Medication HCPCS Code Price
Amphetamine-Dextroamphet 10 Mg Tab $13.50
Amphetamine-Dextroamphet 20 Mg Tab $14.95
Amphetamine-Dextroamphet XR 10 Mg Cap $36.30
Amphetamine-Dextroamphet XR 30 Mg Cap $36.30
Amphetamine-Dextroamphet XR 5 Mg Cap $32.40
Amphotericin B (in MCG) for build of Ophth Inj J0285 $201.30
Amphotericin B deoxycholate 50 Mg Vial J0285 $201.30
AMPicillin Sodium 1 G Vial J0290 $43.10
AMPicillin Sodium 2 G Vial J0290 $77.85
AMPicillin Sodium 500 Mg Vial J0290 $25.00