SOUTH DAKOTA MEDICAID MAC LIST
DRUGS THAT START WITH LETTER M


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GENERIC NAME GPI MAC
MAGNESIUM CHLORIDE INJ 20% 79400010202015 $0.10300
MAGNESIUM CITRATE SOLN 46100020102000 $0.00800
MAGNESIUM SULFATE INJ 12.5% 79400010402010 $0.00000
MAGNESIUM SULFATE INJ 4% 79400010402002 $0.00000
MAGNESIUM SULFATE INJ 50% 79400010402020 $0.00000
MAGNESIUM SULFATE INJ 8% 79400010402004 $0.00000
MALATHION LOTION 0.5% 90900030004120 $2.05690
MANNITOL IV SOLN 10% 37400030002010 $0.00000
MANNITOL IV SOLN 15% 37400030002015 $0.02400
MANNITOL IV SOLN 20% 37400030002020 $0.00000
MANNITOL IV SOLN 25% 37400030002025 $0.00000
MANNITOL IV SOLN 5% 37400030002005 $0.00000
MAPROTILINE HCL TAB 25 MG 58300010100305 $0.00000
MAPROTILINE HCL TAB 50 MG 58300010100310 $0.00000
MAPROTILINE HCL TAB 75 MG 58300010100315 $0.00000
MEBENDAZOLE CHEW TAB 100 MG 15000010000505 $0.00000
MECLIZINE TAB 12.5 MG 50200050000305 $0.00000
MECLIZINE TAB 25 MG 50200050000310 $0.00000
MECLOFENAMATE SODIUM CAP 100 MG 66100040100110 $0.00000
MECLOFENAMATE SODIUM CAP 50 MG 66100040100105 $0.00000
MEDROXYPROGESTERONE ACETATE IM SUSP 150 MG/ML 25150035101820 $39.34160
MEDROXYPROGESTERONE ACETATE TAB 10 MG 26000020200315 $0.15000
MEDROXYPROGESTERONE ACETATE TAB 2.5 MG 26000020200305 $0.18000
MEDROXYPROGESTERONE ACETATE TAB 5 MG 26000020200310 $0.20000
MEFLOQUINE HCL TAB 250 MG 13000025100310 $8.00000
MEGESTROL ACETATE SUSP 40 MG/ML 21404020101810 $0.14000
MEGESTROL ACETATE TAB 20 MG 21404020100305 $0.30000
MEGESTROL ACETATE TAB 40 MG 21404020100310 $0.55000
MELOXICAM TAB 15 MG 66100052000330 $0.21000
MELOXICAM TAB 7.5 MG 66100052000320 $0.14500
MEPERIDINE HCL INJ 100 MG/ML 65100045102030 $0.95590
MEPERIDINE HCL INJ 50 MG/ML 65100045102015 $0.82090
MEPERIDINE HCL TAB 100 MG 65100045100310 $0.75000
MEPERIDINE HCL TAB 50 MG 65100045100305 $0.40000
MEPERIDINE W/ PROMETHAZINE CAP 50-25 MG 65993002200110 $0.30000
MEPROBAMATE TAB 200 MG 57200050000305 $0.00000
MEPROBAMATE TAB 400 MG 57200050000310 $0.00000
MERCAPTOPURINE TAB 50 MG 21300040000305 $1.37500
MESALAMINE ENEMA 4 GM 52500030005105 $0.14380
METAPROTERENOL SULFATE SOLN NEBU 0.4% 44201050202503 $0.00000
METAPROTERENOL SULFATE SOLN NEBU 0.6% 44201050202505 $0.00000
METAPROTERENOL SULFATE SYRUP 10 MG/5ML 44201050201205 $0.03000
METAPROTERENOL SULFATE TAB 10 MG 44201050200305 $0.00000
METFORMIN HCL TAB 1000 MG 27250050000350 $0.14500
METFORMIN HCL TAB 500 MG 27250050000320 $0.10500
METFORMIN HCL TAB 850 MG 27250050000340 $0.17500
METFORMIN HCL TAB SR 24HR 500 MG 27250050007520 $0.11980
METFORMIN HCL TAB SR 24HR 750 MG 27250050007530 $0.27830
METHADONE HCL CONC 10 MG/ML 65100050101310 $0.11280
METHADONE HCL TAB 10 MG 65100050100310 $0.09000
METHADONE HCL TAB 5 MG 65100050100305 $0.06000
METHAZOLAMIDE TAB 25 MG 37100030000303 $0.20000
METHAZOLAMIDE TAB 50 MG 37100030000305 $0.30000
METHENAMINE HIPPURATE TAB 1 GM 53000020200305 $1.22360
METHENAMINE MANDELATE TAB 0.5 GM 53000020100310 $0.00000
METHENAMINE MANDELATE TAB 1 GM 53000020100320 $0.00000
METHIMAZOLE TAB 10 MG 28300010000310 $0.34510
METHIMAZOLE TAB 5 MG 28300010000305 $0.33000
METHOCARBAMOL INJ 100 MG/ML 75100070002005 $0.00000
METHOCARBAMOL TAB 500 MG 75100070000305 $0.18000
METHOCARBAMOL TAB 750 MG 75100070000310 $0.16030
METHOTREXATE SODIUM INJ 25 MG/ML 21300050102030 $0.00000
METHOTREXATE SODIUM INJ PF 25 MG/ML 21300050102031 $1.27580
METHOTREXATE SODIUM TAB 2.5 MG (ANTIRHEUMATIC) 66250050100320 $0.00000
METHOTREXATE SODIUM TAB 2.5 MG (BASE EQUIV) 21300050100310 $0.22500
METHOTREXATE TAB 2.5 MG 21300050000305 $0.00000
METHOTREXATE TAB 2.5 MG 66250050000320 $0.00000
METHSCOPOLAMINE BROMIDE TAB 2.5 MG 49102060100305 $0.82820
METHSCOPOLAMINE BROMIDE TAB 5 MG 49102060100320 $1.50000
METHYCLOTHIAZIDE TAB 2.5 MG 37600055000305 $0.00000
METHYCLOTHIAZIDE TAB 5 MG 37600055000310 $0.00000
METHYLDOPA & HYDROCHLOROTHIAZIDE TAB 250-15 MG 36990002700310 $0.00000
METHYLDOPA & HYDROCHLOROTHIAZIDE TAB 250-15 MG 36995002700310 $0.00000
METHYLDOPA & HYDROCHLOROTHIAZIDE TAB 250-25 MG 36995002700320 $0.00000
METHYLDOPA & HYDROCHLOROTHIAZIDE TAB 250-25 MG 36990002700320 $0.00000
METHYLDOPA TAB 250 MG 36201030000310 $0.17000
METHYLDOPA TAB 500 MG 36201030000315 $0.26500
METHYLPHENIDATE HCL TAB 10 MG 61400020100310 $0.15500
METHYLPHENIDATE HCL TAB 20 MG 61400020100315 $0.29060
METHYLPHENIDATE HCL TAB 5 MG 61400020100305 $0.22000
METHYLPHENIDATE HCL TAB CR 10 MG 61400020100403 $0.63000
METHYLPHENIDATE HCL TAB CR 20 MG 61400020100405 $0.42680
METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJ 1000 MG 22100030202120 $0.00000
METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJ 125 MG 22100030202110 $0.00000
METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJ 40 MG 22100030202105 $0.00000
METHYLPREDNISOLONE SODIUM SUCCINATE FOR INJ 500 MG 22100030202115 $0.00000
METHYLPREDNISOLONE TAB 32 MG 22100030000330 $3.67090
METHYLPREDNISOLONE TAB 4 MG 22100030000310 $0.18500
METHYLPREDNISOLONE TAB 4 MG DOSE PACK 22100030006405 $0.19500
METHYLPREDNISOLONE TAB 8 MG 22100030000315 $1.57580
METIPRANOLOL OPHTH SOLN 0.3% 86250015102020 $1.80480
METOCLOPRAMIDE HCL INJ 5 MG/ML 52300020102005 $0.35000
METOCLOPRAMIDE HCL SOLN 5 MG/5ML (10 MG/10ML) 52300020102013 $0.01500
METOCLOPRAMIDE HCL SYRUP 5 MG/5ML 52300020101205 $0.00000
METOCLOPRAMIDE HCL TAB 10 MG 52300020100305 $0.10000
METOCLOPRAMIDE HCL TAB 5 MG 52300020100303 $0.10000
METOLAZONE TAB 10 MG 37600060000315 $1.15000
METOLAZONE TAB 2.5 MG 37600060000305 $0.64500
METOLAZONE TAB 5 MG 37600060000310 $1.00000
METOPROLOL & HYDROCHLOROTHIAZIDE TAB 100-25 MG 36992002200320 $1.36670
METOPROLOL SUCCINATE TAB SR 24HR 100 MG 33200030057530 $0.00000
METOPROLOL SUCCINATE TAB SR 24HR 200 MG 33200030057540 $0.00000
METOPROLOL SUCCINATE TAB SR 24HR 25 MG 33200030057510 $0.00000
METOPROLOL SUCCINATE TAB SR 24HR 50 MG 33200030057520 $0.00000
METOPROLOL TARTRATE INJ 1 MG/ML 33200030102005 $0.00000
METOPROLOL TARTRATE TAB 100 MG 33200030100315 $0.07000
METOPROLOL TARTRATE TAB 25 MG 33200030100305 $0.04720
METOPROLOL TARTRATE TAB 50 MG 33200030100310 $0.05000
METRONIDAZOLE CAP 375 MG 16000035000107 $3.16400
METRONIDAZOLE CREAM 0.75% 90060040003710 $0.64170
METRONIDAZOLE GEL 0.75% 90060040004010 $0.62190
METRONIDAZOLE IN NACL 0.79% IV SOLN 500 MG/100ML 16000035112020 $0.00000
METRONIDAZOLE LOTION 0.75% 90060040004110 $1.00000
METRONIDAZOLE TAB 250 MG 16000035000305 $0.07000
METRONIDAZOLE TAB 500 MG 16000035000310 $0.15000
METRONIDAZOLE VAGINAL GEL 0.75% 55100035004020 $0.40760
MEXILETINE HCL CAP 150 MG 35200025100105 $0.00000
MEXILETINE HCL CAP 200 MG 35200025100110 $0.00000
MEXILETINE HCL CAP 250 MG 35200025100115 $0.00000
MICONAZOLE NITRATE CREAM 2% 90154050103705 $0.10710
MICONAZOLE NITRATE POWDER 2% 90154050102910 $0.11200
MICONAZOLE NITRATE VAGINAL CREAM 2% 55104050103710 $0.15900
MIDODRINE HCL TAB 10 MG 38000083100340 $1.68360
MIDODRINE HCL TAB 2.5 MG 38000083100320 $0.80000
MIDODRINE HCL TAB 5 MG 38000083100330 $1.39790
MINOCYCLINE HCL CAP 100 MG 04000040100110 $0.62500
MINOCYCLINE HCL CAP 50 MG 04000040100105 $0.35500
MINOCYCLINE HCL CAP 75 MG 04000040100107 $0.44000
MINOCYCLINE HCL TAB 100 MG 04000040100310 $4.09000
MINOCYCLINE HCL TAB 50 MG 04000040100305 $2.48500
MINOCYCLINE HCL TAB 75 MG 04000040100307 $3.20500
MINOCYCLINE HCL TAB SR 24HR 45 MG 04000040107520 $15.63500
MINOXIDIL TAB 10 MG 36400020000310 $0.55000
MINOXIDIL TAB 2.5 MG 36400020000305 $0.29040
MIRTAZAPINE ORALLY DISINTEGRATING TAB 15 MG 58030050007215 $1.35000
MIRTAZAPINE ORALLY DISINTEGRATING TAB 30 MG 58030050007230 $1.94500
MIRTAZAPINE ORALLY DISINTEGRATING TAB 45 MG 58030050007245 $1.44000
MIRTAZAPINE TAB 15 MG 58030050000315 $0.39000
MIRTAZAPINE TAB 30 MG 58030050000330 $0.31000
MIRTAZAPINE TAB 45 MG 58030050000345 $0.58000
MIRTAZAPINE TAB 7.5 MG 58030050000308 $1.09000
MISOPROSTOL TAB 100 MCG 49250030000310 $0.50000
MISOPROSTOL TAB 200 MCG 49250030000320 $0.75000
MITOMYCIN FOR INJ 20 MG 21200050002110 $182.00000
MITOMYCIN FOR INJ 40 MG 21200050002120 $0.00000
MITOMYCIN FOR INJ 5 MG 21200050002105 $56.00000
MOEXIPRIL HCL TAB 15 MG 36100033100320 $0.85000
MOEXIPRIL HCL TAB 7.5 MG 36100033100310 $0.85000
MOEXIPRIL-HYDROCHLOROTHIAZIDE TAB 15-12.5 MG 36991802600316 $0.73590
MOEXIPRIL-HYDROCHLOROTHIAZIDE TAB 15-25 MG 36991802600320 $0.58000
MOEXIPRIL-HYDROCHLOROTHIAZIDE TAB 7.5-12.5 MG 36991802600310 $0.85000
MOMETASONE FUROATE CREAM 0.1% 90550082103710 $0.49540
MOMETASONE FUROATE OINT 0.1% 90550082104210 $0.75000
MOMETASONE FUROATE SOLUTION 0.1% (LOTION) 90550082102010 $0.65000
MORPHINE SULFATE INJ 1 MG/ML 65100055102003 $0.00000
MORPHINE SULFATE INJ 10 MG/ML 65100055102030 $2.50000
MORPHINE SULFATE INJ 15 MG/ML 65100055102040 $0.51000
MORPHINE SULFATE INJ 2 MG/ML 65100055102005 $0.00000
MORPHINE SULFATE INJ 25 MG/ML 65100055102045 $0.00000
MORPHINE SULFATE INJ PF 0.5 MG/ML 65100055102050 $0.55600
MORPHINE SULFATE INJ PF 1 MG/ML 65100055102054 $0.68000
MORPHINE SULFATE ORAL SOLN 10 MG/5ML 65100055102065 $0.00000
MORPHINE SULFATE ORAL SOLN 20 MG/5ML 65100055102070 $0.00000
MORPHINE SULFATE ORAL SOLN 20 MG/ML 65100055102090 $0.00000
MORPHINE SULFATE TAB 15 MG 65100055100310 $0.08000
MORPHINE SULFATE TAB 30 MG 65100055100315 $0.22000
MORPHINE SULFATE TAB SR 12HR 100 MG 65100055107460 $1.39930
MORPHINE SULFATE TAB SR 12HR 15 MG 65100055107415 $0.36180
MORPHINE SULFATE TAB SR 12HR 200 MG 65100055107480 $3.65900
MORPHINE SULFATE TAB SR 12HR 30 MG 65100055107430 $0.62000
MORPHINE SULFATE TAB SR 12HR 60 MG 65100055107445 $1.29340
MUPIROCIN OINT 2% 90100065104210 $0.99610
MYCOPHENOLATE MOFETIL CAP 250 MG 99403030100120 $0.71070
MYCOPHENOLATE MOFETIL TAB 500 MG 99403030100330 $1.42600

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