GE!1011F!AF!!21583011000036105!doxepin!27462011000036107!doxepin 10 mg capsule, 50!Deptran 10!12949011000036105!Deptran 10 mg capsule, 50!!50!2.98!2.98!
GE!1012G!AF!!21583011000036105!doxepin!26942011000036100!doxepin 50 mg tablet, 50!Deptran 50!12135011000036109!Deptran 50 mg tablet, 50!!50!3.02!3.02!
GE!1013H!AF!!21583011000036105!doxepin!27463011000036100!doxepin 25 mg capsule, 50!Deptran 25!12950011000036102!Deptran 25 mg capsule, 50!!50!3.86!3.86!
GE!1196Y!SW!!21310011000036102!chlorpromazine!27254011000036107!chlorpromazine hydrochloride 10 mg tablet, 100!Largactil!12645011000036109!Largactil 10 mg tablet, 100!!100!2.92!2.92!
GE!1895R!AF!!21531011000036103!piroxicam!27881011000036106!piroxicam 10 mg dispersible tablet, 50!Mobilis D-10!12691011000036101!Mobilis D 10 mg dispersible tablet, 50!!50!4.15!4.15!
GE!2390T!AL!!21671011000036106!ampicillin!28098011000036109!ampicillin 500 mg injection, 5 vials!Austrapen!12287011000036106!Austrapen 500 mg powder for injection, 5 vials!!5!4.61!4.61!
GE!2682E!AG!!35687011000036109!polyvinyl alcohol!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!Liquifilm Tears!35557011000036105!Liquifilm Tears 1.4% eye drops, 15 mL!!1!3.50!4.79!
GE!2682E!PE!!35687011000036109!polyvinyl alcohol!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!PVA Tears!35565011000036106!PVA Tears 1.4% eye drops, 15 mL!!1!3.50!3.50!0.00
GE!2899N!AF!!21392011000036104!propranolol!26940011000036104!propranolol hydrochloride 160 mg tablet, 50!Deralin 160!12133011000036108!Deralin 160 mg tablet, 50!!50!4.70!4.70!
GE!2977Q!AF!!21671011000036106!ampicillin!28099011000036101!ampicillin 1 g injection, 5 vials!Ampicyn!13936011000036105!Ampicyn 1 g powder for injection, 5 vials!!5!5.71!5.71!
GE!3062E!AF!!21768011000036103!pindolol!26933011000036106!pindolol 5 mg tablet, 100!Barbloc 5!12123011000036106!Barbloc 5 mg tablet, 100!!100!19.42!19.42!
GE!3179H!PF!!21651011000036108!norethisterone + mestranol!27486011000036108!norethisterone 1 mg + mestranol 50 microgram tablet [21] (&) inert substance tablet [7], 4 x 28!Norinyl-1/28!12986011000036109!Norinyl-1 28 Day (21 x 1 mg/50 microgram tablets, 7 x inert tablets), 4 x 28!!4!6.14!6.14!
GE!3313J!AL!!21671011000036106!ampicillin!28098011000036109!ampicillin 500 mg injection, 5 vials!Austrapen!12287011000036106!Austrapen 500 mg powder for injection, 5 vials!!5!4.61!4.61!
GE!3314K!AF!!21671011000036106!ampicillin!28099011000036101!ampicillin 1 g injection, 5 vials!Ampicyn!13936011000036105!Ampicyn 1 g powder for injection, 5 vials!!5!5.71!5.71!
GE!5201R!AF!!21531011000036103!piroxicam!27881011000036106!piroxicam 10 mg dispersible tablet, 50!Mobilis D-10!12691011000036101!Mobilis D 10 mg dispersible tablet, 50!!50!4.15!4.15!
GE!5259T!SW!!21724011000036103!roxithromycin!27333011000036102!roxithromycin 50 mg dispersible tablet, 10!Rulide D!12753011000036101!Rulide D 50 mg dispersible tablet, 10!!10!5.24!5.24!
GE!5452Y!AF!!44887011000036108!losartan!933224091000036109!losartan potassium 25 mg tablet, 30!Cozavan!933224081000036107!Cozavan 25 mg tablet, 30!!30!3.83!3.83!
GE!5526W!AG!!35687011000036109!polyvinyl alcohol!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!Liquifilm Tears!35557011000036105!Liquifilm Tears 1.4% eye drops, 15 mL!!1!3.50!4.79!
GE!5526W!PE!!35687011000036109!polyvinyl alcohol!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!PVA Tears!35565011000036106!PVA Tears 1.4% eye drops, 15 mL!!1!3.50!3.50!0.00
GE!5532E!AQ!!11731000144100!polyethylene glycol-400 + propylene glycol!154541000144100!polyethylene glycol-400 0.4% + propylene glycol 0.3% eye drops, 28 x 0.8 mL unit doses!Systane!152351000144101!Systane 0.4% / 0.3% eye drops, 28 x 0.8 mL unit doses!!2!7.07!7.07!
GE!8129W!SW!!21724011000036103!roxithromycin!27333011000036102!roxithromycin 50 mg dispersible tablet, 10!Rulide D!12753011000036101!Rulide D 50 mg dispersible tablet, 10!!10!5.24!5.24!
GE!8203R!AF!!44887011000036108!losartan!46465011000036101!losartan potassium 50 mg tablet, 30!Cozavan!933224071000036105!Cozavan 50 mg tablet, 30!!60!5.47!5.47!
GE!8382E!RW!!21386011000036101!dipyridamole + aspirin!27629011000036109!dipyridamole 200 mg + aspirin 25 mg modified release capsule, 60!Diasp SR!701021000168108!Diasp SR modified release capsule, 60!!60!15.73!15.73!
GE!8899J!AF!!12321000144109!risedronate (&) calcium carbonate!55151000144102!risedronate sodium 35 mg tablet [4] (&) calcium (as carbonate) 500 mg tablet [24], 28!Acris Combi!66511000144106!Acris Combi (4 x 35 mg tablets, 24 x 500 mg tablets), 1 pack!!1!22.33!22.33!
GE!9170P!AQ!!11731000144100!polyethylene glycol-400 + propylene glycol!154541000144100!polyethylene glycol-400 0.4% + propylene glycol 0.3% eye drops, 28 x 0.8 mL unit doses!Systane!152351000144101!Systane 0.4% / 0.3% eye drops, 28 x 0.8 mL unit doses!!2!7.07!7.07!
GE!9220G!AG!!35687011000036109!polyvinyl alcohol!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!Liquifilm Tears!35557011000036105!Liquifilm Tears 1.4% eye drops, 15 mL!!1!3.50!4.79!
GE!9220G!PE!!35687011000036109!polyvinyl alcohol!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!PVA Tears!35565011000036106!PVA Tears 1.4% eye drops, 15 mL!!1!3.50!3.50!0.00
GE!9299K!JC!!21480011000036107!hydromorphone!922560011000036101!hydromorphone hydrochloride 4 mg modified release tablet, 14!Jurnista!921430011000036100!Jurnista 4 mg modified release tablet, 14!!14!11.15!11.15!
GE!9406C!JC!!21480011000036107!hydromorphone!73468011000036105!hydromorphone hydrochloride 8 mg modified release tablet, 14!Jurnista!73070011000036109!Jurnista 8 mg modified release tablet, 14!!14!13.94!13.94!
GE!9407D!JC!!21480011000036107!hydromorphone!73479011000036105!hydromorphone hydrochloride 16 mg modified release tablet, 14!Jurnista!73081011000036105!Jurnista 16 mg modified release tablet, 14!!14!23.03!23.03!
GE!9408E!JC!!21480011000036107!hydromorphone!73490011000036106!hydromorphone hydrochloride 32 mg modified release tablet, 14!Jurnista!73092011000036103!Jurnista 32 mg modified release tablet, 14!!14!42.51!42.51!
GE!9409F!JC!!21480011000036107!hydromorphone!73501011000036108!hydromorphone hydrochloride 64 mg modified release tablet, 14!Jurnista!73103011000036100!Jurnista 64 mg modified release tablet, 14!!14!74.92!74.92!
GE!11617K!ON!!21432011000036100!nicotine!898831000168107!nicotine 2 mg lozenge, 216!Nicotinell!898841000168103!Nicotinell Peppermint 2 mg lozenge, 216!!216!35.23!35.23!
GE!11619M!ON!!21432011000036100!nicotine!897951000168105!nicotine 4 mg lozenge, 216!Nicotinell!897961000168107!Nicotinell Peppermint 4 mg lozenge, 216!!216!35.23!35.23!
GE!11618L!ON!!21432011000036100!nicotine!897621000168106!nicotine 2 mg chewing gum, 216!Nicotinell!897631000168109!Nicotinell Mint 2 mg chewing gum, 216!!432!26.42!26.42!
GE!11612E!ON!!21432011000036100!nicotine!897451000168100!nicotine 4 mg chewing gum, 216!Nicotinell!897461000168103!Nicotinell Mint 4 mg chewing gum, 216!!216!35.23!35.23!
GE!11444H!VF!!50747011000036106!medium chain triglycerides!994651000168104!medium chain triglycerides oral liquid, 15 x 225 mL bottles!Betaquik!994661000168102!Betaquik oral liquid, 15 x 225 mL bottles!!2!74.89!74.89!
GE!11584Q!MK!!1228611000168101!ertugliflozin + metformin!1232221000168106!ertugliflozin 2.5 mg + metformin hydrochloride 500 mg tablet, 56!Segluromet 2.5/500!1232231000168109!Segluromet 2.5/500 tablet, 56!!56!45.28!45.28!
GE!11575F!MK!!1228611000168101!ertugliflozin + metformin!1232221000168106!ertugliflozin 2.5 mg + metformin hydrochloride 500 mg tablet, 56!Segluromet 2.5/500!1232231000168109!Segluromet 2.5/500 tablet, 56!!56!45.28!45.28!
GE!11564P!MK!!1228611000168101!ertugliflozin + metformin!1229031000168109!ertugliflozin 2.5 mg + metformin hydrochloride 1 g tablet, 56!Segluromet 2.5/1000!1229041000168100!Segluromet 2.5/1000 tablet, 56!!56!46.59!46.59!
GE!11581M!MK!!1228611000168101!ertugliflozin + metformin!1229031000168109!ertugliflozin 2.5 mg + metformin hydrochloride 1 g tablet, 56!Segluromet 2.5/1000!1229041000168100!Segluromet 2.5/1000 tablet, 56!!56!46.59!46.59!
GE!11562M!MK!!1228611000168101!ertugliflozin + metformin!1232101000168106!ertugliflozin 7.5 mg + metformin hydrochloride 500 mg tablet, 56!Segluromet 7.5/500!1232111000168109!Segluromet 7.5/500 tablet, 56!!56!45.28!45.28!
GE!11568W!MK!!1228611000168101!ertugliflozin + metformin!1232101000168106!ertugliflozin 7.5 mg + metformin hydrochloride 500 mg tablet, 56!Segluromet 7.5/500!1232111000168109!Segluromet 7.5/500 tablet, 56!!56!45.28!45.28!
GE!11569X!MK!!1228611000168101!ertugliflozin + metformin!1228681000168107!ertugliflozin 7.5 mg + metformin hydrochloride 1 g tablet, 56!Segluromet 7.5/1000!1228691000168105!Segluromet 7.5/1000 tablet, 56!!56!46.59!46.59!
GE!11563N!MK!!1228611000168101!ertugliflozin + metformin!1228681000168107!ertugliflozin 7.5 mg + metformin hydrochloride 1 g tablet, 56!Segluromet 7.5/1000!1228691000168105!Segluromet 7.5/1000 tablet, 56!!56!46.59!46.59!
GE!11705C!NO!!21699011000036100!insulin aspart!476231000144102!insulin aspart 100 units/mL fast acting injection, 1 x 10 mL vial!Fiasp!476311000144100!Fiasp 100 units/mL fast acting injection, 10 mL vial!!5!16.33!16.33!
GE!11706D!NO!!21699011000036100!insulin aspart!476411000144109!insulin aspart 100 units/mL fast acting injection, 5 x 3 mL pen devices!Fiasp FlexTouch!476431000144101!Fiasp Flextouch 100 units/mL fast acting injection, 5 x 3 mL pen devices!!5!28.18!28.18!
GE!12744R!JC!!84416011000036108!golimumab!845591000168109!golimumab 50 mg/0.5 mL injection, 0.5 mL pen device!Simponi!845601000168102!Simponi Smartject 50 mg/0.5 mL injection, 0.5 mL pen device!!1!1044.43!1044.43!
GE!12703N!JC!!84416011000036108!golimumab!84636011000036100!golimumab 50 mg/0.5 mL injection, 0.5 mL syringe!Simponi!84004011000036107!Simponi 50 mg/0.5 mL injection, 0.5 mL syringe!!1!1044.43!1044.43!
GE!12702M!UC!!87751011000036108!certolizumab pegol!862491000168105!certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices!Cimzia!862501000168103!Cimzia 200 mg/mL injection, 2 x 1 mL pen devices!!6!952.13!952.13!
GE!12712C!UC!!87751011000036108!certolizumab pegol!87809011000036100!certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes!Cimzia!87446011000036106!Cimzia 200 mg/mL injection, 2 x 1 mL syringes!!6!952.13!952.13!
GE!12742P!UC!!87751011000036108!certolizumab pegol!862491000168105!certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices!Cimzia!862501000168103!Cimzia 200 mg/mL injection, 2 x 1 mL pen devices!!2!952.13!952.13!
GE!12724Q!UC!!87751011000036108!certolizumab pegol!87809011000036100!certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes!Cimzia!87446011000036106!Cimzia 200 mg/mL injection, 2 x 1 mL syringes!!2!952.13!952.13!
GE!12691Y!UC!!87751011000036108!certolizumab pegol!862491000168105!certolizumab pegol 200 mg/mL injection, 2 x 1 mL pen devices!Cimzia!862501000168103!Cimzia 200 mg/mL injection, 2 x 1 mL pen devices!!2!952.13!952.13!
GE!12743Q!UC!!87751011000036108!certolizumab pegol!87809011000036100!certolizumab pegol 200 mg/mL injection, 2 x 1 mL syringes!Cimzia!87446011000036106!Cimzia 200 mg/mL injection, 2 x 1 mL syringes!!2!952.13!952.13!
GE!12708W!LY!!1107081000168107!baricitinib!1107141000168103!baricitinib 2 mg tablet, 28!Olumiant!1107151000168101!Olumiant 2 mg tablet, 28!!28!1149.97!1149.97!
GE!12730B!LY!!1107081000168107!baricitinib!1107291000168103!baricitinib 4 mg tablet, 28!Olumiant!1107301000168102!Olumiant 4 mg tablet, 28!!28!1149.97!1149.97!
GE!12685P!VE!!1462431000168101!upadacitinib!1462491000168102!upadacitinib 15 mg modified release tablet, 28!Rinvoq!1462501000168109!Rinvoq 15 mg modified release tablet, 28!!28!1149.97!1149.97!
GE!12700K!VE!!21584011000036107!adalimumab!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!Humira!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!2!618.90!618.90!
GE!12678G!VE!!21584011000036107!adalimumab!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!Humira!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!2!618.90!618.90!
GE!12729Y!RF!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hadlima!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12729Y!XT!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Amgevita!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12729Y!SZ!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hyrimoz!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12729Y!PK!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Idacio!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12719K!SZ!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hyrimoz!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12719K!XT!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Amgevita!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12719K!RF!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hadlima!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12719K!PK!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Idacio!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12680J!BQ!!33635011000036100!abatacept!899691000168101!abatacept 125 mg/mL injection, 4 x 1 mL pen devices!Orencia ClickJect!899701000168101!Orencia Clickject Autoinjector 125 mg/mL injection, 4 x 1 mL pen devices!!4!839.67!839.67!
GE!12758L!BQ!!33635011000036100!abatacept!7511000036109!abatacept 125 mg/mL injection, 4 x 1 mL syringes!Orencia!7501000036107!Orencia 125 mg/mL injection, 4 x 1 mL syringes!!4!839.67!839.67!
GE!12687R!EW!!21926011000036101!infliximab!1513281000168103!infliximab 120 mg/mL injection, 1 mL pen device!Remsima SC!1513291000168100!Remsima 120 mg/mL injection, 1 mL pen device!!2!332.80!332.80!
GE!12677F!EW!!21926011000036101!infliximab!1513091000168107!infliximab 120 mg/mL injection, 1 mL syringe!Remsima SC!1513101000168102!Remsima with Safety Guard 120 mg/mL injection, 1 mL syringe!!2!332.80!332.80!
GE!12689W!EW!!21926011000036101!infliximab!1513281000168103!infliximab 120 mg/mL injection, 1 mL pen device!Remsima SC!1513291000168100!Remsima 120 mg/mL injection, 1 mL pen device!!1!332.80!332.80!
GE!12688T!EW!!21926011000036101!infliximab!1513091000168107!infliximab 120 mg/mL injection, 1 mL syringe!Remsima SC!1513101000168102!Remsima with Safety Guard 120 mg/mL injection, 1 mL syringe!!1!332.80!332.80!
GE!12748Y!EW!!21926011000036101!infliximab!1513281000168103!infliximab 120 mg/mL injection, 1 mL pen device!Remsima SC!1513291000168100!Remsima 120 mg/mL injection, 1 mL pen device!!2!332.80!332.80!
GE!12753F!EW!!21926011000036101!infliximab!1513091000168107!infliximab 120 mg/mL injection, 1 mL syringe!Remsima SC!1513101000168102!Remsima with Safety Guard 120 mg/mL injection, 1 mL syringe!!2!332.80!332.80!
GE!12720L!PF!!718541000168101!tofacitinib!718571000168108!tofacitinib 5 mg tablet, 56!Xeljanz!718581000168106!Xeljanz 5 mg tablet, 56!!56!1092.47!1092.47!
GE!12718J!PF!!21347011000036107!etanercept!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!Enbrel!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!2!371.81!371.81!
GE!12679H!RF!!21347011000036107!etanercept!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!Brenzys!899301000168102!Brenzys Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!743.60!743.60!
GE!12679H!PF!!21347011000036107!etanercept!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!Enbrel!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!743.60!743.60!
GE!12737J!RF!!21347011000036107!etanercept!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!Brenzys!880521000168109!Brenzys 50 mg/mL injection, 4 x 1 mL syringes!!1!743.60!743.60!
GE!12737J!PF!!21347011000036107!etanercept!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!Enbrel!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!743.60!743.60!
GE!12750C!PF!!21347011000036107!etanercept!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!Enbrel!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!2!371.81!371.81!
GE!12716G!PF!!21347011000036107!etanercept!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!Enbrel!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!743.60!743.60!
GE!12676E!PF!!21347011000036107!etanercept!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!Enbrel!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!743.60!743.60!
GE!12701L!VE!!21584011000036107!adalimumab!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!Humira!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!2!618.90!618.90!
GE!12752E!VE!!21584011000036107!adalimumab!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!Humira!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!2!618.90!618.90!
GE!12690X!SZ!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hyrimoz!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12690X!XT!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Amgevita!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12690X!PK!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Idacio!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12690X!RF!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hadlima!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
GE!12741N!SZ!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hyrimoz!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12741N!PK!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Idacio!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12741N!RF!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hadlima!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
GE!12741N!XT!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Amgevita!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HB!12756J!BQ!!33635011000036100!abatacept!33791011000036102!abatacept 250 mg injection, 1 vial!Orencia!33282011000036104!Orencia 250 mg powder for injection, 1 vial!!1!262.40!262.40!
HB!12717H!JC!!21926011000036101!infliximab!27724011000036101!infliximab 100 mg injection, 1 vial!Remicade!13375011000036107!Remicade 100 mg powder for injection, 1 vial!!1!253.52!253.52!
HB!12717H!OQ!!21926011000036101!infliximab!27724011000036101!infliximab 100 mg injection, 1 vial!Renflexis!971771000168105!Renflexis 100 mg powder for injection, 1 vial!!1!253.52!253.52!
HB!12717H!PF!!21926011000036101!infliximab!27724011000036101!infliximab 100 mg injection, 1 vial!Inflectra!730981000168106!Inflectra 100 mg powder for injection, 1 vial!!1!253.52!253.52!
HB!12740M!PF!!21347011000036107!etanercept!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!Enbrel!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!1!371.81!371.81!
HB!12735G!PF!!21347011000036107!etanercept!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!Enbrel!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!743.60!743.60!
HB!12675D!PF!!21347011000036107!etanercept!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!Enbrel!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!743.60!743.60!
HB!12699J!VE!!21584011000036107!adalimumab!1122481000168105!adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!Humira!1122491000168108!Humira 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!!2!618.90!618.90!
HB!12695E!XT!!21584011000036107!adalimumab!1158041000168108!adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe!Amgevita!1158051000168105!Amgevita 20 mg/0.4 mL injection, 0.4 mL syringe!!2!380.99!380.99!
HB!12696F!VE!!21584011000036107!adalimumab!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!Humira!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!2!618.90!618.90!
HB!12697G!VE!!21584011000036107!adalimumab!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!Humira!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!2!618.90!618.90!
HB!12698H!SZ!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hyrimoz!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HB!12698H!XT!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Amgevita!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HB!12698H!RF!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hadlima!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HB!12698H!PK!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Idacio!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HB!12733E!RF!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hadlima!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HB!12733E!PK!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Idacio!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HB!12733E!SZ!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hyrimoz!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HB!12733E!XT!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Amgevita!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HS!12738K!BQ!!33635011000036100!abatacept!33791011000036102!abatacept 250 mg injection, 1 vial!Orencia!33282011000036104!Orencia 250 mg powder for injection, 1 vial!!1!262.40!262.40!
HS!12751D!JC!!21926011000036101!infliximab!27724011000036101!infliximab 100 mg injection, 1 vial!Remicade!13375011000036107!Remicade 100 mg powder for injection, 1 vial!!1!253.52!253.52!
HS!12751D!PF!!21926011000036101!infliximab!27724011000036101!infliximab 100 mg injection, 1 vial!Inflectra!730981000168106!Inflectra 100 mg powder for injection, 1 vial!!1!253.52!253.52!
HS!12751D!OQ!!21926011000036101!infliximab!27724011000036101!infliximab 100 mg injection, 1 vial!Renflexis!971771000168105!Renflexis 100 mg powder for injection, 1 vial!!1!253.52!253.52!
HS!12734F!PF!!21347011000036107!etanercept!28011011000036101!etanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack!Enbrel!13920011000036109!Enbrel (4 x 25 mg vials, 4 x 1 mL inert diluent syringes), 1 pack!!1!371.81!371.81!
HS!12736H!PF!!21347011000036107!etanercept!898001000168109!etanercept 50 mg/mL injection, 4 x 1 mL pen devices!Enbrel!898011000168107!Enbrel Auto-Injector 50 mg/mL injection, 4 x 1 mL pen devices!!1!743.60!743.60!
HS!12757K!PF!!21347011000036107!etanercept!79241011000036109!etanercept 50 mg/mL injection, 4 x 1 mL syringes!Enbrel!933223531000036103!Enbrel 50 mg/mL injection, 4 x 1 mL syringes!!1!743.60!743.60!
HS!12686Q!VE!!21584011000036107!adalimumab!1122481000168105!adalimumab 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!Humira!1122491000168108!Humira 20 mg/0.2 mL injection, 2 x 0.2 mL syringes!!2!618.90!618.90!
HS!12674C!XT!!21584011000036107!adalimumab!1158041000168108!adalimumab 20 mg/0.4 mL injection, 0.4 mL syringe!Amgevita!1158051000168105!Amgevita 20 mg/0.4 mL injection, 0.4 mL syringe!!2!380.99!380.99!
HS!12732D!VE!!21584011000036107!adalimumab!967421000168103!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!Humira!967431000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL pen devices!!2!618.90!618.90!
HS!12749B!VE!!21584011000036107!adalimumab!967341000168102!adalimumab 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!Humira!967351000168100!Humira 40 mg/0.4 mL injection, 2 x 0.4 mL syringes!!2!618.90!618.90!
HS!12715F!XT!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Amgevita!1157871000168108!Amgevita Sureclick 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HS!12715F!RF!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hadlima!1158711000168107!Hadlima Pushtouch Auto-Injector 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HS!12715F!SZ!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Hyrimoz!1532951000168102!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HS!12715F!PK!!21584011000036107!adalimumab!729821000168108!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!Idacio!1494451000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL pen devices!!2!761.98!761.98!
HS!12731C!XT!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Amgevita!1157971000168103!Amgevita 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HS!12731C!PK!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Idacio!1494331000168104!Idacio 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HS!12731C!RF!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hadlima!1158681000168106!Hadlima 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
HS!12731C!SZ!!21584011000036107!adalimumab!28164011000036107!adalimumab 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!Hyrimoz!1533871000168109!Hyrimoz 40 mg/0.8 mL injection, 2 x 0.8 mL syringes!!2!761.98!761.98!
PL!12496Q!JC!!21480011000036107!hydromorphone!922560011000036101!hydromorphone hydrochloride 4 mg modified release tablet, 14!Jurnista!921430011000036100!Jurnista 4 mg modified release tablet, 14!!28!11.15!11.15!
PL!12482Y!JC!!21480011000036107!hydromorphone!73468011000036105!hydromorphone hydrochloride 8 mg modified release tablet, 14!Jurnista!73070011000036109!Jurnista 8 mg modified release tablet, 14!!28!13.94!13.94!
PL!12473L!JC!!21480011000036107!hydromorphone!73479011000036105!hydromorphone hydrochloride 16 mg modified release tablet, 14!Jurnista!73081011000036105!Jurnista 16 mg modified release tablet, 14!!28!23.03!23.03!
PL!12543E!JC!!21480011000036107!hydromorphone!73490011000036106!hydromorphone hydrochloride 32 mg modified release tablet, 14!Jurnista!73092011000036103!Jurnista 32 mg modified release tablet, 14!!28!42.51!42.51!
PL!12535R!JC!!21480011000036107!hydromorphone!73501011000036108!hydromorphone hydrochloride 64 mg modified release tablet, 14!Jurnista!73103011000036100!Jurnista 64 mg modified release tablet, 14!!28!74.92!74.92!
