Maricopa County
Bid 16018-RFP
5
Solicitation 16018-RFP
PHARMACY BENEFITS MANAGER SERVICES
Bid Designation: Public
Maricopa County
6
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Maricopa County
Bid 16018-RFP
5
Bid 16018-RFP
PHARMACY BENEFITS MANAGER SERVICES
Bid Number 16018-RFP
Bid Title PHARMACY BENEFITS MANAGER SERVICES
Bid Start Date
Oct 22, 2015 7:56:43 AM MST
Bid End Date
Jan 8, 2016 2:00:00 PM MST
Question & Answer
End Date
Nov 16, 2015 11:00:00 AM MST
Bid Contact Steve Dahle
Strategic Team Manager
602-506-3450
[email protected]
Pre-Bid Conference Nov 12, 2015 9:00:00 AM MST
Attendance is mandatory
Location: THERE WILL BE A MANDATORY PRE-PROPOSAL CONFERENCE ON NOVEMBER 12, 2015 AT 9:00
AM, AZ ARIZONA TIME, AT THE MARICOPA COUNTY OFFICE OF PROCUREMENT SERVICES, 320 WEST
LINCOLN STREET, PHOENIX, ARIZONA 85003
Addendum # 1
New Documents 16018-Solicitation Addendum 1 11-24-15.doc
Removed Documents 16018-Solicitation.doc
Previous End Date Dec 18, 2015 2:00:00 PM MST
New End Date Jan 8, 2016 2:00:00 PM MST
Changes were made to the following items:
PHARMACY BENEFITS MANAGER SERVICES Addendum # 2
New Documents 16018- Questions and Answers Addendum 2 12-08-15 .docx
16018-Attachment A, A-1, A-2, A-3 and A-4 Addendum 2 12-08-15.xlsx
16018-Pre-Proposal Meeting Attendees List Addendum 2 12-08-15.pdf
16018-Solicitation Addendum 2 12-08-15.doc
Removed Documents 16018-Attachment A Pricing Page.xlsx
16018-Solicitation Addendum 1 11-24-15.doc
Changes were made to the following items:
PHARMACY BENEFITS MANAGER SERVICES Description
CONTRACTOR shall provide the prescription benefit management services described in this proposal and/or as otherwise mutually
agreed to by the parties in writing, including, but not necessarily limited to, general support and consultative services regarding
pharmacy benefit design and implementation, formulary management, network and rebate management, administrative and claims
processing services, standard reporting packages, marketing, customer service, quality management and utilization management
functions. In addition, CONTRACTOR may develop and implement certain additional clinical intervention and cost-saving (e.g.
12/8/2015
1:11tablet
PM splitting) programs that may be desired by the County, subject to terms and conditions to be agreed in writing between
voluntary
the parties. CONTRACTOR shall manage the current pharmacy benefit plan designs (multiple-tier coinsurance plan with minimum
p. 2
Description
CONTRACTOR shall provide the prescription benefit management services described in this proposal and/or as otherwise mutually
County
agreed to by the parties in writing, including, but not necessarilyMaricopa
limited to,
general support and consultative services regarding Bid 16018-RFP
pharmacy benefit design and implementation, formulary management, network and rebate management, administrative and claims
processing services, standard reporting packages, marketing, customer service, quality management and utilization management
functions. In addition, CONTRACTOR may develop and implement certain additional clinical intervention and cost-saving (e.g.
voluntary tablet splitting) programs that may be desired by the County, subject to terms and conditions to be agreed in writing between
the parties. CONTRACTOR shall manage the current pharmacy benefit plan designs (multiple-tier coinsurance plan with minimum
and maximum costs per tier, and a multiple-tier pharmacy reimbursement account) or future innovative plan designs, Notwithstanding
the foregoing or any termination rights set forth in this Agreement, CONTRACTOR may immediately terminate or refrain from
implementing any formulary management or other clinical program services in any geographic area (in their entirety or for specific
drugs only) if, in Contractor’s sole determination, the implementation or continued provision of such services is or may be in violation of
applicable laws, rules, or regulations governing the practice of pharmacy or prescription benefits management, or may otherwise
present an issue related to the practice of pharmacy or prescriptions benefits management.
Added on Nov 24, 2015:
ADDENDUM ONE (DATED 11/24/15) CHANGE IN CLOSING DATE TO JANAURY 8, 2016.
Added on Dec 8, 2015:
ADDENDUM 2 (DTD 12/8/15) CHANGES TO TABLE OF CONTENTS, SECTION 5.6, SECTION 5.6.20, ATTACHMENT A, A-1, A-2, A-3 A-4,
EXHIBIT 10, ATTENDEES LIST, AND QUESTIONS AND ANSWERS
Addendum # 1
Addendum # 2
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Maricopa County
Bid 16018-RFP
ADDENDUM 2 (DTD 12/8/15) CHANGES TO TABLE OF CONTENTS, SECTION 5.6, SECTION 5.6.20,
ATTACHMENT A, A-1, A-2, A-3 A-4, EXHIBIT 10, ATTENDEES LIST, AND QUESTIONS AND ANSWERS
ADDENDUM #1 (DTD. 11/24/15) SEE REVISED OPENING DATE ON COVER PAGE AND SECTION 5.1.
NOTICE OF SOLICITATION
REQUEST FOR PROPOSAL FOR:
SERIAL 16018-RFP
PHARMACY BENEFIT MANAGER SERVICES (USC)
Notice is hereby given sealed proposals will be received by the Office of Procurement Services, 320 West Lincoln
Street, Phoenix, Arizona 85003-2494, until 2:00 P.M. Arizona time on DECEMBER 18, 2015 JANUARY 8, 2016
for the furnishing of the following services for Maricopa County. Proposals will be opened by the Chief
Procurement Officer (or designated representative) at an open, public meeting at the above time and place.
All Proposals must be signed, sealed and addressed to the Office of Procurement Services, 320 West Lincoln Street,
Phoenix, Arizona 85003-2494, and marked “SERIAL 16018-RFP REQUEST FOR PROPOSAL FOR
PHARMACY BENEFIT MANAGER SERVICES.”
The Maricopa County Procurement Code (“The Code”) governs this procurement and is incorporated by this
reference. Any protest concerning this Request for Proposal must be filed with the Procurement Officer in
accordance with Section MC1-905 of the Code.
ALL ADMINISTRATIVE INFORMATION CONCERNING THIS REQUEST FOR PROPOSAL CAN BE
LOCATED AT http://www.maricopa.gov/procurement/ ANY ADDENDA TO THIS REQUEST FOR
PROPOSAL WILL BE POSTED ON THE MARICOPA COUNTY OFFICE OF PROCUREMENT
SERVICES WEB SITE UNDER THE SOLICITATION SERIAL NUMBER.
PROPOSAL ENVELOPES WITH INSUFFICIENT POSTAGE WILL NOT BE ACCEPTED BY THE
MARICOPA COUNTY OFFICE OF PROCUREMENT SERVICES
DIRECT ALL INQUIRIES TO:
STEVE DAHLE
PROCUREMENT OFFICER
TELEPHONE: (602) 506-3450
EMAIL: [email protected]
THERE WILL BE A MANDATORY PRE-PROPOSAL CONFERENCE ON NOVEMBER 12, 2015 AT 9:00
ARIZONA TIME, AT THE MARICOPA COUNTY OFFICE OF PROCUREMENT SERVICES, 320 WEST
LINCOLN STREET, PHOENIX, ARIZONA 85003
NOTE: MARICOPA COUNTY PUBLISHES ITS SOLICITATIONS ONLINE AND THEY ARE AVAILABLE
FOR VIEWING AND/OR DOWNLOADING AT THE FOLLOWING INTERNET ADDRESS:
http://www.maricopa.gov/procurement/solicitation.aspx
IF THIS DOCUMENT WAS DOWNLOADED FROM THE INTERNET, CONTACT THE
PROCUREMENT OFFICER FOR ANY REFERENCED DRAWINGS.
VENDORS MUST ACKNOWLEDGE RECEIPT OF THIS ADDENDUM WITH THEIR BID
Signature:
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Date:
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TABLE OF CONTENTS
NOTICE
TABLE OF CONTENTS
SECTIONS:
1.0
INTRODUCTION, BACKGROUND AND INTENT
2.0
SCOPE OF WORK
3.0
SPECIAL TERMS & CONDITIONS
ATTACHMENTS:
ATTACHMENT A
PRICING (MARICOPA COUNTY ONLY)
ATTACHMENT A-1
RETAIL ACQUISITION PRICING (MARICOPA COUNTY ONLY)
ATTACHMENT A-2
RETAIL PRICING GENERIC MAIL ORDER ACQUISITION PRICING
(MARICOPA COUNTY ONLY)
ATTACHMENT A-3
SPECIALTY DRUG ACQUISITION PRICING (MARICOPA COUNTY ONLY)
ATTACHMENT A-4
US COMMUNITIES PRICING MATRIX (DUPLICATE AS NECESSARY)
ATTACHMENT B
AGREEMENT/SIGNATURE PAGE
ATTACHMENT C
REFERENCES
ATTACHMENT D
SUPPLIER QUALIFICATIONS COMMITMENTS
U.S. COMMUNITIES ADMINISTRATION AGREEMENT INSTRUCTIONS
SUPPLIER WORKSHEET
NEW SUPPLIER IMPLEMENTATION CHECKLIST
SUPPLIER INFORMATION
ATTACHMENT E
VENDOR QUALIFICATIONS QUESTIONNAIRE
ATTACHMENT F
ZIP CODE GEO ACCESS FOR NETWORK
ATTACHMENT G
HIPAA (BUSINESS ASSOCIATE AGREEMENT)
EXHIBITS:
EXHIBIT 1
VENDOR REGISTRATION PROCEDURES
EXHIBIT 2
LETTER OF TRANSMITTAL SAMPLE
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EXHIBIT 3
DRAFT CONTRACT
EXHIBIT 4
MASTER INTERGOVERNMENTAL COOPERATIVE
PURCHASING AGREEMENT (MICPA)
EXHIBIT 5
ADMINISTRATION AGREEMENT
EXHIBIT 6
STATE NOTICE ADDENDUM
EXHIBIT 7
FEMA STANDARD TERMS AND CONDITIONS ADDENDUM
EXHIBIT 8
COMMUNITY DEVELOPMENT BLOCK GRANT ADDENDUM
EXHIBIT 9
INSURANCE CERTIFICATE EXAMPLE
EXHIBIT 10
12 MONTH MARICOPA COUNTY PRESCRIPTION ACTIVITY
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Bid 16018-RFP
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REQUEST FOR PROPOSAL FOR
1.0
PHARMACY BENEFIT MANAGER SERVICES
INTRODUCTION, BACKGROUND AND INTENT:
1.1
MASTER AGREEMENT
Maricopa County, AZ (herein “Lead Public Agency”) on behalf of itself and all states, local
governments, school districts, and higher education institutions in the United States of America,
and other government agencies and nonprofit organizations (herein “Participating Public
Agencies”) is soliciting proposals from qualified suppliers to enter into a Master Agreement for a
complete line of Pharmacy Benefit Manager Services (herein “Products and Services”).
ALL PRODUCTS OFFERED MUST BE NEW, UNUSED, LATEST DESIGN AND
TECHNOLOGY UNLESS OTHERWISE SPECIFIED.
1.2
OBJECTIVES
A. Provide a comprehensive competitively solicited Master Agreement offering Products and
Services to Participating Public Agencies;
B. Establish the Master Agreement as a Supplier’s primary offering to Participating Public
Agencies;
C. Achieve cost savings for Suppliers and Participating Public Agencies through a single
competitive solicitation process that eliminates the need for multiple bids or proposals;
D. Combine the volumes of Participating Public Agencies to achieve cost effective pricing;
E. Reduce the administrative and overhead costs of Suppliers and Participating Public Agencies
through state of the art ordering and delivery systems;
F.
1.3
Provide Participating Public Agencies with environmentally responsible products and
services.
GENERAL DEFINITION OF PRODUCTS AND/OR SERVICES
CONTRACTORS are to propose the broadest prescription benefit management services they
offer. Therefore, the Contractors should have demonstrated experience in providing the Products
and Services as defined in Section 2.0 of this RFP, including, but not necessarily limited to,
general support and consultative services regarding pharmacy benefit design and implementation,
formulary management, network and rebate management, administrative and claims processing
services, standard reporting packages, marketing, customer service, quality management and
utilization management functions and any related products, services and solutions available from
CONTRACTOR.
1.4
U.S. COMMUNITIES
U.S. Communities Government Purchasing Alliance (herein “U.S. Communities”) assists
Participating Public Agencies to reduce the cost of purchased goods through strategic sourcing
that combines the volumes and the purchasing power of public agencies nationwide. This is
accomplished through an award of competitively solicited contracts for high quality products and
services by large and well recognized public agencies (herein “Lead Public Agencies”). The
contracts provide for use by not only the respective Lead Public Agency, but also by other
Participating Public Agencies.
1.4.1
National Sponsors
U.S. Communities is jointly sponsored by the National Association of Counties (NACo),
the National League of Cities (NLC), the Association of School Business Officials
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International (ASBO), the United States Conference of Mayors (USCM). (herein
“National Sponsors”). Additionally, the National Governors Association (NGA) has
recently become a sponsor.
1.4.2
Advisory Board
The U.S. Communities Advisory Board is made up of key government purchasing
officials from across the United States.
Each Advisory Board Member is expected to actively participate in product bids and
selection, participate in policy direction, and share expertise and purchasing innovations.
Current U.S. Communities Advisory Board Members
Auburn University, AL
City and County of Denver, CO
City of Chicago, IL
City of Houston, TX
City of Kansas City, MO
City of Los Angeles, CA
City of San Antonio, TX
City of Seattle, WA
Cobb County, GA
Denver Public Schools, CO
Emory University, GA
Fairfax County, VA
Fresno Unified School District, CA
Great Valley School District, PA
Harford County Public Schools, MD
1.4.3
Hennepin County, MN
Los Angeles County, CA
Maricopa County, AZ
Miami-Dade County, FL
Nassau BOCES, NY
North Carolina State University, NC
Ocean City, NJ
Onondaga County, NY
Port of Portland, OR
Prince William County Schools, VA
Salem-Keizer School District, OR
San Diego Unified School District, CA
State of Iowa
The School District of Collier County, FL
Participating Public Agencies
Today more than 55,000 public agencies utilize U.S. Communities contracts and
suppliers to procure over $1.8 Billion Dollars in products and services annually. Each
month more than 500 new public agencies register to participate. The continuing rapid
growth of public agency participation is fueled by the program's proven track record of
providing public agencies unparalleled value.
The Supplier(s) must communicate directly with any Participating Public Agency
concerning the placement of orders, issuance of the purchase order, contractual disputes,
invoicing, and payment.
Maricopa County is acting as "Contracting Agent" for the Participating Public Agencies
and shall not be held liable for any costs, damages, expenses, fees, liabilities, etc.
incurred by any other Participating Public Agency.
Each Participating Public Agency enters into a Master Intergovernmental Cooperative
Purchasing Agreement (MICPA) outlining the terms and conditions that allow access to
the Lead Public Agencies’ Master Agreements. Under the terms of the MICPA, the
procurement by the Participating Public Agency shall be construed to be in accordance
with, and governed by, the laws of the state in which the Participating Public Agency
resides. A copy of the MICPA is attached as Exhibit 4.
1.4.4
Estimated Volume
The estimated dollar volume of Products and Services purchased under the proposed
Master Agreement is $100 Million Dollars annually. This estimate is based on the
anticipated volume of the Lead Public Agency, the U.S. Communities Advisory Board
members, and current sales within the U.S. Communities program. While there is no
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minimum quantity of products required to be purchased under the proposed Master
Agreement, Maricopa County and the U.S. Communities Advisory Board Members are
committed to utilizing the Master Agreement. The Advisory Board members shall
determine if the Master Agreement is of value to their agency, and will promote the
Master Agreement among other public agencies nationwide and internationally. The
Advisory Board in 2014 purchased more than $168 Million Dollars of products and
services from existing U.S. Communities contracts.
1.4.5
Marketing Support
U. S. Communities provides marketing support for each Supplier’s products through the
following:
 National Sponsors as referenced above.
 State Associations of Counties, Schools and Municipal Leagues.
 Administrative and marketing personnel that directly promote the U.S. Communities
Suppliers to Participating Public Agencies through public agency meetings, direct
mail, email, online and print advertising, social media, articles, and exhibiting and
presenting at national and local trade shows.
 U.S. Communities provides Suppliers government sales training, and a host of online
marketing and sales management tools to effectively increase sales through U.S.
Communities.
1.4.6
Marketplace
U.S. Communities has developed an online Marketplace, which gives Participating
Public Agencies the ability to purchase from many U.S. Communities contracts directly
from our website. The Marketplace makes it easier for Participating Public Agencies to
access many contracts through a single login and place orders using a procurement card,
credit card or purchase order. Suppliers have the ability to add their products to the
Marketplace at no cost.
1.4.7
Evaluation of Proposals
Proposals will be evaluated by the Lead Public Agency in accordance with, and subject
to, the relevant statutes, ordinances, rules and regulations that govern its procurement
practices.
U.S. Communities Advisory Board members and other Participating Public Agencies will
assist the Lead Public Agency in evaluating proposals. The Supplier(s) that respond(s)
affirmatively meets the requirements of this Request for Proposal and provides the best
overall value will be eligible for a contract award. U.S. Communities reserves the right
to make available or not make available Master Agreements awarded by a Lead Public
Agency to Participating Public Agencies.
1.5
INTENT
This solicitation is to establish a nationwide purchasing agreement with a Pharmacy Benefit
Manager to provide all services in section 2.0 of this document. It is the expectation that the
successful contractor shall be able to provide a Preferred Network and an open network for
prescription purchases.
The intent is for each Proposer to submit its complete Services offering so that Participating Public
Agencies may utilize a wide array of services as appropriate for their needs.
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Other governmental entities under agreement with the County may have access to services
provided hereunder (see also Section 2.17 below and Exhibit 4, MICPA).
It is the intent of the County to make a single award; however, the County reserves the right to
make multiple awards where such action serves the County’s and Participating Public Agencies’
best interests.
2.0
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SCOPE OF SERVICES (PBM GENERAL):
2.1
CONTRACTOR shall provide the prescription benefit management services described in this
proposal and/or as otherwise mutually agreed to by the parties in writing, including, but not
necessarily limited to, general support and consultative services regarding pharmacy benefit
design and implementation, formulary management, network and rebate management,
administrative and claims processing services, standard reporting packages, marketing, customer
service, quality management and utilization management functions. In addition, CONTRACTOR
may develop and implement certain additional clinical intervention and cost-saving (e.g. voluntary
tablet splitting) programs that may be desired by the County, subject to terms and conditions to be
agreed to in writing between the parties. CONTRACTOR shall manage the current pharmacy
benefit plan design (multiple-tier coinsurance plan with maximum costs per tier) or future
innovative plan designs. Notwithstanding the foregoing or any termination rights set forth in this
Agreement, CONTRACTOR may immediately terminate or refrain from implementing any
formulary management or other clinical program services in any geographic area (in their entirety
or for specific drugs only) if, in Contractor’s sole determination, the implementation or continued
provision of such services is or may be in violation of applicable laws, rules, or regulations
governing the practice of pharmacy or prescription benefits management, or may otherwise
present an issue related to the practice of pharmacy or prescriptions benefits management.
2.2
CONTRACTOR shall make membership eligibility/enrollment, copayment/coinsurance and
benefit coverage information, supplied by the County or its designated agent in mutually agreed
upon format, available to network Pharmacies on a weekly basis at the time of dispensing through
the online electronic transmission link maintained between CONTRACTOR and Pharmacies.
Subject to Contractor’s responsibility to load all such data received from County in a timely
manner (within 48 hours of receipt), County is solely responsible for the accuracy, completeness,
reliability, and timeliness of all information provided to CONTRACTOR and acknowledges
Contractor’s reliance thereupon. Any errors or omissions in the information are the sole
responsibility of County. County may not deny claims submitted by any Pharmacy for payment
subsequent to such Pharmacy receiving approval via the online eligibility system.
2.3
Identification cards shall be produced by CONTRACTOR and mailed to the subscriber’s home
address within seven (7) calendar days from receipt of enrollment information. Such cards will
serve only the purpose of Member identification, not Member eligibility. Eligibility as stated will
be established at the time of dispensing through the Online Eligibility System.
2.4
CONTRACTOR, as the authorized pharmacy benefit manager, shall perform formulary
management, rebate sharing and other clinical services described herein. These services will
include, but not necessarily be limited to, prior authorization, step-therapy, systematic prospective,
concurrent and retrospective drug utilization review and other measures that are deemed
appropriate to effectuate formulary management.
Accordingly, County authorizes
CONTRACTOR, as its pharmacy benefit manager, to perform formulary management and other
services described in this Request for Proposals.
2.5
CONTRACTOR shall provide access to the online eligibility, claims payment and/or standard and
ad hoc reporting system(s) (collectively, the “System”) which will allow the County’s specified
personnel to view, enter, and/or extract information residing on the System on an individual, plan
level, and account structure basis. The County asks for ten (10) access codes to be included.
Training to the County personnel will be provided via the County’s day-to-day local account
management team.
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2.6
In addition to the identification cards, CONTRACTOR shall provide its standard introductory
materials for issuance to Members, via paper and electronic media. This includes mail service
order forms, program brochures, newsletters, mail service promotional materials, generic usage
education pieces and retail pharmacy prescription labels. Any correspondence to membership
shall be pre-approved by the County.
2.7
CONTRACTOR shall be responsible for all costs associated with its development and printing of
standard marketing materials that CONTRACTOR provides to County in connection with this
Agreement; provided, however, that all costs associated with the distribution of such materials to
Members are the sole responsibility of County.
2.8
With regard to billing, CONTRACTOR shall invoice the County following the close of each
twice-monthly billing cycle. Such invoices shall include, but not necessarily be limited to,
individual prescription claims, administrative fees and/or any other costs and charges specified in
the agreement. County will pay CONTRACTOR all invoiced amounts within 15 days of receipt
of invoice therefore. CONTRACTOR shall pay claims independently for services provided by
Pharmacies; provided that CONTRACTOR has no obligation to make such payments until
applicable funds have first been received from County.
2.9
CONTRACTOR’S Clinical Pharmacist and Account Manager shall work with the County in
Contractor’s commitment to satisfy the County’s reporting needs. This will include but not
necessarily be limited to standard management reports, provider profiling and analysis (e.g.,
identifying drug patterns), ad hoc reporting needs, recommendations on drug coverage, exclusions,
plan designs and cost-controlling methods.
2.10
CONTRACTOR’S clinical staff shall work with the County to incorporate disease management
and medication therapy management programs or other clinical programs that are deemed
appropriate for the County and that have a return on investment for the County. As with all
programs, mutually agreeable terms for specialized programs will be discussed and agreed upon.
2.11
The following relates to CONTRACTOR’S commitment to providing support personnel, and
general onsite educational assistance throughout the term of the contract.
2.12
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2.11.1
County shall have a dedicated, mutually agreed upon, local CONTRACTOR pharmacy
consultant who will be the County’s key clinical pharmacist and strategist.
2.11.2
County shall have a dedicated local CONTRACTOR Account Manager, who will be the
point of contact for the County.
2.11.3
Local CONTRACTOR Account Manager shall correspond with County’s Employee
Benefits Division regarding service issues through the County’s Case Management
System. Issues must be resolved within 5 business days.
2.11.4
Local staff within CONTRACTOR shall provide onsite staffing of knowledgeable service
personnel to support Open Enrollment, from April through July. Support hours expected
are 10 hours/week from April through July.
2.11.5
CONTRACTOR shall commit to participate in joint operating meetings with the
County’s other health benefit vendors on a quarterly basis.
2.11.6
CONTRACTOR shall commit to attend meetings with County management as needed.
2.11.7
CONTRACTOR shall send the Account Manager to the County’s weekly Service
Meetings as well as provide an onsite staffing commitment of six (6) hours per month for
New Employee Orientation.
CONTRACTOR shall conduct an annual County-specific plan-specific member satisfaction
survey with tabulated results each January. .
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2.13
Reporting. CONTRACTOR shall:
2.13.1
Report number and dollar amounts of claims processed each month on a summary and
detail level by plan and account structure.
2.13.2
Report monthly and year-to-date utilization, by plan and all plans combined, totals of:
top 100 drugs by number of prescriptions filled and by cost; generic, single-source brand
and multi-source brand dispensing rate and average ingredient costs; cost details (plan,
member and total, PMPM and PEPM, average ingredient cost, average dispensing fee,
average discount percentage, and generic efficiency).
2.13.3
Provide annual utilization and trend report including overall and plan-level performance
analysis and recommendations for improvements. Report must also include analysis of
customer complaints and appeals.
2.13.4
Provide quarterly specialty utilization dashboard and summary of activity, and clinical
and economic impact by prevalent diseases.
2.13.5
Provide advance notification of each fund transfer, date and amounts.
2.13.6
Provide annually a SAS70 Audit Report and other reports as required by the County’s
annual internal and/or external auditor.
2.13.7
Provide monthly call center metrics reports including call answer speed, call
abandonment rate, number of calls answered, number of calls resolved in one call, type of
calls (specific to Maricopa County members), and call quality monitoring results.
2.13.8
Provide monthly appeal reports including summary and details of all levels (complaint,
grievance, appeal) of appeal activity including the number received, pended and resolved,
and results with a summary of causes/reasons on all internal and external levels.
2.13.9
Provide online access to ‘ad hoc’ report writer and standard reports, and access to create
data drill down by plan and account structure.
2.13.10 In writing, provide performance guarantee metrics results quarterly, with a final review,
to be documented by County and CONTRACTOR, on an annual basis.
2.14
2.15
Claims Processing. CONTRACTOR shall:
2.14.1
Agree to have data utilization edits in place that identify and deny duplicate claims,
claims filed too soon, claims requiring authorization when such authorization is not in
place (prior authorization or step-care), as well as messages to the pharmacist for review
and approval or denial of the claim due to safety issues.
2.14.2
Provide refunds at the retail pharmacy within a minimum of seven days in the case of a
member paying for a claim that should have been processed and approved through the
claim system.
2.14.3
Provide a process for reimbursing members through submission of a paper
reimbursement request form. County prefers the ability to process such reimbursements
through the CONTRACTOR’S online claims system.
2.14.4
Have the ability to electronically bill the medical insurance carrier for pharmacy provided
wellness services (e.g., flu and pneumonia shots).
Appeals/Grievances. CONTRACTOR shall:
2.15.1
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Supply the appeals policy and procedure for the internal and external appeal process in
compliance with provisions and guidelines of the Health Care Reform legislation
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(currently the Patient Protection and Affordable Care Act and the Health Care and
Education Affordability Reconciliation Act)..
2.15.2
2.16
2.17
Handle the internal and external appeals process.
Customer Service. CONTRACTOR shall:
2.16.1
Provide customer service staff that are fully trained on the County’s benefit plan designs
and are available to employees 24 hours per day, 7 days per week.
2.16.2
Provide CONTRACTOR’S customer service program description including the hours of
operations, locations, training plan, call quality program, scoring tool and quality
standards, production expectations (number of calls per day, time spent in Available
status, etc.), production and quality metrics, staffing ratio, and available services to
handle a diverse population.
2.16.3
County prefers a dedicated customer service team available during the hours of 7 AM to
6 PM MST. Such team will have thorough training in the County’s benefit plan designs.
Implementation Plan
CONTRACTOR will provide a detailed implementation plan with mutually agreed upon tasks,
assignments, owners, and due dates.
2.18
Formulary Changes
CONTRACTOR shall provide advance written notice to the County by no later than 90 days prior
to any Formulary change, with written notice also to be sent to the home address of adversely
impacted members by no later than 60 days prior to the effective date of any change. Additionally,
CONTRACTOR shall notify members no later than 60 days in advance, in writing to their home
address, of the expiration date of a prior authorization and for industry changes (e.g., significant
Black Box Warnings, drug withdrawals when significant impact is expected, etc.)
2.19
Education Support:
CONTRACTOR shall provide the County with an array of educational material and web-based
tools that will help educate members on each product’s plan design and assist them in calculating
and tracking the cost and utilization of their drugs based on product (Coinsurance or Pharmacy
Reimbursement Account) through all delivery channels (retail 30, retail 90, specialty, and mail
service). The tool(s) must also provide alternative suggestions for more cost-effective medication
within the same therapeutic class.
2.20
Data Sharing
CONTRACTOR shall support Maricopa County’s request for full program data integration by
transferring complete Eligibility, Paid Claims and Prescriber (e.g., name, address, phone number,
specialty, DEA and NPI numbers) Data to County’s other vendors (benefit administration, medical,
behavioral health, data warehouse, etc.) on a monthly basis in a mutually agreed upon format,
subject to a mutually agreeable fee between Contractor and vendor for any format changes
CONTRACTOR is required to make.
CONTRACTOR shall support any member deductible or out-of-pocket maximum cross
accumulation requirements by sharing appropriate data with the County’s other vendors in a realtime or as close to real time basis in a mutually agreed upon format, subject to a mutually agreeable
fee between CONTRACTOR and County.
Appropriate mutually agreeable terms and security language will be put in place to protect the
integrity of all data transfers and to insure compliance with all applicable privacy rules and
regulations.
12/8/2015 1:11 PM
p. 13
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
2.21
MAIL ORDER:
Mail order prescriptions for an 84-91 day supply of maintenance medication shall be sent to
Members at Member’s home address, work address or to a local Network pharmacy from the
Participating Mail Service Pharmacy via United Parcel Service, United States Postal Service, or
any other method the Participating Mail Service Pharmacy may select. Limiting the risk of loss or
damage to covered drugs provided hereunder is the responsibility of the Participating Mail Service
Pharmacy until such prescription drugs have been delivered to Member. Certain products that
require cold-pack shipping methods as recommended by the manufacturer will be handled
appropriately. The cost of shipping will be borne by the Participating Mail Service Pharmacy.
Members will pay, or reimburse Participating Mail Service Pharmacy, as applicable, for all
additional expenses due to expedited delivery requested by Member. In addition, to the extent
CONTRACTOR’S shipping costs significantly increase after the effective date of the rates set forth
in this Agreement as a result of rate increases by the United States Postal Service or private mail
package handlers, the parties will negotiate in good faith to reach agreement on an adjustment to
the rates to compensate CONTRACTOR for its increased costs. Member must transmit with the
order to the Participating Mail Service Pharmacy the applicable copayment fee for each
prescription or refill covered by this Proposal.
2.22
NETWORK:
With regard to the actual dispensing process involving the contracted providers in
CONTRACTOR’S network, services will be provided to Members upon the following terms and
conditions:
12/8/2015 1:11 PM
2.22.1
Upon presentation by a Member of his/her identification card, receipt of appropriate
prescriptions, and any required copayment or coinsurance, the Pharmacy shall compound
and dispense all qualified prescriptions and covered drugs pursuant to the pharmacy
benefit plan design and eligibility information provided by the County to
CONTRACTOR and communicated by CONTRACTOR to such Pharmacy via the
Online Eligibility and Claim System at the time of dispensing, subject to legal restrictions
and professional ethics and professional judgment.
2.22.2
Pharmacy shall collect any applicable copayment, coinsurance or deductible amount from
each Member for each covered prescription. As indicated by the Online Eligibility and
Claims System at the time of dispensing. When the Participating Pharmacy’s usual and
customary charge or retail cash price for the prescription is less than the minimum
copayment or coinsurance, the Participating Pharmacy will collect the lowest amount in
lieu of the minimum copayment or coinsurance indicated by the Online Eligibility and
Claims system.
2.22.3
Pharmacy may withhold prescription services to a Member for good cause, including, but
not necessarily limited to, County’s nonpayment for prescription services provided to
Members; the Member’s failure to pay for services rendered (e.g., copayment or
coinsurance); requests by Member for quantities of drugs in excess of prescribed amounts
or refill limitations pursuant to the pharmacy benefit information; quantities of
maintenance drugs in lesser than a three-month supply (after two 30-day fills),or where,
in the professional judgment of the dispensing pharmacist, the prescription should not be
filled.
2.22.4
Pharmacy shall attempt to dispense generic equivalent drugs in lieu of prescribed brand
name drugs if commercially available, meet quality rating standards, and if consistent
with the prescriber’s orders and the dispensing pharmacist’s professional judgment and
state and federal law.
p. 14
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
2.23
2.22.5
PREFERRED NETWORK:
It is expected that the CONTRACTOR will propose a preferred network of retail
pharmacies where the County will receive a greater discount from AWP and the
employee will have lower out-of-pocket costs.
2.22.6
SECONDARY NETWORK:
The County shall require a network that includes the maximum number of retail
pharmacies.
2.22.7
Performance Guarantees
Shall be negotiated yearly and shall be incorporated into the contract.
SPECIALTY DRUGS:
CONTRACTOR shall provide a cost-effective Specialty Pharmacy Program with either
centralized distribution or multi-channel distribution that is national, convenient, consistent and
flexible. Specialty pharmaceuticals are generally high-cost medications that are usually prescribed
for people with complex or chronic medical conditions, i.e., multiple sclerosis, hemophilia,
hepatitis, and rheumatoid arthritis. Medications typically exhibit one or more of the following
characteristics: are injected or infused, however some may be taken orally; have unique
monitoring, storage or shipment requirements; require additional education and support from a
health care professional; and are usually not available at retail pharmacies.
The Program must have developed services to meet the unique challenges of dispensing and
monitoring these medications. The Program must provide cost-effective care and positive patient
outcomes through increased adherence, as well as provide an enhanced patient experience through
the convenience of scheduled delivery, disease management programs and compliance monitoring
employing a care-coordination model. In care coordination, licensed clinicians (nurses,
pharmacists, and physicians) provide comprehensive clinical management services. Clinical
professionals support patients with education, training and mental health support (e.g., behavioral
health, case management or disease management referral). The plan of care will address
education, interventions, compliance, monitoring parameters, and goals and outcomes of therapy.
Non-adherence or non-compliance and the rationale must be communicated to the prescribing
physician.
The Program must contain provisions addressing preferred specialty medications and biosimilars.
3.0
PROCUREMENT REQUIREMENTS:
3.1
12/8/2015 1:11 PM
CONTRACTOR EMPLOYEE MANAGEMENT:
3.1.1
Contractor shall endeavor to maintain the personnel proposed in their offer throughout
the implementation of the Solution. In the event that Contractor personnel’s employment
status changes, Contractor shall provide County a list of proposed candidates with
equivalent experience with the Solution. County reserves the right to assist in the
selection of the replacement candidate. Under no circumstances is it acceptable for the
implementation schedule to be impacted by a personnel change on the part of the
Contractor.
3.1.2
Contractor shall not reassign any provided personnel without the express consent of the
County.
3.1.3
County reserves the right to immediately remove from its premises any Contractor
personnel it determines is a risk to County operations.
p. 15
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
3.2
USAGE REPORT:
The Contractor shall furnish the County a usage report upon re quest delineating the acquisition
activity governed by the Contract. The format of the report shall be approved by the County and
shall disclose the quantity and dollar value of each contract item by individual unit.
3.3
Background Check:
Proposers need to aware that there may be multiple background checks (Sheriff’s Office, County
Attorney's Office, Courts as well as Maricopa County general government) to determine if the
respondent is acceptable to do business with the County. This applies to (but is not limited to) the
company, sub-contractors and employees and the failure to pass these checks shall deem the
respondent non-responsible.
3.4
INVOICES AND PAYMENTS:
3.4.1
The Contractor shall submit one (1) legible copy of their detailed invoice before
payment(s) can be made. Incomplete invoices will not be processed. At a minimum, the
invoice must provide the following information:
•
•
•
•
•
•
•
•
•
•
•
•
•
3.5
3.4.2
Problems regarding billing or invoicing shall be directed to the using agency as listed on
the Purchase Order.
3.4.3
Payment shall be made to the Contractor by Accounts Payable through the Maricopa
County Vendor Express Payment Program. This is an Electronic Funds Transfer (EFT)
process. After Contract Award the Contractor shall complete the Vendor Registration
Form located on the County Department of Finance Vendor Registration Web Site
(http://www.maricopa.gov/Finance/Vendors.aspx).
3.4.4
Discounts offered in the contract shall be calculated based on the date a properly
completed invoice is received by the County (ROI).
3.4.5
EFT payments to the routing and account numbers designated by the Contractor will
include the details on the specific invoices that the payment covers. The Contractor is
required to discuss remittance delivery capabilities with their designated financial
institution for access to those details.
APPLICABLE TAXES:
3.5.1
12/8/2015 1:11 PM
Company name, address and contact
County bill-to name and contact information
Contract Serial Number
County purchase order number
Invoice number and date
Payment terms
Date of service or delivery
Quantity (number of days or weeks)
Contract Item number(s)
Description of Purchase (product or services)
Pricing per unit of purchase
Extended price
Total Amount Due
Payment of Taxes: The Contractor shall pay all applicable taxes. With respect to any
installation labor on items that are not attached to real property performed by Contractor
under the terms of this Contract, the installation labor cost and the gross receipts for
materials provided shall be listed separately on the Contractor’s invoices.
p. 16
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
3.6
3.5.2
State and Local Transaction Privilege Taxes: Maricopa County is subject to all
applicable state and local transaction privilege taxes. To the extent any state and local
transaction privilege taxes apply to sales made under the terms of this contract it is the
responsibility of the seller to collect and remit all applicable taxes to the proper taxing
jurisdiction of authority.
3.5.3
Tax Indemnification: Contractor and all subcontractors shall pay all Federal, state, and
local taxes applicable to its operation and any persons employed by the Contractor.
Contractor shall, and require all subcontractors to hold Maricopa County harmless from
any responsibility for taxes, damages and interest, if applicable, contributions required
under Federal, and/or state and local laws and regulations and any other costs including
transaction privilege taxes, unemployment compensation insurance, Social Security and
Worker’s Compensation.
TAX: (SERVICES)
No tax shall be levied against labor. It is the responsibility of the Contractor to determine any and
all taxes and include the same in proposal price.
3.7
TAX (COMMODITIES):
Tax shall not be levied against labor. Sales/use tax will be determined by County. Tax will not be
used in determining low price.
3.8
POST AWARD MEETING:
The Contractor may be required to attend a post-award meeting with the Using Agency to discuss the
terms and conditions of this Contract. This meeting will be coordinated by the Procurement Officer of
the Contract.
4.0
CONTRACTUAL AND SPECIAL TERMS & CONDITIONS:
4.1
5.0
DRAFT CONTRACT SEE EXHIBIT 5:
INSTRUCTIONS TO RESPONDENTS: (Please note that this Section does not
become part of any resultant contract.)
Bidders and Proposers are solely responsible for submitting bids, proposals, and any modifications or
withdrawals, to be received at the time and designated location required by the solicitation (ITN, RFP,
ROQ, or any other solicitation notice).
Any bid, proposal, modification, or withdrawal received after the designated time is “late” and will be
rejected and not be evaluated per Paragraph MC1-320 of the Maricopa County Procurement Code.
5.1
SCHEDULE OF EVENTS:
Request for Proposals Issued:
OCTOBER 23, 2015
Pre-Proposal Conference:
NOVEMBER 12, 2015
Deadline for written questions is (2) business days after Pre-Proposal Conference. Questions will
not be responded to prior to the Pre-Proposal Conference or after 11/16/2015 deadline has
elapsed. All questions shall be posted to www.bidsync.com and must be received by 11:00 AM
on 11/16/2015 Arizona time. Answers shall be posted as an addendum to the solicitation
Proposals Opening Date:
DECEMBER 18, 2015 JANUARY 8, 2016
Deadline for submission of proposals is 2:00 P.M., Arizona Time, on DECEMBER 18, 2015
JANUARY 08, 2016. All proposals must be received before 2:00 P.M., Arizona Time, on the
12/8/2015 1:11 PM
p. 17
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
above date at the Maricopa County Office of Procurement Services, 320 West Lincoln Street,
Phoenix, Arizona 85003.
Proposed review of Proposals and short list decision:
JANUARY 25, 2016
Proposed Respondent presentations: (if required)
FEBRUARY 8, 2016
Proposed selection and negotiation:
FEBRUARY 22, 2016
Proposed Best & Final (if required)
FEBRUARY 29, 2016
Proposed award of Contract:
APRIL 6, 2016
All responses to this Request for Proposal become the property of Maricopa County and (other
than pricing) will be held confidential, to the extent permissible by law. The County will not be
held accountable if material from proposal responses is obtained without the written consent of the
Respondent by parties other than the County.
5.2
INQUIRIES AND NOTICES:
All inquiries concerning information herein shall be addressed to:
Maricopa County
Office of Procurement Services
ATTN: Contract Administration
320 West Lincoln Street
Phoenix, Arizona 85003
Administrative telephone inquiries shall be addressed to:
STEVE DAHLE, Procurement Officer, 602-506-3450
([email protected])
Inquiries may be submitted by telephone but must be followed up in writing.
communication is binding on Maricopa County.
5.3
No oral
INSTRUCTIONS FOR PREPARING AND SUBMITTING PROPOSALS:
Respondents shall provide their proposals in accordance with Section 5.6 as follows:
5.3.1
Two (2) hardcopies of all proposal documents.
5.3.2
Two (2) flash drives providing all proposal documents in Word, Excel (Attachment A)
and the entire proposal document in PDF format.
5.3.3
Seven (7) flash drives providing the entire proposal in PDF format only.
5.3.4
Respondents shall address proposals identified with return address, serial number and
title in the following manner:
Maricopa County
Office of Procurement Services
ATTN: Contract Administration
320 West Lincoln Street
Phoenix, Arizona 85003
SERIAL 16018 – RFP, Pharmacy Benefit Manager Services
12/8/2015 1:11 PM
p. 18
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
5.3.5
5.4
Proposals shall be signed by an owner, partner or corporate official who has been
authorized to make such commitments. All prices shall be held firm for a period of one
hundred fifty (150) days after the RFP closing date.
EXCEPTIONS TO THE SOLICITATION:
The Respondent shall identify and list all exceptions taken to all sections of 16018–RFP and list
these exceptions referencing the section (paragraph) where the exception exists and identify the
exceptions and the proposed wording for the Respondent’s exception under the heading,
“Exception to the PROPOSAL Solicitation, SERIAL 16018-RFP.” Exceptions that surface
elsewhere and that do not also appear under the heading, “Exceptions to the PROPOSAL
Solicitation, SERIAL 16018-RFP,” shall be considered invalid and void and of no
contractual significance.
The County reserves the right to reject, determine the proposal non-responsive, enter into
negotiation on any of the Respondent exceptions, or accept them outright.
5.5
5.6
GENERAL CONTENT:
5.5.1
The Proposal should be specific and complete in every detail. It should be practical and
provide a straightforward, concise delineation of capabilities to satisfactorily perform the
Contract being sought.
5.5.2
The Respondent should not necessarily limit the proposal to the performance of the
services in accordance with this Request for Proposal but should outline any additional
services and their costs if the Respondent deems them necessary to accomplish the
program.
FORMAT AND CONTENT:
To aid in the evaluation, it is desired that all proposals follow the same general format. The
proposal hardcopy must be submitted in binders and have sections tabbed as below: (Responses
are limited to 200 300 pages, single sided, 10 point font type).
12/8/2015 1:11 PM
5.6.1
Table of Contents
5.6.2
Letter of Transmittal (Exhibit 2)
5.6.3
Executive Summary – This section shall contain an outline of the general approach
utilized in the proposal.
5.6.4
Proposal – This section should contain a statement of all of the programs and services
proposed, as requested in Section 2.1 through 2.23 including conclusions and generalized
recommendations. Proposals should be all-inclusive, detailing respondent’s best offer.
5.6.5
Qualifications – This section shall describe the respondent’s ability and experience
related to the programs and services proposed. All project personnel, as applicable, shall
be listed including a description of assignments and responsibilities, a resume of
professional experience, an estimate of the time each would devote to this program, and
other pertinent information.
5.6.6
Proposal exceptions
5.6.7
ATTACHMENT A
(Pricing Discount Matrix (MARICOPA COUNTY ONLY)
5.6.8
ATTACHMENT A-1
Retail Brand Acquisition Pricing (MARICOPA COUNTY
ONLY)
p. 19
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
5.7
5.6.9
ATTACHMENT A-2
Generic Acquisition Pricing (MARICOPA COUNTY
ONLY)
5.6.10
ATTACHMENT A-3
Specialty Drug Acquisition Pricing (MARICOPA COUNTY
ONLY)
5.6.11
ATTACHMENT B
(Agreement Page)
5.6.12
ATTACHMENT C
(References)
5.6.13
ATTACHMENT D
SUPPLIER QUALIFICATIONS COMMITMENTS,
Offeror must include a narrative of its understanding and
acceptance of the Supplier Commitments.
5.6.14
SUPPLIER WORKSHEET
5.6.15
SUPPLIER INFORMATION
5.6.16
EXHIBIT 5
U.S. COMMUNITIES ADMINISTRATION AGREEMENT,
signed unaltered
5.6.17
ATTACHMENT E
VENDOR QUALIFICATIONS QUESTIONNAIRE
5.6.18
ATTACHMENT F
ZIP CODE GEO ACCESS FOR NETWORK
5.6.19
ATTACHMENT G
SIGNED HIPAA (BUSINESS ASSOCIATE AGREEMENT)
5.6.20
ATTACHMENT A-4
AS NECESSARY)
US COMMUNITIES PRICING MATRIX (DUPLICATE
EVALUATION OF PROPOSAL – SELECTION FACTORS:
A Proposal Evaluation Committee shall be appointed, chaired by the Procurement Officer to evaluate
each Proposal. At the County’s option, Respondents may be invited to make presentations to the
Evaluation Committee. Best and Final Offers and/or Negotiations may be conducted, as needed, with
the highest rated Respondent(s). Proposals will be evaluated on the following criteria which are listed
descending order of importance.
NOTE 1:
12/8/2015 1:11 PM
5.7.1
Services proposed (response to section 2)
5.7.2
Qualifications (including response to Attachment D, E, F and Exhibit 5)
5.7.3
Price
RESPONDENTS ARE REQUIRED TO USE ATTACHED FORMS TO SUBMIT THEIR
PROPOSAL.
p. 20
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
ATTACHMENT A, A-1, A-2, A-3 and A-4
PRICING
SEE EXCEL FILE 16018-ATTACHMENT A, A-1, A-2, A-3 and A-4
12/8/2015 1:11 PM
p. 21
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
ATTACHMENT B
AGREEMENT
Respondent hereby certifies that Respondent has read, understands and agrees that acceptance by Maricopa County of the
Respondent’s Offer will create a binding Contract. Respondent agrees to fully comply with all terms and conditions as set forth in the
Maricopa County Procurement Code, and amendments thereto, together with the specifications and other documentary forms herewith
made a part of this specific procurement
BY SIGNING THIS PAGE THE SUBMITTING RESPONDENT CERTIFIES THAT RESPONDENT HAS REVIEWED
THE ADMINISTRATIVE INFORMATION AND DRAFT RFP CONTRACT’S TERMS AND CONDITIONS LOCATED AT
http://www.maricopa.gov/materials. AND AGREE TO BE CONTRACTUALLY BOUND TO THEM.
RESPONDENT (FIRM) SUBMITTING PROPOSAL
FEDERAL TAX ID NUMBER
PRINTED NAME AND TITLE
AUTHORIZED SIGNATURE
ADDRESS
TELEPHONE
DUNS #
/
CITY
WEB SITE
12/8/2015 1:11 PM
STATE
ZIP
FAX #
DATE
EMAIL ADDRESS
p. 22
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
ATTACHMENT C
RESPONDENT’S REFERENCES
RESPONDENT SUBMITTING PROPOSAL:
1.
COMPANY NAME:
ADDRESS:
CONTACT PERSON:
TELEPHONE:
2.
E-MAIL ADDRESS:
COMPANY NAME:
ADDRESS:
CONTACT PERSON:
TELEPHONE:
3.
E-MAIL ADDRESS:
COMPANY NAME:
ADDRESS:
CONTACT PERSON:
TELEPHONE:
4.
E-MAIL ADDRESS:
COMPANY NAME:
ADDRESS:
CONTACT PERSON:
TELEPHONE:
5.
E-MAIL ADDRESS:
COMPANY NAME:
ADDRESS:
CONTACT PERSON:
TELEPHONE:
12/8/2015 1:11 PM
E-MAIL ADDRESS:
p. 23
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
ATTACHMENT D
(U.S. COMMUNITIES SUPPLIER QUALIFICATIONS RESPONSE)
1.0
SUPPLIERS
1.0.1
Commitments
U.S. Communities views the relationship with an awarded Supplier as an opportunity to
provide maximum benefit to both the Participating Public Agencies and to the Supplier.
The successful foundation of the partnership requires commitments from both U.S.
Communities and the Supplier. U.S. Communities requires the Supplier to make the four
commitments set forth below (Corporate, Pricing, Economy, Sales) to ensure that
Supplier is providing the highest level of public benefit to Participating Public Agencies:
1.0.2
Corporate Commitment.
1.0.2.1 The pricing, terms and conditions of the Master Agreement shall, at all times, be
Supplier’s primary contractual offering of Products and Services to Public
Agencies. All of Supplier’s direct and indirect marketing and sales efforts to
Public Agencies shall demonstrate that the Master Agreement is Supplier’s
primary offering and not just one of Supplier’s contract options.
1.0.2.2 Supplier’s sales force (including inside, direct and/or authorized dealers,
distributors and representatives) shall always present the Master Agreement
when marketing Products or Services to Public Agencies.
1.0.2.3 Supplier shall advise all Public Agencies that are existing customers of Supplier
as to the pricing and other value offered through the Master Agreement.
1.0.2.4 Upon authorization by a Public Agency, Supplier shall transition such Public
Agency to the pricing, terms and conditions of the Master Agreement.
1.0.2.5 Supplier shall ensure that the U.S. Communities program and the Master
Agreement are actively supported by Supplier’s senior executive management.
1.0.2.6 Supplier shall provide a national/senior management level representative with
the authority and responsibility to ensure that the Supplier’s Commitments are
maintained at all times. Supplier shall also designate a lead referral contact
person who shall be responsible for receiving communications from U.S.
Communities concerning new Participating Public Agency registrations and for
ensuring timely follow-up by Supplier’s staff to requests for contact from
Participating Public Agencies. Supplier shall also provide the personnel
necessary to implement and support a supplier-based internet web page
dedicated to Supplier’s U.S. Communities program and linked to U.S.
Communities’ website and shall implement and support such web page.
1.0.2.7 Supplier shall demonstrate in its procurement solicitation response and
throughout the term of the Master Agreement that national/senior management
fully supports the U.S. Communities program and its commitments and
requirements. National/Senior management is defined as the executive(s) with
companywide authority.
1.0.2.8 Where Supplier has an existing contract for Products and Services with a state,
Supplier shall notify the state of the Master Agreement and transition the state to
the pricing, terms and conditions of the Master Agreement upon the state’s
request. Regardless of whether the state decides to transition to the Master
12/8/2015 1:11 PM
p. 24
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Agreement, Supplier shall primarily offer the Master Agreement to all Public
Agencies located within the state.
1.0.3
Pricing Commitment.
1.0.3.1 Supplier represents to U.S. Communities that the pricing offered under the
Master Agreement is the lowest overall available pricing (net to purchaser) on
Products and Services that it offers to Public Agencies. Supplier’s pricing shall
be evaluated on either an overall project basis or the Public Agency’s actual
usage for more frequently purchased Products and Services.
1.0.3.2 Contracts Offering Lower Prices. If a pre-existing contract and/or a Public
Agency’s unique buying pattern provide one or more Public Agencies a lower
price than that offered under the Master Agreement, Supplier shall match that
lower pricing under the Master Agreement and inform the eligible Public
Agencies that the lower pricing is available under the Master Agreement. If an
eligible Public Agency requests to be transitioned to the Master Agreement,
Supplier shall do so and report the Public Agency’s purchases made under the
Master Agreement going forward. The price match only applies to the eligible
Public Agencies. Below are three examples of Supplier’s obligation to match
the pricing under Supplier’s contracts offering lower prices.
1.0.3.2.1
Supplier holds a state contract with lower pricing that is available to
all Public Agencies within the state. Supplier would be required to
match the lower state pricing under the Master Agreement and make
it available to all Public Agencies within the state.
1.0.3.2.2
Supplier holds a regional cooperative contract with lower pricing that
is available only to the ten cooperative members. Supplier would be
required to match the lower cooperative pricing under the Master
Agreement and make it available to the ten cooperative members.
1.0.3.2.3
Supplier holds a contract with an individual Public Agency. The
Public Agency contract does not contain any cooperative language
and therefore other Public Agencies are not eligible to utilize the
contract. Supplier would be required to match the lower pricing
under the Master Agreement and make it available only to the
individual Public Agency.
1.0.3.3 Deviating Buying Patterns. Occasionally U.S. Communities and Supplier may
interact with a Public Agency that has a buying pattern or terms and conditions
that considerably deviate from the normal Public Agency buying pattern and
terms and conditions, and causes Supplier’s pricing under the Master Agreement
to be higher than an alternative contract held by Supplier. This could be created
by a unique end-user preference or requirements. In the event that this situation
occurs, Supplier may address the issue by lowering the price under the Master
Agreement on the item(s) causing the large deviation for that Public Agency.
Supplier would not be required to lower the price for other Public Agencies.
1.0.3.4 Supplier’s Options in Responding to a Third Party Procurement Solicitation.
While it is the objective of U.S. Communities to encourage Public Agencies to
piggyback on to the Master Agreement rather than issue their own procurement
solicitations, U.S. Communities recognizes that for various reasons some Public
Agencies will issue their own solicitations. The following options are available
to Supplier when responding to a Public Agency solicitation:
1.0.3.4.1
12/8/2015 1:11 PM
Supplier may opt not to respond to the procurement solicitation.
Supplier may make the Master Agreement available to the Public
Agency as a comparison to its solicitation responses.
p. 25
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
1.0.3.4.2
Supplier may respond with the pricing, terms and conditions of the
Master Agreement. If Supplier is awarded the contract, the sales
would be reported as sales under the Master Agreement.
1.0.3.4.3
If competitive conditions require pricing lower than the standard
Master Agreement pricing, Supplier may submit lower pricing
through the Master Agreement. If Supplier is awarded the contract,
the sales would be reported as sales under the Master Agreement.
Supplier would not be required to extend the lower price to other
Public Agencies.
1.0.3.4.4
Supplier may respond to the procurement solicitation with pricing
that is higher (net to buyer) than the pricing offered under the Master
Agreement. If awarded a contract, Supplier shall still be bound by all
obligations set forth in this Section 3.3, including, without limitation,
the requirement to continue to advise the awarding Public Agency of
the pricing, terms and conditions of the Master Agreement.
1.0.3.4.5
Supplier may respond to the procurement solicitation with pricing
that is higher (net to buyer) than the pricing offered under the Master
Agreement and if an alternative response is permitted, Supplier may
offer the pricing under the Master Agreement as an alternative for
consideration.
1.0.3.5 Economy Commitment. Supplier shall demonstrate the benefits, including the
pricing advantage, of the Master Agreement over alternative options, including
competitive solicitation pricing and shall proactively offer the terms and pricing
under the Master Agreement to Public Agencies as a more effective alternative
to the cost and time associated with such alternate bids and solicitations.
1.0.3.6 Sales Commitment. Supplier shall market the Master Agreement through
Supplier’s sales force or dealer network that is properly trained, engaged and
committed to offering the Master Agreement as Supplier’s primary offering to
Public Agencies. Supplier’s sales force compensation and incentives shall be
greater than or equal to the compensation and incentives earned under other
contracts to Public Agencies.
1.0.3.6.1
12/8/2015 1:11 PM
Supplier Sales. Supplier shall be responsible for proactive direct
sales of Supplier’s Products and Services to Public Agencies and the
timely follow-up to sales leads identified by U.S. Communities. Use
of product catalogs, targeted advertising, direct mail and other sales
initiatives are encouraged. All of Supplier’s sales materials targeted
towards Public Agencies shall include the U.S. Communities logo.
U.S. Communities hereby grants to Supplier, during the term of this
Agreement, a non-exclusive, revocable, non-transferable, license to
use the U.S. Communities name, trademark, and logo solely to
perform its obligations under this Agreement, and for no other
purpose. Any goodwill, rights, or benefits derived from Supplier's
use of the U.S. Communities name, trademark, or logo shall inure to
the benefit of U.S. Communities. U.S. Communities shall provide
Supplier with its logo and the standards to be employed in the use of
the logo. During the term of the Agreement, Supplier grants to U.S.
Communities an express license to reproduce and use Supplier’s
name and logo in connection with the advertising, marketing and
promotion of the Master Agreement to Public Agencies. Supplier
shall assist U.S. Communities by providing camera-ready logos and
by participating in related trade shows and conferences. At a
minimum, Supplier's sales initiatives shall communicate that (i) the
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Master Agreement was competitively solicited by the Lead Public
Agency, (ii) the Master Agreement provides the best government
pricing, (iii) there is no cost to Participating Public Agencies, and
(iv) the Master Agreement is a non-exclusive contract.
1.0.3.6.2
Branding and Logo Compliance. Supplier shall be responsible for
complying with the U.S. Communities branding and logo standards
and guidelines. Prior to use by Supplier, all U.S. Communities
related marketing material must be submitted to U.S. Communities
for review and approval.
1.0.3.6.3
Sales Force Training. Supplier shall train its national sales force on
the Master Agreement and U.S. Communities program. U.S.
Communities shall be available to train regional or district managers
and generally assist with the education of sales personnel.
1.0.3.7 Participating Public Agency Access. Supplier shall establish the following
communication links to facilitate customer access and communication:
1.0.3.7.1
A dedicated U.S. Communities internet web-based homepage
containing:
(1)
(2)
(3)
(4)
(5)
(6)
U.S. Communities standard logo with Founding Co-Sponsors
logos;
Copy of original procurement solicitation;
Copy of Master Agreement including any amendments;
Summary of Products and Services pricing;
Electronic link to U.S. Communities’ online registration page;
and
Other promotional material as requested by U.S.
Communities.
1.0.3.7.2
A dedicated toll-free national hotline for inquiries regarding U.S.
Communities.
1.0.3.7.3
A dedicated email address for general inquiries in the following
format: uscommunities@(name of supplier).com.
1.0.3.8 Electronic Registration. Supplier shall be responsible for ensuring that each
Public Agency has completed U.S. Communities’ online registration process
prior to processing the Public Agency’s first sales order.
1.0.3.9 Supplier’s Performance Review. Upon request by U.S. Communities, Supplier
shall participate in a performance review meeting with U.S. Communities to
evaluate Supplier’s performance of the covenants set forth in this Agreement.
1.0.3.10 Supplier Content. Supplier may, from time to time, provide certain graphics,
media, and other content to U.S. Communities (collectively "Supplier Content")
for use on U.S. Communities websites and for general marketing and publicity
purposes. Supplier hereby grants to U.S. Communities and its affiliates a nonexclusive, worldwide, perpetual, free, transferrable, license to reproduce,
modify, distribute, publically perform, publically display, and use Supplier
Content in connection with U.S. Communities websites and for general
marketing and publicity purposes, with the right to sublicense each and every
such right. Supplier warrants that: (a) Supplier is the owner of or otherwise has
the unrestricted right to grant the rights in and to Supplier Content as
contemplated hereunder; and (b) the use of Supplier Content and any other
materials or services provided to U.S. Communities as contemplated hereunder
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will not violate, infringe, or misappropriate the intellectual property rights or
other rights of any third party
1.0.3.11 U.S. Communities Administration Agreement Instructions
The Supplier is required to execute the U.S. Communities Administration
Agreement, unaltered (attached hereto as Exhibit 5) and submit with its
Proposal. The Agreement outlines the Supplier’s general duties and
responsibilities in implementing the U.S. Communities contract. Failure to
do so may result in disqualification.
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ATTACHMENT D
SUPPLIER WORKSHEET FOR NATIONAL PROGRAM CONSIDERATION
Suppliers are required to meet specific qualifications. Please respond in the spaces provided after each
qualification statement below:
A. State if pricing for all Products/Services offered will be the most competitive pricing offered by
your organization to Participating Public Agencies nationally.
YES____
NO____
B. Does your company have the ability to provide service to any Participating Public Agencies in the
contiguous 48 states, and the ability to deliver service in Alaska and Hawaii?
YES____
*NO____
(*If no, identify the states where you have the ability to provide service to Participating Public
Agencies.)
C. Does your company have a national sales force, dealer network or distributor with the ability to call
on Participating Public Agencies in at least 35 U.S. states?
YES____
*NO____
(*If no, identify the states where you have the ability to provide service to Participating Public
Agencies.)
D. Check which applies for your company sales last year in the United States:
_____ Sales between $0 and $25,000,000
_____ Sales between $25,000,001 and $50,000,000
_____ Sales greater than $50,000,001
E. Does your company have existing capacity to provide toll-free telephone and state of the art
electronic, facsimile and internet ordering and billing?
YES____
NO____
F.
Will your company assign a dedicated Senior Management level Account Manager to support the
resulting U.S. Communities program contract?
YES____
NO____
G. Does your company agree to respond to all agency referrals from U.S. Communities within 2
business days?
YES____
NO____
H. Does your company maintain records of your overall Participating Public Agencies’ sales that you
can and will share with U.S. Communities to monitor program implementation progress?
YES____
NO____
I.
Will your company commit to the following program implementation schedule?
YES____
NO____
J.
Will the U.S. Communities program contract be your lead public offering to Participating Public
Agencies?
YES____
NO____
______________________________________________________________________________
Submitted by:
________________________________
___________________________________
(Printed Name)
(Signature)
________________________________
(Title)
12/8/2015 1:11 PM
___________________________________
(Date
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New Supplier Implementation Checklist
1. First Conference Call
Target
Completion
After Award
One Week
Initial Kick Off Call to discuss expectations
Establish initial contact people & roles/responsibilities
Supplier Log-In Credentials established
2. Executed Legal Documents
One Week
U.S. Communities Admin Agreement
Lead Public Agency Agreement signed
3. Program Contact Requirements
One Week
Supplier contacts communicated to U.S. Communities Staff
Dedicated email
Dedicated toll free number
Dedicated fax number
4. Second Conference Call
Two Weeks
Set Contract Launch Date & Outline Kick Off Plan
Establish WebEx Training Dates
Review Contract Commitments
Complete Supplier Set Up Form
Complete User Account and User ID Form
Identify Dates for Senior Management Meeting
5. Marketing Kick Off Call
Two Weeks
Overview of Marketing Requirements
Establish Timeline for Marketing Deliverables
Set Weekly Marketing Call
6. Initial NAM & Staff Training Meetings
Three Weeks
Discuss expectations, roles & responsibilities
Introduce and review web-based tools
Review process & expectations of Lead Referral contact with NAM & identified LRC
7. Senior Management Meeting
Four Weeks
Implementation Process Progress Report
U.S. Communities & Vendor Organizational Overview
Supplier Manager to review & further discuss commitments
8. Review Top Joint Target Opportunities
Five Weeks
Top 10 Local Contracts
Review top U.S. Communities PPA's
9. Web Development
Initiate IT contact
Two Weeks
Initiate E-Commerce Conversation
Two Weeks
Product Upload to U.S. Communities site
Five Weeks
10. Sales Training & Roll Out
Program Manager briefing - Coordinate with NAM
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Five Weeks
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Initial remote WebEx training for all sales - Coordinate with NAM
Four Weeks
Initiate contact with Advisory Board (AB) members
Six Weeks
Determine PM & Local Metro teams strategy sessions
Six Weeks
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ATTACHMENT D
SUPPLIER INFORMATION
Please respond to the following requests for information about your company:
National Commitments
Proposer shall provide a written narrative of its understanding and acceptance of the Supplier Qualifications
Commitments requirements in Attachment D.
Company
1.
Total number and location of sales persons employed by your company in the United States;
Example:
NUMBER OF SALES
REPRESENTATIVES
13
6
10
12
6
5
3
CITY
Phoenix
Tucson
Los Angeles
San Francisco
San Diego
Sacramento
Fresno
Etc.
STATE
AZ
AZ
CA
CA
CA
CA
CA
Etc.
Total: 366
2.
Describe how the above sales persons would be utilized in selling this contract, including the time
commitment each sales person will devote to selling this contract.
3.
Number and location of offices in the United States (if applicable);
4.
Number and location of support centers (if applicable);
5.
Annual sales for 2012, 2013 and 2014 in the United States; Sales reporting should be segmented into the
following categories:
SUPPLIER ANNUAL SALES IN THE UNITED STATE FOR 2012, 2013 AND 2014
Segment
2012 Sales
2013 Sales
2014 Sales
Cities
Counties
K-12 (Pubic/Private)
Higher Education (Public/Private)
States
Other Public Sector and Nonprofits
Federal
Private Sector
Total Supplier Sales
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6.
Annual sales for 2012, 2013 and 2014 in the United States for the proposed Products and/or Services;
Sales reporting should be segmented into the following categories:
SUPPLIER ANNUAL SALES IN THE UNITED STATE FOR 2012, 2013 AND 2014
Segment
2012 Sales
2013 Sales
2014 Sales
Cities
Counties
K-12 (Pubic/Private)
Higher Education (Public/Private)
States
Other Public Sector and Nonprofits
Federal
Private Sector
Total Supplier Sales
7.
Submit your current Federal Identification Number and latest Dun & Bradstreet report.
8.
Provide a list with contact information of your company’s ten largest public agency customers.
Distribution
1.
Describe how your company proposes to distribute the Products and Services nationwide.
2.
Identify all other companies that will be involved in processing, handling or shipping the Product
to the end user.
3.
State the effectiveness of the proposed distribution in providing the lowest cost to the end user.
4.
Provide the number, size and location of your company’s distribution facilities, warehouses and
retail network as applicable.
5.
Describe your company’s customer service department staffing levels, hours of operation and
other relevant details.
6.
If
applicable,
describe
your
company’s
ability
to
do
business
with
manufacturer/dealer/distribution organizations that are either small or MWBE businesses as
defined by the Small Business Administration.
a. If applicable, describe other ways your company can be sensitive to a Participating Public
Agency’s desire to utilize local and/or MWBE companies, such as number of local
employees and offices in a particular geographic area, companies your firm is using that may
be local (i.e. local delivery truck company), your company’s diversity of owner employees,
etc.
b. If applicable, provide details on any products or services being offered by your company
where the manufacturer or service provider is either a small or MWBE business as defined by
the Small Business Administration. Provide product/service name, company name and
small/MWBE designation.
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Marketing
1.
Outline your company’s plan for marketing the Products to state and local government agencies
nationwide.
2.
Explain how your company will educate its national sales force about the Master Agreement.
3.
Explain how your company will market and transition the Master Agreement into the primary
offering to Participating Public Agencies.
4.
Explain how your company plans to market the Master Agreement to existing government
customers and transition these customers to the Master Agreement. Please provide the amount of
purchases of existing public agency clients that your company will transition to the U.S.
Communities contract for the initial three years of the contract in the following format within
your proposal.
a.
b.
c.
$________.00 will be transitioned in year one.
$________.00 will be transitioned in year two.
$________.00 will be transitioned in year three.
National Staffing Plan
1.
A staffing plan is required which describes the Proposer’s proposed staff distribution to
implement and manage this contract throughout the term of the contract. At a minimum, this plan
should include the following:
a. Identify the key personnel who will lead and support the implementation period of the
contract outlined in Attachment D, New Supplier Implementation Checklist, along with the
amount of time to be devoted to implementation;
b. Identify the key personnel who are to be engaged in this contract throughout the term of the
contract and their relationship to the contracting organization;
c. Provide a chart that shows 1) the time commitment of each professional staff member that
will be devoted to the contract, 2) each member’s role in maintaining and growing the
contract; and 3) a timeline of each member’s involvement throughout the contract.
2.
Submit the resumes of the below personnel:
a. The person your company proposes to serve as the National Accounts Manager;
b. Each person that will be dedicated full time to U.S. Communities account management;
and
c. Key executive personnel that will be supporting the program.
Products, Services and Systems
1.
12/8/2015 1:11 PM
Provide a description of the Products, Services and Systems to be provided as set forth in Section
2.0 of the RFP. The primary objective is for each Supplier to provide its complete product,
service and solutions offerings so that Participating Public Agencies may order a range of product
as appropriate for their needs.
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2.
Provide a description of any Related Products, Services and Solutions offered by Supplier.
Include any associated costs in Supplier’s Cost Proposal.
3.
Describe any special programs that your company offers that will improve customers’ ability to
access Products, Services or other innovative strategies.
4.
Describe the capacity of your company to broaden the scope of the contract and keep the product
offerings current and ensure that latest products, standards and technology for Pharmacy Benefit
Manager Services.
Quality
1.
Describe your company’s customer support capabilities. Include information on whether any
functions of customer support are in-house, outsourced or subcontracted.
2.
Describe your company’s quality control processes.
3.
Describe your problem escalation process.
4.
How are customer complaints measured and categorized? What processes are in place to know
that a problem has been resolved?
5.
Describe and provide any product or service warranties.
Administration
1.
Describe your company’s capacity to employ telephone, ecommerce, with a specific proposal for
processing orders under the Master Agreement.
2.
State which forms of ordering allow the use of a debit or credit card and the accepted banking
(credit card) affiliation.
3.
Describe your company’s internal management system for processing orders from point of
customer contact through delivery and billing. Please state if you use a single system or platform
for all phases of ordering, processing, delivery and billing.
4.
Describe any existing multi-state cooperative purchasing programs, including the entity’s
name(s), contact person(s) and contact information and annual volume.
5.
Describe the capacity of your company to report monthly sales under the Master Agreement by
Participating Public Agency within each U.S. state.
6.
Describe the capacity of your company to provide management reports, i.e. commodity histories,
procurement card histories, green spend, etc. for each Participating Public Agency.
7.
Please provide any suggested improvements and alternatives for doing business with your
company that will make this arrangement more cost effective for your company and Participating
Public Agencies.
Financial Statements
The Supplier shall include an audited income statement and balance sheet from the two (2) most recent
reporting periods in its proposal.
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Environmental
1.
Provide a brief description of any company environmental initiatives, including your company’s
environmental strategy, your investment in being an environmentally preferable product leader,
and any resources dedicated to your environmental strategy.
2.
Describe your company’s process for defining green products or sustainable processes.
3.
Describe your product’s recyclability. Describe any buy back or take back options offered.
Describe your company’s efforts to reduce or reuse packaging and minimize environmental
footprint in the shipping process.
Additional Information
Please use this opportunity to describe any/all other features, advantages and benefits of your organization
that you feel will provide additional value and benefit to a Participating Public Agency.
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ATTACHMENT E
VENDOR QUALIFICATIONS QUESTIONNAIRE
Prescription Drugs
Please complete each item in the Questionnaire completely and in the order shown. If answers vary based on the
plan you are proposing, please provide the answers separately. Clear reference to readily accessible back-up material
(e.g., plan documents, reports, etc.) is acceptable. Incomplete or inaccurate answers may result in the
disqualification of the proposal.
1.
Provide history and ownership of the pharmacy benefit management (PBM) firm including parent company,
year PBM established, number of PBM employees involved in account management, membership count,
number of group plans in force, number of group plans added and terminated in the past 12 months, the
number, nature and status of any outstanding legal actions pending against your organization, general and
professional liability coverage in force, acquisitions or divestitures in the past 12 months, staff
reorganizations and relocations, computer or telephone system changes in the past 12 months, and any major
changes to your organization or structure anticipated in the next 24 months.
2.
Provide an organizational chart and career profile for all staff involved in the sale, service and financial
relationship with the County. Where are each of these individuals located?
3.
Which sales office will handle the general servicing of this account for retail, mail order and specialty
pharmacy programs? What are the days and hours of operation for the sales and service office?
4.
Can you administer the current benefit plan design (multi-tier coinsurance plan with maximum costs per tier),
described in the Pharmacy Benefit Plan Description available at www.maricopa.gov/benefits, under the
Prescription tab? If not, please explain what provisions you cannot administer.
5.
Does the PBM or another organization perform the following functions? If another organization performs the
function, please include its name and address.










6.
Formulary Management including appeals and utilization management
Formulary Pharmacy and Therapeutics Committee
Drug Manufacturer rebate contracting and invoicing/accounting
Retail Pharmacy Network contracting
Member Services including toll-free phone line and web site
Mail Order drug purchasing and dispensing
Step Therapy and Medical Necessity Reviews
Ownership of Electronic Claim Payment System
Client Management reporting tools and standard report production
Other (Please describe)
Indicate the most recent ratings for your organization:
Rating
Date
Standard & Poor
Duff & Phelps
A.M. Best
Moody’s
7.
Please give your current financial position and the date for which such data is determined for the following
items:
a.
b.
c.
d.
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Members
Assets
Liabilities
Net worth (assets – liabilities)
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8.
Do you agree to meet with Maricopa County on a weekly basis to discuss operational issues?
9.
Do you agree to meet with the various other benefit vendors (medical, behavioral health, etc.) on an ad hoc
and quarterly basis to resolve data exchange issues and to partner for improved drug, medical, and behavioral
health outcomes?
10.
Do you agree to provide a dedicated, mutually agreed upon, local clinical pharmacy consultant who will be
the County’s key clinical pharmacist and strategist?
11.
Do you agree to provide a dedicated, local account manager who will be the main point of contact for
Maricopa County?
12.
Do you agree to provide a dedicated customer service team for Maricopa County who is available between
the hours of 7 AM – 5 PM MST, Monday – Friday (with back-up customer service 24/7)?
13.
Do you agree to provide onsite staffing by knowledgeable service personnel to support Open Enrollment,
from April through July? Anticipated need is 10 hours per week from April through July.
14.
How many clients do you have within Maricopa County?
15.
Please complete Attachment C for three (3) clients who may be contacted with regard to your prescription
plan. Also, please complete Attachment C for two (2) companies who have cancelled your services in the last
two years.
Customer Service
16.
Describe your customer service program including days and hours of operation, location, new employees and
ongoing training plan, call recording and call tracking program, call quality checking program including
scoring tool and quality standards, production expectations (number of calls per day, time spent in Available
status, etc.), production and quality metrics, number of phone line support staff available throughout each
day, and services to handle a diverse population. What types of issues do your customer service
representatives handle? What is your call escalation process? How many days, on average, does it take you to
resolve escalated issues? What types of issues are referred to the employer?
17.
What is your service recovery plan?
18.
List the top five, most common, and the top five most complicated member complaints related to each: retail,
mail order and specialty pharmacies.
19.
What corrective action has been put into place to resolve these complaints?
20.
Provide the following information for the past 12 months for the customer service location you are proposing
would handle customer service for Maricopa County?
 Percent of abandoned calls
 Percent of calls handled by live representatives
 Percent of calls handled by an IVR
 Number of seconds to reach a live customer service representative
 Ratio of supervisors to customer service representatives available on any given day at any given time
21.
Do your customer service representatives have online access to real-time claims processing information?
22.
Will your customer service representatives make outbound calls to a retail pharmacy to resolve a claims
processing problem?
23.
Do you provide customer service to assist members with selecting and/or locating preferred and/or secondary
network pharmacies?
24.
Describe any website self-service capabilities available for the employer, employees and pharmacies.
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25.
Are the pharmacy networks available online through your member portal?
26.
Will a member be able to produce a temporary ID card through your member portal?
27.
Will a member be able to request a replacement or additional ID card through your member portal?
28.
How are members notified of new drug additions, formulary changes, significant changes in the pharmacy
network, new and significant drug warnings, and drug recalls?
29.
Will you agree to perform a Maricopa County-specific member satisfaction survey at least annually, and
report results annually? If yes, please explain how the survey will be administered to ensure sufficient
member participation. Will you guarantee a statistically significant response rate?
30.
Will Maricopa County’s outsourced third party benefits eligibility administration vendor have access to
update eligibility in your system in emergency situations? If not, please explain how a haste enrollment can
be accomplished the same day that it is identified.
31.
Will you provide Maricopa County update and inquiry capabilities to your claims system? If yes, please
describe any limits for updates and inquiries of the system by Maricopa County. Will you provide up to ten
(10) access codes to the County at no additional fees? Will you provide onsite training for the ten County
users?
32.
Will Maricopa County have access to run test claims and to process direct member reimbursement claims
through your claims system?
33.
Do you agree to communicate with Maricopa County’s Employee Benefits Division using Maricopa County’s
case management system within 5 business days to resolve member issues?
Appeals/Grievances
34.
Do you agree to manage the appeal/grievance process for Maricopa County’s non-ERISA plan, in compliance
with federal and state laws and regulations? Do you assume full fiduciary responsibility for this process?
Please provide a copy of your appeals/grievance policy.
35.
How are members notified about decisions that are appealable? Please provide a copy of the notice.
36.
How are first-level member complaints received through your customer service department handled and/or
escalated to an appeal?
37.
Please explain how your appeals process is anticipated to change due to the Patient Protection and Affordable
Care Act?
38.
What reports are available to Maricopa County regarding appeals activity? Please provide a copy of each
report.
39.
What is the County’s expected cost of you handling each level of complaint, appeal and grievance?
Compliance
40.
Do you agree that Maricopa County or its designee will have the right to audit the PBM’s claims, discounts,
rebates, billing, etc. in order to verify compliance with all program requirements and contractual guarantees,
each year and for up to three years after termination of the agreement with the PBM? Do you agree that
Maricopa County may select an auditor of its choice, and that the audit will be conducted with full
cooperation from the PBM if the PBM is given at least 30 day advance notice of the audit?
41.
Do you agree that Maricopa County will not be held responsible for time or miscellaneous costs incurred by
the PBM in the audit process including all costs associated with provision of data, audit finding response
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reports, or system access provided to Maricopa County or its designee during the life of the contract? This
includes any data required to transfer the business to another vendor.
42.
Will you provide copies of your annual SAS70 type II audit including complete audit findings to Maricopa
County each year during the term of the contract?
43.
Do you agree to adhere to all relevant federal and state laws and regulations?
44.
Do you agree that all systems and services are compliant with the HIPAA, Privacy and Security regulations
established by the Department of Health and Human Services and that you will execute the appropriate
Business Associate Agreement as provided by Maricopa County?
45.
Do you agree to abide by the provisions of the HITECH Act in the event of a security/privacy violation, data
breach, or unauthorized data access incident including notifying Maricopa County and the impacted members
of such event? Do you agree to provide Maricopa County with detailed information regarding any required
remedies?
Data Sharing
46.
Do you agree to provide monthly claims data in the required format to the vendor for Maricopa County’s data
warehouse and to the medical and behavioral health vendors at no cost to the County?
47.
Do you agree to provide to the various vendors (e.g. medical, behavioral health) complete member
demographic information and paid claims data on a monthly basis in a mutually agreed upon format, upon
written authorization from Maricopa County?
48.
Do you agree to accept and process within 48 hours of receipt, weekly eligibility/enrollment/plan design data
from the benefits eligibility administration vendor in a HIPAA compliant format?
49.
Describe any programs that you offer to integrate medical (including lab data) and pharmacy data in order to
improve member outcomes and provide cost saving opportunities.
50.
Describe your capabilities to share “real-time” or as close to real-time information with the current medical
vendors for purposes of deductible and out-of-pocket maximum accumulation. Do you have an existing
deductible and out-of-pocket maximum data sharing relationship with the current medical carriers?
51.
Are deductible and out-of-pocket maximum data integration fees included in your administrative fees? If not,
please provide the cost to integrate data.
Financials
52.
Provide a listing of all administrative fees (THESE SHOULD BE INCLUDED IN THE PRICING IN
ATTACHMENT A)
53.
Will there be any additional charges if the benefit plan design is changed? If yes, please explain.
54.
Do you agree to produce ID cards and mail the cards to the member’s home address within seven calendar
days from receipt of enrollment information?
55.
Will postage be included in the administrative fees for ID card generation, duplicate ID cards, mail order
prescriptions and any other notices or mailings?
56.
What is the data source used for AWP?
57.
How often are AWP prices updated in your claims system and member portal?
58.
Do all of your network pharmacy contracts include the lesser of retail, U&C, MAC price or discounted price
provision? Can you guarantee that members always will receive the lowest price in the selected delivery
channel?
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59.
What will a member pay for a drug from a retail store’s $4 list (such as Wal-Mart’s list) if the ingredient cost
plus dispensing fee totaled $3 and the member copay is $5?
60.
Do you guarantee that Maricopa County and the member will be charged the generic cost, if a generic is out
of stock and a brand is substituted?
61.
Describe the minimum, individual and overall discount rate guarantees (including U&C and MAC) in detail
for each delivery channel and each drug type (i.e., generic, single-source brand, multi-source brand, specialty,
bio-similar and bio-similar interchangeable products).
62.
If some network pharmacies provide greater discounts than the minimum discount rate guarantees, are the
discounts passed to Maricopa County?
63.
Describe the retail network pharmacy reimbursement process in detail.
64.
Describe the mail order pharmacy reimbursement process in detail.
65.
Describe the specialty pharmacy reimbursement process in detail.
66.
Explain your MAC pricing strategy for each delivery channel.
67.
How many distinct MAC prices can exist for a specific medication and how are the prices for Maricopa
County determined? How often do they change?
68.
Do you set the MAC price?
69.
What percentage of generic prescriptions has a MAC price?
70.
Does your MAC list include multi-source brand drugs? If yes, what percentage of multi-source brand drugs
has a MAC price?
71.
Will MAC savings increase if certain pharmacies were removed from the preferred and/or secondary
network? If yes, quantify the additional savings.
72.
Do MAC price lists vary between network pharmacies? If yes, please explain.
73.
Describe the available tools for members to determine the best delivery channel to purchase all of their
medication (except specialty medication) at the lowest member cost.
74.
Do you agree to provide members with the Maricopa County discounted cost for excluded medications (e.g.
infertility medication, oral non-sedating antihistamines, etc.)?
75.
Will your organization send recovery letters to members who continue to receive services after their benefits
termination date due to the timing of the data exchange? If yes, please explain your process.
76.
Describe any special banking arrangements you require under the ASO contract, including the method by
which funds are transferred, the frequency, and any initial deposit or minimum balance required.
77.
Do you agree to provide advance notice of each fund transfer including date and amounts?
78.
Describe your invoicing/billing process, frequency and payment requirements.
Mail Order
79.
Where will the mail order facility be located?
80.
What are the days and hours of operation for this facility?
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81.
What is the number of registered pharmacists on staff at the mail order facility? How many are full-time
versus part-time?
82.
What is the number of pharmacy technicians on staff at the mail order facility? How many are full-time
versus part-time?
83.
What is the number of other clinicians on staff at the mail order facility? How many are full-time versus parttime?
84.
What was the total number of prescriptions filled in the most recent 12 months?
85.
How much capacity does the most recent 12 months of prescriptions filled represent?
86.
How many total prescriptions can be accurately filled on a daily basis?
87.
Are any prescriptions being filled at the mail order facility which are being purchased through a retail
pharmacy store?
88.
Do you have a separate customer service department/unit that handles mail order issues only? If yes, please
provide details.
89.
What organizations are used for delivery service?
90.
Does your organization own the mail service facility? If this is a subcontractor, who do you contract with?
91.
Describe your process for ordering initial prescriptions through mail order.
92.
Describe your process for ordering refills by mail, phone, fax, and the Internet.
93.
How far in advance may members order a refill of an 84-91 days’ supply of medication?
94.
Provide the results of your most recent State Board of Pharmacy inspection of your mail order facility.
95.
Describe what physician outreach services you provide at the mail order facility.
96.
How many calendar days advance notice must a member provide in order to guarantee that their medication is
received before their existing supply is depleted?
97.
Will you deliver mail order prescriptions to retail pharmacies, work or other locations other than the
member’s home/mailing address?
98.
Outline your process for prescriptions which are ordered prior to the first available refill date.
99.
What is your average generic dispensing rate for all clients utilizing this mail order facility?
100. What is your average generic substitution rate for all clients utilizing this mail order facility?
101. Explain the process and criteria for providing members with a short-term retail prescription supply in case of
delayed delivery of their mail order prescription. Is the member’s contribution waived for the short-supply?
102. How are members notified when mail order prescriptions have been mailed?
103. How are members notified when a mail order prescription is delayed?
104. What is your process for notifying customers of the expiration date, next refill date and number of refills
remaining for their mail order prescriptions?
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105. Please describe your mail order program including when notifications will be made to the County, the
members and the prescribing physician when a medication’s tier is changed from preferred to non-preferred
or if significant cost changes in a medication occur.
106. Will you provide Maricopa County with a detailed disruption and financial impact analysis at the same time?
107. What is your process for notifying members when they are ordering excluded or very expensive medication?
108. What is your process for notifying members about new and significant drug warnings or product recalls?
109. What are your contingency plans for providing back-up mail order service in the event of a strike, natural
disaster, or backlog?
110. Explain your packaging and shipping of prescriptions that require special handling.
111. Do you require payment of mail order prescriptions before the prescription is filled and shipped or after?
Formulary Management and Rebates
112. Describe how your formulary is established. Include how specific drugs are selected and how often your P&T
committee meets.
113. Are any P&T committee members employed by or under contract with any drug manufacturers?
114. Are any P&T committee members directly employed by your organization?
115. Will you be able to customize and support a specific formulary for Maricopa County?
116. How are maintenance medications for the mandatory 90-day prescription fill/refill program defined? Please
provide a list of your maintenance medication list.
117. How are preventive medications defined? Please provide a list of your preventive medication list.
118. Provide a list of your tier 3 non-preferred brand drugs. How was this list developed? What percentages of
prescriptions typically fall in tier 3?
119. Will you guarantee that any formulary changes which are not economically advantageous to Maricopa
County on an ingredient cost basis be reported and reimbursed to the County on a dollar-for-dollar basis using
the least expensive, therapeutically equivalent alternative drug as the basis for reimbursement?
120. Please describe when and how notifications will be made to the County, the members and the prescribing
physicians when a medication’s tier is changed from preferred to non-preferred or if the cost of a medication
significantly changes. Will you provide Maricopa County with a detailed disruption and financial impact
analysis at the same time?
121. What tools are available to promote formulary compliance and member education?
122. Please describe the rebate program you are proposing for Maricopa County for all medications through all
dispensing channels. Include whether the program is a pass-through, per prescription dispensed, or on brand
prescriptions.
123. How often will you make rebate payments to Maricopa County?
Specialty Pharmacy
124. Describe your specialty pharmacy program including developed services to meet the unique challenges of
dispensing and monitoring these medications, provision of cost-effective care and positive patient outcomes
through increased adherence, convenience of scheduled delivery, disease management programs and
compliance monitoring.
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125. Does your program use a care coordination model? If yes, please explain.
126. Is a care plan developed? If yes, please provide details of what the plan addresses.
127. Can you manage separate plan designs for specialty medication? Please provide examples of your
capabilities.
128. Do you have a specialty medication formulary containing preferred and non-preferred medication? If so,
describe the formulary process and basis for classification as preferred versus non-preferred. Please provide a
list of the preferred and non-preferred products.
129. Do you have a separate customer service department/unit that handles only specialty pharmacy inquires? If
so, what are the customer service hours of operation for your specialty pharmacy program?
130. Describe how you coordinate with other vendors when opportunities are identified by your specialty
pharmacy staff for engaging specialty members in applicable Care Management programs.
131. Provide results from your adherence programs specific to individual disease states.
132. Provide the percentage of your prescriptions that are shipping to a physician’s office, a member location, a
pharmacy location, and any other location (please define).
133. What accreditations or certifications does your specialty pharmacy maintain?
134. Discuss any additional unique capabilities, services or partnership opportunities you could provide to
Maricopa County that would provide significant value to the performance of the specialty pharmacy program.
Is there an additional fee?
135. Discuss your current reporting capabilities and any enhancements that you are making that will enable
Maricopa County to understand the value, performance, and outcomes of the specialty drug management.
136. Discuss your strategy and plan for controlling costs for Maricopa County in regards to biosimilar products,
biosimilar interchangeable products during and after the 12-month exclusivity period.
Implementation, Ongoing Support and Termination
137. Do you agree to load all current prior authorizations, ongoing overrides, current mail order refills, and
accumulator files that exist for current members from the existing PBM at no charge to Maricopa County no
later than the effective date of the contract?
138. Do you agree to implement all future plan design changes at no cost to Maricopa County?
139. Do you agree to provide an annual detailed implementation plan for Open Enrollment and other plan changes
to include tasks and assignments for the PBM, Maricopa County and the benefit eligibility administration
vendor?
140. Describe your run-out process and fees for the end of the contract.
141. Do you agree to write and publish plan collateral such as the Summary Plan Description on at least an annual
basis?
142. Do you agree to attend meetings with Maricopa County management as needed?
143. Describe any communication support you are prepared to provide to introduce the new program and any
associated fees. Provide copies of any generic communications available within the scope of the contract.
144. Are you available to produce educational webinars and/or conduct live webcasts using County technology?
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145. Which of the following can you provide to assist the County with open enrollment and member education? Is
there an additional fee or limitation?
a.
b.
c.
d.
e.
f.
g.
Home mailing – plan summary, network listing, welcome letter, other (please describe)
Mail order material
Website – Describe content and functionality
Newsletter articles
Information to promote generic utilization
Targeted educational communication
Other communication or tools you can provide to educate the member on plan design, etc.
Network Management and Quality Assurance
146. Provide a list of all contracted pharmacies in Maricopa County. Which pharmacies will be in the preferred
network and which will be in the secondary network?
147. Provide a geographic access report for each of the networks you are proposing (both preferred and
secondary), using the census data provided. Please use the full five-digit zip code when preparing this report
and include:
a. One network pharmacy within three miles of residence
b. Three network pharmacies within eight miles of residence
148. List any pharmacy chains excluded from your proposed preferred and secondary networks.
149. Describe your quality assurance activities and standards.
150. Describe your network management processes employed to avoid fraud and abuse.
151. Do you monitor individual physician prescribing patterns? If so, what is monitored and what action is taken?
152. How do you monitor pharmacy errors? List the top five reasons for errors. What is your corrective action and
service recovery process when pharmacy errors occur?
153. Describe your process and timeline for notifying Maricopa County and members regarding a disruption in the
retail pharmacy network.
154. Do you have any network pharmacy chain contracts for which you are currently in negotiations? Are there
any major contracts expiring that will need to be renegotiated before the beginning of this contract? If yes,
please explain.
Clinical Programs
155. Describe in detail your Drug Utilization Review (DUR) and Retrospective Drug Utilization Review (RDUR)
programs.
156. Do all of your pharmacies’ online systems have real-time edits or controls for all of the following? If not,
please explain.

Eligible employee and dependents

Eligible drug

Contract price of drug

Lesser of logic (as previously described)

Drug interactions

Drug allergies

Drug disease interactions

Duplicate prescription

Refill too soon

Proper dosage

Proper days supply

Generic availability
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Bid 16018-RFP
SERIAL 16018-RFP









Member copayment or coinsurance
Out-of-Pocket Maximums
Inappropriate drug due to age
Inappropriate drug due to gender
Over utilization
Under utilization
Possible narcotic abuse (provide detail)
Fraud and abuse (provide detail)
Quantity limits
157. What edits occur at point of sale and which occur retrospectively?
158. Provide a sample of your standard DUR and RDUR reports.
159. How are high-cost claimants identified, monitored and reported?
160. Describe your prior authorization and/or step-therapy protocols. Will you share the protocols with Maricopa
County? How are fees charged for prior-authorization and step-therapy? How do you identify drugs that
should be subject to prior authorization and/or step therapy? Provide a list of your prior authorization and
step-therapy medications.
161. Describe any clinical intervention and cost-savings program (e.g. voluntary pill splitting) program that you
are proposing. Provide verifiable data showing improved outcomes and return on investment.
162. How do you control the filling of separate prescriptions for the same medication at different pharmacies
during the period when it is too early to refill the prescription?
163. Does your system have the capability of restricting the member to having prescriptions filled by only one
prescribing physician and/or at one pharmacy?
164. Do you have a prior authorization requirement for claims that exceed a maximum reimbursement dollar limit?
165. Can you set a maximum reimbursement dollar limit on all claims and notify Maricopa County when the limit
is exceeded the same day the prescription is filled?
166. Describe your compound management approach?
167. Do you have a credentialing process for compound pharmacies within your retail network?
168. Do you agree to provide detailed compound claims utilization reports to Maricopa County on a quarterly
basis?
Reports
169. Do you agree to provide the following reports on a monthly, quarterly and year-to-date basis (based on
Maricopa’s fiscal year) at no cost to Maricopa County?
 Eligibility report showing outcomes of updates and changes
 Paid claims summary report showing total number of claims, ingredient cost, days supply, dispensing
fee, member cost, plan cost, and total cost
 Paid claim detail report showing utilization and ingredient cost by each member claim, drug name,
dosage, submitted charge, allowed charge, member cost, and plan cost
 Detailed utilization report showing number of prescriptions submitted as single-source brand, multisource brand and generics, including average AWP, ingredient cost, dispensing fee, days supply and
discount percentage, PMPM and PEPM, and generic efficiency
 Top 100 drug report by cost
 Top 100 drug report by volume
 High cost claimant report
 Therapeutic exchange report showing the number of PBM initiated exchanges
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Bid 16018-RFP
SERIAL 16018-RFP







Drug utilization review and retrospective drug utilization review activity report showing savings by
type of edit
Formulary savings and rebate report
Prior authorization and other clinical program outcomes reports
Annual utilization and trend reports including overall analysis of plan-level performance and customer
complaints, grievances and appeals and recommendations for changes and improvements.
Quarterly specialty pharmacy utilization dashboard and summary of activity, and clinical and
economic impact by prevalent diseases.
Monthly call center metric reports including answer speed, call abandonment rate, number of calls
answered by a live representative, number of calls resolved in one call, type of calls specific to
Maricopa County members and call quality monitoring results.
Monthly appeals activity reports including summary and detail level of all levels (complaint, grievance
and appeal) including number received, pended or resolved, and results with a summary of
causes/reasons on all internal and external levels.
170. Provide a sample of all monthly, quarterly and annual prescription management reports you will provide to
the County. Will you agree to break such reports out by the general medical option in which the members are
enrolled (for COBRA participants and active employees using the County’s account structure)?
171. Describe any other reports you would be able to supply to Maricopa County on a quarterly basis at no
additional fee in order to help manage benefit cost.
172. Do you provide annual claims paid statements to members? If so, please describe how they are distributed.
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ATTACHMENT F
ZIP CODE GEO ACCESS FOR NETWORK
ZIP
CODES
PREFERRED OPEN
NETWORK
NETWORK
ZIP
CODES
PREFERRED OPEN
NETWORK
NETWORK
ZIP
CODES
PREFERRED OPEN
NETWORK
NETWORK
ZIP
CODES
85001
85076
85242
85325
85002
85078
85243
85326
85003
85079
85244
85327
85004
85080
85246
85329
85005
85082
85248
85331
85006
85083
85249
85335
85007
85085
85250
85337
85008
85086
85251
85338
85009
85087
85252
85339
85010
85118
85253
85340
85011
85119
85254
85342
85012
85120
85255
85343
85013
85122
85256
85345
85014
85123
85257
85351
85015
85124
85258
85353
85016
85127
85259
85354
85017
85128
85260
85355
85018
85132
85262
85358
85019
85138
85263
85361
85020
85139
85266
85363
85021
85140
85267
85372
85022
85142
85268
85373
85023
85143
85269
85374
85024
85193
85271
85375
85027
85194
85272
85376
85028
85201
85274
85377
85029
85202
85275
85378
85030
85203
85277
85379
85031
85204
85280
85380
85032
85205
85281
85381
85033
85206
85282
85382
85034
85207
85283
85383
85035
85208
85284
85385
85036
85209
85285
85387
85037
85210
85286
85388
85040
85211
85295
85390
85041
85212
85296
85392
85042
85213
85297
85395
85043
85214
85298
85396
85044
85215
85299
85501
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PREFERRED
NETWORK
OPEN
NETWORK
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Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
85045
85216
85301
85541
85046
85217
85302
85635
85048
85218
85303
85704
85049
85219
85304
85730
85050
85220
85305
85739
85051
85222
85306
85741
85053
85224
85307
85745
85054
85225
85308
85940
85060
85226
85310
86001
85063
85228
85311
86003
85064
85232
85312
86004
85066
85233
85314
86047
85067
85234
85318
86301
85068
85236
85320
86314
85069
85238
85321
86327
85071
85239
85322
86332
85074
85240
85323
86333
85075
85241
85324
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ATTACHMENT G
MARICOPA COUNTY
Health Insurance Portability and Accountability Act of 1996 (“HIPAA”)
Business Associate Agreement
This Business Associate Agreement (“BAA”) dated ___________, 20__ is entered into between Maricopa County, a
political subdivision of the State of Arizona (“County”), and _________________ (“Contractor”) (collectively, the
“Parties”), and is made a part of the Parties’ Contract dated _____________, 20__ (the “Contract”), pursuant to
which Contractor provides services to County that involve the use and/or disclosure of Protected Health Information
(as defined below).
I.
Definitions
A.
12/8/2015 1:11 PM
Applicable Law means any of the following items, including any amendments to any such item as
such may become effective:
1.
the Health Insurance Portability and Accountability Act of 1996, codified at 42 U.S.C.
§ 1320d et seq. and any current and future regulations promulgated thereunder, including but
not limited to 45 C.F.R. Parts 160 and 164 (hereinafter “HIPAA”);
2.
the Health Information Technology for Economic and Clinical Health Act, enacted as Title
XIII of the American Recovery and Reinvestment Act of 2009, codified at 42 U.S.C. § 17921
et seq. and any current and future regulations promulgated thereunder, including but not
limited to 45 C.F.R. Parts 160 and 164 (hereinafter “HITECH Act”);
3.
the Genetic Information Nondiscrimination Act of 2008, codified scattered sections of 26, 29,
and 42 U.S.C., and any current and future regulations promulgated thereunder, including but
not limited to 45 C.F.R. Parts 160 and 164 (hereinafter “GINA”); and
4.
the HIPAA Privacy, Security, Breach Notification and Enforcement Rules, as modified by the
HITECH Act and GINA, found at 45 C.F.R. Parts 160 and 164 (hereinafter the “HIPAA
Rules”).
B.
Breach shall have the same meaning given to such term under the HIPAA Rules, including, but
not limited to, an impermissible use or disclosure under the Privacy Rule that compromises the
security or privacy of the PHI such that the use or disclosure poses a significant risk of financial,
reputational, or other harm to the affected Individual. Breach does not include those matters
specifically excluded under 45 C.F.R. § 164.402(2).
C.
Business Associate shall have the same meaning as the term “business associate” at 45 C.F.R.
§ 160.103 and, in reference to Contractor, shall include Contractor, its directors, officers, owners,
subcontractors, employees, affiliates, agents and representatives.
D.
Data Aggregation shall have the same meaning as the term “data aggregation” at 45 C.F.R.
§ 164.501.
E.
Department shall have the same meaning as the term “covered entity” at 45 C.F.R. § 160.103 and,
in reference to County, shall include County and its Department of Employee Benefits and Health.
For purposes of this BAA and complying with all of its provisions, including all reporting,
notification, and disclosures required hereunder or in accordance with Applicable Law,
Business Associate shall direct all communications to the following: Attn: Benefits Manager,
Maricopa County Employee Benefits Division, 301 West Jefferson Street, Suite 3200,
Phoenix, AZ 85003-2143; Phone (602) 506-1010.
F.
Designated Record Set shall have the same meaning as the term “designated record set” at 45
C.F.R. § 164.501.
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II.
G.
ePHI means electronic protected health information and shall have the same meaning given to
such term under the HIPAA Rules.
H.
Individual shall have the same meaning given to such term under the HIPAA Rules, including, but
not limited to, the person who is the subject of PHI, as well as any person who qualifies as a
“personal representative” in accordance with 45 C.F.R. § 164.502(g).
I.
Protected Health Information (“PHI”) shall include ePHI and have the same meaning given to the
term “protected health information” under the HIPAA Rules, including, but not limited to, health
information that (1) is created or received by Business Associate from or on behalf of Department,
(2) relates to the physical condition, mental health or other health condition of an Individual, or to
the provision of health care to an Individual (including but not limited to the payment for such
health care), and (3) identifies or can be used to identify an Individual.
J.
Secretary means the Secretary of the United States Department of Health and Human Services
(“HHS”) or any other officer or employee of HHS to whom the authority involved has been
delegated.
K.
Security Incident shall have the same meaning given to such term under the HIPAA Rules,
including, but not limited to, the attempted or successful unauthorized access, use, disclosure,
modification, or destruction of information or interference with system operations in an
information system.
L.
Unsecured PHI shall have the same meaning given to such term under the HIPAA Rules,
including, but not limited to, PHI that has not been rendered unusable, unreadable, or
indecipherable to unauthorized individuals through the use of a technology or methodology
specified by the Secretary in guidance.
Rights and Obligations of Business Associate
A.
General Obligations
Business Associate agrees that:
1.
Prohibition on Unauthorized Use or Disclosure. Business Associate shall not use or
disclose PHI other than as permitted or required by this BAA or by Applicable Law.
2.
Safeguards. Business Associate shall use appropriate safeguards, and comply with
Subpart C of 45 C.F.R. Part 164 with respect to ePHI, to prevent use or disclosure of PHI
other than as provided for by this BAA or by the Applicable Law. Such safeguards shall
include, without limitation, implementing written policies and procedures in compliance
with the Applicable Law, conducting a security risk assessment, and training Business
Associate’s employees who will have access to PHI in accordance with the timelines,
obligations, policies and procedures required by the Applicable Law and implementing
regulations.
3.
Duty to Report Violations. Business Associate shall report to Department any use or
disclosure of PHI that is not permitted by this BAA of which it becomes aware, including
any Breach of Unsecured PHI as required by 45 C.F.R § 164.410 and any Security
Incident of which it becomes aware.
a.
12/8/2015 1:11 PM
Notice to Department. Business Associate shall notify Department without
unreasonable delay and in no case later than ten (10) business days of Business
Associate’s discovery of a Breach of any Unsecured PHI or Security Incident
(together, for purposes of Section II.A, a “Breach”). The notice to Department
shall include, at a minimum, the date(s) of the Breach, the identity of each
Individual whose Unsecured PHI was involved in the Breach, a brief description
of the Breach, and any mitigation efforts. To the extent that Business Associate
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does not know the identities of all affected Individuals when it is required to
notify Department, Business Associate shall provide such additional information
as soon as administratively practicable after such information becomes
available. For purposes of this paragraph, a Breach shall be treated as
discovered as of the first day on which the Breach is known or should
reasonably have been known to Business Associate (including any person, other
than the one committing the Breach, who is an employee, officer, or other agent
of Business Associate).
b.
Notice to Individuals. On behalf of Department, Business Associate shall
provide written notice of the Breach without unreasonable delay, but no later
than sixty (60) calendar days following the date the Breach is discovered, or
such later date as is authorized under 45 C.F.R. § 164.412, to each Individual
whose Unsecured PHI has been, or is reasonably believed by Business Associate
to have been, accessed, used, or disclosed as a result of the Breach. For
purposes of this paragraph, a Breach shall be treated as discovered as of the first
day on which the Breach is known or should reasonably have been known to
Business Associate (including any person, other than the one committing the
Breach, who is an employee, officer, or other agent of Business Associate).
The content, form, and delivery of such written notice shall comply in all
respects with 45 C.F.R. § 164.404(c)-(d).
If the Breach only impacts Department’s Individuals, Department may request
and review a draft of the written notice in advance. Department will promptly
review and comment on such draft within two (2) business days of its receipt.
Business Associate will incorporate agreed upon changes and will provide
notification to affected Individuals in accordance with the breach notification
requirements set forth above.
c.
Notice to Media. On behalf of Department, Business Associate shall provide
written notice of a Breach to the media to the extent required under 45 C.F.R.
§ 164.406.
d.
Notice to Secretary. On behalf of Department, Business Associate shall provide
written notice of a Breach to the Secretary to the extent required under 45 C.F.R.
§ 164.408.
If a Breach involves fewer than five hundred (500) Individuals, Business
Associate shall maintain a log or other documentation of the Breach that
contains such information as would be required to be included if the log were
maintained by Department pursuant to 45 C.F.R. § 164.408, and provide such
log to Department within five (5) business days of Department’s written request.
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4.
Subcontractors and Agents. In accordance with 45 C.F.R. §§ 164.502(e)(1)(ii) and
164.08(b)(2), Business Associate shall ensure that any subcontractor or agent that creates,
receives, maintains, or transmits PHI on behalf of Business Associate agrees to the same
restrictions, conditions, and requirements that apply through this BAA to Business
Associate with respect to PHI.
5.
Access to Books and Records by Secretary. Business Associate shall make its internal
practices, books, and records relating to the use, disclosure, and security of PHI available
to the Secretary for purposes of the Secretary determining Department’s and Business
Associate’s compliance with the HIPAA Rules.
6.
Mitigation. Business Associate shall conduct a risk assessment and mitigate, to the
extent practicable, any harmful effect that is known to Business Associate of (a) a use or
disclosure of PHI by Business Associate in violation of the requirements of this BAA, or
(b) a Breach. Business Associate shall promptly inform Department of all risk
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assessments performed and mitigating measures taken. Department shall have the right
to request that Business Associate perform additional risk assessments and take
additional mitigating measures, as Department deems necessary.
B.
C.
Obligations Relating to Individual Rights
1.
Restrictions on Disclosures. Upon request by an Individual, Department shall determine
whether the Individual shall be granted a restriction on disclosure of PHI pursuant to 45
C.F.R. § 164.522. Department shall not agree to any such restriction without the prior
consent of Business Associate if such restriction would affect Business Associate’s use or
disclosure of PHI, provided, however, that Business Associate’s consent is not required
for requests that must be granted under 42 U.S.C. § 17935(a). Department shall
communicate any grant of a request to Business Associate. For any such request,
Business Associate shall restrict its disclosures of the Individual’s PHI in the same
manner as would be required for Department in accordance with 45 C.F.R. § 164.522(a).
2.
Access to PHI. Upon request by an Individual, Department shall determine whether an
Individual is entitled to access his or her PHI pursuant to 45 C.F.R. § 164.524. If
Department determines that an Individual is entitled to such access, and that such PHI is
under the control of Business Associate, Department shall communicate the decision to
Business Associate. Business Associate shall provide the Individual access to the PHI in
the same manner as would be required for Department. If Business Associate receives an
Individual’s request to access his or her PHI directly from the Individual, Business
Associate shall document such request and, within thirty (30) calendar days after
receiving a written request from the Individual, act upon such request for access in
accordance with 45 C.F.R. § 164.524.
3.
Amendment of PHI. Upon request by an Individual, Department shall determine whether
the Individual is entitled to amend his or her PHI pursuant to 45 C.F.R. § 164.526. If
Department determines that an Individual is entitled to such an amendment, and that such
PHI is both in a Designated Record Set and under the control of Business Associate,
Department shall communicate the decision to Business Associate. Business Associate
shall provide an opportunity to amend the PHI in the same manner as would be required
for Department. If Business Associate receives an Individual’s request to amend his or
her PHI directly from the Individual, to the extent that the PHI in Business Associate’s
possession constitutes a Designated Record Set, Business Associate shall act on such
request within thirty (30) calendar days after a written request by the Individual is
received, to make available PHI for amendment and determine whether to incorporate
any amendments to the PHI, as directed by the Individual, all in accordance with 45
C.F.R. § 164.526.
4.
Accounting of Disclosures. Upon request by an Individual, Department shall determine
whether any Individual is entitled to an accounting pursuant to 45 C.F.R. § 164.528. If
Department determines that an Individual is entitled to an accounting, Department shall
communicate the decision to Business Associate. Business Associate shall provide
information to Department that will enable Department to meet its accounting
obligations. If Business Associate receives an Individual’s request for an accounting
directly from the Individual, Business Associate shall document such request and, within
thirty (30) calendar days after receiving a written request from the Individual, act on such
request to make available directly to the Individual an accounting of disclosures of PHI
about the Individual in accordance with 45 C.F.R. § 164.528.
Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this
BAA or by Applicable Law, Business Associate may:
1.
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Use or disclose PHI to perform functions, activities, or services for or on behalf of
Department, as specified in this BAA and/or the Contract, provided that such use or
disclosure (a) is consistent with Department’s Notice of Privacy Practices, and (b) would
not violate Applicable Law if done by Department;
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D.
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2.
Use PHI for the proper management and administration of Business Associate or to carry
out the legal responsibilities of Business Associate;
3.
Disclose PHI for the proper management and administration of Business Associate, if
necessary to perform its obligations under the Contract; provided that (a) Business
Associate obtains reasonable assurances from the person to whom the information is
disclosed that it will remain confidential and be used or further disclosed only as required
by law or for the purpose for which it was disclosed to the person, and the person notifies
the Business Associate of any instances of which it is aware in which the confidentiality
of the information has been breached, or (b) the disclosures are required by law; and
4.
Use PHI to provide Data Aggregation services, including through subcontractors and
agents, to Department as permitted by 45 C.F.R. § 164.504(e)(2)(i)(B);
5.
De-identify any and all PHI obtained by Business Associate under this BAA, which deidentified information does not constitute PHI, is not subject to this BAA and may be
used and disclosed on Business Associate’s own behalf, if de-identified in accordance
with the de-identification requirements of HIPAA’s Privacy Rule, 45 C.F.R.
§§ 164.502(d) and 164.514(a)-(c); and
6.
Make PHI available to an Individual in accordance with Section II.B of this BAA.
7.
Use the PHI to create a Limited Data Set (“LDS”) and disclose the LDS in compliance
with 45 C.F.R. § 164.514(e), for the sole purposes of “Health Care Operations” or
“Public Health” purposes, as those terms are defined in 45 C.F.R. 164.501; provided that
Business Associate shall: (i) not use or further disclose the information other than as
permitted by this Section C.7 and the HIPAA Rules; (ii) use appropriate safeguards to
prevent use or disclosure of the information other than as provided for by this Section C.7
and the HIPAA Rules; (iii) report to Department any use or disclosure of the information
not provided for by this Section C.7 of which Business Associate becomes aware;
(iv) ensure that any agents or subcontractors to whom Business Associate provides the
LDS agree to the same restrictions and conditions that apply to Business Associate with
respect to such information; and (v) not “identify” the information (as referred to in 45
C.F.R. § 164.514(e)(4)(ii)(C)(5)) or contact the Individuals who are the subject of the
PHI used to create the LDS.
Disclosure to Third Parties. Notwithstanding the foregoing, Business Associate shall not, and
shall require that its directors, officers, owners, employees, subcontractors, and agents do not, use
or disclose any PHI with or to third party persons or entities, unless authorized by this BAA or
required by law and the third party receiving the information has previously signed a written
agreement that: (1) binds the recipient to the provisions, restrictions, and conditions of this BAA
pertaining to PHI for the express benefit of Business Associate and its clients, including
Department; (2) contains reasonable assurances from recipient that the PHI will be held
confidential, safeguarded and protected as provided in this BAA, and only disclosed as required
by law for the purposes for which it was disclosed to recipient; and (3) obligates recipient to
immediately notify Business Associate of any Breach of Unsecured PHI or Security Incident as
more fully described in this BAA; (4) obligates Business Associate and recipient to comply with
the principle of "minimum necessary use and disclosure," in compliance with the requirements of
the HIPAA Rules; and (5) prohibits redisclosures of PHI pertaining to alcohol and substance abuse
treatment except as authorized under 42 C.F.R. § 2.22, unless Department has obtained a consent
compliant with the requirements of 42 C.F.R §2.31. Business Associate agrees to mitigate, to the
extent practicable and as otherwise requested by Department, any harmful effect known to
Business Associate that is the result of such third-party use or disclosure of PHI by Business
Associate in violation of this BAA. Further, Business Associate shall take appropriate corrective
action against any member of its workforce, or its subcontractors or agents, who use or disclose
PHI in contravention of this BAA or state or federal law.
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III.
IV.
Rights and Obligations of Department
A.
Privacy Practices and Restrictions. Upon request, Department shall provide Business Associate
with the notice of privacy practices that Department produces in accordance with 45 C.F.R.
§ 164.520. If Department subsequently revises the notice, Department shall provide a copy of the
revised notice to Business Associate.
B.
Permissible Requests by Department. Department shall not request Business Associate to use
or disclose PHI in any manner that would not be permissible under the HIPAA Rules if done by
Department.
Term and Termination
A.
Term. This BAA shall become effective upon execution by the Parties and shall supersede any
existing Business Associate Agreement among the Parties. The requirements of this BAA shall
end upon the termination of the Contract or upon termination for cause as set forth in Section
IV.B, whichever is earlier.
B.
Termination for Cause. Upon any party’s knowledge of a material breach of this BAA by
another party, the nonbreaching party shall have the following rights:
C.
V.
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1.
If the breach is curable, the nonbreaching party shall provide written notice to the
breaching party and sixty (60) calendar days for the other party to cure the breach. If the
other party fails to cure the breach, the nonbreaching party may terminate this Contract.
2.
If the breach is not curable, the nonbreaching party may immediately terminate this
Contract.
3.
If termination is not feasible, the nonbreaching party may report the problem to the
Secretary.
Effect of Termination.
1.
Except as provided in Sections IV.C.2, upon termination of the Contract or Termination
for Cause under Section IV.B, for any reason, Business Associate shall return or, if
agreed to by Department, destroy all PHI within its possession or control and all PHI that
is in the possession or control of Business Associate’s subcontractors or agents. Business
Associate shall retain no copies of the PHI. If requested by Department, Business
Associate shall transmit PHI to another business associate of Department at termination.
2.
If Business Associate determines that returning or destroying the PHI is infeasible,
Business Associate shall extend the protections of this BAA to such PHI and limit further
uses and disclosures of such PHI to those purposes that make the return or destruction
infeasible, for so long as Business Associate maintains such PHI.
Miscellaneous
A.
Regulatory References. A reference in this BAA to a section in any Applicable Law means the
section in effect or as amended, and for which compliance is required.
B.
Amendment. The Parties agree to take such action as is necessary to amend this BAA from time
to time as is necessary for Department to comply with the requirements of Applicable Law. All
amendments to this BAA shall be in writing and signed by both Parties.
C.
Survival. The respective rights and obligations of Business Associate under Section IV.C of this
BAA shall survive the term and termination of the Contract and this BAA.
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D.
Interpretation. Any ambiguity in this BAA shall be resolved in favor of a meaning that permits
Department to comply with Applicable Law.
E.
No Third Party Beneficiaries. Nothing express or implied in this BAA is intended to confer, nor
shall anything herein confer upon any person, other than Department, Business Associate and their
respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever.
F.
Assignment. No assignment of rights or obligations under this BAA shall be made by either party
without the prior written consent of the other party.
G.
Effect on Agreement. Except as specifically required to implement the purposes of this BAA, or
to the extent inconsistent with this BAA, all other terms of the underlying Contract shall remain in
force and effect.
H.
Counterparts. This BAA may be executed in counterparts, each of which may be deemed an
original.
I.
Regulatory References. Any reference herein to a federal regulatory section within the Code of
Federal Regulations shall be a reference to such section as it may be subsequently updated,
amended or modified.
COUNTY
BUSINESS ASSOCIATE
______________________________
PERSON SIGNING (PLEASE PRINT)
______________________________
PERSON SIGNING (PLEASE PRINT)
______________________________
SIGNATURE
______________________________
SIGNATURE
______________________________
DATE
______________________________
DATE
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EXHIBIT 1
VENDOR REGISTRATION PROCEDURES
BidSync.com Registration is FREE and REQUIRED for all
vendors.
Register On-line at https://www.bidsync.com
Select Free Registration. Upon completion of your on-line
registration, you are responsible for updating any changes to your
information. Please retain your Login ID and Password for future
use.
For assistance, please contact BidSync Vendor Support
Department via phone or email, during regular business hours: 1800-990-9339 or [email protected]
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EXHIBIT 2
SAMPLE TRANSMITTAL LETTER
(To be typed on the letterhead of Offeror)
Maricopa County
Office of Procurement Services
320 West Lincoln Street
Phoenix, Arizona 85003-2494
Re:
RFP Number 16018
To Whom It May Concern:
(NAME OF COMPANY) (Herein referred to as the "RESPONDENT"), hereby submits its response to your Request
for Proposal dated
, and agrees to perform as proposed in their proposal, if awarded the contract. The
Respondent shall thereupon be contractually obligated to carry out its responsibilities respecting the services
proposed.
Kindly advise this in writing on or before
if you should desire to accept this proposal.
Very truly yours,
_______________________________
NAME (please print)
_______________________________
SIGNATURE
_______________________________
TITLE (please print)
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EXHIBIT 3
DRAFT CONTRACT
SEE WORD DOCUMENT 16018-EXHIBIT 3 DRAFT CONTRACT
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EXHIBIT 4
MASTER INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENT
This Master Intergovernmental Cooperative Purchasing Agreement (“Agreement”) is made between certain
government agencies that execute a Lead Public Agency Certificate (collectively, “Lead Public Agencies”) to be
appended and made a part hereof and other government agencies (“Participating Public Agencies”) that agree to the
terms and conditions hereof through the U.S. Communities registration process and made a part hereof.
RECITALS
WHEREAS, after a competitive solicitation and selection process by Lead Public Agencies, in compliance with their
own policies, procedures, rules and regulations, a number of suppliers (each, a “Contract Supplier”) have entered
into Master Agreements with Lead Public Agencies to provide a variety of goods, products and services based
on national and international volumes (herein “Products and Services”);
WHEREAS, Master Agreements are made available by Lead Public Agencies through U.S. Communities and
provide that Participating Public Agencies may purchase Products and Services on the same terms, conditions
and pricing as the Lead Public Agency, subject to any applicable local purchasing ordinances and the laws of the
State of purchase;
WHEREAS, the parties desire to comply with the requirements and formalities of any intergovernmental
cooperative act, if applicable, to the laws of the State of purchase;
WHEREAS, the parties hereto desire to conserve resources and reduce procurement cost;
WHEREAS, the parties hereto desire to improve the efficiency, effectiveness and economy of the procurement of
necessary Products and Services;
NOW, THEREFORE, in consideration of the mutual promises contained in this Agreement, and of the mutual
benefits to result, the parties agree as follows:
1.
That each party will facilitate the cooperative procurement of Products and Services.
2.
That the procurement of Products and Services subject to this Agreement shall be conducted in accordance with
and subject to the relevant statutes, ordinances, rules and regulations that govern each party’s procurement
practices.
3.
That the cooperative use of solicitations obtained by a party to this Agreement shall be in accordance with the
terms and conditions of the solicitation, except as modification of those terms and conditions is otherwise
allowed or required by applicable law.
4.
That the Lead Public Agencies will make available, upon reasonable request and subject to convenience,
information which may assist in improving the effectiveness, efficiency and economy of Participating Public
Agencies’ procurement of Products and Services.
5.
That the Participating Public Agency will make timely payments to the Contract Supplier for Products and
Services received in accordance with the terms and conditions of the procurement. Payment, inspections and
acceptance of Products and Services ordered by the Participating Public Agency shall be the exclusive
obligation of such Participating Public Agency. Disputes between the Participating Public Agency and Contract
Supplier are to be resolved in accord with the law and venue rules of the State of purchase.
6.
The Participating Public Agency shall not use this Agreement as a method for obtaining additional concessions
or reduced prices for similar products or services.
7.
The Participating Public Agency is solely responsible for ordering, accepting, and paying and any other action,
inaction or decision regarding the Products and Services obtained under this Agreement. A Lead Public
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Agency shall not be liable in any manner for any action or inaction or decisions taken by a Participating Public
Agency. The Participating Public Agency shall, to the extent permitted by applicable law, hold the Lead Public
Agency harmless from any liability that may arise from action or inaction of the Participating Public Agency.
8.
The exercise of any rights or remedies by the Participating Public Agency shall be the exclusive obligation of
such Participating Public Agency.
9.
This Agreement shall remain in effect until termination by a party giving thirty (30) days prior written notice to
U.S. Communities at 2999 Oak Road, Suite 710, Walnut Creek, CA 94597.
10. This Agreement shall become effective after execution of the Lead Public Agency Certificate or Participating
Public Agency registration, as applicable.
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EXHIBIT 5
ADMINISTRATION AGREEMENT
This ADMINISTRATION AGREEMENT (“Agreement”) is made as of ________________, by
and between U.S. COMMUNITIES GOVERNMENT PURCHASING ALLIANCE (“U.S.
Communities”) and _______________________ (“Supplier”).
RECITALS
WHEREAS,
(“Lead Public Agency”) has entered into a certain Master Agreement
dated as of even date herewith, referenced as Agreement No. _______, by and between Lead Public Agency and
Supplier (as amended from time to time in accordance with the terms thereof, the “Master Agreement”) for the
purchase of ___________________ (the “Products and Services”);
WHEREAS, the Master Agreement provides that any state, county, city, special district, local government,
school district, private K-12 school, technical or vocational school, higher education institution (including
community colleges, colleges and universities, both public and private), other government agency or nonprofit
organization (each a “Public Agency” and collectively, “Public Agencies”) may purchase Products and Services at
the prices indicated in the Master Agreement upon prior registration with U.S. Communities, in which case the
Public Agency becomes a “Participating Public Agency”;
WHEREAS, U.S. Communities has the administrative and legal capacity to administer purchases under the
Master Agreement to Participating Public Agencies;
WHEREAS, U.S. Communities serves as the administrative agent for Lead Public Agency and other lead
public agencies in connection with other master agreements offered by U.S. Communities;
WHEREAS, Lead Public Agency desires U.S. Communities to proceed with administration of the Master
Agreement on the same basis as other master agreements;
WHEREAS, “U.S. Communities Government Purchasing Alliance” is a trade name licensed by U.S.
Communities Purchasing & Finance Agency; and
WHEREAS, U.S. Communities and Supplier desire to enter into this Agreement to make available the
Master Agreement to Participating Public Agencies.
NOW, THEREFORE, in consideration of the payments to be made hereunder and the mutual covenants
contained in this Agreement, U.S. Communities and Supplier hereby agree as follows:
ARTICLE I
GENERAL TERMS AND CONDITIONS
1.1
The Master Agreement, attached hereto as Exhibit A and incorporated herein by reference as
though fully set forth herein, and the terms and conditions contained therein shall apply to this Agreement except as
expressly changed or modified by this Agreement.
1.2
U.S. Communities shall be afforded all of the rights, privileges and indemnifications afforded to
Lead Public Agency under the Master Agreement, and such rights, privileges and indemnifications shall accrue and
apply with equal effect to U.S. Communities under this Agreement including, without limitation, Supplier’s
obligation to provide insurance and certain indemnifications to Lead Public Agency.
1.3
Supplier shall perform all duties, responsibilities and obligations required under the Master
Agreement in the time and manner specified by the Master Agreement.
1.4
U.S. Communities shall perform all of its duties, responsibilities and obligations as administrator
of purchases under the Master Agreement as set forth herein, and Supplier acknowledges that U.S. Communities
shall act in the capacity of administrator of purchases under the Master Agreement.
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1.5
With respect to any purchases made by Lead Public Agency or any Participating Public Agency
pursuant to the Master Agreement, U.S. Communities (a) shall not be construed as a dealer, re-marketer,
representative, partner, or agent of any type of Supplier, Lead Public Agency or such Participating Public Agency,
(b) shall not be obligated, liable or responsible (i) for any orders made by Lead Public Agency, any Participating
Public Agency or any employee of Lead Public Agency or a Participating Public Agency under the Master
Agreement, or (ii) for any payments required to be made with respect to such order, and (c) shall not be obligated,
liable or responsible for any failure by a Participating Public Agency to (i) comply with procedures or requirements
of applicable law, or (ii) obtain the due authorization and approval necessary to purchase under the Master
Agreement. U.S. Communities makes no representations or guaranties with respect to any minimum purchases
required to be made by Lead Public Agency, any Participating Public Agency, or any employee of Lead Public
Agency or a Participating Public Agency under this Agreement or the Master Agreement.
ARTICLE II
TERM OF AGREEMENT
2.1
This Agreement is effective as of ____________________ and shall terminate upon termination
of the Master Agreement or any earlier termination in accordance with the terms of this Agreement, provided,
however, that the obligation to pay all amounts owed by Supplier to U.S. Communities through the termination of
this Agreement and all indemnifications afforded by Supplier to U.S. Communities shall survive the term of this
Agreement.
ARTICLE III
REPRESENTATIONS AND COVENANTS
3.1
U.S. Communities views the relationship with Supplier as an opportunity to provide benefits to
both Public Agencies and Supplier. The successful foundation of the relationship requires certain representations
and covenants from both U.S. Communities and Supplier.
3.2
U.S. Communities’ Representations and Covenants.
(a)
Marketing. U.S. Communities shall proactively market the Master Agreement to Public
Agencies using resources such as a network of major sponsors including the National League of Cities (NLC),
National Association of Counties (NACo), United States Conference of Mayors (USCM), and the Association of
School Business Officials (ASBO) (collectively, the “Founding Co-Sponsors”) and individual state-level sponsors.
In addition, the U.S. Communities staff shall enhance Supplier’s marketing efforts through meetings with Public
Agencies, participation in key events and tradeshows and by providing online tools to Supplier’s sales force.
(b)
Training and Knowledge Management Support. U.S. Communities shall provide support
for the education, training and engagement of Supplier’s sales force as provided herein. Through its staff (each, a
“Program Manager” and collectively, the “Program Managers”), U.S. Communities shall conduct training sessions
with Supplier and shall conduct calls jointly with Supplier to Public Agencies. U.S. Communities shall also provide
Supplier with access to U.S. Communities’ private intranet website which provides presentations, documents and
information to assist Supplier’s sales force in effectively promoting the Master Agreement.
3.3
Supplier’s Representations and Covenants. Supplier hereby represents and covenants as follows
in order to ensure that Supplier is providing the highest level of public benefit to Participating Public Agencies (such
representations and covenants are sometimes referred to as “Supplier’s Commitments” and are comprised of the
Corporate Commitment, Pricing Commitment, Economy Commitment and Sales Commitment):
(a)
Corporate Commitment.
(i)
The pricing, terms and conditions of the Master Agreement shall, at all times, be
Supplier’s primary contractual offering of Products and Services to Public Agencies. All of Supplier’s direct and
indirect marketing and sales efforts to Public Agencies shall demonstrate that the Master Agreement is Supplier’s
primary offering and not just one of Supplier’s contract options.
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(ii)
Supplier’s sales force (including inside, direct and/or authorized dealers,
distributors and representatives) shall always present the Master Agreement when marketing Products or Services to
Public
Agencies.
(iii)
Supplier shall advise all Public Agencies that are existing customers of Supplier
as to the pricing and other value offered through the Master Agreement.
(iv)
Upon authorization by a Public Agency, Supplier shall transition such Public
Agency to the pricing, terms and conditions of the Master Agreement.
(v)
Supplier shall ensure that the U.S. Communities program and the Master
Agreement are actively supported by Supplier’s senior executive management.
(vi)
Supplier shall provide a national/senior management level representative with
the authority and responsibility to ensure that the Supplier’s Commitments are maintained at all times. Supplier
shall also designate a lead referral contact person who shall be responsible for receiving communications from U.S.
Communities concerning new Participating Public Agency registrations and for ensuring timely follow-up by
Supplier’s staff to requests for contact from Participating Public Agencies. Supplier shall also provide the personnel
necessary to implement and support a supplier-based internet web page dedicated to Supplier’s U.S. Communities
program and linked to U.S. Communities’ website and shall implement and support such web page.
(vii)
Supplier shall demonstrate in its procurement solicitation response and
throughout the term of the Master Agreement that national/senior management fully supports the U.S. Communities
program and its commitments and requirements. National/Senior management is defined as the executive(s) with
companywide authority.
(viii)
Where Supplier has an existing contract for Products and Services with a state,
Supplier shall notify the state of the Master Agreement and transition the state to the pricing, terms and conditions of
the Master Agreement upon the state’s request. Regardless of whether the state decides to transition to the Master
Agreement, Supplier shall primarily offer the Master Agreement to all Public Agencies located within the state.
(b)
Pricing Commitment.
(i)
Supplier represents to U.S. Communities that the pricing offered under the
Master Agreement is the lowest overall available pricing (net to purchaser) on Products and Services that it offers to
Public Agencies. Supplier’s pricing shall be evaluated on either an overall project basis or the Public Agency’s
actual usage for more frequently purchased Products and Services.
(ii)
Contracts Offering Lower Prices. If a pre-existing contract and/or a Public
Agency’s unique buying pattern provide one or more Public Agencies a lower price than that offered under the
Master Agreement, Supplier shall match that lower pricing under the Master Agreement and inform the eligible
Public Agencies that the lower pricing is available under the Master Agreement. If an eligible Public Agency
requests to be transitioned to the Master Agreement, Supplier shall do so and report the Public Agency’s purchases
made under the Master Agreement going forward. The price match only applies to the eligible Public Agencies.
Below are three examples of Supplier’s obligation to match the pricing under Supplier’s contracts offering lower
prices.
(A)
Supplier holds a state contract with lower pricing that is available to all
Public Agencies within the state. Supplier would be required to match the lower state pricing under the
Master Agreement and make it available to all Public Agencies within the state.
(B)
Supplier holds a regional cooperative contract with lower pricing that is
available only to the ten cooperative members. Supplier would be required to match the lower cooperative
pricing under the Master Agreement and make it available to the ten cooperative members.
(C)
Supplier holds a contract with an individual Public Agency. The Public
Agency contract does not contain any cooperative language and therefore other Public Agencies are not
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eligible to utilize the contract. Supplier would be required to match the lower pricing under the Master
Agreement and make it available only to the individual Public Agency.
(iii)
Deviating Buying Patterns. Occasionally U.S. Communities and Supplier may
interact with a Public Agency that has a buying pattern or terms and conditions that considerably deviate from the
normal Public Agency buying pattern and terms and conditions, and causes Supplier’s pricing under the Master
Agreement to be higher than an alternative contract held by Supplier. This could be created by a unique end-user
preference or requirements. In the event that this situation occurs, Supplier may address the issue by lowering the
price under the Master Agreement on the item(s) causing the large deviation for that Public Agency. Supplier would
not be required to lower the price for other Public Agencies.
(iv)
Supplier’s Options in Responding to a Third Party Procurement
Solicitation. While it is the objective of U.S. Communities to encourage Public Agencies to piggyback on to the
Master Agreement rather than issue their own procurement solicitations, U.S. Communities recognizes that for
various reasons some Public Agencies will issue their own solicitations. The following options are available to
Supplier when responding to a Public Agency solicitation:
(A)
Supplier may opt not to respond to the procurement solicitation.
Supplier may make the Master Agreement available to the Public Agency as a comparison to its solicitation
responses.
(B)
Supplier may respond with the pricing, terms and conditions of the
Master Agreement. If Supplier is awarded the contract, the sales would be reported as sales under the
Master Agreement.
(C)
If competitive conditions require pricing lower than the standard
Master Agreement pricing, Supplier may submit lower pricing through the Master Agreement. If Supplier
is awarded the contract, the sales would be reported as sales under the Master Agreement. Supplier would
not be required to extend the lower price to other Public Agencies.
(D)
Supplier may respond to the procurement solicitation with pricing that
is higher (net to buyer) than the pricing offered under the Master Agreement. If awarded a contract,
Supplier shall still be bound by all obligations set forth in this Section 3.3, including, without limitation, the
requirement to continue to advise the awarding Public Agency of the pricing, terms and conditions of the
Master Agreement.
(E)
Supplier may respond to the procurement solicitation with pricing that
is higher (net to buyer) than the pricing offered under the Master Agreement and if an alternative response
is permitted, Supplier may offer the pricing under the Master Agreement as an alternative for consideration.
(c)
Economy Commitment. Supplier shall demonstrate the benefits, including the pricing
advantage, of the Master Agreement over alternative options, including competitive solicitation pricing and shall
proactively offer the terms and pricing under the Master Agreement to Public Agencies as a more effective
alternative to the cost and time associated with such alternate bids and solicitations.
(d)
Sales Commitment. Supplier shall market the Master Agreement through Supplier’s
sales force or dealer network that is properly trained, engaged and committed to offering the Master Agreement as
Supplier’s primary offering to Public Agencies. Supplier’s sales force compensation and incentives shall be greater
than or equal to the compensation and incentives earned under other contracts to Public Agencies.
(i)
Supplier Sales. Supplier shall be responsible for proactive direct sales of
Supplier’s Products and Services to Public Agencies and the timely follow-up to sales leads identified by U.S.
Communities. Use of product catalogs, targeted advertising, direct mail and other sales initiatives are encouraged.
All of Supplier’s sales materials targeted towards Public Agencies shall include the U.S. Communities logo. U.S.
Communities hereby grants to Supplier, during the term of this Agreement, a non-exclusive, revocable, nontransferable, license to use the U.S. Communities name, trademark, and logo solely to perform its obligations under
this Agreement, and for no other purpose. Any goodwill, rights, or benefits derived from Supplier's use of the U.S.
Communities name, trademark, or logo shall inure to the benefit of U.S. Communities. U.S. Communities shall
provide Supplier with its logo and the standards to be employed in the use of the logo. During the term of the
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Agreement, the Supplier shall provide U.S. Communities with its logo and the standards to be employed in the use
of the logo for purposes of reproducing and using Supplier’s name and logo in connection with the advertising,
marketing and promotion of the Master Agreement to Public Agencies. Supplier shall assist U.S. Communities by
providing camera-ready logos and by participating in related trade shows and conferences. At a minimum,
Supplier's sales initiatives shall communicate that (i) the Master Agreement was competitively solicited by the Lead
Public Agency, (ii) the Master Agreement provides the best government pricing, (iii) there is no cost to Participating
Public Agencies, and (iv) the Master Agreement is a non-exclusive contract.
(ii)
Branding and Logo Compliance. Supplier shall be responsible for complying
with the U.S. Communities branding and logo standards and guidelines. Prior to use by Supplier, all U.S.
Communities related marketing material must be submitted to U.S. Communities for review and approval.
(iii)
Sales Force Training. Supplier shall train its national sales force on the Master
Agreement and U.S. Communities program. U.S. Communities shall be available to train regional or district
managers and generally assist with the education of sales personnel.
(iv)
Participating Public Agency Access.
communication links to facilitate customer access and communication:
Supplier shall establish the following
(A)
A dedicated U.S. Communities internet web-based homepage
containing:
(1)
U.S. Communities standard logo with Founding CoSponsors logos;
(2)
Copy of original procurement solicitation;
(3)
Copy of Master Agreement including any amendments;
(4)
Summary of Products and Services pricing;
(5)
Electronic link to U.S. Communities’ online registration
page; and
(6)
Other promotional material as requested by U.S.
Communities.
(B)
A dedicated toll-free national hotline for inquiries regarding
U.S. Communities.
(C)
A dedicated email address for general inquiries in the following
format: uscommunities@(name of supplier).com.
(v)
Electronic Registration. Supplier shall be responsible for ensuring that each
Public Agency has completed U.S. Communities’ online registration process prior to processing the Public
Agency’s first sales order.
(vi)
Supplier’s Performance Review. Upon request by U.S. Communities, Supplier
shall participate in a performance review meeting with U.S. Communities to evaluate Supplier’s performance of the
covenants set forth in this Agreement.
(vii)
Supplier Content. Supplier may, from time to time, provide certain graphics,
media, and other content to U.S. Communities (collectively "Supplier Content") for use on U.S. Communities
websites and for general marketing and publicity purposes. During the term of the Agreement, Supplier hereby
grants to U.S. Communities and its affiliates a non-exclusive, worldwide, free, transferrable, license to reproduce,
modify, distribute, publically perform, publically display, and use Supplier Content in connection with U.S.
Communities websites and for general marketing and publicity purposes, with the right to sublicense each and every
such right. Supplier warrants that: (a) Supplier is the owner of or otherwise has the unrestricted right to grant the
rights in and to Supplier Content as contemplated hereunder; and (b) the use of Supplier Content and any other
materials or services provided to U.S. Communities as contemplated hereunder will not violate, infringe, or
misappropriate the intellectual property rights or other rights of any third party
3.4
Breach of Supplier’s Representations and Covenants. The representations and covenants
set forth in this Agreement are the foundation of the relationship between U.S. Communities and Supplier. If
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Supplier is found to be in violation of, or non-compliance with, one or more of the representations and covenants set
forth in this Agreement, Supplier shall have ninety (90) days from the notice of default to cure such violation or noncompliance and, if Supplier fails to cure such violation or non-compliance within such notice period, it shall be
deemed a cause for immediate termination of the Master Agreement at Lead Public Agency’s sole discretion or this
Agreement at U.S. Communities’ sole discretion.
3.5
Indemnity. Supplier hereby agrees to indemnify and defend U.S. Communities, and its
parent companies, subsidiaries, affiliates, shareholders, member, manager, officers, directors, employees, agents,
and representatives from and against any and all claims, costs, proceedings, demands, losses, damages, and expenses
(including, without limitation, reasonable attorney's fees and legal costs) of any kind or nature, arising from or
relating to, any actual or alleged breach of any of Supplier's representations, warranties, or covenants in this
Agreement.
ARTICLE IV
PRICING AUDITS
4.1
Supplier shall, at Supplier’s sole expense, maintain an accounting of all purchases made by Lead
Public Agency and Participating Public Agencies under the Master Agreement. U.S. Communities and Lead
Public Agency each reserve the right to audit the accounting for a period of three (3) years from the time such
purchases are made. This audit right shall survive termination of this Agreement for a period of one (1) year from
the effective date of termination. U.S. Communities shall have the authority to conduct random audits of Supplier’s
pricing that is offered to Participating Public Agencies at U.S. Communities’ sole cost and expense.
Notwithstanding the foregoing, in the event that U.S. Communities is made aware of any pricing being offered to
three (3) or more Participating Public Agencies that is materially inconsistent with the pricing under the Master
Agreement, U.S. Communities shall have the ability to conduct a reasonable audit of Supplier’s pricing at Supplier’s
sole cost and expense during regular business hours upon reasonable notice. U.S. Communities may conduct the
audit internally or may engage a third-party auditing firm on a non-contingent basis. Supplier shall solely be
responsible for the cost of the audit up to the first $50,000 and U.S. Communities and Supplier shall each be
responsible for fifty percent (50%) of the audit costs that exceed $50,000. In the event of an audit, the requested
materials shall be provided in the format and at the location where kept in the ordinary course of business by
Supplier.
ARTICLE V
FEES & REPORTING
5.1
Administrative Fees. Supplier shall pay to U.S. Communities a monthly administrative fee based
upon the total sales price of all purchases shipped and billed pursuant to the Master Agreement, excluding taxes, in
the amount of two percent (2%) of aggregate purchases made during each calendar month (individually and
collectively, “Administrative Fees”). Supplier’s annual sales shall be measured on a calendar year basis. All
Administrative Fees shall be payable in U.S. Dollars and shall be made by wire to U.S. Communities, or its designee
or trustee as may be directed in writing by U.S. Communities. Administrative Fees shall be due and payable within
thirty (30) days of the end of each calendar month for purchases shipped and billed during such calendar month.
U.S. Communities agrees to pay to Lead Public Agency five percent (5%) of all Administrative Fees received from
Supplier to help offset Lead Public Agency’s costs incurred in connection with managing the Master Agreement
nationally.
5.2
Sales Reports. Within thirty (30) days of the end of each calendar month, Supplier shall deliver to
U.S. Communities an electronic accounting report, in the format prescribed by Exhibit B, attached hereto,
summarizing all purchases made under the Master Agreement during such calendar month (“Sales Report”). All
purchases indicated in the Sales Report shall be denominated in U.S. Dollars. All purchases shipped and billed
pursuant to the Master Agreement for the applicable calendar month shall be included in the Sales Report. U.S.
Communities reserves the right upon reasonable advance notice to Supplier to change the prescribed report format to
accommodate the distribution of the Administrative Fees to its program sponsors and state associations.
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(a)
Monthly Sales Reports shall include all sales reporting under the Master Agreement, and
a breakout of Environmental Preferable (Green) sales reporting. Supplier must make reasonable attempts at filling
in all required information and contact U.S. Communities with a plan to correct any deficiencies of data field
population.
(b)
Submitted reports shall be verified by U.S. Communities against its registration database.
Any data that is inconsistent with the registration database shall be changed prior to processing.
5.3
Exception Reporting/Sales Reports Audits. U.S. Communities or its designee may, at its sole
discretion, compare Supplier’s Sales Reports with Participating Public Agency records or other sales analysis
performed by Participating Public Agencies, sponsors, advisory board members or U.S. Communities staff. If there
is a material discrepancy between the Sales Report and such records or sales analysis as determined by U.S.
Communities, U.S. Communities shall notify Supplier in writing and Supplier shall have thirty (30) days from the
date of such notice to resolve the discrepancy to U.S. Communities’ reasonable satisfaction. Upon resolution of the
discrepancy, Supplier shall remit payment to U.S. Communities’ trustee within fifteen (15) calendar days. Any
questions regarding an exception report should be directed to U.S. Communities in writing to
[email protected]. If Supplier does not resolve the discrepancy to U.S. Communities’ reasonable
satisfaction within thirty (30) days, U.S. Communities shall have the right to engage outside services to conduct an
independent audit of Supplier’s reports. Supplier shall solely be responsible for the cost of the audit up to the first
$50,000 and U.S. Communities and Supplier shall each be responsible for fifty percent (50%) of the audit costs that
exceed $50,000.
5.4
Online Reporting. Within sixty (60) days of the end of each calendar quarter, U.S. Communities
shall provide online reporting to Supplier containing Supplier’s sales reporting for such calendar quarter. Supplier
shall contact U.S. Communities within fifteen (15) days of receiving notification of the online reporting and report
to U.S. Communities any concerns or disputes regarding the reports, including but not limited to concerns regarding
the following:
Report Name
5 Qtr Drop Sales Analysis
Zero States Sales Report
Registered Agency Without Sales Report
Follow up with U.S. Communities
Financial & Reporting Manager
Program Manager
Program Manager
Supplier shall have access to the above reports through the U.S. Communities intranet website. The following
additional reports are also available to Supplier and are useful in resolving reporting issues and enabling Supplier to
better manage its Master Agreement:
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
Agency Sales by Population/Enrollment Report
Hot Prospect Sales Report
New Lead Sales Report
State Comparison Sales Report
Advisory Board Usage Report
Various Agency Type Comparison Reports
Sales Report Builder
5.5
Supplier’s Failure to Provide Reports or Pay Administrative Fees. Failure to provide a Sales
Report or pay Administrative Fees within the time and in the manner specified herein shall be regarded as a material
breach under this Agreement and if not cured within thirty (30) days of written notice to Supplier, shall be deemed a
cause for termination of the Master Agreement at Lead Public Agency’s sole discretion or this Agreement at U.S.
Communities’ sole discretion. All Administrative Fees not paid within thirty (30) days of the end of the previous
calendar month shall bear interest at the rate of one and one-half percent (1.5%) per month until paid in full.
ARTICLE VI
MISCELLANEOUS
6.1
Entire Agreement. This Agreement supersedes any and all other agreements, either oral or in
writing, between the parties hereto with respect to the subject matter hereof, and no other agreement, statement, or
promise relating to the subject matter of this Agreement which is not contained herein shall be valid or binding.
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6.2
Attorney’s Fees. If any action at law or in equity is brought to enforce or interpret the provisions
of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees and costs in addition to any
other relief to which such party may be entitled.
6.3
Assignment.
(a)
Supplier. Neither this Agreement nor any rights or obligations hereunder shall be
assignable by Supplier without prior written consent of U.S. Communities, and any assignment without such consent
shall be void.
(b)
U.S. Communities. This Agreement and any rights or obligations hereunder may be
assigned by U.S. Communities in U.S. Communities’ sole discretion, to an existing or newly established legal entity
that has the authority and capacity to perform U.S. Communities’ obligations hereunder.
6.4
Notices. All reports, notices or other communications given hereunder shall be delivered by firstclass mail, postage prepaid, or overnight delivery requiring signature on receipt to the addresses as set forth below.
U.S. Communities may, by written notice delivered to Supplier, designate any different address to which subsequent
reports, notices or other communications shall be sent.
U.S. Communities:
U.S. Communities
2999 Oak Road, Suite 710
Walnut Creek, California 94597
Attn: Program Manager Administration
Supplier:
________________________________
________________________________
________________________________
________________________________
Attn: U.S. Communities Program Manager
6.5
Severability. If any provision of this Agreement shall be deemed to be, or shall in fact be, illegal,
inoperative or unenforceable, the same shall not affect any other provision or provisions herein contained or render
the same invalid, inoperative or unenforceable to any extent whatever.
6.6
Waiver. Any failure of a party to enforce, for any period of time, any of the provisions under this
Agreement shall not be construed as a waiver of such provisions or of the right of said party thereafter to enforce
each and every provision under this Agreement.
6.7
Counterparts. This Agreement may be executed in several counterparts, each of which shall be an
original and all of which shall constitute but one and the same instrument.
6.8
Modifications. This Agreement may not be effectively amended, changed, modified, altered or
terminated without the prior written consent of the parties hereto.
6.9
Governing Law; Arbitration. This Agreement will be governed by and interpreted in accordance
with the laws of the State of California without regard to any conflict of laws principles. Any dispute, claim, or
controversy arising out of or relating to this Agreement or the breach, termination, enforcement, interpretation or
validity thereof, including the determination of the scope or applicability of this dispute resolution clause, shall be
determined by arbitration in Walnut Creek, California, before one (1) arbitrator. The arbitration shall be
administered by JAMS pursuant to its Comprehensive Arbitration Rules and Procedures. Judgment on the award
may be entered in any court having jurisdiction. This clause shall not preclude parties from seeking provisional
remedies in aid of arbitration from a court of appropriate jurisdiction. The prevailing party will be entitled to
recover its reasonable attorneys' fees and arbitration costs from the other party. The arbitration award shall be final
and binding. Each party commits that prior to commencement of arbitration proceedings, the parties shall submit
the dispute to JAMS for mediation. The parties will cooperate with JAMS and with one another in selecting a
mediator from JAMS panel of neutrals, and in promptly scheduling the mediation proceedings. The parties
covenant that they will participate in the mediation in good faith, and that they will share equally in its costs. The
mediation will be conducted by each party designating a duly authorized officer or other representative to represent
the party with the authority to bind the party, and that the parties agree to exchange informally such information as is
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reasonably necessary and relevant to the issues being mediated. All offers, promises, conduct, and statements,
whether oral or written, made in the course of the mediation by any of the parties, their agents, employees, experts,
and attorneys, and by the mediator or any JAMS employees, are confidential, privileged, and inadmissible for any
purpose, including impeachment, in any arbitration or other proceeding involving the parties, provided that evidence
that is otherwise admissible or discoverable shall not be rendered inadmissible or non-discoverable as a result of its
use in the mediation. If the dispute is not resolved within thirty (30) days from the date of the submission of the
dispute to mediation (or such later date as the parties may mutually agree in writing), the administration of the
arbitration shall proceed. The mediation may continue, if the parties so agree, after the appointment of the
arbitrator. Unless otherwise agreed by the parties, the mediator shall be disqualified from serving as arbitrator in the
case. The pendency of a mediation shall not preclude a party from seeking provisional remedies in aid of the
arbitration from a court of appropriate jurisdiction, and the parties agree not to defend against any application for
provisional relief on the ground that a mediation is pending.
6.10
Successors and Assigns. This Agreement shall inure to the benefit of and shall be binding upon
U.S. Communities, Supplier and any successor and assign thereto; subject, however, to the limitations contained
herein.
[Remainder of Page Intentionally Left Blank – Signatures Follow]
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IN WITNESS WHEREOF, U.S. Communities has caused this Agreement to be executed in its name and
Supplier has caused this Agreement to be executed in its name, all as of the date first written above.
U.S. Communities:
U.S. COMMUNITIES GOVERNMENT PURCHASING ALLIANCE
By
_______________________________
Name: _______________________________
Title:
_______________________________
Supplier:
_____________________________________
By
_______________________________
Name: _______________________________
Title:
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ATTACHMENT A
MASTER AGREEMENT
(Maricopa County Master Agreement/Contract to be attached at time of award.)
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ATTACHMENT B
SALES REPORT FORMAT
Appendix B - US (Data Format)
Sales Report Template
TIN
956000735
956000222
956000735
956000735
066002010
066001854
Column Name
TIN
Supplier ID
Account No.
Agency Name
Dept Name
Address
City
State
Zip
Agency Type
Year
Qtr
Month
Amount
Supplier ID
Account No.
160
89518997
160
34868035
160
89496461
160
89374835
160
328NA0001053
160
328NA0001051
Required
Optional
Yes
Optional
Yes
Optional
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Data Type
Text
Number
Text
Text
Text
Text
Text
Text
Text
Number
Number
Number
Number
Number
Agency Type ID
10
11
12
20
21
22
30
31
40
41
50
80
81
82
84
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Agency Name
CITY OF LA/MGMT EMPL SVCS
LOS ANGELES COUNTY
CITY OF LA/ENVIRON AFFAIR
CITY OF LA/COMMUNITY DEV
GROTON TOWN OF PUBLIC WORKS
GROTON CITY OF
Dept Name
Purchasing
Facilities
Purchasing
Purchasing
Water
Administration
Address
555 RAMIREZ ST STE 312
350 S FIGUEROA ST STE 700
555 RAMIREZ ST STE 312
555 RAMIREZ ST STE 312
123 A St.
123 A St.
City
LOS ANGELES
LOS ANGELES
LOS ANGELES
LOS ANGELES
GROTON
GROTON
State
CA
CA
CA
CA
CT
CT
Zip
90012
90071
90012
90012
06340
06340
Agency Type
20
30
20
20
20
20
Year Qtr Month
2012 2
5
2012 2
5
2012 2
5
2012 2
5
2012 2
5
2012 2
5
Amount
1525.50
1603.64
1625.05
45090.79
318.00
212.00
SALES REPORT DATA FORMAT
Length
Example
Comment
9
956000735
No Dash, Do not omit leading zero.
3
111
See Supplier ID Table Below
25 max
Depends on supplier account no.
255 max
Los Angeles County
255 max
Purchasing Dept
255 max
255 max
Los Angeles
Must be a valid City name
2
CA
5
90071
No Dash, Do not omit leading zero, Valid zip code
2
30
See Agency Type Table Below
4
2010
1
4
2
12
variable
45090.79
Two digit decimal point, no $ sign or commas
Agency Type Table
Agency Type Description
K-12
Community College
College and University
City
City Special District
Consolidated City/County
County
County Special District
Federal
Crown Corporations
Housing Authority
State Agency
Independent Special District
Non-Profit
Other
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EXHIBIT 6
STATE NOTICE ADDENDUM
Pursuant to certain state notice provisions the following public agencies and political subdivisions of the
referenced public agencies are eligible to access the contract award made pursuant to this solicitation.
Public agencies and political subdivisions are hereby given notice of the foregoing request for proposal for
purposes of complying with the procedural requirements of said statutes:
Nationwide:
http://www.usa.gov/Agencies/Local_Government/Cities.shtml
Other states:
State of Oregon, State of Hawaii, State of Washington
State: HI
Account Type: HI Counties, Cities, Colleges
Hawaii County
Honolulu County
Kauai County
Maui County
Kalawao County
Aiea
Anahola
Barbers Point N A S
Camp H M Smith
Captain Cook
Eleele
Ewa Beach
Fort Shafter
Haiku
Hakalau
Haleiwa
Hana
Hanalei
Hanamaulu
Hanapepe
Hauula
Hawaii National Park
Hawaiian Ocean View
Hawi
Hickam AFB
Hilo
Holualoa
Honaunau
Honokaa
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Honolulu
Honomu
Hoolehua
Kaaawa
Kahuku
Kahului
Kailua
Kailua Kona
Kalaheo
Kalaupapa
Kamuela
Kaneohe
Kapaa
Kapaau
Kapolei
Kaumakani
Kaunakakai
Kawela Bay
Keaau
Kealakekua
Kealia
Keauhou
Kekaha
Kihei
Kilauea
Koloa
Kualapuu
Kula
Kunia
Kurtistown
Lahaina
Laie
Lanai City
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Laupahoehoe
Lawai
Lihue
M C B H Kaneohe Bay
Makawao
Makaweli
Maunaloa
Mililani
Mountain View
Naalehu
Ninole
Ocean View
Ookala
Paauhau
Paauilo
Pahala
Pahoa
Paia
Papaaloa
Papaikou
Pearl City
Pearl Harbor
Pepeekeo
Princeville
Pukalani
Puunene
Schofield Barracks
Tripler Army Medical Center
Volvano
Wahiawa
Waialua
Waianae
Waikoloa
Wailuku
Waimanalo
Waimea
Waipahu
Wake Island
Wheeler Army Airfield
Brigham Young University - Hawaii
Chaminade University of Honolulu
Hawaii Business College
Hawaii Pacific University
Hawaii Technology Institute
Heald College - Honolulu
Remington College - Honolulu Campus
University of Phoenix - Hawaii Campus
Hawaii Community College
Honolulu Community College
Kapiolani Community College
Kauai Community College
Leeward Community College
Maui Community College
University of Hawaii at Hilo
University of Hawaii at Manoa
Windward Community College
State: HI (124 records)
STATE OF HAWAII, DEPT. OF
EDUCATION
KE KULA O S. M. KAMAKAU
KAMEHAMEHA SCHOOLS
HANAHAU`OLI SCHOOL
EMMANUAL LUTHERAN SCHOOL
School Lunch Program
Our Savior Lutheran School
Account Type: K-12 (16 records)
Malama Honua Public Charter School
ST JOHN THE BAPTIST
Waimanalo Elementary and Intermediate
School
Kailua High School
PACIFIC BUDDHIST ACADEMY
HAWAII TECHNOLOGY ACADEMY
CONGREGATION OF CHRISTIAN
BROTHERS OF HAWAII, INC.
MARYKNOLL SCHOOL
ISLAND SCHOOL
12/8/2015 1:11 PM
Account Type: County (5 records)
BOARD OF WATER SUPPLY
MAUI COUNTY COUNCIL
Kauai County Council
Honolulu Fire Department
COUNTY OF MAUI
p. 75
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Account Type: Non-Profit (70 records)
Lanai Community Health Center
Maui High Band Booster Club
Naalehu Assembly of God
outrigger canoe club
One Kalakaua
Native Hawaiian Hospitality Association
St. Theresa School
Hawaii Peace and Justice
Kauai Youth Basketball Association
NA HALE O MAUI
LEEWARD HABITAT FOR HUMANITY
WAIANAE COMMUNITY OUTREACH
NA LEI ALOHA FOUNDATION
HAWAII FAMILY LAW CLINIC DBA ALA
KUOLA
BUILDING INDUSTRY ASSOCIATION OF
HAWAII
UNIVERSITY OF HAWAII FEDERAL
CREDIT UNION
LANAKILA REHABILITATION CENTER
INC.
POLYNESIAN CULTURAL CENTER
CTR FOR CULTURAL AND TECH
INTERCHNG BETW EAST AND WEST
BISHOP MUSEUM
ALOCHOLIC REHABILITATION SVS OF
HI INC DBA HINA MAUKA
ASSOSIATION OF OWNERS OF KUKUI
PLAZA
MAUI ECONOMIC DEVELOPMENT
BOARD
NETWORK ENTERPRISES, INC.
HONOLULU HABITAT FOR HUMANITY
ALOHACARE
ORI ANUENUE HALE, INC.
IUPAT, DISTRICT COUNCIL 50
GOODWILL INDUSTRIES OF HAWAII,
INC.
HAROLD K.L. CASTLE FOUNDATION
MAUI ECONOMIC OPPORTUNITY, INC.
EAH, INC.
PARTNERS IN DEVELOPMENT
FOUNDATION
HABITAT FOR HUMANITY MAUI
W. M. KECK OBSERVATORY
12/8/2015 1:11 PM
HAWAII EMPLOYERS COUNCIL
HAWAII STATE FCU
MAUI COUNTY FCU
PUNAHOU SCHOOL
YMCA OF HONOLULU
EASTER SEALS HAWAII
AMERICAN LUNG ASSOCIATION
Pohaha I Ka Lani
Hawaii Area Committee
Lanai Federal Credit Union
READ TO ME INTERNATIONAL
FOUNDATION
MAUI FAMILY YMCA
WAILUKU FEDERAL CREDIT UNION
ST. THERESA CHURCH
HALE MAHAOLU
West Maui Community Federal Credit Union
Hawaii Island Humane Society
Kama'aina Care Inc
International Archaeological Research Institute,
Inc.
Community Empowerment Resources
Tutu and Me Traveling Preschool
First United Methodist Church
AOAO Royal Capitol Plaza
Kumpang Lanai
Child and Family Service
MARINE SURF WAIKIKI, INC.
Hawaii Health Connector
Hawaii Carpenters Market Recovery Program
Fund
Puu Heleakala Community Association
Saint Louis School
Kailua Racquet Club, Ltd.
Homewise Inc.
Hawaii Baptist Academy
Kroc Center Hawaii
Kupu
Account Type: College and University (8
records)
University of the Nations
ARGOSY UNIVERSITY
HAWAII PACIFIC UNIVERSITY
p. 76
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
UNIVERSITY OF HAWAII AT MANOA
RESEARCH CORPORATION OF THE
UNIVERSITY OF HAWAII
BRIGHAM YOUNG UNIVERSITY HAWAII
University Clinical Research and Association
CHAMINADE UNIVERSITY OF
HONOLULU
Account Type: Other (8 records)
Ricoh
Hawaii Information Consortium
Leeward Community Church
E Malama In Keiki O Lanai
Keawala'i Congregational Church
Lanai Community Hospital
Angels at Play Preschool & Kindergarten
Queen Emma Gardens AOAO
Account Type: Community College (2
records)
Honolulu Community College
COLLEGE OF THE MARSHALL ISLANDS
Account Type: State Agency (11 records)
DOT Airports Division Hilo International
Airport
Judiciary - State of Hawaii
ADMIN. SERVICES OFFICE
SOH- JUDICIARY CONTRACTS AND
PURCH
STATE DEPARTMENT OF DEFENSE
HAWAII CHILD SUPPORT
ENFORCEMENT AGENCY
HAWAII HEALTH SYSTEMS
CORPORATION
HAWAII AGRICULTURE RESEARCH
CENTER
STATE OF HAWAII
Third Judicial Circuit - State of Hawaii
Office of the Governor
Account Type: Consolidated City/County (2
records)
CITY AND COUNTY OF HONOLULU
Lanai Youth Center
Account Type: Federal (2 records)
12/8/2015 1:11 PM
US Navy
Defense Information System Agency
State: OR (1,324 records)
Account Type: K-12 (228 records)
Warrenton Hammond School
Columbia Academy
VALLEY CATHOLIC SCHL
CROOK COUNTY SCHOOL DISTRICT
CORBETT SCHL DIST #39
Trinity Lutheran Church and School
Bethel School District #52
Ppmc Education Committee
Stayton Christian School
South Columbia Family School
Sunrise Preschool
St. Therese Parish/School
Portland YouthBuilders
Wallowa County ESD
Fern Ridge School District 28J
Knova Learning
New Horizon Christian School
MOLALLA RIVER ACADEMY
HIGH DESERT EDUCATION SERVICE
DISTRICT
SOUTHWEST CHARTER SCHOOL
WHITEAKER MONTESSORI SCHOOL
CASCADES ACADEMY OF CENTRAL
OREGON
NEAH-KAH-NIE DISTRICT NO.56
INTER MOUNTAIN ESD
STANFIELD SCHOOL DISTRICT
LA GRANDE SCHOOL DISTRICT
CASCADE SCHOOL DISTRICT
DUFUR SCHOOL DISTRICT NO.29
hillsboro school district
GASTON SCHOOL DISTRICT 511J
BEAVERTON SCHOOL DISTRICT
COUNTY OF YAMHILL SCHOOL
DISTRICT 29
WILLAMINA SCHOOL DISTRICT
MCMINNVILLE SCHOOL DISTRICT NO.40
Sheridan School District 48J
THE CATLIN GABEL SCHOOL
p. 77
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
NORTH WASCO CTY SCHOOL DISTRICT
21 - CHENOWITH
CENTRAL CATHOLIC HIGH SCHOOL
CANYONVILLE CHRISTIAN ACADEMY
OUR LADY OF THE LAKE SCHOOL
NYSSA SCHOOL DISTRICT NO. 26
ARLINGTON SCHOOL DISTRICT NO. 3
LIVINGSTONE ADVENTIST ACADEMY
Santiam Canyon SD 129J
WEST HILLS COMMUNITY CHURCH
BANKS SCHOOL DISTRICT
WILLAMETTE EDUCATION SERVICE
DISTRICT
BAKER COUNTY SCHOOL DIST. 16J MALHEUR ESD
HARNEY EDUCATION SERVICE
DISTRICT
GREATER ALBANY PUBLIC SCHOOL
DISTRICT
LAKE OSWEGO SCHOOL DISTRICT 7J
SOUTHERN OREGON EDUCATION
SERVICE DISTRICT
SILVER FALLS SCHOOL DISTRICT
St Helens School District
DAYTON SCHOOL DISTRICT NO.8
Amity School District 4-J
SCAPPOOSE SCHOOL DISTRICT 1J
REEDSPORT SCHOOL DISTRICT
FOREST GROVE SCHOOL DISTRICT
DAVID DOUGLAS SCHOOL DISTRICT
LOWELL SCHOOL DISTRICT NO.71
TIGARD-TUALATIN SCHOOL DISTRICT
SHERWOOD SCHOOL DISTRICT 88J
RAINIER SCHOOL DISTRICT
NORTH CLACKAMAS SCHOOL DISTRICT
MONROE SCHOOL DISTRICT NO.1J
CHILDPEACE MONTESSORI
HEAD START OF LANE COUNTY
HARNEY COUNTY SCHOOL DIST. NO.3
NESTUCCA VALLEY SCHOOL DISTRICT
NO.101
ARCHBISHOP FRANCIS NORBERT
BLANCHET SCHOOL
LEBANON COMMUNITY SCHOOLS NO.9
MT.SCOTT LEARNING CENTERS
SEVEN PEAKS SCHOOL
12/8/2015 1:11 PM
DE LA SALLE N CATHOLIC HS
MULTISENSORY LEARNING ACADEMY
MITCH CHARTER SCHOOL
REALMS CHARTER SCHOOL
BAKER SCHOOL DISTRICT 5-J
PHILOMATH SCHOOL DISTRICT
CLACKAMAS EDUCATION SERVICE
DISTRICT
CANBY SCHOOL DISTRICT
OREGON TRAIL SCHOOL DISTRICT
NO.46
WEST LINN WILSONVILLE SCHOOL
DISTRICT
MOLALLA RIVER SCHOOL DISTRICT
NO.35
ESTACADA SCHOOL DISTRICT NO.108
GLADSTONE SCHOOL DISTRICT
ASTORIA SCHOOL DISTRICT 1C
SEASIDE SCHOOL DISTRICT 10
NORTHWEST REGIONAL EDUCATION
SERVICE DISTRICT
VERNONIA SCHOOL DISTRICT 47J
SOUTH COAST EDUCATION SERVICE
DISTRICT
COOS BAY SCHOOL DISTRICT NO.9
COOS BAY SCHOOL DISTRICT
NORTH BEND SCHOOL DISTRICT 13
COQUILLE SCHOOL DISTRICT 8
MYRTLE POINT SCHOOL DISTRICT
NO.41
BANDON SCHOOL DISTRICT
BROOKING HARBOR SCHOOL DISTRICT
NO.17-C
REDMOND SCHOOL DISTRICT
DESCHUTES COUNTY SD NO.6 - SISTERS
SD
DOUGLAS EDUCATION SERVICE
DISTRICT
ROSEBURG PUBLIC SCHOOLS
GLIDE SCHOOL DISTRICT NO.12
SOUTH UMPQUA SCHOOL DISTRICT #19
YONCALLA SCHOOL DISTRICT NO.32
ELKTON SCHOOL DISTRICT NO.34
DOUGLAS COUNTY SCHOOL DISTRICT
116
HOOD RIVER COUNTY SCHOOL
DISTRICT
PHOENIX-TALENT SCHOOL DISTRICT
NO.4
p. 78
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
CENTRAL POINT SCHOOL DISTRICT NO.
6
JACKSON CO SCHOOL DIST NO.9
ROGUE RIVER SCHOOL DISTRICT NO.35
MEDFORD SCHOOL DISTRICT 549C
CULVER SCHOOL DISTRICT NO.
JEFFERSON COUNTY SCHOOL DISTRICT
509-J
GRANTS PASS SCHOOL DISTRICT 7
LOST RIVER JR/SR HIGH SCHOOL
KLAMATH FALLS CITY SCHOOLS
LANE COUNTY SCHOOL DISTRICT 4J
SPRINGFIELD SCHOOL DISTRICT NO.19
CRESWELL SCHOOL DISTRICT
SOUTH LANE SCHOOL DISTRICT 45J3
LANE COUNTY SCHOOL DISTRICT 69
SIUSLAW SCHOOL DISTRICT
SWEET HOME SCHOOL DISTRICT NO.55
LINN CO. SCHOOL DIST. 95C - SCIO SD
ONTARIO MIDDLE SCHOOL
GERVAIS SCHOOL DIST. #1
NORTH SANTIAM SCHOOL DISTRICT 29J
JEFFERSON SCHOOL DISTRICT
SALEM-KEIZER PUBLIC SCHOOLS
MT. ANGEL SCHOOL DISTRICT NO.91
MARION COUNTY SCHOOL DISTRICT
103 - WASHINGTON ES
MORROW COUNTY SCHOOL DISTRICT
MULTNOMAH EDUCATION SERVICE
DISTRICT
GRESHAM-BARLOW SCHOOL DISTRICT
DALLAS SCHOOL DISTRICT NO. 2
CENTRAL SCHOOL DISTRICT 13J
St. Mary Catholic School
CROSSROADS CHRISTIAN SCHOOL
ST. ANTHONY SCHOOL
Pedee School
HERITAGE CHRISTIAN SCHOOL
BEND-LA PINE SCHOOL DISTRICT
GLENDALE SCHOOL DISTRICT
LINCOLN COUNTY SCHOOL DISTRICT
PORTLAND PUBLIC SCHOOLS
REYNOLDS SCHOOL DISTRICT
CENTENNIAL SCHOOL DISTRICT
NOBEL LEARNING COMMUNITIES
12/8/2015 1:11 PM
St. Stephen's Academy
McMinnville Adventist Christian School
Salem-Keizer 24J
McKay High School
Pine Eagle Charter School
Waldo Middle School
hermiston school district
Clear Creek Middle School
Marist High School
Victory Academy
Vale School District No. 84
St. Mary School
Junction City High School
Three Rivers School District
Fern Ridge School District
JESUIT HIGH SCHL EXEC OFC
LASALLE HIGH SCHOOL
Southwest Christian School
Willamette Christian School
Westside Christian High School
CS LEWIS ACADEMY
Portland America School
Forest Hills Lutheran School
Mosier Community School
Koreducators Lep High
Warrenton Hammond School District
Sutherlin School District
Malheur Elementary School District
Ontario School District
Parkrose School District 3
Riverdale School District 51J
Tillamook School District
Madeleine School
Union School District
Helix School District
Riddle School District
Molalla River School District
Corvallis School District 509J
Falls City School District #57
Portland Christian Schools
LUCKIAMUTE VALLEY CHARTER
SCHOOLS
Deer Creek Elementary School
Yamhill Carlton School District
HARRISBURG SCHL DIST
p. 79
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
CENTRAL CURRY SCHL DIST#1
BNAI BRITH CAMP
OREGON FOOD BANK
HOSANNA CHRISTIAN SCHL
ABIQUA SCHL
Salem keizar school district
Athena Weston School District 29RJ
Butte Falls School District
Bend International School
Imbler School District #11
monument school
PENDLETON SCHOOL DISTRICT #16R
Ohara Catholic School
Reynolds High School
St. Paul School District
St Paul Parish School
EagleRidge High School
Grant Community School
Northwest Academy
Sunny Wolf Charter School
MCKENZIE SCHOOL DISTRICT 068
L'Etoiile French Immersion School
LA GRANDE SCHOOL DISTRICT 001
Marist Catholic High School
Elgin school dist.
PLEASANT HILL SCH DIST #1
Ukiah School District 80R
North Powder Charter School
Siletz Valley School
French American School
Mastery Learning Institute
North Lake School District 14
Early College High School
Account Type: County (51 records)
GILLIAM COUNTY OREGON
UMATILLA COUNTY, OREGON
MULTNOMAH LAW LIBRARY
clackamas county
CLATSOP COUNTY
COLUMBIA COUNTY, OREGON
coos county
CROOK COUNTY ROAD DEPARTMENT
CURRY COUNTY OREGON
DESCHUTES COUNTY
12/8/2015 1:11 PM
GILLIAM COUNTY
GRANT COUNTY, OREGON
HARNEY COUNTY SHERIFFS OFFICE
HOOD RIVER COUNTY
jackson county
josephine county
klamath county
LANE COUNTY
LINN COUNTY
MARION COUNTY , SALEM, OREGON
MULTNOMAH COUNTY
SHERMAN COUNTY
WASCO COUNTY
YAMHILL COUNTY
WALLOWA COUNTY
ASSOCIATION OF OREGON COUNTIES
NAMI LANE COUNTY
BENTON COUNTY
DOUGLAS COUNTY
JEFFERSON COUNTY
LAKE COUNTY
LINCOLN COUNTY
POLK COUNTY
UNION COUNTY
WASHINGTON COUNTY
MORROW COUNTY
Mckenzie Personnel Services
NORCOR Juvenile Detention
Tillamook County Estuary
Job Council
BAKER CNTY GOVT
TILLAMOOK CNTY
Multnomah County Dept of County Assets
Wheeler County
Resource Connections of Oregon
Lane County Sheriff's Office
Clatsop County Sheriff's Office
Harney County Community Corrections
Clackamas County Juvenile Dept
Columbia Basin Care Facility
City of Seaside Police Department
Account Type: Non-Profit (617 records)
Tamarack Aquatic Center
Seven Feathers Casino
p. 80
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
St Paul Baptist Church
Long Tom Watershed Council
San Martin Deporres Catholic Church
Portland Parks Foundation
Cedar Hills Baptist Church
Unitarian Universalist Church in Eugene
Emmanuel Bible Church
Oregon Farm Bureau
Mt Emily Safe Center
Salem First Presbyterian Church
Rolling Hills Baptist Church
Baker Elks
Gates Community Church of Christ
PIP Corps LLC
Turtle Ridge Wildlife Center
Grande Ronde Model Watershed Foundation
Western Environmental Law Center
Oregon District 7 Little League
Mercy Flights, Inc.
The Christian Church of Hillsboro Oregonb
Congregation Neveh Shalom
My Fathers House
Step Forward Activities Inc
HHoly Trinity Greek Orthodox Cathedral
MECOP Inc.
Workforce Northwest Inc
Lane Arts Council
Intergral Youth Services
Children Center At Trinity
Beaverton Christians Church
Oregon Humanities
St. Pius X School
Community Connection of Northeast Oregon,
Inc.
St Mark Presbyterian Church
Living Opportunities, Inc.
Coos Art Museum
OETC
Blanchet House of Hospitality
Merchants Exchange of Portland, Oregon
Coalition for a Livable Future
Central Oregon Visitors Association
Soroptimist International of Gold Beach, OR
Real Life Christian Church
12/8/2015 1:11 PM
Dayton Christian Church
Delphian School
AVON
EPUD-Emerald People's Utility District
Human Solutions, Inc.
The Wallace Medical Concern
Boys & Girls Club of Salem, Marion & Polk
Counties
The Ross Ragland Theater and Cultural Center
Cascade Health Solutions
Umpqua Community Health Center
ALZHEIMERS NETWORK OF OREGON
NATIONAL WILD TURKEY FEDERATION
TILLAMOOK ESTUARIES PARTNERSHIP
LIFEWORKS NW
Independent Development Enterprise Alliance
MID-WILLAMETTE VALLEY
COMMUNITY ACTION AGENCY, INC
HALFWAY HOUSE SERVICES, INC.
REDMOND PROFICIENCY ACADEMY
OHSU FOUNDATION
SHELTERCARE
PRINGLE CREEK SUSTAINABLE LIVING
CENTER
PACIFIC INSTITUTES FOR RESEARCH
Mental Health for Children, Inc.
The Dreaming Zebra Foundation
LAUREL HILL CENTER
THE OREGON COMMUNITY
FOUNDATION
OCHIN
WE CARE OREGON
SE WORKS
ENTERPRISE FOR EMPLOYMENT AND
EDUCATION
OMNIMEDIX INSTITUTE
PORTLAND BUSINESS ALLIANCE
GATEWAY TO COLLEGE NATIONAL
NETWORK
FOUNDATIONS FOR A BETTER OREGON
GOAL ONE COALITION
ATHENA LIBRARY FRIENDS
ASSOCIATION
Coastal Family Health Center
p. 81
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
CENTER FOR COMMUNITY CHANGE
STAND FOR CHILDREN
ST. VINCENT DEPAUL OF LANE COUNTY
EAST SIDE FOURSQUARE CHURCH
CORVALLIS MOUNTAIN RESCUE UNIT
InventSuccess
SHERIDAN JAPANESE SCHOOL
FOUNDATION
The Blosser Center for Dyslexia Resources
MOSAIC CHURCH
HOUSING AUTHORITY OF LINCOLN
COUNTY
RENEWABLE NORTHWEST PROJECT
INTERNATIONAL SUSTAINABLE
DEVELOPMENT FOUNDATION
ST. ANTHONY CHURCH
Good Shepherd Medical Center
Salem Academy
GEN CONF OF SDA CHURCH WESTERN
OR
PORTLAND ADVENTIST ACADEMY
ST VINCENT DE PAUL
OUTSIDE IN
UNITED CEREBRAL PALSY OF OR AND
SW WA
CONSERVATION BIOLOGY INSTITUTE
THE NATIONAL ASSOCIATION OF
CREDIT MANAGEMENT-OREGON, INC.
ROSE VILLA, INC.
NORTHWEST LINE JOINT
APPRENTICESHIP & TRAINING
COMMITTEE
BOYS AND GIRLS CLUBS OF PORTLAND
METROPOLITAN AREA
BLACHLY LANE ELECTRIC
COOPERATIVE
MORNING STAR MISSIONARY BAPTIST
CHURCH
NORTHWEST FOOD PROCESSORS
ASSOCIATION
INDEPENDENT INSURANCE AGENTS
AND BROKERS OF OREGON
OREGON EDUCATION ASSOCIATION
HEARING AND SPEECH INSTITUTE INC
SALEM ELECTRIC
MORRISON CHILD AND FAMILY
SERVICES
JUNIOR ACHIEVEMENT
CENTRAL BIBLE CHURCH
MID COLUMBIA MEDICAL CENTERGREAT 'N SMALL
TRILLIUM FAMILY SERVICES, INC.
YWCA SALEM
PORTLAND ART MUSEUM
SAINT JAMES CATHOLIC CHURCH
SOUTHERN OREGON HUMANE SOCIETY
VOLUNTEERS OF AMERICA OREGON
CENTRAL DOUGLAS COUNTY FAMILY
YMCA
METROPOLITAN FAMILY SERVICE
OREGON MUSUEM OF SCIENCE AND
INDUSTRY
FIRST UNITARIAN CHURCH
12/8/2015 1:11 PM
WILLAMETTE VIEW INC.
PORTLAND HABILITATION CENTER,
INC.
OREGON STATE UNIVERSITY ALUMNI
ASSOCIATION
ROGUE FEDERAL CREDIT UNION
Oregon Research Institute
WILLAMETTE LUTHERAN HOMES, INC
LANE MEMORIAL BLOOD BANK
PORTLAND JEWISH ACADEMY
LANECO FEDERAL CREDIT UNION
GRANT PARK CHURCH
ST. MARYS OF MEDFORD, INC.
US CONFERENCE OF MENONNITE
BRETHREN CHURCHES
FAITHFUL SAVIOR MINISTRIES
OREGON CITY CHURCH OF THE
NAZARENE
OREGON COAST COMMUNITY ACTION
EDUCATION NORTHWEST
COMMUNITY ACTION TEAM, INC.
EUGENE SYMPHONY ASSOCIATION,
INC.
STAR OF HOPE ACTIVITY CENTER INC.
SPARC ENTERPRISES
SOUTHERN OREGON CHILD AND
FAMILY COUNCIL, INC.
SALEM ALLIANCE CHURCH
Lane Council of Governments
FORD FAMILY FOUNDATION
TRAILS CLUB
p. 82
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
NEWBERG FRIENDS CHURCH
WOODBURN AREA CHAMBER OF
COMMERCE
CONTEMPORARY CRAFTS MUSEUM
AND GALLERY
CITY BIBLE CHURCH
OREGON LIONS SIGHT & HEARING
FOUNDATION
PORTLAND WOMENS CRISIS LINE
THE SALVATION ARMY - CASCADE
DIVISION
WILLAMETTE FAMILY
WHITE BIRD CLINIC
GOODWILL INDUSTRIES OF LANE AND
SOUTH COAST COUNTIES
PLANNED PARENTHOOD OF
SOUTHWESTERN OREGON
HOUSING NORTHWEST
OREGON ENVIRONMENTAL COUNCIL
MEALS ON WHEELS PEOPLE, INC.
FAITH CENTER
Bob Belloni Ranch, Inc.
GOOD SHEPHERD COMMUNITIES
SACRED HEART CATHOLIC DAUGHTERS
HELP NOW! ADVOCACY CENTER
TENAS ILLAHEE CHILDCARE CENTER
SUNRISE ENTERPRISES
LOOKING GLASS YOUTH AND FAMILY
SERVICES
SERENITY LANE
EAST HILL CHURCH
LA GRANDE UNITED METHODIST
CHURCH
COAST REHABILITATION SERVICES
Edwards Center Inc
ALVORD-TAYLOR INDEPENDENT
LIVING SERVICES
NEW HOPE COMMUNITY CHURCH
KLAMATH HOUSING AUTHORITY
QUADRIPLEGICS UNITED AGAINST
DEPENDENCY, INC.
SPONSORS, INC.
COLUMBIA COMMUNITY MENTAL
HEALTH
ADDICTIONS RECOVERY CENTER, INC
METRO HOME SAFETY REPAIR
PROGRAM
12/8/2015 1:11 PM
OREGON SUPPORTED LIVING PROGRAM
SOUTH COAST HOSPICE, INC.
ALLFOURONE/CRESTVIEW
CONFERENCE CTR.
The International School
REBUILDING TOGETHER - PORTLAND
INC.
PENDLETON ACADEMIES
PACIFIC FISHERY MANAGEMENT
COUNCIL
DOGS FOR THE DEAF, INC.
PUBLIC DEFENDER SERVICES OF LANE
COUNTY, INC.
EMMAUS CHRISTIAN SCHOOL
DELIGHT VALLEY CHURCH OF CHRIST
SAINT CATHERINE OF SIENA CHURCH
PORT CITY DEVELOPMENT CENTER
VIRGINIA GARCIA MEMORIAL HEALTH
CENTER
CENTRAL CITY CONCERN
CANBY FOURSQUARE CHURCH
EMERALD PUD
VERMONT HILLS FAMILY LIFE CENTER
BENTON HOSPICE SERVICE
INTERNATIONAL SOCIETY FOR
TECHNOLOGY IN EDUCATION
COMMUNITY CANCER CENTER
OPEN MEADOW ALTERNATIVE
SCHOOLS, INC.
CASCADIA BEHAVIORAL HEALTHCARE
WILD SALMON CENTER
BROAD BASE PROGRAMS INC.
SUNNYSIDE FOURSQUARE CHURCH
TRAINING EMPLOYMENT CONSORTIUM
RELEVANT LIFE CHURCH
211INFO
SONRISE CHURCH
LIVING WAY FELLOWSHIP
Women's Safety & Resource Center
SEXUAL ASSAULT RESOURCE CENTER
IRCO
NORTHWEST YOUTH CORPS
TILLAMOOK CNTY WOMENS CRISIS
CENTER
SECURITY FIRST CHILD DEVELOPMENT
CENTER
p. 83
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
CLASSROOM LAW PROJECT
YOUTH GUIDANCE ASSOC.
PREGNANCY RESOUCE CENTERS OF
GRETER PORTLAND
ELMIRA CHURCH OF CHRIST
JASPER MOUNTAIN
ACUMENTRA HEALTH
WORKSYSTEMS INC
COVENANT CHRISTIAN HOOD RIVER
OREGON DONOR PROGRAM
NAMI OREGON
OLIVET BAPTIST CHURCH
SILVERTON AREA COMMUNITY AID
CONFEDERATED TRIBES OF GRAND
RONDE
NEIGHBORIMPACT
CATHOLIC COMMUNITY SERVICES
NEW AVENUES FOR YOUTH INC
LA CLINICA DEL CARINO FAMILY
HEALTH CARE CENTER
DECISION SCIENCE RESEARCH
INSTITUTE, INC.
WESTERN STATES CENTER
HIV ALLIANCE, INC
PARTNERSHIPS IN COMMUNITY LIVING,
INC.
FANCONI ANEMIA RESEARCH FUND
INC.
BLIND ENTERPRISES OF OREGON
OREGON BALLET THEATRE
SMART
All God's Children International
FARMWORKER HOUISNG DEV CORP
UMPQUA COMMUNITY DEVELOPMENT
CORPORATION
REGIONAL ARTS AND CULTURE
COUNCIL
THE EARLY EDUCATION PROGRAM,
INC.
MACDONALD CENTER
EVERGREEN AVIATION MUSEUM AND
CAP. MICHAEL KING.
SELF ENHANCEMENT INC.
FRIENDS OF THE CHILDREN
SOUTH LANE FAMILY NURSERY DBA
FAMILY RELIEF NURSE
PORTLAND SCHOOLS FOUNDATION
SUSTAINABLE NORTHWEST
OREGON DEATH WITH DIGNITY
BIRCH COMMUNITY SERVICES, INC.
BAY AREA FIRST STEP, INC.
OSLC COMMUNITY PROGRAMS
EN AVANT, INC.
ASHLAND COMMUNITY HOSPITAL
NORTHWEST ENERGY EFFICIENCY
ALLIANCE
BONNEVILLE ENVIRONMENTAL
FOUNDATION
SUMMIT VIEW COVENANT CHURCH
SALMON-SAFE INC.
BETHEL CHURCH OF GOD
PROVIDENCE HOOD RIVER MEMORIAL
HOSPITAL
SAINT ANDREW NATIVITY SCHOOL
BARLOW YOUTH FOOTBALL
SPOTLIGHT THEATRE OF PLEASANT
HILL
FAMILIES FIRST OF GRANT COUNTY,
INC.
TOUCHSTONE PARENT ORGANIZATION
CANCER CARE RESOURCES
CASCADIA REGION GREEN BUILDING
COUNCIL
SHERMAN DEVELOPMENT LEAGUE,
INC.
SCIENCEWORKS
WORD OF LIFE COMMUNITY CHURCH
SOCIAL VENTURE PARTNERS
PORTLAND
OREGON PROGRESS FORUM
CENTER FOR RESEARCH TO PRACTICE
WESTERN RIVERS CONSERVANCY
UNITED WAY OF THE COLUMBIA
WILLAMETTE
EUGENE BALLET COMPANY
EAST WEST MINISTRIES
INTERNATIONAL
SISKIYOU INITIATIVE
EDUCATIONAL POLICY IMPROVEMENT
CENTER
North Pacific District of Foursquare Churches
CATHOLIC CHARITIES
COMMUNITY VETERINARY CENTER
12/8/2015 1:11 PM
p. 84
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
FIRST CHURCH OF THE NAZARENE
WESTSIDE BAPTIST CHURCH
Housing Development Center
Hoodview Christian Church
Little Promises Chlildren's Program
UNION GOSPEL MISSION
GRACE BAPTIST CHURCH
COMMUNITY ACTION ORGANIZATION
OUTSIDE IN
MAKING MEMORIES BREAST CANCER
FOUNDATION, INC.
ELAW
COMMUNITY HEALTH CENTER, INC
Greater Portland INC
Boys & Girls Club of Corvallis
Southeast Uplift Neighborhood Coalition
First United Presbyterian Church
PDX Wildlife
Jackson-Josephine 4-C Council
North Coast Family Fellowship
PECI
Childswork Learning Center
Portland Schools Alliance
New Artists Performing Arts Productions, Inc.
Relief Nursery
St. Mary's Episcopal Church
Viking Sal Senior Center
Boys and Girls Club of the rogue valley
DrupalCon Inc., DBA Drupal Association
Albany Partnership for Housing and
Community Development
Hermiston Christian Center & School
Dress for Success Oregon
Beaverton Rock Creek Foursquare Church
St Paul Catholic Church
St Mary's Catholic School and Parish
Polk Soil and Water Conservation District
Street Ministry
La Grande Church of the Nazarene
Spruce Villa, Inc.
House of Prayer for All Nations
Sacred Heart Catholic Church
African American Health Coaliton, Inc.
Happy Canyon Company
12/8/2015 1:11 PM
Village Home Education Resource Center
Monet's Children's Circle
Cascade Housing Association
Dayspring Fellowship
Northwest Habitat Institute
Winding Waters Medical Clinic
First Baptist Church
The Nature Conservancy, Willamette Valley
Field Office
Serenity Lane Health Services
Portland Community Reinvestment Initiatives,
Inc.
GeerCrest Farm & Historical Society
College United Methodist Church
NEDCO
Salem Evangelical Church
Daystar Education, Inc.
Oregon Social Learning Center
Pain Society of Oregon
environmental law alliance worldwide
Community in Action
Safe Harbors
FIRST CHRISTIAN CHURCH
Pacific Classical Ballet
Depaul Industries
African American Health Coalition
Jesus Prayer Book
Coalition Of Community Health
River Network
CCI Enterprises Inc
Oregon Nurses Association
GOODWILL INDUSTRIES OF THE
COLUMBIA WILLAMETTE
Mount Angel Abbey
YMCA OF ASHLAND
YMCA OF COLUMBIA-WILLAMETTE
ASSOCIATION SERVICES
Multnomah Law Library
Friends Of Tryon Creek State P
Ontrack Inc.
Calvin Presbyterian Church
HOLT INTL CHILD
St John The Baptist Catholic
Portland Foursquare Church
Portland Christian Center
p. 85
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Church Extension Plan
Occu Afghanistan Relief Effort
EUGENE FAMILY YMCA
Christ The King Parish and School
Newberg Christian Church
First United Methodist Church
Zion Lutheran Church
Southwest Bible Church
Community Works Inc
Masonic Lodge Pearl 66
Molalla Nazarene Church
Transition Projects, Inc
St Michaels Episcopal Church
Saint Johns Catholich Church
Access Inc
Community Learning Center
Old Mill Center for Children and Families
Sunny Oaks Inc
Hospice Center Bend La Pine
Westside Foursquare Church
Relief Nursery Inc
Morning Star Community Church
MULTNOMAH DEFENDERS INC
Providence Health System
Holy Trinity Catholic Church
Holy Redeemer Catholic Church
Alliance Bible Church
CARE OREGON
Mid Columbia Childrens Council
HUMANE SOCIETY OF REDMOND
Our Redeemer Lutheran Church
Kbps Public Radio
Skyball Salem Keizer Youth Bas
Open Technology Center
Grace Chapel
CHILDREN'S MUSEUM 2ND
Solid Rock
West Chehalem Friends Church
Guide Dogs For The Blind
Aldersgate Camps and Retreats
St. Katherine's Catholic Church
The Alliance NW of the Christian &
Missionary Alliance
Bags of Love
Grand View Baptist Church
12/8/2015 1:11 PM
Green Electronics Council
Scottish Rite
Western Wood Products Association
THE NEXT DOOR
NATIONAL PSORIASIS FOUNDATION
NEW BEGINNINGS CHRISTIAN CENTER
HIGHLAND UNITED CHURCH OF CHRIST
OREGON REPERTORY SINGERS
HIGHLAND HAVEN
FAIR SHARE RESEARCH AND
EDUCATION FUND
Oregon Satsang Society, Inc., A chartered
Affiliate of ECKANKAR , ECKA
First Baptist Church of Enterprise
The Canby Center
Instituto de Cultura y Arte In Xochitl In Cuicatl
OSLC COMMUNITY PROGRAMS OCP
Oregon Nikkei Endowment
Eastern Oregon Alcoholism Foundation
Grantmakers for Education
The Spiral Gallery
The ALS Association Oregon and SW
Washington Chapter
Children's Relief Nursery
Home Builders
World of Speed
SW Community Health Center
Energy Trust of Oregon
St. Vincent de Paul Church
Fr. Bernard Youth Center
Oregon Psychoanalytic Center
Store to Door
Depaul Industries
OUR LADY OF PERPETUAL HELP
CATHOLIC CHURCH ALBANY OREGON
SELCO Community Credit Union
North Coast Christian Church
Union County Economic Development Corp.
Camelto Theatre Company
Camp Fire Columbia
TAKE III OUTREACH
Rolling Hills Community Church
Summa Institute
Amani Center
p. 86
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Billy Webb Elks lodge #1050
Silverton Senior Center
Sandy Seventh-day Adventist Church
Muddy Creek Charter School
A FAMILY FOR EVERY CHILD
1000 FRIENDS OF OREGON
NONPROFIT ASSOCIATION OF OREGON
LUKE DORF INC
FAMILY CARE INC
MEDICAL TEAMS INTL
Clean Slate Canine Rescue & Rehabilitation
St. Martins Episcopal church
Food for Lane County
columbia gorge discovery center and museum
NAMI of Washington County
The Dalles Art Association
Temple Beth Israel
Willamette Leadership Academy/Pioneer
Youth Corps Of Oregon
Rose Haven
OREGON STATE UNIVERSITY
BOOKSTORE INC
FAIRFIELD BAPTIST CHURCH
Sexual Assault Support Services
Neskowin Valley School
RON WILSON CENTER FOR EFFECTIVE
LIVING INC
St. Joseph Shelter
The Inn Home for Boys, Inc.9138
MCKENZIEWATERSHED COUNCIL
MENNONITE HOME OF ALBANY INC
Oregon Technical Assistance Corporation
Oregon And Southern Idaho Laborers
Employers Training School
New Life Fellowship Church of God
Gladstone Senior Center
Education Travel & Culture, Inc.
Rural Development Initiatives
Jason Lee Manor/UMRC
YMCA of Marion and Polk Counties
PacificSource Health
Faith Christian Fellowship
Brookings Elks Lodge
Tillamook Seventh Day Adventist Church
12/8/2015 1:11 PM
Oregon Jewish Community Foundation
East River Fellowship
Holy Family Academy
FIRST BAPTIST CHURCH OF EUGENE
Peace Lutheran Church
Housing Authority of Douglas County
Vietnamese Christian Community Church
Friends for Animals
Family Building Blocks
Goodwill Industries of Lane and South Coast
Friends of Driftwood Library
Consumers Power Inc.
A. C. Gilbert's Discovery Village
First Lutheran Church of Astoria
Fund For Christian Charity
Deer Meadow Assisted Living
Oregon Laborers-Employer Administrative
Fund, LLC
Umpqua Basin Water Association
Alpha Lambda House Corporation
Eugene Creative Care
The Church of Christ of Latter Day Saints
Cascade Height Public Charter School PTA
G.O.B.H.I
Association of Oregon Corrections EMployees,
Inc.
A Jesus Church Family
300 Main Inc
Southwestern Oregon Public Defender
Services, Inc.
Albertina Kerr Centers
Dufur Christian Church
St. Matthew Catholic School
Serendipity Center Inc
CASA of Marion County
Westside Church of Christ Inc
Northwest Family Services
Network Charter School
Ride Connecton
Parenting Now!
Christian Church of Woodburn
Native American Youth and Family Center
Early College Academy
USO Northwest
p. 87
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Norkenzie Christian Church
Little Flower Development Center
Evergreen Wings and Waves
Ascension Episcopal Parish
Center for Family Development
West Salem Foursquare Church
Mount Pisgah Arboretum
Lower Columbia Estuary Partnership
Oasis Shelter Home
Nehalem Bay House
p:ear
Health Share of Oregon
St. Peter Catholic Church
Mid Willamette Valley Community Action
A Hope For Autism Foundation
Breast Friends
SEPTL Southeast Portland Tool Library
National Christian Community Foundation
Legal Aid Services of Oregon LITC
Willamette Valley Babe Ruth
Center For Continuous Improvement
SEIU Local 49
Emerald Media Group
Trillium Sprigs
Youth Dynamics
Ashland Art Center
Apostolic Church of Jesus Christ
DOUGLAS FOREST PROTECTIVE
Oregon Lyme Disease Network
Ecotrust
SPECIAL MOBILITY SERVICES
Historical Outreach Foundation
Teras Interventions and Counseling Inc
Salem Area Chamber of Commerce
First Congregational Chrch
OREGON STATE FAIR
Ronald McDonald House Charities of Oregon
& Southwest Washington
Center for Human Development
Bridges to Change
DePaul Treatment Centers, Inc.
Ministerio International Casa
New Paradise Worship Center
Mission Increase Foundation
Curry Public Transit Inc
12/8/2015 1:11 PM
THREE RIVERS CASINO
Brookings Harbor Christian School
Yamhill Community Care Organization
Portland Japanese Garden
The Madeleine Parish
The Tucker-Maxon Oral School
Southwest Neighborhoods, Inc
Wallowa Valley Center For Wellness
KIDS INTERVENTION AND DIAGNOSTIC
CENTER
Portland Yacht Club
League of Women Voters
United Way of Lane County
Unithed Way
Portland Oregon Visitors Association
Southern Oregon Project Hope
Our United Villages
Samaritan Health Services Inc.
Kilchis House
Calvary Assembly of God
Lake Grove Presbyterian Church
Grace Lutheran School
Western Mennonite School
OEA CHOICE TRUST
American Tinnitus Association
Oregon Coast Aquarium, Inc.
Unitus Community Credit Union
St John the Baptist Greek Orthodox Church
COLUMBIA PACIFIC ECONOMIC
DEVELOPMENT DISTRICT OF OREGON
Oregon Rural Electric Cooperative Association
THE MILL CASINO
Account Type: College and University (33
records)
Oregon State University
Treasure Valley Community College
Unviersity of Oregon
OREGON UNIVERSITY SYSTEM
WESTERN STATES CHIROPRACTIC
COLLEGE
GEORGE FOX UNIVERSITY
LEWIS AND CLARK COLLEGE
PACIFIC UNIVERSITY
p. 88
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
REED COLLEGE
WILLAMETTE UNIVERSITY
LINFIELD COLLEGE
MULTNOMAH BIBLE COLLEGE
NORTHWEST CHRISTIAN COLLEGE
NATIONAL COLLEGE OF NATURAL
MEDICINE
BLUE MOUNTAIN COMMUNITY
COLLEGE
PORTLAND STATE UNIV.
CLACKAMAS COMMUNITY COLLEGE
MARYLHURST UNIVERSITY
OREGON HEALTH AND SCIENCE
UNIVERSITY
BIRTHINGWAY COLLEGE OF
MIDWIFERY
pacific u
UNIVERSITY OF OREGON
CONCORDIA UNIV
Marylhurst University
Corban College
Oregon Center For Advanced T
UNIVERSITY OF PORTLAND
Portland Actors Conservatory
University Of Oregon Athletics Department
Ecola Bible School
Beta Omega Alumnae
Oregon Institute of Technology
EASTERN OREGON UNIVERSITY
Account Type: Other (60 records)
Clackamas River Water Providers
eickhoff dev co inc
Cornerstone Association Inc
The Klamath Tribe
Cannon Beach Fire
Life Flight Network LLC
COVENANT RETIREMENT
COMMUNITIES
PENTAGON FEDERAL CREDIT UNION
SAIF CORPORATION
GREATER HILLSBORO AREA CHAMBER
OF COMMERCE
LANE ELECTRIC COOPERATIVE
USAGENCIES CREDIT UNION
DOUGLAS ELECTRIC COOPERATIVE,
INC.
12/8/2015 1:11 PM
PACIFIC CASCADE FEDERAL CREDIT
UNION
LOCAL GOVERNMENT PERSONNEL
INSTITUTE
GRANTS PASS MANAGEMENT
SERVICES, DBA
SPIRIT WIRELESS
Kartini Clinic
Astra
Beit Hallel
Cvalco
OREGON CORRECTIONS ENTERPRISES
OFFICE OF PUBLIC DEFENSE SERVICES
Clatskanie People's Utility District
PIONEER COMMUNITY DEVELOPMENT
MARION COUNTY HEALTH DEPT
Ricoh USA
Heartfelt Obstetrics & Gynecology
Coquille Economic Development Corporation
CITY/COUNTY INSURANCE SERVICE
COMMUNITY CYCLING CENTER
Shangri La
Portland Impact
Eagle Fern Camp
KLAMATH FAMILY HEAD START
RIVER CITY DANCERS
Oregon Permit Technical Association
KEIZER EAGLES AERIE 3895
Pgma/Cathie Bourne
Sunrise Water
Burns Paiute Tribe
Oregon Public Broadcasting
La Grande Family Practice
Sphere MD
BIENESTAR, INC.
sunrise water authority
EAstern Oregon Trade and Event Center
Waste-Pro
NPKA
Confederated Tribes of Warm Springs
Halsey-Shedd Fire District
Nez Perce Tribe
Obsidian Urgent Care, P.C.
First Presbyterian Church of La Grande
p. 89
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
CONFLUENCE ENVIRONMENTAL CENTE
A&I Benefit Plan Administrators, Inc.
K Churchill Estates
CSC HEAD START
NORTHWEST VINTAGE CAR AND
MOTORCYCLE
TRI-COUNTY HEALTH CARE SAFETY
NET ENTERPRISE
crescent grove cemetery
OAK LODGE WATER DISTRICT
THE PORT OF PORTLAND
WILLAMALANE PARK AND
RECREATION DISTRICT
Account Type: City Special District (21
records)
Roseburg Police Department
Molalla Rural Fire Protection District
MONMOUTH - INDEPENDENCE
NETWORK
EUGENE WATER & ELECTRIC BOARD
MALIN COMMUNITY PARK AND
RECREATION DISTRICT
TILLAMOOK PEOPLES UTILITY
DISTRICT
GLADSTONE POLICE DEPARTMENT
GOLD BEACH POLICE DEPARTMENT
THE NEWPORT PARK AND RECREATION
CENTER
RIVERGROVE WATER DISTRICT
TUALATIN VALLEY FIRE & RESCUE
GASTON RURAL FIRE DEPARTMENT
CITY COUNTY INSURANCE SERVICES
SOUTH SUBURBAN SANITARY DISTRICT
SOUTH FORK WATER BOARD
SUNSET EMPIRE PARK AND
RECREATION
SPRINGFIELD UTILITY BOARD
Tillamook Urban Renewal Agency
Netarts Water District
OAK LODGE SANITARY DISTRICT
Boardman Rural Fire Protection District
Account Type: Independent Special District
(49 records)
Silverton Fire District
Lewis and Clark Rural Fire Protection District
Rainbow Water District
Illinois Valley Fire District
PORT OF TILLAMOOK BAY
12/8/2015 1:11 PM
METROPOLITAN EXPOSITIONRECREATION COMMISSION
REGIONAL AUTOMATED INFORMATION
NETWORK
TUALATIN VALLEY WATER DISTRICT
UNION SOIL & WATER CONSERVATION
DISTRICT
LANE EDUCATION SERVICE DISTRICT
TUALATIN HILLS PARK AND
RECREATION DISTRICT
PORT OF SIUSLAW
CHEHALEM PARK AND RECREATION
DISTRICT
PORT OF ST HELENS
LANE TRANSIT DISTRICT
CENTRAL OREGON
INTERGOVERNMENTAL COUNCIL
HOODLAND FIRE DISTRICT NO.74
MID COLUMBIA COUNCIL OF
GOVERNMENTS
WEST MULTNOMAH SOIL AND WATER
CONSERVATION DISTRICT
SALEM AREA MASS TRANSIT DISTRICT
Banks Fire District #13
KLAMATH COUNTY 9-1-1
GLENDALE RURAL FIRE DISTRICT
COLUMBIA 911 COMMUNICATIONS
DISTRICT
CLACKAMAS RIVER WATER
NW POWER POOL
Lowell Rural Fire Protection District
TriMet Transit
Estacada Rural Fire District
Keizer Fire District
State Accident Insurance Fund Corporation
Bend Metro Park & Recreation District
Port of Hood River
La Pine Park & Recreation District
Siuslaw Public Library District
p. 90
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Columbia River Fire & Rescue
Fern Ridge Library District
Bend Park and Recreation District
Port of Garibaldi
Seal Rock Water District
Rockwood Water P.U.D.
Tillamook Fire District
Tillamook County Transportation Dist
Central Lincoln People's Utility District
Jefferson Park and Recreation
Account Type: City (154 records)
City of Monmouth / Public Works
McMinnville Police Department
City of Sublimity
City of Central Point Parks and Recreation
Gearhart Fire Department
Woodburn City Of
Brookings Fire / Rescue
City of Veneta
CITY OF DAMASCUS
Hermiston Fire & Emergency Svcs
CEDAR MILL COMMUNITY LIBRARY
CITY OF LAKE OSWEGO
LEAGUE OF OREGON CITIES
CITY OF SANDY
CITY OF ASTORIA OREGON
CITY OF BEAVERTON
CITY OF BOARDMAN
CITY OF CANBY
CITY OF CANYONVILLE
CITY OF CENTRAL POINT POLICE
DEPARTMENT
CITY OF CLATSKANIE
CITY OF CONDON
CITY OF COOS BAY
CITY OF CORVALLIS
CITY OF CRESWELL
CITY OF ECHO
CITY OF ESTACADA
CITY OF EUGENE
CITY OF FAIRVIEW
CITY OF GEARHART
CITY OF GOLD HILL
CITY OF GRANTS PASS
12/8/2015 1:11 PM
CITY OF GRESHAM
CITY OF HILLSBORO
CITY OF HOOD RIVER
CITY OF JOHN DAY
CITY OF KLAMATH FALLS
CITY OF LA GRANDE
CITY OF MALIN
CITY OF MCMINNVILLE
CITY OF HALSEY
CITY OF MEDFORD
CITY OF MILL CITY
CITY OF MILWAUKIE
CITY OF MORO
CITY OF MOSIER
CITY OF NEWBERG
CITY OF OREGON CITY
CITY OF PILOT ROCK
CITY OF POWERS
RAINIER POLICE DEPARTMENT
CITY OF REEDSPORT
CITY OF RIDDLE
CITY OF SCAPPOOSE
CITY OF SEASIDE
CITY OF SILVERTON
CITY OF STAYTON
City of Troutdale
CITY OF TUALATIN, OREGON
CITY OF WARRENTON
CITY OF WEST LINN/PARKS
CITY OF WOODBURN
CITY OF TIGARD, OREGON
CITY OF AUMSVILLE
CITY OF PORT ORFORD
CITY OF EAGLE POINT
CITY OF WOOD VILLAGE
St. Helens, City of
CITY OF WINSTON
CITY OF COBURG
CITY OF NORTH PLAINS
CITY OF GERVAIS
CITY OF YACHATS
FLORENCE AREA CHAMBER OF
COMMERCE
PORTLAND DEVELOPMENT
COMMISSION
p. 91
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
CITY OF CANNON BEACH OR
CITY OF ST. PAUL
CITY OF ADAIR VILLAGE
CITY OF WILSONVILLE
CITY OF HAPPY VALLEY
CITY OF SHADY COVE
CITY OF LAKESIDE
CITY OF MILLERSBURG
CITY OF GATES
KEIZER POLICE DEPARTMENT
CITY OF DUNDEE
CITY OF AURORA
THE CITY OF NEWPORT
CITY OF ALBANY
CITY OF ASHLAND
CITY OF LEBANON
CITY OF PORTLAND
CITY OF SALEM
CITY OF SPRINGFIELD
METRO
CITY OF BURNS
CITY OF COTTAGE GROVE
CITY OF DALLAS
CITY OF FALLS CITY
CITY OF PHOENIX
CITY OF PRAIRIE CITY
CITY OF REDMOND
CITY OF SHERWOOD
City of junction city
City of Florence
Columbia Gorge Community
City of Dayton
City of Carlton
City of Pendleton Convention Center
City of Monmouth
City of Philomath
City of Sheridan
Seaside Public Library
City of Yoncalla
La Grande Police Department
Cove City Hall
NW PORTLAND INDIAN HEALTH BOARD
Portland Patrol Services
City Of Bend
City Of Coquille
12/8/2015 1:11 PM
City Of Molalla
ROCKWOOD WATER PEOPLE'S UTILITY
DISTRICT
City of St. Helens
City of North Powder
City of Eugene
City of Cornelius, OR
Toledo Police Department
City of Independence
City of Baker City
McMinnville Water & Light
City of Pendleton Parks & Recreation
CITY OF SWEETHOME
CITY OF THE DALLES
CLACKAMAS FIRE DIST#1
DESCHUTES PUBLIC LIBRARY
STAYTON FIRE DISTRICT
City of Ontario
City of Corvallis Parks and Recreation
North Lincoln Fire & Rescue #1
City of Harrisburg
Gladstone Public Library
Seaside Fire & Rescue
City Of North Bend
City of Union
City of Nehalem
City of Richland
CITY OF LINCOLN CITY
City of Donald
City of Milton-Freewater
CITY OF SCIO
City of Forest Grove
City Govrnment
City of Mt. Angel
Albany Police Department
Account Type: County Special District (33
records)
Umatilla Electric Cooperative
WATER ENVIRONMENT SERVICES
Polk County Fire District No.1
Netarts-Oceanside RFPD
UIUC
Rogue River Fire District
Aurora Rural FIre District
p. 92
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Tillamook County Emergency
Communications District
Southern Coos Hospital
Oregon Cascades West Council of
Governments
MULTONAH COUNTY DRAINAGE
DISTRICT #1
PORT OF BANDON
OR INT'L PORT OF COOS BAY
MID-COLUMBIA CENTER FOR LIVING
DESCHUTES COUNTY RFPD NO.2
YOUNGS RIVER LEWIS AND CLARK
WATER DISTRICT
PACIFIC STATES MARINE FISHERIES
COMMISSION
CENTRAL OREGON IRRIGATION
DISTRICT
MARION COUNTY FIRE DISTRCT #1
COLUMBIA RIVER PUD
SANDY FIRE DISTRICT NO. 72
BAY AREA HOSPITAL DISTRICT
NEAH KAH NIE WATER DISTRICT
PORT OF UMPQUA
EAST MULTNOMAH SOIL AND WATER
CONSERVANCY
Benton Soil & Water Conservation District
DESCHUTES PUBLIC LIBRARY SYSTEM
CLEAN WATER SERVICES
North Douglas County Fire & EMS
Crooked River Ranch Rural Fire Protection
District
PARROTT CREEK CHILD & FAM
South Lane County Fire And Rescue
Lake Chinook Fire & Rescue
Account Type: Community College (16
records)
CENTRAL OREGON COMMUNITY
COLLEGE
UMPQUA COMMUNITY COLLEGE
LANE COMMUNITY COLLEGE
MT. HOOD COMMUNITY COLLEGE
LINN-BENTON COMMUNITY COLLEGE
SOUTHWESTERN OREGON COMMUNITY
COLLEGE
PORTLAND COMMUNITY COLLEGE
12/8/2015 1:11 PM
CHEMEKETA COMMUNITY COLLEGE
ROGUE COMMUNITY COLLEGE
COLUMBIA GORGE COMMUNITY
COLLEGE
TILLAMOOK BAY COMMUNITY
COLLEGE
KLAMATH COMMUNITY COLLEGE
DISTRICT
Oregon Coast Community College
Clatsop Community College
North Portland Bible College
OREGON COMMUNITY COLLEGE
ASSOCIATION
Account Type: State Agency (43 records)
Teacher Standards and Pracitices Commission
Kdrv Channel 12
Opta Oregon Permit Technician
Oregon Forest Resources Institute
Office of the Ong Term Care Ombudsman
Oregon State Lottery
OREGON TOURISM COMMISSION
OREGON STATE POLICE
OFFICE OF THE STATE TREASURER
OREGON DEPT. OF EDUCATION
SEIU LOCAL 503, OPEU
OREGON DEPARTMENT OF FORESTRY
OREGON STATE DEPT OF CORRECTIONS
OREGON CHILD DEVELOPMENT
COALITION
OFFICE OF MEDICAL ASSISTANCE
PROGRAMS
OREGON OFFICE OF ENERGY
OREGON STATE BOARD OF NURSING
BOARD OF MEDICAL EXAMINERS
OREGON LOTTERY
OREGON BOARD OF ARCHITECTS
SANTIAM CANYON COMMUNICATION
CENTER
OREGON DEPT OF TRANSPORTATION
OREGON TRAVEL INFORMATION
COUNCIL
OREGON DEPARTMENT OF EDUCATION
OREGON DEPT. OF CORRECTIONS
DEPARTMENT OF ADMINISTRATIVE
SERVICES
p. 93
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
Oregon Board of Massage Therapists
Oregon Tradeswomen
Oregon Convention Center
OREGON SCHL BRDS ASSOCIAT
Central Oregon Home Health and Hos
Oregon Health Care Quality Cor
OREGON DEPARTMENT OF HUMAN
SERVICES
Oregon Air National Guard
Training & Employment
State of Oregon - Department of Administrative
Services
Aging and People with Disabilities
Oregon State Fair Council
Procurement Services/DAS
STATE OF OREGON
OREGON JUDICIAL DEPARTMENT
City of Astoria Fire Department
Columbia Gorge ESD
Account Type: Consolidated City/County (2
records)
Nehalem Bay Wastewater
Association of Oregon Community Mental
Health Programs
US FISH AND WILDLIFE SERVICE
Bonneville Power Administration
Oregon Army National Guard
USDA Forest Service
Yellowhawk Tribal Health Center
ANGELL JOB CORPS
Account Type: Housing Authority (11
records)
Coquille Indian Housing Authority
COLLEGE HOUSING NORTHWEST
HOUSING AUTHORITY OF CLACKAMAS
COUNTY
HOUSING AUTHORITY OF PORTLAND
WEST VALLEY HOUSING AUTHORITY
HOUSING AUTHORITY AND
COMMUNITY SERVICES AGENCY
NORTH BEND CITY- COOS/URRY
HOUSING AUTHORITY
MARION COUNTY HOUSING
AUTHORITY
HOUSING AUTHORITY OF THE CITY OF
SALEM
Housing Authority of Yamhill County
The Housing Authority of the County of
Umatilla
Account Type: Federal (6 records)
12/8/2015 1:11 PM
p. 94
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
EXHIBIT 7
FEMA STANDARD TERMS AND CONDITIONS ADDENDUM
If any purchase made under the Master Agreement is funded in whole or in part by Federal Emergency Management
Agency (“FEMA”) grants, Contractor shall comply with all federal laws and regulations applicable to the receipt of
FEMA grants, including, but not limited to the contractual procedures set forth in Title 44 of the Code of Federal
Regulations, Part 13 (“44 CFR 13”).
In addition, Contractor agrees to the following specific provisions:
1.
Pursuant to 44 CFR 13.36(i)(1), County is entitled to exercise all administrative, contractual, or other
remedies permitted by law to enforce Contractor’s compliance with the terms of this Master Agreement,
including but not limited to those remedies set forth at 44 CFR 13.43.
2.
Pursuant to 44 CFR 13.36(i)(2), County may terminate the Master Agreement for cause or convenience in
accordance with the procedures set forth in the Master Agreement and those provided by 44 CFR 13.44.
3.
Pursuant to 44 CFR 13.36(i)(3)-(6)(12), and (13), Contractor shall comply with the following federal laws:
a.
Executive Order 11246 of September 24, 1965, entitled “Equal Employment Opportunity,” as
amended by Executive Order 11375 of October 13, 1967, and as supplemented in Department of Labor
(“DOL”) regulations (41 CFR Ch. 60);
b.
Copeland “Anti-Kickback” Act (18 U.S.C. 874), as supplemented in DOL regulations (29 CFR Part 3);
c.
Davis-Bacon Act (40 U.S.C. 276a-276a-7) as supplemented by DOL regulations (29 CFR Part 5);
d.
Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-330) as
supplemented by DOL regulations (29 CFR Part 5);
e.
Section 306 of the Clean Air Act (42 U.S.C. 1857(h), section 508 of the Clean Water Act (33 U.S.C.
1368), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR part 15);
and
f.
Mandatory standards and policies relating to energy efficiency which are contained in the state energy
conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94-163,
89 Stat. 871).
4.
Pursuant to 44 CFR 13.36(i)(7), Contractor shall comply with FEMA requirements and regulations
pertaining to reporting, including but not limited to those set forth at 44 CFR 40 and 41.
5.
Pursuant to 44 CFR 13.36(i)(8), Contractor agrees to the following provisions regarding patents:
a.
6.
All rights to inventions and/or discoveries that arise or are developed, in the course of or under this
Agreement, shall belong to the County and be disposed of in accordance with County policy. The
County, at its own discretion, may file for patents in connection with all rights to any such inventions
and/or discoveries.
Pursuant to 44 CFR 13.36(i)(9), Contractor agrees to the following provisions, regarding copyrights:
a.
If this Agreement results in any copyrightable material or inventions, in accordance with 44 CFR
13.34, FEMA reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or
otherwise use, for Federal Government purposes:
(1) The copyright in any work developed under a grant or contract; and
(2) Any rights of copyright to which a grantee or a contactor purchases ownership with grant support.
12/8/2015 1:11 PM
p. 95
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
7.
Pursuant to 44 CFR 13.36(i)(10), Contractor shall maintain any books, documents, papers, and records of
the Contractor which are directly pertinent to this Master Agreement. At any time during normal business
hours and as often as County deems necessary, Contractor shall permit County, FEMA, the Comptroller
General of United States, or any of their duly authorized representatives to inspect and photocopy such
records for the purpose of making audit, examination, excerpts, and transcriptions.
8.
Pursuant to 44 CFR 13.36(i)(11), Contractor shall retain all required records for three years after FEMA or
County makes final payments and all other pending matters are closed. In addition, Contractor shall comply
with record retention requirements set forth in 44 CFR 13.42.
12/8/2015 1:11 PM
p. 96
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
EXHIBIT 8
COMMUNITY DEVELOPMENT BLOCK GRANT ADDENDUM
Purchases made under this contract may be partially or fully funded with federal grant funds. Funding for this work
may include Federal Funding sources, including Community Development Block Grant (CDBG) funds from the
U.S. Department of Housing and Urban Development. When such funding is provided, Contractor shall comply
with all terms, conditions and requirements enumerated by the grant funding source, as well as requirements of the
State statutes for which the contract is utilized, whichever is the more restrictive requirement. When using Federal
Funding, Contractor shall comply with all wage and latest reporting provisions of the Federal Davis-Bacon Act.
HUD-4010 Labor Provisions also applies to this contract.
12/8/2015 1:11 PM
p. 97
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
EXHIBIT 9
INSURANCE CERTIFICATE EXAMPLE
12/8/2015 1:11 PM
p. 98
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
EXHIBIT 10
TWELVE (12 MONTH PRESCRIPTION ACTIVITY MARICOPA COUNTY)
Summary of Mail Order versus Retail Pharmacy 7/1/2014 to 6/30/2015
Number of Rxs
Ingredient Cost
Mail Order
Others
Total
Mail Order
Percentage
12/8/2015 1:11 PM
2,971
165,643
168,614
581,274
21,188,065
21,769,339
1.76%
2.67%
p. 99
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
NIGP CODE: 94872
RESPONDENT'S NAME:
COUNTY VENDOR NUMBER :
ADDRESS:
P.O. ADDRESS:
TELEPHONE NUMBER:
FACSIMILE NUMBER:
WEB SITE:
CONTACT (REPRESENTATIVE):
REPRESENTATIVE'S E-MAIL ADDRESS:
RESPONDENT IS REQUIRED TO PICK ONE OF THE FOLLOWING PAYMENT TERMS.
FAILURE TO INDICATE PAYMENT TERMS WILL RESULT IN A DEFAULT TO NET 30 DAYS.
RESPONDENT MUST INITIAL THEIR SELECTION BELOW.
[
[
[
[
]
]
]
]
NET 10 DAYS
NET 15 DAYS
NET 20 DAYS
NET 30 DAYS
[
[
[
[
]
]
]
]
NET 45 DAYS
NET 60 DAYS
NET 90 DAYS
2% 10 DAYS NET 30 DAYS
[
[
[
[
]
]
]
]
1% 10 DAYS NET 30 DAYS
2% 30 DAYS NET 31 DAYS
1% 30 DAYS NET 31 DAYS
5% 30 DAYS NET 31 DAYS
MARICOPA COUNTY ONLY
1.0 PRICING (discount off AWP):
1.1 RETAIL PRICING
1.1.1 BRAND NAME AWP LESS DISCOUNT (30 DAY)
1.1.2 DISPENSING FEE
1.1.3 BRAND NAME AWP LESS DISCOUNT (90 DAY)
1.1.2 DISPENSING FEE
1.1.3 GENERIC DISCOUNT (30 day)
1.1.4 DISPENSING FEE
1.1.5 GENERIC DISCOUNT (90 day)
1.1.6 DISPENSING FEE
OPEN NETWORK
PREFERRED NETWORK
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
1.2 MAIL ORDER
1.2.1 BRAND AWP LESS DISCOUNT
1.2.3 GENERIC DISCOUNT
1.2.2 DISPENSING FEE
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
_______________%
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
MINIMUM PER DRUG
PER PRESCRIPTION
1.3 SPECIALTY
1.3.1 BRAND AWP LESS DISCOUNT
1.3.2 DISPENSING FEE
1.3.3 GENERIC DISCOUNT
1.3.5 REBATE ON ALL PRESCRIPTIONS MINUMUM
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
1.4 GENERIC DISCOUNT
1.4.1 SINGLE SOURCE
1.4.2 NON MAC DISCOUNT
_______________%
_______________%
_______________%
_______________%
1.4.3 OVERALL EFFECTIVE GUARANTEED DISCOUNT
_______________%
_______________%
_______________$
_______________$
PER PRESCRIPTION
_______________$
_______________$
PER PRESCRIPTION
2.0 PRICING COST PLUS (PRICE DRUGS IN ATTACHMENT A-1, A-2 AND A-3)
2.1.1 BRAND NAME
_______________%
2.1.2 GENERIC
_______________%
2.1.3 SPECIALITY
_______________%
_______________%
_______________%
_______________%
1.6 REBATES
1.6.1 BRAND NAME DISCOUNTS
1.6.2 GUARANTEED OVERALL REBATES ON ALL
PRESCRIPTIONS
12/8/2015 1:11 PM
p. 100
Maricopa County
16018 ATTACHMENT A-1 BRAND COSTS
Bid 16018-RFP
16018 ATTACHMENT A-1
Brand Drugs - July 2014 to June 2015
Listed in Order of Ingredient Cost - Highest to Lowest
Type
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Product ID
00088221905
00169633910
00088222033
00169750111
59310057922
00186037020
00051846233
15584010101
59148000713
53885024510
00310075190
00078063035
00169406013
00006027731
61958080201
59148000813
00032122401
00169369619
50458057930
61958070101
00310075290
61958120101
65702040810
00469012599
00052027303
49502050002
00430078327
61958110101
66582041431
00085128801
59011043010
50458014030
00310028460
00186037220
00597007541
66780021904
59417010410
54092019112
00002751001
75987003004
27505000405
66780021201
54092047612
00169368512
00049234045
00299590825
10144042760
00169406012
75987002101
50458014130
59148000613
63004871001
00002879959
49502050102
00071101468
00310075590
50419048858
12496120803
59011046010
49702022813
00071101368
59417010310
00071101568
00006011231
59417010710
00456141030
49702020613
59417010510
00006057761
00003362212
20482000230
00071101668
00069422030
00006022761
12/8/2015 1:11 PM
Product
LANTUS SOLOSTAR
NOVOLOG FLEXPEN
LANTUS
NOVOLOG
PROAIR HFA
SYMBICORT
ANDROGEL PUMP
ATRIPLA
ABILIFY
ONETOUCH ULTRA BLUE
CRESTOR
TOBI PODHALER
VICTOZA
JANUVIA
LETAIRIS
ABILIFY
CREON
NOVOLOG MIX 70/30 PREFILL
XARELTO
TRUVADA
CRESTOR
STRIBILD
ACCU-CHEK AVIVA PLUS
XTANDI
NUVARING
EPIPEN 2-PAK
ASACOL HD
COMPLERA
ZETIA
NASONEX
OXYCONTIN
INVOKANA
SEROQUEL XR
SYMBICORT
SPIRIVA HANDIHALER
BYDUREON
VYVANSE
PENTASA
HUMALOG
VIMOVO
APOKYN
BYETTA
LIALDA
NOVOLOG MIX 70/30
RELPAX
EPIDUO
AMPYRA
VICTOZA
RAYOS
INVOKANA
ABILIFY
H.P. ACTHAR
HUMALOG KWIKPEN
EPIPEN-JR 2-PAK
LYRICA
CRESTOR
NEXAVAR
SUBOXONE
OXYCONTIN
TIVICAY
LYRICA
VYVANSE
LYRICA
JANUVIA
VYVANSE
BYSTOLIC
EPZICOM
VYVANSE
JANUMET
REYATAZ
SUBSYS
LYRICA
VIAGRA
ISENTRESS
Generic Indicator - Medispan
Drug Label Name
N
LANTUS
INJ SOLOSTAR
N
NOVOLOG INJ FLEXPEN
N
LANTUS
INJ 100/ML
N
NOVOLOG INJ 100/ML
N
PROAIR HFA AER
N
SYMBICORT AER 160-4.5
N
ANDROGEL GEL 1.62%
N
ATRIPLA TAB
N
ABILIFY TAB 5MG
N
ONETOUCH TES ULTRA BL
N
CRESTOR TAB 10MG
N
TOBI PODHALR CAP 28MG
N
VICTOZA INJ 18MG/3ML
N
JANUVIA TAB 100MG
N
LETAIRIS TAB 10MG
N
ABILIFY TAB 10MG
N
CREON
CAP 24000UNT
N
NOVOLOG MIX INJ FLEXPEN
N
XARELTO TAB 20MG
N
TRUVADA TAB 200-300
N
CRESTOR TAB 20MG
N
STRIBILD TAB
N
ACCU-CHEK TES AVIVA PL
N
XTANDI
CAP 40MG
N
NUVARING MIS
N
EPIPEN 2-PAK INJ 0.3MG
N
ASACOL HD TAB 800MG
N
COMPLERA TAB
N
ZETIA
TAB 10MG
N
NASONEX SPR 50MCG/AC
N
OXYCONTIN TAB 30MG CR
N
INVOKANA TAB 100MG
N
SEROQUEL XR TAB 400MG
N
SYMBICORT AER 80-4.5
N
SPIRIVA CAP HANDIHLR
N
BYDUREON INJ
N
VYVANSE CAP 40MG
N
PENTASA CAP 500MG CR
N
HUMALOG INJ 100/ML
N
VIMOVO
TAB 500-20MG
N
APOKYN
INJ 10MG/ML
N
BYETTA
INJ 10MCG
N
LIALDA
TAB 1.2GM
N
NOVOLOG MIX INJ 70/30
N
RELPAX
TAB 40MG
N
EPIDUO
GEL 0.1-2.5%
N
AMPYRA
TAB 10MG
N
VICTOZA INJ 18MG/3ML
N
RAYOS
TAB 2MG
N
INVOKANA TAB 300MG
N
ABILIFY TAB 2MG
N
H.P. ACTHAR INJ 80UNIT
N
HUMALOG KWIK INJ 100/ML
N
EPIPEN-JR INJ 2-PAK
N
LYRICA
CAP 75MG
N
CRESTOR TAB 5MG
N
NEXAVAR TAB 200MG
N
SUBOXONE MIS 8-2MG
N
OXYCONTIN TAB 60MG CR
N
TIVICAY TAB 50MG
N
LYRICA
CAP 50MG
N
VYVANSE CAP 30MG
N
LYRICA
CAP 100MG
N
JANUVIA TAB 50MG
N
VYVANSE CAP 70MG
N
BYSTOLIC TAB 10MG
N
EPZICOM TAB 600-300
N
VYVANSE CAP 50MG
N
JANUMET TAB 50-1000
N
REYATAZ CAP 300MG
N
SUBSYS
SPR 200MCG
N
LYRICA
CAP 150MG
N
VIAGRA
TAB 100MG
N
ISENTRESS TAB 400MG
Number of Rxs
806
395
414
293
3662
489
231
50
82
468
221
14
76
113
4
52
17
44
122
41
156
30
227
8
279
145
50
32
105
209
116
67
21
163
110
41
216
19
71
13
2
38
32
35
130
117
16
45
18
55
29
1
37
65
85
73
4
116
38
9
84
138
66
40
123
100
13
121
34
14
5
66
172
10
Quantity
20,946
12,117
13,230
10,470
35,445
6,283
27,975
2,160
5,399
115,600
16,815
3,136
1,512
9,150
360
3,306
18,290
3,000
8,275
1,890
12,585
900
50,600
960
701
368
12,198
960
8,010
5,202
7,483
4,256
2,010
2,091
4,893
419
6,651
11,640
2,250
1,980
120
240
5,910
2,000
1,149
5,355
1,320
546
900
3,465
1,350
5
1,338
182
7,293
5,032
300
4,618
2,730
750
6,718
4,470
6,451
2,630
4,235
9,691
750
3,968
5,190
660
570
5,479
766
1,320
UNIT AWP
PRICE
LESS
DISCOUNT
PROPOSED
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
ACTUAL
ACQUISITION
UNIT NET COST
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 101
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
65483089403
00430042014
00310653004
00430375414
00310652401
00008121130
00002512330
63459070060
00131247835
00071101768
00009513502
00085720601
00456140530
00003089421
00085461001
00065853302
65702040710
59011044010
00008122230
00032301613
67386031401
00004080085
53885024450
00002446430
59310020412
59572063106
59148001971
00173069600
00456120230
63402031230
00310075430
00310652004
63402030830
66582031231
65597070118
00025152531
00003421511
00051845030
00002322930
00037024523
50458009801
58468021002
00003142711
63481068447
12496120203
59011048010
63323064907
00002446230
00310028360
59417010610
13548013250
00023367030
58468013001
00310028160
59676056201
49230064551
67386031321
61958090101
00051846230
59011042010
08290320109
00597011630
59310020212
00193731221
66582031331
00186091612
64764017530
00310610530
20482000830
08290320119
59417010210
00023916330
00046110281
68012000316
64011024301
00169183711
16110007501
00186077760
63010002770
99073070827
12/8/2015 1:11 PM
LOTRONEX
N
LO LOESTRIN FE
N
BYDUREON
N
ESTRACE
N
BYETTA
N
PRISTIQ
N
EFFIENT
N
AMRIX
N
VIMPAT
N
LYRICA
N
ZYVOX
N
DULERA
N
BYSTOLIC
N
ELIQUIS
N
DULERA
N
CIPRODEX
N
ACCU-CHEK AVIVA PLUS
N
OXYCONTIN
N
PRISTIQ
N
CREON
N
ONFI
N
TAMIFLU
N
ONETOUCH ULTRA BLUE
N
CIALIS
N
QVAR
N
OTEZLA
N
ABILIFY MAINTENA
N
ADVAIR DISKUS
N
LINZESS
N
LATUDA
N
CRESTOR
N
BYDUREON
N
LATUDA
N
VYTORIN
N
WELCHOL
N
CELEBREX
N
ONGLYZA
N
ANDROGEL
N
STRATTERA
N
DYMISTA
N
ELMIRON
N
AUBAGIO
N
FARXIGA
N
VOLTAREN
N
SUBOXONE
N
OXYCONTIN
N
LEVOTHYROXINE SODIUM
N
CIALIS
N
SEROQUEL XR
N
VYVANSE
N
ACANYA
N
ACZONE
N
RENVELA
N
SEROQUEL XR
N
PREZISTA
N
VELPHORO
N
ONFI
N
CAYSTON
N
ANDROGEL
N
OXYCONTIN
N
BD PEN NEEDLES SHORT/ULTR N
MIRAPEX ER
N
QVAR
N
BAYER CONTOUR NEXT BLOOD N
VYTORIN
N
PULMICORT FLEXHALER
N
DEXILANT
N
ONGLYZA
N
SUBSYS
N
BD PEN NEEDLE/MINI/ULTRAF N
VYVANSE
N
RESTASIS
N
PREMARIN
N
GLUMETZA
N
MAKENA
N
NOVOLIN 70/30
N
MONODOX
O
BRILINTA
N
VIRACEPT
N
FREESTYLE LITE TEST STRIP
N
Maricopa County
LOTRONEX TAB 0.5MG
LO LOESTRIN TAB
BYDUREON INJ
ESTRACE VAG CRE 0.1MG/GM
BYETTA
INJ 10MCG
PRISTIQ TAB 50MG
EFFIENT TAB 10MG
AMRIX
CAP 15MG
VIMPAT
TAB 100MG
LYRICA
CAP 200MG
ZYVOX
TAB 600MG
DULERA
AER 100-5MCG
BYSTOLIC TAB 5MG
ELIQUIS TAB 5MG
DULERA
AER 200-5MCG
CIPRODEX SUS 0.3-0.1%
ACCU-CHEK TES AVIVA PL
OXYCONTIN TAB 40MG CR
PRISTIQ TAB 100MG
CREON
CAP 36000UNT
ONFI
TAB 10MG
TAMIFLU CAP 75MG
ONETOUCH TES ULTRA BL
CIALIS
TAB 20MG
QVAR
AER 80MCG
OTEZLA
TAB 30MG
ABILIFY MAIN INJ 400MG
ADVAIR DISKU AER 250/50
LINZESS CAP 290MCG
LATUDA
TAB 120MG
CRESTOR TAB 40MG
BYDUREON INJ
LATUDA
TAB 80MG
VYTORIN TAB 10-20MG
WELCHOL TAB 625MG
CELEBREX CAP 200MG
ONGLYZA TAB 5MG
ANDROGEL GEL 1%(50MG)
STRATTERA CAP 40MG
DYMISTA SPR 137-50
ELMIRON CAP 100MG
AUBAGIO TAB 14MG
FARXIGA TAB 5MG
VOLTAREN GEL 1%
SUBOXONE MIS 2-0.5MG
OXYCONTIN TAB 80MG CR
LEVOTHYROXIN INJ 100MCG
CIALIS
TAB 5MG
SEROQUEL XR TAB 300MG
VYVANSE CAP 60MG
ACANYA
GEL 1.2-2.5%
ACZONE
GEL 5%
RENVELA TAB 800MG
SEROQUEL XR TAB 150MG
PREZISTA TAB 600MG
VELPHORO CHW 500MG
ONFI
SUS 2.5MG/ML
CAYSTON INH 75MG
ANDROGEL GEL 1.62%
OXYCONTIN TAB 20MG CR
BD PEN NEEDL MIS 31GX5/16
MIRAPEX ER TAB 4.5MG
QVAR
AER 40MCG
BAYER CONTOR TES NEXT
VYTORIN TAB 10-40MG
PULMICORT INH 180MCG
DEXILANT CAP 60MG DR
ONGLYZA TAB 5MG
SUBSYS
SPR 800MCG
BD PEN NEEDL MIS 31GX3/16
VYVANSE CAP 20MG
RESTASIS EMU 0.05%
PREMARIN TAB 0.625MG
GLUMETZA TAB 1000MG
MAKENA
INJ 250MG/ML
NOVOLIN INJ 70/30
MONODOX CAP 75MG
BRILINTA TAB 90MG
VIRACEPT TAB 625MG
FREESTYLE TES LITE
Bid 16018-RFP
15
122
24
95
19
38
35
21
21
57
6
64
96
26
66
129
148
35
33
6
32
168
112
110
92
9
4
51
34
7
37
11
12
29
18
32
24
21
45
85
16
3
22
179
52
16
6
60
9
57
36
56
3
17
4
5
3
2
18
48
152
9
81
35
20
47
51
12
1
139
47
21
40
7
3
37
10
18
4
33
1,110
7,280
208
5,398
115
3,150
2,400
930
2,250
4,680
152
1,144
7,350
3,840
1,066
968
14,950
2,571
2,730
2,660
2,239
1,641
16,700
525
905
540
12
3,780
2,040
510
2,777
132
690
2,550
6,930
2,450
1,740
5,550
1,619
2,323
2,565
84
1,560
35,800
3,967
1,040
180
2,331
764
2,096
1,850
1,950
3,240
1,080
720
1,470
2,400
168
2,250
2,946
36,090
810
792
16,700
1,777
68
1,868
1,080
120
33,440
1,650
2,010
3,266
930
15
1,060
600
2,581
1,440
8,102
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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p. 102
16018 ATTACHMENT A-1 BRAND COSTS
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Brand
Brand
Brand
Brand
Brand
Brand
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Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
08290320122
00004024451
50924098850
66780021007
00065027105
50222050106
65597010430
00456120130
68546022956
00065027225
68968665008
58914050156
00065401303
64764067730
99207046330
50419082502
55494010010
54092051502
00131248035
00169517603
65597010330
00008122201
00131247935
63459022530
00310620530
42546003045
00074345590
00310028260
65649030103
00056051030
00002325130
00006027754
53885027210
00046110511
61958040101
00555105686
00430053550
65702049310
00078036034
50458086101
50458025115
00032121201
00002850101
00003363112
00046087221
51248015001
00597013560
75987004005
00046110711
59310021012
00002880359
00074679922
17772012301
00046110081
00023916360
00023833510
65649020175
50419042301
00004082205
00006496341
00023367090
00430011420
00187099445
00002197590
99207030060
58914017014
00078049471
00074333330
00173083113
20482000430
00173068220
00597008717
65702049210
00006057561
63402030630
00310621030
50458084004
00071101868
64764091830
00597013554
12/8/2015 1:11 PM
BD PEN NEEDLE/NANO/ULTRA N
INVIRASE
N
ACCU-CHEK COMPACT PLUS N
BYETTA
N
PATANOL
N
TACLONEX
N
BENICAR
N
LINZESS
N
AZILECT
N
PATADAY
N
MINIVELLE
N
CANASA
N
VIGAMOX
N
ULORIC
N
SOLODYN
N
FINACEA
N
DICLEGIS
N
INTUNIV
N
VIMPAT
N
VAGIFEM
N
BENICAR
N
PRISTIQ
N
VIMPAT
N
NUVIGIL
N
FARXIGA
N
HPR PLUS
N
SIMCOR
N
SEROQUEL XR
N
XIFAXAN
N
SUSTIVA
N
STRATTERA
N
JANUVIA
N
ONETOUCH VERIO TEST STRIP N
PREMPRO
N
VIREAD
N
CLARAVIS
N
MINASTRIN 24 FE
N
ACCU-CHEK SMARTVIEW STRIPN
DIOVAN
O
NUCYNTA ER
N
ORTHO TRI-CYCLEN LO
N
CREON
N
HUMULIN R U-500 (CONCENTRN
REYATAZ
N
PREMARIN
N
VESICARE
N
PRADAXA
N
PENNSAID
N
PREMPRO
N
QNASL
N
HUMULIN 70/30 KWIKPEN
N
KALETRA
N
OXTELLAR XR
N
PREMARIN
N
RESTASIS
N
TAZORAC
N
MOVIPREP
N
MIRENA
N
TAMIFLU
N
ZOSTAVAX
N
ACZONE
N
DORYX
N
ZOVIRAX
N
AXIRON
N
ZIANA
N
CARAFATE
N
TOBI
O
NORVIR
N
LEVITRA
N
SUBSYS
N
VENTOLIN HFA
N
ATROVENT HFA
N
ACCU-CHEK SMARTVIEW STRIPN
JANUMET
N
LATUDA
N
FARXIGA
N
NUCYNTA
N
LYRICA
N
ULORIC
N
PRADAXA
N
Maricopa County
BD PEN NEEDL MIS 32GX4MM
INVIRASE TAB 500MG
ACCU-CHEK TES COMPACT
BYETTA
INJ 5MCG
PATANOL SOL 0.1% OP
TACLONEX SUS
BENICAR TAB 40MG
LINZESS CAP 145MCG
AZILECT TAB 1MG
PATADAY SOL 0.2%
MINIVELLE DIS 0.05MG
CANASA
SUP 1000MG
VIGAMOX DRO 0.5%
ULORIC
TAB 80MG
SOLODYN TAB 65MG
FINACEA GEL 15%
DICLEGIS TAB 10-10MG
INTUNIV TAB 2MG
VIMPAT
TAB 200MG
VAGIFEM TAB 10MCG
BENICAR TAB 20MG
PRISTIQ TAB 100MG
VIMPAT
TAB 150MG
NUVIGIL TAB 250MG
FARXIGA TAB 5MG
HPR PLUS CRE
SIMCOR
TAB 1000-20
SEROQUEL XR TAB 200MG
XIFAXAN TAB 200MG
SUSTIVA TAB 600MG
STRATTERA CAP 100MG
JANUVIA TAB 100MG
ONETOUCH TES VERIO
PREMPRO TAB 0.3-1.5
VIREAD
TAB 300MG
CLARAVIS CAP 30MG
MINASTRIN 24 CHW FE
ACCU-CHEK TES SMART
DIOVAN
TAB 320MG
NUCYNTA ER TAB 100MG
ORTHO TRI- TAB CYCLN LO
CREON
CAP 12000UNT
HUMULIN R INJ U-500
REYATAZ CAP 200MG
PREMARIN VAG CRE 0.625MG
VESICARE TAB 5MG
PRADAXA CAP 150MG
PENNSAID SOL 2%
PREMPRO TAB .625-2.5
QNASL
AER 80MCG
HUMULIN INJ 70/30KWP
KALETRA TAB 200-50MG
OXTELLAR XR TAB 600MG
PREMARIN TAB 0.3MG
RESTASIS EMU 0.05%
TAZORAC GEL 0.05%
MOVIPREP SOL
MIRENA
IUD SYSTEM
TAMIFLU SUS 6MG/ML
ZOSTAVAX INJ
ACZONE
GEL 5%
DORYX
TAB 200MG
ZOVIRAX CRE 5%
AXIRON
SOL 30MG/ACT
ZIANA
GEL
CARAFATE SUS 1GM/10ML
TOBI
NEB 300/5ML
NORVIR
TAB 100MG
LEVITRA TAB 20MG
SUBSYS
SPR 400MCG
VENTOLIN HFA AER
ATROVENT HFA AER 17MCG
ACCU-CHEK TES SMART
JANUMET TAB 50-500MG
LATUDA
TAB 60MG
FARXIGA TAB 10MG
NUCYNTA TAB 100MG
LYRICA
CAP 300MG
ULORIC
TAB 40MG
PRADAXA CAP 150MG
Bid 16018-RFP
136
5
37
10
43
14
25
26
7
70
41
13
86
17
10
41
32
25
15
34
30
19
6
6
12
38
9
8
8
4
25
10
28
28
10
14
42
42
17
21
43
6
5
7
32
16
11
5
25
63
5
10
5
27
20
9
104
10
38
39
13
9
12
18
11
32
1
16
48
1
130
20
49
8
5
9
13
24
13
8
27,780
1,320
7,293
30
255
960
1,830
1,200
630
182
888
441
258
1,290
300
2,050
1,900
990
915
705
2,295
1,320
720
540
840
17,108
1,260
660
639
360
915
900
6,800
2,156
300
810
2,744
6,700
1,530
1,533
2,044
3,870
180
420
1,110
1,110
1,708
672
1,990
548
375
1,200
840
2,310
1,440
900
104
10
4,020
39
1,170
270
60
1,620
660
25,260
280
870
231
120
2,988
387
5,450
1,080
285
630
1,530
1,560
870
1,440
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p. 103
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00006008061
00023915530
00071101268
59148001113
00023921105
00003142811
16110025904
63402030430
00023367060
49702023113
00173071920
51672528107
64764011901
10631011731
00023320503
00085134102
66582041474
50419040703
65597010130
52544092008
59148000613
00169183411
00069047102
00002325030
16110050201
61958100401
00002803101
61958100301
65597011830
59767001601
54482014701
00310651201
00051842530
64764011907
59148000713
54092051702
69036009815
00193708050
00078035934
59011075204
00456114030
50474080403
00310612560
00085134107
65649030302
00430053514
51248015101
00597002402
00013215036
64764051030
00469260230
64764024060
00065026025
00069024430
64764008060
75987001003
00310626060
00074518290
64764012103
00046110481
66582041454
00003422216
59011075104
00131326832
00002322830
50222050166
59148000913
00074662490
67386031501
00456080060
00006027782
42211020429
50458057830
13913000519
00173071215
52268001201
00049233045
65597011230
00071036924
65976010001
12/8/2015 1:11 PM
JANUMET XR
N
TAZORAC
N
LYRICA
N
ABILIFY
N
COMBIGAN
N
FARXIGA
N
MONODOX
O
LATUDA
N
ACZONE
N
TRIUMEQ
N
FLOVENT HFA
N
TOPICORT
N
COLCRYS
N
ABSORICA
N
LUMIGAN
N
ASMANEX TWISTHALER 60 METN
ZETIA
N
BEYAZ
N
BENICAR
N
OXYTROL
N
ABILIFY
O
NOVOLIN N
N
CHANTIX STARTING MONTH PAN
STRATTERA
N
ACTICLATE
N
RANEXA
N
GLUCAGON EMERGENCY KIT N
RANEXA
N
TRIBENZOR
N
PERTZYE
N
CARNITOR
O
BYETTA
N
ANDROGEL
N
COLCRYS
N
ABILIFY
O
INTUNIV
N
CAPTRACIN
N
BAYER CONTOUR BLOOD GLUCO
N
DIOVAN
O
BUTRANS
N
VIIBRYD
N
NEUPRO
N
KOMBIGLYZE XR
N
ASMANEX TWISTHALER 30 ME N
XIFAXAN
N
MINASTRIN 24 FE
N
VESICARE
N
COMBIVENT RESPIMAT
N
ESTRING
N
ACTOPLUS MET XR
N
MYRBETRIQ
N
AMITIZA
N
TRAVATAN Z
N
TOVIAZ
N
AMITIZA
N
DUEXIS
N
XIGDUO XR
N
SYNTHROID
O
OSENI
N
PREMARIN
N
ZETIA
N
KOMBIGLYZE XR
N
BUTRANS
N
VENLAFAXINE HCL ER
N
STRATTERA
N
TACLONEX
N
ABILIFY
N
SYNTHROID
O
ONFI
N
TUDORZA PRESSAIR
N
JANUVIA
N
ZORVOLEX
N
XARELTO
N
GRALISE
N
AVODART
N
SUPREP BOWEL PREP
N
RELPAX
N
AZOR
N
DILANTIN
O
ARESTIN
N
Maricopa County
JANUMET XR TAB 50-1000
TAZORAC CRE 0.05%
LYRICA
CAP 25MG
ABILIFY TAB 30MG
COMBIGAN SOL 0.2/0.5%
FARXIGA TAB 10MG
MONODOX CAP 100MG
LATUDA
TAB 40MG
ACZONE
GEL 5%
TRIUMEQ TAB
FLOVENT HFA AER 110MCG
TOPICORT SPR 0.25%
COLCRYS TAB 0.6MG
ABSORICA CAP 30MG
LUMIGAN SOL 0.01%
ASMANEX 60 AER 220MCG
ZETIA
TAB 10MG
BEYAZ
TAB
BENICAR TAB 5MG
OXYTROL DIS 3.9MG/24
ABILIFY TAB 2MG
NOVOLIN N INJ U-100
CHANTIX PAK 0.5& 1MG
STRATTERA CAP 80MG
ACTICLATE TAB 150MG
RANEXA
TAB 1000MG
GLUCAGON KIT 1MG
RANEXA
TAB 500MG
TRIBENZOR40- TAB 10-25MG
PERTZYE CAP
CARNITOR INJ 1GM/5ML
BYETTA
INJ 5MCG
ANDROGEL GEL 1%(25MG)
COLCRYS TAB 0.6MG
ABILIFY TAB 5MG
INTUNIV TAB 3MG
CAPTRACIN PAD .0375-5%
BAYER CONTOR TES BLD GLUC
DIOVAN
TAB 160MG
BUTRANS DIS 20MCG/HR
VIIBRYD TAB 40MG
NEUPRO
DIS 4MG/24HR
KOMBIGLYZE TAB 2.5-1000
ASMANEX 30 AER 220MCG
XIFAXAN TAB 550MG
MINASTRIN 24 CHW FE
VESICARE TAB 10MG
COMBIVENT AER RESPIMAT
ESTRING MIS 2MG
ACTOPLUS MET TAB XR
MYRBETRIQ TAB 50MG
AMITIZA CAP 24MCG
TRAVATAN Z DRO 0.004%
TOVIAZ
TAB 8MG
AMITIZA CAP 8MCG
DUEXIS
TAB 800-26.6
XIGDUO XR TAB 5-1000MG
SYNTHROID TAB 75MCG
OSENI
TAB 12.5-15
PREMARIN TAB 1.25MG
ZETIA
TAB 10MG
KOMBIGLYZE TAB 2.5-1000
BUTRANS DIS 10MCG/HR
VENLAFAXINE TAB 225MG ER
STRATTERA CAP 25MG
TACLONEX SUS
ABILIFY TAB 15MG
SYNTHROID TAB 100MCG
ONFI
TAB 20MG
TUDORZA PRES AER 400/ACT
JANUVIA TAB 100MG
ZORVOLEX CAP 35MG
XARELTO TAB 15MG
GRALISE TAB 600MG
AVODART CAP 0.5MG
SUPREP BOWEL SOL PREP
RELPAX
TAB 20MG
AZOR
TAB 5-40MG
DILANTIN CAP 100MG
ARESTIN MIS 1MG
Bid 16018-RFP
12
21
13
2
58
9
6
9
16
1
31
13
16
4
48
19
10
26
8
5
3
12
25
21
9
6
23
9
12
2
2
10
14
30
5
13
3
52
15
12
14
5
6
23
5
33
12
18
20
4
11
11
44
10
12
5
8
113
9
20
10
10
20
17
19
4
5
106
4
17
6
11
13
6
12
63
16
9
27
3
1,350
780
1,511
180
320
630
360
270
960
90
420
1,300
1,214
240
135
35
900
1,568
1,710
120
210
590
1,325
582
270
840
32
1,380
900
1,800
900
14
1,050
1,063
195
570
180
5,200
1,290
48
960
330
1,080
36
234
1,596
720
80
20
720
630
1,080
118
750
1,080
390
960
5,717
450
1,530
840
1,080
80
1,110
590
480
195
5,376
240
19
480
1,750
494
1,020
1,020
22,302
140
750
7,108
63
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p. 104
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
68968663708
50419042101
00046110611
20482000110
54092017312
49909000530
00074663330
00006011254
69263002115
00069046912
00069582060
99073012101
54092051302
59148001013
00002831501
00186091706
24338010620
00085134101
00046110381
00310662702
59310020480
59011041510
00430054050
00074706890
00002323930
00074372790
23155001801
00065924007
00074455290
00469520211
50458082004
00299590845
00074659490
24208050307
52937000120
00078034645
00003422311
00069421030
00456009590
17772010315
24478020020
10631009430
68968051408
59011041010
00085432402
50222050247
53451010101
68968661008
50419040903
00069024230
00525110290
00074929690
00378022201
00299384904
00430047203
00046110181
00051846231
66869020490
00187305050
50458083004
00032122407
00004003909
00069046956
00085140101
50458019215
66582031354
00456224030
00078049115
00088250205
50924088401
00078034445
00085146102
13548007045
00169517604
00187514850
59676082001
00456142030
62541020230
00069422066
00003089321
12/8/2015 1:11 PM
MINIVELLE
N
MIRENA
N
PREMPRO
N
SUBSYS
N
CARBATROL
O
FLUOXETINE HCL
N
NORVIR
N
JANUVIA
N
SINELEE
N
CHANTIX CONTINUING MONTHN
TIKOSYN
N
FREESTYLE TEST STRIPS
N
INTUNIV
N
ABILIFY
N
HUMULIN N
N
PULMICORT FLEXHALER
N
ERYTHROCIN STEARATE
N
ASMANEX TWISTHALER 120 MEN
PREMARIN
N
SYMLINPEN 120
N
QVAR
N
OXYCONTIN
N
MINASTRIN 24 FE
N
SYNTHROID
O
STRATTERA
N
SYNTHROID
O
TETRACYCLINE HCL
N
DUREZOL
N
SYNTHROID
O
PROTOPIC
N
NUCYNTA
N
EPIDUO
N
SYNTHROID
O
LOTEMAX
N
VASCEPA
N
VIVELLE-DOT
N
KOMBIGLYZE XR
N
VIAGRA
N
DALIRESP
N
TROKENDI XR
N
QUILLIVANT XR
N
HALOG
N
COMBIPATCH
N
OXYCONTIN
N
NOXAFIL
N
PICATO
N
HORIZANT
N
MINIVELLE
N
NATAZIA
N
TOVIAZ
N
DEPLIN 15
N
SYNTHROID
O
CHLORTHALIDONE
N
CLOBEX
N
ACTONEL
N
PREMARIN
N
ANDROGEL
N
LIVALO
N
ONEXTON
N
NUCYNTA
N
CREON
N
VALCYTE
N
CHANTIX
N
FORADIL AEROLIZER
N
ORTHO EVRA
O
VYTORIN
N
FETZIMA
N
EXFORGE
O
APIDRA SOLOSTAR
N
ACCU-CHEK COMPACT PLUS N
VIVELLE-DOT
N
ASMANEX TWISTHALER 30 METN
ATRALIN
N
VAGIFEM
N
RETIN-A MICRO PUMP
N
MONOVISC
N
BYSTOLIC
N
QSYMIA
N
VIAGRA
N
ELIQUIS
N
Maricopa County
MINIVELLE DIS 0.0375MG
MIRENA
IUD SYSTEM
PREMPRO TAB 0.45-1.5
SUBSYS
SPR 100MCG
CARBATROL CAP 300MG
FLUOXETINE TAB 60MG
NORVIR
CAP 100MG
JANUVIA TAB 50MG
SINELEE PAD 0.05-5%
CHANTIX PAK 1MG
TIKOSYN CAP 500MCG
FREESTYLE TES
INTUNIV TAB 1MG
ABILIFY TAB 20MG
HUMULIN N INJ U-100
PULMICORT INH 90MCG
ERYTHROCIN TAB 250MG
ASMANEX 120 AER 220MCG
PREMARIN TAB 0.9MG
SYMLNPEN 120 INJ 1000MCG
QVAR
AER 80MCG
OXYCONTIN TAB 15MG CR
MINASTRIN 24 CHW FE
SYNTHROID TAB 125MCG
STRATTERA CAP 60MG
SYNTHROID TAB 137MCG
TETRACYCLINE CAP 500MG
DUREZOL EMU 0.05%
SYNTHROID TAB 50MCG
PROTOPIC OIN 0.1%
NUCYNTA TAB 50MG
EPIDUO
GEL 0.1-2.5%
SYNTHROID TAB 88MCG
LOTEMAX GEL 0.5%
VASCEPA CAP 1GM
VIVELLE-DOT DIS 0.1MG
KOMBIGLYZE TAB 5-1000MG
VIAGRA
TAB 50MG
DALIRESP TAB 500MCG
TROKENDI XR CAP 100MG
QUILLIVANT SUS XR
HALOG
CRE 0.1%
COMBIPATCH DIS .05/.14
OXYCONTIN TAB 10MG CR
NOXAFIL TAB 100MG
PICATO
GEL 0.015%
HORIZANT TAB 600MG
MINIVELLE DIS 0.1MG
NATAZIA TAB
TOVIAZ
TAB 4MG
DEPLIN 15 CAP
SYNTHROID TAB 112MCG
CHLORTHALID TAB 25MG
CLOBEX
SPR 0.05%
ACTONEL TAB 35MG
PREMARIN TAB 0.45MG
ANDROGEL GEL 1.62%
LIVALO
TAB 2MG
ONEXTON GEL 1.2-3.75
NUCYNTA TAB 75MG
CREON
CAP 24000UNT
VALCYTE SOL 50MG/ML
CHANTIX TAB 1MG
FORADIL CAP AEROLIZE
ORTHO EVRA DIS WEEK
VYTORIN TAB 10-40MG
FETZIMA CAP 40MG
EXFORGE TAB 10-320MG
APIDRA
INJ SOLOSTAR
ACCU-CHEK TES COMPACT
VIVELLE-DOT DIS 0.05MG
ASMANEX 30 AER 110MCG
ATRALIN GEL 0.05%
VAGIFEM TAB 10MCG
RETIN-A MICR GEL 0.08%
MONOVISC INJ 88MG/4ML
BYSTOLIC TAB 20MG
QSYMIA
CAP 7.5-46MG
VIAGRA
TAB 100MG
ELIQUIS TAB 2.5MG
Bid 16018-RFP
21
6
14
2
16
10
3
5
2
18
4
6
13
2
29
29
6
10
13
1
23
21
16
72
9
82
11
27
81
5
19
14
83
27
10
14
4
19
4
4
15
10
13
27
2
5
7
19
11
8
16
61
76
5
15
11
6
11
8
11
1
4
13
8
11
5
9
5
8
13
15
13
8
15
4
2
13
16
18
4
360
6
1,120
130
2,640
900
540
450
120
1,008
720
3,400
455
120
430
33
692
16
1,110
32
200
1,142
1,120
4,096
445
4,003
484
140
4,268
500
1,290
630
4,068
135
2,160
368
360
110
360
240
2,280
660
264
1,531
60
15
420
296
812
480
900
3,474
5,505
625
60
866
300
570
400
859
720
352
732
840
87
450
390
390
120
2,244
296
19
360
229
200
12
1,047
480
89
600
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 105
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00074714890
00006057762
52054055022
00310610550
68968667508
50458014190
68040070513
50458056201
75854030430
00310028060
00169183311
00006022131
00085113201
63459022030
59011075804
00173069700
00078037742
00074706990
99207085060
53885014301
50419042201
50458014090
00310610030
64764025303
00065175007
00067434504
59310020240
00002323830
00078043105
00173083013
00187510001
27437010806
00310614530
65597011630
00299591202
65702028810
00131326732
16110005212
00169643810
00173071620
00052433001
17139061740
00025152031
00406013601
40076062405
51672127103
16781039204
00008083622
00078048515
65597010730
00078048815
00023915660
00173075300
00832011150
00024414260
00187073090
00456045901
00310028339
00023915560
00078048615
00169185189
00078037842
00046110811
00054038325
00051848888
00187510203
65597010490
00173069500
50488140101
00173072020
24208053535
99073070822
58914050142
00078036545
68968907503
00078034645
00078031434
50419040303
50419082806
00597015290
12/8/2015 1:11 PM
SYNTHROID
O
JANUMET
N
ALBENZA
N
ONGLYZA
N
MINIVELLE
N
INVOKANA
N
ALCORTIN A
N
INVEGA SUSTENNA
N
PRENATE MINI
N
SEROQUEL XR
N
NOVOLIN R
N
JANUVIA
N
PROVENTIL HFA
N
NUVIGIL
N
BUTRANS
N
ADVAIR DISKUS
N
COMBIPATCH
N
SYNTHROID
O
LUZU
N
ONETOUCH DELICA LANCETS E N
SKYLA
N
INVOKANA
N
ONGLYZA
N
OSENI
N
ILEVRO
N
TRANSDERM-SCOP
N
QVAR
N
STRATTERA
N
FOCALIN XR
N
LEVITRA
N
ELIDEL
N
ANTARA
N
KOMBIGLYZE XR
N
TRIBENZOR
N
DIFFERIN
N
ACCU-CHEK FASTCLIX LANCET N
VENLAFAXINE HCL ER
O
CORDRAN
N
LEVEMIR FLEXTOUCH
N
ADVAIR HFA
N
NEXPLANON
N
ESTROGEL
N
CELEBREX
N
METHYLPHENIDATE HCL ER N
DENAVIR
N
DESOXIMETASONE
N
LOCOID
N
EFFEXOR XR
O
TEKTURNA
N
BENICAR HCT
N
EXFORGE
N
TAZORAC
N
VERAMYST
N
AMANTADINE HCL
N
MULTAQ
N
WELLBUTRIN XL
O
ARMOUR THYROID
O
SEROQUEL XR
N
TAZORAC
N
TEKTURNA
N
NOVOFINE 32GX6MM
N
COMBIPATCH
N
PREMPRO
N
CYCLOPHOSPHAMIDE
N
ANDROGEL PUMP
N
ELIDEL
N
BENICAR
N
ADVAIR DISKUS
N
RELYYT
N
FLOVENT HFA
N
ZIRGAN
N
FREESTYLE LITE TEST STRIP
N
CANASA
N
VIVELLE-DOT
N
BRISDELLE
N
VIVELLE-DOT
O
DIOVAN HCT
O
SAFYRAL
N
DESONATE
N
JARDIANCE
N
Maricopa County
SYNTHROID TAB 200MCG
JANUMET TAB 50-1000
ALBENZA TAB 200MG
ONGLYZA TAB 5MG
MINIVELLE DIS 0.075MG
INVOKANA TAB 300MG
ALCORTIN A GEL
INVEGA SUST INJ 117/0.75
PRENATE MINI CAP
SEROQUEL XR TAB 50MG
NOVOLIN R INJ U-100
JANUVIA TAB 25MG
PROVENTIL AER HFA
NUVIGIL TAB 200MG
BUTRANS DIS 15MCG/HR
ADVAIR DISKU AER 500/50
COMBIPATCH DIS .05/.14
SYNTHROID TAB 150MCG
LUZU
CRE 1%
ONETOUCH MIS LANCETS
SKYLA
IUD 13.5MG
INVOKANA TAB 100MG
ONGLYZA TAB 2.5MG
OSENI
TAB 25-30MG
ILEVRO
DRO 0.3% OP
TRANSDERM-SC DIS 1.5MG
QVAR
AER 40MCG
STRATTERA CAP 18MG
FOCALIN XR CAP 10MG
LEVITRA TAB 10MG
ELIDEL
CRE 1%
ANTARA
CAP 90MG
KOMBIGLYZE TAB 5-1000MG
TRIBENZOR40- TAB 5-25MG
DIFFERIN LOT 0.1%
FASTCLIX MIS LANCETS
VENLAFAXINE TAB 150MG ER
CORDRAN LOT 0.05%
LEVEMIR INJ FLEXTOUC
ADVAIR HFA AER 115/21
NEXPLANON IMP 68MG
ESTROGEL GEL
CELEBREX CAP 100MG
METHYLPHENID TAB 36MG ER
DENAVIR CRE 1%
DESOXIMETAS CRE 0.05%
LOCOID
LOT 0.1%
EFFEXOR XR CAP 150MG
TEKTURNA TAB 150MG
BENICAR HCT TAB 40-25MG
EXFORGE TAB 5-160MG
TAZORAC CRE 0.1%
VERAMYST SPR 27.5MCG
AMANTADINE TAB 100MG
MULTAQ
TAB 400MG
WELLBUTRIN TAB XL 150MG
ARMOUR THYRO TAB 60MG
SEROQUEL XR TAB 300MG
TAZORAC CRE 0.05%
TEKTURNA TAB 300MG
NOVOFINE MIS 32GX6MM
COMBIPATCH DIS .05/.25
PREMPRO TAB 0.625-5
CYCLOPHOSPH CAP 50MG
ANDROGEL GEL PUMP 1%
ELIDEL
CRE 1%
BENICAR TAB 40MG
ADVAIR DISKU AER 100/50
RELYYT
DIS 0.025-5%
FLOVENT HFA AER 220MCG
ZIRGAN
GEL 0.15%
FREESTYLE TES LITE
CANASA
SUP 1000MG
VIVELLE-DOT DIS 0.025MG
BRISDELLE CAP 7.5MG
VIVELLE-DOT DIS 0.1MG
DIOVAN HCT TAB 80/12.5
SAFYRAL TAB
DESONATE GEL 0.05%
JARDIANCE TAB 10MG
Bid 16018-RFP
47
3
6
3
10
3
3
3
21
6
14
3
46
5
7
7
14
60
7
147
4
4
4
3
14
37
17
8
11
10
11
5
2
4
6
92
14
3
6
8
3
9
5
11
4
13
3
3
6
5
5
4
12
10
3
2
66
1
4
4
26
10
6
8
3
3
4
9
1
7
8
26
1
10
10
7
4
8
5
3
2,667
540
26
270
224
270
144
2
750
390
260
270
476
150
28
420
274
2,619
420
31,500
4
240
240
210
24
147
165
277
330
78
330
330
180
360
354
17,636
1,140
360
90
96
3
1,250
540
518
20
780
354
270
480
390
450
240
160
1,380
300
180
6,765
90
240
360
5,420
192
504
184
750
300
360
540
60
84
40
1,500
90
192
420
168
360
504
300
150
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
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$
$
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p. 106
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00078043205
24208060203
00009766701
64764088430
51285040602
00173071820
00065027510
00023004210
00173080913
65597011430
62856052960
99207046630
00169330312
00074707090
00023915630
00078049115
00065026005
60793041130
50458057990
50458054360
65702043810
99073012050
00597010061
24478020525
42211020329
63402073760
65597090230
49909001030
51285043165
58914060120
00071101968
68968052508
00078049305
24090049384
00078050905
00173071204
00006057782
99207030030
00310628030
00597015230
68220014015
00173085910
68462034737
40076000250
00456046001
51285008787
63402051001
76439021890
00078034642
10631011831
65162031684
24208029905
63459021530
65597010690
50924097110
50474059966
00456228030
00469260130
50458054160
18860048060
52544015130
42847010630
52544020431
00430620140
00078036034
00299382230
00173013555
24478019010
00078048815
00074434190
00597014030
56151103001
00064501030
51285041002
00186037028
60793011501
00065064835
51285020401
63402030230
76439020590
12/8/2015 1:11 PM
FOCALIN XR
N
PROLENSA
N
CLEOCIN
N
EDARBI
N
ENJUVIA
N
FLOVENT HFA
N
AZOPT
N
TAZORAC
N
JALYN
N
TRIBENZOR
N
BELVIQ
N
SOLODYN
N
NOVOLOG PENFILL
N
SYNTHROID
O
TAZORAC
N
EXFORGE
N
TRAVATAN Z
N
FLECTOR
N
XARELTO
N
INVOKAMET
N
ACCU-CHEK AVIVA PLUS
N
FREESTYLE TEST STRIPS
N
SPIRIVA RESPIMAT
N
QUILLIVANT XR
N
ZORVOLEX
N
ZETONNA
N
WELCHOL
N
FORFIVO XL
N
QUARTETTE
N
PYLERA
N
LYRICA
N
COMBIPATCH
N
FOCALIN XR
O
TIROSINT
N
TEGRETOL
O
AVODART
N
JANUMET
N
ZIANA
N
XIGDUO XR
N
JARDIANCE
N
CORTIFOAM
N
BREO ELLIPTA
N
OXYCODONE HCL
O
VUSION
N
ARMOUR THYROID
O
SEASONIQUE
O
XOPENEX HFA
N
L-METHYL-B6-B12
N
VIVELLE-DOT
N
ABSORICA
N
LOMEDIA 24 FE
N
LOTEMAX
N
NUVIGIL
N
BENICAR HCT
N
ACCU-CHEK SOFTCLIX LANCET N
KEPPRA XR
O
FETZIMA
N
MYRBETRIQ
N
INVOKAMET
N
ELESTRIN
N
RAPAFLO
N
SILENOR
N
GENERESS FE
N
FEMRING
N
DIOVAN
N
ORACEA
N
WELLBUTRIN SR
O
QUILLIVANT XR
N
EXFORGE
O
SYNTHROID
O
TRADJENTA
N
TRUETEST STRIPS
N
SANTYL
N
ENJUVIA
N
SYMBICORT
N
CYTOMEL
O
TOBRADEX
N
PARAGARD INTRAUTERINE COPN
LATUDA
N
L-METHYLFOLATE CALCIUM N
Maricopa County
FOCALIN XR CAP 20MG
PROLENSA SOL 0.07%
CLEOCIN SUP 100MG
EDARBI
TAB 80MG
ENJUVIA TAB 0.3MG
FLOVENT HFA AER 44MCG
AZOPT
SUS 1% OP
TAZORAC GEL 0.1%
JALYN
CAP
TRIBENZOR20- TAB 5-12.5MG
BELVIQ
TAB 10MG
SOLODYN TAB 80MG
NOVOLOG INJ PENFILL
SYNTHROID TAB 175MCG
TAZORAC CRE 0.1%
EXFORGE TAB 10-320MG
TRAVATAN Z DRO 0.004%
FLECTOR DIS 1.3%
XARELTO TAB 20MG
INVOKAMET TAB 150-1000
ACCU-CHEK TES AVIVA PL
FREESTYLE TES
SPIRIVA SPR RESPIMAT
QUILLIVANT SUS XR
ZORVOLEX CAP 18MG
ZETONNA AER 37MCG
WELCHOL PAK 3.75GM
FORFIVO XL TAB 450MG
QUARTETTE TAB
PYLERA
CAP
LYRICA
CAP 225MG
COMBIPATCH DIS .05/.25
FOCALIN XR CAP 15MG
TIROSINT CAP 75MCG
TEGRETOL TAB 200MG
AVODART CAP 0.5MG
JANUMET TAB 50-1000
ZIANA
GEL
XIGDUO XR TAB 10-1000
JARDIANCE TAB 10MG
CORTIFOAM AER 90MG
BREO ELLIPTA INH 100-25
OXYCODONE CON 100/5ML
VUSION
OIN
ARMOUR THYRO TAB 90MG
SEASONIQUE TAB
XOPENEX HFA AER
L-METHYL- TAB B6-B12
VIVELLE-DOT DIS 0.1MG
ABSORICA CAP 40MG
LOMEDIA 24 TAB FE
LOTEMAX SUS 0.5%
NUVIGIL TAB 150MG
BENICAR HCT TAB 40-12.5
SOFTCLIX MIS LANCETS
KEPPRA XR TAB 750MG
FETZIMA CAP 80MG
MYRBETRIQ TAB 25MG
INVOKAMET TAB 50-1000
ELESTRIN GEL 0.06%
RAPAFLO CAP 4MG
SILENOR TAB 6MG
GENERESS FE CHW
FEMRING MIS 0.05/24H
DIOVAN
TAB 320MG
ORACEA
CAP 40MG
WELLBUTRIN TAB 150MG SR
QUILLIVANT SUS XR
EXFORGE TAB 5-160MG
SYNTHROID TAB 25MCG
TRADJENTA TAB 5MG
TRUETEST TES
SANTYL
OIN 250/GM
ENJUVIA TAB 1.25MG
SYMBICORT AER 160-4.5
CYTOMEL TAB 5MCG
TOBRADEX OIN 0.3-0.1%
PARAGARD IUD T380A
LATUDA
TAB 20MG
L-METHYLFOLA TAB 15MG
Bid 16018-RFP
8
10
10
5
4
14
11
2
5
4
10
2
3
32
7
3
5
10
2
4
26
6
4
4
9
5
2
4
6
3
3
7
7
22
13
4
2
4
3
3
1
6
7
4
43
6
23
19
2
2
12
9
3
3
107
3
5
4
3
6
3
2
5
6
3
3
2
8
3
37
5
14
6
7
6
14
8
2
2
10
240
30
59
450
810
148
110
200
390
360
534
60
75
1,740
210
270
40
235
180
330
1,750
1,350
24
1,200
660
67
120
240
546
360
420
136
210
561
960
360
360
150
150
150
90
360
210
200
3,510
546
435
1,830
159
60
616
45
90
270
14,502
170
210
180
300
494
295
180
420
6
270
90
360
480
270
1,650
150
2,900
240
630
48
1,302
28
2
60
780
$
$
$
$
$
$
$
$
$
$
$
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$
$
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-
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$
$
$
$
$
$
$
$
$
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$
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-
p. 107
16018 ATTACHMENT A-1 BRAND COSTS
Brand
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Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00046110291
00186504031
00378021301
53885099425
65597010530
70074056656
76439025810
66869040490
55566930002
65597011030
00186504031
65649070141
00456141090
00002446330
00009513601
16110050101
65702010110
00074345790
00525055590
66521011710
50924045001
63481081760
00603158858
00469260190
50458086201
00310626030
64764054311
00173082204
75854031530
00065000603
50458058030
24208044605
24338010413
50458056101
58914030180
00078056315
00259110260
00193731150
16781039202
65597011590
50192011309
68791010204
00456321060
00049234005
00456141001
00074328913
00065427325
00597011530
52544004513
53885039310
00496073204
62541030330
00597000160
24208035805
00456046101
00006057562
00007337213
66582031554
00078061915
00065000203
65597010630
16110081230
00023833503
50419049104
10631009307
60505366903
08290328203
00037024330
00023429003
00406144501
00456151260
00093102406
00003422111
63481081560
00071041813
99207046430
53885027150
00007337313
00074518219
00074662419
12/8/2015 1:11 PM
PREMARIN
N
NEXIUM
O
CHLORTHALIDONE
N
ONETOUCH ULTRA BLUE
N
BENICAR HCT
N
PEDIASURE PEPTIDE 1.5 CAL N
PREPLUS
N
LIVALO
N
PREPOPIK
N
AZOR
N
NEXIUM
N
OSMOPREP
N
BYSTOLIC
N
CIALIS
N
ZYVOX
N
ACTICLATE
N
ACCU-CHEK AVIVA PLUS
N
SIMCOR
N
CEREFOLIN NAC
N
FLUVIRIN 2014-2015
N
ACCU-CHEK MULTICLIX LANCE N
OPANA ER (CRUSH RESISTANT N
PROMETHAZINE VC/CODEINE N
MYRBETRIQ
N
NUCYNTA ER
N
XIGDUO XR
N
PREVACID SOLUTAB
N
STAXYN
N
PRENATE MINI
N
MOXEZA
N
XARELTO
N
BESIVANCE
N
ERYTHROMYCIN BASE
N
INVEGA SUSTENNA
N
RECTIV
N
EXFORGE HCT
N
NAFTIN
N
BAYER CONTOUR NEXT BLOOD N
LOCOID
N
TRIBENZOR
N
CAMBIA
N
DERMA-SMOOTHE/FS SCALP O
NAMENDA
N
RELPAX
N
BYSTOLIC
N
TARKA
N
PAZEO
N
MIRAPEX ER
N
CONDYLOX
N
ONETOUCH ULTRASOFT LANCET
N
ANALPRAM ADVANCED
N
STENDRA
N
AGGRENOX
N
ZYLET
N
ARMOUR THYROID
N
JANUMET
N
COREG CR
N
VYTORIN
N
ARCAPTA NEOHALER
N
NEVANAC
N
BENICAR HCT
N
FLUOROPLEX
N
TAZORAC
N
CLIMARA PRO
N
KENALOG
O
PAXIL CR
O
BD PEN NEEDLE/ULTRAFINE/2 N
ASTEPRO
O
LASTACAFT
N
METHYLPHENIDATE HCL ER N
SAVELLA
N
NEFAZODONE HCL
N
KOMBIGLYZE XR
N
OPANA ER (CRUSH RESISTANT N
NITROSTAT
N
SOLODYN
N
ONETOUCH VERIO TEST STRIP N
COREG CR
N
SYNTHROID
O
SYNTHROID
O
Maricopa County
PREMARIN TAB 0.625MG
NEXIUM
CAP 40MG
CHLORTHALID TAB 50MG
ONETOUCH TES ULTRA BL
BENICAR HCT TAB 20-12.5
PEDIASURE LIQ PEPTIDE
PREPLUS TAB 27-1MG
LIVALO
TAB 4MG
PREPOPIK PAK
AZOR
TAB 5-20MG
NEXIUM
CAP 40MG
OSMOPREP TAB 1.5GM
BYSTOLIC TAB 10MG
CIALIS
TAB 10MG
ZYVOX
SUS 100MG/5M
ACTICLATE TAB 75MG
ACCU-CHEK KIT AVIVA PL
SIMCOR
TAB 1000-40
CEREFOLIN TAB NAC
FLUVIRIN INJ 2014-15
ACCU-CHEK MIS MLTICLIX
OPANA ER TAB 30MG
PROMETH VC/ SYP CODEINE
MYRBETRIQ TAB 25MG
NUCYNTA ER TAB 150MG
XIGDUO XR TAB 5-1000MG
PREVACID TAB 15MG STB
STAXYN
TAB 10MG
PRENATE MINI CAP
MOXEZA
SOL 0.5%
XARELTO TAB 10MG
BESIVANCE SUS 0.6%
ERYTHROMYCIN TAB 500MG BS
INVEGA SUST INJ 78/0.5ML
RECTIV
OIN 0.4%
EXFORGEH/10- TAB 320-25
NAFTIN
CRE 2%
BAYER CONTOR TES NEXT
LOCOID
LOT 0.1%
TRIBENZOR40- TAB 5-12.5MG
CAMBIA
POW 50MG
DERMA-SMOOTH OIL /FS SCLP
NAMENDA TAB 10MG
RELPAX
TAB 40MG
BYSTOLIC TAB 10MG
TARKA
TAB 2-240 CR
PAZEO
DRO 0.7%
MIRAPEX ER TAB 3MG
CONDYLOX GEL 0.5%
ONETOUCH US MIS LANCETS
ANALPRAM KIT ADVANCED
STENDRA TAB 200MG
AGGRENOX CAP 25-200MG
ZYLET
SUS 0.5-0.3%
ARMOUR THYRO TAB 120MG
JANUMET TAB 50-500MG
COREG CR CAP 40MG
VYTORIN TAB 10-80MG
ARCAPTA CAP 75MCG
NEVANAC SUS 0.1%
BENICAR HCT TAB 40-12.5
FLUOROPLEX CRE 1%
TAZORAC GEL 0.05%
CLIMARA PRO DIS WEEKLY
KENALOG AER SPRAY
PAXIL CR TAB 25MG
BD PEN NEEDL MIS 29GX1/2"
ASTEPRO SPR 0.15%
LASTACAFT SOL 0.25%
METHYLPHENID TAB 10MG ER
SAVELLA TAB 12.5MG
NEFAZODONE TAB 100MG
KOMBIGLYZE TAB 5-500MG
OPANA ER TAB 15MG
NITROSTAT SUB 0.4MG
SOLODYN TAB 115MG
ONETOUCH TES VERIO
COREG CR CAP 80MG
SYNTHROID TAB 75MCG
SYNTHROID TAB 100MCG
Bid 16018-RFP
5
2
25
35
5
3
66
4
14
3
2
10
4
26
1
2
64
2
14
267
46
2
32
3
3
4
6
13
9
11
9
10
7
2
3
2
3
10
3
2
3
5
3
2
3
3
4
1
3
47
9
7
1
5
26
3
2
2
6
6
2
2
4
3
2
3
13
6
8
23
4
3
1
3
62
1
10
2
16
14
426
180
2,100
1,225
330
51,192
2,760
240
28
270
180
308
450
37
300
60
64
180
388
134
11,730
120
5,813
150
180
240
135
68
330
33
131
50
215
1
90
180
180
1,900
177
180
36
591
240
36
398
264
18
90
10
13,400
9
42
180
30
1,877
180
180
180
180
18
180
60
120
36
200
210
2,900
240
24
870
300
810
90
180
2,125
30
800
180
1,088
1,250
$
$
$
$
$
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$
$
$
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$
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$
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$
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$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 108
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
62175031337
00597004037
16110008045
00078034345
00065853110
00006027728
50419040503
00067434504
50474080203
00173077602
00187540004
63402070101
68025005330
50458056001
00002322730
85836015153
00085146102
75989055012
68968555203
00006033530
10631009630
00456155060
16781046275
24208034425
00187510102
00430047801
00496072604
00065175014
24478021030
50419040901
00025153002
08290328418
00093312298
76439034030
00525804990
65649010302
60631008030
59148000913
59572063027
00173052100
00169643910
00024583102
63481081660
00064081015
54092051702
00008121101
00169185389
00456045801
00003421521
24338013013
54023996107
00003089431
00187520030
00024583302
24338010213
64011021541
10337035960
00597014818
00310075139
00597007547
00054023525
24208062902
10631020601
00299598030
62541030230
62175031237
65580030403
65597011530
00005197105
00597019261
64764056030
17772010201
00078035834
00065033230
62541020330
00299384902
51013080036
24090049284
00093102506
00006911731
12/8/2015 1:11 PM
METHYLPHENIDATE HCL ER N
MICARDIS
O
XOLEGEL
N
VIVELLE-DOT
N
CIPRO HC
N
JANUVIA
N
YAZ
O
TRANSDERM-SCOP
N
NEUPRO
N
LAMICTAL ODT
N
JUBLIA
N
OMNARIS
N
CONZIP
N
INVEGA SUSTENNA
N
STRATTERA
N
GEL-ONE
N
ASMANEX 30 METERED DOSES N
AEROSPAN
N
DAYTRANA
N
BELSOMRA
N
HALOG
N
SAVELLA
N
CLINDAGEL
N
FLUNISOLIDE
O
ELIDEL
N
ACTONEL
O
PRAMOSONE
N
ILEVRO
N
QUILLIVANT XR
N
NATAZIA
N
CELEBREX
N
BD INSULIN SYRINGE ULTRAF N
JINTELI
N
VIRT-PN DHA
N
METANX
N
APRISO
N
EDARBI
N
ABILIFY
O
OTEZLA
N
SEREVENT DISKUS
N
LEVEMIR FLEXPEN
N
AUVI-Q
N
OPANA ER (CRUSH RESISTANT N
REGRANEX
N
INTUNIV
O
PRISTIQ
N
NOVOTWIST 32GX5MM
N
ARMOUR THYROID
O
ONGLYZA
N
ERYPED 400
N
ACTIVE Q
N
ELIQUIS
N
CARAC
N
AUVI-Q
N
ERYTHROMYCIN BASE
N
EVAMIST
N
OXISTAT
N
JENTADUETO
N
CRESTOR
N
SPIRIVA HANDIHALER
N
MORPHINE SULFATE
N
BEPREVE
N
RIOMET
N
MIRVASO
N
STENDRA
N
METHYLPHENIDATE HCL ER N
VENLAFAXINE HCL ER
N
TRIBENZOR
N
PREVNAR 13
N
STRIVERDI RESPIMAT
N
BRINTELLIX
N
TROKENDI XR
N
DIOVAN
O
PATANASE
N
QSYMIA
N
CLOBEX
N
EPICERAM
N
TIROSINT
N
NEFAZODONE HCL
N
SINGULAIR
O
Maricopa County
METHYLPHENID TAB 54MG ER
MICARDIS TAB 40MG
XOLEGEL GEL 2%
VIVELLE-DOT DIS 0.0375MG
CIPRO HC SUS OTIC
JANUVIA TAB 100MG
YAZ
TAB 3-0.02MG
TRANSDERM-SC DIS 1MG
NEUPRO
DIS 2MG/24HR
LAMICTAL ODT TAB 100MG
JUBLIA
SOL 10%
OMNARIS SPR
CONZIP
CAP 100MG
INVEGA SUST INJ 39/0.25
STRATTERA CAP 10MG
GEL-ONE INJ 30MG/3ML
ASMANEX 30 AER 110MCG
AEROSPAN AER 80MCG
DAYTRANA DIS 10MG/9HR
BELSOMRA TAB 20MG
HALOG
OIN 0.1%
SAVELLA TAB 50MG
CLINDAGEL GEL 1%
FLUNISOLIDE SPR 0.025%
ELIDEL
CRE 1%
ACTONEL TAB 150MG
PRAMOSONE LOT 2.5%
ILEVRO
DRO 0.3% OP
QUILLIVANT SUS XR
NATAZIA TAB
CELEBREX CAP 400MG
INSULIN SYRG MIS 1ML/31G
JINTELI TAB 1MG-5MCG
VIRT-PN DHA CAP
METANX
CAP
APRISO
CAP 0.375GM
EDARBI
TAB 80MG
ABILIFY TAB 15MG
OTEZLA
TAB 10/20/30
SEREVENT DIS AER 50MCG
LEVEMIR INJ FLEXPEN
AUVI-Q
INJ 0.15MG
OPANA ER TAB 20MG
REGRANEX GEL 0.01%
INTUNIV TAB 3MG
PRISTIQ TAB 50MG
NOVOTWIST MIS 32GX5MM
ARMOUR THYRO TAB 30MG
ONGLYZA TAB 5MG
ERYPED
SUS 400/5ML
ACTIVE Q SYP 100/5ML
ELIQUIS TAB 5MG
CARAC
CRE 0.5%
AUVI-Q
INJ 0.3MG
ERYTHROMYCIN TAB 250MG BS
EVAMIST SPR 1.53MG
OXISTAT LOT 1%
JENTADUETO TAB 2.5-1000
CRESTOR TAB 10MG
SPIRIVA CAP HANDIHLR
MORPHINE SUL TAB 15MG
BEPREVE DRO 1.5%
RIOMET
SOL
MIRVASO GEL 0.33%
STENDRA TAB 100MG
METHYLPHENID TAB 36MG ER
VENLAFAXINE TAB 225MG ER
TRIBENZOR40- TAB 5-12.5MG
PREVNAR 13 INJ
STRIVERDI AER RESPIMAT
BRINTELLIX TAB 10MG
TROKENDI XR CAP 50MG
DIOVAN
TAB 80MG
PATANASE SPR 0.6%
QSYMIA
CAP 11.25-69
CLOBEX
SPR 0.05%
EPICERAM EMU
TIROSINT CAP 50MCG
NEFAZODONE TAB 200MG
SINGULAIR TAB 10MG
Bid 16018-RFP
4
2
2
4
5
1
3
13
2
2
2
4
5
3
4
1
4
4
4
4
2
3
1
23
2
4
5
4
5
4
1
26
5
9
8
2
2
1
1
2
3
1
2
1
1
2
17
38
1
3
7
1
0
2
5
3
2
1
2
1
65
5
2
3
6
6
2
2
5
3
3
1
2
3
3
2
3
7
4
2
180
360
90
96
50
90
308
54
60
120
8
75
150
1
105
3
6
53
120
110
120
300
75
775
120
4
590
12
900
224
90
3,780
450
450
480
240
180
30
27
240
39
4
120
15
90
120
2,060
2,820
90
300
2,700
180
0
4
232
73
120
180
120
90
4,833
25
900
90
29
180
180
120
2
20
90
90
180
92
90
118
675
234
720
120
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
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$
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$
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$
$
$
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$
$
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$
$
$
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$
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$
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$
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$
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$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
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$
$
$
$
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$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
-
p. 109
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00074331290
00169706515
60258019001
76439030414
00186401001
00781271501
00469520230
60631042530
60631041230
66582031531
00025152531
00023932105
59011075004
00525804918
00456140230
50458058801
63481002509
62175031037
00406015401
00642007030
00023921110
00074329013
65702012810
00006499541
59630058090
51248015003
53885044801
64727330501
00009041702
24338012413
00173086635
65597010390
00002327030
59385001430
65597011890
68040070515
00173075049
00430054014
00145002002
66582031282
24090049984
16110011100
00006473900
00597014860
00245088230
24338013213
42847010610
08290328468
00076011101
59011027160
68040060216
00078034545
00173086910
66582031254
00409321312
42023010901
50967030930
42865010102
41167431006
00525113990
00023361670
11917004813
00496072903
00023004203
24208029915
08290324910
10337035890
08290328411
11980018010
00006496300
16781021616
59011027460
65597011490
00597004137
00009540101
00054023625
64764058030
00006003330
49281018371
00025152551
12/8/2015 1:11 PM
SIMCOR
N
GLUCAGEN HYPOKIT
N
PRENATABS FA
N
ANTIPYRINE/BENZOCAINE
N
NEXIUM
N
TRIAMTERENE/HYDROCHLOROTH
N
PROTOPIC
N
EDARBYCLOR
N
EDARBYCLOR
N
VYTORIN
N
CELEBREX
O
ALPHAGAN P
N
BUTRANS
N
METANX
N
BYSTOLIC
N
CONCERTA
O
FROVA
N
METHYLPHENIDATE HCL ER N
METHYLPHENIDATE HCL ER N
VITAFOL-ONE
N
COMBIGAN
N
TARKA
N
COAGUCHEK XS PT TEST STRI N
RECOMBIVAX HB
N
OSPHENA
N
VESICARE
N
ONETOUCH ULTRA 2
N
NATURE-THROID
N
DEPO-TESTOSTERONE
O
ERY-TAB
N
TANZEUM
N
BENICAR
N
CYMBALTA
O
BUNAVAIL
N
TRIBENZOR
N
ALCORTIN A
N
TREXIMET
N
MINASTRIN 24 FE
N
FABIOR
N
VYTORIN
N
TIROSINT
N
VERDESO
N
PNEUMOVAX 23/5 DOSE
N
JENTADUETO
N
DIVIGEL
N
ERYPED 200
N
SILENOR
N
BD INSULIN SYRINGE ULTRAF N
URIBEL
N
HYSINGLA ER
N
LIMBREL
N
VIVELLE-DOT
N
ANORO ELLIPTA
N
VYTORIN
N
DIAZEPAM
N
CORTISPORIN-TC
N
NESTABS ABC
N
ZENPEP
N
ALLEGRA-D 12 HOUR ALLERGY O
DEPLIN 7.5
N
LATISSE
N
INSULIN SYRINGE/U-100/1ML N
PRAMOSONE
N
TAZORAC
N
LOTEMAX
N
BD INSULIN SYRINGE ULTRAF N
OXISTAT
N
BD INSULIN SYRINGE ULTRAF N
PRED FORTE
O
ZOSTAVAX
N
HYLATOPIC PLUS
N
HYSINGLA ER
N
TRIBENZOR
N
MICARDIS
O
NICOTROL NS
N
MORPHINE SULFATE
N
BRINTELLIX
N
BELSOMRA
N
SKLICE
N
CELEBREX
N
Maricopa County
SIMCOR
TAB 500-20MG
GLUCAGEN INJ HYPOKIT
PRENATABS FA TAB
ANTIPY/BENZO SOL OTIC
NEXIUM
GRA 10MG DR
TRIAMT/HCTZ CAP 50-25MG
PROTOPIC OIN 0.1%
EDARBYCLOR TAB 40-25MG
EDARBYCLOR TAB 40-12.5
VYTORIN TAB 10-80MG
CELEBREX CAP 200MG
ALPHAGAN P SOL 0.1%
BUTRANS DIS 5MCG/HR
METANX
CAP
BYSTOLIC TAB 2.5MG
CONCERTA TAB 27MG
FROVA
TAB 2.5MG
METHYLPHENID TAB 18MG ER
METHYLPHENID TAB 54MG ER
VITAFOL-ONE CAP
COMBIGAN SOL 0.2/0.5%
TARKA
TAB 4-240 CR
COAGUCHEK TES XS PT
RECOMBIVA HB INJ 10MCG/ML
OSPHENA TAB 60MG
VESICARE TAB 5MG
ONETOUCH KIT ULTRA 2
NATURE-THROI TAB 97.5MG
DEPO-TESTOST INJ 200MG/ML
ERY-TAB TAB 333MG EC
TANZEUM INJ 30MG
BENICAR TAB 20MG
CYMBALTA CAP 60MG
BUNAVAIL MIS 4.2-0.7
TRIBENZOR40- TAB 10-25MG
ALCORTIN A GEL
TREXIMET TAB 85-500MG
MINASTRIN 24 CHW FE
FABIOR
AER 0.1%
VYTORIN TAB 10-20MG
TIROSINT CAP 150MCG
VERDESO AER 0.05%
PNEUMOVAX 23 INJ 25/0.5
JENTADUETO TAB 2.5-1000
DIVIGEL GEL 1MG/GM
ERYPED
SUS 200/5ML
SILENOR TAB 6MG
INSULIN SYRG MIS 0.5/31G
URIBEL
CAP 118MG
HYSINGLA ER TAB 20 MG
LIMBREL CAP 500MG
VIVELLE-DOT DIS 0.075MG
ANORO ELLIPT AER 62.5-25
VYTORIN TAB 10-20MG
DIAZEPAM INJ 5MG/ML
CORTISPORIN SUS -TC OTIC
NESTABS ABC MIS
ZENPEP
CAP 10000UNT
ALLEGRA-D TAB 12 HOUR
DEPLIN 7.5 CAP
LATISSE SOL 0.03%
INSULIN SYRG MIS 1ML/31G
PRAMOSONE LOT 1%
TAZORAC GEL 0.1%
LOTEMAX SUS 0.5%
INSULIN SYRG MIS 0.3/31G
OXISTAT CRE 1%
INSULIN SYRG MIS 1ML/30G
PRED FORTE SUS 1% OP
ZOSTAVAX INJ
HYLATOPIC CRE PLUS
HYSINGLA ER TAB 60 MG
TRIBENZOR20- TAB 5-12.5MG
MICARDIS TAB 80MG
NICOTROL NS SPR 10MG/ML
MORPHINE SUL TAB 30MG
BRINTELLIX TAB 20MG
BELSOMRA TAB 10MG
SKLICE
LOT 0.5%
CELEBREX CAP 200MG
Bid 16018-RFP
2
2
42
4
3
5
2
3
3
1
1
6
4
6
4
1
2
5
4
8
3
3
2
2
2
1
42
33
6
5
2
3
1
2
1
3
1
2
1
1
7
1
9
2
3
1
2
19
8
3
7
3
2
1
3
7
8
1
19
3
5
32
2
2
1
6
1
13
3
3
2
1
1
2
2
24
2
2
2
3
180
4
2,315
56
90
390
90
150
150
90
90
35
16
360
240
90
15
150
120
240
30
150
96
11
120
90
42
2,580
60
110
8
150
90
90
90
144
9
168
100
90
196
100
4
120
210
200
60
2,440
258
90
330
56
120
90
280
70
480
270
910
150
15
3,390
473
60
15
2,200
90
2,630
30
2
900
30
90
180
80
2,290
60
60
234
74
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 110
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
11917004814
00173087410
63851050101
00245019111
00456140201
00004025752
59630070248
65702059110
00078043105
00078048915
00299595030
00169185275
49430001715
42546003010
68968555303
00065033230
00065065435
00131326746
63481068706
23635041201
00006007861
65597011130
50474080103
23635051012
52544023528
00169183402
00052030151
00085134102
52427028501
58160084211
16781034996
50458019115
00469520260
00078056845
00085134107
00456142001
00178062002
00456045701
00574704512
00085134107
00078031515
64764089099
13913001119
56151081001
66521011702
00299591825
00378537501
49281039565
08290324911
00023869450
60258018301
76439020630
76439035890
00078055915
00074328913
00173078302
00078043005
08290328466
00316103501
00259120260
65702010610
10019055301
00430017015
55566970001
00173075600
52054055028
42747072601
00299591845
00169185250
65580030409
00456202001
00023485745
68025007130
98302000120
00074780419
10782010130
00074714990
43538060130
00173074100
16781015460
12/8/2015 1:11 PM
INSULIN SYRINGE/0.5ML/31G N
ARNUITY ELLIPTA
N
RABAVERT
N
FOLGARD RX
O
BYSTOLIC
N
XENICAL
N
ORAPRED ODT
N
ACCU-CHEK AVIVA PLUS
N
FOCALIN XR
O
EXFORGE
N
TRI-LUMA
N
NOVOFINE AUTOCOVER 30GX8M
N
ELENZAPATCH
N
HPR PLUS
N
DAYTRANA
N
PATANASE
O
CILOXAN
N
VENLAFAXINE HCL ER
O
LIDODERM
O
EXALGO
O
JANUMET XR
N
AZOR
N
NEUPRO
N
PENNSAID
N
NOR-QD
O
NOVOLIN N RELION
N
GANIRELIX ACETATE
N
ASMANEX 60 METERED DOSES N
MACROBID
O
BOOSTRIX
N
AURSTAT ANTI-ITCH HYDROGE N
ORTHO TRI-CYCLEN
O
PROTOPIC
N
COARTEM
N
ASMANEX TWISTHALER 30 METN
BYSTOLIC
N
OVACE PLUS
N
ARMOUR THYROID
N
BELLADONNA & OPIUM
N
ASMANEX 30 METERED DOSES N
DIOVAN HCT
O
CONTRAVE
N
CAMBIA
N
TRUETRACK TEST
N
FLUVIRIN PF 2014-2015
N
DIFFERIN
O
DOXEPIN HCL
N
FLUZONE HIGH-DOSE PF 2014 N
BD INSULIN SYRINGE ULTRAF N
AZELEX
N
PRENAPLUS
N
L-METHYLFOLATE CALCIUM N
L-METHYLFOLATE CALCIUM N
EXFORGE HCT
N
TARKA
O
LOVAZA
O
FOCALIN XR
N
BD INSULIN SYRINGE/U-100/ N
DERMASORB XM
N
NAFTIN
N
ACCU-CHEK AVIVA
N
TRANSDERM-SCOP
N
ENABLEX
N
PREPOPIK
N
LAMICTAL XR
O
ALBENZA
N
SANCUSO
N
DIFFERIN
O
NOVOFINE 30GX8MM
N
VENLAFAXINE HCL ER
N
LEXAPRO
O
VANIQA
N
CONZIP
N
CLEVER CHEK AUTO-CODE VOI N
K-TAB
O
VITAMEDMD ONE RX/QUATREFO
N
SYNTHROID
O
MORGIDOX 1X100MG
N
CEFTIN
N
CLARIFOAM EF
O
Maricopa County
INSULIN SYRG MIS 0.5/31G
ARNUITY ELPT INH 100MCG
RABAVERT INJ
FOLGARD RX TAB
BYSTOLIC TAB 2.5MG
XENICAL CAP 120MG
ORAPRED ODT TAB 30MG
ACCU-CHEK TES AVIVA PL
FOCALIN XR CAP 10MG
EXFORGE TAB 10-160MG
TRI-LUMA CRE
NOVOFINE AUT MIS 30GX8MM
ELENZAPATCH DIS 4-1%
HPR PLUS CRE
DAYTRANA DIS 15MG/9HR
PATANASE SPR 0.6%
CILOXAN OIN 0.3% OP
VENLAFAXINE TAB 150MG ER
LIDODERM DIS 5%
EXALGO
TAB 12MG
JANUMET XR TAB 50-500MG
AZOR
TAB 10-20MG
NEUPRO
DIS 1MG/24HR
PENNSAID SOL 2%
NOR-QD
TAB 0.35MG
NOVOLIN N INJ RELION
GANIRELIX AC INJ
ASMANEX 60 AER 220MCG
MACROBID CAP 100MG
BOOSTRIX INJ
AURSTAT ANTI GEL -ITCH
ORTHO TRI- TAB CYCLEN
PROTOPIC OIN 0.1%
COARTEM TAB 20-120MG
ASMANEX 30 AER 220MCG
BYSTOLIC TAB 20MG
OVACE PLUS LOT 9.8%
ARMOUR THYRO TAB 15MG
BELLA/OPIUM SUP 16.2-30
ASMANEX 30 AER 220MCG
DIOVAN HCT TAB 160-12.5
CONTRAVE TAB 8-90MG
CAMBIA
POW 50MG
TRUETRACK TES
FLUVIRIN PF INJ 2014-15
DIFFERIN GEL 0.3%
DOXEPIN HCL CAP 75MG
FLUZONE HD INJ PF 14-15
INSULIN SYRG MIS 0.5/31G
AZELEX
CRE 20%
PRENAPLUS TAB
L-METHYLFOLA TAB 7.5MG
L-METHYLFOLA TAB 15MG
EXFORGEH/5- TAB 160-12.5
TARKA
TAB 2-240 CR
LOVAZA
CAP 1GM
FOCALIN XR CAP 5MG
INSULIN SYRG MIS 0.5/30G
DERMASORB XM KIT 39%
NAFTIN
GEL 2%
ACCU-CHEK TES AVIVA
TRANSDERM-SC DIS 1MG
ENABLEX TAB 7.5MG
PREPOPIK PAK
LAMICTAL XR TAB 100MG
ALBENZA TAB 200MG
SANCUSO DIS 3.1MG
DIFFERIN GEL 0.3%
NOVOFINE MIS 30GX8MM
VENLAFAXINE TAB 225MG ER
LEXAPRO TAB 20MG
VANIQA
CRE 13.9%
CONZIP
CAP 100MG
CLEVER CHEK TES VOICE
K-TAB
TAB 10MEQ CR
VITAMEDMD CAP ONE RX
SYNTHROID TAB 300MCG
MORGIDOX KIT 1X100MG
CEFTIN
SUS 250/5ML
CLARIFOAM EF AER 10-5%
Bid 16018-RFP
23
4
2
17
2
1
4
12
2
1
5
1
1
4
2
2
4
2
2
2
1
1
1
2
3
14
1
1
2
17
2
5
1
2
3
2
1
11
3
3
1
3
1
7
53
1
5
17
11
1
21
2
2
1
1
1
2
19
1
1
1
3
2
4
1
1
1
1
9
1
2
3
2
5
4
4
11
1
2
2
3,680
120
2
1,020
180
90
33
625
60
90
150
900
15
400
60
61
14
240
90
37
90
90
30
224
252
190
2
3
34
8
450
364
60
120
3
180
57
1,755
26
3
90
260
12
1,100
26
45
630
8
1,740
50
1,110
180
180
90
90
360
60
2,370
454
60
400
22
60
8
30
4
1
45
1,230
90
60
135
60
250
570
120
330
1
220
120
$
$
$
$
$
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$
$
$
$
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$
$
$
$
$
$
$
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$
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-
$
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$
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$
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$
$
$
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$
$
$
$
$
$
$
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$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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p. 111
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00088250033
11917002529
59011027360
65628008003
13548001109
00052213903
00496079904
00095909016
11980022805
08290320881
00004080285
42023011101
17478030703
00178049502
11917002528
11980017405
00023932110
68094017162
00259412660
00259412690
00078036545
00126007492
27437020603
43538044060
52244002006
58160084252
62991133304
00378021101
50458086001
52544015230
65649051112
00310625030
68094017161
63459020530
64011012408
00085461005
00169183302
00186051060
00024586903
00037682210
24090049684
00574704012
10337035830
00005197102
00006008131
00009370105
23710000602
00145002003
50265019930
52747062130
67544035604
00187170405
00456320560
76439024190
00525031590
13811001030
00574402235
64764025030
00056017270
00093514256
50967031730
52544025524
68220011210
00006393130
00456046301
00131326846
68025006730
53885059501
00046110491
53885091101
00009540001
33332001401
00456221230
24090049584
00603158758
99073013001
00046110091
64764025103
58160082111
10631009160
12/8/2015 1:11 PM
APIDRA
N
INSULIN SYRINGE/1ML/30G X N
HYSINGLA ER
N
FIRST-LANSOPRAZOLE
N
SALEX LOTION
O
SAPHRIS
N
ANALPRAM-HC
O
LORTAB
N
FML FORTE
N
BD PEN NEEDLE/SHORT/ULTRAN
TAMIFLU
N
DELESTROGEN
O
AZASITE
N
OVACE PLUS
N
INSULIN SYRINGE/0.5ML/30G N
PRED MILD
N
ALPHAGAN P
N
SUCRALFATE
N
NAFTIN
N
NAFTIN
N
VIVELLE-DOT
O
PREVIDENT 5000 BOOSTER PL O
SUPRAX
N
NICADAN
N
EDEX
N
BOOSTRIX
N
5-HYDROXY-L-TRYPTOPHAN N
CHLORDIAZEPOXIDE/AMITRIPTN
NUCYNTA ER
N
RAPAFLO
N
PROCTOCORT
O
XIGDUO XR
N
SUCRALFATE
N
NUVIGIL
N
CLINDESSE
N
DULERA
N
NOVOLIN R RELION
N
VIMOVO
N
TOUJEO SOLOSTAR
N
PROCTOFOAM HC
N
TIROSINT
N
BELLADONNA ALKALOIDS & OPN
OXISTAT
N
PREVNAR 13
N
JANUMET XR
N
CAVERJECT
N
SALVAX
O
FABIOR
N
PRENA1/QUATREFOLIC
N
CONCEPT DHA
N
VIAGRA
N
MEPHYTON
N
NAMENDA
N
VIRT-PN
N
NEEVO DHA
N
COMPLETE NATAL DHA
N
BACITRACIN
N
NESINA
N
COUMADIN
O
ALENDRONATE SODIUM
N
NESTABS DHA
N
CRINONE
N
LEVSIN
O
ZIOPTAN
N
ARMOUR THYROID
N
VENLAFAXINE HCL ER
N
DIVIGEL
N
ONETOUCH DELICA LANCETS F N
PREMARIN
N
ONETOUCH ULTRA MINI
N
NICOTROL INHALER
N
AFLURIA PF 2014-2015
N
FETZIMA
N
TIROSINT
N
PROMETHAZINE VC PLAIN
N
FREESTYLE LANCETS
N
PREMARIN
N
OSENI
N
ENGERIX-B
N
EURAX
N
Maricopa County
APIDRA
INJ U-100
INSULIN SYRG MIS 1ML/30G
HYSINGLA ER TAB 40 MG
LANSOPRAZOLE SUS 3MG/ML
SALEX LOTION KIT 6%
SAPHRIS SUB 5MG
ANALPRAM-HC CRE 1-2.5%
LORTAB
ELX 10-300MG
FML FORTE SUS 0.25% OP
BD PEN NEEDL MIS 31GX5/16
TAMIFLU CAP 30MG
DELESTROGEN INJ 20MG/ML
AZASITE SOL 1%
OVACE PLUS CRE 10%
INSULIN SYRG MIS 0.5/30G
PRED MILD SUS 0.12% OP
ALPHAGAN P SOL 0.1%
SUCRALFATE SUS 1GM/10ML
NAFTIN
CRE 1%
NAFTIN
CRE 1%
VIVELLE-DOT DIS 0.025MG
PREVDNT 5000 PST 1.1%
SUPRAX
SUS 200/5ML
NICADAN TAB
EDEX
KIT 20MCG
BOOSTRIX INJ
5-HYDROXY-L- POW TRYPTOPH
CDP/AMITRIP TAB 5-12.5MG
NUCYNTA ER TAB 50MG
RAPAFLO CAP 8MG
PROCTOCORT SUP 30MG
XIGDUO XR TAB 5-500MG
SUCRALFATE SUS 1GM/10ML
NUVIGIL TAB 50MG
CLINDESSE CRE 2%
DULERA
AER 200-5MCG
NOVOLIN R INJ RELION
VIMOVO
TAB 375-20MG
TOUJEO SOLO INJ 300IU/ML
PROCTOFOAM AER HC 1%
TIROSINT CAP 112MCG
BELLA/OPIUM SUP 16.2-60
OXISTAT CRE 1%
PREVNAR 13 INJ
JANUMET XR TAB 100-1000
CAVERJECT INJ 20MCG
SALVAX
AER 6%
FABIOR
AER 0.1%
PRENA1
CAP QUATREFO
CONCEPT DHA CAP
VIAGRA
TAB 100MG
MEPHYTON TAB 5MG
NAMENDA TAB 5MG
VIRT-PN TAB
NEEVO DHA CAP 27-1.13
COMPLETE NAT PAK DHA
BACITRACIN OIN OP
NESINA
TAB 25MG
COUMADIN TAB 5MG
ALENDRONATE TAB 40MG
NESTABS DHA PAK
CRINONE GEL 4% VAG
LEVSIN
TAB 0.125MG
ZIOPTAN DRO 0.0015%
ARMOUR THYRO TAB 240MG
VENLAFAXINE TAB 225MG ER
DIVIGEL GEL 1MG/GM
ONETOUCH MIS 30G
PREMARIN TAB 1.25MG
ONETOUCH KIT ULT MINI
NICOTROL INH
AFLURIA INJ PF 14-15
FETZIMA CAP 120MG
TIROSINT CAP 100MCG
PROMETH VC SYP PLAIN
FREESTYLE MIS LANCETS
PREMARIN TAB 0.3MG
OSENI
TAB 25-15MG
ENGERIX-B INJ 20MCG/ML
EURAX
CRE 10%
Bid 16018-RFP
1
14
1
9
1
1
3
7
4
3
3
2
3
1
20
4
1
1
1
1
1
27
1
4
1
12
2
3
2
2
2
1
1
2
3
2
8
1
1
3
3
1
1
3
1
1
1
1
4
5
12
1
1
3
3
15
6
1
2
1
4
1
2
1
4
2
1
29
1
19
1
45
1
3
10
23
1
1
6
2
20
2,320
30
900
597
30
90
980
20
1,170
34
10
8
57
2,780
20
20
600
60
90
24
3,300
50
120
1
6
60
420
120
60
36
30
1,000
60
23
18
130
180
4
30
90
12
30
2
30
6
200
50
180
330
48
10
60
270
90
900
21
30
180
90
240
32
150
90
360
60
90
3,800
90
19
168
22
30
88
1,990
3,600
90
30
6
120
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
$
$
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$
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$
$
$
$
$
$
$
$
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$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 112
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00299382060
00065414727
00074662411
13811058230
62175031137
00006007131
00299382330
59310020606
00074455219
00006020754
00009074630
45802004611
00456046201
61314064175
00085134101
27437020808
49938010230
00074706819
52544055428
49884000901
75959023360
52054051409
53451010301
00071015623
00054001925
52544024531
00378008601
10019055302
00078036542
59011025530
00054024425
52544029528
00078034542
00078034342
16571007112
51672135203
60793011601
17772010215
50924001901
24338011013
68405000901
54092038701
52544038428
23155001701
10631009362
00074706919
00998020315
00008112312
00126007061
18657010204
00052027301
00406012701
50458019715
10019055301
00065924005
52544004424
51991080990
00186109005
50265029960
76439024560
67544035612
56151085050
64727330801
00078042405
41167412003
67857080330
63402019310
99073070819
00006483703
54799091817
19515089307
51013080090
00023361525
64727330001
24208044335
10922082502
00071015523
00378022210
41167431004
63402071201
12/8/2015 1:11 PM
METROGEL
O
SIMBRINZA
N
SYNTHROID
O
ZATEAN-PN PLUS
N
METHYLPHENIDATE HCL ER N
PROPECIA
O
SOOLANTRA
N
QNASL CHILDRENS
N
SYNTHROID
O
PRINIVIL
O
DEPO-PROVERA CONTRACEPTIVO
GENTAMICIN SULFATE
N
ARMOUR THYROID
N
NEOMYCIN/POLYMYXIN/HYDROC
N
ASMANEX 120 METERED DOSESN
SUPRAX
N
DAPSONE
N
SYNTHROID
O
NECON 10/11-28
N
ISOSORBIDE DINITRATE
N
VAYARIN
N
DEXEDRINE
O
HORIZANT
N
LIPITOR
O
PREDNISONE
N
NECON 1/50-28
N
CAPTOPRIL/HYDROCHLOROTHIA
N
TRANSDERM-SCOP
N
VIVELLE-DOT
N
INTERMEZZO
N
CODEINE SULFATE
O
AMETHYST
N
VIVELLE-DOT
N
VIVELLE-DOT
N
CEFACLOR
N
DESOXIMETASONE
N
CYTOMEL
O
TROKENDI XR
N
ACCU-CHEK COMPACT PLUS CAN
ERYTHROMYCIN ETHYLSUCCINAN
APPTRIM-D
N
ADDERALL XR
O
ZOVIA 1/50E
N
TETRACYCLINE HCL
N
KENALOG
N
SYNTHROID
O
ISOPTO CARPINE
O
DUAVEE
N
PREVIDENT 5000 SENSITIVE O
HYLENEX
N
NUVARING
N
METHYLPHENIDATE HCL ER N
ORTHO-CYCLEN
O
TRANSDERM-SCOP
N
DUREZOL
N
CORDRAN TAPE
N
L-METHYLFOLATE
N
TOPROL XL
O
PRENA1 PLUS/QUATREFOLIC N
NATALVIRT 90 DHA
N
VIAGRA
N
TRUETRACK TEST
N
NATURE-THROID
N
RITALIN LA
N
ALLEGRA ALLERGY
O
PROMISEB
N
LUNESTA
O
FREESTYLE LITE TEST STRIP
N
PNEUMOVAX 23
N
TEARS AGAIN HYDRATE
O
FLULAVAL 2014-2015
N
EPICERAM
N
ZYMAXID
O
NATURE-THROID
N
LOTEMAX
N
FINACEA
N
LIPITOR
O
CHLORTHALIDONE
N
ALLEGRA-D 12 HOUR ALLERGY O
ALVESCO
N
Maricopa County
METROGEL GEL 1%
SIMBRINZA SUS 1-0.2%
SYNTHROID TAB 100MCG
ZATEAN-PN CAP PLUS
METHYLPHENID TAB 27MG ER
PROPECIA TAB 1MG
SOOLANTRA CRE 1%
QNASL CHILD SPR 40MCG
SYNTHROID TAB 50MCG
PRINIVIL TAB 20MG
DEPO-PROVERA INJ 150MG/ML
GENTAMICIN OIN 0.1%
ARMOUR THYRO TAB 180MG
NEO/POLY/HC SUS OP
ASMANEX 120 AER 220MCG
SUPRAX
CAP 400MG
DAPSONE TAB 25MG
SYNTHROID TAB 125MCG
NECON
TAB 10/11-28
ISOSORB DIN TAB 30MG
VAYARIN CAP
DEXEDRINE CAP 15MG CR
HORIZANT TAB 300MG
LIPITOR TAB 20MG
PREDNISONE TAB 50MG
NECON
TAB 1/50-28
CAPTOPR/HCTZ TAB 50-25MG
TRANSDERM-SC DIS 1.5MG
VIVELLE-DOT DIS 0.025MG
INTERMEZZO SUB 3.5MG
CODEINE SULF TAB 30MG
AMETHYST TAB 90-20MCG
VIVELLE-DOT DIS 0.075MG
VIVELLE-DOT DIS 0.0375MG
CEFACLOR SUS 250/5ML
DESOXIMETAS OIN 0.05%
CYTOMEL TAB 25MCG
TROKENDI XR CAP 50MG
ACCU-CHEK KIT COMPACT
ERYTHROM ETH TAB 400MG
APP-TRIM-D CAP
ADDERALL XR CAP 20MG
ZOVIA 1/50E TAB
TETRACYCLINE CAP 250MG
KENALOG AER SPRAY
SYNTHROID TAB 150MCG
ISOPTO CARP SOL 1% OP
DUAVEE
TAB 0.45-20
PREVIDENT PST 5000 SEN
HYLENEX INJ 150 UNIT
NUVARING MIS
METHYLPHENID TAB 27MG ER
ORTHO-CYCLEN TAB 0.25/35
TRANSDERM-SC DIS 1.5MG
DUREZOL EMU 0.05%
CORDRAN 24X3 TAP 4MCG/CM
L-METHYLFOLA TAB 15MG
TOPROL XL TAB 50MG
PRENA1 PLUS MIS QUATREFO
NATALVIRT MIS 90 DHA
VIAGRA
TAB 100MG
TRUETRACK TES
NATURE-THROI TAB 130MG
RITALIN LA CAP 10MG
ALLEGRA ALRG TAB 180MG
PROMISEB CRE
LUNESTA TAB 3MG
FREESTYLE TES LITE
PNEUMOVAX 23 INJ 25/0.5
TEARS AGAIN CAP HYDRATE
FLULAVAL INJ 2014-15
EPICERAM EMU
ZYMAXID SOL 0.5%
NATURE-THROI TAB 65MG
LOTEMAX OIN 0.5%
FINACEA GEL 15%
LIPITOR TAB 10MG
CHLORTHALID TAB 25MG
ALLEGRA-D TAB 12 HOUR
ALVESCO AER 160MCG
Bid 16018-RFP
1
2
3
5
2
1
1
2
7
3
2
6
5
3
1
1
3
7
4
2
7
1
1
1
220
6
2
3
1
1
4
3
1
1
1
1
5
1
4
1
1
2
4
4
1
9
3
2
22
1
2
2
2
3
2
1
1
2
2
5
4
5
11
1
10
2
1
3
3
5
19
1
2
16
1
1
3
6
9
1
60
24
270
150
60
90
30
10
300
270
2
180
390
22
1
14
300
630
336
360
300
120
30
30
1,166
364
180
14
24
30
480
140
24
24
150
60
165
30
4
40
120
35
280
96
63
270
45
60
2,200
4
2
46
168
12
10
1
90
180
240
300
48
450
690
30
420
60
30
150
2
600
10
90
5
960
4
50
270
405
300
6
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
$
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$
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$
$
$
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$
$
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$
$
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$
$
$
$
$
$
$
$
-
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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p. 113
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00517888005
24208060201
11980018005
76331090430
58160081511
00456111030
00456112030
65702059210
00078035834
11917001487
00069421066
58160081552
17772010115
58337000301
00456222030
66220071930
60793070210
24090049884
41167412002
44946104501
00126028766
13811051910
68012000213
00145237105
00430097903
50580072636
24208035305
00006412102
24208071510
65580030303
00186037228
00085720607
08290324907
00378820001
45802004935
13811053630
00591040401
59630058030
58914001106
49281040015
66213042510
91237000128
11917004815
00178085990
00597019090
00378710935
45802004635
65702048310
00006046410
10631009620
59212070248
00029152611
00456080031
13913000811
57599972804
10019055302
64764054411
08290320883
00065065205
67402004045
00078051005
53885027025
00281032608
49908014680
51991054490
50924038110
65597010590
00378008701
00025100131
53885026701
58160082611
24338010013
45802005611
00173068101
75854030330
75854031230
51672402201
42192034130
00069097193
11917001492
12/8/2015 1:11 PM
SPRIX
N
PROLENSA
N
PRED FORTE
O
HEMENATAL OB + DHA
N
TWINRIX
N
VIIBRYD
N
VIIBRYD
N
ACCU-CHEK SMARTVIEW STRIPN
DIOVAN
N
INSULIN SYRINGE/U-100/1ML N
VIAGRA
N
TWINRIX
N
TROKENDI XR
N
VIVOTIF BERNA
N
FETZIMA
N
KRISTALOSE
N
BICILLIN L-A
N
TIROSINT
N
ALLEGRA ALLERGY
O
PNV PRENATAL PLUS MULTIVI N
PREVIDENT 5000 PLUS
O
VOL-PLUS
N
GLUMETZA
N
DUAC
O
ATELVIA
N
ZYRTEC ALLERGY
O
ALREX
N
GARDASIL 9
N
PREDNISOLONE SODIUM PHOSP
N
VENLAFAXINE HCL ER
O
SYMBICORT
N
DULERA
N
BD INSULIN SYRINGE ULTRAF N
KETOPROFEN ER
N
TRIAMCINOLONE ACETONIDE N
TARON-C DHA
N
VERAPAMIL HCL
N
OSPHENA
N
AQUADEKS
N
ADACEL
N
DONNATAL
O
ALCOHOL PADS
N
INSULIN SYRINGE/0.3ML/31G N
CITRANATAL RX
N
MIRAPEX
O
BROMFENAC
N
GENTAMICIN SULFATE
N
ACCU-CHEK NANO SMARTVIEWN
EMEND
N
HALOG
N
ORAPRED ODT
O
BACTROBAN NASAL
N
TUDORZA PRESSAIR
N
ZIPSOR
N
PRECISION XTRA BLOOD GLUC N
TRANSDERM-SCOP
N
PREVACID SOLUTAB
N
BD PEN NEEDLE/NANO/ULTRA N
TOBRADEX ST
N
VANIQA
N
TEGRETOL-XR
N
ONETOUCH VERIO TEST STRIP N
NITRO-BID
N
SELENIUM SULFIDE
N
MULTIGEN PLUS
N
ACCU-CHEK COMFORT CURVE TN
BENICAR HCT
N
MAPROTILINE HCL
N
ALDACTONE
O
ONETOUCH VERIO IQ BLOOD GN
HAVRIX
N
E.E.S. 400
N
GENTAMICIN SULFATE
N
RELENZA DISKHALER
N
PRENATE ESSENTIAL
N
PRENATE DHA
N
ACETAZOLAMIDE
N
PRENAISSANCE
N
VIBRAMYCIN
N
INSULIN SYRINGE/U-100/0.3 N
Maricopa County
SPRIX
SPR 15.75MG
PROLENSA SOL 0.07%
PRED FORTE SUS 1% OP
HEMENATAL OB MIS + DHA
TWINRIX INJ
VIIBRYD TAB 10MG
VIIBRYD TAB 20MG
ACCU-CHEK TES SMART
DIOVAN
TAB 80MG
INSULIN SYRG MIS 1ML/29G
VIAGRA
TAB 50MG
TWINRIX INJ
TROKENDI XR CAP 25MG
VIVOTIF BERN CAP EC
FETZIMA CAP 20MG
KRISTALOSE PAK 10GM
BICILLIN L-A INJ 2400000
TIROSINT CAP 137MCG
ALLEGRA ALRG TAB 180MG
PNV PRENATAL TAB PLUS
PREVIDENT CRE 5000 PLS
VOL-PLUS TAB
GLUMETZA TAB 500MG
DUAC
GEL 1.2-5%
ATELVIA TAB
ZYRTEC ALLGY TAB 10MG
ALREX
SUS 0.2%
GARDASIL 9 INJ
PRED SOD PHO SOL 1% OP
VENLAFAXINE TAB 150MG ER
SYMBICORT AER 80-4.5
DULERA
AER 100-5MCG
INSULIN SYRG MIS 0.5/31G
KETOPROFEN CAP 200MG ER
TRIAMCINOLON OIN 0.5%
TARON-C DHA CAP
VERAPAMIL TAB 40MG
OSPHENA TAB 60MG
AQUADEKS CAP
ADACEL
INJ
DONNATAL TAB
ALCOHOL PAD
INSULIN SYRG MIS 0.3/31G
CITRANATAL TAB RX
MIRAPEX TAB 1MG
BROMFENAC SOL 0.09%
GENTAMICIN OIN 0.1%
ACCU-CHEK KIT NANO
EMEND
CAP 40MG
HALOG
OIN 0.1%
ORAPRED ODT TAB 30MG
BACTROBAN OIN NASAL 2%
TUDORZA PRES AER 400/ACT
ZIPSOR
CAP 25MG
PRECISION TES XTRA
TRANSDERM-SC DIS 1MG
PREVACID TAB 30MG STB
BD PEN NEEDL MIS 32GX4MM
TOBRADEX ST SUS 0.3-0.05
VANIQA
CRE 13.9%
TEGRETOL-XR TAB 100MG
ONETOUCH TES VERIO
NITRO-BID OIN 2%
SELENIUM SUL SHA 2.25%
MULTIGEN PLS TAB
ACCU-CHEK TES COMFORT
BENICAR HCT TAB 20-12.5
MAPROTILINE TAB 50MG
ALDACTONE TAB 25MG
ONETOUCH KIT VERIO IQ
HAVRIX
INJ 1440UNIT
E.E.S. 400 TAB 400MG
GENTAMICIN CRE 0.1%
RELENZA MIS DISKHALE
PRENATE CAP ESSENTIA
PRENATE DHA CAP
ACETAZOLAMID TAB 125MG
PRENAISSANCE CAP
VIBRAMYCIN SYP 50MG/5ML
INSULIN SYRG MIS 0.3/29G
Bid 16018-RFP
1
1
2
4
2
1
1
9
1
9
4
2
1
4
1
1
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9
17
13
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11
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240
2
30
30
250
45
1,100
8
2
30
16
23
30
4
56
270
730
969
300
30
45
4
330
5
0
40
30
7
9
630
30
390
180
810
30
300
2
30
800
930
90
30
5
135
7
2
30
5
11
1
30
100
7
14
360
5
45
150
100
60
360
120
100
30
180
90
5
2
20
90
40
30
30
80
60
180
680
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p. 114
16018 ATTACHMENT A-1 BRAND COSTS
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Brand
50419077701
42192010515
08496313601
00078024915
76439036290
00004080185
50458019201
64727330701
00193709021
00126007292
75854030230
58160090152
00555032402
60258019309
53885041901
99073070805
00074434119
00023031304
68025004430
00069420030
08290324909
00009033102
11086003701
10782019830
00378008401
00093226801
00009041701
00074706811
65649040130
54123095730
43595008003
00009043601
00642007630
00023031604
64727329901
00407141361
24090049184
00013830304
65628008010
60793070010
00456046401
00074929619
17478060430
00054418325
16500054148
65162066810
00135014502
50580072638
52747062030
00071036932
56151014260
18860025330
00054024425
64011024601
13811001490
00193288021
11917002527
65628007010
42023010801
64727329902
00006494300
64727330201
49281001450
13811002710
99073070914
45802005635
08222095633
00071041724
50458065960
50458051360
50924098101
64727331201
61570013120
65628005001
00126028666
49938010130
00065039605
68040061116
11523433202
58160082652
12/8/2015 1:11 PM
CIPRO
O
BPO
N
EASY TOUCH INSULIN SYRING N
FEMARA
O
L-METHYL-B6-B12
N
TAMIFLU
N
ORTHO EVRA
O
NATURE-THROID
N
BAYER CONTOUR BLOOD GLUCO
N
PREVIDENT 5000 BOOSTER PL O
PRENATE DHA
N
FLUARIX QUADRIVALENT 2014 N
HYDROXYZINE PAMOATE
N
PRENATABS RX
N
ONETOUCH ULTRA MINI
N
FREESTYLE LITE BLOOD GLUC N
SYNTHROID
O
BLEPHAMIDE S.O.P.
N
OB COMPLETE ONE
N
VIAGRA
N
BD INSULIN SYRINGE ULTRAF N
CLEOCIN
O
DRITHO-CREME HP
N
VITAPEARL
N
CAPTOPRIL/HYDROCHLOROTHIA
N
AMOXICILLIN
N
DEPO-TESTOSTERONE
O
SYNTHROID
O
ANUSOL-HC
O
ZUBSOLV
N
OLEPTRO
N
R-GENE 10
N
VITAFOL-OB+DHA
N
FML
N
NATURE-THROID
N
OMNIPAQUE
N
TIROSINT
N
XALATAN
O
FIRST-LANSOPRAZOLE
N
BICILLIN L-A
N
ARMOUR THYROID
N
SYNTHROID
O
COSOPT PF
N
DEXAMETHASONE
N
ONE-A-DAY VITACRAVES
N
PRENATAL PLUS
N
NICODERM CQ
O
ZYRTEC ALLERGY
O
CONCEPT OB
N
DILANTIN
O
TRUEPLUS LANCETS 28G
N
GESTICARE DHA
N
CODEINE SULFATE
N
GYNAZOLE-1
N
COMPLETENATE
N
KETOSTIX
N
INSULIN SYRINGE/0.3ML/30G N
FIRST-OMEPRAZOLE
N
COLY-MYCIN S
N
NATURE-THROID
N
PNEUMOVAX 23/1 DOSE
N
NATURE-THROID
N
FLUZONE PF 2014-2015
N
ELITE-OB
N
FREESTYLE FREEDOM LITE
N
GENTAMICIN SULFATE
N
ULTICARE MINI PEN NEEDLES N
NITROSTAT
N
ULTRAM
O
TYLENOL/CODEINE #3
O
ACCU-CHEK MULTICLIX LANCE N
NATURE-THROID
N
SILVADENE
O
FIRST-MOUTHWASH BLM
N
PREVIDENT 5000 PLUS
O
DAPSONE
N
CYCLOGYL
O
FOSTEUM PLUS
N
CLARITIN-D 24 HOUR
O
HAVRIX
N
Maricopa County
CIPRO (5%) SUS 250MG/5
BPO
GEL 4%
INSULIN SYRG MIS 0.3/31G
FEMARA
TAB 2.5MG
L-METHYL- TAB B6-B12
TAMIFLU CAP 45MG
ORTHO EVRA DIS WEEK
NATURE-THROI TAB 113.75MG
BAYER CONTOR TES BLD GLUC
PREVDNT 5000 PST 1.1%
PRENATE DHA CAP
FLUARIX QUAD INJ 2014-15
HYDROXYZ PAM CAP 100MG
PRENATABS RX TAB
ONETOUCH KIT ULT MINI
FREESTYLE MIS LITE
SYNTHROID TAB 25MCG
BLEPHAMIDE OIN S.O.P.
OB COMPLETE CAP ONE
VIAGRA
TAB 25MG
INSULIN SYRG MIS 0.3/31G
CLEOCIN CAP 75MG
DRITHO-CREME CRE HP 1%
VITAPEARL CAP
CAPTOPR/HCTZ TAB 50-15MG
AMOXICILLIN CHW 250MG
DEPO-TESTOST INJ 200MG/ML
SYNTHROID TAB 125MCG
ANUSOL-HC CRE 2.5%
ZUBSOLV SUB 5.7-1.4
OLEPTRO TAB 24HR150
R-GENE 10 INJ 10%
VITAFOL-OB PAK +DHA
FML
OIN 0.1% OP
NATURE-THROI TAB 32.5MG
OMNIPAQUE INJ 300MG/ML
TIROSINT CAP 25MCG
XALATAN SOL 0.005%
LANSOPRAZOLE SUS 3MG/ML
BICILLIN L-A INJ 600000
ARMOUR THYRO TAB 300MG
SYNTHROID TAB 112MCG
COSOPT PF SOL
DEXAMETHASON TAB 2MG
ONE-A-DAY CHW VITACRAV
PRENATAL TAB PLUS
NICODERM CQ DIS 21MG/24H
ZYRTEC ALLGY TAB 10MG
CONCEPT OB CAP
DILANTIN CAP 100MG
TRUPLUS LANC MIS 28G
GESTICARE PAK DHA
CODEINE SULF TAB 30MG
GYNAZOLE-1 CRE 2%
COMPLETENATE CHW
KETOSTIX TES STRIP
INSULIN SYRG MIS 0.3/30G
FIRST-OMEPRA SUS 2MG/ML
COLY-MYCIN S SUS OTIC
NATURE-THROI TAB 32.5MG
PNEUMOVAX 23 INJ 25/0.5
NATURE-THROI TAB 48.75MG
FLUZONE INJ PF 14-15
ELITE-OB TAB
FREESTYLE KIT FREEDOM
GENTAMICIN CRE 0.1%
PEN NEEDLES MIS 31GX6MM
NITROSTAT SUB 0.3MG
ULTRAM
TAB 50MG
TYLENOL/COD TAB #3
ACCU-CHEK MIS MLTICLIX
NATURE-THROI TAB 195MG
SILVADENE CRE 1%
FIRST-MOUTHW SUS BLM
PREVIDENT CRE 5000 PLS
DAPSONE TAB 100MG
CYCLOGYL SOL 1% OP
FOSTEUM PLUS CAP
CLARITIN-D TAB 10-240MG
HAVRIX
INJ 1440UNIT
Bid 16018-RFP
1
1
3
1
3
1
1
7
1
8
1
25
4
10
7
7
4
1
1
1
4
1
1
1
1
13
2
1
1
1
1
1
1
1
8
2
1
1
3
1
1
1
1
9
9
10
1
4
3
2
6
1
2
1
5
2
3
1
1
4
1
7
7
3
4
3
2
3
2
1
3
3
6
2
6
2
2
1
2
1
100
42
900
5
90
10
3
390
100
1,100
30
13
157
540
7
7
120
4
30
3
400
40
50
30
90
366
12
90
30
14
30
900
60
4
540
100
30
8
300
2
90
90
60
190
680
360
28
195
90
120
1,500
60
240
6
210
500
460
300
10
570
0
390
4
90
4
60
200
300
30
60
714
150
190
474
306
60
10
60
60
1
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$
$
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$
$
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p. 115
16018 ATTACHMENT A-1 BRAND COSTS
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Brand
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Brand
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Brand
Brand
Brand
Brand
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Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
60258017901
00126002292
51991054390
53885052401
58160082601
08290329410
00074659419
00006003220
00006468100
00071041824
56151088880
00378267093
64727329801
13925050910
64727330301
13310014601
59310058020
08222094193
00037682004
00054372250
00065039705
00093224001
68220013301
00062331100
50428898224
00310109730
11917015018
00096070735
59310057920
51991017801
53885020801
00603178747
00472173803
41167432005
00135019502
56151014401
00193658621
41167412004
11523432803
59212070048
11845015035
00245000331
08496080801
00603116158
00069012201
00126017916
51991081390
39328010610
27437020108
67544035606
08496301001
00603516721
51285094288
00074707019
00126028733
65162066850
59630070148
08290328438
00281032630
11917009921
52747071130
08290324912
00045020444
00193715101
53885091201
11523433203
28105016020
54092051502
00096070760
62991104904
00054253125
56151103050
08881600145
66019030110
00310027510
00193288050
00169185290
08496310101
00006499500
00603533815
12/8/2015 1:11 PM
PRENATAL-U
N
PREVIDENT 5000 ENAMEL PRO O
MULTIGEN
N
ONETOUCH ULTRASMART
N
HAVRIX
N
BD INSULIN SYRINGE MICROF N
SYNTHROID
O
STROMECTOL
N
M-M-R II W/DILUENT 10 DOS N
NITROSTAT
N
TRUETRACK BLOOD GLUCOSE M
N
PHENYTEK
O
NATURE-THROID
N
PRENATAL PLUS
N
NATURE-THROID
N
BACTRIM DS
O
PROAIR RESPICLICK
N
ULTICARE INSULIN SYRINGE N
COLYTE-FLAVOR PACKS
O
PREDNISONE
N
CYCLOGYL
O
CEPHALEXIN
N
COLYTE-FLAVOR PACKS
N
ORTHO DIAPHRAGM ALL-FLEX/N
CVS WHEY PROTEIN
N
DUTOPROL
N
LANCETS ULTRA THIN 30G
N
DRYSOL
O
PROAIR HFA
N
VINATE II
N
ONETOUCH ULTRA MINI
N
TRI-VIT/FLUORIDE/IRON
N
MICONAZOLE 3
N
ALLEGRA-D 24 HOUR ALLERGY O
NICODERM CQ
O
TRUEPLUS LANCETS 30G
N
MICROLET LANCETS
N
ALLEGRA ALLERGY
O
CLARITIN
N
ORAPRED ODT
O
OMEGA-3-6-9
N
SSKI
N
EASY TOUCH LANCING DEVICE N
DICYCLOMINE HCL
N
TESSALON PERLES
O
PREVIDENT
O
FOLTANX
N
PRENATAL
N
SUPRAX
N
VIAGRA
N
EASY TOUCH LANCETS 30G/TWN
PHENOBARBITAL
N
PLAN B ONE-STEP
O
SYNTHROID
O
PREVIDENT 5000 PLUS
O
PRENATAL PLUS
N
ORAPRED ODT
N
BD INSULIN SYRINGE ULTRAF N
NITRO-BID
N
TRUETRACK BLOOD GLUCOSE M
N
INTEGRA F
N
BD INSULIN SYRINGE ULTRAF N
ZYRTEC ALLERGY
O
BAYER CONTOUR BLOOD GLUCO
N
ONETOUCH ULTRA MINI
N
CLARITIN-D 24 HOUR
O
DERMOTIC
O
INTUNIV
O
DRYSOL
N
ESTRADIOL
N
LITHIUM CARBONATE
O
TRUETEST STRIPS
N
MONOJECT INSULIN SYRINGE/ N
FLUMIST QUADRIVALENT
N
SEROQUEL
O
KETOSTIX
N
NOVOPEN 3 INSULIN DELIVER N
EASY TOUCH PEN NEEDLES/31 N
RECOMBIVAX HB
N
PREDNISONE
N
Maricopa County
PRENATAL-U CAP
PRVDNT 5000 PST ENAML PR
MULTIGEN TAB
ONETOUCH KIT ULT SMRT
HAVRIX
INJ 1440UNIT
INSULIN SYRG MIS 1ML/28G
SYNTHROID TAB 88MCG
STROMECTOL TAB 3MG
M-M-R II INJ LIVE
NITROSTAT SUB 0.4MG
TRUETRACK KIT SYSTEM
PHENYTEK CAP 200MG
NATURE-THROI TAB 16.25MG
PRENAT PLUS TAB 27-1MG
NATURE-THROI TAB 81.25MG
BACTRIM DS TAB 800-160
PROAIR RESPI AER
INSULIN SYRG MIS 1ML/31G
COLYTE/FLAVR SOL PACKS
PREDNISONE SOL 5MG/5ML
CYCLOGYL SOL 2% OP
CEPHALEXIN TAB 500MG
COLYTE/FLAVR SOL PACKS
ORTHO FLEX DPR 70MM
WHEY PROTEIN POW VANILLA
DUTOPROL TAB 100-12.5
LANCET ULTRA MIS THIN 30G
DRYSOL
SOL 20%
PROAIR HFA AER
VINATE II TAB
ONETOUCH KIT ULT MINI
TRI-VIT/FE DRO /FL 0.25
MICONAZOLE 3 SUP 200MG
ALLEGRA-D TAB 24 HOUR
NICODERM CQ DIS 14MG/24H
TRUPLUS LANC MIS 30G
MICROLET MIS LANCETS
ALLEGRA ALRG TAB 180MG
CLARITIN CHW 5MG
ORAPRED ODT TAB 10MG
OMEGA-3-6-9 CAP 1200MG
SSKI
SOL 1GM/ML
EASY TOUCH MIS
DICYCLOMINE SOL 10MG/5ML
TESSALON PER CAP 100MG
PREVIDENT SOL RINSE
FOLTANX TAB
PRENATAL TAB 27-1MG
SUPRAX
TAB 400MG
VIAGRA
TAB 100MG
EASY TOUCH MIS LANC/30G
PHENOBARB TAB 64.8MG
PLAN B
TAB 1.5MG
SYNTHROID TAB 175MCG
PREVIDENT CRE 5000 PLS
PRENATAL TAB PLUS
ORAPRED ODT TAB 15MG
INSULIN SYRG MIS 0.3/31G
NITRO-BID OIN 2%
TRUETRACK KIT SYSTEM
INTEGRA F CAP
INSULIN SYRG MIS 1ML/31G
ZYRTEC ALLGY CAP 10MG
BAYER CONTOR KIT MONITOR
ONETOUCH KIT ULT MINI
CLARITIN-D TAB 10-240MG
DERMOTIC OIL 0.01%
INTUNIV TAB 2MG
DRYSOL
SOL 20%
ESTRADIOL POW
LITHIUM CARB CAP 600MG
TRUETEST TES
INSULIN SYRG MIS 0.3/29G
FLUMIST QUAD SUS 2014-15
SEROQUEL TAB 25MG
KETOSTIX TES STRIP
NOVOPEN 3 MIS
EASY TOUCH MIS 31GX3/16
RECOMBIVA HB INJ 10MCG/ML
PREDNISONE PAK 10MG
Bid 16018-RFP
4
5
2
1
1
1
2
2
1
3
5
1
5
1
5
1
1
2
1
4
1
1
1
1
4
1
4
5
1
2
3
1
1
1
1
6
1
1
2
1
7
2
3
1
1
3
1
2
2
1
7
2
1
1
2
5
1
2
1
2
2
4
2
2
2
1
1
1
3
1
1
1
2
5
1
2
1
1
1
3
120
500
60
1
1
300
60
12
1
250
5
60
360
90
210
20
1
200
4,000
250
5
30
3,785
1
3,628
90
700
245
8
180
3
50
3
30
28
700
400
90
60
3
210
60
3
150
30
1,419
30
120
2
6
700
180
1
30
204
150
3
130
30
2
60
120
60
2
2
30
20
3
180
30
180
50
200
5
7
150
1
100
1
63
$
$
$
$
$
$
$
$
$
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$
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-
$
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$
$
$
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$
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$
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$
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$
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p. 116
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00054317757
00126028802
50580072632
00193741101
52544084828
66689040316
65702040010
50924044601
11917001489
56151024221
44946104509
49281039415
08396801000
11523716102
08554333702
00536730001
11523716202
41167432007
52747071230
00009001758
52268010001
00178058208
56151172301
11523715703
19515089111
00173068221
53885013920
00087040203
08290326895
41167413102
00193654621
53885045802
08396900500
16500052309
65702012410
53885065701
17478021612
00603516732
00173093308
00310028039
56151124001
11523715702
11917013418
08496301601
00054001920
52268070001
11917015019
11523716201
37000045503
00096070760
11845016475
00245006310
40985027175
64727331001
00536065085
00126007592
00054368663
00193737701
08396800900
56151060150
00054418125
13811051950
68025005930
11917013481
08496305601
00087086644
56151060101
00087074002
52544025928
10542005010
53885004610
53885093701
65702048810
00409117830
08271033100
65702010710
58160082011
11917008543
11917015021
00225029515
12/8/2015 1:11 PM
DEXAMETHASONE
N
PREVIDENT FLUORIDE
O
ZYRTEC ALLERGY
O
BAYER CONTOUR NEXT USB BL N
OGESTREL
N
OXYCODONE HCL
O
ACCU-CHEK SOFTCLIX LANCET N
ACCU-CHEK MULTICLIX LANC N
INSULIN SYRINGE/U-100/0.5 N
TRUEPLUS LANCETS 28G
N
PNV PRENATAL PLUS MULTIVI N
FLUZONE SPLIT 2014-2015
N
ULTRA-COMFORT INSULIN SYR N
CLARITIN-D 24 HOUR
O
AGAMATRIX PRESTO TEST STR N
NEPHRO-VITE
O
CLARITIN-D 12 HOUR
O
ALLEGRA-D 24 HOUR ALLERGY O
INTEGRA PLUS
N
HALCION
O
GOLYTELY
O
PREDNISOLONE SODIUM PHOSP
N
TRUEPLUS INSULIN SYRINGE/ N
CLARITIN REDITABS
O
FLULAVAL QUADRIVALENT 201N
VENTOLIN HFA
N
ONETOUCH SURESOFT LANCING
N
POLY-VI-SOL
O
BD SWABS SINGLE USE
N
ALLEGRA ALLERGY
O
BAYER MICROLET LANCETS
N
ONETOUCH ULTRA CONTROL N
CLICKFINE PEN NEEDLE UNIV N
FLINTSTONES GUMMIES
O
ACCU-CHEK SOFTCLIX LANCET N
ONETOUCH VERIO
N
NAPHAZOLINE HCL
N
PHENOBARBITAL
N
VALTREX
O
SEROQUEL XR
N
TRUERESULT BLOOD GLUCOSE N
CLARITIN REDITABS
O
TRUEPLUS LANCETS 33G MICR N
EASY TOUCH INSULIN SYRING N
PREDNISONE
N
GOLYTELY
N
LANCETS MICRO THIN 33G
N
CLARITIN-D 12 HOUR
O
PRILOSEC OTC
N
DRYSOL
O
TRIPLE OMEGA-3-6-9
N
SLO-NIACIN
O
PRENATAL MULTIVITAMIN + D N
NATURE-THROID NT-2.5
N
FERROUS SULFATE
N
PREVIDENT 5000 BOOSTER
O
ROXICET
N
BAYER CONTOUR NEXT BLOOD N
ULTRA-COMFORT INSULIN SYR N
KETOCARE
N
DEXAMETHASONE
N
VOL-PLUS
N
OB COMPLETE PETITE
N
LANCING DEVICE
N
EASY TOUCH INSULIN SYRING N
D-VI-SOL
O
KETOCARE
N
FER-IN-SOL
O
NORINYL 1+35
O
DIALYVITE 800/ZINC
N
ONETOUCH FINEPOINT LANCETN
ONETOUCH ULTRA CONTROL N
ACCU-CHEK SMARTVIEW CONTR
N
DEMEROL
O
LANCETS THIN
N
ACCU-CHEK AVIVA
N
ENGERIX-B
N
PROBIOTIC
N
LANCETS SUPER THIN 28G
N
ANASPAZ
O
Maricopa County
DEXAMETHASON SOL 0.5/5ML
PREVIDENT GEL 1.1% BER
ZYRTEC ALLGY TAB 10MG
BAYER CONTOR KIT NEXT USB
OGESTREL TAB
OXYCODONE SOL 5MG/5ML
ACCU-CHEK KIT SOFTCLIX
ACCU-CHEK KIT MLTICLIX
INSULIN SYRG MIS 0.5/29G
LANCETS MIS 28G
PNV PRENATAL TAB PLUS
FLUZONE SPLT INJ 2014-15
INSULIN SYRG MIS 0.5/31G
CLARITIN-D TAB 10-240MG
AGAMATRIX TES PRESTO
NEPHRO-VITE TAB
CLARITIN-D TAB 5-120MG
ALLEGRA-D TAB 24 HOUR
INTEGRA PLUS CAP
HALCION TAB 0.25MG
GOLYTELY SOL
PREDNISOLONE SOL 25MG/5ML
INSULIN SYRG MIS 1ML/30G
CLARITIN RDT TAB 10MG
FLULAVAL QUA INJ 2014-15
VENTOLIN HFA AER
ONETOUCH MIS LANC DEV
POLY-VI-SOL DRO
BD SWAB REG PAD SNGL USE
ALLEGRA ALRG TAB 60MG
BAYER MICRLT MIS LANCETS
ONETOUCH SOL ULT CONT
CLICKFINE MIS 31GX5/16
FLINTSTONES CHW GUMMIES
SOFTCLIX MIS LANCETS
ONETOUCH KIT VERIO
NAPHAZOLINE SOL 0.1% OP
PHENOBARB TAB 64.8MG
VALTREX TAB 500MG
SEROQUEL XR TAB 50MG
TRUERESULT KIT
CLARITIN RDT TAB 10MG
LANCETS MIS 33G
INSULIN SYRG MIS 1ML/30G
PREDNISONE TAB 50MG
GOLYTELY SOL
LANCETS MICR MIS THIN 33G
CLARITIN-D TAB 5-120MG
PRILOSEC OTC TAB 20MG
DRYSOL
SOL 20%
OMEGA-3-6-9 CAP
SLO-NIACIN TAB 500MG CR
PRENATAL MV MIS + DHA
NATURE THROI TAB 162.5MG
FERROUS SUL LIQ 220/5ML
PREVIDENT PST 5000 BST
ROXICET SOL 5-325/5
BAYER CONTOR KIT NEXT
INSULIN SYRG MIS 0.3/31G
KETOCARE TES
DEXAMETHASON TAB 1MG
VOL-PLUS TAB
OB COMPLETE CAP PETITE
LANCING MIS DEVICE
INSULIN SYRG MIS 0.5/30G
D-VI-SOL LIQ 400UNIT
KETOCARE TES
FER-IN-SOL DRO 15MG/ML
NORINYL TAB 1/35
DIALYVITE TAB 800/ZINC
ONETOUCH MIS LANCETS
ONETOUCH SOL ULT CONT
ACCU-CHEK LIQ SMART
DEMEROL INJ 50MG/ML
LANCETS THIN MIS
ACCU-CHEK SOL
ENGERIX-B INJ 10/0.5ML
PROBIOTIC CAP
LANCETS SUPR MIS THIN 28G
ANASPAZ TAB 0.125MG
Bid 16018-RFP
1
3
3
1
1
2
1
1
2
2
5
9
2
1
1
2
2
1
1
2
1
1
3
1
3
1
1
3
4
1
2
2
1
8
1
1
6
5
1
1
1
1
2
3
14
1
2
1
1
2
2
1
3
1
5
1
1
1
1
1
8
1
2
1
3
2
1
1
1
1
1
1
1
2
1
1
1
1
1
1
400
168
74
1
28
124
1
1
130
420
150
4
180
30
100
180
40
30
30
6
4,000
25
90
30
2
8
100
150
1,000
24
200
2
100
240
200
1
90
72
2
2
1
15
200
60
64
1
200
20
20
120
60
180
90
30
1,005
100
100
1
90
100
31
30
0
1
40
100
100
50
4
90
100
1
2
2
300
1
0
30
100
30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 117
16018 ATTACHMENT A-1 BRAND COSTS
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
Brand
00096070935
10542010008
86227080105
00087040501
49281062115
00409189301
11917013944
11917014455
86227062055
08290329622
50428277289
11917009502
00641036721
11917007506
00904549213
00409397703
00054355563
00054318863
48102000735
40076031530
00093312242
68025004710
00023869430
00430017115
00053687100
00187510401
00187099395
51552038101
12/8/2015 1:11 PM
XERAC AC
N
DIALYVITE VITAMIN D3 MAX N
SURE COMFORT INSULIN SYRI N
POLY-VI-SOL/IRON
O
FLUZONE QUADRIVALENT 2014N
MORPHINE SULFATE
N
D3
N
ALCOHOL SWABS
N
SURE COMFORT INSULIN SYRI N
BD INSULIN SYRINGE/DETACH N
CVS VITAMIN D3
N
THERAGRAN-M PREMIER 50 PLN
DEXAMETHASONE SODIUM PHOS
N
VITAMIN D
N
THERA-M
N
BACTERIOSTATIC WATER FOR N
METHADONE HCL
O
DIAZEPAM
N
BACITRACIN
N
ERYGEL
O
JINTELI
N
LORZONE
N
AZELEX
N
ENABLEX
N
STIMATE
N
XERESE
N
ZOVIRAX
O
ESTRIOL
N
Maricopa County
XERAC-AC SOL 6.25%
VITAMIN D3 TAB 50000UNT
INSULIN SYRG MIS 1ML/28G
POLY-VI-SOL DRO /IRON
FLUZONE QUAD INJ 14-15
MORPHINE SUL INJ 10MG/ML
D3
CAP 400UNIT
ALCOHOL SWAB PAD
INSULIN SYRG MIS 0.5/30G
INSULIN SYRG MIS 1ML/25G
VITAMIN D3 CAP 400UNIT
THERAGRAN-M TAB 50 PLUS
DEXAMETH PHO INJ 10MG/ML
VITAMIN D CAP 400UNIT
THERA-M TAB
BACTER WATER INJ BENZ ALC
METHADONE SOL 5MG/5ML
DIAZEPAM SOL 1MG/ML
BACITRACIN OIN OP
ERYGEL
GEL 2%
JINTELI TAB 1MG-5MCG
LORZONE TAB 750MG
AZELEX
CRE 20%
ENABLEX TAB 15MG
STIMATE SOL 1.5MG/ML
XERESE
CRE 5-1%
ZOVIRAX OIN 5%
ESTRIOL POW MICRONIZ
Bid 16018-RFP
1
3
1
1
1
1
1
2
1
1
1
1
1
1
1
1
2
1
1
-1
-1
1
-1
-1
-1
-1
-1
-1
35
20
20
50
0
2
90
200
10
10
60
30
1
60
30
30
15
5
4
-30
-84
-30
-30
-90
-2
-5
-30
-90
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
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$
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$
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$
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p. 118
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
16018 ATTACHMENT A-2
Generic Drugs - July 2014 to June 2015
Listed in Order of Ingredient Cost - Highest to Lowest
Type
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
Product ID
0
68180029606
00591272060
68180029506
00093747489
59011044010
50383070016
00781210301
00555078802
00093681673
00378557593
59762003301
00228298311
59011042010
59011048010
00054025913
43598022114
55111069312
31722025190
00591352530
55111012290
00378868854
00187520030
64720032110
00054016629
13668008130
00378661493
31722025090
00555078902
55111012190
55111012390
65862044930
60505082901
31722082030
51660014390
68382041210
52544024828
00378164093
65862044830
00378715501
00093540189
00054327099
00378710177
52544098131
00054016329
59746028490
00591271701
00093731456
47335027641
60432026415
68382050010
67253038950
00093716601
68382013201
00591271801
00093113656
00591320205
62037083201
00093553901
68382035405
00603466216
00378251278
65862059505
Product
Generic Indicator - Medispan
Drug Label Name
Number of Rxs
COMPOUND
897
DULOXETINE HCL
Y
DULOXETINE CAP 60MG
201
METFORMIN HCL ER
Y
METFORMIN ER TAB 1000MG
81
DULOXETINE HCL
Y
DULOXETINE CAP 30MG
108
CAPECITABINE
Y
CAPECITABINE TAB 500MG
17
OXYCONTIN
M
OXYCONTIN TAB 40MG CR
70
FLUTICASONE PROPIONATE
Y
FLUTICASONE SPR 50MCG
1221
TACROLIMUS
Y
TACROLIMUS CAP 1MG
71
AMPHETAMINE/DEXTROAMPHETA
Y
AMPHETAMINE CAP 20MG ER
242
BUDESONIDE
Y
BUDESONIDE SUS 0.5MG/2
116
MODAFINIL
Y
MODAFINIL TAB 200MG
42
SILDENAFIL CITRATE
Y
SILDENAFIL TAB 20MG
16
OXYCODONE/ACETAMINOPHEN
Y
OXYCOD/APAP TAB 10-325MG
390
OXYCONTIN
M
OXYCONTIN TAB 20MG CR
135
OXYCONTIN
M
OXYCONTIN TAB 80MG CR
38
MONTELUKAST SODIUM Y
MONTELUKAST TAB 10MG
406
AMOXICILLIN/CLAVULANATE
Y P
AMOX/K CLAV TAB 875MG
1340
SUMATRIPTAN SUCCINATE
Y
SUMATRIPTAN INJ 6MG/0.5
38
ESCITALOPRAM OXALATEY
ESCITALOPRAM TAB 20MG
288
LIDOCAINE
Y
LIDOCAINE PAD 5%
96
ATORVASTATIN CALCIUMY
ATORVASTATIN TAB 20MG
382
CLINDAMYCIN/BENZOYL YPEROX
CLINDAMY/BEN GEL 1-5%
120
CARAC
M
CARAC
CRE 0.5%
9
METAXALONE
Y
METAXALONE TAB 800MG
128
MYCOPHENOLATE MOFETIL
Y
MYCOPHENOLAT TAB 500MG
40
MONTELUKAST SODIUM Y
MONTELUKAST TAB 10MG
209
AMNESTEEM
Y
AMNESTEEM CAP 40MG
56
ESCITALOPRAM OXALATEY
ESCITALOPRAM TAB 10MG
319
AMPHETAMINE/DEXTROAMPHETA
Y
AMPHETAMINE CAP 30MG ER
175
ATORVASTATIN CALCIUMY
ATORVASTATIN TAB 10MG
253
ATORVASTATIN CALCIUMY
ATORVASTATIN TAB 40MG
280
VALACYCLOVIR HCL
Y
VALACYCLOVIR TAB 1GM
264
FLUTICASONE PROPIONATE
Y
FLUTICASONE SPR 50MCG
936
ARIPIPRAZOLE
Y
ARIPIPRAZOLE TAB 5MG
16
VALSARTAN
Y
VALSARTAN TAB 320MG
59
OMEPRAZOLE
Y
OMEPRAZOLE CAP 20MG
955
TRINESSA
Y
TRINESSA TAB
413
VORICONAZOLE
Y
VORICONAZOLE TAB 200MG
7
VALACYCLOVIR HCL
Y
VALACYCLOVIR TAB 500MG
253
BUDESONIDE
Y
BUDESONIDE CAP 3MG/24HR
22
OMEGA-3-ACID ETHYL ESTERS
Y
OMEGA-3-ACID CAP 1GM
40
FLUTICASONE PROPIONATE
Y
FLUTICASONE SPR 50MCG
691
FENOFIBRATE
Y
FENOFIBRATE TAB 160MG
167
ZARAH
Y
ZARAH
TAB 3-0.03MG
153
MYCOPHENOLATE MOFETIL
Y
MYCOPHENOLAT CAP 250MG
50
PANTOPRAZOLE SODIUMY
PANTOPRAZOLE TAB 40MG
628
METHYLPHENIDATE HCL ER
M
METHYLPHENID TAB 36MG ER
111
CLOPIDOGREL
Y
CLOPIDOGREL TAB 75MG
259
SUMATRIPTAN SUCCINATE
Y
SUMATRIPTAN INJ 6MG/0.5
25
FLUTICASONE PROPIONATE
Y
FLUTICASONE SPR 50MCG
616
OMEPRAZOLE
Y
OMEPRAZOLE CAP 40MG
333
DOXYCYCLINE HYCLATE Y
DOXYCYCL HYC CAP 100MG
213
CELECOXIB
Y
CELECOXIB CAP 200MG
35
TAMSULOSIN HCL
Y
TAMSULOSIN CAP 0.4MG
266
METHYLPHENIDATE HCL ER
M
METHYLPHENID TAB 54MG ER
93
ACITRETIN
Y
ACITRETIN CAP 25MG
18
HYDROCODONE/ACETAMINOPHEN
Y
HYDROCO/APAP TAB 5-325MG
1858
METOPROLOL SUCCINATE
Y ER
METOPROLOL TAB 100MG ER
175
ESZOPICLONE
Y
ESZOPICLONE TAB 3MG
102
BUPROPION HCL XL
Y
BUPROPN HCL TAB 300MG XL
188
MODAFINIL
Y
MODAFINIL TAB 200MG
11
CAPECITABINE
Y
CAPECITABINE TAB 500MG
4
DIVALPROEX SODIUM ERY
DIVALPROEX TAB 500MG ER
22
Quantity
167,019
19,110
11,255
10,928
1,544
5,364
27,184
13,600
10,800
11,880
2,460
2,880
33,885
7,840
2,497
29,744
25,932
219
23,352
4,655
31,034
6,040
360
8,068
8,610
15,974
2,730
21,036
6,411
20,400
23,655
8,361
21,440
944
4,890
64,439
29,764
838
9,979
1,935
11,310
13,200
14,070
11,396
11,220
41,097
4,110
21,870
167
12,752
17,416
6,381
2,612
22,675
3,228
540
76,291
15,750
3,574
14,880
870
448
5,070
UNIT AWP
PRICE
ACTUAL
ACQUISITION
LESS
DISCOUNT
PROPOSED
UNIT NET COST
AWP COST
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
NET COST
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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p. 119
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
58468013001
68462012605
47781030301
00555079102
59746000103
55111076260
53746020401
00228348211
59011041010
68180044701
42546017516
00228285111
60505299703
52544095428
62037083101
52544098231
00093729001
00378047305
00555097302
00054025922
62037083001
31722082730
00378370259
52544094028
68180051703
00527134210
00378334053
68180044907
68180033707
00228298150
59762491005
00228306111
62037086120
00115552210
49884050101
00527134310
51660014290
10702000801
00591544005
00378022893
51525029403
00713050324
00093577156
68382009605
00555057202
13668011930
52544024928
00378302501
00378661293
60505257909
00555097202
00378510093
00591396501
52544026829
68645046654
59762285801
63323037905
52544094928
00185041501
51660014190
00093681573
55111072030
00591271960
00228285311
68180076001
51672130803
68180029407
00591377031
00054028913
61269021290
00574082001
RENVELA
M
GABAPENTIN
Y
NITROFURANTOIN MONOHYDRAT
Y
AMPHETAMINE/DEXTROAMPHETA
Y
METHYLPREDNISOLONE DOSE
Y
P
VALGANCICLOVIR
Y
OXYCODONE/ACETAMINOPHEN
Y
ZOLPIDEM TARTRATE ER Y
OXYCONTIN
M
QUETIAPINE FUMARATE Y
SULFACLEANSE 8/4
Y
GUANFACINE ER
Y
DULOXETINE HCL
Y
RECLIPSEN
Y
METOPROLOL SUCCINATE
Y ER
VESTURA
Y
RALOXIFENE HYDROCHLORIDE
Y
DIVALPROEX SODIUM ERY
AMPHETAMINE/DEXTROAMPHETA
Y
MONTELUKAST SODIUM Y
METOPROLOL SUCCINATE
Y ER
ARIPIPRAZOLE
Y
RIZATRIPTAN BENZOATE YODT
AZURETTE
Y
LISINOPRIL
Y
LEVOTHYROXINE SODIUM
Y
XULANE
Y
QUETIAPINE FUMARATE Y
METFORMIN HCL ER
Y
OXYCODONE/ACETAMINOPHEN
Y
SERTRALINE HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
ENOXAPARIN SODIUM Y
FENOFIBRATE
Y
BUDESONIDE
Y
LEVOTHYROXINE SODIUM
Y
VALSARTAN
Y
OXYCODONE HCL
Y
DOXYCYCLINE HYCLATE Y
PIOGLITAZONE HCL
Y
AZELASTINE HCL
Y
ANUCORT-HC
Y
OLANZAPINE
Y
HYDROXYCHLOROQUINEYSULFAT
METHOTREXATE
Y
PIOGLITAZONE HCL
Y
MICROGESTIN FE
Y
CLOMIPRAMINE HCL
Y
AMNESTEEM
Y
ATORVASTATIN CALCIUMY
AMPHETAMINE/DEXTROAMPHETA
Y
ITRACONAZOLE
Y
PROGESTERONE
Y
AMETHIA
Y
MONTELUKAST SODIUM Y
EXEMESTANE
Y
OCTREOTIDE ACETATE Y
LUTERA
Y
BUPROPION HCL SR
Y
VALSARTAN
Y
BUDESONIDE
Y
LAMOTRIGINE ER
Y
METFORMIN HCL ER
Y
GUANFACINE ER
Y
AMLODIPINE BESYLATE/BENAZ
Y
CLOTRIMAZOLE/BETAMETHASON
Y
DULOXETINE HCL
Y
IBANDRONATE SODIUM Y
MONTELUKAST SODIUM Y
FENOFIBRATE
M
TESTOSTERONE CYPIONATE
Y
RENVELA TAB 800MG
GABAPENTIN TAB 600MG
NITROFURANTN CAP 100MG
AMPHETAMINE CAP 15MG ER
METHYLPRED PAK 4MG
VALGANCICLOV TAB 450MG
OXYCOD/APAP TAB 10-325MG
ZOLPIDEM ER TAB 12.5MG
OXYCONTIN TAB 10MG CR
QUETIAPINE TAB 100MG
SULFACLEANSE SUS 8-4%
GUANFACINE TAB 2MG ER
DULOXETINE CAP 60MG
RECLIPSEN TAB
METOPROLOL TAB 50MG ER
VESTURA TAB 3-0.02MG
RALOXIFENE TAB 60MG
DIVALPROEX TAB 500MG ER
AMPHETAMINE TAB 20MG
MONTELUKAST TAB 10MG
METOPROLOL TAB 25MG ER
ARIPIPRAZOLE TAB 10MG
RIZATRIPTAN TAB 10MG ODT
AZURETTE TAB 28 DAY
LISINOPRIL TAB 40MG
LEVOTHYROXIN TAB 50MCG
XULANE
DIS 150-35
QUETIAPINE TAB 300MG
METFORMIN ER TAB 1000MG
OXYCOD/APAP TAB 5-325MG
SERTRALINE TAB 100MG
AMPHETAMINE CAP 30MG ER
ENOXAPARIN INJ 60/0.6ML
FENOFIBRATE TAB 160MG
BUDESONIDE CAP 3MG/24HR
LEVOTHYROXIN TAB 75MCG
VALSARTAN TAB 160MG
OXYCODONE TAB 15MG
DOXYCYCL HYC CAP 100MG
PIOGLITAZONE TAB 30MG
AZELASTINE SPR 0.1%
ANUCORT-HC SUP 25MG
OLANZAPINE TAB 15MG
HYDROXYCHLOR TAB 200MG
METHOTREXATE TAB 2.5MG
PIOGLITAZONE TAB 30MG
MICROGESTIN TAB FE 1/20
CLOMIPRAMINE CAP 25MG
AMNESTEEM CAP 20MG
ATORVASTATIN TAB 20MG
AMPHETAMINE TAB 10MG
ITRACONAZOLE CAP 100MG
PROGESTERONE CAP 200MG
AMETHIA TAB
MONTELUKAST TAB 10MG
EXEMESTANE TAB 25MG
OCTREOTIDE INJ 1000MCG
LUTERA
TAB
BUPROPION TAB 150MG SR
VALSARTAN TAB 80MG
BUDESONIDE SUS 0.25MG/2
LAMOTRIGINE TAB 200MG ER
METFORMIN TAB 500MG ER
GUANFACINE TAB 3MG ER
AMLOD/BENAZP CAP 10-40MG
CLOTRIM/BETA LOT DIPROP
DULOXETINE CAP 20MG
IBANDRONATE TAB 150MG
MONTELUKAST CHW 5MG
FENOFIBRATE CAP 150MG
TESTOST CYP INJ 200MG/ML
5
68
434
90
664
5
124
185
85
46
51
34
34
235
230
112
38
28
223
140
234
8
110
121
504
587
51
39
13
1499
390
62
4
87
9
557
37
168
168
14
139
64
16
61
123
41
208
6
20
118
207
14
85
55
88
11
6
174
171
28
25
6
16
26
33
13
28
41
145
26
143
3,810
13,841
7,035
3,339
14,007
255
11,836
6,003
5,233
5,988
24,123
1,440
2,820
17,500
20,655
8,120
2,220
5,280
13,835
10,320
19,941
480
1,327
9,044
46,990
39,518
363
3,660
1,800
55,575
39,916
2,610
216
7,170
960
34,658
3,030
17,218
5,011
1,200
5,490
1,502
1,260
8,008
4,617
3,210
14,336
1,440
1,140
9,240
11,024
1,680
4,077
5,005
7,020
810
90
12,376
23,300
2,640
2,880
900
2,610
1,017
2,910
2,700
2,400
97
9,360
2,220
513
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
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$
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-
p. 120
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00228289103
68180065101
65162073403
65162041503
00591271701
31722055190
00591260505
66993016502
16571060096
55111029309
60505299603
31722040505
00378912498
00591396401
00228298211
10370010150
00591084501
52544024728
00527134510
00168016260
00378307501
00093735556
65162055310
52544055228
00228306011
00378341301
00228287811
52544027621
00527134710
00591271801
60505017009
68180033307
00228291809
51991035578
31722081930
59762015601
00093520701
00555097402
62037084920
00093894301
10702000901
00093113556
50111078751
50383093335
68462013801
00093529601
00378395177
00781598701
23155012001
00603633020
68382076214
00378340493
00093001298
00781566831
60505405803
68180071160
00591261205
59762015501
16571020150
13668014030
62037086320
53746022005
00527134410
68180075801
00378073501
49884009902
16571050111
42794001802
00093542088
66530025445
51672412401
DULOXETINE HCL
Y
DOXYCYCLINE
Y
FELBAMATE
Y
BUPRENORPHINE HCL/NALOXON
Y
METHYLPHENIDATE HCL ER
Y
LEVOCETIRIZINE DIHYDROCHL
Y
HYDROCODONE/ACETAMINOPHEN
Y
COLCHICINE
M
CROMOLYN SODIUM
Y
SUMATRIPTAN SUCCINATE
Y
DULOXETINE HCL
Y
GABAPENTIN
Y
FENTANYL
Y
PROGESTERONE
Y
OXYCODONE/ACETAMINOPHEN
Y
BUPROPION HCL XL
Y
GLIPIZIDE ER
Y
MONONESSA
Y
LEVOTHYROXINE SODIUM
Y
CLOBETASOL PROPIONATE
Y
CLOMIPRAMINE HCL
Y
FINASTERIDE
Y
METAXALONE
Y
NECON 1/35
Y
AMPHETAMINE/DEXTROAMPHETA
Y
BUPROPION HCL SR
Y
OXYCODONE HCL
Y
MICROGESTIN 1/20
Y
LEVOTHYROXINE SODIUM
Y
METHYLPHENIDATE HCL ER
Y
PRAVASTATIN SODIUM Y
ZIPRASIDONE HCL
Y
DILTIAZEM HCL ER
Y
RIZATRIPTAN BENZOATE Y
ARIPIPRAZOLE
Y
ATORVASTATIN CALCIUMY
OXYBUTYNIN CHLORIDE ER
Y
AMPHETAMINE/DEXTROAMPHETA
Y
ENOXAPARIN SODIUM Y
ACYCLOVIR
Y
OXYCODONE HCL
Y
ACITRETIN
Y
AZITHROMYCIN
Y
LIDOCAINE
Y
OXCARBAZEPINE
Y
METHYLPHENIDATE HCL CD
Y
ATORVASTATIN CALCIUMY
CARBAMAZEPINE ER
Y
ACETAZOLAMIDE ER
Y
VALGANCICLOVIR
Y
CLARITHROMYCIN
Y
TOLTERODINE TARTRATEYER
PANTOPRAZOLE SODIUMY
VORICONAZOLE
Y
NEVIRAPINE ER
Y
CEFDINIR
Y
HYDROCODONE/ACETAMINOPHEN
Y
ATORVASTATIN CALCIUMY
DICLOFENAC SODIUM DRY
PIOGLITAZONE HCL
Y
ENOXAPARIN SODIUM Y
METFORMIN HCL
Y
LEVOTHYROXINE SODIUM
Y
AMLODIPINE BESYLATE/BENAZ
Y
FLUOXETINE HCL
Y
PROPAFENONE HCL ER Y
LOSARTAN POTASSIUM Y
LIOTHYRONINE SODIUM Y
CABERGOLINE
Y
TRETINOIN
Y
CARBAMAZEPINE ER
Y
DULOXETINE CAP 30MG
DOXYCYCLINE CAP 75MG
FELBAMATE TAB 400MG
BUPREN/NALOX SUB 8-2MG
METHYLPHENID TAB 36MG ER
LEVOCETIRIZI TAB 5MG
HYDROCO/APAP TAB 7.5-325
COLCHICINE TAB 0.6MG
CROMOLYN SOD CON 100/5ML
SUMATRIPTAN TAB 100MG
DULOXETINE CAP 30MG
GABAPENTIN TAB 600MG
FENTANYL DIS 100MCG/H
PROGESTERONE CAP 100MG
OXYCOD/APAP TAB 7.5-325
BUPROPN HCL TAB 150MG XL
GLIPIZIDE ER TAB 10MG
MONONESSA TAB
LEVOTHYROXIN TAB 100MCG
CLOBETASOL OIN 0.05%
CLOMIPRAMINE CAP 75MG
FINASTERIDE TAB 5MG
METAXALONE TAB 800MG
NECON
TAB 1/35
AMPHETAMINE CAP 20MG ER
BUPROPION TAB 200MG SR
OXYCODONE TAB 15MG
MICROGESTIN TAB 1/20
LEVOTHYROXIN TAB 125MCG
METHYLPHENID TAB 54MG ER
PRAVASTATIN TAB 40MG
ZIPRASIDONE CAP 60MG
DILTIAZEM CAP 360MG ER
RIZATRIPTAN TAB 10MG
ARIPIPRAZOLE TAB 2MG
ATORVASTATIN TAB 20MG
OXYBUTYNIN TAB 10MG ER
AMPHETAMINE TAB 30MG
ENOXAPARIN INJ 40/0.4ML
ACYCLOVIR TAB 400MG
OXYCODONE TAB 30MG
ACITRETIN CAP 10MG
AZITHROMYCIN TAB 250MG
LIDOCAINE OIN 5%
OXCARBAZEPIN TAB 300MG
METHYLPHENID CAP 20MG
ATORVASTATIN TAB 20MG
CARBAMAZEPIN TAB 200MG ER
ACETAZOLAMID CAP 500MG ER
VALGANCICLOV TAB 450MG
CLARITHROMYC TAB 500MG
TOLTERODINE CAP 4MG ER
PANTOPRAZOLE TAB 40MG
VORICONAZOLE TAB 200MG
NEVIRAPINE TAB 400MG ER
CEFDINIR CAP 300MG
HYDROCO/APAP TAB 10-325MG
ATORVASTATIN TAB 10MG
DICLOFENAC TAB 75MG DR
PIOGLITAZONE TAB 15MG
ENOXAPARIN INJ 100MG/ML
METFORMIN TAB 1000MG
LEVOTHYROXIN TAB 88MCG
AMLOD/BENAZP CAP 10-20MG
FLUOXETINE TAB 20MG
PROPAFENONE CAP 225MG ER
LOSARTAN POT TAB 50MG
LIOTHYRONINE TAB 5MCG
CABERGOLINE TAB 0.5MG
TRETINOIN CRE 0.05%
CARBAMAZEPIN TAB 200MG ER
21
15
4
30
60
96
540
25
5
522
27
65
37
113
168
98
121
170
390
49
4
75
28
154
59
51
139
133
316
53
117
14
13
48
5
82
38
132
21
243
78
4
1276
53
37
39
102
40
10
2
121
13
300
6
4
156
302
113
182
41
11
441
271
49
52
7
235
99
15
35
34
1,793
750
2,160
1,173
2,168
4,950
36,231
1,719
9,600
5,181
1,874
13,941
465
5,775
9,470
8,046
18,661
12,264
25,684
3,120
1,080
6,127
1,862
11,704
1,860
6,270
15,787
8,022
19,394
1,755
9,690
1,496
965
693
314
6,495
3,660
7,712
137
13,181
10,909
330
7,674
4,359
8,051
1,980
7,860
5,713
2,920
120
2,510
1,101
16,602
270
360
2,978
27,932
8,880
18,988
3,210
124
73,873
19,524
4,230
4,225
1,140
20,610
12,855
353
1,665
5,340
$
$
$
$
$
$
$
$
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$
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$
$
$
$
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$
$
$
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$
$
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$
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$
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$
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$
$
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-
$
$
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p. 121
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
55111012490
52544096691
00228289203
00074646332
00555079202
68180048003
00781210201
00591271501
13668008190
67253039115
68382001601
00527134610
68180047903
45802013275
51991047428
60505016909
67253032010
00054455025
00781112305
60505252703
68382013905
00591271601
00378862977
00781282401
00093206098
68180075203
62037086220
16729003510
00378427693
65862037501
00093724806
00093529056
60505258009
00378395277
00093542358
16252057350
00591264001
59762490005
68462050033
68180075601
10702005601
00093731601
52544023328
68180072320
00074304113
53746051401
59762501801
53746046605
00378047301
57664018788
00378870006
68180051503
68180044801
00406052301
00603465516
52544022829
42806050301
00406052201
16571050211
00168020260
68462049833
13668021830
53746051501
00093314705
60505084505
51672400503
51991062328
68180011302
00378004893
00093227534
51525590101
ATORVASTATIN CALCIUMY
QUASENSE
Y
DULOXETINE HCL
Y
GENGRAF
Y
AMPHETAMINE/DEXTROAMPHETA
Y
SIMVASTATIN
Y
TACROLIMUS
Y
METHYLPHENIDATE HCL ER
M
MONTELUKAST SODIUM Y
DOXYCYCLINE HYCLATE Y
LEVOFLOXACIN
Y
LEVOTHYROXINE SODIUM
Y
SIMVASTATIN
Y
FENOFIBRATE
Y
ESTRADIOL/NORETHINDRONE
Y
A
PRAVASTATIN SODIUM Y
METHOTREXATE
Y
METHOTREXATE
Y
TRIAMTERENE/HYDROCHLOROTH
Y
MODAFINIL
Y
TOPIRAMATE
Y
METHYLPHENIDATE HCL ER
M
FENOFIBRATE MICRONIZED
Y
FLUOXETINE HCL
Y
FENOFIBRATE
Y
AMLODIPINE BESYLATE Y
ENOXAPARIN SODIUM Y
ANASTROZOLE
Y
VALACYCLOVIR HCL
Y
ESCITALOPRAM OXALATEY
LAMOTRIGINE
Y
VORICONAZOLE
Y
ATORVASTATIN CALCIUMY
ATORVASTATIN CALCIUMY
GIANVI
Y
RAMIPRIL
Y
BUTALBITAL/APAP/CAFFEINE
Y
SERTRALINE HCL
Y
ZOLMITRIPTAN ODT
Y
AMLODIPINE BESYLATE/BENAZ
Y
OXYCODONE HCL
Y
DESMOPRESSIN ACETATEY
MICROGESTIN FE 1.5/30 Y
CEFDINIR
Y
VICODIN
Y
SPIRONOLACTONE
Y
FLUCONAZOLE
Y
IBUPROFEN
Y
DIVALPROEX SODIUM ERY
OXYCODONE HCL
Y
ACYCLOVIR
Y
LISINOPRIL
Y
QUETIAPINE FUMARATE Y
OXYCODONE/ACETAMINOPHEN
Y
MONTELUKAST SODIUM Y
AMETHIA LO
Y
URSODIOL
Y
OXYCODONE/ACETAMINOPHEN
Y
LOSARTAN POTASSIUM Y
CLINDAMYCIN PHOSPHATE
Y
ZOLMITRIPTAN
Y
ARIPIPRAZOLE
Y
SPIRONOLACTONE
Y
CEPHALEXIN
Y
OLOPATADINE HCL
Y
CARBAMAZEPINE
Y
ESTRADIOL/NORETHINDRONE
Y
A
LEVETIRACETAM
Y
PIOGLITAZONE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
CARISOPRODOL
M
ATORVASTATIN TAB 80MG
QUASENSE TAB
DULOXETINE CAP 60MG
GENGRAF CAP 25MG
AMPHETAMINE CAP 25MG ER
SIMVASTATIN TAB 40MG
TACROLIMUS CAP 0.5MG
METHYLPHENID TAB 18MG ER
MONTELUKAST TAB 10MG
DOXYCYCL HYC TAB 100MG
LEVOFLOXACIN TAB 500MG
LEVOTHYROXIN TAB 112MCG
SIMVASTATIN TAB 20MG
FENOFIBRATE TAB 145MG
ESTRA/NORETH TAB 1-0.5MG
PRAVASTATIN TAB 20MG
METHOTREXATE TAB 2.5MG
METHOTREXATE TAB 2.5MG
TRIAMT/HCTZ TAB 37.5-25
MODAFINIL TAB 200MG
TOPIRAMATE TAB 50MG
METHYLPHENID TAB 27MG ER
FENOFIBRATE CAP 134MG
FLUOXETINE CAP 40MG
FENOFIBRATE TAB 145MG
AMLODIPINE TAB 10MG
ENOXAPARIN INJ 80/0.8ML
ANASTROZOLE TAB 1MG
VALACYCLOVIR TAB 1GM
ESCITALOPRAM TAB 20MG
LAMOTRIGINE TAB 200MG
VORICONAZOLE TAB 200MG
ATORVASTATIN TAB 40MG
ATORVASTATIN TAB 40MG
GIANVI
TAB 3-0.02MG
RAMIPRIL CAP 10MG
BUT/APAP/CAF CAP
SERTRALINE TAB 50MG
ZOLMITRIPTAN TAB 5MG
AMLOD/BENAZP CAP 5-10MG
OXYCODONE TAB 10MG
DESMOPRESSIN TAB 0.1MG
MICROGESTIN TAB FE1.5/30
CEFDINIR SUS 250/5ML
VICODIN TAB 5-300MG
SPIRONOLACT TAB 50MG
FLUCONAZOLE TAB 200MG
IBUPROFEN TAB 800MG
DIVALPROEX TAB 500MG ER
OXYCODONE TAB 15MG
ACYCLOVIR OIN 5%
LISINOPRIL TAB 20MG
QUETIAPINE TAB 200MG
OXYCOD/APAP TAB 10-325MG
MONTELUKAST TAB 10MG
AMETHIA LO TAB
URSODIOL CAP 300MG
OXYCOD/APAP TAB 7.5-325
LOSARTAN POT TAB 100MG
CLINDAMYCIN GEL 1%
ZOLMITRIPTAN TAB 5MG
ARIPIPRAZOLE TAB 10MG
SPIRONOLACT TAB 100MG
CEPHALEXIN CAP 500MG
OLOPATADINE SPR 0.6%
CARBAMAZEPIN TAB 200MG
ESTRA/NORETH TAB 0.5-0.1
LEVETIRACETA TAB 500MG
PIOGLITAZONE TAB 15MG
AMOX/K CLAV TAB 875MG
CARISOPRODOL TAB 250MG
80
59
30
7
39
438
36
40
65
78
286
230
539
25
21
145
55
79
253
10
135
35
58
178
38
471
6
70
57
51
161
4
67
77
51
55
57
354
17
35
219
27
104
115
151
105
66
761
10
71
16
724
35
28
41
27
8
71
158
50
18
3
62
772
19
40
23
63
12
200
24
6,045
5,369
2,950
4,680
1,560
37,515
3,790
1,434
4,350
2,229
2,611
16,622
47,025
1,890
1,652
11,970
2,928
2,696
21,287
300
23,018
1,290
4,920
16,050
2,837
39,810
98
3,959
1,926
3,750
15,143
240
5,220
6,315
3,780
5,850
2,560
29,994
180
3,270
20,098
2,520
7,336
7,860
4,286
10,350
2,632
48,833
1,800
9,458
270
66,700
2,745
4,375
3,030
2,457
1,650
5,283
13,230
3,360
252
210
5,880
22,578
640
9,349
1,596
14,315
1,350
3,754
2,019
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
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$
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$
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$
$
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$
$
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$
$
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-
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$
$
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-
p. 122
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
62175015237
00527134110
66435010799
66685100100
00555095602
00781565615
63304090530
00093065801
68180045001
00093731701
00603760917
00781652386
00591555350
00172541211
00527134910
68180051403
52544084728
68382014005
00168080301
00093013201
64950034047
00228277811
00093739398
65162064210
68382053701
00093738656
13668008030
16729017001
68382031910
65862060012
67253074150
49884057411
68462015713
68180075103
63304090190
68180075009
53746021805
00591204454
42546001510
13668011030
47781073002
00527131301
00093553801
47781010830
13668013701
00228284903
65162010250
52544027928
59762015702
00074304153
55111018015
68462056529
52544089228
00378341101
44183044001
00406147301
13668011130
00228285011
53746010205
00054027313
00093738556
00406838001
00406900076
49884057711
49884021002
52544063028
00093739498
16571050050
00591271601
00093779606
00168016360
METHYLPHENIDATE HCL CD
Y
LEVOTHYROXINE SODIUM
Y
RIBASPHERE RIBAPAK M
AMOXICILLIN/CLAVULANATE
Y P
DEXTROAMPHETAMINE SULFATE
Y
LORYNA
Y
VALACYCLOVIR HCL
Y
CALCITRIOL
Y
QUETIAPINE FUMARATE Y
DESMOPRESSIN ACETATEY
GILDESS FE 1/20
Y
SUMATRIPTAN
M
DOXYCYCLINE HYCLATE Y
FLUCONAZOLE
Y
LEVOTHYROXINE SODIUM
Y
LISINOPRIL
Y
LOW-OGESTREL
Y
TOPIRAMATE
Y
DICLOFENAC SODIUM Y
LAMOTRIGINE
Y
HYDROCODONE BITARTRATE/AC
Y
PROPRANOLOL HCL ER Y
NIACIN ER
Y
FLECAINIDE ACETATE Y
POTASSIUM CITRATE ER Y
VENLAFAXINE HCL ER Y
MONTELUKAST SODIUM Y
ESCITALOPRAM OXALATEY
TRAMADOL HCL
Y
RIZATRIPTAN BENZOATE Y
GEMFIBROZIL
Y
AMLODIPINE BESYLATE/VALSA
Y
ONDANSETRON ODT
Y
AMLODIPINE BESYLATE Y
FENOFIBRATE
Y
AMLODIPINE BESYLATE Y
METFORMIN HCL
Y
RISEDRONATE SODIUM Y
BENZEPRO SHORT CONTACT
Y
DULOXETINE HCL
Y
VANCOMYCIN HCL
Y
PILOCARPINE HYDROCHLORIDE
Y
ESZOPICLONE
Y
EXEMESTANE
Y
ESCITALOPRAM OXALATEY
FLUVOXAMINE MALEATEYER
GABAPENTIN
Y
LEVORA 0.15/30-28
Y
ATORVASTATIN CALCIUMY
VICODIN
Y
TIZANIDINE HCL
Y
NORGESTIMATE/ETHINYLY ESTR
JOLIVETTE
Y
BUPROPION HCL SR
Y
ISOMETHEPTENE/DICHLORALPH
Y
METHYLPHENIDATE HCL ER
Y
DULOXETINE HCL
Y
GUANFACINE ER
Y
GABAPENTIN
Y
IMIPRAMINE PAMOATE Y
VENLAFAXINE HCL ER Y
MORPHINE SULFATE ER Y
FENTANYL
Y
AMLODIPINE BESYLATE/VALSA
Y
PROPAFENONE HCL ER Y
MICROGESTIN FE
Y
NIACIN ER
Y
LOSARTAN POTASSIUM Y
METHYLPHENIDATE HCL ER
Y
LEVETIRACETAM ER
Y
CLOBETASOL PROPIONATE
Y
METHYLPHENID CAP 20MG
LEVOTHYROXIN TAB 25MCG
RIBAPAK PAK 1200/DAY
AMOX/K CLAV TAB 875MG
DEXTROAMPHET CAP 15MG ER
LORYNA
TAB 3-0.02MG
VALACYCLOVIR TAB 1GM
CALCITRIOL CAP 0.5MCG
QUETIAPINE TAB 400MG
DESMOPRESSIN TAB 0.2MG
GILDESS FE TAB 1/20
SUMATRIPTAN SPR 20MG/ACT
DOXYCYCL HYC TAB 100MG
FLUCONAZOLE TAB 150MG
LEVOTHYROXIN TAB 150MCG
LISINOPRIL TAB 10MG
LOW-OGESTREL TAB
TOPIRAMATE TAB 100MG
DICLOFENAC GEL 3%
LAMOTRIGINE CHW 25MG
HYDROCO/APAP SOL 7.5-325
PROPRANOLOL CAP 60MG ER
NIACIN ER TAB 750MG
FLECAINIDE TAB 100MG
POT CITRATE TAB 1080MG
VENLAFAXINE CAP 150MG ER
MONTELUKAST CHW 5MG
ESCITALOPRAM TAB 20MG
TRAMADOL HCL TAB 50MG
RIZATRIPTAN TAB 10MG
GEMFIBROZIL TAB 600MG
AMLOD/VALSAR TAB 5-160MG
ONDANSETRON TAB 4MG ODT
AMLODIPINE TAB 5MG
FENOFIBRATE TAB 160MG
AMLODIPINE TAB 2.5MG
METFORMIN TAB 500MG
RISEDRONATE TAB 150MG
BENZEPRO SC AER 9.8%
DULOXETINE CAP 30MG
VANCOMYCIN CAP 250MG
PILOCARPINE TAB 5MG
ESZOPICLONE TAB 2MG
EXEMESTANE TAB 25MG
ESCITALOPRAM TAB 20MG
FLUVOXAMINE CAP 150MG ER
GABAPENTIN CAP 300MG
LEVORA-28 TAB 0.15/30
ATORVASTATIN TAB 40MG
VICODIN TAB 5-300MG
TIZANIDINE TAB 4MG
NORGEST/ETHI TAB ESTRADIO
JOLIVETTE TAB 0.35MG
BUPROPION TAB 100MG SR
ISOMETH/APAP CAP DICHLOR
METHYLPHENID TAB 20MG ER
DULOXETINE CAP 60MG
GUANFACINE TAB 1MG ER
GABAPENTIN CAP 300MG
IMIPRAM PAM CAP 75MG
VENLAFAXINE CAP 75MG ER
MORPHINE SUL TAB 60MG ER
FENTANYL DIS 100MCG/H
AMLOD/VALSAR TAB 10-320MG
PROPAFENONE CAP 325MG ER
MICROGESTIN TAB FE 1/20
NIACIN ER TAB 1000MG
LOSARTAN POT TAB 25MG
METHYLPHENID TAB 27MG ER
LEVETIRACETA TAB 750MG ER
CLOBETASOL CRE 0.05%
46
331
8
211
11
35
84
29
12
20
105
20
54
713
217
766
91
106
5
5
79
43
8
27
26
140
32
33
1009
22
98
11
412
537
34
103
425
18
21
8
2
19
38
5
40
3
276
79
45
97
229
76
83
75
38
30
11
11
120
4
128
28
17
8
4
105
8
187
35
4
19
1,455
19,819
448
3,886
1,560
2,884
2,307
3,714
1,080
2,310
7,252
144
1,766
1,246
13,376
65,513
6,748
15,150
500
2,700
20,469
3,330
960
4,032
3,630
14,115
2,460
2,625
86,365
277
15,690
930
4,946
44,116
2,820
8,008
81,999
28
2,100
1,020
100
5,760
1,062
390
3,285
540
52,358
5,964
3,885
2,978
23,425
5,208
5,124
7,679
1,391
2,280
1,020
475
25,942
360
14,802
1,676
230
660
600
7,196
720
14,460
1,098
1,260
1,260
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
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$
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-
p. 123
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
66993089630
00591588401
00781563431
60505084805
68180033207
61314064705
00591363001
53746017810
00093002901
00093510556
00591321472
62175027037
00299382230
13107004601
00093505006
00378340293
00245007111
55111025960
00378305001
00143314250
59762015701
66993041330
10370025702
00781118101
52565002285
16729016901
55111016830
68462034690
24208029505
00555095502
68180052002
00185111160
00168020360
00781711783
62037099905
00603634902
00603499121
76204000224
10702001801
00555078702
00093714618
00527163801
51672412501
00378912298
00228287911
00603254428
51672125803
68180051902
63304069301
00228278011
68180012909
68180090213
00228348111
68180011507
00093756956
51660014030
00093751498
10370051110
62175015437
60505083305
00555913167
00093313482
66869014730
61314063705
63304029605
00406051201
66993093430
00168020230
00591246501
00054008013
64720013510
ACITRETIN
Y
METHYLPHENIDATE HCL Y
PIOGLITAZONE HCL-GLIMEPIR
Y
AZELASTINE HCL
Y
ZIPRASIDONE HCL
Y
TOBRAMYCIN/DEXAMETHASONE
Y
HYDROMORPHONE HCL ER
Y
METFORMIN HCL ER
Y
ENALAPRIL MALEATE Y
OLANZAPINE
Y
FENTANYL
Y
OXYBUTYNIN CHLORIDE ER
Y
ORACEA
M
OXYCODONE/ACETAMINOPHEN
Y
PIOGLITAZONE HCL/METFORMI
Y
TOLTERODINE TARTRATEYER
POTASSIUM CITRATE ER Y
ZIPRASIDONE HCL
Y
CLOMIPRAMINE HCL
Y
DOXYCYCLINE HYCLATE Y
ATORVASTATIN CALCIUMY
OMEPRAZOLE/SODIUM BICARBO
Y
CLONIDINE HCL ER
Y
NADOLOL
Y
ECONAZOLE NITRATE Y
ESCITALOPRAM OXALATEY
OLANZAPINE
Y
LEVOCETIRIZINE DIHYDROCHL
Y
TOBRAMYCIN/DEXAMETHASONE
Y
DEXTROAMPHETAMINE SULFATE
Y
LISINOPRIL/HYDROCHLOROTHI
Y
BUPROPION HCL SR
Y
CLINDAMYCIN PHOSPHATE
Y
CALCIPOTRIENE
Y
POTASSIUM CHLORIDE ERY
VALSARTAN/HYDROCHLOROTHIA
Y
OXYCODONE HCL
Y
LEVALBUTEROL HCL
Y
OXYCODONE HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
AZITHROMYCIN
Y
LEVOTHYROXINE SODIUM
Y
CARBAMAZEPINE ER
Y
FENTANYL
Y
OXYCODONE HCL
Y
BUTALBITAL/ACETAMINOPHEN/
Y
CLOBETASOL PROPIONATE
Y
LISINOPRIL/HYDROCHLOROTHI
Y
CLINDAMYCIN HCL
Y
PROPRANOLOL HCL ER Y
FENOFIBRIC ACID DR
Y
DROSPIRENONE/ETHINYLYESTR
ZOLPIDEM TARTRATE ER Y
LEVETIRACETAM
Y
ARIPIPRAZOLE
Y
VALSARTAN
Y
IRBESARTAN
Y
DIVALPROEX SODIUM ERY
METHYLPHENIDATE HCL CD
Y
AZELASTINE HCL
Y
OCELLA
Y
CAMRESE
Y
LIPOFEN
M
PREDNISOLONE ACETATEY
HYDROXYCHLOROQUINEYSULFAT
OXYCODONE/ACETAMINOPHEN
Y
TESTOSTERONE
M
CLINDAMYCIN PHOSPHATE
Y
DESMOPRESSIN ACETATEY
EXEMESTANE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
ACITRETIN CAP 25MG
METHYLPHENID TAB 20MG
PIOGLIT/GLIM TAB 30-2MG
AZELASTINE SPR 0.15%
ZIPRASIDONE CAP 40MG
TOBRA/DEXAME SUS 0.3-0.1%
HYDROMORPHON TAB 16MG ER
METFORMIN TAB 500MG ER
ENALAPRIL TAB 20MG
OLANZAPINE TAB 20MG
FENTANYL DIS 100MCG/H
OXYBUTYNIN TAB 5MG ER
ORACEA
CAP 40MG
OXYCOD/APAP TAB 10-325MG
PIOGLITA/MET TAB 15-850MG
TOLTERODINE CAP 2MG ER
POT CITRATE TAB 1080MG
ZIPRASIDONE CAP 80MG
CLOMIPRAMINE CAP 50MG
DOXYCYCL HYC CAP 100MG
ATORVASTATIN TAB 40MG
OMEPRA/BICAR CAP 40-1100
CLONIDINE TAB 0.1MG ER
NADOLOL TAB 20MG
ECONAZOLE CRE 1%
ESCITALOPRAM TAB 10MG
OLANZAPINE TAB 20MG
LEVOCETIRIZI TAB 5MG
TOBRA/DEXAME SUS 0.3-0.1%
DEXTROAMPHET CAP 10MG ER
LISINOP/HCTZ TAB 20-25MG
BUPROPION TAB 200MG SR
CLINDAMYCIN LOT 1%
CALCIPOTRIEN CRE 0.005%
POT CL MICRO TAB 20MEQ ER
VALSART/HCTZ TAB 320-25MG
OXYCODONE TAB 15MG
LEVALBUTEROL NEB 0.63MG
OXYCODONE TAB 5MG
AMPHETAMINE CAP 10MG ER
AZITHROMYCIN TAB 250MG
LEVOTHYROXIN TAB 137MCG
CARBAMAZEPIN TAB 400MG ER
FENTANYL DIS 50MCG/HR
OXYCODONE TAB 30MG
BUT/APAP/CAF TAB
CLOBETASOL CRE 0.05%
LISINOP/HCTZ TAB 20-12.5
CLINDAMYCIN CAP 300MG
PROPRANOLOL CAP 120MG ER
FENOFIBRIC CAP 135MG DR
DROSPIR/ETHI TAB 3-0.03MG
ZOLPIDEM ER TAB 6.25MG
LEVETIRACETA TAB 1000MG
ARIPIPRAZOLE TAB 5MG
VALSARTAN TAB 40MG
IRBESARTAN TAB 300MG
DIVALPROEX TAB 500MG ER
METHYLPHENID CAP 40MG
AZELASTINE SPR 0.1%
OCELLA
TAB 3-0.03MG
CAMRESE TAB
LIPOFEN CAP 150MG
PREDNISOLONE SUS 1% OP
HYDROXYCHLOR TAB 200MG
OXYCOD/APAP TAB 5-325MG
TESTOSTERONE GEL 1%(50MG)
CLINDAMYCIN GEL 1%
DESMOPRESSIN TAB 0.2MG
EXEMESTANE TAB 25MG
AMPHETAMINE TAB 20MG
4
65
4
29
15
43
7
252
104
5
21
27
7
37
8
9
19
9
3
34
42
4
10
23
32
38
6
49
41
13
258
32
55
7
90
25
47
8
252
25
396
172
17
27
35
95
19
251
278
22
11
26
19
20
2
16
14
7
24
40
27
20
7
80
60
318
9
58
15
3
52
185
4,140
360
1,080
1,314
230
171
53,970
13,380
287
215
1,950
210
4,045
1,410
690
2,763
990
540
1,416
3,300
360
1,110
2,550
2,720
2,745
540
2,100
235
995
24,584
4,318
3,300
840
9,227
2,130
6,280
3,024
16,718
870
2,380
10,544
1,860
320
5,196
4,479
1,440
27,761
7,849
1,740
990
1,960
735
3,555
165
1,140
1,214
1,140
779
2,130
1,932
1,820
630
440
9,420
15,706
1,500
2,100
2,910
270
3,375
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
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p. 124
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
16714069801
00093529701
00093747243
49884072703
00781561892
00591271501
61314063710
63304090430
67767014190
49884086702
00093205701
53746019005
53489017701
68382013616
00955100410
59762453802
00378395077
00093535401
45802015153
60505257809
68180047803
55111053401
60505132309
49884040510
10147170003
52544038328
00603634702
31722027090
45963014190
00781118201
00781405442
68645048254
23155012901
76204020025
00228305911
45802026937
66993047096
10370010250
00143314205
66993011560
52544063128
62037059990
00378200905
00955170310
66530025420
13925017201
00093718856
00406012301
65162064978
00591551305
62175027237
67253014150
49884040410
45802043733
51672126302
00781207601
00591372030
13668007930
00378426153
64764011907
76204020060
00093089201
50383008716
50111078766
00378718505
16252051501
00603254421
00093535301
52544062928
50383026760
68180036109
VALACYCLOVIR HCL
Y
METHYLPHENIDATE HCL CD
Y
RIZATRIPTAN BENZOATE Y
DOXYCYCLINE MONOHYDRATE
Y
VALSARTAN
Y
METHYLPHENIDATE HCL ER
Y
PREDNISOLONE ACETATEY
VALACYCLOVIR HCL
Y
BUPROPION HCL XL
Y
DRONABINOL
Y
NIFEDIPINE ER
Y
NAPROXEN
Y
ALBUTEROL SULFATE Y
LOSARTAN POTASSIUM Y
ENOXAPARIN SODIUM Y
MEDROXYPROGESTERONE
Y ACETA
ATORVASTATIN CALCIUMY
PROGESTERONE
Y
FLUOCINONIDE
Y
ATORVASTATIN CALCIUMY
SIMVASTATIN
Y
DIVALPROEX SODIUM ERY
PRAVASTATIN SODIUM Y
METOPROLOL SUCCINATE
Y ER
ITRACONAZOLE
Y
ZOVIA 1/35E
Y
VALSARTAN/HYDROCHLOROTHIA
Y
QUINAPRIL HCL
Y
BUPROPION HCL XL
Y
NADOLOL
Y
LANSOPRAZOLE/AMOXICILLIN/
Y
ATORVASTATIN CALCIUMY
MEPROBAMATE
Y
ALBUTEROL SULFATE Y
AMPHETAMINE/DEXTROAMPHETA
Y
PERMETHRIN
Y
CROMOLYN SODIUM
Y
BUPROPION HCL XL
Y
DOXYCYCLINE HYCLATE Y
PROPAFENONE HCL ER Y
MICROGESTIN FE 1.5/30 Y
CARTIA XT
Y
BUPROPION HCL XL
Y
ZOLPIDEM TARTRATE ER Y
TRETINOIN
Y
ESTERIFIED ESTROGENS/METH
Y
FLUOXETINE HCL
Y
HYDROCODONE/ACETAMINOPHEN
Y
OXCARBAZEPINE
Y
CARISOPRODOL
Y
OXYBUTYNIN CHLORIDE ER
Y
AMOXICILLIN
Y
METOPROLOL SUCCINATE
Y ER
CLOBETASOL PROPIONATE
Y
NYSTATIN/TRIAMCINOLONE
Y
TAMSULOSIN HCL
Y
TRANEXAMIC ACID
Y
MONTELUKAST SODIUM Y
ZOLMITRIPTAN
Y
COLCRYS
M
ALBUTEROL SULFATE Y
ETODOLAC
Y
GUAIATUSSIN AC
Y
AZITHROMYCIN
Y
METFORMIN HCL
Y
CIPROFLOXACIN HCL
Y
BUTALBITAL/ACETAMINOPHEN/
Y
PROGESTERONE
Y
NORA-BE
Y
CLOBETASOL PROPIONATE
Y
FENOFIBRATE
Y
VALACYCLOVIR TAB 500MG
METHYLPHENID CAP 30MG
RIZATRIPTAN TAB 10MG
DOXYCYC MONO CAP 100MG
VALSARTAN TAB 160MG
METHYLPHENID TAB 18MG ER
PREDNISOLONE SUS 1% OP
VALACYCLOVIR TAB 500MG
BUPROPN HCL TAB 150MG XL
DRONABINOL CAP 2.5MG
NIFEDIPINE TAB 30MG ER
NAPROXEN TAB 500MG
ALBUTEROL TAB 4MG
LOSARTAN POT TAB 50MG
ENOXAPARIN INJ 40/0.4ML
MEDROXYPR AC INJ 150MG/ML
ATORVASTATIN TAB 10MG
PROGESTERONE CAP 200MG
FLUOCINONIDE CRE 0.1%
ATORVASTATIN TAB 10MG
SIMVASTATIN TAB 10MG
DIVALPROEX TAB 500MG ER
PRAVASTATIN TAB 80MG
METOPROLOL TAB 50MG ER
ITRACONAZOLE CAP 100MG
ZOVIA 1/35E TAB
VALSART/HCTZ TAB 160-25MG
QUINAPRIL TAB 40MG
BUPROPN HCL TAB 150MG XL
NADOLOL TAB 40MG
LANSOPR/AMOX MIS /CLARITH
ATORVASTATIN TAB 20MG
MEPROBAMATE TAB 400MG
ALBUTEROL NEB 0.083%
AMPHETAMINE CAP 10MG ER
PERMETHRIN CRE 5%
CROMOLYN SOD CON 100/5ML
BUPROPN HCL TAB 300MG XL
DOXYCYCL HYC CAP 100MG
PROPAFENONE CAP 325MG ER
MICROGESTIN TAB FE1.5/30
CARTIA XT CAP 240/24HR
BUPROPN HCL TAB 300MG XL
ZOLPIDEM ER TAB 12.5MG
TRETINOIN CRE 0.05%
EST ESTROGEN TAB MTEST
FLUOXETINE TAB 10MG
HYDROCO/APAP TAB 5-325MG
OXCARBAZEPIN SUS 300MG/5M
CARISOPRODOL TAB 350MG
OXYBUTYNIN TAB 15MG ER
AMOXICILLIN CAP 500MG
METOPROLOL TAB 25MG ER
CLOBETASOL AER 0.05%
NYSTAT/TRIAM CRE
TAMSULOSIN CAP 0.4MG
TRANEX ACID TAB 650MG
MONTELUKAST CHW 4MG
ZOLMITRIPTAN TAB 5MG
COLCRYS TAB 0.6MG
ALBUTEROL NEB 0.083%
ETODOLAC TAB 400MG
GUAIATUSSIN SYP AC
AZITHROMYCIN TAB 250MG
METFORMIN TAB 500MG
CIPROFLOXACN TAB 500MG
BUT/APAP/CAF TAB
PROGESTERONE CAP 100MG
NORA-BE TAB 0.35MG
CLOBETASOL CRE 0.05%
FENOFIBRATE TAB 145MG
22
29
22
135
9
26
43
39
33
18
47
306
3
94
13
55
59
36
3
52
171
8
33
42
10
55
24
56
56
15
5
31
12
336
17
36
2
29
27
2
69
26
22
40
33
12
71
413
4
358
14
863
49
7
22
57
19
18
17
8
165
35
326
454
192
618
88
43
54
23
14
1,046
930
227
5,262
810
900
430
1,982
3,060
1,028
4,265
18,334
810
8,445
79
55
4,845
1,183
360
4,170
14,354
1,080
2,910
4,695
600
4,340
1,920
6,060
4,126
1,590
560
2,610
1,140
47,550
750
2,639
2,880
2,490
1,240
360
4,844
2,280
1,800
1,198
780
1,080
5,986
15,707
4,820
24,502
1,200
23,097
4,290
700
990
4,554
750
1,200
141
510
42,300
3,579
55,863
2,714
38,139
10,224
4,827
2,158
3,472
1,620
1,020
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
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$
$
$
$
$
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-
p. 125
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68462010430
00781118301
62175011843
00093304501
68462015813
16714069302
00603459315
00228315503
64380073706
00093202631
00168008130
00054007928
43598020614
68382013710
00378710077
00115123301
65862017760
00093737301
59762501601
00093765656
16714069301
00093101042
68382000105
16714069701
00527135001
50111045602
00093767101
76439014111
00093529501
00115133101
00555901658
45802073684
51672529503
50383023310
68180032401
00093423601
17478062512
60758011905
31722024990
00093046301
60505257507
00781613954
00591322379
00378500577
68180046903
00093739298
00228277911
00228306311
55111053301
68180033407
00093576856
16571020210
00591024005
59762015602
68180044601
00378022877
00781714219
68180075701
00472037945
10370011610
00093577056
00378190301
00093067005
68462025401
68180031506
68682052801
50383026650
00406013601
68180072310
00093761356
53746017901
FLUCONAZOLE
Y
NADOLOL
Y
OMEPRAZOLE
Y
VERAPAMIL HCL ER
Y
ONDANSETRON ODT
Y
FLUCONAZOLE
Y
METHYLPREDNISOLONE DOSE
Y
P
BUPRENORPHINE HCL/NALOXON
Y
VITAMIN D
Y
AZITHROMYCIN
Y
NYSTATIN/TRIAMCINOLONE
Y
BALSALAZIDE DISODIUM Y
AMOXICILLIN/CLAVULANATE
Y P
LOSARTAN POTASSIUM Y
FENOFIBRATE
Y
OXYMORPHONE HYDROCHLORIDE
Y
CEFDINIR
Y
AMLODIPINE BESYLATE/BENAZ
Y
FLUCONAZOLE
Y
PARICALCITOL
Y
FLUCONAZOLE
Y
MUPIROCIN
Y
PAROXETINE HCL
Y
VALACYCLOVIR HCL
Y
LEVOTHYROXINE SODIUM
Y
OXYBUTYNIN CHLORIDE Y
AMLODIPINE BESYLATE/BENAZ
Y
LOSARTAN POTASSIUM Y
METHYLPHENIDATE HCL CD
Y
AMPHETAMINE/DEXTROAMPHETA
Y
SPRINTEC 28
Y
CLINDAMYCIN/BENZOYL YPEROX
METRONIDAZOLE
Y
DORZOLAMIDE HCL/TIMOLOL
Y
M
ESZOPICLONE
Y
NADOLOL
Y
LATANOPROST
Y
PREDNISOLONE ACETATEY
ESCITALOPRAM OXALATEY
LAMOTRIGINE
Y
BALSALAZIDE DISODIUM Y
AMOXICILLIN/CLAVULANATE
Y P
TESTOSTERONE CYPIONATE
Y
ALFUZOSIN HCL ER
Y
LOVASTATIN
Y
NIACIN ER
Y
PROPRANOLOL HCL ER Y
AMPHETAMINE/DEXTROAMPHETA
Y
DIVALPROEX SODIUM ERY
ZIPRASIDONE HCL
Y
OLANZAPINE
Y
DICLOFENAC SODIUM DRY
LORAZEPAM
Y
ATORVASTATIN CALCIUMY
QUETIAPINE FUMARATE Y
PIOGLITAZONE HCL
Y
ADAPALENE
Y
AMLODIPINE BESYLATE/BENAZ
Y
CLOTRIMAZOLE/BETAMETHASON
Y
ZOLPIDEM TARTRATE ER Y
OLANZAPINE
Y
MIDODRINE HCL
Y
GEMFIBROZIL
Y
ROPINIROLE HCL
Y
IMIPRAMINE PAMOATE Y
FENOFIBRATE
Y
CLOBETASOL PROPIONATE
Y
METHYLPHENIDATE HCL ER
Y
CEFDINIR
Y
ARIPIPRAZOLE
Y
METFORMIN HCL ER
Y
FLUCONAZOLE TAB 200MG
NADOLOL TAB 80MG
OMEPRAZOLE CAP 20MG
VERAPAMIL TAB 240MG ER
ONDANSETRON TAB 8MG ODT
FLUCONAZOLE TAB 200MG
METHYLPRED PAK 4MG
BUPREN/NALOX SUB 8-2MG
VITAMIN D CAP 50000UNT
AZITHROMYCIN SUS 200/5ML
NYSTAT/TRIAM CRE
BALSALAZIDE CAP 750MG
AMOX/K CLAV TAB 500MG
LOSARTAN POT TAB 100MG
FENOFIBRATE TAB 54MG
OXYMORPHONE TAB 20MG ER
CEFDINIR CAP 300MG
AMLOD/BENAZP CAP 10-20MG
FLUCONAZOLE TAB 100MG
PARICALCITOL CAP 1 MCG
FLUCONAZOLE TAB 200MG
MUPIROCIN OIN 2%
PAROXETINE TAB 40MG
VALACYCLOVIR TAB 1GM
LEVOTHYROXIN TAB 175MCG
OXYBUTYNIN TAB 5MG
AMLOD/BENAZP CAP 10-40MG
LOSARTAN POT TAB 50MG
METHYLPHENID CAP 10MG
AMPHETAMINE CAP 20MG ER
SPRINTEC 28 TAB 28 DAY
CLINDAMY/BEN GEL 1.2-5%
METRONIDAZOL GEL 1%
DORZOL/TIMOL SOL 2-0.5%OP
ESZOPICLONE TAB 3MG
NADOLOL TAB 40MG
LATANOPROST SOL 0.005%
PREDNISOLONE SUS 1% OP
ESCITALOPRAM TAB 5MG
LAMOTRIGINE TAB 100MG
BALSALAZIDE CAP 750MG
AMOX/K CLAV SUS 600/5ML
TESTOST CYP INJ 200MG/ML
ALFUZOSIN TAB 10MG
LOVASTATIN TAB 40MG
NIACIN ER TAB 500MG
PROPRANOLOL CAP 80MG ER
AMPHETAMINE CAP 15MG ER
DIVALPROEX TAB 250MG ER
ZIPRASIDONE CAP 80MG
OLANZAPINE TAB 5MG
DICLOFENAC TAB 50MG DR
LORAZEPAM TAB 0.5MG
ATORVASTATIN TAB 20MG
QUETIAPINE TAB 50MG
PIOGLITAZONE TAB 30MG
ADAPALENE GEL 0.3%
AMLOD/BENAZP CAP 5-20MG
CLOTRIM/BETA CRE DIPROP
ZOLPIDEM ER TAB 12.5MG
OLANZAPINE TAB 10MG
MIDODRINE TAB 10MG
GEMFIBROZIL TAB 600MG
ROPINIROLE TAB 0.5MG
IMIPRAM PAM CAP 100MG
FENOFIBRATE TAB 145MG
CLOBETASOL SOL 0.05%
METHYLPHENID TAB 36MG ER
CEFDINIR SUS 250/5ML
ARIPIPRAZOLE TAB 2MG
METFORMIN TAB 750MG ER
20
10
116
41
139
20
133
8
537
116
23
11
105
74
53
10
30
17
29
4
18
175
55
15
86
48
9
77
25
21
99
20
11
29
18
13
156
62
44
154
14
80
35
13
112
9
24
19
4
16
36
73
395
31
23
8
11
25
50
30
6
17
80
25
1
11
41
18
41
2
101
1,299
910
7,573
4,530
1,805
1,023
2,793
381
5,369
3,800
960
3,510
2,201
6,285
4,560
600
634
1,350
863
360
993
4,114
4,980
766
6,357
7,011
810
6,495
750
690
7,140
900
660
420
822
1,305
535
335
2,250
13,614
3,780
11,375
364
914
10,605
810
1,740
630
1,800
1,154
1,890
6,062
19,891
2,730
1,664
720
495
2,370
2,340
1,245
266
1,530
13,736
4,410
180
870
2,050
660
4,200
120
14,970
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
$
$
$
$
$
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$
$
$
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$
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$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
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-
p. 126
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
59762015801
00955101210
49884073510
00781708035
00591588301
68180051303
45802036862
66993088445
65862022660
65162005310
68180011416
60505257908
57237005920
00093716501
65162064310
66530025345
13811068030
13811068230
52544029128
00054016325
00472080304
00378036001
00574010603
00781561992
00406833001
00378464026
13925017101
00093075701
53746027205
00378001805
57237001830
62037056005
13668013601
51293061201
60505250301
49884040601
49884086802
00378018105
59762444002
64376064801
13925050820
68382013716
00378335299
00555051302
60505309702
16714036304
00781707787
00093075506
00093630195
31722026990
67253001341
29033000412
68462019705
59746017710
00781724055
00781223310
60505279500
60505399203
00168008115
00093007401
00093202623
00378604093
68462033490
49884070155
00093417773
55111014630
00054023025
68462030450
00591046105
60505025302
00093417774
ATORVASTATIN CALCIUMY
ENOXAPARIN SODIUM Y
FLUOXETINE HCL
Y
METRONIDAZOLE
Y
METHYLPHENIDATE HCL Y
LISINOPRIL
Y
IMIQUIMOD
Y
ADAPALENE
Y
CLARITHROMYCIN
Y
CITALOPRAM HYDROBROMIDE
Y
LEVETIRACETAM
Y
ATORVASTATIN CALCIUMY
CEFUROXIME AXETIL
Y
CELECOXIB
Y
FLECAINIDE ACETATE Y
TRETINOIN
Y
ARIPIPRAZOLE
Y
ARIPIPRAZOLE
Y
TRIVORA-28
Y
MYCOPHENOLATE MOFETIL
Y
DESONIDE
Y
NIFEDIPINE ER
Y
BROMOCRIPTINE MESYLATE
Y
VALSARTAN
Y
MORPHINE SULFATE ER Y
ESTRADIOL
Y
ESTERIFIED ESTROGENS/METH
Y
PIROXICAM
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
METOPROLOL TARTRATEY
DULOXETINE HCL
Y
POTASSIUM CHLORIDE ERY
ESCITALOPRAM OXALATEY
PHENAZOPYRIDINE HCL Y
LEFLUNOMIDE
Y
METOPROLOL SUCCINATE
Y ER
DRONABINOL
Y
ALLOPURINOL
Y
METHYLPREDNISOLONE DOSE
Y
P
HYDROCODONE BITARTRATE/AC
Y
FLUOCINOLONE ACETONIDE
Y EA
LOSARTAN POTASSIUM Y
ESTRADIOL
Y
ACETAZOLAMIDE ER
Y
RISEDRONATE SODIUM Y
TRI-LINYAH
Y
METRONIDAZOLE VAGINAL
Y
DIFLUNISAL
Y
ADAPALENE
Y
QUINAPRIL HCL
Y
CEFDINIR
Y
CARBAMAZEPINE ER
Y
PRAVASTATIN SODIUM Y
CYCLOBENZAPRINE HCL Y
FENTANYL
Y
OMEPRAZOLE
Y
IBANDRONATE SODIUM Y
CLOPIDOGREL
Y
NYSTATIN/TRIAMCINOLONE
Y
ZOLPIDEM TARTRATE Y
AZITHROMYCIN
Y
MONTELUKAST SODIUM Y
PRAMIPEXOLE DIHYDROCHLORI
Y
CLOMIPHENE CITRATE Y
CEPHALEXIN
Y
FLUCONAZOLE
Y
QUETIAPINE FUMARATE Y
NORETHINDRONE ACETATE
Y
GLIPIZIDE
Y
CLOPIDOGREL
Y
CEPHALEXIN
Y
ATORVASTATIN TAB 80MG
ENOXAPARIN INJ 120/0.8
FLUOXETINE TAB 20MG
METRONIDAZOL GEL 1%
METHYLPHENID TAB 10MG
LISINOPRIL TAB 5MG
IMIQUIMOD CRE 5%
ADAPALENE GEL 0.3%
CLARITHROMYC TAB 500MG
CITALOPRAM TAB 20MG
LEVETIRACETA TAB 750MG
ATORVASTATIN TAB 20MG
CEFUROXIME TAB 500MG
CELECOXIB CAP 100MG
FLECAINIDE TAB 150MG
TRETINOIN CRE 0.025%
ARIPIPRAZOLE TAB 5MG
ARIPIPRAZOLE TAB 15MG
TRIVORA-28 TAB
MYCOPHENOLAT CAP 250MG
DESONIDE LOT 0.05%
NIFEDIPINE TAB 60MG ER
BROMOCRIPTIN TAB 2.5MG
VALSARTAN TAB 320MG
MORPHINE SUL TAB 30MG ER
ESTRADIOL DIS 0.1MG
EST ESTROGEN TAB MTEST HS
PIROXICAM CAP 20MG
SMZ/TMP DS TAB 800-160
METOPROL TAR TAB 25MG
DULOXETINE CAP 30MG
POT CHLORIDE CAP 10MEQ ER
ESCITALOPRAM TAB 10MG
PHENAZOPYRID TAB 200MG
LEFLUNOMIDE TAB 20MG
METOPROLOL TAB 100MG ER
DRONABINOL CAP 5MG
ALLOPURINOL TAB 300MG
METHYLPRED PAK 4MG
HYDROCO/APAP TAB 5-300MG
FLUOCIN ACET OIL EAR0.01%
LOSARTAN POT TAB 100MG
ESTRADIOL DIS 0.1MG
ACETAZOLAMID CAP 500MG ER
RISEDRONATE TAB 150MG
TRI-LINYAH TAB
METRONIDAZOL GEL 0.75%VAG
DIFLUNISAL TAB 500MG
ADAPALENE GEL 0.1%
QUINAPRIL TAB 20MG
CEFDINIR SUS 250/5ML
CARBAMAZEPIN CAP 300MG ER
PRAVASTATIN TAB 40MG
CYCLOBENZAPR TAB 10MG
FENTANYL DIS 12MCG/HR
OMEPRAZOLE CAP 20MG
IBANDRONATE TAB 150MG
CLOPIDOGREL TAB 75MG
NYSTAT/TRIAM CRE
ZOLPIDEM TAB 10MG
AZITHROMYCIN SUS 200/5ML
MONTELUKAST GRA 4MG
PRAMIPEXOLE TAB 1.5MG
CLOMIPHENE TAB 50MG
CEPHALEXIN SUS 250/5ML
FLUCONAZOLE TAB 200MG
QUETIAPINE TAB 400MG
NORETHIN ACE TAB 5MG
GLIPIZIDE TAB 10MG
CLOPIDOGREL TAB 75MG
CEPHALEXIN SUS 250/5ML
31
3
27
11
81
357
16
11
19
299
20
58
35
3
6
19
1
1
51
10
4
21
22
6
30
11
21
23
634
297
11
39
25
92
16
26
6
177
111
73
15
58
7
7
11
36
84
15
21
28
34
17
46
710
17
115
11
26
27
874
145
7
4
98
88
19
6
22
163
29
86
2,535
30
2,610
660
3,915
30,320
222
495
489
25,369
5,310
5,100
662
540
960
855
90
90
3,892
1,950
944
2,130
1,500
540
1,772
256
888
975
13,696
43,355
653
3,716
1,830
1,195
1,122
2,160
360
15,104
2,331
1,851
300
4,935
124
1,020
15
2,660
5,950
1,830
945
4,380
2,880
1,770
3,855
29,737
165
6,058
25
2,220
675
32,500
2,700
510
1,080
1,563
17,300
1,123
840
1,292
33,510
2,146
17,990
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 127
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00093586101
00093585201
51991060401
50111090101
17478076710
00378342201
16729018201
68180035309
50383026860
00591278986
00378311001
00378464226
00781502207
00054018913
00054028813
62037071001
00378912398
00781713704
00172409660
00406831501
68382013516
65862059401
00378021810
23155011701
55111061701
00093078201
68180044501
62559016001
68180046803
00093202723
00591252205
52544096728
53746020301
00115133301
43478024245
00574085010
51991045757
00185014901
00093738456
52544029021
00781322295
68180051601
00472008216
00228283711
00245007111
24208091055
00472037915
64980032005
65862049647
00378385777
68462046160
00555105756
00378870049
00781711735
76439025216
00228366009
00378047201
00527105001
16252060144
00143178705
00591084401
00555901858
00378180310
53489067890
00378180510
00093204905
23155013701
00713063737
00168042446
00781268401
00228282011
OXYMORPHONE HYDROCHLORIDE
Y
ESCITALOPRAM OXALATEY
VITAMIN D
Y
ETHOSUXIMIDE
Y
PROGESTERONE
Y
NITROFURANTOIN MONOHYDRAT
Y
HYDROCHLOROTHIAZIDEY
SERTRALINE HCL
Y
CLOBETASOL PROPIONATE
Y
TIZANIDINE HCL
Y
TEMAZEPAM
Y
ESTRADIOL
Y
METHYLPREDNISOLONE DOSE
Y
P
BUPRENORPHINE HCL/NALOXON
Y
MONTELUKAST SODIUM Y
POTASSIUM CHLORIDE CR
Y
FENTANYL
Y
CLOBETASOL PROPIONATE
Y
BACLOFEN
Y
MORPHINE SULFATE ER Y
LOSARTAN POTASSIUM Y
DIVALPROEX SODIUM ERY
ATENOLOL
Y
GLIPIZIDE/METFORMIN HCL
Y
ESZOPICLONE
Y
TAMOXIFEN CITRATE
Y
QUETIAPINE FUMARATE Y
FLUVOXAMINE MALEATEY
LOVASTATIN
Y
AZITHROMYCIN
Y
METRONIDAZOLE
Y
SRONYX
Y
OXYCODONE/ACETAMINOPHEN
Y
AMPHETAMINE/DEXTROAMPHETA
Y
TRETINOIN
Y
DIHYDROERGOTAMINE MESYLAT
Y
POLYETHYLENE GLYCOL 3350
Y
MIDODRINE HCL
Y
VENLAFAXINE HCL ER Y
MICROGESTIN 1.5/30 Y
CEFEPIME
Y
LISINOPRIL
Y
ACYCLOVIR
Y
PILOCARPINE HCL
Y
POTASSIUM CITRATE
M
ERYTHROMYCIN
Y
CLOTRIMAZOLE/BETAMETHASON
Y
TRIAMCINOLONE ACETONIDE
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
ESCITALOPRAM OXALATEY
TROSPIUM CHLORIDE Y
CLARAVIS
Y
ACYCLOVIR
Y
CALCIPOTRIENE
Y
VIRTUSSIN A/C
Y
ROPINIROLE ER
Y
DIVALPROEX SODIUM ERY
ACETAZOLAMIDE
Y
ALENDRONATE SODIUM Y
BUTALBITAL/ACETAMINOPHEN/
Y
GLIPIZIDE ER
Y
TRI-SPRINTEC
Y
LEVOTHYROXINE SODIUM
Y
FENOFIBRIC ACID
M
LEVOTHYROXINE SODIUM
Y
TOLTERODINE TARTRATEYER
HYDROCHLOROTHIAZIDEY
METRONIDAZOLE
Y
ADAPALENE
Y
DEXMETHYLPHENIDATE HCL
Y ER
HYDROCHLOROTHIAZIDEY
OXYMORPHONE TAB HCL 5MG
ESCITALOPRAM TAB 20MG
VITAMIN D CAP 50000UNT
ETHOSUXIMIDE CAP 250MG
PROGESTERONE CAP 200MG
NITROFURANTN CAP 100MG
HYDROCHLOROT TAB 12.5MG
SERTRALINE TAB 100MG
CLOBETASOL OIN 0.05%
TIZANIDINE CAP 4MG
TEMAZEPAM CAP 7.5MG
ESTRADIOL DIS 0.05MG
METHYLPRED PAK 4MG
BUPREN/NALOX SUB 8-2MG
MONTELUKAST CHW 4MG
POT CL MICRO TAB 10MEQ CR
FENTANYL DIS 75MCG/HR
CLOBETASOL SHA 0.05%
BACLOFEN TAB 10MG
MORPHINE SUL TAB 15MG ER
LOSARTAN POT TAB 25MG
DIVALPROEX TAB 250MG ER
ATENOLOL TAB 25MG
GLIP/METFORM TAB 5-500MG
ESZOPICLONE TAB 3MG
TAMOXIFEN TAB 20MG
QUETIAPINE TAB 25MG
FLUVOXAMINE TAB 100MG
LOVASTATIN TAB 20MG
AZITHROMYCIN SUS 100/5ML
METRONIDAZOL TAB 500MG
SRONYX
TAB
OXYCOD/APAP TAB 5-325MG
AMPHETAMINE CAP 30MG ER
TRETINOIN CRE 0.05%
DIHYDROERGOT INJ 1MG/ML
POLYETH GLYC POW 3350 NF
MIDODRINE TAB 10MG
VENLAFAXINE CAP 37.5 ER
MICROGESTIN TAB 1.5/30
CEFEPIME INJ 1GM
LISINOPRIL TAB 30MG
ACYCLOVIR SUS 200/5ML
PILOCARPINE TAB 7.5MG
POT CITRATE TAB 1080MG
ERYTHROMYCIN OIN OP
CLOTRIM/BETA CRE DIPROP
TRIAMCINOLON PST 0.1%
SMZ-TMP SUS 200-40/5
ESCITALOPRAM TAB 20MG
TROSPIUM CL TAB 20MG
CLARAVIS CAP 40MG
ACYCLOVIR OIN 5%
CALCIPOTRIEN CRE 0.005%
VIRTUSSIN AC SOL 100-10/5
ROPINIROLE TAB 8MG ER
DIVALPROEX TAB 250MG ER
ACETAZOLAMID TAB 250MG
ALENDRONATE TAB 70MG
BUT/APAP/CAF TAB
GLIPIZIDE ER TAB 5MG
TRI-SPRINTEC TAB
LEVOTHYROXIN TAB 50MCG
FENOFIBRIC TAB 105MG
LEVOTHYROXIN TAB 75MCG
TOLTERODINE CAP 4MG ER
HYDROCHLOROT TAB 12.5MG
METRONIDAZOL GEL 0.75%
ADAPALENE CRE 0.1%
DEXMETHYLPH CAP 15MG ER
HYDROCHLOROT TAB 12.5MG
14
24
285
10
25
59
85
79
14
16
16
10
102
5
35
49
11
7
106
49
79
9
281
17
16
57
25
27
153
80
252
36
205
15
16
12
86
9
75
38
2
38
14
5
9
148
58
27
42
19
6
6
3
5
209
4
5
14
168
67
71
78
86
8
87
4
55
19
10
10
40
1,050
2,280
2,959
1,995
778
1,102
6,135
7,080
840
1,040
480
224
2,142
300
2,250
5,365
118
826
12,356
3,032
6,570
1,380
26,871
3,890
480
3,330
2,700
3,615
13,530
1,845
4,767
2,744
9,916
510
720
60
57,443
1,170
4,581
2,247
120
3,360
3,165
1,440
1,410
550
1,800
210
6,405
1,470
960
330
90
480
39,009
360
1,020
973
1,610
2,764
7,797
4,872
5,880
720
5,370
360
4,350
855
540
300
3,420
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 128
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
64980030130
00172541360
00591315901
52544095021
65862020330
57237001930
00172435770
00378014805
68180041306
00093716605
00378335099
10370010203
00781185220
00168008160
68382000301
00143988701
00591279086
45802066033
00093202694
00603764217
00172435860
42858080101
00093754456
00591288001
00093511898
00574022001
31722040605
23155004403
76439014211
66530024940
00406839001
60505083902
00430011420
00093316753
16729019917
17478076610
45802070000
00093555101
62037060090
68382009810
00093529301
00603577021
65162005410
00378632577
00603188016
16714035904
00093716956
00185014101
68180022303
63323069404
00093002801
00093106001
66993047302
59762054201
55111063960
68180078001
68180011707
00378464426
00378563159
00093106201
45802008386
00574206304
68382000106
00093780956
65162030709
68180035302
51672402301
00378427593
33342008850
00228278111
00378581577
PROCTOZONE-HC
Y
FLUCONAZOLE
Y
URSODIOL
Y
MICROGESTIN 1/20
Y
LOSARTAN POTASSIUM Y
DULOXETINE HCL
Y
RANITIDINE HCL
Y
DOXYCYCLINE HYCLATE Y
IRBESARTAN/HYDROCHLOROTHI
Y
CELECOXIB
Y
ESTRADIOL
Y
BUPROPION HCL XL
Y
AMOXICILLIN/CLAVULANATE
Y P
NYSTATIN/TRIAMCINOLONE
Y
AZATHIOPRINE
Y
AMOXICILLIN
Y
TIZANIDINE HCL
Y
CLINDAMYCIN PHOSPHATE
Y
AZITHROMYCIN
Y
PREVIFEM
Y
RANITIDINE HCL
Y
MORPHINE SULFATE ER Y
DULOXETINE HCL
Y
VERAPAMIL HCL SR
Y
DILTIAZEM HCL ER
Y
LIOTHYRONINE SODIUM Y
GABAPENTIN
Y
LEFLUNOMIDE
Y
LOSARTAN POTASSIUM Y
FLUOROURACIL
Y
MORPHINE SULFATE ER Y
BUDESONIDE
Y
DORYX
M
MINOCYCLINE HCL
Y
LISINOPRIL
Y
PROGESTERONE
Y
TACROLIMUS
Y
DEXMETHYLPHENIDATE HCL
Y ER
CARTIA XT
Y
PAROXETINE HCL
Y
METHYLPHENIDATE HCL CD
Y
SOTALOL HCL
Y
CITALOPRAM HYDROBROMIDE
Y
VALSARTAN/HYDROCHLOROTHIA
Y
LIDOCAINE
Y
FALMINA
Y
AZITHROMYCIN
Y
OXAPROZIN
Y
NIACIN ER
Y
ACETYLCYSTEINE
Y
ENALAPRIL MALEATE Y
SOTALOL HCL
Y
NISOLDIPINE
Y
GLIPIZIDE XL
Y
MINOCYCLINE HCL
Y
ZOLPIDEM TARTRATE ER Y
LEVETIRACETAM ER
Y
ESTRADIOL
Y
SUMATRIPTAN SUCCINATE
Y
SOTALOL HCL
Y
ERYTHROMYCIN/BENZOYL
Y PERO
CLOBETASOL PROPIONATE
Y
PAROXETINE HCL
Y
AMLODIPINE/VALSARTAN/HCTZ
Y
VENLAFAXINE HCL
Y
SERTRALINE HCL
Y
ACETAZOLAMIDE
Y
VALACYCLOVIR HCL
Y
RIZATRIPTAN BENZOATE Y
PROPRANOLOL HCL ER Y
VALSARTAN
Y
PROCTOZONE CRE -HC 2.5%
FLUCONAZOLE TAB 200MG
URSODIOL CAP 300MG
MICROGESTIN TAB 1/20
LOSARTAN POT TAB 100MG
DULOXETINE CAP 60MG
RANITIDINE TAB 150MG
DOXYCYCL HYC CAP 100MG
IRBESAR/HCTZ TAB 150-12.5
CELECOXIB CAP 200MG
ESTRADIOL DIS 0.05MG
BUPROPN HCL TAB 300MG XL
AMOX/K CLAV TAB 875MG
NYSTAT/TRIAM CRE
AZATHIOPRINE TAB 50MG
AMOXICILLIN SUS 400/5ML
TIZANIDINE CAP 6MG
CLINDAMYCIN AER 1%
AZITHROMYCIN SUS 200/5ML
PREVIFEM TAB
RANITIDINE TAB 300MG
MORPHINE SUL TAB 15MG ER
DULOXETINE CAP 60MG
VERAPAMIL CAP 120MG SR
DILTIAZEM CAP 240MG ER
LIOTHYRONINE TAB 5MCG
GABAPENTIN TAB 800MG
LEFLUNOMIDE TAB 20MG
LOSARTAN POT TAB 100MG
FLUOROURACIL CRE 5%
MORPHINE SUL TAB 100MG ER
BUDESONIDE SUS 32MCG
DORYX
TAB 200MG
MINOCYCLINE CAP 100MG
LISINOPRIL TAB 40MG
PROGESTERONE CAP 100MG
TACROLIMUS OIN 0.1%
DEXMETHYLPHE CAP 10MG ER
CARTIA XT CAP 300/24HR
PAROXETINE TAB 20MG
METHYLPHENID CAP 60MG
SOTALOL HCL TAB 120MG
CITALOPRAM TAB 40MG
VALSART/HCTZ TAB 320-25MG
LIDOCAINE PAD 5%
FALMINA TAB
AZITHROMYCIN TAB 500MG
OXAPROZIN TAB 600MG
NIACIN ER TAB 1000MG
ACETYLCYST SOL 20%
ENALAPRIL TAB 10MG
SOTALOL HCL TAB 120MG
NISOLDIPINE TAB 17MG ER
GLIPIZIDE XL TAB 10MG
MINOCYCLINE TAB 100MG
ZOLPIDEM ER TAB 12.5MG
LEVETIRACETA TAB 500MG ER
ESTRADIOL DIS 0.025MG
SUMATRIPTAN TAB 50MG
SOTALOL HCL TAB 160MG
ERYTHROMYCIN GEL /BENZOYL
CLOBETASOL SPR 0.05%
PAROXETINE TAB 40MG
AMLOD/VALSAR TAB /HCTZ
VENLAFAXINE TAB 75MG
SERTRALINE TAB 100MG
ACETAZOLAMID TAB 250MG
VALACYCLOVIR TAB 500MG
RIZATRIPTAN TAB 10MG
PROPRANOLOL CAP 160MG ER
VALSARTAN TAB 320MG
53
6
6
41
47
10
175
22
8
4
11
16
71
12
18
350
3
6
82
44
75
58
7
20
16
18
20
15
41
10
10
13
2
79
74
33
7
7
13
146
4
8
200
11
5
34
192
4
4
4
65
10
4
26
7
23
3
10
132
8
36
3
32
3
31
73
8
22
25
9
6
1,740
720
640
2,436
4,110
812
20,402
696
720
300
108
1,380
1,310
720
3,480
59,850
686
600
2,452
2,968
9,150
3,629
570
2,010
1,440
3,442
3,450
1,020
3,465
400
600
112
60
4,230
6,510
1,282
270
240
1,050
12,195
240
1,320
17,400
990
245
2,464
967
720
360
1,200
6,495
1,200
360
3,510
600
750
1,200
192
1,158
1,200
1,678
375
2,985
270
3,773
6,570
1,410
826
288
810
540
$
$
$
$
$
$
$
$
$
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-
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$
$
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p. 129
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00406101001
42858080201
68180043501
59746033790
51991074890
00378306677
00781613957
00603576521
00093738598
42546001010
31722030201
68645048470
45802042237
00781282201
16729009010
65862052301
00603783188
00093717006
00378557393
67767020201
31722021405
00093081901
00378200593
00555077702
00955170210
00591278886
00093205506
68462050566
65162031684
13668021990
13668021890
00228299650
68180084613
00054001225
65862058701
16729002115
62037059890
68180051802
00378200493
43478024145
60505258008
68462031829
00591354601
13668012030
00555904558
60505014602
50111043401
64720013210
60505016809
00093714656
47335077991
45802056202
00555105786
00527132410
00472040394
59762500901
00781183001
55253080230
00378262510
45802046653
00603760817
00591246401
59762081101
68382031401
53746051105
00093550356
00472082902
49884040610
51991036378
64376065601
66993005702
OXYMORPHONE HYDROCHLORIDE
Y
MORPHINE SULFATE ER Y
GATIFLOXACIN
Y
LOSARTAN POTASSIUM/HYDROC
Y
DULOXETINE HCL
Y
FENOFIBRATE
Y
AMOXICILLIN/CLAVULANATE
Y P
SPIRONOLACTONE
Y
VENLAFAXINE HCL ER Y
BENZEPRO
Y
ALFUZOSIN HCL ER
Y
MONTELUKAST SODIUM Y
DESONIDE
Y
FLUOXETINE HCL
Y
FINASTERIDE
Y
GABAPENTIN
Y
TESTOSTERONE
M
CELECOXIB
Y
MODAFINIL
Y
METHYLPHENIDATE HCL ER
Y
SERTRALINE HCL
Y
NIFEDICAL XL
Y
PAROXETINE HCL ER
Y
AMPHETAMINE/DEXTROAMPHETA
Y
ZOLPIDEM TARTRATE ER Y
TIZANIDINE HCL
Y
TOLTERODINE TARTRATEY
FLUOCINONIDE
Y
LOMEDIA 24 FE
Y
ARIPIPRAZOLE
Y
ARIPIPRAZOLE
Y
TAMSULOSIN HCL
Y
DAYSEE
Y
FLECAINIDE ACETATE Y
AMLODIPINE BESYLATE/BENAZ
Y
PIOGLITAZONE HCL
Y
CARTIA XT
Y
LISINOPRIL/HYDROCHLOROTHI
Y
PAROXETINE HCL ER
Y
TRETINOIN
Y
ATORVASTATIN CALCIUMY
VIORELE
Y
BUTALBITAL/ASPIRIN/CAFFEI
Y
PIOGLITAZONE HCL
Y
AVIANE
Y
OMEPRAZOLE
Y
TRAZODONE HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
PRAVASTATIN SODIUM Y
AZITHROMYCIN
Y
AZELASTINE HCL
Y
CLINDAMYCIN PHOSPHATE
Y
CLARAVIS
Y
DIGOX
Y
CLOBETASOL PROPIONATE
Y
CLINDAMYCIN PHOSPHATE
Y
PROMETHAZINE HCL
Y
MODAFINIL
Y
AMITRIPTYLINE HCL
Y
ECONAZOLE NITRATE Y
GILDESS FE 1.5/30
Y
DESMOPRESSIN ACETATEY
NADOLOL
Y
DIVALPROEX SODIUM ERY
SPIRONOLACTONE
Y
OLANZAPINE/FLUOXETINE
Y
FLUOCINONIDE
Y
METOPROLOL SUCCINATE
Y ER
RIZATRIPTAN BENZOATE YODT
METHIMAZOLE
Y
HYDROXYCHLOROQUINEYSULFAT
OXYMORPHONE TAB HCL 10MG
MORPHINE SUL TAB 30MG ER
GATIFLOXACIN SOL 0.5%
LOSARTAN/HCT TAB 50-12.5
DULOXETINE CAP 60MG
FENOFIBRATE TAB 145MG
AMOX/K CLAV SUS 600/5ML
SPIRONOLACT TAB 100MG
VENLAFAXINE CAP 75MG ER
BENZEPRO AER 5.3%
ALFUZOSIN TAB 10MG
MONTELUKAST TAB 10MG
DESONIDE CRE 0.05%
FLUOXETINE CAP 20MG
FINASTERIDE TAB 5MG
GABAPENTIN TAB 600MG
TESTOSTERONE GEL 10MG/ACT
CELECOXIB CAP 400MG
MODAFINIL TAB 100MG
METHYLPHENID CAP 40MG ER
SERTRALINE TAB 100MG
NIFEDICAL XL TAB 30MG
PAROXETIN ER TAB 37.5MG
AMPHETAMINE TAB 15MG
ZOLPIDEM ER TAB 6.25MG
TIZANIDINE CAP 2MG
TOLTERODINE TAB 2MG
FLUOCINONIDE CRE 0.1%
LOMEDIA 24 TAB FE
ARIPIPRAZOLE TAB 15MG
ARIPIPRAZOLE TAB 10MG
TAMSULOSIN CAP 0.4MG
DAYSEE
TAB
FLECAINIDE TAB 150MG
AMLOD/BENAZP CAP 10-40MG
PIOGLITAZONE TAB 30MG
CARTIA XT CAP 180/24HR
LISINOP/HCTZ TAB 10-12.5
PAROXETINE TAB 25MG ER
TRETINOIN CRE 0.1%
ATORVASTATIN TAB 40MG
VIORELE TAB
BUT/ASA/CAF/ CAP COD 30MG
PIOGLITAZONE TAB 45MG
AVIANE
TAB
OMEPRAZOLE CAP 40MG
TRAZODONE TAB 100MG
AMPHETAMINE TAB 10MG
PRAVASTATIN TAB 10MG
AZITHROMYCIN TAB 250MG
AZELASTINE SPR 0.1%
CLINDAMYCIN SOL 1%
CLARAVIS CAP 40MG
DIGOX
TAB 0.125MG
CLOBETASOL SHA 0.05%
CLINDAMYCIN CRE 2% VAG
PROMETHAZINE TAB 25MG
MODAFINIL TAB 200MG
AMITRIPTYLIN TAB 25MG
ECONAZOLE CRE 1%
GILDESS FE TAB 1.5/30
DESMOPRESSIN TAB 0.1MG
NADOLOL TAB 40MG
DIVALPROEX TAB 250MG ER
SPIRONOLACT TAB 25MG
OLANZA/FLUOX CAP 3-25MG
FLUOCINONIDE SOL 0.05%
METOPROLOL TAB 100MG ER
RIZATRIPTAN TAB 10MG ODT
METHIMAZOLE TAB 10MG
HYDROXYCHLOR TAB 200MG
5
26
15
99
4
8
70
24
43
8
8
29
8
277
14
6
5
2
5
14
66
29
6
30
14
8
6
1
9
1
1
23
9
4
7
5
28
163
7
11
33
26
12
6
39
49
210
26
36
129
22
30
6
24
5
23
155
1
89
18
34
8
9
4
98
4
21
15
14
29
6
561
1,528
50
8,520
360
600
8,550
1,920
5,305
800
660
1,590
480
30,240
930
2,220
300
180
130
420
5,940
2,580
480
2,070
480
1,270
960
120
644
90
90
2,205
819
720
570
450
2,220
13,755
570
495
2,640
1,568
1,090
480
2,828
2,880
20,759
1,560
2,935
1,526
720
1,980
320
1,695
590
960
7,035
90
7,950
1,530
2,352
900
1,170
1,080
10,410
180
1,380
1,470
159
3,225
1,020
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
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-
p. 130
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00527135101
68462036105
59746033990
00591578701
00228202996
00093084092
00093117410
00245004115
49884040701
45802009828
00378181101
00093586201
52544014331
68308071510
23155014301
00378718705
55390016401
16729014701
00603634602
00115069250
45802002683
68462019790
53489011902
00378628110
67253038110
00378180910
00172409760
23155022701
66530026020
00172436560
50111043302
63323004401
51293080201
68462040467
49884041201
23155005519
68462012601
61748030413
66993041630
59762374401
00074304353
24208063110
00054004641
60505267109
00591090030
00555904358
62037083920
00093746556
00093735156
00378041501
00093517301
00378534001
68645048354
00591321272
00527163210
00378456105
68180040203
00591363560
00093585101
65162021250
00378181310
00378016789
00115053301
61314054701
00603576421
00378395377
00378023110
66435010216
60758011910
00093529801
00378581477
LEVOTHYROXINE SODIUM
Y
HYDROXYZINE HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
NORTRIPTYLINE HCL
Y
ALPRAZOLAM
Y
KETOCONAZOLE
Y
PENICILLIN V POTASSIUMY
KLOR-CON 10
Y
METOPROLOL SUCCINATE
Y ER
MESALAMINE
Y
LEVOTHYROXINE SODIUM
Y
OXYMORPHONE HYDROCHLORIDE
Y
TILIA FE
Y
DOXYCYCLINE HYCLATE DR
Y
DOXYCYCLINE HYCLATE DR
Y
METFORMIN HCL
Y
OCTREOTIDE ACETATE Y
QUETIAPINE FUMARATE Y
VALSARTAN/HYDROCHLOROTHIA
Y
ZOLMITRIPTAN ODT
Y
AZELASTINE HCL
Y
PRAVASTATIN SODIUM Y
DOXYCYCLINE HYCLATE Y
DICLOFENAC SODIUM DRY
DOXAZOSIN MESYLATE Y
LEVOTHYROXINE SODIUM
Y
BACLOFEN
Y
ACYCLOVIR
Y
TRETINOIN MICROSPHERE
Y
LABETALOL HCL
Y
TRAZODONE HCL
Y
CYANOCOBALAMIN
Y
PHENAZOPYRIDINE HCL Y
ATOVAQUONE/PROGUANIL
Y HCL
URSODIOL
Y
NARATRIPTAN HCL
Y
GABAPENTIN
Y
MYORISAN
Y
MONTELUKAST SODIUM Y
CLINDAMYCIN PHOSPHATE
Y
VICODIN ES
Y
NEOMYCIN/POLYMYXIN/HC
Y
IPRATROPIUM BROMIDEY
ATORVASTATIN CALCIUMY
GLIPIZIDE ER
Y
APRI
Y
ENOXAPARIN SODIUM Y
IRBESARTAN
Y
LANSOPRAZOLE
Y
DIPHENOXYLATE/ATROPINE
Y
NIFEDICAL XL
Y
DILTIAZEM HCL ER
Y
ATORVASTATIN CALCIUMY
FENTANYL
Y
TRIAMTERENE/HYDROCHLOROTH
Y
POTASSIUM CHLORIDE ERY
CEFPROZIL
Y
LEVETIRACETAM ER
Y
ESCITALOPRAM OXALATEY
PHENYTOIN SODIUM EXTENDED
Y
LEVOTHYROXINE SODIUM
Y
DOXYCYCLINE HYCLATE Y
FENOFIBRATE MICRONIZED
Y
LATANOPROST
Y
SPIRONOLACTONE
Y
ATORVASTATIN CALCIUMY
ATENOLOL
Y
RIBASPHERE
Y
PREDNISOLONE ACETATEY
METHYLPHENIDATE HCL CD
Y
VALSARTAN
Y
LEVOTHYROXIN TAB 200MCG
HYDROXYZ HCL TAB 25MG
LOSARTAN/HCT TAB 100-25
NORTRIPTYLIN CAP 25MG
ALPRAZOLAM TAB 0.5MG
KETOCONAZOLE CRE 2%
PENICILLN VK TAB 500MG
KLOR-CON 10 TAB 10MEQ ER
METOPROLOL TAB 200MG ER
MESALAMINE ENE 4GM
LEVOTHYROXIN TAB 112MCG
OXYMORPHONE TAB HCL 10MG
TILIA FE TAB
DOXYCYCL HYC TAB 150MG DR
DOXYCYCL HYC TAB 150MG DR
METFORMIN TAB 1000MG
OCTREOTIDE INJ 1000MCG
QUETIAPINE TAB 100MG
VALSART/HCTZ TAB 160-12.5
ZOLMITRIPTAN TAB 5MG
AZELASTINE SPR 0.15%
PRAVASTATIN TAB 40MG
DOXYCYCL HYC CAP 100MG
DICLOFENAC TAB 75MG DR
DOXAZOSIN TAB 2MG
LEVOTHYROXIN TAB 100MCG
BACLOFEN TAB 20MG
ACYCLOVIR TAB 400MG
TRETINOIN GEL 0.1%
LABETALOL TAB 200MG
TRAZODONE TAB 50MG
CYANOCOBALAM INJ 1000MCG
PHENAZOPYRID TAB 200MG
ATOVAQ/PROGU TAB 250-100
URSODIOL TAB 250MG
NARATRIPTAN TAB 2.5MG
GABAPENTIN TAB 600MG
MYORISAN CAP 40MG
MONTELUKAST GRA 4MG
CLINDAMYCIN LOT 10MG/ML
VICODIN ES TAB 7.5-300
NEO/POLY/HC SOL 1% OTIC
IPRATROPIUM SPR 0.06%
ATORVASTATIN TAB 80MG
GLIPIZIDE ER TAB 2.5MG
APRI
TAB
ENOXAPARIN INJ 30/0.3ML
IRBESARTAN TAB 150MG
LANSOPRAZOLE CAP 30MG DR
DIPHEN/ATROP TAB 2.5MG
NIFEDICAL XL TAB 60MG
DILTIAZEM CAP 240MG ER
ATORVASTATIN TAB 40MG
FENTANYL DIS 50MCG/HR
TRIAMT/HCTZ CAP 37.5-25
POT CHLORIDE TAB 10MEQ ER
CEFPROZIL SUS 250/5ML
LEVETIRACETA TAB 500MG ER
ESCITALOPRAM TAB 10MG
PHENYTOIN EX CAP 100MG
LEVOTHYROXIN TAB 125MCG
DOXYCYCL HYC TAB 100MG
FENOFIBRATE CAP 200MG
LATANOPROST SOL 0.005%
SPIRONOLACT TAB 50MG
ATORVASTATIN TAB 80MG
ATENOLOL TAB 50MG
RIBASPHERE TAB 200MG
PREDNISOLONE SUS 1% OP
METHYLPHENID CAP 40MG
VALSARTAN TAB 160MG
60
98
122
63
568
34
240
46
10
1
55
4
16
2
4
109
2
13
17
9
12
27
16
31
27
71
31
42
3
20
306
84
67
7
2
18
21
4
5
22
35
88
23
16
55
31
3
8
19
56
22
21
19
11
59
45
28
3
25
20
49
17
9
79
32
21
231
7
19
11
4
3,858
7,965
10,375
7,950
30,032
2,220
6,743
4,575
900
5,040
3,750
360
1,232
120
120
18,495
30
1,348
1,410
105
510
2,250
554
3,260
3,090
4,311
5,121
2,722
120
2,904
26,584
391
841
283
1,080
254
4,335
210
330
1,320
931
890
810
1,320
5,490
2,100
26
1,080
1,230
4,410
2,310
1,964
1,350
135
4,890
4,041
3,000
900
1,635
5,880
3,426
446
690
262
3,210
1,695
25,095
1,176
190
330
360
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
-
p. 131
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
53489011905
55111064505
68382060001
68462025301
00115123313
68645047754
16571021330
00093226401
55111057503
00093520006
00378501201
31722052590
00555088602
00591046005
00378730153
00093724706
60758088005
66685100101
49884040501
57237004230
68180075501
00378100501
00093208517
00713052612
00555905058
00378528001
51672129203
45802070002
45802005911
00054408425
00093226301
00781197301
62175031237
00054004544
00378117101
68180075901
00781632079
62037099901
68382013805
00591321372
68180077901
00591569550
00574011830
68180069806
00591553550
00378014889
00378181701
00378351105
00527132510
13668011890
68382013610
00781708055
00378385677
63304047901
62175013637
00574709012
00591288601
65862035705
00591363630
00115551110
00378117591
00093729605
50383026715
00378632277
65162110305
00781531601
52544093628
66685101202
60505265007
68382009601
49884046565
DOXYCYCLINE HYCLATE Y
OMEPRAZOLE
Y
POTASSIUM CHLORIDE ERY
ROPINIROLE HCL
Y
OXYMORPHONE HYDROCHLORIDE
Y
METOPROLOL SUCCINATE
Y ER
FLUCONAZOLE
Y
AMOXICILLIN
Y
IBANDRONATE SODIUM Y
BUSPIRONE HCL
Y
FELODIPINE ER
Y
FINASTERIDE
Y
ESTRADIOL
Y
GLIPIZIDE
Y
NORETHINDRONE ACETATE/ETH
Y
LAMOTRIGINE
Y
FLUOROMETHOLONE Y
AMOXICILLIN/CLAVULANATE
Y P
METOPROLOL SUCCINATE
Y ER
VALACYCLOVIR HCL
Y
AMLODIPINE BESYLATE/BENAZ
Y
AZATHIOPRINE
Y
TRIAMCINOLONE ACETONIDE
Y
PROMETHEGAN
Y
KARIVA
Y
DILTIAZEM HCL ER
Y
HYDROCORTISONE VALERATE
Y
TACROLIMUS
Y
NYSTATIN
Y
AZATHIOPRINE
Y
AMOXICILLIN
Y
DESIPRAMINE HCL
Y
METHYLPHENIDATE HCL ER
Y
IPRATROPIUM BROMIDEY
NADOLOL
Y
AMLODIPINE BESYLATE/BENAZ
Y
CALCITONIN-SALMON Y
POTASSIUM CHLORIDE ERY
TOPIRAMATE
Y
FENTANYL
Y
ZOLPIDEM TARTRATE ER Y
MINOCYCLINE HCL
Y
TROSPIUM CHLORIDE ERY
TRAMADOL HCL ER
Y
DOXYCYCLINE HYCLATE Y
DOXYCYCLINE HYCLATE Y
LEVOTHYROXINE SODIUM
Y
RISPERIDONE
Y
DIGOX
Y
LOSARTAN POTASSIUM/HYDROC
Y
LOSARTAN POTASSIUM Y
METRONIDAZOLE
Y
ESCITALOPRAM OXALATEY
CEVIMELINE HCL
Y
OMEPRAZOLE
Y
HYDROCORTISONE ACETATE
Y
VERAPAMIL HCL SR
Y
CLOPIDOGREL
Y
TROSPIUM CHLORIDE ERY
FENOFIBRATE
Y
BUSPIRONE HCL
Y
CARVEDILOL
Y
CLOBETASOL PROPIONATE
Y
VALSARTAN/HYDROCHLOROTHIA
Y
IBUPROFEN
Y
ZOLPIDEM TARTRATE ER Y
NECON 7/7/7
Y
AMOXICILLIN/CLAVULANATE
Y P
TIZANIDINE HCL
Y
HYDROXYCHLOROQUINEYSULFAT
CHOLESTYRAMINE
Y
DOXYCYCL HYC CAP 100MG
OMEPRAZOLE CAP 40MG
POT CHLORIDE TAB 10MEQ ER
ROPINIROLE TAB 0.25MG
OXYMORPHONE TAB 20MG ER
METOPROLOL TAB 25MG ER
FLUCONAZOLE TAB 200MG
AMOXICILLIN TAB 875MG
IBANDRONATE TAB 150MG
BUSPIRONE TAB 30MG
FELODIPINE TAB 5MG ER
FINASTERIDE TAB 5MG
ESTRADIOL TAB 1MG
GLIPIZIDE TAB 5MG
NORETH/ETHIN TAB FE 1/20
LAMOTRIGINE TAB 150MG
FLUOROMETHOL SUS 0.1% OP
AMOX/K CLAV TAB 875MG
METOPROLOL TAB 50MG ER
VALACYCLOVIR TAB 500MG
AMLOD/BENAZP CAP 2.5-10MG
AZATHIOPRINE TAB 50MG
TRIAMCINOLON AER 55MCG/AC
PROMETHEGAN SUP 25MG
KARIVA
TAB 28 DAY
DILTIAZEM CAP 180MG ER
HC VALERATE OIN 0.2%
TACROLIMUS OIN 0.1%
NYSTATIN CRE 100000
AZATHIOPRINE TAB 50MG
AMOXICILLIN TAB 500MG
DESIPRAMINE TAB 50MG
METHYLPHENID TAB 36MG ER
IPRATROPIUM SPR 0.03%
NADOLOL TAB 40MG
AMLOD/BENAZP CAP 5-40MG
CALCITONIN SPR 200/ACT
POT CL MICRO TAB 20MEQ ER
TOPIRAMATE TAB 25MG
FENTANYL DIS 75MCG/HR
ZOLPIDEM ER TAB 6.25MG
MINOCYCLINE CAP 100MG
TROSPIUM CHL CAP 60MG ER
TRAMADOL HCL TAB 200MG ER
DOXYCYCL HYC CAP 50MG
DOXYCYCL HYC CAP 100MG
LEVOTHYROXIN TAB 175MCG
RISPERIDONE TAB 1MG
DIGOX
TAB 0.25MG
LOSARTAN/HCT TAB 100-25
LOSARTAN POT TAB 50MG
METRONIDAZOL GEL 1%
ESCITALOPRAM TAB 10MG
CEVIMELINE CAP 30MG
OMEPRAZOLE CAP 40MG
HYDROCORT AC SUP 25MG
VERAPAMIL CAP 360MG SR
CLOPIDOGREL TAB 75MG
TROSPIUM CHL CAP 60MG ER
FENOFIBRATE TAB 54MG
BUSPIRONE TAB 30MG
CARVEDILOL TAB 25MG
CLOBETASOL CRE 0.05%
VALSART/HCTZ TAB 160-12.5
IBUPROFEN TAB 800MG
ZOLPIDEM ER TAB 12.5MG
NECON
TAB 7/7/7
AMOX/K CLAV SUS 400/5ML
TIZANIDINE CAP 6MG
HYDROXYCHLOR TAB 200MG
CHOLESTYRAM POW 4GM
11
26
26
18
5
10
13
320
7
6
15
14
202
162
7
60
24
66
19
17
14
15
21
21
12
17
4
2
65
9
213
4
11
28
9
6
12
21
118
8
13
84
3
10
23
13
50
48
21
47
54
7
12
3
23
17
10
16
3
28
3
58
22
10
232
13
24
54
3
13
8
444
1,440
3,821
1,549
300
2,190
561
6,413
17
840
1,800
1,059
17,375
26,431
532
5,355
140
1,264
2,040
1,010
1,020
3,060
380
268
1,008
1,920
420
200
2,340
2,430
5,614
720
360
1,380
840
540
67
3,372
18,569
80
390
5,015
300
300
1,220
488
2,916
4,720
1,590
3,990
4,440
385
1,177
630
1,530
327
900
1,320
270
2,400
540
10,680
585
960
16,221
570
1,792
7,600
450
1,680
780
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 132
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00603634802
31722023910
00378180501
67253038815
45802045384
68382007116
00378113201
00591329215
68462010340
45963074811
65862037401
59762839801
53746046505
51672404601
00054029513
55111061901
00781223431
66993040932
13668010401
49884001908
67767014130
10370010103
00378501301
00093736898
68462026001
63304045830
60505285001
00591024105
68180048103
16714022502
00378181110
68462047301
59762372802
42794001902
00115552202
00591084510
31722022505
00378180701
60505015701
62037086420
13273021003
00378453201
68382001014
66993012130
51672403201
00185041560
61314062810
00168020437
00115052201
00472103016
00378451893
24208063562
24208029005
68682051492
00378341201
00781560892
00093754356
00116200116
00093081955
43547027903
60505014600
62559015001
64679092603
68645045970
00591067601
00713050312
76204000324
54505010202
64980018601
00378699252
00591288401
VALSARTAN/HYDROCHLOROTHIA
Y
AMLODIPINE BESYLATE Y
LEVOTHYROXINE SODIUM
Y
DOXYCYCLINE HYCLATE Y
ADAPALENE
Y
PRAVASTATIN SODIUM Y
NADOLOL
Y
TELMISARTAN
Y
FLUCONAZOLE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
ESCITALOPRAM OXALATEY
VALACYCLOVIR HCL
Y
IBUPROFEN
Y
ENALAPRIL MALEATE/HYDROCH
Y
ALOSETRON HYDROCHLORIDE
Y
ESZOPICLONE
Y
OMEPRAZOLE
Y
CARBAMAZEPINE ER
Y
ISOSORBIDE MONONITRATE
Y ER
OMEGA-3-ACID ETHYL ESTERS
Y
BUPROPION HCL XL
Y
BUPROPION HCL XL
Y
FELODIPINE ER
Y
LOSARTAN POTASSIUM/HYDROC
Y
VERAPAMIL HCL ER
Y
ONDANSETRON HCL
Y
ALFUZOSIN HCL ER
Y
LORAZEPAM
Y
SIMVASTATIN
Y
LOSARTAN POTASSIUM/HYDROC
Y
LEVOTHYROXINE SODIUM
Y
URSODIOL
Y
CLINDAMYCIN PHOSPHATE
Y
LIOTHYRONINE SODIUM Y
FENOFIBRATE
Y
GLIPIZIDE ER
Y
GEMFIBROZIL
Y
LEVOTHYROXINE SODIUM
Y
BUPROPION HCL
Y
ENOXAPARIN SODIUM Y
SALSALATE
Y
DOXYCYCLINE HYCLATE DR
Y
LAMOTRIGINE
Y
TRANEXAMIC ACID
Y
WARFARIN SODIUM
Y
BUPROPION HCL SR
Y
POLYMYXIN B SULFATE/TRIME
Y
LIDOCAINE
Y
FENOFIBRATE MICRONIZED
Y
HYDROMET
Y
AMLODIPINE BESYLATE/ATORV
Y
NEOMYCIN/POLYMYXIN/HYDROC
Y
TOBRAMYCIN SULFATE Y
TRETINOIN MICROSPHERE
Y
BUPROPION HCL SR
Y
VALSARTAN
Y
DULOXETINE HCL
Y
CHLORHEXIDINE GLUCONATE
Y
NIFEDICAL XL
Y
IRBESARTAN
Y
OMEPRAZOLE
Y
ESTERIFIED ESTROGENS/METH
Y
ENALAPRIL MALEATE Y
ATORVASTATIN CALCIUMY
DICLOFENAC SODIUM ERY
ANUCORT-HC
Y
LEVALBUTEROL HCL
Y
EPINEPHRINE
M
GRISEOFULVIN MICROSIZE
Y
ALBUTEROL SULFATE Y
VERAPAMIL HCL SR
Y
VALSART/HCTZ TAB 320-12.5
AMLODIPINE TAB 10MG
LEVOTHYROXIN TAB 75MCG
DOXYCYCL HYC CAP 50MG
ADAPALENE CRE 0.1%
PRAVASTATIN TAB 20MG
NADOLOL TAB 80MG
TELMISARTAN TAB 20MG
FLUCONAZOLE TAB 150MG
AMPHETAMINE TAB 20MG
ESCITALOPRAM TAB 10MG
VALACYCLOVIR TAB 1GM
IBUPROFEN TAB 600MG
ENALAPR/HCTZ TAB 10-25MG
ALOSETRON TAB 0.5MG
ESZOPICLONE TAB 2MG
OMEPRAZOLE CAP 40MG
CARBAMAZEPIN CAP 300MG ER
ISOSORB MONO TAB 30MG ER
OMEGA-3-ACID CAP 1GM
BUPROPN HCL TAB 150MG XL
BUPROPN HCL TAB 150MG XL
FELODIPINE TAB 10MG ER
LOSARTAN/HCT TAB 100-25
VERAPAMIL TAB 240MG ER
ONDANSETRON TAB 4MG
ALFUZOSIN TAB 10MG
LORAZEPAM TAB 1MG
SIMVASTATIN TAB 80MG
LOSARTAN/HCT TAB 100-25
LEVOTHYROXIN TAB 112MCG
URSODIOL TAB 250MG
CLINDAMYCIN SOL 1%
LIOTHYRONINE TAB 25MCG
FENOFIBRATE TAB 160MG
GLIPIZIDE ER TAB 10MG
GEMFIBROZIL TAB 600MG
LEVOTHYROXIN TAB 88MCG
BUPROPION TAB 100MG
ENOXAPARIN INJ 120/0.8
SALSALATE TAB 750MG
DOXYCYCL HYC TAB 100MG DR
LAMOTRIGINE TAB 200MG
TRANEX ACID TAB 650MG
WARFARIN TAB 5MG
BUPROPION TAB 150MG SR
POLYMYXIN B/ SOL TRIMETHP
LIDOCAINE OIN 5%
FENOFIBRATE CAP 134MG
HYDROMET SYP 5-1.5/5
AMLOD/ATORVA TAB 10-20MG
NEO/POLY/HC SUS 1% OTIC
TOBRAMYCIN SOL 0.3% OP
TRETINOIN GEL 0.04%
BUPROPION TAB 150MG SR
VALSARTAN TAB 80MG
DULOXETINE CAP 30MG
CHLORHEX GLU SOL 0.12%
NIFEDICAL XL TAB 30MG
IRBESARTAN TAB 300MG
OMEPRAZOLE CAP 40MG
EST ESTROGEN TAB MTEST HS
ENALAPRIL TAB 20MG
ATORVASTATIN TAB 20MG
DICLOFENAC TAB 100MG ER
ANUCORT-HC SUP 25MG
LEVALBUTEROL NEB 1.25MG
EPINEPHRINE INJ 0.3MG
GRISEOFULVIN TAB MICR 500
ALBUTEROL NEB 1.25MG/3
VERAPAMIL CAP 240MG SR
15
109
59
21
8
30
5
4
142
33
25
4
340
18
1
11
33
7
58
3
11
17
8
20
22
231
6
311
44
23
37
5
25
16
22
19
38
62
18
3
4
1
54
10
101
29
111
11
12
45
2
73
164
6
27
6
6
347
13
6
28
9
33
22
26
11
6
2
5
30
16
1,350
9,390
3,756
990
360
2,460
450
360
355
1,290
1,395
360
17,126
1,710
60
330
1,230
900
3,741
750
1,155
1,320
720
1,680
1,640
3,050
480
18,185
3,840
1,770
3,090
720
1,560
1,596
1,980
2,700
6,030
3,480
2,370
19
780
180
5,070
300
7,470
3,360
1,110
744
960
9,189
180
730
880
120
3,510
360
420
168,395
1,350
540
1,290
450
4,020
1,260
1,895
229
1,008
8
186
4,125
1,380
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 133
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
55111015810
62756045788
59746038210
49884067314
55253080290
00378715001
62559015801
62175048737
00093545528
61314022505
00378290293
00093936401
00168016330
59746028101
43538060030
00185093998
65162005210
68180012202
00781268701
00378261001
68180088213
00378265010
68382000914
00378014101
00093743398
60505313501
64720013910
69238125108
59762500801
76439030810
68180015301
00527132601
45802060801
68180072210
65162064110
00052031510
65862059912
00713063337
00591578601
59746032430
62037083301
00781322464
49884051303
68462034305
13107004401
60951065370
60505530601
00378464326
64950023048
10888500602
65162070386
68382007216
00093304401
00555021110
00378181501
61314030802
43478024220
31722053401
68382003205
00555912366
63304058830
13668011630
57237001405
62037059790
60505257808
42546014516
00378039001
51672135304
65862053750
00406012501
51672126301
OMEPRAZOLE
Y
CARBIDOPA/LEVODOPA ER
Y
HYDROCHLOROTHIAZIDEY
CABERGOLINE
Y
MODAFINIL
Y
CELECOXIB
Y
FLUVOXAMINE MALEATEY
VERAPAMIL HCL ER
Y
MIMVEY
Y
TIMOLOL MALEATE OPHTHALMI
Y
TELMISARTAN/HYDROCHLOROTH
Y
GLYBURIDE
M
CLOBETASOL PROPIONATE
Y
ESCITALOPRAM OXALATEY
MORGIDOX 1X100MG Y
CHOLESTYRAMINE LIGHTY
CITALOPRAM HYDROBROMIDE
Y
CEPHALEXIN
Y
DEXMETHYLPHENIDATE HCL
Y ER
AMITRIPTYLINE HCL
Y
ENSKYCE
Y
AMITRIPTYLINE HCL
Y
LAMOTRIGINE
Y
SPIRONOLACTONE/HYDROCHLOR
Y
VALSARTAN
Y
QUETIAPINE FUMARATE Y
METHENAMINE HIPPURATE
Y
LOPREEZA
Y
MISOPROSTOL
Y
HYOSCYAMINE SULFATE Y
DESLORATADINE
Y
URSODIOL
Y
CALCITRIOL
M
CEFDINIR
Y
FLECAINIDE ACETATE Y
PREGNYL W/DILUENT BENZYL
Y
RIZATRIPTAN BENZOATE Y
METRONIDAZOLE
Y
NORTRIPTYLINE HCL
Y
VALACYCLOVIR HCL
Y
METOPROLOL SUCCINATE
Y ER
ENOXAPARIN SODIUM Y
MINOCYCLINE HCL
Y
HYDRALAZINE HCL
Y
OXYCODONE/ACETAMINOPHEN
Y
MORPHINE SULFATE ER Y
ACYCLOVIR
Y
ESTRADIOL
Y
NYSTATIN
Y
AMANTADINE HCL
Y
FLUOCINOLONE ACETONIDE
Y SC
PRAVASTATIN SODIUM Y
VERAPAMIL HCL ER
Y
NORETHINDRONE ACETATE
Y
LEVOTHYROXINE SODIUM
Y
AZELASTINE HCL
Y
TRETINOIN
Y
METHOCARBAMOL
Y
DIVALPROEX SODIUM DRY
JOLESSA
Y
AMLODIPINE BESYLATE/ATORV
Y
LOSARTAN POTASSIUM/HYDROC
Y
TAMSULOSIN HCL
Y
CARTIA XT
Y
ATORVASTATIN CALCIUMY
PR BENZOYL PEROXIDE WASH
Y
NIFEDIPINE ER
Y
FLUOCINONIDE
Y
LEVOFLOXACIN
Y
HYDROCODONE/ACETAMINOPHEN
Y
NYSTATIN/TRIAMCINOLONE
Y
OMEPRAZOLE CAP 20MG
CARB/LEVO ER TAB 50-200MG
HYDROCHLOROT CAP 12.5MG
CABERGOLINE TAB 0.5MG
MODAFINIL TAB 200MG
CELECOXIB CAP 200MG
FLUVOXAMINE TAB 25MG
VERAPAMIL CAP 300MG ER
MIMVEY
TAB 1-0.5MG
TIMOLOL GEL SOL 0.5% OP
TELMISA/HCTZ TAB 80-12.5
GLYBURIDE TAB 5MG
CLOBETASOL CRE 0.05%
ESCITALOPRAM TAB 20MG
MORGIDOX CAP 1X100MG
CHOLESTYRAM POW 4GM LITE
CITALOPRAM TAB 10MG
CEPHALEXIN CAP 500MG
DEXMETHYLPH CAP 30MG ER
AMITRIPTYLIN TAB 10MG
ENSKYCE TAB
AMITRIPTYLIN TAB 50MG
LAMOTRIGINE TAB 150MG
SPIRONO/HCTZ TAB 25/25
VALSARTAN TAB 160MG
QUETIAPINE TAB 200MG
METHENAM HIP TAB 1GM
LOPREEZA TAB 1-0.5MG
MISOPROSTOL TAB 200MCG
HYOSCYAMINE TAB 0.125MG
DESLORATADIN TAB 5MG
URSODIOL CAP 300MG
CALCITRIOL OIN 3MCG/GM
CEFDINIR SUS 125/5ML
FLECAINIDE TAB 50MG
PREGNYL INJ 10000UNT
RIZATRIPTAN TAB 5MG
METRONIDAZOL CRE 0.75%
NORTRIPTYLIN CAP 10MG
VALACYCLOVIR TAB 500MG
METOPROLOL TAB 200MG ER
ENOXAPARIN INJ 40/0.4ML
MINOCYCLINE TAB 100MG
HYDRALAZINE TAB 50MG
OXYCOD/APAP TAB 5-325MG
MORPHINE SUL TAB 30MG ER
ACYCLOVIR TAB 400MG
ESTRADIOL DIS 0.0375MG
NYSTATIN SUS 100000
AMANTADINE CAP 100MG
FLUOCIN ACET OIL SCALP
PRAVASTATIN TAB 40MG
VERAPAMIL TAB 180MG ER
NORETHIN ACE TAB 5MG
LEVOTHYROXIN TAB 150MCG
AZELASTINE DRO 0.05%
TRETINOIN CRE 0.05%
METHOCARBAM TAB 750MG
DIVALPROEX TAB 250MG DR
JOLESSA TAB
AMLOD/ATORVA TAB 5-20MG
LOSARTAN/HCT TAB 50-12.5
TAMSULOSIN CAP 0.4MG
CARTIA XT CAP 120/24HR
ATORVASTATIN TAB 10MG
PR BENZOYL LIQ 7% WASH
NIFEDIPINE TAB 90MG ER
FLUOCINONIDE CRE 0.1%
LEVOFLOXACIN TAB 500MG
HYDROCO/APAP TAB 10-325MG
NYSTAT/TRIAM CRE
36
4
121
2
1
3
12
6
4
12
3
41
10
9
4
6
117
251
7
100
30
38
36
19
3
9
11
4
65
22
12
2
2
29
9
12
7
10
58
19
8
4
6
20
146
23
29
5
52
7
7
14
26
9
52
25
16
89
11
12
2
27
16
19
31
8
6
1
50
78
12
3,225
1,872
9,605
72
60
270
1,830
480
336
65
270
7,920
390
885
120
596
8,310
7,320
210
10,570
1,792
4,200
4,326
1,800
270
674
780
336
1,472
1,458
360
360
200
3,100
1,260
17
117
450
10,337
517
720
25
360
3,570
5,695
1,379
2,008
120
9,016
800
828
1,260
2,520
702
2,880
150
360
5,363
2,550
1,092
180
2,190
1,650
1,800
2,730
3,784
540
120
442
5,589
345
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
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$
$
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-
p. 134
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
57664047758
55111046801
67767020001
00093894701
00093738698
00406012701
00093065701
00093735505
44523055008
67253001106
00228253910
00603389028
60505280607
67877010601
00185011701
50383092493
13107007301
00781268201
16252057250
00591521505
00378025301
00378181301
00378464126
45963034302
45802046564
00093721401
24658031205
60505395203
00555101116
68462033290
60505015801
00378182301
00378114501
62037083110
00378773293
10572030201
00378013701
64376064301
10370017611
67767014230
69007082230
59762503001
00955101510
67767020101
55111013781
68180022301
00093722398
62175027137
00378180301
66993066405
16729014601
00093745701
66685100200
00574019451
51672127304
00603107558
00378135505
68180032201
00378827052
68382006710
51672404003
64376064901
67877024801
61314001505
00185041060
00378505001
67877010501
55111072530
68645045870
57664022488
68382024701
METOPROLOL TARTRATEY
METOPROLOL SUCCINATE
Y ER
METHYLPHENIDATE HCL ER
Y
ACYCLOVIR
Y
VENLAFAXINE HCL ER Y
METHYLPHENIDATE HCL ER
Y
CALCITRIOL
Y
FINASTERIDE
Y
SODIUM SULFACETAMIDE/SULF
Y
CEFDINIR
Y
CARBIDOPA/LEVODOPA Y
HYDROCODONE/ACETAMINOPHEN
Y
CARBAMAZEPINE ER
Y
BENZONATATE
Y
LABETALOL HCL
Y
BUPRENORPHINE HCL Y
AMPHETAMINE/DEXTROAMPHETA
Y
DEXMETHYLPHENIDATE HCL
Y
RAMIPRIL
Y
METRONIDAZOLE
Y
ACYCLOVIR
Y
LEVOTHYROXINE SODIUM
Y
ESTRADIOL
Y
DESIPRAMINE HCL
Y
KETOCONAZOLE
Y
METFORMIN HCL
Y
DOXYCYCLINE HYCLATE Y
OMEPRAZOLE
Y
CLONIDINE HCL
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
BUPROPION HCL
Y
LEVOTHYROXINE SODIUM
Y
BUSPIRONE HCL
Y
METOPROLOL SUCCINATE
Y ER
ONDANSETRON ODT
Y
PEG-3350/NACL/NA BICARBON
Y
ALLOPURINOL
Y
HYDROCODONE BITARTRATE/AC
Y
FLUVOXAMINE MALEATEYER
BUPROPION HCL XL
Y
DOXYCYCLINE
M
FLUCONAZOLE
Y
ENOXAPARIN SODIUM Y
METHYLPHENIDATE HCL ER
Y
ZENATANE
Y
NIACIN ER
Y
FOSINOPRIL SODIUM Y
OXYBUTYNIN CHLORIDE ER
Y
LEVOTHYROXINE SODIUM
Y
DULOXETINE HCL
Y
QUETIAPINE FUMARATE Y
GLIPIZIDE/METFORMIN HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
VITAMIN D
Y
FLUOCINONIDE
Y
CHERATUSSIN AC
Y
TRIAMTERENE/HYDROCHLOROTH
Y
ESZOPICLONE
Y
ALBUTEROL SULFATE Y
SIMVASTATIN
Y
ENALAPRIL MALEATE Y
HYDROCODONE BITARTRATE/AC
Y
QUETIAPINE FUMARATE Y
OFLOXACIN
Y
BUPROPION HCL SR
Y
TEMAZEPAM
Y
BENZONATATE
Y
MONTELUKAST SODIUM Y
ATORVASTATIN CALCIUMY
OXYCODONE HCL
Y
BENZONATATE
Y
METOPROL TAR TAB 50MG
METOPROLOL TAB 100MG ER
METHYLPHENID CAP 20MG ER
ACYCLOVIR TAB 800MG
VENLAFAXINE CAP 150MG ER
METHYLPHENID TAB 27MG ER
CALCITRIOL CAP 0.25MCG
FINASTERIDE TAB 5MG
SOD SUL/SULF LIQ 10-2%
CEFDINIR CAP 300MG
CARB/LEVO TAB 25-100MG
HYDROCO/APAP TAB 5-325MG
CARBAMAZEPIN CAP 200MG ER
BENZONATATE CAP 200MG
LABETALOL TAB 200MG
BUPRENORPHIN SUB 2MG
AMPHETAMINE TAB 20MG
DEXMETHYLPHE CAP 5MG
RAMIPRIL CAP 5MG
METRONIDAZOL TAB 500MG
ACYCLOVIR TAB 400MG
LEVOTHYROXIN TAB 125MCG
ESTRADIOL DIS 0.075MG
DESIPRAMINE TAB 50MG
KETOCONAZOLE SHA 2%
METFORMIN TAB 1000MG
DOXYCYCL HYC TAB 100MG
OMEPRAZOLE CAP 20MG
CLONIDINE DIS 0.3/24HR
PRAMIPEXOLE TAB 0.5MG
BUPROPION TAB 75MG
LEVOTHYROXIN TAB 137MCG
BUSPIRONE TAB 7.5MG
METOPROLOL TAB 50MG ER
ONDANSETRON TAB 4MG ODT
PEG-3350/KCL SOL /SODIUM
ALLOPURINOL TAB 100MG
HYDROCO/APAP TAB 10-300MG
FLUVOXAMINE CAP 150MG ER
BUPROPN HCL TAB 300MG XL
DOXYCYCLINE CAP 40MG
FLUCONAZOLE SUS 40MG/ML
ENOXAPARIN INJ 150MG/ML
METHYLPHENID CAP 30MG ER
ZENATANE CAP 40MG
NIACIN ER TAB 1000MG
FOSINOPRIL TAB 20MG
OXYBUTYNIN TAB 10MG ER
LEVOTHYROXIN TAB 50MCG
DULOXETINE CAP 60MG
QUETIAPINE TAB 50MG
GLIP/METFORM TAB 5-500MG
AMOX/K CLAV TAB 500MG
VITAMIN D CAP 50000UNT
FLUOCINONIDE SOL 0.05%
CHERATUSSIN SYP AC
TRIAMT/HCTZ TAB 75-50MG
ESZOPICLONE TAB 1MG
ALBUTEROL NEB 0.083%
SIMVASTATIN TAB 20MG
ENALAPRIL TAB 20MG
HYDROCO/APAP TAB 7.5-300
QUETIAPINE TAB 400MG
OFLOXACIN DRO 0.3%OTIC
BUPROPION TAB 100MG SR
TEMAZEPAM CAP 30MG
BENZONATATE CAP 100MG
MONTELUKAST TAB 10MG
ATORVASTATIN TAB 10MG
OXYCODONE TAB 30MG
BENZONATATE CAP 100MG
117
10
9
88
30
7
27
8
3
23
16
147
3
211
8
6
17
4
20
130
14
39
6
6
82
63
7
55
2
17
21
45
9
18
87
71
125
5
1
7
2
23
1
9
3
3
12
8
61
10
6
9
40
133
8
138
96
5
86
85
22
27
3
51
15
226
168
8
15
10
116
18,891
1,020
300
3,782
2,955
270
1,636
720
681
458
4,860
4,654
900
6,046
1,590
560
1,140
157
1,680
2,560
1,605
2,475
112
540
10,200
10,485
337
2,800
24
1,395
2,265
2,670
1,380
1,560
1,149
288,000
11,795
688
180
630
60
1,540
14
270
90
210
1,800
460
3,135
990
435
2,115
1,041
1,362
720
21,189
7,734
318
13,377
7,470
2,790
745
270
380
1,650
7,898
5,942
600
1,230
1,590
4,269
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
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-
p. 135
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00406324901
00093753656
00591376830
66530025745
16714036004
00603763449
52544095328
76204060012
51672127001
00115133001
55111068405
51672127201
00093504906
00093026492
49884046566
62037069930
00472038245
00074304313
68180051202
00185014001
17478071310
00115132901
52544095121
42192015101
00781140797
62559015901
16714032101
00168016315
00781613948
68180059101
50383080416
60432006500
29300012810
16714034804
57237010401
61442011301
00093205801
55111034101
00093189301
57664014134
54295030720
00378661001
68180072220
68462038829
00378336099
00228299611
00574200802
10370051150
61314064710
65162019050
00143988775
23155024546
62175049064
68462056417
51672128202
00168043224
51672411806
00378180901
00054034807
00555901058
00406907576
62175044601
68462013001
00472390160
59762033302
68462012705
68180051901
51672126303
13107007001
00115148361
52565001259
HYDROMORPHONE HCL Y
ANASTROZOLE
Y
BUDESONIDE
Y
TRETINOIN
Y
MONO-LINYAH
Y
ORSYTHIA
Y
ZENCHENT
Y
IPRATROPIUM BROMIDE/ALBUT
Y
DESOXIMETASONE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
IBUPROFEN
Y
NYSTATIN/TRIAMCINOLONE
Y
PIOGLITAZONE HCL/METFORMI
Y
FLUOCINONIDE
Y
CHOLESTYRAMINE
Y
TAZTIA XT
Y
AUGMENTED BETAMETHASONE
Y
D
VICODIN ES
Y
LISINOPRIL
Y
ETODOLAC
Y
OFLOXACIN
Y
AMPHETAMINE/DEXTROAMPHETA
Y
MICROGESTIN 1.5/30 Y
HYDROQUINONE
Y
HYDROXYCHLOROQUINEYSULFAT
FLUVOXAMINE MALEATEY
LEFLUNOMIDE
Y
CLOBETASOL PROPIONATE
Y
AMOXICILLIN/CLAVULANATE
Y P
RAMIPRIL
Y
PROMETHAZINE/CODEINE
Y
AMOXICILLIN/CLAVULANATE
Y P
HYDROCHLOROTHIAZIDEY
DASETTA 1/35
Y
DOXYCYCLINE HYCLATE Y
ACYCLOVIR
Y
NIFEDIPINE ER
Y
AMLODIPINE BESYLATE/BENAZ
Y
ETODOLAC
Y
RANITIDINE HCL
Y
SODIUM SULFACETAMIDE/SULF
Y
OXYBUTYNIN CHLORIDE ER
Y
CEFDINIR
Y
MARLISSA
Y
ESTRADIOL
Y
TAMSULOSIN HCL
Y
NYSTOP
Y
DIVALPROEX SODIUM ERY
TOBRAMYCIN/DEXAMETHASONE
Y
NAPROXEN
Y
AMOXICILLIN
Y
RIZATRIPTAN BENZOATE Y
HYDROCODONE POLISTIREX/CH
Y
MUPIROCIN
Y
TRIAMCINOLONE ACETONIDE
Y
IMIQUIMOD
Y
FLUOROURACIL
Y
LEVOTHYROXINE SODIUM
Y
TINIDAZOLE
Y
NORTREL 1/35
Y
FENTANYL
Y
PEG 3350/ELECTROLYTESY
ZONISAMIDE
Y
FLUOCINONIDE
Y
LATANOPROST
Y
GABAPENTIN
Y
LISINOPRIL/HYDROCHLOROTHI
Y
NYSTATIN/TRIAMCINOLONE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
DICLOFENAC SODIUM Y
FLUOCINOLONE ACETONIDE
Y
HYDROMORPHON TAB 8MG
ANASTROZOLE TAB 1MG
BUDESONIDE SUS 0.5MG/2
TRETINOIN GEL 0.025%
MONO-LINYAH TAB 0.25-35
ORSYTHIA TAB
ZENCHENT TAB
IPRATROPIUM/ SOL ALBUTER
DESOXIMETAS CRE 0.25%
AMPHETAMINE CAP 15MG ER
IBUPROFEN TAB 800MG
NYSTAT/TRIAM OIN
PIOGLITA/MET TAB 15-500MG
FLUOCINONIDE OIN 0.05%
CHOLESTYRAM POW 4GM
TAZTIA XT CAP 300MG/24
AUG BETAMET OIN 0.05%
VICODIN ES TAB 7.5-300
LISINOPRIL TAB 2.5MG
ETODOLAC TAB 400MG
OFLOXACIN DRO 0.3% OP
AMPHETAMINE CAP 10MG ER
MICROGESTIN TAB 1.5/30
HYDROQUINONE CRE 4%
HYDROXYCHLOR TAB 200MG
FLUVOXAMINE TAB 50MG
LEFLUNOMIDE TAB 10MG
CLOBETASOL CRE 0.05%
AMOX/K CLAV SUS 600/5ML
RAMIPRIL CAP 10MG
PROMETH/COD SYP 6.25-10
AMOX/K CLAV SUS 250/5ML
HYDROCHLOROT TAB 25MG
DASETTA TAB 1/35
DOXYCYCL HYC CAP 100MG
ACYCLOVIR TAB 800MG
NIFEDIPINE TAB 60MG ER
AMLOD/BENAZP CAP 10-20MG
ETODOLAC TAB 500MG
RANITIDINE SYP 75MG/5ML
SOD SUL/SULF EMU 10-5%
OXYBUTYNIN TAB 10MG ER
CEFDINIR SUS 125/5ML
MARLISSA TAB 0.15/30
ESTRADIOL DIS 0.0375MG
TAMSULOSIN CAP 0.4MG
NYSTOP
POW 100000
DIVALPROEX TAB 500MG ER
TOBRA/DEXAME SUS 0.3-0.1%
NAPROXEN TAB 500MG
AMOXICILLIN SUS 400/5ML
RIZATRIPTAN TAB 10MG
HYD POL/CPM LIQ 10-8/5ML
MUPIROCIN CRE 2%
TRIAMCINOLON CRE 0.1%
IMIQUIMOD CRE 5%
FLUOROURACIL CRE 5%
LEVOTHYROXIN TAB 100MCG
TINIDAZOLE TAB 500MG
NORTREL TAB 1/35
FENTANYL DIS 75MCG/HR
PEG 3350 SOL ELECTROL
ZONISAMIDE CAP 100MG
FLUOCINONIDE CRE 0.05%
LATANOPROST SOL 0.005%
GABAPENTIN TAB 800MG
LISINOP/HCTZ TAB 20-12.5
NYSTAT/TRIAM CRE
AMPHETAMINE TAB 10MG
DICLOFENAC GEL 3%
FLUOCIN ACET SOL 0.01%
19
24
3
7
26
26
13
19
5
8
184
2
2
15
2
8
8
31
169
5
60
8
21
19
5
8
1
9
25
12
283
13
476
18
9
17
13
6
12
70
14
7
42
17
4
10
18
5
5
265
212
13
17
13
119
8
5
53
5
29
6
103
17
25
45
7
78
6
23
1
9
1,716
1,202
300
315
1,624
1,680
980
8,280
585
277
11,310
180
360
900
5,292
600
450
715
14,827
1,200
310
240
1,197
539
780
655
90
300
5,125
1,560
49,517
1,900
40,266
1,456
380
940
960
480
1,104
14,831
4,760
450
2,640
1,260
48
1,260
1,080
390
50
16,327
30,075
126
2,020
270
4,650
110
200
2,802
166
2,156
60
412,000
3,240
1,740
182
1,560
7,860
360
1,140
100
600
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 136
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
51672134004
61314014410
60505367503
65862047030
00093075501
59746017310
66993021019
16729002010
00228202796
68462019605
00378616693
54458094808
00406036505
51862055806
00781312293
00378350505
31722022201
00591356115
00603465402
67877023022
43199001401
49884057511
00378049401
00115544513
68180035209
65862019901
50383093355
57664037188
00406114401
60505351706
43547027909
00093555101
47781020404
00781285505
49884092202
00378180001
00555904958
59762496001
13925050604
68382010601
45802002801
00603258232
00378426056
68180021706
31722052630
41616075983
00378191210
16729002015
00378616993
00527131530
00555901258
68462022401
00228249710
67253001342
00228326306
00228289006
68645046054
00406012401
00781652486
00228203150
00603233832
00378191010
00713013512
00591578901
00172409780
55111013001
65162050609
00378170001
52565002230
00378043401
60505006501
AUGMENTED BETAMETHASONE
Y
D
BRIMONIDINE TARTRATEY
PAROXETINE HCL ER
Y
LOSARTAN POTASSIUM/HYDROC
Y
DIFLUNISAL
Y
PREDNISONE
Y
VANCOMYCIN HCL
Y
PIOGLITAZONE HCL
Y
ALPRAZOLAM
Y
PRAVASTATIN SODIUM Y
AMLODIPINE BESYLATE/ATORV
Y
NIFEDIPINE ER
Y
HYDROCODONE/ACETAMINOPHEN
Y
DORYX
M
ENOXAPARIN SODIUM Y
RISPERIDONE
Y
GABAPENTIN
Y
VANCOMYCIN HCL
Y
MONTELUKAST SODIUM Y
MYCOPHENOLATE MOFETIL
Y
HYOSCYAMINE SULFATE YER
AMLODIPINE BESYLATE/VALSA
Y
NIFEDIPINE ER
Y
BUPROPION HCL SR
Y
SERTRALINE HCL
Y
GABAPENTIN
Y
LIDOCAINE
Y
OXYCODONE HCL
Y
METHYLPHENIDATE HCL Y
LEVETIRACETAM ER
Y
IRBESARTAN
Y
DEXMETHYLPHENIDATE HCL
Y
ESTRADIOL
Y
RANITIDINE HCL
Y
MERCAPTOPURINE
Y
LEVOTHYROXINE SODIUM
Y
CRYSELLE-28
Y
SERTRALINE HCL
Y
FLUOCINOLONE ACETONIDE
Y BO
DIVALPROEX SODIUM Y
OLOPATADINE HCL
Y
CARISOPRODOL
Y
ZOLMITRIPTAN
Y
LOSARTAN POTASSIUM/HYDROC
Y
FINASTERIDE
Y
VENLAFAXINE HCL ER Y
CLONAZEPAM
Y
PIOGLITAZONE HCL
Y
AMLODIPINE BESYLATE/ATORV
Y
RIFAMPIN
Y
NORTREL 7/7/7
Y
LITHIUM CARBONATE ERY
NIFEDIPINE
Y
CEFDINIR
Y
OXYMORPHONE HYDROCHLORIDE
Y
DULOXETINE HCL
Y
ATORVASTATIN CALCIUMY
HYDROCODONE/ACETAMINOPHEN
Y
SUMATRIPTAN
M
ALPRAZOLAM
Y
ACETAMINOPHEN/CODEINE
Y #3
CLONAZEPAM
Y
PROCHLORPERAZINE
Y
NORTRIPTYLINE HCL
Y
BACLOFEN
Y
RANITIDINE HCL
Y
INDOMETHACIN ER
Y
NITROFURANTOIN MACROCRYST
Y
ECONAZOLE NITRATE Y
METOPROLOL/HYDROCHLOROTHI
Y
OMEPRAZOLE
Y
AUG BETAMET LOT 0.05%
BRIMONIDINE SOL 0.15%
PAROXETIN ER TAB 37.5MG
LOSARTAN/HCT TAB 100-25
DIFLUNISAL TAB 500MG
PREDNISONE TAB 10MG
VANCOMYCIN CAP 125MG
PIOGLITAZONE TAB 15MG
ALPRAZOLAM TAB 0.25MG
PRAVASTATIN TAB 20MG
AMLOD/ATORVA TAB 5-40MG
NIFEDIPINE TAB 60MG ER
HYDROCO/APAP TAB 5-325MG
DORYX
TAB 200MG
ENOXAPARIN INJ 300/3ML
RISPERIDONE TAB 0.5MG
GABAPENTIN CAP 300MG
VANCOMYCIN CAP 250MG
MONTELUKAST CHW 5MG
MYCOPHENOLAT SUS 200MG/ML
HYOSCYAMINE TAB 0.375 ER
AMLOD/VALSAR TAB 10-160MG
NIFEDIPINE TAB 90MG ER
BUPROPION TAB 200MG SR
SERTRALINE TAB 50MG
GABAPENTIN CAP 300MG
LIDOCAINE OIN 5%
OXYCODONE TAB 20MG
METHYLPHENID TAB 10MG
LEVETIRACETA TAB 750MG ER
IRBESARTAN TAB 300MG
DEXMETHYLPHE CAP 10MG
ESTRADIOL DIS 0.025MG
RANITIDINE CAP 150MG
MERCAPTOPUR TAB 50MG
LEVOTHYROXIN TAB 25MCG
CRYSELLE-28 TAB 28 TABS
SERTRALINE TAB 25MG
FLUOCIN ACET OIL BODY
DIVALPROEX CAP 125MG
OLOPATADINE SPR 0.6%
CARISOPRODOL TAB 350MG
ZOLMITRIPTAN TAB 2.5MG
LOSARTAN/HCT TAB 100-25
FINASTERIDE TAB 1MG
VENLAFAXINE TAB 75MG ER
CLONAZEPAM TAB 1MG
PIOGLITAZONE TAB 15MG
AMLOD/ATORVA TAB 10-20MG
RIFAMPIN CAP 300MG
NORTREL TAB 7/7/7
LITHIUM CARB TAB 450MG ER
NIFEDIPINE CAP 10MG
CEFDINIR SUS 250/5ML
OXYMORPHONE TAB 30MG ER
DULOXETINE CAP 20MG
ATORVASTATIN TAB 40MG
HYDROCO/APAP TAB 7.5-325
SUMATRIPTAN SPR 5MG/ACT
ALPRAZOLAM TAB 1MG
APAP/CODEINE TAB 300-30MG
CLONAZEPAM TAB 0.5MG
PROCHLORPER SUP 25MG
NORTRIPTYLIN CAP 75MG
BACLOFEN TAB 20MG
RANITIDINE CAP 300MG
INDOMETHACIN CAP 75MG ER
NITROFUR MAC CAP 100MG
ECONAZOLE CRE 1%
METOPRL/HCTZ TAB 100-25MG
OMEPRAZOLE CAP 20MG
10
5
4
16
6
266
1
5
339
26
2
6
86
1
3
26
35
1
13
1
8
3
7
3
70
46
3
5
14
2
3
4
7
18
8
75
18
92
6
7
4
82
5
13
10
8
205
5
2
10
18
28
9
11
2
2
12
81
4
297
266
279
14
13
17
8
9
29
14
6
45
600
50
360
1,380
720
7,653
56
450
16,202
2,040
180
660
3,213
30
18
2,625
8,040
30
690
160
900
210
630
540
4,980
8,580
400
1,800
1,590
540
270
120
68
1,251
540
3,270
1,288
7,049
710
1,170
122
7,007
54
1,110
420
540
14,891
450
180
578
1,512
2,982
1,300
1,200
120
210
900
4,181
24
18,302
6,927
19,904
156
1,470
3,225
660
630
612
600
630
4,305
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 137
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00168016230
45963074511
00406036501
24208043405
68180065701
00378479106
00093423401
00555097102
45802006405
00115351101
00378911998
00603634502
00591078001
67767014205
00378527201
00378043301
00781575631
00115681108
13668013401
62175018146
00093003901
61314063715
29300011316
00781217660
45802096126
66530025320
68180048002
00603389121
00093013505
00472080302
00093777201
64376064016
61314001510
00591544305
00603258221
00406114601
65862003099
55111017915
66993007730
60505001606
00591367001
65862052401
00555088702
53746061705
62756001640
24208046325
00115133201
55111046601
00378009401
65862014905
00591040905
00093084030
45802011222
57664074588
60432013350
67253039150
68645048654
50383090110
00185012201
00378165001
00378581377
68462040355
65862014836
68382024801
49884012301
68462030529
60758088010
59746033490
00093737201
00185027701
00603221332
CLOBETASOL PROPIONATE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
HYDROCODONE/ACETAMINOPHEN
Y
OFLOXACIN
Y
DOXYCYCLINE
Y
FLUOROURACIL
Y
BUMETANIDE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
TRIAMCINOLONE ACETONIDE
Y
PYRIDOSTIGMINE BROMIDE
Y
FENTANYL
Y
VALSARTAN/HYDROCHLOROTHIA
Y
SUCRALFATE
Y
BUPROPION HCL XL
Y
ESZOPICLONE
Y
BUPROPION HCL
Y
AMLODIPINE/VALSARTAN/HCTZ
Y
BUPROPION HCL XL
Y
FELODIPINE ER
Y
PANTOPRAZOLE SODIUMY
LAMOTRIGINE
Y
PREDNISOLONE ACETATEY
LAMOTRIGINE
Y
CEFDINIR
Y
CLOBETASOL PROPIONATE
Y
TRETINOIN
Y
SIMVASTATIN
Y
HYDROCODONE/ACETAMINOPHEN
Y
CARVEDILOL
Y
DESONIDE
Y
CLOZAPINE
Y
HYDROCODONE BITARTRATE/AC
Y
OFLOXACIN
Y
PREDNISONE
Y
CARISOPRODOL
Y
METHYLPHENIDATE HCL Y
GLYBURIDE
Y
TIZANIDINE HCL
Y
DULOXETINE HCL
Y
DILT-XR
Y
NABUMETONE
Y
GABAPENTIN
Y
ESTRADIOL
Y
TRAMADOL HYDROCHLORIDE/AC
Y
TESTOSTERONE CYPIONATE
Y
LATANOPROST
Y
AMPHETAMINE/DEXTROAMPHETA
Y
METOPROLOL SUCCINATE
Y ER
CARBIDOPA/LEVODOPA ER
Y
FINASTERIDE
Y
LISINOPRIL
Y
KETOCONAZOLE
Y
MUPIROCIN
Y
REPAGLINIDE
Y
CLOBETASOL PROPIONATE
Y
DOXYCYCLINE HYCLATE Y
LOSARTAN POTASSIUM Y
HYDROCORTISONE/ACETIC
Y ACI
NITROFURANTOIN MONOHYDRAT
Y
NITROFURANTOIN MACROCRYST
Y
VALSARTAN
Y
ADAPALENE
Y
SUMATRIPTAN SUCCINATE
Y
BENZONATATE
Y
LABETALOL HCL
Y
NORETHINDRONE
Y
FLUOROMETHOLONE Y
LOSARTAN POTASSIUM Y
AMLODIPINE BESYLATE/BENAZ
Y
BENAZEPRIL HCL/HYDROCHLOR
Y
AMITRIPTYLINE HCL
Y
CLOBETASOL OIN 0.05%
AMPHETAMINE TAB 10MG
HYDROCO/APAP TAB 5-325MG
OFLOXACIN DRO 0.3% OP
DOXYCYCLINE SUS 25MG/5ML
FLUOROURACIL CRE 5%
BUMETANIDE TAB 2MG
AMPHETAMINE TAB 5MG
TRIAMCINOLON CRE 0.1%
PYRIDOSTIGM TAB 60MG
FENTANYL DIS 12MCG/HR
VALSART/HCTZ TAB 80-12.5
SUCRALFATE TAB 1GM
BUPROPN HCL TAB 300MG XL
ESZOPICLONE TAB 3MG
BUPROPION TAB 75MG
AMLOD/VALSAR TAB /HCTZ
BUPROPN HCL TAB 150MG XL
FELODIPINE TAB 10MG ER
PANTOPRAZOLE TAB 40MG
LAMOTRIGINE TAB 25MG
PREDNISOLONE SUS 1% OP
LAMOTRIGINE TAB 150MG
CEFDINIR CAP 300MG
CLOBETASOL SHA 0.05%
TRETINOIN CRE 0.025%
SIMVASTATIN TAB 40MG
HYDROCO/APAP TAB 7.5-325
CARVEDILOL TAB 6.25MG
DESONIDE LOT 0.05%
CLOZAPINE TAB 100MG
HYDROCO/APAP SOL 7.5-325
OFLOXACIN DRO 0.3%OTIC
PREDNISONE TAB 20MG
CARISOPRODOL TAB 350MG
METHYLPHENID TAB 20MG
GLYBURIDE TAB 5MG
TIZANIDINE TAB 2MG
DULOXETINE CAP 60MG
DILT-XR CAP 240MG
NABUMETONE TAB 500MG
GABAPENTIN TAB 800MG
ESTRADIOL TAB 2MG
TRAMADL/APAP TAB 37.5-325
TESTOST CYP INJ 200MG/ML
LATANOPROST SOL 0.005%
AMPHETAMINE CAP 25MG ER
METOPROLOL TAB 25MG ER
CARB/LEVO ER TAB 50-200MG
FINASTERIDE TAB 5MG
LISINOPRIL TAB 40MG
KETOCONAZOLE CRE 2%
MUPIROCIN OIN 2%
REPAGLINIDE TAB 1MG
CLOBETASOL SOL 0.05%
DOXYCYCL HYC TAB 100MG
LOSARTAN POT TAB 50MG
HC/ACET ACID SOL OTIC
NITROFURANTN CAP 100MG
NITROFUR MAC CAP 50MG
VALSARTAN TAB 80MG
ADAPALENE GEL 0.1%
SUMATRIPTAN TAB 100MG
BENZONATATE CAP 200MG
LABETALOL TAB 200MG
NORETHINDRON TAB 0.35MG
FLUOROMETHOL SUS 0.1% OP
LOSARTAN POT TAB 50MG
AMLOD/BENAZP CAP 5-20MG
BENAZEP/HCTZ TAB 20-25MG
AMITRIPTYLIN TAB 25MG
7
14
81
57
5
5
9
18
28
12
7
8
22
9
10
14
2
16
5
37
71
9
2
19
3
13
52
82
50
5
12
19
35
328
87
4
15
43
2
8
26
5
80
26
11
50
8
15
6
6
36
30
101
1
12
11
22
9
33
16
3
7
46
98
9
32
8
19
9
12
45
300
960
3,040
290
2,940
200
1,290
975
12,712
1,890
65
540
3,358
690
277
2,007
180
960
450
2,084
7,788
135
270
410
354
320
4,680
3,606
7,835
295
720
4,496
350
3,892
6,552
1,080
3,780
2,255
180
840
2,278
1,350
7,334
2,775
106
160
240
1,290
1,440
420
2,940
1,080
2,288
270
620
268
2,010
90
514
683
270
315
468
2,768
1,845
1,344
90
1,860
810
900
4,230
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 138
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68180050203
45802098064
00093204956
00093204998
00172436460
00093720298
51991045758
00591564301
43199002001
00168031004
68382013914
45802057178
67767014290
17478071311
00703858023
00378031893
00781149668
45802006535
51672529404
68180084313
31722073090
65862050320
50383026830
00781570301
63304045930
68645044770
00603389128
00603577121
00378522001
68462022301
45802006435
62175026237
00093100301
59762018103
31722053301
00591273623
16571040250
00378016705
00406851501
50111044101
66993040502
00603537121
49884060411
68382079401
60432027516
00955101601
68645047954
59746012110
65862047090
00603158658
68382026606
00378542028
00781572601
00093720198
42858080301
00378002801
00591532501
00378181510
13668028060
51991038490
60758011915
66530025545
67253070006
00093571205
68462043518
68180012402
00378354752
00378021701
60505039905
00378204501
53489012002
MELOXICAM
Y
HYDROQUINONE
Y
TOLTERODINE TARTRATEYER
TOLTERODINE TARTRATEYER
LABETALOL HCL
Y
PRAVASTATIN SODIUM Y
POLYETHYLENE GLYCOL 3350
Y
MINOXIDIL
Y
METHENAMINE HIPPURATE
Y
DESONIDE
Y
TOPIRAMATE
Y
FEXOFENADINE HCL
Y
BUPROPION HCL XL
Y
OFLOXACIN
Y
ENOXAPARIN SODIUM Y
PIOGLITAZONE HCL
Y
AZITHROMYCIN
Y
TRIAMCINOLONE ACETONIDE
Y
MALATHION
Y
LEVONORGESTREL/ETHINYL
Y ES
IRBESARTAN
Y
AMOXICILLIN/CLAVULANATE
Y P
CLOBETASOL PROPIONATE
Y
OXYCODONE HCL ER
M
ONDANSETRON HCL
Y
ESCITALOPRAM OXALATEY
HYDROCODONE/ACETAMINOPHEN
Y
SOTALOL HCL
Y
DILTIAZEM HCL ER
Y
LITHIUM CARBONATE ERY
TRIAMCINOLONE ACETONIDE
Y
NIFEDIPINE ER
Y
BUSPIRONE HCL
Y
VENLAFAXINE HCL ER Y
METHOCARBAMOL
Y
LEVALBUTEROL HCL
Y
CETIRIZINE HCL
Y
DOXYCYCLINE HYCLATE Y
OXYCODONE HCL
Y
TRAZODONE HCL
Y
URSODIOL
Y
PRIMIDONE
Y
LAMOTRIGINE ER
Y
OXYCODONE HCL
Y
BROMPHEN/PSEUDOEPHEDRINE
Y
ENOXAPARIN SODIUM Y
METOPROLOL SUCCINATE
Y ER
MECLIZINE HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
PROMETHAZINE-DM
Y
PARICALCITOL
Y
FLUOXETINE
Y
OXYCODONE HCL ER
M
PRAVASTATIN SODIUM Y
MORPHINE SULFATE ER Y
NADOLOL
Y
PROBENECID/COLCHICINE
Y
LEVOTHYROXINE SODIUM
Y
PIOGLITAZONE HCL/METFORMI
Y
FOLBIC
Y
PREDNISOLONE ACETATEY
TRETINOIN
Y
SELEGILINE HCL
Y
GLYBURIDE/METFORMINYHCL
ACAMPROSATE CALCIUMY DR
CEPHALEXIN
Y
MERCAPTOPURINE
Y
TOLAZAMIDE
Y
DICLOFENAC SODIUM Y
TACROLIMUS
Y
DOXYCYCLINE HYCLATE Y
MELOXICAM TAB 15MG
HYDROQUINONE CRE 4%
TOLTERODINE CAP 4MG ER
TOLTERODINE CAP 4MG ER
LABETALOL TAB 100MG
PRAVASTATIN TAB 40MG
POLYETH GLYC POW 3350 NF
MINOXIDIL TAB 10MG
METHENAM HIP TAB 1GM
DESONIDE LOT 0.05%
TOPIRAMATE TAB 50MG
FEXOFENADINE TAB 180MG
BUPROPN HCL TAB 300MG XL
OFLOXACIN DRO 0.3% OP
ENOXAPARIN INJ 100MG/ML
PIOGLITAZONE TAB 45MG
AZITHROMYCIN TAB 250MG
TRIAMCINOLON CRE 0.5%
MALATHION LOT 0.5%
LEVONOR/ETHI TAB ESTRADIO
IRBESARTAN TAB 150MG
AMOX/K CLAV TAB 875MG
CLOBETASOL OIN 0.05%
OXYCODONE TAB 10MG ER
ONDANSETRON TAB 8MG
ESCITALOPRAM TAB 20MG
HYDROCO/APAP TAB 7.5-325
SOTALOL HCL TAB 160MG
DILTIAZEM CAP 120MG ER
LITHIUM CARB TAB 300MG ER
TRIAMCINOLON CRE 0.1%
NIFEDIPINE TAB 90MG ER
BUSPIRONE TAB 15MG
VENLAFAXINE CAP 75MG ER
METHOCARBAM TAB 500MG
LEVALBUTEROL NEB 0.31MG
CETIRIZINE TAB 10MG
DOXYCYCL HYC TAB 100MG
OXYCODONE TAB 15MG
TRAZODONE TAB 150MG
URSODIOL TAB 250MG
PRIMIDONE TAB 50MG
LAMOTRIGINE TAB 250MG ER
OXYCODONE TAB 10MG
BROM/PSE/DM SYP
ENOXAPARIN INJ 300/3ML
METOPROLOL TAB 100MG ER
MECLIZINE TAB 25MG
LOSARTAN/HCT TAB 100-25
PROMETHAZINE SYP DM
PARICALCITOL CAP 1 MCG
FLUOXETINE CAP 20MG
OXYCODONE TAB 20MG ER
PRAVASTATIN TAB 20MG
MORPHINE SUL TAB 60MG ER
NADOLOL TAB 20MG
PROBEN/COLCH TAB 500-0.5
LEVOTHYROXIN TAB 150MCG
PIOGLITA/MET TAB 15-500MG
FOLBIC
TAB
PREDNISOLONE SUS 1% OP
TRETINOIN CRE 0.1%
SELEGILINE CAP 5MG
GLYB/METFORM TAB 5-500MG
ACAMPRO CAL TAB 333MG
CEPHALEXIN SUS 250/5ML
MERCAPTOPUR TAB 50MG
TOLAZAMIDE TAB 250MG
DICLOFENAC SOL 1.5%
TACROLIMUS CAP 0.5MG
DOXYCYCL HYC TAB 100MG
151
15
2
2
22
21
80
9
8
3
25
67
8
27
2
2
130
45
2
7
6
44
6
4
99
8
40
2
11
38
76
10
43
2
116
1
204
6
12
61
1
12
1
28
25
2
9
67
12
237
4
2
3
38
8
9
3
23
2
14
6
4
3
8
5
31
7
4
3
1
13
6,924
425
120
120
2,550
1,890
23,460
1,350
480
354
3,300
2,514
540
270
18
180
780
1,515
236
637
540
816
300
300
1,623
540
2,850
360
1,080
4,530
2,820
720
5,185
159
8,421
576
7,680
238
1,292
5,582
540
3,184
60
2,770
4,220
12
750
2,629
1,080
38,087
156
118
180
3,420
480
900
750
1,896
360
1,090
90
180
540
2,700
780
6,400
570
720
450
630
250
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 139
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00185040101
47781072950
55111076303
00781598801
66530025045
62175031337
42192071015
67877010505
00093094801
00168016215
00378140496
17478074102
00093729253
68382079601
00591578801
63304069201
00406015401
55111019605
68645032054
47781023005
65162069179
45802045537
60505311103
00378037301
55111029336
00093007301
00093304505
45802003846
23155024901
00591555501
60505291709
65162062711
55111059430
00591079605
00093576756
31722022205
65862046990
16714040102
76439030910
00378868835
59762106101
00093102606
00378301201
67253038210
64764011901
50111047001
00093423501
00603786449
00093894001
59746021106
66869013730
49884013701
24208029510
00143973801
00168016246
45802042235
31722037690
60505082306
00781538292
00074305453
00378181901
00527163201
68462010230
23155011301
00555079002
00591037201
45802089626
00781615746
00093550456
00168008930
00555902658
AMPHETAMINE/DEXTROAMPHETA
Y
VANCOMYCIN HCL
Y
MONTELUKAST SODIUM Y
CARBAMAZEPINE ER
Y
TRETINOIN MICROSPHERE
Y
METHYLPHENIDATE HCL ER
Y
ANTIPYRINE/BENZOCAINE
Y
BENZONATATE
Y
DICLOFENAC POTASSIUMY
CLOBETASOL PROPIONATE
Y
RIZATRIPTAN BENZOATE Y
VANCOMYCIN HCL
Y
LEVOFLOXACIN
Y
OXYCODONE HCL
Y
NORTRIPTYLINE HCL
Y
CLINDAMYCIN HCL
Y
METHYLPHENIDATE HCL ER
Y
CLOPIDOGREL
Y
OMEPRAZOLE
Y
OXYCODONE/ACETAMINOPHEN
Y
ONDANSETRON HCL
Y
HYDROCORTISONE VALERATE
Y
OLANZAPINE
Y
HYDROXYCHLOROQUINEYSULFAT
SUMATRIPTAN SUCCINATE
Y
ZOLPIDEM TARTRATE Y
VERAPAMIL HCL ER
Y
ERYTHROMYCIN
Y
VENLAFAXINE HCL
Y
PROPRANOLOL HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
TRAMADOL HCL
Y
MONTELUKAST SODIUM Y
SULFASALAZINE
Y
OLANZAPINE
Y
GABAPENTIN
Y
LOSARTAN POTASSIUM/HYDROC
Y
CEFUROXIME AXETIL
Y
HYOSCYAMINE SULFATE Y
CLINDAMYCIN/BENZOYL YPEROX
DIPHENOXYLATE/ATROPINE
Y
NEFAZODONE HCL
Y
CAPTOPRIL
Y
DOXAZOSIN MESYLATE Y
COLCRYS
M
PROPRANOLOL HCL
Y
NADOLOL
Y
TRIAMCINOLONE ACETONIDE
Y
ACYCLOVIR
Y
CYCLOBENZAPRINE HCL Y
LIPOFEN
M
OXYCODONE HCL ER
M
TOBRAMYCIN/DEXAMETHASONE
Y
PREDNISONE
Y
CLOBETASOL PROPIONATE
Y
DESONIDE
Y
QUINAPRIL/HYDROCHLOROTHIA
Y
CALCITONIN-SALMON Y
ATORVASTATIN CALCIUMY
VICODIN HP
Y
LEVOTHYROXINE SODIUM
Y
TRIAMTERENE/HYDROCHLOROTH
Y
FLUCONAZOLE
Y
PROPRANOLOL HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
LOXAPINE SUCCINATE Y
SULFACETAMIDE SODIUM
Y
AMOXICILLIN
Y
OLANZAPINE/FLUOXETINE
Y
NYSTATIN/TRIAMCINOLONE
Y
JUNEL FE 1/20
Y
AMPHETAMINE TAB 20MG
VANCOMYCIN CAP 125MG
MONTELUKAST GRA 4MG
CARBAMAZEPIN TAB 400MG ER
TRETINOIN GEL 0.1%
METHYLPHENID TAB 54MG ER
ANTIPY/BENZO SOL OTIC
BENZONATATE CAP 100MG
DICLOFEN POT TAB 50MG
CLOBETASOL OIN 0.05%
RIZATRIPTAN TAB 10MG
VANCOMYCIN CAP 125MG
LEVOFLOXACIN TAB 500MG
OXYCODONE TAB 20MG
NORTRIPTYLIN CAP 50MG
CLINDAMYCIN CAP 150MG
METHYLPHENID TAB 54MG ER
CLOPIDOGREL TAB 75MG
OMEPRAZOLE CAP 20MG
OXYCOD/APAP TAB 10-325MG
ONDANSETRON SOL 4MG/5ML
HC VALERATE CRE 0.2%
OLANZAPINE TAB 5MG
HYDROXYCHLOR TAB 200MG
SUMATRIPTAN TAB 100MG
ZOLPIDEM TAB 5MG
VERAPAMIL TAB 240MG ER
ERYTHROMYCIN SOL 2%
VENLAFAXINE TAB 75MG
PROPRANOLOL TAB 20MG
LOSARTAN/HCT TAB 100-25
TRAMADOL HCL TAB 50MG
MONTELUKAST CHW 5MG
SULFASALAZIN TAB 500MG
OLANZAPINE TAB 2.5MG
GABAPENTIN CAP 300MG
LOSARTAN/HCT TAB 100-12.5
CEFUROXIME TAB 500MG
HYOSCYAMINE SUB 0.125MG
CLINDAMY/BEN GEL 1-5%
DIPHEN/ATROP TAB 2.5MG
NEFAZODONE TAB 250MG
CAPTOPRIL TAB 25MG
DOXAZOSIN TAB 4MG
COLCRYS TAB 0.6MG
PROPRANOLOL TAB 60MG
NADOLOL TAB 20MG
TRIAMCINOLON LOT 0.1%
ACYCLOVIR CAP 200MG
CYCLOBENZAPR TAB 5MG
LIPOFEN CAP 50MG
OXYCODONE TAB 20MG ER
TOBRA/DEXAME SUS 0.3-0.1%
PREDNISONE TAB 20MG
CLOBETASOL OIN 0.05%
DESONIDE CRE 0.05%
QNAPRIL/HCTZ TAB 20-25MG
CALCITONIN SPR 200/ACT
ATORVASTATIN TAB 20MG
VICODIN HP TAB 10-300MG
LEVOTHYROXIN TAB 200MCG
TRIAMT/HCTZ CAP 37.5-25
FLUCONAZOLE TAB 100MG
PROPRANOLOL TAB 60MG
AMPHETAMINE CAP 5MG ER
LOXAPINE CAP 50MG
SULFACETAMID LOT 10%
AMOXICILLIN SUS 400/5ML
OLANZA/FLUOX CAP 6-25MG
NYSTAT/TRIAM OIN
JUNEL FE TAB 1/20
13
1
3
7
2
6
75
80
15
9
10
1
34
14
20
136
6
9
30
6
15
6
11
6
51
357
7
26
15
64
15
166
4
15
5
36
11
11
16
2
17
3
8
17
3
8
3
13
78
156
3
3
5
234
2
11
7
8
8
7
37
28
21
4
6
5
12
142
1
6
16
810
40
150
376
90
180
1,115
3,676
1,077
270
92
56
294
1,478
3,029
4,589
164
810
1,918
720
670
360
515
840
451
11,626
660
1,560
1,784
9,410
1,227
15,994
240
4,740
150
7,650
930
206
1,870
125
1,825
540
1,890
1,350
121
860
540
780
5,019
5,937
270
180
50
4,435
225
210
900
37
660
406
1,447
2,310
469
810
180
390
1,416
22,740
90
180
1,008
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 140
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00054008826
00591037101
00955100810
00228253010
16714022601
49884006501
68382006810
00378459777
00115146845
51672414506
59746028390
65862020290
00054472831
59762453701
29300013510
68645044870
55111016730
31722021305
52544069230
00093206198
45802088830
68382076114
00591379760
68382014014
65162052010
00472038045
00378075710
00093227434
68682051495
65162010150
00093645156
61442010360
00121077516
00378073593
00603533521
53746010305
00093834401
59762672101
00093104801
00093738201
00093520801
41616075883
59762007401
60505267108
66993066305
00591354260
00093529201
65162051310
68180052001
00378351205
00093403005
00472038115
00378259077
00591273723
68180030320
65862069730
60432053716
00076011101
49884073501
63323002510
59762153001
43386066003
57664023932
00603752149
00591381760
45802075930
00093551489
65224080022
23155004303
60505381009
45802005535
CALCIUM ACETATE
Y
LOXAPINE SUCCINATE Y
ENOXAPARIN SODIUM Y
NIFEDIPINE
Y
LOSARTAN POTASSIUM/HYDROC
Y
GLYCOPYRROLATE
Y
SIMVASTATIN
Y
METOPROLOL SUCCINATE
Y ER
LIDOCAINE/PRILOCAINE Y
IMIQUIMOD
Y
PANTOPRAZOLE SODIUMY
LOSARTAN POTASSIUM Y
PREDNISONE
Y
MEDROXYPROGESTERONE
Y ACETA
CLONIDINE HCL
Y
ESCITALOPRAM OXALATEY
OLANZAPINE
Y
SERTRALINE HCL
Y
MATZIM LA
Y
FENOFIBRATE
Y
OMEPRAZOLE
M
CLARITHROMYCIN
Y
ALBUTEROL SULFATE Y
TOPIRAMATE
Y
PHENAZOPYRIDINE HCL Y
BETAMETHASONE DIPROPIONAT
Y
ATENOLOL
Y
AMOXICILLIN/CLAVULANATE
Y P
TRETINOIN MICROSPHERE
Y PUM
GABAPENTIN
Y
ESOMEPRAZOLE MAGNESIUM
Y
DICLOFENAC SODIUM DRY
GUAIFENESIN/CODEINE Y
FLUOXETINE HCL
Y
PREDNISONE
Y
GABAPENTIN
Y
GLYBURIDE
Y
AMLODIPINE BESYLATE/ATORV
Y
METFORMIN HCL
Y
VENLAFAXINE HCL
Y
OXYBUTYNIN CHLORIDE ER
Y
VENLAFAXINE HCL ER Y
HYDROCORTISONE
Y
ATORVASTATIN CALCIUMY
DULOXETINE HCL
Y
BUPROPION HCL SR
Y
METHYLPHENIDATE HCL CD
Y
SALSALATE
Y
LISINOPRIL/HYDROCHLOROTHI
Y
RISPERIDONE
Y
INDOMETHACIN
Y
BETAMETHASONE DIPROPIONAT
Y
FENOFIBRIC ACID DR
Y
LEVALBUTEROL HCL
Y
CEFUROXIME AXETIL
Y
VENLAFAXINE HCL ER Y
NYSTATIN
Y
URIBEL
Y
FLUOXETINE HCL
Y
CHORIONIC GONADOTROPIN
Y
AMLODIPINE BESYLATE Y
TRIMETHOBENZAMIDE HCL
Y
NITROFURANTOIN
Y
CYCLAFEM 1/35
Y
IPRATROPIUM BROMIDE/ALBUT
Y
PROMETHAZINE HCL
Y
CARBAMAZEPINE ER
Y
CEDAX
M
LEFLUNOMIDE
Y
VALSARTAN/HYDROCHLOROTHIA
Y
TRIAMCINOLONE ACETONIDE
Y
CALC ACETATE CAP 667MG
LOXAPINE CAP 25MG
ENOXAPARIN INJ 80/0.8ML
NIFEDIPINE CAP 20MG
LOSARTAN/HCT TAB 50-12.5
GLYCOPYRROL TAB 1MG
SIMVASTATIN TAB 40MG
METOPROLOL TAB 100MG ER
LIDO/PRILOCN CRE 2.5-2.5%
IMIQUIMOD CRE 5%
PANTOPRAZOLE TAB 20MG
LOSARTAN POT TAB 50MG
PREDNISONE TAB 5MG
MEDROXYPR AC INJ 150MG/ML
CLONIDINE TAB 0.1MG
ESCITALOPRAM TAB 10MG
OLANZAPINE TAB 15MG
SERTRALINE TAB 50MG
MATZIM LA TAB 240MG/24
FENOFIBRATE TAB 48MG
OMEPRAZOLE TAB 20MG
CLARITHROMYC TAB 250MG
ALBUTEROL NEB 0.083%
TOPIRAMATE TAB 100MG
PHENAZOPYRID TAB 200MG
BETAMETH DIP CRE 0.05%
ATENOLOL TAB 100MG
AMOX/K CLAV TAB 500MG
TRETINOIN GEL 0.04%PMP
GABAPENTIN CAP 100MG
ESOMEPRA MAG CAP 40MG DR
DICLOFENAC TAB 75MG DR
GG/CODEINE SOL 100-10/5
FLUOXETINE TAB 20MG
PREDNISONE TAB 1MG
GABAPENTIN CAP 400MG
GLYBURIDE TAB 5MG
AMLOD/ATORVA TAB 5-20MG
METFORMIN TAB 500MG
VENLAFAXINE TAB 75MG
OXYBUTYNIN TAB 15MG ER
VENLAFAXINE TAB 150MG ER
HYDROCORT TAB 10MG
ATORVASTATIN TAB 80MG
DULOXETINE CAP 30MG
BUPROPION TAB 200MG SR
METHYLPHENID CAP 50MG
SALSALATE TAB 750MG
LISINOP/HCTZ TAB 20-25MG
RISPERIDONE TAB 2MG
INDOMETHACIN CAP 50MG
BETAMETH DIP OIN 0.05%
FENOFIBRIC CAP 135MG DR
LEVALBUTEROL NEB 0.63MG
CEFUROXIME TAB 500MG
VENLAFAXINE CAP 150MG ER
NYSTATIN SUS 100000
URIBEL
CAP 118MG
FLUOXETINE TAB 20MG
CHOR GONADOT INJ 10000UNT
AMLODIPINE TAB 5MG
TRIMETHOBENZ CAP 300MG
NITROFURANTN SUS 25MG/5ML
CYCLAFEM TAB 1/35
IPRATROPIUM/ SOL ALBUTER
PROMETHAZINE SUP 25MG
CARBAMAZEPIN CAP 300MG ER
CEDAX
CAP 400MG
LEFLUNOMIDE TAB 10MG
VALSART/HCTZ TAB 320-25MG
TRIAMCINOLON OIN 0.1%
7
5
1
5
14
8
44
7
20
5
39
19
56
15
101
12
11
47
5
9
30
6
34
19
56
9
98
37
2
88
4
16
72
7
50
15
19
1
66
8
3
4
11
27
7
4
4
2
46
22
43
8
2
7
19
18
22
12
7
3
76
13
1
15
12
4
5
2
3
6
60
1,164
840
11
390
1,080
1,750
3,735
630
810
96
1,918
1,800
5,406
15
13,253
600
630
3,275
270
690
1,232
212
9,180
2,790
531
495
9,420
775
100
13,088
94
1,610
13,832
420
4,787
3,480
3,570
90
11,190
840
270
305
1,740
2,340
810
540
120
540
4,290
2,133
3,165
255
180
585
356
1,800
4,886
268
630
3
6,330
670
400
924
5,940
87
600
20
90
420
2,295
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 141
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68382014114
50111099001
60951065270
64720013610
68462024805
65862000605
00603389021
51672404102
00591058201
64980051110
16729000301
69238125208
68382009705
00093031401
57664016758
68382001618
50383026730
31722052690
60432083460
29300013701
00378200877
59762154001
65862008201
68382001701
00781282808
61748004416
61748004408
00472080415
68462015360
43478024345
68462030329
55111064530
63304029601
66685101201
68180050103
51672129303
00378863077
65162022050
57664047458
53746010105
00093002701
45802098901
68645049154
00143972601
62559014901
60432003816
61314063136
68462034301
00093206406
00378563059
00555089902
55111012701
16714061305
68180069706
62175061746
51991007301
43598039030
00555095302
51672411103
00378104901
68462034401
00054458111
00591376001
00245018115
62756016088
00406324401
00093204798
00555902742
31722023790
00093729153
66993088865
TOPIRAMATE
Y
VITAMIN D
Y
MORPHINE SULFATE ER Y
AMPHETAMINE/DEXTROAMPHETA
Y
RANITIDINE HCL
Y
CITALOPRAM HYDROBROMIDE
Y
HYDROCODONE/ACETAMINOPHEN
Y
CARBAMAZEPINE
Y
PROPAFENONE HCL
Y
CLINDAMYCIN PALMITATE
Y HCL
GLIMEPIRIDE
Y
LOPREEZA
Y
PAROXETINE HCL
Y
KETOROLAC TROMETHAMINE
Y
METOPROLOL TARTRATEY
LEVOFLOXACIN
Y
CLOBETASOL PROPIONATE
Y
FINASTERIDE
Y
LINDANE
Y
CLONIDINE HCL
Y
BUPROPION HCL XL
Y
AMLODIPINE BESYLATE Y
GLYBURIDE/METFORMINYHCL
LEVOFLOXACIN
Y
FLUOXETINE
Y
AMINOCAPROIC ACID Y
AMINOCAPROIC ACID Y
DESONIDE
Y
TOPIRAMATE
Y
TRETINOIN
Y
HEATHER
Y
OMEPRAZOLE
Y
HYDROXYCHLOROQUINEYSULFAT
AMOXICILLIN/CLAVULANATE
Y P
MELOXICAM
Y
CLOBETASOL PROPIONATE
Y
FENOFIBRATE MICRONIZED
Y
METFORMIN HCL
Y
METFORMIN HCL
Y
GABAPENTIN
Y
ENALAPRIL MALEATE Y
CALCIPOTRIENE/BETAMETHASO
Y
PANTOPRAZOLE SODIUMY
TESTOSTERONE CYPIONATE
Y
ESTERIFIED ESTROGENS/METH
Y
GENERLAC
Y
NEOMYCIN/POLYMYXIN/DEXAME
Y
HYDRALAZINE HCL
Y
CILOSTAZOL
Y
SUMATRIPTAN SUCCINATE
Y
ESTRADIOL
Y
CIPROFLOXACIN HCL
Y
SERTRALINE HCL
Y
TRAMADOL HCL ER
Y
PANTOPRAZOLE SODIUMY
BUTALBITAL/ACETAMINOPHEN/
Y
FINASTERIDE
Y
DEXTROAMPHETAMINE SULFATE
Y
PHENYTOIN SODIUM EXTENDED
Y
DOXEPIN HCL
Y
HYDRALAZINE HCL
Y
MERCAPTOPURINE
Y
AMLODIPINE BESYLATE/BENAZ
Y
DIVALPROEX SODIUM DRY
TAMSULOSIN HCL
Y
HYDROMORPHONE HCL Y
PIOGLITAZONE HCL
Y
JUNEL 1.5/30
Y
AMLODIPINE BESYLATE Y
LEVOFLOXACIN
Y
CLOBETASOL PROPIONATE
Y
TOPIRAMATE TAB 200MG
VITAMIN D CAP 50000UNT
MORPHINE SUL TAB 15MG ER
AMPHETAMINE TAB 30MG
RANITIDINE TAB 150MG
CITALOPRAM TAB 20MG
HYDROCO/APAP TAB 5-325MG
CARBAMAZEPIN CHW 100MG
PROPAFENONE TAB 150MG
CLINDAMYCIN SOL 75MG/5ML
GLIMEPIRIDE TAB 4MG
LOPREEZA TAB 0.5-0.1
PAROXETINE TAB 10MG
KETOROLAC TAB 10MG
METOPROL TAR TAB 100MG
LEVOFLOXACIN TAB 500MG
CLOBETASOL CRE 0.05%
FINASTERIDE TAB 1MG
LINDANE SHA 1%
CLONIDINE TAB 0.3MG
BUPROPN HCL TAB 150MG XL
AMLODIPINE TAB 10MG
GLYB/METFORM TAB 5-500MG
LEVOFLOXACIN TAB 750MG
FLUOXETINE CAP 20MG
AMINOCAPR AC SYP 25%
AMINOCAPR AC SYP 25%
DESONIDE CRE 0.05%
TOPIRAMATE TAB 50MG
TRETINOIN CRE 0.025%
HEATHER TAB 0.35MG
OMEPRAZOLE CAP 40MG
HYDROXYCHLOR TAB 200MG
AMOX/K CLAV SUS 400/5ML
MELOXICAM TAB 7.5MG
CLOBETASOL SOL 0.05%
FENOFIBRATE CAP 200MG
METFORMIN TAB 1000MG
METFORMIN TAB 1000MG
GABAPENTIN CAP 100MG
ENALAPRIL TAB 5MG
CALCIPOTRIEN OIN BETAMETH
PANTOPRAZOLE TAB 40MG
TESTOST CYP INJ 200MG/ML
EST ESTROGEN TAB MTEST
GENERLAC SOL 10GM/15
NEO/POLY/DEX OIN 0.1% OP
HYDRALAZINE TAB 50MG
CILOSTAZOL TAB 100MG
SUMATRIPTAN TAB 25MG
ESTRADIOL TAB 0.5MG
CIPROFLOXACN TAB 500MG
SERTRALINE TAB 100MG
TRAMADOL HCL TAB 100MG ER
PANTOPRAZOLE TAB 40MG
BUT/APAP/CAF CAP CODEINE
FINASTERIDE TAB 1MG
DEXTROAMPHET TAB 10MG
PHENYTOIN EX CAP 100MG
DOXEPIN HCL CAP 10MG
HYDRALAZINE TAB 100MG
MERCAPTOPUR TAB 50MG
AMLOD/BENAZP CAP 10-20MG
DIVALPROEX TAB 250MG DR
TAMSULOSIN CAP 0.4MG
HYDROMORPHON TAB 4MG
PIOGLITAZONE TAB 30MG
JUNEL 1.5/30 TAB
AMLODIPINE TAB 2.5MG
LEVOFLOXACIN TAB 250MG
CLOBETASOL AER 0.05%
17
108
29
13
59
95
102
3
10
7
49
2
60
67
37
42
17
9
1
22
7
58
7
91
2
1
1
7
24
7
12
17
13
30
85
11
3
44
47
39
29
1
28
7
4
25
23
4
11
32
91
161
23
9
19
19
9
12
8
28
7
10
3
5
13
30
3
10
15
11
3
1,935
996
1,384
600
7,420
7,365
3,522
1,620
2,340
1,658
5,550
168
3,986
1,135
6,400
491
600
330
480
4,050
570
4,320
2,040
712
118
237
237
165
3,120
315
896
630
1,740
3,525
6,370
550
270
7,080
7,320
5,787
3,090
100
1,304
80
300
36,229
80
1,575
1,470
275
7,155
2,736
2,070
270
1,410
575
270
690
2,280
2,939
1,230
450
270
1,140
794
2,766
270
651
1,110
170
300
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 142
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
59746017509
13668010960
68180047902
00093026430
00591412879
00378773493
68180013501
00185077130
68382009905
65162010350
49884040401
68382014316
00591588201
00378661005
68180046701
61314070101
59762007301
00781282301
13668018490
63304069650
47781020604
00378453191
00228234810
00472038215
00093005105
43598031630
00781523864
65862052660
00591271830
51672127202
00172541146
68382006610
00591312879
60505255105
00603316232
00555034458
63304069950
66435010118
76439030210
00591252001
00406036701
00555088202
29300013601
49884087201
43478024445
68682051382
66530025120
00378406701
51672125903
68462056435
47335093640
68462019890
00378180710
00603307932
59762054102
00487950125
00603497532
00378644001
13925050704
59762012201
00603258228
60505313301
16252051401
13107000334
00172541160
00115981103
00093304301
00168008915
60951065570
00603752549
00378048001
PREDNISONE
Y
DULOXETINE HCL
Y
SIMVASTATIN
Y
FLUOCINONIDE
Y
TESTOSTERONE CYPIONATE
Y
ONDANSETRON ODT
Y
ESCITALOPRAM OXALATEY
BISOPROLOL FUMARATEY
PAROXETINE HCL
Y
GABAPENTIN
Y
METOPROLOL SUCCINATE
Y ER
LOSARTAN POTASSIUM/HYDROC
Y
METHYLPHENIDATE HCL Y
OXYBUTYNIN CHLORIDE ER
Y
LOVASTATIN
Y
SULFACETAMIDE SODIUM
Y
HYDROCORTISONE
Y
FLUOXETINE HCL
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
MINOCYCLINE HCL
Y
ESTRADIOL
Y
DOXYCYCLINE HYCLATE DR
Y
PROPYLTHIOURACIL
Y
AUGMENTED BETAMETHASONE
Y
D
CARVEDILOL
Y
AMLODIPINE BESYLATE/ATORV
Y
ONDANSETRON ODT
Y
PIOGLITAZONE HCL/METFORMI
Y
METHYLPHENIDATE HCL ER
M
NYSTATIN/TRIAMCINOLONE
Y
FLUCONAZOLE
Y
SIMVASTATIN
Y
PROGESTERONE
Y
GABAPENTIN
Y
FOLIC ACID
Y
ERRIN
Y
MINOCYCLINE HCL
Y
RIBASPHERE
Y
CHLORDIAZEPOXIDE HCL/CLID
Y
CHLORZOXAZONE
Y
HYDROCODONE/ACETAMINOPHEN
Y
HYDROXYUREA
Y
CLONIDINE HCL
Y
FLUOXETINE HCL
Y
TRETINOIN
Y
TRETINOIN MICROSPHERE
Y
TRETINOIN MICROSPHERE
Y
CELECOXIB
Y
CLOBETASOL PROPIONATE
Y
MUPIROCIN
Y
LEUPROLIDE ACETATE Y
PRAVASTATIN SODIUM Y
LEVOTHYROXINE SODIUM
Y
CYCLOBENZAPRINE HCL Y
GLIPIZIDE XL
Y
ALBUTEROL SULFATE Y
OXYBUTYNIN CHLORIDE Y
VERAPAMIL HCL ER
Y
FLUOCINOLONE ACETONIDE
Y SC
TRANDOLAPRIL/VERAPAMIL
Y HC
CARISOPRODOL
Y
QUETIAPINE FUMARATE Y
CIPROFLOXACIN HCL
Y
MIRTAZAPINE
Y
FLUCONAZOLE
Y
DIGOXIN
Y
VERAPAMIL HCL ER
Y
NYSTATIN/TRIAMCINOLONE
Y
MORPHINE SULFATE ER Y
CYCLAFEM 7/7/7
Y
NIFEDIPINE ER
Y
PREDNISONE TAB 20MG
DULOXETINE CAP 20MG
SIMVASTATIN TAB 20MG
FLUOCINONIDE OIN 0.05%
TESTOST CYP INJ 200MG/ML
ONDANSETRON TAB 8MG ODT
ESCITALOPRAM TAB 10MG
BISOPROL FUM TAB 5MG
PAROXETINE TAB 30MG
GABAPENTIN CAP 400MG
METOPROLOL TAB 25MG ER
LOSARTAN/HCT TAB 100-25
METHYLPHENID TAB 5MG
OXYBUTYNIN TAB 10MG ER
LOVASTATIN TAB 10MG
SULFACET SOD SOL 10% OP
HYDROCORT TAB 5MG
FLUOXETINE CAP 10MG
PRAMIPEXOLE TAB 0.75MG
MINOCYCLINE CAP 100MG
ESTRADIOL DIS 0.05MG
DOXYCYCL HYC TAB 75MG DR
PROPYLTHIOUR TAB 50MG
AUG BETAMET OIN 0.05%
CARVEDILOL TAB 3.125MG
AMLOD/ATORVA TAB 5-40MG
ONDANSETRON TAB 4MG ODT
PIOGLITA/MET TAB 15-850MG
METHYLPHENID TAB 54MG ER
NYSTAT/TRIAM OIN
FLUCONAZOLE TAB 100MG
SIMVASTATIN TAB 10MG
PROGESTERONE INJ 50MG/ML
GABAPENTIN TAB 600MG
FOLIC ACID TAB 1MG
ERRIN
TAB 0.35MG
MINOCYCLINE TAB 100MG
RIBASPHERE CAP 200MG
CHLORD/CLIDI CAP 5-2.5MG
CHLORZOXAZON TAB 500MG
HYDROCO/APAP TAB 10-325MG
HYDROXYUREA CAP 500MG
CLONIDINE TAB 0.2MG
FLUOXETINE CAP 40MG
TRETINOIN GEL 0.025%
TRETINOIN GEL 0.1%
TRETINOIN GEL 0.04%
CELECOXIB CAP 200MG
CLOBETASOL OIN 0.05%
MUPIROCIN CRE 2%
LEUPROLIDE INJ 1MG/0.2
PRAVASTATIN TAB 80MG
LEVOTHYROXIN TAB 88MCG
CYCLOBENZAPR TAB 10MG
GLIPIZIDE XL TAB 5MG
ALBUTEROL NEB 0.083%
OXYBUTYNIN TAB 5MG
VERAPAMIL CAP 240MG ER
FLUOCIN ACET OIL 0.01% SC
TRANDO/VERAP TAB 4-240 ER
CARISOPRODOL TAB 350MG
QUETIAPINE TAB 100MG
CIPROFLOXACN TAB 250MG
MIRTAZAPINE TAB 30MG
FLUCONAZOLE TAB 100MG
DIGOXIN TAB 0.125MG
VERAPAMIL TAB 120MG ER
NYSTAT/TRIAM OIN
MORPHINE SUL TAB 60MG ER
CYCLAFEM TAB 7/7/7
NIFEDIPINE TAB 30MG ER
55
1
51
12
6
26
12
4
34
20
12
15
25
5
37
20
10
72
3
33
3
3
5
5
40
1
50
2
4
5
16
24
8
5
204
21
1
2
7
31
22
11
62
21
5
3
3
2
4
5
1
6
20
135
11
91
10
4
3
2
41
5
153
29
8
8
6
6
6
9
7
785
180
4,410
480
70
411
840
720
2,820
6,360
900
1,170
1,365
540
2,883
300
2,446
5,498
270
1,925
36
90
990
165
5,432
90
649
210
120
180
324
2,160
240
900
18,678
1,092
180
336
480
2,580
1,530
840
9,630
1,590
225
60
60
90
240
180
2
540
1,606
7,364
2,070
12,225
1,560
630
355
120
2,918
405
1,844
2,040
296
720
720
105
360
756
630
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 143
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
50383026745
00378190201
59762306001
68645049054
57237004330
68180022006
31722053712
00781709459
61314014405
00487950160
55111019060
53746021905
25021082310
59762374302
65162065990
54458092510
68682052501
49884074605
43598034190
68180035202
16714029401
69238110305
67877014801
00093715298
00168005960
00527133601
00093729056
62175015337
00555090201
40085089300
00591534701
44523060701
31722037590
62756051183
60505700602
23155010410
47335073788
68462034205
13668013710
65862001501
68682051385
65862059501
16729002215
55111046805
24208058060
00093551389
33342005210
00093729505
00603373932
00591040710
16729019717
61314064725
68382027101
00591346753
00555902858
00115067250
60758077305
51672126403
10631040701
60951060270
00904064460
00168031002
57664037088
45802021002
62037099910
43598031830
00591231719
00781205201
00378459577
00378105405
29033001301
CLOBETASOL PROPIONATE
Y
MIDODRINE HCL
Y
AZITHROMYCIN
Y
PANTOPRAZOLE SODIUMY
VALACYCLOVIR HCL
Y
RABEPRAZOLE SODIUM Y
LEVETIRACETAM
Y
ERYTHROMYCIN/BENZOYL
Y PERO
BRIMONIDINE TARTRATEY
ALBUTEROL SULFATE Y
QUETIAPINE FUMARATE Y
METFORMIN HCL
Y
HALOPERIDOL LACTATE Y
CLINDAMYCIN PHOSPHATE
Y
NIZATIDINE
Y
PRAVASTATIN SODIUM Y
FENOFIBRATE
Y
GLIPIZIDE ER
Y
CLOCORTOLONE PIVALATE
M
SERTRALINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
IBUPROFEN
Y
TEMAZEPAM
Y
SIMVASTATIN
Y
FLUOCINOLONE ACETONIDE
Y
DOXYCYCLINE HYCLATE Y
RALOXIFENE HYDROCHLORIDE
Y
METHYLPHENIDATE HCL CD
Y
NALTREXONE HCL
Y
CLOBETASOL PROPIONATE
Y
PROBENECID
Y
SODIUM SULFACETAMIDE/SULF
Y
QUINAPRIL/HYDROCHLOROTHIA
Y
LETROZOLE
Y
FENTANYL
Y
METFORMIN HCL
Y
BUPROPION HCL SR
Y
HYDRALAZINE HCL
Y
ESCITALOPRAM OXALATEY
AMOXICILLIN
Y
TRETINOIN MICROSPHERE
Y PUM
DIVALPROEX SODIUM ERY
PIOGLITAZONE HCL
Y
METOPROLOL SUCCINATE
Y ER
GENTAMICIN SULFATE Y
CARBAMAZEPINE ER
Y
LOSARTAN POTASSIUM/HYDROC
Y
CARVEDILOL
Y
FUROSEMIDE
Y
LISINOPRIL
Y
LISINOPRIL
Y
TOBRAMYCIN/DEXAMETHASONE
Y
ETODOLAC ER
Y
ALBUTEROL SULFATE Y
JUNEL FE 1.5/30
Y
ZOLMITRIPTAN
Y
KETOROLAC TROMETHAMINE
Y
FLUOCINONIDE
Y
PROCTOSOL HC
Y
ENDOCET
Y
NITROGLYCERIN ER
Y
DESONIDE
Y
OXYCODONE HCL
Y
NITROGLYCERIN LINGUALY
POTASSIUM CHLORIDE ERY
AMLODIPINE BESYLATE/ATORV
Y
VALSARTAN/HYDROCHLOROTHIA
Y
TERAZOSIN HCL
Y
METOPROLOL SUCCINATE
Y ER
ENALAPRIL MALEATE Y
PIROXICAM
Y
CLOBETASOL CRE 0.05%
MIDODRINE TAB 5MG
AZITHROMYCIN TAB 250MG
PANTOPRAZOLE TAB 40MG
VALACYCLOVIR TAB 1GM
RABEPRAZOLE TAB 20MG
LEVETIRACETA TAB 500MG
ERYTHROMYCIN GEL /BENZOYL
BRIMONIDINE SOL 0.15%
ALBUTEROL NEB 0.083%
QUETIAPINE TAB 300MG
METFORMIN TAB 850MG
HALOPER LAC INJ 5MG/ML
CLINDAMYCIN GEL 1%
NIZATIDINE SOL 15MG/ML
PRAVASTATIN TAB 40MG
FENOFIBRATE TAB 48MG
GLIPIZIDE ER TAB 10MG
CLOCORTOLONE CRE PIV 0.1%
SERTRALINE TAB 50MG
AMOX/K CLAV SUS 600/5ML
IBUPROFEN TAB 800MG
TEMAZEPAM CAP 7.5MG
SIMVASTATIN TAB 5MG
FLUOCIN ACET SOL 0.01%
DOXYCYCLINE TAB 20MG
RALOXIFENE TAB 60MG
METHYLPHENID CAP 30MG
NALTREXONE TAB 50MG
CLOBETASOL AER 0.05%
PROBENECID TAB 500MG
SOD SUL/SULF LOT 10-5%
QNAPRIL/HCTZ TAB 20-12.5
LETROZOLE TAB 2.5MG
FENTANYL DIS 25MCG/HR
METFORMIN TAB 1000MG
BUPROPION TAB 150MG SR
HYDRALAZINE TAB 25MG
ESCITALOPRAM TAB 20MG
AMOXICILLIN TAB 875MG
TRETINOIN GEL 0.1%PUMP
DIVALPROEX TAB 500MG ER
PIOGLITAZONE TAB 45MG
METOPROLOL TAB 100MG ER
GENTAMICIN SOL 0.3% OP
CARBAMAZEPIN CAP 200MG ER
LOSARTAN/HCT TAB 100-25
CARVEDILOL TAB 12.5MG
FUROSEMIDE TAB 20MG
LISINOPRIL TAB 10MG
LISINOPRIL TAB 20MG
TOBRA/DEXAME SUS 0.3-0.1%
ETODOLAC ER TAB 400MG
ALBUTEROL NEB 0.63MG/3
JUNEL FE TAB 1.5/30
ZOLMITRIPTAN TAB 5MG
KETOROLAC SOL 0.4%
FLUOCINONIDE OIN 0.05%
PROCTOSOL HC CRE 2.5%
ENDOCET TAB 5-325MG
NITROGLYCER CAP 6.5MG ER
DESONIDE LOT 0.05%
OXYCODONE TAB 10MG
NITROGLYCRN SPR 0.4MG
POT CL MICRO TAB 20MEQ ER
AMLOD/ATORVA TAB 10-20MG
VALSART/HCTZ TAB 160-25MG
TERAZOSIN CAP 2MG
METOPROLOL TAB 25MG ER
ENALAPRIL TAB 20MG
PIROXICAM CAP 20MG
6
13
86
21
14
7
4
10
5
28
2
48
1
6
7
15
7
13
1
40
18
111
4
11
5
18
1
5
3
1
5
4
7
41
10
50
12
24
6
119
1
1
2
5
114
4
8
40
114
78
83
8
3
10
13
4
13
4
17
50
5
2
25
2
10
1
4
35
15
12
7
270
810
516
1,020
336
210
1,530
559
35
10,980
60
10,140
90
360
990
1,095
510
1,110
90
3,055
2,325
7,604
120
930
3,840
1,410
90
150
150
100
773
180
660
1,685
100
8,490
1,290
3,750
360
2,261
50
180
180
495
660
480
720
6,345
11,018
6,480
7,590
30
270
1,200
868
36
65
240
510
2,659
900
177
1,821
24
1,980
90
360
4,380
1,350
1,620
390
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 144
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
13107006801
50111033401
65862058601
45802014167
00093715806
16571021130
68462024920
00591231919
65162030609
00378632477
00228315403
00093730465
49884041301
60505265605
00121077216
00555903270
66758019005
59762011901
00591354160
55111025860
00781520792
62175015137
00781518110
65162034784
00378912198
51672415403
68180011216
16729000617
31722023810
16714066202
00603233921
16252052401
68180035306
10702005701
67253038010
49884030702
53746025402
16714029402
00093511998
24208056162
00143117210
54458099410
00378043501
13107007201
66993096159
00168038360
68382010101
00527135110
16252057101
00378427677
00591367101
45802036853
00168027815
59762054101
68462046699
00781712940
53489064701
66993094231
00054452725
00245007011
68382053601
00781205301
00185094097
00378034505
59762015502
68462033390
68180031301
53746025305
16729021816
65162030209
55111012960
AMPHETAMINE/DEXTROAMPHETA
Y
METRONIDAZOLE
Y
AMLODIPINE BESYLATE/BENAZ
Y
CICLOPIROX NAIL LACQUER
Y
CLARITHROMYCIN
Y
FLUCONAZOLE
Y
RANITIDINE HCL
Y
VALSARTAN/HYDROCHLOROTHIA
Y
VENLAFAXINE HCL
Y
VALSARTAN/HYDROCHLOROTHIA
Y
BUPRENORPHINE HCL/NALOXON
Y
MIRTAZAPINE ODT
Y
URSODIOL
Y
TRIAMTERENE/HYDROCHLOROTH
Y
HYDROCODONE BITARTRATE/AC
Y
TRI-LEGEST FE
Y
KLOR-CON M20
Y
PHENELZINE SULFATE Y
BUPROPION HCL SR
Y
ZIPRASIDONE HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
METHYLPHENIDATE HCL CD
Y
LEVOTHYROXINE SODIUM
Y
ZENCHENT FE
Y
FENTANYL
Y
CALCIPOTRIENE
Y
LEVETIRACETAM
Y
SIMVASTATIN
Y
AMLODIPINE BESYLATE Y
GABAPENTIN
Y
ACETAMINOPHEN/CODEINE
Y
ACARBOSE
Y
SERTRALINE HCL
Y
OXYCODONE HCL
Y
DOXAZOSIN MESYLATE Y
CLONAZEPAM ODT
Y
RANITIDINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
DILTIAZEM HCL ER
Y
ANTIPYRINE/BENZOCAINE
Y
CAPTOPRIL
Y
LISINOPRIL
Y
BUPROPION HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
METRONIDAZOLE
Y
METRONIDAZOLE
Y
VENLAFAXINE HCL
Y
LEVOTHYROXINE SODIUM
Y
RAMIPRIL
Y
VALACYCLOVIR HCL
Y
NABUMETONE
Y
IMIQUIMOD
Y
AMCINONIDE
Y
GLIPIZIDE XL
Y
RIZATRIPTAN BENZOATE Y
ESTRADIOL
Y
DOXYCYCLINE HYCLATE Y
MUPIROCIN CALCIUM Y
LITHIUM CARBONATE Y
POTASSIUM CITRATE ER Y
POTASSIUM CITRATE ER Y
TERAZOSIN HCL
Y
CHOLESTYRAMINE
Y
DIAZEPAM
Y
ATORVASTATIN CALCIUMY
PRAMIPEXOLE DIHYDROCHLORI
Y
IMIPRAMINE HCL
Y
RANITIDINE HCL
Y
CLOPIDOGREL
Y
VENLAFAXINE HCL
Y
RANITIDINE HCL
Y
AMPHETAMINE TAB 5MG
METRONIDAZOL TAB 500MG
AMLOD/BENAZP CAP 10-20MG
CICLOPIROX SOL 8%
CLARITHROMYC TAB 500MG
FLUCONAZOLE TAB 100MG
RANITIDINE TAB 300MG
VALSART/HCTZ TAB 320-25MG
VENLAFAXINE TAB 50MG
VALSART/HCTZ TAB 320-12.5
BUPREN/NALOX SUB 2-0.5MG
MIRTAZAPINE TAB 30MG ODT
URSODIOL TAB 500MG
TRIAMT/HCTZ TAB 37.5-25
HYDROCO/APAP SOL 7.5-325
TRI-LEGEST TAB FE
KLOR-CON M20 TAB 20MEQ ER
PHENELZINE TAB 15MG
BUPROPION TAB 150MG SR
ZIPRASIDONE CAP 60MG
LOSARTAN/HCT TAB 100-25
METHYLPHENID CAP 10MG
LEVOTHYROXIN TAB 50MCG
ZENCHENT FE CHW 0.4MG-35
FENTANYL DIS 25MCG/HR
CALCIPOTRIEN OIN 0.005%
LEVETIRACETA TAB 250MG
SIMVASTATIN TAB 40MG
AMLODIPINE TAB 5MG
GABAPENTIN CAP 300MG
APAP/CODEINE TAB 300-60MG
ACARBOSE TAB 50MG
SERTRALINE TAB 100MG
OXYCODONE TAB 20MG
DOXAZOSIN TAB 1MG
CLONAZEP ODT TAB 0.25MG
RANITIDINE TAB 300MG
AMOX/K CLAV SUS 600/5ML
DILTIAZEM CAP 300MG ER
ANTIPY/BENZO SOL OTIC
CAPTOPRIL TAB 25MG
LISINOPRIL TAB 40MG
BUPROPION TAB 100MG
AMPHETAMINE TAB 15MG
METRONIDAZOL LOT 0.75%
METRONIDAZOL LOT 0.75%
VENLAFAXINE TAB 100MG
LEVOTHYROXIN TAB 200MCG
RAMIPRIL CAP 2.5MG
VALACYCLOVIR TAB 1GM
NABUMETONE TAB 750MG
IMIQUIMOD CRE 5%
AMCINONIDE CRE 0.1%
GLIPIZIDE XL TAB 5MG
RIZATRIPTAN TAB 10MG
ESTRADIOL DIS 0.025MG
DOXYCYCLINE TAB 20MG
MUPIROCIN CA CRE 2%
LITHIUM CARB TAB 300MG
POT CITRATE TAB 540MG ER
POT CITRATE TAB 540MG ER
TERAZOSIN CAP 5MG
CHOLESTYRAM POW 4GM
DIAZEPAM TAB 5MG
ATORVASTATIN TAB 10MG
PRAMIPEXOLE TAB 1MG
IMIPRAM HCL TAB 50MG
RANITIDINE TAB 150MG
CLOPIDOGREL TAB 75MG
VENLAFAXINE TAB 37.5MG
RANITIDINE CAP 150MG
11
60
3
23
7
5
27
5
12
3
2
3
1
30
11
6
3
3
11
4
10
5
28
3
9
2
7
38
63
24
23
3
19
8
10
5
25
16
3
50
3
22
7
6
3
3
4
9
10
9
23
3
2
18
5
3
8
6
25
2
2
28
4
338
8
13
10
62
24
7
6
510
1,127
270
158
134
301
2,520
450
930
270
120
270
180
2,640
2,567
392
1,170
810
1,185
217
780
150
1,680
252
94
120
1,860
2,790
4,890
4,350
1,772
810
1,799
890
1,050
540
3,120
2,450
270
510
810
1,665
1,230
509
177
177
615
1,080
1,080
468
1,888
36
90
1,830
42
72
960
180
3,730
360
360
3,060
2,646
12,170
660
1,650
1,064
5,984
2,160
810
540
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 145
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00591024205
00093512601
55111015330
00378312093
00406036601
68462020801
00781716740
59746017210
51672125303
68382000601
16714039102
00093030801
00378086001
60432045516
00093745601
68382060010
00008060701
00591555601
51672401801
00378044501
44523060301
60432021208
24208034205
65862001705
16729007901
00172572860
00093769156
65862035790
00591264101
00245005815
66758017001
60505352806
59746032530
00591564201
00781261305
00603752117
60505058401
44183018002
00603465316
31722073190
00093075601
60505025303
13668020130
00185011801
65862054890
13668028160
62175013643
76204060005
65862001905
00603576321
00591354060
51672129803
66993089845
76439013510
65862020399
13811068430
66993094215
00591505210
51672129201
68645046154
68382011514
65862056090
51862017901
00143988915
00832003810
00378116591
00591040810
16729019617
66530025945
43598020369
65162050603
LORAZEPAM
Y
BENAZEPRIL HCL
Y
ONDANSETRON HCL
Y
TEMAZEPAM
Y
HYDROCODONE/ACETAMINOPHEN
Y
MOEXIPRIL HCL
Y
ESTRADIOL
Y
PREDNISONE
Y
FLUOCINONIDE
Y
LAMOTRIGINE
Y
CEFDINIR
Y
CLEMASTINE FUMARATEY
CLOZAPINE
Y
HYDROCODONE/HOMATROPINE
Y
GLIPIZIDE/METFORMIN HCL
Y
POTASSIUM CHLORIDE ERY
PANTOPRAZOLE SODIUMY
PROPRANOLOL HCL
Y
ETODOLAC
Y
METOPROLOL/HYDROCHLOROTHI
Y
SODIUM SULFACETAMIDE/SULF
Y
PREDNISOLONE SODIUMYPHOSP
DESMOPRESSIN ACETATEY
AMOXICILLIN
Y
CARBIDOPA/LEVODOPA ER
Y
FAMOTIDINE
Y
AMLODIPINE BESYLATE/VALSA
Y
CLOPIDOGREL
Y
BUTALBITAL/ACETAMINOPHEN/
Y
KLOR-CON M20
Y
KLOR-CON M10
Y
TOLTERODINE TARTRATEY
VALACYCLOVIR HCL
Y
MINOXIDIL
Y
AMOXICILLIN
Y
CYCLAFEM 1/35
Y
EPINASTINE HCL
Y
CEFTIBUTEN
M
MONTELUKAST SODIUM Y
IRBESARTAN
Y
PIROXICAM
Y
CLOPIDOGREL
Y
MOXIFLOXACIN HCL
Y
LABETALOL HCL
Y
VALSARTAN/HYDROCHLOROTHIA
Y
PIOGLITAZONE HCL/METFORMI
Y
OMEPRAZOLE
Y
IPRATROPIUM BROMIDE/ALBUT
Y
CEPHALEXIN
Y
SPIRONOLACTONE
Y
BUPROPION HCL SR
Y
KETOCONAZOLE
Y
CLOTRIMAZOLE/BETAMETHASON
Y
METHOCARBAMOL
Y
LOSARTAN POTASSIUM Y
ARIPIPRAZOLE
Y
MUPIROCIN CALCIUM Y
PREDNISONE
Y
HYDROCORTISONE VALERATE
Y
ATORVASTATIN CALCIUMY
RISPERIDONE
Y
PANTOPRAZOLE SODIUMY
BUTALBITAL/ACETAMINOPHEN/
Y
AMOXICILLIN
Y
OXYBUTYNIN CHLORIDE Y
BUSPIRONE HCL
Y
LISINOPRIL
Y
LISINOPRIL
Y
TRETINOIN MICROSPHERE
Y
AMOXICILLIN/CLAVULANATE
Y P
INDOMETHACIN ER
Y
LORAZEPAM TAB 2MG
BENAZEPRIL TAB 20MG
ONDANSETRON TAB 4MG
TEMAZEPAM CAP 22.5MG
HYDROCO/APAP TAB 7.5-325
MOEXIPRIL TAB 15MG
ESTRADIOL DIS 0.1MG
PREDNISONE TAB 5MG
FLUOCINONIDE CRE 0.05%
LAMOTRIGINE TAB 25MG
CEFDINIR CAP 300MG
CLEMASTINE TAB 2.68MG
CLOZAPINE TAB 100MG
HYDROCOD/HOM SYP 5-1.5/5
GLIP/METFORM TAB 2.5-500M
POT CHLORIDE TAB 10MEQ ER
PANTOPRAZOLE TAB 40MG
PROPRANOLOL TAB 40MG
ETODOLAC TAB 400MG
METOPRL/HCTZ TAB 100-50MG
SOD SUL/SULF CRE 10-5%
PREDNISOLONE SOL 15MG/5ML
DESMOPRESSIN SPR 0.01%
AMOXICILLIN CAP 500MG
CARB/LEVO ER TAB 50-200MG
FAMOTIDINE TAB 20MG
AMLOD/VALSAR TAB 10-160MG
CLOPIDOGREL TAB 75MG
BUT/APAP/CAF CAP CODEINE
KLOR-CON M20 TAB 20MEQ ER
KLOR-CON M10 TAB 10MEQ ER
TOLTERODINE TAB 2MG
VALACYCLOVIR TAB 1GM
MINOXIDIL TAB 2.5MG
AMOXICILLIN CAP 500MG
CYCLAFEM TAB 1/35
EPINASTINE DRO 0.05%
CEFTIBUTEN SUS 180/5ML
MONTELUKAST CHW 4MG
IRBESARTAN TAB 300MG
PIROXICAM CAP 10MG
CLOPIDOGREL TAB 75MG
MOXIFLOXACIN TAB 400MG
LABETALOL TAB 300MG
VALSART/HCTZ TAB 160-12.5
PIOGLITA/MET TAB 15-850MG
OMEPRAZOLE CAP 40MG
IPRATROPIUM/ SOL ALBUTER
CEPHALEXIN CAP 500MG
SPIRONOLACT TAB 25MG
BUPROPION TAB 100MG SR
KETOCONAZOLE CRE 2%
CLOTRIM/BETA CRE 1-0.05%
METHOCARBAM TAB 750MG
LOSARTAN POT TAB 100MG
ARIPIPRAZOLE TAB 30MG
MUPIROCIN CA CRE 2%
PREDNISONE TAB 5MG
HC VALERATE OIN 0.2%
ATORVASTATIN TAB 80MG
RISPERIDONE TAB 2MG
PANTOPRAZOLE TAB 40MG
BUT/APAP/CAF CAP
AMOXICILLIN SUS 250/5ML
OXYBUTYNIN TAB 5MG
BUSPIRONE TAB 15MG
LISINOPRIL TAB 20MG
LISINOPRIL TAB 10MG
TRETINOIN GEL 0.04%
AMOX/K CLAV SUS 600/5ML
INDOMETHACIN CAP 75MG ER
60
38
69
3
23
3
2
56
8
39
10
11
10
19
3
14
32
30
4
4
4
121
3
155
3
72
1
5
4
3
6
1
9
9
171
10
2
1
5
3
6
8
4
5
4
2
27
21
98
35
8
11
10
54
11
1
7
49
3
5
17
18
15
103
6
18
77
71
1
16
3
3,249
3,810
1,052
90
1,475
540
48
3,515
480
3,950
208
1,170
328
3,333
660
1,470
1,650
3,761
480
360
112
5,030
15
3,860
540
5,912
90
450
94
1,170
1,140
180
155
1,410
4,227
728
30
60
390
150
310
454
30
990
450
360
1,830
3,600
2,706
3,705
750
660
435
3,526
990
30
120
3,339
105
450
1,605
930
630
20,850
1,200
3,720
5,998
5,970
45
2,375
300
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 146
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
50111033402
00781523964
00781555531
55111071930
00378258977
55111046705
00781538492
60505367403
65862054790
13668013501
60505258203
66530025645
00378672701
68462013901
00555902542
59746017506
50096050502
53746019010
61314064610
00093711598
13668040910
45802056201
00093512701
50111032803
00172208380
68180059001
59762004001
13925015903
00378350205
00527169505
00591336901
00093526901
00472023516
68462040401
00781531501
00955103710
00603760615
50383004248
00074305413
60505325503
63304062210
45802004811
00054002025
00115132801
68462010960
42192014416
00472024260
68180021109
59746033890
68462053165
50383093093
60505274201
54458093310
68382007016
00406012305
54295030723
49808038460
16714029904
00713063986
00054028325
16729018317
62037069890
00168005646
60505264807
00591252250
00228280111
00299591202
68180012401
00185007460
61314014415
66993083932
METRONIDAZOLE
Y
ONDANSETRON ODT
Y
MONTELUKAST SODIUM Y
LAMOTRIGINE ER
Y
FENOFIBRIC ACID DR
Y
METOPROLOL SUCCINATE
Y ER
ATORVASTATIN CALCIUMY
PAROXETINE HCL ER
Y
VALSARTAN/HYDROCHLOROTHIA
Y
ESCITALOPRAM OXALATEY
AZITHROMYCIN
Y
TRETINOIN
Y
ZONISAMIDE
Y
OXCARBAZEPINE
Y
JUNEL 1/20
Y
PREDNISONE
Y
SODIUM SULFACETAMIDE/SULF
Y
NAPROXEN
Y
NEOMYCIN/POLYMYXIN/HYDROC
Y
PAROXETINE HCL
Y
LOSARTAN POTASSIUM Y
CLINDAMYCIN PHOSPHATE
Y
BENAZEPRIL HCL
Y
HYDRALAZINE HCL
Y
HYDROCHLOROTHIAZIDEY
RAMIPRIL
Y
TRIFLURIDINE
Y
LIDOCAINE
Y
RISPERIDONE
Y
BUTALBITAL/ACETAMINOPHEN/
Y
BUTALBITAL/ACETAMINOPHEN/
Y
ZALEPLON
Y
LEVETIRACETAM
Y
ATOVAQUONE/PROGUANIL
Y HCL
ZOLPIDEM TARTRATE ER Y
METHENAMINE HIPPURATE
Y
GILDESS 1.5/30
Y
PREDNISOLONE
Y
VICODIN HP
Y
LETROZOLE
Y
ATENOLOL
Y
NYSTATIN
Y
LITHIUM CARBONATE ERY
AMPHETAMINE/DEXTROAMPHETA
Y
TOPIRAMATE
Y
SODIUM SULFACETAMIDE/SULF
Y
PERMETHRIN
Y
LOSARTAN POTASSIUM Y
LOSARTAN POTASSIUM/HYDROC
Y
DESOXIMETASONE
Y
BUPRENORPHINE HCL Y
VERAPAMIL HCL ER
Y
SIMVASTATIN
Y
PRAVASTATIN SODIUM Y
HYDROCODONE/ACETAMINOPHEN
Y
SODIUM SULFACETAMIDE/SULF
Y
HYDROCORTISONE BUTYRATE
Y
(
AMOXICILLIN
Y
HALOBETASOL PROPIONATE
Y
OXYMORPHONE HYDROCHLORIDE
Y
HYDROCHLOROTHIAZIDEY
TAZTIA XT
Y
BETAMETHASONE DIPROPIONAT
Y
TIZANIDINE HCL
Y
METRONIDAZOLE
Y
PILOCARPINE HYDROCHLORIDE
Y
DIFFERIN
M
CEPHALEXIN
Y
LOVASTATIN
Y
BRIMONIDINE TARTRATEY
OMEGA-3-ACID ETHYL ESTERS
Y
METRONIDAZOL TAB 500MG
ONDANSETRON TAB 8MG ODT
MONTELUKAST CHW 5MG
LAMOTRIGINE TAB 100MG ER
FENOFIBRIC CAP 45MG DR
METOPROLOL TAB 50MG ER
ATORVASTATIN TAB 40MG
PAROXETINE TAB 25MG ER
VALSART/HCTZ TAB 80-12.5
ESCITALOPRAM TAB 5MG
AZITHROMYCIN TAB 500MG
TRETINOIN GEL 0.01%
ZONISAMIDE CAP 100MG
OXCARBAZEPIN TAB 600MG
JUNEL 1/20 TAB
PREDNISONE TAB 20MG
SOD SUL/SULF LOT 9.8-4.8%
NAPROXEN TAB 500MG
NEO/POLY/HC SOL 1% OTIC
PAROXETINE TAB 20MG
LOSARTAN POT TAB 50MG
CLINDAMYCIN SOL 1%
BENAZEPRIL TAB 40MG
HYDRALAZINE TAB 50MG
HYDROCHLOROT TAB 25MG
RAMIPRIL CAP 5MG
TRIFLURIDINE SOL 1% OP
LIDOCAINE CRE 3%
RISPERIDONE TAB 0.25MG
BUT/APAP/CAF TAB
BUT/APAP/CAF TAB
ZALEPLON CAP 10MG
LEVETIRACETA SOL 100MG/ML
ATOVAQ/PROGU TAB 250-100
ZOLPIDEM ER TAB 6.25MG
METHENAM HIP TAB 1GM
GILDESS TAB 1.5/30
PREDNISOLONE SOL 15MG/5ML
VICODIN HP TAB 10-300MG
LETROZOLE TAB 2.5MG
ATENOLOL TAB 50MG
NYSTATIN OIN 100000
LITHIUM CARB TAB 450MG ER
AMPHETAMINE CAP 5MG ER
TOPIRAMATE TAB 100MG
SOD SUL/SULF LIQ 9-4.5%
PERMETHRIN CRE 5%
LOSARTAN POT TAB 50MG
LOSARTAN/HCT TAB 100-12.5
DESOXIMETAS OIN 0.25%
BUPRENORPHIN SUB 8MG
VERAPAMIL TAB 240MG ER
SIMVASTATIN TAB 20MG
PRAVASTATIN TAB 10MG
HYDROCO/APAP TAB 5-325MG
SOD SUL/SULF EMU 10-5%
HC BUTYRATE CRE 0.1%
AMOXICILLIN CAP 500MG
HALOBETASOL OIN 0.05%
OXYMORPHONE TAB HCL 5MG
HYDROCHLOROT TAB 25MG
TAZTIA XT CAP 240MG/24
BETAMETH DIP OIN 0.05%
TIZANIDINE CAP 2MG
METRONIDAZOL TAB 500MG
PILOCARPINE TAB 5MG
DIFFERIN LOT 0.1%
CEPHALEXIN SUS 250/5ML
LOVASTATIN TAB 40MG
BRIMONIDINE SOL 0.15%
OMEGA-3-ACID CAP 1GM
58
16
5
1
2
8
6
2
5
7
25
4
3
5
8
35
1
66
29
37
24
9
34
5
134
3
4
1
12
7
6
34
1
4
4
4
8
181
5
19
55
21
26
3
19
3
5
14
32
2
3
4
38
9
70
9
1
129
3
4
130
5
4
4
47
3
1
16
13
2
1
1,068
240
390
60
360
660
480
180
390
545
153
180
1,620
480
504
475
57
4,041
290
3,000
2,130
420
3,060
1,305
11,400
450
30
255
1,500
650
570
1,080
1,800
88
120
210
483
8,816
219
1,192
5,745
780
1,440
90
1,800
1,440
360
1,140
2,880
120
144
480
3,180
750
2,162
1,871
60
3,689
150
200
11,130
450
360
315
978
630
59
3,260
1,470
30
360
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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-
p. 147
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
60505700902
43386005019
65162062750
49884067901
00603158558
00054014225
53746061701
00781591601
62037069830
62175061743
00574085005
00472011720
60505291609
00555095402
00093106101
58980062530
52544095931
00591084410
67877024601
16729014817
00054022225
00093206701
00703854023
65162030509
00378180010
10370011710
00093031101
43547027709
00093780798
10370022311
00378312501
00054001825
00472037015
68180089813
43386014007
64980015701
68462025501
24208039915
45802039001
00591350804
00591544210
00781268201
13107015730
00591079501
60793085201
42808011006
00093738498
62175018143
60432046608
51672125801
00093205056
31722082830
00172436660
16714069211
68180033107
00378718605
51991008490
00093101601
42192033101
68134036301
23155010210
64376065501
47335067281
68180030360
13668007090
55111017130
00472040492
00591554405
68645047854
00378004001
45963055930
FENTANYL
Y
GAVILYTE-N/FLAVOR PACK
Y
TRAMADOL HCL
Y
NIFEDIPINE ER
Y
PROMETHAZINE/CODEINE
Y
ACARBOSE
Y
TRAMADOL HYDROCHLORIDE/AC
Y
CHLORPROMAZINE HCL Y
TAZTIA XT
Y
PANTOPRAZOLE SODIUMY
DIHYDROERGOTAMINE MESYLAT
Y
TRETINOIN
Y
LOSARTAN POTASSIUM/HYDROC
Y
DEXTROAMPHETAMINE SULFATE
Y
SOTALOL HCL
Y
X-VIATE
Y
CAZIANT
Y
GLIPIZIDE ER
Y
QUETIAPINE FUMARATE Y
QUETIAPINE FUMARATE Y
QUETIAPINE FUMARATE Y
DOXAZOSIN MESYLATE Y
ENOXAPARIN SODIUM Y
VENLAFAXINE HCL
Y
LEVOTHYROXINE SODIUM
Y
ZOLPIDEM TARTRATE ER Y
LOPERAMIDE HCL
Y
IRBESARTAN
Y
AMLODIPINE/VALSARTAN/HCTZ
Y
TRAMADOL HCL ER
Y
DOXEPIN HCL
Y
PREDNISONE
Y
BETAMETHASONE VALERATE
Y
WYMZYA FE
Y
METHYLERGONOVINE MALEATE
Y
VITAMIN D
Y
ROPINIROLE HCL
Y
IPRATROPIUM BROMIDEY
TACROLIMUS
Y
CLONIDINE HCL
Y
PREDNISONE
Y
DEXMETHYLPHENIDATE HCL
Y ER
PAROXETINE HCL
Y
DICYCLOMINE HCL
Y
LEVOXYL
Y
SULFACETAMIDE SODIUM/SULF
Y
VENLAFAXINE HCL ER Y
PANTOPRAZOLE SODIUMY
DEXAMETHASONE
Y
CLOBETASOL PROPIONATE
Y
TOLTERODINE TARTRATEYER
ARIPIPRAZOLE
Y
LABETALOL HCL
Y
FLUCONAZOLE
Y
ZIPRASIDONE HCL
Y
METFORMIN HCL
Y
FOLBEE
Y
NABUMETONE
Y
NP THYROID 90
Y
NAPROXEN
Y
METFORMIN HCL
Y
METHIMAZOLE
Y
DILTIAZEM HCL ER
Y
CEFUROXIME AXETIL
Y
VALSARTAN
Y
FINASTERIDE
Y
CLOBETASOL PROPIONATE
Y
ALLOPURINOL
Y
METOPROLOL SUCCINATE
Y ER
CLORAZEPATE DIPOTASSIUM
Y
VALACYCLOVIR HCL
Y
FENTANYL DIS 100MCG/H
GAVILYTE-N SOL FLAV PK
TRAMADOL HCL TAB 50MG
NIFEDIPINE TAB 90MG ER
PROMETH/COD SYP 6.25-10
ACARBOSE TAB 100MG
TRAMADL/APAP TAB 37.5-325
CHLORPROMAZ TAB 100MG
TAZTIA XT CAP 240MG/24
PANTOPRAZOLE TAB 40MG
DIHYDROERGOT INJ 1MG/ML
TRETINOIN CRE 0.025%
LOSARTAN/HCT TAB 100-12.5
DEXTROAMPHET CAP 5MG ER
SOTALOL HCL TAB 80MG
X-VIATE CRE 40%
CAZIANT PAK
GLIPIZIDE ER TAB 5MG
QUETIAPINE TAB 200MG
QUETIAPINE TAB 200MG
QUETIAPINE TAB 200MG
DOXAZOSIN TAB 8MG
ENOXAPARIN INJ 40/0.4ML
VENLAFAXINE TAB 100MG
LEVOTHYROXIN TAB 25MCG
ZOLPIDEM ER TAB 6.25MG
LOPERAMIDE CAP 2MG
IRBESARTAN TAB 75MG
AMLOD/VALSAR TAB /HCTZ
TRAMADOL HCL TAB 300MG ER
DOXEPIN HCL CAP 25MG
PREDNISONE TAB 20MG
BETAMETH VAL CRE 0.1%
WYMZYA FE CHW 0.4MG-35
METHYLERGON TAB 0.2MG
VITAMIN D CAP 50000UNT
ROPINIROLE TAB 1MG
IPRATROPIUM SPR 0.06%
TACROLIMUS OIN 0.03%
CLONIDINE DIS 0.1/24HR
PREDNISONE TAB 10MG
DEXMETHYLPHE CAP 5MG ER
PAROXETINE TAB 40MG
DICYCLOMINE TAB 20MG
LEVOXYL TAB 75MCG
SOD SUL/SULF EMU 10-5%
VENLAFAXINE CAP 37.5 ER
PANTOPRAZOLE TAB 40MG
DEXAMETHASON ELX 0.5/5ML
CLOBETASOL CRE 0.05%
TOLTERODINE CAP 2MG ER
ARIPIPRAZOLE TAB 15MG
LABETALOL TAB 300MG
FLUCONAZOLE TAB 150MG
ZIPRASIDONE CAP 20MG
METFORMIN TAB 850MG
FOLBEE
TAB
NABUMETONE TAB 750MG
NP THYROID TAB 90MG
NAPROXEN SUS 125/5ML
METFORMIN TAB 500MG
METHIMAZOLE TAB 5MG
DILTIAZEM CAP 300MG/24
CEFUROXIME TAB 500MG
VALSARTAN TAB 320MG
FINASTERIDE TAB 1MG
CLOBETASOL LOT 0.05%
ALLOPURINOL TAB 300MG
METOPROLOL TAB 50MG ER
CLORAZ DIPOT TAB 7.5MG
VALACYCLOVIR TAB 1GM
2
25
96
5
154
2
8
1
5
15
2
6
10
6
11
17
6
17
1
2
2
4
2
3
24
4
7
3
1
3
12
173
15
3
3
58
10
13
1
3
86
2
7
60
17
9
14
16
7
3
2
1
6
67
3
26
26
4
11
5
49
16
3
10
2
8
2
32
6
4
4
20
100,000
8,237
450
26,666
540
1,362
150
450
1,230
10
120
660
180
1,860
1,445
504
1,980
60
60
60
540
10
630
1,515
120
2,784
270
90
90
1,170
2,013
630
252
19
642
990
240
60
28
3,112
60
630
4,810
1,110
1,871
753
1,320
2,370
105
60
15
870
109
180
5,640
960
630
990
3,040
11,280
2,040
270
176
180
240
118
2,745
540
1,269
69
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 148
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
59762054202
00603210802
55111011230
51672402901
00603763417
00603153658
00378402401
00591231819
52544021928
00093511298
45963034202
50383066730
00185014460
54458092610
60505356209
00781575401
13668040990
51672404806
00378157591
16252057201
51672125302
00603506121
59746002022
57664039758
51672403203
68180038406
51672127003
61442010310
55111072590
49884068505
66993094945
16714029303
45963063504
00591320413
62175015637
00054029225
23155010601
13668011830
00093314505
00378459610
00378116001
57664022388
68645030059
60505299506
59762151701
49884072401
68180055909
00093761843
00603760715
00378401001
00378602389
31722022560
43547027803
13668013610
00555906458
59762374301
31722020930
68382076505
51672129206
00168034646
00378081005
44523054202
68180059802
68462019690
45802005536
60505280707
66993089365
53746020305
66530025715
65162070486
42806050109
GLIPIZIDE XL
Y
AMLODIPINE BESYLATE Y
MOXIFLOXACIN HCL
Y
WARFARIN SODIUM
Y
ORSYTHIA
Y
POTASSIUM CHLORIDE Y
DOXAZOSIN MESYLATE Y
VALSARTAN/HYDROCHLOROTHIA
Y
LEENA
Y
DILTIAZEM HCL ER
Y
DESIPRAMINE HCL
Y
LIDOCAINE/PRILOCAINE Y
AMIODARONE HCL
Y
PRAVASTATIN SODIUM Y
MONTELUKAST SODIUM Y
METHYLPHENIDATE HCL SR
Y
LOSARTAN POTASSIUM Y
CLOTRIMAZOLE/BETAMETHASON
Y
PIOGLITAZONE HCL/METFORMI
Y
RAMIPRIL
Y
FLUOCINONIDE
Y
PERPHENAZINE
Y
RISPERIDONE ODT
Y
METFORMIN HCL
Y
WARFARIN SODIUM
Y
TRAMADOL HCL ER
Y
DESOXIMETASONE
Y
DICLOFENAC SODIUM DRY
MONTELUKAST SODIUM Y
METOCLOPRAMIDE HCL Y
CLINDAMYCIN/BENZOYL YPEROX
AMOXICILLIN/CLAVULANATE
Y P
LOVASTATIN
Y
PODOFILOX
Y
METHYLPHENIDATE HCL CD
Y
ESZOPICLONE
Y
HYDROXYZINE HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
CEPHALEXIN
Y
METOPROLOL SUCCINATE
Y ER
GUANFACINE HCL
Y
OXYCODONE HCL
Y
METFORMIN HCL
Y
DULOXETINE HCL
Y
CELECOXIB
Y
HYDROXYUREA
Y
QUINAPRIL HCL
Y
DORZOLAMIDE HCL
Y
GILDESS 1/20
Y
TEMAZEPAM
Y
DOXYCYCLINE MONOHYDRATE
Y
GEMFIBROZIL
Y
IRBESARTAN
Y
ESCITALOPRAM OXALATEY
KELNOR 1/35
Y
CLINDAMYCIN PHOSPHATE
Y
TERBINAFINE HCL
Y
CLARITHROMYCIN
Y
HYDROCORTISONE VALERATE
Y
TERCONAZOLE
Y
HYDROCHLOROTHIAZIDEY
SODIUM SULFACETAMIDE/SULF
Y
CELECOXIB
Y
PRAVASTATIN SODIUM Y
TRIAMCINOLONE ACETONIDE
Y
CARBAMAZEPINE ER
Y
CLOBETASOL PROPIONATE
Y
OXYCODONE/ACETAMINOPHEN
Y
TRETINOIN
Y
FLUOCINOLONE ACETONIDE
Y BO
NICARDIPINE HCL
Y
GLIPIZIDE XL TAB 10MG
AMLODIPINE TAB 2.5MG
MOXIFLOXACIN TAB 400MG
WARFARIN TAB 2.5MG
ORSYTHIA TAB
POT CHLORIDE LIQ 20%
DOXAZOSIN TAB 4MG
VALSART/HCTZ TAB 320-12.5
LEENA
TAB
DILTIAZEM CAP 120MG ER
DESIPRAMINE TAB 25MG
LIDO/PRILOCN CRE 2.5-2.5%
AMIODARONE TAB 200MG
PRAVASTATIN TAB 20MG
MONTELUKAST TAB 10MG
METHYLPHENID TAB 20MG SR
LOSARTAN POT TAB 50MG
CLOTRIM/BETA CRE DIPROP
PIOGLITA/MET TAB 15-850MG
RAMIPRIL CAP 5MG
FLUOCINONIDE CRE 0.05%
PERPHENAZINE TAB 4MG
RISPERIDONE TAB 1MG ODT
METFORMIN TAB 500MG
WARFARIN TAB 5MG
TRAMADOL HCL TAB 200MG ER
DESOXIMETAS CRE 0.25%
DICLOFENAC TAB 75MG DR
MONTELUKAST TAB 10MG
METOCLOPRAM TAB 10MG
CLINDAMY/BEN GEL 1.2-5%
AMOX/K CLAV SUS 400/5ML
LOVASTATIN TAB 40MG
PODOFILOX SOL 0.5%
METHYLPHENID CAP 60MG
ESZOPICLONE TAB 3MG
HYDROXYZ HCL TAB 25MG
LOSARTAN/HCT TAB 100-25
CEPHALEXIN CAP 250MG
METOPROLOL TAB 50MG ER
GUANFACINE TAB 1MG
OXYCODONE TAB 5MG
METFORMIN TAB 1000MG
DULOXETINE CAP 20MG
CELECOXIB CAP 200MG
HYDROXYUREA CAP 500MG
QUINAPRIL TAB 40MG
DORZOLAMIDE SOL 2% OP
GILDESS TAB 1/20
TEMAZEPAM CAP 15MG
DOXYCYC MONO TAB 100MG
GEMFIBROZIL TAB 600MG
IRBESARTAN TAB 150MG
ESCITALOPRAM TAB 10MG
KELNOR
TAB 1/35
CLINDAMYCIN GEL 1%
TERBINAFINE TAB 250MG
CLARITHROMYC SUS 250/5ML
HC VALERATE OIN 0.2%
TERCONAZOLE CRE 0.4%
HYDROCHLOROT CAP 12.5MG
SOD SUL/SULF CRE 10-5%
CELECOXIB CAP 200MG
PRAVASTATIN TAB 20MG
TRIAMCINOLON OIN 0.1%
CARBAMAZEPIN CAP 300MG ER
CLOBETASOL AER 0.05%
OXYCOD/APAP TAB 5-325MG
TRETINOIN GEL 0.025%
FLUOCIN ACET OIL BODY
NICARDIPINE CAP 20MG
7
5
4
32
8
4
7
5
7
7
5
14
19
11
14
4
9
7
1
2
11
6
1
40
21
4
3
12
2
76
3
15
14
9
2
6
44
6
50
15
29
33
41
2
1
7
3
8
9
108
23
10
3
2
12
6
56
4
2
13
35
1
2
10
31
3
1
44
2
2
2
750
570
23
1,905
504
3,825
810
330
476
570
390
420
1,807
885
1,260
270
930
315
180
360
360
360
90
7,078
2,305
120
420
1,770
180
5,662
135
2,250
1,260
32
60
180
2,460
540
2,134
1,350
3,945
1,726
7,110
90
60
570
540
180
420
3,540
547
1,650
270
225
1,008
240
1,909
600
90
585
3,000
57
180
900
3,200
330
100
1,767
90
237
360
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 149
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
64679010703
68180084813
55111029236
51672405506
00378660505
00093423410
16714040604
60432027504
00168008031
00603374032
00781607861
59762371804
47781020904
00143973805
00093416173
53746014501
61442014360
45802006436
67544051060
00603781878
51991083675
00115147446
60505316109
66993066430
00115146010
67877025145
55111068305
51672403903
49884042801
31722026790
33342002710
13668011790
00172531260
60505363803
00603221521
68001010500
63304062110
65862020230
42195055014
16571012050
00093009001
13668011390
59762311001
45802071708
49884064101
55111032990
00555902058
00603388721
00781208102
00603388728
68462012701
65162046819
10370051010
00406324301
17478028310
00472001304
00093319601
00378427577
00228306411
00093310905
00832112142
64380072406
43547027010
50111048202
65862059801
45963074911
00603418720
55111058601
00093769056
60505311303
68462025701
BUPROPION HCL ER
Y
LEVONORGESTREL AND ETHINY
Y
SUMATRIPTAN SUCCINATE
Y
AMIODARONE HCL
Y
OXYBUTYNIN CHLORIDE ER
Y
BUMETANIDE
Y
LARIN FE 1/20
Y
BROMPHEN/PSEUDOEPHEDRINE
Y
HYDROCORTISONE
Y
FUROSEMIDE
Y
CEFDINIR
Y
TRIAZOLAM
Y
ESTRADIOL
Y
PREDNISONE
Y
AMOXICILLIN
Y
HYDROCODONE/IBUPROFEN
Y
LOVASTATIN
Y
TRIAMCINOLONE ACETONIDE
Y
OMEPRAZOLE
Y
NYSTATIN
Y
EPINASTINE HCL
Y
METRONIDAZOLE
Y
LOSARTAN POTASSIUM Y
DULOXETINE HCL
Y
FENOFIBRIC ACID DR
Y
TRIAMCINOLONE ACETONIDE
Y
IBUPROFEN
Y
ENALAPRIL MALEATE Y
DEXMETHYLPHENIDATE HCL
Y ER
QUINAPRIL HCL
Y
DONEPEZIL HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
CIPROFLOXACIN HCL
Y
TRANEXAMIC ACID
Y
AMITRIPTYLINE HCL
Y
DIVALPROEX SODIUM ERY
ATENOLOL
Y
LOSARTAN POTASSIUM Y
CIPROFLOXACIN
M
CIPROFLOXACIN HCL
Y
EPITOL
Y
LOSARTAN POTASSIUM Y
AZITHROMYCIN
Y
TERCONAZOLE
Y
METHIMAZOLE
Y
NATEGLINIDE
Y
PORTIA-28
Y
HYDROCODONE/ACETAMINOPHEN
Y
CALCIUM ACETATE
Y
HYDROCODONE/ACETAMINOPHEN
Y
GABAPENTIN
Y
CLINDAMYCIN PALMITATE
Y HCL
DIVALPROEX SODIUM ERY
HYDROMORPHONE HCL Y
GENTAMICIN SULFATE Y
GRISEOFULVIN MICROSIZE
Y
CEFADROXIL
Y
VALACYCLOVIR HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
AMOXICILLIN
Y
TESTOSTERONE PUMP M
CALCITRIOL
Y
ROPINIROLE HCL
Y
THEOPHYLLINE CR
Y
TAMSULOSIN HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
LEVETIRACETAM ER
Y
AMLODIPINE BESYLATE/BENAZ
Y
AMLODIPINE BESYLATE/VALSA
Y
OLANZAPINE
Y
ROPINIROLE HCL
Y
BUPROPION TAB 200MG ER
LEVONOR/ETHI TAB ESTRADIO
SUMATRIPTAN TAB 50MG
AMIODARONE TAB 100MG
OXYBUTYNIN TAB 5MG ER
BUMETANIDE TAB 2MG
LARIN FE TAB 1/20
BROM/PSE/DM SYP
HYDROCORT CRE 2.5%
FUROSEMIDE TAB 40MG
CEFDINIR SUS 250/5ML
TRIAZOLAM TAB 0.25MG
ESTRADIOL DIS 0.1MG
PREDNISONE TAB 20MG
AMOXICILLIN SUS 400/5ML
HYDROCOD/IBU TAB 7.5-200
LOVASTATIN TAB 40MG
TRIAMCINOLON CRE 0.1%
OMEPRAZOLE CAP 20MG
NYSTATIN CRE 100000
EPINASTINE DRO 0.05%
METRONIDAZOL GEL 0.75%
LOSARTAN POT TAB 50MG
DULOXETINE CAP 60MG
FENOFIBRIC CAP 135MG DR
TRIAMCINOLON CRE 0.1%
IBUPROFEN TAB 600MG
ENALAPRIL TAB 10MG
DEXMETHYLPH CAP 15MG ER
QUINAPRIL TAB 5MG
DONEPEZIL TAB 5MG
LOSARTAN/HCT TAB 100-12.5
CIPROFLOXACN TAB 500MG
TRANEX ACID TAB 650MG
AMITRIPTYLIN TAB 75MG
DIVALPROEX TAB 250MG ER
ATENOLOL TAB 25MG
LOSARTAN POT TAB 50MG
CIPROFLOXACN SOL 0.2%
CIPROFLOXACN SOL 0.3% OP
EPITOL
TAB 200MG
LOSARTAN POT TAB 25MG
AZITHROMYCIN SUS 100/5ML
TERCONAZOLE SUP 80MG
METHIMAZOLE TAB 10MG
NATEGLINIDE TAB 120MG
PORTIA-28 TAB
HYDROCO/APAP TAB 10-325MG
CALC ACETATE CAP 667MG
HYDROCO/APAP TAB 10-325MG
GABAPENTIN TAB 800MG
CLINDAMYCIN SOL 75MG/5ML
DIVALPROEX TAB 250MG ER
HYDROMORPHON TAB 2MG
GENTAMICIN SOL 0.3% OP
GRISEOFULVIN SUS 125/5ML
CEFADROXIL CAP 500MG
VALACYCLOVIR TAB 500MG
AMPHETAMINE CAP 25MG ER
AMOXICILLIN CAP 500MG
TESTOSTERONE GEL PUMP 1%
CALCITRIOL CAP 0.5MCG
ROPINIROLE TAB 1MG
THEOPHYLLINE TAB 200MG CR
TAMSULOSIN CAP 0.4MG
AMPHETAMINE TAB 30MG
LEVETIRACETA TAB 750MG ER
AMLOD/BENAZP CAP 10-40MG
AMLOD/VALSAR TAB 5-160MG
OLANZAPINE TAB 10MG
ROPINIROLE TAB 3MG
1
2
20
1
2
2
7
15
83
61
8
47
2
93
69
19
11
33
24
25
2
2
10
4
3
16
106
12
3
9
3
11
97
3
7
1
46
10
5
47
7
15
17
5
5
1
19
21
1
15
6
4
2
44
28
7
8
8
3
108
1
2
6
4
5
8
1
1
1
3
4
180
182
197
90
180
540
532
2,006
3,270
6,512
600
415
24
1,698
11,750
1,261
1,170
2,960
2,160
915
20
180
1,080
450
150
7,264
5,262
1,260
90
810
270
930
1,406
90
630
270
4,440
840
70
275
780
1,290
300
15
720
270
1,428
2,000
540
1,230
660
1,000
210
2,180
180
2,268
390
900
90
2,801
150
270
780
960
450
390
180
90
90
90
273
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 150
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
13107003134
00378862877
68382033405
00378037201
68645040170
51991065116
00603389919
68462046447
51672403101
62175044231
53489012005
49884023533
61314063006
65162047505
66530025150
00527132401
45802040109
68462020401
00603221221
41616076083
00093727098
62756079788
00093015010
55111015834
51672302002
65862000705
29033002012
68180013106
53746046405
16714040404
00527134401
65862008101
59762018102
60505025203
59762307002
00591288201
67877010605
68462033090
33342005707
47781026830
65162071310
00378609001
23155014701
00781107705
00054001025
00603221321
00406902576
49884083209
65162021850
45802065087
00591079401
00093083401
68462036001
13668011810
13668001512
00555009796
00054055125
00378086005
49884030902
00378528005
00472390130
00093402901
67457058210
50111064801
00591248279
68180022101
16729015016
43538017645
68180047802
00603358321
65162021950
MIRTAZAPINE
Y
FENOFIBRATE MICRONIZED
Y
TRAMADOL HYDROCHLORIDE/AC
Y
CIMETIDINE
Y
PANTOPRAZOLE SODIUMY
LEVETIRACETAM
Y
HYDROCORTISONE
Y
HYDROCORTISONE BUTYRATE
Y
(
WARFARIN SODIUM
Y
POLYETHYLENE GLYCOL 3350
Y
DOXYCYCLINE HYCLATE Y
HYDROCODONE POLISTIREX/CH
Y
NEOMYCIN/POLYMYXIN/DEXAME
Y
NORETHINDRONE ACETATE
Y
TRETINOIN MICROSPHERE
Y PUM
DIGOX
Y
CICLOPIROX
Y
OXYCODONE HCL
Y
AMITRIPTYLINE HCL
Y
VENLAFAXINE HCL ER Y
PRAVASTATIN SODIUM Y
DIVALPROEX SODIUM DRY
ACETAMINOPHEN/CODEINE
Y #3
OMEPRAZOLE
Y
LIDOCAINE
Y
CITALOPRAM HYDROBROMIDE
Y
CARBAMAZEPINE ER
Y
FENOFIBRATE
Y
IBUPROFEN
Y
PIMTREA
Y
LEVOTHYROXINE SODIUM
Y
GLYBURIDE/METFORMINYHCL
VENLAFAXINE HCL ER Y
TIZANIDINE HCL
Y
AZITHROMYCIN
Y
VERAPAMIL HCL SR
Y
BENZONATATE
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
IRBESARTAN/HYDROCHLOROTHI
Y
MOXIFLOXACIN HCL
Y
GUANFACINE HCL
Y
DILTIAZEM HCL ER
Y
ACARBOSE
Y
ALPRAZOLAM
Y
FLECAINIDE ACETATE Y
AMITRIPTYLINE HCL
Y
FENTANYL
Y
DILTIAZEM CD
Y
METFORMIN HCL
Y
LORATADINE
Y
DICYCLOMINE HCL
Y
CLONAZEPAM
Y
HYDROXYZINE HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
LEVETIRACETAM
Y
CLONAZEPAM ODT
Y
OXYCODONE/ACETAMINOPHEN
Y
CLOZAPINE
Y
CLONAZEPAM ODT
Y
DILTIAZEM HCL ER
Y
FLUOCINONIDE
Y
INDOMETHACIN
Y
FONDAPARINUX SODIUMY
FLUOXETINE HCL
Y
DORZOLAMIDE HCL/TIMOLOL
Y
M
NIACIN ER
Y
QUETIAPINE FUMARATE Y
NEUAC
Y
SIMVASTATIN
Y
FELODIPINE ER
Y
METFORMIN HCL
Y
MIRTAZAPINE TAB 15MG
FENOFIBRATE CAP 67MG
TRAMADL/APAP TAB 37.5-325
CIMETIDINE TAB 400MG
PANTOPRAZOLE TAB 40MG
LEVETIRACETA SOL 100MG/ML
HYDROCORT TAB 5MG
HC BUTYRATE CRE 0.1%
WARFARIN TAB 4MG
POLYETH GLYC POW 3350 NF
DOXYCYCL HYC TAB 100MG
HYD POL/CPM LIQ 10-8/5ML
NEO/POLY/DEX SUS 0.1% OP
NORETHIN ACE TAB 5MG
TRETINOIN GEL 0.04%PMP
DIGOX
TAB 0.125MG
CICLOPIROX SHA 1%
OXYCODONE CAP 5MG
AMITRIPTYLIN TAB 10MG
VENLAFAXINE TAB 37.5 ER
PRAVASTATIN TAB 80MG
DIVALPROEX TAB 250MG DR
APAP/CODEINE TAB 300-30MG
OMEPRAZOLE CAP 20MG
LIDOCAINE OIN 5%
CITALOPRAM TAB 40MG
CARBAMAZEPIN CAP 200MG ER
FENOFIBRATE CAP 130MG
IBUPROFEN TAB 400MG
PIMTREA TAB
LEVOTHYROXIN TAB 88MCG
GLYB/METFORM TAB 2.5-500
VENLAFAXINE CAP 75MG ER
TIZANIDINE TAB 4MG
AZITHROMYCIN TAB 500MG
VERAPAMIL CAP 180MG SR
BENZONATATE CAP 200MG
PRAMIPEXOLE TAB 0.125MG
IRBESAR/HCTZ TAB 150-12.5
MOXIFLOXACIN TAB 400MG
GUANFACINE TAB 2MG
DILTIAZEM CAP 90MG ER
ACARBOSE TAB 25MG
ALPRAZOLAM TAB 0.5MG
FLECAINIDE TAB 50MG
AMITRIPTYLIN TAB 25MG
FENTANYL DIS 25MCG/HR
DILTIAZEM CAP 300MG CD
METFORMIN TAB 500MG
LORATADINE TAB 10MG
DICYCLOMINE CAP 10MG
CLONAZEPAM TAB 2MG
HYDROXYZ HCL TAB 10MG
LOSARTAN/HCT TAB 100-25
LEVETIRACETA TAB 500MG
CLONAZEP ODT TAB 1MG
OXYCOD/APAP TAB 5-325MG
CLOZAPINE TAB 100MG
CLONAZEP ODT TAB 1MG
DILTIAZEM CAP 180MG ER
FLUOCINONIDE CRE 0.05%
INDOMETHACIN CAP 25MG
FONDAPARINUX SOL 2.5/0.5
FLUOXETINE CAP 20MG
DORZOL/TIMOL SOL 2-0.5%OP
NIACIN ER TAB 500MG
QUETIAPINE TAB 400MG
NEUAC
GEL 1.2-5%
SIMVASTATIN TAB 10MG
FELODIPINE TAB 10MG ER
METFORMIN TAB 850MG
32
5
10
6
24
3
9
1
21
18
5
7
18
7
1
6
6
6
22
5
6
1
78
19
3
47
2
1
52
4
29
5
15
34
23
4
40
16
3
2
2
1
2
156
3
21
7
5
45
100
66
43
36
22
2
8
40
8
15
5
13
33
1
54
6
1
1
2
19
2
20
1,837
450
1,088
903
780
1,395
1,415
45
2,385
10,795
102
725
95
232
50
480
720
234
2,640
240
540
360
2,729
990
131
3,660
240
90
3,849
224
1,230
1,560
1,027
1,888
189
360
1,481
1,200
210
20
540
270
540
7,566
540
2,029
65
390
8,640
4,169
4,720
3,489
1,770
1,980
720
415
1,764
196
388
390
390
2,667
4
5,894
60
90
30
90
1,350
180
4,470
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 151
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00093517355
00406905076
00228308306
00093894305
00527139701
00781205401
00591058301
76439032101
65862020190
49884003510
51672125802
43598020752
00378012701
16252059944
00093081101
00527130101
16729009015
65162110205
66993089715
43598020852
00185011101
60505005501
16714022501
59762312001
00713066860
51672403001
00378120001
00781709004
50111045901
13668011510
00904064360
00187065820
00603132958
00378473022
00093754006
00472038145
50383004316
00378641001
00781518192
54458088510
00168000415
68382076506
31722052101
61748020560
49908017380
00378006901
42858080401
00378730853
61703035038
00185077101
16714037404
24208031510
00093779506
00168016346
00185021101
00093316006
00603221621
23155011601
00093208517
00574012901
45802096694
43199001301
00781594992
00378335199
00093613732
13925016420
00378699789
65162070294
00378402201
65862052830
31722023990
NIFEDICAL XL
Y
FENTANYL
Y
ALPRAZOLAM ER
Y
ACYCLOVIR
Y
LOXAPINE
Y
TERAZOSIN HCL
Y
PROPAFENONE HCL
Y
VIRTI-SULF
Y
LOSARTAN POTASSIUM Y
MECLIZINE HCL
Y
CLOBETASOL PROPIONATE
Y
AMOXICILLIN
Y
PINDOLOL
Y
ALENDRONATE SODIUM Y
NORTRIPTYLINE HCL
Y
PRIMIDONE
Y
FINASTERIDE
Y
IBUPROFEN
Y
AUGMENTED BETAMETHASONE
Y
D
AMOXICILLIN/CLAVULANATE
Y P
AMPHETAMINE/DEXTROAMPHETA
Y
SELEGILINE HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
AZITHROMYCIN
Y
HYDROCORTISONE VALERATE
Y
WARFARIN SODIUM
Y
ACEBUTOLOL HCL
Y
KETOCONAZOLE
Y
THEOPHYLLINE ER
Y
LOSARTAN POTASSIUM Y
NITROGLYCERIN ER
Y
DIASTAT ACUDIAL
M
IOPHEN C-NR
Y
PREDNISOLONE SODIUMYPHOSP
TOPIRAMATE
Y
BETAMETHASONE DIPROPIONAT
Y
HYDROCODONE BITARTRATE/HO
Y
DOXEPIN HCL
Y
LEVOTHYROXINE SODIUM
Y
PIOGLITAZONE HCL
Y
TRIAMCINOLONE ACETONIDE
Y
CLARITHROMYCIN
Y
HYDRALAZINE HCL
Y
DESOXIMETASONE
Y
SODIUM SULFACETAMIDE/SULF
Y
INDAPAMIDE
Y
MORPHINE SULFATE ER Y
NORETHINDRONE & ETHINYL
Y
E
METHOTREXATE SODIUMY
BISOPROLOL FUMARATEY
LAMOTRIGINE
Y
POLYMYXIN B SULFATE/TRIME
Y
LEVETIRACETAM ER
Y
CLOBETASOL PROPIONATE
Y
BENAZEPRIL HCL/HYDROCHLOR
Y
CEFDINIR
Y
AMITRIPTYLINE HCL
Y
GLIPIZIDE/METFORMIN HCL
Y
TRIAMCINOLONE ACETONIDE
Y
CLINDAMYCIN PALMITATE
Y HCL
ERYTHROMYCIN
Y
HYOSCYAMINE SULFATE Y
VALSARTAN/HYDROCHLOROTHIA
Y
ESTRADIOL
Y
DIAZEPAM
M
LIDOCAINE HCL/HYDROCORTIS
Y
SODIUM CHLORIDE
Y
FLUOCINOLONE ACETONIDE
Y
DOXAZOSIN MESYLATE Y
VENLAFAXINE HCL ER Y
AMLODIPINE BESYLATE Y
NIFEDICAL XL TAB 60MG
FENTANYL DIS 50MCG/HR
ALPRAZOLAM TAB 0.5MG ER
ACYCLOVIR TAB 400MG
LOXAPINE CAP 50MG
TERAZOSIN CAP 10MG
PROPAFENONE TAB 225MG
VIRTI-SULF CRE 10-5%
LOSARTAN POT TAB 25MG
MECLIZINE TAB 25MG
CLOBETASOL CRE 0.05%
AMOXICILLIN SUS 400/5ML
PINDOLOL TAB 10MG
ALENDRONATE TAB 35MG
NORTRIPTYLIN CAP 25MG
PRIMIDONE TAB 50MG
FINASTERIDE TAB 5MG
IBUPROFEN TAB 600MG
AUG BETAMET OIN 0.05%
AMOX/K CLAV SUS 400/5ML
AMPHETAMINE TAB 10MG
SELEGILINE CAP 5MG
LOSARTAN/HCT TAB 100-25
AZITHROMYCIN SUS 200/5ML
HC VALERATE CRE 0.2%
WARFARIN TAB 3MG
ACEBUTOLOL CAP 200MG
KETOCONAZOLE SHA 2%
THEOPHYLLINE TAB 300MG ER
LOSARTAN POT TAB 100MG
NITROGLYCER CAP 2.5MG ER
DIASTAT ACDL GEL 5-10MG
IOPHEN C-NR LIQ 100-10/5
PREDNISOLONE TAB 30MG ODT
TOPIRAMATE TAB 50MG
BETAMETH DIP OIN 0.05%
HYDROCOD/HOM SYP 5-1.5/5
DOXEPIN HCL CAP 100MG
LEVOTHYROXIN TAB 50MCG
PIOGLITAZONE TAB 15MG
TRIAMCINOLON CRE 0.1%
CLARITHROMYC SUS 250/5ML
HYDRALAZINE TAB 50MG
DESOXIMETAS GEL 0.05%
SOD SUL/SULF LIQ 9-4.5%
INDAPAMIDE TAB 1.25MG
MORPHINE SUL TAB 100MG ER
NORETH/ETHIN CHW FE
METHOTREXATE INJ 25MG/ML
BISOPROL FUM TAB 5MG
LAMOTRIGINE TAB 200MG
POLYMYXIN B/ SOL TRIMETHP
LEVETIRACETA TAB 500MG ER
CLOBETASOL CRE 0.05%
BENAZEP/HCTZ TAB 20-12.5
CEFDINIR CAP 300MG
AMITRIPTYLIN TAB 100MG
GLIP/METFORM TAB 2.5-500M
TRIAMCINOLON SPR 55MCG/AC
CLINDAMYCIN SOL 75MG/5ML
ERYTHROMYCIN GEL 2%
HYOSCYAMINE TAB 0.125MG
VALSART/HCTZ TAB 160-12.5
ESTRADIOL DIS 0.075MG
DIAZEPAM GEL 2.5MG
LIDOCAINE/HC KIT 3-2.5%
SODIUM CHLOR NEB 3%
FLUOCIN ACET OIL 0.01%
DOXAZOSIN TAB 2MG
VENLAFAXINE CAP 75MG ER
AMLODIPINE TAB 10MG
3
4
13
19
2
22
5
3
13
17
6
61
2
28
25
3
7
93
2
14
5
1
5
24
2
27
3
25
4
21
3
1
41
2
7
4
13
6
41
1
27
3
5
2
3
9
2
1
13
5
10
40
1
2
2
3
6
5
3
3
6
7
2
2
1
1
2
2
6
15
25
360
40
480
592
180
1,980
570
84
1,110
992
270
10,988
210
304
2,100
1,440
630
4,119
105
2,050
360
180
450
390
120
2,300
540
3,000
1,080
1,890
540
1
6,512
12
900
180
2,140
390
2,360
90
1,185
500
900
120
1,362
810
120
84
98
450
790
400
180
90
360
60
420
540
82
750
270
440
180
20
2
1
6,000
40
615
960
2,250
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 152
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
62037083010
00591566101
51672128001
45802047264
45802046611
50111043301
00378141105
66993087555
00591521550
00781518592
00093221005
51672411101
57664016658
00406051205
13925015901
00603465416
17478019030
00591555401
00555087204
00591216730
00093834410
00093576956
00378459677
65862000899
65862001005
13668011690
51293080401
00093423301
00591291923
00603307821
13668013301
51672125301
10702000301
43386009019
00168027740
66530025145
60505316009
00143211250
60505003306
62756014301
59746028001
68462046465
00555088604
00603499221
60505252906
00378563259
00172541346
62175089146
00378660501
16714039302
00093002601
51991029301
23155017801
00168026950
00168030915
00168030960
00781105301
66993006027
59746024860
60505274001
00603211628
16571021522
68308002003
00603424728
00603221421
55111025760
00591319752
43538095004
00143988901
00603221232
00555077502
METOPROLOL SUCCINATE
Y ER
SULINDAC
Y
DESONIDE
Y
HYDROCORTISONE ACETATE/PR
Y
ECONAZOLE NITRATE Y
TRAZODONE HCL
Y
VERAPAMIL HCL ER
Y
SODIUM SULFACETAMIDE
Y
METRONIDAZOLE
Y
LEVOTHYROXINE SODIUM
Y
SUCRALFATE
Y
PHENYTOIN SODIUM EXTENDED
Y
METOPROLOL TARTRATEY
OXYCODONE/ACETAMINOPHEN
Y
LIDOCAINE
Y
MONTELUKAST SODIUM Y
LIDOCAINE/PRILOCAINE Y
PROPRANOLOL HCL
Y
MEDROXYPROGESTERONE
Y ACETA
VALSARTAN
Y
GLYBURIDE
Y
OLANZAPINE
Y
METOPROLOL SUCCINATE
Y ER
METFORMIN HCL
Y
METFORMIN HCL
Y
LOSARTAN POTASSIUM/HYDROC
Y
SALSALATE
Y
BUMETANIDE
Y
LEVALBUTEROL HCL
Y
CYCLOBENZAPRINE HCL Y
FELODIPINE ER
Y
FLUOCINONIDE
Y
PROMETHAZINE HCL
Y
GAVILYTE-G
Y
CLINDAMYCIN PHOSPHATE
Y
TRETINOIN MICROSPHERE
Y
LOSARTAN POTASSIUM Y
DOXYCYCLINE HYCLATE Y
PENTOXIFYLLINE ER
Y
METFORMIN HCL ER
Y
ESCITALOPRAM OXALATEY
HYDROCORTISONE BUTYRATE
Y
(
ESTRADIOL
Y
OXYCODONE HCL
Y
ZIPRASIDONE HCL
Y
SUMATRIPTAN SUCCINATE
Y
FLUCONAZOLE
Y
ATORVASTATIN CALCIUMY
OXYBUTYNIN CHLORIDE ER
Y
CEFDINIR
Y
ENALAPRIL MALEATE Y
OXCARBAZEPINE
Y
ISOSORBIDE MONONITRATE
Y ER
CLOBETASOL PROPIONATE
Y
DESONIDE
Y
DESONIDE
Y
BUPROPION HCL
Y
ATOVAQUONE/PROGUANIL
Y HCL
LAMOTRIGINE
Y
VERAPAMIL HCL ER
Y
ALLOPURINOL
Y
TINIDAZOLE
Y
OXYCODONE HCL
Y
LORAZEPAM
Y
AMITRIPTYLINE HCL
Y
ZIPRASIDONE HCL
Y
TERCONAZOLE
Y
CLODAN
Y
AMOXICILLIN
Y
AMITRIPTYLINE HCL
Y
AMPHETAMINE/DEXTROAMPHETA
Y
METOPROLOL TAB 25MG ER
SULINDAC TAB 150MG
DESONIDE CRE 0.05%
HC PRAMOXINE CRE 2.5-1%
ECONAZOLE CRE 1%
TRAZODONE TAB 50MG
VERAPAMIL TAB 240MG ER
SULFACETAMID LOT 10%
METRONIDAZOL TAB 500MG
LEVOTHYROXIN TAB 112MCG
SUCRALFATE TAB 1GM
PHENYTOIN EX CAP 100MG
METOPROL TAR TAB 50MG
OXYCOD/APAP TAB 5-325MG
LIDOCAINE CRE 3%
MONTELUKAST CHW 5MG
LIDO/PRILOCN CRE 2.5-2.5%
PROPRANOLOL TAB 10MG
MEDROXYPR AC TAB 2.5MG
VALSARTAN TAB 40MG
GLYBURIDE TAB 5MG
OLANZAPINE TAB 7.5MG
METOPROLOL TAB 50MG ER
METFORMIN TAB 500MG
METFORMIN TAB 1000MG
LOSARTAN/HCT TAB 50-12.5
SALSALATE TAB 750MG
BUMETANIDE TAB 1MG
LEVALBUTEROL NEB 0.63MG
CYCLOBENZAPR TAB 5MG
FELODIPINE TAB 5MG ER
FLUOCINONIDE CRE 0.05%
PROMETHAZINE TAB 25MG
GAVILYTE-G SOL
CLINDAMYCIN CRE 2% VAG
TRETINOIN GEL 0.04%
LOSARTAN POT TAB 25MG
DOXYCYCL HYC TAB 100MG
PENTOXIFYLLI TAB 400MG ER
METFORMIN TAB 750MG ER
ESCITALOPRAM TAB 10MG
HC BUTYRATE CRE 0.1%
ESTRADIOL TAB 1MG
OXYCODONE TAB 30MG
ZIPRASIDONE CAP 40MG
SUMATRIPTAN TAB 100MG
FLUCONAZOLE TAB 200MG
ATORVASTATIN TAB 20MG
OXYBUTYNIN TAB 5MG ER
CEFDINIR SUS 250/5ML
ENALAPRIL TAB 2.5MG
OXCARBAZEPIN TAB 300MG
ISOSORB MONO TAB 60MG ER
CLOBETASOL SOL 0.05%
DESONIDE OIN 0.05%
DESONIDE OIN 0.05%
BUPROPION TAB 75MG
ATOVAQ/PROGU TAB 250-100
LAMOTRIGINE TAB 200MG
VERAPAMIL TAB 120MG ER
ALLOPURINOL TAB 300MG
TINIDAZOLE TAB 500MG
OXYCODONE CON 100/5ML
LORAZEPAM TAB 1MG
AMITRIPTYLIN TAB 50MG
ZIPRASIDONE CAP 40MG
TERCONAZOLE CRE 0.8%
CLODAN
SHA 0.05%
AMOXICILLIN SUS 250/5ML
AMITRIPTYLIN TAB 10MG
AMPHETAMINE TAB 7.5MG
6
8
4
12
10
67
7
5
34
16
5
5
46
36
5
6
9
31
20
1
7
4
6
47
29
17
1
11
1
53
3
7
50
24
5
1
13
3
5
10
6
1
31
3
1
22
3
3
2
4
17
5
5
4
2
2
6
3
9
3
25
1
1
58
13
1
11
1
66
18
7
450
1,110
90
360
300
6,802
570
590
692
1,440
1,060
1,090
7,680
1,470
170
480
270
4,005
1,740
90
1,380
180
540
8,124
4,472
1,530
180
704
216
2,203
270
210
1,716
96,000
200
45
960
94
810
1,320
420
60
3,360
450
60
252
91
210
120
400
1,710
900
810
200
120
120
645
53
750
540
2,130
60
30
3,916
930
60
220
118
12,100
2,670
314
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 153
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68382009301
42808011012
61314012605
68382003305
00228203910
00574210304
68462038401
00378004710
00378303001
00168032346
16714043901
68001012100
00591231619
00172409680
68382014206
76439020190
49884011701
65862037301
00168005430
00781518492
00378073401
42192070810
00093777205
00185536830
00781518292
50190014263
65862055990
23155000301
00472038015
24208041010
62756016013
00378929091
31722052201
00093742698
60505014601
68645040970
60432083716
29300016915
45802042578
68382002210
00378505101
65162051710
00093754206
16729000417
00093105201
00781519192
00591280560
49884098501
60505327503
68645047654
65862024708
44523060616
65162051510
68180039301
59762081001
00781281001
51672126705
16729000201
51079002320
68462010860
68382027201
00378001801
65862014505
00378013710
00832046515
45802015194
00591034701
45802005935
00781607846
49884064001
53746019405
CARVEDILOL
Y
SULFACETAMIDE SODIUM/SULF
Y
KETOROLAC TROMETHAMINE
Y
DIVALPROEX SODIUM DRY
ALPRAZOLAM
Y
CLOBETASOL PROPIONATE
Y
ESZOPICLONE
Y
METOPROLOL TARTRATEY
DOXYCYCLINE HYCLATE DR
Y
METRONIDAZOLE
Y
NITROFURANTOIN MONOHYDRAT
Y
METOPROLOL SUCCINATE
Y ER
VALSARTAN/HYDROCHLOROTHIA
Y
BACLOFEN
Y
LOSARTAN POTASSIUM/HYDROC
Y
VIRT-VITE FORTE
Y
AMILORIDE HCL
Y
ESCITALOPRAM OXALATEY
NYSTATIN
Y
LEVOTHYROXINE SODIUM
Y
FLUOXETINE HCL
Y
ANTIPYRINE/BENZOCAINE
Y
CLOZAPINE
Y
EPLERENONE
Y
LEVOTHYROXINE SODIUM
Y
NEBUSAL
Y
PANTOPRAZOLE SODIUMY
HYDRALAZINE HCL
Y
BETAMETHASONE DIPROPIONAT
Y
OFLOXACIN
Y
TAMSULOSIN HCL
Y
SELEGILINE HCL
Y
HYDRALAZINE HCL
Y
MONTELUKAST SODIUM Y
OMEPRAZOLE
Y
LOSARTAN POTASSIUM Y
BROMFED DM
Y
TIZANIDINE HCL
Y
FEXOFENADINE HCL
Y
ATENOLOL
Y
CARBIDOPA/LEVODOPA ODT
Y
PHENAZOPYRIDINE HCL Y
DULOXETINE HCL
Y
SIMVASTATIN
Y
ENALAPRIL MALEATE/HYDROCH
Y
LEVOTHYROXINE SODIUM
Y
CLARITHROMYCIN ER Y
NATEGLINIDE
Y
OLANZAPINE ODT
Y
IBUPROFEN
Y
LEVETIRACETAM
Y
SODIUM SULFACETAMIDE
Y WASH
SPIRONOLACTONE
Y
CIPROFLOXACIN
Y
NADOLOL
Y
OXAZEPAM
Y
TRIAMCINOLONE IN ORABASE
Y
GLIMEPIRIDE
Y
METOLAZONE
Y
TOPIRAMATE
Y
ETODOLAC ER
Y
METOPROLOL TARTRATEY
CARVEDILOL
Y
ALLOPURINOL
Y
NYAMYC
Y
FLUOCINONIDE
Y
HYDROCHLOROTHIAZIDEY
NYSTATIN
Y
CEFDINIR
Y
METHIMAZOLE
Y
NAPROXEN SODIUM
Y
CARVEDILOL TAB 6.25MG
SOD SUL/SULF EMU 10-5%
KETOROLAC SOL 0.5%
DIVALPROEX TAB 500MG DR
ALPRAZOLAM TAB 2MG
CLOBETASOL LOT 0.05%
ESZOPICLONE TAB 3MG
METOPROL TAR TAB 100MG
DOXYCYCL HYC TAB 150MG DR
METRONIDAZOL CRE 0.75%
NITROFURANTN CAP 100MG
METOPROLOL TAB 25MG ER
VALSART/HCTZ TAB 160-12.5
BACLOFEN TAB 10MG
LOSARTAN/HCT TAB 50-12.5
VIRT-VITE TAB FORTE
AMILORIDE TAB 5MG
ESCITALOPRAM TAB 5MG
NYSTATIN CRE 100000
LEVOTHYROXIN TAB 100MCG
FLUOXETINE TAB 10MG
ANTIPY/BENZO SOL OTIC
CLOZAPINE TAB 100MG
EPLERENONE TAB 25MG
LEVOTHYROXIN TAB 75MCG
NEBUSAL NEB 3%
PANTOPRAZOLE TAB 20MG
HYDRALAZINE TAB 50MG
BETAMETH DIP CRE 0.05%
OFLOXACIN DRO 0.3%OTIC
TAMSULOSIN CAP 0.4MG
SELEGILINE TAB 5MG
HYDRALAZINE TAB 100MG
MONTELUKAST TAB 10MG
OMEPRAZOLE CAP 40MG
LOSARTAN POT TAB 50MG
BROMFED DM SYP
TIZANIDINE TAB 4MG
FEXOFENADINE TAB 60MG
ATENOLOL TAB 25MG
CARB/LEVO TAB 10-100MG
PHENAZOPYRID TAB 100MG
DULOXETINE CAP 20MG
SIMVASTATIN TAB 10MG
ENALAPR/HCTZ TAB 10-25MG
LEVOTHYROXIN TAB 137MCG
CLARITHROMYC TAB 500MG ER
NATEGLINIDE TAB 120MG
OLANZAPINE TAB 5MG ODT
IBUPROFEN TAB 800MG
LEVETIRACETA TAB 750MG
SODIUM SULFA LIQ 10% WASH
SPIRONOLACT TAB 100MG
CIPROFLOXACN SUS 500MG/5
NADOLOL TAB 20MG
OXAZEPAM CAP 15MG
TRIAMCIN/ORA PST 0.1%
GLIMEPIRIDE TAB 2MG
METOLAZONE TAB 2.5MG
TOPIRAMATE TAB 25MG
ETODOLAC ER TAB 500MG
METOPROL TAR TAB 25MG
CARVEDILOL TAB 25MG
ALLOPURINOL TAB 100MG
NYAMYC
POW 100000
FLUOCINONIDE CRE 0.1%
HYDROCHLOROT CAP 12.5MG
NYSTATIN CRE 100000
CEFDINIR SUS 250/5ML
METHIMAZOLE TAB 5MG
NAPROXEN SOD TAB 550MG
14
4
15
10
45
1
2
35
1
3
8
8
2
12
8
10
4
6
13
20
10
29
11
1
30
8
17
4
7
14
4
2
4
4
11
12
10
20
7
43
1
30
2
13
5
16
4
1
3
52
2
2
5
3
4
6
5
32
3
26
3
39
9
20
4
1
19
20
4
13
53
2,160
1,360
80
1,506
2,783
118
60
5,910
30
135
140
720
180
1,611
720
540
360
180
450
1,320
668
300
308
90
1,620
1,920
810
900
195
140
360
180
1,080
240
990
780
1,630
1,504
540
4,545
270
389
60
990
450
1,215
83
270
62
3,094
360
960
540
300
180
360
30
2,925
270
3,962
150
4,970
1,620
2,850
240
30
2,010
435
400
945
2,805
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 154
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
53746025310
45802062626
44523041501
68645047154
00603760748
00054024425
50111091701
68382019716
51672413806
57664013688
00591566005
00093812301
00527155201
00574016215
00781145310
55111062660
00054054618
00527138301
68382002101
45802095243
00487950103
00378474501
00172572960
68382012305
43478024320
59762314001
52544069430
00378471522
00378268501
43478024120
00781595192
00054025222
00093943301
65862046890
59762018202
68462018022
59762313001
68682099230
00093077198
68462033190
00378267501
55111032201
63739028531
16729016801
68001025506
16714067101
67877022401
00093415580
66993002327
16714069102
16714039703
55111034001
51672408104
00054418425
31722037702
00093075505
76439013410
54879000716
10702001101
00781532501
00093413773
76439010710
16714034704
68462035901
00093736810
41616063868
66530025920
00781615757
24208043410
00378425001
00093101501
RANITIDINE HCL
Y
CETIRIZINE HCL
Y
POTASSIUM CITRATE ER Y
SIMVASTATIN
Y
GILDESS 1/20
Y
CODEINE SULFATE
Y
TORSEMIDE
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
GRANISETRON HCL
Y
VITAMIN D
Y
SULINDAC
Y
DOXAZOSIN MESYLATE Y
BUTALBITAL/ASPIRIN/CAFFEI
Y
DICLOFENAC SODIUM Y
GLIPIZIDE
Y
ZAFIRLUKAST
Y
TELMISARTAN/HYDROCHLOROTH
Y
CLINDAMYCIN HCL
Y
VENLAFAXINE HCL
Y
IBUPROFEN
Y
ALBUTEROL SULFATE Y
BENAZEPRIL HCL/HYDROCHLOR
Y
FAMOTIDINE
Y
AMLODIPINE BESYLATE Y
TRETINOIN
Y
AZITHROMYCIN
Y
MATZIM LA
Y
PREDNISOLONE SODIUMYPHOSP
AMITRIPTYLINE HCL
Y
TRETINOIN
Y
VALSARTAN/HYDROCHLOROTHIA
Y
IRBESARTAN
Y
GLYBURIDE
M
LOSARTAN POTASSIUM/HYDROC
Y
VENLAFAXINE HCL ER Y
MUPIROCIN
Y
AZITHROMYCIN
Y
FLUOCINONIDE
Y
PRAVASTATIN SODIUM Y
PRAMIPEXOLE DIHYDROCHLORI
Y
AMITRIPTYLINE HCL
Y
GLIMEPIRIDE
Y
DILTIAZEM CD
Y
ESCITALOPRAM OXALATEY
DULOXETINE HCL
Y
ONDANSETRON HCL
Y
GABAPENTIN
Y
AMOXICILLIN
Y
LEVALBUTEROL HCL
Y
FLUCONAZOLE
Y
CEFPROZIL
Y
AMLODIPINE BESYLATE/BENAZ
Y
CLINDAMYCIN PHOSPHATE
Y
DEXAMETHASONE
Y
CALCIUM ACETATE
Y
DIFLUNISAL
Y
METHOCARBAMOL
Y
SULFATRIM PEDIATRIC Y
HYDROXYZINE HCL
Y
BROMOCRIPTINE MESYLATE
Y
CEFDINIR
Y
DESLORATADINE
Y
PHILITH
Y
NABUMETONE
Y
LOSARTAN POTASSIUM/HYDROC
Y
ALENDRONATE SODIUM Y
TRETINOIN MICROSPHERE
Y
AMOXICILLIN
Y
OFLOXACIN
Y
DOXEPIN HCL
Y
NABUMETONE
Y
RANITIDINE TAB 150MG
CETIRIZINE SYP 1MG/ML
POT CITRATE TAB 1620MG
SIMVASTATIN TAB 40MG
GILDESS TAB 1/20
CODEINE SULF TAB 30MG
TORSEMIDE TAB 20MG
PRAMIPEXOLE TAB 0.25MG
GRANISETRON TAB 1MG
VITAMIN D CAP 50000UNT
SULINDAC TAB 200MG
DOXAZOSIN TAB 8MG
BUT/ASA/CAFF CAP
DICLOFENAC SOL 1.5%
GLIPIZIDE TAB 10MG
ZAFIRLUKAST TAB 20MG
TELMISA/HCTZ TAB 80-12.5
CLINDAMYCIN CAP 300MG
VENLAFAXINE TAB 75MG
IBUPROFEN SUS 100/5ML
ALBUTEROL NEB 0.083%
BENAZEP/HCTZ TAB 20-12.5
FAMOTIDINE TAB 40MG
AMLODIPINE TAB 10MG
TRETINOIN CRE 0.025%
AZITHROMYCIN SUS 200/5ML
MATZIM LA TAB 360MG/24
PREDNISOLONE TAB 15MG ODT
AMITRIPTYLIN TAB 100MG
TRETINOIN CRE 0.1%
VALSART/HCTZ TAB 320-12.5
IRBESARTAN TAB 300MG
GLYBURIDE TAB 2.5MG
LOSARTAN/HCT TAB 50-12.5
VENLAFAXINE CAP 150MG ER
MUPIROCIN OIN 2%
AZITHROMYCIN SUS 200/5ML
FLUOCINONIDE CRE 0.1%
PRAVASTATIN TAB 10MG
PRAMIPEXOLE TAB 0.25MG
AMITRIPTYLIN TAB 75MG
GLIMEPIRIDE TAB 4MG
DILTIAZEM CAP 240MG CD
ESCITALOPRAM TAB 5MG
DULOXETINE CAP 20MG
ONDANSETRON SOL 4MG/5ML
GABAPENTIN CAP 400MG
AMOXICILLIN SUS 250/5ML
LEVALBUTEROL NEB 1.25MG
FLUCONAZOLE TAB 100MG
CEFPROZIL SUS 250/5ML
AMLOD/BENAZP CAP 5-20MG
CLINDAMYCIN SOL 1%
DEXAMETHASON TAB 4MG
CALC ACETATE CAP 667MG
DIFLUNISAL TAB 500MG
METHOCARBAM TAB 500MG
SULFATRIM PD SUS 200-40/5
HYDROXYZ HCL TAB 25MG
BROMOCRIPTIN TAB 2.5MG
CEFDINIR SUS 250/5ML
DESLORATADIN TAB 5MG
PHILITH TAB 0.4-35
NABUMETONE TAB 750MG
LOSARTAN/HCT TAB 100-25
ALENDRONATE TAB 70MG
TRETINOIN GEL 0.04%
AMOXICILLIN SUS 400/5ML
OFLOXACIN DRO 0.3% OP
DOXEPIN HCL CAP 50MG
NABUMETONE TAB 500MG
28
37
1
17
6
5
7
3
3
40
3
5
6
1
22
1
1
7
2
45
26
1
17
35
7
12
1
2
11
4
1
2
11
6
12
21
14
1
10
5
11
8
3
2
1
1
5
61
2
13
5
3
5
68
2
1
63
13
22
1
3
2
3
5
3
26
1
57
9
10
7
3,240
5,855
120
1,470
357
600
1,710
540
60
401
540
510
270
150
4,230
180
90
431
240
8,076
4,860
180
2,114
3,030
140
375
90
13
570
80
90
120
1,755
420
720
477
338
30
840
330
810
990
270
135
90
100
1,620
12,000
216
147
500
270
300
1,313
450
180
4,115
1,855
1,293
90
300
60
252
660
270
152
20
8,400
85
630
780
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 155
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
16729014717
68382000801
65862046930
00178047002
00168004046
62756079813
00378001401
31722034205
66993088448
23155011010
00093516101
60505001406
00093227234
00781285560
00527139501
17478028435
68462019590
68382070201
51672411606
50111056303
65862021150
68382004101
00781574901
51672403601
00378370159
65162059020
10888713602
68180021506
65862059805
68382002910
53746027101
00093736798
00781542131
16714039301
17478020910
50111064803
65862020299
00378230201
59762669103
00093736510
68180041206
31722026890
55111046901
68382014306
00406036705
60505132305
55111046701
68180051801
62756014202
00574019530
68180018001
43538018245
65162061750
61314012610
00378191405
23155013525
65862014990
00093413764
68462010530
00713063131
00591319872
00378182101
49884003501
66993093570
00591578201
42192013316
67877021705
68645048970
00054011225
51672129006
33342007810
QUETIAPINE FUMARATE Y
LAMOTRIGINE
Y
LOSARTAN POTASSIUM/HYDROC
Y
AVAR-E EMOLLIENT
Y
BETAMETHASONE VALERATE
Y
DIVALPROEX SODIUM DRY
METHOTREXATE
Y
NAPROXEN
Y
ADAPALENE
Y
PROPRANOLOL HCL
Y
HYDROCODONE/IBUPROFEN
Y
DILT-XR
Y
AMOXICILLIN/CLAVULANATE
Y P
RANITIDINE HCL
Y
LOXAPINE
Y
GENTAK
Y
PRAVASTATIN SODIUM Y
POTASSIUM CHLORIDE ERY
METRONIDAZOLE
Y
CYCLOBENZAPRINE HCL Y
MINOCYCLINE HCL
Y
PROMETHAZINE HCL
Y
METHYLPHENIDATE HCL Y
ETODOLAC
Y
RIZATRIPTAN BENZOATE YODT
CALCIUM ACETATE
Y
PROGESTERONE
Y
LOSARTAN POTASSIUM/HYDROC
Y
TAMSULOSIN HCL
Y
METFORMIN HCL
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
LOSARTAN POTASSIUM/HYDROC
Y
PIOGLITAZONE HCL
Y
CEFDINIR
Y
KETOROLAC TROMETHAMINE
Y
FLUOXETINE HCL
Y
LOSARTAN POTASSIUM Y
PRAZOSIN HCL
Y
NIFEDIPINE ER
Y
LOSARTAN POTASSIUM Y
IRBESARTAN
Y
QUINAPRIL HCL
Y
METOPROLOL SUCCINATE
Y ER
LOSARTAN POTASSIUM/HYDROC
Y
HYDROCODONE/ACETAMINOPHEN
Y
PRAVASTATIN SODIUM Y
METOPROLOL SUCCINATE
Y ER
LISINOPRIL/HYDROCHLOROTHI
Y
METFORMIN HCL ER
Y
MEFENAMIC ACID
Y
CEFADROXIL
Y
ROSADAN
Y
TRAMADOL HYDROCHLORIDE/AC
Y
KETOROLAC TROMETHAMINE
Y
CLONAZEPAM
Y
DOXYCYCLINE MONOHYDRATE
Y
FINASTERIDE
Y
CEFDINIR
Y
ONDANSETRON HCL
Y
FLUTICASONE PROPIONATE
Y
FENTANYL
Y
LEVOTHYROXINE SODIUM
Y
MECLIZINE HCL
Y
METRONIDAZOLE VAGINAL
Y
ATENOLOL/CHLORTHALIDONE
Y
SODIUM SULFACETAMIDE/SULF
Y
METFORMIN HCL
Y
SERTRALINE HCL
Y
PERINDOPRIL ERBUMINEY
HYDROCORTISONE VALERATE
Y
VALSARTAN/HYDROCHLOROTHIA
Y
QUETIAPINE TAB 100MG
LAMOTRIGINE TAB 100MG
LOSARTAN/HCT TAB 100-12.5
AVAR-E EMOLL CRE 10-5%
BETAMETH VAL CRE 0.1%
DIVALPROEX TAB 500MG DR
METHOTREXATE TAB 2.5MG
NAPROXEN TAB 500MG
ADAPALENE GEL 0.3%
PROPRANOLOL TAB 10MG
HYDROCOD/IBU TAB 7.5-200
DILT-XR CAP 120MG
AMOX/K CLAV CHW 400MG
RANITIDINE CAP 150MG
LOXAPINE CAP 10MG
GENTAK
OIN 0.3% OP
PRAVASTATIN TAB 10MG
POT CHLORIDE CAP 8MEQ ER
METRONIDAZOL GEL 0.75%
CYCLOBENZAPR TAB 10MG
MINOCYCLINE CAP 100MG
PROMETHAZINE TAB 25MG
METHYLPHENID TAB 10MG
ETODOLAC TAB 500MG
RIZATRIPTAN TAB 5MG ODT
CALC ACETATE CAP 667MG
PROGESTERONE CAP 200MG
LOSARTAN/HCT TAB 50-12.5
TAMSULOSIN CAP 0.4MG
METFORMIN TAB 850MG
SMZ-TMP TAB 400-80MG
LOSARTAN/HCT TAB 50-12.5
PIOGLITAZONE TAB 30MG
CEFDINIR SUS 250/5ML
KETOROLAC SOL 0.5%
FLUOXETINE CAP 20MG
LOSARTAN POT TAB 50MG
PRAZOSIN HCL CAP 2MG
NIFEDIPINE TAB 60MG ER
LOSARTAN POT TAB 50MG
IRBESARTAN TAB 300MG
QUINAPRIL TAB 10MG
METOPROLOL TAB 200MG ER
LOSARTAN/HCT TAB 100-25
HYDROCO/APAP TAB 10-325MG
PRAVASTATIN TAB 80MG
METOPROLOL TAB 50MG ER
LISINOP/HCTZ TAB 10-12.5
METFORMIN TAB 500MG ER
MEFENAM ACID CAP 250MG
CEFADROXIL CAP 500MG
ROSADAN GEL 0.75%
TRAMADL/APAP TAB 37.5-325
KETOROLAC SOL 0.5%
CLONAZEPAM TAB 2MG
DOXYCYC MONO TAB 100MG
FINASTERIDE TAB 5MG
CEFDINIR SUS 250/5ML
ONDANSETRON TAB 4MG
FLUTICASONE CRE 0.05%
FENTANYL DIS 25MCG/HR
LEVOTHYROXIN TAB 300MCG
MECLIZINE TAB 25MG
METRONIDAZOL GEL 0.75%VAG
ATENOL/CHLOR TAB 50-25MG
SOD SUL/SULF SUS 8-4%
METFORMIN TAB 500MG
SERTRALINE TAB 100MG
PERINDOPRIL TAB 8MG
HC VALERATE CRE 0.2%
VALSART/HCTZ TAB 320-25MG
6
27
4
1
3
4
2
64
1
24
4
5
5
5
3
17
6
5
2
69
19
47
7
2
2
2
4
5
3
24
48
6
1
6
7
41
10
5
1
6
2
5
2
6
11
4
6
28
25
1
7
2
3
3
52
14
2
4
43
3
3
4
16
11
8
2
31
9
3
2
3
330
1,605
360
30
405
1,440
96
4,290
45
4,650
412
330
180
358
330
77
540
390
90
3,110
1,040
1,182
750
360
19
430
95
390
390
4,800
1,711
540
90
360
35
4,269
1,080
600
180
540
120
390
120
420
780
360
420
2,400
3,540
30
254
90
465
30
2,775
256
180
300
585
240
30
360
786
770
540
946
5,640
690
150
90
270
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 156
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00185094098
00054025122
51672402801
00781595092
60505265601
60758088015
55111029209
00054002125
45802059475
60505025103
51672529509
00603506021
59762372201
00378250077
57237000511
60432006547
00093077801
49884002201
16252057030
00603646921
00363016522
51079045066
60505250201
60793085301
51525781506
67877022305
51672129801
60432083360
68682037190
00093292901
66993041730
57664039753
68180035206
00185001001
50383026815
16714035501
43386014028
59746000106
23155005810
68180059702
00093005805
60505328006
68382015406
00054001725
62756037088
00555009596
42858010201
16714069101
00093811956
00781548664
55111013030
68180030260
00378156010
68645040770
68382014501
68180011316
45802013132
16714010105
47781030701
00591215990
00093816201
00603703841
51672403501
00093545542
65862014405
00168041630
00781538192
60505251202
67253001241
49884083009
44523056008
CHOLESTYRAMINE
Y
IRBESARTAN
Y
WARFARIN SODIUM
Y
VALSARTAN/HYDROCHLOROTHIA
Y
TRIAMTERENE/HYDROCHLOROTH
Y
FLUOROMETHOLONE Y
SUMATRIPTAN SUCCINATE
Y
LITHIUM CARBONATE ERY
LEVOCETIRIZINE DIHYDROCHL
Y
TIZANIDINE HCL
Y
METRONIDAZOLE
Y
PERPHENAZINE
Y
ALPRAZOLAM
Y
TAMSULOSIN HCL
Y
FLUCONAZOLE
Y
AMOXICILLIN/CLAVULANATE
Y P
CARBAMAZEPINE
Y
ISOSORBIDE DINITRATE Y
RAMIPRIL
Y
ZOLPIDEM TARTRATE Y
WAL-ITIN D 24 HOUR Y
AMLODIPINE BESYLATE Y
LEFLUNOMIDE
Y
LEVOXYL
Y
AZELASTINE HCL
Y
GABAPENTIN
Y
KETOCONAZOLE
Y
LINDANE
Y
DILTIAZEM HCL ER
Y
CYPROHEPTADINE HCL Y
RALOXIFENE HYDROCHLORIDE
Y
METFORMIN HCL
Y
SERTRALINE HCL
Y
LABETALOL HCL
Y
CLOBETASOL PROPIONATE
Y
LEVETIRACETAM
Y
METHYLERGONOVINE MALEATE
Y
METHYLPREDNISOLONE Y
GLYBURIDE
Y
CELECOXIB
Y
TRAMADOL HCL
Y
LEVETIRACETAM ER
Y
RISPERIDONE ODT
Y
PREDNISONE
Y
METOPROLOL/HYDROCHLOROTHI
Y
CLONAZEPAM ODT
Y
OXYCODONE/ACETAMINOPHEN
Y
FLUCONAZOLE
Y
FAMCICLOVIR
Y
RIZATRIPTAN BENZOATE Y
RANITIDINE HCL
Y
CEFUROXIME AXETIL
Y
PHENYTOIN SODIUM EXTENDED
Y
LOSARTAN POTASSIUM Y
RAMIPRIL
Y
LEVETIRACETAM
Y
HALOBETASOL PROPIONATE
Y
GEMFIBROZIL
Y
NITROFURANTOIN MACROCRYST
Y
CICLOPIROX
Y
QUETIAPINE FUMARATE Y
ACETIC ACID
Y
WARFARIN SODIUM
Y
MIMVEY
Y
CARVEDILOL
Y
TACROLIMUS
Y
ATORVASTATIN CALCIUMY
FOSINOPRIL SODIUM Y
CEFDINIR
Y
DILTIAZEM CD
Y
SODIUM SULFACETAMIDE/SULF
Y
CHOLESTYRAM POW 4GM
IRBESARTAN TAB 150MG
WARFARIN TAB 2MG
VALSART/HCTZ TAB 160-25MG
TRIAMT/HCTZ TAB 37.5-25
FLUOROMETHOL SUS 0.1% OP
SUMATRIPTAN TAB 50MG
LITHIUM CARB TAB 300MG ER
LEVOCETIRIZI TAB 5MG
TIZANIDINE TAB 2MG
METRONIDAZOL GEL 1%
PERPHENAZINE TAB 2MG
ALPRAZOLAM TAB 2MG
TAMSULOSIN CAP 0.4MG
FLUCONAZOLE TAB 150MG
AMOX/K CLAV SUS 250/5ML
CARBAMAZEPIN CHW 100MG
ISOSORB DIN TAB 20MG
RAMIPRIL CAP 1.25MG
ZOLPIDEM TAB 10MG
WAL-ITIN D TAB 24 HOUR
AMLODIPINE TAB 2.5MG
LEFLUNOMIDE TAB 10MG
LEVOXYL TAB 88MCG
AZELASTINE DRO 0.05%
GABAPENTIN CAP 300MG
KETOCONAZOLE CRE 2%
LINDANE LOT 1%
DILTIAZEM CAP 360MG ER
CYPROHEPTAD TAB 4MG
RALOXIFENE TAB 60MG
METFORMIN TAB 500MG
SERTRALINE TAB 50MG
LABETALOL TAB 100MG
CLOBETASOL OIN 0.05%
LEVETIRACETA TAB 500MG
METHYLERGON TAB 0.2MG
METHYLPRED TAB 4MG
GLYBURIDE TAB 5MG
CELECOXIB CAP 100MG
TRAMADOL HCL TAB 50MG
LEVETIRACETA TAB 500MG ER
RISPERIDONE TAB 0.5MG OD
PREDNISONE TAB 10MG
METOPRL/HCTZ TAB 50-25MG
CLONAZEP ODT TAB 0.25MG
OXYCOD/APAP TAB 5-325MG
FLUCONAZOLE TAB 100MG
FAMCICLOVIR TAB 500MG
RIZATRIPTAN TAB 10MG
RANITIDINE CAP 300MG
CEFUROXIME TAB 250MG
PHENYTOIN EX CAP 100MG
LOSARTAN POT TAB 25MG
RAMIPRIL CAP 2.5MG
LEVETIRACETA TAB 500MG
HALOBETASOL OIN 0.05%
GEMFIBROZIL TAB 600MG
NITROFUR MAC CAP 50MG
CICLOPIROX SHA 1%
QUETIAPINE TAB 100MG
ACETIC ACID SOL 2% OTIC
WARFARIN TAB 10MG
MIMVEY
TAB 1-0.5MG
CARVEDILOL TAB 12.5MG
TACROLIMUS OIN 0.1%
ATORVASTATIN TAB 10MG
FOSINOPRIL TAB 40MG
CEFDINIR SUS 125/5ML
DILTIAZEM CAP 180MG CD
SOD SUL/SULF EMU 10-5%
3
2
24
1
10
2
15
15
11
10
1
4
30
3
38
2
1
4
4
91
9
2
1
9
3
13
8
2
2
8
2
12
16
6
2
2
2
7
4
1
60
1
3
67
6
5
34
6
7
1
3
5
2
10
3
3
2
4
6
4
1
7
31
1
14
1
3
2
6
3
1
132
180
1,489
90
840
30
171
1,230
915
450
55
360
2,507
277
79
450
540
360
360
3,850
330
360
30
630
18
2,460
255
120
180
419
60
2,430
1,110
660
75
720
10
260
780
180
4,799
720
270
1,989
285
210
1,456
105
93
12
180
102
900
720
270
540
100
600
160
480
60
120
1,364
84
2,520
30
270
225
540
270
227
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
p. 157
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00781350069
33342003811
62756014201
13668011005
54458088810
00093736998
00472011745
55111014430
00093022001
59762002801
16729008110
55111039990
16714039201
43598020351
00168025815
49884058194
10702001601
65162050606
00093312501
65862014930
00781100805
65162053710
00406114201
62175031037
51672128003
16714039202
57664018534
00713063415
00591271730
68382007316
54295030121
00054022931
67253090150
00378700410
00781107905
55111028050
00603255321
24470091310
68180040201
68645044570
00603221721
50383023210
76204010060
51672127406
00363089688
55111062560
60505700702
00555057235
33342007410
68180050201
00713031788
68382013814
16714011112
45802045542
00093527701
00378561707
65862052730
59746032990
67877027207
00378105310
00781556031
68645041170
00591566001
00555032302
00713070489
63304009919
68180055809
00054011825
67877021710
66993047173
47335053183
ENOXAPARIN SODIUM Y
ESCITALOPRAM OXALATEY
METFORMIN HCL ER
Y
DULOXETINE HCL
Y
CLOPIDOGREL
Y
LOSARTAN POTASSIUM/HYDROC
Y
TRETINOIN
Y
FLUCONAZOLE
Y
BICALUTAMIDE
Y
DICLOFENAC SODIUM/MISOPRO
Y
NALTREXONE HCL
Y
LANSOPRAZOLE
Y
CEFDINIR
Y
AMOXICILLIN/CLAVULANATE
Y P
CLOTRIMAZOLE/BETAMETHASON
Y
RIZATRIPTAN BENZOATE YODT
INDOMETHACIN ER
Y
INDOMETHACIN ER
Y
DICLOXACILLIN SODIUM Y
FINASTERIDE
Y
TRIAMTERENE/HYDROCHLOROTH
Y
BENZONATATE
Y
METHYLPHENIDATE HCL Y
METHYLPHENIDATE HCL ER
Y
DESONIDE
Y
CEFDINIR
Y
PROMETHAZINE/CODEINE
Y
MOMETASONE FUROATEY
METHYLPHENIDATE HCL ER
Y
PRAVASTATIN SODIUM Y
SODIUM SULFACETAMIDE/SULF
Y
QUETIAPINE FUMARATE Y
ALPRAZOLAM
Y
PAROXETINE HCL
Y
ALPRAZOLAM
Y
LEVOFLOXACIN
Y
BUTALBITAL/ACETAMINOPHEN/
Y
BP FOAM
Y
CEFPROZIL
Y
AMLODIPINE BESYLATE Y
AMITRIPTYLINE HCL
Y
DORZOLAMIDE HCL
Y
IPRATROPIUM BROMIDEY
BETAMETHASONE DIPROPIONAT
Y
NICOTINE TRANSDERMALY SYST
ZAFIRLUKAST
Y
FENTANYL
Y
METHOTREXATE
Y
VALSARTAN/HYDROCHLOROTHIA
Y
MELOXICAM
Y
CICLOPIROX NAIL LACQUER
Y
TOPIRAMATE
Y
TRAMADOL HCL
Y
HYDROCORTISONE VALERATE
Y
DEXMETHYLPHENIDATE HCL
Y
LEVETIRACETAM
Y
VENLAFAXINE HCL ER Y
DONEPEZIL HCL
Y
UREA
Y
ENALAPRIL MALEATE Y
MONTELUKAST SODIUM Y
LOSARTAN POTASSIUM Y
SULINDAC
Y
HYDROXYZINE PAMOATEY
HYDROCODONE BITARTRATE/AC
Y
SUMATRIPTAN SUCCINATE
Y
QUINAPRIL HCL
Y
ROPINIROLE HCL
Y
METFORMIN HCL
Y
NITROFURANTOIN
Y
TRAMADOL HCL ER
Y
ENOXAPARIN INJ 100MG/ML
ESCITALOPRAM TAB 20MG
METFORMIN TAB 500MG ER
DULOXETINE CAP 30MG
CLOPIDOGREL TAB 75MG
LOSARTAN/HCT TAB 100-12.5
TRETINOIN CRE 0.025%
FLUCONAZOLE TAB 100MG
BICALUTAMIDE TAB 50MG
DICLO/MISOPR TAB 50-0.2MG
NALTREXONE TAB 50MG
LANSOPRAZOLE CAP 30MG DR
CEFDINIR SUS 125/5ML
AMOX/K CLAV SUS 600/5ML
CLOTRIM/BETA CRE DIPROP
RIZATRIPTAN TAB 10MG ODT
INDOMETHACIN CAP 75MG ER
INDOMETHACIN CAP 75MG ER
DICLOXACILL CAP 500MG
FINASTERIDE TAB 5MG
TRIAMT/HCTZ TAB 75-50MG
BENZONATATE CAP 200MG
METHYLPHENID TAB 5MG
METHYLPHENID TAB 18MG ER
DESONIDE CRE 0.05%
CEFDINIR SUS 125/5ML
PROMETH/COD SYP 6.25-10
MOMETASONE CRE 0.1%
METHYLPHENID TAB 36MG ER
PRAVASTATIN TAB 80MG
SOD SUL/SULF LIQ 9-4.5%
QUETIAPINE TAB 50MG
ALPRAZOLAM TAB 0.5MG
PAROXETINE TAB 40MG
ALPRAZOLAM TAB 1MG
LEVOFLOXACIN TAB 500MG
BUT/APAP/CAF CAP CODEINE
BP FOAM AER 9.8%
CEFPROZIL SUS 250/5ML
AMLODIPINE TAB 10MG
AMITRIPTYLIN TAB 150MG
DORZOLAMIDE SOL 2% OP
IPRATROPIUM SOL 0.02%INH
BETAMETH DIP CRE 0.05%
NICOTINE TD DIS 21MG/24H
ZAFIRLUKAST TAB 10MG
FENTANYL DIS 50MCG/HR
METHOTREXATE TAB 2.5MG
VALSART/HCTZ TAB 80-12.5
MELOXICAM TAB 15MG
CICLOPIROX SOL 8%
TOPIRAMATE TAB 25MG
TRAMADOL HCL TAB 50MG
HC VALERATE CRE 0.2%
DEXMETHYLPH TAB 10MG
LEVETIRACETA TAB 750MG
VENLAFAXINE CAP 37.5 ER
DONEPEZIL TAB 5MG
UREA
CRE 40%
ENALAPRIL TAB 10MG
MONTELUKAST TAB 10MG
LOSARTAN POT TAB 100MG
SULINDAC TAB 200MG
HYDROXYZ PAM CAP 25MG
HYDROCO/APAP SOL 7.5-325
SUMATRIPTAN TAB 100MG
QUINAPRIL TAB 20MG
ROPINIROLE TAB 1MG
METFORMIN TAB 500MG
NITROFURANTN SUS 25MG/5ML
TRAMADOL HCL TAB 100MG ER
1
1
19
2
4
3
2
4
4
2
2
3
7
9
7
1
1
1
11
5
19
29
12
2
1
5
67
13
2
2
2
2
80
8
69
14
9
1
3
15
3
5
4
4
3
1
1
1
3
32
6
22
49
2
6
3
11
3
3
8
3
8
9
20
4
13
4
5
28
1
3
5
90
3,360
60
240
270
90
180
120
120
60
90
540
1,050
180
12
180
180
380
330
1,545
914
420
45
60
560
11,983
360
60
180
908
60
4,793
900
4,965
140
220
100
400
1,170
270
90
600
180
84
180
10
96
270
1,857
66
3,010
3,478
90
210
1,080
544
150
596
720
210
420
720
1,701
970
171
360
390
5,730
120
90
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
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$
$
$
$
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$
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$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
$
$
$
$
$
$
$
$
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$
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$
$
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$
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$
$
$
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$
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$
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$
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$
$
$
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$
$
$
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-
p. 158
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378402801
68462019805
62756035664
64980051025
00555077902
50383078130
00603448628
31722077701
45802042337
00245004015
00378511001
24208041005
59762171002
16729019517
16729002116
00781207410
00378003210
00228255196
16571040210
00185014505
00603781874
00574061105
65862047701
00603148158
51672129802
00603138458
67877011601
65862014305
00378047705
23155014801
60758061525
00093769356
51672209208
00781507701
67877012450
00121075908
68382003010
65862042005
59762054001
60793085401
68462023290
68382031501
00555087402
31722022301
00378632377
00781560731
65862000501
00781551501
00378968044
00093724406
00378705001
00472016630
00713032415
54458099610
00168035730
00527134901
00168009960
00574709312
00093715706
00093081201
50383026960
00245008411
65862062690
53489011802
00093736698
64679092503
11528001001
00093721410
00781282431
00527134701
00591282505
DOXAZOSIN MESYLATE Y
PRAVASTATIN SODIUM Y
ONDANSETRON ODT
Y
FLUNISOLIDE
Y
MEDROXYPROGESTERONE
Y ACETA
LIDOCAINE HCL JELLY Y
METHOCARBAMOL
Y
ACYCLOVIR
Y
DESONIDE
Y
KLOR-CON 8
Y
PROCHLORPERAZINE MALEATE
Y
OFLOXACIN
Y
EPLERENONE
Y
LISINOPRIL
Y
PIOGLITAZONE HCL
Y
TRIAMTERENE/HYDROCHLOROTH
Y
METOPROLOL TARTRATEY
DICLOFENAC SODIUM DRY
CETIRIZINE HCL
Y
NABUMETONE
Y
NYSTATIN
Y
PODOFILOX
Y
RAMIPRIL
Y
NYSTATIN
Y
KETOCONAZOLE
Y
LEVETIRACETAM
Y
METHADONE HCL
Y
CARVEDILOL
Y
DIAZEPAM
Y
ACARBOSE
Y
GATIFLOXACIN
Y
AMLODIPINE BESYLATE/VALSA
Y
LORATADINE CHILDRENSY
LORATADINE
Y
SILVER SULFADIAZINE Y
PREDNISOLONE SODIUMYPHOSP
METFORMIN HCL
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
GLIPIZIDE XL
Y
LEVOXYL
Y
OMEPRAZOLE
Y
DIVALPROEX SODIUM ERY
WARFARIN SODIUM
Y
GABAPENTIN
Y
VALSARTAN/HYDROCHLOROTHIA
Y
VALSARTAN
Y
CITALOPRAM HYDROBROMIDE
Y
GRISEOFULVIN MICROSIZE
Y
LEVALBUTEROL HCL
Y
CLARITHROMYCIN ER Y
LOXAPINE SUCCINATE Y
NYSTATIN
Y
FLUOCINOLONE ACETONIDE
Y
LISINOPRIL
Y
LIDOCAINE/PRILOCAINE Y
LEVOTHYROXINE SODIUM
Y
KETOCONAZOLE
Y
HYDROCORTISONE ACETATE
Y
CLARITHROMYCIN
Y
NORTRIPTYLINE HCL
Y
CLOBETASOL PROPIONATE
Y
PROPRANOLOL HCL ER Y
RIZATRIPTAN BENZOATE YODT
DOXYCYCLINE HYCLATE Y
LOSARTAN POTASSIUM Y
ENALAPRIL MALEATE Y
COVARYX
Y
METFORMIN HCL
Y
FLUOXETINE HCL
Y
LEVOTHYROXINE SODIUM
Y
CELECOXIB
Y
DOXAZOSIN TAB 8MG
PRAVASTATIN TAB 80MG
ONDANSETRON TAB 8MG ODT
FLUNISOLIDE SPR 0.025%
MEDROXYPR AC TAB 10MG
LIDOCAINE GEL 2% JELLY
METHOCARBAM TAB 750MG
ACYCLOVIR TAB 400MG
DESONIDE OIN 0.05%
KLOR-CON 8 TAB 8MEQ ER
PROCHLORPER TAB 10MG
OFLOXACIN DRO 0.3%OTIC
EPLERENONE TAB 25MG
LISINOPRIL TAB 5MG
PIOGLITAZONE TAB 30MG
TRIAMT/HCTZ CAP 37.5-25
METOPROL TAR TAB 50MG
DICLOFENAC TAB 75MG DR
CETIRIZINE TAB 10MG
NABUMETONE TAB 500MG
NYSTATIN CRE 100000
PODOFILOX SOL 0.5%
RAMIPRIL CAP 10MG
NYSTATIN SUS 100000
KETOCONAZOLE CRE 2%
LEVETIRACETA SOL 100MG/ML
METHADONE TAB 10MG
CARVEDILOL TAB 6.25MG
DIAZEPAM TAB 10MG
ACARBOSE TAB 50MG
GATIFLOXACIN SOL 0.5%
AMLOD/VALSAR TAB 10-320MG
LORATADINE SOL 5MG/5ML
LORATADINE TAB 10MG
SILVER SULFA CRE 1%
PREDNISOLONE SOL 15MG/5ML
METFORMIN TAB 1000MG
SMZ/TMP DS TAB 800-160
GLIPIZIDE XL TAB 2.5MG
LEVOXYL TAB 100MCG
OMEPRAZOLE CAP 40MG
DIVALPROEX TAB 500MG ER
WARFARIN TAB 4MG
GABAPENTIN CAP 400MG
VALSART/HCTZ TAB 160-25MG
VALSARTAN TAB 40MG
CITALOPRAM TAB 10MG
GRISEOFULVIN TAB MICR 500
LEVALBUTEROL NEB 0.31MG
CLARITHROMYC TAB 500MG ER
LOXAPINE CAP 50MG
NYSTATIN OIN 100000
FLUOCIN ACET CRE 0.025%
LISINOPRIL TAB 20MG
LIDO/PRILOCN CRE 2.5-2.5%
LEVOTHYROXIN TAB 150MCG
KETOCONAZOLE CRE 2%
HYDROCORT AC SUP 30MG
CLARITHROMYC TAB 250MG
NORTRIPTYLIN CAP 50MG
CLOBETASOL GEL 0.05%
PROPRANOLOL CAP 60MG ER
RIZATRIPTAN TAB 10MG ODT
DOXYCYCL HYC CAP 50MG
LOSARTAN POT TAB 100MG
ENALAPRIL TAB 10MG
COVARYX TAB
METFORMIN TAB 1000MG
FLUOXETINE CAP 40MG
LEVOTHYROXIN TAB 125MCG
CELECOXIB CAP 200MG
4
6
6
5
45
17
13
6
1
6
24
15
1
29
10
21
28
9
37
2
11
4
2
5
7
2
18
9
120
1
1
1
28
66
21
62
26
69
8
9
7
2
21
6
2
1
23
1
2
3
1
10
7
38
6
10
5
2
4
9
1
2
3
4
5
7
2
9
12
27
1
360
540
90
125
1,269
840
902
373
60
540
1,043
105
90
2,310
900
1,530
4,140
860
1,394
720
345
14
180
1,000
240
816
1,800
1,620
3,490
270
5
30
4,655
2,233
1,300
2,582
3,630
1,519
720
570
210
90
1,260
1,500
180
90
1,290
30
144
56
90
330
150
3,540
180
861
300
60
80
1,020
60
120
27
152
390
630
180
1,140
960
1,590
30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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-
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-
p. 159
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00574041205
00054008525
67877029605
65862052305
51672130406
00378204293
68180051602
64679092602
00591216039
68180048102
54505033310
00527134301
13668009390
00603233821
00406048501
00378632001
00378075110
00603221432
68001000600
54295031118
00591554310
00093107853
59762045001
00781518992
61314064511
16714068303
68001011903
00591247015
00832070815
00527135401
00955101010
59762374202
00378042401
24208029525
00591530701
60258016201
66993089815
54458099210
00591046210
59762600201
00378102077
00378282077
00591376730
51293061101
57664047453
23155006505
54838052340
00603465302
54838055240
16729000517
00603441521
00093084015
68180048509
00093014901
65862047601
55111059490
68382006916
00781316907
51862015630
57664037718
49884076478
55111033390
68180051701
00185004001
60793085801
00093035001
54458094410
00228254010
59762001601
50383077504
00406889301
POLYETHYLENE GLYCOL 3350
Y
ZALEPLON
Y
IBUPROFEN
Y
GABAPENTIN
Y
TERCONAZOLE
Y
BROMOCRIPTINE MESYLATE
Y
LISINOPRIL
Y
ENALAPRIL MALEATE Y
PHENADOZ
Y
SIMVASTATIN
Y
HYDROCORTISONE
Y
LEVOTHYROXINE SODIUM
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
ACETAMINOPHEN/CODEINE
Y #3
ACETAMINOPHEN/CODEINE
Y #4
VERAPAMIL HCL ER
Y
CYCLOBENZAPRINE HCL Y
AMITRIPTYLINE HCL
Y
GABAPENTIN
Y
UREA
Y
ALLOPURINOL
Y
CEFPROZIL
Y
MICRONIZED COLESTIPOLY HCL
LEVOTHYROXINE SODIUM
Y
NEOMYCIN/POLYMYXIN/HYDROC
Y
SIMVASTATIN
Y
METOPROLOL SUCCINATE
Y ER
MIRTAZAPINE ODT
Y
TOPIRAMATE
Y
HYDROMORPHONE HCL Y
ENOXAPARIN SODIUM Y
MEDROXYPROGESTERONE
Y ACETA
METOPROLOL/HYDROCHLOROTHI
Y
TOBRAMYCIN/DEXAMETHASONE
Y
PROMETHAZINE HCL
Y
RENAL
Y
CLOTRIMAZOLE/BETAMETHASON
Y
LISINOPRIL/HYDROCHLOROTHI
Y
METOPROLOL TARTRATEY
OXAPROZIN
Y
NICARDIPINE HCL
Y
ACARBOSE
Y
BUDESONIDE
Y
PHENAZOPYRIDINE HCL Y
METFORMIN HCL
Y
METRONIDAZOLE
Y
FLUOXETINE HCL
Y
MONTELUKAST SODIUM Y
CETIRIZINE HCL ALLERGY YCH
SIMVASTATIN
Y
MEPERITAB
Y
KETOCONAZOLE
Y
PRAVASTATIN SODIUM Y
NAPROXEN
Y
RAMIPRIL
Y
MONTELUKAST SODIUM Y
SIMVASTATIN
Y
SUMATRIPTAN SUCCINATE
Y
AMIODARONE HCL
Y
TRAMADOL HCL
Y
FENTANYL
Y
PANTOPRAZOLE SODIUMY
LISINOPRIL
Y
MIDODRINE HCL
Y
LEVOXYL
Y
ACETAMINOPHEN/CODEINE
Y
SERTRALINE HCL
Y
CARBIDOPA/LEVODOPA Y
CLINDAMYCIN PALMITATE
Y HCL
LIDOCAINE VISCOUS
Y
AMPHETAMINE/DEXTROAMPHETA
Y
POLYETH GLYC POW 3350 NF
ZALEPLON CAP 10MG
IBUPROFEN TAB 800MG
GABAPENTIN TAB 600MG
TERCONAZOLE CRE 0.4%
BROMOCRIPTIN TAB 2.5MG
LISINOPRIL TAB 30MG
ENALAPRIL TAB 20MG
PHENADOZ SUP 12.5MG
SIMVASTATIN TAB 80MG
HYDROCORT TAB 20MG
LEVOTHYROXIN TAB 75MCG
PRAMIPEXOLE TAB 0.5MG
APAP/CODEINE TAB 300-30MG
APAP/CODEINE TAB 300-60MG
VERAPAMIL CAP 120MG ER
CYCLOBENZAPR TAB 10MG
AMITRIPTYLIN TAB 50MG
GABAPENTIN TAB 600MG
UREA
CRE 39%
ALLOPURINOL TAB 100MG
CEFPROZIL TAB 500MG
COLESTIPOL TAB 1GM
LEVOTHYROXIN TAB 200MCG
NEO/POLY/HC SUS 1% OTIC
SIMVASTATIN TAB 20MG
METOPROLOL TAB 100MG ER
MIRTAZAPINE TAB 30MG ODT
TOPIRAMATE TAB 50MG
HYDROMORPHON TAB 4MG
ENOXAPARIN INJ 100MG/ML
MEDROXYPR AC TAB 10MG
METOPRL/HCTZ TAB 50-25MG
TOBRA/DEXAME SUS 0.3-0.1%
PROMETHAZINE TAB 25MG
RENAL
CAP SOFTGEL
CLOTRIM/BETA CRE 1-0.05%
LISINOP/HCTZ TAB 20-12.5
METOPROL TAR TAB 50MG
OXAPROZIN TAB 600MG
NICARDIPINE CAP 20MG
ACARBOSE TAB 25MG
BUDESONIDE SUS 0.25MG/2
PHENAZOPYRID TAB 100MG
METFORMIN TAB 1000MG
METRONIDAZOL TAB 500MG
FLUOXETINE SOL 20MG/5ML
MONTELUKAST CHW 4MG
CETIRIZINE SOL 5MG/5ML
SIMVASTATIN TAB 20MG
MEPERITAB TAB 50MG
KETOCONAZOLE CRE 2%
PRAVASTATIN TAB 10MG
NAPROXEN TAB 500MG
RAMIPRIL CAP 5MG
MONTELUKAST CHW 5MG
SIMVASTATIN TAB 80MG
SUMATRIPTAN INJ 4MG/0.5
AMIODARONE TAB 400MG
TRAMADOL HCL TAB 50MG
FENTANYL DIS 100MCG/H
PANTOPRAZOLE TAB 40MG
LISINOPRIL TAB 40MG
MIDODRINE TAB 2.5MG
LEVOXYL TAB 150MCG
APAP/CODEINE TAB 300-60MG
SERTRALINE TAB 50MG
CARB/LEVO TAB 25-250MG
CLINDAMYCIN SOL 75MG/5ML
LIDOCAINE SOL 2% VISC
AMPHETAMINE TAB 20MG
10
7
28
2
6
2
8
12
1
6
2
20
4
37
7
2
65
9
2
1
17
3
3
10
11
19
2
2
4
10
1
32
3
3
23
4
7
20
33
1
2
1
1
14
16
21
11
8
31
16
14
11
5
14
3
1
5
1
1
36
1
6
8
5
3
13
13
2
2
60
2
6,324
330
1,933
630
270
120
930
1,440
20
540
360
1,020
360
1,268
840
210
3,743
630
540
227
2,250
60
300
603
110
1,710
180
180
720
911
3
1,302
225
10
788
360
150
1,950
5,580
60
360
270
60
140
2,415
383
4,380
300
4,085
1,320
409
240
390
1,250
270
90
450
1
45
3,149
10
420
615
330
270
679
765
540
510
6,360
180
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
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$
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$
$
$
$
$
$
$
$
$
$
$
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-
p. 160
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68382009906
00093005401
51991081901
00781518392
67112090250
16714022602
00555087202
46287001216
00591327330
00781106105
00603385521
51672125902
24208075060
45963055830
16714061205
51672403803
00781520431
68180038306
67253038310
44523060702
59746033590
43598031930
51672406201
59088099703
00603211521
13668010410
51991062033
68645047054
00054458127
23155010501
00168014630
51672126401
66993040832
00781520992
65862032904
66530025520
16714065204
68682090146
00228315303
65862069790
65862052899
00093517144
45802005505
00093965201
49884074601
59762022001
65162068988
00054001125
65162021210
65862050220
00603499821
00781518692
68180085413
68462026005
45802066032
00603424628
33342005010
00378206301
68382018201
60505314501
00093520601
68462047401
00378206401
17478020911
00832102450
66993009030
00093729353
69238110205
68180011402
00228326211
00555087302
PAROXETINE HCL
Y
BUSPIRONE HCL
Y
PROPRANOLOL HCL ER Y
LEVOTHYROXINE SODIUM
Y
DECARA
Y
LOSARTAN POTASSIUM/HYDROC
Y
MEDROXYPROGESTERONE
Y ACETA
SODIUM POLYSTYRENE SULFON
Y
FAMCICLOVIR
Y
ALPRAZOLAM
Y
HYDROCHLOROTHIAZIDEY
CLOBETASOL PROPIONATE
Y
ATROPINE SULFATE
Y
VALACYCLOVIR HCL
Y
SERTRALINE HCL
Y
ENALAPRIL MALEATE Y
LOSARTAN POTASSIUM/HYDROC
Y
TRAMADOL HCL ER
Y
DOXAZOSIN MESYLATE Y
SODIUM SULFACETAMIDE/SULF
Y
LOSARTAN POTASSIUM Y
AMLODIPINE BESYLATE/ATORV
Y
FLUOROURACIL
Y
LIDOCAINE
Y
ALLOPURINOL
Y
ISOSORBIDE MONONITRATE
Y ER
ANASTROZOLE
Y
SIMVASTATIN
Y
MERCAPTOPURINE
Y
HYDROXYZINE HCL
Y
HYDROCORTISONE
Y
FLUOCINONIDE
Y
CARBAMAZEPINE ER
Y
VALACYCLOVIR HCL
Y
ALENDRONATE SODIUM Y
TRETINOIN
Y
CIPROFLOXACIN HCL
Y
ERYTHROMYCIN/BENZOYL
Y PERO
BUPRENORPHINE HCL Y
VENLAFAXINE HCL ER Y
VENLAFAXINE HCL ER Y
ALENDRONATE SODIUM Y
TRIAMCINOLONE ACETONIDE
Y
PROCHLORPERAZINE MALEATE
Y
GLIPIZIDE ER
Y
QUINAPRIL/HYDROCHLOROTHIA
Y
NITROFURANTOIN
Y
FLECAINIDE ACETATE Y
PHENYTOIN SODIUM EXTENDED
Y
AMOXICILLIN/CLAVULANATE
Y P
OXYCODONE/ACETAMINOPHEN
Y
LEVOTHYROXINE SODIUM
Y
LEVONORGESTREL/ETHINYL
Y ES
VERAPAMIL HCL ER
Y
CLINDAMYCIN PHOSPHATE
Y
LORAZEPAM
Y
LOSARTAN POTASSIUM/HYDROC
Y
ATENOLOL/CHLORTHALIDONE
Y
BUSPIRONE HCL
Y
CEVIMELINE HCL
Y
OXYBUTYNIN CHLORIDE ER
Y
URSODIOL
Y
ATENOLOL/CHLORTHALIDONE
Y
KETOROLAC TROMETHAMINE
Y
BACLOFEN
Y
TRANEXAMIC ACID
Y
LEVOFLOXACIN
Y
IBUPROFEN
Y
LEVETIRACETAM
Y
OXYMORPHONE HYDROCHLORIDE
Y
MEDROXYPROGESTERONE
Y ACETA
PAROXETINE TAB 30MG
BUSPIRONE TAB 10MG
PROPRANOLOL CAP 120MG ER
LEVOTHYROXIN TAB 88MCG
DECARA
CAP 50000UNT
LOSARTAN/HCT TAB 50-12.5
MEDROXYPR AC TAB 2.5MG
SOD POLY SUL POW
FAMCICLOVIR TAB 500MG
ALPRAZOLAM TAB 0.25MG
HYDROCHLOROT CAP 12.5MG
CLOBETASOL OIN 0.05%
ATROPINE SUL SOL 1% OP
VALACYCLOVIR TAB 500MG
SERTRALINE TAB 50MG
ENALAPRIL TAB 5MG
LOSARTAN/HCT TAB 100-12.5
TRAMADOL HCL TAB 100MG ER
DOXAZOSIN TAB 8MG
SOD SUL/SULF LOT 10-5%
LOSARTAN POT TAB 100MG
AMLOD/ATORVA TAB 5-20MG
FLUOROURACIL SOL 2%
LIDOCAINE CRE 3%
ALLOPURINOL TAB 100MG
ISOSORB MONO TAB 30MG ER
ANASTROZOLE TAB 1MG
SIMVASTATIN TAB 20MG
MERCAPTOPUR TAB 50MG
HYDROXYZ HCL TAB 10MG
HYDROCORT OIN 2.5%
FLUOCINONIDE OIN 0.05%
CARBAMAZEPIN CAP 200MG ER
VALACYCLOVIR TAB 1GM
ALENDRONATE TAB 70MG
TRETINOIN CRE 0.1%
CIPROFLOXACN TAB 500MG
ERYTHROMYCIN GEL /BENZOYL
BUPRENORPHIN SUB 8MG
VENLAFAXINE CAP 150MG ER
VENLAFAXINE CAP 75MG ER
ALENDRONATE TAB 70MG
TRIAMCINOLON OIN 0.1%
PROCHLORPER TAB 10MG
GLIPIZIDE ER TAB 10MG
QNAPRIL/HCTZ TAB 20-12.5
NITROFURANTN SUS 25MG/5ML
FLECAINIDE TAB 100MG
PHENYTOIN EX CAP 100MG
AMOX/K CLAV TAB 500MG
OXYCOD/APAP TAB 5-325MG
LEVOTHYROXIN TAB 125MCG
LEVONOR/ETHI TAB 0.1-0.02
VERAPAMIL TAB 240MG ER
CLINDAMYCIN AER 1%
LORAZEPAM TAB 0.5MG
LOSARTAN/HCT TAB 50-12.5
ATENOL/CHLOR TAB 50-25MG
BUSPIRONE TAB 15MG
CEVIMELINE CAP 30MG
OXYBUTYNIN TAB 5MG ER
URSODIOL TAB 500MG
ATENOL/CHLOR TAB 100-25MG
KETOROLAC SOL 0.5%
BACLOFEN TAB 10MG
TRANEX ACID TAB 650MG
LEVOFLOXACIN TAB 750MG
IBUPROFEN TAB 600MG
LEVETIRACETA TAB 750MG
OXYMORPHONE TAB 15MG ER
MEDROXYPR AC TAB 5MG
13
25
1
24
31
3
14
3
3
68
20
3
15
3
12
5
4
3
3
1
4
1
2
2
16
6
1
16
1
32
40
3
3
1
13
2
43
3
4
7
10
26
6
14
2
3
1
2
2
10
17
27
3
2
1
67
5
6
13
1
1
2
6
4
9
2
19
59
3
1
17
750
2,385
90
1,020
213
270
1,200
900
42
2,931
1,560
90
75
180
990
630
240
90
270
60
360
30
40
113
1,650
540
90
1,440
90
1,769
1,389
90
180
30
132
40
664
140
82
510
720
160
2,724
910
360
540
120
210
720
237
902
1,410
196
270
50
3,659
305
540
1,591
90
90
60
480
40
1,170
60
141
2,766
1,080
60
1,012
$
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$
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-
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p. 161
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00054252725
60505017007
53746018905
54505032909
60951071270
00168029360
68180031201
00591040610
00168004160
68180040202
00093503601
59762018002
62175044215
00093742556
00527134601
00603786274
55111052501
00527134101
60505324703
55111053201
45963014230
55111028448
68645015054
00591088501
50111044102
00093316501
68382041101
00591080001
60505369901
50111039701
59762305102
00591359160
51672403401
16714066102
31722022101
57664050658
46672005310
16729000410
00093736610
00115422201
00603616021
59762152001
53746017801
45802004835
00603295921
68180012101
00093001701
45802068028
00591024101
65862047501
67253018010
00472037045
68382019916
60505008000
55111060601
59762014501
00093722498
00093083305
16714029302
16714038802
00781187431
16729003410
00093816301
45802042335
00093001198
59762234006
69238107601
68462030205
00591060501
66689002316
66993006885
LITHIUM CARBONATE Y
PRAVASTATIN SODIUM Y
NAPROXEN
Y
DEXTROAMPHETAMINE SULFATE
Y
ENDOCET
Y
CLOBETASOL PROPIONATE
Y
IMIPRAMINE HCL
Y
LISINOPRIL
Y
BETAMETHASONE VALERATE
Y
CEFPROZIL
Y
DISULFIRAM
Y
VENLAFAXINE HCL ER Y
POLYETHYLENE GLYCOL 3350
Y
MONTELUKAST SODIUM Y
LEVOTHYROXINE SODIUM
Y
TRIAMCINOLONE ACETONIDE
Y
TACROLIMUS
Y
LEVOTHYROXINE SODIUM
Y
FAMCICLOVIR
Y
DIVALPROEX SODIUM Y
BUPROPION HCL XL
Y
FLUOXETINE DR
Y
GLIPIZIDE
Y
LISINOPRIL
Y
TRAZODONE HCL
Y
MINOCYCLINE HCL
Y
OMEPRAZOLE
Y
HYDROXYZINE PAMOATEY
RIZATRIPTAN BENZOATE Y
HYDRALAZINE HCL
Y
AZITHROMYCIN
M
DRONABINOL
Y
WARFARIN SODIUM
Y
GABAPENTIN
Y
GABAPENTIN
Y
METOPROLOL TARTRATEY
BUTALBITAL/ACETAMINOPHEN/
Y
SIMVASTATIN
Y
LOSARTAN POTASSIUM Y
MIDODRINE HCL
Y
TRAZODONE HCL
Y
AMLODIPINE BESYLATE Y
METFORMIN HCL ER
Y
NYSTATIN
Y
CLONIDINE HCL
Y
CEPHALEXIN
Y
MOEXIPRIL HCL
Y
LEVOCETIRIZINE DIHYDROCHL
Y
LORAZEPAM
Y
RAMIPRIL
Y
AMPICILLIN
Y
BETAMETHASONE VALERATE
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
SOTALOL HCL
Y
QUETIAPINE FUMARATE Y
PIROXICAM
Y
FOSINOPRIL SODIUM Y
CLONAZEPAM
Y
AMOXICILLIN/CLAVULANATE
Y P
CEFADROXIL
Y
AMOXICILLIN/CLAVULANATE
Y P
LETROZOLE
Y
QUETIAPINE FUMARATE Y
DESONIDE
Y
PANTOPRAZOLE SODIUMY
DOXAZOSIN MESYLATE Y
AZATHIOPRINE
Y
INDOMETHACIN
Y
LABETALOL HCL
Y
HYDROCODONE BITARTRATE/AC
Y
PANTOPRAZOLE SODIUMY
LITHIUM CARB CAP 300MG
PRAVASTATIN TAB 40MG
NAPROXEN TAB 375MG
DEXTROAMPHET CAP 15MG ER
ENDOCET TAB 10-325MG
CLOBETASOL GEL 0.05%
IMIPRAM HCL TAB 25MG
LISINOPRIL TAB 5MG
BETAMETH VAL LOT 0.1%
CEFPROZIL SUS 250/5ML
DISULFIRAM TAB 500MG
VENLAFAXINE CAP 37.5 ER
POLYETH GLYC POW 3350 NF
MONTELUKAST CHW 5MG
LEVOTHYROXIN TAB 112MCG
TRIAMCINOLON CRE 0.1%
TACROLIMUS CAP 0.5MG
LEVOTHYROXIN TAB 25MCG
FAMCICLOVIR TAB 500MG
DIVALPROEX CAP 125MG
BUPROPN HCL TAB 300MG XL
FLUOXETINE CAP 90MG DR
GLIPIZIDE TAB 5MG
LISINOPRIL TAB 30MG
TRAZODONE TAB 150MG
MINOCYCLINE CAP 50MG
OMEPRAZOLE CAP 10MG
HYDROXYZ PAM CAP 25MG
RIZATRIPTAN TAB 10MG
HYDRALAZINE TAB 100MG
AZITHROMYCIN POW 1GM PAK
DRONABINOL CAP 2.5MG
WARFARIN TAB 7.5MG
GABAPENTIN CAP 100MG
GABAPENTIN CAP 100MG
METOPROL TAR TAB 25MG
BUT/APAP/CAF TAB
SIMVASTATIN TAB 10MG
LOSARTAN POT TAB 100MG
MIDODRINE TAB 5MG
TRAZODONE TAB 50MG
AMLODIPINE TAB 2.5MG
METFORMIN TAB 500MG ER
NYSTATIN OIN 100000
CLONIDINE TAB 0.3MG
CEPHALEXIN CAP 250MG
MOEXIPRIL TAB 7.5MG
LEVOCETIRIZI SOL 2.5/5ML
LORAZEPAM TAB 1MG
RAMIPRIL CAP 2.5MG
AMPICILLIN CAP 250MG
BETAMETH VAL CRE 0.1%
PRAMIPEXOLE TAB 1MG
SOTALOL HCL TAB 80MG
QUETIAPINE TAB 400MG
PIROXICAM CAP 20MG
FOSINOPRIL TAB 40MG
CLONAZEPAM TAB 1MG
AMOX/K CLAV SUS 400/5ML
CEFADROXIL CAP 500MG
AMOX/K CLAV TAB 250MG
LETROZOLE TAB 2.5MG
QUETIAPINE TAB 200MG
DESONIDE OIN 0.05%
PANTOPRAZOLE TAB 20MG
DOXAZOSIN TAB 4MG
AZATHIOPRINE TAB 50MG
INDOMETHACIN CAP 50MG
LABETALOL TAB 100MG
HYDROCO/APAP SOL 7.5-325
PANTOPRAZOLE TAB 40MG
22
2
24
1
5
2
6
30
3
3
1
7
19
4
10
24
1
21
2
1
2
2
17
4
11
11
10
31
1
4
7
1
16
15
12
18
2
7
4
1
13
5
25
11
7
27
2
4
37
2
17
7
1
4
2
2
2
34
6
4
2
9
2
4
9
3
2
7
5
8
7
3,629
180
1,528
120
195
120
420
2,145
180
325
30
300
5,060
300
570
690
120
1,350
42
270
180
6
3,000
180
1,230
510
300
2,280
9
990
8
60
922
2,400
2,679
2,206
480
630
300
135
1,740
208
2,535
240
990
1,226
180
300
2,689
180
1,700
315
90
720
360
60
180
2,622
825
360
39
567
33
60
510
270
450
903
488
1,612
420
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 162
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68462036201
59762500001
00121072104
66685101200
13107005701
00781604155
68382013210
67877022110
00363042553
10888713502
00527134201
00591293201
60505004206
00054457125
00378115001
00185041505
00093014910
16729015401
00527135201
64376065716
53746051405
00574010770
00378008001
68645046370
16729014617
00093728689
00378041510
00093444401
62756020401
23155007101
16729000415
00832003800
69097015915
00185093997
45802026337
00172208980
68382044405
76282021405
68382026101
59762501901
65862000505
16571012025
00093213001
00781178901
00378702501
00591569401
00378077201
60505274205
16571040110
00832712411
53489040001
00168000480
68382004001
51991083933
61314063305
00093730465
68382018314
59746033390
60793085701
00591223015
58980062570
61748020260
00378014105
65862055190
00245005711
67877025130
68382010610
42023013501
59762371803
00603646928
50383072016
HYDROXYZINE HCL
Y
SULFASALAZINE
Y
FLUOXETINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
OXYCODONE HCL
Y
AMOXICILLIN
Y
TAMSULOSIN HCL
Y
METFORMIN HCL
Y
WAL-FEX ALLERGY
Y
PROGESTERONE
Y
LEVOTHYROXINE SODIUM
Y
CLINDAMYCIN HCL
Y
ACYCLOVIR
Y
METHADONE HCL
Y
BUSPIRONE HCL
Y
BUPROPION HCL SR
Y
NAPROXEN
Y
RAMIPRIL
Y
LEVOTHYROXINE SODIUM
Y
BROMPHEN/PSEUDOEPHEDRINE
Y
SPIRONOLACTONE
Y
CLOTRIMAZOLE
Y
INDAPAMIDE
Y
DOXAZOSIN MESYLATE Y
QUETIAPINE FUMARATE Y
LEVETIRACETAM
Y
DIPHENOXYLATE/ATROPINE
Y
GABAPENTIN
Y
GABAPENTIN
Y
METHIMAZOLE
Y
SIMVASTATIN
Y
OXYBUTYNIN CHLORIDE Y
MELOXICAM
Y
CHOLESTYRAMINE LIGHTY
CLINDAMYCIN PHOSPHATE
Y
HYDROCHLOROTHIAZIDEY
FAMOTIDINE
Y
SERTRALINE HCL
Y
ACETAZOLAMIDE ER
Y
QUINAPRIL HCL
Y
CITALOPRAM HYDROBROMIDE
Y
CIPROFLOXACIN HCL
Y
NITROFURANTOIN MACROCRYST
Y
DICLOFENAC SODIUM DRY
LOXAPINE SUCCINATE Y
MINOCYCLINE HCL
Y
VERAPAMIL HCL
Y
VERAPAMIL HCL ER
Y
CETIRIZINE HCL
Y
DIVALPROEX SODIUM DRY
NYSTATIN
Y
TRIAMCINOLONE ACETONIDE
Y
PROMETHAZINE HCL
Y
MEFENAMIC ACID
Y
GENTAMICIN SULFATE Y
MIRTAZAPINE ODT
Y
BUSPIRONE HCL
Y
LOSARTAN POTASSIUM Y
LEVOXYL
Y
MIRTAZAPINE
Y
X-VIATE
Y
ERYTHROMYCIN
Y
SPIRONOLACTONE/HYDROCHLOR
Y
VALSARTAN/HYDROCHLOROTHIA
Y
KLOR-CON M10
Y
TRIAMCINOLONE ACETONIDE
Y
DIVALPROEX SODIUM Y
ESTRADIOL VALERATE Y
TRIAZOLAM
Y
ZOLPIDEM TARTRATE Y
CHLORHEXIDINE GLUCONATE
Y
HYDROXYZ HCL TAB 50MG
SULFASALAZIN TAB 500MG
FLUOXETINE SOL 20MG/5ML
AMOX/K CLAV SUS 400/5ML
OXYCODONE TAB 30MG
AMOXICILLIN SUS 250/5ML
TAMSULOSIN CAP 0.4MG
METFORMIN TAB 1000MG
WAL-FEX ALRG TAB 60MG
PROGESTERONE CAP 100MG
LEVOTHYROXIN TAB 50MCG
CLINDAMYCIN CAP 300MG
ACYCLOVIR CAP 200MG
METHADONE TAB 10MG
BUSPIRONE TAB 10MG
BUPROPION TAB 150MG SR
NAPROXEN TAB 500MG
RAMIPRIL CAP 5MG
LEVOTHYROXIN TAB 300MCG
BROM/PSE/DM SYP
SPIRONOLACT TAB 50MG
CLOTRIMAZOLE LOZ 10MG
INDAPAMIDE TAB 2.5MG
DOXAZOSIN TAB 2MG
QUETIAPINE TAB 50MG
LEVETIRACETA TAB 500MG
DIPHEN/ATROP TAB 2.5MG
GABAPENTIN TAB 800MG
GABAPENTIN TAB 800MG
METHIMAZOLE TAB 10MG
SIMVASTATIN TAB 10MG
OXYBUTYNIN TAB 5MG
MELOXICAM TAB 15MG
CHOLESTYRAM POW 4GM LITE
CLINDAMYCIN PAD 1%
HYDROCHLOROT TAB 50MG
FAMOTIDINE SUS 40MG/5ML
SERTRALINE TAB 100MG
ACETAZOLAMID CAP 500MG ER
QUINAPRIL TAB 5MG
CITALOPRAM TAB 10MG
CIPROFLOXACN SOL 0.3% OP
NITROFUR MAC CAP 50MG
DICLOFENAC TAB 75MG DR
LOXAPINE CAP 25MG
MINOCYCLINE CAP 50MG
VERAPAMIL TAB 120MG
VERAPAMIL TAB 240MG ER
CETIRIZINE TAB 5MG
DIVALPROEX TAB 500MG DR
NYSTATIN TAB 500000
TRIAMCINOLON CRE 0.1%
PROMETHAZINE TAB 12.5MG
MEFENAM ACID CAP 250MG
GENTAMICIN SOL 0.3% OP
MIRTAZAPINE TAB ODT 30MG
BUSPIRONE TAB 30MG
LOSARTAN POT TAB 25MG
LEVOXYL TAB 137MCG
MIRTAZAPINE TAB 15MG ODT
X-VIATE CRE 40%
ERYTHROMYCIN PAD 2%
SPIRONO/HCTZ TAB 25/25
VALSART/HCTZ TAB 320-25MG
KLOR-CON M10 TAB 10MEQ ER
TRIAMCINOLON CRE 0.1%
DIVALPROEX CAP 125MG
ESTRAD VAL INJ 20MG/ML
TRIAZOLAM TAB 0.25MG
ZOLPIDEM TAB 10MG
CHLORHEX GLU SOL 0.12%
15
1
9
7
1
39
3
22
3
2
26
13
11
18
13
6
29
1
3
7
7
7
3
3
5
1
11
1
1
2
8
2
28
2
7
26
1
11
2
2
15
25
3
20
3
13
12
2
14
6
2
17
35
1
31
1
2
5
4
3
4
3
2
2
5
16
1
2
3
82
42
550
810
4,515
550
240
7,070
210
2,890
300
120
1,200
436
1,465
1,548
2,190
1,080
1,860
180
270
1,000
810
270
450
270
270
540
410
270
270
240
600
360
1,706
479
420
2,340
50
600
60
180
990
72
110
2,100
127
600
1,380
180
380
930
210
1,520
1,134
10
175
90
54
450
360
150
796
180
180
120
454
600
270
10
210
2,565
19,866
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 163
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
61748002501
00406012505
00603545021
51991035478
60505258103
64679092403
59746011506
51079045169
00781552737
00603448621
00555100916
00378050301
16714039501
65862009620
53746025401
43598020452
68180089811
13811052701
00555030202
47781030801
61442010260
23155014201
60505291509
54505033105
00093515001
68180075109
55111063701
51672405101
62756044602
00591247319
00363078415
61314022705
68001000603
00378427505
00378004701
00527133010
00832046530
00378967158
60258015001
53489033001
00591264005
00487020103
00574200815
50383027015
00591578301
65162071110
47335053783
00378415105
00093416178
00781501701
00093220401
64679092402
50111045601
00781518892
49884002801
65862055090
00143975001
47335078891
68682036890
00185004709
00168052204
10702001001
00054001829
24470090216
00172376170
50111032801
68382020906
29300014001
43386048024
00603465502
65862047705
ETHOSUXIMIDE
Y
HYDROCODONE/ACETAMINOPHEN
Y
PROPAFENONE HCL
Y
RIZATRIPTAN BENZOATE Y
AZITHROMYCIN
Y
ENALAPRIL MALEATE Y
PROCHLORPERAZINE MALEATE
Y
AMLODIPINE BESYLATE Y
NARATRIPTAN HCL
Y
METHOCARBAMOL
Y
CLONIDINE HCL
Y
BISOPROLOL FUMARATE/HYDRO
Y
CEFPODOXIME PROXETILY
CEFPODOXIME PROXETILY
RANITIDINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
WYMZYA FE
Y
TL GARD RX
Y
HYDROXYZINE PAMOATEY
NITROFURANTOIN MACROCRYST
Y
DICLOFENAC SODIUM DRY
DOXYCYCLINE HYCLATE DR
Y
LOSARTAN POTASSIUM/HYDROC
Y
HYDROCORTISONE
Y
MOEXIPRIL HCL
Y
AMLODIPINE BESYLATE Y
MINOCYCLINE HCL
Y
ETODOLAC ER
Y
CARISOPRODOL
Y
TAMOXIFEN CITRATE
Y
WAL-FEX ALLERGY
Y
TIMOLOL MALEATE
Y
GABAPENTIN
Y
VALACYCLOVIR HCL
Y
METOPROLOL TARTRATEY
BACLOFEN
Y
NYAMYC
Y
IPRATROPIUM BROMIDE/ALBUT
Y
SF 5000 PLUS
Y
IMIPRAMINE HCL
Y
BUTALBITAL/APAP/CAFFEINE
Y
IPRATROPIUM BROMIDE/ALBUT
Y
NYSTOP
Y
CLOBETASOL PROPIONATE
Y EMO
ATENOLOL/CHLORTHALIDONE
Y
GUANFACINE HCL
Y
TRAMADOL HCL ER
Y
TRAMADOL HCL
Y
AMOXICILLIN
Y
DICLOFENAC POTASSIUMY
METOCLOPRAMIDE HCL Y
ENALAPRIL MALEATE Y
OXYBUTYNIN CHLORIDE Y
LEVOTHYROXINE SODIUM
Y
HYDRALAZINE HCL
Y
VALSARTAN/HYDROCHLOROTHIA
Y
TESTOSTERONE ENANTHATE
Y
DESMOPRESSIN ACETATEY
DILTIAZEM HCL ER
Y
FOSINOPRIL SODIUM Y
CICLOPIROX
Y
HYDROXYZINE HCL
Y
PREDNISONE
Y
BP WASH
Y
LISINOPRIL
Y
HYDRALAZINE HCL
Y
ANASTROZOLE
Y
DIVALPROEX SODIUM DRY
ORPHENADRINE CITRATEYER
MONTELUKAST SODIUM Y
RAMIPRIL
Y
ETHOSUXIMIDE CAP 250MG
HYDROCO/APAP TAB 10-325MG
PROPAFENONE TAB 300MG
RIZATRIPTAN TAB 5MG
AZITHROMYCIN TAB 250MG
ENALAPRIL TAB 5MG
PROCHLORPER TAB 10MG
AMLODIPINE TAB 5MG
NARATRIPTAN TAB 2.5MG
METHOCARBAM TAB 750MG
CLONIDINE DIS 0.1/24HR
BISOPRL/HCTZ TAB 5-6.25MG
CEFPODOXIME TAB 200MG
CEFPODOXIME TAB 200MG
RANITIDINE TAB 300MG
AMOX/K CLAV SUS 250/5ML
WYMZYA FE CHW 0.4MG-35
TL GARD RX TAB
HYDROXYZ PAM CAP 50MG
NITROFUR MAC CAP 100MG
DICLOFENAC TAB 50MG DR
DOXYCYCL HYC TAB 100MG DR
LOSARTAN/HCT TAB 50-12.5
HYDROCORT TAB 5MG
MOEXIPRIL TAB 15MG
AMLODIPINE TAB 5MG
MINOCYCLINE TAB 50MG
ETODOLAC ER TAB 400MG
CARISOPRODOL TAB 350MG
TAMOXIFEN TAB 20MG
WAL-FEX ALLR TAB 180MG
TIMOLOL MAL SOL 0.5% OP
GABAPENTIN TAB 600MG
VALACYCLOVIR TAB 500MG
METOPROL TAR TAB 100MG
BACLOFEN TAB 10MG
NYAMYC
POW 100000
IPRATROPIUM/ SOL ALBUTER
SF 5000 PLUS CRE 1.1%
IMIPRAM HCL TAB 10MG
BUT/APAP/CAF CAP
IPRATROPIUM/ SOL ALBUTER
NYSTOP
POW 100000
CLOBETASOL E CRE 0.05%
ATENOL/CHLOR TAB 100-25MG
GUANFACINE TAB 1MG
TRAMADOL HCL TAB 300MG ER
TRAMADOL HCL TAB 50MG
AMOXICILLIN SUS 400/5ML
DICLOFEN POT TAB 50MG
METOCLOPRAM TAB 5MG
ENALAPRIL TAB 5MG
OXYBUTYNIN TAB 5MG
LEVOTHYROXIN TAB 175MCG
HYDRALAZINE TAB 50MG
VALSART/HCTZ TAB 320-12.5
TESTOST ENAN INJ 200MG/ML
DESMOPRESSIN SPR 0.01%
DILTIAZEM CAP 180MG/24
FOSINOPRIL TAB 40MG
CICLOPIROX SHA 1%
HYDROXYZ HCL TAB 10MG
PREDNISONE TAB 20MG
BP WASH LIQ 7%
LISINOPRIL TAB 40MG
HYDRALAZINE TAB 50MG
ANASTROZOLE TAB 1MG
DIVALPROEX TAB 500MG DR
ORPHENADRINE TAB 100MG ER
MONTELUKAST TAB 10MG
RAMIPRIL CAP 10MG
2
9
1
2
16
8
18
21
1
19
2
11
1
1
6
2
1
7
19
3
9
1
4
6
1
16
1
1
8
8
11
18
1
4
10
2
2
11
24
3
1
4
8
2
4
12
1
38
28
8
22
11
4
6
2
2
1
1
2
1
2
19
54
1
5
2
1
2
3
2
2
120
820
90
19
132
660
915
1,350
9
1,070
8
990
20
20
656
300
84
450
1,046
134
452
20
360
675
180
1,380
60
90
690
300
510
130
360
450
2,551
720
120
993
1,581
500
56
990
150
75
360
1,650
30
3,049
3,900
390
2,194
930
360
360
360
120
15
5
180
180
240
1,200
664
480
450
630
90
900
140
180
180
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 164
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378265801
23155022801
13925015714
00472140016
00781151601
63323012310
16252059299
60505022201
00781555431
00228255096
67253032036
47335060413
42858000101
00093026415
45802091987
16729003516
68382012205
16729014016
62756018488
00472037115
10370022001
00555083302
31722020290
00143226010
61314004475
00527134501
00054014025
51672415506
00378700293
65862046730
00781518092
61442014260
00591246915
43598020851
00603420928
53489037001
00472037145
00093002910
76439036590
68462010630
00378105401
76439012510
00093413673
00054457025
65862062090
67877019705
00378354725
00093205606
65862019399
51672127901
00093026592
51293080101
59762500802
59762371704
00378162001
00093526801
50383026625
17478071410
00093081001
00603243421
00591261201
16729027730
23155010205
00378699152
00378710501
50383079616
00093029401
55566150101
00591252101
60432083704
00781575301
MORPHINE SULFATE ER Y
ACYCLOVIR
Y
LIDOCAINE HCL/HYDROCORTIS
Y
CYPROHEPTADINE HCL Y
POTASSIUM CHLORIDE SRY
METHOTREXATE SODIUMY
SUMATRIPTAN SUCCINATE
Y
SOTALOL HCL (AF)
Y
MONTELUKAST SODIUM Y
DICLOFENAC SODIUM DRY
METHOTREXATE
Y
ALPRAZOLAM
Y
OXYCODONE HCL
Y
FLUOCINONIDE
Y
CETIRIZINE HCL
Y
ANASTROZOLE
Y
AMLODIPINE BESYLATE Y
GLIPIZIDE
Y
OXCARBAZEPINE
Y
BETAMETHASONE VALERATE
Y
POTASSIUM CHLORIDE ERY
WARFARIN SODIUM
Y
FOSINOPRIL SODIUM Y
ISOSORBIDE MONONITRATE
Y ER
TRIFLURIDINE
Y
LEVOTHYROXINE SODIUM
Y
ACARBOSE
Y
ADAPALENE
Y
PAROXETINE HCL
Y
FAMCICLOVIR
Y
LEVOTHYROXINE SODIUM
Y
LOVASTATIN
Y
MIRTAZAPINE ODT
Y
AMOXICILLIN/CLAVULANATE
Y P
LISINOPRIL
Y
FELODIPINE ER
Y
BETAMETHASONE VALERATE
Y
ENALAPRIL MALEATE Y
VIRT-VITE FORTE
Y
ONDANSETRON HCL
Y
ENALAPRIL MALEATE Y
GLIMEPIRIDE
Y
CEFDINIR
Y
METHADONE HCL
Y
QUINAPRIL HCL
Y
AMLODIPINE BESYLATE Y
MERCAPTOPURINE
Y
TOLTERODINE TARTRATEY
FLUOXETINE HCL
Y
FLUOCINONIDE
Y
FLUOCINONIDE
Y
PHENAZOPYRIDINE HCL Y
MISOPROSTOL
Y
TRIAZOLAM
Y
DICYCLOMINE HCL
Y
ZALEPLON
Y
CLOBETASOL PROPIONATE
Y
CIPROFLOXACIN HCL
Y
NORTRIPTYLINE HCL
Y
BENZTROPINE MESYLATEY
HYDROCODONE/ACETAMINOPHEN
Y
METHOTREXATE SODIUMY
METFORMIN HCL
Y
ALBUTEROL SULFATE Y
OXYCODONE/ACETAMINOPHEN
Y
HYDROXYZINE HCL
Y
CARBIDOPA/LEVODOPA Y
NOVAREL
Y
METRONIDAZOLE
Y
BROMFED DM
Y
METHYLPHENIDATE HCL Y
MORPHINE SUL TAB 15MG ER
ACYCLOVIR TAB 800MG
LIDOCAINE/HC CRE 3%-0.5%
CYPROHEPTAD SYP 2MG/5ML
POT CHLORIDE TAB 8MEQ SR
METHOTREXATE INJ 25MG/ML
SUMATRIPTAN TAB 100MG
SOTALOL AF TAB 80MG
MONTELUKAST CHW 4MG
DICLOFENAC TAB 50MG DR
METHOTREXATE TAB 2.5MG
ALPRAZOLAM TAB 0.5MG
OXYCODONE TAB 5MG
FLUOCINONIDE OIN 0.05%
CETIRIZINE TAB 10MG
ANASTROZOLE TAB 1MG
AMLODIPINE TAB 5MG
GLIPIZIDE TAB 10MG
OXCARBAZEPIN TAB 300MG
BETAMETH VAL OIN 0.1%
POT CHLORIDE CAP 10MEQ ER
WARFARIN TAB 5MG
FOSINOPRIL TAB 40MG
ISOSORB MONO TAB 60MG ER
TRIFLURIDINE SOL 1% OP
LEVOTHYROXIN TAB 100MCG
ACARBOSE TAB 25MG
ADAPALENE GEL 0.1%
PAROXETINE TAB 20MG
FAMCICLOVIR TAB 500MG
LEVOTHYROXIN TAB 25MCG
LOVASTATIN TAB 20MG
MIRTAZAPINE TAB 15MG ODT
AMOX/K CLAV SUS 400/5ML
LISINOPRIL TAB 2.5MG
FELODIPINE TAB 10MG ER
BETAMETH VAL OIN 0.1%
ENALAPRIL TAB 20MG
VIRT-VITE TAB FORTE
ONDANSETRON TAB 8MG
ENALAPRIL TAB 20MG
GLIMEPIRIDE TAB 4MG
CEFDINIR SUS 125/5ML
METHADONE TAB 5MG
QUINAPRIL TAB 40MG
AMLODIPINE TAB 2.5MG
MERCAPTOPUR TAB 50MG
TOLTERODINE TAB 1MG
FLUOXETINE CAP 20MG
FLUOCINONIDE GEL 0.05%
FLUOCINONIDE GEL 0.05%
PHENAZOPYRID TAB 100MG
MISOPROSTOL TAB 200MCG
TRIAZOLAM TAB 0.125MG
DICYCLOMINE TAB 20MG
ZALEPLON CAP 5MG
CLOBETASOL SOL 0.05%
CIPROFLOXACN SOL 0.3% OP
NORTRIPTYLIN CAP 10MG
BENZTROPINE TAB 1MG
HYDROCO/APAP TAB 10-325MG
METHOTREXATE INJ 50MG/2ML
METFORMIN TAB 500MG
ALBUTEROL NEB 0.63MG/3
OXYCOD/APAP TAB 7.5-325
HYDROXYZ HCL SOL 10MG/5ML
CARB/LEVO TAB 25-250MG
NOVAREL INJ 10000UNT
METRONIDAZOL TAB 250MG
BROMFED DM SYP
METHYLPHENID TAB 20MG
5
12
1
11
2
6
3
3
3
6
3
52
6
2
19
9
16
11
3
6
3
19
4
5
1
15
1
1
7
1
17
6
2
5
22
1
6
3
1
22
3
6
3
15
1
2
1
2
20
2
3
13
2
7
26
12
3
22
11
13
8
7
11
2
3
13
3
1
20
7
3
330
545
98
1,725
360
60
54
540
90
1,080
58
2,697
690
120
1,034
810
1,620
3,240
330
210
185
779
495
450
8
870
270
45
540
21
1,053
420
180
675
1,920
90
270
360
180
330
450
690
300
2,190
180
180
135
60
1,740
75
180
137
181
135
1,668
332
100
125
1,080
853
720
70
2,100
300
158
2,570
470
1
518
836
180
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 165
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
60505001608
00781223231
00603533621
68001019700
16714053311
16714062202
60793085601
68180030220
68180046807
10147075004
65162051150
00093742656
00603616121
00378008801
68462030201
00713053612
62175089143
55111012405
00781282210
00781565815
64679015503
00713063160
16729000101
31722020705
66758017092
55111025660
65862020390
62175026146
54458099510
68462025601
52565002215
23155012101
60505025202
43598021055
64376043815
31722025630
57664037713
00093098301
00168000615
24208083060
00245003660
00378013501
67253001242
00093725601
16714053211
67457011850
00258368890
00378018601
53746054201
68462029201
00378341205
10702001301
00378459510
00603388732
16714068403
17478071512
45802093716
49884049410
68180051501
13668011730
42192010701
43547025750
00781145301
23155010610
00781152610
00245018211
00168038204
43478024545
00603389032
60429031710
16729017017
DILT-XR
Y
OMEPRAZOLE
Y
PREDNISONE
Y
ESCITALOPRAM OXALATEY
SUMATRIPTAN SUCCINATE
Y
ZOLPIDEM TARTRATE Y
LEVOXYL
Y
CEFUROXIME AXETIL
Y
LOVASTATIN
Y
KETOCONAZOLE
Y
SPIRONOLACTONE
Y
MONTELUKAST SODIUM Y
TRAZODONE HCL
Y
CARBIDOPA/LEVODOPA ER
Y
INDOMETHACIN
Y
PROMETHEGAN
Y
ATORVASTATIN CALCIUMY
ATORVASTATIN CALCIUMY
FLUOXETINE HCL
Y
SYEDA
Y
ROPINIROLE HCL
Y
FLUTICASONE PROPIONATE
Y
GLIMEPIRIDE
Y
CITALOPRAM HYDROBROMIDE
Y
KLOR-CON M10
Y
ZIPRASIDONE HCL
Y
LOSARTAN POTASSIUM Y
NIFEDIPINE ER
Y
LISINOPRIL
Y
ROPINIROLE HCL
Y
ECONAZOLE NITRATE Y
ROPINIROLE HCL
Y
TIZANIDINE HCL
Y
SSD
Y
ANTIPYRINE/BENZOCAINE
Y
RALOXIFENE HYDROCHLORIDE
Y
TRAMADOL HCL
Y
NYSTATIN
Y
TRIAMCINOLONE ACETONIDE
Y
NEOMYCIN/POLYMYXIN/DEXAME
Y
PREVALITE
Y
DILTIAZEM HCL
Y
CEFDINIR
Y
GLIMEPIRIDE
Y
SUMATRIPTAN SUCCINATE
Y
ASCORBIC ACID
Y
DILTIAZEM HCL ER
Y
CLONIDINE HCL
Y
POTASSIUM CHLORIDE ERY
VERAPAMIL HCL ER
Y
BUPROPION HCL SR
Y
BETAXOLOL HCL
Y
METOPROLOL SUCCINATE
Y ER
HYDROCODONE/ACETAMINOPHEN
Y
SIMVASTATIN
Y
BRIMONIDINE TARTRATEY
HYDROCORTISONE
Y
DIGOXIN
Y
LISINOPRIL
Y
LOSARTAN POTASSIUM/HYDROC
Y
HYDROCORTISONE ACETATE/PR
Y
CARVEDILOL
Y
GLIPIZIDE
Y
HYDROXYZINE HCL
Y
POTASSIUM CHLORIDE CR
Y
DIVALPROEX SODIUM DRY
SULFACETAMIDE SODIUM
Y
TRETINOIN
Y
HYDROCODONE/ACETAMINOPHEN
Y
LOSARTAN POTASSIUM Y
ESCITALOPRAM OXALATEY
DILT-XR CAP 240MG
OMEPRAZOLE CAP 10MG
PREDNISONE TAB 2.5MG
ESCITALOPRAM TAB 20MG
SUMATRIPTAN TAB 100MG
ZOLPIDEM TAB 10MG
LEVOXYL TAB 125MCG
CEFUROXIME TAB 250MG
LOVASTATIN TAB 20MG
KETOCONAZOLE SHA 2%
SPIRONOLACT TAB 25MG
MONTELUKAST TAB 10MG
TRAZODONE TAB 100MG
CARB/LEVO ER TAB 25-100MG
INDOMETHACIN CAP 50MG
PROMETHEGAN SUP 12.5MG
ATORVASTATIN TAB 20MG
ATORVASTATIN TAB 80MG
FLUOXETINE CAP 20MG
SYEDA
TAB 3-0.03MG
ROPINIROLE TAB 0.5MG
FLUTICASONE CRE 0.05%
GLIMEPIRIDE TAB 1MG
CITALOPRAM TAB 20MG
KLOR-CON M10 TAB 10MEQ ER
ZIPRASIDONE CAP 20MG
LOSARTAN POT TAB 100MG
NIFEDIPINE TAB 60MG ER
LISINOPRIL TAB 30MG
ROPINIROLE TAB 2MG
ECONAZOLE CRE 1%
ROPINIROLE TAB 0.25MG
TIZANIDINE TAB 4MG
SSD
CRE 1%
ANTIPY/BENZO SOL OTIC
RALOXIFENE TAB 60MG
TRAMADOL HCL TAB 50MG
NYSTATIN TAB 500000
TRIAMCINOLON OIN 0.1%
NEO/POLY/DEX SUS 0.1% OP
PREVALITE POW 4GM PK
DILTIAZEM TAB 90MG
CEFDINIR SUS 125/5ML
GLIMEPIRIDE TAB 4MG
SUMATRIPTAN TAB 50MG
ASCORBIC ACD INJ 500MG/ML
DILTIAZEM CAP 180MG/24
CLONIDINE TAB 0.2MG
POT CHLORIDE CAP 10MEQ ER
VERAPAMIL TAB 120MG ER
BUPROPION TAB 150MG SR
BETAXOLOL TAB 10MG
METOPROLOL TAB 25MG ER
HYDROCO/APAP TAB 10-325MG
SIMVASTATIN TAB 40MG
BRIMONIDINE SOL 0.2% OP
HYDROCORT LOT 2.5%
DIGOXIN TAB 0.25MG
LISINOPRIL TAB 20MG
LOSARTAN/HCT TAB 100-12.5
HC PRAMOXINE CRE 2.5-1%
CARVEDILOL TAB 25MG
GLIPIZIDE TAB 10MG
HYDROXYZ HCL TAB 25MG
POT CHLORIDE TAB 10MEQ CR
DIVALPROEX TAB 500MG DR
SULFACETAMID SUS 10%
TRETINOIN GEL 0.01%
HYDROCO/APAP TAB 5-325MG
LOSARTAN POT TAB 50MG
ESCITALOPRAM TAB 20MG
4
8
21
7
7
58
5
3
11
6
9
2
21
2
9
1
1
1
14
1
2
2
13
25
3
1
3
1
4
5
5
4
5
12
16
1
24
2
13
8
2
4
3
9
6
2
2
4
2
1
3
1
5
3
8
4
3
5
14
2
2
10
13
4
3
4
2
2
15
11
7
360
240
1,529
510
115
1,898
270
82
870
1,200
780
120
1,845
360
709
18
90
90
2,780
84
120
180
1,507
1,755
270
60
270
90
240
330
135
210
720
950
235
30
2,153
160
450
45
120
720
300
780
50
100
180
900
180
180
270
180
450
420
720
60
295
150
1,500
180
115
1,800
2,040
855
540
630
236
90
607
900
510
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 166
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378104501
00054309036
50111043303
65862007101
59746012206
00378477501
00378042101
00115123101
00168005515
00603211532
62756013805
43598020751
00591247330
64679071804
31722020801
00555900942
68645048870
00093762056
51672403703
67877019805
00093090001
44523045020
00781562760
55111015430
63304062510
00378668910
42192071214
00781148801
00054414622
49884012401
60505100302
60505100301
17478071130
61748022060
00781516960
51672135108
00781520892
00093834301
49884082111
66993096245
00228306211
55111033901
60505036301
00378312510
45802018242
00093736410
65862056730
43598022040
43547025650
49884073401
31722073030
31604002621
00093112201
59762521001
62756001540
60505057804
00574041207
00406055201
45802045535
00093719801
55111012601
00093719805
63304069401
00555905167
00591024110
00472091145
00603254021
00781572005
00115703301
68462013701
68382070101
DIVALPROEX SODIUM DRY
BUTORPHANOL TARTRATE
Y
TRAZODONE HCL
Y
AMOXICILLIN
Y
MECLIZINE HCL
Y
BENAZEPRIL HCL/HYDROCHLOR
Y
METHYLDOPA
Y
OXYMORPHONE HYDROCHLORIDE
Y
BETAMETHASONE DIPROPIONAT
Y
ALLOPURINOL
Y
GABAPENTIN
Y
AMOXICILLIN
Y
TAMOXIFEN CITRATE
Y
VENLAFAXINE HCL ER Y
CITALOPRAM HYDROBROMIDE
Y
NORTREL 1/35
Y
SERTRALINE HCL
Y
LETROZOLE
Y
ENALAPRIL MALEATE Y
AMLODIPINE BESYLATE Y
KETOCONAZOLE
Y
TINIDAZOLE
Y
PIOGLITAZONE HCL/METFORMI
Y
ONDANSETRON HCL
Y
FUROSEMIDE
Y
PANTOPRAZOLE SODIUMY
AURAX
Y
AMITRIPTYLINE HCL
Y
CLOTRIMAZOLE
Y
LABETALOL HCL
Y
KETOROLAC TROMETHAMINE
Y
KETOROLAC TROMETHAMINE
Y
LIDOCAINE HCL JELLY Y
TRIAMCINOLONE ACETONIDE
Y
BUPROPION HCL SR
Y
CICLOPIROX
Y
VALACYCLOVIR HCL
Y
GLYBURIDE
Y
TRAMADOL HCL ER
Y
METRONIDAZOLE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
AMLODIPINE BESYLATE/BENAZ
Y
OFLOXACIN
Y
DOXEPIN HCL
Y
TRETINOIN
Y
LOSARTAN POTASSIUM Y
MONTELUKAST SODIUM Y
AMOXICILLIN/CLAVULANATE
Y P
CARVEDILOL
Y
FLUOXETINE HCL
Y
IRBESARTAN
Y
D3 ULTRA STRENGTH Y
ETODOLAC ER
Y
PHENYTOIN INFATABS Y
TESTOSTERONE CYPIONATE
Y
AZELASTINE HCL
Y
POLYETHYLENE GLYCOL 3350
Y
OXYCODONE HCL
Y
HYDROCORTISONE VALERATE
Y
FLUOXETINE HCL
Y
CIPROFLOXACIN HCL
Y
FLUOXETINE HCL
Y
MINOCYCLINE HCL
Y
VELIVET
Y
LORAZEPAM
Y
METRONIDAZOLE
Y
BUTALBITAL/ACETAMINOPHEN
Y
POTASSIUM CHLORIDE ERY
FLUDROCORTISONE ACETATE
Y
OXCARBAZEPINE
Y
POTASSIUM CHLORIDE ERY
DIVALPROEX TAB 500MG DR
BUTORPHANOL SOL 10MG/ML
TRAZODONE TAB 50MG
AMOXICILLIN SUS 400/5ML
MECLIZINE TAB 12.5MG
BENAZEP/HCTZ TAB 20-25MG
METHYLDOPA TAB 500MG
OXYMORPHONE TAB 5MG ER
BETAMETH DIP CRE 0.05%
ALLOPURINOL TAB 100MG
GABAPENTIN CAP 300MG
AMOXICILLIN SUS 400/5ML
TAMOXIFEN TAB 20MG
VENLAFAXINE CAP 150MG ER
CITALOPRAM TAB 40MG
NORTREL TAB 1/35
SERTRALINE TAB 50MG
LETROZOLE TAB 2.5MG
ENALAPRIL TAB 2.5MG
AMLODIPINE TAB 5MG
KETOCONAZOLE TAB 200MG
TINIDAZOLE TAB 500MG
PIOGLITA/MET TAB 15-850MG
ONDANSETRON TAB 8MG
FUROSEMIDE TAB 40MG
PANTOPRAZOLE TAB 40MG
AURAX
SOL 5.5-1.4%
AMITRIPTYLIN TAB 50MG
CLOTRIMAZOLE TRO 10MG
LABETALOL TAB 300MG
KETOROLAC SOL 0.5%
KETOROLAC SOL 0.5%
LIDOCAINE GEL 2% JELLY
TRIAMCINOLON LOT 0.1%
BUPROPION TAB 150MG
CICLOPIROX SHA 1%
VALACYCLOVIR TAB 500MG
GLYBURIDE TAB 2.5MG
TRAMADOL HCL TAB 100MG ER
METRONIDAZOL GEL 0.75%
AMPHETAMINE CAP 5MG ER
AMLOD/BENAZP CAP 5-10MG
OFLOXACIN DRO 0.3%OTIC
DOXEPIN HCL CAP 25MG
TRETINOIN CRE 0.025%
LOSARTAN POT TAB 25MG
MONTELUKAST CHW 4MG
AMOX-POT CLA TAB ER
CARVEDILOL TAB 12.5MG
FLUOXETINE TAB 10MG
IRBESARTAN TAB 150MG
VITAMIN D3 CAP 5000UNIT
ETODOLAC ER TAB 400MG
PHENYTOIN CHW 50MG
TESTOST CYP INJ 200MG/ML
AZELASTINE DRO 0.05%
POLYETH GLYC POW 3350 NF
OXYCODONE TAB 5MG
HC VALERATE CRE 0.2%
FLUOXETINE CAP 40MG
CIPROFLOXACN TAB 250MG
FLUOXETINE CAP 40MG
MINOCYCLINE CAP 50MG
VELIVET PAK
LORAZEPAM TAB 1MG
METRONIDAZOL CRE 0.75%
BUTAL/APAP TAB 50-325MG
POT CL MICRO TAB 20MEQ ER
FLUDROCORT TAB 0.1MG
OXCARBAZEPIN TAB 150MG
POT CHLORIDE CAP 10MEQ ER
4
2
44
22
12
2
2
2
2
15
4
24
5
4
20
2
9
10
6
14
12
3
3
19
31
5
1
4
6
2
1
2
7
2
5
2
1
8
2
1
1
1
6
3
2
5
2
2
10
7
1
13
1
8
3
2
13
11
1
9
40
4
13
3
37
1
4
5
1
4
5
450
5
2,731
3,700
810
120
720
120
75
1,110
2,070
3,750
210
360
1,500
168
720
480
540
1,140
129
20
540
256
2,997
330
14
300
266
270
10
10
510
120
238
240
30
780
50
45
30
90
40
300
90
330
180
42
1,740
510
90
1,020
60
340
9
12
233
488
45
630
472
360
570
140
1,426
45
180
303
180
831
194
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 167
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378007001
00603295732
00574200830
00378050101
45802012935
68382009401
65162036111
00591039860
23155011110
60505311403
68682014601
60951070070
00603778552
00185007260
68462022201
00781176401
45802049537
16571030216
00093803601
16714011111
00378182310
16714029701
13107000130
59746017306
68180059801
65862019401
47335073686
00378729653
58980047210
60505014201
76204010025
00168005615
00228266650
68462018147
17478007035
10370022111
00378078293
59762374001
68462018135
45963055711
47335071481
00555017178
10702003645
00115146860
47335017581
68382020405
00603002632
54458094510
29300012910
00591040501
66993006002
00245004011
00781165510
00591321901
00168029315
76439030710
00378105210
53746007801
00378300377
51991029401
00185010401
51991008290
00713064086
62175031137
49884076278
68462029792
00406853001
00245014701
16729015000
68382003510
68180021009
CLORAZEPATE DIPOTASSIUM
Y
CLONIDINE HCL
Y
NYSTOP
Y
BISOPROLOL FUMARATE/HYDRO
Y
HALOBETASOL PROPIONATE
Y
CARVEDILOL
Y
FOLIC ACID
Y
DICLOFENAC SODIUM/MISOPRO
Y
PROPRANOLOL HCL
Y
OLANZAPINE
Y
ENALAPRIL MALEATE/HYDROCH
Y
ENDOCET
Y
HYDROCORTISONE
Y
LOVASTATIN
Y
LITHIUM CARBONATE Y
IMIPRAMINE HCL
Y
DESOXIMETASONE
Y
GUAIFENESIN AC
Y
GLYBURIDE MICRONIZEDY
TRAMADOL HCL
Y
LEVOTHYROXINE SODIUM
Y
AMOXICILLIN/CLAVULANATE
Y P
MIRTAZAPINE
Y
PREDNISONE
Y
CELECOXIB
Y
FLUOXETINE HCL
Y
BUPROPION HCL SR
Y
DESOGESTREL/ETHINYL ESTRA
Y
MELQUIN HP
Y
GLIPIZIDE
Y
IPRATROPIUM BROMIDEY
BETAMETHASONE DIPROPIONAT
Y
GABAPENTIN
Y
CLOTRIMAZOLE
Y
ERYTHROMYCIN
Y
TRAMADOL HCL ER
Y
FEXOFENADINE HCL
Y
MEDROXYPROGESTERONE
Y ACETA
CLOTRIMAZOLE
Y
GABAPENTIN
Y
FINASTERIDE
Y
MEFLOQUINE HCL
Y
SODIUM POLYSTYRENE SULFON
Y
LIDOCAINE/PRILOCAINE Y
LEVOCETIRIZINE DIHYDROCHL
Y
GABAPENTIN
Y
ASPIRIN EC LOW DOSE Y
SERTRALINE HCL
Y
HYDROCHLOROTHIAZIDEY
LISINOPRIL
Y
ATOVAQUONE/PROGUANIL
Y HCL
KLOR-CON 8
Y
PENICILLIN V POTASSIUMY
BUTALBITAL/ASA/CAFFEINE
Y
CLOBETASOL PROPIONATE
Y
HYOSCYAMINE SULFATE YODT
ENALAPRIL MALEATE Y
ESTERIFIED ESTROGENS/METH
Y
CANDESARTAN CILEXETIL/HYD
Y
OXCARBAZEPINE
Y
LISINOPRIL
Y
FOLBEE PLUS
Y
HALOBETASOL PROPIONATE
Y
METHYLPHENIDATE HCL ER
Y
FENTANYL
Y
CICLOPIROX OLAMINE Y
OXYCODONE HCL
Y
PACERONE
Y
QUETIAPINE FUMARATE Y
VENLAFAXINE HCL ER Y
LOSARTAN POTASSIUM Y
CLORAZ DIPOT TAB 15MG
CLONIDINE TAB 0.1MG
NYSTOP
POW 100000
BISOPRL/HCTZ TAB 2.5/6.25
HALOBETASOL CRE 0.05%
CARVEDILOL TAB 12.5MG
FOLIC ACID TAB 1MG
DICLO/MISOPR TAB 75-0.2MG
PROPRANOLOL TAB 20MG
OLANZAPINE TAB 15MG
ENALAPR/HCTZ TAB 10-25MG
ENDOCET TAB 7.5-325
HYDROCORT LOT 2.5%
LOVASTATIN TAB 20MG
LITHIUM CARB CAP 600MG
IMIPRAM HCL TAB 25MG
DESOXIMETAS CRE 0.25%
GUAIFENESIN SYP AC
GLYBURID MCR TAB 6MG
TRAMADOL HCL TAB 50MG
LEVOTHYROXIN TAB 137MCG
AMOX/K CLAV TAB 875MG
MIRTAZAPINE TAB 7.5MG
PREDNISONE TAB 10MG
CELECOXIB CAP 200MG
FLUOXETINE CAP 40MG
BUPROPION TAB 100MG SR
DESO/ETHINYL TAB ESTRADIO
MELQUIN HP CRE 4%
GLIPIZIDE TAB 10MG
IPRATROPIUM SOL 0.02%INH
BETAMETH DIP OIN 0.05%
GABAPENTIN CAP 300MG
CLOTRIMAZOLE CRE 1%
ERYTHROMYCIN OIN OP
TRAMADOL HCL TAB 100MG ER
FEXOFENADINE TAB 180MG
MEDROXYPR AC TAB 2.5MG
CLOTRIMAZOLE CRE 1%
GABAPENTIN CAP 400MG
FINASTERIDE TAB 1MG
MEFLOQUINE TAB 250MG
SOD POLY SUL POW
LIDO/PRILOCN CRE 2.5-2.5%
LEVOCETIRIZI TAB 5MG
GABAPENTIN TAB 600MG
ASPIRIN LOW TAB 81MG EC
SERTRALINE TAB 100MG
HYDROCHLOROT TAB 50MG
LISINOPRIL TAB 2.5MG
ATOVAQ/PROGU TAB 250-100
KLOR-CON 8 TAB 8MEQ ER
PENICILLN VK TAB 500MG
BUT/ASA/CAFF CAP
CLOBETASOL GEL 0.05%
HYOSCYAMINE TAB 0.125MG
ENALAPRIL TAB 5MG
EST ESTROGEN TAB MTEST
CANDESA/HCTZ TAB 32-25MG
OXCARBAZEPIN TAB 600MG
LISINOPRIL TAB 40MG
FOLBEE PLUS TAB
HALOBETASOL CRE 0.05%
METHYLPHENID TAB 27MG ER
FENTANYL DIS 50MCG/HR
CICLOPIROX CRE 0.77%
OXYCODONE TAB 30MG
PACERONE TAB 200MG
QUETIAPINE TAB 400MG
VENLAFAXINE CAP 75MG ER
LOSARTAN POT TAB 25MG
2
18
3
11
3
10
31
1
6
3
3
5
4
9
7
5
2
9
8
13
3
5
5
25
1
3
4
1
3
8
6
2
4
6
12
2
7
7
11
3
4
1
3
5
3
1
74
5
23
19
1
2
11
2
1
3
5
1
1
1
4
4
1
1
1
3
2
3
5
3
4
180
1,665
120
930
45
1,560
3,090
60
960
270
150
150
472
690
510
330
120
2,011
1,050
1,125
270
94
150
772
30
270
300
84
85
1,740
688
60
1,080
405
42
60
172
720
420
1,080
360
12
544
125
90
270
4,738
450
2,070
1,410
17
360
310
120
30
500
450
90
90
60
360
360
50
30
10
270
175
270
390
300
360
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 168
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00603537221
00591079601
59746038506
00378181910
68645049454
68001020000
16729014501
00093083205
00054052363
76439012410
68001025604
55111029109
64679094901
45802080601
00591312001
62037057701
50111043403
55111019790
00781518792
00378407001
00713063437
43547027509
59762669203
00093078486
65862058401
00574022201
00093512501
00093078710
00713063915
10572010001
00603294828
51672411709
00093812201
00555071558
51672300701
66424052035
24208067004
16729003515
60432053760
68001024803
76282022801
00316740007
43598021040
51672130601
00603210932
00781607761
65862000801
00054011925
00832091015
76439034330
60505036302
60505006500
00093913352
00378512301
00054429931
00406048410
00603389721
00378668977
00378363701
13107015599
00603321521
59762100401
51672406104
53746046600
68382002310
68180047801
13668008005
51672127203
64720023710
00054009825
62756051813
PRIMIDONE
Y
SULFASALAZINE
Y
TERAZOSIN HCL
Y
LEVOTHYROXINE SODIUM
Y
LOSARTAN POTASSIUM Y
DICLOFENAC SODIUM DRY
QUETIAPINE FUMARATE Y
CLONAZEPAM
Y
OXYCODONE HCL
Y
GLIMEPIRIDE
Y
DULOXETINE HCL
Y
SUMATRIPTAN SUCCINATE
Y
CLARITHROMYCIN
Y
SALICYLIC ACID
Y
CLINDAMYCIN HCL
Y
METFORMIN HCL ER
Y
TRAZODONE HCL
Y
SIMVASTATIN
Y
LEVOTHYROXINE SODIUM
Y
KETOPROFEN
Y
MOMETASONE FUROATEY
DONEPEZIL HCL
Y
NIFEDIPINE ER
Y
TAMOXIFEN CITRATE
Y
AMLODIPINE BESYLATE/BENAZ
Y
LIOTHYRONINE SODIUM Y
BENAZEPRIL HCL
Y
ATENOLOL
Y
HALOBETASOL PROPIONATE
Y
PEG-3350/ELECTROLYTESY
CLONAZEPAM
Y
NYSTATIN
Y
DOXAZOSIN MESYLATE Y
CAMILA
Y
HYDROCORTISONE/ACETIC
Y ACI
ANTIPYRINE/BENZOCAINE
Y
SODIUM SULFACETAMIDE
Y
ANASTROZOLE
Y
NYSTATIN
Y
MONTELUKAST SODIUM Y
ZONISAMIDE
Y
REA LO 40
Y
SSD
Y
ALCLOMETASONE DIPROPIONAT
Y
AMLODIPINE BESYLATE Y
CEFDINIR
Y
METFORMIN HCL
Y
ROPINIROLE HCL
Y
LORAZEPAM
Y
POTASSIUM CHLORIDE Y
OFLOXACIN
Y
OMEPRAZOLE
Y
AMIODARONE HCL
Y
SOTALOL HCL (AF)
Y
FUROSEMIDE
Y
ACETAMINOPHEN/CODEINE
Y #3
HYDROCODONE/IBUPROFEN
Y
PANTOPRAZOLE SODIUMY
CETIRIZINE HCL
Y
PAROXETINE HCL
Y
DIAZEPAM
Y
NIFEDIPINE
Y
HYDROCORTISONE BUTYRATE
Y
IBUPROFEN
Y
ATENOLOL
Y
SIMVASTATIN
Y
MONTELUKAST SODIUM Y
NYSTATIN/TRIAMCINOLONE
Y
METHYLPHENIDATE HCL Y
OXCARBAZEPINE
Y
CARBIDOPA/LEVODOPA Y
PRIMIDONE TAB 250MG
SULFASALAZIN TAB 500MG
TERAZOSIN CAP 5MG
LEVOTHYROXIN TAB 200MCG
LOSARTAN POT TAB 50MG
DICLOFENAC TAB 75MG DR
QUETIAPINE TAB 25MG
CLONAZEPAM TAB 0.5MG
OXYCODONE SOL 5MG/5ML
GLIMEPIRIDE TAB 2MG
DULOXETINE CAP 30MG
SUMATRIPTAN TAB 25MG
CLARITHROMYC TAB 500MG
SALICYLIC AC CRE 6%
CLINDAMYCIN CAP 300MG
METFORMIN TAB 750MG ER
TRAZODONE TAB 100MG
SIMVASTATIN TAB 5MG
LEVOTHYROXIN TAB 150MCG
KETOPROFEN CAP 50MG
MOMETASONE CRE 0.1%
DONEPEZIL TAB 5MG
NIFEDIPINE TAB 90MG ER
TAMOXIFEN TAB 10MG
AMLOD/BENAZP CAP 5-20MG
LIOTHYRONINE TAB 25MCG
BENAZEPRIL TAB 10MG
ATENOLOL TAB 25MG
HALOBETASOL OIN 0.05%
PEG-3350 SOL ELECTROL
CLONAZEPAM TAB 0.5MG
NYSTATIN SUS 100000
DOXAZOSIN TAB 4MG
CAMILA
TAB 0.35MG
HC/ACET ACID SOL OTIC
ANTIPY/BENZO SOL OTIC
SOD SULFACET SOL 10% OP
ANASTROZOLE TAB 1MG
NYSTATIN SUS 100000
MONTELUKAST TAB 10MG
ZONISAMIDE CAP 100MG
REA LO 40 CRE 40%
SSD
CRE 1%
ALCLOMETASON CRE 0.05%
AMLODIPINE TAB 5MG
CEFDINIR SUS 125/5ML
METFORMIN TAB 500MG
ROPINIROLE TAB 2MG
LORAZEPAM TAB 0.5MG
POT CHLORIDE POW 20MEQ
OFLOXACIN DRO 0.3%OTIC
OMEPRAZOLE CAP 20MG
AMIODARONE TAB 200MG
SOTALOL AF TAB 80MG
FUROSEMIDE TAB 40MG
APAP/CODEINE TAB 300-30MG
HYDROCOD/IBU TAB 7.5-200
PANTOPRAZOLE TAB 40MG
CETIRIZINE TAB 10MG
PAROXETINE TAB 20MG
DIAZEPAM TAB 10MG
NIFEDIPINE CAP 10MG
HC BUTYRATE SOL 0.1%
IBUPROFEN TAB 800MG
ATENOLOL TAB 50MG
SIMVASTATIN TAB 10MG
MONTELUKAST CHW 5MG
NYSTAT/TRIAM OIN
METHYLPHENID TAB 5MG
OXCARBAZEPIN TAB 300MG
CARB/LEVO TAB 25-100MG
3
1
8
3
3
2
9
40
5
8
1
9
1
1
6
5
19
1
8
3
7
2
1
4
1
1
5
22
2
8
21
2
2
3
1
10
6
7
7
4
1
2
2
5
13
4
14
4
6
3
4
3
3
1
33
10
15
4
21
9
21
1
1
18
27
4
4
1
6
1
1
270
540
900
210
270
360
975
3,120
720
1,080
60
78
20
400
152
630
1,455
90
418
540
315
60
90
348
90
90
720
2,055
30
32,000
2,160
480
180
140
10
150
90
100
480
180
540
397
800
75
990
300
2,460
360
360
75
40
270
360
180
3,132
594
320
240
674
750
2,066
168
120
1,200
2,820
360
360
30
180
91
675
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 169
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68382000810
13925004010
59762372803
68180051301
68382039801
13668009290
65862053820
64679092502
67253020110
60432060616
53489017601
00574041202
00378014701
00228255011
64980017410
68382005001
00185040401
68462015811
43547027703
00093553756
55111046605
00781100801
61314064305
00603760648
66685101102
00603211002
00781207401
00781104601
59762501401
60432060416
16714037202
00713063831
61314022715
00378008010
45802018342
10702001150
47781023001
23155012401
00378617301
62756040201
76282042290
53746025360
00603211621
16729002216
00093221001
51672127401
00054350049
00168025846
00378073493
00527155201
51672131003
54838055840
65862057490
50383081016
53746027201
00406048401
00093738756
00641605425
53489037601
00378021610
00378351391
00378427605
63304063201
68645049270
43538017069
00228263650
68382001005
00603107554
53746010901
00591231519
31722020701
LAMOTRIGINE
Y
SALICYLIC ACID CREAM Y
CLINDAMYCIN PHOSPHATE
Y
LISINOPRIL
Y
POTASSIUM CHLORIDE ERM
PRAMIPEXOLE DIHYDROCHLORI
Y
LEVOFLOXACIN
Y
ENALAPRIL MALEATE Y
PENICILLIN V POTASSIUMY
PROMETHAZINE/CODEINE
Y
ALBUTEROL SULFATE Y
POLYETHYLENE GLYCOL 3350
Y
INDOMETHACIN
Y
DICLOFENAC SODIUM DRY
CARISOPRODOL
Y
MELOXICAM
Y
AMPHETAMINE/DEXTROAMPHETA
Y
ONDANSETRON ODT
Y
IRBESARTAN
Y
ESZOPICLONE
Y
METOPROLOL SUCCINATE
Y ER
TRIAMTERENE/HYDROCHLOROTH
Y
TOBRAMYCIN SULFATE Y
GILDESS 1.5/30
Y
AMOXICILLIN/CLAVULANATE
Y P
AMLODIPINE BESYLATE Y
TRIAMTERENE/HYDROCHLOROTH
Y
PERPHENAZINE
Y
SPIRONOLACTONE/HYDROCHLOR
Y
PROMETHAZINE/DEXTROMETHOR
Y
LAMOTRIGINE
Y
CICLOPIROX OLAMINE Y
TIMOLOL MALEATE
Y
INDAPAMIDE
Y
TRETINOIN
Y
HYDROXYZINE HCL
Y
OXYCODONE/ACETAMINOPHEN
Y
ROPINIROLE HCL
Y
METOLAZONE
Y
PHENYTOIN SODIUM EXTENDED
Y
LISINOPRIL
Y
RANITIDINE HCL
Y
ALLOPURINOL
Y
PIOGLITAZONE HCL
Y
SUCRALFATE
Y
BETAMETHASONE DIPROPIONAT
Y
LIDOCAINE VISCOUS
Y
CLOTRIMAZOLE/BETAMETHASON
Y
FLUOXETINE HCL
Y
BUTAL/ASA/CAFF
Y
AUGMENTED BETAMETHASONE
Y
D
CHILDRENS LORATADINEY
MONTELUKAST SODIUM Y
ACYCLOVIR
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
ACETAMINOPHEN/CODEINE
Y #3
MOXIFLOXACIN HCL
Y
MEPERIDINE HCL
Y
TRIMETHOBENZAMIDE HCL
Y
FUROSEMIDE
Y
RISPERIDONE
Y
VALACYCLOVIR HCL
Y
FLUOXETINE HCL
Y
PANTOPRAZOLE SODIUMY
CLINDACIN-P
Y
GABAPENTIN
Y
LAMOTRIGINE
Y
CHERATUSSIN AC
Y
HYDROCODONE/ACETAMINOPHEN
Y
VALSARTAN/HYDROCHLOROTHIA
Y
CITALOPRAM HYDROBROMIDE
Y
LAMOTRIGINE TAB 100MG
SALICYLIC AC KIT 6% CREAM
CLINDAMYCIN PAD 1%
LISINOPRIL TAB 5MG
POT CHLORIDE TAB 20MEQ ER
PRAMIPEXOLE TAB 0.25MG
LEVOFLOXACIN TAB 750MG
ENALAPRIL TAB 10MG
PENICILLN VK TAB 500MG
PROMETH/COD SYP 6.25-10
ALBUTEROL TAB 2MG
POLYETH GLYC POW 3350 NF
INDOMETHACIN CAP 50MG
DICLOFENAC TAB 50MG DR
CARISOPRODOL TAB 350MG
MELOXICAM TAB 7.5MG
AMPHETAMINE TAB 30MG
ONDANSETRON TAB 8MG ODT
IRBESARTAN TAB 75MG
ESZOPICLONE TAB 1MG
METOPROLOL TAB 25MG ER
TRIAMT/HCTZ TAB 75-50MG
TOBRAMYCIN SOL 0.3% OP
GILDESS TAB 1.5/30
AMOX/K CLAV SUS 200/5ML
AMLODIPINE TAB 10MG
TRIAMT/HCTZ CAP 37.5-25
PERPHENAZINE TAB 2MG
SPIRONO/HCTZ TAB 25/25
PROMETHAZINE SYP DM
LAMOTRIGINE TAB 100MG
CICLOPIROX CRE 0.77%
TIMOLOL MAL SOL 0.5% OP
INDAPAMIDE TAB 2.5MG
TRETINOIN CRE 0.1%
HYDROXYZ HCL TAB 25MG
OXYCOD/APAP TAB 10-325MG
ROPINIROLE TAB 2MG
METOLAZONE TAB 5MG
PHENYTOIN EX CAP 100MG
LISINOPRIL TAB 40MG
RANITIDINE TAB 150MG
ALLOPURINOL TAB 300MG
PIOGLITAZONE TAB 45MG
SUCRALFATE TAB 1GM
BETAMETH DIP CRE 0.05%
LIDOCAINE SOL 2% VISC
CLOTRIM/BETA CRE DIPROP
FLUOXETINE TAB 10MG
BUT/ASA/CAFF CAP
AUG BETAMET CRE 0.05%
LORATADINE SOL 5MG/5ML
MONTELUKAST TAB 10MG
ACYCLOVIR SUS 200/5ML
SMZ/TMP DS TAB 800-160
APAP/CODEINE TAB 300-30MG
MOXIFLOXACIN TAB 400MG
MEPERIDINE INJ 100MG/ML
TRIMETHOBENZ CAP 300MG
FUROSEMIDE TAB 40MG
RISPERIDONE TAB 3MG
VALACYCLOVIR TAB 1GM
FLUOXETINE CAP 40MG
PANTOPRAZOLE TAB 40MG
CLINDACIN-P PAD 1%
GABAPENTIN TAB 600MG
LAMOTRIGINE TAB 200MG
CHERATUSSIN SYP AC
HYDROCO/APAP TAB 5-325MG
VALSART/HCTZ TAB 80-12.5
CITALOPRAM TAB 20MG
10
1
4
12
1
2
18
5
10
39
1
10
7
5
16
20
2
5
2
0
3
11
20
4
6
7
4
2
2
35
4
5
6
2
1
12
1
3
3
1
7
11
9
4
4
1
29
2
2
3
1
18
1
2
25
12
1
12
2
12
9
2
6
5
1
1
2
13
15
1
17
555
1
240
1,020
180
60
138
450
279
7,228
30
2,550
450
244
1,380
960
120
72
60
15
150
686
115
168
600
630
360
180
120
5,698
540
210
90
360
45
990
120
210
74
360
630
1,558
690
360
386
60
3,680
90
225
100
100
2,145
30
175
790
819
6
72
100
2,070
570
153
540
200
69
90
270
1,934
502
90
1,170
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 170
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
64679073609
54458093210
00832712311
00245005710
68462035801
00713063818
00603465528
55111072510
00603465532
33342010207
68180058901
00093005301
67877025115
57237005860
53746017805
43547027609
00378602101
00591379783
62175011937
65862019301
00781220205
00143998275
00378968244
42858030301
00093414564
00574019360
00093725501
45802002146
00093816101
50383082416
00245011212
58980015020
68462046806
33342007610
00378061101
00228402411
49884051101
00574082010
64980015101
16729016917
00093834201
00591532101
00093873901
00093736598
68180021709
00093736856
00603385532
64376064805
59762010401
00093104810
00185002201
00378727253
13668042990
00168009930
00472033730
68382003516
00143985316
60758090810
68180055609
13925050104
13668010601
42291062390
54458093710
00168028802
47335038283
00378130001
23155025001
00591381730
43598020354
00378135501
00555086902
METOPROLOL SUCCINATE
Y ER
SIMVASTATIN
Y
DIVALPROEX SODIUM DRY
KLOR-CON M10
Y
NABUMETONE
Y
CICLOPIROX OLAMINE Y
MONTELUKAST SODIUM Y
MONTELUKAST SODIUM Y
MONTELUKAST SODIUM Y
MONTELUKAST SODIUM Y
RAMIPRIL
Y
BUSPIRONE HCL
Y
TRIAMCINOLONE ACETONIDE
Y
CEFUROXIME AXETIL
Y
METFORMIN HCL ER
Y
DONEPEZIL HCL
Y
DOXYCYCLINE MONOHYDRATE
Y
ALBUTEROL SULFATE Y
ISOSORBIDE MONONITRATE
Y ER
FLUOXETINE HCL
Y
TEMAZEPAM
Y
AMOXICILLIN/CLAVULANATE
Y P
LEVALBUTEROL HCL
Y
HYDROMORPHONE HCL Y
LEVALBUTEROL HCL
Y
INDOMETHACIN ER
Y
GLIMEPIRIDE
Y
BETAMETHASONE DIPROPIONAT
Y
QUETIAPINE FUMARATE Y
SULFAMETHOXAZOLE/TRIMETHO
Y
HEMRIL-30
Y
HYPERCARE
Y
RIZATRIPTAN BENZOATE YODT
VALSARTAN/HYDROCHLOROTHIA
Y
METHYLDOPA
Y
ALPRAZOLAM ODT
Y
MINOCYCLINE HCL
Y
TESTOSTERONE CYPIONATE
Y
AMILORIDE HCL
Y
ESCITALOPRAM OXALATEY
GLYBURIDE
Y
PRIMIDONE
Y
MEXILETINE HCL
Y
LOSARTAN POTASSIUM Y
LOSARTAN POTASSIUM/HYDROC
Y
LOSARTAN POTASSIUM/HYDROC
Y
HYDROCHLOROTHIAZIDEY
HYDROCODONE BITARTRATE/AC
Y
SULFASALAZINE
Y
METFORMIN HCL
Y
ORPHENADRINE CITRATEYER
NORETHINDRONE
Y
PANTOPRAZOLE SODIUMY
KETOCONAZOLE
Y
HYDROCORTISONE
Y
VENLAFAXINE HCL ER Y
AMOXICILLIN/CLAVULANATE
Y P
POLYMYXIN B SULFATE/TRIME
Y
QUINAPRIL HCL
Y
PREDNISOLONE SODIUMYPHOSP
ISOSORBIDE MONONITRATE
Y ER
MONTELUKAST SODIUM Y
LOVASTATIN
Y
HYDROCORTISONE
Y
DULOXETINE HCL
Y
LITHIUM CARBONATE ERY
VENLAFAXINE HCL
Y
IPRATROPIUM BROMIDE/ALBUT
Y
AMOXICILLIN/CLAVULANATE
Y P
TRIAMTERENE/HYDROCHLOROTH
Y
WARFARIN SODIUM
Y
METOPROLOL TAB 100MG ER
SIMVASTATIN TAB 40MG
DIVALPROEX TAB 250MG DR
KLOR-CON M10 TAB 10MEQ ER
NABUMETONE TAB 500MG
CICLOPIROX CRE 0.77%
MONTELUKAST TAB 10MG
MONTELUKAST TAB 10MG
MONTELUKAST TAB 10MG
MONTELUKAST TAB 10MG
RAMIPRIL CAP 2.5MG
BUSPIRONE TAB 5MG
TRIAMCINOLON CRE 0.1%
CEFUROXIME TAB 250MG
METFORMIN TAB 500MG ER
DONEPEZIL TAB 10MG
DOXYCYC MONO TAB 50MG
ALBUTEROL NEB 0.083%
ISOSORB MONO TAB 60MG ER
FLUOXETINE CAP 20MG
TEMAZEPAM CAP 30MG
AMOX/K CLAV SUS 400/5ML
LEVALBUTEROL NEB 1.25MG
HYDROMORPHON TAB 8MG
LEVALBUTEROL NEB 0.31MG
INDOMETHACIN CAP 75MG ER
GLIMEPIRIDE TAB 2MG
BETAMETH DIP LOT 0.05%
QUETIAPINE TAB 25MG
SMZ-TMP SUS 200-40/5
HEMRIL-30 SUP 30MG
HYPERCARE SOL 20%
RIZATRIPTAN TAB 10MG ODT
VALSART/HCTZ TAB 160-25MG
METHYLDOPA TAB 250MG
ALPRAZOLAM TAB 1MG ODT
MINOCYCLINE TAB 50MG
TESTOST CYP INJ 200MG/ML
AMILORIDE TAB 5MG
ESCITALOPRAM TAB 10MG
GLYBURIDE TAB 1.25MG
PRIMIDONE TAB 250MG
MEXILETINE CAP 150MG
LOSARTAN POT TAB 50MG
LOSARTAN/HCT TAB 100-25
LOSARTAN/HCT TAB 100-25
HYDROCHLOROT CAP 12.5MG
HYDROCO/APAP TAB 5-300MG
SULFASALAZIN TAB 500MG DR
METFORMIN TAB 500MG
ORPHENADRINE TAB 100MG ER
NORETHINDRON TAB 0.35MG
PANTOPRAZOLE TAB 40MG
KETOCONAZOLE CRE 2%
HYDROCORT CRE 2.5%
VENLAFAXINE CAP 75MG ER
AMOX/K CLAV SUS 600/5ML
POLYMYXIN B/ SOL TRIMETHP
QUINAPRIL TAB 5MG
PRED SOD PHO SOL 5MG/5ML
ISOSORB MONO TAB 120MG ER
MONTELUKAST CHW 5MG
LOVASTATIN TAB 20MG
HYDROCORT LOT 2.5%
DULOXETINE CAP 30MG
LITHIUM CARB TAB 300MG ER
VENLAFAXINE TAB 100MG
IPRATROPIUM/ SOL ALBUTER
AMOX/K CLAV SUS 600/5ML
TRIAMT/HCTZ TAB 75-50MG
WARFARIN TAB 2MG
1
6
3
1
2
2
1
1
1
1
1
18
8
2
9
2
2
12
2
16
21
4
1
1
1
2
9
3
2
6
1
13
1
1
8
1
1
1
2
6
3
2
1
4
1
1
9
4
3
7
6
1
2
3
18
3
2
6
1
4
1
4
9
2
1
3
1
1
3
6
1
90
480
1,080
180
120
180
90
90
90
90
90
1,380
285
40
1,560
60
65
2,175
360
1,650
654
450
72
120
72
60
1,286
180
60
825
20
780
36
90
960
60
60
10
90
540
540
270
270
240
90
90
810
63
300
1,200
320
84
180
120
690
270
500
60
90
175
90
120
810
177
60
360
270
1,080
600
540
270
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 171
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
65862014736
00168000215
54458093610
67877012485
00093721201
76282025010
51672404801
00603421421
31722040501
68462029052
51991077133
31604002680
68180021209
16714040504
62175048637
00378698501
00378700493
23155001101
31722021430
68645047559
00093714923
00228206910
00143972501
00054001729
00093415573
00093026292
41616075881
62175089246
00245004111
64980030550
67253018110
64980050448
16571030316
00093542328
45802012932
00178048008
00093731498
45802008302
31722022105
00591324930
43386055102
65862001205
68462020901
68382001718
59762015802
11673057139
54458096610
00378385610
51672401701
00093812101
68180051401
68382018101
16571020110
00781523980
61314020415
00054026525
42792010701
61314020315
00378110101
68462034105
00378351291
24208039830
50532011310
00378075701
00603548421
00781107810
00093100601
00363918002
00363412262
00054474125
42291032350
SUMATRIPTAN SUCCINATE
Y
TRIAMCINOLONE ACETONIDE
Y
LOVASTATIN
Y
SILVER SULFADIAZINE Y
METFORMIN HCL ER
Y
ESCITALOPRAM OXALATEY
CLOTRIMAZOLE/BETAMETHASON
Y
LISINOPRIL
Y
GABAPENTIN
Y
AUGMENTED BETAMETHASONE
Y
D
LANSOPRAZOLE
Y
COQ10
Y
LOSARTAN POTASSIUM Y
LARIN FE 1.5/30
Y
VERAPAMIL HCL ER
Y
SODIUM CHLORIDE
Y
PAROXETINE HCL
Y
INDOMETHACIN
Y
SERTRALINE HCL
Y
IBUPROFEN
Y
AZITHROMYCIN
Y
OXAZEPAM
Y
PROGESTERONE
Y
PREDNISONE
Y
AMOXICILLIN
Y
FLUOCINONIDE
Y
VENLAFAXINE HCL ER Y
ATORVASTATIN CALCIUMY
KLOR-CON 10
Y
DENTA 5000 PLUS
Y
AMPICILLIN
Y
CYPROHEPTADINE HCL Y
POTASSIUM CHLORIDE Y
GIANVI
Y
HALOBETASOL PROPIONATE
Y
AVAR CLEANSER
Y
CLOPIDOGREL
Y
ERYTHROMYCIN/BENZOYL
Y PERO
GABAPENTIN
Y
VALACYCLOVIR HCL
Y
TINIDAZOLE
Y
SERTRALINE HCL
Y
MOEXIPRIL HCL
Y
LEVOFLOXACIN
Y
ATORVASTATIN CALCIUMY
TGT ALLERGY RELIEF
Y
GLIMEPIRIDE
Y
ESCITALOPRAM OXALATEY
ETODOLAC
Y
DOXAZOSIN MESYLATE Y
LISINOPRIL
Y
BUSPIRONE HCL
Y
DICLOFENAC SODIUM DRY
ONDANSETRON ODT
Y
PILOCARPINE HCL
Y
HYDROMORPHONE HCL Y
SODIUM SULFACETAMIDE/SULF
Y
PILOCARPINE HCL
Y
PRAZOSIN HCL
Y
HYDRALAZINE HCL
Y
RISPERIDONE
Y
IPRATROPIUM BROMIDEY
HYOSCYAMINE SULFATE Y
ATENOLOL
Y
PROPRANOLOL HCL
Y
ATENOLOL
Y
NAPROXEN DR
Y
NICOTINE TRANSDERMALY SYST
NICOTINE POLACRILEX START
Y
PREDNISONE
Y
HYDROXYZINE PAMOATEY
SUMATRIPTAN TAB 50MG
TRIAMCINOLON CRE 0.5%
LOVASTATIN TAB 40MG
SILVER SULFA CRE 1%
METFORMIN TAB 750MG ER
ESCITALOPRAM TAB 10MG
CLOTRIM/BETA CRE DIPROP
LISINOPRIL TAB 40MG
GABAPENTIN TAB 600MG
AUG BETAMET CRE 0.05%
LANSOPRAZOLE CAP 15MG DR
COQ10
CAP 200MG
LOSARTAN POT TAB 100MG
LARIN FE TAB 1.5/30
VERAPAMIL CAP 200MG ER
SOD CHLORIDE NEB 0.9%
PAROXETINE TAB 40MG
INDOMETHACIN CAP 50MG
SERTRALINE TAB 100MG
IBUPROFEN TAB 600MG
AZITHROMYCIN SUS 200/5ML
OXAZEPAM CAP 15MG
PROGESTERONE INJ 50MG/ML
PREDNISONE TAB 10MG
AMOXICILLIN SUS 250/5ML
FLUOCINONIDE CRE 0.05%
VENLAFAXINE TAB 150MG ER
ATORVASTATIN TAB 40MG
KLOR-CON 10 TAB 10MEQ ER
DENTA 5000 CRE PLUS
AMPICILLIN CAP 500MG
CYPROHEPTAD SYP 2MG/5ML
POT CHLORIDE LIQ 10% SF
GIANVI
TAB 3-0.02MG
HALOBETASOL CRE 0.05%
AVAR CLEANSE EMU 10-5%
CLOPIDOGREL TAB 75MG
ERYTHROMYCIN GEL /BENZOYL
GABAPENTIN CAP 100MG
VALACYCLOVIR TAB 1GM
TINIDAZOLE TAB 500MG
SERTRALINE TAB 50MG
MOEXIPRIL TAB 7.5MG
LEVOFLOXACIN TAB 750MG
ATORVASTATIN TAB 80MG
ALLERGY RELF TAB 180MG
GLIMEPIRIDE TAB 4MG
ESCITALOPRAM TAB 10MG
ETODOLAC CAP 300MG
DOXAZOSIN TAB 2MG
LISINOPRIL TAB 10MG
BUSPIRONE TAB 10MG
DICLOFENAC TAB 75MG DR
ONDANSETRON TAB 8MG ODT
PILOCARPINE SOL 2% OP
HYDROMORPHON TAB 8MG
SOD SUL/SULF LOT 10-5%
PILOCARPINE SOL 1% OP
PRAZOSIN HCL CAP 1MG
HYDRALAZINE TAB 10MG
RISPERIDONE TAB 2MG
IPRATROPIUM SPR 0.03%
HYOSCYAMINE SUB 0.125MG
ATENOLOL TAB 100MG
PROPRANOLOL TAB 40MG
ATENOLOL TAB 25MG
NAPROXEN DR TAB 500MG
NICOTINE TD DIS 21MG/24H
NICOTINE POL GUM 2MG STRT
PREDNISONE TAB 1MG
HYDROXYZ PAM CAP 50MG
8
9
3
6
2
1
2
2
1
3
2
3
5
1
1
6
4
7
4
27
3
3
1
20
19
2
1
1
2
13
11
9
2
3
1
2
1
3
6
1
2
9
1
13
4
6
4
3
1
2
17
11
3
2
1
3
1
1
7
8
2
4
5
11
2
15
10
1
1
3
10
69
315
270
510
360
90
75
270
270
200
45
270
345
84
60
1,800
240
270
300
1,216
82
90
30
737
3,500
120
90
90
225
1,071
475
1,015
1,350
84
50
454
90
93
1,240
45
14
570
90
130
315
180
720
270
60
150
1,410
1,620
150
30
15
120
30
15
270
882
180
120
300
1,260
240
1,395
540
28
220
600
750
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 172
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
65862000701
64376065740
16714035303
00781570192
00378161001
00378053101
63323026110
00378265001
00781615752
68645013054
29300018801
62175012837
60505377803
00054022321
00591024001
00591561905
00172392770
00093319301
00378050501
00185007410
00378351491
16714008210
00093712198
00093414664
65862018501
16729014912
00093720656
68462056301
00378072301
00378628010
68001011807
68308032610
63304062410
00185002501
00093075210
54458099809
68382002810
65862001305
60505011600
00603533721
00781106401
16714035903
29300012510
54458095010
63304023901
24208079062
57664043553
76282041290
00378226801
63739028431
16714065102
60793085501
68382005601
68180040103
51672300302
49884070154
00527132501
66758019092
57664017088
68180013601
00781518210
00378471022
23155011901
00378773497
00603417016
00093083201
00093073310
59762306002
57664047451
55111014401
62175027041
CITALOPRAM HYDROBROMIDE
Y
BROMPHEN/PSEUDOEPHEDRINE
Y
FLUOXETINE HCL
Y
LOSARTAN POTASSIUM Y
DICYCLOMINE HCL
Y
SULINDAC
Y
PROGESTERONE
Y
AMITRIPTYLINE HCL
Y
AMOXICILLIN
Y
FLUOXETINE HCL
Y
BISOPROLOL FUMARATE/HYDRO
Y
ISOSORBIDE MONONITRATE
Y ER
VENLAFAXINE HCL ER Y
QUETIAPINE FUMARATE Y
LORAZEPAM
Y
DIAZEPAM
Y
DIAZEPAM
Y
KETOPROFEN
Y
BISOPROLOL FUMARATE/HYDRO
Y
LOVASTATIN
Y
RISPERIDONE
Y
HYDROXYZINE HCL
Y
PAROXETINE HCL
Y
LEVALBUTEROL HCL
Y
CLINDAMYCIN HCL
Y
QUETIAPINE FUMARATE Y
MIRTAZAPINE
Y
ATOVAQUONE/PROGUANIL
Y HCL
ENALAPRIL MALEATE/HYDROCH
Y
DICLOFENAC SODIUM DRY
LEVETIRACETAM
Y
FABB
Y
FUROSEMIDE
Y
LISINOPRIL
Y
ATENOLOL
Y
LISINOPRIL
Y
METFORMIN HCL
Y
SERTRALINE HCL
Y
TERAZOSIN HCL
Y
PREDNISONE
Y
BUPROPION HCL
Y
FALMINA
Y
MELOXICAM
Y
NIFEDIPINE ER
Y
CALCITRIOL
Y
NEOMYCIN/POLYMYXIN/GRAMIC
Y
METFORMIN HCL
Y
FINASTERIDE
Y
TERAZOSIN HCL
Y
DILTIAZEM CD
Y
CIPROFLOXACIN HCL
Y
LEVOXYL
Y
WARFARIN SODIUM
Y
CEFPROZIL
Y
HYDROCORTISONE
Y
CLOMIPHENE CITRATE Y
DIGOX
Y
KLOR-CON M20
Y
HYDROCODONE/ACETAMINOPHEN
Y
ESCITALOPRAM OXALATEY
LEVOTHYROXINE SODIUM
Y
PREDNISOLONE SODIUMYPHOSP
CALCITRIOL
Y
ONDANSETRON ODT
Y
K-EFFERVESCENT
Y
CLONAZEPAM
Y
METOPROLOL TARTRATEY
AZITHROMYCIN
Y
METFORMIN HCL
Y
FLUCONAZOLE
Y
OXYBUTYNIN CHLORIDE ER
Y
CITALOPRAM TAB 40MG
BROM/PSE/DM SYP
FLUOXETINE CAP 40MG
LOSARTAN POT TAB 50MG
DICYCLOMINE CAP 10MG
SULINDAC TAB 200MG
PROGESTERONE INJ 50MG/ML
AMITRIPTYLIN TAB 50MG
AMOXICILLIN SUS 400/5ML
FLUOXETINE CAP 20MG
BISOPRL/HCTZ TAB 5-6.25MG
ISOSORB MONO TAB 30MG ER
VENLAFAXINE CAP 37.5 ER
QUETIAPINE TAB 300MG
LORAZEPAM TAB 0.5MG
DIAZEPAM TAB 5MG
DIAZEPAM TAB 10MG
KETOPROFEN CAP 50MG
BISOPRL/HCTZ TAB 10/6.25
LOVASTATIN TAB 40MG
RISPERIDONE TAB 4MG
HYDROXYZ HCL TAB 25MG
PAROXETINE TAB 40MG
LEVALBUTEROL NEB 0.63MG
CLINDAMYCIN CAP 150MG
QUETIAPINE TAB 300MG
MIRTAZAPINE TAB 15MG
ATOVAQ/PROGU TAB 62.5-25
ENALAPR/HCTZ TAB 10-25MG
DICLOFENAC TAB 50MG DR
LEVETIRACETA TAB 750MG
FABB
TAB
FUROSEMIDE TAB 20MG
LISINOPRIL TAB 2.5MG
ATENOLOL TAB 50MG
LISINOPRIL TAB 5MG
METFORMIN TAB 500MG
SERTRALINE TAB 100MG
TERAZOSIN CAP 2MG
PREDNISONE TAB 5MG
BUPROPION TAB 100MG
FALMINA TAB
MELOXICAM TAB 15MG
NIFEDIPINE TAB 30MG ER
CALCITRIOL CAP 0.25MCG
NEO/POLY/GRA SOL OP
METFORMIN TAB 850MG
FINASTERIDE TAB 5MG
TERAZOSIN CAP 5MG
DILTIAZEM CAP 180MG CD
CIPROFLOXACN TAB 250MG
LEVOXYL TAB 112MCG
WARFARIN TAB 5MG
CEFPROZIL SUS 125/5ML
HYDROCORT CRE 2.5%
CLOMIPHENE TAB 50MG
DIGOX
TAB 0.25MG
KLOR-CON M20 TAB 20MEQ ER
HYDROCO/APAP TAB 7.5-325
ESCITALOPRAM TAB 20MG
LEVOTHYROXIN TAB 75MCG
PREDNISOLONE TAB 10MG ODT
CALCITRIOL CAP 0.5MCG
ONDANSETRON TAB 8MG ODT
K-EFFERVESCE TAB 25MEQ EF
CLONAZEPAM TAB 0.5MG
METOPROL TAR TAB 50MG
AZITHROMYCIN TAB 250MG
METFORMIN TAB 1000MG
FLUCONAZOLE TAB 100MG
OXYBUTYNIN TAB 5MG ER
13
3
1
2
17
2
1
4
15
20
5
3
2
1
36
35
31
2
7
4
1
10
2
1
16
2
6
1
1
3
1
4
17
18
26
15
5
2
7
9
1
1
12
1
2
2
6
3
4
1
23
7
5
4
14
6
2
2
4
1
7
1
2
4
1
43
18
7
3
2
1
990
450
90
270
1,508
360
40
360
2,300
1,530
630
270
270
180
1,648
1,647
1,259
66
630
240
90
430
120
72
541
210
420
34
90
180
180
240
1,395
1,380
2,340
1,290
570
270
570
573
120
84
751
90
78
20
1,440
270
360
90
254
184
560
400
567
35
120
180
240
90
210
6
54
54
90
2,330
2,200
51
675
60
30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 173
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
67877025180
62037057110
63304062301
00713022360
63304009819
64720023810
63304069701
00603752517
00603421428
00008060601
00591060601
45802036342
66993066330
52565002060
00472390115
51672408301
43598020451
60505001506
64950035450
31722053101
00378623301
00228255111
68382054410
65862059601
16714039801
50383007916
54458092710
00781542664
24208079535
00781196610
68382005101
60505264907
10702001201
68382008001
00955171016
42806001410
65162080906
76439013104
13668000805
16714023501
65162053650
43547033710
31722020805
00603448521
16729008101
51672130301
00591086201
43199001101
00378385710
00781176601
00115982203
65162062710
54458088610
24208041105
00185013901
66993046530
16729009001
23155012301
53746019001
00603516732
67877027312
31722021205
00781108901
53746025430
00363020105
60505291703
57664050818
16729017101
60505311203
66993088061
00603321428
TRIAMCINOLONE ACETONIDE
Y
METFORMIN HCL ER
Y
ATENOLOL
Y
FLUOCINOLONE ACETONIDE
Y
SUMATRIPTAN SUCCINATE
Y
METHYLPHENIDATE HCL Y
MINOCYCLINE HCL
Y
CYCLAFEM 7/7/7
Y
LISINOPRIL
Y
PANTOPRAZOLE SODIUMY
LABETALOL HCL
Y
TRETINOIN
Y
DULOXETINE HCL
Y
FLUOCINOLONE ACETONIDE
Y
FLUOCINONIDE
Y
HYDROCORTISONE BUTYRATE
Y
AMOXICILLIN/CLAVULANATE
Y P
DILT-XR
Y
OXYCODONE HCL
Y
TORSEMIDE
Y
CITALOPRAM HYDROBROMIDE
Y
DICLOFENAC SODIUM DRY
LANSOPRAZOLE
Y
CLINDAMYCIN PALMITATE
Y HCL
CEFPROZIL
Y
ACETAMINOPHEN/CODEINE
Y
PRAVASTATIN SODIUM Y
RIZATRIPTAN BENZOATE YODT
NEOMYCIN/POLYMYXIN/DEXAME
Y
FUROSEMIDE
Y
MELOXICAM
Y
TIZANIDINE HCL
Y
HYDROXYZINE HCL
Y
HALOPERIDOL
Y
TRIAMCINOLONE ACETONIDE
Y
MECLIZINE HCL
Y
ALPRAZOLAM ER
Y
ALENDRONATE SODIUM Y
ZOLPIDEM TARTRATE Y
PENICILLIN V POTASSIUMY
BENZONATATE
Y
BENAZEPRIL HCL
Y
CITALOPRAM HYDROBROMIDE
Y
METHOCARBAMOL
Y
NALTREXONE HCL
Y
ECONAZOLE NITRATE Y
LISINOPRIL/HYDROCHLOROTHI
Y
HYOSCYAMINE SULFATE Y
ESCITALOPRAM OXALATEY
IMIPRAMINE HCL
Y
DIGOXIN
Y
TRAMADOL HCL
Y
LISINOPRIL/HYDROCHLOROTHI
Y
BRIMONIDINE TARTRATEY
ETODOLAC
Y
OLANZAPINE
Y
FINASTERIDE
Y
ROPINIROLE HCL
Y
NAPROXEN
Y
PHENOBARBITAL
Y
UREA
Y
SERTRALINE HCL
Y
ALPRAZOLAM
Y
RANITIDINE HCL
Y
NICOTINE POLACRILEX Y
LOSARTAN POTASSIUM/HYDROC
Y
CITALOPRAM HYDROBROMIDE
Y
AMITRIPTYLINE HCL
Y
OLANZAPINE
Y
PREDNICARBATE
Y
DIAZEPAM
Y
TRIAMCINOLON CRE 0.1%
METFORMIN TAB 500MG ER
ATENOLOL TAB 100MG
FLUOCIN ACET CRE 0.01%
SUMATRIPTAN TAB 50MG
METHYLPHENID TAB 10MG
MINOCYCLINE TAB 50MG
CYCLAFEM TAB 7/7/7
LISINOPRIL TAB 40MG
PANTOPRAZOLE TAB 20MG
LABETALOL TAB 200MG
TRETINOIN GEL 0.025%
DULOXETINE CAP 30MG
FLUOCIN ACET CRE 0.025%
FLUOCINONIDE CRE 0.05%
HC BUTYRATE OIN 0.1%
AMOX/K CLAV SUS 250/5ML
DILT-XR CAP 180MG
OXYCODONE SOL 5MG/5ML
TORSEMIDE TAB 20MG
CITALOPRAM TAB 40MG
DICLOFENAC TAB 75MG DR
LANSOPRAZOLE CAP 30MG DR
CLINDAMYCIN SOL 75MG/5ML
CEFPROZIL TAB 250MG
APAP/CODEINE SOL 120-12/5
PRAVASTATIN TAB 10MG
RIZATRIPTAN TAB 10MG ODT
NEO/POLY/DEX OIN 0.1% OP
FUROSEMIDE TAB 40MG
MELOXICAM TAB 15MG
TIZANIDINE CAP 4MG
HYDROXYZ HCL TAB 50MG
HALOPERIDOL TAB 10MG
TRIAMCINOLON AER 55MCG/AC
MECLIZINE TAB 25MG
ALPRAZOLAM TAB 0.5MG ER
ALENDRONATE TAB 70MG
ZOLPIDEM TAB 10MG
PENICILLN VK TAB 500MG
BENZONATATE CAP 100MG
BENAZEPRIL TAB 20MG
CITALOPRAM TAB 40MG
METHOCARBAM TAB 500MG
NALTREXONE TAB 50MG
ECONAZOLE CRE 1%
LISINOP/HCTZ TAB 20-25MG
HYOSCYAMINE SUB 0.125MG
ESCITALOPRAM TAB 20MG
IMIPRAM HCL TAB 50MG
DIGOXIN TAB 0.25MG
TRAMADOL HCL TAB 50MG
LISINOP/HCTZ TAB 10-12.5
BRIMONIDINE SOL 0.2% OP
ETODOLAC TAB 500MG
OLANZAPINE TAB 20MG
FINASTERIDE TAB 5MG
ROPINIROLE TAB 1MG
NAPROXEN TAB 500MG
PHENOBARB TAB 64.8MG
UREA
LOT 40%
SERTRALINE TAB 25MG
ALPRAZOLAM TAB 2MG
RANITIDINE TAB 300MG
NICOTINE POL LOZ 2MG CINN
LOSARTAN/HCT TAB 100-25
CITALOPRAM TAB 20MG
AMITRIPTYLIN TAB 10MG
OLANZAPINE TAB 7.5MG
PREDNICARBAT CRE 0.1%
DIAZEPAM TAB 5MG
7
8
7
1
5
3
1
3
3
3
1
1
1
1
4
2
1
1
3
1
10
3
3
1
2
29
2
1
6
17
18
2
7
1
1
6
1
4
13
14
10
8
11
16
1
2
5
2
3
4
1
17
8
3
1
3
5
1
4
4
1
9
7
6
1
2
9
5
2
1
47
640
1,440
630
60
39
150
60
252
270
270
120
45
90
60
75
30
150
90
344
450
780
180
270
200
80
4,335
180
10
21
1,530
674
35
358
90
16
205
60
32
750
379
300
720
870
1,064
30
115
480
150
210
360
90
1,710
720
50
90
150
330
90
320
220
237
462
750
570
144
180
750
690
37
60
1,848
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 174
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
43386033001
00093081301
43598021830
49483022110
13107004405
00245005790
16714008211
13107015630
64980018106
00185064401
63304057910
59762374101
00093417574
33342005110
16714022402
00603107858
00517075001
00093894705
68645044990
60505024701
65862047099
00781520710
00143992801
68180039201
42192013606
00781537905
00603459321
00121077504
61314065605
53746046501
45963050002
51672125403
00591207030
00228259711
00591048705
16714066301
65162110105
65862070020
68462016205
00378701001
29300012401
45802004064
51672400501
13107007401
00781520631
00591555610
65862001401
16729017217
68645045790
00093035005
47781022905
47335090288
68462035805
51672130302
68462022001
42291062330
00781555592
00603307921
67877019790
60505014701
00781214401
23155005701
60505001508
16714008310
65862014636
53191036201
31722020190
13107015530
00781571001
00527139401
61442014160
TRIMETHOPRIM
Y
NORTRIPTYLINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
NITRO-TIME
Y
OXYCODONE/ACETAMINOPHEN
Y
KLOR-CON M10
Y
HYDROXYZINE HCL
Y
PAROXETINE HCL
Y
DIFLUNISAL
Y
PHENTERMINE HCL
Y
METOPROLOL TARTRATEY
MEDROXYPROGESTERONE
Y ACETA
CEPHALEXIN
Y
LOSARTAN POTASSIUM/HYDROC
Y
LOSARTAN POTASSIUM/HYDROC
Y
CHERATUSSIN DAC
Y
PROGESTERONE
Y
ACYCLOVIR
Y
CYCLOBENZAPRINE HCL Y
MIRTAZAPINE
Y
LOSARTAN POTASSIUM/HYDROC
Y
LOSARTAN POTASSIUM/HYDROC
Y
CIPROFLOXACIN HCL
Y
CIPROFLOXACIN
Y
SULFACETAMIDE SODIUM/SULF
Y
LORAZEPAM
Y
METHYLPREDNISOLONE Y
GUAIFENESIN/CODEINE Y
CIPROFLOXACIN HCL
Y
IBUPROFEN
Y
FINASTERIDE
Y
FLUOCINONIDE-E
Y
LIDOCAINE/PRILOCAINE Y
INDAPAMIDE
Y
ESTRADIOL
Y
GABAPENTIN
Y
IBUPROFEN
Y
CEFUROXIME AXETIL
Y
CARVEDILOL
Y
LOXAPINE SUCCINATE Y
MELOXICAM
Y
SELENIUM SULFIDE
Y
CARBAMAZEPINE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
LOSARTAN POTASSIUM/HYDROC
Y
PROPRANOLOL HCL
Y
AMOXICILLIN
Y
AMITRIPTYLINE HCL
Y
ENALAPRIL MALEATE Y
ACETAMINOPHEN/CODEINE
Y
OXYCODONE/ACETAMINOPHEN
Y
QUETIAPINE FUMARATE Y
NABUMETONE
Y
ECONAZOLE NITRATE Y
LITHIUM CARBONATE Y
MONTELUKAST SODIUM Y
MONTELUKAST SODIUM Y
CYCLOBENZAPRINE HCL Y
AMLODIPINE BESYLATE Y
LORATADINE
Y
AMPICILLIN
Y
GLYBURIDE
Y
DILT-XR
Y
HYDROXYZINE HCL
Y
SUMATRIPTAN SUCCINATE
Y
D3-50
Y
FOSINOPRIL SODIUM Y
PAROXETINE HCL
Y
POTASSIUM CHLORIDE ERY
LOXAPINE
Y
LOVASTATIN
Y
TRIMETHOPRIM TAB 100MG
NORTRIPTYLIN CAP 75MG
AMOX/K CLAV TAB 250MG
NITRO-TIME CAP 2.5MG CR
OXYCOD/APAP TAB 5-325MG
KLOR-CON M10 TAB 10MEQ ER
HYDROXYZ HCL TAB 25MG
PAROXETINE TAB 30MG
DIFLUNISAL TAB 500MG
PHENTERMINE CAP 15MG
METOPROL TAR TAB 25MG
MEDROXYPR AC TAB 5MG
CEPHALEXIN SUS 125/5ML
LOSARTAN/HCT TAB 100-12.5
LOSARTAN/HCT TAB 100-12.5
CHERATUSSIN SOL DAC
PROGESTERONE INJ 50MG/ML
ACYCLOVIR TAB 800MG
CYCLOBENZAPR TAB 5MG
MIRTAZAPINE TAB 15MG
LOSARTAN/HCT TAB 100-25
LOSARTAN/HCT TAB 100-25
CIPROFLOXACN TAB 500MG
CIPROFLOXACN SUS 250MG/5
SOD SUL/SULF EMU 10-5%
LORAZEPAM TAB 2MG
METHYLPRED TAB 4MG
GG/CODEINE SOL 100-10/5
CIPROFLOXACN SOL 0.3% OP
IBUPROFEN TAB 600MG
FINASTERIDE TAB 5MG
FLUOCINONIDE CRE -E 0.05%
LIDO/PRILOCN CRE 2.5-2.5%
INDAPAMIDE TAB 1.25MG
ESTRADIOL TAB 1MG
GABAPENTIN CAP 400MG
IBUPROFEN TAB 400MG
CEFUROXIME TAB 500MG
CARVEDILOL TAB 3.125MG
LOXAPINE CAP 10MG
MELOXICAM TAB 7.5MG
SELENIUM SUL LOT 2.5%
CARBAMAZEPIN TAB 200MG
AMPHETAMINE TAB 30MG
LOSARTAN/HCT TAB 50-12.5
PROPRANOLOL TAB 40MG
AMOXICILLIN TAB 500MG
AMITRIPTYLIN TAB 25MG
ENALAPRIL TAB 20MG
APAP/CODEINE TAB 300-60MG
OXYCOD/APAP TAB 7.5-325
QUETIAPINE TAB 25MG
NABUMETONE TAB 500MG
ECONAZOLE CRE 1%
LITHIUM CARB CAP 150MG
MONTELUKAST CHW 5MG
MONTELUKAST CHW 5MG
CYCLOBENZAPR TAB 10MG
AMLODIPINE TAB 2.5MG
LORATADINE TAB 10MG
AMPICILLIN CAP 250MG
GLYBURIDE TAB 2.5MG
DILT-XR CAP 180MG
HYDROXYZ HCL TAB 50MG
SUMATRIPTAN TAB 25MG
VITAMIN D3 CAP 50000UNT
FOSINOPRIL TAB 20MG
PAROXETINE TAB 20MG
POT CL MICRO TAB 10MEQ ER
LOXAPINE CAP 5MG
LOVASTATIN TAB 10MG
2
4
1
1
8
3
3
3
1
2
9
7
3
1
1
1
1
5
13
11
1
1
22
1
2
3
5
12
12
19
3
1
3
3
8
0
17
1
3
1
9
7
2
1
1
1
7
5
4
3
2
1
2
3
5
1
1
17
3
14
6
5
1
4
3
32
1
4
1
2
4
120
120
21
180
337
208
266
270
60
60
1,170
440
600
90
90
300
20
300
630
435
90
90
364
100
341
310
79
1,426
70
914
270
60
90
270
750
270
1,350
20
540
60
990
840
120
60
90
180
250
420
360
360
65
30
240
120
990
90
90
819
150
840
763
450
90
240
20
270
180
360
180
60
360
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 175
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
49884005401
76439010250
61269021090
64980017001
00527133001
00591354360
11673019402
68382011414
00378628001
00406036605
00172392670
68001023500
29300012501
00603543821
59762491004
68645046954
00536589488
60505265705
00054001021
65862092790
00591086001
68180048709
00093206801
68001021008
65162051210
00172428060
00093104101
59762502901
51672126201
00603385632
00228212710
63304009719
66758016005
00168000680
60505378009
00378014301
42858000201
60505313201
54458099710
31722052010
51672402701
00781181810
16714063201
76439021090
00378623101
16571021030
16714068203
00472127016
00781538892
00781205305
00054028922
13668010510
64980010401
51672406301
00555009696
00378042701
00555092502
45963053830
00781361268
60505377909
51672210208
68180055709
68645044670
00378520905
68462046706
00781604146
00591086205
66758011005
00245005811
00591041401
68382011405
IMIPRAMINE HCL
Y
CEPHALEXIN
Y
FENOFIBRATE
M
HYDROXYZINE PAMOATEY
BACLOFEN
Y
BUPROPION HCL SR
Y
TGT NICOTINE STEP ONE Y
RISPERIDONE
Y
DICLOFENAC SODIUM DRY
HYDROCODONE/ACETAMINOPHEN
Y
DIAZEPAM
Y
POTASSIUM CHLORIDE ERY
MELOXICAM
Y
PROMETHAZINE HCL
Y
SERTRALINE HCL
Y
LISINOPRIL
Y
NICOTINE TRANSDERMALY SYST
TRIAMTERENE/HYDROCHLOROTH
Y
FLECAINIDE ACETATE Y
FINASTERIDE
Y
LISINOPRIL/HYDROCHLOROTHI
Y
PRAVASTATIN SODIUM Y
DOXAZOSIN MESYLATE Y
LISINOPRIL
Y
SALSALATE
Y
VERAPAMIL HCL ER
Y
DICLOFENAC SODIUM ERY
FLUCONAZOLE
Y
DESOXIMETASONE
Y
HYDROCHLOROTHIAZIDEY
CLONIDINE HCL
Y
SUMATRIPTAN SUCCINATE
Y
KLOR-CON 10
Y
TRIAMCINOLONE ACETONIDE
Y
VENLAFAXINE HCL ER Y
INDOMETHACIN
Y
OXYCODONE HCL
Y
QUETIAPINE FUMARATE Y
LISINOPRIL
Y
HYDRALAZINE HCL
Y
WARFARIN SODIUM
Y
FUROSEMIDE
Y
ALENDRONATE SODIUM Y
VIRT-VITE PLUS
Y
CITALOPRAM HYDROBROMIDE
Y
FLUCONAZOLE
Y
SIMVASTATIN
Y
IBUPROFEN
Y
ATORVASTATIN CALCIUMY
TERAZOSIN HCL
Y
MONTELUKAST SODIUM Y
ISOSORBIDE MONONITRATE
Y ER
PHOSPHA 250 NEUTRAL Y
FLUOROURACIL
Y
CLONAZEPAM ODT
Y
SULINDAC
Y
WARFARIN SODIUM
Y
ONDANSETRON HCL
Y
ENOXAPARIN SODIUM Y
VENLAFAXINE HCL ER Y
CETIRIZINE HCL ALLERGY YCH
QUINAPRIL HCL
Y
FINASTERIDE
Y
AMLODIPINE BESYLATE Y
RIZATRIPTAN BENZOATE YODT
AMOXICILLIN
Y
LISINOPRIL/HYDROCHLOROTHI
Y
KLOR-CON 8
Y
KLOR-CON M20
Y
ESTROPIPATE
Y
RISPERIDONE
Y
IMIPRAM HCL TAB 10MG
CEPHALEXIN CAP 500MG
FENOFIBRATE CAP 50MG
HYDROXYZ PAM CAP 50MG
BACLOFEN TAB 10MG
BUPROPION TAB 150MG
TGT NICOTINE DIS 21MG/24H
RISPERIDONE TAB 1MG
DICLOFENAC TAB 50MG DR
HYDROCO/APAP TAB 7.5-325
DIAZEPAM TAB 5MG
POT CL MICRO TAB 20MEQ ER
MELOXICAM TAB 15MG
PROMETHAZINE TAB 25MG
SERTRALINE TAB 100MG
LISINOPRIL TAB 20MG
NICOTINE TD DIS 7MG/24HR
TRIAMT/HCTZ TAB 75-50MG
FLECAINIDE TAB 50MG
FINASTERIDE TAB 1MG
LISINOP/HCTZ TAB 10-12.5
PRAVASTATIN TAB 40MG
DOXAZOSIN TAB 4MG
LISINOPRIL TAB 10MG
SALSALATE TAB 500MG
VERAPAMIL TAB 240MG ER
DICLOFENAC TAB 100MG ER
FLUCONAZOLE SUS 10MG/ML
DESOXIMETAS OIN 0.25%
HYDROCHLOROT TAB 25MG
CLONIDINE TAB 0.1MG
SUMATRIPTAN TAB 25MG
KLOR-CON 10 TAB 10MEQ ER
TRIAMCINOLON OIN 0.1%
VENLAFAXINE CAP 150MG ER
INDOMETHACIN CAP 25MG
OXYCODONE TAB 10MG
QUETIAPINE TAB 50MG
LISINOPRIL TAB 10MG
HYDRALAZINE TAB 25MG
WARFARIN TAB 1MG
FUROSEMIDE TAB 20MG
ALENDRONATE TAB 35MG
VIRT-VITE TAB PLUS
CITALOPRAM TAB 10MG
FLUCONAZOLE TAB 50MG
SIMVASTATIN TAB 10MG
IBUPROFEN SUS 100/5ML
ATORVASTATIN TAB 80MG
TERAZOSIN CAP 5MG
MONTELUKAST CHW 5MG
ISOSORB MONO TAB 60MG ER
PHOSPHA 250 TAB NEUTRAL
FLUOROURACIL SOL 5%
CLONAZEP ODT TAB 0.5MG
SULINDAC TAB 150MG
WARFARIN TAB 3MG
ONDANSETRON TAB 4MG
ENOXAPARIN INJ 120/0.8
VENLAFAXINE CAP 75MG ER
CETIRIZINE SOL 5MG/5ML
QUINAPRIL TAB 10MG
FINASTERIDE TAB 5MG
AMLODIPINE TAB 5MG
RIZATRIPTAN TAB 5MG ODT
AMOXICILLIN SUS 250/5ML
LISINOP/HCTZ TAB 20-25MG
KLOR-CON 8 TAB 8MEQ ER
KLOR-CON M20 TAB 20MEQ ER
ESTROPIPATE TAB 0.75MG
RISPERIDONE TAB 1MG
2
15
1
9
3
1
2
7
3
5
20
3
12
4
3
9
2
6
1
1
9
2
2
9
1
2
4
5
1
31
10
2
2
7
3
7
2
3
21
1
3
14
11
7
5
1
3
9
3
5
1
1
5
1
3
4
10
12
1
3
12
3
3
8
1
16
6
2
2
4
4
240
381
30
691
295
60
42
510
180
220
969
150
585
300
270
900
42
540
60
30
570
120
180
990
60
180
120
175
15
2,460
1,110
18
180
560
150
495
240
104
1,650
540
230
1,293
84
210
420
90
210
1,480
225
450
30
180
282
10
85
360
360
171
1
210
2,445
270
210
660
9
2,750
540
180
194
180
150
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 176
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
16729019801
00378728753
00093024831
00781282410
00378672501
51672131200
76282042210
43386006019
00093317101
68001000501
00781148901
60505316103
00093083310
16714061206
00093206506
00245003530
00603184158
68462055629
00093205755
16714037304
16252060102
68462019005
49884074505
68180087713
68462022517
00832102400
00781144601
00555099702
57664043558
00603766317
60432015016
00067512607
16714007104
00228212910
43386066024
00378157001
65162053750
53489033101
59762232006
00781150610
00591544301
00378023205
00378145401
33342002607
51672127302
17478029111
00555188302
23155010701
55111035260
51672125806
00143995101
00054011625
44523061306
00093083301
29300011416
51672407406
76439020990
43386044024
00781152601
60429031890
00603941858
67877019905
00781104701
43598021352
00093733801
00093736498
59746011306
00781220105
68382003610
00093117201
00591040901
LISINOPRIL
Y
LEVONORGESTREL/ETHINYL
Y ES
CLOTRIMAZOLE
Y
FLUOXETINE HCL
Y
ZONISAMIDE
Y
MUPIROCIN
Y
LISINOPRIL
Y
GAVILYTE-C
Y
CLINDAMYCIN HCL
Y
METHYLPREDNISOLONE DOSE
Y
P
AMITRIPTYLINE HCL
Y
LOSARTAN POTASSIUM Y
CLONAZEPAM
Y
SERTRALINE HCL
Y
CILOSTAZOL
Y
KLOR-CON
Y
VALPROIC ACID
Y
ALYACEN 7/7/7
Y
NIFEDIPINE ER
Y
LAMOTRIGINE
Y
ALENDRONATE SODIUM Y
NAPROXEN
Y
GLIPIZIDE ER
Y
JENCYCLA
Y
MOMETASONE FUROATEY
BACLOFEN
Y
FUROSEMIDE
Y
FLUDROCORTISONE ACETATE
Y
METFORMIN HCL
Y
TRI-PREVIFEM
Y
HYDROXYZINE HCL
Y
NICOTINE
Y
BACLOFEN
Y
CLONIDINE HCL
Y
TRIMETHOBENZAMIDE HCL
Y
TERAZOSIN HCL
Y
BENZONATATE
Y
IMIPRAMINE HCL
Y
DOXAZOSIN MESYLATE Y
ATENOLOL
Y
PREDNISONE
Y
FUROSEMIDE
Y
ESTRADIOL
Y
FAMCICLOVIR
Y
FLUOCINONIDE
Y
CROMOLYN SODIUM
Y
BENZONATATE
Y
HYDROXYZINE HCL
Y
RIVASTIGMINE TARTRATEY
CLOBETASOL PROPIONATE
Y
AMOXICILLIN
Y
ROPINIROLE HCL
Y
SODIUM SULFACETAMIDE
Y WASH
CLONAZEPAM
Y
LAMOTRIGINE
Y
HYDROCORTISONE BUTYRATE
Y
VIRT-VITE
Y
NIFEDIPINE
Y
POTASSIUM CHLORIDE CR
Y
LOSARTAN POTASSIUM Y
RANITIDINE HCL
Y
AMLODIPINE BESYLATE Y
PERPHENAZINE
Y
AMOXICILLIN/CLAVULANATE
Y P
TAMSULOSIN HCL
Y
LOSARTAN POTASSIUM Y
PROCHLORPERAZINE MALEATE
Y
TEMAZEPAM
Y
VENLAFAXINE HCL ER Y
PENICILLIN V POTASSIUMY
LISINOPRIL
Y
LISINOPRIL TAB 30MG
LEVONOR/ETHI TAB 0.1-0.02
CLOTRIMAZOLE SOL 1%
FLUOXETINE CAP 40MG
ZONISAMIDE CAP 25MG
MUPIROCIN OIN 2%
LISINOPRIL TAB 40MG
GAVILYTE-C SOL
CLINDAMYCIN CAP 150MG
METHYLPRED PAK 4MG
AMITRIPTYLIN TAB 75MG
LOSARTAN POT TAB 50MG
CLONAZEPAM TAB 1MG
SERTRALINE TAB 50MG
CILOSTAZOL TAB 50MG
KLOR-CON POW 20MEQ
VALPROIC ACD SYP 250/5ML
ALYACEN TAB 7/7/7
NIFEDIPINE TAB 30MG ER
LAMOTRIGINE TAB 150MG
ALENDRONATE TAB 70MG
NAPROXEN TAB 500MG
GLIPIZIDE ER TAB 5MG
JENCYCLA TAB 0.35MG
MOMETASONE OIN 0.1%
BACLOFEN TAB 10MG
FUROSEMIDE TAB 80MG
FLUDROCORT TAB 0.1MG
METFORMIN TAB 850MG
TRI-PREVIFEM TAB
HYDROXYZ HCL SYP 10MG/5ML
NICOTINE DIS 21MG/24H
BACLOFEN TAB 10MG
CLONIDINE TAB 0.3MG
TRIMETHOBENZ CAP 300MG
TERAZOSIN CAP 10MG
BENZONATATE CAP 200MG
IMIPRAM HCL TAB 25MG
DOXAZOSIN TAB 2MG
ATENOLOL TAB 50MG
PREDNISONE TAB 20MG
FUROSEMIDE TAB 80MG
ESTRADIOL TAB 1MG
FAMCICLOVIR TAB 500MG
FLUOCINONIDE SOL 0.05%
CROMOLYN SOD SOL 4% OP
BENZONATATE CAP 200MG
HYDROXYZ HCL TAB 50MG
RIVASTIGMINE CAP 1.5MG
CLOBETASOL CRE 0.05%
AMOXICILLIN TAB 875MG
ROPINIROLE TAB 0.25MG
SODIUM SULFA LIQ 10% WASH
CLONAZEPAM TAB 1MG
LAMOTRIGINE TAB 200MG
HC BUTYRATE CRE 0.1%
VIRT-VITE TAB
NIFEDIPINE CAP 10MG
POT CHLORIDE TAB 10MEQ CR
LOSARTAN POT TAB 100MG
RANITIDINE SYP 15MG/ML
AMLODIPINE TAB 10MG
PERPHENAZINE TAB 4MG
AMOX/K CLAV SUS 200/5ML
TAMSULOSIN CAP 0.4MG
LOSARTAN POT TAB 25MG
PROCHLORPER TAB 5MG
TEMAZEPAM CAP 15MG
VENLAFAXINE CAP 150MG ER
PENICILLN VK TAB 250MG
LISINOPRIL TAB 40MG
1
1
5
5
2
5
4
6
6
3
1
4
16
2
2
2
1
1
2
4
6
7
4
2
3
3
6
3
7
1
6
2
6
1
1
5
4
1
2
12
21
3
6
2
2
9
5
4
1
2
10
1
1
17
3
1
3
2
3
4
8
6
2
4
2
2
2
16
1
6
1
90
84
150
450
360
132
360
24,000
207
63
90
240
1,230
225
120
44
1,200
84
60
180
64
390
240
168
60
284
1,140
120
1,530
84
1,120
56
300
270
60
450
326
180
120
1,440
301
1,080
630
42
40
90
136
210
30
90
196
60
177
990
255
45
150
80
148
360
806
480
60
400
60
180
90
540
180
178
180
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
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-
p. 177
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00168006015
00591247260
43598021085
00781205101
43547026910
45802096272
00603321421
00591042401
45963057008
00363057139
00781107901
00093585001
62756070713
45802036102
50111064701
00406833062
68180050101
65862069705
67253090250
53746051110
00378105301
00781214501
00591080101
16714052205
00574200316
31722022801
68180065208
43478024415
00185500001
00143985375
68382006705
55111016901
00185004710
49884030802
00591320201
62175011837
00093736656
65162005403
00603544821
24208050510
00603137858
50111078855
68382019816
00603240621
00093026230
68308015230
64376064905
00378963943
13668001005
00168013460
68001021600
00603421432
00378615501
24208041110
00378362777
00781140705
54458099909
67253014050
42291072418
00603421402
00378027105
67253090010
49884072501
00713063815
51672207308
50111046801
65162055410
00832003850
00781543820
65862000805
42291060718
FLUOCINOLONE ACETONIDE
Y
TAMOXIFEN CITRATE
Y
SSD
Y
TERAZOSIN HCL
Y
ROPINIROLE HCL
Y
ERY
Y
DIAZEPAM
Y
TRIAMTERENE/HYDROCHLOROTH
Y
PANTOPRAZOLE SODIUMY
WAL-FEX ALLERGY
Y
ALPRAZOLAM
Y
ESCITALOPRAM OXALATEY
TOPIRAMATE
Y
TRETINOIN
Y
FLUOXETINE HCL
Y
MORPHINE SULFATE ER Y
MELOXICAM
Y
VENLAFAXINE HCL ER Y
ALPRAZOLAM
Y
SPIRONOLACTONE
Y
ENALAPRIL MALEATE Y
AMPICILLIN
Y
HYDROXYZINE PAMOATEY
FINASTERIDE
Y
SODIUM POLYSTYRENE SULFON
Y
ZONISAMIDE
Y
DOXYCYCLINE MONOHYDRATE
Y
TRETINOIN
Y
PHENTERMINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
SIMVASTATIN
Y
QUETIAPINE FUMARATE Y
FOSINOPRIL SODIUM Y
CLONAZEPAM ODT
Y
HYDROCODONE/ACETAMINOPHEN
Y
OMEPRAZOLE
Y
LOSARTAN POTASSIUM Y
CITALOPRAM HYDROBROMIDE
Y
PROPAFENONE HCL
Y
LEVOBUNOLOL HCL
Y
LACTULOSE
Y
AZITHROMYCIN
Y
PRAMIPEXOLE DIHYDROCHLORI
Y
BACLOFEN
Y
FLUOCINONIDE
Y
NYSTATIN
Y
HYDROCODONE BITARTRATE/AC
Y
BUTORPHANOL TARTRATE
Y
CITALOPRAM HYDROBROMIDE
Y
FLUOCINONIDE
Y
TRIAMTERENE/HYDROCHLOROTH
Y
LISINOPRIL
Y
DIGITEK
Y
BRIMONIDINE TARTRATEY
CLOPIDOGREL
Y
HYDROXYCHLOROQUINEYSULFAT
LISINOPRIL
Y
AMOXICILLIN
Y
RANITIDINE HCL
Y
LISINOPRIL
Y
DIAZEPAM
Y
ALPRAZOLAM
Y
BUSPIRONE HCL
Y
CICLOPIROX OLAMINE Y
CHILDRENS LORATADINEY
PROPRANOLOL HCL
Y
DEMECLOCYCLINE HCL Y
OXYBUTYNIN CHLORIDE Y
CEFPODOXIME PROXETILY
METFORMIN HCL
Y
METFORMIN HCL
Y
FLUOCIN ACET CRE 0.025%
TAMOXIFEN TAB 10MG
SSD
CRE 1%
TERAZOSIN CAP 1MG
ROPINIROLE TAB 0.5MG
ERY
PAD 2%
DIAZEPAM TAB 5MG
TRIAMT/HCTZ TAB 37.5-25
PANTOPRAZOLE TAB 40MG
WAL-FEX ALLR TAB 180MG
ALPRAZOLAM TAB 1MG
ESCITALOPRAM TAB 5MG
TOPIRAMATE TAB 25MG
TRETINOIN CRE 0.05%
FLUOXETINE CAP 10MG
MORPHINE SUL TAB 30MG ER
MELOXICAM TAB 7.5MG
VENLAFAXINE CAP 150MG ER
ALPRAZOLAM TAB 1MG
SPIRONOLACT TAB 25MG
ENALAPRIL TAB 10MG
AMPICILLIN CAP 500MG
HYDROXYZ PAM CAP 50MG
FINASTERIDE TAB 5MG
SOD POLY SUL SUS 15GM/60
ZONISAMIDE CAP 100MG
DOXYCYC MONO CAP 100MG
TRETINOIN GEL 0.025%
PHENTERMINE CAP 30MG
AMOX/K CLAV SUS 600/5ML
SIMVASTATIN TAB 20MG
QUETIAPINE TAB 50MG
FOSINOPRIL TAB 40MG
CLONAZEP ODT TAB 0.5MG
HYDROCO/APAP TAB 5-325MG
OMEPRAZOLE CAP 20MG
LOSARTAN POT TAB 100MG
CITALOPRAM TAB 40MG
PROPAFENONE TAB 150MG
LEVOBUNOLOL SOL 0.5% OP
LACTULOSE SOL 10GM/15
AZITHROMYCIN TAB 500MG
PRAMIPEXOLE TAB 0.5MG
BACLOFEN TAB 10MG
FLUOCINONIDE CRE 0.05%
NYSTATIN POW 100000
HYDROCO/APAP TAB 7.5-300
BUTORPHANOL SOL 10MG/ML
CITALOPRAM TAB 20MG
FLUOCINONIDE SOL 0.05%
TRIAMT/HCTZ TAB 37.5-25
LISINOPRIL TAB 40MG
DIGITEK TAB 0.125MG
BRIMONIDINE SOL 0.2% OP
CLOPIDOGREL TAB 75MG
HYDROXYCHLOR TAB 200MG
LISINOPRIL TAB 2.5MG
AMOXICILLIN CAP 250MG
RANITIDINE TAB 150MG
LISINOPRIL TAB 40MG
DIAZEPAM TAB 2MG
ALPRAZOLAM TAB 0.25MG
BUSPIRONE TAB 7.5MG
CICLOPIROX CRE 0.77%
LORATADINE SYP 5MG/5ML
PROPRANOLOL TAB 20MG
DEMECLOCYCL TAB 150MG
OXYBUTYNIN TAB 5MG
CEFPODOXIME TAB 100MG
METFORMIN TAB 500MG
METFORMIN TAB 1000MG
2
4
5
5
5
1
28
2
3
4
17
2
6
2
9
1
14
2
19
5
2
9
15
2
2
3
3
1
2
2
6
1
1
5
8
3
1
12
1
2
5
9
1
8
3
2
2
2
12
1
2
3
2
2
2
1
11
18
4
4
42
13
1
4
8
7
1
3
1
3
6
45
240
425
570
390
60
1,001
180
210
120
1,253
60
780
40
540
60
720
180
1,105
450
180
372
767
180
540
150
140
15
60
275
420
15
180
84
294
210
90
960
270
20
1,973
26
30
366
90
60
36
5
960
60
180
270
120
40
120
180
930
500
720
360
1,875
1,170
60
90
1,170
1,050
120
150
14
810
1,080
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
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$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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$
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$
$
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-
p. 178
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00054017613
00054474225
00378700501
50111064703
00591557101
57664012688
68462035305
00093010910
00093293101
43547033310
62756018418
68084029301
68682036990
69235031050
00591321901
63304058010
00591048801
53746046601
00093720756
48102000335
60793085001
62175018046
00185072060
00603421221
00781107710
00832121800
53489047905
00378797052
00781107701
31722053405
00574018101
00093015506
00781149631
59746024805
61748020160
16714004211
51991083810
68180035109
60793085101
68462029017
00093721906
00603646821
62756071213
43547025450
51293062601
00168005546
00781225801
00245018111
65862069960
00781523492
57664050318
00603516621
00054417925
00378253710
47335060313
00093413664
00378623201
45802097426
60505255101
33342002332
00781150701
45963053930
68462024901
29300012701
00363001339
11673091555
00409488810
13107005999
00093725401
68180012301
31722022305
BUPRENORPHINE HCL Y
PREDNISONE
Y
LOXAPINE SUCCINATE Y
FLUOXETINE HCL
Y
TRIMETHOPRIM
Y
HYDROCODONE/ACETAMINOPHEN
Y
HYDROXYZINE HCL
Y
CARBAMAZEPINE
Y
METHYLDOPA
Y
GABAPENTIN
Y
OXCARBAZEPINE
Y
PHENAZOPYRIDINE HCL Y
DILTIAZEM HCL ER
Y
DOXYCYCLINE HYCLATE Y
BUTALBITAL/ASPIRIN/CAFFEI
Y
METOPROLOL TARTRATEY
ESTRADIOL
Y
IBUPROFEN
Y
MIRTAZAPINE
Y
NEOMYCIN/POLYMYXIN/DEXAME
Y
LEVOXYL
Y
PANTOPRAZOLE SODIUMY
INDOMETHACIN ER
Y
LISINOPRIL
Y
ALPRAZOLAM
Y
JANTOVEN
Y
SULINDAC
Y
IPRATROPIUM BROMIDEY
ALPRAZOLAM
Y
METHOCARBAMOL
Y
POTASSIUM CHLORIDE ERY
TOPIRAMATE
Y
AZITHROMYCIN
Y
LAMOTRIGINE
Y
CLINDAMYCIN PHOSPHATE
Y
ALLOPURINOL
Y
CYPROHEPTADINE HCL Y
SERTRALINE HCL
Y
LEVOXYL
Y
AUGMENTED BETAMETHASONE
Y
D
TOPIRAMATE
Y
ZOLPIDEM TARTRATE Y
TOPIRAMATE
Y
CARVEDILOL
Y
PHENOBARBITAL
Y
BETAMETHASONE DIPROPIONAT
Y
DICLOXACILLIN SODIUM Y
DIVALPROEX SODIUM DRY
CEFUROXIME AXETIL
Y
PRAVASTATIN SODIUM Y
TIZANIDINE HCL
Y
PHENOBARBITAL
Y
DEXAMETHASONE
Y
TRIAMTERENE/HYDROCHLOROTH
Y
ALPRAZOLAM
Y
CEFDINIR
Y
CITALOPRAM HYDROBROMIDE
Y
CETIRIZINE HCL CHILDRENS
Y
GABAPENTIN
Y
LEVOFLOXACIN
Y
ATENOLOL
Y
ONDANSETRON HCL
Y
RANITIDINE HCL
Y
BISOPROLOL FUMARATEY
WAL-ITIN D
Y
TGT OMEPRAZOLE
M
SODIUM CHLORIDE
Y
ACETAMINOPHEN/CODEINE
Y PHO
GLIMEPIRIDE
Y
CEPHALEXIN
Y
GABAPENTIN
Y
BUPRENORPHIN SUB 2MG
PREDNISONE TAB 2.5MG
LOXAPINE CAP 5MG
FLUOXETINE CAP 10MG
TRIMETHOPRIM TAB 100MG
HYDROCO/APAP TAB 5-325MG
HYDROXYZ HCL TAB 25MG
CARBAMAZEPIN TAB 200MG
METHYLDOPA TAB 250MG
GABAPENTIN TAB 800MG
OXCARBAZEPIN TAB 300MG
PHENAZOPYRID TAB 200MG
DILTIAZEM CAP 240MG/24
DOXYCYCL HYC CAP 100MG
BUT/ASA/CAFF CAP
METOPROL TAR TAB 50MG
ESTRADIOL TAB 2MG
IBUPROFEN TAB 800MG
MIRTAZAPINE TAB 30MG
NEO/POLY/DEX OIN 0.1% OP
LEVOXYL TAB 25MCG
PANTOPRAZOLE TAB 20MG
INDOMETHACIN CAP 75MG ER
LISINOPRIL TAB 20MG
ALPRAZOLAM TAB 0.5MG
JANTOVEN TAB 7.5MG
SULINDAC TAB 200MG
IPRATROPIUM SOL 0.02%INH
ALPRAZOLAM TAB 0.5MG
METHOCARBAM TAB 750MG
POT CHLORIDE CAP 10MEQ ER
TOPIRAMATE TAB 25MG
AZITHROMYCIN TAB 250MG
LAMOTRIGINE TAB 200MG
CLINDAMYCIN PAD 1%
ALLOPURINOL TAB 300MG
CYPROHEPTAD TAB 4MG
SERTRALINE TAB 25MG
LEVOXYL TAB 50MCG
AUG BETAMET CRE 0.05%
TOPIRAMATE TAB 100MG
ZOLPIDEM TAB 5MG
TOPIRAMATE TAB 200MG
CARVEDILOL TAB 3.125MG
PHENOBARB TAB 32.4MG
BETAMETH DIP CRE 0.05%
DICLOXACILL CAP 500MG
DIVALPROEX TAB 250MG DR
CEFUROXIME TAB 250MG
PRAVASTATIN TAB 40MG
TIZANIDINE TAB 4MG
PHENOBARB TAB 32.4MG
DEXAMETHASON TAB 0.5MG
TRIAMT/HCTZ CAP 37.5-25
ALPRAZOLAM TAB 0.25MG
CEFDINIR SUS 125/5ML
CITALOPRAM TAB 20MG
CETIRIZINE SYP 1MG/ML
GABAPENTIN TAB 600MG
LEVOFLOXACIN TAB 750MG
ATENOLOL TAB 100MG
ONDANSETRON TAB 8MG
RANITIDINE TAB 300MG
BISOPROL FUM TAB 10MG
WAL-ITIN D TAB 5-120MG
OMEPRAZOLE TAB 20MG
SOD CHLORIDE INJ 0.9%
APAP/CODEINE TAB 300-30MG
GLIMEPIRIDE TAB 1MG
CEPHALEXIN SUS 125/5ML
GABAPENTIN CAP 400MG
3
4
1
3
1
10
8
1
4
1
1
2
1
1
1
6
11
9
2
4
2
4
1
16
20
9
2
2
10
9
1
6
8
7
2
4
1
9
5
4
2
14
3
3
4
1
2
2
1
1
3
4
12
3
24
2
13
7
1
3
8
9
2
2
1
2
5
17
8
2
4
28
600
60
570
90
255
510
60
600
90
270
36
90
20
56
960
570
447
270
14
180
120
30
1,304
1,590
285
240
212
731
231
90
450
44
210
120
360
90
460
150
120
180
640
270
540
240
45
80
540
20
90
270
240
578
150
792
120
750
1,080
120
24
720
129
180
180
60
168
930
440
900
400
473
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 179
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
54505033210
42808010006
00378395205
00603421232
00591554301
00093075305
12843053637
61442017230
60432006575
00093215801
31722052110
59746012106
00185435001
61314001805
00093719856
00093417573
00168003346
00472016615
23155010605
69097015815
00603543832
62756036888
31722028310
00228212850
16714061304
43547025550
00093314701
45802001405
50383058716
23155011801
51079075963
00054354258
43547024850
00781261460
55111039905
13668011710
24658030310
60801000006
59746017206
68382009201
00555083102
00054252731
23155005101
51672408103
60505316108
00093213101
00093571201
00527133825
50111043402
59746038410
11917013940
60505009400
53489033201
45802011846
50383002105
51672127506
51672128902
65862019201
45802096696
50111046903
00378104401
49884005501
53746054205
00904563340
16714029403
23155012201
64980017005
59746038610
13107015430
00781148710
00054429731
HYDROCORTISONE
Y
SODIUM SULFACETAMIDE
Y WASH
ATORVASTATIN CALCIUMY
LISINOPRIL
Y
ALLOPURINOL
Y
ATENOLOL
Y
BAYER LOW DOSE
Y
CEFACLOR
Y
AMOXICILLIN/CLAVULANATE
Y P
TRIMETHOPRIM
Y
HYDRALAZINE HCL
Y
MECLIZINE HCL
Y
ISONIAZID
Y
KETOROLAC TROMETHAMINE
Y
FLUOXETINE HCL
Y
CEPHALEXIN
Y
BETAMETHASONE VALERATE
Y
NYSTATIN
Y
HYDROXYZINE HCL
Y
MELOXICAM
Y
PROMETHAZINE HCL
Y
METOPROLOL/HYDROCHLOROTHI
Y
CYCLOBENZAPRINE HCL Y
CLONIDINE HCL
Y
SERTRALINE HCL
Y
CARVEDILOL
Y
CEPHALEXIN
Y
HYDROCORTISONE
Y
NYSTATIN
Y
CALCITRIOL
Y
ATENOLOL
Y
MEGESTROL ACETATE Y
METFORMIN HCL
Y
RIVASTIGMINE TARTRATEY
LANSOPRAZOLE
Y
LOSARTAN POTASSIUM/HYDROC
Y
SIMVASTATIN
Y
D3
Y
PREDNISONE
Y
CARVEDILOL
Y
WARFARIN SODIUM
Y
LITHIUM CARBONATE Y
NYSTATIN
Y
CLINDAMYCIN PHOSPHATE
Y
LOSARTAN POTASSIUM Y
NITROFURANTOIN MACROCRYST
Y
GLYBURIDE/METFORMINYHCL
DOXYCYCLINE MONOHYDRATE
Y
TRAZODONE HCL
Y
TERAZOSIN HCL
Y
D3
Y
DOXAZOSIN MESYLATE Y
IMIPRAMINE HCL
Y
MOMETASONE FUROATEY
TIMOLOL MALEATE
Y
CLOTRIMAZOLE
Y
NYSTATIN
Y
FLUOXETINE HCL
Y
ERYTHROMYCIN
Y
PROPRANOLOL HCL
Y
DIVALPROEX SODIUM DRY
IMIPRAMINE HCL
Y
POTASSIUM CHLORIDE ERY
GABAPENTIN
Y
AMOXICILLIN/CLAVULANATE
Y P
ROPINIROLE HCL
Y
HYDROXYZINE PAMOATEY
TERAZOSIN HCL
Y
PAROXETINE HCL
Y
AMITRIPTYLINE HCL
Y
FUROSEMIDE
Y
HYDROCORT TAB 10MG
SODIUM SULFA LIQ 10% WASH
ATORVASTATIN TAB 40MG
LISINOPRIL TAB 20MG
ALLOPURINOL TAB 100MG
ATENOLOL TAB 100MG
BAYER LOW TAB 81MG EC
CEFACLOR CAP 500MG
AMOX/K CLAV SUS 250/5ML
TRIMETHOPRIM TAB 100MG
HYDRALAZINE TAB 50MG
MECLIZINE TAB 25MG
ISONIAZID TAB 300MG
KETOROLAC SOL 0.4%
FLUOXETINE CAP 40MG
CEPHALEXIN SUS 125/5ML
BETAMETH VAL OIN 0.1%
NYSTATIN OIN 100000
HYDROXYZ HCL TAB 25MG
MELOXICAM TAB 7.5MG
PROMETHAZINE TAB 25MG
METOPRL/HCTZ TAB 100-25MG
CYCLOBENZAPR TAB 10MG
CLONIDINE TAB 0.2MG
SERTRALINE TAB 100MG
CARVEDILOL TAB 6.25MG
CEPHALEXIN CAP 500MG
HYDROCORT OIN 2.5%
NYSTATIN SUS 100000
CALCITRIOL CAP 0.25MCG
ATENOLOL TAB 25MG
MEGESTROL AC SUS 40MG/ML
METFORMIN TAB 500MG
RIVASTIGMINE CAP 1.5MG
LANSOPRAZOLE CAP 30MG DR
LOSARTAN/HCT TAB 100-12.5
SIMVASTATIN TAB 40MG
VITAMIN D3 CAP 50000UNT
PREDNISONE TAB 5MG
CARVEDILOL TAB 3.125MG
WARFARIN TAB 1MG
LITHIUM CARB CAP 300MG
NYSTATIN TAB 500000
CLINDAMYCIN SOL 1%
LOSARTAN POT TAB 50MG
NITROFUR MAC CAP 100MG
GLYB/METFORM TAB 5-500MG
DOXYCYC MONO TAB 100MG
TRAZODONE TAB 100MG
TERAZOSIN CAP 2MG
D3
CAP 1000UNIT
DOXAZOSIN TAB 2MG
IMIPRAM HCL TAB 50MG
MOMETASONE SOL 0.1%
TIMOLOL MAL SOL 0.5% OP
CLOTRIMAZOLE CRE 1%
NYSTATIN CRE 100000
FLUOXETINE CAP 10MG
ERYTHROMYCIN GEL 2%
PROPRANOLOL TAB 40MG
DIVALPROEX TAB 250MG DR
IMIPRAM HCL TAB 25MG
POT CHLORIDE CAP 10MEQ ER
GABAPENTIN CAP 400MG
AMOX/K CLAV SUS 600/5ML
ROPINIROLE TAB 0.5MG
HYDROXYZ PAM CAP 50MG
TERAZOSIN CAP 10MG
PAROXETINE TAB 10MG
AMITRIPTYLIN TAB 25MG
FUROSEMIDE TAB 20MG
2
1
2
6
5
7
8
1
1
4
2
6
4
1
5
3
2
3
4
11
6
1
11
7
2
7
7
1
2
1
11
1
6
1
1
3
4
4
3
7
7
10
2
1
1
3
1
2
10
5
7
1
4
2
5
3
3
7
1
1
2
2
2
2
1
3
11
3
5
3
17
120
177
135
540
540
630
720
30
75
105
150
165
240
5
390
400
90
75
480
810
204
30
550
1,020
165
780
210
454
290
90
750
600
720
30
14
270
240
32
270
660
420
780
60
60
90
34
120
44
720
450
690
90
255
120
65
225
150
420
60
180
540
120
60
180
200
210
301
540
270
210
1,396
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 180
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00185010210
45963063401
65862019305
00185014405
00591086101
29300014005
60505313001
24658031201
60429036990
68382009805
11917014767
59762372801
16714062201
00781148601
17478028810
00487990425
65862005090
00054808425
65162053610
24208055555
59762491001
51672407008
00603499028
45963055511
31722028201
67405067150
74312017621
53489014301
68382003606
00378004877
62037077760
54879000460
54458091002
54458099110
68382009405
64980030230
10702002501
00093716933
24208073506
00603533821
65862014205
49884005601
00781570231
00093031901
61314065610
60758018805
63304069205
51991018831
62756025083
16714008111
23155019401
16714002112
00378116580
00168009915
61442011201
00093527601
00172375760
16729006712
16729019401
00093053705
00076090201
43478090088
00527135010
00378967193
54458088910
00536840080
68001024804
00378700210
23155024701
00603396821
65862002901
LISINOPRIL
Y
LOVASTATIN
Y
FLUOXETINE HCL
Y
AMIODARONE HCL
Y
LISINOPRIL/HYDROCHLOROTHI
Y
DIVALPROEX SODIUM DRY
QUETIAPINE FUMARATE Y
DOXYCYCLINE HYCLATE Y
PRAVASTATIN SODIUM Y
PAROXETINE HCL
Y
VITAMIN D3
Y
CLINDAMYCIN PHOSPHATE
Y
ZOLPIDEM TARTRATE Y
AMITRIPTYLINE HCL
Y
TIMOLOL MALEATE
Y
ALBUTEROL SULFATE Y
SIMVASTATIN
Y
AZATHIOPRINE
Y
BENZONATATE
Y
BACITRACIN/POLYMYXINYB
SERTRALINE HCL
Y
CETIRIZINE HCL
Y
OXYCODONE HCL
Y
GABAPENTIN
Y
CYCLOBENZAPRINE HCL Y
HYDROXYZINE HCL
Y
D3
Y
SPIRONOLACTONE
Y
VENLAFAXINE HCL ER Y
PIOGLITAZONE HCL
Y
CLARITHROMYCIN ER Y
BETAMETHASONE VALERATE
Y
LISINOPRIL/HYDROCHLOROTHI
Y
LISINOPRIL/HYDROCHLOROTHI
Y
CARVEDILOL
Y
PROCTO-PAK
Y
PHENTERMINE HCL
Y
AZITHROMYCIN
Y
CYCLOPENTOLATE HCL Y
PREDNISONE
Y
CARVEDILOL
Y
IMIPRAMINE HCL
Y
LOSARTAN POTASSIUM Y
DILTIAZEM HCL
Y
CIPROFLOXACIN HCL
Y
GENTAMICIN SULFATE Y
CLINDAMYCIN HCL
Y
METHYLPREDNISOLONE DOSE
Y
P
ANASTROZOLE
Y
HYDROXYZINE HCL
Y
NIFEDIPINE
Y
PROPRANOLOL HCL
Y
BUSPIRONE HCL
Y
KETOCONAZOLE
Y
ACYCLOVIR
Y
DEXMETHYLPHENIDATE HCL
Y
LISINOPRIL
Y
LEVETIRACETAM
Y
LISINOPRIL
Y
NAPROXEN SODIUM
Y
PHOSPHASAL
Y
PROPRANOLOL HCL ER Y
LEVOTHYROXINE SODIUM
Y
IPRATROPIUM BROMIDE/ALBUT
Y
CITALOPRAM HYDROBROMIDE
Y
VITAMIN D3
Y
MONTELUKAST SODIUM Y
PAROXETINE HCL
Y
VENLAFAXINE HCL
Y
HYDROXYZINE HCL
Y
GLYBURIDE
Y
LISINOPRIL TAB 20MG
LOVASTATIN TAB 20MG
FLUOXETINE CAP 20MG
AMIODARONE TAB 200MG
LISINOP/HCTZ TAB 20-12.5
DIVALPROEX TAB 500MG DR
QUETIAPINE TAB 25MG
DOXYCYCL HYC TAB 100MG
PRAVASTATIN TAB 40MG
PAROXETINE TAB 20MG
VITAMIN D3 CAP 5000UNIT
CLINDAMYCIN SOL 1%
ZOLPIDEM TAB 10MG
AMITRIPTYLIN TAB 10MG
TIMOLOL MAL SOL 0.5% OP
ALBUTEROL NEB 1.25MG/3
SIMVASTATIN TAB 5MG
AZATHIOPRINE TAB 50MG
BENZONATATE CAP 100MG
BACIT/POLYMY OIN OP
SERTRALINE TAB 100MG
CETIRIZINE SYP 1MG/ML
OXYCODONE TAB 5MG
GABAPENTIN CAP 100MG
CYCLOBENZAPR TAB 5MG
HYDROXYZ HCL TAB 25MG
D3
CAP 2000UNIT
SPIRONOLACT TAB 25MG
VENLAFAXINE CAP 150MG ER
PIOGLITAZONE TAB 15MG
CLARITHROMYC TAB 500MG ER
BETAMETH VAL LOT 0.1%
LISINOP/HCTZ TAB 20-25MG
LISINOP/HCTZ TAB 20-25MG
CARVEDILOL TAB 12.5MG
PROCTO-PAK CRE 1%
PHENTERMINE TAB 37.5MG
AZITHROMYCIN TAB 500MG
CYCLOPENTOL SOL 1% OP
PREDNISONE TAB 10MG
CARVEDILOL TAB 3.125MG
IMIPRAM HCL TAB 50MG
LOSARTAN POT TAB 100MG
DILTIAZEM TAB 60MG
CIPROFLOXACN SOL 0.3% OP
GENTAMICIN SOL 0.3% OP
CLINDAMYCIN CAP 150MG
METHYLPRED PAK 4MG
ANASTROZOLE TAB 1MG
HYDROXYZ HCL TAB 10MG
NIFEDIPINE CAP 10MG
PROPRANOLOL TAB 10MG
BUSPIRONE TAB 15MG
KETOCONAZOLE CRE 2%
ACYCLOVIR TAB 400MG
DEXMETHYLPH TAB 5MG
LISINOPRIL TAB 2.5MG
LEVETIRACETA TAB 1000MG
LISINOPRIL TAB 2.5MG
NAPROXEN SOD TAB 550MG
PHOSPHASAL TAB
PROPRANOLOL CAP 60MG ER
LEVOTHYROXIN TAB 175MCG
IPRATROPIUM/ SOL ALBUTER
CITALOPRAM TAB 40MG
VITAMIN D3 DRO 400UNIT
MONTELUKAST TAB 10MG
PAROXETINE TAB 20MG
VENLAFAXINE TAB 37.5MG
HYDROXYZ HCL TAB 25MG
GLYBURIDE TAB 2.5MG
15
6
1
3
3
1
4
1
1
2
13
1
24
3
8
2
1
1
8
4
3
10
4
5
10
4
12
5
2
1
1
1
2
7
1
1
7
3
2
13
4
1
1
3
4
12
7
2
1
2
1
3
2
3
2
2
3
1
11
11
1
1
1
1
8
4
1
4
2
2
5
1,290
300
30
270
450
270
390
20
90
180
450
60
720
420
65
150
30
60
225
14
150
1,890
210
570
345
420
780
420
120
30
14
60
360
390
270
28
195
11
30
363
360
180
90
450
40
65
210
42
90
140
60
540
360
60
51
60
270
60
750
447
40
30
90
270
540
450
90
285
120
290
300
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 181
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
68645013154
00378700193
47335060513
68180012302
57664024788
00603533828
59762502101
00713066815
00093416176
00363091503
68645014059
00603616032
00378181710
68308014501
00591084515
00603424732
31722020601
00185010110
00378077101
43598016430
11917014679
00555060702
50190014123
33342007510
52343007112
00603149158
57664024518
00245018215
16714069803
45802012464
00378402101
29300011201
16714066201
43547025010
00093611816
76439012310
65862001901
68382009716
51672129701
60505530701
54458096410
51672413204
68382002201
65162018950
57664014634
60505014101
29300013201
43547033810
45802023701
00603002622
16729015615
00093014905
62175012937
00143992701
42291066790
00555060602
00054011725
00904634540
60505378003
60429032410
45802049383
53746018801
00378615601
00378075101
00603107556
68382005801
68382009706
00143973810
68645045090
67877021905
51991083801
FLUOXETINE HCL
Y
PAROXETINE HCL
Y
ALPRAZOLAM
Y
CEPHALEXIN
Y
CARVEDILOL
Y
PREDNISONE
Y
QUINAPRIL HCL
Y
HYDROCORTISONE VALERATE
Y
AMOXICILLIN
Y
OMEPRAZOLE
M
FAMOTIDINE
Y
TRAZODONE HCL
Y
LEVOTHYROXINE SODIUM
Y
OXYCODONE HCL
Y
GLIPIZIDE ER
Y
LORAZEPAM
Y
CITALOPRAM HYDROBROMIDE
Y
LISINOPRIL
Y
CYCLOBENZAPRINE HCL Y
OLANZAPINE
Y
VITAMIN D3
Y
MEGESTROL ACETATE Y
SODIUM CHLORIDE
Y
VALSARTAN/HYDROCHLOROTHIA
Y
LEVETIRACETAM
Y
OXYBUTYNIN CHLORIDE Y
CARVEDILOL
Y
DIVALPROEX SODIUM DRY
VALACYCLOVIR HCL
Y
HYDROCORTISONE ACETATE/PR
Y
DOXAZOSIN MESYLATE Y
LAMOTRIGINE
Y
GABAPENTIN
Y
METFORMIN HCL
Y
PREDNISOLONE
Y
GLIMEPIRIDE
Y
CEPHALEXIN
Y
PAROXETINE HCL
Y
CLOBETASOL PROPIONATE
Y E
ACYCLOVIR
Y
MELOXICAM
Y
LAMOTRIGINE
Y
ATENOLOL
Y
NAPROXEN
Y
PROMETHAZINE HCL
Y
GLIPIZIDE
Y
ZALEPLON
Y
BENAZEPRIL HCL
Y
SALICYLIC ACID
Y
ASPIRIN EC LOW DOSE Y
SIMVASTATIN
Y
NAPROXEN
Y
ISOSORBIDE MONONITRATE
Y ER
CIPROFLOXACIN HCL
Y
PRAVASTATIN SODIUM Y
MEGESTROL ACETATE Y
ROPINIROLE HCL
Y
METFORMIN HCL
Y
VENLAFAXINE HCL ER Y
ATORVASTATIN CALCIUMY
AMMONIUM LACTATE Y
NAPROXEN
Y
DIGITEK
Y
CYCLOBENZAPRINE HCL Y
CHERATUSSIN AC
Y
WARFARIN SODIUM
Y
PAROXETINE HCL
Y
PREDNISONE
Y
CYCLOBENZAPRINE HCL Y
CEPHALEXIN
Y
CYPROHEPTADINE HCL Y
FLUOXETINE CAP 10MG
PAROXETINE TAB 10MG
ALPRAZOLAM TAB 1MG
CEPHALEXIN SUS 125/5ML
CARVEDILOL TAB 25MG
PREDNISONE TAB 10MG
QUINAPRIL TAB 20MG
HC VALERATE CRE 0.2%
AMOXICILLIN SUS 400/5ML
OMEPRAZOLE TAB 20MG
FAMOTIDINE TAB 20MG
TRAZODONE TAB 50MG
LEVOTHYROXIN TAB 175MCG
OXYCODONE CAP 5MG
GLIPIZIDE ER TAB 10MG
LORAZEPAM TAB 1MG
CITALOPRAM TAB 10MG
LISINOPRIL TAB 10MG
CYCLOBENZAPR TAB 5MG
OLANZAPINE TAB 5MG
VITAMIN D3 CAP 2000UNIT
MEGESTROL AC TAB 40MG
SODIUM CHLOR NEB 7%
VALSART/HCTZ TAB 160-12.5
LEVETIRACETA TAB 750MG
OXYBUTYNIN SYP 5MG/5ML
CARVEDILOL TAB 12.5MG
DIVALPROEX TAB 500MG DR
VALACYCLOVIR TAB 500MG
HC PRAMOXINE CRE 1-2.5%
DOXAZOSIN TAB 1MG
LAMOTRIGINE TAB 100MG
GABAPENTIN CAP 300MG
METFORMIN TAB 1000MG
PREDNISOLONE SOL 15MG/5ML
GLIMEPIRIDE TAB 1MG
CEPHALEXIN CAP 500MG
PAROXETINE TAB 10MG
CLOBETASOL E CRE 0.05%
ACYCLOVIR TAB 800MG
MELOXICAM TAB 15MG
LAMOTRIGINE TAB 150MG
ATENOLOL TAB 25MG
NAPROXEN TAB 375MG
PROMETHAZINE SOL 6.25/5ML
GLIPIZIDE TAB 5MG
ZALEPLON CAP 10MG
BENAZEPRIL TAB 40MG
SALICYLIC AC SHA 6%
ASPIRIN LOW TAB 81MG EC
SIMVASTATIN TAB 5MG
NAPROXEN TAB 500MG
ISOSORB MONO TAB 120MG ER
CIPROFLOXACN TAB 250MG
PRAVASTATIN TAB 20MG
MEGESTROL AC TAB 20MG
ROPINIROLE TAB 0.5MG
METFORMIN TAB 1000MG
VENLAFAXINE CAP 150MG ER
ATORVASTATIN TAB 20MG
AMMONIUM LAC CRE 12%
NAPROXEN TAB 250MG
DIGITEK TAB 0.25MG
CYCLOBENZAPR TAB 10MG
CHERATUSSIN SYP AC
WARFARIN TAB 7.5MG
PAROXETINE TAB 10MG
PREDNISONE TAB 20MG
CYCLOBENZAPR TAB 10MG
CEPHALEXIN CAP 500MG
CYPROHEPTAD TAB 4MG
6
4
11
2
1
15
3
1
6
3
5
10
1
1
1
7
6
18
9
3
9
7
1
2
1
4
3
1
1
1
1
4
1
1
12
3
4
2
2
4
9
2
7
11
8
4
3
4
1
13
1
10
1
14
2
1
5
3
1
2
2
13
1
22
3
2
5
14
12
15
2
420
240
645
400
180
355
270
15
1,050
88
727
705
90
30
90
420
284
1,530
400
150
450
260
240
120
360
1,560
540
270
30
28
90
180
540
180
874
540
110
150
30
210
345
180
630
750
1,845
720
90
360
177
870
90
444
90
110
180
90
330
540
90
135
560
683
90
776
716
180
270
195
493
336
80
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 182
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
65162018810
68645019159
50383004004
55111024901
65862019801
31604002673
00093722006
60429012290
00591048701
16714037501
00093423310
00378527210
00172503470
00143988980
00093204756
00185004301
29300018905
00555038102
00378043505
68180040401
00527133850
76282025110
59390019205
00093730001
68462016505
45802059465
76282040505
50111056301
00904227260
68645019059
67877012440
68645047254
16729000717
60429019515
60758080210
00093576801
16714029702
61314022710
00185061301
00591086005
68382006816
76439034310
54838000650
42291060518
00591093301
31604002516
00378023101
76282021305
60432067160
76439030510
50111032703
11917011818
16714039702
00258368990
00536379001
00093736556
59746000314
00591336905
00228202750
00904621740
53489051701
66689000816
00781574801
54458093010
51672126901
68180046703
57515009239
00185061505
00363060839
53489043301
51672128408
NAPROXEN
Y
METOPROLOL TARTRATEY
PREDNISOLONE SODIUMYPHOSP
QUETIAPINE FUMARATE Y
GABAPENTIN
Y
D3
Y
TOPIRAMATE
Y
VENLAFAXINE HCL ER Y
ESTRADIOL
Y
QUETIAPINE FUMARATE Y
BUMETANIDE
Y
ESZOPICLONE
Y
LISINOPRIL/HYDROCHLOROTHI
Y
AMOXICILLIN
Y
PIOGLITAZONE HCL
Y
MIDODRINE HCL
Y
BISOPROLOL FUMARATE/HYDRO
Y
MEPERIDINE HCL
Y
BUPROPION HCL
Y
CEFPROZIL
Y
DOXYCYCLINE MONOHYDRATE
Y
ESCITALOPRAM OXALATEY
HOMATROPAIRE
Y
MINOCYCLINE HCL
Y
CARVEDILOL
Y
LEVOCETIRIZINE DIHYDROCHL
Y
GABAPENTIN
Y
CYCLOBENZAPRINE HCL Y
NIACIN
Y
METOPROLOL TARTRATEY
SILVER SULFADIAZINE Y
SIMVASTATIN
Y
SIMVASTATIN
Y
FLUTICASONE PROPIONATE
Y
TIMOLOL MALEATE
Y
OLANZAPINE
Y
AMOXICILLIN/CLAVULANATE
Y P
TIMOLOL MALEATE
Y
HYDROXYZINE PAMOATEY
LISINOPRIL/HYDROCHLOROTHI
Y
SIMVASTATIN
Y
POTASSIUM CHLORIDE Y
AQUEOUS VITAMIN D INFANTS
Y
METFORMIN HCL
Y
OXYCODONE/ACETAMINOPHEN
Y
VITAMIN D3
Y
ATENOLOL
Y
SERTRALINE HCL
Y
ERYTHROMYCIN
Y
ANTIPYRINE/BENZOCAINE
Y
HYDRALAZINE HCL
Y
D3
Y
CEFPROZIL
Y
DILTIAZEM HCL ER
Y
VITAMIN D3
Y
LOSARTAN POTASSIUM Y
METHYLPREDNISOLONE Y
BUTALBITAL/ACETAMINOPHEN/
Y
ALPRAZOLAM
Y
SULINDAC
Y
TRAZODONE HCL
Y
NYSTATIN
Y
METHYLPHENIDATE HCL Y
HYDROCHLOROTHIAZIDEY
BETAMETHASONE VALERATE
Y
LOVASTATIN
Y
ULTICARE INSULIN SYRINGE
Y
HYDROXYZINE PAMOATEY
WAL-FEX ALLERGY
Y
PHENTERMINE HCL
Y
TRIAMCINOLONE ACETONIDE
Y
NAPROXEN TAB 250MG
METOPROL TAR TAB 100MG
PRED SOD PHO SOL 5MG/5ML
QUETIAPINE TAB 25MG
GABAPENTIN CAP 100MG
D3
TAB 2000UNIT
TOPIRAMATE TAB 200MG
VENLAFAXINE CAP 75MG ER
ESTRADIOL TAB 1MG
QUETIAPINE TAB 25MG
BUMETANIDE TAB 1MG
ESZOPICLONE TAB 3MG
LISINOP/HCTZ TAB 20-12.5
AMOXICILLIN SUS 250/5ML
PIOGLITAZONE TAB 30MG
MIDODRINE TAB 5MG
BISOPRL/HCTZ TAB 10/6.25
MEPERIDINE TAB 50MG
BUPROPION TAB 100MG
CEFPROZIL TAB 500MG
DOXYCYC MONO TAB 100MG
ESCITALOPRAM TAB 20MG
HOMATROPAIRE SOL 5% OP
MINOCYCLINE CAP 75MG
CARVEDILOL TAB 25MG
LEVOCETIRIZI TAB 5MG
GABAPENTIN TAB 600MG
CYCLOBENZAPR TAB 10MG
NIACIN
TAB 500MG
METOPROL TAR TAB 50MG
SILVER SULFA CRE 1%
SIMVASTATIN TAB 80MG
SIMVASTATIN TAB 80MG
FLUTICASONE SPR 50MCG
TIMOLOL MAL SOL 0.25% OP
OLANZAPINE TAB 5MG
AMOX/K CLAV TAB 875MG
TIMOLOL MAL SOL 0.5% OP
HYDROXYZ PAM CAP 25MG
LISINOP/HCTZ TAB 10-12.5
SIMVASTATIN TAB 40MG
POT CHLORIDE POW 20MEQ
VITAMIN D DRO 400UNIT
METFORMIN TAB 500MG
OXYCOD/APAP TAB 7.5-325
VITAMIN D3 TAB 2000UNIT
ATENOLOL TAB 50MG
SERTRALINE TAB 50MG
ERYTHROMYCIN SOL 2%
ANTIPY/BENZO SOL OTIC
HYDRALAZINE TAB 25MG
D3
CAP 2000UNIT
CEFPROZIL SUS 250/5ML
DILTIAZEM CAP 240MG/24
VITAMIN D3 CAP 2000UNIT
LOSARTAN POT TAB 50MG
METHYLPRED TAB 16MG
BUT/APAP/CAF TAB
ALPRAZOLAM TAB 0.25MG
SULINDAC TAB 200MG
TRAZODONE TAB 150MG
NYSTATIN SUS 100000
METHYLPHENID TAB 5MG
HYDROCHLOROT TAB 25MG
BETAMETH VAL CRE 0.1%
LOVASTATIN TAB 10MG
ULTICARE SYG MIS .3CC/29G
HYDROXYZ PAM CAP 50MG
WAL-FEX ALLR TAB 180MG
PHENTERMINE CAP 30MG
TRIAMCINOLON OIN 0.1%
8
9
2
2
5
18
1
2
9
1
1
1
2
11
1
1
3
4
2
1
2
3
2
2
3
1
1
21
7
6
1
1
1
4
5
3
2
3
3
5
2
3
2
9
1
11
4
5
2
7
2
4
1
1
15
1
3
1
11
1
2
1
2
17
2
4
2
6
3
2
3
851
750
90
360
420
780
60
120
495
270
90
90
150
1,590
90
30
270
114
120
20
72
195
10
60
540
30
90
581
840
990
400
90
90
64
50
180
42
50
270
330
180
21
100
1,380
90
510
585
199
120
70
180
360
75
90
660
90
18
100
772
180
180
200
120
1,290
60
360
200
384
90
120
240
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 183
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00054027903
00185440051
60429011905
68180046901
62756052188
64720013010
00591555410
00093023356
00143223010
00781148610
00093412774
65862039010
00781183010
31722021901
00168001531
00093742456
55111064801
16729014517
00054023763
69238110105
00781607746
68180018102
68382009505
00054455015
68462022110
00378575001
74312035873
60505265301
60429030905
29033000305
00168004015
55111014512
00536589588
00172524160
67877022301
59762180802
42291036960
00603533932
65862052890
43547033610
68382000116
00378032701
66993087931
43547024950
43199002124
00781194131
00363089588
23155011405
00781223410
68645035059
68645046859
51079010763
63304058101
00054449613
00591354125
00603576921
00378035101
67544056460
00536589688
00591079510
00591024010
68180087613
53489014601
60505016907
00603516532
61748021960
43353079080
60258015101
64679092302
29300016815
65862039110
NARATRIPTAN HCL
Y
TIZANIDINE HCL
Y
METHOCARBAMOL
Y
LOVASTATIN
Y
SUMATRIPTAN SUCCINATE
Y
AMPHETAMINE/DEXTROAMPHETA
Y
PROPRANOLOL HCL
Y
ONDANSETRON HCL
Y
ISOSORBIDE MONONITRATE
Y ER
AMITRIPTYLINE HCL
Y
PENICILLIN V POTASSIUMY
ONDANSETRON ODT
Y
PROMETHAZINE HCL
Y
BENZTROPINE MESYLATEY
HYDROCORTISONE
Y
MONTELUKAST SODIUM Y
GLYCOPYRROLATE
Y
QUETIAPINE FUMARATE Y
MORPHINE SULFATE
Y
IBUPROFEN
Y
CEFDINIR
Y
CEFADROXIL
Y
CARVEDILOL
Y
METHOTREXATE
Y
LITHIUM CARBONATE Y
KETOPROFEN
Y
D3 ULTRA STRENGTH Y
TRAZODONE HCL
Y
ACYCLOVIR
Y
SUCRALFATE
Y
BETAMETHASONE VALERATE
Y
FLUCONAZOLE
Y
NICOTINE TRANSDERMALY SYST
ANAGRELIDE HYDROCHLORIDE
Y
GABAPENTIN
Y
PAROXETINE HCL
Y
LAMOTRIGINE
Y
PREDNISONE
Y
VENLAFAXINE HCL ER Y
BENAZEPRIL HCL
Y
PAROXETINE HCL
Y
HALOPERIDOL
Y
ECONAZOLE NITRATE Y
METFORMIN HCL
Y
HYDROCORTISONE ACETATE
Y
AZITHROMYCIN
Y
NICOTINE TRANSDERMALY SYST
PROPRANOLOL HCL
Y
OMEPRAZOLE
Y
CARVEDILOL
Y
CARVEDILOL
Y
AMITRIPTYLINE HCL
Y
METOPROLOL TARTRATEY
LEUCOVORIN CALCIUM Y
BUPROPION HCL SR
Y
SOTALOL HCL
Y
HALOPERIDOL
Y
TERAZOSIN HCL
Y
NICOTINE TRANSDERMALY SYST
DICYCLOMINE HCL
Y
LORAZEPAM
Y
NORETHINDRONE
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
PRAVASTATIN SODIUM Y
PHENOBARBITAL
Y
TRIAMCINOLONE ACETONIDE
Y
POTASSIUM CHLORIDE ERY
SF
Y
ENALAPRIL MALEATE Y
TIZANIDINE HCL
Y
ONDANSETRON ODT
Y
NARATRIPTAN TAB 2.5MG
TIZANIDINE TAB 4MG
METHOCARBAM TAB 750MG
LOVASTATIN TAB 40MG
SUMATRIPTAN TAB 50MG
AMPHETAMINE TAB 5MG
PROPRANOLOL TAB 10MG
ONDANSETRON TAB 4MG
ISOSORB MONO TAB 30MG ER
AMITRIPTYLIN TAB 10MG
PENICILLN VK SOL 250/5ML
ONDANSETRON TAB 4MG ODT
PROMETHAZINE TAB 25MG
BENZTROPINE TAB 1MG
HYDROCORT CRE 1%
MONTELUKAST CHW 4MG
GLYCOPYRROL TAB 1MG
QUETIAPINE TAB 25MG
MORPHINE SUL SOL 10MG/5ML
IBUPROFEN TAB 400MG
CEFDINIR SUS 125/5ML
CEFADROXIL SUS 250/5ML
CARVEDILOL TAB 25MG
METHOTREXATE TAB 2.5MG
LITHIUM CARB CAP 300MG
KETOPROFEN CAP 75MG
VITAMIN D3 CAP 10000UNT
TRAZODONE TAB 50MG
ACYCLOVIR TAB 400MG
SUCRALFATE TAB 1GM
BETAMETH VAL CRE 0.1%
FLUCONAZOLE TAB 150MG
NICOTINE TD DIS 14MG/24H
ANAGRELIDE CAP 0.5MG
GABAPENTIN CAP 300MG
PAROXETINE TAB 10MG
LAMOTRIGINE TAB 200MG
PREDNISONE TAB 20MG
VENLAFAXINE CAP 75MG ER
BENAZEPRIL TAB 10MG
PAROXETINE TAB 40MG
HALOPERIDOL TAB 5MG
ECONAZOLE CRE 1%
METFORMIN TAB 850MG
HYDROCORT AC SUP 25MG
AZITHROMYCIN TAB 500MG
NICOTINE TD DIS 14MG/24H
PROPRANOLOL TAB 80MG
OMEPRAZOLE CAP 40MG
CARVEDILOL TAB 6.25MG
CARVEDILOL TAB 25MG
AMITRIPTYLIN TAB 25MG
METOPROL TAR TAB 100MG
LEUCOVOR CA TAB 5MG
BUPROPION TAB 150MG SR
SOTALOL HCL TAB 80MG
HALOPERIDOL TAB 0.5MG
TERAZOSIN CAP 10MG
NICOTINE TD DIS 21MG/24H
DICYCLOMINE TAB 20MG
LORAZEPAM TAB 0.5MG
NORETHINDRON TAB 0.35MG
SMZ/TMP DS TAB 800-160
PRAVASTATIN TAB 20MG
PHENOBARB TAB 16.2MG
TRIAMCINOLON LOT 0.025%
POT CHLORIDE TAB 10MEQ ER
SF
GEL 1.1%
ENALAPRIL TAB 2.5MG
TIZANIDINE TAB 2MG
ONDANSETRON TAB 8MG ODT
1
2
5
2
2
1
5
1
1
2
8
3
5
3
13
2
1
4
1
11
1
1
2
1
11
2
3
9
5
2
2
8
1
1
1
1
3
12
2
4
1
2
2
1
1
5
1
4
2
3
3
3
1
2
2
3
2
4
3
9
14
2
16
1
2
1
1
6
3
3
2
9
180
310
120
17
30
840
45
90
360
1,600
40
132
150
397
60
90
300
720
760
100
100
540
15
1,350
150
209
570
195
130
45
12
28
60
360
90
90
153
120
360
90
60
60
270
30
17
21
600
180
540
540
270
360
38
112
360
180
360
70
330
604
56
320
90
180
60
180
336
270
140
13
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 184
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
64679071701
60505372401
52544028754
00904634080
68001020808
65162020710
47335073786
50383056510
17478029010
00603497521
42291060710
49884003401
55111015830
54458090402
00904585246
51672126003
00378110505
51525683104
00228202950
00555101016
00172541279
43547027110
24208058064
00555009896
45963063301
00378351593
52343003127
00378520193
65862001099
55111073005
57664050389
00168003315
00378401005
00527131201
62175026037
00378456005
53746019401
00093811856
10135049510
29033000301
00603139364
13107004501
53746011001
00378161005
68180047901
51660072415
43598021025
51672413304
16714069703
74312019377
49884006601
45802011859
00406117003
65162075310
00172376080
51672403301
31604002674
00143988815
00185006310
60432003732
00378115005
65862054990
68462012901
00143988601
61442032301
68382012105
51672413101
53150048505
54629794101
16729018417
00591024201
VENLAFAXINE HCL ER Y
RIZATRIPTAN BENZOATE YODT
NEXT CHOICE ONE DOSE Y
METOPROLOL TARTRATEY
LISINOPRIL
Y
OXYCODONE/ACETAMINOPHEN
Y
BUPROPION HCL SR
Y
NEOMYCIN SULFATE
Y
TOBRAMYCIN SULFATE Y
OXYBUTYNIN CHLORIDE Y
METFORMIN HCL
Y
MECLIZINE HCL
Y
OMEPRAZOLE
Y
AMLODIPINE BESYLATE Y
ALL DAY ALLERGY
Y
CLOTRIMAZOLE
Y
GLIPIZIDE
Y
TRILYTE
Y
ALPRAZOLAM
Y
CLONIDINE HCL
Y
FLUCONAZOLE
Y
ROPINIROLE HCL
Y
GENTAMICIN SULFATE Y
CLONAZEPAM ODT
Y
LOVASTATIN
Y
MIRTAZAPINE
Y
GABAPENTIN
Y
MONTELUKAST SODIUM Y
METFORMIN HCL
Y
ALLOPURINOL
Y
TIZANIDINE HCL
Y
BETAMETHASONE VALERATE
Y
TEMAZEPAM
Y
BUTALBITAL/ASPIRIN/CAFFEI
Y
NIFEDIPINE ER
Y
POTASSIUM CHLORIDE ERY
NAPROXEN SODIUM
Y
FAMCICLOVIR
Y
PROMETHAZINE HCL
Y
SUCRALFATE
Y
LIDOCAINE VISCOUS
Y
OXYCODONE/ACETAMINOPHEN
Y
HYDROCODONE/ACETAMINOPHEN
Y
DICYCLOMINE HCL
Y
SIMVASTATIN
Y
ALLERGY RELIEF/NASAL DECO
Y
SSD
Y
LAMOTRIGINE
Y
VALACYCLOVIR HCL
Y
D-5000 MAXIMUM STRENGTH
Y
GLYCOPYRROLATE
Y
MOMETASONE FUROATEY
NALTREXONE HCL
Y
BENAZEPRIL HCL
Y
LISINOPRIL
Y
WARFARIN SODIUM
Y
D3
Y
AMOXICILLIN
Y
CLONAZEPAM
Y
LACTULOSE
Y
BUSPIRONE HCL
Y
VALSARTAN/HYDROCHLOROTHIA
Y
ZONISAMIDE
Y
AMOXICILLIN
Y
CLONIDINE HCL
Y
AMLODIPINE BESYLATE Y
LAMOTRIGINE
Y
HALOPERIDOL DECANOATE
Y
VITAMIN D3
Y
HYDROCHLOROTHIAZIDEY
LORAZEPAM
Y
VENLAFAXINE CAP 75MG ER
RIZATRIPTAN TAB 10MG ODT
NEXT CHOICE TAB 1.5MG
METOPROL TAR TAB 25MG
LISINOPRIL TAB 20MG
OXYCOD/APAP TAB 7.5-325
BUPROPION TAB 150MG SR
NEOMYCIN TAB 500MG
TOBRAMYCIN SOL 0.3% OP
OXYBUTYNIN TAB 5MG
METFORMIN TAB 1000MG
MECLIZINE TAB 12.5MG
OMEPRAZOLE CAP 20MG
AMLODIPINE TAB 5MG
ALL DAY ALLG TAB 10MG
CLOTRIMAZOLE SOL 1%
GLIPIZIDE TAB 5MG
TRILYTE SOL
ALPRAZOLAM TAB 0.5MG
CLONIDINE DIS 0.2/24HR
FLUCONAZOLE TAB 150MG
ROPINIROLE TAB 2MG
GENTAMICIN SOL 0.3% OP
CLONAZEP ODT TAB 2MG
LOVASTATIN TAB 10MG
MIRTAZAPINE TAB 15MG
GABAPENTIN CAP 300MG
MONTELUKAST TAB 10MG
METFORMIN TAB 1000MG
ALLOPURINOL TAB 300MG
TIZANIDINE TAB 4MG
BETAMETH VAL OIN 0.1%
TEMAZEPAM CAP 15MG
BUT/ASA/CAF/ CAP COD 30MG
NIFEDIPINE TAB 30MG ER
POT CHLORIDE TAB 8MEQ ER
NAPROXEN SOD TAB 550MG
FAMCICLOVIR TAB 250MG
PROMETHAZINE TAB 25MG
SUCRALFATE TAB 1GM
LIDOCAINE SOL 2% VISC
OXYCOD/APAP TAB 7.5-325
HYDROCO/APAP TAB 10-325MG
DICYCLOMINE CAP 10MG
SIMVASTATIN TAB 20MG
ALLERGY RELF TAB DECONGES
SSD
CRE 1%
LAMOTRIGINE TAB 200MG
VALACYCLOVIR TAB 1GM
VITAMIN D3 CAP 5000UNIT
GLYCOPYRROL TAB 2MG
MOMETASONE SOL 0.1%
NALTREXONE TAB 50MG
BENAZEPRIL TAB 20MG
LISINOPRIL TAB 20MG
WARFARIN TAB 6MG
D3
TAB 2000UNIT
AMOXICILLIN SUS 125/5ML
CLONAZEPAM TAB 0.5MG
LACTULOSE SOL 10GM/15
BUSPIRONE TAB 10MG
VALSART/HCTZ TAB 160-25MG
ZONISAMIDE CAP 50MG
AMOXICILLIN SUS 200/5ML
CLONIDINE TAB 0.3MG
AMLODIPINE TAB 2.5MG
LAMOTRIGINE TAB 100MG
HALOPER DEC INJ 100MG/ML
VITAMIN D3 TAB 5000UNIT
HYDROCHLOROT TAB 50MG
LORAZEPAM TAB 2MG
1
1
1
8
9
1
1
7
7
3
3
3
1
3
5
2
2
2
18
1
7
3
3
2
4
5
2
1
4
4
2
3
3
2
1
1
8
1
3
2
9
1
4
4
2
2
2
1
1
5
2
3
1
2
2
2
14
11
4
2
3
1
1
5
2
3
2
1
8
4
14
90
36
1
1,050
690
45
60
42
35
141
540
178
90
270
210
60
1,080
8,000
658
1
9
210
45
27
180
210
1,080
30
675
240
150
45
270
20
30
90
370
6
150
80
920
20
160
420
180
60
150
90
21
330
40
90
8
180
180
135
780
1,650
1,080
2,132
540
30
60
900
360
540
120
1
660
360
339
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 185
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378351191
00363058732
59762153002
00093104901
16714056102
55111064534
00781223401
00591315301
00228300311
57664043551
00603499021
00143129205
68382002410
00603498221
65862020199
59762502201
57664013488
16714029903
00591034810
24208031425
00603421460
00093073301
00832102500
42192013440
00603578128
59762490001
00378210001
00603421032
62756026002
00603901358
61314030302
50428847260
68180036009
60505014102
54458096810
00781502101
00363016552
51672404501
00603294821
68645014154
00378119001
00185540001
16729000515
57237004101
00487990401
00378004501
45802005435
00093227034
00378027493
00363918001
68308021901
46672005350
55111019690
00555083402
43353039180
68001021406
00527135301
68382003001
60505004001
00603295928
00406575501
31722020901
65862000601
10702000601
68382012216
00603294921
00603786174
42858030101
00228402911
00527138201
00904634440
RISPERIDONE
Y
ASPIRIN 81
Y
AMLODIPINE BESYLATE Y
METFORMIN HCL
Y
ZALEPLON
Y
OMEPRAZOLE
Y
OMEPRAZOLE
Y
MINOCYCLINE HCL
Y
CLONAZEPAM
Y
METFORMIN HCL
Y
OXYCODONE HCL
Y
METHOCARBAMOL
Y
ATENOLOL
Y
OXYCODONE/ACETAMINOPHEN
Y
LOSARTAN POTASSIUM Y
QUINAPRIL HCL
Y
BENZONATATE
Y
AMOXICILLIN
Y
TRIAMTERENE/HYDROCHLOROTH
Y
FLURBIPROFEN SODIUM Y
LISINOPRIL
Y
METOPROLOL TARTRATEY
BACLOFEN
Y
SALICYLIC ACID
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
SERTRALINE HCL
Y
LOPERAMIDE HCL
Y
LISINOPRIL
Y
ZONISAMIDE
Y
ACETAMINOPHEN/CODEINE
Y
ATROPINE SULFATE
Y
CVS ALLERGY RELIEF
Y
FENOFIBRATE
Y
GLIPIZIDE
Y
GLIMEPIRIDE
Y
PROCHLORPERAZINE MALEATE
Y
WAL-ITIN D 24 HOUR Y
ENALAPRIL MALEATE/HYDROCH
Y
CLONAZEPAM
Y
FAMOTIDINE
Y
GUANFACINE HCL
Y
LISINOPRIL
Y
SIMVASTATIN
Y
PENICILLIN V POTASSIUMY
ALBUTEROL SULFATE Y
DILTIAZEM HCL
Y
TRIAMCINOLONE ACETONIDE
Y
AMOXICILLIN/CLAVULANATE
Y P
TAMOXIFEN CITRATE
Y
NICOTINE TRANSDERMALY SYST
ESGIC
Y
BUTALBITAL/ACETAMINOPHEN/
Y
CLOPIDOGREL
Y
WARFARIN SODIUM
Y
IBUPROFEN
Y
LOVASTATIN
Y
HYDROMORPHONE HCL Y
METFORMIN HCL
Y
ETODOLAC
Y
CLONIDINE HCL
Y
METHADONE HCL
Y
TERBINAFINE HCL
Y
CITALOPRAM HYDROBROMIDE
Y
CYCLOBENZAPRINE HCL Y
AMLODIPINE BESYLATE Y
CLONAZEPAM
Y
TRIAMCINOLONE ACETONIDE
Y
HYDROMORPHONE HCL Y
OXYCODONE/IBUPROFENY
CLINDAMYCIN HCL
Y
METFORMIN HCL
Y
RISPERIDONE TAB 1MG
ASPIRIN 81 TAB 81MG EC
AMLODIPINE TAB 5MG
METFORMIN TAB 850MG
ZALEPLON CAP 10MG
OMEPRAZOLE CAP 40MG
OMEPRAZOLE CAP 40MG
MINOCYCLINE CAP 75MG
CLONAZEPAM TAB 0.5MG
METFORMIN TAB 850MG
OXYCODONE TAB 5MG
METHOCARBAM TAB 750MG
ATENOLOL TAB 100MG
OXYCOD/APAP TAB 10-325MG
LOSARTAN POT TAB 25MG
QUINAPRIL TAB 40MG
BENZONATATE CAP 200MG
AMOXICILLIN CAP 500MG
TRIAMT/HCTZ TAB 75-50MG
FLURBIPROFEN SOL 0.03% OP
LISINOPRIL TAB 40MG
METOPROL TAR TAB 50MG
BACLOFEN TAB 20MG
SALICYLIC AC GEL 6%
SMZ/TMP DS TAB 800-160
SERTRALINE TAB 50MG
LOPERAMIDE CAP 2MG
LISINOPRIL TAB 5MG
ZONISAMIDE CAP 100MG
APAP/CODEINE SOL 120-12/5
ATROPINE SUL SOL 1% OP
CVS ALLERGY TAB 180MG
FENOFIBRATE TAB 48MG
GLIPIZIDE TAB 5MG
GLIMEPIRIDE TAB 1MG
PROCHLORPER TAB 10MG
WAL-ITIN D TAB 24 HOUR
ENALAPR/HCTZ TAB 5-12.5MG
CLONAZEPAM TAB 0.5MG
FAMOTIDINE TAB 40MG
GUANFACINE TAB 2MG
LISINOPRIL TAB 5MG
SIMVASTATIN TAB 20MG
PENICILLN VK TAB 500MG
ALBUTEROL NEB 1.25MG/3
DILTIAZEM TAB 60MG
TRIAMCINOLON OIN 0.025%
AMOX/K CLAV CHW 200MG
TAMOXIFEN TAB 20MG
NICOTINE TD DIS 21MG/24H
ESGIC
CAP
BUT/APAP/CAF TAB
CLOPIDOGREL TAB 75MG
WARFARIN TAB 7.5MG
IBUPROFEN TAB 800MG
LOVASTATIN TAB 40MG
HYDROMORPHON TAB 2MG
METFORMIN TAB 1000MG
ETODOLAC CAP 300MG
CLONIDINE TAB 0.3MG
METHADONE TAB 5MG
TERBINAFINE TAB 250MG
CITALOPRAM TAB 20MG
CYCLOBENZAPR TAB 5MG
AMLODIPINE TAB 5MG
CLONAZEPAM TAB 1MG
TRIAMCINOLON CRE 0.025%
HYDROMORPHON TAB 2MG
OXYCOD/IBU TAB 5-400MG
CLINDAMYCIN CAP 150MG
METFORMIN TAB 850MG
3
9
3
2
4
1
1
1
5
3
4
7
5
1
1
1
6
7
2
3
2
7
2
1
10
4
6
4
2
10
1
3
1
2
2
3
2
3
8
2
1
5
2
6
1
3
7
1
2
1
1
1
1
6
2
2
4
4
1
1
5
6
3
5
3
13
13
6
3
5
3
65
750
270
360
120
30
30
30
480
540
120
354
330
30
90
30
171
181
180
8
135
900
120
40
214
180
196
360
150
1,550
15
90
30
360
360
160
40
210
645
180
90
390
180
166
90
270
300
14
60
14
30
100
30
252
360
180
155
510
20
180
345
212
270
240
270
530
390
203
30
182
540
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 186
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
31722027810
60429031810
16714061204
00054010022
68001020908
00093015001
00781520731
23155011210
53746022010
00781531701
55111032205
62756025902
68462035401
68382005105
00093736756
00713022415
31722034201
68180035106
00093002810
00603211632
00591530710
00168021560
00378456077
00781145210
68382002401
55111068205
00781518010
61314023710
47335067881
57237007710
43547027809
57664024718
65862019430
64980017802
00378623205
45963060009
00555095202
00093075301
67405057510
00093867578
68382006616
10702000701
31722021230
63304082990
54458098010
16714029601
00093711698
11917009900
68382006624
68382006605
00093117401
00406831562
60429078910
68001026405
00093415579
65862001605
31722033901
68180051201
00093729601
00591554401
00093026215
45802025735
00378245710
60505258100
54458089310
00168026550
00093716798
60505011605
51991077290
00603499828
58980015011
TOPIRAMATE
Y
LOSARTAN POTASSIUM Y
SERTRALINE HCL
Y
AMLODIPINE BESYLATE Y
LISINOPRIL
Y
ACETAMINOPHEN/CODEINE
Y #3
LOSARTAN POTASSIUM/HYDROC
Y
PROPRANOLOL HCL
Y
METFORMIN HCL
Y
ZOLPIDEM TARTRATE Y
GLIMEPIRIDE
Y
ZONISAMIDE
Y
HYDROXYZINE HCL
Y
MELOXICAM
Y
LOSARTAN POTASSIUM/HYDROC
Y
FLUOCINOLONE ACETONIDE
Y
NAPROXEN
Y
SERTRALINE HCL
Y
ENALAPRIL MALEATE Y
ALLOPURINOL
Y
PROMETHAZINE HCL
Y
ERYTHROMYCIN
Y
POTASSIUM CHLORIDE ERY
GLIPIZIDE
Y
ATENOLOL
Y
IBUPROFEN
Y
LEVOTHYROXINE SODIUM
Y
CROMOLYN SODIUM
Y
DILTIAZEM HCL ER
Y
ONDANSETRON ODT
Y
IRBESARTAN
Y
CARVEDILOL
Y
FLUOXETINE HCL
Y
CHLOROQUINE PHOSPHATE
Y
CITALOPRAM HYDROBROMIDE
Y
FINASTERIDE
Y
DEXTROAMPHETAMINE SULFATE
Y
ATENOLOL
Y
HYDROXYZINE HCL
Y
AMOXICILLIN/CLAVULANATE
Y P
SIMVASTATIN
Y
CYCLOBENZAPRINE HCL Y
SERTRALINE HCL
Y
ATORVASTATIN CALCIUMY
CITALOPRAM HYDROBROMIDE
Y
AMOXICILLIN/CLAVULANATE
Y P
PAROXETINE HCL
Y
BIOTIN
Y
SIMVASTATIN
Y
SIMVASTATIN
Y
PENICILLIN V POTASSIUMY
MORPHINE SULFATE ER Y
WARFARIN SODIUM
Y
BUPROPION HCL XL
Y
AMOXICILLIN
Y
AMOXICILLIN
Y
NAPROXEN DR
Y
LISINOPRIL
Y
CARVEDILOL
Y
ALLOPURINOL
Y
FLUOCINONIDE
Y
MOMETASONE FUROATEY
LORAZEPAM
Y
AZITHROMYCIN
Y
BENAZEPRIL HCL
Y
AUGMENTED BETAMETHASONE
Y
D
AMLODIPINE BESYLATE Y
TERAZOSIN HCL
Y
LANSOPRAZOLE
Y
OXYCODONE/ACETAMINOPHEN
Y
HYPERCARE
Y
TOPIRAMATE TAB 25MG
LOSARTAN POT TAB 100MG
SERTRALINE TAB 50MG
AMLODIPINE TAB 2.5MG
LISINOPRIL TAB 40MG
APAP/CODEINE TAB 300-30MG
LOSARTAN/HCT TAB 100-25
PROPRANOLOL TAB 40MG
METFORMIN TAB 1000MG
ZOLPIDEM TAB 5MG
GLIMEPIRIDE TAB 4MG
ZONISAMIDE CAP 50MG
HYDROXYZ HCL TAB 50MG
MELOXICAM TAB 15MG
LOSARTAN/HCT TAB 50-12.5
FLUOCIN ACET OIN 0.025%
NAPROXEN TAB 500MG
SERTRALINE TAB 25MG
ENALAPRIL TAB 10MG
ALLOPURINOL TAB 300MG
PROMETHAZINE TAB 25MG
ERYTHROMYCIN SOL 2%
POT CHLORIDE TAB 8MEQ ER
GLIPIZIDE TAB 5MG
ATENOLOL TAB 100MG
IBUPROFEN TAB 400MG
LEVOTHYROXIN TAB 25MCG
CROMOLYN SOD SOL 4% OP
DILTIAZEM CAP 300MG ER
ONDANSETRON TAB 4MG ODT
IRBESARTAN TAB 150MG
CARVEDILOL TAB 25MG
FLUOXETINE CAP 40MG
CHLOROQUINE TAB 500MG
CITALOPRAM TAB 20MG
FINASTERIDE TAB 1MG
DEXTROAMPHET TAB 5MG
ATENOLOL TAB 100MG
HYDROXYZ HCL TAB 10MG
AMOX/K CLAV SUS 600/5ML
SIMVASTATIN TAB 10MG
CYCLOBENZAPR TAB 10MG
SERTRALINE TAB 25MG
ATORVASTATIN TAB 40MG
CITALOPRAM TAB 20MG
AMOX/K CLAV TAB 500MG
PAROXETINE TAB 30MG
BIOTIN
TAB 1000MCG
SIMVASTATIN TAB 10MG
SIMVASTATIN TAB 10MG
PENICILLN VK TAB 500MG
MORPHINE SUL TAB 15MG ER
WARFARIN TAB 5MG
BUPROPN HCL TAB 300MG XL
AMOXICILLIN SUS 250/5ML
AMOXICILLIN CAP 250MG
NAPROXEN DR TAB 500MG
LISINOPRIL TAB 2.5MG
CARVEDILOL TAB 25MG
ALLOPURINOL TAB 300MG
FLUOCINONIDE CRE 0.05%
MOMETASONE CRE 0.1%
LORAZEPAM TAB 1MG
AZITHROMYCIN TAB 250MG
BENAZEPRIL TAB 40MG
AUG BETAMET CRE 0.05%
AMLODIPINE TAB 5MG
TERAZOSIN CAP 2MG
LANSOPRAZOLE CAP 30MG DR
OXYCOD/APAP TAB 5-325MG
HYPERCARE SOL 20%
4
3
6
1
2
9
1
3
3
11
4
1
2
5
1
1
6
6
1
2
4
1
1
6
6
12
1
2
1
2
2
2
3
1
3
1
2
4
4
1
2
6
2
2
6
1
2
4
1
1
3
1
7
1
9
9
3
5
2
3
1
3
10
2
3
2
4
3
1
2
5
300
150
178
30
180
188
90
540
540
330
270
42
150
210
90
30
480
359
90
270
120
60
90
810
540
414
90
20
30
25
180
360
210
8
270
90
60
360
390
150
180
420
120
30
360
28
180
360
90
90
78
60
392
30
1,120
245
150
450
360
150
15
90
441
12
270
100
300
270
28
90
210
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 187
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
55111028130
53746019301
00378105101
68382005610
68180048609
00713063260
52343005505
00904581089
00378561505
00472033720
00591071860
00781194133
68462010910
62037055901
63044062201
65862070060
64980017405
57237000201
61442012701
49884072704
00093073401
24208073501
00228300350
42291062190
60429073510
00591080105
00143998101
00185540010
62037057101
00093444305
00172365070
00713063215
00378247401
67877022405
00378020810
61971012005
00228300450
51672400502
50102012048
16714008110
43353094280
16714007205
00781148701
68001019600
67253020150
00603158554
00591379830
00555092602
23155010405
42043014338
00093107701
00603388720
00603421132
00603321532
00832091115
66993046130
59762501101
00527058601
59762307001
53746046401
00904623561
50111046803
51672130200
00093310705
00093014801
00603543721
00603616132
00378113401
67877025001
00603211060
43353039174
LEVOFLOXACIN
Y
NAPROXEN SODIUM
Y
ENALAPRIL MALEATE Y
WARFARIN SODIUM
Y
PRAVASTATIN SODIUM Y
FLUTICASONE PROPIONATE
Y
PIOGLITAZONE HCL
Y
LISINOPRIL
Y
LEVETIRACETAM
Y
HYDROCORTISONE
Y
BUSPIRONE HCL
Y
AZITHROMYCIN
Y
TOPIRAMATE
Y
POTASSIUM CHLORIDE ERY
RENO CAPS
Y
CEFUROXIME AXETIL
Y
CARISOPRODOL
Y
HYDROCHLOROTHIAZIDEY
MELOXICAM
Y
DOXYCYCLINE MONOHYDRATE
Y
METOPROLOL TARTRATEY
CYCLOPENTOLATE HCL Y
CLONAZEPAM
Y
MONTELUKAST SODIUM Y
PAROXETINE HCL
Y
HYDROXYZINE PAMOATEY
AMOXICILLIN/CLAVULANATE
Y P
LISINOPRIL
Y
METFORMIN HCL ER
Y
GABAPENTIN
Y
GLIPIZIDE
Y
FLUTICASONE PROPIONATE
Y
DICLOFENAC POTASSIUMY
GABAPENTIN
Y
FUROSEMIDE
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
CLONAZEPAM
Y
CARBAMAZEPINE
Y
AUBRA
Y
HYDROXYZINE HCL
Y
METOPROLOL TARTRATEY
BACLOFEN
Y
AMITRIPTYLINE HCL
Y
ESCITALOPRAM OXALATEY
PENICILLIN V POTASSIUMY
PROMETHAZINE/CODEINE
Y
IPRATROPIUM BROMIDEY
WARFARIN SODIUM
Y
METFORMIN HCL
Y
CEPHALEXIN
Y
CEFPROZIL
Y
HYDROCODONE/ACETAMINOPHEN
Y
LISINOPRIL
Y
DIAZEPAM
Y
LORAZEPAM
Y
OLANZAPINE
Y
SPIRONOLACTONE
Y
DICYCLOMINE HCL
Y
AZITHROMYCIN
Y
IBUPROFEN
Y
PANTOPRAZOLE SODIUMY
PROPRANOLOL HCL
Y
TERCONAZOLE
Y
AMOXICILLIN
Y
NAPROXEN
Y
PROMETHAZINE HCL
Y
TRAZODONE HCL
Y
KETOROLAC TROMETHAMINE
Y
QUETIAPINE FUMARATE Y
AMLODIPINE BESYLATE Y
IBUPROFEN
Y
LEVOFLOXACIN TAB 750MG
NAPROXEN SOD TAB 275MG
ENALAPRIL TAB 2.5MG
WARFARIN TAB 5MG
PRAVASTATIN TAB 20MG
FLUTICASONE OIN 0.005%
PIOGLITAZONE TAB 45MG
LISINOPRIL TAB 40MG
LEVETIRACETA TAB 500MG
HYDROCORT CRE 2.5%
BUSPIRONE TAB 15MG
AZITHROMYCIN TAB 500MG
TOPIRAMATE TAB 100MG
POT CHLORIDE CAP 8MEQ ER
RENO
CAP
CEFUROXIME TAB 500MG
CARISOPRODOL TAB 350MG
HYDROCHLOROT CAP 12.5MG
MELOXICAM TAB 15MG
DOXYCYC MONO CAP 100MG
METOPROL TAR TAB 100MG
CYCLOPENTOL SOL 1% OP
CLONAZEPAM TAB 0.5MG
MONTELUKAST TAB 10MG
PAROXETINE TAB 20MG
HYDROXYZ PAM CAP 50MG
AMOX/K CLAV SUS 200/5ML
LISINOPRIL TAB 5MG
METFORMIN TAB 500MG ER
GABAPENTIN TAB 600MG
GLIPIZIDE TAB 10MG
FLUTICASONE OIN 0.005%
DICLOFEN POT TAB 50MG
GABAPENTIN CAP 400MG
FUROSEMIDE TAB 20MG
SMZ/TMP DS TAB 800-160
CLONAZEPAM TAB 1MG
CARBAMAZEPIN TAB 200MG
AUBRA
TAB 0.1-0.02
HYDROXYZ HCL TAB 10MG
METOPROL TAR TAB 25MG
BACLOFEN TAB 20MG
AMITRIPTYLIN TAB 25MG
ESCITALOPRAM TAB 10MG
PENICILLN VK TAB 500MG
PROMETH/COD SYP 6.25-10
IPRATROPIUM SOL 0.02%INH
WARFARIN TAB 6MG
METFORMIN TAB 1000MG
CEPHALEXIN SUS 250/5ML
CEFPROZIL TAB 250MG
HYDROCO/APAP TAB 10-325MG
LISINOPRIL TAB 10MG
DIAZEPAM TAB 10MG
LORAZEPAM TAB 1MG
OLANZAPINE TAB 5MG
SPIRONOLACT TAB 25MG
DICYCLOMINE CAP 10MG
AZITHROMYCIN TAB 500MG
IBUPROFEN TAB 400MG
PANTOPRAZOLE TAB 40MG
PROPRANOLOL TAB 20MG
TERCONAZOLE CRE 0.8%
AMOXICILLIN CAP 250MG
NAPROXEN TAB 375MG
PROMETHAZINE TAB 12.5MG
TRAZODONE TAB 100MG
KETOROLAC TAB 10MG
QUETIAPINE TAB 100MG
AMLODIPINE TAB 10MG
IBUPROFEN TAB 800MG
7
3
2
4
2
1
3
3
2
4
2
4
1
1
7
1
5
3
4
3
6
3
21
1
2
5
2
7
3
1
1
2
2
1
5
11
5
5
2
5
7
1
4
3
4
9
2
6
2
1
1
1
6
15
17
1
1
6
3
6
2
2
1
7
5
6
3
2
1
6
1
48
180
180
240
60
60
270
270
67
160
120
14
90
30
210
18
270
270
180
62
630
6
872
90
180
344
200
570
270
60
180
45
60
270
630
280
285
115
56
140
1,260
120
120
120
105
1,218
300
210
360
200
20
60
465
394
945
90
90
432
15
350
60
270
20
204
228
160
270
40
90
270
270
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 188
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
62756013101
53746011005
00185020510
61748001860
74312013430
66685100202
00363057175
68308040547
51079068463
00172503460
00487930103
42291032250
00054459525
62175012841
00093005405
00781165501
68682045570
00603100858
45802022211
60505357403
59746033730
42192032901
13668010501
00378075793
00378363205
68180046707
00603374521
68382006516
68180013701
23155002601
68001015200
16729018217
16729013916
65862041901
64125011710
24208045705
00591081085
00378018310
42291066890
00904582460
53489014605
00093319505
51991052633
00781205205
65162019011
00185072401
55111032001
00591065801
62756079888
43547027210
00054039063
00093726710
60429072505
24208058564
00054001820
00378617201
65162054510
00378521005
54458089502
00172572970
00168000380
00093435905
11917014765
65162052110
61442010301
00093630012
59746038406
66758019001
65862007930
45802094778
45963034102
ONDANSETRON HCL
Y
HYDROCODONE/ACETAMINOPHEN
Y
METHIMAZOLE
Y
RIFAMPIN
Y
BIOTIN
Y
AMOXICILLIN/CLAVULANATE
Y P
WAL-FEX ALLERGY
Y
OXYCODONE/ACETAMINOPHEN
Y
ATENOLOL
Y
LISINOPRIL/HYDROCHLOROTHI
Y
SODIUM CHLORIDE
Y
HYDROXYZINE PAMOATEY
MEPERIDINE HCL
Y
ISOSORBIDE MONONITRATE
Y ER
BUSPIRONE HCL
Y
PENICILLIN V POTASSIUMY
METRONIDAZOLE VAGINAL
Y
ALBUTEROL SULFATE Y
FLUTICASONE PROPIONATE
Y
MONTELUKAST SODIUM Y
LOSARTAN POTASSIUM/HYDROC
Y
NP THYROID 30
Y
ISOSORBIDE MONONITRATE
Y ER
ATENOLOL
Y
CARVEDILOL
Y
LOVASTATIN
Y
GLIMEPIRIDE
Y
SIMVASTATIN
Y
ESCITALOPRAM OXALATEY
VERAPAMIL HCL
Y
CARVEDILOL
Y
HYDROCHLOROTHIAZIDEY
GLIPIZIDE
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
FUROSEMIDE
Y
DICLOFENAC SODIUM Y
SILVER SULFADIAZINE Y
PROPRANOLOL HCL
Y
PRAVASTATIN SODIUM Y
VITAMIN D3
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
KETOPROFEN
Y
TERBINAFINE HCL
Y
TERAZOSIN HCL
Y
NAPROXEN
Y
CARISOPRODOL/ASPIRINY
GLIMEPIRIDE
Y
BUSPIRONE HCL
Y
DIVALPROEX SODIUM DRY
ROPINIROLE HCL
Y
OXYCODONE HCL
Y
METFORMIN HCL ER
Y
METFORMIN HCL ER
Y
TROPICAMIDE
Y
PREDNISONE
Y
METOLAZONE
Y
PRIMIDONE
Y
AMLODIPINE BESYLATE Y
AMLODIPINE BESYLATE Y
FAMOTIDINE
Y
TRIAMCINOLONE ACETONIDE
Y
CLOZAPINE
Y
VITAMIN D3
Y
PROMETHAZINE HCL
Y
DICLOFENAC SODIUM DRY
CETIRIZINE HCL
Y
TERAZOSIN HCL
Y
KLOR-CON M20
Y
TERBINAFINE HCL
Y
GLIMEPIRIDE
Y
DESIPRAMINE HCL
Y
ONDANSETRON TAB 8MG
HYDROCO/APAP TAB 10-325MG
METHIMAZOLE TAB 5MG
RIFAMPIN CAP 300MG
BIOTIN
CAP 5000MCG
AMOX/K CLAV TAB 500MG
WAL-FEX ALLR TAB 180MG
OXYCOD/APAP TAB 5-325MG
ATENOLOL TAB 50MG
LISINOP/HCTZ TAB 20-12.5
SOD CHLORIDE NEB 0.9%
HYDROXYZ PAM CAP 25MG
MEPERIDINE TAB 50MG
ISOSORB MONO TAB 30MG ER
BUSPIRONE TAB 10MG
PENICILLN VK TAB 500MG
METRONIDAZOL GEL 0.75%VAG
ALBUTEROL SYP 2MG/5ML
FLUTICASONE CRE 0.05%
MONTELUKAST CHW 5MG
LOSARTAN/HCT TAB 50-12.5
NP THYROID TAB 30MG
ISOSORB MONO TAB 60MG ER
ATENOLOL TAB 100MG
CARVEDILOL TAB 6.25MG
LOVASTATIN TAB 10MG
GLIMEPIRIDE TAB 2MG
SIMVASTATIN TAB 5MG
ESCITALOPRAM TAB 5MG
VERAPAMIL TAB 80MG
CARVEDILOL TAB 25MG
HYDROCHLOROT TAB 12.5MG
GLIPIZIDE TAB 5MG
SMZ-TMP TAB 400-80MG
FUROSEMIDE TAB 40MG
DICLOFENAC SOL 0.1% OP
SILVER SULFA CRE 1%
PROPRANOLOL TAB 20MG
PRAVASTATIN TAB 40MG
VITAMIN D3 TAB 1000UNIT
SMZ/TMP DS TAB 800-160
KETOPROFEN CAP 75MG
TERBINAFINE TAB 250MG
TERAZOSIN CAP 2MG
NAPROXEN TAB 500MG
CARISOPR/ASA TAB 200-325
GLIMEPIRIDE TAB 1MG
BUSPIRONE TAB 10MG
DIVALPROEX TAB 500MG DR
ROPINIROLE TAB 3MG
OXYCODONE SOL 5MG/5ML
METFORMIN TAB 500MG ER
METFORMIN TAB 500MG ER
TROPICAMIDE SOL 1% OP
PREDNISONE TAB 20MG
METOLAZONE TAB 2.5MG
PRIMIDONE TAB 250MG
AMLODIPINE TAB 10MG
AMLODIPINE TAB 10MG
FAMOTIDINE TAB 40MG
TRIAMCINOLON CRE 0.025%
CLOZAPINE TAB 25MG
VITAMIN D3 CAP 1000UNIT
PROMETHAZINE TAB 25MG
DICLOFENAC TAB 75MG DR
CETIRIZINE SYP 5MG/5ML
TERAZOSIN CAP 2MG
KLOR-CON M20 TAB 20MEQ ER
TERBINAFINE TAB 250MG
GLIMEPIRIDE TAB 4MG
DESIPRAMINE TAB 10MG
3
1
1
1
4
1
1
1
8
1
2
3
2
1
5
5
1
10
1
1
1
2
3
1
2
2
2
1
1
1
2
3
3
4
8
2
2
3
1
13
15
1
6
1
10
1
5
2
2
1
1
1
2
1
6
2
1
1
1
1
5
2
4
3
1
1
2
2
3
1
1
40
60
180
20
240
30
90
120
585
90
900
270
70
90
420
93
70
1,325
60
30
90
180
90
180
360
180
180
90
30
180
360
270
270
90
1,020
10
170
540
90
960
242
90
157
90
460
16
450
120
120
15
100
360
360
15
84
1
90
90
90
180
400
56
450
110
90
120
180
44
144
90
30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
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$
$
$
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$
$
$
$
$
$
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-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$
$
$
$
$
$
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$
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-
p. 189
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
50383005116
00185067401
00054008425
54799043105
50111033301
11845015469
45802036335
00378710301
00703367103
65162075110
31722023890
59762444003
60429036890
68001024717
00832102409
60505264405
00603243321
53489014305
00781178905
43478090388
00093716898
29300013610
66993087915
67544037160
60429013910
43353039160
43353021560
58980062510
42192033901
00574722612
00574011302
00143988750
53746021810
00378700110
29300013010
45802001402
68462012801
10702000310
60429036805
60429011901
66685101101
00378709801
52343002445
17478028811
00245086070
62756024064
50383004224
00378218001
60505020901
43353039192
43598020952
00591034705
00093053701
52343002590
59746038510
63304054005
00093820401
51991064501
00054011413
64980051505
00093729501
00054022025
00781570292
00185440023
00172290880
68382011214
00904590460
50428047491
62756044604
59762372003
62756013905
RANITIDINE HCL
Y
HYDROXYZINE PAMOATEY
ZALEPLON
Y
HOMATROPINE HBR
Y
METRONIDAZOLE
Y
D 1000
Y
TRETINOIN
Y
OXYCODONE/ACETAMINOPHEN
Y
METHOTREXATE SODIUMY
BENAZEPRIL HCL
Y
AMLODIPINE BESYLATE Y
METHYLPREDNISOLONE Y
PRAVASTATIN SODIUM Y
ONDANSETRON ODT
Y
BACLOFEN
Y
TRAMADOL HYDROCHLORIDE/AC
Y
BENZTROPINE MESYLATEY
SPIRONOLACTONE
Y
DICLOFENAC SODIUM DRY
PROPRANOLOL HCL ER Y
AMLODIPINE BESYLATE Y
CLONIDINE HCL
Y
ECONAZOLE NITRATE Y
ALLOPURINOL
Y
METOPROLOL SUCCINATE
Y ER
IBUPROFEN
Y
POTASSIUM CHLORIDE ERY
X-VIATE
Y
HYOSCYAMINE SULFATE Y
COMPRO
Y
CALCIUM ACETATE
Y
AMOXICILLIN
Y
METFORMIN HCL
Y
PAROXETINE HCL
Y
HYDROCHLOROTHIAZIDEY
HYDROCORTISONE
Y
ZONISAMIDE
Y
PROMETHAZINE HCL
Y
PRAVASTATIN SODIUM Y
METHOCARBAMOL
Y
AMOXICILLIN/CLAVULANATE
Y P
CIPROFLOXACIN HCL
Y
SIMVASTATIN
Y
TIMOLOL MALEATE
Y
VANDAZOLE
Y
ONDANSETRON ODT
Y
PREDNISOLONE
Y
VERAPAMIL HCL ER
Y
ENALAPRIL MALEATE/HYDROCH
Y
IBUPROFEN
Y
AMOXICILLIN
Y
HYDROCHLOROTHIAZIDEY
NAPROXEN SODIUM
Y
SIMVASTATIN
Y
TERAZOSIN HCL
Y
ALLOPURINOL
Y
CIMETIDINE
Y
V-C FORTE
Y
VALACYCLOVIR HCL
Y
OFLOXACIN
Y
CARVEDILOL
Y
QUETIAPINE FUMARATE Y
LOSARTAN POTASSIUM Y
TIZANIDINE HCL
Y
FUROSEMIDE
Y
RISPERIDONE
Y
BENZONATATE
Y
CVS ALLERGY RELIEF
Y
CARISOPRODOL
Y
ALPRAZOLAM
Y
GABAPENTIN
Y
RANITIDINE SYP 15MG/ML
HYDROXYZ PAM CAP 25MG
ZALEPLON CAP 5MG
HOMATROPINE SOL 5% OP
METRONIDAZOL TAB 250MG
VITAMIN D CHW 1000UNIT
TRETINOIN GEL 0.025%
OXYCOD/APAP TAB 2.5-325
METHOTREXATE INJ 50MG/2ML
BENAZEPRIL TAB 5MG
AMLODIPINE TAB 5MG
METHYLPRED TAB 4MG
PRAVASTATIN TAB 20MG
ONDANSETRON TAB 8MG ODT
BACLOFEN TAB 10MG
TRAMADL/APAP TAB 37.5-325
BENZTROPINE TAB 0.5MG
SPIRONOLACT TAB 25MG
DICLOFENAC TAB 75MG DR
PROPRANOLOL CAP 160MG ER
AMLODIPINE TAB 10MG
CLONIDINE TAB 0.2MG
ECONAZOLE CRE 1%
ALLOPURINOL TAB 300MG
METOPROLOL TAB 25MG ER
IBUPROFEN TAB 800MG
POT CL MICRO TAB 20MEQ ER
X-VIATE CRE 40%
HYOSCYAMINE SUB 0.125MG
COMPRO
SUP 25MG
CALC ACETATE TAB 667MG
AMOXICILLIN SUS 400/5ML
METFORMIN TAB 500MG
PAROXETINE TAB 10MG
HYDROCHLOROT CAP 12.5MG
HYDROCORT OIN 2.5%
ZONISAMIDE CAP 25MG
PROMETHAZINE TAB 25MG
PRAVASTATIN TAB 20MG
METHOCARBAM TAB 750MG
AMOX/K CLAV SUS 200/5ML
CIPROFLOXACN TAB 500MG
SIMVASTATIN TAB 40MG
TIMOLOL MAL SOL 0.5% OP
VANDAZOLE GEL 0.75%
ONDANSETRON TAB 4MG ODT
PREDNISOLONE SOL 15MG/5ML
VERAPAMIL TAB 180MG ER
ENALAPR/HCTZ TAB 10-25MG
IBUPROFEN TAB 800MG
AMOXICILLIN SUS 250/5ML
HYDROCHLOROT CAP 12.5MG
NAPROXEN SOD TAB 550MG
SIMVASTATIN TAB 80MG
TERAZOSIN CAP 5MG
ALLOPURINOL TAB 300MG
CIMETIDINE TAB 400MG
V-C FORTE CAP
VALACYCLOVIR TAB 500MG
OFLOXACIN DRO 0.3% OP
CARVEDILOL TAB 12.5MG
QUETIAPINE TAB 25MG
LOSARTAN POT TAB 100MG
TIZANIDINE TAB 4MG
FUROSEMIDE TAB 20MG
RISPERIDONE TAB 0.25MG
BENZONATATE CAP 100MG
CVS ALLERGY TAB 180MG
CARISOPRODOL TAB 350MG
ALPRAZOLAM TAB 0.5MG
GABAPENTIN CAP 400MG
6
9
1
1
2
2
1
1
1
2
3
1
1
1
1
1
1
1
3
1
2
1
1
1
1
3
1
2
1
1
1
6
5
2
2
4
2
3
1
2
1
6
10
3
1
1
10
1
0
1
4
3
4
4
2
1
1
1
1
1
2
2
1
2
5
1
3
2
3
8
1
690
345
90
5
80
120
15
15
10
180
150
21
90
15
90
90
180
180
240
30
180
540
30
90
30
270
90
57
60
6
42
500
660
180
180
160
120
90
90
150
200
114
450
40
70
15
370
90
85
270
700
150
210
360
180
90
60
90
14
5
240
150
30
90
540
30
110
60
180
420
270
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 190
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
67877029505
57664010788
00781140701
00093312301
00054022125
00185082001
00603211593
08290306500
16714063301
68180089313
00574416035
29300013005
43353073630
59746038606
00378459710
68382018001
29300018813
52343003199
00603210934
00591034805
60429031101
00168000315
00378015210
00172531270
50383074120
00603321432
00904634380
49884002701
00472016330
65862005399
13668011590
51672125901
49884094601
76282041990
65862002801
65862007175
00378502291
00054010122
29300024210
67544051030
63304050401
65862001801
60258000316
53746010201
49884031002
00555083202
43598020850
00185014501
00168002031
63304057901
00378258610
61314029705
68382013510
60429011805
00363091530
68462018117
00143973910
76282025190
43478090288
23155029151
51079073401
29300011101
76204020030
13668001101
11917011820
68462022555
00093611887
43547033510
50383024116
53746046500
00378043305
IBUPROFEN
Y
PROMETHAZINE HCL
Y
HYDROXYCHLOROQUINEYSULFAT
DICLOXACILLIN SODIUM Y
QUETIAPINE FUMARATE Y
BENAZEPRIL HCL
Y
ALLOPURINOL
Y
NORMAL SALINE FLUSH FOR
Y F
ALENDRONATE SODIUM Y
PIRMELLA 1/35
Y
NEOMYCIN/POLYMYXIN/DEXAME
Y
HYDROCHLOROTHIAZIDEY
PANTOPRAZOLE SODIUMY
TERAZOSIN HCL
Y
METOPROLOL SUCCINATE
Y ER
BUSPIRONE HCL
Y
BISOPROLOL FUMARATE/HYDRO
Y
GABAPENTIN
Y
AMLODIPINE BESYLATE Y
TRIAMTERENE/HYDROCHLOROTH
Y
ETODOLAC
Y
TRIAMCINOLONE ACETONIDE
Y
CLONIDINE HCL
Y
CIPROFLOXACIN HCL
Y
ALBUTEROL SULFATE Y
DIAZEPAM
Y
METFORMIN HCL
Y
HYDRALAZINE HCL
Y
NYSTATIN
Y
SIMVASTATIN
Y
LOSARTAN POTASSIUM Y
CLOBETASOL PROPIONATE
Y
TRAMADOL HYDROCHLORIDE/AC
Y
LISINOPRIL
Y
GLYBURIDE
Y
AMOXICILLIN
Y
ALPRAZOLAM ER
Y
AMLODIPINE BESYLATE Y
AMLODIPINE BESYLATE Y
OMEPRAZOLE
Y
ACYCLOVIR
Y
CEPHALEXIN
Y
CYTRA-K
Y
GABAPENTIN
Y
CLONAZEPAM ODT
Y
WARFARIN SODIUM
Y
AMOXICILLIN/CLAVULANATE
Y P
NABUMETONE
Y
HYDROCORTISONE
Y
METOPROLOL TARTRATEY
HYDROXYZINE HCL
Y
SULFACETAMIDE SODIUM/PRED
Y
LOSARTAN POTASSIUM Y
METHOCARBAMOL
Y
OMEPRAZOLE
M
CLOTRIMAZOLE
Y
PREDNISONE
Y
ESCITALOPRAM OXALATEY
PROPRANOLOL HCL ER Y
RANITIDINE HCL
Y
HALOPERIDOL
Y
LAMOTRIGINE
Y
ALBUTEROL SULFATE Y
CITALOPRAM HYDROBROMIDE
Y
VITAMIN D3
Y
MOMETASONE FUROATEY
PREDNISOLONE
Y
BENAZEPRIL HCL
Y
LEVETIRACETAM
Y
IBUPROFEN
Y
BUPROPION HCL
Y
IBUPROFEN TAB 600MG
PROMETHAZINE TAB 12.5MG
HYDROXYCHLOR TAB 200MG
DICLOXACILL CAP 250MG
QUETIAPINE TAB 100MG
BENAZEPRIL TAB 20MG
ALLOPURINOL TAB 100MG
NORMAL SALIN INJ 0.9%
ALENDRONATE TAB 70MG
PIRMELLA TAB 1/35
NEO/POLY/DEX OIN 0.1% OP
HYDROCHLOROT CAP 12.5MG
PANTOPRAZOLE TAB 40MG
TERAZOSIN CAP 10MG
METOPROLOL TAB 100MG ER
BUSPIRONE TAB 5MG
BISOPRL/HCTZ TAB 5-6.25MG
GABAPENTIN CAP 300MG
AMLODIPINE TAB 5MG
TRIAMT/HCTZ TAB 75-50MG
ETODOLAC TAB 400MG
TRIAMCINOLON CRE 0.025%
CLONIDINE TAB 0.1MG
CIPROFLOXACN TAB 500MG
ALBUTEROL NEB 0.5%
DIAZEPAM TAB 5MG
METFORMIN TAB 500MG
HYDRALAZINE TAB 25MG
NYSTATIN CRE 100000
SIMVASTATIN TAB 40MG
LOSARTAN POT TAB 100MG
CLOBETASOL OIN 0.05%
TRAMADL/APAP TAB 37.5-325
LISINOPRIL TAB 10MG
GLYBURIDE TAB 1.25MG
AMOXICILLIN SUS 400/5ML
ALPRAZOLAM TAB 1MG ER
AMLODIPINE TAB 5MG
AMLODIPINE TAB 5MG
OMEPRAZOLE CAP 20MG
ACYCLOVIR TAB 400MG
CEPHALEXIN CAP 250MG
CYTRA-K SOL
GABAPENTIN CAP 300MG
CLONAZEP ODT TAB 2MG
WARFARIN TAB 2.5MG
AMOX/K CLAV SUS 400/5ML
NABUMETONE TAB 500MG
HYDROCORT OIN 1%
METOPROL TAR TAB 25MG
HYDROXYZ HCL TAB 10MG
SULF/PRED NA SOL OP
LOSARTAN POT TAB 25MG
METHOCARBAM TAB 500MG
OMEPRAZOLE TAB 20MG
CLOTRIMAZOLE CRE 1%
PREDNISONE TAB 10MG
ESCITALOPRAM TAB 20MG
PROPRANOLOL CAP 120MG ER
RANITIDINE SYP 15MG/ML
HALOPERIDOL TAB 1MG
LAMOTRIGINE TAB 25MG
ALBUTEROL NEB 0.083%
CITALOPRAM TAB 40MG
VITAMIN D3 CAP 1000UNIT
MOMETASONE OIN 0.1%
PREDNISOLONE SOL 15MG/5ML
BENAZEPRIL TAB 5MG
LEVETIRACETA SOL 100MG/ML
IBUPROFEN TAB 600MG
BUPROPION TAB 75MG
7
4
1
1
1
2
1
1
2
2
1
2
1
2
1
5
1
1
5
1
1
3
1
2
2
9
2
1
1
1
1
1
1
2
2
4
2
2
2
3
1
3
1
1
1
1
1
1
6
4
2
1
1
2
1
5
2
1
1
2
1
3
1
2
4
1
9
2
2
7
1
262
120
60
28
90
180
90
300
24
56
4
180
30
150
90
450
180
540
225
90
60
75
150
34
40
296
240
60
30
90
90
15
60
180
90
550
60
180
180
90
15
89
300
180
12
90
100
60
198
210
200
10
90
240
28
90
162
15
14
630
90
190
90
180
480
45
290
180
120
261
30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 191
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
59762372203
43478090188
00603441621
59746024760
00363078429
53746046400
62756044605
00093412773
00781603955
43598022401
00904615760
00093406710
54458098910
00378145405
00378072419
00378232101
00591041150
53489047901
60505311003
00093403001
67544047553
42291072410
00781196601
68382003506
60429029505
51672413001
45802011937
00093220301
51672411704
60429003210
00378051201
16729000610
00781224801
68462035201
50458059360
00172428660
00168026515
00093005801
16714050101
00591093201
68382009501
57664050652
00093947753
54458090702
00591065805
00378672601
11845014775
16714065202
65862014301
47335060688
68382041205
47335060418
00781138101
10702001110
00378623305
16571041210
59762372103
60505026001
55111072901
67457022102
00904623420
68645048770
52343002399
43598021901
68180024108
00603374021
00555088704
58657050016
68462040601
00904530920
00185001005
ALPRAZOLAM
Y
PROPRANOLOL HCL ER Y
MEPERITAB
Y
LAMOTRIGINE
Y
WAL-FEX ALLERGY
Y
IBUPROFEN
Y
CARISOPRODOL
Y
PENICILLIN V POTASSIUMY
AMOXICILLIN
Y
AMOXICILLIN
Y
VITAMIN D
Y
PRAZOSIN HCL
Y
PAROXETINE HCL
Y
ESTRADIOL
Y
TIZANIDINE HCL
Y
LORAZEPAM
Y
DOXYCYCLINE MONOHYDRATE
Y
SULINDAC
Y
OLANZAPINE
Y
INDOMETHACIN
Y
NAPROXEN
Y
RANITIDINE HCL
Y
FUROSEMIDE
Y
VENLAFAXINE HCL ER Y
HYDROXYZINE PAMOATEY
LAMOTRIGINE
Y
MOMETASONE FUROATEY
METOCLOPRAMIDE HCL Y
NYSTATIN
Y
CARBAMAZEPINE
Y
VERAPAMIL HCL
Y
SIMVASTATIN
Y
DICLOXACILLIN SODIUM Y
HYDROXYZINE HCL
Y
RISPERIDONE
Y
VERAPAMIL HCL ER
Y
AUGMENTED BETAMETHASONE
Y
D
TRAMADOL HCL
Y
TERBINAFINE HCL
Y
OXYCODONE/ACETAMINOPHEN
Y
CARVEDILOL
Y
METOPROLOL TARTRATEY
GLYBURIDE
M
LISINOPRIL/HYDROCHLOROTHI
Y
BUSPIRONE HCL
Y
ZONISAMIDE
Y
D 1000
Y
CIPROFLOXACIN HCL
Y
CARVEDILOL
Y
ALPRAZOLAM
Y
OMEPRAZOLE
Y
ALPRAZOLAM
Y
DICLOFENAC SODIUM ERY
HYDROXYZINE HCL
Y
CITALOPRAM HYDROBROMIDE
Y
CIPROFLOXACIN HCL
Y
ALPRAZOLAM
Y
METFORMIN HCL ER
Y
ALLOPURINOL
Y
METHOTREXATE SODIUMY
LORATADINE CHILDRENSY
SERTRALINE HCL
Y
SIMVASTATIN
Y
AMOXICILLIN
Y
LEVOFLOXACIN
Y
FUROSEMIDE
Y
ESTRADIOL
Y
GUAIFENESIN/CODEINE Y
INDOMETHACIN
Y
CHILDRENS IBUPROFEN Y
LABETALOL HCL
Y
ALPRAZOLAM TAB 2MG
PROPRANOLOL CAP 80MG ER
MEPERITAB TAB 100MG
LAMOTRIGINE TAB 150MG
WAL-FEX ALLR TAB 180MG
IBUPROFEN TAB 400MG
CARISOPRODOL TAB 350MG
PENICILLN VK SOL 250/5ML
AMOXICILLIN SUS 125/5ML
AMOXICILLIN TAB 500MG
VITAMIN D TAB 2000UNIT
PRAZOSIN HCL CAP 1MG
PAROXETINE TAB 20MG
ESTRADIOL TAB 1MG
TIZANIDINE TAB 4MG
LORAZEPAM TAB 0.5MG
DOXYCYC MONO CAP 100MG
SULINDAC TAB 200MG
OLANZAPINE TAB 2.5MG
INDOMETHACIN CAP 50MG
NAPROXEN TAB 500MG
RANITIDINE TAB 150MG
FUROSEMIDE TAB 40MG
VENLAFAXINE CAP 75MG ER
HYDROXYZ PAM CAP 50MG
LAMOTRIGINE TAB 25MG
MOMETASONE OIN 0.1%
METOCLOPRAM TAB 10MG
NYSTATIN SUS 100000
CARBAMAZEPIN TAB 200MG
VERAPAMIL TAB 80MG
SIMVASTATIN TAB 40MG
DICLOXACILL CAP 250MG
HYDROXYZ HCL TAB 10MG
RISPERIDONE TAB 2MG
VERAPAMIL TAB 180MG ER
AUG BETAMET CRE 0.05%
TRAMADOL HCL TAB 50MG
TERBINAFINE TAB 250MG
OXYCOD/APAP TAB 10-325MG
CARVEDILOL TAB 25MG
METOPROL TAR TAB 25MG
GLYBURIDE TAB 1.25MG
LISINOP/HCTZ TAB 10-12.5
BUSPIRONE TAB 10MG
ZONISAMIDE CAP 50MG
D 1000
CAP 1000UNIT
CIPROFLOXACN TAB 500MG
CARVEDILOL TAB 6.25MG
ALPRAZOLAM TAB 2MG
OMEPRAZOLE CAP 20MG
ALPRAZOLAM TAB 0.5MG
DICLOFENAC TAB 100MG ER
HYDROXYZ HCL TAB 25MG
CITALOPRAM TAB 40MG
CIPROFLOXACN TAB 500MG
ALPRAZOLAM TAB 1MG
METFORMIN TAB 500MG ER
ALLOPURINOL TAB 100MG
METHOTREXATE INJ 50MG/2ML
LORATADINE SOL 5MG/5ML
SERTRALINE TAB 25MG
SIMVASTATIN TAB 20MG
AMOXICILLIN TAB 875MG
LEVOFLOXACIN TAB 500MG
FUROSEMIDE TAB 40MG
ESTRADIOL TAB 2MG
GG/CODEINE SOL 100-10/5
INDOMETHACIN CAP 25MG
IBUPROFEN SUS 100/5ML
LABETALOL TAB 100MG
2
1
1
2
1
9
3
2
6
3
4
2
3
2
3
10
2
1
1
2
5
2
4
1
3
1
2
3
1
1
2
1
1
5
1
1
1
8
2
1
1
1
3
2
3
1
2
2
1
3
2
3
1
1
2
7
4
2
2
1
2
2
10
2
2
3
4
1
1
3
1
82
14
40
75
30
300
210
500
900
55
420
60
150
180
74
360
34
60
90
120
300
210
630
42
210
60
45
171
60
180
180
90
40
230
90
30
60
590
114
15
180
120
90
120
240
30
180
28
180
270
40
150
30
120
180
92
210
90
180
10
240
180
675
28
14
210
165
240
60
360
60
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 192
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378226401
76439013611
00121077001
00378071201
43386016106
00172392780
00185010101
00054418025
00172290780
53489021701
00781205405
57664024218
00115147256
67253090050
23155005801
00781537701
16714058102
00591533501
43386053001
00228253810
64125013110
00406036562
45802041926
16729000510
00378014491
42543070010
00185006405
51079013163
00574402435
64679071801
11917012698
00517003225
00591252005
00603295828
00555048401
00904634060
00363008816
00378104910
59762004901
55111029136
00713063231
00093013001
68180024201
23155006501
00781150710
42291061010
43547035910
47469000288
62037064001
31604002585
00172531360
00093444301
62756020201
00603295721
00703367501
51672403103
00378031701
45802095226
00603533832
45802000403
00603616128
00378521077
59762154003
00378510501
23155006401
00781572001
65862001001
00591080005
61314029405
00591397301
00603233822
TERAZOSIN HCL
Y
TRAMADOL HCL
Y
LORAZEPAM
Y
ENALAPRIL MALEATE/HYDROCH
Y
MISOPROSTOL
Y
DIAZEPAM
Y
LISINOPRIL
Y
DEXAMETHASONE
Y
FUROSEMIDE
Y
CLONIDINE HCL
Y
TERAZOSIN HCL
Y
CARVEDILOL
Y
AUGMENTED BETAMETHASONE
Y
D
ALPRAZOLAM
Y
GLYBURIDE
Y
LORAZEPAM
Y
LOSARTAN POTASSIUM Y
TRIHEXYPHENIDYL HCL Y
NYSTATIN
Y
CARBIDOPA/LEVODOPA Y
HYDROCHLOROTHIAZIDEY
HYDROCODONE/ACETAMINOPHEN
Y
AMMONIUM LACTATE Y
SIMVASTATIN
Y
TAMOXIFEN CITRATE
Y
CARISOPRODOL
Y
CLONAZEPAM
Y
AMITRIPTYLINE HCL
Y
ERYTHROMYCIN
Y
VENLAFAXINE HCL ER Y
VITAMIN D3
Y
CYANOCOBALAMIN
Y
CHLORZOXAZONE
Y
CLONIDINE HCL
Y
LEUCOVORIN CALCIUM Y
METOPROLOL TARTRATEY
WAL-ITIN
Y
DOXEPIN HCL
Y
METHYLPREDNISOLONE Y
SUMATRIPTAN SUCCINATE
Y
FLUTICASONE PROPIONATE
Y
ESTAZOLAM
Y
LEVOFLOXACIN
Y
METRONIDAZOLE
Y
ATENOLOL
Y
METFORMIN HCL ER
Y
METFORMIN HCL
Y
COQ-10
Y
OMEPRAZOLE
Y
VITAMIN D
Y
CIPROFLOXACIN HCL
Y
GABAPENTIN
Y
GABAPENTIN
Y
CLONIDINE HCL
Y
METHOTREXATE SODIUMY
WARFARIN SODIUM
Y
CIMETIDINE
Y
IBUPROFEN
Y
PREDNISONE
Y
HYDROCORTISONE
Y
TRAZODONE HCL
Y
AMLODIPINE BESYLATE Y
AMLODIPINE BESYLATE Y
PROCHLORPERAZINE MALEATE
Y
METRONIDAZOLE
Y
POTASSIUM CHLORIDE ERY
METFORMIN HCL
Y
HYDROXYZINE PAMOATEY
DEXAMETHASONE SODIUM
Y PHOS
GLIPIZIDE/METFORMIN HCL
Y
ACETAMINOPHEN/CODEINE
Y #3
TERAZOSIN CAP 2MG
TRAMADOL HCL TAB 50MG
LORAZEPAM CON 2MG/ML
ENALAPR/HCTZ TAB 5-12.5MG
MISOPROSTOL TAB 200MCG
DIAZEPAM TAB 10MG
LISINOPRIL TAB 10MG
DEXAMETHASON TAB 0.75MG
FUROSEMIDE TAB 40MG
CLONIDINE TAB 0.3MG
TERAZOSIN CAP 10MG
CARVEDILOL TAB 3.125MG
AUG BETAMET CRE 0.05%
ALPRAZOLAM TAB 0.25MG
GLYBURIDE TAB 5MG
LORAZEPAM TAB 1MG
LOSARTAN POT TAB 25MG
TRIHEXYPHEN TAB 2MG
NYSTATIN POW 100000
CARB/LEVO TAB 10-100MG
HYDROCHLOROT TAB 25MG
HYDROCO/APAP TAB 5-325MG
AMMONIUM LAC LOT 12%
SIMVASTATIN TAB 20MG
TAMOXIFEN TAB 10MG
CARISOPRODOL TAB 350MG
CLONAZEPAM TAB 1MG
AMITRIPTYLIN TAB 10MG
ERYTHROMYCIN OIN 5MG/GM
VENLAFAXINE CAP 150MG ER
VITAMIN D3 CAP 2000UNIT
CYANOCOBALAM INJ 1000MCG
CHLORZOXAZON TAB 500MG
CLONIDINE TAB 0.2MG
LEUCOVOR CA TAB 5MG
METOPROL TAR TAB 25MG
WAL-ITIN SYP 5MG/5ML
DOXEPIN HCL CAP 10MG
METHYLPRED TAB 8MG
SUMATRIPTAN TAB 25MG
FLUTICASONE OIN 0.005%
ESTAZOLAM TAB 2MG
LEVOFLOXACIN TAB 750MG
METRONIDAZOL TAB 500MG
ATENOLOL TAB 100MG
METFORMIN TAB 500MG ER
METFORMIN TAB 1000MG
COQ-10
CAP 100MG
OMEPRAZOLE CAP 40MG
VITAMIN D CAP 2000UNIT
CIPROFLOXACN TAB 750MG
GABAPENTIN TAB 600MG
GABAPENTIN TAB 600MG
CLONIDINE TAB 0.1MG
METHOTREXATE INJ 250/10ML
WARFARIN TAB 4MG
CIMETIDINE TAB 300MG
IBUPROFEN SUS 100/5ML
PREDNISONE TAB 10MG
HYDROCORT CRE 2.5%
TRAZODONE TAB 100MG
AMLODIPINE TAB 10MG
AMLODIPINE TAB 10MG
PROCHLORPER TAB 5MG
METRONIDAZOL TAB 250MG
POT CL MICRO TAB 20MEQ ER
METFORMIN TAB 1000MG
HYDROXYZ PAM CAP 25MG
DEXAMETH PHO SOL 0.1% OP
GLIP/METFORM TAB 5-500MG
APAP/CODEINE TAB 300-30MG
3
4
2
1
8
4
4
4
1
1
1
1
1
6
2
2
2
6
1
1
7
3
1
1
1
2
2
2
1
1
4
1
1
1
2
7
1
1
1
1
1
1
2
1
1
2
2
1
1
2
3
1
1
4
2
2
1
2
3
4
3
1
1
5
1
2
2
4
1
1
2
150
560
18
90
16
184
450
135
270
90
90
180
50
330
104
90
60
274
15
90
540
65
400
90
60
210
120
120
4
30
240
30
30
90
16
420
300
60
18
9
30
30
17
30
90
270
270
30
14
180
48
30
30
300
20
120
60
360
115
112
270
90
90
108
56
25
180
167
5
20
120
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 193
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
64679096401
00093506105
63304062401
42291020950
13107005901
62037052405
50383077932
27241000406
00591081083
49884030602
65862019999
60505019000
43547034903
00781540605
43292055538
61314001205
50383028210
50428040525
42806001201
29300011105
16714008212
68001021306
64376013201
50383082316
54458093410
60258016001
00378531001
00093013501
00378001891
16729017201
68001012904
60505020801
00185010201
51079010363
60432024516
00228212750
00338000404
64980030760
59746024402
00228300411
00228308406
61314022605
31604001870
00517003125
43386071009
64854003101
50428925507
50111046901
42192033001
23155000201
00245005890
23155004501
00591079410
60429020310
00904634593
00172572880
00185007201
00143988675
68382009806
24208031705
00781572010
00527128201
00378082501
00603448528
00378401201
00143147705
11917014360
45802041954
16714061101
54458094710
59762105002
AZITHROMYCIN
Y
HYDROXYZINE HCL
Y
FUROSEMIDE
Y
CEPHALEXIN
Y
ACETAMINOPHEN/CODEINE
Y PHO
HYDROCODONE/IBUPROFEN
Y
LACTULOSE
Y
RISPERIDONE
Y
SILVER SULFADIAZINE Y
CLONAZEPAM ODT
Y
GABAPENTIN
Y
METFORMIN HCL
Y
PAROXETINE HCL
Y
LORAZEPAM
Y
VITAMIN B-2
Y
OFLOXACIN
Y
CIPROFLOXACIN HCL
Y
CVS ALLERGY RELIEF CHILDR
Y
MECLIZINE HCL
Y
LAMOTRIGINE
Y
HYDROXYZINE HCL
Y
LOVASTATIN
Y
LEVOFLOXACIN
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
SIMVASTATIN
Y
RENA-VITE
Y
ZOLPIDEM TARTRATE Y
CARVEDILOL
Y
METOPROLOL TARTRATEY
AMITRIPTYLINE HCL
Y
FLUOXETINE HCL
Y
ENALAPRIL MALEATE/HYDROCH
Y
LISINOPRIL
Y
SPIRONOLACTONE
Y
ACETAMINOPHEN/CODEINE
Y
CLONIDINE HCL
Y
STERILE WATER IRRIGATION
Y
DENTAGEL
Y
ALENDRONATE SODIUM Y
CLONAZEPAM
Y
ALPRAZOLAM ER
Y
TIMOLOL MALEATE
Y
VITAMIN D
Y
CYANOCOBALAMIN
Y
QUINAPRIL/HYDROCHLOROTHIA
Y
FLUORIDEX DAILY DEFENSE
Y S
CVS ALLERGY RELIEF
Y
PROPRANOLOL HCL
Y
NP THYROID 60
Y
HYDRALAZINE HCL
Y
KLOR-CON M20
Y
HYDROCHLOROTHIAZIDEY
DICYCLOMINE HCL
Y
LISINOPRIL/HYDROCHLOROTHI
Y
METFORMIN HCL
Y
FAMOTIDINE
Y
LOVASTATIN
Y
AMOXICILLIN
Y
PAROXETINE HCL
Y
SULFACETAMIDE SODIUM/PRED
Y
POTASSIUM CHLORIDE ERY
DICYCLOMINE HCL
Y
CLOZAPINE
Y
METHOCARBAMOL
Y
GLIMEPIRIDE
Y
PREDNISONE
Y
VITAMIN D3
Y
AMMONIUM LACTATE Y
SERTRALINE HCL
Y
SERTRALINE HCL
Y
AMOXICILLIN
Y
AZITHROMYCIN TAB 500MG
HYDROXYZ HCL TAB 25MG
FUROSEMIDE TAB 20MG
CEPHALEXIN CAP 500MG
APAP/CODEINE TAB 300-30MG
HYDROCOD/IBU TAB 7.5-200
LACTULOSE SOL 10GM/15
RISPERIDONE TAB 2MG
SILVER SULFA CRE 1%
CLONAZEP ODT TAB 0.125MG
GABAPENTIN CAP 300MG
METFORMIN TAB 500MG
PAROXETINE TAB 30MG
LORAZEPAM TAB 1MG
VITAMIN B-2 TAB 25MG
OFLOXACIN DRO 0.3% OP
CIPROFLOXACN SOL 0.3% OP
ALLERGY RELF SYP 5MG/5ML
MECLIZINE TAB 12.5MG
LAMOTRIGINE TAB 25MG
HYDROXYZ HCL TAB 25MG
LOVASTATIN TAB 10MG
LEVOFLOXACIN TAB 750MG
SMZ-TMP SUS 200-40/5
SIMVASTATIN TAB 10MG
RENA-VITE TAB
ZOLPIDEM TAB 10MG
CARVEDILOL TAB 6.25MG
METOPROL TAR TAB 25MG
AMITRIPTYLIN TAB 25MG
FLUOXETINE CAP 40MG
ENALAPR/HCTZ TAB 5-12.5MG
LISINOPRIL TAB 20MG
SPIRONOLACT TAB 25MG
APAP/CODEINE SOL 120-12/5
CLONIDINE TAB 0.1MG
STERIL WATER SOL IRRIG
DENTAGEL GEL 1.1%
ALENDRONATE TAB 70MG
CLONAZEPAM TAB 1MG
ALPRAZOLAM TAB 1MG ER
TIMOLOL MAL SOL 0.25% OP
VITAMIN D TAB 1000UNIT
CYANOCOBALAM INJ 1000MCG
QNAPRIL/HCTZ TAB 10-12.5
FLUORIDEX DD PST SENSITIV
ALLERGY RELF CAP 10MG
PROPRANOLOL TAB 40MG
NP THYROID TAB 60MG
HYDRALAZINE TAB 25MG
KLOR-CON M20 TAB 20MEQ ER
HYDROCHLOROT CAP 12.5MG
DICYCLOMINE CAP 10MG
LISINOP/HCTZ TAB 20-25MG
METFORMIN TAB 1000MG
FAMOTIDINE TAB 20MG
LOVASTATIN TAB 20MG
AMOXICILLIN SUS 200/5ML
PAROXETINE TAB 20MG
SULF/PRED NA SOL OP
POT CL MICRO TAB 20MEQ ER
DICYCLOMINE TAB 20MG
CLOZAPINE TAB 25MG
METHOCARBAM TAB 500MG
GLIMEPIRIDE TAB 2MG
PREDNISONE TAB 20MG
VITAMIN D3 CAP 5000UNIT
AMMONIUM LAC LOT 12%
SERTRALINE TAB 25MG
SERTRALINE TAB 25MG
AMOXICILLIN TAB 875MG
1
1
3
4
5
1
1
1
3
1
1
1
1
2
11
1
1
3
2
1
1
1
2
1
1
1
10
1
1
1
1
1
1
1
2
3
1
3
1
4
1
4
1
2
1
1
2
2
1
1
1
1
1
1
1
1
1
2
3
1
2
3
2
4
2
4
3
1
2
2
1
3
120
270
105
99
20
946
90
75
10
60
360
90
60
590
5
10
275
75
45
30
90
24
400
30
90
420
180
180
90
90
90
90
90
893
420
7,000
168
4
180
30
20
250
4
30
112
28
180
30
90
30
90
180
90
180
180
90
300
90
5
24
140
14
100
60
115
90
225
120
120
20
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 194
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
50383028202
00574402135
16714062101
00115201101
55111019905
16714069210
50383028205
43353094380
50532011210
51991075933
31722054301
50111064802
00378021801
00603243332
63304065201
59762501701
67877029405
69097012815
76439010450
76439010110
59762105005
11917011540
68382002301
00378302001
00904598660
00904585540
16714061306
00093003905
50111064702
16571010150
50742010701
64679017103
45963055550
49348096844
68645049354
00591048805
00115147345
31722042210
00603424621
13107000505
00378258701
55111073001
00378054101
68382018105
00904572889
00591086105
49884068501
00378162005
00713013212
10572010101
68462019001
00093172101
52376002102
55111072910
13668000901
67877017030
00093913306
00093081205
00378110110
00093412574
00378018101
00781167931
00093081105
60505016401
00093816601
49884029001
65162003310
00065074112
31722054201
64679092906
67253090011
CIPROFLOXACIN HCL
Y
POLYCIN
Y
ZOLPIDEM TARTRATE Y
ORPHENADRINE CITRATEYER
SIMVASTATIN
Y
FLUCONAZOLE
Y
CIPROFLOXACIN HCL
Y
METOPROLOL TARTRATEY
HYOSCYAMINE SULFATE Y
LETROZOLE
Y
INDOMETHACIN
Y
FLUOXETINE HCL
Y
ATENOLOL
Y
BENZTROPINE MESYLATEY
ACYCLOVIR
Y
FLUCONAZOLE
Y
IBUPROFEN
Y
AMLODIPINE BESYLATE Y
AMOXICILLIN
Y
CEPHALEXIN
Y
AMOXICILLIN
Y
VITAMIN D3
Y
ATENOLOL
Y
FAMOTIDINE
Y
VITAMIN D3
Y
IBUPROFEN
Y
SERTRALINE HCL
Y
LAMOTRIGINE
Y
FLUOXETINE HCL
Y
DICLOFENAC SODIUM Y
METOPROLOL TARTRATEY
ROPINIROLE HCL
Y
GABAPENTIN
Y
SM FEXOFENADINE HCL Y
ATENOLOL
Y
ESTRADIOL
Y
FLUTICASONE PROPIONATE
Y
LISINOPRIL
Y
LORAZEPAM
Y
CITALOPRAM HYDROBROMIDE
Y
HYDROXYZINE HCL
Y
ALLOPURINOL
Y
CIMETIDINE
Y
BUSPIRONE HCL
Y
ALLERGY
Y
LISINOPRIL/HYDROCHLOROTHI
Y
METOCLOPRAMIDE HCL Y
DICYCLOMINE HCL
Y
PROMETHEGAN
Y
PEG-3350/ELECTROLYTESY
NAPROXEN
Y
WARFARIN SODIUM
Y
PAROEX
Y
ALLOPURINOL
Y
CITALOPRAM HYDROBROMIDE
Y
ONDANSETRON HCL
Y
AMIODARONE HCL
Y
NORTRIPTYLINE HCL
Y
PRAZOSIN HCL
Y
PENICILLIN V POTASSIUMY
ALLOPURINOL
Y
ONDANSETRON HCL
Y
NORTRIPTYLINE HCL
Y
FLUVOXAMINE MALEATEY
QUETIAPINE FUMARATE Y
MEGESTROL ACETATE Y
ACETAMINOPHEN/CODEINE
Y PHO
TETRACAINE HCL
Y
INDOMETHACIN
Y
LISINOPRIL
Y
ALPRAZOLAM
Y
CIPROFLOXACN SOL 0.3% OP
POLYCIN OIN OP
ZOLPIDEM TAB 5MG
ORPHENADRINE TAB 100MG ER
SIMVASTATIN TAB 20MG
FLUCONAZOLE TAB 150MG
CIPROFLOXACN SOL 0.3% OP
METOPROL TAR TAB 50MG
HYOSCYAMINE TAB 0.125MG
LETROZOLE TAB 2.5MG
INDOMETHACIN CAP 50MG
FLUOXETINE CAP 20MG
ATENOLOL TAB 25MG
BENZTROPINE TAB 0.5MG
ACYCLOVIR CAP 200MG
FLUCONAZOLE TAB 150MG
IBUPROFEN TAB 400MG
AMLODIPINE TAB 10MG
AMOXICILLIN CAP 500MG
CEPHALEXIN CAP 250MG
AMOXICILLIN TAB 875MG
VITAMIN D3 CAP 5000UNIT
ATENOLOL TAB 50MG
FAMOTIDINE TAB 20MG
VITAMIN D3 CAP 5000UNIT
IBUPROFEN TAB 800MG
SERTRALINE TAB 100MG
LAMOTRIGINE TAB 25MG
FLUOXETINE CAP 10MG
DICLOFENAC SOL 0.1% OP
METOPROL TAR TAB 25MG
ROPINIROLE TAB 1MG
GABAPENTIN CAP 100MG
FEXOFENADINE TAB 180MG
ATENOLOL TAB 50MG
ESTRADIOL TAB 2MG
FLUTICASONE CRE 0.05%
LISINOPRIL TAB 40MG
LORAZEPAM TAB 0.5MG
CITALOPRAM TAB 10MG
HYDROXYZ HCL TAB 25MG
ALLOPURINOL TAB 300MG
CIMETIDINE TAB 800MG
BUSPIRONE TAB 10MG
ALLERGY TAB 10MG
LISINOP/HCTZ TAB 20-12.5
METOCLOPRAM TAB 10MG
DICYCLOMINE TAB 20MG
PROMETHEGAN SUP 50MG
PEG-3350 SOL ELECTROL
NAPROXEN TAB 500MG
WARFARIN TAB 5MG
PAROEX
SOL 0.12%
ALLOPURINOL TAB 100MG
CITALOPRAM TAB 10MG
ONDANSETRON TAB 8MG
AMIODARONE TAB 200MG
NORTRIPTYLIN CAP 50MG
PRAZOSIN HCL CAP 1MG
PENICILLN VK SOL 125/5ML
ALLOPURINOL TAB 300MG
ONDANSETRON TAB 4MG
NORTRIPTYLIN CAP 25MG
FLUVOXAMINE TAB 25MG
QUETIAPINE TAB 50MG
MEGESTROL AC TAB 40MG
APAP/CODEINE TAB 300-30MG
TETRACAINE SOL 0.5% OP
INDOMETHACIN CAP 25MG
LISINOPRIL TAB 10MG
ALPRAZOLAM TAB 0.25MG
1
1
9
1
2
2
2
3
1
4
1
1
1
2
1
1
3
1
3
1
1
3
2
1
3
2
2
2
1
1
2
1
1
1
4
1
1
1
5
2
2
1
1
1
2
1
4
2
1
1
3
2
3
1
2
1
2
2
1
2
1
2
2
1
1
1
1
1
2
1
1
5
4
250
20
60
3
10
540
30
38
28
90
90
90
90
3
180
90
75
60
20
90
360
60
180
120
60
105
90
5
270
90
180
30
360
90
30
30
197
60
75
90
10
180
180
90
130
180
15
4,000
160
90
1,419
90
60
15
60
60
30
400
90
27
60
30
30
60
90
2
120
90
180
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 195
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378451493
61442014110
62175089043
68462035301
55111068401
16729014800
00536407810
50428695912
00487980125
00591060701
00603385721
31722052001
49884012101
68382001518
61314065625
00603533732
00093004103
00591379730
64376081201
10702002801
63739068910
57664012613
50111046703
16714035202
53014053007
65862020901
52343002545
42291014110
60429011305
29300013001
50111032701
53746022001
00591252125
42291060527
60429001205
00363022714
00378363501
68001018500
65862020001
00603321528
00603548432
16714061105
00093071101
68645046754
00781522010
68180031101
16714007204
45802037635
50383062750
24658030130
24658030190
00603786290
00338004803
00378400505
00093406701
00904607489
00536440601
00603421002
31604002683
50458059250
00591081055
51079013363
45802065065
54458087910
00781150601
63304062201
00487990130
68462010810
00536845080
43547032010
76439010210
AMLODIPINE BESYLATE/ATORV
Y
LOVASTATIN
Y
ATORVASTATIN CALCIUMY
HYDROXYZINE HCL
Y
IBUPROFEN
Y
QUETIAPINE FUMARATE Y
NIACIN
Y
CVS VITAMIN D3
Y
IPRATROPIUM BROMIDEY
LABETALOL HCL
Y
HYDROCHLOROTHIAZIDEY
HYDRALAZINE HCL
Y
HYDRALAZINE HCL
Y
LEVOFLOXACIN
Y
CIPROFLOXACIN HCL
Y
PREDNISONE
Y
CLOMIPHENE CITRATE Y
ALBUTEROL SULFATE Y
PHENAZOPYRIDINE HCL Y
PHENTERMINE HCL
Y
GABAPENTIN
Y
HYDROCODONE/ACETAMINOPHEN
Y
PROPRANOLOL HCL
Y
FLUOXETINE HCL
Y
METHYLPHENIDATE HCL Y
MINOCYCLINE HCL
Y
SIMVASTATIN
Y
ATENOLOL
Y
METFORMIN HCL
Y
HYDROCHLOROTHIAZIDEY
HYDRALAZINE HCL
Y
METFORMIN HCL
Y
METRONIDAZOLE
Y
METFORMIN HCL
Y
ACYCLOVIR
Y
ASPIRIN EC
Y
CETIRIZINE HCL
Y
QUETIAPINE FUMARATE Y
GABAPENTIN
Y
DIAZEPAM
Y
PROPRANOLOL HCL
Y
SERTRALINE HCL
Y
FLURBIPROFEN
Y
CITALOPRAM HYDROBROMIDE
Y
ATENOLOL
Y
IMIPRAMINE HCL
Y
BACLOFEN
Y
AUGMENTED BETAMETHASONE
Y
D
FERROUS SULFATE
Y
SIMVASTATIN
Y
SIMVASTATIN
Y
TRIAMCINOLONE ACETONIDE
Y
SODIUM CHLORIDE 0.9%Y
ALPRAZOLAM
Y
PRAZOSIN HCL
Y
ALLERGY
Y
VITAMIN B-6
Y
LISINOPRIL
Y
D3
Y
RISPERIDONE
Y
SILVER SULFADIAZINE Y
AMITRIPTYLINE HCL
Y
LORATADINE
Y
HYDROCHLOROTHIAZIDEY
ATENOLOL
Y
ATENOLOL
Y
ALBUTEROL SULFATE Y
TOPIRAMATE
Y
POLYVITAMIN
Y
METFORMIN HCL
Y
CEPHALEXIN
Y
AMLOD/ATORVA TAB 5-20MG
LOVASTATIN TAB 10MG
ATORVASTATIN TAB 10MG
HYDROXYZ HCL TAB 25MG
IBUPROFEN TAB 800MG
QUETIAPINE TAB 200MG
NIACIN
TAB 500MG
VITAMIN D3 CAP 1000UNIT
IPRATROPIUM SOL 0.02%INH
LABETALOL TAB 300MG
HYDROCHLOROT TAB 50MG
HYDRALAZINE TAB 25MG
HYDRALAZINE TAB 100MG
LEVOFLOXACIN TAB 250MG
CIPROFLOXACN SOL 0.3% OP
PREDNISONE TAB 5MG
CLOMIPHENE TAB 50MG
ALBUTEROL NEB 0.083%
PHENAZOPYRID TAB 200MG
PHENTERMINE CAP 30MG
GABAPENTIN CAP 300MG
HYDROCO/APAP TAB 5-325MG
PROPRANOLOL TAB 10MG
FLUOXETINE CAP 20MG
METHYLPHENID TAB 10MG
MINOCYCLINE CAP 50MG
SIMVASTATIN TAB 80MG
ATENOLOL TAB 50MG
METFORMIN TAB 1000MG
HYDROCHLOROT CAP 12.5MG
HYDRALAZINE TAB 25MG
METFORMIN TAB 1000MG
METRONIDAZOL TAB 250MG
METFORMIN TAB 500MG
ACYCLOVIR CAP 200MG
ASPIRIN TAB 325MG EC
CETIRIZINE TAB 5MG
QUETIAPINE TAB 25MG
GABAPENTIN CAP 400MG
DIAZEPAM TAB 10MG
PROPRANOLOL TAB 40MG
SERTRALINE TAB 25MG
FLURBIPROFEN TAB 100MG
CITALOPRAM TAB 40MG
ATENOLOL TAB 25MG
IMIPRAM HCL TAB 10MG
BACLOFEN TAB 20MG
AUG BETAMET CRE 0.05%
FERROUS SULF DRO 15MG/ML
SIMVASTATIN TAB 10MG
SIMVASTATIN TAB 10MG
TRIAMCINOLON CRE 0.1%
SODIUM CHLOR SOL 0.9% IRR
ALPRAZOLAM TAB 1MG
PRAZOSIN HCL CAP 1MG
ALLERGY TAB 10MG
VITAMIN B-6 TAB 25MG
LISINOPRIL TAB 5MG
D3
TAB 1000UNIT
RISPERIDONE TAB 1MG
SILVER SULFA CRE 1%
AMITRIPTYLIN TAB 50MG
LORATADINE TAB 10MG
HYDROCHLOROT TAB 25MG
ATENOLOL TAB 50MG
ATENOLOL TAB 50MG
ALBUTEROL NEB 0.5%
TOPIRAMATE TAB 25MG
POLYVITAMIN DRO
METFORMIN TAB 500MG
CEPHALEXIN CAP 500MG
1
1
1
2
2
1
1
4
1
1
3
1
1
6
2
2
1
1
1
1
1
1
2
1
1
1
3
4
1
1
1
1
1
2
3
12
1
1
1
1
1
1
1
4
2
1
1
1
1
1
1
1
3
4
1
2
16
2
1
1
1
2
3
4
1
1
1
1
2
1
1
90
90
90
90
120
30
360
300
125
15
210
30
60
67
8
75
5
180
9
30
90
40
240
75
30
60
135
270
180
90
90
180
30
120
75
480
90
60
90
60
180
30
30
89
180
30
40
30
50
90
90
80
3,000
300
30
120
480
180
270
90
100
60
90
360
90
90
15
60
100
90
15
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 196
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00378354505
51079080620
00904580989
00378226001
60505011500
00143993901
16714023401
00472127094
00378002301
00781232501
60429011205
42291060618
11917013943
60429002790
45802010660
00363045839
60505011700
31604002671
00603578021
16714062102
00093415073
00603240628
00363056314
00487020160
43353094870
65162018910
61442012710
00093416073
00093512401
64854001601
16714036204
00603295728
23155004710
00591084415
53746010905
00603533928
00172392760
00378680501
67544025160
57664053788
00781107801
00143974001
16714006211
00228212810
00228266611
68382013506
31722053305
00781202001
67405057596
00591042616
16714045301
24208034720
16714029801
00781537105
60429011110
00603389002
67877014605
00591578705
00143129201
68382018205
23155001001
00591544310
00781506020
00185006305
17478020919
00555007102
00603211032
00093517244
64125012710
00781506001
61442010201
MIRTAZAPINE
Y
HYDROXYZINE HCL
Y
LISINOPRIL
Y
TERAZOSIN HCL
Y
TERAZOSIN HCL
Y
AMOXICILLIN
Y
PENICILLIN V POTASSIUMY
IBUPROFEN
Y
DILTIAZEM HCL
Y
INDOMETHACIN
Y
METFORMIN HCL
Y
METFORMIN HCL
Y
D3
Y
ATENOLOL
Y
LORATADINE-D 12HR Y
WAL-ZYR
Y
TERAZOSIN HCL
Y
D3
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
ZOLPIDEM TARTRATE Y
AMOXICILLIN
Y
BACLOFEN
Y
ASPIRIN LOW DOSE
Y
IPRATROPIUM BROMIDE/ALBUT
Y
METHOCARBAMOL
Y
NAPROXEN
Y
MELOXICAM
Y
AMOXICILLIN
Y
BENAZEPRIL HCL
Y
FLUORIDEX DAILY DEFENSE
Y
FAMOTIDINE
Y
CLONIDINE HCL
Y
HYDROCHLOROTHIAZIDEY
GLIPIZIDE ER
Y
HYDROCODONE/ACETAMINOPHEN
Y
PREDNISONE
Y
DIAZEPAM
Y
ZALEPLON
Y
CYCLOBENZAPRINE HCL Y
TRAMADOL HYDROCHLORIDE/AC
Y
ATENOLOL
Y
PREDNISONE
Y
METOCLOPRAMIDE HCL Y
CLONIDINE HCL
Y
GABAPENTIN
Y
LOSARTAN POTASSIUM Y
METHOCARBAMOL
Y
AMOXICILLIN
Y
HYDROXYZINE HCL
Y
VALPROIC ACID
Y
QUETIAPINE FUMARATE Y
ALBUTEROL SULFATE Y
AMOXICILLIN
Y
LORAZEPAM
Y
METFORMIN HCL
Y
HYDROCODONE/ACETAMINOPHEN
Y
TEMAZEPAM
Y
NORTRIPTYLINE HCL
Y
METHOCARBAMOL
Y
BUSPIRONE HCL
Y
INDOMETHACIN
Y
PREDNISONE
Y
AMOXICILLIN
Y
CLONAZEPAM
Y
KETOROLAC TROMETHAMINE
Y
ISONIAZID
Y
AMLODIPINE BESYLATE Y
ALENDRONATE SODIUM Y
FOLIC ACID
Y
AMOXICILLIN
Y
DICLOFENAC SODIUM DRY
MIRTAZAPINE TAB 45MG
HYDROXYZ HCL TAB 25MG
LISINOPRIL TAB 20MG
TERAZOSIN CAP 1MG
TERAZOSIN CAP 1MG
AMOXICILLIN CAP 500MG
PENICILLN VK TAB 250MG
IBUPROFEN SUS 100/5ML
DILTIAZEM TAB 30MG
INDOMETHACIN CAP 25MG
METFORMIN TAB 850MG
METFORMIN TAB 850MG
D3
CAP 2000UNIT
ATENOLOL TAB 25MG
LORATADINE-D TAB 5-120MG
WAL-ZYR TAB 10MG
TERAZOSIN CAP 5MG
VITAMIN D3 TAB 400UNIT
SMZ-TMP TAB 400-80MG
ZOLPIDEM TAB 5MG
AMOXICILLIN SUS 125/5ML
BACLOFEN TAB 10MG
ASPIRIN LOW TAB 81MG EC
IPRATROPIUM/ SOL ALBUTER
METHOCARBAM TAB 500MG
NAPROXEN TAB 375MG
MELOXICAM TAB 15MG
AMOXICILLIN SUS 200/5ML
BENAZEPRIL TAB 5MG
FLUORIDEX GEL 1.1%
FAMOTIDINE TAB 40MG
CLONIDINE TAB 0.1MG
HYDROCHLOROT TAB 25MG
GLIPIZIDE ER TAB 5MG
HYDROCO/APAP TAB 5-325MG
PREDNISONE TAB 20MG
DIAZEPAM TAB 10MG
ZALEPLON CAP 5MG
CYCLOBENZAPR TAB 10MG
TRAMADL/APAP TAB 37.5-325
ATENOLOL TAB 25MG
PREDNISONE TAB 5MG
METOCLOPRAM TAB 10MG
CLONIDINE TAB 0.2MG
GABAPENTIN CAP 300MG
LOSARTAN POT TAB 25MG
METHOCARBAM TAB 500MG
AMOXICILLIN CAP 250MG
HYDROXYZ HCL TAB 10MG
VALPROIC ACD SOL 250/5ML
QUETIAPINE TAB 50MG
ALBUTEROL NEB 0.5%
AMOXICILLIN CAP 250MG
LORAZEPAM TAB 0.5MG
METFORMIN TAB 500MG
HYDROCO/APAP TAB 5-325MG
TEMAZEPAM CAP 15MG
NORTRIPTYLIN CAP 25MG
METHOCARBAM TAB 750MG
BUSPIRONE TAB 15MG
INDOMETHACIN CAP 25MG
PREDNISONE TAB 20MG
AMOXICILLIN TAB 500MG
CLONAZEPAM TAB 0.5MG
KETOROLAC SOL 0.5%
ISONIAZID TAB 300MG
AMLODIPINE TAB 10MG
ALENDRONATE TAB 35MG
FOLIC ACID TAB 1MG
AMOXICILLIN TAB 500MG
DICLOFENAC TAB 50MG DR
1
1
2
1
1
1
1
1
2
1
1
1
1
2
1
1
1
4
2
2
2
2
8
0
1
4
2
2
1
1
1
1
3
1
2
1
10
1
3
1
1
2
2
1
1
1
1
2
1
2
1
1
3
3
2
1
1
2
1
1
2
2
1
1
1
1
1
2
3
1
1
30
60
180
90
90
30
20
240
120
90
180
180
90
180
10
30
90
360
54
50
400
35
600
180
120
144
60
200
90
112
30
60
270
30
42
30
246
30
270
30
60
60
190
180
90
30
90
56
100
600
28
20
63
150
240
30
30
42
60
60
78
28
21
60
3
90
45
8
270
21
21
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 197
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
76439010410
00143129005
67405067196
68382022705
16729017117
11917007463
76282033210
60505019100
68001021000
00093138943
00603294928
00378400377
60429093210
11917008608
50742010810
50742010801
67253090310
68382000905
16571041110
00113201339
00713063115
52343007499
00185440010
00168000580
00781149669
57664016608
67877016930
00093415080
60429002510
00781106101
00378034493
67877012425
00603233802
00172392570
00603233721
59746001504
31722034101
00363078407
00121057716
00168013330
16252051605
55111012850
61442032101
00603385634
00536404610
00591246805
55111018010
00904580889
65162074510
00603421234
57237010099
00904581180
00363039214
60429005210
00536100441
00378700393
00904635361
00555077904
64376081101
11917014764
57237004001
63304058110
13668000810
00536853080
00781168401
67544030280
00603646828
24208096110
00603373921
00904585289
00378232105
AMOXICILLIN
Y
METHOCARBAMOL
Y
HYDROXYZINE HCL
Y
AMIODARONE HCL
Y
AMITRIPTYLINE HCL
Y
VITAMIN E BLEND
Y
WARFARIN SODIUM
Y
METFORMIN HCL
Y
LISINOPRIL
Y
CROMOLYN SODIUM
Y
CLONAZEPAM
Y
ALPRAZOLAM
Y
CARBAMAZEPINE
Y
VITAMIN D3
Y
METOPROLOL TARTRATEY
METOPROLOL TARTRATEY
ALPRAZOLAM
Y
LAMOTRIGINE
Y
CIPROFLOXACIN HCL
Y
ALLERGY & CONGESTIONYRELI
FLUTICASONE PROPIONATE
Y
PAROXETINE HCL
Y
TIZANIDINE HCL
Y
TRIAMCINOLONE ACETONIDE
Y
AZITHROMYCIN
Y
METOPROLOL TARTRATEY
ONDANSETRON HCL
Y
AMOXICILLIN
Y
ATENOLOL
Y
ALPRAZOLAM
Y
ONDANSETRON HCL
Y
SILVER SULFADIAZINE Y
ACETAMINOPHEN/CODEINE
Y #3
DIAZEPAM
Y
ACETAMINOPHEN/CODEINE
Y
METHYLPREDNISOLONE Y
NAPROXEN
Y
WAL-FEX ALLERGY
Y
LACTULOSE
Y
CLOTRIMAZOLE
Y
CIPROFLOXACIN HCL
Y
CIPROFLOXACIN HCL
Y
CLONIDINE HCL
Y
HYDROCHLOROTHIAZIDEY
MULTI-VITAMINS
Y
METOCLOPRAMIDE HCL Y
TIZANIDINE HCL
Y
LISINOPRIL
Y
PROMETHAZINE HCL
Y
LISINOPRIL
Y
METOPROLOL TARTRATEY
LISINOPRIL
Y
IBUPROFEN
Y
CYCLOBENZAPRINE HCL Y
ASPIRIN
Y
PAROXETINE HCL
Y
LEVOFLOXACIN
Y
MEDROXYPROGESTERONE
Y ACETA
PHENAZOPYRIDINE HCL Y
VITAMIN D3
Y
PENICILLIN V POTASSIUMY
METOPROLOL TARTRATEY
ZOLPIDEM TARTRATE Y
POLYVITAMIN/IRON
Y
CETIRIZINE HCL
Y
GLIPIZIDE
Y
ZOLPIDEM TARTRATE Y
CROMOLYN SODIUM
Y
FUROSEMIDE
Y
ALL DAY ALLERGY
Y
LORAZEPAM
Y
AMOXICILLIN CAP 500MG
METHOCARBAM TAB 500MG
HYDROXYZ HCL TAB 25MG
AMIODARONE TAB 200MG
AMITRIPTYLIN TAB 10MG
VITAMIN E CAP 400UNIT
WARFARIN TAB 5MG
METFORMIN TAB 850MG
LISINOPRIL TAB 10MG
CROMOLYN SOD SOL 4% OP
CLONAZEPAM TAB 1MG
ALPRAZOLAM TAB 0.5MG
CARBAMAZEPIN TAB 200MG
VITAMIN D3 CAP 2000UNIT
METOPROL TAR TAB 50MG
METOPROL TAR TAB 50MG
ALPRAZOLAM TAB 2MG
LAMOTRIGINE TAB 150MG
CIPROFLOXACN TAB 250MG
ALLERGY/CONG TAB 5-120MG
FLUTICASONE CRE 0.05%
PAROXETINE TAB 20MG
TIZANIDINE TAB 4MG
TRIAMCINOLON OIN 0.025%
AZITHROMYCIN TAB 250MG
METOPROL TAR TAB 50MG
ONDANSETRON TAB 4MG
AMOXICILLIN SUS 125/5ML
ATENOLOL TAB 50MG
ALPRAZOLAM TAB 0.25MG
ONDANSETRON TAB 8MG
SILVER SULFA CRE 1%
APAP/CODEINE TAB 300-30MG
DIAZEPAM TAB 2MG
APAP/CODEINE TAB 300-15MG
METHYLPRED TAB 32MG
NAPROXEN TAB 375MG
WAL-FEX ALLR TAB 180MG
LACTULOSE SOL 10GM/15
CLOTRIMAZOLE CRE 1%
CIPROFLOXACN TAB 750MG
CIPROFLOXACN TAB 750MG
CLONIDINE TAB 0.1MG
HYDROCHLOROT TAB 25MG
MULTI-VITAMN TAB
METOCLOPRAM TAB 10MG
TIZANIDINE TAB 4MG
LISINOPRIL TAB 10MG
PROMETHAZINE TAB 12.5MG
LISINOPRIL TAB 20MG
METOPROL TAR TAB 25MG
LISINOPRIL TAB 5MG
IBUPROFEN TAB 200MG
CYCLOBENZAPR TAB 10MG
ASPIRIN TAB 81MG EC
PAROXETINE TAB 30MG
LEVOFLOXACIN TAB 750MG
MEDROXYPR AC TAB 10MG
PHENAZOPYRID TAB 100MG
VITAMIN D3 CAP 1000UNIT
PENICILLN VK TAB 250MG
METOPROL TAR TAB 100MG
ZOLPIDEM TAB 10MG
POLYVITAMIN DRO /IRON
CETIRIZINE TAB 10MG
GLIPIZIDE TAB 5MG
ZOLPIDEM TAB 5MG
CROMOLYN SOD SOL 4% OP
FUROSEMIDE TAB 20MG
ALL DAY ALLG TAB 10MG
LORAZEPAM TAB 0.5MG
1
1
1
1
2
3
1
1
2
1
8
1
1
1
1
1
1
1
3
1
1
1
1
1
1
1
2
2
3
7
1
1
3
8
2
1
4
1
2
2
1
1
1
4
4
3
1
2
2
2
1
1
3
4
14
1
2
3
2
2
1
2
5
1
1
1
2
1
4
1
5
24
120
60
30
60
90
56
180
60
10
240
60
180
60
180
180
90
15
34
14
15
90
30
80
6
60
21
300
180
290
15
50
54
177
70
2
66
10
420
60
20
20
180
525
300
132
30
180
40
135
180
90
270
160
540
30
10
30
12
90
30
120
150
50
30
180
40
10
186
30
190
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 198
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00591565810
50111056302
49884005610
63304062310
00363089726
16714050102
00603786190
00378003201
00591551301
00904634180
16714031201
00781615657
31722021330
44946105008
64679096105
68001023700
61442032105
00781579220
50428901406
63739022810
00555003302
50742010110
00093117701
00054329446
10702000201
00143992950
11917013942
11917007630
00172531160
52343002299
59762371903
64376063005
00143988801
50111085101
00363041414
61314014305
00378350591
27241000150
00536308610
67877022205
00093416078
67877014705
68382011505
23155000810
52343005999
67544087970
43386016101
00093964301
63739000410
60429090160
45802084054
52343002490
67877022201
67253090110
67253014310
00603158458
00591551310
64376063105
00555009496
58980015010
00487930133
50383077916
00536408807
00904585260
50383074016
00093729901
51079054220
60505265501
61442012101
00781615646
68462018905
CYCLOBENZAPRINE HCL Y
CYCLOBENZAPRINE HCL Y
IMIPRAMINE HCL
Y
ATENOLOL
Y
IBUPROFEN
Y
TERBINAFINE HCL
Y
TRIAMCINOLONE ACETONIDE
Y
METOPROLOL TARTRATEY
CARISOPRODOL
Y
METOPROLOL TARTRATEY
VENLAFAXINE HCL
Y
AMOXICILLIN
Y
SERTRALINE HCL
Y
NEUTRAL SODIUM FLUORIDE
Y
AZITHROMYCIN
Y
CLONIDINE HCL
Y
CLONIDINE HCL
Y
LEVOFLOXACIN
Y
CVS ALLERGY RELIEF CHILDR
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
CHLORDIAZEPOXIDE HCLY
ATENOLOL
Y
NEOMYCIN SULFATE
Y
FUROSEMIDE
Y
PROMETHAZINE HCL
Y
CIPROFLOXACIN HCL
Y
D3
Y
VITAMIN D
Y
CIPROFLOXACIN HCL
Y
SIMVASTATIN
Y
ALPRAZOLAM
Y
ALPRAZOLAM
Y
AMOXICILLIN
Y
BENZONATATE
Y
ASPIRIN
Y
BRIMONIDINE TARTRATEY
RISPERIDONE
Y
RISPERIDONE
Y
ASPIRIN EC
Y
GABAPENTIN
Y
AMOXICILLIN
Y
TEMAZEPAM
Y
RISPERIDONE
Y
HYDROCHLOROTHIAZIDEY
METOPROLOL TARTRATEY
LORAZEPAM
Y
MISOPROSTOL
Y
PROCHLORPERAZINE MALEATE
Y
ACETAMINOPHEN/CODEINE
Y #3
CLOBETASOL PROPIONATE
Y
LEVONORGESTREL
Y
SIMVASTATIN
Y
GABAPENTIN
Y
ALPRAZOLAM
Y
AMOXICILLIN
Y
PROMETHAZINE HCL PLAIN
Y
CARISOPRODOL
Y
ALPRAZOLAM
Y
CLONAZEPAM ODT
Y
HYPERCARE
Y
SODIUM CHLORIDE
Y
LACTULOSE
Y
CETIRIZINE HCL
Y
ALL DAY ALLERGY
Y
ALBUTEROL SULFATE Y
MELOXICAM
Y
PROCHLORPERAZINE MALEATE
Y
TRAZODONE HCL
Y
FAMOTIDINE
Y
AMOXICILLIN
Y
NAPROXEN
Y
CYCLOBENZAPR TAB 10MG
CYCLOBENZAPR TAB 10MG
IMIPRAM HCL TAB 50MG
ATENOLOL TAB 100MG
IBUPROFEN SUS 100/5ML
TERBINAFINE TAB 250MG
TRIAMCINOLON CRE 0.025%
METOPROL TAR TAB 50MG
CARISOPRODOL TAB 350MG
METOPROL TAR TAB 50MG
VENLAFAXINE TAB 37.5MG
AMOXICILLIN SUS 200/5ML
SERTRALINE TAB 50MG
SOD FLUORIDE SOL 0.2%
AZITHROMYCIN TAB 250MG
CLONIDINE TAB 0.1MG
CLONIDINE TAB 0.1MG
LEVOFLOXACIN TAB 750MG
ALLERGY RELF SOL 5MG/5ML
SMZ/TMP DS TAB 800-160
CHLORDIAZEP CAP 10MG
ATENOLOL TAB 25MG
NEOMYCIN TAB 500MG
FUROSEMIDE SOL 10MG/ML
PROMETHAZINE TAB 12.5MG
CIPROFLOXACN TAB 750MG
D3
CAP 2000UNIT
VITAMIN D CAP 1000UNIT
CIPROFLOXACN TAB 250MG
SIMVASTATIN TAB 10MG
ALPRAZOLAM TAB 0.25MG
ALPRAZOLAM TAB 0.25MG
AMOXICILLIN SUS 125/5ML
BENZONATATE CAP 100MG
ASPIRIN TAB 81MG EC
BRIMONIDINE SOL 0.2% OP
RISPERIDONE TAB 0.5MG
RISPERIDONE TAB 1MG
ASPIRIN TAB 81MG EC
GABAPENTIN CAP 100MG
AMOXICILLIN SUS 200/5ML
TEMAZEPAM CAP 30MG
RISPERIDONE TAB 2MG
HYDROCHLOROT TAB 25MG
METOPROL TAR TAB 25MG
LORAZEPAM TAB 1MG
MISOPROSTOL TAB 200MCG
PROCHLORPER TAB 5MG
APAP/CODEINE TAB 300-30MG
CLOBETASOL OIN 0.05%
LEVONORGESTR TAB 0.75MG
SIMVASTATIN TAB 40MG
GABAPENTIN CAP 100MG
ALPRAZOLAM TAB 0.5MG
AMOXICILLIN SUS 250/5ML
PROMETHAZINE SYP 6.25/5ML
CARISOPRODOL TAB 350MG
ALPRAZOLAM TAB 0.5MG
CLONAZEP ODT TAB 0.125MG
HYPERCARE SOL 20%
SOD CHLORIDE NEB 0.9%
LACTULOSE SOL 10GM/15
CETIRIZINE TAB 10MG
ALL DAY ALLG TAB 10MG
ALBUTEROL SYP 2MG/5ML
MELOXICAM TAB 15MG
PROCHLORPER TAB 10MG
TRAZODONE TAB 150MG
FAMOTIDINE TAB 20MG
AMOXICILLIN SUS 200/5ML
NAPROXEN TAB 375MG
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3
1
1
2
2
2
1
1
2
4
1
1
1
1
11
1
1
1
3
1
1
1
1
2
1
1
2
2
1
1
1
1
1
1
1
1
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
30
30
180
90
120
30
80
180
60
180
4
150
30
473
6
180
180
10
150
20
90
90
6
42
42
16
60
90
20
270
30
30
200
21
330
5
30
45
150
30
75
15
30
180
180
120
4
20
30
60
4
90
90
120
200
240
60
120
5
38
180
240
30
30
240
30
20
30
60
100
60
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 199
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00603002436
00781220101
68180024101
00536308641
11917013944
61442012601
00904585340
43353073245
13107003205
51991029201
00172392660
16714035203
61314039601
51672128901
00143223001
68645035159
53746018901
57664050813
13107001901
59762371904
17478071510
42291014010
60429002710
00603210902
00603424821
27434000211
43386016006
00603374421
57237002901
00781506120
76439013550
16729019701
17478010002
00904557720
68382006401
00536408811
11917014663
53746025318
42858010250
74312017621
30768015605
00093506101
50428797752
00603016921
65862000901
67544087960
68645031054
60429030110
68001025320
00378207401
59762372004
13107002005
00591065701
00093035010
54458099010
76282015310
54629009501
23155010401
00591562001
00228266511
00054026913
00378018210
31604001274
13668033001
00093406901
00904582360
00378021601
60429032605
00409379501
00143974010
00093220305
ASPIRIN CHILDRENS
Y
TEMAZEPAM
Y
LEVOFLOXACIN
Y
ASPIRIN EC
Y
D3
Y
MELOXICAM
Y
IBUPROFEN
Y
HYDROCHLOROTHIAZIDEY
MIRTAZAPINE
Y
OXCARBAZEPINE
Y
DIAZEPAM
Y
FLUOXETINE HCL
Y
CYCLOPENTOLATE HCL Y
NYSTATIN
Y
ISOSORBIDE MONONITRATE
Y ER
CARVEDILOL
Y
NAPROXEN
Y
CITALOPRAM HYDROBROMIDE
Y
HYDROCODONE/ACETAMINOPHEN
Y
ALPRAZOLAM
Y
BRIMONIDINE TARTRATEY
ATENOLOL
Y
ATENOLOL
Y
AMLODIPINE BESYLATE Y
LORAZEPAM
Y
NAC 600
Y
MISOPROSTOL
Y
GLIMEPIRIDE
Y
AMOXICILLIN
Y
AMOXICILLIN
Y
METHOCARBAMOL
Y
LISINOPRIL
Y
CYCLOPENTOLATE HCL Y
CHILDRENS IBUPROFEN Y
WARFARIN SODIUM
Y
CETIRIZINE HCL
Y
ESSENTIAL ONE DAILY MULTI
Y
RANITIDINE HCL
Y
OXYCODONE/ACETAMINOPHEN
Y
D3 SUPER STRENGTH Y
VITAMIN D HIGH POTENCY
Y
HYDROXYZINE HCL
Y
CVS VITAMIN D3
Y
ENTERIC COATED ASPIRINY
METFORMIN HCL
Y
LORAZEPAM
Y
ATENOLOL
Y
CLOPIDOGREL
Y
FLUCONAZOLE
Y
LISINOPRIL
Y
ALPRAZOLAM
Y
HYDROCODONE/ACETAMINOPHEN
Y
BUSPIRONE HCL
Y
ACETAMINOPHEN/CODEINE
Y
PAROXETINE HCL
Y
MELOXICAM
Y
VITAMIN B-2
Y
METFORMIN HCL
Y
DIAZEPAM
Y
GABAPENTIN
Y
LETROZOLE
Y
PROPRANOLOL HCL
Y
FOLIC ACID
Y
TRAZODONE HCL
Y
PRAZOSIN HCL
Y
VITAMIN D3
Y
FUROSEMIDE
Y
ATORVASTATIN CALCIUMY
KETOROLAC TROMETHAMINE
Y
PREDNISONE
Y
METOCLOPRAMIDE HCL Y
ASPIRIN CHLD CHW 81MG
TEMAZEPAM CAP 15MG
LEVOFLOXACIN TAB 500MG
ASPIRIN TAB 81MG EC
D3
CAP 400UNIT
MELOXICAM TAB 7.5MG
IBUPROFEN TAB 400MG
HYDROCHLOROT TAB 25MG
MIRTAZAPINE TAB 45MG
OXCARBAZEPIN TAB 150MG
DIAZEPAM TAB 5MG
FLUOXETINE CAP 20MG
CYCLOPENTOL SOL 1% OP
NYSTATIN CRE 100000
ISOSORB MONO TAB 30MG ER
CARVEDILOL TAB 12.5MG
NAPROXEN TAB 375MG
CITALOPRAM TAB 20MG
HYDROCO/APAP TAB 5-325MG
ALPRAZOLAM TAB 0.25MG
BRIMONIDINE SOL 0.2% OP
ATENOLOL TAB 25MG
ATENOLOL TAB 25MG
AMLODIPINE TAB 5MG
LORAZEPAM TAB 2MG
NAC 600 CAP
MISOPROSTOL TAB 100MCG
GLIMEPIRIDE TAB 1MG
AMOXICILLIN TAB 875MG
AMOXICILLIN TAB 875MG
METHOCARBAM TAB 750MG
LISINOPRIL TAB 20MG
CYCLOPENTOL SOL 1% OP
IBUPROFEN SUS 100/5ML
WARFARIN TAB 2.5MG
CETIRIZINE TAB 10MG
ESSENT ONE TAB DAILY
RANITIDINE TAB 150MG
OXYCOD/APAP TAB 5-325MG
D3 SUPER STR CAP 2000UNIT
VITAMIN D CAP 1000UNIT
HYDROXYZ HCL TAB 25MG
VITAMIN D3 CAP 1000UNIT
ASPIRIN TAB 325MG EC
METFORMIN TAB 850MG
LORAZEPAM TAB 1MG
ATENOLOL TAB 50MG
CLOPIDOGREL TAB 75MG
FLUCONAZOLE TAB 150MG
LISINOPRIL TAB 10MG
ALPRAZOLAM TAB 0.5MG
HYDROCO/APAP TAB 7.5-325
BUSPIRONE TAB 5MG
APAP/CODEINE TAB 300-60MG
PAROXETINE TAB 10MG
MELOXICAM TAB 15MG
VITAMIN B-2 TAB 100MG
METFORMIN TAB 1000MG
DIAZEPAM TAB 10MG
GABAPENTIN CAP 100MG
LETROZOLE TAB 2.5MG
PROPRANOLOL TAB 10MG
FOLIC ACID TAB 400MCG
TRAZODONE TAB 50MG
PRAZOSIN HCL CAP 5MG
VITAMIN D3 TAB 400UNIT
FUROSEMIDE TAB 40MG
ATORVASTATIN TAB 80MG
KETOROLAC INJ 30MG/ML
PREDNISONE TAB 5MG
METOCLOPRAM TAB 10MG
1
2
2
3
1
2
2
3
1
1
7
1
1
1
1
1
1
1
1
1
1
1
1
1
2
1
2
1
1
1
1
1
1
1
1
1
2
1
1
1
1
1
1
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
1
1
1
2
1
1
2
3
1
1
2
2
90
60
10
150
90
60
69
135
30
7
170
30
2
15
30
60
60
30
20
180
5
90
90
30
60
12
6
90
20
20
30
90
2
120
20
30
60
180
20
60
90
30
90
180
90
90
90
30
1
90
30
12
60
15
30
30
120
60
105
21
10
60
180
90
5
120
120
30
5
19
60
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 200
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00185006401
00363045887
67877029601
00406048462
00591561901
24658025005
45802006335
65862019299
59762500701
00406048301
00603210928
00143125610
13668027101
65862053650
53489021510
00185067405
50428280123
00781537705
62756018388
11917013953
52343002499
43353073760
00904585440
00536468001
55111068301
16714029902
00603158654
29300012410
68645045070
16714029802
38485012041
00591040701
00591024210
00378003204
00781261301
16714037102
13668001001
52343003099
00603578121
00185005301
65862018730
00527128210
11917012703
00536331301
00378245701
00172392560
00603102058
68645015159
00172375980
00603321321
68001012900
59762372001
00781320885
00093726701
00093066116
00143988880
64376063010
57664018531
53746014001
51079014120
00172375860
42291060510
00363058714
00378531005
63304077205
00781537901
00781603946
33261015390
64376063205
00093314501
60429018805
CLONAZEPAM
Y
WAL-ZYR
Y
IBUPROFEN
Y
ACETAMINOPHEN/CODEINE
Y #3
DIAZEPAM
Y
CIPROFLOXACIN HCL
Y
TRIAMCINOLONE ACETONIDE
Y
FLUOXETINE HCL
Y
MISOPROSTOL
Y
ACETAMINOPHEN/CODEINE
Y #2
AMLODIPINE BESYLATE Y
HYDROCHLOROTHIAZIDEY
CARBAMAZEPINE
Y
LEVOFLOXACIN
Y
CLONIDINE HCL
Y
HYDROXYZINE PAMOATEY
CVS VITAMIN B-6
Y
LORAZEPAM
Y
OXCARBAZEPINE
Y
FISH OIL
Y
SIMVASTATIN
Y
FUROSEMIDE
Y
IBUPROFEN
Y
VITAMIN B-1
Y
IBUPROFEN
Y
AMOXICILLIN
Y
PROMETHAZINE-DM
Y
MELOXICAM
Y
CYCLOBENZAPRINE HCL Y
AMOXICILLIN
Y
MULTIVITAMINS
Y
LISINOPRIL
Y
LORAZEPAM
Y
METOPROLOL TARTRATEY
AMOXICILLIN
Y
LAMOTRIGINE
Y
CITALOPRAM HYDROBROMIDE
Y
GABAPENTIN
Y
SULFAMETHOXAZOLE/TRIMETHO
Y
BENAZEPRIL HCL
Y
ONDANSETRON HCL
Y
DICYCLOMINE HCL
Y
VITAMIN D3
Y
ASPIRIN EC
Y
LORAZEPAM
Y
DIAZEPAM
Y
ACETAMINOPHEN/CODEINE
Y
GLIPIZIDE
Y
LISINOPRIL
Y
DIAZEPAM
Y
FLUOXETINE HCL
Y
ALPRAZOLAM
Y
CEFTRIAXONE SODIUM Y
METFORMIN HCL ER
Y
ALBUTEROL SULFATE Y
AMOXICILLIN
Y
ALPRAZOLAM
Y
PROMETHAZINE/CODEINE
Y
IBUPROFEN
Y
CHLORDIAZEPOXIDE HCLY
LISINOPRIL
Y
METFORMIN HCL
Y
ASPIRIN 81
Y
ZOLPIDEM TARTRATE Y
LORAZEPAM
Y
LORAZEPAM
Y
AMOXICILLIN
Y
ASPIRIN
Y
ALPRAZOLAM
Y
CEPHALEXIN
Y
TRAZODONE HCL
Y
CLONAZEPAM TAB 1MG
WAL-ZYR TAB 10MG
IBUPROFEN TAB 800MG
APAP/CODEINE TAB 300-30MG
DIAZEPAM TAB 5MG
CIPROFLOXACN TAB 500MG
TRIAMCINOLON CRE 0.025%
FLUOXETINE CAP 10MG
MISOPROSTOL TAB 100MCG
APAP/CODEINE TAB 300-15MG
AMLODIPINE TAB 5MG
HYDROCHLOROT TAB 25MG
CARBAMAZEPIN CHW 100MG
LEVOFLOXACIN TAB 250MG
CLONIDINE TAB 0.1MG
HYDROXYZ PAM CAP 25MG
CVS VIT B-6 TAB 100MG
LORAZEPAM TAB 1MG
OXCARBAZEPIN TAB 150MG
FISH OIL CAP 1200MG
SIMVASTATIN TAB 40MG
FUROSEMIDE TAB 20MG
IBUPROFEN TAB 600MG
VITAMIN B-1 TAB 100MG
IBUPROFEN TAB 600MG
AMOXICILLIN CAP 500MG
PROMETHAZINE SYP DM
MELOXICAM TAB 7.5MG
CYCLOBENZAPR TAB 10MG
AMOXICILLIN CAP 250MG
MULTIVITAMIN CAP
LISINOPRIL TAB 10MG
LORAZEPAM TAB 2MG
METOPROL TAR TAB 50MG
AMOXICILLIN CAP 500MG
LAMOTRIGINE TAB 25MG
CITALOPRAM TAB 20MG
GABAPENTIN CAP 100MG
SMZ/TMP DS TAB 800-160
BENAZEPRIL TAB 10MG
ONDANSETRON TAB 4MG
DICYCLOMINE TAB 20MG
VITAMIN D3 CAP 2000UNIT
ASPIRIN TAB 325MG EC
LORAZEPAM TAB 1MG
DIAZEPAM TAB 2MG
APAP/CODEINE SOL 120-12/5
GLIPIZIDE TAB 10MG
LISINOPRIL TAB 10MG
DIAZEPAM TAB 2MG
FLUOXETINE CAP 40MG
ALPRAZOLAM TAB 0.5MG
CEFTRIAXONE INJ 1GM
METFORMIN TAB 500MG ER
ALBUTEROL SYP 2MG/5ML
AMOXICILLIN SUS 125/5ML
ALPRAZOLAM TAB 0.25MG
PROMETH/COD SYP 6.25-10
IBUPROFEN TAB 200MG
CHLORDIAZEP CAP 25MG
LISINOPRIL TAB 5MG
METFORMIN TAB 500MG
ASPIRIN 81 TAB 81MG EC
ZOLPIDEM TAB 10MG
LORAZEPAM TAB 0.5MG
LORAZEPAM TAB 2MG
AMOXICILLIN SUS 125/5ML
ASPIRIN TAB 325MG EC
ALPRAZOLAM TAB 1MG
CEPHALEXIN CAP 250MG
TRAZODONE TAB 100MG
3
1
1
1
3
1
1
1
2
1
1
1
1
2
1
2
2
2
1
1
2
1
1
1
1
1
1
1
1
1
1
1
2
1
1
1
1
1
3
1
1
1
1
2
2
4
1
1
2
2
1
1
1
1
1
1
1
1
1
1
1
1
2
2
1
1
1
1
1
1
1
90
30
30
20
22
14
15
30
6
42
30
90
12
18
21
40
90
40
14
30
90
90
30
90
30
21
120
30
15
24
30
90
10
90
20
30
45
90
17
30
6
30
30
120
60
106
80
60
60
40
10
60
1
30
120
80
90
118
100
20
30
60
180
60
15
30
100
30
50
14
30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 201
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00054003721
65162066490
31604002678
65162003311
00781604158
00603156758
11917014675
68645047490
68462018801
11917003949
16103036605
00536100836
00904770470
00603421021
00536478701
00409427601
00904051860
00054429725
00363021807
65862007150
00363039212
00378530501
16571041250
00904518640
11673041690
49884073411
00093014805
11917007521
60505265401
00603568320
00555015902
50383080116
43353065230
00093053601
11917011635
25021070101
47469016108
50428923748
00363015712
00904582461
00121050416
00363012140
13668000701
00591246701
00603646932
43353097330
49348007834
00363041412
64125090401
00363056317
00378015201
68180012102
00603137856
51079038620
00904791559
00603294832
00536329201
00406036005
00054418625
00603421128
55111068201
00781196260
00904053060
62756029413
43353078330
00536100410
57664037708
00603294813
57896090101
31604001281
00363029116
CLARITHROMYCIN
Y
RANITIDINE HCL
Y
D3
Y
ACETAMINOPHEN/CODEINE
Y PHO
AMOXICILLIN
Y
PREDNISOLONE
Y
VITAMIN C/ROSE HIPS Y
IBUPROFEN
Y
NAPROXEN
Y
B-COMPLEX/C
Y
ASPIRIN
Y
ASPIRIN
Y
ASPIR-LOW
Y
LISINOPRIL
Y
B COMPLEX
Y
LIDOCAINE HCL
Y
VITAMIN B-6
Y
FUROSEMIDE
Y
ASPIRIN CHILDRENS
Y
AMOXICILLIN
Y
IBUPROFEN
Y
ZOLPIDEM TARTRATE Y
CIPROFLOXACIN HCL
Y
IBUPROFEN
Y
TGT ASPIRIN
Y
FLUOXETINE HCL
Y
NAPROXEN
Y
VITAMIN C
Y
TRAZODONE HCL
Y
RISPERIDONE
Y
CHLORDIAZEPOXIDE HCLY
PROMETHAZINE HCL
Y
TRAZODONE HCL
Y
NAPROXEN SODIUM
Y
A THRU Z ADVANCED Y
KETOROLAC TROMETHAMINE
Y
ACIDOPHILUS
Y
CVS IBUPROFEN
Y
ASPIRIN
Y
VITAMIN D3
Y
ACETAMINOPHEN/CODEINE
Y
IBUPROFEN
Y
ZOLPIDEM TARTRATE Y
METOCLOPRAMIDE HCL Y
ZOLPIDEM TARTRATE Y
TRAZODONE HCL
Y
SM ALL DAY ALLERGY CHILDR
Y
ASPIRIN
Y
LORAZEPAM
Y
ASPIRIN LOW DOSE
Y
CLONIDINE HCL
Y
CEPHALEXIN
Y
LACTULOSE
Y
LORAZEPAM
Y
IBUPROFEN
Y
CLONAZEPAM
Y
VITAMIN C
Y
HYDROCODONE/ACETAMINOPHEN
Y
DEXAMETHASONE
Y
LISINOPRIL
Y
IBUPROFEN
Y
CLARITHROMYCIN
Y
TAB-A-VITE
Y
CEPHALEXIN
Y
DIAZEPAM
Y
ASPIRIN
Y
TRAMADOL HCL
Y
CLONAZEPAM
Y
ASPIRIN
Y
VITAMIN B-1
Y
IBUPROFEN
Y
CLARITHROMYC TAB 500MG
RANITIDINE SYP 15MG/ML
D3
CAP 2000UNIT
APAP/CODEINE TAB 300-30MG
AMOXICILLIN SUS 250/5ML
PREDNISOLONE SYP 15MG/5ML
VITAMIN C TAB 500MG
IBUPROFEN TAB 400MG
NAPROXEN TAB 250MG
B-COMPLEX/C TAB
ASPIRIN CHW 81MG
ASPIRIN CHW 81MG
ASPIR-LOW TAB 81MG EC
LISINOPRIL TAB 5MG
B COMPLEX CAP
LIDOCAINE INJ 1%
VITAMIN B-6 TAB 100MG
FUROSEMIDE TAB 20MG
ASPIRIN CHLD CHW 81MG
AMOXICILLIN SUS 400/5ML
IBUPROFEN TAB 200MG
ZOLPIDEM TAB 5MG
CIPROFLOXACN TAB 500MG
IBUPROFEN TAB 600MG
TGT ASPIRIN TAB 325MG
FLUOXETINE TAB 10MG
NAPROXEN TAB 375MG
VITAMIN C TAB 500MG
TRAZODONE TAB 100MG
RISPERIDONE TAB 0.25MG
CHLORDIAZEP CAP 25MG
PROMETHAZINE SYP 6.25/5ML
TRAZODONE TAB 50MG
NAPROXEN SOD TAB 275MG
A THRU Z TAB ADVANCED
KETOROLAC INJ 30MG/ML
ACIDOPHILUS CAP 100MG
IBUPROFEN TAB 200MG
ASPIRIN TAB 325MG
VITAMIN D3 TAB 1000UNIT
APAP/CODEINE SOL 120-12/5
IBUPROFEN CAP 200MG
ZOLPIDEM TAB 5MG
METOCLOPRAM TAB 5MG
ZOLPIDEM TAB 10MG
TRAZODONE TAB 50MG
ALL DAY ALLG SOL 5MG/5ML
ASPIRIN TAB 81MG EC
LORAZEPAM TAB 0.5MG
ASPIRIN LOW TAB 81MG EC
CLONIDINE TAB 0.1MG
CEPHALEXIN CAP 250MG
LACTULOSE SOL 10GM/15
LORAZEPAM TAB 1MG
IBUPROFEN TAB 200MG
CLONAZEPAM TAB 0.5MG
VITAMIN C TAB 500MG
HYDROCO/APAP TAB 7.5-750
DEXAMETHASON TAB 6MG
LISINOPRIL TAB 10MG
IBUPROFEN TAB 400MG
CLARITHROMYC TAB 500MG
TAB-A-VITE TAB
CEPHALEXIN CAP 500MG
DIAZEPAM TAB 5MG
ASPIRIN TAB 81MG EC
TRAMADOL HCL TAB 50MG
CLONAZEPAM TAB 0.5MG
ASPIRIN TAB 325MG
VITAMIN B-1 TAB 100MG
IBUPROFEN TAB 200MG
2
1
1
1
1
1
3
1
2
1
1
1
1
1
1
1
2
2
1
1
1
2
1
1
2
1
1
1
1
1
2
1
1
1
1
1
2
2
3
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
1
1
1
1
1
1
1
1
1
2
1
2
1
1
1
56
50
30
15
80
30
180
30
30
30
90
90
90
30
90
20
60
60
30
50
63
40
7
20
180
10
20
60
30
15
18
75
30
15
30
2
40
74
150
30
60
40
30
21
30
30
30
30
30
90
30
8
45
20
30
35
60
20
1
30
12
20
30
1
30
60
15
30
90
30
20
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 202
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-2 GENERIC COSTS
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
Generic
12/8/2015 1:11 PM
00093010901
00363043929
00781183201
13668000710
11917007926
50742010410
60432065104
00363039216
00591562005
00378034501
00603212821
00603248321
00409379601
43353007260
00363039308
29300018901
00487950101
00172375880
23155011101
00067512507
43547024810
00603240721
67253038915
00093511798
65862035730
68382011314
67877027221
45802036142
68180038506
CARBAMAZEPINE
Y
ASPIRIN 81
Y
PROMETHAZINE HCL
Y
ZOLPIDEM TARTRATE Y
B-6
Y
FUROSEMIDE
Y
DOXEPIN HCL
Y
IBUPROFEN
Y
DIAZEPAM
Y
DIAZEPAM
Y
ALPRAZOLAM
Y
BISACODYL EC
Y
KETOROLAC TROMETHAMINE
Y
TRAMADOL HCL
Y
IBUPROFEN
Y
BISOPROLOL FUMARATE/HYDRO
Y
ALBUTEROL SULFATE Y
LISINOPRIL
Y
PROPRANOLOL HCL
Y
NICOTINE
Y
METFORMIN HCL
Y
BACLOFEN
Y
DOXYCYCLINE HYCLATE Y
DILTIAZEM HCL ER
Y
CLOPIDOGREL
Y
RISPERIDONE
Y
UREA
Y
TRETINOIN
Y
TRAMADOL HCL ER
Y
CARBAMAZEPIN TAB 200MG
ASPIRIN 81 TAB 81MG EC
PROMETHAZINE TAB 50MG
ZOLPIDEM TAB 5MG
B-6
TAB 100MG
FUROSEMIDE TAB 20MG
DOXEPIN HCL CON 10MG/ML
IBUPROFEN TAB 200MG
DIAZEPAM TAB 10MG
DIAZEPAM TAB 5MG
ALPRAZOLAM TAB 0.5MG
BISACODYL TAB 5MG EC
KETOROLAC INJ 60MG/2ML
TRAMADOL HCL TAB 50MG
IBUPROFEN TAB 200MG
BISOPRL/HCTZ TAB 10/6.25
ALBUTEROL NEB 0.083%
LISINOPRIL TAB 5MG
PROPRANOLOL TAB 20MG
NICOTINE DIS 14MG/24H
METFORMIN TAB 500MG
BACLOFEN TAB 20MG
DOXYCYCL HYC CAP 100MG
DILTIAZEM CAP 180MG ER
CLOPIDOGREL TAB 75MG
RISPERIDONE TAB 0.5MG
UREA
CRE 40%
TRETINOIN CRE 0.05%
TRAMADOL HCL TAB 300MG ER
1
1
1
1
1
1
0
1
2
1
1
1
-1
-1
-1
2
0
0
0
0
-1
0
2
0
-1
1
-1
-1
-1
3
30
1
10
15
8
15
14
6
8
2
2
-2
-120
-24
60
0
-60
-90
-14
-180
0
-90
-90
-90
-120
-170
-135
-30
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 203
16018 ATTACHEMNT A-3 SPECIALTY DRUG COSTS
Maricopa County
Bid 16018-RFP
16018 ATTACHMENT A-3
Specialty Drugs - July 2014 to June 2015
Listed in Order of Ingredient Cost - Highest to Lowest
Type
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
12/8/2015 1:11 PM
Product ID
00074433902
61958180101
61958150101
58406044504
64406000602
00074433902
57894006103
00944305302
50242004062
68546032512
58468022001
00074379902
00944292202
00078059287
00078060751
00169770821
00078056651
50242010040
00074379902
00003218811
00074937402
50242006301
00944305402
58406043504
44087004403
59676022528
00003085222
00173080409
64406000501
57894006003
59627000304
59572041000
00169770521
00944305202
57894003001
00078041520
00078034261
00078060715
57894007001
00074309328
00023392102
00002840001
00074433907
00078043815
00944292302
50242013801
00078034161
00169770421
68546031730
59676036001
00074433907
00004035730
00069100101
00078064930
50474071081
55513007330
65757030001
50242007401
00078041720
00378326694
50474071079
58468184904
00074364103
55513007430
58468009003
00078064781
57894007002
00074366303
00003161112
00004026129
Product
Generic Indicator - Medispan
Drug Label Name
HUMIRA PEN
N
HUMIRA PEN KIT 40MG/0.8
HARVONI
N
HARVONI TAB 90-400MG
SOVALDI
N
SOVALDI TAB 400MG
ENBREL SURECLICK
N
ENBREL SRCLK INJ 50MG/ML
TECFIDERA
N
TECFIDERA CAP 240MG
HUMIRA PEN
N
HUMIRA PEN INJ 40MG/0.8
STELARA
N
STELARA INJ 90MG/ML
ADVATE
N
ADVATE
INJ 1000UNIT
XOLAIR
N
XOLAIR
SOL 150MG
COPAXONE
N
COPAXONE INJ 40MG/ML
CERDELGA
N
CERDELGA CAP 84MG
HUMIRA
N
HUMIRA
KIT 40MG/0.8
ADVATE
N
ADVATE
INJ 500UNIT
TASIGNA
N
TASIGNA CAP 150MG
GILENYA
N
GILENYA CAP 0.5MG
NORDITROPIN FLEXPRO N
NORDITROPIN INJ 15/1.5ML
AFINITOR
N
AFINITOR TAB 5MG
PULMOZYME
N
PULMOZYME SOL 1MG/ML
HUMIRA
N
HUMIRA
INJ 40MG/0.8
ORENCIA
N
ORENCIA INJ 125MG/ML
HUMIRA
N
HUMIRA
KIT 20MG/0.4
TARCEVA
N
TARCEVA TAB 100MG
ADVATE
N
ADVATE
INJ 1500UNIT
ENBREL
N
ENBREL
INJ 50MG/ML
REBIF
N
REBIF
INJ 44/0.5
OLYSIO
N
OLYSIO
CAP 150MG
SPRYCEL
N
SPRYCEL TAB 100MG
VOTRIENT
N
VOTRIENT TAB 200MG
TECFIDERA
N
TECFIDERA CAP 120MG
STELARA
N
STELARA INJ 45MG/0.5
AVONEX PEN
N
AVONEX PEN KIT 30MCG
REVLIMID
N
REVLIMID CAP 10MG
NORDITROPIN FLEXPRO N
NORDITROPIN INJ 10/1.5ML
ADVATE
N
ADVATE
INJ 500UNIT
REMICADE
N
REMICADE INJ 100MG
ZORTRESS
N
ZORTRESS TAB 0.75MG
SANDOSTATIN LAR DEPOTN
SANDOSTATIN KIT LAR 30MG
GILENYA
N
GILENYA CAP 0.5MG
SIMPONI
N
SIMPONI INJ 50/0.5ML
VIEKIRA PAK
N
VIEKIRA PAK TAB
BOTOX
N
BOTOX
INJ 200UNIT
FORTEO
N
FORTEO
SOL 600/2.4
HUMIRA PEN-PSORIASIS STAR
N
HUMIRA PEN KIT PSORIASI
GLEEVEC
N
GLEEVEC TAB 400MG
ADVATE
N
ADVATE
INJ 1000UNIT
ACTEMRA
N
ACTEMRA INJ 162/0.9
SANDOSTATIN LAR DEPOTN
SANDOSTATIN KIT LAR 20MG
NORDITROPIN FLEXPRO N
NORDITROPIN INJ 5/1.5ML
COPAXONE
N
COPAXONE KIT 20MG/ML
ORTHOVISC
N
ORTHOVISC INJ 15MG/ML
HUMIRA PEN-PSORIASIS STAR
N
HUMIRA PEN INJ PSORIASI
PEGASYS
N
PEGASYS INJ
XELJANZ
N
XELJANZ TAB 5MG
GLEEVEC
N
GLEEVEC TAB 400MG
CIMZIA STARTER KIT
N
CIMZIA
KIT STARTER
SENSIPAR
N
SENSIPAR TAB 30MG
VIVITROL
N
VIVITROL INJ 380MG
NUTROPIN AQ NUSPIN 10N
NUTROPIN AQ INJ 10MG/2ML
ZORTRESS
N
ZORTRESS TAB 0.25MG
ETOPOSIDE
N
ETOPOSIDE CAP 50MG
CIMZIA
N
CIMZIA PREFL KIT 200MG/ML
THYROGEN
N
THYROGEN INJ 1.1MG
LUPRON DEPOT
N
LUPRON DEPOT INJ 3.75MG
SENSIPAR
N
SENSIPAR TAB 60MG
SYNVISC ONE
N
SYNVISC ONE INJ 8MG/ML
SANDOSTATIN LAR DEPOTN
SANDOSTATIN KIT LAR 20MG
SIMPONI
N
SIMPONI INJ 50/0.5ML
LUPRON DEPOT
N
LUPRON DEPOT INJ 11.25MG
BARACLUDE
N
BARACLUDE TAB 0.5MG
CELLCEPT
N
CELLCEPT SUS 200MG/ML
Number of Rxs
184
18
17
146
72
87
18
10
61
40
7
44
7
14
21
29
5
26
22
27
12
12
2
23
13
3
7
7
8
5
8
3
7
2
9
3
7
5
9
1
23
14
4
5
1
7
6
12
3
12
2
3
4
1
1
10
6
8
1
4
2
2
6
4
3
1
1
1
2
2
UNIT AWP
PRICE
LESS
DISCOUNT
Quantity PROPOSED
406
504
476
635
4,320
186
19
160,170
249
480
392
110
107,880
1,568
588
114
280
2,625
56
108
48
360
47,220
90
78
84
210
840
616
2
8
84
58
30,600
36
1,620
7
150
4
112
23
34
16
75
16,365
25 $
6 $
54 $
32 $
90 $
8 $
6 $
240 $
30 $
3 $
444 $
6 $
16 $
900 $
88 $
2 $
4 $
6 $
120 $
18 $
1 $
0 $
1 $
60 $
320 $
-
ACTUAL
ACQUISITION
UNIT NET COST
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
p. 204
16018 ATTACHEMNT A-3 SPECIALTY DRUG COSTS
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
Specialty
12/8/2015 1:11 PM
55513071001
00023114501
00172731146
51927901700
38779000431
65628006201
00004110150
00004026129
00003161112
PROLIA
N
BOTOX
N
CYCLOSPORINE MODIFIEDN
PROGESTERONE WETTABLE
N
PROGESTERONE MICRONIZED
N
FIRST-PROGESTERONE VGS
N 10
XELODA
O
CELLCEPT
O
BARACLUDE
O
Maricopa County
PROLIA
SOL 60MG/ML
BOTOX
INJ 100UNIT
CYCLOSPORINE CAP 50MG MOD
PROGESTERONE POW WETTABLE
PROGESTERONE POW MICRONIZ
PROGESTERONE SUP VGS 100
XELODA
TAB 500MG
CELLCEPT SUS 200MG/ML
BARACLUDE TAB 0.5MG
Bid 16018-RFP
2
1
2
1
1
2
3
0
0
2
1
240
90
30
2
308
0
0
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
-
p. 205
Maricopa County
GEOGRAPHIC AREA, STATE, REGION ETC PRICING IS FOR (DUPLICATE PAGE AS NECESSARY)
GROUP SIZE 1-5000 MEMBERS
1.0 PRICING (discount off AWP):
OPEN NETWORK
1.1 RETAIL PRICING
1.1.1 BRAND NAME AWP LESS DISCOUNT (30 DAY)
_______________%
1.1.2 DISPENSING FEE
_______________$
1.1.3 BRAND NAME AWP LESS DISCOUNT (90 DAY)
_______________%
1.1.2 DISPENSING FEE
_______________$
1.1.3 GENERIC DISCOUNT (30 day)
_______________%
1.1.4 DISPENSING FEE
_______________$
1.1.5 GENERIC DISCOUNT (90 day)
_______________%
1.1.6 DISPENSING FEE
_______________$
1.2 MAIL ORDER
1.2.1 BRAND AWP LESS DISCOUNT
1.2.3 GENERIC DISCOUNT
1.2.2 DISPENSING FEE
Bid 16018-RFP
PREFERRED NETWORK
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
_______________%
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
MINIMUM PER DRUG
PER PRESCRIPTION
1.3 SPECIALTY
1.3.1 BRAND AWP LESS DISCOUNT
1.3.2 DISPENSING FEE
1.3.3 GENERIC DISCOUNT
1.3.5 REBATE ON ALL PRESCRIPTIONS MINUMUM
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
1.4 GENERIC DISCOUNT
1.4.1 SINGLE SOURCE
1.4.2 NON MAC DISCOUNT
_______________%
_______________%
_______________%
_______________%
1.4.3 OVERALL EFFECTIVE GUARANTEED DISCOUNT
_______________%
_______________%
1.6 REBATES
1.6.1 BRAND NAME REBATES
_______________$
_______________$
PER PRESCRIPTION
1.6.2 GUARANTEED OVERALL REBATES ON ALL PRESCRIPTIONS
_______________$
_______________$
PER PRESCRIPTION
GEOGRAPHIC AREA, STATE, REGION ETC PRICING IS FOR (DUPLICATE PAGE AS NECESSARY)
GROUP SIZE 5001 TO 30000 MEMBERS
1.0 PRICING (discount off AWP):
OPEN NETWORK
1.1 RETAIL PRICING
1.1.1 BRAND NAME AWP LESS DISCOUNT (30 DAY)
_______________%
1.1.2 DISPENSING FEE
_______________$
1.1.3 BRAND NAME AWP LESS DISCOUNT (90 DAY)
_______________%
1.1.2 DISPENSING FEE
_______________$
1.1.3 GENERIC DISCOUNT (30 day)
_______________%
1.1.4 DISPENSING FEE
_______________$
1.1.5 GENERIC DISCOUNT (90 day)
_______________%
1.1.6 DISPENSING FEE
_______________$
1.2 MAIL ORDER
1.2.1 BRAND AWP LESS DISCOUNT
1.2.3 GENERIC DISCOUNT
1.2.2 DISPENSING FEE
PREFERRED NETWORK
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
_______________%
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
MINIMUM PER DRUG
PER PRESCRIPTION
1.3 SPECIALTY
1.3.1 BRAND AWP LESS DISCOUNT
1.3.2 DISPENSING FEE
1.3.3 GENERIC DISCOUNT
1.3.5 REBATE ON ALL PRESCRIPTIONS MINUMUM
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
1.4 GENERIC DISCOUNT
1.4.1 SINGLE SOURCE
1.4.2 NON MAC DISCOUNT
_______________%
_______________%
_______________%
_______________%
1.4.3 OVERALL EFFECTIVE GUARANTEED DISCOUNT
_______________%
_______________%
12/8/2015 1:11 PM
PER PRESCRIPTION
p. 206
Maricopa County
Bid 16018-RFP
1.6 REBATES
1.6.1 BRAND NAME REBATES
_______________$
_______________$
PER PRESCRIPTION
1.6.2 GUARANTEED OVERALL REBATES ON ALL PRESCRIPTIONS
_______________$
_______________$
PER PRESCRIPTION
GEOGRAPHIC AREA, STATE, REGION ETC PRICING IS FOR (DUPLICATE PAGE AS NECESSARY)
GROUP SIZE 30001 PLUS MEMBERS
OPEN NETWORK
1.1 RETAIL PRICING
1.1.1 BRAND NAME AWP LESS DISCOUNT (30 DAY)
_______________%
1.1.2 DISPENSING FEE
_______________$
1.1.3 BRAND NAME AWP LESS DISCOUNT (90 DAY)
_______________%
1.1.2 DISPENSING FEE
_______________$
1.1.3 GENERIC DISCOUNT (30 day)
_______________%
1.1.4 DISPENSING FEE
_______________$
1.1.5 GENERIC DISCOUNT (90 day)
_______________%
1.1.6 DISPENSING FEE
_______________$
1.2 MAIL ORDER
1.2.1 BRAND AWP LESS DISCOUNT
1.2.3 GENERIC DISCOUNT
1.2.2 DISPENSING FEE
PREFERRED NETWORK
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
PER PRESCRIPTION
_______________%
_______________%
_______________$
PER PRESCRIPTION
PER PRESCRIPTION
MINIMUM PER DRUG
PER PRESCRIPTION
1.3 SPECIALTY
1.3.1 BRAND AWP LESS DISCOUNT
1.3.2 DISPENSING FEE
1.3.3 GENERIC DISCOUNT
1.3.5 REBATE ON ALL PRESCRIPTIONS MINUMUM
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
_______________%
_______________$
1.4 GENERIC DISCOUNT
1.4.1 SINGLE SOURCE
1.4.2 NON MAC DISCOUNT
_______________%
_______________%
_______________%
_______________%
1.4.3 OVERALL EFFECTIVE GUARANTEED DISCOUNT
_______________%
_______________%
1.6 REBATES
1.6.1 BRAND NAME REBATES
_______________$
_______________$
PER PRESCRIPTION
1.6.2 GUARANTEED OVERALL REBATES ON ALL PRESCRIPTIONS
_______________$
_______________$
PER PRESCRIPTION
12/8/2015 1:11 PM
p. 207
Maricopa County
Bid 16018-RFP
EXHIBIT 3
(DRAFT CONTRACT)
CONTRACT PURSUANT TO RFP
SERIAL 16018-RFP
This Contract is entered into this _____ day of ____________, 20__ by and between Maricopa County (“County”),
a political subdivision of the State of Arizona, and _______________________________, an Arizona corporation
(“Contractor”) for the purchase of Pharmacy Benefit Manager Services.
1.0
2.0
CONTRACT TERM:
1.1
This Contract is for a term of five (5) years, beginning on the first (1) day of July, 2017 and
ending the thirtieth (30) day of June, 2022.
1.2
The County may, at its option and with the agreement of the Contractor, renew the term of this
Contract for additional terms up to a maximum of five (5) additional years, (or at the County’s
sole discretion, extend the contract on a month-to-month bases for a maximum of six (6) months
after expiration). The County shall notify the Contractor in writing of its intent to extend the
Contract term at least sixty (60) calendar days prior to the expiration of the original contract term,
or any additional term thereafter.
FEE ADJUSTMENTS:
2.1
3.0
Any request for a fee adjustment must be submitted one hundred and twenty (120) days prior to
the current Contract expiration date. Requests for adjustment in cost of labor and/or materials
must be supported by appropriate documentation. If County agrees to the adjusted fee, County
shall issue written approval of the change. The reasonableness of the request will be determined
by comparing the request with the (Consumer Price Index) or by performing a market survey.
PAYMENTS:
3.1
As consideration for performance of the duties described herein, County shall pay Contractor the
sum(s) stated in Exhibit “A.”
3.2
Payment shall be made upon the County’s receipt of a properly completed invoice.
3.3
INVOICES:
3.3.1
The Contractor shall submit one (1) legible copy of their detailed invoice before
payment(s) can be made. Incomplete invoices will not be processed. At a minimum, the
invoice must provide the following information:
•
•
•
12/8/2015 1:11 PM
Company name, address and contact
County bill-to name and contact information
Contract Serial Number
p. 208
Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
•
•
•
•
•
•
•
•
•
•
3.4
3.5
County purchase order number
Invoice number and date
Payment terms
Date of service or delivery
Quantity (number of days or weeks)
Contract Item number(s)
Description of Purchase (product or services)
Pricing per unit of purchase
Extended price
•
Total Amount Due
3.3.2
Problems regarding billing or invoicing shall be directed to the using agency as listed on
the Purchase Order.
3.3.3
Payment shall be made to the Contractor by Accounts Payable through the Maricopa
County Vendor Express Payment Program. This is an Electronic Funds Transfer (EFT)
process. After Contract Award the Contractor shall complete the Vendor Registration
Form located on the County Department of Finance Vendor Registration Web Site
(http://www.maricopa.gov/Finance/Vendors.aspx).
3.3.4
Discounts offered in the contract shall be calculated based on the date a properly
completed invoice is received by the County (ROI).
3.3.5
EFT payments to the routing and account numbers designated by the Contractor will
include the details on the specific invoices that the payment covers. The Contractor is
required to discuss remittance delivery capabilities with their designated financial
institution for access to those details.
APPLICABLE TAXES:
3.4.1
Payment of Taxes: The Contractor shall pay all applicable taxes. With respect to any
installation labor on items that are not attached to real property performed by Contractor
under the terms of this Contract, the installation labor cost and the gross receipts for
materials provided shall be listed separately on the Contractor’s invoices.
3.4.2
State and Local Transaction Privilege Taxes: Maricopa County is subject to all
applicable state and local transaction privilege taxes. To the extent any state and local
transaction privilege taxes apply to sales made under the terms of this contract it is the
responsibility of the seller to collect and remit all applicable taxes to the proper taxing
jurisdiction of authority.
3.4.3
Tax Indemnification: Contractor and all subcontractors shall pay all Federal, state, and
local taxes applicable to its operation and any persons employed by the Contractor.
Contractor shall, and require all subcontractors to hold Maricopa County harmless from
any responsibility for taxes, damages and interest, if applicable, contributions required
under Federal, and/or state and local laws and regulations and any other costs including
transaction privilege taxes, unemployment compensation insurance, Social Security and
Worker’s Compensation.
TAX: (SERVICES)
No tax shall be levied against labor. It is the responsibility of the Contractor to determine any and
all taxes and include the same in proposal price.
3.6
TAX (COMMODITIES):
Tax shall not be levied against labor. Sales/use tax will be determined by County. Tax will not be
used in determining low price.
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3.7
STRATEGIC ALLIANCE for VOLUME EXPENDITURES ($AVE):
3.7.1
3.8
INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENTS (ICPA’s)
3.8.1
4.0
5.0
County currently holds ICPA’s with numerous governmental entities throughout the State
of Arizona. These agreements allow those entities, with the approval of the Contractor,
to purchase their requirements under the terms and conditions of the County Contract.
Please indicate on Attachment A, your acceptance or rejection regarding such
participation of other governmental entities. Your response will not be considered as an
evaluation factor in awarding a contract
AVAILABILITY OF FUNDS:
4.1
The provisions of this Contract relating to payment for services shall become effective when funds
assigned for the purpose of compensating the Contractor as herein provided are actually available
to County for disbursement. The County shall be the sole judge and authority in determining the
availability of funds under this Contract. County shall keep the Contractor fully informed as to the
availability of funds.
4.2
If any action is taken by any state agency, Federal department or any other agency or
instrumentality to suspend, decrease, or terminate its fiscal obligations under, or in connection
with, this Contract, County may amend, suspend, decrease, or terminate its obligations under, or in
connection with, this Contract. In the event of termination, County shall be liable for payment
only for services rendered prior to the effective date of the termination, provided that such services
are performed in accordance with the provisions of this Contract. County shall give written notice
of the effective date of any suspension, amendment, or termination under this Section, at least ten
(10) days in advance.
DUTIES:
5.1
6.0
The County is a member of the $AVE cooperative purchasing group. $AVE includes the
State of Arizona, many Phoenix metropolitan area municipalities, and many K-12 unified
school districts. Under the $AVE Cooperative Purchasing Agreement, and with the
concurrence of the successful Respondent under this solicitation, a member of $AVE
may access a contract resulting from a solicitation issued by the County. If you do not
want to grant such access to a member of $AVE, please so state in your proposal. In the
absence of a statement to the contrary, the County will assume that you do wish to grant
access to any contract that may result from this Request for Proposal.
The Contractor shall perform all duties stated in Exhibit “B”, or as otherwise directed in writing
by the Procurement Officer.
TERMS and CONDITIONS:
6.1
INDEMNIFICATION:
To the fullest extent permitted by law, and to the extent that claims, damages, losses or expenses
are not covered and paid by insurance purchased by the Contractor, the Contractor shall defend
indemnify and hold harmless the County (as Owner), its agents, representatives, agents, officers,
directors, officials, and employees from and against all claims, damages, losses, and expenses
(including, but not limited to attorneys' fees, court costs, expert witness fees, and the costs and
attorneys' fees for appellate proceedings) arising out of, or alleged to have resulted from the
negligent acts, errors, omissions, or mistakes relating to the performance of this Contract.
Contractor's duty to defend, indemnify, and hold harmless the County, its agents, representatives,
agents, officers, directors, officials, and employees shall arise in connection with any claim,
damage, loss, or expense that is attributable to bodily injury, sickness, disease, death or injury to,
impairment of, or destruction of tangible property, including loss of use resulting there from,
caused by negligent acts, errors, omissions, or mistakes in the performance of this Contract, but
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only to the extent caused by the negligent acts or omissions of the Contractor, a subcontractor, any
one directly or indirectly employed by them, or anyone for whose acts they may be liable,
regardless of whether or not such claim, damage, loss, or expense is caused in part by a party
indemnified hereunder.
The amount and type of insurance coverage requirements set forth herein will in no way be
construed as limiting the scope of the indemnity in this paragraph.
The scope of this indemnification does not extend to the sole negligence of County.
6.2
INSURANCE.
6.2.1
Contractor, at Contractor’s own expense, shall purchase and maintain the herein
stipulated minimum insurance from a company or companies duly licensed by the State
of Arizona and possessing a current A.M. Best, Inc. rating of B++. In lieu of State of
Arizona licensing, the stipulated insurance may be purchased from a company or
companies, which are authorized to do business in the State of Arizona, provided that
said insurance companies meet the approval of County. The form of any insurance
policies and forms must be acceptable to County.
6.2.2
All insurance required herein shall be maintained in full force and effect until all work or
service required to be performed under the terms of the Contract is satisfactorily
completed and formally accepted. Failure to do so may, at the sole discretion of County,
constitute a material breach of this Contract.
6.2.3
Contractor’s insurance shall be primary insurance as respects County, and any insurance
or self-insurance maintained by County shall not contribute to it.
6.2.4
Any failure to comply with the claim reporting provisions of the insurance policies or any
breach of an insurance policy warranty shall not affect the County’s right to coverage
afforded under the insurance policies.
6.2.5
The insurance policies may provide coverage that contains deductibles or self-insured
retentions. Such deductible and/or self-insured retentions shall not be applicable with
respect to the coverage provided to County under such policies. Contractor shall be
solely responsible for the deductible and/or self-insured retention and County, at its
option, may require Contractor to secure payment of such deductibles or self-insured
retentions by a surety bond or an irrevocable and unconditional letter of credit.
6.2.6
The insurance policies required by this Contract, except Workers’ Compensation and
Errors and Omissions, shall name County, its agents, representatives, officers, directors,
officials and employees as Additional Insureds.
6.2.7
The policies required hereunder, except Workers’ Compensation and Errors and
Omissions, shall contain a waiver of transfer of rights of recovery (subrogation) against
County, its agents, representatives, officers, directors, officials and employees for any
claims arising out of Contractor’s work or service.
6.2.8
Commercial General Liability.
Commercial General Liability insurance and, if necessary, Commercial Umbrella
insurance with a limit of not less than $2,000,000 for each occurrence, $4,000,000
Products/Completed Operations Aggregate, and $4,000,000 General Aggregate Limit.
The policy shall include coverage for premises liability, bodily injury, broad form
property damage, personal injury, products and completed operations and blanket
contractual coverage, and shall not contain any provisions which would serve to limit
third party action over claims. There shall be no endorsement or modifications of the
CGL limiting the scope of coverage for liability arising from explosion, collapse, or
underground property damage.
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6.2.9
Automobile Liability.
Commercial/Business Automobile Liability insurance and, if necessary, Commercial
Umbrella insurance with a combined single limit for bodily injury and property damage
of not less than $1,000,000 each occurrence with respect to any of the Contractor’s
owned, hired, and non-owned vehicles assigned to or used in performance of the
Contractor’s work or services or use or maintenance of the Premises under this Contract.
6.2.10
Workers’ Compensation.
Workers’ Compensation insurance to cover obligations imposed by federal and state
statutes having jurisdiction of Contractor’s employees engaged in the performance of the
work or services under this Contract; and Employer’s Liability insurance of not less than
$1,000,000 for each accident, $1,000,000 disease for each employee, and $1,000,000
disease policy limit.
Contractor, its contractors and its subcontractors waive all rights against Contract and its
agents, officers, directors and employees for recovery of damages to the extent these
damages are covered by the Workers’ Compensation and Employer’s Liability or
commercial umbrella liability insurance obtained by Contractor, its contractors and its
subcontractors pursuant to this Contract.
6.2.11
Errors and Omissions (Professional Liability) Insurance.
Errors and Omissions (Professional Liability) insurance and, if necessary, Commercial
Umbrella insurance, which will insure and provide coverage for errors or omissions or
professional liability of the CONTRACTOR, with limits of no less than $2,000,000 for
each claim.
6.2.12
Professional Liability.
Contractor shall maintain Professional Liability insurance which will provide coverage
for any and all acts arising out of the work or services performed by the Contractor under
the terms of this Contract, with a limit of not less than $1,000,000 for each claim, and
$3,000,000 aggregate claims.
6.2.13
6.2.14
Certificates of Insurance.
6.2.13.1
Prior to Contract AWARD, Contractor shall furnish the County with valid and
complete certificates of insurance, or formal endorsements as required by the
Contract in the form provided by the County, issued by Contractor’s
insurer(s), as evidence that policies providing the required coverage,
conditions and limits required by this Contract are in full force and effect.
Such certificates shall identify this contract number and title.
6.2.13.2
In the event any insurance policy (ies) required by this contract is (are) written
on a “claims made” basis, coverage shall extend for two years past completion
and acceptance of Contractor’s work or services and as evidenced by annual
Certificates of Insurance.
6.2.13.3
If a policy does expire during the life of the Contract, a renewal certificate
must be sent to County fifteen (15) days prior to the expiration date.
Cancellation and Expiration Notice.
Applicable to all insurance policies required within the Insurance Requirements of this
Contract, Contractor’s insurance shall not be permitted to expire, be suspended, be
canceled, or be materially changed for any reason without thirty (30) days prior written
notice to Maricopa County. Contractor must provide to Maricopa County, within 2
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business days of receipt, if they receive notice of a policy that has been or will be
suspended, canceled, materially changed for any reason, has expired, or will be expiring.
Such notice shall be sent directly to Maricopa County Office of Procurement Services
and shall be mailed or hand delivered to 320 West Lincoln Street, Phoenix, AZ 85003, or
emailed to Procurement Officer noted in solicitation.
6.3
6.4
WARRANTY OF SERVICES:
6.3.1
The Contractor warrants that all services provided hereunder will conform to the
requirements of the Contract, including all descriptions, specifications and attachments
made a part of this Contract. County’s acceptance of services or goods provided by the
Contractor shall not relieve the Contractor from its obligations under this warranty.
6.3.2
In addition to its other remedies, County may, at the Contractor's expense, require prompt
correction of any services failing to meet the Contractor's warranty herein. Services
corrected by the Contractor shall be subject to all the provisions of this Contract in the
manner and to the same extent as services originally furnished hereunder.
REQUIREMENTS CONTRACT:
6.4.1
6.5
Contractors signify their understanding and agreement by signing a submittal, that the
Contract resulting from the RFP is a requirements contract. However, the Contract does
not guarantee any minimum or maximum number of purchases will be made. It only
indicates that if purchases are made for the materials or services contained in the
Contract, they will be purchased from the Contractor awarded that item if the Contractor
can meet all the delivery requirements of the County. Orders will only be placed when
the County identifies a need and proper authorization and documentation have been
approved.
Background Check:
Contractors need to be aware that there may be multiple background checks (Sheriff’s Office,
County Attorney's Office, Courts as well as Maricopa County general government) to determine if
the respondents employees are acceptable for the contractor to do business with the County. This
applies to (but is not limited to) the company and sub-contractors. Employees or others who fail to
pass these checks shall not be allowed to work on County projects. Failure to meet these
requirements may lead to termination of the contract.
6.6
Suspension of Work
The Procurement Officer may order the Contractor, in writing, to suspend, delay, or interrupt all or
any part of the work of this contract for the period of time that the Procurement Officer determines
appropriate for the convenience of the County. No adjustment shall be made under this clause for
any suspension, delay, or interruption to the extent that performance would have been so
suspended, delayed, or interrupted by any other cause, including the fault or negligence of the
Contractor. No request for adjustment under this clause shall be granted unless the claim, in an
amount stated, is asserted in writing as soon as practicable after the termination of the suspension,
delay, or interruption, but not later than the date of final payment under the contract.
6.7
Stop Work Order
The Procurement Officer may, at any time, by written order to the Contractor, require the
Contractor to stop all, or any part, of the work called for by this contract for a period of 90 days
after the order is delivered to the Contractor, and for any further period to which the parties may
agree. The order shall be specifically identified as a stop work order issued under this clause.
Upon receipt of the order, the Contractor shall immediately comply with its terms and take all
reasonable steps to minimize the incurrence of costs allocable to the work covered by the order
during the period of work stoppage. Within a period of 90 days after a stop-work is delivered to
the Contractor, or within any extension of that period to which the parties shall have agreed, the
Procurement Officer shall either—
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6.8
6.7.1
Cancel the stop-work order; or
6.7.2
Terminate the work covered by the order as provided in the Default, or the Termination
for Convenience of the County, clause of this contract.
6.7.3
The Procurement Officer may make an equitable adjustment in the delivery schedule
and/or contract price, or otherwise, and the contract shall be modified, in writing,
accordingly, if the Contractor demonstrates that the stop work order resulted in an
increase in costs to the Contractor.
UNCONDITIONAL TERMINATION FOR CONVENIENCE:
Maricopa County may terminate the resultant Contract for convenience by providing sixty (60)
calendar days advance notice to the Contractor.
6.9
TERMINATION FOR DEFAULT:
The County may, by written notice of default to the Contractor, terminate this contract in whole or
in part if the Contractor fails to:
6.10
6.9.1
Deliver the supplies or to perform the services within the time specified in this contract or
any extension;
6.9.2
Make progress, so as to endanger performance of this contract; or
6.9.3
Perform any of the other provisions of this contract.
6.9.4
The County’s right to terminate this contract under these subparagraph may be exercised
if the Contractor does not cure such failure within 10 days (or more if authorized in
writing by the County) after receipt of the notice from the Procurement Officer
specifying the failure.
STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST:
Notice is given that pursuant to A.R.S. § 38-511 the County may cancel any Contract without
penalty or further obligation within three years after execution of the contract, if any person
significantly involved in initiating, negotiating, securing, drafting or creating the contract on
behalf of the County is at any time while the Contract or any extension of the Contract is in effect,
an employee or agent of any other party to the Contract in any capacity or consultant to any other
party of the Contract with respect to the subject matter of the Contract. Additionally, pursuant to
A.R.S § 38-511 the County may recoup any fee or commission paid or due to any person
significantly involved in initiating, negotiating, securing, drafting or creating the contract on
behalf of the County from any other party to the contract arising as the result of the Contract.
6.11
CONTRACTOR LICENSE REQUIREMENT:
6.11.1
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The Respondent shall procure all permits, insurance, licenses and pay the charges and
fees necessary and incidental to the lawful conduct of his/her business, and as necessary
complete any required certification requirements, required by any and all governmental
or non-governmental entities as mandated to maintain compliance with and in good
standing for all permits and/or licenses. The Respondent shall keep fully informed of
existing and future trade or industry requirements, Federal, State and Local laws,
ordinances, and regulations which in any manner affect the fulfillment of a Contract and
shall comply with the same. Contractor shall immediately notify both Office of
Procurement Services and the using agency of any and all changes concerning permits,
insurance or licenses.
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6.12
6.13
SUBCONTRACTING:
6.12.1
The Contractor may not assign to another Contractor or Subcontract to another party for
performance of the terms and conditions hereof without the written consent of the
County. All correspondence authorizing subcontracting must reference the Serial
Number and identify the job project.
6.12.2
The Subcontractor’s rate for the job shall not exceed that of the Prime Contractor’s rate,
as bid in the pricing section, unless the Prime Contractor is willing to absorb any higher
rates or the County has approved the increase. The Subcontractor’s invoice shall be
invoiced directly to the Prime Contractor, who in turn shall pass-through the costs to the
County, without mark-up. A copy of the Subcontractor’s invoice must accompany the
Prime Contractor’s invoice.
AMENDMENTS:
All amendments to this Contract shall be in writing and approved/signed by both parties. Maricopa
County Office of Procurement Services shall be responsible for approving all amendments for
Maricopa County.
6.14
6.15
ADDITIONS/DELETIONS OF SERVICE:
6.14.1
The County reserves the right to add and/or delete materials and services to a Contract. If
a service requirement is deleted, payment to the Contractor will be reduced
proportionately, to the amount of service reduced in accordance with the bid price. If
additional materials or services are required from a Contract, prices for such additions
will be negotiated between the Contractor and the County.
6.14.2
The County reserves the right of final approval on proposed staff for all Task Orders.
Also, upon request by the County, the Contractor will be required to remove any
employees working on County projects and substitute personnel based on the discretion
of the County within two business days, unless previously approved by the County.
VALIDITY:
The invalidity, in whole or in part, of any provision of this Contract shall not void or affect the
validity of any other provision of the Contract.
6.16
SEVERABILITY:
The invalidity, in whole or in part, of any provision of this Contract shall not void or affect the
validity of any other provision of this Contract.
6.17
RIGHTS IN DATA:
The County shall have the use of data and reports resulting from a Contract without additional cost
or other restriction except as may be established by law or applicable regulation. Each party shall
supply to the other party, upon request, any available information that is relevant to a Contract and
to the performance thereunder.
6.18
NON-DISCRIMINATION:
CONTRACTOR agrees to comply with all provisions and requirements of Arizona Executive
Order 2009-09 including flow down of all provisions and requirements to any subcontractors.
Executive Order 2009-09 supersedes Executive order 99-4 and amends Executive order 75-5 and
may be viewed and downloaded at the Governor of the State of Arizona’s website
http://azmemory.azlibrary.gov/cdm/singleitem/collection/execorders/id/680/rec/1 which is hereby
incorporated into this contract as if set forth in full herein. During the performance of this contract,
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CONTRACTOR shall not discriminate against any employee, client or any other individual in any
way because of that person’s age, race, creed, color, religion, sex, disability or national origin.
6.19
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
6.19.1
6.19.2
6.20
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The undersigned (authorized official signing for the Contractor) certifies to the best of his
or her knowledge and belief, that the Contractor
6.18.1.1
is not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any Federal
Department or agency;
6.18.1.2
have not within 3-year period preceding this Contract been convicted of or
had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statues or
commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
6.18.1.3
are not presently indicted or otherwise criminally or civilly charged by a
government entity (Federal, State or local) with commission of any of the
offenses enumerated in paragraph (2) of this certification; and
6.18.1.4
have not within a 3-year period preceding this Contract had one or more
public transaction (Federal, State or local) terminated for cause of default.
The Contractor agrees to include, without modification, this clause in all lower tier
covered transactions (i.e. transactions with subcontractors) and in all solicitations for
lower tier covered transactions related to this Contract.
VERIFICATION REGARDING COMPLIANCE WITH ARIZONA REVISED STATUTES §414401 AND FEDERAL IMMIGRATION LAWS AND REGULATIONS:
6.20.1
By entering into the Contract, the Contractor warrants compliance with the Immigration
and Nationality Act (INA using e-verify) and all other federal immigration laws and
regulations related to the immigration status of its employees and A.R.S. §23-214(A). The
contractor shall obtain statements from its subcontractors certifying compliance and shall
furnish the statements to the Procurement Officer upon request. These warranties shall
remain in effect through the term of the Contract. The Contractor and its subcontractors
shall also maintain Employment Eligibility Verification forms (I-9) as required by the
Immigration Reform and Control Act of 1986, as amended from time to time, for all
employees performing work under the Contract and verify employee compliance using the
E-verify system and shall keep a record of the verification for the duration of the
employee’s employment or at least three years, whichever is longer. I-9 forms are available
for download at USCIS.GOV.
6.20.2
The County retains the legal right to inspect contractor and subcontractor employee
documents performing work under this Contract to verify compliance with paragraph 6.19.1
of this Section. Contractor and subcontractor shall be given reasonable notice of the
County’s intent to inspect and shall make the documents available at the time and date
specified. Should the County suspect or find that the Contractor or any of its subcontractors
are not in compliance, the County will consider this a material breach of the contract and
may pursue any and all remedies allowed by law, including, but not limited to: suspension
of work, termination of the Contract for default, and suspension and/or debarment of the
Contractor. All costs necessary to verify compliance are the responsibility of the
Contractor.
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6.21
INFLUENCE
As prescribed in MC1-1202 of the Maricopa County Procurement Code, any effort to influence an
employee or agent to breach the Maricopa County Ethical Code of Conduct or any ethical conduct
may be grounds for Disbarment or Suspension under MC1-902.
An attempt to influence includes, but is not limited to:
6.21.1
A Person offering or providing a gratuity, gift, tip, present, donation, money,
entertainment or educational passes or tickets, or any type valuable contribution or
subsidy,
6.21.2
That is offered or given with the intent to influence a decision, obtain a contract, garner
favorable treatment, or gain favorable consideration of any kind.
If a Person attempts to influence any employee or agent of Maricopa County, the Chief
Procurement Officer, or his designee, reserves the right to seek any remedy provided by the
Maricopa County Procurement Code, any remedy in equity or in the law, or any remedy provided
by this contract.
6.22
6.23
ACCESS TO AND RETENTION OF RECORDS FOR THE PURPOSE OF AUDIT AND/OR
OTHER REVIEW:
6.22.1
In accordance with section MCI 371 of the Maricopa County Procurement Code the
Contractor agrees to retain all books, records, accounts, statements, reports, files, and
other records and back-up documentation relevant to this Contract for six (6) years after
final payment or until after the resolution of any audit questions which could be more
than six (6) years, whichever is latest. The County, Federal or State auditors and any
other persons duly authorized by the Department shall have full access to, and the right to
examine, copy and make use of, any and all said materials.
6.22.2
If the Contractor’s books, records , accounts, statements, reports, files, and other records
and back-up documentation relevant to this Contract are not sufficient to support and
document that requested services were provided, the Contractor shall reimburse Maricopa
County for the services not so adequately supported and documented.
6.22.3
If at any time it is determined by the County that a cost for which payment has been made
is a disallowed cost, the County shall notify the Contractor in writing of the
disallowance. The course of action to address the disallowance shall be at sole discretion
of the County, and may include either an adjustment to future invoices, request for credit,
request for a check or deduction from current billings Submitted by the Contractor by the
amount of the disallowance, or to require reimbursement forthwith of the disallowed
amount by the Contractor by issuing a check payable to Maricopa County.
AUDIT DISALLOWANCES:
If at any time, County determines that a cost for which payment has been made is a disallowed
cost, such as overpayment, County shall notify the Contractor in writing of the disallowance.
County shall also state the means of correction, which may be but shall not be limited to
adjustment of any future claim submitted by the Contractor by the amount of the disallowance, or
to require repayment of the disallowed amount by the Contractor.
6.24
OFFSET FOR DAMAGES;
In addition to all other remedies at Law or Equity, the County may offset from any money due to
the Contractor any amounts Contractor owes to the County for damages resulting from breach or
deficiencies in performance of the contract.
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6.25
PUBLIC RECORDS:
Under Arizona law, all Offers submitted and opened are public records and must be retained by
the Records Manager at the Office of Procurement Services. Offers shall be open to public
inspection and copying after Contract award and execution, except for such Offers or sections
thereof determined to contain proprietary or confidential information. by the Office of
Procurement Services. If an Offeror believes that information in its Offer or any resulting Contract
should not be released in response to a public record request under Arizona law, the Offeror shall
indicate the specific information deemed confidential or proprietary and submit a statement with
its offer detailing the reasons that the information should not be disclosed. Such reasons shall
include the specific harm or prejudice which may arise from disclosure. The Records Manager of
the Office of Procurement Services shall determine whether the identified information is
confidential pursuant to the Maricopa County Procurement Code.
6.26
PRICES:
Contractor warrants that prices extended to County under this Contract are no higher than those
paid by any other customer for these or similar services.
6.27
INTEGRATION:
This Contract represents the entire and integrated agreement between the parties and supersedes
all prior negotiations, proposals, communications, understandings, representations, or agreements,
whether oral or written, express or implied.
6.28
RELATIONSHIPS:
In the performance of the services described herein, the Contractor shall act solely as an
independent contractor, and nothing herein or implied herein shall at any time be construed as to
create the relationship of employer and employee, co-employee, partnership, principal and agent,
or joint venture between the County and the Contractor.
6.29
GOVERNING LAW:
This Contract shall be governed by the laws of the state of Arizona. Venue for any actions or
lawsuits involving this Contract will be in Maricopa County Superior Court or in the United States
District Court for the District of Arizona, sitting in Phoenix, Arizona
6.30
INCORPORATION OF DOCUMENTS:
The following are to be attached to and made part of this Contract:
6.30.1
Exhibit A, Pricing;
6.30.2
Exhibit B, Scope of Work;
6.30.3
Exhibit C, HIPAA (Business Associate Agreement)
NOTICES:
All notices given pursuant to the terms of this Contract shall be addressed to:
For County:
Maricopa County
Office of Procurement Services
ATTN: Contract Administration
320 West Lincoln Street
Phoenix, Arizona 85003-2494
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Maricopa County
Bid 16018-RFP
SERIAL 16018-RFP
For Contractor:
IN WITNESS WHEREOF, this Contract is executed on the date set forth above.
CONTRACTOR
AUTHORIZED SIGNATURE
PRINTED NAME AND TITLE
ADDRESS
DATE
MARICOPA COUNTY
CHAIRMAN, BOARD OF SUPERVISORS
DATE
ATTESTED:
CLERK OF THE BOARD
DATE
APPROVED AS TO FORM:
LEGAL COUNSEL
12/8/2015 1:11 PM
DATE
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Bid 16018-RFP
16018 QUESTIONS AND ANSWERS
1.
Will the County be providing a Summary document of the most recent 12 months of
prescription activity, including information on total # of rxs paid, access point (retail, mail,
retail 90, Specialty), brand/generic usage, etc.
ANSWER
SEE EXHIBIT 10 OF THIS ADDENDUM.
2.
Will the County be providing a report of the Top 100 pharmacies used by members
including the number of prescriptions obtained at each one?
ANSWER
NO. THIS INFORMATION WILL NOT BE PROVIDED.
3.
The Attachment A Pricing Page document
a. Does not have an NDC number for each product listed? AWP pricing is NDC specific.
Please provide an NCD# for each line item
ANSWER
SEE REVISED ATTACHMENTS A-1, A-2 AND A-3.
b. Does not specify a date to be used for the AWP price that is to be supplied in tabs A-1,
A-2, and A-3. Please provide a specific date due to the fact that AWP prices fluctuate.
ANSWER
USE DECEMBER 1, 2015.
c. Does not specify Retail, Retail 90 or Mail—please advise if you would like to see
retail, Retail 90 or Mail or if you will be revising the document to include additional tabs
for each access point.
ANSWER
THERE WILL NOT BE ADDITIONAL TABS FOR RETAIL, RETAIL 90, AND
MAIL ORDER. MAIL ORDER IS INSIGNIFICANT AS IT IS ONLY 1.76% OF
UNIT VOLUME.
d. We have one pharmacy chain at more favorable rates. If we can have top 100
pharmacies with rx count we can provide aggregated discounts. If not, is it permissible to
create new tabs and fill out pricing twice, once at the favorable rates and another tab with
the rest of the network?
ANSWER
THIS INFORMATION WILL NOT BE PROVIDED. ATTACHMENT A IS
ALREADY FORMATTED FOR OPEN NETWORK AND PREFERRED
NETWORK.
4.
12/8/2015 1:11 PM
Are there any Clinical Programs currently in place that need to be duplicated in the new
contract? If so, please provide detail on each program
ANSWER
REFER TO THE CATAMARAN SPD POSTED ON THE BENEFITS WEBSITE
AT WWW.MARICOPA.GOV/BENEFTIS (UNDER THE PRESCRIPTION TAB).
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5.
Attachment F includes all zip codes to provide a Geo Access report, but does not include
the number of employees in each zip code. Will the County provide an updated document
with the number of employees added to the document? This is important particularly with
the Preferred network due to the fact that if 2000 employees are in a zip code without
access versus 2 employees, the overall access percentage to the network is greatly
affected.
ANSWER
NO. THIS INFORMATION WILL NOT BE PROVIDED.
6.
Please confirm for Attachment A-1, A-2 and A-3 that the Net Cost column calculation
should be the AWP price minus the discount (or MAC price for generics if lower than the
AWP discounted price) multiplied by the quantity listed in column D on all 3 tabs.
ANSWER
COLUMN H SHOULD BE THE STANDARD AWP PRICE LESS YOUR
PROPOSED DISCOUNT. COLUMN I SHOULD BE THE ACTUAL
ACQUISITION COST OF THE DRUG. USE REVISED ATTACHMENTS THAT
ARE PART OF THIS ADDENDUM.
7.
Section 5.6.16 Exhibit 5 under the Proposal Format states “signed unaltered”. What if we
have exceptions or deletions needed to be able to sign the US Communities contract?
Please advise how we should include in the bid response.
ANSWER
REFERENCE SECTION 5.4 OF THE RFP.
8.
Exhibit 5 US Communities Administrative Agreement, Section 5.1 indicates “two percent
(2%) of aggregate purchases made during each calendar month (individually and
collectively” as an Administrative Fee to US Communities. Please confirm if this is to be
based on the Plan Cost of Maricopa County for all prescriptions or if it is to be based off
the Administrative fee per Paid Claim that will be charged separately to the County on a
monthly basis.
ANSWER
IF PROPOSER’S PRICING STRATEGY INCLUDES A SEPARATE FEE PER
CLAIM IN ADDITION TO THE PLAN COST, THE U.S. COMMUNITIES
ADMINISTRATION FEE WILL BE BASED ON THE FEE PER CLAIM. IF
PROPOSER’S PRICING STRATEGY INCLUDES ITS COSTS/FEES IN THE
PLAN COST, THE U.S. COMMUNITIES ADMINISTRATION FEE WILL BE
BASED ON THE PLAN COST UNLESS PROPOSER CAN EASILY PROVIDE A
BREAKDOWN OF CHARGES SHOWING THE LINE ITEM FOR CLAIMS
COSTS. IF THIS IS THE CASE, THEN THE ADMINISTRATION FEE WILL BE
BASED ON PLAN COST MINUS CLAIMS COST. IT IS UP TO THE PROPOSER
TO DEMONSTRATE ITS ABILITY TO EASILY BREAK DOWN
CHARGES/COSTS.
9.
It appears that the RFP particularly, Attachment D (Sections; Distribution, Products,
Environmental and Administration) were written to accommodate other US Communities
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Bid 16018-RFP
supplier partners. Are they applicable to the PBM response?
ANSWER
YES, PROPOSERS ARE TO RESPOND TO THE SUPPLIER INFORMATION
SECTION IN ATTACHMENT D. HOWEVER, YOU MAY STATE “NOT
APPLICABLE” IF A QUESTION DOES NOT APPLY TO YOUR COMPANY.
10. Will the county please provide a list of all vendors that attended the bidder’s conference?
ANSWER
YES. SEE ATTACHED.
11. As discussed during the bidder’s conference, proposed pricing for Maricopa County is based on
demographic market conditions. Most if not all vendors cannot support the same contractual rates
in markets such as Hawaii and Alaska. In order to offer a competitive proposal that meets the
integrity of the County and U.S. Communities RFP, will you allow separate pricing proposals for
the Hawaii and Alaska markets?
ANSWER
SEE ATTACHED U.S. COMMUNITIES PRICING REQUEST ATTACHMENT A-4.
DUPLICATE AS NECESSARY TO PROVIDE NATIONWIDE PRICING BASED ON
YOUR BUSINESS MODEL (I.E. BY STATE, REGION MARKET ETC.).
12. Please provide actual call volume and average handle times for previous plan year
ANSWER
THIS INFORMATION IS NOT AVAILABLE.
13. Exhibit 5, Article V 5.1 – Administrative Fees: How does the County anticipate the fee
payment to US Communities will be paid? Are we to add 2% to the cost of prescriptions for
Maricopa County plan participants and then remit the fee to U.S. Communities?
ANSWER
SEE ANSWER TO QUESTION 8. ADDITIONALLY, SEE EXHIBIT 5, SECTION
3.3 (b)(i).
14. Exhibit 5, Article V 5.1 – Administrative Fees: Should our discount guarantees include or
exclude the 2% commissions to be paid to U.S. Communities?
ANSWER
SEE EXHIBIT 5, SECTION 3.3 (b)(i).
15. Exhibit 5 – Administration Agreement – The scope of some or all of this agreement for a
global, publicly held organization would require shareholder approval which is unfeasible in
the timeframe of the RFP. While we support cooperative purchasing arrangements, it is not
the current organizational direction to tie our significant government segment of business to
one cooperative purchasing organization within the scope of one RFP response. Would
Maricopa County consider a proposal for pharmacy benefits management without agreeing
to the administration agreement provided in Exhibit 5?
ANSWER
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THE COUNTY WOULD ONLY CONSIDER A STAND ALONE PROPOSAL IF WE
DO NOT NEGOTIATE A NATIONWIDE CONTRACT. THE COUNTY ALWAYS
RESERVES THE RIGHT FOR MULTIPLE AWARDS.
16. Attachment A-1 Retail Acquisition Pricing, Attachment A-2 Mail Order Acquisition Pricing
and Attachment A-3 Specialty Drug Acquisition Pricing: Can you please provide these
documents with the NDC code for each of the drugs noted on the three tabs? We cannot
provide proper pricing information without that data.
ANSWER
YES. SEE REVISED ATTACHMENTS A-1, A-2 AND A-3.
17. On Excel Attachment A there is a reference to payment terms (see table below). Please
confirm whether this refers to paying claims or the County paying Contractor, and the type
of payment (admin fees, claims paid through bank account, etc.).
RESPONDENT IS REQUIRED TO PICK ONE OF THE FOLLOWING PAYMENT TERMS.
FAILURE TO INDICATE PAYMENT TERMS WILL RESULT IN A DEFAULT TO NET 30 DAYS.
RESPONDENT MUST INITIAL THEIR SELECTION BELOW.
[ ] NET 10 DAYS
[
[ ] NET 15 DAYS
[
[ ] NET 20 DAYS
[
[ ] NET 30 DAYS
[
ANSWER
RESPONSE SHOULD INCLUDE PROPOSED PAYMENT TERMS FOR CLAIMS.
CURRENTLY, CLAIMS ARE PAID SEMI-MONTHLY.
]
]
]
]
NET 45 DAY
NET 60 DAY
NET 90 DAY
2% 10 DAYS
18. Census Report: Can you please provide a census report that shows all eligible employees of
the County and what medical plan they are enrolled in with tier election?
ANSWER
CURRENTLY THERE ARE 9,490 EMPLOYEES IN THE PLANS COVERED BY
THE RFP. POTENTIALLY THERE COULD BE 2,141 ADDITIONAL
EMPLOYEES TO BE COVERED BUT NOT IN THE NEAR FUTURE.
601-CIGNA HMO
604-UHC PPO
TOTAL FOR
THIS PROPOSAL
OTHER
PHARMACY PLAN
606-UHC HDHP
W/HSA
12/8/2015 1:11 PM
SUBSCRIBERS
5,534.00
3,956.00
MEMBERS
12,939.00
9,020.00
9,490.00
21,959.00
2,141.00
5,538.00
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Bid 16018-RFP
19. Pharmacy Plan Design: Can you please provide a copy of the current Pharmacy plan
design? We have tried to pull this from the website provided in Attachment E, but we keep
getting error messages. We also need confirmation of the 7/1/2016 plan designs.
ANSWER
FOR THE 2015-2016 PLAN DESIGN, REFER TO THE CATAMARAN SPD
POSTED ON THE BENEFITS WEBSITE AT WWW.MARICOPA.GOV/BENEFTIS
(UNDER THE PRESCRIPTION TAB). THE 2016-2017 PLAN DESIGN IS NOT YET
AVAILABLE.
20. Pharmacy Claims Utilization data: Can you please provide a pharmacy claims utilization
data file for the most recent 12-month time period that includes NDC-11, drug
name/strength, metric quantity, and days’ supply, date of service/fill date, mail/retail
indicator, generic/brand indicator, and NABP/NPI of dispensing pharmacy? The data file
from Catamaran should break out the Cigna HMO and United Healthcare PPO populations.
We also need the corresponding lives by month.
ANSWER
CLAIMS UTILIZATION WILL NOT BE PROVIDED. MEMBERS ARE LISTED
IN #18. THERE IS VERY LITTLE FLUCTUATION BY MONTH AS THIS IS A
STABLE GOVERNMENT PLAN.
21. Pharmacy Discounts, Rebates, and Fees: Can you please provide the current pharmacy
discounts, rebates earned and/or fees?
ANSWER
SEE CONTRACT 10082-RFP ON THE COUNTY’S CONTRACT WEBSITE.
22. Pharmacy Formulary: Can you please provide a copy of the current pharmacy formulary?
ANSWER
REFER TO THE CATAMARAN PRESCRIPTION DRUG LIST POSTED ON THE
BENEFITS WEBSITE AT WWW.MARICOPA.GOV/BENEFTIS (UNDER THE
PRESCRIPTION TAB).
23. Pharmacy Clinical Programs: Can you please provide a list of the current pharmacy clinical
programs in place today (i.e. step therapy, prior authorizations, quantity limits, etc.)?
ANSWER
REFER TO THE CATAMARAN SPD POSTED ON THE BENEFITS WEBSITE AT
WWW.MARICOPA.GOV/BENEFTIS (UNDER THE PRESCRIPTION TAB).
24. On-site Pharmacy: Does the County contract its own rates at the on-site pharmacy? If the
County has its own rates, please confirm the pharmacy’s NABP number so we can identify
the on-site pharmacy utilization in the claim file.
ANSWER
THE ONSITE PHARMACY WILL BE CONSIDERED PART OF THE NETWORK.
25. Dedicated Account Manager: Does the County require an account manager who works with
no clients other than Maricopa County?
ANSWER
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NO.
26. Dedicated Clinical Pharmacy Consultant: Does the County require a clinical pharmacy
consultant who works with no clients other than Maricopa County?
ANSWER
NO.
27. Dedicated Customer Service: The RFP asks about a dedicated customer service team
available between the hours of 7 AM – 5 PM MST, Monday – Friday. Is it acceptable to
have designated customer service staff members who handle calls from Maricopa County
but may also support some other clients?
ANSWER
THE COUNTY SHOULD HAVE ITS OWN DEDICATED CUSTOMER SERVICE
NUMBER AND THE CUSTOMER SERVICE STAFF MUST BE WELL-VERSED IN
THE COUNTY’S PRESCRIPTION PLAN.
28. Contract Documents: Please clarify the expected response to the multiple contract
documents. Are specific responses required for Exhibits 3, 4, 5, 6, 7, and 8? Can we
provide exceptions? Should exceptions be noted on the Attachment B signature document
or provided separately?
ANSWER
PLEASE REFERENCE SECTION 5.6 FOR REQUIRED PROPOSAL CONTENT
AND SECTION 5.4 FOR EXCEPTIONS INSTRUCTIONS.
29. Insurance: Are Insurance Certificates (Exhibit 9) required as part of the proposal?
ANSWER
NO.
30. Will pharmacy and medical OOP and deductibles continued to be tracked separately for the
HMO and PPO plans in the future?
ANSWER
THIS IS UNDETERMINABLE AT THIS TIME.
31. Is the County willing to accept a quote that excludes the HSA members?
ANSWER
THE PROPOSAL SHOULD EXCLUDE H.S.A. MEMBERS AS THEY ARE
CURRENTLY NOT COVERED UNDER THE CATAMARAN PRESCRIPTION PLAN.
32. Would the County consider a proposal that does not include the U.S. Communities
Government Purchasing Alliance?
ANSWER
SEE ANSWER TO QUESTION 15.
33. Please define the County’s expectations related to acquisition pricing at retail and mail.
ANSWER
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IF THE COUNTY CHOOSES THAT OPTION WE WOULD PAY FOR THE
ACTUAL COST OF THE DRUGS PLUS AN ADMINISTRATIVE FEE.
34. Will the County consider a traditional quote in lieu of retail and mail acquisition pricing?
ANSWER
NO.
35. Please clarify the calculation for this section of Exhibit 5. What is meant by aggregate
purchases?
ANSWER
AGGREGATE PURCHASES MEANS THE COLLECTIVE TOTAL PURCHASES
OF PARTICIPATING PUBLIC AGENCIES. ADDITIONALLY, SEE ANSWER TO
QUESTION 8.
3 6 . 5.1 Administrative Fees. Supplier shall pay to U.S. Communities a monthly administrative
fee based upon the total sales price of all purchases shipped and billed pursuant to the
Master Agreement, excluding taxes, in the amount of two percent (2%) of aggregate
purchases made during each calendar month (individually and collectively, “Administrative
Fees”).
ANSWER
SEE ANSWER TO QUESTION 35.
37. Exhibit 7 refers to purchases funded by FEMA. Is this applicable to this RFP?
ANSWER
YES, EXHIBIT 7 MAY APPLY TO THIS RFP. THE LANGUAGE IS INCLUDED
SHOULD PARTICIPATING PUBLIC AGENCIES EVER HAVE THE NEED TO
UTILIZE THE CONTRACT IN AN EMERGENCY SITUATION WHERE FEMA
GRANTS OR FUNDS ARE USED.
38. Upon further review of the RFP requirements, can the page limit be increased to 300 pages?
ANSWER
YES.
39. What does the data in Attachment A-1, A-2, and A-3 represent? Maricopa county utilization
only or does this include other entities? If Maricopa County, is this utilization currently with
Catamaran or does this also include claims information with OptumRx?
ANSWER
THIS INCLUDES ONLY CATAMARAN DATA AS OPTUM RX VOLUMES ARE
NOT PART OF THIS RFP.
40. Does this RFP cover all Maricopa County pharmacy programs, both Catamaran and
OptumRx?
ANSWER
NO. IT COVERS ONLY THE PROPGRAMS UNDER THE CATAMARAN
PRESCRIPTION PLAN.
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41. Attachment A, row 55, please explain Pricing Cost Plus. Is Maricopa County requesting
Traditional, Pass-though, or some sort of acquisition based pricing?
ANSWER
WE ARE ASKING FOR THE MARK-UP ON DIRECT PASS THROUGH DRUG
PRICES BASED ON ACTUAL COST. FOR ANALYSIS, WE ARE ASKING FOR
THE ACTUAL DRUG COST BASED ON THE RESPONSE TO ATTACHMENT A1, A-2 AND A-3 COLUMN I.
42. Attachment A-1, A-2, and A-3, please provide formula for Net Cost, is this discounted AWP
(Ingredient Cost) or include other elements?
ANSWER
COLUMN H IS THE NET PRICE (AWP) OF THE DRUG/INGREDIENT PRICE
BASED ON THE AWP ON DECEMBER 1, 2015 LESS PROPOSED DISCOUNT.
COLUMN I IS THE ACTUAL INGREDIENT/DRUG COST ON THE SAME DAY.
43. Section 2.8 has 15 day billing terms. Attachment A has 10 day billing terms as an option.
Would Maricopa County agree to 10 day billing terms? Would Maricopa County consider
industry standard billing terms between two and five days?
ANSWER
THE ANSWER TO BOTH QUESTIONS IS YES.
44. Financials Q 52. How should fees for optional services like clinical programs be offered?
Should these be added at the bottom of the first tab in the Excel file, Attachment A, or
should a tab be added for administrative fees?
ANSWER
ADD A TABLE TO YOUR RESPONSE IN THE PRICING SECTION.
45. RFP Contract: Section 4.1. Does the PBM cover the cost of the third party audits up to $50k
and split 50/50 over $50k? How often are these audits?
ANSWER
THE CURRENT PBM COVERS THE COST OF AUDITS. IT WOULD BE
PREFERABLE IF THIS WAS NOT INCLUDED WITH THE SAVINGS BEING
REFLECTED IN THE FEES. THERE HAS ONLY BEEN ONE AUDIT. THE
COUNTY RESERVES THE RIGHT TO CONDUCT AN AUDIT AS FREQUENTLY
AS ANNUALLY.
46. RFP Contract: 5.1 Is this “Administrative Fee” a form of commission and is this applicable
to the PBM bid. If so what is the formula for the 2% of aggregate purchases?
ANSWER
SEE ANSWER TO QUESTION 8.
47. Would the PBM awarded the contract be the only PBM vendor offered through the US
Communities Co-op?
ANSWER
YES, U.S. COMMUNITIES DOES NOT CURRENTLY HAVE A PHARMACY
BENEFIT MANAGER CONTRACT.
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48. Can you provide a list of the firms who participated in the mandatory bidder conference and
confirm firms not in attendance are prohibited from bidding? (
ANSWER
YES. SEE ATTACHED.
49. Can you confirm what administrative services, specific to the pharmacy benefit, are being
provided by US Communities for their collection of the 2% of claims administrative fee?
ANSWER
U.S. COMMUNITIES’ ROLE IS TO:
A. EDUCATE PARTICIPATING PUBLIC AGENCIES ABOUT THE PROGRAM;
B. REMOVE BARRIERS FOR PARTICIPATING PUBLIC AGENCIES TO USE
THE PROGRAM;
C. OPEN DOORS FOR THE SUPPLIER; AND
D. TRAIN AND EDUCATE SUPPLIER
THIS IS ACCOMPLISHED IN A VARIETY OF FORMATS USING PRINT
COLLATERAL, EMAILS TO THE 55,000 PLUS REGISTERED PARTICIPATING
PUBLIC AGENCIES, WEBINARS, TRADE SHOWS, ETC. THERE ARE ELEVEN
(11) PROGRAM MANAGERS WHOSE JOB FUNCTION IS TO PROMOTE THE
PROGRAM ON A DAILY BASIS AS WELL AS MARKETING AND
ADMINISTRATIVE STAFF TO SUPPORT THE PROGRAM. THERE ARE FOUR
(4) NATIONAL FOUNDING CO-SPONSORS AND APPROXIMATELY NINETY
(90) STATE SPONSORS WHO ALSO MARKET THE PROGRAM NATIONALLY
AND REGIONALLY. THE NATIONAL GOVERNORS ASSOCIATION (NGA)
HAS ALSO RECENTLY JOINED AS A SPONSOR OF THE PROGRAM. A FEW
SPECIFIC EXAMPLES OF MARKETING FOR THE PHARMACY BENEFIT
MANAGER CONTRACT INCLUDE WEBINARS, SPEAKING ENGAGEMENTS,
PARTICIPATION IN SOURCING SUMMITS, ARTICLE SUPPORT, AND
SOLUTIONS EMAIL CAMPAIGNS.
50. Would Maricopa County entertain bids only offered to Maricopa County, not open to U.S.
Communities assuming that Supplier’s offer has best in class pricing and volume discounts
ANSWER
SEE ANSWER TO QUESTION 15.
51. Will the PBM awarded the contract have the option to choose to bid on a direct basis on
requests for information (RFIs) or requests for proposal (RFPs) released by Co-op
participating groups?
ANSWER
SEE ATTACHMENT D, SECTION 1.0.3.4.
52. Related to Attachment D, Section 1.0.3- Pricing Commitment
If Public Agency X is a direct client with Supplier and who at the time of contract execution
with Supplier is not a member of the U.S. Communities but later decides to join the U.S.
Communities, which pricing will prevail?
Second to the above question, Does the prevailing pricing, if more competitive than what
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was agreed upon with US communities, have to be offered to all US Communities
participants?
ANSWER
SEE ATTACHMENT D, SECTION 1.0.3.2.
53. Would Maricopa County accept an RFP exclusive to the County without the involvement of
US Communities? )
ANSWER
SEE ANSWER TO QUESTION 15.
54. We are concerned the Maricopa contract is easily available to competitors as part of the
larger US Communities organization. Please describe the process of protecting confidential
contract terms and price.
ANSWER
IT IS ALL PUBLIC INFORMATION.
55. Does Maricopa county cover Medicare lives and if so what Medicare solution does
Maricopa use, EGWP, RDS, other
ANSWER
NO.
56. Will the current plan design be provided to prospective PBMs? It seems the current
documents are not available on the employee benefits website as directed in the solicitation
ANSWER
REFER TO THE CATAMARAN SPD POSTED ON THE BENEFITS WEBSITE AT
WWW.MARICOPA.GOV/BENEFTIS (UNDER THE PRESCRIPTION TAB).
57. Will the PBM be able to modify pricing for groups that are in less competitive markets?
ANSWER
SEE ANSWER TO QUESTION 11.
58. Is the PBM expected to go at risk if the pricing for a current group is better than what the
PBM has contracted?
ANSWER
SEE ANSWER TO QUESTION 11. PROPOSER SHOULD PROPOSE PRICING
THAT IS MOST ADVANTAGEOUS TO PARTICIPATING PUBLIC AGENCIES
AND PROPOSER. ADDITIONALLY, SEE ATTACHMENT D, SECTION 1.0.3.
59. May a PBM submit pricing for Maricopa and other US Communities groups on a case by
case basis?
ANSWER
SEE ANSWER TO QUESTION 11.
60. Can you confirm the effective date of the agreement from this RFP is 7/1/2017? The sample
contract does have 7/1/2017 as the effective date, but the RFP does not directly state an
effective date. There are things in it though that elude to a 7/1/2016 effective date.
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ANSWER
THE COUNTY’S SERVICE WOULD BE EFFECTIVE 7/1/17. THE U.S.
COMMUNITIES PARTICIPATING PUBLIC AGENCES WOULD HAVE ACCESS
TO THE CONTRACT AFTER AWARD PROJECTED TO BE BY AUGUST 2016.
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5
Question and Answers for Bid #16018-RFP - PHARMACY BENEFITS MANAGER SERVICES
Overall Bid Questions
Question 1
Who is the broker / TPA / consultant overseeing this group? (Submitted: Oct 27, 2015 10:49:18 AM MST)
Question 2
1. Will the County be providing a Summary document of the most recent 12 months of prescription activity,
including information on total # of rxs paid, access point (retail, mail, retail 90, Specialty), brand/generic usage, etc.
(Submitted: Nov 11, 2015 11:31:17 AM MST)
Question 3
2. Will the County be providing a report of the Top 100 pharmacies used by members including the number of
prescriptions obtained at each one? (Submitted: Nov 11, 2015 11:31:42 AM MST)
Question 4
5. The Attachment A Pricing Page document
a. Does not have an NDC number for each product listed. AWP pricing is NDC specific. Please provide an NCD#
for each line item
b. Does not specify a date to be used for the AWP price that is to be supplied in tabs A-1, A-2, and A-3. Please
provide a specific date due to the fact that AWP prices fluctuate.
c. Does not specify Retail, Retail 90 or Mail—please advise if you would like to see retail, Retail 90 or Mail or if you
will be revising the document to include additional tabs for each access point.
d. We have one pharmacy chain at more favorable rates. If we can have top 100 pharmacies with rx count we can
provide aggregated discounts. If not, is it permissible to create new tabs and fill out pricing twice, once at the
favorable rates and another tab with the rest of the network? (Submitted: Nov 11, 2015 11:33:03 AM MST)
Question 5
3. Are there any Clinical Programs currently in place that need to be duplicated in the new contract? If so, please
provide detail on each program (Submitted: Nov 11, 2015 11:33:31 AM MST)
Question 6
4. Attachment F includes all zip codes to provide a Geo Access report, but does not include the number of
employees in each zip code. Will the County provide an updated document with the number of employees added
to the document? This is important particularly with the Preferred network due to the fact that if 2000 employees
are in a zip code without access versus 2 employees, the overall access percentage to the network is greatly
affected. (Submitted: Nov 11, 2015 11:34:07 AM MST)
Question 7
6. Please confirm for Attachment A-1, A-2 and A-3 that the Net Cost column calculation should be the AWP price
minus the discount (or MAC price for generics if lower than the AWP discounted price) multiplied by the quantity
listed in column D on all 3 tabs. (Submitted: Nov 11, 2015 11:34:45 AM MST)
Question 8
Section 5.6.16 Exhibit 5 under the Proposal Format states “signed unaltered†. What if we have
exceptions or deletions needed to be able to sign the US Communities contract? Please advise how we should
include in the bid response. (Submitted: Nov 11, 2015 11:35:22 AM MST)
Question 9
Exhibit 5 US Communities Administrative Agreement, Section 5.1 indicates “two percent (2%) of aggregate
purchases made during each calendar month (individually and collectively†as an Administrative Fee to US
Communities. Please confirm if this is to be based on the Plan Cost of Maricopa County for all prescriptions or if it
is to be based off the Administrative fee per Paid Claim that will be charged separately to the County on a monthly
basis. (Submitted: Nov 11, 2015 11:35:50 AM MST)
Question 10
It appears that the RFP particularly, Attachment D (Sections; Distribution, Products, Environmental and
Administration) were written to accommodate other US Communities supplier partners. Are they applicable to the
PBM response? (Submitted: Nov 11, 2015 11:36:42 AM MST)
Question 11
Will the county please provide a list of all vendors that attended the bidders conference? (Submitted: Nov 13, 2015
12:38:49 PM MST)
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Question 12
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Administration) were written to accommodate other US Communities supplier partners. Are they applicable to the
PBM response? (Submitted: Nov 11, 2015 11:36:42 AM MST)
Maricopa County
Bid 16018-RFP
Question 11
Will the county please provide a list of all vendors that attended the bidders conference? (Submitted: Nov 13, 2015
12:38:49 PM MST)
Question 12
As discussed during the bidders conference, proposed pricing for Maricopa County is based on demographic
market conditions. Most if not all vendors cannot support the same contractual rates in markets such as Hawaii
and Alaska. In order to offer a competitive proposal that meets the integrity of the County and U.S. Communities
RFP, will you allow separate pricing proposals for the Hawaii and Alaska markets? (Submitted: Nov 13, 2015 12:39:22
PM MST)
Question 13
Please provide actual call volume and average handle times for previous plan year (Submitted: Nov 13, 2015
1:37:12 PM MST)
Question 14
Exhibit 5, Article V 5.1 – Administrative Fees: How does the County anticipate the fee payment to US
Communities will be paid? Are we to add 2% to the cost of prescriptions for Maricopa County plan participants
and then remit the fee to U.S. Communities? (Submitted: Nov 16, 2015 8:04:31 AM MST)
Question 15
Exhibit 5, Article V 5.1 – Administrative Fees: Should our discount guarantees include or exclude the 2%
commissions to be paid to U.S. Communities? (Submitted: Nov 16, 2015 8:04:44 AM MST)
Question 16
Exhibit 5 – Administration Agreement – The scope of some or all of this agreement for a global, publicly
held organization would require shareholder approval which is unfeasible in the timeframe of the RFP. While we
support cooperative purchasing arrangements, it is not the current organizational direction to tie our significant
government segment of business to one cooperative purchasing organization within the scope of one RFP
response. Would Maricopa County consider a proposal for pharmacy benefits management without agreeing to
the administration agreement provided in Exhibit 5? (Submitted: Nov 16, 2015 8:04:58 AM MST)
Question 17
Attachment A-1 Retail Acquisition Pricing, Attachment A-2 Mail Order Acquisition Pricing and Attachment A-3
Specialty Drug Acquisition Pricing: Can you please provide these documents with the NDC code for each of the
drugs noted on the three tabs? We cannot provide proper pricing information without that data. (Submitted: Nov 16,
2015 8:05:26 AM MST)
Question 18
On Excel Attachment A there is a reference to payment terms. Please confirm whether this refers to Cigna
paying claims or the County paying Cigna, and the type of payment (admin fees, claims paid through bank
account, etc.). (Submitted: Nov 16, 2015 8:05:49 AM MST)
Question 19
Census Report: Can you please provide a census report that shows all eligible employees of the County and
what medical plan they are enrolled in with tier election? (Submitted: Nov 16, 2015 8:06:05 AM MST)
Question 20
Pharmacy Plan Design: Can you please provide a copy of the current Pharmacy plan design? We have tried to
pull this from the website provided in Attachment E, but we keep getting error messages. We also need
confirmation of the 7/1/2016 plan designs. (Submitted: Nov 16, 2015 8:06:21 AM MST)
Question 21
Pharmacy Claims Utilization data: Can you please provide a pharmacy claims utilization data file for the most
recent 12-month time period that includes NDC-11, drug name/strength, metric quantity, and days’ supply,
date of service/fill date, mail/retail indicator, generic/brand indicator, and NABP/NPI of dispensing pharmacy? The
data file from Catamaran should break out the Cigna HMO and United Healthcare PPO populations. We also
need the corresponding lives by month. (Submitted: Nov 16, 2015 8:06:35 AM MST)
Question 22
Pharmacy Discounts, Rebates, and Fees: Can you please provide the current pharmacy discounts, rebates
earned and/or fees? (Submitted: Nov 16, 2015 8:06:45 AM MST)
Question 23
Pharmacy Formulary: Can you please provide a copy of the current pharmacy formulary? (Submitted: Nov 16, 2015
8:07:06 AM MST)
Question 24
Pharmacy Clinical Programs: Can you please provide a list of the current pharmacy clinical programs in place
12/8/2015 1:11 PM
today (i.e. step therapy, prior authorizations, quantity limits, etc.)? (Submitted: Nov 16, 2015 8:07:22 AM MST)
p. 234
Question 23
Pharmacy Formulary: Can you please provide a copy of the current pharmacy formulary? (Submitted: Nov 16, 2015
8:07:06 AM MST)
Maricopa County
Bid 16018-RFP
Question 24
Pharmacy Clinical Programs: Can you please provide a list of the current pharmacy clinical programs in place
today (i.e. step therapy, prior authorizations, quantity limits, etc.)? (Submitted: Nov 16, 2015 8:07:22 AM MST)
Question 25
On-site Pharmacy: Does the County contract its own rates at the on-site pharmacy? If the County has its own
rates, please confirm the pharmacy’s NABP number so we can identify the on-site pharmacy utilization in the
claim file. (Submitted: Nov 16, 2015 8:07:36 AM MST)
Question 26
Dedicated Account Manager: Does the County require an account manager who works with no clients other
than Maricopa County? (Submitted: Nov 16, 2015 8:07:49 AM MST)
Question 27
Dedicated Clinical Pharmacy Consultant: Does the County require a clinical pharmacy consultant who works
with no clients other than Maricopa County? (Submitted: Nov 16, 2015 8:08:02 AM MST)
Question 28
Dedicated Customer Service: The RFP asks about a dedicated customer service team available between the
hours of 7 AM – 5 PM MST, Monday – Friday. Is it acceptable to have designated customer service staff
members who handle calls from Maricopa County but may also support some other clients? (Submitted: Nov 16,
2015 8:08:16 AM MST)
Question 29
Contract Documents: Please clarify the expected response to the multiple contract documents. Are specific
responses required for Exhibits 3, 4, 5, 6, 7, and 8? Can we provide exceptions? Should exceptions be noted on
the Attachment B signature document or provided separately? (Submitted: Nov 16, 2015 8:08:31 AM MST)
Question 30
Insurance: Are Insurance Certificates (Exhibit 9) required as part of the proposal? (Submitted: Nov 16, 2015 8:08:46
AM MST)
Question 31
Will pharmacy and medical OOP and deductibles continued to be tracked separately for the HMO and PPO
plans in the future? (Submitted: Nov 16, 2015 8:09:09 AM MST)
Question 32
Is the County willing to accept a quote that excludes the HSA members? (Submitted: Nov 16, 2015 8:09:26 AM MST)
Question 33
Would the County consider a proposal that does not include the U.S. Communities Government Purchasing
Alliance? (Submitted: Nov 16, 2015 8:09:39 AM MST)
Question 34
Please define the County’s expectations related to acquisition pricing at retail and mail. (Submitted: Nov 16,
2015 8:09:50 AM MST)
Question 35
Will the County consider a traditional quote in lieu of retail and mail acquisition pricing? (Submitted: Nov 16, 2015
8:10:02 AM MST)
Question 36
Please clarify the calculation for this section of Exhibit 5. What is meant by aggregate purchases? 5.1
Administrative Fees. Supplier shall pay to U.S. Communities a monthly administrative fee based upon the total
sales price of all purchases shipped and billed pursuant to the Master Agreement, excluding taxes, in the amount
of two percent (2%) of aggregate purchases made during each calendar month (individually and collectively,
“Administrative Fees†). (Submitted: Nov 16, 2015 8:10:21 AM MST)
Question 37
Exhibit 7 refers to purchases funded by FEMA. Is this applicable to this RFP? (Submitted: Nov 16, 2015 8:10:36 AM
MST)
Question 38
Upon further review of the RFP requirements, can the page limit be increased to 300 pages? (Submitted: Nov 16,
2015 8:10:50 AM MST)
Question 39
What does the data in Attachment A-1, A-2, and A-3 represent? Maricopa county utilization only or does this
12/8/2015
1:11 PM
include
other entities? If Maricopa County, is this utilization currently with Catamaran or does this also include
claims information with OptumRx? (Submitted: Nov 16, 2015 9:37:45 AM MST)
p. 235
Upon further review of the RFP requirements, can the page limit be increased to 300 pages? (Submitted: Nov 16,
2015 8:10:50 AM MST)
Maricopa County
Bid 16018-RFP
Question 39
What does the data in Attachment A-1, A-2, and A-3 represent? Maricopa county utilization only or does this
include other entities? If Maricopa County, is this utilization currently with Catamaran or does this also include
claims information with OptumRx? (Submitted: Nov 16, 2015 9:37:45 AM MST)
Question 40
Does this RFP cover all Maricopa County pharmacy programs, both Catamaran and OptumRx? (Submitted: Nov
16, 2015 9:38:31 AM MST)
Question 41
Attachment A, row 55, please explain Pricing Cost Plus. Is Maricopa County requesting Traditional, Passthough, or some sort of acquisition based pricing? (Submitted: Nov 16, 2015 9:39:17 AM MST)
Question 42
Attachment A-1, A-2, and A-3, please provide formula for Net Cost, is this discounted AWP (Ingredient Cost) or
include other elements? (Submitted: Nov 16, 2015 9:39:32 AM MST)
Question 43
Section 2.8 has 15 day billing terms. Attachment A has 10 day billing terms as an option. Would Maricopa
County agree to 10 day billing terms? Would Maricopa County consider industry standard billing terms between
two and five days? (Submitted: Nov 16, 2015 9:39:46 AM MST)
Question 44
Financials Q 52. How should fees for optional services like clinical programs be offered? Should these be
added at the bottom of the first tab in the Excel file, Attachment A, or should a tab be added for administrative fees?
(Submitted: Nov 16, 2015 9:40:23 AM MST)
Question 45
RFP Contract: Section 4.1. Does the PBM cover the cost of the third party audits up to $50k and split 50/50 over
$50k? How often are these audits? (Submitted: Nov 16, 2015 9:41:19 AM MST)
Question 46
RFP Contract: 5.1 Is this “Administrative Fee†a form of commission and is this applicable to the PBM
bid. If so what is the formula for the 2% of aggregate purchases? (Submitted: Nov 16, 2015 9:41:41 AM MST)
Question 47
Would the PBM awarded the contract be the only PBM vendor offered through the US Communities Co-op?
(Submitted: Nov 16, 2015 10:00:17 AM MST)
Question 48
Can you provide a list of the firms who participated in the mandatory bidder conference and confirm firms not in
attendance are prohibited from bidding? (Submitted: Nov 16, 2015 10:00:47 AM MST)
Question 49
Can you confirm what administrative services, specific to the pharmacy benefit, are being provided by US
Communities for their collection of the 2% of claims administrative fee? (Submitted: Nov 16, 2015 10:01:19 AM MST)
Question 50
Would Maricopa County entertain bids only offered to Maricopa County, not open to U.S. Communities
assuming that Supplier’s offer has best in class pricing and volume discounts? (Submitted: Nov 16, 2015
10:01:39 AM MST)
Question 51
Will the PBM awarded the contract have the option to choose to bid on a direct basis on requests for information
(RFIs) or requests for proposal (RFPs) released by Co-op participating groups? (Submitted: Nov 16, 2015 10:01:58
AM MST)
Question 52
Related to Attachment D, Section 1.0.3- Pricing Commitment
If Public Agency X is a direct client with Supplier and who at the time of contract execution with Supplier is not a
member of the U.S. Communities but later decides to join the U.S. Communities, which pricing will prevail?
Second to the above question, Does the prevailing pricing, if more competitive than what was agreed upon with
US communities, have to be offered to all US Communities participants? (Submitted: Nov 16, 2015 10:02:24 AM MST)
Question 53
Would Maricopa County accept an RFP exclusive to the County without the involvement of US Communities?
(Submitted: Nov 16, 2015 10:24:05 AM MST)
Question 54
12/8/2015 1:11
We PM
are concerned the Maricopa contract is easily available to competitors as part of the larger US
Communities organization. Please describe the process of protecting confidential contract terms and price.
p. 236
Question 53
Would Maricopa County accept an RFP exclusive to the County without the involvement of US Communities?
(Submitted: Nov 16, 2015 10:24:05 AM MST)
Maricopa County
Bid 16018-RFP
Question 54
We are concerned the Maricopa contract is easily available to competitors as part of the larger US
Communities organization. Please describe the process of protecting confidential contract terms and price.
(Submitted: Nov 16, 2015 10:29:20 AM MST)
Question 55
Does Maricopa county cover Medicare lives and if so what Medicare solution does Maricopa use, EGWP, RDS,
other? (Submitted: Nov 16, 2015 10:29:31 AM MST)
Question 56
Will the current plan design be provided to prospective PBMs? It seems the current documents are not
available on the employee benefits website as directed in the solicitation. (Submitted: Nov 16, 2015 10:30:30 AM MST)
Question 57
Will the PBM be able to modify pricing for groups that are in less competitive markets? (Submitted: Nov 16, 2015
10:31:24 AM MST)
Question 58
Is the PBM expected to go at risk if the pricing for a current group is better than what the PBM has contracted?
(Submitted: Nov 16, 2015 10:31:37 AM MST)
Question 59
May a PBM submit pricing for Maricopa and other US Communities groups on a case by case basis?
(Submitted: Nov 16, 2015 10:32:00 AM MST)
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12/8/2015 1:11 PM
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