oct-2021 add delete increase october 1, 2021 pricing
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Oct-2021
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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0.9 % sodium chloride 0.9 % solution $0.0041/Milliliter
0.9 % sodium chloride 0.9 % solution $0.0430/Milliliter
abacavir sulfate 300 MG tablet $0.3745/Each
abacavir sulfate 20 MG/ML Solution $0.5720/Milliliter
abacavir sulfate/lamivudine 600-300MG tablet $2.0015/Each
abacavir/lamivudine/zidovudine 150-300MG tablet $20.3355/Each
abiraterone acetate 250 MG tablet $2.0450/Each
abiraterone acetate 500 MG tablet $140.3554/Each
acamprosate calcium 333 mg tablet, delayed release (enteric coated) $0.4245/Each
acarbose 100 mg tablet $0.2252/Each
acarbose 50 mg tablet $0.1590/Each
acarbose 25 mg tablet $0.1230/Each
acebutolol hcl 200 mg capsule $0.1922/Each
acebutolol hcl 400 mg capsule $0.2500/Each
acetaminophen 500 mg capsule $0.0345/Each
acetaminophen 120 mg Suppository $0.2365/Each
acetaminophen 325 MG Suppository $0.3816/Each
acetaminophen 650 mg Suppository $0.3275/Each
acetaminophen 650 MG Caplet $0.0615/Each
acetaminophen 160 mg/5 ml Elixir $0.0000
acetaminophen 160 MG/5ML Elixir $0.0105/Milliliter
acetaminophen 500MG/15ML Liquid $0.0132/Milliliter
acetaminophen 100 mg/ml Drops $0.0000
acetaminophen 325 mg Caplet $0.0120/Each
acetaminophen 500 mg Caplet $0.0240/Each
acetaminophen 160 MG Tablet, Chewable $0.0718/Each
acetaminophen 80 mg soft chew $0.0386/Each
acetaminophen 80 MG meltaway $0.0505/Each
acetaminophen 160 MG meltaway $0.0715/Each
acetaminophen 80mg/0.8ml Drops, Suspension $0.1318/Milliliter
acetaminophen 160 mg/5ml Liquid $0.0203/Milliliter
acetaminophen 160 MG/5ML suspension $0.2980/Milliliter
acetaminophen 1000MG/100 solution $0.3960/Milliliter
acetaminophen w/codeine 120 mg; 12 mg Elixir $0.0000
acetaminophen w/codeine 300 mg; 15 mg tablet $0.1428/Each
acetaminophen w/codeine 300 mg; 30 mg tablet $0.1099/Each
acetaminophen w/codeine 300 mg; 60 mg tablet $0.2255/Each
acetaminophen with codeine 120-12MG/5 Elixir $0.2778/Milliliter
acetaminophen with codeine 300MG/12.5 Elixir $0.1555/Milliliter
acetaminophen with codeine 120-12MG/5 Solution $0.0128/Milliliter
acetaminophen/butalbital/caffeine 500 mg/50 mg/40 mg Caplet $0.0000
acetaminophen/diphenhydramine tablets 500 mg; 25 mg Caplet $0.0425/Each
acetazolamide 500 mg capsule, extended release $0.3300/Each
acetazolamide 125 mg tablet $0.6165/Each
acetazolamide 250 mg tablet $0.3350/Each
acetic acid 0.25 % Solution $0.0046/Milliliter
acetic acid 2% 15 ml Solution $1.2487/Milliliter
acetic acid\aluminum acetate 0.02 Drops $0.0000
acetic acid\hydrocortisone 2% - 1% Drops $5.8627/Milliliter
acetylcysteine 100 mg/ml Solution $0.3908/Milliliter
acetylcysteine 200 mg/ml Solution $0.3575/Milliliter
acetylcysteine 200 MG/ML Solution $2.8500/Milliliter
acetylcysteine 10% 4 ml Solution $0.0000
acetylcysteine 10% 10 ml Solution $0.0000
acetylcysteine 10% 30 ml Solution $0.0000
acetylcysteine 20% 4 ml Solution $0.0000
acetylcysteine 20% 10 ml Solution $0.0000
acetylcysteine 20% 30 ml Solution $0.0000
acitretin 10 MG capsule $5.7674/Each Decrease
Page 1 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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acitretin 25 MG capsule $10.0665/Each
acitretin 17.5 MG capsule $23.0775/Each
acyclovir 800 mg tablet $0.1350/Each
acyclovir 400 mg tablet $0.0575/Each
acyclovir 5 % Ointment $0.9567/Gram Decrease
acyclovir 200 mg/5 ml Suspension $0.3555/Milliliter
acyclovir 200 mg capsule $0.0975/Each
acyclovir sodium 500 mg/vial Solution $0.0000
acyclovir sodium 1 gm/vial Solution $0.0000
acyclovir sodium 50 MG/ML Solution $0.4500/Milliliter
adapalene 0.001 Gel $0.8120/Gram
adapalene 0.001 Cream $0.0000
adapalene 0.3 % Gel $0.0000
adapalene 0.3% gel 0.3% Gel $1.3170/Gram
adapalene/benzoyl peroxide 0.1 %-2.5% Gel $1.0550/Gram
adefovir dipivoxil 10 MG tablet $22.8785/Each
adenosine 3 MG/ML solution $3.3393/Milliliter
albendazole 200 MG tablet $32.5800/Each Decrease
albuterol 90 mcg Aerosol $0.0000
albuterol sulfate 0.63 mg/3 ml Solution $0.2045/Milliliter
albuterol sulfate 1.25 mg/3 ml Solution $0.2065/Milliliter
albuterol sulfate 2 mg tablet $1.8162/Each
albuterol sulfate 4 mg tablet $0.7650/Each
albuterol sulfate 2 mg/5 ml Syrup $0.0134/Milliliter
albuterol sulfate 4 mg tablet, extended release $1.3345/Each
albuterol sulfate 8 mg tablet, extended release $2.4100/Each
albuterol sulfate 0.5% (5mg/ml) Solution $0.8910/Milliliter
albuterol sulfate 0.083% Solution $0.0422/Milliliter
alclometasone dipropionate 0.05% Cream $1.3825/Gram
alclometasone dipropionate 0.0005 Ointment $0.7950/Gram
alendronate sodium 35 mg tablet $0.3368/Each
alendronate sodium 70 mg/75 mL solution, oral $0.7183/Milliliter
alendronate sodium 10 mg tablet $0.1650/Each
alendronate sodium 40 mg tablet $2.3520/Each
alendronate sodium 5 mg tablet $0.1440/Each
alendronate sodium 70 mg tablet $0.2550/Each
alfuzosin hcl 10 mg tablet, extended release $0.1341/Each
aliskiren hemifumarate 300 MG tablet $7.6425/Each
aliskiren hemifumarate 150 MG tablet $4.9375/Each
allopurinol 100 mg tablet $0.0300/Each
allopurinol 300 mg tablet $0.0750/Each
almotriptan malate 12.5 mg tablet $20.0975/Each
almotriptan malate 6.25 mg tablet $33.8701/Each
alosetron hcl 0.5 mg tablet $9.1160/Each
alosetron hcl 1 mg tablet $10.9413/Each
alprazolam 0.25 mg tablet $0.0185/Each
alprazolam 0.5 mg tablet $0.0135/Each
alprazolam 1 mg tablet $0.0258/Each
alprazolam 2 mg tablet $0.0525/Each
alprazolam 0.5 mg tablet, extended release $0.1818/Each
alprazolam 1 mg tablet, extended release $0.1212/Each
alprazolam 2 mg tablet, extended release $0.1538/Each
alprazolam 3 mg tablet, extended release $0.1725/Each
alprazolam 0.25 MG Tablet,disintegrating $1.0855/Each
alprazolam 0.5 MG Tablet,disintegrating $1.1760/Each
alprazolam 1 MG Tablet,disintegrating $1.1025/Each
alprazolam 2 MG Tablet,disintegrating $3.3550/Each
amantadine hcl 100 mg capsule $0.3075/Each
amantadine hcl 100 MG tablet $0.5560/Each
amantadine hcl 50 mg/5 ml Solution $0.0205/Milliliter
Page 2 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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ambrisentan 5 MG tablet $36.6500/Each
ambrisentan 10 MG tablet $36.6500/Each
amikacin sulfate 500 MG/2ML Solution $3.5240/Milliliter
amikacin sulfate 1000MG/4ML Solution $0.0000
amikacin sulfate/preservative free 100 mg/2 ml Solution $0.0000
amiloride hcl 5 mg tablet $0.2739/Each
amiloride/hydrochlorothiazide 5 MG-50 MG tablet $0.3658/Each
aminocaproic acid 250 MG/ML solution $0.3085/Milliliter
aminocaproic acid 250 mg/ml Solution $0.0000
aminocaproic acid 500 mg tablet $0.0000
aminophylline 200 mg tablet $0.0000
amiodarone hcl 200 mg tablet $0.1235/Each
amiodarone hcl 100 MG tablet $1.4250/Each
amiodarone hcl 400 MG tablet $1.8700/Each
amiodarone HCl 50 MG/ML solution $0.3735/Milliliter
amitriptyline hcl 10 mg tablet $0.0300/Each
amitriptyline hcl 100 mg tablet $0.2550/Each
amitriptyline hcl 150 mg tablet $0.5655/Each
amitriptyline hcl 25 mg tablet $0.0553/Each
amitriptyline hcl 50 mg tablet $0.1775/Each
amitriptyline hcl 75 mg tablet $0.2550/Each
amitriptyline/chlordiazepoxide 12.5MG-5MG tablet $1.1550/Each
amitriptyline/chlordiazepoxide 25 MG-10MG tablet $1.5872/Each
amitriptyline; perphenazine 10 mg; 4 mg tablet $0.0000
amitriptyline; perphenazine 10 mg; 2 mg tablet $0.0000
amitriptyline; perphenazine 25 mg; 2 mg tablet $0.0000
amitriptyline; perphenazine 25 mg; 4 mg tablet $0.0000
amitriptyline; perphenazine 50 mg; 4 mg tablet $0.0000
amlodipine bes/olmesartan med 5 MG-20 MG tablet $0.2550/Each
amlodipine bes/olmesartan med 10 MG-20MG tablet $0.5500/Each
amlodipine bes/olmesartan med 5 MG-40 MG tablet $0.3150/Each
amlodipine bes/olmesartan med 10 MG-40MG tablet $0.2550/Each
amlodipine besylate 2.5 mg tablet $0.0150/Each
amlodipine besylate 10 mg tablet $0.0195/Each
amlodipine besylate 5 mg tablet $0.0150/Each
amlodipine besylate/benazepril 10 mg; 20 mg capsule $0.1212/Each
amlodipine besylate/benazepril 5 mg; 20 mg capsule $0.1110/Each
amlodipine besylate/benazepril 5 mg; 10 mg capsule $0.1052/Each
amlodipine besylate/benazepril 2.5 mg; 10 mg capsule $0.1143/Each
amlodipine besylate/benazepril hcl 5 mg-40 mg capsule $0.1385/Each
amlodipine besylate/benazepril hcl 10 mg-40 mg capsule $0.1465/Each
amlodipine/atorvastatin 5 MG-10 MG tablet $1.9755/Each
amlodipine/atorvastatin 5 MG-20 MG tablet $1.5527/Each Decrease
amlodipine/atorvastatin 5 MG-40 MG tablet $2.2450/Each Decrease
amlodipine/atorvastatin 5 MG-80 MG tablet $5.1000/Each
amlodipine/atorvastatin 10 MG-10MG tablet $1.8875/Each
amlodipine/atorvastatin 10 MG-20MG tablet $2.2735/Each
amlodipine/atorvastatin 10 MG-40MG tablet $2.1650/Each
amlodipine/atorvastatin 10 MG-80MG tablet $2.6850/Each
amlodipine/atorvastatin 2.5MG-10MG tablet $3.7320/Each
amlodipine/atorvastatin 2.5MG-20MG tablet $2.8000/Each
amlodipine/atorvastatin 2.5MG-40MG tablet $3.7481/Each
amlodipine/valsartan 5MG-160MG tablet $0.4250/Each
amlodipine/valsartan 10MG-160MG tablet $0.4130/Each
amlodipine/valsartan 5MG-320MG tablet $0.5435/Each
amlodipine/valsartan 10MG-320MG tablet $0.5820/Each
amlodipine/valsartan/hcthiazid 5-160-12.5 tablet $0.7700/Each
amlodipine/valsartan/hcthiazid 10 mg-160 mg tablet $1.1175/Each
amlodipine/valsartan/hcthiazid 5-160-25MG tablet $0.7445/Each
amlodipine/valsartan/hcthiazid 10-160-25 tablet $0.9534/Each
Page 3 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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amlodipine/valsartan/hcthiazid 10-320-25 tablet $1.1635/Each
ammonium and potassium iodides Tincture $0.0662/Milliliter
ammonium lactate 12% Cream $0.0739/Gram
amox/potassium clavulanate 600-42.9/5 Suspension $0.0334/Milliliter
amox/potassium clavulanate 500-125 mg tablet $0.2400/Each
amox/potassium clavulanate 875-125 mg tablet $0.2165/Each
amox/potassium clavulanate 400-57 mg Tablet, Chewable $2.0000/Each
amox/potassium clavulanate 200-28.5mg Tablet, Chewable $2.3755/Each
amox/potassium clavulanate 400-57/5 Suspension $0.0555/Milliliter
amox/potassium clavulanate 200-28.5/5 Suspension $0.0550/Milliliter
amoxapine 150 mg tablet $0.0000
amoxicillin 875 mg tablet $0.1195/Each
amoxicillin 125 mg Tablet, Chewable $0.0000
amoxicillin 250 mg Tablet, Chewable $0.2306/Each
amoxicillin 125 mg/5 ml Suspension $0.0199/Milliliter
amoxicillin 250 mg/5 ml Suspension $0.0165/Milliliter
amoxicillin 400 mg Tablet, Chewable $0.0000
amoxicillin 200 mg/5 ml Suspension $0.0299/Milliliter
amoxicillin (trihydrate) 250 mg capsule $0.0754/Each
amoxicillin (trihydrate) 500 mg capsule $0.0595/Each
amoxicillin os 400 mg/5 ml Suspension $0.0353/Milliliter
amoxicillin trihydrate 500 mg tablet $0.1230/Each
amoxicillin trihydrate/potassium clavulanate 250-125mg tablet $1.5125/Each
amoxicillin trihydrate/potassium clavulanate 250 - 62.5/5 ml Suspension $0.4385/Milliliter
amoxicillin trihydrate/potassium clavulanate 1000-62.5 tablet, extended release $4.8852/Each
amphet asp/amphet/d-amphet 10 mg capsule, extended release $0.0000
amphet asp/amphet/d-amphet 20 mg capsule, extended release $0.0000
amphet asp/amphet/d-amphet 30 mg capsule, extended release $0.0000
amphet asp/amphet/d-amphet 5 mg capsule, extended release $0.0000
amphet asp/amphet/d-amphet 15 mg capsule, extended release $0.0000
amphet asp/amphet/d-amphet 25 mg capsule, extended release $0.0000
amphet asp/amphet/d-amphet 15 mg tablet $0.2655/Each
amphetamine sulfate 10 MG tablet $3.7125/Each
amphetamine sulfate 5 MG tablet $4.7835/Each
amphetamine/d-amphetamine salts 7.5 mg tablet $0.5035/Each
amphetamine/d-amphetamine salts 12.5 mg tablet $0.4555/Each
amphetamine/d-amphetamine salts 5 mg tablet $0.1575/Each
amphetamine/d-amphetamine salts 10 mg tablet $0.2055/Each
amphetamine/d-amphetamine salts 30 mg tablet $0.4415/Each
amphetamine/d-amphetamine salts 20 mg tablet $0.2055/Each
ampicillin sodium 1 G Solution $2.0500/Each
ampicillin sodium 10 G Solution $33.5500/Each
ampicillin sodium 2 G Solution $3.2500/Each
ampicillin sodium 250 MG Solution $0.8250/Each
ampicillin sodium 500 MG Solution $1.1250/Each
ampicillin sodium/sulbactam Na 1.5 G Solution $1.9500/Each
ampicillin sodium/sulbactam Na 15 G Solution $16.9550/Each
ampicillin sodium/sulbactam sodium 3 gm Solution $5.6280/Each
ampicillin trihydrate 250 mg capsule $0.0000
ampicillin trihydrate 500 mg capsule $0.1115/Each
ampicillin trihydrate 125 mg/5 ml Suspension $0.0000
amylase/lipase/protease 48,000 units; 16,000 units; 48,000 units capsule,delayed release (e.c.) $0.0000
amylase/lipase/protease 65,000 units; 20,000 units; 65,000 units capsule,delayed release (e.c.) $0.0000
amylase/lipase/protease 56,000 units; 20,000 units; 44,000 units capsule,delayed release (e.c.) $0.0000
amylase/lipase/protease 33,200 units; 10,000 units; 38,000 units capsule,delayed release (e.c.) $0.0000
amylase/lipase/protease 20,000 units; 4,500 units; 25,000 units capsule,delayed release (e.c.) $0.0000
amylase/lipase/protease 66,400 units; 20,000 units; 75,000 units capsule,delayed release (e.c.) $0.0000
anagrelide hcl 0.5 mg capsule $0.3860/Each
anagrelide hcl 1 mg capsule $1.0025/Each
anastrozole 1 mg tablet $0.1070/Each
Page 4 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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antipyrine/benzocaine otic 5.4%/1.4% Drops $0.0000
aprepitant 80 MG capsule $158.2940/Each
aprepitant 125 MG capsule $247.0687/Each
aprepitant 125MG-80MG capsule $149.4000/Each
aprepitant 40 MG capsule $74.7045/Each
arformoterol tartrate 15MCG/2ML solution $6.0415/Milliliter
aripiprazole 10 MG tablet $0.1890/Each
aripiprazole 15 MG tablet $0.1855/Each
aripiprazole 20 MG tablet $0.2458/Each
aripiprazole 30 MG tablet $0.2456/Each
aripiprazole 5 MG tablet $0.1830/Each
aripiprazole 1 MG/ML Solution $1.2150/Milliliter
aripiprazole 2 MG tablet $0.1655/Each
aripiprazole 10 MG Tablet,disintegrating $26.1890/Each
aripiprazole 15 MG Tablet,disintegrating $28.4142/Each
armodafinil 200 MG tablet $0.6095/Each
armodafinil 150 MG tablet $0.9199/Each
armodafinil 50 MG tablet $0.1465/Each
armodafinil 250 MG tablet $0.8912/Each
arsenic trioxide 10 MG/10ML solution $20.5750/Milliliter
aspirin 81 mg tablet, delayed release (enteric coated) $0.0150/Each
aspirin 325 mg Caplet $0.0120/Each
aspirin 81 mg Caplet $0.0075/Each
aspirin 5 gr Caplet $0.0150/Each
aspirin buffered 325 mg Caplet $0.0000
aspirin w/codeine 325 mg; 30 mg tablet $0.0000
aspirin w/codeine 325 mg; 60 mg tablet $0.0000
aspirin/acetaminophen/caffeine 250-250-65 tablet $0.0350/Each
aspirin/butalbital/caffeine/codeine 30 mg capsule $1.0443/Each
aspirin/dipyridamole 25mg-200mg capsule, extended release $0.8650/Each
atazanavir sulfate 150 MG capsule $4.5855/Each
atazanavir sulfate 200 MG capsule $3.9550/Each
atazanavir sulfate 300 MG capsule $5.9201/Each Decrease
atenolol 100 mg tablet $0.0210/Each
atenolol 50 mg tablet $0.0150/Each
atenolol 25 mg tablet $0.0150/Each
atenolol; chlorthal 50 mg; 25 mg tablet $0.3750/Each
atenolol; chlorthal 100 mg; 25 mg tablet $0.4095/Each
atomoxetine HCl 10 MG capsule $1.0150/Each
atomoxetine HCl 18 MG capsule $0.8602/Each
atomoxetine HCl 25 MG capsule $0.8530/Each
atomoxetine HCl 40 MG capsule $1.0660/Each
atomoxetine HCl 60 MG capsule $1.9015/Each
atomoxetine HCl 80 MG capsule $1.6652/Each
atomoxetine HCl 100 MG capsule $0.9510/Each
atorvastatin calcium 10 mg tablet $0.0300/Each
atorvastatin calcium 20 mg tablet $0.0300/Each
atorvastatin calcium 40 mg tablet $0.0500/Each
atorvastatin calcium 80 mg tablet $0.1000/Each
atovaquone 750 mg/5 ml Suspension $1.0763/Milliliter
atovaquone/proguanil hcl 250-100 MG tablet $2.6555/Each
atovaquone/proguanil hcl 62.5-25 MG tablet $0.9115/Each
atropine sulfate 0.4 MG/ML solution $4.7225/Milliliter
atropine sulfate 0.01 Drops $0.0000
atropine sulfate 1%, 15 ml Drops $0.0000
azacitidine 100 MG Solution $114.5000/Each
azathioprine 50 mg tablet $0.2700/Each
azelaic acid 15 % gel $1.1250/Gram
azelastine hcl 205.5MCG Spray, Non-Aerosol $0.4965/Milliliter
azelastine hcl 137 mcg Aerosol, Spray $0.2825/Milliliter
Page 5 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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azelastine hcl 0.0005 Drops $0.9375/Milliliter
azelastine/fluticasone 137-50 MCG spray, non-aerosol $4.9524/Gram Decrease
azithromycin 100 mg/5 ml Suspension $0.4677/Milliliter
azithromycin 250 mg tablet $0.2833/Each
azithromycin 600 mg tablet $1.4075/Each
azithromycin 500 MG Solution $3.5020/Each
azithromycin 500 mg tablet $0.7575/Each
azithromycin 200 mg/5 ml Suspension $0.3500/Milliliter
azithromycin 200 MG/5ML Suspension $0.0000
azithromycin 200 MG/5ML Suspension $0.0000
azithromycin 200 MG/5ML Suspension $0.0000
bacitracin 500 units/gm Ointment $0.0766/Gram
bacitracin 50000 UNIT Solution $6.1599/Each
bacitracin zinc/polymyxin B 500-10K/G ointment $0.0835/Gram
bacitracin/neomycin sulfate/polymyxin b 400 units/3.5 mg/5,000 units per gm Ointment $0.1095/Gram Decrease
bacitracin/neomycin/polymyxin b/hc 3.5 gr Ointment $0.0000
bacitracin/polymyxin b sulfate 500-10K/G Ointment $0.0000
bacitracin/polymyxin b sulfate 500-10K/G Ointment $2.7000/Gram
bacitracin/polymyxin b sulfate 15 gr Ointment $0.0000
baclofen 10 mg tablet $0.0772/Each
baclofen 20 mg tablet $0.0930/Each
baclofen 5 MG tablet $0.8156/Each
balanced salt irrig soln no.2 solution $0.1987/Milliliter
balsalazide disodium 750 mg capsule $0.3255/Each
benazepril hcl 5 mg tablet $0.0252/Each
benazepril hcl 10 mg tablet $0.0292/Each
benazepril hcl 20 mg tablet $0.0435/Each
benazepril hcl 40 mg tablet $0.0600/Each
benazepril/hctz 5-6.25 mg tablet $1.1000/Each
benazepril/hctz 10-12.5 mg tablet $0.6235/Each
benazepril/hctz 20-12.5 mg tablet $0.0655/Each
benazepril/hctz 20-25 mg tablet $0.4952/Each
benzocaine/menthol 15MG-3.6MG lozenge $0.1058/Each
benzonatate 150 MG capsule $0.2375/Each
benzonatate 100 mg capsule $0.0840/Each
benzonatate 200 mg capsule $0.1405/Each
benzoyl peroxide 9% Cleanser $0.0000
benzoyl peroxide 10 % Gel $0.0725/Gram
benzoyl peroxide 0.05 Gel $0.2335/Gram
benzoyl peroxide 2.5 % Gel $0.2260/Gram
benzoyl peroxide 4 % Cleanser $0.0000
benzoyl peroxide 10 % Cleanser $0.0520/Gram
benzoyl peroxide 10 % Lotion $0.0799/Milliliter
benzoyl peroxide 8 % Cleanser $0.0000
benzoyl peroxide 3 % Cleanser $0.0000
benzoyl peroxide 6 % Cleanser $0.0755/Gram
benzoyl peroxide 5 % Cleanser $0.0448/Gram
benztropine mesylate 0.5 mg tablet $0.0945/Each
benztropine mesylate 1 mg tablet $0.0933/Each
benztropine mesylate 2 mg tablet $0.1145/Each
bepotastine besilate 1.5 % drops $40.7950/Milliliter
betamethasone acetate,sod phos 6 MG/ML Suspension $7.5550/Milliliter
betamethasone dipropionate 0.05 % cream $0.6510/Gram
betamethasone dipropionate 0.05%, 15 gm Cream $0.0000
betamethasone dipropionate 0.05%, 45 gm Cream $0.0000
betamethasone dipropionate 0.0005 Ointment $1.8360/Gram
betamethasone dipropionate 0.05%, 15 gm Ointment $2.1595/Gram
betamethasone dipropionate 0.05%, 45 gm Ointment $1.0650/Gram
betamethasone dipropionate 0.05%, 50 gm Ointment $0.0000
betamethasone dipropionate 0.05%, 60 ml Lotion $0.4475/Milliliter
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NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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betamethasone dipropionate 0.05% Gel $0.6204/Gram
betamethasone dipropionate augmented 0.05% Cream $0.1245/Gram
betamethasone dipropionate augmented 0.0005 Ointment $1.0267/Gram
betamethasone valerate 0.1 % Cream $0.4145/Gram
betamethasone valerate 0.1%, 15 gm Cream $0.0000
betamethasone valerate 0.1%, 45 gm Cream $0.0000
betamethasone valerate 0.001 Ointment $0.4665/Gram
betamethasone valerate 0.1%, 15 gm Ointment $0.0000
betamethasone valerate 0.1%, 45 gm Ointment $0.0000
betamethasone valerate 0.1%, 60 ml Lotion $0.5442/Milliliter
betamethasone valerate 0.12 % Foam $0.7575/Gram
betamethasone/propylene glyc 0.05 % Lotion $1.0276/Milliliter Decrease
betaxolol hcl 10 MG tablet $0.5500/Each
betaxolol HCl 20 MG tablet $0.8850/Each
betaxolol hcl 0.5 % Drops $7.2000/Milliliter
bethanechol chloride 10 mg tablet $0.1515/Each
bethanechol chloride 25 mg tablet $0.4215/Each
bethanechol chloride 5 mg tablet $0.0840/Each
bethanechol chloride 50 mg tablet $0.4242/Each Decrease
bexarotene 75 MG capsule $40.8295/Each
bicalutamide 50 mg tablet $0.1765/Each
bimatoprost 0.03 % drops $35.4500/Milliliter
bisacodyl 5 mg Caplet $0.0000
bisacodyl 10 mg Suppository $0.0840/Each
bisacodyl 5 mg tablet, delayed release (enteric coated) $0.0216/Each
bismuth subsalicylate 262 mg Tablet, Chewable $0.0538/Each
bismuth subsalicylate 262 MG Caplet $0.0621/Each
bismuth subsalicylate 262mg/15ml Liquid $0.0088/Milliliter
bismuth subsalicylate 525MG/15ML liquid $0.0095/Milliliter
bisoprolol fumarate 10 mg tablet $0.2725/Each
bisoprolol fumarate 5 mg tablet $0.2530/Each
bisoprolol/hctz 2.5/6.25 tablet $0.0447/Each
bisoprolol/hctz 5/6.25 tablet $0.0606/Each
bisoprolol/hctz 10/6.25 tablet $0.0393/Each
bivalirudin 250 MG Solution $135.2500/Each
bleomycin sulfate 15 unit Solution $44.3850/Each
bleomycin sulfate 30 unit Solution $82.6210/Each
brimonide tartrate 0.15% Drops $20.7060/Milliliter
brimonidine tartrate 0.002 Drops $0.3756/Milliliter
bromfenac sodium 0.09% Drops $42.0400/Milliliter
bromocriptine mesylate 5 mg capsule $3.6395/Each
bromocriptine mesylate 2.5 mg tablet $1.6395/Each
brompheniramin/pseudoephedrine 1-15MG/5ML Elixir $0.0095/Milliliter
brompheniramine/phenylephrine 1-2.5 MG/5 Elixir $0.0180/Milliliter
brompheniramine/phenylephrine 4MG-10MG tablet $0.6445/Each
budesonide 0.25MG/2ML suspension $0.6355/Milliliter
budesonide 0.5 MG/2ML suspension $0.6735/Milliliter
budesonide 3 mg Capsule, Delayed and Extended Release $0.9045/Each
budesonide 9 MG Tablet, Delayed and Extended Release $25.6740/Each
budesonide 32MCG Spray, Non-Aerosol $1.1724/Milliliter
budesonide 1 MG/2 ML suspension $3.3585/Milliliter
budesonide 32 mcg Spray, Non-Aerosol $0.0000
bumetanide 0.25 MG/ML solution $0.4402/Milliliter
bumetanide 0.5 mg tablet $0.3355/Each
bumetanide 1 mg tablet $0.2550/Each
bumetanide 2 mg tablet $0.3559/Each
bupivacaine HCl/epinephrine 0.25-.0005 solution $0.1881/Milliliter
buprenorphine HCl 0.3 MG/ML solution $14.3950/Milliliter
buprenorphine hcl 2 mg Tablet, Sublingual $0.2345/Each
buprenorphine hcl 8 mg Tablet, Sublingual $0.7520/Each
Page 7 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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buprenorphine hcl/naloxone hcl 2 mg-0.5mg Tablet, Sublingual $1.0555/Each
buprenorphine hcl/naloxone hcl 8 mg-2 mg Tablet, Sublingual $1.2550/Each
bupropion hcl 75 mg tablet $0.0888/Each
bupropion hcl 100 mg tablet $0.1765/Each
bupropion hcl 150 mg tablet, extended release $0.0790/Each
bupropion hcl 100 mg tablet, extended release $0.0750/Each
bupropion hcl 200 mg tablet, extended release $0.1575/Each
bupropion hcl 150 mg tablet, extended release $0.1096/Each
bupropion hcl 300 mg tablet, extended release $0.1867/Each
bupropion hcl 150 mg tablet, extended release $0.2725/Each
bupropion HCl 450 MG tablet, extended release $7.6550/Each
buspirone hcl 7.5 MG tablet $0.2752/Each
buspirone hcl 5 mg tablet $0.0213/Each
buspirone hcl 10 mg tablet $0.0290/Each
buspirone hcl 15 mg tablet $0.0435/Each
buspirone hcl 30 mg tablet $0.2205/Each
busulfan 60 MG/10ML solution $21.5500/Milliliter
butalb/acetaminophen/caffeine 50-325/15 solution $2.2985/Milliliter
butalb/acetaminophen/caffeine 50-325-40 capsule $1.6288/Each
butalbit/acetamin/caff/codeine 50-300-30 capsule $4.8785/Each
butalbital/acetaminophen 50MG-300MG tablet $6.8875/Each
butalbital/acetaminophen 50MG-300MG capsule $10.9616/Each
butalbital/acetaminophen 50MG-325MG tablet $0.8885/Each
butalbital/acetaminophen/caffeine 50-300-40 capsule $0.5040/Each
butalbital/apap/caffeine compound 50 mg/325 mg/40 mg tablet $0.2199/Each
butalbital/apap/caffeine/codeine 50 mg/325 mg/40 mg/30 mg capsule $0.9251/Each
butalbital/aspirin/caff 50 mg/325 mg/40 mg capsule $0.8695/Each
butalbital/aspirin/caffeine 50 mg/325 mg/40 mg tablet $0.0000
butorphanol tartrate 10 mg/ml Spray, Non-Aerosol $11.7260/Milliliter
cabergoline 0.5 mg tablet $2.5150/Each
caffeine 200 MG tablet $0.0890/Each
caffeine citrate 60 MG/3 ML solution $7.4190/Milliliter
caffeine citrated 60 mg/3 ml Solution $0.0000
calamine/zinc oxide 8 %-8 % lotion $0.0088/Milliliter
calcipotriene 0.005 % ointment $2.2095/Gram
calcipotriene 0.005 % Cream $0.0000
calcipotriene 0.00005 Solution $1.0575/Milliliter
calcipotriene/betamethasone 0.005-.064 Ointment $4.6852/Gram Decrease
calcipotriene/betamethasone 0.005-.064 suspension $7.3185/Gram
calcitonin,salmon,synthetic 200 units/dose Spray, Non-Aerosol $7.7135/Milliliter
calcitriol 1 MCG/ML solution $7.2275/Milliliter
calcitriol 1 mcg/ml Solution $4.7971/Milliliter Decrease
calcitriol 0.25 mcg capsule $0.2225/Each
calcitriol 0.5 mcg capsule $0.3180/Each
calcium acetate 667 mg capsule $0.1746/Each
calcium acetate 667 MG tablet $0.0000
calcium carbonate 1250 mg Caplet $0.0240/Each
calcium carbonate 600 MG tablet $0.0175/Each
calcium carbonate 500 MG/5ML Suspension $0.0168/Milliliter
calcium carbonate 200(500)mg Tablet, Chewable $0.0150/Each
calcium carbonate 300MG(750) Tablet, Chewable $0.0115/Each
calcium carbonate 400(1000) tablet,chewable $0.0300/Each
calcium carbonate 320MG(750) tablet,chewable $0.0320/Each
calcium carbonate 215(500)MG Tablet, Chewable $0.0138/Each
calcium carbonate/cholecalciferol (vitamin d3) 600 mg-400 Caplet $0.0168/Each
calcium carbonate/cholecalciferol (vitamin d3) 500 mg-200 Caplet $0.0316/Each
calcium carbonate/cyanocobalamin/folic acid/pyridoxine 200-12-1 tablet, extended release $0.2000/Each
calcium polycarbophil 625 mg Caplet $0.0600/Each
camphor Spirit $0.0400/Milliliter
candesartan cilexetil 4 mg tablet $0.5597/Each
Page 8 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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candesartan cilexetil 8 mg tablet $0.5640/Each
candesartan cilexetil 16 mg tablet $0.7200/Each
candesartan cilexetil 32 mg tablet $1.0200/Each
candesartan/hydrochlorothiazid 32mg-25mg tablet $1.5095/Each
candesartan/hydrochlorothiazid 16-12.5mg tablet $2.1315/Each
candesartan/hydrochlorothiazid 32-12.5mg tablet $1.3590/Each
capecitabine 150 MG tablet $0.2915/Each
capecitabine 500 mg tablet $0.4765/Each
captopril 100 mg tablet $1.3205/Each
captopril 25 mg tablet $0.7395/Each
captopril 50 mg tablet $0.8670/Each
captopril 12.5 mg tablet $0.4635/Each Decrease
captopril; hydrochlorothiazide 25 mg; 15 mg tablet $0.0263/Each
captopril; hydrochlorothiazide 25 mg; 25 mg tablet $0.0568/Each
captopril; hydrochlorothiazide 50 mg; 15 mg tablet $0.0665/Each
captopril; hydrochlorothiazide 50 mg; 25 mg tablet $0.0000
carbamazepine 200 mg tablet $0.2850/Each
carbamazepine 100 mg Tablet, Chewable $0.2845/Each
carbamazepine 200 mg capsule, extended release $0.6365/Each
carbamazepine 300 mg capsule, extended release $1.3015/Each
carbamazepine 100 mg capsule, extended release $0.5155/Each
carbamazepine 100 MG/5ML suspension $0.6049/Milliliter
carbamazepine 100 MG tablet, extended release $0.6255/Each
carbamazepine 200 mg tablet, extended release $1.1700/Each
carbamazepine 400 mg tablet, extended release $2.0885/Each
carbamazepine 100 mg/5 ml Suspension $0.1210/Milliliter
carbamide peroxide 6.5 % Drops $0.1005/Milliliter
carbetapentane/ephedrine/phenylephrine/chlorpheniramine 30-5-5-4 mg/5 ml Liquid $0.0000
carbidopa 25 MG tablet $3.5125/Each
carbidopa/levodopa 10mg-100mg Tablet,disintegrating $0.6300/Each
carbidopa/levodopa 25MG-100MG Tablet,disintegrating $0.6850/Each
carbidopa/levodopa 25MG-250MG Tablet,disintegrating $0.8700/Each
carbidopa/levodopa/entacapone 18.75-75MG tablet $1.2960/Each
carbidopa/levodopa/entacapone 31.25-125 tablet $0.9350/Each
carbidopa/levodopa/entacapone 37.5-150MG tablet $1.0825/Each
carbidopa/levodopa/entacapone 25-100-200 tablet $0.9870/Each
carbidopa/levodopa/entacapone 12.5-50 MG tablet $0.9550/Each
carbidopa/levodopa/entacapone 50-200-200 tablet $0.8335/Each
carbidopa; levodopa 10 mg; 100 mg tablet $0.0922/Each
carbidopa; levodopa 25 mg; 100 mg tablet $0.0750/Each
carbidopa; levodopa 25 mg; 250 mg tablet $0.1255/Each
carbidopa; levodopa er 50 mg; 200 mg tablet, extended release $0.3382/Each
carbidopa; levodopa er 25 mg; 100 mg tablet, extended release $0.1650/Each
carbinoxamine maleate 4 mg/5 ml Liquid $0.0712/Milliliter
carbinoxamine maleate 4 MG tablet $0.2240/Each
carbinoxamine maleate; pseudoephedrine; dextrometh hbr 15-60-4/5 Syrup $0.0000
carbinoxamine maleate; pseudoephedrine; dextrometh hbr 4-15-1 Drops $0.0000
carbinoxamine maleate; pseudoephedrine; dextrometh hbr 4-15-2 Drops $0.0000
carbinoxamine maleate; pseudoephedrine; dextrometh hbr 4 mg; 60 mg; 15 mg per 5 ml Syrup $0.0000
carboplatin 10 mg/ ml Solution $0.7545/Milliliter
carboplatin 50 mg Solution $0.0000
carboplatin 150 mg Solution $0.0000
carboplatin 450 mg Solution $0.0000
carboxymethylcellulose sodium 0.5 % drops $0.2030/Milliliter
carboxymethylcellulose sodium 0.5 % Dropperette $0.1815/Each
car-b-pen ta/phenylephrine/pyr 30 mg; 5 mg; 30 mg/5 ml Suspension $0.0000
carisoprodol 350 mg tablet $0.0621/Each
carisoprodol 250 MG tablet $1.3335/Each
carisoprodol/asa compound 200 mg; 325 mg tablet $0.4334/Each
carisoprodol/aspirin/codeine 200-325-16 tablet $1.9000/Each
Page 9 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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carmustine 100 MG solution $2925.0000/Each
carteolol hcl 0.01 Drops $0.9528/Milliliter
carvedilol 25 mg tablet $0.0295/Each
carvedilol 12.5 mg tablet $0.0195/Each
carvedilol 3.125 mg tablet $0.0150/Each
carvedilol 6.25 mg tablet $0.0308/Each
carvedilol phosphate 20 MG capsule, extended release $5.9530/Each
caspofungin acetate 50 MG Solution $74.5550/Each
caspofungin acetate 70 MG Solution $79.5550/Each
cefaclor 500 mg tablet, extended release $0.0000
cefaclor 250 mg capsule $0.7453/Each
cefaclor 500 mg capsule $1.1355/Each
cefaclor 125 mg/5 ml Suspension $0.0000
cefaclor 250 mg/5 ml Suspension $0.0000
cefaclor 187 mg/5 ml Suspension $0.0000
cefaclor 375 mg/5 ml Suspension $0.0000
cefadroxil 500 mg capsule $0.2000/Each
cefadroxil 1 gm tablet $3.9000/Each
cefadroxil hydrate 250 mg/5 ml Suspension $0.1935/Milliliter
cefadroxil hydrate 500 mg/5 ml Suspension $0.2595/Milliliter
cefazolin sodium 1 gm Solution $1.1550/Each
cefazolin sodium 10 gm Solution $10.5798/Each
cefazolin sodium 500 MG Solution $1.6200/Each
cefdinir 250 mg/5 ml Suspension $0.0809/Milliliter
cefdinir 300 mg capsule $0.4379/Each
cefdinir 125 mg/5 ml Suspension $0.0905/Milliliter
cefepime HCl 1 G Solution $4.7150/Each
cefepime hcl 2 gm Solution $9.4103/Each
cefixime 400 MG capsule $11.3300/Each
cefixime 100 MG/5ML Suspension $2.8775/Milliliter
cefixime 200 MG/5ML Suspension $5.6945/Milliliter
cefotetan disodium 1 G Solution $11.0250/Each
cefoxitin sodium 1 G Solution $3.8995/Each
cefoxitin sodium 2 G Solution $8.3000/Each
cefoxitin sodium 10 G Solution $30.8000/Each
cefpodoxime 100 mg tablet $2.9355/Each
cefpodoxime 200 mg tablet $4.3805/Each
cefpodoxime proxetil 50 MG/5 ML Suspension $0.5800/Milliliter
cefpodoxime proxetil 100 mg/5 ml Suspension $1.2500/Milliliter
cefprozil 250 mg tablet $0.7400/Each
cefprozil 500 mg tablet $0.9355/Each
cefprozil 125 mg/5 ml Suspension $0.2175/Milliliter
cefprozil 250 mg/5 ml Suspension $0.2130/Milliliter
ceftazidime pentahydrate 1 gm Solution $5.3880/Each
ceftazidime pentahydrate 2 gm Solution $9.8062/Each
ceftazidime pentahydrate 6 gm Solution $24.0786/Each
ceftriaxone sodium 250 mg Solution $1.5926/Each
ceftriaxone sodium 500 mg Solution $1.1805/Each
ceftriaxone sodium 1 gm Solution $1.4885/Each
ceftriaxone sodium 2 gm Solution $4.4352/Each
ceftriaxone sodium 10 gm Solution $20.7648/Each
cefuroxime 250 mg tablet $0.3660/Each
cefuroxime 500 mg tablet $0.7175/Each
cefuroxime axetil 250 mg/5 ml Suspension $0.0000
cefuroxime axetil 125 mg/5 ml Suspension $0.0000
cefuroxime sodium 750 MG solution $2.8225/Each
cefuroxime sodium 7.5 G Solution $19.9500/Each
cefuroxime sodium 1.5 G solution $5.4299/Each
celecoxib 400 MG capsule $0.4950/Each
celecoxib 100 MG capsule $0.0600/Each
Page 10 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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celecoxib 200 MG capsule $0.1450/Each
celecoxib 50 MG capsule $0.1500/Each
cephalexin 750 MG capsule $3.8152/Each
cephalexin 250 mg capsule $0.0890/Each
cephalexin 500 mg capsule $0.0755/Each
cephalexin 125 mg/5 ml Suspension $0.0605/Milliliter
cephalexin 250 mg/5 ml Suspension $0.0665/Milliliter
cetirizine hcl 5 mg Tablet, Chewable $1.3735/Each
cetirizine hcl 10 mg Tablet, Chewable $1.8075/Each
cetirizine HCl 5 MG/5 ML solution $0.0235/Milliliter
cetirizine hcl 1 mg/ml Solution $0.0000
cetirizine hcl 10 mg tablet $0.0000
cetirizine hcl 5 mg tablet $0.0338/Each
cevimeline hcl 30 mg capsule $1.1155/Each
chloral hydrate 500 mg capsule $0.0000
chlordiazepoxide 10 mg capsule $0.0700/Each
chlordiazepoxide 25 mg capsule $0.0700/Each
chlordiazepoxide 5 mg capsule $0.0895/Each
chlorhexidine 0.12% Liquid $0.0048/Milliliter
chlorhexidine gluconate 4 % Cleanser $0.0176/Milliliter
chloroquine phosphate 250 MG tablet $2.0080/Each
chloroquine phosphate 500 MG tablet $3.5550/Each
chlorothiazide 250 mg tablet $0.0000
chlorothiazide 500 mg tablet $0.0000
chlorpheniramin/pseudoephed/dm 1-15-5MG/5 Elixir $0.0200/Milliliter
chlorpheniramine maleate 4 mg Caplet $0.0000
chlorpheniramine/dextromethorp 4 MG-30 MG tablet $0.0975/Each
chlorpheniramine/phenylephrine 4MG-10MG tablet $0.1700/Each
chlorpromazine hcl 10 mg tablet $1.5655/Each
chlorpromazine hcl 25 mg tablet $1.8136/Each Decrease
chlorpromazine hcl 50 mg tablet $2.7350/Each
chlorpromazine hcl 100 mg tablet $3.2953/Each Decrease
chlorpromazine hcl 200 mg tablet $6.6835/Each
chlorpropamide 100 mg tablet $0.0000
chlorpropamide 250 mg tablet $0.0000
chlorthalidone 100 mg tablet $0.0000
chlorthalidone 25 mg tablet $0.1870/Each
chlorthalidone 50 mg tablet $0.3270/Each
chlorzoxazone 500 mg Caplet $0.2284/Each
chlorzoxazone 375 MG tablet $5.6725/Each
chlorzoxazone 750 MG tablet $3.3425/Each
cholecalciferol (vitamin d3) 1000 UNIT tablet $0.0219/Each
cholecalciferol (vitamin d3) 2000 UNIT capsule $0.0375/Each
cholestyramine 4 gm Powder $0.1215/Gram
cholestyramine lite 4 gm Packet $1.3725/Each
cholestyramine lite 4 gm Powder $0.1415/Gram
cholestyramine/sucrose 4 gm Packet $1.2183/Each
choline magnesium trisalicylate 500 mg Caplet $0.0000
choline magnesium trisalicylate 750 mg Caplet $0.0000
choline magnesium trisalicylate 1000 mg Caplet $0.0000
ciclopirox 0.08 Solution $1.5630/Milliliter
ciclopirox 0.0077 Gel $0.5895/Gram
ciclopirox 0.01 Shampoo $0.3235/Milliliter
ciclopirox 0.77% Cream $0.1215/Gram
ciclopirox 0.77% Lotion $0.9115/Milliliter
cidofovir 75 MG/ML solution $147.6500/Milliliter
cilostazol 100 mg tablet $0.1035/Each
cilostazol 50 mg tablet $0.0845/Each
cimetidine 200 mg tablet $0.1380/Each
cimetidine 300 mg tablet $0.2556/Each
Page 11 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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cimetidine 400 mg tablet $0.5665/Each
cimetidine 800 mg tablet $0.5656/Each
cimetidine hcl 300 MG/5ML Liquid $0.0000
cinacalcet HCl 30 MG tablet $1.9683/Each Decrease
cinacalcet HCl 60 MG tablet $1.6770/Each
cinacalcet HCl 90 MG tablet $3.5550/Each
ciprofloxacin 0.003 Drops $0.9450/Milliliter
ciprofloxacin 250 mg tablet $0.0945/Each
ciprofloxacin 500 mg tablet $0.1075/Each
ciprofloxacin 750 mg tablet $0.2000/Each
ciprofloxacin 250 MG/5ML suspension $0.8168/Milliliter
ciprofloxacin 500 MG/5ML suspension $0.9561/Milliliter
ciprofloxacin in 5 % dextrose 200MG/0.1L solution $0.0299/Milliliter
ciprofloxacin lactate/d5w 400 mg/200 ml Solution $0.0210/Milliliter
ciprofloxacin/ciprofloxa hcl 500 mg tablet, extended release $0.0000
ciprofloxacin/ciprofloxa hcl 1000 mg tablet, extended release $0.0000
cisplatin 1 MG/ML Solution $0.2025/Milliliter
citalopram 20 mg tablet $0.0295/Each
citalopram 40 mg tablet $0.0375/Each
citalopram 10 mg/5 ml Solution $0.2563/Milliliter
citalopram 10 mg tablet $0.0348/Each
citric acid/sodium citrate 334-500MG Solution $0.0200/Milliliter
cladribine 10 mg/10 ml Solution $28.3030/Milliliter
clarithromycin 125 mg/5 ml Suspension $0.8157/Milliliter
clarithromycin 250 mg/5 ml Suspension $1.2246/Milliliter
clarithromycin 500 mg tablet, extended release $2.7825/Each
clarithromycin 500 mg tablet $0.6265/Each
clarithromycin 250 mg tablet $0.5095/Each
clemastine fumarate 1.34 MG tablet $0.1775/Each
clidinium/chlordiazepoxide 2.5 mg/5 mg capsule $0.0000
clindamycin hcl 150 mg capsule $0.0972/Each
clindamycin HCl 75 MG capsule $0.2000/Each
clindamycin hcl 300 mg capsule $0.1504/Each
clindamycin palmitate hcl 75 mg/5 ml Solution $0.1886/Milliliter
clindamycin phos/benzoyl perox 1.2%-2.5% gel $2.2025/Gram
clindamycin phos/benzoyl perox 1 %-5 % Gel $1.9815/Gram
clindamycin phosphate 0.02 Cream $1.4150/Gram
clindamycin phosphate 150 mg/ml Solution $0.9231/Milliliter
clindamycin phosphate 1% 0.01 Foam $3.0020/Gram
clindamycin phosphate 1% 1% Solution $0.2285/Milliliter
clindamycin phosphate 1% 1% Lotion $0.7950/Milliliter
clindamycin phosphate 1% 1% Gel $0.8465/Gram
clindamycin phosphate 1% 1% pledget $0.2754/Each
clindamycin phosphate/benzoyl peroxide 1% - 5% Gel $1.1545/Gram
clindamycin phosphate/benzoyl peroxide 1.2(1)%-5% Gel $1.0065/Gram
clindamycin phosphate/dextrose 5 % in water 300MG/50ML Solution $0.1722/Milliliter
clindamycin phosphate/dextrose 5 % in water 600MG/50ML Solution $0.2597/Milliliter
clindamycin phosphate/dextrose 5 % in water 900MG/50ML Solution $0.3172/Milliliter
clindamycin/tretinoin 1.2-0.025% Gel $10.0588/Gram
clobazam 20 MG tablet $0.6765/Each
clobazam 10 MG tablet $0.3642/Each
clobazam 2.5 MG/ML Suspension $0.7335/Milliliter
clobetasol propionate 0.05% Solution $0.4380/Milliliter
clobetasol propionate 0.05% Gel $0.2765/Gram
clobetasol propionate 0.0005 Shampoo $0.8685/Milliliter
clobetasol propionate 0.05 % Spray, Non-Aerosol $0.7775/Milliliter
clobetasol propionate 0.05% Ointment $0.4545/Gram
clobetasol propionate 0.05% Cream $0.5745/Gram
clobetasol propionate 0.05 % Lotion $0.8515/Milliliter
clobetasol propionate 0.0005 Foam $1.1525/Gram
Page 12 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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clobetasol propionate/emollient 0.05% Cream $0.8161/Gram Decrease
clobetasol propionate/emollient 0.05 % Foam $2.6255/Gram
clofarabine 20 MG/20ML solution $52.1500/Milliliter
clomiphene citrate 50 mg tablet $0.0000
clomipramine hcl 25 mg capsule $1.4865/Each
clomipramine hcl 50 mg capsule $1.7525/Each
clomipramine hcl 75 mg capsule $0.4005/Each
clonazepam 0.5 mg tablet $0.0150/Each
clonazepam 1 mg tablet $0.0281/Each
clonazepam 2 mg tablet $0.0417/Each
clonazepam odt 0.125 mg Tablet,disintegrating $0.5000/Each
clonazepam odt 0.25 mg Tablet,disintegrating $0.6850/Each
clonazepam odt 0.5 mg Tablet,disintegrating $0.5765/Each
clonazepam odt 1 mg Tablet,disintegrating $0.5265/Each
clonazepam odt 2 mg Tablet,disintegrating $0.8485/Each
clonidine 0.1 mg/24 hr Patch, Transdermal Weekly $0.0000
clonidine 0.2 mg/24 hr Patch, Transdermal Weekly $0.0000
clonidine 0.3 mg/24 hr Patch, Transdermal Weekly $0.0000
clonidine hcl 0.1 mg tablet $0.0246/Each
clonidine hcl 0.2 mg tablet $0.0265/Each
clonidine hcl 0.3 mg tablet $0.0395/Each
clonidine hcl 0.1 MG tablet, extended release $0.3500/Each
clopidogrel 75 MG tablet $0.0792/Each
clopidogrel bisulfate 300 MG tablet $9.8135/Each
clorazepate dipotassium 15 mg capsule $0.0000
clorazepate dipotassium 3.75 mg capsule $0.0000
clorazepate dipotassium 7.5 mg capsule $0.0000
clorazepate dipotassium 15 mg tablet $0.4716/Each
clorazepate dipotassium 3.75 mg tablet $0.9075/Each
clorazepate dipotassium 7.5 mg tablet $1.3625/Each
clotrimazole 10 mg Troche $0.3585/Each
clotrimazole 0.01 Cream $0.0739/Gram
clotrimazole 0.01 Cream $0.0813/Gram
clotrimazole 0.01 Liquid $1.3075/Milliliter
clotrimazole/betamethasone dipropionate 1-0.05%, 15 gm Cream $0.2055/Gram
clotrimazole/betamethasone dipropionate 1-0.05%, 45 gm Cream $0.1935/Gram
clotrimazole/betamethasone dipropionate 1-0.05% Lotion $2.4395/Milliliter
clozapine 25 mg tablet $0.2900/Each
clozapine 100 mg tablet $0.5875/Each
clozapine 50 mg tablet $0.5762/Each
clozapine 25 MG Tablet,disintegrating $2.0080/Each
clozapine 100 MG Tablet,disintegrating $4.7245/Each
clozapine 200 mg tablet $1.4145/Each
coal tar 0.5 % Shampoo $0.0115/Milliliter
codeine sulfate 15 MG tablet $0.4374/Each
codeine sulfate 30 MG tablet $0.3315/Each
codeine sulfate 60 MG tablet $0.7832/Each
colchicine 0.6 mg tablet $0.8141/Each Decrease
colchicine 0.6 MG capsule $1.3850/Each Add
colesevelam HCl 625 MG tablet $0.3675/Each
colesevelam HCl 3.75 G Granules $6.7830/Each
colestipol hcl 5 G Granules $2.0800/Each
colestipol hcl 1 gm tablet $0.6335/Each
colistimethate sodium 150 mg Solution $15.1800/Each
cosyntropin 0.25 MG solution $23.5500/Each
cromolyn sodium 20 MG/ML Concentrate $0.2585/Milliliter
cromolyn sodium 10 mg/ml Solution $0.0000
cromolyn sodium 5.2 MG solution $0.2085/Milliliter
cromolyn sodium 0.04 Drops $0.2625/Milliliter
cyanocobalamin (vitamin b-12) 1000 MCG Caplet $0.0554/Each
Page 13 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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cyanocobalamin (vitamin b-12) 1000 MCG Caplet $0.0000
cyanocobalamin (vitamin b-12) 1000MCG/ML Solution $1.1015/Milliliter
cyanocobalamin/folic ac/vit B6 1-2.2-25MG tablet $0.1560/Each
cyclobenzaprine hcl 5 mg tablet $0.0360/Each
cyclobenzaprine hcl 10 mg tablet $0.0240/Each
cyclobenzaprine HCl 15 MG capsule, extended release $7.4050/Each
cyclobenzaprine HCl 30 MG capsule, extended release $13.1075/Each
cyclobenzaprine hcl 7.5 MG tablet $1.4415/Each
cyclopentolate HCl 0.005 Drops $4.1050/Milliliter
cyclopentolate hcl 1%, 2 ml Drops $1.4055/Milliliter
cyclopentolate HCl 0.02 Drops $2.9500/Milliliter
cyclophosphamide 25 MG capsule $4.9500/Each
cyclophosphamide 50 MG capsule $5.6950/Each
cyclophosphamide 1 G Solution $360.0000/Each
cyclophosphamide 500 MG Solution $179.9500/Each
cyclophosphamide 2 G Solution $719.7500/Each
cyclophosphamide 50 mg tablet $0.0000
cycloserine 250 MG capsule $57.7500/Each
cyclosporine 100 MG capsule $5.9365/Each
cyclosporine 25 MG capsule $1.7640/Each
cyclosporine, modified 50 MG capsule $0.8745/Each
cyclosporine, modified 100 mg/ml Solution $2.6035/Milliliter
cyclosporine, modified 25 mg capsule $0.3505/Each
cyclosporine, modified 100 mg capsule $1.2515/Each
cyproheptadine hcl 2 mg/5 ml Solution $0.0357/Milliliter
cyproheptadine hcl 4 mg tablet $0.0600/Each
cytarabine/PF 20 MG/ML solution $0.6585/Milliliter
cytarabine/pf 2 g/20 ml Solution $0.9720/Milliliter
cytarabine/PF 100 MG/5ML solution $0.7655/Milliliter
dacarbazine 200 mg Solution $14.2010/Each
dactinomycin 0.5 MG solution $925.8500/Each
dalfampridine 10 MG tablet, extended release $0.8550/Each
danazol 100 MG capsule $3.8080/Each
danazol 200 mg capsule $3.5765/Each
danazol 50 MG capsule $3.0095/Each
dantrolene sodium 100 mg capsule $1.2545/Each
dantrolene sodium 25 mg capsule $0.5899/Each
dantrolene sodium 50 mg capsule $1.1879/Each
dantrolene sodium 20 MG solution $69.6000/Each
dapsone 5 % Gel $2.8252/Gram Decrease
dapsone 100 MG tablet $0.6974/Each
dapsone 25 MG tablet $0.7442/Each
daptomycin 500 MG Solution $28.2300/Each Decrease
daptomycin 350 MG solution $40.1825/Each
darifenacin hydrobromide 7.5 MG tablet, extended release $1.8285/Each
darifenacin hydrobromide 15 MG tablet, extended release $0.4350/Each
daunorubicin hcl 5 mg/ml Solution $18.2247/Milliliter
decitabine 50 MG Solution $241.8185/Each
deferasirox 125 MG Tablet, Dispersible $2.5000/Each
deferasirox 250 MG Tablet, Dispersible $5.0000/Each
deferasirox 500 MG Tablet, Dispersible $10.0000/Each
deferasirox 90 MG tablet $7.6000/Each
deferasirox 180 MG tablet $1.4500/Each
deferasirox 360 MG tablet $23.7055/Each
deferasirox 90 MG granules $35.0200/Each
deferasirox 180 MG granules $70.0500/Each
deferasirox 360 MG granules $140.1150/Each
deferiprone 500 MG tablet $60.2500/Each
deferoxamine mesylate 500 mg Solution $12.2985/Each
deferoxamine mesylate 2 gm Solution $25.1358/Each
Page 14 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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demeclocycline 150 mg tablet $3.0165/Each
demeclocycline 300 mg tablet $5.3145/Each
desipramine hcl 10 mg tablet $0.4345/Each
desipramine hcl 100 mg tablet $0.3885/Each
desipramine hcl 150 mg tablet $1.0845/Each
desipramine hcl 25 mg tablet $0.1334/Each
desipramine hcl 50 mg tablet $0.6240/Each
desipramine hcl 75 mg tablet $2.1575/Each
desloratadine 5 mg tablet $0.2805/Each
desmopressin 0.1 mg/ml Aerosol, Spray $8.7690/Milliliter
desmopressin acetate 4 mcg/ml Solution $0.0000
desmopressin acetate 4 mcg/ml Solution $0.0000
desmopressin acetate 0.1 mg tablet $0.2945/Each
desmopressin acetate 0.2 mg tablet $0.4805/Each
desogestrel/ethiny estradiol (desogen, ortho-cept, apri) 0.15 mg/30 mcg tablet $0.0000
desogestrel/ethiny estradiol (desogen, ortho-cept, apri) 0.15 mg/30 mcg tablet $0.1600/Each Decrease
desogestrel/ethiny estradiol (kariva, mircette) 0.15 mg/20 mcg tablet $0.3500/Each
desogestrel/ethiny estradiol 7-7-7 (cyclessa, velivet) 0.1-25/0.125-25/0.15-25 mg-mcg tablet $0.3375/Each
desonide 0.05 % Cream $0.5365/Gram
desonide 0.05%; 15 gm Cream $0.0000
desonide 0.05%; 60 gm Cream $0.0000
desonide 0.05 % ointment $0.7500/Gram
desonide 0.05%; 15 gm Ointment $0.0000
desonide 0.05%; 60 gm Ointment $0.0000
desonide 0.0005 Lotion $1.1150/Milliliter
desoximetasone 0.05%; 15 gm Gel $3.4550/Gram
desoximetasone 0.05%; 60 gm Gel $2.5030/Gram
desoximetasone 0.05 % ointment $2.9805/Gram
desoximetasone 0.25 % ointment $0.4000/Gram
desoximetasone 0.25%; 15 gm Ointment $0.0000
desoximetasone 0.25%; 60 gm Ointment $0.0000
desoximetasone 0.05 % Cream $0.0000
desoximetasone 0.05%; 15 gm Cream $0.0000
desoximetasone 0.05%; 60 gm Cream $0.0000
desoximetasone 0.0025 Cream $0.4585/Gram
desoximetasone 0.25%; 15 gm Cream $0.0000
desoximetasone 0.25%; 60 gm Cream $0.0000
desoximetasone 0.25 % spray, non-aerosol $1.2835/Milliliter
desvenlafaxine succinate 25 MG tablet, extended release $0.6054/Each
desvenlafaxine succinate 50 MG tablet, extended release $0.4300/Each
desvenlafaxine succinate 100 MG tablet, extended release $0.4050/Each
dexamethasone 1.5MG (21) tablet $0.0767/Each
dexamethasone 1.5MG (51) tablet $0.0767/Each
dexamethasone 0.5 mg/5 ml Elixir $0.1055/Milliliter
dexamethasone 0.5 MG/5ML solution $0.0356/Milliliter
dexamethasone 0.5 mg tablet $0.0674/Each
dexamethasone 0.75 MG tablet $0.1000/Each
dexamethasone 1.5 MG tablet $0.0767/Each
dexamethasone 4 mg tablet $0.1199/Each
dexamethasone 6 MG tablet $0.5695/Each
dexamethasone 1.5MG (27) tablet $0.0767/Each
dexamethasone 1.5 MG(49) tablet $0.0767/Each
dexamethasone 1.5 MG(39) tablet $0.0767/Each
dexamethasone 1.5MG (35) tablet $0.0767/Each
dexamethasone sodium phosp/PF 10 MG/ML solution $4.4000/Milliliter
dexamethasone sodium phosphate 10 MG/ML solution $0.5500/Milliliter
dexamethasone sodium phosphate 4 MG/ML solution $0.1756/Milliliter
dexmedetomidine HCl 200MCG/2ML solution $3.2950/Milliliter
dexmedetomidine in 0.9 % NaCl 200 MCG/50 solution $1.0385/Milliliter
dexmedetomidine in 0.9 % NaCl 400MCG/100 solution $1.0750/Milliliter
Page 15 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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dexmethylphenidate hcl 2.5 mg tablet $0.1520/Each
dexmethylphenidate hcl 5 mg tablet $0.2475/Each
dexmethylphenidate hcl 10 mg tablet $0.2550/Each
dexmethylphenidate hcl 5 mg capsule, extended release $0.0000
dexmethylphenidate hcl 10 mg capsule, extended release $0.0000
dexmethylphenidate hcl 20 mg capsule, extended release $0.0000
dexmethylphenidate hcl 30 MG capsule, extended release $0.0000
dexmethylphenidate hcl 40 MG capsule, extended release $0.0000
dexmethylphenidate hcl 15 MG capsule, extended release $0.0000
dexrazoxane HCl 250 MG Solution $215.8750/Each
dexrazoxane HCl 500 MG Solution $286.0000/Each
dextroamphetamine sulfate 10 mg capsule, extended release $1.1945/Each
dextroamphetamine sulfate 15 mg capsule, extended release $1.2535/Each
dextroamphetamine sulfate 5 mg capsule, extended release $0.9545/Each
dextroamphetamine sulfate 10 mg tablet $0.4855/Each
dextroamphetamine sulfate 5 mg tablet $0.2815/Each
dextroamphetamine sulfate 5 MG/5 ML Solution $0.0000
dextromethorphan hb/doxylamine 15-6.25/15 liquid $0.0115/Milliliter
dextromethorphan HBr 15 MG/5 ML liquid $0.0165/Milliliter
dextromethorphan hbr/phenylephrine hcl/chlorpheniramine 15-12.5-4 Syrup $0.0000
dextrose 4 G tablet,chewable $0.0200/Each
dextrose 5 % and 0.9 % NaCl 5 %-0.9 % solution $0.0035/Milliliter
dextrose 5 % in water 5 % Solution $0.0141/Milliliter
dhcodeine bt/acetaminophn/caff 32-713-60 tablet $0.0000
diazepam 5 MG/ML solution $12.9251/Milliliter
diazepam 10 mg tablet $0.0271/Each
diazepam 2 mg tablet $0.0240/Each
diazepam 5 mg tablet $0.0185/Each
diazepam 5 MG/ML Concentrate $0.9485/Milliliter
diclofenac potassium 50 mg tablet $0.4435/Each
diclofenac sodium 1.5 % drops $0.1515/Milliliter
diclofenac sodium 0.001 Drops $1.5173/Milliliter
diclofenac sodium 25 mg tablet, delayed release (enteric coated) $0.8100/Each
diclofenac sodium 50 mg tablet, delayed release (enteric coated) $0.1195/Each
diclofenac sodium 75 mg tablet, delayed release (enteric coated) $0.0985/Each
diclofenac sodium 1 % Gel $0.0660/Gram
diclofenac sodium 3 % Gel $0.3990/Gram
diclofenac sodium xr 100 mg tablet, extended release $0.1755/Each
diclofenac sodium/misoprostol 75 MG-200 tablet, delayed release (enteric coated) $1.5500/Each
diclofenac sodium/misoprostol 50 MG-200 tablet, delayed release (enteric coated) $1.5500/Each
dicloxacillin sodium 250 mg capsule $0.2990/Each
dicloxacillin sodium 500 mg capsule $0.5700/Each
dicyclomine hcl 10 mg capsule $0.0438/Each
dicyclomine hcl 20 mg tablet $0.0567/Each
dicyclomine HCl 10 MG/5 ML solution $0.2015/Milliliter
didanosine 250 mg capsule,delayed release (e.c.) $4.9895/Each
didanosine 400 mg capsule,delayed release (e.c.) $3.1975/Each
didanosine 125 mg capsule,delayed release (e.c.) $1.5960/Each
didanosine 200 mg capsule,delayed release (e.c.) $6.4841/Each
diflorasone diacetate 0.05% Cream $10.4165/Gram
diflorasone diacetate 0.05% Ointment $2.8476/Gram
diflunisal 250 mg tablet $0.0000
diflunisal 500 mg tablet $1.0685/Each
digoxin 50 MCG/ML Elixir $2.0999/Milliliter
digoxin .125 mg tablet $0.1605/Each
digoxin .250 mg tablet $0.2895/Each
dihydroergotamine mesylate 1 MG/ML Solution $85.4555/Milliliter
dihydroergotamine mesylate 0.5MG/SPRY spray, non-aerosol $119.3562/Milliliter
diltiazem hcl 90 mg capsule, extended release $2.3545/Each
diltiazem hcl 120 mg capsule, extended release $3.1045/Each
Page 16 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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diltiazem hcl 60 mg capsule, extended release $1.4000/Each
diltiazem hcl 180 mg capsule, extended release $0.2251/Each
diltiazem hcl 240 mg capsule, extended release $0.2550/Each
diltiazem hcl 300 mg capsule, extended release $0.3150/Each
diltiazem hcl 120 mg capsule, extended release $0.1500/Each
diltiazem hcl 360 mg capsule, extended release $0.5498/Each
diltiazem hcl 180 mg capsule, extended release $0.3510/Each
diltiazem hcl 120 mg capsule, extended release $0.2250/Each
diltiazem hcl 240 mg capsule, extended release $0.3750/Each
diltiazem hcl 300 mg capsule, extended release $0.5685/Each
diltiazem hcl 30 mg tablet $0.1095/Each
diltiazem hcl 60 mg tablet $0.1699/Each
diltiazem hcl 90 mg Caplet $0.2806/Each
diltiazem hcl 120 mg Caplet $0.3000/Each
diltiazem HCl 5 MG/ML Solution $0.2900/Milliliter
diltiazem hcl 360 mg capsule, extended release $1.6550/Each
diltiazem hcl 180 mg capsule, extended release $0.4455/Each
diltiazem hcl 240 mg capsule, extended release $0.4825/Each
diltiazem hcl 120 mg capsule, extended release $0.3435/Each
diltiazem hcl 180 MG tablet, extended release $1.9294/Each
diltiazem hcl 240 MG tablet, extended release $2.3400/Each
diltiazem hcl 300 MG tablet, extended release $2.6707/Each
diltiazem hcl 360 MG tablet, extended release $3.2710/Each
diltiazem hcl 420 MG tablet, extended release $3.5520/Each
diltiazem hcl 420 mg capsule, extended release $0.2265/Each
dimenhydrinate 50 MG tablet $0.0443/Each
dimethyl fumarate 120-240 MG capsule,delayed release (e.c.) $7.5200/Each
dimethyl fumarate 120 MG capsule,delayed release (e.c.) $8.7500/Each
dimethyl fumarate 240 MG capsule,delayed release (e.c.) $3.6250/Each
diphenhydra/phenyleph/acetamin 12.5-5-325 tablet $0.0745/Each
diphenhydramine 25 mg Caplet $0.0240/Each
diphenhydramine 50 mg capsule $0.0235/Each
diphenhydramine HCl 25 MG tablet $0.0300/Each
diphenhydramine HCl 50 MG capsule $0.0220/Each
diphenhydramine hcl 25 MG capsule $0.1397/Each
diphenhydramine HCl 50 MG/30ML liquid $0.0125/Milliliter
diphenhydramine HCl 6.25MG/ML Drops $1.6500/Milliliter
diphenhydramine HCl 50 MG/ML Solution $1.6555/Milliliter
diphenhydramine hcl 50 MG/ML Solution $0.6401/Milliliter
diphenhydramine HCl 25 MG tablet $0.0100/Each
diphenhydramine HCl/zinc acet 2 %-0.1 % Cream $0.0200/Gram
diphenoxylate hcl; atropine sulfate 2.5 mg; 0.025 mg/5 ml Liquid $0.0000
diphenoxylate hcl; atropine sulfate 2.5 mg; 0.025 mg tablet $0.2248/Each
dipyridamole 25 mg tablet $0.2555/Each
dipyridamole 50 mg tablet $0.0834/Each
dipyridamole 75 mg tablet $0.1200/Each
disopyramide 100 mg capsule $0.5520/Each
disopyramide 150 mg capsule $0.0000
disopyramide cr 150 mg capsule, extended release $0.0000
disulfiram 250 mg tablet $1.2379/Each
disulfiram 500 MG tablet $3.4555/Each
divalproex sodium 250 mg tablet, delayed release (enteric coated) $0.0692/Each
divalproex sodium 500 mg tablet, delayed release (enteric coated) $0.0780/Each
divalproex sodium 125 mg tablet, delayed release (enteric coated) $0.0355/Each
divalproex sodium 125 mg Capsule, Delayed Release Sprinkle $0.2970/Each
divalproex sodium 500 mg tablet, extended release $0.2455/Each
divalproex sodium 250 mg tablet, extended release $0.1605/Each
DM/acetaminophen/doxylamine 15MG-325MG capsule $0.1635/Each
DM/PE/acetaminophen/doxylamine 5-325MG/15 liquid $0.0140/Milliliter
d-methorp tan/p-epd tan/d-cp 25 mg; 75 mg; 2.5 mg/5 ml Suspension $0.0000
Page 17 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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d-methorphan hb/pe/chlorphenir 15 mg; 6 mg; 2 mg/5 ml Liquid $0.0000
d-methorphan hb/p-epd hcl/bpm 15 mg; 45 mg; 4 mg/5 ml Syrup $0.0000
d-methorphan hb/p-epd hcl/bpm 4 mg; 15 mg; 1 mg/ml Drops $0.0000
d-methorphan hb/p-epd hcl/bpm 3 mg; 12.5 mg;1 mg/ml Drops $0.0000
d-methorphan hb/p-epd hcl/bpm 30 mg; 60 mg; 4 mg/5 ml Syrup $0.0000
d-methorphan hb/p-epd hcl/bpm 10 mg; 30 mg; 2 mg/5 ml Liquid $0.0000
d-methorphan/PE/acetaminophen 20-10-650 powder $0.5365/Each
d-methorphan/PE/acetaminophen 10-5-325MG tablet $0.0899/Each
d-methorphan/PE/acetaminophen 20-10-500 powder $0.4775/Each
d-methorphan/PE/acetaminophen 5-325MG/15 liquid $0.0140/Milliliter
docetaxel 20MG/ML(1) Solution $26.5000/Milliliter
docetaxel 80 MG/4 ML Solution $21.3500/Milliliter
docetaxel 160 MG/8ML solution $20.5417/Milliliter
docetaxel 80 MG/8 ML Solution $17.6500/Milliliter
docetaxel 20 MG/2 ML Solution $17.7500/Milliliter
docetaxel 160MG/16ML Solution $34.7555/Milliliter
docosanol 10 % cream $6.2035/Gram
docusate calcium 240 mg capsule $0.0600/Each
docusate sodium 100 mg capsule $0.0175/Each
docusate sodium 50 mg capsule $0.2760/Each
docusate sodium 150 mg/15 ml Liquid $0.0109/Milliliter
docusate sodium 60 MG/15ML Liquid $0.0091/Milliliter
docusate sodium 100 MG Caplet $0.0233/Each
docusate sodium 283 mg Enema $2.0647/Each
docusate sodium 283 MG/5ML Enema $0.4402/Milliliter
docusate sodium/casanthranol 100 mg/30 mg capsule $0.0000
docusate sodium/casanthranol 60 mg/30 mg per 15 ml Liquid $0.0000
dofetilide 125 MCG capsule $1.2095/Each Decrease
dofetilide 250 MCG capsule $1.2752/Each Decrease
dofetilide 500 MCG capsule $0.9800/Each Decrease
donepezil hcl 10 mg tablet $0.0367/Each
donepezil hcl 5 mg tablet $0.0367/Each
donepezil hcl 5 mg Tablet,disintegrating $0.1680/Each
donepezil hcl 10 mg Tablet,disintegrating $0.1765/Each
donepezil hcl 23 mg tablet $0.6995/Each
dorzolamide hcl 0.02 Drops $1.2429/Milliliter
doxazosin mesylate 1 mg tablet $0.0390/Each
doxazosin mesylate 2 mg tablet $0.0300/Each
doxazosin mesylate 4 mg tablet $0.1355/Each
doxazosin mesylate 8 mg tablet $0.1175/Each
doxepin hcl 10 mg capsule $0.3145/Each
doxepin hcl 100 mg capsule $0.7065/Each
doxepin hcl 150 mg capsule $0.6425/Each
doxepin hcl 25 mg capsule $0.3490/Each
doxepin hcl 50 mg capsule $0.5055/Each
doxepin hcl 75 mg capsule $0.4153/Each
doxepin hcl 10 MG/ML Concentrate $0.0600/Milliliter
doxepin HCl 3 MG tablet $8.6925/Each
doxepin HCl 6 MG tablet $7.6000/Each
doxercalciferol 4MCG/2ML solution $1.6950/Milliliter
doxercalciferol 0.5 MCG capsule $9.6520/Each
doxercalciferol 1 MCG capsule $17.0100/Each Decrease
doxercalciferol 2.5 MCG capsule $19.1560/Each
doxorubicin HCl 10 MG solution $29.9950/Each
doxorubicin HCl 50 MG solution $299.8550/Each
doxorubicin hcl 2 mg/ ml Solution $1.6797/Milliliter
doxorubicin hcl 10 mg/5 ml Solution $2.2680/Milliliter
doxorubicin hcl 50 mg/25 ml Solution $0.7785/Milliliter
doxorubicin hcl 20 mg/10 ml Solution $1.8475/Milliliter
doxorubicin hcl peg-liposomal 2 MG/ML Suspension $78.7555/Milliliter
Page 18 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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doxycycline hyclate 20 mg tablet $0.1935/Each
doxycycline hyclate 75 MG tablet, delayed release (enteric coated) $6.0555/Each
doxycycline hyclate 100 MG tablet, delayed release (enteric coated) $5.3715/Each
doxycycline hyclate 200 MG tablet, delayed release (enteric coated) $26.4555/Each
doxycycline hyclate 75 MG tablet $19.4555/Each
doxycycline hyclate 150 MG tablet $10.0555/Each
doxycycline hyclate 50 MG tablet, delayed release (enteric coated) $8.0555/Each
doxycycline hyclate 100 mg capsule $0.1050/Each
doxycycline hyclate 50 mg capsule $0.2580/Each
doxycycline hyclate 100 mg tablet $0.0555/Each
doxycycline hyclate 150 MG tablet, delayed release (enteric coated) $8.8255/Each
doxycycline monohydrate 50 mg tablet $0.2505/Each
doxycycline monohydrate 75 MG tablet $0.5550/Each
doxycycline monohydrate 150 mg tablet $5.8035/Each
doxycycline monohydrate 100 mg Caplet $0.2250/Each
doxycycline monohydrate 25 MG/5 ML suspension $0.2700/Milliliter
doxycycline monohydrate 100 mg capsule $0.3275/Each
doxycycline monohydrate 50 mg capsule $0.1215/Each
doxycycline monohydrate 75 MG capsule $8.8800/Each
doxycycline monohydrate 150 mg capsule $10.5710/Each
doxylamine succinate 25 MG tablet $0.1225/Each
doxylamine succinate/vit B6 10 MG-10MG tablet, delayed release (enteric coated) $4.2065/Each
dronabinol 2.5 mg capsule $0.8400/Each
dronabinol 5 mg capsule $2.2585/Each
dronabinol 10 mg capsule $3.0230/Each
drospir/eth estra/levomefol ca 3-0.02(24) tablet $2.1555/Each Decrease
drospir/eth estra/levomefol Ca 3-0.03(21) tablet $2.9400/Each
droxidopa 100 MG capsule $3.7866/Each
droxidopa 200 MG capsule $7.0341/Each
droxidopa 300 MG capsule $11.6514/Each
duloxetine hcl 20 mg capsule,delayed release (e.c.) $0.0952/Each
duloxetine hcl 30 mg capsule,delayed release (e.c.) $0.0780/Each
duloxetine hcl 60 mg capsule,delayed release (e.c.) $0.0900/Each
duloxetine hcl 40 MG capsule,delayed release (e.c.) $2.1000/Each
dutasteride 0.5 MG capsule $0.2345/Each
dutasteride/tamsulosin hcl 0.5-0.4 MG capsule, extended release $2.2755/Each
econazole nitrate 1% Cream $0.1850/Gram
econazole nitrate 1% Cream $0.0000
econazole nitrate 1% Cream $0.0000
econazole nitrate 1% Cream $0.0000
efavirenz 600 MG tablet $6.2800/Each
efavirenz/emtricit/tenofovr df 600-200MG tablet $6.7586/Each Decrease
electrolyte oral solution 540 ml Liquid $0.0000
electrolyte oral solution 1000 ml Liquid $0.0000
eletriptan hydrobromide 20 MG tablet $1.8459/Each
eletriptan hydrobromide 40 MG tablet $2.4845/Each
emtricitabine/tenofovir (TDF) 200-300 MG tablet $0.7569/Each
emtricitabine/tenofovir (TDF) 100-150 MG tablet $30.5250/Each
emtricitabine/tenofovir (TDF) 133-200 MG tablet $30.5250/Each
emtricitabine/tenofovir (TDF) 167-250 MG tablet $30.5250/Each
enalapril maleate 5 mg tablet $0.1705/Each
enalapril maleate 10 mg tablet $0.1745/Each
enalapril maleate 20 mg tablet $0.1965/Each
enalapril maleate 2.5 mg tablet $0.1215/Each
enalapril maleate/hctz 10 mg/25 mg Caplet $0.1890/Each
enalapril maleate/hctz 5 mg/12.5 mg tablet $0.1382/Each
enalaprilat dihydrate 1.25 mg/ml Injectable $3.0240/Milliliter
enoxaparin sodium 30 mg/0.3 ml Solution $9.6015/Milliliter
enoxaparin sodium 150 mg/ml Solution $9.6015/Milliliter
enoxaparin sodium 120 mg/0.8 ml Solution $9.6015/Milliliter
Page 19 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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enoxaparin sodium 60 mg/0.6 ml Solution $8.2500/Milliliter
enoxaparin sodium 80 mg/0.8 ml Solution $9.6015/Milliliter
enoxaparin sodium 100 mg/ml Solution $8.3595/Milliliter
enoxaparin sodium 40 mg/0.4 ml Solution $9.6015/Milliliter
enoxaparin sodium 300MG/3ML Solution $9.6015/Milliliter
entacapone 200 MG tablet $0.3945/Each
entecavir 0.5 MG tablet $0.7575/Each
entecavir 1 mg tablet $1.2210/Each
epinastine hcl 0.05 % Drops $4.3685/Milliliter
epinephrine 1 MG/ML(1) Solution $2.0775/Milliliter
epinephrine 0.1 MG/ML Solution $0.4500/Milliliter
epinephrine 0.15MG/0.3 solution $143.7500/Each
epirubicin hcl 50 mg/25 ml Solution $2.1175/Milliliter
epirubicin hcl 200 mg/0.1 l Solution $1.9688/Milliliter
eplerenone 25 mg tablet $0.6292/Each
eplerenone 50 mg tablet $0.8552/Each
epoprostenol na 0.5 mg Solution $0.0000
epoprostenol na 1.5 mg Solution $0.0000
eptifibatide 75MG/100ML solution $3.5951/Milliliter
eptifibatide 2 MG/ML solution $11.4255/Milliliter
ergocalciferol (vitamin d2) 8000/ML Drops $0.5400/Milliliter
ergocalciferol (vitamin d2) 50000 unit capsule $0.0990/Each
erlotinib HCl 150 MG tablet $14.9500/Each
erlotinib HCl 100 MG tablet $13.0000/Each
erlotinib HCl 25 MG tablet $9.9500/Each
ertapenem sodium 1 G solution $79.8345/Each
erythromycin 0.005 Ointment $1.8501/Gram
erythromycin 2% Solution $0.4189/Milliliter
erythromycin base 250 MG capsule,delayed release (e.c.) $4.3800/Each
erythromycin base 250 mg tablet $9.0744/Each
erythromycin base 500 mg tablet $14.1135/Each
erythromycin base 250 MG tablet, delayed release (enteric coated) $4.7213/Each Decrease
erythromycin base 333 mg Caplet $0.0000
erythromycin base 500 MG tablet, delayed release (enteric coated) $10.0542/Each
erythromycin base/benzoyl peroxide 3%; 5% Gel $1.8995/Gram
erythromycin base/ethanol 2% Gel $0.8552/Gram
erythromycin base/ethanol 2 % pledget $0.8950/Each
erythromycin ethylsuccinate 200 MG/5ML Suspension $0.0000 Delete
erythromycin ethylsuccinate 400 MG/5ML suspension $0.0000 Delete
erythromycin/sulfisoxazole 200 mg/600 mg per 5 ml Suspension $0.0000
escitalopram oxalate 10 MG tablet $0.0445/Each
escitalopram oxalate 20 MG tablet $0.0569/Each
escitalopram oxalate 5 MG tablet $0.0300/Each
escitalopram oxalate 5 MG/5 ML Solution $0.3525/Milliliter
esomeprazole magnesium 20 mg capsule,delayed release (e.c.) $0.2795/Each
esomeprazole magnesium 40 mg capsule,delayed release (e.c.) $0.1500/Each
esomeprazole sodium 40 MG solution $7.5500/Each
estazolam 1 mg tablet $0.5335/Each
estazolam 2 mg tablet $0.5365/Each
esterified estrogens/methyltestosterone (h.s.) 0.625-1.25 mg tablet $0.0000
esterified estrogens/methyltestosterone (h.s.) 1.25-2.5 mg tablet $0.0000
estradiol 1 mg tablet $0.0852/Each
estradiol 2 mg tablet $0.0885/Each
estradiol 0.5 mg tablet $0.0850/Each
estradiol 0.06mg/24h Patch, Transdermal Weekly $10.0005/Each
estradiol .0375mg/24 Patch, Transdermal Weekly $12.1015/Each
estradiol 10 MCG insert $10.1655/Each
estradiol 0.05 mg/24hr Patch, Transdermal Semiweekly $7.1141/Each Decrease
estradiol 0.1 mg/24 hr Patch, Transdermal Semiweekly $6.9075/Each
estradiol .025 mg/24hr Patch, Transdermal Semiweekly $7.4925/Each
Page 20 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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estradiol .075 mg/24hr Patch, Transdermal Semiweekly $6.8999/Each Decrease
estradiol .1 mg Patch, Transdermal Weekly $12.8748/Each Decrease
estradiol .05 mg Patch, Transdermal Weekly $13.3472/Each
estradiol .0375 mg/24hr Patch, Transdermal Semiweekly $7.3495/Each
estradiol .025 mg Patch, Transdermal Weekly $12.5905/Each
estradiol .075 mg Patch, Transdermal Weekly $12.7545/Each
estradiol 0.01 % Cream $1.5500/Gram
estradiol valerate 20 MG/ML Oil $18.3415/Milliliter
estradiol valerate 40 MG/ML Oil $0.0000
estradiol valerate/dienogest 3-2-1(28) tablet $0.0000
estradiol/norethindrone acetate 0.5-0.1mg tablet $1.2270/Each
estradiol/norethindrone acetate (activella) 1-0.5 mg tablet $1.4820/Each
estropipate 0.75 mg tablet $0.0000
estropipate 1.5 mg tablet $0.0000
estropipate 3 mg tablet $0.0000
eszopiclone 3 mg tablet $0.1445/Each
eszopiclone 2 mg tablet $0.2275/Each
eszopiclone 1 mg tablet $0.1115/Each
ethacrynic acid 25 MG tablet $3.0000/Each
ethambutol hcl 100 MG tablet $0.3075/Each
ethambutol hcl 400 mg tablet $0.5225/Each
ethinyl estradiol/drospirenone 0.02-3(24) tablet $0.4305/Each
ethinyl estradiol/drospirenone (yasmin, ocella) 0.03-3 mg tablet $0.1205/Each Decrease
ethosuximide 250 mg capsule $0.3900/Each
ethosuximide 250 mg/5 ml Solution $0.1150/Milliliter
ethynodiol diacetate/ethinyl estradiol (demulen 1/35, zovia 1/35e) 1 mg/35 mcg tablet $0.3375/Each
ethynodiol diacetate/ethinyl estradiol (demulen 1/50, zovia 1/50e) 1 mg/50 mcg tablet $0.5000/Each
etodolac 200 mg capsule $0.6105/Each
etodolac 300 mg capsule $0.2745/Each
etodolac 400 mg tablet $0.3855/Each
etodolac 600 mg tablet, extended release $1.8445/Each
etodolac 400 mg tablet, extended release $1.6050/Each
etodolac 500 mg tablet $0.4275/Each
etodolac 500 mg tablet, extended release $1.3325/Each
etonogestrel/ethinyl estradiol .12-.015MG Ring, Vaginal $95.1500/Each
etoposide 20 mg/ml Solution $1.4500/Milliliter
etoposide 50 mg capsule $71.5000/Each
eucalyptus oil/menthol/camphor 1.2%-4.8% ointment $0.0185/Gram
everolimus 5 MG tablet $232.4590/Each
everolimus 0.25 MG tablet $7.8850/Each
everolimus 0.5 MG tablet $15.7460/Each
everolimus 0.75 MG tablet $23.6210/Each
everolimus 2.5 MG tablet $226.9726/Each
everolimus 7.5 MG tablet $237.4097/Each
exemestane 25 mg tablet $1.6248/Each Decrease
ezetimibe 10 MG tablet $0.1025/Each
ezetimibe/simvastatin 10 MG-10MG tablet $1.1755/Each
ezetimibe/simvastatin 10 MG-20MG tablet $0.6544/Each
ezetimibe/simvastatin 10 MG-80MG tablet $1.3525/Each
ezetimibe/simvastatin 10 MG-40MG tablet $0.8981/Each
famciclovir 125 mg tablet $0.2532/Each
famciclovir 500 mg tablet $0.7125/Each
famciclovir 250 mg tablet $0.4665/Each
famotidine 40 mg/5 ml Suspension $0.0000
famotidine 10 MG/ML solution $0.4588/Milliliter
famotidine 20 mg tablet $0.0347/Each
famotidine 40 mg tablet $0.0480/Each
famotidine 10 mg tablet $0.0842/Each
famotidine/calcium carbonate/magnesium 10-800-165 Tablet, Chewable $0.2135/Each
famotidine/PF 20 MG/2 ML solution $0.4234/Milliliter
Page 21 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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febuxostat 40 MG tablet $0.8550/Each
febuxostat 80 MG tablet $0.8550/Each
felbamate 600 mg/5 ml Suspension $1.3125/Milliliter
felbamate 400 mg Caplet $1.9535/Each
felbamate 600 mg Caplet $2.2750/Each
felodipine 2.5 mg tablet, extended release $0.1295/Each
felodipine 5 mg tablet, extended release $0.2167/Each
felodipine 10 mg tablet, extended release $0.1215/Each
fenofibrate 160 mg tablet $0.2835/Each
fenofibrate 54 mg tablet $0.0963/Each
fenofibrate 40 MG tablet $8.3050/Each Add
fenofibrate 120 MG tablet $14.0080/Each
fenofibrate nanocrystallized 48 MG tablet $0.1785/Each
fenofibrate nanocrystallized 145MG tablet $0.1516/Each
fenofibrate,micronized 43 mg capsule $0.6480/Each
fenofibrate,micronized 130 mg capsule $0.9850/Each
fenofibrate,micronized 134 mg capsule $0.1845/Each
fenofibrate,micronized 200 mg capsule $0.3540/Each
fenofibrate,micronized 67 mg capsule $0.2125/Each
fenofibric acid (choline) 45 MG capsule,delayed release (e.c.) $0.4325/Each
fenofibric acid (choline) 135 MG capsule,delayed release (e.c.) $0.7895/Each
fenoprofen calcium 600 mg tablet $0.0000
fentanyl 25 mcg Patch, Transdermal 72 Hours $2.2215/Each
fentanyl 50 mcg Patch, Transdermal 72 Hours $3.8550/Each
fentanyl 75 mcg Patch, Transdermal 72 Hours $5.7550/Each
fentanyl 100 mcg Patch, Transdermal 72 Hours $5.7550/Each
fentanyl 12 mcg/hr Patch, Transdermal 72 Hours $6.4930/Each
fentanyl 62.5MCG/HR Patch, Transdermal 72 Hours $48.6500/Each
fentanyl 87.5MCG/HR Patch, Transdermal 72 Hours $66.2500/Each
fentanyl 37.5MCG/HR Patch, Transdermal 72 Hours $39.9425/Each
fentanyl citrate 600 mcg lozenge on a handle $11.8550/Each
fentanyl citrate 800 mcg lozenge on a handle $14.5211/Each
fentanyl citrate 1,200 mcg lozenge on a handle $17.2550/Each
fentanyl citrate 1,600 mcg lozenge on a handle $24.4550/Each
fentanyl citrate 200 mcg lozenge on a handle $17.1116/Each
fentanyl citrate 400 mcg lozenge on a handle $15.7236/Each
fentanyl citrate/PF 50 MCG/ML solution $0.7177/Milliliter
fentanyl citrate/PF 50 MCG/ML solution $0.3610/Milliliter
ferrous fumarate 324(106)MG tablet $0.2972/Each
ferrous fumarate/docusate sodium/folic acid 106-50-1mg tablet $0.2000/Each
ferrous fumarate/folic acid 106 mg; 1 mg tablet $0.0000
ferrous sulfate 220 mg/5 ml Elixir $0.0000
ferrous sulfate 75 mg/0.6 ml; 50 ml Drops $0.0000
ferrous sulfate 325 mg tablet $0.0150/Each
ferrous sulfate 15 MG/ML Drops $0.0530/Milliliter
fexofenadine hcl 30 mg tablet $0.0000
fexofenadine hcl 60 mg tablet $0.3360/Each
fexofenadine hcl 180 mg gelcap $0.2028/Each
fexofenadine hcl/pseudoephedrine hcl 60mg-120mg tablet, extended release $0.6220/Each
finasteride 1 MG tablet $0.0000
finasteride 5 mg tablet $0.0600/Each
flavoxate hcl 100 mg tablet $0.7245/Each
flecainide acetate 100 mg tablet $0.1500/Each
flecainide acetate 50 mg tablet $0.0900/Each
flecainide acetate 150 mg tablet $0.2850/Each
floxuridine 500 MG solution $115.0000/Each
fluconazole 100 mg tablet $0.2891/Each
fluconazole 200 mg tablet $0.6530/Each
fluconazole 50 mg tablet $0.1720/Each
fluconazole 150 mg tablet $0.6585/Each
Page 22 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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fluconazole 40 mg/ml Suspension $0.3412/Milliliter
fluconazole 10 mg/ml Suspension $0.3095/Milliliter
fluconazole in dextrose,iso-os 200MG/0.1L solution $0.0000
fluconazole in dextrose,iso-os 400MG/0.2L solution $0.0000
fluconazole in saline, iso-osmotic 400 mg/200 ml Solution $0.0580/Milliliter
flucytosine 250 MG capsule $30.7599/Each
flucytosine 500 MG capsule $33.6137/Each
fludarabine phosphate 50 mg/2 ml Solution $125.6101/Milliliter
fludarabine phosphate 50 mg Solution $95.2560/Each
fludrocortisone acetate 0.1 mg tablet $0.3315/Each
flumazenil 0.1 MG/ML Solution $0.8500/Milliliter
flunisolide 0.00025 Spray, Non-Aerosol $0.0000
flunisolide 0.00025 Aerosol, Spray $1.7606/Milliliter
fluocinolone 0.01% Cream $1.1715/Gram
fluocinolone 0.025% Cream $1.3425/Gram
fluocinolone 0.025% Ointment $1.1115/Gram
fluocinolone 0.01%, 60 mL Solution $0.7115/Milliliter
fluocinolone acetonide 0.01 % Oil $0.1995/Milliliter
fluocinolone acetonide oil 0.01 % Drops $1.5450/Milliliter
fluocinolone/shower cap 0.01 % Oil $0.3249/Milliliter
fluocinonide 0.1 % Cream $1.1650/Gram
fluocinonide 0.05% Gel $0.9397/Gram Decrease
fluocinonide 0.05% Cream $0.6995/Gram
fluocinonide 0.05% Ointment $0.3600/Gram
fluocinonide 0.05% Solution $0.5374/Milliliter
fluocinonide/emollient 0.05% Cream $0.7375/Gram
fluoride (sodium) 1.1 % Gel $0.0659/Gram
fluorometholone 0.1% Drops, Suspension $12.6900/Milliliter
fluorouracil 0.05 Cream $1.7917/Gram
fluorouracil 0.05 Solution $4.8115/Milliliter
fluorouracil 50 mg/ml Solution $0.0000
fluorouracil 50 mg/ml; 10 ml Solution $0.2015/Milliliter
fluorouracil 50 mg/ml; 20 ml Solution $0.2325/Milliliter
fluorouracil 50 mg/ml; 50 ml Solution $0.3911/Milliliter
fluorouracil 50 mg/ml; 100 ml Solution $0.1445/Milliliter
fluoxetine hcl 90 mg capsule,delayed release (e.c.) $25.7400/Each
fluoxetine hcl 10 mg capsule $0.0389/Each
fluoxetine hcl 20 mg capsule $0.0263/Each
fluoxetine hcl 40 mg capsule $0.0450/Each
fluoxetine hcl 10 mg tablet $0.0389/Each
fluoxetine hcl 20 mg/5 ml Solution $0.0450/Milliliter
fluoxetine hcl 20 mg tablet $0.0263/Each
fluoxetine hcl 60 MG tablet $1.1250/Each
fluphenazine 1 mg tablet $2.2500/Each
fluphenazine 10 mg tablet $5.9500/Each
fluphenazine 2.5 mg tablet $3.0695/Each
fluphenazine 5 mg tablet $0.1920/Each
fluphenazine decanoate 25 mg/ml Solution $12.2500/Milliliter
flurandrenolide 0.05 % cream $5.4655/Gram
flurandrenolide 0.05 % ointment $7.5655/Gram
flurandrenolide 0.05 % lotion $1.7085/Milliliter
flurazepam hcl 15 mg capsule $0.3442/Each
flurazepam hcl 30 mg capsule $0.4148/Each
flurbiprofen 50 mg tablet $0.0000
flurbiprofen 100 mg tablet $0.3300/Each
flurbiprofen sodium 0.03 % Drops $1.1580/Milliliter
flutamide 125 MG capsule $0.4305/Each
fluticasone propionate 0.05 % Lotion $3.1550/Milliliter
fluticasone propionate 0.05% Cream $0.2295/Gram
fluticasone propionate 0.005% Ointment $0.3015/Gram
Page 23 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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fluticasone propionate 50 mcg Spray, Suspension $0.2375/Gram
fluvastatin sodium 20 MG capsule $2.5550/Each
fluvastatin sodium 40 MG capsule $2.5550/Each
fluvastatin sodium 80 mg tablet, extended release $5.2137/Each
fluvoxamine 25 mg tablet $0.1200/Each
fluvoxamine 50 mg tablet $0.1992/Each
fluvoxamine 100 mg tablet $0.2791/Each
fluvoxamine maleate 100 mg capsule, extended release $3.9925/Each
fluvoxamine maleate 150 mg capsule, extended release $4.4115/Each
folic acid 1 mg tablet $0.0110/Each
folic acid 0.4 MG tablet $0.0110/Each
folic acid/vitamin b comp w-c 1 mg capsule $0.1350/Each
fomepizole 1 G/ML solution $551.9500/Milliliter
fondaparinux sodium 2.5 mg/0.5 Solution $28.9044/Milliliter
fondaparinux sodium 5mg/0.4ml Solution $122.8500/Milliliter
fondaparinux sodium 7.5mg/0.6 Solution $64.0595/Milliliter
fondaparinux sodium 10mg/0.8ml Solution $51.6490/Milliliter
formoterol fumarate 20 MCG/2ML solution $7.8596/Milliliter
fosamprenavir calcium 700 MG tablet $12.6245/Each
fosaprepitant dimeglumine 150 MG solution $144.5255/Each
fosinopril sodium 40 mg tablet $0.2097/Each
fosinopril sodium 10 mg tablet $0.1193/Each
fosinopril sodium 20 mg tablet $0.1237/Each
fosinopril sodium/hctz 20-12.5 mg tablet $0.6521/Each
fosinopril sodium/hctz 10-12.5 mg tablet $0.4275/Each
fosphenytoin sodium 100MG PE/2 Solution $0.8675/Milliliter
fosphenytoin sodium 500 PE/10 Solution $0.6000/Milliliter
frovatriptan succinate 2.5 MG tablet $11.4025/Each
fulvestrant 250 MG/5ML solution $115.8500/Milliliter
furosemide 10 MG/ML Solution $0.5152/Milliliter
furosemide 10 mg/ml Solution $0.0655/Milliliter
furosemide 20 mg tablet $0.0135/Each
furosemide 40 mg tablet $0.0120/Each
furosemide 80 mg tablet $0.0340/Each
gabapentin 100 mg capsule $0.0295/Each
gabapentin 300 mg capsule $0.0473/Each
gabapentin 400 mg capsule $0.0632/Each
gabapentin 250 mg/5 ml Solution $0.1055/Milliliter
gabapentin 250 MG/5ML solution $0.3250/Milliliter Add
gabapentin 300 MG/6ML solution $0.3333/Milliliter
gabapentin 800 mg tablet $0.1298/Each
gabapentin 600 mg tablet $0.0570/Each
galantamine hydrobromide 8 mg capsule, extended release $1.1950/Each
galantamine hydrobromide 16 mg capsule, extended release $0.9568/Each
galantamine hydrobromide 24 mg capsule, extended release $0.9568/Each
galantamine hydrobromide 12 mg tablet $0.5005/Each
galantamine hydrobromide 4 mg tablet $0.4805/Each
galantamine hydrobromide 8 mg tablet $0.4645/Each
gatifloxacin 0.5 % Drops $13.9972/Milliliter Decrease
gemcitabine hcl 2 g Solution $123.8743/Each
gemcitabine HCl 1 G/26.3ML Solution $0.9000/Milliliter
gemcitabine HCl 2 G/52.6ML Solution $1.0550/Milliliter
gemcitabine HCl 200MG/5.26 solution $1.3250/Milliliter
gemcitabine hcl 200 mg Solution $7.5355/Each
gemcitabine hcl 1 g Solution $41.5800/Each
gemfibrozil 600 mg tablet $0.1062/Each
gentamicin sulfate 0.1% Cream $1.6775/Gram
gentamicin sulfate 0.1% Ointment $1.3900/Gram
gentamicin sulfate 0.3 % Ointment $2.8457/Gram
gentamicin sulfate 0.3% Drops $0.5000/Milliliter
Page 24 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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gentamicin sulfate 0.3%, 15 ml Drops $0.0000
gentamicin sulfate 40 mg/ml Solution $0.4800/Milliliter
glatiramer acetate 40 MG/ML Solution $0.0000
glimepiride 1 mg tablet $0.0150/Each
glimepiride 2 mg tablet $0.0255/Each
glimepiride 4 mg tablet $0.0150/Each
glipizide 5 mg tablet $0.0251/Each
glipizide 10 mg tablet $0.0300/Each
glipizide 10 mg tablet, extended release $0.1850/Each
glipizide 5 mg tablet, extended release $0.1355/Each
glipizide 2.5 mg tablet, extended release $0.1275/Each
glipizide/metformin hcl 2.5-250 mg tablet $0.2490/Each
glipizide/metformin hcl 2.5-500 mg tablet $0.1620/Each
glipizide/metformin hcl 5 mg; 500 mg tablet $0.1575/Each
glyburide 1.25 mg tablet $0.0450/Each
glyburide 2.5 mg tablet $0.0336/Each
glyburide 5 mg tablet $0.0550/Each
glyburide, micronized 1.5 mg tablet $0.0345/Each
glyburide, micronized 3 mg tablet $0.0323/Each
glyburide, micronized 6 mg tablet $0.0660/Each
glyburide/metformin hcl 1.25/250 mg tablet $0.0450/Each
glyburide/metformin hcl 5/500 mg tablet $0.0256/Each
glyburide/metformin hcl 2.5/500 mg tablet $0.0506/Each
glycerin ADULT Suppository $0.4228/Each
glycerin pediatric Suppository $0.0668/Each
glycerin Liquid $0.0334/Milliliter
glycerin 99.5 % liquid $0.0265/Milliliter
glycerin/witch hazel leaf Pads, Medicated $0.0255/Each
glycopyrrolate 0.2 MG/ML Solution $7.0555/Milliliter
glycopyrrolate 1 mg tablet $0.1200/Each
glycopyrrolate 2 mg tablet $0.3651/Each
granisetron hcl 1 mg tablet $1.8900/Each
granisetron hcl 1 mg/ml; MDV Solution $7.1094/Milliliter
granisetron hcl 1 mg/ml; SDV Solution $6.6000/Milliliter
griseofulvin ultramicrosize 125 MG tablet $2.6000/Each
griseofulvin ultramicrosize 250 MG tablet $2.9450/Each
griseofulvin, microsize 500 MG tablet $6.4130/Each
griseofulvin,microsize 125 mg/5 ml Suspension $0.1835/Milliliter
guaifen/dextromethorphan/pe 5-2.5 MG/5 liquid $0.0355/Milliliter
guaifen/dextromethorphan/pe 18-10MG/15 liquid $0.0980/Milliliter
guaifen/dm hb/p-ephedrine 100 mg; 15 mg; 40 mg/5 ml Syrup $0.0000
guaifen/phenyleph/acetaminophn 200-5-325 tablet $0.1800/Each
guaifenesin 100 mg/5 ml Syrup $0.0000
guaifenesin 200 mg Caplet $0.0000
guaifenesin 1200 mg Caplet $0.0000
guaifenesin 600 mg Caplet $0.0000
guaifenesin 100 mg/5 ml Liquid $0.0000
guaifenesin; codeine phosphate 100 mg; 10 mg Liquid $0.0000
guaifenesin; codeine phosphate (sugar-free) 100 mg; 10 mg Liquid $0.0000
guaifenesin; dextromethorphan hbr 100 mg; 10 mg Liquid $0.0000
guaifenesin; dextromethorphan hbr 100 mg; 10 mg Liquid $0.0000
guaifenesin; hydrocodone bitartrate 100 mg; 5 mg Liquid $0.0000
guaifenesin; phenylephrine hcl 600 mg; 40 mg tablet, extended release $0.0000
guaifenesin; pseudoephedrine hcl 100 mg; 30 mg Liquid $0.0000
guaifenesin; pseudoephedrine hcl 600 mg; 120 mg Caplet $0.0000
guaifenesin; pseudoephedrine hcl; codeine 100 mg; 30 mg; 10 mg Liquid $0.0000
guanfacine 1 mg tablet $0.4035/Each
guanfacine 2 mg tablet $0.6755/Each
guanfacine hcl 1 mg tablet, extended release $0.1665/Each
guanfacine hcl 2 mg tablet, extended release $0.2250/Each
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NAME OF GENERIC DRUG STRENGTH FORM
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guanfacine hcl 3 mg tablet, extended release $0.2400/Each
guanfacine hcl 4 mg tablet, extended release $0.1995/Each
halobetasol propionate 0.05% Ointment $1.2050/Gram
halobetasol propionate 0.05% Cream $0.9215/Gram
haloperidol 0.5 mg tablet $0.1975/Each
haloperidol 1 mg tablet $0.3189/Each
haloperidol 10 mg tablet $0.4359/Each
haloperidol 2 mg tablet $0.3792/Each
haloperidol 20 mg tablet $0.9525/Each
haloperidol 5 mg tablet $0.3425/Each
haloperidol decanoate 50 mg/ml Solution $8.5410/Milliliter
haloperidol decanoate 100 mg/ml Solution $31.9800/Milliliter
haloperidol decanoate 100 mg/ml Solution $0.0000
haloperidol lactate 5 MG/ML Solution $0.8275/Milliliter
haloperidol lactate 2 MG/ML Concentrate $0.2500/Milliliter
haloperidol lactate 2 mg/ml; 15 ml Concentrate $0.0000
haloperidol lactate 2 mg/ml; 120 ml Concentrate $0.0000
hc acetate/lidocaine hcl 0.5%; 3% Cream $0.8252/Gram
heparin sodium,porcine 5000/ML Solution $1.0779/Milliliter
heparin sodium,porcine 10000/ML Solution $1.8925/Milliliter
heparin sodium,porcine 1000/ML solution $0.1650/Milliliter
hydralazine HCl 20 MG/ML Solution $3.7500/Milliliter
hydralazine hcl 10 mg tablet $0.0448/Each
hydralazine hcl 100 mg tablet $0.0900/Each
hydralazine hcl 25 mg tablet $0.0300/Each
hydralazine hcl 50 mg tablet $0.0545/Each
hydrochlorothiazide 12.5 MG tablet $0.0375/Each
hydrochlorothiazide 12.5 mg capsule $0.0374/Each
hydrochlorothiazide 25 mg tablet $0.0096/Each
hydrochlorothiazide 50 mg tablet $0.0177/Each
hydrocodone bit/acetaminophen 7.5-325/15 Solution $0.0845/Milliliter
hydrocodone bit/acetaminophen 10MG-300MG tablet $0.5585/Each
hydrocodone bit/homatropine 5-1.5 mg/5 Solution $0.1080/Milliliter
hydrocodone/acetaminophen 5MG-300MG tablet $0.1945/Each
hydrocodone/acetaminophen 7.5-300MG tablet $0.6575/Each
hydrocodone/acetaminophen 7.5-325/15 solution $0.2175/Milliliter
hydrocodone/acetaminophen 2.5-108/5 solution $0.6175/Milliliter
hydrocodone/acetaminophen 5-217MG/10 solution $0.3185/Milliliter
hydrocodone/apap 5 mg; 325 mg tablet $0.0455/Each
hydrocodone/apap 7.5 mg; 325 mg tablet $0.0695/Each
hydrocodone/apap 7.5/500 mg Elixir $0.0000
hydrocodone/apap 10 mg; 325 mg tablet $0.0845/Each
hydrocodone/apap 5 mg; 500 mg tablet $0.0000
hydrocodone/apap 10 mg; 650 mg tablet $0.0000
hydrocodone/apap 7.5 mg; 650 mg tablet $0.0000
hydrocodone/apap 10 mg; 500 mg tablet $0.0000
hydrocodone/apap 7.5 mg; 750 mg tablet $0.0000
hydrocodone/apap 2.5 mg; 500 mg tablet $0.0000
hydrocodone/apap 7.5 mg; 500 mg tablet $0.0000
hydrocodone/apap 10 mg; 660 mg tablet $0.0000
hydrocodone/apap 10 mg; 750 mg tablet $0.0000
hydrocodone/cpm/pseudoephed 5-4-60MG/5 Solution $0.0000
hydrocodone/ibuprofen 5MG-200MG tablet $2.6500/Each
hydrocodone/ibuprofen 7.5 mg; 200 mg tablet $0.2500/Each
hydrocodone/ibuprofen 10MG-200MG tablet $2.0663/Each
hydrocortisone 10 MG tablet $0.1680/Each
hydrocortisone 20 mg tablet $0.3350/Each
hydrocortisone 5 MG tablet $0.1128/Each
hydrocortisone 2.5 % Cream $0.4550/Gram
hydrocortisone 2.5% Cream $0.0000
Page 26 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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hydrocortisone 0.5% Cream $0.0980/Gram
hydrocortisone 1% Cream $0.0395/Gram
hydrocortisone 2.5% Cream $0.1100/Gram
hydrocortisone 0.5% Ointment $0.1100/Gram
hydrocortisone 1% Ointment $0.0765/Gram
hydrocortisone 2.5% Ointment $0.0865/Gram
hydrocortisone 1% Lotion $0.0662/Milliliter
hydrocortisone 2.5% Lotion $0.1450/Milliliter
hydrocortisone 100MG/60ML Enema $0.0743/Milliliter
hydrocortisone acetate 25 mg Suppository $0.0000
hydrocortisone acetate 1 % Cream $0.0000
hydrocortisone butyrate 0.001 Cream $1.4045/Gram
hydrocortisone butyrate 0.1 % Ointment $1.2224/Gram
hydrocortisone butyrate 0.1 % Solution $1.2224/Milliliter
hydrocortisone butyrate 0.1 % lotion $6.4925/Milliliter
hydrocortisone butyrate/emoll 0.1 % Cream $2.9350/Gram
hydrocortisone powder NA Powder $0.0000
hydrocortisone valerate 0.2% Ointment $2.8215/Gram
hydrocortisone valerate 0.2% Cream $0.8875/Gram
hydromorphone hcl 2 mg tablet $0.0806/Each
hydromorphone hcl 4 mg tablet $0.1173/Each
hydromorphone hcl 8 mg tablet $0.2715/Each
hydromorphone hcl 1 MG/ML Liquid $0.2455/Milliliter
hydromorphone hcl 12 MG tablet, extended release $8.8455/Each
hydromorphone HCl 32 MG tablet, extended release $28.3550/Each
hydromorphone hcl 16 MG tablet, extended release $7.7075/Each
hydromorphone hcl 8 MG tablet, extended release $6.4855/Each
hydroquinone 4% 0.04 Cream $0.9755/Gram
hydroquinone 4% 4% Gel $0.0000
hydroquinone 4% w/ sunscreen 0.04 Cream $0.0000
hydroxocobalamin 1000MCG/ML solution $1.0369/Milliliter
hydroxychloroquine sulfate 200 mg tablet $0.2615/Each
hydroxyprogesterone caproat/PF 250 MG/ML oil $285.0000/Milliliter
hydroxyprogesterone caproate 250 MG/ML Oil $236.8500/Milliliter
hydroxyprogesterone caproate 250 MG/ML oil $352.4425/Milliliter
hydroxyurea 500 mg capsule $0.2165/Each
hydroxyzine 10 mg/5 ml Solution $0.0269/Milliliter
hydroxyzine hcl 10 mg tablet $0.0375/Each
hydroxyzine hcl 25 mg tablet $0.0445/Each
hydroxyzine hcl 50 mg tablet $0.0765/Each
hydroxyzine pam 25 mg capsule $0.0695/Each
hydroxyzine pam 50 mg capsule $0.0750/Each
hydroxyzine pamoate 100 MG capsule $0.4315/Each
hyoscyamine sulfate 0.125 mg Tablet,disintegrating $0.0918/Each
hyoscyamine sulfate 0.375 mg capsule, extended release $0.0000
hyoscyamine sulfate 125MCG/5ML Elixir $0.0658/Milliliter
hyoscyamine sulfate 0.125 mg/ml Drops $0.7825/Milliliter
hyoscyamine sulfate 0.375 mg tablet, extended release $0.1666/Each
hyoscyamine sulfate 0.125 mg tablet $0.0992/Each
hyoscyamine sulfate 0.125 mg Tablet, Sublingual $0.1516/Each
ibandronate sodium 150 MG tablet $5.6025/Each
ibandronate sodium 3 mg/3 ml Solution $41.1525/Milliliter
ibuprofen 200 mg capsule $0.0993/Each
ibuprofen 400 mg Caplet $0.0535/Each
ibuprofen 600 mg Caplet $0.0445/Each
ibuprofen 200 mg Caplet $0.0392/Each
ibuprofen 800 mg Caplet $0.0500/Each
ibuprofen 100 MG Tablet, Chewable $0.1318/Each
ibuprofen 100 mg/5 ml Liquid $0.0299/Milliliter
ibuprofen 50 mg/1.25 Drops, Suspension $0.2435/Milliliter
Page 27 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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ibuprofen/diphenhydramine cit 200MG-38MG tablet $0.1195/Each
ibuprofen/oxycodone hcl 400 mg; 5 mg tablet $1.2370/Each
icatibant acetate 30 MG/3 ML solution $1145.7500/Milliliter
icosapent ethyl 1 G capsule $2.4598/Each
idarubicin hcl 1 mg/ml Solution $16.8714/Milliliter
ifosfamide 1 g Solution $26.1820/Each
ifosfamide 3 g Solution $110.2046/Each
ifosfamide 1 G/20 ML solution $3.6500/Milliliter
ifosfamide 3 G/60 ML solution $2.4500/Milliliter
imatinib mesylate 400 MG tablet $3.3930/Each Decrease
imatinib mesylate 100 MG tablet $1.6125/Each
imipenem/cilastatin sodium 250 mg Solution $5.9063/Each
imipenem/cilastatin sodium 500 mg Solution $9.1000/Each
imipramine hcl 10 mg tablet $0.1140/Each
imipramine hcl 25 mg tablet $0.0905/Each
imipramine hcl 50 mg tablet $0.1230/Each
imipramine pamoate 100 mg capsule $3.5805/Each
imipramine pamoate 125 mg capsule $8.2500/Each
imipramine pamoate 150 mg capsule $6.4800/Each
imipramine pamoate 75 mg capsule $3.7765/Each
imiquimod 5 % Cream $0.9363/Each
indapamide 2.5 mg tablet $0.1193/Each
indapamide 1.25 mg tablet $0.1050/Each
indomethacin 25 mg capsule $0.0459/Each
indomethacin 50 mg capsule $0.0542/Each
indomethacin sr 75 mg capsule, extended release $0.4415/Each
iodine/sodium iodide 2 % Tincture $0.0678/Milliliter
ipratropium bromide 0.2 mg/ml Solution $0.0425/Milliliter
ipratropium bromide 0.0006 Spray, Non-Aerosol $1.3708/Milliliter
ipratropium bromide 0.0003 Spray, Non-Aerosol $0.7795/Milliliter
ipratropium/albuterol sulfate 0.5-2.5 mg/3 ml Solution $0.0589/Milliliter
irbesartan 150 MG tablet $0.1223/Each
irbesartan 300 MG tablet $0.1539/Each
irbesartan 75 MG tablet $0.0668/Each
irbesartan/hydrochlorothiazide 150-12.5MG tablet $0.0960/Each
irbesartan/hydrochlorothiazide 300-12.5MG tablet $0.2964/Each
irinotecan hcl 40 mg/2 ml Solution $6.4793/Milliliter
irinotecan hcl 100 mg/5 ml Solution $3.1440/Milliliter
irinotecan hcl 500 mg/25 ml Solution $0.0000
iron polysaccharides complex 150 mg capsule $0.1120/Each
iron,carbonyl/ascorbic acid/cyanocobalamin/folic acid 100-250-1 tablet $0.3155/Each
iron,carbonyl/ascorbic acid/cyanocobalamin/folic acid 100-320-1 capsule, extended release $0.2000/Each
isoniazid 300 mg tablet $0.1215/Each
isoproterenol HCl 0.2 MG/ML solution $44.6875/Milliliter
isosorbide dinitrate 10 mg tablet $0.2615/Each
isosorbide dinitrate 20 mg tablet $0.3435/Each
isosorbide dinitrate 30 mg tablet $0.6270/Each
isosorbide dinitrate 5 mg tablet $0.3300/Each Decrease
isosorbide dinitrate 40 mg tablet, extended release $0.0000
isosorbide dinitrate 5 mg Tablet, Sublingual $0.0000
isosorbide dinitrate 2.5 mg Tablet, Sublingual $0.0000
isosorbide mononitrate 20 mg tablet $0.1560/Each
isosorbide mononitrate 10 mg tablet $0.1920/Each
isosorbide mononitrate 60 mg tablet, extended release $0.1050/Each
isosorbide mononitrate 120 mg tablet, extended release $0.4200/Each
isosorbide mononitrate 30 mg tablet, extended release $0.0675/Each
isotretinoin 30 MG capsule $3.0350/Each
isotretinoin 25 MG capsule $28.9420/Each
isotretinoin 35 MG capsule $28.9420/Each
isotretinoin 10 mg capsule $2.2952/Each
Page 28 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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isotretinoin 20 mg capsule $2.4958/Each
isotretinoin 40 mg capsule $2.7958/Each
isradipine 2.5 MG capsule $0.7675/Each
isradipine 5 MG capsule $1.2625/Each
itraconazole 10 MG/ML solution $1.7850/Milliliter
itraconazole 200 mg capsule $0.9078/Each Decrease
ivermectin 3 MG tablet $3.9125/Each
ketoconazole 2% Shampoo $0.0590/Milliliter
ketoconazole 2% Cream $0.3975/Gram
ketoconazole 2 % Cream $0.0000
ketoconazole 2 % Cream $0.0000
ketoconazole 2 % Cream $0.0000
ketoconazole 200 mg tablet $1.2460/Each
ketoconazole 2 % Foam $3.2959/Gram
ketoprofen 200 mg capsule, extended release $6.1160/Each
ketoprofen 50 mg capsule $0.3840/Each
ketoprofen 75 mg capsule $0.4560/Each
ketorolac tromethamine 0.4% Drops $6.5885/Milliliter
ketorolac tromethamine 30 MG/ML solution $3.8000/Milliliter
ketorolac tromethamine 10 mg tablet $0.7385/Each
ketorolac tromethamine 60 mg/2 ml Solution $1.0365/Milliliter
ketorolac tromethamine 15 MG/ML solution $1.7904/Milliliter
ketorolac tromethamine 30MG/ML(1) Solution $1.0789/Milliliter
ketorolac tromethamine 30 mg/ml Cartridge $0.0000
ketorolac tromethamine 15 mg/ml Cartridge $0.0000
ketorolac tromethamine 0.5% Drops $1.4649/Milliliter
labetalol hcl 300 mg tablet $0.2342/Each
labetalol hcl 200 mg tablet $0.1385/Each
labetalol hcl 100 mg tablet $0.0900/Each
lactase 3000 UNIT tablet $0.1005/Each
lactase 9000 UNIT tablet $0.2400/Each
lactulose 10 gm/15 ml Solution $0.0150/Milliliter
lactulose 10 gm/15 ml Solution $0.0000
lactulose 10 gm/15 ml Solution $0.0120/Milliliter
lactulose 20 G/30 ML solution $0.0288/Milliliter
lactulose 10 G/15 ML solution $0.0675/Milliliter
lamivudine 300 MG tablet $1.0375/Each
lamivudine 150 MG tablet $0.2389/Each
lamivudine 10 MG/ML Solution $0.2645/Milliliter
lamivudine 100 mg tablet $2.3555/Each
lamivudine/zidovudine 150 - 300 mg tablet $0.6985/Each
lamotrigine 50 mg Tablet,disintegrating $3.5805/Each
lamotrigine 25 mg Tablet,disintegrating $4.4155/Each
lamotrigine 100 mg Tablet,disintegrating $5.1325/Each
lamotrigine 200 mg Tablet,disintegrating $6.3132/Each
lamotrigine 25MG (35) tablet $6.4150/Each
lamotrigine 25 MG tablet, extended release $1.3795/Each
lamotrigine 50 MG tablet, extended release $1.5232/Each
lamotrigine 100 MG tablet, extended release $1.3350/Each Decrease
lamotrigine 200 MG tablet, extended release $1.9023/Each Decrease
lamotrigine 300 MG tablet, extended release $2.2250/Each
lamotrigine 250 MG tablet, extended release $4.9995/Each
lamotrigine 100 mg tablet $0.0525/Each
lamotrigine 25 mg tablet $0.0320/Each
lamotrigine 25 mg Tablet, Chewable Dispersible $0.1775/Each
lamotrigine 5 mg Tablet, Chewable Dispersible $0.1525/Each
lamotrigine 150 mg tablet $0.0645/Each
lamotrigine 200 mg tablet $0.0755/Each
lansoprazole 15 mg capsule,delayed release (e.c.) $0.2215/Each
lansoprazole 30 mg capsule,delayed release (e.c.) $0.0655/Each
Page 29 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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lansoprazole 15 mg tablet, delayed release (enteric coated) $5.1445/Each
lansoprazole 30 mg tablet, delayed release (enteric coated) $5.7045/Each
lansoprazole/amoxicillin/clarithromycin 30-500-500 capsule $2.5725/Each
lanthanum carbonate 1000 MG Tablet, Chewable $7.9500/Each
latanoprost 0.00005 Drops $1.8288/Milliliter
leflunomide 10 mg tablet $0.7650/Each
leflunomide 20 mg tablet $1.0175/Each
letrozole 2.5 mg tablet $0.1155/Each
leucovorin calcium 100 MG Solution $1.1735/Each
leucovorin calcium 350 MG Solution $14.9265/Each
leucovorin calcium 50 MG Solution $6.0960/Each
leucovorin calcium 10 MG tablet $5.4972/Each
leucovorin calcium 15 MG tablet $4.9585/Each
leucovorin calcium 25 mg tablet $5.6675/Each
leucovorin calcium 5 mg tablet $0.6000/Each
leucovorin calcium 200 MG Solution $14.7000/Each
leucovorin calcium 500 MG solution $94.8950/Each
leuprolide acetate 1 mg/0.2 ml Kit $148.2500/Each
levalbuterol hcl 0.31MG/3ML Solution $0.3035/Milliliter
levalbuterol HCl 1.25MG/0.5 Solution $3.3595/Each
levalbuterol hcl 0.63MG/3ML Solution $0.2115/Milliliter
levalbuterol hcl 1.25MG/3ML Solution $0.2030/Milliliter
levetiracetam 500 mg tablet, extended release $0.2225/Each
levetiracetam 500 MG/5ML Solution $0.0352/Milliliter
levetiracetam 100 mg/ml Solution $0.0375/Milliliter
levetiracetam 750 mg tablet, extended release $0.4956/Each
levetiracetam 500 mg/5 ml Solution $1.3126/Milliliter
levetiracetam 750 mg tablet $0.1485/Each
levetiracetam 250 mg tablet $0.0775/Each
levetiracetam 500 mg tablet $0.0901/Each
levetiracetam 1000 mg tablet $0.2189/Each
levobunolol hcl 0.50% Drops $0.4717/Milliliter
levobunolol hcl 0.25% Drops $0.0000
levocarnitine 330 mg tablet $0.0000
levocarnitine 200 mg/ml Solution $2.1370/Milliliter
levocarnitine 100 mg/ml Liquid $0.2409/Milliliter
levocetirizine dihydrochloride 5 mg tablet $0.0000
levocetirizine dihydrochloride 2.5 mg/5 ml Solution $0.2375/Milliliter
levofloxacin 250MG/10ML Solution $0.9425/Milliliter
levofloxacin 25 MG/ML solution $0.9510/Milliliter
levofloxacin 250 mg tablet $0.1265/Each
levofloxacin 500 mg tablet $0.1500/Each
levofloxacin 0.005 Drops $6.3035/Milliliter
levofloxacin 750 mg tablet $0.3055/Each
levofloxacin in dextrose 5 % 250MG/50ML solution $0.0559/Milliliter
levofloxacin in dextrose 5 % 500MG/0.1L solution $0.0275/Milliliter
levofloxacin in dextrose 5 % 750MG/.15L solution $0.0230/Milliliter
levoleucovorin calcium 10 MG/ML solution $6.5500/Milliliter
levoleucovorin calcium 50 MG Solution $104.6320/Each
levonorgestrel 1.5 mg tablet $10.3075/Each
levonorgestrel 0.75 mg tablet $0.0000
levonorgestrel/ethinyl estradiol (alesse, levlite, aviane) 0.1 mg/20 mcg tablet $0.1825/Each
levonorgestrel/ethinyl estradiol (alesse, levlite, aviane) 0.1 mg/20 mcg tablet $0.0000
levonorgestrel/ethinyl estradiol (levlen, nordette, levora 0.15/30) 0.15 mg/30 mcg tablet $0.1065/Each
levonorgestrel/ethinyl estradiol (levlen, nordette, levora 0.15/30) 0.15 mg/30 mcg tablet $0.0000
levonorgestrel/ethinyl estradiol (seasonale, jolessa, quasense) 0.15 mg/30 mcg tablet $0.1175/Each Decrease
levonorgestrel/ethinyl estradiol triphasic (tri-levlen, triphasil, trivora-28) 0.05 mg/30 mcg; 0.075 mg/40 mcg; 0.125 mg/30 mcg tablet $0.2000/Each
levonorgestrel/ethinyl estradiol triphasic (tri-levlen, triphasil, trivora-28) 0.05 mg/30 mcg; 0.075 mg/40 mcg; 0.125 mg/30 mcg tablet $0.0000
levonorgestrel-eth estra 90-20mcg tablet $0.7155/Each
levonorgestrel-eth estra/ethinyl estradiol 100-20(84) tablet $0.3699/Each
Page 30 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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levonorgestrel-eth estra/ethinyl estradiol 150-30 (84) tablet $0.3564/Each
levorphanol tartrate 2 MG tablet $44.2500/Each
levothyroxine 112 mcg tablet $0.2515/Each
levothyroxine 25 mcg tablet $0.1765/Each
levothyroxine 50 mcg tablet $0.2099/Each
levothyroxine 100 mcg tablet $0.2250/Each
levothyroxine 75 mcg tablet $0.2505/Each
levothyroxine 200 mcg tablet $0.2800/Each
levothyroxine 125 mcg tablet $0.2425/Each
levothyroxine 150 mcg tablet $0.1515/Each
levothyroxine 175 mcg tablet $0.3335/Each
levothyroxine 300 mcg tablet $0.2500/Each
levothyroxine 88 mcg tablet $0.2759/Each
levothyroxine 137 mcg tablet $0.2315/Each
levothyroxine sodium 100 MCG Solution $99.1940/Each
lidocaine 2% Gel $0.3008/Milliliter
lidocaine 5 % Ointment $0.2955/Gram
lidocaine 5 % Adhesive Patch, Medicated $2.2595/Each
lidocaine 5 % Cream $0.4265/Gram
lidocaine HCl 0.02 Gel $0.4700/Milliliter
lidocaine hcl 10 MG/ML Solution $0.0412/Milliliter
lidocaine hcl 2% Solution $0.0409/Milliliter
lidocaine HCl 40 MG/ML Solution $0.4800/Milliliter
lidocaine hcl 3 % Cream $0.6785/Gram
lidocaine HCl/PF 10 MG/ML solution $0.0820/Milliliter
lidocaine/aloe vera 0.5 % Aerosol, Spray $0.0244/Gram
lidocaine/prilocaine 2.5-2.5% Cream $0.2055/Gram
lindane 1% Lotion $0.0000
lindane 1% Shampoo $0.0000
linezolid 600 mg tablet $2.0550/Each
linezolid 100 MG/5ML Suspension $2.7050/Milliliter
linezolid 600MG/300 Solution $0.1350/Milliliter
liothyronine sodium 25 mcg tablet $0.5125/Each
liothyronine sodium 5 mcg tablet $0.4000/Each
liothyronine sodium 50 mcg tablet $0.8325/Each
lisinopril 5 mg tablet $0.0155/Each
lisinopril 10 mg tablet $0.0180/Each
lisinopril 20 mg tablet $0.0220/Each
lisinopril 40 mg tablet $0.0435/Each
lisinopril 2.5 mg tablet $0.0141/Each
lisinopril 30 mg tablet $0.0450/Each
lisinopril/hctz 20 mg/12.5 mg tablet $0.0330/Each
lisinopril/hctz 20 mg/25 mg tablet $0.0389/Each
lisinopril/hctz 10 mg/12.5 mg tablet $0.0296/Each
lithium carbonate 300 mg capsule $0.0360/Each
lithium carbonate 150 mg capsule $0.0552/Each
lithium carbonate 600 MG capsule $0.1080/Each
lithium carbonate 300 mg tablet $0.1666/Each
lithium carbonate 450 mg tablet, extended release $0.1955/Each
lithium carbonate 300 mg tablet, extended release $0.1355/Each
lithium citrate 8 mEq/5 ml Solution $0.2273/Milliliter
loperamide hcl 2 mg capsule $0.1185/Each
loperamide hcl 2 mg Caplet $0.1030/Each
loperamide hcl 1 mg/5 ml Liquid $0.0362/Milliliter
loperamide HCl 1MG/7.5ML liquid $0.0248/Milliliter
lopinavir/ritonavir 400-100/5 Solution $2.5300/Milliliter
loratadine 10 mg Tablet,disintegrating $0.0000
loratadine 5 mg/5 ml Solution $0.0000
loratadine 10 mg tablet $0.0000
loratadine 5 MG tablet,chewable $0.4053/Each
Page 31 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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lorazepam 2 mg/ml Solution $0.6575/Milliliter
lorazepam 2 mg/ml Solution $0.0000
lorazepam 0.5 mg tablet $0.0240/Each
lorazepam 1 mg tablet $0.0274/Each
lorazepam 2 mg tablet $0.0450/Each
lorazepam 2 mg/ml Concentrate $0.4808/Milliliter
losartan potassium 25 mg tablet $0.0385/Each
losartan potassium 50 mg tablet $0.0355/Each
losartan potassium 100 mg tablet $0.0462/Each
losartan potassium/hydrochlorothiazide 50-12.5 mg tablet $0.0750/Each
losartan potassium/hydrochlorothiazide 100 mg-25 mg tablet $0.0775/Each
losartan potassium/hydrochlorothiazide 100-12.5 mg tablet $0.1048/Each
loteprednol etabonate 0.5 % Drops, Gel $0.0000
loteprednol etabonate 0.5 % drops, suspension $0.0000
lovastatin 20 mg tablet $0.0400/Each
lovastatin 40 mg tablet $0.0420/Each
lovastatin 10 mg tablet $0.0325/Each
loxapine succinate 10 mg capsule $0.4100/Each
loxapine succinate 25 mg capsule $0.6476/Each
loxapine succinate 5 mg capsule $0.2465/Each
loxapine succinate 50 mg capsule $0.8115/Each
lysine 500 MG tablet $0.0225/Each
mag carb/aluminum hydrox/algin 358-95/15 liquid $0.0127/Milliliter
mag hydrox/aluminum hyd/simeth 400-400-40 liquid $0.0080/Milliliter
mag hydrox/aluminum hyd/simeth 200-200-25 tablet,chewable $0.0247/Each
magnesium carb/aluminum hydrox 105-160MG tablet,chewable $0.0300/Each
magnesium citrate solution $0.0050/Milliliter
magnesium hydroxide/aluminum hydroxide/simethicone 200-200-20 Gel $0.0074/Milliliter
magnesium oxide 400 mg Caplet $0.0185/Each
magnesium oxide 200 MG tablet $0.0000
magnesium sulfate 495 MG/5 G Granules $0.0170/Gram
malathion 0.005 Lotion $3.5915/Milliliter
maprotiline hcl 25 mg tablet $0.0000
maprotiline hcl 50 mg tablet $0.0000
maprotiline hcl 75 mg tablet $0.0000
meclizine hcl 12.5 mg Caplet $0.0720/Each
meclizine hcl 25 mg tablet $0.1275/Each
meclizine HCl 25 MG tablet,chewable $0.0175/Each
meclofenamate sodium 100 mg capsule $0.0000
meclofenamate sodium 50 mg capsule $0.0000
medroxyprogesterone acet 150 mg/ml Suspension $24.3230/Milliliter
medroxyprogesterone acet 150 mg/ml Suspension $35.6800/Milliliter
medroxyprogesterone acetate 10 mg tablet $0.1680/Each
medroxyprogesterone acetate 2.5 mg tablet $0.1360/Each
medroxyprogesterone acetate 5 mg tablet $0.1560/Each
mefenamic acid 250 mg capsule $1.7265/Each Decrease
mefloquine hcl 250 MG tablet $3.3525/Each
megestrol acetate 625mg/5ml Suspension $1.6350/Milliliter
megestrol acetate 400MG/10ML suspension $0.3760/Milliliter
megestrol acetate 20 mg tablet $0.1250/Each
megestrol acetate 40 mg tablet $0.2076/Each
megestrol acetate 40 mg/ml Suspension $0.0981/Milliliter
meloxicam 7.5 mg tablet $0.0195/Each
meloxicam 15 mg tablet $0.0195/Each
meloxicam, submicronized 5 MG capsule $24.5900/Each
meloxicam, submicronized 10 MG capsule $24.5900/Each
melphalan HCl 50 MG solution $260.0000/Each
memantine hcl 10 mg tablet $0.0895/Each
memantine hcl 5 mg tablet $0.1265/Each
memantine HCl 2 MG/ML Solution $1.2000/Milliliter
Page 32 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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memantine HCl 7 MG Capsule Sprinkle, Extended Release $1.9975/Each
memantine HCl 14 MG Capsule Sprinkle, Extended Release $1.3125/Each
memantine HCl 21 MG Capsule Sprinkle, Extended Release $1.5556/Each Decrease
memantine HCl 28 MG Capsule Sprinkle, Extended Release $1.3125/Each
menthol 5.8 MG lozenge $0.0295/Each
menthol 5.4 MG lozenge $0.0247/Each
menthol 2 % gel $0.0290/Gram
meperidine hcl 100 mg tablet $1.0250/Each
meperidine hcl 50 mg tablet $0.5175/Each
meprobamate 200 mg tablet $0.0000
meprobamate 400 mg tablet $2.9699/Each
mercaptopurine 50 mg tablet $0.7189/Each
meropenem 500 mg Solution $6.1688/Each
meropenem 1 G Solution $10.9200/Each
mesalamine 0.375G capsule, extended release $2.3460/Each
mesalamine 800 MG tablet, delayed release (enteric coated) $4.9645/Each
mesalamine 400 MG capsule (with delayed release tablets) $1.8365/Each
mesalamine 4g/60ml Enema $0.1317/Milliliter
mesalamine 1000 MG Suppository $4.5405/Each
mesalamine w/cleansing wipes 4 G/60 ML Enema $130.5365/Each
mesna 100 MG/ML Solution $1.1000/Milliliter
metaxalone 800 mg tablet $0.5055/Each
metformin 500 mg tablet $0.0188/Each
metformin 850 mg tablet $0.0404/Each
metformin 1000 mg tablet $0.0237/Each
metformin hcl 750 mg tablet, extended release $0.0675/Each
metformin hcl 1000 MG tablet, extended release $1.1430/Each
metformin hcl 500 MG tablet, extended release $1.1290/Each Decrease
metformin hcl 500 mg tablet, extended release $0.0285/Each
metformin hcl 500 MG tablet, extended release $4.3695/Each
metformin hcl 1000 MG tablet, extended release $7.1185/Each
meth/meblue/sod phos/psal/hyos 81-0.12MG tablet $6.1822/Each
methadone HCl 5 MG/5 ML solution $0.2412/Milliliter
methadone HCl 10 MG/5 ML solution $0.4825/Milliliter
methadone hcl 10 mg/ml Concentrate $0.0494/Milliliter
methadone hcl 10 mg tablet $0.1324/Each
methadone hcl 5 mg tablet $0.1275/Each
methadone hcl 40 mg tablet $0.3125/Each
methamphetamine hydrochloride 5 mg tablet $3.5985/Each
methazolamide 50 MG tablet $3.5890/Each
methazolamide 25 MG tablet $3.1095/Each
methenam/sod phos/mblue/hyoscy 81.6-.12MG tablet $3.3625/Each
methenamine hippurate 1 g tablet $0.9000/Each
methenamine mandelate 1 G tablet $1.2805/Each
methenamine mandelate 500 MG tablet $0.6300/Each
methimazole 10 mg tablet $0.0750/Each
methimazole 5 mg tablet $0.0555/Each
methocarbamol 100 MG/ML solution $2.2087/Milliliter
methocarbamol 500 mg tablet $0.0575/Each
methocarbamol 750 mg tablet $0.0755/Each
methotrexate 2.5 mg tablet $0.5325/Each
methotrexate sodium 25 mg/ml Solution $1.8840/Milliliter
methotrexate sodium/pf 25 mg/ml Solution $1.4160/Milliliter
methotrexate sodium/PF 1 G solution $62.4950/Each
methoxsalen 10 MG capsule $46.3555/Each
methscopolamine bromide 2.5 MG tablet $0.3595/Each
methscopolamine bromide 5 mg tablet $1.5055/Each
methyl salicylate/menthol 15%-10% Cream $0.0245/Gram
methylcellulose 500 MG tablet $0.0545/Each
methyldopa 250 mg tablet $0.0615/Each
Page 33 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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methyldopa 500 mg tablet $0.1005/Each
methylergonovine maleate .2MG/ML(1) solution $13.2800/Milliliter
methylergonovine maleate 0.2 MG tablet $29.4645/Each
methylphenidate hcl 54 MG tablet, extended release $0.0000
methylphenidate hcl 18 MG tablet, extended release $0.0000
methylphenidate hcl 36 MG tablet, extended release $0.0000
methylphenidate hcl 10 mg tablet $0.1325/Each
methylphenidate hcl 5 mg tablet $0.1215/Each
methylphenidate hcl 20 mg tablet $0.2695/Each
methylphenidate hcl 20 mg tablet, extended release $0.7385/Each
methylphenidate hcl 27 mg tablet, extended release $0.0000
methylphenidate hcl 10 MG capsule, extended release $1.5174/Each Decrease
methylphenidate hcl 20 MG capsule, extended release $1.2950/Each
methylphenidate hcl 30 MG capsule, extended release $1.8500/Each
methylphenidate hcl 20 MG capsule, extended release $1.4335/Each Decrease
methylphenidate hcl 30 MG capsule, extended release $1.4860/Each Decrease
methylphenidate hcl 40 MG capsule, extended release $1.1887/Each Decrease
methylphenidate HCl 10 MG capsule, extended release $2.8425/Each
methylphenidate hcl 2.5 MG Tablet, Chewable $1.8500/Each
methylphenidate hcl 5 MG Tablet, Chewable $2.7000/Each
methylphenidate hcl 10 MG Tablet, Chewable $3.1500/Each
methylphenidate hcl 5 MG/5 ML Solution $0.1035/Milliliter
methylphenidate hcl 10 MG/5 ML Solution $0.1470/Milliliter
methylphenidate hcl 40 MG capsule, extended release $2.4264/Each Decrease
methylphenidate hcl 50 MG capsule, extended release $3.3245/Each
methylphenidate hcl 60 MG capsule, extended release $2.4179/Each Decrease
methylphenidate HCl 60 MG capsule, extended release $7.4245/Each
methylphenidate HCl 72 MG tablet, extended release $7.5000/Each
methylphenidate hcl 10 MG tablet, extended release $0.6479/Each Decrease
methylphenidate HCl 10 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylphenidate HCl 15 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylphenidate HCl 20 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylphenidate HCl 30 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylphenidate HCl 40 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylphenidate HCl 50 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylphenidate HCl 60 MG Capsule Sprinkle, Extended Release $6.0450/Each
methylprednisolone 16 MG tablet $2.0550/Each
methylprednisolone 32 MG tablet $2.9875/Each
methylprednisolone 4 mg tablet $0.2175/Each
methylprednisolone 8 MG tablet $1.2150/Each
methylprednisolone acetate 40 MG/ML suspension $5.7000/Milliliter
methylprednisolone acetate 80 MG/ML Suspension $6.8400/Milliliter
methylprednisolone dosepak 4 mg tablet $0.1650/Each
methylprednisolone sod succ 1000 MG Solution $24.1000/Each
methylprednisolone sod succ 125 MG solution $9.1500/Each
methylprednisolone sod succ 40 MG Solution $3.9500/Each
methyltestosterone 10 MG capsule $68.7350/Each
metipranolol 0.3 % Drops $0.0000
metoclopramide hcl 5 mg/5 ml Solution $0.0150/Milliliter
metoclopramide hcl 10 mg Caplet $0.0240/Each
metoclopramide hcl 5 mg tablet $0.0274/Each
metolazone 10 mg tablet $0.9024/Each
metolazone 2.5 mg tablet $1.0285/Each
metolazone 5 mg tablet $0.6475/Each
metoprolol succinate 25 mg tablet, extended release $0.1245/Each
metoprolol succinate 50 mg tablet, extended release $0.1100/Each
metoprolol succinate 100 mg tablet, extended release $0.1835/Each
metoprolol succinate 200 mg tablet, extended release $0.3775/Each
metoprolol tartrate 25 mg tablet $0.0168/Each
metoprolol tartrate 100 mg tablet $0.0300/Each
Page 34 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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metoprolol tartrate 50 mg tablet $0.0240/Each
metoprolol tartrate 37.5 MG tablet $0.0655/Each
metoprolol tartrate 75 MG tablet $0.2025/Each
metoprolol/hydrochlorothiazide 50 MG-25MG tablet $0.7679/Each
metoprolol/hydrochlorothiazide 100MG-25MG tablet $1.2132/Each
metoprolol/hydrochlorothiazide 100MG-50MG tablet $1.4500/Each
metronidazole 1 % Gel $1.6975/Gram
metronidazole 1 % Gel $1.0905/Gram
metronidazole 750 mg tablet, extended release $0.0000
metronidazole 250 mg tablet $0.1935/Each
metronidazole 500 mg tablet $0.1229/Each
metronidazole 375 mg capsule $3.1080/Each
metronidazole 0.75 % Lotion $2.1215/Milliliter
metronidazole 0.0075 Gel $0.5170/Gram
metronidazole 0.0075 Cream $0.8723/Gram
metronidazole 0.75% Gel $0.5865/Gram
mexiletine hcl 150 mg capsule $0.0000
mexiletine hcl 200 mg capsule $0.7470/Each
mexiletine hcl 250 mg capsule $0.0000
micafungin sodium 50 MG solution $91.6300/Each
micafungin sodium 100 MG solution $183.2600/Each
miconazole nitrate 2 % Cream $0.1050/Gram
miconazole nitrate 100 MG Suppository $0.7396/Each
miconazole nitrate 200 MG suppository $11.2415/Each
miconazole nitrate 2 % Cream $0.1200/Gram
midazolam HCl 5 MG/5 ML solution $0.3088/Milliliter
midazolam HCl 10 MG/2 ML solution $1.7225/Milliliter
midazolam HCl 5 MG/ML(1) solution $1.7533/Milliliter
midazolam HCl 5 MG/ML Solution $0.2500/Milliliter
midazolam HCl 2 MG/ML Syrup $0.6205/Milliliter
midodrine hcl 10 mg tablet $0.4030/Each
midodrine hcl 5 mg tablet $0.2820/Each
midodrine hcl 2.5 mg tablet $0.3275/Each
miglitol 25 MG tablet $2.0400/Each
miglitol 50 MG tablet $2.2502/Each
miglitol 100 MG tablet $2.6553/Each
miglustat 100 MG capsule $260.8700/Each
milrinone lactate 1 mg/ml Solution $0.2955/Milliliter
milrinone lactate/d5w 20MG/100ML Solution $0.1596/Milliliter
milrinone lactate/d5w 40MG/200ML Solution $0.1675/Milliliter
mineral oil Oil $0.0120/Milliliter
mineral oil Enema $0.0175/Milliliter
mineral oil/petrolatum,hydrophilic Ointment $0.0263/Gram
mineral oil/petrolatum,white 15 %-83 % Ointment $0.6855/Gram
minocycline HCl 75 MG tablet $1.8500/Each
minocycline hcl 45 MG tablet, extended release $3.0280/Each
minocycline hcl 90 MG tablet, extended release $5.9832/Each
minocycline hcl 135MG tablet, extended release $3.0280/Each
minocycline HCl 65 MG tablet, extended release $6.6445/Each
minocycline HCl 115MG tablet, extended release $6.6455/Each
minocycline HCl 55 MG tablet, extended release $20.4805/Each
minocycline HCl 80 MG tablet, extended release $3.4255/Each
minocycline HCl 105 MG tablet, extended release $4.8335/Each
minocycline hcl 100 mg capsule $0.3300/Each
minocycline hcl 50 mg capsule $0.1919/Each
minocycline hcl 100 mg tablet $1.8725/Each
minocycline hcl 50 MG tablet $0.9599/Each
minocycline hcl 75 mg capsule $0.4200/Each
minoxidil 10 mg tablet $0.1600/Each
minoxidil 2.5 mg tablet $0.0955/Each
Page 35 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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mirtazapine 15 mg tablet $0.0795/Each
mirtazapine 30 mg tablet $0.1040/Each
mirtazapine 45 mg tablet $0.1146/Each
mirtazapine 7.5 mg tablet $0.7445/Each
mirtazapine soltab 15 mg Tablet,disintegrating $0.5645/Each
mirtazapine soltab 30 mg Tablet,disintegrating $0.6535/Each
mirtazapine soltab 45 mg Tablet,disintegrating $0.7325/Each
misoprostol 200 mcg tablet $0.7078/Each
misoprostol 100 mcg tablet $0.4188/Each
mitomycin 20 mg Solution $139.2800/Each
mitomycin 5 mg Solution $102.5000/Each
mitomycin 40 MG Solution $262.5120/Each
mitoxantrone hcl 2 mg/ml Concentrate $23.3718/Milliliter
modafinil 100 mg tablet $0.4365/Each
modafinil 200 mg tablet $0.4025/Each
moexipril hcl 7.5 mg tablet $0.8630/Each
moexipril hcl 15 mg tablet $0.7186/Each
moexipril hcl/hctz 15-12.5 mg tablet $0.0000
moexipril hcl/hctz 15-25 mg tablet $0.0000
moexipril hcl/hctz 7.5-12.5 mg tablet $0.0000
mometasone furoate 0.1 % Lotion $0.2620/Milliliter
mometasone furoate 0.1% Cream $0.3050/Gram
mometasone furoate 0.1% Ointment $0.2025/Gram
mometasone furoate 50 MCG Spray, Non-Aerosol $1.8075/Gram
montelukast sodium 4 MG Granules $0.8740/Each
montelukast sodium 4 mg Tablet, Chewable $0.0675/Each
montelukast sodium 5 mg Tablet, Chewable $0.0825/Each
montelukast sodium 10 mg tablet $0.0565/Each
morphine sulfate 10 MG/5 ML Solution $0.0690/Milliliter
morphine sulfate 20 MG/5 ML solution $0.1005/Milliliter
morphine sulfate 20 mg/ml Solution $0.2365/Milliliter
morphine sulfate 15 mg tablet $0.1980/Each
morphine sulfate 30 mg tablet $0.3275/Each
morphine sulfate 200 mg tablet, extended release $2.1439/Each
morphine sulfate 30 mg tablet, extended release $0.2425/Each
morphine sulfate 60 mg tablet, extended release $0.5683/Each
morphine sulfate 100 mg tablet, extended release $1.0060/Each
morphine sulfate 15 mg tablet, extended release $0.2000/Each
morphine sulfate 120 MG capsule, extended release $18.8204/Each
morphine sulfate 10 MG capsule, extended release $2.2455/Each
morphine sulfate 20 MG capsule, extended release $2.5665/Each
morphine sulfate 50 MG capsule, extended release $3.4345/Each
morphine sulfate 100 MG capsule, extended release $10.2955/Each
morphine sulfate 80 MG capsule, extended release $10.6495/Each
morphine sulfate 30 MG capsule, extended release $1.8550/Each
morphine sulfate 60 MG capsule, extended release $4.4635/Each
moxifloxacin HCl 0.5 % drops $5.5545/Milliliter
moxifloxacin hcl 400 MG tablet $1.5475/Each
multivit/iron sulf/folic acid 15MG-0.4MG tablet $0.0184/Each
multivitamin gummie $0.0240/Each
multivitamin Caplet $0.0272/Each
multivitamin with folic acid 400 MCG tablet $0.0367/Each
multivitamin with minerals Caplet $0.0568/Each
multivitamin w-minerals/lutein Caplet $0.0665/Each
multivitamins with iron Tablet, Chewable $0.0342/Each
multivit-mins no.63/iron/folic 27 MG-1 MG tablet $0.0000
multivit-mins60/iron fum/folic 27 MG-1 MG tablet $0.1500/Each
mupirocin 2% Ointment $0.1720/Gram
mupirocin calcium 2 % Cream $6.6134/Gram Decrease
mycophenolate mofetil 250 mg capsule $0.1455/Each
Page 36 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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mycophenolate mofetil 500 mg tablet $0.1855/Each
mycophenolate mofetil 200 MG/ML Suspension $4.3750/Milliliter
mycophenolate sodium 180 MG tablet, delayed release (enteric coated) $0.6000/Each
mycophenolate sodium 360 MG tablet, delayed release (enteric coated) $1.5940/Each
nabumetone 500 mg tablet $0.1358/Each
nabumetone 750 mg tablet $0.1800/Each
nadolol 120 mg tablet $0.0000
nadolol 160 mg tablet $0.0000
nadolol 40 mg tablet $0.4750/Each
nadolol 80 mg tablet $0.4960/Each
nadolol 20 mg tablet $0.4620/Each
nafcillin sodium 1 G Solution $8.0555/Each
nafcillin sodium 10 G Solution $49.2555/Each
nafcillin sodium 2 G Solution $8.5555/Each
naftifine hcl 2 % Cream $4.4860/Gram
naloxone HCl 1 MG/ML solution $16.2938/Milliliter
naloxone HCl 0.4 MG/ML Solution $5.8000/Milliliter
naltrexone hcl 50 mg tablet $0.5965/Each
naphazoline HCl/glycerin 0.012-0.2% drops $0.1275/Milliliter
naproxen 250 mg tablet $0.0488/Each
naproxen 375 mg tablet $0.0604/Each
naproxen 500 mg tablet $0.0610/Each
naproxen 125 MG/5ML suspension $1.7425/Milliliter
naproxen ec 375 mg tablet, delayed release (enteric coated) $0.1335/Each
naproxen ec 500 mg tablet, delayed release (enteric coated) $0.1913/Each
naproxen sodium 220 MG capsule $0.1375/Each
naproxen sodium 500 mg tablet, extended release $0.0000
naproxen sodium 275 mg tablet $0.2865/Each
naproxen sodium 550 mg tablet $0.3975/Each
naproxen sodium 220 mg Caplet $0.0600/Each
naproxen sodium 375 MG tablet, extended release $7.5550/Each
naproxen sodium/pseudoephedrin 220-120MG tablet, extended release $0.2515/Each
naratriptan hcl 2.5 MG tablet $1.2250/Each
naratriptan hcl 1 MG tablet $1.0200/Each
nateglinide 60 mg tablet $0.2035/Each
nateglinide 120 mg tablet $0.4685/Each
nefazodone hcl 50 mg tablet $0.0000
nefazodone hcl 100 mg tablet $0.0000
nefazodone hcl 150 mg tablet $0.0000
nefazodone hcl 200 mg tablet $0.0000
nefazodone hcl 250 mg tablet $0.0000
neomy sulf/polymyx b sulf/hc 3.5-10,000-10 Drops, Suspension $0.0000
neomycin sulf/bacitracin/poly 3.5MG-400 ointment $7.1205/Gram
neomycin sulf/polymyxin B sulf 40-200K/ML solution $8.1250/Milliliter
neomycin sulfate 500 MG tablet $0.6300/Each
neomycin sulfate/polymyxin b sulfate/gramicidin d 1.75 mg-10k Drops $3.7550/Milliliter
neomycin/bacit/p-myx/hydrocort 3.5-10K-1 ointment $3.3750/Gram
neomycin/polymyxin b/dexamethasone 0.1% Ointment $3.2025/Gram
neomycin/polymyxin b/dexamethasone 3.5 mg/10,000 units/0.1% per ml Drops, Suspension $2.6695/Milliliter
neomycin/polymyxin b/dexamethasone 3.5 mg/10,000 units/0.1% per gm Ointment $0.0000
neomycin/polymyxin b/hc 0.01 Solution $2.4585/Milliliter
neomycin/polymyxin b/hc 3.5 mg/10,000 units/10 mg per ml Drops, Suspension $5.1593/Milliliter
neomycn/bacitrc/polymyx/pramox 3.5-10K-10 ointment $0.1325/Gram
nevirapine 400 mg tablet, extended release $1.6965/Each
nevirapine 100 MG tablet, extended release $5.2655/Each
nevirapine 200 mg tablet $0.1025/Each
niacin 500 mg tablet, extended release $0.4748/Each
niacin 750 mg tablet, extended release $0.3600/Each
niacin 1000 mg tablet, extended release $0.4920/Each
niacin 500 MG capsule, extended release $0.0615/Each
Page 37 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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niacin 250 mg capsule, extended release $0.0000
niacin 500 MG tablet $0.0190/Each
niacin 500 mg Caplet $0.0000
niacin 750 MG tablet, extended release $0.0885/Each
nicardipine hcl 20 mg capsule $1.5335/Each
nicardipine hcl 30 mg capsule $2.3125/Each
nicotine 7 mg/24 hr Patch, Transdermal 24 Hours $1.4800/Each
nicotine 14 mg/24 hr Patch, Transdermal 24 Hours $1.4800/Each
nicotine 21 mg/24 hr Patch, Transdermal 24 Hours $1.4800/Each
nicotine 11MG/24HR Patch, Transdermal 24 Hours $0.0000
nicotine 22 MG/24HR Patch, Transdermal 24 Hours $0.0000
nicotine 15MG/16HR Patch, Transdermal 24 Hours $0.0000
nicotine 21-14-7MG Patch, Transdermal Daily, Sequential $0.8828/Each
nicotine polacrilex 2 MG Gum $0.2033/Each
nicotine polacrilex 4 MG Gum $0.2598/Each
nicotine polacrilex 4 MG lozenge $0.3875/Each
nicotine polacrilex 2 MG lozenge $0.3745/Each
nicotine polacrilex 4 MG lozenge $0.3945/Each
nicotine polacrilex 2 MG lozenge $0.3925/Each
nifedipine 10 mg capsule $0.5200/Each
nifedipine 20 mg capsule $1.4895/Each
nifedipine cc 30 mg tablet, extended release $0.1050/Each
nifedipine cc 60 mg tablet, extended release $0.1200/Each
nifedipine cc 90 mg tablet, extended release $0.4000/Each
nifedipine er 30 mg tablet, extended release $0.1755/Each
nifedipine er 60 mg tablet, extended release $0.2422/Each
nifedipine er 90 mg tablet, extended release $0.4135/Each
nilutamide 150 MG tablet $115.4565/Each
nimodipine 30 mg capsule $6.3715/Each
nisoldipine 8.5mg tablet, extended release $3.5860/Each
nisoldipine 17 mg tablet, extended release $4.2785/Each
nisoldipine 25.5 mg tablet, extended release $5.8925/Each
nisoldipine 34 mg tablet, extended release $5.3585/Each
nitrofurantoin 25 MG/5 ML Suspension $0.0000
nitrofurantoin 100 mg capsule $0.4475/Each
nitrofurantoin macrocrystal 25 MG capsule $3.4164/Each Decrease
nitrofurantoin macrocrystals 100 mg capsule $0.6310/Each
nitrofurantoin macrocrystals 50 mg capsule $0.5675/Each
nitroglycerin 2.5 mg capsule, extended release $0.4200/Each
nitroglycerin 6.5 mg capsule, extended release $0.4950/Each
nitroglycerin 9 mg capsule, extended release $0.9885/Each
nitroglycerin 0.4 mg/HR Patch, Transdermal 24 Hours $0.5080/Each
nitroglycerin 0.1MG/HR Patch, Transdermal 24 Hours $0.4665/Each
nitroglycerin 0.2 mg/HR Patch, Transdermal 24 Hours $0.3695/Each
nitroglycerin 0.6 mg/HR Patch, Transdermal 24 Hours $0.7025/Each
nitroglycerin 0.3 mg Tablet, Sublingual $0.2395/Each
nitroglycerin 0.4 mg Tablet, Sublingual $0.3205/Each
nitroglycerin 0.6 mg Tablet, Sublingual $0.2055/Each
nitroglycerin 400MCG/SPR Spray, Non-Aerosol $13.5546/Gram Decrease
nitroprusside sodium 25 MG/ML solution $8.7455/Milliliter
nizatidine 150 mg/10 ml Solution $0.8445/Milliliter
nizatidine 150 mg capsule $0.2265/Each
nizatidine 300 mg capsule $0.4400/Each
norelgestromin/ethin.estradiol 150-35/24H Patch, Transdermal Weekly $0.0000
noreth a-et estra/fe fumarate (loestrin fe, junel fe, microgestin fe) 1.5-0.03 mg tablet $0.2250/Each
noreth a-et estra/fe fumarate (loestrin fe, junel fe, microgestin fe) 1-0.02mg tablet $0.2000/Each
noreth-ethinyl estradiol/iron 0.8-25(24) Tablet, Chewable $2.0835/Each
norethindrone (errin, camila, jolivette, ortho micronor) 0.35 mg tablet $0.1200/Each
norethindrone acetate 5 mg tablet $0.5500/Each
norethindrone acetate/ethinyl estradiol biphasic (ortho-novum 10/11, necon 10/11) 0.5 mg/35 mcg; 1 mg/35 mcg tablet $0.0000
Page 38 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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norethindrone ac-eth estradiol 0.5MG-2.5 tablet $1.5250/Each
norethindrone ac-eth estradiol 1MG-5MCG tablet $1.2215/Each
norethindrone a-e estradiol (junel, microgestin, loestrin) 1.5-0.030 mg tablet $0.4600/Each
norethindrone a-e estradiol (junel, microgestin, loestrin) 1-0.02mg tablet $0.3000/Each
norethindrone a-e estradiol/ferrous fumarate (estrostep fe, tri-legest fe, tilia fe) 5-7-9-7 tablet $0.7500/Each
norethindrone/ethinyl estradiol 1 mg/35 mcg tablet $0.2215/Each
norethindrone/ethinyl estradiol (balziva, ovcon-35, zenchent) 0.4 mg/35 mcg tablet $0.1905/Each Decrease
norethindrone/ethinyl estradiol (brevicon, modicon, necon 0.5/35) 0.5 mg/35 mcg tablet $0.3900/Each
norethindrone/ethinyl estradiol (brevicon, modicon, necon 0.5/35) 0.5 mg/35 mcg tablet $0.0000
norethindrone/ethinyl estradiol (necon 1/35, norinyl 1+35, ortho-novum 1/35) 1 mg/35 mcg tablet $0.3156/Each
norethindrone/ethinyl estradiol (necon 7/7/7, nortrel 7/7/7, ortho-novum 7/7/7) .5-35/0.75-35/1-35 mg-mcg tablet $0.2500/Each
norethindrone/mestranol (necon 1/50, norinyl 1+50, ortho-novum 1/50 1 mg/50 mcg tablet $0.0000
norethindrone-e.estradiol-iron 1 mg-20(24) tablet $0.3000/Each
norethindrone-e.estradiol-iron 1MG-20(24) tablet $0.8550/Each
norethindrone-ethinyl estradiol 7-9-5 tablet $0.3500/Each
norethindrone-ethinyl estradiol 7-9-5 tablet $0.0000
norethindrone-ethinyl estradiol/ferrous fumarate 0.4-35(21) tablet $0.5615/Each
norgestimate-ethinyl estradiol 7 days X 3 LO tablet $0.2348/Each
norgestimate-ethinyl estradiol (ortho-cyclen, sprintec, mononessa) 0.25 mg/35 mcg tablet $0.1465/Each
norgestimate-ethinyl estradiol (ortho-cyclen, sprintec, mononessa) 0.25 mg/35 mcg tablet $0.0000
norgestimate-ethinyl estradiol (tri-sprintec, ortho tri-cyclen, trinessa) 7-7-7 tablet $0.1975/Each
norgestrel/ethinyl estradiol (lo/ovral, low-ogestrel) 0.3 mg/30 mcg tablet $0.3500/Each
norgestrel/ethinyl estradiol (ogestrel) 0.5 mg/50 mcg tablet $0.6865/Each
nortriptyline hcl 10 mg capsule $0.0705/Each
nortriptyline hcl 25 mg capsule $0.0955/Each
nortriptyline hcl 50 mg capsule $0.0905/Each
nortriptyline hcl 75 mg capsule $0.1655/Each
nortriptyline hcl 10 mg/5 ml Solution $0.2155/Milliliter
nystatin 100,000 units/gm Cream $0.1935/Gram
nystatin 100,000 units/gm Ointment $0.2500/Gram
nystatin 100,000 units/gm Powder $0.2500/Gram
nystatin 100,000 units/ml Suspension $0.1020/Milliliter
nystatin 500,000 units tablet $0.3582/Each
nystatin/triamcinolone 100,000 units/gm; 0.1% Cream $0.3655/Gram
nystatin/triamcinolone 100,000 units/gm; 0.1% Ointment $0.3325/Gram
octreotide acetate 50 MCG/ML Solution $2.8735/Milliliter
octreotide acetate 500 mcg/ml Solution $15.0085/Milliliter
octreotide acetate 100 mcg/ml Solution $2.9295/Milliliter
octreotide acetate 50 MCG/ML Solution $14.0668/Milliliter
octreotide acetate 100 MCG/ML Solution $2.8755/Milliliter
octreotide acetate 500 MCG/ML Solution $128.4684/Milliliter
octreotide acetate 200 mcg/ml Solution $6.3965/Milliliter
octreotide acetate 1000 mcg/ml Solution $30.8000/Milliliter
ofloxacin 0.003 Drops $1.8720/Milliliter
ofloxacin 0.3% Drops $1.9355/Milliliter
ofloxacin 200 mg tablet $0.0000
ofloxacin 300 mg tablet $0.0000
ofloxacin 400 mg tablet $3.1615/Each
olanzapine 7.5 mg tablet $0.0765/Each
olanzapine 10 mg tablet $0.1135/Each
olanzapine 5 mg tablet $0.0885/Each
olanzapine 2.5 mg tablet $0.0765/Each
olanzapine 15 mg tablet $0.1595/Each
olanzapine 20 mg tablet $0.2125/Each
olanzapine 10 MG Solution $26.9765/Each
olanzapine 15 mg Tablet,disintegrating $0.8295/Each
olanzapine 20 mg Tablet,disintegrating $0.1855/Each
olanzapine 5 mg Tablet,disintegrating $0.4425/Each
olanzapine 10 mg Tablet,disintegrating $0.5495/Each
olanzapine/fluoxetine hcl 6MG-25MG capsule $5.0775/Each
Page 39 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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olanzapine/fluoxetine hcl 6MG-50MG capsule $5.0775/Each
olanzapine/fluoxetine HCl 12MG-25MG capsule $6.7120/Each
olanzapine/fluoxetine hcl 12MG-50MG capsule $8.9825/Each
olanzapine/fluoxetine hcl 3 mg-25 mg capsule $3.4545/Each
olmesartan medoxomil 5 MG tablet $0.0450/Each
olmesartan medoxomil 20 MG tablet $0.0688/Each
olmesartan medoxomil 40 MG tablet $0.1200/Each
olmesartan/amlodipin/hcthiazid 20-5-12.5 tablet $1.3865/Each
olmesartan/amlodipin/hcthiazid 40-5-12.5 tablet $1.7750/Each
olmesartan/amlodipin/hcthiazid 40-5-25 MG tablet $1.4565/Each
olmesartan/amlodipin/hcthiazid 40-10-12.5 tablet $1.7058/Each
olmesartan/amlodipin/hcthiazid 40-10-25MG tablet $1.9465/Each
olmesartan/hydrochlorothiazide 20-12.5 MG tablet $0.1401/Each
olmesartan/hydrochlorothiazide 40-12.5 MG tablet $0.1951/Each
olmesartan/hydrochlorothiazide 40 MG-25MG tablet $0.1951/Each
olopatadine hcl 0.1 % Drops $2.1745/Milliliter
olopatadine hcl 0.2 % Drops $2.9640/Milliliter
olopatadine hcl 0.6 % Spray, Non-Aerosol $0.1335/Gram
omega-3 acid ethyl esters 1 G capsule $0.2317/Each
omeprazole 20 mg capsule,delayed release (e.c.) $0.0225/Each
omeprazole 20 mg tablet, delayed release (enteric coated) $0.4445/Each
omeprazole 10 mg capsule,delayed release (e.c.) $0.1462/Each
omeprazole 40 mg capsule,delayed release (e.c.) $0.0622/Each
omeprazole magnesium 20 mg tablet, delayed release (enteric coated) $0.6050/Each
omeprazole/sodium bicarbonate 20MG-1.1G capsule $0.5550/Each
omeprazole/sodium bicarbonate 40MG-1.1G capsule $1.2385/Each Decrease
omeprazole/sodium bicarbonate 20-1680MG Powder $34.4555/Each
omeprazole/sodium bicarbonate 40-1680MG Powder $18.5165/Each
ondansetron 4 mg Tablet,disintegrating $0.1675/Each
ondansetron 8 mg Tablet,disintegrating $0.0384/Each
ondansetron hcl 2 mg/ml; MDV Solution $0.0000
ondansetron hcl 4 mg/5 ml Solution $0.1685/Milliliter
ondansetron hcl 4 mg tablet $0.0488/Each
ondansetron hcl 8 mg tablet $0.0545/Each
ondansetron hcl 4 mg/2 ml; SDV Solution $0.1895/Milliliter
ondansetron hcl/d5w/pf 32 mg/50 ml Solution $0.0000
ondansetron HCl/PF 4 MG/2 ML solution $0.7625/Milliliter
opium tincture 10 MG/ML Tincture $2.9900/Milliliter
orphenadrine citrate 30 MG/ML solution $3.1700/Milliliter
orphenadrine citrate 100 mg tablet, extended release $0.3005/Each
orphenadrine with aspirin and caffeine 25 mg; 385 mg; 30 mg tablet $0.0000
orphenadrine with aspirin and caffeine 50 mg; 770 mg; 60 mg tablet $0.0000
oseltamivir phosphate 6 MG/ML Suspension $0.5043/Milliliter
oseltamivir phosphate 75 MG capsule $2.2252/Each
oseltamivir phosphate 30 MG capsule $2.8500/Each
oseltamivir phosphate 45 MG capsule $3.1500/Each
oxacillin sodium 1 G solution $8.9000/Each
oxacillin sodium 10 G solution $53.2500/Each
oxacillin sodium 2 G solution $11.2500/Each
oxaliplatin 50 MG Solution $20.0000/Each
oxaliplatin 100 MG solution $124.0000/Each
oxaliplatin 50 mg/10 ml Solution $2.5095/Milliliter
oxaliplatin 100 mg/20 ml Solution $4.0875/Milliliter
oxandrolone 2.5 mg tablet $2.7960/Each
oxandrolone 10 mg tablet $13.3980/Each
oxaprozin 600 mg Caplet $0.9200/Each
oxazepam 10 mg capsule $0.4735/Each
oxazepam 15 mg capsule $0.4406/Each
oxazepam 30 mg capsule $1.2905/Each
oxcarbazepine 300 mg tablet $0.1405/Each
Page 40 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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oxcarbazepine 600 mg tablet $0.2490/Each
oxcarbazepine 300 mg/5 ml Suspension $0.2490/Milliliter
oxcarbazepine 150 mg tablet $0.1146/Each
oxiconazole nitrate 1 % Cream $3.4625/Gram
oxybutynin 5 mg/5 ml Syrup $0.0198/Milliliter
oxybutynin 5 mg tablet $0.0780/Each
oxybutynin chloride 5 mg tablet, extended release $0.1850/Each
oxybutynin chloride 10 mg tablet, extended release $0.1440/Each
oxybutynin chloride 15 mg tablet, extended release $0.1650/Each
oxycodone / apap 7.5 mg; 325 mg tablet $0.1055/Each
oxycodone / apap 10/325 mg tablet $0.1360/Each
oxycodone / apap 7.5 mg; 500 mg tablet $0.0000
oxycodone / apap 10 mg; 650 mg tablet $0.0000
oxycodone / apap 5 mg; 325 mg tablet $0.0500/Each
oxycodone / apap 5 mg; 500 mg capsule $0.0000
oxycodone hcl 5 MG/5 ML Solution $0.1245/Milliliter
oxycodone hcl 20 mg/ml Concentrate $1.5585/Milliliter
oxycodone hcl 10 mg tablet, extended release $0.0000
oxycodone hcl 20 mg tablet, extended release $0.0000
oxycodone hcl 40 mg tablet, extended release $0.0000
oxycodone hcl 5 mg capsule $0.5842/Each
oxycodone hcl 80 mg tablet, extended release $0.0000
oxycodone hcl 5 mg tablet $0.0585/Each
oxycodone hcl 10 MG tablet $0.0800/Each
oxycodone hcl 15 mg tablet $0.1355/Each
oxycodone hcl 30 mg tablet $0.1955/Each
oxycodone hcl 20 MG tablet $0.2285/Each
oxycodone HCl 10 MG tablet, extended release $0.0000
oxycodone HCl 20 MG tablet, extended release $0.0000
oxycodone HCl 40 MG tablet, extended release $0.0000
oxycodone HCl 80 MG tablet, extended release $0.0000
oxycodone HCl/acetaminophen 2.5-325 MG tablet $1.3815/Each
oxycodone hcl/aspirin 4.8355-325 tablet $0.3341/Each
oxycodone/aspirin 4.88-325 mg tablet $0.0000
oxymetazoline HCl 0.05 % spray, non-aerosol $0.0580/Milliliter
oxymorphone hcl 5 mg tablet $0.5345/Each
oxymorphone hcl 10 mg tablet $1.1425/Each
oxymorphone hcl 5 mg tablet, extended release $1.6095/Each
oxymorphone hcl 10 mg tablet, extended release $3.1287/Each
oxymorphone hcl 20 mg tablet, extended release $5.4839/Each
oxymorphone hcl 40 mg tablet, extended release $8.5855/Each
oxymorphone hcl 30 mg tablet, extended release $7.1268/Each
paclitaxel 6 mg/ml Concentrate $0.9435/Milliliter
paliperidone 1.5 mg tablet, extended release $4.8300/Each
paliperidone 3 mg tablet, extended release $6.2105/Each
paliperidone 6 mg tablet, extended release $5.8442/Each Decrease
paliperidone 9 mg tablet, extended release $8.0200/Each
palonosetron HCl 0.25MG/5ML Solution $7.3850/Milliliter
palonosetron HCl 0.25MG/5ML solution $8.7950/Milliliter
pamidronate disodium 30 mg Solution $0.0000
pamidronate disodium 90 mg Solution $0.0000
pamidronate disodium 3 mg/ml Solution $1.2625/Milliliter
pamidronate disodium 9 mg/ml Solution $8.2031/Milliliter
pantoprazole sodium 40 MG solution $2.9999/Each
pantoprazole sodium 40 mg tablet, delayed release (enteric coated) $0.0575/Each
pantoprazole sodium 20 mg tablet, delayed release (enteric coated) $0.0550/Each
paricalcitol 2 MCG/ML solution $3.9667/Milliliter
paricalcitol 1 MCG capsule $1.0255/Each
paricalcitol 2 MCG capsule $2.7720/Each
paricalcitol 4MCG capsule $11.0145/Each
Page 41 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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paricalcitol 5 MCG/ML solution $9.8750/Milliliter
paromomycin sulfate 250 MG capsule $3.7450/Each
paroxetine hcl 10 mg tablet $0.0450/Each
paroxetine hcl 20 mg tablet $0.0699/Each
paroxetine hcl 30 mg tablet $0.1200/Each
paroxetine hcl 40 mg tablet $0.1110/Each
paroxetine hcl 10 mg/5 ml Suspension $0.0000
paroxetine hcl 25 mg tablet, extended release $1.0500/Each
paroxetine hcl 12.5 mg tablet, extended release $0.9765/Each
paroxetine hcl 37.5 mg tablet, extended release $0.7335/Each
paroxetine mesylate 7.5 MG capsule $2.5675/Each
ped mvit a,c,d3 no.21/fluoride 0.25 MG/ML Drops $0.1334/Milliliter
pedi multivit 45/fluoride/iron 0.25-10/ML drops $0.1500/Milliliter
pedi multivit no.17 w-fluoride 0.5 MG Tablet, Chewable $0.0700/Each
peg 3350/sod sulf anhyd/sodium bicarbonate/sod chloride/kcl 236 - 22.74 g Solution $0.0046/Milliliter
peg3350/sod sul/NaCl/KCl/asb/C 7.5-2.691G powder $73.9500/Each
pemoline 18.75 mg tablet $0.0000
pemoline 37.5 mg tablet $0.0000
pemoline 75 mg tablet $0.0000
penicillin G potassium 5MM UNIT solution $9.0000/Each
penicillin G potassium 20MM UNIT Solution $51.6500/Each
penicillin v potassium 125 mg/5 ml, 100 ml Solution $0.0613/Milliliter
penicillin v potassium 250 mg/5 ml Solution $0.0507/Milliliter
penicillin v potassium 250 mg tablet $0.0600/Each
penicillin v potassium 500 mg tablet $0.1045/Each
pentazocine/naloxone hcl 50 mg/0.5 mg tablet $1.7750/Each
pentoxifylline 400 mg tablet, extended release $0.1675/Each
p-ephed hcl/brompheniramin 45 mg; 4 mg/5 ml Syrup $0.0000
perindopril erbumine 2 mg tablet $0.4155/Each
perindopril erbumine 4 mg tablet $0.3210/Each
perindopril erbumine 8 mg tablet $0.4995/Each
permethrin 5% Cream $0.2915/Gram
perphenazine 16 mg tablet $0.5800/Each
perphenazine 2 mg tablet $0.2235/Each
perphenazine 4 mg tablet $0.4568/Each
perphenazine 8 mg tablet $0.0225/Each
phenazopyridine hcl 100 mg tablet $0.5925/Each
phenazopyridine hcl 200 mg Caplet $0.6844/Each
phenazopyridine HCl 95 MG tablet $0.1065/Each
phenazopyridine HCl 97.5 MG tablet $0.1775/Each
phenelzine sulfate 15 MG tablet $0.5329/Each
phenobarb/hyoscy/atropine/scop 16.2MG/5ML elixir $1.7551/Milliliter
phenobarbital 20 mg/5 ml Elixir $0.1000/Milliliter
phenobarbital 15 mg tablet $0.0302/Each
phenobarbital 60 mg tablet $0.0000
phenobarbital 30 mg tablet $0.0000
phenobarbital 100 mg tablet $0.4105/Each
phenobarbital 16.2 mg tablet $0.2555/Each
phenobarbital 32.4 MG tablet $0.4733/Each
phenobarbital 64.8 MG tablet $0.4055/Each
phenobarbital 97.2MG tablet $0.4250/Each
phenobarbital sodium 130MG/ML solution $65.0982/Milliliter
phenobarbital sodium 65 MG/ML solution $25.0800/Milliliter
phenol 1.4 % Aerosol, Spray $0.0103/Milliliter
phenoxybenzamine HCl 10 MG capsule $49.9055/Each
phentermine hcl 30 mg capsule $0.0000
phentermine hcl 37.5 mg Caplet $0.0000
phentolamine mesylate 5 MG solution $375.5000/Each
phenyleph/mineral oil/petrolat 0.25 %-14% ointment $0.0430/Gram
phenyleph/pramoxin/glycr/w.pet 0.25%-1% Cream $0.0475/Gram
Page 42 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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phenylephrine HCl 10 MG tablet $0.0440/Each
phenylephrine HCl 1 % spray, non-aerosol $0.0588/Milliliter
phenylephrine HCl 1 % drops $0.0650/Milliliter
phenylephrine HCl 0.25 % Suppository $0.1086/Each
phenylephrine HCl/acetaminophn 5 MG-325MG tablet $0.0549/Each
phenylephrine hcl/chlor-mal 12.5-4 mg/5 Syrup $0.0000
phenylephrine HCl/cocoa butter 0.25-88.44 Suppository $0.2000/Each
phenylephrine hcl/cod/prometh 5-10-6.25 Syrup $0.0000
phenylephrine/acetaminophn/cpm 5-325-2MG tablet $0.0725/Each
phenylephrine/chlorpheniramine 5-4.5 mg/5 ml Suspension $0.0000
phenylephrine/DM/acetaminop/GG 5-325-200 tablet $0.1700/Each
phenylephrine/hydrocodone/chlorpheniramine 5-2.5-2 mg/5 ml Liquid $0.0000
phenylephrine/pyril tan/cp 5 mg; 12.5 mg; 2 mg/5 ml Suspension $0.0000
phenytoin 50 MG Tablet, Chewable $0.2550/Each
phenytoin 100 MG/4ML suspension $1.6188/Milliliter
phenytoin sodium 125 mg/5 ml Suspension $0.0795/Milliliter
phenytoin sodium 100 mg capsule $0.1662/Each
phenytoin sodium extended 300 MG capsule $1.0140/Each
phenytoin sodium extended 200 MG capsule $1.0515/Each
phosphorated carbo(dext-fruct) liquid $0.0165/Milliliter
phytonadione (vit K1) 5 MG tablet $40.8375/Each
phytonadione (vit K1) 10 MG/ML solution $44.9500/Milliliter
pilocarpine hcl 7.5 mg tablet $0.6825/Each
pilocarpine hcl 5 mg tablet $0.3829/Each
pilocarpine hcl 0.5% Drops $0.0000
pilocarpine hcl 1% Drops $4.1696/Milliliter
pilocarpine hcl 2% Drops $0.0000
pilocarpine hcl 4% Drops $4.6425/Milliliter
pilocarpine hcl 6% Drops $0.0000
pimecrolimus 1 % Cream $0.0000
pindolol 10 mg tablet $0.7526/Each
pindolol 5 mg tablet $0.6285/Each
pioglitazone hcl 15 MG tablet $0.0600/Each
pioglitazone hcl 30 MG tablet $0.0600/Each
pioglitazone hcl 45 MG tablet $0.0840/Each
pioglitazone hcl/glimepiride 30 mg-4 mg tablet $8.7850/Each
pioglitazone hcl/glimepiride 30 mg-2 mg tablet $8.7850/Each
pioglitazone hcl/metformin hcl 15MG-500MG tablet $0.4500/Each
pioglitazone hcl/metformin hcl 15MG-850MG tablet $0.4500/Each
piperacillin sodium/tazobactam sodium 2.25 gm Solution $5.7750/Each
piperacillin sodium/tazobactam sodium 3.375 gm Solution $4.3000/Each
piperacillin sodium/tazobactam sodium 4.5 gm Solution $7.4900/Each Decrease
piperacillin sodium/tazobactam sodium 40.5 gm Solution $128.9178/Each
piperonyl butoxide/pyrethrins 4%-0.33% Shampoo $0.0350/Milliliter
piroxicam 10 mg capsule $0.2555/Each
piroxicam 20 mg capsule $0.3945/Each
pnv #116/iron fumarate/fa/dha 28-800-200 capsule $0.2000/Each
pnv #78/iron asp gly/fa#1/dha 18-1-300MG capsule $0.2000/Each
pnv #86/iron poly/fa/dha/epa 32-1-120MG capsule $0.2000/Each
PNV 102/iron/folate/dha 90-1-200MG capsule $0.2000/Each
pnv 112/iron/fa/om-3s/dha/epa 3.33-.33MG gummie $0.2000/Each
PNV 119/iron fum/folic acid 29 MG-1 MG tablet $0.2000/Each
PNV 12/iron/methylfolate/dha 29-1-350MG capsule,delayed release (e.c.) $0.2000/Each
pnv 156/iron/lmfol/om3/dha/epa 27MG-0.8MG capsule $0.2000/Each
pnv cmb#82/iron ps cmplx/folic acid/omega 3/dha/epa/fish oil 13.5-0.5mg tablet, delayed release (enteric coated) $0.2000/Each
pnv cmb#95/ferrous fumarate/fa 28mg-0.8mg Caplet $0.2000/Each
pnv comb.12/iron,carbonyl/fa cmb #1/docusate sodium/dha 90-0.4-250 Combination Package $0.2000/Each
pnv comb.no26/iron asp gly/fa/docusate sodium/fat combo no.7 30-1-50mg capsule $0.2000/Each
pnv comb.no5/fe asp gly/docusate/folic acid/fat combo no.4 30-50-1mg capsule $0.2000/Each
pnv comb.no58/iron bisgly/fa 10MG-0.4MG capsule $0.2000/Each
Page 43 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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pnv no.100/iron/fa/dha/epa 27 MG-1 MG capsule $0.2000/Each
pnv no.106/iron/folate #6/dha 27.5MG-1MG capsule $0.2000/Each
pnv no.111/iron/folate/dha 38-1-225MG capsule $0.2000/Each
pnv no.115/iron fumarate/fa 29 MG-1 MG Tablet, Chewable $0.2000/Each
pnv no.118/iron fumarate/fa 29 MG-1 MG Tablet, Chewable $0.2000/Each
pnv no.121/iron/folic acid 28MG-0.8MG tablet $0.2000/Each
pnv no.122/iron/folic acid 27MG-0.8MG tablet $0.2000/Each
PNV no.139/iron,carb/folic/dha 33MG-0.8MG capsule $0.2000/Each
PNV no.143/iron/methylfolate 29 MG-1 MG tablet $0.2000/Each
PNV no.153/FA/om3/dha/epa/fish 400-35-25 gummie $0.2000/Each
PNV no.162/iron glu/folic acid 12 MG-1 MG tablet $0.2000/Each
PNV no.163/iron/folate no.10 20 MG-1 MG tablet $0.2000/Each
PNV no.165/iron fum/folic acid 13 MG-1 MG tablet,chewable $0.2000/Each
pnv no.20/iron fumarate/fa/docusate na/fish oil conc/dha/epa 27-1-500mg capsule $0.2000/Each
pnv no.35/iron fumarate/folate comb. #6/dha 29-1-300mg capsule $0.0000
pnv no.63/iron,carbonyl/fa/dha 27-800-200 capsule $0.2000/Each
pnv no.66/iron,carbonyl/fa/dha 20-1-320MG capsule $0.2000/Each
pnv no.74/iron fum/fa/coq10 18-1-125MG capsule $0.2000/Each
pnv no.74/iron fum/fa/dha 27-1-300MG capsule $0.2000/Each
pnv no.80/iron/mfolate/dss/dha 38-1-25 MG capsule $0.2000/Each
pnv no.81/iron cbn&gluc/fa/dss 27-1-50 MG tablet $0.2000/Each
pnv no.86/iron/mfolate/dss/dha 38-1-50 MG capsule,delayed release (e.c.) $0.2000/Each
pnv no.88/iron ps,heme/fa/dha 28-6-1 MG capsule $0.2000/Each
pnv no.90/iron fum & ps/fa/dha 32-1.25 MG capsule $0.2000/Each
pnv no17/iron,carb/iron bisgly/fa/fish oil/dha/omega 3,6 #1 35-5-1.2mg capsule $0.2000/Each
pnv no18/iron,carbonyl/folic acid/docusate na/ubidecar/dha 15-0.5-25 tablet $0.0000
pnv with ca #37/iron carb, asp, & gly/fa/omega-3 fatty acids 27-1-330mg capsule $0.2000/Each
pnv with ca no.37/iron carb & asp gly/fa/omega-3 fatty acids 27-1-330mg capsule $0.0000
pnv with ca,no.72/iron,carb/fa 29 MG-1 MG tablet $0.2000/Each
pnv#102/iron/fa/dha/lutein 27-800-200 capsule $0.2000/Each
pnv#102/iron/folate #1/dss/dha 90-1-200mg capsule $0.2000/Each
pnv#31/iron,el.&glu/fa/dss/dha 35-1-50 MG capsule $0.2000/Each
pnv#64/iron/lmfolate/algal/soy 27-1.13 MG capsule $0.2000/Each
pnv#64/iron/lmfolate/algal/soy 27-1.13 MG capsule $0.2000/Each
pnv#67/iron ps/fa cmb#1/dha 29-1-200MG capsule $0.2000/Each
pnv#71/iron/folic acid/dha 30-1.4-200 capsule,delayed release (e.c.) $0.2000/Each
pnv#75/iron fum/fa/om3/dha/epa 28-800-223 capsule $0.2000/Each
pnv#85/iron carb./iron asp.glycinate/folic acid/dha/fish oil 40-10-1 mg capsule $0.2000/Each
pnv,ca,no.35/iron,carbonyl & asp gly/fa/dss/omega-3 27-1-50mg capsule $0.2000/Each
pnv/fa/b6/calcium carb/ginger 1.2-42 MG tablet $0.2000/Each
pnv/fa/b6/calcium phos/ginger 1.2-40-100 tablet $0.2000/Each
pnv/fa/b6/calcium phos/ginger 1.2-42 MG tablet $0.0000
pnv/fe bisgly/omega-3/fa 29-250-1MG Combination Package $0.2000/Each
pnv/fe sulf/fa/min aa chel 14-0.25MG tablet $0.2000/Each
pnv/ferrous fumarate/doss/fa 65 MG-1 MG tablet $0.2000/Each
pnv/ferrous sulfate/folic acid 27MG-0.8MG tablet $0.2000/Each
pnv/ferrous sulfate/folic acid 40-1MG/15 Liquid $0.2000/Milliliter
pnv/ferrous sulfate/folic acid 27-<0.5MG tablet $0.2000/Each
pnv/iron,carbonyl/docusate/fa 95-50-1MG capsule $0.2000/Each
pnv/iron,carbonyl/docusate/fa 100-1MG Caplet $0.2000/Each
pnv/iron,carbonyl/folic acid 65 MG-1 MG tablet $0.2000/Each
pnv/iron/dha/epa/omega-3/fa 60 MG-1 MG Combination Package $0.2000/Each
pnv/iron/docusate/fa/lmefolate 90-50-1MG tablet $0.2000/Each
pnv/iron/folic acid 40-1MG Tablet, Chewable $0.2000/Each
pnv100/iron edta&ps/fa/omega3 27-1-374MG capsule,delayed release (e.c.) $0.2000/Each
pnv103/fa/omega3/dha/fish oil 0.4-32.5mg gummie $0.2000/Each
pnv103/fe/fa/dha/epa/other om3 27 MG-1 MG Capsule, Soft Chewable $0.2000/Each
pnv105/iron/fa/omega 3/dha/epa 27-1-380MG capsule,delayed release (e.c.) $0.2000/Each
pnv106/iron/fa/om3/dha/epa 25-1-400MG capsule $0.2000/Each
pnv106/iron/fa/om3/dha/epa 25-1-430MG capsule $0.2000/Each
Page 44 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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pnv107/iron/fa/om3/dha/epa 25-1-400MG capsule,delayed release (e.c.) $0.2000/Each
pnv107/iron/fa/om3/dha/epa 25-1-430MG capsule,delayed release (e.c.) $0.2000/Each
pnv110/iron/fa/omega 3/dha/epa 26-1-278 mg capsule $0.2000/Each
pnv113/fe/l-mef/om3/dha/epa/fs 4.5-1-150 Liquid $0.2000/Each
pnv113/iron/fa/omega-3/dha/epa 24-1-272MG capsule $0.2000/Each
pnv115/iron fumarate/fa/dss 29-1-25 MG tablet $0.2000/Each
pnv117/iron/fa/om3/dha/epa 25 MG-1 MG capsule $0.2000/Each
pnv119/iron fumarate/fa/dss 29-1-25 MG tablet $0.2000/Each
pnv120/levomefolate/omega3/dha 267MCG-321 capsule $0.2000/Each
pnv133/ferrous fumarate/fa 28MG-0.8MG tablet $0.2000/Each
pnv135/iron/l-mefol/omega3/dha 18-800-290 capsule $0.2000/Each
pnv14/fe fum/fa#1/dha/doss ca 27-1-50 MG capsule $0.2000/Each
PNV151/iron/FA/o3/dha/epa/fish 27-800-260 capsule $0.2000/Each
PNV157/iron/FA/o3/dha/epa/fish 4-0.5-150 capsule $0.2000/Each
PNV158/iron/FA/o3/dha/epa/fish 13.5-0.5MG capsule $0.2000/Each
pnv166/iron/FA/o3/dha/epa/fish 27MG-0.8MG capsule $0.2000/Each
pnv174/iron/FA/o3/dha/epa/fish 28-1-35 MG capsule $0.2000/Each
pnv2/iron b-g suc-p/fa/omega-3 29-1-300MG capsule,delayed release (e.c.) $0.2000/Each
pnv2/iron b-g suc-p/fa/omega-3 29-1-300MG Combination Package $0.2000/Each
pnv34/iron,carb&fum/fa/dss/dha 27-1-50 MG capsule $0.2000/Each
pnv34/iron,carbonyl/fa/dss/dha 29-1-50 MG capsule $0.2000/Each
pnv50/iron fum&bisglycinate/fa 25 MG-1 MG tablet $0.2000/Each
pnv53/iron fum/fa/docusate/dha 29-1.25-55 capsule $0.2000/Each
pnv59/iron,carb&fum/fa/dss/dha 27-1-50MG capsule $0.2000/Each
pnv59/iron,carbonyl/fa/dss/dha 29-1-50 MG capsule $0.2000/Each
pnv62/fa/om3/dha/epa/fish oil 400-35-25 gummie $0.2000/Each
pnv72/iron,carb&glu/fa/dss/dha 90-1-300MG capsule $0.2000/Each
pnv73/iron,carb&glu/fa/dss/dha 35-1-50 MG capsule $0.2000/Each
pnv76/iron,carb&glu/fa/dss/dha 27-1-50 MG capsule $0.2000/Each
podofilox 0.5 % Solution $12.7500/Milliliter
polyethylene glycol 17 gm Powder $1.1961/Each
polyethylene glycol NA Powder $0.0195/Gram
polyvinyl alcohol/povidone 0.5%-0.6% drops $0.0940/Milliliter
posaconazole 100 MG tablet, delayed release (enteric coated) $37.3685/Each
potassium bicarb/citrate 25 mEq tablet, effervescent $0.2160/Each
potassium chloride 8 MEQ capsule, extended release $0.1680/Each
potassium chloride 10 mEq capsule, extended release $0.1555/Each
potassium chloride 20 mEq Packet $1.0605/Each
potassium chloride 40 mEq/15 ml Liquid $0.5350/Milliliter
potassium chloride 20 mEq/15 ml Liquid $0.2425/Milliliter
potassium chloride 10 mEq tablet, extended release $0.1410/Each
potassium chloride 10 mEq tablet, extended release $0.1275/Each
potassium chloride 20 mEq tablet, extended release $0.2075/Each
potassium chloride 8 mEq tablet, extended release $0.2220/Each
potassium chloride 20 MEQ tablet, extended release $0.2280/Each
potassium chloride 15 MEQ tablet, extended release $0.8218/Each
potassium chloride/bicarb 25 mEq tablet, effervescent $0.0000
potassium citrate 5 MEQ tablet, extended release $0.5962/Each
potassium citrate 10 MEQ tablet, extended release $0.5265/Each
potassium citrate 15 MEQ tablet, extended release $0.8790/Each
potassium citrate/citric acid 1100-334/5 Solution $0.0789/Milliliter
potassium iodide 1 G/ML Solution $0.0000
povidone iodine 0.1 Ointment $0.0000
povidone iodine 0.1 Solution $0.0177/Milliliter
pramipexole di-hcl 0.75 mg tablet, extended release $6.0521/Each
pramipexole di-hcl 0.375 mg tablet, extended release $8.6500/Each
pramipexole di-hcl 1.5 mg tablet, extended release $7.4584/Each Decrease
pramipexole di-hcl 3 mg tablet, extended release $7.8215/Each
pramipexole di-HCl 4.5 MG tablet, extended release $9.2000/Each
pramipexole di-HCl 2.25 MG tablet, extended release $10.8950/Each
Page 45 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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pramipexole di-hcl 0.75 mg tablet $0.1217/Each
pramipexole dihydrochloride 1 mg tablet $0.0450/Each
pramipexole dihydrochloride 1.5 mg tablet $0.0585/Each
pramipexole dihydrochloride 0.125 mg tablet $0.0300/Each
pramipexole dihydrochloride 0.25 mg tablet $0.0300/Each
pramipexole dihydrochloride 0.5 mg tablet $0.0515/Each
pramoxine HCl/calamine 1 %-8 % lotion $0.0140/Milliliter
pramoxine HCl/camph/zinc acet lotion $0.0160/Milliliter
prasugrel hcl 5 MG tablet $0.3570/Each
prasugrel hcl 10 MG tablet $0.3145/Each
pravastatin sodium 80 mg tablet $0.1505/Each
pravastatin sodium 10 mg tablet $0.0725/Each
pravastatin sodium 20 mg tablet $0.0725/Each
pravastatin sodium 40 mg tablet $0.0725/Each
prazosin hcl 1 mg capsule $0.1800/Each
prazosin hcl 2 mg capsule $0.2250/Each
prazosin hcl 5 mg capsule $0.3825/Each
prednisolone 15 mg/5 ml Solution $0.0340/Milliliter
prednisolone acetate 1% Drops, Suspension $5.3046/Milliliter
prednisolone sod phosphate 5 MG/5 ML Solution $0.5465/Milliliter
prednisolone sod phosphate 10 MG Tablet,disintegrating $8.4800/Each
prednisolone sod phosphate 15 MG Tablet,disintegrating $14.1400/Each
prednisolone sod phosphate 30 MG Tablet,disintegrating $18.1800/Each
prednisolone sod phosphate 1 % Drops $4.7525/Milliliter
prednisolone sod phosphate 10 MG/5 ML Solution $2.5750/Milliliter
prednisolone sodium phosphate 20 MG/5 ML solution $3.6015/Milliliter
prednisolone sodium phosphate 15 mg/5 ml Solution $0.0625/Milliliter
prednisolone sodium phosphate 25 MG/5 ML solution $1.2373/Milliliter
prednisone 1 mg tablet $0.0450/Each
prednisone 10 mg tablet $0.0985/Each
prednisone 2.5 mg tablet $0.1368/Each
prednisone 20 mg tablet $0.1135/Each
prednisone 5 mg tablet $0.0775/Each
prednisone 50 MG tablet $0.2840/Each
prednisone 5 MG tablet $0.5669/Each
prednisone 10 mg tablet $0.6880/Each
pregabalin 25 MG capsule $0.1347/Each
pregabalin 50 MG capsule $0.0455/Each
pregabalin 75 MG capsule $0.0555/Each
pregabalin 100 MG capsule $0.0657/Each
pregabalin 150 MG capsule $0.0695/Each
pregabalin 200 MG capsule $0.1450/Each
pregabalin 300 MG capsule $0.1665/Each
pregabalin 225 MG capsule $0.1459/Each
pregabalin 20 MG/ML solution $0.1665/Milliliter
pregabalin 82.5 MG tablet, extended release $9.0980/Each
pregabalin 165 MG tablet, extended release $9.0980/Each
pregabalin 330 MG tablet, extended release $9.0980/Each
prenatal #103/iron fumarate/fa 27 MG-1 MG tablet $0.2000/Each
prenatal #108/iron,carbonyl/fa 30 MG-1 MG tablet $0.2000/Each
prenatal #48/iron cb&glu/fa/b6 20-1-25 MG tablet $0.2000/Each
prenatal #57/iron/fa/dss/dha 29-1.25-55 capsule $0.2000/Each
prenatal #58/iron/fa/dss/dha 29-1.25-55 capsule $0.2000/Each
prenatal #79/iron asp gly/fa#1 20 MG-1 MG tablet $0.2000/Each
prenatal #92/iron/fa #8/ps-dha 1.5-8.73MG capsule,delayed release (e.c.) $0.2000/Each
prenatal 147/iron/folic acid 13 MG-1 MG tablet $0.2000/Each
prenatal 148/iron/folate 6/dha 27-1-205 capsule $0.2000/Each
prenatal 168/iron/folic/omega3 27-800-235 capsule $0.2000/Each
prenatal cmb#95/iron/fa/dha 28-800-200 capsule $0.2000/Each
prenatal comb no.42/folic acid 1.4 MG Tablet, Chewable $0.2000/Each
Page 46 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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prenatal no.123/iron/folic ac 50-1.25 MG Caplet $0.2000/Each
prenatal no.13/iron ps/fa cb#1 29 MG-1 MG Caplet $0.2000/Each
prenatal no.137/iron/folic acd 27MG-0.8MG tablet $0.2000/Each
prenatal no.144/folic acid 400 MCG gummie $0.2000/Each
prenatal no.25/iron/fa #6/dha 30-1-200MG capsule $0.2000/Each
prenatal no.29/iron carb & asp.glycinate/fa/dha/fish oil 40-10-1 mg capsule $0.2000/Each
prenatal no.30/iron carbonly & asparto glycinate/fa/omega3 30-10-1 mg capsule $0.2000/Each
prenatal no.40/iron/fa/dha 27-0.8-250 capsule $0.2000/Each
prenatal no.52/iron/fa/dha 28-1-200MG capsule $0.2000/Each
prenatal no.56/iron carbonyl & asparto glycinate/fa/dha 35-5-1 mg capsule $0.2000/Each
prenatal no.75/iron/folate #1 18 MG-1 MG tablet $0.2000/Each
prenatal no.77/iron asp gly/fa 20 MG-1 MG tablet $0.2000/Each
prenatal no.82/iron/folate #2 27 MG-1 MG tablet $0.2000/Each
prenatal no.93/iron/fa #9/dha 31-1-200 mg capsule $0.2000/Each
prenatal vit #105/iron/fa/dha 30-1.4-300 capsule $0.2000/Each
prenatal vit #113/iron/folate 4.5 MG-1MG Tablet, Chewable $0.2000/Each
prenatal vit #116/iron/fa/dha 28-800-200 capsule $0.2000/Each
prenatal vit #16/iron fum & ps complex/folic acid/omega-3 35-1-200mg capsule $0.2000/Each
prenatal vit #49/iron fum/fa 6.75-0.2MG tablet $0.2000/Each
prenatal vit #60/iron fum/fa 27 MG-1 MG tablet $0.2000/Each
prenatal vit #68/iron/fa#6/dha 28-1-400MG capsule $0.2000/Each
prenatal vit #69/iron/fa#6/dha 27-1-400MG capsule $0.2000/Each
prenatal vit #83/iron/fa#6/dha 29-1-150MG capsule $0.2000/Each
prenatal vit #91/fe fum/fa/dha 28-975-200 capsule $0.2000/Each
prenatal vit comb no.4/iron carbonyl-iron gluconate/fa/doss 27-1-50mg tablet $0.2000/Each
prenatal vit no.109/iron/fa 40-1MG Tablet, Chewable $0.2000/Each
prenatal vit no.112/folic acid 1 MG Tablet, Chewable $0.2000/Each
prenatal vit no.114/fa/ginger 1MG-500MG tablet $0.2000/Each
prenatal vit no.124/iron/fa 27MG-0.8MG tablet $0.2000/Each
prenatal vit no.126/iron/fa 28MG-0.8MG tablet $0.2000/Each
prenatal vit no.128/iron/fa 28MG-0.8MG tablet $0.2000/Each
prenatal vit no.129/iron/fa 27MG-0.8MG tablet $0.2000/Each
prenatal vit no.130/iron/fa 27MG-0.8MG tablet $0.2000/Each
prenatal vit no.131/iron/fa 28MG-0.8MG tablet $0.2000/Each
prenatal vit no.138/folic/dha 0.4MG-25MG tablet,chewable $0.2000/Each
prenatal vit no.170/iron/folic 27 MG-1 MG tablet $0.2000/Each
prenatal vit no.44/iron/fa/dha 29-1-350MG capsule $0.0000
prenatal vit no.87/iron/fa/dha 18-1-350MG capsule $0.2000/Each
prenatal vit w/o calc no.10/iron fum&polysac comp/fa/omega-3 30-1-310.1 capsule $0.2000/Each
prenatal vit w-ca,fe,fa(<1 mg) Combination Package $0.2000/Each
prenatal vit w-ca,fe,fa(<1 mg) capsule $0.2000/Each
prenatal vit with ca #75/iron fum/folic acid/omega-3/dha/epa 28-800-440 capsule $0.2000/Each
prenatal vit with ca no.64/iron carb&gluc/folic acid/dss/dha 90-1-300mg capsule $0.2000/Each
prenatal vit with ca no.68/iron fumarate/folic acid #1/dha 28-1-300mg capsule $0.2000/Each
prenatal vit with calcium #32/iron/fa/fish oil 27-1-880mg capsule $0.2000/Each
prenatal vit with calcium #34/iron/folic acid 28 mg-1 mg tablet, extended release $0.2000/Each
prenatal vit with calcium #34/iron/folic acid/dha 28-1-250mg capsule $0.2000/Each
prenatal vit with calcium #60/iron/folic acid/dha 27-1-250mg capsule $0.2000/Each
prenatal vit with calcium #69/iron,carbon/folic acid/dss/dha 27-1-50mg capsule $0.2000/Each
prenatal vit with calcium #69/iron,carbon/folic acid/dss/dha 28-1-50 mg capsule $0.2000/Each
prenatal vit with calcium cmb 11/ferrous fumarate/folic acid 65 mg-1 mg Caplet $0.2000/Each
prenatal vit with calcium comb no.63/iron,carbonyl/fa/b6 20-1-25 mg tablet $0.2000/Each
prenatal vit with calcium comb no.65/iron polysacch cmplx/fa 60 mg-1 mg capsule $0.2000/Each
prenatal vit with calcium no. 40/iron fumarate/fa cmb no.1 27 mg-1 mg tablet $0.2000/Each
prenatal vit with calcium no.39/iron fum/folic acid/dss/dha 30-1.2-55 capsule $0.2000/Each
prenatal vit with calcium no.39/iron fum/folic acid/dss/dha 30-1.24-55 capsule $0.0000
prenatal vit with calcium no.61/iron fumarate/folic acid/dha 28-975-200 capsule $0.2000/Each
prenatal vit with calcium no.66/iron fum/folic acid/dss/dha 26-1.2-55 capsule $0.2000/Each
prenatal vit with calcium no.66/iron fum/folic acid/dss/dha 27-1.25-55 capsule $0.2000/Each
prenatal vit with calcium no.80/iron fum/folic acid/dss/dha 27-1.25-55 capsule $0.2000/Each
Page 47 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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prenatal vit with calcium no.80/iron fum/folic acid/dss/dha 29-1.25-55 capsule $0.2000/Each
prenatal vit with calcium no42/iron fum/fa/l-mefolate ca/dha 27-1.13 mg capsule $0.2000/Each
prenatal vit with calcium no42/iron fum/fa/l-mefolate ca/dha 27-400-1 capsule $0.2000/Each
prenatal vit with calcium no42/iron fum/fa/l-mefolate ca/dha 27mg-400 capsule $0.2000/Each
prenatal vit with calcium no8-iron ps cmplx,fa& levomefolate 29-400-1 Caplet $0.2000/Each
prenatal vit with calcium no8-iron ps cmplx,fa,l-mefolate ca 29-1.13 mg tablet $0.2000/Each
prenatal vit#101/iron/fa/dha 27-800-200 capsule $0.2000/Each
prenatal vit#118/iron/fa#6/dha 30-1-300MG capsule $0.2000/Each
prenatal vit#42/fa cmb#6 1 mg Tablet, Chewable $0.2000/Each
prenatal vit#65/iron fum&ps/fa 40-1.25 MG capsule $0.2000/Each
prenatal vit#84/iron/fa#1/dha 18-1-300MG capsule $0.2000/Each
prenatal vit#85/iron/fa#1/dha 10-1-200MG capsule $0.2000/Each
prenatal vit#96/ferrous fum/fa 27MG-0.8MG tablet $0.2000/Each
prenatal vit#98/ferrous fum/fa 9MG-267MCG tablet $0.2000/Each
prenatal vit/fe fumarate/fa 28-1 mg tablet $0.2000/Each
prenatal vit/fe fumarate/fa 27 mg; 1 mg tablet $0.2000/Each
prenatal vit/iron fumarate/fa 60MG-0.8MG tablet $0.2000/Each
prenatal vit/iron fumarate/fa 45-1MG tablet $0.2000/Each
prenatal vit/iron fumarate/fa 45MG-0.8MG tablet $0.2000/Each
prenatal vit/iron fumarate/fa 29MG-0.8MG tablet $0.2000/Each
prenatal vit/iron fumarate/fa 29 MG-1 MG tablet $0.2000/Each
prenatal vit/iron fumarate/fa 108.9-0.4 tablet $0.2000/Each
prenatal vit/iron,carb/doss/fa 90 mg; 50 mg; 1 mg Caplet $0.2000/Each
prenatal vit/iron,carbonyl/fa 60 MG-1 MG tablet $0.2000/Each
prenatal vit28&calcium/iron/fa 60 MG-1 MG tablet $0.2000/Each
prenatal vitamin #55/iron fumarate & bisglycinate/folic acid 28 mg-1 mg Tablet, Chewable $0.2000/Each
prenatal vitamin 27 with calcium/ferrous fumarate/folic acid 60 mg-1 mg tablet $0.2000/Each
prenatal vitamin comb no.42/iron fumarat/fa/levomefolate/dha 27-400-1 capsule $0.2000/Each
prenatal vitamin comb no.79/iron fumarat/fa/lmefolate ca/dha 27-1.13 mg capsule $0.0000
prenatal vitamin combination no.19/iron/folic acid/dha 22-6-1-200 capsule $0.2000/Each
prenatal vitamin combination no.8/iron/folic acid/dha 22-6-1-200 capsule $0.2000/Each
prenatal vitamin combo no.22/iron/folic acid/omega-3/dha 28-6-1-203 capsule $0.2000/Each
prenatal vitamin combo no.8/iron ps cmplx & aspgl/fa/dha 22-6-1-200 capsule $0.2000/Each
prenatal vitamin no.15/iron,carbonyl/folic acid/docusate sod 90-1-50 mg tablet $0.2000/Each
prenatal vitamin no.16/iron,carbonyl/folic acid/docusate sod 90-1-50 mg tablet $0.2000/Each
prenatal vitamin no.17/iron,carbonyl/folic acid/docusate sod 90-1-50 mg tablet $0.2000/Each
prenatal vitamin no.18/iron,carbonyl/folic acid/docusate sod 90-1-50 mg tablet $0.2000/Each
prenatal vitamin no.67/sodium feredetate-iron poly/fa/omega3 27-1-300mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamin no.77/sodium feredetate-iron poly/fa/omega3 27-1-430mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamin no.81/sodium feredetate-iron poly/fa/omega3 27-1-430mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamin no.86/iron bis-glycinate/folic acid 32 mg-1 mg tablet $0.2000/Each
prenatal vitamin no.88/iron ps complex/fa/l-mefolate ca/dha 29-0.5-1.4 Caplet $0.2000/Each
prenatal vitamin no.94/sodium feredetate-iron poly/fa/omega3 26-1-374mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamin w-o calcium/fe bisgly/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamin w-o calcium/ferrous gluconate/folic acid 30-0.8mg tablet $0.2000/Each
prenatal vitamin w-o calcium/iron polysaccharides complex/fa 29 mg-1 mg Caplet $0.2000/Each
prenatal vitamin w-o calcium/iron,carbonyl/docusate/fa 29-50-1mg Caplet $0.2000/Each
prenatal vitamin w-o calcium/iron,carbonyl/docusate/fa 29-50-1mg Caplet $0.2000/Each
prenatal vitamin w-o vit a/fe carbonyl-fe fumarate/fa 30mg-1mg tablet $0.2000/Each
prenatal vitamin w-o vit a/fe carbonyl-fe fumarate/fa 40-1mg Caplet $0.2000/Each
prenatal vitamin w-o vit a/ferrous fumarate/docusate/fa 28 mg-1 mg capsule $0.2000/Each
prenatal vitamin w-o vit a/ferrous fumarate/docusate/fa/zinc 28-1-66mg capsule $0.2000/Each
prenatal vitamin w-o vit a/ferrous fumarate/folic acid 40-1mg Tablet, Chewable $0.2000/Each
prenatal vitamin w-o vit a/ferrous fumarate/folic acid 40-1mg Caplet $0.2000/Each
prenatal vitamins #39/iron amino acid chelate/fa combo#6/dha 30-1-300 mg capsule $0.2000/Each
prenatal vitamins #45/iron/fa 28 MG-1 MG Tablet, Chewable $0.2000/Each
prenatal vitamins comb #83/iron,carbonyl/iron asparto gly/fa 30-20-1 mg tablet $0.2000/Each
prenatal vitamins comb 10/ferrous fumarate/folic acid 65 mg-1 mg Caplet $0.2000/Each
prenatal vitamins comb 10/ferrous fumarate/folic acid/dha 65-1-250mg Caplet $0.2000/Each
prenatal vitamins comb no.1/iron,carbonyl/docusate/fa 90-50-1mg tablet $0.2000/Each
Page 48 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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prenatal vitamins comb no.19/iron bg hcl suc-prot/fa/omega-3 29-1-400mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.19/iron bg hcl&succ-p2/fa/omega-3 29-1-400mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.19/iron b-g suc che-pr/fa/omega-3 29-1-400mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.2/iron b-g suc-p/fa/omega-3 29-1-250mg capsule $0.2000/Each
prenatal vitamins comb no.20/iron bisgly/folic acid/dha 26-1-200mg Caplet $0.2000/Each
prenatal vitamins comb no.21/iron/folic acid 14mg-0.4mg Caplet $0.2000/Each
prenatal vitamins comb no.25/iron bisgly/folic acid 25mg-1mg Caplet $0.2000/Each
prenatal vitamins comb no.3/fe fumarate-fe gluconate/fa 20mg-0.8mg tablet $0.2000/Each
prenatal vitamins comb no.43/iron,carbonyl/fa/docusate sod 29-1-50mg Caplet $0.2000/Each
prenatal vitamins comb no.44/iron,carbonyl/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamins comb no.47/ferrous fumarate/fa cmb #1/dha 27-1-300mg capsule $0.2000/Each
prenatal vitamins comb no.48/iron na feredetate/fa/omega-3 30-1-440mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.52/iron b-g suc-p/folic acid 29 mg-1 mg Caplet $0.2000/Each
prenatal vitamins comb no.53/iron b-g hcl suc-p/fa/omega-3 29-1-400mg capsule $0.2000/Each
prenatal vitamins comb no.53/iron b-g suc-p/fa/omega-3 29-1-400mg capsule $0.2000/Each
prenatal vitamins comb no.54/iron b-g hcl suc-p/fa/omega-3 29-1-430mg capsule $0.2000/Each
prenatal vitamins comb no.54/iron b-g suc-p/fa/omega-3 29-1-430mg capsule $0.2000/Each
prenatal vitamins comb no.55/iron bg hcl suc-prot/fa/omega-3 29-1-430mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.55/iron bg hcl&succ-p2/fa/omega-3 29-1-430mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.55/iron b-g suc che-pr/fa/omega-3 29-1-430mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins comb no.59/ferrous sulfate/folic acid/dha 28-975-200 Powder, Effervescent $0.2000/Each
prenatal vitamins comb no.62/ferrous fumarate/folic acid/dha 27-1-250mg capsule $0.2000/Each
prenatal vitamins comb no.7/fe asp gly/docusate/folic acid 30-50-1mg Caplet $0.2000/Each
prenatal vitamins comb no.70/ferrous fumarate/folic acid/dha 28-1-250mg capsule $0.0000
prenatal vitamins comb no.72/ferrous fumarate/folic acid 27 mg-1 mg tablet $0.2000/Each
prenatal vitamins comb no.73/ferrous fumarate/folic acid 28 mg-1 mg tablet $0.2000/Each
prenatal vitamins comb no.74/ferrous fumarate/folic acid 27 mg-1 mg tablet $0.2000/Each
prenatal vitamins comb no.76/iron,carbonyl/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamins comb no.78/ferrous fumarate/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamins comb no.84/iron,carbonyl/folic acid/dha 20-1-100mg Tablet, Chewable $0.2000/Each
prenatal vitamins comb no.87/iron bisgly/folic acid/dha 32-1-230mg capsule $0.2000/Each
prenatal vitamins comb no.89/ferrous fumarate/folic acid 25mg-0.8mg tablet $0.2000/Each
prenatal vitamins comb no.90/ferrous fumarate/folic acid 9 mg-0.5mg tablet $0.2000/Each
prenatal vitamins comb. no.21 with iron & folic acid 28-6-1 mg tablet $0.2000/Each
prenatal vitamins combo #36/ferrous fumarate/folate combo #6 26 mg-1 mg tablet $0.2000/Each
prenatal vitamins combo no.14/ferrous fumarate/folic acid 29 mg-1 mg Tablet, Chewable $0.2000/Each
prenatal vitamins combo no.23/iron ps complex/folic acid 155 mg-1mg capsule $0.0000
prenatal vitamins combo no.25/ferrous fumarate/fa/dha 30-975-200 capsule $0.2000/Each
prenatal vitamins combo no.28/ferrous fumarate/folic acid 27 mg-1 mg tablet $0.2000/Each
prenatal vitamins combo no.33/iron ps cmplx/folic acid/dha 29-1-250mg Caplet $0.2000/Each
prenatal vitamins combo no.34/iron,carb/folic acid/dss/dha 30-1-50 mg capsule $0.2000/Each
prenatal vitamins combo no.37/ferrous fumarate/folic acid 29 mg-1 mg Tablet, Chewable $0.2000/Each
prenatal vitamins combo no.8/iron ps cmplx & aspgly/fa 22-6-1mg tablet $0.2000/Each
prenatal vitamins no.11/ferrous fumarate/folic acid/omega-3 28-1-200mg capsule $0.2000/Each
prenatal vitamins no.12/iron,carbonyl/fa/docusate na/omega-3 29-1-50mg capsule,delayed release (e.c.) $0.2000/Each
prenatal vitamins no.13/iron,carbonyl/fa/docusate na/dha 90-1-250mg Combination Package $0.2000/Each
prenatal vitamins no.15/iron fumarate & polysac comp/fa 85 mg-1 mg capsule $0.2000/Each
prenatal vitamins no.18/iron,carbonyl/fa/ubidecarenone/dha 15-0.5-50 tablet $0.2000/Each
prenatal vitamins no.22/iron cbn & gluc/folic acid/dss 27-1-50mg tablet $0.2000/Each
prenatal vitamins no.22/iron cbn&glucon/folic acid/dss/dha 27-1-50mg Caplet $0.2000/Each
prenatal vitamins no.22/iron,carbonyl/fa/docusate na/dha 90-1-250mg Caplet $0.2000/Each
prenatal vitamins no.24/iron amino acid chelate/fa/dha 30-975-300 capsule $0.2000/Each
prenatal vitamins no.24/iron amino acid chelate/folic acid 30 mg-975 tablet $0.2000/Each
prenatal vitamins no.24/iron cbn&glucon/folic acid/doss/dha 30-1-75mg Combination Package $0.2000/Each
prenatal vitamins no.26/iron polysaccharides/fa/dha 29-1-200 mg capsule $0.2000/Each
prenatal vitamins no.27/iron carbonyl & fumarate/folic acid 60 mg-1 mg tablet $0.2000/Each
prenatal vitamins no.38/iron cbn&glucon/folic acid/dss/dha 35-1-50mg capsule $0.2000/Each
prenatal vitamins no.38/iron fumarate/folate comb no.6/dha 28-1-300mg capsule $0.0000
prenatal vitamins no.4/ferrous fumarate/folic acid 106 mg-1mg capsule $0.2000/Each
prenatal vitamins no.4/iron cbn&gluconat/folic acid/doss/dha 27-1-50mg Combination Package $0.2000/Each
Page 49 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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prenatal vitamins no.45/iron,carbonyl/fa/docusate sod/dha 90-1-250mg Combination Package $0.2000/Each
prenatal vitamins no.46/iron,carbonyl/folic acid/dha 7-400-100 tablet $0.2000/Each
prenatal vitamins without calcium no.9/iron/folic acid 60 mg-1 mg tablet $0.2000/Each
prenatal vitamins w-o ca comb. no. 8 with iron & folic acid 22-6-1mg tablet $0.2000/Each
prenatal vitamins/fe carbonyl-fe sulfate/folic acid 60 mg-1 mg tablet $0.2000/Each
prenatal vitamins/ferrous bis-glycinate chelate/folic acid 27 mg-1 mg tablet $0.2000/Each
prenatal vitamins/ferrous bis-glycinate chelate/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/docusate/folic acid 90-50-1mg Caplet $0.2000/Each
prenatal vitamins/ferrous fumarate/docusate/folic acid 29 mg-1 mg Caplet $0.2000/Each
prenatal vitamins/ferrous fumarate/docusate/folic acid 40-25-1mg Caplet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 60 mg-1 mg Caplet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 65 mg-1 mg Caplet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 40-1mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 65 mg-1 mg capsule $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 66-1mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 27-0.5mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 27mg-0.8mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 75-1mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 28mg-0.8mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 35-1mg Tablet, Chewable $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 17mg-1mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 15-1mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 27 mg-1 mg Bar $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 28 mg-1 mg Bar $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid 29 mg-1 mg Tablet, Chewable $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid/fatty acids 30mg-1mg Combination Package $0.2000/Each
prenatal vitamins/ferrous fumarate/folic acid/selenium 27 mg-1 mg tablet $0.2000/Each
prenatal vitamins/ferrous fumarate/omega-3/fa/fat combo no.1 30-300-1mg Combination Package $0.2000/Each
prenatal vitamins/ferrous gluconate/folic acid 30-0.4mg tablet $0.2000/Each
prenatal vitamins/ferrous gluconate/folic acid 30-0.8mg tablet $0.2000/Each
prenatal vitamins/ferrous gluconate/folic acid 2.2-.1-455 Powder $0.2000/Gram
prenatal vitamins/iron fumarate & bis-glycinat/fa/aspartame 29 mg-1 mg Tablet, Chewable $0.2000/Each
prenatal vitamins/iron fumarate & bis-glycinat/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamins/iron polysaccharides complex/folic acid 60 mg-1 mg tablet $0.2000/Each
prenatal vitamins/iron,carbonyl/docusate/calcium/folic acid 90-1-600mg Combination Package $0.2000/Each
prenatal vitamins/iron,carbonyl/folic acid 29 mg-1 mg tablet $0.2000/Each
prenatal vitamins/iron,carbonyl/folic acid 50-1mg tablet $0.2000/Each
prenatal vitamins/iron,carbonyl/omega-3/fa/fat combo no.1 27-300-1mg capsule $0.2000/Each
prenatal vitamins/iron,carbonyl/omega-3/fa/min aa chel 29-600-1mg Combination Package $0.2000/Each
prenatal vits #32/iron/fa/dha 27-1-150MG capsule $0.2000/Each
prenatal vits #4/iron fumarate & polysacc complex/folic acid 106 mg-1mg capsule $0.2000/Each
prenatal vits #43/iron/fa/dha 27-1-200mg capsule $0.2000/Each
prenatal vits #92/iron/fa/dha 28MG-0.8MG capsule,delayed release (e.c.) $0.2000/Each
prenatal vits #93/iron fum/fa 9MG-267MCG tablet $0.2000/Each
prenatal vits cmb w-o ca no.1/fe bisgly/folic acid 28 mg-1 mg Caplet $0.2000/Each
prenatal vits cmb w-o ca no.2 106 mg-1mg capsule $0.2000/Each
prenatal vits w-ca,fe,fa(<1mg) Caplet $0.2000/Each
prenatal vits w-ca,fe,fa(1mg) capsule $0.2000/Each
prenatal vits w-ca,fe,fa(1mg) Caplet $0.2000/Each
prenatal vits w-ca,fe,fa(1mg)/selenium tablet $0.2000/Each
prenatal vits with calcium #36/ferrous fumarate/folic acid 13.5-0.4mg capsule $0.2000/Each
prenatal vits without calc no3/ferrous fumarate/folic acid 106 mg-1mg capsule $0.2000/Each
prenatal vits without calc no4/ferrous fumarate/folic acid 106.5-1mg capsule $0.2000/Each
prenatal vits without calc no5/ferrous fumarate/folic acid 106.5-1mg capsule $0.2000/Each
prenatal vits w-o ca comb. no. 7 w/ iron & folic acid & dha 28-1.25mg capsule $0.2000/Each
prenatal72/iron fum/fa/om3/dha 27-1-250MG capsule $0.2000/Each
prenatl vit6/iron/fa/b12/ca/d3 35MG-1.1MG tablet $0.2000/Each
prenatl vit6/iron/fa/b12/ca/d3 35 MG-5 MG tablet $0.2000/Each
primidone 250 mg tablet $0.1340/Each
primidone 50 mg tablet $0.0621/Each
Page 50 of 61
NAME OF GENERIC DRUG STRENGTH FORM
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probenecid 0.5 gm tablet $0.4745/Each
probenecid w/colchicine 0.5 gm/0.5 mg tablet $0.0000
probenecid/colchicine 500-0.5 MG tablet $0.6485/Each
prochlorperazine edisylate 10 MG/2 ML solution $2.8850/Milliliter
prochlorperazine maleate 25 mg Suppository $7.1345/Each
prochlorperazine maleate 10 mg tablet $0.0584/Each
prochlorperazine maleate 5 mg tablet $0.0421/Each
progesterone 50 MG/ML Oil $2.3000/Milliliter
progesterone,micronized 100 MG capsule $0.2100/Each
progesterone,micronized 200 MG capsule $0.6265/Each
promethazine hcl 25 mg/ml Solution $1.1025/Milliliter
promethazine hcl 50 mg/ml Solution $2.3310/Milliliter
promethazine hcl 25 mg/ml Solution $1.0865/Milliliter
promethazine hcl 50 mg/ml Solution $2.4192/Milliliter
promethazine hcl 25 mg Suppository $4.8255/Each
promethazine hcl 50 mg Suppository $24.4775/Each
promethazine hcl 12.5 mg Suppository $2.9895/Each
promethazine hcl 6.25 mg/5 ml Solution $0.0120/Milliliter
promethazine hcl 12.5 mg tablet $0.0675/Each
promethazine hcl 25 mg tablet $0.0392/Each
promethazine hcl 50 mg tablet $0.0750/Each
promethazine vc 6.25 mg/5 mg per 5 ml Syrup $0.0000
promethazine vc w/codeine 6.25 mg/5 mg/10 mg per 5 ml Syrup $0.0000
promethazine w/dm 6.25-15/5 Solution $0.0000
promethazine/codeine 10-6.25/5 ml Syrup $0.0205/Milliliter
propafenone hcl 150 mg tablet $0.1920/Each
propafenone hcl 300 mg tablet $0.4926/Each
propafenone hcl 225 mg tablet $0.2700/Each
propafenone hcl 225 mg capsule, extended release $1.1224/Each
propafenone hcl 325 mg capsule, extended release $1.2720/Each
propafenone hcl 425 mg capsule, extended release $3.0290/Each
proparacaine HCl 0.5 % Drops $1.4745/Milliliter
propofol 10 MG/ML emulsion $0.1045/Milliliter
propoxyphene hcl 65 mg capsule $0.0000
propoxyphene napsylate; apap 100 mg; 650 mg tablet $0.0000
propoxyphene; apap 65/650 mg tablet $0.0000
Page 51 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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propranolol hcl 80 mg capsule, extended release $0.4040/Each
propranolol hcl 120 mg capsule, extended release $0.4267/Each
propranolol hcl 160 mg capsule, extended release $0.8591/Each Decrease
propranolol hcl 60 mg capsule, extended release $0.5649/Each
propranolol hcl 10 mg tablet $0.0746/Each
propranolol hcl 20 mg tablet $0.1245/Each
propranolol hcl 40 mg tablet $0.1690/Each
propranolol hcl 60 mg tablet $0.2395/Each
propranolol hcl 80 mg tablet $0.1560/Each
propranolol HCl 20 MG/5 ML solution $0.1115/Milliliter
propranolol/hctz 40 mg; 25 mg tablet $0.0000
propranolol/hctz 80 mg; 25 mg tablet $0.0000
propylthiouracil 50 mg tablet $0.6355/Each
protriptyline hcl 10 mg tablet $1.6795/Each
protriptyline hcl 5 mg tablet $1.3800/Each
pseudoephedrine HCl 15 MG/5 ML liquid $0.0105/Milliliter
pseudoephedrine hcl 30 mg Caplet $0.0361/Each
pseudoephedrine hcl 60 mg tablet $0.0329/Each
pseudoephedrine hcl/cetirizine hcl 120 mg; 5 mg tablet, extended release $0.0000
pseudoephedrine hcl; chlorpheniramine maleate 120 mg; 8 mg capsule, extended release $0.0000
pseudoephedrine hcl; chlorpheniramine maleate 30 mg; 2 mg per 5 ml Solution $0.0000
pseudoephedrine sulfate/loratadine 240-10 mg tablet, extended release $0.0000
psyllium NA Powder $0.0346/Gram
psyllium husk 0.52G capsule $0.0530/Each
psyllium husk (with sugar) 3.4 G/7 G powder $0.0125/Gram
psyllium husk/aspartame 3.4G/5.8G powder $0.0185/Gram
psyllium seed (with dextrose) Powder $0.0137/Gram
psyllium seed/sucrose oral powder NA Powder $0.0122/Gram
psyllium/sucrose oral packet NA Packet $0.0000
pv w-o vit a/fe fumarate/fa 106 MG-1MG capsule $0.2000/Each
pv w-o vit a/iron,carbonyl/fa 29 MG-1 MG tablet $0.2000/Each
pyrazinamide 500 MG tablet $2.7466/Each
pyridostigmine bromide 60 MG/5 ML syrup $2.3300/Milliliter
pyridostigmine bromide 60 mg tablet $0.3665/Each
pyridostigmine bromide 180 mg tablet, extended release $2.5050/Each
quetiapine fumarate 150 MG tablet, extended release $0.2340/Each
quetiapine fumarate 50 mg tablet $0.0330/Each
quetiapine fumarate 400 mg tablet $0.1615/Each
quetiapine fumarate 25 mg tablet $0.0315/Each
quetiapine fumarate 100 mg tablet $0.0665/Each
quetiapine fumarate 200 mg tablet $0.0855/Each
quetiapine fumarate 300 mg tablet $0.1297/Each
quetiapine fumarate 200 MG tablet, extended release $0.2215/Each
quetiapine fumarate 300 MG tablet, extended release $0.3231/Each
quetiapine fumarate 400 MG tablet, extended release $0.4545/Each
quetiapine fumarate 50 MG tablet, extended release $0.1295/Each
quinapril hcl 10 mg tablet $0.0663/Each
quinapril hcl 20 mg tablet $0.1015/Each
quinapril hcl 5 mg tablet $0.0663/Each
quinapril hcl 40 mg tablet $0.1015/Each
quinapril hcl/hctz 10-12.5 mg tablet $0.3625/Each
quinapril hcl/hctz 20-12.5 mg tablet $0.2760/Each
quinapril hcl/hctz 20-25 mg tablet $0.1675/Each
quinidine gluconate 324 mg tablet, extended release $0.0000
quinidine sulfate 200 mg tablet $0.0000
quinine sulfate 324 MG capsule $1.5045/Each
quinine sulfate 325 mg capsule $0.0000
quinine sulfate 260 mg tablet $0.0000
rabeprazole sodium 20 MG tablet, delayed release (enteric coated) $0.1800/Each
raloxifene hcl 60 MG tablet $0.3150/Each
Page 52 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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ramelteon 8 MG tablet $1.8600/Each
ramipril 1.25 mg capsule $0.0975/Each
ramipril 2.5 mg capsule $0.0598/Each
ramipril 5 mg capsule $0.0450/Each
ramipril 10 mg capsule $0.0750/Each
ranitidine hcl 150 mg tablet $0.0395/Each
ranitidine hcl 300 mg tablet $0.0685/Each
ranitidine hcl 150 mg/10 ml Solution $0.0225/Milliliter
ranitidine hcl 150 mg capsule $0.2625/Each
ranitidine hcl 300 mg capsule $0.5825/Each
ranolazine 500 MG tablet, extended release $0.3524/Each
ranolazine 1000 MG tablet, extended release $0.6065/Each
rasagiline mesylate 1 MG tablet $1.6305/Each
rasagiline mesylate 0.5 MG tablet $2.6907/Each Decrease
repaglinide 0.5 MG tablet $0.1875/Each
repaglinide 1 MG tablet $0.1155/Each
repaglinide 2 MG tablet $0.1050/Each
ribavirin 200 mg capsule $0.3515/Each
ribavirin 200 mg tablet $0.4695/Each
rifabutin 150 mg capsule $11.3500/Each
rifampin 150 MG capsule $0.8085/Each
rifampin 300 mg capsule $0.7075/Each
rifampin 600 MG solution $83.3500/Each
riluzole 50 MG tablet $0.4345/Each
rimantadine hcl 100 mg tablet $1.7590/Each
Ringer's solution solution $0.0047/Milliliter
ringer's solution,lactated Solution $0.0022/Milliliter
Ringer's solution,lactated solution $0.0032/Milliliter
risedronate sodium 35 mg tablet $2.2650/Each
risedronate sodium 35 mg tablet, delayed release (enteric coated) $27.2275/Each
risedronate sodium 30 MG tablet $24.2500/Each
risedronate sodium 5 MG tablet $4.7555/Each
risedronate sodium 150 mg tablet $11.1345/Each Decrease
risperidone 1 mg/ml Solution $0.3175/Milliliter
risperidone 1 mg tablet $0.0473/Each
risperidone 2 mg tablet $0.0635/Each
risperidone 3 mg tablet $0.0600/Each
risperidone 4 mg tablet $0.0945/Each
risperidone 1 mg Tablet,disintegrating $0.8725/Each
risperidone 2 mg Tablet,disintegrating $0.7162/Each
risperidone 0.5 mg Tablet,disintegrating $0.4575/Each
risperidone 0.25 MG Tablet,disintegrating $2.0455/Each
risperidone 3 mg Tablet,disintegrating $1.5585/Each
risperidone 4 mg Tablet,disintegrating $1.9065/Each
risperidone 0.25 mg tablet $0.0150/Each
risperidone 0.5 mg tablet $0.0270/Each
ritonavir 100 MG tablet $0.0000
rivastigmine tartrate 1.5 MG capsule $0.3882/Each
rivastigmine tartrate 3 MG capsule $0.3255/Each
rivastigmine tartrate 4.5 MG capsule $0.3845/Each
rivastigmine tartrate 6 MG capsule $0.4040/Each
rizatriptan benzoate 5 MG tablet $0.8055/Each
rizatriptan benzoate 10 MG tablet $0.5832/Each
rizatriptan benzoate 5 MG Tablet,disintegrating $0.9862/Each
rizatriptan benzoate 10 MG Tablet,disintegrating $0.8945/Each
rocuronium bromide 10 MG/ML solution $0.5635/Milliliter
ropinirole hcl 12 MG tablet, extended release $2.6361/Each Decrease
ropinirole hcl 6 MG tablet, extended release $1.9350/Each
ropinirole hcl 0.25 mg tablet $0.0248/Each
ropinirole hcl 1 mg tablet $0.0569/Each
Page 53 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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ropinirole hcl 2 mg tablet $0.0628/Each
ropinirole hcl 5 mg tablet $0.0705/Each
ropinirole hcl 0.5 mg tablet $0.0254/Each
ropinirole hcl 4 mg tablet $0.0576/Each
ropinirole hcl 3 mg tablet $0.0705/Each
ropinirole hcl 2 MG tablet, extended release $0.4950/Each
ropinirole hcl 4 MG tablet, extended release $0.4950/Each
ropinirole hcl 8 MG tablet, extended release $0.9895/Each
ropivacaine HCl/PF 2 MG/ML solution $0.2607/Milliliter
ropivacaine HCl/PF 5 MG/ML solution $0.3528/Milliliter
rosuvastatin calcium 10 MG tablet $0.0855/Each
rosuvastatin calcium 20 MG tablet $0.0600/Each
rosuvastatin calcium 40 MG tablet $0.1415/Each
rosuvastatin calcium 5 MG tablet $0.0550/Each
salicylic acid 17 % Liquid $0.2535/Milliliter
salicylic acid 27.5 % Film-Forming Liquid with Applicator $4.8025/Milliliter
salicylic acid 6 % Cream $0.0565/Gram
salicylic acid 6 % Shampoo $0.1320/Milliliter
salsalate 500 mg tablet $0.5695/Each
salsalate 750 mg Caplet $0.5500/Each
sanctura 20 MG tablet $0.4935/Each
sapropterin dihydrochloride 100 MG powder $30.6200/Each
sapropterin dihydrochloride 100 MG Tablet, Soluble $32.2000/Each
scopolamine 1 MG/3 DAY Patch,Transdermal 3 day $12.6282/Each Decrease
selegiline hcl 5 mg tablet $0.9455/Each
selegiline hcl 5 mg capsule $1.0675/Each
selenium sulfide 2.25 % Shampoo $0.5000/Milliliter
selenium sulfide 2.5% Lotion $0.0000
selenium sulfide 2.3 % shampoo $1.1676/Milliliter
sennosides 8.6 mg tablet $0.0197/Each
sennosides 15 MG tablet $0.1300/Each
sennosides 8.8MG/5ML Liquid $0.0400/Milliliter
sennosides 25 MG tablet $0.1075/Each
sennosides/docusate sodium 8.6mg-50mg tablet $0.0282/Each
sertraline hcl 25 mg tablet $0.0345/Each
sertraline hcl 50 mg tablet $0.0396/Each
sertraline hcl 100 mg tablet $0.0475/Each
sertraline hcl 20 mg/ml Concentrate $0.4695/Milliliter
sevelamer carbonate 0.8 G Powder $9.4600/Each
sevelamer carbonate 2.4 G Powder $9.9355/Each
sevelamer carbonate 800 MG tablet $0.3180/Each
sevoflurane liquid $0.5200/Milliliter
sildenafil citrate 20 MG tablet $0.0885/Each
sildenafil citrate 10 MG/ML suspension $17.4075/Milliliter
silodosin 4 MG capsule $1.0800/Each
silodosin 8 MG capsule $0.9385/Each
silver sulfadiazine 1% Cream $0.1500/Gram
simethicone 40mg/0.6ml Drops, Suspension $0.0720/Milliliter
simethicone 80 mg Tablet, Chewable $0.0260/Each
simethicone 125 MG Tablet, Chewable $0.0440/Each
simethicone 125 MG capsule $0.0769/Each
simethicone 180 MG capsule $0.0562/Each
simvastatin 5 mg tablet $0.0200/Each
simvastatin 10 mg tablet $0.0360/Each
simvastatin 20 mg tablet $0.0212/Each
simvastatin 40 mg tablet $0.0371/Each
simvastatin 80 mg tablet $0.0903/Each
sirolimus 1 mg tablet $5.7690/Each
sirolimus 2 mg tablet $11.6595/Each
sirolimus 0.5 mg tablet $3.9635/Each
Page 54 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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sod phos di, mono/k phos mono 250 MG Caplet $0.3100/Each
sodium benzoate/sod phenylacet 10 %-10 % solution $202.4500/Milliliter
sodium bicarbonate 1 MEQ/ML Solution $0.1720/Milliliter
sodium bicarbonate 650 MG tablet $0.0135/Each
sodium chloride 0.9%; 3 ml Solution $0.0000
sodium chloride 0.9%; 25 ml Solution $0.0000
sodium chloride 0.9%; 50 ml Solution $0.0000
sodium chloride 0.9%; 100 ml Solution $0.0000
sodium chloride 0.9%; 150 ml Solution $0.0000
sodium chloride 0.9%; 250 ml Solution $0.0000
sodium chloride 0.9%; 500 ml Solution $0.0000
sodium chloride 0.9%; 1000 ml Solution $0.0000
sodium chloride 4 MEQ/ML solution $0.0921/Milliliter
sodium chloride 2.5 MEQ/ML solution $0.0778/Milliliter
sodium chloride 0.9%; 10 ml Solution $0.0000
sodium chloride 5 % Ointment $2.1943/Gram
sodium chloride 5 % Drops $0.3475/Milliliter
sodium chloride 0.65 % Aerosol, Spray $0.0240/Milliliter
sodium chloride 0.9 % (flush) 0.009 solution $0.0450/Milliliter
sodium chloride for inhalation 0.9 % solution $0.0850/Milliliter
sodium chloride/sodium bicarbonate 420 g Solution $0.0041/Milliliter
sodium ferric gluconat/sucrose 62.5MG/5ML solution $1.6000/Milliliter
sodium fluoride 1.1% Cream $0.0720/Gram
sodium fluoride 0.5 mg/ml Drops $0.1355/Milliliter
sodium fluoride 0.25(0.55) Tablet, Chewable $0.0450/Each
sodium fluoride .5 mg Tablet, Chewable $0.0300/Each
sodium fluoride 1 mg Tablet, Chewable $0.0450/Each
sodium phenylbutyrate 0.94 G/G powder $17.7000/Gram
sodium phosphate,monobasic/sodium phosphate,dibasic 19g-7g/118 Enema $0.0065/Milliliter
sodium polystyrene sulfonate Powder $0.0955/Gram
sodium sulfate/sodium chloride/sodium bicarbonate/potassium chloride/polyethylene glycol N/A Solution $0.0035/Milliliter
sofosbuvir/velpatasvir 400-100 MG tablet $280.0000/Each Add
solifenacin succinate 5 MG tablet $0.1800/Each
solifenacin succinate 10 MG tablet $0.1950/Each
sotalol hcl 160 mg tablet $0.1800/Each
sotalol hcl 80 mg tablet $0.0540/Each
sotalol hcl 240 mg tablet $0.1500/Each
sotalol hcl 120 mg tablet $0.1190/Each
spironolactone 100 mg tablet $0.1856/Each
spironolactone 25 mg tablet $0.0534/Each
spironolactone 50 mg tablet $0.1151/Each
spironolactone/hctz 25 mg/25 mg tablet $0.6054/Each
stavudine 15 mg capsule $1.2625/Each
stavudine 20 mg capsule $0.8880/Each
stavudine 30 mg capsule $1.3345/Each
stavudine 40 mg capsule $0.8160/Each
sucralfate 1 G/10 ML suspension $0.3845/Milliliter
sucralfate 1 gm tablet $0.1650/Each
sulfacetamide sodium 10% Drops $2.3885/Milliliter
sulfacetamide sodium 10 % Lotion $0.6865/Milliliter
sulfacetamide sodium 10 % Cleanser $0.2100/Milliliter
sulfacetamide sodium/sulfur 10-5%(w/w) Cream $0.0000
sulfacetamide sodium/sulfur 10%-5% Pads, Medicated $7.6612/Each
sulfacetamide sodium/sulfur 10 %-2 % Cream $5.9160/Gram
sulfacetamide sodium/sulfur 8 %-4 % Suspension $0.1650/Milliliter
sulfacetamide sodium/sulfur 9.8%-4.8% Cleanser $0.6841/Gram
sulfacetamide sodium/sulfur 10-5%(w/w) Cleanser $0.1443/Gram
sulfacetamide/prednisolone sp 10 %-0.23% Drops $1.7824/Milliliter
sulfadiazine 500 MG tablet $3.6700/Each
sulfamethoxazole/trimethoprim 800-160/20 suspension $0.2591/Milliliter
Page 55 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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sulfasalazine 500 mg tablet $0.1714/Each
sulfasalazine 500 mg tablet, delayed release (enteric coated) $0.1645/Each
sulindac 150 mg tablet $0.1455/Each
sulindac 200 mg tablet $0.1825/Each
sumatriptan 5 mg Spray, Non-Aerosol $41.6225/Each
sumatriptan 20 mg Spray, Non-Aerosol $38.5123/Each Decrease
sumatriptan succ/naproxen sod 85MG-500MG tablet $20.3700/Each Decrease
sumatriptan succinate 50 mg tablet $0.4995/Each
sumatriptan succinate 100 mg tablet $0.5552/Each
sumatriptan succinate 25 mg tablet $0.4085/Each
sumatriptan succinate 6 mg/0.5 ml Cartridge $105.9533/Milliliter Decrease
sumatriptan succinate 4 mg/0.5 ml Solution $128.0965/Milliliter
sumatriptan succinate 4 mg/0.5 ml Solution $147.7300/Milliliter
sumatriptan succinate 6 mg/0.5 ml Pen Injector $75.8015/Milliliter
sumatriptan succinate 6 mg/0.5 ml Solution $22.4170/Milliliter Decrease
tacrolimus 0.03 % Ointment $2.6143/Gram Decrease
tacrolimus 0.1 % Ointment $2.0345/Gram
tacrolimus anhydrous 1 mg capsule $0.0000
tacrolimus anhydrous 5 mg capsule $0.0000
tacrolimus anhydrous 0.5 mg capsule $0.0000
tadalafil 20 MG tablet $0.7705/Each
tamoxifen citrate 10 mg tablet $0.2700/Each
tamoxifen citrate 20 mg tablet $0.4900/Each
tamsulosin hcl 0.4 mg capsule, extended release $0.0675/Each
tavaborole 5 % solution $92.5400/Milliliter
tazarotene 0.001 Cream $2.9550/Gram
telmisartan 40 MG tablet $0.2100/Each
telmisartan 80 MG tablet $0.2575/Each
telmisartan 20 mg tablet $0.2575/Each
telmisartan/amlodipine 40 MG-5 MG tablet $2.4925/Each
telmisartan/amlodipine 40 MG-10MG tablet $3.8804/Each
telmisartan/amlodipine 80 MG-5 MG tablet $3.0815/Each
telmisartan/amlodipine 80 MG-10MG tablet $4.5840/Each
telmisartan/hydrochlorothiazide 40 mg-12.5 mg tablet $0.7175/Each
telmisartan/hydrochlorothiazide 80-12.5 mg tablet $0.5890/Each
telmisartan/hydrochlorothiazide 80 mg-25 mg tablet $1.0255/Each
temazepam 15 mg capsule $0.0471/Each
temazepam 30 mg capsule $0.0644/Each
temazepam 7.5 mg capsule $1.6310/Each
temazepam 22.5 mg capsule $3.0715/Each
temozolomide 5 MG capsule $0.9165/Each
temozolomide 20 MG capsule $1.7035/Each
temozolomide 100 MG capsule $7.8635/Each
temozolomide 250 MG capsule $15.9165/Each
temozolomide 140 MG capsule $11.9850/Each Decrease
temozolomide 180 MG capsule $14.6400/Each
temsirolimus FDN 30MG/3 solution $975.0000/Milliliter
tenofovir disoproxil fumarate 300 MG tablet $0.3950/Each
terazosin 1 mg capsule $0.1038/Each
terazosin 2 mg capsule $0.1012/Each
terazosin 5 mg capsule $0.0915/Each
terazosin 10 mg capsule $0.0845/Each
terbinafine hcl 250 mg tablet $0.1345/Each
terbutaline sulfate 5 MG tablet $0.9600/Each
terbutaline sulfate 2.5 MG tablet $0.0000
terbutaline sulfate 1 MG/ML solution $7.9300/Milliliter
terconazole 80 mg Suppository $23.7928/Each
terconazole 0.4% Cream $0.4488/Gram
terconazole 0.8% Cream $1.1632/Gram
testosterone 1.25g (1%) Gel $0.8525/Gram
Page 56 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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testosterone 30MG/1.5ML solution $1.0575/Milliliter
testosterone 20.25/1.25 gel $0.7426/Gram Decrease
testosterone 1.25G-1.62 gel $10.3175/Gram
testosterone 2.5G-1.62% gel $9.4045/Gram
testosterone 25mg(1%) Gel $1.6650/Gram
testosterone 50 mg (1%) Gel $1.0348/Gram
testosterone 50 mg (1%) Gel $1.1129/Gram
testosterone 10 MG (2%) gel $5.4655/Gram
testosterone cypionate 100 MG/ML Oil $3.5450/Milliliter
testosterone cypionate 200 MG/ML Oil $0.0000
testosterone cypionate 200 MG/ML Oil $9.9500/Milliliter
testosterone cypionate 2000 MG/10 ML Oil $3.9500/Milliliter
testosterone enanthate 200 MG/ML Oil $11.7355/Milliliter
tetrabenazine 12.5 MG tablet $6.0650/Each
tetrabenazine 25 MG tablet $2.5155/Each
tetracaine hcl 0.5 % Drops $0.5355/Milliliter
tetracycline hcl 250 mg capsule $0.2445/Each
tetracycline hcl 500 mg capsule $1.2350/Each
tetrahydroz/dext 70/peg 400/pv 0.05-.1-1% drops $0.0932/Milliliter
tetrahydrozoline HCl 0.05 % drops $0.0795/Milliliter
theophylline 300 mg capsule, extended release $0.0000
theophylline 200 mg tablet, extended release $0.4446/Each
theophylline 300 mg tablet, extended release $0.4455/Each
theophylline anhydrous 100 MG tablet, extended release $0.3603/Each
theophylline anhydrous 400 MG tablet, extended release $0.5100/Each
theophylline anhydrous 600 MG tablet, extended release $0.8100/Each
theophylline anhydrous 80 MG/15ML liquid $0.1575/Milliliter
thiamine HCl 100 MG/ML solution $4.0407/Milliliter
thioridazine hcl 100 mg/ml Concentrate $0.0000
thioridazine hcl 30 mg/ml Concentrate $0.0000
thioridazine hcl 25 mg tablet $0.5111/Each
thioridazine hcl 50 mg tablet $0.3720/Each
thioridazine hcl 10 mg tablet $0.4650/Each
thioridazine hcl 100 mg tablet $0.7320/Each
thioridazine hcl 15 mg tablet $0.0000
thioridazine hcl 200 mg tablet $0.0000
thiotepa 15 MG solution $701.6550/Each
thiothixene 1 mg capsule $0.6120/Each
thiothixene 10 mg capsule $1.7400/Each
thiothixene 2 mg capsule $1.1346/Each
thiothixene 5 mg capsule $1.2360/Each
thyroid,pork 15 MG tablet $0.3225/Each
thyroid,pork 30 MG tablet $0.3899/Each
thyroid,pork 60 MG tablet $0.4205/Each
thyroid,pork 90 MG tablet $0.7126/Each
thyroid,pork 120 MG tablet $0.9750/Each
tiagabine hcl 4 mg tablet $3.7765/Each
tiagabine hcl 2 mg tablet $4.0915/Each
ticlopidine hcl 250 mg tablet $0.0000
tigecycline 50 MG solution $74.0850/Each
timolol maleate 10 mg tablet $0.0000
timolol maleate 5 MG tablet $0.9950/Each
timolol maleate 0.0025 Drops $0.5079/Milliliter
timolol maleate 0.005 Drops $0.6605/Milliliter
timolol maleate 0.0025 Gel-Forming Solution $21.0452/Milliliter
timolol maleate 0.005 Gel-Forming Solution $22.0275/Milliliter
timolol maleate/dorzolamide hcl 0.5%-2% Drops $0.8970/Milliliter
timolol maleate/PF 0.5 % solution $5.4250/Each
tinidazole 250 MG tablet $1.9142/Each
tinidazole 500 MG tablet $1.8335/Each
Page 57 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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tioconazole 6.5 % ointment $2.1545/Gram
tizanidine hcl 2 mg tablet $0.0645/Each
tizanidine hcl 4 mg tablet $0.0300/Each
tizanidine hcl 2 MG capsule $0.1935/Each
tizanidine hcl 4 MG capsule $0.1212/Each
tizanidine hcl 6 MG capsule $0.5580/Each
tobramycin 0.3 % drops $0.9600/Milliliter
tobramycin 0.003 OPTH SOLN $0.0000
tobramycin in 0.225% nacl 300 MG/5ML Solution $3.7754/Milliliter Decrease
tobramycin sulfate 1.2 gm Solution $101.9813/Each
tobramycin sulfate 40 mg/ml Solution $0.6773/Milliliter
tobramycin sulfate/dexamethasone 0.3 - 0.1% Drops, Suspension $13.6896/Milliliter Decrease
tolbutamide 500 mg tablet $0.0000
tolcapone 100 MG tablet $94.2004/Each
tolmetin sodium 400 mg capsule $0.0000
tolmetin sodium 200 mg tablet $0.0000
tolmetin sodium 600 mg tablet $0.0000
tolnaftate 1 % Aerosol Powder $0.0265/Gram
tolnaftate 1 % Cream $0.0800/Gram
tolterodine tartrate 4 MG capsule, extended release $1.2615/Each
tolterodine tartrate 2 MG capsule, extended release $1.6005/Each
tolterodine tartrate 1 MG tablet $0.7465/Each
tolterodine tartrate 2 MG tablet $0.5550/Each
topiramate 50 mg tablet $0.0325/Each
topiramate 100 mg tablet $0.0665/Each
topiramate 200 mg tablet $0.0965/Each
topiramate 25 mg tablet $0.0285/Each
topiramate 15 mg Capsule, Sprinkle $0.3476/Each
topiramate 25 mg Capsule, Sprinkle $0.3545/Each
topotecan hcl 4 mg Solution $126.0000/Each
topotecan HCl 4 MG/4 ML solution $11.2150/Milliliter
toremifene citrate 60 MG tablet $25.5500/Each
torsemide 5 mg tablet $0.0665/Each
torsemide 10 mg tablet $0.0675/Each
torsemide 20 mg tablet $0.0866/Each
torsemide 100 mg tablet $0.1875/Each
tramadol 50 mg tablet $0.0176/Each
tramadol hcl 100 mg tablet, extended release $0.7745/Each
tramadol hcl 200 mg tablet, extended release $1.3200/Each
tramadol hcl 300 MG tablet, extended release $2.2566/Each
tramadol hcl 100 mg tablet, extended release $1.4035/Each
tramadol hcl 200 MG tablet, extended release $2.0035/Each
tramadol hcl 300 mg tablet, extended release $3.1935/Each
tramadol hcl/apap 37.5/325 mg tablet $0.1200/Each
trandolapril 1 mg tablet $0.1910/Each
trandolapril 2 mg tablet $0.1290/Each
trandolapril 4 mg tablet $0.1910/Each
trandolapril/verapamil HCl 2 mg-180 mg tablet,immed and extend rel biphase 24hr $4.8330/Each
trandolapril/verapamil HCl 1 mg-240 mg tablet,immed and extend rel biphase 24hr $3.4915/Each
trandolapril/verapamil HCl 2 mg-240 mg tablet,immed and extend rel biphase 24hr $3.5000/Each
trandolapril/verapamil HCl 4 mg-240 mg tablet,immed and extend rel biphase 24hr $4.8330/Each
tranexamic acid 650 MG tablet $1.5565/Each
tranexamic acid 1000 MG/10 Solution $1.9000/Milliliter
tranylcypromine sulfate 10 mg tablet $1.1175/Each
travoprost 0.004 % drops $0.0000
trazodone hcl 50 mg tablet $0.0475/Each
trazodone hcl 100 mg tablet $0.0625/Each
trazodone hcl 150 mg tablet $0.0900/Each
trazodone hcl 300 mg tablet $1.2695/Each
treprostinil sodium 1 MG/ML solution $37.7755/Milliliter
Page 58 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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treprostinil sodium 2.5 MG/ML solution $94.4285/Milliliter
treprostinil sodium 5 MG/ML solution $188.8565/Milliliter
treprostinil sodium 10 MG/ML solution $377.7135/Milliliter
tretinoin 0.0001 Gel $0.0000
tretinoin 0.00025 Gel $0.0000
tretinoin 0.05 % gel $4.3315/Gram
tretinoin 0.0005 Cream $0.0000
tretinoin 0.001 Cream $0.0000
tretinoin 0.00025 Cream $0.0000
tretinoin 0.0005 Liquid $0.0000
tretinoin 10 mg capsule $18.8855/Each
tretinoin microspheres 0.04 % Gel $7.2525/Gram
tretinoin microspheres 0.1 % Gel $7.7465/Gram
tretinoin microspheres 0.04 % Gel $6.2735/Gram
tretinoin microspheres 0.1 % Gel $4.9295/Gram
triamcinolone acetonide 40 MG/ML suspension $6.4500/Milliliter
triamcinolone acetonide 0.025 % Cream $0.0805/Gram
triamcinolone acetonide 0.025%, 15gm Cream $0.0000
triamcinolone acetonide 0.025%, 80gm Cream $0.0000
triamcinolone acetonide 0.001 Cream $0.0388/Gram
triamcinolone acetonide 0.005 Cream $0.1605/Gram
triamcinolone acetonide 0.025 % Ointment $0.0935/Gram
triamcinolone acetonide 0.025%, 80gm Ointment $0.0000
triamcinolone acetonide 0.001 Ointment $0.0545/Gram
triamcinolone acetonide 0.5 % Ointment $0.2580/Gram
triamcinolone acetonide 0.00025 Lotion $0.3885/Milliliter
triamcinolone acetonide 0.001 Lotion $0.2795/Milliliter
triamcinolone acetonide 0.001 Paste $4.0500/Gram
triamcinolone acetonide 55 MCG Aerosol, Spray $0.6625/Milliliter
triamterene & hydrochlorothiazide 50 mg; 25 mg capsule $0.0000
triamterene & hydrochlorothiazide 37.5 mg; 25 mg capsule $0.1643/Each
triamterene & hydrochlorothiazide 75 mg; 50 mg tablet $0.0840/Each
triamterene & hydrochlorothiazide 37.5 mg; 25 mg tablet $0.0810/Each
triazolam 0.25 mg tablet $1.0150/Each
triazolam 0.125 mg tablet $0.8412/Each
trientine HCl 250 MG capsule $50.0000/Each
trifluoperazine hcl 1 mg tablet $0.5800/Each
trifluoperazine hcl 10 mg tablet $1.3403/Each
trifluoperazine hcl 2 mg tablet $0.7500/Each
trifluoperazine hcl 5 mg tablet $0.8935/Each
trifluridine 1 % Drops $16.9400/Milliliter
trihexyphenidyl HCl 2 MG/5 ML Elixir $0.0505/Milliliter
trihexyphenidyl hcl 2 mg tablet $0.0660/Each
trihexyphenidyl hcl 5 mg tablet $0.1080/Each
trimethobenzamide 100 mg Suppository $0.0000
trimethobenzamide 200 mg Suppository $0.0000
trimethobenzamide hcl 300 mg capsule $0.9628/Each
trimethoprim 100 mg tablet $0.2388/Each
trimethoprim and sulfamethoxazole 40 mg; 200 mg per 5 ml Suspension $0.1005/Milliliter
trimethoprim and sulfamethoxazole ds 160 mg; 800 mg Caplet $0.0480/Each
trimethoprim and sulfamethoxazole ss 80 mg; 400 mg tablet $0.0435/Each
trimethoprim/polymyxin b 1 mg/10,000 units/ml Drops $0.3828/Milliliter
trimipramine maleate 100 MG capsule $3.7555/Each
trimipramine maleate 25 MG capsule $3.1555/Each
trimipramine maleate 50 MG capsule $4.4555/Each
triprolidine HCl 0.625MG/ML drops $1.2000/Milliliter
triprolidine HCl 0.313MG/ML drops $1.5000/Milliliter
trolamine salicylate 10 % Cream $0.0295/Gram
tropicamide 0.5 % Drops $0.0000
tropicamide 1 % Drops $0.0000
Page 59 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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trospium chloride 60 MG capsule, extended release $3.6255/Each
urea 10 % Cream $0.0000
urea 40 % Cream $0.2550/Gram
urea 50 % Cream $0.0000
urea 50 % Ointment $0.0000
urea 40 % Foam $2.0615/Gram
ursodiol 300 mg capsule $0.5790/Each
ursodiol 250 mg tablet $0.5265/Each
ursodiol 500 mg tablet $1.3135/Each
valacyclovir hcl 500 mg Caplet $0.2675/Each
valacyclovir hcl 1000 mg Caplet $0.4849/Each
valganciclovir hcl 450 mg tablet $3.4815/Each
valganciclovir HCl 50 MG/ML solution $8.5095/Milliliter
valproic acid 250 mg capsule $0.1548/Each
valproic acid 250 mg/5 ml Solution $0.0150/Milliliter
valproic acid (as sodium salt) 250 MG/5ML solution $0.1385/Milliliter
valproic acid (as sodium salt) 500MG/10ML solution $0.0960/Milliliter
valsartan 320 MG tablet $0.1289/Each
valsartan 160 MG tablet $0.1590/Each
valsartan 80 MG tablet $0.0700/Each
valsartan 40 MG tablet $0.0875/Each
valsartan/hydrochlorothiazide 80-12.5MG tablet $0.1365/Each
valsartan/hydrochlorothiazide 160-12.5MG tablet $0.1956/Each
valsartan/hydrochlorothiazide 160-25MG tablet $0.2553/Each
valsartan/hydrochlorothiazide 320MG-25MG tablet $0.2335/Each
valsartan/hydrochlorothiazide 320-12.5MG tablet $0.2285/Each
vancomycin hcl 500 mg Solution $0.0000
vancomycin HCl 750 MG solution $10.0955/Each
vancomycin hcl 500 mg Solution $3.8536/Each
vancomycin hcl 1 gm Solution $4.7350/Each
vancomycin HCl 10 G Solution $33.3500/Each
vancomycin hcl 5 gm Solution $19.6419/Each
vancomycin hcl 125 MG capsule $1.9814/Each Decrease
vancomycin hcl 250 MG capsule $3.3735/Each
venlafaxine hcl 37.5 MG tablet, extended release $2.2855/Each
venlafaxine hcl 75 MG tablet, extended release $2.0845/Each
venlafaxine hcl 150 MG tablet, extended release $1.7500/Each
venlafaxine hcl 225 MG tablet, extended release $2.4650/Each Decrease
venlafaxine hcl 25 mg tablet $0.0850/Each
venlafaxine hcl 37.5 mg tablet $0.0600/Each
venlafaxine hcl 50 mg tablet $0.0725/Each
venlafaxine hcl 75 mg tablet $0.0690/Each
venlafaxine hcl 100 mg tablet $0.0945/Each
venlafaxine hcl 37.5 MG capsule, extended release $0.0955/Each
venlafaxine hcl 75 MG capsule, extended release $0.0930/Each
venlafaxine hcl 150 MG capsule, extended release $0.1515/Each
verapamil HCl 2.5 MG/ML solution $7.3290/Milliliter
verapamil hcl 120 mg tablet $0.0923/Each
verapamil hcl 80 mg tablet $0.0440/Each
verapamil hcl 180 mg capsule, extended release $0.6435/Each
verapamil hcl 240 mg capsule, extended release $0.9672/Each
verapamil hcl 120 mg capsule, extended release $0.8213/Each
verapamil hcl 360 mg capsule, extended release $4.2588/Each
verapamil hcl 240 mg Caplet $0.0826/Each
verapamil hcl 180 mg Caplet $0.1435/Each
verapamil hcl 120 mg Caplet $0.1745/Each
verapamil HCl 40 MG tablet $0.1310/Each
verapamil hcl 100 mg capsule, extended release $0.7855/Each
verapamil hcl 200 mg capsule, extended release $1.1625/Each
verapamil hcl 300 mg capsule, extended release $1.6215/Each
Page 60 of 61
NAME OF GENERIC DRUG STRENGTH FORM
October 1, 2021 Pricing
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vigabatrin 500 MG Powder $0.0000
vincristine sulfate 1 mg/ ml Solution $5.1000/Milliliter
vincristine sulfate 2 mg/2 ml Solution $7.0274/Milliliter
vinorelbine tartrate 10 mg/ml Solution $20.4750/Milliliter
vinorelbine tartrate 50 mg/5 ml Solution $11.6725/Milliliter
vits A and D/white pet/lanolin ointment $0.0220/Gram
voriconazole 50 mg tablet $2.2265/Each
voriconazole 200 mg tablet $2.5650/Each Decrease
voriconazole 200 MG Solution $29.5500/Each
voriconazole 200 MG/5ML Suspension $9.4750/Milliliter
warfarin sodium 10 mg tablet $0.0685/Each
warfarin sodium 2 mg tablet $0.1050/Each
warfarin sodium 1 mg tablet $0.0685/Each
warfarin sodium 5 mg tablet $0.0540/Each
warfarin sodium 2.5 mg tablet $0.0645/Each
warfarin sodium 7.5 mg tablet $0.0725/Each
warfarin sodium 3 mg tablet $0.0995/Each
warfarin sodium 4 mg tablet $0.0775/Each
warfarin sodium 6 mg tablet $0.0725/Each
water for injection, bacteriostatic vial NA Solution $0.0000
water for injection, sterile iv solution NA Solution $0.0000
water for injection,sterile Solution $0.0838/Milliliter
water for irrigation, sterile solution NA Solution $0.0000
witch hazel 86 % solution $0.0055/Milliliter
zafirlukast 20 mg tablet $0.5330/Each
zafirlukast 10 mg tablet $1.0645/Each
zaleplon 5 mg capsule $0.1724/Each
zaleplon 10 mg capsule $0.1728/Each
zidovudine 50 mg/5 ml Syrup $0.1235/Milliliter
zidovudine 100 mg capsule $1.3950/Each
zidovudine 300 mg tablet $0.2345/Each
zileuton 600 MG tablet, extended release $13.5020/Each
zinc oxide 10 % Ointment $0.0528/Gram
zinc oxide 20 % Ointment $0.0812/Gram
zinc oxide 40 % ointment $0.0174/Gram
ziprasidone hcl 20 mg capsule $0.2625/Each
ziprasidone hcl 40 mg capsule $0.2445/Each
ziprasidone hcl 60 mg capsule $0.2550/Each
ziprasidone hcl 80 mg capsule $0.3155/Each
ziprasidone mesylate FNL 20MG/1 solution $42.2633/Each
zoledronic acid 4 MG/5 ML Solution $7.4000/Milliliter
zoledronic acid/mannitol-water 5 MG/100ML Solution $1.1000/Milliliter
zoledronic acid/mannitol-water 5 MG/100ML solution $1.1000/Milliliter
zolmitriptan 5 MG Tablet,disintegrating $2.8115/Each
zolmitriptan 2.5 MG Tablet,disintegrating $2.5935/Each
zolmitriptan 2.5 MG tablet $1.2275/Each
zolmitriptan 5 MG tablet $1.1475/Each
zolpidem tartrate 5 mg tablet $0.0318/Each
zolpidem tartrate 10 mg tablet $0.0275/Each
zolpidem tartrate 6.25 mg tablet, extended release $0.1595/Each
zolpidem tartrate 12.5 mg tablet, extended release $0.2165/Each
zolpidem tartrate 1.75 MG Tablet, Sublingual $6.7865/Each
zolpidem tartrate 3.5 MG Tablet, Sublingual $5.8565/Each
zonisamide 25 mg capsule $0.0845/Each
zonisamide 50 mg capsule $0.1350/Each
zonisamide 100 mg capsule $0.1201/Each
Page 61 of 61
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