| Product Name |
Manufacturer |
NDC or UPC |
Package Size |
AWP Per Package |
AWP Per Pill |
| Marketed Product |
| RYBELSUS® TAB 3 mg |
NOVO NORDISK |
00169-4303-30 |
30 EA |
$1,233.01 |
$41.10 |
| RYBELSUS® TAB 7 mg |
NOVO NORDISK |
00169-4307-30 |
30 EA |
$1,233.01 |
$41.10 |
| RYBELSUS® TAB 14 mg |
NOVO NORDISK |
00169-4314-30 |
30 EA |
$1,233.01 |
$41.10 |
| Other Products |
| EXENATIDE (5MCG/0.02ML) | AMNEAL | 70121-1685-01 | Non-pill product |
| EXENATIDE (10MCG/0.04ML) | AMNEAL | 70121-1686-01 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | HIKMA | 00143-9144-02 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | HIKMA | 00143-9144-03 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | TEVA | 00480-3667-20 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | TEVA | 00480-3667-22 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | LUPIN | 70748-0346-02 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | LUPIN | 70748-0346-03 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | MEITHEAL | 71288-0563-84 | Non-pill product |
| LIRAGLUTIDE (18MG/3ML) | MEITHEAL | 71288-0563-85 | Non-pill product |
| MOUNJARO® (2.5MG/0.5ML) | ELI LILLY | 00002-1506-80 | Non-pill product |
| MOUNJARO® (5MG/0.5ML) | ELI LILLY | 00002-1495-80 | Non-pill product |
| MOUNJARO® (7.5MG/0.5ML) | ELI LILLY | 00002-1484-80 | Non-pill product |
| MOUNJARO® (10MG/0.5ML) | ELI LILLY | 00002-1471-80 | Non-pill product |
| MOUNJARO® (12.5MG/0.5ML) | ELI LILLY | 00002-1460-80 | Non-pill product |
| MOUNJARO® (15MG/0.5ML) | ELI LILLY | 00002-1457-80 | Non-pill product |
| OZEMPIC® (0.25MG OR 0.5MG DOSE) | NOVO NORDISK | 00169-4181-13 | Non-pill product |
| OZEMPIC® (1MG DOSE) | NOVO NORDISK | 00169-4130-13 | Non-pill product |
| OZEMPIC® (2MG DOSE) | NOVO NORDISK | 00169-4772-12 | Non-pill product |
| SAXENDA® (18MG/3ML) | NOVO NORDISK | 00169-2800-15 | Non-pill product |
| SOLIQUA® 100/33 (100-33 UNIT-MCG/ML) | SANOFI-AVENTIS | 00024-5761-05 | Non-pill product |
| TRULICITY® (.75MG/5ML) | ELI LILLY | 00002-1433-80 | Non-pill product |
| TRULICITY® (1.5MG/5ML) | ELI LILLY | 00002-1434-80 | Non-pill product |
| TRULICITY® (3MG/5ML) | ELI LILLY | 00002-2236-80 | Non-pill product |
| TRULICITY® (4.5MG/5ML) | ELI LILLY | 00002-3182-80 | Non-pill product |
| VICTOZA® (18MG/3ML) | NOVO NORDISK | 00169-4060-12 | Non-pill product |
| VICTOZA® (18MG/3ML) | NOVO NORDISK | 00169-4060-13 | Non-pill product |
| WEGOVY® (0.25MG/0.5ML) | NOVO NORDISK | 00169-4525-14 | Non-pill product |
| WEGOVY® (0.5MG/0.5ML) | NOVO NORDISK | 00169-4505-14 | Non-pill product |
| WEGOVY® (1MG/0.5ML) | NOVO NORDISK | 00169-4501-14 | Non-pill product |
| WEGOVY® (1.7MG/0.75ML) | NOVO NORDISK | 00169-4517-14 | Non-pill product |
| WEGOVY® (2.4MG/0.75ML) | NOVO NORDISK | 00169-4524-14 | Non-pill product |
| WEGOVY® TABLETS 1.5MG (bottle) | NOVO NORDISK | 00169-4415-31 | 30 EA | $1,618.82 | $53.96 |
| WEGOVY® TABLETS 4MG (bottle) | NOVO NORDISK | 00169-4404-31 | 30 EA | $1,618.82 | $53.96 |
| WEGOVY® TABLETS 9MG (bottle) | NOVO NORDISK | 00169-4409-31 | 30 EA | $1,618.82 | $53.96 |
| WEGOVY® TABLETS 25MG (bottle) | NOVO NORDISK | 00169-4425-31 | 30 EA | $1,618.82 | $53.96 |
| XULTOPHY® 100/3.6 (100-3.6 UNIT-MG/ML) | NOVO NORDISK | 00169-2911-15 | Non-pill product |
| ZEPBOUND® (2.5MG/0.5ML) | ELI LILLY | 00002-2506-80 | Non-pill product |
| ZEPBOUND® (5MG/0.5ML) | ELI LILLY | 00002-2495-80 | Non-pill product |
| ZEPBOUND® (7.5MG/0.5ML) | ELI LILLY | 00002-2484-80 | Non-pill product |
| ZEPBOUND® (10MG/0.5ML) | ELI LILLY | 00002-2471-80 | Non-pill product |
| ZEPBOUND® (12.5MG/0.5ML) | ELI LILLY | 00002-2460-80 | Non-pill product |
| ZEPBOUND® (15MG/0.5ML) | ELI LILLY | 00002-2457-80 | Non-pill product |