2013 HCPCS	2013 Short Description	2013 Days	2013 Units	2013 Minimum Unit Cost	2013 Maximum Unit Cost	2013 Mean Unit Cost	2013 Median Unit Cost	2013 CV of Unit Cost	Final CY 2015 XRef HCPCS/CPT Code(s)	Final CY 2015 XRef SI	Final CY 2015  XRef APC	Final CY 2015 Payment Rate
90371	Hep b ig im	645	"2,541"	$2.53	"$4,288.66"	$236.68	$148.75	$197.76	90371	K	1630	$117.38
90375	Rabies ig im/sc	"2,095"	"12,634"	$0.79	"$13,632.64"	$315.58	$200.40	$352.28	90375	K	9133	$247.57
90376	Rabies ig heat treated	772	"5,367"	$12.21	"$4,724.06"	$290.32	$208.31	$312.64	90376	K	9134	$237.82
90378	Rsv mab im 50mg	6	8	$23.82	"$4,685.62"	"$1,947.79"	$476.01	$137.99	90378	K	9003	"$1,947.79"
90385	Rh ig minidose im	6	6	$27.87	$289.44	$99.00	$67.35	$98.90	90385	N		
90396	Varicella-zoster ig im	168	168	$33.00	$391.04	$119.45	$154.60	$51.72	90396	K	9135	$119.45
90476	Adenovirus vaccine type 4	13	13	$3.38	$66.44	$25.49	$19.71	$89.34	90476	N		
90585	Bcg vaccine percut	447	447	$12.21	"$2,413.41"	$194.43	$206.59	$74.33	90585	K	9137	$121.96
90632	Hep a vaccine adult im	"6,897"	"6,897"	$7.47	$200.80	$47.86	$42.65	$53.33	90632	N		
90633	Hep a vacc ped/adol 2 dose	105	105	$5.40	$98.34	$29.17	$27.02	$63.63	90633	N		
90634	Hep a vacc ped/adol 3 dose	2	2	$13.24	$108.08	$60.66	$60.66	$110.55	90634	N		
90636	Hep a/hep b vacc adult im	"4,372"	"4,372"	$10.91	$331.15	$69.75	$59.80	$52.04	90636	N		
90644	Meningoccl hib vac 4 dose im	5	5	$10.76	$286.71	$191.85	$187.53	$58.76	90644	E		
90645	Hib vaccine hboc im	"1,281"	"1,281"	$3.31	$76.78	$23.09	$19.30	$56.75	90645	N		
90646	Hib vaccine prp-d im	187	187	$5.40	$58.29	$26.37	$27.76	$42.43	90646	N		
90647	Hib vaccine prp-omp im	546	546	$3.42	$117.56	$29.53	$22.05	$72.54	90647	N		
90648	Hib vaccine prp-t im	"2,413"	"2,413"	$2.58	$81.78	$23.16	$22.50	$55.45	90648	N		
90649	Hpv vaccine 4 valent im	282	282	$15.40	$374.07	$105.07	$95.92	$57.07	90649	M		
90650	Hpv vaccine 2 valent im	4	4	$143.44	$143.44	$143.44	$143.44	$0.00	90650	M		
90675	Rabies vaccine im	"9,920"	"9,920"	$34.23	$977.11	$217.36	$201.96	$52.29	90675	K	9139	$223.78
90676	Rabies vaccine id	77	77	$75.08	$367.15	$172.30	$183.62	$52.55	90676	K	9140	$172.30
90680	Rotovirus vacc 3 dose oral	4	4	$26.69	$156.52	$61.98	$32.36	$101.82	90680	N		
90681	Rotavirus vacc 2 dose oral	4	4	$0.19	$80.49	$38.82	$37.29	$91.70	90681	E		
90690	Typhoid vaccine oral	236	236	$4.53	$129.32	$28.15	$22.73	$61.72	90690	N		
90691	Typhoid vaccine im	900	900	$8.65	$157.55	$50.33	$43.08	$50.59	90691	N		
90692	Typhoid vaccine h-p sc/id	30	30	$14.88	$80.84	$29.68	$19.07	$79.58	90692	N		
90696	Dtap-ipv vacc 4-6 yr im	24	24	$2.62	$52.12	$25.28	$31.39	$53.37	90696	N		
90698	Dtap-hib-ip vaccine im	251	251	$8.33	$105.64	$43.81	$28.02	$68.62	90698	N		
90700	Dtap vaccine < 7 yrs im	"1,003"	"1,003"	$4.98	$196.45	$37.38	$32.18	$70.89	90700	N		
90702	Dt vaccine < 7 yrs im	305	305	$3.33	$131.52	$28.31	$22.51	$70.24	90702	N		
90703	Tetanus vaccine im	"15,404"	"15,404"	$1.13	$258.10	$27.31	$22.16	$84.95	90703	N		
90704	Mumps vaccine sc	11	11	$11.95	$49.99	$30.73	$36.27	$41.94	90704	N		
90705	Measles vaccine sc	2	2	$8.60	$74.00	$41.30	$41.30	$111.97	90705	N		
90706	Rubella vaccine sc	2	2	$10.42	$33.92	$22.17	$22.17	$74.95	90706	N		
90707	Mmr vaccine sc	"1,054"	"1,054"	$7.10	$161.55	$50.48	$46.30	$55.25	90707	N		
90708	Measles-rubella vaccine sc	3	3	$23.53	$121.98	$89.16	$121.98	$63.75	90708	N		
90710	Mmrv vaccine sc	34	36	$20.88	$150.30	$47.86	$31.80	$58.01	90710	N		
90712	Oral poliovirus vaccine	9	9	$23.30	$92.55	$41.31	$35.35	$59.38	90712	N		
90713	Poliovirus ipv sc/im	"3,487"	"3,487"	$3.42	$176.55	$29.46	$25.10	$63.83	90713	N		
90714	Td vaccine no prsrv 7/> im	"144,824"	"144,824"	$2.46	$143.22	$22.39	$20.45	$55.79	90714	N		
90715	Tdap vaccine 7 yrs/> im	"313,062"	"313,062"	$3.42	$286.44	$38.51	$35.69	$56.23	90715	N		
90716	Chicken pox vaccine sc	249	249	$17.54	$231.00	$60.30	$45.32	$61.55	90716	M		
90717	Yellow fever vaccine sc	427	427	$13.03	$369.86	$70.13	$66.82	$57.65	90717	N		
90719	Diphtheria vaccine im	"1,569"	"1,569"	$3.62	$164.36	$23.72	$16.85	$74.86	90719	N		
90720	Dtp/hib vaccine im	268	268	$11.23	$92.55	$30.49	$25.29	$58.89	90720	N		
90721	Dtap/hib vaccine im	"1,285"	"1,285"	$8.91	$60.00	$24.31	$19.53	$37.23	90721	N		
90725	Cholera vaccine injectable	1	1	$32.32	$32.32	$32.32	$32.32	.	90725	N		
90733	Meningococcal vaccine sc	"1,081"	"1,081"	$9.81	$410.64	$109.63	$105.27	$51.75	90733	K	9143	$106.49
90734	Meningococcal vaccine im	"1,683"	"1,683"	$13.69	$385.56	$109.98	$113.68	$46.81	90734	N		
90735	Encephalitis vaccine sc	37	37	$35.98	$463.72	$108.29	$82.30	$94.54	90735	K	9144	$108.29
90736	Zoster vacc sc	"8,471"	"8,471"	$16.57	$562.66	$116.39	$93.28	$60.60	90736	M		
90738	Inactivated je vacc im	32	32	$60.09	$268.50	$184.33	$186.73	$43.78	90738	M		
90749	Vaccine toxoid	504	504	$6.72	$77.65	$24.81	$25.28	$38.63	90749	N		
A4216	"Sterile water/saline, 10 ml"	"29,171"	"59,175"	$0.04	$437.04	$5.47	$2.97	$173.87	A4216	N		
A4218	Sterile saline or water	"10,959"	"30,768"	$0.17	$59.84	$3.89	$3.29	$164.99	A4218	N		
A4641	Radiopharm dx agent noc	"6,870"	"8,066"	$0.34	"$3,606.36"	$153.10	$46.94	$221.92	A4641	N		
A4642	In111 satumomab	83	83	$22.49	"$1,780.17"	$281.12	$75.05	$128.84	A4642	N		
A9500	Tc99m sestamibi	"584,003"	"1,030,737"	$2.41	"$1,451.30"	$88.27	$71.33	$98.73	A9500	N		
A9501	Technetium tc-99m teboroxime	71	80	$0.59	$518.61	$84.06	$16.49	$203.01	A9501	N		
A9502	Tc99m tetrofosmin	"299,596"	"527,714"	$3.01	"$1,094.06"	$75.48	$62.80	$99.75	A9502	N		
A9503	Tc99m medronate	"229,811"	"229,811"	$1.91	$233.03	$27.99	$20.12	$91.24	A9503	N		
A9504	Tc99m apcitide	22	22	$9.23	$639.96	$109.73	$10.15	$160.19	A9504	N		
A9505	Tl201 thallium	"43,992"	"146,110"	$0.26	$693.73	$32.34	$20.96	$228.50	A9505	N		
A9507	In111 capromab	561	561	$244.36	"$4,806.94"	"$1,269.75"	"$1,287.83"	$55.76	A9507	N		
A9508	"I131 iodobenguate, dx"	105	222	$0.12	"$2,994.96"	$321.06	$63.68	$259.05	A9508	N		
A9509	Iodine i-123 sod iodide mil	"1,548"	"3,313"	$3.76	"$2,282.95"	$165.12	$112.34	$153.16	A9509	N		
A9510	Tc99m disofenin	"5,668"	"5,668"	$4.21	$401.36	$53.06	$38.24	$91.44	A9510	N		
A9512	Tc99m pertechnetate	"12,180"	"93,509"	$0.03	"$2,237.87"	$8.22	$1.47	"$1,353.62"	A9512	N		
A9516	Iodine i-123 sod iodide mic	"26,077"	"57,477"	$0.68	"$1,199.46"	$40.36	$29.14	$180.18	A9516	N		
A9517	"I131 iodide cap, rx"	"8,007"	"355,477"	$0.01	"$12,057.68"	$17.29	$10.97	"$1,863.20"	A9517	K	1064	$17.29
A9521	Tc99m exametazime	"3,099"	"3,099"	$31.89	"$2,808.91"	$562.95	$400.31	$90.71	A9521	N		
A9524	"I131 serum albumin, dx"	373	830	$10.26	"$5,902.00"	$134.78	$28.98	$445.59	A9524	N		
A9526	Nitrogen n-13 ammonia	990	"1,864"	$26.32	"$1,571.19"	$195.35	$125.37	$216.06	A9526	N		
A9528	"Iodine i-131 iodide cap, dx"	"3,431"	"14,409"	$0.08	"$1,444.80"	$27.61	$15.29	$379.47	A9528	N		
A9529	"I131 iodide sol, dx"	374	"1,703"	$0.12	$453.82	$14.32	$11.51	$316.26	A9529	N		
A9530	"I131 iodide sol, rx"	645	"36,108"	$0.04	$369.59	$10.28	$8.72	$858.83	A9530	K	1150	$10.28
A9531	I131 max 100uci	"2,290"	"16,779"	$0.05	"$3,544.91"	$7.72	$2.61	"$1,474.82"	A9531	N		
A9532	"I125 serum albumin, dx"	46	127	$37.38	$180.02	$90.10	$84.59	$34.86	A9532	N		
A9536	Tc99m depreotide	166	166	$17.42	$345.99	$82.19	$74.55	$53.39	A9536	N		
A9537	Tc99m mebrofenin	"67,845"	"67,845"	$3.41	$314.00	$42.23	$32.23	$83.95	A9537	N		
A9538	Tc99m pyrophosphate	"3,534"	"3,534"	$2.27	$423.11	$37.90	$27.37	$101.24	A9538	N		
A9539	Tc99m pentetate	"20,519"	"24,548"	$1.25	$404.91	$32.49	$22.67	$114.41	A9539	N		
A9540	Tc99m maa	"73,874"	"73,874"	$1.46	$262.77	$27.65	$18.40	$106.77	A9540	N		
A9541	Tc99m sulfur colloid	"91,889"	"91,889"	$2.57	$582.17	$57.47	$37.94	$108.51	A9541	N		
A9542	"In111 ibritumomab, dx"	22	22	$29.58	"$4,006.62"	$910.83	$517.80	$123.73	A9542	N		
A9543	"Y90 ibritumomab, rx"	227	227	"$3,490.72"	"$90,525.29"	"$16,966.82"	"$14,542.00"	$69.35	A9543	K	1643	"$16,966.82"
A9544	"I131 tositumomab, dx"	38	38	$145.54	"$3,115.00"	$974.62	$904.02	$78.93	A9544	N		
A9545	"I131 tositumomab, rx"	21	21	"$3,341.52"	"$35,322.27"	"$11,291.53"	"$10,720.61"	$61.85	A9545	E		
A9547	In111 oxyquinoline	"2,893"	"3,072"	$37.23	"$4,172.55"	$552.10	$437.80	$79.38	A9547	N		
A9548	In111 pentetate	"3,403"	"4,488"	$16.73	"$4,149.11"	$434.35	$325.62	$105.23	A9548	N		
A9550	Tc99m gluceptate	48	48	$0.53	$136.05	$25.19	$12.44	$121.01	A9550	N		
A9551	Tc99m succimer	304	304	$16.67	$665.09	$149.92	$152.98	$64.34	A9551	N		
A9552	F18 fdg	"326,140"	"326,140"	$19.74	"$1,703.67"	$225.62	$188.75	$65.05	A9552	N		
A9553	Cr51 chromate	43	43	$29.52	$767.09	$284.13	$229.26	$77.44	A9553	N		
A9554	"I125 iothalamate, dx"	484	484	$12.75	"$1,148.49"	$110.83	$137.94	$91.39	A9554	N		
A9555	Rb82 rubidium	"14,986"	"29,972"	$4.55	"$2,363.68"	$204.21	$130.92	$151.68	A9555	N		
A9556	Ga67 gallium	"1,370"	"7,162"	$0.28	$504.01	$29.72	$18.02	$310.24	A9556	N		
A9557	Tc99m bicisate	437	437	$70.38	"$1,998.56"	$580.60	$573.25	$63.11	A9557	N		
A9558	Xe133 xenon 10mci	"36,668"	"48,398"	$1.66	$416.89	$39.95	$28.91	$106.41	A9558	N		
A9559	Co57 cyano	55	55	$0.42	$19.79	$2.08	$0.42	$215.78	A9559	N		
A9560	Tc99m labeled rbc	"19,152"	"19,152"	$3.21	$887.51	$78.57	$57.84	$110.36	A9560	N		
A9561	Tc99m oxidronate	"46,310"	"46,310"	$1.31	$318.11	$29.97	$21.17	$100.30	A9561	N		
A9562	Tc99m mertiatide	"19,349"	"19,349"	$11.02	"$1,083.66"	$154.64	$123.83	$77.48	A9562	N		
A9563	P32 na phosphate	18	65	$0.85	$822.73	$213.56	$47.58	$251.91	A9563	K	1675	$213.56
A9564	P32 chromic phosphate	5	19	$6.56	"$1,036.82"	$906.62	"$1,036.82"	$70.01	A9564	K	1676	$906.62
A9566	Tc99m fanolesomab	4	4	$31.59	$436.81	$234.20	$234.20	$99.90	A9566	N		
A9567	Technetium tc-99m aerosol	"12,854"	"12,854"	$2.31	$351.67	$39.00	$27.55	$101.47	A9567	N		
A9568	Technetium tc99m arcitumomab	377	378	$14.43	$21.51	$15.54	$14.43	$11.28	A9568	N		
A9569	Technetium tc-99m auto wbc	"1,305"	"1,305"	$57.87	"$3,098.75"	$649.85	$563.03	$68.00	A9569	N		
A9570	Indium in-111 auto wbc	"1,795"	"1,795"	$15.09	"$6,234.46"	$717.94	$583.53	$73.52	A9570	N		
A9571	Indium in-111 auto platelet	10	12	$64.83	"$1,419.02"	$553.05	$502.14	$95.42	A9571	N		
A9572	Indium in-111 pentetreotide	"5,612"	"5,938"	$69.18	"$8,185.85"	"$1,331.57"	"$1,075.32"	$77.85	A9572	N		
A9576	Inj prohance multipack	"10,469"	"173,534"	$0.05	$255.73	$3.30	$2.57	$700.67	A9576	N		
A9577	Inj multihance	"137,928"	"2,093,743"	$0.01	$188.92	$3.95	$3.02	$340.45	A9577	N		
A9578	Inj multihance multipack	"14,473"	"208,393"	$0.61	$24.00	$6.85	$6.80	$253.15	A9578	N		
A9579	"Gad-base mr contrast nos,1ml"	"402,542"	"6,915,242"	$0.01	$295.70	$3.73	$2.95	$387.44	A9579	N		
A9580	Sodium fluoride f-18	"1,513"	"1,513"	$21.59	$641.24	$137.47	$112.38	$71.39	A9580	N		
A9581	Gadoxetate disodium inj	"12,151"	"128,456"	$0.02	$202.14	$12.95	$11.10	$237.47	A9581	N		
A9582	Iodine i-123 iobenguane	402	402	$13.81	"$6,504.30"	"$1,380.34"	"$1,130.17"	$78.60	A9582	N		
A9583	Gadofosveset trisodium inj	"1,416"	"14,719"	$0.72	$46.81	$10.26	$8.19	$188.08	A9583	N		
A9584	Iodine i-123 ioflupane	"5,774"	"5,774"	$226.31	"$4,232.51"	"$1,118.85"	"$1,012.92"	$59.35	A9584	N		
A9585	Gadobutrol injection	"140,760"	"10,209,417"	$0.01	$169.84	$0.79	$0.57	"$1,245.79"	A9585	N		
A9600	Sr89 strontium	37	89	$9.75	"$17,419.05"	"$1,345.01"	$883.22	$225.04	A9600	K	0701	"$1,345.01"
A9604	Sm 153 lexidronam	333	333	$301.88	"$14,266.56"	"$3,294.58"	"$2,844.39"	$65.31	A9604	K	1295	"$3,294.58"
A9698	Non-rad contrast materialnoc	"6,258"	"10,670"	$0.24	$679.36	$22.46	$11.40	$233.90	A9698	N		
A9699	Radiopharm rx agent noc	414	414	$5.95	"$19,292.40"	"$6,111.87"	"$5,497.57"	$59.99	A9699	N		
C1204	Tc 99m tilmanocept	231	231	$4.37	"$2,584.56"	$237.25	$175.05	$116.56	A9520	G	1463	$240.00
C9113	"Inj pantoprazole sodium, via"	"266,893"	"309,975"	$1.17	$103.11	$13.63	$10.79	$79.84	C9113	N		
C9121	"Injection, argatroban"	285	"10,706"	$0.26	"$1,570.96"	$21.13	$18.59	"$1,137.98"	C9121	K	9121	$21.13
C9130	"Injection, ivig bivigam"	4	280	$20.99	$37.10	$35.25	$37.10	$128.26	J1556	G	9130	$36.21
C9131	In ado-trastuzumab emtansine	"2,745"	"721,725"	$0.32	"$1,171.94"	$25.52	$23.85	"$1,375.76"	J9354	G	9131	$29.14
C9132	"Kcentra, per i.u."	56	"113,278"	$0.20	"$1,054.07"	$1.39	$1.24	"$28,851.37"	C9132	G	9132	$1.39
C9248	"Inj, clevidipine butyrate"	51	"1,233"	$0.23	$463.58	$4.22	$3.28	"$1,661.67"	C9248	K	9248	$4.22
C9250	Artiss fibrin sealant	458	851	$33.06	"$1,078.95"	$217.54	$206.05	$86.87	C9250	N		
C9254	"Injection, lacosamide"	475	"114,540"	$0.02	$263.37	$0.26	$0.18	"$7,258.57"	C9254	N		
C9257	Bevacizumab injection	"40,354"	"321,123"	$0.23	"$1,089.11"	$6.96	$4.07	$471.58	C9257	K	1281	$6.96
C9275	Hexaminolevulinate hcl	480	488	$7.00	"$2,367.87"	$598.70	$659.48	$51.15	C9275	N		
C9285	"Patch, lidocaine/tetracaine"	654	"1,005"	$3.19	$38.30	$11.56	$9.62	$52.14	C9285	N		
C9290	"Inj, bupivacaine liposome"	"10,290"	"2,296,957"	$0.03	"$6,975.51"	$1.27	$0.90	"$19,385.56"	C9290	N		
C9292	"Injection, pertuzumab"	"5,218"	"247,324"	$1.19	"$1,091.88"	$91.71	$84.40	$341.62	J9306	K	1471	$10.22
C9293	"Injection, glucarpidase"	1	400	$223.85	$223.85	$223.85	$223.85	.	C9293	K	9293	$223.85
C9294	"Inj, taliglucerase alfa"	74	"32,780"	$2.29	$31.68	$17.74	$17.18	"$1,329.26"	J3060	G	9294	$31.94
C9295	"Injection, carfilzomib"	"35,991"	"1,999,492"	$0.18	$202.50	$27.11	$25.02	$370.13	J9047	G	9295	$29.81
C9296	"Injection, ziv-aflibercept"	"2,230"	"715,400"	$0.68	$103.17	$13.10	$12.02	"$1,109.46"	J9400	G	9296	$8.12
C9297	Omacetaxine mepesuccinate	357	"156,157"	$0.69	$7.76	$2.82	$2.23	"$1,245.54"	J9262	G	9297	$2.48
C9298	"Injection, ocriplasmin"	107	370	$229.32	"$6,150.02"	$991.81	$786.65	$121.19	J7316	G	9298	"$1,046.75"
C9352	"Neuragen nerve guide, per cm"	111	194	$302.56	"$5,478.05"	"$1,076.51"	$830.32	$91.31	C9352	N		
C9353	"Neurawrap nerve protector,cm"	81	149	$98.87	"$6,113.95"	"$1,043.51"	$537.06	$117.20	C9353	N		
C9354	"Veritas collagen matrix, cm2"	86	"1,780"	$15.74	"$4,262.76"	$85.35	$33.19	"$1,524.26"	C9354	N		
C9355	"Neuromatrix nerve cuff, cm"	19	92	$41.18	"$4,789.07"	$401.75	$256.73	$382.65	C9355	N		
C9356	"Tenoglide tendon prot, cm2"	85	"1,111"	$1.10	"$5,776.34"	$148.16	$35.48	"$1,341.47"	C9356	N		
C9358	"Surgimend, fetal"	176	"14,222"	$1.01	"$8,255.52"	$15.41	$8.27	"$8,305.94"	C9358	N		
C9359	"Implnt,bon void filler-putty"	701	"1,329"	$14.29	"$6,392.94"	$523.77	$213.82	$186.02	C9359	N		
C9360	"Surgimend, neonatal"	40	"8,789"	$3.04	"$2,584.30"	$9.95	$5.42	"$5,396.07"	C9360	N		
C9361	Neuromend nerve wrap	66	325	$24.61	"$2,988.38"	$189.74	$62.56	$427.47	C9361	N		
C9362	"Implnt,bon void filler-strip"	128	314	$25.15	"$5,690.43"	$314.51	$224.77	$240.02	C9362	N		
C9363	Integra meshed bil wound mat	321	"10,181"	$1.62	"$6,523.02"	$74.74	$24.63	"$2,323.49"	C9363	N		
C9364	"Porcine implant, permacol"	131	"8,548"	$3.86	"$5,172.20"	$27.72	$16.73	"$3,857.19"	C9364	N		
J0120	Tetracyclin injection	5	19	$4.60	"$1,547.14"	$97.97	$18.76	$759.88	J0120	K	1666	$97.97
J0129	Abatacept injection	"48,810"	"3,689,299"	$0.02	$357.41	$21.80	$20.17	$433.81	J0129	K	9230	$32.25
J0130	Abciximab injection	929	"2,339"	$70.34	"$2,724.61"	$612.63	$538.83	$95.28	J0130	K	1605	$739.17
J0131	Acetaminophen injection	"194,928"	"21,325,537"	$0.01	"$1,105.48"	$0.22	$0.16	"$4,643.33"	J0131	N		
J0132	Acetylcysteine injection	"1,904"	"160,570"	$0.02	$444.27	$3.26	$2.16	"$2,034.34"	J0132	K	1272	$2.19
J0133	Acyclovir injection	"2,319"	"492,252"	$0.01	$108.07	$0.27	$0.14	"$5,832.34"	J0133	N		
J0135	Adalimumab injection	252	506	$137.35	"$1,707.09"	$543.97	$613.79	$65.73	J0135	K	1083	$570.94
J0150	Injection adenosine 6 mg	"26,209"	"85,358"	$0.14	$613.28	$18.01	$11.22	$247.64	J0153	N		
J0152	Adenosine injection	"35,174"	"89,962"	$3.39	"$1,934.95"	$104.17	$87.18	$118.39	J0153	N		
J0171	Adrenalin epinephrine inject	"328,649"	"6,579,392"	$0.01	$866.35	$0.58	$0.19	"$1,910.33"	J0171	N		
J0178	Aflibercept injection	"29,233"	"64,029"	$126.60	"$2,715.26"	$813.21	$877.43	$59.50	J0178	K	1420	$980.50
J0180	Agalsidase beta injection	"2,878"	"227,311"	$0.30	$531.85	$122.97	$112.25	$398.78	J0180	K	9208	$152.35
J0200	Alatrofloxacin mesylate	1	6	$38.86	$38.86	$38.86	$38.86	.	J0200	K	1667	$38.86
J0205	Alglucerase injection	3	428	$55.25	$55.25	$55.25	$55.25	$0.00	J0205	E		
J0207	Amifostine	"1,732"	"1,810"	$109.81	"$3,462.09"	$714.09	$575.81	$67.11	J0207	K	7000	$310.72
J0210	Methyldopate hcl injection	2	2	$1.85	$13.59	$7.72	$7.72	$107.53	J0210	N		
J0220	Alglucosidase alfa injection	33	"4,802"	$57.77	$169.53	$132.88	$161.01	$425.75	J0220	K	9234	$206.63
J0221	Lumizyme injection	"1,755"	"277,909"	$18.68	$464.82	$128.26	$122.22	$709.18	J0221	K	1413	$153.64
J0256	Alpha 1 proteinase inhibitor	"19,577"	"10,882,449"	$0.01	$72.28	$3.58	$3.15	"$1,472.01"	J0256	K	0901	$4.11
J0257	Glassia injection	"1,603"	"752,622"	$0.02	$75.11	$3.61	$3.26	"$2,502.20"	J0257	K	1415	$3.98
J0278	Amikacin sulfate injection	"6,853"	"51,482"	$0.01	$257.50	$4.36	$1.77	$587.19	J0278	N		
J0280	Aminophyllin 250 mg inj	"45,914"	"56,217"	$0.09	$104.24	$5.11	$3.23	$126.72	J0280	N		
J0282	Amiodarone hcl	"16,076"	"242,170"	$0.01	$667.45	$2.77	$1.08	$914.48	J0282	N		
J0285	Amphotericin b	841	"1,081"	$1.11	$268.60	$33.06	$23.31	$152.42	J0285	N		
J0287	Amphotericin b lipid complex	598	"18,314"	$2.41	$144.83	$18.56	$19.23	$230.26	J0287	K	9024	$10.41
J0288	Ampho b cholesteryl sulfate	5	5	$29.06	$29.06	$29.06	$29.06	$0.00	J0288	N		
J0289	Amphotericin b liposome inj	"2,964"	"96,748"	$2.17	$147.20	$26.84	$26.94	$303.62	J0289	K	0736	$16.83
J0290	Ampicillin 500 mg inj	"19,722"	"75,501"	$0.05	$198.76	$5.65	$3.97	$193.37	J0290	N		
J0295	Ampicillin sodium per 1.5 gm	"38,036"	"102,937"	$0.24	$164.26	$9.13	$7.18	$137.68	J0295	N		
J0300	Amobarbital 125 mg inj	127	514	$0.33	$893.77	$146.51	$124.05	$179.10	J0300	K	1341	$146.51
J0330	Succinycholine chloride inj	"316,714"	"2,412,237"	$0.01	$667.66	$1.25	$0.67	$571.02	J0330	N		
J0348	Anidulafungin injection	480	"45,309"	$0.51	$489.31	$2.54	$2.22	"$3,283.93"	J0348	N		
J0360	Hydralazine hcl injection	"191,185"	"214,327"	$1.65	$76.00	$13.39	$12.21	$59.55	J0360	N		
J0380	Inj metaraminol bitartrate	158	177	$6.42	$6.43	$6.42	$6.42	$0.07	J0380	N		
J0390	Chloroquine injection	7	40	$0.44	$38.81	$10.69	$1.05	$376.49	J0390	N		
J0400	Aripiprazole injection	444	"33,636"	$0.10	"$2,173.90"	$1.06	$0.60	"$16,263.48"	J0400	N		
J0456	Azithromycin	"61,565"	"66,379"	$1.47	$157.68	$20.25	$15.28	$83.63	J0456	N		
J0461	Atropine sulfate injection	"108,567"	"8,517,159"	$0.01	$806.08	$0.14	$0.07	"$4,022.81"	J0461	N		
J0470	Dimecaprol injection	5	8	$0.37	"$1,850.81"	$706.06	$47.48	$177.64	J0470	N		
J0475	Baclofen 10 mg injection	"13,336"	"63,091"	$0.79	"$3,624.51"	$198.49	$175.54	$152.32	J0475	K	9032	$162.80
J0476	Baclofen intrathecal trial	446	610	$3.07	"$1,324.51"	$119.94	$81.35	$176.99	J0476	K	1631	$76.29
J0480	Basiliximab	283	283	$511.45	"$4,922.15"	"$2,053.09"	"$1,951.38"	$42.57	J0480	K	1683	"$2,716.18"
J0485	Belatacept injection	"4,111"	"2,108,955"	$0.24	$44.25	$3.24	$2.90	$877.69	J0485	K	9286	$3.81
J0490	Belimumab injection	"5,642"	"479,535"	$0.68	$606.69	$34.97	$33.12	$521.34	J0490	K	1353	$39.48
J0500	Dicyclomine injection	"20,224"	"20,868"	$1.64	$232.96	$31.32	$27.05	$64.37	J0500	N		
J0515	Inj benztropine mesylate	"4,287"	"8,153"	$0.12	$967.49	$34.09	$29.10	$134.94	J0515	N		
J0520	Bethanechol chloride inject	7	21	$1.55	$1.55	$1.55	$1.55	$0.00	J0520	N		
J0558	Peng benzathine/procaine inj	956	"10,996"	$0.04	$95.35	$4.45	$3.11	$523.29	J0558	N		
J0561	Penicillin g benzathine inj	"7,317"	"93,531"	$0.01	$339.73	$5.23	$4.16	$514.39	J0561	N		
J0583	Bivalirudin	"90,290"	"25,626,185"	$0.01	"$2,348.36"	$2.47	$2.29	"$1,613.38"	J0583	K	3041	$3.42
J0585	"Injection,onabotulinumtoxina"	"50,100"	"9,998,822"	$0.01	"$1,529.53"	$5.10	$4.73	"$1,461.22"	J0585	K	0902	$5.56
J0586	Abobotulinumtoxina	501	"69,240"	$0.66	$33.39	$5.70	$4.97	$612.93	J0586	K	1289	$7.43
J0587	"Inj, rimabotulinumtoxinb"	"1,661"	"119,356"	$0.76	"$1,303.74"	$11.22	$8.22	"$1,513.20"	J0587	K	9018	$11.30
J0588	Incobotulinumtoxin a	871	"150,198"	$0.01	$74.15	$4.85	$4.22	$802.70	J0588	K	9278	$4.48
J0592	Buprenorphine hydrochloride	"3,586"	"13,055"	$0.66	$237.82	$7.44	$4.74	$262.32	J0592	N		
J0594	Busulfan injection	89	"11,328"	$6.54	$47.19	$26.60	$27.16	$388.59	J0594	K	1178	$28.94
J0595	Butorphanol tartrate 1 mg	"8,410"	"16,786"	$0.31	$58.34	$4.87	$3.87	$109.96	J0595	N		
J0597	"C-1 esterase, berinert"	108	"15,761"	$10.14	"$2,576.04"	$40.26	$34.74	"$3,736.98"	J0597	K	9269	$37.64
J0598	"C-1 esterase, cinryze"	169	"17,550"	$9.44	"$1,167.05"	$45.42	$53.42	$618.30	J0598	K	9251	$51.86
J0600	Edetate calcium disodium inj	15	17	$21.65	$171.85	$80.54	$76.48	$56.50	J0600	K	1274	"$3,477.51"
J0610	Calcium gluconate injection	"51,393"	"123,846"	$0.04	$150.75	$5.49	$3.60	$180.85	J0610	N		
J0620	Calcium glycer & lact/10 ml	20	36	$12.60	$21.15	$17.50	$17.89	$16.80	J0620	N		
J0636	Inj calcitriol per 0.1 mcg	"1,455"	"33,463"	$0.04	$96.68	$1.51	$1.62	$752.39	J0636	N		
J0637	Caspofungin acetate	"3,638"	"37,797"	$0.33	$318.36	$34.79	$37.62	$160.80	J0637	K	9019	$11.84
J0638	Canakinumab injection	2	300	$18.08	$18.08	$18.08	$18.08	$0.00	J0638	K	1311	$90.96
J0640	Leucovorin calcium injection	"104,378"	"1,235,570"	$0.03	$547.99	$7.38	$4.89	$507.73	J0640	N		
J0641	Levoleucovorin injection	"9,275"	"5,849,891"	$0.01	$19.42	$1.85	$1.71	"$1,365.40"	J0641	K	1236	$1.77
J0670	Inj mepivacaine hcl/10 ml	"21,504"	"64,235"	$0.15	$62.71	$3.99	$2.82	$164.42	J0670	N		
J0690	Cefazolin sodium injection	"1,314,251"	"4,123,728"	$0.04	$313.50	$5.49	$4.04	$176.47	J0690	N		
J0692	Cefepime hcl for injection	"52,743"	"224,015"	$0.18	$199.63	$9.36	$7.53	$181.00	J0692	N		
J0694	Cefoxitin sodium injection	"36,619"	"71,620"	$1.15	$144.19	$14.53	$12.65	$87.59	J0694	N		
J0696	Ceftriaxone sodium injection	"691,781"	"3,203,226"	$0.01	$784.07	$6.24	$4.20	$260.04	J0696	N		
J0697	Sterile cefuroxime injection	"17,051"	"35,573"	$0.88	$105.13	$9.79	$8.27	$100.28	J0697	N		
J0698	Cefotaxime sodium injection	"4,071"	"5,756"	$0.49	$128.76	$19.37	$9.93	$117.35	J0698	N		
J0702	Betamethasone acet&sod phosp	"82,398"	"325,192"	$0.11	$165.15	$6.81	$4.83	$209.48	J0702	N		
J0706	Caffeine citrate injection	"1,482"	"47,129"	$0.03	$180.06	$2.40	$2.08	$669.80	J0706	N		
J0712	Ceftaroline fosamil inj	"5,580"	"507,781"	$0.02	$135.11	$0.88	$0.80	"$2,344.80"	J0712	N		
J0713	Inj ceftazidime per 500 mg	"16,024"	"58,310"	$0.23	$216.13	$7.68	$5.89	$202.58	J0713	N		
J0715	Ceftizoxime sodium / 500 mg	913	"2,326"	$0.92	$108.63	$8.26	$6.86	$207.57	J0715	N		
J0716	Centruroides immune f(ab)	23	47	$552.63	"$3,111.69"	"$1,210.30"	$616.84	$103.67	J0716	K	1431	"$1,210.30"
J0718	Certolizumab pegol inj	"5,499"	"2,004,940"	$0.04	$41.12	$4.25	$3.21	"$1,503.10"	J0717	K	1474	$6.56
J0720	Chloramphenicol sodium injec	81	88	$2.29	$90.91	$26.00	$21.49	$80.46	J0720	N		
J0725	Chorionic gonadotropin/1000u	5	36	$2.24	$10.78	$8.29	$10.78	$138.16	J0725	K	1668	$18.07
J0735	Clonidine hydrochloride	"6,121"	"12,129"	$0.03	$838.78	$24.74	$14.02	$201.26	J0735	N		
J0740	Cidofovir injection	"2,003"	"2,003"	$0.84	"$2,673.08"	$489.10	$533.00	$76.69	J0740	K	9033	$588.10
J0743	Cilastatin sodium injection	"8,781"	"33,837"	$0.63	$399.91	$17.90	$15.31	$140.07	J0743	N		
J0744	Ciprofloxacin iv	"129,910"	"285,241"	$0.08	$147.90	$9.20	$6.43	$143.95	J0744	N		
J0745	Inj codeine phosphate /30 mg	457	731	$0.52	$1.93	$0.98	$0.99	$12.32	J0745	N		
J0760	Colchicine injection	24	43	$0.27	$24.65	$5.19	$2.03	$190.44	J0760	N		
J0770	Colistimethate sodium inj	"1,444"	"2,699"	$5.87	$127.24	$28.75	$24.64	$74.67	J0770	N		
J0775	"Collagenase, clost hist inj"	613	"52,049"	$0.31	$534.55	$36.83	$33.05	$606.25	J0775	K	1340	$38.26
J0780	Prochlorperazine injection	"36,520"	"38,498"	$1.01	$54.70	$9.45	$7.59	$68.79	J0780	N		
J0795	Corticorelin ovine triflutal	25	"2,303"	$2.63	$287.60	$6.42	$6.04	$950.82	J0795	K	1684	$7.72
J0800	Corticotropin injection	5	5	$4.51	$117.38	$49.76	$28.08	$105.98	J0800	K	1280	"$3,324.92"
J0833	Cosyntropin injection nos	"1,298"	"1,298"	$10.73	$215.81	$84.68	$82.94	$51.16	J0833	K	0835	$84.68
J0834	Cosyntropin cortrosyn inj	"8,505"	"8,505"	$10.04	$616.04	$95.11	$88.85	$56.45	J0834	N		
J0840	Crotalidae poly immune fab	143	751	$210.50	"$5,380.05"	"$1,654.87"	"$1,492.01"	$128.58	J0840	K	9274	"$2,493.12"
J0850	Cytomegalovirus imm iv /vial	691	"2,261"	$269.61	"$2,806.55"	$982.00	$876.09	$66.67	J0850	K	0903	"$1,013.87"
J0878	Daptomycin injection	"154,769"	"94,277,577"	$0.04	$87.57	$0.59	$0.53	"$1,498.80"	J0878	K	9124	$0.67
J0881	"Darbepoetin alfa, non-esrd"	"160,270"	"31,146,739"	$0.03	$282.54	$4.62	$4.35	$680.94	J0881	K	1685	$3.77
J0885	"Epoetin alfa, non-esrd"	"219,175"	"6,806,417"	$0.21	"$1,051.24"	$13.55	$13.28	$338.27	J0885	K	1686	$11.65
J0894	Decitabine injection	"37,549"	"1,687,862"	$0.07	$106.89	$30.32	$28.30	$297.45	J0894	K	9231	$28.25
J0895	Deferoxamine mesylate inj	"11,184"	"50,718"	$0.18	$664.67	$16.09	$13.14	$158.89	J0895	N		
J0897	Denosumab injection	"154,358"	"15,051,704"	$0.02	"$2,105.68"	$12.41	$11.61	$568.57	J0897	K	9272	$14.45
J0945	Brompheniramine maleate inj	15	16	$1.18	$16.04	$3.04	$1.18	$172.97	J0945	N		
J1000	Depo-estradiol cypionate inj	950	"1,178"	$0.31	$63.23	$8.81	$3.00	$178.50	J1000	N		
J1020	Methylprednisolone 20 mg inj	"20,753"	"59,681"	$0.24	$47.38	$3.90	$3.40	$125.25	J1020	N		
J1030	Methylprednisolone 40 mg inj	"209,263"	"319,508"	$0.51	$73.70	$8.44	$7.42	$83.96	J1030	N		
J1040	Methylprednisolone 80 mg inj	"240,394"	"263,578"	$1.51	$86.57	$13.84	$12.26	$64.25	J1040	N		
J1050	Medroxyprogesterone acetate	"9,777"	"1,345,003"	$0.02	"$1,377.24"	$0.37	$0.28	"$5,667.28"	J1050	N		
J1070	Testosterone cypionat 100 mg	"5,128"	"8,546"	$0.65	$58.48	$9.29	$5.65	$133.38	J1071	N		
J1080	Testosterone cypionat 200 mg	"38,999"	"45,797"	$0.60	$123.90	$15.25	$11.46	$89.22	J1071	N		
J1094	Inj dexamethasone acetate	"18,546"	"172,173"	$0.02	$201.06	$1.92	$1.29	$484.49	J1094	N		
J1100	Dexamethasone sodium phos	"1,372,641"	"14,499,095"	$0.01	$663.67	$0.84	$0.49	$570.17	J1100	N		
J1110	Inj dihydroergotamine mesylt	"3,062"	"4,072"	$2.51	$478.90	$52.75	$43.50	$90.78	J1110	N		
J1120	Acetazolamid sodium injectio	"5,270"	"5,944"	$4.69	$251.30	$43.27	$39.72	$58.24	J1120	N		
J1160	Digoxin injection	"11,052"	"13,753"	$0.27	$65.56	$6.22	$4.66	$97.39	J1160	N		
J1162	Digoxin immune fab (ovine)	254	612	$0.77	"$4,904.45"	$659.58	$555.54	$121.99	J1162	K	1687	"$2,051.63"
J1165	Phenytoin sodium injection	"9,928"	"137,757"	$0.05	$283.03	$1.57	$0.93	$533.56	J1165	N		
J1170	Hydromorphone injection	"1,364,295"	"2,267,238"	$0.15	$158.42	$7.01	$4.93	$124.83	J1170	N		
J1180	Dyphylline injection	2	9	$0.27	$3.43	$0.62	$0.27	$479.67	J1180	E		
J1190	Dexrazoxane hcl injection	659	"2,732"	$0.26	$820.95	$220.83	$191.94	$116.06	J1190	K	0726	$144.86
J1200	Diphenhydramine hcl injectio	"913,736"	"963,580"	$0.17	$79.87	$5.85	$3.89	$108.24	J1200	N		
J1205	Chlorothiazide sodium inj	"1,122"	"1,274"	$0.40	$755.80	$172.85	$186.82	$71.74	J1205	K	0747	$122.65
J1212	Dimethyl sulfoxide 50% 50 ml	"1,108"	"1,108"	$9.04	$304.10	$76.30	$74.74	$57.14	J1212	N		
J1230	Methadone injection	413	"1,098"	$0.15	$148.65	$8.93	$5.95	$238.23	J1230	N		
J1240	Dimenhydrinate injection	"2,347"	"2,347"	$2.43	$36.35	$11.51	$11.48	$43.21	J1240	N		
J1245	Dipyridamole injection	"23,599"	"115,095"	$0.03	"$1,063.57"	$9.81	$4.34	$361.72	J1245	N		
J1250	Inj dobutamine hcl/250 mg	"52,202"	"77,767"	$0.76	$227.10	$18.43	$13.66	$109.11	J1250	N		
J1260	Dolasetron mesylate	"1,825"	"2,888"	$1.47	$58.99	$15.65	$12.47	$74.33	J1260	N		
J1265	Dopamine injection	"10,771"	"136,305"	$0.02	$463.97	$2.16	$1.54	$732.61	J1265	N		
J1267	Doripenem injection	"2,465"	"192,976"	$0.01	$95.35	$0.91	$0.73	"$2,508.76"	J1267	N		
J1270	"Injection, doxercalciferol"	"3,488"	"13,801"	$0.35	$312.28	$7.87	$5.45	$296.04	J1270	N		
J1290	Ecallantide injection	35	"1,210"	$130.67	$472.01	$230.22	$253.56	$232.77	J1290	K	9263	$375.64
J1300	Eculizumab injection	"4,297"	"430,261"	$0.16	$742.47	$178.04	$166.35	$540.48	J1300	K	9236	$206.14
J1320	Amitriptyline injection	79	133	$0.26	$9.25	$2.51	$1.55	$114.31	J1320	N		
J1324	Enfuvirtide injection	13	641	$0.65	$69.49	$18.63	$31.01	$618.03	J1324	K	1361	$18.63
J1325	Epoprostenol injection	332	"1,612"	$2.49	$642.22	$28.90	$23.93	$210.47	J1325	N		
J1327	Eptifibatide injection	"14,163"	"300,409"	$0.03	"$2,509.82"	$24.09	$21.16	$463.23	J1327	K	1607	$24.09
J1330	Ergonovine maleate injection	2	3	$4.25	$9.69	$6.06	$4.25	$73.26	J1330	N		
J1335	Ertapenem injection	"149,443"	"285,783"	$3.66	$330.66	$40.35	$36.51	$75.26	J1335	N		
J1364	Erythro lactobionate /500 mg	"1,378"	"3,180"	$0.41	$120.48	$20.43	$16.72	$119.74	J1364	K	1669	$45.01
J1380	Estradiol valerate 10 mg inj	713	"2,491"	$0.66	$226.96	$8.21	$5.72	$242.79	J1380	N		
J1410	Inj estrogen conjugate 25 mg	179	231	$1.92	$460.97	$106.45	$100.30	$77.74	J1410	K	9038	$180.14
J1430	Ethanolamine oleate 100 mg	91	196	$15.88	$661.59	$194.60	$158.97	$99.52	J1430	K	1688	$311.06
J1436	Etidronate disodium inj	7	7	$1.61	$108.32	$36.45	$9.76	$132.53	J1436	N		
J1438	Etanercept injection	507	909	$51.24	$611.71	$189.91	$194.24	$62.44	J1438	K	1608	$285.27
J1440	Filgrastim 300 mcg injection	"70,941"	"75,360"	$51.84	"$1,016.88"	$263.08	$238.03	$47.72	J1442	K	1469	$0.99
J1441	Filgrastim 480 mcg injection	"83,326"	"83,326"	$79.93	"$1,530.94"	$403.49	$378.36	$45.80	J1442	K	1469	$0.99
J1450	Fluconazole	"8,054"	"9,911"	$0.86	$321.81	$26.81	$14.53	$135.67	J1450	N		
J1451	"Fomepizole, 15 mg"	29	"2,685"	$1.88	$797.89	$9.45	$8.43	"$1,617.16"	J1451	K	1689	$9.45
J1452	Intraocular fomivirsen na	3	4	$11.65	$51.43	$21.60	$11.65	$112.81	J1452	N		
J1453	Fosaprepitant injection	"117,349"	"17,583,705"	$0.04	$28.08	$1.85	$1.65	$764.68	J1453	K	9242	$1.73
J1455	Foscarnet sodium injection	"1,433"	"8,998"	$0.96	$440.97	$37.50	$41.31	$134.37	J1455	N		
J1457	Gallium nitrate injection	30	567	$1.89	$1.89	$1.89	$1.89	$0.00	J1457	N		
J1458	Galsulfase injection	87	"6,525"	$280.38	$387.19	$348.75	$356.33	$81.94	J1458	K	9224	$359.12
J1459	Inj ivig privigen 500 mg	"51,614"	"4,049,097"	$0.21	$912.44	$39.00	$36.49	$480.75	J1459	K	1214	$37.03
J1460	Gamma globulin 1 cc inj	367	"1,130"	$0.45	"$5,742.82"	$43.29	$17.38	$849.58	J1460	N		
J1557	Gammaplex injection	181	"10,088"	$24.68	$73.76	$35.77	$34.99	$236.83	J1557	K	9270	$35.84
J1559	Hizentra injection	138	"22,540"	$4.96	$9.79	$8.86	$9.54	$183.37	J1559	K	1312	$7.94
J1560	Gamma globulin > 10 cc inj	7	7	$59.98	"$1,212.15"	$403.60	$93.65	$136.91	J1560	N		
J1561	Gamunex-c/gammaked	"44,241"	"3,547,058"	$0.09	$932.59	$43.75	$41.88	$428.65	J1561	K	0948	$40.02
J1562	"Vivaglobin, inj"	2	126	$2.85	$7.63	$7.40	$7.63	$154.36	J1562	E		
J1566	"Immune globulin, powder"	"13,167"	"939,047"	$0.07	$326.07	$35.48	$31.85	$464.29	J1566	K	2731	$26.75
J1568	Octagam injection	"16,463"	"1,176,363"	$0.01	$845.63	$34.13	$32.19	$526.07	J1568	K	0943	$36.92
J1569	Gammagard liquid injection	"44,371"	"3,317,816"	$0.21	"$3,492.27"	$44.80	$41.74	$395.61	J1569	K	0944	$39.36
J1570	Ganciclovir sodium injection	"3,193"	"3,762"	$9.47	$484.17	$89.30	$80.77	$59.65	J1570	N		
J1571	Hepagam b im injection	203	"2,615"	$1.09	$132.66	$57.06	$53.92	$118.99	J1571	K	0946	$53.70
J1572	Flebogamma injection	"21,806"	"1,609,201"	$0.19	$261.21	$36.65	$34.43	$396.01	J1572	K	0947	$37.76
J1573	"Hepagam b intravenous, inj"	716	"35,544"	$2.53	$491.73	$68.11	$60.36	$373.13	J1573	K	1138	$68.11
J1580	Garamycin gentamicin inj	"170,845"	"265,107"	$0.12	$182.66	$7.50	$4.81	$144.71	J1580	N		
J1590	Gatifloxacin injection	3	5	$15.86	$45.58	$21.80	$15.86	$86.21	J1590	N		
J1595	Injection glatiramer acetate	202	202	$16.91	"$2,572.68"	$188.39	$93.52	$183.40	J1595	K	1015	$188.39
J1599	"Ivig non-lyophilized, nos"	322	"24,015"	$0.64	$462.61	$49.89	$56.19	$399.90	J1599	N		
J1600	Gold sodium thiomaleate inj	4	17	$0.40	$18.95	$4.27	$5.44	$273.79	J1600	K	1742	$4.27
J1610	Glucagon hydrochloride/1 mg	"53,170"	"58,851"	$12.22	$576.35	$104.29	$95.41	$60.26	J1610	K	9042	$146.07
J1620	Gonadorelin hydroch/ 100 mcg	1	2	$232.83	$232.83	$232.83	$232.83	.	J1620	E		
J1626	Granisetron hcl injection	"87,661"	"752,886"	$0.08	$432.34	$5.88	$2.37	$863.15	J1626	N		
J1630	Haloperidol injection	"58,143"	"72,378"	$0.34	$89.30	$8.00	$6.63	$89.15	J1630	N		
J1631	Haloperidol decanoate inj	"12,564"	"35,063"	$0.39	$296.34	$21.36	$22.09	$110.70	J1631	N		
J1640	"Hemin, 1 mg"	"1,510"	"452,215"	$0.31	$154.44	$11.90	$10.20	"$1,558.66"	J1640	K	1690	$20.73
J1642	Inj heparin sodium per 10 u	"913,030"	"38,966,597"	$0.01	"$1,997.48"	$0.22	$0.10	"$2,446.97"	J1642	N		
J1644	Inj heparin sodium per 1000u	"1,320,618"	"11,477,804"	$0.01	"$8,015.89"	$1.94	$1.02	$824.06	J1644	N		
J1645	Dalteparin sodium	"13,240"	"44,952"	$1.07	$238.85	$16.62	$12.20	$151.04	J1645	N		
J1650	Inj enoxaparin sodium	"867,860"	"4,754,241"	$0.07	$480.64	$7.07	$6.07	$207.46	J1650	N		
J1652	Fondaparinux sodium	"29,934"	"281,816"	$0.04	$210.47	$7.43	$6.35	$330.23	J1652	N		
J1670	Tetanus immune globulin inj	"1,493"	"1,493"	$1.50	$940.88	$122.70	$54.93	$118.88	J1670	K	1670	$326.32
J1700	Hydrocortisone acetate inj	500	"1,535"	$0.07	$146.12	$8.61	$9.07	$203.41	J1700	N		
J1710	Hydrocortisone sodium ph inj	360	639	$0.46	$21.28	$4.81	$3.20	$132.96	J1710	N		
J1720	Hydrocortisone sodium succ i	"103,002"	"121,032"	$0.54	$75.52	$9.10	$6.96	$85.18	J1720	N		
J1725	Hydroxyprogesterone caproate	311	"82,270"	$0.02	$32.63	$1.45	$0.64	"$1,777.82"	J1725	K	1354	$1.45
J1730	Diazoxide injection	1	1	$253.31	$253.31	$253.31	$253.31	.	J1730	E		
J1740	Ibandronate sodium injection	"6,724"	"20,171"	$11.73	$771.39	$141.39	$132.83	$84.94	J1740	K	9229	$151.80
J1741	Ibuprofen injection	"3,498"	"34,966"	$0.26	$662.51	$2.15	$1.46	$774.93	J1741	N		
J1742	Ibutilide fumarate injection	"2,182"	"2,753"	$22.02	"$1,424.44"	$268.18	$222.59	$74.21	J1742	K	9044	$112.30
J1743	Idursulfase injection	37	888	$242.81	$433.08	$285.95	$242.81	$115.68	J1743	K	9232	$483.05
J1744	Icatibant injection	8	271	$4.55	$259.81	$192.18	$176.85	$98.61	J1744	K	1443	$192.18
J1745	Infliximab injection	"116,437"	"5,497,675"	$0.01	"$1,487.33"	$66.70	$61.17	$332.74	J1745	K	7043	$74.34
J1750	Inj iron dextran	"21,800"	"325,455"	$0.95	$788.85	$17.48	$15.66	$225.91	J1750	K	1237	$12.16
J1756	Iron sucrose injection	"154,312"	"32,781,149"	$0.01	$51.82	$0.60	$0.52	"$1,347.39"	J1756	N		
J1786	Imuglucerase injection	"1,776"	"677,504"	$1.36	$116.29	$41.96	$41.49	$793.31	J1786	K	1327	$42.01
J1790	Droperidol injection	"24,207"	"25,235"	$0.58	$56.95	$8.83	$7.34	$74.24	J1790	N		
J1800	Propranolol injection	966	"1,429"	$0.40	$75.34	$10.02	$8.60	$108.97	J1800	N		
J1815	Insulin injection	"248,307"	"10,053,083"	$0.01	"$2,415.10"	$0.58	$0.32	"$2,707.36"	J1815	N		
J1817	Insulin for insulin pump use	"11,896"	"157,567"	$0.01	$220.98	$2.19	$0.63	$917.13	J1817	N		
J1830	Interferon beta-1b / .25 mg	12	12	$49.27	$325.89	$243.48	$264.76	$37.51	J1830	K	0910	$243.48
J1835	Itraconazole injection	1	2	$12.79	$12.79	$12.79	$12.79	.	J1835	E		
J1840	Kanamycin sulfate 500 mg inj	123	178	$3.91	$34.33	$10.97	$11.94	$47.93	J1840	N		
J1850	Kanamycin sulfate 75 mg inj	3	16	$0.04	$22.62	$1.79	$0.58	$851.37	J1850	N		
J1885	Ketorolac tromethamine inj	"1,087,734"	"2,713,119"	$0.02	$273.84	$3.32	$2.18	$168.03	J1885	N		
J1890	Cephalothin sodium injection	237	303	$1.34	$24.12	$5.86	$5.89	$45.81	J1890	N		
J1930	Lanreotide injection	350	"36,600"	$4.78	$73.81	$32.75	$30.38	$483.75	J1930	K	9237	$41.40
J1931	Laronidase injection	306	"147,133"	$16.58	$57.12	$26.94	$21.15	$971.82	J1931	K	9209	$29.45
J1940	Furosemide injection	"387,369"	"850,892"	$0.02	$181.91	$3.34	$2.05	$174.08	J1940	N		
J1945	Lepirudin	16	22	$2.38	"$1,665.35"	$235.52	$172.81	$187.36	J1945	K	1693	$235.52
J1950	Leuprolide acetate /3.75 mg	"1,026"	"2,377"	$7.81	"$3,128.21"	$508.14	$417.21	$142.50	J1950	K	0800	$829.72
J1953	Levetiracetam injection	"20,171"	"1,987,625"	$0.01	$221.21	$0.62	$0.48	"$2,513.09"	J1953	N		
J1956	Levofloxacin injection	"277,126"	"628,476"	$0.47	$268.99	$14.16	$11.73	$110.24	J1956	N		
J1960	Levorphanol tartrate inj	26	119	$1.48	$22.22	$3.65	$1.49	$187.25	J1960	N		
J1980	Hyoscyamine sulfate inj	"4,443"	"9,010"	$0.66	$106.30	$19.65	$17.25	$93.66	J1980	N		
J1990	Chlordiazepoxide injection	21	34	$0.31	$4.67	$3.17	$3.43	$63.02	J1990	N		
J2001	Lidocaine injection	"725,462"	"11,236,087"	$0.01	$543.06	$0.49	$0.19	"$1,075.96"	J2001	N		
J2010	Lincomycin injection	"1,065"	"1,870"	$1.21	$52.88	$8.99	$6.68	$102.07	J2010	N		
J2020	Linezolid injection	"8,193"	"35,848"	$1.32	$376.41	$41.32	$33.54	$143.93	J2020	K	9001	$45.66
J2060	Lorazepam injection	"423,084"	"487,239"	$0.18	$127.64	$7.39	$5.24	$101.18	J2060	N		
J2150	Mannitol injection	"20,901"	"31,578"	$0.10	$161.28	$6.55	$3.88	$173.20	J2150	N		
J2170	Mecasermin injection	23	28	$0.19	$1.49	$0.40	$0.19	$106.71	J2170	N		
J2175	Meperidine hydrochl /100 mg	"320,188"	"388,785"	$0.31	$81.11	$6.93	$5.17	$98.83	J2175	N		
J2180	Meperidine/promethazine inj	"2,459"	"3,240"	$0.20	$35.83	$6.79	$4.27	$113.61	J2180	N		
J2185	Meropenem	"21,180"	"314,216"	$0.02	$546.85	$5.14	$3.65	$533.09	J2185	N		
J2210	Methylergonovin maleate inj	507	588	$2.17	$34.31	$10.34	$9.78	$51.47	J2210	N		
J2212	Methylnaltrexone injection	"2,613"	"276,613"	$0.03	$202.35	$0.57	$0.46	"$3,985.53"	J2212	N		
J2248	Micafungin sodium injection	"10,632"	"1,146,662"	$0.09	$149.29	$1.61	$1.51	$796.65	J2248	K	9227	$0.98
J2250	Inj midazolam hydrochloride	"3,386,121"	"11,275,771"	$0.01	$547.22	$2.71	$1.66	$218.30	J2250	N		
J2260	Inj milrinone lactate / 5 mg	"6,345"	"33,547"	$0.78	$302.91	$14.60	$17.72	$214.54	J2260	N		
J2265	Minocycline hydrochloride	39	"4,122"	$0.37	$58.17	$0.81	$0.50	"$5,127.49"	J2265	N		
J2270	Morphine sulfate injection	"1,260,743"	"1,880,738"	$0.18	$105.40	$6.31	$4.37	$117.59	J2270	N		
J2275	Morphine sulfate injection	"75,349"	"127,402"	$0.09	$211.23	$6.94	$4.74	$147.84	J2274	N		
J2278	Ziconotide injection	"1,163"	"369,433"	$0.02	"$4,810.95"	$6.49	$5.73	"$9,454.58"	J2278	K	1694	$6.87
J2280	"Inj, moxifloxacin 100 mg"	"13,723"	"52,719"	$0.41	$291.31	$9.68	$8.00	$251.11	J2280	N		
J2300	Inj nalbuphine hydrochloride	"8,595"	"12,121"	$0.37	$85.55	$6.06	$4.47	$111.78	J2300	N		
J2310	Inj naloxone hydrochloride	"27,697"	"41,822"	$0.62	$141.02	$12.01	$10.22	$91.03	J2310	N		
J2315	"Naltrexone, depot form"	207	"64,593"	$0.02	"$1,269.37"	$2.41	$2.39	"$4,061.07"	J2315	K	0759	$2.88
J2320	Nandrolone decanoate 50 mg	28	28	$13.63	$141.75	$122.78	$141.75	$37.07	J2320	K	1743	$122.78
J2323	Natalizumab injection	"36,766"	"11,025,686"	$0.04	$208.16	$10.26	$9.06	$977.54	J2323	K	9126	$14.91
J2325	Nesiritide injection	257	"3,808"	$0.27	"$1,732.00"	$55.27	$52.69	$808.27	J2325	K	1695	$55.27
J2353	"Octreotide injection, depot"	"38,877"	"1,118,316"	$1.48	$645.64	$112.47	$105.35	$253.22	J2353	K	1207	$141.87
J2354	"Octreotide inj, non-depot"	"3,786"	"75,191"	$0.19	"$2,045.10"	$4.12	$2.58	"$1,541.00"	J2354	N		
J2355	Oprelvekin injection	"1,160"	"1,160"	$52.77	$592.98	$234.29	$251.55	$50.41	J2355	K	7011	$321.88
J2357	Omalizumab injection	"60,208"	"3,838,357"	$0.01	$138.83	$20.29	$18.20	$443.32	J2357	K	9300	$27.85
J2358	Olanzapine long-acting inj	"1,446"	"57,991"	$0.24	"$1,548.95"	$3.15	$2.07	"$2,542.79"	J2358	K	1331	$2.75
J2360	Orphenadrine injection	"55,738"	"55,738"	$2.83	$87.62	$18.21	$17.23	$54.07	J2360	N		
J2370	Phenylephrine hcl injection	"244,452"	"699,220"	$0.01	$396.97	$4.12	$1.81	$241.23	J2370	N		
J2400	Chloroprocaine hcl injection	"4,782"	"5,318"	$0.79	$190.38	$17.20	$13.23	$72.53	J2400	N		
J2405	Ondansetron hcl injection	"3,703,702"	"19,796,764"	$0.01	"$6,028.06"	$2.41	$1.28	$356.16	J2405	N		
J2410	Oxymorphone hcl injection	25	37	$1.01	$16.50	$7.25	$4.37	$99.90	J2410	N		
J2425	Palifermin injection	310	"32,023"	$0.92	$25.41	$7.31	$1.47	"$1,083.84"	J2425	K	1696	$14.85
J2426	Paliperidone palmitate inj	"5,902"	"979,819"	$0.01	$377.40	$5.82	$5.43	"$1,395.45"	J2426	K	9255	$7.91
J2430	Pamidronate disodium /30 mg	"14,786"	"36,095"	$0.79	$818.61	$49.84	$26.75	$206.73	J2430	N		
J2440	Papaverin hcl injection	"2,684"	"5,682"	$0.04	$81.63	$4.09	$2.53	$161.06	J2440	N		
J2460	Oxytetracycline injection	3	10	$0.55	$5.92	$3.77	$5.92	$155.95	J2460	E		
J2469	Palonosetron hcl	"306,079"	"3,057,965"	$0.31	$496.59	$29.85	$27.31	$203.87	J2469	K	9210	$20.01
J2501	Paricalcitol	"10,710"	"55,933"	$0.20	$249.30	$5.65	$4.71	$262.71	J2501	N		
J2503	Pegaptanib sodium injection	47	47	$375.91	"$1,534.13"	$741.17	$690.53	$40.12	J2503	K	1697	"$1,034.02"
J2504	"Pegademase bovine, 25 iu"	5	17	$0.18	$7.43	$2.85	$1.44	$200.10	J2504	K	1739	$281.40
J2505	"Injection, pegfilgrastim 6mg"	"161,534"	"161,534"	$567.12	"$11,844.56"	"$2,968.59"	"$2,778.20"	$45.33	J2505	K	9119	"$3,403.54"
J2507	Pegloticase injection	"1,100"	"8,909"	$44.97	"$2,628.76"	$382.33	$321.11	$162.06	J2507	K	9281	$856.64
J2510	Penicillin g procaine inj	92	331	$0.90	$59.60	$11.70	$9.55	$171.72	J2510	N		
J2515	Pentobarbital sodium inj	53	378	$1.86	$123.35	$28.59	$23.05	$204.56	J2515	K	1456	$35.82
J2540	Penicillin g potassium inj	"1,436"	"34,695"	$0.08	$84.06	$1.75	$1.02	"$1,169.02"	J2540	N		
J2543	Piperacillin/tazobactam	"100,264"	"571,749"	$0.09	$466.34	$7.84	$6.54	$176.32	J2543	N		
J2550	Promethazine hcl injection	"387,824"	"442,122"	$0.27	$65.03	$6.08	$4.33	$101.32	J2550	N		
J2560	Phenobarbital sodium inj	"1,158"	"3,509"	$0.09	$89.91	$10.48	$6.72	$201.58	J2560	N		
J2562	Plerixafor injection	"2,087"	"46,574"	$4.68	"$4,853.94"	$279.22	$244.30	$218.99	J2562	K	9252	$301.20
J2590	Oxytocin injection	914	"1,797"	$0.23	$40.48	$6.95	$5.08	$122.47	J2590	N		
J2597	Inj desmopressin acetate	"3,777"	"89,837"	$0.18	$436.46	$7.64	$4.65	$763.21	J2597	K	1440	$5.08
J2650	Prednisolone acetate inj	86	92	$4.64	$51.74	$12.51	$9.07	$101.42	J2650	N		
J2675	Inj progesterone per 50 mg	48	83	$1.14	$381.95	$48.50	$2.80	$320.68	J2675	N		
J2680	Fluphenazine decanoate 25 mg	"6,724"	"12,613"	$0.64	$320.31	$17.02	$13.25	$194.84	J2680	N		
J2690	Procainamide hcl injection	666	777	$1.45	$104.03	$20.98	$19.12	$66.64	J2690	N		
J2700	Oxacillin sodium injeciton	"1,099"	"32,421"	$0.40	$174.82	$3.01	$2.93	$538.85	J2700	N		
J2710	Neostigmine methylslfte inj	"285,904"	"3,217,992"	$0.01	"$1,245.45"	$0.87	$0.45	$888.90	J2710	N		
J2720	Inj protamine sulfate/10 mg	"36,532"	"229,410"	$0.03	$102.46	$2.22	$1.65	$298.27	J2720	N		
J2724	Protein c concentrate	3	"3,900"	$10.72	$10.72	$10.72	$10.72	$0.00	J2724	K	1139	$14.52
J2730	Pralidoxime chloride inj	181	200	$0.80	$23.26	$6.59	$7.45	$40.10	J2730	K	1023	$89.16
J2760	Phentolaine mesylate inj	248	291	$12.76	$365.25	$82.02	$72.95	$68.23	J2760	K	1458	$113.40
J2765	Metoclopramide hcl injection	"296,890"	"331,275"	$0.12	$69.67	$5.76	$3.89	$104.67	J2765	N		
J2770	Quinupristin/dalfopristin	344	568	$1.61	$374.45	$32.00	$3.12	$230.71	J2770	K	2770	$245.22
J2778	Ranibizumab injection	"25,172"	"128,751"	$37.91	"$2,532.37"	$341.45	$338.89	$94.05	J2778	K	9233	$396.43
J2780	Ranitidine hydrochloride inj	"59,305"	"116,148"	$0.11	$84.30	$4.41	$2.82	$142.42	J2780	N		
J2783	Rasburicase	668	"11,078"	$14.65	"$6,181.69"	$175.79	$161.24	$423.41	J2783	K	0738	$218.75
J2785	Regadenoson injection	"531,296"	"2,127,903"	$1.41	"$1,400.92"	$52.35	$47.46	$136.44	J2785	N		
J2788	Rho d immune globulin 50 mcg	25	25	$12.16	$232.12	$48.99	$41.05	$87.40	J2788	N		
J2790	Rho d immune globulin inj	794	794	$13.60	$360.63	$93.27	$80.01	$60.64	J2790	N		
J2791	Rhophylac injection	198	"6,033"	$0.76	$170.82	$13.90	$7.81	$897.20	J2791	K	0945	$4.80
J2792	"Rho(d) immune globulin h, sd"	272	"45,411"	$3.62	"$2,087.60"	$19.71	$19.05	"$1,935.02"	J2792	K	1609	$18.85
J2793	Rilonacept injection	22	"5,100"	$0.14	$0.15	$0.15	$0.15	$24.54	J2793	K	1291	$0.15
J2794	"Risperidone, long acting"	"13,248"	"928,305"	$0.01	"$1,046.26"	$5.16	$4.41	"$1,599.63"	J2794	K	9125	$6.16
J2795	Ropivacaine hcl injection	"95,217"	"16,457,446"	$0.01	$754.36	$0.22	$0.16	"$9,942.73"	J2795	N		
J2796	Romiplostim injection	"25,095"	"937,573"	$0.75	"$1,995.87"	$44.33	$39.80	$359.33	J2796	K	9245	$53.63
J2800	Methocarbamol injection	"11,159"	"13,892"	$2.24	$235.72	$33.97	$34.82	$60.22	J2800	N		
J2805	Sincalide injection	"37,415"	"37,415"	$7.69	$429.00	$68.92	$58.73	$67.31	J2805	N		
J2810	Inj theophylline per 40 mg	589	"5,811"	$0.10	"$1,902.65"	$1.52	$0.52	"$5,163.70"	J2810	N		
J2820	Sargramostim injection	"4,575"	"38,094"	$4.78	$296.88	$32.47	$33.06	$187.78	J2820	K	0731	$30.13
J2850	Inj secretin synthetic human	546	"6,741"	$5.08	$608.03	$49.11	$30.28	$726.17	J2850	K	1700	$34.78
J2910	Aurothioglucose injeciton	26	390	$0.47	$1.06	$0.66	$0.49	$157.65	J2910	N		
J2916	Na ferric gluconate complex	"41,004"	"438,161"	$0.53	$108.73	$6.79	$6.26	$225.61	J2916	N		
J2920	Methylprednisolone injection	"104,265"	"193,634"	$0.31	$87.69	$6.20	$4.61	$112.20	J2920	N		
J2930	Methylprednisolone injection	"415,467"	"515,216"	$0.82	$59.05	$8.59	$6.83	$78.62	J2930	N		
J2940	Somatrem injection	1	2	$6.96	$6.96	$6.96	$6.96	.	J2940	E		
J2941	Somatropin injection	3	12	$49.75	$50.38	$50.28	$50.38	$1.14	J2941	K	7034	$50.28
J2950	Promazine hcl injection	"1,177"	"1,270"	$0.94	$11.65	$3.67	$3.77	$46.43	J2950	N		
J2993	Reteplase injection	14	14	$638.35	"$2,738.23"	"$1,395.75"	"$1,535.23"	$40.62	J2993	K	9005	"$2,301.91"
J2995	Inj streptokinase /250000 iu	6	6	$1.42	$68.12	$12.54	$1.42	$217.20	J2995	N		
J2997	Alteplase recombinant	"50,281"	"185,557"	$1.12	"$2,053.39"	$54.54	$47.75	$175.29	J2997	K	7048	$64.30
J3000	Streptomycin injection	153	153	$7.10	$25.61	$15.41	$13.24	$38.86	J3000	N		
J3010	Fentanyl citrate injeciton	"3,336,144"	"5,591,851"	$0.05	$199.26	$5.45	$3.59	$134.83	J3010	N		
J3030	Sumatriptan succinate / 6 mg	"4,727"	"4,727"	$6.24	$331.08	$62.02	$52.53	$67.91	J3030	N		
J3070	Pentazocine injection	487	"3,862"	$0.15	$243.23	$3.15	$0.16	$913.02	J3070	K	1484	$140.12
J3095	Telavancin injection	71	"4,987"	$3.03	$20.65	$4.53	$4.38	$525.43	J3095	K	9258	$4.52
J3101	Tenecteplase injection	"1,817"	"81,286"	$0.39	"$8,061.70"	$60.39	$46.84	"$1,846.72"	J3101	K	9002	$86.21
J3105	Terbutaline sulfate inj	"2,251"	"2,481"	$0.63	$136.47	$12.81	$8.87	$96.38	J3105	N		
J3120	Testosterone enanthate inj	"1,172"	"2,511"	$0.26	$46.74	$12.19	$10.18	$117.08	J3121	N		
J3130	Testosterone enanthate inj	"7,608"	"8,776"	$0.26	$905.76	$44.35	$20.89	$120.19	J3121	#N/A	#N/A	#N/A
J3230	Chlorpromazine hcl injection	"5,235"	"6,654"	$0.58	$184.29	$16.29	$11.23	$128.62	J3230	N		
J3240	Thyrotropin injection	"7,165"	"7,165"	$134.69	"$4,473.29"	$933.81	$836.73	$56.59	J3240	K	9108	"$1,430.43"
J3243	Tigecycline injection	"10,382"	"890,889"	$0.05	$216.99	$1.62	$1.27	"$1,992.62"	J3243	K	9228	$2.00
J3246	Tirofiban hcl	430	"19,154"	$0.64	$382.89	$9.84	$8.61	$507.72	J3246	K	7041	$9.84
J3250	Trimethobenzamide hcl inj	"2,159"	"2,459"	$0.51	$52.51	$10.13	$8.07	$87.58	J3250	N		
J3260	Tobramycin sulfate injection	"18,794"	"54,142"	$0.10	$842.44	$7.72	$4.99	$225.91	J3260	N		
J3262	Tocilizumab injection	"17,145"	"9,263,423"	$0.02	$72.68	$3.47	$3.19	"$1,176.32"	J3262	K	9264	$3.68
J3265	Injection torsemide 10 mg/ml	108	229	$0.37	$21.77	$5.32	$4.82	$148.61	J3265	N		
J3280	Thiethylperazine maleate inj	103	536	$3.46	$3.76	$3.67	$3.76	$8.70	J3280	N		
J3285	Treprostinil injection	57	472	$2.35	"$1,094.07"	$86.79	$79.14	$428.41	J3285	K	1701	$61.24
J3300	Triamcinolone a inj prs-free	"9,322"	"415,185"	$0.10	$526.16	$2.14	$0.71	"$1,705.72"	J3300	K	1253	$3.73
J3301	Triamcinolone acet inj nos	"344,298"	"2,044,667"	$0.04	$230.63	$3.41	$2.76	$274.15	J3301	N		
J3302	Triamcinolone diacetate inj	"3,762"	"44,900"	$0.25	$46.45	$3.14	$3.34	$305.12	J3302	N		
J3303	Triamcinolone hexacetonl inj	"4,584"	"31,320"	$0.29	$172.76	$3.96	$3.01	$268.38	J3303	N		
J3310	Perphenazine injeciton	20	176	$0.17	$405.98	$3.70	$0.17	"$2,544.57"	J3310	N		
J3315	Triptorelin pamoate	"2,852"	"10,451"	$16.48	"$3,611.83"	$299.45	$202.65	$159.52	J3315	K	9122	$170.77
J3320	Spectinomycn di-hcl inj	1	1	$23.36	$23.36	$23.36	$23.36	.	J3320	N		
J3350	Urea injection	15	15	$10.55	$110.70	$39.97	$10.55	$113.47	J3350	K	1459	$39.97
J3357	Ustekinumab injection	"1,461"	"97,638"	$0.02	$354.33	$102.75	$103.57	$390.91	J3357	K	9261	$162.29
J3360	Diazepam injection	"72,750"	"138,264"	$0.15	$91.03	$6.32	$5.14	$115.56	J3360	N		
J3364	Urokinase 5000 iu injection	70	70	$49.11	$69.42	$56.33	$54.50	$12.31	J3364	N		
J3370	Vancomycin hcl injection	"437,781"	"1,175,084"	$0.16	$295.55	$9.28	$6.66	$152.21	J3370	N		
J3385	Velaglucerase alfa	"1,268"	"49,303"	$32.81	"$1,437.40"	$378.90	$386.85	$306.29	J3385	K	9271	$353.35
J3396	Verteporfin injection	279	"39,763"	$2.01	$33.00	$8.43	$7.76	$484.33	J3396	K	1203	$10.79
J3410	Hydroxyzine hcl injection	"13,251"	"29,054"	$0.07	$72.79	$3.82	$2.96	$125.84	J3410	N		
J3411	Thiamine hcl 100 mg	"35,546"	"55,267"	$0.46	$91.87	$8.08	$6.48	$92.29	J3411	N		
J3415	Pyridoxine hcl 100 mg	541	653	$0.59	$76.67	$12.42	$9.58	$86.12	J3415	N		
J3420	Vitamin b12 injection	"279,342"	"279,342"	$0.12	$65.03	$4.62	$2.76	$113.00	J3420	N		
J3430	Vitamin k phytonadione inj	"17,916"	"161,680"	$0.01	$154.95	$1.94	$1.38	$436.93	J3430	N		
J3465	"Injection, voriconazole"	555	"24,956"	$0.38	$343.15	$6.59	$5.60	$859.98	J3465	K	1052	$3.97
J3470	Hyaluronidase injection	"26,537"	"30,852"	$1.98	$399.87	$39.99	$31.45	$94.20	J3470	N		
J3471	"Ovine, up to 999 usp units"	"25,314"	"4,214,560"	$0.01	$570.15	$0.46	$0.28	"$10,113.46"	J3471	N		
J3472	"Ovine, 1000 usp units"	923	"20,239"	$0.60	$245.07	$3.36	$0.63	"$2,117.78"	J3472	N		
J3473	Hyaluronidase recombinant	"9,583"	"1,131,081"	$0.08	$210.30	$0.64	$0.41	"$7,149.34"	J3473	N		
J3475	Inj magnesium sulfate	"245,910"	"1,160,209"	$0.01	$234.05	$2.76	$1.74	$283.03	J3475	N		
J3480	Inj potassium chloride	"183,312"	"2,620,691"	$0.01	$252.60	$1.22	$0.60	$736.53	J3480	N		
J3485	Zidovudine	18	"1,330"	$0.55	$106.06	$1.64	$1.27	"$2,373.04"	J3485	K	1744	$1.50
J3486	Ziprasidone mesylate	"16,992"	"36,462"	$1.35	$149.82	$13.00	$10.65	$111.52	J3486	N		
J3487	Zoledronic acid	"53,761"	"213,263"	$7.36	"$3,374.21"	$199.39	$192.42	$94.80	J3489	K	1356	$47.48
J3490	Drugs unclassified injection	"634,528"	"3,096,752"	$0.01	"$19,532.77"	$5.53	$0.95	"$1,963.47"	J3490	N		
J3590	Unclassified biologics	"4,156"	"6,695"	$0.03	"$7,174.44"	$245.25	$11.79	$410.98	J3590	N		
J7030	Normal saline solution infus	"1,952,268"	"2,397,133"	$0.42	$287.54	$16.18	$14.44	$87.14	J7030	N		
J7040	Normal saline solution infus	"746,260"	"915,089"	$0.38	$226.79	$13.59	$11.72	$85.58	J7040	N		
J7042	5% dextrose/normal saline	"77,271"	"151,531"	$0.09	$165.99	$10.09	$6.88	$147.19	J7042	N		
J7050	Normal saline solution infus	"1,005,494"	"1,485,972"	$0.13	$463.84	$13.54	$10.66	$103.83	J7050	N		
J7060	5% dextrose/water	"193,994"	"271,451"	$0.19	$323.78	$13.91	$10.59	$101.22	J7060	N		
J7070	D5w infusion	"57,306"	"75,006"	$0.06	$214.15	$15.30	$13.62	$106.04	J7070	N		
J7100	Dextran 40 infusion	636	759	$1.29	$178.29	$22.46	$9.33	$166.59	J7100	N		
J7110	Dextran 75 infusion	498	855	$20.58	$22.72	$20.88	$20.58	$1.97	J7110	N		
J7120	Ringers lactate infusion	"1,022,839"	"1,392,448"	$0.55	$262.77	$16.19	$14.36	$80.29	J7120	N		
J7131	Hypertonic saline sol	"3,843"	"119,362"	$0.01	$61.07	$0.16	$0.03	"$3,483.05"	J7131	N		
J7178	Human fibrinogen conc inj	7	"20,179"	$0.79	$747.37	$0.90	$0.81	"$34,039.41"	J7178	K	1478	$0.90
J7180	Factor xiii anti-hem factor	1	2	$819.53	$819.53	$819.53	$819.53	.	J7180	N		
J7183	Wilate injection	105	"444,053"	$0.51	$1.30	$0.86	$0.87	"$1,247.22"	J7183	K	1352	$0.95
J7185	Xyntha inj	16	"44,266"	$0.55	$5.42	$1.53	$1.47	"$3,940.54"	J7185	K	1268	$1.17
J7186	Antihemophilic viii/vwf comp	82	"203,124"	$0.28	"$2,117.87"	$0.98	$0.79	"$45,715.99"	J7186	K	1213	$0.94
J7187	"Humate-p, inj"	"1,157"	"4,288,578"	$0.01	$11.24	$0.80	$0.68	"$3,573.21"	J7187	K	1704	$0.95
J7189	Factor viia	204	"1,754,470"	$0.10	"$2,547.65"	$1.21	$1.25	"$38,117.24"	J7189	K	1705	$1.73
J7190	Factor viii	444	"4,301,378"	$0.13	$138.05	$0.66	$0.62	"$7,818.40"	J7190	K	0925	$0.93
J7191	Factor viii (porcine)	3	"2,855"	$0.19	$18.00	$0.20	$0.19	"$8,793.01"	J7191	K	1464	$0.20
J7192	Factor viii recombinant nos	"1,041"	"10,735,362"	$0.07	$403.11	$0.81	$0.72	"$10,812.18"	J7192	K	0927	$1.14
J7193	Factor ix non-recombinant	237	"2,443,170"	$0.07	$1.90	$0.46	$0.44	"$5,350.79"	J7193	K	0931	$1.01
J7194	Factor ix complex	322	"791,593"	$0.04	"$3,456.31"	$1.00	$0.87	"$35,044.60"	J7194	K	0928	$1.12
J7195	Factor ix recombinant	380	"3,475,845"	$0.07	$88.74	$1.06	$1.14	"$8,770.72"	J7195	K	0932	$1.35
J7197	Antithrombin iii injection	198	"536,358"	$0.44	$185.95	$1.84	$1.54	"$4,914.38"	J7197	K	1263	$3.27
J7198	Anti-inhibitor	149	"1,600,615"	$0.02	$2.73	$1.00	$0.91	"$4,291.10"	J7198	K	0929	$1.70
J7308	Aminolevulinic acid hcl top	"4,388"	"5,217"	$30.42	$355.16	$128.55	$114.29	$55.46	J7308	K	7308	$242.30
J7309	"Methyl aminolevulinate, top"	16	30	$69.07	$111.05	$106.33	$111.05	$14.19	J7309	K	1338	$106.33
J7310	Ganciclovir long act implant	17	17	$19.68	"$16,488.00"	"$5,517.76"	$50.41	$140.45	J7310	K	0913	"$16,960.00"
J7311	Fluocinolone acetonide implt	105	105	"$5,847.30"	"$28,545.00"	"$14,357.94"	"$13,905.95"	$29.45	J7311	K	9225	"$19,641.05"
J7312	Dexamethasone intra implant	516	"3,640"	$15.71	"$1,406.63"	$154.66	$157.09	$115.01	J7312	K	9256	$201.31
J7315	Ophthalmic mitomycin	"1,043"	"1,858"	$0.10	"$1,766.52"	$57.71	$27.97	$243.79	J7315	G	1448	$57.71
J7321	Hyalgan/supartz inj per dose	"20,242"	"26,766"	$13.43	"$1,132.01"	$103.81	$68.94	$98.28	J7321	K	0873	$90.81
J7323	Euflexxa inj per dose	"15,907"	"21,168"	$23.64	$970.51	$150.06	$127.83	$77.57	J7323	K	0875	$160.42
J7324	Orthovisc inj per dose	"10,165"	"13,091"	$29.07	$664.30	$165.16	$116.53	$89.79	J7324	K	0877	$186.89
J7325	Synvisc or synvisc-one	"19,355"	"840,214"	$0.09	"$2,054.30"	$13.99	$12.33	$772.62	J7325	K	0874	$12.50
J7326	Gel-one	938	"1,175"	$101.49	"$1,827.83"	$436.82	$197.89	$96.42	J7326	K	1417	$562.08
J7335	Capsaicin 8% patch	125	"4,518"	$0.24	$946.68	$32.18	$22.52	"$1,364.49"	J7336	K	1665	$2.65
J7500	Azathioprine oral 50mg	"5,661"	"10,719"	$0.02	$22.32	$1.68	$1.22	$168.13	J7500	N		
J7501	Azathioprine parenteral	12	28	$1.06	$154.14	$49.55	$3.32	$191.48	J7501	K	0887	$217.30
J7502	Cyclosporine oral 100 mg	"2,077"	"3,752"	$0.19	$74.72	$6.01	$4.74	$107.35	J7502	N		
J7504	Lymphocyte immune globulin	39	166	$112.56	"$2,372.49"	"$1,040.94"	$975.71	$128.75	J7504	K	0890	$852.69
J7506	Prednisone oral	"223,672"	"1,568,220"	$0.01	$81.61	$0.33	$0.17	$525.96	J7506	N		
J7507	Tacrolimus imme rel oral 1mg	"19,157"	"69,205"	$0.10	$122.39	$5.01	$3.68	$325.92	J7507	N		
J7509	Methylprednisolone oral	"5,770"	"34,617"	$0.02	$123.74	$1.39	$1.04	$552.21	J7509	N		
J7510	Prednisolone oral per 5 mg	"3,346"	"24,210"	$0.01	$27.75	$0.35	$0.08	$807.93	J7510	N		
J7511	Antithymocyte globuln rabbit	777	"3,409"	$48.11	"$1,411.41"	$503.02	$440.69	$122.45	J7511	K	9104	$594.74
J7515	Cyclosporine oral 25 mg	"2,740"	"9,203"	$0.07	$19.60	$2.15	$1.81	$140.22	J7515	N		
J7516	Cyclosporin parenteral 250mg	98	126	$2.48	$220.95	$63.66	$45.54	$84.86	J7516	N		
J7517	Mycophenolate mofetil oral	"14,574"	"56,630"	$0.02	"$1,150.22"	$3.68	$2.41	$410.24	J7517	N		
J7518	Mycophenolic acid	"3,211"	"12,174"	$0.09	$23.36	$4.72	$4.08	$128.38	J7518	N		
J7520	"Sirolimus, oral"	"1,268"	"2,746"	$0.34	$168.33	$11.38	$9.93	$116.27	J7520	N		
J7525	Tacrolimus injection	58	58	$21.45	$245.24	$131.74	$118.35	$45.59	J7525	K	9006	$141.10
J7527	Oral everolimus	62	621	$0.03	$320.29	$29.16	$9.76	$418.00	J7527	N		
J7599	Immunosuppressive drug noc	113	158	$0.03	$124.46	$28.55	$9.03	$191.99	J7599	N		
J7674	"Methacholine chloride, neb"	"3,265"	"255,726"	$0.01	$688.18	$0.81	$0.56	"$3,178.10"	J7674	N		
J8501	Oral aprepitant	"8,870"	"206,684"	$0.18	$199.54	$6.67	$6.55	$318.07	J8501	K	0868	$7.68
J8510	Oral busulfan	2	2	$2.26	$22.07	$12.16	$12.17	$115.15	J8510	N		
J8520	"Capecitabine, oral, 150 mg"	37	358	$2.02	$123.37	$9.05	$8.03	$388.50	J8520	K	7042	$8.67
J8521	"Capecitabine, oral, 500 mg"	163	550	$4.48	$286.81	$27.83	$21.10	$176.67	J8521	K	0934	$28.63
J8530	Cyclophosphamide oral 25 mg	"2,366"	"45,259"	$0.12	$55.09	$1.98	$1.61	$432.98	J8530	N		
J8540	Oral dexamethasone	"93,731"	"4,605,050"	$0.01	$10.53	$0.07	$0.03	"$1,257.21"	J8540	N		
J8560	Etoposide oral 50 mg	44	281	$12.67	$119.20	$72.31	$77.35	$53.06	J8560	K	0802	$57.09
J8597	Antiemetic drug oral nos	"12,792"	"19,110"	$0.04	$49.73	$4.37	$1.46	$207.31	J8597	N		
J8600	Melphalan oral 2 mg	37	135	$0.68	$42.49	$5.92	$6.40	$146.86	J8600	N		
J8610	Methotrexate oral 2.5 mg	"1,848"	"8,654"	$0.09	$33.58	$2.86	$2.19	$210.95	J8610	N		
J8700	Temozolomide	153	"4,996"	$3.85	$151.45	$15.03	$11.49	$759.61	J8700	K	1086	$5.39
J8705	Topotecan oral	6	12	$550.61	$550.61	$550.61	$550.61	$0.00	J8705	K	1238	$94.74
J9000	Doxorubicin hcl injection	"40,205"	"357,635"	$0.25	$818.66	$14.23	$9.21	$587.99	J9000	N		
J9002	Doxil injection	"6,546"	"45,308"	$3.99	"$2,647.25"	$493.63	$466.95	$144.80	Q2050	K	7046	$490.49
J9010	Alemtuzumab injection	"1,006"	"2,703"	$0.01	"$2,836.64"	$486.75	$524.57	$120.97	J9010	E		
J9015	Aldesleukin injection	440	480	$136.64	"$2,145.98"	$686.38	$554.56	$58.33	J9015	K	0807	"$2,110.63"
J9017	Arsenic trioxide injection	"4,591"	"64,684"	$0.17	$632.46	$46.49	$36.83	$355.97	J9017	K	9012	$53.58
J9019	Erwinaze injection	48	"1,812"	$10.88	$568.28	$443.51	$568.28	$197.31	J9019	K	9289	$354.76
J9020	"Asparaginase, nos"	28	49	$25.53	$277.36	$90.41	$101.80	$78.81	J9020	K	0814	$64.56
J9025	Azacitidine injection	"85,703"	"14,486,233"	$0.01	$76.45	$5.52	$5.00	$747.57	J9025	K	1709	$4.08
J9027	Clofarabine injection	573	"23,614"	$23.82	$390.88	$144.69	$142.71	$278.59	J9027	K	1710	$134.10
J9031	Bcg live intravesical vac	"21,464"	"21,464"	$17.64	$480.57	$152.33	$138.88	$49.10	J9031	K	0809	$121.96
J9033	Bendamustine injection	"39,347"	"6,594,749"	$0.09	$262.15	$18.65	$17.58	$614.73	J9033	K	9243	$22.21
J9035	Bevacizumab injection	"100,136"	"7,012,179"	$0.07	"$2,024.31"	$58.28	$54.75	$408.51	J9035	K	9214	$66.65
J9040	Bleomycin sulfate injection	"2,908"	"5,330"	$3.52	$848.91	$74.75	$46.67	$141.62	J9040	N		
J9041	Bortezomib injection	"127,805"	"3,946,217"	$0.01	$431.12	$41.01	$37.54	$286.64	J9041	K	9207	$46.08
J9042	Brentuximab vedotin inj	"1,869"	"255,097"	$0.88	"$1,614.37"	$94.66	$88.02	$614.25	J9042	K	9287	$110.82
J9043	Cabazitaxel injection	"3,666"	"204,383"	$0.02	"$3,274.23"	$134.40	$116.66	$667.24	J9043	K	9276	$142.42
J9045	Carboplatin injection	"171,363"	"1,341,867"	$0.03	$849.19	$22.75	$9.25	$451.96	J9045	N		
J9050	Carmustine injection	222	622	$1.35	"$2,671.81"	$371.97	$162.20	$210.27	J9050	K	0812	"$1,861.12"
J9055	Cetuximab injection	"44,520"	"2,460,499"	$0.01	"$2,753.60"	$50.12	$47.14	$385.83	J9055	K	9215	$53.29
J9060	Cisplatin 10 mg injection	"55,599"	"479,917"	$0.03	"$2,361.11"	$9.66	$4.56	$527.94	J9060	N		
J9065	Inj cladribine per 1 mg	975	"9,645"	$4.91	$238.36	$45.89	$37.81	$225.23	J9065	K	0858	$21.21
J9070	Cyclophosphamide 100 mg inj	"66,081"	"787,458"	$0.04	"$1,686.09"	$33.36	$28.98	$288.04	J9070	K	1408	$63.16
J9098	Cytarabine liposome inj	328	"1,626"	$52.33	"$1,070.50"	$481.72	$419.45	$106.19	J9098	K	1166	$561.39
J9100	Cytarabine hcl 100 mg inj	"3,498"	"33,603"	$0.25	"$2,021.00"	$5.41	$2.64	"$1,033.65"	J9100	N		
J9120	Dactinomycin injection	100	230	$4.92	$994.44	$543.44	$592.26	$75.97	J9120	K	0752	$807.19
J9130	Dacarbazine 100 mg inj	"4,608"	"37,228"	$0.68	$545.82	$12.37	$8.67	$370.89	J9130	N		
J9150	Daunorubicin injection	65	524	$8.33	$57.31	$33.40	$33.50	$107.11	J9150	K	0820	$22.56
J9155	Degarelix injection	"4,922"	"511,910"	$0.03	$43.28	$4.93	$4.41	$589.98	J9155	K	1296	$3.55
J9160	Denileukin diftitox inj	40	168	$313.32	"$4,682.67"	"$1,598.47"	$344.70	$253.50	J9160	E		
J9171	Docetaxel injection	"64,264"	"7,156,680"	$0.01	$277.10	$15.24	$13.28	$701.52	J9171	K	0823	$4.66
J9175	Elliotts b solution per ml	51	371	$2.61	$38.29	$8.33	$6.66	$137.29	J9175	N		
J9178	"Inj, epirubicin hcl, 2 mg"	"2,297"	"128,468"	$0.22	$427.33	$7.02	$2.94	"$1,553.66"	J9178	N		
J9179	Eribulin mesylate injection	"8,976"	"212,358"	$1.57	"$1,822.52"	$93.68	$78.03	$456.41	J9179	K	1426	$99.01
J9181	Etoposide injection	"74,067"	"1,261,636"	$0.07	"$1,550.32"	$3.33	$1.46	"$1,036.83"	J9181	N		
J9185	Fludarabine phosphate inj	"8,856"	"10,312"	$15.68	"$1,116.24"	$179.65	$157.84	$66.77	J9185	K	0842	$70.98
J9190	Fluorouracil injection	"135,928"	"885,940"	$0.02	"$1,171.53"	$7.65	$4.43	$371.67	J9190	N		
J9200	Floxuridine injection	342	"1,091"	$0.16	$261.63	$79.37	$111.04	$105.15	J9200	K	0827	$55.65
J9201	Gemcitabine hcl injection	"135,569"	"1,125,028"	$0.02	"$1,713.42"	$77.19	$53.05	$279.74	J9201	N		
J9202	Goserelin acetate implant	"7,044"	"17,757"	$30.14	"$1,827.98"	$294.23	$273.36	$76.08	J9202	K	0810	$225.02
J9206	Irinotecan injection	"60,796"	"840,400"	$0.02	"$1,175.81"	$35.44	$14.22	$537.73	J9206	N		
J9207	Ixabepilone injection	"1,819"	"106,356"	$1.53	$929.00	$63.11	$58.42	$408.49	J9207	K	9240	$70.21
J9208	Ifosfamide injection	"2,289"	"8,196"	$1.89	"$1,701.49"	$70.17	$42.30	$395.77	J9208	K	0831	$33.41
J9209	Mesna injection	"4,434"	"46,751"	$0.06	$207.54	$14.67	$9.48	$422.73	J9209	N		
J9211	Idarubicin hcl injection	93	356	$22.43	$577.12	$155.63	$106.26	$156.72	J9211	K	0832	$49.11
J9213	Interferon alfa-2a inj	18	18	$362.75	"$1,177.14"	$733.57	$880.22	$38.22	J9213	K	1460	$733.57
J9214	Interferon alfa-2b inj	"7,376"	"220,746"	$0.02	"$1,165.08"	$19.55	$17.44	$602.02	J9214	K	0836	$21.17
J9216	Interferon gamma 1-b inj	2	3	$1.13	$889.25	$297.17	$1.13	$244.02	J9216	K	0838	$297.17
J9217	Leuprolide acetate suspnsion	"63,151"	"203,861"	$7.81	"$12,477.57"	$473.61	$367.47	$139.06	J9217	K	9217	$229.26
J9218	Leuprolide acetate injeciton	55	432	$0.89	"$2,001.15"	$54.82	$48.96	$826.13	J9218	N		
J9219	Leuprolide acetate implant	12	12	$46.22	"$1,281.13"	$664.05	$664.13	$97.06	J9219	E		
J9225	Vantas implant	177	177	$540.65	"$12,215.11"	"$3,873.60"	"$3,164.01"	$60.96	J9225	K	1711	"$3,001.59"
J9226	Supprelin la implant	1	1	"$18,253.48"	"$18,253.48"	"$18,253.48"	"$18,253.48"	.	J9226	K	1142	"$18,317.24"
J9228	Ipilimumab injection	"4,055"	"1,036,070"	$1.66	$564.18	$110.05	$102.96	$732.39	J9228	K	9284	$133.61
J9230	Mechlorethamine hcl inj	96	119	$11.61	$352.60	$91.99	$66.02	$82.27	J9230	K	0751	$189.63
J9245	Inj melphalan hydrochl 50 mg	667	"1,850"	$104.52	"$19,257.56"	"$1,309.12"	"$1,250.39"	$131.90	J9245	K	0840	"$1,226.63"
J9250	Methotrexate sodium inj	"10,303"	"88,383"	$0.01	"$6,021.96"	$2.85	$0.62	"$2,174.56"	J9250	N		
J9260	Methotrexate sodium inj	"4,561"	"12,703"	$0.02	$228.08	$9.66	$4.38	$349.13	J9260	N		
J9261	Nelarabine injection	82	"1,886"	$13.50	$625.71	$168.10	$145.73	$456.73	J9261	K	0825	$138.87
J9263	Oxaliplatin	"71,107"	"22,829,849"	$0.01	$48.93	$5.44	$4.20	"$1,561.46"	J9263	K	1738	$0.58
J9264	Paclitaxel protein bound	"43,356"	"8,949,700"	$0.04	$237.54	$9.61	$8.89	$707.78	J9264	K	1712	$9.70
J9265	Paclitaxel injection	"163,766"	"1,005,636"	$0.03	"$1,002.75"	$31.91	$14.22	$398.36	J9267	N		
J9266	Pegaspargase injection	69	96	$85.25	"$8,135.51"	"$3,945.53"	"$3,584.57"	$72.55	J9266	K	0843	"$6,220.80"
J9268	Pentostatin injection	458	458	$346.61	"$4,938.92"	"$1,578.86"	"$1,446.65"	$54.00	J9268	K	0844	"$1,483.27"
J9270	Plicamycin (mithramycin) inj	12	74	$0.42	$34.06	$3.02	$0.69	$661.80	J9270	N		
J9280	Mitomycin injection	"20,623"	"123,166"	$0.33	"$2,536.38"	$47.08	$36.69	$252.31	J9280	K	1232	$20.88
J9293	Mitoxantrone hydrochl / 5 mg	"1,055"	"4,696"	$0.84	$725.68	$91.48	$54.83	$212.58	J9293	K	0864	$32.34
J9302	Ofatumumab injection	"2,603"	"446,538"	$3.41	$561.88	$46.10	$43.24	$782.21	J9302	K	9260	$47.76
J9303	Panitumumab injection	"6,366"	"295,942"	$0.02	$695.12	$84.73	$79.63	$312.82	J9303	K	9235	$94.79
J9305	Pemetrexed injection	"48,613"	"4,453,825"	$0.52	"$2,485.08"	$53.39	$49.83	$493.07	J9305	K	9213	$60.27
J9307	Pralatrexate injection	"1,014"	"43,931"	$13.18	$398.42	$166.90	$157.02	$290.52	J9307	K	9259	$197.12
J9310	Rituximab injection	"124,821"	"970,211"	$13.20	"$3,352.67"	$567.52	$538.81	$128.33	J9310	K	0849	$708.68
J9315	Romidepsin injection	"1,762"	"45,711"	$17.51	$714.49	$249.43	$228.70	$201.54	J9315	K	9265	$270.64
J9320	Streptozocin injection	265	265	$61.81	"$1,718.21"	$339.89	$290.77	$71.96	J9320	K	0850	$335.28
J9328	Temozolomide injection	305	"87,244"	$1.67	$10.00	$5.33	$5.28	$626.25	J9328	K	9253	$5.68
J9330	Temsirolimus injection	"8,774"	"215,554"	$0.01	$255.18	$56.06	$46.81	$309.58	J9330	K	1168	$58.83
J9340	Thiotepa injection	262	944	$31.68	"$1,505.50"	$408.51	$436.75	$59.24	J9340	K	0851	$408.51
J9351	Topotecan injection	"17,025"	"766,774"	$0.01	$232.56	$13.86	$9.92	$583.61	J9351	K	1350	$1.83
J9355	Trastuzumab injection	"83,550"	"3,090,658"	$0.01	"$1,696.95"	$69.09	$64.09	$303.98	J9355	K	1613	$82.49
J9357	Valrubicin injection	740	"2,960"	$48.24	"$3,111.11"	$731.87	$641.12	$121.65	J9357	K	1235	"$1,085.29"
J9360	Vinblastine sulfate inj	"4,820"	"49,447"	$0.07	$206.33	$4.79	$3.02	$481.03	J9360	N		
J9370	Vincristine sulfate 1 mg inj	"24,826"	"46,123"	$0.63	$336.22	$17.36	$11.15	$151.78	J9370	N		
J9390	Vinorelbine tartrate inj	"24,360"	"113,274"	$0.33	$773.31	$36.53	$24.45	$233.83	J9390	N		
J9395	"Injection, fulvestrant"	"41,557"	"788,165"	$1.08	"$1,844.08"	$82.70	$75.58	$209.88	J9395	K	9120	$91.27
J9600	Porfimer sodium injection	68	139	"$1,893.88"	"$35,415.41"	"$16,231.65"	"$15,932.52"	$65.87	J9600	K	0856	"$16,231.65"
J9999	Chemotherapy drug	"5,009"	"14,292"	$0.01	"$10,031.25"	$267.33	$12.55	$465.77	J9999	N		
P9041	"Albumin (human),5%, 50ml"	"5,150"	"211,243"	$0.07	$674.85	$21.82	$17.49	$784.86	P9041	K	0961	$10.91
P9045	"Albumin (human), 5%, 250 ml"	"18,421"	"141,796"	$1.57	"$3,372.50"	$66.47	$56.35	$239.03	P9045	K	0963	$54.54
P9046	"Albumin (human), 25%, 20 ml"	"3,620"	"28,717"	$2.38	$878.21	$32.90	$33.35	$295.09	P9046	K	0964	$22.49
P9047	"Albumin (human), 25%, 50ml"	"51,207"	"169,810"	$2.43	"$1,631.67"	$73.68	$62.59	$133.43	P9047	K	0965	$53.44
Q0138	"Ferumoxytol, non-esrd"	"31,683"	"16,037,708"	$0.02	$28.23	$0.80	$0.70	"$1,816.90"	Q0138	K	1297	$0.74
Q0162	Ondansetron oral	"185,653"	"1,619,227"	$0.01	$386.09	$1.78	$0.52	$611.73	Q0162	N		
Q0163	Diphenhydramine hcl 50mg	"81,782"	"87,994"	$0.01	$38.36	$1.06	$0.68	$130.94	Q0163	N		
Q0164	Prochlorperazine maleate 5mg	"6,687"	"13,097"	$0.01	$24.26	$0.69	$0.55	$177.06	Q0164	N		
Q0166	Granisetron hcl 1 mg oral	"14,768"	"21,636"	$0.33	$881.90	$29.37	$29.74	$121.08	Q0166	N		
Q0167	Dronabinol 2.5mg oral	"1,604"	"3,837"	$0.28	$41.40	$6.29	$5.18	$99.53	Q0167	N		
Q0169	Promethazine hcl 12.5mg oral	"2,359"	"5,201"	$0.01	$10.58	$0.85	$0.63	$151.62	Q0169	N		
Q0171	Chlorpromazine hcl 10mg oral	690	"7,474"	$0.02	$20.17	$0.30	$0.20	$612.20	Q0161	N		
Q0172	Chlorpromazine hcl 25mg oral	906	"4,452"	$0.06	$21.40	$1.34	$1.22	$217.48	Q0162	N		
Q0173	Trimethobenzamide hcl 250mg	75	205	$0.22	$23.87	$1.79	$1.40	$174.82	Q0173	N		
Q0175	Perphenazine 4mg oral	827	"2,099"	$0.10	$14.00	$1.45	$1.31	$129.83	Q0175	N		
Q0177	Hydroxyzine pamoate 25mg	"6,190"	"10,563"	$0.02	$11.56	$1.00	$0.71	$131.56	Q0177	N		
Q0180	Dolasetron mesylate oral	392	392	$6.31	$98.52	$66.00	$78.41	$39.90	Q0180	N		
Q2004	Bladder calculi irrig sol	1	1	$42.11	$42.11	$42.11	$42.11	.	Q2004	N		
Q2009	Fosphenytoin inj pe	"9,591"	"168,989"	$0.04	$270.66	$3.30	$1.38	$806.31	Q2009	N		
Q2017	"Teniposide, 50 mg"	3	3	$2.39	$2.39	$2.39	$2.39	$0.00	Q2017	K	7035	$2.39
Q2026	Radiesse injection	14	68	$22.75	$865.66	$71.92	$29.73	$461.85	Q2026	B		
Q2043	Sipuleucel-t auto cd54+	"1,425"	"1,425"	"$4,834.62"	"$60,452.50"	"$23,597.70"	"$22,048.14"	$44.67	Q2043	K	9273	"$35,094.12"
Q2049	Imported lipodox inj	"2,943"	"19,420"	$8.84	"$2,235.79"	$501.73	$476.50	$98.62	Q2049	K	1421	$508.43
Q2050	Doxorubicin inj 10mg	"7,716"	"51,580"	$0.68	"$3,767.13"	$492.69	$470.26	$136.94	Q2050	K	7046	$490.49
Q2051	Zoldedronic acid 1mg	"84,330"	"369,181"	$2.36	"$5,404.91"	$163.69	$153.16	$125.29	J3489	K	1356	$47.48
Q3025	Im inj interferon beta 1-a	"5,416"	"16,214"	$12.88	"$5,472.77"	$359.04	$269.35	$237.90	Q3027	K	1472	$36.37
Q4081	"Epoetin alfa, 100 units esrd"	"15,510"	"1,216,570"	$0.01	$808.27	$1.92	$1.39	"$2,301.34"	Q4081	N		
Q4100	"Skin substitute, nos"	"1,058"	"11,524"	$0.05	"$25,464.86"	$139.46	$18.63	"$1,582.87"	Q4100	N		
Q4101	Apligraf	"32,453"	"1,538,817"	$0.12	"$3,735.69"	$29.95	$25.90	$567.34	Q4101	N		
Q4102	Oasis wound matrix	"25,644"	"414,131"	$0.01	"$4,868.92"	$8.47	$4.77	"$1,356.78"	Q4102	N		
Q4103	Oasis burn matrix	37	"1,049"	$0.92	$44.80	$7.21	$3.50	$613.78	Q4103	N		
Q4104	Integra bmwd	399	"23,745"	$0.10	"$8,941.94"	$33.41	$13.92	"$4,190.57"	Q4104	N		
Q4105	Integra drt	17	500	$10.02	"$6,289.06"	$99.41	$17.88	"$2,567.29"	Q4105	N		
Q4106	Dermagraft	"17,575"	"681,680"	$0.18	$274.05	$30.12	$26.95	$383.34	Q4106	N		
Q4107	Graftjacket	653	"11,951"	$2.48	"$7,743.03"	$109.78	$71.40	"$1,080.68"	Q4107	N		
Q4108	Integra matrix	82	"2,901"	$0.55	"$3,702.63"	$48.98	$22.29	"$1,983.65"	Q4108	N		
Q4110	Primatrix	"3,126"	"77,811"	$0.01	"$2,795.72"	$37.21	$30.13	$581.93	Q4110	N		
Q4111	Gammagraft	37	"1,975"	$1.65	$482.21	$5.61	$2.73	"$2,409.60"	Q4111	N		
Q4112	Cymetra injectable	86	153	$49.80	"$1,095.58"	$185.23	$154.51	$109.68	Q4112	N		
Q4113	Graftjacket xpress	50	91	$186.17	"$3,931.62"	$858.68	$572.48	$124.76	Q4113	N		
Q4114	Integra flowable wound matri	102	253	$198.69	"$8,345.09"	"$1,275.91"	$915.13	$128.59	Q4114	N		
Q4115	Alloskin	236	"8,341"	$1.85	$26.02	$12.60	$14.62	$210.71	Q4115	N		
Q4116	Alloderm	"1,552"	"132,480"	$0.29	"$8,955.79"	$35.91	$25.75	"$4,380.35"	Q4116	N		
Q4118	Matristem micromatrix	"1,993"	"263,606"	$0.01	"$10,776.26"	$3.84	$2.31	"$16,743.43"	Q4118	N		
Q4119	Matristem wound matrix	"2,030"	"87,017"	$0.02	"$14,728.50"	$10.69	$5.42	"$6,041.08"	Q4119	N		
Q4120	Matristem burn matrix	39	"2,936"	$0.20	"$2,784.37"	$22.49	$15.72	"$4,000.75"	Q4120	N		
Q4121	Theraskin	"2,331"	"101,436"	$0.24	$923.61	$23.86	$16.97	"$1,311.63"	Q4121	G	1479	$32.42
Q4122	Dermacell	50	770	$8.30	"$3,455.76"	$130.23	$41.36	"$1,077.57"	Q4122	G	1419	$130.23
Q4123	Alloskin	6	442	$11.17	$462.51	$25.13	$11.17	"$1,207.65"	Q4123	N		
Q4124	Oasis tri-layer wound matrix	"4,201"	"226,870"	$0.03	"$1,411.51"	$11.30	$9.54	$940.74	Q4124	N		
Q4125	Arthroflex	30	743	$3.29	"$3,216.15"	$77.36	$46.36	"$1,316.65"	Q4125	N		
Q4126	Memoderm/derma/tranz/integup	19	338	$4.86	"$1,651.14"	$49.55	$37.80	"$1,025.07"	Q4126	N		
Q4127	Talymed	19	575	$4.65	$4.65	$4.65	$4.65	$0.00	Q4127	G	1449	$4.65
Q4128	Flexhd/allopatchhd/matrixhd	151	"8,233"	$9.13	"$13,507.19"	$43.36	$28.10	"$4,822.71"	Q4128	N		
Q4129	Unite biomatrix	4	23	$65.99	"$2,116.29"	$182.96	$65.99	$641.04	Q4129	N		
Q4130	Strattice tm	267	"25,867"	$0.13	"$13,984.36"	$38.28	$24.64	"$6,087.11"	Q4130	N		
Q4131	Epifix	"1,903"	"11,478"	$4.90	"$5,857.43"	$135.54	$114.08	$221.71	Q4131	N		
Q4132	Grafix core	58	"1,667"	$46.64	$358.60	$103.75	$86.32	$234.12	Q4132	N		
Q4133	Grafix prime	78	"1,546"	$40.11	"$6,000.77"	$109.87	$85.25	"$1,010.60"	Q4133	N		
Q4134	Hmatrix	8	106	$20.71	"$1,089.00"	$45.93	$20.71	$957.25	Q4134	N		
Q4135	Mediskin	5	"1,216"	$0.63	$215.06	$1.03	$0.82	"$11,144.39"	Q4135	N		
Q4136	Ezderm	44	"2,601"	$0.36	$423.41	$5.63	$0.36	"$1,595.70"	Q4136	N		
Q9951	"Locm >= 400 mg/ml iodine,1ml"	"8,582"	"596,719"	$0.01	$288.85	$0.68	$0.45	"$3,298.16"	Q9951	N		
Q9953	"Inj fe-based mr contrast,1ml"	"5,299"	"61,419"	$0.12	$269.04	$4.34	$2.74	$911.59	Q9953	N		
Q9954	"Oral mr contrast, 100 ml"	710	"3,434"	$0.08	$106.83	$7.25	$2.31	$407.00	Q9954	N		
Q9955	"Inj perflexane lip micros,ml"	3	6	$59.63	$203.55	$107.60	$59.63	$109.21	Q9955	N		
Q9956	"Inj octafluoropropane mic,ml"	"11,598"	"28,026"	$0.33	"$1,171.16"	$50.99	$42.45	$134.28	Q9956	N		
Q9957	"Inj perflutren lip micros,ml"	"80,328"	"140,971"	$4.78	$805.05	$78.18	$66.67	$89.87	Q9957	N		
Q9958	"Hocm <=149 mg/ml iodine, 1ml"	"18,742"	"2,733,767"	$0.01	$458.02	$0.37	$0.14	"$11,741.94"	Q9958	N		
Q9959	"Hocm 150-199mg/ml iodine,1ml"	"1,142"	"86,919"	$0.02	$504.89	$0.39	$0.13	"$13,311.24"	Q9959	N		
Q9960	"Hocm 200-249mg/ml iodine,1ml"	"5,358"	"295,620"	$0.03	$549.90	$0.42	$0.25	"$7,411.69"	Q9960	N		
Q9961	"Hocm 250-299mg/ml iodine,1ml"	"19,900"	"945,378"	$0.01	$597.61	$0.37	$0.24	"$2,551.62"	Q9961	N		
Q9962	"Hocm 300-349mg/ml iodine,1ml"	"10,683"	"721,698"	$0.01	$645.51	$1.08	$0.48	"$6,037.92"	Q9962	N		
Q9963	"Hocm 350-399mg/ml iodine,1ml"	"87,795"	"3,899,080"	$0.01	$359.39	$0.64	$0.30	"$4,010.92"	Q9963	N		
Q9964	"Hocm>= 400mg/ml iodine, 1ml"	"3,023"	"254,362"	$0.03	$118.54	$0.88	$0.53	"$3,611.64"	Q9964	N		
Q9965	"Locm 100-199mg/ml iodine,1ml"	"108,439"	"3,018,051"	$0.01	"$3,502.96"	$2.05	$0.69	"$2,766.53"	Q9965	N		
Q9966	"Locm 200-299mg/ml iodine,1ml"	"333,277"	"14,475,161"	$0.01	"$1,084.67"	$0.97	$0.46	"$2,730.51"	Q9966	N		
Q9967	"Locm 300-399mg/ml iodine,1ml"	"3,158,290"	"323,140,000"	$0.01	"$2,194.66"	$0.73	$0.52	"$1,809.14"	Q9967	N		
Q9968	Visualization adjunct	"20,830"	"746,440"	$0.01	"$3,927.46"	$4.39	$0.26	"$2,541.63"	Q9968	K	1446	$4.39
