Hospital

KAHI MOHALA

Ewa Beach, HI · CCN 124001 · Rates published

1,644 distinct procedures filed

15 distinct payers

26,329 rate rows

2026-07-15 last MRF observed

Data quality

18,045 of 26,329 rate rows are consumer-grade (68.5%)

8,284 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
exceeds 10× this hospital's gross charge — excluded from medians	4,789
per-diem day rate — not a per-procedure price	3,368
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	64
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	63

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.queens.org/wp-content/uploads/990073524_queens-medical-center-kahi-mohala_standardcharges-4.csv
Found on page	https://www.queens.org/pricing-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-22
Content fingerprint	3eab8207001bc776… · 35,874,231 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
883 MS_DRG	Disorders Of Personality & Impulse Control	8	$19,069.23	$36,138.46	$19,534.30	nat. median $16,489 1.2× median
886 MS_DRG	Behavioral & Developmental Disorders	8	$18,520.27	$35,040.54	$18,940.83	nat. median $16,721 1.1× median
896 MS_DRG	Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy With Comorbity	8	$18,370.13	$34,740.26	$18,778.52	nat. median $15,465 1.2× median
884 MS_DRG	Organic Disturbances & Intellectual Disability	8	$17,312.38	$32,624.75	$17,635.00	nat. median $14,237 1.2× median
895 MS_DRG	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	8	$15,186.33	$28,372.67	$15,336.58	nat. median $13,089 1.2× median
885 MS_DRG	Psychoses	8	$14,820.05	$27,640.09	$14,940.59	nat. median $12,307 1.2× median
887 MS_DRG	Other Mental Disorder Diagnoses	8	$12,663.90	$23,428.22	$12,663.90	nat. median $10,452 1.2× median
9513 APR_DRG	Moderately Extensive Procedure Unrelated To Principal Diagnosis	9	$11,858.42	$21,716.83	$11,858.42	nat. median $20,070 0.6× median
882 MS_DRG	Neuroses Except Depressive	8	$10,312.77	$19,078.62	$10,312.77	nat. median $9,333 1.1× median
880 MS_DRG	Acute Adjustment Reaction & Psychosocial Dysfunction	8	$10,277.61	$19,013.58	$10,277.61	nat. median $8,946 1.1× median
881 MS_DRG	Depressive Neuroses	8	$9,817.53	$18,162.43	$9,817.53	nat. median $8,587 1.1× median
897 MS_DRG	Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy Without Comorbit…	8	$9,487.70	$17,552.25	$9,487.70	nat. median $8,342 1.1× median
894 MS_DRG	Alcohol/drug Abuse Or Dependence; Left Ama	8	$6,819.15	$12,615.43	$6,819.15	nat. median $6,099 1.1× median
7513 APR_DRG	Major Depressive Disorders & Other/Unspecified Psychoses	9	$5,566.60	$9,133.21	$5,566.60	nat. median $7,613 0.7× median
7763 APR_DRG	Other Drug Abuse & Dependence	9	$5,146.94	$8,293.89	$5,146.94	nat. median $6,557 0.8× median
7502 APR_DRG	Schizophrenia	9	$4,212.64	$6,425.28	$4,212.64	nat. median $5,802 0.7× median
7532 APR_DRG	Bipolar Disorders	9	$3,861.89	$5,723.78	$3,861.89	nat. median $4,640 0.8× median
7752 APR_DRG	Alcohol Abuse & Dependence	9	$3,799.81	$5,599.62	$3,799.81	nat. median $4,746 0.8× median
90656 CPT	Flulaval 2024-2025 Formula	11	$3,634.50	$3,634.50	$3,634.50	nat. median $29 outlier · 124.0×
90651 CPT	Gardasil 9	11	$3,634.50	$3,634.50	$3,634.50	nat. median $408 outlier · 8.9×
90396 CPT	Varizig	11	$3,634.50	$3,634.50	$3,634.50	nat. median $2,590 1.4× median
90648 CPT	Acthib	11	$3,634.50	$3,634.50	$3,634.50	nat. median $35 outlier · 104.8×
90697 CPT	Vaxelis	11	$3,634.50	$3,634.50	$3,634.50	nat. median $165 outlier · 22.0×
90696 CPT	Kinrix	11	$3,634.50	$3,634.50	$3,634.50	nat. median $82 outlier · 44.2×
90698 CPT	Pentacel	11	$3,634.50	$3,634.50	$3,634.50	nat. median $127 outlier · 28.5×
90700 CPT	Infanrix	11	$3,634.50	$3,634.50	$3,634.50	nat. median $57 outlier · 63.7×
90702 CPT	Diphtheria And Tetanus Toxoids Adsorbed	11	$3,634.50	$3,634.50	$3,634.50	nat. median $80 outlier · 45.7×
90704 CPT	Mumpsvax	11	$3,634.50	$3,634.50	$3,634.50	nat. median $28 outlier · 130.3×
90705 CPT	Attenuvax	11	$3,634.50	$3,634.50	$3,634.50	nat. median $23 outlier · 156.3×
90706 CPT	Meruvax Ii	11	$3,634.50	$3,634.50	$3,634.50	nat. median $26 outlier · 139.9×
90636 CPT	Twinrix	11	$3,634.50	$3,634.50	$3,634.50	nat. median $174 outlier · 20.9×
90381 CPT	Beyfortus	11	$3,634.50	$3,634.50	$3,634.50	nat. median $856 outlier · 4.2×
90377 CPT	Rabies Ig Ht&sol Human Im/sc	11	$3,634.50	$3,634.50	$3,634.50	nat. median $568 outlier · 6.4×
90691 CPT	Typhim Vi	11	$3,634.50	$3,634.50	$3,634.50	nat. median $161 outlier · 22.5×
90686 CPT	Flulaval Quadrivalent 2023-2024 Formula	11	$3,634.50	$3,634.50	$3,634.50	nat. median $33 outlier · 109.3×
90633 CPT	Havrix Pediatric	11	$3,634.50	$3,634.50	$3,634.50	nat. median $62 outlier · 58.3×
90682 CPT	Flublok Quadrivalent 2023-2024 Formula	11	$3,634.50	$3,634.50	$3,634.50	nat. median $83 outlier · 43.8×
90734 CPT	Menactra	11	$3,634.50	$3,634.50	$3,634.50	nat. median $231 outlier · 15.7×
90732 CPT	Pneumovax 23	11	$3,634.50	$3,634.50	$3,634.50	nat. median $162 outlier · 22.4×
90680 CPT	Rotateq	11	$3,634.50	$3,634.50	$3,634.50	nat. median $132 outlier · 27.6×
90743 CPT	Hepb Vacc 2 Dose Adolesc IM	11	$3,634.50	$3,634.50	$3,634.50	nat. median $81 outlier · 45.0×
90744 CPT	Hepb Vacc 3 Dose Ped/adol IM	11	$3,634.50	$3,634.50	$3,634.50	nat. median $49 outlier · 73.8×
90746 CPT	Hepb Vaccine 3 Dose Adult IM	11	$3,634.50	$3,634.50	$3,634.50	nat. median $97 outlier · 37.3×
90750 CPT	Shingrix	11	$3,634.50	$3,634.50	$3,634.50	nat. median $234 outlier · 15.5×
91300 CPT	Pfizer-biontech Covid-19 Vaccine	11	$3,634.50	$3,634.50	$3,634.50	nat. median $52 outlier · 69.5×
91301 CPT	Moderna Covid-19 Vaccine	11	$3,634.50	$3,634.50	$3,634.50	nat. median $53 outlier · 68.7×
91303 CPT	Janssen Covid-19 Vaccine	11	$3,634.50	$3,634.50	$3,634.50	nat. median $53 outlier · 68.6×
91305 CPT	Pfizer-biontech Covid-19 Vaccine Age 12yr & Older	11	$3,634.50	$3,634.50	$3,634.50	nat. median $37 outlier · 97.7×
91312 CPT	Pfizer-biontech Covid-19 Bivalent Vacc 12yr &older	11	$3,634.50	$3,634.50	$3,634.50	nat. median $20 outlier · 181.2×
91313 CPT	Moderna Covid-19 Vaccine, Bivalent Age 6yr & Older	11	$3,634.50	$3,634.50	$3,634.50	nat. median $52 outlier · 69.8×

Other procedures at this hospital

Browse this hospital's 1,644 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

883	MS_DRG	Disorders Of Personality & Impulse Control	9	8	—	—	$19,069.23	$36,138.46	$19,534.30	2026-07-15
886	MS_DRG	Behavioral & Developmental Disorders	9	8	—	—	$18,520.27	$35,040.54	$18,940.83	2026-07-15
896	MS_DRG	Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy With Comorbity	9	8	—	—	$18,370.13	$34,740.26	$18,778.52	2026-07-15
884	MS_DRG	Organic Disturbances & Intellectual Disability	9	8	—	—	$17,312.38	$32,624.75	$17,635.00	2026-07-15
895	MS_DRG	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	9	8	—	—	$15,186.33	$28,372.67	$15,336.58	2026-07-15
885	MS_DRG	Psychoses	9	8	—	—	$14,820.05	$27,640.09	$14,940.59	2026-07-15
887	MS_DRG	Other Mental Disorder Diagnoses	9	8	—	—	$12,663.90	$23,428.22	$12,663.90	2026-07-15
9513	APR_DRG	Moderately Extensive Procedure Unrelated To Principal Diagnosis	13	9	—	—	$11,858.42	$21,716.83	$11,858.42	2026-07-15
882	MS_DRG	Neuroses Except Depressive	9	8	—	—	$10,312.77	$19,078.62	$10,312.77	2026-07-15
880	MS_DRG	Acute Adjustment Reaction & Psychosocial Dysfunction	9	8	—	—	$10,277.61	$19,013.58	$10,277.61	2026-07-15
881	MS_DRG	Depressive Neuroses	9	8	—	—	$9,817.53	$18,162.43	$9,817.53	2026-07-15
897	MS_DRG	Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy Without Comorbit…	9	8	—	—	$9,487.70	$17,552.25	$9,487.70	2026-07-15
894	MS_DRG	Alcohol/drug Abuse Or Dependence; Left Ama	9	8	—	—	$6,819.15	$12,615.43	$6,819.15	2026-07-15
7513	APR_DRG	Major Depressive Disorders & Other/Unspecified Psychoses	13	9	—	—	$5,566.60	$9,133.21	$5,566.60	2026-07-15
7763	APR_DRG	Other Drug Abuse & Dependence	13	9	—	—	$5,146.94	$8,293.89	$5,146.94	2026-07-15
7502	APR_DRG	Schizophrenia	13	9	—	—	$4,212.64	$6,425.28	$4,212.64	2026-07-15
7532	APR_DRG	Bipolar Disorders	13	9	—	—	$3,861.89	$5,723.78	$3,861.89	2026-07-15
7752	APR_DRG	Alcohol Abuse & Dependence	13	9	—	—	$3,799.81	$5,599.62	$3,799.81	2026-07-15
90656	CPT	Flulaval 2024-2025 Formula	11	11	$52.20	$36.54 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90651	CPT	Gardasil 9	11	11	$902.94	$632.06 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90396	CPT	Varizig	11	11	$6,002.07	$4,201.45 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90648	CPT	Acthib	11	11	$34.82	$24.37 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90697	CPT	Vaxelis	11	11	$418.33	$292.83 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90696	CPT	Kinrix	11	11	$164.51	$115.16 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90698	CPT	Pentacel	11	11	$281.68	$197.18 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90700	CPT	Infanrix	11	11	$75.19	$52.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90702	CPT	Diphtheria And Tetanus Toxoids Adsorbed	11	11	$177.63	$124.34 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90704	CPT	Mumpsvax	11	11	$50.41	$35.29 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90705	CPT	Attenuvax	11	11	$43.76	$30.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90706	CPT	Meruvax Ii	11	11	$50.61	$35.43 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90636	CPT	Twinrix	11	11	$360.07	$252.05 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90381	CPT	Beyfortus	11	11	$1,529.36	$1,070.55 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90377	CPT	Rabies Ig Ht&sol Human Im/sc	11	11	$9,358.91	$6,551.24 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90691	CPT	Typhim Vi	11	11	$423.23	$296.26 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90686	CPT	Flulaval Quadrivalent 2023-2024 Formula	11	11	$45.56	$31.89 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90633	CPT	Havrix Pediatric	11	11	$105.54	$73.88 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90682	CPT	Flublok Quadrivalent 2023-2024 Formula	11	11	$153.04	$107.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90734	CPT	Menactra	11	11	$407.00	$284.90 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90732	CPT	Pneumovax 23	11	11	$321.98	$225.39 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90680	CPT	Rotateq	11	11	$280.48	$196.34 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90743	CPT	Hepb Vacc 2 Dose Adolesc IM	11	11	$196.53	$137.57 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90744	CPT	Hepb Vacc 3 Dose Ped/adol IM	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90746	CPT	Hepb Vaccine 3 Dose Adult IM	11	11	$196.53	$137.57 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90750	CPT	Shingrix	11	11	$592.65	$414.86 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91300	CPT	Pfizer-biontech Covid-19 Vaccine	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91301	CPT	Moderna Covid-19 Vaccine	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91303	CPT	Janssen Covid-19 Vaccine	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91305	CPT	Pfizer-biontech Covid-19 Vaccine Age 12yr & Older	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91312	CPT	Pfizer-biontech Covid-19 Bivalent Vacc 12yr &older	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91313	CPT	Moderna Covid-19 Vaccine, Bivalent Age 6yr & Older	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91316	CPT	Moderna Covid-19 Vaccine Bivalent Booster 6mo<6yrs	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91318	CPT	Pfizer-biontech Covid-19 Vaccine 2023-2024 6mo<5yr	11	11	$474.38	$332.07 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91320	CPT	Comirnaty 2023-2024 Age 12 And Older	11	11	$330.00	$231.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91321	CPT	Moderna Covid-19 Vaccine 2023-2024 Ages 6mo<12yrs	11	11	$352.00	$246.40 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
91322	CPT	Spikevax 2023-2024 Formula	11	11	$352.00	$246.40 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
A9270	HCPCS	Non-covered Item Or Service	11	11	$47.58	$33.31 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
A9577	HCPCS	Multihance	11	11	$289.03	$202.32 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
A9578	HCPCS	Multihance	11	11	$1,519.93	$1,063.95 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
A9579	HCPCS	Magnevist	11	11	$1,141.25	$798.88 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
A9581	HCPCS	Eovist	11	11	$375.38	$262.77 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
A9585	HCPCS	Gadobutrol Injection	11	11	$228.25	$159.78 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9041	HCPCS	Andexxa	11	11	$6,875.00	$4,812.50 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90632	CPT	Vaqta	11	11	$228.21	$159.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90380	CPT	Beyfortus	11	11	$1,529.36	$1,070.55 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90723	CPT	Pediarix	11	11	$274.65	$192.26 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90717	CPT	Yf-vax	11	11	$646.71	$452.70 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90677	CPT	Prevnar 20	11	11	$753.10	$527.17 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90716	CPT	Varivax	11	11	$526.26	$368.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0122	HCPCS	Inj., Eravacycline, 1 Mg	11	11	$184.48	$129.14 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0121	HCPCS	Nuzyra	11	11	$1,313.29	$919.30 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90715	CPT	Adacel	11	11	$129.12	$90.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90675	CPT	Rabies Vaccine IM	11	11	$1,195.18	$836.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0129	HCPCS	Orencia	11	11	$4,262.50	$2,983.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0131	HCPCS	Acetaminophen	11	11	$40.15	$28.11 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0132	HCPCS	Acetylcysteine	11	11	$88.78	$62.15 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0133	HCPCS	Acyclovir Injection	11	11	$42.22	$29.55 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0134	HCPCS	Acetaminophen	11	11	$26.40	$18.48 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0137	HCPCS	Acetaminophen	11	11	$33.00	$23.10 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0139	HCPCS	Humira	11	11	$19,037.21	$13,326.05 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0153	HCPCS	Adenosine	11	11	$30.12	$21.08 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0171	HCPCS	Epinephrine	11	11	$22.28	$15.60 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0174	HCPCS	Leqembi	11	11	$718.39	$502.87 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0180	HCPCS	Fabrazyme	11	11	$3,074.56	$2,152.19 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0202	HCPCS	Injection, Alemtuzumab	11	11	$4,853.75	$3,397.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0207	HCPCS	Amifostine	11	11	$1,375.00	$962.50 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0209	HCPCS	Sodium Thiosulfate	11	11	$330.00	$231.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0216	HCPCS	Alfentanil Hcl	11	11	$29.04	$20.33 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0225	HCPCS	Amvuttra	11	11	$328,215.25	$229,750.68 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0248	HCPCS	Veklury	11	11	$1,789.48	$1,252.64 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0256	HCPCS	Alpha 1 Proteinase Inhibitor	11	11	$1.63	$1.14 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0270	HCPCS	Prostin Vr Pediatric	11	11	$465.70	$325.99 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0278	HCPCS	Amikacin Sulfate	11	11	$20.08	$14.06 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0280	HCPCS	Aminophylline Novaplus	11	11	$31.27	$21.89 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0282	HCPCS	Amiodarone Hcl	11	11	$8.25	$5.78 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0283	HCPCS	Nexterone	11	11	$127.05	$88.94 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0287	HCPCS	Abelcet	11	11	$288.75	$202.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0289	HCPCS	Ambisome	11	11	$875.36	$612.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0290	HCPCS	Ampicillin 500 Mg Inj	11	11	$19.54	$13.68 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0295	HCPCS	Ampicillin Sulbactam 1.5 Gm	11	11	$12.32	$8.62 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0330	HCPCS	Succinycholine Chloride Inj	11	11	$29.43	$20.60 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0348	HCPCS	Eraxis	11	11	$524.95	$367.47 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0349	HCPCS	Rezzayo	11	11	$5,746.51	$4,022.56 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0360	HCPCS	Hydralazine Hcl	11	11	$46.86	$32.80 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0401	HCPCS	Abilify Maintena Vial	11	11	$7,987.21	$5,591.05 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0456	HCPCS	Azithromycin	11	11	$9.63	$6.74 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0457	HCPCS	Injection, Aztreonam, 100 Mg	11	11	$99.22	$69.45 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0461	HCPCS	Atropine Sulfate Injection	11	11	$4.83	$3.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0470	HCPCS	Bal In Oil	11	11	$465.50	$325.85 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0475	HCPCS	Baclofen 10 Mg Injection	11	11	$2,599.14	$1,819.40 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0476	HCPCS	Baclofen Intrathecal Trial	11	11	$90.67	$63.47 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0480	HCPCS	Simulect	11	11	$12,788.47	$8,951.93 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0485	HCPCS	Nulojix	11	11	$2,667.17	$1,867.02 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0490	HCPCS	Benlysta	11	11	$1,780.49	$1,246.34 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0491	HCPCS	Saphnelo	11	11	$14,961.76	$10,473.23 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0500	HCPCS	Dicyclomine Injection	11	11	$67.65	$47.36 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0515	HCPCS	Benztropine Mesylate	11	11	$129.25	$90.48 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0517	HCPCS	Fasenra Pfs	11	11	$16,079.39	$11,255.57 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0558	HCPCS	Bicillin C-r	11	11	$668.58	$468.01 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0561	HCPCS	Penicillin G Benzathine Inj	11	11	$473.44	$331.41 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0565	HCPCS	Zinplava	11	11	$10,450.00	$7,315.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0571	HCPCS	Buprenorphine	11	11	$168.47	$117.93 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0572	HCPCS	Buprenorphine-naloxone	11	11	$183.65	$128.56 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0574	HCPCS	Buprenorphine-naloxone	11	11	$4.59	$3.21 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0583	HCPCS	Bivalirudin	11	11	$192.50	$134.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0585	HCPCS	Botox	11	11	$3,580.50	$2,506.35 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0586	HCPCS	Dysport	11	11	$1,453.38	$1,017.37 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90620	CPT	Bexsero	11	11	$650.04	$455.03 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9488	HCPCS	Vaprisol	11	11	$1,637.63	$1,146.34 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9399	HCPCS	Terlivaz	11	11	$2,717.00	$1,901.90 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90714	CPT	Tenivac	11	11	$112.06	$78.44 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9293	HCPCS	Voraxaze	11	11	$118,890.75	$83,223.53 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0638	HCPCS	Ilaris	11	11	$58,806.97	$41,164.88 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0637	HCPCS	Caspofungin Acetate	11	11	$926.75	$648.73 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9257	HCPCS	Bevacizumab Injection	11	11	$2,191.59	$1,534.11 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90713	CPT	Ipol	11	11	$1,209.51	$846.66 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90671	CPT	Pcv15 Vaccine IM	11	11	$659.66	$461.76 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0640	HCPCS	Leucovorin Calcium Injection	11	11	$192.50	$134.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0641	HCPCS	Leucovorin Calcium	11	11	$17.88	$12.52 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0651	HCPCS	Levothyroxine Sodium	11	11	$243.90	$170.73 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0665	HCPCS	Inj, Bupivacaine, Nos, 0.5mg	11	11	$1.19	$0.83 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0666	HCPCS	Exparel	11	11	$1,096.37	$767.46 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0670	HCPCS	Inj Mepivacaine Hcl/10 Ml	11	11	$41.58	$29.11 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0690	HCPCS	Cefazolin Sodium Injection	11	11	$6.08	$4.26 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0692	HCPCS	Cefepime Hcl For Injection	11	11	$16.75	$11.73 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0694	HCPCS	Cefoxitin Sodium	11	11	$54.87	$38.41 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0695	HCPCS	Zerbaxa	11	11	$479.49	$335.64 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0696	HCPCS	Ceftriaxone Sodium Injection	11	11	$7.96	$5.57 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0697	HCPCS	Cefuroxime Sodium	11	11	$8.04	$5.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0698	HCPCS	Claforan	11	11	$36.99	$25.89 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0699	HCPCS	Fetroja	11	11	$640.31	$448.22 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0701	HCPCS	Cefepime	11	11	$74.25	$51.98 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0702	HCPCS	Betamethasone Acet&sod Phosp	11	11	$15.14	$10.60 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0703	HCPCS	Cefepime	11	11	$82.09	$57.46 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0706	HCPCS	Caffeine Citrate Injection	11	11	$27.50	$19.25 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0712	HCPCS	Ceftaroline Fosamil Inj	11	11	$588.48	$411.94 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0714	HCPCS	Avycaz	11	11	$1,142.26	$799.58 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0717	HCPCS	Cimzia	11	11	$16,498.44	$11,548.91 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0735	HCPCS	Clonidine Hcl	11	11	$68.75	$48.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0736	HCPCS	Inj, Clindamycin Phosp 300mg	11	11	$19.12	$13.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0742	HCPCS	Recarbrio	11	11	$869.39	$608.57 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0743	HCPCS	Cilastatin Sodium Injection	11	11	$30.84	$21.59 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0744	HCPCS	Ciprofloxacin IV	11	11	$0.01	—	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0745	HCPCS	Codeine Phosphate	11	11	$6.99	$4.89 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0750	HCPCS	Emtricitabine-tenofovir Disoproxil Fumarate	11	11	$68.73	$48.11 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0770	HCPCS	Coly-mycin M Parenteral	11	11	$77.00	$53.90 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0775	HCPCS	Xiaflex	11	11	$19,547.06	$13,682.94 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0780	HCPCS	Prochlorperazine Edisylate	11	11	$12.73	$8.91 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0834	HCPCS	Cortrosyn	11	11	$293.10	$205.17 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0850	HCPCS	Cytogam	11	11	$4,073.85	$2,851.70 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0872	HCPCS	Daptomycin	11	11	$137.50	$96.25 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0875	HCPCS	Dalvance	11	11	$4,892.61	$3,424.83 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0878	HCPCS	Daptomycin	11	11	$178.75	$125.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0879	HCPCS	Korsuva	11	11	$412.51	$288.76 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0881	HCPCS	Aranesp	11	11	$2,128.50	$1,489.95 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0882	HCPCS	Aranesp	11	11	$2,128.50	$1,489.95 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0883	HCPCS	Argatroban	11	11	$522.50	$365.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0885	HCPCS	Epoetin Alfa, Non-esrd	11	11	$73.50	$51.45 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0894	HCPCS	Decitabine	11	11	$240.00	$168.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0895	HCPCS	Deferoxamine Mesylate	11	11	$35.62	$24.93 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0896	HCPCS	Reblozyl	11	11	$33,933.27	$23,753.29 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0897	HCPCS	Prolia	11	11	$5,157.44	$3,610.21 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1000	HCPCS	Depo-estradiol	11	11	$675.57	$472.90 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1010	HCPCS	Methylprednisolone Acetate Novaplus	11	11	$44.88	$31.42 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1050	HCPCS	Medroxyprogesterone Acetate	11	11	$94.58	$66.21 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1071	HCPCS	Testosterone Cypionate	11	11	$35.75	$25.03 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1100	HCPCS	Dexamethasone Sodium Phos	11	11	$0.11	$0.08 27% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1110	HCPCS	Dihydroergotamine Mesylate	11	11	$288.75	$202.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1120	HCPCS	Acetazolamide	11	11	$109.18	$76.43 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1160	HCPCS	Digoxin	11	11	$16.45	$11.52 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1162	HCPCS	Digoxin Immune Fab (ovine)	11	11	$13,678.50	$9,574.95 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1165	HCPCS	Phenytoin Sodium	11	11	$3.83	$2.68 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1171	HCPCS	Inj, Hydromorphone, 0.1 Mg	11	11	$59.40	$41.58 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1190	HCPCS	Zinecard	11	11	$1,185.20	$829.64 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1200	HCPCS	Diphenhydramine Hcl	11	11	$4.40	$3.08 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1205	HCPCS	Chlorothiazide Sodium	11	11	$818.68	$573.08 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1212	HCPCS	Rimso-50	11	11	$2,006.82	$1,404.77 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1230	HCPCS	Methadone Hcl	11	11	$1,292.01	$904.41 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1245	HCPCS	Dipyridamole	11	11	$30.25	$21.18 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1250	HCPCS	Inj Dobutamine Hcl/250 Mg	11	11	$13.97	$9.78 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1265	HCPCS	Dopamine Injection	11	11	$39.19	$27.43 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1270	HCPCS	Injection, Doxercalciferol	11	11	$19.13	$13.39 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1299	HCPCS	Soliris	11	11	$17,938.23	$12,556.76 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1303	HCPCS	Ultomiris	11	11	$65,865.14	$46,105.60 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1306	HCPCS	Leqvio	11	11	$9,866.26	$6,906.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1323	HCPCS	Elrexfio	11	11	$22,744.98	$15,921.49 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1325	HCPCS	Veletri	11	11	$151.97	$106.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1326	HCPCS	Vyloy	11	11	$4,400.00	$3,080.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1327	HCPCS	Integrilin	11	11	$1,496.28	$1,047.40 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1335	HCPCS	Ertapenem Injection	11	11	$165.00	$115.50 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1364	HCPCS	Erythrocin Lactobionate	11	11	$301.80	$211.26 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1380	HCPCS	Estradiol Valerate	11	11	$360.12	$252.08 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1410	HCPCS	Premarin Intravenous	11	11	$1,036.42	$725.49 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1430	HCPCS	Ethamolin	11	11	$1,385.73	$970.01 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1436	HCPCS	Didronel I.v.	11	11	$185.63	$129.94 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1437	HCPCS	Monoferric	11	11	$9,657.21	$6,760.05 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1438	HCPCS	Enbrel	11	11	$3,845.88	$2,692.12 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1439	HCPCS	Injectafer	11	11	$4,049.64	$2,834.75 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1442	HCPCS	Neupogen	11	11	$865.79	$606.05 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1447	HCPCS	Granix	11	11	$1,099.70	$769.79 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1450	HCPCS	Fluconazole	11	11	$24.75	$17.33 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1451	HCPCS	Fomepizole	11	11	$4,761.93	$3,333.35 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1453	HCPCS	Fosaprepitant Dimeglumine	11	11	$115.50	$80.85 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1455	HCPCS	Foscavir	11	11	$1,320.00	$924.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1459	HCPCS	Inj Ivig Privigen 500 Mg	11	11	$10,552.30	$7,386.61 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1460	HCPCS	Gamastan	11	11	$1,307.33	$915.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1561	HCPCS	Gamunex-c	11	11	$8,180.70	$5,726.49 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1568	HCPCS	Octagam 10%	11	11	$5,341.88	$3,739.32 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1569	HCPCS	Gammagard Liquid Injection	11	11	$14,405.33	$10,083.73 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1570	HCPCS	Ganciclovir	11	11	$267.50	$187.25 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1571	HCPCS	Hepagam B	11	11	$2,447.34	$1,713.14 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1572	HCPCS	Flebogamma 5% Dif	11	11	$2,911.70	$2,038.19 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1573	HCPCS	Hepagam B	11	11	$2,447.34	$1,713.14 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1580	HCPCS	Gentamicin Sulfate	11	11	$91.63	$64.14 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1595	HCPCS	Injection Glatiramer Acetate	11	11	$343.75	$240.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1596	HCPCS	Glycopyrrolate	11	11	$7.48	$5.24 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1602	HCPCS	Simponi Aria	11	11	$5,497.78	$3,848.45 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1610	HCPCS	Glucagon Emergency Kit	11	11	$770.00	$539.00 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1611	HCPCS	Glucagon	11	11	$694.87	$486.41 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1626	HCPCS	Granisetron Hcl Injection	11	11	$17.19	$12.03 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1628	HCPCS	Tremfya	11	11	$40,057.71	$28,040.40 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1630	HCPCS	Haloperidol Lactate	11	11	$16.48	$11.54 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1631	HCPCS	Haloperidol Decanoate	11	11	$60.50	$42.35 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1640	HCPCS	Panhematin	11	11	$30,778.36	$21,544.85 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1642	HCPCS	Heparin Lock Flush	11	11	$2.75	$1.93 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1644	HCPCS	Inj Heparin Sodium Per 1000u	11	11	$17.88	$12.52 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1645	HCPCS	Fragmin	11	11	$1,376.61	$963.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1650	HCPCS	Inj Enoxaparin Sodium	11	11	$20.50	$14.35 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1652	HCPCS	Fondaparinux Sodium	11	11	$149.38	$104.57 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1670	HCPCS	Hypertet	11	11	$1,785.22	$1,249.65 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1720	HCPCS	Solu-cortef 100mg Vial	11	11	$61.88	$43.32 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1729	HCPCS	Hydroxyprogesterone Caproate	11	11	$1,877.02	$1,313.91 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1740	HCPCS	Ibandronate Sodium	11	11	$687.50	$481.25 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1742	HCPCS	Corvert	11	11	$1,539.54	$1,077.68 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1743	HCPCS	Elaprase	11	11	$8,882.23	$6,217.56 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0630	HCPCS	Calcitonin-salmon	11	11	$7,318.72	$5,123.10 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0613	HCPCS	Calcium Gluconate-sodium Chloride	11	11	$54.32	$38.02 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9254	HCPCS	Lacosamide	11	11	$180.18	$126.13 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0612	HCPCS	Calcium Gluconate	11	11	$27.56	$19.29 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1815	HCPCS	Insulin Injection	11	11	$50.11	$35.08 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1806	HCPCS	Esmolol Hcl	11	11	$328.63	$230.04 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J0606	HCPCS	Parsabiv	11	11	$567.74	$397.42 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
C9250	HCPCS	Artiss	11	11	$2,528.49	$1,769.94 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
90710	CPT	Proquad	11	11	$786.97	$550.88 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1805	HCPCS	Esmolol Hcl	11	11	$255.75	$179.03 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1823	HCPCS	Uplizna	11	11	$128,561.13	$89,992.79 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1830	HCPCS	Betaseron	11	11	$192.22	$134.55 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1833	HCPCS	Cresemba	11	11	$1,084.55	$759.19 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1836	HCPCS	Inj, Metronidazole, 10 Mg	11	11	$5.78	$4.05 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1885	HCPCS	Ketorolac Tromethamine	11	11	$8.00	$5.60 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1920	HCPCS	Labetalol Hcl	11	11	$24.99	$17.49 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1921	HCPCS	Labetalol Hcl	11	11	$19.25	$13.48 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1930	HCPCS	Somatuline Depot	11	11	$26,295.50	$18,406.85 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1932	HCPCS	Lanreotide	11	11	$24,454.82	$17,118.37 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1938	HCPCS	Furosemide	11	11	$2.75	$1.93 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1939	HCPCS	Inj, Bumetanide, 0.5 Mg	11	11	$6.26	$4.38 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1940	HCPCS	Furosemide	11	11	$14.02	$9.81 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1943	HCPCS	Aristada Initio	11	11	$6,696.83	$4,687.78 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1944	HCPCS	Aripiprazole Lauroxil 1 Mg	11	11	$5,092.76	$3,564.93 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1950	HCPCS	Lupron Depot	11	11	$14,859.27	$10,401.49 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1953	HCPCS	Levetiracetam	11	11	$50.88	$35.62 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1955	HCPCS	Carnitor	11	11	$106.91	$74.84 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1956	HCPCS	Levofloxacin In 5% Dextrose	11	11	$11.55	$8.09 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2002	HCPCS	Lidocaine Hcl-dextrose	11	11	$24.75	$17.33 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2020	HCPCS	Linezolid Injection	11	11	$8.67	$6.07 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2060	HCPCS	Lorazepam	11	11	$5.23	$3.66 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2175	HCPCS	Demerol Hydrochloride	11	11	$16.61	$11.63 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2182	HCPCS	Nucala	11	11	$9,907.76	$6,935.43 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2185	HCPCS	Meropenem	11	11	$56.94	$39.86 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2210	HCPCS	Methylergonovine Maleate	11	11	$86.02	$60.21 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2212	HCPCS	Relistor	11	11	$467.31	$327.12 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2248	HCPCS	Micafungin Sodium	11	11	$132.00	$92.40 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2250	HCPCS	Inj Midazolam Hydrochloride	11	11	$14.40	$10.08 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2260	HCPCS	Milrinone Lactate In Dextrose	11	11	$41.80	$29.26 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2270	HCPCS	Morphine Sulfate Injection	11	11	$56.93	$39.85 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2272	HCPCS	Morphine Sulfate	11	11	$7.90	$5.53 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2274	HCPCS	Inj Morphine Pf Epid Ithc	11	11	$796.40	$557.48 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2278	HCPCS	Prialt	11	11	$8,787.85	$6,151.50 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2280	HCPCS	Moxifloxacin Hcl	11	11	$121.00	$84.70 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J2290	HCPCS	Nafcillin	11	11	$30.25	$21.18 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15
J1800	HCPCS	Propranolol Hcl	11	11	$31.57	$22.10 30% off	$3,634.50	$3,634.50	$3,634.50	2026-07-15

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