Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits — General Pharmaceutical Benefits
| PBS Item code | Drug name Form and Strength |
Pack size | Price | Manufacturer |
|---|---|---|---|---|
| 10818J | Mometasonemometasone furoate 0.1% cream, 15 g | 1 | $7.90 | AL |
| 10792B | Mometasonemometasone furoate 0.1% cream, 15 g | 1 | $7.78 | AL |
| 10815F | Mometasonemometasone furoate 0.1% cream, 15 g | 1 | $4.58 | AF,JM |
| 10818J | Mometasonemometasone furoate 0.1% cream, 15 g | 1 | $4.37 | AF,JM |
| 10792B | Mometasonemometasone furoate 0.1% cream, 15 g | 1 | $4.25 | AF,JM |
| 10819K | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $13.19 | AL |
| 10826T | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $12.37 | AL |
| 10805Q | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $11.96 | AL |
| 10804P | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $11.71 | AL |
| 10819K | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $7.69 | AF,EO |
| 10826T | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $6.87 | AF,EO |
| 10805Q | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $6.46 | AF,EO |
| 10804P | Mometasonemometasone furoate 0.1% lotion, 30 mL | 1 | $6.21 | AF,EO |
| 10812C | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $9.75 | AL |
| 10814E | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $8.52 | AL |
| 10828X | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $8.11 | AL |
| 10793C | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $7.90 | AL |
| 10791Y | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $7.78 | AL |
| 10812C | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $6.22 | AF,EO,JM |
| 10814E | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $4.99 | AF,EO,JM |
| 10828X | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $4.58 | AF,EO,JM |
| 10793C | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $4.37 | AF,EO,JM |
| 10791Y | Mometasonemometasone furoate 0.1% ointment, 15 g | 1 | $4.25 | AF,EO,JM |
| 14526M | Montelukastmontelukast 4 mg chewable tablet, 28 | 28 | $6.86 | AL,HQ,RF,SZ,TX,WG |
| 14553Y | Montelukastmontelukast 5 mg chewable tablet, 28 | 28 | $6.76 | AL,HQ,RF,SZ,TX,WG |
| 12009C | Morphinemorphine sulfate pentahydrate 30 mg tablet, 20 | 20 | $21.40 | RW |
| 12067D | Morphinemorphine sulfate pentahydrate 30 mg tablet, 20 | 20 | $21.40 | RW |
| 13579Q | Moxonidinemoxonidine 200 microgram tablet, 30 | 30 | $6.76 | AL,GO,GQ,RF,SZ,TX,TY,WG |
| 13552G | Moxonidinemoxonidine 400 microgram tablet, 30 | 30 | $8.93 | AL,GO,GQ,RF,SZ,TX,TY,WG |
| 12931N | Mycobacterium bovis BCG Danish strainMycobacterium bovis BCG Danish strain 30 mg injection, 4 vials | 1 | $596.42 | LM |
| 8649F | Mycophenolatemycophenolate mofetil 250 mg capsule, 100 | 100 | $22.28 | CR,SZ,TX |
| 13884R | Mycophenolatemycophenolate mofetil 250 mg capsule, 100 | 100 | $21.66 | CR,SZ,TX |
| 14071N | Mycophenolatemycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL | 1 | $210.05 | CR,RO |
| 8650G | Mycophenolatemycophenolate mofetil 500 mg tablet, 50 | 50 | $22.26 | AF,CR,GQ,SZ,XT |
| 14000W | Mycophenolatemycophenolate mofetil 500 mg tablet, 50 | 50 | $21.64 | AF,CR,GQ,SZ,XT |
| 13856G | Mycophenolatemycophenolate 180 mg enteric tablet, 120 | 120 | $96.81 | NV,XT |
| 13938N | Mycophenolatemycophenolate 360 mg enteric tablet, 120 | 120 | $147.36 | CR,NV,XT |
| 5176K | Naproxennaproxen 250 mg tablet, 50 | 50 | $7.18 | IX |
| 1674D | Naproxennaproxen 250 mg tablet, 50 | 50 | $7.18 | IX |
| 8298R | Naratriptannaratriptan 2.5 mg tablet, 2 | 2 | $8.58 | AS |
| 9734H | Naratriptannaratriptan 2.5 mg tablet, 2 | 2 | $8.58 | AS |
| 9316H | Nebivololnebivolol 1.25 mg tablet, 28 | 28 | $11.70 | AF,AL,FK,GQ,SZ,TX,WG |
| 13568D | Nebivololnebivolol 1.25 mg tablet, 28 | 28 | $10.47 | AF,AL,FK,GQ,SZ,TX,WG |
| 13510C | Nebivololnebivolol 5 mg tablet, 28 | 28 | $25.51 | AF,CR,FK,GQ,SZ,TX,WG |
| 13441K | Nebivololnebivolol 10 mg tablet, 28 | 28 | $28.52 | AF,CR,FK,GQ,SZ,TX,WG |
| 13550E | Nicorandilnicorandil 10 mg tablet, 60 | 1 | $11.14 | AF,TX |
| 13551F | Nicorandilnicorandil 20 mg tablet, 60 | 1 | $14.55 | AF,TX |
| 13502P | Nifedipinenifedipine 30 mg modified release tablet, 30 | 30 | $9.35 | TX |
| 13376B | Nifedipinenifedipine 60 mg modified release tablet, 30 | 30 | $11.12 | TX |
| 2732T | Nitrazepamnitrazepam 5 mg tablet, 25 | 25 | $5.17 | AF,IL |
| 14306Y | Nizatidinenizatidine 150 mg capsule, 60 | 60 | $12.90 | AF,RF |
| 14306Y | Nizatidinenizatidine 150 mg capsule, 60 | 60 | $20.49 | RW |
| 14372K | Nizatidinenizatidine 300 mg capsule, 30 | 30 | $12.90 | AF,RF |
| 14372K | Nizatidinenizatidine 300 mg capsule, 30 | 30 | $20.49 | RW |
| 13873E | Norethisteronenorethisterone 5 mg tablet, 30 | 30 | $24.67 | BN |
| 15135N | OdevixibatOdevixibat 200 microgram capsule, 30 | 30 | $5592.84 | IS |
| 15157R | OdevixibatOdevixibat 200 microgram capsule, 30 | 30 | $5592.84 | IS |
| 15185F | OdevixibatOdevixibat 200 microgram capsule, 30 | 30 | $5592.84 | IS |
| 15192N | OdevixibatOdevixibat 200 microgram capsule, 30 | 30 | $5592.84 | IS |
| 15136P | OdevixibatOdevixibat 200 microgram capsule, 30 | 30 | $5592.84 | IS |
| 15195R | OdevixibatOdevixibat 200 microgram capsule, 30 | 30 | $5592.84 | IS |
| 15183D | OdevixibatOdevixibat 400 microgram capsule, 30 | 30 | $11185.67 | IS |
| 15186G | OdevixibatOdevixibat 400 microgram capsule, 30 | 30 | $11185.67 | IS |
| 15167G | OdevixibatOdevixibat 400 microgram capsule, 30 | 30 | $11185.67 | IS |
| 15184E | OdevixibatOdevixibat 400 microgram capsule, 30 | 30 | $11185.67 | IS |
| 15151K | OdevixibatOdevixibat 400 microgram capsule, 30 | 30 | $11185.67 | IS |
| 15174P | OdevixibatOdevixibat 400 microgram capsule, 30 | 30 | $11185.67 | IS |
| 15166F | OdevixibatOdevixibat 600 microgram capsule, 30 | 30 | $16752.84 | IS |
| 15181B | OdevixibatOdevixibat 600 microgram capsule, 30 | 30 | $16752.84 | IS |
| 15193P | OdevixibatOdevixibat 600 microgram capsule, 30 | 30 | $16752.84 | IS |
| 15194Q | OdevixibatOdevixibat 600 microgram capsule, 30 | 30 | $16752.84 | IS |
| 15158T | OdevixibatOdevixibat 600 microgram capsule, 30 | 30 | $16752.84 | IS |
| 15164D | OdevixibatOdevixibat 600 microgram capsule, 30 | 30 | $16752.84 | IS |
| 15182C | OdevixibatOdevixibat 1.2 mg capsule, 30 | 30 | $33505.67 | IS |
| 15196T | OdevixibatOdevixibat 1.2 mg capsule, 30 | 30 | $33505.67 | IS |
| 15134M | OdevixibatOdevixibat 1.2 mg capsule, 30 | 30 | $33505.67 | IS |
| 15163C | OdevixibatOdevixibat 1.2 mg capsule, 30 | 30 | $33505.67 | IS |
| 15150J | OdevixibatOdevixibat 1.2 mg capsule, 30 | 30 | $33505.67 | IS |
| 15165E | OdevixibatOdevixibat 1.2 mg capsule, 30 | 30 | $33505.67 | IS |
| 12642J | Ofatumumabofatumumab 20 mg/0.4 mL injection, 0.4 mL pen device | 1 | $2109.64 | NV |
| 5567B | Ofloxacinofloxacin 0.3% eye drops, 5 mL | 1 | $10.39 | VE |
| 8383F | Ofloxacinofloxacin 0.3% eye drops, 5 mL | 1 | $10.39 | VE |
| 9294E | Olanzapineolanzapine 210 mg modified release injection [1 vial] (&) inert substance diluent [3 mL vial], 1 pack | 1 | $157.31 | PB |
| 9295F | Olanzapineolanzapine 300 mg modified release injection [1 vial] (&) inert substance diluent [3 mL vial], 1 pack | 1 | $256.01 | PB |
| 11522K | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 12170M | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 12932P | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 13783K | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 11503K | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 12169L | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 12921C | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 13782J | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 14181J | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 14689D | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 14216F | Olaparibolaparib 100 mg tablet, 56 | 56 | $3311.78 | AP |
| 11528R | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 12157W | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 12929L | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 13800H | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 11539H | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 12161C | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 12913P | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 13807Q | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 14208T | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 14687B | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 14215E | Olaparibolaparib 150 mg tablet, 56 | 56 | $3311.78 | AP |
| 13505T | Olmesartanolmesartan medoxomil 20 mg tablet, 30 | 30 | $6.58 | AF,BG,CR,MQ,RW,SZ,TX,TY,WG |
| 13505T | Olmesartanolmesartan medoxomil 20 mg tablet, 30 | 30 | $10.58 | AL |
| 13533G | Olmesartanolmesartan medoxomil 40 mg tablet, 30 | 30 | $8.56 | AF,BG,CR,MQ,RW,SZ,TX,TY,WG |
| 13533G | Olmesartanolmesartan medoxomil 40 mg tablet, 30 | 30 | $13.06 | AL |
| 13449W | Olmesartan + amlodipineolmesartan medoxomil 20 mg + amlodipine 5 mg tablet, 30 | 30 | $6.35 | AF,CR,RW,SZ,TY,WG |
| 13449W | Olmesartan + amlodipineolmesartan medoxomil 20 mg + amlodipine 5 mg tablet, 30 | 30 | $10.35 | AL |
| 13964Y | Olmesartan + amlodipineolmesartan medoxomil 40 mg + amlodipine 5 mg tablet, 30 | 30 | $8.03 | AF,CR,RW,SZ,TY,WG |
| 13964Y | Olmesartan + amlodipineolmesartan medoxomil 40 mg + amlodipine 5 mg tablet, 30 | 30 | $12.03 | AL |
| 13943W | Olmesartan + amlodipineolmesartan medoxomil 40 mg + amlodipine 10 mg tablet, 30 | 30 | $8.44 | AF,CR,RW,SZ,TY,WG |
| 13943W | Olmesartan + amlodipineolmesartan medoxomil 40 mg + amlodipine 10 mg tablet, 30 | 30 | $12.44 | AL |
| 13481M | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 20 mg + amlodipine 5 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $8.45 | AL,TX |
| 13481M | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 20 mg + amlodipine 5 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $12.45 | AF |
| 13513F | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $11.29 | AL,TX |
| 13513F | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $15.29 | AF |
| 13512E | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 25 mg tablet, 30 | 30 | $12.85 | AL,TX |
| 13512E | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 25 mg tablet, 30 | 30 | $16.85 | AF |
| 13482N | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $11.70 | AL,TX |
| 13482N | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $15.96 | AF |
| 14002Y | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 25 mg tablet, 30 | 30 | $13.23 | AL,TX |
| 14002Y | Olmesartan + amlodipine + hydrochlorothiazideolmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 25 mg tablet, 30 | 30 | $17.23 | AF |
| 13447R | Olmesartan + hydrochlorothiazideolmesartan medoxomil 20 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $6.76 | AF,CR,RW,SZ,TX,TY,WG |
| 13447R | Olmesartan + hydrochlorothiazideolmesartan medoxomil 20 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $9.76 | AL |
| 13601W | Olmesartan + hydrochlorothiazideolmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $7.53 | AF,CR,RW,SZ,TX,TY,WG |
| 13601W | Olmesartan + hydrochlorothiazideolmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg tablet, 30 | 30 | $11.39 | AL |
| 13602X | Olmesartan + hydrochlorothiazideolmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30 | 30 | $8.19 | AF,CR,RW,SZ,TX,TY,WG |
| 13602X | Olmesartan + hydrochlorothiazideolmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30 | 30 | $12.06 | AL |
| 12281J | Omeprazoleomeprazole 20 mg enteric capsule, 30 | 30 | $6.76 | AF,CR,HX,SZ,TX,WG |
| 14464G | Omeprazoleomeprazole 20 mg enteric capsule, 30 | 30 | $6.76 | AF,CR,HX,SZ,TX,WG |
| 14559G | Omeprazoleomeprazole 20 mg enteric capsule, 30 | 30 | $6.76 | AF,CR,HX,SZ,TX,WG |
| 14465H | Omeprazoleomeprazole 20 mg enteric capsule, 30 | 30 | $5.53 | AF,CR,HX,SZ,TX,WG |
| 14432N | Omeprazoleomeprazole 10 mg enteric tablet, 30 | 30 | $6.22 | PB |
| 12272X | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $6.76 | AF,RW,TX,WG |
| 14364B | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $6.76 | AF,RW,TX,WG |
| 14533X | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $6.76 | AF,RW,TX,WG |
| 14558F | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $5.53 | AF,RW,TX,WG |
| 12270T | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $13.91 | PB |
| 14397R | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $13.91 | PB |
| 14557E | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $13.91 | PB |
| 14363Y | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $12.68 | PB |
| 12270T | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $6.76 | FJ,FQ,SZ |
| 14397R | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $6.76 | FJ,FQ,SZ |
| 14557E | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $6.76 | FJ,FQ,SZ |
| 14363Y | Omeprazoleomeprazole 20 mg enteric tablet, 30 | 30 | $5.53 | FJ,FQ,SZ |
| 15268N | Opicaponeopicapone 50 mg capsule, 30 | 30 | $143.19 | XY |
| 3134Y | Oxazepamoxazepam 15 mg tablet, 25 | 25 | $5.17 | AF,AS |
| 3135B | Oxazepamoxazepam 30 mg tablet, 25 | 25 | $5.17 | AF,TX,WG |
| 3135B | Oxazepamoxazepam 30 mg tablet, 25 | 25 | $6.01 | RW |
| 3135B | Oxazepamoxazepam 30 mg tablet, 25 | 25 | $9.09 | AS |
| 8588B | Oxcarbazepineoxcarbazepine 60 mg/mL oral liquid, 250 mL | 1 | $45.68 | NV |
| 13936L | Oxcarbazepineoxcarbazepine 60 mg/mL oral liquid, 250 mL | 1 | $45.36 | NV |
| 14562K | Oxcarbazepineoxcarbazepine 150 mg tablet, 100 | 100 | $45.68 | NV |
| 14033N | Oxcarbazepineoxcarbazepine 300 mg tablet, 100 | 100 | $74.85 | NV |
| 13935K | Oxcarbazepineoxcarbazepine 600 mg tablet, 100 | 100 | $125.09 | NV |
| 13957N | Oxybutyninoxybutynin hydrochloride 5 mg tablet, 100 | 100 | $11.30 | SW |
| 13984B | Oxybutyninoxybutynin 3.9 mg/24 hours patch, 8 | 1 | $28.79 | TT |
| 12031F | Oxycodoneoxycodone hydrochloride 10 mg capsule, 20 | 20 | $16.27 | BZ,MF |
| 12074L | Oxycodoneoxycodone hydrochloride 10 mg capsule, 20 | 20 | $16.27 | BZ,MF |
| 15087C | palovarotenepalovarotene 10 mg capsule, 28 | 28 | $99981.03 | IS |
| 8020D | pancreatic extractpancreatic extract 10 000 units modified release capsule, 100 | 100 | $27.47 | GO |
| 13560Q | pancreatic extractpancreatic extract 10 000 units modified release capsule, 100 | 100 | $27.48 | GO |
| 8021E | pancreatic extractpancreatic extract 25 000 units modified release capsule, 100 | 100 | $54.74 | GO |
| 13470Y | pancreatic extractpancreatic extract 25 000 units modified release capsule, 100 | 100 | $54.77 | GO |
| 12595X | pancreatic extractpancreatic extract 35 000 units modified release capsule, 100 | 100 | $76.65 | GO |
| 13407P | pancreatic extractpancreatic extract 35 000 units modified release capsule, 100 | 100 | $76.67 | GO |
| 5453B | pancreatic extractpancreatic extract 5000 units/100 mg enteric coated granules, 20 g | 1 | $34.96 | GO |
| 13375Y | pancreatic extractpancreatic extract 5000 units/100 mg enteric coated granules, 20 g | 1 | $34.97 | GO |
| 12282K | Pantoprazolepantoprazole 40 mg enteric coated granules, 30 sachets | 30 | $23.58 | NQ |
| 14466J | Pantoprazolepantoprazole 40 mg enteric coated granules, 30 sachets | 30 | $23.58 | NQ |
| 14500E | Pantoprazolepantoprazole 40 mg enteric coated granules, 30 sachets | 30 | $23.58 | NQ |
| 14395P | Pantoprazolepantoprazole 40 mg enteric coated granules, 30 sachets | 30 | $22.35 | NQ |
| 14501F | Pantoprazolepantoprazole 20 mg enteric tablet, 30 | 30 | $5.17 | AF,BG,HQ,RA,RW,SZ,TW,TX,WG,ZS |
| 14501F | Pantoprazolepantoprazole 20 mg enteric tablet, 30 | 30 | $10.12 | NQ |
| 12277E | Pantoprazolepantoprazole 40 mg enteric tablet, 30 | 30 | $5.55 | AF,BG,CR,HQ,RA,RW,SZ,TW,TX,WG,ZS |
| 14330F | Pantoprazolepantoprazole 40 mg enteric tablet, 30 | 30 | $5.55 | AF,BG,CR,HQ,RA,RW,SZ,TW,TX,WG,ZS |
| 14362X | Pantoprazolepantoprazole 40 mg enteric tablet, 30 | 30 | $5.55 | BG,TW,TX |
| 12277E | Pantoprazolepantoprazole 40 mg enteric tablet, 30 | 30 | $10.50 | NQ |
| 14330F | Pantoprazolepantoprazole 40 mg enteric tablet, 30 | 30 | $10.50 | NQ |
| 14362X | Pantoprazolepantoprazole 40 mg enteric tablet, 30 | 30 | $10.50 | NQ |
Last updated
1 June 2026