`Gattex Subcutaneous Kit 5 MG
`Gattex Subcutaneous Kit 5 MG
`NutreStore Oral Packet 5 GM
`
`Labeler
`NPS PHARMACEUTICALS
`NPS PHARMACEUTICALS
`EMMAUS MEDICAL
`
`Zorbtive Subcutaneous Solution Reconstituted 8.8 MG SERONO
`
`Product Name
`Gattex Subcutaneous Kit 5 MG
`Gattex Subcutaneous Kit 5 MG
`NutreStore Oral Packet 5 GM
`
`Labeler
`NPS PHARMACEUTICALS
`NPS PHARMACEUTICALS
`EMMAUS MEDICAL
`
`Zorbtive Subcutaneous Solution Reconstituted 8.8 MG SERONO
`
`Size
`
`Qty
`
`1
`1
`84
`
`1
`
`Size
`
`Qty
`
`1
`1
`84
`
`1
`
`AWP 1 Package Price
`$37,620.00
`$1,442.40
`$322.56
`
`$8,720.29
`
`WAC 1 Package Price
`$31,350.00
`$1,202.00
`$268.80
`
`$7,266.91
`
`1
`1
`1
`
`7
`
`1
`1
`1
`
`7
`
`Gattex
`
`Page 1
`
`
`
`AWP 1 Effective Date
`01/01/2015
`01/01/2015
`09/26/2009
`
`AWP 2 Package Price
`$34,200.00
`$1,311.60
`$336.00
`
`AWP 2 Effective Date
`07/01/2014
`07/01/2014
`06/05/2008
`
`AWP 3 Package Price
`$31,249.20
`$1,197.60
`
`01/09/2015
`
`$7,963.74
`
`01/17/2014
`
`$7,408.13
`
`WAC 1 Effective Date
`01/01/2015
`01/01/2015
`06/05/2008
`
`WAC 2 Package Price
`$28,500.00
`$1,093.00
`
`WAC 2 Effective Date
`07/01/2014
`07/01/2014
`
`WAC 3 Package Price
`$26,041.00
`$998.00
`
`01/09/2015
`
`$6,636.45
`
`01/17/2014
`
`$6,173.44
`
`Gattex
`
`Page 2
`
`
`
`AWP 3 Effective Date
`01/01/2014
`01/01/2014
`
`AWP 4 Package Price
`$29,096.40
`$1,114.80
`
`AWP 4 Effective Date
`01/29/2013
`01/29/2013
`
`AWP 5 Package Price
`
`07/26/2013
`
`$6,988.80
`
`11/28/2012
`
`$6,532.78
`
`WAC 3 Effective Date
`01/01/2014
`01/01/2014
`
`WAC 4 Package Price
`$24,247.00
`$929.00
`
`WAC 4 Effective Date
`01/29/2013
`01/29/2013
`
`WAC 5 Package Price
`
`07/26/2013
`
`$5,824.00
`
`11/28/2012
`
`$5,443.98
`
`Gattex
`
`Page 3
`
`
`
`AWP 5 Effective Date
`
`AWP 6 Package Price
`
`AWP 6 Effective Date
`
`AWP 7 Package Price
`
`12/21/2011
`
`$6,163.00
`
`01/07/2011
`
`$5,983.49
`
`WAC 5 Effective Date
`
`WAC 6 Package Price
`
`WAC 6 Effective Date
`
`WAC 7 Package Price
`
`12/21/2011
`
`$5,135.83
`
`01/07/2011
`
`$4,986.24
`
`Gattex
`
`Page 4
`
`
`
`AWP 7 Effective Date
`
`AWP 8 Package Price
`
`AWP 8 Effective Date
`
`AWP 9 Package Price
`
`11/20/2009
`
`$5,644.80
`
`09/26/2009
`
`$5,880.00
`
`WAC 7 Effective Date
`
`WAC 8 Package Price
`
`WAC 8 Effective Date
`
`WAC 9 Package Price
`
`11/20/2009
`
`$4,704.00
`
`01/13/2009
`
`$4,480.00
`
`Gattex
`
`Page 5
`
`
`
`AWP 9 Effective Date
`
`AWP 10 Package Price
`
`AWP 10 Effective Date
`
`AWP 11 Package Price
`
`01/13/2009
`
`$5,600.00
`
`05/01/2004
`
`WAC 9 Effective Date
`
`WAC 10 Package Price
`
`WAC 10 Effective Date
`
`WAC 11 Package Price
`
`05/01/2004
`
`Gattex
`
`Page 6
`
`
`
`AWP 11 Effective Date
`
`WAC 11 Effective Date
`
`Gattex
`
`Page 7
`
`
`
`Date Exported:
`
`Exported By:
`
`Subset Name:
`
`12/10/2015
`
`Katrina Kulp
`
`Gattex
`
`Subset Create Date:
`
`12/10/2015
`
`Subset Criteria
`Include
`
`Restrict To:
`
`Exclude:
`
`Report Setup
`Report Name:
`
`Type:
`
`Workgroup:
`
`Report Owner:
`
`Column Selection:
`
`Sorting
`Sort 1:
`
`Sort 2:
`
`Sort 3:
`
`Product Name (Drug Name) = NutreStore
`Product Name (Drug Name) = Gattex
`Product Name (Drug Name) = Zorbtive
`
`(None)
`
`(None)
`
`price history
`
`Custom report
`
`All Users
`
`Andrew Loghin
`
`Product Name
`Labeler
`Size
`Qty
`AWP History
`WAC History
`
`Product Name (ascending)
`
`(none)
`
`(none)
`
`Price History Customization
`Orientation:
`
`Horizontal (provides last 11 reported prices)
`
`Column Selection:
`
`History Package Price
`
`Info
`
`Page 8
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