Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL

W Bloomfield, MI · CCN 230302 · Rates published

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You selected 93350 (HCPCS)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

8,611 distinct procedures filed
46 distinct payers
895,814 rate rows
2025-06-28 last MRF observed · ⚠ 16 mo old
Data quality

137,688 of 895,814 rate rows are consumer-grade (15.4%)

758,126 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 — reasonRows
professional (physician) fee — not the facility price 533,963
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 223,886
exceeds 10× this hospital's gross charge — excluded from medians 152
template filing: same amount across many unrelated codes — excluded 87
percent-of-charges filed in the dollar field — excluded from medians 31
placeholder amount (≤ $0.02) — excluded from medians 7

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/381357020-1407867559_henry-ford-health_standardcharges.csv
Found on page https://www.henryford.com/visitors/billing/cost-of-care/hospital-standard-charges
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint 2d24df7dfe4644b4… · 823,411,512 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
00310453530
NDC 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 13 $2.10 $102,914.18 $65,580.93 nat. median
$37,433
1.8× median
72187040101
NDC 		Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 13 $2.10 $83,180.91 $53,006.12 nat. median
$64,653
0.8× median
50242015001
NDC 		Ocrelizumab 30 Mg/ml Intravenous Solution 13 $2.10 $51,024.49 $32,514.79 nat. median
$33,712
1.0× median
55292070254
NDC 		Hemin 350 Mg Intravenous Powder For Solution 13 $2.10 $28,296.42 $18,031.58 nat. median
$22,128
0.8× median
82959011101
NDC 		Imetelstat 188 Mg Intravenous Solution 13 $2.10 $26,328.12 $16,777.30 nat. median
$19,060
0.9× median
57894050301
NDC 		Daratumumab 1 800 Mg-hyaluronidase-fihj 30 000 Unit/15 Ml Subcut 13 $2.10 $25,961.61 $16,543.75 nat. median
$15,948
1.0× median
70114034001
NDC 		Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 13 $2.10 $23,497.78 $14,973.70 nat. median
$9,523
1.6× median
50242008525_2
NDC 		Alteplase 100 Mg IV Solution For Pulmonary Embolism 13 $2.10 $22,762.04 $14,504.86 nat. median
$14,871
1.0× median
50242008527_2
NDC 		Alteplase 100 Mg IV Solution For Pulmonary Embolism 13 $2.10 $22,762.04 $14,504.86 nat. median
$17,926
0.8× median
50242008525
NDC 		Alteplase 100 Mg Intravenous Solution 13 $2.10 $22,762.04 $14,504.86 nat. median
$11,199
1.3× median
50242008527
NDC 		Alteplase 100 Mg Intravenous Solution 13 $2.10 $22,762.04 $14,504.86 nat. median
$14,984
1.0× median
64406000801
NDC 		Natalizumab 300 Mg/15 Ml Intravenous Solution 13 $2.10 $22,082.85 $14,072.05 nat. median
$16,649
0.8× median
50242007001
NDC 		Obinutuzumab 1 000 Mg/40 Ml Intravenous Solution 13 $2.10 $21,356.50 $13,609.19 nat. median
$12,587
1.1× median
50242012047
NDC 		Tenecteplase 50 Mg Intravenous Solution 13 $2.10 $20,246.48 $12,901.85 nat. median
$10,373
1.2× median
50242012047_2
NDC 		Tenecteplase 50 Mg Intravenous Solution For Stroke 13 $2.10 $20,246.48 $12,901.85 nat. median
$12,631
1.0× median
66887000301
NDC 		Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injecti 13 $2.10 $19,658.38 $12,527.08 nat. median
$13,340
0.9× median
50242010901
NDC 		Rituximab 1 600 Mg/13.4 Ml (120 Mg/ml)-hyaluronidase Subcutaneou 13 $2.10 $19,479.71 $12,413.23 nat. median
$13,039
1.0× median
50242010801
NDC 		Rituximab 1 400 Mg/11.7 Ml (120 Mg/ml)-hyaluronidase Subcutaneou 13 $2.10 $17,050.14 $10,865.02 nat. median
$6,708
1.6× median
25682000101
NDC 		Eculizumab 300 Mg/30 Ml Intravenous Solution 13 $2.10 $16,872.76 $10,751.98 nat. median
$13,700
0.8× median
55513019001
NDC 		Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 13 $2.10 $16,601.23 $10,578.95 nat. median
$9,306
1.1× median
00006302602
NDC 		Pembrolizumab 25 Mg/ml Intravenous Solution 13 $2.10 $14,995.56 $9,555.75 nat. median
$5,447
1.8× median
70720072210
NDC 		Ziconotide 100 Mcg/ml Intrathecal Solution 13 $2.10 $14,396.62 $9,174.09 nat. median
$10,814
0.8× median
70720072310
NDC 		Ziconotide 25 Mcg/ml Intrathecal Solution 13 $2.10 $14,396.62 $9,174.09 nat. median
$10,148
0.9× median
00024515175
NDC 		Rasburicase 7.5 Mg Intravenous Solution 13 $2.10 $13,897.78 $8,856.20 nat. median
$8,061
1.1× median
00944270007
NDC 		Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 13 $2.10 $13,155.67 $8,383.31 nat. median
$5
outlier · 1612.2×
00944270013
NDC 		Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 13 $2.10 $13,155.67 $8,383.31 nat. median
$18
outlier · 454.9×
00944270007_2
NDC 		Immune Globulin (human) (igg) 10 % IV Solution (nicu) 13 $2.10 $13,155.67 $8,383.31 nat. median
$18
outlier · 464.4×
24338005008
NDC 		Carmustine In Polifeprosan 7.7 Mg Wafer For Implant 13 $2.10 $12,535.29 $7,987.98 nat. median
$45,752
outlier · 0.2×
50633012011
NDC 		Digoxin Immune Fab 40 Mg Intravenous Solution 13 $2.10 $12,373.15 $7,884.65 nat. median
$8,461
0.9× median
50242005306
NDC 		Rituximab 10 Mg/ml Concentrate Intravenous 13 $2.10 $12,191.09 $7,768.64 nat. median
$4,792
1.6× median
00078033184
NDC 		Basiliximab 20 Mg Intravenous Solution 13 $2.10 $11,601.93 $7,393.20 nat. median
$14
outlier · 524.3×
50242004413
NDC 		Alteplase 100 Mg IV Solution For Pulmonary Embolism 13 $2.10 $11,383.18 $7,253.80 nat. median
$3,201
outlier · 2.3×
50242004406_2
NDC 		Alteplase 50 Mg Intravenous Solution 13 $2.10 $11,383.18 $7,253.80 nat. median
$6,955
1.0× median
50242004413_2
NDC 		Alteplase 50 Mg Intravenous Solution 13 $2.10 $11,383.18 $7,253.80 nat. median
$3
outlier · 2492.7×
50242004406
NDC 		Alteplase 100 Mg IV Solution For Pulmonary Embolism 13 $2.10 $11,383.18 $7,253.80 nat. median
$6,955
1.0× median
63833083501
NDC 		C1 Esterase Inhibitor 500 Unit (10 Ml) Intravenous Solution 13 $2.10 $11,050.69 $7,041.93 nat. median
$6,964
1.0× median
72205004601
NDC 		Thiotepa 100 Mg Solution For Injection 13 $2.10 $11,033.60 $7,031.04 nat. median
$7,777
0.9× median
63459010450
NDC 		Rituximab-abbs 10 Mg/ml Intravenous Solution 13 $2.10 $10,976.06 $6,994.37 nat. median
$4,952
1.4× median
63459010450_2
NDC 		Rituximab-abbs Ingredient For Desensitization 13 $2.10 $10,976.06 $6,994.37 nat. median
$3,750
1.9× median
00310461150
NDC 		Durvalumab 50 Mg/ml Intravenous Solution 13 $2.10 $10,717.85 $6,829.83 nat. median
$82
outlier · 83.5×
00002762301
NDC 		Pemetrexed Disodium 500 Mg Intravenous Powder For Solution 13 $2.10 $10,498.30 $6,689.92 nat. median
$7,140
0.9× median
00069024901_2
NDC 		Rituximab-pvvr Ingredient For Desensitization 13 $2.10 $9,311.32 $5,933.54 nat. median
$1,448
outlier · 4.1×
00069024901
NDC 		Rituximab-pvvr 10 Mg/ml Intravenous Solution 13 $2.10 $9,311.32 $5,933.54 nat. median
$4,852
1.2× median
00074379902
NDC 		Adalimumab 40 Mg/0.8 Ml Subcutaneous Syringe Kit 13 $2.10 $8,994.05 $5,731.36 nat. median
$6,583
0.9× median
59676061001
NDC 		Trabectedin 1 Mg Intravenous Solution 13 $2.10 $8,959.58 $5,709.39 nat. median
$5,576
1.0× median
13533031805
NDC 		Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution 13 $2.10 $8,803.10 $5,609.68 nat. median
$4,361
1.3× median
42367054032
NDC 		Dantrolene 250 Mg Intravenous Suspension 14 $2.10 $8,575.24 $5,602.26 nat. median
$4,434
1.3× median
00944270006
NDC 		Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 13 $2.10 $8,771.88 $5,589.79 nat. median
$12
outlier · 480.2×
00310450525
NDC 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 13 $2.10 $8,615.69 $5,490.25 nat. median
$6,743
0.8× median
42367054032_2
NDC 		Dantrolene 250 Mg Intravenous Suspension 13 $2.10 $8,575.24 $5,464.48 nat. median
$5,337
1.0× median

Other procedures at this hospital

Browse this hospital's 8,611 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
00310453530 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 15 13 $119,390.00 — $2.10 $102,914.18 $65,580.93 2025-06-28
72187040101 NDC Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 15 13 $96,497.57 — $2.10 $83,180.91 $53,006.12 2025-06-28
50242015001 NDC Ocrelizumab 30 Mg/ml Intravenous Solution 15 13 $59,193.14 — $2.10 $51,024.49 $32,514.79 2025-06-28
55292070254 NDC Hemin 350 Mg Intravenous Powder For Solution 15 13 $32,826.47 — $2.10 $28,296.42 $18,031.58 2025-06-28
82959011101 NDC Imetelstat 188 Mg Intravenous Solution 15 13 $30,543.06 — $2.10 $26,328.12 $16,777.30 2025-06-28
57894050301 NDC Daratumumab 1 800 Mg-hyaluronidase-fihj 30 000 Unit/15 Ml Subcut 15 13 $30,117.88 — $2.10 $25,961.61 $16,543.75 2025-06-28
70114034001 NDC Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 15 13 $27,259.61 — $2.10 $23,497.78 $14,973.70 2025-06-28
50242008525 NDC Alteplase 100 Mg Intravenous Solution 15 13 $26,406.08 — $2.10 $22,762.04 $14,504.86 2025-06-28
50242008525_2 NDC Alteplase 100 Mg IV Solution For Pulmonary Embolism 15 13 $26,406.08 — $2.10 $22,762.04 $14,504.86 2025-06-28
50242008527_2 NDC Alteplase 100 Mg IV Solution For Pulmonary Embolism 15 13 $26,406.08 — $2.10 $22,762.04 $14,504.86 2025-06-28
50242008527 NDC Alteplase 100 Mg Intravenous Solution 15 13 $26,406.08 — $2.10 $22,762.04 $14,504.86 2025-06-28
64406000801 NDC Natalizumab 300 Mg/15 Ml Intravenous Solution 15 13 $25,618.15 — $2.10 $22,082.85 $14,072.05 2025-06-28
50242007001 NDC Obinutuzumab 1 000 Mg/40 Ml Intravenous Solution 15 13 $24,775.52 — $2.10 $21,356.50 $13,609.19 2025-06-28
50242012047 NDC Tenecteplase 50 Mg Intravenous Solution 15 13 $23,487.80 — $2.10 $20,246.48 $12,901.85 2025-06-28
50242012047_2 NDC Tenecteplase 50 Mg Intravenous Solution For Stroke 15 13 $23,487.80 — $2.10 $20,246.48 $12,901.85 2025-06-28
66887000301 NDC Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injecti 15 13 $22,805.54 — $2.10 $19,658.38 $12,527.08 2025-06-28
50242010901 NDC Rituximab 1 600 Mg/13.4 Ml (120 Mg/ml)-hyaluronidase Subcutaneou 15 13 $22,598.27 — $2.10 $19,479.71 $12,413.23 2025-06-28
50242010801 NDC Rituximab 1 400 Mg/11.7 Ml (120 Mg/ml)-hyaluronidase Subcutaneou 15 13 $19,779.75 — $2.10 $17,050.14 $10,865.02 2025-06-28
25682000101 NDC Eculizumab 300 Mg/30 Ml Intravenous Solution 15 13 $19,573.97 — $2.10 $16,872.76 $10,751.98 2025-06-28
55513019001 NDC Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 15 13 $19,258.97 — $2.10 $16,601.23 $10,578.95 2025-06-28
00006302602 NDC Pembrolizumab 25 Mg/ml Intravenous Solution 15 13 $17,396.24 — $2.10 $14,995.56 $9,555.75 2025-06-28
70720072310 NDC Ziconotide 25 Mcg/ml Intrathecal Solution 15 13 $16,701.42 — $2.10 $14,396.62 $9,174.09 2025-06-28
70720072210 NDC Ziconotide 100 Mcg/ml Intrathecal Solution 15 13 $16,701.42 — $2.10 $14,396.62 $9,174.09 2025-06-28
00024515175 NDC Rasburicase 7.5 Mg Intravenous Solution 15 13 $16,122.71 — $2.10 $13,897.78 $8,856.20 2025-06-28
00944270007_2 NDC Immune Globulin (human) (igg) 10 % IV Solution (nicu) 15 13 $15,261.80 — $2.10 $13,155.67 $8,383.31 2025-06-28
00944270013 NDC Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 15 13 $15,261.80 — $2.10 $13,155.67 $8,383.31 2025-06-28
00944270007 NDC Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 15 13 $15,261.80 — $2.10 $13,155.67 $8,383.31 2025-06-28
24338005008 NDC Carmustine In Polifeprosan 7.7 Mg Wafer For Implant 15 13 $14,542.10 — $2.10 $12,535.29 $7,987.98 2025-06-28
50633012011 NDC Digoxin Immune Fab 40 Mg Intravenous Solution 15 13 $14,354.00 — $2.10 $12,373.15 $7,884.65 2025-06-28
50242005306 NDC Rituximab 10 Mg/ml Concentrate Intravenous 15 13 $14,142.80 — $2.10 $12,191.09 $7,768.64 2025-06-28
00078033184 NDC Basiliximab 20 Mg Intravenous Solution 15 13 $13,459.31 — $2.10 $11,601.93 $7,393.20 2025-06-28
50242004406_2 NDC Alteplase 50 Mg Intravenous Solution 15 13 $13,205.54 — $2.10 $11,383.18 $7,253.80 2025-06-28
50242004413 NDC Alteplase 100 Mg IV Solution For Pulmonary Embolism 15 13 $13,205.54 — $2.10 $11,383.18 $7,253.80 2025-06-28
50242004406 NDC Alteplase 100 Mg IV Solution For Pulmonary Embolism 15 13 $13,205.54 — $2.10 $11,383.18 $7,253.80 2025-06-28
50242004413_2 NDC Alteplase 50 Mg Intravenous Solution 15 13 $13,205.54 — $2.10 $11,383.18 $7,253.80 2025-06-28
63833083501 NDC C1 Esterase Inhibitor 500 Unit (10 Ml) Intravenous Solution 15 13 $12,819.83 — $2.10 $11,050.69 $7,041.93 2025-06-28
72205004601 NDC Thiotepa 100 Mg Solution For Injection 15 13 $12,800.00 — $2.10 $11,033.60 $7,031.04 2025-06-28
63459010450_2 NDC Rituximab-abbs Ingredient For Desensitization 15 13 $12,733.25 — $2.10 $10,976.06 $6,994.37 2025-06-28
63459010450 NDC Rituximab-abbs 10 Mg/ml Intravenous Solution 15 13 $12,733.25 — $2.10 $10,976.06 $6,994.37 2025-06-28
00310461150 NDC Durvalumab 50 Mg/ml Intravenous Solution 15 13 $12,433.70 — $2.10 $10,717.85 $6,829.83 2025-06-28
00002762301 NDC Pemetrexed Disodium 500 Mg Intravenous Powder For Solution 15 13 $12,179.00 — $2.10 $10,498.30 $6,689.92 2025-06-28
00069024901 NDC Rituximab-pvvr 10 Mg/ml Intravenous Solution 15 13 $10,802.00 — $2.10 $9,311.32 $5,933.54 2025-06-28
00069024901_2 NDC Rituximab-pvvr Ingredient For Desensitization 15 13 $10,802.00 — $2.10 $9,311.32 $5,933.54 2025-06-28
00074379902 NDC Adalimumab 40 Mg/0.8 Ml Subcutaneous Syringe Kit 15 13 $10,433.93 — $2.10 $8,994.05 $5,731.36 2025-06-28
59676061001 NDC Trabectedin 1 Mg Intravenous Solution 15 13 $10,393.94 — $2.10 $8,959.58 $5,709.39 2025-06-28
13533031805 NDC Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution 15 13 $10,212.41 — $2.10 $8,803.10 $5,609.68 2025-06-28
42367054032 NDC Dantrolene 250 Mg Intravenous Suspension 16 14 $9,948.08 — $2.10 $8,575.24 $5,602.26 2025-06-28
00944270006 NDC Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 15 13 $10,176.20 — $2.10 $8,771.88 $5,589.79 2025-06-28
00310450525 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 15 13 $9,995.00 — $2.10 $8,615.69 $5,490.25 2025-06-28
42367054032_2 NDC Dantrolene 250 Mg Intravenous Suspension 15 13 $9,948.08 — $2.10 $8,575.24 $5,464.48 2025-06-28
50242006101 NDC Bevacizumab 25 Mg/ml Intravenous Solution 15 13 $9,613.28 — $2.10 $8,286.65 $5,280.57 2025-06-28
67457067502 NDC Calcitonin (salmon) 200 Unit/ml Injection Solution 15 13 $9,401.30 — $2.10 $8,103.92 $5,164.13 2025-06-28
76075010101 NDC Carfilzomib 60 Mg Intravenous Solution 15 13 $9,389.48 — $2.10 $8,093.73 $5,157.64 2025-06-28
00025016608_2 NDC Nafarelin 2 Mg/ml Nasal Spray 16 14 $9,077.99 — $2.10 $7,379.50 $5,112.27 2025-06-28
00025016608 NDC Nafarelin 2 Mg/ml Nasal Spray 16 14 $9,077.99 — $2.10 $7,825.23 $5,112.27 2025-06-28
63459039120 NDC Bendamustine 100 Mg Intravenous Powder For Solution 15 13 $8,965.40 — $2.10 $7,728.17 $4,924.69 2025-06-28
42227008101 NDC C1 Esterase Inhibitor 500 Unit (5 Ml) Intravenous Solution 15 13 $8,785.40 — $2.10 $7,573.01 $4,825.82 2025-06-28
71469023101 NDC Aminolevulinic Acid Hcl 30 Mg/ml Oral Solution 16 14 $8,417.00 — $2.10 $7,255.45 $4,740.03 2025-06-28
49411005208 NDC Aminocaproic Acid 250 Mg/ml (25 %) Oral Solution 16 14 $8,389.88 — $2.10 $7,232.08 $4,724.76 2025-06-28
49411005208_2 NDC Aminocaproic Acid 250 Mg/ml (25 %) Oral Solution 16 14 $8,389.88 — $2.10 $6,820.13 $4,724.76 2025-06-28
55513020701 NDC Bevacizumab-awwb 25 Mg/ml Intravenous Solution 15 13 $8,422.69 — $2.10 $7,260.36 $4,626.58 2025-06-28
43598005111 NDC Calcitonin (salmon) 200 Unit/ml Injection Solution 15 13 $7,989.05 — $2.10 $6,886.56 $4,388.39 2025-06-28
42367052025 NDC Bendamustine 25 Mg/ml Intravenous Solution 15 13 $7,842.48 — $2.10 $6,760.22 $4,307.87 2025-06-28
82959011201 NDC Imetelstat 47 Mg Intravenous Solution 15 13 $7,636.89 — $2.10 $6,583.00 $4,194.94 2025-06-28
69853010201 NDC Factor Xa Inactivated-zhzo (recombinant) 200 Mg Intravenous Solu 15 13 $7,505.00 — $2.10 $6,469.31 $4,122.50 2025-06-28
63459034804 NDC Bendamustine (bendeka) 25 Mg/ml Intravenous Solution 15 13 $7,471.40 — $2.10 $6,440.35 $4,104.04 2025-06-28
00069034201 NDC Bevacizumab-bvzr 25 Mg/ml Intravenous Solution 15 13 $7,410.80 — $2.10 $6,388.11 $4,070.75 2025-06-28
00597019705 NDC Idarucizumab 2.5 Gram/50 Ml Intravenous Solution 15 13 $7,364.30 — $2.10 $6,348.03 $4,045.21 2025-06-28
69344010101 NDC Indomethacin 25 Mg/5 Ml Oral Suspension 16 14 $7,108.61 — $2.10 $6,127.62 $4,003.22 2025-06-28
55513011101 NDC Darbepoetin Alfa 300 Mcg/0.6 Ml In Polysorbate Injection Syringe 15 13 $6,971.00 — $2.10 $6,009.00 $3,829.17 2025-06-28
00944265804 NDC Immune Glob Gamma(igg) 10 Gram-gly-gluc-iga 0 To 50 Mcg/ml IV So 15 13 $6,732.80 — $2.10 $5,803.67 $3,698.33 2025-06-28
50242009601 NDC Faricimab-svoa 6 Mg/0.05 Ml Intravitreal Solution 15 13 $6,702.90 — $2.10 $5,777.90 $3,681.90 2025-06-28
67457083306 NDC Pegfilgrastim-jmdb 6 Mg/0.6 Ml Subcutaneous Syringe 15 13 $6,267.51 — $2.10 $5,402.59 $3,442.74 2025-06-28
83257000541 NDC Pegfilgrastim-jmdb 6 Mg/0.6 Ml Subcutaneous Syringe 15 13 $6,267.51 — $2.10 $5,402.59 $3,442.74 2025-06-28
70842024001 NDC Rezafungin 200 Mg Intravenous Solution 15 13 $6,151.01 — $2.10 $5,302.17 $3,378.75 2025-06-28
57894005427 NDC Ustekinumab 130 Mg/26 Ml Intravenous Solution 15 13 $6,123.55 — $2.10 $5,278.50 $3,363.67 2025-06-28
65219059420 NDC Tocilizumab-aazg 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 15 13 $5,925.20 — $2.10 $5,107.52 $3,254.71 2025-06-28
65219059420_2 NDC Tocilizumab-aazg 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution - 15 13 $5,925.20 — $2.10 $5,107.52 $3,254.71 2025-06-28
44087353501 NDC Avelumab 20 Mg/ml Intravenous Solution 15 13 $5,858.12 — $2.10 $5,049.70 $3,217.87 2025-06-28
67386013051 NDC Eptinezumab-jjmr 100 Mg/ml Intravenous Solution 16 14 $5,488.49 — $2.10 $4,731.08 $3,090.85 2025-06-28
58468035703 NDC Alemtuzumab 30 Mg/ml Intravenous Solution 16 14 $5,345.00 — $2.10 $4,607.39 $3,010.04 2025-06-28
62856058446 NDC Rufinamide 40 Mg/ml Oral Suspension 16 14 $5,278.62 — $2.10 $4,550.17 $2,972.66 2025-06-28
62856058446_2 NDC Rufinamide 40 Mg/ml Oral Suspension 16 14 $5,278.62 — $2.10 $4,290.99 $2,972.66 2025-06-28
46287002001_2 NDC Spironolactone 25 Mg/5 Ml Oral Suspension 16 14 $5,199.96 — $2.10 $4,227.05 $2,928.36 2025-06-28
46287002001 NDC Spironolactone 25 Mg/5 Ml Oral Suspension 16 14 $5,199.96 — $2.10 $4,482.37 $2,928.36 2025-06-28
00074364103 NDC Leuprolide 3.75 Mg Intramuscular Syringe Kit 16 14 $5,196.02 — $2.10 $4,478.97 $2,926.14 2025-06-28
62856060001 NDC Decitabine 50 Mg Intravenous Solution 16 14 $5,183.00 — $2.10 $4,467.75 $2,918.81 2025-06-28
00944270005 NDC Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 16 14 $5,090.60 — $2.10 $4,388.10 $2,866.78 2025-06-28
00187301220 NDC Pyridostigmine Bromide 60 Mg/5 Ml Oral Syrup 16 14 $4,928.93 — $2.10 $4,248.74 $2,775.72 2025-06-28
00187301220_2 NDC Pyridostigmine Bromide 60 Mg/5 Ml Oral Syrup 16 14 $4,928.93 — $2.10 $4,006.73 $2,775.72 2025-06-28
70127010010 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $4,906.50 — $2.10 $4,229.40 $2,763.10 2025-06-28
70127010001 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $4,906.50 — $2.10 $4,229.40 $2,763.10 2025-06-28
70127010010_2 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $4,906.50 — $2.10 $3,988.49 $2,763.10 2025-06-28
70127010001_2 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $4,906.50 — $2.10 $3,988.49 $2,763.10 2025-06-28
66733095823 NDC Cetuximab 200 Mg/100 Ml Intravenous Solution 16 14 $4,874.60 — $2.10 $4,201.91 $2,745.13 2025-06-28
63020004901 NDC Bortezomib 3.5 Mg Injection Powder For Solution 16 14 $4,859.00 — $2.10 $4,188.46 $2,736.35 2025-06-28
67386031321 NDC Clobazam 2.5 Mg/ml Oral Suspension 16 14 $4,701.30 — $2.10 $4,052.52 $2,647.53 2025-06-28
67386031321_2 NDC Clobazam 2.5 Mg/ml Oral Suspension 16 14 $4,701.30 — $2.10 $3,821.69 $2,647.53 2025-06-28
55513002801 NDC Darbepoetin Alfa 200 Mcg/0.4 Ml In Polysorbate Injection Syringe 16 14 $4,649.00 — $2.10 $4,007.44 $2,618.09 2025-06-28
24201040002 NDC Calcitonin (salmon) 200 Unit/ml Injection Solution 16 14 $4,505.00 — $2.10 $3,883.31 $2,536.99 2025-06-28
00002850101_4 NDC Insulin Regular Human U-500(concentrate) 500 Unit/ml Subcutaneou 16 14 $4,466.00 — $2.10 $3,630.41 $2,515.03 2025-06-28
00002850101_3 NDC "insulin Regular Human U-500 """"concentrate"""" 500 Unit/ml Subcutaneo""" 16 14 $4,466.00 — $2.10 $3,630.41 $2,515.03 2025-06-28
00002850101_2 NDC Insulin Regular Human U-500(concentrate) 500 Unit/ml Subcutaneou 16 14 $4,466.00 — $2.10 $3,849.69 $2,515.03 2025-06-28
00002850101 NDC "insulin Regular Human U-500 """"concentrate"""" 500 Unit/ml Subcutaneo""" 16 14 $4,466.00 — $2.10 $3,849.69 $2,515.03 2025-06-28
00003218713 NDC Abatacept (with Maltose) 250 Mg Intravenous Solution 16 14 $4,392.44 — $2.10 $3,786.28 $2,473.61 2025-06-28
67684190102 NDC Ethiodized Oil 480 Mg Iodine/ml For Injection 16 14 $4,301.00 — $2.10 $3,496.28 $2,422.11 2025-06-28
70408023932 NDC Nitrofurantoin 25 Mg/5 Ml Oral Suspension 16 14 $4,289.00 — $2.10 $3,697.12 $2,415.35 2025-06-28
25021067620_2 NDC Pentobarbital Sodium 50 Mg/ml Injection Solution 16 14 $4,205.00 — $2.10 $3,624.71 $2,368.05 2025-06-28
25021067620 NDC Pentobarbital Sodium 50 Mg/ml Injection Solution 16 14 $4,205.00 — $2.10 $3,624.71 $2,368.05 2025-06-28
00004026129_2 NDC Mycophenolate Mofetil 200 Mg/ml Oral Powder For Suspension 16 14 $4,147.40 — $2.10 $3,575.06 $2,335.61 2025-06-28
00004026129 NDC Mycophenolate Mofetil 200 Mg/ml Oral Powder For Suspension 16 14 $4,147.40 — $2.10 $3,575.06 $2,335.61 2025-06-28
00023334807 NDC Dexamethasone 0.7 Mg Intravitreal Implant 16 14 $4,124.00 — $2.10 $3,554.89 $2,322.43 2025-06-28
55513022301 NDC Romiplostim 125 Mcg Subcutaneous Solution 16 14 $3,937.94 — $2.10 $3,394.50 $2,217.65 2025-06-28
25021025251 NDC Mitomycin 40 Mg Intravenous Solution 16 14 $3,841.79 — $2.10 $3,311.62 $2,163.51 2025-06-28
25021025251_2 NDC Mitomycin 40 Mg/40 Ml (1 Mg/ml) Intravesical Syringe 16 14 $3,841.79 — $2.10 $3,311.62 $2,163.51 2025-06-28
67457022005 NDC Isosulfan Blue 1 % Subcutaneous Solution 16 14 $3,647.57 — $2.10 $3,144.21 $2,054.13 2025-06-28
67457022005_2 NDC Isosulfan Blue 1 % Subcutaneous Solution 16 14 $3,647.57 — $2.10 $2,965.11 $2,054.13 2025-06-28
67457022005_3 NDC Isosulfan Blue 1 % Subcutaneous Solution 16 14 $3,647.57 — $2.10 $3,144.21 $2,054.13 2025-06-28
59338077501 NDC Ferumoxytol 510 Mg/17 Ml (30 Mg/ml) Intravenous Solution 16 14 $3,585.87 — $2.10 $3,091.02 $2,019.39 2025-06-28
70720072010 NDC Ziconotide 100 Mcg/ml Intrathecal Solution 16 14 $3,578.76 — $2.10 $3,084.89 $2,015.38 2025-06-28
57894003001 NDC Infliximab 100 Mg Intravenous Solution 16 14 $3,553.46 — $2.10 $3,063.08 $2,001.13 2025-06-28
50419042401 NDC Levonorgestrel 17.5 Mcg/24 Hr (up To 5 Yrs) 19.5mg Intrauterine 16 14 $3,545.37 — $2.10 $3,056.11 $1,996.58 2025-06-28
55513002704 NDC Darbepoetin Alfa 150 Mcg/0.3 Ml In Polysorbate Injection Syringe 16 14 $3,488.00 — $2.10 $3,006.66 $1,964.27 2025-06-28
50419042301 NDC Levonorgestrel 21 Mcg/24 Hr (up To 8 Years) 52 Mg Intrauterine D 16 14 $3,471.87 — $2.10 $2,992.75 $1,955.18 2025-06-28
59365512801 NDC Copper 380 Square Mm Intrauterine Device 16 14 $3,418.50 — $2.10 $2,946.75 $1,925.12 2025-06-28
00944265707 NDC Immune Glob Gamma(igg) 5 Gram-gly-gluc-iga 0 To 50 Mcg/ml IV Sol 16 14 $3,368.90 — $2.10 $2,903.99 $1,897.20 2025-06-28
00944265603 NDC Immune Glob Gamma(igg) 5 Gram-gly-gluc-iga 0 To 50 Mcg/ml IV Sol 16 14 $3,368.90 — $2.10 $2,903.99 $1,897.20 2025-06-28
00024515010 NDC Rasburicase 1.5 Mg Intravenous Solution 16 14 $3,228.56 — $2.10 $2,783.02 $1,818.16 2025-06-28
00004003909 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $3,215.51 — $2.10 $2,771.77 $1,810.82 2025-06-28
00004003909_2 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $3,215.51 — $2.10 $2,613.89 $1,810.82 2025-06-28
66794015701 NDC Baclofen 40 000 Mcg/20 Ml (2 000 Mcg/ml) Intrathecal Syringe 16 14 $3,124.74 — $2.10 $2,693.53 $1,759.70 2025-06-28
60694190100 NDC Ethiodized Oil 480 Mg Iodine/ml For Injection 16 14 $3,086.00 — $2.10 $2,508.61 $1,737.88 2025-06-28
00310450012 NDC Durvalumab 50 Mg/ml Intravenous Solution 16 14 $3,022.11 — $2.10 $2,605.06 $1,701.90 2025-06-28
10122062010 NDC Cangrelor 50 Mg Intravenous Solution 16 14 $3,008.60 — $2.10 $2,593.41 $1,694.29 2025-06-28
10122062001_2 NDC Cangrelor 50 Mg Intravenous Solution 16 14 $3,008.60 — $2.10 $2,593.41 $1,694.29 2025-06-28
10122062001 NDC Cangrelor 50 Mg Intravenous Solution 16 14 $3,008.60 — $2.10 $2,593.41 $1,694.29 2025-06-28
10122062010_2 NDC Cangrelor 50 Mg Intravenous Solution 16 14 $3,008.60 — $2.10 $2,593.41 $1,694.29 2025-06-28
50633031011 NDC Hydroxocobalamin 5 Gram Intravenous Solution 16 14 $2,999.00 — $2.10 $2,585.14 $1,688.88 2025-06-28
54288010502 NDC Ethyl Alcohol 99 % Intra-arterial Solution 16 14 $2,990.00 — $2.10 $2,577.38 $1,683.82 2025-06-28
54288010515 NDC Ethyl Alcohol 99 % Intra-arterial Solution 16 14 $2,990.00 — $2.10 $2,577.38 $1,683.82 2025-06-28
65219059210 NDC Tocilizumab-aazg 200 Mg/10 Ml (20 Mg/ml) Intravenous Solution 16 14 $2,987.60 — $2.10 $2,575.31 $1,682.47 2025-06-28
67457021102 NDC Fomepizole 1 Gram/ml Intravenous Solution 16 14 $2,963.00 — $2.10 $2,554.11 $1,668.62 2025-06-28
70127010006_2 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $2,944.50 — $2.10 $2,393.58 $1,658.20 2025-06-28
70127010006 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $2,944.50 — $2.10 $2,538.16 $1,658.20 2025-06-28
70127010060 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $2,944.50 — $2.10 $2,538.16 $1,658.20 2025-06-28
70127010060_2 NDC Cannabidiol 100 Mg/ml Oral Solution 16 14 $2,944.50 — $2.10 $2,393.58 $1,658.20 2025-06-28
66794015702 NDC Baclofen 40 000 Mcg/20 Ml (2 000 Mcg/ml) Intrathecal Solution 16 14 $2,910.42 — $2.10 $2,508.78 $1,639.00 2025-06-28
50419042201 NDC Levonorgestrel 14 Mcg/24 Hr (up To 3 Yrs) 13.5 Mg Intrauterine D 16 14 $2,891.16 — $2.10 $2,492.18 $1,628.15 2025-06-28
00069080901 NDC Infliximab-dyyb 100 Mg Intravenous Solution 16 14 $2,888.84 — $2.10 $2,490.18 $1,626.85 2025-06-28
50242005121 NDC Rituximab 10 Mg/ml Concentrate Intravenous 16 14 $2,868.56 — $2.10 $2,472.70 $1,615.43 2025-06-28
00023585801 NDC Levonorgestrel 20.4 Mcg/24 Hr (up To 8 Yrs) 52 Mg Intrauterine D 16 14 $2,737.08 — $2.10 $2,359.36 $1,541.39 2025-06-28
63459010310 NDC Rituximab-abbs 10 Mg/ml Intravenous Solution 16 14 $2,586.65 — $2.10 $2,229.69 $1,456.67 2025-06-28
63459010310_2 NDC Rituximab-abbs Ingredient For Desensitization 16 14 $2,586.65 — $2.10 $2,229.69 $1,456.67 2025-06-28
65162069388_2 NDC Atovaquone 750 Mg/5 Ml Oral Suspension 16 14 $2,584.85 — $2.10 $2,101.22 $1,455.66 2025-06-28
65162069388 NDC Atovaquone 750 Mg/5 Ml Oral Suspension 16 14 $2,584.85 — $2.10 $2,228.14 $1,455.66 2025-06-28
00944270004 NDC Immune Glob Gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection So 16 14 $2,547.80 — $2.10 $2,196.20 $1,434.80 2025-06-28
77777071087 NDC Alteplase 10 Mg/250 Ml Ivpb (bag 1) 16 14 $2,492.75 — $2.10 $2,148.75 $1,403.80 2025-06-28
77777071206 NDC Alteplase 10 Mg/250 Ml Ivpb (bag 2) 16 14 $2,492.75 — $2.10 $2,148.75 $1,403.80 2025-06-28
00002764001 NDC Pemetrexed Disodium 100 Mg Intravenous Powder For Solution 16 14 $2,475.80 — $2.10 $2,134.14 $1,394.25 2025-06-28
66302073204 NDC Treprostinil 32 Mcg Cartridge With Inhaler 16 14 $2,467.94 — $2.10 $2,127.36 $1,389.82 2025-06-28
66302074804 NDC Treprostinil 48 Mcg Cartridge With Inhaler 16 14 $2,467.94 — $2.10 $2,127.36 $1,389.82 2025-06-28
66302071604 NDC Treprostinil 16 Mcg Cartridge With Inhaler 16 14 $2,467.94 — $2.10 $2,127.36 $1,389.82 2025-06-28
66302076404 NDC Treprostinil 64 Mcg Cartridge With Inhaler 16 14 $2,467.94 — $2.10 $2,127.36 $1,389.82 2025-06-28
66302066401 NDC Treprostinil 64 Mcg Cartridge With Inhaler 16 14 $2,466.33 — $2.10 $2,125.98 $1,388.91 2025-06-28
66302061601 NDC Treprostinil 16 Mcg Cartridge With Inhaler 16 14 $2,466.33 — $2.10 $2,125.98 $1,388.91 2025-06-28
66733094823 NDC Cetuximab 100 Mg/50 Ml Intravenous Solution 16 14 $2,462.30 — $2.10 $2,122.50 $1,386.64 2025-06-28
50242006001 NDC Bevacizumab 25 Mg/ml Intravenous Solution 16 14 $2,440.82 — $2.10 $2,103.99 $1,374.55 2025-06-28
70010005140 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $2,405.82 — $2.10 $2,073.82 $1,354.84 2025-06-28
70010005140_2 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $2,405.82 — $2.10 $1,955.69 $1,354.84 2025-06-28
70069081001_2 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $2,389.98 — $2.10 $1,942.81 $1,345.92 2025-06-28
70069081001 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $2,389.98 — $2.10 $2,060.16 $1,345.92 2025-06-28
55513002504 NDC Darbepoetin Alfa 100 Mcg/0.5 Ml In Polysorbate Injection Syringe 16 14 $2,327.00 — $2.10 $2,005.87 $1,310.45 2025-06-28
78206016201 NDC Infliximab-abda 100 Mg Intravenous Solution 16 14 $2,310.17 — $2.10 $1,991.37 $1,300.97 2025-06-28
78206016299 NDC Infliximab-abda 100 Mg Intravenous Solution 16 14 $2,310.17 — $2.10 $1,991.37 $1,300.97 2025-06-28
43598065011 NDC Thiotepa 15 Mg Solution For Injection 16 14 $2,300.00 — $2.10 $1,982.60 $1,295.24 2025-06-28
63459039008 NDC Bendamustine 25 Mg Intravenous Powder For Solution 16 14 $2,278.85 — $2.10 $1,964.37 $1,283.34 2025-06-28
50742052005 NDC Cyclophosphamide 200 Mg/ml Intravenous Solution 16 14 $2,247.50 — $2.10 $1,937.35 $1,265.68 2025-06-28
66302020603 NDC Treprostinil 1.74 Mg/2.9 Ml (0.6 Mg/ml) Solution For Nebulizatio 16 14 $2,241.44 — $2.10 $1,932.12 $1,262.26 2025-06-28
23155021631 NDC Cidofovir 75 Mg/ml Intravenous Solution 16 14 $2,225.00 — $2.10 $1,917.95 $1,253.01 2025-06-28
00781315401 NDC Ferumoxytol 510 Mg/17 Ml (30 Mg/ml) Intravenous Solution 16 14 $2,221.31 — $2.10 $1,914.77 $1,250.93 2025-06-28
00069023801_2 NDC Rituximab-pvvr Ingredient For Desensitization 16 14 $2,200.40 — $2.10 $1,896.74 $1,239.16 2025-06-28
00069023801 NDC Rituximab-pvvr 10 Mg/ml Intravenous Solution 16 14 $2,200.40 — $2.10 $1,896.74 $1,239.16 2025-06-28
70199002611 NDC Vitamin A Palmitate 50 000 Unit/ml Intramuscular Solution 16 14 $2,161.25 — $2.10 $1,863.00 $1,217.11 2025-06-28
67457017750_2 NDC Dimethyl Sulfoxide 50 % Intravesical Solution 16 14 $2,160.00 — $2.10 $1,861.92 $1,216.40 2025-06-28
55513020601 NDC Bevacizumab-awwb 25 Mg/ml Intravenous Solution 16 14 $2,143.20 — $2.10 $1,847.44 $1,206.95 2025-06-28
31722003523_2 NDC Aminocaproic Acid 250 Mg/ml (25 %) Oral Solution 16 14 $2,134.92 — $2.10 $1,735.48 $1,202.28 2025-06-28
31722003523 NDC Aminocaproic Acid 250 Mg/ml (25 %) Oral Solution 16 14 $2,134.92 — $2.10 $1,840.30 $1,202.28 2025-06-28
67457017750 NDC Dimethyl Sulfoxide (dmso Rimso-50) 50% Topical Solution (for Ex 16 14 $2,090.00 — $2.10 $1,801.58 $1,176.99 2025-06-28
00074104008 NDC Beractant 25 Mg/ml In 0.9 % Sodium Chloride Intratracheal Suspen 16 14 $2,038.64 — $2.10 $1,757.31 $1,148.06 2025-06-28
00054031950 NDC Linezolid 100 Mg/5 Ml Oral Suspension 16 14 $2,020.55 — $2.10 $1,741.71 $1,137.88 2025-06-28
24338013610_2 NDC Erythromycin Ethylsuccinate 200 Mg/5 Ml Oral Powder For Suspensi 16 14 $1,989.80 — $2.10 $1,617.51 $1,120.55 2025-06-28
24338013610 NDC Erythromycin Ethylsuccinate 200 Mg/5 Ml Oral Powder For Suspensi 16 14 $1,989.80 — $2.10 $1,715.21 $1,120.55 2025-06-28
13533063402 NDC Tetanus Immune Globulin (pf) 250 Unit/ml Intramuscular Syringe 16 14 $1,952.51 — $2.10 $1,683.06 $1,099.55 2025-06-28
00143927901 NDC Mitomycin 20 Mg Intravenous Solution 16 14 $1,946.00 — $2.10 $1,677.45 $1,095.89 2025-06-28
16729010811 NDC Mitomycin 20 Mg Intravenous Solution 16 14 $1,945.94 — $2.10 $1,677.40 $1,095.86 2025-06-28
00023114501 NDC Onabotulinumtoxina 100 Unit Solution For Injection 16 14 $1,943.00 — $2.10 $1,674.87 $1,094.20 2025-06-28
63261025021_3 NDC Isosulfan Blue 1 % Subcutaneous Solution 16 14 $1,892.00 — $2.10 $1,630.90 $1,065.48 2025-06-28
63261025021_2 NDC Isosulfan Blue 1 % Subcutaneous Solution 16 14 $1,892.00 — $2.10 $1,538.01 $1,065.48 2025-06-28
63261025021 NDC Isosulfan Blue 1 % Subcutaneous Solution 16 14 $1,892.00 — $2.10 $1,630.90 $1,065.48 2025-06-28
00069031501 NDC Bevacizumab-bvzr 25 Mg/ml Intravenous Solution 16 14 $1,890.20 — $2.10 $1,629.35 $1,064.47 2025-06-28
60793070210_2 NDC Penicillin G Benzathine 2 400 000 Unit/4 Ml Intramuscular Syring 16 14 $1,879.92 — $2.10 $1,620.49 $1,058.68 2025-06-28
60793070210 NDC Penicillin G Benzathine 2 400 000 Unit/4 Ml Intramuscular Syring 16 14 $1,879.92 — $2.10 $1,620.49 $1,058.68 2025-06-28
49401010101 NDC Belimumab 120 Mg Intravenous Solution 16 14 $1,871.90 — $2.10 $1,613.58 $1,054.16 2025-06-28
60687076513 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $1,869.64 — $2.10 $1,611.63 $1,052.88 2025-06-28
60687076513_2 NDC Valganciclovir 50 Mg/ml Oral Solution 16 14 $1,869.64 — $2.10 $1,519.83 $1,052.88 2025-06-28
28595024035 NDC Amoxicillin 125 Mg-potassium Clavulanate 31.25 Mg/5 Ml Oral Susp 16 14 $1,807.10 — $2.10 $1,557.72 $1,017.67 2025-06-28
14789090107_2 NDC Procainamide 100 Mg/ml Injection Solution 16 14 $1,805.00 — $2.10 $1,555.91 $1,016.49 2025-06-28
14789001507 NDC Isoproterenol 0.2 Mg/ml Injection Solution 16 14 $1,805.00 — $2.10 $1,555.91 $1,016.49 2025-06-28
14789090107 NDC Procainamide 100 Mg/ml Injection Solution 16 14 $1,805.00 — $2.10 $1,555.91 $1,016.49 2025-06-28
62756052940 NDC Desmopressin 4 Mcg/ml Injection Solution 16 14 $1,787.60 — $2.10 $1,540.91 $1,006.69 2025-06-28
25021046110 NDC Desmopressin 4 Mcg/ml Injection Solution 16 14 $1,745.00 — $2.10 $1,504.19 $982.70 2025-06-28
00078072915 NDC Betaxolol 0.25 % Eye Drops Suspension 16 14 $1,665.77 — $2.10 $1,435.89 $938.08 2025-06-28
00009379401 NDC Ibutilide Fumarate 0.1 Mg/ml Intravenous Solution 16 14 $1,651.55 — $2.10 $1,423.64 $930.07 2025-06-28
66794015601 NDC Baclofen 20 000 Mcg/20 Ml (1 000 Mcg/ml) Intrathecal Syringe 16 14 $1,598.22 — $2.10 $1,377.67 $900.03 2025-06-28
63323065903 NDC Indomethacin 1 Mg Intravenous Solution 16 14 $1,591.82 — $2.10 $1,372.15 $896.43 2025-06-28
59148002050_2 NDC Tolvaptan 15 Mg Tablet 16 14 $1,562.10 — $2.10 $1,269.83 $879.69 2025-06-28
59148002050 NDC Tolvaptan 15 Mg Tablet 16 14 $1,562.10 — $2.10 $1,346.53 $879.69 2025-06-28
67457019501 NDC Melphalan Hcl 50 Mg Intravenous Powder For Solution 16 14 $1,550.00 — $2.10 $1,336.10 $872.88 2025-06-28
71288012902 NDC Dactinomycin 0.5 Mg Intravenous Solution 16 14 $1,550.00 — $2.10 $1,336.10 $872.88 2025-06-28
00049316044 NDC Voriconazole 200 Mg/5 Ml (40 Mg/ml) Oral Suspension 16 14 $1,542.88 — $2.10 $1,329.96 $868.87 2025-06-28
00049316044_2 NDC Voriconazole 200 Mg/5 Ml (40 Mg/ml) Oral Suspension 16 14 $1,542.88 — $2.10 $1,254.21 $868.87 2025-06-28
00074395646 NDC Lopinavir-ritonavir 400 Mg-100 Mg/5 Ml Oral Solution 16 14 $1,541.00 — $2.10 $1,328.34 $867.82 2025-06-28
00259161001 NDC Incobotulinumtoxina 100 Unit Intramuscular Solution 16 14 $1,538.00 — $2.10 $1,325.76 $866.12 2025-06-28
55513054610 NDC Filgrastim 480 Mcg/1.6 Ml Injection Solution 16 14 $1,508.99 — $2.10 $1,300.75 $849.79 2025-06-28
00310737020 NDC Budesonide-formoterol Hfa 160 Mcg-4.5 Mcg/actuation Aerosol Inha 16 14 $1,505.38 — $2.10 $1,297.64 $847.75 2025-06-28
77777071475 NDC Phentolamine 5 Mg In 0.9% Sodium Chloride 10 Ml (for Extravasati 16 14 $1,474.91 — $2.10 $1,271.37 $830.60 2025-06-28
77777071475_2 NDC Phentolamine 5 Mg In 0.9% Sodium Chloride 10 Ml (for Extravasati 16 14 $1,474.91 — $2.10 $1,271.37 $830.60 2025-06-28
00143956401 NDC Phentolamine 5 Mg Injection Solution 16 14 $1,474.91 — $2.10 $1,271.37 $830.60 2025-06-28
00143956410 NDC Phentolamine 5 Mg Injection Solution 16 14 $1,474.89 — $2.10 $1,271.36 $830.59 2025-06-28
10019095616 NDC Cyclophosphamide 1 Gram Intravenous Powder For Solution 16 14 $1,458.44 — $2.10 $1,257.18 $821.32 2025-06-28
10019095601 NDC Cyclophosphamide 1 Gram Intravenous Powder For Solution 16 14 $1,458.44 — $2.10 $1,257.18 $821.32 2025-06-28
76310002425_2 NDC Foscarnet 24 Mg/ml Intravenous Solution 16 14 $1,445.00 — $2.10 $1,245.59 $813.75 2025-06-28
76310002415 NDC Foscarnet 24 Mg/ml Intravenous Solution 16 14 $1,445.00 — $2.10 $1,245.59 $813.75 2025-06-28
76310002415_2 NDC Foscarnet 24 Mg/ml Intravenous Solution 16 14 $1,445.00 — $2.10 $1,245.59 $813.75 2025-06-28
76310002425 NDC Foscarnet 24 Mg/ml Intravenous Solution 16 14 $1,445.00 — $2.10 $1,245.59 $813.75 2025-06-28
00078035752_2 NDC Oxcarbazepine 300 Mg/5 Ml (60 Mg/ml) Oral Suspension 16 14 $1,438.25 — $2.10 $1,169.15 $809.95 2025-06-28
00078035752 NDC Oxcarbazepine 300 Mg/5 Ml (60 Mg/ml) Oral Suspension 16 14 $1,438.25 — $2.10 $1,239.77 $809.95 2025-06-28
63459091217 NDC Tbo-filgrastim 480 Mcg/0.8 Ml Subcutaneous Syringe 16 14 $1,436.30 — $2.10 $1,238.09 $808.86 2025-06-28
63459091236 NDC Tbo-filgrastim 480 Mcg/0.8 Ml Subcutaneous Syringe 16 14 $1,436.30 — $2.10 $1,238.09 $808.86 2025-06-28
62225060000 NDC Phenylephrine 1 %-ketorolac 0.3 % Intraocular Concentrate For Ir 16 14 $1,421.00 — $2.10 $1,224.90 $800.24 2025-06-28
62225060004 NDC Phenylephrine 1 %-ketorolac 0.3 % Intraocular Concentrate For Ir 16 14 $1,421.00 — $2.10 $1,224.90 $800.24 2025-06-28
55513002304 NDC Darbepoetin Alfa 60 Mcg/0.3 Ml In Polysorbate Injection Syringe 16 14 $1,398.20 — $2.10 $1,205.25 $787.39 2025-06-28
00131541072_2 NDC Lacosamide 10 Mg/ml Oral Solution 16 14 $1,372.50 — $2.10 $1,115.71 $772.92 2025-06-28
00131541072 NDC Lacosamide 10 Mg/ml Oral Solution 16 14 $1,372.50 — $2.10 $1,183.10 $772.92 2025-06-28
66689030708 NDC Mycophenolate Mofetil 200 Mg/ml Oral Powder For Suspension 16 14 $1,362.44 — $2.10 $1,174.42 $767.26 2025-06-28
66689030708_2 NDC Mycophenolate Mofetil 200 Mg/ml Oral Powder For Suspension 16 14 $1,362.44 — $2.10 $1,174.42 $767.26 2025-06-28
00046087221 NDC Conjugated Estrogens 0.625 Mg/gram Vaginal Cream 16 14 $1,355.18 — $2.10 $1,168.17 $763.17 2025-06-28
00955102104 NDC Docetaxel 80 Mg/4 Ml (20 Mg/ml) Intravenous Solution 16 14 $1,355.00 — $2.10 $1,168.01 $763.07 2025-06-28
62559015304 NDC Opium Tincture 10 Mg/ml (morphine) Oral 16 14 $1,351.66 — $2.10 $1,165.13 $761.19 2025-06-28
47426020101 NDC Aprepitant 130 Mg/18 Ml (7.2 Mg/ml) Intravenous Emulsion 16 14 $1,341.99 — $2.10 $1,156.80 $755.75 2025-06-28
00069130904 NDC Epoetin Alfa-epbx 40 000 Unit/ml Injection Solution 16 14 $1,328.60 — $2.10 $1,145.25 $748.20 2025-06-28
49281025051 NDC Rabies Vaccine Human Diploid (pf) 2.5 Unit Intramuscular Solutio 16 14 $1,306.43 — $2.10 $1,126.14 $735.71 2025-06-28
46287002004_2 NDC Spironolactone 25 Mg/5 Ml Oral Suspension 16 14 $1,301.71 — $2.10 $1,058.16 $733.06 2025-06-28
46287002004 NDC Spironolactone 25 Mg/5 Ml Oral Suspension 16 14 $1,301.71 — $2.10 $1,122.07 $733.06 2025-06-28
00173052100 NDC Salmeterol 50 Mcg/dose Blister Powder For Inhalation 16 14 $1,275.44 — $2.10 $1,099.43 $718.26 2025-06-28
66215050115_2 NDC Macitentan 10 Mg Tablet 16 14 $1,265.04 — $2.10 $1,028.35 $712.41 2025-06-28
66215050115 NDC Macitentan 10 Mg Tablet 16 14 $1,265.04 — $2.10 $1,090.46 $712.41 2025-06-28
50632001301 NDC Rabies Vaccine Purified Chicken Embryo Cell (pf) 2.5 Unit IM Su 16 14 $1,246.73 — $2.10 $1,074.68 $702.10 2025-06-28
50632001001 NDC Rabies Vaccine Purified Chicken Embryo Cell (pf) 2.5 Unit IM Su 16 14 $1,246.73 — $2.10 $1,074.68 $702.10 2025-06-28
65219059004 NDC Tocilizumab-aazg 80 Mg/4 Ml (20 Mg/ml) Intravenous Solution 16 14 $1,225.04 — $2.10 $1,055.98 $689.88 2025-06-28
81284031505 NDC Indigotindisulfonate Sodium 8 Mg/ml (0.8 %) Intravenous Solution 16 14 $1,205.00 — $2.10 $1,038.71 $678.60 2025-06-28
81284031500 NDC Indigotindisulfonate Sodium 8 Mg/ml (0.8 %) Intravenous Solution 16 14 $1,205.00 — $2.10 $1,038.71 $678.60 2025-06-28
65250026620 NDC Bupivacaine Liposome(pf) 1.3 %(13.3 Mg/ml) Suspension For Infilt 16 14 $1,201.04 — $2.10 $1,035.30 $676.37 2025-06-28
00268024705_2 NDC Histamine 1 Mg/ml (2.75 Mg/ml) Percutaneous Solution 16 14 $1,193.00 — $2.10 $1,028.37 $671.84 2025-06-28
00268024705 NDC Histamine 1 Mg/ml (2.75 Mg/ml) Percutaneous Solution 16 14 $1,193.00 — $2.10 $1,028.37 $671.84 2025-06-28
00456270010 NDC Ceftazidime-avibactam 2.5 Gram Intravenous Solution 16 14 $1,191.76 — $2.10 $1,027.30 $671.14 2025-06-28
00456270010_2 NDC Ceftazidime-avibactam 2.5 Gram Intravenous Solution 16 14 $1,191.76 — $2.10 $1,027.30 $671.14 2025-06-28
00074726950 NDC Cyclosporine Modified 100 Mg/ml Oral Solution 16 14 $1,190.90 — $2.10 $1,026.56 $670.65 2025-06-28
00074726950_2 NDC Cyclosporine Modified 100 Mg/ml Oral Solution 16 14 $1,190.90 — $2.10 $1,026.56 $670.65 2025-06-28
69238202708 NDC Spironolactone 25 Mg/5 Ml Oral Suspension 16 14 $1,187.36 — $2.10 $1,023.50 $668.66 2025-06-28
69238202708_2 NDC Spironolactone 25 Mg/5 Ml Oral Suspension 16 14 $1,187.36 — $2.10 $965.20 $668.66 2025-06-28
70004069531 NDC Isoproterenol 200 Mcg/50 Ml(4 Mcg/ml) In 0.9 % Sodium Chloride I 16 14 $1,186.50 — $2.10 $1,022.76 $668.17 2025-06-28
00074104004 NDC Beractant 25 Mg/ml In 0.9 % Sodium Chloride Intratracheal Suspen 16 14 $1,154.00 — $2.10 $994.75 $649.88 2025-06-28
00469042001 NDC Isavuconazonium Sulfate 372 Mg Intravenous Solution 16 14 $1,153.67 — $2.10 $994.46 $649.69 2025-06-28
10019095501 NDC Cyclophosphamide 500 Mg Intravenous Powder For Solution 16 14 $1,148.75 — $2.10 $990.22 $646.92 2025-06-28
10019095550 NDC Cyclophosphamide 500 Mg Intravenous Powder For Solution 16 14 $1,148.75 — $2.10 $990.22 $646.92 2025-06-28
50742051902 NDC Cyclophosphamide 200 Mg/ml Intravenous Solution 16 14 $1,148.75 — $2.10 $990.22 $646.92 2025-06-28
66215060406 NDC Selexipag 400 Mcg Tablet 16 14 $1,147.30 — $2.10 $988.97 $646.10 2025-06-28
66215060806 NDC Selexipag 800 Mcg Tablet 16 14 $1,147.30 — $2.10 $988.97 $646.10 2025-06-28
66215060806_2 NDC Selexipag 800 Mcg Tablet 16 14 $1,147.30 — $2.10 $932.64 $646.10 2025-06-28
66215060406_2 NDC Selexipag 400 Mcg Tablet 16 14 $1,147.30 — $2.10 $932.64 $646.10 2025-06-28
65219013120 NDC Cyclophosphamide 1 Gram Intravenous Powder For Solution 16 14 $1,130.00 — $2.10 $974.06 $636.36 2025-06-28
49771000201 NDC Mitomycin 0.2 Mg Ophthalmic Kit 16 14 $1,127.00 — $2.10 $971.47 $634.67 2025-06-28
66302064801 NDC Treprostinil 48 Mcg Cartridge With Inhaler 16 14 $1,121.48 — $2.10 $966.72 $631.56 2025-06-28
66302063201 NDC Treprostinil 32 Mcg Cartridge With Inhaler 16 14 $1,121.48 — $2.10 $966.72 $631.56 2025-06-28
42023010405 NDC Tuberculin Ppd 5 Tub. Unit/0.1 Ml Intradermal Injection Solution 16 14 $1,120.88 — $2.10 $911.16 $631.23 2025-06-28
00078072910 NDC Betaxolol 0.25 % Eye Drops Suspension 16 14 $1,112.27 — $2.10 $958.78 $626.38 2025-06-28
00046074905 NDC Conjugated Estrogens 25 Mg Solution For Injection 16 14 $1,109.15 — $2.10 $956.09 $624.62 2025-06-28
69344010233 NDC Indomethacin 50 Mg Rectal Suppository 16 14 $1,087.22 — $2.10 $937.18 $612.27 2025-06-28
81665030102 NDC Cocaine 4 % Nasal Solution 16 14 $1,078.50 — $2.10 $929.67 $607.36 2025-06-28
00409159304 NDC Tromethamine 36 Mg/ml (0.3 M) Intravenous Solution 16 14 $1,076.00 — $2.10 $927.51 $605.95 2025-06-28
66794016202 NDC Morphine (pf) 25 Mg/ml Injection Solution 16 14 $1,066.88 — $2.10 $919.65 $600.82 2025-06-28
66794016202_2 NDC Morphine (pf) 25 Mg/ml Injection Solution 16 14 $1,066.88 — $2.10 $919.65 $600.82 2025-06-28
00069029201 NDC Filgrastim-aafi 480 Mcg/0.8 Ml Subcutaneous Syringe 16 14 $1,056.20 — $2.10 $910.44 $594.80 2025-06-28
62135048149 NDC Cephalexin 250 Mg/5 Ml Oral Suspension 16 14 $1,055.00 — $2.10 $909.41 $594.12 2025-06-28
52652800101_2 NDC Zonisamide 100 Mg/5 Ml Oral Suspension 16 14 $1,051.35 — $2.10 $854.64 $592.07 2025-06-28
52652800101 NDC Zonisamide 100 Mg/5 Ml Oral Suspension 16 14 $1,051.35 — $2.10 $906.26 $592.07 2025-06-28
11994001104_2 NDC Perflutren Lipid Microspheres 1.1 Mg/ml Intravenous Suspension 16 14 $1,049.38 — $2.10 $853.04 $590.95 2025-06-28
11994001104_3 NDC Perflutren Lipid Microspheres 1.1 Mg/ml Intravenous Suspension 16 14 $1,049.38 — $2.10 $904.57 $590.95 2025-06-28
11994001104 NDC Perflutren Lipid Microspheres 1.1 Mg/ml Intravenous Suspension 16 14 $1,049.38 — $2.10 $904.57 $590.95 2025-06-28
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