Description - DE Medical Assistance Program

J3265 INJECTION TORSEMIDE 10 MG/ML 5 $0.00
J3270 IMIPRAMINE HCL INJECTION O $0.00
J3280 THIETHYLPERAZINE MALEATE INJ 5 $0.00
J3285 TREPROSTINIL INJECTION 6 $0.00
J3300 TRIAMCINOLONE A INJ PRS-FREE 3 $0.32
J3301 TRIAMCINOLONE ACET INJ NOS 3 $1.40
J3302 TRIAMCINOLONE DIACETATE INJ 5 $0.00
J3303 TRIAMCINOLONE HEXACETONL INJ 3 $1.48
J3305 INJ TRIMETREXATE GLUCORONATE 5 $0.00
J3310 PERPHENAZINE INJECITON 5 $0.00
J3315 TRIPTORELIN PAMOATE 5 $0.00
J3320 SPECTINOMYCN DI-HCL INJ 5 $0.00
J3340 INJECTION, CRYPTENAMINE ACETATE, UP O $0.00
J3350 UREA INJECTION 5 $0.00
J3355 UROFOLLITROPIN, 75 IU 9 $0.00
J3360 DIAZEPAM INJECTION 3 $0.52
J3364 UROKINASE 5000 IU INJECTION 5 $0.00
J3365 UROKINASE 250,000 IU INJ 5 $0.00
J3370 VANCOMYCIN HCL INJECTION 3 $3.23
J3380 INJECTION, ISOXSUPRINE HCL, UP TO 1 O $0.00
J3390 METHOXAMINE INJECTION O $0.00
J3395 VERTEPORFIN INJECTION O $0.00
J3396 VERTEPORFIN INJECTION 3 $9.49
J3400 TRIFLUPROMAZINE HCL INJ 5 $0.00
J3410 HYDROXYZINE HCL INJECTION 3 $1.43
J3411 THIAMINE HCL 100 MG 3 $2.50
J3415 PYRIDOXINE HCL 100 MG 6 $0.00
J3420 VITAMIN B12 INJECTION 3 $0.27
J3430 VITAMIN K PHYTONADIONE INJ 5 $0.00
J3450 MEPHENTERMINE SULFATE INJ O $0.00
J3465 INJECTION, VORICONAZOLE 6 $0.00
J3470 HYALURONIDASE INJECTION 5 $0.00
J3471 OVINE, UP TO 999 USP UNITS 3 $0.15
J3472 OVINE, 1000 USP UNITS 3 $132.92
J3473 HYALURONIDASE RECOMBINANT 3 $0.48
J3475 INJ MAGNESIUM SULFATE 3 $0.05
J3480 INJ POTASSIUM CHLORIDE 3 $0.02
J3485 ZIDOVUDINE 5 $0.00
J3486 ZIPRASIDONE MESYLATE 3 $5.91
J3487 ZOLEDRONIC ACID 3 $219.39
J3488 RECLAST INJECTION 3 $220.20
J3490 DRUGS UNCLASSIFIED INJECTION 5 $0.00
J3500 VITAMIN THERAPY O $0.00
J3520 EDETATE DISODIUM PER 150 MG 5 $0.00
J3530 NASAL VACCINE INHALATION 9 $0.00
J3535 METERED DOSE INHALER DRUG 9 $0.00
J3540 AUTOGENOUS BLOOD EXTRACT, INTRAVENO O $0.00
J3550 INTRA-ARTERIAL OXYGEN INJECTION O $0.00
J3560 ADRENAL CORTEX EXTRACT O $0.00