Greenwich Hospital Price Master - CT.gov
Greenwich Hospital Price Master - CT.gov Greenwich Hospital Price Master - CT.gov
2785000126157 TI CORT FIX MIS 5.57X40MM 5,615.40 4/1/2013 2785000128323 ACL TIGHTROPE ABS BUTTON 8X12 AR-1588TB 783.10 4/1/2013 2785000128373 SCREW VA LCKG 5.0 SELFTAP 65MM 818.17 4/1/2013 2785000128374 SCREW VA LCKG 5.0 SELFTAP 70MM 818.17 4/1/2013 2785000128375 SCREW VA LCKG 5.0 SELFTAP 75MM 818.17 4/1/2013 2785000128380 SCREW VA LOCKING 5.0MM 80MM 818.17 4/1/2013 2785000128969 CONTINUUM SHELL CLUSTER 5 5,137.90 4/1/2013 2785000129013 LINER CONT LE ELE LNR LL 36X 5 8 5,065.32 4/1/2013 2785000130986 INSERT TIB EF 5 6 GRN 12MM LCCK NXGN 5,034.34 4/1/2013 2785000131088 PINN MAR +4 10D 32IDX50OD 2,903.20 4/1/2013 2785000131937 TUBE SHAPARD GROMENT VENT 1.14 LUMEN 57.30 4/1/2013 2785000132109 STEM TAPER ML NECK STD 12/14 9,954.92 4/1/2013 2785000132675 WEDGE FEM 8MM SZ4 RT DIST PFC SGMA 2,205.94 4/1/2013 2785000132676 INSERT TIB SZ4 17.5 RP STAB PFC SGMA 5,114.03 4/1/2013 2785000132677 UNIVERSAL STEM 75X20MM FLUTED 6,146.38 4/1/2013 2785000132678 UNIVERSAL STEM 115X18MM FLUTED 6,146.38 4/1/2013 2785000133621 INSERT TIB SZ2.5 10.0 RP STAB PFC SGMA 5,114.03 4/1/2013 2785000133622 SCREW EXP TI POLY 8MMX65MM 2,674.00 4/1/2013 2785000133748 STENT WALLFLEX UNCOV RX 8X80 6,876.00 4/1/2013 2785000134058 FEMORAL STEM SZ3 1570-05-090 3,544.04 4/1/2013 2785000134059 NK GSF FEMUR NON-POROUS 9,206.20 4/1/2013 2785000222474 SCREW VA LCKG 5.0 SLFTAP 40MM STRDR 602.42 4/1/2013 2785000222486 SUTURE ANCHOR HEALICOIL PK 4.5 1,535.64 4/1/2013 2785000222487 SCREW VA LCKG 5.0 SLFTAP 22MM STRDR 602.42 4/1/2013 2785000222488 SCREW VA LCKG 5.0 SLFTAP 38MM STRDR 602.41 4/1/2013 2785000228361 ACL TIGHTROPE RT W/TI 1,501.26 4/1/2013 2785001431436 PATCH PARIETEX VENTRAL SM 4CM 1,442.13 4/1/2013 2785002232519 STENT WALLFLEX PARTUNCOV 10X60 BILIARY 10,466.80 4/1/2013 2785003726833 SHEATH GUIDING PINNCLE 5FR STR 343.80 4/1/2013 2785005725254 PEGGED GLENOID AFFINITI 48 7,153.71 4/1/2013 3430000313545 INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG IV KIT 3,492.65 4/1/2013 6370000110011 FAMOTIDINE 20 MG TABLET 3.00 4/1/2013 6370000110037 FINASTERIDE 5 MG TABLET 5.73 4/1/2013 6370000110041 FLECAINIDE 100 MG TABLET 3.00 4/1/2013 6370000110044 FLUCONAZOLE 100 MG TABLET 3.00 4/1/2013 6370000110045 FLUCONAZOLE 200 MG TABLET 3.00 4/1/2013 6370000110046 FLUCONAZOLE 50 MG TABLET 3.00 4/1/2013 6370000110054 FLUDROCORTISONE 0.1 MG TABLET 3.00 4/1/2013 6370000110069 FLUOXETINE 10 MG CAPSULE 3.00 4/1/2013 6370000110070 FLUOXETINE 20 MG CAPSULE 3.00 4/1/2013 6370000110080 FLURBIPROFEN 0.03 % EYE DROPS 16.64 4/1/2013 6370000110117 GLIPIZIDE 5 MG TABLET 3.00 4/1/2013 6370000110125 GLYBURIDE 1.25 MG TABLET 3.00 4/1/2013 6370000110126 GLYBURIDE 2.5 MG TABLET 3.00 4/1/2013 6370000110188 HEXACHLOROPHENE 3 % TOPICAL LIQUID 19.43 4/1/2013 6370000110235 HYDROXYCHLOROQUINE 200 MG TABLET 3.00 4/1/2013 6370000110236 HYDROXYUREA 500 MG CAPSULE 5.29 4/1/2013 6370000110246 IBUPROFEN 100 MG/5 ML ORAL SUSP 3.00 4/1/2013 6370000110284 NPH INSULIN HUMAN RECOMB 100 UNIT/ML SUSP, SUB-Q INJ 0.75 4/1/2013 6370000110368 KETOCONAZOLE 2 % TOPICAL CREAM 17.82 4/1/2013 6370000110371 KETOROLAC 10 MG TABLET 3.00 4/1/2013 6370000110373 LABETALOL 100 MG TABLET 3.00 4/1/2013 6370000110374 LABETALOL 200 MG TABLET 3.00 4/1/2013 6370000110403 LEVOTHYROXINE 88 MCG TABLET 3.00 4/1/2013 6370000110404 LEVOTHYROXINE 112 MCG TABLET 3.00 4/1/2013 6370000110443 LIOTHYRONINE 5 MCG TABLET 3.00 4/1/2013 6370000110451 LISINOPRIL 5 MG TABLET 3.00 4/1/2013 6370000110454 LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013 6370000110466 LORATADINE 10 MG TABLET 3.00 4/1/2013 6370000110491 MAGNESIUM OXIDE 400 MG TABLET 3.00 4/1/2013 6370000110521 MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSP 15.12 4/1/2013 6370000110533 MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE 8.23 4/1/2013 6370000110534 MESALAMINE 400 MG TABLET,DELAYED RELEASE 11.14 4/1/2013 6370000110544 METFORMIN 500 MG TABLET 3.00 4/1/2013 6370000110553 METHIMAZOLE 5 MG TABLET 3.00 4/1/2013 6370000110572 METHYLERGONOVINE 0.2 MG TABLET 8.67 4/1/2013 6370000110587 METOLAZONE 2.5 MG TABLET 3.00 4/1/2013 6370000110588 METOLAZONE 5 MG TABLET 3.58 4/1/2013 6370000110592 METRONIDAZOLE 0.75 % VAGINAL GEL 131.13 4/1/2013 6370000110595 MEXILETINE 150 MG CAPSULE 3.00 4/1/2013 6370000110606 MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER 923.87 4/1/2013 6370000110609 MIDODRINE 2.5 MG TABLET 3.00 4/1/2013 6370000110628 MISOPROSTOL 100 MCG TABLET 9.93 4/1/2013 6370000110674 MUPIROCIN 2 % TOPICAL OINTMENT 34.51 4/1/2013 6370000110685 NALTREXONE 50 MG TABLET 13.80 4/1/2013 6370000110778 ONDANSETRON HCL 4 MG TABLET 0.75 4/1/2013 6370000110810 OXYBUTYNIN CHLORIDE 5 MG/5 ML SYRUP 9.12 4/1/2013 6370000110813 OXYCODONE 5 MG/5 ML ORAL SOLN 6.61 4/1/2013 6370000110814 OXYCODONE 5 MG TABLET 3.00 4/1/2013 6370000110839 PEG 3350-ELECTROLYTES 236 G-22.74 G-6.74 G-5.86 G ORAL SOLUTION 25.40 4/1/2013 6370000110855 PAROXETINE 20 MG TABLET 3.00 4/1/2013 6370000110865 MULTIVITAMIN ORAL LIQUID 3.00 4/1/2013 6370000111024 PHYTONADIONE 5 MG TABLET 46.70 4/1/2013 6370000111067 SODIUM DI- AND MONOPHOSPHATE-K PHOSPHATE MONO 250 MG TABLET 3.00 4/1/2013 6370000111105 HYDROCORTISONE-PRAMOXINE 1 %-1 % TOPICAL FOAM 191.71 4/1/2013 6370000111110 PRAVASTATIN 10 MG TABLET 3.00 4/1/2013 6370000111111 PRAVASTATIN 20 MG TABLET 3.00 4/1/2013 6370000111112 PRAVASTATIN 40 MG TABLET 3.00 4/1/2013 6370000111129 PRIMIDONE 50 MG TABLET 3.00 4/1/2013 6370000111138 PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY 12.81 4/1/2013
6370000111218 PSYLLIUM ORAL PACKET 3.00 4/1/2013 6370000111239 PYRIDOSTIGMINE BROMIDE 60 MG TABLET 3.36 4/1/2013 6370000111293 RIFAMPIN 300 MG CAPSULE 12.55 4/1/2013 6370000111340 SELEGILINE 5 MG TABLET 8.14 4/1/2013 6370000111349 SENNOSIDES 8.6 MG TABLET 3.00 4/1/2013 6370000111351 SERTRALINE 50 MG TABLET 3.00 4/1/2013 6370000111359 SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK 3.00 4/1/2013 6370000111395 SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA 6.76 4/1/2013 6370000111403 SODIUM CHLORIDE 0.9 % IRRIGATION SOLN 6.35 4/1/2013 6370000111421 SOTALOL 80 MG TABLET 3.00 4/1/2013 6370000111441 SUCRALFATE 100 MG/ML ORAL SUSP 14.74 4/1/2013 6370000111442 SUCRALFATE 1 GRAM TABLET 3.00 4/1/2013 6370000111507 TERBUTALINE 1 MG/ML SUB-Q 11.43 4/1/2013 6370000111561 TIMOLOL MALEATE 0.25 % EYE DROPS 15.18 4/1/2013 6370000111562 TIMOLOL MALEATE 0.5 % EYE DROPS 28.33 4/1/2013 6370000111566 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT 861.38 4/1/2013 6370000111567 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE DROPS, SUSP 134.49 4/1/2013 6370000111624 URSODIOL 300 MG CAPSULE 3.00 4/1/2013 6370000111630 VANCOMYCIN 250 MG/5 ML ORAL SOLUTION 88.40 4/1/2013 6370000111639 VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE 5.97 4/1/2013 6370000111664 WARFARIN 1 MG TABLET 3.00 4/1/2013 6370000111701 ZOLPIDEM 5 MG TABLET 3.00 4/1/2013 6370000112024 MECLIZINE 12.5 MG TABLET 3.00 4/1/2013 6370000112097 THEOPHYLLINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR 1.50 4/1/2013 6370000112098 THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR 1.85 4/1/2013 6370000112203 VENLAFAXINE 25 MG TABLET 3.00 4/1/2013 6370000112207 VENLAFAXINE 37.5 MG TABLET 4.86 4/1/2013 6370000112329 CARBIDOPA-LEVODOPA ER 25 MG-100 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013 6370000112556 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID 0.75 4/1/2013 6370000112580 IPRATROPIUM BROMIDE 0.02 % SOLN FOR INHALATION 3.00 4/1/2013 6370000112729 TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG CAPSULE 3.00 4/1/2013 6370000113089 LISINOPRIL 2.5 MG TABLET 3.00 4/1/2013 6370000113668 THEOPHYLLINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR 3.00 4/1/2013 6370000113818 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT 13.82 4/1/2013 6370000113981 LAMOTRIGINE 25 MG TABLET 1.50 4/1/2013 6370000113982 LAMOTRIGINE 100 MG TABLET 3.00 4/1/2013 6370000114041 IPRATROPIUM-ALBUTEROL 18 MCG-103 MCG/ACTUATION AEROSOL INHALER 1,215.92 4/1/2013 6370000114087 ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET 3.00 4/1/2013 6370000114468 ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ELIXIR 6.28 4/1/2013 6370000114471 DORZOLAMIDE 2 % EYE DROPS 288.36 4/1/2013 6370000114632 TRAMADOL 50 MG TABLET 3.00 4/1/2013 6370000114719 METFORMIN 850 MG TABLET 3.00 4/1/2013 6370000114793 TIZANIDINE 4 MG TABLET 3.00 4/1/2013 6370000114823 LOSARTAN 25 MG TABLET 3.00 4/1/2013 6370000114824 LOSARTAN 50 MG TABLET 3.00 4/1/2013 6370000114953 ATOVAQUONE 750 MG/5 ML ORAL SUSP 145.36 4/1/2013 6370000114966 HYDROCODONE 5 MG-ACETAMINOPHEN 500 MG TABLET 3.00 4/1/2013 6370000115327 SUMATRIPTAN 25 MG TABLET 10.87 4/1/2013 6370000115747 CARVEDILOL 6.25 MG TABLET 3.00 4/1/2013 6370000115748 CARVEDILOL 25 MG TABLET 3.00 4/1/2013 6370000115749 CARVEDILOL 12.5 MG TABLET 3.00 4/1/2013 6370000115797 AZITHROMYCIN 200 MG/5 ML ORAL SUSP 158.88 4/1/2013 6370000116053 DESMOPRESSIN 0.2 MG TABLET 6.89 4/1/2013 6370000116205 ANASTROZOLE 1 MG TABLET 3.00 4/1/2013 6370000116299 DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM 12.27 4/1/2013 6370000116355 GLIMEPIRIDE 1 MG TABLET 3.00 4/1/2013 6370000116356 GLIMEPIRIDE 2 MG TABLET 3.00 4/1/2013 6370000116439 RITONAVIR 100 MG CAPSULE 52.57 4/1/2013 6370000116632 PAROXETINE 10 MG TABLET 3.40 4/1/2013 6370000116958 MUPIROCIN 2 % NASAL OINTMENT 58.57 4/1/2013 6370000117023 HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET 3.00 4/1/2013 6370000117464 BUSPIRONE 15 MG TABLET 3.00 4/1/2013 6370000117466 MIRTAZAPINE 15 MG TABLET 3.00 4/1/2013 6370000117837 ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER 287.91 4/1/2013 6370000117936 OLANZAPINE 5 MG TABLET 40.22 4/1/2013 6370000118293 TORSEMIDE 20 MG TABLET 6.55 4/1/2013 6370000118307 GABAPENTIN 400 MG CAPSULE 1.50 4/1/2013 6370000118308 GABAPENTIN 300 MG CAPSULE 3.00 4/1/2013 6370000118309 GABAPENTIN 100 MG CAPSULE 3.00 4/1/2013 6370000118313 RISPERIDONE 1 MG TABLET 3.00 4/1/2013 6370000118386 BUPROPION HCL SR 150 MG TABLET,SUSTAINED-RELEASE 4.40 4/1/2013 6370000118551 CARVEDILOL 3.125 MG TABLET 3.00 4/1/2013 6370000118621 LATANOPROST 0.005 % EYE DROPS 579.57 4/1/2013 6370000118742 PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG TABLET 3.00 4/1/2013 6370000118920 TOPIRAMATE 25 MG TABLET 1.50 4/1/2013 6370000118922 TOPIRAMATE 100 MG TABLET 3.00 4/1/2013 6370000119713 DIAZOXIDE 50 MG/ML ORAL SUSP 1,162.25 4/1/2013 6370000119720 FLUNISOLIDE 25 MCG (0.025 %) NASAL SPRAY 236.54 4/1/2013 6370000119733 KETOROLAC 0.5 % EYE DROPS 163.58 4/1/2013 6370000119769 TOBRAMYCIN 0.3 % EYE OINTMENT 492.89 4/1/2013 6370000120920 MORPHINE ER 15 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013 6370000120921 MORPHINE ER 30 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013 6370000120943 AZITHROMYCIN 250 MG TABLET 7.57 4/1/2013 6370000121057 OLANZAPINE 2.5 MG TABLET 34.08 4/1/2013 6370000121061 OXCARBAZEPINE 300 MG TABLET 3.00 4/1/2013 6370000121062 CITALOPRAM 20 MG TABLET 1.50 4/1/2013 6370000121290 PRAMIPEXOLE 0.25 MG TABLET 1.50 4/1/2013 6370000121374 MYCOPHENOLATE MOFETIL 500 MG TABLET 2.32 4/1/2013 6370000121396 CEFUROXIME AXETIL 250 MG/5 ML ORAL SUSP 760.10 4/1/2013 6370000121688 ROPINIROLE 0.25 MG TABLET 3.94 4/1/2013
- Page 1 and 2: Greenwich Hospital Price Master as
- Page 3 and 4: 27200017 HC ELECTRODE TRANSVENOUS P
- Page 5 and 6: 27800067 HC STAPLER SKIN ROYAL 35 2
- Page 7 and 8: 30000464 HC ACTIVATED PROTEIN C RES
- Page 9 and 10: 30001771 HC CYSTIC FIBROSIS NEWBORN
- Page 11 and 12: 30100318 HC MOL DIA;SEP BY GEL E4,E
- Page 13 and 14: 30600038 HC PAPILLOMAVIRUS, HUMAN:A
- Page 15 and 16: 32000101 HC XR ANKLE 2 VIEWS 406.00
- Page 17 and 18: 36000178 HC BX BREAST NDL PERC W/GU
- Page 19 and 20: 40000043 HC US GUIDANCE INTRAOPERAT
- Page 21 and 22: 61000039 HC MRI UPR EXTREM JT W/O C
- Page 23 and 24: 98100016 HCPR REPAIR LAC SIMPLE SCA
- Page 25 and 26: 27250001628 SUTURE SILK 6-0 S1769K
- Page 27 and 28: 250000051465 CEFUROXIME SODIUM 750
- Page 29 and 30: 270500013282 INDERMIL TISSUE ADHESI
- Page 31 and 32: 272500012059 BLANKET WARMER BAIR HU
- Page 33 and 34: 272500015138 BLADE DIEGO SERRATED 4
- Page 35 and 36: 276500023575 LENSE SN60WF18.5 569.1
- Page 37 and 38: 278500015237 CUP BIPOLAR 5001-53-28
- Page 39 and 40: 278500232831 POLARIS STENT KIT 7FR
- Page 41 and 42: 637000017753 TEMAZEPAM 15 MG CAPSUL
- Page 43 and 44: 2500000433512 ESCITALOPRAM 10 MG TA
- Page 45: 2705000126822 TUBE VACUUM AQUILEX H
- Page 49 and 50: 6370000129858 METOPROLOL SUCCINATE
- Page 51 and 52: 25000005113667 SODIUM CHLORIDE 0.9
6370000111218 PSYLLIUM ORAL PACKET 3.00 4/1/2013<br />
6370000111239 PYRIDOSTIGMINE BROMIDE 60 MG TABLET 3.36 4/1/2013<br />
6370000111293 RIFAMPIN 300 MG CAPSULE 12.55 4/1/2013<br />
6370000111340 SELEGILINE 5 MG TABLET 8.14 4/1/2013<br />
6370000111349 SENNOSIDES 8.6 MG TABLET 3.00 4/1/2013<br />
6370000111351 SERTRALINE 50 MG TABLET 3.00 4/1/2013<br />
6370000111359 SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK 3.00 4/1/2013<br />
6370000111395 SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA 6.76 4/1/2013<br />
6370000111403 SODIUM CHLORIDE 0.9 % IRRIGATION SOLN 6.35 4/1/2013<br />
6370000111421 SOTALOL 80 MG TABLET 3.00 4/1/2013<br />
6370000111441 SUCRALFATE 100 MG/ML ORAL SUSP 14.74 4/1/2013<br />
6370000111442 SUCRALFATE 1 GRAM TABLET 3.00 4/1/2013<br />
6370000111507 TERBUTALINE 1 MG/ML SUB-Q 11.43 4/1/2013<br />
6370000111561 TIMOLOL MALEATE 0.25 % EYE DROPS 15.18 4/1/2013<br />
6370000111562 TIMOLOL MALEATE 0.5 % EYE DROPS 28.33 4/1/2013<br />
6370000111566 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT 861.38 4/1/2013<br />
6370000111567 TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE DROPS, SUSP 134.49 4/1/2013<br />
6370000111624 URSODIOL 300 MG CAPSULE 3.00 4/1/2013<br />
6370000111630 VANCOMYCIN 250 MG/5 ML ORAL SOLUTION 88.40 4/1/2013<br />
6370000111639 VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE 5.97 4/1/2013<br />
6370000111664 WARFARIN 1 MG TABLET 3.00 4/1/2013<br />
6370000111701 ZOLPIDEM 5 MG TABLET 3.00 4/1/2013<br />
6370000112024 MECLIZINE 12.5 MG TABLET 3.00 4/1/2013<br />
6370000112097 THEOPHYLLINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR 1.50 4/1/2013<br />
6370000112098 THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR 1.85 4/1/2013<br />
6370000112203 VENLAFAXINE 25 MG TABLET 3.00 4/1/2013<br />
6370000112207 VENLAFAXINE 37.5 MG TABLET 4.86 4/1/2013<br />
6370000112329 CARBIDOPA-LEVODOPA ER 25 MG-100 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013<br />
6370000112556 DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID 0.75 4/1/2013<br />
6370000112580 IPRATROPIUM BROMIDE 0.02 % SOLN FOR INHALATION 3.00 4/1/2013<br />
6370000112729 TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG CAPSULE 3.00 4/1/2013<br />
6370000113089 LISINOPRIL 2.5 MG TABLET 3.00 4/1/2013<br />
6370000113668 THEOPHYLLINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR 3.00 4/1/2013<br />
6370000113818 BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT 13.82 4/1/2013<br />
6370000113981 LAMOTRIGINE 25 MG TABLET 1.50 4/1/2013<br />
6370000113982 LAMOTRIGINE 100 MG TABLET 3.00 4/1/2013<br />
6370000114041 IPRATROPIUM-ALBUTEROL 18 MCG-103 MCG/A<strong>CT</strong>UATION AEROSOL INHALER 1,215.92 4/1/2013<br />
6370000114087 ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET 3.00 4/1/2013<br />
6370000114468 ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ELIXIR 6.28 4/1/2013<br />
6370000114471 DORZOLAMIDE 2 % EYE DROPS 288.36 4/1/2013<br />
6370000114632 TRAMADOL 50 MG TABLET 3.00 4/1/2013<br />
6370000114719 METFORMIN 850 MG TABLET 3.00 4/1/2013<br />
6370000114793 TIZANIDINE 4 MG TABLET 3.00 4/1/2013<br />
6370000114823 LOSARTAN 25 MG TABLET 3.00 4/1/2013<br />
6370000114824 LOSARTAN 50 MG TABLET 3.00 4/1/2013<br />
6370000114953 ATOVAQUONE 750 MG/5 ML ORAL SUSP 145.36 4/1/2013<br />
6370000114966 HYDROCODONE 5 MG-ACETAMINOPHEN 500 MG TABLET 3.00 4/1/2013<br />
6370000115327 SUMATRIPTAN 25 MG TABLET 10.87 4/1/2013<br />
6370000115747 CARVEDILOL 6.25 MG TABLET 3.00 4/1/2013<br />
6370000115748 CARVEDILOL 25 MG TABLET 3.00 4/1/2013<br />
6370000115749 CARVEDILOL 12.5 MG TABLET 3.00 4/1/2013<br />
6370000115797 AZITHROMYCIN 200 MG/5 ML ORAL SUSP 158.88 4/1/2013<br />
6370000116053 DESMOPRESSIN 0.2 MG TABLET 6.89 4/1/2013<br />
6370000116205 ANASTROZOLE 1 MG TABLET 3.00 4/1/2013<br />
6370000116299 DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM 12.27 4/1/2013<br />
6370000116355 GLIMEPIRIDE 1 MG TABLET 3.00 4/1/2013<br />
6370000116356 GLIMEPIRIDE 2 MG TABLET 3.00 4/1/2013<br />
6370000116439 RITONAVIR 100 MG CAPSULE 52.57 4/1/2013<br />
6370000116632 PAROXETINE 10 MG TABLET 3.40 4/1/2013<br />
6370000116958 MUPIROCIN 2 % NASAL OINTMENT 58.57 4/1/2013<br />
6370000117023 HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET 3.00 4/1/2013<br />
6370000117464 BUSPIRONE 15 MG TABLET 3.00 4/1/2013<br />
6370000117466 MIRTAZAPINE 15 MG TABLET 3.00 4/1/2013<br />
6370000117837 ALBUTEROL SULFATE HFA 90 MCG/A<strong>CT</strong>UATION AEROSOL INHALER 287.91 4/1/2013<br />
6370000117936 OLANZAPINE 5 MG TABLET 40.22 4/1/2013<br />
6370000118293 TORSEMIDE 20 MG TABLET 6.55 4/1/2013<br />
6370000118307 GABAPENTIN 400 MG CAPSULE 1.50 4/1/2013<br />
6370000118308 GABAPENTIN 300 MG CAPSULE 3.00 4/1/2013<br />
6370000118309 GABAPENTIN 100 MG CAPSULE 3.00 4/1/2013<br />
6370000118313 RISPERIDONE 1 MG TABLET 3.00 4/1/2013<br />
6370000118386 BUPROPION HCL SR 150 MG TABLET,SUSTAINED-RELEASE 4.40 4/1/2013<br />
6370000118551 CARVEDILOL 3.125 MG TABLET 3.00 4/1/2013<br />
6370000118621 LATANOPROST 0.005 % EYE DROPS 579.57 4/1/2013<br />
6370000118742 PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG TABLET 3.00 4/1/2013<br />
6370000118920 TOPIRAMATE 25 MG TABLET 1.50 4/1/2013<br />
6370000118922 TOPIRAMATE 100 MG TABLET 3.00 4/1/2013<br />
6370000119713 DIAZOXIDE 50 MG/ML ORAL SUSP 1,162.25 4/1/2013<br />
6370000119720 FLUNISOLIDE 25 MCG (0.025 %) NASAL SPRAY 236.54 4/1/2013<br />
6370000119733 KETOROLAC 0.5 % EYE DROPS 163.58 4/1/2013<br />
6370000119769 TOBRAMYCIN 0.3 % EYE OINTMENT 492.89 4/1/2013<br />
6370000120920 MORPHINE ER 15 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013<br />
6370000120921 MORPHINE ER 30 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013<br />
6370000120943 AZITHROMYCIN 250 MG TABLET 7.57 4/1/2013<br />
6370000121057 OLANZAPINE 2.5 MG TABLET 34.08 4/1/2013<br />
6370000121061 OXCARBAZEPINE 300 MG TABLET 3.00 4/1/2013<br />
6370000121062 CITALOPRAM 20 MG TABLET 1.50 4/1/2013<br />
6370000121290 PRAMIPEXOLE 0.25 MG TABLET 1.50 4/1/2013<br />
6370000121374 MYCOPHENOLATE MOFETIL 500 MG TABLET 2.32 4/1/2013<br />
6370000121396 CEFUROXIME AXETIL 250 MG/5 ML ORAL SUSP 760.10 4/1/2013<br />
6370000121688 ROPINIROLE 0.25 MG TABLET 3.94 4/1/2013
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