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× Placeholder ACETAMINOPHEN 500MG TAB WH RND 50---BRAND: TYLENOL XS 500MG TAB 50---MFR: GERI-CARE PHARMACEUTICAL---NDC: 57896-0204-05 $1.70
$1.70
× Placeholder CEFTRIAXONE SODIUM 2GM RECONSTITUTED INJ YL 1X10VL---BRAND: ROCEPHIN 2GM INJ 1X10VL (14299---MFR: SANDOZ SERVICES INC---NDC: 00781-3209-95 $47.40
$47.40
× CEFTRIAXONE SODIUM SOL 1 GM---(ROCEPHIN INJ)---SIZE---10X1EA---MFR---SANDOZ---NDC---00781-3208-95 CEFTRIAXONE SODIUM SOL 1 GM---(ROCEPHIN INJ)---SIZE---10X1EA---MFR---SANDOZ---NDC---00781-3208-95 $20.01
$20.01
× Placeholder SODIUM CHLORIDE 0.9% NEBULIZING S---(SODIUM CHLORIDE)---SIZE---30X3ML---MFR---NEPHRO---NDC---00487-9301-33 $12.24
$12.24
× Placeholder SODIUM CHLORIDE 0.9% NEBULIZING S---(SODIUM CHLORIDE)---SIZE---100X3ML---MFR---NEPHRO---NDC---00487-9301-03 $30.74
$30.74
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Subtotal $112.09
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Total $112.09
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