mac

50393 0000 000026670 20081009 00000000

30800 0015 000237600 20081009 00000000

30800 0060 000230360 20081009 00000000

20041 0000 000057240 20081009 00000000

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

ACARBOSE 0000 100 mg TABLET TAB $1.2413 20080905 00000000 20080905

ACARBOSE 0000 25 mg TABLET TAB $0.9626 20080905 00000000 20080905

ACARBOSE 0000 50 mg TABLET TAB $0.8632 20080905 00000000 20080905

ACEBUTOLOL HCL 0000 200 mg CAPSULE CAP $0.2333 20070305 00000000 20080905

ACEBUTOLOL HCL 0000 400 mg CAPSULE CAP $0.4357 20070305 00000000 20080905

ACETAMINOPHEN 0000 100 mg/ml MILLILITER DROPS $0.1864 20020906 20021206 20021206

ACETAMINOPHEN 0000 120 mg EACH SUPP $0.4250 20020906 20021206 20021206

ACETAMINOPHEN 0000 160 mg/5 ml MILLILITER ELIXIR $0.0157 20020906 20021206 20021206

ACETAMINOPHEN 0000 325 mg TABLET TAB $0.0110 20020906 20021206 20021206

ACETAMINOPHEN 0000 500 mg CAPSULE CAP $0.0169 20020405 20021206 20021206

ACETAMINOPHEN 0000 500 mg TABLET TAB $0.0152 20020906 20021206 20021206

ACETAMINOPHEN 0000 650 mg EACH SUPP $0.2390 20020906 20021206 20021206

ACETAMINOPHEN 0000 80 mg TABLET TAB, CHEW $0.0796 20020906 20021206 20021206

ACETAMINOPHEN W/CODEINE 0000 120 mg; 12 mg MILLILITER ELIXIR $0.0147 20080905 00000000 20080905

ACETAMINOPHEN W/CODEINE 0000 300 mg; 15 mg TABLET TAB $0.0662 20080919 00000000 20080919

ACETAMINOPHEN W/CODEINE 0000 300 mg; 30 mg TABLET TAB $0.0767 20080919 00000000 20080919

ACETAMINOPHEN W/CODEINE 0000 300 mg; 60 mg TABLET TAB $0.1550 20080919 00000000 20080919

ACETAMINOPHEN/BUTALBITAL/CAFFEINE 0000 500 mg/50 mg/40 mg TABLET TAB $0.1485 20080905 00000000 20080905

ACETAMINOPHEN/DIPHENHYDRAMINE TABLETS 0000 500 mg; 25 mg TABLET TAB $0.1500 20020405 20021206 20021206

ACETAZOLAMIDE 0000 125 mg TABLET TAB $0.0812 20071205 20080919 20080919

ACETAZOLAMIDE 0000 250 mg TABLET TAB $0.3561 20080919 00000000 20080919

ACETIC ACID 2% 0000 15 ml MILLILITER SOLN $0.1400 20021206 20030509 20030606

ACETYLCYSTEINE 10% 0010 10 ml MILLILITER SOLN $0.6432 20020906 20021206 20030606

ACETYLCYSTEINE 10% 0030 30 ml MILLILITER SOLN $0.4023 20020605 20021206 20030606

ACETYLCYSTEINE 10% 0004 4 ml MILLILITER SOLN $0.5700 20020605 20021206 20030606

ACETYLCYSTEINE 20% 0010 10 ml MILLILITER SOLN $0.7000 20020405 20021206 20021206

ACETYLCYSTEINE 20% 0030 30 ml MILLILITER SOLN $0.3095 20020605 20021206 20021206

ACETYLCYSTEINE 20% 0004 4 ml MILLILITER SOLN $0.7125 20020605 20021206 20021206

ACYCLOVIR 0000 200 mg CAPSULE CAP $0.0720 20080905 00000000 20080905

ACYCLOVIR 0000 200 mg/5 ml MILLILITER SOLN $0.2552 20080905 00000000 20080905

ACYCLOVIR 0000 400 mg TABLET TAB $0.0807 20080905 00000000 20080905

ACYCLOVIR 0000 800 mg TABLET TAB $0.1746 20080905 00000000 20080905

ACYCLOVIR SODIUM 0000 1 gm/vial GRAM PWDR for INJ $64.4200 20020405 20020605 20020605

ACYCLOVIR SODIUM 0000 500 mg/vial GRAM PWDR for INJ $9.2300 20020405 20020605 20020605

ALBUTEROL 0000 90 mcg GRAM AER $0.4236 20060505 20060929 20080905

ALBUTEROL SULFATE 0000 0.083% MILLILITER INH SOLN $0.0488 20080919 00000000 20080919

ALBUTEROL SULFATE 0000 0.5% (5mg/ml) MILLILITER INH SOLN $0.1680 20080919 00000000 20080919

ALBUTEROL SULFATE 0000 2 mg TABLET TAB $0.0887 20080919 00000000 20080919

ALBUTEROL SULFATE 0000 2 mg/5 ml MILLILITER SYR $0.0128 20080919 00000000 20080919

ALBUTEROL SULFATE 0000 4 mg TABLET TAB $0.1161 20080919 00000000 20080919

ALBUTEROL SULFATE 0000 4 mg TABLET TAB, ER $1.2795 20080919 00000000 20080919

ALBUTEROL SULFATE 0000 8 mg TABLET TAB, ER $2.3987 20080919 00000000 20080919

ALCLOMETASONE DIPROPIONATE 0000 0.05% GRAM CRM $1.0860 20080905 00000000 20080905

ALENDRONATE SODIUM 0000 10 mg TABLET TAB $0.3980 20081003 00000000 20081003

ALENDRONATE SODIUM 0000 35 mg TABLET TAB $2.6190 20080919 00000000 20080919

ALENDRONATE SODIUM 0000 40 mg TABLET TAB $4.2388 20080905 00000000 20080905

ALENDRONATE SODIUM 0000 5 mg TABLET TAB $1.3552 20080905 00000000 20080905

ALENDRONATE SODIUM 0000 70 mg TABLET TAB $7.1715 20080919 00000000 20080919

ALLOPURINOL 0000 100 mg TABLET TAB $0.0458 20080919 00000000 20080919

ALLOPURINOL 0000 300 mg TABLET TAB $0.0816 20080919 00000000 20080919

ALPRAZOLAM 0000 0.25 mg TABLET TAB $0.0452 20080919 00000000 20080919

ALPRAZOLAM 0000 0.5 mg TABLET TAB $0.0480 20080919 00000000 20080919

ALPRAZOLAM 0000 0.5 mg TABLET TAB, ER $0.5037 20080905 00000000 20080905

ALPRAZOLAM 0000 1 mg TABLET TAB $0.0498 20080919 00000000 20080919

ALPRAZOLAM 0000 1 mg TABLET TAB, ER $0.6282 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 2 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

ALPRAZOLAM 0000 2 mg TABLET TAB $0.1073 20080919 00000000 20080919

ALPRAZOLAM 0000 2 mg TABLET TAB, ER $0.7563 20080905 00000000 20080905

ALPRAZOLAM 0000 3 mg TABLET TAB, ER $1.1240 20080905 00000000 20080905

AMANTADINE HCL 0000 100 mg CAPSULE CAP $0.4227 20080905 00000000 20080905

AMANTADINE HCL 0000 50 mg/5 ml MILLILITER SYR $0.0236 20080905 00000000 20080905

AMINOPHYLLINE 0000 200 mg TABLET TAB $0.0411 20030606 20031205 20050902

AMIODARONE HCL 0000 200 mg TABLET TAB $0.2307 20080919 00000000 20080919

AMITRIPTYLINE HCL 0000 10 mg TABLET TAB $0.0242 20080919 00000000 20080919

AMITRIPTYLINE HCL 0000 100 mg TABLET TAB $0.0615 20080919 00000000 20080919

AMITRIPTYLINE HCL 0000 150 mg TABLET TAB $0.1203 20080919 00000000 20080919

AMITRIPTYLINE HCL 0000 25 mg TABLET TAB $0.0276 20080919 00000000 20080919

AMITRIPTYLINE HCL 0000 50 mg TABLET TAB $0.0356 20080919 00000000 20080919

AMITRIPTYLINE HCL 0000 75 mg TABLET TAB $0.0558 20080919 00000000 20080919

AMITRIPTYLINE; PERPHENAZINE 0000 10 mg; 2 mg TABLET TAB $0.1280 20070605 20080919 20080919

AMITRIPTYLINE; PERPHENAZINE 0000 10 mg; 4 mg TABLET TAB $0.0977 20051206 20060505 20060505

AMITRIPTYLINE; PERPHENAZINE 0000 25 mg; 2 mg TABLET TAB $0.1484 20070605 20080919 20080919

AMITRIPTYLINE; PERPHENAZINE 0000 25 mg; 4 mg TABLET TAB $0.1822 20070605 20080919 20080919

AMITRIPTYLINE; PERPHENAZINE 0000 50 mg; 4 mg TABLET TAB $0.3631 20070605 20080919 20080919

AMLODIPINE BESYLATE 0000 10 mg TABLET TAB $0.0755 20080919 00000000 20080919

AMLODIPINE BESYLATE 0000 2.5 mg TABLET TAB $0.0674 20080919 00000000 20080919

AMLODIPINE BESYLATE 0000 5 mg TABLET TAB $0.0674 20080919 00000000 20080919

AMLODIPINE BESYLATE/BENAZEPRIL 0000 10 mg; 20 mg CAPSULE CAP $3.0437 20080919 00000000 20080919

AMLODIPINE BESYLATE/BENAZEPRIL 0000 2.5 mg; 10 mg CAPSULE CAP $2.4398 20080305 00000000 20080605

AMLODIPINE BESYLATE/BENAZEPRIL 0000 5 mg; 10 mg CAPSULE CAP $2.4762 20080919 00000000 20080919

AMLODIPINE BESYLATE/BENAZEPRIL 0000 5 mg; 20 mg CAPSULE CAP $2.6147 20080919 00000000 20080919

AMMONIUM LACTATE 0000 12% GRAM CRM $0.0579 20080919 00000000 20080919

AMOX/POTASSIUM CLAVULANATE 0000 200-28.5/5 MILLILITER PWDR for ORAL SUSP $0.1713 20071205 00000000 20080605

AMOX/POTASSIUM CLAVULANATE 0000 200-28.5mg TABLET TAB, CHEW $1.0830 20070305 20070723 20080905

AMOX/POTASSIUM CLAVULANATE 0000 400-57 mg TABLET TAB, CHEW $1.1634 20080919 00000000 20080919

AMOX/POTASSIUM CLAVULANATE 0000 400-57/5 MILLILITER PWDR for ORAL SUSP $0.2637 20080905 00000000 20080905

AMOX/POTASSIUM CLAVULANATE 0000 500-125 mg TABLET TAB $0.9585 20080905 00000000 20080905

AMOX/POTASSIUM CLAVULANATE 0000 600-42.9/5 MILLILITER PWDR for ORAL SUSP $0.2739 20080919 00000000 20080919

AMOX/POTASSIUM CLAVULANATE 0000 875-125 mg TABLET TAB $1.0710 20080919 00000000 20080919

AMOXAPINE 0000 100 mg TABLET TAB $0.8809 20020906 20021206 20021206

AMOXAPINE 0000 150 mg TABLET TAB $1.1512 20061205 20071205 20080305

AMOXAPINE 0000 25 mg TABLET TAB $0.3291 20020906 20021206 20021206

AMOXAPINE 0000 50 mg TABLET TAB $0.4146 20020906 20021206 20021206

AMOXICILLIN 0000 125 mg TABLET TAB, CHEW $0.1333 20050603 20051206 20070305

AMOXICILLIN 0000 125 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.0182 20071205 00000000 20080605

AMOXICILLIN 0000 200 mg/5 ml MILLILITER SUSP $0.0501 20071205 00000000 20080605

AMOXICILLIN 0000 250 mg TABLET TAB, CHEW $0.1938 20080905 00000000 20080905

AMOXICILLIN 0000 250 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.0167 20080919 00000000 20080919

AMOXICILLIN 0000 400 mg TABLET TAB, CHEW $0.4338 20080905 00000000 20080905

AMOXICILLIN 0000 875 mg TABLET TAB $0.3167 20080919 00000000 20080919

AMOXICILLIN (TRIHYDRATE) 0000 250 mg CAPSULE CAP $0.0569 20080919 00000000 20080919

AMOXICILLIN (TRIHYDRATE) 0000 500 mg CAPSULE CAP $0.1032 20080919 00000000 20080919

AMOXICILLIN OS 0000 400 mg/5 ml MILLILITER SUSP RECON $0.0555 20080919 00000000 20080919

AMPHET ASP/AMPHET/D-AMPHET 0000 15 mg TABLET TAB $0.4529 20080919 00000000 20080919

AMPHETAMINE/D-AMPHETAMINE SALTS 0000 10 mg TABLET TAB $0.2423 20080905 00000000 20080905

AMPHETAMINE/D-AMPHETAMINE SALTS 0000 12.5 mg TABLET TAB $0.4578 20080905 00000000 20080905

AMPHETAMINE/D-AMPHETAMINE SALTS 0000 20 mg TABLET TAB $0.2423 20080905 00000000 20080905

AMPHETAMINE/D-AMPHETAMINE SALTS 0000 30 mg TABLET TAB $0.2423 20080905 00000000 20080905

AMPHETAMINE/D-AMPHETAMINE SALTS 0000 5 mg TABLET TAB $0.2423 20080905 00000000 20080905

AMPHETAMINE/D-AMPHETAMINE SALTS 0000 7.5 mg TABLET TAB $0.4578 20080905 00000000 20080905

AMPICILLIN SODIUM/SULBACTAM SODIUM 0000 3 gm EACH VIAL $11.9400 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 3 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

AMPICILLIN TRIHYDRATE 0000 125 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.0130 20020405 20020906 20020906

AMPICILLIN TRIHYDRATE 0000 250 mg CAPSULE CAP $0.1058 20080905 00000000 20080905

AMPICILLIN TRIHYDRATE 0000 500 mg CAPSULE CAP $0.1869 20080919 00000000 20080919

20,000 units; 4,500 units;

AMYLASE/LIPASE/PROTEASE 0000 25,000 units CAPSULE CAP, DR $0.2667 20081009 00000000 20081009

33,200 units; 10,000 units;

AMYLASE/LIPASE/PROTEASE 0000 38,000 units CAPSULE CAP, DR $0.5844 20080905 00000000 20080905

48,000 units; 16,000 units;

AMYLASE/LIPASE/PROTEASE 0000 48,000 units CAPSULE CAP, DR $0.5525 20061205 00000000 20080605

56,000 units; 20,000 units;

AMYLASE/LIPASE/PROTEASE 0000 44,000 units CAPSULE CAP, DR $0.9112 20080919 00000000 20080919

65,000 units; 20,000 units;

AMYLASE/LIPASE/PROTEASE 0000 65,000 units CAPSULE CAP, DR $0.8114 20080919 00000000 20080919

66,400 units; 20,000 units;

AMYLASE/LIPASE/PROTEASE 0000 75,000 units CAPSULE CAP, DR $0.6239 20061205 00000000 20080605

ANAGRELIDE HCL 0000 0.5 mg CAPSULE CAP $0.1607 20080905 00000000 20080905

ANAGRELIDE HCL 0000 1 mg CAPSULE CAP $0.3212 20070919 00000000 20080905

ANTIPYRINE/BENZOCAINE OTIC 0000 5.4%/1.4% MILLILITER OTIC SOLN $0.0960 20080905 00000000 20080905

ASPIRIN 0000 325 mg TABLET TAB $0.0116 20020906 20021206 20021206

ASPIRIN 0000 5 gr TABLET TAB, EC $0.0171 20020906 20021206 20021206

ASPIRIN BUFFERED 0000 325 mg TABLET TAB $0.0188 20020906 20021206 20021206

ASPIRIN W/CODEINE 0000 325 mg; 30 mg TABLET TAB $0.1517 20030305 20040305 20040305

ASPIRIN W/CODEINE 0000 325 mg; 60 mg TABLET TAB $0.1550 20020405 20020906 20020906

ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE 0000 30 mg CAPSULE CAP $0.8580 20080305 00000000 20080905

ATENOLOL 0000 100 mg TABLET TAB $0.0575 20080919 00000000 20080919

ATENOLOL 0000 25 mg TABLET TAB $0.0302 20080919 00000000 20080919

ATENOLOL 0000 50 mg TABLET TAB $0.0371 20080919 00000000 20080919

ATENOLOL; CHLORTHAL 0000 100 mg; 25 mg TABLET TAB $0.1253 20080919 00000000 20080919

ATENOLOL; CHLORTHAL 0000 50 mg; 25 mg TABLET TAB $0.0750 20080919 00000000 20080919

ATROPINE SULFATE 0000 0.01 MILLILITER OPTH SOLN $0.1571 20080919 00000000 20080919

ATROPINE SULFATE 0015 1%, 15 ml MILLILITER OPTH SOLN $0.5550 20030825 20050304 20050304

AZATHIOPRINE 0000 50 mg TABLET TAB $0.2109 20080905 00000000 20080905

AZITHROMYCIN 0000 100 mg/5 ml MILLILITER SUSP $1.4990 20080919 00000000 20080919

AZITHROMYCIN 0000 200 mg/5 ml MILLILITER SUSP $1.4990 20080919 00000000 20080919

AZITHROMYCIN 0000 250 mg TABLET TAB $2.6060 20080905 00000000 20080905

AZITHROMYCIN 0000 500 mg TABLET TAB $5.3436 20080905 00000000 20080905

AZITHROMYCIN 0000 600 mg TABLET TAB $5.1780 20080905 00000000 20080905

BACITRACIN 0000 500 units/gm GRAM OINT $0.0420 20020906 20021206 20031205

400 units/3.5 mg/5,000

BACITRACIN/NEOMYCIN SULFATE/POLYMYXIN B 0000 units per gm GRAM OINT $0.0533 20020405 20021206 20060605

BACITRACIN/NEOMYCIN/POLYMYXIN B/HC 0000 3.5 gr GRAM OPTH OINT $2.5303 20020906 20021206 20021206

BACITRACIN/POLYMYXIN B SULFATE 0000 15 gr GRAM OINT $0.0496 20020405 20021005 20021005

BACLOFEN 0000 10 mg TABLET TAB $0.0729 20080919 00000000 20080919

BACLOFEN 0000 20 mg TABLET TAB $0.1130 20080919 00000000 20080919

BALSALAZIDE DISODIUM 0000 750 mg CAPSULE CAP $0.4690 20080919 00000000 20080919

BENAZEPRIL HCL 0000 10 mg TABLET TAB $0.0908 20080305 00000000 20080905

BENAZEPRIL HCL 0000 20 mg TABLET TAB $0.0926 20080305 00000000 20080905

BENAZEPRIL HCL 0000 40 mg TABLET TAB $0.0926 20080305 00000000 20080905

BENAZEPRIL HCL 0000 5 mg TABLET TAB $0.0908 20080305 00000000 20080905

BENAZEPRIL/HCTZ 0000 10-12.5 mg TABLET TAB $0.1818 20080305 00000000 20080905

BENAZEPRIL/HCTZ 0000 20-12.5 mg TABLET TAB $0.1791 20080305 00000000 20080905

BENAZEPRIL/HCTZ 0000 20-25 mg TABLET TAB $0.1818 20080305 00000000 20080905

BENAZEPRIL/HCTZ 0000 5-6.25 mg TABLET TAB $0.1977 20080305 00000000 20080905

BENZONATATE 0000 100 mg CAPSULE CAP $0.2058 20080919 00000000 20080919

BENZONATATE 0000 200 mg CAPSULE CAP $0.5142 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 4 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

BENZTROPINE MESYLATE 0000 0.5 mg TABLET TAB $0.0656 20080305 00000000 20080905

BENZTROPINE MESYLATE 0000 1 mg TABLET TAB $0.0696 20080305 00000000 20080905

BENZTROPINE MESYLATE 0000 2 mg TABLET TAB $0.1013 20080305 00000000 20080905

BETAMETHASONE DIPROPIONATE 0000 0.0005 GRAM OINT $0.1952 20060605 20061205 20061205

BETAMETHASONE DIPROPIONATE 0000 0.0005 GRAM GEL $1.3590 20080305 00000000 20080905

BETAMETHASONE DIPROPIONATE 0015 0.05%, 15 gm GRAM CRM $0.1010 20071205 00000000 20080605

BETAMETHASONE DIPROPIONATE 0015 0.05%, 15 gm GRAM OINT $0.1010 20061205 00000000 20080605

BETAMETHASONE DIPROPIONATE 0045 0.05%, 45 gm GRAM CRM $0.0584 20061205 00000000 20080605

BETAMETHASONE DIPROPIONATE 0045 0.05%, 45 gm GRAM OINT $0.0546 20080919 00000000 20080919

BETAMETHASONE DIPROPIONATE 0050 0.05%, 50 gm GRAM OINT $0.5827 20020605 20021206 20030606

BETAMETHASONE DIPROPIONATE 0060 0.05%, 60 ml MILLILITER LOT $0.0626 20080919 00000000 20080919

BETAMETHASONE DIPROPIONATE AUGMENTED 0000 0.0005 GRAM OINT $0.4000 20080919 00000000 20080919

BETAMETHASONE DIPROPIONATE AUGMENTED 0000 0.05% GRAM CRM $0.6920 20080919 00000000 20080919

BETAMETHASONE VALERATE 0000 0.001 GRAM OINT $0.1192 20050603 20051206 20051206

BETAMETHASONE VALERATE 0015 0.001 GRAM OINT $0.0960 20071205 00000000 20080605

BETAMETHASONE VALERATE 0045 0.001 GRAM OINT $0.0624 20071205 00000000 20080605

BETAMETHASONE VALERATE 0015 0.1%, 15 gm GRAM CRM $0.0960 20071205 00000000 20080605

BETAMETHASONE VALERATE 0045 0.1%, 45 gm GRAM CRM $0.0474 20080919 00000000 20080919

BETAMETHASONE VALERATE 0060 0.1%, 60 ml MILLILITER LOT $0.0700 20080919 00000000 20080919

BETHANECHOL CHLORIDE 0000 10 mg TABLET TAB $0.4472 20080919 00000000 20080919

BETHANECHOL CHLORIDE 0000 25 mg TABLET TAB $0.5309 20080919 00000000 20080919

BETHANECHOL CHLORIDE 0000 5 mg TABLET TAB $0.2475 20080919 00000000 20080919

BETHANECHOL CHLORIDE 0000 50 mg TABLET TAB $0.9263 20080919 00000000 20080919

BISACODYL 0000 10 mg EACH SUPP $0.1030 20020906 20021206 20021206

BISACODYL 0000 5 mg TABLET TAB, EC $0.0176 20020906 20021206 20021206

BISOPROLOL FUMARATE 0000 10 mg TABLET TAB $0.7883 20080919 00000000 20080919

BISOPROLOL FUMARATE 0000 5 mg TABLET TAB $0.7562 20080919 00000000 20080919

BISOPROLOL/HCTZ 0000 10/6.25 TABLET TAB $0.0824 20080919 00000000 20080919

BISOPROLOL/HCTZ 0000 2.5/6.25 TABLET TAB $0.0745 20061205 00000000 20080605

BISOPROLOL/HCTZ 0000 5/6.25 TABLET TAB $0.0745 20071205 00000000 20080605

BRIMONIDINE TARTRATE 0000 0.002 MILLILITER DROPS $2.4120 20080305 00000000 20080905

BROMOCRIPTINE MESYLATE 0000 2.5 mg TABLET TAB $1.7781 20080305 00000000 20080905

BUMETANIDE 0000 0.5 mg TABLET TAB $0.1519 20081003 00000000 20081003

BUMETANIDE 0000 1 mg TABLET TAB $0.1937 20081003 00000000 20081003

BUMETANIDE 0000 2 mg TABLET TAB $0.1901 20081003 00000000 20081003

BUPROPION HCL 0000 100 mg TABLET TAB $0.2403 20080919 00000000 20080919

BUPROPION HCL 0000 100 mg TABLET TAB, SR $0.8364 20080919 00000000 20080919

BUPROPION HCL 0000 150 mg TABLET TAB, SR $0.9017 20080919 00000000 20080919

BUPROPION HCL 0000 150 mg TABLET TAB, SA $1.1402 20080919 00000000 20080919

BUPROPION HCL 0000 150 mg TABLET TAB, ER $4.1436 20080905 00000000 20080905

BUPROPION HCL 0000 200 mg TABLET TAB, SR $1.5574 20080919 00000000 20080919

BUPROPION HCL 0000 300 mg TABLET TAB, ER $2.4905 20080919 00000000 20080919

BUPROPION HCL 0000 75 mg TABLET TAB $0.2271 20080919 00000000 20080919

BUSPIRONE HCL 0000 10 mg TABLET TAB $0.0606 20080305 00000000 20080905

BUSPIRONE HCL 0000 15 mg TABLET TAB $0.0957 20080305 00000000 20080905

BUSPIRONE HCL 0000 30 mg TABLET TAB $0.8385 20080305 00000000 20080905

BUSPIRONE HCL 0000 5 mg TABLET TAB $0.0441 20080905 00000000 20080905

BUTALBITAL/APAP/CAFFEINE COMPOUND 0000 50 mg/325 mg/40 mg TABLET TAB $0.0785 20080305 00000000 20080905

50 mg/325 mg/40 mg/30

BUTALBITAL/APAP/CAFFEINE/CODEINE 0000 mg CAPSULE CAP $0.4289 20080919 00000000 20080919

BUTALBITAL/ASPIRIN/CAFF 0000 50 mg/325 mg/40 mg CAPSULE CAP $0.4635 20080305 00000000 20080905

BUTALBITAL/ASPIRIN/CAFFEINE 0000 50 mg/325 mg/40 mg TABLET TAB $0.1337 20080919 00000000 20080919

BUTORPHANOL TARTRATE 0000 10 mg/ml MILLILITER NASAL SPRAY $9.0720 20080919 00000000 20080919

CABERGOLINE 0000 0.5 mg TABLET TAB $23.3045 20080905 00000000 20080905

CALCIUM CARBONATE 0000 1250 mg TABLET TAB $0.0160 20020405 20020906 20020906







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 5 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

CALCIUM POLYCARBOPHIL 0000 625 mg TABLET TAB $0.0950 20020405 20021206 20021206

CAPTOPRIL 0000 100 mg TABLET TAB $0.0803 20080919 00000000 20080919

CAPTOPRIL 0000 12.5 mg TABLET TAB $0.0186 20080919 00000000 20080919

CAPTOPRIL 0000 25 mg TABLET TAB $0.0200 20080919 00000000 20080919

CAPTOPRIL 0000 50 mg TABLET TAB $0.0302 20080919 00000000 20080919

CAPTOPRIL; HYDROCHLOROTHIAZIDE 0000 25 mg; 15 mg TABLET TAB $0.0782 20080919 00000000 20080919

CAPTOPRIL; HYDROCHLOROTHIAZIDE 0000 25 mg; 25 mg TABLET TAB $0.0765 20080919 00000000 20080919

CAPTOPRIL; HYDROCHLOROTHIAZIDE 0000 50 mg; 15 mg TABLET TAB $0.1569 20080919 00000000 20080919

CAPTOPRIL; HYDROCHLOROTHIAZIDE 0000 50 mg; 25 mg TABLET TAB $0.1569 20080919 00000000 20080919

CARBAMAZEPINE 0000 100 mg TABLET TAB, CHEW $0.1140 20070605 00000000 20080605

CARBAMAZEPINE 0000 100 mg/5 ml MILLILITER SUSP $0.0419 20080919 00000000 20080919

CARBAMAZEPINE 0000 200 mg TABLET TAB $0.0533 20080919 00000000 20080919

CARBETAPENTANE/EPHEDRINE/PHENYLEPHRINE/CHLO

RPHENIRAMINE 0000 30-5-5-4 mg/5 ml MILLILITER SUSP $0.1892 20071205 20080404 20080605

CARBIDOPA; LEVODOPA 0000 10 mg; 100 mg TABLET TAB $0.2283 20080919 00000000 20080919

CARBIDOPA; LEVODOPA 0000 25 mg; 100 mg TABLET TAB $0.2268 20080919 00000000 20080919

CARBIDOPA; LEVODOPA 0000 25 mg; 250 mg TABLET TAB $0.2873 20080919 00000000 20080919

CARBIDOPA; LEVODOPA ER 0000 25 mg; 100 mg TABLET TAB, ER $0.3939 20080919 00000000 20080919

CARBIDOPA; LEVODOPA ER 0000 50 mg; 200 mg TABLET TAB, ER $0.6468 20080919 00000000 20080919

CARBINOXAMINE MALEATE 0000 4 mg/5 ml MILLILITER LIQ $0.1206 20080919 00000000 20080919

CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE;

DEXTROMETH HBR 0000 4-15-1 MILLILITER DROPS $0.2840 20050603 20051206 20051206

CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE;

DEXTROMETH HBR 0000 4-15-2 MILLILITER DROPS $0.1490 20040305 20041203 20041203

CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE;

DEXTROMETH HBR 0000 15-60-4/5 SYRUP SYR $0.1490 20040305 20041203 20041203

CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE; 4 mg; 60 mg; 15 mg per 5

DEXTROMETH HBR 0000 ml MILLILITER SYR $0.1050 20020405 20020906 20040305

CARBOPLATIN 0000 10 mg/ ml MILLILITER VIAL $2.7270 20080919 00000000 20080919

CARBOPLATIN 0000 150 mg EACH VIAL $54.0000 20080919 00000000 20080919

CARBOPLATIN 0000 450 mg EACH VIAL $161.9880 20080919 00000000 20080919

CARBOPLATIN 0000 50 mg EACH VIAL $17.9520 20080919 00000000 20080919

CAR-B-PEN TA/PHENYLEPHRINE/PYR 0000 30 mg; 5 mg; 30 mg/5 ml MILLILITER SUSP $0.2387 20070605 20071005 20071005

CARISOPRODOL 0000 350 mg TABLET TAB $0.0644 20080305 00000000 20080905

CARISOPRODOL/ASA COMPOUND 0000 200 mg; 325 mg TABLET TAB $0.1622 20080305 00000000 20080905

CARTEOLOL HCL 0000 0.01 MILLILITER SOLN $1.8510 20080919 00000000 20080919

CARVEDILOL 0000 12.5 mg TABLET TAB $0.0660 20080905 00000000 20080905

CARVEDILOL 0000 25 mg TABLET TAB $0.0660 20080905 00000000 20080905

CARVEDILOL 0000 3.125 mg TABLET TAB $0.0660 20080905 00000000 20080905

CARVEDILOL 0000 6.25 mg TABLET TAB $0.0660 20080905 00000000 20080905

CEFACLOR 0000 125 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.0659 20070919 20080305 20080305

CEFACLOR 0000 187 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.1123 20070305 20080305 20080305

CEFACLOR 0000 250 mg CAPSULE CAP $0.3602 20070919 20080305 20080305

CEFACLOR 0000 250 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.1812 20060605 20061205 20080305

CEFACLOR 0000 375 mg/5 ml MILLILITER PWDR for ORAL SUSP $0.2718 20060605 20061205 20080305

CEFACLOR 0000 500 mg CAPSULE CAP $0.6467 20070919 20080305 20080305

CEFACLOR 0000 500 mg TABLET TAB, ER $3.9767 20031205 20050331 20051206

CEFADROXIL 0000 1 gm TABLET TAB $5.6118 20030905 20040305 20050902

CEFADROXIL 0000 500 mg CAPSULE CAP $0.5682 20080305 00000000 20080905

CEFAZOLIN SODIUM 0000 1 gm EACH VIAL $1.9776 20080905 00000000 20080905

CEFAZOLIN SODIUM 0000 1 gm vial GRAM PWDR for INJ $0.2406 20020405 20020906 20020906

CEFAZOLIN SODIUM 0000 10 gm EACH VIAL $13.7310 20080905 00000000 20080905

CEFAZOLIN SODIUM 0000 10 gm vial GRAM PWDR for INJ $16.0000 20020405 20020906 20020906

CEFDINIR 0000 125 mg/5 ml MILLILITER SUSP $0.6273 20080905 00000000 20080905

CEFDINIR 0000 250 mg/5 ml MILLILITER SUSP $1.2570 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 6 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

CEFDINIR 0000 300 mg CAPSULE CAP $3.9690 20080905 00000000 20080905

CEFPODOXIME 0000 100 mg TABLET TAB $3.9066 20080905 00000000 20080905

CEFPODOXIME 0000 200 mg TABLET TAB $5.1618 20080905 00000000 20080905

CEFPROZIL 0000 125 mg/5 ml MILLILITER SUSP $0.2429 20080905 00000000 20080905

CEFPROZIL 0000 250 mg TABLET TAB $1.4387 20080905 00000000 20080905

CEFPROZIL 0000 250 mg/5 ml MILLILITER SUSP $0.3569 20080905 00000000 20080905

CEFPROZIL 0000 500 mg TABLET TAB $2.3976 20080905 00000000 20080905

CEFTAZIDIME PENTAHYDRATE 0000 1 gm EACH VIAL $9.3630 20080905 00000000 20080905

CEFTAZIDIME PENTAHYDRATE 0000 2 gm EACH VIAL $17.1645 20080905 00000000 20080905

CEFTAZIDIME PENTAHYDRATE 0000 6 gm EACH VIAL $54.7025 20080905 00000000 20080905

CEFTRIAXONE SODIUM 0000 1 gm EACH VIAL $5.9700 20080905 00000000 20080905

CEFTRIAXONE SODIUM 0000 10 gm EACH VIAL $70.8900 20080905 00000000 20080905

CEFTRIAXONE SODIUM 0000 2 gm EACH VIAL $11.9400 20080905 00000000 20080905

CEFTRIAXONE SODIUM 0000 250 mg EACH VIAL $2.6115 20080905 00000000 20080905

CEFTRIAXONE SODIUM 0000 500 mg EACH VIAL $4.7730 20080905 00000000 20080905

CEFUROXIME 0000 250 mg TABLET TAB $0.3603 20080905 00000000 20080905

CEFUROXIME 0000 500 mg TABLET TAB $0.6041 20080905 00000000 20080905

CEFUROXIME AXETIL 0000 125 mg/5 ml MILLILITER SUSP $0.5612 20080919 00000000 20080919

CEFUROXIME AXETIL 0000 250 mg/5 ml MILLILITER SUSP $0.8412 20080919 00000000 20080919

CEPHALEXIN 0000 125 mg/5 ml MILLILITER SUSP $0.0632 20080305 00000000 20080905

CEPHALEXIN 0000 250 mg CAPSULE CAP $0.1037 20080919 00000000 20080919

CEPHALEXIN 0000 250 mg/5 ml MILLILITER SUSP RECON $0.0668 20080919 00000000 20080919

CEPHALEXIN 0000 500 mg CAPSULE CAP $0.1661 20080919 00000000 20080919

CETIRIZINE HCL 0000 1 mg/ml MILLILITER SYR $0.0464 20080905 00000000 20080905

CETIRIZINE HCL 0000 10 mg TABLET TAB $0.1614 20080919 00000000 20080919

CETIRIZINE HCL 0000 10 mg TABLET TAB, CHEW $0.8340 20080919 00000000 20080919

CETIRIZINE HCL 0000 5 mg TABLET TAB $0.6607 20080201 00000000 20080605

CETIRIZINE HCL 0000 5 mg TABLET TAB, CHEW $0.8340 20080919 00000000 20080919

CHLORAL HYDRATE 0000 500 mg CAPSULE CAP $0.0263 20020405 20020424 20020424

CHLORDIAZEPOXIDE 0000 10 mg CAPSULE CAP $0.0646 20080919 00000000 20080919

CHLORDIAZEPOXIDE 0000 25 mg CAPSULE CAP $0.0854 20080919 00000000 20080919

CHLORDIAZEPOXIDE 0000 5 mg CAPSULE CAP $0.0838 20080919 00000000 20080919

CHLORHEXIDINE 0000 0.12% MILLILITER ORAL RINSE $0.0083 20080905 00000000 20080905

CHLOROTHIAZIDE 0000 250 mg TABLET TAB $0.1110 20021206 20030509 20031205

CHLOROTHIAZIDE 0000 500 mg TABLET TAB $0.2377 20021206 20030509 20031205

CHLORPHENIRAMINE MALEATE 0000 4 mg TABLET TAB $0.0185 20020906 20021206 20021206

CHLORPROMAZINE HCL 0000 10 mg TABLET TAB $0.1854 20080919 00000000 20080919

CHLORPROMAZINE HCL 0000 100 mg TABLET TAB $0.2822 20080919 00000000 20080919

CHLORPROMAZINE HCL 0000 200 mg TABLET TAB $0.3556 20080919 00000000 20080919

CHLORPROMAZINE HCL 0000 25 mg TABLET TAB $0.1889 20071205 00000000 20080605

CHLORPROMAZINE HCL 0000 50 mg TABLET TAB $0.2211 20080919 00000000 20080919

CHLORPROPAMIDE 0000 100 mg TABLET TAB $0.1944 20020308 20020705 20051206

CHLORPROPAMIDE 0000 250 mg TABLET TAB $0.3102 20070605 00000000 20080605

CHLORTHALIDONE 0000 100 mg TABLET TAB $0.1500 20020605 20021206 20031205

CHLORTHALIDONE 0000 25 mg TABLET TAB $0.1363 20080919 00000000 20080919

CHLORTHALIDONE 0000 50 mg TABLET TAB $0.1861 20080919 00000000 20080919

CHLORZOXAZONE 0000 500 mg TABLET TAB $0.0552 20080305 00000000 20080905

CHOLESTYRAMINE 0000 4 gm GRAM PWDR for ORAL SUSP $0.1099 20080919 00000000 20080919

CHOLESTYRAMINE LITE 0000 4 gm GRAM PWDR for ORAL SUSP $0.1436 20080919 00000000 20080919

CHOLESTYRAMINE LITE 0000 4 gm EACH PWDR PACKET $0.9810 20080919 00000000 20080919

CHOLESTYRAMINE/SUCROSE 0000 4 gm EACH PWDR PACKET $1.5924 20080919 00000000 20080919

CHOLINE MAGNESIUM TRISALICYLATE 0000 1000 mg TABLET TAB $0.4961 20080905 00000000 20080905

CHOLINE MAGNESIUM TRISALICYLATE 0000 500 mg TABLET TAB $0.2537 20080905 00000000 20080905

CHOLINE MAGNESIUM TRISALICYLATE 0000 750 mg TABLET TAB $0.3164 20080905 00000000 20080905

CICLOPIROX 0000 0.77% MILLILITER TOP SUSP $0.9824 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 7 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

CICLOPIROX 0000 0.77% GRAM CRM $1.3560 20080919 00000000 20080919

CILOSTAZOL 0000 100 mg TABLET TAB $0.2355 20080905 00000000 20080905

CILOSTAZOL 0000 50 mg TABLET TAB $0.2235 20080905 00000000 20080905

CIMETIDINE 0000 200 mg TABLET TAB $0.0558 20080919 00000000 20080919

CIMETIDINE 0000 300 mg TABLET TAB $0.0620 20080919 00000000 20080919

CIMETIDINE 0000 400 mg TABLET TAB $0.0600 20080919 00000000 20080919

CIMETIDINE 0000 800 mg TABLET TAB $0.1191 20080919 00000000 20080919

CIPROFLOXACIN 0000 0.003 MILLILITER SOLN $1.8540 20080905 00000000 20080905

CIPROFLOXACIN 0000 250 mg TABLET TAB $0.0716 20080305 00000000 20080905

CIPROFLOXACIN 0000 500 mg TABLET TAB $0.0852 20070919 00000000 20080605

CIPROFLOXACIN 0000 750 mg TABLET TAB $0.1728 20080905 00000000 20080905

CIPROFLOXACIN LACTATE/D5W 0000 400 mg/200 ml MILLILITER IV $0.0291 20080905 00000000 20080905

CITALOPRAM 0000 10 mg TABLET TAB $0.0603 20080919 00000000 20080919

CITALOPRAM 0000 10 mg/5 ml MILLILITER SOLN $0.2525 20080919 00000000 20080919

CITALOPRAM 0000 20 mg TABLET TAB $0.0665 20080919 00000000 20080919

CITALOPRAM 0000 40 mg TABLET TAB $0.0678 20080919 00000000 20080919

CLARITHROMYCIN 0000 125 mg/5 ml MILLILITER SUSP $0.3352 20080104 00000000 20080905

CLARITHROMYCIN 0000 250 mg TABLET TAB $0.5205 20080305 00000000 20080905

CLARITHROMYCIN 0000 250 mg/5 ml MILLILITER SUSP $0.6794 20080905 00000000 20080905

CLARITHROMYCIN 0000 500 mg TABLET TAB $0.5205 20080305 00000000 20080905

CLARITHROMYCIN 0000 500 mg TABLET TAB, ER $4.2460 20080905 00000000 20080905

CLIDINIUM/CHLORDIAZEPOXIDE 0000 2.5 mg/5 mg CAPSULE CAP $0.0440 20030606 20050331 20060605

CLINDAMYCIN HCL 0000 150 mg CAPSULE CAP $0.1148 20080919 00000000 20080919

CLINDAMYCIN HCL 0000 300 mg CAPSULE CAP $0.6369 20080919 00000000 20080919

CLINDAMYCIN PHOSPHATE 1% 0000 0.01 EACH PLEDGET $0.4444 20070605 00000000 20080605

CLINDAMYCIN PHOSPHATE 1% 0000 0.01 GRAM TOP GEL $0.3416 20080919 00000000 20080919

CLINDAMYCIN PHOSPHATE 1% 0000 0.01 MILLILITER TOP SOLN $0.0956 20080919 00000000 20080919

CLINDAMYCIN PHOSPHATE 1% 0000 0.01 MILLILITER TOP LOTION $0.3375 20080919 00000000 20080919

CLINDAMYCIN PHOSPHATE 1% 0030 30 ml MILLILITER TOP SOLN $0.1388 20011201 20011220 20011220

CLINDAMYCIN PHOSPHATE 1% 0060 60 ml MILLILITER TOP SOLN $0.1388 20011201 20011220 20011220

CLOBETASOL PROPIONATE 0000 0.05% GRAM OINT $0.1680 20080919 00000000 20080919

CLOBETASOL PROPIONATE 0000 0.05% GRAM CRM $0.1968 20080919 00000000 20080919

CLOBETASOL PROPIONATE 0000 0.05% MILLILITER TOP SOLN $0.1764 20080919 00000000 20080919

CLOBETASOL PROPIONATE 0000 0.05% GRAM GEL $0.5764 20080919 00000000 20080919

CLOBETASOL PROPIONATE/EMOLLIENT 0000 0.05% GRAM CRM $0.3876 20061205 00000000 20080605

CLOMIPHENE CITRATE 0000 50 mg TABLET TAB $2.3784 20020605 20021206 20021206

CLOMIPRAMINE HCL 0000 25 mg CAPSULE CAP $0.1113 20080905 00000000 20080905

CLOMIPRAMINE HCL 0000 50 mg CAPSULE CAP $0.1493 20070305 00000000 20080905

CLOMIPRAMINE HCL 0000 75 mg CAPSULE CAP $0.2258 20080905 00000000 20080905

CLONAZEPAM 0000 0.5 mg TABLET TAB $0.0287 20080905 00000000 20080905

CLONAZEPAM 0000 1 mg TABLET TAB $0.0384 20080905 00000000 20080905

CLONAZEPAM 0000 2 mg TABLET TAB $0.0558 20080905 00000000 20080905

CLONAZEPAM ODT 0000 0.125 mg TABLET TAB, orally disintegrating $1.1397 20080305 00000000 20080905

CLONAZEPAM ODT 0000 0.25 mg TABLET TAB, orally disintegrating $1.1580 20080905 00000000 20080905

CLONAZEPAM ODT 0000 0.5 mg TABLET TAB, orally disintegrating $1.2720 20080305 00000000 20080905

CLONAZEPAM ODT 0000 1 mg TABLET TAB, orally disintegrating $1.4535 20080305 00000000 20080905

CLONAZEPAM ODT 0000 2 mg TABLET TAB, orally disintegrating $2.0145 20080305 00000000 20080905

CLONIDINE HCL 0000 0.1 mg TABLET TAB $0.0539 20080305 00000000 20080905

CLONIDINE HCL 0000 0.2 mg TABLET TAB $0.0698 20080305 00000000 20080905

CLONIDINE HCL 0000 0.3 mg TABLET TAB $0.0891 20080905 00000000 20080905

CLORAZEPATE DIPOTASSIUM 0000 15 mg CAPSULE CAP $1.5000 20020405 20020906 20020906

CLORAZEPATE DIPOTASSIUM 0000 15 mg TABLET TAB $0.1847 20080305 00000000 20080905

CLORAZEPATE DIPOTASSIUM 0000 3.75 mg CAPSULE CAP $0.8000 20020405 20020906 20020906

CLORAZEPATE DIPOTASSIUM 0000 3.75 mg TABLET TAB $0.0962 20080305 00000000 20080905

CLORAZEPATE DIPOTASSIUM 0000 7.5 mg CAPSULE CAP $1.1000 20020405 20020906 20020906







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 8 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

CLORAZEPATE DIPOTASSIUM 0000 7.5 mg TABLET TAB $0.1389 20080305 00000000 20080905

CLOTRIMAZOLE 0000 0.01 GRAM VAG CRM $0.1276 20011201 20020605 20020605

CLOTRIMAZOLE 0000 0.01 GRAM CRM $0.2810 20011201 20020605 20020605

CLOTRIMAZOLE 0000 0.01 MILLILITER SOLN $0.3950 20020405 20020605 20020605

CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0000 1-0.05% MILLILITER LOT $0.7680 20080919 00000000 20080919

CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0015 1-0.05% GRAM CRM $0.3328 20080919 00000000 20080919

CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0045 1-0.05% GRAM CRM $0.1658 20080919 00000000 20080919

CLOZAPINE 0000 100 mg TABLET TAB $1.3401 20080305 00000000 20080905

CLOZAPINE 0000 25 mg TABLET TAB $0.5925 20080305 00000000 20080905

COLCHICINE 0000 0.6 mg TABLET TAB $0.0546 20080919 00000000 20080919

COLESTIPOL HCL 0000 1 gm TABLET TAB $0.5577 20080305 00000000 20080905

COLISTIMETHATE SODIUM 0000 150 mg EACH VIAL $27.8760 20080905 00000000 20080905

CROMOLYN SODIUM 0000 0.04 MILLILITER OPTH SOLN $0.6990 20080919 00000000 20080919

CROMOLYN SODIUM 0000 10 mg/ml MILLILITER INH SOLN $0.0965 20080919 00000000 20080919

CYCLOBENZAPRINE HCL 0000 10 mg TABLET TAB $0.0731 20080905 00000000 20080905

CYCLOBENZAPRINE HCL 0000 5 mg TABLET TAB $0.0857 20080305 00000000 20080905

CYCLOPENTOLATE HCL 0002 1%, 2 ml MILLILITER OPTH SOLN $2.1304 20020405 20020906 20020906

CYPROHEPTADINE HCL 0000 4 mg TABLET TAB $0.1139 20080919 00000000 20080919

DEFEROXAMINE MESYLATE 0000 2 gm EACH VIAL $60.1650 20080905 00000000 20080905

DEFEROXAMINE MESYLATE 0000 500 mg EACH VIAL $18.7238 20080905 00000000 20080905

DEMECLOCYCLINE 0000 150 mg TABLET TAB $7.9104 20080305 00000000 20080905

DEMECLOCYCLINE 0000 300 mg TABLET TAB $14.2169 20080919 00000000 20080919

DESIPRAMINE HCL 0000 10 mg TABLET TAB $0.1451 20080919 00000000 20080919

DESIPRAMINE HCL 0000 100 mg TABLET TAB $0.5484 20080919 00000000 20080919

DESIPRAMINE HCL 0000 150 mg TABLET TAB $0.7944 20080919 00000000 20080919

DESIPRAMINE HCL 0000 25 mg TABLET TAB $0.1743 20080919 00000000 20080919

DESIPRAMINE HCL 0000 50 mg TABLET TAB $0.3279 20080919 00000000 20080919

DESIPRAMINE HCL 0000 75 mg TABLET TAB $0.4173 20080919 00000000 20080919

DESMOPRESSIN 0000 0.1 mg/ml MILLILITER NASAL SPRAY $15.3900 20080919 00000000 20080919

DESMOPRESSIN ACETATE 0000 0.1 mg TABLET TAB $1.7180 20080305 00000000 20080905

DESMOPRESSIN ACETATE 0000 0.2 mg TABLET TAB $1.9374 20080905 00000000 20080905

DESMOPRESSIN ACETATE 0000 4 mcg/ml EACH VIAL $19.5504 20080905 00000000 20080905

DESMOPRESSIN ACETATE 0000 4 mcg/ml EACH AMPUL $19.5504 20080905 00000000 20080905

DESOGESTREL/ETHINY ESTRADIOL (DESOGEN, ORTHO-

CEPT, APRI) 0000 0.15 mg/30 mcg TABLET TAB $0.6355 20080305 00000000 20080905

DESOGESTREL/ETHINY ESTRADIOL (KARIVA,

MIRCETTE) 0000 0.15 mg/20 mcg TABLET TAB $1.5661 20080919 00000000 20080919

DESOGESTREL/ETHINY ESTRADIOL 7-7-7 (CYCLESSA, 0.1-25/0.125-25/0.15-25

VELIVET) 0000 mg-mcg TABLET TAB $0.8849 20080305 00000000 20080905

DESONIDE 0000 0.0005 MILLILITER LOT $0.4674 20080905 00000000 20080905

DESONIDE 0015 0.05%; 15 gm GRAM CRM $0.2501 20080305 00000000 20080905

DESONIDE 0015 0.05%; 15 gm GRAM OINT $0.2240 20080305 00000000 20080905

DESONIDE 0060 0.05%; 60 gm GRAM CRM $0.1377 20080305 00000000 20080905

DESONIDE 0060 0.05%; 60 gm GRAM OINT $0.1313 20080305 00000000 20080905

DESOXIMETASONE 0000 0.0025 GRAM CRM $0.6880 20060303 20060906 20060906

DESOXIMETASONE 0015 0.05%; 15 gm GRAM GEL $1.8352 20080919 00000000 20080919

DESOXIMETASONE 0015 0.05%; 15 gm GRAM CRM $1.9632 20080919 00000000 20080919

DESOXIMETASONE 0060 0.05%; 60 gm GRAM GEL $1.0746 20080919 00000000 20080919

DESOXIMETASONE 0060 0.05%; 60 gm GRAM CRM $1.8968 20080919 00000000 20080919

DESOXIMETASONE 0015 0.25%; 15 gm GRAM OINT $2.3760 20081009 00000000 20081009

DESOXIMETASONE 0015 0.25%; 15 gm GRAM CRM $2.2752 20080805 00000000 20080905

DESOXIMETASONE 0060 0.25%; 60 gm GRAM OINT $2.3036 20081009 00000000 20081009

DESOXIMETASONE 0060 0.25%; 60 gm GRAM CRM $1.1672 20080805 00000000 20080905

DEXAMETHASONE 0000 0.5 mg TABLET TAB $0.0935 20050304 20050902 20070305

DEXAMETHASONE 0000 0.5 mg/5 ml MILLILITER ELIXIR $0.0357 20020308 20020906 20020906







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 9 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

DEXAMETHASONE 0000 4 mg TABLET TAB $0.1145 20080919 00000000 20080919

DEXTROAMPHETAMINE SULFATE 0000 10 mg CAPSULE CAP, SA $1.5397 20080805 00000000 20080905

DEXTROAMPHETAMINE SULFATE 0000 10 mg TABLET TAB $0.2042 20080305 00000000 20080905

DEXTROAMPHETAMINE SULFATE 0000 15 mg CAPSULE CAP, SA $1.9654 20080805 00000000 20080905

DEXTROAMPHETAMINE SULFATE 0000 5 mg TABLET TAB $0.1614 20080305 00000000 20080905

DEXTROAMPHETAMINE SULFATE 0000 5 mg CAPSULE CAP, SA $1.3697 20080805 00000000 20080905

DIAZEPAM 0000 10 mg TABLET TAB $0.0431 20080919 00000000 20080919

DIAZEPAM 0000 2 mg TABLET TAB $0.0336 20080919 00000000 20080919

DIAZEPAM 0000 5 mg TABLET TAB $0.0323 20080919 00000000 20080919

DICLOFENAC POTASSIUM 0000 50 mg TABLET TAB $0.1446 20080305 00000000 20080905

DICLOFENAC SODIUM 0000 25 mg TABLET TAB, EC $0.8202 20080514 00000000 20080514

DICLOFENAC SODIUM 0000 50 mg TABLET TAB, EC $0.3779 20080514 00000000 20080514

DICLOFENAC SODIUM 0000 75 mg TABLET TAB, EC $0.4195 20080514 00000000 20080514

DICLOFENAC SODIUM XR 0000 100 mg TABLET TAB, XR $0.5313 20080905 00000000 20080905

DICLOXACILLIN SODIUM 0000 250 mg CAPSULE CAP $0.3087 20080919 00000000 20080919

DICLOXACILLIN SODIUM 0000 500 mg CAPSULE CAP $0.6173 20080919 00000000 20080919

DICYCLOMINE HCL 0000 10 mg CAPSULE CAP $0.0452 20070919 00000000 20080905

DICYCLOMINE HCL 0000 20 mg TABLET TAB $0.0554 20070919 00000000 20080905

DIFLORASONE DIACETATE 0000 0.05% GRAM CRM $0.5885 20080919 00000000 20080919

DIFLORASONE DIACETATE 0000 0.05% GRAM OINT $0.5778 20080919 00000000 20080919

DIFLUNISAL 0000 250 mg TABLET TAB $0.8938 20020405 20020906 20050304

DIFLUNISAL 0000 500 mg TABLET TAB $0.9416 20080305 00000000 20080905

DIGOXIN 0000 .125 mg TABLET TAB $0.1091 20080919 00000000 20080919

DIGOXIN 0000 .250 mg TABLET TAB $0.1091 20080919 00000000 20080919

DILTIAZEM HCL 0000 120 mg CAPSULE CAP, SR 12HR $1.1393 20070305 20080305 20080905

DILTIAZEM HCL 0000 120 mg CAPSULE CAP, SR 24HR $0.6344 20080905 00000000 20080905

DILTIAZEM HCL 0000 120 mg TABLET TAB $0.1522 20080905 00000000 20080905

DILTIAZEM HCL 0000 120 mg CAPSULE CAP, CR $0.3810 20080919 00000000 20080919

DILTIAZEM HCL 0000 120 mg CAPSULE CAP, ER $0.5619 20080919 00000000 20080919

DILTIAZEM HCL 0000 180 mg CAPSULE CAP, SR 24HR $0.7407 20080905 00000000 20080905

DILTIAZEM HCL 0000 180 mg CAPSULE CAP, CR $0.4049 20080305 00000000 20080905

DILTIAZEM HCL 0000 180 mg CAPSULE CAP, SA $0.6797 20080905 00000000 20080905

DILTIAZEM HCL 0000 240 mg CAPSULE CAP, SR 24HR $1.0196 20080905 00000000 20080905

DILTIAZEM HCL 0000 240 mg CAPSULE CAP, CR $0.4407 20080305 00000000 20080905

DILTIAZEM HCL 0000 240 mg CAPSULE CAP, SA $0.9437 20080905 00000000 20080905

DILTIAZEM HCL 0000 30 mg TABLET TAB $0.0401 20080905 00000000 20080905

DILTIAZEM HCL 0000 300 mg CAPSULE CAP, SR 24HR $1.3923 20080905 00000000 20080905

DILTIAZEM HCL 0000 300 mg CAPSULE CAP, ER $1.2497 20080919 00000000 20080919

DILTIAZEM HCL 0000 360 mg CAPSULE CAP, ER $1.2609 20080919 00000000 20080919

DILTIAZEM HCL 0000 60 mg CAPSULE CAP, SR 12HR $0.5505 20080305 00000000 20080905

DILTIAZEM HCL 0000 60 mg TABLET TAB $0.0695 20080905 00000000 20080905

DILTIAZEM HCL 0000 90 mg CAPSULE CAP, SR 12HR $0.7676 20080919 00000000 20080919

DILTIAZEM HCL 0000 90 mg TABLET TAB $0.1047 20080905 00000000 20080905

DILTIAZEM HCL 0000 420 mg CAPSULE CAP, SA $1.4156 20080919 00000000 20080919

DIPHENHYDRAMINE 0000 25 mg CAPSULE CAP $0.0210 20080905 00000000 20080905

DIPHENHYDRAMINE 0000 50 mg CAPSULE CAP $0.0382 20080905 00000000 20080905

DIPHENOXYLATE HCL; ATROPINE SULFATE 0000 2.5 mg; 0.025 mg TABLET TAB $0.0593 20080305 00000000 20080905

DIPHENOXYLATE HCL; ATROPINE SULFATE 0000 2.5 mg; 0.025 mg/5 ml MILLILITER SOLN $0.2189 20040305 20050902 20060906

DIPYRIDAMOLE 0000 25 mg TABLET TAB $0.2159 20071205 00000000 20080605

DIPYRIDAMOLE 0000 50 mg TABLET TAB $0.3363 20071205 00000000 20080605

DIPYRIDAMOLE 0000 75 mg TABLET TAB $0.4674 20071205 00000000 20080605

DISOPYRAMIDE 0000 100 mg CAPSULE CAP $0.4166 20080305 00000000 20080905

DISOPYRAMIDE 0000 150 mg CAPSULE CAP $0.4783 20080305 00000000 20080905

DISOPYRAMIDE CR 0000 150 mg CAPSULE CAP, CR $1.0639 20060906 20070305 20070305

DIVALPROEX SODIUM 0000 125 mg TABLET TAB, EC $0.0944 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 10 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

DIVALPROEX SODIUM 0000 250 mg TABLET TAB, EC $0.1736 20080905 00000000 20080905

DIVALPROEX SODIUM 0000 500 mg TABLET TAB, EC $0.3095 20080905 00000000 20080905



D-METHORP TAN/P-EPD TAN/D-CP 0000 25 mg; 75 mg; 2.5 mg/5 ml MILLILITER SUSP $0.2775 20061205 20080104 20080104

D-METHORPHAN HB/PE/CHLORPHENIR 0000 15 mg; 6 mg; 2 mg/5 ml MILLILITER SYR $0.0331 20080919 00000000 20080919

D-METHORPHAN HB/P-EPD HCL/BPM 0000 10 mg; 30 mg; 2 mg/5 ml MILLILITER SYR $0.0270 20061205 20080104 20080104

D-METHORPHAN HB/P-EPD HCL/BPM 0000 15 mg; 45 mg; 4 mg/5 ml MILLILITER SYR $0.0161 20071205 20080104 20080104

D-METHORPHAN HB/P-EPD HCL/BPM 0000 30 mg; 60 mg; 4 mg/5 ml MILLILITER SYR $0.0465 20070605 20080104 20080104

D-METHORPHAN HB/P-EPD HCL/BPM 0000 4 mg; 15 mg; 1 mg/ml MILLILITER DROPS $0.5291 20061205 20080104 20080104

D-METHORPHAN HB/P-EPD HCL/BPM 0000 3 mg; 12.5 mg;1 mg/ml MILLILITER DROPS $0.8720 20070605 20080104 20080104

DOCUSATE CALCIUM 0000 240 mg CAPSULE CAP $0.0696 20020906 20021206 20031205

DOCUSATE SODIUM 0000 100 mg CAPSULE CAP $0.0271 20020906 20021206 20031205

DOCUSATE SODIUM 0000 150 mg/15 ml MILLILITER LIQ $0.0140 20020906 20021206 20031205

DOCUSATE SODIUM 0000 50 mg CAPSULE CAP $0.0910 20020906 20021206 20021206

DOCUSATE SODIUM/CASANTHRANOL 0000 100 mg/30 mg CAPSULE CAP $0.0226 20020906 20021206 20021206

DOCUSATE SODIUM/CASANTHRANOL 0000 60 mg/30 mg per 15 ml MILLILITER SYR $0.0095 20020906 20021206 20021206

DOCUSATE SODIUM/SENNA 0000 50 mg/8.6 mg TABLET TAB $0.0935 20020906 20021206 20021206

DOXAZOSIN MESYLATE 0000 1 mg TABLET TAB $0.0569 20080305 00000000 20080905

DOXAZOSIN MESYLATE 0000 2 mg TABLET TAB $0.0567 20080305 00000000 20080905

DOXAZOSIN MESYLATE 0000 4 mg TABLET TAB $0.0699 20080305 00000000 20080905

DOXAZOSIN MESYLATE 0000 8 mg TABLET TAB $0.0773 20080905 00000000 20080905

DOXEPIN HCL 0000 10 mg CAPSULE CAP $0.0516 20080919 00000000 20080919

DOXEPIN HCL 0000 100 mg CAPSULE CAP $0.1337 20080919 00000000 20080919

DOXEPIN HCL 0000 150 mg CAPSULE CAP $0.2785 20080919 00000000 20080919

DOXEPIN HCL 0000 25 mg CAPSULE CAP $0.0588 20080919 00000000 20080919

DOXEPIN HCL 0000 50 mg CAPSULE CAP $0.0830 20080919 00000000 20080919

DOXEPIN HCL 0000 75 mg CAPSULE CAP $0.1163 20080919 00000000 20080919

DOXORUBICIN HCL 0000 2 mg/ ml MILLILITER VIAL $1.8180 20080919 00000000 20080919

DOXYCYCLINE HYCLATE 0000 100 mg CAPSULE CAP $0.0915 20080919 00000000 20080919

DOXYCYCLINE HYCLATE 0000 100 mg TABLET TAB $0.0957 20071205 00000000 20080605

DOXYCYCLINE HYCLATE 0000 20 mg TABLET TAB $0.8649 20080919 00000000 20080919

DOXYCYCLINE HYCLATE 0000 50 mg CAPSULE CAP $0.0939 20071205 00000000 20080605

DOXYCYCLINE MONOHYDRATE 0000 100 mg CAPSULE CAP $0.7330 20080919 00000000 20080919

DOXYCYCLINE MONOHYDRATE 0000 50 mg CAPSULE CAP $0.3504 20080919 00000000 20080919

DOXYCYCLINE MONOHYDRATE 0000 100 mg TABLET TAB $2.4708 20080305 00000000 20080905

DOXYCYCLINE MONOHYDRATE 0000 50 mg TABLET TAB $1.6172 20080905 00000000 20080905

DRONABINOL 0000 5 mg CAPSULE CAP $10.7225 20080905 00000000 20080905

DRONABINOL 0000 10 mg CAPSULE CAP $19.6923 20080905 00000000 20080905

DRONABINOL 0000 2.5 mg CAPSULE CAP $5.1536 20080905 00000000 20080905

ECONAZOLE NITRATE 0000 1% GRAM CRM $0.6560 20061205 00000000 20080605

ELECTROLYTE ORAL SOLUTION 1000 1000 ml MILLILITER SOLN $0.0038 20020405 20021206 20021206

ELECTROLYTE ORAL SOLUTION 0540 540 ml MILLILITER SOLN $0.0074 20020405 20021206 20021206

ENALAPRIL MALEATE 0000 10 mg TABLET TAB $0.0416 20080919 00000000 20080919

ENALAPRIL MALEATE 0000 2.5 mg TABLET TAB $0.0296 20080919 00000000 20080919

ENALAPRIL MALEATE 0000 20 mg TABLET TAB $0.0461 20080919 00000000 20080919

ENALAPRIL MALEATE 0000 5 mg TABLET TAB $0.0341 20080919 00000000 20080919

ENALAPRIL MALEATE/HCTZ 0000 10 mg/25 mg TABLET TAB $0.1202 20080919 00000000 20080919

ENALAPRIL MALEATE/HCTZ 0000 5 mg/12.5 mg TABLET TAB $0.1100 20080919 00000000 20080919

ERYTHROMYCIN 0000 0.005 GRAM OPTH OINT $0.5075 20070919 00000000 20080905

ERYTHROMYCIN 0000 2% MILLILITER SOLN $0.2256 20080919 00000000 20080919

ERYTHROMYCIN BASE 0000 250 mg TABLET TAB $0.1214 20061205 20080919 20080919

ERYTHROMYCIN BASE 0000 333 mg TABLET TAB $0.1920 20020405 20020906 20041203

ERYTHROMYCIN BASE 0000 500 mg TABLET TAB $0.1644 20020906 20030509 20031205

ERYTHROMYCIN BASE/BENZOYL PEROXIDE 0000 3%; 5% GRAM GEL $1.5560 20080919 00000000 20080919

ERYTHROMYCIN BASE/ETHANOL 0000 2% GRAM GEL $0.5368 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 11 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

ERYTHROMYCIN ETHYLSUCCINATE (EES) 0000 400 mg TABLET TAB $0.1549 20030305 20030905 20080905

ERYTHROMYCIN/SULFISOXAZOLE 0000 200 mg/600 mg per 5 ml MILLILITER GRAN FOR ORAL SUSP $0.1211 20070919 20080305 20080905

ESTAZOLAM 0000 1 mg TABLET TAB $0.2967 20080905 00000000 20080905

ESTAZOLAM 0000 2 mg TABLET TAB $0.5137 20080905 00000000 20080905

ESTERIFIED ESTROGENS/METHYLTESTOSTERONE

(H.S.) 0000 0.625-1.25 mg TABLET TAB $0.6210 20080919 00000000 20080919

ESTERIFIED ESTROGENS/METHYLTESTOSTERONE

(H.S.) 0000 1.25-2.5 mg TABLET TAB $0.7409 20080919 00000000 20080919

ESTRADIOL 0000 .025 mg PATCH PATCH $7.6170 20080919 00000000 20080919

ESTRADIOL 0000 .05 mg PATCH PATCH $7.5720 20080919 00000000 20080919

ESTRADIOL 0000 .075 mg PATCH PATCH $7.7430 20080919 00000000 20080919

ESTRADIOL 0000 .1 mg PATCH PATCH $7.6650 20080919 00000000 20080919

ESTRADIOL 0000 0.5 mg TABLET TAB $0.0497 20080905 00000000 20080905

ESTRADIOL 0000 1 mg TABLET TAB $0.0501 20080905 00000000 20080905

ESTRADIOL 0000 2 mg TABLET TAB $0.0656 20080905 00000000 20080905

ESTROPIPATE 0000 0.75 mg TABLET TAB $0.1011 20080919 00000000 20080919

ESTROPIPATE 0000 1.5 mg TABLET TAB $0.1215 20080919 00000000 20080919

ESTROPIPATE 0000 3 mg TABLET TAB $0.7469 20060906 20070305 20070305

ETHINYL ESTRADIOL/DROSPIRENONE (YASMIN,

OCELLA) 0000 0.03-3 mg TABLET TAB $1.7498 20080805 00000000 20080905

ETHOSUXIMIDE 0000 250 mg CAPSULE CAP $1.0094 20080919 00000000 20080919

ETHOSUXIMIDE 0000 250 mg/5 ml MILLILITER SYR $0.0842 20080919 00000000 20080919

ETHYNODIOL DIACETATE/ETHINYL ESTRADIOL

(DEMULEN 1/35, ZOVIA 1/35E) 0000 1 mg/35 mcg TABLET TAB $0.7274 20080305 00000000 20080905

ETHYNODIOL DIACETATE/ETHINYL ESTRADIOL

(DEMULEN 1/50, ZOVIA 1/50E) 0000 1 mg/50 mcg TABLET TAB $0.9754 20080305 00000000 20080905

ETODOLAC 0000 200 mg CAPSULE CAP $0.2896 20080305 00000000 20080905

ETODOLAC 0000 300 mg CAPSULE CAP $0.1941 20080919 00000000 20080919

ETODOLAC 0000 400 mg TABLET TAB $0.1709 20080905 00000000 20080905

ETODOLAC 0000 400 mg TABLET TAB, ER $0.9332 20080919 00000000 20080919

ETODOLAC 0000 500 mg TABLET TAB $0.3012 20080919 00000000 20080919

ETODOLAC 0000 600 mg TABLET TAB, ER $2.0160 20080919 00000000 20080919

ETODOLAC 0000 500 mg TABLET TAB, ER $0.9632 20080919 00000000 20080919

FAMCICLOVIR 0000 125 mg TABLET TAB $3.7176 20080305 00000000 20080605

FAMCICLOVIR 0000 250 mg TABLET TAB $4.0416 20080305 00000000 20080605

FAMCICLOVIR 0000 500 mg TABLET TAB $8.1200 20080305 00000000 20080605

FAMOTIDINE 0000 20 mg TABLET TAB $0.0507 20080919 00000000 20080919

FAMOTIDINE 0000 40 mg TABLET TAB $0.0935 20080919 00000000 20080919

FELODIPINE 0000 10 mg TABLET TAB, ER $2.3307 20080905 00000000 20080905

FELODIPINE 0000 2.5 mg TABLET TAB, ER $1.2981 20080905 00000000 20080905

FELODIPINE 0000 5 mg TABLET TAB, ER $1.2981 20080905 00000000 20080905

FENTANYL 0000 100 mcg PATCH PATCH $33.9750 20080919 00000000 20080919

FENTANYL 0000 25 mcg PATCH PATCH $9.3930 20080919 00000000 20080919

FENTANYL 0000 50 mcg PATCH PATCH $17.1780 20080919 00000000 20080919

FENTANYL 0000 75 mcg PATCH PATCH $26.2020 20080919 00000000 20080919

FENTANYL CITRATE 0000 1,200 mcg EACH LOZENGE $33.6725 20080905 00000000 20080905

FENTANYL CITRATE 0000 1,600 mcg EACH LOZENGE $40.6031 20080905 00000000 20080905

FENTANYL CITRATE 0000 200 mcg EACH LOZENGE $15.1271 20080905 00000000 20080905

FENTANYL CITRATE 0000 400 mcg EACH LOZENGE $18.5904 20080905 00000000 20080905

FENTANYL CITRATE 0000 600 mcg EACH LOZENGE $22.7712 20080905 00000000 20080905

FERROUS FUMARATE/FOLIC ACID 0000 106 mg; 1 mg TABLET TAB $0.1871 20061205 20080919 20080919

FERROUS SULFATE 0000 220 mg/5 ml MILLILITER ELIXIR $0.0098 20020906 20021206 20021206

FERROUS SULFATE 0000 325 mg TABLET TAB $0.0248 20020906 20021206 20021206

FERROUS SULFATE 0000 75 mg/0.6 ml; 50 ml MILLILITER DROPS $0.0746 20020906 20021206 20021206

FEXOFENADINE HCL 0000 180 mg TABLET TAB $1.3092 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 12 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

FEXOFENADINE HCL 0000 30 mg TABLET TAB $0.4881 20080905 00000000 20080905

FEXOFENADINE HCL 0000 60 mg TABLET TAB $0.8438 20080905 00000000 20080905

FINASTERIDE 0000 5 mg TABLET TAB $1.4156 20080905 00000000 20080905

FLAVOXATE HCL 0000 100 mg TABLET TAB $1.2878 20070305 00000000 20080905

FLECAINIDE ACETATE 0000 100 mg TABLET TAB $0.3903 20080905 00000000 20080905

FLECAINIDE ACETATE 0000 150 mg TABLET TAB $0.8880 20080905 00000000 20080905

FLECAINIDE ACETATE 0000 50 mg TABLET TAB $0.3143 20080905 00000000 20080905

FLUCONAZOLE 0000 10 mg/ml MILLILITER SUSP $0.3386 20080305 00000000 20080905

FLUCONAZOLE 0000 100 mg TABLET TAB $0.1781 20080305 00000000 20080905

FLUCONAZOLE 0000 150 mg TABLET TAB $0.3050 20080905 00000000 20080905

FLUCONAZOLE 0000 200 mg TABLET TAB $0.3335 20080905 00000000 20080905

FLUCONAZOLE 0000 40 mg/ml MILLILITER SUSP $0.6779 20080305 00000000 20080905

FLUCONAZOLE 0000 50 mg TABLET TAB $0.1226 20080305 00000000 20080905

FLUCONAZOLE IN SALINE, ISO-OSMOTIC 0000 400 mg/200 ml MILLILITER IV $0.1727 20080905 00000000 20080905

FLUDROCORTISONE ACETATE 0000 0.1 mg TABLET TAB $0.7572 20080919 00000000 20080919

FLUNISOLIDE 0000 0.00025 MILLILITER NASAL SPRAY $0.7373 20080919 00000000 20080919

FLUNISOLIDE 0000 0.00025 MILLILITER SPRAY $1.0157 20081003 00000000 20081003

FLUOCINOLONE 0000 0.01% GRAM CRM $0.0648 20060906 20070305 20070305

FLUOCINOLONE 0000 0.025% GRAM CRM $0.0816 20060906 20070305 20070305

FLUOCINOLONE 0000 0.025% GRAM OINT $0.0744 20060906 20070305 20070305

FLUOCINOLONE 0060 0.01%, 60 ml MILLILITER SOLN $0.0572 20060906 20070305 20070305

FLUOCINONIDE 0000 0.05% GRAM GEL $0.4961 20080305 00000000 20080905

FLUOCINONIDE 0000 0.05% GRAM CRM $0.1040 20080305 00000000 20080905

FLUOCINONIDE 0000 0.05% GRAM OINT $0.3150 20080305 00000000 20080905

FLUOCINONIDE 0000 0.05% MILLILITER SOLN $0.1038 20080905 00000000 20080905

FLUOCINONIDE/EMOLLIENT 0000 0.05% GRAM CRM $0.2010 20080905 00000000 20080905

FLUOROMETHOLONE 0000 0.001 MILLILITER OPTH SUSP $1.4740 20011221 20020605 20040922

FLUOROMETHOLONE 0010 0.1%; 10 ml MILLILITER SUSP $1.1067 20011201 20011220 20040922

FLUOROMETHOLONE 0015 0.1%; 15 ml MILLILITER SUSP $0.8361 20011201 20011220 20040922

FLUOROMETHOLONE 0005 0.1%; 5 ml MILLILITER SUSP $1.4180 20011201 20011220 20040922

FLUOROURACIL 0000 50 mg/ml MILLILITER VIAL $0.3426 20080919 00000000 20080919

FLUOROURACIL 0000 50 mg/ml; 10 ml MILLILITER VIAL $0.4104 20080905 00000000 20080905

FLUOROURACIL 0000 50 mg/ml; 100 ml MILLILITER VIAL $0.3426 20080905 00000000 20080905

FLUOROURACIL 0000 50 mg/ml; 20 ml MILLILITER VIAL $0.4106 20080905 00000000 20080905

FLUOROURACIL 0000 50 mg/ml; 50 ml MILLILITER VIAL $0.3807 20080905 00000000 20080905

FLUOXETINE HCL 0000 10 mg CAPSULE CAP $0.0408 20080919 00000000 20080919

FLUOXETINE HCL 0000 10 mg TABLET TAB $0.0408 20080919 00000000 20080919

FLUOXETINE HCL 0000 20 mg CAPSULE CAP $0.0408 20080919 00000000 20080919

FLUOXETINE HCL 0000 20 mg TABLET TAB $0.0408 20080919 00000000 20080919

FLUOXETINE HCL 0000 20 mg/5 ml SYRUP SYR $0.0506 20080919 00000000 20080919

FLUOXETINE HCL 0000 40 mg CAPSULE CAP $0.7175 20080919 00000000 20080919

FLUPHENAZINE 0000 1 mg TABLET TAB $0.0792 20080919 00000000 20080919

FLUPHENAZINE 0000 10 mg TABLET TAB $0.1563 20080919 00000000 20080919

FLUPHENAZINE 0000 2.5 mg TABLET TAB $0.1011 20080919 00000000 20080919

FLUPHENAZINE 0000 5 mg TABLET TAB $0.1127 20080919 00000000 20080919

FLUPHENAZINE DECANOATE 0000 25 mg/ml MILLILITER INJ $9.2112 20080919 00000000 20080919

FLURAZEPAM HCL 0000 15 mg CAPSULE CAP $0.0699 20080305 00000000 20080905

FLURAZEPAM HCL 0000 30 mg CAPSULE CAP $0.0867 20080305 00000000 20080905

FLURBIPROFEN 0000 100 mg TABLET TAB $0.1562 20080305 00000000 20080905

FLUTICASONE PROPIONATE 0000 0.005% GRAM OINT $0.4040 20071205 00000000 20080605

FLUTICASONE PROPIONATE 0000 0.05% GRAM CRM $0.4811 20080919 00000000 20080919

FLUTICASONE PROPIONATE 0000 50 mcg GRAM NASAL SPRAY $0.5616 20080905 00000000 20080905

FLUVOXAMINE 0000 100 mg TABLET TAB $0.3855 20080919 00000000 20080919

FLUVOXAMINE 0000 25 mg TABLET TAB $0.3350 20080919 00000000 20080919

FLUVOXAMINE 0000 50 mg TABLET TAB $0.3548 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 13 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

FOLIC ACID 0000 1 mg TABLET TAB $0.0224 20080919 00000000 20080919

FOSINOPRIL SODIUM 0000 10 mg TABLET TAB $0.2145 20080305 00000000 20080905

FOSINOPRIL SODIUM 0000 20 mg TABLET TAB $0.2145 20080305 00000000 20080905

FOSINOPRIL SODIUM 0000 40 mg TABLET TAB $0.2145 20080305 00000000 20080905

FOSINOPRIL SODIUM/HCTZ 0000 10-12.5 mg TABLET TAB $1.0268 20080305 00000000 20080905

FOSINOPRIL SODIUM/HCTZ 0000 20-12.5 mg TABLET TAB $1.0508 20070305 00000000 20080905

FUROSEMIDE 0000 20 mg TABLET TAB $0.0293 20080919 00000000 20080919

FUROSEMIDE 0000 40 mg TABLET TAB $0.0306 20080919 00000000 20080919

FUROSEMIDE 0000 80 mg TABLET TAB $0.0636 20080919 00000000 20080919

GABAPENTIN 0000 100 mg CAPSULE CAP $0.0518 20080919 00000000 20080919

GABAPENTIN 0000 300 mg CAPSULE CAP $0.0860 20080919 00000000 20080919

GABAPENTIN 0000 400 mg CAPSULE CAP $0.1142 20080919 00000000 20080919

GABAPENTIN 0000 600 mg TABLET TAB $0.3167 20080919 00000000 20080919

GABAPENTIN 0000 800 mg TABLET TAB $0.4116 20080919 00000000 20080919

GEMFIBROZIL 0000 600 mg TABLET TAB $0.1155 20080919 00000000 20080919

GENTAMICIN SULFATE 0000 0.001 GRAM CRM $0.1776 20020906 20030305 20030305

GENTAMICIN SULFATE 0000 0.001 GRAM OINT $0.1776 20020906 20030305 20050304

GENTAMICIN SULFATE 0000 0.003 MILLILITER OPTH SOLN $0.3000 20080905 00000000 20080905

GENTAMICIN SULFATE 0015 0.3%, 15 ml MILLILITER OPTH SOLN $0.2870 20050902 20060303 20060303

GENTAMICIN SULFATE 0000 40 mg/ml MILLILITER VIAL $0.4698 20080905 00000000 20080905

GLIMEPIRIDE 0000 1 mg TABLET TAB $0.0334 20080905 00000000 20080905

GLIMEPIRIDE 0000 2 mg TABLET TAB $0.0558 20080905 00000000 20080905

GLIMEPIRIDE 0000 4 mg TABLET TAB $0.0827 20080305 00000000 20080905

GLIPIZIDE 0000 10 mg TABLET TAB $0.0599 20080919 00000000 20080919

GLIPIZIDE 0000 10 mg TABLET TAB, SA $0.3873 20080919 00000000 20080919

GLIPIZIDE 0000 2.5 mg TABLET TAB, SA $0.2700 20080919 00000000 20080919

GLIPIZIDE 0000 5 mg TABLET TAB $0.0422 20080919 00000000 20080919

GLIPIZIDE 0000 5 mg TABLET TAB, SA $0.1958 20080919 00000000 20080919

GLYBURIDE 0000 1.25 mg TABLET TAB $0.0875 20070605 00000000 20080605

GLYBURIDE 0000 2.5 mg TABLET TAB $0.0632 20080919 00000000 20080919

GLYBURIDE 0000 5 mg TABLET TAB $0.0615 20080919 00000000 20080919

GLYBURIDE, Micronized 0000 1.5 mg TABLET TAB $0.0353 20071205 00000000 20080605

GLYBURIDE, Micronized 0000 3 mg TABLET TAB $0.0401 20080919 00000000 20080919

GLYBURIDE, Micronized 0000 6 mg TABLET TAB $0.0731 20080919 00000000 20080919

GLYBURIDE/METFORMIN HCL 0000 1.25/250 mg TABLET TAB $0.1400 20080919 00000000 20080919

GLYBURIDE/METFORMIN HCL 0000 2.5/500 mg TABLET TAB $0.1406 20080919 00000000 20080919

GLYBURIDE/METFORMIN HCL 0000 5/500 mg TABLET TAB $0.1509 20080919 00000000 20080919

GRANISETRON HCL 0000 1 mg TABLET TAB $16.0392 20080919 00000000 20080919

GRANISETRON HCL 0000 1 mg/ml; MDV MILLILITER VIAL $52.2360 20080919 00000000 20080919

GRANISETRON HCL 0000 1 mg/ml; SDV MILLILITER VIAL $81.9675 20080919 00000000 20080919



GUAIFEN/DM HB/P-EPHEDRINE 0000 100 mg; 15 mg; 40 mg/5 ml MILLILITER SYR $0.0363 20061205 20080104 20080104

GUAIFENESIN 0000 100 mg/5 ml MILLILITER SYR $0.0105 20020906 20021206 20021206

GUAIFENESIN 0000 1200 mg TABLET TAB, SR $0.1197 20030905 20031222 20040305

GUAIFENESIN 0000 200 mg TABLET TAB $0.0781 20041203 20050331 20050331

GUAIFENESIN 0000 600 mg TABLET TAB, ER $0.1074 20030606 20030703 20040305

GUAIFENESIN; CODEINE PHOSPHATE 0000 100 mg; 10 mg MILLILITER SYR $0.0105 20071205 00000000 20080605

GUAIFENESIN; CODEINE PHOSPHATE (Sugar-Free) 0000 100 mg; 10 mg MILLILITER LIQ $0.0126 20080919 00000000 20080919

GUAIFENESIN; DEXTROMETHORPHAN HBr 0000 100 mg; 10 mg MILLILITER LIQ $0.0107 20080919 00000000 20080919

GUAIFENESIN; DEXTROMETHORPHAN HBr 0000 100 mg; 10 mg MILLILITER SYR $0.0105 20020906 20021206 20051206

GUAIFENESIN; HYDROCODONE BITARTRATE 0000 100 mg; 5 mg MILLILITER SYR $0.0146 20080305 20080618 20080618

GUAIFENESIN; PHENYLEPHRINE HCL 0000 600 mg; 40 mg TABLET TAB, SA $0.1407 20071205 20080104 20080104

GUAIFENESIN; PSEUDOEPHEDRINE HCL 0000 100 mg; 30 mg MILLILITER SYR $0.0208 20020405 20021206 20031205

GUAIFENESIN; PSEUDOEPHEDRINE HCL 0000 600 mg; 120 mg TABLET TAB $0.0936 20030606 20040305 20040922

GUAIFENESIN; PSEUDOEPHEDRINE HCL; CODEINE 0000 100 mg; 30 mg; 10 mg MILLILITER SYR $0.0182 20040604 20041203 20041203







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 14 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

GUANFACINE 0000 1 mg TABLET TAB $0.1026 20080919 00000000 20080919

GUANFACINE 0000 2 mg TABLET TAB $0.1421 20080919 00000000 20080919

HALOBETASOL PROPIONATE 0000 0.05% GRAM OINT $0.7640 20080919 00000000 20080919

HALOBETASOL PROPIONATE 0000 0.05% GRAM CRM $0.7688 20080919 00000000 20080919

HALOPERIDOL 0000 0.5 mg TABLET TAB $0.0707 20080305 00000000 20080905

HALOPERIDOL 0000 1 mg TABLET TAB $0.1085 20080905 00000000 20080905

HALOPERIDOL 0000 10 mg TABLET TAB $1.1847 20080305 00000000 20080905

HALOPERIDOL 0000 2 mg TABLET TAB $0.1527 20080305 00000000 20080905

HALOPERIDOL 0000 20 mg TABLET TAB $0.3193 20020906 20030121 20071205

HALOPERIDOL 0000 5 mg TABLET TAB $0.1700 20080919 00000000 20080919

HALOPERIDOL DECANOATE 0000 100 mg/ml MILLILITER INJ $29.6304 20031205 20050331 20050331

HALOPERIDOL DECANOATE 0005 100 mg/ml MILLILITER INJ $6.0600 20080919 00000000 20080919

HALOPERIDOL DECANOATE 0000 50 mg/ml MILLILITER SOLN $6.1350 20080919 00000000 20080919

HALOPERIDOL LACTATE 0120 2 mg/ml; 120 ml MILLILITER CONC $0.0545 20080919 00000000 20080919

HALOPERIDOL LACTATE 0015 2 mg/ml; 15 ml MILLILITER CONC $0.2800 20020605 20030305 20050603

HC ACETATE/LIDOCAINE HCL 0000 0.5%; 3% GRAM CRM $0.5875 20080919 00000000 20080919

HYDRALAZINE HCL 0000 10 mg TABLET TAB $0.1904 20080305 00000000 20080905

HYDRALAZINE HCL 0000 100 mg TABLET TAB $0.5617 20080905 00000000 20080905

HYDRALAZINE HCL 0000 25 mg TABLET TAB $0.2220 20080905 00000000 20080905

HYDRALAZINE HCL 0000 50 mg TABLET TAB $0.2918 20080905 00000000 20080905

HYDROCHLOROTHIAZIDE 0000 12.5 mg CAPSULE CAP $0.1194 20080919 00000000 20080919

HYDROCHLOROTHIAZIDE 0000 25 mg TABLET TAB $0.0293 20080919 00000000 20080919

HYDROCHLOROTHIAZIDE 0000 50 mg TABLET TAB $0.0627 20080919 00000000 20080919

HYDROCODONE/APAP 0000 10 mg; 325 mg TABLET TAB $0.2186 20080905 00000000 20080905

HYDROCODONE/APAP 0000 10 mg; 500 mg TABLET TAB $0.1713 20080905 00000000 20080905

HYDROCODONE/APAP 0000 10 mg; 650 mg TABLET TAB $0.0806 20080305 00000000 20080905

HYDROCODONE/APAP 0000 10 mg; 660 mg TABLET TAB $0.1877 20080905 00000000 20080905

HYDROCODONE/APAP 0000 10 mg; 750 mg TABLET TAB $0.6722 20080305 00000000 20080905

HYDROCODONE/APAP 0000 2.5 mg; 500 mg TABLET TAB $0.1100 20080905 00000000 20080905

HYDROCODONE/APAP 0000 5 mg; 325 mg TABLET TAB $0.2478 20080305 00000000 20080905

HYDROCODONE/APAP 0000 5 mg; 500 mg TABLET TAB $0.0347 20080905 00000000 20080905

HYDROCODONE/APAP 0000 7.5 mg; 325 mg TABLET TAB $0.2910 20080305 00000000 20080905

HYDROCODONE/APAP 0000 7.5 mg; 500 mg TABLET TAB $0.0701 20080305 00000000 20080905

HYDROCODONE/APAP 0000 7.5 mg; 650 mg TABLET TAB $0.0813 20080305 00000000 20080905

HYDROCODONE/APAP 0000 7.5 mg; 750 mg TABLET TAB $0.0578 20080305 00000000 20080905

HYDROCODONE/APAP 0000 7.5/500 mg MILLILITER SOLN $0.0218 20080305 00000000 20080905

HYDROCODONE/IBUPROFEN 0000 7.5 mg; 200 mg TABLET TAB $0.4538 20080905 00000000 20080905

HYDROCORTISONE 0000 0.5% GRAM CRM $0.0508 20020906 20021206 20021206

HYDROCORTISONE 0000 0.5% GRAM OINT $0.0400 20020405 20021206 20050304

HYDROCORTISONE 0000 0.01 GRAM CRM $0.0450 20080919 00000000 20080919

HYDROCORTISONE 0000 0.01 GRAM OINT $0.0461 20080919 00000000 20080919

HYDROCORTISONE 0000 0.01 MILLILITER LOT $0.0446 20080305 00000000 20080905

HYDROCORTISONE 0000 2.5% GRAM CRM-RECTAL $0.1950 20080305 00000000 20080905

HYDROCORTISONE 0000 2.5% GRAM CRM $0.0911 20080905 00000000 20080905

HYDROCORTISONE 0000 2.5% GRAM OINT $0.1368 20071205 00000000 20080605

HYDROCORTISONE 0000 2.5% MILLILITER LOT $0.2864 20080905 00000000 20080905

HYDROCORTISONE ACETATE 0000 25 mg EACH SUPP $0.1226 20080305 00000000 20080905

HYDROCORTISONE POWDER 0000 NA GRAM POWDER $2.7552 20020405 20021206 20021206

HYDROCORTISONE VALERATE 0000 0.2% GRAM OINT $0.8660 20080305 00000000 20080905

HYDROCORTISONE VALERATE 0000 0.2% GRAM CRM $0.3761 20080305 00000000 20080905

HYDROMORPHONE HCL 0000 2 mg TABLET TAB $0.1110 20080919 00000000 20080919

HYDROMORPHONE HCL 0000 4 mg TABLET TAB $0.1442 20080919 00000000 20080919

HYDROMORPHONE HCL 0000 8 mg TABLET TAB $0.7028 20080919 00000000 20080919

HYDROQUINONE 4% 0000 0.04 GRAM CRM $0.3281 20080919 00000000 20080919

HYDROQUINONE 4% 0000 4% GRAM GEL $0.8980 20050304 20050902 20050902







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 15 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

HYDROQUINONE 4% w/ SUNSCREEN 0000 0.04 GRAM CRM $0.6626 20021206 20030606 20051206

HYDROXYCHLOROQUINE SULFATE 0000 200 mg TABLET TAB $0.1694 20080905 00000000 20080905

HYDROXYUREA 0000 500 mg CAPSULE CAP $0.3147 20080905 00000000 20080905

HYDROXYZINE 0000 10 mg/5 ml MILLILITER SYR $0.0854 20080514 00000000 20080605

HYDROXYZINE HCL 0000 10 mg TABLET TAB $0.2450 20080919 00000000 20080919

HYDROXYZINE HCL 0000 25 mg TABLET TAB $0.2675 20080919 00000000 20080919

HYDROXYZINE HCL 0000 50 mg TABLET TAB $0.4347 20080919 00000000 20080919

HYDROXYZINE PAM 0000 25 mg CAPSULE CAP $0.0744 20080919 00000000 20080919

HYDROXYZINE PAM 0000 50 mg CAPSULE CAP $0.1058 20070605 00000000 20080605

HYOSCYAMINE SULFATE 0000 0.125 mg TABLET TAB $0.0463 20080919 00000000 20080919

HYOSCYAMINE SULFATE 0000 0.125 mg TABLET TAB, sublingual $0.6107 20080905 00000000 20080905

HYOSCYAMINE SULFATE 0000 0.125 mg TABLET TAB, orally disintegrating $0.4399 20080919 00000000 20080919

HYOSCYAMINE SULFATE 0000 0.125 mg/ml MILLILITER DROPS $1.3170 20080919 00000000 20080919

HYOSCYAMINE SULFATE 0000 0.375 mg TABLET TAB, ER $1.1733 20080905 00000000 20080905

HYOSCYAMINE SULFATE 0000 0.375 mg CAPSULE CAP, SR $0.1225 20080919 00000000 20080919

IBUPROFEN 0000 200 mg TABLET TAB $0.0294 20020605 20021206 20021206

IBUPROFEN 0000 400 mg TABLET TAB $0.0320 20080919 00000000 20080919

IBUPROFEN 0000 600 mg TABLET TAB $0.0387 20080919 00000000 20080919

IBUPROFEN 0000 800 mg TABLET TAB $0.0512 20080919 00000000 20080919

IBUPROFEN/OXYCODONE HCL 0000 400 mg; 5 mg TABLET TAB $1.2726 20080919 00000000 20080919

IMIPRAMINE HCL 0000 10 mg TABLET TAB $0.1694 20080919 00000000 20080919

IMIPRAMINE HCL 0000 25 mg TABLET TAB $0.2166 20080919 00000000 20080919

IMIPRAMINE HCL 0000 50 mg TABLET TAB $0.3287 20080919 00000000 20080919

INDAPAMIDE 0000 1.25 mg TABLET TAB $0.0598 20080919 00000000 20080919

INDAPAMIDE 0000 2.5 mg TABLET TAB $0.0776 20080919 00000000 20080919

INDOMETHACIN 0000 25 mg CAPSULE CAP $0.2048 20080905 00000000 20080905

INDOMETHACIN 0000 50 mg CAPSULE CAP $0.2520 20080905 00000000 20080905

INDOMETHACIN SR 0000 75 mg CAPSULE CAP, SR $2.1875 20080905 00000000 20080905

IPRATROPIUM BROMIDE 0000 0.0003 MILLILITER NASAL INH SOLN $0.4935 20080905 00000000 20080905

IPRATROPIUM BROMIDE 0000 0.0006 MILLILITER NASAL INH SOLN $0.9461 20080905 00000000 20080905

IPRATROPIUM BROMIDE 0000 0.2 mg/ml MILLILITER INH SOLN $0.0702 20080305 00000000 20080905

IPRATROPIUM/ALBUTEROL SULFATE 0000 0.5-2.5 mg/3 ml MILLILITER SOLN $0.4805 20080905 00000000 20080905

IRON/FA/VITAMIN B COMP W-C/MIN 0000 106 mg; 1 mg TABLET TAB $0.3297 20061205 20070605 20070605

ISOSORBIDE DINITRATE 0000 10 mg TABLET TAB $0.0353 20080919 00000000 20080919

ISOSORBIDE DINITRATE 0000 2.5 mg TABLET TAB, SL $0.0587 20061205 00000000 20080605

ISOSORBIDE DINITRATE 0000 20 mg TABLET TAB $0.0368 20080919 00000000 20080919

ISOSORBIDE DINITRATE 0000 30 mg TABLET TAB $0.1651 20080919 00000000 20080919

ISOSORBIDE DINITRATE 0000 5 mg TABLET TAB, SL $0.0644 20080905 00000000 20080905

ISOSORBIDE DINITRATE 0000 5 mg TABLET TAB $0.0323 20080305 00000000 20080905

ISOSORBIDE MONONITRATE 0000 10 mg TABLET TAB $0.6451 20050603 20051206 20051206

ISOSORBIDE MONONITRATE 0000 120 mg TABLET TAB, ER $0.1592 20080919 00000000 20080919

ISOSORBIDE MONONITRATE 0000 20 mg TABLET TAB $0.1166 20080919 00000000 20080919

ISOSORBIDE MONONITRATE 0000 30 mg TABLET TAB, ER $0.0588 20080919 00000000 20080919

ISOSORBIDE MONONITRATE 0000 60 mg TABLET TAB, ER $0.0647 20080919 00000000 20080919

ISOTRETINOIN 0000 10 mg CAPSULE CAP $5.1260 20080919 00000000 20080919

ISOTRETINOIN 0000 20 mg CAPSULE CAP $5.3760 20080919 00000000 20080919

ISOTRETINOIN 0000 40 mg CAPSULE CAP $5.8001 20080919 00000000 20080919

KETOCONAZOLE 0000 2% GRAM CRM $0.5256 20080919 00000000 20080919

KETOCONAZOLE 0000 200 mg TABLET TAB $0.2796 20080919 00000000 20080919

KETOCONAZOLE 0000 2% MILLILITER SHAMPOO $0.1354 20080919 00000000 20080919

KETOPROFEN 0000 100 mg CAPSULE CAP, ER $1.6195 20020405 20020906 20020906

KETOPROFEN 0000 150 mg CAPSULE CAP, ER $1.9150 20021206 20030509 20030509

KETOPROFEN 0000 200 mg TABLET CAP, SR 24HR $2.3589 20080305 00000000 20080905

KETOPROFEN 0000 25 mg CAPSULE CAP $0.1619 20020308 20020906 20020906

KETOPROFEN 0000 50 mg CAPSULE CAP $0.1831 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 16 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

KETOPROFEN 0000 75 mg CAPSULE CAP $0.1212 20080919 00000000 20080919

KETOROLAC TROMETHAMINE 0000 10 mg TABLET TAB $0.2369 20080919 00000000 20080919

LABETALOL HCL 0000 100 mg TABLET TAB $0.1262 20080919 00000000 20080919

LABETALOL HCL 0000 200 mg TABLET TAB $0.1836 20080919 00000000 20080919

LABETALOL HCL 0000 300 mg TABLET TAB $0.2727 20080919 00000000 20080919

LACTULOSE 0000 10 gm/15 ml MILLILITER SYR $0.0151 20051206 20060605 20060605

LACTULOSE 0000 10 gm/15 ml MILLILITER SOLN $0.0117 20080919 00000000 20080919

LACTULOSE 0000 10 gm/15 ml MILLILITER SOLN $0.0139 20080919 00000000 20080919

LAMOTRIGINE 0000 100 mg TABLET TAB $3.9151 20080905 00000000 20080905

LAMOTRIGINE 0000 150 mg TABLET TAB $4.2906 20080905 00000000 20080905

LAMOTRIGINE 0000 200 mg TABLET TAB $4.6716 20080905 00000000 20080905

LAMOTRIGINE 0000 25 mg TABLET TAB, CHEW $2.4162 20080919 00000000 20080919

LAMOTRIGINE 0000 25 mg TABLET TAB $3.4279 20080905 00000000 20080905

LAMOTRIGINE 0000 5 mg TABLET TAB, CHEW $2.5280 20080305 00000000 20080605

LEFLUNOMIDE 0000 10 mg TABLET TAB $0.4980 20080919 00000000 20080919

LEFLUNOMIDE 0000 20 mg TABLET TAB $0.4820 20080919 00000000 20080919

LEUCOVORIN CALCIUM 0000 25 mg TABLET TAB $10.0332 20080919 00000000 20080919

LEUCOVORIN CALCIUM 0000 5 mg TABLET TAB $1.2033 20080919 00000000 20080919

LEUPROLIDE ACETATE 0000 1 mg/0.2 ml EACH KIT $140.8320 20080919 00000000 20080919

LEVOBUNOLOL HCL 0000 0.25% MILLILITER OPTH SOLN $1.1250 20030606 20050902 20070305

LEVOBUNOLOL HCL 0000 0.50% MILLILITER OPTH SOLN $0.5760 20080905 00000000 20080905

LEVOBUNOLOL HCL 0010 0.5%, 10 ml MILLILITER OPTH SOLN $1.5860 20011201 20011220 20011220

LEVOBUNOLOL HCL 0015 0.5%, 15 ml MILLILITER OPTH SOLN $1.3100 20011201 20011220 20011220

LEVOBUNOLOL HCL 0005 0.5%, 5 ml MILLILITER OPTH SOLN $1.4040 20011201 20011220 20011220

LEVOCARNITINE 0000 100 mg/ml MILLILITER LIQ $0.2340 20080919 00000000 20080919

LEVONORGESTREL/ETHINYL ESTRADIOL (ALESSE,

LEVLITE, AVIANE) 0000 0.1 mg/20 mcg TABLET TAB $0.7181 20080919 00000000 20080919

LEVONORGESTREL/ETHINYL ESTRADIOL (LEVLEN,

NORDETTE, LEVORA 0.15/30) 0000 0.15 mg/30 mcg TABLET TAB $0.8182 20080305 00000000 20080905

LEVONORGESTREL/ETHINYL ESTRADIOL (SEASONALE,

JOLESSA, QUASENSE) 0000 0.15 mg/30 mcg TABLET TAB $1.2391 20080919 00000000 20080919

0.05 mg/30 mcg; 0.075

LEVONORGESTREL/ETHINYL ESTRADIOL TRIPHASIC mg/40 mcg; 0.125 mg/30

(TRI-LEVLEN, TRIPHASIL, TRIVORA-28) 0000 mcg TABLET TAB $0.7127 20080905 00000000 20080905

LEVOTHYROXINE 0000 100 mcg TABLET TAB $0.1526 20080919 00000000 20080919

LEVOTHYROXINE 0000 112 mcg TABLET TAB $0.1752 20080919 00000000 20080919

LEVOTHYROXINE 0000 125 mcg TABLET TAB $0.1770 20080919 00000000 20080919

LEVOTHYROXINE 0000 150 mcg TABLET TAB $0.1830 20080919 00000000 20080919

LEVOTHYROXINE 0000 175 mcg TABLET TAB $0.2169 20080919 00000000 20080919

LEVOTHYROXINE 0000 200 mcg TABLET TAB $0.2199 20080919 00000000 20080919

LEVOTHYROXINE 0000 25 mcg TABLET TAB $0.1182 20080919 00000000 20080919

LEVOTHYROXINE 0000 300 mcg TABLET TAB $0.3197 20080919 00000000 20080919

LEVOTHYROXINE 0000 50 mcg TABLET TAB $0.1317 20080919 00000000 20080919

LEVOTHYROXINE 0000 75 mcg TABLET TAB $0.1421 20080919 00000000 20080919

LEVOTHYROXINE 0000 88 mcg TABLET TAB $0.1436 20080919 00000000 20080919

LIDOCAINE 0000 2% GRAM GEL $0.4040 20080305 00000000 20080905

LIDOCAINE HCL 0000 2% MILLILITER VISCOUS ORAL $0.0278 20080905 00000000 20080905

LIDOCAINE/PRILOCAINE 0000 2.5-2.5% GRAM CRM $0.2780 20080919 00000000 20080919

LINDANE 0000 0.01 MILLILITER LOT $0.1770 20021206 20030606 20031205

LINDANE 0000 0.01 MILLILITER SHAMPOO $0.5375 20030415 20030905 20031205

LISINOPRIL 0000 10 mg TABLET TAB $0.0495 20080919 00000000 20080919

LISINOPRIL 0000 2.5 mg TABLET TAB $0.0261 20080919 00000000 20080919

LISINOPRIL 0000 20 mg TABLET TAB $0.0668 20080919 00000000 20080919

LISINOPRIL 0000 30 mg TABLET TAB $0.1206 20080919 00000000 20080919

LISINOPRIL 0000 40 mg TABLET TAB $0.1208 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 17 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

LISINOPRIL 0000 5 mg TABLET TAB $0.0336 20080919 00000000 20080919

LISINOPRIL/HCTZ 0000 10 mg/12.5 mg TABLET TAB $0.0644 20080919 00000000 20080919

LISINOPRIL/HCTZ 0000 20 mg/12.5 mg TABLET TAB $0.1065 20080919 00000000 20080919

LISINOPRIL/HCTZ 0000 20 mg/25 mg TABLET TAB $0.1302 20080919 00000000 20080919

LITHIUM CARBONATE 0000 300 mg CAPSULE CAP $0.0449 20071205 00000000 20080605

LITHIUM CARBONATE 0000 300 mg TABLET TAB $0.1842 20030305 20030905 20080905

LITHIUM CARBONATE 0000 300 mg TABLET TAB, ER $0.3182 20080305 00000000 20080905

LITHIUM CARBONATE 0000 450 mg TABLET TAB, SA $0.3159 20080919 00000000 20080919

LITHIUM CITRATE 0000 8 mEq/5 ml MILLILITER SYR $0.0377 20080305 00000000 20080905

LOPERAMIDE HCL 0000 1 mg/5 ml MILLILITER LIQ $0.0308 20020906 20021206 20021206

LOPERAMIDE HCL 0000 2 mg CAPSULE CAP $0.0866 20071205 00000000 20080605

LOPERAMIDE HCL 0000 2 mg TABLET TAB $0.2375 20020405 20021206 20021206

LORATADINE 0000 10 mg TABLET TAB $0.1496 20080919 00000000 20080919

LORATADINE 0000 10 mg TABLET TAB, orally disintegrating $0.5540 20080305 00000000 20080605

LORATADINE 0000 5 mg/5 ml MILLILITER SYR $0.0510 20080919 00000000 20080919

LORAZEPAM 0000 0.5 mg TABLET TAB $0.0465 20080919 00000000 20080919

LORAZEPAM 0000 1 mg TABLET TAB $0.0498 20080919 00000000 20080919

LORAZEPAM 0000 2 mg TABLET TAB $0.0902 20080919 00000000 20080919

LOVASTATIN 0000 10 mg TABLET TAB $0.1410 20080919 00000000 20080919

LOVASTATIN 0000 20 mg TABLET TAB $0.2320 20080919 00000000 20080919

LOVASTATIN 0000 40 mg TABLET TAB $0.3624 20080919 00000000 20080919

LOXAPINE SUCCINATE 0000 10 mg CAPSULE CAP $0.6627 20080919 00000000 20080919

LOXAPINE SUCCINATE 0000 25 mg CAPSULE CAP $0.9747 20080919 00000000 20080919

LOXAPINE SUCCINATE 0000 5 mg CAPSULE CAP $0.5363 20080305 00000000 20080905

LOXAPINE SUCCINATE 0000 50 mg CAPSULE CAP $1.2953 20080919 00000000 20080919

MAPROTILINE HCL 0000 25 mg TABLET TAB $0.3722 20061205 20080919 20080919

MAPROTILINE HCL 0000 50 mg TABLET TAB $0.5513 20061205 20080919 20080919

MAPROTILINE HCL 0000 75 mg TABLET TAB $0.7564 20061205 20070605 20070605

MECLIZINE HCL 0000 12.5 mg TABLET TAB $0.0456 20071205 00000000 20080605

MECLIZINE HCL 0000 25 mg TABLET TAB $0.0790 20080905 00000000 20080905

MECLOFENAMATE SODIUM 0000 100 mg CAPSULE CAP $0.7589 20061205 20071205 20071205

MECLOFENAMATE SODIUM 0000 50 mg CAPSULE CAP $0.4568 20061205 20071205 20071205

MEDROXYPROGESTERONE ACET 0000 150 mg/ml EACH SYRN $53.8200 20080905 00000000 20080905

MEDROXYPROGESTERONE ACET 0000 150 mg/ml EACH VIAL $43.3950 20080905 00000000 20080905

MEDROXYPROGESTERONE ACETATE 0000 10 mg TABLET TAB $0.0912 20071205 00000000 20080605

MEDROXYPROGESTERONE ACETATE 0000 2.5 mg TABLET TAB $0.0906 20080919 00000000 20080919

MEDROXYPROGESTERONE ACETATE 0000 5 mg TABLET TAB $0.0983 20080919 00000000 20080919

MEGESTROL ACETATE 0000 20 mg TABLET TAB $0.1669 20080919 00000000 20080919

MEGESTROL ACETATE 0000 40 mg TABLET TAB $0.2454 20080919 00000000 20080919

MEGESTROL ACETATE 0000 40 mg/ml MILLILITER SUSP $0.1723 20071205 00000000 20080605

MELOXICAM 0000 15 mg TABLET TAB $0.0447 20080905 00000000 20080905

MELOXICAM 0000 7.5 mg TABLET TAB $0.0387 20080305 00000000 20080905

MEPERIDINE HCL 0000 100 mg TABLET TAB $0.4064 20080919 00000000 20080919

MEPERIDINE HCL 0000 50 mg TABLET TAB $0.2331 20080919 00000000 20080919

MEPROBAMATE 0000 200 mg TABLET TAB $0.1510 20020308 20020705 20031205

MEPROBAMATE 0000 400 mg TABLET TAB $0.1642 20021206 20030115 20031205

MERCAPTOPURINE 0000 50 mg TABLET TAB $1.6334 20080919 00000000 20080919

METFORMIN 0000 1000 mg TABLET TAB $0.0753 20080919 00000000 20080919

METFORMIN 0000 500 mg TABLET TAB $0.0414 20080919 00000000 20080919

METFORMIN 0000 850 mg TABLET TAB $0.0630 20080919 00000000 20080919

METFORMIN HCL 0000 500 mg TABLET TAB, SR $0.0735 20080919 00000000 20080919

METFORMIN HCL 0000 750 mg TABLET TAB, SR $0.1473 20080919 00000000 20080919

METHADONE HCL 0000 10 mg TABLET TAB $0.0963 20080919 00000000 20080919

METHADONE HCL 0000 5 mg TABLET TAB $0.0644 20080919 00000000 20080919

METHAMPHETAMINE HYDROCHLORIDE 0000 5 mg TABLET TAB $1.6098 20050304 20050603 20050603







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 18 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

METHIMAZOLE 0000 10 mg TABLET TAB $0.4407 20080919 00000000 20080919

METHIMAZOLE 0000 5 mg TABLET TAB $0.2567 20080919 00000000 20080919

METHOCARBAMOL 0000 500 mg TABLET TAB $0.0818 20080305 00000000 20080905

METHOCARBAMOL 0000 750 mg TABLET TAB $0.0929 20080305 00000000 20080905

METHOTREXATE 0000 2.5 mg TABLET TAB $0.2646 20080919 00000000 20080919

METHYLDOPA 0000 250 mg TABLET TAB $0.1472 20080305 00000000 20080905

METHYLDOPA 0000 500 mg TABLET TAB $0.2700 20080305 00000000 20080905

METHYLPHENIDATE HCL 0000 10 mg TABLET TAB $0.1245 20080919 00000000 20080919

METHYLPHENIDATE HCL 0000 20 mg TABLET TAB $0.2226 20080305 00000000 20080905

METHYLPHENIDATE HCL 0000 20 mg TABLET TAB, ER $0.3434 20080905 00000000 20080905

METHYLPHENIDATE HCL 0000 5 mg TABLET TAB $0.0989 20080305 00000000 20080905

METHYLPREDNISOLONE 0000 4 mg TABLET TAB $0.0989 20080919 00000000 20080919

METHYLPREDNISOLONE DOSEPAK 0000 4 mg TABLET TAB $0.1086 20080919 00000000 20080919

METOCLOPRAMIDE HCL 0000 10 mg TABLET TAB $0.0552 20080905 00000000 20080905

METOCLOPRAMIDE HCL 0000 5 mg TABLET TAB $0.0593 20080305 00000000 20080905

METOCLOPRAMIDE HCL 0000 5 mg/5 ml MILLILITER SYR $0.0107 20080905 00000000 20080905

METOLAZONE 0000 10 mg TABLET TAB $0.9539 20080919 00000000 20080919

METOLAZONE 0000 2.5 mg TABLET TAB $0.5385 20080919 00000000 20080919

METOLAZONE 0000 5 mg TABLET TAB $0.8589 20080919 00000000 20080919

METOPROLOL SUCCINATE 0000 100 mg TABLET TAB, SA $0.7364 20080905 00000000 20080905

METOPROLOL SUCCINATE 0000 200 mg TABLET TAB, SA $1.1717 20080905 00000000 20080905

METOPROLOL SUCCINATE 0000 25 mg TABLET TAB, SA $0.5390 20080905 00000000 20080905

METOPROLOL TARTRATE 0000 100 mg TABLET TAB $0.0593 20080919 00000000 20080919

METOPROLOL TARTRATE 0000 25 mg TABLET TAB $0.0435 20080919 00000000 20080919

METOPROLOL TARTRATE 0000 50 mg TABLET TAB $0.0405 20080919 00000000 20080919

METRONIDAZOLE 0000 0.0075 GRAM CRM $1.3922 20080919 00000000 20080919

METRONIDAZOLE 0000 250 mg TABLET TAB $0.0528 20080305 00000000 20080905

METRONIDAZOLE 0000 375 mg CAPSULE CAP $2.9467 20080905 00000000 20080905

METRONIDAZOLE 0000 500 mg TABLET TAB $0.1016 20080905 00000000 20080905

METRONIDAZOLE 0000 750 mg TABLET TAB, ER $6.9832 20040604 20050603 20050902

METRONIDAZOLE 0000 0.75% GRAM VAG GEL $0.4994 20080905 00000000 20080905

MEXILETINE HCL 0000 150 mg CAPSULE CAP $0.3089 20040604 20051206 20070305

MEXILETINE HCL 0000 200 mg CAPSULE CAP $0.5366 20050603 20051206 20070305

MEXILETINE HCL 0000 250 mg CAPSULE CAP $0.6062 20050902 20051206 20070305

MIDODRINE HCL 0000 10 mg TABLET TAB $1.8474 20080919 00000000 20080919

MIDODRINE HCL 0000 2.5 mg TABLET TAB $0.6695 20080919 00000000 20080919

MIDODRINE HCL 0000 5 mg TABLET TAB $1.0310 20080919 00000000 20080919

MINOCYCLINE HCL 0000 100 mg CAPSULE CAP $0.3690 20080905 00000000 20080905

MINOCYCLINE HCL 0000 50 mg CAPSULE CAP $0.2060 20080905 00000000 20080905

MINOCYCLINE HCL 0000 75 mg CAPSULE CAP $0.5229 20080305 00000000 20080905

MINOXIDIL 0000 10 mg TABLET TAB $0.3653 20080305 00000000 20080905

MINOXIDIL 0000 2.5 mg TABLET TAB $0.2207 20080305 00000000 20080905

MIRTAZAPINE 0000 15 mg TABLET TAB $0.1730 20080919 00000000 20080919

MIRTAZAPINE 0000 30 mg TABLET TAB $0.2190 20080919 00000000 20080919

MIRTAZAPINE 0000 45 mg TABLET TAB $0.3092 20080919 00000000 20080919

MIRTAZAPINE SOLTAB 0000 15 mg TABLET TAB $1.3950 20080919 00000000 20080919

MIRTAZAPINE SOLTAB 0000 30 mg TABLET TAB $1.4370 20080919 00000000 20080919

MIRTAZAPINE SOLTAB 0000 45 mg TABLET TAB $1.4795 20080919 00000000 20080919

MOEXIPRIL HCL 0000 15 mg TABLET TAB $0.7254 20080905 00000000 20080905

MOEXIPRIL HCL 0000 7.5 mg TABLET TAB $0.7382 20080905 00000000 20080905

MOMETASONE FUROATE 0000 0.1% GRAM OINT $0.9570 20080919 00000000 20080919

MOMETASONE FUROATE 0000 0.1% GRAM CRM $0.7751 20080919 00000000 20080919

MORPHINE SULFATE 0000 100 mg TABLET TAB, SR $1.1364 20080905 00000000 20080905

MORPHINE SULFATE 0000 15 mg TABLET TAB $0.0794 20080305 00000000 20080905

MORPHINE SULFATE 0000 15 mg TABLET TAB, SR $0.2741 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 19 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

MORPHINE SULFATE 0000 200 mg TABLET TAB, ER $1.6971 20080905 00000000 20080905

MORPHINE SULFATE 0000 30 mg TABLET TAB $0.1242 20080905 00000000 20080905

MORPHINE SULFATE 0000 30 mg TABLET TAB, SR $0.4262 20080305 00000000 20080905

MORPHINE SULFATE 0000 60 mg TABLET TAB, SR $0.7644 20080905 00000000 20080905

MUPIROCIN 0000 2% GRAM OINT $0.4841 20080919 00000000 20080919

NABUMETONE 0000 500 mg TABLET TAB $0.3323 20080905 00000000 20080905

NABUMETONE 0000 750 mg TABLET TAB $0.3770 20080905 00000000 20080905

NADOLOL 0000 120 mg TABLET TAB $0.6221 20051206 20060605 20060605

NADOLOL 0000 160 mg TABLET TAB $0.8497 20060605 20061205 20070305

NADOLOL 0000 20 mg TABLET TAB $0.2498 20071205 00000000 20080605

NADOLOL 0000 40 mg TABLET TAB $0.3020 20071205 00000000 20080605

NADOLOL 0000 80 mg TABLET TAB $0.3253 20080919 00000000 20080919

NALTREXONE HCL 0000 50 mg TABLET TAB $1.5045 20080305 00000000 20080905

NAPROXEN 0000 250 mg TABLET TAB $0.0477 20061205 00000000 20080605

NAPROXEN 0000 375 mg TABLET TAB $0.0666 20070605 00000000 20080605

NAPROXEN 0000 500 mg TABLET TAB $0.0684 20080919 00000000 20080919

NAPROXEN EC 0000 375 mg TABLET TAB, DR $0.2003 20080919 00000000 20080919

NAPROXEN EC 0000 500 mg TABLET TAB, DR $0.2067 20080919 00000000 20080919

NAPROXEN SODIUM 0000 220 mg TABLET TAB $0.0794 20020906 20021206 20051206

NAPROXEN SODIUM 0000 275 mg TABLET TAB $0.1350 20080919 00000000 20080919

NAPROXEN SODIUM 0000 500 mg TABLET TAB, ER $1.1864 20080919 00000000 20080919

NAPROXEN SODIUM 0000 550 mg TABLET TAB $0.1695 20080919 00000000 20080919

NEFAZODONE HCL 0000 100 mg TABLET TAB $0.5133 20080919 00000000 20080919

NEFAZODONE HCL 0000 150 mg TABLET TAB $0.5795 20080919 00000000 20080919

NEFAZODONE HCL 0000 200 mg TABLET TAB $0.6072 20080919 00000000 20080919

NEFAZODONE HCL 0000 250 mg TABLET TAB $0.6417 20061205 20071205 20071205

NEFAZODONE HCL 0000 50 mg TABLET TAB $0.5301 20061205 20071205 20071205

NEOMYCIN/POLYMYXIN B/DEXAMETHASONE 0000 0.1% GRAM OINT $0.7715 20080305 00000000 20080905

3.5 mg/10,000 units/0.1%

NEOMYCIN/POLYMYXIN B/DEXAMETHASONE 0000 per gm GRAM OPTH OINT $0.9497 20021206 20030509 20030606

3.5 mg/10,000 units/0.1%

NEOMYCIN/POLYMYXIN B/DEXAMETHASONE 0000 per ml MILLILITER OPTH SUSP $0.4950 20080305 00000000 20080905

NEOMYCIN/POLYMYXIN B/HC 0000 0.01 MILLILITER OTIC SOLN $1.2120 20080905 00000000 20080905

5 mg/10,000 units/10 mg

NEOMYCIN/POLYMYXIN B/HC 0000 per ml MILLILITER OTIC SUSP $1.2330 20080905 00000000 20080905

NIACIN 0000 250 mg CAPSULE CAP, SR $0.0405 20020605 20021206 20021206

NIACIN 0000 500 mg TABLET TAB, SR $0.0434 20051206 20060303 20060605

NICARDIPINE HCL 0000 20 mg CAPSULE CAP $0.0930 20080305 00000000 20080905

NICARDIPINE HCL 0000 30 mg CAPSULE CAP $0.1668 20080919 00000000 20080919

NIFEDIPINE 0000 10 mg CAPSULE CAP $0.6768 20080905 00000000 20080905

NIFEDIPINE 0000 20 mg CAPSULE CAP $0.3628 20061205 20070605 20071205

NIFEDIPINE CC 0000 30 mg TABLET TAB $0.6896 20080305 00000000 20080905

NIFEDIPINE CC 0000 60 mg TABLET TAB $1.3458 20080905 00000000 20080905

NIFEDIPINE CC 0000 90 mg TABLET TAB $2.3165 20080305 00000000 20080905

NIFEDIPINE ER 0000 30 mg TABLET TAB $0.7745 20080905 00000000 20080905

NIFEDIPINE ER 0000 60 mg TABLET TAB $1.3108 20080905 00000000 20080905

NIFEDIPINE ER 0000 90 mg TABLET TAB $2.3822 20080305 00000000 20080905

NITROFURANTOIN 0000 100 mg CAPSULE CAP $0.4254 20080305 00000000 20080905

NITROFURANTOIN MACROCRYSTALS 0000 100 mg CAPSULE CAP $1.0671 20080305 00000000 20080905

NITROFURANTOIN MACROCRYSTALS 0000 50 mg CAPSULE CAP $0.5907 20071205 00000000 20080605

NITROGLYCERIN 0000 0.2 mg/HR PATCH PATCH $0.6146 20080305 00000000 20080905

NITROGLYCERIN 0000 0.3 mg TABLET TAB, sublingual $0.0330 20080305 00000000 20080905

NITROGLYCERIN 0000 0.4 mg TABLET TAB, sublingual $0.0339 20080919 00000000 20080919

NITROGLYCERIN 0000 0.4 mg/HR PATCH PATCH $0.5810 20080305 00000000 20080905

NITROGLYCERIN 0000 0.6 mg TABLET TAB, sublingual $0.0330 20080305 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 20 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

NITROGLYCERIN 0000 0.6 mg/HR PATCH PATCH $0.8888 20070919 00000000 20080905

NITROGLYCERIN 0000 2.5 mg CAPSULE CAP, SR $0.0834 20080919 00000000 20080919

NITROGLYCERIN 0000 6.5 mg CAPSULE CAP, SR $0.1036 20080919 00000000 20080919

NITROGLYCERIN 0000 9 mg CAPSULE CAP, SR $0.1458 20080305 00000000 20080905

NIZATIDINE 0000 150 mg CAPSULE CAP $0.3548 20080919 00000000 20080919

NIZATIDINE 0000 300 mg CAPSULE CAP $0.8021 20080919 00000000 20080919

NORETH A-ET ESTRA/FE FUMARATE (LOESTRIN FE,

JUNEL FE, MICROGESTIN FE) 0000 1.5-0.03 mg TABLET TAB $0.7315 20080905 00000000 20080905

NORETH A-ET ESTRA/FE FUMARATE (LOESTRIN FE,

JUNEL FE, MICROGESTIN FE) 0000 1-0.02mg TABLET TAB $0.7262 20080305 00000000 20080905

NORETHINDRONE ACETATE/ETHINYL ESTRADIOL 0.5 mg/35 mcg; 1 mg/35

BIPHASIC (ORTHO-NOVUM 10/11, NECON 10/11) 0000 mcg TABLET TAB $0.9271 20080305 00000000 20080905

NORETHINDRONE A-E ESTRADIOL

(JUNEL, MICROGESTIN, LOESTRIN) 0000 1.5-0.030 mg TABLET TAB $1.1458 20070305 00000000 20080905

NORETHINDRONE A-E ESTRADIOL

(JUNEL, MICROGESTIN, LOESTRIN) 0000 1-0.02mg TABLET TAB $1.1458 20070305 00000000 20080905

NORETHINDRONE A-E ESTRADIOL/FERROUS

FUMARATE

(ESTROSTEP FE, TRI-LEGEST FE, TILIA FE) 0000 5-7-9-7 TABLET TAB $1.5163 20080305 00000000 20080905

NORETHINDRONE

(ERRIN, CAMILA, JOLIVETTE, ORTHO MICRONOR) 0000 0.35 mg TABLET TAB $0.9470 20080919 00000000 20080919

NORETHINDRONE/ETHINYL ESTRADIOL (BREVICON,

MODICON, NECON 0.5/35) 0000 0.5 mg/35 mcg TABLET TAB $0.8878 20060906 00000000 20080905

NORETHINDRONE/ETHINYL ESTRADIOL (NECON 1/35,

NORINYL 1+35, ORTHO-NOVUM 1/35) 0000 1 mg/35 mcg TABLET TAB $0.7349 20080919 00000000 20080919

NORETHINDRONE/ETHINYL ESTRADIOL (NECON 7/7/7,

NORTREL 7/7/7, ORTHO-NOVUM 7/7/7) 0000 .5-35/0.75-35/1-35 mg-mcg TABLET TAB $0.8543 20080919 00000000 20080919

NORETHINDRONE/MESTRANOL (NECON 1/50, NORINYL

1+50, ORTHO-NOVUM 1/50 0000 1 mg/50 mcg TABLET TAB $0.8482 20080305 00000000 20080905

NORGESTIMATE-ETHINYL ESTRADIOL (ORTHO-CYCLEN,

SPRINTEC, MONONESSA) 0000 0.25 mg/35 mcg TABLET TAB $0.6280 20080919 00000000 20080919

NORGESTIMATE-ETHINYL ESTRADIOL (TRI-SPRINTEC,

ORTHO TRI-CYCLEN, TRINESSA) 0000 7-7-7 TABLET TAB $0.6321 20080919 00000000 20080919

NORGESTREL/ETHINYL ESTRADIOL (LO/OVRAL, LOW-

OGESTREL) 0000 0.3 mg/30 mcg TABLET TAB $0.7864 20080905 00000000 20080905

NORGESTREL/ETHINYL ESTRADIOL (OGESTREL) 0000 0.5 mg/50 mcg TABLET TAB $1.3282 20080305 00000000 20080905

NORTRIPTYLINE HCL 0000 10 mg CAPSULE CAP $0.0489 20080905 00000000 20080905

NORTRIPTYLINE HCL 0000 10 mg/5 ml MILLILITER SOLN $0.0864 20060906 20070305 20070305

NORTRIPTYLINE HCL 0000 25 mg CAPSULE CAP $0.0564 20080305 00000000 20080905

NORTRIPTYLINE HCL 0000 50 mg CAPSULE CAP $0.0717 20080905 00000000 20080905

NORTRIPTYLINE HCL 0000 75 mg CAPSULE CAP $0.1190 20080305 00000000 20080905

NYSTATIN 0000 100,000 units/gm GRAM CRM $0.0791 20080905 00000000 20080905

NYSTATIN 0000 100,000 units/gm GRAM OINT $0.1040 20080905 00000000 20080905

NYSTATIN 0000 100,000 units/gm GRAM POWDER $0.7280 20080919 00000000 20080919

NYSTATIN 0000 100,000 units/ml MILLILITER SUSP $0.0825 20080919 00000000 20080919

NYSTATIN 0000 500,000 units TABLET TAB $0.3563 20020405 20020906 20030305

NYSTATIN/TRIAMCINOLONE 0000 100,000 units/gm; 0.1% GRAM CRM $0.1031 20080905 00000000 20080905

NYSTATIN/TRIAMCINOLONE 0000 100,000 units/gm; 0.1% GRAM OINT $0.1031 20080905 00000000 20080905

OCTREOTIDE ACETATE 0000 100 mcg/ml EACH VIAL $20.6040 20080905 00000000 20080905

OCTREOTIDE ACETATE 0000 200 mcg/ml MILLILITER VIAL $27.1704 20080905 00000000 20080905

OCTREOTIDE ACETATE 0000 500 mcg/ml EACH VIAL $90.2988 20080905 00000000 20080905

OFLOXACIN 0000 0.3% MILLILITER OPTH SOLN $0.9960 20080905 00000000 20080905

OFLOXACIN 0000 200 mg TABLET TAB $3.0105 20080905 00000000 20080905

OFLOXACIN 0000 300 mg TABLET TAB $3.5475 20080905 00000000 20080905

OFLOXACIN 0000 400 mg TABLET TAB $3.5667 20080305 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 21 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

OMEPRAZOLE 0000 10 mg CAPSULE CAP, DR $0.9272 20080905 00000000 20080905

OMEPRAZOLE 0000 20 mg TABLET TAB, DR $0.7832 20080919 00000000 20080919

OMEPRAZOLE 0000 20 mg CAPSULE CAP, DR $0.3195 20080905 00000000 20080905

OMEPRAZOLE 0000 40 mg CAPSULE CAP, DR $6.1074 20080905 00000000 20080905

OMEPRAZOLE MAGNESIUM 0000 20 mg TABLET TAB $0.7832 20080919 00000000 20080919

ONDANSETRON 0000 4 mg TABLET TAB, orally disintegrating $0.4010 20080905 00000000 20080905

ONDANSETRON 0000 8 mg TABLET TAB, orally disintegrating $0.6304 20080905 00000000 20080905

ONDANSETRON HCL 0000 4 mg/2 ml; SDV MILLILITER VIAL $0.6750 20080805 00000000 20080805

ONDANSETRON HCL 0000 2 mg/ml; MDV MILLILITER VIAL $0.6090 20080919 00000000 20080919

ONDANSETRON HCL 0000 4 mg TABLET TAB $0.5724 20081009 00000000 20081009

ONDANSETRON HCL 0000 8 mg TABLET TAB $0.7660 20080919 00000000 20080919

ONDANSETRON HCL 0000 4 mg/5 ml MILLILITER SOLN $3.3126 20080919 00000000 20080919

ORPHENADRINE CITRATE 0000 100 mg TABLET TAB, SR $0.6746 20080905 00000000 20080905

ORPHENADRINE WITH ASPIRIN AND CAFFEINE 0000 25 mg; 385 mg; 30 mg TABLET TAB $0.7950 20050304 20050902 20070305

ORPHENADRINE WITH ASPIRIN AND CAFFEINE 0000 50 mg; 770 mg; 60 mg TABLET TAB $1.8085 20080905 00000000 20080905

OXANDROLONE 0000 10 mg TABLET TAB $14.2050 20080919 00000000 20080919

OXANDROLONE 0000 2.5 mg TABLET TAB $4.1891 20080919 00000000 20080919

OXAPROZIN 0000 600 mg TABLET TAB $0.1391 20080305 00000000 20080905

OXAZEPAM 0000 10 mg CAPSULE CAP $0.2697 20080919 00000000 20080919

OXAZEPAM 0000 15 mg CAPSULE CAP $0.4569 20080919 00000000 20080919

OXAZEPAM 0000 30 mg CAPSULE CAP $1.0272 20080919 00000000 20080919

OXCARBAZEPINE 0000 150 mg TABLET TAB $0.6394 20081003 00000000 20081003

OXCARBAZEPINE 0000 300 mg TABLET TAB $1.4262 20081003 00000000 20081003

OXCARBAZEPINE 0000 600 mg TABLET TAB $1.7829 20081003 00000000 20081003

OXYBUTYNIN 0000 5 mg TABLET TAB $0.0533 20080305 00000000 20080905

OXYBUTYNIN 0000 5 mg/5 ml MILLILITER SYR $0.0249 20080305 00000000 20080905

OXYBUTYNIN CHLORIDE 0000 10 mg TABLET TAB, SA $2.6267 20080919 00000000 20080919

OXYBUTYNIN CHLORIDE 0000 15 mg TABLET TAB, SA $2.9510 20080919 00000000 20080919

OXYBUTYNIN CHLORIDE 0000 5 mg TABLET TAB, SA $2.6267 20080919 00000000 20080919

OXYCODONE / APAP 0000 10 mg; 650 mg TABLET TAB $0.6342 20080905 00000000 20080905

OXYCODONE / APAP 0000 10/325 mg TABLET TAB $0.6500 20080305 00000000 20080905

OXYCODONE / APAP 0000 5 mg; 325 mg TABLET TAB $0.0647 20080905 00000000 20080905

OXYCODONE / APAP 0000 5 mg; 500 mg CAPSULE CAP $0.0996 20080305 00000000 20080905

OXYCODONE / APAP 0000 7.5 mg; 325 mg TABLET TAB $0.4761 20080905 00000000 20080905

OXYCODONE / APAP 0000 7.5 mg; 500 mg TABLET TAB $0.4677 20080905 00000000 20080905

OXYCODONE HCL 0000 10 mg TABLET TAB, SR 12HR $0.6089 20060906 20070105 20070105

OXYCODONE HCL 0000 20 mg TABLET TAB, SR 12HR $1.1703 20060906 20070105 20070105

OXYCODONE HCL 0000 30 mg TABLET TAB $0.4908 20080905 00000000 20080905

OXYCODONE HCL 0000 40 mg TABLET TAB, SR 12HR $2.0520 20060906 20070105 20070105

OXYCODONE HCL 0000 5 mg TABLET TAB $0.1011 20080305 00000000 20080905

OXYCODONE HCL 0000 80 mg TABLET TAB, SR $3.8927 20060906 20070105 20070105

OXYCODONE HCL 0000 15 mg TABLET TAB $0.2838 20080919 00000000 20080919

OXYCODONE HCL 0000 20 mg/ml MILLILITER SOLN $0.5970 20080919 00000000 20080919

OXYCODONE HCL 0000 5 mg CAPSULE CAP $0.1108 20080919 00000000 20080919

OXYCODONE/ASPIRIN 0000 4.88-325 mg TABLET TAB $0.8500 20080919 00000000 20080919

PANTOPRAZOLE SODIUM 0000 20 mg TABLET TAB, EC $3.6133 20080905 00000000 20080905

PANTOPRAZOLE SODIUM 0000 40 mg TABLET TAB, EC $3.6133 20080919 00000000 20080919

PAROXETINE HCL 0000 10 mg TABLET TAB $0.2000 20080919 00000000 20080919

PAROXETINE HCL 0000 12.5 mg TABLET TAB $2.7704 20080905 00000000 20080905

PAROXETINE HCL 0000 20 mg TABLET TAB $0.2315 20080919 00000000 20080919

PAROXETINE HCL 0000 25 mg TABLET TAB $2.8912 20080905 00000000 20080905

PAROXETINE HCL 0000 30 mg TABLET TAB $0.2415 20080919 00000000 20080919

PAROXETINE HCL 0000 40 mg TABLET TAB $0.2906 20080919 00000000 20080919

PEMOLINE 0000 18.75 mg TABLET TAB $0.9148 20040604 20051206 20051206

PEMOLINE 0000 37.5 mg TABLET TAB $1.4236 20050603 20051206 20051206







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 22 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

PEMOLINE 0000 75 mg TABLET TAB $2.3875 20041203 20051206 20051206

PENICILLIN V POTASSIUM 0100 125 mg/5 ml, 100 ml MILLILITER PWDR for ORAL SOLN $0.0304 20071205 00000000 20080605

PENICILLIN V POTASSIUM 0000 250 mg TABLET TAB $0.1113 20080919 00000000 20080919

PENICILLIN V POTASSIUM 0000 250 mg/5 ml MILLILITER SUSP RECON $0.0304 20071205 00000000 20080605

PENICILLIN V POTASSIUM 0000 500 mg TABLET TAB $0.2142 20080919 00000000 20080919

PENTAZOCINE/NALOXONE HCL 0000 50 mg/0.5 mg TABLET TAB $1.1479 20080905 00000000 20080905

PENTOXIFYLLINE 0000 400 mg TABLET TAB, CR $0.1029 20080305 00000000 20080905

P-EPHED HCL/BROMPHENIRAMIN 0000 45 mg; 4 mg/5 ml MILLILITER SYR $0.0202 20080919 00000000 20080919

P-EPHED HCL/CARBINOX MAL 0000 15-1 mg/ml MILLILITER DROPS $0.1856 20041203 20050331 20050331

PERMETHRIN 0000 5% GRAM CRM $0.1470 20080919 00000000 20080919

PERPHENAZINE 0000 16 mg TABLET TAB $0.5076 20080919 00000000 20080919

PERPHENAZINE 0000 2 mg TABLET TAB $0.2120 20080919 00000000 20080919

PERPHENAZINE 0000 4 mg TABLET TAB $0.2709 20080919 00000000 20080919

PERPHENAZINE 0000 8 mg TABLET TAB $0.3764 20080919 00000000 20080919

PHENAZOPYRIDINE HCL 0000 100 mg TABLET TAB $0.0792 20080919 00000000 20080919

PHENAZOPYRIDINE HCL 0000 200 mg TABLET TAB $0.1106 20080919 00000000 20080919

PHENOBARBITAL 0000 100 mg TABLET TAB $0.0372 20080919 00000000 20080919

PHENOBARBITAL 0000 15 mg TABLET TAB $0.0232 20080919 00000000 20080919

PHENOBARBITAL 0000 20 mg/5 ml MILLILITER ELIXIR $0.0111 20030606 20031205 20080905

PHENOBARBITAL 0000 30 mg TABLET TAB $0.0119 20080919 00000000 20080919

PHENOBARBITAL 0000 60 mg TABLET TAB $0.0284 20080905 00000000 20080905

PHENTERMINE HCL 0000 30 mg CAPSULE CAP $0.3251 20080919 00000000 20080919

PHENTERMINE HCL 0000 37.5 mg TABLET TAB $0.2285 20080919 00000000 20080919

PHENYLEPHRINE/CHLORPHENIRAMINE 0000 5-4.5 mg/5 ml MILLILITER SUSP $0.0707 20080919 00000000 20080919

PHENYLEPHRINE/HYDROCODONE/CHLORPHENIRAMINE 0000 5-2.5-2 mg/5 ml MILLILITER SYR $0.0135 20071205 20080919 20080919

PHENYLEPHRINE/PYRIL TAN/CP 0000 5 mg; 12.5 mg; 2 mg/5 ml MILLILITER SUSP $0.1742 20061205 20080919 20080919

PHENYTOIN SODIUM 0000 100 mg CAPSULE CAP, ER $0.2492 20080919 00000000 20080919

PHENYTOIN SODIUM 0000 125 mg/5 ml MILLILITER SUSP $0.1159 20061205 00000000 20080605

PILOCARPINE HCL 0000 0.5% MILLILITER OPTH SOLN $0.2312 20021206 20030509 20030509

PILOCARPINE HCL 0000 0.01 MILLILITER OPTH SOLN $0.1541 20080919 00000000 20080919

PILOCARPINE HCL 0000 2% MILLILITER OPTH SOLN $0.2060 20080919 00000000 20080919

PILOCARPINE HCL 0000 4% MILLILITER OPTH SOLN $0.2832 20080919 00000000 20080919

PILOCARPINE HCL 0000 6% MILLILITER OPTH SOLN $0.4590 20080919 00000000 20080919

PILOCARPINE HCL 0000 5 mg TABLET TAB $0.3894 20080919 00000000 20080919

PINDOLOL 0000 10 mg TABLET TAB $0.1569 20080905 00000000 20080905

PINDOLOL 0000 5 mg TABLET TAB $0.1265 20080305 00000000 20080905

PIROXICAM 0000 10 mg CAPSULE CAP $0.0715 20070305 00000000 20080905

PIROXICAM 0000 20 mg CAPSULE CAP $0.0824 20080905 00000000 20080905

POLYETHYLENE GLYCOL 0000 17 gm EACH PACKET $1.0355 20070919 20080305 20080605

POLYETHYLENE GLYCOL 0000 NA GRAM POWDER $0.0613 20080905 00000000 20080905

POTASSIUM BICARB/CITRATE 0000 25 mEq TABLET EFFERV TAB $0.2195 20070605 00000000 20080605

POTASSIUM CHLORIDE 0000 10 mEq CAPSULE CAP, CR $0.4668 20080919 00000000 20080919

POTASSIUM CHLORIDE 0000 10 mEq TABLET TAB, CR $0.1550 20080919 00000000 20080919

POTASSIUM CHLORIDE 0000 10 mEq TABLET TAB, ER $0.1202 20080919 00000000 20080919

POTASSIUM CHLORIDE 0000 20 mEq EACH PWDR PACKET $0.1850 20070605 00000000 20080605

POTASSIUM CHLORIDE 0000 20 mEq TABLET TAB, CR $0.1280 20080919 00000000 20080919

POTASSIUM CHLORIDE 0000 20 mEq/15 ml MILLILITER LIQ $0.0049 20071205 00000000 20080605

POTASSIUM CHLORIDE 0000 8 mEq TABLET TAB, CR $0.0912 20080919 00000000 20080919

POTASSIUM CHLORIDE 0000 40 mEq/15 ml MILLILITER LIQ $0.0056 20080919 00000000 20080919

POTASSIUM CHLORIDE/BICARB 0000 25 mEq TABLET EFFERV TAB $0.5220 20061205 20080919 20080919

POVIDONE IODINE 0000 0.1 GRAM OINT $0.0668 20020605 20021206 20021206

POVIDONE IODINE 0000 0.1 MILLILITER SOLN $0.0106 20020605 20021206 20021206

PRAVASTATIN SODIUM 0000 10 mg TABLET TAB $0.1249 20080905 00000000 20080905

PRAVASTATIN SODIUM 0000 20 mg TABLET TAB $0.1625 20080305 00000000 20080905

PRAVASTATIN SODIUM 0000 40 mg TABLET TAB $0.2135 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 23 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

PRAVASTATIN SODIUM 0000 80 mg TABLET TAB $0.4413 20080905 00000000 20080905

PRAZOSIN HCL 0000 1 mg CAPSULE CAP $0.1491 20080919 00000000 20080919

PRAZOSIN HCL 0000 2 mg CAPSULE CAP $0.2880 20080919 00000000 20080919

PRAZOSIN HCL 0000 5 mg CAPSULE CAP $0.4832 20080919 00000000 20080919

PREDNISOLONE 0000 15 mg/5 ml MILLILITER SYR $0.0276 20080919 00000000 20080919

PREDNISOLONE ACETATE 0000 1% MILLILITER OPTH SUSP $1.5816 20080905 00000000 20080905

PREDNISOLONE SODIUM PHOSPHATE 0000 15 mg/5 ml MILLILITER SOLN $0.1137 20080919 00000000 20080919

PREDNISONE 0000 1 mg TABLET TAB $0.1311 20080919 00000000 20080919

PREDNISONE 0000 10 mg TABLET TAB $0.0357 20080919 00000000 20080919

PREDNISONE 0000 20 mg TABLET TAB $0.0614 20080919 00000000 20080919

PREDNISONE 0000 5 mg TABLET TAB $0.0291 20080919 00000000 20080919

PRENATAL VIT/FE FUMARATE/FA 0000 27 mg; 1 mg TABLET TAB $0.0590 20080919 00000000 20080919

PRENATAL VIT/FE FUMARATE/FA 0000 28-1 mg TABLET TAB $0.1014 20080919 00000000 20080919

PRENATAL VIT/IRON,CARB/DOSS/FA 0000 90 mg; 50 mg; 1 mg TABLET TAB $0.1644 20070605 20080919 20080919

PRIMIDONE 0000 250 mg TABLET TAB $0.2916 20080919 00000000 20080919

PRIMIDONE 0000 50 mg TABLET TAB $0.2379 20080919 00000000 20080919

PROBENECID 0000 0.5 gm TABLET TAB $0.4890 20080305 00000000 20080905

PROBENECID W/COLCHICINE 0000 0.5 gm/0.5 mg TABLET TAB $0.7307 20020405 20020605 20041203

PROCHLORPERAZINE MALEATE 0000 10 mg TABLET TAB $0.0675 20080919 00000000 20080919

PROCHLORPERAZINE MALEATE 0000 25 mg EACH SUPP $1.3625 20080919 00000000 20080919

PROCHLORPERAZINE MALEATE 0000 5 mg TABLET TAB $0.0753 20080919 00000000 20080919

PROMETHAZINE HCL 0000 12.5 mg EACH SUPP $0.7113 20080905 00000000 20080905

PROMETHAZINE HCL 0000 25 mg TABLET TAB $0.2507 20080919 00000000 20080919

PROMETHAZINE HCL 0000 25 mg EACH SUPP $0.6912 20080305 00000000 20080905

PROMETHAZINE HCL 0000 50 mg EACH SUPP $3.7826 20050603 20050902 20080905

PROMETHAZINE HCL 0000 50 mg TABLET TAB $0.3875 20080905 00000000 20080905

PROMETHAZINE HCL 0000 6.25 mg/5 ml MILLILITER SYR $0.0224 20080905 00000000 20080905

PROMETHAZINE VC 0000 6.25 mg/5 mg per 5 ml MILLILITER SYR $0.0194 20020405 20020906 20050603

6.25 mg/5 mg/10 mg per 5

PROMETHAZINE VC W/CODEINE 0000 ml MILLILITER SYR $0.0303 20020308 20020906 20050603

PROMETHAZINE W/DM 0000 6.25-15/5 MILLILITER SYR $0.0155 20080919 00000000 20080919

PROMETHAZINE/CODEINE 0000 10-6.25/5 ml MILLILITER SYR $0.0165 20080905 00000000 20080905

PROPAFENONE HCL 0000 150 mg TABLET TAB $0.2820 20080905 00000000 20080905

PROPAFENONE HCL 0000 225 mg TABLET TAB $0.4071 20080905 00000000 20080905

PROPAFENONE HCL 0000 300 mg TABLET TAB $1.3443 20080305 00000000 20080905

PROPOXYPHENE HCL 0000 65 mg CAPSULE CAP $0.1982 20080305 00000000 20080905

PROPOXYPHENE NAPSYLATE; APAP 0000 100 mg; 650 mg TABLET TAB $0.0617 20080305 00000000 20080905

PROPOXYPHENE; APAP 0000 65/650 mg TABLET TAB $0.2333 20070919 00000000 20080905

PROPRANOLOL HCL 0000 10 mg TABLET TAB $0.0407 20080919 00000000 20080919

PROPRANOLOL HCL 0000 120 mg CAPSULE CAP, ER $1.3817 20080919 00000000 20080919

PROPRANOLOL HCL 0000 160 mg CAPSULE CAP, ER $1.7748 20080919 00000000 20080919

PROPRANOLOL HCL 0000 20 mg TABLET TAB $0.0414 20080919 00000000 20080919

PROPRANOLOL HCL 0000 40 mg TABLET TAB $0.0582 20080919 00000000 20080919

PROPRANOLOL HCL 0000 60 mg CAPSULE CAP, ER $0.9403 20080919 00000000 20080919

PROPRANOLOL HCL 0000 60 mg TABLET TAB $0.9953 20080919 00000000 20080919

PROPRANOLOL HCL 0000 80 mg CAPSULE CAP, ER $1.1130 20080919 00000000 20080919

PROPRANOLOL HCL 0000 80 mg TABLET TAB $0.0699 20080919 00000000 20080919

PROPRANOLOL/HCTZ 0000 40 mg; 25 mg TABLET TAB $0.1853 20080919 00000000 20080919

PROPRANOLOL/HCTZ 0000 80 mg; 25 mg TABLET TAB $0.2321 20061205 20080919 20080919

PSEUDOEPHEDRINE HCL 0000 30 mg TABLET TAB $0.0314 20020906 20021206 20021206

PSEUDOEPHEDRINE HCL 0000 60 mg TABLET TAB $0.0300 20020906 20021206 20021206

PSEUDOEPHEDRINE HCL/CETIRIZINE HCL 0000 120 mg; 5 mg TABLET TAB $0.8880 20080404 00000000 20080404

PSEUDOEPHEDRINE HCL; CHLORPHENIRAMINE

MALEATE 0000 120 mg; 8 mg CAPSULE CAP, SA $1.2115 20080919 00000000 20080919









d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 24 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

PSEUDOEPHEDRINE HCL; CHLORPHENIRAMINE

MALEATE 0000 30 mg; 2 mg per 5 ml MILLILITER SYR $0.0120 20020405 20021206 20021206

PSEUDOEPHEDRINE SULFATE/LORATADINE 0000 240-10 mg TABLET TAB, SA $0.8752 20080919 00000000 20080919

PSYLLIUM 0000 NA GRAM ORAL PWDR $0.0090 20020906 20021206 20021206

PSYLLIUM SEED/SUCROSE ORAL POWDER 0000 NA GRAM ORAL PWDR $0.1134 20020906 20021206 20021206

PSYLLIUM/SUCROSE ORAL PACKET 0000 NA EACH ORAL PACKETS $0.0210 20020405 20021206 20021206

PYRIDOSTIGMINE BROMIDE 0000 60 mg TABLET TAB $0.3762 20080919 00000000 20080919

QUINAPRIL HCL 0000 10 mg TABLET TAB $0.1293 20080305 00000000 20080905

QUINAPRIL HCL 0000 20 mg TABLET TAB $0.1293 20080305 00000000 20080905

QUINAPRIL HCL 0000 40 mg TABLET TAB $0.1293 20080305 00000000 20080905

QUINAPRIL HCL 0000 5 mg TABLET TAB $0.1293 20080305 00000000 20080905

QUINAPRIL HCL/HCTZ 0000 10-12.5 mg TABLET TAB $0.9481 20080905 00000000 20080905

QUINAPRIL HCL/HCTZ 0000 20-12.5 mg TABLET TAB $0.9481 20080905 00000000 20080905

QUINAPRIL HCL/HCTZ 0000 20-25 mg TABLET TAB $0.9481 20080905 00000000 20080905

QUINIDINE GLUCONATE 0000 324 mg TABLET TAB, SR $0.7930 20061205 20070605 20070605

QUINIDINE SULFATE 0000 200 mg TABLET TAB $0.1631 20061205 20070605 20070605

QUININE SULFATE 0000 260 mg TABLET TAB $0.2234 20060906 20070305 20070305

QUININE SULFATE 0000 325 mg CAPSULE CAP $0.2264 20060906 20070305 20070305

RAMIPRIL 0000 10 mg CAPSULE CAP $1.8773 20080305 00000000 20080605

RAMIPRIL 0000 5 mg CAPSULE CAP $1.6044 20080305 00000000 20080605

RANITIDINE HCL 0000 150 mg CAPSULE CAP $0.2550 20080305 00000000 20080905

RANITIDINE HCL 0000 150 mg TABLET TAB $0.0339 20080919 00000000 20080919

RANITIDINE HCL 0000 150 mg/10 ml MILLILITER SYR $0.2030 20080905 00000000 20080905

RANITIDINE HCL 0000 300 mg CAPSULE CAP $0.7684 20030305 20051206 20051206

RANITIDINE HCL 0000 300 mg TABLET TAB $0.0621 20080919 00000000 20080919

RIBAVIRIN 0000 200 mg TABLET TAB $1.2582 20080919 00000000 20080919

RIBAVIRIN 0000 200 mg CAPSULE CAP $1.8144 20080919 00000000 20080919

RIFAMPIN 0000 300 mg CAPSULE CAP $1.6634 20061205 00000000 20080605

RISPERIDONE 0000 0.25 mg TABLET TAB $2.9799 20080905 00000000 20080905

RISPERIDONE 0000 0.5 mg TABLET TAB $3.2598 20080905 00000000 20080905

RISPERIDONE 0000 1 mg TABLET TAB $3.4648 20080905 00000000 20080905

RISPERIDONE 0000 2 mg TABLET TAB $5.7782 20080905 00000000 20080905

RISPERIDONE 0000 3 mg TABLET TAB $6.7854 20080905 00000000 20080905

RISPERIDONE 0000 4 mg TABLET TAB $9.1244 20080905 00000000 20080905

ROPINIROLE HCL 0000 0.25 mg TABLET TAB $0.4848 20080618 00000000 20080905

ROPINIROLE HCL 0000 0.5 mg TABLET TAB $0.4848 20080618 00000000 20080905

ROPINIROLE HCL 0000 1 mg TABLET TAB $0.4848 20080618 00000000 20080905

ROPINIROLE HCL 0000 2 mg TABLET TAB $0.4848 20080618 00000000 20080905

ROPINIROLE HCL 0000 3 mg TABLET TAB $0.5151 20080618 00000000 20080905

ROPINIROLE HCL 0000 4 mg TABLET TAB $0.5151 20080618 00000000 20080905

ROPINIROLE HCL 0000 5 mg TABLET TAB $0.5151 20080618 00000000 20080905

SALSALATE 0000 500 mg TABLET TAB $0.0389 20080905 00000000 20080905

SALSALATE 0000 750 mg TABLET TAB $0.0522 20080905 00000000 20080905

SELEGILINE HCL 0000 5 mg CAPSULE CAP $0.3536 20080305 00000000 20080905

SELEGILINE HCL 0000 5 mg TABLET TAB $0.1524 20070305 20080305 20080905

SELENIUM SULFIDE 0000 2.5% MILLILITER LOT/SHAMP $0.0522 20080919 00000000 20080919

SERTRALINE HCL 0000 100 mg TABLET TAB $0.1250 20080919 00000000 20080919

SERTRALINE HCL 0000 20 mg/ml MILLILITER CONC $0.6860 20080919 00000000 20080919

SERTRALINE HCL 0000 25 mg TABLET TAB $0.1000 20080919 00000000 20080919

SERTRALINE HCL 0000 50 mg TABLET TAB $0.1010 20080919 00000000 20080919

SILVER SULFADIAZINE 0000 0.01 GRAM CRM $0.1023 20080305 00000000 20080905

SIMETHICONE 0000 80 mg TABLET TAB, CHEW $0.0278 20020906 20021206 20021206

SIMVASTATIN 0000 10 mg TABLET TAB $0.0504 20080305 00000000 20080905

SIMVASTATIN 0000 20 mg TABLET TAB $0.0674 20080905 00000000 20080905

SIMVASTATIN 0000 40 mg TABLET TAB $0.1007 20080905 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 25 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

SIMVASTATIN 0000 5 mg TABLET TAB $0.0639 20080305 00000000 20080905

SIMVASTATIN 0000 80 mg TABLET TAB $0.1226 20080905 00000000 20080905

SODIUM CHLORIDE 0010 0.9%; 10 ml MILLILITER INJ $0.0564 20020906 20030305 20030305

SODIUM CHLORIDE 0100 0.9%; 100 ml MILLILITER IV $0.0192 20060906 00000000 20080905

SODIUM CHLORIDE 1000 0.9%; 1000 ml MILLILITER IV $0.0019 20080305 00000000 20080905

SODIUM CHLORIDE 0150 0.9%; 150 ml MILLILITER IV $0.0108 20080305 00000000 20080905

SODIUM CHLORIDE 0025 0.9%; 25 ml MILLILITER IV $0.0989 20080905 00000000 20080905

SODIUM CHLORIDE 0250 0.9%; 250 ml MILLILITER IV $0.0062 20080305 00000000 20080905

SODIUM CHLORIDE 0003 0.9%; 3 ml MILLILITER INH SOLN $0.0398 20020906 20021206 20021206

SODIUM CHLORIDE 0050 0.9%; 50 ml MILLILITER IV $0.0384 20080905 00000000 20080905

SODIUM CHLORIDE 0500 0.9%; 500 ml MILLILITER IV $0.0032 20080305 00000000 20080905

SODIUM FLUORIDE 0000 1.1% GRAM CRM $0.0939 20080919 00000000 20080919

SODIUM FLUORIDE 0000 .5 mg TABLET TAB, CHEW $0.0227 20080905 00000000 20080905

SODIUM FLUORIDE 0000 0.5 mg/ml MILLILITER DROPS $0.0645 20080919 00000000 20080919

SODIUM FLUORIDE 0000 1 mg TABLET TAB, CHEW $0.0222 20080305 00000000 20080905

SODIUM SULFATE/SODIUM CHLORIDE/SODIUM

BICARBONATE/POTASSIUM CHLORIDE/POLYETHYLENE

GLYCOL 0000 N/A MILLILITER SOLN $0.0028 20071205 00000000 20080605

SOTALOL HCL 0000 120 mg TABLET TAB $0.1995 20080919 00000000 20080919

SOTALOL HCL 0000 160 mg TABLET TAB $0.2424 20080919 00000000 20080919

SOTALOL HCL 0000 240 mg TABLET TAB $0.5352 20020716 20020801 20031205

SOTALOL HCL 0000 80 mg TABLET TAB $0.1199 20080919 00000000 20080919

SPIRONOLACTONE 0000 100 mg TABLET TAB $0.8621 20080919 00000000 20080919

SPIRONOLACTONE 0000 25 mg TABLET TAB $0.1598 20080919 00000000 20080919

SPIRONOLACTONE 0000 50 mg TABLET TAB $0.4373 20080919 00000000 20080919

SPIRONOLACTONE/HCTZ 0000 25 mg/25 mg TABLET TAB $0.2726 20080919 00000000 20080919

SUCRALFATE 0000 1 gm TABLET TAB $0.1791 20080919 00000000 20080919

SULFACETAMIDE SODIUM 0000 10% MILLILITER OPTH SOLN $0.1430 20080919 00000000 20080919

SULFASALAZINE 0000 500 mg TABLET TAB $0.1113 20071205 00000000 20080605

SULFASALAZINE 0000 500 mg TABLET TAB, DR $0.3194 20080919 00000000 20080919

SULINDAC 0000 150 mg TABLET TAB $0.1851 20080905 00000000 20080905

SULINDAC 0000 200 mg TABLET TAB $0.2780 20080305 00000000 20080905

TAMOXIFEN CITRATE 0000 10 mg TABLET TAB $0.1620 20080919 00000000 20080919

TAMOXIFEN CITRATE 0000 20 mg TABLET TAB $0.3320 20080919 00000000 20080919

TEMAZEPAM 0000 15 mg CAPSULE CAP $0.0858 20080919 00000000 20080919

TEMAZEPAM 0000 30 mg CAPSULE CAP $0.1140 20080919 00000000 20080919

TERAZOSIN 0000 1 mg CAPSULE CAP $0.1050 20080919 00000000 20080919

TERAZOSIN 0000 10 mg CAPSULE CAP $0.1050 20080919 00000000 20080919

TERAZOSIN 0000 2 mg CAPSULE CAP $0.1050 20080919 00000000 20080919

TERAZOSIN 0000 5 mg CAPSULE CAP $0.1050 20080919 00000000 20080919

TERBINAFINE HCL 0000 250 mg TABLET TAB $0.2265 20080305 00000000 20080905

TERCONAZOLE 0000 0.4% GRAM CRM $0.3294 20080919 00000000 20080919

TERCONAZOLE 0000 0.8% GRAM CRM $0.7308 20080919 00000000 20080919

TERCONAZOLE 0000 80 mg EACH SUPP $14.0720 20080305 00000000 20080605

TETRACYCLINE HCL 0000 250 mg CAPSULE CAP $0.0548 20060906 00000000 20080905

TETRACYCLINE HCL 0000 500 mg CAPSULE CAP $0.0785 20080305 00000000 20080905

THEOPHYLLINE 0000 200 mg TABLET TAB, SR 12HR $0.1977 20080919 00000000 20080919

THEOPHYLLINE 0000 300 mg CAPSULE CAP, SR 12HR $0.5982 20070305 20070723 20071205

THEOPHYLLINE 0000 300 mg TABLET TAB, SR 12HR $0.2450 20080919 00000000 20080919

THIORIDAZINE HCL 0000 10 mg TABLET TAB $0.1260 20080305 00000000 20080905

THIORIDAZINE HCL 0000 100 mg TABLET TAB $0.3000 20080305 00000000 20080905

THIORIDAZINE HCL 0000 100 mg/ml MILLILITER CONC $0.1517 20020906 20030509 20040305

THIORIDAZINE HCL 0000 15 mg TABLET TAB $0.3930 20020605 20030509 20050603

THIORIDAZINE HCL 0000 200 mg TABLET TAB $0.9806 20020906 20030509 20050902

THIORIDAZINE HCL 0000 25 mg TABLET TAB $0.1812 20080305 00000000 20080905







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 26 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

THIORIDAZINE HCL 0000 30 mg/ml MILLILITER CONC $0.0800 20021206 20030509 20040305

THIORIDAZINE HCL 0000 50 mg TABLET TAB $0.2327 20080305 00000000 20080905

THIOTHIXENE 0000 1 mg CAPSULE CAP $0.1571 20080905 00000000 20080905

THIOTHIXENE 0000 10 mg CAPSULE CAP $0.4232 20080905 00000000 20080905

THIOTHIXENE 0000 2 mg CAPSULE CAP $0.2231 20080905 00000000 20080905

THIOTHIXENE 0000 5 mg CAPSULE CAP $0.3304 20080905 00000000 20080905

TICLOPIDINE HCL 0000 250 mg TABLET TAB $0.1908 20080919 00000000 20080919

TIMOLOL MALEATE 0000 0.0025 MILLILITER OPTH SOLN $0.4560 20080305 00000000 20080905

TIMOLOL MALEATE 0000 0.0025 MILLILITER GEL $4.5600 20080905 00000000 20080905

TIMOLOL MALEATE 0000 0.005 MILLILITER OPTH SOLN $0.4290 20080305 00000000 20080905

TIMOLOL MALEATE 0000 0.005 MILLILITER GEL $5.4264 20080905 00000000 20080905

TIMOLOL MALEATE 0010 0.25%; 10 cc MILLILITER SOLN $0.6630 20011201 20011220 20040922

TIMOLOL MALEATE 0015 0.25%; 15 cc MILLILITER SOLN $0.6104 20011201 20011220 20040922

TIMOLOL MALEATE 0005 0.25%; 5 cc MILLILITER SOLN $0.6340 20011201 20011220 20040922

TIMOLOL MALEATE 0010 0.5%; 10 cc MILLILITER SOLN $0.8010 20011201 20011220 20040922

TIMOLOL MALEATE 0015 0.5%; 15 cc MILLILITER SOLN $0.7130 20011201 20011220 20040922

TIMOLOL MALEATE 0005 0.5%; 5 cc MILLILITER SOLN $1.1980 20011201 20011220 20040922

TIMOLOL MALEATE 0000 10 mg TABLET TAB $0.3572 20060906 20070305 20070305

TIZANIDINE HCL 0000 2 mg TABLET TAB $0.0909 20080919 00000000 20080919

TIZANIDINE HCL 0000 4 mg TABLET TAB $0.0971 20080919 00000000 20080919

TOBRAMYCIN 0000 0.003 DROPS OPTH SOLN $0.3840 20080919 00000000 20080919

TOBRAMYCIN SULFATE 0000 1.2 gm EACH VIAL $122.4626 20080905 00000000 20080905

TOBRAMYCIN SULFATE 0000 40 mg/ml MILLILITER VIAL $1.1472 20080905 00000000 20080905

TOLBUTAMIDE 0000 500 mg TABLET TAB $0.2158 20080305 00000000 20080905

TOLMETIN SODIUM 0000 200 mg TABLET TAB $0.8910 20060605 20061205 20070305

TOLMETIN SODIUM 0000 400 mg CAPSULE CAP $0.8350 20080919 00000000 20080919

TOLMETIN SODIUM 0000 600 mg TABLET TAB $1.4077 20061205 00000000 20080605

TORSEMIDE 0000 10 mg TABLET TAB $0.1503 20080919 00000000 20080919

TORSEMIDE 0000 100 mg TABLET TAB $0.8755 20080919 00000000 20080919

TORSEMIDE 0000 20 mg TABLET TAB $0.2048 20080919 00000000 20080919

TORSEMIDE 0000 5 mg TABLET TAB $0.1610 20080919 00000000 20080919

TRAMADOL 0000 50 mg TABLET TAB $0.0434 20080905 00000000 20080905

TRAMADOL HCL/APAP 0000 37.5/325 mg TABLET TAB $0.4570 20080919 00000000 20080919

TRANDOLAPRIL 0000 1 mg TABLET TAB $0.5036 20080305 00000000 20080905

TRANDOLAPRIL 0000 2 mg TABLET TAB $0.5036 20080305 00000000 20080905

TRANDOLAPRIL 0000 4 mg TABLET TAB $0.4631 20080305 00000000 20080905

TRAZODONE HCL 0000 100 mg TABLET TAB $0.0596 20080919 00000000 20080919

TRAZODONE HCL 0000 150 mg TABLET TAB $0.1349 20080919 00000000 20080919

TRAZODONE HCL 0000 300 mg TABLET TAB $4.4946 20080919 00000000 20080919

TRAZODONE HCL 0000 50 mg TABLET TAB $0.0366 20080919 00000000 20080919

TRETINOIN 0000 0.0001 GRAM GEL $1.9200 20080919 00000000 20080919

TRETINOIN 0000 0.00025 GRAM GEL $1.9200 20080919 00000000 20080919

TRETINOIN 0000 0.00025 GRAM CRM $0.9443 20080305 00000000 20080905

TRETINOIN 0000 0.0005 GRAM CRM $1.3613 20080919 00000000 20080919

TRETINOIN 0000 0.0005 MILLILITER LIQ $1.3400 20020405 20030509 20040305

TRETINOIN 0000 0.001 GRAM CRM $1.5795 20080919 00000000 20080919

TRIAMCINOLONE ACETONIDE 0000 0.00025 MILLILITER LOT $0.4557 20080305 00000000 20080905

TRIAMCINOLONE ACETONIDE 0000 0.001 GRAM CRM $0.0590 20080305 00000000 20080905

TRIAMCINOLONE ACETONIDE 0000 0.001 GRAM OINT $0.0701 20080919 00000000 20080919

TRIAMCINOLONE ACETONIDE 0000 0.001 GRAM PASTE $0.9960 20021206 20030107 20080905

TRIAMCINOLONE ACETONIDE 0000 0.001 MILLILITER LOT $0.4036 20080919 00000000 20080919

TRIAMCINOLONE ACETONIDE 0000 0.005 GRAM CRM $0.1224 20080919 00000000 20080919

TRIAMCINOLONE ACETONIDE 0015 0.025%, 15 gm GRAM CRM $0.0710 20071205 00000000 20080605

TRIAMCINOLONE ACETONIDE 0060 0.025%, 60 ml MILLILITER LOT $0.4490 20011201 20011220 20060605

TRIAMCINOLONE ACETONIDE 0080 0.025%, 80 gm GRAM CRM $0.0252 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 27 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

TRIAMCINOLONE ACETONIDE 0080 0.025%, 80 gm GRAM OINT $0.0245 20080919 00000000 20080919

TRIAMCINOLONE ACETONIDE 0005 0.1%, 5 gm GRAM PASTE $0.8250 20011201 20011220 20060605

TRIAMCINOLONE ACETONIDE 0015 0.5%, 15 gm GRAM CRM $0.1835 20011201 20011220 20030305

TRIAMTERENE & HYDROCHLOROTHIAZIDE 0000 37.5 mg; 25 mg CAPSULE CAP $0.0623 20070305 00000000 20080905

TRIAMTERENE & HYDROCHLOROTHIAZIDE 0000 37.5 mg; 25 mg TABLET TAB $0.0644 20080305 00000000 20080905

TRIAMTERENE & HYDROCHLOROTHIAZIDE 0000 50 mg; 25 mg CAPSULE CAP $0.3908 20080919 00000000 20080919

TRIAMTERENE & HYDROCHLOROTHIAZIDE 0000 75 mg; 50 mg TABLET TAB $0.0405 20080305 00000000 20080905

TRIAZOLAM 0000 0.125 mg TABLET TAB $0.1859 20080919 00000000 20080919

TRIAZOLAM 0000 0.25 mg TABLET TAB $0.1778 20080919 00000000 20080919

TRIFLUOPERAZINE HCL 0000 1 mg TABLET TAB $0.3089 20080919 00000000 20080919

TRIFLUOPERAZINE HCL 0000 10 mg TABLET TAB $0.8984 20080919 00000000 20080919

TRIFLUOPERAZINE HCL 0000 2 mg TABLET TAB $0.4589 20080919 00000000 20080919

TRIFLUOPERAZINE HCL 0000 5 mg TABLET TAB $0.5978 20080919 00000000 20080919

TRIHEXYPHENIDYL HCL 0000 2 mg TABLET TAB $0.0728 20071205 00000000 20080605

TRIHEXYPHENIDYL HCL 0000 5 mg TABLET TAB $0.1545 20080305 00000000 20080905

TRIMETHOBENZAMIDE 0000 100 mg EACH SUPP $0.4125 20050902 20060303 20060605

TRIMETHOBENZAMIDE 0000 200 mg EACH SUPP $0.4650 20050902 20060303 20060605

TRIMETHOPRIM 0000 100 mg TABLET TAB $0.4253 20080919 00000000 20080919

TRIMETHOPRIM 0000 200 mg TABLET TAB $0.3000 20011201 20020308 20020308

TRIMETHOPRIM AND SULFAMETHOXAZOLE 0000 40 mg; 200 mg per 5 ml MILLILITER SUSP $0.0266 20080905 00000000 20080905

TRIMETHOPRIM AND SULFAMETHOXAZOLE DS 0000 160 mg; 800 mg TABLET TAB $0.1389 20080919 00000000 20080919

TRIMETHOPRIM AND SULFAMETHOXAZOLE SS 0000 80 mg; 400 mg TABLET TAB $0.1368 20080905 00000000 20080905

TRIMETHOPRIM/POLYMYXIN B 0000 1 mg/10,000 units/ml MILLILITER OPTH SOLN $0.1815 20080919 00000000 20080919

URSODIOL 0000 300 mg CAPSULE CAP $0.5832 20080919 00000000 20080919

VALPROIC ACID 0000 250 mg CAPSULE CAP $0.2699 20080919 00000000 20080919

VALPROIC ACID 0000 250 mg/5 ml MILLILITER SYR $0.0197 20080919 00000000 20080919

VANCOMYCIN HCL 0000 1 gm EACH VIAL $9.6660 20080905 00000000 20080905

VANCOMYCIN HCL 0000 5 gm EACH VIAL $42.4200 20080905 00000000 20080905

VANCOMYCIN HCL 0000 500 mg EACH VIAL $5.0760 20080905 00000000 20080905

VENLAFAXINE HCL 0000 100 mg TABLET TAB $1.8979 20080305 00000000 20080605

VENLAFAXINE HCL 0000 25 mg TABLET TAB $1.5926 20080305 00000000 20080605

VENLAFAXINE HCL 0000 50 mg TABLET TAB $1.6896 20080305 00000000 20080605

VENLAFAXINE HCL 0000 37.5 mg TABLET TAB $1.2215 20080905 00000000 20080905

VENLAFAXINE HCL 0000 75 mg TABLET TAB $1.3260 20080905 00000000 20080905

VERAPAMIL HCL 0000 100 mg CAPSULE CAP, ER $1.3020 20080919 00000000 20080919

VERAPAMIL HCL 0000 120 mg CAPSULE CAP, SR $0.5951 20070919 00000000 20080905

VERAPAMIL HCL 0000 120 mg TABLET TAB $0.1040 20080919 00000000 20080919

VERAPAMIL HCL 0000 120 mg TABLET TAB, SR $0.4457 20080919 00000000 20080919

VERAPAMIL HCL 0000 180 mg CAPSULE CAP, SR $0.6329 20070305 00000000 20080905

VERAPAMIL HCL 0000 180 mg TABLET TAB, SR $0.2930 20080905 00000000 20080905

VERAPAMIL HCL 0000 200 mg CAPSULE CAP, ER $1.6082 20080919 00000000 20080919

VERAPAMIL HCL 0000 240 mg CAPSULE CAP, SR $0.7037 20070305 00000000 20080905

VERAPAMIL HCL 0000 240 mg TABLET TAB, SR $0.2840 20080905 00000000 20080905

VERAPAMIL HCL 0000 300 mg CAPSULE CAP, ER $2.3370 20080919 00000000 20080919

VERAPAMIL HCL 0000 360 mg CAPSULE CAP, SR $1.8296 20080919 00000000 20080919

VERAPAMIL HCL 0000 80 mg TABLET TAB $0.0711 20080919 00000000 20080919

VINCRISTINE SULFATE 0000 1 mg/ ml MILLILITER VIAL $11.2125 20080919 00000000 20080919

WARFARIN SODIUM 0000 1 mg TABLET TAB $0.1283 20080919 00000000 20080919

WARFARIN SODIUM 0000 10 mg TABLET TAB $0.1398 20080919 00000000 20080919

WARFARIN SODIUM 0000 2 mg TABLET TAB $0.1283 20080919 00000000 20080919

WARFARIN SODIUM 0000 2.5 mg TABLET TAB $0.1283 20080919 00000000 20080919

WARFARIN SODIUM 0000 3 mg TABLET TAB $0.1283 20080919 00000000 20080919

WARFARIN SODIUM 0000 4 mg TABLET TAB $0.1283 20080919 00000000 20080919

WARFARIN SODIUM 0000 5 mg TABLET TAB $0.1283 20080919 00000000 20080919

WARFARIN SODIUM 0000 6 mg TABLET TAB $0.1340 20080919 00000000 20080919







d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 28 of 29 12/2/20115:36 PM

State of North Carolina MAC Update FINAL

October 9, 2008





ADD/DELETE/REA

NAME OF DRUG PckgSize STRENGTH UNIT FORM CTIVATE Final Price Effective Date End Date Last Review Date

WARFARIN SODIUM 0000 7.5 mg TABLET TAB $0.1497 20080919 00000000 20080919

WATER FOR INJECTION, BACTERIOSTATIC VIAL 0000 NA MILLILITER INJ $0.0847 20020906 20030305 20030305

WATER FOR INJECTION, STERILE IV SOLUTION 0000 NA MILLILITER IV $0.0031 20020605 20021206 20031205

WATER FOR IRRIGATION, STERILE SOLUTION 0000 NA MILLILITER IRRIG $0.0064 20020605 20021206 20030305

ZALEPLON 0000 10 mg CAPSULE CAP $0.4761 20080805 00000000 20080805

ZALEPLON 0000 5 mg CAPSULE CAP $0.4643 20080805 00000000 20080805

ZIDOVUDINE 0000 100 mg CAPSULE CAP $1.4131 20080919 00000000 20080919

ZIDOVUDINE 0000 300 mg TABLET TAB $0.5325 20080905 00000000 20080905

ZIDOVUDINE 0000 50 mg/5 ml MILLILITER SYR $0.1694 20080919 00000000 20080919

ZOLPIDEM TARTRATE 0000 10 mg TABLET TAB $0.0371 20080919 00000000 20080919

ZOLPIDEM TARTRATE 0000 5 mg TABLET TAB $0.0371 20080919 00000000 20080919

ZONISAMIDE 0000 100 mg CAPSULE CAP $0.2612 20080305 00000000 20080905

ZONISAMIDE 0000 25 mg CAPSULE CAP $0.1109 20080305 00000000 20080905

ZONISAMIDE 0000 50 mg CAPSULE CAP $0.2320 20080919 00000000 20080919









d5e16f33-b1ff-4690-b35f-cca2d0617b5e.xlsFinal MAC

Mercer Government Human Services Consulting Page 29 of 29 12/2/20115:36 PM