2021 Essential Asthma Drug Lists with WAC (Wholesale Acquisition Cost) as required by NRS 439B.630
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 $33.81 GLAXOSMITHKLINE
00173-0716-22 ADVAIR HFA 115-21 MCG INHALE $27.35 GLAXOSMITHKLINE
00173-0717-20 ADVAIR HFA 230-21 MCG INHALE $44.47 GLAXOSMITHKLINE
00173-0717-22 ADVAIR HFA 230-21 MCG INHALE $40.57 GLAXOSMITHKLINE
00173-0715-20 ADVAIR HFA 45-21 MCG INHALER $27.21 GLAXOSMITHKLINE
00173-0715-22 ADVAIR HFA 45-21 MCG INHALER $27.35 GLAXOSMITHKLINE
59310-0812-06 AIRDUO RESPICLICK 113-14 MCG $350.33 TEVA SPECIALTY
59310-0822-06 AIRDUO RESPICLICK 232-14 MCG $350.33 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
69097-0142-60 ALBUTEROL HFA 90 MCG INHALER $8.62 CIPLA USA, INC.
68180-0963-01 ALBUTEROL HFA 90 MCG INHALER $4.23 LUPIN PHARMACEU
00254-1007-52 ALBUTEROL HFA 90 MCG INHALER $5.37 PAR PHARM.
45802-0088-01 ALBUTEROL HFA 90 MCG INHALER $4.23 PERRIGO CO.
66993-0019-68 ALBUTEROL HFA 90 MCG INHALER $2.00 PRASCO LABS
00093-3174-31 ALBUTEROL HFA 90 MCG INHALER $4.23 TEVA USA
00591-3467-53 ALBUTEROL SUL 0.63 MG/3 ML S $0.44 ACTAVIS/TEVA
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
00591-3468-53 ALBUTEROL SUL 1.25 MG/3 ML S $0.44 ACTAVIS/TEVA
00378-6992-52 ALBUTEROL SUL 1.25 MG/3 ML S $0.44 MYLAN
00487-9904-25 ALBUTEROL SUL 1.25 MG/3 ML S $0.44 NEPHRON CORP
00487-9904-01 ALBUTEROL SUL 1.25 MG/3 ML S $0.44 NEPHRON CORP
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
00591-3797-30 ALBUTEROL SUL 2.5 MG/3 ML SO $0.05 ACTAVIS/TEVA
60687-0395-83 ALBUTEROL SUL 2.5 MG/3 ML SO $0.07 AHP
00378-8270-91 ALBUTEROL SUL 2.5 MG/3 ML SO $0.05 MYLAN
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
00378-8270-93 ALBUTEROL SUL 2.5 MG/3 ML SO $0.07 MYLAN
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
00487-9501-01 ALBUTEROL SUL 2.5 MG/3 ML SO $0.07 NEPHRON CORP
76204-0200-60 ALBUTEROL SUL 2.5 MG/3 ML SO $0.05 RITEDOSE PHARMA
76204-0200-25 ALBUTEROL SUL 2.5 MG/3 ML SO $0.05 RITEDOSE PHARMA
76204-0200-01 ALBUTEROL SUL 2.5 MG/3 ML SO $0.07 RITEDOSE PHARMA
76204-0200-30 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
68084-0949-25 ALBUTEROL SULFATE 2 MG TAB $6.23 AHP
69238-1344-01 ALBUTEROL SULFATE 2 MG TAB $0.99 AMNEAL PHARMACE
53489-0176-01 ALBUTEROL SULFATE 2 MG TAB $1.88 MUTUAL PHARM CO
00378-0255-01 ALBUTEROL SULFATE 2 MG TAB $4.70 MYLAN
64980-0442-01 ALBUTEROL SULFATE 2 MG TAB $2.50 RISING PHARM
69543-0290-10 ALBUTEROL SULFATE 2 MG TAB $0.99 VIRTUS PHARMACE
69238-1345-01 ALBUTEROL SULFATE 4 MG TAB $0.99 AMNEAL PHARMACE
00378-0572-01 ALBUTEROL SULFATE 4 MG TAB $4.70 MYLAN
64980-0443-01 ALBUTEROL SULFATE 4 MG TAB $2.50 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 $7.46 GLAXOSMITHKLINE
00173-0869-10 ANORO ELLIPTA 62.5-25 MCG IN $7.24 GLAXOSMITHKLINE
63402-0675-30 ARCAPTA NEOHALER 75 MCG CAP $8.59 SUNOVION PHARMA
00173-0874-14 ARNUITY ELLIPTA 100 MCG INH $6.14 GLAXOSMITHKLINE
00173-0874-10 ARNUITY ELLIPTA 100 MCG INH $6.14 GLAXOSMITHKLINE
00173-0876-14 ARNUITY ELLIPTA 200 MCG INH $8.22 GLAXOSMITHKLINE
00173-0876-10 ARNUITY ELLIPTA 200 MCG INH $8.22 GLAXOSMITHKLINE
00173-0888-10 ARNUITY ELLIPTA 50 MCG INH $6.14 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
00085-2222-01 ASMANEX HFA 50 MCG INHALER $13.65 MERCK SHARP & D
00085-1461-02 ASMANEX TWISTHALER 110 MCG # $177.39 MERCK SHARP & D
00085-1341-07 ASMANEX TWISTHALER 220 MCG # $191.55 MERCK SHARP & D
00085-1341-06 ASMANEX TWISTHALER 220 MCG # $73.96 MERCK SHARP & D
00085-1341-02 ASMANEX TWISTHALER 220 MCG # $224.78 MERCK SHARP & D
00085-1341-01 ASMANEX TWISTHALR 220 MCG #1 $322.10 MERCK SHARP & D
00487-2784-01 ASTHMANEFRIN RFILL 2.25% SOL $0.83 NEPHRON CORP
00597-0087-17 ATROVENT 17 MCG HFA INHALER $33.17 BOEHRINGER ING.
00310-4600-39 BEVESPI AEROSPHERE INHALER $36.93 ASTRAZENECA
00310-4600-12 BEVESPI AEROSPHERE INHALER $36.93 ASTRAZENECA
00173-0859-14 BREO ELLIPTA 100-25 MCG INH $5.13 GLAXOSMITHKLINE
00173-0859-10 BREO ELLIPTA 100-25 MCG INH $6.21 GLAXOSMITHKLINE
00173-0882-10 BREO ELLIPTA 200-25 MCG INH $6.21 GLAXOSMITHKLINE
00173-0882-14 BREO ELLIPTA 200-25 MCG INH $5.13 GLAXOSMITHKLINE
00310-4616-12 BREZTRI AEROSPHERE INHALER $55.18 ASTRAZENECA
00310-4616-39 BREZTRI AEROSPHERE INHALER $55.18 ASTRAZENECA
63402-0911-64 BROVANA 15 MCG/2 ML SOLUTION $9.38 SUNOVION PHARMA
63402-0911-30 BROVANA 15 MCG/2 ML SOLUTION $9.38 SUNOVION PHARMA
00115-1687-74 BUDESONIDE 0.25 MG/2 ML SUSP $1.42 AMNEAL PHARMACE
69097-0318-87 BUDESONIDE 0.25 MG/2 ML SUSP $2.38 CIPLA USA, INC.
76282-0640-38 BUDESONIDE 0.25 MG/2 ML SUSP $1.09 EXELAN PHARMACE
00487-9601-30 BUDESONIDE 0.25 MG/2 ML SUSP $2.38 NEPHRON CORP
00487-9601-01 BUDESONIDE 0.25 MG/2 ML SUSP $3.95 NEPHRON CORP
00781-7515-87 BUDESONIDE 0.25 MG/2 ML SUSP $3.77 SANDOZ
00093-6815-73 BUDESONIDE 0.25 MG/2 ML SUSP $3.77 TEVA USA
00093-6815-55 BUDESONIDE 0.25 MG/2 ML SUSP $3.77 TEVA USA
00115-1689-74 BUDESONIDE 0.5 MG/2 ML SUSP $1.49 AMNEAL PHARMACE
69097-0319-87 BUDESONIDE 0.5 MG/2 ML SUSP $2.50 CIPLA USA, INC.
68180-0984-30 BUDESONIDE 0.5 MG/2 ML SUSP $0.50 LUPIN PHARMACEU
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
00093-6816-73 BUDESONIDE 0.5 MG/2 ML SUSP $4.43 TEVA USA
00093-6816-55 BUDESONIDE 0.5 MG/2 ML SUSP $4.43 TEVA USA
69097-0321-53 BUDESONIDE 1 MG/2 ML INH SUS $5.00 CIPLA USA, INC.
69097-0321-87 BUDESONIDE 1 MG/2 ML INH SUS $5.21 CIPLA USA, INC.
00781-7517-87 BUDESONIDE 1 MG/2 ML INH SUS $9.23 SANDOZ
00093-6817-73 BUDESONIDE 1 MG/2 ML INH SUS $9.23 TEVA USA
00310-7370-20 BUDESONIDE-FORMOTEROL 160-4. $24.52 ASTRAZENECA/PRA
00310-7372-20 BUDESONIDE-FORMOTEROL 80-4.5 $21.45 ASTRAZENECA/PRA
59310-0610-31 CINQAIR 100 MG/10 ML VIAL $95.10 TEVA SPECIALTY
00597-0024-02 COMBIVENT RESPIMAT 20-100 MC $110.88 BOEHRINGER ING.
00310-0088-39 DALIRESP 250 MCG TABLET $13.21 ASTRAZENECA
00310-0088-28 DALIRESP 250 MCG TABLET $13.21 ASTRAZENECA
00310-0095-90 DALIRESP 500 MCG TABLET $13.21 ASTRAZENECA
00310-0095-39 DALIRESP 500 MCG TABLET null ASTRAZENECA
00310-0095-30 DALIRESP 500 MCG TABLET $13.21 ASTRAZENECA
72124-0001-01 DUAKLIR PRESSAIR 400-12MCG I $995.00 CIRCASSIA/ASTRA
00085-7206-07 DULERA 100 MCG-5 MCG INHALER $23.95 MERCK SHARP & D
00085-7206-01 DULERA 100 MCG-5 MCG INHALER $23.95 MERCK SHARP & D
00085-4610-05 DULERA 200 MCG-5 MCG INHALER $23.95 MERCK SHARP & D
00085-4610-01 DULERA 200 MCG-5 MCG INHALER $23.95 MERCK SHARP & D
00085-2223-01 DULERA 50 MCG-5 MCG INHALER $23.95 MERCK SHARP & D
70408-0644-34 ELIXOPHYLLIN 80 MG/15 ML ELI $0.67 NOSTRUM LABORAT
00310-1730-30 FASENRA 30 MG/ML SYRINGE $5,195.03 ASTRAZENECA
00310-1830-30 FASENRA PEN 30 MG/ML $5,195.03 ASTRAZENECA
00173-0602-00 FLOVENT 100 MCG DISKUS $4.13 GLAXOSMITHKLINE
00173-0602-02 FLOVENT 100 MCG DISKUS $3.31 GLAXOSMITHKLINE
00173-0601-00 FLOVENT 250 MCG DISKUS $5.53 GLAXOSMITHKLINE
00173-0601-02 FLOVENT 250 MCG DISKUS $4.43 GLAXOSMITHKLINE
00173-0600-02 FLOVENT 50 MCG DISKUS $3.14 GLAXOSMITHKLINE
00173-0719-20 FLOVENT HFA 110 MCG INHALER $22.15 GLAXOSMITHKLINE
00173-0720-20 FLOVENT HFA 220 MCG INHALER $34.41 GLAXOSMITHKLINE
00173-0718-20 FLOVENT HFA 44 MCG INHALER $18.73 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
00173-0873-10 INCRUSE ELLIPTA 62.5 MCG INH $11.80 GLAXOSMITHKLINE
00591-3798-83 IPRATROPIUM BR 0.02% SOLN $0.06 ACTAVIS/TEVA
00591-3798-60 IPRATROPIUM BR 0.02% SOLN $0.06 ACTAVIS/TEVA
00591-3798-30 IPRATROPIUM BR 0.02% SOLN $0.06 ACTAVIS/TEVA
00378-7970-52 IPRATROPIUM BR 0.02% SOLN $0.07 MYLAN
00378-7970-93 IPRATROPIUM BR 0.02% SOLN $0.07 MYLAN
00378-7970-91 IPRATROPIUM BR 0.02% SOLN $0.07 MYLAN
00487-9801-01 IPRATROPIUM BR 0.02% SOLN $0.08 NEPHRON CORP
00487-9801-60 IPRATROPIUM BR 0.02% SOLN $0.07 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
76204-0100-30 IPRATROPIUM BR 0.02% SOLN $0.07 RITEDOSE PHARMA
76204-0100-60 IPRATROPIUM BR 0.02% SOLN $0.07 RITEDOSE PHARMA
76204-0100-25 IPRATROPIUM BR 0.02% SOLN $0.07 RITEDOSE PHARMA
47335-0706-49 IPRATROPIUM BR 0.02% SOLN $0.06 SUN PHARMA GLOB
47335-0706-54 IPRATROPIUM BR 0.02% SOLN $0.06 SUN PHARMA GLOB
00591-3817-66 IPRATROPIUM-ALBUTEROL 0.5-3( $0.13 ACTAVIS/TEVA
00591-3817-39 IPRATROPIUM-ALBUTEROL 0.5-3( $0.13 ACTAVIS/TEVA
60687-0405-83 IPRATROPIUM-ALBUTEROL 0.5-3( $0.17 AHP
69097-0840-53 IPRATROPIUM-ALBUTEROL 0.5-3( $0.22 CIPLA USA, INC.
69097-0173-64 IPRATROPIUM-ALBUTEROL 0.5-3( $0.10 CIPLA USA, INC.
69097-0173-53 IPRATROPIUM-ALBUTEROL 0.5-3( $0.10 CIPLA USA, INC.
00378-9671-30 IPRATROPIUM-ALBUTEROL 0.5-3( $0.17 MYLAN
00378-9671-93 IPRATROPIUM-ALBUTEROL 0.5-3( $0.17 MYLAN
00378-9671-60 IPRATROPIUM-ALBUTEROL 0.5-3( $0.17 MYLAN
00487-0201-03 IPRATROPIUM-ALBUTEROL 0.5-3( $0.10 NEPHRON CORP
00487-0201-01 IPRATROPIUM-ALBUTEROL 0.5-3( $0.17 NEPHRON CORP
00487-0201-60 IPRATROPIUM-ALBUTEROL 0.5-3( $0.10 NEPHRON CORP
76204-0600-12 IPRATROPIUM-ALBUTEROL 0.5-3( $0.13 RITEDOSE PHARMA
76204-0600-05 IPRATROPIUM-ALBUTEROL 0.5-3( $0.13 RITEDOSE PHARMA
76204-0600-60 IPRATROPIUM-ALBUTEROL 0.5-3( $0.13 RITEDOSE PHARMA
76204-0600-30 IPRATROPIUM-ALBUTEROL 0.5-3( $0.13 RITEDOSE PHARMA
76204-0600-01 IPRATROPIUM-ALBUTEROL 0.5-3( $0.22 RITEDOSE PHARMA
00781-7146-63 IPRATROPIUM-ALBUTEROL 0.5-3( $0.17 SANDOZ
00378-9690-52 LEVALBUTEROL 0.31 MG/3 ML SO $0.93 MYLAN
66993-0021-27 LEVALBUTEROL 0.31 MG/3 ML SO $0.93 PRASCO LABS
76204-0700-01 LEVALBUTEROL 0.31 MG/3 ML SO $0.53 RITEDOSE PHARMA
76204-0700-25 LEVALBUTEROL 0.31 MG/3 ML SO $0.40 RITEDOSE PHARMA
00115-9931-78 LEVALBUTEROL 0.63 MG/3 ML SO $0.40 AMNEAL PHARMACE
00378-9691-52 LEVALBUTEROL 0.63 MG/3 ML SO $0.93 MYLAN
16714-0095-25 LEVALBUTEROL 0.63 MG/3 ML SO $0.57 NORTHSTAR RX LL
66993-0022-27 LEVALBUTEROL 0.63 MG/3 ML SO $0.93 PRASCO LABS
76204-0800-25 LEVALBUTEROL 0.63 MG/3 ML SO $0.40 RITEDOSE PHARMA
76204-0800-01 LEVALBUTEROL 0.63 MG/3 ML SO $0.53 RITEDOSE PHARMA
00093-4146-64 LEVALBUTEROL 0.63 MG/3 ML SO $1.79 TEVA USA
00093-4146-56 LEVALBUTEROL 0.63 MG/3 ML SO $1.79 TEVA USA
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
76204-0900-25 LEVALBUTEROL 1.25 MG/3 ML SO $0.40 RITEDOSE PHARMA
00093-4148-56 LEVALBUTEROL 1.25 MG/3 ML SO $1.79 TEVA USA
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 $19.81 SUNOVION PHARMA
63402-0201-00 LONHALA MAGNAIR 25 MCG START $19.81 SUNOVION PHARMA
16729-0119-10 MONTELUKAST SOD 10 MG TABLET $0.23 ACCORD HEALTHCA
16729-0119-17 MONTELUKAST SOD 10 MG TABLET $0.23 ACCORD HEALTHCA
16729-0119-15 MONTELUKAST SOD 10 MG TABLET $0.23 ACCORD HEALTHCA
27241-0018-90 MONTELUKAST SOD 10 MG TABLET $0.40 AJANTA PHARMA L
27241-0018-03 MONTELUKAST SOD 10 MG TABLET $0.40 AJANTA PHARMA L
65862-0574-90 MONTELUKAST SOD 10 MG TABLET $0.22 AUROBINDO PHARM
69452-0105-32 MONTELUKAST SOD 10 MG TABLET $0.08 BIONPHARMA INC.
69452-0105-13 MONTELUKAST SOD 10 MG TABLET $0.17 BIONPHARMA INC.
68001-0361-03 MONTELUKAST SOD 10 MG TABLET $0.13 BLUEPOINT LABOR
68001-0361-05 MONTELUKAST SOD 10 MG TABLET $0.16 BLUEPOINT LABOR
68001-0361-04 MONTELUKAST SOD 10 MG TABLET $0.13 BLUEPOINT LABOR
31722-0726-30 MONTELUKAST SOD 10 MG TABLET $0.23 CAMBER PHARMACE
31722-0726-10 MONTELUKAST SOD 10 MG TABLET $0.20 CAMBER PHARMACE
31722-0726-90 MONTELUKAST SOD 10 MG TABLET $0.20 CAMBER PHARMACE
55111-0725-90 MONTELUKAST SOD 10 MG TABLET $0.43 DR.REDDY'S LAB
55111-0725-10 MONTELUKAST SOD 10 MG TABLET $0.42 DR.REDDY'S LAB
55111-0725-30 MONTELUKAST SOD 10 MG TABLET $0.43 DR.REDDY'S LAB
68645-0560-54 MONTELUKAST SOD 10 MG TABLET $0.43 LEGACY PHARMACE
33342-0102-15 MONTELUKAST SOD 10 MG TABLET $0.06 MACLEODS PHARMA
33342-0102-07 MONTELUKAST SOD 10 MG TABLET $0.06 MACLEODS PHARMA
33342-0102-10 MONTELUKAST SOD 10 MG TABLET $0.06 MACLEODS PHARMA
00904-6808-61 MONTELUKAST SOD 10 MG TABLET $0.33 MAJOR PHARMACEU
57237-0255-30 MONTELUKAST SOD 10 MG TABLET $0.06 RISING PHARM
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
00781-5560-31 MONTELUKAST SOD 10 MG TABLET $1.31 SANDOZ
00093-7426-56 MONTELUKAST SOD 10 MG TABLET $0.43 TEVA USA
00093-7426-10 MONTELUKAST SOD 10 MG TABLET $0.41 TEVA USA
00093-7426-98 MONTELUKAST SOD 10 MG TABLET $0.43 TEVA USA
13668-0081-30 MONTELUKAST SOD 10 MG TABLET $0.75 TORRENT PHARMAC
13668-0081-90 MONTELUKAST SOD 10 MG TABLET $0.75 TORRENT PHARMAC
13668-0081-05 MONTELUKAST SOD 10 MG TABLET $0.75 TORRENT PHARMAC
29300-0220-13 MONTELUKAST SOD 10 MG TABLET $0.25 UNICHEM PHARMAC
29300-0220-10 MONTELUKAST SOD 10 MG TABLET $0.22 UNICHEM PHARMAC
29300-0220-19 MONTELUKAST SOD 10 MG TABLET $0.25 UNICHEM PHARMAC
00143-9649-09 MONTELUKAST SOD 10 MG TABLET $0.43 WEST-WARD/HIKMA
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
00093-7487-56 MONTELUKAST SOD 4 MG GRANULE $3.04 TEVA USA
13668-0531-94 MONTELUKAST SOD 4 MG GRANULE $4.50 TORRENT PHARMAC
27241-0016-03 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
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.
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
57237-0212-90 MONTELUKAST SOD 4 MG TAB CHE $0.34 RISING PHARM
57237-0212-30 MONTELUKAST SOD 4 MG TAB CHE $0.35 RISING PHARM
00781-5554-31 MONTELUKAST SOD 4 MG TAB CHE $0.75 SANDOZ
00093-7424-98 MONTELUKAST SOD 4 MG TAB CHE $0.85 TEVA USA
00093-7424-56 MONTELUKAST SOD 4 MG TAB CHE $0.85 TEVA USA
13668-0079-90 MONTELUKAST SOD 4 MG TAB CHE $0.75 TORRENT PHARMAC
13668-0079-30 MONTELUKAST SOD 4 MG TAB CHE $0.75 TORRENT PHARMAC
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
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
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.
31722-0728-90 MONTELUKAST SOD 5 MG TAB CHE $0.34 CAMBER PHARMACE
31722-0728-30 MONTELUKAST SOD 5 MG TAB CHE $0.35 CAMBER PHARMACE
62175-0205-46 MONTELUKAST SOD 5 MG TAB CHE $0.79 KREMERS/LANNETT
62175-0205-32 MONTELUKAST SOD 5 MG TAB CHE $0.79 KREMERS/LANNETT
62175-0205-43 MONTELUKAST SOD 5 MG TAB CHE $0.79 KREMERS/LANNETT
33342-0111-10 MONTELUKAST SOD 5 MG TAB CHE $0.50 MACLEODS PHARMA
33342-0111-07 MONTELUKAST SOD 5 MG TAB CHE $0.52 MACLEODS PHARMA
57237-0213-90 MONTELUKAST SOD 5 MG TAB CHE $0.34 RISING PHARM
57237-0213-30 MONTELUKAST SOD 5 MG TAB CHE $0.35 RISING PHARM
00054-0289-22 MONTELUKAST SOD 5 MG TAB CHE $0.75 ROXANE/WEST-WAR
00054-0289-13 MONTELUKAST SOD 5 MG TAB CHE $0.85 ROXANE/WEST-WAR
00781-5555-31 MONTELUKAST SOD 5 MG TAB CHE $0.75 SANDOZ
00781-5555-92 MONTELUKAST SOD 5 MG TAB CHE $0.75 SANDOZ
00093-7425-98 MONTELUKAST SOD 5 MG TAB CHE $0.85 TEVA USA
00093-7425-56 MONTELUKAST SOD 5 MG TAB CHE $0.85 TEVA USA
13668-0080-05 MONTELUKAST SOD 5 MG TAB CHE $0.75 TORRENT PHARMAC
13668-0080-90 MONTELUKAST SOD 5 MG TAB CHE $0.75 TORRENT PHARMAC
13668-0080-30 MONTELUKAST SOD 5 MG TAB CHE $0.75 TORRENT PHARMAC
00143-9650-09 MONTELUKAST SOD 5 MG TAB CHE $0.79 WEST-WARD/HIKMA
00173-0892-01 NUCALA 100 MG/ML AUTO-INJECT $3,120.19 GLAXOSMITHKLINE
00173-0881-01 NUCALA 100 MG/ML POWDER VIAL $3,120.19 GLAXOSMITHKLINE
00173-0892-42 NUCALA 100 MG/ML SYRINGE $3,120.19 GLAXOSMITHKLINE
49502-0605-30 PERFOROMIST 20 MCG/2 ML SOLN $9.29 MYLAN SPECIALTY
49502-0605-61 PERFOROMIST 20 MCG/2 ML SOLN $9.29 MYLAN SPECIALTY
59310-0117-20 PROAIR DIGIHALER 90 MCG INHA $146.67 TEVA 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
00085-1132-04 PROVENTIL HFA 90 MCG INHALER $11.90 MERCK SHARP & D
00085-1132-01 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 $256.89 ASTRAZENECA
00186-0917-06 PULMICORT 90 MCG FLEXHALER $191.84 ASTRAZENECA
59310-0302-40 QVAR REDIHALER 40 MCG $18.84 TEVA SPECIALTY
59310-0304-80 QVAR REDIHALER 80 MCG $25.23 TEVA SPECIALTY
63402-0815-06 SEEBRI NEOHALER 15.6 MCG INH $6.57 SUNOVION PHARMA
00173-0521-00 SEREVENT DISKUS 50 MCG $6.85 GLAXOSMITHKLINE
00173-0520-00 SEREVENT DISKUS 50 MCG $8.67 GLAXOSMITHKLINE
00006-9117-54 SINGULAIR 10 MG TABLET $7.61 MERCK SHARP & D
00006-9117-31 SINGULAIR 10 MG TABLET $7.61 MERCK SHARP & D
00597-0075-75 SPIRIVA 18 MCG CP-HANDIHALER $18.93 BOEHRINGER ING.
00597-0075-41 SPIRIVA 18 MCG CP-HANDIHALER $15.93 BOEHRINGER ING.
00597-0075-47 SPIRIVA 18 MCG CP-HANDIHALER $15.93 BOEHRINGER ING.
00597-0160-61 SPIRIVA RESPIMAT 1.25 MCG IN $119.50 BOEHRINGER ING.
00597-0100-51 SPIRIVA RESPIMAT 2.5 MCG INH $18.75 BOEHRINGER ING.
00597-0100-61 SPIRIVA RESPIMAT 2.5 MCG INH $119.50 BOEHRINGER ING.
00597-0155-31 STIOLTO RESPIMAT INHAL SPRAY $42.96 BOEHRINGER ING.
00597-0155-61 STIOLTO RESPIMAT INHAL SPRAY $109.60 BOEHRINGER ING.
00597-0155-70 STIOLTO RESPIMAT INHAL SPRAY $18.75 BOEHRINGER ING.
00597-0192-61 STRIVERDI RESPIMAT INHAL SPR $58.38 BOEHRINGER ING.
00186-0370-20 SYMBICORT 160-4.5 MCG INHALE $36.44 ASTRAZENECA
00186-0370-28 SYMBICORT 160-4.5 MCG INHALE $42.09 ASTRAZENECA
00186-0372-20 SYMBICORT 80-4.5 MCG INHALER $31.88 ASTRAZENECA
00186-0372-28 SYMBICORT 80-4.5 MCG INHALER $31.82 ASTRAZENECA
00143-9746-10 TERBUTALINE SULF 1 MG/ML VIA $4.00 WEST-WARD/HIKMA
62559-0721-01 TERBUTALINE SULFATE 2.5 MG T $2.50 ANI PHARMACEUTI
00115-2611-01 TERBUTALINE SULFATE 2.5 MG T $4.35 IMPAX/AMNEAL
00527-1318-01 TERBUTALINE SULFATE 2.5 MG T $4.35 LANNETT CO. INC
00115-2622-01 TERBUTALINE SULFATE 5 MG TAB $3.40 AMNEAL PHARMACE
62559-0722-01 TERBUTALINE SULFATE 5 MG TAB $3.05 ANI PHARMACEUTI
00527-1311-01 TERBUTALINE SULFATE 5 MG TAB $5.32 LANNETT CO. INC
24979-0133-01 TERBUTALINE SULFATE 5 MG TAB $2.50 TWI PHARMACEUTI
52244-0100-10 THEO-24 ER 100 MG CAPSULE $2.65 AUXILIUM/ENDO P
52244-0200-10 THEO-24 ER 200 MG CAPSULE $3.94 AUXILIUM/ENDO P
52244-0300-10 THEO-24 ER 300 MG CAPSULE $4.84 AUXILIUM/ENDO P
52244-0400-10 THEO-24 ER 400 MG CAPSULE $6.82 AUXILIUM/ENDO P
00121-0820-16 THEOPHYLLINE 80 MG/15 ML SOL $0.16 PHARMACEUTICAL
27808-0033-01 THEOPHYLLINE 80 MG/15 ML SOL $0.16 TRIS PHARMA INC
50111-0483-01 THEOPHYLLINE ER 100 MG TABLE $0.35 TEVA USA
62332-0025-31 THEOPHYLLINE ER 300 MG TAB $3.44 ALEMBIC PHARMAC
68462-0380-01 THEOPHYLLINE ER 400 MG TABLE $1.22 GLENMARK PHARMA
00378-0486-01 THEOPHYLLINE ER 400 MG TABLE $1.22 MYLAN
29033-0001-01 THEOPHYLLINE ER 400 MG TABLE $1.22 NOSTRUM LABORAT
42858-0701-01 THEOPHYLLINE ER 400 MG TABLE $1.04 RHODES PHARMACE
62332-0026-31 THEOPHYLLINE ER 450 MG TAB $4.84 ALEMBIC PHARMAC
68462-0356-01 THEOPHYLLINE ER 600 MG TABLE $1.77 GLENMARK PHARMA
00378-0487-01 THEOPHYLLINE ER 600 MG TABLE $1.77 MYLAN
29033-0002-01 THEOPHYLLINE ER 600 MG TABLE $1.77 NOSTRUM LABORAT
42858-0702-01 THEOPHYLLINE ER 600 MG TABLE $1.50 RHODES PHARMACE
00173-0887-10 TRELEGY ELLIPTA 100-62.5-25 $10.03 GLAXOSMITHKLINE
00173-0887-14 TRELEGY ELLIPTA 100-62.5-25 $10.02 GLAXOSMITHKLINE
00173-0893-14 TRELEGY ELLIPTA 200-62.5-25 $10.02 GLAXOSMITHKLINE
00173-0893-10 TRELEGY ELLIPTA 200-62.5-25 $10.03 GLAXOSMITHKLINE
00310-0800-60 TUDORZA PRESSAIR 400 MCG INH $351.75 ASTRAZENECA
72124-0002-01 TUDORZA PRESSAIR 400 MCG INH $571.48 CIRCASSIA/ASTRA
72124-0002-02 TUDORZA PRESSAIR 400 MCG INH $285.74 CIRCASSIA/ASTRA
63402-0681-60 UTIBRON NEOHALER 27.5-15.6 M $6.12 SUNOVION PHARMA
00173-0682-20 VENTOLIN HFA 90 MCG INHALER $3.08 GLAXOSMITHKLINE
00173-0682-24 VENTOLIN HFA 90 MCG INHALER $2.76 GLAXOSMITHKLINE
00378-9320-32 WIXELA 100-50 INHUB $1.56 MYLAN
00378-9321-32 WIXELA 250-50 INHUB $1.94 MYLAN
00378-9322-32 WIXELA 500-50 INHUB $2.55 MYLAN
50242-0040-62 XOLAIR 150 MG/1.2 ML POWDER $1,162.34 GENENTECH, INC.
50242-0215-01 XOLAIR 150 MG/ML SYRINGE $1,162.34 GENENTECH, INC.
50242-0214-01 XOLAIR 75 MG/0.5 ML SYRINGE $1,162.34 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.
63402-0510-01 XOPENEX HFA 45 MCG INHALER $4.55 SUNOVION PHARMA
49502-0806-93 YUPELRI 175 MCG/3 ML SOLUTIO $12.57 MYLAN SPECIALTY
31722-0007-60 ZAFIRLUKAST 10 MG TABLET $1.23 CAMBER PHARMACE
55111-0625-60 ZAFIRLUKAST 10 MG TABLET $1.80 DR.REDDY'S LAB
49884-0549-02 ZAFIRLUKAST 10 MG TABLET $1.52 PAR PHARM.
55111-0626-60 ZAFIRLUKAST 20 MG TABLET $1.80 DR.REDDY'S LAB
49884-0554-02 ZAFIRLUKAST 20 MG TABLET $1.52 PAR PHARM.
49884-0723-08 ZILEUTON ER 600 MG TABLET $25.06 PAR PHARM.
66993-0485-32 ZILEUTON ER 600 MG TABLET $26.82 PRASCO LABS
10122-0901-12 ZYFLO 600 MG FILMTAB $31.33 CHIESI USA, INC

**WAC information selected from data provided by manufacturer, PBM or wholesaler reports.**