|
70748-0272-13
|
1
|
36F79723D0140
|
X |
Golden Sta
|
RISPERIDONE 50MG/VIL INJ,SUSP,SA
|
RISPERIDONE 50MG/VIL INJ,SUSP,SA
|
$730.43
|
$0.00
|
$0.00
|
|
13811-0701-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
HYDROMORPHONE HCL 8MG 24HR TAB,SA
|
HYDROMORPHONE HCL 8MG 24HR TAB,SA
|
$731.36
|
$0.00
|
$0.00
|
|
60505-4682-09
|
90
|
36F79723D0140
|
X |
Golden Sta
|
PIRFENIDONE 801MG TAB,ORAL
|
PIRFENIDONE 801MG TAB,ORAL
|
$731.40
|
$0.00
|
$0.00
|
|
49884-0009-10
|
1000
|
36F79723D0140
|
X |
Golden Sta
|
ISOSORBIDE DINITRATE 30MG TAB,ORAL
|
ISOSORBIDE DINITRATE 30MG TAB,ORAL
|
$765.36
|
$0.00
|
$0.00
|
|
00054-0471-21
|
60
|
36F79723D0140
|
X |
Golden Sta
|
EVEROLIMUS 0.5MG TAB
|
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5MG TAB
|
$780.73
|
$0.00
|
$0.00
|
|
00121-1016-42
|
42X5ML
|
36F79723D0140
|
X |
Golden Sta
|
ATOVAQUONE 750MG/5ML SUSP,ORAL
|
ATOVAQUONE 750MG/5ML SUSP,ORAL
|
$782.10
|
$0.00
|
$0.00
|
|
13668-0593-86
|
6
|
36F79723D0140
|
X |
Golden Sta
|
APREPITANT 125MG CAP
|
APREPITANT 125MG CAP
|
$789.91
|
$0.00
|
$0.00
|
|
69315-0286-06
|
60
|
36F79723D0140
|
X |
Golden Sta
|
ETRAVIRINE 200MG TAB
|
ETRAVIRINE 200MG TAB
|
$795.99
|
$0.00
|
$0.00
|
|
00121-3036-95
|
10X15ML
|
36F79723D0140
|
X |
Golden Sta
|
LACOSAMIDE 10MG/ML SOLN,ORAL
|
LACOSAMIDE 10MG/ML SOLN,ORAL
|
$800.10
|
$0.00
|
$0.00
|
|
69315-0285-20
|
120
|
36F79723D0140
|
X |
Golden Sta
|
ETRAVIRINE 100MG TAB
|
ETRAVIRINE 100MG TAB
|
$806.52
|
$0.00
|
$0.00
|
|
00641-1398-35
|
25X2ML
|
36F79723D0140
|
X |
Golden Sta
|
CHLORPROMAZINE HCL 25MG/ML INJ
|
CHLORPROMAZINE HCL 25MG/ML INJ
|
$819.27
|
$0.00
|
$0.00
|
|
00121-1896-00
|
100X30ML
|
36F79723D0140
|
X |
Golden Sta
|
POTASSIUM CHLORIDE 20MEQ/15ML LIQUID,ORAL,30ML
|
POTASSIUM CHLORIDE 20MEQ/15ML LIQUID,ORAL,30M
|
$823.55
|
$0.00
|
$0.00
|
|
51672-1402-04
|
60GM
|
36F79723D0140
|
X |
Golden Sta
|
BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIENE 0.005% SUSP,TOP
|
BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIE
|
$828.00
|
$0.00
|
$0.00
|
|
51407-0931-11
|
26ML
|
36F79723D0140
|
X |
Golden Sta
|
USTEKINUMAB-SRLF 5MG/ML INJ,SOLN,26ML
|
IMULDOSA 5MG/ML INJ,SOLN,26ML
|
$836.00
|
$0.00
|
$0.00
|
|
51672-4042-02
|
500
|
36F79723D0140
|
X |
Golden Sta
|
CLORAZEPATE DIPOTASSIUM 3.75MG TAB
|
CLORAZEPATE DIPOTASSIUM 3.75MG TAB
|
$841.98
|
$0.00
|
$0.00
|
|
73473-0309-10
|
100GM
|
36F79723D0140
|
X |
Golden Sta
|
TAZAROTENE 0.05% GEL,TOP
|
TAZAROTENE 0.05% GEL,TOP
|
$856.89
|
$0.00
|
$0.00
|
|
24201-0010-20
|
20ML
|
36F79723D0140
|
X |
Golden Sta
|
PENTOBARBITAL NA 50MG/ML INJ
|
PENTOBARBITAL NA 50MG/ML INJ
|
$884.99
|
$0.00
|
$0.00
|
|
73473-0310-10
|
100GM
|
36F79723D0140
|
X |
Golden Sta
|
TAZAROTENE 0.1% GEL,TOP
|
TAZAROTENE 0.1% GEL,TOP
|
$894.69
|
$0.00
|
$0.00
|
|
70954-0200-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
DIGOXIN 62.5MCG TAB
|
DIGOXIN 62.5MCG TAB
|
$903.17
|
$0.00
|
$0.00
|
|
51672-4043-02
|
500
|
36F79723D0140
|
X |
Golden Sta
|
CLORAZEPATE DIPOTASSIUM 7.5MG TAB
|
CLORAZEPATE DIPOTASSIUM 7.5MG TAB
|
$915.01
|
$0.00
|
$0.00
|
|
60505-6188-00
|
2.4ML
|
36F79723D0140
|
X |
Golden Sta
|
TERIPARATIDE RECOMBINANT 250MCG/ML (600MCG) INJ,PEN,2.4ML
|
TERIPARATIDE RECOMBINANT 250MCG/ML (600MCG) I
|
$916.83
|
$0.00
|
$0.00
|
|
60505-4130-07
|
100
|
36F79723D0140
|
X |
Golden Sta
|
OXCARBAZEPINE 600MG TAB,SA
|
OXCARBAZEPINE 600MG TAB,SA
|
$923.01
|
$0.00
|
$0.00
|
|
60505-4660-06
|
60
|
36F79723D0140
|
X |
Golden Sta
|
ESLICARBAZEPINE ACETATE 600MG TAB,ORAL
|
ESLICARBAZEPINE ACETATE 600MG TAB,ORAL
|
$932.32
|
$0.00
|
$0.00
|
|
51407-0781-60
|
60
|
36F79723D0140
|
X |
Golden Sta
|
ESLICARBAZEPINE ACETATE 600MG TAB,ORAL
|
ESLICARBAZEPINE ACETATE 600MG TAB,ORAL
|
$932.32
|
$0.00
|
$0.00
|
|
75907-0008-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
ACETAMINOPHEN 300MG/BUTALBITAL 50MG CAP
|
ACETAMINOPHEN 300MG/BUTALBITAL 50MG CAP
|
$947.45
|
$0.00
|
$0.00
|
|
00143-1171-10
|
1000
|
36F79723D0140
|
X |
Golden Sta
|
CAPTOPRIL 12.5MG TAB
|
CAPTOPRIL 12.5MG TAB
|
$949.36
|
$0.00
|
$0.00
|
|
00054-0528-63
|
460ML
|
36F79723D0140
|
X |
Golden Sta
|
RUFINAMIDE 40MG/ML SUSP,ORAL
|
RUFINAMIDE 40MG/ML SUSP,ORAL
|
$961.52
|
$0.00
|
$0.00
|
|
43386-0771-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
FLUCYTOSINE 250MG CAP
|
FLUCYTOSINE 250MG CAP
|
$995.01
|
$0.00
|
$0.00
|
|
51407-0184-05
|
500
|
36F79723D0140
|
X |
Golden Sta
|
RABEPRAZOLE NA 20MG TAB,EC
|
RABEPRAZOLE NA 20MG TAB,EC
|
$998.74
|
$0.00
|
$0.00
|
|
00054-0879-49
|
100ML
|
36F79723D0140
|
X |
Golden Sta
|
MERCAPTOPURINE 20MG/ML SUSP,ORAL
|
MERCAPTOPURINE 20MG/ML SUSP,ORAL
|
$1,029.67
|
$0.00
|
$0.00
|
|
00121-4048-95
|
10X20ML
|
36F79723D0140
|
X |
Golden Sta
|
LACOSAMIDE 10MG/ML SOLN,ORAL
|
LACOSAMIDE 10MG/ML SOLN,ORAL
|
$1,066.79
|
$0.00
|
$0.00
|
|
13811-0702-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
HYDROMORPHONE HCL 12MG 24HR TAB,SA
|
HYDROMORPHONE HCL 12MG 24HR TAB,SA
|
$1,093.08
|
$0.00
|
$0.00
|
|
00054-0472-21
|
60
|
36F79723D0140
|
X |
Golden Sta
|
EVEROLIMUS 0.75MG TAB
|
EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75MG TAB
|
$1,166.07
|
$0.00
|
$0.00
|
|
70954-0365-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
PHENOXYBENZAMINE HCL 10MG CAP
|
PHENOXYBENZAMINE HCL 10MG CAP
|
$1,186.42
|
$0.00
|
$0.00
|
|
43975-0315-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
BEXAROTENE 75MG CAP
|
BEXAROTENE 75MG CAP
|
$1,188.00
|
$0.00
|
$0.00
|
|
62559-0204-03
|
300ML
|
36F79723D0140
|
X |
Golden Sta
|
BACLOFEN 5MG/ML SUSP,ORAL
|
BACLOFEN 5MG/ML SUSP,ORAL
|
$1,191.30
|
$0.00
|
$0.00
|
|
51407-0191-10
|
1000
|
36F79723D0140
|
X |
Golden Sta
|
EZETIMIBE 10MG/SIMVASTATIN 20MG TAB
|
EZETIMIBE 10MG/SIMVASTATIN 20MG TAB
|
$1,209.47
|
$0.00
|
$0.00
|
|
70954-0637-10
|
237ML
|
36F79723D0140
|
X |
Golden Sta
|
INDOMETHACIN 25MG/5ML SUSP,ORAL
|
INDOMETHACIN 25MG/5ML SUSP,ORAL
|
$1,221.62
|
$0.00
|
$0.00
|
|
00143-9280-01
|
100ML
|
36F79723D0140
|
X |
Golden Sta
|
MITOMYCIN 40MG/VIL INJ
|
MITOMYCIN 40MG/VIL INJ
|
$1,251.36
|
$0.00
|
$0.00
|
|
51672-1402-08
|
2X60GM
|
36F79723D0140
|
X |
Golden Sta
|
BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIENE 0.005% SUSP,TOP
|
BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIE
|
$1,408.96
|
$0.00
|
$0.00
|
|
70408-0239-32
|
240ML
|
36F79723D0140
|
X |
Golden Sta
|
NITROFURANTOIN 25MG/5ML SUSP,ORAL
|
NITROFURANTOIN 25MG/5ML SUSP,ORAL
|
$1,414.69
|
$0.00
|
$0.00
|
|
13811-0703-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
HYDROMORPHONE HCL 16MG 24HR TAB,SA
|
HYDROMORPHONE HCL 16MG 24HR TAB,SA
|
$1,457.44
|
$0.00
|
$0.00
|
|
51407-0741-12
|
120
|
36F79723D0140
|
X |
Golden Sta
|
ZILEUTON 600MG TAB,SA
|
ZILEUTON 600MG TAB,SA
|
$1,465.10
|
$0.00
|
$0.00
|
|
00054-0604-21
|
60
|
36F79723D0140
|
X |
Golden Sta
|
EVEROLIMUS 1MG TAB
|
EVEROLIMUS (IMMUNOSUPPRESSIVE) 1MG TAB
|
$1,472.09
|
$0.00
|
$0.00
|
|
51407-0190-10
|
1000
|
36F79723D0140
|
X |
Golden Sta
|
EZETIMIBE 10MG/SIMVASTATIN 10MG TAB
|
EZETIMIBE 10MG/SIMVASTATIN 10MG TAB
|
$1,521.54
|
$0.00
|
$0.00
|
|
51407-0836-05
|
500
|
36F79723D0140
|
X |
Golden Sta
|
LURASIDONE HCL 20MG TAB
|
LURASIDONE HCL 20MG TAB
|
$1,534.50
|
$0.00
|
$0.00
|
|
51407-0837-05
|
500
|
36F79723D0140
|
X |
Golden Sta
|
LURASIDONE HCL 60MG TAB
|
LURASIDONE HCL 60MG TAB
|
$1,534.50
|
$0.00
|
$0.00
|
|
51407-0838-05
|
500
|
36F79723D0140
|
X |
Golden Sta
|
LURASIDONE HCL 1200MG TAB
|
LURASIDONE HCL 120MG TAB
|
$1,534.50
|
$0.00
|
$0.00
|
|
51407-0929-11
|
0.5ML
|
36F79723D0140
|
X |
Golden Sta
|
USTEKINUMAB-SRLF 45MG/0.5ML INJ,SYR,0.5ML
|
IMULDOSA 45MG/0.5ML INJ,SYR,0.5ML
|
$1,587.04
|
$0.00
|
$0.00
|
|
68308-0115-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
METHAMPHETAMINE HCL 5MG TAB
|
METHAMPHETAMINE HCL 5MG TAB
|
$1,597.35
|
$0.00
|
$0.00
|
|
60505-0406-03
|
112ML
|
36F79723D0140
|
X |
Golden Sta
|
DICLOFENAC NA 2% SOLN,TOP
|
DICLOFENAC NA 2% SOLN,TOP
|
$1,600.65
|
$0.00
|
$0.00
|
|
24201-0010-50
|
50ML
|
36F79723D0140
|
X |
Golden Sta
|
PENTOBARBITAL NA 50MG/ML INJ
|
PENTOBARBITAL NA 50MG/ML INJ
|
$1,648.24
|
$0.00
|
$0.00
|
|
62559-0173-31
|
3X10
|
36F79723D0140
|
X |
Golden Sta
|
NILUTAMIDE 150MG TAB
|
NILUTAMIDE 150MG TAB
|
$1,672.44
|
$0.00
|
$0.00
|
|
13811-0704-10
|
100
|
36F79723D0140
|
X |
Golden Sta
|
HYDROMORPHONE HCL 32MG 24HR TAB,SA
|
HYDROMORPHONE HCL 32MG 24HR TAB,SA
|
$1,927.55
|
$0.00
|
$0.00
|
|
51407-0765-90
|
90
|
36F79723D0140
|
X |
Golden Sta
|
DROXIDOPA 100MG CAP,ORAL
|
DROXIDOPA 100MG CAP,ORAL
|
$1,955.69
|
$0.00
|
$0.00
|
|
43386-0770-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
FLUCYTOSINE 500MG CAP
|
FLUCYTOSINE 500MG CAP
|
$1,990.00
|
$0.00
|
$0.00
|
|
51407-0832-05
|
500
|
36F79723D0140
|
X |
Golden Sta
|
LURASIDONE HCL 40MG TAB
|
LURASIDONE HCL 40MG TAB
|
$2,000.00
|
$0.00
|
$0.00
|
|
51407-0833-05
|
500
|
36F79723D0140
|
X |
Golden Sta
|
LURASIDONE HCL 80MG TAB
|
LURASIDONE HCL 80MG TAB
|
$2,000.00
|
$0.00
|
$0.00
|
|
71357-0001-06
|
6X500ML
|
36F79723D0140
|
X |
Golden Sta
|
TROMETHAMINE 18GM/BTL INJ
|
TROMETHAMINE 18GM/BTL INJ
|
$2,054.47
|
$0.00
|
$0.00
|
|
10370-0268-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
TRETINOIN 10MG CAP
|
TRETINOIN 10MG CAP
|
$2,100.76
|
$0.00
|
$0.00
|
|
00054-0438-25
|
100
|
36F79723D0140
|
X |
Golden Sta
|
LEVORPHANOL TARTRATE 2MG TAB
|
LEVORPHANOL TARTRATE 2MG TAB
|
$2,137.17
|
$0.00
|
$0.00
|
|
49884-0720-08
|
120
|
36F79723D0140
|
X |
Golden Sta
|
SAPROPTERIN DIHYDROCHLORIDE 100MG TAB,SOLUBLE
|
SAPROPTERIN DIHYDROCHLORIDE 100MG TAB,SOLUBLE
|
$2,406.03
|
$0.00
|
$0.00
|
|
60505-3628-06
|
60
|
36F79723D0140
|
X |
Golden Sta
|
DASATINIB 20MG TAB
|
DASATINIB 20MG TAB
|
$2,518.29
|
$0.00
|
$0.00
|
|
60505-4317-00
|
10
|
36F79723D0140
|
X |
Golden Sta
|
TOLVAPTAN (EQV-SAMSCA) 15MG TAB
|
TOLVAPTAN (EQV-SAMSCA) 15MG TAB
|
$2,790.04
|
$0.00
|
$0.00
|
|
49884-0873-72
|
30
|
36F79723D0140
|
X |
Golden Sta
|
SAPROPTERIN DIHYDROCHLORIDE 500MG/PKT PWDR,ORAL
|
SAPROPTERIN DIHYDROCHLORIDE 500MG/PKT PWDR,OR
|
$2,849.25
|
$0.00
|
$0.00
|
|
00378-6678-28
|
28
|
36F79723D0140
|
X |
Golden Sta
|
SUNITINIB MALATE 12.5MG CAP,ORAL
|
SUNITINIB MALATE 12.5MG CAP,ORAL
|
$2,959.42
|
$0.00
|
$0.00
|
|
51407-0930-11
|
1ML
|
36F79723D0140
|
X |
Golden Sta
|
USTEKINUMAB-SRLF 90MG/ML INJ,SYR
|
IMULDOSA 90MG/ML INJ,SYR
|
$3,174.09
|
$0.00
|
$0.00
|
|
24201-0101-04
|
4X5ML
|
36F79723D0140
|
X |
Golden Sta
|
VALRUBICIN 40MG/ML SOLN,INTRAVESICAL
|
VALRUBICIN 40MG/ML SOLN,INTRAVESICAL
|
$3,250.00
|
$0.00
|
$0.00
|
|
51407-0766-90
|
90
|
36F79723D0140
|
X |
Golden Sta
|
DROXIDOPA 200MG CAP,ORAL
|
DROXIDOPA 200MG CAP,ORAL
|
$3,852.21
|
$0.00
|
$0.00
|
|
00054-0576-25
|
100
|
36F79723D0140
|
X |
Golden Sta
|
DEFERIPRONE 500MG TAB,ORAL
|
DEFERIPRONE 500MG TAB,ORAL
|
$4,402.50
|
$0.00
|
$0.00
|
|
60505-3631-03
|
30
|
36F79723D0140
|
X |
Golden Sta
|
DASATINIB 100MG TAB
|
DASATINIB 100MG TAB
|
$4,538.77
|
$0.00
|
$0.00
|
|
60505-3816-03
|
30
|
36F79723D0140
|
X |
Golden Sta
|
DASATINIB 80MG TAB
|
DASATINIB 80MG TAB
|
$4,538.77
|
$0.00
|
$0.00
|
|
60505-3817-03
|
30
|
36F79723D0140
|
X |
Golden Sta
|
DASATINIB 140MG TAB
|
DASATINIB 140MG TAB
|
$4,538.77
|
$0.00
|
$0.00
|
|
60505-3629-06
|
60
|
36F79723D0140
|
X |
Golden Sta
|
DASATINIB 50MG TAB
|
DASATINIB 50MG TAB
|
$5,036.56
|
$0.00
|
$0.00
|
|
60505-3630-06
|
60
|
36F79723D0140
|
X |
Golden Sta
|
DASATINIB 70MG TAB
|
DASATINIB 70MG TAB
|
$5,036.56
|
$0.00
|
$0.00
|
|
00054-0711-19
|
50
|
36F79723D0140
|
X |
Golden Sta
|
DEFERIPRONE 1000MG TAB,ORAL
|
DEFERIPRONE 1000MG TAB (THREE TIMES A DAY)
|
$5,608.00
|
$0.00
|
$0.00
|
|
51407-0767-90
|
90
|
36F79723D0140
|
X |
Golden Sta
|
DROXIDOPA 300MG CAP,ORAL
|
DROXIDOPA 200MG CAP,ORAL
|
$5,774.68
|
$0.00
|
$0.00
|
|
00378-6679-28
|
28
|
36F79723D0140
|
X |
Golden Sta
|
SUNITINIB MALATE 25MG CAP,ORAL
|
SUNITINIB MALATE 25MG CAP,ORAL
|
$5,928.13
|
$0.00
|
$0.00
|
|
00054-0482-13
|
30
|
36F79723D0140
|
X |
Golden Sta
|
EVEROLIMUS 10MG TAB
|
EVEROLIMUS (ANTINEOPLASTIC) 10MG TAB
|
$6,647.48
|
$0.00
|
$0.00
|
|
51407-0872-12
|
120
|
36F79723D0140
|
X |
Golden Sta
|
PAZOPANIB 200MG TAB
|
PAZOPANIB 200MG TAB
|
$8,010.39
|
$0.00
|
$0.00
|
|
51407-0760-12
|
120
|
36F79723D0140
|
X |
Golden Sta
|
SORAFENIB 200MG TAB
|
SORAFENIB 200MG TAB
|
$8,175.50
|
$0.00
|
$0.00
|
|
43598-0672-30
|
30
|
36F79723D0140
|
X |
Golden Sta
|
PYRIMETHAMINE 25MG TAB
|
PYRIMETHAMINE 25MG TAB
|
$8,687.25
|
$0.00
|
$0.00
|
|
00378-6681-28
|
28
|
36F79723D0140
|
X |
Golden Sta
|
SUNITINIB MALATE 37.5MG CAP,ORAL
|
SUNITINIB MALATE 37.5MG CAP,ORAL
|
$8,892.67
|
$0.00
|
$0.00
|
|
00378-6680-28
|
28
|
36F79723D0140
|
X |
Golden Sta
|
SUNITINIB MALATE 50MG CAP,ORAL
|
SUNITINIB MALATE 50MG CAP,ORAL
|
$10,321.12
|
$0.00
|
$0.00
|
|
42799-0950-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
VIGABATRIN 500MG TAB
|
VIGABATRIN 500MG TAB
|
$10,406.77
|
$0.00
|
$0.00
|
|
60505-3801-02
|
4X28
|
36F79723D0140
|
X |
Golden Sta
|
NILOTINIB HCL 150MG CAP,ORAL
|
NILOTINIB HCL 150MG CAP,ORAL
|
$12,735.48
|
$0.00
|
$0.00
|
|
60505-3802-02
|
4X28
|
36F79723D0140
|
X |
Golden Sta
|
NILOTINIB HCL 200MG CAP,ORAL
|
NILOTINIB HCL 200MG CAP,ORAL
|
$12,750.54
|
$0.00
|
$0.00
|
|
60505-3803-07
|
120
|
36F79723D0140
|
X |
Golden Sta
|
NILOTINIB HCL 50MG CAP,ORAL
|
NILOTINIB HCL 50MG CAP,ORAL
|
$13,815.81
|
$0.00
|
$0.00
|
|
60505-4665-03
|
30
|
36F79723D0140
|
X |
Golden Sta
|
TASIMELTEON 20MG CAP,ORAL
|
TASIMELTEON 20MG CAP,ORAL
|
$15,819.42
|
$0.00
|
$0.00
|
|
43598-0672-01
|
100
|
36F79723D0140
|
X |
Golden Sta
|
PYRIMETHAMINE 25MG TAB
|
PYRIMETHAMINE 25MG TAB
|
$29,249.02
|
$0.00
|
$0.00
|