Browse by Standard Packs
Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits
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| Item code | Drug name Form and Strength |
Pack size | Price | Manufacturer |
|---|---|---|---|---|
| 13869Y | ACARBOSEacarbose 100 mg tablet, 90 | 90 | $22.84 | AL,RW |
| 13955L | ACARBOSEacarbose 50 mg tablet, 90 | 90 | $16.80 | AF,AL,RW |
| 1003T | ACICLOVIRaciclovir 200 mg tablet, 25 | 25 | $8.27 | HX |
| 12332C | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12350B | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12351C | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12354F | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12357J | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12436M | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12440R | ADALIMUMABadalimumab 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $351.43 | XT |
| 12380N | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes | 2 | $668.67 | EW,LR,VE |
| 12382Q | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes | 2 | $668.67 | EW,LR,VE |
| 12453K | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes | 2 | $668.67 | EW,LR,VE |
| 12455M | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes | 2 | $668.67 | EW,LR,VE |
| 12347W | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.07 | EW,LR,VE |
| 12381P | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.07 | EW,LR,VE |
| 12383R | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.01 | EW,LR,VE |
| 12414J | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.01 | EW,LR,VE |
| 12432H | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.07 | EW,LR,VE |
| 12433J | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.07 | EW,LR,VE |
| 12454L | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.07 | EW,LR,VE |
| 13221W | ADALIMUMABadalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices | 2 | $550.01 | EW,LR |
| 12360M | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.67 | VE |
| 12374G | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.67 | VE |
| 12419P | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.67 | VE |
| 12426B | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.67 | VE |
| 12448E | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.61 | VE |
| 12449F | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.61 | VE |
| 12450G | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL pen device | 1 | $668.67 | VE |
| 12339K | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.67 | VE |
| 12372E | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.67 | VE |
| 12393G | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.67 | VE |
| 12395J | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.61 | VE |
| 12408C | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.61 | VE |
| 12409D | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.67 | VE |
| 12524E | ADALIMUMABadalimumab 80 mg/0.8 mL injection, 0.8 mL syringe | 1 | $668.67 | VE |
| 12330Y | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.83 | PK,RF,SZ,XT |
| 12356H | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.89 | PK,RF,SZ,XT |
| 12369B | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.83 | PK,RF,SZ,XT |
| 12370C | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.89 | PK,RF,SZ,XT |
| 12385W | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.83 | PK,RF,SZ,XT |
| 12386X | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.89 | PK,RF,SZ,XT |
| 12388B | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.89 | PK,RF,SZ,XT |
| 12402R | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices | 2 | $672.89 | PK,RF,SZ,XT |
| 12331B | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes | 2 | $672.89 | PK,RF,SZ,XT |
| 12333D | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes | 2 | $672.89 | PK,RF,SZ,XT |
| 12387Y | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes | 2 | $672.89 | PK,RF,SZ,XT |
| 12416L | ADALIMUMABadalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes | 2 | $672.89 | PK,RF,SZ,XT |
| 13363H | ADAPALENE + BENZOYL PEROXIDEadapalene 0.1% + benzoyl peroxide 2.5% gel, 30 g | 1 | $25.00 | GA |
| 8697R | ADRENALINE (EPINEPHRINE)adrenaline (epinephrine) 150 microgram/0.3 mL injection, 0.3 mL pen device | 1 | $75.66 | AF,AL,XT |
| 8698T | ADRENALINE (EPINEPHRINE)adrenaline (epinephrine) 300 microgram/0.3 mL injection, 0.3 mL pen device | 1 | $75.66 | AF,AL,XT |
| 12655C | ADRENALINE (EPINEPHRINE)adrenaline (epinephrine) 500 microgram/0.3 mL injection, 0.3 mL pen device | 1 | $75.66 | XT |
| 13499L | ALENDRONATEalendronate 70 mg tablet, 4 | 4 | $6.22 | AL,SZ,TX |
| 13835E | ALENDRONATE + COLECALCIFEROLalendronate 70 mg + colecalciferol 140 microgram (5600 units) tablet, 4 | 4 | $7.83 | MQ |
| 14003B | ALENDRONATE + COLECALCIFEROLalendronate 70 mg + colecalciferol 70 microgram (2800 units) tablet, 4 | 4 | $7.83 | MQ |
| 13358C | ALLOPURINOLallopurinol 100 mg tablet, 200 | 200 | $7.17 | AF,GX,RF,SZ,VO |
| 13358C | ALLOPURINOLallopurinol 100 mg tablet, 200 | 200 | $12.79 | RW |
| 13575L | ALLOPURINOLallopurinol 300 mg tablet, 60 | 60 | $6.07 | AF,GX,RF,SZ,VO |
| 13575L | ALLOPURINOLallopurinol 300 mg tablet, 60 | 60 | $11.71 | RW |
| 13897K | ALOGLIPTINalogliptin 6.25 mg tablet, 28 | 28 | $45.33 | TK |
| 13977P | ALOGLIPTINalogliptin 12.5 mg tablet, 28 | 28 | $45.33 | TK |
| 13953J | ALOGLIPTINalogliptin 25 mg tablet, 28 | 28 | $45.33 | TK |
| 13989G | ALOGLIPTIN + METFORMINalogliptin 12.5 mg + metformin hydrochloride 1 g tablet, 56 | 56 | $48.29 | TK |
| 14062D | ALOGLIPTIN + METFORMINalogliptin 12.5 mg + metformin hydrochloride 500 mg tablet, 56 | 56 | $46.86 | TK |
| 14061C | ALOGLIPTIN + METFORMINalogliptin 12.5 mg + metformin hydrochloride 850 mg tablet, 56 | 56 | $47.87 | TK |
| 13032X | AMIFAMPRIDINEamifampridine 10 mg tablet, 100 | 100 | $2226.27 | OJ |
| 13410T | AMILORIDE + HYDROCHLOROTHIAZIDEamiloride hydrochloride dihydrate 5 mg + hydrochlorothiazide 50 mg tablet, 50 | 50 | $6.23 | AS |
| 1486F | AMILORIDE + HYDROCHLOROTHIAZIDEamiloride hydrochloride dihydrate 5 mg + hydrochlorothiazide 50 mg tablet, 50 | 50 | $7.38 | AS |
| 11331J | AMINO ACID FORMULA SUPPLEMENTED WITH PREBIOTICS, PROBIOTICS AND LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid formula supplemented with prebiotics, probiotics and long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $39.04 | SB |
| 11340W | AMINO ACID FORMULA SUPPLEMENTED WITH PREBIOTICS, PROBIOTICS AND LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid formula supplemented with prebiotics, probiotics and long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $39.04 | SB |
| 11343B | AMINO ACID FORMULA SUPPLEMENTED WITH PREBIOTICS, PROBIOTICS AND LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid formula supplemented with prebiotics, probiotics and long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $39.06 | SB |
| 12072J | AMINO ACID FORMULA WITH CARBOHYDRATE WITHOUT PHENYLALANINEamino acid formula with carbohydrate without phenylalanine modified release tablet, 6 x 77 | 1 | $328.57 | OH |
| 10806R | AMINO ACID FORMULA WITH CARBOHYDRATE, VITAMINS, MINERALS AND TRACE ELEMENTS WITHOUT PHENYLALANINEamino acid formula with carbohydrate, vitamins, minerals and trace elements without phenylalanine powder for oral liquid, 30 x 20 g sachets | 1 | $237.24 | OH |
| 12006X | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE WITHOUT METHIONINEamino acid formula with fat, carbohydrate without methionine modified release tablet, 6 x 77 | 1 | $590.78 | OH |
| 10683G | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE WITHOUT PHENYLALANINEamino acid formula with fat, carbohydrate without phenylalanine tablet: modified release, 4 x 110 g | 1 | $263.12 | OH |
| 12015J | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with fat, carbohydrate without phenylalanine and tyrosine modified release tablet, 6 x 77 | 1 | $598.48 | OH |
| 12014H | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with fat, carbohydrate without valine, leucine and isoleucine modified release tablet, 6 x 77 | 1 | $590.78 | OH |
| 3417W | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS AND TRACE ELEMENTS WITHOUT METHIONINE AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACIDamino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without methionine and supplemented with docosahexaenoic acid oral liquid, 36 x 125 mL bottles | 1 | $543.24 | SB |
| 10632N | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS AND TRACE ELEMENTS WITHOUT PHENYLALANINEamino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without phenylalanine oral liquid: powder for, 30 x 34 g bottles | 1 | $363.77 | OH |
| 9330C | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS AND TRACE ELEMENTS WITHOUT PHENYLALANINE AND TYROSINE, AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACIDamino acid formula with fat, carbohydrate, vitamins, minerals and trace elements without phenylalanine and tyrosine, and supplemented with docosahexaenoic acid oral liquid, 36 x 125 mL bottles | 1 | $543.24 | SB |
| 10934L | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS AND TRACE ELEMENTS, WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with fat, carbohydrate, vitamins, minerals and trace elements, without phenylalanine and tyrosine powder for oral liquid, 30 x 34 g bottles | 1 | $704.50 | OH |
| 10522T | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDESamino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides powder for oral liquid, 400 g | 1 | $41.94 | NT |
| 10527C | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDESamino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides powder for oral liquid, 400 g | 1 | $41.94 | NT |
| 11161K | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDESamino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides powder for oral liquid, 400 g | 1 | $41.94 | SB |
| 11183N | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDESamino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides powder for oral liquid, 400 g | 1 | $41.94 | SB |
| 12643K | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDESamino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides powder for oral liquid, 800 g | 1 | $81.93 | QH |
| 12650T | AMINO ACID FORMULA WITH FAT, CARBOHYDRATE, VITAMINS, MINERALS, TRACE ELEMENTS AND MEDIUM CHAIN TRIGLYCERIDESamino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides powder for oral liquid, 800 g | 1 | $81.93 | QH |
| 10715Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT LYSINE AND LOW IN TRYPTOPHANamino acid formula with vitamins and minerals without lysine and low in tryptophan powder for oral liquid, 30 x 18 g sachets | 1 | $227.91 | NU |
| 2650L | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT LYSINE AND LOW IN TRYPTOPHANamino acid formula with vitamins and minerals without lysine and low in tryptophan powder for oral liquid, 400 g | 1 | $82.27 | SB |
| 10466W | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT LYSINE AND LOW IN TRYPTOPHANamino acid formula with vitamins and minerals without lysine and low in tryptophan powder for oral liquid, 500 g | 1 | $295.71 | SB |
| 9438R | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT LYSINE AND LOW IN TRYPTOPHANamino acid formula with vitamins and minerals without lysine and low in tryptophan powder for oral liquid, 30 x 24 g sachets | 1 | $455.82 | VF |
| 5484P | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT LYSINE AND LOW IN TRYPTOPHANamino acid formula with vitamins and minerals without lysine and low in tryptophan powder for oral liquid, 30 x 25 g sachets | 1 | $513.03 | VF |
| 2640Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINEamino acid formula with vitamins and minerals without methionine oral liquid, 30 x 174 mL sachets | 1 | $837.70 | VF |
| 10693T | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINEamino acid formula with vitamins and minerals without methionine oral liquid: powder for, 30 x 36 g sachets | 1 | $433.73 | NU |
| 8417B | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINEamino acid formula with vitamins and minerals without methionine powder for oral liquid, 400 g | 1 | $78.16 | SB |
| 1548L | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINEamino acid formula with vitamins and minerals without methionine oral liquid, 30 x 125 mL pouches | 1 | $850.51 | SB |
| 8744F | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINEamino acid formula with vitamins and minerals without methionine powder for oral liquid, 30 x 25 g sachets | 1 | $637.89 | VF |
| 12273Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINEamino acid formula with vitamins and minerals without methionine powder for oral liquid, 30 x 29 g sachets | 1 | $837.70 | SB |
| 3443F | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE, THREONINE AND VALINE AND LOW IN ISOLEUCINEamino acid formula with vitamins and minerals without methionine, threonine and valine and low in isoleucine powder for oral liquid, 30 x 25 g sachets | 1 | $637.89 | VF |
| 10730R | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE, THREONINE AND VALINE AND LOW IN ISOLEUCINEamino acid formula with vitamins and minerals without methionine, threonine and valine and low in isoleucine powder for oral liquid, 30 x 18 g sachets | 1 | $216.86 | NU |
| 8058D | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT METHIONINE, THREONINE AND VALINE AND LOW IN ISOLEUCINEamino acid formula with vitamins and minerals without methionine, threonine and valine and low in isoleucine powder for oral liquid, 400 g | 1 | $78.16 | SB |
| 5483N | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 85 g sachets | 1 | $214.92 | VF |
| 9021T | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 125 mL pouches | 1 | $416.03 | SB |
| 9396M | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 36 x 125 mL bottles | 1 | $258.23 | SB |
| 8846N | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 130 mL pouches | 1 | $315.31 | VF |
| 10411Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 174 mL pouches | 1 | $420.86 | VF |
| 2474F | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 174 mL pouches | 1 | $420.86 | VF |
| 8746H | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 18 x 250 mL | 18 | $168.73 | SB |
| 9397N | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 60 x 62.5 mL pouches | 1 | $335.93 | SB |
| 10258X | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid: powder for, 30 x 36 g sachets | 1 | $215.17 | SB |
| 2382J | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 87 mL pouches | 1 | $210.20 | VF |
| 2739E | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine powder for oral liquid, 500 g | 1 | $137.59 | SB |
| 8591E | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine powder for oral liquid, 30 x 25 g sachets | 1 | $315.48 | VF |
| 1909L | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine powder for oral liquid, 30 x 34 g sachets | 1 | $420.86 | VF |
| 12136R | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine powder for oral liquid, 30 x 28 g sachets | 1 | $416.03 | SB |
| 2806Q | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINEamino acid formula with vitamins and minerals without phenylalanine oral semi-solid, 36 x 109 g tubs | 1 | $503.94 | SB |
| 8445L | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with vitamins and minerals without phenylalanine and tyrosine powder for oral liquid, 400 g | 1 | $78.16 | SB |
| 1547K | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with vitamins and minerals without phenylalanine and tyrosine oral liquid, 30 x 125 mL pouches | 1 | $671.57 | SB |
| 2701E | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with vitamins and minerals without phenylalanine and tyrosine oral liquid, 30 x 174 mL pouches | 1 | $837.70 | VF |
| 10260B | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with vitamins and minerals without phenylalanine and tyrosine oral liquid: powder for, 30 x 36 g sachets | 1 | $433.73 | SB |
| 12274B | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT PHENYLALANINE AND TYROSINEamino acid formula with vitamins and minerals without phenylalanine and tyrosine powder for oral liquid, 30 x 28 g sachets | 1 | $837.70 | SB |
| 2654Q | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine oral liquid, 30 x 174 mL pouches | 1 | $837.70 | VF |
| 12285N | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine powder for oral liquid, 30 x 28 g sachets | 1 | $837.70 | SB |
| 10259Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine oral liquid: powder for, 30 x 36 g sachets | 1 | $433.73 | SB |
| 2380G | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine powder for oral liquid, 400 g | 1 | $78.16 | SB |
| 1546J | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine oral liquid, 30 x 125 mL pouches | 1 | $850.51 | SB |
| 2375B | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine oral liquid, 30 x 130 mL pouches | 1 | $637.89 | VF |
| 8057C | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine powder for oral liquid, 500 g | 1 | $278.98 | SB |
| 8632H | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula with vitamins and minerals without valine, leucine and isoleucine powder for oral liquid, 30 x 25 g sachets | 1 | $637.89 | VF |
| 9499Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS WITHOUT VALINE, LEUCINE AND ISOLEUCINE WITH FAT, CARBOHYDRATE AND TRACE ELEMENTS AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACIDamino acid formula with vitamins and minerals without valine, leucine and isoleucine with fat, carbohydrate and trace elements and supplemented with docosahexaenoic acid oral liquid, 36 x 125 mL bottles | 1 | $543.24 | SB |
| 11836Y | AMINO ACID FORMULA WITH VITAMINS AND MINERALS, LOW PHENYLALANINE AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACID AND ARACHIDONIC ACIDamino acid formula with vitamins and minerals, low phenylalanine and supplemented with docosahexaenoic acid and arachidonic acid powder for oral liquid, 30 x 25 g sachets | 1 | $237.23 | VF |
| 11185Q | AMINO ACID FORMULA WITH VITAMINS AND MINERALS, LOW PHENYLALANINE AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACID AND ARACHIDONIC ACIDamino acid formula with vitamins and minerals, low phenylalanine and supplemented with docosahexaenoic acid and arachidonic acid powder for oral liquid, 30 x 12.5 g sachets | 1 | $118.61 | SB |
| 11859E | AMINO ACID FORMULA WITH VITAMINS AND MINERALS, LOW PHENYLALANINE AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACID AND ARACHIDONIC ACIDamino acid formula with vitamins and minerals, low phenylalanine and supplemented with docosahexaenoic acid and arachidonic acid powder for oral liquid, 30 x 12.5 g sachets | 1 | $118.61 | VF |
| 11653H | AMINO ACID FORMULA WITH VITAMINS, MINERALS AND LONG CHAIN POLYUNSATURATED FATTY ACIDS WITHOUT PHENYLALANINEamino acid formula with vitamins, minerals and long chain polyunsaturated fatty acids without phenylalanine powder for oral liquid, 400 g | 1 | $75.97 | VF |
| 8479G | AMINO ACID FORMULA WITH VITAMINS, MINERALS AND LONG CHAIN POLYUNSATURATED FATTY ACIDS WITHOUT PHENYLALANINEamino acid formula with vitamins, minerals and long chain polyunsaturated fatty acids without phenylalanine powder for oral liquid, 400 g | 1 | $71.42 | SB |
| 8678R | AMINO ACID FORMULA WITHOUT PHENYLALANINEamino acid formula without phenylalanine 1 g tablet, 75 | 1 | $48.41 | SB |
| 10161T | AMINO ACID FORMULA WITHOUT VALINE, LEUCINE AND ISOLEUCINEamino acid formula without valine, leucine and isoleucine containing 5 g of protein equivalent powder for oral liquid, 30 x 6 g sachets | 1 | $246.51 | VF |
| 1180D | AMINO ACID SYNTHETIC FORMULAamino acid synthetic formula powder for oral liquid, 400 g | 1 | $35.85 | SB |
| 1192R | AMINO ACID SYNTHETIC FORMULAamino acid synthetic formula powder for oral liquid, 400 g | 1 | $35.85 | SB |
| 1521C | AMINO ACID SYNTHETIC FORMULAamino acid synthetic formula powder for oral liquid, 400 g | 1 | $35.87 | SB |
| 2250K | AMINO ACID SYNTHETIC FORMULAamino acid synthetic formula powder for oral liquid, 400 g | 1 | $35.87 | AB |
| 8574G | AMINO ACID SYNTHETIC FORMULAamino acid synthetic formula powder for oral liquid, 400 g | 1 | $35.85 | AB |
| 8575H | AMINO ACID SYNTHETIC FORMULAamino acid synthetic formula powder for oral liquid, 400 g | 1 | $35.85 | AB |
| 2246F | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $38.50 | SB |
| 2560R | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $38.50 | SB |
| 9339M | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $28.44 | AB |
| 9340N | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDSamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids powder for oral liquid, 400 g | 1 | $28.44 | AB |
| 1545H | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides powder for oral liquid, 400 g | 1 | $38.51 | SB |
| 2900P | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides powder for oral liquid, 400 g | 1 | $38.50 | NT |
| 2928D | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides powder for oral liquid, 400 g | 1 | $38.50 | NT |
| 5466Q | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides powder for oral liquid, 400 g | 1 | $38.50 | SB |
| 5467R | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides powder for oral liquid, 400 g | 1 | $38.50 | SB |
| 13615N | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides with 2-fucosyllactose and lacto-N-neotetraose powder for oral liquid, 400 g | 1 | $38.50 | NT |
| 13627F | AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDESamino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides with 2-fucosyllactose and lacto-N-neotetraose powder for oral liquid, 400 g | 1 | $38.50 | NT |
| 8736T | AMISULPRIDEamisulpride 100 mg/mL oral liquid, 60 mL | 1 | $67.73 | SW |
| 13532F | AMLODIPINEamlodipine 5 mg tablet, 30 | 30 | $5.02 | AF,BG,CR,ED,GQ,GX,IB,JB,RW,SZ,TX,VO |
| 13532F | AMLODIPINEamlodipine 5 mg tablet, 30 | 30 | $16.19 | AS |
| 13562T | AMLODIPINEamlodipine 10 mg tablet, 30 | 30 | $5.02 | AF,BG,CR,ED,GQ,GX,IB,JB,RW,SZ,TX,VO |
| 13562T | AMLODIPINEamlodipine 10 mg tablet, 30 | 30 | $16.20 | AS |
| 13479K | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 10 mg tablet, 30 | 30 | $5.95 | AF |
| 13479K | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 10 mg tablet, 30 | 30 | $10.95 | AS |
| 13384K | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 20 mg tablet, 30 | 30 | $6.15 | AF |
| 13384K | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 20 mg tablet, 30 | 30 | $11.15 | AS |
| 13536K | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 40 mg tablet, 30 | 30 | $7.06 | AF |
| 13536K | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 40 mg tablet, 30 | 30 | $12.06 | AS |
| 13963X | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 80 mg tablet, 30 | 30 | $8.43 | AF |
| 13963X | AMLODIPINE + ATORVASTATINamlodipine 10 mg + atorvastatin 80 mg tablet, 30 | 30 | $13.43 | AS |
| 13596N | AMLODIPINE + ATORVASTATINamlodipine 5 mg + atorvastatin 10 mg tablet, 30 | 30 | $5.27 | AF |
| 13567C | AMLODIPINE + ATORVASTATINamlodipine 5 mg + atorvastatin 20 mg tablet, 30 | 30 | $6.00 | AF |
| 13415C | AMLODIPINE + ATORVASTATINamlodipine 5 mg + atorvastatin 40 mg tablet, 30 | 30 | $6.37 | AF |
| 13415C | AMLODIPINE + ATORVASTATINamlodipine 5 mg + atorvastatin 40 mg tablet, 30 | 30 | $11.37 | AS |
| 13597P | AMLODIPINE + ATORVASTATINamlodipine 5 mg + atorvastatin 80 mg tablet, 30 | 30 | $7.74 | AF |
| 13597P | AMLODIPINE + ATORVASTATINamlodipine 5 mg + atorvastatin 80 mg tablet, 30 | 30 | $12.74 | AS |
| 13454D | AMLODIPINE + VALSARTANamlodipine 10 mg + valsartan 160 mg tablet, 28 | 28 | $12.85 | NM |
| 13454D | AMLODIPINE + VALSARTANamlodipine 10 mg + valsartan 160 mg tablet, 28 | 28 | $16.85 | NV |
| 13389Q | AMLODIPINE + VALSARTANamlodipine 10 mg + valsartan 320 mg tablet, 28 | 28 | $15.12 | NM |
| 13389Q | AMLODIPINE + VALSARTANamlodipine 10 mg + valsartan 320 mg tablet, 28 | 28 | $19.12 | NV |
| 13516J | AMLODIPINE + VALSARTANamlodipine 5 mg + valsartan 160 mg tablet, 28 | 28 | $12.32 | NM |
| 13516J | AMLODIPINE + VALSARTANamlodipine 5 mg + valsartan 160 mg tablet, 28 | 28 | $16.32 | NV |
| 13604B | AMLODIPINE + VALSARTANamlodipine 5 mg + valsartan 320 mg tablet, 28 | 28 | $14.91 | NM |
| 13604B | AMLODIPINE + VALSARTANamlodipine 5 mg + valsartan 320 mg tablet, 28 | 28 | $18.91 | NV |
| 13421J | AMLODIPINE + VALSARTANamlodipine 5 mg + valsartan 80 mg tablet, 28 | 28 | $10.29 | NM |
| 13421J | AMLODIPINE + VALSARTANamlodipine 5 mg + valsartan 80 mg tablet, 28 | 28 | $14.29 | NV |
| 13514G | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 | 28 | $14.36 | NM |
| 13514G | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 | 28 | $18.36 | NV |
| 13390R | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 | 28 | $15.88 | NM |
| 13390R | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 | 28 | $25.88 | NV |
| 13573J | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 10 mg + valsartan 320 mg + hydrochlorothiazide 25 mg tablet, 28 | 28 | $18.15 | NM |
| 13573J | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 10 mg + valsartan 320 mg + hydrochlorothiazide 25 mg tablet, 28 | 28 | $22.15 | NV |
| 13448T | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 | 28 | $13.84 | NM |
| 13448T | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 | 28 | $23.84 | NV |
| 13603Y | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 | 28 | $15.35 | NM |
| 13603Y | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDEamlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 | 28 | $19.35 | NV |
| 11998L | AMOXICILLINamoxicillin 250 mg capsule, 20 | 20 | $5.02 | AF,AL,RF,TX |
| 11998L | AMOXICILLINamoxicillin 250 mg capsule, 20 | 20 | $9.70 | AS |
| 11947T | AMOXICILLINamoxicillin 500 mg capsule, 20 | 20 | $5.02 | AF,AL,BG,GQ,RF,SZ,TX,VO |
| 11947T | AMOXICILLINamoxicillin 500 mg capsule, 20 | 20 | $9.69 | AS |
| 11941L | AMOXICILLIN + CLAVULANIC ACIDamoxicillin 500 mg + clavulanic acid 125 mg tablet, 10 | 10 | $5.32 | AF,RW,SZ,TW,TX,TY,XT |
| 11941L | AMOXICILLIN + CLAVULANIC ACIDamoxicillin 500 mg + clavulanic acid 125 mg tablet, 10 | 10 | $10.73 | AS |
| 11933C | AMOXICILLIN + CLAVULANIC ACIDamoxicillin 875 mg + clavulanic acid 125 mg tablet, 10 | 10 | $5.62 | AF,AL,BG,HQ,RW,SZ,TW,TX,XT |
| 11933C | AMOXICILLIN + CLAVULANIC ACIDamoxicillin 875 mg + clavulanic acid 125 mg tablet, 10 | 10 | $12.40 | AS |
| 13179P | AMOXICILLIN + CLAVULANIC ACIDamoxicillin 875 mg + clavulanic acid 125 mg tablet, 20 | 20 | $50.07 | DZ,QY,QZ |
| 13190F | AMOXICILLIN + CLAVULANIC ACIDamoxicillin 875 mg + clavulanic acid 125 mg tablet, 20 | 20 | $50.07 | DZ,QY,QZ |
| 13858J | ANASTROZOLEanastrozole 1 mg tablet, 30 | 30 | $10.12 | AF,GQ,SZ,TX |
| 13858J | ANASTROZOLEanastrozole 1 mg tablet, 30 | 30 | $13.29 | AP |
| 13525W | APIXABANapixaban 5 mg tablet, 60 | 60 | $81.44 | BQ |
| 13464P | APIXABANapixaban 2.5 mg tablet, 60 | 60 | $81.44 | BQ |
| 12133N | APOMORPHINEapomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL cartridges | 5 | $137.09 | IT |
| 12142C | APOMORPHINEapomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL vials | 5 | $421.17 | IT |
| 12319J | APOMORPHINEapomorphine hydrochloride hemihydrate 50 mg/10 mL injection, 5 x 10 mL syringes | 5 | $226.97 | TD |
| 12306Q | APOMORPHINEapomorphine hydrochloride hemihydrate 50 mg/5 mL injection, 5 x 5 mL ampoules | 5 | $171.76 | TD |
| 12137T | APOMORPHINEapomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices | 5 | $137.09 | TD |
| 10036F | ARACHIDONIC ACID AND DOCOSAHEXAENOIC ACID WITH CARBOHYDRATEarachidonic acid and docosahexaenoic acid with carbohydrate containing 200 mg arachidonic acid and 100 mg docosahexaenoic acid powder for oral liquid, 30 x 4 g sachets | 1 | $81.96 | VF |
| 10093F | ARGININE WITH CARBOHYDRATEarginine with carbohydrate containing 5 g arginine powder for oral liquid, 30 x 7.6 g sachets | 1 | $218.19 | VF |
| 5482M | ARGININE WITH CARBOHYDRATEarginine with carbohydrate containing 2 g arginine powder for oral liquid, 30 x 4 g sachets | 1 | $164.87 | VF |
| 9437Q | ARGININE WITH CARBOHYDRATEarginine with carbohydrate containing 500 mg arginine powder for oral liquid, 30 x 4 g sachets | 1 | $109.88 | VF |
| 10922W | ARMODAFINILarmodafinil 50 mg tablet, 30 | 30 | $47.36 | TB |
| 13260X | ASCIMINIBasciminib 40 mg tablet, 60 | 60 | $6043.25 | NV |
| 13540P | ATENOLOLatenolol 50 mg tablet, 30 | 30 | $5.02 | AF,BG,GQ,RW,SZ,TX,TY |
| 13540P | ATENOLOLatenolol 50 mg tablet, 30 | 30 | $18.46 | IX |
| 13600T | ATENOLOLatenolol 50 mg/10 mL oral liquid, 300 mL | 1 | $35.63 | AE |
| 9092M | ATOMOXETINEatomoxetine 10 mg capsule, 28 | 28 | $33.15 | SZ,TX |
| 9093N | ATOMOXETINEatomoxetine 18 mg capsule, 28 | 28 | $33.15 | SZ,TX |
| 9094P | ATOMOXETINEatomoxetine 25 mg capsule, 28 | 28 | $33.15 | SZ,TX |
| 9095Q | ATOMOXETINEatomoxetine 40 mg capsule, 28 | 28 | $33.15 | SZ,TX |
| 9096R | ATOMOXETINEatomoxetine 60 mg capsule, 28 | 28 | $33.15 | SZ,TX |
| 13495G | ATORVASTATINatorvastatin 10 mg tablet, 30 | 30 | $5.02 | AF,AS,BG,CR,GQ,HX,IB,RA,RF,TX,VO |
| 13529C | ATORVASTATINatorvastatin 20 mg tablet, 30 | 30 | $5.12 | TX |
| 13468W | ATORVASTATINatorvastatin 40 mg tablet, 30 | 30 | $6.02 | AF,AS,BG,CR,GQ,HX,IB,RA,RF,TX,VO |
| 13374X | ATORVASTATINatorvastatin 80 mg tablet, 30 | 30 | $6.61 | AF,AS,BG,CR,GQ,HX,IB,RA,RF,TX,VO |
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