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 |
|---|---|---|---|---|
| 13555K | PERINDOPRILperindopril arginine 10 mg tablet, 30 | 30 | $6.78 | RX,SZ,TX,WG,XT |
| 13555K | PERINDOPRILperindopril arginine 10 mg tablet, 30 | 30 | $16.70 | SE |
| 13494F | PERINDOPRILperindopril arginine 2.5 mg tablet, 30 | 30 | $5.11 | RX,SZ,TX,WG,XT |
| 13494F | PERINDOPRILperindopril arginine 2.5 mg tablet, 30 | 30 | $14.85 | SE |
| 13585B | PERINDOPRILperindopril arginine 5 mg tablet, 30 | 30 | $5.80 | RX,SZ,TX,WG,XT |
| 13585B | PERINDOPRILperindopril arginine 5 mg tablet, 30 | 30 | $15.25 | SE |
| 13372T | PERINDOPRILperindopril erbumine 8 mg tablet, 30 | 30 | $6.78 | AF,AL,IB,RW,SZ,TX,WG |
| 13404L | PERINDOPRILperindopril erbumine 2 mg tablet, 30 | 30 | $5.11 | AF,AL,IB,RW,SZ,TX,WG |
| 13371R | PERINDOPRILperindopril erbumine 4 mg tablet, 30 | 30 | $5.80 | AL |
| 13382H | PERINDOPRIL + AMLODIPINEperindopril arginine 10 mg + amlodipine 10 mg tablet, 30 | 30 | $8.36 | RX,TX,WG,XT |
| 13382H | PERINDOPRIL + AMLODIPINEperindopril arginine 10 mg + amlodipine 10 mg tablet, 30 | 30 | $20.21 | SE |
| 13478J | PERINDOPRIL + AMLODIPINEperindopril arginine 10 mg + amlodipine 5 mg tablet, 30 | 30 | $7.67 | RX,TX,WG,XT |
| 13478J | PERINDOPRIL + AMLODIPINEperindopril arginine 10 mg + amlodipine 5 mg tablet, 30 | 30 | $19.21 | SE |
| 13381G | PERINDOPRIL + AMLODIPINEperindopril arginine 5 mg + amlodipine 10 mg tablet, 30 | 30 | $6.84 | RX,TX,WG,XT |
| 13381G | PERINDOPRIL + AMLODIPINEperindopril arginine 5 mg + amlodipine 10 mg tablet, 30 | 30 | $18.23 | SE |
| 13508Y | PERINDOPRIL + AMLODIPINEperindopril arginine 5 mg + amlodipine 5 mg tablet, 30 | 30 | $6.16 | RX,TX,WG,XT |
| 13508Y | PERINDOPRIL + AMLODIPINEperindopril arginine 5 mg + amlodipine 5 mg tablet, 30 | 30 | $17.24 | SE |
| 13476G | PERINDOPRIL + INDAPAMIDEperindopril erbumine 4 mg + indapamide hemihydrate 1.25 mg tablet, 30 | 30 | $6.16 | AF,AL,GX,RW,SZ,TX,WG |
| 13506W | PERINDOPRIL + INDAPAMIDEperindopril arginine 5 mg + indapamide hemihydrate 1.25 mg tablet, 30 | 30 | $13.30 | SE |
| 13506W | PERINDOPRIL + INDAPAMIDEperindopril arginine 5 mg + indapamide hemihydrate 1.25 mg tablet, 30 | 30 | $6.16 | RX |
| 13413Y | PERINDOPRIL + INDAPAMIDEperindopril arginine 2.5 mg + indapamide hemihydrate 625 microgram tablet, 30 | 30 | $12.97 | SE |
| 13413Y | PERINDOPRIL + INDAPAMIDEperindopril arginine 2.5 mg + indapamide hemihydrate 625 microgram tablet, 30 | 30 | $5.11 | RX |
| 13148B | PHENELZINEphenelzine 15 mg tablet, 60 | 60 | $82.82 | DZ |
| 1166J | PHENOXYBENZAMINEphenoxybenzamine hydrochloride 10 mg capsule, 30 | 1 | $223.22 | GH |
| 13968E | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg capsule, 50 | 50 | $6.52 | AF,IL |
| 5012T | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 150 mg/5 mL oral liquid, 100 mL | 1 | $8.25 | AF |
| 9143F | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 150 mg/5 mL oral liquid, 100 mL | 1 | $8.25 | AF |
| 5024K | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 125 mg/5 mL powder for oral liquid, 100 mL | 1 | $6.16 | AE |
| 8976K | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 125 mg/5 mL powder for oral liquid, 100 mL | 1 | $6.16 | AE |
| 5029Q | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg/5 mL powder for oral liquid, 100 mL | 1 | $6.89 | AE |
| 8977L | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg/5 mL powder for oral liquid, 100 mL | 1 | $6.89 | AE |
| 14044E | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg tablet, 25 | 25 | $3.89 | AF |
| 1703P | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg tablet, 25 | 25 | $5.09 | AF |
| 1787C | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg tablet, 25 | 25 | $5.09 | AF |
| 3360W | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 250 mg tablet, 25 | 25 | $5.09 | AF |
| 3028J | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 500 mg tablet, 25 | 25 | $6.09 | AF |
| 3361X | PHENOXYMETHYLPENICILLINphenoxymethylpenicillin 500 mg tablet, 25 | 25 | $6.09 | AF |
| 9384X | PHENYLALANINE WITH CARBOHYDRATEphenylalanine with carbohydrate containing 50 mg phenylalanine powder for oral liquid, 30 x 4 g sachets | 1 | $109.92 | VF |
| 13841L | PHENYTOINphenytoin 30 mg/5 mL oral liquid, 500 mL | 1 | $15.52 | UJ |
| 13894G | PHENYTOINphenytoin 50 mg chewable tablet, 200 | 200 | $54.68 | UJ |
| 13972J | PHENYTOINphenytoin sodium 100 mg capsule, 200 | 200 | $22.72 | UJ |
| 14015P | PHENYTOINphenytoin sodium 30 mg capsule, 200 | 200 | $41.97 | UJ |
| 13850Y | PHOSPHORUSphosphorus 500 mg effervescent tablet, 100 | 100 | $71.68 | FG |
| 14355M | PILOCARPINEpilocarpine hydrochloride 1% eye drops, 15 mL | 1 | $7.71 | NV |
| 14523J | PILOCARPINEpilocarpine hydrochloride 2% eye drops, 15 mL | 1 | $8.80 | NV |
| 14550T | PILOCARPINEpilocarpine hydrochloride 4% eye drops, 15 mL | 1 | $11.28 | NV |
| 13898L | PIOGLITAZONEpioglitazone 15 mg tablet, 28 | 28 | $9.04 | AF,EW,TX,XT |
| 13921Q | PIOGLITAZONEpioglitazone 30 mg tablet, 28 | 28 | $12.63 | AF,EW,TX,XT |
| 14057W | PIOGLITAZONEpioglitazone 45 mg tablet, 28 | 28 | $15.70 | AF,EW,TX |
| 11406H | PIRFENIDONEpirfenidone 267 mg tablet, 90 | 90 | $169.57 | AF,RZ,SZ,XT |
| 13866T | PIZOTIFENpizotifen 500 microgram tablet, 100 | 100 | $14.01 | AE |
| 13100L | POLYETHYLENE GLYCOL-400 + PROPYLENE GLYCOLpolyethylene glycol-400 0.4% + propylene glycol 0.3% eye drops, 30 x 0.8 mL unit doses | 1 | $12.87 | AQ |
| 13113E | POLYETHYLENE GLYCOL-400 + PROPYLENE GLYCOLpolyethylene glycol-400 0.4% + propylene glycol 0.3% eye drops, 30 x 0.8 mL unit doses | 1 | $12.87 | AQ |
| 14520F | POLYETHYLENE GLYCOL-400 + PROPYLENE GLYCOLpolyethylene glycol-400 0.4% + propylene glycol 0.3% eye drops, 30 x 0.8 mL unit doses | 1 | $11.67 | AQ |
| 14421B | POLYETHYLENE GLYCOL-400 + PROPYLENE GLYCOLpolyethylene glycol-400 0.4% + propylene glycol 0.3% eye drops, 15 mL | 1 | $4.92 | AQ,PP |
| 9475Q | POLYLACTIC ACIDpolylactic acid 150 mg injection, 1 vial | 1 | $189.35 | GA |
| 9476R | POLYLACTIC ACIDpolylactic acid 150 mg injection, 1 vial | 1 | $189.35 | GA |
| 13357B | POTASSIUM CHLORIDEpotassium chloride 600 mg (potassium 8 mmol) modified release tablet, 200 | 200 | $14.23 | AS |
| 13486T | POTASSIUM CHLORIDE + POTASSIUM BICARBONATE + POTASSIUM CARBONATEpotassium chloride 595 mg + potassium bicarbonate 384 mg + potassium carbonate 152 mg (total potassium 14 mmol) effervescent tablet, 60 | 60 | $14.76 | AS |
| 14324X | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 375 microgram modified release tablet, 30 | 30 | $10.16 | BY,RW,TX |
| 14459B | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 750 microgram modified release tablet, 30 | 30 | $17.67 | BY,RW,TX |
| 14532W | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 1 mg tablet, 100 | 100 | $67.63 | AF,BY,RW,TX |
| 14360T | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 1.5 mg modified release tablet, 30 | 30 | $32.94 | BY,RW,TX |
| 14556D | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 2.25 mg modified release tablet, 30 | 30 | $48.20 | BY,RW,TX |
| 14329E | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 250 microgram tablet, 100 | 100 | $17.18 | AF,BY,RW,TX |
| 14460C | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 3 mg modified release tablet, 30 | 30 | $69.86 | BY,RW,TX |
| 14461D | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 3.75 mg modified release tablet, 30 | 30 | $85.88 | BY,RW,TX |
| 14325Y | PRAMIPEXOLEpramipexole dihydrochloride monohydrate 4.5 mg modified release tablet, 30 | 30 | $104.83 | BY,RW,TX |
| 13496H | PRAVASTATINpravastatin sodium 10 mg tablet, 30 | 30 | $5.11 | RF,SZ,TY,WG |
| 13496H | PRAVASTATINpravastatin sodium 10 mg tablet, 30 | 30 | $8.04 | AF |
| 13496H | PRAVASTATINpravastatin sodium 10 mg tablet, 30 | 30 | $10.06 | RW |
| 13497J | PRAVASTATINpravastatin sodium 20 mg tablet, 30 | 30 | $5.38 | AF,RF,SZ,TY,WG |
| 13497J | PRAVASTATINpravastatin sodium 20 mg tablet, 30 | 30 | $10.36 | RW |
| 13432Y | PRAVASTATINpravastatin sodium 40 mg tablet, 30 | 30 | $6.20 | AF,RF,SZ,TY,WG |
| 13432Y | PRAVASTATINpravastatin sodium 40 mg tablet, 30 | 30 | $11.18 | RW |
| 13527Y | PRAVASTATINpravastatin sodium 80 mg tablet, 30 | 30 | $8.24 | RF,TY |
| 13527Y | PRAVASTATINpravastatin sodium 80 mg tablet, 30 | 30 | $13.39 | RW |
| 13553H | PRAZOSINprazosin 1 mg tablet, 100 | 100 | $6.53 | PF,TX |
| 13400G | PRAZOSINprazosin 2 mg tablet, 100 | 100 | $8.28 | PF,TX |
| 13367M | PRAZOSINprazosin 5 mg tablet, 100 | 100 | $12.96 | PF,TX |
| 13888Y | PREDNISOLONEprednisolone 1 mg tablet, 100 | 100 | $6.50 | AS |
| 13888Y | PREDNISOLONEprednisolone 1 mg tablet, 100 | 100 | $5.50 | LN |
| 14045F | PREDNISOLONEprednisolone 5 mg tablet, 60 | 60 | $5.94 | AS,IL |
| 13837G | PREDNISOLONE SODIUM PHOSPHATEprednisolone (as sodium phosphate) 5 mg/mL oral liquid, 30 mL | 1 | $8.79 | LN |
| 13837G | PREDNISOLONE SODIUM PHOSPHATEprednisolone (as sodium phosphate) 5 mg/mL oral liquid, 30 mL | 1 | $10.86 | AS |
| 1920C | PREDNISOLONE SODIUM PHOSPHATEprednisolone (as sodium phosphate) 20 mg/100 mL enema, 7 x 100 mL | 7 | $43.46 | AS |
| 2554K | PREDNISOLONE SODIUM PHOSPHATEprednisolone (as sodium phosphate) 5 mg suppository, 10 | 1 | $10.70 | AS |
| 14043D | PREDNISONEprednisone 1 mg tablet, 100 | 100 | $6.44 | AS |
| 14043D | PREDNISONEprednisone 1 mg tablet, 100 | 100 | $5.44 | LN |
| 13944X | PREDNISONEprednisone 5 mg tablet, 60 | 60 | $5.85 | AS,IL |
| 13942T | PROBENECIDprobenecid 500 mg tablet, 100 | 100 | $65.37 | FF |
| 14108M | PROCHLORPERAZINEprochlorperazine maleate 5 mg tablet, 250 | 250 | $137.36 | OJ |
| 14129P | PROCHLORPERAZINEprochlorperazine maleate 5 mg tablet, 250 | 250 | $137.36 | OJ |
| 12465C | PROGESTERONEprogesterone 200 mg pessary, 15 | 15 | $39.89 | ON |
| 1948M | PROMETHAZINEpromethazine hydrochloride 50 mg/2 mL injection, 5 x 2 mL ampoules | 5 | $13.99 | PF |
| 3374N | PROMETHAZINEpromethazine hydrochloride 50 mg/2 mL injection, 5 x 2 mL ampoules | 5 | $13.99 | PF |
| 13927B | PROPANTHELINEpropantheline bromide 15 mg tablet, 100 | 100 | $6.71 | RW |
| 1953T | PROPANTHELINEpropantheline bromide 15 mg tablet, 100 | 100 | $7.91 | RW |
| 13386M | PROPRANOLOLpropranolol hydrochloride 10 mg tablet, 100 | 100 | $5.69 | TX,WG |
| 13386M | PROPRANOLOLpropranolol hydrochloride 10 mg tablet, 100 | 100 | $8.68 | AF |
| 13386M | PROPRANOLOLpropranolol hydrochloride 10 mg tablet, 100 | 100 | $14.17 | IX |
| 13542R | PROPRANOLOLpropranolol hydrochloride 40 mg tablet, 100 | 100 | $5.96 | TX,WG |
| 13542R | PROPRANOLOLpropranolol hydrochloride 40 mg tablet, 100 | 100 | $8.95 | AF |
| 13542R | PROPRANOLOLpropranolol hydrochloride 40 mg tablet, 100 | 100 | $14.44 | IX |
| 13836F | PROPYLTHIOURACILpropylthiouracil 50 mg tablet, 100 | 100 | $16.93 | FF |
| 1955X | PROPYLTHIOURACILpropylthiouracil 50 mg tablet, 100 | 100 | $18.13 | FF |
| 10658Y | PROTEIN FORMULA WITH AMINO ACIDS, CARBOHYDRATES, VITAMINS AND MINERALS WITHOUT PHENYLALANINE, AND SUPPLEMENTED WITH DOCOSAHEXAENOIC ACIDprotein formula with amino acids, carbohydrates, vitamins and minerals without phenylalanine, and supplemented with docosahexaenoic acid oral liquid, 30 x 130 mL pouches | 1 | $363.60 | OH |
| 11939J | PROTEIN FORMULA WITH CARBOHYDRATE, FAT, VITAMINS AND MINERALSprotein formula with carbohydrate, fat, vitamins and minerals oral liquid, 12 x 500 mL bottles | 1 | $225.01 | NU |
| 12191P | PROTEIN FORMULA WITH VITAMINS AND MINERALS, AND LOW IN POTASSIUM, PHOSPHORUS, CALCIUM, CHLORIDE AND VITAMIN Aprotein formula with vitamins and minerals, and low in potassium, phosphorus, calcium, chloride and vitamin A oral liquid, 24 x 125 mL bottles | 1 | $165.11 | VF |
| 8259Q | PROTEIN HYDROLYSATE FORMULA WITH MEDIUM CHAIN TRIGLYCERIDESprotein hydrolysate formula with medium chain triglycerides powder for oral liquid, 450 g | 1 | $24.25 | NU |
| 14392L | PYRIDOSTIGMINEpyridostigmine bromide 10 mg tablet, 50 | 50 | $7.65 | IL |
| 2724J | PYRIDOSTIGMINEpyridostigmine bromide 10 mg tablet, 50 | 50 | $8.85 | IL |
| 14462E | PYRIDOSTIGMINEpyridostigmine bromide 180 mg modified release tablet, 50 | 50 | $43.01 | IL |
| 2608G | PYRIDOSTIGMINEpyridostigmine bromide 180 mg modified release tablet, 50 | 50 | $43.41 | IL |
| 14529Q | PYRIDOSTIGMINEpyridostigmine bromide 60 mg tablet, 150 | 150 | $39.68 | IL |
| 13982X | QUINAGOLIDEquinagolide 75 microgram tablet, 30 | 30 | $64.88 | FP |
| 14502G | RABEPRAZOLErabeprazole sodium 10 mg enteric tablet, 28 | 28 | $5.98 | RW,SZ,TX,WG |
| 14502G | RABEPRAZOLErabeprazole sodium 10 mg enteric tablet, 28 | 28 | $10.99 | JC |
| 12286P | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $5.98 | AF,AL,RN,RW,SZ,TX,VO,WG |
| 12286P | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $10.99 | JC |
| 14396Q | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $4.78 | AF,AL,RN,RW,SZ,TX,VO,WG |
| 14396Q | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $9.79 | JC |
| 14433P | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $5.98 | AF,AL,RN,RW,SZ,TX,VO,WG |
| 14433P | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $10.99 | JC |
| 14463F | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $5.98 | AF,AL,RN,RW,SZ,TX,VO,WG |
| 14463F | RABEPRAZOLErabeprazole sodium 20 mg enteric tablet, 30 | 30 | $10.99 | JC |
| 13426P | RALOXIFENEraloxifene hydrochloride 60 mg tablet, 28 | 28 | $23.33 | LY |
| 13426P | RALOXIFENEraloxifene hydrochloride 60 mg tablet, 28 | 28 | $19.24 | GQ,RF,ZS |
| 13431X | RAMIPRILramipril 1.25 mg capsule, 30 | 30 | $5.11 | AF |
| 13430W | RAMIPRILramipril 10 mg capsule, 30 | 30 | $6.16 | AF,RF,SW,SZ,TX,TY,WA,WG |
| 13405M | RAMIPRILramipril 2.5 mg capsule, 30 | 30 | $5.11 | AF,TX |
| 13556L | RAMIPRILramipril 5 mg capsule, 30 | 30 | $5.11 | AF,TX |
| 13582W | RAMIPRILramipril 1.25 mg tablet, 30 | 30 | $5.11 | AF,AL,RF,SW,SZ,WA,WG |
| 13368N | RAMIPRILramipril 10 mg tablet, 30 | 30 | $6.16 | AF,AL,SW,SZ,TX,WG |
| 13466R | RAMIPRILramipril 2.5 mg tablet, 30 | 30 | $5.11 | AF,AL,RF,SW,SZ,TX,WA,WG |
| 13526X | RAMIPRILramipril 5 mg tablet, 30 | 30 | $5.11 | AF,AL,RF,SW,SZ,TX,WA,WG |
| 13563W | RAMIPRIL + FELODIPINEramipril 2.5 mg + felodipine 2.5 mg modified release tablet, 30 | 30 | $6.70 | SW |
| 13534H | RAMIPRIL + FELODIPINEramipril 5 mg + felodipine 5 mg modified release tablet, 30 | 30 | $8.30 | SW |
| 14458Y | RASAGILINErasagiline 1 mg tablet, 30 | 30 | $22.47 | CR,EV,HQ,RW,SZ,WG |
| 14458Y | RASAGILINErasagiline 1 mg tablet, 30 | 30 | $25.03 | TB |
| 14474T | REBOXETINEreboxetine 4 mg tablet, 60 | 60 | $29.11 | PF |
| 12200D | RIFAMPICINrifampicin 150 mg capsule, 10 | 10 | $18.65 | AF |
| 12189M | RIFAMPICINrifampicin 300 mg capsule, 10 | 10 | $8.51 | AF |
| 14393M | RILUZOLEriluzole 50 mg tablet, 56 | 56 | $127.81 | CR,SW,SZ |
| 11662T | RILUZOLEriluzole 50 mg/10 mL oral liquid, 300 mL | 1 | $98.44 | CS |
| 14429K | RILUZOLEriluzole 50 mg/10 mL oral liquid, 300 mL | 1 | $98.49 | CS |
| 13488X | RISEDRONATErisedronate sodium 150 mg tablet, 1 | 1 | $24.54 | TT,TX |
| 13459J | RISEDRONATErisedronate sodium 35 mg tablet, 4 | 4 | $22.82 | SZ,TX,WG |
| 13364J | RISEDRONATErisedronate sodium 35 mg enteric tablet, 4 | 4 | $22.82 | TT |
| 13360E | RISEDRONATErisedronate sodium 5 mg tablet, 28 | 28 | $26.41 | TT |
| 8780D | RISPERIDONErisperidone 25 mg modified release injection [1 vial] (&) inert substance diluent [2 mL syringe], 1 pack | 1 | $88.95 | JC |
| 8781E | RISPERIDONErisperidone 37.5 mg modified release injection [1 vial] (&) inert substance diluent [2 mL syringe], 1 pack | 1 | $115.85 | JC |
| 8782F | RISPERIDONErisperidone 50 mg modified release injection [1 vial] (&) inert substance diluent [2 mL syringe], 1 pack | 1 | $142.47 | JC |
| 11872W | RISPERIDONErisperidone 500 microgram tablet, 20 | 20 | $4.51 | JC |
| 11873X | RISPERIDONErisperidone 500 microgram tablet, 20 | 20 | $4.51 | JC |
| 1842Y | RISPERIDONErisperidone 500 microgram tablet, 20 | 20 | $4.51 | JC |
| 1846E | RISPERIDONErisperidone 500 microgram tablet, 20 | 20 | $4.51 | JC |
| 13521P | RIVAROXABANrivaroxaban 10 mg tablet, 30 | 30 | $42.44 | AF,AL,TB |
| 13462M | RIVAROXABANrivaroxaban 20 mg tablet, 28 | 28 | $37.21 | AF,AL,TB |
| 13366L | RIVAROXABANrivaroxaban 2.5 mg tablet, 60 | 60 | $37.74 | AF,TB |
| 13463N | RIVAROXABANrivaroxaban 15 mg tablet, 28 | 28 | $37.65 | AF,AL,TB |
| 10551H | RIZATRIPTANrizatriptan 10 mg orally disintegrating tablet, 2 | 2 | $6.70 | GX,RF,WG |
| 9313E | RIZATRIPTANrizatriptan 10 mg wafer, 2 | 2 | $8.66 | AL |
| 9313E | RIZATRIPTANrizatriptan 10 mg wafer, 2 | 2 | $8.07 | AF |
| 13586C | ROSUVASTATINrosuvastatin 10 mg tablet, 30 | 30 | $6.16 | AF,BG,CR,GQ,GX,RA,RW,SZ,TX,TY,WG |
| 13586C | ROSUVASTATINrosuvastatin 10 mg tablet, 30 | 30 | $11.10 | FK |
| 13588E | ROSUVASTATINrosuvastatin 20 mg tablet, 30 | 30 | $6.22 | AF,BG,CR,GQ,GX,RA,RW,SZ,TX,TY,WG |
| 13588E | ROSUVASTATINrosuvastatin 20 mg tablet, 30 | 30 | $11.16 | FK |
| 13589F | ROSUVASTATINrosuvastatin 40 mg tablet, 30 | 30 | $7.84 | AF,BG,CR,GQ,GX,RA,RW,SZ,TX,TY,WG |
| 13589F | ROSUVASTATINrosuvastatin 40 mg tablet, 30 | 30 | $12.78 | FK |
| 13406N | ROSUVASTATINrosuvastatin 5 mg tablet, 30 | 30 | $5.11 | AF,BG,CR,GQ,GX,RA,RW,SZ,TX,TY,WG |
| 13406N | ROSUVASTATINrosuvastatin 5 mg tablet, 30 | 30 | $10.04 | FK |
| 14327C | ROTIGOTINErotigotine 2 mg/24 hours patch, 28 | 28 | $60.93 | UC |
| 14326B | ROTIGOTINErotigotine 4 mg/24 hours patch, 28 | 28 | $81.26 | UC |
| 14431M | ROTIGOTINErotigotine 6 mg/24 hours patch, 28 | 28 | $92.22 | UC |
| 14359R | ROTIGOTINErotigotine 8 mg/24 hours patch, 28 | 28 | $102.55 | UC |
| 11993F | ROXITHROMYCINroxithromycin 300 mg tablet, 5 | 5 | $5.42 | RW,SZ,TX,TY |
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