program-code!item-code!manufacturer-code!brand-name!unit-of-measure!mp-id!mp-pt!mpuu-id!mpuu-pt!mpp-id!mpp-pt!tpuu-id!tpuu-pt!tpp-id!tpp-pt!vial-content!mq-pack!mq-uu!cemp-tpp!cemp-tpuu!memp-tpp!memp-tpuu!pfdi
GE!1011F!AF!Deptran 10!!21583011000036105!doxepin!!!27462011000036107!doxepin 10 mg capsule, 50!!!12949011000036105!Deptran 10 mg capsule, 50!!1!50!2.98!0.00!2.98!!
GE!1012G!AF!Deptran 50!!21583011000036105!doxepin!!!26942011000036100!doxepin 50 mg tablet, 50!!!12135011000036109!Deptran 50 mg tablet, 50!!1!50!3.02!0.00!3.02!!
GE!1013H!AF!Deptran 25!!21583011000036105!doxepin!!!27463011000036100!doxepin 25 mg capsule, 50!!!12950011000036102!Deptran 25 mg capsule, 50!!1!50!3.86!0.00!3.86!!
GE!1463B!PF!Pfizer Australia Pty Ltd!!858661000168109!heparin!!!27220011000036101!heparin sodium 5000 units/5 mL injection, 50 x 5 mL ampoules!!!12587011000036103!Heparin Sodium (Pfizer (Perth)) 5000 units/5 mL injection, 50 x 5 mL ampoules!!1!50!73.47!0.00!73.47!!
GE!2977Q!AF!Ampicyn!!21671011000036106!ampicillin!!!28099011000036101!ampicillin 1 g injection, 5 vials!!!13936011000036105!Ampicyn 1 g powder for injection, 5 vials!!1!5!5.71!0.00!5.71!!
GE!3062E!AF!Barbloc 5!!21768011000036103!pindolol!!!26933011000036106!pindolol 5 mg tablet, 100!!!12123011000036106!Barbloc 5 mg tablet, 100!!1!100!19.42!0.00!19.42!!
GE!3179H!PF!Norinyl-1/28!!21651011000036108!norethisterone + mestranol!!!27486011000036108!norethisterone 1 mg + mestranol 50 microgram tablet [21] (&) inert substance tablet [7], 4 x 28!!!12986011000036109!Norinyl-1 28 Day (21 x 1 mg/50 microgram tablets, 7 x inert tablets), 4 x 28!!1!4!8.96!0.00!8.96!!
GE!3314K!AF!Ampicyn!!21671011000036106!ampicillin!!!28099011000036101!ampicillin 1 g injection, 5 vials!!!13936011000036105!Ampicyn 1 g powder for injection, 5 vials!!1!5!5.71!0.00!5.71!!
GE!5259T!SW!Rulide D!!21724011000036103!roxithromycin!!!27333011000036102!roxithromycin 50 mg dispersible tablet, 10!!!12753011000036101!Rulide D 50 mg dispersible tablet, 10!!1!10!5.24!0.00!5.24!!
GE!8129W!SW!Rulide D!!21724011000036103!roxithromycin!!!27333011000036102!roxithromycin 50 mg dispersible tablet, 10!!!12753011000036101!Rulide D 50 mg dispersible tablet, 10!!1!10!5.24!0.00!5.24!!
GE!8334P!SW!Intal Forte CFC-Free!!21253011000036107!cromoglycate!!!27622011000036104!sodium cromoglycate 5 mg/actuation inhalation, 112 actuations!!!13211011000036105!Intal Forte CFC-Free 5 mg/actuation inhalation, 112 actuations!!1!1!25.79!0.00!25.79!!
GE!8382E!RW!Diasp SR!!21386011000036101!dipyridamole + aspirin!!!27629011000036109!dipyridamole 200 mg + aspirin 25 mg modified release capsule, 60!!!701021000168108!Diasp SR modified release capsule, 60!!1!60!20.91!0.00!20.91!!
GE!8403G!SG!Rebif 44!!21462011000036109!interferon beta-1a!!!27700011000036102!interferon beta-1a 12 million units (44 microgram)/0.5 mL injection, 12 x 0.5 mL syringes!!!13333011000036109!Rebif 12 million units (44 microgram)/0.5 mL injection, 12 x 0.5 mL syringes!!1!12!763.52!0.00!763.52!!
GE!8767K!SW!Intal CFC-Free!!21253011000036107!cromoglycate!!!28131011000036101!sodium cromoglycate 1 mg/actuation inhalation, 200 actuations!!!14079011000036106!Intal CFC-Free 1 mg/actuation inhalation, 200 actuations!!1!1!21.90!0.00!21.90!!
GE!8899J!AF!Acris Combi!!12321000144109!risedronate (&) calcium carbonate!!!55151000144102!risedronate sodium 35 mg tablet [4] (&) calcium (as carbonate) 500 mg tablet [24], 28!!!66511000144106!Acris Combi (4 x 35 mg tablets, 24 x 500 mg tablets), 1 pack!!1!1!22.33!0.00!22.33!!
GE!8968B!SG!Rebif 44!!21462011000036109!interferon beta-1a!!!1213801000168104!interferon beta-1a 12 million units (44 microgram)/0.5 mL injection, 12 x 0.5 mL pen devices!!!1213811000168101!Rebif Rebidose 12 million units (44 microgram)/0.5 mL injection, 12 x 0.5 mL pen devices!!1!12!763.52!0.00!763.52!!
GE!9332E!SG!Rebif 44!!21462011000036109!interferon beta-1a!!!86455011000036102!interferon beta-1a 36 million units (132 microgram)/1.5 mL injection, 4 x 1.5 mL cartridges!!!85766011000036105!Rebif 36 million units (132 microgram)/1.5 mL injection, 4 x 1.5 mL cartridges!!1!4!763.52!0.00!763.52!!
GE!9412J!GO!Creon 40,000!!9341000144106!pancreatic extract!!!44341000144100!pancreatic extract 40 000 units modified release capsule, 100!!!133941000144105!Creon 40 000 units modified release capsule, 100!!2!200!77.63!0.00!77.63!!
GE!9413K!GO!Creon 40,000!!9341000144106!pancreatic extract!!!44341000144100!pancreatic extract 40 000 units modified release capsule, 100!!!133941000144105!Creon 40 000 units modified release capsule, 100!!2!200!77.63!0.00!77.63!!
GE!10410X!VF!PKU Air 15!!50738011000036108!amino acid formula with vitamins and minerals without phenylalanine!!!710051000168106!amino acid formula with vitamins and minerals without phenylalanine oral liquid, 30 x 130 mL pouches!!!350411000144101!PKU Air 15 oral liquid: solution, 30 x 130 mL pouch!!4!4!286.85!0.00!286.85!!
GE!10668L!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
GE!10628J!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
GE!10670N!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
GE!10992M!QH!PKU Bettermilk Lite!!132091000036106!glycomacropeptide and essential amino acids with vitamins and minerals!!!858861000168105!glycomacropeptide and essential amino acids with vitamins and minerals powder for oral liquid, 30 x 51 g sachets!!!858871000168104!PKU Bettermilk Lite powder for oral liquid, 30 x 51 g sachets!!4!4!480.97!0.00!480.97!!
GE!11444H!VF!Betaquik!!50747011000036106!medium chain triglycerides!!!994651000168104!medium chain triglycerides oral liquid, 15 x 225 mL bottles!!!994661000168102!Betaquik oral liquid, 15 x 225 mL bottles!!2!2!118.53!0.00!118.53!!
GE!11584Q!MK!Segluromet 2.5/500!!1228611000168101!ertugliflozin + metformin!!!1232221000168106!ertugliflozin 2.5 mg + metformin hydrochloride 500 mg tablet, 56!!!1232231000168109!Segluromet 2.5/500 tablet, 56!!1!56!45.28!0.00!45.28!!
GE!11575F!MK!Segluromet 2.5/500!!1228611000168101!ertugliflozin + metformin!!!1232221000168106!ertugliflozin 2.5 mg + metformin hydrochloride 500 mg tablet, 56!!!1232231000168109!Segluromet 2.5/500 tablet, 56!!1!56!45.28!0.00!45.28!!
GE!11564P!MK!Segluromet 2.5/1000!!1228611000168101!ertugliflozin + metformin!!!1229031000168109!ertugliflozin 2.5 mg + metformin hydrochloride 1 g tablet, 56!!!1229041000168100!Segluromet 2.5/1000 tablet, 56!!1!56!46.59!0.00!46.59!!
GE!11581M!MK!Segluromet 2.5/1000!!1228611000168101!ertugliflozin + metformin!!!1229031000168109!ertugliflozin 2.5 mg + metformin hydrochloride 1 g tablet, 56!!!1229041000168100!Segluromet 2.5/1000 tablet, 56!!1!56!46.59!0.00!46.59!!
GE!11562M!MK!Segluromet 7.5/500!!1228611000168101!ertugliflozin + metformin!!!1232101000168106!ertugliflozin 7.5 mg + metformin hydrochloride 500 mg tablet, 56!!!1232111000168109!Segluromet 7.5/500 tablet, 56!!1!56!45.28!0.00!45.28!!
GE!11568W!MK!Segluromet 7.5/500!!1228611000168101!ertugliflozin + metformin!!!1232101000168106!ertugliflozin 7.5 mg + metformin hydrochloride 500 mg tablet, 56!!!1232111000168109!Segluromet 7.5/500 tablet, 56!!1!56!45.28!0.00!45.28!!
GE!11569X!MK!Segluromet 7.5/1000!!1228611000168101!ertugliflozin + metformin!!!1228681000168107!ertugliflozin 7.5 mg + metformin hydrochloride 1 g tablet, 56!!!1228691000168105!Segluromet 7.5/1000 tablet, 56!!1!56!46.59!0.00!46.59!!
GE!11563N!MK!Segluromet 7.5/1000!!1228611000168101!ertugliflozin + metformin!!!1228681000168107!ertugliflozin 7.5 mg + metformin hydrochloride 1 g tablet, 56!!!1228691000168105!Segluromet 7.5/1000 tablet, 56!!1!56!46.59!0.00!46.59!!
GE!12744R!JC!Simponi!!84416011000036108!golimumab!!!845591000168109!golimumab 50 mg/0.5 mL injection, 0.5 mL pen device!!!845601000168102!Simponi Smartject 50 mg/0.5 mL injection, 0.5 mL pen device!!1!1!1044.43!0.00!1044.43!!
GE!12703N!JC!Simponi!!84416011000036108!golimumab!!!84636011000036100!golimumab 50 mg/0.5 mL injection, 0.5 mL syringe!!!84004011000036107!Simponi 50 mg/0.5 mL injection, 0.5 mL syringe!!1!1!1044.43!0.00!1044.43!!
GE!12702M!UC!Cimzia!!87751011000036108!certolizumab pegol!!!862491000168105!certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices!!!862501000168103!Cimzia 200 mg/mL injection, 2 x 1 mL pen devices!!3!6!952.13!0.00!952.13!!
GE!12712C!UC!Cimzia!!87751011000036108!certolizumab pegol!!!87809011000036100!certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes!!!87446011000036106!Cimzia 200 mg/mL injection, 2 x 1 mL syringes!!3!6!952.13!0.00!952.13!!
GE!12742P!UC!Cimzia!!87751011000036108!certolizumab pegol!!!862491000168105!certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices!!!862501000168103!Cimzia 200 mg/mL injection, 2 x 1 mL pen devices!!1!2!952.13!0.00!952.13!!
GE!12724Q!UC!Cimzia!!87751011000036108!certolizumab pegol!!!87809011000036100!certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes!!!87446011000036106!Cimzia 200 mg/mL injection, 2 x 1 mL syringes!!1!2!952.13!0.00!952.13!!
GE!12691Y!UC!Cimzia!!87751011000036108!certolizumab pegol!!!862491000168105!certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices!!!862501000168103!Cimzia 200 mg/mL injection, 2 x 1 mL pen devices!!1!2!952.13!0.00!952.13!!
GE!12743Q!UC!Cimzia!!87751011000036108!certolizumab pegol!!!87809011000036100!certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes!!!87446011000036106!Cimzia 200 mg/mL injection, 2 x 1 mL syringes!!1!2!952.13!0.00!952.13!!
GE!12708W!LY!Olumiant!!1107081000168107!baricitinib!!!1107141000168103!baricitinib 2 mg tablet, 28!!!1107151000168101!Olumiant 2 mg tablet, 28!!1!28!1149.97!0.00!1149.97!!
GE!12730B!LY!Olumiant!!1107081000168107!baricitinib!!!1107291000168103!baricitinib 4 mg tablet, 28!!!1107301000168102!Olumiant 4 mg tablet, 28!!1!28!1149.97!0.00!1149.97!!
GE!12685P!VE!Rinvoq!!1462431000168101!upadacitinib!!!1462491000168102!upadacitinib 15 mg modified release tablet, 28!!!1462501000168109!Rinvoq 15 mg modified release tablet, 28!!1!28!1149.97!0.00!1149.97!!
GE!12700K!VE!Humira!!21584011000036107!adalimumab!!!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12678G!VE!Humira!!21584011000036107!adalimumab!!!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12729Y!RF!Hadlima!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12729Y!PK!Idacio!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12729Y!XT!Amgevita!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12729Y!SZ!Hyrimoz!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12719K!XT!Amgevita!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12719K!PK!Idacio!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12719K!RF!Hadlima!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12719K!SZ!Hyrimoz!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12680J!BQ!Orencia ClickJect!!33635011000036100!abatacept!!!899691000168101!abatacept 125 mg/mL injection, 4 x 1 mL pen devices!!!899701000168101!Orencia Clickject Autoinjector 125 mg/mL injection, 4 x 1 mL pen devices!!1!4!852.28!0.00!852.28!!
GE!12758L!BQ!Orencia!!33635011000036100!abatacept!!!7511000036109!abatacept 125 mg/mL injection, 4 x 1 mL syringes!!!7501000036107!Orencia 125 mg/mL injection, 4 x 1 mL syringes!!1!4!852.28!0.00!852.28!!
GE!12687R!EW!Remsima SC!!21926011000036101!infliximab!!!1513281000168103!infliximab 120 mg/mL injection, 1 mL pen device!!!1513291000168100!Remsima 120 mg/mL injection, 1 mL pen device!!2!2!332.80!0.00!332.80!!
GE!12677F!EW!Remsima SC!!21926011000036101!infliximab!!!1513091000168107!infliximab 120 mg/mL injection, 1 mL syringe!!!1513101000168102!Remsima with Safety Guard 120 mg/mL injection, 1 mL syringe!!2!2!332.80!0.00!332.80!!
GE!12689W!EW!Remsima SC!!21926011000036101!infliximab!!!1513281000168103!infliximab 120 mg/mL injection, 1 mL pen device!!!1513291000168100!Remsima 120 mg/mL injection, 1 mL pen device!!1!1!332.80!0.00!332.80!!
GE!12688T!EW!Remsima SC!!21926011000036101!infliximab!!!1513091000168107!infliximab 120 mg/mL injection, 1 mL syringe!!!1513101000168102!Remsima with Safety Guard 120 mg/mL injection, 1 mL syringe!!1!1!332.80!0.00!332.80!!
GE!12748Y!EW!Remsima SC!!21926011000036101!infliximab!!!1513281000168103!infliximab 120 mg/mL injection, 1 mL pen device!!!1513291000168100!Remsima 120 mg/mL injection, 1 mL pen device!!2!2!332.80!0.00!332.80!!
GE!12753F!EW!Remsima SC!!21926011000036101!infliximab!!!1513091000168107!infliximab 120 mg/mL injection, 1 mL syringe!!!1513101000168102!Remsima with Safety Guard 120 mg/mL injection, 1 mL syringe!!2!2!332.80!0.00!332.80!!
GE!12720L!PF!Xeljanz!!718541000168101!tofacitinib!!!718571000168108!tofacitinib 5 mg tablet, 56!!!718581000168106!Xeljanz 5 mg tablet, 56!!1!56!1092.47!0.00!1092.47!!
GE!12718J!PF!Enbrel!!21347011000036107!etanercept!!!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!!!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!2!2!469.63!0.00!469.63!!
GE!12679H!RF!Brenzys!!21347011000036107!etanercept!!!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!!!899301000168102!Brenzys Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!1!939.25!0.00!939.25!!
GE!12679H!PF!Enbrel!!21347011000036107!etanercept!!!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!!!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!1!939.25!0.00!939.25!!
GE!12737J!RF!Brenzys!!21347011000036107!etanercept!!!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!!!880521000168109!Brenzys 50 mg/mL injection, 4 x 1 mL syringes!!1!1!939.25!0.00!939.25!!
GE!12737J!PF!Enbrel!!21347011000036107!etanercept!!!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!!!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!1!939.25!0.00!939.25!!
GE!12750C!PF!Enbrel!!21347011000036107!etanercept!!!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!!!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!2!2!469.63!0.00!469.63!!
GE!12716G!PF!Enbrel!!21347011000036107!etanercept!!!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!!!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!1!939.25!0.00!939.25!!
GE!12676E!PF!Enbrel!!21347011000036107!etanercept!!!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!!!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!1!939.25!0.00!939.25!!
GE!12701L!VE!Humira!!21584011000036107!adalimumab!!!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12752E!VE!Humira!!21584011000036107!adalimumab!!!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12690X!PK!Idacio!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12690X!SZ!Hyrimoz!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12690X!RF!Hadlima!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12690X!XT!Amgevita!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
GE!12741N!XT!Amgevita!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12741N!SZ!Hyrimoz!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12741N!RF!Hadlima!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12741N!PK!Idacio!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
GE!12909K!PF!Enbrel!!21347011000036107!etanercept!!!1547341000168104!etanercept 50 mg/mL injection, 4 x 1 mL cartridges!!!1547351000168102!Enbrel 50 mg/mL injection, 4 x 1 mL cartridges!!1!1!939.25!0.00!939.25!!
GE!12907H!PF!Enbrel!!21347011000036107!etanercept!!!1547341000168104!etanercept 50 mg/mL injection, 4 x 1 mL cartridges!!!1547351000168102!Enbrel 50 mg/mL injection, 4 x 1 mL cartridges!!1!1!939.25!0.00!939.25!!
HB!10661D!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
HB!10667K!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
HB!10669M!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
HB!12756J!BQ!Orencia!!33635011000036100!abatacept!!!33791011000036102!abatacept 250 mg injection, 1 vial!!!33282011000036104!Orencia 250 mg powder for injection, 1 vial!!1!1!266.34!0.00!266.34!!
HB!12717H!OQ!Renflexis!!21926011000036101!infliximab!!!27724011000036101!infliximab 100 mg injection, 1 vial!!!971771000168105!Renflexis 100 mg powder for injection, 1 vial!!1!1!253.52!0.00!253.52!!
HB!12717H!JC!Remicade!!21926011000036101!infliximab!!!27724011000036101!infliximab 100 mg injection, 1 vial!!!13375011000036107!Remicade 100 mg powder for injection, 1 vial!!1!1!253.52!0.00!253.52!!
HB!12717H!PF!Inflectra!!21926011000036101!infliximab!!!27724011000036101!infliximab 100 mg injection, 1 vial!!!730981000168106!Inflectra 100 mg powder for injection, 1 vial!!1!1!253.52!0.00!253.52!!
HB!12740M!PF!Enbrel!!21347011000036107!etanercept!!!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!!!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!1!1!469.63!0.00!469.63!!
HB!12735G!PF!Enbrel!!21347011000036107!etanercept!!!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!!!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!1!939.25!0.00!939.25!!
HB!12675D!PF!Enbrel!!21347011000036107!etanercept!!!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!!!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!1!939.25!0.00!939.25!!
HB!12699J!VE!Humira!!21584011000036107!adalimumab!!!1122481000168105!adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!!!1122491000168108!Humira 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!!1!2!818.54!0.00!818.54!!
HB!12695E!XT!Amgevita!!21584011000036107!adalimumab!!!1158041000168108!adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe!!!1158051000168105!Amgevita 20 mg/0.4 mL injection, 0.4 mL syringe!!2!2!409.27!0.00!409.27!!
HB!12696F!VE!Humira!!21584011000036107!adalimumab!!!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!1!2!818.54!0.00!818.54!!
HB!12697G!VE!Humira!!21584011000036107!adalimumab!!!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!1!2!818.54!0.00!818.54!!
HB!12698H!PK!Idacio!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HB!12698H!SZ!Hyrimoz!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HB!12698H!XT!Amgevita!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HB!12698H!RF!Hadlima!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HB!12733E!SZ!Hyrimoz!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HB!12733E!XT!Amgevita!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HB!12733E!PK!Idacio!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HB!12733E!RF!Hadlima!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HB!12908J!PF!Enbrel!!21347011000036107!etanercept!!!1547341000168104!etanercept 50 mg/mL injection, 4 x 1 mL cartridges!!!1547351000168102!Enbrel 50 mg/mL injection, 4 x 1 mL cartridges!!1!1!939.25!0.00!939.25!!
HS!10672Q!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
HS!10653Q!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
HS!10679C!GI!Harvoni!!717591000168105!ledipasvir + sofosbuvir!!!717621000168107!ledipasvir 90 mg + sofosbuvir 400 mg tablet, 28!!!717631000168105!Harvoni tablet, 28!!1!28!11875.00!0.00!11875.00!!
HS!12738K!BQ!Orencia!!33635011000036100!abatacept!!!33791011000036102!abatacept 250 mg injection, 1 vial!!!33282011000036104!Orencia 250 mg powder for injection, 1 vial!!1!1!266.34!0.00!266.34!!
HS!12751D!PF!Inflectra!!21926011000036101!infliximab!!!27724011000036101!infliximab 100 mg injection, 1 vial!!!730981000168106!Inflectra 100 mg powder for injection, 1 vial!!1!1!253.52!0.00!253.52!!
HS!12751D!JC!Remicade!!21926011000036101!infliximab!!!27724011000036101!infliximab 100 mg injection, 1 vial!!!13375011000036107!Remicade 100 mg powder for injection, 1 vial!!1!1!253.52!0.00!253.52!!
HS!12751D!OQ!Renflexis!!21926011000036101!infliximab!!!27724011000036101!infliximab 100 mg injection, 1 vial!!!971771000168105!Renflexis 100 mg powder for injection, 1 vial!!1!1!253.52!0.00!253.52!!
HS!12734F!PF!Enbrel!!21347011000036107!etanercept!!!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!!!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!1!1!469.63!0.00!469.63!!
HS!12736H!PF!Enbrel!!21347011000036107!etanercept!!!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!!!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!1!939.25!0.00!939.25!!
HS!12757K!PF!Enbrel!!21347011000036107!etanercept!!!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!!!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!1!939.25!0.00!939.25!!
HS!12686Q!VE!Humira!!21584011000036107!adalimumab!!!1122481000168105!adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!!!1122491000168108!Humira 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!!1!2!818.54!0.00!818.54!!
HS!12674C!XT!Amgevita!!21584011000036107!adalimumab!!!1158041000168108!adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe!!!1158051000168105!Amgevita 20 mg/0.4 mL injection, 0.4 mL syringe!!2!2!409.27!0.00!409.27!!
HS!12732D!VE!Humira!!21584011000036107!adalimumab!!!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!1!2!818.54!0.00!818.54!!
HS!12749B!VE!Humira!!21584011000036107!adalimumab!!!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!1!2!818.54!0.00!818.54!!
HS!12715F!PK!Idacio!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HS!12715F!SZ!Hyrimoz!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HS!12715F!RF!Hadlima!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HS!12715F!XT!Amgevita!!21584011000036107!adalimumab!!!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!1!2!818.54!0.00!818.54!!
HS!12731C!XT!Amgevita!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HS!12731C!PK!Idacio!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HS!12731C!RF!Hadlima!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HS!12731C!SZ!Hyrimoz!!21584011000036107!adalimumab!!!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!1!2!818.54!0.00!818.54!!
HS!12906G!PF!Enbrel!!21347011000036107!etanercept!!!1547341000168104!etanercept 50 mg/mL injection, 4 x 1 mL cartridges!!!1547351000168102!Enbrel 50 mg/mL injection, 4 x 1 mL cartridges!!1!1!939.25!0.00!939.25!!
IN!7257Y!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!7257Y!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7257Y!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!7257Y!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7257Y!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IN!7257Y!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7258B!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!7258B!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7258B!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!7258B!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7258B!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7258B!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IN!7259C!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!7259C!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7259C!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!7259C!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!7259C!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IN!7259C!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!10193L!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!10193L!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!10193L!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IN!10193L!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IN!10193L!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IN!10193L!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4613T!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!4613T!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4613T!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!4613T!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4613T!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IP!4613T!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4614W!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!4614W!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4614W!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!4614W!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4614W!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IP!4614W!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4615X!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!4615X!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4615X!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!4615X!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!4615X!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IP!4615X!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!10179R!SZ!Riximyo!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1056431000168104!Riximyo 100 mg/10 mL injection, 10 mL vial!1056441000168108!Riximyo 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!10179R!SZ!Riximyo!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1056371000168108!Riximyo 500 mg/50 mL injection, 50 mL vial!1056381000168106!Riximyo 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!10179R!EW!Truxima!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!27457011000036100!rituximab 100 mg/10 mL injection, 2 x 10 mL vials!1124031000168106!Truxima 100 mg/10 mL injection, 10 mL vial!1124041000168102!Truxima 100 mg/10 mL injection, 2 x 10 mL vials!100!!800!135.92!67.96!135.92!67.96!
IP!10179R!EW!Truxima!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1123861000168107!Truxima 500 mg/50 mL injection, 50 mL vial!1123871000168101!Truxima 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
IP!10179R!PF!Ruxience!1 mg!21460011000036105!rituximab!22804011000036108!rituximab 100 mg/10 mL injection, vial!1558141000168100!rituximab 100 mg/10 mL injection, 10 mL vial!1558131000168109!Ruxience 100 mg/10 mL injection, 10 mL vial!1558151000168103!Ruxience 100 mg/10 mL injection, 10 mL vial!100!!800!67.96!67.96!67.96!67.96!
IP!10179R!PF!Ruxience!1 mg!21460011000036105!rituximab!22805011000036107!rituximab 500 mg/50 mL injection, vial!27458011000036104!rituximab 500 mg/50 mL injection, 50 mL vial!1558101000168102!Ruxience 500 mg/50 mL injection, 50 mL vial!1558111000168104!Ruxience 500 mg/50 mL injection, 50 mL vial!500!!800!339.80!339.80!339.80!339.80!
