Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits — General Pharmaceutical Benefits
| PBS Item code | Drug name Form and Strength |
Pack size | Price | Manufacturer |
|---|---|---|---|---|
| 14416R | Escitalopramescitalopram 20 mg tablet, 28 | 28 | $5.30 | AF,BG,DZ,HQ,HX,RW,TX,TY,WG |
| 14415Q | Escitalopramescitalopram 20 mg tablet, 28 | 28 | $5.30 | AF,DZ,HQ,HX,RW,WG,ZS |
| 14416R | Escitalopramescitalopram 20 mg tablet, 28 | 28 | $19.28 | LU |
| 14812N | Esketamineesketamine 28 mg/2 actuations nasal spray, 2 actuations | 1 | $322.18 | JC |
| 14836W | Esketamineesketamine 28 mg/2 actuations nasal spray, 2 actuations | 1 | $319.33 | JC |
| 14794P | Esketamineesketamine 28 mg/2 actuations nasal spray, 2 x 2 actuations | 2 | $638.65 | JC |
| 14830M | Esketamineesketamine 28 mg/2 actuations nasal spray, 3 x 2 actuations | 3 | $945.46 | JC |
| 14815R | Esketamineesketamine 28 mg/2 actuations nasal spray, 2 x 2 actuations | 2 | $626.14 | JC |
| 14786F | Esketamineesketamine 28 mg/2 actuations nasal spray, 3 x 2 actuations | 3 | $932.95 | JC |
| 12275C | Esomeprazoleesomeprazole 20 mg enteric capsule, 30 | 30 | $6.80 | AL |
| 14303T | Esomeprazoleesomeprazole 20 mg enteric capsule, 30 | 30 | $6.80 | AL |
| 14510Q | Esomeprazoleesomeprazole 20 mg enteric capsule, 30 | 30 | $6.80 | AL |
| 14537D | Esomeprazoleesomeprazole 20 mg enteric capsule, 30 | 30 | $5.52 | AL |
| 12290W | Esomeprazoleesomeprazole 40 mg enteric capsule, 30 | 30 | $9.64 | AL |
| 14405E | Esomeprazoleesomeprazole 40 mg enteric capsule, 30 | 30 | $9.64 | AL |
| 14445G | Esomeprazoleesomeprazole 40 mg enteric capsule, 30 | 30 | $8.36 | AL |
| 12287Q | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $6.80 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 14308C | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $6.80 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 14444F | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $6.80 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 14481E | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $5.52 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 12287Q | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $13.52 | AP |
| 14308C | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $13.52 | AP |
| 14444F | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $13.52 | AP |
| 14481E | Esomeprazoleesomeprazole 20 mg enteric tablet, 30 | 30 | $12.24 | AP |
| 12283L | Esomeprazoleesomeprazole 40 mg enteric tablet, 30 | 30 | $9.64 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 14373L | Esomeprazoleesomeprazole 40 mg enteric tablet, 30 | 30 | $9.64 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 14512T | Esomeprazoleesomeprazole 40 mg enteric tablet, 30 | 30 | $8.36 | AF,BG,GQ,MQ,RA,RF,RW,TY,WG |
| 12283L | Esomeprazoleesomeprazole 40 mg enteric tablet, 30 | 30 | $16.43 | AP |
| 14373L | Esomeprazoleesomeprazole 40 mg enteric tablet, 30 | 30 | $16.43 | AP |
| 14512T | Esomeprazoleesomeprazole 40 mg enteric tablet, 30 | 30 | $15.15 | AP |
| 9329B | essential amino acids formulaessential amino acids formula powder for oral liquid, 2 x 200 g | 1 | $168.29 | SB |
| 2027Q | essential amino acids formula with minerals and vitamin Cessential amino acids formula with minerals and vitamin C powder for oral liquid, 400 g | 1 | $99.90 | SB |
| 13759E | essential amino acids formula with vitamins and mineralsessential amino acids formula with vitamins and minerals powder for oral liquid, 30 x 12.5 g sachets | 1 | $194.13 | VF |
| 13978Q | Estradiolestradiol 10 microgram modified release pessary, 18 | 18 | $18.62 | AS,NO |
| 13931F | Estradiolestradiol 2 mg tablet, 56 | 56 | $8.58 | XT |
| 13872D | Estradiolestradiol valerate 1 mg tablet, 56 | 56 | $5.71 | GH |
| 13980T | Estradiolestradiol valerate 2 mg tablet, 56 | 56 | $6.94 | GH |
| 14642P | Estradiolestradiol 0.1% (1 mg/g) gel, 28 x 500 mg sachets | 1 | $10.82 | OX |
| 14026F | Estradiolestradiol 0.1% (1 mg/g) gel, 28 x 1 g sachets | 1 | $14.37 | OX |
| 14741W | Estradiolestradiol 0.06% (750 microgram/actuation) gel, 64 actuations | 1 | $24.63 | HB |
| 14024D | estradiol (&) estradiol + dydrogesteroneestradiol 1 mg tablet [14] (&) estradiol 1 mg + dydrogesterone 10 mg tablet [14], 28 | 1 | $12.97 | XT |
| 13930E | estradiol (&) estradiol + dydrogesteroneestradiol 2 mg tablet [14] (&) estradiol 2 mg + dydrogesterone 10 mg tablet [14], 28 | 1 | $12.97 | XT |
| 13981W | estradiol (&) estradiol + norethisterone acetateestradiol 50 microgram/24 hours patch [4] (&) estradiol 50 microgram/24 hours + norethisterone acetate 250 microgram/24 hours patch [4], 8 | 1 | $31.49 | SZ |
| 13932G | estradiol (&) estradiol + norethisterone acetateestradiol 50 microgram/24 hours patch [4] (&) estradiol 50 microgram/24 hours + norethisterone acetate 140 microgram/24 hours patch [4], 8 | 1 | $33.11 | SZ |
| 14336M | estradiol + norethisterone acetateestradiol 50 microgram/24 hours + norethisterone acetate 250 microgram/24 hours patch, 8 | 1 | $23.19 | SZ |
| 13902Q | estradiol + norethisterone acetateestradiol 50 microgram/24 hours + norethisterone acetate 140 microgram/24 hours patch, 8 | 1 | $24.89 | SZ |
| 14059Y | Estriolestriol 500 microgram pessary, 15 | 1 | $14.98 | AS |
| 13926Y | Estriolestriol 0.1% (1 mg/g) cream, 15 g | 1 | $13.54 | AS |
| 13693Q | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 1954W | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 3445H | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 8637N | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 8778B | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 9035M | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 9037P | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 3448L | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 8638P | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 8779C | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 9036N | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 9429G | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 11197H | Etanerceptetanercept 25 mg injection [4 vials] (&) inert substance diluent [4 x 1 mL syringes], 1 pack | 1 | $407.25 | PF |
| 11703Y | Ethosuximideethosuximide 250 mg capsule, 100 | 100 | $139.68 | IX |
| 14014N | Ethosuximideethosuximide 250 mg/5 mL oral liquid, 200 mL | 1 | $61.77 | IX |
| 8842J | Everolimuseverolimus 750 microgram tablet, 60 | 60 | $435.73 | CR,NV |
| 14040Y | Everolimuseverolimus 750 microgram tablet, 60 | 60 | $435.70 | CR,NV |
| 9352F | Everolimuseverolimus 1 mg tablet, 60 | 60 | $580.95 | CR,NV |
| 13941R | Everolimuseverolimus 1 mg tablet, 60 | 60 | $578.26 | CR,NV |
| 11484K | Evolocumabevolocumab 140 mg/mL injection, 1 mL pen device | 1 | $208.14 | AN |
| 11985T | Evolocumabevolocumab 140 mg/mL injection, 1 mL pen device | 1 | $208.14 | AN |
| 10958R | Evolocumabevolocumab 140 mg/mL injection, 1 mL pen device | 1 | $208.12 | AN |
| 11977J | Evolocumabevolocumab 140 mg/mL injection, 1 mL pen device | 1 | $208.12 | AN |
| 13857H | Exemestaneexemestane 25 mg tablet, 30 | 30 | $39.26 | GQ,SZ,TX,WG |
| 14036R | Exemestaneexemestane 25 mg tablet, 30 | 30 | $39.26 | GQ,SZ,TX,WG |
| 13857H | Exemestaneexemestane 25 mg tablet, 30 | 30 | $41.91 | PF |
| 14036R | Exemestaneexemestane 25 mg tablet, 30 | 30 | $41.91 | PF |
| 13440J | Ezetimibeezetimibe 10 mg tablet, 30 | 30 | $7.15 | AF,BG,CR,GQ,RW,SZ,TX,WG,XT |
| 13440J | Ezetimibeezetimibe 10 mg tablet, 30 | 30 | $10.39 | AL |
| 13629H | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 5 mg tablet [30], 60 | 1 | $13.77 | AF,SZ |
| 13629H | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 5 mg tablet [30], 60 | 1 | $16.56 | AL |
| 13569E | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 10 mg tablet [30], 60 | 1 | $15.12 | AF,CR,SZ |
| 13569E | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 10 mg tablet [30], 60 | 1 | $18.01 | AL |
| 13480L | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 20 mg tablet [30], 60 | 1 | $17.04 | AF,CR,SZ |
| 13480L | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 20 mg tablet [30], 60 | 1 | $19.93 | AL |
| 13537L | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60 | 1 | $16.73 | AF,CR,SZ |
| 13537L | ezetimibe (&) rosuvastatinezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60 | 1 | $19.73 | AL |
| 13539N | Ezetimibe + atorvastatinezetimibe 10 mg + atorvastatin 10 mg tablet, 30 | 30 | $10.87 | AF,GQ,XT |
| 13622Y | Ezetimibe + atorvastatinezetimibe 10 mg + atorvastatin 20 mg tablet, 30 | 30 | $11.42 | AF,GQ,XT |
| 13416D | Ezetimibe + atorvastatinezetimibe 10 mg + atorvastatin 40 mg tablet, 30 | 30 | $15.49 | AF |
| 13416D | Ezetimibe + atorvastatinezetimibe 10 mg + atorvastatin 40 mg tablet, 30 | 30 | $13.33 | GQ,XT |
| 13538M | Ezetimibe + atorvastatinezetimibe 10 mg + atorvastatin 80 mg tablet, 30 | 30 | $18.98 | AF |
| 13538M | Ezetimibe + atorvastatinezetimibe 10 mg + atorvastatin 80 mg tablet, 30 | 30 | $16.07 | GQ,XT |
| 13385L | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 10 mg tablet, 30 | 30 | $9.03 | CR,MQ,RW,SZ,TX,WG |
| 13385L | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 10 mg tablet, 30 | 30 | $10.97 | AL |
| 13442L | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 20 mg tablet, 30 | 30 | $9.35 | CR,MQ,RW,SZ,TX,WG |
| 13442L | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 20 mg tablet, 30 | 30 | $11.29 | AL |
| 13535J | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 40 mg tablet, 30 | 30 | $9.81 | CR,MQ,RW,SZ,TX,WG |
| 13535J | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 40 mg tablet, 30 | 30 | $12.72 | AL |
| 13595M | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 80 mg tablet, 30 | 30 | $10.45 | CR,MQ,RW,SZ,TX,WG |
| 13595M | Ezetimibe + simvastatinezetimibe 10 mg + simvastatin 80 mg tablet, 30 | 30 | $13.36 | AL |
| 15047Y | Famotidinefamotidine 20 mg tablet, 60 | 60 | $6.38 | RW |
| 15061Q | Famotidinefamotidine 40 mg tablet, 30 | 30 | $6.38 | RW |
| 13519M | Febuxostatfebuxostat 80 mg tablet, 28 | 28 | $39.28 | CR,FK |
| 13377C | Felodipinefelodipine 2.5 mg modified release tablet, 30 | 30 | $5.91 | IX,IY,XT |
| 13561R | Felodipinefelodipine 5 mg modified release tablet, 30 | 30 | $6.55 | IY,RW |
| 13561R | Felodipinefelodipine 5 mg modified release tablet, 30 | 30 | $10.24 | IX |
| 13531E | Felodipinefelodipine 10 mg modified release tablet, 30 | 30 | $9.64 | IY,RW |
| 13531E | Felodipinefelodipine 10 mg modified release tablet, 30 | 30 | $13.28 | IX |
| 13469X | Fenofibratefenofibrate 48 mg tablet, 60 | 60 | $6.80 | AL,GO,GQ,RA,TX,TY,WG |
| 13587D | Fenofibratefenofibrate 145 mg tablet, 30 | 30 | $8.72 | AL,BG,GO,GQ,LR,RA,SZ,TX,TY,WG,XT |
| 10104T | Ferric carboxymaltoseiron (as ferric carboxymaltose) 500 mg/10 mL injection, 10 mL vial | 1 | $45.29 | AF,RZ,TB,XT,XW |
| 11615H | Ferric derisomaltoseiron (as ferric derisomaltose) 500 mg/5 mL injection, 5 mL vial | 1 | $134.46 | FK |
| 10788T | Flucloxacillinflucloxacillin 500 mg capsule, 24 | 24 | $10.99 | AF,AL,MQ |
| 1433K | Fludrocortisonefludrocortisone acetate 100 microgram tablet, 100 | 100 | $13.07 | AS,DZ |
| 14548Q | Fluoxetinefluoxetine 20 mg capsule, 28 | 28 | $6.30 | AF,BG,GQ,RF,SZ,TX,WG |
| 14717N | Fluoxetinefluoxetine 20 mg tablet, 28 | 28 | $6.30 | AF |
| 14515Y | fluticasone furoatefluticasone furoate 100 microgram/actuation powder for inhalation, 30 actuations | 1 | $18.07 | GK |
| 14380W | fluticasone furoatefluticasone furoate 200 microgram/actuation powder for inhalation, 30 actuations | 1 | $31.10 | GK |
| 14346C | fluticasone furoate + umeclidinium + vilanterolfluticasone furoate 100 microgram/actuation + umeclidinium 62.5 microgram/actuation + vilanterol 25 microgram/actuation powder for inhalation, 30 actuations | 1 | $73.28 | GK |
| 14382Y | fluticasone furoate + umeclidinium + vilanterolfluticasone furoate 200 microgram/actuation + umeclidinium 62.5 microgram/actuation + vilanterol 25 microgram/actuation powder for inhalation, 30 actuations | 1 | $77.06 | GK |
| 14379T | fluticasone furoate + vilanterolfluticasone furoate 100 microgram/actuation + vilanterol 25 microgram/actuation powder for inhalation, 30 actuations | 1 | $44.06 | GK |
| 14345B | fluticasone furoate + vilanterolfluticasone furoate 200 microgram/actuation + vilanterol 25 microgram/actuation powder for inhalation, 30 actuations | 1 | $58.64 | GK |
| 14412M | fluticasone propionatefluticasone propionate 100 microgram/actuation powder for inhalation, 60 actuations | 1 | $8.25 | TX |
| 14412M | fluticasone propionatefluticasone propionate 100 microgram/actuation powder for inhalation, 60 actuations | 1 | $12.12 | GK |
| 14381X | fluticasone propionatefluticasone propionate 250 microgram/actuation powder for inhalation, 60 actuations | 1 | $15.48 | TX |
| 14381X | fluticasone propionatefluticasone propionate 250 microgram/actuation powder for inhalation, 60 actuations | 1 | $19.36 | GK |
| 14487L | fluticasone propionatefluticasone propionate 50 microgram/actuation inhalation, 120 actuations | 1 | $9.75 | TX |
| 14487L | fluticasone propionatefluticasone propionate 50 microgram/actuation inhalation, 120 actuations | 1 | $13.63 | GK |
| 14347D | fluticasone propionatefluticasone propionate 125 microgram/actuation inhalation, 120 actuations | 1 | $15.48 | LR,TX |
| 14347D | fluticasone propionatefluticasone propionate 125 microgram/actuation inhalation, 120 actuations | 1 | $18.39 | GK |
| 14411L | fluticasone propionate + formoterolfluticasone propionate 50 microgram/actuation + formoterol fumarate dihydrate 5 microgram/actuation inhalation, 120 actuations | 1 | $27.60 | MF |
| 14343X | fluticasone propionate + formoterolfluticasone propionate 125 microgram/actuation + formoterol fumarate dihydrate 5 microgram/actuation inhalation, 120 actuations | 1 | $28.16 | MF |
| 14344Y | fluticasone propionate + formoterolfluticasone propionate 250 microgram/actuation + formoterol fumarate dihydrate 10 microgram/actuation inhalation, 120 actuations | 1 | $39.52 | MF |
| 14413N | fluticasone propionate + salmeterolfluticasone propionate 100 microgram/actuation + salmeterol 50 microgram/actuation powder for inhalation, 60 actuations | 1 | $32.12 | TX |
| 14413N | fluticasone propionate + salmeterolfluticasone propionate 100 microgram/actuation + salmeterol 50 microgram/actuation powder for inhalation, 60 actuations | 1 | $36.00 | GK |
| 14449L | fluticasone propionate + salmeterolfluticasone propionate 250 microgram/actuation + salmeterol 50 microgram/actuation powder for inhalation, 60 actuations | 1 | $30.79 | LR,OX,SZ,TX |
| 14449L | fluticasone propionate + salmeterolfluticasone propionate 250 microgram/actuation + salmeterol 50 microgram/actuation powder for inhalation, 60 actuations | 1 | $35.64 | GK |
| 14450M | fluticasone propionate + salmeterolfluticasone propionate 500 microgram/actuation + salmeterol 50 microgram/actuation powder for inhalation, 60 actuations | 1 | $40.79 | LR,OX,SZ,TX |
| 14450M | fluticasone propionate + salmeterolfluticasone propionate 500 microgram/actuation + salmeterol 50 microgram/actuation powder for inhalation, 60 actuations | 1 | $44.67 | GK |
| 14414P | fluticasone propionate + salmeterolfluticasone propionate 50 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations | 1 | $32.12 | TX |
| 14414P | fluticasone propionate + salmeterolfluticasone propionate 50 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations | 1 | $36.00 | GK |
| 14544L | fluticasone propionate + salmeterolfluticasone propionate 125 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations | 1 | $30.79 | AF,LR,SZ,TX |
| 14544L | fluticasone propionate + salmeterolfluticasone propionate 125 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations | 1 | $35.64 | GK |
| 14311F | fluticasone propionate + salmeterolfluticasone propionate 250 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations | 1 | $40.79 | AF,LR,SZ,TX |
| 14311F | fluticasone propionate + salmeterolfluticasone propionate 250 microgram/actuation + salmeterol 25 microgram/actuation inhalation, 120 actuations | 1 | $44.67 | GK |
| 14488M | Fluvoxaminefluvoxamine maleate 50 mg tablet, 30 | 30 | $8.06 | AL,RW,TX,WG |
| 14488M | Fluvoxaminefluvoxamine maleate 50 mg tablet, 30 | 30 | $11.45 | GO |
| 14314J | Fluvoxaminefluvoxamine maleate 100 mg tablet, 30 | 30 | $10.87 | AF,RW,TX,WG |
| 14314J | Fluvoxaminefluvoxamine maleate 100 mg tablet, 30 | 30 | $14.27 | GO |
| 2958Q | Folic acidfolic acid 500 microgram tablet, 100 | 100 | $4.69 | AF,PP |
| 1437P | Folic acidfolic acid 5 mg tablet, 100 | 100 | $5.72 | AF |
| 8740B | Folinic acidfolinic acid 50 mg/5 mL injection, 5 mL vial | 1 | $21.37 | DZ,PF |
| 10877L | Follitropin alfafollitropin alfa 150 units (11 microgram)/0.25 mL injection, 5 x 0.25 mL pen devices | 5 | $224.82 | FX |
| 10876K | Follitropin alfafollitropin alfa 225 units (16.5 microgram)/0.375 mL injection, 5 x 0.375 mL pen devices | 5 | $337.21 | FX |
| 8713N | Follitropin alfafollitropin alfa 300 units (21.84 microgram)/0.48 mL injection, 0.48 mL pen device | 1 | $94.69 | SG |
| 12769C | Follitropin alfafollitropin alfa 300 units (22 microgram)/0.5 mL injection, 0.5 mL cartridge | 1 | $94.69 | TT |
| 8714P | Follitropin alfafollitropin alfa 450 units (32.76 microgram)/0.72 mL injection, 0.72 mL pen device | 1 | $142.00 | SG |
| 12808D | Follitropin alfafollitropin alfa 450 units (33 microgram)/0.75 mL injection, 0.75 mL cartridge | 1 | $142.00 | TT |
| 10865W | Follitropin alfafollitropin alfa 75 units (5.5 microgram)/0.125 mL injection, 5 x 0.125 mL pen devices | 5 | $112.42 | FX |
| 8715Q | Follitropin alfafollitropin alfa 900 units (65.52 microgram)/1.44 mL injection, 1.44 mL pen device | 1 | $358.70 | SG |
| 12778M | Follitropin alfafollitropin alfa 900 units (66 microgram)/1.5 mL injection, 1.5 mL cartridge | 1 | $358.70 | TT |
| 8565T | Follitropin betafollitropin beta 300 units/0.36 mL injection, 0.36 mL cartridge | 1 | $100.12 | OQ |
| 8566W | Follitropin betafollitropin beta 600 units/0.72 mL injection, 0.72 mL cartridge | 1 | $195.35 | OQ |
| 8871X | Follitropin betafollitropin beta 900 units/1.08 mL injection, 1.08 mL cartridge | 1 | $290.37 | OQ |
| 8775W | fondaparinuxfondaparinux sodium 2.5 mg/0.5 mL injection, 2 x 0.5 mL syringes | 2 | $29.39 | AS |
| 14419X | Formoterolformoterol fumarate dihydrate 12 microgram powder for inhalation, 60 capsules | 60 | $19.04 | SZ |
| 14547P | Formoterolformoterol fumarate dihydrate 6 microgram/actuation powder for inhalation, 60 actuations | 1 | $13.20 | AP |
| 14517C | Formoterolformoterol fumarate dihydrate 12 microgram/actuation powder for inhalation, 60 actuations | 1 | $18.56 | AP |
| 14887M | Foslevodopa + foscarbidopafoslevodopa 2.4 g/10 mL + foscarbidopa 120 mg/10 mL injection, 7 x 10 mL vials | 7 | $1317.08 | VE |
| 14896B | Foslevodopa + foscarbidopafoslevodopa 2.4 g/10 mL + foscarbidopa 120 mg/10 mL injection, 7 x 10 mL vials | 7 | $1317.08 | VE |
| 14876Y | Foslevodopa + foscarbidopafoslevodopa 2.4 g/10 mL + foscarbidopa 120 mg/10 mL injection, 7 x 10 mL vials | 7 | $1304.57 | VE |
| 14886L | Foslevodopa + foscarbidopafoslevodopa 2.4 g/10 mL + foscarbidopa 120 mg/10 mL injection, 7 x 10 mL vials | 7 | $1304.57 | VE |
| 15336E | Fruquintinibfruquintinib 1 mg capsule, 21 | 21 | $1393.41 | TK |
| 13504R | Furosemidefurosemide 10 mg/mL oral liquid, 30 mL | 1 | $29.47 | SW |
| 13473D | Furosemidefurosemide 20 mg tablet, 100 | 100 | $7.80 | AF,TX,WG |
| 1810G | Furosemidefurosemide 20 mg tablet, 50 | 50 | $5.30 | AF,TY |
| 13501N | Furosemidefurosemide 20 mg tablet, 50 | 50 | $4.02 | AF,TY |
| 13473D | Furosemidefurosemide 20 mg tablet, 100 | 100 | $8.81 | TY |
| 13472C | Furosemidefurosemide 40 mg tablet, 100 | 100 | $5.30 | AF,TX,WG,ZS |
| 13472C | Furosemidefurosemide 40 mg tablet, 100 | 100 | $6.29 | TY |
| 13474E | Furosemidefurosemide 500 mg tablet, 50 | 50 | $12.07 | RW |
| 10782L | Fusidatesodium fusidate 250 mg tablet, 36 | 36 | $89.52 | LO |
| 15401N | FutibatinibFutibatinib 4 mg tablet, 35 | 35 | $4177.01 | TJ |
| 12478R | Galcanezumabgalcanezumab 120 mg/mL injection, 1 mL pen device | 1 | $507.12 | LY |
| 15317E | Garadacimabgaradacimab 200 mg/1.2 mL injection, 1.2 mL pen device | 1 | $30285.69 | VK |
| 13618R | Gemfibrozilgemfibrozil 600 mg tablet, 60 | 60 | $12.17 | AF,RW |
| 15289Q | Givosirangivosiran 189 mg/mL injection, 1 mL vial | 1 | $82145.84 | WM |
| 13868X | Glibenclamideglibenclamide 5 mg tablet, 100 | 100 | $6.30 | SW |
| 14740T | Gliclazidegliclazide 30 mg modified release tablet, 100 | 100 | $7.71 | AL,CR,SZ,TX |
| 13922R | Gliclazidegliclazide 60 mg modified release tablet, 60 | 60 | $16.30 | SE |
| 13922R | Gliclazidegliclazide 60 mg modified release tablet, 60 | 60 | $6.72 | CR,GQ,SZ,XT,XW |
| 13896J | Gliclazidegliclazide 80 mg tablet, 100 | 100 | $7.57 | RW,TY |
| 13848W | Glimepirideglimepiride 1 mg tablet, 30 | 30 | $5.30 | SZ,WG,XT |
| 13870B | Glimepirideglimepiride 2 mg tablet, 30 | 30 | $5.30 | SZ,WG,XT |
| 14020X | Glimepirideglimepiride 3 mg tablet, 30 | 30 | $5.49 | SZ,XT |
| 14055R | Glimepirideglimepiride 4 mg tablet, 30 | 30 | $6.00 | SZ,WG,XT |
| 14019W | Glipizideglipizide 5 mg tablet, 100 | 100 | $9.05 | AF,PF |
| 3107M | glucose and ketone indicator urineglucose and ketone indicator urine diagnostic strip, 50 | 1 | $6.42 | DX |
| 13549D | Glyceryl trinitrateglyceryl trinitrate 400 microgram/actuation spray, 200 actuations | 1 | $14.82 | SW |
| 14371J | Glyceryl trinitrateglyceryl trinitrate 5 mg/24 hours patch, 30 | 30 | $18.30 | IL |
Last updated
1 September 2026