|
Inj., fibryga, 1 mg
|
$1.11 |
$1.21 |
$1.21 |
|
|
Inj fluphenazine hcl 1.25 mg
|
$7.35 |
$7.43 |
$7.43 |
|
|
Inj, focinvez, 1mg
|
$2.87 |
$2.87 |
$3.14 |
|
|
Inj for ext venography
|
$3,786.00 |
$5,110.00 |
$6,311.00 |
|
|
Inj for mammo ductogram
|
$4,881.00 |
$5,339.00 |
$6,311.00 |
|
|
Inj, fosaprepitant (teva)
|
$1.13 |
$1.13 |
$2.04 |
|
|
Inj fosnetupitant, palonoset
|
$606.35 |
$606.35 |
$679.51 |
|
|
Inj, fulvestrant (fresenius)
|
$3.32 |
$3.32 |
$53.00 |
|
|
Inj, fulvestrant (teva)
|
$21.20 |
$46.21 |
$46.21 |
|
|
Inj givosiran 0.5 mg
|
$112.14 |
$117.19 |
$117.19 |
|
|
Inj glofitamab gxbm, 2.5 mg
|
$2,701.04 |
$2,770.57 |
$2,770.57 |
|
|
Inj glycopyrrolate fres kabi
|
$1.80 |
$1.85 |
$1.85 |
|
|
Inj, granisetron, xr, 0.1 mg
|
$4.96 |
$4.96 |
$5.71 |
|
|
Inj., guselkumab, 1 mg
|
$74.47 |
$74.86 |
$74.86 |
|
|
Inj, hemgenix, per tx dose
|
$3,672,900.00 |
$3,685,266.67 |
$3,685,266.67 |
|
|
Inj. herceptin hylecta, 10mg
|
$62.97 |
$62.97 |
$63.79 |
|
|
Inj herzuma 10 mg
|
$60.44 |
$77.49 |
$77.49 |
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$39.34 |
$107.43 |
$184.07 |
|
|
Inj hrt cath w/s&i sel hrt ang
|
$47.73 |
$252.87 |
$467.55 |
|
|
Inj hrt cath w/s&i sel hrt art
|
$49.66 |
$142.27 |
$277.71 |
|
|
Inj hrt cath w/s&i sel left vent
|
$38.18 |
$98.35 |
$186.42 |
|
|
Inj hrt cath w/s&i sel right vent
|
$37.92 |
$97.79 |
$138.85 |
|
|
Inj human fibrinogen con nos
|
$1.45 |
$1.52 |
$1.52 |
|
|
Inj hydroxocobalamin IV 25mg
|
$5.03 |
$5.18 |
$5.18 |
|
|
Inj., ibalizumab-uiyk, 10 mg
|
$77.06 |
$79.39 |
$79.39 |
|
|
Inj, idacio, 1 mg
|
$8.92 |
$8.92 |
$14.63 |
|
|
Inj imip 4 cilas 4 releb 2mg
|
$2.51 |
$2.61 |
$2.61 |
|
|
Inj, immphentiv, 20 mcg
|
$0.13 |
$0.13 |
$0.15 |
|
|
Inj. inebilizumab-cdon, 1 mg
|
$484.40 |
$494.43 |
$494.43 |
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$972.98 |
$3,986.00 |
$6,839.00 |
|
|
Inj. infugem, 100 mg
|
$40.28 |
$40.28 |
$40.28 |
|
|
Inj intralesional <= 7 lsn(s)
|
$217.16 |
$3,986.00 |
$6,839.00 |
|
|
Inj intralesional > 7 lsns
|
$217.16 |
$3,986.00 |
$6,839.00 |
|
|
Inj, invega hafyera/trinza
|
$12.66 |
$12.96 |
$12.96 |
|
|
Inj ivig privigen 500 mg
|
$48.58 |
$50.43 |
$50.43 |
|
|
Inj, ixinity, 1 i.u
|
$1.81 |
$1.91 |
$1.91 |
|
|
Inj. jivi 1 iu
|
$2.44 |
$2.65 |
$2.65 |
|
|
Inj, kovaltry, 1 i.u
|
$1.48 |
$1.58 |
$1.58 |
|
|
Inj, lanreotide, (cipla) 1mg
|
$24.45 |
$24.45 |
$36.80 |
|
|
Inj, lecanemab-irmb, 1 mg
|
$1.33 |
$1.33 |
$1.34 |
|
|
Inj, lenacapavir, 1 mg
|
$21.99 |
$22.02 |
$22.02 |
|
|
Inj, levothyroxine, freskabi
|
$3.75 |
$7.10 |
$7.10 |
|
|
Inj, levothyroxine, hikma
|
$5.14 |
$5.14 |
$5.14 |
|
|
Inj, lovotibeglogene autotem
|
$3,261,355.00 |
$3,261,355.00 |
$3,286,000.00 |
|
|
Inj. lumasiran, 0.5 mg
|
$317.88 |
$329.10 |
$329.10 |
|
|
Inj., lumoxiti, 0.01 mg
|
$23.39 |
$23.39 |
$23.39 |
|
|
Inj luxturna 1 billion vec g
|
$3,084.46 |
$3,163.15 |
$3,163.15 |
|
|
Inj marstacim-hncq, 0.5 mg
|
$50.71 |
$50.71 |
$50.71 |
|
|
Inj melpha hydroch nos 50 mg
|
$108.03 |
$108.03 |
$153.54 |
|
|
Inj, melphalan (apotex) 1 mg
|
$64.78 |
$64.78 |
$64.78 |
|
|
Inj melphalan (hepzato) 1 mg
|
$773.80 |
$787.79 |
$787.79 |
|
|
Inj., meropenem, vaborbactam
|
$2.09 |
$2.18 |
$2.18 |
|
|
Inj meropenem (wg crit care)
|
$1.62 |
$1.62 |
$1.62 |
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$39.54 |
$48.27 |
$48.27 |
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$238.85 |
$248.50 |
$248.50 |
|
|
Inj, motixafortide, 0.25 mg
|
$25.22 |
$25.22 |
$25.22 |
|
|
Inj. naxitamab-gqgk, 1 mg
|
$642.15 |
$685.91 |
$685.91 |
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$729.46 |
$3,986.00 |
$6,839.00 |
|
|
Inj, nithiodote, 3mg / 125mg
|
$2.17 |
$2.17 |
$2.17 |
|
|
Inj nivolumab 2 mg hyaluron
|
$26.74 |
$26.74 |
$26.74 |
|
|
Inj, nogapendekin pmln, 1mcg
|
$92.19 |
$94.12 |
$94.12 |
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Inj, nyposi 1 mcg
|
$0.55 |
$0.55 |
$0.55 |
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$47.24 |
$47.24 |
$47.24 |
|
|
Inj ogivri 10 mg
|
$44.59 |
$44.59 |
$54.16 |
|
|
Inj, oliceridine 0.1 mg
|
$1.23 |
$1.30 |
$1.30 |
|
|
Inj olipudase alfa-rpcp 1mg
|
$382.56 |
$393.82 |
$393.82 |
|
|
Inj, omacetaxine mep, 0.01mg
|
$4.03 |
$4.03 |
$4.03 |
|
|
Inj., omadacycline, 1 mg
|
$3.80 |
$4.01 |
$4.01 |
|
|
Inj onase abepar-xioi treat
|
$2,388,614.23 |
$2,452,115.60 |
$2,452,115.60 |
|
|
Inj ontruzant 10 mg
|
$21.99 |
$21.99 |
$34.17 |
|
|
Inj, palonosetron (posfrea)
|
$58.84 |
$58.84 |
$59.74 |
|
|
Inj, panzyga, 500 mg
|
$67.46 |
$74.46 |
$74.46 |
|
|
Inj, pasireotide long acting
|
$479.84 |
$563.79 |
$563.79 |
|
|
Inj., patisiran, 0.1 mg
|
$98.88 |
$99.82 |
$99.82 |
|
|
Inj, pedmark, 100 mg
|
$95.14 |
$95.14 |
$96.08 |
|
|
Inj, pegcetacoplan, 1mg
|
$141.91 |
$141.91 |
$147.36 |
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$27.99 |
$27.99 |
$346.76 |
|
|
Inj, pegulicianine, 1 mg
|
$36.45 |
$36.45 |
$37.51 |
|
|
Inj. pemetrexed, 10 mg
|
$50.83 |
$52.74 |
$52.74 |
|
|
Inj pemetrexed (accord) 10mg
|
$9.66 |
$9.74 |
$9.74 |
|
|
Inj, pemetrexed (avyxa) 10mg
|
$83.28 |
$83.28 |
$83.28 |
|
|
Inj pemetrexed ditromethamin
|
$10.34 |
$10.34 |
$10.55 |
|
|
Inj pemetrexed, hospira 10mg
|
$0.62 |
$4.93 |
$4.93 |
|
|
Inj pemetrexed (teva) 10mg
|
$3.79 |
$3.79 |
$5.52 |
|
|
Inj, pemrydi rtu, 10 mg
|
$80.10 |
$80.10 |
$82.30 |
|
|
Inj peritoneal venous shunt
|
$4,350.00 |
$5,419.00 |
$6,311.00 |
|
|
Inj., perseris, 0.5 mg
|
$12.14 |
$12.14 |
$12.19 |
|
|
Inj plasminogen tvmh 1mg
|
$32.31 |
$32.31 |
$32.55 |
|
|
Inj., plazomicin, 5 mg
|
$3.57 |
$3.57 |
$3.59 |
|
|
Inj proc lumbr disk ea lvl
|
$3,786.00 |
$5,419.00 |
$6,311.00 |
|
|
Inj proc myelogram lumbar
|
$3,786.00 |
$5,110.00 |
$6,839.00 |
|
|
Inj proc sialogram
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
|
|
Inj recombin esperoct per iu
|
$2.17 |
$2.26 |
$2.26 |
|
|
Inj, releuko 1 mcg
|
$0.41 |
$0.41 |
$0.47 |
|
|
Inj retacrit esrd on dialysi
|
$0.76 |
$0.76 |
$0.76 |
|
|
Inj retro urethrocysto
|
$3,786.00 |
$5,110.00 |
$6,311.00 |
|
|
Inj, rimabotulinumtoxinb
|
$12.99 |
$13.34 |
$13.34 |
|
|
Inj roctavian ml 2x10^13vc g
|
$12,007.81 |
$12,368.21 |
$12,368.21 |
|