|
Inj. herceptin hylecta, 10mg
|
$62.97 |
$62.97 |
$62.97 |
$8,193.78
|
|
Inj herzuma 10 mg
|
$77.49 |
$77.49 |
$77.49 |
$7,775.46
|
|
Inj human fibrinogen con nos
|
$1.52 |
$1.52 |
$1.52 |
$3.95
|
|
Inj hydroxocobalamin IV 25mg
|
$5.18 |
$5.18 |
$5.18 |
$2,452.32
|
|
Inj., ibalizumab-uiyk, 10 mg
|
$79.39 |
$79.39 |
$79.39 |
$3,542.09
|
|
Inj, idacio, 1 mg
|
$8.92 |
$8.92 |
$8.92 |
$14.63
|
|
Inj imip 4 cilas 4 releb 2mg
|
$2.61 |
$2.61 |
$2.61 |
$739.77
|
|
Inj, immphentiv, 20 mcg
|
$0.13 |
$0.13 |
$0.13 |
$21.00
|
|
Inj. inebilizumab-cdon, 1 mg
|
$494.43 |
$494.43 |
$494.43 |
$70,014.65
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$985.43 |
$985.43 |
$985.43 |
$1,928.00
|
|
Inj intralesional <= 7 lsn(s)
|
$219.93 |
$219.93 |
$219.93 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$219.93 |
$219.93 |
$219.93 |
$234.00
|
|
Inj, invega hafyera/trinza
|
$12.96 |
$12.96 |
$12.96 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$50.43 |
$50.43 |
$50.43 |
$6,967.29
|
|
Inj, ixinity, 1 i.u
|
$1.91 |
$1.91 |
$1.91 |
$6.99
|
|
Inj. jivi 1 iu
|
$2.65 |
$2.65 |
$2.65 |
$2.65
|
|
Inj, kovaltry, 1 i.u
|
$1.58 |
$1.58 |
$1.58 |
$5.07
|
|
Inj, lanreotide, (cipla) 1mg
|
$24.45 |
$24.45 |
$24.45 |
$11,648.70
|
|
Inj, lecanemab-irmb, 1 mg
|
$1.33 |
$1.33 |
$1.33 |
$1,174.88
|
|
Inj, lenacapavir, 1 mg
|
$22.02 |
$22.02 |
$22.02 |
$24,398.00
|
|
Inj, levothyroxine, freskabi
|
$7.10 |
$7.10 |
$7.10 |
$320.80
|
|
Inj, levothyroxine, hikma
|
$5.14 |
$5.14 |
$5.14 |
$42.89
|
|
Inj, lovotibeglogene autotem
|
$3,261,355.00 |
$3,261,355.00 |
$3,261,355.00 |
$4,488,461.15
|
|
Inj. lumasiran, 0.5 mg
|
$329.10 |
$329.10 |
$329.10 |
$96,930.47
|
|
Inj., lumoxiti, 0.01 mg
|
$23.39 |
$23.39 |
$23.39 |
$3,881.27
|
|
Inj luxturna 1 billion vec g
|
$3,163.15 |
$3,163.15 |
$3,163.15 |
$3,084.46
|
|
Inj marstacim-hncq, 0.5 mg
|
$50.71 |
$50.71 |
$50.71 |
$50.71
|
|
Inj melpha hydroch nos 50 mg
|
$108.03 |
$108.03 |
$108.03 |
$1,713.99
|
|
Inj, melphalan (apotex) 1 mg
|
$64.78 |
$64.78 |
$64.78 |
$64.78
|
|
Inj melphalan (hepzato) 1 mg
|
$787.79 |
$787.79 |
$787.79 |
$787.79
|
|
Inj., meropenem, vaborbactam
|
$2.18 |
$2.18 |
$2.18 |
$556.87
|
|
Inj meropenem (wg crit care)
|
$1.62 |
$1.62 |
$1.62 |
$83.19
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$48.27 |
$48.27 |
$48.27 |
$1,496.55
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$248.50 |
$248.50 |
$248.50 |
$8,304.04
|
|
Inj, motixafortide, 0.25 mg
|
$25.22 |
$25.22 |
$25.22 |
$25.22
|
|
Inj. naxitamab-gqgk, 1 mg
|
$685.91 |
$685.91 |
$685.91 |
$42,064.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$738.80 |
$738.80 |
$738.80 |
$1,413.35
|
|
Inj, nithiodote, 3mg / 125mg
|
$2.17 |
$2.17 |
$2.17 |
$472.76
|
|
Inj nivolumab 2 mg hyaluron
|
$26.74 |
$26.74 |
$26.74 |
$15,599.68
|
|
Inj, nogapendekin pmln, 1mcg
|
$94.12 |
$94.12 |
$94.12 |
$94.12
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$2,881.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$2,726.90
|
|
Inj, nyposi 1 mcg
|
$0.55 |
$0.55 |
$0.55 |
$0.55
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$47.24 |
$47.24 |
$47.24 |
$1,058.98
|
|
Inj ogivri 10 mg
|
$44.59 |
$44.59 |
$44.59 |
$4,492.28
|
|
Inj, oliceridine 0.1 mg
|
$1.30 |
$1.30 |
$1.30 |
$1.23
|
|
Inj olipudase alfa-rpcp 1mg
|
$393.82 |
$393.82 |
$393.82 |
$13,239.99
|
|
Inj., omadacycline, 1 mg
|
$4.01 |
$4.01 |
$4.01 |
$865.34
|
|
Inj onase abepar-xioi treat
|
$2,452,115.60 |
$2,452,115.60 |
$2,452,115.60 |
$3,572,794.09
|
|
Inj ontruzant 10 mg
|
$21.99 |
$21.99 |
$21.99 |
$6,706.27
|
|
Inj, palonosetron (posfrea)
|
$58.84 |
$58.84 |
$58.84 |
$59.74
|
|
Inj, panzyga, 500 mg
|
$74.46 |
$74.46 |
$74.46 |
$8,041.38
|
|
Inj, pasireotide long acting
|
$563.79 |
$563.79 |
$563.79 |
$33,745.84
|
|
Inj., patisiran, 0.1 mg
|
$99.82 |
$99.82 |
$99.82 |
$17,613.00
|
|
Inj, pedmark, 100 mg
|
$95.14 |
$95.14 |
$95.14 |
$96.08
|
|
Inj, pegcetacoplan, 1mg
|
$141.91 |
$141.91 |
$141.91 |
$3,662.96
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$27.99 |
$27.99 |
$27.99 |
$6,614.40
|
|
Inj, pegulicianine, 1 mg
|
$36.45 |
$36.45 |
$36.45 |
$51.76
|
|
Inj. pemetrexed, 10 mg
|
$52.74 |
$52.74 |
$52.74 |
$104.72
|
|
Inj pemetrexed (accord) 10mg
|
$9.74 |
$9.74 |
$9.74 |
$579.77
|
|
Inj, pemetrexed (avyxa) 10mg
|
$83.28 |
$83.28 |
$83.28 |
$112.10
|
|
Inj pemetrexed ditromethamin
|
$10.34 |
$10.34 |
$10.34 |
$895.03
|
|
Inj pemetrexed, hospira 10mg
|
$4.93 |
$4.93 |
$4.93 |
$64.35
|
|
Inj pemetrexed (teva) 10mg
|
$3.79 |
$3.79 |
$3.79 |
$200.85
|
|
Inj, pemrydi rtu, 10 mg
|
$80.10 |
$80.10 |
$80.10 |
$82.30
|
|
Inj., perseris, 0.5 mg
|
$12.14 |
$12.14 |
$12.14 |
$5,146.85
|
|
Inj plasminogen tvmh 1mg
|
$32.31 |
$32.31 |
$32.31 |
$4,456.80
|
|
Inj., plazomicin, 5 mg
|
$3.57 |
$3.57 |
$3.57 |
$607.16
|
|
Inj recombin esperoct per iu
|
$2.26 |
$2.26 |
$2.26 |
$6.63
|
|
Inj, releuko 1 mcg
|
$0.41 |
$0.41 |
$0.41 |
$475.36
|
|
Inj retacrit esrd on dialysi
|
$0.76 |
$0.76 |
$0.76 |
$307.40
|
|
Inj, rimabotulinumtoxinb
|
$13.34 |
$13.34 |
$13.34 |
$714.24
|
|
Inj roctavian ml 2x10^13vc g
|
$12,368.21 |
$12,368.21 |
$12,368.21 |
$130,068.54
|
|
Inj romidepsin non-lyo 0.1mg
|
$28.52 |
$28.52 |
$28.52 |
$9,892.69
|
|
Inj, rykindo, 0.5 mg
|
$13.03 |
$13.03 |
$13.03 |
$13.03
|
|
Inj scleros sol mult veins
|
$442.22 |
$442.22 |
$442.22 |
$707.85
|
|
Inj scleros sol sgl vein
|
$442.22 |
$442.22 |
$442.22 |
$561.88
|
|
Inj, sculptra, 0.5mg
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Inj sebelipase alfa 1 mg
|
$539.69 |
$539.69 |
$539.69 |
$539.69
|
|
Inj secretin synthetic human
|
$43.79 |
$43.79 |
$43.79 |
$1,234.65
|
|
Inj secukinumab intrav 1mg
|
$17.84 |
$17.84 |
$17.84 |
$4,413.21
|
|
Inj, sezaby, 1 mg
|
$1.15 |
$1.15 |
$1.15 |
$235.85
|
|
Inj, spesolimab-sbzo, 1 mg
|
$65.73 |
$65.73 |
$65.73 |
$90,007.62
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$442.22 |
$442.22 |
$442.22 |
$436.80
|
|
Inj, susvimo 0.1 mg
|
$78.43 |
$78.43 |
$78.43 |
$2,598.44
|
|
Inj, sutimlimab-jome, 10 mg
|
$18.11 |
$18.11 |
$18.11 |
$3,453.73
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$348.62 |
$348.62 |
$348.62 |
$67,538.30
|
|
Inj, taliglucerace alfa 10 u
|
$41.06 |
$41.06 |
$41.06 |
$1,573.27
|
|
Inj teclistamab cqyv 0.5 mg
|
$33.27 |
$33.27 |
$33.27 |
$17,517.56
|
|
Inj tedizolid phosphate
|
$1.91 |
$1.91 |
$1.91 |
$664.72
|
|
Inj teplizumab mzwv 5 mcg
|
$37.65 |
$37.65 |
$37.65 |
$22,340.08
|
|
Inj. teprotumumab-trbw 10 mg
|
$359.09 |
$359.09 |
$359.09 |
$35,034.78
|
|
Inj, testosterone, azmiro
|
$1.33 |
$1.33 |
$1.33 |
$1.33
|
|
Inj thiotepa nos 1 mg
|
$12.24 |
$12.24 |
$12.24 |
$3,170.16
|
|
Inj., tildrakizumab, 1 mg
|
$126.24 |
$126.24 |
$126.24 |
$26,635.60
|
|
Inj, tislelizumab-jsgr
|
$57.42 |
$57.42 |
$57.42 |
$9,764.09
|
|
Inj tofersen intrathec 1 mg
|
$155.34 |
$155.34 |
$155.34 |
$293.34
|
|
Inj, tofidence, 1 mg
|
$5.79 |
$5.79 |
$5.79 |
$86.87
|
|
Inj travoprost intra impl
|
$195.25 |
$195.25 |
$195.25 |
$197.16
|
|
Inj triamcinolone ace X-ray 1mg
|
$18.21 |
$18.21 |
$18.21 |
$1,090.75
|