RFQ ATTACH 2 - Business Template.xlsx

XLSX spreadsheet 98 KB Posted

Attached to
FMS Cache Rx Products Federal contract opportunity
Solicitation number
75A50325Q00006
Issued by
Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response

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Written by GovTribe AI ·

This is a business pricing template spreadsheet for pharmaceutical products required by the Center for the Strategic National Stockpile (SNS) under solicitation 75A50325Q00006. The template allows vendors to provide pricing for 224 different pharmaceutical products across a base period and four option periods, including various medications, vaccines, and medical supplies. Products range from basic medications like acetaminophen and ibuprofen to more specialized items like insulin products requiring refrigeration and controlled substances.

The template requires vendors to provide both individual unit pricing and case quantity pricing for each item, with specific quantity requirements listed for each product. Vendors may bid on individual items, groups of items, or all items, but must provide pricing for the full quantity of any item offered. The template is structured to support the SNS mission of maintaining pharmaceutical stockpiles for public health emergencies, under the Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response. Large business offerors must submit small business subcontracting plans.

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Other files for this federal contract opportunity

Other files attached to FMS Cache Rx Products, newest first.
File Type Posted
RFQ ATTACH 1 - Technical Product List Template.xlsx XLSX spreadsheet
RFQ ATTACH 4 - Reps and Certs.docx DOCX document
75A50325Q00006_FMS Cache Rx Products.pdf PDF
RFQ ATTACH 3 - QnA Template.docx DOCX document
RFQ ATTACH 5 - SBCX Industry Subcontracting Guide.pdf PDF

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PRICING - Base

ATTACHMENT 2 - BUSINESS TEMPLATE

NOTE: Offerors may provide pricing for one item, a group of items, or all items, at the discretion of the Offeror. However, the Offeror must provide pricing for the full quantity of each item offered. Quantity variations are not permitted as each item's entire quantity will be awarded to only one Offeror.

COMPANY NAMEBASE YR USG QTYUnit of Measure (UoM)ITEM NOPRODUCT DESCRIPTIONVENDOR'S NDC #VENDOR'S EACH QTYEACH UNIT PRICEEXTENDED EACH PRICEVENDOR'S CASE QUANTITYVENDOR'S CASE UNIT PRICEEXTENDED CASE PRICE TOTAL
50EA1Acetaminophen Infant Drops 100 mg / 1 mL, 15 mL$ -$ - 0$ -$ - 0
100EA2Acetaminophen Oral Liquid 160mg/5mL; 120mL, Bottle$ -$ - 0$ -$ - 0
10PK3Acetaminophen Suppositories 120mg$ -$ - 0$ -$ - 0
30BT4Acetaminophen Tablets, 325mg, 100's$ -$ - 0$ -$ - 0
30BT5Acetaminophen Tablets, 500 mg, 100's$ -$ - 0$ -$ - 0
20BT6Activated Charcoal, 50gm, 30mL$ -$ - 0$ -$ - 0
10BT7Acyclovir Capsules, 200 mg (Zovirax), 100's$ -$ - 0$ -$ - 0
10PK8Adenosine Injection 3mg/mL, 2mL vial$ -$ - 0$ -$ - 0
11PK9Albuterol Inhalation Solution 0.083 3mL$ - 0$ - 0$ - 0$ - 0
250Each10Albuterol Inhalers, 17gm$ - 0$ - 0$ - 0$ - 0
10Each11Albuterol Sulfate Syrup 2mg/5mL, 480mL$ - 0$ - 0$ - 0$ - 0
10BT12Allopurinol Tablets 100 mg, 100's (Zyloprim)$ - 0$ - 0$ - 0$ - 0
20BT13Amiodardone HCL Tablets 200 mg, 90's (Cordarone)$ - 0$ - 0$ - 0$ - 0
30PK14Amiodarone HCl Injection, 150 mg / 3 ml, SDV$ - 0$ - 0$ - 0$ - 0
10Bottle of 10015Amoxicillin Capsules 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10016Amoxicillin Chewable Tablets 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
50Each17Amoxicillin Oral Susp. 250mg/5mL; 150mL$ - 0$ - 0$ - 0$ - 0
100Pkg 2018Amoxicillin/Clalvulanic Chewable Tablet 400 mg/57 mg$ - 0$ - 0$ - 0$ - 0
100Each19Amoxicillin/Clavulanic Oral Susp 200 mg/28.5 mg/5 mL, 50 mL$ - 0$ - 0$ - 0$ - 0
150Bottle of 2020Amoxicillin/Clavulanic Tablets 875 mg/125 mg, 20's$ - 0$ - 0$ - 0$ - 0
20Pkg 4821Antacid Liquid Reg Str; 150mL$ - 0$ - 0$ - 0$ - 0
30Each22Antipyrine/Benzocaine Otic Solution, 15 ml$ - 0$ - 0$ - 0$ - 0
120Bottle of 3623Aspirin Chewable Tablets, 81mg; 36's$ - 0$ - 0$ - 0$ - 0
30Bottle of 10024Aspirin Tablets, 325mg, 100's$ - 0$ - 0$ - 0$ - 0
50Bottle of 10025Atenolol Tablets 50 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Pkg 1026Atropine Injection 0.1 mg/mL, 10mL Syr$ - 0$ - 0$ - 0$ - 0
50Each27Azithromycin Syrup 200 mg/ 5 ml, 30 mL$ - 0$ - 0$ - 0$ - 0
10Blister pack of 3x6 (18)28Azithromycin Tabs. 250 mg, 18's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10029Baclofen Tablets 10 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Vial30Benztropine Mesylate 1 mg/mL, 2 mL amp (Cogentin), 5's$ - 0$ - 0$ - 0$ - 0
10Box31Bisacodyl Suppositories 10 mg, 12/box$ - 0$ - 0$ - 0$ - 0
10Bottle of 5032Bisacodyl Tablets 5 mg, 50's$ - 0$ - 0$ - 0$ - 0
50Each33Brimonidine Tartrate Ophth Solution 0.2% (Alphagan P) 5mL$ - 0$ - 0$ - 0$ - 0
50Each34Brinzolamide Ophth Suspension 1% (Azopt) 5mL$ - 0$ - 0$ - 0$ - 0
10Pkg 2535Bupivacaine Marcaine Injection, 0.5 30 ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 6036Bupropion Hydrochloride XR Tablets 150 mg, 60's (Wellbutrin XL)$ - 0$ - 0$ - 0$ - 0
20Each37Calamine Lotion, Phenolated, 4 oz. bottles$ - 0$ - 0$ - 0$ - 0
10Pkg 1038Calcium Chloride Injection 10%, 10 mL, Syr$ - 0$ - 0$ - 0$ - 0
20Bottle of 10039Carbamazepine Tablets 200 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10040Carbidopa/Levodopa 25mg/250 mg, 100s (Sinemet)$ - 0$ - 0$ - 0$ - 0
30Pkg 1041Ceftriaxone Injection 1 gm$ - 0$ - 0$ - 0$ - 0
30Bottle of 10042Cephalexin Capsules 500 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Each43Cephalexin Oral Susp. 250 mg/5 ml, 200 ml$ - 0$ - 0$ - 0$ - 0
30120 ml Bottle44Cetirizine HCL syrup 5 mg/5 mL, 120 ml (Zyrtec)$ - 0$ - 0$ - 0$ - 0
10Bottle of 10045Ciprofloxacin Tablets 250mg, 100's$ - 0$ - 0$ - 0$ - 0
30Bottle of 10046Ciprofloxacin Tablets 500mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10047Citalopram Hydrobromide Tablets 10 mg, 100's (Celexa)$ - 0$ - 0$ - 0$ - 0
20Each48Clarithromycin Tablets (BIAXIN XL) 500 mg, 14's x 4$ - 0$ - 0$ - 0$ - 0
20Bottle of 10049Clindamycin HCL Capsules 150 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10050Clonidine HCl Tablets 0.1mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10051Colchicine/Probenecid Tablets 0.5 mg/500 mg, 100's (Col-Probenecid)$ - 0$ - 0$ - 0$ - 0
10Vial52Cyanocobalamin 1000mcg IM injection 1mL, 25s$ - 0$ - 0$ - 0$ - 0
10Bottle of 10053Cyclobenzaprine HCl Tablets 10 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Each54Desitin Diaper Rash Ointment, 30Gm$ - 0$ - 0$ - 0$ - 0
10Pkg 2555Dexamethasone NA Phosphate Injection 4 mg/ml, 5ml$ - 0$ - 0$ - 0$ - 0
20Pkg 2456D50W (Dextrose 50%) Injection 50mL Syr$ - 0$ - 0$ - 0$ - 0
20Pkg 1257Dextrose 5% & Sodium Chloride 0.45% Inj. 1000 mL$ - 0$ - 0$ - 0$ - 0
10Pkg 2458Dextrose 5% & Sodium Chloride 0.45% Inj. 500 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 2459Dextrose 5% & Sodium Chloride 0.9% Inj. 500 mL$ - 0$ - 0$ - 0$ - 0
20Bottle of 10060Dicloxacillin Sodium Capsules, 250 mg equiv., 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10061Digoxin Tablets 0.125mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 9062Diltiazem HCL XR Capsules 120 mg (Cardizem CD), 90's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10063Diphenhydramine Capsules 25mg; 100s$ - 0$ - 0$ - 0$ - 0
20Each64Diphenhydramine Elixir 12.5mg/5ml, 120ml$ - 0$ - 0$ - 0$ - 0
10Pkg 2565Diphenhydramine Injection 50mg/ml, 1 mL vial$ - 0$ - 0$ - 0$ - 0
10Pkg 1066Dobutamine Hydrochloride Inj. 250 mg/20 ml, vials$ - 0$ - 0$ - 0$ - 0
30Bottle of 10067Docusate Sodium Tablets 100 mg, 100s$ - 0$ - 0$ - 0$ - 0
10Pkg 2568Dopamine Injection 40mg/ml, 10ml vial$ - 0$ - 0$ - 0$ - 0
10Bottle of 10069Doxycycline Hycalate Tabs.,100 mg UD, 100's$ - 0$ - 0$ - 0$ - 0
100Each70Enoxaparin Sodium 40 mg/0.4mL syringe (Lovenox)$ - 0$ - 0$ - 0$ - 0
10Each71Epinephrine 1:1,000 (1mg/ml) 30 ml vial$ - 0$ - 0$ - 0$ - 0
10Pkg 1072Epinephrine 1:10,000 (0.1mg/ml) 10ml Syr$ - 0$ - 0$ - 0$ - 0
10Bottle of 10073Erythromycin Enteric Coated Tablets 250mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10074Famotidine Tablets 20mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10075Felodipine Tablets 5 mg, 100s$ - 0$ - 0$ - 0$ - 0
10Bottle of 10076Ferrous gluconate 325 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Each77Fluconazole Tablets150 mg, UD 12/box (Diflucan)$ - 0$ - 0$ - 0$ - 0
12025 ml Bottle78Flunisolide Nasal Spray 0.025%, 25 mL (Nasarel)$ - 0$ - 0$ - 0$ - 0
50Each79Fluocinolone Acetonide Cream 0.025%, 15 gm$ - 0$ - 0$ - 0$ - 0
10Bottle of 10080Fluoxetine Hydrochloride Capsules 20 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10081Folic Acid Tablets 1 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10082Furosemide Tablets 40mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10083Gabapentin Capsules 100mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10084Gabapentin Capsules 300mg, 100's$ - 0$ - 0$ - 0$ - 0
50Each85Gentamicin Ophthalmic Solution 3mg/ml 5ml$ - 0$ - 0$ - 0$ - 0
10Bottle of 10086Glipizide Tablets 5 mg, 100s (Glucotrol)$ - 0$ - 0$ - 0$ - 0
50Each87Glucagon for Injection 1mg, 1 mL, Syr$ - 0$ - 0$ - 0$ - 0
150Pkg of 1288Glucose Tablets, Box$ - 0$ - 0$ - 0$ - 0
20Bottle of 10089Glyburide Tablets 5mg, 100's$ - 0$ - 0$ - 0$ - 0
100Each90Guaifenesin DM Syrup; 4oz$ - 0$ - 0$ - 0$ - 0
10Pkg 1091Haloperidol Injection 5mg/mL, 1mL vial$ - 0$ - 0$ - 0$ - 0
10Bottle of 10092Haloperidol Tablets 1 mg, 100's UD$ - 0$ - 0$ - 0$ - 0
30Pkg 2593Heparin Lock Flush Kit, 100 units/mL, 1mL vials$ - 0$ - 0$ - 0$ - 0
10Bottle of 2594Hydralazine 20mg/mL, 1mL vial, 25's$ - 0$ - 0$ - 0$ - 0
30Bottle of 10095Hydrochlorothiazide Tablets 25mg, 100's$ - 0$ - 0$ - 0$ - 0
120Each96Hydrocortisone Cream 1%, 1 oz$ - 0$ - 0$ - 0$ - 0
50Each97Ibuprofen Oral Drops, 15 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 2498Ibuprofen Oral Suspension 100mg/5mL, 120mL$ - 0$ - 0$ - 0$ - 0
60Pkg 899Infant formula-Enfacare liquid 3oz$ - 0$ - 0$ - 0$ - 0
120Each100Ipratropium Bromide Inhalation Aerosol, 14.7g$ - 0$ - 0$ - 0$ - 0
30Each101Ipratropium Bromide Inhalation Solution, 0.02%, 2.5 ml, packs (25 bullets / pack)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100102Isoniazid Tablets 300 mg, 100s$ - 0$ - 0$ - 0$ - 0
10Bottle of 100103Isosorbide Tablets 10mg; 100s$ - 0$ - 0$ - 0$ - 0
10Pkg 10104Ketoralac Injection 30mg/mL; 2mL vial$ - 0$ - 0$ - 0$ - 0
20Pkg 12105Lactated Ringers Injection, 1000ml$ - 0$ - 0$ - 0$ - 0
502.5 ml Bottle106Latanoprost Ophth Solution 0.005% (Xalatan) 2.5mL$ - 0$ - 0$ - 0$ - 0
10Pkg 3107Levlen, 28 pills / compact, 3 compacts / box$ - 0$ - 0$ - 0$ - 0
10Each108Levonorgestrel-28, 3's (ALTAVERA)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100109Levothroid Sodium Tablets 100 mcg; 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100110Levothyroxine Sodium Tablets 50 mcg; 100's$ - 0$ - 0$ - 0$ - 0
10Pkg 25111Lidocaine 1% Injection 20mL vial$ - 0$ - 0$ - 0$ - 0
10Pkg 10112Lidocaine 1% Injection, 5 mL Syr$ - 0$ - 0$ - 0$ - 0
10Pkg 5113Lidocaine 1% w/Epinephrine Injection; 10mL vial$ - 0$ - 0$ - 0$ - 0
20Each114Lidocaine 2% Viscous 100mL$ - 0$ - 0$ - 0$ - 0
10Pkg 10115Lidocaine/Prilocaine Cream 5gm$ - 0$ - 0$ - 0$ - 0
30Bottle of 100116Lisinopril Tablets 10 mg, 100's (Zestril)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100117Lithium Carbonate Tablets 300mg, 100's$ - 0$ - 0$ - 0$ - 0
10Pkg 6118Lo-Ovral, 28 pills / compact, 6 compacts / box$ - 0$ - 0$ - 0$ - 0
10Bottle of 100119Loperamide HCl Capsules, 2mg; 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100120Loratadine tablets 10 mg, 100/box (Claritin) UD$ - 0$ - 0$ - 0$ - 0
20Bottle of 90121Losartan Potassium Tablets 25 mg, 90's (Cozaar)$ - 0$ - 0$ - 0$ - 0
10Pkg 10122Magnesium Sulfate Injection 5 g/ml 10 ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 12123Mebendazole Tablets 100mg, 12's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100124Meclizine Hydrochloride Tablets 25 mg, 100's$ - 0$ - 0$ - 0$ - 0
50Bottle of 100125Metformin Tablets 500 mg, 100s (Glucophage)$ - 0$ - 0$ - 0$ - 0
10Pkg 25126Methylprednisolone Injection 125mg; 2mL$ - 0$ - 0$ - 0$ - 0
10Each127Methylprednisolone Sodium Injection 1000mg$ - 0$ - 0$ - 0$ - 0
10Bottle of 21128Methylprednisolone Tablets 4 mg; 21's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100129Metocloperamide HydrochlorideTablets 10mg; 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100130Metoprolol Tablets 50mg; 100s$ - 0$ - 0$ - 0$ - 0
10Bottle of 50131Metronidazole Tablets 500mg; 50s$ - 0$ - 0$ - 0$ - 0
120Each132Miconazole Cream 2% 30gm;$ - 0$ - 0$ - 0$ - 0
60Each133Miconazole Vaginal Cream 45gm$ - 0$ - 0$ - 0$ - 0
20Bottle of 90134Montelukast Sodium Tablets 10 mg, 90s (Singulair)$ - 0$ - 0$ - 0$ - 0
60Each135Mupirocin Ointment 2%, 30 g Tube$ - 0$ - 0$ - 0$ - 0
20Each136Neomycin/PolymyxinHC Otic Suspension 10mL$ - 0$ - 0$ - 0$ - 0
100Pkg 10137Naloxone Hydrochloride Injection 0.4 mg/ml, 1 ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 100138Nifedipine Capsules 30mg, 100's$ - 0$ - 0$ - 0$ - 0
120Pkg 25139Nitroglycerin Sublingual Tablets 0.4mg, pills / vial$ - 0$ - 0$ - 0$ - 0
10Pkg 30140Nitroglycerin Transdermal System 0.2mg/hr$ - 0$ - 0$ - 0$ - 0
10Each141Nitroprusside Sodium 50 mg, 2 mL vial$ - 0$ - 0$ - 0$ - 0
20Bottle of 100142Nortriptyline HCl Capsules 25 mg, 100's$ - 0$ - 0$ - 0$ - 0
60Each143Nupercainal HC 1% Cream 1oz.$ - 0$ - 0$ - 0$ - 0
480Each144Nutrient Supplement, Powdered, Vanilla, 14 oz.$ - 0$ - 0$ - 0$ - 0
120Each145Nystatin Cream 100,000 Units/Gm; 15gm$ - 0$ - 0$ - 0$ - 0
50Each146Nystatin Oral Suspension 100,000 Units/mL; 60mL$ - 0$ - 0$ - 0$ - 0
120Each147Ocean Nasal Spray 45mL$ - 0$ - 0$ - 0$ - 0
50Bottle of 100148Omeprazole Tablets 20 mg, 100s (Prilosec)$ - 0$ - 0$ - 0$ - 0
40Each149Opthalmic Irrigating Solution, 4 oz.$ - 0$ - 0$ - 0$ - 0
10Bottle of 100150Oxybutynin 5 mg tablets IR, 100s$ - 0$ - 0$ - 0$ - 0
20Each151Oxymetazoline Nasal Spray, 15 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 24152Pedialyte Solution, 33.8 oz$ - 0$ - 0$ - 0$ - 0
50Pkg 24153PeptoBismol Chewable Tablets, box$ - 0$ - 0$ - 0$ - 0
60Each154Permethrin Cream 5%, 60 g Tubes$ - 0$ - 0$ - 0$ - 0
120Each155Permethrin Topical Cream Rinse 60ml$ - 0$ - 0$ - 0$ - 0
20Each156Phenytoin Oral Suspension 125 mg/5 mL, 237mL$ - 0$ - 0$ - 0$ - 0
20Bottle of 100157Phenytoin Sodium Capsules, 100 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100158Pioglitazone Tablets 15 mg, 90s (Actos)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100159Potassium Supplement 10mEq/tablet; 100s$ - 0$ - 0$ - 0$ - 0
105 ml Bottle160Prednisolone Acetate Ophth Suspension 0.12% (Pred Mild) 5mL$ - 0$ - 0$ - 0$ - 0
10240 ml Bottle161Prednisolone Syrup 15 mg / 5 mL, 240 mL$ - 0$ - 0$ - 0$ - 0
10Bottle of 100162Prednisone Tablets 20mg; 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100163Prednisone Tablets 5mg; 100s$ - 0$ - 0$ - 0$ - 0
20Each164Pregnancy Kit (Urine)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100165Premarin, 0.625 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100166Prenatal Vitamins, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100167Propranolol HCl Tablets, 20 mg, 100's$ - 0$ - 0$ - 0$ - 0
200Pkg 24168Pseudoephedrine Tablets 30mg$ - 0$ - 0$ - 0$ - 0
10Bottle of 100169Pyridoxine 50 mg, 100s (Vitamin B6)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100170Quetiapine Fumarate Tablets 25 mg, 100s (Seroquel)$ - 0$ - 0$ - 0$ - 0
20Pkg 30171Racepinephrine Inhalation Solution, 2.25%, 0.5mL, vials$ - 0$ - 0$ - 0$ - 0
10Bottle of 100172Rifampin Tablets 300 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Bottle of 60173Risperidone Tablets 1mg, 60's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100174Senokot Tablets 8.6 mg, 100s$ - 0$ - 0$ - 0$ - 0
120Each175Serevent Diskus Inhaler 50 mcg$ - 0$ - 0$ - 0$ - 0
20Each176Silver Sulfadiazine 1% Cream, 50 gm$ - 0$ - 0$ - 0$ - 0
10Bottle of 100177SMZ/TMP DS Tablets, 800/160mg, 100's$ - 0$ - 0$ - 0$ - 0
30Each178SMZ/TMP Oral Suspension, 100mL$ - 0$ - 0$ - 0$ - 0
10Pkg 10179Sodium Bicarbonate Injection 50mEq; 50mL; 10s Syr$ - 0$ - 0$ - 0$ - 0
10Pkg 25180Sodium Chloride 0.9% inj. (Bacteriostatic), 30mL$ - 0$ - 0$ - 0$ - 0
20Pkg 12181Sodium Chloride 0.9% inj., 1000 mL$ - 0$ - 0$ - 0$ - 0
10Pkg 24182Sodium Chloride 0.9% inj., 250 mL$ - 0$ - 0$ - 0$ - 0
10Pkg 24183Sodium Chloride 0.9% inj., 500 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 16184Sodium Chloride 0.9% irrig., 1000 mL$ - 0$ - 0$ - 0$ - 0
10Pkg 100185Sodium Chloride Inhalation Solution 0.9%, 3mL$ - 0$ - 0$ - 0$ - 0
50Each186Sodium Sulfacetamide 15% Ophth Soln, 5mL$ - 0$ - 0$ - 0$ - 0
20Bottle of 100187Spironolactone Tablets 25 mg, 100s (Aldactone)$ - 0$ - 0$ - 0$ - 0
60Pkg 16188Sterile Water for Irrigation 1000mL$ - 0$ - 0$ - 0$ - 0
10Bottle of 100189Sulfasalazine Tablets 500 mg EC, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100190Terazosin HCl Capsules 1 mg, 100's (Hytrin)$ - 0$ - 0$ - 0$ - 0
10Pkg 12191Tetracaine (Proparacaine) 0.5% Ophth Soln, 15mL$ - 0$ - 0$ - 0$ - 0
10Pkg 25192Thiamine Hydrochloride 100 mg/ml, 2 ml$ - 0$ - 0$ - 0$ - 0
100Each193Timolol Maleate Ophthmalmic Solution 0.5%, 5 mL$ - 0$ - 0$ - 0$ - 0
30Each194Tincture of Benzoin, 4 oz.$ - 0$ - 0$ - 0$ - 0
10Bottle of 100195Trazodone Hydrochloride Tablets 50 mg, 100's$ - 0$ - 0$ - 0$ - 0
120Each196Triamcinolone Acetonide Cream 0.1%, 15 gm$ - 0$ - 0$ - 0$ - 0
30Bottle of 100197Valporic Acid Capsules, 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 90198Venlafaxine Tablets 37.5 mg, 90s (Effexor)$ - 0$ - 0$ - 0$ - 0
10Each199Verapamil Extended-Release Tablets 240 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100200Vitamin K Tablets 5 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Bottle of 100201Warfarin Sodium Tablets 1 mg, 100's (Coumadin)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100202Warfarin Sodium Tablets 5 mg, 100's (Coumadin)$ - 0$ - 0$ - 0$ - 0
20Pkg 25203Water For Injection, Bacteriostatic 30ml vial$ - 0$ - 0$ - 0$ - 0
50Pkg 3204Zolmitriptan Tablet 5mg, package (Zomig)$ - 0$ - 0$ - 0$ - 0
100Each205Humulin-NPH 100U/mL; 10mL - refrigerate$ - 0$ - 0$ - 0$ - 0
10010 ml206Humulin-Regular 100 U/mL; 10mL - refrigerate$ - 0$ - 0$ - 0$ - 0
5010 ml207Insulin Glargine 10mL vial - refrigerate$ - 0$ - 0$ - 0$ - 0
201 Bottle of 10 ml208Insulin Human and Insulin Isophane Suspension 70/30, 10 ml - refrigerate$ - 0$ - 0$ - 0$ - 0
10package of 12each 25 mg209Promethazine Suppositories 25 mg, Adult - refrigerate$ - 0$ - 0$ - 0$ - 0
20010 each in box210Tetanus & Diphtheria Toxoids Ads (peds); 0.5 mL vial (10 EA / box) - refrigerate$ - 0$ - 0$ - 0$ - 0
20010 each in box211Tetanus Toxoid (Tetanus & Diphtheria Toxoids Abs) Adult, 0.5mL Syr (10 EA / box) - refrigerate$ - 0$ - 0$ - 0$ - 0
10Bottle of 100212Acetaminophen / Oxycodone HCl Tablets 325 mg / 5 mg, 100's (Percocet 5)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100213Adderal XR Capsules 5 mg, 100's (amphetamine mixed salts)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100214Clonazepam Tablets 0.5 mg, 100's$ - 0$ - 0$ - 0$ - 0
1010 ml bottle215Diazepam Injection, 5mg/ml, 10ml vial$ - 0$ - 0$ - 0$ - 0
10Bottle of 100216Diazepam Tablets, 5 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100217Hydrocodone / Acetaminophen, 5mg / 500mg Tablets, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100218Lorazepam Tablets, 1 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100219Methylphenidate XR Tablets (Concerta) 18 mg, 100's$ - 0$ - 0$ - 0$ - 0
1001 ml bottle220Morphine Sulfate Injection, 10mg/ml, 1ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 100221Oxycodone HCL XR Tablets 20 mg, 100's (Oxycontin)$ - 0$ - 0$ - 0$ - 0
1016 OZ Bottle222Phenobarbital Elixir, 20mg / 5ml, 16oz$ - 0$ - 0$ - 0$ - 0
10Bottle of 100223Phenobarbital Tablets, 30 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100224Zolpidem Tablets, 10mg, 100's UD$ - 0$ - 0$ - 0$ - 0

PRICING - Option 1

ATTACHMENT 2 - BUSINESS TEMPLATE

NOTE: Offerors may provide pricing for one item, a group of items, or all items, at the discretion of the Offeror. However, the Offeror must provide pricing for the full quantity of each item offered. Quantity variations are not permitted as each item's entire quantity will be awarded to only one Offeror.

COMPANY NAMEOption Period 1 USG QTYUnit of Measure (UoM)ITEM NOPRODUCT DESCRIPTIONVENDOR'S NDC #VENDOR'S EACH QTYEACH UNIT PRICEEXTENDED EACH PRICEVENDOR'S CASE QUANTITYVENDOR'S CASE UNIT PRICEEXTENDED CASE PRICE TOTAL
100EA1Acetaminophen Infant Drops 100 mg / 1 mL, 15 mL$ -$ - 0$ -$ - 0
200EA2Acetaminophen Oral Liquid 160mg/5mL; 120mL, Bottle$ -$ - 0$ -$ - 0
20PK3Acetaminophen Suppositories 120mg$ -$ - 0$ -$ - 0
60BT4Acetaminophen Tablets, 325mg, 100's$ -$ - 0$ -$ - 0
60BT5Acetaminophen Tablets, 500 mg, 100's$ -$ - 0$ -$ - 0
40BT6Activated Charcoal, 50gm, 30mL$ -$ - 0$ -$ - 0
20BT7Acyclovir Capsules, 200 mg (Zovirax), 100's$ -$ - 0$ -$ - 0
20PK8Adenosine Injection 3mg/mL, 2mL vial$ -$ - 0$ -$ - 0
22PK9Albuterol Inhalation Solution 0.083 3mL$ - 0$ - 0$ - 0$ - 0
500Each10Albuterol Inhalers, 17gm$ - 0$ - 0$ - 0$ - 0
20Each11Albuterol Sulfate Syrup 2mg/5mL, 480mL$ - 0$ - 0$ - 0$ - 0
20BT12Allopurinol Tablets 100 mg, 100's (Zyloprim)$ - 0$ - 0$ - 0$ - 0
40BT13Amiodardone HCL Tablets 200 mg, 90's (Cordarone)$ - 0$ - 0$ - 0$ - 0
60PK14Amiodarone HCl Injection, 150 mg / 3 ml, SDV$ - 0$ - 0$ - 0$ - 0
20Bottle of 10015Amoxicillin Capsules 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10016Amoxicillin Chewable Tablets 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
100Each17Amoxicillin Oral Susp. 250mg/5mL; 150mL$ - 0$ - 0$ - 0$ - 0
200Pkg 2018Amoxicillin/Clalvulanic Chewable Tablet 400 mg/57 mg$ - 0$ - 0$ - 0$ - 0
200Each19Amoxicillin/Clavulanic Oral Susp 200 mg/28.5 mg/5 mL, 50 mL$ - 0$ - 0$ - 0$ - 0
300Bottle of 2020Amoxicillin/Clavulanic Tablets 875 mg/125 mg, 20's$ - 0$ - 0$ - 0$ - 0
40Pkg 4821Antacid Liquid Reg Str; 150mL$ - 0$ - 0$ - 0$ - 0
60Each22Antipyrine/Benzocaine Otic Solution, 15 ml$ - 0$ - 0$ - 0$ - 0
240Bottle of 3623Aspirin Chewable Tablets, 81mg; 36's$ - 0$ - 0$ - 0$ - 0
60Bottle of 10024Aspirin Tablets, 325mg, 100's$ - 0$ - 0$ - 0$ - 0
100Bottle of 10025Atenolol Tablets 50 mg, 100's$ - 0$ - 0$ - 0$ - 0
40Pkg 1026Atropine Injection 0.1 mg/mL, 10mL Syr$ - 0$ - 0$ - 0$ - 0
100Each27Azithromycin Syrup 200 mg/ 5 ml, 30 mL$ - 0$ - 0$ - 0$ - 0
20Blister pack of 3x6 (18)28Azithromycin Tabs. 250 mg, 18's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10029Baclofen Tablets 10 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Vial30Benztropine Mesylate 1 mg/mL, 2 mL amp (Cogentin), 5's$ - 0$ - 0$ - 0$ - 0
20Box31Bisacodyl Suppositories 10 mg, 12/box$ - 0$ - 0$ - 0$ - 0
20Bottle of 5032Bisacodyl Tablets 5 mg, 50's$ - 0$ - 0$ - 0$ - 0
100Each33Brimonidine Tartrate Ophth Solution 0.2% (Alphagan P) 5mL$ - 0$ - 0$ - 0$ - 0
100Each34Brinzolamide Ophth Suspension 1% (Azopt) 5mL$ - 0$ - 0$ - 0$ - 0
20Pkg 2535Bupivacaine Marcaine Injection, 0.5 30 ml$ - 0$ - 0$ - 0$ - 0
40Bottle of 6036Bupropion Hydrochloride XR Tablets 150 mg, 60's (Wellbutrin XL)$ - 0$ - 0$ - 0$ - 0
40Each37Calamine Lotion, Phenolated, 4 oz. bottles$ - 0$ - 0$ - 0$ - 0
20Pkg 1038Calcium Chloride Injection 10%, 10 mL, Syr$ - 0$ - 0$ - 0$ - 0
40Bottle of 10039Carbamazepine Tablets 200 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10040Carbidopa/Levodopa 25mg/250 mg, 100s (Sinemet)$ - 0$ - 0$ - 0$ - 0
60Pkg 1041Ceftriaxone Injection 1 gm$ - 0$ - 0$ - 0$ - 0
60Bottle of 10042Cephalexin Capsules 500 mg, 100's$ - 0$ - 0$ - 0$ - 0
40Each43Cephalexin Oral Susp. 250 mg/5 ml, 200 ml$ - 0$ - 0$ - 0$ - 0
60120 ml Bottle44Cetirizine HCL syrup 5 mg/5 mL, 120 ml (Zyrtec)$ - 0$ - 0$ - 0$ - 0
20Bottle of 10045Ciprofloxacin Tablets 250mg, 100's$ - 0$ - 0$ - 0$ - 0
60Bottle of 10046Ciprofloxacin Tablets 500mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10047Citalopram Hydrobromide Tablets 10 mg, 100's (Celexa)$ - 0$ - 0$ - 0$ - 0
40Each48Clarithromycin Tablets (BIAXIN XL) 500 mg, 14's x 4$ - 0$ - 0$ - 0$ - 0
40Bottle of 10049Clindamycin HCL Capsules 150 mg, 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 10050Clonidine HCl Tablets 0.1mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10051Colchicine/Probenecid Tablets 0.5 mg/500 mg, 100's (Col-Probenecid)$ - 0$ - 0$ - 0$ - 0
20Vial52Cyanocobalamin 1000mcg IM injection 1mL, 25s$ - 0$ - 0$ - 0$ - 0
20Bottle of 10053Cyclobenzaprine HCl Tablets 10 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Each54Desitin Diaper Rash Ointment, 30Gm$ - 0$ - 0$ - 0$ - 0
20Pkg 2555Dexamethasone NA Phosphate Injection 4 mg/ml, 5ml$ - 0$ - 0$ - 0$ - 0
40Pkg 2456D50W (Dextrose 50%) Injection 50mL Syr$ - 0$ - 0$ - 0$ - 0
40Pkg 1257Dextrose 5% & Sodium Chloride 0.45% Inj. 1000 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 2458Dextrose 5% & Sodium Chloride 0.45% Inj. 500 mL$ - 0$ - 0$ - 0$ - 0
40Pkg 2459Dextrose 5% & Sodium Chloride 0.9% Inj. 500 mL$ - 0$ - 0$ - 0$ - 0
40Bottle of 10060Dicloxacillin Sodium Capsules, 250 mg equiv., 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 10061Digoxin Tablets 0.125mg, 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 9062Diltiazem HCL XR Capsules 120 mg (Cardizem CD), 90's$ - 0$ - 0$ - 0$ - 0
40Bottle of 10063Diphenhydramine Capsules 25mg; 100s$ - 0$ - 0$ - 0$ - 0
40Each64Diphenhydramine Elixir 12.5mg/5ml, 120ml$ - 0$ - 0$ - 0$ - 0
20Pkg 2565Diphenhydramine Injection 50mg/ml, 1 mL vial$ - 0$ - 0$ - 0$ - 0
20Pkg 1066Dobutamine Hydrochloride Inj. 250 mg/20 ml, vials$ - 0$ - 0$ - 0$ - 0
60Bottle of 10067Docusate Sodium Tablets 100 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Pkg 2568Dopamine Injection 40mg/ml, 10ml vial$ - 0$ - 0$ - 0$ - 0
20Bottle of 10069Doxycycline Hycalate Tabs.,100 mg UD, 100's$ - 0$ - 0$ - 0$ - 0
200Each70Enoxaparin Sodium 40 mg/0.4mL syringe (Lovenox)$ - 0$ - 0$ - 0$ - 0
20Each71Epinephrine 1:1,000 (1mg/ml) 30 ml vial$ - 0$ - 0$ - 0$ - 0
20Pkg 1072Epinephrine 1:10,000 (0.1mg/ml) 10ml Syr$ - 0$ - 0$ - 0$ - 0
20Bottle of 10073Erythromycin Enteric Coated Tablets 250mg, 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 10074Famotidine Tablets 20mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10075Felodipine Tablets 5 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Bottle of 10076Ferrous gluconate 325 mg, 100s$ - 0$ - 0$ - 0$ - 0
40Each77Fluconazole Tablets150 mg, UD 12/box (Diflucan)$ - 0$ - 0$ - 0$ - 0
24025 ml Bottle78Flunisolide Nasal Spray 0.025%, 25 mL (Nasarel)$ - 0$ - 0$ - 0$ - 0
100Each79Fluocinolone Acetonide Cream 0.025%, 15 gm$ - 0$ - 0$ - 0$ - 0
20Bottle of 10080Fluoxetine Hydrochloride Capsules 20 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10081Folic Acid Tablets 1 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10082Furosemide Tablets 40mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10083Gabapentin Capsules 100mg, 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 10084Gabapentin Capsules 300mg, 100's$ - 0$ - 0$ - 0$ - 0
100Each85Gentamicin Ophthalmic Solution 3mg/ml 5ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 10086Glipizide Tablets 5 mg, 100s (Glucotrol)$ - 0$ - 0$ - 0$ - 0
100Each87Glucagon for Injection 1mg, 1 mL, Syr$ - 0$ - 0$ - 0$ - 0
300Pkg of 1288Glucose Tablets, Box$ - 0$ - 0$ - 0$ - 0
40Bottle of 10089Glyburide Tablets 5mg, 100's$ - 0$ - 0$ - 0$ - 0
200Each90Guaifenesin DM Syrup; 4oz$ - 0$ - 0$ - 0$ - 0
20Pkg 1091Haloperidol Injection 5mg/mL, 1mL vial$ - 0$ - 0$ - 0$ - 0
20Bottle of 10092Haloperidol Tablets 1 mg, 100's UD$ - 0$ - 0$ - 0$ - 0
60Pkg 2593Heparin Lock Flush Kit, 100 units/mL, 1mL vials$ - 0$ - 0$ - 0$ - 0
20Bottle of 2594Hydralazine 20mg/mL, 1mL vial, 25's$ - 0$ - 0$ - 0$ - 0
60Bottle of 10095Hydrochlorothiazide Tablets 25mg, 100's$ - 0$ - 0$ - 0$ - 0
240Each96Hydrocortisone Cream 1%, 1 oz$ - 0$ - 0$ - 0$ - 0
100Each97Ibuprofen Oral Drops, 15 mL$ - 0$ - 0$ - 0$ - 0
40Pkg 2498Ibuprofen Oral Suspension 100mg/5mL, 120mL$ - 0$ - 0$ - 0$ - 0
120Pkg 899Infant formula-Enfacare liquid 3oz$ - 0$ - 0$ - 0$ - 0
240Each100Ipratropium Bromide Inhalation Aerosol, 14.7g$ - 0$ - 0$ - 0$ - 0
60Each101Ipratropium Bromide Inhalation Solution, 0.02%, 2.5 ml, packs (25 bullets / pack)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100102Isoniazid Tablets 300 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Bottle of 100103Isosorbide Tablets 10mg; 100s$ - 0$ - 0$ - 0$ - 0
20Pkg 10104Ketoralac Injection 30mg/mL; 2mL vial$ - 0$ - 0$ - 0$ - 0
40Pkg 12105Lactated Ringers Injection, 1000ml$ - 0$ - 0$ - 0$ - 0
1002.5 ml Bottle106Latanoprost Ophth Solution 0.005% (Xalatan) 2.5mL$ - 0$ - 0$ - 0$ - 0
20Pkg 3107Levlen, 28 pills / compact, 3 compacts / box$ - 0$ - 0$ - 0$ - 0
20Each108Levonorgestrel-28, 3's (ALTAVERA)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100109Levothroid Sodium Tablets 100 mcg; 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 100110Levothyroxine Sodium Tablets 50 mcg; 100's$ - 0$ - 0$ - 0$ - 0
20Pkg 25111Lidocaine 1% Injection 20mL vial$ - 0$ - 0$ - 0$ - 0
20Pkg 10112Lidocaine 1% Injection, 5 mL Syr$ - 0$ - 0$ - 0$ - 0
20Pkg 5113Lidocaine 1% w/Epinephrine Injection; 10mL vial$ - 0$ - 0$ - 0$ - 0
40Each114Lidocaine 2% Viscous 100mL$ - 0$ - 0$ - 0$ - 0
20Pkg 10115Lidocaine/Prilocaine Cream 5gm$ - 0$ - 0$ - 0$ - 0
60Bottle of 100116Lisinopril Tablets 10 mg, 100's (Zestril)$ - 0$ - 0$ - 0$ - 0
40Bottle of 100117Lithium Carbonate Tablets 300mg, 100's$ - 0$ - 0$ - 0$ - 0
20Pkg 6118Lo-Ovral, 28 pills / compact, 6 compacts / box$ - 0$ - 0$ - 0$ - 0
20Bottle of 100119Loperamide HCl Capsules, 2mg; 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 100120Loratadine tablets 10 mg, 100/box (Claritin) UD$ - 0$ - 0$ - 0$ - 0
40Bottle of 90121Losartan Potassium Tablets 25 mg, 90's (Cozaar)$ - 0$ - 0$ - 0$ - 0
20Pkg 10122Magnesium Sulfate Injection 5 g/ml 10 ml$ - 0$ - 0$ - 0$ - 0
40Bottle of 12123Mebendazole Tablets 100mg, 12's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100124Meclizine Hydrochloride Tablets 25 mg, 100's$ - 0$ - 0$ - 0$ - 0
100Bottle of 100125Metformin Tablets 500 mg, 100s (Glucophage)$ - 0$ - 0$ - 0$ - 0
20Pkg 25126Methylprednisolone Injection 125mg; 2mL$ - 0$ - 0$ - 0$ - 0
20Each127Methylprednisolone Sodium Injection 1000mg$ - 0$ - 0$ - 0$ - 0
20Bottle of 21128Methylprednisolone Tablets 4 mg; 21's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100129Metocloperamide HydrochlorideTablets 10mg; 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 100130Metoprolol Tablets 50mg; 100s$ - 0$ - 0$ - 0$ - 0
20Bottle of 50131Metronidazole Tablets 500mg; 50s$ - 0$ - 0$ - 0$ - 0
240Each132Miconazole Cream 2% 30gm;$ - 0$ - 0$ - 0$ - 0
120Each133Miconazole Vaginal Cream 45gm$ - 0$ - 0$ - 0$ - 0
40Bottle of 90134Montelukast Sodium Tablets 10 mg, 90s (Singulair)$ - 0$ - 0$ - 0$ - 0
120Each135Mupirocin Ointment 2%, 30 g Tube$ - 0$ - 0$ - 0$ - 0
40Each136Neomycin/PolymyxinHC Otic Suspension 10mL$ - 0$ - 0$ - 0$ - 0
200Pkg 10137Naloxone Hydrochloride Injection 0.4 mg/ml, 1 ml$ - 0$ - 0$ - 0$ - 0
40Bottle of 100138Nifedipine Capsules 30mg, 100's$ - 0$ - 0$ - 0$ - 0
240Pkg 25139Nitroglycerin Sublingual Tablets 0.4mg, pills / vial$ - 0$ - 0$ - 0$ - 0
20Pkg 30140Nitroglycerin Transdermal System 0.2mg/hr$ - 0$ - 0$ - 0$ - 0
20Each141Nitroprusside Sodium 50 mg, 2 mL vial$ - 0$ - 0$ - 0$ - 0
40Bottle of 100142Nortriptyline HCl Capsules 25 mg, 100's$ - 0$ - 0$ - 0$ - 0
120Each143Nupercainal HC 1% Cream 1oz.$ - 0$ - 0$ - 0$ - 0
960Each144Nutrient Supplement, Powdered, Vanilla, 14 oz.$ - 0$ - 0$ - 0$ - 0
240Each145Nystatin Cream 100,000 Units/Gm; 15gm$ - 0$ - 0$ - 0$ - 0
100Each146Nystatin Oral Suspension 100,000 Units/mL; 60mL$ - 0$ - 0$ - 0$ - 0
240Each147Ocean Nasal Spray 45mL$ - 0$ - 0$ - 0$ - 0
100Bottle of 100148Omeprazole Tablets 20 mg, 100s (Prilosec)$ - 0$ - 0$ - 0$ - 0
80Each149Opthalmic Irrigating Solution, 4 oz.$ - 0$ - 0$ - 0$ - 0
20Bottle of 100150Oxybutynin 5 mg tablets IR, 100s$ - 0$ - 0$ - 0$ - 0
40Each151Oxymetazoline Nasal Spray, 15 mL$ - 0$ - 0$ - 0$ - 0
40Pkg 24152Pedialyte Solution, 33.8 oz$ - 0$ - 0$ - 0$ - 0
100Pkg 24153PeptoBismol Chewable Tablets, box$ - 0$ - 0$ - 0$ - 0
120Each154Permethrin Cream 5%, 60 g Tubes$ - 0$ - 0$ - 0$ - 0
240Each155Permethrin Topical Cream Rinse 60ml$ - 0$ - 0$ - 0$ - 0
40Each156Phenytoin Oral Suspension 125 mg/5 mL, 237mL$ - 0$ - 0$ - 0$ - 0
40Bottle of 100157Phenytoin Sodium Capsules, 100 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100158Pioglitazone Tablets 15 mg, 90s (Actos)$ - 0$ - 0$ - 0$ - 0
40Bottle of 100159Potassium Supplement 10mEq/tablet; 100s$ - 0$ - 0$ - 0$ - 0
205 ml Bottle160Prednisolone Acetate Ophth Suspension 0.12% (Pred Mild) 5mL$ - 0$ - 0$ - 0$ - 0
20240 ml Bottle161Prednisolone Syrup 15 mg / 5 mL, 240 mL$ - 0$ - 0$ - 0$ - 0
20Bottle of 100162Prednisone Tablets 20mg; 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100163Prednisone Tablets 5mg; 100s$ - 0$ - 0$ - 0$ - 0
40Each164Pregnancy Kit (Urine)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100165Premarin, 0.625 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100166Prenatal Vitamins, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100167Propranolol HCl Tablets, 20 mg, 100's$ - 0$ - 0$ - 0$ - 0
400Pkg 24168Pseudoephedrine Tablets 30mg$ - 0$ - 0$ - 0$ - 0
20Bottle of 100169Pyridoxine 50 mg, 100s (Vitamin B6)$ - 0$ - 0$ - 0$ - 0
40Bottle of 100170Quetiapine Fumarate Tablets 25 mg, 100s (Seroquel)$ - 0$ - 0$ - 0$ - 0
40Pkg 30171Racepinephrine Inhalation Solution, 2.25%, 0.5mL, vials$ - 0$ - 0$ - 0$ - 0
20Bottle of 100172Rifampin Tablets 300 mg, 100s$ - 0$ - 0$ - 0$ - 0
40Bottle of 60173Risperidone Tablets 1mg, 60's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100174Senokot Tablets 8.6 mg, 100s$ - 0$ - 0$ - 0$ - 0
240Each175Serevent Diskus Inhaler 50 mcg$ - 0$ - 0$ - 0$ - 0
40Each176Silver Sulfadiazine 1% Cream, 50 gm$ - 0$ - 0$ - 0$ - 0
20Bottle of 100177SMZ/TMP DS Tablets, 800/160mg, 100's$ - 0$ - 0$ - 0$ - 0
60Each178SMZ/TMP Oral Suspension, 100mL$ - 0$ - 0$ - 0$ - 0
20Pkg 10179Sodium Bicarbonate Injection 50mEq; 50mL; 10s Syr$ - 0$ - 0$ - 0$ - 0
20Pkg 25180Sodium Chloride 0.9% inj. (Bacteriostatic), 30mL$ - 0$ - 0$ - 0$ - 0
40Pkg 12181Sodium Chloride 0.9% inj., 1000 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 24182Sodium Chloride 0.9% inj., 250 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 24183Sodium Chloride 0.9% inj., 500 mL$ - 0$ - 0$ - 0$ - 0
40Pkg 16184Sodium Chloride 0.9% irrig., 1000 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 100185Sodium Chloride Inhalation Solution 0.9%, 3mL$ - 0$ - 0$ - 0$ - 0
100Each186Sodium Sulfacetamide 15% Ophth Soln, 5mL$ - 0$ - 0$ - 0$ - 0
40Bottle of 100187Spironolactone Tablets 25 mg, 100s (Aldactone)$ - 0$ - 0$ - 0$ - 0
120Pkg 16188Sterile Water for Irrigation 1000mL$ - 0$ - 0$ - 0$ - 0
20Bottle of 100189Sulfasalazine Tablets 500 mg EC, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100190Terazosin HCl Capsules 1 mg, 100's (Hytrin)$ - 0$ - 0$ - 0$ - 0
20Pkg 12191Tetracaine (Proparacaine) 0.5% Ophth Soln, 15mL$ - 0$ - 0$ - 0$ - 0
20Pkg 25192Thiamine Hydrochloride 100 mg/ml, 2 ml$ - 0$ - 0$ - 0$ - 0
200Each193Timolol Maleate Ophthmalmic Solution 0.5%, 5 mL$ - 0$ - 0$ - 0$ - 0
60Each194Tincture of Benzoin, 4 oz.$ - 0$ - 0$ - 0$ - 0
20Bottle of 100195Trazodone Hydrochloride Tablets 50 mg, 100's$ - 0$ - 0$ - 0$ - 0
240Each196Triamcinolone Acetonide Cream 0.1%, 15 gm$ - 0$ - 0$ - 0$ - 0
60Bottle of 100197Valporic Acid Capsules, 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 90198Venlafaxine Tablets 37.5 mg, 90s (Effexor)$ - 0$ - 0$ - 0$ - 0
20Each199Verapamil Extended-Release Tablets 240 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100200Vitamin K Tablets 5 mg, 100s$ - 0$ - 0$ - 0$ - 0
40Bottle of 100201Warfarin Sodium Tablets 1 mg, 100's (Coumadin)$ - 0$ - 0$ - 0$ - 0
40Bottle of 100202Warfarin Sodium Tablets 5 mg, 100's (Coumadin)$ - 0$ - 0$ - 0$ - 0
40Pkg 25203Water For Injection, Bacteriostatic 30ml vial$ - 0$ - 0$ - 0$ - 0
100Pkg 3204Zolmitriptan Tablet 5mg, package (Zomig)$ - 0$ - 0$ - 0$ - 0
200Each205Humulin-NPH 100U/mL; 10mL - refrigerate$ - 0$ - 0$ - 0$ - 0
20010 ml206Humulin-Regular 100 U/mL; 10mL - refrigerate$ - 0$ - 0$ - 0$ - 0
10010 ml207Insulin Glargine 10mL vial - refrigerate$ - 0$ - 0$ - 0$ - 0
401 Bottle of 10 ml208Insulin Human and Insulin Isophane Suspension 70/30, 10 ml - refrigerate$ - 0$ - 0$ - 0$ - 0
20package of 12each 25 mg209Promethazine Suppositories 25 mg, Adult - refrigerate$ - 0$ - 0$ - 0$ - 0
40010 each in box210Tetanus & Diphtheria Toxoids Ads (peds); 0.5 mL vial (10 EA / box) - refrigerate$ - 0$ - 0$ - 0$ - 0
40010 each in box211Tetanus Toxoid (Tetanus & Diphtheria Toxoids Abs) Adult, 0.5mL Syr (10 EA / box) - refrigerate$ - 0$ - 0$ - 0$ - 0
20Bottle of 100212Acetaminophen / Oxycodone HCl Tablets 325 mg / 5 mg, 100's (Percocet 5)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100213Adderal XR Capsules 5 mg, 100's (amphetamine mixed salts)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100214Clonazepam Tablets 0.5 mg, 100's$ - 0$ - 0$ - 0$ - 0
2010 ml bottle215Diazepam Injection, 5mg/ml, 10ml vial$ - 0$ - 0$ - 0$ - 0
20Bottle of 100216Diazepam Tablets, 5 mg, 100's$ - 0$ - 0$ - 0$ - 0
40Bottle of 100217Hydrocodone / Acetaminophen, 5mg / 500mg Tablets, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100218Lorazepam Tablets, 1 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100219Methylphenidate XR Tablets (Concerta) 18 mg, 100's$ - 0$ - 0$ - 0$ - 0
2001 ml bottle220Morphine Sulfate Injection, 10mg/ml, 1ml$ - 0$ - 0$ - 0$ - 0
40Bottle of 100221Oxycodone HCL XR Tablets 20 mg, 100's (Oxycontin)$ - 0$ - 0$ - 0$ - 0
2016 OZ Bottle222Phenobarbital Elixir, 20mg / 5ml, 16oz$ - 0$ - 0$ - 0$ - 0
20Bottle of 100223Phenobarbital Tablets, 30 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100224Zolpidem Tablets, 10mg, 100's UD$ - 0$ - 0$ - 0$ - 0

PRICING - Option 2

ATTACHMENT 2 - BUSINESS TEMPLATE

NOTE: Offerors may provide pricing for one item, a group of items, or all items, at the discretion of the Offeror. However, the Offeror must provide pricing for the full quantity of each item offered. Quantity variations are not permitted as each item's entire quantity will be awarded to only one Offeror.

COMPANY NAMEOption Period 2 USG QTYUnit of Measure (UoM)ITEM NOPRODUCT DESCRIPTIONVENDOR'S NDC #VENDOR'S EACH QTYEACH UNIT PRICEEXTENDED EACH PRICEVENDOR'S CASE QUANTITYVENDOR'S CASE UNIT PRICEEXTENDED CASE PRICE TOTAL
50EA1Acetaminophen Infant Drops 100 mg / 1 mL, 15 mL$ -$ - 0$ -$ - 0
100EA2Acetaminophen Oral Liquid 160mg/5mL; 120mL, Bottle$ -$ - 0$ -$ - 0
10PK3Acetaminophen Suppositories 120mg$ -$ - 0$ -$ - 0
30BT4Acetaminophen Tablets, 325mg, 100's$ -$ - 0$ -$ - 0
30BT5Acetaminophen Tablets, 500 mg, 100's$ -$ - 0$ -$ - 0
20BT6Activated Charcoal, 50gm, 30mL$ -$ - 0$ -$ - 0
10BT7Acyclovir Capsules, 200 mg (Zovirax), 100's$ -$ - 0$ -$ - 0
10PK8Adenosine Injection 3mg/mL, 2mL vial$ -$ - 0$ -$ - 0
11PK9Albuterol Inhalation Solution 0.083 3mL$ - 0$ - 0$ - 0$ - 0
250Each10Albuterol Inhalers, 17gm$ - 0$ - 0$ - 0$ - 0
10Each11Albuterol Sulfate Syrup 2mg/5mL, 480mL$ - 0$ - 0$ - 0$ - 0
10BT12Allopurinol Tablets 100 mg, 100's (Zyloprim)$ - 0$ - 0$ - 0$ - 0
20BT13Amiodardone HCL Tablets 200 mg, 90's (Cordarone)$ - 0$ - 0$ - 0$ - 0
30PK14Amiodarone HCl Injection, 150 mg / 3 ml, SDV$ - 0$ - 0$ - 0$ - 0
10Bottle of 10015Amoxicillin Capsules 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10016Amoxicillin Chewable Tablets 250 mg, 100's$ - 0$ - 0$ - 0$ - 0
50Each17Amoxicillin Oral Susp. 250mg/5mL; 150mL$ - 0$ - 0$ - 0$ - 0
100Pkg 2018Amoxicillin/Clalvulanic Chewable Tablet 400 mg/57 mg$ - 0$ - 0$ - 0$ - 0
100Each19Amoxicillin/Clavulanic Oral Susp 200 mg/28.5 mg/5 mL, 50 mL$ - 0$ - 0$ - 0$ - 0
150Bottle of 2020Amoxicillin/Clavulanic Tablets 875 mg/125 mg, 20's$ - 0$ - 0$ - 0$ - 0
20Pkg 4821Antacid Liquid Reg Str; 150mL$ - 0$ - 0$ - 0$ - 0
30Each22Antipyrine/Benzocaine Otic Solution, 15 ml$ - 0$ - 0$ - 0$ - 0
120Bottle of 3623Aspirin Chewable Tablets, 81mg; 36's$ - 0$ - 0$ - 0$ - 0
30Bottle of 10024Aspirin Tablets, 325mg, 100's$ - 0$ - 0$ - 0$ - 0
50Bottle of 10025Atenolol Tablets 50 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Pkg 1026Atropine Injection 0.1 mg/mL, 10mL Syr$ - 0$ - 0$ - 0$ - 0
50Each27Azithromycin Syrup 200 mg/ 5 ml, 30 mL$ - 0$ - 0$ - 0$ - 0
10Blister pack of 3x6 (18)28Azithromycin Tabs. 250 mg, 18's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10029Baclofen Tablets 10 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Vial30Benztropine Mesylate 1 mg/mL, 2 mL amp (Cogentin), 5's$ - 0$ - 0$ - 0$ - 0
10Box31Bisacodyl Suppositories 10 mg, 12/box$ - 0$ - 0$ - 0$ - 0
10Bottle of 5032Bisacodyl Tablets 5 mg, 50's$ - 0$ - 0$ - 0$ - 0
50Each33Brimonidine Tartrate Ophth Solution 0.2% (Alphagan P) 5mL$ - 0$ - 0$ - 0$ - 0
50Each34Brinzolamide Ophth Suspension 1% (Azopt) 5mL$ - 0$ - 0$ - 0$ - 0
10Pkg 2535Bupivacaine Marcaine Injection, 0.5 30 ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 6036Bupropion Hydrochloride XR Tablets 150 mg, 60's (Wellbutrin XL)$ - 0$ - 0$ - 0$ - 0
20Each37Calamine Lotion, Phenolated, 4 oz. bottles$ - 0$ - 0$ - 0$ - 0
10Pkg 1038Calcium Chloride Injection 10%, 10 mL, Syr$ - 0$ - 0$ - 0$ - 0
20Bottle of 10039Carbamazepine Tablets 200 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10040Carbidopa/Levodopa 25mg/250 mg, 100s (Sinemet)$ - 0$ - 0$ - 0$ - 0
30Pkg 1041Ceftriaxone Injection 1 gm$ - 0$ - 0$ - 0$ - 0
30Bottle of 10042Cephalexin Capsules 500 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Each43Cephalexin Oral Susp. 250 mg/5 ml, 200 ml$ - 0$ - 0$ - 0$ - 0
30120 ml Bottle44Cetirizine HCL syrup 5 mg/5 mL, 120 ml (Zyrtec)$ - 0$ - 0$ - 0$ - 0
10Bottle of 10045Ciprofloxacin Tablets 250mg, 100's$ - 0$ - 0$ - 0$ - 0
30Bottle of 10046Ciprofloxacin Tablets 500mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10047Citalopram Hydrobromide Tablets 10 mg, 100's (Celexa)$ - 0$ - 0$ - 0$ - 0
20Each48Clarithromycin Tablets (BIAXIN XL) 500 mg, 14's x 4$ - 0$ - 0$ - 0$ - 0
20Bottle of 10049Clindamycin HCL Capsules 150 mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10050Clonidine HCl Tablets 0.1mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10051Colchicine/Probenecid Tablets 0.5 mg/500 mg, 100's (Col-Probenecid)$ - 0$ - 0$ - 0$ - 0
10Vial52Cyanocobalamin 1000mcg IM injection 1mL, 25s$ - 0$ - 0$ - 0$ - 0
10Bottle of 10053Cyclobenzaprine HCl Tablets 10 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Each54Desitin Diaper Rash Ointment, 30Gm$ - 0$ - 0$ - 0$ - 0
10Pkg 2555Dexamethasone NA Phosphate Injection 4 mg/ml, 5ml$ - 0$ - 0$ - 0$ - 0
20Pkg 2456D50W (Dextrose 50%) Injection 50mL Syr$ - 0$ - 0$ - 0$ - 0
20Pkg 1257Dextrose 5% & Sodium Chloride 0.45% Inj. 1000 mL$ - 0$ - 0$ - 0$ - 0
10Pkg 2458Dextrose 5% & Sodium Chloride 0.45% Inj. 500 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 2459Dextrose 5% & Sodium Chloride 0.9% Inj. 500 mL$ - 0$ - 0$ - 0$ - 0
20Bottle of 10060Dicloxacillin Sodium Capsules, 250 mg equiv., 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10061Digoxin Tablets 0.125mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 9062Diltiazem HCL XR Capsules 120 mg (Cardizem CD), 90's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10063Diphenhydramine Capsules 25mg; 100s$ - 0$ - 0$ - 0$ - 0
20Each64Diphenhydramine Elixir 12.5mg/5ml, 120ml$ - 0$ - 0$ - 0$ - 0
10Pkg 2565Diphenhydramine Injection 50mg/ml, 1 mL vial$ - 0$ - 0$ - 0$ - 0
10Pkg 1066Dobutamine Hydrochloride Inj. 250 mg/20 ml, vials$ - 0$ - 0$ - 0$ - 0
30Bottle of 10067Docusate Sodium Tablets 100 mg, 100s$ - 0$ - 0$ - 0$ - 0
10Pkg 2568Dopamine Injection 40mg/ml, 10ml vial$ - 0$ - 0$ - 0$ - 0
10Bottle of 10069Doxycycline Hycalate Tabs.,100 mg UD, 100's$ - 0$ - 0$ - 0$ - 0
100Each70Enoxaparin Sodium 40 mg/0.4mL syringe (Lovenox)$ - 0$ - 0$ - 0$ - 0
10Each71Epinephrine 1:1,000 (1mg/ml) 30 ml vial$ - 0$ - 0$ - 0$ - 0
10Pkg 1072Epinephrine 1:10,000 (0.1mg/ml) 10ml Syr$ - 0$ - 0$ - 0$ - 0
10Bottle of 10073Erythromycin Enteric Coated Tablets 250mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10074Famotidine Tablets 20mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10075Felodipine Tablets 5 mg, 100s$ - 0$ - 0$ - 0$ - 0
10Bottle of 10076Ferrous gluconate 325 mg, 100s$ - 0$ - 0$ - 0$ - 0
20Each77Fluconazole Tablets150 mg, UD 12/box (Diflucan)$ - 0$ - 0$ - 0$ - 0
12025 ml Bottle78Flunisolide Nasal Spray 0.025%, 25 mL (Nasarel)$ - 0$ - 0$ - 0$ - 0
50Each79Fluocinolone Acetonide Cream 0.025%, 15 gm$ - 0$ - 0$ - 0$ - 0
10Bottle of 10080Fluoxetine Hydrochloride Capsules 20 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10081Folic Acid Tablets 1 mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10082Furosemide Tablets 40mg, 100's$ - 0$ - 0$ - 0$ - 0
10Bottle of 10083Gabapentin Capsules 100mg, 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 10084Gabapentin Capsules 300mg, 100's$ - 0$ - 0$ - 0$ - 0
50Each85Gentamicin Ophthalmic Solution 3mg/ml 5ml$ - 0$ - 0$ - 0$ - 0
10Bottle of 10086Glipizide Tablets 5 mg, 100s (Glucotrol)$ - 0$ - 0$ - 0$ - 0
50Each87Glucagon for Injection 1mg, 1 mL, Syr$ - 0$ - 0$ - 0$ - 0
150Pkg of 1288Glucose Tablets, Box$ - 0$ - 0$ - 0$ - 0
20Bottle of 10089Glyburide Tablets 5mg, 100's$ - 0$ - 0$ - 0$ - 0
100Each90Guaifenesin DM Syrup; 4oz$ - 0$ - 0$ - 0$ - 0
10Pkg 1091Haloperidol Injection 5mg/mL, 1mL vial$ - 0$ - 0$ - 0$ - 0
10Bottle of 10092Haloperidol Tablets 1 mg, 100's UD$ - 0$ - 0$ - 0$ - 0
30Pkg 2593Heparin Lock Flush Kit, 100 units/mL, 1mL vials$ - 0$ - 0$ - 0$ - 0
10Bottle of 2594Hydralazine 20mg/mL, 1mL vial, 25's$ - 0$ - 0$ - 0$ - 0
30Bottle of 10095Hydrochlorothiazide Tablets 25mg, 100's$ - 0$ - 0$ - 0$ - 0
120Each96Hydrocortisone Cream 1%, 1 oz$ - 0$ - 0$ - 0$ - 0
50Each97Ibuprofen Oral Drops, 15 mL$ - 0$ - 0$ - 0$ - 0
20Pkg 2498Ibuprofen Oral Suspension 100mg/5mL, 120mL$ - 0$ - 0$ - 0$ - 0
60Pkg 899Infant formula-Enfacare liquid 3oz$ - 0$ - 0$ - 0$ - 0
120Each100Ipratropium Bromide Inhalation Aerosol, 14.7g$ - 0$ - 0$ - 0$ - 0
30Each101Ipratropium Bromide Inhalation Solution, 0.02%, 2.5 ml, packs (25 bullets / pack)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100102Isoniazid Tablets 300 mg, 100s$ - 0$ - 0$ - 0$ - 0
10Bottle of 100103Isosorbide Tablets 10mg; 100s$ - 0$ - 0$ - 0$ - 0
10Pkg 10104Ketoralac Injection 30mg/mL; 2mL vial$ - 0$ - 0$ - 0$ - 0
20Pkg 12105Lactated Ringers Injection, 1000ml$ - 0$ - 0$ - 0$ - 0
502.5 ml Bottle106Latanoprost Ophth Solution 0.005% (Xalatan) 2.5mL$ - 0$ - 0$ - 0$ - 0
10Pkg 3107Levlen, 28 pills / compact, 3 compacts / box$ - 0$ - 0$ - 0$ - 0
10Each108Levonorgestrel-28, 3's (ALTAVERA)$ - 0$ - 0$ - 0$ - 0
10Bottle of 100109Levothroid Sodium Tablets 100 mcg; 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100110Levothyroxine Sodium Tablets 50 mcg; 100's$ - 0$ - 0$ - 0$ - 0
10Pkg 25111Lidocaine 1% Injection 20mL vial$ - 0$ - 0$ - 0$ - 0
10Pkg 10112Lidocaine 1% Injection, 5 mL Syr$ - 0$ - 0$ - 0$ - 0
10Pkg 5113Lidocaine 1% w/Epinephrine Injection; 10mL vial$ - 0$ - 0$ - 0$ - 0
20Each114Lidocaine 2% Viscous 100mL$ - 0$ - 0$ - 0$ - 0
10Pkg 10115Lidocaine/Prilocaine Cream 5gm$ - 0$ - 0$ - 0$ - 0
30Bottle of 100116Lisinopril Tablets 10 mg, 100's (Zestril)$ - 0$ - 0$ - 0$ - 0
20Bottle of 100117Lithium Carbonate Tablets 300mg, 100's$ - 0$ - 0$ - 0$ - 0
10Pkg 6118Lo-Ovral, 28 pills / compact, 6 compacts / box$ - 0$ - 0$ - 0$ - 0
10Bottle of 100119Loperamide HCl Capsules, 2mg; 100's$ - 0$ - 0$ - 0$ - 0
20Bottle of 100120Loratadine tablets 10 mg, 100/box (Claritin) UD$ - 0$ - 0$ - 0$ - 0
20Bottle of 90121Losartan Potassium Tablets 25 mg, 90's (Cozaar)$ - 0$ - 0$ - 0$ - 0
10Pkg 10122Magnesium Sulfate Injection 5 g/ml 10 ml$ - 0$ - 0$ - 0$ - 0
20Bottle of 12123Mebendazole Tablets 100mg, 12's$ - 0$ - 0$ - 0$ - 0
10Bottle of 100124Meclizine Hydrochloride Tablets 25 mg, 100's$ - 0$ - 0$ - 0$ - 0
50Bottle of 100125Metformin Tablets 500 mg, 100s (Glucophage)$ - 0$ - 0$ - 0$ - 0
10Pkg 25126Methylprednisolone Injection 125mg; 2mL$ - 0$ - 0$ - 0$ - 0
10Each127Methylprednisolone Sodium Injection 1000mg$ - 0$ - 0$ - 0$ - 0
10Bottle of 21128Methylprednisolone Tablets 4 mg; 21's$ - 0$ - 0$ - 0$ - 0

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