NV.gov
2020EAL
| NDC | Drug | WAC | Manufacturer |
|---|---|---|---|
| 00173-0695-00 | ADVAIR 100-50 DISKUS | $5.28 | GLAXOSMITHKLINE |
| 00173-0695-04 | ADVAIR 100-50 DISKUS | $10.84 | GLAXOSMITHKLINE |
| 00173-0696-00 | ADVAIR 250-50 DISKUS | $6.57 | GLAXOSMITHKLINE |
| 00173-0696-04 | ADVAIR 250-50 DISKUS | $10.84 | GLAXOSMITHKLINE |
| 00173-0697-00 | ADVAIR 500-50 DISKUS | $8.64 | GLAXOSMITHKLINE |
| 00173-0697-04 | ADVAIR 500-50 DISKUS | $17.66 | GLAXOSMITHKLINE |
| 00173-0716-20 | ADVAIR HFA 115-21 MCG INHALE | $32.83 | GLAXOSMITHKLINE |
| 00173-0716-22 | ADVAIR HFA 115-21 MCG INHALE | $26.56 | GLAXOSMITHKLINE |
| 00173-0717-20 | ADVAIR HFA 230-21 MCG INHALE | $43.17 | GLAXOSMITHKLINE |
| 00173-0717-22 | ADVAIR HFA 230-21 MCG INHALE | $39.39 | GLAXOSMITHKLINE |
| 00173-0715-20 | ADVAIR HFA 45-21 MCG INHALER | $26.42 | GLAXOSMITHKLINE |
| 00173-0715-22 | ADVAIR HFA 45-21 MCG INHALER | $26.56 | GLAXOSMITHKLINE |
| 59310-0812-06 | AIRDUO RESPICLICK 113-14 MCG | $320.23 | TEVA SPECIALTY |
| 59310-0822-06 | AIRDUO RESPICLICK 232-14 MCG | $320.23 | TEVA SPECIALTY |
| 59310-0805-06 | AIRDUO RESPICLICK 55-14 MCG | $320.23 | TEVA SPECIALTY |
| 00487-9901-30 | ALBUTEROL 2.5 MG/0.5 ML SOL | $0.38 | NEPHRON CORP |
| 50383-0741-20 | ALBUTEROL 5 MG/ML SOLUTION | $2.41 | HI-TECH/AKORN C |
| 00093-3174-31 | ALBUTEROL HFA 90 MCG INHALER | $4.23 | TEVA USA |
| 00254-1007-52 | ALBUTEROL HFA 90 MCG INHALER | $5.37 | PAR PHARM. |
| 66993-0019-68 | ALBUTEROL HFA 90 MCG INHALER | $2.00 | PRASCO LABS |
| 00378-6991-52 | ALBUTEROL SUL 0.63 MG/3 ML S | $0.44 | MYLAN |
| 00487-0301-01 | ALBUTEROL SUL 0.63 MG/3 ML S | $0.44 | NEPHRON CORP |
| 00591-3467-53 | ALBUTEROL SUL 0.63 MG/3 ML S | $0.44 | ACTAVIS/TEVA |
| 00378-6992-52 | ALBUTEROL SUL 1.25 MG/3 ML S | $0.44 | MYLAN |
| 00487-9904-01 | ALBUTEROL SUL 1.25 MG/3 ML S | $0.44 | NEPHRON CORP |
| 00487-9904-25 | ALBUTEROL SUL 1.25 MG/3 ML S | $0.44 | NEPHRON CORP |
| 00591-3468-53 | ALBUTEROL SUL 1.25 MG/3 ML S | $0.44 | ACTAVIS/TEVA |
| 00378-8270-52 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | MYLAN |
| 00378-8270-55 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.07 | MYLAN |
| 00378-8270-91 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | MYLAN |
| 00378-8270-93 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.07 | MYLAN |
| 00487-9501-01 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.07 | NEPHRON CORP |
| 00487-9501-03 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | NEPHRON CORP |
| 00487-9501-25 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | NEPHRON CORP |
| 00487-9501-60 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | NEPHRON CORP |
| 00591-3797-30 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | ACTAVIS/TEVA |
| 00591-3797-60 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | ACTAVIS/TEVA |
| 00591-3797-83 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | ACTAVIS/TEVA |
| 76204-0200-01 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.07 | RITEDOSE PHARMA |
| 76204-0200-25 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | RITEDOSE PHARMA |
| 76204-0200-30 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | RITEDOSE PHARMA |
| 76204-0200-60 | ALBUTEROL SUL 2.5 MG/3 ML SO | $0.05 | RITEDOSE PHARMA |
| 00472-0825-16 | ALBUTEROL SULF 2 MG/5 ML SYR | $0.05 | ACTAVIS/TEVA |
| 50383-0740-16 | ALBUTEROL SULF 2 MG/5 ML SYR | $0.10 | HI-TECH/AKORN C |
| 70752-0102-12 | ALBUTEROL SULF 2 MG/5 ML SYR | $0.07 | QUAGEN PHARMACE |
| 00378-0255-01 | ALBUTEROL SULFATE 2 MG TAB | $4.70 | MYLAN |
| 53489-0176-01 | ALBUTEROL SULFATE 2 MG TAB | $4.70 | MUTUAL PHARM CO |
| 64980-0442-01 | ALBUTEROL SULFATE 2 MG TAB | $4.70 | RISING PHARM |
| 69543-0290-10 | ALBUTEROL SULFATE 2 MG TAB | $0.99 | VIRTUS PHARMACE |
| 00378-0572-01 | ALBUTEROL SULFATE 4 MG TAB | $4.70 | MYLAN |
| 53489-0177-01 | ALBUTEROL SULFATE 4 MG TAB | $4.70 | MUTUAL PHARM CO |
| 64980-0443-01 | ALBUTEROL SULFATE 4 MG TAB | $4.70 | RISING PHARM |
| 69543-0291-10 | ALBUTEROL SULFATE 4 MG TAB | $0.99 | VIRTUS PHARMACE |
| 00378-4122-01 | ALBUTEROL SULFATE ER 4 MG TA | $1.43 | MYLAN |
| 70515-0712-01 | ALVESCO 160 MCG INHALER | $44.95 | COVIS PHARMA |
| 70515-0711-01 | ALVESCO 80 MCG INHALER | $44.95 | COVIS PHARMA |
| 00173-0869-06 | ANORO ELLIPTA 62.5-25 MCG IN | $7.24 | GLAXOSMITHKLINE |
| 00173-0869-10 | ANORO ELLIPTA 62.5-25 MCG IN | $7.03 | GLAXOSMITHKLINE |
| 63402-0675-30 | ARCAPTA NEOHALER 75 MCG CAP | $8.59 | SUNOVION PHARMA |
| 59310-0705-06 | ARMONAIR RESPICLICK 55 MCG | $169.28 | TEVA SPECIALTY |
| 00173-0874-10 | ARNUITY ELLIPTA 100 MCG INH | $5.96 | GLAXOSMITHKLINE |
| 00173-0874-14 | ARNUITY ELLIPTA 100 MCG INH | $5.96 | GLAXOSMITHKLINE |
| 00173-0876-10 | ARNUITY ELLIPTA 200 MCG INH | $7.98 | GLAXOSMITHKLINE |
| 00173-0876-14 | ARNUITY ELLIPTA 200 MCG INH | $7.98 | GLAXOSMITHKLINE |
| 00173-0888-10 | ARNUITY ELLIPTA 50 MCG INH | $5.96 | GLAXOSMITHKLINE |
| 00085-4333-01 | ASMANEX HFA 100 MCG INHALER | $14.72 | MERCK SHARP & D |
| 00085-4334-01 | ASMANEX HFA 200 MCG INHALER | $17.30 | MERCK SHARP & D |
| 00085-1461-02 | ASMANEX TWISTHALER 110 MCG # | $177.39 | MERCK SHARP & D |
| 00085-1341-02 | ASMANEX TWISTHALER 220 MCG # | $224.78 | MERCK SHARP & D |
| 00085-1341-06 | ASMANEX TWISTHALER 220 MCG # | $73.96 | MERCK SHARP & D |
| 00085-1341-07 | ASMANEX TWISTHALER 220 MCG # | $191.55 | MERCK SHARP & D |
| 00085-1341-01 | ASMANEX TWISTHALR 220 MCG #1 | $322.10 | MERCK SHARP & D |
| 00597-0087-17 | ATROVENT 17 MCG HFA INHALER | $31.89 | BOEHRINGER ING. |
| 00310-4600-12 | BEVESPI AEROSPHERE INHALER | $34.14 | ASTRAZENECA |
| 00310-4600-39 | BEVESPI AEROSPHERE INHALER | $34.14 | ASTRAZENECA |
| 00173-0859-10 | BREO ELLIPTA 100-25 MCG INH | $6.03 | GLAXOSMITHKLINE |
| 00173-0859-14 | BREO ELLIPTA 100-25 MCG INH | $4.98 | GLAXOSMITHKLINE |
| 00173-0882-10 | BREO ELLIPTA 200-25 MCG INH | $6.03 | GLAXOSMITHKLINE |
| 00173-0882-14 | BREO ELLIPTA 200-25 MCG INH | $4.98 | GLAXOSMITHKLINE |
| 63402-0911-30 | BROVANA 15 MCG/2 ML SOLUTION | $8.94 | SUNOVION PHARMA |
| 63402-0911-64 | BROVANA 15 MCG/2 ML SOLUTION | $8.94 | SUNOVION PHARMA |
| 00093-6815-73 | BUDESONIDE 0.25 MG/2 ML SUSP | $3.77 | TEVA USA |
| 00115-1687-74 | BUDESONIDE 0.25 MG/2 ML SUSP | $2.38 | IMPAX GENERICS |
| 00487-9601-01 | BUDESONIDE 0.25 MG/2 ML SUSP | $3.95 | NEPHRON CORP |
| 00487-9601-30 | BUDESONIDE 0.25 MG/2 ML SUSP | $2.38 | NEPHRON CORP |
| 00781-7515-87 | BUDESONIDE 0.25 MG/2 ML SUSP | $3.77 | SANDOZ |
| 69097-0318-87 | BUDESONIDE 0.25 MG/2 ML SUSP | $2.38 | CIPLA USA, INC. |
| 00093-6816-55 | BUDESONIDE 0.5 MG/2 ML SUSP | $4.43 | TEVA USA |
| 00093-6816-73 | BUDESONIDE 0.5 MG/2 ML SUSP | $4.43 | TEVA USA |
| 00115-1689-74 | BUDESONIDE 0.5 MG/2 ML SUSP | $2.50 | IMPAX GENERICS |
| 00487-9701-01 | BUDESONIDE 0.5 MG/2 ML SUSP | $4.65 | NEPHRON CORP |
| 00487-9701-30 | BUDESONIDE 0.5 MG/2 ML SUSP | $2.50 | NEPHRON CORP |
| 00781-7516-87 | BUDESONIDE 0.5 MG/2 ML SUSP | $4.43 | SANDOZ |
| 68180-0984-30 | BUDESONIDE 0.5 MG/2 ML SUSP | $2.50 | LUPIN PHARMACEU |
| 69097-0319-87 | BUDESONIDE 0.5 MG/2 ML SUSP | $2.50 | CIPLA USA, INC. |
| 00093-6817-73 | BUDESONIDE 1 MG/2 ML INH SUS | $9.23 | TEVA USA |
| 00781-7517-87 | BUDESONIDE 1 MG/2 ML INH SUS | $9.23 | SANDOZ |
| 69097-0321-87 | BUDESONIDE 1 MG/2 ML INH SUS | $5.21 | CIPLA USA, INC. |
| 59310-0610-31 | CINQAIR 100 MG/10 ML VIAL | $93.20 | TEVA SPECIALTY |
| 00172-6406-49 | CROMOLYN 20 MG/2 ML NEB SOLN | $2.72 | TEVA USA |
| 69784-0205-60 | CROMOLYN 20 MG/2 ML NEB SOLN | $9.04 | WOODWARD PHARMA |
| 00085-7206-01 | DULERA 100 MCG-5 MCG INHALER | $23.95 | MERCK SHARP & D |
| 00085-7206-07 | DULERA 100 MCG-5 MCG INHALER | $23.95 | MERCK SHARP & D |
| 00085-4610-01 | DULERA 200 MCG-5 MCG INHALER | $23.95 | MERCK SHARP & D |
| 00085-4610-05 | DULERA 200 MCG-5 MCG INHALER | $23.95 | MERCK SHARP & D |
| 00310-1730-30 | FASENRA 30 MG/ML SYRINGE | $4,969.18 | ASTRAZENECA |
| 00173-0602-00 | FLOVENT 100 MCG DISKUS | $4.01 | GLAXOSMITHKLINE |
| 00173-0602-02 | FLOVENT 100 MCG DISKUS | $3.21 | GLAXOSMITHKLINE |
| 00173-0601-00 | FLOVENT 250 MCG DISKUS | $5.37 | GLAXOSMITHKLINE |
| 00173-0601-02 | FLOVENT 250 MCG DISKUS | $4.30 | GLAXOSMITHKLINE |
| 00173-0600-02 | FLOVENT 50 MCG DISKUS | $3.05 | GLAXOSMITHKLINE |
| 00173-0719-20 | FLOVENT HFA 110 MCG INHALER | $21.51 | GLAXOSMITHKLINE |
| 00173-0720-20 | FLOVENT HFA 220 MCG INHALER | $33.41 | GLAXOSMITHKLINE |
| 00173-0718-20 | FLOVENT HFA 44 MCG INHALER | $18.19 | GLAXOSMITHKLINE |
| 66993-0584-97 | FLUTICASONE-SALMETEROL 100-5 | $4.75 | PRASCO LABS |
| 00093-3608-82 | FLUTICASONE-SALMETEROL 113-1 | $95.40 | TEVA USA |
| 00093-3609-82 | FLUTICASONE-SALMETEROL 232-1 | $95.40 | TEVA USA |
| 66993-0585-97 | FLUTICASONE-SALMETEROL 250-5 | $5.90 | PRASCO LABS |
| 66993-0586-97 | FLUTICASONE-SALMETEROL 500-5 | $7.76 | PRASCO LABS |
| 00093-3607-82 | FLUTICASONE-SALMETEROL 55-14 | $95.40 | TEVA USA |
| 00173-0873-06 | INCRUSE ELLIPTA 62.5 MCG INH | $10.41 | GLAXOSMITHKLINE |
| 00173-0873-10 | INCRUSE ELLIPTA 62.5 MCG INH | $11.46 | GLAXOSMITHKLINE |
| 00378-7970-52 | IPRATROPIUM BR 0.02% SOLN | $0.07 | MYLAN |
| 00378-7970-93 | IPRATROPIUM BR 0.02% SOLN | $0.07 | MYLAN |
| 00487-9801-01 | IPRATROPIUM BR 0.02% SOLN | $0.08 | NEPHRON CORP |
| 00487-9801-25 | IPRATROPIUM BR 0.02% SOLN | $0.07 | NEPHRON CORP |
| 00487-9801-30 | IPRATROPIUM BR 0.02% SOLN | $0.07 | NEPHRON CORP |
| 00487-9801-60 | IPRATROPIUM BR 0.02% SOLN | $0.07 | NEPHRON CORP |
| 00591-3798-30 | IPRATROPIUM BR 0.02% SOLN | $0.06 | ACTAVIS/TEVA |
| 00591-3798-60 | IPRATROPIUM BR 0.02% SOLN | $0.06 | ACTAVIS/TEVA |
| 00591-3798-83 | IPRATROPIUM BR 0.02% SOLN | $0.06 | ACTAVIS/TEVA |
| 00781-7157-29 | IPRATROPIUM BR 0.02% SOLN | $0.07 | SANDOZ |
| 76204-0100-01 | IPRATROPIUM BR 0.02% SOLN | $0.08 | RITEDOSE PHARMA |
| 76204-0100-25 | IPRATROPIUM BR 0.02% SOLN | $0.07 | RITEDOSE PHARMA |
| 76204-0100-30 | IPRATROPIUM BR 0.02% SOLN | $0.07 | RITEDOSE PHARMA |
| 76204-0100-60 | IPRATROPIUM BR 0.02% SOLN | $0.07 | RITEDOSE PHARMA |
| 00378-9671-30 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.17 | MYLAN |
| 00378-9671-60 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.17 | MYLAN |
| 00378-9671-93 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.17 | MYLAN |
| 00487-0201-01 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.17 | NEPHRON CORP |
| 00487-0201-03 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.10 | NEPHRON CORP |
| 00487-0201-60 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.10 | NEPHRON CORP |
| 00591-3817-39 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.13 | ACTAVIS/TEVA |
| 00591-3817-66 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.13 | ACTAVIS/TEVA |
| 00781-7146-63 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.17 | SANDOZ |
| 69097-0173-53 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.10 | CIPLA USA, INC. |
| 69097-0173-64 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.10 | CIPLA USA, INC. |
| 76204-0600-01 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.22 | RITEDOSE PHARMA |
| 76204-0600-05 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.13 | RITEDOSE PHARMA |
| 76204-0600-12 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.13 | RITEDOSE PHARMA |
| 76204-0600-30 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.13 | RITEDOSE PHARMA |
| 76204-0600-60 | IPRATROPIUM-ALBUTEROL 0.5-3( | $0.13 | RITEDOSE PHARMA |
| 00093-4145-56 | LEVALBUTEROL 0.31 MG/3 ML SO | $1.79 | TEVA USA |
| 00093-4145-64 | LEVALBUTEROL 0.31 MG/3 ML SO | $1.79 | TEVA USA |
| 66993-0021-27 | LEVALBUTEROL 0.31 MG/3 ML SO | $0.93 | PRASCO LABS |
| 76204-0700-25 | LEVALBUTEROL 0.31 MG/3 ML SO | $0.40 | RITEDOSE PHARMA |
| 00093-4146-56 | LEVALBUTEROL 0.63 MG/3 ML SO | $1.79 | TEVA USA |
| 00093-4146-64 | LEVALBUTEROL 0.63 MG/3 ML SO | $1.79 | TEVA USA |
| 00115-9931-78 | LEVALBUTEROL 0.63 MG/3 ML SO | $1.72 | IMPAX GENERICS |
| 00378-9691-52 | LEVALBUTEROL 0.63 MG/3 ML SO | $0.93 | MYLAN |
| 66993-0022-27 | LEVALBUTEROL 0.63 MG/3 ML SO | $0.93 | PRASCO LABS |
| 76204-0800-01 | LEVALBUTEROL 0.63 MG/3 ML SO | $0.53 | RITEDOSE PHARMA |
| 76204-0800-24 | LEVALBUTEROL 0.63 MG/3 ML SO | $0.83 | RITEDOSE PHARMA |
| 76204-0800-25 | LEVALBUTEROL 0.63 MG/3 ML SO | $0.40 | RITEDOSE PHARMA |
| 00093-4148-56 | LEVALBUTEROL 1.25 MG/3 ML SO | $1.79 | TEVA USA |
| 00378-9682-44 | LEVALBUTEROL 1.25 MG/3 ML SO | $1.79 | MYLAN |
| 00378-9692-52 | LEVALBUTEROL 1.25 MG/3 ML SO | $0.93 | MYLAN |
| 66993-0023-27 | LEVALBUTEROL 1.25 MG/3 ML SO | $0.93 | PRASCO LABS |
| 76204-0900-01 | LEVALBUTEROL 1.25 MG/3 ML SO | $0.53 | RITEDOSE PHARMA |
| 76204-0900-24 | LEVALBUTEROL 1.25 MG/3 ML SO | $0.83 | RITEDOSE PHARMA |
| 76204-0900-25 | LEVALBUTEROL 1.25 MG/3 ML SO | $0.40 | RITEDOSE PHARMA |
| 00378-6993-93 | LEVALBUTEROL CONC 1.25 MG/0. | $5.36 | MYLAN |
| 00591-2927-54 | LEVALBUTEROL TAR HFA 45 MCG | $3.93 | ACTAVIS/TEVA |
| 63402-0301-01 | LONHALA MAGNAIR 25 MCG REFIL | $18.88 | SUNOVION PHARMA |
| 63402-0201-00 | LONHALA MAGNAIR 25 MCG START | $18.88 | SUNOVION PHARMA |
| 00054-0259-13 | MONTELUKAST SOD 10 MG TABLET | $0.43 | ROXANE/WEST-WAR |
| 00054-0259-22 | MONTELUKAST SOD 10 MG TABLET | $0.43 | ROXANE/WEST-WAR |
| 00093-7426-10 | MONTELUKAST SOD 10 MG TABLET | $0.41 | TEVA USA |
| 00093-7426-56 | MONTELUKAST SOD 10 MG TABLET | $0.43 | TEVA USA |
| 00093-7426-98 | MONTELUKAST SOD 10 MG TABLET | $0.43 | TEVA USA |
| 00603-4655-28 | MONTELUKAST SOD 10 MG TABLET | $0.34 | QUALITEST/PAR P |
| 00781-5560-31 | MONTELUKAST SOD 10 MG TABLET | $1.31 | SANDOZ |
| 00781-5560-92 | MONTELUKAST SOD 10 MG TABLET | $1.31 | SANDOZ |
| 13668-0081-05 | MONTELUKAST SOD 10 MG TABLET | $0.75 | TORRENT PHARMAC |
| 13668-0081-30 | MONTELUKAST SOD 10 MG TABLET | $0.75 | TORRENT PHARMAC |
| 13668-0081-90 | MONTELUKAST SOD 10 MG TABLET | $0.75 | TORRENT PHARMAC |
| 16729-0119-10 | MONTELUKAST SOD 10 MG TABLET | $0.23 | ACCORD HEALTHCA |
| 16729-0119-15 | MONTELUKAST SOD 10 MG TABLET | $0.23 | ACCORD HEALTHCA |
| 16729-0119-17 | MONTELUKAST SOD 10 MG TABLET | $0.23 | ACCORD HEALTHCA |
| 27241-0018-03 | MONTELUKAST SOD 10 MG TABLET | $0.40 | AJANTA PHARMA L |
| 27241-0018-09 | MONTELUKAST SOD 10 MG TABLET | $0.40 | AJANTA PHARMA L |
| 27241-0018-90 | MONTELUKAST SOD 10 MG TABLET | $0.40 | AJANTA PHARMA L |
| 29300-0220-10 | MONTELUKAST SOD 10 MG TABLET | $0.22 | UNICHEM PHARMAC |
| 29300-0220-13 | MONTELUKAST SOD 10 MG TABLET | $0.25 | UNICHEM PHARMAC |
| 29300-0220-19 | MONTELUKAST SOD 10 MG TABLET | $0.25 | UNICHEM PHARMAC |
| 31722-0726-10 | MONTELUKAST SOD 10 MG TABLET | $0.20 | CAMBER PHARMACE |
| 31722-0726-30 | MONTELUKAST SOD 10 MG TABLET | $0.23 | CAMBER PHARMACE |
| 31722-0726-90 | MONTELUKAST SOD 10 MG TABLET | $0.20 | CAMBER PHARMACE |
| 33342-0102-07 | MONTELUKAST SOD 10 MG TABLET | $0.06 | MACLEODS PHARMA |
| 33342-0102-10 | MONTELUKAST SOD 10 MG TABLET | $0.06 | MACLEODS PHARMA |
| 33342-0102-15 | MONTELUKAST SOD 10 MG TABLET | $0.06 | MACLEODS PHARMA |
| 55111-0725-30 | MONTELUKAST SOD 10 MG TABLET | $0.43 | DR.REDDY'S LAB |
| 55111-0725-90 | MONTELUKAST SOD 10 MG TABLET | $0.43 | DR.REDDY'S LAB |
| 57237-0255-30 | MONTELUKAST SOD 10 MG TABLET | $0.06 | RISING PHARM |
| 62175-0210-32 | MONTELUKAST SOD 10 MG TABLET | $0.79 | KREMERS/LANNETT |
| 62175-0210-46 | MONTELUKAST SOD 10 MG TABLET | $0.79 | KREMERS/LANNETT |
| 65862-0574-90 | MONTELUKAST SOD 10 MG TABLET | $0.22 | AUROBINDO PHARM |
| 68001-0248-03 | MONTELUKAST SOD 10 MG TABLET | $0.41 | BLUEPOINT LABOR |
| 68001-0248-04 | MONTELUKAST SOD 10 MG TABLET | $0.43 | BLUEPOINT LABOR |
| 68001-0248-05 | MONTELUKAST SOD 10 MG TABLET | $0.43 | BLUEPOINT LABOR |
| 68001-0361-03 | MONTELUKAST SOD 10 MG TABLET | $0.13 | BLUEPOINT LABOR |
| 68001-0361-04 | MONTELUKAST SOD 10 MG TABLET | $0.13 | BLUEPOINT LABOR |
| 68001-0361-05 | MONTELUKAST SOD 10 MG TABLET | $0.16 | BLUEPOINT LABOR |
| 68645-0560-54 | MONTELUKAST SOD 10 MG TABLET | $0.43 | LEGACY PHARMACE |
| 69452-0105-13 | MONTELUKAST SOD 10 MG TABLET | $0.17 | BIONPHARMA INC. |
| 69452-0105-19 | MONTELUKAST SOD 10 MG TABLET | $0.11 | BIONPHARMA INC. |
| 69452-0105-32 | MONTELUKAST SOD 10 MG TABLET | $0.08 | BIONPHARMA INC. |
| 00093-7487-56 | MONTELUKAST SOD 4 MG GRANULE | $3.04 | TEVA USA |
| 13668-0531-94 | MONTELUKAST SOD 4 MG GRANULE | $4.50 | TORRENT PHARMAC |
| 27241-0015-31 | MONTELUKAST SOD 4 MG GRANULE | $3.00 | AJANTA PHARMA L |
| 55111-0763-03 | MONTELUKAST SOD 4 MG GRANULE | $4.53 | DR.REDDY'S LAB |
| 66993-0416-30 | MONTELUKAST SOD 4 MG GRANULE | $4.99 | PRASCO LABS |
| 00054-0288-13 | MONTELUKAST SOD 4 MG TAB CHE | $0.75 | WEST-WARD/HIKMA |
| 00054-0288-22 | MONTELUKAST SOD 4 MG TAB CHE | $0.75 | WEST-WARD/HIKMA |
| 00093-7424-56 | MONTELUKAST SOD 4 MG TAB CHE | $0.85 | TEVA USA |
| 00093-7424-98 | MONTELUKAST SOD 4 MG TAB CHE | $0.85 | TEVA USA |
| 00603-4653-16 | MONTELUKAST SOD 4 MG TAB CHE | $0.88 | PAR PHARM. |
| 00781-5554-31 | MONTELUKAST SOD 4 MG TAB CHE | $0.75 | SANDOZ |
| 00781-5554-92 | MONTELUKAST SOD 4 MG TAB CHE | $0.75 | SANDOZ |
| 13668-0079-30 | MONTELUKAST SOD 4 MG TAB CHE | $0.75 | TORRENT PHARMAC |
| 13668-0079-90 | MONTELUKAST SOD 4 MG TAB CHE | $0.75 | TORRENT PHARMAC |
| 27241-0016-03 | MONTELUKAST SOD 4 MG TAB CHE | $0.80 | AJANTA PHARMA L |
| 27241-0016-09 | MONTELUKAST SOD 4 MG TAB CHE | $0.80 | AJANTA PHARMA L |
| 31722-0727-30 | MONTELUKAST SOD 4 MG TAB CHE | $0.35 | CAMBER PHARMACE |
| 31722-0727-90 | MONTELUKAST SOD 4 MG TAB CHE | $0.34 | CAMBER PHARMACE |
| 33342-0110-07 | MONTELUKAST SOD 4 MG TAB CHE | $0.52 | MACLEODS PHARMA |
| 33342-0110-10 | MONTELUKAST SOD 4 MG TAB CHE | $0.50 | MACLEODS PHARMA |
| 57237-0212-30 | MONTELUKAST SOD 4 MG TAB CHE | $0.35 | RISING PHARM |
| 57237-0212-90 | MONTELUKAST SOD 4 MG TAB CHE | $0.34 | RISING PHARM |
| 65862-0567-90 | MONTELUKAST SOD 4 MG TAB CHE | $0.22 | AUROBINDO PHARM |
| 69452-0106-13 | MONTELUKAST SOD 4 MG TAB CHE | $0.21 | BIONPHARMA INC. |
| 69452-0106-19 | MONTELUKAST SOD 4 MG TAB CHE | $0.20 | BIONPHARMA INC. |
| 00054-0289-13 | MONTELUKAST SOD 5 MG TAB CHE | $0.85 | ROXANE/WEST-WAR |
| 00054-0289-22 | MONTELUKAST SOD 5 MG TAB CHE | $0.75 | ROXANE/WEST-WAR |
| 00093-7425-56 | MONTELUKAST SOD 5 MG TAB CHE | $0.85 | TEVA USA |
| 00093-7425-98 | MONTELUKAST SOD 5 MG TAB CHE | $0.85 | TEVA USA |
| 00781-5555-31 | MONTELUKAST SOD 5 MG TAB CHE | $0.75 | SANDOZ |
| 00781-5555-92 | MONTELUKAST SOD 5 MG TAB CHE | $0.75 | SANDOZ |
| 13668-0080-05 | MONTELUKAST SOD 5 MG TAB CHE | $0.75 | TORRENT PHARMAC |
| 13668-0080-30 | MONTELUKAST SOD 5 MG TAB CHE | $0.75 | TORRENT PHARMAC |
| 13668-0080-90 | MONTELUKAST SOD 5 MG TAB CHE | $0.75 | TORRENT PHARMAC |
| 27241-0017-03 | MONTELUKAST SOD 5 MG TAB CHE | $0.90 | AJANTA PHARMA L |
| 27241-0017-09 | MONTELUKAST SOD 5 MG TAB CHE | $0.90 | AJANTA PHARMA L |
| 31722-0728-30 | MONTELUKAST SOD 5 MG TAB CHE | $0.35 | CAMBER PHARMACE |
| 31722-0728-90 | MONTELUKAST SOD 5 MG TAB CHE | $0.34 | CAMBER PHARMACE |
| 33342-0111-07 | MONTELUKAST SOD 5 MG TAB CHE | $0.52 | MACLEODS PHARMA |
| 33342-0111-10 | MONTELUKAST SOD 5 MG TAB CHE | $0.50 | MACLEODS PHARMA |
| 57237-0213-30 | MONTELUKAST SOD 5 MG TAB CHE | $0.35 | RISING PHARM |
| 57237-0213-90 | MONTELUKAST SOD 5 MG TAB CHE | $0.34 | RISING PHARM |
| 65862-0568-90 | MONTELUKAST SOD 5 MG TAB CHE | $0.22 | AUROBINDO PHARM |
| 69452-0107-13 | MONTELUKAST SOD 5 MG TAB CHE | $0.21 | BIONPHARMA INC. |
| 69452-0107-19 | MONTELUKAST SOD 5 MG TAB CHE | $0.20 | BIONPHARMA INC. |
| 00173-0892-01 | NUCALA 100 MG/ML AUTO-INJECT | $3,021.21 | GLAXOSMITHKLINE |
| 00173-0881-01 | NUCALA 100 MG/ML POWDER VIAL | $3,021.21 | GLAXOSMITHKLINE |
| 49502-0605-30 | PERFOROMIST 20 MCG/2 ML SOLN | $8.68 | MYLAN SPECIALTY |
| 49502-0605-61 | PERFOROMIST 20 MCG/2 ML SOLN | $8.68 | MYLAN SPECIALTY |
| 59310-0579-22 | PROAIR HFA 90 MCG INHALER | $7.87 | TEVA SPECIALTY |
| 59310-0580-20 | PROAIR RESPICLICK 90 MCG INH | $62.52 | TEVA SPECIALTY |
| 00085-1132-01 | PROVENTIL HFA 90 MCG INHALER | $11.90 | MERCK SHARP & D |
| 00085-1132-04 | PROVENTIL HFA 90 MCG INHALER | $11.90 | MERCK SHARP & D |
| 00186-1988-04 | PULMICORT 0.25 MG/2 ML RESPU | $4.36 | ASTRAZENECA |
| 00186-1989-04 | PULMICORT 0.5 MG/2 ML RESPUL | $5.13 | ASTRAZENECA |
| 00186-1990-04 | PULMICORT 1 MG/2 ML RESPULE | $10.26 | ASTRAZENECA |
| 00186-0916-12 | PULMICORT 180 MCG FLEXHALER | $236.38 | ASTRAZENECA |
| 00186-0917-06 | PULMICORT 90 MCG FLEXHALER | $176.53 | ASTRAZENECA |
| 59310-0302-40 | QVAR REDIHALER 40 MCG | $17.94 | TEVA SPECIALTY |
| 59310-0304-80 | QVAR REDIHALER 80 MCG | $24.03 | TEVA SPECIALTY |
| 00173-0520-00 | SEREVENT DISKUS 50 MCG | $8.42 | GLAXOSMITHKLINE |
| 00173-0521-00 | SEREVENT DISKUS 50 MCG | $6.65 | GLAXOSMITHKLINE |
| 00006-9117-31 | SINGULAIR 10 MG TABLET | $7.61 | MERCK SHARP & D |
| 00006-9117-54 | SINGULAIR 10 MG TABLET | $7.61 | MERCK SHARP & D |
| 00597-0160-61 | SPIRIVA RESPIMAT 1.25 MCG IN | $113.81 | BOEHRINGER ING. |
| 00597-0100-31 | SPIRIVA RESPIMAT 2.5 MCG INH | $46.39 | BOEHRINGER ING. |
| 00597-0100-51 | SPIRIVA RESPIMAT 2.5 MCG INH | $18.75 | BOEHRINGER ING. |
| 00597-0100-61 | SPIRIVA RESPIMAT 2.5 MCG INH | $113.81 | BOEHRINGER ING. |
| 00597-0192-61 | STRIVERDI RESPIMAT INHAL SPR | $56.13 | BOEHRINGER ING. |
| 00186-0370-20 | SYMBICORT 160-4.5 MCG INHALE | $35.02 | ASTRAZENECA |
| 00186-0370-28 | SYMBICORT 160-4.5 MCG INHALE | $40.46 | ASTRAZENECA |
| 00186-0372-20 | SYMBICORT 80-4.5 MCG INHALER | $30.64 | ASTRAZENECA |
| 00186-0372-28 | SYMBICORT 80-4.5 MCG INHALER | $30.58 | ASTRAZENECA |
| 52244-0100-10 | THEO-24 ER 100 MG CAPSULE | $2.41 | AUXILIUM/ENDO P |
| 52244-0200-10 | THEO-24 ER 200 MG CAPSULE | $3.59 | AUXILIUM/ENDO P |
| 52244-0300-10 | THEO-24 ER 300 MG CAPSULE | $4.41 | AUXILIUM/ENDO P |
| 52244-0400-10 | THEO-24 ER 400 MG CAPSULE | $6.20 | AUXILIUM/ENDO P |
| 27808-0033-01 | THEOPHYLLINE 80 MG/15 ML SOL | $0.16 | TRIS PHARMA INC |
| 54838-0556-80 | THEOPHYLLINE 80 MG/15 ML SOL | $0.16 | SILARX/LANNETT |
| 50111-0482-02 | THEOPHYLLINE ER 200 MG TABLE | $0.41 | TEVA USA |
| 62332-0025-31 | THEOPHYLLINE ER 300 MG TAB | $3.44 | ALEMBIC PHARMAC |
| 00378-0486-01 | THEOPHYLLINE ER 400 MG TABLE | $1.22 | MYLAN |
| 42858-0701-01 | THEOPHYLLINE ER 400 MG TABLE | $1.04 | RHODES PHARMACE |
| 62332-0026-31 | THEOPHYLLINE ER 450 MG TAB | $4.84 | ALEMBIC PHARMAC |
| 42858-0702-01 | THEOPHYLLINE ER 600 MG TABLE | $1.50 | RHODES PHARMACE |
| 00173-0887-10 | TRELEGY ELLIPTA 100-62.5-25 | $9.55 | GLAXOSMITHKLINE |
| 00173-0887-14 | TRELEGY ELLIPTA 100-62.5-25 | $9.54 | GLAXOSMITHKLINE |
| 00173-0682-20 | VENTOLIN HFA 90 MCG INHALER | $3.08 | GLAXOSMITHKLINE |
| 00173-0682-24 | VENTOLIN HFA 90 MCG INHALER | $2.76 | GLAXOSMITHKLINE |
| 50242-0040-62 | XOLAIR 150 MG/1.2 ML POWDER | $1,128.48 | GENENTECH, INC. |
| 50242-0215-01 | XOLAIR 150 MG/ML SYRINGE | $1,128.48 | GENENTECH, INC. |
| 50242-0214-01 | XOLAIR 75 MG/0.5 ML SYRINGE | $1,128.48 | GENENTECH, INC. |
| 17478-0173-24 | XOPENEX 0.63 MG/3 ML SOLUTIO | $3.48 | AKORN INC. |
| 17478-0174-24 | XOPENEX 1.25 MG/3 ML SOLUTIO | $3.48 | AKORN INC. |
| 17478-0171-30 | XOPENEX CONC 1.25 MG/0.5 ML | $6.83 | AKORN INC. |
| 63402-0510-01 | XOPENEX HFA 45 MCG INHALER | $4.55 | SUNOVION PHARMA |
| 49884-0549-02 | ZAFIRLUKAST 10 MG TABLET | $1.52 | PAR PHARM. |
| 55111-0625-60 | ZAFIRLUKAST 10 MG TABLET | $1.80 | DR.REDDY'S LAB |
| 49884-0554-02 | ZAFIRLUKAST 20 MG TABLET | $1.52 | PAR PHARM. |
| 55111-0626-60 | ZAFIRLUKAST 20 MG TABLET | $1.80 | DR.REDDY'S LAB |
| 66993-0485-32 | ZILEUTON ER 600 MG TABLET | $26.82 | PRASCO LABS |
**WAC information selected from data provided by manufacturer, PBM or wholesaler reports.**