Chemotherapy Agent list.xlsx
XLSX spreadsheet 494 KB Posted
- Solicitation number
- 36C26025Q0047
About this file
This document is a solicitation (Solicitation Number: 36C26025Q0047) for the provision of pharmacy compounding products and services by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 20 (VHA VISN 20). The solicitation is for a contingency requirement to ensure availability of compounded medications for the Boise VA. Key details include the requirement for various chemotherapy agents, electrolytes, IV fluids, and other pharmaceutical products to be provided on an as-needed basis. The solicitation has an estimated period of performance of one year with four one-year option periods. Pricing terms include both per-unit and per-liter/milliliter costs. There are no set-asides indicated in the document. The closing date for responses is June 30, 2025.
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Text version
Chemo Agent List
| Name | Brand Name | Generic Name | NDC | HCPC | Ordering Period 1 Price Each | Cost x 1.5 Supplies (Price Codes 02,05,14,16,17) | Ordering Period 2 Price Each | Ordering Period 3 Price Each | Ordering Period 4 Price Each | Ordering Period 5 Price Each | Price Code | Drug Category | Medi Span Unit Each | Metric Units Each | NDC Unit Qual | Therapy Type | Route |
| Reclast Inj Sol 5mg/100ml | Reclast | Zoledronic Acid | 00078043561 | J3489 | 1,570.86 | 15 | Bisphosphonate | ML | 100.00 | ML | IV | ||||||
| Zoledronic Acid Inj Conc 4mg/5ml | Zoledronic Acid | Zoledronic Acid | 55111068507 | J3489 | 90.00 | 15 | Bisphosphonate | ML | 5.00 | ML | IV | ||||||
| Zoledronic Acid Inj Conc 4mg/5ml | Zoledronic Acid | Zoledronic Acid | 67457039054 | J3489 | 52.80 | 15 | Bisphosphonate | ML | 5.00 | ML | IV | ||||||
| Zoledronic Acid Inj Conc 4mg/5ml | Zoledronic Acid | Zoledronic Acid | 00409421501 | J3489 | 53.59 | 15 | Bisphosphonate | ML | 5.00 | ML | IV | ||||||
| Zoledronic Acid Inj Conc 4mg/5ml | Zoledronic Acid | Zoledronic Acid | 16729024231 | J3489 | 838.29 | 15 | Bisphosphonate | ML | 5.00 | ML | IV | ||||||
| Zoledronic Acid Inj Conc 4mg/5ml | Zoledronic Acid | Zoledronic Acid | 69367019050 | J3489 | 838.29 | 15 | Bisphosphonate | ML | 5.00 | ML | IV | ||||||
| Zoledronic Acid Inj Conc 4mg/5ml | Zoledronic Acid | Zoledronic Acid | 54288010001 | J3489 | 45.00 | 15 | Bisphosphonate | ML | 5.00 | ML | IV | ||||||
| Zoledronic Acid Inj Sol 5mg/100ml | Zoledronic Acid | Zoledronic Acid | 55111068852 | J3489 | 360.00 | 15 | Bisphosphonate | ML | 100.00 | ML | IV | ||||||
| Zoledronic Acid Inj Sol 5mg/100ml | Zoledronic Acid | Zoledronic Acid | 25021083082 | J3489 | 420.00 | 15 | Bisphosphonate | ML | 100.00 | ML | IV | ||||||
| Zoledronic Acid Inj Sol 5mg/100ml | Zoledronic Acid | Zoledronic Acid | 67457061910 | J3489 | 282.00 | 15 | Bisphosphonate | ML | 100.00 | ML | IV | ||||||
| Zoledronic Acid Inj Sol 5mg/100ml | Zoledronic Acid | Zoledronic Acid | 67457079410 | J3489 | 132.00 | 15 | Bisphosphonate | ML | 100.00 | ML | IV | ||||||
| Zinc Sulfate Inj Sol 1mg/ml 10ml | Zinc Sulfate | Zinc Sulfate | 65219040101 | J3490 | 16.80 | 07 | Electrolyte | ML | 10.00 | ML | IV | ||||||
| Sterile Water for Irriga 1000ml Btl | Sterile Water for Irrigation | Water For Irrigation Sterile | 00338000404 | A4217 | 4.86 | ERROR:#REF! | 05 | Irrigation | ML | 1000.00 | ML | ||||||
| Sterile Water for Irriga 250ml Btl | Sterile Water for Irrigation | Water For Irrigation Sterile | 00338000402 | A4217 | 5.65 | ERROR:#REF! | 05 | Irrigation | ML | 250.00 | ML | IRR | |||||
| Sterile Water for Irriga 500ml Btl | Sterile Water for Irrigation | Water For Irrigation Sterile | 00338000403 | A4217 | 5.45 | ERROR:#REF! | 05 | Irrigation | ML | 500.00 | ML | IRR | |||||
| Sterile Water for Irrigation 1000ml | Sterile Water for Irrigation | Water For Irrigation Sterile | 00264210100 | A4217 | 4.40 | ERROR:#REF! | 05 | Irrigation | ML | 1000.00 | ML | TOP | |||||
| Sterile Water for Irrigation 250ml | Sterile Water for Irrigation | Water For Irrigation Sterile | 00990613922 | A4217 | 6.30 | ERROR:#REF! | 05 | Irrigation | ML | 250.00 | ML | IRR | |||||
| Sterile Water for Irrigation 500ml | Water For Irrigation, Sterile | Water For Irrigation Sterile | 00264210110 | A4217 | 3.90 | ERROR:#REF! | 05 | Irrigation | ML | 500.00 | ML | IRR | |||||
| Sterile Water 1000ml Baxter | Sterile Water for Injection | Water For Injection Sterile | 00338001304 | A4217 | 11.58 | 07 | IV Fluids | ML | 1000.00 | ML | IV | ||||||
| Sterile Water 2000ml | Sterile Water for Injection | Water For Injection Sterile | 00338001306 | A4217 | 8.16 | 07 | TPN Base | ML | 2000.00 | ML | IV | ||||||
| Sterile Water 3000ml | Sterile Water for Injection | Water For Injection Sterile | 00338001308 | A4217 | 14.46 | 07 | TPN Base | ML | 3000.00 | ML | IV | ||||||
| Sterile Water 5000ml | Sterile Water for Injection | Water For Injection Sterile | 00338001329 | A4217 | 24.35 | 07 | TPN Base | ML | 5000.00 | ML | IV | ||||||
| Sterile Water for Inj PFS 10ml | Sterile Water for Injection | Water For Injection Sterile | 64253002030 | A4216 | 1.60 | ERROR:#REF! | 05 | IV Fluids | ML | 10.00 | ML | IV | |||||
| Sterile Water for Injection 10ml | Sterile Water for Injection | Water For Injection Sterile | 00409488710 | A4216 | 1.25 | ERROR:#REF! | 05 | IV Fluids | ML | 10.00 | ML | IV | |||||
| Sterile Water for Injection 10ml | Sterile Water for Injection | Water For Injection Sterile | 63323018510 | A4216 | 5.27 | ERROR:#REF! | 05 | IV Fluids | ML | 10.00 | ML | IV | |||||
| Sterile Water for Injection 20ml | Sterile Water for Injection | Water For Injection Sterile | 00409488720 | A4216 | 1.76 | ERROR:#REF! | 05 | IV Fluids | ML | 20.00 | ML | IV | |||||
| Sterile Water for Injection 20ml | Sterile Water for Injection | Water For Injection Sterile | 63323018520 | A4216 | 6.88 | ERROR:#REF! | 05 | IV Fluids | ML | 20.00 | ML | IV | |||||
| Sterile Water for Injection 50ml | Sterile Water for Injection | Water For Injection Sterile | 63323018550 | A4216 | 8.92 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sterile Water for Injection 100ml | Water For Injection Sterile | Water For Injection Sterile | 00409488799 | A4217 | 5.96 | ERROR:#REF! | 05 | IV Fluids | ML | 100.00 | ML | IV | |||||
| Bacteriostatic H2O for Inj 30ml | Bacteriostatic Water for Inj | Water For Inject Bacteriostat | 00409397703 | A4216 | 2.28 | ERROR:#REF! | 16 | IV Fluids | ML | 30.00 | ML | IV | |||||
| Voriconazole Inj 200mg | Voriconazole | Voriconazole | 71288002730 | J3465 | 42.00 | 01 | Antifungal | EA | 1.00 | UN | IV | ||||||
| Pyridoxine HCl Inj Sol 100mg/ml | Pyridoxine HCl | Vitamin B-6 | 67457028101 | J3415 | 18.24 | 01 | PN Additive | ML | 1.00 | ML | IV | ||||||
| Cyanocobalamin Inj Sol 1000mcg/ml | Cyanocobalamin | Vitamin B-12 | 70069000510 | J3420 | 4.45 | 01 | PN Additive | ML | 1.00 | ML | IM/IV | ||||||
| Cyanocobalamin Inj Sol 1000mcg/ml | Cyanocobalamin | Vitamin B-12 | 63323004444 | J3420 | 3.86 | 01 | PN Additive | ML | 1.00 | ML | INJ | ||||||
| Cyanocobalamin Inj Sol 1000mcg/ml | Cyanocobalamin | Vitamin B-12 | 69680011225 | J3420 | 3.86 | 01 | PN Additive | ML | 1.00 | ML | IM | ||||||
| Thiamine HCl Inj Sol 200mg/2ml | Thiamine HCl | Vitamin B-1 | 72603013925 | J3411 | 11.29 | 08 | PN Additive | ML | 2.00 | ML | IV | ||||||
| Abraxane Inj 100mg | Abraxane | PACLitaxel Protein-Bound Part | 68817013450 | J9264 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Acetaminophen Tab 325mg UD | Acetaminophen | Acetaminophen | 00904677361 | A9150 | 0.06 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | OTHER | PO | ||||
| Alimta Inj 100mg | Alimta | PEMEtrexed Disodium | 00002764001 | J9305 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Alimta Inj 500mg | Alimta | PEMEtrexed Disodium | 00002762301 | J9305 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| AzaCITIDine Inj 100mg | AzaCITIDine | AzaCITIDine | 00781325394 | J9025 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| AzaCITIDine Inj 100mg | AzaCITIDine | AzaCITIDine | 72485020101 | J9025 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Vancomycin HCl Inj 750mg/150ml | Vancomycin HCl | Vancomycin HCl | 70594005603 | J3372 | 14.40 | 01 | Antibiotic | ML | 150.00 | ML | |||||||
| Valproate Sod Inj 500mg/5ml | Valproate Sodium | Valproate Sodium | 63323049416 | J3490 | 2.47 | 01 | CNS Agent | ML | 5.00 | ML | IV | ||||||
| Triamcinolone Acet Inj 40mg/ml 1ml | Triamcinolone Acetonide | Triamcinolone Acetonide | 70121104902 | J3301 | 10.20 | 01 | Hormonal Agent | ML | 1.00 | ML | IV | ||||||
| Triamcinolone Acet Inj 40mg/ml 5ml | Triamcinolone Acetonide | Triamcinolone Acetonide | 70121116801 | J3301 | 52.02 | 01 | Hormonal Agent | ML | 5.00 | ML | |||||||
| AzaCITIDine Inj 100mg | AzaCITIDine | AzaCITIDine | 16729030610 | J9025 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Trazimera Inj 150mg | Trazimera | Trastuzumab-qyyp | 00069030801 | Q5116 | 1,453.32 | 01 | Immunomodulator | EA | 1.00 | UN | IV | ||||||
| Trazimera Inj 420mg | Trazimera | Trastuzumab-qyyp | 00069030501 | Q5116 | 4,069.30 | 01 | Immunomodulator | EA | 1.00 | UN | IV | ||||||
| Herzuma Inj 420mg | Herzuma | Trastuzumab-pkrb | 63459030547 | Q5113 | 4,712.40 | 01 | Immunomodulator | EA | 1.00 | UN | IV | ||||||
| AzaCITIDine Inj 100mg | AzaCITIDine | AzaCITIDine | 71288011530 | J9025 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Kanjinti Inj Sol 150mg | Kanjinti | Trastuzumab-anns | 55513014101 | Q5117 | 1,632.08 | 01 | Immunomodulator | EA | 1.00 | UN | IV | ||||||
| AzaCITIDine Inj 100mg | AzaCITIDine | AzaCITIDine | 43598046562 | J9025 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | |||||||
| Tranexamic Acid Inj Sol 1000mg/10ml | Tranexamic Acid | Tranexamic Acid | 81284061110 | J3490 | 6.60 | 01 | Antifibrinolytic | ML | 10.00 | ML | |||||||
| Tranexamic Acid Inj Sol 1000mg/10ml | Tranexamic Acid | Tranexamic Acid | 72485010710 | J3490 | 13.80 | 01 | Antifibrinolytic | ML | 10.00 | ML | |||||||
| Multrys-4 Inj Sol 1ml | Multrys | Trace Minerals Cu-Mn-Se-Zn | 00517930225 | J3490 | 28.62 | 07 | Electrolyte | ML | 1.00 | ML | |||||||
| Belrapzo Inj Sol 100mg/4ml | Belrapzo | Bendamustine HCl | 42367052125 | J9036 | 01 | Antineoplastic | ML | 4.00 | ML | CHEMO | IV | ||||||
| MIC, EXT 12in Bolus 30cm | B9998 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| Bendeka Inj Sol 100mg/4ml | Bendeka | Bendamustine HCl | 63459034804 | J9034 | 01 | Antineoplastic | ML | 4.00 | ML | CHEMO | IV | ||||||
| Topotecan HCl Inj Sol 4mg/4ml | Topotecan HCl | Topotecan HCl | 16729024331 | J9351 | 519.25 | 01 | Antineoplastic | ML | 4.00 | ML | IV | ||||||
| Recothrom Thrmb Topical 5000units | Recothrom | Thrombin (Recombinant) | 00338032201 | J3590 | 103.20 | ERROR:#REF! | 14 | Coagulant | EA | 1.00 | UN | TOP | |||||
| Thiamine HCl Inj Sol 200mg/2ml | Thiamine HCl | Thiamine HCl | 67457019602 | J3411 | 10.67 | 08 | PN Additive | ML | 2.00 | ML | IV | ||||||
| Thiamine HCl Inj Sol 200mg/2ml | Thiamine HCl | Thiamine HCl | 00641622825 | J3411 | 11.94 | 08 | PN Additive | ML | 2.00 | ML | IV | ||||||
| Thiamine HCl Inj Sol 200mg/2ml | Thiamine HCl | Thiamine HCl | 25021050002 | J3411 | 11.94 | 08 | PN Additive | ML | 2.00 | ML | IV | ||||||
| Thiamine HCl Inj Sol 200mg/2ml | Thiamine HCl | Thiamine HCl | 55150027325 | J3411 | 7.89 | 08 | PN Additive | ML | 2.00 | ML | IV | ||||||
| Bleomycin Sulfate Inj 15units | Bleomycin Sulfate | Bleomycin Sulfate | 71288010610 | J9040 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Sterile Water 1000ml | Sterile Water for Injection | Sterile Water for Injection | 00264785000 | A4217 | 5.18 | ERROR:#REF! | 05 | IV Fluids | ML | 1000.00 | ML | IV | |||||
| Sterile Water 500ml | Sterile Water for Injection | Sterile Water for Injection | 00264785010 | A4217 | 4.71 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Sterile Water for Injection 50ml | Sterile Water for Injection | Sterile Water for Injection | 00409488750 | A4216 | 3.21 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sodium Phosphate3mm/ml 50ml | Sodium Phosphate | Sodium Phosphate | 63323088656 | J3490 | 164.84 | 07 | Electrolyte | ML | 50.00 | ML | IV | ||||||
| Sod Chl 0.9% 5ml Flush | Sodium Chloride Flush | Sodium Chloride Flush | 08881570125 | A4216 | 0.67 | ERROR:#REF! | 16 | Flush Solution | ML | 5.00 | ML | IV | |||||
| Normal Saline Flush 10ml *SF* BX | Sodium Chloride 0.9% Syringe *SF* | Sodium Chloride 0.9% Syringe *SF* | 08290306553 | A4216 | 1.48 | ERROR:#REF! | 16 | Flush Solution | ML | 10.00 | ML | ||||||
| Normal Saline Flush 10ml *SF* CS | Sodium Chloride 0.9% Syringe *SF* | Sodium Chloride 0.9% Syringe *SF* | 08290306553 | A4216 | 1.48 | ERROR:#REF! | 16 | Flush Solution | ML | 10.00 | ML | IV | |||||
| Normal Saline Flush 10ml | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 63807010010 | A4216 | 3.59 | ERROR:#REF! | 16 | Flush Solution | ML | 10.00 | ML | IV | |||||
| Normal Saline Flush 10ml BX | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 08290306547 | A4216 | 0.62 | ERROR:#REF! | 16 | Flush Solution | ML | 10.00 | ML | IV | |||||
| Normal Saline Flush 10ml BX | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 08290306546 | A4216 | 0.62 | ERROR:#REF! | 16 | Flush Solution | ML | 10.00 | ML | IV | |||||
| Normal Saline Flush 10ml CS | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 08290306546 | A4216 | 0.62 | ERROR:#REF! | 16 | Flush Solution | ML | 10.00 | ML | IV | |||||
| Normal Saline Flush 3ml BX | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 08290306544 | A4216 | 0.55 | ERROR:#REF! | 16 | Flush Solution | ML | 3.00 | ML | IV | |||||
| Normal Saline Flush 5ml BX | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 08290306545 | A4216 | 0.55 | ERROR:#REF! | 16 | Flush Solution | ML | 5.00 | ML | IV | |||||
| Normal Saline Flush 5ml CS | Sodium Chloride 0.9% Syringe | Sodium Chloride 0.9% Syringe | 08290306545 | A4216 | 0.55 | ERROR:#REF! | 16 | Flush Solution | ML | 5.00 | ML | IV | |||||
| Sodium Chloride 0.45% Inj 1000ml | Sodium Chloride 0.45% | Sodium Chloride 0.45% | 00264780200 | J3490 | 4.68 | ERROR:#REF! | 05 | IV Fluids | ML | 1000.00 | ML | IV | |||||
| Sodium Chloride 0.45% Inj 500ml | Sodium Chloride 0.45% | Sodium Chloride 0.45% | 00338004303 | J3490 | 5.66 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Sodium Chloride 0.45% Inj 500ml | Sodium Chloride 0.45% | Sodium Chloride 0.45% | 63323062655 | J3490 | 4.80 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Sodium Chloride Irrig 0.9% 250ml | Sodium Chloride | Sodium Chloride (GU Irrigant) | 00338004802 | A4217 | 5.28 | ERROR:#REF! | 05 | Irrigation | ML | 250.00 | ML | IRR | |||||
| Sodium Chloride Irrig 0.9% 250ml | Sodium Chloride | Sodium Chloride (GU Irrigant) | 57896000225 | A4217 | 1.37 | ERROR:#REF! | 05 | Irrigation | ML | 250.00 | ML | IRR | |||||
| Sodium Chloride Irrig 0.9% 500ml | Sodium Chloride | Sodium Chloride (GU Irrigant) | 00990613803 | A4217 | 6.30 | ERROR:#REF! | 05 | Irrigation | ML | 500.00 | ML | IRR | |||||
| Sodium Chloride Irrig 0.9% 250ml | Sodium Chloride (GU Irrigant) | Sodium Chloride (GU Irrigant) | 00409613822 | A4217 | 6.30 | ERROR:#REF! | 05 | Irrigation | ML | 250.00 | ML | IRR | |||||
| Sodium Chloride Irrig 0.9% 250ml | Sodium Chloride (GU Irrigant) | Sodium Chloride (GU Irrigant) | 00990613822 | A4217 | 6.30 | ERROR:#REF! | 05 | Irrigation | ML | 250.00 | ML | ||||||
| Sodium Chloride Irrig 0.9% 1000ml | Sodium Chloride Irrigant | Sodium Chloride (GU Irrigant) | 00409713809 | A4217 | 6.30 | ERROR:#REF! | 05 | Irrigation | ML | 1000.00 | ML | TOP | |||||
| Sodium Chloride 4meq/ml 200ml | Sodium Chloride | Sodium Chloride | 63323009963 | J7131 | 45.85 | 07 | Electrolyte | ML | 200.00 | ML | IV | ||||||
| Sodium Chloride 4meq/ml 200ml(Hang) | Sodium Chloride | Sodium Chloride | 63323009963 | J7131 | 45.85 | 07 | Electrolyte | ML | 200.00 | ML | IV | ||||||
| Sodium Chloride 4meq/ml 30ml(Hang) | Sodium Chloride | Sodium Chloride | 63323009330 | J7131 | 8.05 | 07 | Electrolyte | ML | 30.00 | ||||||||
| Sodium Chloride 0.9% Inj 1000ml | Sodium Chloride 0.9% | Sodium Chloride | 00264780009 | J7030 | 3.28 | ERROR:#REF! | 05 | IV Fluids | ML | 1000.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 100ml | Sodium Chloride 0.9% | Sodium Chloride | 00338004948 | A4217 | 3.29 | ERROR:#REF! | 05 | IV Fluids | ML | 100.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 100ml MB+ | Sodium Chloride 0.9% | Sodium Chloride | 00338055318 | A4217 | 8.00 | ERROR:#REF! | 05 | IV Fluids | ML | 100.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 100ml Mult | Sodium Chloride 0.9% | Sodium Chloride | 00338004938 | A4217 | 3.08 | ERROR:#REF! | 05 | IV Fluids | ML | 100.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 100ml PAB | Sodium Chloride 0.9% | Sodium Chloride | 00264180032 | A4217 | 3.26 | ERROR:#REF! | 05 | IV Fluids | ML | 100.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 100ml Quad | Sodium Chloride 0.9% | Sodium Chloride | 00338004918 | A4217 | 3.17 | ERROR:#REF! | 05 | IV Fluids | ML | 100.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 10ml PF | Sodium Chloride 0.9% | Sodium Chloride | 00409488810 | A4216 | 1.13 | ERROR:#REF! | 05 | IV Fluids | ML | 10.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 150ml | Sodium Chloride 0.9% | Sodium Chloride | 00990798361 | A4217 | 6.30 | ERROR:#REF! | 05 | IV Fluids | ML | 150.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 20ml PF | Sodium Chloride 0.9% | Sodium Chloride | 00409488820 | A4216 | 1.57 | ERROR:#REF! | 05 | IV Fluids | ML | 20.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 250ml | Sodium Chloride 0.9% | Sodium Chloride | 00338004902 | J7050 | 5.14 | ERROR:#REF! | 05 | IV Fluids | ML | 250.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 250ml | Sodium Chloride 0.9% | Sodium Chloride | 00264780020 | A4217 | 3.45 | ERROR:#REF! | 05 | IV Fluids | ML | 250.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 25ml | Sodium Chloride 0.9% | Sodium Chloride | 00990798420 | A4217 | 2.66 | ERROR:#REF! | 05 | IV Fluids | ML | 25.00 | ML | ||||||
| Sodium Chloride 0.9% Inj 500ml | Sodium Chloride 0.9% | Sodium Chloride | 00338004903 | J7040 | 5.06 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Bolus Feeding Set 12in | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| Sodium Chloride 0.9% Inj 500ml | Sodium Chloride 0.9% | Sodium Chloride | 00264780010 | A4217 | 4.06 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Bolus Feeding Tube 24Fr | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| Sodium Chloride 0.9% Inj 50ml | Sodium Chloride 0.9% | Sodium Chloride | 00264180031 | A4217 | 3.24 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 50ml | Sodium Chloride 0.9% | Sodium Chloride | 00338004941 | A4217 | 3.06 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 50ml MB+ | Sodium Chloride 0.9% | Sodium Chloride | 00338055311 | A4217 | 8.00 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 50ml Multi | Sodium Chloride 0.9% | Sodium Chloride | 00338004931 | A4217 | 2.83 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 50ml Quad | Sodium Chloride 0.9% | Sodium Chloride | 00338004911 | A4217 | 3.17 | ERROR:#REF! | 05 | IV Fluids | ML | 50.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj 10ml PF | Sodium Chloride 0.9% (PF) | Sodium Chloride | 63323018610 | A4216 | 1.22 | ERROR:#REF! | 05 | IV Fluids | ML | 10.00 | ML | IV | |||||
| Sodium Chloride 0.9% Inj Bact 30ml | Sodium Chloride 0.9% Bact | Sodium Chloride | 00409196607 | A4216 | 1.46 | ERROR:#REF! | 05 | IV Fluids | ML | 30.00 | ML | IV | |||||
| Sodium Chloride 3% Inj 500ml | Sodium Chloride 3% | Sodium Chloride | 00338005403 | J7131 | 7.62 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Sodium Chloride 3% Inj 500ml | Sodium Chloride 3% | Sodium Chloride | 00264780510 | J7131 | 6.27 | ERROR:#REF! | 05 | IV Fluids | ML | 500.00 | ML | IV | |||||
| Sodium Bicarbonate 8.4% 1meq/ml | Sodium Bicarbonate | Sodium Bicarbonate | 63323008950 | J3490 | 29.81 | 01 | Electrolyte | ML | 50.00 | ML | IV | ||||||
| Sodium Acetate 2meq/ml 100ml | Sodium Acetate | Sodium Acetate | 69784023110 | J3490 | 29.86 | 07 | Electrolyte | ML | 100.00 | ML | IV | ||||||
| Sodium Acetate 2meq/ml 100ml(Hang) | Sodium Acetate | Sodium Acetate | 69784023110 | J3490 | 29.86 | 07 | Electrolyte | ML | 100.00 | ML | IV | ||||||
| Sodium Acetate 2meq/ml 50ml | Sodium Acetate | Sodium Acetate | 69784023010 | J3490 | 21.80 | 07 | Electrolyte | ML | 50.00 | ML | IV | ||||||
| Sodium Acetate 2meq/ml 50ml(Hang) | Sodium Acetate | Sodium Acetate | 69784023010 | J3490 | 21.80 | 07 | Electrolyte | ML | 50.00 | ML | IV | ||||||
| Skin Refrigerant Medi-First Spray | Skin Refrigerant Medi-First Spray | Skin Refrigerant Medi-First Spray | A9150 | 32.00 | ERROR:#REF! | 14 | Topical | ML | 118.00 | ML | TOP | ||||||
| Bacteriostatic Sodium Chloride 10ml | Bacteriostatic Sodium Chloride | Saline-Benzyl Alcohol | 63323092410 | A4216 | 1.13 | ERROR:#REF! | 16 | IV Fluids | ML | 10.00 | ML | IV | |||||
| Evenity SubQ Sol 105mg/1.17ml PFS | Evenity | Romosozumab-aqqg | 55513088002 | J3111 | 1,502.25 | 01 | Bisphosphonate | ML | 1.17 | ML | INJ | ||||||
| Istodax Inj 10mg | Istodax | RomiDEPsin | 59572098401 | J9319 | 3,838.38 | 01 | Antineoplastic | EA | 1.00 | ML | IV | ||||||
| Bortezomib Inj 3.5mg | Bortezomib | Bortezomib | 70710141101 | J9041 | 01 | Antineoplastic | EA | 1.00 | UN | ONCOLOGY | IV | ||||||
| CARBOplatin Inj Sol 150mg/15ml | CARBOplatin | CARBOplatin | 00703424601 | J9045 | 01 | Antineoplastic | ML | 15.00 | ML | CHEMO | IV | ||||||
| Riabni Inj 10mg/ml 10ml | Riabni | Rituximab-arrx | 55513022401 | Q5123 | 860.16 | 01 | Immunomodulator | ML | 10.00 | ML | IV | ||||||
| Riabni Inj 10mg/ml 50ml | Riabni | Rituximab-arrx | 55513032601 | Q5123 | 4,300.80 | 01 | Immunomodulator | ML | 50.00 | ML | IV | ||||||
| Truxima Inj 10mg/ml 10ml | Truxima | riTUXimab-abbs | 63459010310 | Q5115 | 1,014.66 | 01 | Immunomodulator | ML | 10.00 | ML | IV | ||||||
| Truxima Inj 10mg/ml 50ml | Truxima | riTUXimab-abbs | 63459010450 | Q5115 | 5,073.30 | 01 | Immunomodulator | ML | 50.00 | ML | IV | ||||||
| Rituxan Inj Conc 10mg/ml 10ml | Rituxan | RiTUXimab | 50242005121 | J9312 | 1,127.42 | 01 | Immunomodulator | ML | 10.00 | ML | IV | ||||||
| Rituxan Inj Conc 10mg/ml 10ml | Rituxan | RiTUXimab | 50242005110 | J9312 | 1,127.42 | 01 | Immunomodulator | ML | 10.00 | ML | IV | ||||||
| Rituxan Inj Conc 10mg/ml 50ml | Rituxan | RiTUXimab | 50242005306 | J9312 | 5,637.12 | 01 | Immunomodulator | ML | 50.00 | ML | IV | ||||||
| Phenergan Inj Sol 25mg/ml | Phenergan | Promethazine HCl | 00641608425 | J2550 | 4.05 | 01 | Antiemetic | ML | 1.00 | ML | IV | ||||||
| Promethazine HCl Inj 25mg/ml Amp | Promethazine HCI | Promethazine HCl | 39822552503 | J2550 | 2.50 | 01 | AntiEMEtic | ML | 1.00 | ML | IV | ||||||
| Promethazine HCl Inj 25mg/ml Amp | Promethazine HCl | Promethazine HCl | 00641149535 | J2550 | 2.22 | 01 | AntiEMEtic | ML | 1.00 | ML | IV | ||||||
| Promethazine HCl Inj 50mg/ml Amp | Promethazine HCl | Promethazine HCl | 00641149635 | J2550 | 3.11 | 01 | AntiEMEtic | ML | 1.00 | ML | IV | ||||||
| Promethazine HCl Inj Sol 25mg/ml | Promethazine HCl | Promethazine HCl | 00641620825 | J2550 | 2.09 | 01 | AntiEMEtic | ML | 1.00 | ML | IV | ||||||
| Promethazine HCl Inj Sol 50mg/ml | Promethazine HCl | Promethazine HCl | 00641092925 | J2550 | 4.61 | 01 | AntiEMEtic | ML | 1.00 | ML | IV | ||||||
| Promethazine HCl Tab 12.5mg | Promethazine HCl | Promethazine HCl | 65162074510 | J8499 | 0.49 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Promethazine HCl Tab 12.5mg | Promethazine HCl | Promethazine HCl | 53746074501 | J8499 | 0.49 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | ||||||
| Promethazine HCl Tab 12.5mg UD | Promethazine HCl | Promethazine HCl | 60687066001 | J8499 | 0.56 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Promethazine HCl Tab 25mg | Promethazine HCl | Promethazine HCl | 00904646161 | J8499 | 0.95 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Promethazine HCl Tab 25mg | Promethazine HCl | Promethazine HCl | 68382004101 | J8499 | 0.51 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Promethazine HCl Tab 25mg UD | Promethazine HCl | Promethazine HCl | 00904730461 | J8499 | 0.18 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Prochlorperazine Inj 5mg/ml 2ml | Prochlorperazine Edisylate | Prochlorperazine Edisylate | 23155029442 | J0780 | 6.72 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Prochlorperazine Inj 5mg/ml 2ml | Prochlorperazine Edisylate | Prochlorperazine Edisylate | 23155052341 | J0780 | 10.80 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Prochlorperazine Inj 5mg/ml 2ml | Prochlorperazine Edisylate | Prochlorperazine Edisylate | 23155029441 | J0780 | 6.53 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Prochlorperazine Inj 5mg/ml 2ml | Prochlorperazine Edisylate | Prochlorperazine Edisylate | 70860077802 | J0780 | 7.62 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Prochlorperazine Inj 5mg/ml 2ml | Prochlorperazine Edisylate | Prochlorperazine Edisylate | 67457064099 | J0780 | 22.20 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Prochlorperazine Inj 5mg/ml 2ml | Prochlorperazine Edisylate | Prochlorperazine Edisylate | 00713035109 | J0780 | 5.55 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| PredniSONE Tab 10mg UD | PredniSONE | PredniSONE | 00054001720 | J7512 | 0.27 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 10mg UD | PredniSONE | PredniSONE | 60687013401 | J7512 | 0.21 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 10mg UD | PredniSONE | PredniSONE | 00904692361 | J7512 | 0.19 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 2.5mg | PredniSONE | PredniSONE | 00054474225 | J7512 | 0.16 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | ||||||
| PredniSONE Tab 20mg | PredniSONE | PredniSONE | 00054001820 | J7512 | 0.28 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 20mg | PredniSONE | PredniSONE | 59746017506 | J7512 | 1.50 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 20mg | PredniSONE | PredniSONE | 00904712761 | J7512 | 0.20 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 20mg UD | PredniSONE | PredniSONE | 60687014501 | J7512 | 0.24 | ERROR:#REF! | 14 | Oral | EA | 1.00 | PO | ||||||
| PredniSONE Tab 5mg | PredniSONE | PredniSONE | 00054872425 | J7512 | 0.25 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| PredniSONE Tab 5mg UD | PredniSONE | predniSONE | 60687012201 | J7512 | 0.20 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Folotyn Inj Sol 40mg/2ml | Folotyn | PRALAtrexate | 48818000102 | J9307 | 16,290.05 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Folotyn Inj Sol 40mg/2ml | Folotyn | PRALAtrexate | 72893000501 | J9307 | 17,094.60 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Potassium Phosphate 3mm/mL 5mL | Potassium Phosphates | Potassium Phosphates | 00517205125 | J3490 | 28.76 | 07 | Electrolyte | ML | 5.00 | ML | IV | ||||||
| Potassium Phosphate 3mm/mL 5mL | Potassium Phosphate | Potassium Phosphate | 65219005229 | J3490 | 28.78 | 07 | Electrolyte | ML | 5.00 | ML | IV | ||||||
| Potassium Chloride 40meq/100ml (PB) | Potassium Chloride | Potassium Chloride | 00338070348 | J3480 | 4.86 | 07 | Electrolyte | ML | 100.00 | ML | |||||||
| Potassium Acetate 2meq/ml 100ml | Potassium Acetate | Potassium Acetate | 51754200404 | J3490 | 26.40 | 07 | Electrolyte | ML | 100.00 | ML | IV | ||||||
| Noxafil Inj Sol 300mg/16.7mL | Noxafil | Posaconazole | 00085433101 | J3490 | 636.54 | 01 | Antifungal | ML | 16.70 | ML | IV | ||||||
| Poly-Vi-Sol Oral Sol 50 mg/ml | POLY-VI-SOL | Poly-Vi-Sol Oral Sol 50 mg/mL | 00087040203 | A9152 | 9.84 | ERROR:#REF! | 14 | Oral | ML | 50.00 | UN | PO | |||||
| Polivy Inj 140mg | Polivy | Polatuzumab Vedotin-piiq | 50242010501 | J9309 | 21,683.20 | 01 | Antineoplastic | EA | 1.00 | UN | IV | ||||||
| Polivy Inj 30mg | Polivy | Polatuzumab Vedotin-piiq | 50242010301 | J9309 | 4,646.41 | 01 | Antineoplastic | EA | 1.00 | UN | IV | ||||||
| Piperacillin/Tazobactam 3.375gm | Piperacillin Sod-Tazobactam | Piperacillin Sod-Tazobactam | 65219043620 | J2543 | 4.80 | 01 | Antibiotic | EA | 1.00 | UN | IV | ||||||
| Piperacillin/Tazobactam 40.5gm | Piperacillin Sod-Tazobactam | Piperacillin Sod-Tazobactam | 00781318094 | J2543 | 85.88 | 01 | Antibiotic | EA | 1.00 | UN | IV | ||||||
| Piperacillin/Tazobactam 40.5gm | Piperacillin Sod-Tazobactam | Piperacillin Sod-Tazobactam | 60505626200 | J2543 | 82.80 | 01 | Antibiotic | EA | 1.00 | UN | IV | ||||||
| CARBOplatin Inj Sol 150mg/15ml | CARBOplatin | CARBOplatin | 16729029533 | J9045 | 01 | Antineoplastic | ML | 15.00 | ML | CHEMO | IV | ||||||
| Phesgo Inj 600mg-600mg-20000units | Phesgo | Pertuz-Trastuz-Hyaluron-zzxf | 50242026001 | J9316 | 10,653.38 | 01 | Immunomodulator | ML | 10.00 | ML | SQ | ||||||
| Gebauers Spray and Stretch AERO | Gebauers Spray and Stretch AERO | Pentafluoroprop-Tetrafluoroeth | 00386000404 | J8499 | 38.17 | ERROR:#REF! | 14 | Topical | ML | 116.00 | ML | TOP | |||||
| Pain Ease AERO | Pain Ease AERO | Pentafluoroprop-Tetrafluoroeth | 00386000803 | A9150 | 34.82 | ERROR:#REF! | 14 | Topical | ML | 103.50 | ML | TOP | |||||
| Pain Ease AERO | Pain Ease AERO | Pentafluoroprop-Tetrafluoroeth | 00386000804 | A9150 | 13.40 | ERROR:#REF! | 14 | Topical | ML | 30.00 | ML | TOP | |||||
| Pain Ease AERO | Pain Ease AERO | Pentafluoropropane-Tetrafluoroethan | 00386000802 | A9150 | 36.15 | ERROR:#REF! | 14 | Topical | ML | 116.00 | ML | TOP | |||||
| Bicillin C-R 900/300 IM Susp 1.2MU | Bicillin C-R 900/300 | Penicillin G Benzathine & Procaine | 60793060210 | J0558 | 291.74 | 01 | Antibiotic | ML | 2.00 | ML | IM | ||||||
| MIC, F-Tube, 16Fr x 3.0cm | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| CARBOplatin Inj Sol 150mg/15ml | CARBOplatin | CARBOplatin | 61703033922 | J9045 | 01 | Antineoplastic | ML | 15.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 150mg/15ml | CARBOplatin | CARBOplatin | 00703424681 | J9045 | 01 | Antineoplastic | ML | 15.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 150mg/15ml | CARBOplatin | CARBOplatin | 54288016501 | J9045 | 01 | Antineoplastic | ML | 15.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 50mg/5ml | CARBOplatin | CARBOplatin | 00703424401 | J9045 | 01 | Antineoplastic | ML | 5.00 | ML | CHEMO | IV | ||||||
| MIC, F-Tube, 18 x 2.0 | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| CARBOplatin Inj Sol 50mg/5ml | CARBOplatin | CARBOplatin | 16729029531 | J9045 | 01 | Antineoplastic | ML | 5.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 50mg/5ml | CARBOplatin | CARBOplatin | 61703033918 | J9045 | 01 | Antineoplastic | ML | 5.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 600mg/60ml | CARBOplatin | CARBOplatin | 71288010051 | J9045 | 01 | Antineoplastic | ML | 60.00 | ML | CHEMO | IV | ||||||
| Keytruda Inj Sol 100mg/4ml | Keytruda | Pembrolizumab | 00006302604 | J9271 | 6,802.42 | 01 | Immunomodulator | ML | 4.00 | ML | IV | ||||||
| Keytruda Inj Sol 100mg/4ml-Patriot | Keytruda | Pembrolizumab | 00006302604 | J9271 | 6,802.42 | 01 | Immunomodulator | ML | 4.00 | ML | IV | ||||||
| Palforzia 3mg Daily PK | Palforzia (3 MG Daily Dose) | Peanut (Arachis hypogaea) Allergen | 71881010145 | J3590 | 17.06 | ERROR:#REF! | 14 | Oral | EA | 45.00 | UN | PO | |||||
| Palforzia 300mg Maintenance PK | Palforzia (300mg Maintenance) | Peanut (Arachis hypogaea) Allergen | 71881011130 | J3590 | 51.18 | ERROR:#REF! | 14 | Oral | EA | 30.00 | UN | PO | |||||
| MIC, F-Tube, 20 x 2.0 | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| Palforzia Starter PK | Palforzia Initial Escalation | Peanut (Arachis hypogaea) Allergen | 71881011313 | J3590 | 3.98 | ERROR:#REF! | 14 | Oral | EA | 13.00 | UN | PO | |||||
| Pantoprazole Sod Inj 40mg | Pantoprazole Sodium | Pantoprazole Sodium | 55150020210 | J2470 | 8.50 | 01 | Gastric Disorder | EA | 1.00 | UN | IV | ||||||
| Pantoprazole Sod Inj 40mg | Pantoprazole Sodium | Pantoprazole Sodium | 00143930010 | J2470 | 3.36 | 01 | Gastric Disorder | EA | 1.00 | UN | IV | ||||||
| Pantoprazole Sod Inj 40mg | Pantoprazole Sodium | Pantoprazole Sodium | 00781323295 | J2470 | 6.13 | 01 | Gastric Disorder | EA | 1.00 | UN | IV | ||||||
| Pantoprazole Sod Inj 40mg | Pantoprazole Sodium | Pantoprazole Sodium | 62756012944 | J2470 | 8.50 | 01 | Gastric Disorder | EA | 1.00 | UN | IV | ||||||
| Pantoprazole Sod Inj 40mg | Pantoprazole Sodium | Pantoprazole Sodium | 67850015010 | J2470 | 5.00 | 01 | Gastric Disorder | EA | 1.00 | UN | |||||||
| Pantoprazole Sod Inj 40mg | Pantoprazole Sodium | Pantoprazole Sodium | 72603012810 | J2470 | 7.01 | 01 | Gastric Disorder | EA | 1.00 | UN | IV | ||||||
| Vectibix Inj Sol 100mg/5ml | Vectibix | Panitumumab | 55513095401 | J9303 | 2,070.46 | 01 | Immunomodulator | ML | 5.00 | ML | IV | ||||||
| CARBOplatin Inj Sol 600mg/60ml | CARBOplatin | CARBOplatin | 47781060694 | J9045 | 01 | Antineoplastic | ML | 60.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 600mg/60ml | CARBOplatin | CARBOplatin | 16729029512 | J9045 | 01 | Antineoplastic | ML | 60.00 | ML | CHEMO | IV | ||||||
| CARBOplatin Inj Sol 600mg/60ml | CARBOplatin | CARBOplatin | 55150038601 | J9045 | 01 | Antineoplastic | ML | 60.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 100mg/100ml | CISplatin | CISplatin | 67457042410 | J9060 | 01 | Antineoplastic | ML | 100.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 100mg/100ml | CISplatin | CISplatin | 63323010365 | J9060 | 01 | Antineoplastic | ML | 100.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 100mg/100ml | CISplatin | CISplatin | 00703574811 | J9060 | 01 | Antineoplastic | ML | 100.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 100mg/100ml | CISplatin | CISplatin | 44567051001 | J9060 | 01 | Antineoplastic | ML | 100.00 | ML | CHEMO | IV | ||||||
| Mini One Button 12Fr 1.2cm | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| CISplatin Inj Sol 100mg/100ml | CISplatin | CISplatin | 16729028838 | J9060 | 01 | Antineoplastic | ML | 100.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 100mg/100ml | CISplatin | CISplatin | 00143950501 | J9060 | 01 | Antineoplastic | ML | 100.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 200mg/200ml | CISplatin | CISplatin | 63323010364 | J9060 | 01 | Antineoplastic | ML | 200.00 | ML | CHEMO | |||||||
| CISplatin Inj Sol 200mg/200ml | CISplatin | Cisplatin | 44567051101 | J9060 | 01 | Antineoplastic | ML | 200.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 50mg/50ml | CISplatin | CISplatin | 00703574711 | J9060 | 01 | Antineoplastic | ML | 50.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 50mg/50ml | CISplatin | CISplatin | 63323010351 | J9060 | 01 | Antineoplastic | ML | 50.00 | ML | CHEMO | IV | ||||||
| CISplatin Inj Sol 50mg/50ml | CISplatin | CISplatin | 16729028811 | J9060 | 01 | Antineoplastic | ML | 50.00 | ML | CHEMO | IV | ||||||
| PACLitaxel Inj Conc 30mg/5ml | PACLitaxel | PACLitaxel | 70860020005 | J9267 | 16.20 | 01 | Antineoplastic | ML | 5.00 | ML | |||||||
| CISplatin Inj Sol 50mg/50ml | CISplatin | CISplatin | 00143950401 | J9060 | 01 | Antineoplastic | ML | 50.00 | ML | CHEMO | IV | ||||||
| Cladribine Inj Sol 10mg/10ml | Cladribine | Cladribine | 63323014010 | J9065 | 01 | Antineoplastic | ML | 10.00 | ML | CHEMO | IV | ||||||
| Cyclophosphamide Inj 1gm | Cyclophosphamide | Cyclophosphamide | 00781324494 | J9075 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Cyclophosphamide Inj 1gm | Cyclophosphamide | Cyclophosphamide | 70121123901 | J9075 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Cyclophosphamide Inj 1gm | Cyclophosphamide | Cyclophosphamide | 16714085701 | J9075 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Oxaliplatin Inj Sol 100mg/20ml | Oxaliplatin | Oxaliplatin | 72266016201 | J9263 | 30.00 | 01 | Antineoplastic | ML | 20.00 | ML | IV | ||||||
| Oxaliplatin Inj Sol 100mg/20ml | Oxaliplatin | Oxaliplatin | 00703398601 | J9263 | 120.00 | 01 | Antineoplastic | ML | 20.00 | ML | IV | ||||||
| Oxaliplatin Inj Sol 100mg/20ml | Oxaliplatin | Oxaliplatin | 71288010120 | J9263 | 24.00 | 01 | Antineoplastic | ML | 20.00 | ML | |||||||
| Oxaliplatin Inj Sol 100mg/20mL | Oxaliplatin | Oxaliplatin | 72603010101 | J9263 | 273.57 | 01 | Antineoplastic | ML | 20.00 | ML | |||||||
| Cyclophosphamide Inj 500mg | Cyclophosphamide | Cyclophosphamide | 10019095501 | J9075 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Cyclophosphamide Inj 500mg | Cyclophosphamide | Cyclophosphamide | 00781323394 | J9075 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Cyclophosphamide Inj 500mg | Cyclophosphamide | Cyclophosphamide | 70121123801 | J9075 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCI | Ondansetron HCl | 67457044022 | J2405 | 0.72 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Tab 4mg | Ondansetron HCI | Ondansetron HCl | 57237007710 | J8597 | 22.28 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron HCl Tab 4mg UD | Ondansetron HCI | Ondansetron HCl | 00904655161 | J8597 | 0.74 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 25021078220 | J2405 | 18.00 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 23155016831 | J2405 | 6.02 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 23155037731 | J2405 | 6.02 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 00409475901 | J2405 | 8.63 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 23155054931 | J2405 | 10.50 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 23155055031 | J2405 | 6.05 | 01 | AntiEMEtic | 20.00 | ML | IV | |||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 16729029805 | J2405 | 9.45 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 40mg/20ml | Ondansetron HCl | Ondansetron HCl | 72266012401 | J2405 | 6.00 | 01 | AntiEMEtic | ML | 20.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 00703722102 | J2405 | 2.40 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 64679072601 | J2405 | 23.24 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 00703722104 | J2405 | 2.40 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 00409475503 | J2405 | 1.54 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 23155019642 | J2405 | 1.11 | 01 | Antiemetic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 55150012502 | J2405 | 2.40 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 00781301095 | J2405 | 24.05 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 23155037841 | J2405 | 0.56 | 01 | Antiemetic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 23155054742 | J2405 | 0.55 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 60505613005 | J2405 | 0.72 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 23155054841 | J2405 | 0.56 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Inj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 70860077602 | J2405 | 0.60 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl lnj Sol 4mg/2ml | Ondansetron HCl | Ondansetron HCl | 23155054842 | J2405 | 0.56 | 01 | AntiEMEtic | ML | 2.00 | ML | IV | ||||||
| Ondansetron HCl Tab 4mg | Ondansetron HCl | Ondansetron HCl | 57237007530 | J8597 | 24.78 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron HCl Tab 4mg | Ondansetron HCl | Ondansetron HCl | 65862018730 | J8597 | 24.20 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron HCl Tab 4mg | Ondansetron HCl | Ondansetron HCl | 16714015901 | J8597 | 24.26 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Mini One Button 20Fr 3.0cm | B4088 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| Ondansetron HCl Tab 8mg | Ondansetron HCl | Ondansetron HCl | 68084022101 | J8597 | 1.15 | ERROR:#REF! | 14 | Oral | EA | 1.00 | |||||||
| Ondansetron HCl Tab 8mg | Ondansetron HCl | Ondansetron HCl | 16714016001 | J8597 | 38.73 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron ODT Tab 4mg | Ondansetron ODT | Ondansetron HCl | 65862039010 | J8597 | 22.29 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | ||||||
| Ondansetron ODT Tab 4mg | Ondansetron | Ondansetron | 57237007730 | J8597 | 22.29 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron ODT Tab 4mg UD | Ondansetron | Ondansetron | 68462015713 | J8597 | 23.11 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron ODT Tab 4mg UD | Ondansetron | Ondansetron | 16714020030 | J8597 | 22.57 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron ODT Tab 8mg | Ondansetron | Ondansetron | 57237007810 | J8597 | 37.13 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron ODT Tab 8mg | Ondansetron | Ondansetron | 16714020130 | J8597 | 37.50 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Ondansetron ODT Tab 8mg UD | Ondansetron | Ondansetron | 65862039110 | J8597 | 37.13 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| SandoSTATIN LAR Depot Kit 30mg | SandoSTATIN LAR | Octreotide Acetate | 00078082581 | J2353 | 8,295.07 | 01 | Hormonal Agent | EA | 1.00 | UN | SQ | ||||||
| Gazyva Inj Sol 1000mg/40ml | Gazyva | Obinutuzumab | 50242007001 | J9301 | 9,890.21 | 01 | Antineoplastic | ML | 40.00 | ML | IV | ||||||
| Cyclophosphamide Inj 500mg/2.5ml | Cyclophosphamide | Cyclophosphamide | 50742051902 | J9073 | 01 | Antineoplastic | ML | 2.50 | UN | CHEMO | IV | ||||||
| Cytarabine (PF) Inj 100mg/ml 20ml | Cytarabine | Cytarabine (PF) | 61703031922 | J9100 | 01 | Antineoplastic | ML | 20.00 | ML | CHEMO | IV | ||||||
| Opdivo Inj Sol 240mg/24ml-Patriot | Opdivo | Nivolumab | 00003373413 | J9299 | 9,161.57 | 01 | Immunomodulator | ML | 24.00 | ML | IV | ||||||
| Cytarabine (PF) Inj 100mg/ml 20ml | Cytarabine | Cytarabine (PF) | 63323012020 | J9100 | 01 | Antineoplastic | ML | 20.00 | ML | CHEMO | IV | ||||||
| Naproxen Tab 220mg | Naproxen Sodium | Naproxen Sodium | 00536109406 | J8499 | 0.09 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Naproxen Tab 250mg | Naproxen | Naproxen | 68462018801 | J8499 | 0.78 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Naproxen Tab 250mg | Naproxen | Naproxen | 70010013701 | J8499 | 0.81 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Naproxen Tab 250mg UD | Naproxen | Naproxen | 50268059415 | J8499 | 0.78 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Naloxone HCl Inj Sol 0.4mg/1ml | Naloxone HCl | Naloxone HCl | 67457029202 | J2310 | 23.72 | 01 | Opiate Antagonist | ML | 1.00 | ML | IV | ||||||
| Naloxone HCl Inj Sol 0.4mg/ml | Naloxone HCl | Naloxone HCl | 67457059902 | J2310 | 23.72 | 01 | Opiate Antagonist | ML | 1.00 | ML | IV | ||||||
| Multivitamin Childrens Chewable Tab | Multivitamin Childrens | Multivitamin Childrens | 80681004900 | A9150 | 0.03 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| MitoXANTRONE HCl Inj 25mg/12.5ml | MitoXANTRONE HCl | MitoXANTRONE HCl | 61703034365 | J9293 | 258.84 | 01 | Antineoplastic | ML | 12.50 | ML | |||||||
| MitoXANTRONE HCl Inj 25mg/12.5ml | MitoXANTRONE HCl | MitoXANTRONE HCl | 00703468001 | J9293 | 324.71 | 01 | Antineoplastic | ML | 12.50 | ML | |||||||
| Cytarabine (PF) Inj 100mg/ml 20ml | Cytarabine | Cytarabine (PF) | 71288010920 | J9100 | 01 | Antineoplastic | ML | 20.00 | ML | CHEMO | IV | ||||||
| Cytarabine (PF) Inj 20mg/ml 5ml | Cytarabine (PF) | Cytarabine (PF) | 61703030538 | J9100 | 01 | Antineoplastic | ML | 5.00 | ML | CHEMO | IV | ||||||
| Cytarabine (PF) Inj 20mg/ml 5ml | Cytarabine (PF) | Cytarabine (PF) | 67457045552 | J9100 | 01 | Antineoplastic | ML | 5.00 | ML | CHEMO | IV | ||||||
| Dacarbazine Inj Sol 100mg | Dacarbazine | Dacarbazine | 63323012710 | J9130 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| G-Tube Balloon 20Fr 20cc Dual ENFit | B4087 | 0.00 | ERROR:#REF! | 02 | Enteral Items | 0.00 | ENTERAL | ||||||||||
| Dacarbazine Inj Sol 200mg | Dacarbazine | Dacarbazine | 63323012820 | J9130 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Dacarbazine Inj Sol 200mg | Dacarbazine | Dacarbazine | 00703507501 | J9130 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Dacarbazine Inj Sol 200mg | Dacarbazine | Dacarbazine | 00143924510 | J9130 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| DACTINomycin Inj 0.5mg | DACTINomycin | DACTINomycin | 66993048983 | J9120 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| DACTINomycin inj 0.5mg | DACTINomycin | DACTINomycin | 67457051305 | J9120 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| Decitabine Inj 50mg | Decitabine | Decitabine | 67457031625 | J0894 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| MitoMYcin Inj Sol 5mg | MitoMYcin | MitoMYcin | 71288013720 | J9280 | 180.00 | 01 | Antineoplastic | EA | 1.00 | UN | IV | ||||||
| Midazolam HCl Inj Sol 50mg/10ml | Midazolam HCl | Midazolam HCl | 23155060142 | J2250 | 11.04 | 01 | CNS Agent | ML | 10.00 | ML | IV | ||||||
| Metoprolol Tartrate Inj Sol 5mg/5ml | Metoprolol Tartrate | Metoprolol Tartrate | 00409177805 | J3490 | 1.48 | 01 | Antihypertensive | ML | 5.00 | ML | IV | ||||||
| Metoclopramide HCl Inj Sol 10mg/2ml | Metoclopramide HCl | Metoclopramide HCl | 00409341401 | J2765 | 1.49 | 01 | Gastric Disorder | ML | 2.00 | ML | IV | ||||||
| MethylPREDNISolone Sod Suc 125mg | MethylPREDNISolone Sodium Succ | MethylPREDNISolone Sodium Succ | 63323025803 | J2919 | 13.98 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| MethylPREDNISolone Sod Suc 125mg | MethylPREDNISolone Sodium Succ | MethylPREDNISolone Sodium Succ | 43598012925 | J2919 | 9.12 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| MethylPREDNISolone Sod Succ 1gm | MethylPREDNISolone Sodium Succ | MethylPREDnisolone Sodium Succ | 63323026530 | J2919 | 41.06 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| MethylPREDNISolone Sod Succ 1gm | MethylPREDnisolone Sodium Succ | MethylPREDnisolone Sodium Succ | 43598013074 | J2919 | 39.00 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| MethylPREDNISolone Sod Succ 40mg | MethylPREDNISolone Sodium Succ | MethylPREDNISolone Sodium Succ | 63323025503 | J2919 | 7.30 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| MethylPREDNISolone Sod Succ 40mg | MethylPREDNISolone Sodium Succ | MethylPREDNISolone Sodium Succ | 43598012725 | J2919 | 5.76 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| Solu-MEDROL Inj 125mg AOV | Solu- MEDROL | MethylPREDNISolone Sodium Succ | 00009004704 | J2919 | 13.06 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| Solu-MEDROL Inj 125mg AOV | Solu-MEDROL | MethylPREDNISolone Sodium Succ | 00009004722 | J2919 | 12.50 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| Solu-MEDROL Inj 125mg AOV | Solu-MEDROL | MethylPREDNISolone Sodium Succ | 00009004726 | J2919 | 12.50 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| Solu-MEDROL Inj 40mg AOV | Solu-MEDROL | MethylPREDNISolone Sodium Succ | 00009003928 | J2919 | 7.76 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| Solu-MEDROL Inj 40mg AOV | Solu-MEDROL | MethylPREDNISolone Sodium Succ | 00009003932 | J2919 | 7.76 | 01 | Hormonal Agent | EA | 1.00 | UN | IV | ||||||
| Methotrexate Sod PF Inj 1gm/40ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 61703040841 | J9260 | 44.08 | 01 | Antineoplastic | ML | 40.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 1gm/40ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 00703367801 | J9260 | 39.90 | 01 | Antineoplastic | ML | 40.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 1gm/40ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 61703012440 | J9260 | 44.08 | 01 | Antineoplastic | ML | 40.00 | ML | |||||||
| Methotrexate Sod PF Inj 1gm/40ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 00703367881 | J9260 | 39.90 | 01 | Antineoplastic | ML | 40.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 1gm/40ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 16729027735 | J9255 | 41.16 | 01 | Antineoplastic | ML | 40.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 250mg/10ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 00703367501 | J9260 | 10.84 | 01 | Antineoplastic | ML | 10.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 250mg/10ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 16729027703 | J9255 | 11.17 | 01 | Antineoplastic | ML | 10.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 50mg/2ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 00703367103 | J9260 | 4.56 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 50mg/2ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 00143951910 | J9260 | 4.03 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 50mg/2ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 00703367101 | J9260 | 12.42 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Methotrexate Sod PF Inj 50mg/2ml | Methotrexate Sodium (PF) | Methotrexate Sodium (PF) | 16729027730 | J9255 | 4.90 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Methotrexate Sod Inj 50mg/2ml | Methotrexate Sodium | Methotrexate Sodium | 61703035038 | J9260 | 8.72 | 01 | Antineoplastic | ML | 2.00 | ML | IV | ||||||
| Methocarbamol Inj Sol 1000mg/10ml | Methocarbamol | Methocarbamol | 63323077810 | J2800 | 12.00 | 01 | Muscle Relaxant | ML | 10.00 | ML | IV | ||||||
| Methocarbamol Inj Sol 1000mg/10ml | Methocarbamol | Methocarbamol | 71288071610 | J2800 | 10.80 | 01 | Muscle Relaxant | ML | 10.00 | ML | |||||||
| Mesna Inj Sol 100mg/ml 10ml | Mesna | Mesna | 25021020110 | J9209 | 24.00 | 01 | Detoxifying Agent | ML | 10.00 | ML | IV | ||||||
| Mesna Inj Sol 100mg/ml 10ml | Mesna | Mesna | 10019095301 | J9209 | 30.00 | 01 | Detoxifying Agent | ML | 10.00 | ML | IV | ||||||
| Mesna Inj Sol 100mg/ml 10ml | Mesna | Mesna | 25021020111 | J9209 | 24.00 | 01 | Detoxifying Agent | ML | 10.00 | ML | IV | ||||||
| Mesna Inj Sol 100mg/ml 10ml | Mesna | Mesna | 63323073311 | J9209 | 79.56 | 01 | Detoxifying Agent | ML | 10.00 | ML | |||||||
| Mesnex Inj Sol 100mg/ml 10ml | Mesnex | Mesna | 00338130501 | J9209 | 30.00 | 01 | Detoxifying Agent | ML | 10.00 | ML | IV | ||||||
| Meropenem/ NaCl Inj Sol 1gm/50ml | Meropenem in NaCl | Meropenem in NaCl | 00264318511 | J2184 | 35.89 | 01 | Antibiotic | EA | 1.00 | UN | |||||||
| Mastisol Adhesive External Liq Drop | MASTISOL LIQUID ADHESIVE | Mastisol Adhesive | 00496052348 | 2.35 | ERROR:#REF! | 02 | Topical | EA | 48.00 | UN | TOP | ||||||
| Mannitol Inj Sol 20% 500ml | Mannitol | Mannitol | 00990771503 | J3490 | 22.86 | 01 | Diuretic | ML | 500.00 | ML | IV | ||||||
| Magnesium Sulf in D5W 10mg/mL 100mL | Magnesium Sulfate in D5W | Magnesium Sulfate in D5W | 00409672723 | J3490 | 9.87 | 07 | IV Fluids | ML | 100.00 | ML | IV | ||||||
| Magnesium Sulf in D5W 10mg/mL 100mL | Magnesium Sulfate in D5W | Magnesium Sulfate in D5W | 44567041024 | J3490 | 3.77 | 07 | IV Fluids | ML | 100.00 | ML | IV | ||||||
| Magnesium Sulf in D5W 10mg/mL 100mL | Magnesium Sulfate in D5W | Magnesium Sulfate in D5W | 63323010801 | J3490 | 9.77 | 07 | IV Fluids | ML | 100.00 | ML | IV | ||||||
| Mag Sulf 0.325meq/mL 100mL(Pool) | Magnesium Sulfate | Magnesium Sulfate | 44567042124 | J3475 | 4.50 | 07 | Electrolyte | ML | 100.00 | ML | |||||||
| Mag Sulf 0.325meq/mL 50mL(Pool) | Magnesium Sulfate | Magnesium Sulfate | 00409672924 | J3475 | 19.44 | 07 | Electrolyte | ML | 50.00 | ML | IV | ||||||
| Mag Sulf 0.325meq/mL 1000mL (Pool) | Magnesium Sulfate | Magnesium Sulfate | 00409316412 | J3475 | 10.11 | 07 | Electrolyte | ML | 1000.00 | ML | IV | ||||||
| Mag Sulf 0.325meq/mL 1000mL(Hang) | Magnesium Sulfate | Magnesium Sulfate | 00409672909 | J3475 | 10.11 | 07 | Electrolyte | ML | 1000.00 | ML | IV | ||||||
| Mag Sulf 0.325meq/mL 1000mL(Hang) | Magnesium Sulfate | Magnesium Sulfate | 63323010610 | J3475 | 10.96 | 07 | Electrolyte | ML | 1000.00 | ML | IV | ||||||
| Mag Sulf 0.325meq/mL 1000mL(Hang) | Magnesium Sulfate | Magnesium Sulfate | 00409316412 | J3475 | 10.11 | 07 | Electrolyte | ML | 1000.00 | ML | IV | ||||||
| Mag Sulf 0.325meq/mL 500mL(Pool) | Magnesium Sulfate | Magnesium Sulfate | 00409672903 | J3475 | 6.82 | 07 | Electrolyte | ML | 500.00 | ML | IV | ||||||
| Magnesium Sulfate Inj 50% 2mL | Magnesium Sulfate | Magnesium Sulfate | 63323006403 | J3475 | 2.72 | 07 | Electrolyte | ML | 2.00 | ML | |||||||
| Decitabine Inj 50mg | Decitabine | Decitabine | 00143938501 | J0894 | 01 | Antineoplastic | EA | 1.00 | UN | CHEMO | IV | ||||||
| LORazepam Inj Sol 2mg/ml 10ml | LORazepam | LORazepam | 76329826101 | J2060 | 12.00 | 01 | CNS Agent | ML | 10.00 | ML | IV | ||||||
| LORazepam Inj Sol 2mg/ml 1ml | LORazepam | LORazepam | 00641604425 | J2060 | 1.55 | 01 | CNS Agent | ML | 1.00 | ML | IV | ||||||
| LORazepam Inj Sol 2mg/ml 1ml | LORazepam | LORazepam | 00409677802 | J2060 | 2.05 | 01 | CNS Agent | ML | 1.00 | ML | IV | ||||||
| Claritin 10mg Tab | Claritin | Loratadine | 11523716002 | A9150 | 1.18 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Claritin Reditabs Tab 10mg | Claritin Reditabs | Loratadine | 11523715703 | A9150 | 0.94 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | ||||||
| Loratadine Tab 10mg | Loratadine | Loratadine | 45802065078 | J8499 | 0.30 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Loratadine Tab 10mg | Loratadine | Loratadine | 16571082203 | J8499 | 0.30 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | ||||||
| Loratadine Tab 10mg | Loratadine | Loratadine | 00904685207 | J8499 | 0.08 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Loratadine Tab 10mg | Loratadine | Loratadine | 45802065065 | A9150 | 0.30 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Loratadine Tab 10mg UD | Loratadine | Loratadine | 51079024620 | J8499 | 0.86 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Loratadine Tab 10mg UD | Loratadine | Loratadine | 68084024801 | J8499 | 0.70 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Loratadine Tab 10mg UD | Loratadine | Loratadine | 00904685261 | J8499 | 0.29 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | PO | |||||
| Loratadine Tab 10mg UD | Loratadine | Loratadine | 50268048915 | J8499 | 0.70 | ERROR:#REF! | 14 | Oral | EA | 1.00 | UN | BOLUS | |||||
| Loratadine Childrens Sol 5mg/5ml | Loratadine Childrens | Loratadine | 51672213108 | A9150 | 9.89 | ERROR:#REF! | 14 | Oral | ML | 120.00 | ML | PO | |||||
| Loratadine Childrens Sol 5mg/5ml | Loratadine Childrens | Loratadine | 54838055840 | A9150 | 8.50 | ERROR:#REF! | 14 | Oral | ML | 120.00 | ML | PO | |||||
| Loratadine Childrens Sol 5mg/5ml | Loratadine Childrens | Loratadine | 00904676720 | A9150 | 5.83 | ERROR:#REF! | 14 | Oral | ML | 120.00 | ML | PO | |||||
| LMX 4 Plus External Cream 4% Kit | LMX 4 Plus | Lidocaine-Transparent Dressing | 00496088207 | J3490 | 48.07 | ERROR:#REF! | 14 | Topical | EA | 1.00 | GR | ||||||
| Synera External Patch 70-70mg | Synera | Lidocaine-Tetracaine | 10885000210 | C9285 | 20.34 | ERROR:#REF! | 14 | Topical | EA | 1.00 | UN | TOP | |||||
| Lidocaine-Prilocaine Cream 2.5% 30g | Lidocaine-Prilocaine | Lidocaine-Prilocaine | 00168035730 | J3490 | 18.10 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine-Prilocaine Cream 2.5% 30g | Lidocaine-Prilocaine | Lidocaine-Prilocaine | 62332058231 | J3490 | 27.19 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine-Prilocaine Cream 2.5% 30g | Lidocaine-Prilocaine | Lidocaine-Prilocaine | 00574204230 | J3490 | 18.10 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine-Prilocaine Cream 2.5% 30g | Lidocaine-Prilocaine | Lidocaine-Prilocaine | 63629960401 | J3490 | 48.00 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine-Prilocaine Cream 2.5% 5g | Lidocaine-Prilocaine | Lidocaine-Prilocaine | 62332058204 | J3490 | 9.18 | ERROR:#REF! | 14 | Topical | GM | 5.00 | GR | TOP | |||||
| Lidocaine HCl Inj 1% 10ml | Lidocaine HCl | Lidocaine HCl (Local Anesth.) | 63323020110 | J3490 | 2.93 | 01 | CNS Agent | ML | 10.00 | ML | IM/IV | ||||||
| Lidocaine HCl Inj 2% 20ml | Lidocaine HCl | Lidocaine HCl (Local Anesth.) | 55150025520 | J3490 | 5.04 | 01 | CNS Agent | ML | 20.00 | ML | IM/IV | ||||||
| Lidocaine HCl Inj Sol 1% 10ml | Lidocaine HCl | Lidocaine HCl (Local Anesth.) | 55150025110 | J3490 | 3.24 | 01 | CNS Agent | ML | 10.00 | ML | |||||||
| Lidocaine HCl Inj Sol 2% 50ml | Lidocaine HCl | Lidocaine HCl (Local Anesth.) | 00409427702 | J3490 | 5.03 | 01 | CNS Agent | ML | 50.00 | ML | |||||||
| Lidocaine HCl (PF) Inj Sol 1% 5ml | Lidocaine HCl (PF) | Lidocaine HCl (Local Anesth.) | 55150016205 | J3490 | 4.05 | 01 | CNS Agent | ML | 5.00 | ML | IM/IV | ||||||
| Lidocaine HCl PF Inj Sol 1% 30ml | Lidocaine HCl (PF) | Lidocaine HCl (Local Anesth.) | 55150016330 | J3490 | 4.35 | 01 | CNS Agent | ML | 30.00 | ML | IM/IV | ||||||
| Xylocaine-MPF Inj Sol 1% 2ml | Xylocaine-MPF | Lidocaine HCl (Local Anesth.) | 63323049227 | J3490 | 2.83 | 01 | CNS Agent | ML | 2.00 | ML | IV | ||||||
| Lidocaine External Cream 3% 30gm | Lidocaine HCl | Lidocaine HCl | 13925015901 | J3490 | 58.35 | ERROR:#REF! | 14 | Topical | GM | 28.35 | GR | TOP | |||||
| Lidocaine HCl Inj Sol 1% 20ml | Lidocaine HCl | Lidocaine HCl | 00409427601 | J3490 | 1.90 | 01 | CNS Agent | ML | 20.00 | ML | IM/IV | ||||||
| Lidocaine HCl Inj Sol 1% 2ml | Lidocaine HCl | Lidocaine HCl | 63323020102 | J3490 | 3.12 | 01 | CNS Agent | ML | 2.00 | ML | IM/IV | ||||||
| Lidocaine HCl Inj Sol 1% 50ml | Lidocaine HCl | Lidocaine HCl | 00409427602 | J3490 | 3.82 | 01 | CNS Agent | ML | 50.00 | ML | IV | ||||||
| Lidocaine HCl Inj Sol 2% 2ml | Lidocaine HCl | Lidocaine HCl | 63323020202 | J3490 | 3.12 | 01 | CNS Agent | ML | 2.00 | ML | IM/IV | ||||||
| Xylocaine-MPF Inj Sol 1% 5ml | Xylocaine-MPF | Lidocaine HCl | 63323049257 | J3490 | 4.72 | 01 | CNS Agent | ML | 5.00 | ML | IM/IV | ||||||
| Xylocaine-MPF Inj Sol 1% 5ml | Xylocaine-MPF | Lidocaine HCl | 63323049236 | J3490 | 1.67 | 01 | CNS Agent | ML | 5.00 | ML | |||||||
| Lidocaine External Cream 5% 30gm | Lidocaine (Anorectal) | Lidocaine (Anorectal) | 75834014130 | J3490 | 15.54 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| LMX 5 External Cream 5% 15gm | LMX 5 | Lidocaine (Anorectal) | 00496088315 | J3490 | 36.31 | ERROR:#REF! | 14 | Topical | GM | 15.00 | GR | TOP | |||||
| AneCream External Cream 4% 30gm | AneCream | Lidocaine | 24357070130 | J3490 | 30.00 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine External Cream 4% 15gm | Lidocaine | Lidocaine | 43199004051 | J3490 | 19.20 | ERROR:#REF! | 14 | Topical | GM | 15.00 | GR | TOP | |||||
| Lidocaine External Cream 4% 15gm | Lidocaine | Lidocaine | 00536126720 | J3490 | 11.14 | ERROR:#REF! | 14 | Topical | GM | 15.00 | GR | TOP | |||||
| Lidocaine External Cream 4% 30gm | Lidocaine | Lidocaine | 43199004030 | J3490 | 33.60 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine External Cream 4% 30gm | Lidocaine | Lidocaine | 47781057073 | J3490 | 33.60 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | ||||||
| Lidocaine External Cream 4% 30gm | Lidocaine | Lidocaine | 42291039930 | J3490 | 33.60 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine External Cream 4% 30gm | Lidocaine | Lidocaine | 52565012230 | J3490 | 33.60 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine External Cream 4% 30gm | Lidocaine | Lidocaine | 00536128128 | J3490 | 17.22 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| Lidocaine External Cream 4%15gm | Lidocaine | Lidocaine | 39328002415 | J3490 | 30.00 | ERROR:#REF! | 14 | Topical | GM | 15.00 | GR | TOP | |||||
| Lidocaine External Cream 4%15gm | Lidocaine | Lidocaine | 39328002430 | J3490 | 59.00 | ERROR:#REF! | 14 | Topical | GM | 30.00 | GR | TOP | |||||
| LMX 4 External Cream 4% 15gm | LMX 4 | Lidocaine | 00496088215 | J3490 | 29.21 | ERROR:#REF! | 14 | Topical | GM | 15.00 | GR | top |
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .