Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148008213 |
Jynarque 15mg tablets, 30 count bottle |
01/01/2025 |
755.99 |
11555.86 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148007928 |
Jynarque 15mg/15mg Kit |
01/01/2025 |
1411.18 |
21570.93 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148008313 |
Jynarque 30mg tablets, 30 count bottle |
01/01/2025 |
755.99 |
11555.86 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148008028 |
Jynarque 30mg/15mg Kit |
01/01/2025 |
1411.18 |
21570.93 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148008728 |
Jynarque 45mg/15mg 4x Kit |
01/01/2025 |
1411.18 |
21570.93 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148008828 |
Jynarque 60mg/30mg 4x Kit |
01/01/2025 |
1411.18 |
21570.93 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000067 |
Otsuka America Pharmaceutical, Inc. |
03/24/2025 |
59148008928 |
Jynarque 90mg/30mg 4x Kit |
01/01/2025 |
1411.18 |
21570.93 |
04/07/2030 |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
None |
1 |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990793819 |
DEXTROSE 10% INJ USP 1000ML 500ML FILL CS of 12 |
01/01/2025 |
285.84 |
66.36 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990793519 |
DEXTROSE 20% INJ USP 1000ML 500ML FILL CS of 12 |
01/01/2025 |
35.28 |
136.92 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792323 |
DEXTROSE 5% INJ USP LIFECARE 100ML CS of 48 |
01/01/2025 |
78.24 |
103.68 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792337 |
DEXTROSE 5% INJ USP LIFECARE 100ML CS of 80 |
01/01/2025 |
78.40 |
168.00 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792320 |
DEXTROSE 5% INJ USP LIFECARE 25ML QUAD/PK CS of 48 |
01/01/2025 |
343.68 |
107.04 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792255 |
DEXTROSE 5% INJ USP LIFECARE 500ML 2-PT CS of 18 |
01/01/2025 |
66.96 |
99.54 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792313 |
DEXTROSE 5% INJ USP LIFECARE 50ML CS of 48 |
01/01/2025 |
75.84 |
107.04 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792336 |
DEXTROSE 5% INJ USP LIFECARE 50ML CS of 80 |
01/01/2025 |
68.00 |
170.40 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792409 |
DEXTROSE 5%/0.225% SODIUM CL INJ USP LC 1000 ML CS of 12 |
01/01/2025 |
12.60 |
66.36 |
None |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792403 |
DEXTROSE 5%/0.225% SODIUM CL INJ USP LC 500 ML CS of 24 |
01/01/2025 |
24.24 |
132.72 |
None |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792509 |
DEXTROSE 5%/0.3% SODIUM CL INJ USP LC 1000 ML CS of 12 |
01/01/2025 |
237.12 |
66.36 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990792503 |
DEXTROSE 5%/0.3% SODIUM CL INJ USP LC 500 ML CS of 24 |
01/01/2025 |
38.16 |
132.72 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990737262 |
IONOSOL MB AND 5% DEXTROSE INJ LIFECARE 250ML CS of 24 |
01/01/2025 |
102.96 |
132.24 |
None |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990796509 |
NORMOSOL-M/5% DEXTROSE INJ LIFECARE 1000 ML CS of 12 |
01/01/2025 |
31.92 |
66.36 |
None |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990796809 |
NORMOSOL-R/5% DEXTROSE INJ LIFECARE 1000 ML CS of 12 |
01/01/2025 |
92.40 |
66.36 |
None |
Single Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990711109 |
POTASSIUM CL 20MEQ 5% DEX/LACT RINGERS 1000ML CS of 12 |
01/01/2025 |
25.92 |
110.64 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990797205 |
SODIUM CL 0.9% IRRIGATION USP LIFECARE 1000ML CS of 12 |
01/01/2025 |
48.60 |
51.72 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990797207 |
SODIUM CL 0.9% IRRIGATION USP LIFECARE 2000ML CS of 6 |
01/01/2025 |
24.66 |
41.94 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990797208 |
SODIUM CL 0.9% IRRIGATION USP LIFECARE 3000ML CS of 4 |
01/01/2025 |
11.52 |
34.48 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990773037 |
SODIUM CL INJ USP 0.45% 100 ML CS of 80 |
01/01/2025 |
105.60 |
189.60 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990773036 |
SODIUM CL INJ USP 0.45% 50 ML CS of 80 |
01/01/2025 |
259.20 |
228.00 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990798423 |
SODIUM CL INJ USP 0.9% 100 ML FLEXIBLE CONTAINER CS of 48 |
01/01/2025 |
70.56 |
111.84 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990798413 |
SODIUM CL INJ USP 0.9% 50 ML FLEXIBLE CONTAINER CS of 48 |
01/01/2025 |
64.32 |
118.08 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990798437 |
SODIUM CL INJ USP 0.9% LIFECARE 100ML CS of 80 |
01/01/2025 |
89.60 |
153.60 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990798436 |
SODIUM CL INJ USP 0.9% LIFECARE 50 ML CS of 80 |
01/01/2025 |
121.60 |
116.00 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990798355 |
SODIUM CL INJ USP 0.9% LIFECARE 500 ML 2-PT CS of 18 |
01/01/2025 |
34.38 |
99.54 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990798420 |
SODIUM CL INJ USP 0.9% LIFECARE QUAD/PK 25 ML CS of 48 |
01/01/2025 |
58.08 |
106.56 |
None |
Non-innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |
Rx0000622 |
Otsuka ICU Medical |
04/29/2025 |
00990797305 |
STERILE WATER FOR IRRIG FLEX CONTAINER 1000 ML CS of 12 |
01/01/2025 |
49.20 |
51.36 |
None |
Innovator Multiple Source Drug |
None |
None |
None |
1 |
None |
1 |
No improvement. |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
None |
WAC submitted at CASE price. |