Greenwich Hospital Price Master - CT.gov

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6370000121800 ROPINIROLE 0.5 MG TABLET 3.92 4/1/2013 6370000121823 QUETIAPINE 25 MG TABLET 22.46 4/1/2013 6370000121824 QUETIAPINE 100 MG TABLET 38.55 4/1/2013 6370000122142 CLOPIDOGREL 75 MG TABLET 3.00 4/1/2013 6370000122251 MUPIROCIN 2 % TOPICAL CREAM 313.09 4/1/2013 6370000122257 OFLOXACIN 0.3 % EAR DROPS 50.36 4/1/2013 6370000122509 MONTELUKAST 10 MG TABLET 3.05 4/1/2013 6370000122510 MONTELUKAST 5 MG CHEWABLE TABLET 3.00 4/1/2013 6370000122560 SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSP 15.12 4/1/2013 6370000122584 REPAGLINIDE 0.5 MG TABLET 15.52 4/1/2013 6370000122783 TOLTERODINE 2 MG TABLET 19.29 4/1/2013 6370000122982 DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS 148.40 4/1/2013 6370000122992 AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET 22.75 4/1/2013 6370000123122 PROGESTERONE MICRONIZED 100 MG CAPSULE 12.81 4/1/2013 6370000124216 SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TABLET 3.00 4/1/2013 6370000124268 ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000124385 HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS 822.33 4/1/2013 6370000124470 OXYBUTYNIN CHLORIDE ER 5 MG TABLET,24 HR EXTENDED RELEASE 13.52 4/1/2013 6370000124473 CILOSTAZOL 50 MG TABLET 3.00 4/1/2013 6370000124500 CELECOXIB 100 MG CAPSULE 16.24 4/1/2013 6370000124501 CELECOXIB 200 MG CAPSULE 23.44 4/1/2013 6370000124521 ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000124576 TIMOLOL 0.5 % EYE GEL FORMING SOLN 217.24 4/1/2013 6370000124984 POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER 25.70 4/1/2013 6370000125118 CIPROFLOXACIN 250 MG TABLET 3.00 4/1/2013 6370000125119 CIPROFLOXACIN 500 MG TABLET 3.00 4/1/2013 6370000125246 AMOXICILLIN 400 MG/5 ML ORAL SUSP 23.82 4/1/2013 6370000125424 POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET 7.98 4/1/2013 6370000125519 RISPERIDONE 0.25 MG TABLET 3.00 4/1/2013 6370000125528 PIOGLITAZONE 15 MG TABLET 35.52 4/1/2013 6370000125530 PIOGLITAZONE 45 MG TABLET 58.87 4/1/2013 6370000125855 GABAPENTIN 600 MG TABLET 3.61 4/1/2013 6370000125892 TEMOZOLOMIDE 5 MG CAPSULE 62.27 4/1/2013 6370000126224 PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE 3.00 4/1/2013 6370000126225 PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE 3.00 4/1/2013 6370000126546 OSELTAMIVIR 75 MG CAPSULE 56.53 4/1/2013 6370000126755 LEVONORGESTREL 0.75 MG TABLET 88.78 4/1/2013 6370000126816 LEVETIRACETAM 250 MG TABLET 3.00 4/1/2013 6370000126817 LEVETIRACETAM 500 MG TABLET 3.38 4/1/2013 6370000126854 MOXIFLOXACIN 400 MG TABLET 78.07 4/1/2013 6370000127049 OXCARBAZEPINE 150 MG TABLET 3.00 4/1/2013 6370000127333 NIFEDIPINE ER 30 MG TABLET,24 HR EXTENDED RELEASE 6.56 4/1/2013 6370000127467 DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE 1,263.27 4/1/2013 6370000127471 NITROGLYCERIN 0.1 MG/HR TRANSDERM 24 HR PATCH 3.70 4/1/2013 6370000127472 NITROGLYCERIN 0.2 MG/HR TRANSDERM 24 HR PATCH 3.07 4/1/2013 6370000127473 NITROGLYCERIN 0.3 MG/HR TRANSDERM 24 HR PATCH 21.95 4/1/2013 6370000127474 NITROGLYCERIN 0.4 MG/HR TRANSDERM 24 HR PATCH 3.00 4/1/2013 6370000127480 DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000127505 CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERM PATCH 160.87 4/1/2013 6370000127506 CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERM PATCH 270.83 4/1/2013 6370000127630 RIZATRIPTAN 10 MG DISINTEGRATING TABLET 158.72 4/1/2013 6370000127644 DIPYRIDAMOLE-ASPIRIN ER 200 MG-25 MG MPHASE 12 HR CAPSULE,EXT.RELEASE 22.10 4/1/2013 6370000127696 SCOPOLAMINE 1.5 MG 72 HR TRANSDERM PATCH 54.93 4/1/2013 6370000127697 ONDANSETRON 4 MG DISINTEGRATING TABLET 3.00 4/1/2013 6370000127856 TAMSULOSIN ER 0.4 MG CAPSULE,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000127857 VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR 1.71 4/1/2013 6370000127860 NICOTINE 7 MG/24 HR DAILY PATCH 16.25 4/1/2013 6370000127862 NICOTINE 14 MG/24 HR DAILY PATCH 13.78 4/1/2013 6370000127863 NICOTINE 21 MG/24 HR DAILY PATCH 13.78 4/1/2013 6370000127889 PHENOL 1.4 % MUCOSAL AEROSOL SPRAY 4.58 4/1/2013 6370000127905 FENTANYL 25 MCG/HR TRANSDERM PATCH 17.39 4/1/2013 6370000127906 FENTANYL 50 MCG/HR TRANSDERM PATCH 90.63 4/1/2013 6370000127907 FENTANYL 75 MCG/HR TRANSDERM PATCH 138.49 4/1/2013 6370000127908 FENTANYL 100 MCG/HR TRANSDERM PATCH 64.42 4/1/2013 6370000127920 OXYCODONE ER 10 MG TABLET,EXTENDED RELEASE,12 HR 10.48 4/1/2013 6370000127921 OXYCODONE ER 20 MG TABLET,EXTENDED RELEASE,12 HR 20.03 4/1/2013 6370000127922 OXYCODONE ER 40 MG TABLET,EXTENDED RELEASE,12 HR 35.16 4/1/2013 6370000127993 POLYVINYL ALCOHOL 1 % EYE DROPS 56.11 4/1/2013 6370000127994 POLYVINYL ALCOHOL 1.4 % EYE DROPS 9.82 4/1/2013 6370000127999 SODIUM POLYSTYRENE SULFONATE 15 GRAM/60 ML ORAL SUSP 36.58 4/1/2013 6370000128159 OLANZAPINE 5 MG DISINTEGRATING TABLET 59.44 4/1/2013 6370000128188 CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID 17.99 4/1/2013 6370000128203 LIDOCAINE 5 % (700 MG/PATCH) ADHESIVE PATCH 42.75 4/1/2013 6370000128224 LINEZOLID 600 MG TABLET 544.17 4/1/2013 6370000128357 FERRIC SUBSULFATE 259 MG/G TOPICAL SOLN 71.53 4/1/2013 6370000128810 NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS, SUSP 50.23 4/1/2013 6370000128824 HYDROCORTISONE 2.5 % RECTAL CREAM 21.15 4/1/2013 6370000128827 ZINC OXIDE 16 % TOPICAL OINTMENT 13.16 4/1/2013 6370000128836 MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP 3.00 4/1/2013 6370000128900 OXYCODONE 30 MG TABLET 2.09 4/1/2013 6370000128970 BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION AEROSOL INHALER 621.12 4/1/2013 6370000129272 DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000129274 DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000129276 DILTIAZEM CD 300 MG CAPSULE,EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000129302 PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML ORAL SOLN 5.20 4/1/2013 6370000129346 DILTIAZEM ER (XR/XT) 120 MG CAPSULE,EXTENDED RELEASE,CONTROLLED 3.00 4/1/2013 6370000129424 CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM 105.54 4/1/2013 6370000129434 TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR 31.94 4/1/2013 6370000129676 SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL 3.64 4/1/2013 6370000129778 ZIPRASIDONE 20 MG CAPSULE 50.38 4/1/2013
6370000129858 METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR 5.86 4/1/2013 6370000130070 METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR 5.35 4/1/2013 6370000130510 IPRATROPIUM-ALBUTEROL 0.5 MG-3 MG(2.5 MG BASE)/3 ML NEB SOLUTION 3.00 4/1/2013 6370000130961 CALCIUM ACETATE 667 MG CAPSULE 3.00 4/1/2013 6370000131158 BRIMONIDINE 0.15 % EYE DROPS 350.59 4/1/2013 6370000131177 AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSP 60.96 4/1/2013 6370000131209 VALSARTAN 80 MG TABLET 18.79 4/1/2013 6370000131578 ALBUTEROL SULFATE 1.25 MG/3 ML NEB SOLUTION 3.75 4/1/2013 6370000131921 ENOXAPARIN 120 MG/0.8 ML SUB-Q SYRINGE 17.27 4/1/2013 6370000132215 FONDAPARINUX 2.5 MG/0.5 ML SUB-Q SYRINGE 23.13 4/1/2013 6370000132267 PEGFILGRASTIM 6 MG/0.6 ML SUB-Q SYRINGE 18,092.86 4/1/2013 6370000132893 LEUPROLIDE 7.5 MG SUB-Q SYRINGE 794.89 4/1/2013 6370000133227 AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET 4.88 4/1/2013 6370000133228 AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET 4.77 4/1/2013 6370000133512 ESCITALOPRAM 10 MG TABLET 22.78 4/1/2013 6370000133669 LEUPROLIDE 22.5 MG SUB-Q SYRINGE 794.91 4/1/2013 6370000134089 DUTASTERIDE 0.5 MG CAPSULE 22.88 4/1/2013 6370000134153 EZETIMIBE 10 MG TABLET 24.89 4/1/2013 6370000134370 ARIPIPRAZOLE 15 MG TABLET 110.71 4/1/2013 6370000134505 HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET 3.00 4/1/2013 6370000134594 LANSOPRAZOLE 15 MG DELAYED RELEASE,DISINTEGRATING TABLET 40.12 4/1/2013 6370000134595 LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET 40.12 4/1/2013 6370000134711 BUPRENORPHINE 2 MG SUBLINGUAL TABLET 7.67 4/1/2013 6370000134713 BUPRENORPHINE-NALOXONE 2 MG-0.5 MG SUBLINGUAL TABLET 32.71 4/1/2013 6370000134714 BUPRENORPHINE-NALOXONE 8 MG-2 MG SUBLINGUAL TABLET 58.62 4/1/2013 6370000134769 NICOTINE (POLACRILEX) 2 MG BUCCAL LOZENGE 3.00 4/1/2013 6370000134814 NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR SOLN 63.95 4/1/2013 6370000135134 ROSUVASTATIN 10 MG TABLET 22.00 4/1/2013 6370000135236 LEUPROLIDE (4 MONTH) 30 MG SUB-Q SYRINGE 794.91 4/1/2013 6370000135699 MOXIFLOXACIN 0.5 % EYE DROPS 513.97 4/1/2013 6370000135943 POTASSIUM CHLORIDE ER 20 MEQ TABLET,EXTENDED RELEASE(PART/CRYST) 3.00 4/1/2013 6370000136386 SODIUM CITRATE ORAL SOLN 7.24 4/1/2013 6370000136438 ARIPIPRAZOLE 5 MG TABLET 110.71 4/1/2013 6370000136590 LEVETIRACETAM 100 MG/ML ORAL SOLN 26.45 4/1/2013 6370000136612 ROSUVASTATIN 5 MG TABLET 22.00 4/1/2013 6370000136775 BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE 3.80 4/1/2013 6370000136959 AMIODARONE 100 MG TABLET 14.55 4/1/2013 6370000136962 DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID 3.00 4/1/2013 6370000136966 MEMANTINE 10 MG TABLET 20.95 4/1/2013 6370000137068 LANOLIN TOPICAL CREAM 19.03 4/1/2013 6370000137170 MEMANTINE 5 MG TABLET 24.52 4/1/2013 6370000137182 FOSAMPRENAVIR 700 MG TABLET 75.49 4/1/2013 6370000137371 GLYCERIN-SODIUM HYALURONATE TOPICAL GEL 20.19 4/1/2013 6370000137635 ESCITALOPRAM 5 MG TABLET 20.10 4/1/2013 6370000137637 METOPROLOL TARTRATE 25 MG TABLET 3.00 4/1/2013 6370000137649 GLIPIZIDE ER 5 MG TABLET, EXTENDED RELEASE 24 HR 3.00 4/1/2013 6370000137651 GUAIFENESIN ER 600 MG TABLET,EXTENDED RELEASE 3.00 4/1/2013 6370000138092 ARTIFICIAL TEAR (GONIOSCOPIC HYPROMELLOSE) 2.5 % EYE DROPS 38.30 4/1/2013 6370000138285 ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP 4.39 4/1/2013 6370000138315 TIOTROPIUM BROMIDE 18 MCG CAPSULE WITH INHALATION DEVICE 82.00 4/1/2013 6370000138421 MIRTAZAPINE 7.5 MG TABLET 3.00 4/1/2013 6370000138701 NEOMYCIN-BACITRACIN-POLYMYXIN 3.5 MG-400 UNIT-10,000 UNIT/G EYE OINT 221.50 4/1/2013 6370000138978 B COMPLEX-VITAMIN C-FOLIC ACID 1 MG CAPSULE 3.43 4/1/2013 6370000139063 RIFAXIMIN 200 MG TABLET 48.58 4/1/2013 6370000139136 NYSTATIN 100,000 UNIT/G TOPICAL POWDER 16.86 4/1/2013 6370000139255 EMTRICITABINE-TENOFOVIR 200 MG-300 MG TABLET 234.64 4/1/2013 6370000139275 DULOXETINE 20 MG CAPSULE,DELAYED RELEASE 30.00 4/1/2013 6370000139276 DULOXETINE 30 MG CAPSULE,DELAYED RELEASE 33.63 4/1/2013 6370000139277 DULOXETINE 60 MG CAPSULE,DELAYED RELEASE 33.63 4/1/2013 6370000139803 FONDAPARINUX 7.5 MG/0.6 ML SUB-Q SYRINGE 22.53 4/1/2013 6370000140009 FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET 10.74 4/1/2013 6370000140369 MESALAMINE 1,000 MG RECTAL SUPPOSITORY 105.41 4/1/2013 6370000140697 FLUTICASONE 44 MCG/ACTUATION AEROSOL INHALER 671.83 4/1/2013 6370000140698 FLUTICASONE 110 MCG/ACTUATION AEROSOL INHALER 899.55 4/1/2013 6370000140699 FLUTICASONE 220 MCG/ACTUATION AEROSOL INHALER 1,397.28 4/1/2013 6370000141135 DONEPEZIL 5 MG DISINTEGRATING TABLET 6.64 4/1/2013 6370000141136 DONEPEZIL 10 MG DISINTEGRATING TABLET 5.71 4/1/2013 6370000141142 IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER 1,105.61 4/1/2013 6370000141382 FENTANYL 12 MCG/HR TRANSDERM PATCH 94.23 4/1/2013 6370000141497 PARICALCITOL 1 MCG CAPSULE 56.73 4/1/2013 6370000142163 PREGABALIN 50 MG CAPSULE 18.74 4/1/2013 6370000142164 PREGABALIN 75 MG CAPSULE 18.74 4/1/2013 6370000143391 LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET 36.74 4/1/2013 6370000143556 DIGOXIN 50 MCG/ML ORAL SOLN 3.00 4/1/2013 6370000170306 ARIPIPRAZOLE 2 MG TABLET 110.72 4/1/2013 6370000170434 RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR 22.90 4/1/2013 6370000170536 FLUTICASONE 50 MCG/ACTUATION NASAL SPRAY, SUSP 109.12 4/1/2013 6370000176988 HYDROCHLOROTHIAZIDE 12.5 MG TABLET 3.00 4/1/2013 6370000177411 CAFFEINE CITRATED 60 MG/3 ML (20 MG/ML) ORAL SOLN 5.97 4/1/2013 6370000177615 SITAGLIPTIN 25 MG TABLET 41.84 4/1/2013 6370000177616 SITAGLIPTIN 50 MG TABLET 41.84 4/1/2013 6370000177617 SITAGLIPTIN 100 MG TABLET 41.84 4/1/2013 6370000177664 CARVEDILOL PHOSPHATE ER 10 MG CAPSULE,EXT.RELEASE24HR MULTIPHASE 26.33 4/1/2013 6370000177665 CARVEDILOL PHOSPHATE ER 20 MG CAPSULE,EXT.RELEASE24HR MULTIPHASE 26.33 4/1/2013 6370000177667 CARVEDILOL PHOSPHATE ER 80 MG CAPSULE,EXT.RELEASE24HR MULTIPHASE 26.33 4/1/2013 6370000177725 METOCLOPRAMIDE 5 MG/5 ML ORAL SOLN 4.89 4/1/2013 6370000177790 PREDNISOLONE 10 MG DISINTEGRATING TABLET 37.65 4/1/2013 6370000177822 BECLOMETHASONE DIPROPIONATE (AQUEOUS) 42 MCG (0.042 %) NASAL SPRAY 820.27 4/1/2013 6370000178653 ALISKIREN 150 MG TABLET 16.43 4/1/2013 6370000181453 BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER 617.93 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 and 46: 2705000126822 TUBE VACUUM AQUILEX H
Page 47: 6370000111218 PSYLLIUM ORAL PACKET
Page 51 and 52: 25000005113667 SODIUM CHLORIDE 0.9

Greenwich Hospital Price Master - CT.gov

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