Browse by Standard Packs
Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits
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| Item code | Drug name Form and Strength |
Pack size | Price | Manufacturer |
|---|---|---|---|---|
| 14034P | LEVETIRACETAMlevetiracetam 500 mg tablet, 60 | 60 | $18.43 | RW,VO |
| 14428J | LEVODOPA + BENSERAZIDElevodopa 200 mg + benserazide 50 mg tablet, 100 | 100 | $28.43 | RO |
| 14387F | LEVODOPA + BENSERAZIDElevodopa 100 mg + benserazide 25 mg capsule, 100 | 100 | $18.47 | RO |
| 14525L | LEVODOPA + BENSERAZIDElevodopa 100 mg + benserazide 25 mg modified release capsule, 100 | 100 | $22.03 | RO |
| 14551W | LEVODOPA + BENSERAZIDElevodopa 200 mg + benserazide 50 mg capsule, 100 | 100 | $28.43 | RO |
| 14388G | LEVODOPA + BENSERAZIDElevodopa 50 mg + benserazide 12.5 mg capsule, 100 | 100 | $14.11 | RO |
| 14552X | LEVODOPA + BENSERAZIDElevodopa 100 mg + benserazide 25 mg dispersible tablet, 100 | 100 | $24.21 | RO |
| 14356N | LEVODOPA + BENSERAZIDElevodopa 50 mg + benserazide 12.5 mg dispersible tablet, 100 | 100 | $14.11 | RO |
| 14455T | LEVODOPA + BENSERAZIDElevodopa 100 mg + benserazide 25 mg tablet, 100 | 100 | $18.47 | RO |
| 11919H | LEVODOPA + CARBIDOPAlevodopa 20 mg/mL + carbidopa monohydrate 5 mg/mL intestinal gel, 7 x 100 mL | 7 | $1473.72 | VE |
| 8970D | LEVODOPA + CARBIDOPAlevodopa 20 mg/mL + carbidopa monohydrate 5 mg/mL intestinal gel, 7 x 100 mL | 7 | $1461.24 | VE |
| 14427H | LEVODOPA + CARBIDOPAlevodopa 100 mg + carbidopa 25 mg tablet, 100 | 100 | $21.38 | AF,AL,RW,TX |
| 14322T | LEVODOPA + CARBIDOPAlevodopa 200 mg + carbidopa 50 mg modified release tablet, 100 | 100 | $58.55 | AL |
| 14454R | LEVODOPA + CARBIDOPAlevodopa 250 mg + carbidopa 25 mg tablet, 100 | 100 | $25.81 | AL,RW,TX |
| 14554B | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 100 mg + carbidopa 25 mg + entacapone 200 mg tablet, 100 | 100 | $64.25 | HX,SZ,TB,TX |
| 8798C | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 100 mg + carbidopa 25 mg + entacapone 200 mg tablet, 100 | 100 | $64.20 | HX,SZ,TB,TX |
| 14527N | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 125 mg + carbidopa 31.25 mg + entacapone 200 mg tablet, 100 | 100 | $66.70 | HX,SZ,TB,TX |
| 9345W | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 125 mg + carbidopa 31.25 mg + entacapone 200 mg tablet, 100 | 100 | $66.64 | HX,SZ,TB,TX |
| 14357P | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 150 mg + carbidopa 37.5 mg + entacapone 200 mg tablet, 100 | 100 | $70.34 | HX,SZ,TB,TX |
| 8799D | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 150 mg + carbidopa 37.5 mg + entacapone 200 mg tablet, 100 | 100 | $70.29 | HX,SZ,TB,TX |
| 14457X | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 200 mg + carbidopa 50 mg + entacapone 200 mg tablet, 100 | 100 | $75.94 | HX,SZ,TB,TX |
| 9292C | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 200 mg + carbidopa 50 mg + entacapone 200 mg tablet, 100 | 100 | $75.88 | HX,SZ,TB,TX |
| 14456W | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 50 mg + carbidopa 12.5 mg + entacapone 200 mg tablet, 100 | 100 | $58.17 | HX,SZ,TB,TX |
| 8797B | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 50 mg + carbidopa 12.5 mg + entacapone 200 mg tablet, 100 | 100 | $58.12 | HX,SZ,TB,TX |
| 14498C | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 75 mg + carbidopa 18.75 mg + entacapone 200 mg tablet, 100 | 100 | $60.85 | HX,SZ,TB,TX |
| 9344T | LEVODOPA + CARBIDOPA + ENTACAPONElevodopa 75 mg + carbidopa 18.75 mg + entacapone 200 mg tablet, 100 | 100 | $60.80 | HX,SZ,TB,TX |
| 13954K | LINAGLIPTINlinagliptin 5 mg tablet, 30 | 30 | $43.64 | BY |
| 13959Q | LINAGLIPTIN + METFORMINlinagliptin 2.5 mg + metformin hydrochloride 500 mg tablet, 60 | 60 | $45.66 | BY |
| 14065G | LINAGLIPTIN + METFORMINlinagliptin 2.5 mg + metformin hydrochloride 850 mg tablet, 60 | 60 | $46.49 | BY |
| 13879L | LINAGLIPTIN + METFORMINlinagliptin 2.5 mg + metformin hydrochloride 1 g tablet, 60 | 60 | $46.97 | BY |
| 13966C | LIOTHYRONINEliothyronine sodium 20 microgram tablet, 100 | 100 | $46.69 | AS |
| 14352J | LIQUID PARAFFIN + GLYCEROL + TYLOXAPOL + POLOXAMER-188 + TROMETAMOL HYDROCHLORIDE + TROMETAMOL + CETALKONIUM CHLORIDEliquid paraffin + glycerol + tyloxapol + poloxamer-188 + trometamol hydrochloride + trometamol + cetalkonium chloride eye drops, 10 mL | 1 | $24.74 | CS |
| 13584Y | LISINOPRILlisinopril 10 mg tablet, 30 | 30 | $6.16 | AL,RW,SZ,TX,WG |
| 13584Y | LISINOPRILlisinopril 10 mg tablet, 30 | 30 | $11.00 | IX |
| 13402J | LISINOPRILlisinopril 20 mg tablet, 30 | 30 | $6.48 | AL,RW,SZ,TX,WG |
| 13402J | LISINOPRILlisinopril 20 mg tablet, 30 | 30 | $11.31 | IX |
| 13583X | LISINOPRILlisinopril 5 mg tablet, 30 | 30 | $5.12 | AL,RW,SZ,TX,WG |
| 13583X | LISINOPRILlisinopril 5 mg tablet, 30 | 30 | $9.94 | IX |
| 8290H | LITHIUM CARBONATElithium carbonate 450 mg modified release tablet, 100 | 100 | $36.23 | AS |
| 10889D | LOPERAMIDEloperamide hydrochloride 2 mg capsule, 12 | 12 | $2.45 | AS,CR |
| 14341T | MACROGOL-3350macrogol-3350 1 g/g powder for oral liquid, 510 g | 1 | $11.87 | KY |
| 14408H | MACROGOL-3350 + SODIUM CHLORIDE + BICARBONATE + POTASSIUM CHLORIDEmacrogol-3350 13.125 g + sodium chloride 350.7 mg + sodium bicarbonate 178.5 mg + potassium chloride 46.6 mg powder for oral liquid, 30 sachets | 1 | $8.67 | GX,RF,RW,TX,XT |
| 9327X | MEDIUM CHAIN TRIGLYCERIDESmedium chain triglycerides oral liquid, 250 mL bottle | 1 | $20.24 | SB |
| 3128P | MEDIUM CHAIN TRIGLYCERIDESmedium chain triglycerides oral oil, 500 mL | 1 | $52.95 | SB |
| 13849X | MEDROXYPROGESTERONEmedroxyprogesterone acetate 10 mg tablet, 30 | 30 | $15.97 | PF |
| 13849X | MEDROXYPROGESTERONEmedroxyprogesterone acetate 10 mg tablet, 30 | 30 | $9.27 | FZ |
| 13928C | MEDROXYPROGESTERONEmedroxyprogesterone acetate 10 mg tablet, 100 | 100 | $32.00 | PF |
| 13928C | MEDROXYPROGESTERONEmedroxyprogesterone acetate 10 mg tablet, 100 | 100 | $25.30 | FZ |
| 14067J | MEDROXYPROGESTERONEmedroxyprogesterone acetate 100 mg tablet, 100 | 100 | $76.47 | PF |
| 13881N | MEDROXYPROGESTERONEmedroxyprogesterone acetate 200 mg tablet, 60 | 60 | $87.23 | PF |
| 13961T | MEDROXYPROGESTERONEmedroxyprogesterone acetate 250 mg tablet, 60 | 60 | $89.88 | PF |
| 13956M | MEDROXYPROGESTERONEmedroxyprogesterone acetate 5 mg tablet, 56 | 56 | $12.46 | PF |
| 13956M | MEDROXYPROGESTERONEmedroxyprogesterone acetate 5 mg tablet, 56 | 56 | $7.88 | FZ |
| 1598D | MERCAPTOPURINEmercaptopurine monohydrate 50 mg tablet, 25 | 25 | $40.14 | LM |
| 1598D | MERCAPTOPURINEmercaptopurine monohydrate 50 mg tablet, 25 | 25 | $42.00 | AS |
| 13356Y | MESALAZINEmesalazine 1.2 g modified release tablet, 120 | 120 | $165.02 | RA |
| 13456F | MESALAZINEmesalazine 4 g modified release granules, 30 sachets | 30 | $120.80 | FP |
| 13518L | MESALAZINEmesalazine 3 g modified release granules, 30 sachets | 30 | $92.51 | FD |
| 13422K | MESALAZINEmesalazine 800 mg enteric tablet, 90 | 90 | $68.83 | EU |
| 11554D | MESALAZINEmesalazine 1 g enteric tablet, 60 | 60 | $64.54 | FD |
| 13394Y | MESALAZINEmesalazine 1 g enteric tablet, 60 | 60 | $64.60 | FD |
| 8753Q | MESALAZINEmesalazine 1 g/100 mL enema, 7 x 100 mL | 1 | $51.65 | FP |
| 13355X | MESALAZINEmesalazine 1 g modified release granules, 100 sachets | 100 | $98.08 | FP |
| 13398E | MESALAZINEmesalazine 1 g modified release granules, 100 sachets | 100 | $107.09 | FD |
| 8616L | MESALAZINEmesalazine 2 g/60 mL enema, 7 x 60 mL | 1 | $51.65 | FD |
| 8617M | MESALAZINEmesalazine 4 g/60 mL enema, 7 x 60 mL | 1 | $80.83 | FD |
| 8768L | MESALAZINEmesalazine 1 g/application foam, 14 applications | 1 | $59.79 | FD |
| 12463Y | MESALAZINEmesalazine 1.6 g enteric tablet, 60 | 60 | $72.51 | EU |
| 13395B | MESALAZINEmesalazine 1.6 g enteric tablet, 60 | 60 | $72.57 | EU |
| 13460K | MESALAZINEmesalazine 1.5 g modified release granules, 60 sachets | 60 | $92.51 | FD |
| 13361F | MESALAZINEmesalazine 500 mg modified release granules, 100 sachets | 100 | $57.28 | FD |
| 8598M | MESALAZINEmesalazine 500 mg modified release granules, 100 sachets | 100 | $57.23 | FD |
| 13397D | MESALAZINEmesalazine 2 g modified release granules, 60 sachets | 60 | $120.80 | FP |
| 13576M | MESALAZINEmesalazine 1 g modified release tablet, 60 | 60 | $64.26 | FP |
| 3413P | MESALAZINEmesalazine 1 g modified release tablet, 60 | 60 | $64.21 | FP |
| 13487W | MESALAZINEmesalazine 1.2 g modified release tablet, 60 | 60 | $82.51 | NQ,TK |
| 9353G | MESALAZINEmesalazine 1.2 g modified release tablet, 60 | 60 | $82.46 | NQ,TK |
| 13423L | MESALAZINEmesalazine 250 mg enteric tablet, 100 | 100 | $34.04 | GO |
| 13362G | MESALAZINEmesalazine 500 mg enteric tablet, 100 | 100 | $57.28 | FD |
| 8731M | MESALAZINEmesalazine 500 mg enteric tablet, 100 | 100 | $57.23 | FD |
| 13396C | MESALAZINEmesalazine 500 mg modified release tablet, 100 | 100 | $57.28 | FP |
| 2214M | MESALAZINEmesalazine 500 mg modified release tablet, 100 | 100 | $57.23 | FP |
| 14056T | METFORMINmetformin hydrochloride 1 g tablet, 90 | 90 | $6.70 | AF,BG,HQ,MQ,RW,SZ,TY,WG,ZS |
| 14056T | METFORMINmetformin hydrochloride 1 g tablet, 90 | 90 | $11.59 | AL |
| 13847T | METFORMINmetformin hydrochloride 1 g modified release tablet, 60 | 60 | $6.70 | AF,CR,MQ,RF,SZ,TX,WG |
| 13847T | METFORMINmetformin hydrochloride 1 g modified release tablet, 60 | 60 | $12.04 | AL |
| 13976N | METFORMINmetformin hydrochloride 500 mg tablet, 100 | 100 | $5.63 | AF,BG,HQ,MQ,RF,SZ,TY,WG,ZS |
| 13976N | METFORMINmetformin hydrochloride 500 mg tablet, 100 | 100 | $11.10 | AL |
| 13899M | METFORMINmetformin hydrochloride 500 mg modified release tablet, 120 | 120 | $6.70 | CR,MQ,RW,SZ,TX,WG |
| 13899M | METFORMINmetformin hydrochloride 500 mg modified release tablet, 120 | 120 | $12.04 | AL |
| 13952H | METFORMINmetformin hydrochloride 850 mg tablet, 60 | 60 | $5.63 | AF,BG,MQ,RF,SZ,TY,WG,ZS |
| 13952H | METFORMINmetformin hydrochloride 850 mg tablet, 60 | 60 | $11.10 | AL |
| 14005D | METHENAMINE HIPPURATEmethenamine hippurate 1 g tablet, 100 | 100 | $20.70 | AS,IL |
| 11268C | METHOTREXATEmethotrexate 15 mg/0.3 mL injection, 0.3 mL syringe | 1 | $20.55 | LM |
| 14102F | METHOTREXATEmethotrexate 15 mg/0.3 mL injection, 0.3 mL syringe | 1 | $20.55 | LM |
| 11288D | METHOTREXATEmethotrexate 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $20.55 | LM |
| 14097Y | METHOTREXATEmethotrexate 20 mg/0.4 mL injection, 0.4 mL syringe | 1 | $20.55 | LM |
| 11295L | METHOTREXATEmethotrexate 25 mg/0.5 mL injection, 0.5 mL syringe | 1 | $20.55 | LM |
| 14103G | METHOTREXATEmethotrexate 25 mg/0.5 mL injection, 0.5 mL syringe | 1 | $20.55 | LM |
| 13882P | METHOTREXATEmethotrexate 50 mg/2 mL injection, 5 x 2 mL vials | 5 | $29.82 | PF |
| 11275K | METHOTREXATEmethotrexate 7.5 mg/0.15 mL injection, 0.15 mL syringe | 1 | $20.55 | LM |
| 14091P | METHOTREXATEmethotrexate 7.5 mg/0.15 mL injection, 0.15 mL syringe | 1 | $20.55 | LM |
| 11283W | METHOTREXATEmethotrexate 10 mg/0.2 mL injection, 0.2 mL syringe | 1 | $20.55 | LM |
| 14089M | METHOTREXATEmethotrexate 10 mg/0.2 mL injection, 0.2 mL syringe | 1 | $20.55 | LM |
| 10834F | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $9.86 | LO |
| 10834F | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $5.92 | NB,XT |
| 10836H | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $10.46 | LO |
| 10836H | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $6.52 | NB,XT |
| 10839L | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $9.86 | LO |
| 10839L | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $5.92 | AS,NB,XT |
| 10840M | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $10.46 | LO |
| 10840M | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $6.52 | AS,NB,XT |
| 10843Q | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $9.74 | LO |
| 10843Q | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $5.80 | AS,NB,XT |
| 10844R | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $10.06 | LO |
| 10844R | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $6.12 | AS,NB,XT |
| 10845T | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $9.74 | LO |
| 10845T | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $5.80 | NB,XT |
| 10846W | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $11.66 | LO |
| 10846W | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $7.72 | NB,XT |
| 10848Y | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $11.66 | LO |
| 10848Y | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $7.72 | AS,NB,XT |
| 10853F | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $10.06 | LO |
| 10853F | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% ointment, 15 g | 1 | $6.12 | NB,XT |
| 11739W | METHYLPREDNISOLONEmethylprednisolone 40 mg injection [1 chamber] (&) inert substance diluent [1 mL chamber], 1 dual chamber vial | 1 | $6.88 | PF |
| 10833E | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $9.74 | LO |
| 10833E | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $5.80 | XT |
| 10835G | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $10.06 | LO |
| 10835G | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $6.12 | XT |
| 10842P | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $11.66 | LO |
| 10842P | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $7.72 | XT |
| 10851D | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $9.86 | LO |
| 10851D | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $5.92 | XT |
| 10855H | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $10.46 | LO |
| 10855H | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% cream, 15 g | 1 | $6.52 | XT |
| 10830B | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% lotion, 20 g | 1 | $6.93 | LO |
| 10838K | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% lotion, 20 g | 1 | $7.57 | LO |
| 10852E | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% lotion, 20 g | 1 | $7.17 | LO |
| 10856J | METHYLPREDNISOLONEmethylprednisolone aceponate 0.1% lotion, 20 g | 1 | $8.37 | LO |
| 13420H | METOPROLOL SUCCINATEMETOPROLOL SUCCINATE Tablet 190 mg (controlled release), 30 | 30 | $30.86 | AF,AP,CR,RW |
| 13543T | METOPROLOL SUCCINATEMETOPROLOL SUCCINATE Tablet 47.5 mg (controlled release), 30 | 30 | $20.61 | AF,AP,CR,RW |
| 13544W | METOPROLOL SUCCINATEMETOPROLOL SUCCINATE Tablet 95 mg (controlled release), 30 | 30 | $25.16 | AF,AP,CR,RW |
| 13541Q | METOPROLOL TARTRATEMETOPROLOL TARTRATE Tablet 100 mg, 60 | 60 | $5.37 | AF,RW,SZ,TX,WG,ZS |
| 13541Q | METOPROLOL TARTRATEMETOPROLOL TARTRATE Tablet 100 mg, 60 | 60 | $18.52 | AP |
| 13598Q | METOPROLOL TARTRATEMETOPROLOL TARTRATE Tablet 50 mg, 100 | 100 | $5.11 | AF,RW,SZ,TX,WG,ZS |
| 13598Q | METOPROLOL TARTRATEMETOPROLOL TARTRATE Tablet 50 mg, 100 | 100 | $18.26 | AP |
| 14366D | MIANSERINmianserin hydrochloride 10 mg tablet, 50 | 50 | $10.20 | AF |
| 14505K | MIANSERINmianserin hydrochloride 20 mg tablet, 50 | 50 | $18.85 | AF |
| 14270C | MIDAZOLAMmidazolam 10 mg/mL oral liquid, 1 mL syringe | 1 | $135.37 | IX |
| 14299N | MIDAZOLAMmidazolam 10 mg/mL oral liquid, 1 mL syringe | 1 | $135.37 | IX |
| 14292F | MIDAZOLAMmidazolam 5 mg/0.5 mL oral liquid, 0.5 mL syringe | 1 | $135.37 | IX |
| 14293G | MIDAZOLAMmidazolam 5 mg/0.5 mL oral liquid, 0.5 mL syringe | 1 | $135.37 | IX |
| 14238J | MIDAZOLAMmidazolam 7.5 mg/0.75 mL oral liquid, 0.75 mL syringe | 1 | $135.37 | IX |
| 14291E | MIDAZOLAMmidazolam 7.5 mg/0.75 mL oral liquid, 0.75 mL syringe | 1 | $135.37 | IX |
| 3092R | MILK POWDER SYNTHETIC LOW CALCIUMmilk powder synthetic low calcium powder for oral liquid, 400 g | 1 | $44.49 | SB |
| 8630F | MILK PROTEIN AND FAT FORMULA WITH VITAMINS AND MINERALS CARBOHYDRATE FREEmilk protein and fat formula with vitamins and minerals carbohydrate free powder for oral liquid, 225 g | 1 | $37.54 | SB |
| 14483G | MINOCYCLINEminocycline 50 mg tablet, 60 | 60 | $11.55 | AF |
| 14483G | MINOCYCLINEminocycline 50 mg tablet, 60 | 60 | $14.78 | AS |
| 14041B | MINOXIDILminoxidil 10 mg tablet, 100 | 100 | $33.32 | PF |
| 14507M | MIRTAZAPINEmirtazapine 15 mg tablet, 30 | 30 | $5.34 | AF,BG,RF,SZ,TY,WG |
| 14369G | MIRTAZAPINEmirtazapine 15 mg orally disintegrating tablet, 30 | 30 | $6.54 | RF |
| 14473R | MIRTAZAPINEmirtazapine 30 mg tablet, 30 | 30 | $6.16 | AF,BG,RF,SZ,TY,VO,WG |
| 14473R | MIRTAZAPINEmirtazapine 30 mg tablet, 30 | 30 | $12.17 | AL |
| 14370H | MIRTAZAPINEmirtazapine 30 mg orally disintegrating tablet, 30 | 30 | $7.10 | RF |
| 14561J | MIRTAZAPINEmirtazapine 45 mg tablet, 30 | 30 | $7.51 | AF,BG,RF,SZ,TY,WG |
| 14475W | MIRTAZAPINEmirtazapine 45 mg orally disintegrating tablet, 30 | 30 | $9.47 | RF |
| 14560H | MOCLOBEMIDEmoclobemide 150 mg tablet, 60 | 60 | $9.00 | AF,SZ,WG,XT |
| 14560H | MOCLOBEMIDEmoclobemide 150 mg tablet, 60 | 60 | $11.03 | GO |
| 14442D | MOCLOBEMIDEmoclobemide 300 mg tablet, 60 | 60 | $13.41 | AF,SZ,WG,XT |
| 14442D | MOCLOBEMIDEmoclobemide 300 mg tablet, 60 | 60 | $15.44 | GO |
| 8816B | MODAFINILmodafinil 100 mg tablet, 60 | 60 | $62.66 | AL,GQ,RW,SZ,TX,WG |
| 8816B | MODAFINILmodafinil 100 mg tablet, 60 | 60 | $68.06 | TB |
| 9386B | MODIFIED LONG CHAIN AMYLOPECTINmodified long chain amylopectin powder for oral liquid, 30 x 60 g sachets | 1 | $160.91 | VF |
| 10792B | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $7.77 | AL |
| 10792B | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $4.24 | AF,AS |
| 10809X | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $8.49 | AL |
| 10809X | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $4.96 | AF,AS |
| 10815F | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $8.09 | AL |
| 10815F | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $4.56 | AF,AS |
| 10818J | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $7.89 | AL |
| 10818J | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $4.36 | AF,AS |
| 10827W | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $9.69 | AL |
| 10827W | MOMETASONEmometasone furoate 0.1% cream, 15 g | 1 | $6.16 | AF,AS |
| 10804P | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $10.69 | AL |
| 10804P | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $6.19 | AF,EO |
| 10805Q | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $10.93 | AL |
| 10805Q | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $6.43 | AF,EO |
| 10819K | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $12.13 | AL |
| 10819K | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $7.63 | AF,EO |
| 10826T | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $11.33 | AL |
| 10826T | MOMETASONEmometasone furoate 0.1% lotion, 30 mL | 1 | $6.83 | AF,EO |
| 10791Y | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $7.77 | AL |
| 10791Y | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $4.24 | AF,AS,EO |
| 10793C | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $7.89 | AL |
| 10793C | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $4.36 | AF,AS,EO |
| 10812C | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $9.69 | AL |
| 10812C | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $6.16 | AF,AS,EO |
| 10814E | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $8.49 | AL |
| 10814E | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $4.96 | AF,AS,EO |
| 10828X | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $8.09 | AL |
| 10828X | MOMETASONEmometasone furoate 0.1% ointment, 15 g | 1 | $4.56 | AF,AS,EO |
| 14526M | MONTELUKASTmontelukast 4 mg chewable tablet, 28 | 28 | $6.80 | AF,AL,GX,HQ,RF,SZ,TX,WG |
| 14553Y | MONTELUKASTmontelukast 5 mg chewable tablet, 28 | 28 | $6.70 | AF,AL,GX,HQ,RF,SZ,TX,WG |
| 12009C | MORPHINEmorphine sulfate pentahydrate 30 mg tablet, 20 | 20 | $21.16 | RW |
| 12067D | MORPHINEmorphine sulfate pentahydrate 30 mg tablet, 20 | 20 | $21.16 | RW |
| 13747M | MORPHINEmorphine sulfate 2 mg/mL oral solution, 100 mL | 100 | $48.12 | DZ |
| 13753W | MORPHINEmorphine sulfate 2 mg/mL oral solution, 100 mL | 100 | $48.12 | DZ |
| 13749P | MORPHINEmorphine sulfate 2 mg/mL oral solution, 500 mL | 500 | $115.24 | DZ |
| 13750Q | MORPHINEmorphine sulfate 10 mg/5 mL oral solution, 100 mL | 100 | $67.35 | LM |
| 13740E | MORPHINEmorphine sulfate 10 mg/5 mL oral solution, 300 mL | 300 | $103.89 | LM |
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