ARTICULAR SYRINGE,"$5,210" 1074,,J7500,AZATHIOPRINE 50 MG TABLET,$4 1075,,J7502,CYCLOSPORINE 100 MG CAPSULE,$105 1076,,J7507,TACROLIMUS 0.5 MG CAPSULE,$10 1077,,J7507,TACROLIMUS 1 MG CAPSULE,$15 1078,,J7507,TACROLIMUS ORAL SUSPENSION 1 MG/ML (IP-CMPD),$47 1079,,J7509,METHYLPREDNISOLONE 16 MG TABLET,$25 1080,,J7509,METHYLPREDNISOLONE 4 MG TABLET,$9 1081,,J7510,PREDNISOLONE 5 MG TABLET,$93 1082,,J7512,PREDNISONE 1 MG TABLET,$3 1083,,J7512,PREDNISONE 10 MG TABLET,$2 1084,,J7512,PREDNISONE 2.5 MG TABLET,$2 1085,,J7512,PREDNISONE 20 MG TABLET,$2 1086,,J7512,PREDNISONE 5 MG TABLET,$2 1087,,J7512,PREDNISONE 5 MG/5 ML ORAL SOLUTION,$89 1088,,J7512,PREDNISONE 50 MG TABLET,$2 1089,,J7517,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,$7 1090,,J7520,SIROLIMUS 1 MG/ML ORAL SOLUTION,$13 1091,,J7999,BEVACIZUMAB INTRAVITREAL INJECTION 2.5 MG/0.1 ML,$129 1092,,J8501,APREPITANT 125 MG (25 MG/ML FINAL CONCENTRATION) ORAL SUSPENSION,$464 1093,,J8501,APREPITANT 125 MG CAPSULE,$810 1094,,J8501,APREPITANT 40 MG CAPSULE,$281 1095,,J8501,APREPITANT 80 MG CAPSULE,$518 1096,,J8521,CAPECITABINE 500 MG TABLET,$393 1097,,J8530,CYCLOPHOSPHAMIDE 50 MG CAPSULE,$502 1098,,J8540,DEXAMETHASONE 0.5 MG TABLET,$2 1099,,J8540,DEXAMETHASONE 0.75 MG TABLET,$2 1100,,J8540,DEXAMETHASONE 1 MG TABLET,$2 1101,,J8540,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),$59 1102,,J8540,DEXAMETHASONE 2 MG TABLET,$4 1103,,J8540,DEXAMETHASONE 4 MG TABLET,$19 1104,,J8610,METHOTREXATE SODIUM 2.5 MG TABLET,$180 1105,,J8700,TEMOZOLOMIDE 100 MG CAPSULE,$869 1106,,J8700,TEMOZOLOMIDE 140 MG CAPSULE,"$8,228" 1107,,J8700,TEMOZOLOMIDE 180 MG CAPSULE,$912 1108,,J8700,TEMOZOLOMIDE 20 MG CAPSULE,$461 1109,,J8700,TEMOZOLOMIDE 250 MG CAPSULE,"$1,026" 1110,,J8700,TEMOZOLOMIDE 5 MG CAPSULE,$77 1111,,J8700,TEMOZOLOMIDE ORAL SUSPENSION 10 MG/ML (IP-CMPD),$564 1112,,J8999,LOMUSTINE 40 MG CAPSULE,"$2,038" 1113,,J8999,MITOTANE 500 MG TABLET,$47 1114,,J9000,DOXORUBICIN 2 MG/ML INJ CONTAINER,$222 1115,,J9000,DOXORUBICIN 50 MG/2 ML INJ (LC BEADS),$993 1116,,J9000,DOXORUBICIN 50 MG/2.5 ML INJ (ONCOZENE BEADS),"$1,472" 1117,,J9000,DOXORUBICIN INJ 50 MG/1.5 ML (TACE),"$2,509" 1118,,J9015,ALDESLEUKIN INTRATHECAL INJ 4.58 MILLION UNITS/ML,$376 1119,,J9017,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,"$2,350" 1120,,J9019,"ASPARAGINASE ERWINIA INJ 10,000 UNITS/ML","$29,823" 1121,,J9022,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION","$27,067" 1122,,J9022,ATEZOLIZUMAB 60 MG/ML INJECTION CONTAINER,"$26,659" 1123,,J9023,AVELUMAB 20 MG/ML INTRAVENOUS SOLUTION,"$19,595" 1124,,J9025,AZACITIDINE INJECTION 10 MG/ML,"$1,782" 1125,,J9025,AZACITIDINE SUBCUTANEOUS SOLUTION 25 MG/ML,"$1,295" 1126,,J9027,CLOFARABINE 20 MG/20 ML INTRAVENOUS SOLUTION,"$20,248" 1127,,J9030,BCG LIVE 50 MG INTRAVESICAL SUSPENSION,$174 1128,,J9030,BCG LIVE INTRAVESICAL 17 MG IN 50 ML NS (IP-CMPD),$236 1129,,J9030,BCG LIVE INTRAVESICAL 50 MG IN 50 ML NS (IP-CMPD),$551 1130,,J9030,BCG LIVE INTRAVESICAL SOLN 50 MG/ML,$263 1131,,J9031,BCG LIVE INTRAVESICAL 17 MG IN 50 ML NS (IP-CMPD),$239 1132,,J9031,BCG LIVE INTRAVESICAL 50 MG IN 50 ML NS (IP-CMPD),$551 1133,,J9031,BCG LIVE INTRAVESICAL SOLN 50 MG/ML,$271 1134,,J9034,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,"$12,769" 1135,,J9035,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,"$16,169" 1136,,J9039,BLINATUMOMAB 12.5 MCG/ML CONTAINER,"$38,321" 1137,,J9040,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,$291 1138,,J9040,BLEOMYCIN 3 UNITS/ML INJ CONTAINER,$356 1139,,J9040,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,$294 1140,,J9040,BLEOMYCIN 6 UNITS/ML SCLEROTHERAPY INJ CONTAINER,$119 1141,,J9041,BORTEZOMIB SUBCUTANEOUS INJ 2.5 MG/ML,"$3,363" 1142,,J9042,BRENTUXIMAB VEDOTIN INJ 5 MG/ML,"$47,852" 1143,,J9043,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,"$24,647" 1144,,J9045,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,$305 1145,,J9045,CARBOPLATIN IVPB 4 MG/ML IN 250 ML (DESENSITIZATION STOCK SOLN),$455 1146,,J9047,CARFILZOMIB 2 MG/ML INJ CONTAINER,"$8,055" 1147,,J9055,CETUXIMAB 2 MG/ML INJ CONTAINER,"$15,344" 1148,,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,$165 1149,,J9060,CISPLATIN IVPB 0.4 MG/ML IN 250 ML NS (DESENSITIZATION STOCK SOLN),$312 1150,,J9065,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,"$1,337" 1151,,J9070,CYCLOPHOSPHAMIDE 20 MG/ML INJ CONTAINER,"$2,359" 1152,,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,$82 1153,,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) IV INJECTION SOLUTION,$18 1154,,J9119,CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION,"$29,004" 1155,,J9120,DACTINOMYCIN 500 MCG/ML INJ,"$14,770" 1156,,J9130,DACARBAZINE 10 MG/ML INJ CONTAINER,$273 1157,,J9145,DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION,"$22,284" 1158,,J9150,DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,"$1,239" 1159,,J9153,DAUNORUBICIN-CYTARABINE LIPOSOMAL INJECTION 2.2 MG-5 MG/ML,"$39,412" 1160,,J9155,DEGARELIX 20 MG/ML SQ INJ,"$1,431" 1161,,J9155,DEGARELIX 40 MG/ML SQ INJ,"$4,847" 1162,,J9171,DOCETAXEL 20 MG/ML INJ CONTAINER,"$1,942" 1163,,J9173,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,"$17,949" 1164,,J9176,ELOTUZUMAB 25 MG/ML INJ CONTAINER,"$19,528" 1165,,J9178,EPIRUBICIN 2 MG/ML INJ CONTAINER,$269 1166,,J9179,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,"$7,648" 1167,,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,$126 1168,,J9181,ETOPOSIDE PHOSPHATE INJ 20 MG/ML (MAX CONC),$799 1169,,J9185,FLUDARABINE 25 MG/ML INJ,$452 1170,,J9190,FLUOROURACIL 50 MG/ML INJ CONTAINER,$183 1171,,J9190,FLUOROURACIL INTRALESIONAL 50 MG/ML INJ CONTAINER,$7 1172,,J9201,GEMCITABINE 38 MG/ML INJ CONTAINER,$279 1173,,J9201,GEMCITABINE INTRAVESICULAR INJ 40 MG/ML,"$4,712" 1174,,J9202,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,"$3,268" 1175,,J9202,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,"$1,090" 1176,,J9203,GEMTUZUMAB OZOGAMICIN INJECTION 1 MG/ML,"$26,398" 1177,,J9204,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,"$42,249" 1178,,J9205,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,"$17,055" 1179,,J9206,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,$324 1180,,J9207,IXABEPILONE 2 MG/ML INJ CONTAINER,"$17,968" 1181,,J9208,IFOSFAMIDE 50 MG/ML INJ CONTAINER,$530 1182,,J9209,MESNA 100 MG/ML INTRAVENOUS SOLUTION,$219 1183,,J9211,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,$601 1184,,J9214,INTERFERON ALFA-2B 10 MILLION UNIT/ML INJ CONTAINER,$763 1185,,J9214,INTERFERON ALFA-2B 50 MILLION UNIT (1 ML) SOLUTION FOR INJECTION,"$3,816" 1186,,J9217,LEUPROLIDE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,"$15,955" 1187,,J9217,LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,"$7,977" 1188,,J9217,LEUPROLIDE 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,"$2,325" 1189,,J9217,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,"$10,636" 1190,,J9217,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,"$2,659" 1191,,J9226,HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT,"$104,720" 1192,,J9228,IPILIMUMAB 5 MG/ML INJ CONTAINER,"$78,358" 1193,,J9228,IPILIMUMAB 5 MG/ML INJ CONTAINER (S1404),"$415,201" 1194,,J9229,INOTUZUMAB OZOGAMICIN INJECTION 0.25 MG/ML,"$41,294" 1195,,J9245,MELPHALAN INJ 5 MG/ML,"$28,248" 1196,,J9250,METHOTREXATE 25 MG/ML INJECTION,$42 1197,,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,$11 1198,,J9260,METHOTREXATE SODIUM 25 MG/ML INJ CONTAINER,$234 1199,,J9261,NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,"$11,898" 1200,,J9263,OXALIPLATIN 5 MG/ML INJ CONTAINER,$942 1201,,J9263,OXALIPLATIN IVPB 0.5 MG/ML IN 500 ML D5W (DESENSITIZATION STOCK SOLN),"$1,012" 1202,,J9264,PACLITAXEL-PROTEIN BOUND IVPB 5 MG/ML,"$9,103" 1203,,J9266,PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,"$41,371" 1204,,J9267,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",$305 1205,,J9271,PEMBROLIZUMAB 25 MG/ML INJ CONTAINER,"$29,950" 1206,,J9280,MITOMYCIN 0.5 MG/ML INJ CONTAINER,"$1,774" 1207,,J9280,MITOMYCIN 2 MG/ML INTRAVESICULAR CONTAINER,"$4,019" 1208,,J9293,"MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS",$773 1209,,J9299,NIVOLUMAB 10 MG/ML INJ CONTAINER,"$33,021" 1210,,J9301,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION","$18,737" 1211,,J9302,OFATUMUMAB 20 MG/ML INJ CONTAINER,"$30,886" 1212,,J9303,PANITUMUMAB 20 MG/ML INJ CONTAINER,"$18,466" 1213,,J9305,PEMETREXED 25 MG/ML INJ CONTAINER,"$20,329" 1214,,J9306,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,"$17,500" 1215,,J9308,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,"$25,530" 1216,,J9311,"RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN","$23,901" 1217,,J9312,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS","$22,626" 1218,,J9315,ROMIDEPSIN INJ 5 MG/ML,"$21,815" 1219,,J9320,STREPTOZOCIN 100 MG/ML INJ,$952 1220,,J9325,TALIMOGENE LAHERPAREPVEC 10EXP6 (1 MILLION) PFU/ML SUSP FOR INJECTION,$384 1221,,J9325,TALIMOGENE LAHERPAREPVEC 10EXP8 (100 MILLION)PFU/ML SUSP FOR INJECTION,"$31,319" 1222,,J9328,TEMOZOLOMIDE IVPB 2.5 MG/ML,"$6,592" 1223,,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,"$4,865" 1224,,J9340,THIOTEPA 10.4 MG/ML INJ (USA),"$1,909" 1225,,J9351,TOPOTECAN 1 MG/ML INJECTION,$247 1226,,J9352,TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,"$23,762" 1227,,J9354,ADO-TRASTUZUMAB EMTANSINE 20 MG/ML INJ CONTAINER,"$24,719" 1228,,J9355,TRASTUZUMAB 21 MG/ML INJ CONTAINER,"$14,617" 1229,,J9360,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,$209 1230,,J9370,VINCRISTINE 1 MG/ML INJ CONTAINER,$119 1231,,J9390,VINORELBINE 10 MG/ML INJ CONTAINER,$368 1232,,J9395,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,"$5,500" 1233,,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,$332 1234,,Q2043,SIPULEUCEL-T IN LACTATED RINGERS 50 MILLION CELL/250 ML IV SUSPENSION,"$164,115" 1235,,Q2050,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION","$9,286" 1236,,Q9961,IOTHALAMATE MEGLUMINE 60 % INJECTION SOLUTION,$35 1237,,Q9966,IODIXANOL 270 MG IODINE/ML INTRAVENOUS SOLUTION,$78 1238,,Q9966,IOHEXOL 240 MG IODINE/ML INTRAVENOUS SOLUTION,$10 1239,,Q9967,IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,$130 1240,,Q9967,IOHEXOL 300 MG IODINE/ML INTRATHECAL SOLUTION,$10 1241,,Q9967,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,$52 1242,,Q9967,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,$130 1243,0343 & 0344,0343, NUCLEAR MEDICINE - DIAGNOSTIC & THERAPEUTIC RADIOPHARMACEUTICALS , 1244,IP/OP,HCPCS Code,HCPCS Code Description, Average Charges per Date of Service 1245,IP,A9500,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,$130 1246,,A9503,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,$73 1247,,A9509,IODINE-123 SODIUM IODIDE 100 MICROCURIE CAPSULE,"$1,992" 1248,,A9517,IODINE-131 SODIUM IODIDE CAPSULE (TREATMENT),"$4,169" 1249,,A9520,TECHNETIUM TC 99M-TILMANOCEPT INJECTION,"$1,176" 1250,,A9521,TECHNETIUM TC 99M-EXAMETAZIME INJECTION,"$2,324" 1251,,A9529,IODINE-131 SODIUM IODIDE SOLUTION (DIAGNOSTIC),$174 1252,,A9530,IODINE-131 SODIUM IODIDE SOLUTION (TREATMENT),"$4,750" 1253,,A9537,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,$46 1254,,A9539,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,$209 1255,,A9540,KIT FOR PREPARATION OF TC 99M-ALBUMIN 2.5 MG INTRAVENOUS SOLUTION,$243 1256,,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,$216 1257,,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION (FILTERED),$220 1258,,A9548,PENTETATE INDIUM DISODIUM IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,"$2,058" 1259,,A9552,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,$994 1260,,A9556,GALLIUM-67 CITRATE INJECTION,$752 1261,,A9560,TECHNETIUM TC 99M-RED BLOOD CELLS INJECTION,$114 1262,,A9562,TECHNETIUM TC 99M-MERTIATIDE INJECTION,$546 1263,,A9567,TECHNETIUM TC99M PENTETIC ACID (DTPA) AEROSOL,$649 1264,,A9570,INDIUM 111-WBC INJECTION,"$2,003" 1265,,A9582,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN,"$4,164" 1266,,A9587,KIT FOR THE PREPARATION OF GA-68-DOTATATE 40 MCG INTRAVENOUS SOLN,"$6,075" 1267,,A9588,FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,"$6,200" 1268,,C9408,IODINE I-131 IOBENGUANE INJECTION (TREATMENT),"$258,099" 1269,OP,A9500,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,$119 1270,,A9503,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,$74 1271,,A9509,IODINE-123 SODIUM IODIDE 100 MICROCURIE CAPSULE,"$1,915" 1272,,A9513,LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION,"$73,112" 1273,,A9515,CHOLINE C-11 INJECTION,"$2,472" 1274,,A9516,IODINE-123 SODIUM IODIDE 200 MICROCURIE CAPSULE,"$4,294" 1275,,A9517,IODINE-131 SODIUM IODIDE CAPSULE (TREATMENT),"$3,657" 1276,,A9520,TECHNETIUM TC 99M-TILMANOCEPT INJECTION,"$1,140" 1277,,A9528,IODINE-131 SODIUM IODIDE CAPSULE (DIAGNOSTIC),$240 1278,,A9529,IODINE-131 SODIUM IODIDE SOLUTION (DIAGNOSTIC),$152 1279,,A9530,IODINE-131 SODIUM IODIDE SOLUTION (TREATMENT),"$2,187" 1280,,A9537,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,$46 1281,,A9539,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,$209 1282,,A9540,KIT FOR PREPARATION OF TC 99M-ALBUMIN 2.5 MG INTRAVENOUS SOLUTION,$243 1283,,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,$216 1284,,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION (FILTERED),$217 1285,,A9548,PENTETATE INDIUM DISODIUM IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,"$2,058" 1286,,A9552,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,$999 1287,,A9560,TECHNETIUM TC 99M-RED BLOOD CELLS INJECTION,$110 1288,,A9562,TECHNETIUM TC 99M-MERTIATIDE INJECTION,$546 1289,,A9567,TECHNETIUM TC99M PENTETIC ACID (DTPA) AEROSOL,$641 1290,,A9570,INDIUM 111-WBC INJECTION,"$2,003" 1291,,A9572,INDIUM-111 PENTETREOTIDE INJECTION,"$6,525" 1292,,A9580,FLUORINE-18 SODIUM FLUORIDE INJECTION 200 MCI/ML,$225 1293,,A9582,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN,"$4,164" 1294,,A9587,KIT FOR THE PREPARATION OF GA-68-DOTATATE 40 MCG INTRAVENOUS SOLN,"$6,023" 1295,,A9588,FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,"$6,174" 1296,,A9604,"SAMARIUM SM 153 LEXIDRONAM 5,550 MBQ/3 ML INTRAVENOUS SOLUTION","$12,947" 1297,,A9606,"RADIUM RA 223 DICHLORID 1,100 KBQ/ML(30 MICROCURIE/ML)INTRAVENOUS SOLN","$45,043"