SOUTH DAKOTA MEDICAID MAC LIST
DRUGS THAT START WITH LETTER P


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GENERIC NAME GPI MAC
PANTOPRAZOLE SODIUM EC TAB 20 MG (BASE EQUIV) ************** $0.00000
PANTOPRAZOLE SODIUM EC TAB 20 MG (BASE EQUIV) 49270070100610 $2.94930
PANTOPRAZOLE SODIUM EC TAB 40 MG (BASE EQUIV) 49270070100620 $2.88130
PANTOPRAZOLE SODIUM EC TAB 40 MG (BASE EQUIV) ************** $0.00000
PANTOPRAZOLE SODIUM EC TAB 40 MG (BASE EQUIV) ************** $0.00000
PAPAVERINE HCL CAP CR 150 MG 40100060100205 $0.00000
PAPAVERINE HCL INJ 30 MG/ML 40100060102005 $0.93990
PAREGORIC 2 MG/5ML 47100040001510 $0.20000
PAROMOMYCIN SULFATE CAP 250 MG 07000055100110 $1.70000
PAROXETINE HCL ORAL SUSP 10 MG/5ML (BASE EQUIV) 58160060001820 $0.48500
PAROXETINE HCL TAB 10 MG 58160060000310 $0.38430
PAROXETINE HCL TAB 20 MG 58160060000320 $0.35910
PAROXETINE HCL TAB 30 MG 58160060000330 $0.47010
PAROXETINE HCL TAB 40 MG 58160060000340 $0.49150
PAROXETINE HCL TAB SR 24HR 12.5 MG 58160060007520 $2.55510
PAROXETINE HCL TAB SR 24HR 25 MG 58160060007530 $2.63950
PEDIATRIC MULTIPLE VITAMINS W/ FL & FE CHEW TAB 0.5-12 MG 78450000000520 $0.00000
PEDIATRIC MULTIPLE VITAMINS W/ FL & FE CHEW TAB 1-12 MG 78450000000530 $0.00000
PEDIATRIC MULTIPLE VITAMINS W/ FL & FE DROPS 0.25-10 MG/ML 78450000002008 $0.06000
PEDIATRIC MULTIPLE VITAMINS W/ FL & FE DROPS 0.5-10 MG/ML 78450000002018 $0.00000
PEDIATRIC MULTIPLE VITAMINS W/ FLUORIDE CHEW TAB 0.5 MG 78441000000510 $0.16500
PEDIATRIC MULTIPLE VITAMINS W/ FLUORIDE CHEW TAB 1 MG 78441000000520 $0.18870
PEDIATRIC MULTIPLE VITAMINS W/ FLUORIDE SOLN 0.25 MG/ML 78441000002005 $0.07000
PEDIATRIC MULTIPLE VITAMINS W/ FLUORIDE SOLN 0.5 MG/ML 78441000002010 $0.07000
PEDIATRIC MULTIPLE VITAMINS W/ FLUORIDE TAB 1 MG 78441000000320 $0.00000
PEDIATRIC VITAMINS ACD FLUORIDE & IRON DROPS 0.25-10 MG/ML 78452000002010 $0.07000
PEDIATRIC VITAMINS ACD W/ FLUORIDE CHEW TAB 1 MG 78440500000520 $0.00000
PEDIATRIC VITAMINS ACD W/ FLUORIDE SOLN 0.25 MG/ML 78440500002010 $0.05200
PEDIATRIC VITAMINS ACD W/ FLUORIDE SOLN 0.5 MG/ML 78440500002020 $0.06000
PEG 3350-KCL-NA BICARB-NACL-NA SULFATE FOR SOLN 240 46992005302140 $0.00000
PEG 3350-KCL-SOD BICARB-NACL FOR SOLN 420 GM 46992004302120 $0.00510
PEMOLINE CHEW TAB 37.5 MG 61400030000505 $0.00000
PEMOLINE TAB 18.75 MG 61400030000305 $0.00000
PEMOLINE TAB 37.5 MG 61400030000310 $0.00000
PEMOLINE TAB 75 MG 61400030000315 $0.00000
PENICILLIN G POTASSIUM FOR INJ 20 MU 01100010102135 $0.00000
PENICILLIN G POTASSIUM FOR INJ 5 MU 01100010102125 $0.00000
PENICILLIN G SODIUM FOR INJ 5000000 U 01100010202105 $0.00000
PENICILLIN V (BASE) FOR SOLN 125 MG/5ML 01100040002105 $0.00000
PENICILLIN V (BASE) FOR SOLN 250 MG/5ML 01100040002110 $0.00000
PENICILLIN V POTASSIUM FOR SOLN 125 MG/5ML 01100040102105 $0.00000
PENICILLIN V POTASSIUM FOR SOLN 250 MG/5ML 01100040102110 $0.00000
PENICILLIN V POTASSIUM TAB 250 MG 01100040100310 $0.11500
PENICILLIN V POTASSIUM TAB 500 MG 01100040100315 $0.19500
PENTAZOCINE W/ NALOXONE TAB 50-0.5 MG 65200040300310 $0.00000
PENTOXIFYLLINE TAB CR 400 MG 85200010000410 $0.15000
PERINDOPRIL ERBUMINE TAB 2 MG 36100035100310 $0.55820
PERINDOPRIL ERBUMINE TAB 4 MG 36100035100320 $0.59010
PERINDOPRIL ERBUMINE TAB 8 MG 36100035100330 $0.71690
PERMETHRIN CREAM 5% 90900035003720 $0.17670
PERMETHRIN CREME RINSE 1% 90900035000910 $0.04200
PERMETHRIN LOTION 1% 90900035004110 $0.12800
PERPHENAZINE TAB 16 MG 59200045000320 $1.17050
PERPHENAZINE TAB 2 MG 59200045000305 $0.57720
PERPHENAZINE TAB 4 MG 59200045000310 $0.77710
PERPHENAZINE TAB 8 MG 59200045000315 $0.94290
PERPHENAZINE W/ AMITRIPTYLINE TAB 2-10 MG 62990002200310 $0.00000
PERPHENAZINE W/ AMITRIPTYLINE TAB 2-25 MG 62990002200315 $0.00000
PERPHENAZINE W/ AMITRIPTYLINE TAB 4-10 MG 62990002200320 $0.00000
PERPHENAZINE W/ AMITRIPTYLINE TAB 4-25 MG 62990002200325 $0.00000
PERPHENAZINE W/ AMITRIPTYLINE TAB 4-50 MG 62990002200330 $0.00000
PHENAZOPYRIDINE HCL TAB 100 MG 56300010100305 $0.10000
PHENAZOPYRIDINE HCL TAB 200 MG 56300010100310 $0.20000
PHENDIMETRAZINE TARTRATE CAP 35 MG 61200050100105 $0.00000
PHENDIMETRAZINE TARTRATE CAP CR 105 MG 61200050100205 $0.00000
PHENDIMETRAZINE TARTRATE CAP SR 24HR 105 MG 61200050107010 $0.64000
PHENDIMETRAZINE TARTRATE TAB 35 MG 61200050100305 $0.16000
PHENOBARBITAL & BELLADONNA ALK ELIXIR 16 MG/5ML 49109902251010 $0.00000
PHENOBARBITAL & BELLADONNA ALK TAB 15 MG 49109902250308 $0.00000
PHENOBARBITAL & BELLADONNA ALK TAB 16.2 MG 49109902250312 $0.08910
PHENOBARBITAL ELIXIR 20 MG/5ML 60100060001010 $0.01500
PHENOBARBITAL TAB 100 MG 60100060000325 $0.03500
PHENOBARBITAL TAB 15 MG 60100060000305 $0.01500
PHENOBARBITAL TAB 16.2 MG 60100060000308 $0.02000
PHENOBARBITAL TAB 30 MG 60100060000315 $0.00000
PHENOBARBITAL TAB 32.4 MG 60100060000317 $0.02000
PHENOBARBITAL TAB 60 MG 60100060000320 $0.02860
PHENOBARBITAL TAB 64.8 MG 60100060000322 $0.00000
PHENOBARBITAL TAB 97.2 MG 60100060000324 $0.00000
PHENTERMINE HCL CAP 15 MG 61200070100110 $0.82080
PHENTERMINE HCL CAP 30 MG 61200070100115 $0.45000
PHENTERMINE HCL CAP 37.5 MG 61200070100120 $0.46000
PHENTERMINE HCL CAP CR 30 MG 61200070100210 $0.00000
PHENTERMINE HCL CAP CR 37.5 MG 61200070100220 $0.00000
PHENTERMINE HCL TAB 37.5 MG 61200070100310 $0.37900
PHENYLEPH-CHLORPHEN W/ HYDROCODONE SYRUP 5-2-2.5 MG/ 43995303501205 $0.02500
PHENYLEPH-CHLORPHEN W/ HYDROCODONE SYRUP 7.5-2-2 MG/5ML 43995303501250 $0.00000
PHENYLEPH-PYRILAMINE W/ HYDROCODONE SYRUP 5-8.33-1.6 43995303521210 $0.02000
PHENYLEPHRINE HCL TAB 10 MG 42101040100310 $0.12100
PHENYLEPHRINE-BROMPHENIRAMINE-DM ELIXIR 2.5-1-5 MG/5 43995803081020 $0.02590
PHENYLEPHRINE-CHLORPHEN-DIHYDROCODEINE SYRUP 7.5-2-3 MG/5ML 43995303131220 $0.00000
PHENYLEPHRINE-CHLORPHEN-DM LIQUID 3.5-1-3 MG/ML 43995803120960 $0.46000
PHENYLEPHRINE-CHLORPHEN-DM SYRUP 12.5-4-15 MG/5ML 43995803121250 $0.03680
PHENYLEPHRINE-DEXBROMPHEN-HYDROCODONE SYRUP 5-1-2.5 43995303851230 $0.28500
PHENYLEPHRINE-GG TAB CR 40-600 MG 43996202100420 $0.00000
PHENYLEPHRINE-GG TAB CR 40-600 MG 43996202107480 $0.00000
PHENYLEPHRINE-GG TAB SR 12HR 30-600 MG 43996202107440 $0.00000
PHENYLEPHRINE-GUAIFENESIN CAP SR 12HR 30-400 MG 43996202106960 $0.00000
PHENYLEPHRINE-GUAIFENESIN SYRUP 7.5-100 MG/5ML 43996202101230 $0.08500
PHENYLEPHRINE-GUAIFENESIN TAB 10-400 MG 43996202100320 $0.16600
PHENYLEPHRINE-GUAIFENESIN TAB SR 12HR 20-600 MG 43996202107430 $0.00000
PHENYLEPHRINE-GUAIFENESIN TAB SR 12HR 25-800 MG 43996202107437 $0.00000
PHENYLEPHRINE-GUAIFENESIN TAB SR 12HR 40-1200 MG 43996202107485 $0.00000
PHENYLEPHRINE-PROMETHAZINE W/ CODEINE SYRUP 5-6.25-10 MG/5ML 43995303101210 $0.08500
PHENYTOIN SODIUM EXTENDED CAP 100 MG 72200030200110 $0.19810
PHENYTOIN SUSP 125 MG/5ML 72200030001810 $0.07500
PHYTONADIONE INJ 10 MG/ML 77204030002010 $0.00000
PILOCARPINE HCL OPHTH SOLN 0.5% 86501030102010 $0.00000
PILOCARPINE HCL OPHTH SOLN 3% 86501030102025 $0.00000
PILOCARPINE HCL OPHTH SOLN 6% 86501030102040 $0.53000
PILOCARPINE HCL OPTH SOLN 1% 86501030102015 $0.19000
PILOCARPINE HCL OPTH SOLN 2% 86501030102020 $0.25000
PILOCARPINE HCL OPTH SOLN 4% 86501030102030 $0.35000
PILOCARPINE HCL TAB 5 MG 88501560100310 $0.42000
PINDOLOL TAB 10 MG 33100030000310 $0.00000
PINDOLOL TAB 5 MG 33100030000305 $0.00000
PIROXICAM CAP 10 MG 66100070000105 $0.12500
PIROXICAM CAP 20 MG 66100070000110 $0.13500
PODOFILOX SOLN 0.5% 90750015002020 $20.00000
POLYETHYLENE GLYCOL 3350 ORAL PACKET 46600033003020 $1.29910
POLYETHYLENE GLYCOL 3350 ORAL POWDER 46600033002910 $0.03600
POLYVINYL ALCOHOL OPHTH SOLN 1.4% 86200050002030 $0.17350
POT BICARBONATE & CHLORIDE POWD PACK 20 MEQ 79709902103030 $0.00000
POTASSIUM BICARBONATE EFFER TAB 25 MEQ 79700020000810 $0.20000
POTASSIUM CHLORIDE 0.15% IN D5W LACTATED RINGERS 79993003252010 $0.00000
POTASSIUM CHLORIDE CAP CR 10 MEQ 79700030000210 $0.00000
POTASSIUM CHLORIDE INJ 1.5 MEQ/ML 79700030002003 $0.00000
POTASSIUM CHLORIDE INJ 2 MEQ/ML 79700030002005 $0.10000
POTASSIUM CHLORIDE MICROENCAPSULATED CRYS CR TAB 10 79700030100430 $0.12930
POTASSIUM CHLORIDE MICROENCAPSULATED CRYS CR TAB 20 79700030100440 $0.16630
POTASSIUM CHLORIDE ORAL LIQ 10% 79700030000910 $0.00600
POTASSIUM CHLORIDE ORAL LIQ 20% 79700030000920 $0.00900
POTASSIUM CHLORIDE POWDER PACKET 20 MEQ 79700030003015 $0.12000
POTASSIUM CHLORIDE TAB CR 10 MEQ 79700030000430 $0.17160
POTASSIUM CHLORIDE TAB CR 8 MEQ 79700030000420 $0.08540
POTASSIUM CITRATE TAB CR 1080 MG (10 MEQ) 56202010200440 $0.26690
POTASSIUM CITRATE TAB CR 540 MG (5 MEQ) 56202010200420 $0.21000
POTASSIUM PHOSPHATE DIBASIC INJ 3 MMOLE/ML 79600010012005 $0.08800
PRAVASTATIN SODIUM TAB 10 MG 39400065100320 $0.49000
PRAVASTATIN SODIUM TAB 20 MG 39400065100330 $0.38500
PRAVASTATIN SODIUM TAB 40 MG 39400065100340 $0.50500
PRAVASTATIN SODIUM TAB 80 MG 39400065100360 $0.78090
PRAZOSIN HCL CAP 1 MG 36202030100105 $0.16000
PRAZOSIN HCL CAP 2 MG 36202030100110 $0.27000
PRAZOSIN HCL CAP 5 MG 36202030100115 $0.42000
PREDNICARBATE CREAM 0.1% 90550083003710 $0.00000
PREDNISOLONE ACETATE INJ SUSP 25 MG/ML 22100040101805 $0.00000
PREDNISOLONE ACETATE INJ SUSP 50 MG/ML 22100040101810 $0.00000
PREDNISOLONE ACETATE OPTH SUSP 1% 86300050101815 $1.40000
PREDNISOLONE SOD PHOSPHATE LIQ 6.7 MG/5ML (5MG/5ML B 22100040200910 $0.00000
PREDNISOLONE SOD PHOSPHATE ORAL SOLN 15 MG/5ML (BASE 22100040202020 $0.10980
PREDNISOLONE SOD PHOSPHATE ORAL SOLN 5 MG/5ML (BASE 22100040202040 $0.14000
PREDNISOLONE SODIUM PHOSPHATE OPHTH SOLN 1% 86300050202015 $0.00000
PREDNISOLONE SODIUM PHOSPHATE OPTH SOLN 0.125% 86300050202005 $0.00000
PREDNISOLONE SYRUP 15 MG/5ML 22100040001205 $0.08500
PREDNISOLONE SYRUP 5 MG/5ML 22100040001203 $0.11000
PREDNISOLONE TAB 5 MG 22100040000305 $0.00000
PREDNISONE TAB 1 MG 22100045000305 $0.11580
PREDNISONE TAB 10 MG 22100045000320 $0.05500
PREDNISONE TAB 10 MG DOSE PACK 22100045006410 $0.25500
PREDNISONE TAB 2.5 MG 22100045000310 $0.04500
PREDNISONE TAB 20 MG 22100045000325 $0.08000
PREDNISONE TAB 5 MG 22100045000315 $0.00000
PREDNISONE TAB 5 MG DOSE PACK 22100045006405 $0.14500
PREDNISONE TAB 50 MG 22100045000335 $0.00000
PRENATAL MULTIVITAMINS & MINERALS W/ IRON & FA TAB 1 MG 78512000000320 $0.00000
PRIMIDONE TAB 250 MG 72600060000310 $0.59520
PRIMIDONE TAB 50 MG 72600060000305 $0.23000
PROBENECID TAB 500 MG 68100010000310 $0.54000
PROCAINAMIDE HCL CAP 250 MG 35100020100105 $0.00000
PROCAINAMIDE HCL CAP 375 MG 35100020100110 $0.00000
PROCAINAMIDE HCL CAP 500 MG 35100020100115 $0.00000
PROCAINAMIDE HCL TAB CR 500 MG 35100020100410 $0.00000
PROCHLORPERAZINE MALEATE TAB 10 MG 59200055100310 $0.08640
PROCHLORPERAZINE MALEATE TAB 5 MG 59200055100305 $0.22500
PROCHLORPERAZINE SUPPOS 25 MG 59200055005215 $1.61000
PROGESTERONE IM IN OIL 50 MG/ML 26000040001705 $2.52000
PROMETHAZINE & PHENYLEPHRINE SYRUP 6.25-5 MG/5ML 43993002701210 $0.06000
PROMETHAZINE HCL INJ 25 MG/ML 41400020102005 $1.28810
PROMETHAZINE HCL INJ 50 MG/ML 41400020102010 $1.89240
PROMETHAZINE HCL SUPPOS 12.5 MG 41400020105205 $0.75000
PROMETHAZINE HCL SUPPOS 25 MG 41400020105210 $1.10000
PROMETHAZINE HCL SUPPOS 50 MG 41400020105215 $0.00000
PROMETHAZINE HCL SYRUP 6.25 MG/5ML 41400020101210 $0.03500
PROMETHAZINE HCL TAB 12.5 MG 41400020100305 $0.31340
PROMETHAZINE HCL TAB 25 MG 41400020100310 $0.22220
PROMETHAZINE HCL TAB 50 MG 41400020100315 $0.55000
PROMETHAZINE W/ CODEINE SYRUP 6.25-10 MG/5ML 43995202341210 $0.01890
PROMETHAZINE-DM SYRUP 6.25-15 MG/5ML 43995702301210 $0.02000
PROPAFENONE HCL TAB 150 MG 35300050000320 $0.51500
PROPAFENONE HCL TAB 225 MG 35300050000325 $0.64500
PROPAFENONE HCL TAB 300 MG 35300050000330 $1.68000
PROPARACAINE HCL OPTH SOLN 0.5% 86750020102005 $0.43100
PROPOXYPHENE COMPOUND CAP 65 MG 65992002100110 $0.00000
PROPOXYPHENE HCL CAP 65 MG 65100085100110 $0.25000
PROPOXYPHENE W/ APAP TAB 65-650 MG 65992002200320 $0.15000
PROPOXYPHENE-N W/ APAP TAB 100-500 MG 65992002400317 $1.36430
PROPOXYPHENE-N W/ APAP TAB 100-650 MG 65992002400320 $0.18670
PROPOXYPHENE-N W/ APAP TAB 50-325 MG 65992002400310 $0.45000
PROPRANOLOL & HYDROCHLOROTHIAZIDE TAB 40-25 MG 36992002400310 $0.16000
PROPRANOLOL & HYDROCHLOROTHIAZIDE TAB 80-25 MG 36992002400320 $0.00000
PROPRANOLOL HCL CAP SR 24HR 120 MG 33100040107035 $1.20500
PROPRANOLOL HCL CAP SR 24HR 160 MG 33100040107040 $1.58500
PROPRANOLOL HCL CAP SR 24HR 60 MG 33100040107025 $0.84000
PROPRANOLOL HCL CAP SR 24HR 80 MG 33100040107030 $1.00000
PROPRANOLOL HCL TAB 10 MG 33100040100305 $0.04000
PROPRANOLOL HCL TAB 20 MG 33100040100310 $0.04000
PROPRANOLOL HCL TAB 40 MG 33100040100315 $0.08500
PROPRANOLOL HCL TAB 60 MG 33100040100320 $0.89000
PROPRANOLOL HCL TAB 80 MG 33100040100325 $0.11000
PROPRANOLOL HCL TAB 90 MG 33100040100330 $0.00000
PROPYLTHIOURACIL TAB 50 MG 28300020000310 $0.10000
PROTRIPTYLINE HCL TAB 10 MG 58200070100310 $2.18160
PROTRIPTYLINE HCL TAB 5 MG 58200070100305 $1.52680
PSEUDOEPHED TAN-DEXCHLORPHEN TAN-DM TAN SUS 75-2.5-2 43995803331830 $0.00000
PSEUDOEPHED-BROMPHEN-DM LIQUID 12.5-1-3 MG/ML 43995803320915 $0.67370
PSEUDOEPHED-BROMPHEN-DM SYRUP 30-2-10 MG/5ML 43995803321210 $0.22180
PSEUDOEPHED-BROMPHEN-DM SYRUP 45-4-15 MG/5ML 43995803321230 $0.10000
PSEUDOEPHED-CARBINOXAMINE-DM SOLN 25-2-4 MG/ML 43995803342010 $0.00000
PSEUDOEPHED-CHLORPHEN-DIHYDROCODEINE SYRUP 15-2-7.5 MG/5ML 43995303551220 $0.00000
PSEUDOEPHEDRINE W/ COD-GG SOLN 30-10-100 MG/5ML 43997303302010 $0.00000
PSEUDOEPHEDRINE-CHLORPHEN W/ CODEINE LIQ 30-2-10 MG/ 43995303200910 $0.00000
PSEUDOEPHEDRINE-GG CAP CR 120-250 MG 43996202300220 $0.00000
PSEUDOEPHEDRINE-GG CAP CR 60-300 MG 43996202300210 $0.00000
PSEUDOEPHEDRINE-GG TAB SR 12HR 120-1200 MG 43996202307492 $0.00000
PSEUDOEPHEDRINE-GG TAB SR 12HR 120-600 MG 43996202307480 $0.25000
PSEUDOEPHEDRINE-GG TAB SR 12HR 45-600 MG 43996202307410 $0.00000
PSEUDOEPHEDRINE-GG TAB SR 12HR 60-1200 MG 43996202307447 $0.00000
PSEUDOEPHEDRINE-GG TAB SR 12HR 60-600 MG 43996202307435 $0.00000
PSEUDOEPHEDRINE-GG TAB SR 12HR 80-800 MG 43996202307452 $0.00000
PSEUDOEPHEDRINE-GUAIFENESIN CAP SR 12HR 120-400 MG 43996202306970 $0.92500
PSEUDOEPHEDRINE-TRIPROLIDINE W/ COD SYRUP 30-1.25-10 MG/5ML 43995303221210 $0.00000
PYRAZINAMIDE TAB 500 MG 09000070000310 $0.00000
PYRIDOSTIGMINE BROMIDE TAB 60 MG 76000050100305 $0.30500

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