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Utah State Maximum Allowable Cost List
as of 10/7/2013
SMAC disputes MUST be submitted to Goold Health Systems for review within 30 days of the date of service.
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
0.08635 06/25/2012All NDCs
*Alcohol Swabs*** 0.02172 06/25/2012All NDCs
*Amino Acid Electrolyte Infusion 8.5%*** 0.01724 06/25/2012All NDCs
*Amino Acid Infusion 8.5%*** 0.01608 06/25/2012All NDCs
*Amino Acids-Protein Hydrolysate Liquid*** 0.02209 06/25/2012All NDCs
*Artificial Tear Ophth Ointment*** 1.06197 06/25/2012All NDCs
*B-Complex Vitamin Cap** 0.03480 06/25/2012All NDCs
*B-Complex Vitamin Inj** 1.15600 06/25/2012All NDCs
*B-Complex w/ C & E + Zn Tab*** 0.17500 06/25/2012All NDCs
*B-Complex w/ C & E Tab*** 0.17500 06/25/2012All NDCs
*B-Complex w/ C & Folic Acid Cap 1 MG*** 0.20388 06/25/2012All NDCs
*B-Complex w/ C & Folic Acid Tab 0.8 MG*** 0.08100 06/25/2012All NDCs
*B-Complex w/ C & Folic Acid Tab 1 MG*** 0.16536 06/25/2012All NDCs
*B-Complex w/ C & Folic Acid Tab*** 0.17500 06/25/2012All NDCs
*B-Complex w/ C + MG Zn Cap*** 0.17500 06/25/2012All NDCs
*B-Complex w/ C Cap** 0.17500 06/25/2012All NDCs
*B-Complex w/ C Tab CR** 0.17500 06/25/2012All NDCs
*B-Complex w/ C Tab** 0.17500 06/25/2012All NDCs
*B-Complex w/ Folic Acid Tab** 0.02460 06/25/2012All NDCs
*B-Complex w/Biotin & Folic Acid Tab*** 0.17500 06/25/2012All NDCs
*Cod Liver Oil Cap*** 0.02388 06/25/2012All NDCs
*Diaper Rash Products - Ointment** 0.05506 06/25/2012All NDCs
*Emollient - Ointment** 0.02154 06/25/2012All NDCs
*Flavoring Agent - Concentrate** 0.06980 06/25/2012All NDCs
*Gelatin Capsules (Empty)** 0.01152 06/25/2012All NDCs
*Hexavitamins Tab*** 0.17500 06/25/2012All NDCs
*Hydroquinone Cream 4% w/ Sunscreens*** 0.90793 06/25/2012All NDCs
*Hydroquinone Gel 4% w/ Sunscreens*** 0.95069 06/25/2012All NDCs
*Iron w/ Vitamin Tab** 0.17500 06/25/2012All NDCs
*L-Methylfolate w/ Vit B6-Vit B12 Tab 3-35-2
MG***
1.30000 06/25/2012All NDCs
*Lactobacillus - Packet** 0.62000 06/25/2012All NDCs
*Lactobacillus Acidophilus-Pectin Cap** 0.02736 06/25/2012All NDCs
*Lactobacillus Chew Tab** 0.10800 06/25/2012All NDCs
*Lactobacillus Tab** 0.03360 06/25/2012All NDCs
*Masks*** 11.52000 06/25/2012All NDCs
Page 1 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
*Menthol-Methyl Salicylate Cream*** 0.05774 06/25/2012All NDCs
*Mesalamine Rectal Enema 4 GM & Cleanser
Wipe Kit**
164.20800 06/25/2012All NDCs
*Mineral Oil-Hydrophilic Petrolatum
Ointment***
0.02180 06/25/2012All NDCs
*Misc. Devices** 0.07056 06/25/2012All NDCs
*Multiple Vitamin Cap** 0.17500 06/25/2012All NDCs
*Multiple Vitamin Inj** 0.17500 06/25/2012All NDCs
*Multiple Vitamin Liquid** 0.17500 06/25/2012All NDCs
*Multiple Vitamin Tab** 0.01056 06/25/2012All NDCs
*Multiple Vitamins w/ Calcium Tab** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Iron Tab** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals & FA Tab 1.25
MG***
0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals & FA Tab 2.8
MG***
0.16366 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals Cap** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals Chew Tab** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals Liquid** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals Pack** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals Tab CR** 0.17500 06/25/2012All NDCs
*Multiple Vitamins w/ Minerals Tab** 0.16366 06/25/2012All NDCs
*Neomycin-Bacitracin-Polymyxin Oint*** 0.18903 0.10583 01/01/2013All NDCs
*Nystatin Topical Powder** 1.46000 0.95562 07/01/2013All NDCs
*Omega-3 Fatty Acids Cap 1000 MG** 0.04584 06/25/2012All NDCs
*Omega-3 Fatty Acids Cap 500 MG** 0.03452 06/25/2012All NDCs
*Oral Electrolyte Solution*** 0.00527 06/25/2012All NDCs
*Oral Vehicles*** 0.01897 06/25/2012All NDCs
*Pediatric Multiple Vitamin Liq** 0.17500 06/25/2012All NDCs
*Pediatric Multiple Vitamin w/ C & FA Chew
Tab**
0.02460 06/25/2012All NDCs
*Pediatric Multiple Vitamin w/ C Liqd 60
MG/5ML**
0.17500 06/25/2012All NDCs
*Pediatric Multiple Vitamin w/ C Soln 35
MG/ML**
0.09480 06/25/2012All NDCs
*Pediatric Multiple Vitamin w/ Minerals & C
Chew Tab 60 MG**
0.04840 06/25/2012All NDCs
*Pediatric Multiple Vitamins w/ Fl-Fe Chew
Tab 1-12 MG**
0.07140 06/25/2012All NDCs
*Pediatric Multiple Vitamins w/ Fluoride Chew
Tab 0.25 MG***
0.22680 0.18049 01/01/2013All NDCs
*Pediatric Multiple Vitamins w/ Fluoride Chew
Tab 0.5 MG***
0.22680 06/25/2012All NDCs
*Pediatric Multiple Vitamins w/ Fluoride Chew
Tab 1 MG***
0.22680 06/25/2012All NDCs
Page 2 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
*Pediatric Multiple Vitamins w/ Fluoride Soln
0.25 MG/ML***
0.23600 06/25/2012All NDCs
*Pediatric Multiple Vitamins w/ Iron Chew Tab
15 MG**
0.02472 06/25/2012All NDCs
*Pediatric Multiple Vitamins w/ Iron Drops 10
MG/ML**
0.07968 06/25/2012All NDCs
*Pediatric Vitamins ACD Fluoride & Fe Drops
0.25-10 MG/ML***
0.18540 06/25/2012All NDCs
*Pediatric Vitamins ACD w/ Fluoride Soln 0.25
MG/ML***
0.14960 06/25/2012All NDCs
*Pediatric Vitamins ADC Drops 1500 Unit-400
Unit-35 MG/ML***
0.09480 06/25/2012All NDCs
*Prenat Vit-Fe Poly Cmplx-Fe Heme Poly-FA
Tab 22-6-1 MG***
0.17500 11/21/2012All NDCs
*Prenat w/FE Cbn-L Methylfol-FA-CA-DSS
Tab & DHA Cap Pack***
0.17500 11/28/2012All NDCs
*Prenat w/Fe Poly-Na Fered-FA Tab 25-1 &
Omega Cap DR 400MG*
0.17500 06/25/2012All NDCs
*Prenat w/Fe Poly-Na Fered-FA Tab 25-1 &
Omega Cap DR 430MG*
0.17500 06/25/2012All NDCs
*Prenat w/FeCbn-FA-DSS Tab 29-1 MG &
Omega 3 Cap 387 MG Pak*
0.17500 12/05/2012All NDCs
*Prenat w/o A w/ Fe Asp Gly-FA-DSS-Omega
Ther Pak 30-1 MG***
0.17500 11/21/2012All NDCs
*Prenat w/o A w/ Fe Cbn-DSS-Methylfol-FA
Tab 90-0.6-0.4MG***
0.17500 11/28/2012All NDCs
*Prenat w/o A w/ Fe Chelate-L Methylfol-FA
Tab & DHA Cap Pk*
0.17500 11/21/2012All NDCs
*Prenat w/o A w/FeCbn-Methylf-FA-DHA Cap
29-0.6-0.4-350 MG**
0.17500 12/05/2012All NDCs
*Prenat w/o A w/FeFum-Methfol-FA-DHA Cap
30-0.6-0.4-200 MG**
0.17500 11/28/2012All NDCs
*Prenat-Fe Poly Cmplx-Fe Hem Poly-FA-DHA
Cap 11-3-0.5-100MG*
0.17500 12/05/2012All NDCs
*Prenatal Multivitamins & Minerals w/ Fe & FA
Tab 0.25 MG***
0.17500 12/05/2012All NDCs
*Prenatal Multivitamins & Minerals w/ Iron &
FA Cap 0.1MG***
0.17500 12/05/2012All NDCs
*Prenatal Multivitamins & Minerals w/ Iron &
FA Cap 1 MG***
0.17500 11/28/2012All NDCs
*Prenatal Multivitamins & Minerals w/Iron &
FA Tab 0.8 MG***
0.17500 11/20/2012All NDCs
*Prenatal MV w/FeCbn-FeGl-DSS-FA Tab &
DHA Cap 275 MG Pack*
0.17500 11/28/2012All NDCs
*Prenatal MV & Min w/Fe Bisg-FA Tab & DHA
Cap 200 MG Pack***
0.17500 12/05/2012All NDCs
*Prenatal MV w/Fe Fum-FA Tab 28-1 MG &
DHA Cap 250 MG Pack *
0.17500 11/21/2012All NDCs
Page 3 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
*Prenatal MV-Min w/Fe-FA Tab & Ca Chew
Tab Therapy Pack***
0.17500 11/28/2012All NDCs
*Prenatal Vit w/ Docusate-Iron-FA Tab 65-1
MG***
0.17500 11/28/2012All NDCs
*Prenatal Vit w/ DSS-Fe Fumarate-FA Tab
CR 90-1 MG***
0.17500 11/21/2012All NDCs
*Prenatal Vit w/ DSS-Iron Carbonyl-FA Tab
29-1 MG***
0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Bisglyc-Fe Prot Succ-FA
Tab 29-1 MG***
0.17500 12/05/2012All NDCs
*Prenatal Vit w/ Fe Bisglycinate Chelate-FA
Tab 25-1 MG***
0.17500 12/05/2012All NDCs
*Prenatal Vit w/ Fe Bisglycinate Chelate-FA
Tab 28-1 MG***
0.36170 0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Fum-FA-Omega 3 Cap
28-1.25-200 MG***
0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Fum-Fe Bisglycin-FA
Chew Tab 28-1 MG***
0.17500 11/28/2012All NDCs
*Prenatal Vit w/ Fe Fumarate-FA Cap
13.5-0.4 MG***
0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Fumarate-FA Tab 14-0.4
MG***
0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Fumarate-FA Tab 17-1
MG***
0.17500 12/05/2012All NDCs
*Prenatal Vit w/ Fe Fumarate-FA Tab 27-0.8
MG***
0.17500 06/25/2012All NDCs
*Prenatal Vit w/ Fe Fumarate-FA Tab 28-0.8
MG***
0.17500 11/07/2012All NDCs
*Prenatal Vit w/ Fe Fumarate-FA Tab 75-1
MG***
0.17500 11/28/2012All NDCs
*Prenatal Vit w/ Fe Gluc-Fe Fum-FA Tab
20-0.8 MG***
0.17500 12/05/2012All NDCs
*Prenatal Vit w/ Fe Gluconate-FA Tab 30-0.8
MG***
0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Polysac Cmplx-FA Tab
60-1 MG***
0.21089 0.17500 11/21/2012All NDCs
*Prenatal Vit w/ Fe Sulfate-FA Tab 27-0.8
MG***
0.17500 11/28/2012All NDCs
*Prenatal Vit w/ Iron Carbonyl-FA Tab 65-1
MG***
0.17500 11/28/2012All NDCs
*Prenatal Vit w/ Iron Carbonyl-Fe Sulf-FA Tab
60-1MG***
0.17500 11/21/2012All NDCs
*Prenatal Vitamin Fast Dissolving Tab** 0.17500 11/21/2012All NDCs
*Prenatal w/ Fe Carbonyl-Fe
Bisglyc-FA-Omega Cap 27-1 MG***
0.17500 06/25/2012All NDCs
*Prenatal w/ Fe Cbnyl-Fe Asp-Fe
Glyc-FA-Omega Cap 20-7-1 MG*
0.17500 12/05/2012All NDCs
*Prenatal w/ Fe PolyCmplx-Methylfol-FA Tab
29-1.13-0.4 MG***
0.17500 11/21/2012All NDCs
Page 4 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
*Prenatal w/Fe Fum-FA Tab 27-0.8 MG &
DHA Cap 200 MG Pack *
0.17500 11/21/2012All NDCs
*Prenatal w/Fe Fumarate-FA-DSS-Fish Oil
Cap 27-1-710 MG***
0.17500 12/05/2012All NDCs
*Prenatal w/FE Polys Cmplx-FA-Ca Tab &
Omega 3 Cap Pack***
0.17500 11/21/2012All NDCs
*Prenatal w/o A Vit w/ Fe Carbonyl-FA Tab
29-1 MG***
0.17500 06/25/2012All NDCs
*Prenatal w/o A Vit w/ Fe Fumarate-FA Tab
DR 30-1 MG***
0.17500 11/21/2012All NDCs
*Prenatal w/o A w/Fe Cbn-DSS-FA Tab &
DHA Cap 250 MG Pack***
0.17500 11/28/2012All NDCs
*Prenatal w/o A w/Fe Cbn-DSS-FA-DHA Cap
29-1-265 MG***
0.17500 01/16/2013All NDCs
*Prenatal w/o A w/FeCbn-Fe Asp
Glyc-FA-Fish Cap 50-1-476 MG*
0.17500 08/08/2012All NDCs
*Prenatal without A w/ Fe
Carbonyl-Docusate-FA Tab 90-1MG***
0.17500 11/21/2012All NDCs
*Salicylic Acid Cream 6% & Cleanser Liqd
Kit**
159.08400 06/25/2012All NDCs
*Salicylic Acid Lotion 6% & Cleanser Liqd Kit** 0.15324 06/25/2012All NDCs
*Skin Protectants Misc - Cream*** 0.04067 06/25/2012All NDCs
*Skin Protectants Misc - Lotion*** 0.01319 06/25/2012All NDCs
*Sodium Phosphates - Enema*** 0.00587 06/25/2012All NDCs
*Sodium Phosphates - Soln*** 0.06454 06/25/2012All NDCs
*Sodium Polystyrene Sulfonate Powder** 0.23821 06/25/2012All NDCs
*Speciality Vitamin Product Cap** 0.17500 06/25/2012All NDCs
*Speciality Vitamin Product Tab** 0.17500 06/25/2012All NDCs
*Throat Lozenges - Lozenges** 0.04000 06/25/2012All NDCs
*Vitamins A & D Cap*** 0.17500 06/25/2012All NDCs
*Vitamins A & D Oint** 0.02947 06/25/2012All NDCs
*Vitamins A & D Tab*** 0.17500 06/25/2012All NDCs
*Vitamins w/ Lipotropics Cap** 0.17500 06/25/2012All NDCs
*Vitamins w/ Lipotropics Tab** 0.04140 06/25/2012All NDCs
*Witch Hazel (Hamamelis Virginiana)
Cleansing Pads**
0.05508 06/25/2012All NDCs
*Wound Dressings - Emulsion*** 0.66373 06/25/2012All NDCs
1ST CHOICE MIS LANCETS
(08517015722)
0.03553 10/14/2011Specific NDC
1ST CHOICE MIS LANCETS
(08517030722)
0.03171 10/14/2011Specific NDC
1ST CHOICE MIS LANCETS
(08517035722)
0.03553 10/14/2011Specific NDC
1ST CHOICE MIS LANCETS
(08517065722)
0.04248 10/14/2011Specific NDC
Page 5 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Acarbose Tab 100 MG 0.89594 06/25/2012All NDCs
Acarbose Tab 25 MG 0.69478 06/25/2012All NDCs
Acarbose Tab 50 MG 0.50063 09/01/2012All NDCs
ACCU-CHEK MIS MLTICLIX
(50924045001)
0.09087 10/14/2011Specific NDC
ACCU-CHEK MIS MLTICLIX
(50924098101)
0.07156 10/14/2011Specific NDC
Acebutolol HCl Cap 200 MG 0.42883 06/25/2012All NDCs
Acebutolol HCl Cap 400 MG 0.62782 06/25/2012All NDCs
Acetaminophen Cap 500 MG 0.03746 06/25/2012All NDCs
Acetaminophen Chew Tab 160 MG 0.14065 06/25/2012All NDCs
Acetaminophen Chew Tab 80 MG 0.04600 06/25/2012All NDCs
Acetaminophen Dispersible Tab 160 MG 0.08750 06/25/2012All NDCs
Acetaminophen Dispersible Tab 80 MG 0.05600 06/25/2012All NDCs
Acetaminophen Elixir 160 MG/5ML 0.02761 06/25/2012All NDCs
Acetaminophen Liquid 160 MG/5ML 0.00895 06/25/2012All NDCs
Acetaminophen Soln 100 MG/ML 0.15450 06/25/2012All NDCs
Acetaminophen Soln 160 MG/5ML 0.01327 06/25/2012All NDCs
Acetaminophen Suppos 120 MG 0.50792 06/25/2012All NDCs
Acetaminophen Suppos 325 MG 0.62900 06/25/2012All NDCs
Acetaminophen Suppos 650 MG 0.33210 06/25/2012All NDCs
Acetaminophen Susp 160 MG/5ML 0.02172 08/27/2012All NDCs
Acetaminophen Susp 80 MG/0.8ML 0.00000 0.17584 10/01/2012All NDCs
Acetaminophen Tab 325 MG 0.01429 06/25/2012All NDCs
Acetaminophen Tab 500 MG 0.01080 06/25/2012All NDCs
Acetaminophen Tab CR 650 MG 0.05786 06/25/2012All NDCs
Acetaminophen w/ Codeine Soln 120-12
MG/5ML
0.02939 06/25/2012All NDCs
Acetaminophen w/ Codeine Tab 300-15 MG 0.14028 06/25/2012All NDCs
Acetaminophen w/ Codeine Tab 300-30 MG 0.19985 06/25/2012All NDCs
Acetaminophen w/ Codeine Tab 300-60 MG 0.32034 06/25/2012All NDCs
Acetaminophen-Caffeine-Dihydrocodeine Tab
712.8-60-32 MG
1.68336 06/25/2012All NDCs
Acetaminophen-Isometheptene-Dichloral Cap
325-65-100 MG
1.81500 06/25/2012All NDCs
Acetazolamide Cap SR 12HR 500 MG 3.28094 2.92000 07/01/2013All NDCs
Acetazolamide Tab 250 MG 0.48103 0.57538 01/01/2013All NDCs
Acetic Acid 2% in Aluminum Acetate Otic Soln 0.92700 06/25/2012All NDCs
Acetic Acid Irrigation Soln 0.25% 0.00317 06/25/2012All NDCs
Acetic Acid Otic Soln 2% 2.06000 06/25/2012All NDCs
Acetylcysteine Inhal Soln 10% 0.39480 06/25/2012All NDCs
Acetylcysteine Inhal Soln 20% 0.25064 06/25/2012All NDCs
Page 6 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
ACTI-LANCE MIS 28G (51028000128) 0.11448 10/14/2011Specific NDC
Acyclovir Cap 200 MG 0.13822 06/25/2012All NDCs
Acyclovir Sodium For Inj 1000 MG 37.57300 06/25/2012All NDCs
Acyclovir Sodium For Inj 500 MG 0.00000 06/25/2012All NDCs
Acyclovir Sodium IV Soln 50 MG/ML 0.00000 06/25/2012All NDCs
Acyclovir Susp 200 MG/5ML 0.22489 06/25/2012All NDCs
Acyclovir Tab 400 MG 0.20811 06/25/2012All NDCs
Acyclovir Tab 800 MG 0.40942 0.33092 01/01/2013All NDCs
Adapalene Cream 0.1% 5.24000 06/25/2012All NDCs
Adapalene Gel 0.1% 4.25413 3.27622 10/01/2012All NDCs
ADVATE INJ 1000UNIT (00944294310) 1.29780 10/14/2011Specific NDC
ADVATE INJ 1500UNIT (00944294410) 1.29780 10/14/2011Specific NDC
ADVATE INJ 2000UNIT (00944294510) 1.29780 10/14/2011Specific NDC
ADVATE INJ 250UNIT (00944294110) 1.29780 10/14/2011Specific NDC
ADVATE INJ 3000UNIT (00944294610) 1.29780 10/14/2011Specific NDC
ADVATE INJ 500UNIT (00944294210) 1.29780 10/14/2011Specific NDC
ADVIL TAB 200MG (00573016151) 0.06125 10/14/2011Specific NDC
ADVIL CHILD SUS 100/5ML (00573017030) 0.03308 10/14/2011Specific NDC
ADVIL CHILD SUS 100/5ML (00573017130) 0.03308 10/14/2011Specific NDC
ADVOCATE MIS LANCETS
(94046000106)
0.01892 10/14/2011Specific NDC
ADVOCATE MIS LANCETS
(94046000109)
0.01892 10/14/2011Specific NDC
AGAMATRIX MIS 33G (08554197101) 0.04727 10/14/2011Specific NDC
Albumin, Human Inj 25% 2.19192 06/25/2012All NDCs
Albuterol Sulfate Soln Nebu 0.083% (2.5
MG/3ML)
0.10755 06/25/2012All NDCs
Albuterol Sulfate Soln Nebu 0.5% (5 MG/ML) 0.21818 06/25/2012All NDCs
Albuterol Sulfate Soln Nebu 0.63 MG/3ML
(Base Equiv)
0.42744 06/25/2012All NDCs
Albuterol Sulfate Soln Nebu 1.25 MG/3ML
(Base Equiv)
0.42744 06/25/2012All NDCs
Albuterol Sulfate Syrup 2 MG/5ML 0.04138 06/25/2012All NDCs
Albuterol Sulfate Tab 2 MG 0.21326 06/25/2012All NDCs
Albuterol Sulfate Tab 4 MG 0.13327 06/25/2012All NDCs
Albuterol Sulfate Tab SR 12HR 4 MG 0.94206 1.22780 07/29/2013All NDCs
Albuterol Sulfate Tab SR 12HR 8 MG 1.76632 1.93000 03/02/2013All NDCs
Alclometasone Dipropionate Oint 0.05% 0.77465 06/25/2012All NDCs
Alcohol Absolute Inj 98% 12.00000 06/25/2012All NDCs
ALDURAZYME INJ 2.9MG/5M
(58468007001)
155.00000 09/04/2012Specific NDC
Alendronate Sodium Tab 10 MG 0.22334 09/01/2012All NDCs
Alendronate Sodium Tab 35 MG 0.54375 09/01/2012All NDCs
Page 7 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Alendronate Sodium Tab 40 MG 5.09748 06/25/2012All NDCs
Alendronate Sodium Tab 5 MG 0.40149 06/25/2012All NDCs
Alendronate Sodium Tab 70 MG 0.69063 09/01/2012All NDCs
Alfuzosin HCl Tab SR 24HR 10 MG 0.40910 09/01/2012All NDCs
Allopurinol Tab 100 MG 0.07341 06/25/2012All NDCs
Allopurinol Tab 300 MG 0.16263 0.07040 01/01/2013All NDCs
ALMACONE MLT CHW (00536303501) 0.02919 10/14/2011Specific NDC
Alprazolam Orally Disintegrating Tab 0.25 MG 1.29480 06/25/2012All NDCs
Alprazolam Orally Disintegrating Tab 0.5 MG 1.61328 06/25/2012All NDCs
Alprazolam Orally Disintegrating Tab 1 MG 2.15244 06/25/2012All NDCs
Alprazolam Tab 0.25 MG 0.05742 0.02805 01/01/2013All NDCs
Alprazolam Tab 0.5 MG 0.06527 0.03100 01/01/2013All NDCs
Alprazolam Tab 1 MG 0.08276 0.03433 01/01/2013All NDCs
Alprazolam Tab 2 MG 0.16319 0.07447 01/01/2013All NDCs
Alprazolam Tab SR 24HR 0.5 MG 0.35015 09/01/2012All NDCs
Alprazolam Tab SR 24HR 1 MG 0.63512 0.47151 01/01/2013All NDCs
Alprazolam Tab SR 24HR 2 MG 2.62803 0.65607 04/03/2013All NDCs
Alprazolam Tab SR 24HR 3 MG 4.14848 06/25/2012All NDCs
Alum & Mag Hydroxide-Simethicone Chew
Tab 200-200-25 MG
0.03592 06/25/2012All NDCs
Alum & Mag Hydroxide-Simethicone Susp
200-200-20 MG/5ML
0.00630 06/25/2012All NDCs
Alum & Mag Hydroxide-Simethicone Susp
225-200-25 MG/5ML
0.00686 06/25/2012All NDCs
Alum & Mag Hydroxide-Simethicone Susp
400-400-40 MG/5ML
0.00731 06/25/2012All NDCs
Alum & Mag Hydroxide-Simethicone Susp
500-450-40 MG/5ML
0.00815 06/25/2012All NDCs
Aluminum & Magnesium Hydroxides Susp
225-200 MG/5ML
0.00527 06/25/2012All NDCs
Aluminum Chloride Soln 20% 0.14400 06/25/2012All NDCs
Aluminum Hydroxide Gel Susp 320 MG/5ML 0.00913 06/25/2012All NDCs
Aluminum Hydroxide-Magnesium Carbonate
Susp 95-358 MG/15ML
0.01302 06/25/2012All NDCs
Aluminum Hydroxide-Magnesium Trisilicate
Chew Tab 80-20 MG
0.04241 06/25/2012All NDCs
Amantadine HCl Cap 100 MG 1.66769 07/06/2012All NDCs
Amantadine HCl Syrup 50 MG/5ML 0.06135 06/25/2012All NDCs
Amantadine HCl Tab 100 MG 1.49832 06/25/2012All NDCs
Amikacin Sulfate Inj 1 GM/4ML (250 MG/ML) 0.00000 06/25/2012All NDCs
Amikacin Sulfate Inj 50 MG/ML 1.39050 06/25/2012All NDCs
Amikacin Sulfate Inj 500 MG/2ML (250
MG/ML)
0.00000 06/25/2012All NDCs
Page 8 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Amiloride & Hydrochlorothiazide Tab 5-50 MG 0.06312 06/25/2012All NDCs
Amiloride HCl Tab 5 MG 0.99629 0.72131 04/03/2013All NDCs
Aminocaproic Acid Syrup 25% 1.03550 06/25/2012All NDCs
Aminocaproic Acid Tab 500 MG 1.86000 06/25/2012All NDCs
Aminophylline Tab 100 MG 0.07341 06/25/2012All NDCs
Aminophylline Tab 200 MG 0.07902 06/25/2012All NDCs
Amiodarone HCl Tab 200 MG 0.23391 0.16891 01/01/2013All NDCs
Amiodarone HCl Tab 400 MG 3.36760 06/25/2012All NDCs
Amitriptyline HCl Tab 10 MG 0.05686 06/25/2012All NDCs
Amitriptyline HCl Tab 100 MG 0.14639 0.05150 01/01/2013All NDCs
Amitriptyline HCl Tab 150 MG 0.22726 06/25/2012All NDCs
Amitriptyline HCl Tab 25 MG 0.06107 0.02157 01/01/2013All NDCs
Amitriptyline HCl Tab 50 MG 0.07089 06/25/2012All NDCs
Amitriptyline HCl Tab 75 MG 0.13327 0.04775 01/01/2013All NDCs
Amlodipine Besylate Tab 10 MG 0.16665 06/25/2012All NDCs
Amlodipine Besylate Tab 2.5 MG 0.12064 0.02838 01/01/2013All NDCs
Amlodipine Besylate Tab 5 MG 0.12064 0.02949 01/01/2013All NDCs
Amlodipine Besylate-Benazepril HCl Cap
10-20 MG
1.05500 0.71219 07/01/2013All NDCs
Amlodipine Besylate-Benazepril HCl Cap
10-40 MG
4.89648 1.04942 10/01/2012All NDCs
Amlodipine Besylate-Benazepril HCl Cap
2.5-10 MG
2.05061 06/25/2012All NDCs
Amlodipine Besylate-Benazepril HCl Cap 5-10
MG
2.09123 0.80288 01/01/2013All NDCs
Amlodipine Besylate-Benazepril HCl Cap 5-20
MG
0.91075 0.64521 07/01/2013All NDCs
Amlodipine Besylate-Benazepril HCl Cap 5-40
MG
1.45388 1.00220 07/01/2013All NDCs
AMNESTEEM CAP 10MG (00378661193) 12.18376 12/05/2012Specific NDC
AMNESTEEM CAP 20MG (00378661293) 7.71069 12/05/2012Specific NDC
Amoxapine Tab 100 MG 1.28969 06/25/2012All NDCs
Amoxapine Tab 150 MG 2.03400 06/25/2012All NDCs
Amoxapine Tab 25 MG 0.47516 06/25/2012All NDCs
Amoxapine Tab 50 MG 0.77165 06/25/2012All NDCs
Amoxicillin & K Clavulanate Chew Tab 400-57
MG
2.66243 1.35685 01/01/2013All NDCs
Amoxicillin & K Clavulanate For Susp
200-28.5 MG/5ML
0.26654 06/25/2012All NDCs
Amoxicillin & K Clavulanate For Susp
250-62.5 MG/5ML
0.82968 06/25/2012All NDCs
Amoxicillin & K Clavulanate For Susp 400-57
MG/5ML
0.21275 09/01/2012All NDCs
Page 9 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Amoxicillin & K Clavulanate For Susp
600-42.9 MG/5ML
0.19466 0.16444 01/01/2013All NDCs
Amoxicillin & K Clavulanate Tab 250-125 MG 4.57192 06/25/2012All NDCs
Amoxicillin & K Clavulanate Tab 500-125 MG 0.81575 09/01/2012All NDCs
Amoxicillin & K Clavulanate Tab 875-125 MG 0.99092 09/01/2012All NDCs
Amoxicillin & K Clavulanate Tab SR 12HR
1000-62.5 MG
3.64500 3.16472 07/01/2013All NDCs
Amoxicillin (Trihydrate) Cap 250 MG 0.06107 06/25/2012All NDCs
Amoxicillin (Trihydrate) Cap 500 MG 0.11157 06/25/2012All NDCs
Amoxicillin (Trihydrate) Chew Tab 200 MG 0.34492 06/25/2012All NDCs
Amoxicillin (Trihydrate) Chew Tab 250 MG 0.33719 06/25/2012All NDCs
Amoxicillin (Trihydrate) Chew Tab 400 MG 0.42148 06/25/2012All NDCs
Amoxicillin (Trihydrate) For Susp 125
MG/5ML
0.01879 06/25/2012All NDCs
Amoxicillin (Trihydrate) For Susp 200
MG/5ML
0.07045 06/25/2012All NDCs
Amoxicillin (Trihydrate) For Susp 250
MG/5ML
0.02796 06/25/2012All NDCs
Amoxicillin (Trihydrate) For Susp 400
MG/5ML
0.03835 09/01/2012All NDCs
Amoxicillin (Trihydrate) Tab 500 MG 0.44220 06/25/2012All NDCs
Amoxicillin (Trihydrate) Tab 875 MG 0.22350 09/01/2012All NDCs
Amphetamine-Dextroamphetamine Cap SR
24HR 10 MG
5.88624 4.35377 07/01/2013All NDCs
Amphetamine-Dextroamphetamine Cap SR
24HR 15 MG
5.88624 4.20748 07/01/2013All NDCs
Amphetamine-Dextroamphetamine Cap SR
24HR 20 MG
4.13409 4.48000 07/11/2013All NDCs
Amphetamine-Dextroamphetamine Cap SR
24HR 25 MG
5.88624 5.35833 01/01/2013All NDCs
Amphetamine-Dextroamphetamine Cap SR
24HR 30 MG
5.88624 4.36513 07/01/2013All NDCs
Amphetamine-Dextroamphetamine Cap SR
24HR 5 MG
5.88624 4.52265 07/01/2013All NDCs
Amphetamine-Dextroamphetamine Tab 10
MG
1.19980 06/25/2012All NDCs
Amphetamine-Dextroamphetamine Tab 12.5
MG
1.06642 06/25/2012All NDCs
Amphetamine-Dextroamphetamine Tab 15
MG
1.19980 06/25/2012All NDCs
Amphetamine-Dextroamphetamine Tab 20
MG
1.23000 06/25/2012All NDCs
Amphetamine-Dextroamphetamine Tab 30
MG
1.19980 06/25/2012All NDCs
Amphetamine-Dextroamphetamine Tab 5 MG 1.36400 1.17000 07/01/2013All NDCs
Amphetamine-Dextroamphetamine Tab 7.5
MG
1.06642 06/25/2012All NDCs
Page 10 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Amphotericin B For Inj 50 MG 18.92631 06/25/2012All NDCs
Ampicillin & Sulbactam Sodium For Inj 1-0.5
GM
3.60758 06/25/2012All NDCs
Ampicillin & Sulbactam Sodium For IV Soln
10-5 GM
59.36683 06/25/2012All NDCs
Ampicillin & Sulbactam Sodium For IV Soln
2-1 GM
6.64352 06/25/2012All NDCs
Ampicillin Cap 250 MG 0.10082 06/25/2012All NDCs
Ampicillin Cap 500 MG 0.16199 06/25/2012All NDCs
Ampicillin For Susp 125 MG/5ML 0.06396 06/25/2012All NDCs
Ampicillin For Susp 250 MG/5ML 0.10876 06/25/2012All NDCs
Ampicillin Sodium For Inj 2 GM 0.00000 06/25/2012All NDCs
Anagrelide HCl Cap 0.5 MG 0.41103 06/25/2012All NDCs
Anagrelide HCl Cap 1 MG 0.82207 06/25/2012All NDCs
Anastrozole Tab 1 MG 1.61960 0.36600 01/01/2013All NDCs
ANTIOXIDANT CAP (00182446619) 0.17500 01/16/2006Specific NDC
Antipyrine-Benzocaine Otic Soln 54-14
MG/ML (5.4-1.4%)
0.82640 0.76519 01/01/2013All NDCs
APATATE FORT LIQ (00482001608) 0.17500 10/14/2011Specific NDC
AQUADEKS CAP (58914001106) 0.17500 10/14/2011Specific NDC
AQUADEKS DRO (58914021460) 0.16366 10/14/2011Specific NDC
Arginine Tab 500 MG 0.06576 06/25/2012All NDCs
Ascorbic Acid Chew Tab 500 MG 0.03300 06/25/2012All NDCs
Ascorbic Acid Inj 500 MG/ML 0.33360 06/25/2012All NDCs
Ascorbic Acid Tab 1000 MG 0.04488 06/25/2012All NDCs
Ascorbic Acid Tab 250 MG 0.01776 06/25/2012All NDCs
Ascorbic Acid Tab 500 MG 0.02104 06/25/2012All NDCs
Aspirin Buffered (Ca Carb-Mg Carb-Mg Ox)
Tab 325 MG
0.01439 06/25/2012All NDCs
Aspirin Chew Tab 81 MG 0.04484 06/25/2012All NDCs
Aspirin Tab 325 MG 0.01564 06/25/2012All NDCs
Aspirin Tab Delayed Release 325 MG 0.01929 06/25/2012All NDCs
Aspirin Tab Delayed Release 81 MG 0.02999 06/25/2012All NDCs
Aspirin-Acetaminophen-Caffeine Tab
250-250-65 MG
0.03024 06/25/2012All NDCs
ASSURE LANCE MIS LOW FLOW
(08317980125)
0.12746 10/14/2011Specific NDC
ASSURE LANCE MIS LOW FLOW
(08317980225)
0.11587 10/14/2011Specific NDC
Atenolol & Chlorthalidone Tab 100-25 MG 0.28692 06/25/2012All NDCs
Atenolol & Chlorthalidone Tab 50-25 MG 0.10493 06/25/2012All NDCs
Atenolol Tab 100 MG 0.14194 0.03778 01/01/2013All NDCs
Atenolol Tab 25 MG 0.08349 06/25/2012All NDCs
Page 11 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Atenolol Tab 50 MG 0.09305 06/25/2012All NDCs
Atorvastatin Calcium Tab 10 MG (Base
Equivalent)
0.22041 06/25/2012All NDCs
Atorvastatin Calcium Tab 20 MG (Base
Equivalent)
0.31346 06/25/2012All NDCs
Atorvastatin Calcium Tab 40 MG (Base
Equivalent)
0.31346 06/25/2012All NDCs
Atorvastatin Calcium Tab 80 MG (Base
Equivalent)
0.31346 06/25/2012All NDCs
Atropine Sulfate Inj 0.4 MG/ML 2.10000 06/25/2012All NDCs
Atropine Sulfate Ophth Soln 1% 2.75010 06/25/2012All NDCs
AURORA MIS LANCETS (32671020144) 0.05407 10/14/2011Specific NDC
AURORA LANCE MIS 30G (08214065724) 0.05400 10/14/2011Specific NDC
AURORA LANCE MIS THIN 23G
(08214015724)
0.05400 10/14/2011Specific NDC
AUTO LANCET MIS (51709000729) 0.13132 10/14/2011Specific NDC
Azathioprine Tab 50 MG 0.16100 09/01/2012All NDCs
Azelastine HCl Nasal Spray 137 MCG/SPRAY
(1 MG/ML)
2.62334 09/01/2012All NDCs
Azelastine HCl Ophth Soln 0.05% 16.65000 12.50000 10/01/2012All NDCs
Azithromycin For Susp 100 MG/5ML 0.87542 09/01/2012All NDCs
Azithromycin For Susp 200 MG/5ML 0.63798 09/01/2012All NDCs
Azithromycin Powd Pack for Susp 1 GM 21.92000 06/25/2012All NDCs
Azithromycin Tab 250 MG 0.69417 09/01/2012All NDCs
Azithromycin Tab 500 MG 1.45416 09/01/2012All NDCs
Azithromycin Tab 600 MG 6.46059 06/25/2012All NDCs
Bacitracin Oint 500 Unit/GM 0.09338 06/25/2012All NDCs
Bacitracin Ophth Oint 500 Unit/GM 12.68228 06/25/2012All NDCs
Bacitracin Zinc Oint 500 Unit/GM 0.21257 06/25/2012All NDCs
Bacitracin-Polymyxin B Ophth Oint 3.37881 06/25/2012All NDCs
Baclofen Powder 2.68800 06/25/2012All NDCs
Baclofen Tab 10 MG 0.04909 06/25/2012All NDCs
Baclofen Tab 20 MG 0.08351 06/25/2012All NDCs
Balsalazide Disodium Cap 750 MG 1.00967 0.30094 10/01/2012All NDCs
BAYER MICRLT MIS LANCETS
(00193654621)
0.07694 10/14/2011Specific NDC
BD ECLIPSE MIS 1ML/30G (08290305778) 0.39521 10/14/2011Specific NDC
BD LANCET UF MIS 30G (08290325772) 0.05121 10/14/2011Specific NDC
BD LANCET UF MIS 30G (08290325773) 0.05646 10/14/2011Specific NDC
BD LANCET UF MIS 33G (08290322057) 0.06805 10/14/2011Specific NDC
BD LANCET UF MIS 33G (08290322065) 0.06805 10/14/2011Specific NDC
BD MICROTAIN MIS LANCETS
(08290366592)
0.19660 10/14/2011Specific NDC
Page 12 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
BD MICROTAIN MIS LANCETS
(08290366593)
0.28474 10/14/2011Specific NDC
BD MICROTAIN MIS LANCETS
(08290366594)
0.28474 10/14/2011Specific NDC
BD ULT FINE MIS LANCETS
(54868580700)
0.08837 10/14/2011Specific NDC
BEBULIN VH INJ 200-1200 (64193024402) 0.43825 10/14/2011Specific NDC
Beclomethasone Dipropionate (Bulk) Powder 36.48000 06/25/2012All NDCs
Belladonna Alkaloids & Opium Suppos
16.2-30 MG
22.23600 06/25/2012All NDCs
Belladonna Alkaloids-Phenobarbital Elixir 16.2
MG/5ML
0.13480 06/25/2012All NDCs
Belladonna Alkaloids-Phenobarbital Tab 16.2
MG
0.02420 06/25/2012All NDCs
Benazepril & Hydrochlorothiazide Tab 10-12.5
MG
0.42064 0.14807 01/01/2013All NDCs
Benazepril & Hydrochlorothiazide Tab 20-12.5
MG
0.15375 09/01/2012All NDCs
Benazepril & Hydrochlorothiazide Tab 20-25
MG
0.16288 0.42070 10/10/2012All NDCs
Benazepril & Hydrochlorothiazide Tab 5-6.25
MG
0.44356 06/25/2012All NDCs
Benazepril HCl Tab 10 MG 0.07488 09/01/2012All NDCs
Benazepril HCl Tab 20 MG 0.23390 0.07370 01/01/2013All NDCs
Benazepril HCl Tab 40 MG 0.25417 0.08585 01/01/2013All NDCs
Benazepril HCl Tab 5 MG 0.24833 06/25/2012All NDCs
BENEFIX INJ 1000UNIT (58394000101) 0.78615 11/30/2011Specific NDC
BENEFIX INJ 1000UNIT (58394000105) 0.89610 10/14/2011Specific NDC
BENEFIX INJ 1000UNIT (58394000106) 0.89610 10/14/2011Specific NDC
BENEFIX INJ 250UNIT (58394000301) 0.78615 10/14/2011Specific NDC
BENEFIX INJ 250UNIT (58394000305) 0.89610 10/14/2011Specific NDC
BENEFIX INJ 250UNIT (58394000306) 0.89610 10/14/2011Specific NDC
BENEFIX INJ 500UNIT (58394000201) 0.78615 10/14/2011Specific NDC
BENEFIX INJ 500UNIT (58394000205) 0.89610 10/14/2011Specific NDC
BENEFIX INJ 500UNIT (58394000206) 0.89610 10/14/2011Specific NDC
Benzocaine Dental Gel 20% 0.26520 06/25/2012All NDCs
Benzonatate Cap 100 MG 0.13121 06/25/2012All NDCs
Benzonatate Cap 200 MG 0.23006 06/25/2012All NDCs
Benzoyl Peroxide Creamy Wash 4% &
Cleanser Lotion Kit
56.02800 06/25/2012All NDCs
Benzoyl Peroxide Gel 10% 0.28220 06/25/2012All NDCs
Benzoyl Peroxide Gel 2.5% 0.26900 06/25/2012All NDCs
Benzoyl Peroxide Gel 5% 0.27540 06/25/2012All NDCs
Benzoyl Peroxide Liq 10% 0.12121 06/25/2012All NDCs
Page 13 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Benzoyl Peroxide Liq 4% 0.27767 06/25/2012All NDCs
Benzoyl Peroxide Liq 5% 0.11090 06/25/2012All NDCs
Benzoyl Peroxide Liq 7% 0.20785 06/25/2012All NDCs
Benzoyl Peroxide Lotion 10% 0.09200 06/25/2012All NDCs
Benzoyl Peroxide Lotion 3% 0.19619 06/25/2012All NDCs
Benzoyl Peroxide Lotion 5% 0.08040 06/25/2012All NDCs
Benzoyl Peroxide Lotion 9% 0.23380 06/25/2012All NDCs
Benzoyl Peroxide-Erythromycin Gel 5-3% 0.89002 09/01/2012All NDCs
Benztropine Mesylate Inj 1 MG/ML 36.00000 06/25/2012All NDCs
Benztropine Mesylate Tab 0.5 MG 0.06986 06/25/2012All NDCs
Benztropine Mesylate Tab 1 MG 0.07930 0.04480 01/01/2013All NDCs
Benztropine Mesylate Tab 2 MG 0.11297 06/25/2012All NDCs
Beta Carotene Cap 10000 Unit 0.02580 06/25/2012All NDCs
Betamethasone Dipropionate Augmented
Cream 0.05%
0.67674 07/01/2012All NDCs
Betamethasone Dipropionate Augmented Gel
0.05%
1.45752 06/25/2012All NDCs
Betamethasone Dipropionate Augmented
Lotion 0.05%
1.61280 06/25/2012All NDCs
Betamethasone Dipropionate Augmented Oint
0.05%
3.49288 2.75652 07/01/2013All NDCs
Betamethasone Dipropionate Cream 0.05% 1.19730 06/25/2012All NDCs
Betamethasone Dipropionate Lotion 0.05% 0.14028 06/25/2012All NDCs
Betamethasone Dipropionate Oint 0.05% 1.82770 06/25/2012All NDCs
Betamethasone Valerate Cream 0.1% 0.11194 0.53433 11/06/2012All NDCs
Betamethasone Valerate Lotion 0.1% 0.75933 06/25/2012All NDCs
Betamethasone Valerate Oint 0.1% 0.64803 06/25/2012All NDCs
Betaxolol HCl Tab 10 MG 1.19280 06/25/2012All NDCs
Bethanechol Chloride Tab 10 MG 0.26267 09/01/2012All NDCs
Bethanechol Chloride Tab 25 MG 0.29575 09/01/2012All NDCs
Bethanechol Chloride Tab 5 MG 0.45723 06/25/2012All NDCs
Bethanechol Chloride Tab 50 MG 0.98721 06/25/2012All NDCs
Bicalutamide Tab 50 MG 0.49652 07/01/2012All NDCs
BIOSUPP LIQ (45737021316) 0.17500 10/14/2011Specific NDC
BIOTECT PLUS CAP (58552030860) 0.17500 12/11/2004Specific NDC
BIOTECT PLUS LIQ (45737021416) 0.17500 10/14/2011Specific NDC
Biotin Cap 5 MG 0.04582 06/25/2012All NDCs
Biotin Tab 300 MCG 0.02844 06/25/2012All NDCs
BIOVOL SYP (45737021516) 0.17500 10/14/2011Specific NDC
Bisacodyl Suppos 10 MG 0.19440 06/25/2012All NDCs
Bisacodyl Tab Delayed Release 5 MG 0.04557 06/25/2012All NDCs
Bismuth Subsalicylate Chew Tab 262 MG 0.07184 06/25/2012All NDCs
Page 14 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Bismuth Subsalicylate Susp 262 MG/15ML 0.00877 06/25/2012All NDCs
Bismuth Subsalicylate Tab 262 MG 0.07705 06/25/2012All NDCs
Bisoprolol & Hydrochlorothiazide Tab 10-6.25
MG
0.07911 06/25/2012All NDCs
Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25
MG
0.16720 0.07463 01/01/2013All NDCs
Bisoprolol & Hydrochlorothiazide Tab 5-6.25
MG
0.17889 06/25/2012All NDCs
Bisoprolol Fumarate Tab 10 MG 0.99957 06/25/2012All NDCs
Bisoprolol Fumarate Tab 5 MG 0.99957 0.78728 04/03/2013All NDCs
BL LANCETS MIS (38396032490) 0.03669 07/17/2011Specific NDC
BL LANCETS MIS THIN (38396032590) 0.03669 07/17/2011Specific NDC
BL LANCETS MIS THIN (38396032690) 0.04519 07/17/2011Specific NDC
Black Cohosh (Cimicifuga racemosa) Cap
540 MG
0.06780 06/25/2012All NDCs
Bleomycin Sulfate For Inj 15 Unit 0.00000 06/25/2012All NDCs
Bleomycin Sulfate For Inj 30 Unit 0.00000 06/25/2012All NDCs
BREVICON TAB 0.5/35 (52544025428) 2.05816 10/14/2011Specific NDC
Brimonidine Tartrate Ophth Soln 0.15% 13.20000 06/25/2012All NDCs
Brimonidine Tartrate Ophth Soln 0.2% 4.20855 1.50750 10/01/2012All NDCs
Bromfenac Sodium Ophth Soln 0.09% (Base
Equivalent)
51.36960 06/25/2012All NDCs
Bromocriptine Mesylate Cap 5 MG 4.44400 06/25/2012All NDCs
Bromocriptine Mesylate Tab 2.5 MG 0.92560 09/01/2012All NDCs
Brompheniramine & Pseudoephedrine Syrup
4-45 MG/5ML
0.09520 06/25/2012All NDCs
Budesonide Cap SR 24HR 3 MG 13.00000 11.20520 07/01/2013All NDCs
Budesonide Inhalation Susp 0.25 MG/2ML 3.38896 3.46000 09/10/2012All NDCs
Budesonide Inhalation Susp 0.5 MG/2ML 4.96000 3.80116 07/01/2013All NDCs
Bumetanide Tab 0.5 MG 0.16301 06/25/2012All NDCs
Bumetanide Tab 1 MG 0.26317 0.12488 01/01/2013All NDCs
Bumetanide Tab 2 MG 0.15000 09/01/2012All NDCs
Buprenorphine HCl SL Tab 2 MG (Base
Equiv)
1.87625 09/01/2012All NDCs
Buprenorphine HCl SL Tab 8 MG (Base
Equiv)
2.71490 2.42003 07/01/2013All NDCs
Bupropion HCl (Smoking Deterrent) Tab SR
12HR 150 MG
1.71428 0.60599 07/01/2013All NDCs
Bupropion HCl Tab 100 MG 0.55064 06/25/2012All NDCs
Bupropion HCl Tab 75 MG 0.47886 06/25/2012All NDCs
Bupropion HCl Tab SR 12HR 100 MG 0.39663 09/01/2012All NDCs
Bupropion HCl Tab SR 12HR 150 MG 0.41971 09/01/2012All NDCs
Bupropion HCl Tab SR 12HR 200 MG 0.59354 09/01/2012All NDCs
Bupropion HCl Tab SR 24HR 150 MG 0.71698 09/01/2012All NDCs
Page 15 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Bupropion HCl Tab SR 24HR 300 MG 0.98948 0.87813 01/01/2013All NDCs
Buspirone HCl Tab 10 MG 0.06677 06/25/2012All NDCs
Buspirone HCl Tab 15 MG 0.09614 06/25/2012All NDCs
Buspirone HCl Tab 30 MG 1.68461 0.73659 04/03/2013All NDCs
Buspirone HCl Tab 5 MG 0.04928 06/25/2012All NDCs
Buspirone HCl Tab 7.5 MG 1.22078 06/25/2012All NDCs
Butalbital-Acetaminophen-Caff w/ COD Cap
50-325-40-30 MG
0.78453 0.33029 10/01/2012All NDCs
Butalbital-Acetaminophen-Caffeine Cap
50-325-40 MG
0.43430 06/25/2012All NDCs
Butalbital-Acetaminophen-Caffeine Tab
50-325-40 MG
0.19104 06/25/2012All NDCs
Butalbital-Acetaminophen-Caffeine Tab
50-500-40 MG
0.40603 06/25/2012All NDCs
Butalbital-Aspirin-Caff w/ Codeine Cap
50-325-40-30 MG
0.70413 09/01/2012All NDCs
Butorphanol Tartrate Nasal Soln 10 MG/ML 7.11360 09/01/2012All NDCs
Cabergoline Tab 0.5 MG 13.78605 13.02105 07/01/2013All NDCs
Caffeine Citrate Oral Soln 60 MG/3ML (10
MG/ML Base Equiv)
11.97379 06/25/2012All NDCs
Calamine Lotion 0.01526 06/25/2012All NDCs
Calcipotriene Oint 0.005% 4.94200 06/25/2012All NDCs
Calcipotriene Soln 0.005% (50 MCG/ML) 2.27450 06/25/2012All NDCs
Calcitonin (Salmon) Nasal Soln 200 Unit/ACT 19.25251 15.97274 04/03/2013All NDCs
Calcitriol Cap 0.25 MCG 0.67178 09/01/2012All NDCs
Calcitriol Cap 0.5 MCG 1.49386 06/25/2012All NDCs
Calcitriol Oral Soln 1 MCG/ML 8.99846 01/01/2013All NDCs
Calcium Acetate (Phosphate Binder) Cap 667
MG (169 MG Ca)
0.75804 06/25/2012All NDCs
Calcium Carbonate (Antacid) Chew Tab 1000
MG
0.04290 06/25/2012All NDCs
Calcium Carbonate (Antacid) Chew Tab 500
MG
0.02059 06/25/2012All NDCs
Calcium Carbonate (Antacid) Chew Tab 750
MG
0.03371 06/25/2012All NDCs
Calcium Carbonate (Antacid) Tab 648 MG 0.00748 06/25/2012All NDCs
Calcium Carbonate (Antacid) Tab 650 MG 0.06969 06/25/2012All NDCs
Calcium Carbonate Chew Tab 1250 MG (500
MG Elemental Ca)
0.03480 06/25/2012All NDCs
Calcium Carbonate Tab 1250 MG (500 MG
Elemental Ca)
0.07099 06/25/2012All NDCs
Calcium Carbonate Tab 1500 MG (600 MG
Elemental Ca)
0.06166 06/25/2012All NDCs
Calcium Carbonate Tab 600 MG 0.05948 06/25/2012All NDCs
Page 16 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Calcium Carbonate-Cholecalciferol Tab 500
MG-400 Unit
0.01800 06/25/2012All NDCs
Calcium Carbonate-Vitamin D Tab 500
MG-200 Unit
0.01386 06/25/2012All NDCs
Calcium Carbonate-Vitamin D Tab 600
MG-200 Unit
0.01920 06/25/2012All NDCs
Calcium Carbonate-Vitamin D Tab 600
MG-400 Unit
0.02000 06/25/2012All NDCs
Calcium Citrate Tab 950 MG (200 MG
Elemental Ca)
0.03288 06/25/2012All NDCs
Calcium Citrate-Vitamin D Tab 200 MG-250
Unit (Elemental Ca)
0.04020 06/25/2012All NDCs
Calcium Citrate-Vitamin D Tab 315 MG-250
Unit (Elemental Ca)
0.03492 06/25/2012All NDCs
Calcium Gluconate Tab 500 MG 0.12707 06/25/2012All NDCs
Calcium Polycarbophil Tab 625 MG 0.07534 06/25/2012All NDCs
Calcium Tab 600 MG 0.05400 06/25/2012All NDCs
Calcium w/ Vitamin D Tab 600 MG-200 Unit 0.04980 06/25/2012All NDCs
Calcium-Magnesium-Zinc Tab 333-133-5 MG 0.02460 06/25/2012All NDCs
Capsaicin Cream 0.025% 0.12810 06/25/2012All NDCs
Capsicum Oleoresin Cream 0.025% 0.21243 06/25/2012All NDCs
Captopril & Hydrochlorothiazide Tab 25-15
MG
0.22062 06/25/2012All NDCs
Captopril & Hydrochlorothiazide Tab 25-25
MG
0.22071 06/25/2012All NDCs
Captopril & Hydrochlorothiazide Tab 50-15
MG
0.95233 0.18009 01/01/2013All NDCs
Captopril & Hydrochlorothiazide Tab 50-25
MG
0.34622 06/25/2012All NDCs
Captopril Tab 100 MG 0.10100 06/25/2012All NDCs
Captopril Tab 12.5 MG 0.02179 06/25/2012All NDCs
Captopril Tab 25 MG 0.02459 06/25/2012All NDCs
Captopril Tab 50 MG 0.03647 06/25/2012All NDCs
Carbamazepine Cap SR 12HR 200 MG 1.75000 06/25/2012All NDCs
Carbamazepine Cap SR 12HR 300 MG 1.48000 07/01/2013All NDCs
Carbamazepine Chew Tab 100 MG 0.08430 06/25/2012All NDCs
Carbamazepine Susp 100 MG/5ML 0.14000 06/25/2012All NDCs
Carbamazepine Tab 200 MG 0.07940 0.04831 01/01/2013All NDCs
Carbamazepine Tab SR 12HR 200 MG 0.93216 0.83179 04/03/2013All NDCs
Carbamazepine Tab SR 12HR 400 MG 1.59475 2.28000 07/03/2013All NDCs
Carbamide Peroxide 6.5% Otic Soln 0.09200 06/25/2012All NDCs
Carbidopa & Levodopa Tab 10-100 MG 0.17738 09/01/2012All NDCs
Carbidopa & Levodopa Tab 25-100 MG 0.15091 09/01/2012All NDCs
Carbidopa & Levodopa Tab 25-250 MG 0.21000 09/01/2012All NDCs
Page 17 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Carbidopa & Levodopa Tab CR 25-100 MG 0.27144 09/01/2012All NDCs
Carbidopa & Levodopa Tab CR 50-200 MG 0.29771 09/01/2012All NDCs
Carbinoxamine Maleate Liquid 4 MG/5ML 0.10625 06/25/2012All NDCs
Carbinoxamine Maleate Tab 4 MG 0.65832 06/25/2012All NDCs
Carbitol Liquid 0.07680 06/25/2012All NDCs
Carbonyl Iron Chew Tab 15 MG (Elemental
Iron)
0.23980 06/25/2012All NDCs
Carboplatin IV Soln 150 MG/15ML 1.29780 06/25/2012All NDCs
Carboplatin IV Soln 450 MG/45ML 1.33900 06/25/2012All NDCs
Carboplatin IV Soln 50 MG/5ML 0.93318 06/25/2012All NDCs
Carboplatin IV Soln 600 MG/60ML 1.46775 06/25/2012All NDCs
Carboxymethylcellulose Sodium Ophth Soln
0.5%
0.56240 06/25/2012All NDCs
CARDENZ TAB (17204042940) 0.17500 01/01/2011Specific NDC
CAREONE LANC MIS 28G (08214035721) 0.03514 10/14/2011Specific NDC
CAREONE LANC MIS THIN 23G
(08214015721)
0.03514 10/14/2011Specific NDC
Carisoprodol Tab 250 MG 3.17364 06/25/2012All NDCs
Carisoprodol Tab 350 MG 0.07958 06/25/2012All NDCs
Carisoprodol w/ Aspirin Tab 200-325 MG 0.25326 06/25/2012All NDCs
Carteolol HCl Ophth Soln 1% 3.42996 06/25/2012All NDCs
Carvedilol Tab 12.5 MG 0.13327 06/25/2012All NDCs
Carvedilol Tab 25 MG 0.13327 06/25/2012All NDCs
Carvedilol Tab 3.125 MG 0.13327 0.04968 01/01/2013All NDCs
Carvedilol Tab 6.25 MG 0.13327 0.04660 01/01/2013All NDCs
Castor Oil 0.03646 06/25/2012All NDCs
Cefaclor Cap 250 MG 0.80690 06/25/2012All NDCs
Cefaclor Cap 500 MG 1.32385 06/25/2012All NDCs
Cefaclor For Susp 125 MG/5ML 0.14564 06/25/2012All NDCs
Cefaclor For Susp 250 MG/5ML 0.29086 06/25/2012All NDCs
Cefaclor For Susp 375 MG/5ML 0.40757 06/25/2012All NDCs
Cefadroxil Cap 500 MG 1.34723 0.79600 07/01/2013All NDCs
Cefadroxil For Susp 250 MG/5ML 0.46968 06/25/2012All NDCs
Cefadroxil For Susp 500 MG/5ML 0.65021 06/25/2012All NDCs
Cefadroxil Tab 1 GM 5.51644 06/25/2012All NDCs
Cefazolin Sodium For Inj 1 GM 2.01623 06/25/2012All NDCs
Cefazolin Sodium For Inj 10 GM 9.73353 06/25/2012All NDCs
Cefdinir Cap 300 MG 1.93969 09/01/2012All NDCs
Cefdinir For Susp 125 MG/5ML 0.28000 0.68200 12/05/2012All NDCs
Cefdinir For Susp 250 MG/5ML 0.50120 1.03000 11/23/2012All NDCs
Cefepime HCl For Inj 1 GM 16.97280 06/25/2012All NDCs
Cefepime HCl For Inj 2 GM 13.10920 09/01/2012All NDCs
Page 18 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Cefotaxime Sodium For Inj 1 GM 2.64000 06/25/2012All NDCs
Cefoxitin Sodium For Inj 2 GM 15.01152 06/25/2012All NDCs
Cefpodoxime Proxetil For Susp 100 MG/5ML 0.80432 06/25/2012All NDCs
Cefpodoxime Proxetil For Susp 50 MG/5ML 0.44418 06/25/2012All NDCs
Cefpodoxime Proxetil Tab 100 MG 3.74895 06/25/2012All NDCs
Cefpodoxime Proxetil Tab 200 MG 6.76560 06/25/2012All NDCs
Cefprozil For Susp 125 MG/5ML 0.38157 06/25/2012All NDCs
Cefprozil For Susp 250 MG/5ML 0.69151 06/25/2012All NDCs
Cefprozil Tab 250 MG 2.23885 06/25/2012All NDCs
Cefprozil Tab 500 MG 4.30113 2.06300 10/01/2012All NDCs
Ceftazidime For Inj 1 GM 6.99600 06/25/2012All NDCs
Ceftazidime For Inj 2 GM 14.04000 06/25/2012All NDCs
Ceftazidime For Inj 6 GM 23.09010 06/25/2012All NDCs
Ceftriaxone Sodium For Inj 1 GM 3.70801 3.26525 01/01/2013All NDCs
Ceftriaxone Sodium For Inj 10 GM 32.44511 06/25/2012All NDCs
Ceftriaxone Sodium For Inj 2 GM 5.56202 06/25/2012All NDCs
Ceftriaxone Sodium For Inj 250 MG 2.23320 06/25/2012All NDCs
Ceftriaxone Sodium For Inj 500 MG 4.14000 1.71600 01/01/2013All NDCs
Ceftriaxone Sodium For IV Soln 1 GM 17.10000 06/25/2012All NDCs
Cefuroxime Axetil For Susp 125 MG/5ML 0.52923 06/25/2012All NDCs
Cefuroxime Axetil For Susp 250 MG/5ML 0.79490 06/25/2012All NDCs
Cefuroxime Axetil Tab 250 MG 0.51559 06/25/2012All NDCs
Cefuroxime Axetil Tab 500 MG 0.77271 09/01/2012All NDCs
CENTRUM CHW (00005452819) 0.17500 10/14/2011Specific NDC
CENTRUM CHW (00005452835) 0.17500 10/14/2011Specific NDC
CENTRUM CHW (00005452861) 0.17500 10/14/2011Specific NDC
CENTRUM LIQ (00005434361) 0.17500 10/14/2011Specific NDC
CENTRUM TAB (00005423918) 0.17500 10/14/2011Specific NDC
CENTRUM TAB (00005423930) 0.17500 10/14/2011Specific NDC
CENTRUM TAB (00005423936) 0.17500 10/14/2011Specific NDC
CENTRUM TAB CARDIO (00005432960) 0.17500 10/14/2011Specific NDC
CENTRUM TAB PERFORMA
(00005443013)
0.17500 10/14/2011Specific NDC
CENTRUM TAB PERFORMA
(54868036700)
0.17500 07/01/2010Specific NDC
CENTRUM TAB SILVER (00005446367) 0.17500 10/14/2011Specific NDC
CENTRUM TAB SILVER (00005475650) 0.17500 10/14/2011Specific NDC
Cephalexin Cap 250 MG 0.15431 06/25/2012All NDCs
Cephalexin Cap 500 MG 0.25531 0.12836 10/01/2012All NDCs
Cephalexin For Susp 125 MG/5ML 0.08351 06/25/2012All NDCs
Cephalexin For Susp 250 MG/5ML 0.06875 09/01/2012All NDCs
Page 19 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Cephalexin Tab 250 MG 0.88451 06/25/2012All NDCs
Cephalexin Tab 500 MG 1.73829 06/25/2012All NDCs
Cetirizine HCl Chew Tab 10 MG 4.31240 06/25/2012All NDCs
Cetirizine HCl Chew Tab 5 MG 0.90960 06/25/2012All NDCs
Cetirizine HCl Syrup 1 MG/ML (5 MG/5ML) 0.05662 07/01/2012All NDCs
Cetirizine HCl Tab 10 MG 0.05921 06/25/2012All NDCs
Cetirizine HCl Tab 5 MG 0.36219 06/25/2012All NDCs
Cetirizine-Pseudoephedrine Tab SR 12HR
5-120 MG
0.60190 06/25/2012All NDCs
Cherry Syrup 0.02596 06/25/2012All NDCs
CHEW-12 CHW (11694084601) 0.17500 07/01/2010Specific NDC
CHILD-MULTI CHW VITAMINS
(41163023031)
0.17500 10/14/2011Specific NDC
Chloral Hydrate Syrup 500 MG/5ML 0.00000 06/25/2012All NDCs
Chlordiazepoxide HCl Cap 10 MG 0.08211 06/25/2012All NDCs
Chlordiazepoxide HCl Cap 25 MG 0.09258 06/25/2012All NDCs
Chlordiazepoxide HCl Cap 5 MG 0.10652 06/25/2012All NDCs
Chlordiazepoxide-Amitriptyline Tab 10-25 MG 0.91503 06/25/2012All NDCs
Chlordiazepoxide-Amitriptyline Tab 5-12.5 MG 0.64851 06/25/2012All NDCs
Chlorhexidine Gluconate Liquid 4% 0.04871 06/25/2012All NDCs
Chlorhexidine Gluconate Soln 0.12% 0.01019 06/25/2012All NDCs
Chloroquine Phosphate Tab 500 MG 4.03200 2.02760 04/03/2013All NDCs
Chlorothiazide Tab 250 MG 0.11440 06/25/2012All NDCs
Chlorothiazide Tab 500 MG 0.19506 06/25/2012All NDCs
Chlorphen Tan & Phenyleph Tan Tab 9-25
MG
1.13844 06/25/2012All NDCs
Chlorpheniramine & Phenylephrine Liquid
1-3.5 MG/ML
1.07120 06/25/2012All NDCs
Chlorpheniramine & Phenylephrine Syrup
4-12.5 MG/5ML
0.10850 06/25/2012All NDCs
Chlorpheniramine & Pseudoephedrine Cap
CR 8-120 MG
1.06605 06/25/2012All NDCs
Chlorpheniramine & Pseudoephedrine Tab
4-60 MG
0.93403 06/25/2012All NDCs
Chlorpheniramine Maleate Tab 4 MG 0.05149 06/25/2012All NDCs
Chlorpromazine HCl Tab 10 MG 0.40963 06/25/2012All NDCs
Chlorpromazine HCl Tab 100 MG 1.83700 06/25/2012All NDCs
Chlorpromazine HCl Tab 200 MG 2.55200 06/25/2012All NDCs
Chlorpromazine HCl Tab 25 MG 0.85833 1.14400 06/11/2013All NDCs
Chlorpromazine HCl Tab 50 MG 1.15000 1.53000 07/03/2013All NDCs
Chlorpropamide Tab 250 MG 0.45985 06/25/2012All NDCs
Chlorthalidone Tab 25 MG 0.34809 06/25/2012All NDCs
Chlorthalidone Tab 50 MG 0.42928 06/25/2012All NDCs
Page 20 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Chlorzoxazone Tab 500 MG 0.07079 06/25/2012All NDCs
Cholecalciferol Cap 1000 Unit 0.08267 06/25/2012All NDCs
Cholecalciferol Cap 2000 Unit 0.06120 06/25/2012All NDCs
Cholecalciferol Cap 5000 Unit 0.02460 06/25/2012All NDCs
Cholecalciferol Oral Liquid 400 Unit/ML 0.13080 06/25/2012All NDCs
Cholecalciferol Tab 1000 Unit 0.01968 06/25/2012All NDCs
Cholecalciferol Tab 2000 Unit 0.02892 06/25/2012All NDCs
Cholecalciferol Tab 400 Unit 0.01500 06/25/2012All NDCs
Cholestyramine Light Powder 4 GM/DOSE 0.20507 06/25/2012All NDCs
Cholestyramine Light Powder Packets 4 GM 1.19401 1.09552 04/03/2013All NDCs
Cholestyramine Powder 4 GM/DOSE 0.11393 06/25/2012All NDCs
Cholestyramine Powder Packets 4 GM 1.19401 06/25/2012All NDCs
Choline & Magnesium Salicylates Tab 1000
MG
0.54526 06/25/2012All NDCs
Choline & Magnesium Salicylates Tab 500
MG
0.48303 06/25/2012All NDCs
Choline & Magnesium Salicylates Tab 750
MG
0.40498 06/25/2012All NDCs
Ciclopirox Gel 0.77% 2.59440 06/25/2012All NDCs
Ciclopirox Olamine Cream 0.77% (Base
Equiv)
0.29222 09/01/2012All NDCs
Ciclopirox Olamine Susp 0.77% (Base Equiv) 1.40285 06/25/2012All NDCs
Ciclopirox Shampoo 1% 1.17880 06/25/2012All NDCs
Ciclopirox Solution 8% 1.48998 06/25/2012All NDCs
Cilostazol Tab 100 MG 0.65165 0.31265 04/03/2013All NDCs
Cilostazol Tab 50 MG 0.26421 06/25/2012All NDCs
Cimetidine HCl Soln 300 MG/5ML 0.10652 06/25/2012All NDCs
Cimetidine Tab 200 MG 0.10163 06/25/2012All NDCs
Cimetidine Tab 300 MG 0.06541 06/25/2012All NDCs
Cimetidine Tab 400 MG 0.14477 0.06235 01/01/2013All NDCs
Cimetidine Tab 800 MG 0.25952 06/25/2012All NDCs
Ciprofloxacin HCl (Bulk) Powder 0.21120 06/25/2012All NDCs
Ciprofloxacin HCl Ophth Soln 0.3% 2.15533 1.37809 01/01/2013All NDCs
Ciprofloxacin HCl Tab 100 MG (Base Equiv) 2.60333 06/25/2012All NDCs
Ciprofloxacin HCl Tab 250 MG (Base Equiv) 0.18660 06/25/2012All NDCs
Ciprofloxacin HCl Tab 500 MG (Base Equiv) 0.23313 06/25/2012All NDCs
Ciprofloxacin HCl Tab 750 MG (Base Equiv) 0.44891 0.34600 01/01/2013All NDCs
Ciprofloxacin-Ciprofloxacin HCl Tab SR 24HR
500 MG (Base Eq)
9.40680 06/25/2012All NDCs
Cisplatin Inj 100 MG/100ML (1 MG/ML) 2.81972 06/25/2012All NDCs
Cisplatin Inj 200 MG/200ML (1 MG/ML) 2.82206 06/25/2012All NDCs
Cisplatin Inj 50 MG/50ML (1 MG/ML) 0.00000 06/25/2012All NDCs
Page 21 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Citalopram Hydrobromide Oral Soln 10
MG/5ML
0.29216 0.23515 04/03/2013All NDCs
Citalopram Hydrobromide Tab 10 MG (Base
Equiv)
0.17117 0.06607 01/01/2013All NDCs
Citalopram Hydrobromide Tab 20 MG (Base
Equiv)
0.04439 09/01/2012All NDCs
Citalopram Hydrobromide Tab 40 MG (Base
Equiv)
0.18613 0.05839 01/01/2013All NDCs
CITRANATAL CAP HARMONY
(00178079730)
0.45000 10/02/2013Specific NDC
CITRANATAL MIS 90 DHA (00178082930) 0.45000 10/02/2013Specific NDC
CITRANATAL PAK ASSURE
(00178089330)
0.16366 0.45000 10/02/2013Specific NDC
CITRANATAL TAB RX (00178085990) 0.16366 10/14/2011Specific NDC
Citric Acid Powder 0.02326 06/25/2012All NDCs
CLARAVIS CAP 10MG (00555105456) 12.18376 12/05/2012Specific NDC
CLARAVIS CAP 10MG (00555105486) 12.18376 12/05/2012Specific NDC
CLARAVIS CAP 20MG (00555105556) 7.71069 12/05/2012Specific NDC
CLARAVIS CAP 20MG (00555105586) 7.71069 12/05/2012Specific NDC
Clarithromycin For Susp 125 MG/5ML 0.39551 06/25/2012All NDCs
Clarithromycin For Susp 250 MG/5ML 0.75272 06/25/2012All NDCs
Clarithromycin Tab 250 MG 1.24552 06/25/2012All NDCs
Clarithromycin Tab 500 MG 3.09633 2.89944 07/01/2013All NDCs
Clarithromycin Tab SR 24HR 500 MG 3.28121 2.99121 07/01/2013All NDCs
CLARITIN SYP 5MG/5ML (11523716301) 0.06671 10/14/2011Specific NDC
CLARITIN SYP 5MG/5ML (11523719701) 0.06559 10/14/2011Specific NDC
CLARITIN SYP 5MG/5ML (41100008035) 0.06671 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523716001) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523716002) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523716003) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523716005) 0.09876 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523723701) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523723703) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523723705) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (11523723706) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100008016) 0.09876 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100008018) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100008022) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100080247) 0.09876 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100080317) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100080510) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (41100080614) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (49999012310) 0.72600 10/14/2011Specific NDC
Page 22 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
CLARITIN TAB 10MG (54569549500) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (54868524700) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (55289042104) 0.04224 07/01/2010Specific NDC
CLARITIN TAB 10MG (55289042105) 0.04224 07/01/2010Specific NDC
CLARITIN TAB 10MG (55289042107) 0.04224 07/01/2010Specific NDC
CLARITIN TAB 10MG (67544015230) 0.72600 10/14/2011Specific NDC
CLARITIN TAB 10MG (67544015253) 0.72600 07/01/2010Specific NDC
CLARITIN TAB 10MG (67544015260) 0.72600 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(11523716101)
1.00000 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(11523716102)
0.98880 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(11523716103)
1.00000 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(41100008043)
0.98880 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(41100008049)
1.00000 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(41100080289)
1.00000 10/14/2011Specific NDC
CLARITIN-D TAB 10-240MG
(57866799001)
1.00000 07/01/2010Specific NDC
CLARITIN-D TAB 5-120MG (00247121307) 0.80000 06/17/2011Specific NDC
CLARITIN-D TAB 5-120MG (00247121315) 0.80000 06/17/2011Specific NDC
CLARITIN-D TAB 5-120MG (11523716201) 0.85902 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (11523716202) 0.72847 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (11523716203) 0.59894 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (11523716204) 0.80000 07/01/2010Specific NDC
CLARITIN-D TAB 5-120MG (41100008099) 0.80000 07/01/2010Specific NDC
CLARITIN-D TAB 5-120MG (41100080208) 0.80000 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (41100080217) 0.80000 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (41100080319) 0.80000 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (52959044315) 0.80000 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (52959044320) 0.80000 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (52959044330) 0.80000 10/14/2011Specific NDC
CLARITIN-D TAB 5-120MG (55289063610) 0.80000 09/23/2011Specific NDC
CLARITIN-D TAB 5-120MG (57866340102) 0.80000 07/01/2010Specific NDC
CLARITIN-D TAB 5-120MG (57866351002) 0.80000 07/01/2010Specific NDC
Clemastine Fumarate Tab 1.34 MG (1 MG
Base Equiv)
0.20892 06/25/2012All NDCs
Clemastine Fumarate Tab 2.68 MG 0.54059 06/25/2012All NDCs
Clidinium & Chlordiazepoxide Cap 2.5-5 MG 0.94800 06/25/2012All NDCs
Clindamycin HCl Cap 150 MG 0.27592 0.11401 01/01/2013All NDCs
Page 23 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Clindamycin HCl Cap 300 MG 1.36874 0.57412 10/01/2012All NDCs
Clindamycin Palmitate HCl For Soln 75
MG/5ML (Base Equiv)
0.56448 06/25/2012All NDCs
Clindamycin Phosphate Foam 1% 2.64036 06/25/2012All NDCs
Clindamycin Phosphate Gel 1% 1.56310 1.71000 03/18/2013All NDCs
Clindamycin Phosphate Inj 300 MG/2ML 1.15083 06/25/2012All NDCs
Clindamycin Phosphate Inj 600 MG/4ML 0.80804 06/25/2012All NDCs
Clindamycin Phosphate Inj 9 GM/60ML 0.80804 06/25/2012All NDCs
Clindamycin Phosphate Inj 900 MG/6ML 0.80804 06/25/2012All NDCs
Clindamycin Phosphate IV Soln 600 MG/4ML 1.17839 06/25/2012All NDCs
Clindamycin Phosphate IV Soln 900 MG/6ML 1.01005 06/25/2012All NDCs
Clindamycin Phosphate Lotion 1% 0.46530 1.32133 01/16/2013All NDCs
Clindamycin Phosphate Soln 1% 0.19265 1.08190 02/22/2013All NDCs
Clindamycin Phosphate Swab 1% 0.58919 06/25/2012All NDCs
Clindamycin Phosphate Vaginal Cream 2% 0.93762 1.73000 06/20/2013All NDCs
Clindamycin Phosphate-Benzoyl Peroxide Gel
1-5%
3.25704 06/25/2012All NDCs
Clobetasol Propionate Cream 0.05% 0.33091 06/25/2012All NDCs
Clobetasol Propionate Emollient Base Cream
0.05%
0.68134 0.52017 04/03/2013All NDCs
Clobetasol Propionate Foam 0.05% 2.02272 07/01/2012All NDCs
Clobetasol Propionate Gel 0.05% 0.43394 06/25/2012All NDCs
Clobetasol Propionate Oint 0.05% 0.36406 06/25/2012All NDCs
Clobetasol Propionate Soln 0.05% 0.15656 06/25/2012All NDCs
Clomipramine HCl Cap 25 MG 0.26428 9.28570 07/29/2013All NDCs
Clomipramine HCl Cap 50 MG 7.45000 8.65000 07/26/2013All NDCs
Clomipramine HCl Cap 75 MG 0.58688 9.28572 06/19/2013All NDCs
Clonazepam Orally Disintegrating Tab 0.125
MG
1.00334 0.63766 07/01/2013All NDCs
Clonazepam Orally Disintegrating Tab 0.25
MG
1.00334 06/25/2012All NDCs
Clonazepam Orally Disintegrating Tab 0.5 MG 1.00167 06/25/2012All NDCs
Clonazepam Orally Disintegrating Tab 1 MG 1.14471 06/25/2012All NDCs
Clonazepam Orally Disintegrating Tab 2 MG 1.58607 06/25/2012All NDCs
Clonazepam Tab 0.5 MG 0.02138 09/01/2012All NDCs
Clonazepam Tab 1 MG 0.07294 0.03311 01/01/2013All NDCs
Clonazepam Tab 2 MG 0.04350 09/01/2012All NDCs
Clonidine HCl Powder 21.88800 06/25/2012All NDCs
Clonidine HCl Tab 0.1 MG 0.04554 09/01/2012All NDCs
Clonidine HCl Tab 0.2 MG 0.13186 0.07607 01/01/2013All NDCs
Clonidine HCl Tab 0.3 MG 0.16974 0.05804 01/01/2013All NDCs
Clonidine HCl TD Patch Weekly 0.1
MG/24HR
22.52250 20.65000 07/01/2013All NDCs
Page 24 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Clonidine HCl TD Patch Weekly 0.2
MG/24HR
36.66719 35.66700 07/01/2013All NDCs
Clonidine HCl TD Patch Weekly 0.3
MG/24HR
48.85524 47.65066 07/01/2013All NDCs
Clopidogrel Bisulfate Tab 75 MG (Base Equiv) 0.26000 06/25/2012All NDCs
Clorazepate Dipotassium Tab 15 MG 0.25756 06/25/2012All NDCs
Clorazepate Dipotassium Tab 3.75 MG 0.12878 0.18590 07/31/2013All NDCs
Clorazepate Dipotassium Tab 7.5 MG 0.18208 06/25/2012All NDCs
Clotrimazole Cream 1% 0.78000 06/25/2012All NDCs
Clotrimazole Crystals 1.96800 06/25/2012All NDCs
Clotrimazole Soln 1% 0.44189 06/25/2012All NDCs
Clotrimazole Troche 10 MG 0.60471 09/01/2012All NDCs
Clotrimazole Vaginal Cream 1% 0.16290 06/25/2012All NDCs
Clotrimazole Vaginal Cream 2% 0.36749 06/25/2012All NDCs
Clotrimazole w/ Betamethasone Cream
1-0.05%
1.00735 06/25/2012All NDCs
Clotrimazole w/ Betamethasone Lotion
1-0.05%
1.69417 2.23000 11/28/2012All NDCs
Clozapine Tab 100 MG 2.05837 1.05554 07/01/2013All NDCs
Clozapine Tab 200 MG 4.75001 06/25/2012All NDCs
Clozapine Tab 25 MG 0.95984 0.61961 04/03/2013All NDCs
Clozapine Tab 50 MG 1.14524 06/25/2012All NDCs
CLUSIMAR SYP (12939016008) 0.17500 10/14/2011Specific NDC
COAGUCHEK MIS LANCETS
(50924004301)
0.21321 10/14/2011Specific NDC
Coal Tar Shampoo 0.5% 0.01104 06/25/2012All NDCs
Cocaine HCl Soln 10% 53.92500 06/25/2012All NDCs
Coenzyme Q10 Cap 200 MG 0.58280 06/25/2012All NDCs
Coenzyme Q10 Cap 50 MG 0.21960 06/25/2012All NDCs
COLACE CAP 100MG (67618010110) 0.27810 10/14/2011Specific NDC
COLACE CAP 100MG (67618010130) 0.25646 10/14/2011Specific NDC
COLACE CAP 100MG (67618010152) 0.22724 10/14/2011Specific NDC
COLACE CAP 100MG (67618010160) 0.23252 10/14/2011Specific NDC
COLACE SYP 60/15ML (67618010316) 0.03483 10/14/2011Specific NDC
Colchicine Tab 0.6 MG 0.10800 06/25/2012All NDCs
Colchicine w/ Probenecid Tab 0.5-500 MG 0.96780 06/25/2012All NDCs
Colestipol HCl Granule Packets 5 GM 2.40360 06/25/2012All NDCs
Colestipol HCl Tab 1 GM 0.50817 06/25/2012All NDCs
Colistimethate Sodium For Inj 150 MG 33.60000 06/25/2012All NDCs
COMFORTOUCH MIS LANCET
(08214046001)
0.02989 10/14/2011Specific NDC
COMFORTOUCH MIS LANCET
(08214046501)
0.03615 10/14/2011Specific NDC
Page 25 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
COMFORTOUCH MIS LANCET
(08470043001)
0.03595 10/14/2011Specific NDC
COMFORTOUCH MIS LANCET
(08470043501)
0.04341 10/14/2011Specific NDC
COMFORTOUCH MIS LANCET
(08470046001)
0.03595 10/14/2011Specific NDC
COMFORTOUCH MIS LANCET
(08470046501)
0.04341 10/14/2011Specific NDC
COMMIT LOZ 2MG CHRY
(00135045201)
0.63361 10/14/2011Specific NDC
COMMIT LOZ 2MG CHRY
(00135045202)
0.42240 12/31/2011Specific NDC
COMMIT LOZ 2MG CHRY
(00135045203)
0.39025 10/14/2011Specific NDC
COMMIT LOZ 2MG MINT (00135020803) 0.45110 10/14/2011Specific NDC
COMMIT LOZ 4MG CHRY
(00135045301)
0.45110 10/14/2011Specific NDC
COMMIT LOZ 4MG CHRY
(00135045302)
0.42240 11/30/2011Specific NDC
COMMIT LOZ 4MG CHRY
(00135045303)
0.39025 10/14/2011Specific NDC
COMMIT LOZ 4MG MINT (00135020903) 0.45110 10/14/2011Specific NDC
Condoms Latex Lubricated 0.23900 06/25/2012All NDCs
Cromolyn Sodium Nasal Aerosol Soln 5.2
MG/ACT (4%)
0.32262 06/25/2012All NDCs
Cromolyn Sodium Ophth Soln 4% 1.98856 0.82000 07/01/2013All NDCs
Cromolyn Sodium Soln Nebu 20 MG/2ML 0.28379 06/25/2012All NDCs
CVS LANCETS MIS 21G (38396050275) 0.03669 10/14/2011Specific NDC
CVS LANCETS MIS ORIGINAL
(59779032304)
0.03425 10/14/2011Specific NDC
CVS LANCETS MIS THIN (59779032301) 0.04341 10/14/2011Specific NDC
CVS LANCETS MIS THIN (59779032302) 0.03425 10/14/2011Specific NDC
CVS LANCETS MIS THIN 26G
(38396050175)
0.04519 10/14/2011Specific NDC
CVS LANCETS MIS THIN 26G
(38396050375)
0.03669 10/14/2011Specific NDC
CVS LANCETS MIS THIN 26G
(50428001771)
0.04341 10/14/2011Specific NDC
CVS LANCETS MIS THIN 26G
(50428001772)
0.03425 10/14/2011Specific NDC
CVS LANCETS MIS THIN 30G
(38396052175)
0.04519 10/14/2011Specific NDC
CVS LANCETS MIS THIN 30G
(38396052275)
0.03669 10/14/2011Specific NDC
Cyanocobalamin Inj 1000 MCG/ML 0.68365 06/25/2012All NDCs
Cyanocobalamin Tab 100 MCG 0.01704 06/25/2012All NDCs
Page 26 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Cyanocobalamin Tab 1000 MCG 0.03816 06/25/2012All NDCs
Cyanocobalamin Tab 500 MCG 0.02520 06/25/2012All NDCs
CYCLESSA PAK (00052028306) 1.49258 10/14/2011Specific NDC
Cyclobenzaprine HCl Cap SR 24HR 15 MG 11.09380 06/25/2012All NDCs
Cyclobenzaprine HCl Cap SR 24HR 30 MG 10.16660 06/25/2012All NDCs
Cyclobenzaprine HCl Tab 10 MG 0.09679 0.05012 01/01/2013All NDCs
Cyclobenzaprine HCl Tab 5 MG 0.09501 06/25/2012All NDCs
Cyclopentolate HCl Ophth Soln 1% 0.68157 06/25/2012All NDCs
Cyclophosphamide For Inj 1 GM 128.71441 06/25/2012All NDCs
Cyclophosphamide For Inj 2 GM 257.42882 06/25/2012All NDCs
Cyclophosphamide For Inj 500 MG 64.36493 06/25/2012All NDCs
Cyclophosphamide Tab 50 MG 2.96757 06/25/2012All NDCs
Cyclosporine Cap 100 MG 4.81448 06/25/2012All NDCs
Cyclosporine Cap 25 MG 1.20561 06/25/2012All NDCs
Cyclosporine Modified Cap 100 MG 4.07598 3.10000 07/01/2013All NDCs
Cyclosporine Modified Cap 25 MG 1.02021 06/25/2012All NDCs
Cyclosporine Modified Oral Soln 100 MG/ML 5.65824 06/25/2012All NDCs
Cyproheptadine HCl Syrup 2 MG/5ML 0.08191 0.10500 01/15/2013All NDCs
Cyproheptadine HCl Tab 4 MG 0.09743 0.32487 05/20/2013All NDCs
Cytarabine For Inj 1 GM 0.00000 06/25/2012All NDCs
Cytarabine For Inj 100 MG 0.32733 06/25/2012All NDCs
Cytarabine For Inj 2 GM 41.15026 06/25/2012All NDCs
Cytarabine For Inj 500 MG 0.00000 06/25/2012All NDCs
Cytarabine Inj 20 MG/ML 0.33063 06/25/2012All NDCs
Cytarabine Inj PF 100 MG/ML 0.78780 06/25/2012All NDCs
Cytarabine Inj PF 20 MG/ML 0.00000 06/25/2012All NDCs
D 1000 PLUS TAB ALOE (11845015395) 0.17500 10/14/2011Specific NDC
Danazol Cap 200 MG 3.68739 06/25/2012All NDCs
Dantrolene Sodium Cap 100 MG 1.53936 06/25/2012All NDCs
Dantrolene Sodium Cap 25 MG 0.91283 06/25/2012All NDCs
Dantrolene Sodium Cap 50 MG 1.23747 06/25/2012All NDCs
Dapsone Tab 100 MG 1.30000 06/25/2012All NDCs
Dapsone Tab 25 MG 1.06000 06/25/2012All NDCs
DECONGESTANT TAB 120MG ER
(37205044652)
0.43260 10/14/2011Specific NDC
DECUBI-VITE CAP (55198000100) 0.17500 10/14/2011Specific NDC
Demeclocycline HCl Tab 150 MG 8.88004 06/25/2012All NDCs
Demeclocycline HCl Tab 300 MG 16.07432 3.37995 10/01/2012All NDCs
Desipramine HCl Tab 10 MG 0.84128 07/20/2012All NDCs
Desipramine HCl Tab 100 MG 0.90612 06/25/2012All NDCs
Desipramine HCl Tab 150 MG 1.93512 06/25/2012All NDCs
Page 27 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Desipramine HCl Tab 25 MG 0.88837 1.13400 11/20/2012All NDCs
Desipramine HCl Tab 50 MG 1.57119 06/25/2012All NDCs
Desipramine HCl Tab 75 MG 0.63448 06/25/2012All NDCs
Desmopressin Acetate Nasal Spray Soln
0.01%
22.15537 06/25/2012All NDCs
Desmopressin Acetate Nasal Spray Soln
0.01% (Refrigerated)
38.39136 34.86267 07/01/2013All NDCs
Desmopressin Acetate Tab 0.1 MG 1.33662 09/01/2012All NDCs
Desmopressin Acetate Tab 0.2 MG 1.40188 1.31000 04/03/2013All NDCs
Desogest-Eth Estrad & Eth Estrad Tab
0.15-0.02/0.01 MG(21/5)
1.65481 06/25/2012All NDCs
Desogest-Ethin Est Tab
0.1-0.025/0.125-0.025/0.15-0.025MG-MG
0.92809 06/25/2012All NDCs
Desogestrel & Ethinyl Estradiol Tab 0.15
MG-30 MCG
1.02408 0.66564 07/01/2013All NDCs
DESONIDE LOT 0.05% (00168031002) 1.89660 10/09/2012Specific NDC
DESONIDE OIN 0.05% (45802042335) 0.71500 10/05/2012Specific NDC
Desonide Cream 0.05% 0.84950 4.21960 06/10/2013All NDCs
Desonide Lotion 0.05% 0.44519 06/25/2012All NDCs
Desonide Oint 0.05% 0.38129 06/25/2012All NDCs
Desoximetasone Cream 0.05% 2.53792 06/25/2012All NDCs
Desoximetasone Cream 0.25% 2.53676 1.44730 04/03/2013All NDCs
Desoximetasone Gel 0.05% 3.00657 06/25/2012All NDCs
Desoximetasone Oint 0.25% 3.15013 06/25/2012All NDCs
Dexamethasone Acetate Powder 20.40000 06/25/2012All NDCs
Dexamethasone Elixir 0.5 MG/5ML 0.20759 06/25/2012All NDCs
Dexamethasone Sodium Phosphate Inj 4
MG/ML
0.16834 06/25/2012All NDCs
Dexamethasone Sodium Phosphate Ophth
Soln 0.1%
3.27386 06/25/2012All NDCs
Dexamethasone Tab 0.5 MG 0.14577 0.06700 01/01/2013All NDCs
Dexamethasone Tab 0.75 MG 0.25554 06/25/2012All NDCs
Dexamethasone Tab 1.5 MG 0.09939 01/01/2013All NDCs
Dexamethasone Tab 4 MG 0.12408 06/25/2012All NDCs
Dexamethasone Tab 6 MG 0.75195 06/25/2012All NDCs
Dexmethylphenidate HCl Cap SR 24 HR 40
MG
7.84590 07/02/2013All NDCs
Dexmethylphenidate HCl Tab 10 MG 1.08150 06/25/2012All NDCs
Dexmethylphenidate HCl Tab 2.5 MG 0.52762 06/25/2012All NDCs
Dexmethylphenidate HCl Tab 5 MG 0.75218 06/25/2012All NDCs
Dextroamphetamine Sulfate Cap SR 24HR 10
MG
4.37136 06/25/2012All NDCs
Dextroamphetamine Sulfate Cap SR 24HR 15
MG
4.63000 5.68000 04/17/2013All NDCs
Page 28 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Dextroamphetamine Sulfate Cap SR 24HR 5
MG
3.13000 06/25/2012All NDCs
Dextroamphetamine Sulfate Tab 10 MG 0.32125 2.12300 09/05/2012All NDCs
Dextroamphetamine Sulfate Tab 5 MG 0.27030 2.01000 09/05/2012All NDCs
Dextromethorphan HBr Liquid 15 MG/5ML 0.03966 06/25/2012All NDCs
Dextromethorphan HBr Syrup 15 MG/5ML 0.02023 06/25/2012All NDCs
Dextromethorphan HBr Syrup 7.5 MG/5ML 0.04109 06/25/2012All NDCs
Dextromethorphan-Guaifenesin Liquid 10-100
MG/5ML
0.02350 06/25/2012All NDCs
Dextromethorphan-Guaifenesin Liquid 10-200
MG/5ML
0.01722 06/25/2012All NDCs
Dextromethorphan-Guaifenesin Liquid 5-100
MG/5ML
0.04068 06/25/2012All NDCs
Dextromethorphan-Guaifenesin Syrup 10-100
MG/5ML
0.00891 06/25/2012All NDCs
Dextromethorphan-Guaifenesin Tab 20-400
MG
0.10776 06/25/2012All NDCs
Dextromethorphan-Guaifenesin Tab SR
12HR 60-1200 MG
0.57588 06/25/2012All NDCs
Dextromethorphan-Phenylephrine-APAP Cap
10-5-325 MG
0.18500 06/25/2012All NDCs
Dextrose 5% w/ Sodium Chloride 0.225% 0.00214 06/25/2012All NDCs
Dextrose 5% w/ Sodium Chloride 0.45% 0.00210 06/25/2012All NDCs
Dextrose 5% w/ Sodium Chloride 0.9% 0.00374 06/25/2012All NDCs
Dextrose Inj 10% 0.00632 06/25/2012All NDCs
Dextrose Inj 5% 0.00561 06/25/2012All NDCs
Dextrose Inj 50% 0.00380 06/25/2012All NDCs
Dextrose Inj 70% 0.01337 06/25/2012All NDCs
DIABETES PAK HEALTH (31604001020) 0.17500 10/14/2011Specific NDC
DIABEVITE TAB (55039011606) 0.17500 07/01/2010Specific NDC
DIALYVITE TAB 800/IRON (10542007510) 0.17500 10/14/2011Specific NDC
DIASENSE TAB MULTIVIT
(00165009930)
0.17500 03/17/2011Specific NDC
Diazepam IM Inj Device 10 MG/2ML 1.17071 06/25/2012All NDCs
Diazepam Inj 5 MG/ML 0.48203 06/25/2012All NDCs
Diazepam Rectal Gel Delivery System 10 MG 320.67600 06/25/2012All NDCs
Diazepam Rectal Gel Delivery System 2.5 MG 270.32400 06/25/2012All NDCs
Diazepam Rectal Gel Delivery System 20 MG 320.67600 06/25/2012All NDCs
Diazepam Tab 10 MG 0.05358 06/25/2012All NDCs
Diazepam Tab 2 MG 0.03956 06/25/2012All NDCs
Diazepam Tab 5 MG 0.06714 0.02547 01/01/2013All NDCs
Dibucaine Rectal Ointment 1% 0.21428 06/25/2012All NDCs
Diclofenac Potassium Tab 50 MG 0.35939 06/25/2012All NDCs
Diclofenac Sodium Ophth Soln 0.1% 2.25869 01/01/2013All NDCs
Page 29 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Diclofenac Sodium Tab Delayed Release 25
MG
1.09834 06/25/2012All NDCs
Diclofenac Sodium Tab Delayed Release 50
MG
0.44404 06/25/2012All NDCs
Diclofenac Sodium Tab Delayed Release 75
MG
0.54711 0.37685 10/01/2012All NDCs
Diclofenac Sodium Tab SR 24HR 100 MG 1.43841 0.43659 10/01/2012All NDCs
Dicloxacillin Sodium Cap 250 MG 0.50985 0.29925 10/01/2012All NDCs
Dicloxacillin Sodium Cap 500 MG 0.92700 0.50925 10/01/2012All NDCs
Dicyclomine HCl Cap 10 MG 0.11319 06/25/2012All NDCs
Dicyclomine HCl Tab 20 MG 0.03787 06/25/2012All NDCs
Didanosine Delayed Release Capsule 200
MG
4.77045 06/25/2012All NDCs
Didanosine Delayed Release Capsule 250
MG
6.07908 06/25/2012All NDCs
Didanosine Delayed Release Capsule 400
MG
9.49457 06/25/2012All NDCs
Diethylpropion HCl Tab SR 24HR 75 MG 1.01232 06/25/2012All NDCs
Diflorasone Diacetate Cream 0.05% 1.67105 06/25/2012All NDCs
Diflorasone Diacetate Oint 0.05% 2.89546 06/25/2012All NDCs
Diflunisal Tab 500 MG 1.08198 06/25/2012All NDCs
Digoxin Tab 0.125 MG 0.19939 06/25/2012All NDCs
Digoxin Tab 0.25 MG 0.19939 06/25/2012All NDCs
Dihydroergotamine Mesylate Nasal Spray 4
MG/ML
182.95800 08/01/2013All NDCs
Diltiazem HCl Cap SR 12HR 120 MG 0.95597 06/25/2012All NDCs
Diltiazem HCl Cap SR 12HR 60 MG 0.64156 06/25/2012All NDCs
Diltiazem HCl Cap SR 12HR 90 MG 0.73349 06/25/2012All NDCs
Diltiazem HCl Cap SR 24HR 120 MG 0.65886 06/25/2012All NDCs
Diltiazem HCl Cap SR 24HR 180 MG 0.77478 06/25/2012All NDCs
Diltiazem HCl Cap SR 24HR 240 MG 0.82842 06/25/2012All NDCs
Diltiazem HCl Coated Beads Cap SR 24HR
120 MG
0.37805 09/01/2012All NDCs
Diltiazem HCl Coated Beads Cap SR 24HR
180 MG
0.57209 09/01/2012All NDCs
Diltiazem HCl Coated Beads Cap SR 24HR
240 MG
1.50476 0.66229 07/01/2013All NDCs
Diltiazem HCl Coated Beads Cap SR 24HR
300 MG
0.98986 09/01/2012All NDCs
Diltiazem HCl Coated Beads Tab SR 24HR
180 MG
2.85640 06/25/2012All NDCs
Diltiazem HCl Coated Beads Tab SR 24HR
240 MG
3.20160 06/25/2012All NDCs
Diltiazem HCl Coated Beads Tab SR 24HR
360 MG
4.48080 06/25/2012All NDCs
Page 30 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Diltiazem HCl Extended Release Beads Cap
SR 24HR 120 MG
0.74653 06/25/2012All NDCs
Diltiazem HCl Extended Release Beads Cap
SR 24HR 180 MG
0.96665 0.63945 01/01/2013All NDCs
Diltiazem HCl Extended Release Beads Cap
SR 24HR 240 MG
1.27840 06/25/2012All NDCs
Diltiazem HCl Extended Release Beads Cap
SR 24HR 300 MG
1.77692 06/25/2012All NDCs
Diltiazem HCl Extended Release Beads Cap
SR 24HR 360 MG
1.19639 09/01/2012All NDCs
Diltiazem HCl Extended Release Beads Cap
SR 24HR 420 MG
1.89820 06/25/2012All NDCs
Diltiazem HCl Tab 120 MG 0.21800 06/25/2012All NDCs
Diltiazem HCl Tab 30 MG 0.09530 06/25/2012All NDCs
Diltiazem HCl Tab 60 MG 0.10418 06/25/2012All NDCs
Diltiazem HCl Tab 90 MG 0.21622 0.09063 01/01/2013All NDCs
Diphenhydramine HCl Cap 25 MG 0.01429 06/25/2012All NDCs
Diphenhydramine HCl Cap 50 MG 0.02081 06/25/2012All NDCs
Diphenhydramine HCl Elixir 12.5 MG/5ML 0.01281 06/25/2012All NDCs
Diphenhydramine HCl Inj 50 MG/ML 2.04699 06/25/2012All NDCs
Diphenhydramine HCl Liquid 12.5 MG/5ML 0.01281 06/25/2012All NDCs
Diphenhydramine HCl Syrup 12.5 MG/5ML 0.01094 06/25/2012All NDCs
Diphenhydramine HCl Tab 25 MG 0.02100 06/25/2012All NDCs
Diphenhydramine HCl Tab 50 MG 0.06912 06/25/2012All NDCs
Diphenhydramine-Acetaminophen Tab
25-500 MG (sleep)
0.04512 06/25/2012All NDCs
Diphenhydramine-Phenylephrine Liq 6.25-2.5
MG/5ML
0.02125 06/25/2012All NDCs
Diphenoxylate w/ Atropine Tab 2.5-0.025 MG 0.14615 06/25/2012All NDCs
Dipyridamole Tab 25 MG 0.27851 06/25/2012All NDCs
Dipyridamole Tab 50 MG 0.44853 06/25/2012All NDCs
Dipyridamole Tab 75 MG 0.60013 06/25/2012All NDCs
Disopyramide Phosphate Cap 100 MG 0.55917 06/25/2012All NDCs
Disopyramide Phosphate Cap 150 MG 0.58807 06/25/2012All NDCs
Disopyramide Phosphate Cap SR 12HR 150
MG
1.35389 06/25/2012All NDCs
Disulfiram Tab 250 MG 3.01028 2.56492 07/01/2013All NDCs
Disulfiram Tab 500 MG 5.58360 06/25/2012All NDCs
Divalproex Sodium Cap Sprinkle 125 MG 0.54862 0.44647 04/03/2013All NDCs
Divalproex Sodium Tab Delayed Release 125
MG
0.25167 06/25/2012All NDCs
Divalproex Sodium Tab Delayed Release 250
MG
0.08088 0.14000 06/05/2013All NDCs
Divalproex Sodium Tab Delayed Release 500
MG
0.14700 09/01/2012All NDCs
Page 31 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Divalproex Sodium Tab SR 24 HR 250 MG 1.89000 2.18000 07/20/2013All NDCs
Divalproex Sodium Tab SR 24 HR 500 MG 0.40730 3.52070 06/19/2013All NDCs
Docosahexaenoic Acid Cap 200 MG 0.17500 12/05/2012All NDCs
Docusate Calcium Cap 240 MG 0.06320 06/25/2012All NDCs
Docusate Sodium Cap 100 MG 0.02894 06/25/2012All NDCs
Docusate Sodium Cap 250 MG 0.06945 06/25/2012All NDCs
Docusate Sodium Liquid 150 MG/15ML 0.00888 06/25/2012All NDCs
Docusate Sodium Syrup 60 MG/15ML 0.00783 06/25/2012All NDCs
Docusate Sodium Tab 100 MG 0.03588 06/25/2012All NDCs
Donepezil Hydrochloride Tab 10 MG 0.15840 06/25/2012All NDCs
Donepezil Hydrochloride Tab 5 MG 0.16000 06/25/2012All NDCs
Dorzolamide HCl Ophth Soln 2% 2.09455 09/01/2012All NDCs
Dorzolamide HCl-Timolol Maleate Ophth Soln
22.3-6.8 MG/ML
2.96125 2.48104 07/01/2013All NDCs
Doxazosin Mesylate Tab 1 MG 0.06011 06/25/2012All NDCs
Doxazosin Mesylate Tab 2 MG 0.05918 06/25/2012All NDCs
Doxazosin Mesylate Tab 4 MG 0.07491 06/25/2012All NDCs
Doxazosin Mesylate Tab 8 MG 0.08831 06/25/2012All NDCs
Doxepin HCl Cap 10 MG 0.08332 06/25/2012All NDCs
Doxepin HCl Cap 100 MG 0.30771 06/25/2012All NDCs
Doxepin HCl Cap 150 MG 0.65866 06/25/2012All NDCs
Doxepin HCl Cap 25 MG 0.14498 06/25/2012All NDCs
Doxepin HCl Cap 50 MG 0.29150 07/25/2012All NDCs
Doxepin HCl Cap 75 MG 0.19190 06/25/2012All NDCs
Doxepin HCl Conc 10 MG/ML 0.10708 06/25/2012All NDCs
Doxorubicin HCl For Inj 10 MG 0.90437 06/25/2012All NDCs
Doxorubicin HCl For Inj 50 MG 33.59046 06/25/2012All NDCs
Doxorubicin HCl Inj 2 MG/ML 1.09581 06/25/2012All NDCs
Doxycycline Hyclate Cap 100 MG 0.07591 3.51990 02/16/2013All NDCs
Doxycycline Hyclate Cap 50 MG 0.12317 06/25/2012All NDCs
Doxycycline Hyclate Tab 100 MG 1.66100 4.41000 02/18/2013All NDCs
Doxycycline Hyclate Tab 20 MG 0.87317 0.42023 01/01/2013All NDCs
Doxycycline Hyclate Tab Delayed Release
100 MG
9.34992 06/25/2012All NDCs
Doxycycline Hyclate Tab Delayed Release 75
MG
7.27060 06/25/2012All NDCs
Doxycycline Monohydrate Cap 100 MG 0.57000 09/01/2012All NDCs
Doxycycline Monohydrate Cap 50 MG 0.91726 06/25/2012All NDCs
Doxycycline Monohydrate Tab 100 MG 0.85400 09/01/2012All NDCs
Doxycycline Monohydrate Tab 50 MG 2.23021 06/25/2012All NDCs
Doxylamine Succinate (Sleep) Tab 25 MG 0.14100 06/25/2012All NDCs
Page 32 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Doxylamine Succinate Powder 1.68960 06/25/2012All NDCs
Dronabinol Cap 10 MG 21.62200 06/25/2012All NDCs
Dronabinol Cap 2.5 MG 4.58416 3.15719 04/03/2013All NDCs
Dronabinol Cap 5 MG 11.77420 6.30561 07/01/2013All NDCs
Drospirenone-Ethinyl Estradiol Tab 3-0.02 MG 2.42785 1.73394 07/01/2013All NDCs
Drospirenone-Ethinyl Estradiol Tab 3-0.03 MG 2.11555 1.70830 07/01/2013All NDCs
DURAVITE TAB (55039099606) 0.17500 07/01/2010Specific NDC
E-Z JECT MIS 21G (38396030400) 0.03669 10/14/2011Specific NDC
E-Z JECT MIS 21G COLR (38396030500) 0.04519 10/14/2011Specific NDC
E-Z JECT MIS 21G COLR (38396030600) 0.03669 10/14/2011Specific NDC
E-Z JECT MIS 30G (38396030800) 0.04519 10/14/2011Specific NDC
E-Z JECT MIS 32G COLR (38396030900) 0.04519 10/14/2011Specific NDC
E-Z JECT MIS LANC 21G (38396030300) 0.04519 10/14/2011Specific NDC
E-Z JECT MIS THIN 26G (38396030100) 0.04519 10/14/2011Specific NDC
E-Z JECT MIS THIN 26G (38396030200) 0.03669 10/14/2011Specific NDC
EASY COMFORT MIS 30G (91237000104) 0.03615 12/03/2011Specific NDC
EASY COMFORT MIS 30G (91237000116) 0.03615 12/03/2011Specific NDC
EASY TOUCH MIS 28G (91237000115) 0.03615 10/14/2011Specific NDC
Econazole Nitrate Cream 1% 0.45749 0.21226 01/01/2013All NDCs
ECOTRIN TAB 325MG EC
(00135001427)
0.04016 10/14/2011Specific NDC
ECOTRIN TAB 325MG EC
(00135001430)
0.03279 10/14/2011Specific NDC
Enalapril Maleate & Hydrochlorothiazide Tab
10-25 MG
0.33905 06/25/2012All NDCs
Enalapril Maleate & Hydrochlorothiazide Tab
5-12.5 MG
0.32665 06/25/2012All NDCs
Enalapril Maleate Tab 10 MG 0.06845 06/25/2012All NDCs
Enalapril Maleate Tab 2.5 MG 0.04423 06/25/2012All NDCs
Enalapril Maleate Tab 20 MG 0.07996 06/25/2012All NDCs
Enalapril Maleate Tab 5 MG 0.05330 06/25/2012All NDCs
ENFOLAST-N TAB (42192031390) 1.11787 02/19/2012Specific NDC
ENLIVE LIQ (70074053463) 0.17500 10/14/2011Specific NDC
Enoxaparin Sodium Inj 100 MG/ML 72.04737 52.71179 01/01/2013All NDCs
Enoxaparin Sodium Inj 120 MG/0.8ML 117.08250 105.02233 10/01/2012All NDCs
Enoxaparin Sodium Inj 150 MG/ML 117.08880 06/25/2012All NDCs
Enoxaparin Sodium Inj 30 MG/0.3ML 67.31300 56.86475 01/01/2013All NDCs
Enoxaparin Sodium Inj 40 MG/0.4ML 72.72812 59.96000 01/01/2013All NDCs
Enoxaparin Sodium Inj 60 MG/0.6ML 66.58491 64.87243 01/01/2013All NDCs
Enoxaparin Sodium Inj 80 MG/0.8ML 67.39081 58.55656 01/01/2013All NDCs
Epinastine HCl Ophth Soln 0.05% 20.54160 06/25/2012All NDCs
Epinephrine HCl Inj 1 MG/ML 0.28000 06/25/2012All NDCs
Page 33 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Epinephrine Inj Device 0.15 MG/0.15ML
(1:1000)
63.39600 06/25/2012All NDCs
Epinephrine Inj Device 0.3 MG/0.3ML
(1:1000)
63.39600 06/25/2012All NDCs
Eplerenone Tab 25 MG 3.71960 2.06265 07/01/2013All NDCs
Eplerenone Tab 50 MG 2.54354 2.12629 04/03/2013All NDCs
EQL LANCETS MIS 21G COLR
(38396030740)
0.04519 10/14/2011Specific NDC
EQL LANCETS MIS THIN 26G
(38396030140)
0.04519 10/14/2011Specific NDC
EQL LANCETS MIS THIN 26G
(38396030240)
0.03669 10/14/2011Specific NDC
EQL LANCETS MIS THIN 30G
(38396030540)
0.04519 10/14/2011Specific NDC
EQL LANCETS MIS THIN 30G
(38396030640)
0.03669 10/14/2011Specific NDC
Ergocalciferol Cap 50000 Unit 0.44338 10/01/2012All NDCs
Ergocalciferol Soln 8000 Unit/ML 1.21120 06/25/2012All NDCs
Ergotamine w/ Caffeine Tab 1-100 MG 0.93311 06/25/2012All NDCs
Erythromycin Ethylsuccinate Tab 400 MG 0.78162 06/25/2012All NDCs
Erythromycin Gel 2% 0.58291 06/25/2012All NDCs
Erythromycin Ophth Oint 5 MG/GM 4.19358 06/25/2012All NDCs
Erythromycin Pads 2% 1.22133 06/25/2012All NDCs
Erythromycin Soln 2% 0.06425 0.64250 02/27/2013All NDCs
Erythromycin Tab 250 MG 2.31000 2.80500 04/01/2013All NDCs
Erythromycin Tab 500 MG 2.53680 06/25/2012All NDCs
Erythromycin-Sulfisoxazole For Susp 200-600
MG/5ML
0.16871 06/25/2012All NDCs
Escitalopram Oxalate Tab 10 MG (Base
Equiv)
3.19781 0.17290 10/03/2012All NDCs
Escitalopram Oxalate Tab 20 MG (Base
Equiv)
3.38196 0.19344 10/03/2012All NDCs
Escitalopram Oxalate Tab 5 MG (Base Equiv) 3.11300 0.16055 10/03/2012All NDCs
Estazolam Tab 1 MG 0.55412 06/25/2012All NDCs
Estazolam Tab 2 MG 0.60313 06/25/2012All NDCs
Esterified Estrogens & Methyltestosterone
Tab 0.625-1.25 MG
0.00000 06/25/2012All NDCs
Esterified Estrogens & Methyltestosterone
Tab 1.25-2.5 MG
1.62000 06/25/2012All NDCs
Estradiol & Norethindrone Acetate Tab 1-0.5
MG
1.88839 09/01/2012All NDCs
Estradiol Powder 4.08000 06/25/2012All NDCs
Estradiol Tab 0.5 MG 0.09799 06/25/2012All NDCs
Estradiol Tab 1 MG 0.14168 0.05433 01/01/2013All NDCs
Estradiol Tab 2 MG 0.12394 06/25/2012All NDCs
Page 34 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Estradiol TD Patch Weekly 0.025 MG/24HR 10.94830 06/25/2012All NDCs
Estradiol TD Patch Weekly 0.0375 MG/24HR
(37.5 MCG/24HR)
14.50800 06/25/2012All NDCs
Estradiol TD Patch Weekly 0.05 MG/24HR 10.94830 06/25/2012All NDCs
Estradiol TD Patch Weekly 0.06 MG/24HR 14.50800 06/25/2012All NDCs
Estradiol TD Patch Weekly 0.075 MG/24HR 10.94830 06/25/2012All NDCs
Estradiol TD Patch Weekly 0.1 MG/24HR 10.94830 06/25/2012All NDCs
Estradiol Valerate IM in Oil 10 MG/ML 14.62800 06/25/2012All NDCs
Estriol Micronized Powder 115.20000 06/25/2012All NDCs
Estropipate Tab 0.75 MG 0.24505 06/25/2012All NDCs
Estropipate Tab 1.5 MG 0.29158 06/25/2012All NDCs
Estropipate Tab 3 MG 0.67924 06/25/2012All NDCs
Ethambutol HCl Tab 100 MG 0.45588 06/25/2012All NDCs
Ethambutol HCl Tab 400 MG 1.31988 06/25/2012All NDCs
Ethosuximide Cap 250 MG 1.02550 06/25/2012All NDCs
Ethosuximide Soln 250 MG/5ML 0.06648 0.28330 12/26/2012All NDCs
Ethynodiol Diacetate & Ethinyl Estradiol Tab 1
MG-35 MCG
0.82437 06/25/2012All NDCs
Etodolac Cap 200 MG 0.54711 06/25/2012All NDCs
Etodolac Tab 400 MG 0.36689 06/25/2012All NDCs
Etodolac Tab 500 MG 0.62453 0.38233 10/01/2012All NDCs
Etodolac Tab SR 24HR 400 MG 1.08281 06/25/2012All NDCs
Etodolac Tab SR 24HR 500 MG 1.13155 06/25/2012All NDCs
Etodolac Tab SR 24HR 600 MG 2.04875 06/25/2012All NDCs
Etoposide Cap 50 MG 44.28874 06/25/2012All NDCs
Etoposide Inj 20 MG/ML 1.30932 06/25/2012All NDCs
EX-L TAB (11694097301) 0.17500 07/01/2010Specific NDC
Exemestane Tab 25 MG 6.50000 5.35800 07/01/2013All NDCs
EZ SMART MIS LANCETS (53459000073) 0.01853 10/14/2011Specific NDC
EZ-LETS MIS LANCETS (25294087100) 0.03646 07/06/2011Specific NDC
EZ-LETS 23G MIS LANCETS
(25294000806)
0.03646 07/06/2011Specific NDC
EZ-LETS 23G MIS LANCETS
(25294000807)
0.03213 07/06/2011Specific NDC
EZ-LETS 26G MIS LANCETS
(25294000802)
0.03646 07/06/2011Specific NDC
EZ-LETS 26G MIS LANCETS
(25294000803)
0.03213 07/06/2011Specific NDC
EZ-LETS 28G MIS LANCETS
(25294000804)
0.03646 07/06/2011Specific NDC
EZ-LETS 28G MIS LANCETS
(25294000805)
0.03213 07/06/2011Specific NDC
Famciclovir Tab 125 MG 4.49081 06/25/2012All NDCs
Page 35 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Famciclovir Tab 250 MG 4.88273 1.13345 04/03/2013All NDCs
Famciclovir Tab 500 MG 2.21084 1.99882 01/01/2013All NDCs
Famotidine For Susp 40 MG/5ML 1.48500 10/01/2012All NDCs
Famotidine Inj 10 MG/ML 0.00000 06/25/2012All NDCs
Famotidine Tab 10 MG 0.10280 06/25/2012All NDCs
Famotidine Tab 20 MG 0.14028 0.04116 01/01/2013All NDCs
Famotidine Tab 40 MG 0.06600 09/01/2012All NDCs
FC LANCETS MIS COLORED
(38396030513)
0.04519 10/14/2011Specific NDC
FC LANCETS MIS COLORED
(38396030613)
0.03669 10/14/2011Specific NDC
FC LANCETS MIS THIN (38396030113) 0.04519 10/14/2011Specific NDC
FC LANCETS MIS THIN (38396030213) 0.03669 10/14/2011Specific NDC
FD&C Yellow #6 Aluminum Lake Powder 0.35616 06/25/2012All NDCs
Fe Fumarate w/ B12-Vit C-FA-IFC Cap
110-0.015-75-0.5-240 MG
0.39120 06/25/2012All NDCs
FEIBA VH INJ IMMUNO (64193022203) 1.67633 10/14/2011Specific NDC
FEIBA VH INJ IMMUNO (64193022204) 1.67633 10/14/2011Specific NDC
FEIBA VH INJ IMMUNO (64193022205) 1.67633 10/14/2011Specific NDC
Felbamate Tab 400 MG 5.01146 06/25/2012All NDCs
Felbamate Tab 600 MG 5.74360 4.56468 04/03/2013All NDCs
Felodipine Tab SR 24HR 10 MG 2.09750 1.05076 10/01/2012All NDCs
Felodipine Tab SR 24HR 2.5 MG 1.16717 06/25/2012All NDCs
Felodipine Tab SR 24HR 5 MG 1.16717 0.69540 10/01/2012All NDCs
Fenofibrate Micronized Cap 134 MG 1.32638 06/25/2012All NDCs
Fenofibrate Micronized Cap 200 MG 2.05933 06/25/2012All NDCs
Fenofibrate Micronized Cap 67 MG 0.72043 06/25/2012All NDCs
Fenofibrate Tab 160 MG 1.49377 1.26496 07/01/2013All NDCs
Fenofibrate Tab 54 MG 0.61190 06/25/2012All NDCs
Fenoprofen Calcium Tab 600 MG 1.24666 06/25/2012All NDCs
Fentanyl Citrate Inj 0.05 MG/ML 0.27423 06/25/2012All NDCs
Fentanyl Citrate Lollipop 1200 MCG 34.72400 06/25/2012All NDCs
Fentanyl Citrate Lollipop 1600 MCG 42.82626 06/25/2012All NDCs
Fentanyl Citrate Lollipop 200 MCG 14.52613 06/25/2012All NDCs
Fentanyl Citrate Lollipop 400 MCG 18.40384 06/25/2012All NDCs
Fentanyl Citrate Lollipop 600 MCG 22.54163 06/25/2012All NDCs
Fentanyl Citrate Lollipop 800 MCG 26.70850 06/25/2012All NDCs
Fentanyl TD Patch 72HR 100 MCG/HR 29.39028 22.25383 01/01/2013All NDCs
Fentanyl TD Patch 72HR 12 MCG/HR 14.93711 06/25/2012All NDCs
Fentanyl TD Patch 72HR 25 MCG/HR 5.48160 06/25/2012All NDCs
Fentanyl TD Patch 72HR 50 MCG/HR 11.76000 9.36000 07/01/2013All NDCs
Fentanyl TD Patch 72HR 75 MCG/HR 18.96214 17.28000 07/01/2013All NDCs
Page 36 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
FER-IN-SOL DRO 15MG/ML
(00087074002)
0.14909 10/14/2011Specific NDC
Ferrous Fumarate Tab 325 MG (106 MG
Elemental Fe)
0.13640 06/25/2012All NDCs
Ferrous Gluconate Tab 325 MG 0.06960 06/25/2012All NDCs
Ferrous Gluconate Tab 325 MG (37.5 MG
Elemental Fe)
0.03828 06/25/2012All NDCs
Ferrous Sulfate Dried Tab 200 MG (65 MG
Elemental Fe)
0.02256 06/25/2012All NDCs
Ferrous Sulfate Dried Tab CR 160 MG (50
MG Fe Equivalent)
0.17000 06/25/2012All NDCs
Ferrous Sulfate Elixir 220 MG/5ML (44
MG/5ML Elemental Fe)
0.00952 06/25/2012All NDCs
Ferrous Sulfate Soln 75 MG/0.6ML 0.08729 06/25/2012All NDCs
Ferrous Sulfate Soln 75 MG/ML (15 MG/ML
Elemental Fe)
0.10200 06/25/2012All NDCs
Ferrous Sulfate Tab 325 MG (65 MG
Elemental Fe)
0.00946 06/25/2012All NDCs
Ferrous Sulfate Tab EC 325 MG (65 MG Fe
Equivalent)
0.11634 06/25/2012All NDCs
Ferrous Sulfate-Vit C-Folic Acid Tab CR
105-500-0.8 MG
0.55800 06/25/2012All NDCs
FEVERALL INF SUP 80MG (00472120006) 0.61928 10/14/2011Specific NDC
FEVERALL INF SUP 80MG (00472120050) 0.57257 10/14/2011Specific NDC
Fexofenadine HCl Tab 180 MG 0.64523 09/01/2012All NDCs
Fexofenadine HCl Tab 30 MG 0.53832 06/25/2012All NDCs
Fexofenadine HCl Tab 60 MG 1.07925 06/25/2012All NDCs
Fexofenadine-Pseudoephedrine Tab SR
12HR 60-120 MG
2.15028 06/25/2012All NDCs
Fexofenadine-Pseudoephedrine Tab SR
24HR 180-240 MG
4.43004 06/25/2012All NDCs
Finasteride Tab 5 MG 0.36764 09/01/2012All NDCs
FINGERSTIX MIS LANCETS
(00193596531)
0.14345 10/14/2011Specific NDC
Flavoxate HCl Tab 100 MG 1.01141 07/01/2012All NDCs
Flecainide Acetate Tab 100 MG 0.33542 09/01/2012All NDCs
Flecainide Acetate Tab 150 MG 1.80761 0.80841 07/01/2013All NDCs
Flecainide Acetate Tab 50 MG 0.22422 09/01/2012All NDCs
Fluconazole For Susp 10 MG/ML 0.76504 0.30179 10/01/2012All NDCs
Fluconazole For Susp 40 MG/ML 1.58104 0.77869 10/01/2012All NDCs
Fluconazole Tab 100 MG 0.15500 09/01/2012All NDCs
Fluconazole Tab 150 MG 0.28854 09/01/2012All NDCs
Fluconazole Tab 200 MG 0.27513 09/01/2012All NDCs
Fluconazole Tab 50 MG 0.36921 0.14062 01/01/2013All NDCs
Fludrocortisone Acetate Tab 0.1 MG 0.57760 06/25/2012All NDCs
Page 37 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Flunisolide Nasal Soln 25 MCG/ACT
(0.025%)
1.94948 06/25/2012All NDCs
Flunisolide Nasal Soln 29 MCG/ACT
(0.025%)
1.01664 06/25/2012All NDCs
Fluocinolone Acetonide Cream 0.01% 0.76529 06/25/2012All NDCs
Fluocinolone Acetonide Cream 0.025% 0.57989 06/25/2012All NDCs
Fluocinolone Acetonide Oint 0.025% 0.57989 06/25/2012All NDCs
Fluocinolone Acetonide Soln 0.01% 1.23450 06/25/2012All NDCs
Fluocinonide Cream 0.05% 0.51766 06/25/2012All NDCs
Fluocinonide Emulsified Base Cream 0.05% 0.22941 06/25/2012All NDCs
Fluocinonide Gel 0.05% 0.46434 06/25/2012All NDCs
Fluocinonide Oint 0.05% 0.46223 0.91250 08/20/2013All NDCs
Fluocinonide Soln 0.05% 1.38000 1.29662 01/01/2013All NDCs
Fluorometholone Ophth Susp 0.1% 1.55273 06/25/2012All NDCs
Fluorouracil Cream 5% 5.64965 4.47873 07/01/2013All NDCs
Fluorouracil Inj 1 GM/20ML (50 MG/ML) 0.12158 06/25/2012All NDCs
Fluorouracil Inj 2.5 GM/50ML (50 MG/ML) 0.11222 06/25/2012All NDCs
Fluorouracil Inj 5 GM/100ML (50 MG/ML) 0.10287 06/25/2012All NDCs
Fluorouracil Inj 500 MG/10ML (50 MG/ML) 0.11222 06/25/2012All NDCs
Fluoxetine HCl (PMDD) Cap 10 MG 0.11155 06/25/2012All NDCs
Fluoxetine HCl (PMDD) Cap 20 MG 0.09401 06/25/2012All NDCs
Fluoxetine HCl Cap 10 MG 0.11155 0.03902 01/01/2013All NDCs
Fluoxetine HCl Cap 20 MG 0.09401 06/25/2012All NDCs
Fluoxetine HCl Cap 40 MG 0.38278 09/01/2012All NDCs
Fluoxetine HCl Cap Delayed Release 90 MG 31.59600 06/25/2012All NDCs
Fluoxetine HCl Solution 20 MG/5ML 0.17444 0.11976 04/03/2013All NDCs
Fluoxetine HCl Tab 10 MG 0.16135 0.06910 01/01/2013All NDCs
Fluoxetine HCl Tab 20 MG 0.60450 07/11/2012All NDCs
FLUPHENAZ DE INJ 25MG/ML
(63323027205)
21.37190 24.90400 08/06/2013Specific NDC
Fluphenazine Decanoate Inj 25 MG/ML 1.48320 06/25/2012All NDCs
Fluphenazine HCl Inj 2.5 MG/ML 9.77280 06/25/2012All NDCs
Fluphenazine HCl Oral Conc 5 MG/ML 0.99233 06/25/2012All NDCs
Fluphenazine HCl Tab 1 MG 0.19268 06/25/2012All NDCs
Fluphenazine HCl Tab 10 MG 0.38253 06/25/2012All NDCs
Fluphenazine HCl Tab 2.5 MG 0.25952 06/25/2012All NDCs
Fluphenazine HCl Tab 5 MG 0.27101 06/25/2012All NDCs
Flurazepam HCl Cap 15 MG 0.09118 06/25/2012All NDCs
Flurazepam HCl Cap 30 MG 0.10736 06/25/2012All NDCs
Flurbiprofen Sodium Ophth Soln 0.03% 2.25000 08/08/2012All NDCs
Flurbiprofen Tab 100 MG 0.22800 06/25/2012All NDCs
Page 38 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Flurbiprofen Tab 50 MG 0.60873 06/25/2012All NDCs
Flutamide Cap 125 MG 1.60749 06/25/2012All NDCs
Fluticasone Propionate Cream 0.05% 0.82001 0.62237 07/01/2013All NDCs
Fluticasone Propionate Nasal Susp 50
MCG/ACT
1.40445 1.30990 01/01/2013All NDCs
Fluticasone Propionate Oint 0.005% 0.52937 09/01/2012All NDCs
Fluvoxamine Maleate Tab 100 MG 0.86698 0.32705 01/01/2013All NDCs
Fluvoxamine Maleate Tab 25 MG 0.79076 06/25/2012All NDCs
Fluvoxamine Maleate Tab 50 MG 0.40675 09/01/2012All NDCs
Folic Acid Tab 1 MG 0.03535 06/25/2012All NDCs
Folic Acid Tab 400 MCG 0.01032 06/25/2012All NDCs
Folic Acid Tab 800 MCG 0.01824 06/25/2012All NDCs
Folic Acid-Cyanocobalamin-Vit B6-Vit
D-Calcium Tab
0.17500 06/25/2012All NDCs
Folic Acid-Vitamin B6-Vitamin B12 Tab
2.2-25-0.5 MG
0.36504 06/25/2012All NDCs
Fondaparinux Sodium Inj 10 MG/0.8ML 162.96000 06/25/2012All NDCs
Fondaparinux Sodium Inj 2.5 MG/0.5ML 110.78400 06/25/2012All NDCs
Fondaparinux Sodium Inj 5 MG/0.4ML 308.66400 275.17188 10/01/2012All NDCs
Fondaparinux Sodium Inj 7.5 MG/0.6ML 205.77600 181.05833 01/01/2013All NDCs
Formaldehyde Solution 10% 0.38566 06/25/2012All NDCs
Fosinopril Sodium & Hydrochlorothiazide Tab
10-12.5 MG
1.25826 06/25/2012All NDCs
Fosinopril Sodium & Hydrochlorothiazide Tab
20-12.5 MG
1.25826 06/25/2012All NDCs
Fosinopril Sodium Tab 10 MG 0.16433 09/01/2012All NDCs
Fosinopril Sodium Tab 20 MG 0.51721 0.44600 04/03/2013All NDCs
Fosinopril Sodium Tab 40 MG 0.52212 06/25/2012All NDCs
FP LANCETS MIS (38396033277) 0.03669 10/14/2011Specific NDC
FP LANCETS MIS THIN (38396033577) 0.03669 10/14/2011Specific NDC
FREESTYLE MIS LANCETS
(99073013001)
0.07850 04/04/2013Specific NDC
FREESTYLE MIS LANCETS
(99073070428)
0.18953 10/14/2011Specific NDC
Furosemide Inj 10 MG/ML 0.20857 06/25/2012All NDCs
Furosemide Oral Soln 10 MG/ML 0.12158 06/25/2012All NDCs
Furosemide Tab 20 MG 0.05265 0.01327 01/01/2013All NDCs
Furosemide Tab 40 MG 0.05602 06/25/2012All NDCs
Furosemide Tab 80 MG 0.09754 06/25/2012All NDCs
Gabapentin Cap 100 MG 0.07715 06/25/2012All NDCs
Gabapentin Cap 300 MG 0.11578 06/25/2012All NDCs
Gabapentin Cap 400 MG 0.14383 06/25/2012All NDCs
Gabapentin Oral Soln 250 MG/5ML 0.28478 06/25/2012All NDCs
Page 39 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Gabapentin Powder 2.45760 06/25/2012All NDCs
Gabapentin Tab 600 MG 0.44104 0.36299 01/01/2013All NDCs
Gabapentin Tab 800 MG 0.72560 0.38800 07/01/2013All NDCs
Galantamine Hydrobromide Cap SR 24HR 16
MG
5.49920 2.75981 01/01/2013All NDCs
Galantamine Hydrobromide Tab 12 MG 3.05160 06/25/2012All NDCs
Galantamine Hydrobromide Tab 4 MG 2.74960 06/25/2012All NDCs
GAMMAGARD INJ 10GM/100
(00944270005)
10.65404 10/14/2011Specific NDC
GAMMAGARD INJ 1GM/10ML
(00944270002)
10.65435 10/14/2011Specific NDC
GAMMAGARD INJ 2.5GM/25
(00944270003)
10.65435 10/14/2011Specific NDC
GAMMAGARD INJ 5GM/50ML
(00944270004)
10.65404 10/14/2011Specific NDC
GAMMAGARD SD INJ 10GM HU
(00944262004)
654.66337 10/14/2011Specific NDC
GAMMAGARD SD INJ 2.5GM HU
(00944262002)
163.66584 10/14/2011Specific NDC
GAMMAGARD SD INJ 5GM HU
(00944262003)
327.33168 10/14/2011Specific NDC
GAMUNEX INJ 10% (13533064512) 8.96025 10/14/2011Specific NDC
GAMUNEX INJ 10% (13533064515) 8.96041 10/14/2011Specific NDC
GAMUNEX INJ 10% (13533064520) 8.96041 10/14/2011Specific NDC
GAMUNEX INJ 10% (13533064524) 8.96041 10/14/2011Specific NDC
GAMUNEX INJ 10% (13533064571) 8.96041 10/14/2011Specific NDC
Ganciclovir Cap 500 MG 7.29259 06/25/2012All NDCs
GAVISCON CHW (00135009626) 0.05523 10/14/2011Specific NDC
GAVISCON CHW (00135009675) 0.07518 10/14/2011Specific NDC
GAVISCON SUS (00135009441) 0.01461 10/14/2011Specific NDC
Gelatin Cap 650 MG 0.03204 06/25/2012All NDCs
Gemfibrozil Tab 600 MG 0.11871 06/25/2012All NDCs
Gentamicin Sulfate Cream 0.1% 0.18704 06/25/2012All NDCs
Gentamicin Sulfate Inj 40 MG/ML 1.26500 06/30/2012All NDCs
Gentamicin Sulfate Oint 0.1% 0.18704 06/25/2012All NDCs
Gentamicin Sulfate Ophth Oint 0.3% 4.34146 06/25/2012All NDCs
Gentamicin Sulfate Ophth Soln 0.3% 1.15750 07/23/2012All NDCs
Glimepiride Tab 1 MG 0.09782 06/25/2012All NDCs
Glimepiride Tab 2 MG 0.15551 0.06142 01/01/2013All NDCs
Glimepiride Tab 4 MG 0.06779 09/01/2012All NDCs
Glipizide Tab 10 MG 0.11147 06/25/2012All NDCs
Glipizide Tab 5 MG 0.06537 06/25/2012All NDCs
Glipizide Tab SR 24HR 10 MG 0.53935 06/25/2012All NDCs
Page 40 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Glipizide Tab SR 24HR 2.5 MG 0.31414 06/25/2012All NDCs
Glipizide Tab SR 24HR 5 MG 0.29839 06/25/2012All NDCs
Glipizide-Metformin HCl Tab 2.5-250 MG 0.64040 06/25/2012All NDCs
Glipizide-Metformin HCl Tab 2.5-500 MG 0.76392 06/25/2012All NDCs
Glipizide-Metformin HCl Tab 5-500 MG 0.76392 06/25/2012All NDCs
GLUCOCOM MIS 28G (08525010300) 0.05561 10/14/2011Specific NDC
GLUCOCOM MIS 30G (08525011200) 0.05701 10/14/2011Specific NDC
GLUCOCOM MIS 33G (08525011300) 0.05840 10/14/2011Specific NDC
GLUCOSAMINE TAB MSM CMPL
(00904547352)
0.10860 02/19/2012Specific NDC
Glucosamine Sulfate Cap 500 MG 0.11160 06/25/2012All NDCs
Glucosamine-Chondroitin Cap 500-400 MG 0.13550 06/25/2012All NDCs
Glucosamine-Chondroitin Tab 500-400 MG 0.17980 06/25/2012All NDCs
Glucosamine-Chondroitin-MSM Tab
750-400-375 MG
0.17600 06/25/2012All NDCs
Glucose Gel 40% 0.08136 06/25/2012All NDCs
GLUCOSOURCE MIS LANCETS
(08278220011)
0.03839 10/14/2011Specific NDC
Glyburide Micronized Tab 1.5 MG 0.12114 06/25/2012All NDCs
Glyburide Micronized Tab 3 MG 0.10126 06/25/2012All NDCs
Glyburide Micronized Tab 6 MG 0.08321 06/25/2012All NDCs
Glyburide Tab 1.25 MG 0.11634 06/25/2012All NDCs
Glyburide Tab 2.5 MG 0.15878 06/25/2012All NDCs
Glyburide Tab 5 MG 0.15036 06/25/2012All NDCs
Glyburide-Metformin Tab 1.25-250 MG 0.16551 06/25/2012All NDCs
Glyburide-Metformin Tab 2.5-500 MG 0.33624 0.12275 01/01/2013All NDCs
Glyburide-Metformin Tab 5-500 MG 0.36032 0.20736 04/03/2013All NDCs
Glycerin Liquid 0.03388 06/25/2012All NDCs
Glycerin Suppos 1.2 GM 0.12500 06/25/2012All NDCs
Glycerin Suppos 2.1 GM 0.11900 06/25/2012All NDCs
Glycerin Suppos 80.7% 0.09600 06/25/2012All NDCs
Glycerin Topical Liquid 0.00743 06/25/2012All NDCs
Glycopyrrolate Inj 0.2 MG/ML 0.30127 0.43956 10/29/2012All NDCs
Glycopyrrolate Tab 1 MG 0.56656 09/01/2012All NDCs
Glycopyrrolate Tab 2 MG 1.01306 09/01/2012All NDCs
GNP LANCETS MIS (87701057044) 0.04627 10/14/2011Specific NDC
GNP LANCETS MIS (87701057046) 0.03472 10/14/2011Specific NDC
GNP LANCETS MIS 21G (38396034264) 0.04519 10/14/2011Specific NDC
GNP LANCETS MIS 21G (38396034364) 0.03669 10/14/2011Specific NDC
GNP LANCETS MIS SUP THIN
(87701039908)
0.05554 10/14/2011Specific NDC
GNP LANCETS MIS THIN (87701044671) 0.04051 10/14/2011Specific NDC
Page 41 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
GNP LANCETS MIS THIN 26G
(38396034464)
0.04519 10/14/2011Specific NDC
GNP LANCETS MIS THIN 26G
(38396034564)
0.03669 10/14/2011Specific NDC
GNP LANCETS MIS THIN 26G
(87701095986)
0.03855 10/14/2011Specific NDC
Granisetron HCl Inj 1 MG/ML 0.00000 06/25/2012All NDCs
Granisetron HCl Inj 4 MG/4ML (1 MG/ML) 0.00000 06/25/2012All NDCs
Granisetron HCl Tab 1 MG 37.50849 9.28471 01/01/2013All NDCs
Griseofulvin Microsize Susp 125 MG/5ML 0.26837 06/25/2012All NDCs
Guaifenesin Liquid 100 MG/5ML 0.01036 06/25/2012All NDCs
Guaifenesin Syrup 100 MG/5ML 0.00668 06/25/2012All NDCs
Guaifenesin Tab 200 MG 0.03600 06/25/2012All NDCs
Guaifenesin Tab 400 MG 0.09360 06/25/2012All NDCs
Guaifenesin-Codeine Soln 100-10 MG/5ML 0.01192 06/25/2012All NDCs
Guanfacine HCl Tab 1 MG 0.11615 0.08111 01/01/2013All NDCs
Guanfacine HCl Tab 2 MG 0.34092 0.11975 01/01/2013All NDCs
GYNE-LOTRIM CRE 1% VAG
(00085088709)
0.21120 07/01/2010Specific NDC
GYNE-LOTRIM CRE 1% VAG
(00085088711)
0.21120 07/01/2010Specific NDC
GYNE-LOTRIM CRE 1% VAG
(54868041801)
0.21120 10/14/2011Specific NDC
HAEMOLANCE MIS HIGH FLO
(08317990800)
0.17268 10/14/2011Specific NDC
HAEMOLANCE MIS LOW FLOW
(08317950000)
0.14780 10/14/2011Specific NDC
HAEMOLANCE MIS LOW FLOW
(08317955000)
0.17149 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS (08317990200) 0.17268 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS (08317990250) 0.20054 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS (08317990700) 0.17268 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS (08317990750) 0.20054 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS LOW
(08317990900)
0.17268 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS LOW
(08317990950)
0.20054 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS MAX
(08317990600)
0.17268 10/14/2011Specific NDC
HAEMOLANCE MIS PLUS PED
(08317990400)
0.17268 10/14/2011Specific NDC
HAEMOLANCE MIS RETRACT
(08317015001)
0.14780 10/14/2011Specific NDC
HAEMOLANCE MIS RETRACT
(08317035050)
0.17149 10/14/2011Specific NDC
Halobetasol Propionate Cream 0.05% 1.05330 06/25/2012All NDCs
Page 42 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Halobetasol Propionate Oint 0.05% 1.08312 06/25/2012All NDCs
Haloperidol Decanoate IM Soln 50 MG/ML 23.06880 06/25/2012All NDCs
Haloperidol Lactate Oral Conc 2 MG/ML 0.12803 06/25/2012All NDCs
Haloperidol Tab 0.5 MG 0.05663 09/01/2012All NDCs
Haloperidol Tab 1 MG 0.21793 0.08659 01/01/2013All NDCs
Haloperidol Tab 10 MG 0.74313 1.31228 09/09/2013All NDCs
Haloperidol Tab 2 MG 0.12633 0.56727 09/25/2013All NDCs
Haloperidol Tab 20 MG 0.00000 06/25/2012All NDCs
Haloperidol Tab 5 MG 0.34021 0.14288 10/01/2012All NDCs
HC VALERATE OIN 0.2% (51672129201) 4.01000 01/21/2013Specific NDC
HELIXATE FS SOL 250UNIT
(00053813001)
0.87537 12/15/2011Specific NDC
HEMENATAL OB MIS + DHA (76331090430) 0.45000 10/02/2013Specific NDC
Heparin Sod Lock Flush & NaCl Lock Flush
10 Unt/ML-0.9% Kit
0.30000 06/25/2012All NDCs
Heparin Sodium (Porcine) Inj 1000 Unit/ML 0.78518 06/25/2012All NDCs
Heparin Sodium (Porcine) Inj 10000 Unit/ML 3.49325 06/25/2012All NDCs
Heparin Sodium (Porcine) Inj 20000 Unit/ML 16.09536 06/25/2012All NDCs
Heparin Sodium (Porcine) Inj 5000 Unit/ML 4.99200 06/25/2012All NDCs
Heparin Sodium (Porcine) Lock Flush IV Soln
10 Unit/ML
0.23380 06/25/2012All NDCs
Heparin Sodium (Porcine) Lock Flush IV Soln
100 Unit/ML
0.02624 06/25/2012All NDCs
HOMINEX-2 POW (70074051119) 0.14906 10/14/2011Specific NDC
HUMULIN INJ 70/30 (00002871517) 6.56880 01/26/2012Specific NDC
HUMULIN N PN INJ U-100 (00002873001) 10.61418 10/14/2011Specific NDC
HUMULIN N PN INJ U-100 (00002873059) 10.61418 10/14/2011Specific NDC
HUMULIN PEN INJ 70/30 (00002877001) 10.61418 10/14/2011Specific NDC
HUMULIN PEN INJ 70/30 (00002877059) 10.61418 10/14/2011Specific NDC
HYALEX TAB (17204043240) 0.17500 01/01/2011Specific NDC
Hydralazine & HCTZ Cap 50-50 MG 0.89053 06/25/2012All NDCs
Hydralazine HCl Tab 10 MG 0.15441 06/25/2012All NDCs
Hydralazine HCl Tab 100 MG 0.73303 0.30214 07/01/2013All NDCs
Hydralazine HCl Tab 25 MG 0.19576 06/25/2012All NDCs
Hydralazine HCl Tab 50 MG 0.24913 0.14096 01/01/2013All NDCs
Hydrochlorothiazide Cap 12.5 MG 0.11466 06/25/2012All NDCs
Hydrochlorothiazide Tab 12.5 MG 0.33600 0.15121 01/01/2013All NDCs
Hydrochlorothiazide Tab 25 MG 0.05357 06/25/2012All NDCs
Hydrochlorothiazide Tab 50 MG 0.04666 06/25/2012All NDCs
Hydrocod Polst-Chlorphen Polst CR Susp
10-8 MG/5ML
0.58577 06/25/2012All NDCs
Hydrocodone Bitartrate Powder 7.29600 06/25/2012All NDCs
Page 43 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Hydrocodone w/ Homatropine Syrup 5-1.5
MG/5ML
0.14280 06/25/2012All NDCs
Hydrocodone-Acetaminophen Soln 7.5-500
MG/15ML
0.02660 09/01/2012All NDCs
Hydrocodone-Acetaminophen Tab 10-325
MG
0.15651 09/01/2012All NDCs
Hydrocodone-Acetaminophen Tab 10-500
MG
0.25547 0.20397 01/01/2013All NDCs
Hydrocodone-Acetaminophen Tab 10-650
MG
0.17320 06/25/2012All NDCs
Hydrocodone-Acetaminophen Tab 10-660
MG
0.50502 06/25/2012All NDCs
Hydrocodone-Acetaminophen Tab 10-750
MG
0.86172 06/25/2012All NDCs
Hydrocodone-Acetaminophen Tab 2.5-500
MG
0.20481 06/25/2012All NDCs
Hydrocodone-Acetaminophen Tab 5-325 MG 0.14843 09/01/2012All NDCs
Hydrocodone-Acetaminophen Tab 5-500 MG 0.10757 0.04765 01/01/2013All NDCs
Hydrocodone-Acetaminophen Tab 7.5-325
MG
0.40680 0.23113 01/01/2013All NDCs
Hydrocodone-Acetaminophen Tab 7.5-500
MG
0.15775 0.07507 01/01/2013All NDCs
Hydrocodone-Acetaminophen Tab 7.5-650
MG
0.19759 06/25/2012All NDCs
Hydrocodone-Acetaminophen Tab 7.5-750
MG
0.14477 06/25/2012All NDCs
Hydrocodone-Ibuprofen Tab 7.5-200 MG 0.47061 0.28563 01/01/2013All NDCs
Hydrocortisone Acetate Suppos 25 MG 1.29950 06/25/2012All NDCs
Hydrocortisone Acetate Suppos 30 MG 3.99650 06/25/2012All NDCs
Hydrocortisone Acetate w/ Pramoxine Rectal
Cream 1-1%
2.33600 06/25/2012All NDCs
Hydrocortisone Acetate w/ Pramoxine Rectal
Cream 2.5-1%
1.73920 06/25/2012All NDCs
Hydrocortisone Acetate-Aloe Vera Oint 1% 0.11008 06/25/2012All NDCs
Hydrocortisone Butyrate Oint 0.1% 0.57422 1.57931 06/10/2013All NDCs
Hydrocortisone Cream 0.5% 0.04769 06/25/2012All NDCs
Hydrocortisone Cream 1% 0.05237 06/25/2012All NDCs
Hydrocortisone Cream 2.5% 0.15431 06/25/2012All NDCs
Hydrocortisone Enema 100 MG/60ML 0.12385 06/25/2012All NDCs
Hydrocortisone Lotion 2.5% 0.31482 09/01/2012All NDCs
Hydrocortisone Oint 0.5% 0.10790 06/25/2012All NDCs
Hydrocortisone Oint 1% 0.05237 06/25/2012All NDCs
Hydrocortisone Oint 2.5% 0.09922 06/25/2012All NDCs
Hydrocortisone Rectal Cream 2.5% 0.18775 09/01/2012All NDCs
Hydrocortisone Tab 10 MG 0.44264 06/25/2012All NDCs
Page 44 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Hydrocortisone Tab 20 MG 0.13200 06/25/2012All NDCs
Hydrocortisone Valerate Cream 0.2% 0.51697 06/25/2012All NDCs
Hydrocortisone Valerate Oint 0.2% 0.61566 06/25/2012All NDCs
Hydrocortisone w/ Acetic Acid Otic Soln 1-2% 10.77990 10.28491 07/01/2013All NDCs
Hydrocortisone-Aloe Vera Cream 0.5% 0.04769 06/25/2012All NDCs
Hydrocortisone-Aloe Vera Cream 1% 0.05237 06/25/2012All NDCs
Hydromorphone HCl Inj 10 MG/ML 1.87471 06/25/2012All NDCs
Hydromorphone HCl Inj 2 MG/ML 0.41280 06/25/2012All NDCs
Hydromorphone HCl Preservative Free (PF)
Inj 10 MG/ML
1.87471 10/17/2012All NDCs
Hydromorphone HCl Preservative Free (PF)
Inj 2 MG/ML
0.41280 10/17/2012All NDCs
Hydromorphone HCl Tab 2 MG 0.25347 06/25/2012All NDCs
Hydromorphone HCl Tab 4 MG 0.32221 0.13363 10/01/2012All NDCs
Hydromorphone HCl Tab 8 MG 1.06929 0.59026 07/01/2013All NDCs
Hydroquinone Cream 4% 0.90793 06/25/2012All NDCs
Hydroxychloroquine Sulfate Tab 200 MG 0.13256 09/01/2012All NDCs
Hydroxyprogesterone Caproate (Bulk) Powder 2.88000 06/25/2012All NDCs
Hydroxyurea Cap 500 MG 0.33988 09/01/2012All NDCs
Hydroxyzine HCl IM Soln 50 MG/ML 0.78795 06/25/2012All NDCs
Hydroxyzine HCl Syrup 10 MG/5ML 0.06564 06/25/2012All NDCs
Hydroxyzine HCl Tab 10 MG 0.45499 0.12984 01/01/2013All NDCs
Hydroxyzine HCl Tab 25 MG 0.53428 0.13146 10/01/2012All NDCs
Hydroxyzine HCl Tab 50 MG 0.31700 0.20854 01/01/2013All NDCs
Hydroxyzine Pamoate Cap 100 MG 0.48428 06/25/2012All NDCs
Hydroxyzine Pamoate Cap 25 MG 0.10755 06/25/2012All NDCs
Hydroxyzine Pamoate Cap 50 MG 0.14701 06/25/2012All NDCs
Hyoscyamine Sulfate Elixir 0.125 MG/5ML 0.07608 06/25/2012All NDCs
Hyoscyamine Sulfate Soln 0.125 MG/ML 1.46750 09/01/2012All NDCs
Hyoscyamine Sulfate Tab 0.125 MG 0.70406 0.39833 07/01/2013All NDCs
Hyoscyamine Sulfate Tab Disp 0.125 MG 0.93627 0.52967 04/03/2013All NDCs
Hyoscyamine Sulfate Tab SL 0.125 MG 0.59092 06/25/2012All NDCs
Hyoscyamine Sulfate Tab SR 12HR 0.375
MG
1.24743 0.80600 10/01/2012All NDCs
Hypromellose (Bulk) Powder 0.03994 06/25/2012All NDCs
Hypromellose Ophth Soln 0.4% 0.22000 06/25/2012All NDCs
Ibandronate Sodium Tab 150 MG (Base
Equivalent)
83.16863 07/01/2013All NDCs
Ibuprofen Cap 200 MG 0.04430 06/25/2012All NDCs
Ibuprofen Chew Tab 100 MG 0.14000 06/25/2012All NDCs
Ibuprofen Susp 100 MG/5ML 0.03527 0.04659 09/27/2012All NDCs
Ibuprofen Susp 40 MG/ML 0.42080 06/25/2012All NDCs
Page 45 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Ibuprofen Tab 200 MG 0.05400 06/25/2012All NDCs
Ibuprofen Tab 400 MG 0.03226 06/25/2012All NDCs
Ibuprofen Tab 600 MG 0.03899 06/25/2012All NDCs
Ibuprofen Tab 800 MG 0.05966 06/25/2012All NDCs
ICAPS AREDS TAB FORMULA
(00065804010)
0.17500 10/14/2011Specific NDC
ICAPS LUTEIN TAB ZEAXANTH
(00065804053)
0.17500 10/14/2011Specific NDC
ICAPS LUTEIN TAB ZEAXANTH
(00065804054)
0.17500 10/14/2011Specific NDC
ICAPS PLUS TAB (00065804030) 0.17500 10/14/2011Specific NDC
ICAPS PLUS TAB (00065804052) 0.17500 10/14/2011Specific NDC
Imipramine HCl Tab 10 MG 0.24718 06/25/2012All NDCs
Imipramine HCl Tab 25 MG 0.33210 06/25/2012All NDCs
Imipramine HCl Tab 50 MG 0.43058 0.25539 01/01/2013All NDCs
Imipramine Pamoate Cap 100 MG 14.16040 06/25/2012All NDCs
Imipramine Pamoate Cap 150 MG 14.16040 06/25/2012All NDCs
Imipramine Pamoate Cap 75 MG 14.16040 06/25/2012All NDCs
Imiquimod Cream 5% 17.91264 17.57198 07/01/2013All NDCs
Indapamide Tab 1.25 MG 0.09679 06/25/2012All NDCs
Indapamide Tab 2.5 MG 0.10521 06/25/2012All NDCs
Indomethacin Cap 25 MG 0.16075 09/01/2012All NDCs
Indomethacin Cap 50 MG 0.22287 09/01/2012All NDCs
Indomethacin Cap CR 75 MG 1.94518 1.58651 04/03/2013All NDCs
INSULIN SYRG MIS 0.3/30G (08222093356) 0.15102 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (08290328280) 0.21192 11/11/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (08290328431) 0.18704 11/11/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (08290843101) 0.21707 11/11/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (11110035324) 0.13518 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (12333090170) 0.11031 10/01/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (38396040818) 0.13518 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (41405330301) 0.05253 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (41405330310) 0.22209 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (57515009335) 0.15102 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/30G (86227062035) 0.24874 10/14/2011Specific NDC
INSULIN SYRG MIS 0.3/31G (08290328438) 0.25080 04/16/2012Specific NDC
INSULIN SYRG MIS 0.5/30G (08222093554) 0.15102 10/14/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (08290328279) 0.21192 11/11/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (08290846601) 0.21707 11/11/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (08474011078) 0.16184 10/14/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (12333090270) 0.11031 10/01/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (38396040708) 0.13518 10/14/2011Specific NDC
Page 46 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
INSULIN SYRG MIS 0.5/30G (38396040712) 0.13518 10/14/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (41405530301) 0.05253 10/14/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (41405530310) 0.22209 10/14/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (57515009355) 0.15102 10/14/2011Specific NDC
INSULIN SYRG MIS 0.5/30G (86227062055) 0.24874 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(08222093158)
0.15102 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(08290328278)
0.21192 11/11/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(08290841101)
0.21707 11/11/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(08474011178)
0.16184 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(08496801501)
0.33797 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(12333090370)
0.11031 10/01/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(38396040812)
0.13518 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(38396041808)
0.13518 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(41405130301)
0.05253 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(41405130310)
0.22209 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(57515009315)
0.15102 10/14/2011Specific NDC
INSULIN SYRG MIS 1ML/30G
(86227062105)
0.24874 10/14/2011Specific NDC
Insulin Syringe/Needle U-100 0.3 ML 30 x 1/2" 0.17767 06/25/2012All NDCs
Insulin Syringe/Needle U-100 1/2 ML 30 x 1/2" 0.17767 06/25/2012All NDCs
Insulin Syringe/Needle U-100 1/2 ML 31 x
5/16"
0.26613 06/25/2012All NDCs
Iodoquinol-HC Cream 1% 0.88522 06/25/2012All NDCs
Ipratropium Bromide Inhal Soln 0.02% 0.10100 06/25/2012All NDCs
Ipratropium Bromide Nasal Soln 0.03% (21
MCG/SPRAY)
0.28277 09/01/2012All NDCs
Ipratropium Bromide Nasal Soln 0.06% (42
MCG/SPRAY)
0.70000 2.14340 09/26/2013All NDCs
Ipratropium-Albuterol Nebu Soln 0.5-2.5(3)
MG/3ML
0.12014 09/01/2012All NDCs
Irbesartan Tab 150 MG 0.35000 10/31/2012All NDCs
Irbesartan Tab 300 MG 0.51250 10/31/2012All NDCs
Irbesartan Tab 75 MG 0.35000 10/31/2012All NDCs
Irbesartan-Hydrochlorothiazide Tab 150-12.5
MG
0.93750 10/31/2012All NDCs
Page 47 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Irbesartan-Hydrochlorothiazide Tab 300-12.5
MG
1.56250 10/31/2012All NDCs
Irinotecan HCl Inj 40 MG/2ML (20 MG/ML) 5.40365 06/25/2012All NDCs
Iron Polysacch Complex-Vit B12-FA Cap
150-0.025-1 MG
0.14388 06/25/2012All NDCs
Iron-Vit C-Vit B12-Folic Acid Cap CR
100-320-0.025-1 MG
0.17500 06/25/2012All NDCs
Iron-Vit C-Vit B12-Folic Acid Tab
100-250-0.025-1 MG
0.23800 06/25/2012All NDCs
Isoniazid Syrup 50 MG/5ML 0.09894 06/25/2012All NDCs
Isoniazid Tab 300 MG 0.08323 06/25/2012All NDCs
Isosorbide Dinitrate SL Tab 2.5 MG 0.14475 06/25/2012All NDCs
Isosorbide Dinitrate SL Tab 5 MG 0.14475 06/25/2012All NDCs
Isosorbide Dinitrate Tab 10 MG 0.04909 06/25/2012All NDCs
Isosorbide Dinitrate Tab 20 MG 0.05265 06/25/2012All NDCs
Isosorbide Dinitrate Tab 30 MG 0.34222 06/25/2012All NDCs
Isosorbide Dinitrate Tab 5 MG 0.04563 06/25/2012All NDCs
Isosorbide Mononitrate Tab 10 MG 0.57142 06/25/2012All NDCs
Isosorbide Mononitrate Tab 20 MG 0.28995 06/25/2012All NDCs
Isosorbide Mononitrate Tab SR 24HR 120
MG
0.35588 06/25/2012All NDCs
Isosorbide Mononitrate Tab SR 24HR 30 MG 0.15738 06/25/2012All NDCs
Isosorbide Mononitrate Tab SR 24HR 60 MG 0.15878 06/25/2012All NDCs
Isotretinoin Cap 20 MG 7.71069 6.71292 07/01/2013All NDCs
Isotretinoin Cap 40 MG 8.90500 7.35210 07/01/2013All NDCs
Isoxsuprine HCl Tab 10 MG 1.04016 06/25/2012All NDCs
Isradipine Cap 2.5 MG 1.05439 06/25/2012All NDCs
Isradipine Cap 5 MG 1.54183 06/25/2012All NDCs
Itraconazole Cap 100 MG 7.18703 06/25/2012All NDCs
K-PAX CAP DOUBLE (88856000002) 0.17500 10/14/2011Specific NDC
K-PAX CAP SINGLE (88856000001) 0.17500 10/14/2011Specific NDC
KELP/LEC/B6/ TAB VIN XTRA
(12333915201)
0.17500 10/01/2011Specific NDC
Ketamine HCl (Bulk) Powder 3.07200 06/25/2012All NDCs
Ketoconazole Cream 2% 0.23240 09/01/2012All NDCs
Ketoconazole Foam 2% 3.54936 06/25/2012All NDCs
Ketoconazole Powder 2.76480 06/25/2012All NDCs
Ketoconazole Shampoo 2% 0.17174 0.10906 01/01/2013All NDCs
Ketoconazole Tab 200 MG 0.66123 0.34000 10/01/2012All NDCs
Ketoprofen Cap 50 MG 0.08250 09/01/2012All NDCs
Ketoprofen Cap 75 MG 0.29088 06/25/2012All NDCs
Ketoprofen Cap SR 24HR 200 MG 2.36061 06/25/2012All NDCs
Ketoprofen Powder 0.50880 06/25/2012All NDCs
Page 48 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Ketorolac Tromethamine IM Inj 60 MG/2ML
(30 MG/ML)
0.74160 06/25/2012All NDCs
Ketorolac Tromethamine Inj 30 MG/ML 1.05060 06/25/2012All NDCs
Ketorolac Tromethamine Inj 300 MG/10ML
(30 MG/ML)
0.74160 06/25/2012All NDCs
Ketorolac Tromethamine Inj 60 MG/2ML (30
MG/ML)
0.57937 06/25/2012All NDCs
Ketorolac Tromethamine Ophth Soln 0.4% 2.40625 09/01/2012All NDCs
Ketorolac Tromethamine Ophth Soln 0.5% 6.72000 3.10500 10/01/2012All NDCs
Ketorolac Tromethamine Tab 10 MG 0.28263 09/01/2012All NDCs
Ketotifen Fumarate Ophth Soln 0.025% (Base
Equiv)
1.03560 06/25/2012All NDCs
KINNEY MIS LANCETS (08214018718) 0.03483 10/14/2011Specific NDC
KINNEY THIN MIS LANCETS
(08214020718)
0.03483 10/14/2011Specific NDC
KLB6 CAP (74312001210) 0.17500 02/01/2003Specific NDC
KOGENATE FS INJ 1000/BS
(00026379550)
1.29780 10/14/2011Specific NDC
KOGENATE FS INJ 1000UNIT
(00026378550)
1.29780 10/14/2011Specific NDC
KOGENATE FS INJ 250/BS (00026379220) 1.29780 10/14/2011Specific NDC
KOGENATE FS INJ 250UNIT
(00026378220)
1.29780 10/14/2011Specific NDC
KOGENATE FS INJ 500/BS (00026379330) 1.29780 10/14/2011Specific NDC
KOGENATE FS INJ 500UNIT
(00026378330)
1.29780 10/14/2011Specific NDC
KONSYL-D POW 52.3% (00224182203) 0.00875 10/14/2011Specific NDC
KONSYL-D POW 52.3% (00224182207) 0.01715 10/14/2011Specific NDC
KROGER LANCE MIS (36652030418) 0.02259 07/17/2011Specific NDC
KROGER LANCE MIS THIN (36652030118) 0.04519 07/17/2011Specific NDC
KROGER LANCE MIS THIN (36652030218) 0.03669 07/17/2011Specific NDC
Labetalol HCl Tab 100 MG 0.46425 0.37099 04/03/2013All NDCs
Labetalol HCl Tab 200 MG 0.33500 06/25/2012All NDCs
Labetalol HCl Tab 300 MG 0.50156 06/25/2012All NDCs
Lactase Tab 3000 Unit 0.08500 06/25/2012All NDCs
Lactated Ringer's Solution 0.00869 06/25/2012All NDCs
Lactic Acid (Ammonium Lactate) Cream 12% 0.07740 06/25/2012All NDCs
Lactic Acid (Ammonium Lactate) Lotion 10% 0.07576 06/25/2012All NDCs
Lactic Acid (Ammonium Lactate) Lotion 12% 0.05101 06/25/2012All NDCs
Lactic Acid (Ammonium Lactate) Lotion 5% 0.05777 06/25/2012All NDCs
Lactic Acid w/ Vitamin E Cream 10%-3500
Unit/30GM
0.13016 06/25/2012All NDCs
Lactose Powder 0.00922 06/25/2012All NDCs
LACTRASE CAP 250MG (00091350501) 0.47222 10/14/2011Specific NDC
Page 49 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Lactulose (Encephalopathy) Solution 10
GM/15ML
0.02066 06/25/2012All NDCs
Lactulose Solution 10 GM/15ML 0.01207 06/25/2012All NDCs
Lamotrigine Tab 100 MG 0.10338 07/01/2012All NDCs
Lamotrigine Tab 150 MG 0.08802 07/01/2012All NDCs
Lamotrigine Tab 200 MG 0.42912 0.31900 01/01/2013All NDCs
Lamotrigine Tab 25 MG 0.43969 0.07756 10/01/2012All NDCs
Lamotrigine Tab Chewable Dispersible 25 MG 0.39525 0.33374 04/03/2013All NDCs
Lamotrigine Tab Chewable Dispersible 5 MG 0.61809 0.32033 07/01/2013All NDCs
LANCET MIS 2MM (08326200001) 0.15527 10/14/2011Specific NDC
LANCET STAND MIS 21G (38396091825) 0.04519 10/14/2011Specific NDC
LANCET STAND MIS 21G (38396091925) 0.03669 10/14/2011Specific NDC
LANCET SUPER MIS THIN 30G
(08214065726)
0.03523 10/14/2011Specific NDC
LANCET SUPER MIS THIN 30G
(08214465714)
0.03523 10/14/2011Specific NDC
LANCET SUPER MIS THIN 30G
(38396032325)
0.04519 10/14/2011Specific NDC
LANCET SUPER MIS THIN 30G
(38396054764)
0.04519 10/14/2011Specific NDC
LANCET ULTRA MIS THIN 30G
(38396030318)
0.04519 10/14/2011Specific NDC
LANCETS MIS (08464010001) 0.14831 08/25/2011Specific NDC
LANCETS MIS (38396030312) 0.04519 10/14/2011Specific NDC
LANCETS MIS (38396030412) 0.03669 10/14/2011Specific NDC
LANCETS MIS 21G (38396030418) 0.03669 10/14/2011Specific NDC
LANCETS MIS 21G (38396050132) 0.04519 10/14/2011Specific NDC
LANCETS MIS 21G COLR
(38396035506)
0.04519 10/14/2011Specific NDC
LANCETS MIS 21G COLR
(38396036606)
0.03669 10/14/2011Specific NDC
LANCETS MIS 26G (38396030316) 0.04519 10/14/2011Specific NDC
LANCETS MIS 28G (38415040028) 0.07725 11/20/2011Specific NDC
LANCETS MIS COLORED
(38396030608)
0.03669 10/14/2011Specific NDC
LANCETS MIS THIN (38396030112) 0.04519 10/14/2011Specific NDC
LANCETS MIS THIN (38396030512) 0.04519 10/14/2011Specific NDC
LANCETS MIS THIN 26G (38396031506) 0.04519 10/14/2011Specific NDC
LANCETS MIS THIN 30G (38396030416) 0.04519 10/14/2011Specific NDC
LANCETS MIS THIN 30G (38396031156) 0.04519 10/14/2011Specific NDC
LANCETS THIN MIS 26G (38396030118) 0.04519 10/14/2011Specific NDC
LANCETS THIN MIS 26G (38396030157) 0.04519 10/14/2011Specific NDC
LANCETS THIN MIS 26G (38396030218) 0.03669 10/14/2011Specific NDC
Page 50 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
LANCETS THIN MIS 26G (38396031225) 0.04519 10/14/2011Specific NDC
LANCETS THIN MIS 26G (38396032225) 0.03669 10/14/2011Specific NDC
LANCETS THIN MIS 28G (08222072016) 0.05790 10/14/2011Specific NDC
LANCETS THIN MIS 28G (57515007201) 0.05790 10/14/2011Specific NDC
LANCETS ULTR MIS THIN (08271036100) 0.03855 10/14/2011Specific NDC
LANCETS ULTR MIS THIN (08271036200) 0.03858 10/14/2011Specific NDC
LANCETS ULTR MIS THIN (98302000104) 0.08497 10/14/2011Specific NDC
LANCETS ULTR MIS THIN 28G
(08214535714)
0.03483 10/14/2011Specific NDC
LANCETS ULTR MIS THIN 30G
(38396030557)
0.04519 10/14/2011Specific NDC
LANCETS ULTR MIS THIN 30G
(40986001668)
0.01529 10/14/2011Specific NDC
LANCETS ULTR MIS THIN 30G
(40986001669)
0.01429 11/11/2011Specific NDC
Lanolin 0.05915 06/25/2012All NDCs
Lansoprazole Cap Delayed Release 15 MG 1.43596 0.90581 07/01/2013All NDCs
Lansoprazole Cap Delayed Release 30 MG 1.44070 0.94724 07/01/2013All NDCs
Lansoprazole Tab Delayed Release Orally
Disintegrating 15 MG
5.66652 8.44500 09/26/2013All NDCs
Lansoprazole Tab Delayed Release Orally
Disintegrating 30 MG
5.66652 06/25/2012All NDCs
Latanoprost Ophth Soln 0.005% 4.80000 06/25/2012All NDCs
LB LANCET MIS 28G (08214035726) 0.03445 10/14/2011Specific NDC
Leflunomide Tab 10 MG 1.28948 0.60948 07/01/2013All NDCs
Leflunomide Tab 20 MG 0.46729 09/01/2012All NDCs
Letrozole Tab 2.5 MG 0.31800 06/25/2012All NDCs
Leucovorin Calcium For Inj 100 MG 0.00000 06/25/2012All NDCs
Leucovorin Calcium For Inj 200 MG 7.65722 06/25/2012All NDCs
Leucovorin Calcium For Inj 350 MG 14.80785 06/25/2012All NDCs
Leucovorin Calcium For Inj 50 MG 0.25835 06/25/2012All NDCs
Leucovorin Calcium Tab 25 MG 10.57363 06/25/2012All NDCs
Leucovorin Calcium Tab 5 MG 1.56509 1.04669 01/01/2013All NDCs
Leuprolide Acetate Inj Kit 5 MG/ML 111.24040 06/25/2012All NDCs
Levetiracetam Oral Soln 100 MG/ML 0.35926 0.15761 01/01/2013All NDCs
Levetiracetam Tab 1000 MG 0.59353 07/25/2012All NDCs
Levetiracetam Tab 250 MG 0.16965 07/01/2012All NDCs
Levetiracetam Tab 500 MG 0.16996 07/01/2012All NDCs
Levetiracetam Tab 750 MG 0.30854 07/01/2012All NDCs
Levetiracetam Tab SR 24HR 500 MG 0.88940 0.51063 04/03/2013All NDCs
Levetiracetam Tab SR 24HR 750 MG 1.33540 0.88416 10/01/2012All NDCs
Levobunolol HCl Ophth Soln 0.5% 1.02384 06/25/2012All NDCs
Levocarnitine Oral Soln 1 GM/10ML (10%) 0.19475 06/25/2012All NDCs
Page 51 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Levocarnitine Tab 330 MG 0.66477 06/25/2012All NDCs
Levocetirizine Dihydrochloride Soln 2.5
MG/5ML (0.5 MG/ML)
0.42887 04/03/2013All NDCs
Levocetirizine Dihydrochloride Tab 5 MG 0.39364 09/01/2012All NDCs
Levofloxacin IV Soln 25 MG/ML 1.90000 06/25/2012All NDCs
Levofloxacin Ophth Soln 0.5% 14.35200 06/25/2012All NDCs
Levofloxacin Oral Soln 25 MG/ML 1.20700 06/25/2012All NDCs
Levofloxacin Tab 250 MG 0.40392 06/25/2012All NDCs
Levofloxacin Tab 500 MG 0.92592 0.35167 10/01/2012All NDCs
Levofloxacin Tab 750 MG 0.59973 09/01/2012All NDCs
Levonorg-Eth Est Tab 0.15-0.03MG(84) & Eth
Est Tab 0.01MG(7)
2.83306 2.87300 09/25/2013All NDCs
Levonorgestrel & Ethinyl Estradiol (91-Day)
Tab 0.15-0.03 MG
1.36393 1.14300 04/03/2013All NDCs
Levonorgestrel & Ethinyl Estradiol Tab 0.1
MG-20 MCG
0.73133 0.79300 04/11/2013All NDCs
Levonorgestrel & Ethinyl Estradiol Tab 0.15
MG-30 MCG
0.85333 06/25/2012All NDCs
Levonorgestrel Tab 0.75 MG 17.55000 16.48500 07/01/2013All NDCs
Levonorgestrel-Eth Estra Tab
0.05-30/0.075-40/0.125-30MG-MCG
0.75842 06/25/2012All NDCs
Levonorgestrel-Ethinyl Estradiol (Continuous)
Tab 90-20 MCG
2.03657 06/25/2012All NDCs
Levothyroxine Sodium For Inj 200 MCG 50.92800 06/25/2012All NDCs
Levothyroxine Sodium Tab 100 MCG 0.27916 06/25/2012All NDCs
Levothyroxine Sodium Tab 112 MCG 0.32200 06/25/2012All NDCs
Levothyroxine Sodium Tab 125 MCG 0.32686 06/25/2012All NDCs
Levothyroxine Sodium Tab 137 MCG 0.34904 06/25/2012All NDCs
Levothyroxine Sodium Tab 150 MCG 0.33668 06/25/2012All NDCs
Levothyroxine Sodium Tab 175 MCG 0.39981 06/25/2012All NDCs
Levothyroxine Sodium Tab 200 MCG 0.21700 06/25/2012All NDCs
Levothyroxine Sodium Tab 25 MCG 0.21678 06/25/2012All NDCs
Levothyroxine Sodium Tab 300 MCG 0.56329 0.28945 01/01/2013All NDCs
Levothyroxine Sodium Tab 50 MCG 0.24624 06/25/2012All NDCs
Levothyroxine Sodium Tab 75 MCG 0.27215 06/25/2012All NDCs
Levothyroxine Sodium Tab 88 MCG 0.14518 06/25/2012All NDCs
Lidocaine Cream 4% 1.00000 06/25/2012All NDCs
Lidocaine HCl Cream 3% 1.98307 06/25/2012All NDCs
Lidocaine HCl Gel 2% 0.39963 06/25/2012All NDCs
Lidocaine HCl Local Inj 1% 0.06797 06/25/2012All NDCs
Lidocaine HCl Powder 1.16304 06/25/2012All NDCs
Lidocaine HCl Soln 4% 0.14151 06/25/2012All NDCs
Lidocaine HCl Viscous Soln 2% 0.04797 06/25/2012All NDCs
Page 52 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Lidocaine Oint 5% 1.61700 06/25/2012All NDCs
Lidocaine-Hydrocortisone Acetate Cream
3-0.5%
1.78540 06/25/2012All NDCs
Lidocaine-Hydrocortisone Acetate Lotion
3-0.5%
0.99715 06/25/2012All NDCs
Lidocaine-Hydrocortisone Acetate Rectal
Cream 3-0.5%
2.18413 06/25/2012All NDCs
Lidocaine-Hydrocortisone Acetate Rectal
Cream Kit 3-1%
16.80600 06/25/2012All NDCs
Lidocaine-Hydrocortisone Acetate Rectal Gel
2.8-0.55%
1.03620 06/25/2012All NDCs
Lidocaine-Prilocaine Cream 2.5-2.5% 0.65749 0.59264 01/01/2013All NDCs
Lidocaine-Prilocaine Kit 2.5-2.5% 0.65749 06/25/2012All NDCs
LIFE PACK MIS MENS (54629205253) 0.17500 10/14/2011Specific NDC
LIFE PACK MIS WOMENS (54629205273) 0.17500 10/14/2011Specific NDC
Lindane Lotion 1% 1.76208 06/25/2012All NDCs
Lindane Shampoo 1% 1.76208 06/25/2012All NDCs
Lisinopril & Hydrochlorothiazide Tab 10-12.5
MG
0.09438 06/25/2012All NDCs
Lisinopril & Hydrochlorothiazide Tab 20-12.5
MG
0.05796 09/01/2012All NDCs
Lisinopril & Hydrochlorothiazide Tab 20-25
MG
0.05955 09/01/2012All NDCs
Lisinopril Tab 10 MG 0.06312 0.02871 01/01/2013All NDCs
Lisinopril Tab 2.5 MG 0.03441 06/25/2012All NDCs
Lisinopril Tab 20 MG 0.07435 06/25/2012All NDCs
Lisinopril Tab 30 MG 0.15253 06/25/2012All NDCs
Lisinopril Tab 40 MG 0.14028 0.07518 01/01/2013All NDCs
Lisinopril Tab 5 MG 0.04517 06/25/2012All NDCs
LITE TOUCH MIS LANCETS
(32671020133)
0.05407 10/14/2011Specific NDC
LITE TOUCH MIS LANCETS
(32671020233)
0.04635 10/14/2011Specific NDC
LITE TOUCH MIS LANCETS
(32671020244)
0.04635 10/14/2011Specific NDC
Lithium Carbonate Cap 150 MG 0.08025 07/01/2012All NDCs
Lithium Carbonate Cap 300 MG 0.12511 0.03636 10/01/2012All NDCs
Lithium Carbonate Cap 600 MG 0.18052 07/01/2013All NDCs
Lithium Carbonate Tab 300 MG 0.19945 06/25/2012All NDCs
Lithium Carbonate Tab CR 300 MG 0.23441 09/01/2012All NDCs
Lithium Carbonate Tab CR 450 MG 0.40247 06/25/2012All NDCs
Lithium Citrate Oral Soln 8 mEq/5ML 0.11123 06/25/2012All NDCs
LO/OVRAL-28 TAB (00008251401) 1.62252 10/14/2011Specific NDC
LO/OVRAL-28 TAB (00008251402) 1.62252 11/30/2011Specific NDC
Page 53 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
LOESTRIN 21 TAB 1.5/30 (51285008297) 2.15316 10/14/2011Specific NDC
LOESTRIN FE TAB 1.5/30 (51285008498) 1.72553 10/14/2011Specific NDC
LOESTRIN FE TAB 1/20 (35356036328) 1.89328 10/14/2011Specific NDC
LOESTRIN FE TAB 1/20 (51285008198) 1.77065 10/14/2011Specific NDC
LONGS LANCET MIS STANDARD
(38396032870)
0.03271 10/14/2011Specific NDC
LONGS LANCET MIS THIN (38396032970) 0.03271 10/14/2011Specific NDC
LONGS LANCET MIS ULTRA TH
(38396033070)
0.04519 10/14/2011Specific NDC
Loperamide HCl Cap 2 MG 0.18263 0.10014 01/01/2013All NDCs
Loperamide HCl Liq 1 MG/5ML (0.2 MG/ML) 0.03469 06/25/2012All NDCs
Loperamide HCl Liq 1 MG/7.5ML 0.03469 06/25/2012All NDCs
Loperamide HCl Tab 2 MG 0.23110 06/25/2012All NDCs
Loratadine & Pseudoephedrine Tab SR 12HR
5-120 MG
0.74818 06/25/2012All NDCs
Loratadine & Pseudoephedrine Tab SR 24HR
10-240 MG
0.52565 06/25/2012All NDCs
Loratadine Rapidly-Disintegrating Tab 10 MG 0.44040 06/25/2012All NDCs
Loratadine Syrup 5 MG/5ML 0.06546 06/25/2012All NDCs
Loratadine Tab 10 MG 0.19250 0.10692 01/01/2013All NDCs
Lorazepam (Bulk) Powder 3.02352 06/25/2012All NDCs
Lorazepam Conc 2 MG/ML 1.08205 01/01/2013All NDCs
Lorazepam Inj 2 MG/ML 0.84975 06/25/2012All NDCs
Lorazepam Inj 4 MG/ML 3.55388 06/25/2012All NDCs
Lorazepam Tab 0.5 MG 0.06920 0.03162 01/01/2013All NDCs
Lorazepam Tab 1 MG 0.07687 06/25/2012All NDCs
Lorazepam Tab 2 MG 0.13719 06/25/2012All NDCs
Losartan Potassium & Hydrochlorothiazide
Tab 100-12.5 MG
0.40880 06/25/2012All NDCs
Losartan Potassium & Hydrochlorothiazide
Tab 100-25 MG
0.40880 0.28242 01/01/2013All NDCs
Losartan Potassium & Hydrochlorothiazide
Tab 50-12.5 MG
0.30040 0.11791 10/01/2012All NDCs
Losartan Potassium Tab 100 MG 0.12731 09/01/2012All NDCs
Losartan Potassium Tab 25 MG 0.20186 0.07181 01/01/2013All NDCs
Losartan Potassium Tab 50 MG 0.27160 06/25/2012All NDCs
Lovastatin Tab 10 MG 0.30722 06/25/2012All NDCs
Lovastatin Tab 20 MG 0.10850 09/01/2012All NDCs
Lovastatin Tab 40 MG 0.10086 09/01/2012All NDCs
Loxapine Succinate Cap 10 MG 0.66591 0.50164 01/01/2013All NDCs
Loxapine Succinate Cap 25 MG 0.97791 06/25/2012All NDCs
Loxapine Succinate Cap 5 MG 0.76709 06/25/2012All NDCs
Loxapine Succinate Cap 50 MG 1.29851 06/25/2012All NDCs
Page 54 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Lysine Acetate Tab 500 MG 0.02676 06/25/2012All NDCs
Magaldrate Susp 540 MG/5ML 0.00823 06/25/2012All NDCs
Magaldrate w/ Simethicone Susp 540-40
MG/5ML
0.01194 06/25/2012All NDCs
Magnesium Chloride Tab CR 535 MG (64 MG
Elemental Mg)
0.08100 06/25/2012All NDCs
Magnesium Citrate Soln 0.00466 06/25/2012All NDCs
Magnesium Hydroxide Susp 400 MG/5ML 0.00659 06/25/2012All NDCs
Magnesium Oxide Tab 400 MG 0.06790 06/25/2012All NDCs
Magnesium Oxide Tab 500 MG (Mg
Supplement)
0.02304 06/25/2012All NDCs
Magnesium Sulfate Inj 50% 0.12720 06/25/2012All NDCs
Magnesium Sulfate Oral Granules 0.00259 06/25/2012All NDCs
MAJOR COMFOR MIS LANCETS
(00904437525)
0.05001 10/14/2011Specific NDC
Malathion Lotion 0.5% 3.10516 06/25/2012All NDCs
Mebendazole Chew Tab 100 MG 4.50110 06/25/2012All NDCs
Meclizine HCl Tab 12.5 MG 0.05602 06/25/2012All NDCs
Meclizine HCl Tab 25 MG 0.31008 06/25/2012All NDCs
MEDI-LANCE MIS LANCETS
(32671020100)
0.02781 10/14/2011Specific NDC
MEDI-LANCE MIS LANCETS
(32671020200)
0.02085 10/14/2011Specific NDC
MEDLANCE MIS EXTR 21G
(08271138300)
0.10038 12/31/2011Specific NDC
MEDLANCE MIS LITE 25G
(08271138100)
0.10038 10/14/2011Specific NDC
MEDLANCE MIS UNV 21G
(08271138200)
0.10038 10/14/2011Specific NDC
MEDLANCE PLS MIS LITE 25G
(51028000125)
0.11448 10/14/2011Specific NDC
MEDLANCE PLS MIS UNIV 21G
(51028000121)
0.11448 10/14/2011Specific NDC
Medroxyprogesterone Acetate IM Susp 150
MG/ML
40.98127 06/25/2012All NDCs
Medroxyprogesterone Acetate Tab 10 MG 0.22074 0.07878 01/01/2013All NDCs
Medroxyprogesterone Acetate Tab 2.5 MG 0.18938 06/25/2012All NDCs
Medroxyprogesterone Acetate Tab 5 MG 0.23734 06/25/2012All NDCs
Mefloquine HCl Tab 250 MG 8.18049 5.73500 07/01/2013All NDCs
Megestrol Acetate Susp 40 MG/ML 0.08235 09/01/2012All NDCs
Megestrol Acetate Tab 20 MG 0.32630 06/25/2012All NDCs
Megestrol Acetate Tab 40 MG 0.57659 0.22863 07/01/2013All NDCs
MEIJER MIS LANCETS (38396030120) 0.04519 10/14/2011Specific NDC
MEIJER MIS LANCETS (38396030220) 0.03669 10/14/2011Specific NDC
MEIJER MIS LANCETS (38396030320) 0.04519 10/14/2011Specific NDC
Page 55 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
MEIJER MIS LANCETS (38396030420) 0.03669 10/14/2011Specific NDC
Melatonin Tab 3 MG 0.06840 06/25/2012All NDCs
Meloxicam Tab 15 MG 0.05367 06/25/2012All NDCs
Meloxicam Tab 7.5 MG 0.04143 06/25/2012All NDCs
MENS PAK (31604001025) 0.17500 11/11/2011Specific NDC
Menthol Lozenge 7 MG 0.04000 06/25/2012All NDCs
Menthol-Zinc Oxide Oint 0.44-20.625% 0.03398 06/25/2012All NDCs
Meperidine HCl Tab 100 MG 0.95770 0.32779 07/01/2013All NDCs
Meperidine HCl Tab 50 MG 0.29815 06/25/2012All NDCs
Meprobamate Tab 200 MG 1.08166 06/25/2012All NDCs
Meprobamate Tab 400 MG 1.21949 3.22000 07/29/2013All NDCs
Mercaptopurine Tab 50 MG 2.77288 1.38739 10/01/2012All NDCs
Meropenem IV For Soln 500 MG 33.78240 06/25/2012All NDCs
Mesalamine Enema 4 GM 0.20329 0.23500 01/15/2013All NDCs
METAMUCIL POW 63% (37000074117) 0.02020 02/19/2012Specific NDC
Metaproterenol Sulfate Syrup 10 MG/5ML 0.05210 06/25/2012All NDCs
Metaxalone Tab 800 MG 3.58848 06/25/2012All NDCs
Metformin HCl Tab 1000 MG 0.07398 06/25/2012All NDCs
Metformin HCl Tab 500 MG 0.04255 06/25/2012All NDCs
Metformin HCl Tab 850 MG 0.06949 06/25/2012All NDCs
Metformin HCl Tab SR 24HR 500 MG 0.15691 0.05786 10/01/2012All NDCs
Metformin HCl Tab SR 24HR 750 MG 0.36851 0.18381 01/01/2013All NDCs
Methadone HCl Conc 10 MG/ML 0.10119 0.63646 04/11/2013All NDCs
Methadone HCl Tab 10 MG 0.09071 06/25/2012All NDCs
Methadone HCl Tab 5 MG 0.06411 06/25/2012All NDCs
Methadone HCl Tab For Oral Susp 40 MG 0.22989 06/25/2012All NDCs
Methazolamide Tab 25 MG 0.29459 06/25/2012All NDCs
Methazolamide Tab 50 MG 0.43488 06/25/2012All NDCs
Methenamine Hippurate Tab 1 GM 1.72710 06/25/2012All NDCs
Methenamine Mandelate Tab 1 GM 1.36290 06/25/2012All NDCs
Methimazole Tab 10 MG 0.67112 0.24404 10/01/2012All NDCs
Methimazole Tab 5 MG 0.39392 0.19525 01/01/2013All NDCs
Methocarbamol Tab 500 MG 0.18171 06/25/2012All NDCs
Methocarbamol Tab 750 MG 0.20531 0.12158 01/01/2013All NDCs
METHOCEL POW K100M (51552021705) 0.03994 02/19/2012Specific NDC
METHOCEL POW K100M (51552021706) 0.03994 02/19/2012Specific NDC
Methotrexate Sodium Inj 25 MG/ML 2.08575 06/25/2012All NDCs
Methotrexate Sodium Inj PF 25 MG/ML 1.33270 06/25/2012All NDCs
Methotrexate Sodium Tab 2.5 MG (Base
Equiv)
2.45000 2.02021 07/01/2013All NDCs
Methscopolamine Bromide Tab 2.5 MG 2.43456 06/25/2012All NDCs
Page 56 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Methyclothiazide Tab 5 MG 1.04674 06/25/2012All NDCs
Methylcellulose Gel 1% 0.04800 06/25/2012All NDCs
Methyldopa Tab 250 MG 0.17021 06/25/2012All NDCs
Methyldopa Tab 500 MG 0.48899 0.30731 04/03/2013All NDCs
Methylergonovine Maleate Tab 0.2 MG 1.34288 5.79911 01/04/2013All NDCs
Methylphenidate HCl Tab 10 MG 0.17474 0.87027 03/08/2013All NDCs
Methylphenidate HCl Tab 20 MG 0.87060 1.23000 05/20/2013All NDCs
Methylphenidate HCl Tab 5 MG 0.23804 0.60364 05/21/2013All NDCs
Methylphenidate HCl Tab CR 10 MG 0.73224 1.16000 06/17/2013All NDCs
Methylphenidate HCl Tab SA OSM 18 MG 5.66136 06/25/2012All NDCs
Methylphenidate HCl Tab SA OSM 27 MG 5.80332 5.32234 04/03/2013All NDCs
Methylphenidate HCl Tab SA OSM 36 MG 5.98596 5.34000 07/01/2013All NDCs
Methylphenidate HCl Tab SA OSM 54 MG 6.51348 5.73000 07/01/2013All NDCs
Methylphenidate TD Patch 10 MG/9HR 6.47333 6.92630 08/19/2013All NDCs
Methylprednisolone Acetate Inj Susp 40
MG/ML
0.00000 06/25/2012All NDCs
Methylprednisolone Sodium Succinate For Inj
1000 MG
10.93287 06/25/2012All NDCs
Methylprednisolone Sodium Succinate For Inj
125 MG
2.84589 06/25/2012All NDCs
Methylprednisolone Sodium Succinate For Inj
40 MG
1.80765 06/25/2012All NDCs
Methylprednisolone Sodium Succinate For Inj
500 MG
5.95432 06/25/2012All NDCs
Methylprednisolone Tab 16 MG 2.98152 06/25/2012All NDCs
Methylprednisolone Tab 32 MG 4.44000 06/25/2012All NDCs
Methylprednisolone Tab 4 MG 0.25693 1.17000 10/24/2012All NDCs
Methylprednisolone Tab 4 MG Dose Pack 1.07100 06/25/2012All NDCs
Metoclopramide HCl Soln 5 MG/5ML (10
MG/10ML)
0.01449 06/25/2012All NDCs
Metoclopramide HCl Tab 10 MG 0.10240 0.05949 01/01/2013All NDCs
Metoclopramide HCl Tab 5 MG 0.14615 0.05056 01/01/2013All NDCs
Metolazone Tab 10 MG 1.25555 06/25/2012All NDCs
Metolazone Tab 2.5 MG 0.40000 09/01/2012All NDCs
Metolazone Tab 5 MG 0.52238 09/01/2012All NDCs
Metoprolol & Hydrochlorothiazide Tab 100-25
MG
1.59540 06/25/2012All NDCs
Metoprolol & Hydrochlorothiazide Tab 50-25
MG
1.02120 06/25/2012All NDCs
Metoprolol Succinate Tab SR 24HR 100 MG 1.22325 06/25/2012All NDCs
Metoprolol Succinate Tab SR 24HR 200 MG 1.94632 1.79369 04/03/2013All NDCs
Metoprolol Succinate Tab SR 24HR 25 MG 0.70174 09/01/2012All NDCs
Metoprolol Succinate Tab SR 24HR 50 MG 0.81406 06/25/2012All NDCs
Page 57 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Metoprolol Tartrate Tab 100 MG 0.06453 06/25/2012All NDCs
Metoprolol Tartrate Tab 25 MG 0.06733 06/25/2012All NDCs
Metoprolol Tartrate Tab 50 MG 0.04676 06/25/2012All NDCs
Metronidazole Benzoate Powder 0.67200 06/25/2012All NDCs
Metronidazole Cap 375 MG 3.62242 06/25/2012All NDCs
Metronidazole Cream 0.75% 1.38891 06/25/2012All NDCs
Metronidazole Gel 0.75% 3.15109 2.25583 07/01/2013All NDCs
Metronidazole in NaCl 0.79% IV Soln 500
MG/100ML
0.09420 06/25/2012All NDCs
Metronidazole Lotion 0.75% 1.09375 3.29000 08/05/2013All NDCs
Metronidazole Powder 0.24960 06/25/2012All NDCs
Metronidazole Tab 250 MG 0.32000 06/25/2012All NDCs
Metronidazole Tab 500 MG 0.53925 06/25/2012All NDCs
Metronidazole Vaginal Gel 0.75% 0.37201 06/25/2012All NDCs
Mexiletine HCl Cap 150 MG 0.49640 06/25/2012All NDCs
Mexiletine HCl Cap 200 MG 0.90829 06/25/2012All NDCs
Mexiletine HCl Cap 250 MG 1.18617 06/25/2012All NDCs
Miconazole Nitrate Cream 2% 0.17280 06/25/2012All NDCs
Miconazole Nitrate Ointment 2% 0.13705 06/25/2012All NDCs
Miconazole Nitrate Powder 1.38240 06/25/2012All NDCs
Miconazole Nitrate Powder 2% 0.08480 06/25/2012All NDCs
Miconazole Nitrate Vaginal Cream 2% 0.18248 06/25/2012All NDCs
Miconazole Nitrate Vaginal Kit 7.91042 06/25/2012All NDCs
Miconazole Nitrate Vaginal Supp 200 MG &
2% Cream 9 GM Kit
7.47782 06/25/2012All NDCs
Miconazole Nitrate Vaginal Suppos 100 MG 0.72062 06/25/2012All NDCs
Midazolam HCl Inj 10 MG/10ML (Base
Equivalent)
0.27810 06/25/2012All NDCs
Midazolam HCl Inj 2 MG/2ML (Base
Equivalent)
0.34501 06/25/2012All NDCs
Midazolam HCl Inj 5 MG/5ML (Base
Equivalent)
0.34501 06/25/2012All NDCs
Midodrine HCl Tab 10 MG 1.50588 0.99030 04/03/2013All NDCs
Midodrine HCl Tab 2.5 MG 0.30838 09/01/2012All NDCs
Midodrine HCl Tab 5 MG 0.47556 09/01/2012All NDCs
MILCO-B-FORT TAB (17204039840) 0.17500 07/01/2010Specific NDC
Mineral Oil Enema 0.01489 06/25/2012All NDCs
Minocycline HCl Cap 100 MG 0.31325 09/01/2012All NDCs
Minocycline HCl Cap 50 MG 0.18325 09/01/2012All NDCs
Minocycline HCl Cap 75 MG 1.45080 06/25/2012All NDCs
Minocycline HCl Tab 100 MG 2.49002 01/01/2013All NDCs
Minocycline HCl Tab SR 24HR 90 MG 22.30400 06/25/2012All NDCs
Page 58 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Minoxidil Tab 10 MG 0.65139 0.26988 01/01/2013All NDCs
Minoxidil Tab 2.5 MG 0.29646 06/25/2012All NDCs
MIRALAX POW 3350 NF (41100082073) 0.03271 10/14/2011Specific NDC
MIRALAX POW 3350 NF (41100082076) 0.03699 10/14/2011Specific NDC
Mirtazapine Orally Disintegrating Tab 15 MG 1.81924 1.10412 07/01/2013All NDCs
Mirtazapine Orally Disintegrating Tab 30 MG 1.03834 09/01/2012All NDCs
Mirtazapine Orally Disintegrating Tab 45 MG 1.99717 1.12981 04/03/2013All NDCs
Mirtazapine Tab 15 MG 0.16479 06/25/2012All NDCs
Mirtazapine Tab 30 MG 0.20781 06/25/2012All NDCs
Mirtazapine Tab 45 MG 0.32846 06/25/2012All NDCs
Mirtazapine Tab 7.5 MG 0.27920 06/25/2012All NDCs
Misoprostol Tab 100 MCG 0.63635 06/25/2012All NDCs
Misoprostol Tab 200 MCG 0.62387 09/01/2012All NDCs
Mitomycin For Inj 20 MG 137.16756 06/25/2012All NDCs
Mitomycin For Inj 5 MG 48.47626 06/25/2012All NDCs
Mitoxantrone HCl Inj Conc 20 MG/10ML (2
MG/ML)
37.79005 06/25/2012All NDCs
Mitoxantrone HCl Inj Conc 25 MG/12.5ML (2
MG/ML)
41.77076 06/25/2012All NDCs
Mitoxantrone HCl Inj Conc 30 MG/15ML (2
MG/ML)
39.39764 06/25/2012All NDCs
Modafinil Tab 200 MG 19.13242 04/03/2013All NDCs
MODICON TAB 0.5/35 (00062171415) 1.59852 10/14/2011Specific NDC
Moexipril HCl Tab 15 MG 0.50287 09/01/2012All NDCs
Moexipril HCl Tab 7.5 MG 1.06126 06/25/2012All NDCs
Moexipril-Hydrochlorothiazide Tab 15-12.5
MG
1.13266 0.51414 01/01/2013All NDCs
Moexipril-Hydrochlorothiazide Tab 15-25 MG 0.75292 0.53742 01/01/2013All NDCs
Moexipril-Hydrochlorothiazide Tab 7.5-12.5
MG
1.13266 06/25/2012All NDCs
Mometasone Furoate Cream 0.1% 0.24861 09/01/2012All NDCs
Mometasone Furoate Oint 0.1% 0.82716 0.39991 01/01/2013All NDCs
Mometasone Furoate Solution 0.1% (Lotion) 0.35097 06/25/2012All NDCs
MONOCLATE-P INJ 1000UNIT
(00053765604)
0.61725 10/14/2011Specific NDC
MONOCLATE-P INJ 250UNIT
(00053765601)
0.61725 10/14/2011Specific NDC
MONOCLATE-P INJ 500UNIT
(00053765602)
0.61725 10/14/2011Specific NDC
MONOLET MIS LANCETS
(08881602018)
0.04627 10/14/2011Specific NDC
MONOLET MIS LANCETS
(08881602075)
0.04542 10/14/2011Specific NDC
Page 59 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
MONOLET MIS LANCETS
(08881602125)
0.05623 10/14/2011Specific NDC
MONOLET MIS LANCETS
(08881602141)
0.03784 10/14/2011Specific NDC
MONOLET MIS LANCETS
(08881602190)
0.03784 10/14/2011Specific NDC
MONOLET THIN MIS LANCETS
(08881602208)
0.05623 10/14/2011Specific NDC
MONOLET THIN MIS LANCETS
(08881602216)
0.04627 10/14/2011Specific NDC
MONONINE INJ 1000UNIT
(00053766804)
0.72835 10/14/2011Specific NDC
MONONINE INJ 250UNIT (00053766801) 0.77880 07/01/2010Specific NDC
MONONINE INJ 500UNIT (00053766802) 0.77880 03/09/2011Specific NDC
Montelukast Sodium Chew Tab 4 MG (Base
Equiv)
0.44250 10/01/2012All NDCs
Montelukast Sodium Chew Tab 5 MG (Base
Equiv)
0.44250 10/01/2012All NDCs
Montelukast Sodium Tab 10 MG (Base Equiv) 0.44250 10/01/2012All NDCs
Morphine Sulfate (Concentrate) Oral Soln 20
MG/ML
0.60000 06/25/2012All NDCs
Morphine Sulfate Inj 10 MG/ML 1.01900 06/25/2012All NDCs
Morphine Sulfate IV Soln 50 MG/ML 0.43878 06/25/2012All NDCs
Morphine Sulfate Tab 15 MG 0.14151 06/25/2012All NDCs
Morphine Sulfate Tab 30 MG 0.24117 06/25/2012All NDCs
Morphine Sulfate Tab CR 100 MG 0.85922 07/01/2013All NDCs
Morphine Sulfate Tab CR 15 MG 0.26000 07/01/2013All NDCs
Morphine Sulfate Tab CR 200 MG 1.38881 07/01/2013All NDCs
Morphine Sulfate Tab CR 30 MG 0.37891 07/01/2013All NDCs
Morphine Sulfate Tab SR 12HR 100 MG 0.84488 09/01/2012All NDCs
Morphine Sulfate Tab SR 12HR 15 MG 0.20188 09/01/2012All NDCs
Morphine Sulfate Tab SR 12HR 200 MG 6.51533 1.53381 04/03/2013All NDCs
Morphine Sulfate Tab SR 12HR 30 MG 1.00400 0.37263 10/01/2012All NDCs
Morphine Sulfate Tab SR 12HR 60 MG 1.64370 0.63272 10/01/2012All NDCs
MUCINEX TAB 600MG ER
(63824000810)
0.33881 10/14/2011Specific NDC
MUCINEX TAB 600MG ER
(63824000820)
0.37428 10/14/2011Specific NDC
MUCINEX TAB 600MG ER
(63824000840)
0.35342 10/14/2011Specific NDC
MUCINEX TAB 600MG ER
(63824000850)
0.33937 10/14/2011Specific NDC
MULTI VITAMN TAB MINERALS
(54629111301)
0.17500 10/14/2011Specific NDC
MULTI-DELYN LIQ /IRON (54838000970) 0.17500 10/14/2011Specific NDC
Page 60 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
MULTI-DELYN LIQ /IRON (54838000980) 0.17500 10/14/2011Specific NDC
Mupirocin Oint 2% 0.48277 09/01/2012All NDCs
MURO 128 OIN 5% OP (24208038555) 4.00818 10/14/2011Specific NDC
MURO 128 OIN 5% OP (24208038556) 3.08780 10/14/2011Specific NDC
MURO 128 SOL 5% OP (24208027715) 0.93524 10/14/2011Specific NDC
MURO 128 SOL 5% OP (24208027730) 0.60255 10/14/2011Specific NDC
MYCELEX-7 CRE 1% VAG (16500002502) 0.21120 05/14/2011Specific NDC
MYCELEX-7 CRE 1% VAG (16500002507) 0.21120 05/14/2011Specific NDC
MYCELEX-7 CRE 1% VAG (16500002508) 0.21120 05/14/2011Specific NDC
MYCELEX-7 CRE 1% VAG (16500002509) 0.21120 05/14/2011Specific NDC
Mycophenolate Mofetil Cap 250 MG 0.47450 07/01/2012All NDCs
Mycophenolate Mofetil Tab 500 MG 0.51950 07/01/2012All NDCs
MYORISAN CAP 10MG (61748030111) 12.18376 12/05/2012Specific NDC
MYORISAN CAP 10MG (61748030113) 12.18376 12/05/2012Specific NDC
MYORISAN CAP 20MG (61748030211) 7.71069 12/05/2012Specific NDC
MYORISAN CAP 20MG (61748030213) 7.71069 12/05/2012Specific NDC
Nabumetone Tab 500 MG 0.23322 09/01/2012All NDCs
Nabumetone Tab 750 MG 0.28200 09/01/2012All NDCs
Nadolol Tab 20 MG 0.18563 3.10000 01/08/2013All NDCs
Nadolol Tab 40 MG 0.40112 3.21000 12/21/2012All NDCs
Nadolol Tab 80 MG 0.66217 06/25/2012All NDCs
Nafcillin Sodium For Inj 1 GM 14.01360 06/25/2012All NDCs
Nafcillin Sodium For Inj 10 GM 133.22520 06/25/2012All NDCs
Nafcillin Sodium For Inj 2 GM 27.19200 06/25/2012All NDCs
Naltrexone HCl Tab 50 MG 1.22333 09/01/2012All NDCs
Naproxen Sodium Tab 220 MG 0.07428 06/25/2012All NDCs
Naproxen Sodium Tab 275 MG 0.21832 06/25/2012All NDCs
Naproxen Sodium Tab 550 MG 0.37809 0.13525 10/01/2012All NDCs
Naproxen Susp 125 MG/5ML 0.07052 06/25/2012All NDCs
Naproxen Tab 250 MG 0.05481 06/25/2012All NDCs
Naproxen Tab 375 MG 0.06981 06/25/2012All NDCs
Naproxen Tab 500 MG 0.06511 06/25/2012All NDCs
Naproxen Tab EC 375 MG 0.76477 0.35970 04/03/2013All NDCs
Naproxen Tab EC 500 MG 0.20156 09/01/2012All NDCs
Naratriptan HCl Tab 1 MG (Base Equiv) 7.63611 01/01/2013All NDCs
Naratriptan HCl Tab 2.5 MG (Base Equiv) 24.00000 6.47269 10/01/2012All NDCs
Nateglinide Tab 120 MG 1.47384 06/25/2012All NDCs
Nateglinide Tab 60 MG 1.56920 0.92480 07/01/2013All NDCs
NECON TAB 1/50-28 (52544024531) 0.81306 0.86937 10/30/2012Specific NDC
NECON TAB 10/11-28 (52544055428) 0.88671 10/14/2011Specific NDC
Nefazodone HCl Tab 100 MG 0.67152 06/25/2012All NDCs
Page 61 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Nefazodone HCl Tab 150 MG 1.11809 06/25/2012All NDCs
Nefazodone HCl Tab 200 MG 1.10407 06/25/2012All NDCs
Nefazodone HCl Tab 250 MG 1.37633 06/25/2012All NDCs
Nefazodone HCl Tab 50 MG 1.27123 06/25/2012All NDCs
Neomycin Sulfate Tab 500 MG 1.22220 0.95775 01/01/2013All NDCs
Neomycin-Bacitrac Zn-Polymyx
5(3.5)MG-400Unt-10000Unt Op Oin
10.97857 01/01/2013All NDCs
Neomycin-Bacitracin-Polymyxin-Pramoxine
Oint 1%
0.16292 06/25/2012All NDCs
Neomycin-Polymyx-Gramicid Op Sol
1.75-10000-0.25MG-UNT-MG/ML
1.89384 06/25/2012All NDCs
Neomycin-Polymyxin-Dexamethasone Ophth
Oint 0.1%
3.69283 06/25/2012All NDCs
Neomycin-Polymyxin-Dexamethasone Ophth
Susp 0.1%
2.60040 06/25/2012All NDCs
Neomycin-Polymyxin-HC Ophth Susp 9.39363 06/25/2012All NDCs
Neomycin-Polymyxin-HC Otic Soln 1% 1.88125 09/01/2012All NDCs
Neomycin-Polymyxin-HC Otic Susp 3.5
MG/ML-10000 Unit/ML-1%
2.37930 1.90722 10/01/2012All NDCs
Nevirapine Tab 200 MG 0.22000 10/31/2012All NDCs
NEXA PLUS CAP (00245037430) 0.45000 10/02/2013Specific NDC
Niacin Cap CR 500 MG 0.04812 06/25/2012All NDCs
Niacin Tab 100 MG 0.01932 06/25/2012All NDCs
Niacin Tab 500 MG 0.03647 06/25/2012All NDCs
Niacin Tab CR 1000 MG 0.06264 06/25/2012All NDCs
Niacin Tab CR 500 MG 0.04788 06/25/2012All NDCs
Niacinamide Tab 500 MG 0.03240 06/25/2012All NDCs
Niacinamide w/ Zinc-Copper &Folic Acid Tab
750-25-1.5-0.5 MG
0.17500 06/25/2012All NDCs
Nicardipine HCl Cap 20 MG 0.31564 06/25/2012All NDCs
NICODERM CQ DIS 14MG/24H
(00135019502)
2.71700 10/14/2011Specific NDC
NICODERM CQ DIS 21MG/24H
(00135014502)
2.71700 10/14/2011Specific NDC
NICODERM CQ DIS 21MG/24H
(00135019401)
3.15290 10/14/2011Specific NDC
NICODERM CQ DIS 21MG/24H
(00135019402)
2.71700 10/14/2011Specific NDC
NICODERM CQ DIS 21MG/24H
(00135019403)
2.30940 10/14/2011Specific NDC
NICODERM CQ DIS 7MG/24HR
(00135019602)
2.71700 10/14/2011Specific NDC
NICORETTE GUM 2MG CINN
(00135046602)
0.38184 10/14/2011Specific NDC
Page 62 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
NICORETTE GUM 2MG MINT
(00135017009)
0.45175 10/14/2011Specific NDC
NICORETTE GUM 2MG MINT
(00135017010)
0.29690 10/14/2011Specific NDC
NICORETTE GUM 2MG MINT
(00135022501)
0.56470 10/14/2011Specific NDC
NICORETTE GUM 2MG ORIG
(00135015709)
0.45175 10/14/2011Specific NDC
NICORETTE GUM 2MG ORIG
(00135015710)
0.29690 10/14/2011Specific NDC
NICORETTE GUM 2MGFRUIT
(00135024101)
0.56470 10/14/2011Specific NDC
NICORETTE GUM 2MGFRUIT
(00135024102)
0.38184 10/14/2011Specific NDC
NICORETTE GUM 4MG CINN
(00135046702)
0.38184 10/14/2011Specific NDC
NICORETTE GUM 4MG MINT
(00135017109)
0.45175 10/14/2011Specific NDC
NICORETTE GUM 4MG MINT
(00135017110)
0.29690 10/14/2011Specific NDC
NICORETTE GUM 4MG MINT
(00135022601)
0.56470 10/14/2011Specific NDC
NICORETTE GUM 4MG MINT
(00135022602)
0.38184 10/14/2011Specific NDC
NICORETTE GUM 4MG ORIG
(00135015809)
0.45175 10/14/2011Specific NDC
NICORETTE GUM 4MG ORIG
(00135015810)
0.29690 10/14/2011Specific NDC
NICORETTE GUM 4MGFRUIT
(00135024201)
0.56470 10/14/2011Specific NDC
NICORETTE GUM 4MGFRUIT
(00135024202)
0.38184 10/14/2011Specific NDC
NICORETTE ST GUM 2MG MINT
(00135017007)
0.34713 10/14/2011Specific NDC
NICORETTE ST GUM 2MG MINT
(00135022502)
0.38184 10/14/2011Specific NDC
NICORETTE ST GUM 2MG ORIG
(00135015707)
0.34713 10/14/2011Specific NDC
NICORETTE ST GUM 4MG MINT
(00135017107)
0.34713 10/14/2011Specific NDC
NICORETTE ST GUM 4MG ORIG
(00135015807)
0.34713 10/14/2011Specific NDC
Nicotine Polacrilex Gum 2 MG 0.26386 06/25/2012All NDCs
Nicotine Polacrilex Gum 4 MG 0.31518 06/25/2012All NDCs
Nicotine Polacrilex Lozenge 2 MG 0.48265 06/25/2012All NDCs
Nicotine Polacrilex Lozenge 4 MG 0.50225 06/25/2012All NDCs
Nicotine TD Patch 24HR 14 MG/24HR 1.94560 1.98000 09/12/2012All NDCs
Nicotine TD Patch 24HR 21 MG/24HR 1.64818 1.95800 09/11/2012All NDCs
Page 63 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Nicotine TD Patch 24HR 7 MG/24HR 1.94560 1.99100 09/12/2012All NDCs
Nifedipine Cap 10 MG 0.83699 0.74631 01/01/2013All NDCs
Nifedipine Cap 20 MG 1.54678 06/25/2012All NDCs
Nifedipine Powder 2.20800 06/25/2012All NDCs
Nifedipine Tab SR 24HR 30 MG 0.87326 0.57933 01/01/2013All NDCs
Nifedipine Tab SR 24HR 60 MG 1.00700 0.92154 07/01/2013All NDCs
Nifedipine Tab SR 24HR 90 MG 1.98177 06/25/2012All NDCs
Nifedipine Tab SR 24HR Osmotic 30 MG 0.97167 0.55113 10/01/2012All NDCs
Nifedipine Tab SR 24HR Osmotic 60 MG 1.68083 0.82488 10/01/2012All NDCs
Nifedipine Tab SR 24HR Osmotic 90 MG 1.97452 1.07500 07/01/2013All NDCs
Nisoldipine Tab SR 24HR 8.5 MG 5.52756 06/25/2012All NDCs
Nitrofurantoin Macrocrystalline Cap 100 MG 1.71606 09/01/2012All NDCs
Nitrofurantoin Macrocrystalline Cap 50 MG 0.84928 06/25/2012All NDCs
Nitrofurantoin Monohydrate Macrocrystalline
Cap 100 MG
2.44005 2.33000 07/01/2013All NDCs
Nitrofurantoin Susp 25 MG/5ML 2.54056 1.85031 07/01/2013All NDCs
Nitroglycerin Cap CR 2.5 MG 0.53496 06/25/2012All NDCs
Nitroglycerin Cap CR 6.5 MG 0.61776 06/25/2012All NDCs
Nitroglycerin Cap CR 9 MG 0.34840 06/25/2012All NDCs
Nitroglycerin SL Tab 0.3 MG 0.10729 06/25/2012All NDCs
Nitroglycerin SL Tab 0.4 MG 0.10729 06/25/2012All NDCs
Nitroglycerin SL Tab 0.6 MG 0.10729 06/25/2012All NDCs
Nitroglycerin TD Patch 24HR 0.1 MG/HR 0.85713 07/01/2012All NDCs
Nitroglycerin TD Patch 24HR 0.2 MG/HR 0.62881 06/25/2012All NDCs
Nitroglycerin TD Patch 24HR 0.4 MG/HR 0.75705 06/25/2012All NDCs
Nitroglycerin TD Patch 24HR 0.6 MG/HR 1.13120 06/25/2012All NDCs
Nitroglycerin TL Soln 0.4 MG/SPRAY (400
MCG/SPRAY)
23.27500 06/25/2012All NDCs
NIX CREM RIN LIQ 1% (54569108501) 0.11887 10/14/2011Specific NDC
Nizatidine Cap 150 MG 0.20160 0.32351 01/14/2013All NDCs
Nizatidine Cap 300 MG 0.80916 09/01/2012All NDCs
Nizatidine Oral Soln 15 MG/ML 0.66150 06/25/2012All NDCs
NORDETTE-28 TAB (51285009158) 1.92052 10/14/2011Specific NDC
Norethindrone & Ethinyl Estradiol Tab 0.4
MG-35 MCG
1.23709 06/25/2012All NDCs
Norethindrone & Ethinyl Estradiol Tab 0.5
MG-35 MCG
0.88671 06/25/2012All NDCs
Norethindrone & Ethinyl Estradiol Tab 1
MG-35 MCG
0.81306 06/25/2012All NDCs
Norethindrone & Ethinyl Estradiol-Fe Chew
Tab 0.4 MG-35 MCG
2.50900 06/25/2012All NDCs
Norethindrone Ac-Ethinyl Estrad-Fe Tab
1-20/1-30/1-35 MG-MCG
1.57672 06/25/2012All NDCs
Page 64 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Norethindrone Ace & Ethinyl Estradiol Tab 1
MG-20 MCG
1.05427 06/25/2012All NDCs
Norethindrone Ace & Ethinyl Estradiol Tab 1.5
MG-30 MCG
1.06457 06/25/2012All NDCs
Norethindrone Ace & Ethinyl Estradiol-FE Tab
1 MG-20 MCG
0.79071 06/25/2012All NDCs
Norethindrone Ace & Ethinyl Estradiol-FE Tab
1.5 MG-30 MCG
0.79843 06/25/2012All NDCs
Norethindrone Acetate Tab 5 MG 2.04604 06/25/2012All NDCs
Norethindrone Acetate-Ethinyl Estradiol Tab 1
MG-5 MCG
2.24906 06/25/2012All NDCs
Norethindrone Tab 0.35 MG 1.01860 06/25/2012All NDCs
Norethindrone-Eth Estradiol Tab
0.5-35/0.75-35/1-35 MG-MCG
0.88837 06/25/2012All NDCs
Norethindrone-Eth Estradiol Tab
0.5-35/1-35/0.5-35 MG-MCG
1.21415 06/25/2012All NDCs
Norgestimate & Ethinyl Estradiol Tab 0.25
MG-35 MCG
0.45773 09/01/2012All NDCs
Norgestimate-Eth Estrad Tab
0.18-25/0.215-25/0.25-25 MG-MCG
1.99771 06/25/2012All NDCs
Norgestimate-Eth Estrad Tab
0.18-35/0.215-35/0.25-35 MG-MCG
0.44032 09/01/2012All NDCs
Norgestrel & Ethinyl Estradiol Tab 0.3 MG-30
MCG
0.84202 06/25/2012All NDCs
NORINYL TAB 1+50-28 (52544026531) 2.24328 10/14/2011Specific NDC
NORINYL TAB 1/35 (52544025928) 2.05761 10/14/2011Specific NDC
NORINYL TAB 1/35 (52544025931) 1.27434 07/08/2011Specific NDC
Nortriptyline HCl Cap 10 MG 0.09530 06/25/2012All NDCs
Nortriptyline HCl Cap 25 MG 0.12909 06/25/2012All NDCs
Nortriptyline HCl Cap 50 MG 0.15688 06/25/2012All NDCs
Nortriptyline HCl Cap 75 MG 0.20603 06/25/2012All NDCs
Nortriptyline HCl Soln 10 MG/5ML 0.10516 06/25/2012All NDCs
NOVA SURE MIS LANCETS
(08548043421)
0.05561 10/14/2011Specific NDC
NOVOLIN INJ 70/30 (00169183711) 5.02435 10/14/2011Specific NDC
NUCYNTA ER TAB 200MG (50458086301) 7.78980 10/17/2012Specific NDC
NUQUIN HP GEL 4% (58980047505) 0.95069 02/19/2012Specific NDC
NUQUIN HP GEL 4% (58980047510) 0.95069 02/19/2012Specific NDC
Nystatin Cream 100000 Unit/GM 0.72495 06/25/2012All NDCs
Nystatin Oint 100000 Unit/GM 0.76560 06/25/2012All NDCs
Nystatin Susp 100000 Unit/ML 0.17164 06/25/2012All NDCs
Nystatin Tab 500000 Unit 0.63670 06/25/2012All NDCs
Nystatin-Triamcinolone Cream 100000-0.1
Unit/GM-%
3.16400 3.50220 01/08/2013All NDCs
Page 65 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Nystatin-Triamcinolone Oint 100000-0.1
Unit/GM-%
0.09118 06/25/2012All NDCs
O-CAL FA TAB (00813931601) 0.17500 06/25/2012Specific NDC
OB COMPLETE CAP ONE (68025004430) 0.45000 10/02/2013Specific NDC
Octreotide Acetate Inj 100 MCG/ML (0.1
MG/ML)
5.00581 06/25/2012All NDCs
Octreotide Acetate Inj 1000 MCG/ML (1
MG/ML)
73.69676 06/25/2012All NDCs
Octreotide Acetate Inj 200 MCG/ML (0.2
MG/ML)
11.12404 06/25/2012All NDCs
Octreotide Acetate Inj 50 MCG/ML (0.05
MG/ML)
3.75436 06/25/2012All NDCs
Ofloxacin Ophth Soln 0.3% 0.65089 09/01/2012All NDCs
Ofloxacin Otic Soln 0.3% 1.09876 2.24000 07/09/2013All NDCs
Ofloxacin Tab 200 MG 3.69542 06/25/2012All NDCs
Ofloxacin Tab 300 MG 4.39778 06/25/2012All NDCs
Ofloxacin Tab 400 MG 4.63779 06/25/2012All NDCs
OGESTREL TAB (52544084828) 1.23931 10/14/2011Specific NDC
Olanzapine Orally Disintegrating Tab 10 MG 2.64330 09/01/2012All NDCs
Olanzapine Orally Disintegrating Tab 15 MG 9.26000 07/01/2012All NDCs
Olanzapine Orally Disintegrating Tab 20 MG 6.24875 5.51515 07/01/2013All NDCs
Olanzapine Orally Disintegrating Tab 5 MG 1.95000 2.53000 11/15/2012All NDCs
Olanzapine Tab 10 MG 0.42163 06/25/2012All NDCs
Olanzapine Tab 15 MG 0.63006 06/25/2012All NDCs
Olanzapine Tab 2.5 MG 0.25046 06/25/2012All NDCs
Olanzapine Tab 20 MG 0.84846 06/25/2012All NDCs
Olanzapine Tab 5 MG 0.27603 06/25/2012All NDCs
Olanzapine Tab 7.5 MG 0.34060 06/25/2012All NDCs
Omeprazole Cap Delayed Release 10 MG 0.44000 09/01/2012All NDCs
Omeprazole Cap Delayed Release 20 MG 0.12125 09/01/2012All NDCs
Omeprazole Cap Delayed Release 40 MG 1.13153 0.41519 04/03/2013All NDCs
Omeprazole Delayed Release Tab 20 MG 0.64000 06/25/2012All NDCs
Omeprazole-Sodium Bicarbonate Cap
20-1100 MG
5.75040 06/25/2012All NDCs
Omeprazole-Sodium Bicarbonate Cap
40-1100 MG
5.75040 06/25/2012All NDCs
OMNICAP TAB (64038010330) 0.17500 10/14/2011Specific NDC
ONCOVITE TAB (00178055001) 0.17500 10/14/2011Specific NDC
Ondansetron HCl and Dextrose Inj 32
MG/50ML
0.61707 06/25/2012All NDCs
Ondansetron HCl Inj 4 MG/2ML (2 MG/ML) 0.59104 06/25/2012All NDCs
Ondansetron HCl Inj 40 MG/20ML (2 MG/ML) 0.17914 06/25/2012All NDCs
Ondansetron HCl Oral Soln 4 MG/5ML 1.92780 1.08587 07/01/2013All NDCs
Page 66 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Ondansetron HCl Tab 24 MG 7.51853 06/25/2012All NDCs
Ondansetron HCl Tab 4 MG 0.26500 0.22028 01/01/2013All NDCs
Ondansetron HCl Tab 8 MG 0.27938 09/01/2012All NDCs
Ondansetron Orally Disintegrating Tab 4 MG 0.50247 06/25/2012All NDCs
Ondansetron Orally Disintegrating Tab 8 MG 0.68993 06/25/2012All NDCs
ONE-A-DAY TAB CHOLEST
(16500052128)
0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB ESSENT (16500007303) 0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB ESSENT (16500007317) 0.17500 05/14/2011Specific NDC
ONE-A-DAY TAB MAX FORM
(16500007511)
0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB MAX FORM
(16500007513)
0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB MENS (16500008004) 0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB MENS (16500008012) 0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB WOMENS
(16500007406)
0.17500 10/14/2011Specific NDC
ONE-A-DAY TAB WOMENS
(16500007410)
0.17500 10/14/2011Specific NDC
ONETOUCH MIS LANC DEV
(53885013920)
0.15758 10/14/2011Specific NDC
ONETOUCH MIS LANC DEV
(53885014020)
0.15758 10/14/2011Specific NDC
ONETOUCH MIS LANC DEV
(53885014110)
0.15758 10/14/2011Specific NDC
ONETOUCH MIS LANCETS
(53885004610)
0.07786 10/14/2011Specific NDC
ONETOUCH MIS LANCETS
(53885010207)
0.05237 10/14/2011Specific NDC
ONETOUCH TES ULTRA BL
(68115071800)
0.93227 04/01/2011Specific NDC
ONETOUCH US MIS LANCETS
(53885039310)
0.07971 10/14/2011Specific NDC
ONETOUCH US MIS LANCETS
(54868579800)
0.10343 10/14/2011Specific NDC
Opium Tincture 1% (10 MG/ML) (Morphine
Equiv)
6.72895 06/25/2012All NDCs
OPTISOURCE CHW (43900017500) 0.17500 09/28/2011Specific NDC
OPTIVITE TAB P.M.T. (50520000103) 0.17500 01/02/2003Specific NDC
Orphenadrine Citrate Tab SR 12HR 100 MG 0.97498 06/25/2012All NDCs
ORTHO TRI- TAB CYCLEN (35356002168) 1.46103 10/14/2011Specific NDC
ORTHO-CEPT TAB 28 (00062179615) 1.02408 10/14/2011Specific NDC
ORTHO-NOVUM TAB 1/35 (00062176115) 1.46526 10/14/2011Specific NDC
ORTHO-NOVUM TAB 7/7/7 (00062178115) 0.78822 10/14/2011Specific NDC
Oxandrolone Tab 10 MG 17.80040 06/25/2012All NDCs
Page 67 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Oxandrolone Tab 2.5 MG 5.24928 06/25/2012All NDCs
Oxaprozin Tab 600 MG 0.34536 2.32000 11/23/2012All NDCs
Oxazepam Cap 10 MG 0.50156 06/25/2012All NDCs
Oxazepam Cap 15 MG 0.53392 06/25/2012All NDCs
Oxazepam Cap 30 MG 1.15379 06/25/2012All NDCs
Oxcarbazepine Susp 300 MG/5ML (60
MG/ML)
0.56083 0.68326 12/07/2012All NDCs
Oxcarbazepine Tab 150 MG 0.84171 0.22494 10/01/2012All NDCs
Oxcarbazepine Tab 300 MG 1.59924 0.33013 10/01/2012All NDCs
Oxcarbazepine Tab 600 MG 0.61475 09/01/2012All NDCs
Oxybutynin Chloride Syrup 5 MG/5ML 0.02599 06/25/2012All NDCs
Oxybutynin Chloride Tab 5 MG 0.12090 06/25/2012All NDCs
Oxybutynin Chloride Tab SR 24HR 10 MG 1.38413 1.26310 07/01/2013All NDCs
Oxybutynin Chloride Tab SR 24HR 15 MG 1.37771 1.79000 05/01/2013All NDCs
Oxybutynin Chloride Tab SR 24HR 5 MG 1.35988 1.20681 04/03/2013All NDCs
Oxycodone HCl Cap 5 MG 0.19995 06/25/2012All NDCs
Oxycodone HCl Conc 20 MG/ML 5.96000 6.90000 05/30/2013All NDCs
Oxycodone HCl Soln 5 MG/5ML 0.05716 0.18238 05/15/2013All NDCs
Oxycodone HCl Tab 10 MG 0.34651 04/03/2013All NDCs
Oxycodone HCl Tab 15 MG 0.23512 0.29340 11/03/2012All NDCs
Oxycodone HCl Tab 20 MG 0.63535 04/03/2013All NDCs
Oxycodone HCl Tab 30 MG 0.48832 0.38984 04/03/2013All NDCs
Oxycodone HCl Tab 5 MG 0.22436 0.15014 10/01/2012All NDCs
Oxycodone HCl Tab SR 12HR 10 MG 1.39784 06/25/2012All NDCs
Oxycodone HCl Tab SR 12HR 20 MG 2.67494 06/25/2012All NDCs
Oxycodone HCl Tab SR 12HR 80 MG 8.92534 06/25/2012All NDCs
Oxycodone w/ Acetaminophen Cap 5-500 MG 0.25768 06/25/2012All NDCs
Oxycodone w/ Acetaminophen Tab 10-325
MG
0.51410 0.40294 01/01/2013All NDCs
Oxycodone w/ Acetaminophen Tab 10-650
MG
1.26960 0.47356 10/01/2012All NDCs
Oxycodone w/ Acetaminophen Tab 2.5-325
MG
1.96716 06/25/2012All NDCs
Oxycodone w/ Acetaminophen Tab 5-325 MG 0.17024 06/25/2012All NDCs
Oxycodone w/ Acetaminophen Tab 7.5-325
MG
0.36187 09/01/2012All NDCs
Oxycodone w/ Acetaminophen Tab 7.5-500
MG
0.43763 09/01/2012All NDCs
Oxycodone-Aspirin Tab 4.8355-325 MG 0.91278 06/25/2012All NDCs
Oxycodone-Ibuprofen Tab 5-400 MG 1.13866 06/25/2012All NDCs
Oxymetazoline HCl Nasal Soln 0.05% 0.31920 06/25/2012All NDCs
Oxymorphone HCl Tab SR 12HR 15 MG 4.88904 06/25/2012All NDCs
Oxymorphone HCl Tab SR 12HR 7.5 MG 2.68068 06/25/2012All NDCs
Page 68 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Oyster Shell Calcium Tab 500 MG 0.01343 06/25/2012All NDCs
Pamidronate Disodium For Inj 30 MG 37.08013 06/25/2012All NDCs
Pamidronate Disodium For Inj 90 MG 111.24040 06/25/2012All NDCs
Pamidronate Disodium IV Soln 3 MG/ML 3.70801 06/25/2012All NDCs
Pantoprazole Sodium EC Tab 20 MG (Base
Equiv)
0.20000 06/25/2012All NDCs
Pantoprazole Sodium EC Tab 40 MG (Base
Equiv)
0.13440 06/25/2012All NDCs
Paromomycin Sulfate Cap 250 MG 4.86000 06/25/2012All NDCs
Paroxetine HCl Oral Susp 10 MG/5ML (Base
Equiv)
0.48840 06/25/2012All NDCs
Paroxetine HCl Tab 10 MG 0.10542 09/01/2012All NDCs
Paroxetine HCl Tab 20 MG 0.33434 0.13564 01/01/2013All NDCs
Paroxetine HCl Tab 30 MG 0.16438 09/01/2012All NDCs
Paroxetine HCl Tab 40 MG 0.17042 09/01/2012All NDCs
Paroxetine HCl Tab SR 24HR 12.5 MG 2.62800 2.31536 07/01/2013All NDCs
Paroxetine HCl Tab SR 24HR 25 MG 2.70282 2.36463 07/01/2013All NDCs
Paroxetine HCl Tab SR 24HR 37.5 MG 2.79634 06/25/2012All NDCs
PC LANCETS MIS 30G (08214535716) 0.04341 10/14/2011Specific NDC
PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate
For Soln 236 GM
0.00455 06/25/2012All NDCs
PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate
For Soln 240 GM
0.00231 06/25/2012All NDCs
PEG 3350-KCl-Sod Bicarb-NaCl For Soln 420
GM
0.00634 06/25/2012All NDCs
Penicillin V Potassium For Soln 125 MG/5ML 0.03398 06/25/2012All NDCs
Penicillin V Potassium For Soln 250 MG/5ML 0.03329 06/25/2012All NDCs
Penicillin V Potassium Tab 250 MG 0.19752 06/25/2012All NDCs
Penicillin V Potassium Tab 500 MG 0.33574 0.18344 01/01/2013All NDCs
Pentazocine w/ Naloxone Tab 50-0.5 MG 1.16904 06/25/2012All NDCs
Pentoxifylline Tab CR 400 MG 0.24646 0.15522 01/01/2013All NDCs
PEPCID AC TAB 20MG (16837085505) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085508) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085509) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085512) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085525) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085544) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085550) 0.14028 05/22/2012Specific NDC
PEPCID AC TAB 20MG (16837085565) 0.14028 05/22/2012Specific NDC
Permethrin Cream 5% 0.86278 1.07000 08/14/2013All NDCs
Permethrin Lotion 1% 0.10723 06/25/2012All NDCs
Perphenazine Tab 16 MG 1.27703 06/25/2012All NDCs
Page 69 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Perphenazine Tab 2 MG 0.68161 0.96000 09/10/2013All NDCs
Perphenazine Tab 4 MG 0.85800 1.47600 07/31/2013All NDCs
Perphenazine Tab 8 MG 0.85389 1.17900 06/12/2013All NDCs
Perphenazine-Amitriptyline Tab 2-10 MG 0.46939 06/25/2012All NDCs
Perphenazine-Amitriptyline Tab 2-25 MG 0.59761 06/25/2012All NDCs
Perphenazine-Amitriptyline Tab 4-50 MG 1.07477 06/25/2012All NDCs
Phenazopyridine HCl Tab 100 MG 0.20718 06/25/2012All NDCs
Phenazopyridine HCl Tab 200 MG 0.26610 06/25/2012All NDCs
Phenazopyridine-Butabarbital-Hyoscyamine
Tab 150-15-0.3 MG
2.29553 06/25/2012All NDCs
Phenelzine Sulfate Tab 15 MG 0.79820 06/25/2012All NDCs
PHENEX-2 POW (70074051123) 0.07481 11/11/2011Specific NDC
PHENEX-2 POW (70074055756) 0.08348 10/14/2011Specific NDC
Phenobarbital Elixir 20 MG/5ML 0.03650 0.15274 04/24/2013All NDCs
Phenobarbital Tab 100 MG 0.11763 06/25/2012All NDCs
Phenobarbital Tab 15 MG 0.01584 06/25/2012All NDCs
Phenobarbital Tab 30 MG 0.03012 0.18259 02/01/2013All NDCs
Phenobarbital Tab 32.4 MG 0.12100 06/25/2012All NDCs
Phenobarbital Tab 60 MG 0.08402 06/25/2012All NDCs
Phenol Liquid 1.4% 0.01322 06/25/2012All NDCs
Phentermine HCl Cap 15 MG 1.50444 06/25/2012All NDCs
PHENYL-FREE POW 2HP (00087008141) 0.10252 10/14/2011Specific NDC
PHENYLADE POW (00847095000) 0.23661 10/14/2011Specific NDC
PHENYLADE POW MTE (00847095960) 0.23661 10/14/2011Specific NDC
Phenylephrine in Hard Fat Rectal Suppos
0.25%
0.20900 06/25/2012All NDCs
Phenylephrine w/ DM-GG Syrup 5-10-100
MG/5ML
0.01739 06/25/2012All NDCs
Phenylephrine-Brompheniramine-DM Elixir
2.5-1-5 MG/5ML
0.02125 06/25/2012All NDCs
Phenylephrine-Chlorphen-DM Liquid 10-4-15
MG/5ML
0.04820 06/25/2012All NDCs
Phenylephrine-Chlorphen-DM Liquid 2-1-3
MG/ML
0.57960 06/25/2012All NDCs
Phenylephrine-Chlorphen-DM Liquid 3.5-1-3
MG/ML
1.47480 06/25/2012All NDCs
Phenylephrine-Chlorphen-DM Syrup
12.5-4-15 MG/5ML
0.18754 06/25/2012All NDCs
Phenylephrine-Chlorphen-DM Syrup 5-2-15
MG/5ML
0.05408 06/25/2012All NDCs
Phenylephrine-DM Soln 2.5-5 MG/5ML 0.04109 06/25/2012All NDCs
Phenylephrine-Promethazine w/ Codeine
Syrup 5-6.25-10 MG/5ML
0.09024 06/25/2012All NDCs
Page 70 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Phenylephrine-Shark Liver Oil-MO-Pet Oint
0.25-3-14-71.9%
0.06338 06/25/2012All NDCs
Phenytoin Sodium Extended Cap 100 MG 0.24946 06/25/2012All NDCs
Phenytoin Susp 125 MG/5ML 0.14224 06/25/2012All NDCs
Pilocarpine HCl Ophth Soln 1% 2.10120 06/25/2012All NDCs
Pilocarpine HCl Ophth Soln 2% 2.15270 06/25/2012All NDCs
Pilocarpine HCl Ophth Soln 4% 2.26600 06/25/2012All NDCs
Pilocarpine HCl Ophth Soln 6% 0.67207 06/25/2012All NDCs
Pilocarpine HCl Tab 5 MG 1.01054 0.34738 10/01/2012All NDCs
Pindolol Tab 10 MG 0.31590 06/25/2012All NDCs
Pindolol Tab 5 MG 0.52955 06/25/2012All NDCs
Pioglitazone HCl Tab 15 MG (Base Equiv) 3.10000 0.20875 02/27/2013All NDCs
Pioglitazone HCl Tab 30 MG (Base Equiv) 4.06080 0.46250 02/27/2013All NDCs
Pioglitazone HCl Tab 45 MG (Base Equiv) 4.35860 0.51250 02/27/2013All NDCs
Piperacillin Sodium-Tazobactam Sodium For
Inj 3-0.375 GM
15.36960 06/25/2012All NDCs
Piperacillin Sodium-Tazobactam Sodium For
Inj 4-0.5 GM
21.04680 06/25/2012All NDCs
Piroxicam Cap 10 MG 1.16600 08/28/2012All NDCs
Piroxicam Cap 20 MG 1.87570 06/25/2012All NDCs
PKU 3 POW (81361093470) 0.17613 10/14/2011Specific NDC
PMS FORMULA TAB (54629011310) 0.17500 07/01/2010Specific NDC
Podofilox Soln 0.5% 16.21143 14.79714 07/01/2013All NDCs
Polyethylene Glycol 1450 Liquid 0.01776 06/25/2012All NDCs
Polyethylene Glycol 3350 Oral Packet 1.62813 09/01/2012All NDCs
Polyethylene Glycol 3350 Oral Powder 0.03392 0.04730 10/12/2012All NDCs
Polymyxin B-Trimethoprim Ophth Soln 10000
Unit/ML-0.1%
1.15594 06/25/2012All NDCs
Polysaccharide Iron Complex Cap 150 MG
(Iron Equivalent)
0.19392 06/25/2012All NDCs
Polyvinyl Alcohol Ophth Soln 1.4% 0.23360 06/25/2012All NDCs
Polyvinyl Alcohol-Povidone Ophth Soln 5-6
MG/ML (0.5-0.6%)
0.10720 06/25/2012All NDCs
Pot Phos Monobasic w/Sod Phos Di &
Monobas Tab 155-852-130MG
0.13500 06/25/2012All NDCs
Potassium Bicarbonate Effer Tab 25 mEq 0.25620 06/25/2012All NDCs
Potassium Chloride Cap CR 10 mEq 0.76671 06/25/2012All NDCs
Potassium Chloride Cap CR 8 mEq 0.90216 06/25/2012All NDCs
Potassium Chloride Inj 2 mEq/ML 0.03244 06/25/2012All NDCs
Potassium Chloride Microencapsulated Crys
CR Tab 10 mEq
0.43768 06/25/2012All NDCs
Potassium Chloride Microencapsulated Crys
CR Tab 20 mEq
0.30678 06/25/2012All NDCs
Page 71 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Potassium Chloride Oral Liq 10% (20
MEQ/15ML)
0.00701 0.01747 08/03/2013All NDCs
Potassium Chloride Oral Liq 20% (40
MEQ/15ML)
0.01848 06/25/2012All NDCs
Potassium Chloride Powder Packet 20 mEq 0.79309 06/25/2012All NDCs
Potassium Chloride Tab CR 10 mEq 0.36161 06/25/2012All NDCs
Potassium Chloride Tab CR 8 mEq (600 MG) 0.39425 06/25/2012All NDCs
Potassium Citrate & Citric Acid Powder Pack
3300-1002 MG
0.71748 06/25/2012All NDCs
Potassium Citrate & Citric Acid Soln 1100-334
MG/5ML
0.02788 06/25/2012All NDCs
Potassium Citrate Tab CR 10 MEQ (1080
MG)
1.18448 06/25/2012All NDCs
Potassium Citrate Tab CR 5 MEQ (540 MG) 0.72708 06/25/2012All NDCs
Pramipexole Dihydrochloride Tab 0.125 MG 0.23333 06/25/2012All NDCs
Pramipexole Dihydrochloride Tab 0.25 MG 0.23333 0.12583 01/01/2013All NDCs
Pramipexole Dihydrochloride Tab 0.5 MG 0.23333 06/25/2012All NDCs
Pramipexole Dihydrochloride Tab 0.75 MG 0.23333 06/25/2012All NDCs
Pramipexole Dihydrochloride Tab 1 MG 0.11834 09/01/2012All NDCs
Pramipexole Dihydrochloride Tab 1.5 MG 0.20000 06/25/2012All NDCs
Pramoxine-HC Cream 1-2.5% 2.17183 06/25/2012All NDCs
Pramoxine-HC-Chloroxylenol Otic Soln
10-10-1 MG/ML
1.23720 06/25/2012All NDCs
PRASCION FC PAD 10-5% (66993090530) 6.64120 02/19/2012Specific NDC
PRASCION FC PAD 10-5% (66993090560) 6.64120 02/19/2012Specific NDC
Prasterone Powder 1.49760 06/25/2012All NDCs
Pravastatin Sodium Tab 10 MG 0.09959 09/01/2012All NDCs
Pravastatin Sodium Tab 20 MG 0.08195 0.15023 09/18/2013All NDCs
Pravastatin Sodium Tab 40 MG 0.12228 0.71250 09/28/2013All NDCs
Pravastatin Sodium Tab 80 MG 0.29861 09/01/2012All NDCs
Prazosin HCl Cap 1 MG 0.22680 0.13767 01/01/2013All NDCs
Prazosin HCl Cap 2 MG 0.29516 0.21588 01/01/2013All NDCs
Prazosin HCl Cap 5 MG 0.37924 0.32149 01/01/2013All NDCs
PRECISN XTRA TES KETONE
(57599074501)
3.76618 10/14/2011Specific NDC
Prednicarbate Cream 0.1% 0.90820 06/25/2012All NDCs
Prednicarbate Oint 0.1% 1.22980 06/25/2012All NDCs
Prednisolone Acetate Ophth Susp 1% 1.58522 06/25/2012All NDCs
Prednisolone Sod Phosph Oral Soln 6.7
MG/5ML (5 MG/5ML Base)
0.19970 0.67560 08/19/2013All NDCs
Prednisolone Sod Phosphate Oral Soln 15
MG/5ML (Base Equiv)
0.19537 0.09204 01/01/2013All NDCs
Prednisolone Sodium Phosphate Ophth Soln
1%
4.63193 06/25/2012All NDCs
Page 72 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Prednisolone Syrup 15 MG/5ML (USP
Solution Equivalent)
0.08957 0.04342 01/01/2013All NDCs
Prednisone Tab 1 MG 0.18171 0.08022 01/01/2013All NDCs
Prednisone Tab 10 MG 0.05751 06/25/2012All NDCs
Prednisone Tab 2.5 MG 0.06107 06/25/2012All NDCs
Prednisone Tab 20 MG 0.07519 06/25/2012All NDCs
Prednisone Tab 5 MG 0.01898 06/25/2012All NDCs
Prednisone Tab 50 MG 0.23762 06/25/2012All NDCs
PRENATAL TAB PLUS (00440818030) 0.17500 07/01/2010Specific NDC
PRENEXA CAP (00245017830) 0.45000 10/02/2013Specific NDC
Prilocaine HCl Powder 1.09440 06/25/2012All NDCs
Primidone Tab 250 MG 0.75333 0.20458 10/01/2012All NDCs
Primidone Tab 50 MG 0.10625 09/01/2012All NDCs
PRIVIGEN INJ 10GRAMS (44206043710) 10.28973 10/14/2011Specific NDC
PRIVIGEN INJ 20GRAMS (44206043820) 10.28973 10/14/2011Specific NDC
PRIVIGEN INJ 5 GRAMS (44206043605) 10.28973 10/14/2011Specific NDC
Probenecid Tab 500 MG 0.66018 06/25/2012All NDCs
Prochlorperazine Maleate Tab 10 MG 0.16533 0.07188 01/01/2013All NDCs
Prochlorperazine Maleate Tab 5 MG 0.17912 06/25/2012All NDCs
Prochlorperazine Suppos 25 MG 2.35227 3.19000 09/04/2012All NDCs
PRODIGY MIS 26G (08321000170) 0.24009 10/14/2011Specific NDC
Progesterone IM in Oil 50 MG/ML 3.72000 06/25/2012All NDCs
Progesterone Micronized Powder 0.49920 06/25/2012All NDCs
Progesterone Powder 1.35000 06/25/2012All NDCs
Promethazine & Phenylephrine Syrup 6.25-5
MG/5ML
0.06621 06/25/2012All NDCs
Promethazine HCl (Bulk) Powder 7.20000 06/25/2012All NDCs
Promethazine HCl Inj 25 MG/ML 1.01970 06/25/2012All NDCs
Promethazine HCl Inj 50 MG/ML 0.00000 06/25/2012All NDCs
Promethazine HCl Suppos 12.5 MG 0.89894 06/25/2012All NDCs
Promethazine HCl Suppos 25 MG 3.48760 9.74700 09/13/2013All NDCs
Promethazine HCl Suppos 50 MG 9.66900 06/25/2012All NDCs
Promethazine HCl Syrup 6.25 MG/5ML 0.03598 06/25/2012All NDCs
Promethazine HCl Tab 12.5 MG 0.42085 0.11549 01/01/2013All NDCs
Promethazine HCl Tab 25 MG 0.26400 0.10380 01/01/2013All NDCs
Promethazine HCl Tab 50 MG 0.41821 06/25/2012All NDCs
Promethazine w/ Codeine Syrup 6.25-10
MG/5ML
0.01974 06/25/2012All NDCs
Propafenone HCl Cap SR 12HR 225 MG 5.67360 06/25/2012All NDCs
Propafenone HCl Cap SR 12HR 325 MG 7.18800 06/25/2012All NDCs
Propafenone HCl Tab 150 MG 0.22463 09/01/2012All NDCs
Propafenone HCl Tab 225 MG 0.38675 09/01/2012All NDCs
Page 73 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Propafenone HCl Tab 300 MG 2.29425 06/25/2012All NDCs
Proparacaine HCl Ophth Soln 0.5% 0.57937 06/25/2012All NDCs
Propoxyphene HCl Cap 65 MG 0.23445 06/25/2012All NDCs
Propoxyphene HCl w/ APAP Tab 65-650 MG 0.10194 06/25/2012All NDCs
Propoxyphene-N w/ Acetaminophen Tab
100-650 MG
0.15585 06/25/2012All NDCs
Propoxyphene-N w/ Acetaminophen Tab
50-325 MG
0.71881 06/25/2012All NDCs
Propranolol & Hydrochlorothiazide Tab 40-25
MG
0.08201 06/25/2012All NDCs
Propranolol & Hydrochlorothiazide Tab 80-25
MG
0.12345 06/25/2012All NDCs
Propranolol HCl Cap SR 24HR 120 MG 0.75650 1.01000 07/12/2013All NDCs
Propranolol HCl Cap SR 24HR 160 MG 1.07488 09/01/2012All NDCs
Propranolol HCl Cap SR 24HR 60 MG 0.52738 0.46281 01/01/2013All NDCs
Propranolol HCl Cap SR 24HR 80 MG 0.52115 0.82500 09/09/2013All NDCs
Propranolol HCl Inj 1 MG/ML 9.60000 06/25/2012All NDCs
Propranolol HCl Tab 10 MG 0.05471 06/25/2012All NDCs
Propranolol HCl Tab 20 MG 0.06593 06/25/2012All NDCs
Propranolol HCl Tab 40 MG 0.07930 06/25/2012All NDCs
Propranolol HCl Tab 60 MG 0.83347 0.71855 04/03/2013All NDCs
Propranolol HCl Tab 80 MG 0.09539 06/25/2012All NDCs
Propylthiouracil Tab 50 MG 0.15120 06/25/2012All NDCs
Protriptyline HCl Tab 10 MG 1.81922 07/01/2013All NDCs
Pseudoephed-Bromphen-DM Elixir 15-1-5
MG/5ML
0.01109 06/25/2012All NDCs
Pseudoephed-Bromphen-DM Syrup 45-4-15
MG/5ML
0.13147 06/25/2012All NDCs
Pseudoephed-Chlorphen-DM Liq 15-1-5
MG/5ML
0.02023 06/25/2012All NDCs
Pseudoephedrine HCl Liq 15 MG/5ML 0.01393 06/25/2012All NDCs
Pseudoephedrine HCl Liq 30 MG/5ML 0.02034 06/25/2012All NDCs
Pseudoephedrine HCl Syrup 30 MG/5ML 0.01577 06/25/2012All NDCs
Pseudoephedrine HCl Tab 30 MG 0.06548 07/27/2012All NDCs
Pseudoephedrine HCl Tab 60 MG 0.03784 06/25/2012All NDCs
Pseudoephedrine HCl Tab SR 12HR 120 MG 0.29760 06/25/2012All NDCs
Psyllium Cap 0.52 GM 0.05287 06/25/2012All NDCs
Psyllium Powder 28.3% 0.02074 06/25/2012All NDCs
Psyllium Powder 33% 0.01104 06/25/2012All NDCs
Psyllium Powder 48.57% 0.01595 06/25/2012All NDCs
Psyllium Powder 58.6% 0.02020 06/25/2012All NDCs
Psyllium Powder 95% 0.01022 06/25/2012All NDCs
PX LANCETS MIS 28G (08326281101) 0.04635 10/14/2011Specific NDC
Page 74 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
PX LANCETS MIS 28G (08326281102) 0.04635 10/14/2011Specific NDC
PX LANCETS MIS ULT THIN
(08214035729)
0.03004 10/14/2011Specific NDC
Pyreth-Piperonyl Butox Sham-Permeth
Aero-Nit Remover Gel Kit
12.67200 06/25/2012All NDCs
Pyrethrins-Piperonyl Butoxide Liq 0.33-4% 0.05075 06/25/2012All NDCs
Pyrethrins-Piperonyl Butoxide Shampoo
0.33-4%
0.03718 06/25/2012All NDCs
Pyridostigmine Bromide Tab 60 MG 0.36750 09/01/2012All NDCs
Pyridoxine HCl Inj 100 MG/ML 10.78800 06/25/2012All NDCs
Pyridoxine HCl Tab 100 MG 0.02549 06/25/2012All NDCs
Pyridoxine HCl Tab 25 MG 0.03900 06/25/2012All NDCs
Pyridoxine HCl Tab 50 MG 0.01956 06/25/2012All NDCs
Pyridoxine-Kelp-Lecithin-Vinegar Cap
5-0.75-200-50 MG
0.17500 06/25/2012All NDCs
Pyridoxine-Kelp-Lecithin-Vinegar Tab
20-33-400-80 MG
0.17500 06/25/2012All NDCs
Pyridoxine-Kelp-Lecithin-Vinegar Tab
8.3-25-100-40 MG
0.17500 06/25/2012All NDCs
QC LANCETS MIS (36652030522) 0.04519 07/17/2011Specific NDC
QC LANCETS MIS (36652030622) 0.03669 07/17/2011Specific NDC
QC LANCETS MIS THIN (36652030122) 0.04519 07/17/2011Specific NDC
Quetiapine Fumarate Tab 100 MG 0.26000 06/25/2012All NDCs
Quetiapine Fumarate Tab 200 MG 0.49400 06/25/2012All NDCs
Quetiapine Fumarate Tab 25 MG 0.15938 06/25/2012All NDCs
Quetiapine Fumarate Tab 300 MG 0.66300 0.54362 04/03/2013All NDCs
Quetiapine Fumarate Tab 400 MG 0.70200 06/25/2012All NDCs
Quetiapine Fumarate Tab 50 MG 0.25610 06/25/2012All NDCs
Quinacrine HCl Powder 1.11360 06/25/2012All NDCs
Quinapril HCl Tab 10 MG 0.23380 06/25/2012All NDCs
Quinapril HCl Tab 20 MG 0.23380 06/25/2012All NDCs
Quinapril HCl Tab 40 MG 0.23380 06/25/2012All NDCs
Quinapril HCl Tab 5 MG 0.23380 06/25/2012All NDCs
Quinapril-Hydrochlorothiazide Tab 10-12.5
MG
0.94451 06/25/2012All NDCs
Quinapril-Hydrochlorothiazide Tab 20-12.5
MG
0.94451 06/25/2012All NDCs
Quinapril-Hydrochlorothiazide Tab 20-25 MG 0.94451 06/25/2012All NDCs
Quinidine Gluconate Tab CR 324 MG 0.96188 06/25/2012All NDCs
Quinidine Sulfate Tab 200 MG 0.15087 06/25/2012All NDCs
Quinidine Sulfate Tab 300 MG 0.28736 06/25/2012All NDCs
RA E-ZJECT MIS 28G (38396031114) 0.04519 10/14/2011Specific NDC
Page 75 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
RA E-ZJECT MIS THIN 26G
(38396030114)
0.04519 10/14/2011Specific NDC
RA E-ZJECT MIS THIN 28G
(38396031214)
0.03669 10/14/2011Specific NDC
RA E-ZJECT MIS ULT THIN
(38396030514)
0.04519 10/14/2011Specific NDC
RAGUS TAB (17204043840) 0.17500 01/01/2011Specific NDC
Ramipril Cap 1.25 MG 0.12084 09/01/2012All NDCs
Ramipril Cap 10 MG 0.14048 09/01/2012All NDCs
Ramipril Cap 2.5 MG 0.10000 09/01/2012All NDCs
Ramipril Cap 5 MG 0.10000 09/01/2012All NDCs
Ranitidine HCl Cap 150 MG 0.79728 06/25/2012All NDCs
Ranitidine HCl Cap 300 MG 2.05578 06/25/2012All NDCs
Ranitidine HCl Syrup 15 MG/ML (75 MG/5ML) 0.05740 09/01/2012All NDCs
Ranitidine HCl Tab 150 MG 0.08677 06/25/2012All NDCs
Ranitidine HCl Tab 300 MG 0.16579 0.07029 01/01/2013All NDCs
Ranitidine HCl Tab 75 MG 0.09520 06/25/2012All NDCs
Raspberry Syrup 0.03007 06/25/2012All NDCs
RECOMBINATE INJ 220-400
(00944283110)
1.25917 10/14/2011Specific NDC
RECOMBINATE INJ 401-800
(00944283210)
1.25917 10/14/2011Specific NDC
RECOMBINATE INJ 801-1240
(00944283310)
1.25917 10/14/2011Specific NDC
REFACTO INJ 1000UNIT (58394000502) 1.10000 04/09/2011Specific NDC
REFACTO INJ 1000UNIT (58394000504) 1.10000 01/31/2011Specific NDC
RELION MIS LANCETS (38396045002) 0.03669 10/14/2011Specific NDC
RELION LANCE MIS THIN 26G
(38396044902)
0.04519 10/14/2011Specific NDC
RELION LANCE MIS THIN 26G
(81306021214)
0.03043 10/14/2011Specific NDC
RELION N INJ 100/ML (59060183402) 4.56703 10/14/2011Specific NDC
RELION R INJ 100/ML (59060183302) 4.56703 10/14/2011Specific NDC
RELION STAND MIS LANC 21G
(81306022114)
0.01545 10/14/2011Specific NDC
RELION ULTRA MIS THIN 30G
(38396045102)
0.04519 10/14/2011Specific NDC
RELION ULTRA MIS THIN 30G
(38396045202)
0.03669 10/14/2011Specific NDC
RELION ULTRA MIS THIN 30G
(38396045302)
0.04519 10/14/2011Specific NDC
RELION ULTRA MIS THIN 30G
(81306021314)
0.04442 10/14/2011Specific NDC
RELION ULTRA MIS THIN 30G
(81306022314)
0.02255 10/14/2011Specific NDC
Page 76 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
RENEW ADV MIS REFILLS
(38396044455)
0.11587 10/14/2011Specific NDC
REPLACE CAP (11694084201) 0.17500 07/01/2010Specific NDC
REPLACE CAP (11694084205) 0.17500 07/01/2010Specific NDC
RI-MAG PLUS SUS (24385040940) 0.00845 10/14/2011Specific NDC
Ribavirin Cap 200 MG 0.89310 0.47912 07/01/2013All NDCs
Ribavirin Tab 200 MG 2.74741 0.72537 10/01/2012All NDCs
Ribavirin Tab 400 MG 14.78652 06/25/2012All NDCs
Ribavirin Tab 600 MG 22.25180 06/25/2012All NDCs
RID LIQ (74300000320) 0.04631 10/14/2011Specific NDC
RID LIQ (74300000412) 0.08890 10/14/2011Specific NDC
RID LIQ (74300000414) 0.06604 10/14/2011Specific NDC
Rifampin Cap 300 MG 1.34084 1.17656 04/03/2013All NDCs
Rimantadine Hydrochloride Tab 100 MG 1.41407 06/25/2012All NDCs
Risperidone Orally Disintegrating Tab 0.5 MG 1.67858 09/01/2012All NDCs
Risperidone Orally Disintegrating Tab 1 MG 5.50243 2.49810 04/03/2013All NDCs
Risperidone Orally Disintegrating Tab 2 MG 8.94600 06/25/2012All NDCs
Risperidone Orally Disintegrating Tab 3 MG 11.28985 06/25/2012All NDCs
Risperidone Orally Disintegrating Tab 4 MG 9.55953 01/01/2013All NDCs
Risperidone Soln 1 MG/ML 0.83646 0.74119 04/03/2013All NDCs
Risperidone Tab 0.25 MG 0.20604 09/01/2012All NDCs
Risperidone Tab 0.5 MG 0.21375 0.17557 01/01/2013All NDCs
Risperidone Tab 1 MG 0.14229 09/01/2012All NDCs
Risperidone Tab 2 MG 2.37156 0.23604 10/01/2012All NDCs
Risperidone Tab 3 MG 0.30813 09/01/2012All NDCs
Risperidone Tab 4 MG 0.43811 0.27464 01/01/2013All NDCs
Rivastigmine Tartrate Cap 1.5 MG 2.96342 09/01/2012All NDCs
Rivastigmine Tartrate Cap 3 MG 3.03152 2.28460 01/01/2013All NDCs
Rivastigmine Tartrate Cap 4.5 MG 4.07380 06/25/2012All NDCs
Rivastigmine Tartrate Cap 6 MG 2.91562 09/01/2012All NDCs
ROBITUSSN DM SYP (00031868612) 0.02133 10/20/2010Specific NDC
Ropinirole Hydrochloride Tab 0.25 MG 0.25068 09/01/2012All NDCs
Ropinirole Hydrochloride Tab 0.5 MG 0.49259 0.23827 01/01/2013All NDCs
Ropinirole Hydrochloride Tab 1 MG 0.27563 09/01/2012All NDCs
Ropinirole Hydrochloride Tab 2 MG 0.70282 0.22421 01/01/2013All NDCs
Ropinirole Hydrochloride Tab 3 MG 0.72910 0.30625 10/01/2012All NDCs
Ropinirole Hydrochloride Tab 4 MG 0.72910 0.46297 04/03/2013All NDCs
Ropinirole Hydrochloride Tab 5 MG 0.54740 0.29689 07/01/2013All NDCs
RX SUPPORT TAB HEARTBUR
(11845015065)
0.17500 10/14/2011Specific NDC
Saccharin Powder 0.38095 06/25/2012All NDCs
Page 77 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
SAFE-T-PRO MIS LANCETS
(50924095120)
0.19466 10/14/2011Specific NDC
SAFE-T-PRO MIS PLUS (50924007920) 0.21321 10/14/2011Specific NDC
SAFETY LET MIS LANCETS
(38415010001)
0.05021 11/20/2011Specific NDC
Salicylic Acid Cream 6% 0.16674 06/25/2012All NDCs
Salicylic Acid Lotion 6% 0.16110 06/25/2012All NDCs
Salicylic Acid Soln 26% 7.18560 06/25/2012All NDCs
Saline Injection Bacteriostatic 0.04571 06/25/2012All NDCs
Saline Injection w/ Benzyl Alcohol 0.04571 06/25/2012All NDCs
Saline Nasal Spray 0.65% 0.02100 06/25/2012All NDCs
Salsalate Tab 500 MG 0.13970 06/25/2012All NDCs
Salsalate Tab 750 MG 0.18403 06/25/2012All NDCs
SB LANCETS MIS THIN (15127099010) 0.04457 10/14/2011Specific NDC
SB LANCETS MIS THIN (15127099020) 0.03472 10/14/2011Specific NDC
SB LANCETS MIS ULTR THN
(15127099110)
0.04457 10/14/2011Specific NDC
SB LANCETS MIS ULTR THN
(15127099120)
0.03472 10/14/2011Specific NDC
SB NAT FIBER POW 49% (15127080319) 0.01461 10/14/2011Specific NDC
SEASONALE TAB (51285005866) 2.68950 05/23/2012Specific NDC
SELECT-OB+ PAK DHA (00642007530) 0.45000 10/02/2013Specific NDC
Selegiline HCl Cap 5 MG 0.83425 06/25/2012All NDCs
Selegiline HCl Tab 5 MG 1.39000 06/25/2012All NDCs
Selenium Sulfide Lotion 1% 0.01675 06/25/2012All NDCs
Selenium Sulfide Lotion 2.5% 0.07014 06/25/2012All NDCs
Selenium Sulfide-Pyrithione Zinc in Urea
Shampoo 2.25%
0.60866 06/25/2012All NDCs
Senna Syrup 176 MG/5ML 0.06050 06/25/2012All NDCs
Senna Tab 187 MG 0.02966 06/25/2012All NDCs
Sennosides Syrup 8.8 MG/5ML 0.06456 06/25/2012All NDCs
Sennosides Tab 8.6 MG 0.03784 06/25/2012All NDCs
Sennosides-Docusate Sodium Tab 8.6-50 MG 0.08490 06/25/2012All NDCs
SENOKOT TAB 8.6MG (67618030010) 0.16253 10/14/2011Specific NDC
SENOKOT TAB 8.6MG (67618030011) 0.19011 10/14/2011Specific NDC
SENOKOT TAB 8.6MG (67618030020) 0.21475 10/14/2011Specific NDC
SENOKOT TAB 8.6MG (67618030050) 0.17921 10/14/2011Specific NDC
Sertraline HCl Oral Conc 20 MG/ML 0.82760 06/25/2012All NDCs
Sertraline HCl Tab 100 MG 0.11999 06/25/2012All NDCs
Sertraline HCl Tab 25 MG 0.11999 06/25/2012All NDCs
Sertraline HCl Tab 50 MG 0.05445 06/25/2012All NDCs
Sildenafil Citrate Tab 20 MG 0.65000 07/24/2013All NDCs
Page 78 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Silver Sulfadiazine Cream 1% 0.05873 0.22500 09/15/2012All NDCs
Simethicone Cap 180 MG 0.26600 06/25/2012All NDCs
Simethicone Chew Tab 125 MG 0.06360 06/25/2012All NDCs
Simple - Syrup 0.02525 06/25/2012All NDCs
Simvastatin Tab 10 MG 0.15691 06/25/2012All NDCs
Simvastatin Tab 20 MG 0.04340 09/01/2012All NDCs
Simvastatin Tab 40 MG 0.06177 09/01/2012All NDCs
Simvastatin Tab 5 MG 0.16366 06/25/2012All NDCs
Simvastatin Tab 80 MG 0.09354 09/01/2012All NDCs
SM GLUCOSE CHW ORANGE
(49348091301)
0.92236 12/03/2011Specific NDC
SM GLUCOSE CHW ORANGE
(49348091409)
0.10490 12/03/2011Specific NDC
SM GLUCOSE CHW RASPBERY
(49348091501)
0.92236 12/03/2011Specific NDC
SM GLUCOSE CHW RASPBERY
(49348091609)
0.10490 12/03/2011Specific NDC
SM LANCETS MIS 21G (38396070339) 0.04519 10/14/2011Specific NDC
SM LANCETS MIS 21G (38396073339) 0.03669 10/14/2011Specific NDC
SM LANCETS MIS 21G (38396074339) 0.03669 10/14/2011Specific NDC
SM LANCETS MIS THIN 26G
(38396071339)
0.04519 10/14/2011Specific NDC
SM LANCETS MIS THIN 26G
(38396075339)
0.03669 10/14/2011Specific NDC
SM LANCETS MIS THIN 30G
(38396072339)
0.04519 10/14/2011Specific NDC
Sodium Bicarbonate Inj 8.4% 0.01467 06/25/2012All NDCs
Sodium Bicarbonate Tab 325 MG 0.00892 06/25/2012All NDCs
Sodium Bicarbonate Tab 650 MG 0.01054 06/25/2012All NDCs
Sodium Chloride Hypertonic Ophth Oint 5% 2.67285 06/25/2012All NDCs
Sodium Chloride Hypertonic Ophth Soln 5% 0.75962 06/25/2012All NDCs
Sodium Chloride Inj 0.45% 0.00208 06/25/2012All NDCs
Sodium Chloride Inj 0.9% 0.02796 06/25/2012All NDCs
Sodium Chloride Irrigation Soln 0.9% 0.00313 06/25/2012All NDCs
Sodium Chloride IV Soln 0.9% 0.00295 06/25/2012All NDCs
Sodium Chloride Soln Nebu 0.9% 0.04119 06/25/2012All NDCs
Sodium Chloride Soln Nebu 10% 0.04880 06/25/2012All NDCs
Sodium Chloride Tab 1 GM 0.05280 06/25/2012All NDCs
Sodium Citrate & Citric Acid Soln 500-334
MG/5ML
0.01519 06/25/2012All NDCs
Sodium Fluoride Chew Tab 0.25 MG F (from
0.55 MG NaF)
0.03790 06/25/2012All NDCs
Sodium Fluoride Chew Tab 0.5 MG F (from
1.1 MG NaF)
0.03990 06/25/2012All NDCs
Page 79 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Sodium Fluoride Chew Tab 1 MG F (from 2.2
MG NaF)
0.03790 06/25/2012All NDCs
Sodium Fluoride Cream 1.1% 0.12101 06/25/2012All NDCs
Sodium Fluoride Gel 1.1% (0.5% F) 0.11352 06/25/2012All NDCs
Sodium Fluoride Soln 0.125 MG/DROP F
(0.275 MG/DROP NaF)
0.18704 06/25/2012All NDCs
Sodium Fluoride Soln 0.5 MG/ML F (from 1.1
MG/ML NaF)
0.16272 06/25/2012All NDCs
Sodium Fluoride Tab 0.5 MG F (from 1.1 MG
NaF)
0.03035 06/25/2012All NDCs
Sodium Fluoride Tab 1 MG F (from 2.2 MG
NaF)
0.02834 06/25/2012All NDCs
Sodium Hydroxide Solution 10% 0.02164 06/25/2012All NDCs
Sodium Polystyrene Sulfonate Oral Susp 15
GM/60ML
0.05701 06/25/2012All NDCs
SOFT TOUCH MIS LANCETS
(50924058510)
0.06488 10/14/2011Specific NDC
SOFT TOUCH MIS LANCETS
(50924093720)
0.04403 10/14/2011Specific NDC
SOFTCLIX MIS LANCETS (50924097110) 0.08111 10/14/2011Specific NDC
SOFTCLIX MIS LANCETS (54868493100) 0.11904 10/14/2011Specific NDC
SOFTCLIX MIS LANCETS (65702012410) 0.06141 10/14/2011Specific NDC
Sorbitol Solution (Bulk) 0.00913 06/25/2012All NDCs
Sotalol HCl (AFIB/AFL) Tab 120 MG 0.52228 06/25/2012All NDCs
Sotalol HCl (AFIB/AFL) Tab 160 MG 0.53030 06/25/2012All NDCs
Sotalol HCl (AFIB/AFL) Tab 80 MG 0.32011 06/25/2012All NDCs
Sotalol HCl Tab 120 MG 0.19350 09/01/2012All NDCs
Sotalol HCl Tab 160 MG 0.53030 06/25/2012All NDCs
Sotalol HCl Tab 240 MG 3.71755 0.50412 10/01/2012All NDCs
Sotalol HCl Tab 80 MG 0.09681 09/01/2012All NDCs
SOURCECF CAP (68212050060) 0.17500 10/14/2011Specific NDC
SOURCECF CHW (68212060090) 0.17500 10/14/2011Specific NDC
Spironolactone & Hydrochlorothiazide Tab
25-25 MG
0.32387 06/25/2012All NDCs
Spironolactone Tab 100 MG 0.67791 06/25/2012All NDCs
Spironolactone Tab 25 MG 0.09943 09/01/2012All NDCs
Spironolactone Tab 50 MG 0.52740 0.28707 01/01/2013All NDCs
Squaric Acid Dibutylester Powder 17.63520 06/25/2012All NDCs
Stannous Fluoride Conc 0.63% 0.03740 06/25/2012All NDCs
STIMATE SOL 1.5MG/ML (00053687100) 230.00000 04/26/2012Specific NDC
STRESS-600/ TAB ZINC (00245013389) 0.17500 10/14/2011Specific NDC
Sucralfate Susp 1 GM/10ML 0.51000 06/25/2012All NDCs
Sucralfate Tab 1 GM 0.34510 06/25/2012All NDCs
Sulfacetamide Sodium Liquid 10% 0.31906 06/25/2012All NDCs
Page 80 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Sulfacetamide Sodium Lotion 10% (Acne) 0.61780 06/25/2012All NDCs
Sulfacetamide Sodium Ophth Soln 10% 0.88487 3.35907 10/12/2012All NDCs
Sulfacetamide Sodium w/ Sulfur Cleansing
Cloth 10-5%
6.64120 06/25/2012All NDCs
Sulfacetamide Sodium w/ Sulfur Emulsion
10-5%
0.84638 06/25/2012All NDCs
Sulfacetamide Sodium w/ Sulfur Lotion 10-5% 0.80000 06/25/2012All NDCs
Sulfacetamide Sodium w/ Sulfur Susp 10-5% 1.90000 06/25/2012All NDCs
Sulfacetamide Sodium-Prednisolone Ophth
Soln 10-0.23(0.25)%
2.89688 06/25/2012All NDCs
Sulfamethoxazole-Trimethoprim Susp 200-40
MG/5ML
0.09284 06/25/2012All NDCs
Sulfamethoxazole-Trimethoprim Tab 400-80
MG
0.12391 06/25/2012All NDCs
Sulfamethoxazole-Trimethoprim Tab 800-160
MG
0.07087 09/01/2012All NDCs
Sulfasalazine Tab 500 MG 0.14636 0.18046 03/11/2013All NDCs
Sulfasalazine Tab Delayed Release 500 MG 0.28327 06/25/2012All NDCs
Sulindac Tab 150 MG 0.31021 06/25/2012All NDCs
Sulindac Tab 200 MG 0.40112 06/25/2012All NDCs
Sumatriptan Nasal Spray 20 MG/ACT 42.99000 06/25/2012All NDCs
Sumatriptan Nasal Spray 5 MG/ACT 42.99000 06/25/2012All NDCs
Sumatriptan Succinate Inj 4 MG/0.5ML 166.17600 06/25/2012All NDCs
Sumatriptan Succinate Inj 6 MG/0.5ML 166.17600 141.92119 04/03/2013All NDCs
Sumatriptan Succinate Tab 100 MG 1.05573 09/01/2012All NDCs
Sumatriptan Succinate Tab 25 MG 2.42187 1.83172 07/01/2013All NDCs
Sumatriptan Succinate Tab 50 MG 0.92431 09/01/2012All NDCs
SUPER POW NU-THERA
(58223010652)
0.17500 10/14/2011Specific NDC
SUPER GINSEN CAP MULTI
(11845113705)
0.17500 10/14/2011Specific NDC
SUPER THIN MIS LANCET (38396030508) 0.04519 10/14/2011Specific NDC
SUPER THIN MIS LANCETS
(11917001648)
0.02997 10/14/2011Specific NDC
SUPER THIN MIS LANCETS
(38396030520)
0.04519 10/14/2011Specific NDC
SURE-LANCE MIS LANCETS
(59707000110)
0.05747 10/14/2011Specific NDC
SURE-LANCE MIS LANCETS
(59707000112)
0.05747 10/14/2011Specific NDC
TAB-A-VITE TAB WOMENS
(00904571352)
0.17500 10/14/2011Specific NDC
Tacrolimus Cap 0.5 MG 1.65628 1.12840 07/01/2013All NDCs
Tacrolimus Cap 1 MG 3.03694 1.85951 07/01/2013All NDCs
Tacrolimus Cap 5 MG 17.80025 10.32817 07/01/2013All NDCs
Page 81 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
TAGAMET HB TAB 200MG (00135014805) 0.12279 10/14/2011Specific NDC
Tamoxifen Citrate Tab 10 MG (Base
Equivalent)
0.38627 06/25/2012All NDCs
Tamoxifen Citrate Tab 20 MG (Base
Equivalent)
0.25125 09/01/2012All NDCs
Tamsulosin HCl Cap 0.4 MG 0.22772 09/01/2012All NDCs
TECHLITE MIS LANCETS (08317880125) 0.01568 10/14/2011Specific NDC
TECHLITE MIS LANCETS (08317880128) 0.01568 10/14/2011Specific NDC
TECHLITE MIS LANCETS (08317880225) 0.01564 10/14/2011Specific NDC
TECHLITE MIS LANCETS (08317880228) 0.01564 10/14/2011Specific NDC
TECHLITE AST MIS LANCETS
(08317880300)
0.01568 10/14/2011Specific NDC
Temazepam Cap 15 MG 0.12765 06/25/2012All NDCs
Temazepam Cap 30 MG 0.16347 0.10198 01/01/2013All NDCs
Temazepam Cap 7.5 MG 5.58489 4.59644 07/01/2013All NDCs
Terazosin HCl Cap 1 MG 0.13327 06/25/2012All NDCs
Terazosin HCl Cap 10 MG 0.13327 06/25/2012All NDCs
Terazosin HCl Cap 2 MG 0.13327 0.08138 01/01/2013All NDCs
Terazosin HCl Cap 5 MG 0.13327 06/25/2012All NDCs
Terbinafine HCl Cream 1% 0.30120 06/25/2012All NDCs
Terbinafine HCl Tab 250 MG 0.62396 0.21624 10/01/2012All NDCs
Terbutaline Sulfate Tab 2.5 MG 0.32401 06/25/2012All NDCs
Terbutaline Sulfate Tab 5 MG 0.56532 06/25/2012All NDCs
Terconazole Vaginal Cream 0.4% 0.77206 06/25/2012All NDCs
Terconazole Vaginal Cream 0.8% 1.85812 0.71833 10/01/2012All NDCs
Terconazole Vaginal Suppos 80 MG 12.60209 06/25/2012All NDCs
Testosterone Cypionate IM in Oil 100 MG/ML 4.54275 07/01/2012All NDCs
Testosterone Enanthate IM in Oil 200 MG/ML 13.12482 06/25/2012All NDCs
Tetracaine HCl Inj 1% 2.52936 06/25/2012All NDCs
Tetracaine HCl Ophth Soln 0.5% 0.67520 06/25/2012All NDCs
Tetracaine HCl Powder 0.68736 06/25/2012All NDCs
Tetracycline HCl Cap 250 MG 0.06434 06/25/2012All NDCs
Tetracycline HCl Cap 500 MG 0.09118 06/25/2012All NDCs
Tetrahydroz-Dextran-PEG-Povidone Ophth
Soln 0.05-0.1-1-1%
0.11200 06/25/2012All NDCs
Tetrahydrozoline HCl Ophth Soln 0.05% 0.11200 06/25/2012All NDCs
TGT LANCET MIS 23G (08214015720) 0.03414 10/14/2011Specific NDC
TGT LANCET MIS 28G (08214030720) 0.03078 10/14/2011Specific NDC
TGT LANCET MIS 28G (08214035720) 0.03669 10/14/2011Specific NDC
TGT LANCET MIS 30G (08214065720) 0.03523 10/14/2011Specific NDC
Theophylline Tab SR 12HR 100 MG 0.18433 06/25/2012All NDCs
Theophylline Tab SR 12HR 200 MG 0.20201 06/25/2012All NDCs
Page 82 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Theophylline Tab SR 12HR 300 MG 0.24549 06/25/2012All NDCs
Theophylline Tab SR 24HR 400 MG 1.13264 06/25/2012All NDCs
Theophylline Tab SR 24HR 600 MG 1.63662 06/25/2012All NDCs
THERA-M TAB (00904549213) 0.17500 10/14/2011Specific NDC
THERA-M TAB (00904549280) 0.17500 10/14/2011Specific NDC
THERA-TABS M TAB (57896062110) 0.17500 10/14/2011Specific NDC
THERAGRAN-M TAB (11917006737) 0.17500 10/14/2011Specific NDC
THERAGRAN-M TAB 50 PLUS
(11917007784)
0.17500 10/14/2011Specific NDC
THERAGRAN-M TAB ADVANCED
(11917009568)
0.17500 10/14/2011Specific NDC
THERAGRAN-M TAB PREMIER
(11917006739)
0.17500 10/14/2011Specific NDC
THERAGRAN-M TAB PREMIER
(11917006740)
0.17500 10/14/2011Specific NDC
THERAGRAN-M TAB PREMIER
(11917009501)
0.17500 10/14/2011Specific NDC
THERAMILL CAP FORTE (17204054685) 0.17500 10/14/2011Specific NDC
THERAMILL CAP FORTE (17204054750) 0.17500 10/14/2011Specific NDC
THERAPEUTIC SOL (00482011614) 0.17500 10/14/2011Specific NDC
Thiamine HCl Inj 100 MG/ML 5.97000 06/25/2012All NDCs
Thiamine HCl Tab 100 MG 0.02069 06/25/2012All NDCs
Thiamine HCl Tab 50 MG 0.01644 06/25/2012All NDCs
THIN LANCETS MIS (38396030108) 0.04519 10/14/2011Specific NDC
THIN LANCETS MIS (38396030208) 0.03669 10/14/2011Specific NDC
THIN LANCETS MIS (57599004305) 0.04859 10/14/2011Specific NDC
THIN LANCETS MIS (57599868205) 0.04140 10/14/2011Specific NDC
THIN LANCETS MIS (57599868206) 0.04140 10/14/2011Specific NDC
THIN LANCETS MIS 26G (38396050232) 0.05786 10/14/2011Specific NDC
THIN LANCETS MIS 26G (38396050332) 0.03669 10/14/2011Specific NDC
THIN LANCETS MIS 30G (38396050432) 0.04519 10/14/2011Specific NDC
Thioridazine HCl Tab 10 MG 0.09650 09/01/2012All NDCs
Thioridazine HCl Tab 100 MG 0.24100 0.32260 01/11/2013All NDCs
Thioridazine HCl Tab 25 MG 0.35334 06/25/2012All NDCs
Thioridazine HCl Tab 50 MG 0.18881 09/01/2012All NDCs
Thiothixene Cap 1 MG 0.12981 06/25/2012All NDCs
Thiothixene Cap 10 MG 0.38017 06/25/2012All NDCs
Thiothixene Cap 2 MG 0.17395 06/25/2012All NDCs
Thiothixene Cap 5 MG 0.27710 06/25/2012All NDCs
Ticlopidine HCl Tab 250 MG 0.25550 06/25/2012All NDCs
Timolol Maleate Ophth Gel Forming Soln
0.25%
7.64777 06/25/2012All NDCs
Page 83 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Timolol Maleate Ophth Gel Forming Soln
0.5%
8.46250 7.92721 07/01/2013All NDCs
Timolol Maleate Ophth Soln 0.25% 0.65232 06/25/2012All NDCs
Timolol Maleate Ophth Soln 0.5% 0.84171 06/25/2012All NDCs
Timolol Maleate Tab 10 MG 0.45909 06/25/2012All NDCs
Timolol Maleate Tab 20 MG 0.84712 06/25/2012All NDCs
Timolol Maleate Tab 5 MG 0.37118 06/25/2012All NDCs
Tizanidine HCl Tab 2 MG 0.20652 06/25/2012All NDCs
Tizanidine HCl Tab 4 MG 0.07316 0.36820 09/12/2013All NDCs
Tobramycin Sulfate Inj 1.2 GM/30ML (40
MG/ML)
1.15033 06/25/2012All NDCs
Tobramycin Sulfate Inj 10 MG/ML 0.00000 06/25/2012All NDCs
Tobramycin Sulfate Inj 2 GM/50ML (40
MG/ML)
1.11125 06/25/2012All NDCs
Tobramycin Sulfate Inj 80 MG/2ML (40
MG/ML)
1.15033 06/25/2012All NDCs
Tobramycin Sulfate Ophth Soln 0.3% 2.35042 06/25/2012All NDCs
Tobramycin-Dexamethasone Ophth Susp
0.3-0.1%
13.06900 07/01/2012All NDCs
Tolazamide Tab 250 MG 0.96254 06/25/2012All NDCs
Tolazamide Tab 500 MG 1.45361 06/25/2012All NDCs
Tolbutamide Tab 500 MG 0.81094 06/25/2012All NDCs
Tolmetin Sodium Cap 400 MG 0.91348 06/25/2012All NDCs
Tolmetin Sodium Tab 200 MG 0.57937 06/25/2012All NDCs
Tolmetin Sodium Tab 600 MG 2.25864 06/25/2012All NDCs
Tolnaftate Cream 1% 0.05040 06/25/2012All NDCs
Topiramate Sprinkle Cap 15 MG 2.32200 0.69792 04/03/2013All NDCs
Topiramate Sprinkle Cap 25 MG 1.59000 0.55268 04/03/2013All NDCs
Topiramate Tab 100 MG 0.10146 07/01/2012All NDCs
Topiramate Tab 200 MG 0.14625 07/01/2012All NDCs
Topiramate Tab 25 MG 0.04646 07/01/2012All NDCs
Topiramate Tab 50 MG 0.07166 07/01/2012All NDCs
Torsemide Tab 10 MG 0.44891 06/25/2012All NDCs
Torsemide Tab 100 MG 2.72854 0.62105 04/03/2013All NDCs
Torsemide Tab 20 MG 0.10188 09/01/2012All NDCs
Torsemide Tab 5 MG 0.42085 06/25/2012All NDCs
Tramadol HCl Tab 50 MG 0.04667 06/25/2012All NDCs
Tramadol HCl Tab SR 24HR 100 MG 3.23440 2.71791 10/01/2012All NDCs
Tramadol HCl Tab SR 24HR 200 MG 5.34960 4.31771 10/01/2012All NDCs
Tramadol HCl Tab SR 24HR 300 MG 5.98558 4.83955 07/01/2013All NDCs
Tramadol-Acetaminophen Tab 37.5-325 MG 0.50400 0.38760 04/03/2013All NDCs
Trandolapril Tab 1 MG 0.62342 06/25/2012All NDCs
Page 84 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Trandolapril Tab 2 MG 0.62342 06/25/2012All NDCs
Trandolapril Tab 4 MG 0.25600 09/01/2012All NDCs
Tranylcypromine Sulfate Tab 10 MG 1.06548 06/25/2012All NDCs
Trazodone HCl Tab 100 MG 0.10661 0.05283 01/01/2013All NDCs
Trazodone HCl Tab 150 MG 0.29113 0.11771 10/01/2012All NDCs
Trazodone HCl Tab 300 MG 3.36720 2.82587 10/01/2012All NDCs
Trazodone HCl Tab 50 MG 0.06939 06/25/2012All NDCs
Tretinoin (Facial Wrinkles) Cream 0.05% 3.24000 06/25/2012All NDCs
Tretinoin Cap 10 MG 21.08090 06/25/2012All NDCs
Tretinoin Cream 0.025% 0.72111 09/01/2012All NDCs
Tretinoin Cream 0.05% 1.30070 09/01/2012All NDCs
Tretinoin Cream 0.1% 1.88661 1.37300 01/01/2013All NDCs
Tretinoin Gel 0.01% 1.44234 06/25/2012All NDCs
Tretinoin Gel 0.025% 1.09195 09/01/2012All NDCs
Triamcinolone Acetonide Cream 0.025% 0.03507 06/25/2012All NDCs
Triamcinolone Acetonide Cream 0.1% 0.22359 06/25/2012All NDCs
Triamcinolone Acetonide Cream 0.5% 0.51126 06/25/2012All NDCs
Triamcinolone Acetonide Dental Paste 0.1% 10.65127 06/25/2012All NDCs
Triamcinolone Acetonide Lotion 0.025% 0.46350 06/25/2012All NDCs
Triamcinolone Acetonide Lotion 0.1% 0.55620 06/25/2012All NDCs
Triamcinolone Acetonide Nasal Inhal 55
MCG/ACT
5.71753 4.68685 07/01/2013All NDCs
Triamcinolone Acetonide Oint 0.025% 0.05360 06/25/2012All NDCs
Triamcinolone Acetonide Oint 0.05% 0.06419 06/25/2012All NDCs
Triamcinolone Acetonide Oint 0.1% 0.13438 06/25/2012All NDCs
Triamcinolone Acetonide Oint 0.5% 0.52014 06/25/2012All NDCs
Triamcinolone Acetonide Powder 6.72000 06/25/2012All NDCs
Triamterene & Hydrochlorothiazide Cap
37.5-25 MG
0.15169 06/25/2012All NDCs
Triamterene & Hydrochlorothiazide Cap 50-25
MG
1.60433 06/25/2012All NDCs
Triamterene & Hydrochlorothiazide Tab
37.5-25 MG
0.13984 06/25/2012All NDCs
Triamterene & Hydrochlorothiazide Tab 75-50
MG
0.20500 08/01/2012All NDCs
Triazolam Tab 0.125 MG 0.28169 06/25/2012All NDCs
Triazolam Tab 0.25 MG 0.30404 0.15000 01/01/2013All NDCs
Trifluoperazine HCl Tab 1 MG 0.43754 06/25/2012All NDCs
Trifluoperazine HCl Tab 10 MG 1.22418 0.76098 07/01/2013All NDCs
Trifluoperazine HCl Tab 2 MG 0.64534 06/25/2012All NDCs
Trifluoperazine HCl Tab 5 MG 0.81221 0.52414 04/03/2013All NDCs
Trifluridine Ophth Soln 1% 15.89295 06/25/2012All NDCs
Page 85 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Trihexyphenidyl HCl Tab 2 MG 0.11924 06/25/2012All NDCs
Trihexyphenidyl HCl Tab 5 MG 0.21463 0.13130 01/01/2013All NDCs
Trimethobenzamide HCl Cap 300 MG 1.22440 06/25/2012All NDCs
Trimethoprim Tab 100 MG 0.24744 09/01/2012All NDCs
TRIVEEN-CF TAB NAC (13811056890) 1.11787 02/19/2012Specific NDC
TRUPLUS LANC MIS 28G (56151014260) 0.05021 10/14/2011Specific NDC
Trypsin w/ Castor Oil & Peruvian Balsam Oint 0.87600 06/25/2012All NDCs
TUMS CHW 500MG (00135007003) 0.03454 10/14/2011Specific NDC
TUMS CHW 500MG (00135007027) 0.02275 10/14/2011Specific NDC
TUMS CHW 500MG (00135007048) 0.03733 10/14/2011Specific NDC
TUMS CHW 500MG (00135007127) 0.02275 10/14/2011Specific NDC
TUMS CHW 500MG (00135007148) 0.03733 10/14/2011Specific NDC
TUMS CALCIUM CHW 750MG
(00135022301)
0.05261 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135007422) 0.04376 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135007424) 0.05182 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135007425) 0.03556 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135007446) 0.05601 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135007625) 0.03556 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135014001) 0.05601 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135014002) 0.04376 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135014003) 0.03556 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135015405) 0.04268 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135017802) 0.04376 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135017803) 0.03556 10/14/2011Specific NDC
TUMS E-X CHW 750MG (00135017808) 0.05601 10/14/2011Specific NDC
TUMS KIDS CHW 750MG (00135046901) 0.08604 10/14/2011Specific NDC
TUMS SMOOTHI CHW 750MG
(00135024402)
0.05689 10/14/2011Specific NDC
TUMS SMOOTHI CHW 750MG
(00135045603)
0.05689 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135011883)
0.04741 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135011983)
0.04741 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135018004)
0.05449 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135018014)
0.03891 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135018103)
0.05472 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135018114)
0.03891 10/14/2011Specific NDC
Page 86 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
TUMS ULTRA CHW 1000MG
(00135018214)
0.03891 10/14/2011Specific NDC
TUMS ULTRA CHW 1000MG
(00135022801)
0.05472 10/14/2011Specific NDC
TYR COOLER LIQ (50600053992) 0.17500 10/14/2011Specific NDC
TYREX-2 POW (70074051127) 0.14906 10/14/2011Specific NDC
ULTILET MIS 26G (08326261001) 0.04635 10/14/2011Specific NDC
ULTILET MIS 28G (08326281001) 0.04635 10/14/2011Specific NDC
ULTILET MIS 28G (08326281002) 0.04635 10/14/2011Specific NDC
ULTILET MIS 30G (08326301001) 0.04635 10/14/2011Specific NDC
ULTILET MIS LANCETS (08326280001) 0.04635 10/14/2011Specific NDC
ULTILET MIS LANCETS (08326280002) 0.04635 10/14/2011Specific NDC
ULTRA MEGA TAB 75MG CR
(48107005067)
0.17500 07/01/2010Specific NDC
ULTRA MEGA TAB TWO (48107005064) 0.17500 07/01/2010Specific NDC
ULTRA MEGA TAB TWO (48107005065) 0.17500 07/01/2010Specific NDC
ULTRA MEGA G TAB 100MG
(48107005070)
0.17500 07/01/2010Specific NDC
ULTRA MEGA G TAB 100MG
(48107005071)
0.17500 07/01/2010Specific NDC
ULTRA MEGA G TAB 100MG
(48107005073)
0.17500 07/01/2010Specific NDC
ULTRA MEGA G TAB 75MG CR
(48107005066)
0.17500 07/01/2010Specific NDC
ULTRA THIN MIS LANCETS
(50428235155)
0.03140 10/14/2011Specific NDC
ULTRA THIN MIS LANCETS
(50428235157)
0.03993 10/14/2011Specific NDC
ULTRA THIN MIS LANCETS
(98302000106)
0.08497 10/14/2011Specific NDC
ULTRA-THIN MIS 28G (51709000726) 0.03746 10/14/2011Specific NDC
ULTRA-THIN MIS 28G (51709000727) 0.03283 10/14/2011Specific NDC
ULTRA-THIN MIS 30G (51709000728) 0.03746 10/14/2011Specific NDC
UNILET MIS 21G (08470040001) 0.03595 10/14/2011Specific NDC
UNILET EX II MIS 28G (08214053001) 0.02687 10/14/2011Specific NDC
UNILET EX II MIS 28G (08214053501) 0.02687 10/14/2011Specific NDC
UNILET EX II MIS 28G (08470053001) 0.03190 10/14/2011Specific NDC
UNILET EX II MIS 28G (08470053501) 0.03229 10/14/2011Specific NDC
UNILET EXCEL MIS 23G (08214051001) 0.02687 10/14/2011Specific NDC
UNILET EXCEL MIS 23G (08214051501) 0.02687 10/14/2011Specific NDC
UNILET EXCEL MIS 23G (08470051001) 0.03190 10/14/2011Specific NDC
UNILET EXCEL MIS 23G (08470051501) 0.03229 10/14/2011Specific NDC
UNILET G.P MIS SUPR 23G
(08214045001)
0.02850 10/14/2011Specific NDC
Page 87 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
UNILET G.P MIS SUPR 23G
(08214045501)
0.03568 10/14/2011Specific NDC
UNILET G.P. MIS 21G (08214041401) 0.03336 10/14/2011Specific NDC
UNILET G.P. MIS 21G (08214041801) 0.02665 10/14/2011Specific NDC
UNILET G.P. MIS 21G (08470041401) 0.03900 10/14/2011Specific NDC
UNILET G.P. MIS 21G (08470041801) 0.03182 10/14/2011Specific NDC
UNILET GP 28 MIS ULT THIN
(08214092001)
0.02618 10/14/2011Specific NDC
UNILET GP 28 MIS ULT THIN
(08214092501)
0.02781 10/14/2011Specific NDC
UNILET GP 28 MIS ULT THIN
(08470092001)
0.03595 10/14/2011Specific NDC
UNILET GP 28 MIS ULT THIN
(08470092501)
0.04341 10/14/2011Specific NDC
UNILET LANCE MIS 21G (08214040001) 0.03452 10/14/2011Specific NDC
UNILET SUPER MIS 23G (08214044001) 0.03452 10/14/2011Specific NDC
UNILET SUPER MIS 23G (08214044501) 0.03754 10/14/2011Specific NDC
UNILET SUPER MIS 23G (08470044001) 0.03839 10/14/2011Specific NDC
UNILET SUPER MIS 23G (08470044501) 0.04156 10/14/2011Specific NDC
UNILET SUPER MIS G.P. 23G
(08470045001)
0.03715 10/14/2011Specific NDC
UNILET SUPER MIS G.P. 23G
(08470045501)
0.04156 10/14/2011Specific NDC
UNISTIK 3 MIS COMFORT (08470104701) 0.21383 10/14/2011Specific NDC
UNISTIK 3 MIS EXTRA (08470101201) 0.20270 10/14/2011Specific NDC
UNISTIK 3 MIS EXTRA (08470101401) 0.18030 10/14/2011Specific NDC
UNISTIK 3 MIS NORMAL (08470100701) 0.21383 10/14/2011Specific NDC
UNISTIK CZT MIS COMFORT
(08470104801)
0.21630 10/14/2011Specific NDC
UNISTIK CZT MIS NORMAL (08470100801) 0.21630 10/14/2011Specific NDC
UNIVERSAL 1 MIS LANC 26G
(38396030137)
0.04519 10/14/2011Specific NDC
UNIVERSAL 1 MIS LANC 30G
(38396030537)
0.04519 10/14/2011Specific NDC
Urea Cream 20% 0.12148 06/25/2012All NDCs
Urea Cream 40% 0.23867 06/25/2012All NDCs
Urea Lotion 10% 0.04100 06/25/2012All NDCs
Urea Lotion 40% 0.13022 09/01/2012All NDCs
Ursodiol Cap 300 MG 0.44350 09/01/2012All NDCs
Ursodiol Tab 250 MG 2.57508 1.97317 04/03/2013All NDCs
Ursodiol Tab 500 MG 3.86000 2.72958 07/01/2013All NDCs
V-R FATIGUE TAB COMPLEX
(49348031012)
0.17500 10/14/2011Specific NDC
Valacyclovir HCl Tab 1 GM 2.92189 2.17857 07/01/2013All NDCs
Page 88 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
Valacyclovir HCl Tab 500 MG 1.50512 1.30064 07/01/2013All NDCs
Valproate Sodium Syrup 250 MG/5ML (Base
Equiv)
0.04842 0.01547 01/01/2013All NDCs
Valproic Acid Cap 250 MG 0.18200 09/01/2012All NDCs
VALUE HEALTH MIS LANCETS
(38396032300)
0.03669 10/14/2011Specific NDC
Vancomycin HCl Cap 250 MG 41.73146 04/03/2013All NDCs
Vancomycin HCl For Inj 10 GM 133.73837 06/25/2012All NDCs
Vancomycin HCl For Inj 1000 MG 5.18570 09/01/2012All NDCs
Vancomycin HCl For Inj 500 MG 3.03950 06/25/2012All NDCs
Vancomycin HCl For Inj 5000 MG 25.90974 06/25/2012All NDCs
Vancomycin HCl in Dextrose Inj 1 GM/200ML 0.09352 06/25/2012All NDCs
Venlafaxine HCl Cap SR 24HR 150 MG
(Base Equivalent)
0.29883 09/01/2012All NDCs
Venlafaxine HCl Cap SR 24HR 37.5 MG
(Base Equivalent)
0.55920 06/25/2012All NDCs
Venlafaxine HCl Cap SR 24HR 75 MG (Base
Equivalent)
0.27583 09/01/2012All NDCs
Venlafaxine HCl Tab 100 MG 0.63992 0.58157 04/03/2013All NDCs
Venlafaxine HCl Tab 25 MG 1.37601 0.53381 10/01/2012All NDCs
Venlafaxine HCl Tab 37.5 MG 0.41975 09/01/2012All NDCs
Venlafaxine HCl Tab 50 MG 1.53528 0.37420 10/01/2012All NDCs
Venlafaxine HCl Tab 75 MG 1.60402 0.43981 10/01/2012All NDCs
Venlafaxine HCl Tab SR 24HR 150 MG (Base
Equivalent)
3.34158 1.99715 07/01/2013All NDCs
Venlafaxine HCl Tab SR 24HR 225 MG (Base
Equivalent)
7.98120 06/25/2012All NDCs
Venlafaxine HCl Tab SR 24HR 37.5 MG
(Base Equivalent)
3.41120 2.80235 04/03/2013All NDCs
Venlafaxine HCl Tab SR 24HR 75 MG (Base
Equivalent)
3.81920 2.43575 04/03/2013All NDCs
Verapamil HCl Cap SR 24HR 100 MG 1.45230 06/25/2012All NDCs
Verapamil HCl Cap SR 24HR 120 MG 0.77156 06/25/2012All NDCs
Verapamil HCl Cap SR 24HR 180 MG 0.81365 0.53746 04/03/2013All NDCs
Verapamil HCl Cap SR 24HR 200 MG 1.87054 06/25/2012All NDCs
Verapamil HCl Cap SR 24HR 240 MG 0.92588 0.64937 04/03/2013All NDCs
Verapamil HCl Cap SR 24HR 300 MG 2.72152 06/25/2012All NDCs
Verapamil HCl Cap SR 24HR 360 MG 1.62178 06/25/2012All NDCs
Verapamil HCl Tab 120 MG 0.10736 06/25/2012All NDCs
Verapamil HCl Tab 40 MG 0.21367 06/25/2012All NDCs
Verapamil HCl Tab 80 MG 0.07229 06/25/2012All NDCs
Verapamil HCl Tab CR 120 MG 0.72406 0.33579 10/01/2012All NDCs
Verapamil HCl Tab CR 180 MG 0.23125 09/01/2012All NDCs
Verapamil HCl Tab CR 240 MG 0.40682 06/25/2012All NDCs
Page 89 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
VI-STRESS TAB (00536475308) 0.17500 10/14/2011Specific NDC
VIACTIV MULT CHW VITAMIN
(00045016415)
0.17500 01/01/2012Specific NDC
VIACTIV MULT CHW VITAMIN
(00045016460)
0.17500 10/14/2011Specific NDC
VICON-C CAP (50474027322) 0.17500 12/07/2011Specific NDC
VIMAR/IRON SYP FORTE (12939050408) 0.17500 07/01/2010Specific NDC
Vinblastine Sulfate For Inj 10 MG 0.79401 06/25/2012All NDCs
Vinblastine Sulfate Inj 1 MG/ML 1.02174 06/25/2012All NDCs
Vincristine Sulfate IV Soln 1 MG/ML 4.05657 06/25/2012All NDCs
VITA-BOB CAP (00372002701) 0.17500 07/01/2010Specific NDC
VITA-PLUS H CAP (00372002401) 0.17500 07/01/2010Specific NDC
VITAFOL-ONE CAP (00642007030) 0.45000 10/02/2013Specific NDC
VITAMAX CHW (49813000101) 0.17500 11/20/2011Specific NDC
Vitamin E Cap 1000 Unit 0.17424 06/25/2012All NDCs
Vitamin E Cap 400 Unit 0.05316 06/25/2012All NDCs
VITASANA TAB (93190008039) 0.17500 07/01/2010Specific NDC
VITASANA TAB (93190008040) 0.17500 07/01/2010Specific NDC
Voriconazole Tab 200 MG 45.02960 36.67480 01/01/2013All NDCs
VPRIV INJ 400UNIT (54092070104) 1,365.80000 02/20/2012Specific NDC
W&F LANCETS MIS 21G (38396016201) 0.04519 10/14/2011Specific NDC
W&F LANCETS MIS 26G (38396000010) 0.04519 10/14/2011Specific NDC
W&F LANCETS MIS 26G (38396001078) 0.04519 10/14/2011Specific NDC
W&F LANCETS MIS 26G (38396090178) 0.04519 10/14/2011Specific NDC
W&F LANCETS MIS 30G (38396050178) 0.04519 10/14/2011Specific NDC
Warfarin Sodium Tab 1 MG 0.10079 09/01/2012All NDCs
Warfarin Sodium Tab 10 MG 0.35027 0.13654 01/01/2013All NDCs
Warfarin Sodium Tab 2 MG 0.31824 06/25/2012All NDCs
Warfarin Sodium Tab 2.5 MG 0.12746 09/01/2012All NDCs
Warfarin Sodium Tab 3 MG 0.37786 0.12538 10/01/2012All NDCs
Warfarin Sodium Tab 4 MG 0.39002 06/25/2012All NDCs
Warfarin Sodium Tab 5 MG 0.35705 0.11700 01/01/2013All NDCs
Warfarin Sodium Tab 6 MG 0.35869 0.11650 10/01/2012All NDCs
Warfarin Sodium Tab 7.5 MG 0.17750 09/01/2012All NDCs
Water For Injection 0.02317 06/25/2012All NDCs
Water For Irrigation, Sterile Irrigation Soln 0.00338 06/25/2012All NDCs
Water For IV Injection 0.01613 06/25/2012All NDCs
WD LANCETS MIS (36652030331) 0.04519 07/17/2011Specific NDC
WD LANCETS MIS THIN (36652030131) 0.04519 07/17/2011Specific NDC
WD LANCETS MIS THIN (36652030231) 0.03669 07/17/2011Specific NDC
Page 90 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
WEIGHT SMART TAB ADVANCED
(16500051328)
0.17500 10/14/2011Specific NDC
WEIGHT SMART TAB ADVANCED
(16500051329)
0.17500 10/14/2011Specific NDC
White Petrolatum Gel 0.01902 06/25/2012All NDCs
WITEPSOL H15 MIS (51552085806) 0.02855 02/19/2012Specific NDC
WOMENS PAK (31604001015) 0.17500 11/11/2011Specific NDC
WOMENS BIO- TAB MULTIPLE
(48107000008)
0.17500 10/30/2011Specific NDC
WOMENS MENOP MIS VITA PAK
(48107004673)
0.17500 07/01/2010Specific NDC
WOMENS VITA MIS PAK (48107004676) 0.17500 07/01/2010Specific NDC
XPHE MAXAMAD POW ORANGE
(49735012357)
0.07349 10/14/2011Specific NDC
XPHE MAXAMAD POW STRAWBER
(49735012371)
0.07349 10/14/2011Specific NDC
XPHE MAXAMAD POW UNFLAVOR
(49735012358)
0.07349 10/14/2011Specific NDC
Zafirlukast Tab 10 MG 1.59080 1.29894 01/01/2013All NDCs
Zafirlukast Tab 20 MG 1.24528 1.18906 04/03/2013All NDCs
Zaleplon Cap 10 MG 0.69076 0.31238 01/01/2013All NDCs
Zaleplon Cap 5 MG 0.30948 09/01/2012All NDCs
Zidovudine Cap 100 MG 1.55998 06/25/2012All NDCs
Zidovudine Syrup 10 MG/ML 0.18160 06/25/2012All NDCs
Zidovudine Tab 300 MG 0.85199 06/25/2012All NDCs
Zinc Gluconate Tab 50 MG (Elemental Zn) 0.17500 06/25/2012All NDCs
Zinc Oxide Oint 20% 0.08423 06/25/2012All NDCs
Zinc Oxide Oint 40% 0.01650 06/25/2012All NDCs
Zinc Sulfate Cap 220 MG (50 MG Elemental
Zn)
0.02652 06/25/2012All NDCs
Zinc Tab 50 MG 0.02436 06/25/2012All NDCs
Ziprasidone HCl Cap 20 MG 4.13560 2.92000 01/01/2013All NDCs
Ziprasidone HCl Cap 40 MG 4.25170 2.92000 01/01/2013All NDCs
Ziprasidone HCl Cap 60 MG 4.30112 3.54000 01/01/2013All NDCs
Ziprasidone HCl Cap 80 MG 5.07456 3.54000 01/01/2013All NDCs
Zolpidem Tartrate Tab 10 MG 0.06584 06/25/2012All NDCs
Zolpidem Tartrate Tab 5 MG 0.06584 06/25/2012All NDCs
Zolpidem Tartrate Tab CR 12.5 MG 3.33257 2.74220 07/01/2013All NDCs
Zolpidem Tartrate Tab CR 6.25 MG 4.27148 3.17521 07/01/2013All NDCs
Zonisamide Cap 100 MG 0.14388 09/01/2012All NDCs
Zonisamide Cap 25 MG 0.18059 06/25/2012All NDCs
Zonisamide Cap 50 MG 0.19752 06/25/2012All NDCs
ZOVIA 1/50E TAB (52544038428) 0.91844 10/14/2011Specific NDC
Page 91 of 92
Product Description
Previous
SMAC Price
Current
SMAC Price
Current SMAC
Effective DateSMAC Type
ZYPREXA RELP INJ 300MG (00002763611) 795.00000 07/01/2011Specific NDC
ZYPREXA ZYDI TAB 5MG (00002445385) 0.00000 03/24/2011Specific NDC
ZYRTEC ALLGY TAB 10MG (49999027514) 0.16460 10/14/2011Specific NDC
ZYRTEC ALLGY TAB 10MG (49999027590) 0.16460 10/14/2011Specific NDC
ZYRTEC ALLGY TAB 10MG (50580072630) 0.16460 10/14/2011Specific NDC
ZYRTEC ALLGY TAB 10MG (50580072632) 0.16460 10/14/2011Specific NDC
ZYRTEC ALLGY TAB 10MG (50580072636) 0.16460 10/14/2011Specific NDC
ZYRTEC ALLGY TAB 10MG (50580072638) 0.16460 10/14/2011Specific NDC
ZYRTEC CHILD CHW ALG 10MG
(50580072219)
0.69782 10/14/2011Specific NDC
ZYRTEC CHILD SYP 1MG/ML
(50580072410)
0.07115 07/13/2011Specific NDC
ZYRTEC-D TAB 5-120MG (49999049012) 2.66384 10/14/2011Specific NDC
ZYRTEC-D TAB 5-120MG (49999049024) 2.26729 10/14/2011Specific NDC
ZYRTEC-D TAB 5-120MG (50580072850) 0.84459 10/14/2011Specific NDC
ZYRTEC-D TAB 5-120MG (50580072852) 0.60448 10/14/2011Specific NDC
ZYRTEC-D TAB 5-120MG (54868587900) 0.86101 10/14/2011Specific NDC
Page 92 of 92