utah state maximum allowable cost list · *pediatric vitamins adc drops 1500 unit-400 unit-35...

Utah State Maximum Allowable Cost List

as of 8/5/2016

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

*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 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

*Calamine Lotion*** 0.01526 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

*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

*Menthol-Methyl Salicylate Cream*** 0.05774 06/25/2012All NDCs

Page 2 of 93All SMACs are reviewed quarterly. The current SMAC effective date listed does not correspond to

the date the SMAC was last reviewed.

Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


*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 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** 0.86589 1.31990 12/28/2015All 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/ Fluoride Chew

Tab 0.25 MG***

0.22680 0.18049 01/01/2013All NDCs


Tab 0.5 MG***

0.22680 0.17813 01/01/2015All NDCs


Tab 1 MG***

0.22680 0.18448 01/01/2014All NDCs

*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



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


*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 MV Fe Fum-FA Tab 18-1 MG &

Coenzyme Q10 Cap 125 MG**

0.17500 06/04/2014All NDCs

*Prenat Vit-Fe Poly Cmplx-Fe Heme Poly-FA

Tab 22-6-1 MG***

0.17500 11/21/2012All NDCs

*Prenat Vit-Fe Poly Cmplx-Fe Heme Poly-FA

Tab 28-6-1 MG***

0.17500 10/09/2013All NDCs

*Prenat w/ Fe Fum-FA Tab 28-0.8 MG &

Omega 3 Cap 223 MG Pak*

0.17500 01/15/2014All NDCs

*Prenat w/ Fe Poly Cmplx-Fe Asp-Fe Gly-FA

Tab & DHA Cap Pak*

0.17500 10/09/2013All NDCs

*Prenat w/ Iron Cbn-Fe Asp Glyc-FA-Omega

Cap 30-10-1-200 MG*

0.17500 10/09/2013All NDCs

*Prenat w/Fe Poly-Na Fered-FA Tab 25-1 &

Omega Cap DR 400MG*

0.17500 06/25/2012All NDCs


Omega Cap DR 430MG*

0.17500 06/25/2012All NDCs


Omega Cap 278 MG***

0.17500 0.17500 10/09/2013All NDCs


Omega Cap DR 300MG*

0.17500 10/09/2013All NDCs


Omega Cap DR 374MG*

0.17500 0.17500 10/09/2013All NDCs


Omega Cap DR 380MG*

0.17500 10/09/2013All NDCs


Omega Cap DR 430MG*

0.17500 10/09/2013All 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 FeFum-FA Tab 27-1 MG & Fish

Oil Chew Cap Pak**

0.17500 10/09/2013All NDCs

*Prenat w/o A w/ Fe Bisglyc-FA Tab 32-1 MG

& Omega Cap Pack*

0.17500 0.17500 10/09/2013All NDCs

*Prenat w/o A w/ Fe Cbnyl-FA Tab 20-1 MG &

Vit B6 Tab Pak*

0.17500 10/09/2013All 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/ Fe

Fumerate-Methylfolate-FA-Omega 3 Cap***

0.17500 10/09/2013All NDCs

*Prenat w/o A w/FeAsp-Methylf-FA-Omeg

Cap 29-0.6-0.4-340 MG*

0.17500 02/25/2014All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


*Prenat w/o A

w/FeCbn-FeAspGlyc-FA-Omega Cap

35-5-1-200 MG**

0.17500 0.17500 10/09/2013All NDCs

*Prenat w/o A w/FeCbn-FeGlu-FA Tab 20-1

MG & Vit B6 Tab Pak*

0.17500 10/09/2013All 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

27-0.6-0.4-300 MG**

0.17500 0.17500 10/09/2013All 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 w/o A

w/FeFum-Methylfol-FA-Omegas Cap 27-1.53

MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenat w/o Vit A w/ Fe Fum-DSS-FA-DHA

Cap 29-1.25-337.5 MG*

0.17500 0.17500 10/09/2013All NDCs

*Prenat-Fe Bis-Fe Prot Succ-FA-Ca Tab &

Omega 3 Cap 250 Pk**

0.17500 0.17500 10/09/2013All NDCs



0.17500 0.17500 10/09/2013All NDCs



0.17500 0.17500 10/09/2013All NDCs


Omega Cap DR 400 Pk*

0.17500 0.17500 10/09/2013All NDCs


Omega Cap DR 430 Pk*

0.17500 0.17500 10/09/2013All NDCs

*Prenat-Fe Poly Cmplx-Fe Heme Poly-FA Tab

& Omega 3 Cap Pck*

0.17500 10/09/2013All NDCs

*Prenat-Fe Poly Cmplx-Fe Heme

Poly-FA-DHA Cap 22-6-1-200 MG*

0.17500 10/09/2013All NDCs

*Prenat-FePoly-NaFered-FA Tab 13-13-1 &

Omega Cap DR 374 MG*

0.17500 10/09/2013All NDCs

*Prenatal Multivitamins & Minerals w/ Fe & FA

Tab 0.25 MG***

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 Carbonyl-FA-DHA

Tab 15-0.5-50 MG***

0.17500 10/09/2013All NDCs

*Prenatal MV w/ Fe Polysac Cmplx-FA-DHA

Cap 27-1-200 MG***

0.17500 10/09/2013All NDCs

*Prenatal MV w/ Fe Polysac Cmplx-FA-DHA

Cap 29-1-200 MG***

0.17500 10/09/2013All NDCs

*Prenatal MV w/Fe Carbonyl-DSS-FA-DHA

Tab 15-25-0.5-50 MG***

0.17500 10/09/2013All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


*Prenatal MV w/Fe Fum-FA Tab 65-1 MG &

DHA Cap 250 MG Pack *

0.17500 0.17500 10/09/2013All NDCs

*Prenatal MV w/Fe Poly-FA Chw 29-1 MG &

DHA Cap 250 MG Pak *

0.17500 10/09/2013All 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

29-1 MG***

0.17500 0.17500 10/09/2013All 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/ DSS-Iron Carbonyl-FA Tab

90-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Fe Bisglycinate Chelate-FA

Tab 29-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Fe Cbn-Fe Asp Glyc-FA Tab

30-20-1 MG***

0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Fe Cbn-Fe Asp

Glyc-FA-Omega 3 Cap 27-1MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Fe Fum-FA-Omega 3 Cap

28-0.8-235 MG***

0.17500 01/15/2014All NDCs


28-1-200 MG***

0.17500 0.17500 10/09/2013All NDCs


28-1-215.8 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Fe Fum-Fe Bisglycin-FA

Chew Tab 28-1 MG***

0.17500 11/28/2012All NDCs

*Prenatal Vit w/ Fe Fum-Methylfolate-FA Tab

27-0.6-0.4 MG***

0.17500 0.17500 10/09/2013All 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 Chew Tab

29-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Fe Fumarate-FA Tab 14-0.4

MG***

0.17500 11/21/2012All NDCs


MG***

0.17500 06/25/2012All NDCs

*Prenatal Vit w/ Fe Fumarate-FA Tab 27-1

MG***

0.17500 0.17500 10/09/2013All NDCs


MG***

0.17500 11/07/2012All NDCs


MG***

0.17500 0.17500 10/09/2013All NDCs


MG***

0.17500 0.17500 10/09/2013All NDCs


MG***

0.17500 0.17500 10/09/2013All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC



MG***

0.17500 0.17500 10/09/2013All NDCs


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 Chew

Tab 29-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Iron Carbonyl-FA Tab 29-1

MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Iron Carbonyl-FA Tab 50-1.25

MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Iron Carbonyl-FA Tab 65-1

MG***

0.17500 11/28/2012All NDCs

*Prenatal Vit w/ Iron Carbonyl-Fe Gluc-FA

Tab 27-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/ Sel-Fe Fumarate-FA Tab

27-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vit w/o Vit A w/ Fe Bisglycinate-FA

Tab 32-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal Vitamin Fast Dissolving Tab** 0.17500 11/21/2012All NDCs

*Prenatal w/ Calcium Carbonate-B6-B12-FA

Tab 1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/ Calcium-Vit B6-FA-Ginger Tab

1.2 MG**

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/ Sod Feredetate-FA Tab 30-1 &

Omega 3 Cap DR***

0.17500 10/09/2013All NDCs

*Prenatal w/Fe Cbnyl-Fe Asp

Glyc-FA-DSS-Omega Cap 20-7-1 MG*

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/Fe Fum-FA Tab 27-0.8 MG &


0.17500 11/21/2012All NDCs

*Prenatal w/Fe Fum-FA Tab DR 27-1 MG &


0.17500 10/09/2013All NDCs

*Prenatal w/Fe Fum-Fe Poly -FA-Omega 3

Cap 15-15-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/Fe Fum-Fe Poly -FA-Omega 3

Cap 53.5-38-1 MG***

0.17500 10/09/2013All NDCs

*Prenatal w/Fe Fumarate-FA-DSS-Fish Oil

Cap 27-1-500 MG***

0.17500 10/09/2013All NDCs

*Prenatal w/o A Vit w/ Fe Cbn-Fe Fum-FA

Tab 60-1 MG***

0.17500 10/09/2013All NDCs

*Prenatal w/o A Vit w/ Fe Fum-FA Tab Chew

28-1 MG***

0.17500 10/09/2013All NDCs


29-1 MG***

0.17500 10/09/2013All NDCs


40-1 MG***

0.17500 0.17500 10/09/2013All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


*Prenatal w/o A Vit w/ Fe Fumarate-FA Cap

106.5-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/o A Vit w/ Fe Fumarate-FA Tab

30-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/o A w/ Fe Carbonyl-Fe

Gluc-DSS-FA Tab 27-1MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/o A w/ FeFum-L Methylfol-FA Tab

18-0.6-0.4 MG***

0.17500 03/05/2014All NDCs

*Prenatal w/o A w/Fe Cbn-DSS-FA-DHA Cap

27-1-250 MG***

0.17500 10/09/2013All 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/Fe Fum-Fe Poly-FA Cap

130-92.4-1 MG***

0.17500 10/09/2013All NDCs

*Prenatal w/o A w/Fe Fum-Fe Poly-FA Cap

162.115.2-1 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/o A w/FeCbn-Fe Asp

Glyc-FA-Fish Cap 40-10-1 MG*

0.17500 10/09/2013All NDCs

*Prenatal w/o A w/FeCbn-Fe Asp

Glyc-FA-Fish Cap 50-1-476 MG*

0.17500 08/08/2012All NDCs

*Prenatal w/o A w/FeCbn-FeAspGlyc-FA-DHA

Chew 15-5-1-100 MG*

0.17500 10/09/2013All NDCs

*Prenatal w/o Vit A w/ Fe Cbn-DSS-FA-DHA

Cap 30-1-260 MG***

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/o Vit A w/ Fe Fum-Doc-FA-DHA

Cap 29-1.25-350 MG*

0.17500 0.17500 10/09/2013All NDCs

*Prenatal w/o Vit A w/ Fe Fum-DSS-FA-DHA

Cap 26-1.2-300 MG**

0.17500 10/09/2013All NDCs


Cap 27-1.25-300 MG*

0.17500 10/09/2013All NDCs


Cap 29-1.25-325 MG*

0.17500 0.17500 10/09/2013All NDCs


Cap 30-1.2-265 MG**

0.17500 10/09/2013All NDCs

*Prenatal w/o Vit A w/ Fe Fum-FA-Omega 3

Cap 28-1-250 MG***

0.17500 10/09/2013All NDCs

*Prenatal w/o Vit A w/ Fe Polysac Cmplx-FA

Cap 60-1 MG***

0.17500 10/09/2013All NDCs

*Prenatal w/o Vit A w/Fe Fum-DSS-FA-DHA

Cap 30-1.24-265 MG**

0.17500 10/09/2013All NDCs

*Prenatal without A w/ Fe Asparto Gly-Doc-FA

Tab 30-1MG***

0.17500 0.17500 10/09/2013All 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



Product Description

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SMAC Price

Current

SMAC Price

Current SMAC


*Sodium Phosphates - Soln*** 0.06454 06/25/2012All NDCs

*Sodium Polystyrene Sulfonate Powder** 0.23821 0.17644 01/01/2014All NDCs

*Spacer/Aerosol-Holding Chambers -

Device***

31.55000 03/23/2016All 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


(08517030722)

0.03171 10/14/2011Specific NDC


(08517035722)

0.03553 10/14/2011Specific NDC


(08517065722)

0.04248 10/14/2011Specific NDC

Acamprosate Calcium Tab Delayed Release

333 MG

0.85438 10/01/2015All NDCs

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 0.36626 10/01/2015All 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



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Acetaminophen Suppos 120 MG 0.50792 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 0.27840 0.23092 07/01/2015All NDCs

Acetaminophen w/ Hydrocodone Tab 500-2.5

MG

0.20481 06/25/2012All NDCs

Acetaminophen w/ Hydrocodone Tab 500-5

MG

0.04765 0.04075 11/20/2013All NDCs


MG

0.15775 0.07507 01/01/2013All NDCs


MG

0.17320 06/25/2012All NDCs


MG

0.19759 06/25/2012All NDCs


MG

0.50502 06/25/2012All NDCs


MG

0.14477 06/25/2012All NDCs

Acetaminophen-Caffeine-Dihydrocodeine Tab

712.8-60-32 MG

1.68336 06/25/2012All NDCs

Acetazolamide Cap SR 12HR 500 MG 2.01454 2.76520 04/28/2016All NDCs

Acetazolamide Tab 250 MG 2.21540 2.11456 04/01/2016All 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 1.60267 01/01/2014All NDCs

Acetylcysteine Inhal Soln 10% 0.39480 06/25/2012All NDCs

Acetylcysteine Inhal Soln 20% 0.25064 06/25/2012All NDCs

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 Susp 200 MG/5ML 0.43518 0.77746 12/14/2015All NDCs

Acyclovir Tab 400 MG 0.20811 0.19378 01/01/2016All NDCs

Acyclovir Tab 800 MG 0.33092 0.27009 07/01/2015All NDCs

Adapalene Cream 0.1% 5.24000 06/25/2012All NDCs

Adapalene Gel 0.1% 3.27622 2.50933 04/01/2016All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


ADVATE INJ 1000UNIT (00944294310) 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 0.06933 01/01/2014All NDCs

Albuterol Sulfate Soln Nebu 0.5% (5 MG/ML) 0.62950 0.56808 07/01/2015All NDCs

Albuterol Sulfate Soln Nebu 0.63 MG/3ML

(Base Equiv)

0.42744 0.34080 04/01/2016All NDCs

Albuterol Sulfate Soln Nebu 1.25 MG/3ML

(Base Equiv)

0.42744 0.34430 01/01/2014All 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 3.32800 11/13/2015All NDCs

Albuterol Sulfate Tab SR 12HR 4 MG 1.22780 1.47330 06/15/2016All NDCs

Albuterol Sulfate Tab SR 12HR 8 MG 1.76632 1.93000 03/02/2013All NDCs

Alclometasone Dipropionate Cream 0.05% 2.19616 04/20/2016All 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





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 0.34000 0.32057 10/01/2015All NDCs

Alprazolam Orally Disintegrating Tab 0.25 MG 1.29480 06/25/2012All NDCs

Alprazolam Orally Disintegrating Tab 0.5 MG 1.61328 1.42932 10/01/2015All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


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 0.43078 0.41320 07/01/2016All 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

400-400-40 MG/5ML

0.00731 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 1.41000 1.17843 04/01/2016All NDCs

Amantadine HCl Syrup 50 MG/5ML 0.06135 06/25/2012All NDCs

Amantadine HCl Tab 100 MG 1.49832 06/25/2012All NDCs

Amiloride & Hydrochlorothiazide Tab 5-50 MG 0.06312 06/25/2012All NDCs

Amiloride HCl Tab 5 MG 0.56681 0.41557 07/01/2015All NDCs

Aminocaproic Acid Syrup 25% 1.03550 06/25/2012All NDCs

Aminocaproic Acid Tab 500 MG 1.86000 4.46250 05/28/2014All 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 0.04739 0.13520 08/22/2014All 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

0.55753 0.51095 07/01/2015All NDCs


10-40 MG

0.96703 0.47203 10/01/2014All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC



2.5-10 MG

2.05061 06/25/2012All NDCs

Amlodipine Besylate-Benazepril HCl Cap 5-10

MG

0.75333 0.46937 07/01/2015All NDCs


MG

0.47519 0.35451 10/01/2015All NDCs


MG

0.83118 0.56352 07/01/2015All NDCs

Amlodipine Besylate-Valsartan Tab 10-160

MG

0.80629 07/01/2015All NDCs

Amlodipine Besylate-Valsartan Tab 10-320

MG

1.02353 07/01/2015All NDCs

Amlodipine Besylate-Valsartan Tab 5-160 MG 0.71066 07/01/2015All NDCs

Amlodipine Besylate-Valsartan Tab 5-320 MG 0.90162 07/01/2015All 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




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


250-62.5 MG/5ML

0.64603 0.49039 04/01/2016All NDCs

Amoxicillin & K Clavulanate For Susp 400-57

MG/5ML

0.37500 0.16514 04/01/2016All NDCs


600-42.9 MG/5ML

0.14460 0.10781 07/01/2015All NDCs

Amoxicillin & K Clavulanate Tab 250-125 MG 4.57192 06/25/2012All NDCs

Amoxicillin & K Clavulanate Tab 500-125 MG 0.81575 0.69487 10/01/2014All NDCs

Amoxicillin & K Clavulanate Tab 875-125 MG 0.62357 1.24700 05/24/2016All 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 250 MG 0.33719 06/25/2012All NDCs

Amoxicillin (Trihydrate) For Susp 125

MG/5ML

0.01879 06/25/2012All NDCs


MG/5ML

0.07045 06/25/2012All NDCs


MG/5ML

0.02796 06/25/2012All NDCs


MG/5ML

0.03835 09/01/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


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

3.71400 3.48938 07/01/2016All NDCs


24HR 15 MG

3.72500 3.54752 07/01/2016All NDCs


24HR 20 MG

3.15334 3.55210 01/05/2016All NDCs


24HR 25 MG

3.36534 3.67540 02/01/2016All NDCs


24HR 30 MG

3.65958 3.50093 04/01/2016All NDCs


24HR 5 MG

3.43658 3.79850 03/08/2016All NDCs

Amphetamine-Dextroamphetamine Tab 10

MG

0.97062 0.70527 04/01/2016All NDCs

Amphetamine-Dextroamphetamine Tab 12.5

MG

0.98612 0.74920 04/01/2016All NDCs


MG

0.88903 0.76220 04/01/2016All NDCs


MG

0.86430 0.73440 07/01/2016All NDCs


MG

0.82578 0.69482 04/01/2016All NDCs

Amphetamine-Dextroamphetamine Tab 5 MG 1.10500 0.93135 10/01/2015All NDCs

Amphetamine-Dextroamphetamine Tab 7.5

MG

1.06642 06/25/2012All NDCs

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

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 0.36600 0.31963 01/01/2015All 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



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


AQUADEKS DRO (58914021460) 0.16366 10/14/2011Specific NDC

Arginine Tab 500 MG 0.06576 06/25/2012All NDCs

Aripiprazole Oral Solution 1 MG/ML 5.38964 07/01/2016All NDCs

Aripiprazole Tab 10 MG 14.91210 7.97000 01/20/2016All 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



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 0.39920 11/01/2015All NDCs

Atenolol Tab 100 MG 0.14194 0.03778 01/01/2013All NDCs

Atenolol Tab 25 MG 0.08349 06/25/2012All NDCs

Atenolol Tab 50 MG 0.09305 06/25/2012All NDCs

Atorvastatin Calcium Tab 10 MG (Base

Equivalent)

0.22041 06/25/2012All NDCs


Equivalent)

0.31346 06/25/2012All NDCs


Equivalent)

0.31346 0.30147 07/01/2016All NDCs


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% 2.68000 12.69975 09/15/2015All NDCs

AURORA LANCE MIS 30G (08214065724) 0.05400 10/14/2011Specific NDC

AURORA LANCE MIS THIN 23G

(08214015724)

0.05400 10/14/2011Specific NDC



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


AUTO LANCET MIS (51709000729) 0.13132 10/14/2011Specific NDC

Azathioprine Tab 50 MG 0.35100 0.49580 12/10/2015All NDCs

Azelastine HCl Nasal Spray 0.1% (137

MCG/SPRAY)

1.17181 0.99167 07/01/2016All NDCs

Azelastine HCl Ophth Soln 0.05% 16.65000 12.50000 10/01/2012All NDCs

Azithromycin For Susp 100 MG/5ML 1.07541 0.82041 04/01/2016All NDCs

Azithromycin For Susp 200 MG/5ML 0.91124 0.63868 07/01/2016All NDCs

Azithromycin Powd Pack for Susp 1 GM 21.92000 06/25/2012All NDCs

AZITHROMYCIN SUS 200/5ML

(00093202623)

1.16524 11/04/2014Specific NDC

AZITHROMYCIN SUS 200/5ML

(59762312001)

1.24520 02/16/2015Specific NDC

Azithromycin Tab 250 MG 0.69417 09/01/2012All 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 0.24000 0.20263 04/01/2015All NDCs

Baclofen Tab 20 MG 0.42520 0.35570 01/01/2015All NDCs

Balsalazide Disodium Cap 750 MG 0.58900 0.56154 07/01/2016All 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 MICROTAIN MIS LANCETS

(08290366592)

0.19660 10/14/2011Specific NDC


(08290366593)

0.28474 10/14/2011Specific NDC


(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

Benazepril & Hydrochlorothiazide Tab 10-12.5

MG

1.46157 1.10556 10/01/2015All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC



MG

1.32500 1.07575 04/01/2016All NDCs

Benazepril & Hydrochlorothiazide Tab 20-25

MG

1.05042 1.25247 07/01/2016All NDCs


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

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 0.18157 04/01/2016All NDCs

Benzoyl Peroxide Liq 10% 0.12121 06/25/2012All NDCs




Benzoyl Peroxide Lotion 10% 0.09200 06/25/2012All NDCs




Benzoyl Peroxide-Erythromycin Gel 5-3% 0.89002 7.05787 05/20/2016All NDCs

Benztropine Mesylate Inj 1 MG/ML 36.00000 06/25/2012All NDCs

Benztropine Mesylate Tab 0.5 MG 0.06986 0.16000 06/17/2014All NDCs

Benztropine Mesylate Tab 1 MG 0.04480 0.19653 09/22/2013All 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%

0.51396 0.28500 04/01/2016All 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%

2.75652 2.37223 07/01/2014All NDCs

Betamethasone Dipropionate Cream 0.05% 1.19730 06/25/2012All NDCs

Betamethasone Dipropionate Lotion 0.05% 0.14028 0.58620 06/15/2015All NDCs

Betamethasone Dipropionate Oint 0.05% 1.82770 06/25/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Betamethasone Valerate Cream 0.1% 0.72000 0.82451 07/13/2015All 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 0.31817 04/01/2015All 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

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

Black Cohosh (Cimicifuga racemosa) Cap

540 MG

0.06780 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% 1.50750 0.85488 07/01/2015All 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 3.09650 2.86705 10/01/2015All NDCs

Budesonide Delayed Release Particles Cap 3

MG

8.96895 04/13/2016All 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 0.67850 0.61879 10/01/2015All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Bumetanide Tab 2 MG 0.89540 0.24605 10/01/2015All NDCs

Buprenorphine HCl SL Tab 2 MG (Base

Equiv)

1.87625 1.07686 07/01/2015All NDCs

Buprenorphine HCl SL Tab 8 MG (Base

Equiv)

2.13520 1.86776 04/01/2016All NDCs

Buprenorphine HCl-Naloxone HCl SL Tab

2-0.5 MG (Base Equiv)

3.62500 07/01/2015All NDCs

Buprenorphine HCl-Naloxone HCl SL Tab 8-2

MG (Base Equiv)

5.69000 07/01/2015All NDCs

Bupropion HCl (Smoking Deterrent) Tab SR

12HR 150 MG

0.60599 0.47621 10/01/2015All NDCs

Bupropion HCl Tab 100 MG 0.55342 0.71340 03/14/2016All NDCs

Bupropion HCl Tab 75 MG 0.50922 0.47409 07/01/2016All NDCs

Bupropion HCl Tab SR 12HR 100 MG 0.31649 0.25881 07/01/2015All NDCs





Buspirone HCl Tab 10 MG 0.06677 06/25/2012All NDCs


Buspirone HCl Tab 30 MG 0.73659 0.57745 10/01/2014All NDCs


Buspirone HCl Tab 7.5 MG 0.89854 0.77824 10/01/2015All NDCs

Butalbital-Acetaminophen-Caff w/ COD Cap

50-325-40-30 MG

1.11250 1.08383 01/01/2015All 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 0.66352 01/02/2015All 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 15.55908 13.52231 10/01/2014All NDCs

Cabergoline Tab 0.5 MG 9.47181 9.28488 07/01/2016All NDCs

Caffeine Citrate Oral Soln 60 MG/3ML (10

MG/ML Base Equiv)

11.97379 06/25/2012All NDCs

Calcipotriene Cream 0.005% 4.90097 10/01/2015All 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 14.48471 12.15146 01/01/2015All NDCs

Calcitriol Cap 0.25 MCG 0.67178 09/01/2012All NDCs

Calcitriol Cap 0.5 MCG 1.49386 0.92007 01/01/2014All NDCs

Calcitriol Oral Soln 1 MCG/ML 8.99846 7.01700 04/02/2014All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Calcium Acetate (Phosphate Binder) Cap 667

MG (169 MG Ca)

0.46040 0.41758 07/01/2016All NDCs

Calcium Carbonate (Antacid) Chew Tab 1000

MG

0.04290 06/25/2012All NDCs


MG

0.02059 06/25/2012All NDCs


MG

0.03371 06/25/2012All NDCs

Calcium Carbonate (Antacid) Tab 648 MG 0.00748 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

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


MG-200 Unit

0.01920 06/25/2012All NDCs


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

Candesartan Cilexetil Tab 8 MG 2.32000 07/01/2016All 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


MG

0.22071 06/25/2012All NDCs


MG

0.95233 0.18009 01/01/2013All NDCs


MG

0.34622 06/25/2012All NDCs

Captopril Tab 100 MG 0.10100 06/25/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


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 1.92883 1.49158 10/01/2015All NDCs

Carbamazepine Cap SR 12HR 100 MG 1.39312 1.27937 10/01/2015All NDCs



Carbamazepine Chew Tab 100 MG 0.42510 0.38208 07/01/2015All NDCs

Carbamazepine Susp 100 MG/5ML 0.12018 0.14018 10/21/2015All NDCs

Carbamazepine Tab 200 MG 0.80140 0.67410 07/01/2016All NDCs

Carbamazepine Tab SR 12HR 200 MG 1.29580 1.18010 01/01/2015All NDCs

Carbamazepine Tab SR 12HR 400 MG 2.44821 3.36250 12/23/2015All 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 0.19852 10/01/2015All NDCs

Carbidopa & Levodopa Tab CR 25-100 MG 0.27144 09/01/2012All NDCs

Carbidopa & Levodopa Tab CR 50-200 MG 0.74000 0.44690 04/01/2016All 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




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 & Codeine Tab

200-325-16 MG

1.83750 04/20/2016All 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 0.04859 11/20/2013All NDCs

Carvedilol Tab 25 MG 0.13327 0.12222 10/01/2015All NDCs



Castor Oil 0.03646 06/25/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


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



Cefadroxil Cap 500 MG 0.62151 0.37787 10/01/2015All 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 1.18484 1.15874 07/01/2016All NDCs

Cefdinir For Susp 125 MG/5ML 0.38307 0.46520 12/11/2015All NDCs

Cefdinir For Susp 250 MG/5ML 1.18520 0.51725 07/01/2016All 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

Cefotaxime Sodium For Inj 1 GM 2.64000 06/25/2012All NDCs

Cefoxitin Sodium For IV Soln 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 4.16123 04/02/2014All 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 3.26525 2.51204 11/20/2013All NDCs

Ceftriaxone Sodium For Inj 10 GM 32.44511 06/25/2012All NDCs

Ceftriaxone Sodium For Inj 2 GM 5.56202 3.55944 01/01/2015All 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 1.53200 1.49389 07/01/2015All NDCs

Cefuroxime Axetil Tab 500 MG 0.77271 2.59000 03/16/2014All NDCs

Celecoxib Cap 100 MG 0.94235 0.72539 04/01/2016All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Celecoxib Cap 200 MG 1.23353 1.59000 07/19/2016All NDCs

Celecoxib Cap 400 MG 2.91333 04/01/2015All NDCs

Celecoxib Cap 50 MG 0.65210 10/15/2015All NDCs

CENTRUM CHW (00005452835) 0.17500 10/14/2011Specific NDC

CENTRUM CHW (00005452861) 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 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 0.17520 10/15/2014All NDCs

Cephalexin For Susp 250 MG/5ML 0.19585 0.17474 01/01/2016All NDCs

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 4.43066 04/20/2015All NDCs

Cetirizine HCl Oral Soln 1 MG/ML (5

MG/5ML)

0.07080 01/01/2015All NDCs

Cetirizine HCl Tab 10 MG 0.05921 0.13300 11/30/2015All NDCs

Cetirizine HCl Tab 5 MG 0.36219 0.26069 01/01/2015All 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

Chlordiazepoxide HCl Cap 10 MG 0.08211 06/25/2012All NDCs



Chlordiazepoxide HCl-Clidinium Bromide Cap

5-2.5 MG

0.94800 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

Chlorpheniramine & Phenylephrine Liquid

1-3.5 MG/ML

1.07120 06/25/2012All NDCs



Product Description

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SMAC Price

Current

SMAC Price

Current SMAC


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 2.64520 2.44319 04/01/2016All NDCs





Chlorpropamide Tab 250 MG 0.45985 06/25/2012All NDCs

Chlorthalidone Tab 25 MG 0.78780 0.91250 05/01/2015All NDCs

Chlorthalidone Tab 50 MG 0.42928 1.18450 11/03/2015All NDCs

Chlorzoxazone Tab 500 MG 0.07079 0.23500 01/06/2015All NDCs

Cholecalciferol Cap 1000 Unit 0.08267 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



Cholestyramine Light Powder 4 GM/DOSE 0.20507 0.24510 12/11/2014All NDCs

Cholestyramine Light Powder Packets 4 GM 1.09552 1.99500 07/10/2014All NDCs

Cholestyramine Powder 4 GM/DOSE 0.11393 0.24500 09/18/2014All NDCs

Cholestyramine Powder Packets 4 GM 2.04000 1.82821 04/01/2016All NDCs

Choline & Magnesium Salicylates Tab 1000

MG

0.54526 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 0.31265 0.24922 07/01/2014All 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 0.35031 0.33080 10/01/2014All 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




Product Description

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SMAC Price

Current

SMAC Price

Current SMAC



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

Citalopram Hydrobromide Oral Soln 10

MG/5ML

0.19270 0.29540 06/26/2015All NDCs

Citalopram Hydrobromide Tab 10 MG (Base

Equiv)

0.17117 0.06607 01/01/2013All NDCs


Equiv)

0.04439 09/01/2012All NDCs


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 0.17500 01/07/2015Specific NDC

CITRANATAL MIS B-CALM (00178083230) 0.73510 12/17/2014Specific NDC

CITRANATAL PAK ASSURE

(00178089330)

0.45000 0.17500 01/07/2015Specific 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




Clarithromycin For Susp 125 MG/5ML 0.39551 06/25/2012All NDCs

Clarithromycin For Susp 250 MG/5ML 0.75272 0.66048 10/01/2015All NDCs

Clarithromycin Tab 250 MG 1.24552 06/25/2012All NDCs

Clarithromycin Tab 500 MG 1.64968 1.63518 10/01/2015All NDCs

Clarithromycin Tab SR 24HR 500 MG 2.99121 3.52100 09/17/2014All NDCs

CLARITIN SYP 5MG/5ML (11523719701) 0.06559 10/14/2011Specific NDC

CLARITIN TAB 10MG (11523716001) 0.72600 10/14/2011Specific NDC













Product Description

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SMAC Price

Current

SMAC Price

Current SMAC














CLARITIN-D TAB 10-240MG

(11523716102)

0.98880 10/14/2011Specific NDC


(11523716103)

1.00000 10/14/2011Specific NDC


(41100008043)

0.98880 10/14/2011Specific NDC


(41100008049)

1.00000 10/14/2011Specific NDC


(41100080289)

1.00000 10/14/2011Specific NDC

CLARITIN-D TAB 5-120MG (11523716201) 0.85902 10/14/2011Specific 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

Clindamycin HCl Cap 150 MG 0.27592 0.11401 01/01/2013All NDCs

Clindamycin HCl Cap 300 MG 0.57412 0.30925 11/20/2013All NDCs

Clindamycin Palmitate HCl For Soln 75

MG/5ML (Base Equiv)

0.49117 0.29194 10/01/2015All NDCs

Clindamycin Phosphate Foam 1% 2.64036 06/25/2012All NDCs

Clindamycin Phosphate Gel 1% 1.71000 1.62850 04/02/2014All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Clindamycin Phosphate Inj 300 MG/2ML 1.15083 06/25/2012All NDCs


Clindamycin Phosphate Inj 9 GM/60ML 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% 1.42469 1.21053 01/01/2016All NDCs

Clindamycin Phosphate Soln 1% 1.08190 0.86263 10/01/2015All NDCs

Clindamycin Phosphate Swab 1% 0.58919 0.39833 01/01/2015All 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% 4.42500 4.23659 04/01/2015All 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 2.62000 04/06/2016All NDCs

Clobetasol Propionate Oint 0.05% 5.05000 6.67000 10/03/2015All NDCs

Clobetasol Propionate Shampoo 0.05% 1.69076 10/01/2015All NDCs

Clobetasol Propionate Soln 0.05% 1.99900 2.19852 01/04/2016All NDCs

Clomiphene Citrate Tab 50 MG 0.76290 11/20/2013All NDCs

Clomipramine HCl Cap 25 MG 8.69878 8.96120 03/11/2015All NDCs



Clonazepam Orally Disintegrating Tab 0.125

MG

0.98000 0.71021 10/01/2015All NDCs

Clonazepam Orally Disintegrating Tab 0.25

MG

0.72510 0.84520 02/09/2016All NDCs

Clonazepam Orally Disintegrating Tab 0.5 MG 1.00167 0.81151 10/01/2015All NDCs

Clonazepam Orally Disintegrating Tab 1 MG 0.85068 1.01210 02/01/2016All 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 Tab SR 12HR 0.1 MG 3.27560 3.26070 07/01/2016All NDCs

Clonidine HCl TD Patch Weekly 0.1

MG/24HR

20.16500 16.48142 04/01/2016All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC



MG/24HR

28.11819 26.52000 07/01/2016All NDCs


MG/24HR

37.52000 35.05853 04/01/2016All 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 0.18590 0.32000 11/12/2014All NDCs

Clorazepate Dipotassium Tab 7.5 MG 0.18208 0.43520 05/02/2016All NDCs

Clotrimazole Cream 1% 0.78000 0.76445 10/01/2015All NDCs

Clotrimazole Crystals 1.96800 06/25/2012All NDCs

Clotrimazole Soln 1% 0.44189 3.61000 03/29/2016All NDCs

Clotrimazole Troche 10 MG 0.60471 0.50948 01/01/2014All 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 1.10000 1.08573 10/01/2015All 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




Colchicine Tab 0.6 MG 0.10800 5.36000 02/05/2016All NDCs

Colchicine w/ Probenecid Tab 0.5-500 MG 0.96780 0.82553 01/01/2015All NDCs

Colestipol HCl Granule Packets 5 GM 2.40360 06/25/2012All NDCs

Colestipol HCl Tab 1 GM 0.50817 0.82310 10/30/2015All NDCs

Colistimethate Sodium For Inj 150 MG 33.60000 16.67678 04/02/2014All NDCs

COMFORTOUCH MIS LANCET

(08214046001)

0.02989 10/14/2011Specific NDC


(08214046501)

0.03615 10/14/2011Specific NDC



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC



(08470043001)

0.03595 10/14/2011Specific NDC


(08470043501)

0.04341 10/14/2011Specific NDC


(08470046001)

0.03595 10/14/2011Specific NDC


(08470046501)

0.04341 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 1.41200 02/10/2015All 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


(38396050375)

0.03669 10/14/2011Specific NDC


(50428001771)

0.04341 10/14/2011Specific NDC


(38396052175)

0.04519 10/14/2011Specific NDC


(38396052275)

0.03669 10/14/2011Specific NDC

Cyanocobalamin Inj 1000 MCG/ML 9.62500 6.99762 07/01/2016All NDCs

Cyanocobalamin Tab 100 MCG 0.01704 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 0.04137 11/20/2013All 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 5.26000 8.14520 08/13/2015All NDCs

Cyclosporine Cap 25 MG 1.20561 06/25/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


Cyclosporine Modified Cap 100 MG 3.10000 2.10018 04/02/2014All NDCs

Cyclosporine Modified Cap 25 MG 0.80334 0.69935 04/01/2015All 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 0.32487 0.63000 01/21/2014All NDCs

Cytarabine For Inj 100 MG 0.32733 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

D 1000 PLUS TAB ALOE (11845015395) 0.17500 10/14/2011Specific NDC

Danazol Cap 200 MG 3.68739 6.14210 11/03/2015All NDCs

Dantrolene Sodium Cap 100 MG 1.53936 06/25/2012All NDCs

Dantrolene Sodium Cap 25 MG 0.91283 0.72225 07/01/2015All NDCs

Dantrolene Sodium Cap 50 MG 1.23747 1.04556 07/01/2015All 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 3.01250 2.67172 10/01/2015All NDCs


Desipramine HCl Tab 25 MG 1.13400 0.97338 10/01/2015All NDCs



Desmopressin Acetate Nasal Spray Soln

0.01%

16.45291 19.72520 06/16/2015All NDCs

Desmopressin Acetate Nasal Spray Soln

0.01% (Refrigerated)

19.74402 19.53240 04/01/2016All NDCs

Desmopressin Acetate Tab 0.1 MG 1.33662 1.20627 10/01/2015All NDCs

Desmopressin Acetate Tab 0.2 MG 1.28035 1.05002 04/01/2016All 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

0.60631 0.48307 04/01/2016All NDCs

DESONIDE LOT 0.05% (00168031002) 1.89660 10/09/2012Specific NDC

Desonide Cream 0.05% 4.02435 3.94847 01/01/2015All NDCs

Desonide Lotion 0.05% 0.44519 2.57850 11/12/2014All NDCs

Desonide Oint 0.05% 3.29500 3.15242 07/01/2014All NDCs

Desoximetasone Cream 0.05% 2.53792 06/25/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


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 10

MG

6.18944 6.98520 10/07/2015All NDCs


MG

5.01554 10/01/2015All NDCs


MG

4.22258 5.74520 10/08/2015All NDCs


MG

5.43054 10/01/2015All 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

3.14339 3.75400 10/12/2015All NDCs


MG

4.56000 4.38633 04/01/2016All NDCs


MG

3.13000 2.31413 07/01/2015All NDCs

Dextroamphetamine Sulfate Tab 10 MG 1.48288 1.62500 04/19/2016All NDCs

Dextroamphetamine Sulfate Tab 5 MG 1.64000 1.48140 10/01/2015All 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


MG/5ML

0.01722 06/25/2012All NDCs


MG/5ML

0.04068 06/25/2012All NDCs

Dextromethorphan-Guaifenesin Syrup 10-100

MG/5ML

0.00891 06/25/2012All NDCs



Product Description

Previous

SMAC Price

Current

SMAC Price

Current SMAC


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 Inj 10% 0.00632 06/25/2012All NDCs




DIABETES PAK HEALTH (31604001020) 0.17500 10/14/2011Specific NDC

DIALYVITE TAB 800/IRON (10542007510) 0.17500 10/14/2011Specific NDC

Diazepam Inj 5 MG/ML 0.48203 7.59854 06/10/2015All 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 0.03313 11/20/2013All NDCs

Diazepam Tab 2 MG 0.03956 06/25/2012All NDCs

Diazepam Tab 5 MG 0.02547 0.02310 11/20/2013All NDCs

Dibucaine Rectal Ointment 1% 0.21428 06/25/2012All NDCs

Diclofenac Potassium Tab 50 MG 0.18697 0.46500 02/13/2015All NDCs

Diclofenac Sodium Ophth Soln 0.1% 2.25869 01/01/2013All NDCs

Diclofenac Sodium Tab Delayed Release 25

MG

1.09834 06/25/2012All NDCs

Diclofenac Sodium Tab Delayed Release 50

MG

0.36883 0.28281 10/01/2015All NDCs

Diclofenac Sodium Tab Del

utah state maximum allowable cost list · *pediatric vitamins adc drops 1500 unit-400 unit-35...

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