1 Medicaid Run : 12/21/17 NE Weekly List Old AMIODARONE HCL 200 MG TABLET ORAL 12/20/2017 0.15321 0.14370 6.6 HYDRALAZINE HCL 10 MG TABLET ORAL 12/20/2017 0.05226 0.05213 0.2 LISINOPRIL 10 MG TABLET ORAL 12/20/2017 0.01659 0.02188 ( 24.2) LISINOPRIL 20 MG TABLET ORAL 12/20/2017 0.02202 0.02238 ( 1.6) LISINOPRIL 40 MG TABLET ORAL 12/20/2017 0.04548 0.04596 ( 1.0) LISINOPRIL 5 MG TABLET ORAL 12/20/2017 0.01131 0.01400 ( 19.2) VERAPAMIL HCL 120 MG TABLET ORAL 01/12/2016 0.08529 0.08094 5.4 DILTIAZEM HCL 60 MG TABLET ORAL 12/20/2017 0.20872 0.21437 ( 2.6) POTASSIUM CHLORIDE 8 MEQ TABLET ER ORAL 07/07/2015 0.17405 0.17082 1.9 GLYBURIDE 5 MG TABLET ORAL 06/27/2017 0.04904 0.05580 ( 12.1) GLIPIZIDE 10 MG TABLET ORAL 09/15/2015 0.03286 0.02731 20.3 GLIPIZIDE 5 MG TABLET ORAL 08/18/2015 0.02412 0.01859 29.7 ERGOCALCIFEROL (VITAMIN D2) 8000/ML DROPS ORAL 12/20/2017 0.66375 0.67514 ( 1.7) CYANOCOBALAMIN (VITAMIN B-12) 1000MCG/ML VIAL INJECTION 08/29/2017 0.75978 1.13811 ( 33.2) ALLOPURINOL 300 MG TABLET ORAL 09/13/2016 0.10693 0.10712 ( 0.2) SUCRALFATE 1 G TABLET ORAL 03/04/2015 0.28810 0.28813 ( 0.0) TESTOSTERONE CYPIONATE 100 MG/ML VIAL INTRAMUSC 12/20/2017 4.92756 5.26542 ( 6.4) ESTRADIOL 1 MG TABLET ORAL 12/20/2017 0.16905 0.17535 ( 3.6) ETHYNODIOL D-ETHINYL ESTRADIOL 1 MG-35MCG TABLET ORAL 12/20/2017 0.81995 0.79810 2.7 NORETHINDRONE 0.35 MG TABLET ORAL 04/18/2017 0.44268 0.44148 0.3 LIDOCAINE HCL/EPINEPHRINE 2-1:100K VIAL INJECTION 07/03/2017 0.09005 0.10793 ( 16.6) TEMAZEPAM 30 MG CAPSULE ORAL 07/11/2017 0.07292 0.06660 9.5 HYDROXYZINE HCL 50 MG TABLET ORAL 07/07/2015 0.08538 0.08040 6.2 CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET ORAL 05/16/2017 1.19997 1.33317 ( 10.0)
2 Medicaid Run : 12/21/17 NE Weekly List Old CLORAZEPATE DIPOTASSIUM 7.5 MG TABLET ORAL 05/03/2016 1.62354 1.80645 ( 10.1) LORAZEPAM 2 MG/ML VIAL INJECTION 12/20/2017 0.76782 0.90477 ( 15.1) CHLORPROMAZINE HCL 50 MG TABLET ORAL 12/13/2017 4.19450 4.70575 ( 10.9) PERPHENAZINE 8 MG TABLET ORAL 12/20/2017 0.93519 1.00969 ( 7.4) PROMETHAZINE HCL 50 MG/ML AMPUL INJECTION 12/20/2017 2.39860 2.35505 1.8 PROMETHAZINE HCL 25 MG SUPP.RECT RECTAL 05/03/2017 7.86400 7.55968 4.0 LOXAPINE SUCCINATE 25 MG CAPSULE ORAL 12/20/2017 0.79020 0.76420 3.4 MORPHINE SULFATE 30 MG TABLET ER ORAL 12/05/2017 0.44796 0.43724 2.5 MORPHINE SULFATE 60 MG TABLET ER ORAL 04/18/2017 0.64776 0.67268 ( 3.7) ACETAMINOPHEN WITH CODEINE 300MG-30MG TABLET ORAL 05/26/2015 0.14405 0.14563 ( 1.1) OXYCODONE HCL 5 MG/5 ML SOLUTION ORAL 05/26/2015 0.24589 0.24656 ( 0.3) METHADONE HCL 5 MG TABLET ORAL 12/20/2017 0.19457 0.21185 ( 8.2) NALTREXONE HCL 50 MG TABLET ORAL 12/20/2017 0.82812 0.83616 ( 1.0) VALPROIC ACID 250 MG CAPSULE ORAL 03/14/2017 0.26103 0.23932 9.1 METHOCARBAMOL 750 MG TABLET ORAL 09/20/2016 0.08396 0.07919 6.0 DRONABINOL 2.5 MG CAPSULE ORAL 12/20/2017 3.52044 3.19000 10.4 ALBUTEROL SULFATE 4 MG TABLET ORAL 12/20/2017 4.64614 4.42966 4.9 ALBUTEROL SULFATE 2.5 MG/3ML VIAL-NEB INHALATION 12/20/2017 0.05521 0.05219 5.8 LABETALOL HCL 5 MG/ML VIAL INTRAVEN 04/19/2016 0.18526 0.19799 ( 6.4) HETASTARCH IN 0.9 NACL 6-0.9 PLAST. BAG INTRAVEN 12/20/2017 0.03709 0.05292 ( 29.9) WARFARIN SODIUM 10 MG TABLET ORAL 04/19/2016 0.18680 0.20676 ( 9.7) WARFARIN SODIUM 2.5 MG TABLET ORAL 07/07/2015 0.13388 0.12998 3.0 LEVOTHYROXINE SODIUM 50 MCG TABLET ORAL 01/06/2015 0.39624 0.46163 ( 14.2) METHIMAZOLE 10 MG TABLET ORAL 12/20/2017 0.13400 0.13293 0.8
3 Medicaid Run : 12/21/17 NE Weekly List Old METHYLPREDNISOLONE SOD SUCC 125 MG VIAL INJECTION 05/09/2017 5.28000 8.52600 ( 38.1) METHYLPREDNISOLONE SOD SUCC 40 MG VIAL INJECTION 05/02/2017 3.96000 5.41401 ( 26.9) TRIAMCINOLONE ACETONIDE 40 MG/ML VIAL INJECTION 12/20/2017 6.47700 8.12400 ( 20.3) HYDROCORTISONE VALERATE 0.2 OINT. (G) TOPICAL 12/20/2017 3.97613 4.07909 ( 2.5) DESOXIMETASONE 0.25 CREAM (G) TOPICAL 06/19/2017 0.97641 1.15329 ( 15.3) FLUOCINONIDE 0.05 GEL (GRAM) TOPICAL 04/21/2015 2.80654 2.93788 ( 4.5) FLUOCINONIDE 0.05 CREAM (G) TOPICAL 09/29/2015 0.74817 0.70618 5.9 FLUOCINONIDE 0.05 OINT. (G) TOPICAL 10/11/2016 1.53944 1.61514 ( 4.7) ALCLOMETASONE DIPROPIONATE 0.05 OINT. (G) TOPICAL 08/01/2017 0.60717 0.59347 2.3 MOMETASONE FUROATE 0.1 CREAM (G) TOPICAL 12/20/2017 0.28497 0.27336 4.2 ACYCLOVIR 5 OINT. (G) TOPICAL 05/23/2017 6.81651 6.61585 3.0 ERYTHROMYCIN BASE/ETHANOL 2 GEL (GRAM) TOPICAL 04/19/2016 2.66548 2.68000 ( 0.5) CLINDAMYCIN PHOSPHATE 1 SOLUTION TOPICAL 07/21/2015 0.53600 0.49178 9.0 CHLORTHALIDONE 25 MG TABLET ORAL 12/20/2017 1.11881 1.16433 ( 3.9) CHLORTHALIDONE 50 MG TABLET ORAL 12/20/2017 1.18684 1.28184 ( 7.4) BUMETANIDE 0.5 MG TABLET ORAL 10/03/2017 0.71891 0.72347 ( 0.6) INDAPAMIDE 2.5 MG TABLET ORAL 12/20/2017 0.19537 0.20770 ( 5.9) AMILORIDE HCL 5 MG TABLET ORAL 12/20/2017 0.45975 0.44863 2.5 COLCHICINE 0.6 MG TABLET ORAL 12/20/2017 6.73748 6.74370 ( 0.1) INDOMETHACIN 25 MG CAPSULE ORAL 10/10/2017 0.06700 0.06888 ( 2.7) IBUPROFEN 400 MG TABLET ORAL 12/20/2017 0.04610 0.04197 9.8 IBUPROFEN 600 MG TABLET ORAL 07/12/2016 0.05213 0.04821 8.1 CISPLATIN 1 MG/ML VIAL INTRAVEN 12/20/2017 0.20502 0.21172 ( 3.2) DACARBAZINE 200 MG VIAL INTRAVEN 12/20/2017 16.00830 14.01750 14.2
4 Medicaid Run : 12/21/17 NE Weekly List Old PENICILLIN G POTASSIUM 5MM UNIT VIAL INJECTION 12/20/2017 7.49300 7.56000 ( 0.9) AMPICILLIN SODIUM 1 G VIAL INJECTION 12/20/2017 2.32624 2.77200 ( 16.1) AMPICILLIN SODIUM 250 MG VIAL INJECTION 12/20/2017 0.84420 1.26496 ( 33.3) AMPICILLIN SODIUM 500 MG VIAL INJECTION 12/20/2017 1.40700 1.47400 ( 4.5) AMOXICILLIN/POTASSIUM CLAV 250-62.5/5 SUSP RECON ORAL 04/18/2016 0.56280 0.63605 ( 11.5) CEFTRIAXONE SODIUM 10 G VIAL INJECTION 12/20/2017 15.12000 17.30400 ( 12.6) METHENAMINE HIPPURATE 1 G TABLET ORAL 12/20/2017 1.41678 1.20600 17.5 CIPROFLOXACIN HCL 250 MG TABLET ORAL 08/15/2017 0.08080 0.07986 1.2 MORPHINE SULFATE 100 MG TABLET ER ORAL 11/03/2015 1.00527 0.99455 1.1 SOTALOL HCL 160 MG TABLET ORAL 12/20/2017 0.28515 0.23128 23.3 FLUCONAZOLE IN NACL,ISO-OSM 200MG/0.1L PIGGYBACK INTRAVEN 12/20/2017 0.05360 0.02848 88.2 FLUCONAZOLE IN NACL,ISO-OSM 400MG/0.2L PIGGYBACK INTRAVEN 06/09/2015 0.02948 0.01732 70.2 CLOBETASOL PROPIONATE 0.05 SOLUTION TOPICAL 03/21/2017 1.52170 1.15401 31.9 DOXAZOSIN MESYLATE 1 MG TABLET ORAL 12/20/2017 0.37614 0.34331 9.6 DOXAZOSIN MESYLATE 2 MG TABLET ORAL 12/20/2017 0.35442 0.36341 ( 2.5) DOXAZOSIN MESYLATE 4 MG TABLET ORAL 12/20/2017 0.40562 0.35751 13.5 DOXAZOSIN MESYLATE 8 MG TABLET ORAL 07/11/2017 0.35710 0.36006 ( 0.8) FENTANYL 25 MCG/HR PATCH TD72 TRANSDERM 03/21/2017 2.45488 2.47096 ( 0.7) FENTANYL 50MCG/HR PATCH TD72 TRANSDERM 03/21/2017 4.07880 4.36128 ( 6.5) FENTANYL 75MCG/HR PATCH TD72 TRANSDERM 03/21/2017 6.15442 6.39826 ( 3.8) FENTANYL 100 MCG/HR PATCH TD72 TRANSDERM 03/21/2017 7.36560 7.74960 ( 5.0) CIPROFLOXACIN IN 5 DEXTROSE 400MG/0.2L PIGGYBACK INTRAVEN 12/20/2017 0.01674 0.01789 ( 6.4) CEFOXITIN SODIUM 2 G VIAL INTRAVEN 12/20/2017 7.37870 7.62000 ( 3.2) CARTEOLOL HCL 1 DROPS OPHTHALMIC 12/20/2017 1.01304 1.00500 0.8 FLUDARABINE PHOSPHATE 50 MG VIAL INTRAVEN 12/20/2017 87.67850 92.25000 ( 5.0)
5 Medicaid Run : 12/21/17 NE Weekly List Old BUTORPHANOL TARTRATE 10 MG/ML SPRAY NASAL 12/20/2017 14.75880 16.23716 ( 9.1) DILTIAZEM HCL 180 MG CAP ER DEG ORAL 12/20/2017 0.48082 0.67040 ( 28.3) SUMATRIPTAN SUCCINATE 100 MG TABLET ORAL 12/20/2017 0.73700 0.74263 ( 0.8) SOTALOL HCL 240 MG TABLET ORAL 12/20/2017 0.42639 0.38927 9.5 LISINOPRIL 2.5 MG TABLET ORAL 12/20/2017 0.01327 0.01420 ( 6.5) TERBINAFINE HCL 250 MG TABLET ORAL 12/20/2017 0.12529 0.12953 ( 3.3) KETOROLAC TROMETHAMINE 0.5 DROPS OPHTHALMIC 09/06/2016 1.34000 1.14838 16.7 MELPHALAN HCL 50 MG VIAL INTRAVEN 12/20/2017 973.75000 1127.50000 ( 13.6) DESMOPRESSIN ACETATE 0.1 MG TABLET ORAL 04/24/2017 1.19126 1.05860 12.5 ACARBOSE 100 MG TABLET ORAL 12/20/2017 0.28796 0.30793 ( 6.5) PRAVASTATIN SODIUM 40 MG TABLET ORAL 03/15/2016 0.16452 0.18194 ( 9.6) LISINOPRIL/HYDROCHLOROTHIAZIDE 10-12.5MG TABLET ORAL 12/20/2017 0.02680 0.03205 ( 16.4) TORSEMIDE 10 MG TABLET ORAL 10/17/2017 0.07558 0.08750 ( 13.6) TORSEMIDE 20 MG TABLET ORAL 12/20/2017 0.10358 0.12221 ( 15.2) IPRATROPIUM BROMIDE 0.2 MG/ML SOLUTION INHALATION 12/20/2017 0.05767 0.05771 ( 0.1) BENAZEPRIL/HYDROCHLOROTHIAZIDE 20 MG-25MG TABLET ORAL 12/27/2016 0.60193 0.85144 ( 29.3) GLIPIZIDE 5 MG TAB ER 24 ORAL 12/20/2017 0.18733 0.19216 ( 2.5) FLUCONAZOLE 150 MG TABLET ORAL 04/19/2016 1.37127 1.36635 0.4 ADENOSINE 3 MG/ML SYRINGE INTRAVEN 12/20/2017 6.76783 8.69700 ( 22.2) VINORELBINE TARTRATE 10 MG/ML VIAL INTRAVEN 12/20/2017 10.90200 11.21250 ( 2.8) SOTALOL HCL 120 MG TABLET ORAL 12/20/2017 0.22860 0.17407 31.3 FOSINOPRIL SODIUM 40 MG TABLET ORAL 12/20/2017 0.27515 0.38352 ( 28.3) RILUZOLE 50 MG TABLET ORAL 12/20/2017 1.51554 1.59281 ( 4.9) TOPIRAMATE 50 MG TABLET ORAL 12/20/2017 0.04958 0.05092 ( 2.6) TIZANIDINE HCL 2 MG TABLET ORAL 07/11/2017 0.12973 0.11466 13.1
6 Medicaid Run : 12/21/17 NE Weekly List Old AMMONIUM LACTATE 12 CREAM (G) TOPICAL 12/20/2017 0.10891 0.11026 ( 1.2) TIZANIDINE HCL 4 MG TABLET ORAL 09/08/2015 0.12382 0.11465 8.0 ADENOSINE 3 MG/ML VIAL INTRAVEN 12/20/2017 3.44850 4.12236 ( 16.3) PRAMIPEXOLE DI-HCL 1.5 MG TABLET ORAL 12/20/2017 0.08427 0.08472 ( 0.5) MEMANTINE HCL 10 MG TABLET ORAL 01/12/2016 0.18537 0.19553 ( 5.2) DILTIAZEM HCL 360 MG CAP ER 24H ORAL 12/20/2017 7.32160 7.60180 ( 3.7) DACTINOMYCIN 0.5 MG VIAL INTRAVEN 12/20/2017 1556.16525 585.71565 165.7 Addition SILDENAFIL CITRATE 25 MG TABLET ORAL 12/20/2017 31.53925.. Addition SILDENAFIL CITRATE 50 MG TABLET ORAL 12/20/2017 29.81896.. Addition SILDENAFIL CITRATE 100 MG TABLET ORAL 12/20/2017 29.81896.. PARICALCITOL 5 MCG/ML VIAL INTRAVEN 12/20/2017 5.55650 8.53824 ( 34.9) LEFLUNOMIDE 10 MG TABLET ORAL 04/18/2017 3.41792 3.34400 2.2 ENTACAPONE 200 MG TABLET ORAL 12/20/2017 1.59728 2.47900 ( 35.6) LISINOPRIL 30 MG TABLET ORAL 12/20/2017 0.04650 0.05588 ( 16.8) ROPINIROLE HCL 4 MG TABLET ORAL 12/20/2017 0.09367 0.10050 ( 6.8) MOXIFLOXACIN HCL 400 MG TABLET ORAL 12/20/2017 3.29780 3.21948 2.4 AMITRIPTYLINE HCL 10 MG TABLET ORAL 12/20/2017 0.12194 0.12055 1.2 NORTRIPTYLINE HCL 25 MG CAPSULE ORAL 12/20/2017 0.16080 0.13036 23.4 DESIPRAMINE HCL 25 MG TABLET ORAL 07/05/2016 1.19059 1.19233 ( 0.1) CLOMIPRAMINE HCL 50 MG CAPSULE ORAL 08/18/2015 5.21487 5.48932 ( 5.0) CITALOPRAM HYDROBROMIDE 10 MG/5 ML SOLUTION ORAL 12/20/2017 0.74683 0.29112 156.5 CITALOPRAM HYDROBROMIDE 10 MG TABLET ORAL 12/20/2017 0.02640 0.02546 3.7 FLUOXETINE HCL 10 MG CAPSULE ORAL 06/09/2015 0.02975 0.02680 11.0 BUPROPION HCL 100 MG TAB ER 12H ORAL 02/07/2017 0.09270 0.09353 ( 0.9) TRAZODONE HCL 150 MG TABLET ORAL 01/12/2016 0.15772 0.19028 ( 17.1)
7 Medicaid Run : 12/21/17 NE Weekly List Old MIRTAZAPINE 30 MG TABLET ORAL 04/15/2016 0.12060 0.13070 ( 7.7) OXYCODONE HCL 15 MG TABLET ORAL 07/25/2017 0.12743 0.12060 5.7 OXYCODONE HCL 30 MG TABLET ORAL 04/04/2017 0.20971 0.18752 11.8 GALANTAMINE HBR 4 MG TABLET ORAL 10/03/2017 0.55789 0.57508 ( 3.0) GALANTAMINE HBR 8 MG TABLET ORAL 10/17/2017 0.55610 0.57508 ( 3.3) CYCLOBENZAPRINE HCL 5 MG TABLET ORAL 05/26/2015 0.03618 0.03390 6.7 METOPROLOL SUCCINATE 25 MG TAB ER 24H ORAL 12/20/2017 0.43001 0.41931 2.6 CASPOFUNGIN ACETATE 50 MG VIAL INTRAVEN 12/20/2017 112.72950 113.77500 ( 0.9) CASPOFUNGIN ACETATE 70 MG VIAL INTRAVEN 12/20/2017 118.72575 122.11850 ( 2.8) GABAPENTIN 250 MG/5ML SOLUTION ORAL 12/20/2017 0.15625 0.15055 3.8 NYSTATIN/TRIAMCIN 100000-0.1 OINT. (G) TOPICAL 12/19/2017 0.71467 2.11363 ( 66.2) OXYCODONE HCL/ACETAMINOPHEN 7.5-325 MG TABLET ORAL 06/06/2017 0.17246 0.17326 ( 0.5) OXYCODONE HCL/ACETAMINOPHEN 10MG-325MG TABLET ORAL 05/23/2017 0.22592 0.22512 0.4 DEXMETHYLPHENIDATE HCL 10 MG TABLET ORAL 12/20/2017 1.09880 1.13109 ( 2.9) FROVATRIPTAN SUCCINATE 2.5 MG TABLET ORAL 10/04/2016 35.99117 31.84106 13.0 NEEDLES, DISPOSABLE 26GX1/2" DIS NEEDLE MISCELL 12/20/2017 0.05762 0.08707 ( 33.8) PRAVASTATIN SODIUM 80 MG TABLET ORAL 08/09/2016 0.24224 0.26532 ( 8.7) OLMESARTAN MEDOXOMIL 5 MG TABLET ORAL 12/20/2017 0.09023 0.09335 ( 3.3) AMLODIPINE BESYLATE/BENAZEPRIL 10 MG-20MG CAPSULE ORAL 09/29/2015 0.20368 0.19765 3.1 AMIODARONE HCL 50 MG/ML VIAL INTRAVEN 12/20/2017 0.43476 0.53600 ( 18.9) FOSAMPRENAVIR CALCIUM 700 MG TABLET ORAL 12/20/2017 15.74825 17.49790 ( 10.0) EZETIMIBE/SIMVASTATIN 10 MG-10MG TABLET ORAL 12/20/2017 4.18396 4.64904 ( 10.0) EZETIMIBE/SIMVASTATIN 10 MG-20MG TABLET ORAL 12/20/2017 4.18411 4.64904 ( 10.0) EZETIMIBE/SIMVASTATIN 10 MG-80MG TABLET ORAL 12/20/2017 4.18455 4.64948 ( 10.0)
8 Medicaid Run : 12/21/17 NE Weekly List Old EZETIMIBE/SIMVASTATIN 10 MG-40MG TABLET ORAL 12/20/2017 3.75452 3.95208 ( 5.0) DULOXETINE HCL 20 MG CAPSULE DR ORAL 12/20/2017 0.39351 0.40177 ( 2.1) DULOXETINE HCL 30 MG CAPSULE DR ORAL 12/20/2017 0.36693 0.37520 ( 2.2) MORPHINE SULFATE 20 MG CAP ER PEL ORAL 04/25/2017 4.18664 4.40682 ( 5.0) LIDOCAINE HCL/PF 15 MG/ML AMPUL INJECTION 12/20/2017 0.51818 0.55141 ( 6.0) LIDOCAINE HCL/PF 10 MG/ML AMPUL INJECTION 12/20/2017 0.30016 0.37134 ( 19.2) IBUPROFEN LYSINE/PF 20 MG/2 ML VIAL INTRAVEN 12/20/2017 210.15917 199.97919 5.1 DAPSONE 5 GEL (GRAM) TOPICAL 12/20/2017 5.14308 5.55688 ( 7.4) FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET ORAL 04/19/2016 0.31058 0.44235 ( 29.8) MORPHINE SULFATE 80 MG CAP ER PEL ORAL 05/15/2015 10.64981 11.31845 ( 5.9) MORPHINE SULFATE 60 MG CAP ER PEL ORAL 04/25/2017 8.40324 9.33648 ( 10.0) CARVEDILOL PHOSPHATE 80 MG CPMP 24HR ORAL 12/20/2017 7.53491 8.47840 ( 11.1) VIT A/VIT C/VIT E/ZINC/COPPER 14320-226 CAPSULE ORAL 12/20/2017 0.24221 0.24946 ( 2.9) CYCLOBENZAPRINE HCL 7.5 MG TABLET ORAL 07/18/2017 3.84978 3.77428 2.0 QUETIAPINE FUMARATE 300 MG TAB ER 24H ORAL 12/20/2017 1.14436 1.31722 ( 13.1) AMLODIPINE BES/OLMESARTAN MED 5 MG-20 MG TABLET ORAL 06/19/2017 0.81740 0.81934 ( 0.2) SEVELAMER CARBONATE 800 MG TABLET ORAL 12/20/2017 2.28296 2.35741 ( 3.2) GUAIFEN/DEXTROMETHORPHAN/PE 380-15-10 TABLET ORAL 12/20/2017 0.69233 0.63437 9.1 HEPARIN SODIUM,PORCINE/NS/PF 1000/500ML IV SOLN INTRAVEN 12/20/2017 0.00879 0.01026 ( 14.3) LEVETIRACETAM 500 MG TAB ER 24H ORAL 05/09/2017 0.28698 0.30731 ( 6.6) VENLAFAXINE HCL 75 MG TAB ER 24 ORAL 12/12/2017 5.08409 2.55716 98.8 VENLAFAXINE HCL 150 MG TAB ER 24 ORAL 12/12/2017 4.73822 2.74560 72.6 DOBUTAMINE HCL IN DEXTROSE 5 250 MG/250 IV SOLN INTRAVEN 12/20/2017 0.11235 0.09687 16.0 DOPAMINE HCL IN DEXTROSE 5 400MG/.25L PLAST. BAG INTRAVEN 12/20/2017 0.06957 0.06546 6.3
9 Medicaid Run : 12/21/17 NE Weekly List Old QUETIAPINE FUMARATE 150 MG TAB ER 24H ORAL 12/20/2017 1.04855 0.99919 4.9 LEVETIRACETAM 750 MG TAB ER 24H ORAL 12/20/2017 0.41227 0.47123 ( 12.5) AMLODIPINE/VALSARTAN/HCTHIAZID 10MG-160MG TABLET ORAL 12/20/2017 4.05636 4.92800 ( 17.7) AMLODIPINE/VALSARTAN/HCTHIAZID 5-160-25MG TABLET ORAL 12/20/2017 3.31496 3.32596 ( 0.3) GEMCITABINE HCL 2 G VIAL INTRAVEN 12/20/2017 99.90675 97.44665 2.5 SEVELAMER CARBONATE 0.8 G POWD PACK ORAL 12/20/2017 14.37497 15.99955 ( 10.2) DONEPEZIL HCL 23 MG TABLET ORAL 05/17/2016 1.78667 1.86230 ( 4.1) OLMESARTAN/AMLODIPIN/HCTHIAZID 40-10-12.5 TABLET ORAL 12/20/2017 2.57682 2.65484 ( 2.9) CLOZAPINE 200 MG TAB RAPDIS ORAL 11/17/2017 20.72575 15.10512 37.2 OMEGA-3/DHA/EPA/FISH OIL 300-1000MG CAPSULE DR ORAL 12/20/2017 0.08587 0.05617 52.9 SODIUM FERRIC GLUCONAT/SUCROSE 62.5MG/5ML VIAL INTRAVEN 12/20/2017 5.24964 4.94551 6.1 METRONIDAZOLE 1 GEL W/PUMP TOPICAL 01/12/2016 4.16472 4.28376 ( 2.8) PARICALCITOL 5 MCG/ML VIAL INJECTION 12/19/2017 7.01853 8.22600 ( 14.7) PARICALCITOL 2 MCG/ML VIAL INJECTION 07/05/2016 4.23878 4.72877 ( 10.4)