Medicare Part B Competitive Acquisition Program CAP 2006 Drugs Payment Amounts Bioscrip Inc Vendor Identification VIN Q103 Payment Amounts are based on the median of ac by fwo93561

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									 Medicare Part B Competitive Acquisition Program (CAP)

 2006 Drugs & Payment Amounts

 Bioscrip, Inc.             Vendor Identification (VIN): Q103
 Payment Amounts are based on the median of accepted bids and include PPI update



                                                              Payment
 HCPCS Long Description                                       Amount NDCs
            INJECTION, ADENOSINE FOR THERAPEUTIC                           63323-0651-04, 63323-0651-02, 55390-0068-01, 55390-0067-10, 00703-8773-01,
 J0150      USE, 6 MG                                              34.24   00703-8771-03,
            INJECTION, ADENOSINE FOR DIAGNOSTIC
 J0152      USE, 30 MG                                             73.78   00469-0871-30, 00469-0871-20
            INJECTION, ADRENALIN, EPINEPHRINE, 1 ML                        00548-9061-00, 00548-3316-00, 00548-2016-00, 00548-1016-00, 00548-1014-00,
 J0170      AMPULE                                                  0.59   00409-7241-01, 00409-4921-34, 00409-4901-18
 J0207      INJECTION, AMIFOSTINE, 500 MG                          461.3   58178-0017-03
 J0215      INJECTION, ALEFACEPT, 0.5 MG                           27.88   59627-0021-04, 59627-0021-03
                                                                           00517-3820-25, 00517-3810-25, 00409-7386-01, 00409-7385-01, 00409-5922-01,
 J0280      INJECTION, AMINOPHYLLIN, 250 MG                         0.37   00409-5921-01
 J0290      INJECTION, AMPICILLIN SODIUM, 500 MG                    2.37   63323-0399-23, 63323-0389-10, 63323-0388-10, 63323-0387-10, 00781-3408-95
 J0475      INJECTION, BACLOFEN, 10 MG                            199.81   58281-0563-01, 58281-0561-04, 58281-0561-02, 58281-0560-01
            INJECTION, PENICILLIN G BENZATHINE AND
 J0540      PENICILLIN G PROCAINE, 1,200,000 UNITS                 26.05   61570-0141-10, 61570-0140-10
            INJECTION, PENICILLIN G BENZATHINE AND
 J0550      PENICILLIN G PROCAINE, 2,400,000 UNITS                 29.31   61570-0144-10, 61570-0142-10
            INJECTION, PENICILLIN G BENZATHINE,
 J0570      1,200,000 UNITS                                        35.44   61570-0147-10
 J0585      BOTULINUM TOXIN TYPE A, PER UNIT                        5.15   00023-9232-01, 00023-1145-01
 J0587      BOTULINUM TOXIN TYPE B, PER 100 UNITS                   8.15   59075-0712-10, 10454-0711-10, 10454-0710-10




CAP final price list 2006                                                                                                                               1
           INJECTION, EDETATE CALCIUM DISODIUM,
 J0600     1000 MG                                   42.39   00089-0510-06
 J0637     INJECTION, CASPOFUNGIN ACETATE, 5 MG      34.14   00006-3823-10, 00006-3822-10
           INJECTION, LEUCOVORIN CALCIUM, PER 50             55390-0054-01, 55390-0053-01, 55390-0052-10, 55390-0051-10, 55390-0009-01,
 J0640     MG                                         1.38   00703-5145-01, 00703-5140-01
           INJECTION, MEPIVACAINE HYDROCHLORIDE,             00186-0422-01, 00186-0420-01, 00186-0418-01, 00186-0412-01, 00186-0410-01,
 J0670     PER 10 ML                                  1.57   00074-2047-50, 00074-1067-20, 00074-1041-30, 00074-1038-50
                                                             66860-0003-02, 66860-0002-03, 66860-0001-03, 63323-0446-61, 63323-0238-61,
                                                             63323-0237-10, 63323-0236-10, 63304-0941-10, 63304-0940-25, 60505-0749-05,
                                                             60505-0749-04, 10019-0611-03, 10019-0610-01, 00781-3346-95, 00781-3157-96,
 J0690     INJECTION, CEFAZOLIN SODIUM, 500 MG        1.46   00591-2366-68, 00591-2365-69, 00143-9924-90, 00143-9923-90, 00074-4732-03
           INJECTION, CEFEPIME HYDROCHLORIDE, 500            51479-0055-30, 51479-0055-20, 51479-0055-10, 51479-0054-30, 51479-0054-20,
 J0692     MG                                         8.11   51479-0054-10, 51479-0053-10
                                                             63323-0348-61, 63323-0347-20, 63323-0346-10, 63323-0345-10, 63323-0344-10,
                                                             60505-0753-04, 60505-0753-00, 60505-0752-04, 60505-0752-00, 60505-0751-04,
                                                             60505-0751-00, 60505-0750-04, 60505-0750-00, 60505-0679-09, 60505-0679-08,
                                                             60505-0679-05, 10019-0688-04, 10019-0687-03, 10019-0686-02, 10019-0685-01,
                                                             00781-3210-46, 00781-3209-95, 00781-3208-95, 00781-3207-95, 00781-3206-95,
           INJECTION, CEFTRIAXONE SODIUM, PER 250            00409-7338-01, 00409-7337-01, 00409-7336-04, 00409-7335-03, 00409-7334-10,
 J0696     MG                                         8.73   00409-7333-04, 00409-7332-01
                                                             63323-0335-10, 63323-0334-61, 63323-0333-61, 63323-0332-15, 63323-0331-15,
                                                             00039-0024-50, 00039-0024-25, 00039-0023-50, 00039-0023-25, 00039-0020-01,
                                                             00039-0019-50, 00039-0019-25, 00039-0019-11, 00039-0019-10, 00039-0018-50,
 J0698     INJECTION, CEFOTAXIME SODIUM, PER GM       4.47   00039-0018-25, 00039-0018-11, 00039-0018-10, 00039-0017-10
           INJECTION, BETAMETHASONE ACETATE &
           BETAMETHASONE SODIUM PHOSPHATE, PER
 J0702     3 MG                                       5.19   00085-0566-05
           INJECTION, BETAMETHASONE SODIUM
 J0704     PHOSPHATE, PER 4 MG                        1.18   Not currently available. Please contact vendor for information about availability.
           INJECTION, CLONIDINE HYDROCHLORIDE, 1
 J0735     MG                                        66.49   66591-0975-41, 66591-0965-41
 J0800     INJECTION, CORTICOTROPIN, 40 UNITS       112.53   63004-7731-01
                                                             55513-0058-04, 55513-0054-04, 55513-0048-01, 55513-0046-01, 55513-0044-01,
           INJECTION, DARBEPOETIN ALFA, 1 MCG                55513-0043-04, 55513-0041-04, 55513-0039-04, 55513-0037-04, 55513-0015-01,
 J0881     (NON-ESRD USE)                             3.15   55513-0014-01, 55513-0013-04, 55513-0012-04, 55513-0011-04, 55513-0010-04



CAP final price list 2006                                                                                                                         2
                                                              59676-0340-01, 59676-0320-01, 59676-0312-01, 59676-0310-02, 59676-0310-01,
                                                              59676-0304-02, 59676-0304-01, 59676-0303-02, 59676-0303-01, 59676-0302-02,
           INJECTION, EPOETIN ALPHA, (FOR NON ESRD            59676-0302-01, 55513-0823-10, 55513-0478-10, 55513-0283-10, 55513-0267-10,
 J0885     USE), PER 1000 UNITS                        9.67   55513-0148-10, 55513-0144-10, 55513-0126-10
           INJECTION, DEFEROXAMINE MESYLATE, 500
 J0895     MG                                         16.14   00409-2337-25, 00409-2336-10
           INJECTION, DEPO-ESTRADIOL CYPIONATE, 5
 J1000     MG                                           5.5   00009-0271-01
           INJECTION, METHYLPREDNISOLONE
 J1020     ACETATE, 20 MG                              2.91   00009-0274-01
           INJECTION, METHYLPREDNISOLONE                      00703-0031-04, 00703-0031-01, 00009-3073-03, 00009-3073-01, 00009-0280-52,
 J1030     ACETATE, 40 MG                              5.58   00009-0280-51, 00009-0280-03, 00009-0280-02
           INJECTION, METHYLPREDNISOLONE
 J1040     ACETATE, 80 MG                              9.96   00703-0051-04, 00703-0051-01, 00009-0306-12, 00009-0306-02
           INJECTION, MEDROXYPROGESTERONE
 J1051     ACETATE, 50 MG                              5.43   00009-0626-01
           INJECTION, DEXAMETHASONE ACETATE, 1
 J1094     MG                                          0.78   Not currently available. Please contact vendor for information about availability.
           INJECTION, DEXAMETHASONE SODIUM                    63323-0516-10, 63323-0506-01, 63323-0165-30, 63323-0165-05, 63323-0165-01,
 J1100     PHOSPHATE, 1MG                              0.11   00641-0367-25, 00517-4930-25, 00517-4905-25, 00517-4901-25
           INJECTION, DEXRAZOXANE
 J1190     HYDROCHLORIDE, PER 250 MG                 210.09   55390-0060-02, 55390-0014-02
 J1200     INJECTION, DIPHENHYDRAMINE HCL, 50 MG       0.75   00641-0376-25, 00409-2290-31
           INJECTION, DMSO, DIMETHYL SULFOXIDE,
 J1212     50%, 50 ML                                  44.4   67457-0145-50, 00433-0433-05
 J1245     INJECTION, DIPYRIDAMOLE, PER 10 MG          2.01   55390-0555-90, 00641-2569-44
           INJECTION, DOBUTAMINE HYDROCHLORIDE,
 J1250     PER 250 MG                                  5.36   55390-0560-90, 00409-2025-54
 J1260     INJECTION, DOLASETRON MESYLATE, 10 MG       6.84   00088-1209-26, 00088-1206-32
 J1335     INJECTION, ERTAPENEM SODIUM, 500 MG        23.41   00006-3843-71
 J1440     INJECTION, FILGRASTIM (G-CSF), 300 MCG    186.71   55513-0924-10, 55513-0530-10
 J1441     INJECTION, FILGRASTIM (G-CSF), 480 MCG    293.57   55513-0546-10, 55513-0209-10
                                                              61703-0414-64, 61703-0414-63, 59762-5037-02, 59762-5036-02, 59762-5035-02,
 J1450     INJECTION FLUCONAZOLE, 200 MG               15.9   55390-0046-01, 55390-0012-01, 00703-1019-09



CAP final price list 2006                                                                                                                          3
           INJECTION, GARAMYCIN, GENTAMICIN, 80
 J1580     MG                                        1.06   63323-0513-02, 63323-0010-20, 63323-0010-02, 00409-1207-03, 00074-3402-01
           INJECTION, GOLD SODIUM THIOMALATE, 50
 J1600     MG                                        9.81   66758-0011-03, 66758-0011-02, 11098-0533-10, 11098-0533-01
           INJECTION, GRANISETRON
 J1626     HYDROCHLORIDE, 100 MCG                    7.49   00004-0242-08, 00004-0240-09, 00004-0239-09
                                                            63323-0471-05, 63323-0471-01, 63323-0469-05, 63323-0469-01, 60505-0703-01,
           INJECTION, HALOPERIDOL DECANOATE, PER            60505-0702-01, 55390-0413-05, 55390-0413-01, 55390-0412-05, 55390-0412-01,
 J1631     50 MG                                     8.04   00703-7023-01, 00703-7021-03, 00703-7013-01, 00703-7011-03
                                                            63323-0545-05, 63323-0545-01, 63323-0544-11, 63323-0544-01, 63323-0017-10,
                                                            17474-0125-05, 17474-0125-03, 17474-0125-02, 17474-0125-01, 17474-0123-05,
                                                            17474-0123-03, 17474-0123-02, 17474-0123-01, 00641-2443-45, 00641-2442-45,
                                                            00641-2438-45, 00641-2436-45, 00641-0393-25, 00641-0392-25, 00641-0389-25,
                                                            00641-0387-25, 00641-0272-25, 00409-1281-35, 00409-1281-33, 00409-1281-32,
           INJECTION, HEPARIN SODIUM, (HEPARIN              00409-1281-31, 00409-1280-35, 00409-1280-33, 00409-1280-32, 00409-1280-31,
 J1642     LOCK FLUSH), PER 10 UNITS                 0.05   00409-1152-78, 00409-1152-70
                                                            63323-0915-01, 63323-0542-07, 63323-0542-01, 63323-0540-31, 63323-0540-11,
           INJECTION, HEPARIN SODIUM, PER 1000              63323-0262-01, 63323-0047-10, 00641-2470-45, 00641-2460-45, 00641-2450-45,
 J1644     UNITS                                     0.13   00641-2440-45, 00641-0410-25, 00641-0400-25, 00409-1316-66, 00409-1316-32
           INJECTION, DALTEPARIN SODIUM, PER 2500           00013-5191-01, 00013-5190-01, 00013-2436-06, 00013-2426-91, 00013-2426-01,
 J1645     IU                                       10.93   00013-2406-91
                                                            00075-2915-01, 00075-2912-01, 00075-0626-03, 00075-0624-30, 00075-0623-00,
 J1650     INJECTION, ENOXAPARIN SODIUM, 10 MG       5.71   00075-0622-80, 00075-0621-60, 00075-0620-40
 J1655     INJECTION, TINZAPARIN SODIUM, 1000 IU     2.42   67211-0342-53, 67211-0342-08
           INJECTION, HYDROCORTISONE SODIUM                 00009-0920-03, 00009-0912-05, 00009-0909-16, 00009-0909-08, 00009-0900-20,
 J1720     SUCCINATE, 100 MG                         1.96   00009-0900-13, 00009-0825-01
 J1745     INJECTION INFLIXIMAB, 10 MG               56.1   57894-0030-01
 J1756     INJECTION, IRON SUCROSE, 1 MG             0.37   00517-2340-10
                                                            63323-0162-02, 55390-0481-10, 55390-0481-02, 55390-0480-01, 10019-0030-04,
           INJECTION, KETOROLAC TROMETHAMINE,               10019-0030-03, 10019-0029-02, 00409-3796-01, 00409-3795-01, 00409-3793-01,
 J1885     PER 15 MG                                  0.5   00409-2287-61
 J1940     INJECTION, FUROSEMIDE, 20 MG              0.43   63323-0280-10, 00517-5710-25, 00409-6102-10, 00409-6102-04, 00409-6102-02
 J1956     INJECTION, LEVOFLOXACIN, 250 MG           7.79   00045-0069-51, 00045-0065-55
           INJECTION, LIDOCAINE HCL FOR                     00409-7931-32, 00409-7931-24, 00338-0409-03, 00338-0409-02, 00264-9594-20,
 J2001     INTRAVENOUS INFUSION, 10 MG               0.02   00264-9594-10



CAP final price list 2006                                                                                                                4
 J2010     INJECTION, LINCOMYCIN HCL, 300 MG             3.7   00009-0555-02
 J2150     INJECTION, MANNITOL, 25% IN 50 ML            0.89   63323-0024-25, 00517-4050-25, 00409-4031-01
                                                               67457-0160-20, 61703-0242-50, 10019-0070-02, 10019-0070-01, 00703-8006-03,
 J2260     INJECTION, MILRINONE LACTATE, 5 MG           4.12   00703-8005-03
           INJECTION, NALBUPHINE HYDROCHLORIDE,
 J2300     PER 10 MG                                    1.34   00409-1467-01, 00409-1465-01, 00409-1464-01, 00409-1463-01
 J2325     INJECTION, NESIRITIDE, 0.1 MG               31.39   65847-0205-25
           INJECTION, OCTREOTIDE, DEPOT FORM FOR
 J2353     INTRAMUSCULAR INJECTION, 1 MG               91.67   00078-0342-61, 00078-0341-61, 00078-0340-61
           INJECTION, OCTREOTIDE, NON-DEPOT                    55390-0164-01, 55390-0163-01, 55390-0162-10, 55390-0161-10, 00703-3343-01,
           SUBCUTANEOUS OR INTRAVENOUS                         00703-3333-01, 00703-3321-04, 00703-3311-04, 00703-3301-04, 00078-0184-25,
 J2354     INJECTION, 25 MCG                            5.14   00078-0183-25, 00078-0182-01, 00078-0181-01, 00078-0180-01
           INJECTION, ONDANSETRON
 J2405     HYDROCHLORIDE, PER 1 MG                      4.03   00173-0461-00, 00173-0442-02, 00173-0442-00
           INJECTION, PAMIDRONATE DISODIUM, PER
 J2430     30 MG                                       42.66   61703-0324-39, 55390-0129-01, 00781-3147-84, 00703-4085-51, 00703-4075-59
 J2505     INJECTION, PEGFILGRASTIM, 6 MG            2182.16   55513-0190-01
 J2550     INJECTION, PROMETHAZINE HCL, 50 MG           2.11   00703-2201-04, 00641-1496-35, 00641-1495-35, 00641-0929-25, 00641-0928-25
           INJECTION, FLUPHENAZINE DECANOATE, 25
 J2680     MG                                           1.28   55390-0465-05, 00703-5003-01
 J2765     INJECTION, METOCLOPRAMIDE HCL, 10 MG         0.49   61703-0210-35, 61703-0210-21, 61703-0210-11, 60977-0451-03, 60977-0451-02
           INJECTION, RANITIDINE HYDROCHLORIDE,
 J2780     25 MG                                        0.71   55390-0616-10, 55390-0616-01
           INJECTION, SARGRAMOSTIM (GM-CSF), 50
 J2820     MCG                                         22.96   50419-0595-05, 50419-0002-33
                                                               63323-0186-20,63323-0186-10,63323-0186-00,17474-3002-01,00517-2810-
           INJECTION, SODIUM CHLORIDE, 0.9%, PER 2             25,00517-0648-25,00409-4888-50,00409-4888-20,00409-4888-12,00409-4888-
 J2912     ML                                           0.12   10,00409-1966-14,00409-1966-12,00409-1966-07,00409-1966-05,00409-1966-04
           INJECTION, SODIUM FERRIC GLUCONATE
 J2916     COMPLEX IN SUCROSE INJECTION, 12.5 MG        4.93   52544-0922-26
           INJECTION, METHYLPREDNISOLONE SODIUM
 J2920     SUCCINATE, 40 MG                             2.08   00409-5684-01, 00009-0113-19
           INJECTION, METHYLPREDNISOLONE SODIUM
 J2930     SUCCINATE, 125 MG                            2.66   00009-3389-01, 00009-0796-01, 00009-0758-01, 00009-0698-01, 00009-0190-16



CAP final price list 2006                                                                                                                   5
 J2997     INJECTION, ALTEPLASE RECOMBINANT, 1 MG     33.01   50242-0085-27, 50242-0044-13, 50242-0041-64
 J3260     INJECTION, TOBRAMYCIN SULFATE, 80 MG        1.63   63323-0307-51, 63323-0306-30, 00409-3590-02, 00409-3578-01
           INJECTION, TRIAMCINOLONE ACETONIDE,
 J3301     PER 10MG                                    1.44   00003-0494-20, 00003-0293-28
           INJECTION, TRIAMCINOLONE DIACETATE,
 J3302     PER 5MG                                     0.32   Not currently available. Please contact vendor for information about availability.
           INJECTION, TRIAMCINOLONE
 J3303     HEXACETONIDE, PER 5MG                       1.75   54643-1056-00, 54643-1054-00
 J3315     INJECTION, TRIPTORELIN PAMOATE, 3.75 MG   391.53   52544-0154-76, 52544-0153-76
                                                              63323-0314-61, 63323-0284-20, 63323-0221-10, 00409-6533-01, 00409-6509-01,
 J3370     INJECTION, VANCOMYCIN HCL, 500 MG           3.35   00409-4332-01
 J3396     INJECTION, VERTEPORFIN, 0.1 MG               9.4   58768-0150-15
 J3410     INJECTION, HYDROXYZINE HCL, 25 MG           0.19   63323-0021-01, 00517-5610-25, 00517-5602-25, 00517-4201-25
           INJECTION, VITAMIN B-12
 J3420     CYANOCOBALAMIN, UP TO 1000 MCG              0.31   00517-0130-05, 00517-0032-25
           INJECTION, MAGNESIUM SULFATE, PER 500              63323-0064-50, 63323-0064-20, 63323-0064-10, 00517-2650-25, 00517-2610-25,
 J3475     MG                                          0.13   00409-6729-09, 00409-6729-03, 00409-2168-03, 00409-2168-02
           INJECTION, POTASSIUM CHLORIDE, PER 2               63323-0967-30, 63323-0965-20, 63323-0965-15, 63323-0965-10, 00409-6653-05,
 J3480     MEQ                                         0.05   00409-6651-06, 00409-6636-01, 00409-1513-02, 00074-3934-02
 J3487     INJECTION, ZOLEDRONIC ACID, 1 MG          210.04   00078-0387-25
                                                              00409-7984-37, 00409-7984-36, 00409-7984-23, 00409-7983-61, 00409-7983-55,
                                                              00409-7983-53, 00409-7983-09, 00409-7983-03, 00409-7983-02, 00409-7101-67,
                                                              00409-7101-02, 00409-1583-02, 00409-1583-01, 00338-0553-18, 00338-0049-48,
                                                              00338-0049-41, 00338-0049-38, 00338-0049-31, 00338-0049-18, 00338-0049-11,
                                                              00338-0049-04, 00338-0049-03, 00338-0049-02, 00338-0049-01, 00264-7800-20,
           INFUSION, NORMAL SALINE SOLUTION , 1000            00264-7800-10, 00264-7800-00, 00264-4000-55, 00264-1800-36, 00264-1800-32,
 J7030     CC                                           1.1   00264-1800-31, 00264-1400-10
           INFUSION, NORMAL SALINE SOLUTION,
 J7040     STERILE (500 ML=1 UNIT)                     0.55   00409-7983-09, 00338-0049-04, 00264-7800-10, 00264-7800-00, 00264-1400-10
           5% DEXTROSE/NORMAL SALINE (500 ML = 1
 J7042     UNIT)                                       0.39   00409-7941-09, 00338-0089-04, 00264-7610-00




CAP final price list 2006                                                                                                                          6
                                                               00264-1400-10, 00409-7984-37, 00409-7984-36, 00409-7984-23, 00409-7984-20,
                                                               00409-7984-13, 00409-7983-61, 00409-7983-55, 00409-7983-53, 00409-7983-09,
                                                               00409-7983-03, 00409-7983-02, 00409-7101-67, 00409-7101-66, 00409-7101-02,
                                                               00409-1584-11, 00409-1583-02, 00409-1583-01, 00338-0553-18, 00338-0553-11,
                                                               00338-0049-48, 00338-0049-41, 00338-0049-38, 00338-0049-31, 00338-0049-18,
           INFUSION, NORMAL SALINE SOLUTION , 250              00338-0049-11, 00338-0049-10, 00338-0049-04, 00338-0049-03, 00338-0049-02,
 J7050     CC                                           0.27   00338-0049-01
                                                               00409-7922-09, 00338-0017-04, 00409-7923-37, 00409-7923-36, 00409-7923-23,
                                                               00409-7923-20, 00409-7923-13, 00409-7922-61, 00409-7922-53, 00409-7922-03,
                                                               00409-7922-02, 00409-7100-67, 00409-7100-66, 00409-7100-02, 00409-1523-11,
 J7060     5% DEXTROSE/WATER (500 ML = 1 UNIT)          1.18   00409-1523-01, 00409-1522-03, 00409-1522-02, 00409-1522-01
 J7070     INFUSION, D5W, 1000 CC                       2.35   00409-7922-09, 00338-0017-04, 00338-0017-03, 00264-7510-10, 00264-7510-00
 J7120     RINGERS LACTATE INFUSION, 1000 CC            0.97   00264-1750-00, 00264-1350-10, 00338-0117-04, 00338-0117-03
           SODIUM HYALURONATE, PER 20 TO 25 MG
 J7317     DOSE FOR INTRA-ARTICULAR INJECTION         112.05   08363-7761-01, 08363-7765-01, 08024-0724-12, 08024-0724-20
           HYLAN G-F 20, 16 MG, FOR INTRA ARTICULAR
 J7320     INJECTION                                  209.05   58468-0090-01, 68115-0535-03, 66267-0921-03, 00008-9149-02, 00008-9149-01
 J9000     DOXORUBICIN HCL, 10 MG                       6.12   55390-0238-01, 55390-0232-10, 10019-0921-02, 10019-0920-01
           DOXORUBICIN HYDROCHLORIDE, ALL LIPID
 J9001     FORMULATIONS, 10 MG                        382.78   17314-9600-02, 17314-9600-01
 J9031     BCG (INTRAVESICAL) PER INSTILLATION        121.57   49281-0880-01
                                                               61703-0332-18, 61703-0323-22, 55390-0006-01, 55390-0005-01, 00703-3155-01,
 J9040     BLEOMYCIN SULFATE, 15 UNITS                 51.14   00703-3154-01
                                                               61703-0339-56, 61703-0339-50, 61703-0339-22, 61703-0339-18, 55390-0155-01,
                                                               55390-0154-01, 55390-0153-01, 55390-0152-01, 55390-0151-01, 55390-0150-01,
                                                               10019-0915-01, 00703-4248-01, 00703-3268-71, 00703-3266-01, 00703-3264-01,
 J9045     CARBOPLATIN, 50 MG                          37.01   00703-3249-11, 00703-3246-11, 00703-3244-11
 J9050     CARMUSTINE, 100 MG                          146.1   00015-3012-38
           CISPLATIN, POWDER OR S0LUTION, PER 10
 J9060     MG                                           2.48   55390-0112-99, 55390-0112-50, 55390-0099-01
 J9062     CISPLATIN, 50 MG                            12.45   55390-0112-99, 55390-0112-50, 55390-0099-01, 00703-5748-11, 00703-5747-11
 J9065     INJECTION, CLADRIBINE, PER 1 MG             39.83   63323-0140-10, 55390-0124-01
 J9070     CYCLOPHOSPHAMIDE, 100 MG                     2.22   Not currently available. Please contact vendor for information about availability.
 J9080     CYCLOPHOSPHAMIDE, 200 MG                     4.43   Not currently available. Please contact vendor for information about availability.
 J9090     CYCLOPHOSPHAMIDE, 500 MG                    17.81   10019-0955-01, 00015-0502-41



CAP final price list 2006                                                                                                                           7
 J9091     CYCLOPHOSPHAMIDE, 1.0 GRAM               22.22   10019-0956-01
 J9092     CYCLOPHOSPHAMIDE, 2.0 GRAM               44.45   10019-0957-01, 00015-0506-41
 J9093     CYCLOPHOSPHAMIDE, LYOPHILIZED, 100 MG     0.38   Not currently available. Please contact vendor for information about availability.
 J9094     CYCLOPHOSPHAMIDE, LYOPHILIZED, 200 MG     0.76   00015-0546-41
 J9095     CYCLOPHOSPHAMIDE, LYOPHILIZED, 500 MG      1.9   Not currently available. Please contact vendor for information about availability.
           CYCLOPHOSPHAMIDE, LYOPHILIZED, 1.0
 J9096     GRAM                                       3.8   Not currently available. Please contact vendor for information about availability.
           CYCLOPHOSPHAMIDE, LYOPHILIZED, 2.0
 J9097     GRAM                                      7.62   Not currently available. Please contact vendor for information about availability.
 J9098     CYTARABINE LIPOSOME, 10 MG              401.87   57665-0331-01
 J9100     CYTARABINE, 100 MG                         1.5   55390-0131-10
 J9110     CYTARABINE, 500 MG                        7.53   55390-0134-01, 55390-0133-01
 J9130     DACARBAZINE, 100 MG                       5.45   63323-0127-10
 J9140     DACARBAZINE, 200 MG                      10.91   61703-0327-22, 55390-0090-10, 00703-5075-03, 00703-5075-01
 J9150     DAUNORUBICIN, 10 MG                      25.09   55390-0281-10, 00703-5233-13, 55390-0108-10, 55390-0108-01
 J9170     DOCETAXEL, 20 MG                        308.34   00075-8001-80, 00075-8001-20
 J9178     INJECTION, EPIRUBICIN HCL, 2 MG          25.99   00009-5093-01, 00009-5091-01
 J9181     ETOPOSIDE, 10 MG                          0.51   55390-0293-01, 55390-0292-01, 55390-0291-01, 00703-5657-01, 00703-5653-01
                                                            55390-0293-01, 55390-0292-01, 55390-0291-01, 00703-5657-01, 00703-5656-01,
 J9182     ETOPOSIDE, 100 MG                         5.15   00703-5653-01
 J9185     FLUDARABINE PHOSPHATE, 50 MG            277.99   00703-5854-01, 00703-4852-11
                                                            63323-0117-61, 63323-0117-51, 63323-0117-20, 00703-3019-12, 00703-3018-12,
 J9190     FLUOROURACIL, 500 MG                      0.66   00703-3015-13
 J9200     FLOXURIDINE, 500 MG                      63.43   63323-0145-07, 61703-0331-09
 J9201     GEMCITABINE HCL, 200 MG                 121.69   00002-7502-01, 00002-7501-01
 J9202     GOSERELIN ACETATE IMPLANT, PER 3.6 MG    183.8   00310-0951-30, 00310-0950-36
 J9206     IRINOTECAN, 20 MG                       133.27   00009-7529-02, 00009-7529-01
 J9208     IFOSFAMIDE, 1 GM                         36.41   63323-0142-10, 10019-0925-01
 J9209     MESNA, 200 MG                            11.07   10019-0953-02, 10019-0953-01
 J9211     IDARUBICIN HYDROCHLORIDE, 5 MG           301.2   00703-4156-11
           INTERFERON, ALFA-2A, RECOMBINANT, 3
 J9213     MILLION UNITS                            34.51   00004-2016-09, 00004-2015-09, 00004-2015-07




CAP final price list 2006                                                                                                                        8
           INTERFERON, ALFA-2B, RECOMBINANT, 1               00085-1254-01, 00085-1242-01, 00085-1235-01, 00085-1179-02, 00085-1168-01,
 J9214     MILLION UNITS                             13.96   00085-1133-01, 00085-1110-01, 00085-0571-02, 00085-0539-01
 J9219     LEUPROLIDE ACETATE IMPLANT, 65 MG       2490.56   00026-9711-01
           INJECTION, MELPHALAN HYDROCHLORIDE,
 J9245     50 MG                                    791.39   59572-0301-01
 J9250     METHOTREXATE SODIUM, 5 MG                  0.19   55390-0034-10, 55390-0033-10
 J9260     METHOTREXATE SODIUM, 50 MG                 1.91   61703-0408-41, 55390-0034-10, 55390-0033-10, 55390-0032-10
 J9263     INJECTION, OXALIPLATIN, 0.5 MG             8.95   00024-0597-04, 00024-0596-02, 00024-0591-20, 00024-0590-10
 J9265     PACLITAXEL, 30 MG                         13.99   55390-0114-50, 55390-0114-20, 55390-0114-05
 J9268     PENTOSTATIN, PER 10 MG                  1995.72   62701-0800-01
 J9280     MITOMYCIN, 5 MG                            23.4   63323-0190-20
 J9290     MITOMYCIN, 20 MG                          93.61   63323-0191-40, 55390-0252-01
 J9291     MITOMYCIN, 40 MG                         187.21   55390-0253-01
           INJECTION, MITOXANTRONE
 J9293     HYDROCHLORIDE, PER 5 MG                  340.01   44087-1530-01, 44087-1525-01, 44087-1520-01
 J9310     RITUXIMAB, 100 MG                        478.75   50242-0053-06, 50242-0051-21
 J9320     STREPTOZOCIN, 1 GM                       162.42   00703-4636-01
 J9340     THIOTEPA, 15 MG                           50.35   55390-0030-10
 J9350     TOPOTECAN, 4 MG                          802.06   00007-4201-05, 00007-4201-01
 J9355     TRASTUZUMAB, 10 MG                         57.1   50242-0134-68
 J9360     VINBLASTINE SULFATE, 1 MG                  1.04   63323-0278-10
 J9370     VINCRISTINE SULFATE, 1 MG                  3.77   61703-0309-16, 61703-0309-06, 00703-4412-11, 00703-4402-11
 J9375     VINCRISTINE SULFATE, 2 MG                  7.56   61703-0309-16, 61703-0309-06, 00703-4412-11, 00703-4402-11
 J9390     VINORELBINE TARTRATE, PER 10 MG           44.97   61703-0341-09, 55390-0070-01, 55390-0069-01, 00703-4183-01, 00703-4182-01
 J9395     INJECTION, FULVESTRANT, 25 MG             85.39   00310-0720-50, 00310-0720-25
 J9600     PORFIMER SODIUM, 75 MG                  2588.03   58914-0155-75
           INJECTION, INTERFERON BETA-1A, 11 MCG
 Q3025     FOR INTRAMUSCULAR USE                     97.72 59627-0002-05, 59627-0001-03
                                                      New CAP Drugs
 J0128     ABARELIX INJECTION, 10 MG                 71.18   68158-0149-51
 J0180     AGALSIDASE BETA INJECTION, 1 MG          133.55   58468-0041-01, 58468-0040-01




CAP final price list 2006                                                                                                                 9
                                                           55390-0226-04, 55390-0226-02, 55390-0225-02, 00703-9040-03, 00703-9032-03,
 J0278     AMIKACIN, 100MG                          1.01   00409-1956-01, 00409-1955-01
 J0878     DAPTOMYCIN INJECTION, 1 MG               0.31   67919-0011-01
 J1751     IRON DEXTRAN 165, 50MG                  12.39   52544-0931-02
 J1752     IRON DEXTRAN 267, 50MG                  10.71   00517-0234-10, 00517-0134-10
 J1931     LARONIDASE INJECTION, 0.1 MG            25.06   58468-0070-01
 J2357     OMALIZUMAB INJECTION, 5 MG              16.68   50242-0040-62
 J2469     PALONOSETRON HCL, 25MCG                 18.89   58063-0797-25
 J2503     PEGAPTANIB, 0.3MG                     1107.54   68782-0001-01
 J2794     RISPERIDONE, LONG ACTING, 0.5MG          4.93   50458-0308-11, 50458-0307-11, 50458-0306-11
 J9035     BEVACIZUMAB INJECTION, 10MG             59.97   50242-0061-01, 50242-0060-01
 J9041     BORTEZOMIB INJECTION, 0.1MG             30.47   63020-0049-01
 J9055     CETUXIMAB INJECTION, 10MG               52.25   66733-0948-23
 J9225     HISTRELIN IMPLANT, 50MG               3141.15   55592-0500-01
           PACLITAXEL PROTEIN BOUND PARTICLES,
 J9264     1MG                                      8.73   68817-0134-50
 J9305     PEMETREXED INJECTION, 10MG              42.71   00002-7623-01




CAP final price list 2006                                                                                                               10

								
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