Overview

CDM Standard Charge File
Aetna
Aetna MCR ADV
Blue Cross Health Options
Blue Cross NWB
Blue Cross PPC
Blue Cross Traditional
Freedom Health HMO-PPO MCR ADV
Freedom Health MCD ADV
Humana Choice Care
Humana MCR ADV HMO-PPO
Molina MCD ADV
Multiplan PHCS
Seminole Tribe MCR ADV
Simply Health MCD ADV
Staywell Healthy Kids MCD ADV
Sunshine State HP MCD ADV
Tricare Humana
UHC
UHC MCR ADV HMO-PPO
UPMC MCR ADV
VA Community Care Network
Vivida MCD ADV
Wellcare MCD ADV


Sheet 1: CDM Standard Charge File

Naples Community Hospital























File Updated: 12/18/2020
















































Charge Code Description CPT® Alternate CPT® HCPCS Alternate HCPCS CPT® Modifier Revenue Code NDC Code Service Location Gross Charge/Unit Cash Price Minimum Allowable Maximum Allowable Aetna International - Inpatient Aetna International - Outpatient Beech Street - Inpatient/Outpatient Cigna - Inpatient/Outpatient Consortium - Inpatient/Outpatient First Health - Outpatient Freedom Health PPO - Inpatient/Outpatient Mail Handlers - Inpatient/Outpatient Multiplan PHCS - Outpatient Seminole Tribe Employee PPO - Inpatient/Outpatient UPMC Commercial eff 2018/01/01 - Inpatient/Outpatient
7195886 ROOM/BED: Private




110
IP 2037 814.8 1018.5 1833.3 1629.6
1833.3 1385.16 1161.09
1222.2 1425.9
1731.45 1018.5
7195886 ROOM/BED: Private - NCH Room and Bed 2N Angio




110
IP 2937 1174.8 1468.5 2643.3 2349.6
2643.3 1997.16 1674.09
1762.2 2055.9
2496.45 1468.5
7195886 ROOM/BED: Private - NCH Room and Bed 6N GVS




110
IP 2487 994.8 1243.5 2238.3 1989.6
2238.3 1691.16 1417.59
1492.2 1740.9
2113.95 1243.5
7195886 ROOM/BED: Private - NCH Room and Bed CVRU




110
IP 4751 1900.4 2375.5 4275.9 3800.8
4275.9 3230.68 2708.07
2850.6 3325.7
4038.35 2375.5
7195886 ROOM/BED: Private - NCH Room and Bed L&D




110
IP 2131 852.4 1065.5 1917.9 1704.8
1917.9 1449.08 1214.67
1278.6 1491.7
1811.35 1065.5
7195886 ROOM/BED: Private - NCH Room and Bed Post Angio




110
IP 2937 1174.8 1468.5 2643.3 2349.6
2643.3 1997.16 1674.09
1762.2 2055.9
2496.45 1468.5
7195886 ROOM/BED: Private - NCH Room and Bed Psych




110
IP 2467 986.8 1233.5 2220.3 1973.6
2220.3 1677.56 1406.19
1480.2 1726.9
2096.95 1233.5
7195886 ROOM/BED: Private - NCH Room and Bed SICU




110
IP 2037 814.8 1018.5 1833.3 1629.6
1833.3 1385.16 1161.09
1222.2 1425.9
1731.45 1018.5
7204287 PRIVATE WOMEN & CHILDREN




110
IP 2131 852.4 1065.5 1917.9 1704.8
1917.9 1449.08 1214.67
1278.6 1491.7
1811.35 1065.5
7195887 ROOM/BED: Semi Private




120
IP 1762 704.8 881 1585.8 1409.6
1585.8 1198.16 1004.34
1057.2 1233.4
1497.7 881
7195887 ROOM/BED: Semi Private - NCH Room and Bed 2N Angio




120
IP 2662 1064.8 1331 2395.8 2129.6
2395.8 1810.16 1517.34
1597.2 1863.4
2262.7 1331
7195887 ROOM/BED: Semi Private - NCH Room and Bed L&D




120
IP 1856 742.4 928 1670.4 1484.8
1670.4 1262.08 1057.92
1113.6 1299.2
1577.6 928
7195887 ROOM/BED: Semi Private - NCH Room and Bed Post Angio




120
IP 2662 1064.8 1331 2395.8 2129.6
2395.8 1810.16 1517.34
1597.2 1863.4
2262.7 1331
7195887 ROOM/BED: Semi Private - NCH Room and Bed Psych




120
IP 2192 876.8 1096 1972.8 1753.6
1972.8 1490.56 1249.44
1315.2 1534.4
1863.2 1096
7204288 SEMI PRIVATE L&D-MED/SURG




120
IP 1856 742.4 928 1670.4 1484.8
1670.4 1262.08 1057.92
1113.6 1299.2
1577.6 928
7739954 Room/Bed Hospice




120
IP 1187 474.8 593.5 1068.3 949.6
1068.3 807.16 676.59
712.2 830.9
1008.95 593.5
7195880 Suite - Women and Children




140
IP 2383 953.2 1191.5 2144.7 1906.4
2144.7 1620.44 1358.31
1429.8 1668.1
2025.55 1191.5
7195882 ROOM/BED: Nursery




170
IP 1194 477.6 597 1074.6 955.2
1074.6 811.92 680.58
716.4 835.8
1014.9 597
7204289 NORMAL NEWBORN CARE




170
IP 1194 477.6 597 1074.6 955.2
1074.6 811.92 680.58
716.4 835.8
1014.9 597
7195881 ROOM/BED NICU




174
IP 3080 1232 1540 2772 2464
2772 2094.4 1755.6
1848 2156
2618 1540
7195881 ROOM/BED NICU - ACN/CCN




174
IP 2134 853.6 1067 1920.6 1707.2
1920.6 1451.12 1216.38
1280.4 1493.8
1813.9 1067
7195879 ROOM/BED:ICU - Base




200
IP 3768 1507.2 1884 3391.2 3014.4
3391.2 2562.24 2147.76
2260.8 2637.6
3202.8 1884
7195879 ROOM/BED:ICU - CVRU




200
IP 4751 1900.4 2375.5 4275.9 3800.8
4275.9 3230.68 2708.07
2850.6 3325.7
4038.35 2375.5
7195879 ROOM/BED:ICU - SICU




200
IP 3541 1416.4 1770.5 3186.9 2832.8
3186.9 2407.88 2018.37
2124.6 2478.7
3009.85 1770.5
7195885 ROOM/BED: PICU




203
IP 3517 1406.8 1758.5 3165.3 2813.6
3165.3 2391.56 2004.69
2110.2 2461.9
2989.45 1758.5
7195884 ROOM/BED:PCU




206
IP 3055 1222 1527.5 2749.5 2444
2749.5 2077.4 1741.35
1833 2138.5
2596.75 1527.5
7204286 PRIVATE W&C PROGRESSIVE CARE




206
IP 3055 1222 1527.5 2749.5 2444
2749.5 2077.4 1741.35
1833 2138.5
2596.75 1527.5
702871599997-0287-15 Standard (HUMALOG) Sliding Scale Insulin Protocol




250 99997-0287-15 IP/OP 0.01 0.004 0.005 0.009 0.008 0.0085 0.009 0.0068 0.0057 0.0085 0.006 0.007 0.0085 0.0085 0.005
702872399997-0287-23 Standard PLUS (HUMALOG) Sliding Scale Insulin Protocol




250 99997-0287-23 IP/OP 0.01 0.004 0.005 0.009 0.008 0.0085 0.009 0.0068 0.0057 0.0085 0.006 0.007 0.0085 0.0085 0.005
701669499999-9999-31 Premixed Infusion*




250 99999-9999-31 IP/OP 0.06 0.024 0.03 0.054 0.048 0.051 0.054 0.0408 0.0342 0.051 0.036 0.042 0.051 0.051 0.03
702500099999-9999-30 patch removal




250 99999-9999-30 IP/OP 0.06 0.024 0.03 0.054 0.048 0.051 0.054 0.0408 0.0342 0.051 0.036 0.042 0.051 0.051 0.03
702448299999-9999-28 tower access, NCOL Acudose




250 99999-9999-28 IP/OP 0.06 0.024 0.03 0.054 0.048 0.051 0.054 0.0408 0.0342 0.051 0.036 0.042 0.051 0.051 0.03
702520899999-9999-19 Refrigerated Med Access




250 99999-9999-19 IP/OP 0.06 0.024 0.03 0.054 0.048 0.051 0.054 0.0408 0.0342 0.051 0.036 0.042 0.051 0.051 0.03
702751999997-0275-19 Pharmacy Dosing Protocol




250 99997-0275-19 IP/OP 0.06 0.024 0.03 0.054 0.048 0.051 0.054 0.0408 0.0342 0.051 0.036 0.042 0.051 0.051 0.03
703144699997-0314-38 Non-formulary Med (CHARGE)




250 99997-0314-38 IP/OP 0.06 0.024 0.03 0.054 0.048 0.051 0.054 0.0408 0.0342 0.051 0.036 0.042 0.051 0.051 0.03
700897200904-7591-80 ferrous sulfate 325 mg Tab




250 00904-7591-80 IP/OP 0.1 0.04 0.05 0.09 0.08 0.085 0.09 0.068 0.057 0.085 0.06 0.07 0.085 0.085 0.05
700165400536-3305-10 aspirin 325 mg Tab




250 00536-3305-10 IP/OP 0.12 0.048 0.06 0.108 0.096 0.102 0.108 0.0816 0.0684 0.102 0.072 0.084 0.102 0.102 0.06
702418500904-5823-60 vitamin D3 (cholecalciferol) 10 mcg (400 unit) Tab




250 00904-5823-60 IP/OP 0.15 0.06 0.075 0.135 0.12 0.1275 0.135 0.102 0.0855 0.1275 0.09 0.105 0.1275 0.1275 0.075
816022307610-0178-40 vitamin D3 (cholecalciferol) 125 mcg (5000 unit) Tab




250 07610-0178-40 IP/OP 0.15 0.06 0.075 0.135 0.12 0.1275 0.135 0.102 0.0855 0.1275 0.09 0.105 0.1275 0.1275 0.075
702350000904-0270-60 vitamin E 100 unit Cap




250 00904-0270-60 IP/OP 0.16 0.064 0.08 0.144 0.128 0.136 0.144 0.1088 0.0912 0.136 0.096 0.112 0.136 0.136 0.08
702044900536-5904-10 senna 8.6 mg Tab




250 00536-5904-10 IP/OP 0.17 0.068 0.085 0.153 0.136 0.1445 0.153 0.1156 0.0969 0.1445 0.102 0.119 0.1445 0.1445 0.085
703076000904-5824-60 vitamin D3 (cholecalciferol) 25 mcg (1000 unit) Tab




250 00904-5824-60 IP/OP 0.17 0.068 0.085 0.153 0.136 0.1445 0.153 0.1156 0.0969 0.1445 0.102 0.119 0.1445 0.1445 0.085
702348400904-2085-60 vitamin A 10,000 unit Cap




250 00904-2085-60 IP/OP 0.18 0.072 0.09 0.162 0.144 0.153 0.162 0.1224 0.1026 0.153 0.108 0.126 0.153 0.153 0.09
751443851552-0873-06 soybean oil Liq




250 51552-0873-06 IP/OP 0.18 0.072 0.09 0.162 0.144 0.153 0.162 0.1224 0.1026 0.153 0.108 0.126 0.153 0.153 0.09
702068800536-1047-10 sodium bicarbonate 650 mg Tab




250 00536-1047-10 IP/OP 0.19 0.076 0.095 0.171 0.152 0.1615 0.171 0.1292 0.1083 0.1615 0.114 0.133 0.1615 0.1615 0.095
702196796295-0127-77 vitamin B1 (thiamine) 100 mg Tab




250 96295-0127-77 IP/OP 0.2 0.08 0.1 0.18 0.16 0.17 0.18 0.136 0.114 0.17 0.12 0.14 0.17 0.17 0.1
700410400904-0012-59 chlorpheniramine 4 mg Tab




250 00904-0012-59 IP/OP 0.21 0.084 0.105 0.189 0.168 0.1785 0.189 0.1428 0.1197 0.1785 0.126 0.147 0.1785 0.1785 0.105
700159700904-0523-80 vitamin C (ascorbic acid) 500 mg Tab




250 00904-0523-80 IP/OP 0.22 0.088 0.11 0.198 0.176 0.187 0.198 0.1496 0.1254 0.187 0.132 0.154 0.187 0.187 0.11
703154500904-0536-60 multivitamin with iron PED Chew Tab




250 00904-0536-60 IP/OP 0.22 0.088 0.11 0.198 0.176 0.187 0.198 0.1496 0.1254 0.187 0.132 0.154 0.187 0.187 0.11
700298311845-0091-51 calcium, oyster shell 500 mg Tab




250 11845-0091-51 IP/OP 0.23 0.092 0.115 0.207 0.184 0.1955 0.207 0.1564 0.1311 0.1955 0.138 0.161 0.1955 0.1955 0.115
700167000536-1004-41 aspirin 81 mg Tab Enteric




250 00536-1004-41 IP/OP 0.24 0.096 0.12 0.216 0.192 0.204 0.216 0.1632 0.1368 0.204 0.144 0.168 0.204 0.204 0.12
701592837205-0080-78 multivitamin Tab




250 37205-0080-78 IP/OP 0.24 0.096 0.12 0.216 0.192 0.204 0.216 0.1632 0.1368 0.204 0.144 0.168 0.204 0.204 0.12
701971400536-4408-01 vitamin B6 (pyridoxine) 50 mg Tab




250 00536-4408-01 IP/OP 0.24 0.096 0.12 0.216 0.192 0.204 0.216 0.1632 0.1368 0.204 0.144 0.168 0.204 0.204 0.12
701596900904-0260-13 multivitamin (surbex-t) B Complex with C




250 00904-0260-13 IP/OP 0.26 0.104 0.13 0.234 0.208 0.221 0.234 0.1768 0.1482 0.221 0.156 0.182 0.221 0.221 0.13
703183400093-4127-73 penicillin VK 50 mg/mL PEDIATRIC Oral Susp




250 00093-4127-73 IP/OP 0.26 0.104 0.13 0.234 0.208 0.221 0.234 0.1768 0.1482 0.221 0.156 0.182 0.221 0.221 0.13
701650400182-4405-01 niacin 500 mg Tab




250 00182-4405-01 IP/OP 0.28 0.112 0.14 0.252 0.224 0.238 0.252 0.1904 0.1596 0.238 0.168 0.196 0.238 0.238 0.14
702487000904-3207-13 vitamin B12 (cyanocobalamin) 500 mcg Tab




250 00904-3207-13 IP/OP 0.28 0.112 0.14 0.252 0.224 0.238 0.252 0.1904 0.1596 0.238 0.168 0.196 0.238 0.238 0.14
702705500904-3162-60 selenium 50 mcg Tab




250 00904-3162-60 IP/OP 0.28 0.112 0.14 0.252 0.224 0.238 0.252 0.1904 0.1596 0.238 0.168 0.196 0.238 0.238 0.14
700007800536-3231-01 acetaminophen 500 mg Tab




250 00536-3231-01 IP/OP 0.29 0.116 0.145 0.261 0.232 0.2465 0.261 0.1972 0.1653 0.2465 0.174 0.203 0.2465 0.2465 0.145
701868238485-0863-35 potassium chloride/sodium chloride 450 mg/30 mg Tab




250 38485-0863-35 IP/OP 0.3 0.12 0.15 0.27 0.24 0.255 0.27 0.204 0.171 0.255 0.18 0.21 0.255 0.255 0.15
805928735046-0001-20 vitamin B2 (riboflavin) 50 mg Tab




250 35046-0001-20 IP/OP 0.3 0.12 0.15 0.27 0.24 0.255 0.27 0.204 0.171 0.255 0.18 0.21 0.255 0.255 0.15
700309800182-4439-26 calcium/vitamin D 500 mg/200 unit Tab




250 00182-4439-26 IP/OP 0.33 0.132 0.165 0.297 0.264 0.2805 0.297 0.2244 0.1881 0.2805 0.198 0.231 0.2805 0.2805 0.165
702740200087-0365-03 MCT OIL 1 mL




250 00087-0365-03 IP/OP 0.35 0.14 0.175 0.315 0.28 0.2975 0.315 0.238 0.1995 0.2975 0.21 0.245 0.2975 0.2975 0.175
740002100904-5551-59 diphenhydrAMINE 25 mg Tab




250 00904-5551-59 IP/OP 0.36 0.144 0.18 0.324 0.288 0.306 0.324 0.2448 0.2052 0.306 0.216 0.252 0.306 0.306 0.18
702352600904-0274-60 vitamin E 400 unit Cap




250 00904-0274-60 IP/OP 0.36 0.144 0.18 0.324 0.288 0.306 0.324 0.2448 0.2052 0.306 0.216 0.252 0.306 0.306 0.18
700112667253-0148-46 amoxicillin 50 mg/mL Oral Susp




250 67253-0148-46 IP/OP 0.37 0.148 0.185 0.333 0.296 0.3145 0.333 0.2516 0.2109 0.3145 0.222 0.259 0.3145 0.3145 0.185
700164763739-0023-01 aspirin 325 mg Tab Enteric




250 63739-0023-01 IP/OP 0.37 0.148 0.185 0.333 0.296 0.3145 0.333 0.2516 0.2109 0.3145 0.222 0.259 0.3145 0.3145 0.185
700303100182-4151-01 calcium citrate 950 mg Tab




250 00182-4151-01 IP/OP 0.37 0.148 0.185 0.333 0.296 0.3145 0.333 0.2516 0.2109 0.3145 0.222 0.259 0.3145 0.3145 0.185
701603300904-5492-13 multivitamin, therapeutic M Tab




250 00904-5492-13 IP/OP 0.37 0.148 0.185 0.333 0.296 0.3145 0.333 0.2516 0.2109 0.3145 0.222 0.259 0.3145 0.3145 0.185
700996200088-1175-47 gaviscon Tab Chew




250 00088-1175-47 IP/OP 0.38 0.152 0.19 0.342 0.304 0.323 0.342 0.2584 0.2166 0.323 0.228 0.266 0.323 0.323 0.19
702060500536-1019-01 simethicone 80 mg Tab Chew




250 00536-1019-01 IP/OP 0.39 0.156 0.195 0.351 0.312 0.3315 0.351 0.2652 0.2223 0.3315 0.234 0.273 0.3315 0.3315 0.195
700168870000-0103-03 aspirin 81 mg Tab Chew




250 70000-0103-03 IP/OP 0.42 0.168 0.21 0.378 0.336 0.357 0.378 0.2856 0.2394 0.357 0.252 0.294 0.357 0.357 0.21
701144851079-0731-20 ibuprofen 200 mg Tab




250 51079-0731-20 IP/OP 0.42 0.168 0.21 0.378 0.336 0.357 0.378 0.2856 0.2394 0.357 0.252 0.294 0.357 0.357 0.21
702534900603-5168-21 PHENobarbital 100 mg Tab




250 00603-5168-21 IP/OP 0.42 0.168 0.21 0.378 0.336 0.357 0.378 0.2856 0.2394 0.357 0.252 0.294 0.357 0.357 0.21
700061563739-0644-10 alprazolam 0.25 mg Tab




250 63739-0644-10 IP/OP 0.43 0.172 0.215 0.387 0.344 0.3655 0.387 0.2924 0.2451 0.3655 0.258 0.301 0.3655 0.3655 0.215
700995400088-1174-47 gaviscon extra strength Tab Chew




250 00088-1174-47 IP/OP 0.43 0.172 0.215 0.387 0.344 0.3655 0.387 0.2924 0.2451 0.3655 0.258 0.301 0.3655 0.3655 0.215
700246200904-6407-61 bisacodyl 5 mg Tab Enteric




250 00904-6407-61 IP/OP 0.44 0.176 0.22 0.396 0.352 0.374 0.396 0.2992 0.2508 0.374 0.264 0.308 0.374 0.374 0.22
700299166553-0004-01 calcium carbonate 500 mg Tab Chew




250 66553-0004-01 IP/OP 0.46 0.184 0.23 0.414 0.368 0.391 0.414 0.3128 0.2622 0.391 0.276 0.322 0.391 0.391 0.23
700308000904-1882-61 calcium/vitamin D 250 mg/125 unit Tab




250 00904-1882-61 IP/OP 0.47 0.188 0.235 0.423 0.376 0.3995 0.423 0.3196 0.2679 0.3995 0.282 0.329 0.3995 0.3995 0.235
700963265162-0361-11 folic acid 1 mg Tab




250 65162-0361-11 IP/OP 0.47 0.188 0.235 0.423 0.376 0.3995 0.423 0.3196 0.2679 0.3995 0.282 0.329 0.3995 0.3995 0.235
702089400223-1760-01 sodium chloride 1 g Tab




250 00223-1760-01 IP/OP 0.48 0.192 0.24 0.432 0.384 0.408 0.432 0.3264 0.2736 0.408 0.288 0.336 0.408 0.408 0.24
702632163739-0201-15 PHENobarbital 32.4 mg Tab UD




250 63739-0201-15 IP/OP 0.48 0.192 0.24 0.432 0.384 0.408 0.432 0.3264 0.2736 0.408 0.288 0.336 0.408 0.408 0.24
701088700172-2083-60 hydrochlorothiazide 25 mg Tab




250 00172-2083-60 IP/OP 0.51 0.204 0.255 0.459 0.408 0.4335 0.459 0.3468 0.2907 0.4335 0.306 0.357 0.4335 0.4335 0.255
802118754629-9161-00 vitamin C (ascorbic acid) 125 mg Chewable Tab




250 54629-9161-00 IP/OP 0.53 0.212 0.265 0.477 0.424 0.4505 0.477 0.3604 0.3021 0.4505 0.318 0.371 0.4505 0.4505 0.265
700893100574-0508-11 ferrous gluconate 324 mg Tab




250 00574-0508-11 IP/OP 0.54 0.216 0.27 0.486 0.432 0.459 0.486 0.3672 0.3078 0.459 0.324 0.378 0.459 0.459 0.27
700726300536-1065-01 docusate calcium 240 mg Cap




250 00536-1065-01 IP/OP 0.55 0.22 0.275 0.495 0.44 0.4675 0.495 0.374 0.3135 0.4675 0.33 0.385 0.4675 0.4675 0.275
702843400904-4215-51 arginine 500 mg Tab




250 00904-4215-51 IP/OP 0.56 0.224 0.28 0.504 0.448 0.476 0.504 0.3808 0.3192 0.476 0.336 0.392 0.476 0.476 0.28
700116700093-4161-76 amoxicillin 80 mg/mL Oral Susp




250 00093-4161-76 IP/OP 0.59 0.236 0.295 0.531 0.472 0.5015 0.531 0.4012 0.3363 0.5015 0.354 0.413 0.5015 0.5015 0.295
700650558914-0015-16 dicyclomine 10 mg/5 mL 120 mL Syr




250 58914-0015-16 IP/OP 0.59 0.236 0.295 0.531 0.472 0.5015 0.531 0.4012 0.3363 0.5015 0.354 0.413 0.5015 0.5015 0.295
702466424208-0387-62 multivitamin with minerals (ocuvite) Tab




250 24208-0387-62 IP/OP 0.59 0.236 0.295 0.531 0.472 0.5015 0.531 0.4012 0.3363 0.5015 0.354 0.413 0.5015 0.5015 0.295
808521600904-5791-46 acetaminophen 80 mg ODT Tab




250 00904-5791-46 IP/OP 0.59 0.236 0.295 0.531 0.472 0.5015 0.531 0.4012 0.3363 0.5015 0.354 0.413 0.5015 0.5015 0.295
700300700394-0100-02 calcium carb/sod fluoride 364 mg/8.3 mg Tab




250 00394-0100-02 IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
700572199999-9999-49 Non-formulary Con IV




250 99999-9999-49 IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
700570599999-9999-50 Non-formulary Med Int IV




250 99999-9999-50 IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
700569799999-9999-51 Non-formulary Controlled Acudose Med A




250 99999-9999-51 IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
805168054629-7354-01 bifidobacterium-lactobacillus (PROBIOTIC) Cap




250 54629-7354-01 IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
808985699999-9999-51B Non-formulary Controlled Acudose Med B




250 99999-9999-51B IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
808986099999-9999-51C Non-formulary Controlled Acudose Med C




250 99999-9999-51C IP/OP 0.61 0.244 0.305 0.549 0.488 0.5185 0.549 0.4148 0.3477 0.5185 0.366 0.427 0.5185 0.5185 0.305
701958100536-3607-35 pseudoEPHEDrine 30 mg Tab




250 00536-3607-35 IP/OP 0.62 0.248 0.31 0.558 0.496 0.527 0.558 0.4216 0.3534 0.527 0.372 0.434 0.527 0.527 0.31
757268800185-4351-30 isoniazid 100 mg Tab




250 00185-4351-30 IP/OP 0.63 0.252 0.315 0.567 0.504 0.5355 0.567 0.4284 0.3591 0.5355 0.378 0.441 0.5355 0.5355 0.315
701953236652-0377-18 protegra Cap




250 36652-0377-18 IP/OP 0.64 0.256 0.32 0.576 0.512 0.544 0.576 0.4352 0.3648 0.544 0.384 0.448 0.544 0.544 0.32
702764299997-0276-42 metoclopramide 1 mg/mL PED Syrup




250 99997-0276-42 IP/OP 0.65 0.26 0.325 0.585 0.52 0.5525 0.585 0.442 0.3705 0.5525 0.39 0.455 0.5525 0.5525 0.325
701708010888-2732-09 omega/3 (fish oil) 1200 mg cap




250 10888-2732-09 IP/OP 0.68 0.272 0.34 0.612 0.544 0.578 0.612 0.4624 0.3876 0.578 0.408 0.476 0.578 0.578 0.34
701403868585-0005-75 magnesium chloride 64 mg Tab SR




250 68585-0005-75 IP/OP 0.7 0.28 0.35 0.63 0.56 0.595 0.63 0.476 0.399 0.595 0.42 0.49 0.595 0.595 0.35
702058900603-0211-20 simethicone 125 mg Tab Chew




250 00603-0211-20 IP/OP 0.7 0.28 0.35 0.63 0.56 0.595 0.63 0.476 0.399 0.595 0.42 0.49 0.595 0.595 0.35
702706300121-0531-05 PHENobarbital 4 mg/1 mL PED Elixir




250 00121-0531-05 IP/OP 0.7 0.28 0.35 0.63 0.56 0.595 0.63 0.476 0.399 0.595 0.42 0.49 0.595 0.595 0.35
801964500536-1098-08 melatonin 5 mg Tab




250 00536-1098-08 IP/OP 0.7 0.28 0.35 0.63 0.56 0.595 0.63 0.476 0.399 0.595 0.42 0.49 0.595 0.595 0.35
702396363739-0270-01 zinc sulfate 220 mg Cap




250 63739-0270-01 IP/OP 0.72 0.288 0.36 0.648 0.576 0.612 0.648 0.4896 0.4104 0.612 0.432 0.504 0.612 0.612 0.36
701028300713-0101-26 glycerin adult Sup




250 00713-0101-26 IP/OP 0.73 0.292 0.365 0.657 0.584 0.6205 0.657 0.4964 0.4161 0.6205 0.438 0.511 0.6205 0.6205 0.365
702122365862-0496-47 septra/bactrim Oral Sus




250 65862-0496-47 IP/OP 0.74 0.296 0.37 0.666 0.592 0.629 0.666 0.5032 0.4218 0.629 0.444 0.518 0.629 0.629 0.37
702393000074-4526-05 zinc chloride 1 mg/mL 50 mL MDV Inj




250 00074-4526-05 IP/OP 0.74 0.296 0.37 0.666 0.592 0.629 0.666 0.5032 0.4218 0.629 0.444 0.518 0.629 0.629 0.37
700685100904-2051-12 dimenhyDRINATE 50 mg Tab




250 00904-2051-12 IP/OP 0.76 0.304 0.38 0.684 0.608 0.646 0.684 0.5168 0.4332 0.646 0.456 0.532 0.646 0.646 0.38
799786700904-5306-61 diphenhydrAMINE 25 mg Cap UD




250 00904-5306-61 IP/OP 0.76 0.304 0.38 0.684 0.608 0.646 0.684 0.5168 0.4332 0.646 0.456 0.532 0.646 0.646 0.38
701252900904-5224-52 lactase 3000 units Tab




250 00904-5224-52 IP/OP 0.78 0.312 0.39 0.702 0.624 0.663 0.702 0.5304 0.4446 0.663 0.468 0.546 0.663 0.663 0.39
702476319810-0002-01 excedrin es Tab




250 19810-0002-01 IP/OP 0.8 0.32 0.4 0.72 0.64 0.68 0.72 0.544 0.456 0.68 0.48 0.56 0.68 0.68 0.4
701848400005-2500-86 polycarbophil 625 mg Tab




250 00005-2500-86 IP/OP 0.82 0.328 0.41 0.738 0.656 0.697 0.738 0.5576 0.4674 0.697 0.492 0.574 0.697 0.697 0.41
700925117478-0404-01 fluorescein oph 1 mg Strip




250 17478-0404-01 IP/OP 0.86 0.344 0.43 0.774 0.688 0.731 0.774 0.5848 0.4902 0.731 0.516 0.602 0.731 0.731 0.43
700975651079-0072-20 furosemide 20 mg Tab




250 51079-0072-20 IP/OP 0.89 0.356 0.445 0.801 0.712 0.7565 0.801 0.6052 0.5073 0.7565 0.534 0.623 0.7565 0.7565 0.445
701681900904-0643-61 nitroGLYCERIN 2.5 mg Cap ER




250 00904-0643-61 IP/OP 0.9 0.36 0.45 0.81 0.72 0.765 0.81 0.612 0.513 0.765 0.54 0.63 0.765 0.765 0.45
700626549502-0810-05 water, sterile 5 mL Sol Inh UD




250 49502-0810-05 IP/OP 0.91 0.364 0.455 0.819 0.728 0.7735 0.819 0.6188 0.5187 0.7735 0.546 0.637 0.7735 0.7735 0.455
703196600087-0866-44 vitamin D3 (cholecalciferol) 10 mcg (400 unit)/mL PEDIATRIC Oral Liq




250 00087-0866-44 IP/OP 0.94 0.376 0.47 0.846 0.752 0.799 0.846 0.6392 0.5358 0.799 0.564 0.658 0.799 0.799 0.47
700976400378-0216-10 furosemide 40 mg Tab




250 00378-0216-10 IP/OP 0.96 0.384 0.48 0.864 0.768 0.816 0.864 0.6528 0.5472 0.816 0.576 0.672 0.816 0.816 0.48
702421900904-6009-61 lorazepam 2 mg Tab




250 00904-6009-61 IP/OP 0.98 0.392 0.49 0.882 0.784 0.833 0.882 0.6664 0.5586 0.833 0.588 0.686 0.833 0.833 0.49
807467912547-0170-21 diphenhydrAMINE 25 mg GELCAP




250 12547-0170-21 IP/OP 0.98 0.392 0.49 0.882 0.784 0.833 0.882 0.6664 0.5586 0.833 0.588 0.686 0.833 0.833 0.49
700245400574-7050-50 bisacodyl 10 mg Sup




250 00574-7050-50 IP/OP 0.99 0.396 0.495 0.891 0.792 0.8415 0.891 0.6732 0.5643 0.8415 0.594 0.693 0.8415 0.8415 0.495
7225121 CATAPRES 0.1MG TAB 7004724




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
7225119 FLUOR-I-STRIP 9MG STRIP 7009285




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
7225130 LASIX 40MG TAB 7009764




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
7225150 MOTRIN 400MG TAB 7011455




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
7225216 PREDNISONE 20 MG TAB 7018971




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
7225132 TYLENOL 120MG SUP 7000037




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
4286905 SOD CHLOR 0.9% 3ML NEB




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
4286901 WATER STERILE 3 ML NEB




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
3814918 SOD CHLOR 0.9% 3ML NEB




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
4286925 WATER STERILE 3 ML NEB




250
IP/OP 1 0.4 0.5 0.9 0.8 0.85 0.9 0.68 0.57 0.85 0.6 0.7 0.85 0.85 0.5
701029100713-0102-13 glycerin pediatric Sup




250 00713-0102-13 IP/OP 1.03 0.412 0.515 0.927 0.824 0.8755 0.927 0.7004 0.5871 0.8755 0.618 0.721 0.8755 0.8755 0.515
700727100904-2244-61 docusate sodium 100 mg Cap




250 00904-2244-61 IP/OP 1.05 0.42 0.525 0.945 0.84 0.8925 0.945 0.714 0.5985 0.8925 0.63 0.735 0.8925 0.8925 0.525
701089500182-0557-89 hydrochlorothiazide 50 mg Tab




250 00182-0557-89 IP/OP 1.06 0.424 0.53 0.954 0.848 0.901 0.954 0.7208 0.6042 0.901 0.636 0.742 0.901 0.901 0.53
700832900555-0886-02 estradiol 1 mg Tab




250 00555-0886-02 IP/OP 1.07 0.428 0.535 0.963 0.856 0.9095 0.963 0.7276 0.6099 0.9095 0.642 0.749 0.9095 0.9095 0.535
700217300486-1132-01 beelith tablet




250 00486-1132-01 IP/OP 1.1 0.44 0.55 0.99 0.88 0.935 0.99 0.748 0.627 0.935 0.66 0.77 0.935 0.935 0.55
7025067999997-0250-67 ED_nitroglycerin 0.4 mg EA TAB SL




250 999997-0250-67 IP/OP 1.1 0.44 0.55 0.99 0.88 0.935 0.99 0.748 0.627 0.935 0.66 0.77 0.935 0.935 0.55
703171949348-0639-04 ibuprofen 100 mg Chew Tab




250 49348-0639-04 IP/OP 1.11 0.444 0.555 0.999 0.888 0.9435 0.999 0.7548 0.6327 0.9435 0.666 0.777 0.9435 0.9435 0.555
701406163739-0354-10 magnesium oxide 400 mg Tab




250 63739-0354-10 IP/OP 1.12 0.448 0.56 1.008 0.896 0.952 1.008 0.7616 0.6384 0.952 0.672 0.784 0.952 0.952 0.56
701649679854-0201-25 niacin 50 mg Tab




250 79854-0201-25 IP/OP 1.12 0.448 0.56 1.008 0.896 0.952 1.008 0.7616 0.6384 0.952 0.672 0.784 0.952 0.952 0.56
759681263824-0732-16 benzocaine-menthol (Cepacol ES) Loz




250 63824-0732-16 IP/OP 1.13 0.452 0.565 1.017 0.904 0.9605 1.017 0.7684 0.6441 0.9605 0.678 0.791 0.9605 0.9605 0.565
700387400093-4177-73 cepHALEXIN 50 mg/mL PEDIATRIC Oral Susp




250 00093-4177-73 IP/OP 1.14 0.456 0.57 1.026 0.912 0.969 1.026 0.7752 0.6498 0.969 0.684 0.798 0.969 0.969 0.57
701359200054-8526-25 lithium 150 mg Cap




250 00054-8526-25 IP/OP 1.14 0.456 0.57 1.026 0.912 0.969 1.026 0.7752 0.6498 0.969 0.684 0.798 0.969 0.969 0.57
700204199999-9999-77 acyclovir 5 mg/mL PEDIATRIC IV Syringe

J0133

250 99999-9999-77 IP/OP 1.15 0.46 0.575 1.035 0.92 0.9775 1.035 0.782 0.6555 0.9775 0.69 0.805 0.9775 0.9775 0.575
700401351079-0374-20 chlordiazepoxide 5 mg Cap




250 51079-0374-20 IP/OP 1.16 0.464 0.58 1.044 0.928 0.986 1.044 0.7888 0.6612 0.986 0.696 0.812 0.986 0.986 0.58
725712546017-0018-16 caffeine 200 mg Tab




250 46017-0018-16 IP/OP 1.18 0.472 0.59 1.062 0.944 1.003 1.062 0.8024 0.6726 1.003 0.708 0.826 1.003 1.003 0.59
701041600603-4890-21 guaifenesin 200 mg Tab




250 00603-4890-21 IP/OP 1.21 0.484 0.605 1.089 0.968 1.0285 1.089 0.8228 0.6897 1.0285 0.726 0.847 1.0285 1.0285 0.605
753389363833-0761-20 Water, STERILE Diluent For Kcentra




250 63833-0761-20 IP/OP 1.21 0.484 0.605 1.089 0.968 1.0285 1.089 0.8228 0.6897 1.0285 0.726 0.847 1.0285 1.0285 0.605
700466600028-0108-01 clofazimine 50 mg Cap




250 00028-0108-01 IP/OP 1.25 0.5 0.625 1.125 1 1.0625 1.125 0.85 0.7125 1.0625 0.75 0.875 1.0625 1.0625 0.625
701221400143-1767-01 isosorbide dinitrate 5 mg Tab SL




250 00143-1767-01 IP/OP 1.25 0.5 0.625 1.125 1 1.0625 1.125 0.85 0.7125 1.0625 0.75 0.875 1.0625 1.0625 0.625
701360000054-8527-25 lithium 300 mg Cap




250 00054-8527-25 IP/OP 1.27 0.508 0.635 1.143 1.016 1.0795 1.143 0.8636 0.7239 1.0795 0.762 0.889 1.0795 1.0795 0.635
701977100185-4346-01 quinidine 200 mg Tab




250 00185-4346-01 IP/OP 1.27 0.508 0.635 1.143 1.016 1.0795 1.143 0.8636 0.7239 1.0795 0.762 0.889 1.0795 1.0795 0.635
807752877333-0938-10 vitamin B12 (cyanocobalamin) 1000 mcg Tab




250 77333-0938-10 IP/OP 1.28 0.512 0.64 1.152 1.024 1.088 1.152 0.8704 0.7296 1.088 0.768 0.896 1.088 1.088 0.64
702527300904-5293-52 glucosAMINE 500 mg Cap




250 00904-5293-52 IP/OP 1.29 0.516 0.645 1.161 1.032 1.0965 1.161 0.8772 0.7353 1.0965 0.774 0.903 1.0965 1.0965 0.645
702481300045-0123-03 acetaminophen (ER charge) 160mg/5 mL Sus




250 00045-0123-03 IP/OP 1.34 0.536 0.67 1.206 1.072 1.139 1.206 0.9112 0.7638 1.139 0.804 0.938 1.139 1.139 0.67
700106800093-2267-01 amoxicillin 125 mg Tab Chew




250 00093-2267-01 IP/OP 1.36 0.544 0.68 1.224 1.088 1.156 1.224 0.9248 0.7752 1.156 0.816 0.952 1.156 1.156 0.68
700894900067-4347-60 ferrous sulfate Tab ER




250 00067-4347-60 IP/OP 1.41 0.564 0.705 1.269 1.128 1.1985 1.269 0.9588 0.8037 1.1985 0.846 0.987 1.1985 1.1985 0.705
700133267253-0180-10 ampicillin 250 mg Cap




250 67253-0180-10 IP/OP 1.42 0.568 0.71 1.278 1.136 1.207 1.278 0.9656 0.8094 1.207 0.852 0.994 1.207 1.207 0.71
702539842799-0404-01 zidovudine 10 mg/mL Syrup




250 42799-0404-01 IP/OP 1.42 0.568 0.71 1.278 1.136 1.207 1.278 0.9656 0.8094 1.207 0.852 0.994 1.207 1.207 0.71
702204951079-0586-20 thiothixene 1 mg Cap




250 51079-0586-20 IP/OP 1.43 0.572 0.715 1.287 1.144 1.2155 1.287 0.9724 0.8151 1.2155 0.858 1.001 1.2155 1.2155 0.715
701897160687-0145-01 predniSONE 20 mg Tab




250 60687-0145-01 IP/OP 1.44 0.576 0.72 1.296 1.152 1.224 1.296 0.9792 0.8208 1.224 0.864 1.008 1.224 1.224 0.72
702371649502-0810-03 WATER, STERILE 3 ML NEB




250 49502-0810-03 IP/OP 1.45 0.58 0.725 1.305 1.16 1.2325 1.305 0.986 0.8265 1.2325 0.87 1.015 1.2325 1.2325 0.725
700636451079-0284-20 diazepam 2 mg Tab




250 51079-0284-20 IP/OP 1.46 0.584 0.73 1.314 1.168 1.241 1.314 0.9928 0.8322 1.241 0.876 1.022 1.241 1.241 0.73
700601800054-8179-25 dexamethasone 0.5 mg Tab




250 00054-8179-25 IP/OP 1.47 0.588 0.735 1.323 1.176 1.2495 1.323 0.9996 0.8379 1.2495 0.882 1.029 1.2495 1.2495 0.735
701874064980-0104-01 potassium/sodium phos (k-phos neutral) Tab




250 64980-0104-01 IP/OP 1.47 0.588 0.735 1.323 1.176 1.2495 1.323 0.9996 0.8379 1.2495 0.882 1.029 1.2495 1.2495 0.735
740014600185-0615-01 hydrOXYzine pamoate 50 mg Cap




250 00185-0615-01 IP/OP 1.48 0.592 0.74 1.332 1.184 1.258 1.332 1.0064 0.8436 1.258 0.888 1.036 1.258 1.258 0.74
700110000781-2020-01 amoxicillin 250 mg Cap




250 00781-2020-01 IP/OP 1.51 0.604 0.755 1.359 1.208 1.2835 1.359 1.0268 0.8607 1.2835 0.906 1.057 1.2835 1.2835 0.755
701895500054-4741-31 predniSONE 1 mg Tab




250 00054-4741-31 IP/OP 1.51 0.604 0.755 1.359 1.208 1.2835 1.359 1.0268 0.8607 1.2835 0.906 1.057 1.2835 1.2835 0.755
700409600143-1210-01 chlorothiazide 500 mg Tab




250 00143-1210-01 IP/OP 1.53 0.612 0.765 1.377 1.224 1.3005 1.377 1.0404 0.8721 1.3005 0.918 1.071 1.3005 1.3005 0.765
702133000004-0009-49 sulfiSOXAZOLE 500 mg Tab




250 00004-0009-49 IP/OP 1.54 0.616 0.77 1.386 1.232 1.309 1.386 1.0472 0.8778 1.309 0.924 1.078 1.309 1.309 0.77
700507799999-9999-57 ticarcillin/clavulanate 50 mg/mL PEDIATRIC IV Syringe




250 99999-9999-57 IP/OP 1.57 0.628 0.785 1.413 1.256 1.3345 1.413 1.0676 0.8949 1.3345 0.942 1.099 1.3345 1.3345 0.785
702545500182-1802-89 salsalate 500 mg Tab




250 00182-1802-89 IP/OP 1.58 0.632 0.79 1.422 1.264 1.343 1.422 1.0744 0.9006 1.343 0.948 1.106 1.343 1.343 0.79
700027600364-2232-01 acetoHEXAMIDE 250 mg Tab




250 00364-2232-01 IP/OP 1.6 0.64 0.8 1.44 1.28 1.36 1.44 1.088 0.912 1.36 0.96 1.12 1.36 1.36 0.8
700649700378-1610-01 dicyclomine 10 mg Cap




250 00378-1610-01 IP/OP 1.6 0.64 0.8 1.44 1.28 1.36 1.44 1.088 0.912 1.36 0.96 1.12 1.36 1.36 0.8
702518257664-0506-08 metoprolol 25 mg Tab




250 57664-0506-08 IP/OP 1.63 0.652 0.815 1.467 1.304 1.3855 1.467 1.1084 0.9291 1.3855 0.978 1.141 1.3855 1.3855 0.815
702298100028-0117-01 tripelennamine 50 mg Tab




250 00028-0117-01 IP/OP 1.65 0.66 0.825 1.485 1.32 1.4025 1.485 1.122 0.9405 1.4025 0.99 1.155 1.4025 1.4025 0.825
701600951991-0198-11 iron polysaccharide/NIFEREX-150 Forte Cap




250 51991-0198-11 IP/OP 1.66 0.664 0.83 1.494 1.328 1.411 1.494 1.1288 0.9462 1.411 0.996 1.162 1.411 1.411 0.83
701020059762-3725-01 glyBURIDE 1.25 mg Tab




250 59762-3725-01 IP/OP 1.67 0.668 0.835 1.503 1.336 1.4195 1.503 1.1356 0.9519 1.4195 1.002 1.169 1.4195 1.4195 0.835
700468299999-9999-60 nafcillin 30 mg/mL PEDIATRIC IV SYRINGE




250 99999-9999-60 IP/OP 1.69 0.676 0.845 1.521 1.352 1.4365 1.521 1.1492 0.9633 1.4365 1.014 1.183 1.4365 1.4365 0.845
700222399999-9999-70 ampicillin/sulbactam 45 mg/mL PEDIATRIC IV Syringe




250 99999-9999-70 IP/OP 1.69 0.676 0.845 1.521 1.352 1.4365 1.521 1.1492 0.9633 1.4365 1.014 1.183 1.4365 1.4365 0.845
701498868084-0009-01 metoclopramide 10 mg Tab




250 68084-0009-01 IP/OP 1.72 0.688 0.86 1.548 1.376 1.462 1.548 1.1696 0.9804 1.462 1.032 1.204 1.462 1.462 0.86
700324751079-0870-20 carbamazepine 100 mg Tab Chew




250 51079-0870-20 IP/OP 1.78 0.712 0.89 1.602 1.424 1.513 1.602 1.2104 1.0146 1.513 1.068 1.246 1.513 1.513 0.89
701059800781-1391-13 haloperidol 0.5 mg Tab




250 00781-1391-13 IP/OP 1.78 0.712 0.89 1.602 1.424 1.513 1.602 1.2104 1.0146 1.513 1.068 1.246 1.513 1.513 0.89
701167900088-5021-01 INSULIN GLARGINE LANTUS VIAL




250 00088-5021-01 IP/OP 1.8 0.72 0.9 1.62 1.44 1.53 1.62 1.224 1.026 1.53 1.08 1.26 1.53 1.53 0.9
702866500006-3239-66 chlorothiazide 250 mg/5 mL PEDS Oral Susp




250 00006-3239-66 IP/OP 1.8 0.72 0.9 1.62 1.44 1.53 1.62 1.224 1.026 1.53 1.08 1.26 1.53 1.53 0.9
740015300185-0674-01 hydrOXYzine pamoate 25 mg Cap




250 00185-0674-01 IP/OP 1.81 0.724 0.905 1.629 1.448 1.5385 1.629 1.2308 1.0317 1.5385 1.086 1.267 1.5385 1.5385 0.905
703166999997-0316-69 ampicillin 50 mg/mL PEDIATRIC Oral Susp




250 99997-0316-69 IP/OP 1.82 0.728 0.91 1.638 1.456 1.547 1.638 1.2376 1.0374 1.547 1.092 1.274 1.547 1.547 0.91
703180099997-0318-00 doxycycline 5 mg/mL PEDIATRIC Oral Susp




250 99997-0318-00 IP/OP 1.82 0.728 0.91 1.638 1.456 1.547 1.638 1.2376 1.0374 1.547 1.092 1.274 1.547 1.547 0.91
703184299997-0318-42 septra/bactrim PEDIATRIC Oral Susp




250 99997-0318-42 IP/OP 1.82 0.728 0.91 1.638 1.456 1.547 1.638 1.2376 1.0374 1.547 1.092 1.274 1.547 1.547 0.91
703185999997-0318-59 sulfiSOXAZOLE 100 mg/mL PEDIATRIC Oral Susp




250 99997-0318-59 IP/OP 1.82 0.728 0.91 1.638 1.456 1.547 1.638 1.2376 1.0374 1.547 1.092 1.274 1.547 1.547 0.91
703190999997-0319-09 sodium chloride 2.5 mEq/mL PEDIATRIC Oral Sol




250 99997-0319-09 IP/OP 1.82 0.728 0.91 1.638 1.456 1.547 1.638 1.2376 1.0374 1.547 1.092 1.274 1.547 1.547 0.91
722711929300-0135-10N clonIDINE NICU 5 mcg/mL Oral Syrup




250 29300-0135-10N IP/OP 1.82 0.728 0.91 1.638 1.456 1.547 1.638 1.2376 1.0374 1.547 1.092 1.274 1.547 1.547 0.91
701900300054-0019-25 predniSONE 50 mg Tab




250 00054-0019-25 IP/OP 1.86 0.744 0.93 1.674 1.488 1.581 1.674 1.2648 1.0602 1.581 1.116 1.302 1.581 1.581 0.93
701420200555-0872-02 medroxyPROGESTERone 2.5 mg Tab




250 00555-0872-02 IP/OP 1.89 0.756 0.945 1.701 1.512 1.6065 1.701 1.2852 1.0773 1.6065 1.134 1.323 1.6065 1.6065 0.945
702921899997-0292-18 sodium bicarbonate NICU 0.5 mEq/mL IV Syringe




250 99997-0292-18 IP/OP 1.89 0.756 0.945 1.701 1.512 1.6065 1.701 1.2852 1.0773 1.6065 1.134 1.323 1.6065 1.6065 0.945
700892352747-0307-70 ferrous fumurate 324 mg Tab




250 52747-0307-70 IP/OP 1.9 0.76 0.95 1.71 1.52 1.615 1.71 1.292 1.083 1.615 1.14 1.33 1.615 1.615 0.95
700087016729-0171-01 amitriptyline 10 mg Tab




250 16729-0171-01 IP/OP 1.92 0.768 0.96 1.728 1.536 1.632 1.728 1.3056 1.0944 1.632 1.152 1.344 1.632 1.632 0.96
700472463739-0060-10 clonidine 0.1 mg Tab




250 63739-0060-10 IP/OP 1.92 0.768 0.96 1.728 1.536 1.632 1.728 1.3056 1.0944 1.632 1.152 1.344 1.632 1.632 0.96
702496152747-0306-70 hemocyte F Tab




250 52747-0306-70 IP/OP 1.93 0.772 0.965 1.737 1.544 1.6405 1.737 1.3124 1.1001 1.6405 1.158 1.351 1.6405 1.6405 0.965
700637251079-0285-20 diazepam 5 mg Tab




250 51079-0285-20 IP/OP 1.94 0.776 0.97 1.746 1.552 1.649 1.746 1.3192 1.1058 1.649 1.164 1.358 1.649 1.649 0.97
700606700054-8181-25 dexamethasone 1.5 mg Tab




250 00054-8181-25 IP/OP 1.94 0.776 0.97 1.746 1.552 1.649 1.746 1.3192 1.1058 1.649 1.164 1.358 1.649 1.649 0.97
701573800054-0235-24 morphine 15 mg IR Tab




250 00054-0235-24 IP/OP 1.95 0.78 0.975 1.755 1.56 1.6575 1.755 1.326 1.1115 1.6575 1.17 1.365 1.6575 1.6575 0.975
700749551079-0436-20 doxepin 10 mg Cap




250 51079-0436-20 IP/OP 1.96 0.784 0.98 1.764 1.568 1.666 1.764 1.3328 1.1172 1.666 1.176 1.372 1.666 1.666 0.98
702210600456-0461-01 thyroid desiccated 120 mg Tab




250 00456-0461-01 IP/OP 1.96 0.784 0.98 1.764 1.568 1.666 1.764 1.3328 1.1172 1.666 1.176 1.372 1.666 1.666 0.98
700046600093-0661-16 albuterol 2 mg/5 mL Oral Syrup




250 00093-0661-16 IP/OP 1.97 0.788 0.985 1.773 1.576 1.6745 1.773 1.3396 1.1229 1.6745 1.182 1.379 1.6745 1.6745 0.985
701415242806-0012-01 meclizine 12.5 mg Tab




250 42806-0012-01 IP/OP 1.97 0.788 0.985 1.773 1.576 1.6745 1.773 1.3396 1.1229 1.6745 1.182 1.379 1.6745 1.6745 0.985
700073000555-0483-02 amiloride/hydrochlorothiazide 5 mg/50 mg Tab




250 00555-0483-02 IP/OP 1.99 0.796 0.995 1.791 1.592 1.6915 1.791 1.3532 1.1343 1.6915 1.194 1.393 1.6915 1.6915 0.995
7225139 AMOXIL 250MG CAP 7001100




250
IP/OP 2 0.8 1 1.8 1.6 1.7 1.8 1.36 1.14 1.7 1.2 1.4 1.7 1.7 1
7225122 BENTYL 20MG TAB 7006521




250
IP/OP 2 0.8 1 1.8 1.6 1.7 1.8 1.36 1.14 1.7 1.2 1.4 1.7 1.7 1
7225120 DEBROX OTIC 15ML SOL 7003312




250
IP/OP 2 0.8 1 1.8 1.6 1.7 1.8 1.36 1.14 1.7 1.2 1.4 1.7 1.7 1
7225142 DONNATAL 10ML ELI 7007370




250
IP/OP 2 0.8 1 1.8 1.6 1.7 1.8 1.36 1.14 1.7 1.2 1.4 1.7 1.7 1
7225145 MOTRIN SUS 100 MG/5 ML 7024821




250
IP/OP 2 0.8 1 1.8 1.6 1.7 1.8 1.36 1.14 1.7 1.2 1.4 1.7 1.7 1
701092960505-2656-01 HCTZ/triamterene 25 mg/37.5 mg Tab




250 60505-2656-01 IP/OP 2.05 0.82 1.025 1.845 1.64 1.7425 1.845 1.394 1.1685 1.7425 1.23 1.435 1.7425 1.7425 1.025
702540600603-3899-19 hydrocortisone 5 mg Tab




250 00603-3899-19 IP/OP 2.05 0.82 1.025 1.845 1.64 1.7425 1.845 1.394 1.1685 1.7425 1.23 1.435 1.7425 1.7425 1.025
807996800023-0506-01 lubricant eye drops (REFRESH) 0.4 mL each UD




250 00023-0506-01 IP/OP 2.08 0.832 1.04 1.872 1.664 1.768 1.872 1.4144 1.1856 1.768 1.248 1.456 1.768 1.768 1.04
700652100378-1620-01 dicyclomine 20 mg Tab




250 00378-1620-01 IP/OP 2.15 0.86 1.075 1.935 1.72 1.8275 1.935 1.462 1.2255 1.8275 1.29 1.505 1.8275 1.8275 1.075
702415139328-0106-10 multivitamin, prenatal Tab




250 39328-0106-10 IP/OP 2.17 0.868 1.085 1.953 1.736 1.8445 1.953 1.4756 1.2369 1.8445 1.302 1.519 1.8445 1.8445 1.085
700014400093-0150-01 codeine/acetaminophen 30/300 mg (#3) Tab




250 00093-0150-01 IP/OP 2.19 0.876 1.095 1.971 1.752 1.8615 1.971 1.4892 1.2483 1.8615 1.314 1.533 1.8615 1.8615 1.095
701475651079-0200-20 methyldopa 250 mg Tab




250 51079-0200-20 IP/OP 2.22 0.888 1.11 1.998 1.776 1.887 1.998 1.5096 1.2654 1.887 1.332 1.554 1.887 1.887 1.11
700757868180-0657-01 doxycycline 25 mg/5 mL Oral Susp




250 68180-0657-01 IP/OP 2.26 0.904 1.13 2.034 1.808 1.921 2.034 1.5368 1.2882 1.921 1.356 1.582 1.921 1.921 1.13
700474029300-0136-01 clonidine 0.2 mg Tab




250 29300-0136-01 IP/OP 2.27 0.908 1.135 2.043 1.816 1.9295 2.043 1.5436 1.2939 1.9295 1.362 1.589 1.9295 1.9295 1.135
701015000591-0460-01 glipiZIDE 5 mg Tab




250 00591-0460-01 IP/OP 2.28 0.912 1.14 2.052 1.824 1.938 2.052 1.5504 1.2996 1.938 1.368 1.596 1.938 1.938 1.14
701147168084-0772-01 ibuprofen 800 mg Tab




250 68084-0772-01 IP/OP 2.31 0.924 1.155 2.079 1.848 1.9635 2.079 1.5708 1.3167 1.9635 1.386 1.617 1.9635 1.9635 1.155
701888051079-0631-20 prazosin 2 mg Cap




250 51079-0631-20 IP/OP 2.31 0.924 1.155 2.079 1.848 1.9635 2.079 1.5708 1.3167 1.9635 1.386 1.617 1.9635 1.9635 1.155
702129859762-0104-01 sulfasalazine 500 mg Tab Enteric




250 59762-0104-01 IP/OP 2.32 0.928 1.16 2.088 1.856 1.972 2.088 1.5776 1.3224 1.972 1.392 1.624 1.972 1.972 1.16
702615600904-5015-46 ubiquinone (CoE Q10) 30 mg Cap




250 00904-5015-46 IP/OP 2.32 0.928 1.16 2.088 1.856 1.972 2.088 1.5776 1.3224 1.972 1.392 1.624 1.972 1.972 1.16
701461600054-3555-63 methadone 5 mg/5 mL UD Sol




250 00054-3555-63 IP/OP 2.34 0.936 1.17 2.106 1.872 1.989 2.106 1.5912 1.3338 1.989 1.404 1.638 1.989 1.989 1.17
701979700591-5454-01 quinidine 300 mg Tab




250 00591-5454-01 IP/OP 2.34 0.936 1.17 2.106 1.872 1.989 2.106 1.5912 1.3338 1.989 1.404 1.638 1.989 1.989 1.17
701873260258-0006-01 potassium/sodium phos (neutra-phos) Pkt




250 60258-0006-01 IP/OP 2.35 0.94 1.175 2.115 1.88 1.9975 2.115 1.598 1.3395 1.9975 1.41 1.645 1.9975 1.9975 1.175
701460860687-0214-01 methadone 5 mg Tab




250 60687-0214-01 IP/OP 2.36 0.944 1.18 2.124 1.888 2.006 2.124 1.6048 1.3452 2.006 1.416 1.652 2.006 2.006 1.18
702074600409-4888-10 sodium chloride 0.9% PF 10 mL Inj




250 00409-4888-10 IP/OP 2.36 0.944 1.18 2.124 1.888 2.006 2.124 1.6048 1.3452 2.006 1.416 1.652 2.006 2.006 1.18
701145553746-0464-01 ibuprofen 400 mg Tab




250 53746-0464-01 IP/OP 2.37 0.948 1.185 2.133 1.896 2.0145 2.133 1.6116 1.3509 2.0145 1.422 1.659 2.0145 2.0145 1.185
746440351991-0182-11 hemocyte plus Tab




250 51991-0182-11 IP/OP 2.39 0.956 1.195 2.151 1.912 2.0315 2.151 1.6252 1.3623 2.0315 1.434 1.673 2.0315 2.0315 1.195
700399900555-0033-02 chlordiazepoxide 10 mg Cap




250 00555-0033-02 IP/OP 2.41 0.964 1.205 2.169 1.928 2.0485 2.169 1.6388 1.3737 2.0485 1.446 1.687 2.0485 2.0485 1.205
759007900487-9007-60 sodium chloride 7% Neb




250 00487-9007-60 IP/OP 2.42 0.968 1.21 2.178 1.936 2.057 2.178 1.6456 1.3794 2.057 1.452 1.694 2.057 2.057 1.21
701162051079-0190-20 indomethacin 25 mg Cap




250 51079-0190-20 IP/OP 2.43 0.972 1.215 2.187 1.944 2.0655 2.187 1.6524 1.3851 2.0655 1.458 1.701 2.0655 2.0655 1.215
809608660687-0231-01 sertraline 25 mg Tab




250 60687-0231-01 IP/OP 2.43 0.972 1.215 2.187 1.944 2.0655 2.187 1.6524 1.3851 2.0655 1.458 1.701 2.0655 2.0655 1.215
701941700115-1659-01 propranolol 10 mg Tab




250 00115-1659-01 IP/OP 2.47 0.988 1.235 2.223 1.976 2.0995 2.223 1.6796 1.4079 2.0995 1.482 1.729 2.0995 2.0995 1.235
700228000832-1081-00 benztropine 1 mg Tab




250 00832-1081-00 IP/OP 2.48 0.992 1.24 2.232 1.984 2.108 2.232 1.6864 1.4136 2.108 1.488 1.736 2.108 2.108 1.24
701084623155-0001-01 hydrALAZINE 10 mg Tab




250 23155-0001-01 IP/OP 2.5 1 1.25 2.25 2 2.125 2.25 1.7 1.425 2.125 1.5 1.75 2.125 2.125 1.25
700400500555-0159-02 chlordiazepoxide 25 mg Cap




250 00555-0159-02 IP/OP 2.59 1.036 1.295 2.331 2.072 2.2015 2.331 1.7612 1.4763 2.2015 1.554 1.813 2.2015 2.2015 1.295
701152149884-0054-01 imipramine 10 mg Tab




250 49884-0054-01 IP/OP 2.6 1.04 1.3 2.34 2.08 2.21 2.34 1.768 1.482 2.21 1.56 1.82 2.21 2.21 1.3
701963137000-0023-04 psyllium (metamucil) Packet




250 37000-0023-04 IP/OP 2.6 1.04 1.3 2.34 2.08 2.21 2.34 1.768 1.482 2.21 1.56 1.82 2.21 2.21 1.3
702201500781-1614-01 thioridazine 15 mg Tab




250 00781-1614-01 IP/OP 2.61 1.044 1.305 2.349 2.088 2.2185 2.349 1.7748 1.4877 2.2185 1.566 1.827 2.2185 2.2185 1.305
700977200378-0232-01 furosemide 80 mg Tab




250 00378-0232-01 IP/OP 2.64 1.056 1.32 2.376 2.112 2.244 2.376 1.7952 1.5048 2.244 1.584 1.848 2.244 2.244 1.32
701656100766-0045-08 nicotine 2 mg Gum




250 00766-0045-08 IP/OP 2.64 1.056 1.32 2.376 2.112 2.244 2.376 1.7952 1.5048 2.244 1.584 1.848 2.244 2.244 1.32
701458268084-0738-01 methadone 10 mg Tab




250 68084-0738-01 IP/OP 2.65 1.06 1.325 2.385 2.12 2.2525 2.385 1.802 1.5105 2.2525 1.59 1.855 2.2525 2.2525 1.325
702639600517-1805-25 DOPamine 40 mg/mL OPD Sol

J1265

250 00517-1805-25 IP/OP 2.65 1.06 1.325 2.385 2.12 2.2525 2.385 1.802 1.5105 2.2525 1.59 1.855 2.2525 2.2525 1.325
701599351991-0635-11 TRINSICON/FEROCON Cap




250 51991-0635-11 IP/OP 2.66 1.064 1.33 2.394 2.128 2.261 2.394 1.8088 1.5162 2.261 1.596 1.862 2.261 2.261 1.33
701653842806-0501-09 niCARdipine 20 mg Cap




250 42806-0501-09 IP/OP 2.66 1.064 1.33 2.394 2.128 2.261 2.394 1.8088 1.5162 2.261 1.596 1.862 2.261 2.261 1.33
701535700054-8577-11 mineral oil light Sterile 100% 10 mL Liq




250 00054-8577-11 IP/OP 2.67 1.068 1.335 2.403 2.136 2.2695 2.403 1.8156 1.5219 2.2695 1.602 1.869 2.2695 2.2695 1.335
700328813668-0268-01 carbamazepine 200 mg Tab




250 13668-0268-01 IP/OP 2.69 1.076 1.345 2.421 2.152 2.2865 2.421 1.8292 1.5333 2.2865 1.614 1.883 2.2865 2.2865 1.345
701466523155-0070-01 methimazole 5 mg Tab




250 23155-0070-01 IP/OP 2.69 1.076 1.345 2.421 2.152 2.2865 2.421 1.8292 1.5333 2.2865 1.614 1.883 2.2865 2.2865 1.345
700111800093-2268-01 amoxicillin 250 mg Tab Chew




250 00093-2268-01 IP/OP 2.72 1.088 1.36 2.448 2.176 2.312 2.448 1.8496 1.5504 2.312 1.632 1.904 2.312 2.312 1.36
702508300121-1744-10 guaifenesin 200 mg/10 mL UD Syr




250 00121-1744-10 IP/OP 2.72 1.088 1.36 2.448 2.176 2.312 2.448 1.8496 1.5504 2.312 1.632 1.904 2.312 2.312 1.36
701043263824-0008-15 guaifenesin 600 mg Tab LA




250 63824-0008-15 IP/OP 2.76 1.104 1.38 2.484 2.208 2.346 2.484 1.8768 1.5732 2.346 1.656 1.932 2.346 2.346 1.38
701021823155-0057-01 glyBURIDE 2.5 mg Tab




250 23155-0057-01 IP/OP 2.78 1.112 1.39 2.502 2.224 2.363 2.502 1.8904 1.5846 2.363 1.668 1.946 2.363 2.363 1.39
702110853746-0511-01 spironolactone 25 mg Tab




250 53746-0511-01 IP/OP 2.78 1.112 1.39 2.502 2.224 2.363 2.502 1.8904 1.5846 2.363 1.668 1.946 2.363 2.363 1.39
702512500015-7970-99 oxacillin 30 mg/mL PEDIATRIC IV Syringe




250 00015-7970-99 IP/OP 2.78 1.112 1.39 2.502 2.224 2.363 2.502 1.8904 1.5846 2.363 1.668 1.946 2.363 2.363 1.39
798572646287-0009-01 isoniazid 10 mg/1 mL Oral Syrup




250 46287-0009-01 IP/OP 2.78 1.112 1.39 2.502 2.224 2.363 2.502 1.8904 1.5846 2.363 1.668 1.946 2.363 2.363 1.39
701363400378-1450-01 lithium 450 mg Tab CR




250 00378-1450-01 IP/OP 2.81 1.124 1.405 2.529 2.248 2.3885 2.529 1.9108 1.6017 2.3885 1.686 1.967 2.3885 2.3885 1.405
701903700603-5371-21 primidone 50 mg Tab




250 00603-5371-21 IP/OP 2.81 1.124 1.405 2.529 2.248 2.3885 2.529 1.9108 1.6017 2.3885 1.686 1.967 2.3885 2.3885 1.405
700118300093-3109-53 amoxicillin 500 mg Cap




250 00093-3109-53 IP/OP 2.83 1.132 1.415 2.547 2.264 2.4055 2.547 1.9244 1.6131 2.4055 1.698 1.981 2.4055 2.4055 1.415
700753700904-1262-61 doxepin 50 mg Cap




250 00904-1262-61 IP/OP 2.83 1.132 1.415 2.547 2.264 2.4055 2.547 1.9244 1.6131 2.4055 1.698 1.981 2.4055 2.4055 1.415
700049051079-0658-20 albuterol 4 mg Tab




250 51079-0658-20 IP/OP 2.85 1.14 1.425 2.565 2.28 2.4225 2.565 1.938 1.6245 2.4225 1.71 1.995 2.4225 2.4225 1.425
700676000093-0318-01 diltiazem 30 mg Tab




250 00093-0318-01 IP/OP 2.86 1.144 1.43 2.574 2.288 2.431 2.574 1.9448 1.6302 2.431 1.716 2.002 2.431 2.431 1.43
701422800555-0873-02 medroxyPROGESTERone 5 mg Tab




250 00555-0873-02 IP/OP 2.86 1.144 1.43 2.574 2.288 2.431 2.574 1.9448 1.6302 2.431 1.716 2.002 2.431 2.431 1.43
702207251079-0588-20 thiothixene 5 mg Cap




250 51079-0588-20 IP/OP 2.87 1.148 1.435 2.583 2.296 2.4395 2.583 1.9516 1.6359 2.4395 1.722 2.009 2.4395 2.4395 1.435
701481400406-1144-01 methylphenidate 10 mg Tab




250 00406-1144-01 IP/OP 2.89 1.156 1.445 2.601 2.312 2.4565 2.601 1.9652 1.6473 2.4565 1.734 2.023 2.4565 2.4565 1.445
702202351079-0566-20 thioridazine 25 mg Tab




250 51079-0566-20 IP/OP 2.91 1.164 1.455 2.619 2.328 2.4735 2.619 1.9788 1.6587 2.4735 1.746 2.037 2.4735 2.4735 1.455
700058100378-0137-01 allopurinol 100 mg Tab




250 00378-0137-01 IP/OP 2.92 1.168 1.46 2.628 2.336 2.482 2.628 1.9856 1.6644 2.482 1.752 2.044 2.482 2.482 1.46
701016868084-0111-01 glipiZIDE 5 mg Tab XL




250 68084-0111-01 IP/OP 2.92 1.168 1.46 2.628 2.336 2.482 2.628 1.9856 1.6644 2.482 1.752 2.044 2.482 2.482 1.46
701418600555-0779-02 medroxyPROGESTERone 10 mg Tab




250 00555-0779-02 IP/OP 2.97 1.188 1.485 2.673 2.376 2.5245 2.673 2.0196 1.6929 2.5245 1.782 2.079 2.5245 2.5245 1.485
7197275 CONTRAST MEDIA 200-299MG 1ML 3992492

Q9966

250
IP/OP 3 1.2 1.5 2.7 2.4 2.55 2.7 2.04 1.71 2.55 1.8 2.1 2.55 2.55 1.5
7197269 CONTRAST MEDIA 300-399MG 1ML 3992427

Q9967

250
IP/OP 3 1.2 1.5 2.7 2.4 2.55 2.7 2.04 1.71 2.55 1.8 2.1 2.55 2.55 1.5
7225133 AURALGAN 10ML OTIC SOL 7001456




250
IP/OP 3 1.2 1.5 2.7 2.4 2.55 2.7 2.04 1.71 2.55 1.8 2.1 2.55 2.55 1.5
7225221 BENADRYL 12.5 MG/5 ML UD SYR 7400385




250
IP/OP 3 1.2 1.5 2.7 2.4 2.55 2.7 2.04 1.71 2.55 1.8 2.1 2.55 2.55 1.5
7225222 VISTARIL CAP PER 25 MG 7400146




250
IP/OP 3 1.2 1.5 2.7 2.4 2.55 2.7 2.04 1.71 2.55 1.8 2.1 2.55 2.55 1.5
4286920 Xopenex 0.31mg/3mL




250
IP/OP 3 1.2 1.5 2.7 2.4 2.55 2.7 2.04 1.71 2.55 1.8 2.1 2.55 2.55 1.5
702218900378-0221-01 timolol 10 mg Tab




250 00378-0221-01 IP/OP 3.01 1.204 1.505 2.709 2.408 2.5585 2.709 2.0468 1.7157 2.5585 1.806 2.107 2.5585 2.5585 1.505
701094500009-0031-01 hydrocortisone 10 mg Tab




250 00009-0031-01 IP/OP 3.03 1.212 1.515 2.727 2.424 2.5755 2.727 2.0604 1.7271 2.5755 1.818 2.121 2.5755 2.5755 1.515
702867399997-0286-73 spironolactone 10 mg/mL PEDS Oral Susp




250 99997-0286-73 IP/OP 3.03 1.212 1.515 2.727 2.424 2.5755 2.727 2.0604 1.7271 2.5755 1.818 2.121 2.5755 2.5755 1.515
757268377333-0516-25 melatonin 3 mg Tab




250 77333-0516-25 IP/OP 3.03 1.212 1.515 2.727 2.424 2.5755 2.727 2.0604 1.7271 2.5755 1.818 2.121 2.5755 2.5755 1.515
702112453489-0144-01 spironolactone/hydrochlorothiazide 25 mg/25 mg Tab




250 53489-0144-01 IP/OP 3.05 1.22 1.525 2.745 2.44 2.5925 2.745 2.074 1.7385 2.5925 1.83 2.135 2.5925 2.5925 1.525
702547100904-7727-14 gaviscon 30 mL Oral Susp




250 00904-7727-14 IP/OP 3.06 1.224 1.53 2.754 2.448 2.601 2.754 2.0808 1.7442 2.601 1.836 2.142 2.601 2.601 1.53
701086123155-0002-10 hydrALAZINE 25 mg Tab




250 23155-0002-10 IP/OP 3.07 1.228 1.535 2.763 2.456 2.6095 2.763 2.0876 1.7499 2.6095 1.842 2.149 2.6095 2.6095 1.535
701468131722-0533-01 methocarbamol 500 mg Tab




250 31722-0533-01 IP/OP 3.07 1.228 1.535 2.763 2.456 2.6095 2.763 2.0876 1.7499 2.6095 1.842 2.149 2.6095 2.6095 1.535
701944100603-5483-21 propranolol 20 mg Tab




250 00603-5483-21 IP/OP 3.08 1.232 1.54 2.772 2.464 2.618 2.772 2.0944 1.7556 2.618 1.848 2.156 2.618 2.618 1.54
700005200713-0164-12 acetaminophen 325 mg Sup




250 00713-0164-12 IP/OP 3.09 1.236 1.545 2.781 2.472 2.6265 2.781 2.1012 1.7613 2.6265 1.854 2.163 2.6265 2.6265 1.545
781543865628-0070-03 omeprazole 2 mg/mL NICU/PEDS Oral Susp




250 65628-0070-03 IP/OP 3.11 1.244 1.555 2.799 2.488 2.6435 2.799 2.1148 1.7727 2.6435 1.866 2.177 2.6435 2.6435 1.555
701146367877-0320-05 ibuprofen 600 mg Tab




250 67877-0320-05 IP/OP 3.12 1.248 1.56 2.808 2.496 2.652 2.808 2.1216 1.7784 2.652 1.872 2.184 2.652 2.652 1.56
813958800450-0134-08 loperamide 2 mg/15 mL Oral Solution




250 00450-0134-08 IP/OP 3.16 1.264 1.58 2.844 2.528 2.686 2.844 2.1488 1.8012 2.686 1.896 2.212 2.686 2.686 1.58
700476529300-0137-01 clonidine 0.3 mg Tab




250 29300-0137-01 IP/OP 3.17 1.268 1.585 2.853 2.536 2.6945 2.853 2.1556 1.8069 2.6945 1.902 2.219 2.6945 2.6945 1.585
700498900054-0243-24 codeine sulfate 15 mg Tab




250 00054-0243-24 IP/OP 3.18 1.272 1.59 2.862 2.544 2.703 2.862 2.1624 1.8126 2.703 1.908 2.226 2.703 2.703 1.59
703129768094-0004-62P cetirizine 1 mg/mL PEDIATRIC Oral Syrup




250 68094-0004-62P IP/OP 3.18 1.272 1.59 2.862 2.544 2.703 2.862 2.1624 1.8126 2.703 1.908 2.226 2.703 2.703 1.59
701684300603-4784-20 nitroGLYCERIN 9 mg Cap ER




250 00603-4784-20 IP/OP 3.23 1.292 1.615 2.907 2.584 2.7455 2.907 2.1964 1.8411 2.7455 1.938 2.261 2.7455 2.7455 1.615
702346800591-0343-01 verapamil 80 mg Tab




250 00591-0343-01 IP/OP 3.23 1.292 1.615 2.907 2.584 2.7455 2.907 2.1964 1.8411 2.7455 1.938 2.261 2.7455 2.7455 1.615
700978067877-0222-01 gabapentin 100 mg Cap




250 67877-0222-01 IP/OP 3.24 1.296 1.62 2.916 2.592 2.754 2.916 2.2032 1.8468 2.754 1.944 2.268 2.754 2.754 1.62
702200700378-0612-01 thioridazine 10 mg Tab




250 00378-0612-01 IP/OP 3.28 1.312 1.64 2.952 2.624 2.788 2.952 2.2304 1.8696 2.788 1.968 2.296 2.788 2.788 1.64
700006050580-0501-10 acetaminophen 325 mg Tab




250 50580-0501-10 IP/OP 3.32 1.328 1.66 2.988 2.656 2.822 2.988 2.2576 1.8924 2.822 1.992 2.324 2.822 2.822 1.66
702454060432-0092-16 oxybutynin 5 mg/5 mL Syrup




250 60432-0092-16 IP/OP 3.32 1.328 1.66 2.988 2.656 2.822 2.988 2.2576 1.8924 2.822 1.992 2.324 2.822 2.822 1.66
702504207431-2028-32 melatonin 1 mg Tab




250 07431-2028-32 IP/OP 3.32 1.328 1.66 2.988 2.656 2.822 2.988 2.2576 1.8924 2.822 1.992 2.324 2.822 2.822 1.66
702680064679-0945-01 zonisamide 25 mg Cap




250 64679-0945-01 IP/OP 3.32 1.328 1.66 2.988 2.656 2.822 2.988 2.2576 1.8924 2.822 1.992 2.324 2.822 2.822 1.66
700166200574-7036-12 aspirin 600 mg Sup




250 00574-7036-12 IP/OP 3.33 1.332 1.665 2.997 2.664 2.8305 2.997 2.2644 1.8981 2.8305 1.998 2.331 2.8305 2.8305 1.665
701510023155-0064-01 metronidazole 250 mg Tab




250 23155-0064-01 IP/OP 3.33 1.332 1.665 2.997 2.664 2.8305 2.997 2.2644 1.8981 2.8305 1.998 2.331 2.8305 2.8305 1.665
702290816571-0160-10 trihexyphenidyl 2 mg Tab




250 16571-0160-10 IP/OP 3.33 1.332 1.665 2.997 2.664 2.8305 2.997 2.2644 1.8981 2.8305 1.998 2.331 2.8305 2.8305 1.665
701259449702-0205-48 lamIVUDINE 10 mg/mL Oral Solution




250 49702-0205-48 IP/OP 3.35 1.34 1.675 3.015 2.68 2.8475 3.015 2.278 1.9095 2.8475 2.01 2.345 2.8475 2.8475 1.675
700262900185-0128-01 bumetanide 0.5 mg Tab




250 00185-0128-01 IP/OP 3.36 1.344 1.68 3.024 2.688 2.856 3.024 2.2848 1.9152 2.856 2.016 2.352 2.856 2.856 1.68
701412900378-0060-01 maprotiline 25 mg Tab




250 00378-0060-01 IP/OP 3.39 1.356 1.695 3.051 2.712 2.8815 3.051 2.3052 1.9323 2.8815 2.034 2.373 2.8815 2.8815 1.695
700249699999-9999-67 cefOXITIN 50 mg/mL PEDIATRIC IV Syringe




250 99999-9999-67 IP/OP 3.39 1.356 1.695 3.051 2.712 2.8815 3.051 2.3052 1.9323 2.8815 2.034 2.373 2.8815 2.8815 1.695
701050763824-0056-34 guaifenesin/dextromethorphan 600/30 mg Tab LA




250 63824-0056-34 IP/OP 3.4 1.36 1.7 3.06 2.72 2.89 3.06 2.312 1.938 2.89 2.04 2.38 2.89 2.89 1.7
701087949884-0028-01 hydrALAZINE 50 mg Tab




250 49884-0028-01 IP/OP 3.41 1.364 1.705 3.069 2.728 2.8985 3.069 2.3188 1.9437 2.8985 2.046 2.387 2.8985 2.8985 1.705
726702810939-0751-33 ubiquinone (CoE Q10) 100 mg Cap




250 10939-0751-33 IP/OP 3.43 1.372 1.715 3.087 2.744 2.9155 3.087 2.3324 1.9551 2.9155 2.058 2.401 2.9155 2.9155 1.715
701734642858-0001-10 oxyCODONE 5 mg IR Tab




250 42858-0001-10 IP/OP 3.45 1.38 1.725 3.105 2.76 2.9325 3.105 2.346 1.9665 2.9325 2.07 2.415 2.9325 2.9325 1.725
701293300074-4341-90 levothyroxine 0.025 mg Tab




250 00074-4341-90 IP/OP 3.48 1.392 1.74 3.132 2.784 2.958 3.132 2.3664 1.9836 2.958 2.088 2.436 2.958 2.958 1.74
702261950111-0434-03 trazodone 100 mg Tab




250 50111-0434-03 IP/OP 3.49 1.396 1.745 3.141 2.792 2.9665 3.141 2.3732 1.9893 2.9665 2.094 2.443 2.9665 2.9665 1.745
700013600121-0504-05 codeine/acetaminophen 12/120 mg UD Syr




250 00121-0504-05 IP/OP 3.51 1.404 1.755 3.159 2.808 2.9835 3.159 2.3868 2.0007 2.9835 2.106 2.457 2.9835 2.9835 1.755
702047200904-6339-61 sennosides/docusate 8.6 mg/50 mg Tab




250 00904-6339-61 IP/OP 3.51 1.404 1.755 3.159 2.808 2.9835 3.159 2.3868 2.0007 2.9835 2.106 2.457 2.9835 2.9835 1.755
702507559630-0300-65 ED_nitroglycerin 0.4 mg (per EA) ED USE Spr




250 59630-0300-65 IP/OP 3.57 1.428 1.785 3.213 2.856 3.0345 3.213 2.4276 2.0349 3.0345 2.142 2.499 3.0345 3.0345 1.785
702675004142-0000-32 saccharomyces b.(FLORASTOR) 250 mg Cap




250 04142-0000-32 IP/OP 3.58 1.432 1.79 3.222 2.864 3.043 3.222 2.4344 2.0406 3.043 2.148 2.506 3.043 3.043 1.79
740022959746-0113-06 prochlorperazine 5 mg Tab




250 59746-0113-06 IP/OP 3.59 1.436 1.795 3.231 2.872 3.0515 3.231 2.4412 2.0463 3.0515 2.154 2.513 3.0515 3.0515 1.795
701968000187-3010-30 pyridostigmine 60 mg Tab




250 00187-3010-30 IP/OP 3.63 1.452 1.815 3.267 2.904 3.0855 3.267 2.4684 2.0691 3.0855 2.178 2.541 3.0855 3.0855 1.815
703174399997-0317-43 cefPODOXIME10 mg/mL PEDIATRIC Oral Susp




250 99997-0317-43 IP/OP 3.63 1.452 1.815 3.267 2.904 3.0855 3.267 2.4684 2.0691 3.0855 2.178 2.541 3.0855 3.0855 1.815
700326200078-0510-05 carbamazepine 100 mg Tab XR




250 00078-0510-05 IP/OP 3.65 1.46 1.825 3.285 2.92 3.1025 3.285 2.482 2.0805 3.1025 2.19 2.555 3.1025 3.1025 1.825
700645500781-1785-60 diclofenac sodium 25 mg Tab Enteric




250 00781-1785-60 IP/OP 3.66 1.464 1.83 3.294 2.928 3.111 3.294 2.4888 2.0862 3.111 2.196 2.562 3.111 3.111 1.83
703172799997-0317-27 cefADROXIL 50 mg/mL PEDIATRIC Oral Susp




250 99997-0317-27 IP/OP 3.68 1.472 1.84 3.312 2.944 3.128 3.312 2.5024 2.0976 3.128 2.208 2.576 3.128 3.128 1.84
740003900904-2056-61 diphenhydrAMINE 50 mg Cap




250 00904-2056-61 IP/OP 3.72 1.488 1.86 3.348 2.976 3.162 3.348 2.5296 2.1204 3.162 2.232 2.604 3.162 3.162 1.86
702357500832-1211-00 warfarin 1 mg Tab




250 00832-1211-00 IP/OP 3.72 1.488 1.86 3.348 2.976 3.162 3.348 2.5296 2.1204 3.162 2.232 2.604 3.162 3.162 1.86
700452600378-8730-35 clindamycin 15 mg/mL Oral Liquid




250 00378-8730-35 IP/OP 3.75 1.5 1.875 3.375 3 3.1875 3.375 2.55 2.1375 3.1875 2.25 2.625 3.1875 3.1875 1.875
701134923155-0105-01 hydrOXYzine HCL (atarax) 10 mg Tab




250 23155-0105-01 IP/OP 3.77 1.508 1.885 3.393 3.016 3.2045 3.393 2.5636 2.1489 3.2045 2.262 2.639 3.2045 3.2045 1.885
700244749884-0693-01 biperiden 2 mg Tab




250 49884-0693-01 IP/OP 3.78 1.512 1.89 3.402 3.024 3.213 3.402 2.5704 2.1546 3.213 2.268 2.646 3.213 3.213 1.89
701361800032-4492-01 lithium 300 mg Tab SR




250 00032-4492-01 IP/OP 3.8 1.52 1.9 3.42 3.04 3.23 3.42 2.584 2.166 3.23 2.28 2.66 3.23 3.23 1.9
701646200187-3100-10 neostigmine 15 mg Tab




250 00187-3100-10 IP/OP 3.8 1.52 1.9 3.42 3.04 3.23 3.42 2.584 2.166 3.23 2.28 2.66 3.23 3.23 1.9
700140739822-9950-02 amyl nitrite 0.3 mL Inhalant




250 39822-9950-02 IP/OP 3.81 1.524 1.905 3.429 3.048 3.2385 3.429 2.5908 2.1717 3.2385 2.286 2.667 3.2385 3.2385 1.905
700090400904-0201-61 amitriptyline 25 mg Tab




250 00904-0201-61 IP/OP 3.85 1.54 1.925 3.465 3.08 3.2725 3.465 2.618 2.1945 3.2725 2.31 2.695 3.2725 3.2725 1.925
700015100093-0350-01 codeine/acetaminophen 60/300 mg (#4) Tab




250 00093-0350-01 IP/OP 3.86 1.544 1.93 3.474 3.088 3.281 3.474 2.6248 2.2002 3.281 2.316 2.702 3.281 3.281 1.93
701023455370-0147-07 glyBURIDE micronized 3 mg Tab




250 55370-0147-07 IP/OP 3.86 1.544 1.93 3.474 3.088 3.281 3.474 2.6248 2.2002 3.281 2.316 2.702 3.281 3.281 1.93
701810451672-4111-03 phenytoin 100 mg Cap SR




250 51672-4111-03 IP/OP 3.87 1.548 1.935 3.483 3.096 3.2895 3.483 2.6316 2.2059 3.2895 2.322 2.709 3.2895 3.2895 1.935
702359100832-1212-00 warfarin 2 mg Tab




250 00832-1212-00 IP/OP 3.88 1.552 1.94 3.492 3.104 3.298 3.492 2.6384 2.2116 3.298 2.328 2.716 3.298 3.298 1.94
701296600074-6594-90 levothyroxine 0.088 mg Tab




250 00074-6594-90 IP/OP 3.89 1.556 1.945 3.501 3.112 3.3065 3.501 2.6452 2.2173 3.3065 2.334 2.723 3.3065 3.3065 1.945
700136500781-2145-01 ampicillin 500 mg Cap




250 00781-2145-01 IP/OP 3.91 1.564 1.955 3.519 3.128 3.3235 3.519 2.6588 2.2287 3.3235 2.346 2.737 3.3235 3.3235 1.955
701011916729-0002-01 glimepiride 2 mg Tab




250 16729-0002-01 IP/OP 3.94 1.576 1.97 3.546 3.152 3.349 3.546 2.6792 2.2458 3.349 2.364 2.758 3.349 3.349 1.97
702292400023-4741-10 trimeprazine 2.5 mg Tab




250 00023-4741-10 IP/OP 3.96 1.584 1.98 3.564 3.168 3.366 3.564 2.6928 2.2572 3.366 2.376 2.772 3.366 3.366 1.98
701777551079-0889-20 pentoxifylline 400 mg Tab CR




250 51079-0889-20 IP/OP 3.98 1.592 1.99 3.582 3.184 3.383 3.582 2.7064 2.2686 3.383 2.388 2.786 3.383 3.383 1.99
703019000074-7804-13 potassium chloride 10 mEq Tab ER




250 00074-7804-13 IP/OP 3.98 1.592 1.99 3.582 3.184 3.383 3.582 2.7064 2.2686 3.383 2.388 2.786 3.383 3.383 1.99
702360900832-1213-00 warfarin 2.5 mg Tab




250 00832-1213-00 IP/OP 3.99 1.596 1.995 3.591 3.192 3.3915 3.591 2.7132 2.2743 3.3915 2.394 2.793 3.3915 3.3915 1.995
702361700832-1214-00 warfarin 3 mg Tab




250 00832-1214-00 IP/OP 3.99 1.596 1.995 3.591 3.192 3.3915 3.591 2.7132 2.2743 3.3915 2.394 2.793 3.3915 3.3915 1.995
702362500832-1215-00 warfarin 4 mg Tab




250 00832-1215-00 IP/OP 3.99 1.596 1.995 3.591 3.192 3.3915 3.591 2.7132 2.2743 3.3915 2.394 2.793 3.3915 3.3915 1.995
7225220 BENADRYL 50 MG CAP 7400039




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
7225114 LORTAB 5/500MG TAB 7000185




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
7225151 SEPTRA/BACTRIM TAB 7021231




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
7225138 TYLENOL-CODEINE SYR UD 7000136




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
7225123 XANAX 0.25MG TAB 7000615




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
4286904 SOD CHLOR 3% 15ML NEB




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
3814917 SOD CHLOR 3% 15ML NEB




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
31244 ATROPINE SULF 1MG NEB




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
37816 ATROPINE SULF 1MG NEB




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
39415 ATROPINE SULF 1MG NEB




250
IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
700648959772-6048-01 dicloxacillin 250 mg Cap




250 59772-6048-01 IP/OP 4 1.6 2 3.6 3.2 3.4 3.6 2.72 2.28 3.4 2.4 2.8 3.4 3.4 2
702123153746-0271-01 septra/bactrim tab




250 53746-0271-01 IP/OP 4.02 1.608 2.01 3.618 3.216 3.417 3.618 2.7336 2.2914 3.417 2.412 2.814 3.417 3.417 2.01
701226300781-1842-01 isoxsuprine 20 mg Tab




250 00781-1842-01 IP/OP 4.03 1.612 2.015 3.627 3.224 3.4255 3.627 2.7404 2.2971 3.4255 2.418 2.821 3.4255 3.4255 2.015
700003745802-0732-30 acetaminophen 120 mg Sup




250 45802-0732-30 IP/OP 4.03 1.612 2.015 3.627 3.224 3.4255 3.627 2.7404 2.2971 3.4255 2.418 2.821 3.4255 3.4255 2.015
701595169543-0260-10 multivitamin B Complex with C and FA (nephrocap)




250 69543-0260-10 IP/OP 4.07 1.628 2.035 3.663 3.256 3.4595 3.663 2.7676 2.3199 3.4595 2.442 2.849 3.4595 3.4595 2.035
701163851079-0191-20 indomethacin 50 mg Cap




250 51079-0191-20 IP/OP 4.11 1.644 2.055 3.699 3.288 3.4935 3.699 2.7948 2.3427 3.4935 2.466 2.877 3.4935 3.4935 2.055
701863366758-0190-13 potassium chloride 20 mEq Tab SR




250 66758-0190-13 IP/OP 4.11 1.644 2.055 3.699 3.288 3.4935 3.699 2.7948 2.3427 3.4935 2.466 2.877 3.4935 3.4935 2.055
702296543386-0330-01 trimethoprim 100 mg Tab




250 43386-0330-01 IP/OP 4.14 1.656 2.07 3.726 3.312 3.519 3.726 2.8152 2.3598 3.519 2.484 2.898 3.519 3.519 2.07
701769200781-1205-01 penicillin VK 250 mg Tab




250 00781-1205-01 IP/OP 4.15 1.66 2.075 3.735 3.32 3.5275 3.735 2.822 2.3655 3.5275 2.49 2.905 3.5275 3.5275 2.075
702603246500-0034-30 colloidal oatmeal Packet




250 46500-0034-30 IP/OP 4.15 1.66 2.075 3.735 3.32 3.5275 3.735 2.822 2.3655 3.5275 2.49 2.905 3.5275 3.5275 2.075
701594476439-0364-90 B Complex/folic acid (FOLTX)




250 76439-0364-90 IP/OP 4.15 1.66 2.075 3.735 3.32 3.5275 3.735 2.822 2.3655 3.5275 2.49 2.905 3.5275 3.5275 2.075
702364100832-1216-00 warfarin 5 mg Tab




250 00832-1216-00 IP/OP 4.16 1.664 2.08 3.744 3.328 3.536 3.744 2.8288 2.3712 3.536 2.496 2.912 3.536 3.536 2.08
752035868084-0895-09 hydroCODONE/APAP 5/325 mg Tab




250 68084-0895-09 IP/OP 4.16 1.664 2.08 3.744 3.328 3.536 3.744 2.8288 2.3712 3.536 2.496 2.912 3.536 3.536 2.08
700430299999-9999-61 imipenem 5 mg/mL PEDIATRIC IV Syringe




250 99999-9999-61 IP/OP 4.17 1.668 2.085 3.753 3.336 3.5445 3.753 2.8356 2.3769 3.5445 2.502 2.919 3.5445 3.5445 2.085
703198263739-0192-10 PHENobarbital 16.2 mg Tab UD




250 63739-0192-10 IP/OP 4.17 1.668 2.085 3.753 3.336 3.5445 3.753 2.8356 2.3769 3.5445 2.502 2.919 3.5445 3.5445 2.085
701012751079-0811-20 glipiZIDE 10 mg Tab




250 51079-0811-20 IP/OP 4.18 1.672 2.09 3.762 3.344 3.553 3.762 2.8424 2.3826 3.553 2.508 2.926 3.553 3.553 2.09
701245300185-0117-05 labetalol 200 mg Tab




250 00185-0117-05 IP/OP 4.18 1.672 2.09 3.762 3.344 3.553 3.762 2.8424 2.3826 3.553 2.508 2.926 3.553 3.553 2.09
700384100093-3145-01 cephalexin 250 mg Cap




250 00093-3145-01 IP/OP 4.2 1.68 2.1 3.78 3.36 3.57 3.78 2.856 2.394 3.57 2.52 2.94 3.57 3.57 2.1
701435000054-8595-11 meperidine 50 mg Tab




250 00054-8595-11 IP/OP 4.2 1.68 2.1 3.78 3.36 3.57 3.78 2.856 2.394 3.57 2.52 2.94 3.57 3.57 2.1
701381651079-0417-20 lorazepam 0.5 mg Tab




250 51079-0417-20 IP/OP 4.21 1.684 2.105 3.789 3.368 3.5785 3.789 2.8628 2.3997 3.5785 2.526 2.947 3.5785 3.5785 2.105
701380845802-0106-39 loratadine/pseudoEPHEDrine 5 mg/120 mg Tab SR




250 45802-0106-39 IP/OP 4.22 1.688 2.11 3.798 3.376 3.587 3.798 2.8696 2.4054 3.587 2.532 2.954 3.587 3.587 2.11
702252860505-0233-01 torsemide 10 mg Tab




250 60505-0233-01 IP/OP 4.25 1.7 2.125 3.825 3.4 3.6125 3.825 2.89 2.4225 3.6125 2.55 2.975 3.6125 3.6125 2.125
702422723155-0102-05 metformin 500 mg Tab




250 23155-0102-05 IP/OP 4.26 1.704 2.13 3.834 3.408 3.621 3.834 2.8968 2.4282 3.621 2.556 2.982 3.621 3.621 2.13
700008600713-0165-50 acetaminophen 650 mg Sup




250 00713-0165-50 IP/OP 4.27 1.708 2.135 3.843 3.416 3.6295 3.843 2.9036 2.4339 3.6295 2.562 2.989 3.6295 3.6295 2.135
700342963739-0049-10 carisoprodol 350 mg Tab




250 63739-0049-10 IP/OP 4.28 1.712 2.14 3.852 3.424 3.638 3.852 2.9104 2.4396 3.638 2.568 2.996 3.638 3.638 2.14
701299000074-7068-90 levothyroxine 0.125 mg Tab




250 00074-7068-90 IP/OP 4.29 1.716 2.145 3.861 3.432 3.6465 3.861 2.9172 2.4453 3.6465 2.574 3.003 3.6465 3.6465 2.145
702690900536-0091-85 aluminum hydroxide 30 mL Oral Susp




250 00536-0091-85 IP/OP 4.3 1.72 2.15 3.87 3.44 3.655 3.87 2.924 2.451 3.655 2.58 3.01 3.655 3.655 2.15
701119042858-0301-25 HYDROmorphone 2 mg Tab




250 42858-0301-25 IP/OP 4.33 1.732 2.165 3.897 3.464 3.6805 3.897 2.9444 2.4681 3.6805 2.598 3.031 3.6805 3.6805 2.165
701945800115-1661-01 propranolol 40 mg Tab




250 00115-1661-01 IP/OP 4.33 1.732 2.165 3.897 3.464 3.6805 3.897 2.9444 2.4681 3.6805 2.598 3.031 3.6805 3.6805 2.165
701123242858-0302-25 HYDROmorphone 4 mg Tab




250 42858-0302-25 IP/OP 4.34 1.736 2.17 3.906 3.472 3.689 3.906 2.9512 2.4738 3.689 2.604 3.038 3.689 3.689 2.17
701153900781-1764-01 imipramine 25 mg Tab




250 00781-1764-01 IP/OP 4.34 1.736 2.17 3.906 3.472 3.689 3.906 2.9512 2.4738 3.689 2.604 3.038 3.689 3.689 2.17
700900445802-0425-78 fexofenadine 60 mg Tab




250 45802-0425-78 IP/OP 4.35 1.74 2.175 3.915 3.48 3.6975 3.915 2.958 2.4795 3.6975 2.61 3.045 3.6975 3.6975 2.175
809923300536-1186-12 phenylephrine 0.25% (Preparation H) Rectal Sup




250 00536-1186-12 IP/OP 4.36 1.744 2.18 3.924 3.488 3.706 3.924 2.9648 2.4852 3.706 2.616 3.052 3.706 3.706 2.18
701469931722-0534-01 methocarbamol 750 mg Tab




250 31722-0534-01 IP/OP 4.39 1.756 2.195 3.951 3.512 3.7315 3.951 2.9852 2.5023 3.7315 2.634 3.073 3.7315 3.7315 2.195
702054812870-0001-01 silver nitrate TOPical Stick




250 12870-0001-01 IP/OP 4.39 1.756 2.195 3.951 3.512 3.7315 3.951 2.9852 2.5023 3.7315 2.634 3.073 3.7315 3.7315 2.195
702118100093-2210-01 sucralfate 1 g Tab




250 00093-2210-01 IP/OP 4.41 1.764 2.205 3.969 3.528 3.7485 3.969 2.9988 2.5137 3.7485 2.646 3.087 3.7485 3.7485 2.205
701301400074-7069-90 levothyroxine 0.15 mg Tab




250 00074-7069-90 IP/OP 4.42 1.768 2.21 3.978 3.536 3.757 3.978 3.0056 2.5194 3.757 2.652 3.094 3.757 3.757 2.21
701689251672-4001-01 nortriptyline 10 mg Cap




250 51672-4001-01 IP/OP 4.44 1.776 2.22 3.996 3.552 3.774 3.996 3.0192 2.5308 3.774 2.664 3.108 3.774 3.774 2.22
701484800781-5748-01 methylphenidate 5 mg Tab




250 00781-5748-01 IP/OP 4.47 1.788 2.235 4.023 3.576 3.7995 4.023 3.0396 2.5479 3.7995 2.682 3.129 3.7995 3.7995 2.235
700682800093-0319-01 diltiazem 60 mg Tab




250 00093-0319-01 IP/OP 4.48 1.792 2.24 4.032 3.584 3.808 4.032 3.0464 2.5536 3.808 2.688 3.136 3.808 3.808 2.24
701222200228-2620-11 isosorbide mononitrate 20 mg Tab




250 00228-2620-11 IP/OP 4.51 1.804 2.255 4.059 3.608 3.8335 4.059 3.0668 2.5707 3.8335 2.706 3.157 3.8335 3.8335 2.255
701455800185-4416-01 metformin 500 mg Tab XR




250 00185-4416-01 IP/OP 4.51 1.804 2.255 4.059 3.608 3.8335 4.059 3.0668 2.5707 3.8335 2.706 3.157 3.8335 3.8335 2.255
700914500115-7033-01 fludrocortisone 0.1 mg Tab




250 00115-7033-01 IP/OP 4.52 1.808 2.26 4.068 3.616 3.842 4.068 3.0736 2.5764 3.842 2.712 3.164 3.842 3.842 2.26
701950800228-2348-10 propylthiouracil 50 mg Tab




250 00228-2348-10 IP/OP 4.52 1.808 2.26 4.068 3.616 3.842 4.068 3.0736 2.5764 3.842 2.712 3.164 3.842 3.842 2.26
700282700378-1140-05 busPIRone 5 mg Tab




250 00378-1140-05 IP/OP 4.53 1.812 2.265 4.077 3.624 3.8505 4.077 3.0804 2.5821 3.8505 2.718 3.171 3.8505 3.8505 2.265
702342700904-2924-61 verapamil 120 mg Tab




250 00904-2924-61 IP/OP 4.54 1.816 2.27 4.086 3.632 3.859 4.086 3.0872 2.5878 3.859 2.724 3.178 3.859 3.859 2.27
700608300054-4183-25 dexamethasone 2 mg Tab




250 00054-4183-25 IP/OP 4.6 1.84 2.3 4.14 3.68 3.91 4.14 3.128 2.622 3.91 2.76 3.22 3.91 3.91 2.3
701727000832-0038-00 oxybutynin 5 mg Tab




250 00832-0038-00 IP/OP 4.6 1.84 2.3 4.14 3.68 3.91 4.14 3.128 2.622 3.91 2.76 3.22 3.91 3.91 2.3
701503557664-0167-58 metoprolol 100 mg Tab




250 57664-0167-58 IP/OP 4.61 1.844 2.305 4.149 3.688 3.9185 4.149 3.1348 2.6277 3.9185 2.766 3.227 3.9185 3.9185 2.305
701508400904-6341-61 metoprolol 50 mg Tab




250 00904-6341-61 IP/OP 4.61 1.844 2.305 4.149 3.688 3.9185 4.149 3.1348 2.6277 3.9185 2.766 3.227 3.9185 3.9185 2.305
701297400074-6624-90 levothyroxine 0.1 mg Tab




250 00074-6624-90 IP/OP 4.63 1.852 2.315 4.167 3.704 3.9355 4.167 3.1484 2.6391 3.9355 2.778 3.241 3.9355 3.9355 2.315
701465749884-0641-01 methimazole 10 mg Tab




250 49884-0641-01 IP/OP 4.65 1.86 2.325 4.185 3.72 3.9525 4.185 3.162 2.6505 3.9525 2.79 3.255 3.9525 3.9525 2.325
700335300378-0078-01 carbidopa/levodopa 10 mg/100 mg Tab




250 00378-0078-01 IP/OP 4.67 1.868 2.335 4.203 3.736 3.9695 4.203 3.1756 2.6619 3.9695 2.802 3.269 3.9695 3.9695 2.335
701771816714-0235-01 penicillin VK 500 mg Tab




250 16714-0235-01 IP/OP 4.69 1.876 2.345 4.221 3.752 3.9865 4.221 3.1892 2.6733 3.9865 2.814 3.283 3.9865 3.9865 2.345
703136200065-8064-01 ocular lubricant GENTEAL Gel




250 00065-8064-01 IP/OP 4.72 1.888 2.36 4.248 3.776 4.012 4.248 3.2096 2.6904 4.012 2.832 3.304 4.012 4.012 2.36
701540749884-0256-01 minoxidil 2.5 mg Tab




250 49884-0256-01 IP/OP 4.73 1.892 2.365 4.257 3.784 4.0205 4.257 3.2164 2.6961 4.0205 2.838 3.311 4.0205 4.0205 2.365
701443454092-0189-81 mesalamine 250 mg Cap SR




250 54092-0189-81 IP/OP 4.74 1.896 2.37 4.266 3.792 4.029 4.266 3.2232 2.7018 4.029 2.844 3.318 4.029 4.029 2.37
701816151079-0129-06 phenytoin 50 mg Tab Chew




250 51079-0129-06 IP/OP 4.74 1.896 2.37 4.266 3.792 4.029 4.266 3.2232 2.7018 4.029 2.844 3.318 4.029 4.029 2.37
700280160505-0158-01 buPROPion 75 mg Tab




250 60505-0158-01 IP/OP 4.8 1.92 2.4 4.32 3.84 4.08 4.32 3.264 2.736 4.08 2.88 3.36 4.08 4.08 2.4
700469051079-0881-20 clonAZEPAM 0.5 mg Tab




250 51079-0881-20 IP/OP 4.83 1.932 2.415 4.347 3.864 4.1055 4.347 3.2844 2.7531 4.1055 2.898 3.381 4.1055 4.1055 2.415
701060600904-5923-61 haloperidol 1 mg Tab




250 00904-5923-61 IP/OP 4.83 1.932 2.415 4.347 3.864 4.1055 4.347 3.2844 2.7531 4.1055 2.898 3.381 4.1055 4.1055 2.415
702090249502-0640-15 SODIUM CHLORIDE 3% 15ML NEB




250 49502-0640-15 IP/OP 4.84 1.936 2.42 4.356 3.872 4.114 4.356 3.2912 2.7588 4.114 2.904 3.388 4.114 4.114 2.42
702696651672-2114-02 acetaminophen 80 mg Sup




250 51672-2114-02 IP/OP 4.85 1.94 2.425 4.365 3.88 4.1225 4.365 3.298 2.7645 4.1225 2.91 3.395 4.1225 4.1225 2.425
701013500049-1560-66 glipiZIDE 10 mg Tab XL




250 00049-1560-66 IP/OP 4.9 1.96 2.45 4.41 3.92 4.165 4.41 3.332 2.793 4.165 2.94 3.43 4.165 4.165 2.45
701759300006-0672-68 penicillamine 125 mg Cap




250 00006-0672-68 IP/OP 4.91 1.964 2.455 4.419 3.928 4.1735 4.419 3.3388 2.7987 4.1735 2.946 3.437 4.1735 4.1735 2.455
702111653746-0514-01 spironolactone 50 mg Tab




250 53746-0514-01 IP/OP 4.94 1.976 2.47 4.446 3.952 4.199 4.446 3.3592 2.8158 4.199 2.964 3.458 4.199 4.199 2.47
700175363304-0621-01 atenolol 25 mg Tab




250 63304-0621-01 IP/OP 4.95 1.98 2.475 4.455 3.96 4.2075 4.455 3.366 2.8215 4.2075 2.97 3.465 4.2075 4.2075 2.475
752002800516-0092-01 iodoquinol 210 mg Tab




250 00516-0092-01 IP/OP 4.95 1.98 2.475 4.455 3.96 4.2075 4.455 3.366 2.8215 4.2075 2.97 3.465 4.2075 4.2075 2.475
700713100093-3129-01 disopyramide 150 mg Cap




250 00093-3129-01 IP/OP 4.96 1.984 2.48 4.464 3.968 4.216 4.464 3.3728 2.8272 4.216 2.976 3.472 4.216 4.216 2.48
701294100074-4552-19 levothyroxine 0.05 mg Tab




250 00074-4552-19 IP/OP 4.96 1.984 2.48 4.464 3.968 4.216 4.464 3.3728 2.8272 4.216 2.976 3.472 4.216 4.216 2.48
702255160505-0234-01 torsemide 20 mg Tab




250 60505-0234-01 IP/OP 4.97 1.988 2.485 4.473 3.976 4.2245 4.473 3.3796 2.8329 4.2245 2.982 3.479 4.2245 4.2245 2.485
701022663739-0119-10 glyBURIDE 5 mg Tab




250 63739-0119-10 IP/OP 4.99 1.996 2.495 4.491 3.992 4.2415 4.491 3.3932 2.8443 4.2415 2.994 3.493 4.2415 4.2415 2.495
702498700781-5077-01 loratadine 10 mg Tab




250 00781-5077-01 IP/OP 4.99 1.996 2.495 4.491 3.992 4.2415 4.491 3.3932 2.8443 4.2415 2.994 3.493 4.2415 4.2415 2.495
7225140 MAALOX 30ML SUS 7005184




250
IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
7225116 PROVENTIL 120ML SYR 7000466




250
IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
4286918 ALBUTEROL 2.5MG/0.5ML NEB




250
IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
4286923 ALBUTEROL 2.5MG/0.5ML NEB




250
IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
3814931 ALBUTEROL 2.5MG/0.5ML NEB




250
IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
3081967 AMINOPHYLLIN ^250MG INJ

J0280

250
IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
702213000456-0458-01 thyroid desiccated 30 mg Tab




250 00456-0458-01 IP/OP 5 2 2.5 4.5 4 4.25 4.5 3.4 2.85 4.25 3 3.5 4.25 4.25 2.5
701790843386-0360-21 phenelzine 15 mg Tab




250 43386-0360-21 IP/OP 5.04 2.016 2.52 4.536 4.032 4.284 4.536 3.4272 2.8728 4.284 3.024 3.528 4.284 4.284 2.52
700093800378-0211-01 LIMBITROL 12.5 mg/5 mg Tab




250 00378-0211-01 IP/OP 5.08 2.032 2.54 4.572 4.064 4.318 4.572 3.4544 2.8956 4.318 3.048 3.556 4.318 4.318 2.54
701578700054-0517-41 morphine 20 mg/mL UD CONC




250 00054-0517-41 IP/OP 5.08 2.032 2.54 4.572 4.064 4.318 4.572 3.4544 2.8956 4.318 3.048 3.556 4.318 4.318 2.54
703181899997-0318-18 erythromycin ES 40 mg/mL PEDIATRIC Oral Susp




250 99997-0318-18 IP/OP 5.08 2.032 2.54 4.572 4.064 4.318 4.572 3.4544 2.8956 4.318 3.048 3.556 4.318 4.318 2.54
700752951079-0437-20 doxepin 25 mg Cap




250 51079-0437-20 IP/OP 5.09 2.036 2.545 4.581 4.072 4.3265 4.581 3.4612 2.9013 4.3265 3.054 3.563 4.3265 4.3265 2.545
700503600591-5325-01 colchicine/probenecid 0.5 mg/500 mg Tab




250 00591-5325-01 IP/OP 5.1 2.04 2.55 4.59 4.08 4.335 4.59 3.468 2.907 4.335 3.06 3.57 4.335 4.335 2.55
701295800074-5182-19 levothyroxine 0.075 mg Tab




250 00074-5182-19 IP/OP 5.11 2.044 2.555 4.599 4.088 4.3435 4.599 3.4748 2.9127 4.3435 3.066 3.577 4.3435 4.3435 2.555
700417900093-0542-01 chlorZOXAZONE 500 mg Tab




250 00093-0542-01 IP/OP 5.14 2.056 2.57 4.626 4.112 4.369 4.626 3.4952 2.9298 4.369 3.084 3.598 4.369 4.369 2.57
702578668180-0722-20 cefdinir 25 mg/mL PEDIATRIC Oral Susp




250 68180-0722-20 IP/OP 5.14 2.056 2.57 4.626 4.112 4.369 4.626 3.4952 2.9298 4.369 3.084 3.598 4.369 4.369 2.57
702424300025-2732-34 disopyramide 100 mg CR Cap




250 00025-2732-34 IP/OP 5.2 2.08 2.6 4.68 4.16 4.42 4.68 3.536 2.964 4.42 3.12 3.64 4.42 4.42 2.6
700901241167-4310-06 fexofenadine/pseudoEPHED 60 mg/120 mg 12-hr Tab




250 41167-4310-06 IP/OP 5.23 2.092 2.615 4.707 4.184 4.4455 4.707 3.5564 2.9811 4.4455 3.138 3.661 4.4455 4.4455 2.615
701416000904-6517-61 meclizine 25 mg Tab




250 00904-6517-61 IP/OP 5.26 2.104 2.63 4.734 4.208 4.471 4.734 3.5768 2.9982 4.471 3.156 3.682 4.471 4.471 2.63
702257700904-6365-61 tramadol 50 mg Tab




250 00904-6365-61 IP/OP 5.27 2.108 2.635 4.743 4.216 4.4795 4.743 3.5836 3.0039 4.4795 3.162 3.689 4.4795 4.4795 2.635
700337900228-2539-10 carbidopa/levodopa 25 mg/100 mg Tab




250 00228-2539-10 IP/OP 5.28 2.112 2.64 4.752 4.224 4.488 4.752 3.5904 3.0096 4.488 3.168 3.696 4.488 4.488 2.64
701366700378-0415-01 diphenoxylate/atropine (lomotil) Tab




250 00378-0415-01 IP/OP 5.29 2.116 2.645 4.761 4.232 4.4965 4.761 3.5972 3.0153 4.4965 3.174 3.703 4.4965 4.4965 2.645
701627200904-6069-61 naproxen 250 mg Tab




250 00904-6069-61 IP/OP 5.3 2.12 2.65 4.77 4.24 4.505 4.77 3.604 3.021 4.505 3.18 3.71 4.505 4.505 2.65
701298200074-9296-90 levothyroxine 0.112 mg Tab




250 00074-9296-90 IP/OP 5.31 2.124 2.655 4.779 4.248 4.5135 4.779 3.6108 3.0267 4.5135 3.186 3.717 4.5135 4.5135 2.655
700783400093-0026-01 enalapril 2.5 mg Tab




250 00093-0026-01 IP/OP 5.35 2.14 2.675 4.815 4.28 4.5475 4.815 3.638 3.0495 4.5475 3.21 3.745 4.5475 4.5475 2.675
739452600832-1217-00 warfarin 6 mg Tab




250 00832-1217-00 IP/OP 5.36 2.144 2.68 4.824 4.288 4.556 4.824 3.6448 3.0552 4.556 3.216 3.752 4.556 4.556 2.68
752049700406-0124-62 hydroCODONE/APAP 7.5/325 mg Tab




250 00406-0124-62 IP/OP 5.36 2.144 2.68 4.824 4.288 4.556 4.824 3.6448 3.0552 4.556 3.216 3.752 4.556 4.556 2.68
700718062756-0796-88 divalproex sodium 125 mg Tab Enteric




250 62756-0796-88 IP/OP 5.37 2.148 2.685 4.833 4.296 4.5645 4.833 3.6516 3.0609 4.5645 3.222 3.759 4.5645 4.5645 2.685
700905300591-3219-01 fioriNAL Cap




250 00591-3219-01 IP/OP 5.38 2.152 2.69 4.842 4.304 4.573 4.842 3.6584 3.0666 4.573 3.228 3.766 4.573 4.573 2.69
701608268084-0051-01 nabumetone 500 mg Tab




250 68084-0051-01 IP/OP 5.38 2.152 2.69 4.842 4.304 4.573 4.842 3.6584 3.0666 4.573 3.228 3.766 4.573 4.573 2.69
702427600517-4601-25 glycopyrrolate 0.2 mg/ml Inj




250 00517-4601-25 IP/OP 5.38 2.152 2.69 4.842 4.304 4.573 4.842 3.6584 3.0666 4.573 3.228 3.766 4.573 4.573 2.69
758336566689-0694-30 methadone 10 mg/mL Oral Concentrate




250 66689-0694-30 IP/OP 5.38 2.152 2.69 4.842 4.304 4.573 4.842 3.6584 3.0666 4.573 3.228 3.766 4.573 4.573 2.69
700092051079-0147-20 amitriptyline 75 mg Tab




250 51079-0147-20 IP/OP 5.42 2.168 2.71 4.878 4.336 4.607 4.878 3.6856 3.0894 4.607 3.252 3.794 4.607 4.607 2.71
702712100378-6987-89 SODIUM CHLORIDE 0.9% 15ML NEB




250 00378-6987-89 IP/OP 5.42 2.168 2.71 4.878 4.336 4.607 4.878 3.6856 3.0894 4.607 3.252 3.794 4.607 4.607 2.71
702621400487-9901-30 ALBUTEROL 2.5MG/0.5ML NEB




250 00487-9901-30 IP/OP 5.45 2.18 2.725 4.905 4.36 4.6325 4.905 3.706 3.1065 4.6325 3.27 3.815 4.6325 4.6325 2.725
703178499997-0317-84 clarithromycin 50 mg/mL PEDIATRIC Oral Susp




250 99997-0317-84 IP/OP 5.45 2.18 2.725 4.905 4.36 4.6325 4.905 3.706 3.1065 4.6325 3.27 3.815 4.6325 4.6325 2.725
701517500093-8739-01 mexiletine 150 mg Cap




250 00093-8739-01 IP/OP 5.47 2.188 2.735 4.923 4.376 4.6495 4.923 3.7196 3.1179 4.6495 3.282 3.829 4.6495 4.6495 2.735
700638000054-3185-44 diazepam 5 mg/mL UD CONC




250 00054-3185-44 IP/OP 5.5 2.2 2.75 4.95 4.4 4.675 4.95 3.74 3.135 4.675 3.3 3.85 4.675 4.675 2.75
700470863739-0264-10 clonAZEPAM 1 mg Tab




250 63739-0264-10 IP/OP 5.52 2.208 2.76 4.968 4.416 4.692 4.968 3.7536 3.1464 4.692 3.312 3.864 4.692 4.692 2.76
701093751079-0433-20 HCTZ/triamterene 50 mg/75 mg Tab




250 51079-0433-20 IP/OP 5.53 2.212 2.765 4.977 4.424 4.7005 4.977 3.7604 3.1521 4.7005 3.318 3.871 4.7005 4.7005 2.765
702214800456-0459-01 thyroid desiccated 60 mg Tab




250 00456-0459-01 IP/OP 5.55 2.22 2.775 4.995 4.44 4.7175 4.995 3.774 3.1635 4.7175 3.33 3.885 4.7175 4.7175 2.775
809699100132-0190-12 glycerin PEDIATRIC 4 mL Liquid Enema




250 00132-0190-12 IP/OP 5.55 2.22 2.775 4.995 4.44 4.7175 4.995 3.774 3.1635 4.7175 3.33 3.885 4.7175 4.7175 2.775
701237000005-3285-43 ketoprofen 50 mg Cap




250 00005-3285-43 IP/OP 5.56 2.224 2.78 5.004 4.448 4.726 5.004 3.7808 3.1692 4.726 3.336 3.892 4.726 4.726 2.78
701382400904-5981-61 lorazepam 1 mg Tab




250 00904-5981-61 IP/OP 5.58 2.232 2.79 5.022 4.464 4.743 5.022 3.7944 3.1806 4.743 3.348 3.906 4.743 4.743 2.79
702365800832-1218-00 warfarin 7.5 mg Tab




250 00832-1218-00 IP/OP 5.58 2.232 2.79 5.022 4.464 4.743 5.022 3.7944 3.1806 4.743 3.348 3.906 4.743 4.743 2.79
700059970710-1210-01 allopurinol 300 mg Tab




250 70710-1210-01 IP/OP 5.59 2.236 2.795 5.031 4.472 4.7515 5.031 3.8012 3.1863 4.7515 3.354 3.913 4.7515 4.7515 2.795
701302200074-7070-90 levothyroxine 0.175 mg Tab




250 00074-7070-90 IP/OP 5.62 2.248 2.81 5.058 4.496 4.777 5.058 3.8216 3.2034 4.777 3.372 3.934 4.777 4.777 2.81
700336151079-0978-20 carbidopa/levodopa 25 mg/100 mg Tab CR




250 51079-0978-20 IP/OP 5.63 2.252 2.815 5.067 4.504 4.7855 5.067 3.8284 3.2091 4.7855 3.378 3.941 4.7855 4.7855 2.815
701413700378-0092-01 maprotiline 75 mg Tab




250 00378-0092-01 IP/OP 5.63 2.252 2.815 5.067 4.504 4.7855 5.067 3.8284 3.2091 4.7855 3.378 3.941 4.7855 4.7855 2.815
702366663323-0185-10 water, sterile 10 mL Inj




250 63323-0185-10 IP/OP 5.63 2.252 2.815 5.067 4.504 4.7855 5.067 3.8284 3.2091 4.7855 3.378 3.941 4.7855 4.7855 2.815
700062367253-0901-10 alprazolam 0.5 mg Tab




250 67253-0901-10 IP/OP 5.66 2.264 2.83 5.094 4.528 4.811 5.094 3.8488 3.2262 4.811 3.396 3.962 4.811 4.811 2.83
700338768084-0094-01 carbidopa/levodopa 25 mg/250 mg Tab




250 68084-0094-01 IP/OP 5.73 2.292 2.865 5.157 4.584 4.8705 5.157 3.8964 3.2661 4.8705 3.438 4.011 4.8705 4.8705 2.865
700646300228-2743-06 diclofenac sodium 50 mg Tab Enteric




250 00228-2743-06 IP/OP 5.73 2.292 2.865 5.157 4.584 4.8705 5.157 3.8964 3.2661 4.8705 3.438 4.011 4.8705 4.8705 2.865
702358300832-1219-00 warfarin 10 mg Tab




250 00832-1219-00 IP/OP 5.74 2.296 2.87 5.166 4.592 4.879 5.166 3.9032 3.2718 4.879 3.444 4.018 4.879 4.879 2.87
702649500121-0547-05 promethazine/codeine 6.25 mg/10 mg/5 mL Syr UD




250 00121-0547-05 IP/OP 5.75 2.3 2.875 5.175 4.6 4.8875 5.175 3.91 3.2775 4.8875 3.45 4.025 4.8875 4.8875 2.875
740021100904-6461-61 promethazine 25 mg Tab




250 00904-6461-61 IP/OP 5.76 2.304 2.88 5.184 4.608 4.896 5.184 3.9168 3.2832 4.896 3.456 4.032 4.896 4.896 2.88
701057268084-0748-25 guanfacine 1 mg Tab




250 68084-0748-25 IP/OP 5.85 2.34 2.925 5.265 4.68 4.9725 5.265 3.978 3.3345 4.9725 3.51 4.095 4.9725 4.9725 2.925
700001147781-0341-01 acarbose 50 mg Tab




250 47781-0341-01 IP/OP 5.86 2.344 2.93 5.274 4.688 4.981 5.274 3.9848 3.3402 4.981 3.516 4.102 4.981 4.981 2.93
701358464679-0928-01 lisinopril 5 mg Tab




250 64679-0928-01 IP/OP 5.88 2.352 2.94 5.292 4.704 4.998 5.292 3.9984 3.3516 4.998 3.528 4.116 4.998 4.998 2.94
700176151079-0684-19 atenolol 50 mg Tab




250 51079-0684-19 IP/OP 5.89 2.356 2.945 5.301 4.712 5.0065 5.301 4.0052 3.3573 5.0065 3.534 4.123 5.0065 5.0065 2.945
701065500781-1396-13 haloperidol 5 mg Tab




250 00781-1396-13 IP/OP 5.9 2.36 2.95 5.31 4.72 5.015 5.31 4.012 3.363 5.015 3.54 4.13 5.015 5.015 2.95
701534048433-0202-30 mineral oil 100% 30 mL UD Liq




250 48433-0202-30 IP/OP 5.91 2.364 2.955 5.319 4.728 5.0235 5.319 4.0188 3.3687 5.0235 3.546 4.137 5.0235 5.0235 2.955
811682943386-0160-06 miSOPROStol 25 mcg Oral/Vaginal Tab




250 43386-0160-06 IP/OP 5.93 2.372 2.965 5.337 4.744 5.0405 5.337 4.0324 3.3801 5.0405 3.558 4.151 5.0405 5.0405 2.965
702135500378-0427-01 sulindac 150 mg Tab




250 00378-0427-01 IP/OP 5.94 2.376 2.97 5.346 4.752 5.049 5.346 4.0392 3.3858 5.049 3.564 4.158 5.049 5.049 2.97
701220649884-0020-01 isosorbide dinitrate 5 mg Tab




250 49884-0020-01 IP/OP 5.96 2.384 2.98 5.364 4.768 5.066 5.364 4.0528 3.3972 5.066 3.576 4.172 5.066 5.066 2.98
701356868180-0514-03 lisinopril 10 mg Tab




250 68180-0514-03 IP/OP 5.96 2.384 2.98 5.364 4.768 5.066 5.364 4.0528 3.3972 5.066 3.576 4.172 5.066 5.066 2.98
700717200074-6114-11 divalproex sodium 125 mg Cap Sprink




250 00074-6114-11 IP/OP 5.99 2.396 2.995 5.391 4.792 5.0915 5.391 4.0732 3.4143 5.0915 3.594 4.193 5.0915 5.0915 2.995
702420100378-7005-01 loxapine 5 mg Cap




250 00378-7005-01 IP/OP 6.01 2.404 3.005 5.409 4.808 5.1085 5.409 4.0868 3.4257 5.1085 3.606 4.207 5.1085 5.1085 3.005
701902965162-0545-10 primidone 250 mg Tab




250 65162-0545-10 IP/OP 6.03 2.412 3.015 5.427 4.824 5.1255 5.427 4.1004 3.4371 5.1255 3.618 4.221 5.1255 5.1255 3.015
700105000591-5714-01 amoxapine 50 mg Tab




250 00591-5714-01 IP/OP 6.04 2.416 3.02 5.436 4.832 5.134 5.436 4.1072 3.4428 5.134 3.624 4.228 5.134 5.134 3.02
701372560687-0229-01 loperamide 2 mg Cap




250 60687-0229-01 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
701397299999-9999-36 MAGIC MOUTHWASH oral suspension 5 mL




250 99999-9999-36 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
700516867457-0612-20P vancomycin 5 mg/mL PEDIATRIC IV Syringe




250 67457-0612-20P IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
700506900206-8452-16P piperacillin/tazobactam 45 mg/mL PEDIATRIC IV Syringe




250 00206-8452-16P IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702574563323-0401-26P aztreonam 10 mg/mL PEDIATRIC IV Syringe




250 63323-0401-26P IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702575268094-0123-62 OXcarbazepine 60 mg/1 mL Oral Susp




250 68094-0123-62 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702704899999-9999-14 morphine 1 mg/mL PED ORAL SOL




250 99999-9999-14 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702816099997-0281-60 morphine NICU 0.1 mg/mL ORAL SOL




250 99997-0281-60 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702922600409-7935-19N NICU D20% (D20W) NICU IV Syringe




250 00409-7935-19N IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702927500781-9221-91P clindamycin 12 mg/mL PEDIATRIC IV Syringe




250 00781-9221-91P IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702928300781-9220-09N clindamycin NICU 6 mg/mL IV Syringe




250 00781-9220-09N IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702929199997-0292-91 FAT emulsion, IV 20% PEDIATRIC IV Syringe




250 99997-0292-91 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702949999997-0294-99 rocuronium 10 mg/mL PEDIATRIC IV Syringe




250 99997-0294-99 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702961499997-0296-14 valproate sodium 5 mg/mL PEDIATRIC IV Syringe




250 99997-0296-14 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702969799997-0296-97 penicillin G SODIUM 100,000 units/mL PEDIATRIC IV Syringe




250 99997-0296-97 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702972199997-0297-21 tobramycin 2 mg/mL PEDIATRIC IV Syringe




250 99997-0297-21 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
702974799997-0297-47 heparin 100 units/mL PF Inj




250 99997-0297-47 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703036499997-0303-64 NICU isoproterenol 10 mcg/mL IV Syringe




250 99997-0303-64 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703042299997-0304-22 niCARdipine 0.1 mg/mL PEDIATRIC IV Syringe




250 99997-0304-22 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703044899997-0304-48 nitroPRUSSIDE 200 mcg/mL PEDIATRIC IV Syringe




250 99997-0304-48 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703040699997-0304-06 indomethacin NICU (IVH) IV Syringe




250 99997-0304-06 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703050599997-0305-05 ganciclovir 5 mg/mL PEDIATRIC IV Syringe




250 99997-0305-05 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703051399997-0305-13 pentamidine 6 mg/mL PEDIATRIC IV Syringe




250 99997-0305-13 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703117251525-0115-01 hyoscyamine 0.375 mg Tab SR




250 51525-0115-01 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703175099997-0317-50 cefPROZIL 50 mg/mL PEDIATRIC Oral Susp




250 99997-0317-50 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
703191799997-0319-17 lorazepam NICU 0.4 mg/mL IV Syringe




250 99997-0319-17 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
739621660505-6093-05P cefAZOLIN 20 mg/mL PEDIATRIC Inj




250 60505-6093-05P IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
744283499997-0324-02 calcium GLUBIONATE 360 mg/mL PEDIATRIC Oral Syringe




250 99997-0324-02 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
745567699997-0324-28 hydrALAZINE NICU 1 mg/mL IV Syringe




250 99997-0324-28 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
750176116963-0020-09 acetylcysteine 600 mg Cap




250 16963-0020-09 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
750437199997-0324-69 methadone 1 mg/mL PEDIATRIC Oral Liq




250 99997-0324-69 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265200173-0682-54A albuterol 90 mcg/inh IntraOp




250 00173-0682-54A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265367457-0153-03A amiodarone 50 mg/mL IntraOp




250 67457-0153-03A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265425021-0672-10A atracurium 10 mg/mL IntraOp




250 25021-0672-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265561553-0324-71A atropine 0.4 mg/mL IntraOp




250 61553-0324-71A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265600409-4911-34A atropine 0.1 mg/mL Abboject IntraOp




250 00409-4911-34A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265700409-1159-02A bupivacaine 0.25% IntraOp




250 00409-1159-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265800409-1560-29A bupivacaine 0.5% IntraOp




250 00409-1560-29A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794265900409-1749-29A bupivacaine 0.5% w/EPinephrine 1:200,000 IntraOp




250 00409-1749-29A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794266063323-0472-17A bupivacaine 0.75% IntraOp




250 63323-0472-17A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794266100409-4928-34A calcium CHLORIDE 100 mg/mL Abboject IntraOp




250 00409-4928-34A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794266200009-0856-08A carboprost 250 mcg/mL IntraOp




250 00009-0856-08A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794266600641-6013-01A diltiazem 5 mg/mL IntraOp




250 00641-6013-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267061553-0304-72A ePHEDrine 5 mg/mL IntraOp




250 61553-0304-72A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267176329-3316-01A EPinephrine 0.1 mg/mL Abboject IntraOp




250 76329-3316-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267200409-7241-01A EPinephrine 1 mg/mL IntraOp




250 00409-7241-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267363323-0652-10A esmolol 10 mg/mL IntraOp




250 63323-0652-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267400409-8061-01A etomidate 2 mg/mL IntraOp




250 00409-8061-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267563323-0739-12A famotidine 10 mg/mL IntraOp




250 63323-0739-12A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794267700143-9684-10A flumazenil 0.1 mg/mL IntraOp




250 00143-9684-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794268000143-9682-25A glycopyrrolate 0.2 mg/mL IntraOp




250 00143-9682-25A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794268163323-0276-02A heparin 1000 unit/mL IntraOp




250 63323-0276-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794268200002-8215-17A insulin, humulin regular 100 unit/mL IntraOp




250 00002-8215-17A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794268717478-0808-01A indigo carmine 8 mg/mL IntraOp




250 17478-0808-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794268861570-0581-10A ketamine 10 mg/mL IntraOp




250 61570-0581-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794268963323-0162-01A ketorolac 30 mg/mL IntraOp




250 63323-0162-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269017478-0062-35A ocular lubricant ophth oint IntraOp




250 17478-0062-35A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269100409-2267-25A labetalol 5 mg/mL IntraOp




250 00409-2267-25A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269200143-9673-10A levETIRAcetam 100 mg/mL IntraOp




250 00143-9673-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269363323-0492-57A lidocaine 1% IntraOp




250 63323-0492-57A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269563323-0489-17A lidocaine 2% w/EPinephrine 1:200,000 IntraOp




250 63323-0489-17A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269600409-4903-34A lidocaine 20 mg/mL Abboject IntraOp




250 00409-4903-34A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269717478-0811-10A lidocaine 2% TOPical Gel IntraOp




250 17478-0811-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794269963323-0024-25A mannitol 0.25 g/mL IntraOp




250 63323-0024-25A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794270142023-0105-01A methohexital 500 mg/50 mL IntraOp




250 42023-0105-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794270217478-0504-01A methylene blue 10 mg/mL IntraOp




250 17478-0504-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794270317478-0501-01A methylergonovine 0.2 mg/mL IntraOp




250 17478-0501-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794270500409-1778-05A metoprolol 1 mg/mL IntraOp




250 00409-1778-05A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794271200281-0326-30A nitroGLYCERIN 2% Topical Ointment IntraOp




250 00281-0326-30A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794271861553-0346-70A PHENYLephrine 100 mcg/mL IntraOp




250 61553-0346-70A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794271917478-0510-02A physostigmine 1 mg/mL IntraOp




250 17478-0510-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794272367457-0198-05A REMIfentanil 50 mcg/mL IntraOp




250 67457-0198-05A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794272400409-9558-49A rocuronium 10 mg/mL IntraOp




250 00409-9558-49A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794272563323-0285-23A ropivacaine 0.2% IntraOp




250 63323-0285-23A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794272800409-6629-02A succinylcholine 20 mg/mL IntraOp




250 00409-6629-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794272900409-3380-31A SUFentanil 50 mcg/mL IntraOp




250 00409-3380-31A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794273117478-0045-32A tetracaine 1% IntraOp




250 17478-0045-32A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794273263323-0302-09A vasopressin 20 unit/mL IntraOp




250 63323-0302-09A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794273300409-1144-01A verapamil 2.5 mg/mL IntraOp




250 00409-1144-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794273467457-0572-20A vecuronium 1 mg IntraOp




250 67457-0572-20A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794697000409-1761-02A bupivacaine 0.75% D8.25 SPINAL IntraOp




250 00409-1761-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794875400009-0011-04A hydrocortisone 100 mg/2 mL IntraOp




250 00009-0011-04A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794893463304-0205-18A midazolam 2 mg/mL ORAL SYRUP IntraOp




250 63304-0205-18A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794893763323-0269-57A propofol 10 mg/mL IntraOp




250 63323-0269-57A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794893800067-4345-04A scopolamine PATCH 1.5 mg IntraOp




250 00067-4345-04A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
794894100713-0164-12A acetaminophen RECTAL SUPP 325 mg IntraOp




250 00713-0164-12A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
795481839822-1000-01A tranexamic acid 1000 mg/100 mL IntraOp




250 39822-1000-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
795866600641-6022-01N famotidine 0.2 mg/mL NICU IV Syringe

J3490

250 00641-6022-01N IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
795867400409-9042-02A bupivacaine 0.25% w/EPinephrine 1:200,000 IntraOp




250 00409-9042-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
796066576329-6300-05A lidocaine 4% TOPical Solution IntraOp




250 76329-6300-05A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
800785739822-1000-01B tranexamic acid 1250 mg/100 mL IntraOp




250 39822-1000-01B IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
800786039822-1000-01C tranexamic acid 1500 mg/100 mL IntraOp




250 39822-1000-01C IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
800786939822-1000-01D tranexamic acid 1750 mg/100 mL IntraOp




250 39822-1000-01D IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
800787739822-1000-01E tranexamic acid 2000 mg/100 mL IntraOp




250 39822-1000-01E IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
800788139822-1000-01F tranexamic acid 2250 mg/100 mL IntraOp




250 39822-1000-01F IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
800789139822-1000-01G tranexamic acid 2500 mg/100 mL IntraOp




250 39822-1000-01G IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
804984160846-0805-01 levoTHYROXINE 25 mcg/mL PEDIATRIC Oral Susp




250 60846-0805-01 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
805598499999-0223-18 Emergency Spinal Kit




250 99999-0223-18 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
805599499998-0223-18 Lab Order by Pharmacist (eMAR Notification)




250 99998-0223-18 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
805934299903-2220-18 Aerogen Solo Nebulization Syringe^




250 99903-2220-18 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
806362300006-5423-12A sugammadex 100 mg/mL IntraOp




250 00006-5423-12A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
807488642367-0540-32A dantrolene 50 mg/mL IntraOp




250 42367-0540-32A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
807488971266-9025-05A ePHEDrine 10 mg/mL IntraOp




250 71266-9025-05A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
807995400409-1482-02A nitroGLYCERIN 20 mcg/mL IntraOp




250 00409-1482-02A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808000063323-0286-23A ropivacaine 0.5% IntraOp




250 63323-0286-23A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808000300409-9158-25A phytonadione (Vit K) 10 mg/mL IntraOp




250 00409-9158-25A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808000663323-0262-55A heparin 5000 unit/mL IntraOp




250 63323-0262-55A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808000900409-3213-10A diazePAM 5 mg/mL IntraOp




250 00409-3213-10A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808004500409-4346-09A aminocaproic acid 250 mg/mL IntraOp




250 00409-4346-09A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808433200173-0540-47A cisatracurium 2 mg/mL IntraOp




250 00173-0540-47A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808433500603-1393-64A lidocaine 2% TOPical VISCOUS IntraOp




250 00603-1393-64A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
808523416729-0239-93A dexmedetomidine 100 mcg/mL IV Push IntraOp




250 16729-0239-93A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
809115799999-9999-51D Non-formulary Nurse Server Med D




250 99999-9999-51D IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
809124600409-1902-01A procainamide 100 mg/mL IntraOp




250 00409-1902-01A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
810813301050-6011-69 Low Compression Microspheres (LC Bead in NS)




250 01050-6011-69 IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
812184045802-0732-30A acetaminophen RECTAL SUPP 120 mg IntraOp




250 45802-0732-30A IP/OP 6.05 2.42 3.025 5.445 4.84 5.1425 5.445 4.114 3.4485 5.1425 3.63 4.235 5.1425 5.1425 3.025
701683549483-0222-06 nitroGLYCERIN 6.5 mg Cap ER




250 49483-0222-06 IP/OP 6.06 2.424 3.03 5.454 4.848 5.151 5.454 4.1208 3.4542 5.151 3.636 4.242 5.151 5.151 3.03
702320363739-0251-10 valproic acid 250 mg Cap




250 63739-0251-10 IP/OP 6.08 2.432 3.04 5.472 4.864 5.168 5.472 4.1344 3.4656 5.168 3.648 4.256 5.168 5.168 3.04
700684400093-0320-01 diltiazem 90 mg Tab




250 00093-0320-01 IP/OP 6.13 2.452 3.065 5.517 4.904 5.2105 5.517 4.1684 3.4941 5.2105 3.678 4.291 5.2105 5.2105 3.065
700746100904-5522-61 doxazosin 1 mg Tab




250 00904-5522-61 IP/OP 6.15 2.46 3.075 5.535 4.92 5.2275 5.535 4.182 3.5055 5.2275 3.69 4.305 5.2275 5.2275 3.075
701159649884-0590-01 indapamide 2.5 mg Tab




250 49884-0590-01 IP/OP 6.16 2.464 3.08 5.544 4.928 5.236 5.544 4.1888 3.5112 5.236 3.696 4.312 5.236 5.236 3.08
702532300378-8088-01 tramadol/acetaminophen 37.5/325 Tab




250 00378-8088-01 IP/OP 6.2 2.48 3.1 5.58 4.96 5.27 5.58 4.216 3.534 5.27 3.72 4.34 5.27 5.27 3.1
700297529033-0026-02 calcium acetate 667 mg Cap




250 29033-0026-02 IP/OP 6.21 2.484 3.105 5.589 4.968 5.2785 5.589 4.2228 3.5397 5.2785 3.726 4.347 5.2785 5.2785 3.105
700428651079-0807-20 cimetidine 300 mg Tab




250 51079-0807-20 IP/OP 6.22 2.488 3.11 5.598 4.976 5.287 5.598 4.2296 3.5454 5.287 3.732 4.354 5.287 5.287 3.11
701026700087-6074-11 glyBURIDE/metformin 5 mg/500 mg Tab




250 00087-6074-11 IP/OP 6.23 2.492 3.115 5.607 4.984 5.2955 5.607 4.2364 3.5511 5.2955 3.738 4.361 5.2955 5.2955 3.115
701507636000-0033-10 metoprolol 5 mg/5 mL Inj




250 36000-0033-10 IP/OP 6.29 2.516 3.145 5.661 5.032 5.3465 5.661 4.2772 3.5853 5.3465 3.774 4.403 5.3465 5.3465 3.145
700220743547-0338-10 benazepril 40 mg Tab




250 43547-0338-10 IP/OP 6.35 2.54 3.175 5.715 5.08 5.3975 5.715 4.318 3.6195 5.3975 3.81 4.445 5.3975 5.3975 3.175
700219965162-0752-10 benazepril 10 mg Tab




250 65162-0752-10 IP/OP 6.36 2.544 3.18 5.724 5.088 5.406 5.724 4.3248 3.6252 5.406 3.816 4.452 5.406 5.406 3.18
701354300574-0222-01 liothyronine 25 mcg Tab




250 00574-0222-01 IP/OP 6.36 2.544 3.18 5.724 5.088 5.406 5.724 4.3248 3.6252 5.406 3.816 4.452 5.406 5.406 3.18
700091251079-0133-20 amitriptyline 50 mg Tab




250 51079-0133-20 IP/OP 6.38 2.552 3.19 5.742 5.104 5.423 5.742 4.3384 3.6366 5.423 3.828 4.466 5.423 5.423 3.19
701025900228-2752-11 glyBURIDE/metformin 2.5 mg/500 mg Tab




250 00228-2752-11 IP/OP 6.39 2.556 3.195 5.751 5.112 5.4315 5.751 4.3452 3.6423 5.4315 3.834 4.473 5.4315 5.4315 3.195
701793216571-0330-16 PHENobarbital 20 mg/5 mL UD Elixir




250 16571-0330-16 IP/OP 6.4 2.56 3.2 5.76 5.12 5.44 5.76 4.352 3.648 5.44 3.84 4.48 5.44 5.44 3.2
701628068462-0189-01 naproxen 375 mg Tab




250 68462-0189-01 IP/OP 6.41 2.564 3.205 5.769 5.128 5.4485 5.769 4.3588 3.6537 5.4485 3.846 4.487 5.4485 5.4485 3.205
702490460505-0157-01 buPROPion 100 mg Tab




250 60505-0157-01 IP/OP 6.41 2.564 3.205 5.769 5.128 5.4485 5.769 4.3588 3.6537 5.4485 3.846 4.487 5.4485 5.4485 3.205
701357600603-4212-32 lisinopril 20 mg Tab




250 00603-4212-32 IP/OP 6.44 2.576 3.22 5.796 5.152 5.474 5.796 4.3792 3.6708 5.474 3.864 4.508 5.474 5.474 3.22
701511842292-0001-19 metroNIDAZOLE 500 mg Tab




250 42292-0001-19 IP/OP 6.45 2.58 3.225 5.805 5.16 5.4825 5.805 4.386 3.6765 5.4825 3.87 4.515 5.4825 5.4825 3.225
700539051991-0838-01 cyproheptadine 4 mg Tab




250 51991-0838-01 IP/OP 6.46 2.584 3.23 5.814 5.168 5.491 5.814 4.3928 3.6822 5.491 3.876 4.522 5.491 5.491 3.23
701238800378-5750-01 ketoprofen 75 mg Cap




250 00378-5750-01 IP/OP 6.49 2.596 3.245 5.841 5.192 5.5165 5.841 4.4132 3.6993 5.5165 3.894 4.543 5.5165 5.5165 3.245
702341968462-0292-01 verapamil 120 mg Tab SR




250 68462-0292-01 IP/OP 6.49 2.596