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!1196Y!SW!Largactil!!21310011000036102!chlorpromazine!!!27254011000036107!chlorpromazine hydrochloride 10 mg tablet, 100!!!12645011000036109!Largactil 10 mg tablet, 100!!1!100!2.92!0.00!2.92!!
GE!1895R!AF!Mobilis D-10!!21531011000036103!piroxicam!!!27881011000036106!piroxicam 10 mg dispersible tablet, 50!!!12691011000036101!Mobilis D 10 mg dispersible tablet, 50!!1!50!4.15!0.00!4.15!!
GE!2682E!AG!Liquifilm Tears!!35687011000036109!polyvinyl alcohol!!!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!!!35557011000036105!Liquifilm Tears 1.4% eye drops, 15 mL!!1!1!3.50!0.00!4.79!!
GE!2682E!PE!PVA Tears!!35687011000036109!polyvinyl alcohol!!!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!!!35565011000036106!PVA Tears 1.4% eye drops, 15 mL!!1!1!3.50!0.00!3.50!!0.00
GE!2899N!AF!Deralin 160!!21392011000036104!propranolol!!!26940011000036104!propranolol hydrochloride 160 mg tablet, 50!!!12133011000036108!Deralin 160 mg tablet, 50!!1!50!4.70!0.00!4.70!!
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!6.14!0.00!6.14!!
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!5201R!AF!Mobilis D-10!!21531011000036103!piroxicam!!!27881011000036106!piroxicam 10 mg dispersible tablet, 50!!!12691011000036101!Mobilis D 10 mg dispersible tablet, 50!!1!50!4.15!0.00!4.15!!
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!5452Y!AF!Cozavan!!44887011000036108!losartan!!!933224091000036109!losartan potassium 25 mg tablet, 30!!!933224081000036107!Cozavan 25 mg tablet, 30!!1!30!3.83!0.00!3.83!!
GE!5526W!AG!Liquifilm Tears!!35687011000036109!polyvinyl alcohol!!!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!!!35557011000036105!Liquifilm Tears 1.4% eye drops, 15 mL!!1!1!3.50!0.00!4.79!!
GE!5526W!PE!PVA Tears!!35687011000036109!polyvinyl alcohol!!!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!!!35565011000036106!PVA Tears 1.4% eye drops, 15 mL!!1!1!3.50!0.00!3.50!!0.00
GE!5532E!AQ!Systane!!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!!!152351000144101!Systane 0.4% / 0.3% eye drops, 28 x 0.8 mL unit doses!!2!2!7.07!0.00!7.07!!
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!8203R!AF!Cozavan!!44887011000036108!losartan!!!46465011000036101!losartan potassium 50 mg tablet, 30!!!933224071000036105!Cozavan 50 mg tablet, 30!!2!60!5.47!0.00!5.47!!
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!15.73!0.00!15.73!!
GE!8750M!AP!Symbicort Turbuhaler 400/12!!21281011000036101!budesonide + formoterol (eformoterol)!!!83499011000036101!budesonide 400 microgram/actuation + formoterol (eformoterol) fumarate dihydrate 12 microgram/actuation powder for inhalation, 2 x 60 actuations!!!83332011000036105!Symbicort Turbuhaler 400/12 powder for inhalation, 2 x 60 actuations!!1!1!44.14!0.00!44.14!!
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!9170P!AQ!Systane!!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!!!152351000144101!Systane 0.4% / 0.3% eye drops, 28 x 0.8 mL unit doses!!2!2!7.07!0.00!7.07!!
GE!9220G!PE!PVA Tears!!35687011000036109!polyvinyl alcohol!!!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!!!35565011000036106!PVA Tears 1.4% eye drops, 15 mL!!1!1!3.50!0.00!3.50!!0.00
GE!9220G!AG!Liquifilm Tears!!35687011000036109!polyvinyl alcohol!!!35772011000036106!polyvinyl alcohol 1.4% eye drops, 15 mL!!!35557011000036105!Liquifilm Tears 1.4% eye drops, 15 mL!!1!1!3.50!0.00!4.79!!
GE!11617K!ON!Nicotinell!!21432011000036100!nicotine!!!898831000168107!nicotine 2 mg lozenge, 216!!!898841000168103!Nicotinell Peppermint 2 mg lozenge, 216!!1!216!35.23!0.00!35.23!!
GE!11619M!ON!Nicotinell!!21432011000036100!nicotine!!!897951000168105!nicotine 4 mg lozenge, 216!!!897961000168107!Nicotinell Peppermint 4 mg lozenge, 216!!1!216!35.23!0.00!35.23!!
GE!11618L!ON!Nicotinell!!21432011000036100!nicotine!!!897621000168106!nicotine 2 mg chewing gum, 216!!!897631000168109!Nicotinell Mint 2 mg chewing gum, 216!!2!432!26.42!0.00!26.42!!
GE!11612E!ON!Nicotinell!!21432011000036100!nicotine!!!897451000168100!nicotine 4 mg chewing gum, 216!!!897461000168103!Nicotinell Mint 4 mg chewing gum, 216!!1!216!35.23!0.00!35.23!!
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!11705C!NO!Fiasp!!21699011000036100!insulin aspart!!!476231000144102!insulin aspart 100 units/mL fast acting injection, 1 x 10 mL vial!!!476311000144100!Fiasp 100 units/mL fast acting injection, 10 mL vial!!5!5!16.33!0.00!16.33!!
GE!11706D!NO!Fiasp FlexTouch!!21699011000036100!insulin aspart!!!476411000144109!insulin aspart 100 units/mL fast acting injection, 5 x 3 mL pen devices!!!476431000144101!Fiasp Flextouch 100 units/mL fast acting injection, 5 x 3 mL pen devices!!5!5!28.18!0.00!28.18!!
GE!11924N!TX!APO-Donepezil!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!101521000036104!Donepezil (Apo) 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!RW!Aridon 10!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!102061000036108!Aridon 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!AF!Arazil!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!101451000036106!Arazil 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!VO!NOUMED DONEPEZIL!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!1240401000168101!Donepezil (Noumed) 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!HQ!Donepezil GH!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!933201151000036107!Donepezil Hydrochloride (GH) 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!PF!Aricept!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!12942011000036100!Aricept 10 mg tablet, 28!!1!28!7.44!0.00!14.09!!
GE!11924N!SZ!Donepezil Sandoz!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!101201000036106!Donepezil Hydrochloride (Sandoz) 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!RF!Aridon APN 10!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!671031000168106!Aridon APN 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11924N!RZ!Donepezil-DRLA!!21256011000036101!donepezil!!!27456011000036103!donepezil hydrochloride 10 mg tablet, 28!!!101191000036109!Donepezil Hydrochloride (DRLA) 10 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!VO!NOUMED DONEPEZIL!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!1240731000168103!Donepezil (Noumed) 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!RF!Aridon APN 5!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!671061000168103!Aridon APN 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!HQ!Donepezil GH!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!933201041000036108!Donepezil Hydrochloride (GH) 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!RW!Aridon 5!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!102051000036105!Aridon 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!SZ!Donepezil Sandoz!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!101211000036108!Donepezil Hydrochloride (Sandoz) 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!RZ!Donepezil-DRLA!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!101181000036107!Donepezil Hydrochloride (DRLA) 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!PF!Aricept!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!12941011000036106!Aricept 5 mg tablet, 28!!1!28!7.44!0.00!10.16!!
GE!11922L!TX!APO-Donepezil!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!101531000036102!Donepezil (Apo) 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11922L!AF!Arazil!!21256011000036101!donepezil!!!27455011000036105!donepezil hydrochloride 5 mg tablet, 28!!!101461000036109!Arazil 5 mg tablet, 28!!1!28!7.44!0.00!7.44!!0.00
GE!11917F!AF!Galantyl!!21521011000036100!galantamine!!!28248011000036107!galantamine 8 mg modified release capsule, 28!!!87453011000036102!Galantyl 8 mg modified release capsule, 28!!1!28!20.35!0.00!20.35!!
GE!11917F!RW!Gamine XR!!21521011000036100!galantamine!!!28248011000036107!galantamine 8 mg modified release capsule, 28!!!43471000036104!Gamine XR 8 mg modified release capsule, 28!!1!28!20.35!0.00!20.35!!
GE!11917F!JC!Reminyl!!21521011000036100!galantamine!!!28248011000036107!galantamine 8 mg modified release capsule, 28!!!14249011000036104!Reminyl 8 mg modified release capsule, 28!!1!28!20.35!0.00!20.35!!
GE!11917F!TX!APO-Galantamine MR!!21521011000036100!galantamine!!!28248011000036107!galantamine 8 mg modified release capsule, 28!!!43481000036102!Galantamine MR (Apo) 8 mg modified release capsule, 28!!1!28!20.35!0.00!20.35!!
GE!11918G!TX!APO-Galantamine MR!!21521011000036100!galantamine!!!28249011000036104!galantamine 16 mg modified release capsule, 28!!!43521000036102!Galantamine MR (Apo) 16 mg modified release capsule, 28!!1!28!24.89!0.00!24.89!!
GE!11918G!AF!Galantyl!!21521011000036100!galantamine!!!28249011000036104!galantamine 16 mg modified release capsule, 28!!!87450011000036105!Galantyl 16 mg modified release capsule, 28!!1!28!24.89!0.00!24.89!!
GE!11918G!RW!Gamine XR!!21521011000036100!galantamine!!!28249011000036104!galantamine 16 mg modified release capsule, 28!!!43501000036107!Gamine XR 16 mg modified release capsule, 28!!1!28!24.89!0.00!24.89!!
GE!11918G!JC!Reminyl!!21521011000036100!galantamine!!!28249011000036104!galantamine 16 mg modified release capsule, 28!!!14250011000036107!Reminyl 16 mg modified release capsule, 28!!1!28!24.89!0.00!24.89!!
GE!11899G!AF!Galantyl!!21521011000036100!galantamine!!!28250011000036107!galantamine 24 mg modified release capsule, 28!!!87455011000036101!Galantyl 24 mg modified release capsule, 28!!1!28!29.66!0.00!29.66!!
GE!11899G!TX!APO-Galantamine MR!!21521011000036100!galantamine!!!28250011000036107!galantamine 24 mg modified release capsule, 28!!!43491000036100!Galantamine MR (Apo) 24 mg modified release capsule, 28!!1!28!29.66!0.00!29.66!!
GE!11899G!RW!Gamine XR!!21521011000036100!galantamine!!!28250011000036107!galantamine 24 mg modified release capsule, 28!!!43511000036109!Gamine XR 24 mg modified release capsule, 28!!1!28!29.66!0.00!29.66!!
GE!11899G!JC!Reminyl!!21521011000036100!galantamine!!!28250011000036107!galantamine 24 mg modified release capsule, 28!!!14251011000036100!Reminyl 24 mg modified release capsule, 28!!1!28!29.66!0.00!29.66!!
GE!11925P!NV!Exelon!!21413011000036101!rivastigmine!!!27691011000036102!rivastigmine 1.5 mg capsule, 56!!!13321011000036106!Exelon 1.5 mg capsule, 56!!1!56!47.77!0.00!47.77!!
GE!11904M!NV!Exelon Patch 15!!21413011000036101!rivastigmine!!!731071000168100!rivastigmine 13.3 mg/24 hours patch, 30!!!731081000168102!Exelon-15 13.3 mg/24 hours patch, 30!!1!30!64.64!0.00!64.64!!
GE!11901J!NV!Exelon!!21413011000036101!rivastigmine!!!27692011000036108!rivastigmine 3 mg capsule, 56!!!13322011000036100!Exelon 3 mg capsule, 56!!1!56!47.77!0.00!47.77!!
GE!11923M!NV!Exelon!!21413011000036101!rivastigmine!!!27693011000036101!rivastigmine 4.5 mg capsule, 56!!!13323011000036107!Exelon 4.5 mg capsule, 56!!1!56!47.77!0.00!47.77!!
GE!11916E!NV!Exelon!!21413011000036101!rivastigmine!!!27694011000036104!rivastigmine 6 mg capsule, 56!!!13324011000036109!Exelon 6 mg capsule, 56!!1!56!47.77!0.00!47.77!!
GE!11912Y!NV!Exelon Patch 5!!21413011000036101!rivastigmine!!!38682011000036101!rivastigmine 4.6 mg/24 hours patch, 30!!!36785011000036108!Exelon-5 4.6 mg/24 hours patch, 30!!1!30!64.64!0.00!64.64!!
GE!11903L!NV!Exelon Patch 10!!21413011000036101!rivastigmine!!!38683011000036108!rivastigmine 9.5 mg/24 hours patch, 30!!!36786011000036101!Exelon-10 9.5 mg/24 hours patch, 30!!1!30!64.64!0.00!64.64!!
GE!11902K!TX!APO-Memantine!!37759011000036103!memantine!!!38842011000036103!memantine hydrochloride 10 mg tablet, 56!!!920422011000036106!Memantine (Apo) 10 mg tablet, 56!!1!56!28.09!0.00!28.09!!
GE!11902K!GQ!Memantine generichealth!!37759011000036103!memantine!!!38842011000036103!memantine hydrochloride 10 mg tablet, 56!!!667601000168105!Memantine (Generic Health) 10 mg tablet, 56!!1!56!28.09!0.00!28.09!!
GE!11902K!LU!Ebixa!!37759011000036103!memantine!!!38842011000036103!memantine hydrochloride 10 mg tablet, 56!!!36961011000036101!Ebixa 10 mg tablet, 56!!1!56!28.09!0.00!28.09!!
GE!11902K!RW!Memanxa!!37759011000036103!memantine!!!38842011000036103!memantine hydrochloride 10 mg tablet, 56!!!84002011000036103!Memanxa 10 mg tablet, 56!!1!56!28.09!0.00!28.09!!
GE!11905N!LU!Ebixa!!37759011000036103!memantine!!!83496011000036105!memantine hydrochloride 20 mg tablet, 28!!!83325011000036104!Ebixa 20 mg tablet, 28!!1!28!28.09!0.00!28.09!!
GE!11905N!TX!APO-Memantine!!37759011000036103!memantine!!!83496011000036105!memantine hydrochloride 20 mg tablet, 28!!!649551000168108!Memantine (Apo) 20 mg tablet, 28!!1!28!28.09!0.00!28.09!!
GE!11905N!GQ!Memantine generichealth!!37759011000036103!memantine!!!83496011000036105!memantine hydrochloride 20 mg tablet, 28!!!785231000168103!Memantine (Generic Health) 20 mg tablet, 28!!1!28!28.09!0.00!28.09!!
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!618.90!0.00!618.90!!
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!618.90!0.00!618.90!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!839.67!0.00!839.67!!
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!839.67!0.00!839.67!!
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!371.81!0.00!371.81!!
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!743.60!0.00!743.60!!
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!743.60!0.00!743.60!!
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!743.60!0.00!743.60!!
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!743.60!0.00!743.60!!
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!371.81!0.00!371.81!!
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!743.60!0.00!743.60!!
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!743.60!0.00!743.60!!
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!618.90!0.00!618.90!!
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!618.90!0.00!618.90!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
HB!12756J!BQ!Orencia!!33635011000036100!abatacept!!!33791011000036102!abatacept 250 mg injection, 1 vial!!!33282011000036104!Orencia 250 mg powder for injection, 1 vial!!1!1!262.40!0.00!262.40!!
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!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!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!371.81!0.00!371.81!!
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!743.60!0.00!743.60!!
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!743.60!0.00!743.60!!
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!618.90!0.00!618.90!!
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!380.99!0.00!380.99!!
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!618.90!0.00!618.90!!
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!618.90!0.00!618.90!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
HS!12738K!BQ!Orencia!!33635011000036100!abatacept!!!33791011000036102!abatacept 250 mg injection, 1 vial!!!33282011000036104!Orencia 250 mg powder for injection, 1 vial!!1!1!262.40!0.00!262.40!!
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!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!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!371.81!0.00!371.81!!
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!743.60!0.00!743.60!!
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!743.60!0.00!743.60!!
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!618.90!0.00!618.90!!
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!380.99!0.00!380.99!!
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!618.90!0.00!618.90!!
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!618.90!0.00!618.90!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
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!761.98!0.00!761.98!!
