Disclaimer: Price listing does not guarantee coveragedhhr.wv.gov/bms/BMS...

Generic Name Prev. SMAC Price Prev. Effective Date

Current SMAC Price

Current Effective Date

0.9 % SODIUM CHLORIDE INJECTION VIAL (ML) 0.9 % 0.05712 08/12/2014

0.9 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 0.9 %

0.00196 03/06/2015 0.00196 08/21/2015

0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK WITH THREADED PORT (ML)

0.03505 01/30/2015 0.03505 08/21/2015

0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK WITH VIAL PORT (NON-THREADED)

0.04175 07/18/2014

ABACAVIR SULFATE ORAL TABLET 300 MG 1.77633 11/25/2017 0.36867 05/22/2020

ABIRATERONE ACETATE ORAL TABLET 250 MG 3.78000 02/21/2020 4.56040 02/24/2020

ACAMPROSATE CALCIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 333 MG

0.74145 04/09/2020 0.70192 06/19/2020

ACARBOSE ORAL TABLET 100 MG 0.18990 03/02/2018 0.13000 11/16/2018

ACEBUTOLOL HCL ORAL CAPSULE 200 MG 0.40001 06/04/2019 0.60776 10/07/2019

ACEBUTOLOL HCL ORAL CAPSULE 400 MG 0.26000 03/27/2015 0.26000 08/21/2015

ACETAMINOPHEN ORAL CAPSULE 500 MG 0.01093 08/12/2014

ACETAMINOPHEN ORAL DROPS 80MG/0.8ML 0.17160 10/11/2013 0.17160 08/21/2015

ACETAMINOPHEN ORAL LIQUID (ML) 160 MG/5ML 0.00932 09/27/2013 0.00932 08/21/2015

ACETAMINOPHEN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 160 MG/5ML

0.02137 08/21/2015 0.02033 02/17/2017

ACETAMINOPHEN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 160 MG/5ML

0.01083 06/09/2017 0.02033 03/02/2018

ACETAMINOPHEN ORAL TABLET 325 MG 0.00830 06/20/2014 0.00830 08/21/2015

ACETAMINOPHEN ORAL TABLET 500 MG 0.01040 04/03/2015 0.01040 08/21/2015

ACETAMINOPHEN ORAL TABLET,CHEWABLE 80 MG 0.04651 04/03/2015 0.04651 08/21/2015

ACETAMINOPHEN ORAL TABLET,DISINTEGRATING 80 MG 0.05113 08/21/2015

ACETAMINOPHEN RECTAL SUPPOSITORY, RECTAL 120 MG 0.20324 08/22/2014 0.20324 08/21/2015

ACETAMINOPHEN WITH CODEINE PHOSPHATE ORAL SOLUTION, ORAL 120-12MG/5

0.01332 01/30/2015 0.01332 08/21/2015

ACETAMINOPHEN WITH CODEINE PHOSPHATE ORAL SOLUTION, ORAL 120-12MG/5

0.21394 03/27/2015 0.21394 08/21/2015

ACETAMINOPHEN WITH CODEINE PHOSPHATE ORAL SOLUTION, ORAL 300MG/12.5

0.10079 03/27/2015 0.10079 08/21/2015

ACETAMINOPHEN WITH CODEINE PHOSPHATE ORAL TABLET 300MG-15MG

0.14344 09/19/2014 0.14344 08/21/2015

0.10480 10/20/2017 0.09167 12/22/2017

0.19101 05/20/2016 0.17150 08/17/2018

ACETAMINOPHEN/DIPHENHYDRAMINE HCL ORAL TABLET 500MG-25MG 0.04047 04/24/2015 0.04047 08/21/2015

ACETAZOLAMIDE ORAL CAPSULE, EXTENDED RELEASE 500 MG 0.94140 09/22/2017 0.70000 11/16/2018

ACETAZOLAMIDE ORAL TABLET 125 MG 1.52593 08/21/2015 1.29790 11/16/2018

ACETAZOLAMIDE ORAL TABLET 250 MG 1.02880 02/22/2019 0.69948 05/17/2019

ACETIC ACID IRRIGATION SOLUTION, IRRIGATION 0.25 % 0.00350 03/01/2013

ACETIC ACID OTIC SOLUTION, NON-ORAL 2 % 1.81591 08/21/2015 1.65333 02/21/2020

West Virginia MedicaidState Maximum Allowable Cost (SMAC) List

Disclaimer: Price listing does not guarantee coverage

Effective 8/7/2020

Current SMAC Price

ACETIC ACID/ALUMINUM ACETATE DROPS 2 % 0.84000 01/25/2013 0.84000 08/21/2015

ACETYLCYSTEINE INTRAVENOUS VIAL (ML) 200 MG/ML 5.26400 03/06/2015 5.26400 08/21/2015

ACETYLCYSTEINE MISCELLANEOUS VIAL (ML) 100 MG/ML 0.45068 08/21/2015 0.35144 02/21/2020

ACETYLCYSTEINE MISCELLANEOUS VIAL (ML) 200 MG/ML 0.19900 02/21/2020 0.34100 03/27/2020

ACETYLCYSTEINE/MECOBALAMIN/LEVOMEFOLATE CALCIUM ORAL TABLET 600-2-6 MG

1.89794 02/20/2015 1.89794 08/21/2015

ACITRETIN ORAL CAPSULE 10 MG 6.66667 11/24/2017 9.53166 12/18/2017

ACITRETIN ORAL CAPSULE 17.5 MG 42.31920 03/21/2014

ACITRETIN ORAL CAPSULE 25 MG 12.56000 01/25/2019 9.33333 05/17/2019

ACYCLOVIR ORAL CAPSULE 200 MG 0.08844 08/21/2015 0.05480 09/22/2017

ACYCLOVIR ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 200 MG/5ML 0.37206 11/16/2018 0.40698 01/19/2020

ACYCLOVIR ORAL TABLET 400 MG 0.06655 07/14/2017 0.05351 11/16/2018

ACYCLOVIR ORAL TABLET 800 MG 0.13520 12/22/2017 0.11600 08/16/2019

ACYCLOVIR SODIUM INTRAVENOUS VIAL (EA) 500 MG 31.20600 08/22/2014 31.20600 08/21/2015

ACYCLOVIR SODIUM INTRAVENOUS VIAL (ML) 50 MG/ML 1.40750 07/25/2014

ACYCLOVIR TOPICAL OINTMENT (GRAM) 5 % 1.94109 11/15/2019 0.89933 05/22/2020

ADAPALENE TOPICAL CREAM (GRAM) 0.1 % 3.51289 04/26/2013

ADAPALENE TOPICAL GEL (GRAM) 0.1 % 1.82556 06/22/2018 1.58578 11/15/2019

ADAPALENE TOPICAL GEL (GRAM) 0.3 % 4.68580 08/21/2015 3.41117 06/16/2017

ADAPALENE TOPICAL GEL WITH PUMP (GRAM) 0.3 % 4.61985 04/10/2015 4.61985 08/21/2015

ADEFOVIR DIPIVOXIL ORAL TABLET 10 MG 26.52627 09/27/2013

ALBUMIN HUMAN INTRAVENOUS INTRAVENOUS SOLUTION 25 % 1.51200 05/01/2015 1.51200 08/21/2015

ALBUMIN HUMAN INTRAVENOUS INTRAVENOUS SOLUTION 5 % 0.21588 09/19/2014 0.21588 08/21/2015

ALBUTEROL SULFATE INHALATION SOLUTION, NON-ORAL 5 MG/ML 1.45230 10/23/2017 2.12250 12/27/2019

ALBUTEROL SULFATE INHALATION VIAL, NEBULIZER (EA) 2.5 MG/0.5 0.43876 08/01/2014

ALBUTEROL SULFATE INHALATION VIAL, NEBULIZER (ML) 0.63MG/3ML 0.15441 11/16/2018 0.11333 11/15/2019

ALBUTEROL SULFATE INHALATION VIAL, NEBULIZER (ML) 1.25MG/3ML 0.19073 06/21/2019 0.15240 12/20/2019

ALBUTEROL SULFATE INHALATION VIAL, NEBULIZER (ML) 2.5 MG/3ML 0.05253 08/21/2015 0.03400 01/19/2018

ALBUTEROL SULFATE ORAL SYRUP 2 MG/5 ML 0.01277 08/21/2015 0.03571 08/28/2019

ALBUTEROL SULFATE ORAL TABLET 2 MG 4.56651 08/21/2015 4.05000 12/25/2015

ALBUTEROL SULFATE ORAL TABLET 4 MG 4.11250 08/21/2015 3.62765 12/25/2015

ALBUTEROL SULFATE ORAL TABLET, EXTENDED RELEASE 12 HR 4 MG 1.18451 04/25/2014

ALBUTEROL SULFATE ORAL TABLET, EXTENDED RELEASE 12 HR 8 MG 1.71821 04/05/2013

ALCLOMETASONE DIPROPIONATE TOPICAL CREAM (GRAM) 0.05 % 0.88300 08/16/2019 0.62717 03/20/2020

ALCLOMETASONE DIPROPIONATE TOPICAL OINTMENT (GRAM) 0.05 % 0.58692 06/28/2013

ALENDRONATE SODIUM ORAL SOLUTION, ORAL 70 MG/75ML 2.45700 09/27/2013

ALENDRONATE SODIUM ORAL TABLET 10 MG 0.18750 08/21/2015 0.13200 10/20/2017

ALENDRONATE SODIUM ORAL TABLET 40 MG 2.80060 03/27/2015

ALFUZOSIN HCL ORAL TABLET, EXTENDED RELEASE 24 HR 10 MG 0.11326 03/16/2018 0.05870 05/22/2020

Effective 8/7/2020

Current SMAC Price

ALLOPURINOL ORAL TABLET 100 MG 0.07267 11/16/2018 0.04709 01/25/2019

ALLOPURINOL ORAL TABLET 300 MG 0.09110 07/26/2019 0.05230 07/17/2020

ALMOTRIPTAN MALATE ORAL TABLET 12.5 MG 25.31000 08/25/2017 16.33370 10/19/2018

ALPHA LIPOIC ACID ORAL CAPSULE 200 MG 0.12771 08/08/2014 0.12771 08/21/2015

ALPHA LIPOIC ACID ORAL CAPSULE 50 MG 0.10210 08/12/2014 0.10210 08/21/2015

ALPRAZOLAM ORAL TABLET 0.25 MG 0.01509 05/16/2014 0.01509 08/21/2015

ALPRAZOLAM ORAL TABLET 0.5 MG 0.01780 04/17/2015 0.01780 08/21/2015

ALPRAZOLAM ORAL TABLET 1 MG 0.01970 02/06/2015 0.01970 08/21/2015

ALPRAZOLAM ORAL TABLET 2 MG 0.07213 09/28/2015 0.04891 12/22/2017

ALPRAZOLAM ORAL TABLET, EXTENDED RELEASE 24 HR 0.5 MG 0.36136 08/21/2015 0.18083 09/22/2017

ALPRAZOLAM ORAL TABLET, EXTENDED RELEASE 24 HR 1 MG 0.44913 08/21/2015 0.21717 09/22/2017

ALPRAZOLAM ORAL TABLET,DISINTEGRATING 0.25 MG 1.36123 03/01/2013 1.36123 08/21/2015

ALPRAZOLAM ORAL TABLET,DISINTEGRATING 0.5 MG 1.51669 01/25/2013 1.51669 08/21/2015

ALPRAZOLAM ORAL TABLET,DISINTEGRATING 1 MG 2.02358 01/25/2013 2.02358 08/21/2015

ALPRAZOLAM ORAL TABLET,DISINTEGRATING 2 MG 3.00202 01/25/2013 3.00202 08/21/2015

ALUMINUM HYDROXIDE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 320 MG/5ML

0.00813 08/21/2015

AMANTADINE HCL ORAL CAPSULE 100 MG 0.43730 12/22/2017 0.24644 08/17/2018

AMANTADINE HCL ORAL SOLUTION, ORAL 50 MG/5 ML 0.01733 04/03/2015 0.01733 08/21/2015

AMANTADINE HCL ORAL TABLET 100 MG 0.13100 08/16/2019 0.43980 06/09/2020

AMBRISENTAN ORAL TABLET 10 MG 38.40000 02/21/2020

AMBRISENTAN ORAL TABLET 5 MG 38.40000 02/21/2020

AMCINONIDE TOPICAL CREAM (GRAM) 0.1 % 2.82140 08/12/2014

AMCINONIDE TOPICAL LOTION (ML) 0.1 % 1.90000 08/12/2014

AMCINONIDE TOPICAL OINTMENT (GRAM) 0.1 % 4.53600 08/30/2013

AMIKACIN SULFATE INJECTION VIAL (ML) 1000MG/4ML 3.14373 12/05/2014 3.14373 08/21/2015

AMIKACIN SULFATE INJECTION VIAL (ML) 500 MG/2ML 2.95555 12/05/2014 2.95555 08/21/2015

AMILORIDE HCL ORAL TABLET 5 MG 0.14880 11/15/2019 0.13230 05/22/2020

AMILORIDE HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 5 MG-50 MG 0.42250 05/30/2014 0.42250 08/21/2015

AMINO ACIDS ORAL POWDER (GRAM) 0.25540 08/12/2014

AMINOCAPROIC ACID INTRAVENOUS VIAL (ML) 250 MG/ML 0.08148 02/06/2015 0.08148 08/21/2015

AMINOCAPROIC ACID ORAL TABLET 1000 MG 18.30610 08/12/2014 18.30610 08/21/2015

AMINOCAPROIC ACID ORAL TABLET 500 MG 5.37896 10/11/2013 5.37896 08/21/2015

AMINOPHYLLINE INTRAVENOUS VIAL (ML) 250MG/10ML 0.30912 01/30/2015 0.30912 08/21/2015

AMINOPHYLLINE INTRAVENOUS VIAL (ML) 500MG/20ML 0.07270 08/12/2014

AMIODARONE HCL INTRAVENOUS AMPUL (ML) 50 MG/ML 0.33600 01/25/2013

AMIODARONE HCL ORAL TABLET 100 MG 2.16500 11/24/2017 1.97100 03/20/2020

AMITRIPTYLINE HCL ORAL TABLET 10 MG 0.05742 11/16/2018 0.03550 08/16/2019

Effective 8/7/2020

Current SMAC Price

AMITRIPTYLINE HCL/CHLORDIAZEPOXIDE ORAL TABLET 12.5MG-5MG 1.07296 08/01/2014

AMITRIPTYLINE HCL/CHLORDIAZEPOXIDE ORAL TABLET 25 MG-10MG 1.51380 05/02/2014

AMLODIPINE BESYLATE ORAL TABLET 10 MG 0.02527 08/21/2015 0.01238 09/21/2018

AMLODIPINE BESYLATE ORAL TABLET 2.5 MG 0.05960 08/21/2015 0.01756 07/14/2017

AMLODIPINE BESYLATE ORAL TABLET 5 MG 0.06240 08/21/2015 0.01300 08/25/2017

AMLODIPINE BESYLATE/ATORVASTATIN CALCIUM ORAL TABLET 10 MG-10MG

3.63000 09/30/2016 1.46667 11/15/2019

3.93004 04/10/2015 3.93004 08/21/2015

3.69400 05/25/2018 2.50000 09/20/2019

6.55993 08/21/2015 5.53825 06/16/2017

AMLODIPINE BESYLATE/ATORVASTATIN CALCIUM ORAL TABLET 2.5MG-10MG

5.07347 08/12/2014 5.07347 08/21/2015

3.01200 09/22/2017 2.46833 03/20/2020

6.55993 08/21/2015 5.92000 09/30/2016

AMLODIPINE BESYLATE/ATORVASTATIN CALCIUM ORAL TABLET 5 MG-10 MG

4.55853 08/21/2015 3.16379 06/16/2017

3.93250 08/21/2015 2.74000 05/25/2018

3.35767 09/22/2017 3.09133 02/21/2020

5.92000 09/30/2016 3.28900 05/17/2019

AMLODIPINE BESYLATE/BENAZEPRIL HCL ORAL CAPSULE 10 MG-20MG 0.22277 09/30/2016 0.10120 08/25/2017

AMLODIPINE BESYLATE/BENAZEPRIL HCL ORAL CAPSULE 10 MG-40MG 0.14950 11/24/2017 0.09950 07/26/2019

AMLODIPINE BESYLATE/BENAZEPRIL HCL ORAL CAPSULE 2.5MG-10MG 0.46372 03/25/2016 0.08560 09/22/2017

AMLODIPINE BESYLATE/BENAZEPRIL HCL ORAL CAPSULE 5 MG-10 MG 0.14570 08/25/2017 0.07450 08/17/2018

AMLODIPINE BESYLATE/OLMESARTAN MEDOXOMIL ORAL TABLET 10 MG-20MG

0.52000 11/24/2017 0.31333 11/15/2019

AMLODIPINE BESYLATE/OLMESARTAN MEDOXOMIL ORAL TABLET 10 MG-40MG

0.69044 03/17/2017 0.49867 05/17/2019

AMLODIPINE BESYLATE/OLMESARTAN MEDOXOMIL ORAL TABLET 5 MG-20 MG

0.65033 10/20/2017 0.44433 12/22/2017

AMLODIPINE BESYLATE/OLMESARTAN MEDOXOMIL ORAL TABLET 5 MG-40 MG

0.72933 11/16/2018 0.35000 05/22/2020

AMLODIPINE BESYLATE/VALSARTAN ORAL TABLET 10MG-160MG 0.47493 04/22/2016 0.35000 03/15/2019

AMLODIPINE BESYLATE/VALSARTAN ORAL TABLET 10MG-320MG 0.53089 05/20/2016 0.43333 11/24/2017

AMLODIPINE BESYLATE/VALSARTAN ORAL TABLET 5 MG-160MG 0.42633 10/21/2019 0.33484 12/20/2019

Effective 8/7/2020

Current SMAC Price

AMLODIPINE BESYLATE/VALSARTAN ORAL TABLET 5 MG-320MG 0.45034 03/03/2017 0.37667 11/15/2019

AMLODIPINE BESYLATE/VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 10-160-25

4.40212 01/01/2017 0.91533 05/25/2018

AMLODIPINE BESYLATE/VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 10-320-25

1.41000 05/25/2018 0.94467 05/17/2019

AMLODIPINE BESYLATE/VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 10MG-160MG

4.40212 01/01/2017 1.15000 03/15/2019

AMLODIPINE BESYLATE/VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 5-160-12.5

3.88023 01/01/2017 1.74210 08/25/2017

AMLODIPINE BESYLATE/VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 5-160-25MG

3.88023 08/21/2015 3.88023 01/01/2017

AMMONIUM CHLORIDE VIAL (ML) 5 MEQ/ML 0.42630 01/25/2013

AMMONIUM LACTATE TOPICAL CREAM (GRAM) 12 % 0.03021 04/26/2019 0.05714 06/05/2019

AMMONIUM LACTATE TOPICAL LOTION (GRAM) 12 % 0.07500 03/25/2016 0.01588 05/22/2020

AMOXAPINE ORAL TABLET 100 MG 1.16865 11/22/2013

AMOXICILLIN ORAL CAPSULE 250 MG 0.04730 04/10/2015 0.04730 08/21/2015

AMOXICILLIN ORAL CAPSULE 500 MG 0.06941 08/21/2015 0.05236 06/16/2017

AMOXICILLIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML

0.01420 04/24/2015 0.01420 08/21/2015

0.05684 08/21/2015 0.02500 08/25/2017

0.02291 10/20/2017 0.01825 07/26/2019

0.02680 08/21/2015 0.01901 07/26/2019

AMOXICILLIN ORAL TABLET 500 MG 0.25550 08/17/2018 0.13125 05/17/2019

AMOXICILLIN ORAL TABLET 875 MG 0.12230 06/16/2017 0.08590 12/22/2017

AMOXICILLIN ORAL TABLET,CHEWABLE 125 MG 0.15067 01/25/2013

AMOXICILLIN ORAL TABLET,CHEWABLE 250 MG 0.26748 10/03/2014 0.26748 08/21/2015

AMOXICILLIN ORAL TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 775 MG

11.26813 12/26/2014 11.26813 08/21/2015

AMOXICILLIN/POTASSIUM CLAVULANATE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 200-28.5/5

0.11239 08/21/2015 0.03290 11/24/2017

0.55083 03/20/2020 0.30000 05/22/2020

AMOXICILLIN/POTASSIUM CLAVULANATE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 400-57MG/5

0.08554 03/03/2017 0.06173 11/15/2019

0.08168 03/03/2017 0.06436 11/16/2018

AMOXICILLIN/POTASSIUM CLAVULANATE ORAL TABLET 250-125 MG 4.14283 08/21/2015 3.35700 08/17/2018

AMOXICILLIN/POTASSIUM CLAVULANATE ORAL TABLET, EXTENDED RELEASE 12 HR 1000-62.5

3.37383 10/31/2014

AMOXICILLIN/POTASSIUM CLAVULANATE ORAL TABLET,CHEWABLE 200-28.5MG

1.00222 03/01/2013 1.00222 08/21/2015

Effective 8/7/2020

Current SMAC Price

AMOXICILLIN/POTASSIUM CLAVULANATE ORAL TABLET,CHEWABLE 400-57MG

1.51840 08/22/2014 3.77335 04/22/2016

AMPHOTERICIN B INJECTION VIAL (EA) 50 MG 20.87400 05/30/2014

AMPICILLIN SODIUM INJECTION VIAL (EA) 1 G 2.89120 01/25/2013

AMPICILLIN SODIUM INJECTION VIAL (EA) 10 G 36.92358 12/26/2014 36.92358 08/21/2015

AMPICILLIN SODIUM INJECTION VIAL (EA) 125 MG 3.50250 08/12/2014

AMPICILLIN SODIUM INJECTION VIAL (EA) 2 G 6.57000 11/08/2013 6.49900 05/17/2019

AMPICILLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 1 G

12.17907 08/12/2014

AMPICILLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 2 G

23.62640 01/25/2013

AMPICILLIN SODIUM/SULBACTAM SODIUM INJECTION VIAL (EA) 1.5 G 2.57012 07/18/2014 2.57012 08/21/2015

AMPICILLIN SODIUM/SULBACTAM SODIUM INJECTION VIAL (EA) 15 G 20.70600 08/12/2014 20.70600 08/21/2015

AMPICILLIN SODIUM/SULBACTAM SODIUM INJECTION VIAL (EA) 3 G 6.47640 08/23/2013 6.47640 08/21/2015

AMPICILLIN SODIUM/SULBACTAM SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 1.5 G

3.24240 01/25/2013

AMPICILLIN SODIUM/SULBACTAM SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 3 G

5.22060 01/25/2013 5.22060 08/21/2015

AMPICILLIN TRIHYDRATE ORAL CAPSULE 250 MG 0.09000 08/12/2014 0.09000 08/21/2015

AMPICILLIN TRIHYDRATE ORAL CAPSULE 500 MG 0.14370 08/21/2015 0.46990 05/15/2020

AMPICILLIN TRIHYDRATE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML

0.03950 02/08/2013 0.03950 08/21/2015

AMPICILLIN TRIHYDRATE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 250 MG/5ML

0.06860 02/08/2013 0.06860 08/21/2015

ANAGRELIDE HCL ORAL CAPSULE 0.5 MG 0.60112 05/16/2014

ANAGRELIDE HCL ORAL CAPSULE 1 MG 1.29259 05/16/2014

ANASTROZOLE ORAL TABLET 1 MG 0.08533 06/16/2017 0.04100 08/16/2019

ANTIPYRINE/BENZOCAINE DROPS 5.4 %-1.4% 0.43271 02/06/2015 0.43271 08/21/2015

ANTIPYRINE/BENZOCAINE DROPS 5.5 %-1.4% 10.70600 12/26/2014 10.70600 08/21/2015

ANTIVENIN,LATRODECTUS MACTANS INJECTION VIAL (EA) 6000 UNIT 57.33000 12/12/2014 57.33000 08/21/2015

ANTIVENIN,MICRURUS FULVIUS INJECTION VIAL (EA) 1496.32000 01/25/2013

APRACLONIDINE HCL OPHTHALMIC DROPS 0.5 % 12.32550 08/21/2015 10.34900 08/16/2019

ARGATROBAN IN 0.9 % SODIUM CHLORIDE INTRAVENOUS VIAL (ML) 125 MG/125

11.61817 01/25/2013

ARGATROBAN IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS VIAL (ML) 50 MG/50ML

3.85000 08/12/2014

ARGATROBAN INTRAVENOUS VIAL (ML) 100 MG/ML 412.36020 05/01/2015 412.36020 08/21/2015

ARGININE HCL ORAL TABLET 1000 MG 0.14760 08/12/2014

ARGININE ORAL CAPSULE 500 MG 0.08386 08/12/2014 0.08386 08/21/2015

ARIPIPRAZOLE ORAL SOLUTION, ORAL 1 MG/ML 2.79055 03/17/2017 2.75841 04/21/2017

ARIPIPRAZOLE ORAL TABLET 10 MG 0.17992 03/20/2020 0.15550 05/22/2020

Effective 8/7/2020

Current SMAC Price

ARMODAFINIL ORAL TABLET 150 MG 1.03341 08/01/2018

ARMODAFINIL ORAL TABLET 200 MG 1.37000 08/25/2017 1.27067 02/21/2020

ARMODAFINIL ORAL TABLET 250 MG 1.19665 08/01/2018 1.09333 01/25/2019

ASCORBIC ACID ORAL TABLET 1000 MG 0.05352 08/12/2014 0.05352 08/21/2015

ASCORBIC ACID ORAL TABLET, EXTENDED RELEASE 1000 MG 0.07311 08/12/2014 0.07311 08/21/2015

ASCORBIC ACID ORAL TABLET,CHEWABLE 250 MG 0.02510 01/25/2013

ASCORBIC ACID ORAL TABLET,CHEWABLE 500 MG 0.04768 08/12/2014 0.04768 08/21/2015

ASPIRIN ORAL TABLET 325 MG 0.00616 03/27/2015 0.00616 08/21/2015

ASPIRIN ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 325 MG 0.00872 05/01/2015 0.00872 08/21/2015

ASPIRIN ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 81 MG 0.00804 04/03/2015 0.00804 08/21/2015

ASPIRIN ORAL TABLET,CHEWABLE 81 MG 0.02048 05/01/2015 0.02048 08/21/2015

ASPIRIN/ACETAMINOPHEN/CAFFEINE ORAL TABLET 250-250-65 0.04476 04/24/2015 0.04476 08/21/2015

ASPIRIN/CALCIUM CARBONATE/MAGNESIUM ORAL TABLET 325 MG 0.02015 03/07/2014 0.02015 08/21/2015

ASPIRIN/SODIUM BICARBONATE/CITRIC ACID ORAL TABLET, EFFERVESCENT 325-1916MG

0.09644 08/12/2014 0.09644 08/21/2015

ATAZANAVIR SULFATE ORAL CAPSULE 150 MG 4.58000 02/21/2020

ATENOLOL ORAL TABLET 100 MG 0.03400 08/21/2015 0.01518 09/22/2017

ATENOLOL/CHLORTHALIDONE ORAL TABLET 100MG-25MG 0.45970 11/24/2017 0.39948 03/02/2018

ATENOLOL/CHLORTHALIDONE ORAL TABLET 50 MG-25MG 0.35135 03/02/2018 0.32495 11/16/2018

ATOMOXETINE HCL ORAL CAPSULE 10 MG 2.33485 10/24/2019 1.79000 05/22/2020

ATORVASTATIN CALCIUM ORAL TABLET 10 MG 0.05920 08/17/2018 0.04039 11/15/2019

ATOVAQUONE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 750 MG/5ML

2.21000 12/21/2018 1.42857 11/15/2019

ATOVAQUONE/PROGUANIL HCL ORAL TABLET 250-100 MG 2.23250 05/17/2019 2.19550 11/15/2019

ATOVAQUONE/PROGUANIL HCL ORAL TABLET 62.5-25 MG 1.85045 06/06/2014 0.92151 01/13/2017

ATROPINE SULFATE INJECTION SYRINGE (ML) 0.05 MG/ML 2.23272 01/25/2013

Effective 8/7/2020

Current SMAC Price

ATROPINE SULFATE INJECTION SYRINGE (ML) 0.1 MG/ML 0.43014 01/25/2013 0.43014 08/21/2015

ATROPINE SULFATE INJECTION VIAL (ML) 0.4 MG/ML 0.85480 08/12/2014 0.85480 08/21/2015

ATROPINE SULFATE INJECTION VIAL (ML) 1 MG/ML 1.50320 08/12/2014

ATROPINE SULFATE OPHTHALMIC DROPS 1 % 8.17320 08/22/2015 9.81029 01/31/2020

ATROPINE SULFATE OPHTHALMIC OINTMENT (GRAM) 1 % 3.98000 02/08/2013

AZATHIOPRINE ORAL TABLET 50 MG 0.21600 04/26/2019 0.18135 11/15/2019

AZELASTINE HCL NASAL AEROSOL, SPRAY WITH PUMP (ML) 137 MCG 0.33442 11/16/2018 0.27345 07/26/2019

AZELASTINE HCL NASAL AEROSOL, SPRAY WITH PUMP (ML) 205.5 MCG 1.16607 08/16/2019 1.02000 02/21/2020

AZELASTINE HCL OPHTHALMIC DROPS 0.05 % 2.20055 11/24/2017 1.31000 12/21/2018

AZITHROMYCIN INTRAVENOUS VIAL (EA) 500 MG 3.77260 08/12/2014 3.77260 08/21/2015

AZITHROMYCIN INTRAVENOUS VIAL WITH THREADED PORT (EA) 500 MG 12.68820 01/25/2013

AZITHROMYCIN ORAL PACKET (EA) 1 G 20.29440 01/17/2014 20.29440 08/21/2015

AZITHROMYCIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 100 MG/5ML

0.58000 08/16/2019 0.42933 05/22/2020

AZITHROMYCIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 200 MG/5ML

0.55000 04/17/2020 0.48084 07/17/2020

AZITHROMYCIN ORAL TABLET 250 MG 0.29000 10/20/2017 0.27106 01/19/2018

AZTREONAM INJECTION VIAL (EA) 1 G 27.67800 08/15/2014

AZTREONAM INJECTION VIAL (EA) 2 G 39.02640 01/30/2015 39.02640 08/21/2015

B-COMPLEX WITH VITAMIN C ORAL TABLET 0.02618 08/15/2014 0.02618 08/21/2015

BACITRACIN OPHTHALMIC OINTMENT (GRAM) 500 UNIT/G 13.86800 08/21/2015 27.98908 08/15/2018

BACITRACIN TOPICAL OINTMENT (GRAM) 500 UNIT/G 0.06722 04/19/2013 0.06722 08/21/2015

BACITRACIN ZINC TOPICAL OINTMENT (GRAM) 500 UNIT/G 0.10676 04/17/2015 0.10676 08/21/2015

BACITRACIN/POLYMYXIN B SULFATE OPHTHALMIC OINTMENT (GRAM) 500-10K/G

2.81450 08/21/2015 2.05714 08/16/2019

BACITRACIN/POLYMYXIN B SULFATE TOPICAL OINTMENT (GRAM) 500-10K/G

0.27376 01/25/2013 0.27376 08/21/2015

BACLOFEN MISCELLANEOUS POWDER (GRAM) 100 % 2.61831 02/13/2015 2.61831 08/21/2015

BACLOFEN ORAL TABLET 10 MG 0.07070 01/25/2019 0.05757 01/24/2020

BACLOFEN ORAL TABLET 20 MG 0.19580 02/04/2020 0.14090 05/22/2020

BALSALAZIDE DISODIUM ORAL CAPSULE 750 MG 0.35921 09/22/2017 0.22496 03/02/2018

BCG LIVE INTRAVESICAL VIAL (EA) 50 MG 291.39600 01/25/2013

BENAZEPRIL HCL ORAL TABLET 10 MG 0.03800 10/20/2017 0.01900 11/16/2018

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 10-12.5MG 0.63132 06/16/2017 0.60520 12/22/2017

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 20 MG-25MG 0.87187 03/03/2017 0.49535 06/16/2017

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 20-12.5 MG 0.19990 08/17/2018 0.68974 08/25/2018

BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 5-6.25MG 0.45890 08/21/2015

BENZOCAINE/MENTHOL MUCOUS MEMBRANE LOZENGE 15MG-3.6MG 0.09806 02/13/2015 0.09806 08/21/2015

BENZONATATE ORAL CAPSULE 100 MG 0.09980 11/16/2018 0.08282 11/15/2019

Effective 8/7/2020

Current SMAC Price

BENZONATATE ORAL CAPSULE 200 MG 0.14064 09/30/2016 0.08920 08/16/2019

BENZOYL PEROXIDE TOPICAL CLEANSER (GRAM) 10 % 0.04197 05/01/2015 0.04197 08/21/2015

BENZOYL PEROXIDE TOPICAL CLEANSER (GRAM) 5 % 0.04075 08/09/2013 0.04075 08/21/2015

BENZOYL PEROXIDE TOPICAL FOAM (GRAM) 5.3% 2.00832 08/12/2014

BENZOYL PEROXIDE TOPICAL FOAM (GRAM) 9.8 % 1.60318 08/12/2014

BENZOYL PEROXIDE TOPICAL GEL (GRAM) 10 % 0.21574 03/20/2015 0.21574 08/21/2015

BENZOYL PEROXIDE TOPICAL GEL (GRAM) 2.5 % 0.23088 08/16/2013

BENZOYL PEROXIDE TOPICAL GEL (GRAM) 5 % 0.18789 02/27/2015 0.18789 08/21/2015

BENZPHETAMINE HCL ORAL TABLET 50 MG 0.43389 11/07/2014 0.43389 08/21/2015

BENZTROPINE MESYLATE INJECTION AMPUL (ML) 2 MG/2 ML 23.40625 08/12/2014

BENZTROPINE MESYLATE INJECTION VIAL (ML) 2 MG/2 ML 40.39560 01/25/2013 40.39560 08/21/2015

BENZTROPINE MESYLATE ORAL TABLET 0.5 MG 0.08100 09/22/2017 0.05221 07/26/2019

BENZTROPINE MESYLATE ORAL TABLET 1 MG 0.09106 08/25/2017 0.05550 09/21/2018

BENZTROPINE MESYLATE ORAL TABLET 2 MG 0.09210 02/22/2019 0.07071 08/16/2019

BETA-CAROTENE(A) W-C AND E/LUTEIN/MINERALS ORAL TABLET 1000-60-2

0.06145 08/12/2014 0.06145 08/21/2015

BETA-CAROTENE/ASCORBIC ACID/VITE AC/ZINC OXIDE/CUPRIC OXIDE ORAL CAPSULE 14320-226

0.16420 08/12/2014 0.16420 08/21/2015

BETA-CAROTENE/ASCORBIC ACID/VITE AC/ZINC OXIDE/CUPRIC OXIDE ORAL TABLET 7160-113

0.06620 08/12/2014

BETAMETHASONE ACETATE/BETAMETHASONE SODIUM PHOSPHATE INJECTION VIAL (ML) 6 MG/ML

5.60000 01/25/2013 5.60000 08/21/2015

BETAMETHASONE DIPROPIONATE TOPICAL CREAM (GRAM) 0.05 % 1.02000 05/22/2020 0.88400 07/17/2020

BETAMETHASONE DIPROPIONATE TOPICAL GEL (GRAM) 0.05 % 1.21450 01/25/2013

BETAMETHASONE DIPROPIONATE TOPICAL LOTION (ML) 0.05 % 0.23117 08/16/2019 0.45600 02/07/2020

BETAMETHASONE DIPROPIONATE TOPICAL OINTMENT (GRAM) 0.05 % 1.57591 03/29/2013 1.57591 08/21/2015

BETAMETHASONE DIPROPIONATE/PROPYLENE GLYCOL TOPICAL CREAM (GRAM) 0.05 %

0.34930 08/21/2015 0.17260 01/25/2019

BETAMETHASONE DIPROPIONATE/PROPYLENE GLYCOL TOPICAL LOTION (ML) 0.05 %

1.77637 08/16/2013

BETAMETHASONE DIPROPIONATE/PROPYLENE GLYCOL TOPICAL OINTMENT (GRAM) 0.05 %

1.66174 06/16/2017 0.86311 08/16/2019

BETAMETHASONE VALERATE TOPICAL CREAM (GRAM) 0.1 % 0.16667 02/21/2020 0.56973 07/01/2020

BETAMETHASONE VALERATE TOPICAL FOAM (GRAM) 0.12 % 3.31660 08/21/2015 2.50000 10/25/2019

BETAMETHASONE VALERATE TOPICAL LOTION (ML) 0.1 % 0.79430 03/29/2013 0.79430 08/21/2015

BETAMETHASONE VALERATE TOPICAL OINTMENT (GRAM) 0.1 % 0.69422 09/04/2018 0.56667 02/21/2020

BETAXOLOL HCL OPHTHALMIC DROPS 0.5 % 7.27680 01/25/2013

BETAXOLOL HCL ORAL TABLET 10 MG 0.51160 08/16/2019

BETHANECHOL CHLORIDE ORAL TABLET 10 MG 0.29680 08/25/2017 0.11950 05/17/2019

BICALUTAMIDE ORAL TABLET 50 MG 0.21667 08/25/2017 0.10180 08/17/2018

BIOFLAVONOID, LEMON/VITAMIN B COMP AND C ORAL TABLET 200-100 MG

0.14285 05/03/2013

BIOTIN ORAL CAPSULE 2500 MCG 0.09390 08/12/2014

Effective 8/7/2020

Current SMAC Price

BISACODYL ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 5 MG 0.00996 01/16/2015 0.00996 08/21/2015

BISACODYL RECTAL SUPPOSITORY, RECTAL 10 MG 0.09491 08/12/2014 0.09491 08/21/2015

BISMUTH SUBSALICYLATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 262MG/15ML

0.00732 03/20/2015 0.00732 08/21/2015

BISMUTH SUBSALICYLATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 525MG/15ML

0.01095 04/24/2015 0.01095 08/21/2015

BISMUTH SUBSALICYLATE ORAL TABLET,CHEWABLE 262 MG 0.09120 08/21/2015 0.05733 01/25/2019

BISOPROLOL FUMARATE ORAL TABLET 10 MG 0.42566 11/15/2019 0.52457 03/24/2020

BISOPROLOL FUMARATE ORAL TABLET 5 MG 0.38074 02/21/2020 0.30530 07/17/2020

BISOPROLOL FUMARATE/HYDROCHLOROTHIAZIDE ORAL TABLET 10-6.25MG

0.06432 04/17/2015 0.06432 08/21/2015

BISOPROLOL FUMARATE/HYDROCHLOROTHIAZIDE ORAL TABLET 2.5-6.25MG

0.04920 10/20/2017 0.03462 03/02/2018

BISOPROLOL FUMARATE/HYDROCHLOROTHIAZIDE ORAL TABLET 5-6.25MG

0.42720 10/25/2019 0.33813 02/21/2020

BRIMONIDINE TARTRATE OPHTHALMIC DROPS 0.15 % 16.27762 08/21/2015 16.27762 04/22/2016

BRIMONIDINE TARTRATE OPHTHALMIC DROPS 0.2 % 0.51810 02/22/2019 0.42067 06/19/2020

BROMFENAC SODIUM OPHTHALMIC DROPS 0.09 % 39.30875 09/26/2014 39.30875 08/21/2015

BROMOCRIPTINE MESYLATE ORAL CAPSULE 5 MG 6.00042 03/25/2016 4.25000 10/19/2018

BROMOCRIPTINE MESYLATE ORAL TABLET 2.5 MG 2.15134 05/28/2019 1.06633 11/15/2019

BROMPHENIRAMINE MALEATE/PHENYLEPHRINE HCL ORAL LIQUID (ML) 4-10MG/5ML

0.15294 01/25/2013 0.15294 08/21/2015

BROMPHENIRAMINE MALEATE/PHENYLEPHRINE HCL/DEXTROMETHORPHAN ORAL LIQUID (ML) 4-10-20/5

0.11830 09/13/2013 0.11830 08/21/2015

BROMPHENIRAMINE MALEATE/PHENYLEPHRINE HCL/DEXTROMETHORPHAN ORAL LIQUID (ML) 4-7.5-15/5

0.09960 12/12/2014 0.09960 08/21/2015

BROMPHENIRAMINE MALEATE/PHENYLEPHRINE HCL/DEXTROMETHORPHAN ORAL SOLUTION, ORAL 1-2.5-5/5

0.01700 02/06/2015 0.01700 08/21/2015

BROMPHENIRAMINE MALEATE/PSEUDOEPHEDRINE HCL/DEXTROMETHORPHAN ORAL ELIXIR 1-15-5MG/5

0.01880 03/27/2015

BROMPHENIRAMINE MALEATE/PSEUDOEPHEDRINE HCL/DEXTROMETHORPHAN ORAL SYRUP 2-30-10/5

0.12883 09/20/2017 0.05776 11/16/2018

BUDESONIDE INHALATION AMPUL FOR NEBULIZATION (ML) 0.25MG/2ML 2.80662 12/02/2016 0.51467 11/15/2019

BUDESONIDE INHALATION AMPUL FOR NEBULIZATION (ML) 0.5 MG/2ML 0.93000 06/21/2019 0.74983 11/15/2019

BUDESONIDE INHALATION AMPUL FOR NEBULIZATION (ML) 1 MG/2 ML 4.43100 11/15/2019 4.11367 06/19/2020

BUDESONIDE ORAL CAPSULE, DELAYED, AND EXTENDED RELEASE 3 MG

0.89630 08/16/2019 0.48290 04/17/2020

BUMETANIDE INJECTION VIAL (ML) 0.25 MG/ML 0.26572 01/25/2013 0.26572 08/21/2015

BUMETANIDE ORAL TABLET 0.5 MG 0.15517 02/20/2015 0.15517 08/21/2015

BUMETANIDE ORAL TABLET 1 MG 0.37153 05/17/2019 0.27990 05/22/2020

BUMETANIDE ORAL TABLET 2 MG 0.99030 05/24/2016 0.64435 03/03/2017

BUPIVACAINE HCL INJECTION VIAL (ML) 2.5 MG/ML 0.04200 04/25/2014

BUPIVACAINE HCL INJECTION VIAL (ML) 5 MG/ML 0.05090 04/25/2014 0.05090 08/21/2015

BUPIVACAINE HCL/EPINEPHRINE BITARTRATE INJECTION CARTRIDGE (ML) 0.5-1:200K

0.26130 08/12/2014

BUPIVACAINE HCL/EPINEPHRINE INJECTION VIAL (ML) 0.25-.0005 0.12253 01/25/2013

BUPIVACAINE HCL/EPINEPHRINE INJECTION VIAL (ML) 0.5-1:200K 0.11900 01/25/2013

BUPIVACAINE HCL/EPINEPHRINE/PF INJECTION VIAL (ML) 0.25-.0005 0.27733 01/25/2013

Effective 8/7/2020

Current SMAC Price

BUPIVACAINE HCL/EPINEPHRINE/PF INJECTION VIAL (ML) 0.5-1:200K 0.25992 01/25/2013

BUPIVACAINE HCL/PF INJECTION AMPUL (ML) 2.5 MG/ML 0.11790 08/12/2014

BUPIVACAINE HCL/PF INJECTION AMPUL (ML) 5 MG/ML 0.08690 08/12/2014

BUPIVACAINE HCL/PF INJECTION AMPUL (ML) 7.5 MG/ML 0.10478 01/25/2013 0.10478 08/21/2015

BUPIVACAINE HCL/PF INJECTION VIAL (ML) 2.5 MG/ML 0.06089 08/12/2014

BUPIVACAINE HCL/PF INJECTION VIAL (ML) 5 MG/ML 0.06736 08/12/2014

BUPIVACAINE HCL/PF INJECTION VIAL (ML) 7.5 MG/ML 0.13428 08/12/2014

BUPRENORPHINE HCL INJECTION CARTRIDGE (ML) 0.3 MG/ML 12.18000 01/25/2013

BUPRENORPHINE HCL SUBLINGUAL TABLET, SUBLINGUAL 2 MG 1.05933 06/16/2017 0.43600 09/22/2017

BUPRENORPHINE HCL SUBLINGUAL TABLET, SUBLINGUAL 8 MG 0.95666 06/25/2019 0.65800 09/20/2019

BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL TABLET, SUBLINGUAL 2 MG-0.5MG

2.60728 06/16/2017 1.19133 11/15/2019

BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL TABLET, SUBLINGUAL 8 MG-2 MG

2.31650 09/21/2018 1.75693 11/15/2019

BUPROPION HCL ORAL TABLET 100 MG 0.18600 09/22/2017 0.11485 08/16/2019

BUPROPION HCL ORAL TABLET 75 MG 0.14167 11/15/2019 0.08950 05/22/2020

BUPROPION HCL ORAL TABLET, EXTENDED RELEASE 12 HR 150 MG 0.44367 03/25/2016 0.20967 07/14/2017

BUPROPION HCL ORAL TABLET,SUSTAINED-RELEASE 12 HR 100 MG 0.07644 03/02/2018 0.12200 07/23/2018

BUSPIRONE HCL ORAL TABLET 10 MG 0.03984 10/20/2017 0.04536 11/29/2018

BUSPIRONE HCL ORAL TABLET 7.5 MG 0.35967 05/17/2019 0.33000 11/15/2019

BUTALBITAL/ACETAMINOPHEN ORAL TABLET 50MG-325MG 0.86233 03/14/2014 1.09000 08/07/2015

BUTALBITAL/ACETAMINOPHEN/CAFFEINE ORAL CAPSULE 50-300-40 2.36850 08/03/2018 1.86500 10/19/2018

BUTALBITAL/ACETAMINOPHEN/CAFFEINE ORAL CAPSULE 50-325-40 1.35905 03/27/2015

BUTALBITAL/ACETAMINOPHEN/CAFFEINE ORAL TABLET 50-325-40 0.22890 12/20/2019 0.15773 05/22/2020

BUTALBITAL/ACETAMINOPHEN/CAFFEINE/CODEINE PHOSPHATE ORAL CAPSULE 50-300-30

4.30822 03/06/2015

BUTALBITAL/ACETAMINOPHEN/CAFFEINE/CODEINE PHOSPHATE ORAL CAPSULE 50-325-30

1.04965 08/21/2015 1.01795 03/02/2018

BUTALBITAL/ASPIRIN/CAFFEINE ORAL CAPSULE 50-325-40 0.88420 01/24/2020 1.00000 05/04/2020

BUTALBITAL/ASPIRIN/CAFFEINE ORAL TABLET 50-325-40 0.29110 12/17/2018

BUTENAFINE HCL TOPICAL CREAM (GRAM) 1 % 0.40179 08/21/2015 0.40179 01/01/2019

BUTORPHANOL TARTRATE INJECTION VIAL (ML) 1 MG/ML 1.94300 01/25/2013 1.94300 08/21/2015

BUTORPHANOL TARTRATE INJECTION VIAL (ML) 2 MG/ML 1.94300 01/25/2013 1.94300 08/21/2015

BUTORPHANOL TARTRATE NASAL AEROSOL, SPRAY (ML) 10 MG/ML 16.32960 08/21/2015 12.19584 06/16/2017

CABERGOLINE ORAL TABLET 0.5 MG 2.93000 06/21/2019 2.12000 07/26/2019

CAFFEINE CITRATE INTRAVENOUS VIAL (ML) 60 MG/3 ML 3.35400 04/03/2015 3.35400 08/21/2015

CAFFEINE CITRATE ORAL SOLUTION, ORAL 60 MG/3 ML 6.70190 08/21/2015 6.66666 01/25/2019

Effective 8/7/2020

Current SMAC Price

CAFFEINE/SODIUM BENZOATE INJECTION VIAL (ML) 250 MG/ML 2.73000 01/25/2013

CALCIPOTRIENE TOPICAL CREAM (GRAM) 0.005 % 1.70100 04/26/2019 0.88683 01/24/2020

CALCIPOTRIENE TOPICAL OINTMENT (GRAM) 0.005 % 4.22790 08/12/2014

CALCIPOTRIENE TOPICAL SOLUTION, NON-ORAL 0.005 % 2.64568 06/16/2017 1.56000 05/25/2018

CALCIPOTRIENE/BETAMETHASONE DIPROPIONATE TOPICAL OINTMENT (GRAM) 0.005-.064

8.11932 06/16/2017 8.11932 01/01/2018

CALCITONIN,SALMON,SYNTHETIC NASAL AEROSOL, SPRAY WITH PUMP (ML) 200/SPRAY

10.40270 09/25/2015 9.78378 09/30/2016

CALCITRIOL INTRAVENOUS AMPUL (ML) 1 MCG/ML 4.68130 05/10/2013

CALCITRIOL ORAL CAPSULE 0.25 MCG 0.17150 11/16/2018 0.13009 08/16/2019

CALCITRIOL ORAL CAPSULE 0.5 MCG 0.50783 02/08/2018 0.20400 11/16/2018

CALCITRIOL ORAL SOLUTION, ORAL 1 MCG/ML 5.49667 08/26/2016 4.59200 08/16/2019

CALCITRIOL TOPICAL OINTMENT (GRAM) 3 MCG/G 6.43120 01/09/2015 6.43120 01/01/2018

CALCIUM ACETATE ORAL CAPSULE 667 MG 0.51577 03/31/2020 0.29233 07/17/2020

CALCIUM ACETATE ORAL TABLET 667 MG 0.36813 01/03/2014 0.30825 11/16/2018

CALCIUM ACETATE/ALUMINUM SULFATE TOPICAL POWDER IN PACKET (EA) 952-1347MG

0.72740 01/25/2013

CALCIUM CARBONATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 500 MG/5ML

0.01799 01/25/2013

CALCIUM CARBONATE ORAL TABLET 500(1250) 0.01434 06/21/2013 0.01434 08/21/2015

CALCIUM CARBONATE ORAL TABLET 600 MG 0.02144 07/26/2013 0.02144 08/21/2015

CALCIUM CARBONATE ORAL TABLET,CHEWABLE 200(500)MG 0.01357 02/06/2015 0.01357 08/21/2015

CALCIUM CARBONATE ORAL TABLET,CHEWABLE 300MG(750) 0.02554 02/27/2015 0.02554 08/21/2015

CALCIUM CARBONATE ORAL TABLET,CHEWABLE 400(1000) 0.04240 08/21/2015 0.02986 08/17/2018

CALCIUM CARBONATE ORAL TABLET,CHEWABLE 500(1250) 0.03420 08/12/2014

CALCIUM CARBONATE/CHOLECALCIFEROL (VITAMIN D3) ORAL CAPSULE 600 MG-400

0.04855 08/12/2014

CALCIUM CARBONATE/CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET 250 MG-125

0.01032 01/25/2013 0.01032 08/21/2015

0.02170 08/12/2014 0.02170 08/21/2015

0.01599 08/12/2014 0.01599 08/21/2015

0.03507 08/12/2014 0.03507 08/21/2015

0.01899 01/25/2013 0.01899 08/21/2015

0.01956 02/27/2015 0.01956 08/21/2015

0.05873 02/13/2015 0.05873 08/21/2015

CALCIUM CARBONATE/CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET,CHEWABLE 500 MG-100

0.03420 08/21/2015

CALCIUM CARBONATE/ERGOCALCIFEROL (VITAMIN D2) TABLET 250 MG-125

0.02170 08/12/2014 0.02170 08/21/2015

CALCIUM CARBONATE/MAGNESIUM HYDROXIDE ORAL TABLET,CHEWABLE 675-135 MG

0.01352 08/21/2015

CALCIUM CHLORIDE INTRAVENOUS SYRINGE (ML) 100 MG/ML 0.47124 08/12/2014 0.47124 08/21/2015

CALCIUM CHLORIDE INTRAVENOUS VIAL (ML) 100 MG/ML 0.17500 01/25/2013

Effective 8/7/2020

Current SMAC Price

CALCIUM CITRATE ORAL TABLET 200(950)MG 0.03070 08/12/2014 0.03070 08/21/2015

CALCIUM CITRATE ORAL TABLET 250 MG 0.05565 01/25/2013

CALCIUM CITRATE/CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET 200 MG-250

0.04005 08/12/2014

CALCIUM CITRATE/CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET 315 MG-250

0.04615 11/21/2014 0.04615 08/21/2015

CALCIUM CITRATE/CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET 315MG-5MCG

0.05724 08/12/2014 0.05724 08/21/2015

CALCIUM POLYCARBOPHIL ORAL TABLET 625 MG 0.06417 08/12/2014 0.06417 08/21/2015

CANDESARTAN CILEXETIL ORAL TABLET 16 MG 1.34663 05/17/2019 1.17100 11/15/2019

CANDESARTAN CILEXETIL/HYDROCHLOROTHIAZIDE ORAL TABLET 16-12.5MG

1.87708 11/07/2014 1.87708 08/21/2015

CANDESARTAN CILEXETIL/HYDROCHLOROTHIAZIDE ORAL TABLET 32-12.5MG

2.91948 01/25/2013 2.91948 08/21/2015

CANDESARTAN CILEXETIL/HYDROCHLOROTHIAZIDE ORAL TABLET 32MG-25MG

3.15984 08/12/2014 3.15984 08/21/2015

CAPECITABINE ORAL TABLET 150 MG 8.21479 04/24/2015 8.21479 08/21/2015

CAPECITABINE ORAL TABLET 500 MG 5.07000 11/24/2017 3.86667 11/15/2019

CAPSAICIN TOPICAL CREAM (GRAM) 0.025 % 0.06709 04/05/2013 0.06709 08/21/2015

CAPSAICIN TOPICAL CREAM (GRAM) 0.075 % 0.09338 08/12/2014 0.09338 08/21/2015

CAPSAICIN/METHYL SALICYLATE/MENTHOL TOPICAL LOTION (GRAM) 0.002%-20%

2.36327 01/25/2013

CAPTOPRIL MISCELLANEOUS POWDER (GRAM) 100 % 56.85764 02/22/2013 56.85764 08/21/2015

CAPTOPRIL ORAL TABLET 100 MG 1.12780 05/09/2014 1.12780 08/21/2015

CAPTOPRIL ORAL TABLET 12.5 MG 0.46645 08/15/2014 0.46645 08/21/2015

CAPTOPRIL/HYDROCHLOROTHIAZIDE ORAL TABLET 25 MG-15MG 0.33384 12/27/2013 0.33384 08/21/2015

CARBAMAZEPINE ORAL CAPSULE,EXTENDED RELEASE MULTIPHASE 12HR 100 MG

1.26909 06/06/2019 1.25017 03/20/2020

1.25113 08/21/2015

1.55500 10/17/2019 1.45789 05/22/2020

0.93459 11/15/2019 1.46300 11/16/2019

CARBAMAZEPINE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 100 MG/5ML

0.11631 07/18/2014 0.11631 01/01/2020

CARBAMAZEPINE ORAL TABLET 200 MG 0.32256 03/02/2020 0.17940 07/17/2020

CARBAMAZEPINE ORAL TABLET, EXTENDED RELEASE 12 HR 100 MG 0.49080 11/15/2019 0.63951 01/21/2020

Effective 8/7/2020

Current SMAC Price

CARBAMAZEPINE ORAL TABLET,CHEWABLE 100 MG 0.28300 02/24/2019 0.23768 09/20/2019

CARBAMIDE PEROXIDE OTIC DROPS 6.5 % 0.11614 08/21/2015 0.06800 08/25/2017

CARBIDOPA ORAL TABLET 25 MG 5.19620 10/19/2018 3.86500 01/25/2019

CARBIDOPA/LEVODOPA ORAL TABLET 10MG-100MG 0.09610 09/22/2017 0.06610 05/22/2020

CARBIDOPA/LEVODOPA ORAL TABLET, EXTENDED RELEASE 25MG-100MG

0.18200 08/17/2018 0.11510 10/19/2018

CARBIDOPA/LEVODOPA ORAL TABLET, EXTENDED RELEASE 50MG-200MG

0.42000 09/11/2019 0.31670 05/22/2020

CARBIDOPA/LEVODOPA ORAL TABLET,DISINTEGRATING 10MG-100MG 0.77305 01/25/2013 0.77305 08/21/2015

CARBIDOPA/LEVODOPA/ENTACAPONE ORAL TABLET 12.5-50 MG 2.13334 08/21/2015 2.13334 04/22/2016

CARBIDOPA/LEVODOPA/ENTACAPONE ORAL TABLET 18.75-75MG 2.62496 08/12/2014 2.62496 04/22/2016

CARBIDOPA/LEVODOPA/ENTACAPONE ORAL TABLET 25-100-200 1.37907 03/03/2017 0.83370 09/22/2017

CARBIDOPA/LEVODOPA/ENTACAPONE ORAL TABLET 31.25-125 2.62481 04/22/2016 1.13280 02/22/2019

CARBIDOPA/LEVODOPA/ENTACAPONE ORAL TABLET 37.5-150MG 0.84205 11/15/2019 0.62336 02/21/2020

CARBIDOPA/LEVODOPA/ENTACAPONE ORAL TABLET 50-200-200 0.83370 09/22/2017 0.54950 05/17/2019

CARBINOXAMINE MALEATE ORAL LIQUID (ML) 4 MG/5 ML 0.09112 03/15/2013 0.09112 08/21/2015

CARBINOXAMINE MALEATE ORAL TABLET 4 MG 0.49602 05/10/2013 0.49602 08/21/2015

CARBOXYMETHYLCELLULOSE SODIUM OPHTHALMIC DROPPERETTE, GEL 1 %

0.32162 03/29/2013

CARBOXYMETHYLCELLULOSE SODIUM OPHTHALMIC DROPPERETTE, SINGLE-USE DROP DISPENSER 0.5 %

0.20828 08/12/2014 0.20828 08/21/2015

CARBOXYMETHYLCELLULOSE SODIUM OPHTHALMIC DROPS 0.5 % 0.33524 08/12/2014 0.33524 08/21/2015

CARISOPRODOL ORAL TABLET 250 MG 2.31410 02/08/2013 1.93208 06/16/2017

CARISOPRODOL ORAL TABLET 350 MG 0.07909 08/21/2015 0.05359 07/14/2017

CARISOPRODOL/ASPIRIN ORAL TABLET 200-325 MG 1.52430 08/12/2014 1.52430 08/21/2015

CARISOPRODOL/ASPIRIN/CODEINE PHOSPHATE ORAL TABLET 200-325-16

1.94250 01/25/2013 1.94250 08/21/2015

CARTEOLOL HCL OPHTHALMIC DROPS 1 % 1.17210 01/25/2013

CARVEDILOL ORAL TABLET 12.5 MG 0.04968 08/21/2015 0.01920 06/16/2017

CARVEDILOL ORAL TABLET 25 MG 0.03886 08/21/2015 0.02489 11/16/2018

CASTOR OIL ORAL OIL (ML) 0.05545 01/25/2013

CEFACLOR ORAL CAPSULE 250 MG 1.39260 02/01/2013 1.39260 08/21/2015

CEFACLOR ORAL CAPSULE 500 MG 1.61040 08/12/2014 1.61040 08/21/2015

CEFACLOR ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML

0.68231 01/25/2013

1.36453 01/25/2013 1.36453 08/21/2015

2.04680 01/25/2013

CEFACLOR ORAL TABLET, EXTENDED RELEASE 12 HR 500 MG 3.48600 01/25/2013 3.48600 08/21/2015

Effective 8/7/2020

Current SMAC Price

CEFADROXIL ORAL CAPSULE 500 MG 0.16550 03/16/2018 0.12410 02/22/2019

CEFADROXIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 250 MG/5ML

0.36218 02/06/2015 0.20630 11/15/2019

CEFADROXIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 500 MG/5ML

0.50605 02/06/2015 0.24250 11/16/2018

CEFADROXIL ORAL TABLET 1 G 2.32518 01/25/2013

CEFAZOLIN SODIUM INJECTION VIAL (EA) 1 G 5.80360 09/26/2014 5.80360 08/21/2015

CEFAZOLIN SODIUM INJECTION VIAL (EA) 10 G 6.55920 09/26/2014 6.55920 08/21/2015

CEFAZOLIN SODIUM INJECTION VIAL (EA) 500 MG 1.03662 01/25/2013

CEFAZOLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 1 G

4.26300 01/25/2013

CEFAZOLIN SODIUM/DEXTROSE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 1 G/50 ML

0.20427 01/25/2013

CEFAZOLIN SODIUM/DEXTROSE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 2 G/50 ML

17.93574 01/25/2013

CEFAZOLIN SODIUM/DEXTROSE, ISO-OSMOTIC INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1 G/50 ML

0.07526 07/18/2014

CEFDINIR ORAL CAPSULE 300 MG 0.40142 08/17/2018 0.33556 11/16/2018

CEFDINIR ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML 0.12375 11/16/2018 0.11329 05/22/2020

CEFDINIR ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 250 MG/5ML 0.12749 05/17/2019 0.08000 12/20/2019

CEFDITOREN PIVOXIL ORAL TABLET 200 MG 10.31835 11/28/2014 10.31835 08/21/2015

CEFDITOREN PIVOXIL ORAL TABLET 400 MG 10.31835 11/28/2014 10.31835 08/21/2015

CEFEPIME HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 1 G/50 ML

0.55476 01/25/2013

CEFEPIME HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 2 G/50 ML

14.59910 08/12/2014

CEFEPIME HCL IN ISO-OSMOTIC DEXTROSE INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1 G/50 ML

1.09878 11/07/2014

CEFEPIME HCL IN ISO-OSMOTIC DEXTROSE INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 2 G/100 ML

0.88078 07/25/2014

CEFEPIME HCL INJECTION VIAL (EA) 1 G 4.04600 08/16/2019 3.99900 03/20/2020

CEFEPIME HCL INJECTION VIAL (EA) 2 G 3.93300 03/02/2018 6.00500 06/20/2018

CEFIXIME ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 100 MG/5ML 3.56300 05/01/2015 3.56300 08/21/2015

CEFIXIME ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 200 MG/5ML 7.12610 05/01/2015 7.12610 08/21/2015

CEFOTAXIME SODIUM INJECTION VIAL (EA) 1 G 2.12524 09/06/2013 2.12524 08/21/2015

CEFOTAXIME SODIUM INJECTION VIAL (EA) 10 G 18.35400 01/25/2013

CEFOTAXIME SODIUM INJECTION VIAL (EA) 2 G 4.12516 08/12/2014 4.12516 08/21/2015

CEFOTAXIME SODIUM INJECTION VIAL (EA) 500 MG 1.26000 10/04/2013 1.26000 08/21/2015

CEFOTETAN DISODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 1 G/50 ML

12.81880 08/12/2014

CEFOTETAN DISODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 2 G/50 ML

17.59800 01/25/2013

CEFOTETAN DISODIUM INJECTION VIAL (EA) 1 G 9.55920 01/25/2013

CEFOTETAN DISODIUM INJECTION VIAL (EA) 2 G 19.91500 01/25/2013

CEFOTETAN DISODIUM INTRAVENOUS VIAL (EA) 10 G 98.60200 01/25/2013

CEFOXITIN SODIUM INTRAVENOUS VIAL (EA) 1 G 4.45484 03/20/2015 4.45484 08/21/2015

CEFOXITIN SODIUM INTRAVENOUS VIAL (EA) 10 G 32.13068 01/25/2013

CEFOXITIN SODIUM INTRAVENOUS VIAL (EA) 2 G 7.94256 03/20/2015 7.94256 08/21/2015

Effective 8/7/2020

Current SMAC Price

CEFOXITIN SODIUM/DEXTROSE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 1 G/50 ML

0.45037 04/19/2013

CEFOXITIN SODIUM/DEXTROSE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 2 G/50 ML

0.92383 01/25/2013

CEFPODOXIME PROXETIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 100 MG/5ML

1.14772 03/29/2013

CEFPODOXIME PROXETIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 50 MG/5 ML

0.52444 08/12/2014

CEFPODOXIME PROXETIL ORAL TABLET 100 MG 4.71590 05/03/2013 3.61735 06/16/2017

CEFPODOXIME PROXETIL ORAL TABLET 200 MG 2.46500 10/19/2018 2.20000 05/22/2020

CEFPROZIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML

0.29385 08/22/2014 0.14400 02/22/2019

CEFPROZIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 250 MG/5ML

0.23730 09/22/2017 0.21875 11/16/2018

CEFPROZIL ORAL TABLET 250 MG 0.98670 08/21/2015 0.65800 06/16/2017

CEFPROZIL ORAL TABLET 500 MG 1.19535 06/16/2017 1.07200 02/21/2020

CEFTAZIDIME IN DEXTROSE 5% AND WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 1 G/50 ML

9.03846 01/25/2013

CEFTAZIDIME IN DEXTROSE 5% AND WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 2 G/50 ML

13.01154 01/25/2013

CEFTAZIDIME INJECTION VIAL (EA) 1 G 4.82560 11/08/2013 4.82560 08/21/2015

CEFTRIAXONE SODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 1 G/50 ML

0.54291 01/25/2013

CEFTRIAXONE SODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (EA) 2 G/50 ML

0.94697 01/25/2013

CEFTRIAXONE SODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1 G/50 ML

0.23839 07/18/2014

CEFTRIAXONE SODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 2 G/50 ML

0.56464 04/04/2014

CEFTRIAXONE SODIUM INJECTION VIAL (EA) 1 G 1.40413 03/02/2018 0.92998 08/16/2019

CEFTRIAXONE SODIUM INJECTION VIAL (EA) 250 MG 0.63100 08/17/2018 0.12600 05/17/2019

CEFTRIAXONE SODIUM INJECTION VIAL (EA) 500 MG 1.32048 08/21/2015 0.85100 08/25/2017

CEFTRIAXONE SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 1 G

3.51120 02/15/2013

CEFTRIAXONE SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 2 G

6.39660 01/25/2013

CEFUROXIME AXETIL ORAL TABLET 250 MG 0.34339 08/16/2019 0.26250 05/22/2020

CEFUROXIME AXETIL ORAL TABLET 500 MG 0.42400 01/24/2020 0.38067 06/19/2020

CEFUROXIME SODIUM INJECTION VIAL (EA) 1.5 G 4.35422 08/12/2014 4.35422 08/21/2015

CEFUROXIME SODIUM INJECTION VIAL (EA) 750 MG 2.72428 11/14/2014 2.72428 08/21/2015

CEFUROXIME SODIUM INTRAVENOUS VIAL (EA) 1.5 G 4.35422 08/12/2014 4.35422 08/21/2015

CEFUROXIME SODIUM INTRAVENOUS VIAL (EA) 7.5 G 17.79645 08/12/2014 17.79645 08/21/2015

CELECOXIB ORAL CAPSULE 100 MG 0.15240 11/16/2018 0.12000 01/25/2019

Effective 8/7/2020

Current SMAC Price

CEPHALEXIN ORAL CAPSULE 250 MG 0.07390 09/22/2017 0.06050 03/16/2018

CEPHALEXIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML

0.14563 08/21/2015 0.09450 11/24/2017

CEPHALEXIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 250 MG/5ML

0.09433 11/16/2018 0.08460 10/25/2019

CEPHALEXIN ORAL TABLET 250 MG 0.40092 01/25/2013

CEPHALEXIN ORAL TABLET 500 MG 0.80132 01/25/2013

CETIRIZINE HCL ORAL SOLUTION, ORAL 1 MG/ML 0.03306 08/21/2015 0.01500 12/21/2018

CETIRIZINE HCL ORAL SOLUTION, ORAL 5 MG/5 ML 0.03306 07/07/2017

CETIRIZINE HCL ORAL TABLET 10 MG 0.04666 09/22/2017 0.03192 11/15/2019

CETIRIZINE HCL ORAL TABLET 5 MG 0.07567 08/21/2015 0.02870 11/15/2019

CETIRIZINE HCL ORAL TABLET,CHEWABLE 10 MG 1.66170 06/06/2014 1.66170 08/21/2015

CETIRIZINE HCL ORAL TABLET,CHEWABLE 5 MG 2.74179 08/21/2015 1.66166 01/25/2019

CETIRIZINE HCL/PSEUDOEPHEDRINE HCL ORAL TABLET, EXTENDED RELEASE 12 HR 5 MG-120MG

0.50458 01/25/2019 0.65776 03/05/2019

CEVIMELINE HCL ORAL CAPSULE 30 MG 0.98965 12/10/2019 0.90460 03/20/2020

CHLORAMPHENICOL SOD SUCCINATE INTRAVENOUS VIAL (EA) 1 G 2.64689 01/25/2013

CHLORDIAZEPOXIDE HCL ORAL CAPSULE 10 MG 0.08863 08/21/2015 0.05930 12/22/2017

CHLORDIAZEPOXIDE/CLIDINIUM BROMIDE ORAL CAPSULE 5 MG-2.5MG 0.27604 02/27/2015 0.27604 08/21/2015

CHLORHEXIDINE GLUCONATE MUCOUS MEMBRANE MOUTHWASH 0.12 %

0.00598 03/13/2015 0.00598 08/21/2015

CHLOROQUINE PHOSPHATE ORAL TABLET 250 MG 0.86970 03/01/2013 0.86970 08/21/2015

CHLOROQUINE PHOSPHATE ORAL TABLET 500 MG 3.44058 08/12/2014 3.44058 08/21/2015

CHLOROTHIAZIDE ORAL TABLET 250 MG 0.15141 12/13/2013 0.15141 08/21/2015

CHLOROTHIAZIDE SODIUM INTRAVENOUS VIAL (EA) 500 MG 98.11300 04/17/2015 98.11300 08/21/2015

CHLORPHENIRAMINE MALEATE ORAL SYRUP 2 MG/5 ML 0.01798 01/25/2013 0.01798 08/21/2015

CHLORPHENIRAMINE MALEATE ORAL TABLET 4 MG 0.00634 02/06/2015 0.00634 08/21/2015

CHLORPHENIRAMINE MALEATE ORAL TABLET, EXTENDED RELEASE 12 MG

0.34709 08/21/2015

CHLORPHENIRAMINE MALEATE/PHENYLEPHRINE HCL ORAL LIQUID (ML) 4-10MG/5ML

0.02660 08/12/2014

CHLORPHENIRAMINE MALEATE/PHENYLEPHRINE HCL/DEXTROMETHORPHAN ORAL LIQUID (ML) 2-5-15MG/5

0.06860 08/12/2014 0.06860 08/21/2015

CHLORPHENIRAMINE MALEATE/PHENYLEPHRINE HCL/DEXTROMETHORPHAN ORAL LIQUID (ML) 4-10-15/5

0.04500 08/12/2014

CHLORPHENIRAMINE MALEATE/PSEUDOEPHEDRINE HCL ORAL TABLET 4 MG-60 MG

0.05310 08/12/2014

CHLORPHENIRAMINE MALEATE/PSEUDOEPHEDRINE/DEXTROMETHORPHAN ORAL LIQUID (ML) 1-15-5MG/5

0.01868 01/25/2013 0.01868 08/21/2015

CHLORPROMAZINE HCL INJECTION AMPUL (ML) 25 MG/ML 18.81600 11/08/2013

CHLORPROMAZINE HCL ORAL TABLET 10 MG 2.65000 01/22/2016 1.55000 05/22/2020

Effective 8/7/2020

Current SMAC Price

CHLORPROPAMIDE TABLET 100 MG 0.84154 06/27/2014 0.84154 08/21/2015

CHLORPROPAMIDE TABLET 250 MG 0.85230 08/12/2014

CHLORTHALIDONE ORAL TABLET 25 MG 0.32970 01/24/2020 0.21557 05/22/2020

CHLORTHALIDONE ORAL TABLET 50 MG 0.59540 01/25/2019 0.35950 08/16/2019

CHLORZOXAZONE ORAL TABLET 500 MG 0.23400 04/10/2015 0.23400 08/21/2015

CHOLECALCIFEROL (VIT D3)/FOLIC ACID ORAL CAPSULE 3775 UNIT 15.16153 05/01/2015

CHOLECALCIFEROL (VITAMIN D3) ORAL CAPSULE 10 MCG 0.03240 05/01/2015 0.03240 08/21/2015

CHOLECALCIFEROL (VITAMIN D3) ORAL CAPSULE 100 MCG 0.06993 02/08/2013

CHOLECALCIFEROL (VITAMIN D3) ORAL CAPSULE 1250 MCG 0.14700 09/26/2014

CHOLECALCIFEROL (VITAMIN D3) ORAL CAPSULE 250 MCG 0.64783 12/26/2014 0.64783 08/21/2015

CHOLECALCIFEROL (VITAMIN D3) ORAL DROPS 125 MCG/ML 0.07303 08/12/2014

CHOLECALCIFEROL (VITAMIN D3) ORAL LIQUID (ML) 10MCG/5ML 0.02914 01/25/2013

CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET 10 MCG 0.01786 04/17/2015 0.01786 08/21/2015

CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET 75 MCG 0.05516 01/25/2013

CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET,CHEWABLE 10 MCG 0.02509 01/25/2013 0.02509 08/21/2015

CHOLECALCIFEROL (VITAMIN D3) ORAL TABLET,CHEWABLE 25 MCG 0.06098 08/12/2014 0.06098 08/21/2015

CHOLECALCIFEROL (VITAMIN D3) SUBLINGUAL SPRAY, SUSPENSION (ML) 25MCG/SPRY

0.30847 01/25/2013

CHOLESTYRAMINE (WITH SUGAR) ORAL POWDER (GRAM) 4 G 0.17550 07/26/2019 0.14794 10/25/2019

CHOLESTYRAMINE (WITH SUGAR) ORAL POWDER IN PACKET (EA) 4 G 1.33367 08/25/2017 1.21063 02/21/2020

CHOLESTYRAMINE/ASPARTAME ORAL POWDER (GRAM) 4 G 0.23748 04/22/2019 0.19459 06/19/2020

CHOLESTYRAMINE/ASPARTAME ORAL POWDER IN PACKET (EA) 4 G 1.58483 02/22/2019 1.30321 11/15/2019

CHOLINE SALICYLATE/MAGNESIUM SALICYLATE ORAL LIQUID (ML) 500 MG/5ML

0.12848 01/25/2013

CHORIONIC GONADOTROPIN, HUMAN INTRAMUSCULAR VIAL (EA) 10000 UNIT

184.04000 07/12/2013

CICLOPIROX OLAMINE TOPICAL CREAM (GRAM) 0.77 % 0.14964 08/12/2014 0.10611 01/24/2020

CICLOPIROX OLAMINE TOPICAL SUSPENSION, TOPICAL (ML) 0.77 % 0.37748 01/25/2013

CICLOPIROX TOPICAL GEL (GRAM) 0.77 % 1.12739 06/16/2017 0.89877 11/15/2019

CICLOPIROX TOPICAL SHAMPOO 1 % 0.39030 05/25/2018 0.24717 11/15/2019

CICLOPIROX TOPICAL SOLUTION, NON-ORAL 8 % 1.49242 04/26/2019 1.45000 05/22/2020

CICLOPIROX/UREA/CAMPHOR/MENTHOL/EUCALYPTOL TOPICAL SOLUTION, NON-ORAL 8 %

266.99400 01/25/2013

CIDOFOVIR INTRAVENOUS VIAL (ML) 75 MG/ML 118.10400 08/12/2014

CILOSTAZOL ORAL TABLET 100 MG 0.11183 03/02/2018 0.08000 02/22/2019

CILOSTAZOL ORAL TABLET 50 MG 0.10087 11/16/2018 0.08083 04/17/2020

CIMETIDINE HCL ORAL SOLUTION, ORAL 300 MG/5ML 0.06283 05/17/2013 0.06283 08/21/2015

Effective 8/7/2020

Current SMAC Price

CIMETIDINE ORAL TABLET 200 MG 0.23684 08/21/2015 0.19530 06/19/2020

CINACALCET HCL ORAL TABLET 30 MG 5.76000 02/21/2020

CIPROFLOXACIN HCL OPHTHALMIC DROPS 0.3 % 0.56000 10/19/2018 2.30160 06/06/2019

CIPROFLOXACIN HCL ORAL TABLET 100 MG 10.65167 09/26/2014

CIPROFLOXACIN HCL ORAL TABLET 250 MG 0.10750 07/14/2017 0.09120 08/17/2018

CIPROFLOXACIN HCL OTIC DROPPERETTE, SINGLE-USE DROP DISPENSER 0.2 %

12.61951 08/01/2014

CIPROFLOXACIN LACTATE VIAL (ML) 200MG/20ML 0.08890 01/25/2013

CIPROFLOXACIN LACTATE VIAL (ML) 400MG/40ML 0.06320 08/12/2014

CIPROFLOXACIN LACTATE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 200MG/0.1L

0.01697 01/25/2013 0.01697 08/21/2015

CIPROFLOXACIN LACTATE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 400MG/0.2L

0.01204 03/01/2013

CIPROFLOXACIN ORAL SUSPENSION, MICROCAPSULE RECONSTITUTED 250 MG/5ML

0.85323 08/22/2014

CIPROFLOXACIN ORAL SUSPENSION, MICROCAPSULE RECONSTITUTED 500 MG/5ML

0.99890 08/22/2014

CIPROFLOXACIN/CIPROFLOXACIN HCL TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 1000 MG

7.79233 01/25/2013 7.79233 08/21/2015

CIPROFLOXACIN/CIPROFLOXACIN HCL TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 500 MG

6.85916 01/25/2013 6.85916 08/21/2015

CISATRACURIUM BESYLATE INTRAVENOUS VIAL (ML) 10 MG/ML 11.95425 01/16/2015 11.95425 08/21/2015

CISATRACURIUM BESYLATE INTRAVENOUS VIAL (ML) 2 MG/ML 2.36880 08/12/2014 2.36880 08/21/2015

CITALOPRAM HYDROBROMIDE ORAL SOLUTION, ORAL 10 MG/5 ML 0.24500 01/25/2019 0.20829 07/17/2020

CITALOPRAM HYDROBROMIDE ORAL TABLET 10 MG 0.02661 05/01/2015 0.02661 08/21/2015

CITRATE PHOSPHATE DEXTROS SOLN MISCELLANEOUS SOLUTION, NON-ORAL 2.63 G/100

0.08318 01/25/2013

CITRIC ACID/SODIUM CITRATE ORAL SOLUTION, ORAL 334-500MG 0.02013 11/14/2014 0.02013 08/21/2015

CLARITHROMYCIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 125 MG/5ML

0.36569 05/17/2013

CLARITHROMYCIN ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 250 MG/5ML

1.14740 12/11/2017 1.22798 04/16/2018

CLARITHROMYCIN ORAL TABLET 250 MG 2.64794 08/21/2015 0.34333 06/16/2017

CLARITHROMYCIN ORAL TABLET 500 MG 0.45686 03/03/2017 0.40642 05/22/2020

CLARITHROMYCIN ORAL TABLET, EXTENDED RELEASE 24 HR 500 MG 3.50443 08/21/2015 3.18447 06/16/2017

CLINDAMYCIN HCL ORAL CAPSULE 150 MG 0.08641 08/21/2015 0.07460 09/21/2018

CLINDAMYCIN HCL ORAL CAPSULE 300 MG 0.25661 08/21/2015 0.19938 03/03/2017

CLINDAMYCIN HCL ORAL CAPSULE 75 MG 0.41720 01/25/2013

Effective 8/7/2020

Current SMAC Price

CLINDAMYCIN PALMITATE HCL ORAL SOLUTION, RECONSTITUTED, ORAL 75 MG/5 ML

0.19640 09/22/2017 0.23180 02/15/2018

CLINDAMYCIN PHOSPHATE INJECTION VIAL (ML) 150 MG/ML 0.35600 08/12/2014

CLINDAMYCIN PHOSPHATE TOPICAL FOAM (GRAM) 1 % 3.71476 08/21/2015 3.56290 11/15/2019

CLINDAMYCIN PHOSPHATE TOPICAL GEL (GRAM) 1 % 0.87733 05/22/2020 0.86167 07/17/2020

CLINDAMYCIN PHOSPHATE TOPICAL LOTION (ML) 1 % 1.00375 03/20/2020 0.89300 05/22/2020

CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION, NON-ORAL 1 % 0.31316 06/16/2017 0.20259 02/22/2019

CLINDAMYCIN PHOSPHATE TOPICAL SWAB, MEDICATED 1 % 0.32269 03/19/2019 0.29097 11/15/2019

CLINDAMYCIN PHOSPHATE VAGINAL CREAM WITH APPLICATOR 2 % 1.37550 08/16/2019 1.71925 08/23/2019

CLINDAMYCIN PHOSPHATE VIAL WITH THREADED PORT (ML) 300 MG/2ML

2.99418 01/25/2013

CLINDAMYCIN PHOSPHATE VIAL WITH THREADED PORT (ML) 600 MG/4ML

1.60881 01/25/2013

CLINDAMYCIN PHOSPHATE VIAL WITH THREADED PORT (ML) 900MG/6ML

1.51899 01/25/2013

CLINDAMYCIN PHOSPHATE/BENZOYL PEROXIDE TOPICAL GEL (GRAM) 1 %-5 %

2.44740 02/22/2019 1.52390 03/20/2020

CLINDAMYCIN PHOSPHATE/BENZOYL PEROXIDE TOPICAL GEL (GRAM) 1.2(1)%-5%

3.16462 08/12/2014 1.13000 08/16/2019

CLINDAMYCIN PHOSPHATE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 300MG/50ML

0.11749 08/12/2014

0.16505 11/07/2014 0.16505 08/21/2015

0.21492 10/24/2014 0.21492 08/21/2015

CLOBAZAM ORAL TABLET 20 MG 0.80000 04/17/2020

CLOBETASOL PROPIONATE TOPICAL CREAM (GRAM) 0.05 % 0.89179 02/13/2020 0.63767 05/22/2020

CLOBETASOL PROPIONATE TOPICAL FOAM (GRAM) 0.05 % 1.24600 03/20/2020 1.03090 05/22/2020

CLOBETASOL PROPIONATE TOPICAL GEL (GRAM) 0.05 % 2.30000 05/25/2018 1.25150 08/16/2019

CLOBETASOL PROPIONATE TOPICAL LOTION (ML) 0.05 % 1.57000 12/21/2018 0.67797 11/15/2019

CLOBETASOL PROPIONATE TOPICAL OINTMENT (GRAM) 0.05 % 0.39284 01/24/2020 0.20242 06/19/2020

CLOBETASOL PROPIONATE TOPICAL SHAMPOO 0.05 % 1.53000 05/26/2018 1.47407 11/15/2019

CLOBETASOL PROPIONATE TOPICAL SOLUTION, NON-ORAL 0.05 % 0.63510 10/25/2019 0.51260 06/19/2020

CLOBETASOL PROPIONATE TOPICAL SPRAY, NON-AEROSOL (ML) 0.05 % 4.33264 03/06/2015

CLOBETASOL PROPIONATE/EMOLLIENT BASE TOPICAL CREAM (GRAM) 0.05 %

1.20000 12/20/2019 0.66483 03/20/2020

CLOBETASOL PROPIONATE/EMOLLIENT BASE TOPICAL FOAM (GRAM) 0.05 %

3.64100 08/12/2014 3.64100 08/21/2015

CLOCORTOLONE PIVALATE TOPICAL CREAM (GRAM) 0.1 % 5.01620 03/07/2014

CLOMIPHENE CITRATE ORAL TABLET 50 MG 1.01394 08/21/2015 0.58467 09/22/2017

CLOMIPRAMINE HCL ORAL CAPSULE 25 MG 3.50000 02/22/2019 2.85000 02/21/2020

CLONAZEPAM ORAL TABLET 0.5 MG 0.01635 12/12/2014 0.01635 08/21/2015

CLONAZEPAM ORAL TABLET 1 MG 0.02613 02/06/2015 0.02613 08/21/2015

CLONAZEPAM ORAL TABLET 2 MG 0.04039 08/21/2015 0.02645 11/16/2018

CLONAZEPAM ORAL TABLET,DISINTEGRATING 0.125 MG 0.72847 09/19/2014 0.70200 11/15/2019

Effective 8/7/2020

Current SMAC Price

CLONAZEPAM ORAL TABLET,DISINTEGRATING 1 MG 0.58810 03/16/2018 0.74870 03/18/2020

CLONAZEPAM ORAL TABLET,DISINTEGRATING 2 MG 1.09330 01/25/2013

CLONIDINE HCL ORAL TABLET 0.1 MG 0.02704 08/21/2015 0.01272 09/21/2018

CLONIDINE HCL ORAL TABLET, EXTENDED RELEASE 12 HR 0.1 MG 0.88817 07/26/2019 0.69150 05/22/2020

CLONIDINE HCL/PF EPIDURAL VIAL (ML) 1000MCG/10 2.29944 08/12/2014

CLONIDINE HCL/PF EPIDURAL VIAL (ML) 5000MCG/10 10.09700 08/12/2014 10.09700 08/21/2015

CLONIDINE TRANSDERMAL PATCH, TRANSDERMAL WEEKLY 0.1MG/24HR

8.79250 11/15/2019 4.99750 05/22/2020

14.26950 11/15/2019 12.69000 12/20/2019

21.24500 11/15/2019 18.23000 12/20/2019

CLOPIDOGREL BISULFATE ORAL TABLET 300 MG 14.71960 04/17/2015 14.71960 08/21/2015

CLOPIDOGREL BISULFATE ORAL TABLET 75 MG 0.05800 06/16/2017 0.05198 10/25/2019

CLORAZEPATE DIPOTASSIUM ORAL TABLET 15 MG 0.26100 08/21/2015 2.39650 09/19/2016

CLORAZEPATE DIPOTASSIUM ORAL TABLET 3.75 MG 0.19698 08/15/2014 0.19698 08/21/2015

CLORAZEPATE DIPOTASSIUM ORAL TABLET 7.5 MG 0.30128 08/01/2014 0.30128 08/21/2015

CLOTRIMAZOLE MUCOUS MEMBRANE TROCHE 10 MG 0.97392 03/27/2015

CLOTRIMAZOLE TOPICAL CREAM (GRAM) 1 % 0.10907 08/21/2015 0.07533 06/19/2020

CLOTRIMAZOLE TOPICAL SOLUTION, NON-ORAL 1 % 0.32656 01/25/2013

CLOTRIMAZOLE VAGINAL CREAM WITH APPLICATOR 1 % 0.07865 03/01/2013 0.07865 08/21/2015

CLOTRIMAZOLE VAGINAL CREAM WITH APPLICATOR 2 % 0.32760 08/12/2014 0.32760 08/21/2015

CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE TOPICAL CREAM (GRAM) 1 %-0.05 %

0.20951 02/22/2019 0.19625 05/22/2020

CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE TOPICAL LOTION (ML) 1 %-0.05 %

3.46640 05/31/2013

CLOZAPINE ORAL TABLET 100 MG 0.32882 03/03/2020 0.27600 07/17/2020

CLOZAPINE ORAL TABLET,DISINTEGRATING 100 MG 4.61480 08/17/2018 4.51730 08/16/2019

CLOZAPINE ORAL TABLET,DISINTEGRATING 12.5 MG 1.55925 01/25/2013

CLOZAPINE ORAL TABLET,DISINTEGRATING 25 MG 2.09823 01/25/2013

COAL TAR TOPICAL SHAMPOO 1 % 0.03020 08/12/2014

COCAINE HCL SOLUTION, NON-ORAL 4 % 15.19980 01/25/2013

CODEINE PHOSPHATE/BUTALBITAL/ASPIRIN/CAFFEINE ORAL CAPSULE 30-50-325

1.89262 08/21/2015 1.23660 09/22/2017

CODEINE PHOSPHATE/GUAIFENESIN ORAL LIQUID (ML) 10-100MG/5 0.05079 08/21/2015 0.02594 08/25/2017

CODEINE PHOSPHATE/GUAIFENESIN ORAL LIQUID (ML) 6.3-100/5 0.03518 08/12/2014

CODEINE PHOSPHATE/GUAIFENESIN ORAL LIQUID (ML) 7.5-225/5 0.04970 08/12/2014

CODEINE SULFATE ORAL TABLET 15 MG 0.36736 03/01/2013

Effective 8/7/2020

Current SMAC Price

CODEINE SULFATE ORAL TABLET 30 MG 0.44059 09/19/2014 0.44059 08/21/2015

CODEINE SULFATE ORAL TABLET 60 MG 0.79681 09/19/2014 0.79681 08/21/2015

COLCHICINE ORAL CAPSULE 0.6 MG 4.16383 05/17/2019 3.83870 07/26/2019

COLCHICINE ORAL TABLET 0.6 MG 5.02150 03/20/2020 4.29990 06/19/2020

COLESTIPOL HCL ORAL GRANULES (GRAM) 5 G 0.20871 01/25/2013

COLESTIPOL HCL ORAL PACKET (EA) 5 G 2.75100 01/16/2015

COLESTIPOL HCL ORAL TABLET 1 G 0.66658 02/25/2020 0.57208 05/22/2020

COLISTIN (AS COLISTIMETHATE SODIUM) INJECTION VIAL (EA) 150 MG 26.57000 06/24/2019 22.52000 10/25/2019

CORTISONE ACETATE ORAL TABLET 25 MG 3.04785 02/20/2015 3.04785 08/21/2015

COSYNTROPIN INJECTION VIAL (EA) 0.25 MG 64.39973 04/19/2013 64.39973 08/21/2015

COSYNTROPIN VIAL (ML) 0.25 MG/ML 151.55280 01/25/2013

CROMOLYN SODIUM INHALATION AMPUL FOR NEBULIZATION (ML) 20 MG/2 ML

1.16380 10/03/2014

CROMOLYN SODIUM NASAL AEROSOL, SPRAY WITH PUMP (ML) 5.2 MG 0.33554 01/25/2013 0.33554 08/21/2015

CROMOLYN SODIUM OPHTHALMIC DROPS 4 % 0.67817 08/21/2015 0.46600 09/30/2016

CROMOLYN SODIUM ORAL CONCENTRATE, ORAL 20 MG/ML 0.87906 08/21/2015 0.25000 03/15/2019

CUPRIC CHLORIDE INTRAVENOUS VIAL (ML) 0.4 MG/ML 0.15460 08/12/2014

CYANOCOBALAMIN (VITAMIN B-12) ORAL TABLET 100 MCG 0.01365 02/13/2015 0.01365 08/21/2015

CYANOCOBALAMIN (VITAMIN B-12) ORAL TABLET 500 MCG 0.02101 02/13/2015 0.02101 08/21/2015

CYANOCOBALAMIN (VITAMIN B-12) ORAL TABLET, EXTENDED RELEASE 1000 MCG

0.03872 08/12/2014 0.03872 08/21/2015

CYANOCOBALAMIN (VITAMIN B-12) SUBLINGUAL TABLET, SUBLINGUAL 1000 MCG

0.05332 08/12/2014 0.05332 08/21/2015

CYANOCOBALAMIN (VITAMIN B-12) SUBLINGUAL TABLET, SUBLINGUAL 5000 MCG

0.10737 03/08/2013

CYANOCOBALAMIN/FOLIC ACID ORAL TABLET 0.5 MG-1MG 0.12600 01/25/2013

CYANOCOBALAMIN/FOLIC ACID/PYRIDOXINE ORAL TABLET 2-2.5-25MG 0.43177 03/20/2015 0.43177 08/21/2015

CYANOCOBALAMIN/LEVOMEFOLATE CALCIUM/PYRIDOXINE HCL (B6) ORAL TABLET 2-1.13-25

0.89950 07/18/2014

CYANOCOBALAMIN/LEVOMEFOLATE CALCIUM/PYRIDOXINE/RIBOFLAVIN ORAL TABLET 1-6-50-5MG

2.02075 02/20/2015 2.02075 08/21/2015

CYCLOBENZAPRINE HCL ORAL TABLET 10 MG 0.02680 08/21/2015 0.01476 11/16/2018

CYCLOBENZAPRINE HCL ORAL TABLET 5 MG 0.03457 10/20/2017 0.02130 01/24/2020

CYCLOBENZAPRINE HCL ORAL TABLET 7.5 MG 3.36504 08/21/2015 1.79990 05/17/2019

CYCLOPENTOLATE HCL OPHTHALMIC DROPS 1 % 1.65266 05/10/2013 1.65266 08/21/2015

CYCLOPENTOLATE HCL OPHTHALMIC DROPS 2 % 3.33840 02/08/2013

CYCLOPHOSPHAMIDE INTRAVENOUS VIAL (EA) 1 G 432.93460 12/12/2014

CYCLOPHOSPHAMIDE INTRAVENOUS VIAL (EA) 2 G 1063.88300 12/12/2014 1063.88300 08/21/2015

CYCLOPHOSPHAMIDE INTRAVENOUS VIAL (EA) 500 MG 266.22500 12/12/2014 266.22500 08/21/2015

CYCLOPHOSPHAMIDE ORAL CAPSULE 25 MG 8.29164 09/05/2014 5.41000 09/21/2018

CYCLOSPORINE ORAL CAPSULE 100 MG 5.25882 05/23/2014 8.83300 07/08/2020

CYCLOSPORINE ORAL CAPSULE 25 MG 3.39817 09/27/2018 1.82000 01/25/2019

CYCLOSPORINE, MODIFIED ORAL CAPSULE 100 MG 2.20106 02/27/2015 1.21667 03/03/2017

CYCLOSPORINE, MODIFIED ORAL CAPSULE 25 MG 0.51042 05/20/2016 0.23923 03/03/2017

CYCLOSPORINE, MODIFIED ORAL CAPSULE 50 MG 1.20163 07/25/2014

Effective 8/7/2020

Current SMAC Price

CYCLOSPORINE, MODIFIED ORAL SOLUTION, ORAL 100 MG/ML 2.00000 09/22/2017 1.76740 02/22/2019

CYPROHEPTADINE HCL ORAL SYRUP 2 MG/5 ML 0.08798 02/27/2015 0.06816 03/02/2018

CYPROHEPTADINE HCL ORAL TABLET 4 MG 0.23460 08/16/2019 0.14405 11/15/2019

CYTARABINE INJECTION VIAL (ML) 20 MG/ML 0.40080 08/12/2014 0.40080 08/21/2015

CYTARABINE/PF INJECTION VIAL (ML) 100 MG/5ML 1.97106 01/25/2013 1.97106 08/21/2015

CYTARABINE/PF INJECTION VIAL (ML) 2 G/20 ML 0.82997 08/12/2014 0.82997 08/21/2015

CYTARABINE/PF INJECTION VIAL (ML) 20 MG/ML 0.76440 01/16/2015 0.76440 08/21/2015

DACARBAZINE INTRAVENOUS VIAL (EA) 100 MG 7.93800 01/25/2013

DANAZOL ORAL CAPSULE 100 MG 3.38527 02/13/2015

DANAZOL ORAL CAPSULE 200 MG 4.80198 03/20/2015 4.80198 08/21/2015

DANAZOL ORAL CAPSULE 50 MG 2.25628 02/13/2015

DANTROLENE SODIUM INTRAVENOUS VIAL (EA) 20 MG 68.04000 01/25/2013

DANTROLENE SODIUM ORAL CAPSULE 100 MG 1.51750 02/08/2013 0.82590 03/20/2020

DAPSONE ORAL TABLET 100 MG 1.25033 01/25/2019 1.17600 03/20/2020

DARIFENACIN HYDROBROMIDE ORAL TABLET, EXTENDED RELEASE 24 HR 7.5 MG

2.60744 11/15/2019 2.41867 02/21/2020

DAUNORUBICIN HCL INTRAVENOUS VIAL (ML) 5 MG/ML 18.76077 08/12/2014 18.76077 08/21/2015

DECITABINE INTRAVENOUS VIAL (EA) 50 MG 1375.39150 12/12/2014 1375.39150 08/21/2015

DEFEROXAMINE MESYLATE INJECTION VIAL (EA) 2 G 26.33481 01/25/2013 26.33481 08/21/2015

DEMECLOCYCLINE HCL ORAL TABLET 150 MG 2.95730 03/16/2018 2.71000 11/16/2018

DEMECLOCYCLINE HCL ORAL TABLET 300 MG 7.13944 02/27/2015 7.13944 08/21/2015

DESIPRAMINE HCL ORAL TABLET 10 MG 0.71980 05/17/2019 0.57533 11/15/2019

DESIPRAMINE HCL ORAL TABLET 150 MG 4.38839 08/12/2014

DESLORATADINE ORAL TABLET 5 MG 0.33544 11/24/2017 0.25470 10/25/2019

DESLORATADINE ORAL TABLET,DISINTEGRATING 2.5 MG 10.07649 01/24/2014 10.07649 08/21/2015

DESLORATADINE ORAL TABLET,DISINTEGRATING 5 MG 4.07750 01/25/2013 4.07750 08/21/2015

DESMOPRESSIN ACETATE (NON-REFRIGERATED) NASAL AEROSOL, SPRAY WITH PUMP (ML) 10/SPRAY

14.44800 04/26/2019 13.10000 02/21/2020

DESMOPRESSIN ACETATE INJECTION AMPUL (ML) 4 MCG/ML 16.22800 08/30/2013

DESMOPRESSIN ACETATE INJECTION VIAL (ML) 4 MCG/ML 8.62810 05/16/2014

DESMOPRESSIN ACETATE NASAL AEROSOL, SPRAY WITH PUMP (ML) 10/SPRAY

28.62300 02/06/2015

DESMOPRESSIN ACETATE NASAL SOLUTION, NON-ORAL 0.1 MG/ML 25.31760 03/08/2013

DESMOPRESSIN ACETATE ORAL TABLET 0.1 MG 0.41720 11/15/2019 0.23400 06/19/2020

DESMOPRESSIN ACETATE ORAL TABLET 0.2 MG 0.50930 10/25/2019 0.44210 03/20/2020

DESOGESTREL-ETHINYL ESTRADIOL ORAL TABLET 0.15-0.03 0.21696 03/02/2018 0.10127 03/20/2020

DESOGESTREL-ETHINYL ESTRADIOL ORAL TABLET 7 DAYS X 3 0.81931 08/21/2015 0.52119 06/16/2017

Effective 8/7/2020

Current SMAC Price

DESOGESTREL-ETHINYL ESTRADIOL/ETHINYL ESTRADIOL ORAL TABLET 21-5 (28)

0.46310 03/03/2017 0.37988 03/02/2018

DESONIDE TOPICAL CREAM (GRAM) 0.05 % 1.15112 06/21/2019 0.91650 03/20/2020

DESONIDE TOPICAL LOTION (ML) 0.05 % 1.83560 12/05/2014 1.66017 11/15/2019

DESONIDE TOPICAL OINTMENT (GRAM) 0.05 % 1.28900 08/16/2019 0.70000 10/25/2019

DESOXIMETASONE TOPICAL CREAM (GRAM) 0.05 % 3.19548 02/07/2014

DESOXIMETASONE TOPICAL CREAM (GRAM) 0.25 % 0.73085 06/16/2017 0.57933 03/20/2020

DESOXIMETASONE TOPICAL GEL (GRAM) 0.05 % 2.73169 01/25/2013

DESOXIMETASONE TOPICAL OINTMENT (GRAM) 0.05 % 5.41981 02/07/2014 5.41981 08/21/2015

DESOXIMETASONE TOPICAL OINTMENT (GRAM) 0.25 % 3.72602 06/16/2017 0.79000 12/20/2019

DESVENLAFAXINE FUMARATE TABLET, EXTENDED RELEASE 24 HR 100 MG

4.64370 04/04/2014

DESVENLAFAXINE FUMARATE TABLET, EXTENDED RELEASE 24 HR 50 MG

4.64370 04/04/2014

DESVENLAFAXINE SUCCINATE ORAL TABLET, EXTENDED RELEASE 24 HR 100 MG

0.50550 11/15/2019 0.77253 02/06/2020

0.82000 04/27/2018 0.76900 08/16/2019

0.75488 01/25/2019 0.71833 05/17/2019

DEXAMETHASONE ORAL ELIXIR 0.5 MG/5ML 0.14107 04/21/2017 0.06692 09/22/2017

DEXAMETHASONE ORAL SOLUTION, ORAL 0.5 MG/5ML 0.03446 08/22/2014

DEXAMETHASONE ORAL TABLET 1.5 MG 0.09841 02/07/2014 0.09841 08/21/2015

DEXAMETHASONE ORAL TABLET 4 MG 0.34200 04/06/2018 0.93000 05/28/2019

DEXAMETHASONE SODIUM PHOSPHATE INJECTION VIAL (ML) 10 MG/ML 0.80490 08/12/2014 0.80490 08/21/2015

DEXAMETHASONE SODIUM PHOSPHATE INJECTION VIAL (ML) 4 MG/ML 0.28517 08/12/2014 0.28517 08/21/2015

DEXAMETHASONE SODIUM PHOSPHATE OPHTHALMIC DROPS 0.1 % 3.31265 08/21/2015 9.46200 04/16/2018

DEXAMETHASONE SODIUM PHOSPHATE/PF INJECTION VIAL (ML) 10 MG/ML

6.35376 01/25/2013

DEXCHLORPHENIRAMINE MALEATE/PSEUDOEPHEDRINE/CHLOPHEDIANOL ORAL LIQUID (ML) 1-30-12.5

0.08050 08/12/2014

DEXMETHYLPHENIDATE HCL ORAL CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 10 MG

6.50059 03/27/2015 5.84742 12/02/2016

DEXMETHYLPHENIDATE HCL ORAL CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 5 MG

5.46315 03/27/2015

DEXMETHYLPHENIDATE HCL ORAL TABLET 10 MG 0.41200 08/16/2019 0.39990 10/25/2019

DEXMETHYLPHENIDATE HCL ORAL TABLET 2.5 MG 0.47427 12/02/2016 0.19260 09/22/2017

DEXMETHYLPHENIDATE HCL ORAL TABLET 5 MG 0.31590 11/15/2019 0.20000 01/24/2020

DEXRAZOXANE HCL INTRAVENOUS VIAL (EA) 250 MG 165.25050 01/16/2015

DEXRAZOXANE HCL INTRAVENOUS VIAL (EA) 500 MG 286.43625 01/16/2015

DEXTROAMPHETAMINE SULF-SACCHARATE/AMPHETAMINE SULF-ASPARTATE ORAL CAPSULE, EXT RELEASE 24 HR 10 MG

1.42000 01/23/2020 1.60104 07/09/2020

1.80000 01/22/2020 1.69990 05/22/2020

1.38000 05/22/2020 0.70200 07/17/2020

1.89020 11/15/2019 1.89020 01/22/2020

Effective 8/7/2020

Current SMAC Price

1.51574 11/15/2019 1.51574 01/22/2020

3.82332 01/22/2020 2.02485 03/20/2020

DEXTROAMPHETAMINE SULF-SACCHARATE/AMPHETAMINE SULF-ASPARTATE ORAL TABLET 10 MG

0.42600 06/25/2019 0.33058 11/15/2019

DEXTROAMPHETAMINE SULF-SACCHARATE/AMPHETAMINE SULF-ASPARTATE ORAL TABLET 12.5 MG

0.23110 09/22/2017 0.52690 01/08/2018

0.50545 03/16/2019 0.37100 09/20/2019

0.56320 03/08/2019 0.37150 09/20/2019

0.21010 03/20/2020 0.36280 05/16/2020

0.40500 06/22/2018 0.25450 11/16/2018

DEXTROAMPHETAMINE SULF-SACCHARATE/AMPHETAMINE SULF-ASPARTATE ORAL TABLET 7.5 MG

0.69359 12/02/2016 0.54333 03/03/2017

DEXTROAMPHETAMINE SULFATE ORAL CAPSULE, EXTENDED RELEASE 10 MG

0.46820 03/20/2020 1.19950 04/17/2020

1.85122 11/14/2017 0.88868 09/21/2018

2.62825 01/01/2017 2.06516 06/16/2017

DEXTROAMPHETAMINE SULFATE ORAL SOLUTION, ORAL 5 MG/5 ML 1.27716 01/24/2014 1.27716 08/21/2015

DEXTROAMPHETAMINE SULFATE ORAL TABLET 10 MG 0.42930 01/24/2020 0.40200 03/20/2020

DEXTROAMPHETAMINE SULFATE ORAL TABLET 5 MG 0.64600 03/22/2019 0.34350 05/17/2019

DEXTROMETHORPHAN HBR/ACETAMINOPHEN/DOXYLAMINE ORAL LIQUID (ML) 15-325/15

0.01469 08/22/2014 0.01469 08/21/2015

DEXTROMETHORPHAN HBR/PHENYLEPHRINE HCL/DEXBROMPHENIRAMINE ORAL SYRUP 20-10-2/5

0.05168 08/12/2014 0.05168 08/21/2015

DEXTROMETHORPHAN POLISTIREX ORAL SUSPENSION, EXTENDED RELEASE 12 HR 30 MG/5 ML

0.08530 03/20/2015 0.08530 08/21/2015

DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS DEHP-FREE BAG, INJECTION (ML) 10 %-0.2 %

0.04179 01/25/2013

DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 10 %-0.2 %

0.03704 01/25/2013

DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 10%-0.45%

0.01077 01/25/2013

DEXTROSE 10 % IN WATER INTRAVENOUS DEHP-FREE BAG, INJECTION (ML) 10 %

0.00819 01/25/2013

DEXTROSE 10 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 10 %

0.00207 04/05/2013

DEXTROSE 2.5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 2.5%-0.45%

0.00250 08/12/2014 0.00250 08/21/2015

0.00864 01/25/2013

DEXTROSE 25 % IN WATER INTRAVENOUS SYRINGE (ML) 25 % 0.38140 08/12/2014

0.00877 01/25/2013 0.00877 08/21/2015

0.00870 08/12/2014

0.00228 01/25/2013

Effective 8/7/2020

Current SMAC Price

0.00230 01/25/2013

0.00181 08/22/2014 0.00181 08/21/2015

0.00274 01/09/2015 0.00274 08/21/2015

DEXTROSE 5 % IN LACTATED RINGERS INTRAVENOUS INTRAVENOUS SOLUTION 5 %

0.00214 01/25/2013

DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 5 % 0.00275 07/25/2014 0.00275 08/21/2015

DEXTROSE 5 % IN WATER INTRAVENOUS PIGGYBACK WITH THREADED PORT (ML)

0.02997 01/30/2015 0.02997 08/21/2015

DEXTROSE 5 % IN WATER INTRAVENOUS PIGGYBACK WITH VIAL PORT (NON-THREADED)

0.07096 01/25/2013

DEXTROSE 5 % IN WATER INTRAVENOUS VIAL (ML) 5 % 0.53214 01/25/2013

0.00630 01/25/2013 0.00630 08/21/2015

DEXTROSE 50 % IN WATER INTRAVENOUS SYRINGE (ML) 50 % 0.09475 04/05/2013 0.09475 08/21/2015

DEXTROSE 50 % IN WATER INTRAVENOUS VIAL (ML) 50 % 0.02540 08/12/2014

0.00532 04/19/2013 0.00532 08/21/2015

DEXTROSE ORAL SOLUTION, ORAL 5 % 0.01679 01/16/2015 0.01679 08/21/2015

DIAZEPAM INJECTION SYRINGE (ML) 5 MG/ML 3.71280 01/25/2013

DIAZEPAM INJECTION VIAL (ML) 5 MG/ML 1.36920 07/12/2013

DIAZEPAM ORAL CONCENTRATE, ORAL 5 MG/ML 1.83609 01/16/2015

DIAZEPAM ORAL SOLUTION, ORAL 5 MG/5 ML 0.10010 05/09/2014

DIAZEPAM ORAL TABLET 10 MG 0.02396 09/19/2014 0.02396 08/21/2015

DIAZEPAM RECTAL KIT 12.5-15-20 234.84300 04/01/2019 232.00000 10/25/2019

DIAZEPAM RECTAL KIT 2.5 MG 197.11300 08/22/2014 197.11300 04/01/2019

DIAZEPAM RECTAL KIT 5-7.5-10MG 245.00000 10/25/2019 234.39000 11/15/2019

DICLOFENAC POTASSIUM ORAL TABLET 50 MG 0.25630 11/16/2018 0.99990 07/16/2020

DICLOFENAC SODIUM OPHTHALMIC DROPS 0.1 % 1.02376 05/02/2014 1.02376 08/21/2015

DICLOFENAC SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 25 MG

0.99526 03/28/2014

0.09565 03/03/2017 0.08500 01/24/2020

0.09565 07/14/2017 0.08230 01/24/2020

DICLOFENAC SODIUM ORAL TABLET, EXTENDED RELEASE 24 HR 100 MG

0.66130 12/19/2018 1.60000 06/04/2019

DICLOFENAC SODIUM TOPICAL DROPS 1.5 % 0.90000 04/27/2018 0.11873 11/15/2019

DICLOFENAC SODIUM TOPICAL GEL (GRAM) 1 % 0.17595 11/15/2019 0.14776 05/22/2020

DICLOFENAC SODIUM TOPICAL GEL (GRAM) 3 % 1.49000 05/25/2018 0.68850 03/20/2020

DICLOFENAC SODIUM/MISOPROSTOL ORAL TABLET,IMMEDIATE,DELAY RELEASE,BIPHASE 50 MG-200

2.34693 08/21/2015 1.56576 06/16/2017

DICLOFENAC SODIUM/MISOPROSTOL ORAL TABLET,IMMEDIATE,DELAY RELEASE,BIPHASE 75 MG-200

1.94983 03/03/2017 1.59850 05/22/2020

DICLOXACILLIN SODIUM ORAL CAPSULE 250 MG 0.33183 09/26/2014 0.33183 08/21/2015

Effective 8/7/2020

Current SMAC Price

DICLOXACILLIN SODIUM ORAL CAPSULE 500 MG 0.67080 09/26/2014 0.67080 08/21/2015

DICYCLOMINE HCL ORAL CAPSULE 10 MG 0.14349 11/15/2019 0.11241 04/17/2020

DICYCLOMINE HCL ORAL SOLUTION, ORAL 10 MG/5 ML 0.21028 04/03/2015

DICYCLOMINE HCL ORAL TABLET 20 MG 0.18270 10/04/2019 0.14990 07/17/2020

DIDANOSINE ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 125 MG

2.70223 01/25/2013

4.32270 02/08/2013

5.50853 01/25/2013

8.60350 02/08/2013

DIETHYLPROPION HCL ORAL TABLET 25 MG 0.23090 08/21/2015 0.18070 11/24/2017

DIETHYLPROPION HCL ORAL TABLET, EXTENDED RELEASE 75 MG 0.88524 08/22/2014 0.88524 08/21/2015

DIFLORASONE DIACETATE TOPICAL CREAM (GRAM) 0.05 % 3.29067 08/21/2015

DIFLORASONE DIACETATE TOPICAL OINTMENT (GRAM) 0.05 % 2.47670 08/12/2014 2.47670 08/21/2015

DIFLUNISAL ORAL TABLET 500 MG 1.18611 05/17/2013 1.18611 08/21/2015

DIGOXIN INJECTION SYRINGE (ML) 250 MCG/ML 1.58760 01/25/2013

DIGOXIN ORAL SOLUTION, ORAL 50 MCG/ML 0.56138 04/17/2015 0.68654 08/24/2017

DIGOXIN ORAL TABLET 125 MCG 0.24247 05/17/2019 0.21936 03/20/2020

DIGOXIN ORAL TABLET 250 MCG 0.29347 08/16/2019 0.17780 10/25/2019

DIHYDROERGOTAMINE MESYLATE INJECTION AMPUL (ML) 1 MG/ML 104.81800 03/13/2015

DIHYDROERGOTAMINE MESYLATE INJECTION VIAL (ML) 1 MG/ML 37.55430 01/25/2013

DIHYDROERGOTAMINE MESYLATE NASAL AEROSOL, SPRAY WITH PUMP (ML) 0.5MG/SPRY

296.65500 07/05/2017 324.99800 09/24/2019

DILTIAZEM HCL INTRAVENOUS VIAL WITH THREADED PORT (EA) 100 MG 14.71680 01/25/2013

DILTIAZEM HCL ORAL CAPSULE, EXT RELEASE 24 HR 120 MG 0.18874 10/19/2018 0.13167 05/17/2019

DILTIAZEM HCL ORAL CAPSULE, EXTENDED RELEASE 12 HR 60 MG 1.97040 04/10/2015

DILTIAZEM HCL ORAL CAPSULE, EXTENDED RELEASE 12 HR 90 MG 1.05763 05/16/2014 2.33360 07/24/2018

DILTIAZEM HCL ORAL CAPSULE, EXTENDED RELEASE 24HR 120 MG 0.31426 08/21/2015 0.23822 03/02/2018

DILTIAZEM HCL ORAL CAPSULE,EXTENDED-RELEASE 24HR DEGRADABLE 120 MG

0.44907 09/30/2016 0.35690 09/22/2017

0.58869 08/21/2015 0.41490 03/17/2017

0.45397 03/02/2018 0.42815 03/16/2018

DILTIAZEM HCL ORAL TABLET 120 MG 0.28520 11/16/2018 0.26220 02/22/2019

Effective 8/7/2020

Current SMAC Price

DILTIAZEM HCL ORAL TABLET, EXTENDED RELEASE 24 HR 180 MG 2.04560 08/21/2015 1.63333 05/17/2019

DILUENT FOR EPOPROSTENOL SODIUM (GLYCINE) INTRAVENOUS VIAL (ML)

0.14700 01/25/2013

DIMENHYDRINATE INJECTION VIAL (ML) 50 MG/ML 4.98960 01/25/2013

DIMENHYDRINATE ORAL TABLET 50 MG 0.01809 01/25/2013 0.01809 08/21/2015

DIMETHICONE TOPICAL CREAM (ML) 5 % 0.03918 04/10/2015 0.03918 08/21/2015

DIMETHICONE TOPICAL SPRAY, NON-AEROSOL (ML) 2 % 0.03000 08/12/2014

DIPHENHYDRAMINE HCL INJECTION VIAL (ML) 50 MG/ML 0.59000 08/16/2019

DIPHENHYDRAMINE HCL ORAL CAPSULE 25 MG 0.03163 08/21/2015 0.02020 10/20/2017

DIPHENHYDRAMINE HCL ORAL ELIXIR 12.5MG/5ML 0.00512 01/25/2013 0.00512 08/21/2015

DIPHENHYDRAMINE HCL ORAL LIQUID (ML) 12.5MG/5ML 0.00578 01/16/2015 0.00578 08/21/2015

DIPHENHYDRAMINE HCL ORAL SYRUP 12.5MG/5ML 0.01260 08/12/2014

DIPHENHYDRAMINE HCL ORAL TABLET 25 MG 0.02104 02/06/2015 0.02104 08/21/2015

DIPHENOXYLATE HCL/ATROPINE SULFATE ORAL LIQUID (ML) 2.5-.025/5 0.10803 01/25/2013

DIPHENOXYLATE HCL/ATROPINE SULFATE ORAL TABLET 2.5-.025MG 0.29000 02/22/2019 0.21900 11/15/2019

DIPYRIDAMOLE ORAL TABLET 25 MG 0.05708 02/13/2015 0.05708 08/21/2015

DISOPYRAMIDE PHOSPHATE ORAL CAPSULE 100 MG 0.34801 05/01/2015 0.34801 08/21/2015

DISOPYRAMIDE PHOSPHATE ORAL CAPSULE 150 MG 0.35458 08/21/2015

DISULFIRAM ORAL TABLET 250 MG 0.78000 01/25/2019 1.50849 04/09/2019

DISULFIRAM ORAL TABLET 500 MG 3.76000 01/08/2018 0.87360 03/02/2018

DIVALPROEX SODIUM ORAL CAPSULE, DELAYED RELEASE SPRINKLE 125 MG

0.29874 03/20/2020 0.23220 06/19/2020

DIVALPROEX SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 125 MG

0.05896 08/21/2015 0.04414 03/02/2018

0.10366 08/21/2015 0.06000 08/25/2017

0.10326 01/19/2018 0.07662 12/20/2019

DIVALPROEX SODIUM ORAL TABLET, EXTENDED RELEASE 24 HR 250 MG

0.28108 04/01/2020 0.14808 06/19/2020

DIVALPROEX SODIUM ORAL TABLET, EXTENDED RELEASE 24 HR 500 MG

0.20742 12/20/2019 0.14998 04/17/2020

DOBUTAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 1000MG/250

0.08730 08/12/2014

Effective 8/7/2020

Current SMAC Price

DOBUTAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 250 MG/250

0.04960 08/12/2014

DOBUTAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 500 MG/500

0.02810 08/12/2014

DOBUTAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 500MG/250

0.05620 08/12/2014

DOBUTAMINE HCL INTRAVENOUS VIAL (ML) 250MG/20ML 0.15780 08/12/2014

DOBUTAMINE HCL INTRAVENOUS VIAL (ML) 500MG/40ML 0.15830 08/12/2014

DOCETAXEL INTRAVENOUS VIAL (ML) 140 MG/7ML 43.50599 01/23/2015 43.50599 08/21/2015

DOCETAXEL INTRAVENOUS VIAL (ML) 160 MG/8ML 675.67500 08/12/2014

DOCETAXEL INTRAVENOUS VIAL (ML) 160MG/16ML 67.85567 08/12/2014 67.85567 08/21/2015

DOCETAXEL INTRAVENOUS VIAL (ML) 20 MG/2 ML 60.99275 08/12/2014 60.99275 08/21/2015

DOCETAXEL INTRAVENOUS VIAL (ML) 200MG/20ML 42.61540 05/01/2015

DOCETAXEL INTRAVENOUS VIAL (ML) 20MG/ML(1) 53.07450 02/27/2015 53.07450 08/21/2015

DOCETAXEL INTRAVENOUS VIAL (ML) FNL 20MG/2 148.61475 01/25/2013 148.61475 08/21/2015

DOCETAXEL INTRAVENOUS VIAL (ML) FNL 80MG/8 297.22950 01/25/2013 297.22950 08/21/2015

DOCUSATE CALCIUM ORAL CAPSULE 240 MG 0.05135 08/12/2014 0.05135 08/21/2015

DOCUSATE SODIUM ORAL CAPSULE 100 MG 0.01474 01/30/2015 0.01474 08/21/2015

DOCUSATE SODIUM ORAL CAPSULE 250 MG 0.04068 03/27/2015 0.04068 08/21/2015

DOCUSATE SODIUM ORAL LIQUID (ML) 50 MG/5 ML 0.00902 08/12/2014 0.00902 08/21/2015

DOCUSATE SODIUM ORAL SYRUP 60 MG/15ML 0.00788 08/12/2014 0.00788 08/21/2015

DOCUSATE SODIUM ORAL TABLET 100 MG 0.02938 08/21/2015 0.01740 08/17/2018

DOCUSATE SODIUM RECTAL ENEMA (ML) 283 MG/5ML 3.28266 08/21/2015

DOCUSATE SODIUM/BENZOCAINE RECTAL ENEMA (ML) 283-20MG/5 2.68029 08/21/2015

DOFETILIDE ORAL CAPSULE 125 MCG 4.55000 08/25/2017 3.55783 09/22/2017

DOFETILIDE ORAL CAPSULE 500 MCG 2.61000 10/25/2019 1.71667 03/20/2020

DONEPEZIL HCL ORAL TABLET 10 MG 0.05607 08/25/2017 0.03508 09/22/2017

DONEPEZIL HCL ORAL TABLET,DISINTEGRATING 10 MG 0.27257 01/30/2015

DONEPEZIL HCL ORAL TABLET,DISINTEGRATING 5 MG 0.37252 08/21/2015 0.22000 03/20/2020

DOPAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS PLASTIC BAG, INJECTION (ML) 200MG/.25L

0.02960 08/12/2014

0.03690 08/12/2014

DOPAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS PLASTIC BAG, INJECTION (ML) 400MG/0.5L

0.04060 08/12/2014

0.08010 08/12/2014

DOPAMINE HCL IN DEXTROSE 5 % IN WATER INTRAVENOUS PLASTIC BAG, INJECTION (ML) 800MG/0.5L

0.05100 08/12/2014

DOPAMINE HCL INTRAVENOUS VIAL (ML) 400 MG/5ML 0.50263 01/25/2013

DOPAMINE HCL INTRAVENOUS VIAL (ML) 400MG/10ML 0.07980 01/25/2013

Effective 8/7/2020

Current SMAC Price

DORZOLAMIDE HCL OPHTHALMIC DROPS 2 % 0.81880 08/25/2017 0.78900 12/20/2019

DORZOLAMIDE HCL/TIMOLOL MALEATE OPHTHALMIC DROPS 22.3-6.8/1 0.78900 09/20/2019 1.73621 01/29/2020

DOXAZOSIN MESYLATE ORAL TABLET 1 MG 0.13300 09/22/2017 0.05640 09/20/2019

DOXEPIN HCL ORAL CAPSULE 10 MG 0.37514 08/21/2015 0.22778 05/17/2019

DOXEPIN HCL ORAL CAPSULE 150 MG 0.92954 03/20/2015

DOXEPIN HCL ORAL CONCENTRATE, ORAL 10 MG/ML 0.05720 08/12/2014

DOXERCALCIFEROL ORAL CAPSULE 0.5 MCG 11.21120 01/01/2017 11.21120 01/02/2017

DOXERCALCIFEROL ORAL CAPSULE 1 MCG 22.42149 01/01/2017 22.42149 01/02/2017

DOXERCALCIFEROL ORAL CAPSULE 2.5 MCG 25.97343 01/01/2017 25.97343 01/02/2017

DOXORUBICIN HCL INTRAVENOUS VIAL (EA) 10 MG 40.96400 08/08/2014 40.96400 08/21/2015

DOXORUBICIN HCL INTRAVENOUS VIAL (EA) 50 MG 29.40000 03/07/2014 29.40000 08/21/2015

DOXORUBICIN HCL PEGYLATED LIPOSOMAL INTRAVENOUS VIAL (ML) 2 MG/ML

80.99070 04/05/2013

DOXYCYCLINE HYCLATE INTRAVENOUS VIAL (EA) 100 MG 13.86000 11/14/2014 13.86000 08/21/2015

DOXYCYCLINE HYCLATE ORAL CAPSULE 100 MG 0.13096 05/22/2020 0.10060 07/17/2020

DOXYCYCLINE HYCLATE ORAL CAPSULE 50 MG 0.28216 04/08/2019 0.21890 11/15/2019

DOXYCYCLINE HYCLATE ORAL TABLET 100 MG 0.12565 08/16/2019 0.09980 04/17/2020

DOXYCYCLINE HYCLATE ORAL TABLET 20 MG 0.62690 08/21/2015 0.20961 07/08/2016

DOXYCYCLINE HYCLATE ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 100 MG

9.19320 08/17/2018 5.36500 10/19/2018

8.72316 04/24/2015 5.65000 06/21/2019

7.15693 08/12/2014

DOXYCYCLINE MONOHYDRATE ORAL CAPSULE 100 MG 0.16447 11/16/2018 0.14700 01/24/2020

DOXYCYCLINE MONOHYDRATE ORAL CAPSULE 150 MG 17.25512 01/25/2013

DOXYCYCLINE MONOHYDRATE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 25 MG/5 ML

0.26565 03/20/2015 0.23433 05/17/2019

DOXYCYCLINE MONOHYDRATE ORAL TABLET 100 MG 0.56939 06/16/2017 0.22315 03/20/2020

DOXYLAMINE SUCCINATE ORAL TABLET 25 MG 0.20563 08/21/2015

DRONABINOL ORAL CAPSULE 10 MG 9.55706 12/02/2016 7.63483 09/22/2017

Effective 8/7/2020

Current SMAC Price

DRONABINOL ORAL CAPSULE 2.5 MG 1.56000 12/21/2018 1.49667 11/15/2019

DRONABINOL ORAL CAPSULE 5 MG 3.24900 11/15/2019 2.50000 03/20/2020

DROPERIDOL INJECTION AMPUL (ML) 2.5 MG/ML 0.84840 01/25/2013

DROPERIDOL INJECTION VIAL (ML) 2.5 MG/ML 1.48750 01/25/2013

DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE CALCIUM ORAL TABLET 3-0.02(24)

3.80020 02/26/2019 3.28512 11/15/2019

DULOXETINE HCL ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 20 MG

0.19211 11/16/2018 0.15437 08/16/2019

0.15200 12/21/2018 0.10633 12/20/2019

2.98102 04/23/2019 2.25600 02/21/2020

0.11663 08/16/2019 0.10200 06/19/2020

DUTASTERIDE ORAL CAPSULE 0.5 MG 0.13530 08/16/2019 0.11478 07/17/2020

DUTASTERIDE/TAMSULOSIN HCL ORAL CAPSULE,EXTENDED RELEASE MULTIPHASE 24HR 0.5-0.4 MG

2.40833 11/16/2018 2.18600 08/16/2019

ECONAZOLE NITRATE TOPICAL CREAM (GRAM) 1 % 0.44717 11/15/2019 0.24988 05/22/2020

ELECTROLYTE-48 SOLUTION/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 5 %

0.00430 08/12/2014

ELECTROLYTES/DEXTROSE ORAL SOLUTION, ORAL 0.00517 02/27/2015 0.00517 08/21/2015

ELETRIPTAN HYDROBROMIDE ORAL TABLET 20 MG 9.80000 04/27/2018 5.01000 12/20/2019

ELETRIPTAN HYDROBROMIDE ORAL TABLET 40 MG 5.31750 05/17/2019 3.67667 09/20/2019

EMOLLIENT COMBINATION NO.10 TOPICAL EMULSION (GRAM) 0.44835 01/25/2013 0.44835 08/21/2015

EMOLLIENT COMBINATION NO.32 TOPICAL EMULSION (GRAM) 0.72194 08/29/2014 0.72194 08/21/2015

EMOLLIENT COMBINATION NO.44 TOPICAL FOAM (GRAM) 0.90811 01/25/2013

EMOLLIENT COMBINATION NO.53 TOPICAL CREAM (GRAM) 0.49685 08/12/2014

EMOLLIENT COMBINATION NO.53 TOPICAL FOAM (GRAM) 1.01001 01/25/2013

ENALAPRIL MALEATE MISCELLANEOUS POWDER (GRAM) 100 % 3.35240 08/12/2014 3.35240 08/21/2015

ENALAPRIL MALEATE ORAL TABLET 10 MG 0.07090 09/20/2019 0.05510 11/15/2019

ENALAPRIL MALEATE ORAL TABLET 2.5 MG 0.06000 08/25/2017 0.05650 07/26/2019

ENALAPRIL MALEATE/HYDROCHLOROTHIAZIDE ORAL TABLET 10 MG-25MG

0.14036 08/21/2015 0.09050 06/16/2017

ENALAPRIL MALEATE/HYDROCHLOROTHIAZIDE ORAL TABLET 5MG-12.5MG

0.08740 05/31/2013 0.08740 08/21/2015

ENALAPRILAT DIHYDRATE INTRAVENOUS VIAL (ML) 1.25 MG/ML 1.78220 09/12/2014

ENOXAPARIN SODIUM SUBCUTANEOUS SYRINGE (ML) 100 MG/ML 10.08000 08/01/2018 9.69900 07/17/2020

ENOXAPARIN SODIUM SUBCUTANEOUS SYRINGE (ML) 120MG/.8ML 19.56825 02/26/2016 17.76502 04/21/2017

ENOXAPARIN SODIUM SUBCUTANEOUS SYRINGE (ML) 150 MG/ML 12.95000 09/21/2018 11.45550 11/15/2019

ENOXAPARIN SODIUM SUBCUTANEOUS SYRINGE (ML) 30MG/0.3ML 10.59000 08/22/2019 8.99667 03/20/2020

ENOXAPARIN SODIUM SUBCUTANEOUS VIAL (ML) 300MG/3ML 59.20133 03/06/2015 59.20133 08/21/2015

Effective 8/7/2020

Current SMAC Price

ENTACAPONE ORAL TABLET 200 MG 0.33480 11/15/2019 0.63276 12/27/2019

ENTECAVIR ORAL TABLET 0.5 MG 1.70800 05/17/2019 0.69967 11/15/2019

ENTECAVIR ORAL TABLET 1 MG 5.88033 09/22/2017 5.88030 09/23/2017

ENZYMES,DIGESTIVE ORAL CAPSULE 0.05940 08/12/2014 0.05940 08/21/2015

EPHEDRINE SULFATE VIAL (ML) 50 MG/ML 4.10130 01/25/2013 4.10130 08/21/2015

EPINASTINE HCL OPHTHALMIC DROPS 0.05 % 9.27130 08/21/2015 5.46126 06/16/2017

EPINEPHRINE HCL/PF INJECTION AMPUL (ML) 1 MG/ML(1) 682.71000 02/20/2015

EPINEPHRINE INJECTION SYRINGE (ML) 0.1 MG/ML 0.47910 08/12/2014 0.47910 08/21/2015

EPINEPHRINE INJECTION VIAL (ML) 1 MG/ML 0.20160 08/12/2014 0.20160 08/21/2015

EPIRUBICIN HCL INTRAVENOUS VIAL (EA) 200 MG 1992.09500 01/25/2013

EPLERENONE ORAL TABLET 25 MG 0.65000 05/22/2020 0.78922 05/28/2020

EPLERENONE ORAL TABLET 50 MG 1.26499 06/16/2017 0.98300 08/16/2019

EPOPROSTENOL SODIUM (GLYCINE) INTRAVENOUS VIAL (EA) 0.5 MG 12.85200 01/25/2013

EPOPROSTENOL SODIUM (GLYCINE) INTRAVENOUS VIAL (EA) 1.5 MG 24.45100 01/25/2013

EPROSARTAN MESYLATE ORAL TABLET 600 MG 2.39820 01/25/2013

ERGOCALCIFEROL (VITAMIN D2) ORAL CAPSULE 1250 MCG 0.16000 06/16/2017 0.09770 09/22/2017

ERGOCALCIFEROL (VITAMIN D2) ORAL TABLET 10 MCG 0.02380 02/08/2013

ERGOCALCIFEROL (VITAMIN D2) ORAL TABLET 50 MCG 0.05446 01/25/2013

ERGOLOID MESYLATES ORAL TABLET 1 MG 5.67287 02/06/2015

ERLOTINIB HCL ORAL TABLET 100 MG 12.50000 02/21/2020

ERYTHROMYCIN BASE IN ETHANOL TOPICAL GEL (GRAM) 2 % 2.23000 01/25/2019 1.68000 07/26/2019

ERYTHROMYCIN BASE IN ETHANOL TOPICAL SOLUTION, NON-ORAL 2 % 0.42017 06/21/2019 0.32978 11/15/2019

ERYTHROMYCIN BASE IN ETHANOL TOPICAL SWAB, MEDICATED 2 % 1.10370 02/08/2013

ERYTHROMYCIN BASE OPHTHALMIC OINTMENT (GRAM) 5 MG/GRAM 1.68401 06/16/2017 1.63247 02/22/2019

ERYTHROMYCIN BASE ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 250 MG

2.41500 08/21/2015 4.82650 07/19/2019

ERYTHROMYCIN BASE ORAL TABLET 250 MG 9.39950 01/25/2019 7.81000 06/21/2019

ERYTHROMYCIN BASE ORAL TABLET 500 MG 9.78572 08/21/2015 12.26652 05/16/2016

ERYTHROMYCIN BASE/BENZOYL PEROXIDE TOPICAL GEL (GRAM) 3 %-5 %

2.91330 08/27/2019 1.97425 03/20/2020

ESCITALOPRAM OXALATE ORAL SOLUTION, ORAL 5 MG/5 ML 0.36009 02/26/2016 0.14983 04/26/2019

ESCITALOPRAM OXALATE ORAL TABLET 10 MG 0.06080 06/16/2017 0.04554 09/22/2017

ESOMEPRAZOLE MAGNESIUM ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 20 MG

0.23553 05/17/2019 0.19700 08/16/2019

ESOMEPRAZOLE MAGNESIUM ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 40 MG

0.22614 08/16/2019 0.15306 04/17/2020

ESOMEPRAZOLE SODIUM INTRAVENOUS VIAL (EA) 20 MG 9.22875 04/24/2015 9.22875 08/21/2015

ESOMEPRAZOLE SODIUM INTRAVENOUS VIAL (EA) 40 MG 10.43250 04/24/2015 10.43250 08/21/2015

ESTAZOLAM ORAL TABLET 1 MG 0.26770 08/12/2014

ESTAZOLAM ORAL TABLET 2 MG 0.29330 08/12/2014 0.29330 08/21/2015

Effective 8/7/2020

Current SMAC Price

ESTRADIOL ORAL TABLET 0.5 MG 0.10410 08/25/2017 0.06180 09/22/2017

ESTRADIOL ORAL TABLET 1 MG 0.11270 07/14/2017 0.07130 05/22/2020

ESTRADIOL ORAL TABLET 2 MG 0.13700 06/16/2017 0.11000 10/20/2017

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL SEMIWEEKLY .025MG/24H

8.45640 06/16/2017 7.60625 07/26/2019

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL SEMIWEEKLY .0375MG/24

7.27000 10/19/2018 6.67875 05/17/2019

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL SEMIWEEKLY .075MG/24H

6.63000 06/22/2018 5.61875 08/16/2019

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL SEMIWEEKLY 0.05MG/24H

6.18000 12/21/2018 8.09043 11/26/2019

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL SEMIWEEKLY 0.1MG/24HR

5.94125 05/17/2019 7.76750 05/29/2020

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL WEEKLY .025MG/24H

15.92223 09/20/2013 13.00000 03/03/2017

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL WEEKLY .0375MG/24

12.39250 12/22/2017 11.07000 01/24/2020

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL WEEKLY .075MG/24H

10.55000 05/02/2014

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL WEEKLY 0.05MG/24H

9.98000 05/17/2019 13.11750 11/06/2019

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL WEEKLY 0.06MG/24H

15.47000 04/25/2014 12.05375 06/16/2017

ESTRADIOL TRANSDERMAL PATCH, TRANSDERMAL WEEKLY 0.1MG/24HR

14.16352 12/25/2015 12.42131 06/16/2017

ESTRADIOL VAGINAL TABLET 10 MCG 8.45065 05/22/2020 7.73889 07/17/2020

ESTRADIOL/NORETHINDRONE ACETATE ORAL TABLET 0.5-0.1 MG 1.73571 03/15/2019 2.26160 04/13/2020

ESTRADIOL/NORETHINDRONE ACETATE ORAL TABLET 1 MG-0.5MG 2.83847 03/25/2016 2.29848 06/16/2017

ESTROGENS,ESTERIFIED/METHYLTESTOSTERONE ORAL TABLET 0.625-1.25

1.58654 08/12/2014 1.58654 08/21/2015

ESTROGENS,ESTERIFIED/METHYLTESTOSTERONE ORAL TABLET 1.25-2.5MG

1.74068 08/12/2014 1.74068 08/21/2015

ESTROPIPATE TABLET 0.75 MG 0.36322 04/25/2014 0.36322 08/21/2015

ESTROPIPATE TABLET 1.5 MG 0.50765 04/25/2014

ESTROPIPATE TABLET 3 MG 0.70270 08/12/2014

ESZOPICLONE ORAL TABLET 1 MG 0.29577 09/22/2017 0.26290 05/17/2019

ETHACRYNIC ACID ORAL TABLET 25 MG 5.52000 08/16/2019

ETHAMBUTOL HCL ORAL TABLET 100 MG 0.28000 11/24/2017 0.16920 08/17/2018

ETHINYL ESTRADIOL/DROSPIRENONE ORAL TABLET 0.02-3(28) 0.49000 03/15/2019 0.36702 08/16/2019

ETHINYL ESTRADIOL/DROSPIRENONE ORAL TABLET 0.03MG-3MG 0.39301 08/17/2018 0.24209 07/17/2020

ETHOSUXIMIDE ORAL CAPSULE 250 MG 1.08530 03/02/2018 0.70270 02/22/2019

ETHOSUXIMIDE ORAL SOLUTION, ORAL 250 MG/5ML 0.27221 01/25/2019 0.15389 06/19/2020

ETHYL ALCOHOL INJECTION AMPUL (ML) 98 % 7.48300 12/12/2014 7.48300 08/21/2015

ETHYL ALCOHOL INJECTION VIAL (ML) 98 % 12.09096 08/12/2014

ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL ORAL TABLET 1 MG-35MCG

0.70226 03/03/2017 0.58262 11/24/2017

ETIDRONATE DISODIUM ORAL TABLET 200 MG 3.02458 01/24/2014

Effective 8/7/2020

Current SMAC Price

ETIDRONATE DISODIUM ORAL TABLET 400 MG 6.04777 11/22/2013 6.04777 08/21/2015

ETODOLAC ORAL CAPSULE 200 MG 0.89280 01/13/2017 0.84280 11/24/2017

ETODOLAC ORAL CAPSULE 300 MG 1.02950 11/24/2017 0.70490 03/02/2018

ETODOLAC ORAL TABLET 400 MG 0.42692 08/17/2018 0.34640 11/16/2018

ETODOLAC ORAL TABLET 500 MG 0.49930 08/25/2017 0.26330 11/15/2019

ETODOLAC ORAL TABLET, EXTENDED RELEASE 24 HR 400 MG 2.03084 08/21/2015 1.21731 06/16/2017

ETOPOSIDE ORAL CAPSULE 50 MG 56.82120 02/15/2013

EXEMESTANE ORAL TABLET 25 MG 2.18833 07/25/2019 1.29833 11/15/2019

EZETIMIBE ORAL TABLET 10 MG 0.13771 01/15/2020 0.07384 04/17/2020

EZETIMIBE/SIMVASTATIN ORAL TABLET 10 MG-10MG 2.62000 04/27/2018 2.37300 11/16/2018

EZETIMIBE/SIMVASTATIN ORAL TABLET 10 MG-20MG 1.90000 06/21/2019

FAMCICLOVIR ORAL TABLET 125 MG 0.46454 08/21/2015 0.35833 11/16/2018

FAMOTIDINE IN SODIUM CHLORIDE, ISO-OSMOTIC/PF INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 20 MG/50ML

0.13650 01/25/2013

FAMOTIDINE INTRAVENOUS VIAL (ML) 10 MG/ML 0.26572 01/09/2015 0.26572 08/21/2015

FAMOTIDINE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 40MG/5ML 1.14744 03/03/2020 1.99680 05/18/2020

FAMOTIDINE ORAL TABLET 10 MG 0.08920 03/27/2015 0.08920 08/21/2015

FAMOTIDINE/PF INTRAVENOUS VIAL (ML) 20 MG/2 ML 0.37429 08/12/2014 0.37429 08/21/2015

FEBUXOSTAT ORAL TABLET 40 MG 4.80000 02/21/2020

FEBUXOSTAT ORAL TABLET 80 MG 4.97000 02/21/2020

FELBAMATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 600 MG/5ML 1.58070 12/02/2016 1.10721 05/22/2020

FELBAMATE ORAL TABLET 400 MG 1.34690 10/20/2017 0.86430 08/16/2019

FELBAMATE ORAL TABLET 600 MG 1.48180 02/22/2019 1.41430 03/20/2020

FELODIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 10 MG 0.34000 05/20/2016 0.09000 11/24/2017

FELODIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 2.5 MG 0.54257 08/21/2015 0.14760 09/22/2017

FELODIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 5 MG 0.19800 07/14/2017 0.07260 11/24/2017

FENOFIBRATE NANOCRYSTALLIZED ORAL TABLET 145 MG 0.16870 08/16/2019 0.15547 06/19/2020

FENOFIBRATE NANOCRYSTALLIZED ORAL TABLET 48 MG 0.14196 05/17/2019 0.10550 11/15/2019

FENOFIBRATE ORAL CAPSULE 150 MG 5.00920 01/23/2017 5.55870 09/05/2017

FENOFIBRATE ORAL CAPSULE 50 MG 1.73180 08/01/2014

FENOFIBRATE ORAL TABLET 160 MG 0.29844 02/11/2020 0.19590 04/17/2020

FENOFIBRATE ORAL TABLET 54 MG 0.18444 11/16/2018 0.16656 11/15/2019

FENOFIBRATE,MICRONIZED ORAL CAPSULE 130 MG 2.43400 08/17/2018 1.89200 10/19/2018

Effective 8/7/2020

Current SMAC Price

FENOFIBRIC ACID (CHOLINE) ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 135 MG

1.21444 08/01/2018 0.84544 02/22/2019

FENOFIBRIC ACID (CHOLINE) ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 45 MG

0.41211 09/22/2017 0.37988 01/25/2019

FENOFIBRIC ACID ORAL TABLET 105 MG 2.10232 05/30/2014 2.03967 08/25/2017

FENOFIBRIC ACID ORAL TABLET 35 MG 0.70070 08/12/2014

FENOPROFEN CALCIUM ORAL TABLET 600 MG 1.53587 02/07/2014 1.53587 08/21/2015

FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 1200 MCG 31.46500 01/25/2013

FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 200 MCG 13.16280 01/25/2013 7.47933 09/22/2017

FENTANYL CITRATE/PF INTRAVENOUS SYRINGE (ML) 100MCG/2ML 0.65520 01/25/2013 0.65520 08/21/2015

FENTANYL TRANSDERMAL PATCH, TRANSDERMAL 72 HOURS 100 MCG/HR

7.70600 08/17/2018 6.41480 02/22/2019

7.16254 01/13/2020 7.60912 02/20/2020

2.22000 10/25/2019 2.16000 05/22/2020

FENTANYL TRANSDERMAL PATCH, TRANSDERMAL 72 HOURS 37.5MCG/HR

42.45400 05/01/2015

FENTANYL TRANSDERMAL PATCH, TRANSDERMAL 72 HOURS 50MCG/HR

3.05057 11/15/2019 2.49800 01/24/2020

61.68800 05/01/2015

FENTANYL TRANSDERMAL PATCH, TRANSDERMAL 72 HOURS 75MCG/HR

4.63650 11/15/2019 7.43407 02/12/2020

83.99000 05/01/2015

FERROUS FUMARATE/ASCORBIC ACID/B12-IF/FOLIC ACID ORAL CAPSULE 110-0.5MG

0.18226 08/30/2013

FERROUS GLUCONATE ORAL TABLET 240(27)MG 0.03859 08/12/2014

FERROUS SULFATE ORAL DROPS 15 MG/ML 0.06072 03/06/2015 0.06072 08/21/2015

FERROUS SULFATE ORAL SOLUTION, ORAL 220 (44)/5 0.00626 04/10/2015 0.00626 08/21/2015

FERROUS SULFATE ORAL TABLET 325(65) MG 0.00838 04/10/2015 0.00838 08/21/2015

FEXOFENADINE HCL ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 30 MG/5 ML

0.05664 02/27/2015

FEXOFENADINE HCL ORAL TABLET 180 MG 0.19000 11/16/2018 0.15500 08/16/2019

FEXOFENADINE HCL ORAL TABLET 60 MG 0.31707 08/21/2015 0.24340 08/16/2019

FEXOFENADINE HCL/PSEUDOEPHEDRINE HCL ORAL TABLET, EXTENDED RELEASE 12 HR 60MG-120MG

0.66733 08/21/2015

FINASTERIDE ORAL TABLET 1 MG 0.31250 03/25/2016 0.09000 08/25/2017

FINASTERIDE ORAL TABLET 5 MG 0.13871 03/03/2017 0.05049 09/22/2017

FISH OIL/BORAGE OIL/FLAXSEED OIL/OMEGA 3,6,9 COMBINATION NO1 ORAL CAPSULE 400-400 MG

0.06168 08/12/2014

Effective 8/7/2020

Current SMAC Price

FISH OIL/DOCOSAHEXAENOIC ACID/EICOSAPENTAENOIC ACID ORAL CAPSULE 1200-144MG

0.01579 01/25/2013

FLAVOXATE HCL ORAL TABLET 100 MG 0.80990 08/21/2015 0.45341 06/16/2017

FLECAINIDE ACETATE ORAL TABLET 100 MG 0.20830 11/16/2018 0.17710 08/16/2019

FLUCONAZOLE IN DEXTROSE, ISO-OSMOTIC INTRAVENOUS SOLUTION, PIGGYBACK (ML) 200MG/0.1L

0.09824 04/24/2015 0.09824 08/21/2015

FLUCONAZOLE IN DEXTROSE, ISO-OSMOTIC INTRAVENOUS SOLUTION, PIGGYBACK (ML) 400MG/0.2L

0.05315 04/24/2015 0.05315 08/21/2015

FLUCONAZOLE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 200MG/0.1L

0.01660 08/25/2017 0.03849 03/27/2020

FLUCONAZOLE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 400MG/0.2L

0.03369 04/24/2015 0.03369 08/21/2015

FLUCONAZOLE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS IV SOLUTION, PIGGYBACK, BOTTLE (ML) 200MG/0.1L

0.05285 03/06/2015 0.05285 08/21/2015

FLUCONAZOLE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS IV SOLUTION, PIGGYBACK, BOTTLE (ML) 400MG/0.2L

0.09450 01/25/2013 0.09450 08/21/2015

FLUCONAZOLE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 10 MG/ML

0.32278 08/21/2015 0.23000 09/22/2017

FLUCONAZOLE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 40 MG/ML

0.49314 09/22/2017 0.47400 10/25/2019

FLUCONAZOLE ORAL TABLET 100 MG 0.54328 11/16/2018 0.46613 11/15/2019

FLUCYTOSINE ORAL CAPSULE 250 MG 57.44830 11/21/2014 57.44830 08/21/2015

FLUCYTOSINE ORAL CAPSULE 500 MG 111.16350 11/21/2014 111.16350 08/21/2015

FLUDROCORTISONE ACETATE ORAL TABLET 0.1 MG 0.37080 12/06/2016 0.30660 10/20/2017

FLUNISOLIDE NASAL AEROSOL, SPRAY (ML) 25 MCG 1.92500 03/13/2015 1.92500 08/21/2015

FLUOCINOLONE ACETONIDE OIL OTIC DROPS 0.01 % 6.56750 10/19/2018 4.81200 12/21/2018

FLUOCINOLONE ACETONIDE TOPICAL CREAM (GRAM) 0.01 % 1.82185 08/12/2014 1.82185 08/21/2015

FLUOCINOLONE ACETONIDE TOPICAL CREAM (GRAM) 0.025 % 1.39143 08/21/2015 1.29967 02/21/2020

FLUOCINOLONE ACETONIDE TOPICAL OIL (ML) 0.01 % 1.30643 08/21/2015 0.55000 02/22/2019

FLUOCINOLONE ACETONIDE TOPICAL OINTMENT (GRAM) 0.025 % 1.18650 08/22/2014

FLUOCINOLONE ACETONIDE TOPICAL SOLUTION, NON-ORAL 0.01 % 1.56983 08/16/2019 0.90000 11/15/2019

FLUOCINOLONE ACETONIDE/SHOWER CAP TOPICAL OIL (ML) 0.01 % 1.31863 08/21/2015 0.50719 03/20/2020

FLUOCINONIDE TOPICAL CREAM (GRAM) 0.05 % 0.79753 11/24/2017 0.53592 10/25/2019

FLUOCINONIDE TOPICAL CREAM (GRAM) 0.1 % 13.23945 02/27/2015 11.07021 12/02/2016

FLUOCINONIDE TOPICAL GEL (GRAM) 0.05 % 1.04867 01/24/2020 1.50566 03/04/2020

FLUOCINONIDE TOPICAL OINTMENT (GRAM) 0.05 % 0.78790 08/30/2013 0.42932 07/08/2016

FLUOCINONIDE TOPICAL SOLUTION, NON-ORAL 0.05 % 1.13388 05/02/2014 0.79333 02/21/2020

FLUOCINONIDE/EMOLLIENT BASE TOPICAL CREAM (GRAM) 0.05 % 0.25684 06/07/2013 0.25684 08/21/2015

FLUORIDE (SODIUM) DENTAL CREAM (GRAM) 1.1 % 0.08013 08/21/2015 0.06294 10/25/2019

FLUORIDE (SODIUM) DENTAL GEL (GRAM) 1.1 % 0.06890 09/27/2013 0.06890 08/21/2015

FLUORIDE (SODIUM) ORAL DROPS 0.5 MG/ML 0.17316 08/21/2015 0.10320 11/24/2017

Effective 8/7/2020

Current SMAC Price

FLUORIDE (SODIUM) ORAL TABLET,CHEWABLE 0.25(0.55) 0.03738 03/01/2013 0.03738 08/21/2015

FLUORIDE (SODIUM) ORAL TABLET,CHEWABLE 0.5(1.1)MG 0.03740 02/22/2013 0.03740 08/21/2015

FLUORIDE (SODIUM) ORAL TABLET,CHEWABLE 1MG(2.2MG) 0.03852 04/19/2013 0.03852 08/21/2015

FLUOROMETHOLONE OPHTHALMIC SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 0.1 %

10.37820 02/20/2015 12.54792 04/27/2019

FLUOROURACIL INTRAVENOUS VIAL (ML) 1 G/20 ML 0.25200 03/27/2015 0.25200 08/21/2015

FLUOROURACIL INTRAVENOUS VIAL (ML) 2.5 G/50ML 0.19859 03/27/2015

FLUOROURACIL INTRAVENOUS VIAL (ML) 5 G/100 ML 0.12840 09/22/2017 0.11050 03/20/2020

FLUOROURACIL INTRAVENOUS VIAL (ML) 500MG/10ML 0.25200 03/27/2015 0.25200 08/21/2015

FLUOROURACIL TOPICAL CREAM (GRAM) 0.5 % 41.44770 12/26/2014

FLUOROURACIL TOPICAL CREAM (GRAM) 5 % 4.05885 08/21/2015 4.05885 04/15/2016

FLUOROURACIL TOPICAL SOLUTION, NON-ORAL 2 % 4.95080 08/12/2014

FLUOROURACIL TOPICAL SOLUTION, NON-ORAL 5 % 7.93170 05/17/2013

FLUOXETINE HCL ORAL CAPSULE 10 MG 0.02814 05/01/2015 0.02814 08/21/2015

FLUOXETINE HCL ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 90 MG

29.33500 02/21/2014 29.33500 08/21/2015

FLUOXETINE HCL ORAL SOLUTION, ORAL 20 MG/5 ML 0.41658 07/27/2019 0.49922 04/23/2020

FLUOXETINE HCL ORAL TABLET 10 MG 0.05507 03/20/2015 0.05507 08/21/2015

FLUOXETINE HCL ORAL TABLET 20 MG 0.67167 07/26/2019 0.56167 11/15/2019

FLUOXETINE HCL ORAL TABLET 60 MG 2.97158 07/05/2013

FLUPHENAZINE DECANOATE INJECTION VIAL (ML) 25 MG/ML 13.83300 08/17/2018 16.70660 11/06/2019

FLUPHENAZINE HCL INJECTION VIAL (ML) 2.5 MG/ML 10.58000 03/01/2013

FLUPHENAZINE HCL ORAL CONCENTRATE, ORAL 5 MG/ML 0.81136 01/25/2013

FLUPHENAZINE HCL ORAL ELIXIR 2.5 MG/5ML 0.26710 01/25/2013

FLUPHENAZINE HCL ORAL TABLET 1 MG 3.20310 03/11/2019 2.52000 02/21/2020

FLUPHENAZINE HCL ORAL TABLET 2.5 MG 0.47850 06/12/2018 3.16710 08/23/2019

FLURAZEPAM HCL ORAL CAPSULE 15 MG 0.19583 08/22/2014 0.19583 08/21/2015

FLURAZEPAM HCL ORAL CAPSULE 30 MG 0.35100 08/22/2014 0.35100 08/21/2015

FLURBIPROFEN ORAL TABLET 100 MG 0.36823 02/20/2015 0.36823 08/21/2015

FLURBIPROFEN ORAL TABLET 50 MG 0.22113 09/19/2014 0.22113 08/21/2015

FLURBIPROFEN SODIUM OPHTHALMIC DROPS 0.03 % 1.57114 08/21/2015 1.14467 06/16/2017

FLUTAMIDE ORAL CAPSULE 125 MG 0.63643 08/21/2015 0.49639 11/24/2017

FLUTICASONE PROPIONATE NASAL SPRAY, SUSPENSION 50 MCG 0.32375 12/02/2016 0.15892 01/27/2017

FLUTICASONE PROPIONATE TOPICAL CREAM (GRAM) 0.05 % 0.23000 08/25/2017 0.18317 08/16/2019

FLUTICASONE PROPIONATE TOPICAL LOTION (ML) 0.05 % 4.54942 08/30/2013 4.54942 08/21/2015

FLUTICASONE PROPIONATE TOPICAL OINTMENT (GRAM) 0.005 % 0.48681 03/01/2013

FLUTICASONE PROPIONATE/SALMETEROL XINAFOATE INHALATION BLISTER, WITH INHALATION DEVICE 250-50 MCG

2.45000 04/17/2020 3.04950 05/02/2020

FLUVASTATIN SODIUM ORAL CAPSULE 20 MG 2.64600 03/27/2015 2.64600 04/22/2016

Effective 8/7/2020

Current SMAC Price

FLUVASTATIN SODIUM ORAL CAPSULE 40 MG 2.64297 08/23/2013 2.64297 04/22/2016

FLUVOXAMINE MALEATE ORAL CAPSULE, EXT RELEASE 24 HR 100 MG 7.12857 10/10/2014

FLUVOXAMINE MALEATE ORAL CAPSULE, EXT RELEASE 24 HR 150 MG 7.65030 10/10/2014

FLUVOXAMINE MALEATE ORAL TABLET 100 MG 0.33360 02/21/2020 0.42234 07/13/2020

FOLIC ACID INJECTION VIAL (ML) 5 MG/ML 1.79410 02/15/2013

FOLIC ACID ORAL TABLET 0.4 MG 0.01380 02/06/2015 0.01380 08/21/2015

FOLIC ACID ORAL TABLET 1 MG 0.02320 08/21/2015 0.00800 03/02/2018

FOLIC ACID/ARGININE HCL/CYANOCOBALAMIN/VIT B6/BLACK PEPPER TABLET 2-500-500

0.56210 01/25/2013

FOLIC ACID/MULTIVIT WITH MINERALS/LUTEIN ORAL TABLET 0.4MG-250 0.03600 01/25/2013

FOLIC ACID/PYRIDOXINE HCL/CA PHOS DIBASIC & TRIBASIC/GINGER ORAL TABLET 1.2-40-100

0.72360 01/25/2013 0.72360 08/21/2015

FOLIC ACID/VITAMIN B COMPLEX AND VITAMIN C ORAL TABLET 0.8 MG 0.09960 08/12/2014 0.09960 08/21/2015

FONDAPARINUX SODIUM SUBCUTANEOUS SYRINGE (ML) 10MG/0.8ML 94.71000 01/09/2015 94.71000 08/21/2015

FONDAPARINUX SODIUM SUBCUTANEOUS SYRINGE (ML) 2.5 MG/0.5 83.02000 08/21/2015 28.20200 02/21/2020

FONDAPARINUX SODIUM SUBCUTANEOUS SYRINGE (ML) 5MG/0.4ML 110.40650 01/09/2015 110.40650 08/21/2015

FONDAPARINUX SODIUM SUBCUTANEOUS SYRINGE (ML) 7.5MG/0.6 129.37800 01/09/2015 129.37800 08/21/2015

FORMALDEHYDE SOLUTION WITH APPLICATOR (ML) 10 % 0.36953 01/25/2013

FOSCARNET SODIUM INTRAVENOUS INFUSION BOTTLE (ML) 24 MG/ML 0.25326 01/30/2015 0.25326 08/21/2015

FOSINOPRIL SODIUM ORAL TABLET 10 MG 0.15448 08/21/2015 0.11000 12/21/2018

FOSINOPRIL SODIUM/HYDROCHLOROTHIAZIDE ORAL TABLET 10-12.5MG 0.74360 08/12/2014 0.74360 08/21/2015

FOSINOPRIL SODIUM/HYDROCHLOROTHIAZIDE ORAL TABLET 20-12.5 MG

1.06964 08/12/2014 1.06964 08/21/2015

FOSPHENYTOIN SODIUM INJECTION VIAL (ML) 100MG PE/2 0.91763 01/30/2015 0.91763 08/21/2015

FOSPHENYTOIN SODIUM INJECTION VIAL (ML) 500 PE/10 0.75985 01/30/2015 0.75985 08/21/2015

FUROSEMIDE INJECTION VIAL (ML) 10 MG/ML 0.40508 08/21/2015 0.36590 08/16/2019

FUROSEMIDE ORAL SOLUTION, ORAL 10 MG/ML 0.11127 05/17/2013

FUROSEMIDE ORAL SOLUTION, ORAL 40MG/5ML 0.14150 01/25/2013

FUROSEMIDE ORAL TABLET 20 MG 0.01363 04/24/2015 0.01363 08/21/2015

GABAPENTIN MISCELLANEOUS POWDER (GRAM) 100 % 1.14400 08/21/2015

GABAPENTIN ORAL CAPSULE 100 MG 0.03654 08/21/2015 0.02447 10/20/2017

GABAPENTIN ORAL SOLUTION, ORAL 250 MG/5ML 0.29166 01/25/2013

GABAPENTIN ORAL SOLUTION, ORAL 250 MG/5ML 0.15513 03/29/2019 0.11517 08/16/2019

GABAPENTIN ORAL SOLUTION, ORAL 300 MG/6ML 0.29164 01/25/2013

GABAPENTIN ORAL TABLET 600 MG 0.08738 01/27/2017 0.06198 04/17/2020

Effective 8/7/2020

Current SMAC Price

GABAPENTIN ORAL TABLET 800 MG 0.12078 07/14/2017 0.10138 12/22/2017

GALANTAMINE HBR ORAL CAPSULE, EXTENDED RELEASE PELLETS 24 HR 16 MG

1.31666 08/16/2019 1.18400 09/20/2019

2.00142 06/16/2017 0.83300 03/02/2018

1.22142 09/21/2018 0.43700 08/16/2019

GALANTAMINE HBR ORAL SOLUTION, ORAL 4 MG/ML 2.95575 01/25/2013 2.95575 08/21/2015

GALANTAMINE HBR ORAL TABLET 12 MG 0.65067 09/22/2017 0.15067 08/16/2019

GANCICLOVIR SODIUM INTRAVENOUS VIAL (EA) 500 MG 62.00208 02/27/2015

GANIRELIX ACETATE SUBCUTANEOUS SYRINGE (ML) 250MCG/0.5 243.87300 01/25/2013

GATIFLOXACIN OPHTHALMIC DROPS 0.5 % 24.56800 05/25/2018 20.80000 10/19/2018

GEMCITABINE HCL INTRAVENOUS VIAL (EA) 1 G 39.64700 01/23/2015 39.64700 08/21/2015

GEMCITABINE HCL INTRAVENOUS VIAL (EA) 2 G 96.93425 08/08/2014 96.93425 08/21/2015

GEMCITABINE HCL INTRAVENOUS VIAL (EA) 200 MG 9.28800 01/23/2015 9.28800 08/21/2015

GEMCITABINE HCL INTRAVENOUS VIAL (ML) 1 G/26.3ML 2.87559 08/12/2014

GEMCITABINE HCL INTRAVENOUS VIAL (ML) 2 G/52.6ML 3.25580 08/12/2014

GEMCITABINE HCL INTRAVENOUS VIAL (ML) 200MG/5.26 3.55320 08/12/2014

GEMFIBROZIL ORAL TABLET 600 MG 0.07726 06/16/2017 0.06021 12/22/2017

GENTAMICIN SULFATE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 100MG/50ML

0.13213 01/25/2013

GENTAMICIN SULFATE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 120MG/0.1L

0.06630 01/25/2013

GENTAMICIN SULFATE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 70 MG/50ML

0.15469 01/25/2013

GENTAMICIN SULFATE IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 90MG/100ML

0.07491 01/25/2013

GENTAMICIN SULFATE INJECTION VIAL (ML) 20 MG/2 ML 1.45158 01/25/2013

GENTAMICIN SULFATE INJECTION VIAL (ML) 40 MG/ML 0.51161 08/12/2014 1.35660 01/16/2017

GENTAMICIN SULFATE OPHTHALMIC DROPS 0.3 % 0.68286 11/24/2017 0.62300 06/21/2019

GENTAMICIN SULFATE OPHTHALMIC OINTMENT (GRAM) 0.3 % 3.99600 08/21/2015 8.10000 10/23/2019

GENTAMICIN SULFATE TOPICAL CREAM (GRAM) 0.1 % 1.86566 07/18/2018

GENTAMICIN SULFATE TOPICAL OINTMENT (GRAM) 0.1 % 2.52733 02/07/2019 2.02650 03/20/2020

GENTAMICIN SULFATE/PF INJECTION VIAL (ML) 20 MG/2 ML 1.09954 08/12/2014

GENTAMICIN SULFATE/PF INTRAVENOUS VIAL WITH THREADED PORT (ML) 100MG/10ML

0.29434 01/25/2013

GENTAMICIN SULFATE/PF INTRAVENOUS VIAL WITH THREADED PORT (ML) 60 MG/6 ML

0.39255 01/25/2013

GLIMEPIRIDE ORAL TABLET 1 MG 0.03490 12/22/2017 0.01800 01/25/2019

GLIPIZIDE ORAL TABLET 10 MG 0.05265 08/21/2015 0.02000 08/25/2017

GLIPIZIDE ORAL TABLET 5 MG 0.03000 08/21/2015 0.01935 10/20/2017

GLIPIZIDE ORAL TABLET, EXTENDED RELEASE 24 HR 10 MG 0.19510 07/26/2019 0.14525 12/20/2019

Effective 8/7/2020

Current SMAC Price

GLIPIZIDE ORAL TABLET, EXTENDED RELEASE 24 HR 2.5 MG 0.15400 12/22/2017 0.10667 03/15/2019

GLIPIZIDE ORAL TABLET, EXTENDED RELEASE 24 HR 5 MG 0.10660 03/16/2018 0.07990 10/25/2019

GLIPIZIDE/METFORMIN HCL ORAL TABLET 2.5-250 MG 0.34151 11/08/2013 0.34151 08/21/2015

GLIPIZIDE/METFORMIN HCL ORAL TABLET 2.5-500 MG 0.43480 05/20/2016 0.23690 05/17/2019

GLIPIZIDE/METFORMIN HCL ORAL TABLET 5 MG-500MG 0.24565 11/24/2017 0.21777 11/16/2018

GLUCOSAMINE SULFATE ORAL TABLET 750 MG 0.33095 01/25/2013

GLUCOSAMINE SULFATE/CHONDROITIN SULFATE/METHYLSULFONYLMETHAN ORAL TABLET 500-200 MG

1.20120 01/25/2013

GLYBURIDE ORAL TABLET 1.25 MG 0.07710 03/02/2018 0.06020 02/22/2019

GLYBURIDE ORAL TABLET 2.5 MG 0.13169 08/21/2015 0.03220 09/22/2017

GLYBURIDE ORAL TABLET 5 MG 0.11240 08/25/2017 0.04420 09/22/2017

GLYBURIDE,MICRONIZED ORAL TABLET 1.5 MG 0.02590 08/12/2014 0.02590 08/21/2015

GLYBURIDE,MICRONIZED ORAL TABLET 3 MG 0.02840 08/12/2014 0.02840 08/21/2015

GLYBURIDE,MICRONIZED ORAL TABLET 6 MG 0.09900 05/17/2013 0.09900 08/21/2015

GLYBURIDE/METFORMIN HCL ORAL TABLET 1.25-250MG 0.09353 08/21/2015 0.03860 11/16/2018

GLYBURIDE/METFORMIN HCL ORAL TABLET 2.5-500 MG 0.08911 08/21/2015 0.05000 08/25/2017

GLYBURIDE/METFORMIN HCL ORAL TABLET 5 MG-500MG 0.04340 08/25/2017 0.02658 02/22/2019

GLYCINE ORAL POWDER (GRAM) 0.21190 08/12/2014

GLYCINE UROLOGIC SOLUTION IRRIGATION SOLUTION, IRRIGATION 1.5 %

0.00291 08/12/2014

GLYCOPYRROLATE INJECTION VIAL (ML) 0.2 MG/ML 0.22100 08/21/2015

GLYCOPYRROLATE ORAL TABLET 1 MG 0.11360 05/17/2019 0.06940 03/20/2020

GLYCOPYRROLATE ORAL TABLET 2 MG 0.26900 09/22/2017 0.17170 03/02/2018

GRANISETRON HCL INTRAVENOUS VIAL (ML) 1 MG/ML 4.71250 01/25/2013 4.71250 08/21/2015

GRANISETRON HCL INTRAVENOUS VIAL (ML) 1 MG/ML(1) 7.21995 01/25/2013 6.71000 05/17/2019

GRANISETRON HCL ORAL TABLET 1 MG 1.52404 02/27/2015 1.52404 08/21/2015

GRANISETRON HCL/PF INTRAVENOUS VIAL (ML) 100 MCG/ML 3.21880 08/12/2014

GRISEOFULVIN ULTRAMICROSIZE ORAL TABLET 125 MG 3.68837 10/17/2014 3.68837 08/21/2015

GRISEOFULVIN ULTRAMICROSIZE ORAL TABLET 250 MG 4.28393 08/21/2015 2.81345 06/16/2017

GRISEOFULVIN, MICROSIZE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 125 MG/5ML

0.12406 01/31/2014 0.12406 08/21/2015

GRISEOFULVIN, MICROSIZE ORAL TABLET 500 MG 5.95588 12/05/2014

GUAIFENESIN ORAL LIQUID (ML) 100 MG/5ML 0.00603 09/19/2014 0.00603 08/21/2015

GUAIFENESIN ORAL TABLET 200 MG 0.04248 10/31/2014 0.04248 08/21/2015

GUAIFENESIN ORAL TABLET 400 MG 0.05655 08/12/2014 0.05655 08/21/2015

GUAIFENESIN ORAL TABLET, EXTENDED RELEASE 12 HR 600 MG 0.31161 08/21/2015

GUAIFENESIN/DEXTROMETHORPHAN HBR ORAL LIQUID (ML) 100-10MG/5

0.01776 11/07/2014 0.01776 08/21/2015

GUAIFENESIN/DEXTROMETHORPHAN HBR ORAL SYRUP 100-10MG/5 0.00801 08/12/2014 0.00801 08/21/2015

GUAIFENESIN/DEXTROMETHORPHAN HBR ORAL TABLET 400MG-20MG 0.07778 08/21/2015

GUAIFENESIN/DEXTROMETHORPHAN HBR/PHENYLEPHRINE ORAL DROPS 5-2.5MG/ML

0.15389 10/10/2014

GUAIFENESIN/DEXTROMETHORPHAN HBR/PHENYLEPHRINE ORAL LIQUID (ML) 100-10-5MG

0.01987 04/24/2015 0.01987 08/21/2015

Effective 8/7/2020

Current SMAC Price

GUAIFENESIN/DEXTROMETHORPHAN HBR/PHENYLEPHRINE ORAL LIQUID (ML) 100-15-5/5

0.03941 08/12/2014 0.03941 08/21/2015

GUAIFENESIN/DEXTROMETHORPHAN HBR/PHENYLEPHRINE ORAL LIQUID (ML) 200-10-5/5

0.02590 08/12/2014

GUAIFENESIN/DEXTROMETHORPHAN HBR/PHENYLEPHRINE ORAL LIQUID (ML) 200-20-10

0.07980 08/12/2014 0.07980 08/21/2015

GUAIFENESIN/DEXTROMETHORPHAN HBR/PHENYLEPHRINE ORAL TABLET 380-15-10

0.47192 12/12/2014 0.47192 08/21/2015

GUAIFENESIN/PHENYLEPHRINE HCL ORAL TABLET 380MG-10MG 0.43170 08/12/2014

GUANFACINE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 1 MG 0.32400 07/26/2019 0.29290 12/20/2019

GUANIDINE HCL ORAL TABLET 125 MG 0.17724 01/25/2013

HALOBETASOL PROPIONATE TOPICAL CREAM (GRAM) 0.05 % 0.92200 08/16/2019 0.79908 11/15/2019

HALOBETASOL PROPIONATE TOPICAL OINTMENT (GRAM) 0.05 % 2.05920 06/16/2017 1.65860 03/20/2020

HALOPERIDOL DECANOATE INTRAMUSCULAR AMPUL (ML) 100 MG/ML 43.21000 04/15/2019 35.04600 05/17/2019

HALOPERIDOL DECANOATE INTRAMUSCULAR AMPUL (ML) 50 MG/ML 21.74667 01/25/2013

HALOPERIDOL DECANOATE INTRAMUSCULAR VIAL (ML) 100 MG/ML 43.24600 10/13/2015 38.75000 12/21/2018

HALOPERIDOL DECANOATE INTRAMUSCULAR VIAL (ML) 50 MG/ML 22.14000 08/21/2015 22.00000 01/25/2019

HALOPERIDOL LACTATE INJECTION AMPUL (ML) 5 MG/ML 5.15760 01/25/2013

HALOPERIDOL LACTATE INJECTION VIAL (ML) 5 MG/ML 1.02376 08/21/2015 0.63747 08/17/2018

HALOPERIDOL LACTATE ORAL CONCENTRATE, ORAL 2 MG/ML 0.03924 08/17/2018 0.06721 05/23/2019

HALOPERIDOL ORAL TABLET 0.5 MG 0.21117 10/11/2013 0.15250 08/25/2017

HALOPERIDOL ORAL TABLET 1 MG 0.33160 02/22/2018 0.28000 05/25/2018

HEPARIN SODIUM,PORCINE IN 0.45 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 12500/250

0.04754 04/10/2015 0.04754 08/21/2015

0.02356 04/10/2015 0.02356 08/21/2015

0.01978 04/10/2015 0.01978 08/21/2015

HEPARIN SODIUM,PORCINE IN 0.9 % SODIUM CHLORIDE/PF INTRAVENOUS INTRAVENOUS SOLUTION 1000/500ML

0.00720 01/25/2013 0.00720 08/21/2015

HEPARIN SODIUM,PORCINE IN 0.9 % SODIUM CHLORIDE/PF INTRAVENOUS INTRAVENOUS SOLUTION 2K/1000ML

0.00440 08/12/2014 0.00440 08/21/2015

HEPARIN SODIUM,PORCINE INJECTION CARTRIDGE (ML) 5000/ML(1) 3.65400 01/25/2013

HEPARIN SODIUM,PORCINE INJECTION VIAL (ML) 1000/ML 0.20739 11/28/2014 0.20739 08/21/2015

HEPARIN SODIUM,PORCINE INJECTION VIAL (ML) 20000/ML 8.04388 04/03/2015

HEPARIN SODIUM,PORCINE INTRAVENOUS SYRINGE (ML) 500/5 ML 0.32928 11/15/2013

HEPARIN SODIUM,PORCINE INTRAVENOUS VIAL (ML) 100/ML 0.03983 04/05/2013 0.03983 08/21/2015

HEPARIN SODIUM,PORCINE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 12500/250

0.05431 04/24/2015 0.05431 08/21/2015

Effective 8/7/2020

Current SMAC Price

HEPARIN SODIUM,PORCINE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 20K/500ML

0.01097 04/17/2015 0.01097 08/21/2015

HEPARIN SODIUM,PORCINE/PF INJECTION CARTRIDGE (ML) 5000/0.5ML 3.99840 05/01/2015 3.99840 08/21/2015

HEPARIN SODIUM,PORCINE/PF INJECTION VIAL (ML) 1000/ML 3.64676 08/12/2014

HEPARIN SODIUM,PORCINE/PF INJECTION VIAL (ML) 5000/0.5ML 9.36923 01/25/2013

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 1 UNIT/ML 0.53235 05/31/2013 0.53235 08/21/2015

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 10 UNIT/ML 0.15678 05/31/2013 0.15678 08/21/2015

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 100/ML (1) 0.14740 05/31/2013

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 1000/10 ML 0.14740 05/31/2013

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 200/2 ML 0.14740 05/31/2013

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 300/3 ML 0.15513 07/25/2014 0.15513 08/21/2015

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS SYRINGE (ML) 500/5 ML 0.09299 03/07/2014 0.09299 08/21/2015

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS VIAL (ML) 10 UNIT/ML 1.27250 08/12/2014

HEPARIN SODIUM,PORCINE/PF INTRAVENOUS VIAL (ML) 100/ML (1) 1.63384 01/25/2013

HYDRALAZINE HCL INJECTION VIAL (ML) 20 MG/ML 4.60408 07/19/2013

HYDRALAZINE HCL ORAL TABLET 10 MG 0.05309 08/21/2015 0.03468 08/25/2017

HYDROCHLOROTHIAZIDE ORAL CAPSULE 12.5 MG 0.05352 08/21/2015 0.02000 08/25/2017

HYDROCHLOROTHIAZIDE ORAL TABLET 12.5 MG 0.08000 08/25/2017 0.05327 11/15/2019

HYDROCHLOROTHIAZIDE ORAL TABLET 25 MG 0.02250 08/21/2015 0.00892 10/20/2017

HYDROCHLOROTHIAZIDE ORAL TABLET 50 MG 0.04931 08/21/2015 0.01144 08/25/2017

HYDROCODONE BITARTRATE MISCELLANEOUS POWDER (GRAM) 100 % 7.56450 08/21/2015

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL SOLUTION, ORAL 2.5-108/5

0.56630 05/30/2014

0.47191 01/25/2013

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL SOLUTION, ORAL 5-217MG/10

0.59709 08/01/2014

0.16755 08/12/2014

0.07831 07/11/2017 0.04658 11/24/2017

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL TABLET 10MG-300MG

1.78019 10/17/2014 0.60510 09/22/2017

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL TABLET 10MG-325MG

0.16477 05/19/2017 0.10886 06/16/2017

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL TABLET 2.5-325 MG

0.69069 04/03/2015

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL TABLET 5 MG-300MG

0.65450 09/22/2017 0.32970 05/22/2020

HYDROCODONE BITARTRATE/ACETAMINOPHEN ORAL TABLET 5 MG-325MG

0.14569 03/03/2017 0.06500 08/25/2017

1.07550 06/16/2017 0.70230 09/22/2017

0.09087 01/25/2019 0.07087 08/16/2019

Effective 8/7/2020

Current SMAC Price

HYDROCODONE BITARTRATE/HOMATROPINE METHYLBROMIDE ORAL SYRUP 5-1.5 MG/5

0.52500 01/25/2013

HYDROCODONE BITARTRATE/HOMATROPINE METHYLBROMIDE ORAL SYRUP 5-1.5 MG/5

0.06580 08/12/2014

HYDROCODONE BITARTRATE/HOMATROPINE METHYLBROMIDE ORAL TABLET 5 MG-1.5MG

0.71674 01/30/2015 0.71674 08/21/2015

HYDROCODONE POLISTIREX/CHLORPHENIRAMINE POLISTIREX ORAL SUSPENSION, EXTENDED RELEASE 12 HR 10-8MG/5ML

0.40047 11/24/2017 0.38226 10/19/2018

HYDROCODONE/IBUPROFEN ORAL TABLET 10MG-200MG 3.99069 04/10/2015 3.99069 08/21/2015

HYDROCODONE/IBUPROFEN ORAL TABLET 2.5-200 MG 2.04491 01/25/2013 2.04491 08/21/2015

HYDROCODONE/IBUPROFEN ORAL TABLET 5MG-200MG 2.49634 08/21/2015 2.23740 09/22/2017

HYDROCODONE/IBUPROFEN ORAL TABLET 7.5-200 MG 0.25323 05/20/2016 0.15400 07/14/2017

HYDROCORTISONE ACETATE MISCELLANEOUS POWDER (GRAM) 3.23180 01/25/2013 3.23180 08/21/2015

HYDROCORTISONE ACETATE RECTAL SUPPOSITORY, RECTAL 25 MG 2.93375 08/16/2019 2.38958 03/20/2020

HYDROCORTISONE ACETATE RECTAL SUPPOSITORY, RECTAL 30 MG 3.95180 08/12/2014

HYDROCORTISONE ACETATE/LIDOCAINE HCL/ALOE VERA RECTAL KIT 2.5-3%(7G)

251.09000 07/18/2014

HYDROCORTISONE ACETATE/PRAMOXINE HCL TOPICAL CREAM (GRAM) 2.5 %-1 %

1.29675 05/01/2015 1.29675 08/21/2015

HYDROCORTISONE BUTYRATE TOPICAL CREAM (GRAM) 0.1 % 1.02530 02/15/2013 1.02530 08/21/2015

HYDROCORTISONE BUTYRATE TOPICAL OINTMENT (GRAM) 0.1 % 1.88020 05/09/2014 1.88020 08/21/2015

HYDROCORTISONE BUTYRATE TOPICAL SOLUTION, NON-ORAL 0.1 % 0.21870 07/25/2014 0.21870 08/21/2015

HYDROCORTISONE BUTYRATE/EMOLLIENT BASE TOPICAL CREAM (GRAM) 0.1 %

6.29588 12/27/2013

HYDROCORTISONE MISCELLANEOUS POWDER (GRAM) 2.18774 08/12/2014 2.18774 08/21/2015

HYDROCORTISONE ORAL TABLET 10 MG 0.28362 05/20/2016 0.21970 09/22/2017

HYDROCORTISONE RECTAL ENEMA (ML) 100MG/60ML 0.06885 12/05/2014 0.06885 08/21/2015

HYDROCORTISONE TOPICAL CREAM (GRAM) 0.5 % 0.08224 04/05/2013 0.08224 08/21/2015

HYDROCORTISONE TOPICAL CREAM (GRAM) 1 % 0.05060 01/30/2015 0.05060 08/21/2015

HYDROCORTISONE TOPICAL CREAM (GRAM) 2.5 % 0.08792 10/25/2019 0.07675 05/22/2020

HYDROCORTISONE TOPICAL CREAM WITH PERINEAL APPLICATOR 1 % 0.66820 01/25/2013

HYDROCORTISONE TOPICAL CREAM WITH PERINEAL APPLICATOR 2.5 %

0.42190 12/23/2019 0.34234 05/22/2020

HYDROCORTISONE TOPICAL LOTION (GRAM) 1 % 0.04414 08/12/2014

HYDROCORTISONE TOPICAL LOTION (ML) 1 % 0.03153 08/12/2014 0.03153 08/21/2015

HYDROCORTISONE TOPICAL LOTION (ML) 2.5 % 0.23863 04/12/2013

HYDROCORTISONE TOPICAL OINTMENT (GRAM) 1 % 0.10490 01/30/2015 0.10490 08/21/2015

HYDROCORTISONE TOPICAL OINTMENT (GRAM) 2.5 % 0.11200 08/12/2014 0.11200 08/21/2015

HYDROCORTISONE VALERATE TOPICAL CREAM (GRAM) 0.2 % 1.43182 11/15/2019 1.04733 05/22/2020

HYDROCORTISONE VALERATE TOPICAL OINTMENT (GRAM) 0.2 % 4.59200 07/25/2014 4.59200 08/21/2015

HYDROCORTISONE/ACETIC ACID OTIC DROPS 1 %-2 % 9.82215 08/21/2015 8.85454 01/13/2017

HYDROCORTISONE/ALOE VERA TOPICAL CREAM (GRAM) 1 % 0.08883 08/21/2015 0.04374 01/25/2019

HYDROCORTISONE/IODOQUINOL TOPICAL CREAM (GRAM) 1 %-1 % 0.43200 08/12/2014

Effective 8/7/2020

Current SMAC Price

HYDROCORTISONE/MINERAL OIL/PETROLATUM,WHITE OINTMENT (GRAM) 1 %

0.12564 01/25/2013

HYDROMORPHONE HCL INJECTION AMPUL (ML) 1 MG/ML 0.87360 01/25/2013

HYDROMORPHONE HCL INJECTION AMPUL (ML) 4 MG/ML 1.33560 01/25/2013

HYDROMORPHONE HCL INJECTION SYRINGE (ML) 0.5MG/.5ML 8.44200 06/21/2013

HYDROMORPHONE HCL INJECTION SYRINGE (ML) 1 MG/ML 3.90600 01/25/2013

HYDROMORPHONE HCL INJECTION VIAL (ML) 2 MG/ML 0.87780 08/12/2014

HYDROMORPHONE HCL ORAL LIQUID (ML) 1 MG/ML 0.27988 01/25/2013

HYDROMORPHONE HCL ORAL TABLET 2 MG 0.07780 08/25/2017 0.05790 05/22/2020

HYDROMORPHONE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 12 MG

14.29670 08/01/2014 14.29670 08/21/2015

19.06219 08/21/2015 15.75000 05/25/2018

37.91137 08/01/2014

9.53110 08/01/2014 9.53110 08/21/2015

HYDROMORPHONE HCL RECTAL SUPPOSITORY, RECTAL 3 MG 8.58670 02/01/2013

HYDROMORPHONE HCL/PF INJECTION AMPUL (ML) 1 MG/ML 0.87360 01/25/2013

HYDROMORPHONE HCL/PF INJECTION SYRINGE (ML) 4 MG/ML 3.78000 01/25/2013

HYDROMORPHONE HCL/PF INJECTION VIAL (ML) 10 MG/ML 1.90750 01/30/2015 1.61638 12/02/2016

HYDROQUINONE MICROSPHERES TOPICAL CREAM, EXTENDED RELEASE (GRAM) 4 %

2.49387 01/25/2013

HYDROQUINONE TOPICAL CREAM (GRAM) 4 % 2.30566 08/21/2015 0.83056 11/15/2019

HYDROXOCOBALAMIN INTRAMUSCULAR VIAL (ML) 1000MCG/ML 0.89273 01/25/2013

HYDROXYUREA ORAL CAPSULE 500 MG 0.21423 11/24/2017 0.18352 03/02/2018

HYDROXYZINE HCL INTRAMUSCULAR VIAL (ML) 50 MG/ML 1.75000 01/25/2013 1.75000 08/21/2015

HYDROXYZINE HCL ORAL SOLUTION, ORAL 10 MG/5 ML 0.05916 08/21/2015 0.03692 03/02/2018

HYDROXYZINE HCL ORAL TABLET 10 MG 0.07338 08/21/2015 0.03772 09/22/2017

HYDROXYZINE PAMOATE ORAL CAPSULE 100 MG 0.52378 08/15/2014 0.52378 08/21/2015

HYOSCYAMINE SULFATE ORAL DROPS 0.125MG/ML 1.29622 04/24/2015 1.29622 08/21/2015

HYOSCYAMINE SULFATE ORAL ELIXIR 125MCG/5ML 0.04790 12/26/2014

HYOSCYAMINE SULFATE ORAL TABLET 0.125 MG 0.13030 09/22/2017 0.11025 08/16/2019

HYOSCYAMINE SULFATE ORAL TABLET, EXTENDED RELEASE 12 HR 0.375 MG

0.60697 07/18/2014 0.60697 08/21/2015

Effective 8/7/2020

Current SMAC Price

HYOSCYAMINE SULFATE ORAL TABLET,DISINTEGRATING 0.125 MG 0.18450 03/16/2018 0.12900 05/17/2019

HYOSCYAMINE SULFATE SUBLINGUAL TABLET, SUBLINGUAL 0.125 MG 0.19432 12/25/2015 0.07000 07/14/2017

HYPROMELLOSE OPHTHALMIC DROPS 0.3 % 0.35978 08/12/2014

HYPROMELLOSE OPHTHALMIC DROPS 0.4 % 0.17850 01/25/2013

IBANDRONATE SODIUM INTRAVENOUS SYRINGE (ML) 3 MG/3 ML 74.36375 11/14/2014

IBANDRONATE SODIUM ORAL TABLET 150 MG 4.66000 06/22/2018 4.34278 11/15/2019

IBUPROFEN ORAL CAPSULE 200 MG 0.10261 04/10/2015 0.10261 08/21/2015

IBUPROFEN ORAL SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 50 MG/1.25

0.22167 01/30/2015 0.22167 08/21/2015

IBUPROFEN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 100 MG/5ML 0.02262 04/17/2015 0.02262 08/21/2015

IBUPROFEN ORAL TABLET 200 MG 0.01635 01/16/2015 0.01635 08/21/2015

IBUPROFEN ORAL TABLET,CHEWABLE 100 MG 0.12702 08/21/2015 0.12802 05/03/2019

IBUPROFEN/OXYCODONE HCL ORAL TABLET 400 MG-5MG 1.03130 08/12/2014 1.03130 08/21/2015

IFOSFAMIDE INTRAVENOUS VIAL (EA) 3 G 88.61300 01/25/2013

IFOSFAMIDE INTRAVENOUS VIAL (ML) 1 G/20 ML 2.09300 02/27/2015 2.09300 08/21/2015

IFOSFAMIDE INTRAVENOUS VIAL (ML) 3 G/60 ML 1.93007 10/17/2014 1.93007 08/21/2015

IFOSFAMIDE/MESNA KIT 3G-1G 281.14725 01/25/2013

IMIPENEM/CILASTATIN SODIUM INTRAVENOUS VIAL (EA) 250 MG 4.41000 08/12/2014 4.41000 08/21/2015

IMIPENEM/CILASTATIN SODIUM INTRAVENOUS VIAL (EA) 500 MG 8.82000 04/18/2014 8.82000 08/21/2015

IMIPRAMINE HCL ORAL TABLET 10 MG 0.10780 08/25/2017 0.06140 11/24/2017

IMIPRAMINE PAMOATE ORAL CAPSULE 100 MG 5.97100 03/07/2014

IMIQUIMOD TOPICAL CREAM IN PACKET (EA) 5 % 2.07408 06/16/2017 1.89000 12/20/2019

INDAPAMIDE ORAL TABLET 1.25 MG 0.30448 08/01/2014 0.17220 09/22/2017

INDAPAMIDE ORAL TABLET 2.5 MG 0.17880 09/22/2017 0.14820 01/24/2020

INDOMETHACIN ORAL CAPSULE 25 MG 0.07340 12/22/2017 0.02910 11/16/2018

INDOMETHACIN ORAL CAPSULE 50 MG 0.09440 03/02/2018 0.07690 09/21/2018

INDOMETHACIN ORAL CAPSULE, EXTENDED RELEASE 75 MG 0.32783 07/14/2017 0.27750 03/02/2018

INDOMETHACIN SODIUM INTRAVENOUS VIAL (EA) 1 MG 365.86025 08/12/2014

IPRATROPIUM BROMIDE INHALATION SOLUTION, NON-ORAL 0.2 MG/ML 0.06013 08/21/2015 0.03720 07/26/2019

IPRATROPIUM BROMIDE NASAL AEROSOL, SPRAY (ML) 21 MCG 0.62500 12/25/2015 0.59969 04/21/2017

IPRATROPIUM BROMIDE NASAL AEROSOL, SPRAY (ML) 42 MCG 2.39930 05/03/2019 1.51067 07/17/2020

IPRATROPIUM BROMIDE/ALBUTEROL SULFATE INHALATION AMPUL FOR NEBULIZATION (ML) 0.5-3MG/3

0.05553 03/03/2017 0.04815 07/26/2019

IRBESARTAN ORAL TABLET 150 MG 0.13666 08/25/2017 0.11244 10/20/2017

IRBESARTAN ORAL TABLET 75 MG 0.14563 08/21/2015 0.08700 09/22/2017

Effective 8/7/2020

Current SMAC Price

IRBESARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 150-12.5MG 0.18022 03/02/2018 0.15667 08/17/2018

IRBESARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 300-12.5MG 0.19011 09/22/2017 0.17176 11/16/2018

IRON CARBONYL,GLUC/FOLIC ACID/VIT B12/VIT C/DOCUSATE SODIUM TABLET 90-1-50 MG

0.78945 08/21/2015 2.02566 12/13/2018

IRON POLYSACCHAR COMPLX/IRON HEME POLYPEPTIDE/FOLIC ACID/B12 ORAL TABLET 22-6-1-25

2.61148 01/25/2013 2.61148 08/21/2015

IRON POLYSACCHARIDE COMPLEX ORAL CAPSULE 150 MG 0.12990 08/16/2013 0.12990 08/21/2015

IRON POLYSACCHARIDE COMPLEX/CYANOCOBALAMIN/FOLIC ACID ORAL CAPSULE 150-25-1

0.19524 02/20/2015 0.19524 08/21/2015

IRON POLYSACCHARIDE COMPLEX/IRON HEME POLYPEPTIDE ORAL TABLET 28 MG

0.37090 08/12/2014

IRON,CARBONYL ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 15MG/1.25

0.12650 08/12/2014

IRON,CARBONYL/ASCORBIC ACID/CYANOCOBALAMIN/FOLIC ACID ORAL TABLET 100-250-1

0.80738 08/12/2014

IRON,CARBONYL/DOCUSATE SODIUM/B12-IF/FOLIC ACID/MULTIVIT-MIN TABLET, EXTENDED RELEASE 24 HR 150-50-1MG

0.47055 01/25/2013

ISOMETHEPTENE MUCATE/DICHLORALPHENAZONE/ACETAMINOPHEN CAPSULE 65-100-325

4.71877 09/19/2014 4.71877 08/21/2015

ISONIAZID INJECTION VIAL (ML) 100 MG/ML 63.03150 01/25/2013

ISONIAZID ORAL SOLUTION, ORAL 50 MG/5 ML 0.09983 01/25/2013

ISONIAZID ORAL TABLET 100 MG 0.04221 12/13/2013 0.04221 08/21/2015

ISONIAZID ORAL TABLET 300 MG 0.06993 11/28/2014 0.06993 08/21/2015

ISOPROPYL ALCOHOL IN GLYCERIN OTIC DROPS 95 %-5 % 0.07020 08/12/2014 0.07020 08/21/2015

ISOSORBIDE DINITRATE ORAL TABLET 10 MG 0.68863 08/21/2015 0.22376 09/30/2016

ISOSORBIDE DINITRATE ORAL TABLET, EXTENDED RELEASE 40 MG 1.24501 12/05/2014 1.24501 08/21/2015

ISOSORBIDE MONONITRATE ORAL TABLET 10 MG 0.19730 01/25/2013 0.19730 08/21/2015

ISOSORBIDE MONONITRATE ORAL TABLET 20 MG 0.12251 10/11/2013 0.09070 01/19/2018

ISOSORBIDE MONONITRATE ORAL TABLET, EXTENDED RELEASE 24 HR 120 MG

0.31550 09/22/2017 0.24000 11/24/2017

0.10900 11/16/2018 0.07058 05/17/2019

0.08680 01/24/2020 0.06790 03/20/2020

ISOSULFAN BLUE SUBCUTANEOUS VIAL (ML) 1 % 110.57218 04/03/2015 110.57218 08/21/2015

ISOTRETINOIN ORAL CAPSULE 10 MG 6.52054 01/22/2016 3.70100 10/19/2018

ISOXSUPRINE HCL ORAL TABLET 10 MG 0.80892 04/03/2015 0.80892 08/21/2015

ISRADIPINE ORAL CAPSULE 2.5 MG 0.95543 02/13/2015 0.95543 08/21/2015

ISRADIPINE ORAL CAPSULE 5 MG 1.39713 03/27/2015 1.39713 08/21/2015

ITRACONAZOLE ORAL CAPSULE 100 MG 1.62600 09/20/2019 1.09133 11/15/2019

IVERMECTIN ORAL TABLET 3 MG 7.57155 01/16/2015

Effective 8/7/2020

Current SMAC Price

KETOCONAZOLE ORAL TABLET 200 MG 0.98460 12/22/2017 0.93167 03/02/2018

KETOCONAZOLE TOPICAL CREAM (GRAM) 2 % 0.46671 02/21/2020 0.36634 07/17/2020

KETOCONAZOLE TOPICAL SHAMPOO 2 % 0.07500 03/17/2017 0.05789 08/25/2017

KETOPROFEN ORAL CAPSULE 75 MG 0.40169 03/06/2015 0.40169 08/21/2015

KETOPROFEN ORAL CAPSULE, EXTENDED RELEASE PELLETS 24 HR 200 MG

5.64648 03/13/2015 5.64648 08/21/2015

KETOROLAC TROMETHAMINE INJECTION SYRINGE (ML) 30 MG/ML 1.81000 04/25/2014

KETOROLAC TROMETHAMINE INJECTION VIAL (ML) 15 MG/ML 1.01304 02/13/2015 1.01304 08/21/2015

KETOROLAC TROMETHAMINE INJECTION VIAL (ML) 30 MG/ML 1.31943 01/25/2013

KETOROLAC TROMETHAMINE INJECTION VIAL (ML) 30MG/ML(1) 1.08696 02/13/2015 1.08696 08/21/2015

KETOROLAC TROMETHAMINE INTRAMUSCULAR VIAL (ML) 60 MG/2 ML 0.97981 02/13/2015 0.97981 08/21/2015

KETOROLAC TROMETHAMINE OPHTHALMIC DROPS 0.4 % 7.81600 03/27/2015 7.81600 08/21/2015

KETOROLAC TROMETHAMINE OPHTHALMIC DROPS 0.5 % 1.29534 08/21/2015 1.13433 08/25/2017

KETOROLAC TROMETHAMINE ORAL TABLET 10 MG 0.69950 11/16/2018 0.58960 05/22/2020

KETOTIFEN FUMARATE OPHTHALMIC DROPS 0.025 % 0.92080 03/27/2015 0.92080 08/21/2015

LABETALOL HCL INTRAVENOUS SYRINGE (ML) 20 MG/4 ML 0.65310 01/25/2013 0.65310 08/21/2015

LABETALOL HCL ORAL TABLET 100 MG 0.14153 05/17/2019 0.10450 09/20/2019

LACTIC ACID CREAM (GRAM) 10 % 0.08303 01/25/2013

LACTIC ACID LOTION (ML) 10 % 0.04280 08/12/2014

LACTULOSE ORAL SOLUTION, ORAL 10 G/15 ML 0.03407 04/03/2015

LACTULOSE ORAL SOLUTION, ORAL 10 G/15 ML 0.01396 04/24/2015

LACTULOSE ORAL SOLUTION, ORAL 10 G/15 ML 0.01301 11/21/2014 0.01301 08/21/2015

LACTULOSE ORAL SOLUTION, ORAL 20 G/30 ML 0.02205 02/07/2014 0.02205 08/21/2015

LAMIVUDINE ORAL SOLUTION, ORAL 10 MG/ML 0.34922 03/13/2015 0.27563 11/24/2017

LAMIVUDINE ORAL TABLET 150 MG 1.72083 03/17/2017 0.65500 11/15/2019

LAMIVUDINE ORAL TABLET 300 MG 1.61000 11/24/2017 1.31000 11/15/2019

LAMIVUDINE/ZIDOVUDINE ORAL TABLET 150-300 MG 0.91667 09/22/2017 0.33467 05/22/2020

LAMOTRIGINE ORAL TABLET 100 MG 0.05167 08/25/2017 0.03960 12/22/2017

LAMOTRIGINE ORAL TABLET, CHEWABLE DISPERSIBLE 25 MG 0.13440 02/21/2020 0.20031 04/08/2020

LAMOTRIGINE ORAL TABLET, CHEWABLE DISPERSIBLE 5 MG 0.08870 02/22/2019 0.17130 05/21/2019

LAMOTRIGINE ORAL TABLET, DOSE PACK 25MG (35) 2.90500 01/25/2013

LAMOTRIGINE ORAL TABLET, EXTENDED RELEASE 24 HR 100 MG 1.92966 01/25/2019 1.72650 06/21/2019

Effective 8/7/2020

Current SMAC Price

LAMOTRIGINE ORAL TABLET,DISINTEGRATING 100 MG 5.81000 08/17/2018 3.93467 05/22/2020

LANOLIN/MINERAL OIL/PETROLATUM,WHITE OPHTHALMIC OINTMENT (GRAM)

0.91000 01/25/2013 0.91000 08/21/2015

LANSOPRAZOLE ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 15 MG

0.28500 06/16/2017 0.13167 05/17/2019

LANSOPRAZOLE ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 MG

0.15656 07/14/2017 0.08467 03/15/2019

LANSOPRAZOLE/AMOXICILLIN TRIHYDRATE/CLARITHROMYCIN ORAL COMBINATION PACKAGE (EA) 30-500-500

3.59300 03/20/2015

LATANOPROST OPHTHALMIC DROPS 0.005 % 1.67400 10/19/2018 1.62800 04/17/2020

LEFLUNOMIDE ORAL TABLET 10 MG 0.76500 02/22/2019 0.66667 05/17/2019

LEFLUNOMIDE ORAL TABLET 20 MG 1.34389 08/16/2019 1.03800 03/20/2020

LETROZOLE ORAL TABLET 2.5 MG 0.10433 07/14/2017 0.08978 04/17/2020

LEUCOVORIN CALCIUM INJECTION VIAL (EA) 200 MG 16.25400 08/12/2014 16.25400 08/21/2015

LEUCOVORIN CALCIUM INJECTION VIAL (EA) 50 MG 5.85200 08/12/2014 5.85200 08/21/2015

LEUCOVORIN CALCIUM INJECTION VIAL (EA) 500 MG 99.22500 01/25/2013

LEUCOVORIN CALCIUM INJECTION VIAL (ML) 10 MG/ML 0.29460 08/12/2014 0.29460 08/21/2015

LEUCOVORIN CALCIUM ORAL TABLET 10 MG 5.25150 08/12/2014

LEUCOVORIN CALCIUM ORAL TABLET 15 MG 5.85368 01/25/2013

LEUCOVORIN CALCIUM ORAL TABLET 25 MG 7.83744 05/17/2013 4.84400 03/02/2018

LEUCOVORIN CALCIUM ORAL TABLET 5 MG 0.64904 12/02/2016 0.60030 08/17/2018

LEUPROLIDE ACETATE SUBCUTANEOUS KIT 1 MG/0.2ML 129.30375 03/13/2015 129.30375 08/21/2015

LEVALBUTEROL HCL INHALATION VIAL, NEBULIZER (EA) 1.25MG/0.5 4.52639 12/26/2014 4.52639 08/21/2015

LEVALBUTEROL HCL INHALATION VIAL, NEBULIZER (ML) 0.31MG/3ML 0.78893 08/21/2015 0.54096 03/17/2017

LEVETIRACETAM IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 1000MG/100

0.59877 01/25/2013

LEVETIRACETAM IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 1500MG/100

0.77967 01/25/2013

LEVETIRACETAM IN SODIUM CHLORIDE, ISO-OSMOTIC INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 500MG/0.1L

0.36284 01/25/2013

LEVETIRACETAM INTRAVENOUS VIAL (ML) 500 MG/5ML 1.29524 08/12/2014 1.29524 08/21/2015

LEVETIRACETAM ORAL SOLUTION, ORAL 100 MG/ML 0.04966 08/21/2015 0.03332 10/20/2017

LEVETIRACETAM ORAL SOLUTION, ORAL 500 MG/5ML 1.06824 08/21/2015 0.05210 09/30/2016

LEVETIRACETAM ORAL TABLET 1000 MG 0.21650 07/26/2019 0.19483 07/17/2020

LEVETIRACETAM ORAL TABLET, EXTENDED RELEASE 24 HR 500 MG 0.16667 07/26/2019 0.74117 06/29/2020

LEVETIRACETAM ORAL TABLET, EXTENDED RELEASE 24 HR 750 MG 0.27750 05/17/2019 0.21650 05/22/2020

LEVOBUNOLOL HCL OPHTHALMIC DROPS 0.5 % 2.15200 09/30/2016 0.58000 12/21/2018

Effective 8/7/2020

Current SMAC Price

LEVOCARNITINE (WITH SUGAR) ORAL SOLUTION, ORAL 100 MG/ML 0.27042 06/22/2018 0.19661 11/15/2019

LEVOCARNITINE ORAL TABLET 330 MG 0.53495 04/24/2015 0.72599 05/25/2018

LEVOCARNITINE ORAL TABLET 500 MG 0.24450 10/24/2014 0.24450 08/21/2015

LEVOCETIRIZINE DIHYDROCHLORIDE ORAL SOLUTION, ORAL 2.5 MG/5ML

0.43651 08/12/2014 0.43651 08/21/2015

LEVOCETIRIZINE DIHYDROCHLORIDE ORAL TABLET 5 MG 0.07215 11/16/2018 0.06111 04/26/2019

LEVOFLOXACIN INTRAVENOUS VIAL (ML) 25 MG/ML 0.55298 08/12/2014

LEVOFLOXACIN OPHTHALMIC DROPS 0.5 % 7.88880 01/25/2013

LEVOFLOXACIN ORAL SOLUTION, ORAL 250MG/10ML 0.88900 08/12/2014

LEVOFLOXACIN ORAL TABLET 250 MG 0.14767 08/21/2015 0.05240 03/15/2019

LEVOFLOXACIN/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 250MG/50ML

0.11258 08/12/2014

LEVOFLOXACIN/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 500MG/0.1L

0.06601 08/12/2014 0.02228 11/24/2017

LEVOFLOXACIN/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 750MG/.15L

0.05357 08/12/2014 0.01569 11/24/2017

LEVOMEFOLATE CALCIUM ORAL TABLET 15 MG 2.04831 01/23/2015 2.04831 08/21/2015

LEVOMEFOLATE CALCIUM ORAL TABLET 7.5 MG 2.05620 02/20/2015 2.05620 08/21/2015

LEVONORGESTREL ORAL TABLET 0.75 MG 12.79600 01/25/2013 12.79600 08/21/2015

LEVONORGESTREL ORAL TABLET 1.5 MG 10.22000 05/17/2019 8.50000 12/20/2019

LEVONORGESTREL/ETHINYL ESTRADIOL AND ETHINYL ESTRADIOL ORAL TABLET, DOSE PACK, 3 MONTHS 100-20(84)

0.99800 12/21/2018 0.41879 01/25/2019

LEVONORGESTREL/ETHINYL ESTRADIOL AND ETHINYL ESTRADIOL ORAL TABLET, DOSE PACK, 3 MONTHS 150-30(84)

0.31610 03/20/2020 0.56003 05/12/2020

LEVONORGESTREL/ETHINYL ESTRADIOL ORAL TABLET 0.1-0.02MG 0.21078 03/15/2019 0.09595 07/17/2020

LEVONORGESTREL/ETHINYL ESTRADIOL ORAL TABLET 0.15-0.03 0.19619 09/30/2016 0.11607 03/02/2018

LEVONORGESTREL/ETHINYL ESTRADIOL ORAL TABLET 6-5-10 0.68718 08/12/2014 0.18904 07/08/2016

LEVONORGESTREL/ETHINYL ESTRADIOL ORAL TABLET 90-20 MCG 1.48500 04/24/2015

LEVONORGESTREL/ETHINYL ESTRADIOL ORAL TABLET, DOSE PACK, 3 MONTHS 0.15-0.03

0.40699 05/23/2018 0.32100 11/16/2018

LEVORPHANOL TARTRATE ORAL TABLET 2 MG 1.12600 08/12/2014 1.12600 08/21/2015

LEVOTHYROXINE SODIUM INTRAVENOUS VIAL (EA) 100 MCG 77.11900 11/07/2014 77.11900 08/21/2015

LEVOTHYROXINE SODIUM INTRAVENOUS VIAL (EA) 500 MCG 44.60050 01/25/2013 44.60050 08/21/2015

LEVOTHYROXINE SODIUM ORAL TABLET 100 MCG 0.20882 07/14/2017 0.32886 03/17/2020

Effective 8/7/2020

Current SMAC Price

LIDOCAINE HCL IN DEXTROSE 5% IN WATER/PF INTRAVENOUS INTRAVENOUS SOLUTION 4 MG/ML

0.01280 08/12/2014

LIDOCAINE HCL IN DEXTROSE 5% IN WATER/PF INTRAVENOUS INTRAVENOUS SOLUTION 8 MG/ML

0.02029 01/25/2013

LIDOCAINE HCL IN DEXTROSE 7.5 % IN WATER/PF INTRATHECAL AMPUL (ML) 5 %

6.05930 08/12/2014

LIDOCAINE HCL INJECTION VIAL (ML) 10 MG/ML 0.05802 02/07/2014 0.05802 08/21/2015

LIDOCAINE HCL INJECTION VIAL (ML) 20 MG/ML 0.06084 01/25/2013

LIDOCAINE HCL MUCOUS MEMBRANE JELLY (ML) 2 % 0.27545 02/14/2014 0.27545 08/21/2015

LIDOCAINE HCL MUCOUS MEMBRANE JELLY WITH PREFILLED APPLICATOR (ML) 2 %

0.34943 12/12/2014 0.34943 08/21/2015

LIDOCAINE HCL MUCOUS MEMBRANE SOLUTION, NON-ORAL 40 MG/ML 0.06266 08/12/2014 0.06266 08/21/2015

LIDOCAINE HCL MUCOUS MEMBRANE SOLUTION, ORAL 2 % 0.02375 08/21/2015 0.07917 05/21/2018

LIDOCAINE HCL TOPICAL CREAM (GRAM) 3 % 1.03527 07/17/2020

LIDOCAINE HCL TOPICAL SOLUTION, ORAL 4 % 1.05248 01/25/2013

LIDOCAINE HCL/EPINEPHRINE BITARTRATE INJECTION CARTRIDGE (ML) 2 %-1:100K

0.14933 01/25/2013

LIDOCAINE HCL/EPINEPHRINE BITARTRATE INJECTION CARTRIDGE (ML) 2%-1:50000

0.14933 01/25/2013

LIDOCAINE HCL/EPINEPHRINE INJECTION VIAL (ML) 1%-1:100K 0.06995 01/25/2013 0.06995 08/21/2015

LIDOCAINE HCL/EPINEPHRINE INJECTION VIAL (ML) 2 %-1:100K 0.07910 08/12/2014 0.07910 08/21/2015

LIDOCAINE HCL/EPINEPHRINE/PF INJECTION VIAL (ML) 2%-1:200K 0.35740 08/12/2014 0.35740 08/21/2015

LIDOCAINE HCL/HYDROCORTISONE ACETATE RECTAL CREAM (GRAM) 3 %-0.5 %

1.78500 03/13/2015

LIDOCAINE HCL/HYDROCORTISONE ACETATE RECTAL CREAM WITH APPLICATOR 3 %-0.5 %

1.37036 02/06/2015 1.37036 08/21/2015

LIDOCAINE HCL/HYDROCORTISONE ACETATE RECTAL CREAM WITH APPLICATOR 3%-1%(7 G)

251.09000 01/25/2013

LIDOCAINE HCL/HYDROCORTISONE ACETATE RECTAL GEL WITH APPLICATOR (GRAM) 3-2.5%(7G)

251.09000 01/25/2013

LIDOCAINE HCL/HYDROCORTISONE ACETATE RECTAL KIT 3 %-0.5 % 7.69340 08/21/2015

LIDOCAINE HCL/PF INJECTION AMPUL (ML) 10 MG/ML 0.35751 12/20/2013 0.35751 08/21/2015

LIDOCAINE HCL/PF INJECTION AMPUL (ML) 15 MG/ML 0.66715 01/25/2013

LIDOCAINE HCL/PF INJECTION VIAL (ML) 20 MG/ML 0.48516 08/12/2014

LIDOCAINE HCL/PF INJECTION VIAL (ML) 5 MG/ML 0.11002 01/25/2013

LIDOCAINE HCL/PF INTRAVENOUS SYRINGE (ML) 100 MG/5ML 0.66080 01/25/2013 0.66080 08/21/2015

LIDOCAINE HCL/PF INTRAVENOUS SYRINGE (ML) 50 MG/5 ML 0.88790 08/12/2014

LIDOCAINE HCL/PF INTRAVENOUS VIAL (ML) 20 MG/ML 0.28224 01/25/2013

LIDOCAINE MISCELLANEOUS POWDER (GRAM) 0.19471 08/21/2015

LIDOCAINE TOPICAL ADHESIVE PATCH, MEDICATED 5 % 2.15204 02/21/2020 2.46633 05/14/2020

LIDOCAINE TOPICAL CREAM (GRAM) 4 % 0.79667 08/16/2019 0.31433 02/21/2020

LIDOCAINE TOPICAL CREAM (GRAM) 5 % 1.05645 12/26/2014 1.05645 08/21/2015

LIDOCAINE TOPICAL OINTMENT (GRAM) 5 % 0.22550 01/24/2020 0.20580 07/17/2020

Effective 8/7/2020

Current SMAC Price

LIDOCAINE/PRILOCAINE TOPICAL CREAM (GRAM) 2.5 %-2.5% 0.19392 11/15/2019 0.17500 05/22/2020

LIDOCAINE/PRILOCAINE TOPICAL KIT 2.5 %-2.5% 1.40764 01/25/2013 1.40764 08/21/2015

LINDANE TOPICAL LOTION (ML) 1 % 1.59670 02/08/2013 1.59670 08/21/2015

LINDANE TOPICAL SHAMPOO 1 % 1.59670 02/08/2013 1.59670 08/21/2015

LINEZOLID IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 600MG/300

0.50400 03/13/2015 0.50400 08/21/2015

LINEZOLID ORAL TABLET 600 MG 1.51000 02/21/2020 2.34734 03/04/2020

LIOTHYRONINE SODIUM ORAL TABLET 25 MCG 0.65000 03/17/2017 0.42480 07/14/2017

LISINOPRIL ORAL TABLET 10 MG 0.02112 04/17/2015 0.02112 08/21/2015

LISINOPRIL ORAL TABLET 2.5 MG 0.01635 05/01/2015 0.01635 08/21/2015

LISINOPRIL/HYDROCHLOROTHIAZIDE ORAL TABLET 10-12.5MG 0.02693 03/06/2015 0.02693 08/21/2015

LISINOPRIL/HYDROCHLOROTHIAZIDE ORAL TABLET 20 MG-25MG 0.05186 08/21/2015 0.02920 10/20/2017

LISINOPRIL/HYDROCHLOROTHIAZIDE ORAL TABLET 20-12.5 MG 0.04063 08/21/2015 0.02670 04/27/2018

LITHIUM CARBONATE ORAL CAPSULE 150 MG 0.06052 02/13/2015 0.06052 08/21/2015

LITHIUM CARBONATE ORAL TABLET 300 MG 0.14961 04/17/2015 0.14961 08/21/2015

LITHIUM CARBONATE ORAL TABLET, EXTENDED RELEASE 300 MG 0.12000 09/21/2018 0.09970 07/17/2020

LITHIUM CARBONATE ORAL TABLET, EXTENDED RELEASE 450 MG 0.17713 02/22/2019 0.10100 05/17/2019

LITHIUM CITRATE ORAL SOLUTION, ORAL 8 MEQ/5 ML 0.03921 01/25/2013

LOPERAMIDE HCL ORAL CAPSULE 2 MG 0.28182 03/10/2019 0.22363 11/15/2019

LOPERAMIDE HCL ORAL LIQUID (ML) 1MG/7.5ML 0.03361 08/12/2014 0.03361 08/21/2015

LOPERAMIDE HCL ORAL TABLET 2 MG 0.08953 08/12/2014 0.08953 08/21/2015

LORATADINE ORAL SOLUTION, ORAL 5 MG/5 ML 0.04500 08/21/2015 0.03325 11/16/2018

LORATADINE ORAL TABLET 10 MG 0.05136 08/21/2015 0.03157 10/20/2017

LORATADINE ORAL TABLET,DISINTEGRATING 10 MG 0.38100 02/01/2013 0.38100 08/21/2015

LORATADINE/PSEUDOEPHEDRINE SULFATE ORAL TABLET, EXTENDED RELEASE 12 HR 5 MG-120MG

0.58500 04/07/2017 0.75400 07/16/2018

LORATADINE/PSEUDOEPHEDRINE SULFATE ORAL TABLET, EXTENDED RELEASE 24 HR 10MG-240MG

0.36808 11/16/2018 0.30533 05/22/2020

LORAZEPAM INJECTION SYRINGE (ML) 2 MG/ML 1.76400 02/15/2013 1.76400 08/21/2015

LORAZEPAM INJECTION SYRINGE (ML) 4 MG/ML 2.46960 01/25/2013

LORAZEPAM INJECTION VIAL (ML) 2 MG/ML 0.59480 03/02/2018 0.46840 11/15/2019

LORAZEPAM INJECTION VIAL (ML) 4 MG/ML 1.14324 01/25/2013

LORAZEPAM ORAL CONCENTRATE, ORAL 2 MG/ML 0.29067 09/21/2018 0.26900 11/15/2019

LORAZEPAM ORAL TABLET 0.5 MG 0.03047 08/21/2015 0.02030 10/20/2017

LORAZEPAM ORAL TABLET 1 MG 0.03287 08/21/2015 0.01735 12/22/2017

Effective 8/7/2020

Current SMAC Price

LORAZEPAM ORAL TABLET 2 MG 0.05247 08/21/2015 0.03950 08/17/2018

LOSARTAN POTASSIUM ORAL TABLET 100 MG 0.06386 06/16/2017 0.04114 10/20/2017

LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE ORAL TABLET 100-12.5MG

0.08772 08/25/2017 0.07169 12/22/2017

LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE ORAL TABLET 100MG-25MG

0.06639 04/27/2018 0.19126 03/16/2020

LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE ORAL TABLET 50-12.5 MG

0.05099 11/16/2018 0.19909 06/30/2020

LOVASTATIN ORAL TABLET 10 MG 0.05820 09/22/2017 0.04733 05/22/2020

LOXAPINE SUCCINATE ORAL CAPSULE 10 MG 0.26000 03/02/2018 0.66531 06/03/2019

MAGNESIUM CARBONATE/ALUMINUM HYDROXIDE/ALGINIC ACID ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 358-95/15

0.01253 01/25/2013

MAGNESIUM CHLORIDE ORAL TABLET, EXTENDED RELEASE 64 MG 0.08364 01/25/2013

MAGNESIUM HYDROXIDE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 400 MG/5ML

0.00419 08/12/2014 0.00419 08/21/2015

MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE/SIMETHICONE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 200-200-20

0.00592 09/19/2014 0.00592 08/21/2015

MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE/SIMETHICONE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 400-400-40

0.00967 12/26/2014 0.00967 08/21/2015

MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE/SIMETHICONE ORAL TABLET,CHEWABLE 200-200-25

0.03062 08/12/2014 0.03062 08/21/2015

MAGNESIUM OXIDE ORAL CAPSULE 400 MG 0.08450 08/12/2014

MAGNESIUM OXIDE ORAL TABLET 400 MG 0.02077 02/06/2015 0.02077 08/21/2015

MAGNESIUM SULFATE IN STERILE WATER INTRAVENOUS INTRAVENOUS SOLUTION 20 G/500ML

0.01970 08/12/2014

MAGNESIUM SULFATE IN STERILE WATER INTRAVENOUS INTRAVENOUS SOLUTION 40G/1000ML

0.01440 08/12/2014

MAGNESIUM SULFATE IN STERILE WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 2 G/50 ML

0.24560 08/12/2014

0.13419 07/25/2014

0.23100 08/12/2014

MAGNESIUM SULFATE INJECTION SYRINGE (ML) 4 MEQ/ML 0.63168 01/25/2013

MAGNESIUM SULFATE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 1 G/100 ML

0.11630 08/12/2014

MALATHION TOPICAL LOTION (ML) 0.5 % 2.54547 08/21/2015 3.71143 08/12/2019

MANGANESE CHLORIDE INTRAVENOUS VIAL (ML) 0.1 MG/ML 0.17390 08/12/2014

MANNITOL INTRAVENOUS INTRAVENOUS SOLUTION 10 % 0.01620 08/12/2014

Effective 8/7/2020

Current SMAC Price

MANNITOL/SORBITOL SOLUTION URETHRAL SOLUTION, IRRIGATION 0.54G-2.7G

0.00569 01/25/2013

MAPROTILINE HCL ORAL TABLET 25 MG 0.59890 08/12/2014

MECLIZINE HCL ORAL TABLET 12.5 MG 0.03685 02/27/2015 0.03685 08/21/2015

MECLIZINE HCL ORAL TABLET 25 MG 0.12062 03/03/2017 0.04200 11/15/2019

MECLOFENAMATE SODIUM ORAL CAPSULE 100 MG 3.34760 08/12/2014 3.34760 08/21/2015

MECLOFENAMATE SODIUM ORAL CAPSULE 50 MG 1.91160 08/12/2014

MECOBALAMIN/LEVOMEFOLATE CALCIUM/PYRIDOXAL PHOSPHATE ORAL TABLET 2-3-35 MG

0.88358 03/27/2015 0.88358 08/21/2015

MEDROXYPROGESTERONE ACETATE INTRAMUSCULAR VIAL (ML) 150 MG/ML

42.38726 11/13/2019 35.40500 05/22/2020

MEDROXYPROGESTERONE ACETATE ORAL TABLET 10 MG 0.12690 08/21/2015 0.09842 07/14/2017

MEDROXYPROGESTERONE ACETATE ORAL TABLET 2.5 MG 0.10570 08/25/2017 0.07140 03/20/2020

MEDROXYPROGESTERONE ACETATE ORAL TABLET 5 MG 0.21370 05/19/2017 0.11870 03/02/2018

MEFENAMIC ACID ORAL CAPSULE 250 MG 6.03867 08/17/2018 1.46000 10/19/2018

MEFLOQUINE HCL ORAL TABLET 250 MG 3.74400 04/05/2013 3.74400 08/21/2015

MEGESTROL ACETATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 400MG/10ML

0.29429 08/08/2014 0.29429 08/21/2015

MEGESTROL ACETATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 400MG/10ML

0.08856 11/19/2019 0.07566 03/20/2020

MEGESTROL ACETATE ORAL TABLET 20 MG 0.11377 06/27/2014

MEGESTROL ACETATE ORAL TABLET 40 MG 0.14931 07/14/2017 0.10500 08/16/2019

MELATONIN ORAL TABLET, EXTENDED RELEASE 3 MG 0.06370 01/25/2013

MELATONIN/TRYPTOPHAN ORAL CAPSULE 3 MG-100MG 5.05750 01/31/2014

MELOXICAM ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 7.5 MG/5ML 1.33161 02/21/2014

MELOXICAM ORAL TABLET 15 MG 0.03190 08/21/2015 0.01655 08/17/2018

MELOXICAM ORAL TABLET 7.5 MG 0.02466 05/01/2015 0.02466 08/21/2015

MEMANTINE HCL ORAL CAPSULE SPRINKLE, EXTENDED RELEASE 24 HR 21 MG

2.50450 08/16/2019 2.41733 05/22/2020

MEMANTINE HCL ORAL CAPSULE SPRINKLE, EXTENDED RELEASE 24 HR 28 MG

1.93938 11/15/2019 0.97767 06/19/2020

MEMANTINE HCL ORAL TABLET 10 MG 0.08633 11/16/2018 0.06912 12/20/2019

MEMANTINE HCL ORAL TABLET 5 MG 0.18583 08/25/2017 0.09917 09/22/2017

MENTHOL MUCOUS MEMBRANE LOZENGE 8 MG 0.06420 08/12/2014

MENTHOL TOPICAL GEL (GRAM) 10 % 0.11397 01/25/2013

MEPERIDINE HCL INJECTION CARTRIDGE (ML) 10 MG/ML 0.49911 01/25/2013

MEPERIDINE HCL ORAL SOLUTION, ORAL 50 MG/5 ML 0.14191 01/25/2013

MEPERIDINE HCL ORAL TABLET 100 MG 0.32670 03/06/2015

MEPERIDINE HCL ORAL TABLET 50 MG 1.31433 08/21/2015 0.41454 06/16/2017

MEPERIDINE HCL/PF INJECTION VIAL (ML) 100 MG/ML 2.35200 01/25/2013

MEPIVACAINE HCL/PF INJECTION CARTRIDGE (ML) 30 MG/ML 0.17730 08/12/2014

Effective 8/7/2020

Current SMAC Price

MEPROBAMATE ORAL TABLET 200 MG 4.81285 10/17/2014 4.81285 08/21/2015

MEPROBAMATE ORAL TABLET 400 MG 0.98070 01/25/2013 0.98070 08/21/2015

MERCAPTOPURINE ORAL TABLET 50 MG 0.88334 09/22/2017 0.76000 05/17/2019

MEROPENEM INTRAVENOUS VIAL (EA) 1 G 11.34682 08/21/2015 16.85013 01/23/2017

MEROPENEM INTRAVENOUS VIAL (EA) 500 MG 4.50240 12/26/2014 4.50240 08/21/2015

MESALAMINE ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 1.2 G

3.19075 01/29/2020 2.22400 04/17/2020

MESALAMINE ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 800 MG

4.25000 11/15/2019 4.25000 01/01/2020

MESALAMINE RECTAL ENEMA (ML) 4 G/60 ML 0.19094 04/21/2017 0.16262 03/02/2018

MESALAMINE WITH CLEANSING WIPES RECTAL ENEMA KIT 4 G/60 ML 119.73500 12/26/2014 110.04250 06/16/2017

METAPROTERENOL SULFATE ORAL SYRUP 10 MG/5 ML 0.02460 08/12/2014 0.02460 08/21/2015

METAPROTERENOL SULFATE ORAL TABLET 10 MG 0.69965 01/25/2013 0.69965 08/21/2015

METAPROTERENOL SULFATE ORAL TABLET 20 MG 0.97496 01/25/2013 0.97496 08/21/2015

METAXALONE ORAL TABLET 800 MG 0.52160 04/26/2019 0.45990 05/22/2020

METFORMIN HCL ORAL TABLET 1000 MG 0.03664 08/21/2015 0.02659 10/20/2017

METFORMIN HCL ORAL TABLET, EXTENDED RELEASE 24 HR 1000 MG 3.80000 05/17/2019 3.67350 11/15/2019

METHADONE HCL INJECTION VIAL (ML) 10 MG/ML 6.01720 01/25/2013

METHADONE HCL ORAL CONCENTRATE, ORAL 10 MG/ML 0.62300 02/01/2013

METHADONE HCL ORAL SOLUTION, ORAL 10 MG/5 ML 0.09670 07/18/2014

METHADONE HCL ORAL SOLUTION, ORAL 5 MG/5 ML 0.12491 01/25/2013

METHADONE HCL ORAL TABLET 10 MG 0.10562 05/19/2017 0.08790 11/16/2018

METHADONE HCL ORAL TABLET 5 MG 0.11840 10/25/2019 0.10660 01/24/2020

METHADONE HCL ORAL TABLET, SOLUBLE 40 MG 0.22381 01/25/2013 0.22381 08/21/2015

METHAMPHETAMINE HCL ORAL TABLET 5 MG 4.11749 05/01/2015 4.11749 08/21/2015

METHAZOLAMIDE ORAL TABLET 25 MG 2.68163 03/13/2015

METHAZOLAMIDE ORAL TABLET 50 MG 2.59840 12/05/2014

METHENAMINE HIPPURATE ORAL TABLET 1 G 0.59990 03/20/2020 1.11735 07/08/2020

METHENAMINE MANDELATE ORAL TABLET 500 MG 0.62041 01/25/2013

METHENAMINE/METHYLENE BLUE/SOD PHOS/P.SALICYLATE/HYOSCYAMINE ORAL CAPSULE 118-10-36

1.80978 03/06/2015 1.80978 08/21/2015

METHENAMINE/METHYLENE BLUE/SOD PHOS/P.SALICYLATE/HYOSCYAMINE ORAL TABLET 81-0.12MG

4.27272 03/06/2015 4.27272 08/21/2015

METHENAMINE/METHYLENE BLUE/SOD PHOS/P.SALICYLATE/HYOSCYAMINE ORAL TABLET 81.6-10.8

0.91000 09/12/2014

METHENAMINE/SOD PHOSPH,MONOBASIC/METHYLENE BLUE/HYOSCYAMINE ORAL TABLET 81.6-.12MG

2.26793 03/06/2015

METHIMAZOLE ORAL TABLET 10 MG 0.15839 08/21/2015 0.09155 03/03/2017

METHIMAZOLE ORAL TABLET 5 MG 0.08482 02/27/2015 0.04940 09/22/2017

METHOCARBAMOL INJECTION VIAL (ML) 100 MG/ML 4.14861 02/13/2015

Effective 8/7/2020

Current SMAC Price

METHOCARBAMOL ORAL TABLET 500 MG 0.05895 08/25/2017 0.03100 11/16/2018

METHOCARBAMOL ORAL TABLET 750 MG 0.05730 12/22/2017 0.10932 08/23/2019

METHOTREXATE SODIUM INJECTION VIAL (ML) 25 MG/ML 3.00720 01/30/2015

METHOTREXATE SODIUM ORAL TABLET 2.5 MG 0.38159 11/15/2019 0.35990 06/19/2020

METHOTREXATE SODIUM/PF INJECTION VIAL (ML) 25 MG/ML 0.58357 08/21/2015 2.87500 10/02/2019

METHOXSALEN ORAL CAPSULE, LIQUID-FILLED, RAPID RELEASE 10 MG 66.75860 09/05/2014

METHSCOPOLAMINE BROMIDE ORAL TABLET 2.5 MG 1.53056 08/21/2015 0.31450 08/17/2018

METHSCOPOLAMINE BROMIDE ORAL TABLET 5 MG 2.17750 05/20/2016 0.86350 09/22/2017

METHYCLOTHIAZIDE TABLET 5 MG 1.21660 01/25/2013

METHYL SALICYLATE MISCELLANEOUS OIL (ML) 0.47540 08/12/2014

METHYLDOPA ORAL TABLET 250 MG 0.12359 07/14/2017 0.06990 03/02/2018

METHYLDOPA ORAL TABLET 500 MG 0.32656 08/21/2015 0.16892 05/19/2017

METHYLDOPA/HYDROCHLOROTHIAZIDE ORAL TABLET 250MG-15MG 0.67180 08/12/2014

METHYLDOPA/HYDROCHLOROTHIAZIDE ORAL TABLET 250MG-25MG 1.51046 12/26/2014

METHYLERGONOVINE MALEATE INJECTION AMPUL (ML) .2MG/ML(1) 4.75860 08/12/2014

METHYLERGONOVINE MALEATE INJECTION VIAL (ML) .2MG/ML(1) 6.39450 01/25/2013

METHYLERGONOVINE MALEATE ORAL TABLET 0.2 MG 53.75250 01/25/2019 27.26667 05/22/2020

METHYLPHENIDATE HCL ORAL CAPSULE,EXTENDED RELEASE BIPHASIC 30-70 10 MG

4.03956 12/09/2017 2.29720 07/26/2019

2.94350 12/08/2017 2.94350 12/09/2017

2.96640 12/09/2017 3.27270 05/16/2018

4.30300 12/08/2017 4.30300 12/09/2017

4.55740 12/09/2017 4.24000 07/26/2019

6.76633 12/08/2017 6.76633 12/09/2017

3.68500 10/19/2018 3.59850 05/17/2019

4.36506 04/25/2014 3.78000 07/26/2019

4.27230 11/24/2017 3.85000 06/22/2018

METHYLPHENIDATE HCL ORAL SOLUTION, ORAL 10 MG/5 ML 0.90135 04/10/2015

METHYLPHENIDATE HCL ORAL SOLUTION, ORAL 5 MG/5 ML 0.73600 02/27/2015 0.73600 03/02/2016

METHYLPHENIDATE HCL ORAL TABLET 10 MG 0.18500 01/25/2019 0.15585 07/17/2020

METHYLPHENIDATE HCL ORAL TABLET, EXTENDED RELEASE 10 MG 2.31000 05/25/2018 1.67990 08/16/2019

METHYLPHENIDATE HCL ORAL TABLET, EXTENDED RELEASE 20 MG 2.23490 03/16/2018 1.70023 08/17/2018

METHYLPHENIDATE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 18 MG

7.32227 01/05/2018 4.56290 11/15/2019

6.98215 01/05/2018 5.31480 11/15/2019

6.58990 07/09/2019 6.27617 11/15/2019

Effective 8/7/2020

Current SMAC Price

4.40970 11/15/2019 5.65671 12/05/2019

METHYLPREDNISOLONE ACETATE INJECTION VIAL (ML) 40 MG/ML 3.47672 08/12/2014 3.47672 08/21/2015

METHYLPREDNISOLONE ACETATE INJECTION VIAL (ML) 80 MG/ML 7.07957 08/12/2014 7.07957 08/21/2015

METHYLPREDNISOLONE ORAL TABLET 16 MG 2.47842 04/03/2015 1.95015 06/16/2017

METHYLPREDNISOLONE ORAL TABLET 32 MG 3.62572 04/03/2015

METHYLPREDNISOLONE ORAL TABLET, DOSE PACK 4 MG 0.20571 04/17/2020 0.19148 05/22/2020

METHYLPREDNISOLONE SODIUM SUCCINATE INJECTION VIAL (EA) 125 MG

4.08408 01/25/2013

METHYLPREDNISOLONE SODIUM SUCCINATE INJECTION VIAL (EA) 40 MG

3.53132 01/25/2013

METHYLPREDNISOLONE SODIUM SUCCINATE INTRAVENOUS VIAL (EA) 1000 MG

17.05200 01/25/2013

METIPRANOLOL OPHTHALMIC DROPS 0.3 % 2.91720 01/25/2013

METOCLOPRAMIDE HCL INJECTION SYRINGE (ML) 10 MG/2 ML 0.66573 05/24/2013 0.66573 08/21/2015

METOCLOPRAMIDE HCL INJECTION VIAL (ML) 5 MG/ML 0.37728 02/13/2015 0.37728 08/21/2015

METOCLOPRAMIDE HCL ORAL SOLUTION, ORAL 10 MG/10ML 0.04456 08/09/2013 0.04456 08/21/2015

METOCLOPRAMIDE HCL ORAL SOLUTION, ORAL 5 MG/5 ML 0.01217 08/21/2015 0.03870 07/16/2018

METOCLOPRAMIDE HCL ORAL TABLET 10 MG 0.04069 08/21/2015 0.02797 11/16/2018

METOCLOPRAMIDE HCL ORAL TABLET 5 MG 0.04126 08/21/2015 0.02200 09/22/2017

METOLAZONE ORAL TABLET 10 MG 0.84230 05/17/2013

METOLAZONE ORAL TABLET 2.5 MG 0.12540 05/22/2020 1.17600 06/06/2020

METOLAZONE ORAL TABLET 5 MG 0.68220 01/24/2020 1.11320 02/25/2020

METOPROLOL SUCCINATE ORAL TABLET, EXTENDED RELEASE 24 HR 100 MG

0.20520 09/21/2018 0.17251 05/22/2020

0.43860 12/20/2019 0.32643 02/21/2020

0.10200 06/21/2019 0.06050 07/17/2020

0.18560 06/16/2017 0.09250 09/21/2018

METOPROLOL TARTRATE INTRAVENOUS AMPUL (ML) 5 MG/5 ML 0.23020 08/12/2014 0.23020 08/21/2015

METOPROLOL TARTRATE INTRAVENOUS SYRINGE (ML) 5 MG/5 ML 0.70560 01/25/2013

METOPROLOL TARTRATE ORAL TABLET 100 MG 0.03114 08/21/2015 0.02070 05/22/2020

METOPROLOL TARTRATE/HYDROCHLOROTHIAZIDE ORAL TABLET 100MG-25MG

0.84850 06/16/2017 0.63568 06/21/2019

METOPROLOL TARTRATE/HYDROCHLOROTHIAZIDE ORAL TABLET 100MG-50MG

1.53410 02/08/2013

METOPROLOL TARTRATE/HYDROCHLOROTHIAZIDE ORAL TABLET 50 MG-25MG

0.70970 11/24/2017 0.67570 03/02/2018

METRONIDAZOLE IN SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 500MG/0.1L

0.01400 04/05/2013 0.01400 08/21/2015

METRONIDAZOLE ORAL CAPSULE 375 MG 3.91048 01/31/2014 3.91048 08/21/2015

METRONIDAZOLE ORAL TABLET 250 MG 0.17910 12/22/2017 0.07480 08/16/2019

Effective 8/7/2020

Current SMAC Price

METRONIDAZOLE ORAL TABLET 500 MG 0.14590 09/22/2017 0.11483 11/16/2018

METRONIDAZOLE TOPICAL CREAM (GRAM) 0.75 % 1.18465 10/07/2019 0.88756 05/22/2020

METRONIDAZOLE TOPICAL GEL (GRAM) 0.75 % 1.23346 06/16/2017 0.81000 12/21/2018

METRONIDAZOLE TOPICAL LOTION (ML) 0.75 % 2.93220 01/17/2014 2.39124 06/16/2017

METRONIDAZOLE VAGINAL GEL WITH APPLICATOR (GRAM) 0.75 % 0.72500 06/26/2019 1.04743 06/04/2020

MEXILETINE HCL ORAL CAPSULE 150 MG 0.55042 01/30/2015 0.55042 08/21/2015

MEXILETINE HCL ORAL CAPSULE 200 MG 0.70746 10/03/2014

MEXILETINE HCL ORAL CAPSULE 250 MG 0.48191 08/09/2013

MICONAZOLE NITRATE TOPICAL CREAM (GRAM) 2 % 0.05700 03/07/2014 0.05700 08/21/2015

MICONAZOLE NITRATE TOPICAL OINTMENT (GRAM) 2 % 0.08500 08/12/2014

MICONAZOLE NITRATE TOPICAL TINCTURE 2 % 0.39340 08/12/2014

MICONAZOLE NITRATE VAGINAL CREAM WITH APPLICATOR 2 % 0.09470 04/24/2015 0.09470 08/21/2015

MICONAZOLE NITRATE VAGINAL KIT 200 MG-2 % 7.83470 08/21/2015 7.64000 01/25/2019

MICONAZOLE NITRATE VAGINAL SUPPOSITORY, VAGINAL 100 MG 0.44030 01/25/2013 0.44030 08/21/2015

MICONAZOLE NITRATE VAGINAL SUPPOSITORY, VAGINAL 200 MG 12.26633 01/25/2013

MIDODRINE HCL ORAL TABLET 10 MG 0.71570 08/05/2019 0.55753 02/21/2020

MIDODRINE HCL ORAL TABLET 2.5 MG 0.31350 12/04/2018 0.28820 11/15/2019

MIDODRINE HCL ORAL TABLET 5 MG 0.35870 08/16/2019 0.31930 10/25/2019

MILRINONE LACTATE INTRAVENOUS VIAL (ML) 1 MG/ML 0.29545 08/25/2017 0.27241 05/22/2020

MILRINONE LACTATE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 20MG/100ML

0.13280 08/12/2014 0.13280 08/21/2015

MILRINONE LACTATE/DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 40MG/200ML

0.16676 10/03/2014 0.16676 08/21/2015

MINERAL OIL RECTAL ENEMA (ML) 0.01182 08/21/2015

MINERAL OIL TOPICAL LOTION (ML) 0.01828 08/12/2014

MINERAL OIL/PETROLATUM,WHITE OPHTHALMIC OINTMENT (GRAM) 15 %-83 %

0.81740 08/12/2014

MINERAL OIL/PETROLATUM,WHITE OPHTHALMIC OINTMENT (GRAM) 15%-85%

1.90107 01/16/2015 1.90107 08/21/2015

MINERAL OIL/PETROLATUM,WHITE OPHTHALMIC OINTMENT (GRAM) 3 %-94 %

4.48140 08/21/2015

MINOCYCLINE HCL ORAL CAPSULE 100 MG 0.30445 04/17/2015 0.30445 08/21/2015

MINOCYCLINE HCL ORAL CAPSULE 50 MG 0.19068 03/03/2017 0.13650 03/15/2019

MINOCYCLINE HCL ORAL CAPSULE 75 MG 0.35403 08/12/2014

MINOCYCLINE HCL ORAL TABLET 100 MG 2.20000 05/25/2018 1.80620 11/16/2018

MINOCYCLINE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 135 MG 3.56811 01/25/2013 3.56811 08/21/2015

MINOXIDIL ORAL TABLET 10 MG 0.20050 11/24/2017 0.12250 11/16/2018

MINOXIDIL ORAL TABLET 2.5 MG 0.01538 08/25/2017 0.04230 09/05/2019

MIRTAZAPINE ORAL TABLET 15 MG 0.06475 11/15/2019 0.05000 07/17/2020

Effective 8/7/2020

Current SMAC Price

MIRTAZAPINE ORAL TABLET 7.5 MG 0.70950 02/21/2020 0.66000 04/17/2020

MIRTAZAPINE ORAL TABLET,DISINTEGRATING 15 MG 0.58000 08/25/2017 0.47533 11/24/2017

MISOPROSTOL ORAL TABLET 100 MCG 0.42254 09/19/2014 0.42254 08/21/2015

MISOPROSTOL ORAL TABLET 200 MCG 0.77996 07/29/2016 0.69441 03/03/2017

MITOMYCIN INTRAVENOUS VIAL (EA) 40 MG 256.23975 08/21/2015 990.94800 11/05/2015

MODAFINIL ORAL TABLET 100 MG 1.82967 03/02/2018 0.49100 10/19/2018

MODAFINIL ORAL TABLET 200 MG 0.35717 11/15/2019 0.63463 11/29/2019

MOEXIPRIL HCL ORAL TABLET 15 MG 0.37580 02/08/2013 0.37580 08/21/2015

MOEXIPRIL HCL ORAL TABLET 7.5 MG 0.37580 08/12/2014 0.37580 08/21/2015

MOEXIPRIL HCL/HYDROCHLOROTHIAZIDE TABLET 15-12.5MG 0.51310 08/12/2014

MOEXIPRIL HCL/HYDROCHLOROTHIAZIDE TABLET 15-25MG 0.37076 01/25/2013 0.37076 08/21/2015

MOEXIPRIL HCL/HYDROCHLOROTHIAZIDE TABLET 7.5-12.5MG 0.50960 01/25/2013 0.50960 08/21/2015

MOLYBDENUM (AMMONIUM MOLYBDATE) VIAL (ML) 25 MCG/ML 0.32672 01/25/2013

MOMETASONE FUROATE NASAL AEROSOL, SPRAY WITH PUMP (GRAM) 50 MCG

2.67456 08/16/2019 2.32029 02/21/2020

MOMETASONE FUROATE TOPICAL CREAM (GRAM) 0.1 % 0.49044 06/25/2019 0.18611 08/16/2019

MOMETASONE FUROATE TOPICAL OINTMENT (GRAM) 0.1 % 0.20169 11/15/2019 0.18244 03/20/2020

MOMETASONE FUROATE TOPICAL SOLUTION, NON-ORAL 0.1 % 0.22914 08/21/2015 0.30258 10/16/2019

MONTELUKAST SODIUM ORAL GRANULES IN PACKET (EA) 4 MG 2.29967 10/19/2018 1.78811 02/22/2019

MONTELUKAST SODIUM ORAL TABLET 10 MG 0.12093 03/03/2017 0.05967 06/16/2017

MONTELUKAST SODIUM ORAL TABLET,CHEWABLE 4 MG 0.12956 03/02/2018 0.10275 08/17/2018

MONTELUKAST SODIUM ORAL TABLET,CHEWABLE 5 MG 0.08100 06/21/2019 0.06795 06/19/2020

MORPHINE SULFATE INJECTION SYRINGE (ML) 10 MG/ML 1.83954 05/23/2014 1.83954 08/21/2015

MORPHINE SULFATE INJECTION SYRINGE (ML) 5 MG/ML 1.83954 05/23/2014

MORPHINE SULFATE INJECTION VIAL (ML) 10 MG/ML 0.74480 01/25/2013

MORPHINE SULFATE INTRAVENOUS CARTRIDGE (ML) 10 MG/ML 3.25500 01/25/2013

MORPHINE SULFATE INTRAVENOUS PATIENT CONTROLLED ANALGESIA SYRINGE 30 MG/30ML

0.33600 11/08/2013 0.33600 08/21/2015

MORPHINE SULFATE INTRAVENOUS SYRINGE (ML) 10 MG/ML 1.80600 12/26/2014

Effective 8/7/2020

Current SMAC Price

MORPHINE SULFATE INTRAVENOUS VIAL (ML) 25 MG/ML 1.33770 07/26/2013

MORPHINE SULFATE INTRAVENOUS VIAL (ML) 50 MG/ML 1.03719 06/27/2014

MORPHINE SULFATE INTRAVENOUS VIAL WITH THREADED PORT (ML) 100 MG/4ML

4.96650 01/25/2013

MORPHINE SULFATE INTRAVENOUS VIAL WITH THREADED PORT (ML) 250MG/10ML

1.99080 01/25/2013

MORPHINE SULFATE ORAL CAPSULE, EXTENDED RELEASE PELLETS 10 MG

2.38833 09/22/2017 2.16080 11/24/2017

12.63000 08/21/2015 11.91976 12/02/2016

2.41414 06/16/2017 1.25730 09/22/2017

3.44336 06/16/2017 1.18850 11/15/2019

6.65266 08/21/2015 4.71535 06/16/2017

7.95944 08/21/2015 5.37753 01/27/2017

10.60675 08/21/2015 8.45051 06/16/2017

MORPHINE SULFATE ORAL CAPSULE,EXTENDED RELEASE MULTIPHASE 24HR 120 MG

13.81709 02/21/2014

4.01072 02/21/2014

5.94685 02/21/2014

7.78841 02/21/2014

9.91130 02/21/2014

11.71044 02/21/2014

MORPHINE SULFATE ORAL SOLUTION, ORAL 10 MG/5 ML 0.05473 08/21/2015 0.04420 08/17/2018

MORPHINE SULFATE ORAL SOLUTION, ORAL 100 MG/5ML 0.23910 09/30/2016 0.22056 08/16/2019

MORPHINE SULFATE ORAL SOLUTION, ORAL 20 MG/5 ML 0.08307 01/16/2015 0.08307 08/21/2015

MORPHINE SULFATE ORAL TABLET 15 MG 0.11466 04/03/2015

MORPHINE SULFATE ORAL TABLET 30 MG 0.17240 04/11/2014 0.49746 11/05/2018

MORPHINE SULFATE ORAL TABLET, EXTENDED RELEASE 100 MG 0.98200 11/24/2017 1.07226 04/09/2018

MORPHINE SULFATE RECTAL SUPPOSITORY, RECTAL 10 MG 3.85880 08/12/2014

MORPHINE SULFATE/PF INJECTION AMPUL (ML) 0.5 MG/ML 2.23713 01/25/2013

Effective 8/7/2020

Current SMAC Price

MORPHINE SULFATE/PF INJECTION AMPUL (ML) 1 MG/ML 3.80940 01/25/2013

MORPHINE SULFATE/PF INJECTION VIAL (ML) 0.5 MG/ML 0.42080 08/12/2014

MORPHINE SULFATE/PF INJECTION VIAL (ML) 1 MG/ML 0.41240 08/12/2014

MORPHINE SULFATE/PF INTRAVENOUS PATIENT CONTROLLED ANALGESIA VIAL 150MG/30ML

0.61320 01/25/2013

MORPHINE SULFATE/PF INTRAVENOUS PATIENT CONTROLLED ANALGESIA VIAL 30 MG/30ML

0.50469 01/25/2013

MOXIFLOXACIN HCL ORAL TABLET 400 MG 1.78867 03/15/2019 1.33333 11/15/2019

multivit no.49/ferrous fumarate/folic acid/levomefolate/dha CAPSULE 27-1.13 MG

1.81370 01/25/2013 1.81370 08/21/2015

multivitamin comb no.48/ferrous fumarate/folic acid/dha CAPSULE 28-1-250MG 3.34740 09/26/2014

MULTIVITAMIN COMBINATION NO.47/FERROUS FUM/FOLATE NO.1/DHA ORAL CAPSULE 27-1-300MG

1.43085 04/24/2015 0.81153 06/16/2017

multivitamin combination no.50/iron ps complex/folic acid CAPSULE 155 MG-1MG

0.20689 01/25/2013

MULTIVITAMIN COMBINATION NO.51/FERROUS FUMARATE/FOLIC ACID ORAL CAPSULE 106.5-1MG

0.60753 01/23/2015 0.60753 08/21/2015

multivitamin combo no.52/iron/iron asparto gly/folic/omega-3 CAPSULE 27-1-330MG

0.98583 12/26/2014 0.98583 08/21/2015

MULTIVITAMIN ORAL TABLET 0.01441 02/20/2015 0.01441 08/21/2015

MULTIVITAMIN WITH IRON ORAL TABLET 0.01954 08/12/2014 0.01954 08/21/2015

MULTIVITAMIN WITH MINERALS NO.69/IRON,CARBONYL/FOLIC ACID ORAL TABLET 50-1.25 MG

1.05126 04/19/2013

MULTIVITAMIN WITH MINERALS NO.7/FOLIC ACID ORAL CAPSULE 1 MG 0.17550 02/15/2013

MULTIVITAMIN WITH MINERALS/FERROUS GLUCONATE ORAL LIQUID (ML) 9 MG/15 ML

0.01674 08/12/2014 0.01674 08/21/2015

MULTIVITAMIN WITH MINERALS/FOLIC ACID ORAL TABLET 0.4 MG 0.80780 08/12/2014 0.80780 08/21/2015

MULTIVITAMIN WITH MINERALS/FOLIC ACID/LYCOPENE/LUTEIN ORAL TABLET .4-300-250

0.04317 03/27/2015 0.04317 08/21/2015

MULTIVITAMIN WITH MINERALS/FOLIC ACID/LYCOPENE/LUTEIN ORAL TABLET 500-300MCG

0.05011 08/12/2014

MULTIVITAMIN WITH MINERALS/LUTEIN ORAL TABLET 0.04780 08/12/2014 0.04780 08/21/2015

MULTIVITAMIN,STRESS FORMULA/ZINC ORAL TABLET 0.04810 05/02/2014 0.04810 08/21/2015

MULTIVITAMIN,THERAPEUTIC ORAL TABLET 0.02440 08/12/2014

MULTIVITAMIN-MINERALS NO.71/IRON FUMARAT/FOLIC ACID NO.1/DHA ORAL CAPSULE 28-1-300MG

1.28123 10/10/2014

MULTIVITS WITH CALCIUM AND MINERALS/IRON FUMARATE/FOLIC ACID ORAL TABLET 9MG-400MCG

0.03495 08/12/2014

MUPIROCIN CALCIUM TOPICAL CREAM (GRAM) 2 % 2.58284 02/06/2015 2.58284 08/21/2015

MUPIROCIN TOPICAL OINTMENT (GRAM) 2 % 0.20477 11/24/2017 0.17500 12/21/2018

MV-MIN 75/FERROUS FUM/IRON PS CPLX/FOLIC AC/OMEGA-3/DHA/EPA ORAL CAPSULE 35-1-200MG

0.74013 04/10/2015

MV-MINS NO.74/FERROUS FUMARATE/IRON PS CPLX/FOLIC ACID ORAL CAPSULE 85 MG-1 MG

1.15359 01/25/2013

MYCOPHENOLATE MOFETIL ORAL CAPSULE 250 MG 0.19250 11/24/2017 0.12520 01/19/2018

MYCOPHENOLATE MOFETIL ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 200 MG/ML

4.24000 07/26/2019 5.06388 03/31/2020

MYCOPHENOLATE MOFETIL ORAL TABLET 500 MG 0.20142 03/03/2017 0.16100 06/21/2019

MYCOPHENOLATE SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 180 MG

1.39966 03/03/2017 0.82950 11/16/2018

Effective 8/7/2020

Current SMAC Price

MYCOPHENOLATE SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 360 MG

2.89000 03/15/2019 2.80967 09/20/2019

NABUMETONE ORAL TABLET 500 MG 0.14920 08/01/2018 0.12800 05/22/2020

NABUMETONE ORAL TABLET 750 MG 0.20923 05/19/2017 0.15891 09/22/2017

NADOLOL ORAL TABLET 20 MG 1.25218 01/08/2018 0.29000 11/15/2019

NADOLOL/BENDROFLUMETHIAZIDE ORAL TABLET 40 MG-5 MG 1.72368 01/25/2013

NADOLOL/BENDROFLUMETHIAZIDE ORAL TABLET 80 MG-5 MG 2.25914 01/25/2013

NAFCILLIN IN DEXTROSE, ISO-OSMOTIC INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1 G/50 ML

0.25511 01/25/2013

NAFCILLIN IN DEXTROSE, ISO-OSMOTIC INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 2 G/100 ML

0.53762 07/25/2014

NAFCILLIN SODIUM INJECTION VIAL (EA) 1 G 11.78070 01/16/2015

NAFCILLIN SODIUM INJECTION VIAL (EA) 10 G 69.68850 03/06/2015

NAFCILLIN SODIUM INJECTION VIAL (EA) 2 G 11.96470 03/06/2015 11.96470 08/21/2015

NAFCILLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 1 G 12.56750 08/12/2014

NAFCILLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 2 G 26.14500 03/29/2013

NALBUPHINE HCL INJECTION AMPUL (ML) 20 MG/ML 3.45670 01/25/2013

NALBUPHINE HCL INJECTION VIAL (ML) 10 MG/ML 1.19280 01/25/2013 1.19280 08/21/2015

NALBUPHINE HCL INJECTION VIAL (ML) 20 MG/ML 1.70020 08/12/2014

NALOXONE HCL INJECTION SYRINGE (ML) 0.4 MG/ML 3.15000 01/25/2013

NALOXONE HCL INJECTION SYRINGE (ML) 1 MG/ML 7.11900 11/15/2013 7.11900 08/21/2015

NALTREXONE HCL ORAL TABLET 50 MG 0.71722 10/25/2019 0.66875 11/15/2019

NAPHAZOLINE HCL DROPS 0.1 % 0.11787 01/25/2013 0.11787 08/21/2015

NAPHAZOLINE HCL/GLYCERIN OPHTHALMIC DROPS 0.012-0.25 0.13090 04/03/2015

NAPROXEN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 125 MG/5ML 0.81200 05/04/2018 0.85722 08/24/2018

NAPROXEN ORAL TABLET 250 MG 0.04181 08/12/2014 0.04181 08/21/2015

NAPROXEN ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 375 MG

0.12990 12/22/2017 0.11150 11/15/2019

NAPROXEN ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 500 MG

0.17979 08/21/2015 0.13450 03/15/2019

NAPROXEN SODIUM ORAL TABLET 220 MG 0.04739 04/03/2015 0.04739 08/21/2015

NARATRIPTAN HCL ORAL TABLET 1 MG 4.82300 09/30/2016 3.92785 06/16/2017

NARATRIPTAN HCL ORAL TABLET 2.5 MG 1.10278 11/15/2019 2.12614 05/07/2020

NATEGLINIDE ORAL TABLET 120 MG 0.36656 08/16/2019 0.14756 02/21/2020

NATEGLINIDE ORAL TABLET 60 MG 0.28945 08/16/2019 0.26967 05/22/2020

NEFAZODONE HCL ORAL TABLET 100 MG 1.09937 10/03/2014 1.09937 08/21/2015

Effective 8/7/2020

Current SMAC Price

NEFAZODONE HCL ORAL TABLET 250 MG 0.66582 08/23/2013

NEFAZODONE HCL ORAL TABLET 50 MG 0.56680 08/12/2014

NEOMYCIN SULF/BACITRACIN ZINC/POLYMYXIN B SULF/PRAMOXINE HCL TOPICAL OINTMENT (GRAM) 3.5-10K-10

0.16974 08/21/2015 0.07183 08/17/2018

NEOMYCIN SULFATE ORAL TABLET 500 MG 0.50000 11/24/2017 0.61422 08/18/2018

NEOMYCIN SULFATE/BACITRACIN ZINC/POLYMYXIN B TOPICAL OINTMENT (GRAM) 3.5-400-5K

0.08442 02/13/2015 0.08442 08/21/2015

NEOMYCIN SULFATE/BACITRACIN ZINC/POLYMYXIN B/HYDROCORTISONE OPHTHALMIC OINTMENT (GRAM) 3.5-10K-1

12.81263 08/21/2015 12.16571 03/02/2018

NEOMYCIN SULFATE/BACITRACIN/POLYMYXIN B OPHTHALMIC OINTMENT (GRAM) 3.5MG-400

8.09100 08/21/2015 3.90000 02/22/2019

NEOMYCIN SULFATE/POLYMYXIN B SULFATE IRRIGATION AMPUL (ML) 40-200K/ML

7.53960 04/12/2013

NEOMYCIN SULFATE/POLYMYXIN B SULFATE IRRIGATION VIAL (ML) 40-200K/ML

5.02645 01/25/2013

NEOMYCIN SULFATE/POLYMYXIN B SULFATE/GRAMICIDIN D OPHTHALMIC DROPS 1.75MG-10K

4.33580 05/24/2013 4.33580 08/21/2015

NEOMYCIN SULFATE/POLYMYXIN B SULFATE/HYDROCORTISONE OPHTHALMIC SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 3.5-10K-10

13.05287 03/08/2013

NEOMYCIN SULFATE/POLYMYXIN B SULFATE/HYDROCORTISONE OTIC SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 3.5-10K-1

2.05680 08/21/2015 7.04760 09/22/2015

NEOMYCIN/POLYMYXIN B SULFATE/DEXAMETHASONE OPHTHALMIC OINTMENT (GRAM) 3.5-10K-.1

2.52857 08/16/2019 1.53143 09/20/2019

NEOMYCIN/POLYMYXIN B SULFATE/DEXAMETHASONE OPHTHALMIC SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 0.1 %

2.60900 06/22/2018 2.47400 07/17/2020

NEVIRAPINE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 50 MG/5 ML 0.40225 01/25/2013

NEVIRAPINE ORAL TABLET 200 MG 0.19200 08/21/2015 0.10617 09/22/2017

NEVIRAPINE ORAL TABLET, EXTENDED RELEASE 24 HR 400 MG 15.82373 08/21/2015 3.59633 11/24/2017

NIACIN (INOSITOL NIACINATE) ORAL TABLET 500 MG 0.02737 08/21/2015

NIACIN ORAL CAPSULE, EXTENDED RELEASE 250 MG 0.04147 02/01/2013

NIACIN ORAL CAPSULE, EXTENDED RELEASE 500 MG 0.04930 08/12/2014

NIACIN ORAL TABLET 100 MG 0.01270 08/12/2014 0.01270 08/21/2015

NIACIN ORAL TABLET 50 MG 0.01274 01/25/2013

NIACIN ORAL TABLET 500 MG 0.02000 08/12/2014 0.02000 08/21/2015

NIACIN ORAL TABLET, EXTENDED RELEASE 1000 MG 0.05775 01/25/2013

NIACIN ORAL TABLET, EXTENDED RELEASE 24 HR 1000 MG 1.24189 10/20/2017 0.81100 11/15/2019

NIACIN ORAL TABLET, EXTENDED RELEASE 24 HR 500 MG 0.33656 07/26/2019 0.08178 11/15/2019

NIACIN ORAL TABLET, EXTENDED RELEASE 500 MG 0.03081 08/12/2014 0.03081 08/21/2015

NIACINAMIDE ORAL TABLET 500 MG 0.02737 04/05/2013

NICARDIPINE HCL ORAL CAPSULE 20 MG 0.34500 02/08/2013

NICARDIPINE HCL ORAL CAPSULE 30 MG 0.35170 08/12/2014

NICOTINE POLACRILEX BUCCAL GUM 2 MG 0.17264 11/16/2018 0.20629 04/02/2019

NICOTINE POLACRILEX BUCCAL GUM 4 MG 0.14927 01/19/2018 0.21527 05/15/2019

NICOTINE POLACRILEX BUCCAL LOZENGE 2 MG 0.36791 08/21/2015

NICOTINE POLACRILEX BUCCAL LOZENGE 4 MG 0.33277 05/26/2017 0.29250 08/16/2019

Effective 8/7/2020

Current SMAC Price

NICOTINE POLACRILEX BUCCAL MINI LOZENGE 4 MG 0.38277 05/26/2017

NICOTINE TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 14MG/24HR

1.24071 08/16/2019 1.16303 02/21/2020

NICOTINE TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 21 MG/24HR

1.36143 11/16/2018 1.30714 02/22/2019

NICOTINE TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 7MG/24HR 1.46910 06/21/2019 1.29714 11/15/2019

NIFEDIPINE MISCELLANEOUS POWDER (GRAM) 2.02800 08/21/2015

NIFEDIPINE ORAL CAPSULE 10 MG 0.43570 11/24/2017 0.40990 02/22/2019

NIFEDIPINE ORAL CAPSULE 20 MG 1.61182 08/21/2015 1.31822 06/16/2017

NIFEDIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 30 MG 0.16274 08/17/2018 0.10000 12/20/2019

NIFEDIPINE ORAL TABLET, EXTENDED RELEASE 30 MG 0.13326 08/25/2017 0.11185 11/16/2018

NIMODIPINE ORAL CAPSULE 30 MG 13.27890 08/21/2015 2.09000 05/17/2019

NISOLDIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 17 MG 4.66057 04/22/2016 3.86000 05/20/2016

NISOLDIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 20 MG 10.97514 03/13/2015

NISOLDIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 25.5 MG 5.87636 01/25/2013

NISOLDIPINE ORAL TABLET, EXTENDED RELEASE 24 HR 8.5MG 3.94911 12/02/2016 3.89950 11/16/2018

NITROFURANTOIN MACROCRYSTAL ORAL CAPSULE 100 MG 0.91780 07/14/2017 0.74480 03/02/2018

NITROFURANTOIN MACROCRYSTAL ORAL CAPSULE 50 MG 0.47000 10/25/2019 0.39193 02/21/2020

NITROFURANTOIN MONOHYDRATE/MACROCRYSTALS ORAL CAPSULE 100 MG

0.52928 04/17/2020 0.46800 05/22/2020

NITROFURANTOIN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 25 MG/5 ML

1.31539 03/02/2018 9.40983 04/23/2019

NITROGLYCERIN IN 5 % DEXTROSE IN WATER INTRAVENOUS INFUSION BOTTLE (ML) 200MG/500

0.01110 08/12/2014

NITROGLYCERIN IN 5 % DEXTROSE IN WATER INTRAVENOUS INFUSION BOTTLE (ML) 50MG/500ML

0.02260 08/12/2014

NITROGLYCERIN INTRAVENOUS VIAL (ML) 50 MG/10ML 0.47040 01/25/2013

NITROGLYCERIN ORAL CAPSULE, EXTENDED RELEASE 2.5 MG 0.33267 05/17/2013 0.33267 08/21/2015

NITROGLYCERIN ORAL CAPSULE, EXTENDED RELEASE 6.5 MG 0.32960 02/15/2013 0.32960 08/21/2015

NITROGLYCERIN ORAL CAPSULE, EXTENDED RELEASE 9 MG 0.17330 08/12/2014 0.17330 08/21/2015

NITROGLYCERIN TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 0.1MG/HR

0.69594 08/21/2015 0.52033 08/16/2019

0.43967 03/03/2017 0.35275 11/24/2017

0.43334 09/30/2016 0.39678 02/22/2019

0.97601 08/21/2015 0.54533 10/20/2017

NITROGLYCERIN TRANSLINGUAL AEROSOL, SPRAY (GRAM) 400MCG/SPR

27.46701 01/25/2013

Effective 8/7/2020

Current SMAC Price

NITROGLYCERIN TRANSLINGUAL SPRAY, NON-AEROSOL (GRAM) 400MCG/SPR

31.99165 01/05/2018 23.27500 01/25/2019

NIZATIDINE ORAL CAPSULE 150 MG 0.26336 08/21/2015 0.18833 08/25/2017

NIZATIDINE ORAL CAPSULE 300 MG 0.56236 08/21/2015 0.36667 11/16/2018

NIZATIDINE ORAL SOLUTION, ORAL 150MG/10ML 0.49300 08/21/2015 1.00143 10/26/2019

NORETHINDRONE ACETATE ORAL TABLET 5 MG 0.65960 06/21/2019 0.99460 08/08/2019

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL ORAL TABLET 0.5MG-2.5

2.00956 04/27/2018

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL ORAL TABLET 1.5-0.03MG

0.57873 09/22/2017 0.42460 05/22/2020

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL ORAL TABLET 1MG-20MCG

0.20508 01/24/2020 0.13889 05/22/2020

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL ORAL TABLET 1MG-5MCG

1.65878 04/03/2019 1.33988 05/17/2019

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET 1.5-30(21)

0.16679 11/15/2019 0.15557 05/22/2020

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET 1MG-20(21)

0.19802 02/22/2019 0.14387 06/21/2019

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET 1MG-20(24)

1.05273 11/24/2017 0.73809 01/25/2019

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET 5-7-9-7

1.42880 08/21/2015 0.91503 06/16/2017

NORETHINDRONE ACETATE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET,CHEWABLE 1MG-20(24)

1.88500 04/17/2020

NORETHINDRONE ORAL TABLET 0.35 MG 0.10917 03/16/2018 0.07500 11/15/2019

NORETHINDRONE-ETHINYL ESTRADIOL ORAL TABLET 0.4-0.035 0.39583 06/16/2017 0.24429 02/21/2020

NORETHINDRONE-ETHINYL ESTRADIOL ORAL TABLET 0.5-0.035 0.70263 02/26/2016 0.66000 04/27/2018

NORETHINDRONE-ETHINYL ESTRADIOL ORAL TABLET 1 MG-35MCG 0.60029 03/25/2016 0.28925 06/16/2017

NORETHINDRONE-ETHINYL ESTRADIOL ORAL TABLET 7 DAYS X 3 0.37448 06/16/2017 0.15179 11/15/2019

NORETHINDRONE-ETHINYL ESTRADIOL ORAL TABLET 7-9-5 0.98375 01/25/2013 0.59237 06/16/2017

NORETHINDRONE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET,CHEWABLE 0.4-35(21)

1.86241 08/21/2015 1.46607 10/20/2017

NORETHINDRONE-ETHINYL ESTRADIOL/FERROUS FUMARATE ORAL TABLET,CHEWABLE 0.8-25(24)

1.60596 04/27/2018

NORGESTIMATE-ETHINYL ESTRADIOL ORAL TABLET 0.25-0.035 0.21536 11/16/2018 0.12787 03/15/2019

NORGESTIMATE-ETHINYL ESTRADIOL ORAL TABLET 7DAYSX3 28 0.19123 11/16/2018 0.10250 03/15/2019

NORGESTIMATE-ETHINYL ESTRADIOL ORAL TABLET 7DAYSX3 LO 0.17845 01/24/2020 0.15456 06/19/2020

NORGESTREL-ETHINYL ESTRADIOL ORAL TABLET 0.3-0.03MG 0.26161 11/16/2018 0.41660 06/18/2020

NORTRIPTYLINE HCL ORAL CAPSULE 10 MG 0.07000 08/25/2017 0.05556 10/25/2019

NORTRIPTYLINE HCL ORAL SOLUTION, ORAL 10 MG/5 ML 0.26055 02/27/2015 0.26055 08/21/2015

NYSTATIN MISCELLANEOUS POWDER (EA) 10B UNIT 17265.36000 01/25/2013

NYSTATIN MISCELLANEOUS POWDER (EA) 150MM UNIT 98.76650 01/25/2013

NYSTATIN MISCELLANEOUS POWDER (EA) 500MM UNIT 156.49700 01/25/2013 156.49700 08/21/2015

Effective 8/7/2020

Current SMAC Price

NYSTATIN MISCELLANEOUS POWDER (EA) 50MM UNIT 47.31300 01/25/2013 47.31300 08/21/2015

NYSTATIN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 100000/ML 0.06036 06/16/2017 0.04816 08/17/2018

NYSTATIN ORAL TABLET 500K UNIT 0.40617 05/19/2017 0.34870 08/17/2018

NYSTATIN TOPICAL CREAM (GRAM) 100000/G 0.17875 11/15/2019 0.16033 01/24/2020

NYSTATIN TOPICAL OINTMENT (GRAM) 100000/G 0.32875 11/16/2018 0.28593 06/21/2019

NYSTATIN TOPICAL POWDER (GRAM) 100000/G 0.29656 07/26/2019 0.26384 11/15/2019

NYSTATIN/TRIAMCINOLONE ACETONIDE TOPICAL CREAM (GRAM) 100000-0.1

0.95666 04/26/2019 0.38408 02/21/2020

NYSTATIN/TRIAMCINOLONE ACETONIDE TOPICAL OINTMENT (GRAM) 100000-0.1

0.55533 02/22/2019 0.18333 09/20/2019

OCTREOTIDE ACETATE INJECTION AMPUL (ML) 100 MCG/ML 4.02220 03/07/2014

OCTREOTIDE ACETATE INJECTION SYRINGE (ML) 100 MCG/ML 15.96000 03/21/2014

OCTREOTIDE ACETATE INJECTION VIAL (ML) 100 MCG/ML 5.15580 05/01/2015 5.15580 08/21/2015

OCTREOTIDE ACETATE INJECTION VIAL (ML) 1000MCG/ML 34.03343 02/27/2015 34.03343 08/21/2015

OFLOXACIN OPHTHALMIC DROPS 0.3 % 2.10000 02/22/2019 1.83240 11/15/2019

OFLOXACIN OTIC DROPS 0.3 % 2.52000 05/22/2020 3.89183 07/02/2020

OLANZAPINE INTRAMUSCULAR VIAL (EA) 10 MG 29.05000 02/01/2013

OLANZAPINE ORAL TABLET 10 MG 0.13334 11/16/2018 0.10867 04/17/2020

OLANZAPINE ORAL TABLET 2.5 MG 0.10093 08/25/2017 0.07267 03/02/2018

OLANZAPINE ORAL TABLET 7.5 MG 0.10995 05/17/2019 0.08533 08/16/2019

OLANZAPINE ORAL TABLET,DISINTEGRATING 10 MG 0.35333 11/16/2018 0.76425 03/19/2020

OLANZAPINE/FLUOXETINE HCL ORAL CAPSULE 12MG-25MG 15.27470 08/15/2014

OLANZAPINE/FLUOXETINE HCL ORAL CAPSULE 12MG-50MG 15.27773 08/12/2014

OLANZAPINE/FLUOXETINE HCL ORAL CAPSULE 3 MG-25 MG 7.51917 11/14/2014 7.51917 08/21/2015

OLANZAPINE/FLUOXETINE HCL ORAL CAPSULE 6MG-25MG 10.13740 08/01/2014 10.13740 08/21/2015

OLANZAPINE/FLUOXETINE HCL ORAL CAPSULE 6MG-50MG 10.13740 08/01/2014 7.04000 01/25/2019

OLMESARTAN MEDOXOMIL ORAL TABLET 20 MG 0.10100 04/27/2018 0.08956 06/19/2020

OLMESARTAN MEDOXOMIL ORAL TABLET 40 MG 0.16863 04/27/2018

OLMESARTAN MEDOXOMIL ORAL TABLET 5 MG 0.08550 11/16/2018 0.05067 07/26/2019

Effective 8/7/2020

Current SMAC Price

OLMESARTAN MEDOXOMIL/AMLODIPINE BESYLATE/HYDROCHLOROTHIAZIDE ORAL TABLET 20-5-12.5

1.37855 11/15/2019 1.37855 01/01/2020

1.82389 11/15/2019 1.82389 01/01/2020

OLMESARTAN MEDOXOMIL/AMLODIPINE BESYLATE/HYDROCHLOROTHIAZIDE ORAL TABLET 40-10-25MG

1.61800 11/16/2018 1.61800 01/01/2020

1.00133 05/17/2019 1.00133 01/01/2020

OLMESARTAN MEDOXOMIL/AMLODIPINE BESYLATE/HYDROCHLOROTHIAZIDE ORAL TABLET 40-5-25 MG

1.71000 11/16/2018 1.71000 01/01/2020

OLMESARTAN MEDOXOMIL/HYDROCHLOROTHIAZIDE ORAL TABLET 20-12.5 MG

0.13000 08/17/2018 0.08333 03/15/2019

OLMESARTAN MEDOXOMIL/HYDROCHLOROTHIAZIDE ORAL TABLET 40 MG-25MG

0.20000 04/27/2018 0.17600 02/22/2019

OLMESARTAN MEDOXOMIL/HYDROCHLOROTHIAZIDE ORAL TABLET 40-12.5 MG

0.12000 04/27/2018

OLOPATADINE HCL NASAL AEROSOL, SPRAY WITH PUMP (GRAM) 0.6 % 2.15000 06/21/2019 2.35611 06/24/2019

OLOPATADINE HCL OPHTHALMIC DROPS 0.1 % 2.57629 11/15/2019 2.39000 05/22/2020

OMEGA-3 ACID ETHYL ESTERS ORAL CAPSULE 1 G 0.21378 01/01/2019 0.18871 05/22/2020

OMEGA-3 FATTY ACIDS/DOCOSAHEXAENOIC ACID/EPA/FISH OIL ORAL CAPSULE 1000 MG

0.05283 08/12/2014

OMEPRAZOLE ORAL CAPSULE,DELAYED RELEASE (ENTERIC COATED) 10 MG

0.11633 08/25/2017 0.02056 08/17/2018

0.08682 08/21/2015 0.03862 07/14/2017

0.05675 04/26/2019 0.04480 01/24/2020

OMEPRAZOLE ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 20 MG

0.47857 08/25/2017 0.19321 02/21/2020

OMEPRAZOLE/SODIUM BICARBONATE ORAL CAPSULE 20MG-1.1G 6.58183 09/22/2017 1.95000 10/25/2019

OMEPRAZOLE/SODIUM BICARBONATE ORAL CAPSULE 40MG-1.1G 1.85000 10/25/2019 1.28050 11/15/2019

ONDANSETRON HCL INTRAVENOUS VIAL (ML) 2 MG/ML 0.07865 01/16/2015 0.07865 08/21/2015

ONDANSETRON HCL ORAL SOLUTION, ORAL 4 MG/5 ML 0.25940 07/26/2019 0.23744 11/15/2019

ONDANSETRON HCL ORAL TABLET 4 MG 0.07664 11/16/2018 0.05643 05/22/2020

ONDANSETRON HCL ORAL TABLET 8 MG 0.12277 11/16/2018 0.09415 05/22/2020

ONDANSETRON HCL/PF INJECTION AMPUL (ML) 4 MG/2 ML 8.31950 01/25/2013

ONDANSETRON HCL/PF INJECTION SYRINGE (ML) 4 MG/2 ML 0.93551 05/01/2015 0.93551 08/21/2015

ONDANSETRON HCL/PF INJECTION VIAL (ML) 4 MG/2 ML 0.25000 11/16/2018 0.14720 03/20/2020

ONDANSETRON ORAL TABLET,DISINTEGRATING 4 MG 0.22616 11/15/2019 0.16667 07/17/2020

ONDANSETRON ORAL TABLET,DISINTEGRATING 8 MG 0.24400 07/26/2019 0.22773 11/15/2019

OPIUM TINCTURE ORAL TINCTURE 10 MG/ML 3.65310 08/02/2013 2.38890 03/02/2018

OPIUM/BELLADONNA ALKALOIDS RECTAL SUPPOSITORY, RECTAL 30-16.2 MG

19.61500 07/18/2014

OPIUM/BELLADONNA ALKALOIDS RECTAL SUPPOSITORY, RECTAL 60-16.2 MG

23.41675 10/24/2014

ORPHENADRINE CITRATE ORAL TABLET, EXTENDED RELEASE 100 MG 0.18230 09/22/2017 0.14850 11/16/2018

OSELTAMIVIR PHOSPHATE ORAL CAPSULE 30 MG 5.33000 01/25/2019

OSELTAMIVIR PHOSPHATE ORAL CAPSULE 45 MG 5.55000 01/25/2019

OSELTAMIVIR PHOSPHATE ORAL CAPSULE 75 MG 2.92000 03/20/2020 1.84057 05/22/2020

Effective 8/7/2020

Current SMAC Price

OSELTAMIVIR PHOSPHATE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 6 MG/ML

1.02317 11/15/2019 0.63350 05/22/2020

OXACILLIN SODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1 G/50 ML

0.25790 01/25/2013

OXACILLIN SODIUM IN ISO-OSMOTIC DEXTROSE INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 2 G/50 ML

0.23003 09/26/2014

OXACILLIN SODIUM INJECTION VIAL (EA) 1 G 8.82240 08/22/2014 8.82240 08/21/2015

OXACILLIN SODIUM INJECTION VIAL (EA) 10 G 86.55715 08/22/2014

OXACILLIN SODIUM INJECTION VIAL (EA) 2 G 15.23550 08/22/2014 15.23550 08/21/2015

OXACILLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 1 G 0.86301 01/25/2013

OXACILLIN SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 2 G 2.23201 01/25/2013

OXANDROLONE ORAL TABLET 10 MG 9.27840 01/25/2013 9.27840 08/21/2015

OXANDROLONE ORAL TABLET 2.5 MG 3.00096 08/12/2014 3.00096 08/21/2015

OXAPROZIN ORAL TABLET 600 MG 0.89000 10/19/2018 0.76500 03/20/2020

OXAZEPAM ORAL CAPSULE 10 MG 0.56183 01/13/2017 0.51416 01/27/2017

OXAZEPAM ORAL CAPSULE 15 MG 0.77475 12/02/2016 0.74047 04/21/2017

OXAZEPAM ORAL CAPSULE 30 MG 1.11314 04/24/2015

OXCARBAZEPINE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 300 MG/5ML

0.25400 12/21/2018 0.31168 01/07/2019

OXCARBAZEPINE ORAL TABLET 150 MG 0.09147 08/17/2018 0.07880 07/26/2019

OXYBUTYNIN CHLORIDE ORAL SYRUP 5 MG/5 ML 0.02124 05/17/2013 0.02124 08/21/2015

OXYBUTYNIN CHLORIDE ORAL TABLET 5 MG 0.11303 06/21/2019 0.07000 05/22/2020

OXYBUTYNIN CHLORIDE ORAL TABLET, EXTENDED RELEASE 24 HR 10 MG

0.22747 11/15/2019 0.21537 05/22/2020

0.20670 05/22/2020 0.15440 07/17/2020

0.31306 11/15/2019 0.18040 01/24/2020

OXYCODONE HCL ORAL CAPSULE 5 MG 1.29200 08/21/2015 0.41790 06/16/2017

OXYCODONE HCL ORAL CONCENTRATE, ORAL 20 MG/ML 3.73320 09/30/2016 2.80000 05/25/2018

OXYCODONE HCL ORAL SOLUTION, ORAL 5 MG/5 ML 0.15271 09/20/2019 0.09998 11/15/2019

OXYCODONE HCL ORAL TABLET 10 MG 0.15800 07/14/2017 0.13000 03/02/2018

OXYCODONE HCL ORAL TABLET,ORAL ONLY,EXTENDED RELEASE 12 HR 40 MG

5.78530 03/03/2017 5.78530 03/04/2017

OXYCODONE HCL ORAL TABLET,ORAL ONLY,EXTENDED RELEASE 12 HR 80 MG

9.41957 03/03/2017 9.41957 03/04/2017

OXYCODONE HCL/ACETAMINOPHEN ORAL TABLET 10MG-325MG 0.27202 07/17/2019 0.25078 08/16/2019

OXYCODONE HCL/ACETAMINOPHEN ORAL TABLET 2.5-325 MG 1.43437 05/01/2015 1.24120 11/24/2017

OXYCODONE HCL/ACETAMINOPHEN ORAL TABLET 5 MG-325MG 0.09991 03/03/2017 0.06530 09/21/2018

OXYCODONE HCL/ACETAMINOPHEN ORAL TABLET 7.5-325 MG 0.22515 05/17/2019 0.16020 11/15/2019

Effective 8/7/2020

Current SMAC Price

OXYCODONE HCL/ASPIRIN ORAL TABLET 4.8355-325 0.40759 11/07/2014 0.40759 08/21/2015

OXYMORPHONE HCL ORAL TABLET 10 MG 2.46947 07/14/2017 1.92770 11/24/2017

OXYMORPHONE HCL ORAL TABLET 5 MG 1.64692 08/21/2015 1.36790 11/24/2017

OXYMORPHONE HCL ORAL TABLET, EXTENDED RELEASE 12 HR 10 MG 2.43642 08/21/2015 2.81100 01/29/2018

OXYMORPHONE HCL ORAL TABLET, EXTENDED RELEASE 12 HR 15 MG 3.54294 04/03/2015

OXYMORPHONE HCL ORAL TABLET, EXTENDED RELEASE 12 HR 7.5 MG 1.91827 05/16/2014

PALIPERIDONE ORAL TABLET, EXTENDED RELEASE 24 HR 6 MG 17.55344 01/03/2017 8.99000 06/21/2019

PALIPERIDONE ORAL TABLET, EXTENDED RELEASE 24 HR 9 MG 13.28867 12/27/2019 12.64833 02/21/2020

PAMIDRONATE DISODIUM INTRAVENOUS VIAL (EA) 30 MG 10.37300 02/27/2015 10.37300 08/21/2015

PAMIDRONATE DISODIUM INTRAVENOUS VIAL (EA) 90 MG 26.85500 02/27/2015 26.85500 08/21/2015

PAMIDRONATE DISODIUM INTRAVENOUS VIAL (ML) 30MG/10ML 1.47400 08/12/2014 1.47400 08/21/2015

PAMIDRONATE DISODIUM INTRAVENOUS VIAL (ML) 60 MG/10ML 4.62000 01/25/2013

PAMIDRONATE DISODIUM INTRAVENOUS VIAL (ML) 90 MG/10ML 4.54740 08/08/2014 4.54740 08/21/2015

PANTOPRAZOLE SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 20 MG

0.05756 12/22/2017 0.04411 01/19/2018

PANTOPRAZOLE SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 40 MG

0.11779 08/21/2015 0.05189 06/16/2017

PAREGORIC LIQUID (ML) 2 MG/5 ML 0.46388 04/26/2013

PARICALCITOL INJECTION VIAL (ML) 2 MCG/ML 3.52800 03/27/2015

PARICALCITOL INJECTION VIAL (ML) 5 MCG/ML 8.82000 01/30/2015

PARICALCITOL ORAL CAPSULE 1 MCG 2.80000 05/25/2018 0.94067 08/17/2018

PARICALCITOL ORAL CAPSULE 2 MCG 15.52623 07/04/2014 8.23334 03/03/2017

PARICALCITOL ORAL CAPSULE 4 MCG 31.05270 07/04/2014

PAROMOMYCIN SULFATE ORAL CAPSULE 250 MG 2.95152 06/14/2013

PAROXETINE HCL ORAL TABLET 10 MG 0.05431 12/22/2017 0.04078 11/16/2018

PAROXETINE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 25 MG 1.44307 05/17/2019 1.27800 03/20/2020

PEANUT OIL MISCELLANEOUS OIL (ML) 0.09990 08/12/2014 0.09990 08/21/2015

PEG 3350/SOD SULF/SOD BICARB/SOD CHLORIDE/POTASSIUM CHLORIDE ORAL SOLUTION, RECONSTITUTED, ORAL 236-22.74G

0.00288 12/05/2014

PEG 3350/SOD SULF/SOD BICARB/SOD CHLORIDE/POTASSIUM CHLORIDE ORAL SOLUTION, RECONSTITUTED, ORAL 240-22.72G

0.00219 08/22/2014 0.00219 08/21/2015

PENICILLIN G POTASSIUM INJECTION VIAL (EA) 20MM UNIT 24.80100 08/12/2014

PENICILLIN G POTASSIUM INJECTION VIAL (EA) 5MM UNIT 26.68167 04/17/2015 26.68167 08/21/2015

PENICILLIN G POTASSIUM/DEXTROSE-WATER INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1MM/50ML

0.19490 01/25/2013

0.21880 01/25/2013

Effective 8/7/2020

Current SMAC Price

0.13440 01/25/2013

PENICILLIN G PROCAINE INTRAMUSCULAR SYRINGE (ML) 1.2MM/2 ML 11.84540 01/25/2013 11.84540 08/21/2015

PENICILLIN G PROCAINE INTRAMUSCULAR SYRINGE (ML) 600000/ML 13.05360 01/25/2013

PENICILLIN G SODIUM INJECTION VIAL (EA) 5MM UNIT 40.12055 08/09/2013

PENICILLIN V POTASSIUM ORAL SOLUTION, RECONSTITUTED, ORAL 125 MG/5ML

0.02349 04/05/2013

PENICILLIN V POTASSIUM ORAL SOLUTION, RECONSTITUTED, ORAL 250 MG/5ML

0.05111 04/03/2015

PENICILLIN V POTASSIUM ORAL TABLET 250 MG 0.17072 08/21/2015 0.07000 11/24/2017

PENICILLIN V POTASSIUM ORAL TABLET 500 MG 0.07250 11/15/2019 0.05740 01/24/2020

PENTAZOCINE HCL/NALOXONE HCL ORAL TABLET 50MG-0.5MG 2.10324 04/03/2015 2.10324 08/21/2015

PENTOXIFYLLINE ORAL TABLET, EXTENDED RELEASE 400 MG 0.14637 08/25/2017 0.12795 11/16/2018

PERINDOPRIL ERBUMINE ORAL TABLET 2 MG 0.85163 01/25/2013

PERINDOPRIL ERBUMINE ORAL TABLET 4 MG 0.61627 08/21/2015 0.58980 11/15/2019

PERINDOPRIL ERBUMINE ORAL TABLET 8 MG 0.70278 08/29/2014 0.70278 08/21/2015

PERMETHRIN TOPICAL CREAM (GRAM) 5 % 0.45460 03/20/2019 0.29678 02/21/2020

PERMETHRIN TOPICAL LIQUID (ML) 1 % 0.04372 12/13/2013 0.04372 08/21/2015

PERPHENAZINE ORAL TABLET 16 MG 1.67330 10/24/2014 1.53480 09/22/2017

PERPHENAZINE/AMITRIPTYLINE HCL ORAL TABLET 2 MG-10 MG 0.85974 03/13/2015

PERPHENAZINE/AMITRIPTYLINE HCL ORAL TABLET 4 MG-50 MG 1.96854 03/13/2015 2.47290 03/06/2018

PERPHENAZINE/AMITRIPTYLINE HCL ORAL TABLET 4MG-10MG 0.47570 08/12/2014

PETROLATUM,WHITE TOPICAL OINTMENT IN PACKET (GRAM) 13.09140 08/21/2015

PETROLATUM,WHITE/WATER TOPICAL LOTION (ML) 0.00860 08/12/2014

PHENAZOPYRIDINE HCL ORAL TABLET 100 MG 0.51200 11/24/2017 0.26500 06/21/2019

PHENAZOPYRIDINE HCL ORAL TABLET 200 MG 0.68905 11/16/2018 0.40000 05/22/2020

PHENDIMETRAZINE TARTRATE ORAL TABLET 35 MG 0.13406 08/12/2014 0.13406 08/21/2015

PHENELZINE SULFATE ORAL TABLET 15 MG 0.58450 01/25/2013 0.44016 09/30/2016

PHENOBARBITAL ORAL ELIXIR 20 MG/5 ML 0.12828 01/30/2015 0.11000 07/26/2019

PHENOBARBITAL ORAL TABLET 100 MG 0.22053 04/19/2013

PHENOBARBITAL ORAL TABLET 16.2 MG 0.16065 08/21/2015 0.37408 09/23/2015

PHENOBARBITAL ORAL TABLET 97.2MG 0.90673 03/01/2018 0.85000 05/25/2018

PHENOBARBITAL SODIUM INJECTION VIAL (ML) 130MG/ML 13.60800 01/25/2013

PHENOBARBITAL SODIUM INJECTION VIAL (ML) 65 MG/ML 10.58400 07/26/2013

Effective 8/7/2020

Current SMAC Price

PHENOBARBITAL/HYOSCYAMINE SULF/ATROPINE SULF/SCOPOLAMINE HB ORAL ELIXIR 16.2MG/5ML

0.11741 08/21/2015

PHENOBARBITAL/HYOSCYAMINE SULF/ATROPINE SULF/SCOPOLAMINE HB ORAL TABLET 16.2 MG

0.02701 08/21/2015

PHENTERMINE HCL ORAL CAPSULE 15 MG 0.76603 08/21/2015 0.16000 09/22/2017

PHENTERMINE HCL ORAL CAPSULE 30 MG 0.19443 08/21/2015 0.14830 08/25/2017

PHENTERMINE HCL ORAL CAPSULE 37.5 MG 0.32924 08/21/2015 0.10540 09/22/2017

PHENTERMINE HCL ORAL TABLET 37.5 MG 0.08429 08/21/2015 0.06571 04/26/2019

PHENYLEPHRINE HCL OPHTHALMIC DROPS 10 % 6.86000 02/27/2015 6.86000 08/21/2015

PHENYLEPHRINE HCL OPHTHALMIC DROPS 2.5 % 6.61924 02/27/2015 6.61924 08/21/2015

PHENYLEPHRINE HCL ORAL SOLUTION, ORAL 2.5 MG/5ML 0.04150 08/12/2014

PHENYLEPHRINE HCL ORAL TABLET 10 MG 0.04135 09/19/2014 0.04135 08/21/2015

PHENYLEPHRINE HCL/PROMETHAZINE HCL ORAL SYRUP 5-6.25MG/5 0.23791 10/31/2014 0.23791 08/21/2015

PHENYTOIN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 100 MG/4ML 0.27300 08/12/2014

PHENYTOIN ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 125 MG/5ML 0.08026 03/17/2017 0.06283 08/17/2018

PHENYTOIN ORAL TABLET,CHEWABLE 50 MG 0.19360 08/17/2018 0.29720 12/18/2019

PHENYTOIN SODIUM EXTENDED ORAL CAPSULE 100 MG 0.17390 03/15/2019 0.16530 10/25/2019

PHENYTOIN SODIUM EXTENDED ORAL CAPSULE 200 MG 0.55990 08/12/2014

PHENYTOIN SODIUM INTRAVENOUS AMPUL (ML) 50 MG/ML 0.57670 08/12/2014

PHENYTOIN SODIUM INTRAVENOUS SYRINGE (ML) 50 MG/ML 0.68460 01/25/2013

PHENYTOIN SODIUM INTRAVENOUS VIAL (ML) 50 MG/ML 0.37563 08/12/2014

PHOSPHORATED CARBOHYDRATE (DEXTROSE AND FRUCTOSE) ORAL SOLUTION, ORAL

0.03038 08/12/2014

PHYTONADIONE (VIT K1) INJECTION AMPUL (ML) 10 MG/ML 26.38440 08/22/2014

PHYTONADIONE (VIT K1) ORAL TABLET 100 MCG 0.02140 08/12/2014 0.02140 08/21/2015

PHYTONADIONE (VIT K1) ORAL TABLET 5 MG 44.17600 08/16/2019

PILOCARPINE HCL OPHTHALMIC DROPS 1 % 4.34000 04/26/2013 4.34000 08/21/2015

PILOCARPINE HCL ORAL TABLET 5 MG 0.74470 02/22/2019 0.28990 11/15/2019

PILOCARPINE HCL ORAL TABLET 7.5 MG 1.15570 05/20/2016 1.04620 11/16/2018

PINDOLOL ORAL TABLET 10 MG 0.97925 06/16/2017 0.79990 02/22/2019

PINDOLOL ORAL TABLET 5 MG 0.85750 03/02/2018 0.65800 01/25/2019

PIOGLITAZONE HCL ORAL TABLET 15 MG 0.07000 08/25/2017 0.05857 11/16/2018

PIOGLITAZONE HCL/GLIMEPIRIDE ORAL TABLET 30 MG-2 MG 21.94569 03/01/2013 6.57850 06/16/2017

PIOGLITAZONE HCL/GLIMEPIRIDE ORAL TABLET 30 MG-4 MG 21.94569 03/01/2013 10.75527 06/16/2017

PIOGLITAZONE HCL/METFORMIN HCL ORAL TABLET 15MG-500MG 1.12650 08/17/2018 1.11033 03/20/2020

PIOGLITAZONE HCL/METFORMIN HCL ORAL TABLET 15MG-850MG 1.02022 11/24/2017 0.61100 02/21/2020

PIPERACILLIN SODIUM/TAZOBACTAM SODIUM INTRAVENOUS VIAL (EA) 2.25 G

3.74530 08/21/2015 4.62000 10/05/2016

11.98000 08/21/2015 3.25000 05/22/2020

Effective 8/7/2020

Current SMAC Price

15.01360 07/19/2013 4.35700 05/22/2020

95.66330 08/21/2015 72.90000 01/25/2019

PIPERACILLIN SODIUM/TAZOBACTAM SODIUM INTRAVENOUS VIAL WITH THREADED PORT (EA) 2.25 G

8.32230 01/25/2013

12.66720 01/31/2014

15.73320 01/25/2013

PIPERONYL BUTOXIDE/PYRETHRINS TOPICAL SHAMPOO 4%-0.33% 0.03613 05/03/2013 0.03613 08/21/2015

PIROXICAM ORAL CAPSULE 10 MG 0.53490 11/24/2017 0.44020 03/15/2019

PIROXICAM ORAL CAPSULE 20 MG 0.57000 10/19/2018 0.23350 11/16/2018

PODOFILOX TOPICAL SOLUTION, NON-ORAL 0.5 % 16.47695 04/22/2016 12.20500 09/30/2016

POLYDIMETHYLSILOXANES/SILICON DIOXIDE TOPICAL GEL (GRAM) 3.96690 04/03/2015

POLYETHYLENE GLYCOL 3350 ORAL POWDER (GRAM) 17G/DOSE 0.04100 08/21/2015 0.02099 05/19/2017

POLYETHYLENE GLYCOL 3350 ORAL POWDER IN PACKET (EA) 17G 1.03071 06/19/2020 1.46800 07/14/2020

POLYETHYLENE GLYCOL 400/HYPROMELLOSE/GLYCERIN OPHTHALMIC DROPS 1-0.2-0.2%

0.06720 01/25/2013

POLYMYXIN B SULFATE/TRIMETHOPRIM OPHTHALMIC DROPS 10000-1/ML

0.41400 12/22/2017 0.38700 09/20/2019

POLYVINYL ALCOHOL OPHTHALMIC DROPS 1.4 % 0.13400 01/25/2013 0.13400 08/21/2015

POTASSIUM ALUM/SALICYLIC ACID/TALC/BENTONITE TOPICAL POWDER (GRAM)

0.06740 08/12/2014

POTASSIUM ALUM/TALC/BENTONITE TOPICAL POWDER (GRAM) 0.07530 08/12/2014

POTASSIUM BICARBONATE/CITRIC ACID ORAL TABLET, EFFERVESCENT 25 MEQ

0.21200 05/01/2015 0.18200 08/17/2018

POTASSIUM CHLORIDE IN 0.45 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 20 MEQ/L

0.00410 08/12/2014

0.00283 04/19/2013

0.00510 01/25/2013

POTASSIUM CHLORIDE IN 5 % DEXTROSE IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 20 MEQ/L

0.00310 08/12/2014

0.00266 01/25/2013

0.00209 01/25/2013 0.00209 08/21/2015

POTASSIUM CHLORIDE IN DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 20 MEQ/L

0.00320 08/12/2014

POTASSIUM CHLORIDE IN DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 40 MEQ/L

0.00540 08/12/2014

POTASSIUM CHLORIDE IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 10 MEQ/L

0.00234 01/25/2013

0.00322 01/25/2013

0.00200 01/25/2013

0.00227 01/25/2013

Effective 8/7/2020

Current SMAC Price

0.00320 08/12/2014

0.00230 08/12/2014

0.00236 01/25/2013

0.00228 01/25/2013

POTASSIUM CHLORIDE IN DEXTROSE 5% AND 0.3 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 20 MEQ/L

0.00322 01/25/2013 0.00322 08/21/2015

POTASSIUM CHLORIDE IN LACTATED RINGERS AND 5 % DEXTROSE INTRAVENOUS INTRAVENOUS SOLUTION 20 MEQ/L

0.00610 08/12/2014

POTASSIUM CHLORIDE IN LACTATED RINGERS AND 5 % DEXTROSE INTRAVENOUS INTRAVENOUS SOLUTION 40 MEQ/L

0.00403 01/25/2013

POTASSIUM CHLORIDE IN WATER FOR INJECTION, STERILE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 10MEQ/0.1L

0.02218 01/25/2013

POTASSIUM CHLORIDE IN WATER FOR INJECTION, STERILE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 10MEQ/50ML

0.06570 08/12/2014

0.02180 01/25/2013

POTASSIUM CHLORIDE IN WATER FOR INJECTION, STERILE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 20MEQ/50ML

0.10610 08/12/2014

0.04528 01/25/2013 0.04528 08/21/2015

0.04897 01/25/2013

POTASSIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION 2 MEQ/ML

0.02779 08/22/2014

POTASSIUM CHLORIDE INTRAVENOUS VIAL (ML) 2 MEQ/ML 0.02303 04/19/2013 0.02303 08/21/2015

POTASSIUM CHLORIDE ORAL CAPSULE, EXTENDED RELEASE 10 MEQ 0.27000 08/25/2017 0.09794 09/22/2017

POTASSIUM CHLORIDE ORAL CAPSULE, EXTENDED RELEASE 8 MEQ 0.41723 02/26/2016 0.15000 08/16/2019

POTASSIUM CHLORIDE ORAL LIQUID (ML) 20MEQ/15ML 0.23230 10/25/2019 0.28252 12/09/2019

POTASSIUM CHLORIDE ORAL LIQUID (ML) 40MEQ/15ML 0.38055 11/16/2018 0.56550 07/10/2020

POTASSIUM CHLORIDE ORAL PACKET (EA) 20 MEQ 4.03333 11/15/2019 4.93300 01/13/2020

POTASSIUM CHLORIDE ORAL TABLET, EXT RELEASE, PARTICLES/CRYSTALS 10 MEQ

0.19245 11/16/2018 0.16745 08/16/2019

POTASSIUM CHLORIDE ORAL TABLET, EXT RELEASE, PARTICLES/CRYSTALS 20 MEQ

0.18912 02/22/2019 0.18056 10/25/2019

POTASSIUM CHLORIDE ORAL TABLET, EXTENDED RELEASE 10 MEQ 0.14650 12/21/2018 0.13899 07/26/2019

POTASSIUM CHLORIDE ORAL TABLET, EXTENDED RELEASE 8 MEQ 0.35868 08/21/2015 0.15500 08/25/2017

POTASSIUM CHLORIDE/POTASSIUM BICARBONATE/CITRIC ACID TABLET, EFFERVESCENT 25 MEQ

0.68997 01/25/2013

POTASSIUM CITRATE ORAL TABLET, EXTENDED RELEASE 10 MEQ 0.65371 04/25/2019 0.52180 07/26/2019

POVIDONE-IODINE TOPICAL OINTMENT (GRAM) 10 % 0.06258 01/25/2013 0.06258 08/21/2015

POVIDONE-IODINE TOPICAL SOLUTION, NON-ORAL 10 % 0.00639 04/17/2015 0.00639 08/21/2015

POVIDONE-IODINE TOPICAL SWAB, MEDICATED 10 % 0.15276 08/12/2014

POVIDONE-IODINE VAGINAL SOLUTION, NON-ORAL 0.3 % 0.00990 08/12/2014

PRAMIPEXOLE DI-HCL ORAL TABLET 0.125 MG 0.06600 08/25/2017 0.03978 09/22/2017

Effective 8/7/2020

Current SMAC Price

PRAMIPEXOLE DI-HCL ORAL TABLET 1 MG 0.04395 08/25/2017 0.03333 05/22/2020

PRAMIPEXOLE DI-HCL ORAL TABLET, EXTENDED RELEASE 24 HR 0.375 MG

11.95470 05/01/2015

PRAMIPEXOLE DI-HCL ORAL TABLET, EXTENDED RELEASE 24 HR 0.75 MG

11.29637 04/24/2015

PRAMIPEXOLE DI-HCL ORAL TABLET, EXTENDED RELEASE 24 HR 1.5 MG 11.29637 04/24/2015

PRAMOXINE HCL TOPICAL TOWELETTE (EA) 1 % 0.35233 01/25/2013

PRASUGREL HCL ORAL TABLET 10 MG 0.41000 04/17/2020 0.27733 05/22/2020

PRASUGREL HCL ORAL TABLET 5 MG 0.21000 01/25/2019 0.69533 04/06/2020

PRAVASTATIN SODIUM ORAL TABLET 10 MG 0.06264 09/20/2019 0.04363 03/20/2020

PRAZOSIN HCL ORAL CAPSULE 1 MG 0.25364 11/15/2019 0.22789 05/22/2020

PREDNICARBATE TOPICAL CREAM (GRAM) 0.1 % 1.10483 12/26/2014 1.10483 08/21/2015

PREDNICARBATE TOPICAL OINTMENT (GRAM) 0.1 % 1.13044 04/24/2015 1.13044 08/21/2015

PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 1 %

4.86400 05/22/2020 6.27143 06/18/2020

PREDNISOLONE ORAL SOLUTION, ORAL 15 MG/5 ML 0.03992 08/30/2013 0.03992 08/21/2015

PREDNISOLONE SODIUM PHOSPHATE OPHTHALMIC DROPS 1 % 4.19720 02/08/2013 4.19720 08/21/2015

PREDNISOLONE SODIUM PHOSPHATE ORAL SOLUTION, ORAL 15 MG/5 ML

0.08044 12/26/2014 0.08044 08/21/2015

1.48119 12/05/2014

0.57224 02/21/2014 0.57224 08/21/2015

PREDNISOLONE SODIUM PHOSPHATE ORAL TABLET,DISINTEGRATING 10 MG

10.06877 02/13/2015 10.06877 08/21/2015

16.78133 02/13/2015

21.57604 02/13/2015

PREDNISONE ORAL SOLUTION, ORAL 5 MG/5 ML 0.25220 02/07/2018 0.58034 07/03/2018

PREDNISONE ORAL TABLET 1 MG 0.19015 03/27/2015 0.09709 09/30/2016

PREDNISONE ORAL TABLET 2.5 MG 0.14040 08/21/2015 0.10130 11/15/2019

PREDNISONE ORAL TABLET 50 MG 0.28608 08/12/2014

PREDNISONE ORAL TABLET, DOSE PACK 10 MG 0.78000 02/06/2015 0.78000 08/21/2015

Effective 8/7/2020

Current SMAC Price

PREDNISONE ORAL TABLET, DOSE PACK 5 MG 0.45000 10/24/2014 0.45000 08/21/2015

PREGABALIN ORAL CAPSULE 100 MG 0.15800 02/21/2020

PREGABALIN ORAL CAPSULE 150 MG 0.19717 11/15/2019 0.16000 04/01/2020

PRENATAL VIT 17/IRON/FOLIC ACID/FISH OIL/DHA/OMEGA 3,6 NO.1 CAPSULE 35-5-1.2MG

1.61980 01/25/2013 1.61980 08/21/2015

PRENATAL VIT NO.21/IRON POLYSACCH,HEME POLYPEP/FOLIC ACID TABLET 28-6-1 MG

1.47032 08/12/2014

PRENATAL VIT NO.22/IRON CBN,GLUCON/FOLIC ACID/DOCUSATE/DHA COMBINATION PACKAGE (EA) 27-1-50 MG

0.63047 07/05/2013 0.63047 08/21/2015

PRENATAL VIT NO.81/SOD.FEREDETATE-IRON PS/FOLIC ACID/OMEGA-3 ORAL COMBINATION PACKAGE, TABLET AND DR CAP 27-1-430MG

0.86509 01/25/2013

PRENATAL VIT WITH CALCIUM 15/IRON/FOLIC ACID/DOCUSATE SODIUM TABLET 90-1-50 MG

0.11873 08/29/2014 0.11873 08/21/2015

0.13967 08/29/2014 0.13967 08/21/2015

0.08180 08/12/2014 0.08180 08/21/2015

PRENATAL VIT WITH CALCIUM 53/IRON BIS,S-P/FOLIC ACID/OMEGA-3 ORAL COMBINATION PACKAGE (EA) 29-1-400MG

0.43260 01/25/2013

PRENATAL VIT WITH CALCIUM 95/FERROUS FUMARATE/FOLIC ACID/DHA ORAL COMBINATION PACKAGE (EA) 28-800-200

0.10500 04/19/2013

PRENATAL VIT WITH CALCIUM NO.126/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 28MG-0.8MG

0.04810 01/25/2016

PRENATAL VIT WITH CALCIUM NO.128/FERROUS FUMARATE/FOLIC ACID TABLET 28MG-0.8MG

0.04207 01/25/2016

0.04257 01/25/2016

0.04207 01/25/2016

PRENATAL VIT WITH CALCIUM NO.131/FERROUS FUMARATE/FOLIC ACID TABLET 28MG-0.8MG

0.04810 01/25/2016

PRENATAL VIT WITH CALCIUM NO.40/IRON FUMARATE/FOLATE NO.1 ORAL TABLET 27 MG-1 MG

1.33925 05/02/2014

PRENATAL VIT WITH CALCIUM NO.69/IRON/FOLIC ACID/DOCUSATE/DHA CAPSULE 28-1-50 MG

1.38343 01/31/2014

PRENATAL VITAMIN 27 WITH CALCIUM/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 60 MG-1 MG

0.20146 05/17/2013

PRENATAL VITAMIN CALCIUM,IRON,FOLIC ACID (LESS THAN 1 MG) ORAL TABLET

0.04207 04/05/2013 0.04207 08/21/2015

PRENATAL VITAMIN COMBO NO.22/IRON/FOLIC ACID/OMEGA-3/DHA COMBINATION PACKAGE (EA) 28-6-1-203

0.62446 08/12/2014

PRENATAL VITAMIN NO.19/IRON POLYSAC,IRON HEME/FOLIC ACID/DHA CAPSULE 22-6-1-200

2.08973 05/03/2013 2.08973 08/21/2015

PRENATAL VITAMIN NO.52/IRON/FOLIC ACID/OMEGA-3/DHA ORAL COMBINATION PACKAGE (EA) 29-1-200MG

0.36225 01/25/2013

Effective 8/7/2020

Current SMAC Price

PRENATAL VITAMIN NO.59/IRON CARB,FUM/FOLIC ACID/DOCUSATE/DHA CAPSULE 27-1-50 MG

4.46109 12/12/2014

PRENATAL VITAMIN NO.86/IRON BIS-GLYCINATE/FOLIC ACID ORAL TABLET 32 MG-1 MG

0.83875 09/05/2014 0.83875 08/21/2015

PRENATAL VITAMIN WITH CALCIUM NO.76/IRON,CARBONYL/FOLIC ACID ORAL TABLET 29 MG-1 MG

0.22547 08/12/2014 0.22547 08/21/2015

PRENATAL VITAMINS NO.11/FERROUS FUMARATE/FOLIC ACID/OMEGA-3 ORAL CAPSULE 28-1-200MG

2.01177 04/03/2015

PRENATAL VITAMINS NO.119/IRON FUMARATE/FOLIC ACID ORAL TABLET 29-1-25 MG

0.44586 01/31/2014 0.44586 08/21/2015

PRENATAL VITAMINS NO.25/FERROUS FUMARATE/FOLIC ACID/DHA CAPSULE 30-975-200

0.55977 04/19/2013

PRENATAL VITAMINS WITH CALCIUM/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 27MG-0.8MG

0.04257 04/12/2013 0.04257 08/21/2015

PRENATAL VITAMINS WITH CALCIUM/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 28MG-0.8MG

0.04810 08/12/2014 0.04810 08/21/2015

PRENATAL VITS NO.115/IRON FUMARATE/FOLIC ACID/DOCUSATE SOD. TABLET 29-1-25 MG

0.61940 04/04/2014 0.61940 08/21/2015

PRENATAL VITS NO.119/IRON FUMARATE/FOLIC ACID/DOCUSATE SOD. TABLET 29-1-25 MG

0.44586 01/31/2014 0.44586 08/21/2015

PRENATAL VITS NO.151/IRON FUM/FOLIC ACID/OMEGA3/DHA/EPA/FISH ORAL CAPSULE 27-800-228

0.11428 08/12/2014

PRENATAL VITS NO.24/IRON AMINO ACID CHELATE/FOLIC ACID/DHA COMBINATION PACKAGE (EA) 30-975-300

0.41988 04/19/2013

PRENATAL VITS NO.34/IRON,CARB/FOLIC ACID/DOCUSATE SODIUM/DHA CAPSULE 30-1-50 MG

1.58305 01/25/2013 1.58305 08/21/2015

PRENATAL VITS WITH CALCIUM 118/FERROUS FUMARATE/FOLIC ACID ORAL TABLET,CHEWABLE 29 MG-1 MG

0.60102 11/08/2013 0.60102 08/21/2015

PRENATAL VITS WITH CALCIUM 95/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 28MG-0.8MG

0.05924 12/19/2014 0.05924 08/21/2015

PRENATAL VITS WITH CALCIUM NO.21/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 14 MG-400

0.06411 01/25/2013

PRENATAL VITS WITH CALCIUM NO.72/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 27 MG-1 MG

0.06606 03/13/2015 0.06606 08/21/2015

0.26832 08/29/2014 0.26832 08/21/2015

0.02170 08/21/2015

PRENATAL VITS WITH CALCIUM NO.80/IRON FUM/FOLIC ACID/DSS/DHA CAPSULE 29-1.25-55

1.98769 01/25/2013 1.98769 08/21/2015

PRENATAL VITS WITH CALCIUM NO.87/IRON BISGLY/FOLIC ACID/DHA ORAL COMBINATION PACKAGE (EA) 32-1-230MG

0.59733 01/17/2014 0.59733 08/21/2015

PRENATAL VITS WITH CALCIUM NO.90/FERROUS FUMARATE/FOLIC ACID TABLET 9 MG-0.5MG

0.08394 01/25/2013

PRENATAL VITS WITH CALCIUM NO.93/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 9MG-267MCG

0.05495 04/19/2013

PRENATAL VITS WITH CALCIUM NO.96/FERROUS FUMARATE/FOLIC ACID ORAL TABLET 27MG-0.8MG

0.06924 08/12/2014

PRENATAL VITS, CALCIUM NO.91/FERROUS FUMARATE/FOLIC ACID/DHA ORAL COMBINATION PACKAGE (EA) 28-975-200

0.16328 04/19/2013

PRENATAL VITS,CALCIUM NO.66/IRON FUM/FOLIC ACID/DOCUSATE/DHA CAPSULE 26-1.2-55

1.21550 08/29/2014 1.21550 08/21/2015

PRENATAL VITS,CALCIUM NO.66/IRON FUM/FOLIC ACID/DOCUSATE/DHA CAPSULE 27-1.25-55

0.45240 09/26/2014 0.45240 08/21/2015

PRIMAQUINE PHOSPHATE ORAL TABLET 26.3 MG 1.17327 11/07/2014 1.17327 08/21/2015

Effective 8/7/2020

Current SMAC Price

PRIMIDONE ORAL TABLET 250 MG 0.16411 08/21/2015 0.14150 08/25/2017

PRIMIDONE ORAL TABLET 50 MG 0.08737 08/21/2015 0.06000 08/25/2017

PROBENECID ORAL TABLET 500 MG 0.51720 08/21/2015 0.79640 07/18/2019

PROBENECID/COLCHICINE ORAL TABLET 500-0.5 MG 0.67760 10/10/2014

PROCAINAMIDE HCL INJECTION VIAL (ML) 100 MG/ML 1.98490 08/12/2014

PROCAINAMIDE HCL INJECTION VIAL (ML) 500 MG/ML 8.23200 01/25/2013

PROCHLORPERAZINE EDISYLATE INJECTION VIAL (ML) 10 MG/2 ML 2.63900 01/17/2014 2.63900 08/21/2015

PROCHLORPERAZINE EDISYLATE INJECTION VIAL (ML) 5 MG/ML 1.68000 01/25/2013

PROCHLORPERAZINE MALEATE ORAL TABLET 10 MG 0.05210 10/20/2017 0.34730 12/05/2019

PROCHLORPERAZINE MALEATE ORAL TABLET 5 MG 0.24370 07/05/2019 0.18950 11/15/2019

PROCHLORPERAZINE RECTAL SUPPOSITORY, RECTAL 25 MG 8.90000 08/08/2014 8.90000 08/21/2015

PROGESTERONE INTRAMUSCULAR VIAL (ML) 50 MG/ML 2.02150 01/25/2013 1.55900 03/02/2018

PROGESTERONE MISCELLANEOUS POWDER (GRAM) 100 % 0.47840 08/21/2015

PROGESTERONE, MICRONIZED MISCELLANEOUS POWDER (GRAM) 100 %

0.37440 08/21/2015

PROGESTERONE, MICRONIZED ORAL CAPSULE 100 MG 0.24402 06/21/2019 0.19990 03/20/2020

PROGESTERONE, MICRONIZED ORAL CAPSULE 200 MG 0.96465 08/16/2019 0.71130 09/20/2019

PROMETHAZINE HCL INJECTION AMPUL (ML) 25 MG/ML 1.67584 10/24/2014

PROMETHAZINE HCL INJECTION AMPUL (ML) 50 MG/ML 1.79970 08/12/2014

PROMETHAZINE HCL INJECTION VIAL (ML) 25 MG/ML 0.76113 11/22/2013 0.76113 08/21/2015

PROMETHAZINE HCL INJECTION VIAL (ML) 50 MG/ML 1.91280 08/12/2014

PROMETHAZINE HCL ORAL SYRUP 6.25MG/5ML 0.01454 02/27/2015 0.01454 08/21/2015

PROMETHAZINE HCL ORAL TABLET 12.5 MG 0.05630 09/22/2017 0.04160 12/22/2017

PROMETHAZINE HCL ORAL TABLET 25 MG 0.09320 08/21/2015 0.03140 07/14/2017

PROMETHAZINE HCL ORAL TABLET 50 MG 0.14740 08/21/2015 0.10467 04/21/2017

PROMETHAZINE HCL RECTAL SUPPOSITORY, RECTAL 12.5 MG 8.24914 01/13/2017 7.87258 06/16/2017

PROMETHAZINE HCL RECTAL SUPPOSITORY, RECTAL 25 MG 5.25000 02/21/2020 4.35583 05/22/2020

PROMETHAZINE HCL RECTAL SUPPOSITORY, RECTAL 50 MG 25.03550 10/17/2014

PROMETHAZINE HCL/CODEINE ORAL SYRUP 6.25-10/5 0.01528 01/25/2013 0.01528 08/21/2015

PROMETHAZINE HCL/DEXTROMETHORPHAN HBR ORAL SYRUP 6.25-15/5 0.04860 10/21/2019 0.06227 12/11/2019

PROMETHAZINE/PHENYLEPHRINE HCL/CODEINE ORAL SYRUP 6.25-5-10 0.08490 08/21/2015 0.01101 11/24/2017

PROPAFENONE HCL ORAL CAPSULE, EXTENDED RELEASE 12 HR 225 MG

3.07683 03/20/2020 1.88000 05/22/2020

5.37947 04/21/2017 3.30000 12/20/2019

6.99942 10/31/2014 5.15292 06/16/2017

PROPAFENONE HCL ORAL TABLET 150 MG 0.21963 08/21/2015 0.11450 08/25/2017

PROPANTHELINE BROMIDE ORAL TABLET 15 MG 0.59475 03/20/2015 0.59475 08/21/2015

PROPARACAINE HCL OPHTHALMIC DROPS 0.5 % 0.81433 04/05/2013 0.81433 08/21/2015

PROPRANOLOL HCL MISCELLANEOUS POWDER (GRAM) 17.22364 08/23/2013 17.22364 08/21/2015

PROPRANOLOL HCL ORAL CAPSULE, EXTENDED RELEASE 24HR 120 MG 0.54990 01/24/2020 0.48840 03/20/2020

Effective 8/7/2020

Current SMAC Price

PROPRANOLOL HCL ORAL SOLUTION, ORAL 20 MG/5 ML 0.15914 07/18/2014

PROPRANOLOL HCL ORAL SOLUTION, ORAL 40MG/5ML 0.20614 03/15/2013

PROPRANOLOL HCL ORAL TABLET 10 MG 0.10768 01/24/2019 0.07170 04/26/2019

PROPRANOLOL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 40 MG-25MG

0.71600 08/12/2014

PROPRANOLOL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 80 MG-25MG

0.87940 08/12/2014

PROTAMINE SULFATE INTRAVENOUS VIAL (ML) 10 MG/ML 1.17782 08/12/2014

PROTECTIVES COMBINATION NO.2/CERAMIDES 1,3,6-11 TOPICAL CREAM (GRAM)

1.87360 08/12/2014

PROTRIPTYLINE HCL ORAL TABLET 10 MG 1.94520 08/21/2015 1.23085 06/16/2017

PROTRIPTYLINE HCL ORAL TABLET 5 MG 1.43575 07/29/2016 1.10701 12/02/2016

PSEUDOEPHEDRINE HCL ORAL TABLET 30 MG 0.02680 11/21/2014 0.02680 08/21/2015

PSEUDOEPHEDRINE HCL ORAL TABLET 60 MG 0.02105 08/12/2014 0.02105 08/21/2015

PSEUDOEPHEDRINE HCL/CHLOPHEDIANOL HCL/GUAIFENESIN ORAL LIQUID (ML) 30-12.5/5

0.08600 08/12/2014

PSEUDOEPHEDRINE HCL/CODEINE PHOSPHATE/GUAIFENESIN ORAL SYRUP 30-10-100

0.15863 01/30/2015 0.15863 08/21/2015

PSYLLIUM HUSK (WITH SUGAR) ORAL POWDER (GRAM) 3.4 G/7 G 0.01464 12/26/2014 0.01464 08/21/2015

PSYLLIUM SEED (WITH SUGAR) ORAL POWDER (GRAM) 0.00920 08/12/2014 0.00920 08/21/2015

PSYLLIUM SEED ORAL POWDER (GRAM) 0.01780 01/25/2013 0.01780 08/21/2015

PYRANTEL PAMOATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 50 MG/ML

0.16310 01/25/2013

PYRAZINAMIDE ORAL TABLET 500 MG 1.88174 07/25/2014

PYRIDOSTIGMINE BROMIDE ORAL TABLET 60 MG 0.24830 01/24/2020 0.34550 02/17/2020

PYRIDOXINE HCL (VITAMIN B6) INJECTION VIAL (ML) 100 MG/ML 7.86632 01/25/2013

PYRIDOXINE HCL (VITAMIN B6) ORAL TABLET 100 MG 0.02559 08/12/2014 0.02559 08/21/2015

PYRIDOXINE HCL (VITAMIN B6) ORAL TABLET 25 MG 0.02190 08/12/2014

PYRIDOXINE HCL (VITAMIN B6) ORAL TABLET 50 MG 0.01407 09/27/2013 0.01407 08/21/2015

QUETIAPINE FUMARATE ORAL TABLET 100 MG 0.03670 09/21/2018 0.03110 07/26/2019

QUETIAPINE FUMARATE ORAL TABLET, EXTENDED RELEASE 24 HR 150 MG

0.32842 11/15/2019 0.10817 03/20/2020

0.46666 01/25/2019 0.25400 11/15/2019

Effective 8/7/2020

Current SMAC Price

0.53330 07/26/2019 0.46206 11/15/2019

0.65533 04/11/2019 0.46000 06/21/2019

0.28000 11/16/2018 0.11959 05/17/2019

QUINAPRIL HCL ORAL TABLET 10 MG 0.15690 08/21/2015 0.13756 12/22/2017

QUINAPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 10-12.5MG 0.56012 07/04/2014 0.56012 08/21/2015

QUINAPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 20 MG-25MG 0.49945 08/21/2015 0.35755 11/16/2018

QUINAPRIL HCL/HYDROCHLOROTHIAZIDE ORAL TABLET 20-12.5 MG 0.42731 08/21/2015 0.36578 11/16/2018

QUINIDINE GLUCONATE ORAL TABLET, EXTENDED RELEASE 324 MG 0.84810 08/12/2014 0.84810 08/21/2015

QUINIDINE GLUCONATE VIAL (ML) 80 MG/ML 3.64770 01/25/2013

QUINIDINE SULFATE ORAL TABLET 200 MG 0.09930 01/25/2013

QUINIDINE SULFATE ORAL TABLET 300 MG 0.18360 08/12/2014

QUINIDINE SULFATE ORAL TABLET, EXTENDED RELEASE 300 MG 0.67330 08/12/2014

QUININE SULFATE ORAL CAPSULE 324 MG 3.07125 08/21/2015 1.83367 09/22/2017

RABEPRAZOLE SODIUM ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 20 MG

0.31567 10/20/2017 0.19089 03/20/2020

RALOXIFENE HCL ORAL TABLET 60 MG 0.32133 05/17/2019 0.27733 07/17/2020

RAMELTEON ORAL TABLET 8 MG 3.03167 01/01/2020 2.79767 05/22/2020

RAMIPRIL ORAL CAPSULE 1.25 MG 0.12030 12/21/2018 0.09855 11/15/2019

RAMIPRIL ORAL CAPSULE 10 MG 0.05856 08/21/2015 0.03852 10/20/2017

RAMIPRIL ORAL CAPSULE 2.5 MG 0.09500 08/21/2015 0.04723 11/24/2017

RAMIPRIL ORAL CAPSULE 5 MG 0.06081 11/16/2018 0.02720 07/26/2019

RANITIDINE HCL CAPSULE 150 MG 0.31000 06/21/2019 0.41255 10/11/2019

RANITIDINE HCL CAPSULE 300 MG 1.03000 10/19/2018 0.81033 11/16/2018

RANITIDINE HCL SYRUP 15 MG/ML 0.03000 06/21/2019 0.05891 12/17/2019

RANITIDINE HCL TABLET 150 MG 0.04560 05/01/2015 0.04560 08/21/2015

RANITIDINE HCL VIAL (ML) 25 MG/ML 1.01383 02/20/2015 1.01383 08/21/2015

RANOLAZINE ORAL TABLET, EXTENDED RELEASE 12 HR 1000 MG 0.71411 01/24/2020

RANOLAZINE ORAL TABLET, EXTENDED RELEASE 12 HR 500 MG 0.37763 01/24/2020

RASAGILINE MESYLATE ORAL TABLET 1 MG 4.40000 11/15/2019 5.08438 11/27/2019

REPAGLINIDE ORAL TABLET 0.5 MG 0.17060 11/24/2017 0.08777 11/16/2018

REPAGLINIDE ORAL TABLET 1 MG 0.13355 11/16/2018 0.11823 05/22/2020

REPAGLINIDE ORAL TABLET 2 MG 0.18605 12/22/2017 0.10198 08/17/2018

RIBAVIRIN ORAL CAPSULE 200 MG 0.79060 03/13/2015 0.79060 08/21/2015

RIBAVIRIN ORAL TABLET 200 MG 0.72584 08/21/2015 0.61089 10/23/2015

RIBOFLAVIN (VITAMIN B2) ORAL TABLET 25 MG 0.02310 08/12/2014

RIFABUTIN ORAL CAPSULE 150 MG 12.24594 08/12/2014

Effective 8/7/2020

Current SMAC Price

RIFAMPIN ORAL CAPSULE 150 MG 1.02820 12/13/2013 0.91689 11/20/2015

RIFAMPIN ORAL CAPSULE 300 MG 0.48100 11/24/2017 0.47600 07/26/2019

RILUZOLE ORAL TABLET 50 MG 0.85000 09/21/2018 0.28500 04/17/2020

RIMANTADINE HCL ORAL TABLET 100 MG 1.70880 08/12/2014 1.70880 08/21/2015

RINGER'S SOLUTION INTRAVENOUS INTRAVENOUS SOLUTION 0.00250 08/12/2014

RINGER'S SOLUTION IRRIGATION SOLUTION, IRRIGATION 0.00710 08/12/2014

RINGER'S SOLUTION,LACTATED INTRAVENOUS INTRAVENOUS SOLUTION

0.03400 08/21/2015 0.00364 04/21/2017

RINGER'S SOLUTION,LACTATED IRRIGATION SOLUTION, IRRIGATION 0.00220 01/25/2013

RISEDRONATE SODIUM ORAL TABLET 150 MG 31.25000 03/15/2019 28.95000 06/21/2019

RISEDRONATE SODIUM ORAL TABLET 30 MG 29.56000 03/25/2016

RISPERIDONE ORAL SOLUTION, ORAL 1 MG/ML 0.21474 11/15/2019 0.16267 06/19/2020

RISPERIDONE ORAL TABLET 0.25 MG 0.04949 08/25/2017 0.02047 03/20/2020

RISPERIDONE ORAL TABLET 0.5 MG 0.04150 10/20/2017 0.02083 01/24/2020

RISPERIDONE ORAL TABLET 1 MG 0.06372 08/25/2017 0.03897 09/22/2017

RISPERIDONE ORAL TABLET,DISINTEGRATING 0.25 MG 5.90310 03/22/2013

RISPERIDONE ORAL TABLET,DISINTEGRATING 0.5 MG 0.67437 06/16/2017 0.50000 04/27/2018

RISPERIDONE ORAL TABLET,DISINTEGRATING 1 MG 0.93124 01/27/2017 0.48786 03/02/2018

RISPERIDONE ORAL TABLET,DISINTEGRATING 4 MG 6.09630 02/06/2015

RIVASTIGMINE TARTRATE ORAL CAPSULE 1.5 MG 0.15325 11/16/2018 0.11583 05/17/2019

RIVASTIGMINE TARTRATE ORAL CAPSULE 3 MG 0.20075 11/16/2018 0.11583 05/17/2019

RIVASTIGMINE TARTRATE ORAL CAPSULE 4.5 MG 0.26333 09/22/2017 0.11583 05/17/2019

RIVASTIGMINE TARTRATE ORAL CAPSULE 6 MG 0.45891 09/22/2017 0.10250 08/16/2019

RIVASTIGMINE TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 13.3MG/24H

3.94122 08/16/2019 3.66667 03/20/2020

RIVASTIGMINE TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 4.6MG/24HR

3.44000 12/20/2019 2.53000 02/21/2020

RIVASTIGMINE TRANSDERMAL PATCH, TRANSDERMAL 24 HOURS 9.5MG/24HR

3.99967 11/15/2019 3.57000 02/21/2020

RIZATRIPTAN BENZOATE ORAL TABLET 10 MG 0.51667 03/15/2019 0.37778 07/26/2019

RIZATRIPTAN BENZOATE ORAL TABLET 5 MG 0.57750 03/20/2020 0.43333 04/17/2020

RIZATRIPTAN BENZOATE ORAL TABLET,DISINTEGRATING 10 MG 0.83889 09/22/2017 0.49000 12/21/2018

RIZATRIPTAN BENZOATE ORAL TABLET,DISINTEGRATING 5 MG 0.85000 09/21/2018 0.55500 08/16/2019

ROPINIROLE HCL ORAL TABLET 0.25 MG 0.10162 08/21/2015 0.06306 07/14/2017

ROPINIROLE HCL ORAL TABLET 0.5 MG 0.05230 03/16/2018 0.04000 12/20/2019

ROPINIROLE HCL ORAL TABLET 1 MG 0.05854 07/14/2017 0.04490 04/27/2018

Effective 8/7/2020

Current SMAC Price

ROPINIROLE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 12 MG 7.95362 08/21/2015 4.25900 08/17/2018

ROPIVACAINE HCL/PF INJECTION VIAL (ML) 10 MG/ML 0.49701 10/17/2014 0.49701 08/21/2015

ROPIVACAINE HCL/PF INJECTION VIAL (ML) 2 MG/ML 0.23912 12/05/2014

ROPIVACAINE HCL/PF INJECTION VIAL (ML) 5 MG/ML 0.29748 10/17/2014

ROPIVACAINE HCL/PF INJECTION VIAL (ML) 7.5 MG/ML 0.42672 12/05/2014

ROSUVASTATIN CALCIUM ORAL TABLET 10 MG 0.08622 03/16/2018 0.06033 09/21/2018

SACCHAROMYCES BOULARDII ORAL CAPSULE 250 MG 0.55650 10/10/2014

SALICYLIC ACID TOPICAL FILM-FORMING LIQUID WITH APPLICATOR 27.5 %

7.24360 01/31/2014

SALICYLIC ACID TOPICAL LIQUID (ML) 26 % 6.03610 01/25/2013

SALICYLIC ACID/COAL TAR/SULFUR SHAMPOO 2 %-1 %-2% 0.20597 01/25/2013

SALSALATE ORAL TABLET 500 MG 0.24147 11/07/2014 0.24147 08/21/2015

SALSALATE ORAL TABLET 750 MG 1.38136 06/16/2017 0.60680 05/25/2018

SCOPOLAMINE HYDROBROMIDE VIAL (ML) 0.4 MG/ML 3.78000 01/25/2013

SELEGILINE HCL ORAL CAPSULE 5 MG 1.61219 08/12/2014 1.61219 08/21/2015

SELEGILINE HCL ORAL TABLET 5 MG 1.25290 11/28/2014 1.25290 08/21/2015

SELENIUM INTRAVENOUS VIAL (ML) 40 MCG/ML 0.24063 01/25/2013

SELENIUM ORAL TABLET 200 MCG 0.05669 08/12/2014 0.05669 08/21/2015

SELENIUM SULFIDE TOPICAL SHAMPOO 2.5 % 0.07952 09/19/2014 0.07952 08/21/2015

SENNOSIDES ORAL SYRUP 8.8MG/5ML 0.04146 08/12/2014 0.04146 08/21/2015

SENNOSIDES ORAL TABLET 8.6 MG 0.00978 05/01/2015 0.00978 08/21/2015

SENNOSIDES/DOCUSATE SODIUM ORAL TABLET 8.6MG-50MG 0.01946 11/07/2014 0.01946 08/21/2015

SERTRALINE HCL ORAL CONCENTRATE, ORAL 20 MG/ML 0.68521 05/19/2017 0.65250 08/16/2019

SERTRALINE HCL ORAL TABLET 100 MG 0.07310 08/21/2015 0.04255 10/20/2017

SILDENAFIL CITRATE ORAL TABLET 20 MG 0.10600 03/20/2020 0.07400 07/17/2020

SILVER NITRATE TOPICAL SOLUTION, NON-ORAL 0.5 % 0.03476 01/25/2013

SILVER SULFADIAZINE TOPICAL CREAM (GRAM) 1 % 0.08520 03/15/2019 0.07140 12/20/2019

SILVER TOPICAL GEL, EXTENDED RELEASE (ML) 48.44700 01/25/2013

SIMETHICONE ORAL CAPSULE 125 MG 0.08754 03/13/2015 0.08754 08/21/2015

SIMETHICONE ORAL CAPSULE 180 MG 0.07370 08/21/2015 0.03333 03/02/2018

Effective 8/7/2020

Current SMAC Price

SIMETHICONE ORAL SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 40MG/0.6ML

0.08040 08/21/2015 0.05634 11/16/2018

SIMETHICONE ORAL TABLET,CHEWABLE 125 MG 0.07236 02/06/2015 0.07236 08/21/2015

SIMETHICONE ORAL TABLET,CHEWABLE 80 MG 0.02452 11/21/2014 0.02452 08/21/2015

SIMVASTATIN ORAL TABLET 10 MG 0.03578 08/21/2015 0.02311 10/20/2017

SIROLIMUS ORAL TABLET 0.5 MG 3.99000 09/21/2018 5.70661 11/21/2019

SIROLIMUS ORAL TABLET 1 MG 7.15000 12/20/2019 7.77140 01/21/2020

SIROLIMUS ORAL TABLET 2 MG 22.65484 12/08/2017 16.95000 09/21/2018

SODIUM BENZOATE MISCELLANEOUS POWDER (GRAM) 0.04664 01/25/2013 0.04664 08/21/2015

SODIUM BICARBONATE INTRAVENOUS SYRINGE (ML) 0.5MEQ/ML 0.44100 01/25/2013

SODIUM BICARBONATE INTRAVENOUS SYRINGE (ML) 0.9MEQ/ML 0.12734 01/25/2013

SODIUM BICARBONATE INTRAVENOUS SYRINGE (ML) 1 MEQ/ML 0.09770 08/12/2014 0.09770 08/21/2015

SODIUM BICARBONATE INTRAVENOUS SYRINGE (ML) 10MEQ/10ML 0.74256 01/25/2013

SODIUM BICARBONATE INTRAVENOUS VIAL (ML) 0.5MEQ/ML 0.42840 03/01/2013

SODIUM BICARBONATE INTRAVENOUS VIAL (ML) 1 MEQ/ML 0.13238 11/07/2014

SODIUM BICARBONATE ORAL TABLET 325 MG 0.02155 01/25/2013 0.02155 08/21/2015

SODIUM BICARBONATE ORAL TABLET 650 MG 0.00953 03/22/2013 0.00953 08/21/2015

SODIUM CHLORIDE 0.45 % INTRAVENOUS INTRAVENOUS SOLUTION 0.45 %

0.00260 03/07/2014

SODIUM CHLORIDE 0.45 % INTRAVENOUS PIGGYBACK WITH THREADED PORT (ML)

0.04345 01/30/2015 0.04345 08/21/2015

SODIUM CHLORIDE 3 % INTRAVENOUS INTRAVENOUS SOLUTION 3 % 0.00878 04/19/2013

SODIUM CHLORIDE 5 % INTRAVENOUS INTRAVENOUS SOLUTION 5 % 0.00770 08/12/2014

SODIUM CHLORIDE FOR INHALATION INHALATION VIAL, NEBULIZER (ML) 0.9 %

0.05389 03/06/2015 0.05389 08/21/2015

SODIUM CHLORIDE FOR INHALATION INHALATION VIAL, NEBULIZER (ML) 10 %

0.04183 03/01/2013

0.04633 04/03/2015 0.04980 03/28/2018

0.07000 11/01/2013

SODIUM CHLORIDE INTRAVENOUS VIAL (ML) 2.5 MEQ/ML 0.02780 04/05/2013 0.02780 08/21/2015

SODIUM CHLORIDE INTRAVENOUS VIAL (ML) 4 MEQ/ML 0.03239 11/22/2013

SODIUM CHLORIDE IRRIGATING SOLUTION IRRIGATION SOLUTION, IRRIGATION 0.9 %

0.00764 08/12/2014 0.00764 08/21/2015

SODIUM CHLORIDE MISCELLANEOUS TABLET, SOLUBLE 1000 MG 0.09895 12/26/2014

SODIUM CHLORIDE NASAL AEROSOL, SPRAY (ML) 0.65 % 0.02561 02/13/2015 0.02561 08/21/2015

SODIUM CHLORIDE OPHTHALMIC OINTMENT (GRAM) 5 % 2.49240 08/12/2014 1.85007 06/16/2017

SODIUM CHLORIDE/SODIUM BICARBONATE/POTASSIUM CHLORIDE/PEG ORAL SOLUTION, RECONSTITUTED, ORAL 420G

0.00401 06/27/2014 0.00401 08/21/2015

SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INTRAVENOUS VIAL (ML) 62.5MG/5ML

5.15944 05/01/2015 5.15944 08/21/2015

Effective 8/7/2020

Current SMAC Price

SODIUM HYPOCHLORITE MISCELLANEOUS SOLUTION, NON-ORAL 0.125 %

9.54390 08/12/2014

SODIUM HYPOCHLORITE MISCELLANEOUS SOLUTION, NON-ORAL 0.25 %

0.04024 01/25/2013

SODIUM HYPOCHLORITE MISCELLANEOUS SOLUTION, NON-ORAL 0.5 % 0.04024 01/25/2013

SODIUM LACTATE VIAL (ML) 5 MEQ/ML 0.39992 01/25/2013

SODIUM MORRHUATE VIAL (ML) 50 MG/ML 1.96000 01/25/2013

SODIUM PHOSPHATE,DIBASIC/POT PHOS,MONOB/SOD PHOSPHATE MONO ORAL TABLET 250 MG

0.21890 11/24/2017 0.16750 03/20/2020

SODIUM PHOSPHATE,MONOBASIC/SODIUM PHOSPHATE,DIBASIC RECTAL ENEMA (ML) 19G-7G/118

0.00578 08/12/2014 0.00578 08/21/2015

SODIUM POLYSTYRENE SULFONATE ENEMA (ML) 30 G/120ML 0.25725 07/26/2013

SODIUM POLYSTYRENE SULFONATE ENEMA (ML) 50 G/200ML 0.15435 07/26/2013

SODIUM POLYSTYRENE SULFONATE ORAL POWDER (GRAM) 0.19415 08/21/2015 0.08976 02/22/2019

SODIUM POLYSTYRENE SULFONATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 15 G/60 ML

0.11988 10/10/2014

SODIUM/POTASSIUM/POTASSIUM CITRATE/SODIUM CITRATE/CIT AC ORAL SOLUTION, ORAL 500-550/5

0.02493 01/23/2015 0.02493 08/21/2015

SOLIFENACIN SUCCINATE ORAL TABLET 10 MG 0.30000 04/17/2020 0.15733 06/19/2020

SORBITOL SOLUTION IRRIGATION SOLUTION, IRRIGATION 3 % 0.00351 01/25/2013

SORBITOL SOLUTION IRRIGATION SOLUTION, IRRIGATION 3.3 % 0.00332 01/25/2013

SOTALOL HCL INTRAVENOUS VIAL (ML) 150MG/10ML 5.68750 01/25/2013

SOTALOL HCL ORAL TABLET 120 MG 0.09290 11/15/2019 0.07900 01/24/2020

SPINOSAD TOPICAL SUSPENSION, TOPICAL (ML) 0.9 % 1.59301 08/18/2017 1.59301 01/01/2018

SPIRONOLACTONE MISCELLANEOUS POWDER (GRAM) 100 % 4.24580 08/12/2014 4.24580 08/21/2015

SPIRONOLACTONE ORAL TABLET 100 MG 0.23410 08/16/2019 0.16950 09/20/2019

SPIRONOLACTONE, MICRONIZED MISCELLANEOUS POWDER (GRAM) 100 %

9.66880 08/12/2014

SPIRONOLACTONE/HYDROCHLOROTHIAZIDE ORAL TABLET 25 MG-25MG 0.90011 03/29/2018 0.72980 08/17/2018

STAVUDINE ORAL CAPSULE 15 MG 1.32500 08/12/2014

STAVUDINE ORAL CAPSULE 40 MG 0.98233 02/26/2016 0.91833 11/24/2017

STAVUDINE ORAL SOLUTION, RECONSTITUTED, ORAL 1 MG/ML 0.27563 01/25/2013

STREPTOMYCIN SULFATE INTRAMUSCULAR VIAL (EA) 1 G 11.16500 01/25/2013

SUCRALFATE ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 1 G/10 ML 0.40574 03/04/2020 0.42860 04/06/2020

SUCRALFATE ORAL TABLET 1 G 0.19994 01/04/2018 0.15950 05/22/2020

SULFACETAMIDE SODIUM OPHTHALMIC DROPS 10 % 2.74986 08/21/2015 1.92000 12/21/2018

SULFACETAMIDE SODIUM OPHTHALMIC OINTMENT (GRAM) 10 % 13.17200 05/23/2014 13.17200 08/21/2015

SULFACETAMIDE SODIUM TOPICAL CLEANSER (ML) 10 % 0.37761 08/12/2014 0.37761 08/21/2015

Effective 8/7/2020

Current SMAC Price

SULFACETAMIDE SODIUM TOPICAL CLEANSER, GEL (ML) 10 % 1.02906 02/13/2015

SULFACETAMIDE SODIUM TOPICAL CLEANSER, GEL EXTENDED RELEASE 10 %

0.85753 10/25/2013

SULFACETAMIDE SODIUM TOPICAL SUSPENSION, TOPICAL (ML) 10 % 0.61247 01/25/2013 0.61247 08/21/2015

SULFACETAMIDE SODIUM/PREDNISOLONE SODIUM PHOSPHATE OPHTHALMIC DROPS 10 %-0.23%

2.56476 02/15/2013 2.56476 08/21/2015

SULFACETAMIDE SODIUM/SULFUR TOPICAL CLEANSER (GRAM) 10-5%(W/W)

0.07523 02/20/2015 0.07523 08/21/2015

SULFACETAMIDE SODIUM/SULFUR TOPICAL CLEANSER (GRAM) 9 %-4.5 %

0.26751 08/21/2015 0.09064 11/15/2019

SULFACETAMIDE SODIUM/SULFUR TOPICAL CLEANSER (ML) 9 %-4 % 0.22315 01/25/2013

SULFACETAMIDE SODIUM/SULFUR TOPICAL CREAM (GRAM) 10-5%(W/W) 4.86785 08/22/2014 4.86785 08/21/2015

SULFACETAMIDE SODIUM/SULFUR TOPICAL PADS, MEDICATED (EA) 10 %-5 %

4.47784 03/20/2015 4.47784 08/21/2015

SULFACETAMIDE SODIUM/SULFUR TOPICAL SUSPENSION, TOPICAL (GRAM) 10-5%(W/W)

1.58340 05/02/2014

SULFACETAMIDE SODIUM/SULFUR TOPICAL SUSPENSION, TOPICAL (ML) 8 %-4 %

0.20782 08/12/2014

SULFACETAMIDE SODIUM/SULFUR/AVOBENZONE/OCTINOXATE/OCTYL SAL TOPICAL COMBINATION PACKAGE, CLEANSER AND CREAM 9 %-4.5 %

0.47020 11/21/2014

SULFACETAMIDE SODIUM/SULFUR/UREA TOPICAL CLEANSER (ML) 10%-5%-10%

0.49178 01/25/2013

SULFADIAZINE ORAL TABLET 500 MG 3.21496 12/05/2014 3.21496 08/21/2015

SULFAMETHOXAZOLE/TRIMETHOPRIM INTRAVENOUS VIAL (ML) 80-16MG/ML

0.78029 11/07/2014

SULFAMETHOXAZOLE/TRIMETHOPRIM ORAL SUSPENSION, ORAL (FINAL DOSE FORM) 200-40MG/5

0.13732 11/16/2018 0.12203 07/26/2019

SULFAMETHOXAZOLE/TRIMETHOPRIM ORAL TABLET 400MG-80MG 0.06393 08/17/2018 0.04490 08/16/2019

SULFAMETHOXAZOLE/TRIMETHOPRIM ORAL TABLET 800-160 MG 0.07643 08/25/2017 0.04090 12/22/2017

SULFASALAZINE ORAL TABLET 500 MG 0.15600 02/27/2015 0.15600 08/21/2015

SULFASALAZINE ORAL TABLET, DELAYED RELEASE (ENTERIC COATED) 500 MG

0.22563 09/30/2016 0.12670 08/25/2017

SULINDAC ORAL TABLET 150 MG 0.15930 08/21/2015 0.12100 09/22/2017

SULINDAC ORAL TABLET 200 MG 0.19673 03/02/2018 0.13438 08/17/2018

SUMATRIPTAN NASAL SPRAY, NON-AEROSOL (EA) 20 MG 45.17086 06/16/2017 40.67000 06/22/2018

SUMATRIPTAN NASAL SPRAY, NON-AEROSOL (EA) 5 MG 38.32500 05/22/2020 47.08153 05/28/2020

SUMATRIPTAN SUCCINATE ORAL TABLET 100 MG 0.44444 06/16/2017 0.36778 03/02/2018

SUMATRIPTAN SUCCINATE SUBCUTANEOUS CARTRIDGE (ML) 6 MG/0.5ML

129.12200 01/25/2013 129.12200 08/21/2015

SUMATRIPTAN SUCCINATE SUBCUTANEOUS PEN INJECTOR (ML) 6 MG/0.5ML

91.25000 01/25/2019 86.52000 06/21/2019

SUMATRIPTAN SUCCINATE SUBCUTANEOUS VIAL (ML) 6 MG/0.5ML 39.30000 10/19/2018 32.50000 01/25/2019

TACROLIMUS ORAL CAPSULE 0.5 MG 0.11703 03/03/2017 0.08055 08/17/2018

TACROLIMUS ORAL CAPSULE 1 MG 0.18660 03/03/2017 0.13478 11/16/2018

TACROLIMUS ORAL CAPSULE 5 MG 0.39610 09/21/2018 5.46000 01/17/2020

TACROLIMUS TOPICAL OINTMENT (GRAM) 0.03 % 5.17608 11/24/2017 4.11000 12/20/2019

Effective 8/7/2020

Current SMAC Price

TACROLIMUS TOPICAL OINTMENT (GRAM) 0.1 % 4.83523 11/24/2017 3.49000 05/22/2020

TADALAFIL ORAL TABLET 10 MG 1.05000 06/21/2019

TADALAFIL ORAL TABLET 20 MG 1.05000 06/21/2019 0.42967 08/16/2019

TADALAFIL ORAL TABLET 5 MG 0.28400 01/24/2020 0.25900 05/22/2020

TAMOXIFEN CITRATE ORAL TABLET 10 MG 0.24955 08/21/2015 0.15000 11/24/2017

TAMOXIFEN CITRATE ORAL TABLET 20 MG 0.24500 04/17/2020 0.46024 05/13/2020

TAMSULOSIN HCL ORAL CAPSULE 0.4 MG 0.09815 11/24/2017 0.06065 11/16/2018

TEA TREE OIL TOPICAL OIL (ML) 100 % 0.25509 08/12/2014

TELMISARTAN ORAL TABLET 20 MG 0.70000 01/01/2017 0.13809 06/16/2017

TELMISARTAN/AMLODIPINE BESYLATE ORAL TABLET 40 MG-10MG 3.87707 08/21/2015 3.87707 01/01/2020

TELMISARTAN/AMLODIPINE BESYLATE ORAL TABLET 40 MG-5 MG 3.87707 10/03/2014 3.87707 08/21/2015

TELMISARTAN/AMLODIPINE BESYLATE ORAL TABLET 80 MG-10MG 3.87707 08/21/2015 3.87707 01/01/2020

TELMISARTAN/AMLODIPINE BESYLATE ORAL TABLET 80 MG-5 MG 3.87707 08/21/2015 3.87707 01/01/2020

TELMISARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 40-12.5 MG 2.39935 06/16/2017 0.73000 05/25/2018

TELMISARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 80 MG-25MG 1.23867 08/17/2018 0.56667 11/15/2019

TELMISARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 80-12.5MG 1.28950 09/21/2018 1.17000 02/22/2019

TEMAZEPAM ORAL CAPSULE 15 MG 0.06445 08/21/2015 0.04590 03/02/2018

TEMAZEPAM ORAL CAPSULE 22.5 MG 4.17825 06/16/2017 3.96400 04/17/2020

TEMAZEPAM ORAL CAPSULE 30 MG 0.08040 03/06/2015 0.08040 08/21/2015

TEMAZEPAM ORAL CAPSULE 7.5 MG 3.36810 06/16/2017 1.55470 09/22/2017

TEMOZOLOMIDE ORAL CAPSULE 100 MG 96.94428 10/28/2016 42.23000 09/21/2018

TEMOZOLOMIDE ORAL CAPSULE 140 MG 128.55828 07/29/2016

TEMOZOLOMIDE ORAL CAPSULE 180 MG 127.00000 09/22/2017 60.22000 05/22/2020

TENIPOSIDE INTRAVENOUS AMPUL (ML) 50 MG/5 ML 56.11060 08/16/2013 56.11060 08/21/2015

TERAZOSIN HCL ORAL CAPSULE 1 MG 0.05574 08/29/2014 0.05574 08/21/2015

TERBINAFINE HCL ORAL TABLET 250 MG 0.10367 08/25/2017 0.08000 12/20/2019

TERBINAFINE HCL TOPICAL CREAM (GRAM) 1 % 0.39135 04/10/2015 0.39135 08/21/2015

TERBUTALINE SULFATE ORAL TABLET 2.5 MG 0.27990 12/26/2014 1.26973 10/01/2015

TERCONAZOLE VAGINAL CREAM WITH APPLICATOR 0.4 % 0.48888 03/03/2017 0.71068 01/16/2020

TERCONAZOLE VAGINAL CREAM WITH APPLICATOR 0.8 % 1.43255 07/05/2013 1.43255 08/21/2015

TERCONAZOLE VAGINAL SUPPOSITORY, VAGINAL 80 MG 22.83867 04/12/2013 22.83867 08/21/2015

TESTOSTERONE CYPIONATE INTRAMUSCULAR VIAL (ML) 100 MG/ML 4.13840 08/12/2014

TESTOSTERONE CYPIONATE INTRAMUSCULAR VIAL (ML) 200 MG/ML 15.27368 01/22/2020 16.21857 04/24/2020

TESTOSTERONE ENANTHATE INTRAMUSCULAR VIAL (ML) 200 MG/ML 11.89300 04/19/2013 11.89300 08/21/2015

Effective 8/7/2020

Current SMAC Price

TESTOSTERONE MISCELLANEOUS POWDER (GRAM) 0.19136 08/21/2015

TESTOSTERONE PROPIONATE MISCELLANEOUS POWDER (GRAM) 1.55480 08/21/2015

TESTOSTERONE TRANSDERMAL GEL (GRAM) 50 MG (1%) 1.92771 04/22/2016 1.28256 06/16/2017

TESTOSTERONE TRANSDERMAL GEL IN METERED-DOSE PUMP 10 MG (2%)

13.97550 11/14/2014 4.85000 10/25/2019

TESTOSTERONE TRANSDERMAL GEL IN METERED-DOSE PUMP 12.5/1.25G

1.92710 03/06/2015 1.92710 08/21/2015

TESTOSTERONE TRANSDERMAL GEL IN PACKET (GRAM) 25MG(1%) 4.08296 03/06/2015

TESTOSTERONE TRANSDERMAL GEL IN PACKET (GRAM) 50 MG (1%) 1.98413 01/01/2017 1.98413 01/03/2017

TETANUS AND DIPHTHERIA TOXOIDS, ADULT INTRAMUSCULAR VIAL (ML) 2-2 LF/0.5

30.27570 01/25/2013 30.27570 08/21/2015

TETANUS,DIPHTHERIA TOXOID PED/PF INTRAMUSCULAR VIAL (ML) 5-25/0.5ML

150.18360 11/07/2014 150.18360 08/21/2015

TETRACAINE HCL OPHTHALMIC DROPS 0.5 % 0.49187 01/25/2013 0.49187 08/21/2015

TETRACAINE HCL/PF OPHTHALMIC DROPS 0.5 % 8.12960 08/12/2014

TETRACYCLINE HCL MISCELLANEOUS POWDER (GRAM) 0.66757 05/01/2015 0.66757 08/21/2015

TETRACYCLINE HCL ORAL CAPSULE 250 MG 4.62950 08/21/2015 3.20000 09/21/2018

TETRACYCLINE HCL ORAL CAPSULE 500 MG 3.86019 09/21/2018 2.19010 11/15/2019

THEOPHYLLINE ANHYDROUS ORAL ELIXIR 80 MG/15ML 0.58429 07/05/2013 0.58429 08/21/2015

THEOPHYLLINE ANHYDROUS ORAL SOLUTION, ORAL 80 MG/15ML 0.15122 08/12/2014 0.15122 08/21/2015

THEOPHYLLINE ANHYDROUS ORAL TABLET, EXTENDED RELEASE 12 HR 100 MG

0.31010 01/30/2015 0.31010 08/21/2015

0.39893 01/30/2015 0.39893 08/21/2015

2.59756 03/14/2018 2.59756 06/08/2018

2.63490 07/12/2017 4.55210 01/11/2018

THEOPHYLLINE ANHYDROUS ORAL TABLET, EXTENDED RELEASE 400 MG

0.95030 02/01/2013

THEOPHYLLINE ANHYDROUS ORAL TABLET, EXTENDED RELEASE 600 MG

1.37320 02/01/2013

THEOPHYLLINE IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 200MG/0.1L

0.03335 01/25/2013

THEOPHYLLINE IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 200MG/50ML

0.09490 08/12/2014

THEOPHYLLINE IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 400MG/.25L

0.01852 01/25/2013

THEOPHYLLINE IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 400MG/0.5L

0.00730 01/25/2013

THEOPHYLLINE IN DEXTROSE 5 % IN WATER INTRAVENOUS INTRAVENOUS SOLUTION 800MG/.25L

0.01890 08/12/2014

THIAMINE HCL INJECTION VIAL (ML) 100 MG/ML 3.68193 08/12/2014

THIAMINE HCL ORAL TABLET 100 MG 0.01375 08/12/2014 0.01375 08/21/2015

THIAMINE HCL ORAL TABLET 50 MG 0.01586 01/25/2013

THIAMINE HCL/RIBOFLAVIN/NIACINAMIDE/DEXPANTHENOL/PYRIDOXINE INJECTION VIAL (ML) 100-2MG/ML

1.31319 01/25/2013

THIAMINE MONONITRATE (VIT B1) ORAL TABLET 100 MG 0.02524 04/24/2015 0.02524 08/21/2015

THIORIDAZINE HCL ORAL TABLET 10 MG 0.35490 05/30/2014

THIORIDAZINE HCL ORAL TABLET 100 MG 0.79650 07/21/2016 0.83510 01/20/2017

Effective 8/7/2020

Current SMAC Price

THIORIDAZINE HCL ORAL TABLET 25 MG 0.24040 02/15/2013

THIORIDAZINE HCL ORAL TABLET 50 MG 0.59970 05/19/2017 0.56010 11/16/2018

THIOTHIXENE ORAL CAPSULE 1 MG 0.44352 12/26/2014 0.44352 08/21/2015

TIAGABINE HCL ORAL TABLET 2 MG 4.68720 03/27/2015 4.68720 08/21/2015

TIAGABINE HCL ORAL TABLET 4 MG 4.68720 03/27/2015 4.68720 08/21/2015

TICLOPIDINE HCL TABLET 250 MG 1.31502 11/14/2014 1.31502 08/21/2015

TIMOLOL MALEATE OPHTHALMIC DROPS 0.25 % 0.45600 11/24/2017 0.42400 02/22/2019

TIMOLOL MALEATE OPHTHALMIC DROPS 0.5 % 0.56636 02/22/2019 0.51000 04/26/2019

TIMOLOL MALEATE OPHTHALMIC GEL-FORMING SOLUTION 0.25 % 19.30600 06/27/2014

TIMOLOL MALEATE OPHTHALMIC GEL-FORMING SOLUTION 0.5 % 19.15060 07/18/2014

TIMOLOL MALEATE ORAL TABLET 10 MG 0.99344 06/06/2014

TINIDAZOLE ORAL TABLET 250 MG 0.87620 08/22/2014 0.87620 01/01/2017

TINIDAZOLE ORAL TABLET 500 MG 2.65000 06/22/2018 1.67000 06/21/2019

TIZANIDINE HCL ORAL CAPSULE 2 MG 0.60000 12/21/2018 0.29733 02/21/2020

TIZANIDINE HCL ORAL TABLET 2 MG 0.02233 11/16/2018 0.07180 04/07/2020

TIZANIDINE HCL ORAL TABLET 4 MG 0.03761 05/22/2020 0.06295 06/16/2020

TOBRAMYCIN OPHTHALMIC DROPS 0.3 % 1.09667 06/16/2017 0.82800 11/24/2017

TOBRAMYCIN SULFATE INJECTION VIAL (EA) 1.2 G 67.77984 08/01/2014

TOBRAMYCIN SULFATE INJECTION VIAL (ML) 10 MG/ML 1.10250 01/25/2013

TOBRAMYCIN SULFATE INJECTION VIAL (ML) 40 MG/ML 0.57335 10/03/2014 0.57335 08/21/2015

TOBRAMYCIN SULFATE/SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 60 MG/50ML

0.31870 01/25/2013

TOBRAMYCIN SULFATE/SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 80MG/100ML

0.18270 01/25/2013

TOBRAMYCIN/DEXAMETHASONE OPHTHALMIC SUSPENSION, DROPS(FINAL DOSAGE FORM)(ML) 0.3 %-0.1%

12.90400 08/25/2017 12.90400 01/01/2018

TOLAZAMIDE TABLET 250 MG 2.22090 08/12/2014 2.22090 08/21/2015

TOLAZAMIDE TABLET 500 MG 1.52140 08/12/2014

TOLBUTAMIDE TABLET 500 MG 0.73440 08/12/2014

TOLMETIN SODIUM ORAL CAPSULE 400 MG 1.16584 01/25/2013 1.16584 08/21/2015

TOLMETIN SODIUM ORAL TABLET 200 MG 0.52500 02/08/2013

TOLMETIN SODIUM ORAL TABLET 600 MG 2.47650 08/12/2014 2.47650 08/21/2015

TOLNAFTATE TOPICAL AEROSOL, POWDER (GRAM) 1 % 0.04750 08/21/2015

TOLNAFTATE TOPICAL CREAM (GRAM) 1 % 0.11078 01/09/2015 0.11078 08/21/2015

TOLNAFTATE TOPICAL POWDER (GRAM) 1 % 0.04750 08/12/2014 0.04750 08/21/2015

TOLTERODINE TARTRATE ORAL CAPSULE, EXT RELEASE 24 HR 2 MG 1.23116 03/20/2020 1.12933 07/17/2020

Effective 8/7/2020

Current SMAC Price

TOLTERODINE TARTRATE ORAL CAPSULE, EXT RELEASE 24 HR 4 MG 1.12667 05/17/2019 0.90000 05/22/2020

TOLTERODINE TARTRATE ORAL TABLET 1 MG 0.72917 11/16/2018 0.43100 11/15/2019

TOLTERODINE TARTRATE ORAL TABLET 2 MG 0.58475 05/17/2019 0.38750 05/22/2020

TOPIRAMATE ORAL CAPSULE SPRINKLE, EXTENDED RELEASE 24 HR 100 MG

12.64551 09/19/2014 16.13817 04/05/2019

15.54000 09/19/2014 16.10700 05/21/2018

20.06300 05/09/2019 22.09013 03/07/2020

4.87551 09/19/2014 5.74233 09/12/2018

6.72182 04/20/2018 7.40912 09/12/2018

TOPIRAMATE ORAL CAPSULE, SPRINKLE 15 MG 0.23103 04/21/2017 0.48250 03/10/2020

TOPIRAMATE ORAL CAPSULE, SPRINKLE 25 MG 0.46055 09/30/2016 0.44733 08/17/2018

TOPIRAMATE ORAL TABLET 100 MG 0.06500 08/25/2017 0.03583 02/22/2019

TOPOTECAN HCL INTRAVENOUS VIAL (EA) 4 MG 81.26200 01/23/2015 81.26200 08/21/2015

TOPOTECAN HCL INTRAVENOUS VIAL (ML) 4 MG/4 ML 30.38490 01/09/2015 30.38490 08/21/2015

TORSEMIDE ORAL TABLET 10 MG 0.06650 10/20/2017 0.04670 11/15/2019

TORSEMIDE VIAL (ML) 20 MG/2 ML 4.31340 01/25/2013

TORSEMIDE VIAL (ML) 50 MG/5 ML 2.34654 01/25/2013

TRAMADOL HCL ORAL TABLET 50 MG 0.01510 04/27/2018 0.01627 09/18/2018

TRAMADOL HCL ORAL TABLET, EXTENDED RELEASE 24 HR 100 MG 1.65067 05/25/2018 1.49967 03/20/2020

TRAMADOL HCL ORAL TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 100 MG

1.86080 08/12/2014 1.86080 08/21/2015

5.44880 08/15/2014 5.44880 08/21/2015

3.77000 01/25/2013 3.77000 08/21/2015

TRAMADOL HCL/ACETAMINOPHEN ORAL TABLET 37.5-325MG 0.21668 08/21/2015 0.08010 09/22/2017

TRANDOLAPRIL ORAL TABLET 1 MG 0.25064 08/21/2015 0.21120 08/25/2017

TRANDOLAPRIL/VERAPAMIL HCL ORAL TABLET,IMMED AND EXTEND REL BIPHASE 24HR 1MG-240 MG

3.70321 05/01/2015

TRANDOLAPRIL/VERAPAMIL HCL ORAL TABLET,IMMED AND EXTEND REL BIPHASE 24HR 2 MG-180MG

3.70321 05/01/2015

Effective 8/7/2020

Current SMAC Price

3.70321 05/01/2015

TRANEXAMIC ACID INTRAVENOUS AMPUL (ML) 1000 MG/10 4.94036 04/10/2015 4.94036 08/21/2015

TRANEXAMIC ACID INTRAVENOUS VIAL (ML) 1000 MG/10 4.18675 02/13/2015 4.18675 08/21/2015

TRANEXAMIC ACID ORAL TABLET 650 MG 1.07400 05/17/2019 1.81496 05/09/2020

TRANYLCYPROMINE SULFATE ORAL TABLET 10 MG 1.49220 03/02/2018 1.01000 10/25/2019

TRAVOPROST (BENZALKONIUM) DROPS 0.004 % 29.13400 05/03/2013

TRAVOPROST OPHTHALMIC DROPS 0.004 % 46.20000 07/17/2020

TRAZODONE HCL ORAL TABLET 100 MG 0.10300 04/20/2016 0.06178 07/14/2017

TRETINOIN ORAL CAPSULE 10 MG 18.81170 12/05/2014

TRETINOIN TOPICAL CREAM (GRAM) 0.025 % 2.08949 03/20/2020 2.39910 03/30/2020

TRETINOIN TOPICAL GEL (GRAM) 0.01 % 1.51858 04/01/2019 3.77480 10/08/2019

TRETINOIN TOPICAL GEL (GRAM) 0.025 % 3.33916 08/19/2019 2.89600 03/20/2020

TRIAMCINOLONE ACETONIDE DENTAL PASTE (GRAM) 0.1 % 5.58000 12/21/2018 5.19600 03/20/2020

TRIAMCINOLONE ACETONIDE INJECTION VIAL (ML) 10 MG/ML 1.52320 08/01/2014 1.52320 08/21/2015

TRIAMCINOLONE ACETONIDE INJECTION VIAL (ML) 40 MG/ML 2.89400 08/01/2014 2.89400 08/21/2015

TRIAMCINOLONE ACETONIDE NASAL AEROSOL, SPRAY (GRAM) 55 MCG 4.71467 03/27/2015 4.71467 08/21/2015

TRIAMCINOLONE ACETONIDE TOPICAL AEROSOL (GRAM) 0.147MG/G 2.72467 05/01/2015 2.64159 03/20/2020

TRIAMCINOLONE ACETONIDE TOPICAL CREAM (GRAM) 0.025 % 0.09310 08/12/2014 0.09310 08/21/2015

TRIAMCINOLONE ACETONIDE TOPICAL LOTION (ML) 0.025 % 0.76647 08/12/2014

TRIAMCINOLONE ACETONIDE TOPICAL LOTION (ML) 0.1 % 0.40833 11/24/2017 0.38000 11/15/2019

TRIAMCINOLONE ACETONIDE TOPICAL OINTMENT (GRAM) 0.025 % 0.28560 08/21/2015 0.13286 08/16/2019

TRIAMTERENE/HYDROCHLOROTHIAZIDE ORAL CAPSULE 37.5-25 MG 0.11056 03/03/2017 0.04697 12/22/2017

TRIAMTERENE/HYDROCHLOROTHIAZIDE ORAL TABLET 37.5-25 MG 0.15561 05/19/2017 0.07000 08/25/2017

TRIAMTERENE/HYDROCHLOROTHIAZIDE ORAL TABLET 75 MG-50MG 0.18148 08/21/2015 0.05500 09/22/2017

TRIAZOLAM ORAL TABLET 0.125 MG 0.20980 03/01/2013 0.20980 08/21/2015

TRIAZOLAM ORAL TABLET 0.25 MG 0.86737 02/13/2015 0.86737 08/21/2015

TRIFLUOPERAZINE HCL ORAL TABLET 1 MG 0.61215 04/24/2015 0.55090 11/24/2017

TRIFLURIDINE OPHTHALMIC DROPS 1 % 21.91752 04/15/2019 22.80000 06/17/2020

TRIHEXYPHENIDYL HCL ORAL ELIXIR 2 MG/5 ML 0.06175 02/13/2015

Effective 8/7/2020

Current SMAC Price

TRIHEXYPHENIDYL HCL ORAL TABLET 2 MG 0.05735 11/22/2013

TRIHEXYPHENIDYL HCL ORAL TABLET 5 MG 0.09110 08/25/2017 0.06878 01/19/2018

TRIMETHOBENZAMIDE HCL ORAL CAPSULE 300 MG 1.14618 04/12/2013

TRIMETHOPRIM ORAL TABLET 100 MG 0.27023 02/13/2015 0.16520 09/22/2017

TRIPROLIDINE HCL/PSEUDOEPHEDRINE HCL ORAL LIQUID (ML) 0.938-10/1

1.59900 08/12/2014 1.59900 08/21/2015

TRIPROLIDINE HCL/PSEUDOEPHEDRINE HCL ORAL SYRUP 1.25-30/5 0.05830 08/12/2014

TRIPROLIDINE HCL/PSEUDOEPHEDRINE HCL ORAL TABLET 2.5MG-60MG 0.05247 01/25/2013 0.05247 08/21/2015

TROPICAMIDE OPHTHALMIC DROPS 0.5 % 0.64860 08/12/2014

TROPICAMIDE OPHTHALMIC DROPS 1 % 0.52737 08/12/2014 0.34733 11/24/2017

TROSPIUM CHLORIDE ORAL CAPSULE, EXT RELEASE 24 HR 60 MG 4.06176 12/02/2016 3.77843 06/16/2017

TROSPIUM CHLORIDE ORAL TABLET 20 MG 0.37433 09/22/2017 0.25217 05/17/2019

UREA TOPICAL CREAM (GRAM) 40 % 0.16364 08/21/2015 1.75937 03/06/2019

UREA TOPICAL FOAM (GRAM) 35 % 0.88531 09/05/2014

UREA TOPICAL GEL WITH PREFILLED APPLICATOR (ML) 45 % 5.82575 01/25/2013

UREA TOPICAL KIT 40%-0.2% 282.72300 01/25/2013

UREA TOPICAL LOTION (GRAM) 45 % 0.17003 01/25/2013 0.17003 08/21/2015

UREA TOPICAL LOTION (ML) 40 % 0.07492 09/26/2014 0.07492 08/21/2015

UREA TOPICAL NAIL FILM SUSPENSION (ML) 40 % 11.93033 02/14/2014

UREA/HYALURONATE SODIUM KIT 40%-0.2% 282.72300 01/25/2013

URSODIOL MISCELLANEOUS POWDER (GRAM) 100 % 1.52880 08/21/2015

URSODIOL ORAL CAPSULE 300 MG 1.28215 08/16/2019 0.79510 09/20/2019

URSODIOL ORAL TABLET 250 MG 0.89760 10/15/2018 0.71540 01/24/2020

URSODIOL ORAL TABLET 500 MG 1.05000 11/24/2017 0.63240 05/17/2019

VALACYCLOVIR HCL ORAL TABLET 1000 MG 0.37833 01/19/2018 0.34233 09/21/2018

VALACYCLOVIR HCL ORAL TABLET 500 MG 0.21606 06/21/2019 0.18200 07/26/2019

VALGANCICLOVIR HCL ORAL TABLET 450 MG 19.10000 09/22/2017 5.24417 11/15/2019

VALPROIC ACID (AS SODIUM SALT) (VALPROATE SODIUM) MISCELLANEOUS POWDER (GRAM) 100 %

0.69225 08/12/2014

VALPROIC ACID (AS SODIUM SALT) (VALPROATE SODIUM) ORAL SOLUTION, ORAL 250 MG/5ML

0.15149 05/01/2015 0.15149 08/21/2015

VALPROIC ACID (AS SODIUM SALT) (VALPROATE SODIUM) ORAL SOLUTION, ORAL 250 MG/5ML

0.01420 05/17/2013 0.01897 02/14/2020

VALPROIC ACID (AS SODIUM SALT) (VALPROATE SODIUM) ORAL SOLUTION, ORAL 500MG/10ML

0.08532 08/12/2014

VALPROIC ACID ORAL CAPSULE 250 MG 0.22504 04/12/2018 0.14010 02/22/2019

VALSARTAN ORAL TABLET 160 MG 0.46207 11/15/2019 0.32845 05/22/2020

VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 160-12.5MG 0.11778 03/16/2018 0.66866 03/14/2020

VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 160-25MG 0.20035 03/03/2017 0.14689 03/16/2018

VALSARTAN/HYDROCHLOROTHIAZIDE ORAL TABLET 320MG-25MG 0.43524 12/19/2019 0.32422 05/22/2020

Effective 8/7/2020

Current SMAC Price

VANCOMYCIN HCL INTRAVENOUS VIAL (EA) 1 G 3.85000 05/17/2019 2.93100 03/20/2020

VANCOMYCIN HCL INTRAVENOUS VIAL (EA) 500 MG 2.11680 08/12/2014 2.11680 08/21/2015

VANCOMYCIN HCL INTRAVENOUS VIAL (EA) 750 MG 6.69900 01/25/2013

VANCOMYCIN HCL INTRAVENOUS VIAL WITH THREADED PORT (EA) 750 MG

10.90110 01/25/2013

VANCOMYCIN HCL ORAL CAPSULE 125 MG 2.25000 11/16/2018 2.10033 02/21/2020

VANCOMYCIN HCL ORAL CAPSULE 250 MG 7.23600 11/24/2017 6.49950 05/17/2019

VANCOMYCIN IN 5 % DEXTROSE IN WATER INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 1G/200ML

0.29786 07/25/2014

VANCOMYCIN IN 5 % DEXTROSE IN WATER INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 500MG/0.1L

0.18969 11/07/2014

VANCOMYCIN IN 5 % DEXTROSE IN WATER INTRAVENOUS IV SOLUTION, PIGGYBACK PREMIX FROZEN(ML) 750MG/.15L

0.17722 07/25/2014

VASOPRESSIN VIAL (ML) 20 UNIT/ML 3.14184 08/12/2014 3.14184 08/21/2015

VENLAFAXINE HCL ORAL CAPSULE, EXT RELEASE 24 HR 150 MG 0.14709 03/02/2018 0.14250 07/26/2019

VENLAFAXINE HCL ORAL CAPSULE, EXT RELEASE 24 HR 37.5 MG 0.10578 01/19/2018 0.09175 05/22/2020

VENLAFAXINE HCL ORAL CAPSULE, EXT RELEASE 24 HR 75 MG 0.15843 11/15/2019 0.09733 04/17/2020

VENLAFAXINE HCL ORAL TABLET 100 MG 0.09980 08/16/2019 0.05010 06/19/2020

VENLAFAXINE HCL ORAL TABLET 37.5 MG 0.11380 07/26/2019 0.07010 07/17/2020

VENLAFAXINE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 150 MG 3.19458 08/21/2015 2.62298 12/02/2016

VENLAFAXINE HCL ORAL TABLET, EXTENDED RELEASE 24 HR 37.5 MG 3.22698 03/27/2015

VERAPAMIL HCL INTRAVENOUS AMPUL (ML) 2.5 MG/ML 1.65480 01/25/2013

VERAPAMIL HCL INTRAVENOUS SYRINGE (ML) 2.5 MG/ML 4.46460 01/25/2013

VERAPAMIL HCL INTRAVENOUS VIAL (ML) 2.5 MG/ML 2.14400 01/25/2013 2.14400 08/21/2015

VERAPAMIL HCL MISCELLANEOUS POWDER (GRAM) 100 % 0.53976 08/21/2015

VERAPAMIL HCL ORAL CAPSULE, EXTENDED RELEASE PELLETS 24 HR 120 MG

1.35700 09/21/2016 0.86929 06/16/2017

0.70015 04/10/2015 0.70015 08/21/2015

0.89550 05/15/2015 0.89550 08/21/2015

2.54807 04/10/2015 2.54807 08/21/2015

VERAPAMIL HCL ORAL CAPSULE,24HR EXTENDED RELEASE PELLET CT 100 MG

1.23210 08/12/2014 1.23210 08/21/2015

1.58723 01/25/2013 1.58723 08/21/2015

2.09080 02/27/2015 2.09080 08/21/2015

Effective 8/7/2020

Current SMAC Price

VERAPAMIL HCL ORAL TABLET 120 MG 0.06180 09/22/2017 0.04790 10/25/2019

VERAPAMIL HCL ORAL TABLET 40 MG 0.18824 05/30/2014

VERAPAMIL HCL ORAL TABLET 80 MG 0.05600 08/12/2014 0.05600 08/21/2015

VERAPAMIL HCL ORAL TABLET, EXTENDED RELEASE 120 MG 0.16750 03/16/2018 0.11030 08/17/2018

VINBLASTINE SULFATE INTRAVENOUS VIAL (ML) 1 MG/ML 2.22600 01/25/2013

VIT B COMPLEX/VIT C/FOLIC ACID/FERROUS FUMARATE/VIT E ACET ORAL TABLET 500-400-18

0.05547 01/25/2013

VITAMIN A/ASCORBIC ACID/ZINC/PROPOLIS (BEE GLUE) ORAL LOZENGE 15 MG

0.02440 08/12/2014

VITAMIN B COMPLEX AND VITAMIN C NO.20/FOLIC ACID ORAL CAPSULE 1 MG

0.16037 08/21/2015 0.09490 11/24/2017

VITAMIN B COMPLEX NO.3/FOLIC ACID/ASCORBIC ACID(VITC)/BIOTIN ORAL TABLET 1MG-60MG

0.12810 08/12/2014 0.12810 08/21/2015

VITAMIN B COMPLEX/LYSINE ORAL LIQUID (ML) 790MG/15ML 0.03270 01/25/2013

VITAMIN E (DL-ALPHA TOCOPHERYL ACETATE) ORAL CAPSULE 400 UNIT 0.04540 08/21/2015

VITAMIN E MIXED ORAL CAPSULE 400 UNIT 0.05369 08/12/2014 0.05369 08/21/2015

VITAMIN E ORAL CAPSULE 100 UNIT 0.02028 01/25/2013 0.02028 08/21/2015

VITAMIN E ORAL CAPSULE 200 UNIT 0.02860 08/12/2014

VITAMIN E ORAL DROPS 50 UNIT/ML 0.94477 01/31/2014

VITAMINS A AND D/WHITE PETROLATUM/LANOLIN TOPICAL OINTMENT IN PACKET (GRAM)

0.03450 08/12/2014

VORICONAZOLE INTRAVENOUS VIAL (EA) 200 MG 44.58750 08/12/2014

VORICONAZOLE ORAL SUSPENSION, RECONSTITUTED, ORAL (ML) 200 MG/5ML

9.84947 12/27/2013

VORICONAZOLE ORAL TABLET 200 MG 5.00600 08/17/2018 3.00000 05/17/2019

VORICONAZOLE ORAL TABLET 50 MG 5.86000 07/08/2016 4.93290 09/21/2018

WARFARIN SODIUM ORAL TABLET 1 MG 0.14230 01/19/2018 0.09226 08/16/2019

WARFARIN SODIUM ORAL TABLET 2.5 MG 0.20194 08/21/2015 0.06420 08/16/2019

WARFARIN SODIUM ORAL TABLET 7.5 MG 0.17462 08/21/2015 0.06695 08/16/2019

WATER FOR INJ.,BACTERIOSTATIC INJECTION VIAL (ML) 0.02828 03/20/2015 0.02828 08/21/2015

WATER FOR INJECTION,STERILE INJECTION AMPUL (ML) 0.08820 01/25/2013 0.08820 08/21/2015

WATER FOR INJECTION,STERILE INJECTION VIAL (ML) 0.07489 08/21/2015 0.05462 02/22/2019

WATER FOR INJECTION,STERILE INTRAVENOUS INTRAVENOUS SOLUTION

0.00226 05/01/2015 0.00226 08/21/2015

WATER FOR IRRIGATION,STERILE IRRIGATION SOLUTION, IRRIGATION 0.00545 08/12/2014 0.00545 08/21/2015

Effective 8/7/2020

Current SMAC Price

WATER ORAL LIQUID (ML) 0.01165 01/16/2015 0.01165 08/21/2015

WITCH HAZEL TOPICAL PADS, MEDICATED (EA) 50 % 0.07692 08/12/2014 0.07692 08/21/2015

ZAFIRLUKAST ORAL TABLET 10 MG 1.19188 01/25/2013 1.19188 01/01/2017

ZAFIRLUKAST ORAL TABLET 20 MG 1.11667 02/21/2020 0.82500 04/17/2020

ZALEPLON ORAL CAPSULE 10 MG 0.21311 08/21/2015 0.13820 09/22/2017

ZALEPLON ORAL CAPSULE 5 MG 0.21208 08/21/2015 0.17120 08/17/2018

ZIDOVUDINE ORAL CAPSULE 100 MG 0.82839 11/08/2013 0.82839 08/21/2015

ZIDOVUDINE ORAL SYRUP 10 MG/ML 0.12787 05/10/2013 0.09521 11/24/2017

ZIDOVUDINE ORAL TABLET 300 MG 0.37007 08/21/2015 0.30183 11/24/2017

ZINC CHLORIDE INTRAVENOUS VIAL (ML) 1 MG/ML 0.17050 08/12/2014

ZINC SULFATE INTRAVENOUS VIAL (ML) 1 MG/ML 0.21874 01/25/2013

ZINC SULFATE INTRAVENOUS VIAL (ML) 5 MG/ML 0.65343 01/25/2013

ZIPRASIDONE HCL ORAL CAPSULE 20 MG 0.22400 12/20/2019 0.19433 05/22/2020

ZOLEDRONIC ACID IN MANNITOL AND 0.9 % SODIUM CHLORIDE INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 4 MG/100ML

10.14930 08/16/2013

ZOLEDRONIC ACID IN MANNITOL AND WATER FOR INJECTION INTRAVENOUS INTRAVENOUS SOLUTION, PIGGYBACK (ML) 5 MG/100ML

8.37592 10/25/2013

ZOLMITRIPTAN ORAL TABLET 2.5 MG 5.62000 06/16/2017 0.96500 09/21/2018

ZOLMITRIPTAN ORAL TABLET 5 MG 2.88000 02/21/2020 2.65000 04/17/2020

ZOLMITRIPTAN ORAL TABLET,DISINTEGRATING 2.5 MG 7.56000 06/16/2017 5.64000 06/22/2018

ZOLMITRIPTAN ORAL TABLET,DISINTEGRATING 5 MG 5.50481 06/16/2017 3.89667 09/22/2017

ZOLPIDEM TARTRATE ORAL TABLET 10 MG 0.02680 03/27/2015 0.02680 08/21/2015

ZOLPIDEM TARTRATE ORAL TABLET 5 MG 0.02680 03/13/2015 0.02680 08/21/2015

ZOLPIDEM TARTRATE ORAL TABLET, EXTENDED RELEASE MULTIPHASE 12.5 MG

0.52530 12/22/2017 0.48879 03/16/2018

ZOLPIDEM TARTRATE ORAL TABLET, EXTENDED RELEASE MULTIPHASE 6.25 MG

0.38000 10/19/2018 0.18852 06/21/2019

ZONISAMIDE ORAL CAPSULE 100 MG 0.14126 04/05/2019 0.10150 03/20/2020

Effective 8/7/2020

Disclaimer: Price listing does not guarantee coveragedhhr.wv.gov/bms/BMS...

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