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2021 Price List IVDESC IVCPTCD IVPRICE1 *CONCHA WATER/COLUMN 133.95 .BUBBLE HUMIDIFIER 66.90 .CONCH COLUMN 96.20 .CONCHA PAK 66.90 .CROUP TENT 87.35 .HEAT MOISTURE EXCHANGER 56.90 .HHN CIRCUIT 38.65 .HUMAN ALBUMIN 50G P9046 287.30 .INCENTIVE SPIROMETRY DISPOSIBLE 77.65 .INITIAL NEBULIZER 80.70 .IPPB CIRCUIT 38.65 .MANUAL RESUSCITATOR DISPOSIBLE 109.55 .METERED DOSE INHALER ADAPTER 28.90 .OXIMETER PROBER, DISPOSABLE 115.35 .OXYHOOD 144.20 .PEAK FLOW METER 77.65 1/2 NS (half normal saline) :250ML J7050 33.20 10 GUAGE NEEDLE 493.95 1'ST 30 MINUTES O.R. 1,449.00 1'ST HOUR RECOVERY 776.25 A & D OINT SINGLE 2.32 A & D OINTMENT 2 OZ OINT 6.70 ABDOMINAL/PERITONEAL/BILIARY OR RELATED 7,278.00 ABO BLOOD TYPING 86900 263.00 ACCU-CHECK/CARDIAC REHAB 82947QW 7.25 ACCU-CHECK/ICU 82947QW 37.00 ACCU-CHECK/MEDICAL 82947QW 37.00 ACCU-CHECK/NEWBORN NURSERY 82947QW 37.00 ACCU-CHECK/OB 82947QW 39.00 ACCU-CHECK/OP SURGERY 82947QW 39.00 ACCU-CHECK/PEDI 82947QW 39.00 ACCU-CHECK/STEPDOWN 82947QW 38.65 ACCU-CHECK/SURGICAL 82947QW 39.00 ACCU-CHEK CHEMSTRIPS INFORM II (BX) 51.25 ACCUPRIL (quinapril) 20 MG TAB 3.10 ACCUPRIL (quinapril) 10MG TAB 3.35 ACCUPRIL (quinapril) 20MG TAB 3.35 ACCUPRIL (quinapril) 5MG TAB 3.70 ACE DOUBLE NON-STERILE 4 77.40 ACE DOUBLE NON-STERILE 6 87.05 ACE DOUBLE STERILE 4 115.35 ACE DOUBLE STERILE 6 149.20 ACE STERILE 3 66.90 ACE STERILE 4 69.35 ACE STERILE 6 80.45 ACETIC ACID 0.25% IRRIGATION 1000ML 36.57 ACHROMYCIN OPTH SUSP 1% 18.80 ACID MANTLE CT.1OZ. 8.76 ACTHAR : 40 UNITS 69.00 ACTIFED SYRUP : 1OZ 3.87 ACTIFED SYRUP : 5ML 2.32 ACTIFED TABLET 1.80 ACTIGALL (ursodiol) 300MG 6.70 ACTIV CHARCOAL W/O SORB. : 25GM 19.10 ACTIV CHARCOAL W/SOR : 25GM/120ML 21.12 ACTIV CHARCOAL W/SOR : 50MG/240 27.04 ACTOS (pioglitazone) 15MG 12.30 ACTOS (pioglitazone) 30MG 7.50 ACTOS (pioglitazone) 45MG 18.35 ACU-CLIP 637.30 ADAPTER CONVERTIBLE S/LOCK 80.45 ADAPTER FEMORAL 5 DEGREE C1713 2,471.22 ADAPTER IRRIGATION DUAL 65.25 ADAPTER SPIKE SIMPULSE 32.80 ADAPTER SWIVEL 62.15 ADAPTOR CONVERTIBLE 58.85 ADDERALL (amphet salts) 30MG TAB 4.00 ADDERALL XR (amphet salts) 15 MG TAB 4.00 ADDERALL XR (amphet salts) 20MG TAB 4.00 ADDERALL XR (amphet salts) 30MG TAB 4.00 ADDERALL (amphet salts) 20MG TAB 4.00 ADDERALL (amphet salts) 10MG TAB 4.00 ADDERALL XR (amphet salts) 25MG TAB 4.00 ADDERALL XR (amphet salts) 5MG TAB 4.00 ADDERALL XR (amphet salts)10MG TAB 4.00 ADHESIVE MEDICAL STERILE 115.65 ADRENALIN (epineph)1:1000 TOPICAL 30ML J0171 43.00 ADRENALIN (epinephrine) 1: 1000 1MG J0171 17.15 ADVAIR 500/50 DISKUS *HOSP* #14 J3535 243.00 ADVAIR 100/50 DISKUS *HOSP* #14 J3535 125.95 ADVAIR 115/21 HFA 12GM J3535 309.00 ADVAIR 230/21 HFA 12GM J3535 322.45 ADVAIR 250/50 DISKUS *HOSP* #14 J3535 193.00 ADVAIR 45/21 HFA 12GM J3535 189.70 ADVIL (ibuprofen) 200MG 0.10 AEROBID-M INHALER 114.85 AFB SMEAR (MYCOBACT) 87206 30.00 AFRIN NASAL SPRAY : 15ML 13.39 AFRIN NOSE DROPS : 15ML 12.11 AGGRASTAT (tirofiban) 12.5MG/250ML PREMX J3246 895.00 AIRWAY NASOPHARYNGEAL 26FR ARGYLE 103.30 AIRWAY NASOPHARYNGEAL 28FR 131.66 AIRWAY NASOPHARYNGEAL 30FR 108.35 AIRWAY NASOPHARYNGEAL 32FR 125.65 AKTEN (lidocaine ) 3.5% OPTH GEL 1ML 33.90 ALBUMIN 25%: 12.5GM/50ML 156.82 ALBUMIN 5%: 12.5GM/250ML 141.37 ALCOHOL DEHYDRATED : 1ML AMP 26.53 ALDACTAZIDE (hctz/spironolactone) TAB 1.81 ALDACTONE (spironolactone) 25MG 2.30 ALDACTONE (spironolactone) 50MG 3.10 ALDOMET (methyldopa) 250MG 1.81 ALDOMET (methyldopa) 500MG 3.10 ALDOMET (methyldopa): 250MG/5ML INJ J0210 28.07 ALDOMET 250MG/5ML LIQ : 1OZ 10.56 ALDOMET 250MG/5ML LIQ : 5ML 1.81 ALDORIL (methyldopa/hctz) 25MG 2.32 ALEXIS CONTAINED EXTRACTION SYSTEM 14CM 850.00 ALIGIDERM CALCIUM ALGINATE WOUND PACKAGE 66.90 ALIMENTUM ADVANCED : 32OZ 15.97 ALKA SELTZER TABS 1.81 ALLDRESS 4 x 4 30.55 ALLDRESS 6 x 6 30.55 ALLEGRA (fexofenadine) 180MG 6.20 ALLEGRA (fexofenadine) 60MG 3.25 ALLEGRA-D (fexofenadine/psedoephrine) 3.25 ALOPHEN TAB 1.81 ALPHAKERI BATH OIL 4 OZ 10.05 ALPHAKERI BODY LOT.3.75OZ 13.91 ALTACE (ramipril) 10MG 3.50 ALTACE (ramipril) 2.5MG 2.84 ALTACE (ramipril) 5MG 2.84 ALTERNAGEL SUSP : 12 OZ 9.27 ALTRX NEUTRAL 36 ID X 56 OD C1713 1,278.15 ALTRX NEUTRAL 36 ID X 58 OD C1713 1,278.15 ALTRX NEUTRAL 36 ID X 60 OD C1713 1,278.15 ALTRX NEUTRAL 36 ID X 62 OD C1713 1,278.15 ALTRX NEUTRAL 36MM ID 52MM OD 1,278.15 ALUM (USP) POWDER 40GM 33.00 ALUPENT (metaprotere)10MG/15ML LIQ : 1OZ 6.70 ALUPENT (metaproteren)10MG/5ML LIQ : 5ML 2.32 ALUPENT (metaproterenol) 20MG 1.81 AMARYL (glimepiride) 1MG 1.81 AMARYL (glimepiride) 2MG 1.81 AMARYL (glimepiride) 4MG 2.22 AMBIEN (zolpidem) 10MG 5.93 AMBIEN (zolpidem) 5MG 4.90 AMICAR (aminocap ) 1.25GM/5ML LIQ:1OZ 83.95 AMICAR (aminocap ) 1.25GM/5ML LIQ : 5ML 12.11 AMICAR (aminocaproic acid) 500 MG TABLET 8.50 AMICAR INJ : 250MG/ML 20ML 35.80 AMIDATE (etomidate) 20MG/10ML AMP 63.30 AMIKIN (amikacin) DOSING PER PHARMACY 28.07 AMIKIN (amikacin) 500MG/NS 100ML PB J0278 193.00 AMIKIN(amikacin): 1000MG/4ML VIAL J0278 175.20 AMIKIN(amikacin): 500MG VIAL J0278 224.03 AMINOPHYLLINE: 250MG/10ML INJ J0280 14.20 AMINOPHYLLINE: 500MG/20ML INJ J0280 12.62 AMNIO HOOK 29.70 AMNIOFIX 2 X 12CM HUMAN TISSUE GRAFT 1,287.55 AMOXICILLIN 125/5 : 150ML 12.00 AMOXICILLIN 125MG/5ML : UD 3.87 AMOXICILLIN 125MG/5ML SUSP: 80ML 10.25 AMOXICILLIN 200MG/5ML : UD 5.00 AMOXICILLIN 200MG/5ML: 100ML 30.35 AMOXICILLIN 250/5 : 150ML LIQ 13.25 AMOXICILLIN 250MG CAPSULE 1.81 AMOXICILLIN 250MG/5ML : UD 4.38 AMOXICILLIN 500MG CAPSULE 2.50 AMOXICILLIN 875MG TABLET 2.32 AMOXIL (amoxicillin) 200MG/5ML 50ML 11.50 AMOXIL 400MG/5ML U/D 5.00 AMOXIL(AMOXICILLIN ) 400MG/5ML : 100ML 33.25 AMPICILLIN : 125MG VIAL J0290 12.11 AMPICILLIN : 1GM VIAL J0290 14.00 AMPICILLIN : 250MG VIAL J0290 12.11 AMPICILLIN : 2GM VIAL J0290 30.00 AMPICILLIN : 500MG VIAL J0290 15.45 AMPICILLIN 1GM/50ML NS PB J0290 31.00 AMPICILLIN 250MG CAP 1.81 AMPICILLIN 2GM / NS 100ML PB J0290 43.03 AMPICILLIN 500MG CAP 1.81 AMYL NITRATE VAPOROLE 6.70 AMYTAL : 100MG AMPS 12.62 AMYTAL : 500MG INJECTION 12.11 ANAFRANIL (clomipramine) 25MG 2.84 ANALGESIA/DAY PAT CONTRLO 102.35 ANALPRAM HC (hydrocort/pramox) 2.5% 28GM 63.00 ANAPROX (naproxen) 275MG 3.35 ANAPROX DS (naproxen) 550 MG** NF 4.20 ANASPAZ /LEVSIN (hyoscyamine)0.125MG TAB 2.84 ANCEF (cefazolin) 1GM/SW 10ML PB J0690 33.74 ANCEF (cefazolin) 2GM/ 20ML SW PB J0690 42.49 ANCEF (cefazolin) 2GM/ 50ML D5W **OC J0690 48.00 ANCEF (cefazolin) : 1GM VIAL J0690 19.32 ANCEF (cefazolin) : 500MG VIAL J0690 16.48 ANCEF (cefazolin) 500MG/SW 5ML PB J0690 32.45 ANCEF(CEFAZOLIN) : 25MG J0690 12.11 ANCHOR 3.5MM PANALOK ABSORBABLE C1713 807.75 ANCHOR 5.OMM CORKSCREW W/#2 SUTURE 627.60 ANCHOR 6.5MM CORKSCREW W/#2 SUTURE 581.00 ANCHOR HARPOON SUTURE SIZE 2 / 36 692.20 ANCHOR SUTURE 2.2MM MICRO CORKSCREW FT 629.30 ANCHOR SUTURE 3.5 X 12.1MM CORKSCREW 517.50 ANCHOR SUTURE 3.5MM BIO-PUSHLOCK 703.00 ANCHOR SUTURE 4.75 X 19.1 PEEK SWIVELOCK C1713 795.25 ANCHOR SUTURE 5.5 CROSSFT 1,257.98 ANCHOR SUTURE 5.5 X 19.1 PEEK SWIVELOCK C1713 795.25 ANCHOR SUTURE 5.5MM SWIVELOCK W/#2 WRE 725.10 ANCHOR SUTURE 6.5 CROSSFT 798.90 ANCHOR SUTURE POPLOK 4.5MM 805.01 ANCHOR THREADED BLUNT STD 12MM TROCAR 867.90 ANES EMERGENCY KIT 1.00 ANOSCOPE LARGE SANI-SCOPE DISP 85.40 ANSAID (FLURBIPROFEN) 50MG 3.35 ANTABUSE (disulfiram) 250MG TAB 2.84 ANTENNA EXTERNAL 326.85 ANTIBODY SCREEN 86850 112.00 ANTILIRIUM : 2ML AMPS 27.56 ANTIMICROBIAL SUS. (FUNGUS) 87186 178.40 ANTIVENIN-SNAKE 1 VIAL J0840 3,739.00 ANTIVENOM-BLK WED SPIDER 48.67 ANTIVERT (meclizine) 12.5MG TAB 1.81 ANTIVERT (meclizine) 25MG TAB 1.81 ANUSOL HC (hydrocortisone) SUPP 9.30 ANUSOL SUPP 2.32 ANUSOL-HC 2.5%(hydrocortisone )CRM 1 OZ 45.32 APLIGRAF, PER 1 SQ CM Q4101 150.00 APLISOL PPD 0.1ML 12.11 APP LOW COST SKIN SUB GRAFT 1ST 100 CM 15277 1,309.10 APP LOW COST SKIN SUB GRAFT 1ST 100CM 15273 4,385.65 APP LOW COST SKIN SUB GRAFT 1ST 25CM 15271 1,309.10 APP LOW COST SKIN SUB GRAFT ADD 100CM 15278 837.20 APP LOW COST SKIN SUB GRAFT ADD 100CM 15274 2,803.40 APP LOW COST SKIN SUB GRAFT ADD 25CM 15272 446.75 APP LOW COST SKIN SUB GRAFT ADD 25CM 15276 446.75 APP LOW COST SKIN SUB GRAFT ADD 25CM 15275 1,309.10 APPLICATION OF BILATERAL MULTI LAYER 2958150 406.00 APPLICATION OF UNNA BOOT 2958050 883.80 APPLICATION SKIN SUB GRAFT/ARM/LEG 15271 3,921.00 APPLICATION SKIN SUB GRAFT/ARM/LEG 25SQ 15273 3,253.00 APPLICATION SKIN SUB GRAFT/ARM/LEG EA AD 15272 273.20 APPLICATION SKIN SUB GRAFT/ARM/LEG INFAN 15274 802.40 APPLICATION SKIN SUB GRAFT/FACE/SCALP 15276 274.30 APPLICATION SKIN SUB GRAFT/FACE/SCALP 15278 802.40 APPLICATION SKIN SUB GRAFT/FACE/SCALP 15277 1,882.00 APPLICATION SKIN SUB GRAFT/FACE/SCALP 15275 3,921.00 APPLICATOR FLEXITIP ARISTA 49.45 APPLICATOR FLEXITIP XL ARISTA 67.52 APPLY MULTILAYER COMP LOWER LEG 29581 339.00 APPLY TOTAL CONTACT LEG CAST 29445 439.20 APPLY UNNA BOOT 29580 439.20 APRESOLINE (hyDRALazine) 10MG TAB 2.10 APRESOLINE (hyDRALazine) 25MG TAB 1.81 APRESOLINE(hyDRALazine) 20MG/1ML INJ J0360 27.25 AQUACEL 4 X 4 41.30 AQUACEL ROPE 41.30 AQUAGUIDE 12-14 FR URETERAL 55CM 211.43 AQUAMEPHYTON (vitamin K) 10MG/ML AMP J3430 123.33 AQUAMEPHYTON (vitamin K) 1MG/0.5ML INJ J3430 19.33 AQUASOL A (vitamin A) CAPSULE 1.81 ARCH KOH-EFFICIENT 2.5CM 341.45 ARCH KOH-EFFICIENT 3.0CM 341.44 ARCH KOH-EFFICIENT 3.5CM 341.44 ARCH KOH-EFFICIENT 4.0CM 273.10 AREDIA ( pamidronate) 30MG VIAL J2430 530.30 ARICEPT (donepezil) 5MG TAB 14.00 ARICEPT (donepezil)10MG TAB 12.50 ARISTOCORT A 0.1% 15GM 23.69 AROM-COT 17.25 ARTANE (trihexyphenidyl) 2MG TAB 1.81 ARTHROCENTESIS 20600 612.00 ARTHROSCOPY 1,650.40 ARTHROWAND 2.3MM BEVEL SHORT 25 DEGREE 623.70 ARTHROWAND 3.0MM CAPSURE 30 DEGREE 901.45 ARTHROWAND 3.5MM TURBO VAC 90 DEGREE 633.65 ARTHROWAND 50 MULTIVAC/TRISTAR
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