Sulfasalazine Tablet, Delayed Release
Pricing Report NDC 59762-0104-5
View Wholesale Price per Unit, Acquisition Costs, and Historic Pricing Trends
Current Package Pricing Information
The current wholesale acquisition cost for Sulfasalazine (NDC 59762-0104-5) is $0.28404 per EA. This benchmark price is based on the National Average Drug Acquisition Cost (NADAC) and has been effective since Jun 17, 2026.
As a a human prescription drug provided by Mylan Pharmaceuticals Inc., this medication is distributed in a 1 BOTTLE in 1 CARTON / 100 TABLET, DELAYED RELEASE in 1 BOTTLE configuration. The pricing data is derived from C/I - Chain or Independent Pharmacy surveys, reflecting the actual invoice prices paid by community pharmacies to drug wholesalers.
NADAC Pricing Summary
NADAC pricing snapshot for this package NDC
Acquisition Cost $0.28404 Per EA
Pricing Unit
Effective Date
Jun 17, 2026
Billable Units
1 EA
Estimated Package Price
$0.28
Data Status
As of Jul 08, 2026
Pricing Methodology Explanation
The NADAC was calculated using information from the most recently completed pharmacy survey.
The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
Historical Pricing Trends & Acquisition Cost Benchmarks
Since Nov 2013, the NADAC wholesale price for (NDC ) has moved within a range of $0.14703 to $0.28404 per EA. Over this 12 years and 6 months period, the pricing trend reflects the shifting acquisition costs reported by retail and chain pharmacies to the Centers for Medicare and Medicaid Services (CMS). The following interactive chart and historical table detail every recorded price adjustment based on these federal surveys.
Price Range
$0.1470 - $0.2840
$0.1470 - $0.2840
Market Volatility
93.19% Variance
93.19% Variance
Latest Trend
1.03%
1.03%
| Date | Unit Price | Unit | Source | Method | Rate |
|---|---|---|---|---|---|
| Jun 17, 2026 | $0.28404 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2026 | $0.28404 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 20, 2026 | $0.28114 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 20, 2026 | $0.28114 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2026 | $0.28016 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2026 | $0.28016 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 18, 2026 | $0.27822 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 18, 2026 | $0.27822 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 18, 2026 | $0.27498 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 18, 2026 | $0.27498 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 21, 2026 | $0.27354 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 21, 2026 | $0.27354 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 17, 2025 | $0.26800 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 17, 2025 | $0.26800 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 19, 2025 | $0.26404 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 19, 2025 | $0.26404 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 22, 2025 | $0.25480 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 22, 2025 | $0.25480 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 17, 2025 | $0.25143 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 17, 2025 | $0.25143 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 20, 2025 | $0.24417 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 20, 2025 | $0.24417 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 23, 2025 | $0.23888 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 23, 2025 | $0.23888 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 18, 2025 | $0.23703 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 18, 2025 | $0.23703 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 21, 2025 | $0.24223 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 21, 2025 | $0.24223 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 23, 2025 | $0.24706 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 23, 2025 | $0.24706 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 19, 2025 | $0.24640 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 19, 2025 | $0.24640 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 19, 2025 | $0.24529 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 19, 2025 | $0.24529 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 22, 2025 | $0.24405 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 22, 2025 | $0.24405 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 18, 2024 | $0.24679 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 18, 2024 | $0.24679 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 28, 2024 | $0.25910 | EA | C/I - Chain or Independent Pharmacy | Code 3, 6 | G - Generic |
| Aug 28, 2024 | $0.25910 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Aug 28, 2024 | $0.25910 | EA | C/I - Chain or Independent Pharmacy | Code 3, 6 | G - Generic |
| Aug 28, 2024 | $0.25910 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Aug 21, 2024 | $0.18389 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 21, 2024 | $0.18389 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 17, 2024 | $0.14703 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 17, 2024 | $0.14703 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 19, 2024 | $0.23294 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 19, 2024 | $0.23294 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 22, 2024 | $0.17840 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 22, 2024 | $0.17840 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 17, 2024 | $0.17658 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 17, 2024 | $0.17658 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 20, 2024 | $0.23612 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 20, 2024 | $0.23612 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 21, 2024 | $0.23995 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 21, 2024 | $0.23995 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 17, 2024 | $0.23132 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 17, 2024 | $0.23132 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 20, 2023 | $0.23095 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 20, 2023 | $0.23095 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 22, 2023 | $0.23568 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 22, 2023 | $0.23568 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 18, 2023 | $0.23233 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 18, 2023 | $0.23233 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 20, 2023 | $0.22788 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 20, 2023 | $0.22788 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 23, 2023 | $0.24227 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 23, 2023 | $0.24227 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 19, 2023 | $0.24550 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 19, 2023 | $0.24550 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 21, 2023 | $0.23925 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 21, 2023 | $0.23925 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 17, 2023 | $0.23843 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 17, 2023 | $0.23843 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 19, 2023 | $0.23846 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 19, 2023 | $0.23846 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 22, 2023 | $0.19334 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 22, 2023 | $0.19334 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 22, 2023 | $0.19334 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 22, 2023 | $0.19334 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 22, 2023 | $0.23700 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 22, 2023 | $0.23700 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 22, 2023 | $0.23700 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 22, 2023 | $0.23700 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 18, 2023 | $0.23709 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 18, 2023 | $0.23709 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 18, 2023 | $0.23709 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 18, 2023 | $0.23709 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 21, 2022 | $0.24181 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 21, 2022 | $0.24181 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 21, 2022 | $0.24181 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 21, 2022 | $0.24181 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 23, 2022 | $0.23375 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 23, 2022 | $0.23375 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 23, 2022 | $0.23375 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 23, 2022 | $0.23375 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 19, 2022 | $0.25127 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 19, 2022 | $0.25127 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 19, 2022 | $0.25127 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 19, 2022 | $0.25127 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 21, 2022 | $0.24034 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 21, 2022 | $0.24034 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 21, 2022 | $0.24034 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 21, 2022 | $0.24034 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 17, 2022 | $0.23928 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 17, 2022 | $0.23928 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 17, 2022 | $0.23928 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 17, 2022 | $0.23928 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 20, 2022 | $0.21901 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 20, 2022 | $0.21901 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 20, 2022 | $0.21901 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 20, 2022 | $0.21901 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 22, 2022 | $0.23588 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 22, 2022 | $0.23588 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 22, 2022 | $0.23588 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 22, 2022 | $0.23588 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 18, 2022 | $0.23518 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 18, 2022 | $0.23518 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 18, 2022 | $0.23518 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 18, 2022 | $0.23518 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 20, 2022 | $0.24086 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 20, 2022 | $0.24086 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 20, 2022 | $0.24086 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 20, 2022 | $0.24086 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 23, 2022 | $0.23640 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 23, 2022 | $0.23640 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 23, 2022 | $0.23640 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 23, 2022 | $0.23640 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 19, 2022 | $0.25236 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Dec 22, 2021 | $0.24486 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 22, 2021 | $0.24486 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 22, 2021 | $0.24486 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 22, 2021 | $0.24486 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 17, 2021 | $0.23601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 17, 2021 | $0.23601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 17, 2021 | $0.23601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 17, 2021 | $0.23601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 18, 2021 | $0.23374 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Jul 21, 2021 | $0.23581 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 21, 2021 | $0.23581 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 21, 2021 | $0.23581 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 21, 2021 | $0.23581 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 23, 2021 | $0.22633 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 23, 2021 | $0.22633 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 23, 2021 | $0.22633 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 23, 2021 | $0.22633 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 19, 2021 | $0.23067 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 19, 2021 | $0.23067 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 19, 2021 | $0.23067 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 19, 2021 | $0.23067 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 21, 2021 | $0.22001 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 21, 2021 | $0.22001 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 21, 2021 | $0.22001 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 21, 2021 | $0.22001 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 17, 2021 | $0.22949 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 17, 2021 | $0.22949 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 17, 2021 | $0.22949 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 17, 2021 | $0.22949 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 17, 2021 | $0.23017 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 17, 2021 | $0.23017 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 17, 2021 | $0.23017 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 17, 2021 | $0.23017 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 20, 2021 | $0.22601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 20, 2021 | $0.22601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 20, 2021 | $0.22601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 20, 2021 | $0.22601 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 23, 2020 | $0.23617 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 23, 2020 | $0.23617 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 23, 2020 | $0.23617 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 23, 2020 | $0.23617 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 18, 2020 | $0.22755 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 18, 2020 | $0.22755 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 18, 2020 | $0.22755 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 18, 2020 | $0.22755 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 21, 2020 | $0.23258 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 21, 2020 | $0.23258 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 21, 2020 | $0.23258 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 21, 2020 | $0.23258 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 23, 2020 | $0.22066 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 23, 2020 | $0.22066 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 23, 2020 | $0.22066 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 23, 2020 | $0.22066 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 19, 2020 | $0.21933 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 19, 2020 | $0.21933 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 19, 2020 | $0.21933 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 19, 2020 | $0.21933 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 22, 2020 | $0.23414 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 22, 2020 | $0.23414 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 22, 2020 | $0.23414 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 22, 2020 | $0.23414 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2020 | $0.23858 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2020 | $0.23858 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2020 | $0.23858 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2020 | $0.23858 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2020 | $0.21418 | EA | C/I - Chain or Independent Pharmacy | Code 4, 6 | G - Generic |
| Apr 15, 2020 | $0.22765 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 18, 2020 | $0.22765 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 18, 2020 | $0.22765 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 19, 2020 | $0.22053 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 19, 2020 | $0.22053 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 22, 2020 | $0.22914 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 22, 2020 | $0.22914 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 18, 2019 | $0.23507 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 18, 2019 | $0.23507 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 20, 2019 | $0.22489 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 20, 2019 | $0.22489 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 23, 2019 | $0.23777 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 23, 2019 | $0.23777 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 18, 2019 | $0.23379 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 18, 2019 | $0.23379 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 21, 2019 | $0.22575 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 21, 2019 | $0.22575 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 17, 2019 | $0.23047 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 17, 2019 | $0.23047 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 19, 2019 | $0.23347 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 19, 2019 | $0.23347 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 22, 2019 | $0.23246 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 22, 2019 | $0.23246 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 17, 2019 | $0.22989 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 17, 2019 | $0.22989 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 20, 2019 | $0.22422 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 20, 2019 | $0.22422 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 20, 2019 | $0.22592 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 20, 2019 | $0.22592 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 23, 2019 | $0.22231 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 23, 2019 | $0.22231 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 19, 2018 | $0.22050 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 19, 2018 | $0.22050 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 21, 2018 | $0.22387 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 21, 2018 | $0.22387 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 17, 2018 | $0.22990 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 17, 2018 | $0.22990 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 19, 2018 | $0.22960 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 19, 2018 | $0.22960 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 22, 2018 | $0.22931 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 22, 2018 | $0.22931 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 18, 2018 | $0.23098 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 18, 2018 | $0.23098 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 20, 2018 | $0.23147 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 20, 2018 | $0.23147 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 23, 2018 | $0.23471 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 23, 2018 | $0.23471 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 18, 2018 | $0.22764 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 18, 2018 | $0.22764 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 21, 2018 | $0.23215 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 21, 2018 | $0.23215 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 21, 2018 | $0.23325 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 21, 2018 | $0.23325 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 17, 2018 | $0.23187 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 17, 2018 | $0.23187 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 20, 2017 | $0.22817 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 20, 2017 | $0.22817 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 22, 2017 | $0.23559 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 22, 2017 | $0.23559 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 18, 2017 | $0.23727 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 18, 2017 | $0.23727 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 20, 2017 | $0.24018 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 20, 2017 | $0.24018 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 23, 2017 | $0.23050 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 23, 2017 | $0.23050 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 19, 2017 | $0.23197 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 19, 2017 | $0.23197 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 21, 2017 | $0.23130 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 21, 2017 | $0.23130 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 17, 2017 | $0.23732 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 17, 2017 | $0.23732 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 19, 2017 | $0.23434 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 19, 2017 | $0.23434 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 22, 2017 | $0.23457 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 22, 2017 | $0.23457 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 22, 2017 | $0.23915 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 22, 2017 | $0.23915 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 18, 2017 | $0.23990 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 18, 2017 | $0.23990 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 21, 2016 | $0.23821 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 21, 2016 | $0.23821 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 23, 2016 | $0.24108 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 23, 2016 | $0.24108 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 19, 2016 | $0.24503 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 19, 2016 | $0.24503 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 21, 2016 | $0.24283 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 21, 2016 | $0.24283 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 17, 2016 | $0.24594 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 17, 2016 | $0.24594 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 20, 2016 | $0.24740 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 20, 2016 | $0.24740 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 22, 2016 | $0.23791 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 22, 2016 | $0.23791 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 18, 2016 | $0.24643 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 18, 2016 | $0.24643 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 20, 2016 | $0.24495 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 20, 2016 | $0.24495 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 23, 2016 | $0.24655 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 23, 2016 | $0.24655 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 17, 2016 | $0.24143 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 17, 2016 | $0.24143 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 20, 2016 | $0.25100 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 20, 2016 | $0.25100 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 23, 2015 | $0.24522 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 23, 2015 | $0.24522 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 18, 2015 | $0.24635 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 18, 2015 | $0.24635 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 21, 2015 | $0.24309 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 21, 2015 | $0.24309 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 23, 2015 | $0.25148 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 23, 2015 | $0.25148 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 19, 2015 | $0.25167 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 19, 2015 | $0.25167 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 22, 2015 | $0.25772 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 22, 2015 | $0.25772 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2015 | $0.25675 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 17, 2015 | $0.25675 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 20, 2015 | $0.25475 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 20, 2015 | $0.25475 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2015 | $0.25227 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 22, 2015 | $0.25227 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 18, 2015 | $0.22826 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 18, 2015 | $0.22826 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 18, 2015 | $0.21827 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 18, 2015 | $0.21827 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 21, 2015 | $0.21803 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 21, 2015 | $0.21803 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 17, 2014 | $0.20753 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 17, 2014 | $0.20753 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 19, 2014 | $0.21286 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 19, 2014 | $0.21286 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 22, 2014 | $0.21712 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Oct 22, 2014 | $0.21712 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 17, 2014 | $0.22622 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Sep 17, 2014 | $0.22622 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 20, 2014 | $0.22739 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Aug 20, 2014 | $0.22739 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 23, 2014 | $0.21254 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jul 23, 2014 | $0.21254 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 18, 2014 | $0.20943 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jun 18, 2014 | $0.20943 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 21, 2014 | $0.20848 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| May 21, 2014 | $0.20848 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 23, 2014 | $0.21839 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Apr 23, 2014 | $0.21839 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 19, 2014 | $0.22445 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Mar 19, 2014 | $0.22445 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 19, 2014 | $0.21487 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Feb 19, 2014 | $0.21487 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 22, 2014 | $0.21841 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Jan 22, 2014 | $0.21841 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 18, 2013 | $0.21056 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Dec 18, 2013 | $0.21056 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 21, 2013 | $0.21176 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
| Nov 21, 2013 | $0.21176 | EA | C/I - Chain or Independent Pharmacy | Code 1, 6 | G - Generic |
Pricing Methodology Legend
- Code 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
- Code 3: The NADAC based on survey data has been adjusted to reflect changes in published pricing, or as a result of an inquiry to the help desk.
- Code 4: The NADAC was carried forward from the previous file.
- Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
Understanding NADAC Pricing Data
The National Average Drug Acquisition Cost (NADAC) is compiled by the Centers for Medicare and Medicaid Services (CMS). This data is derived from random monthly surveys of more than 60,000 pharmacies across all 50 states.
Important Price Distinction:
The prices listed on this page represent the wholesale invoice price paid by pharmacies to acquire the drug. This is NOT the retail price paid by consumers at the pharmacy counter. Final patient costs typically include pharmacy markups, professional dispensing fees, and insurance adjustments.
NADAC Pricing Data Last Updated on: July 08, 2026
