A19-J.7-PWS TECHNICAL EXHIBIT 3A- CY2023 PHARMACY TRANSACTIONS FOR THE DCMWC PROGRAM (1).xlsx
XLSX spreadsheet 5 MB Posted
- Attached to
- PHARMACY BENEFITS MANAGEMENT SERVICES (PBM) Federal contract opportunity
- Solicitation number
- 1605C3-24-R-00011
About this file
This document is a Request for Proposals (RFP) for Pharmacy Benefits Management (PBM) Services on behalf of the U.S. Department of Labor (DOL), Office of Workers' Compensation Programs (OWCP). The Government anticipates a single award fixed priced contract. Questions about the RFP must be submitted by October 21, 2024, and responses will be provided as an amendment. The due date for proposals will be provided in a later amendment. The RFP seeks a contractor to provide PBM services, including processing pharmacy claims and managing a network of pharmacies. No additional details about the required services or performance objectives are provided, as this appears to be just the cover page and not the full Performance Work Statement or Statement of Objectives.
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Text version
DCMWC RX Transactions
| TCN_REDACTED | LINE_ITEM_CODE | CASE_REDACTED | AGE_GROUP | DATE_OF_SERVICE | NDC | NDC_DESCRIPTION | C_DAW_CD | Drug Quantity | Days' Supply | DISPENSE_PHARMACY_NPI | PHARMACY_NABP | PRESCRIBER_ID | CLAIMANT_STATE_CD | CLAIMANT_ZIP_CD | COMPOUND_IND |
| f8209cf3-7f27-452e-98c9-3edb175c8936 | 01 | 8c7b42b1-c502-4327-847b-8027366f5fe7 | >= 65 | 2023-01-01 | 00054001925 | Prednisone Tab 50 MG | 0 | 5 | 5 | 1144319807 | 3970678 | 1588624035 | PA | 15650 | 1 |
| 1078f9bf-105c-427e-8217-61bf92095d8a | 01 | a5598059-f8e6-4694-90f1-2a6fc46c4b6b | >= 65 | 2023-01-02 | 69097014260 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 20.1 | 30 | 1265530976 | 3961287 | 1356742084 | PA | 17901 | 1 |
| fab47127-32e5-4a50-b634-7c6b2e851389 | 01 | 79f8b36c-1e4b-42b1-8e58-1d798ea4999b | >= 65 | 2023-01-01 | 69315011710 | Furosemide Tab 40 MG | 0 | 180 | 90 | 1497853139 | 3938810 | 1902284821 | PA | 17941 | 1 |
| b6b9893c-0872-4eee-8238-8d4a985457bd | 01 | 79f8b36c-1e4b-42b1-8e58-1d798ea4999b | >= 65 | 2023-01-02 | 00245531911 | Potassium Chloride Microencapsulated Crys ER Tab 20 mEq | 0 | 90 | 90 | 1497853139 | 3938810 | 1902284821 | PA | 17941 | 1 |
| a977f981-a106-4489-b1f2-77b453eee11c | 01 | a5299281-a041-4782-93e4-b2fd3a38f424 | >= 65 | 2023-01-02 | 00245531711 | Potassium Chloride Microencapsulated Crys ER Tab 10 mEq | 0 | 30 | 30 | 1861595621 | 3965639 | 1851348189 | PA | 15320 | 1 |
| 5318f20d-982c-4e7f-8a1a-f6fd37ffb4aa | 01 | 5d92e895-f037-4f5a-b116-fc1c2b54543d | >= 65 | 2023-01-01 | 59746017310 | Prednisone Tab 10 MG | 0 | 21 | 9 | 1750467239 | 3927576 | 1376773754 | PA | 15370 | 1 |
| 069e4f47-90b1-4bb7-81f5-4a6b291600a1 | 01 | 5d92e895-f037-4f5a-b116-fc1c2b54543d | >= 65 | 2023-01-01 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 17 | 1750467239 | 3927576 | 1376773754 | PA | 15370 | 1 |
| dde3a11e-06b7-4361-9066-781d2eb866a5 | 01 | 5d92e895-f037-4f5a-b116-fc1c2b54543d | >= 65 | 2023-01-01 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1750467239 | 3927576 | 1376773754 | PA | 15370 | 1 |
| 7e3f82e6-239e-4554-b431-ab244a6e652c | 01 | 5d92e895-f037-4f5a-b116-fc1c2b54543d | >= 65 | 2023-01-01 | 67877019905 | Amlodipine Besylate Tab 10 MG (Base Equivalent) | 0 | 30 | 30 | 1750467239 | 3927576 | 1790765352 | PA | 15370 | 1 |
| be123f89-c8ca-4355-b811-9aa5684daddc | 01 | c39f8d3e-8e5e-46f2-9c34-7c0547a52cff | >= 65 | 2023-01-02 | 59746017310 | Prednisone Tab 10 MG | 0 | 50 | 20 | 1003800657 | 3957391 | 1861474371 | PA | 17830 | 1 |
| f9d4ed0b-4f5c-4223-9030-224402ae49c4 | 01 | 242256c1-d964-44ba-b4b5-e9c2e5e45f04 | >= 65 | 2023-01-02 | 43547040211 | Furosemide Tab 40 MG | 0 | 30 | 30 | 1649204025 | 4808006 | 1386689230 | VA | 24282 | 1 |
| a9705b72-8eaf-4172-8600-a9e7a4e9ec2e | 01 | 242256c1-d964-44ba-b4b5-e9c2e5e45f04 | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 25 | 1649204025 | 4808006 | 1386689230 | VA | 24282 | 1 |
| 8f659fcd-3864-4585-87fa-4450acd68853 | 01 | 242256c1-d964-44ba-b4b5-e9c2e5e45f04 | >= 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1649204025 | 4808006 | 1386689230 | VA | 24282 | 1 |
| 093b6c08-6530-44f7-9d9a-ecea2fed17d2 | 01 | a7e2a2f3-8e5a-4b93-881e-6638757b9ded | < 65 | 2023-01-01 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 1 | 60 | 30 | 1063515542 | 3420104 | 1760872808 | NC | 28659 | 1 |
| d3826457-ecbb-4c98-b103-2245dfc0b93a | 01 | f808539b-c590-4c6b-9644-2c78f1be0b2f | >= 65 | 2023-01-02 | 00781261305 | Amoxicillin (Trihydrate) Cap 500 MG | 0 | 28 | 7 | 1366541229 | 4819984 | 1477559474 | VA | 24614 | 1 |
| 6760e1f9-65cd-4e63-8bd2-a80b4e93ffe0 | 01 | 47b31a80-3d6b-47c9-b543-657c521e5380 | >= 65 | 2023-01-01 | 00173087610 | Fluticasone Furoate Aerosol Powder Breath Activ 200 MCG/ACT | 0 | 30 | 30 | 1891854949 | 4214057 | 1780182253 | SC | 29047 | 1 |
| 80ea899e-a503-4d8c-80a1-5f492d08d0c3 | 01 | c2d362ac-eb72-49b3-9c26-c9f59cfea537 | < 65 | 2023-01-02 | 00597015561 | Tiotropium Br-Olodaterol Inhal Aero Soln 2.5-2.5 MCG/ACT | 0 | 4 | 30 | 1255381265 | 4839253 | BD9031066 | VA | 24279 | 1 |
| ad8c5997-2306-4598-9ab1-4d6b24da9567 | 01 | 8d78347d-808a-4adf-acc3-bc0dd07d8daa | >= 65 | 2023-01-02 | 45802081184 | Naloxone HCl Nasal Spray 4 MG/0.1ML | 0 | 2 | 1 | 1992942841 | 4841436 | 1831160530 | VA | 24243 | 1 |
| cce9be97-f5f3-428f-98b6-a72fe2bd3db2 | 01 | 023303be-65d4-4658-be56-114f79bf01d7 | >= 65 | 2023-01-02 | 00143980305 | Doxycycline Hyclate Cap 100 MG | 0 | 20 | 10 | 1992705339 | 4828539 | 1548225808 | VA | 24609 | 1 |
| fd9dde6f-3fd2-4456-8203-a4db3e2dac2f | 01 | 023303be-65d4-4658-be56-114f79bf01d7 | >= 65 | 2023-01-02 | 59746017106 | Prednisone Tab 1 MG | 0 | 150 | 30 | 1992705339 | 4828539 | 1548225808 | VA | 24609 | 1 |
| 941d91c1-84b9-4989-bcd9-ac6afb05af71 | 01 | f61780bf-ec47-4f5b-8aff-27f47ee6e63f | >= 65 | 2023-01-02 | 00597002402 | Ipratropium-Albuterol Inhal Aerosol Soln 20-100 MCG/ACT | 0 | 12 | 60 | 1992942841 | 4841436 | 1205861333 | VA | 24219 | 1 |
| 614d9933-3127-4820-b663-a926e77ff0fa | 01 | 92dd8290-04d0-474a-b6d6-99eb1a4427fd | >= 65 | 2023-01-01 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 25 | 1699792895 | 4824199 | 1861770380 | VA | 24273 | 1 |
| bd99ce03-cf24-42f8-ab17-0d667c78e218 | 01 | 92dd8290-04d0-474a-b6d6-99eb1a4427fd | >= 65 | 2023-01-01 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1699792895 | 4824199 | 1205861333 | VA | 24273 | 1 |
| fa0b815b-e64a-45d6-8144-04287761fedb | 01 | d37434fd-10c2-47ad-a019-836b12b7fabe | >= 65 | 2023-01-02 | 72578000118 | Doxycycline Hyclate Tab 100 MG | 0 | 20 | 10 | 1063446854 | 5011248 | 1699725168 | WV | 25208 | 1 |
| 237d2211-49ae-4025-878e-662340f01804 | 01 | d37434fd-10c2-47ad-a019-836b12b7fabe | >= 65 | 2023-01-02 | 68180071160 | Cefdinir Cap 300 MG | 0 | 20 | 10 | 1063446854 | 5011248 | 1699725168 | WV | 25208 | 1 |
| e6e8fc66-3165-45ea-997f-5bda92605c1a | 01 | d37434fd-10c2-47ad-a019-836b12b7fabe | >= 65 | 2023-01-02 | 70954006020 | Prednisone Tab 20 MG | 0 | 10 | 5 | 1063446854 | 5011248 | 1699725168 | WV | 25208 | 1 |
| bfb2dd4f-fd3c-47bb-89c6-fff6e1d69b2b | 01 | 1cd76072-453e-4417-9274-32ec6d16ba3d | >= 65 | 2023-01-01 | 52244040010 | Theophylline Cap ER 24HR 400 MG | 0 | 30 | 30 | 1164449492 | 1826518 | 1740233402 | WV | 25682 | 1 |
| 9f9a75e3-5d3f-46d4-afad-376672cf50b8 | 01 | ce81031c-ce7b-420a-864a-77a69a3344cb | >= 65 | 2023-01-02 | 00173089310 | Fluticasone-Umeclidinium-Vilanterol AEPB 200-62.5-25 MCG/ACT | 8 | 60 | 30 | 1801956701 | 5006401 | 1750363685 | WV | 25651 | 1 |
| d815bb47-30b0-4309-883f-058acff5dcdb | 01 | ce81031c-ce7b-420a-864a-77a69a3344cb | >= 65 | 2023-01-02 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 25 | 1801956701 | 5006401 | 1750363685 | WV | 25651 | 1 |
| 4cc0e08d-af01-47d4-84d4-bc7e492eb497 | 01 | e57757ef-e6f0-47d4-be3e-cdb7dd482e08 | >= 65 | 2023-01-02 | 00310737220 | Budesonide-Formoterol Fumarate Dihyd Aerosol 80-4.5 MCG/ACT | 0 | 10.2 | 30 | 1720182496 | 3436690 | 1811135379 | VA | 24630 | 1 |
| e8bf660c-7c5e-436b-aa83-fbbd3d05ab8a | 01 | 35e94681-b99f-4a75-acd3-c269900d692d | >= 65 | 2023-01-02 | 53746051501 | Spironolactone Tab 100 MG | 0 | 90 | 90 | 1194828830 | 1813220 | 1528001633 | WV | 25682 | 1 |
| ec1767d9-9f3a-4b81-926a-880d15521153 | 01 | a02b683a-3b15-4be4-b383-6a6a92049a4f | >= 65 | 2023-01-02 | 53746052101 | Promethazine HCl Tab 25 MG | 0 | 120 | 30 | 1275636631 | 5007275 | 1396766051 | WV | 25827 | 1 |
| 3207f51d-0932-4f89-9a69-f178bb4d87b6 | 01 | d3b92ee8-4aef-4b04-b0ed-f5a2adce8606 | >= 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 180 | 90 | 1194828830 | 1813220 | 1770605891 | WV | 25670 | 1 |
| 41e88898-6144-4789-8840-a05fe5043344 | 01 | c7f0698c-f6a8-4de8-aa3e-d095aa7e39ec | >= 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1336326792 | 5054630 | 1265400865 | WV | 248440625 | 1 |
| fadfea55-35d1-4d03-ae17-885d6164a59d | 01 | c7f0698c-f6a8-4de8-aa3e-d095aa7e39ec | >= 65 | 2023-01-02 | 00173068220 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 30 | 1336326792 | 5054630 | 1265400865 | WV | 248440625 | 1 |
| 02ba8ce3-089f-4c7b-9002-e1c8d5d905de | 01 | 73a7e076-68d7-4642-a7b1-82f1601652ac | >= 65 | 2023-01-02 | 59310030480 | Beclomethasone Diprop HFA Breath Act Inh Aer 80 MCG/ACT | 0 | 10.6 | 30 | 1619050754 | 5009255 | 1164486486 | WV | 25801 | 1 |
| 256279fc-e29f-456d-8d02-e3cf42ad5ca0 | 01 | 73a7e076-68d7-4642-a7b1-82f1601652ac | >= 65 | 2023-01-02 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1619050754 | 5009255 | 1164486486 | WV | 25801 | 1 |
| ca2e9a18-0c8d-4f4d-b7c9-22c956337ae3 | 01 | 73a7e076-68d7-4642-a7b1-82f1601652ac | >= 65 | 2023-01-02 | 66993058697 | Fluticasone-Salmeterol Aer Powder BA 500-50 MCG/ACT | 0 | 60 | 30 | 1619050754 | 5009255 | 1164486486 | WV | 25801 | 1 |
| 928f93e4-1f1b-4201-8469-1fab5ec39757 | 01 | 73a7e076-68d7-4642-a7b1-82f1601652ac | >= 65 | 2023-01-02 | 16729011917 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1619050754 | 5009255 | 1437429362 | WV | 25801 | 1 |
| 17dca102-6129-41f0-97d5-83d30f777723 | 01 | 73a7e076-68d7-4642-a7b1-82f1601652ac | >= 65 | 2023-01-02 | 62332002531 | Theophylline Tab ER 12HR 300 MG | 0 | 60 | 30 | 1619050754 | 5009255 | 1164486486 | WV | 25801 | 1 |
| 79e93e93-7a67-4da9-88e6-a0ef6c9e3e20 | 01 | a2fbd780-a310-43f6-ad9d-6fc4898aabf7 | >= 65 | 2023-01-02 | 00597007541 | Tiotropium Bromide Monohydrate Inhal Cap 18 MCG (Base Equiv) | 0 | 30 | 30 | 1972523629 | 5012113 | 1619082690 | WV | 24724 | 1 |
| 6a3c518b-fcfc-4d01-a27e-0663ad709516 | 01 | a2fbd780-a310-43f6-ad9d-6fc4898aabf7 | >= 65 | 2023-01-02 | 00378967160 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 360 | 30 | 1972523629 | 5012113 | 1750834644 | WV | 24724 | 1 |
| fee641ac-b4d0-433d-a5d2-205de58be560 | 01 | ceb15fef-0bfc-4d25-9cce-1afb001dd2f2 | < 65 | 2023-01-02 | 70954006020 | Prednisone Tab 20 MG | 0 | 10 | 5 | 1063446854 | 5011248 | 1699725168 | WV | 25565 | 1 |
| dd163f64-d65d-47b7-a367-5854f8d94cd7 | 01 | ceb15fef-0bfc-4d25-9cce-1afb001dd2f2 | < 65 | 2023-01-02 | 72578000118 | Doxycycline Hyclate Tab 100 MG | 0 | 20 | 10 | 1063446854 | 5011248 | 1699725168 | WV | 25565 | 1 |
| 98a6f92b-f981-4703-b8c4-2995847e2b2f | 01 | ceb15fef-0bfc-4d25-9cce-1afb001dd2f2 | < 65 | 2023-01-02 | 68180071160 | Cefdinir Cap 300 MG | 0 | 20 | 10 | 1063446854 | 5011248 | 1699725168 | WV | 25565 | 1 |
| 4005ccc6-0656-4437-b027-cfe409a9ef86 | 01 | 8ac81409-fff6-4689-890c-d53766daedf5 | < 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1194828830 | 1813220 | 1134724826 | WV | 25676 | 1 |
| b076c356-f20f-4da6-a3ec-5f8dacaa5123 | 01 | 5f3423d2-e138-4e2e-863a-0e2d7f714e0b | >= 65 | 2023-01-01 | 60505082901 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1932133717 | 5010448 | 1407060015 | WV | 25901 | 1 |
| 017e5eba-d716-47d9-be6e-0501621dd3d8 | 01 | 8a1cb7d0-f112-46d7-8d11-131fa78105a3 | >= 65 | 2023-01-02 | 68001000501 | Methylprednisolone Tab Therapy Pack 4 MG (21) | 0 | 21 | 6 | 1316018195 | 5006374 | 1154618056 | WV | 24874 | 1 |
| 91d317eb-4541-4cde-b566-029f54f0cc4f | 01 | 8a1cb7d0-f112-46d7-8d11-131fa78105a3 | >= 65 | 2023-01-02 | 00143980305 | Doxycycline Hyclate Cap 100 MG | 0 | 8 | 4 | 1316018195 | 5006374 | 1154618056 | WV | 24874 | 1 |
| 563b20d1-7d0d-4140-90e5-5c4bfa430eaa | 01 | c43a276d-f4f0-4468-bda4-89af9a79f0d6 | >= 65 | 2023-01-01 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 30 | 1649796061 | 5057460 | 1619354131 | WV | 25306 | 1 |
| ad7ddfec-d458-4161-af3a-1beeb32a2da2 | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 43547040111 | Furosemide Tab 20 MG | 0 | 30 | 30 | 1083740864 | 5054464 | 1295826576 | WV | 25608 | 1 |
| ccd4bf40-ecb4-4867-aaa4-c1680abf8047 | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 25 | 1083740864 | 5054464 | 1295826576 | WV | 25608 | 1 |
| fed76e0e-39c7-40f1-929f-8f88f54f38d2 | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 16714009625 | Levalbuterol HCl Soln Nebu 1.25 MG/3ML (Base Equiv) | 0 | 300 | 25 | 1083740864 | 5054464 | 1295826576 | WV | 25608 | 1 |
| d7699b32-f677-41b2-b076-0903762d127f | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 8 | 60 | 30 | 1083740864 | 5054464 | 1295826576 | WV | 25608 | 1 |
| 949baa7e-1580-4cb6-919e-72aae1034387 | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 67877019790 | Amlodipine Besylate Tab 2.5 MG (Base Equivalent) | 0 | 30 | 30 | 1083740864 | 5054464 | 1619961232 | WV | 25608 | 1 |
| c365f24b-e33f-47ec-bf7c-e25547a01727 | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 00054327099 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1083740864 | 5054464 | 1609802644 | WV | 25608 | 1 |
| a06d30e0-65c5-4730-a2d8-d724e6edc8ea | 01 | 30abc705-5261-4e3c-9ec9-cab0548fe6fd | < 65 | 2023-01-02 | 31722072610 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1083740864 | 5054464 | 1609802644 | WV | 25608 | 1 |
| 293fd6ce-620d-40db-9f3a-f62f15e3b322 | 01 | 06c391df-e587-4cff-abaa-a443c59c8c53 | >= 65 | 2023-01-02 | 68180016006 | Azithromycin Tab 250 MG | 0 | 13 | 30 | 1275636631 | 5007275 | 1902844848 | WV | 25823 | 1 |
| 529e284e-519d-4d58-ac82-fe92eeff134e | 01 | b9841ebd-448b-4445-ba6f-93ed38ac119a | >= 65 | 2023-01-02 | 65862057490 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 90 | 90 | 1881797546 | 5008518 | 1861686289 | WV | 24735 | 1 |
| b8b6e1c0-b4c1-46b8-9df7-ed6756d83f16 | 01 | 0e380998-5bd1-4d54-9278-b075c3af8a33 | >= 65 | 2023-01-02 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1801814595 | 5054034 | 1962595926 | WV | 25865 | 1 |
| 8961c4a2-f33b-479f-95c4-ffd800e058f6 | 01 | 5e47532d-0a7f-48cd-8bc4-778499307dc1 | >= 65 | 2023-01-02 | 66993013597 | Fluticasone Furoate-Vilanterol Aero Powd BA 100-25 MCG/ACT | 0 | 60 | 30 | 1407959166 | 5011058 | 1518917632 | WV | 25801 | 1 |
| c77c0913-ecf3-4e6c-8171-67e80d29d1aa | 01 | df056a42-84c1-445a-84c7-39c2511821f4 | >= 65 | 2023-01-01 | 00378827052 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 375 | 31 | 1265663207 | 5055098 | 1326228552 | WV | 25306 | 1 |
| 43e3b783-eb99-4bef-97f0-ba065c4862f7 | 01 | c9666b29-9617-41ec-a4ef-e1956dbbc6f0 | >= 65 | 2023-01-02 | 65862057490 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 60 | 60 | 1275636631 | 5007275 | 1750686283 | WV | 25921 | 1 |
| 7584e98a-32a5-419b-91d8-1932976c1947 | 01 | 7ef51796-0155-409c-bbc8-ffb6c5b5a6ba | >= 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1679802466 | 5055137 | 1265475826 | WV | 24818 | 1 |
| 72d8bf6e-0f79-479a-a41a-960f5d36bc28 | 01 | 85a8ab8d-857d-4880-89d1-d7ed02ad9dbe | >= 65 | 2023-01-02 | 00832532511 | Potassium Chloride Microencapsulated Crys ER Tab 20 mEq | 0 | 30 | 30 | 1467479667 | 3669693 | 1871546929 | OH | 43723 | 1 |
| c828ad22-4977-48af-8428-9170c3a0d39d | 01 | 7d5c7a69-701d-4331-b2fa-9c2f67363790 | >= 65 | 2023-01-02 | 00093117401 | Penicillin V Potassium Tab 500 MG | 0 | 40 | 10 | 1356450605 | 3656052 | 1003093790 | OH | 43915 | 1 |
| 5d6f909b-bc3b-40af-891e-5ad53dac866e | 01 | 7d5c7a69-701d-4331-b2fa-9c2f67363790 | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 54 | 84 | 1356450605 | 3656052 | 1780673772 | OH | 43915 | 1 |
| ea729f14-f14c-409c-8098-e0b529e23a3d | 01 | afa88455-902c-461f-a70b-f65d8187a5aa | >= 65 | 2023-01-02 | 62332065560 | Formoterol Fumarate Soln Nebu 20 MCG/2ML | 0 | 120 | 30 | 1063448314 | 3669009 | 1871079392 | OH | 43903 | 1 |
| ae43a5ba-f483-40b3-97c5-998c478921f2 | 01 | afa88455-902c-461f-a70b-f65d8187a5aa | >= 65 | 2023-01-02 | 69097032187 | Budesonide Inhalation Susp 1 MG/2ML | 0 | 120 | 30 | 1063448314 | 3669009 | 1871079392 | OH | 43903 | 1 |
| f0fa2958-cae5-4c7e-8c8a-a2f8979fabd0 | 01 | 87e6590f-66e5-44f3-b271-1e513eb7c3e7 | >= 65 | 2023-01-01 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 54 | 50 | 1730106873 | 5011387 | 1275643314 | OH | 45767 | 1 |
| 13e86c2f-6084-4bcb-92cc-1a0a76530e07 | 01 | 233aa064-8c18-463b-9d04-fd1c0bb055e6 | >= 65 | 2023-01-02 | 42806071401 | Benzonatate Cap 100 MG | 0 | 30 | 10 | 1114088911 | 1519454 | 1801894621 | IN | 47512 | 1 |
| eaf13230-1710-40b0-ba01-6a5e1241c6a1 | 01 | fbdc35c0-24c5-4d14-aa0c-86c044aacb11 | >= 65 | 2023-01-02 | 70954005920 | Prednisone Tab 10 MG | 0 | 30 | 30 | 1770686453 | 1503932 | 1326535816 | IN | 47848 | 1 |
| ceb45b9a-d543-4595-9e0c-07b29cfa6653 | 01 | 1ca320bb-2321-4b0a-a8e7-7e4ce7cc35b6 | >= 65 | 2023-01-01 | 00597015561 | Tiotropium Br-Olodaterol Inhal Aero Soln 2.5-2.5 MCG/ACT | 0 | 4 | 30 | 1497858104 | 1517397 | 1194915298 | IN | 47567 | 1 |
| cfe5c87b-6be4-4763-bd5c-a70189013691 | 01 | d5ce6dd0-4684-4b23-aeef-9a394c4436e5 | >= 65 | 2023-01-02 | 53746054201 | Potassium Chloride Cap ER 10 mEq | 0 | 90 | 90 | 1104929819 | 1519480 | 1205412954 | IN | 47591 | 1 |
| 9216c068-3774-4458-ae29-fbe9553e639c | 01 | f1e9ffee-e15f-4531-b1a3-4192e38e477e | >= 65 | 2023-01-02 | 53746051101 | Spironolactone Tab 25 MG | 0 | 45 | 90 | 1740383462 | 1525407 | 1104099142 | IN | 47619 | 1 |
| dbec471b-a304-4eb5-93a0-8d5adc08cf60 | 01 | 2cff6da6-d2e2-47c6-8b8d-cdf1502fdede | >= 65 | 2023-01-02 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1083256614 | 1838373 | 1699029207 | KY | 40914 | 1 |
| a400cd05-9dd3-4bb0-9b07-9992932d9984 | 01 | 2cff6da6-d2e2-47c6-8b8d-cdf1502fdede | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 30 | 1083256614 | 1838373 | 1699029207 | KY | 40914 | 1 |
| 6ade8efc-1ce2-4ad2-9185-ed7fe82f8fe9 | 01 | 2cff6da6-d2e2-47c6-8b8d-cdf1502fdede | >= 65 | 2023-01-02 | 00487950160 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 180 | 10 | 1083256614 | 1838373 | 1699029207 | KY | 40914 | 1 |
| 069a55e3-3217-4afd-9308-9a80db9dacbb | 01 | 19a9e889-9f9c-41ea-b272-693190cccce1 | >= 65 | 2023-01-02 | 00173087310 | Umeclidinium Br Aero Powd Breath Act 62.5 MCG/ACT (Base Eq) | 0 | 30 | 30 | 1659483592 | 1411189 | 1649428475 | IL | 62865 | 1 |
| c8067fac-5cee-45f1-9e2c-df59149bcca7 | 01 | 19a9e889-9f9c-41ea-b272-693190cccce1 | >= 65 | 2023-01-02 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1659483592 | 1411189 | 1649428475 | IL | 62865 | 1 |
| 8e5ad6a3-c22f-4744-b77d-1266f5544a7a | 01 | 982ed263-f5ab-4e82-a23e-f8aa957151b6 | >= 65 | 2023-01-02 | 69315011610 | Furosemide Tab 20 MG | 0 | 90 | 90 | 1750484424 | 1446485 | 1083183677 | IL | 61870 | 1 |
| 0f8c69de-8a30-46de-89d6-a8aa2b143b6f | 01 | e8680f5a-79a7-42aa-878f-3365b71152b1 | >= 65 | 2023-01-02 | 00832532510 | Potassium Chloride Microencapsulated Crys ER Tab 20 mEq | 0 | 30 | 30 | 1144355736 | 1456917 | 1174529663 | IL | 62959 | 1 |
| 9a1e575f-a38f-4682-8a6e-ad9a071f33cb | 01 | 3f96126e-31f6-4192-b428-5c4e1f1a705a | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 17 | 1447390588 | 1812228 | 1083669741 | KY | 41858 | 1 |
| c3ca6fdd-e250-408b-a4ab-216548c4b1c8 | 01 | c23f4cee-ff4a-45c5-a6ac-edecb7ec9757 | >= 65 | 2023-01-01 | 59746017210 | Prednisone Tab 5 MG | 0 | 90 | 90 | 1992722318 | 1818977 | 1083725204 | KY | 41647 | 1 |
| 9aaaf4d7-7466-429c-8de7-c2ea43469c0b | 01 | 6fe14de6-74cc-4ab0-aa48-924ecaec4d04 | >= 65 | 2023-01-02 | 00054074287 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 6.7 | 16 | 1356864623 | 1836420 | 1184604878 | KY | 40972 | 1 |
| b141626c-9314-4651-97ff-aa6c8864edce | 01 | 6fe14de6-74cc-4ab0-aa48-924ecaec4d04 | >= 65 | 2023-01-02 | 76204060030 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 360 | 30 | 1356864623 | 1836420 | 1184604878 | KY | 40972 | 1 |
| 824b3906-17c5-489f-9d03-88fbe5ee646c | 01 | d72ef06d-5498-43f2-8e6d-b42407b9e910 | >= 65 | 2023-01-02 | 68462072101 | Theophylline Tab ER 12HR 300 MG | 0 | 15 | 30 | 1063430536 | 1821277 | 1821627068 | KY | 40818 | 1 |
| 01b5600c-d011-442b-869f-89e740074203 | 01 | d72ef06d-5498-43f2-8e6d-b42407b9e910 | >= 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1063430536 | 1821277 | 1821627068 | KY | 40818 | 1 |
| 0379844b-2355-44ed-9f1f-86b053a11882 | 01 | d72ef06d-5498-43f2-8e6d-b42407b9e910 | >= 65 | 2023-01-02 | 31722072250 | Levofloxacin Tab 500 MG | 0 | 5 | 5 | 1063430536 | 1821277 | 1083669741 | KY | 40818 | 1 |
| 8b0984e0-7fd1-4cd1-9daf-1dd35dea2dc1 | 01 | d72ef06d-5498-43f2-8e6d-b42407b9e910 | >= 65 | 2023-01-02 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 17 | 1063430536 | 1821277 | 1821627068 | KY | 40818 | 1 |
| 0c1bb3ca-779e-40d0-8c71-f19ecc96b813 | 01 | 8be7feec-0402-4ad0-9aa0-c057fd75f721 | >= 65 | 2023-01-01 | 67877054360 | Cefdinir Cap 300 MG | 0 | 20 | 10 | 1194828848 | 1815464 | 1033673769 | KY | 41701 | 1 |
| 55e73108-1ad9-4990-bddf-94d27e2908dc | 01 | 8be7feec-0402-4ad0-9aa0-c057fd75f721 | >= 65 | 2023-01-01 | 00904698640 | Guaifenesin Tab ER 12HR 600 MG | 0 | 60 | 30 | 1194828848 | 1815464 | 1033673769 | KY | 41701 | 1 |
| 49e735b9-696d-49a5-a79e-e6538d38cdb8 | 01 | 8be7feec-0402-4ad0-9aa0-c057fd75f721 | >= 65 | 2023-01-01 | 59746000103 | Methylprednisolone Tab Therapy Pack 4 MG (21) | 0 | 21 | 6 | 1194828848 | 1815464 | 1033673769 | KY | 41701 | 1 |
| f5b8f793-5f0c-4919-ae89-812e4fc17fa7 | 01 | 4d39ffe2-7fe1-4c27-bd66-78ed26da315d | >= 65 | 2023-01-02 | 00115993278 | Levalbuterol HCl Soln Nebu 1.25 MG/3ML (Base Equiv) | 0 | 225 | 25 | 1215913959 | 1813612 | 1528001633 | KY | 41564 | 1 |
| 549b7f13-7a0b-4d39-a203-2198614fe90e | 01 | bbaeddd2-4abd-45e5-b4e9-799aead56da6 | < 65 | 2023-01-02 | 00173088210 | Fluticasone Furoate-Vilanterol Aero Powd BA 200-25 MCG/ACT | 0 | 60 | 30 | 1407436264 | 1839200 | 1669575981 | KY | 41773 | 1 |
| d2d988b5-72d8-4ffc-b5db-c71ad67b9501 | 01 | bbaeddd2-4abd-45e5-b4e9-799aead56da6 | < 65 | 2023-01-02 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 20 | 1407436264 | 1839200 | 1669575981 | KY | 41773 | 1 |
| 830d6028-14f8-4792-a5f5-1ba14b104c47 | 01 | 416a6e37-8849-4b08-ad0e-897ad2efe893 | < 65 | 2023-01-02 | 69097017353 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 90 | 8 | 1306902572 | 1813826 | 1326016460 | KY | 40944 | 1 |
| ef346c3a-bb4f-43ca-b36c-909b0f0b3a4c | 01 | 416a6e37-8849-4b08-ad0e-897ad2efe893 | < 65 | 2023-01-02 | 72205020030 | Roflumilast Tab 500 MCG | 0 | 30 | 1 | 1306902572 | 1813826 | 1326016460 | KY | 40944 | 1 |
| 5dd02f3f-d863-4e63-9a1c-a50f3857a018 | 01 | 416a6e37-8849-4b08-ad0e-897ad2efe893 | < 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 17 | 1306902572 | 1813826 | 1326016460 | KY | 40944 | 1 |
| 4f7ab403-9dfb-46f3-bfe9-78ff556bed51 | 01 | 416a6e37-8849-4b08-ad0e-897ad2efe893 | < 65 | 2023-01-02 | 76204001001 | Albuterol Sulfate Soln Nebu 0.63 MG/3ML (Base Equiv) | 0 | 360 | 30 | 1306902572 | 1813826 | 1316052442 | KY | 40944 | 1 |
| 438bbf92-cca5-44bb-b0ba-1dcc8a568b53 | 01 | 416a6e37-8849-4b08-ad0e-897ad2efe893 | < 65 | 2023-01-02 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1306902572 | 1813826 | 1750749065 | KY | 40944 | 1 |
| 37d7f242-b104-4090-b22a-6d6b9adc871a | 01 | 391395fb-00c6-40bb-9c15-90273e1aa2e5 | >= 65 | 2023-01-01 | 63323069210 | Acetylcysteine Inhal Soln 20% | 0 | 210 | 17 | 1972521441 | 1821633 | 1811975683 | KY | 41339 | 1 |
| d163d194-5e4c-454e-a4b1-b3d5422b37dd | 01 | e31e8999-cc07-4d36-945a-3eddddd749fb | >= 65 | 2023-01-02 | 00173087310 | Umeclidinium Br Aero Powd Breath Act 62.5 MCG/ACT (Base Eq) | 0 | 30 | 30 | 1568473072 | 1822750 | 1376620773 | KY | 41268 | 1 |
| f9ab1752-67cf-463f-afc6-6d121458c3da | 01 | f9852965-66f8-40c2-b225-c7992a552e5b | >= 65 | 2023-01-02 | 00093506105 | Hydroxyzine HCl Tab 25 MG | 0 | 30 | 15 | 1043635279 | 4845092 | 1831168004 | VA | 246200000 | 1 |
| 4339234a-e2fa-46e6-9481-5b9545a162be | 01 | f9852965-66f8-40c2-b225-c7992a552e5b | >= 65 | 2023-01-02 | 59746017310 | Prednisone Tab 10 MG | 0 | 30 | 30 | 1043635279 | 4845092 | 1831168004 | VA | 246200000 | 1 |
| df833ae7-32cb-4639-a5b3-a316738f6a02 | 01 | f9852965-66f8-40c2-b225-c7992a552e5b | >= 65 | 2023-01-02 | 00186037020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 1 | 10.2 | 30 | 1043635279 | 4845092 | 1831168004 | VA | 246200000 | 1 |
| b6a7e6bb-1e62-46fa-b892-e6ffc83210e7 | 01 | 272d4977-fd85-423c-930c-d7384acc3312 | >= 65 | 2023-01-02 | 76204060030 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 360 | 30 | 1144799719 | 1837915 | 1821627068 | KY | 41858 | 1 |
| d2a0645d-74de-40c6-9f37-7420c280e525 | 01 | 5153d539-6318-4a9c-8811-504029e41da3 | >= 65 | 2023-01-02 | 59746017210 | Prednisone Tab 5 MG | 0 | 30 | 30 | 1730294760 | 1828207 | 1083760649 | KY | 41522 | 1 |
| dff1461c-0e93-4589-9b4b-02e6a6926e0e | 01 | 5153d539-6318-4a9c-8811-504029e41da3 | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 33 | 1730294760 | 1828207 | 1083760649 | KY | 41522 | 1 |
| 1331a661-47c4-41e5-b935-359f2bb1903c | 01 | af41821f-4eca-4bd5-857c-c0e2772926c0 | >= 65 | 2023-01-02 | 76204060060 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 180 | 15 | 1750441960 | 5004089 | 1861807489 | KY | 41564 | 1 |
| 64b5f8b6-c85a-4976-9707-8e34141c5995 | 01 | 76d34a1b-1235-43af-9b2b-c2577d63cf79 | >= 65 | 2023-01-02 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1356007629 | 5058765 | 1629020326 | KY | 41267 | 1 |
| e30f164a-5e4b-4cbc-9446-caa86be3e5f0 | 01 | 20f4d26c-c497-4c9e-a381-df54a64c55c4 | < 65 | 2023-01-01 | 76204020060 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 360 | 30 | 1720005044 | 1819549 | 1669575981 | KY | 41774 | 1 |
| efeb3050-a876-46b3-98c5-36e082425d3c | 01 | 88b82636-c951-4991-8eac-d8d60d3920dc | < 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1518015569 | 1829083 | 1033298641 | KY | 41230 | 1 |
| 43d428b6-b0d9-4d12-a684-b6d598d3b8c5 | 01 | 88b82636-c951-4991-8eac-d8d60d3920dc | < 65 | 2023-01-02 | 60505082901 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1518015569 | 1829083 | 1033298641 | KY | 41230 | 1 |
| 38b6688b-a474-4c68-b566-ab819c22c0bd | 01 | 88b82636-c951-4991-8eac-d8d60d3920dc | < 65 | 2023-01-02 | 68001036305 | Sildenafil Citrate Tab 20 MG | 0 | 30 | 30 | 1518015569 | 1829083 | 1033298641 | KY | 41230 | 1 |
| 6479cc2b-bbe5-47ac-8787-9a6bce54dae7 | 01 | 88b82636-c951-4991-8eac-d8d60d3920dc | < 65 | 2023-01-02 | 76204020030 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 360 | 30 | 1518015569 | 1829083 | 1033298641 | KY | 41230 | 1 |
| 0f9cc832-20fe-45df-8604-862b0175ebdd | 01 | b05fc8b7-5318-4e5d-9878-793dd6e3387a | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 16 | 1306902572 | 1813826 | 1669575981 | KY | 409720265 | 1 |
| 9e665c16-4c73-4baa-b457-cb3d1cbec97c | 01 | b05fc8b7-5318-4e5d-9878-793dd6e3387a | >= 65 | 2023-01-02 | 00904698640 | Guaifenesin Tab ER 12HR 600 MG | 0 | 60 | 30 | 1306902572 | 1813826 | 1669575981 | KY | 409720265 | 1 |
| fef300d7-3321-476b-9739-56713344553e | 01 | b05fc8b7-5318-4e5d-9878-793dd6e3387a | >= 65 | 2023-01-02 | 60505082901 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1306902572 | 1813826 | 1669575981 | KY | 409720265 | 1 |
| e326df0c-fb89-4c0f-a91f-4c6483f9836a | 01 | b05fc8b7-5318-4e5d-9878-793dd6e3387a | >= 65 | 2023-01-02 | 69097017353 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 180 | 30 | 1306902572 | 1813826 | 1669575981 | KY | 409720265 | 1 |
| 8f63c433-4fd2-4bd2-b4a0-ea9dba4ba212 | 01 | a08db8a9-f2f6-4b4d-8756-ef5e2f55bc5e | >= 65 | 2023-01-02 | 68462015713 | Ondansetron Orally Disintegrating Tab 4 MG | 0 | 15 | 5 | 1588187884 | 1836468 | 1467403451 | KY | 42635 | 1 |
| 9824db16-f54d-4012-8cf6-831ab9460148 | 01 | a08db8a9-f2f6-4b4d-8756-ef5e2f55bc5e | >= 65 | 2023-01-02 | 31722063231 | Oseltamivir Phosphate Cap 75 MG (Base Equiv) | 0 | 10 | 5 | 1588187884 | 1836468 | 1467403451 | KY | 42635 | 1 |
| 330be830-d731-43fa-856f-108eaa42b041 | 01 | 053290a3-38d7-4822-bef8-cb55f883040f | >= 65 | 2023-01-01 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1962406421 | 1803635 | 1962846618 | KY | 42347 | 1 |
| f6a1a550-3088-4f55-afa8-8390f351f141 | 01 | 6f8ddca3-c053-472e-a118-0369355e26e3 | >= 65 | 2023-01-02 | 66993058497 | Fluticasone-Salmeterol Aer Powder BA 100-50 MCG/ACT | 0 | 60 | 30 | 1275518953 | 1808964 | 1215929575 | KY | 40831 | 1 |
| 84fca541-0f25-4817-b685-8e31acee1fd6 | 01 | 14a3736e-51ea-4aac-9212-117c40fda887 | < 65 | 2023-01-02 | 00597015561 | Tiotropium Br-Olodaterol Inhal Aero Soln 2.5-2.5 MCG/ACT | 0 | 4 | 30 | 1235642687 | 1836317 | 1649527094 | KY | 40855 | 1 |
| 70c72ab2-c4d2-4004-a4da-b3e880d39e55 | 01 | bbb97000-8c58-4d51-9dbc-79aa0914c5ef | >= 65 | 2023-01-02 | 00173089310 | Fluticasone-Umeclidinium-Vilanterol AEPB 200-62.5-25 MCG/ACT | 0 | 60 | 30 | 1457693822 | 1833640 | 1275070229 | KY | 40962 | 1 |
| aa265f0b-817e-4934-ac21-234bf94704d3 | 01 | bbb97000-8c58-4d51-9dbc-79aa0914c5ef | >= 65 | 2023-01-02 | 00378932132 | Fluticasone-Salmeterol Aer Powder BA 250-50 MCG/ACT | 0 | 60 | 30 | 1457693822 | 1833640 | 1588073886 | KY | 40962 | 1 |
| 424f21df-bd23-4e9e-843f-2d418fbafa72 | 01 | c203a470-981f-4920-b855-82c0ea2927f4 | >= 65 | 2023-01-02 | 69315011610 | Furosemide Tab 20 MG | 0 | 60 | 60 | 1386714715 | 1807392 | 1275021859 | KY | 41572 | 1 |
| d7f72cc9-6e9d-4f64-b6a5-4e1790d873c5 | 01 | c203a470-981f-4920-b855-82c0ea2927f4 | >= 65 | 2023-01-02 | 42582021618 | Doxycycline Hyclate Cap 100 MG | 0 | 6 | 6 | 1386714715 | 1807392 | 1275021859 | KY | 41572 | 1 |
| 57438bb2-d89b-4e19-b4fa-3f8f3b24da56 | 01 | c203a470-981f-4920-b855-82c0ea2927f4 | >= 65 | 2023-01-02 | 59746017506 | Prednisone Tab 20 MG | 0 | 8 | 3 | 1386714715 | 1807392 | 1275021859 | KY | 41572 | 1 |
| 304f9a0e-b80c-4b83-81db-4dd9fae616be | 01 | c203a470-981f-4920-b855-82c0ea2927f4 | >= 65 | 2023-01-02 | 65862050320 | Amoxicillin & K Clavulanate Tab 875-125 MG | 0 | 14 | 7 | 1386714715 | 1807392 | 1912565243 | KY | 41572 | 1 |
| 97d11e8e-4b1d-4e4b-a5f8-b4ded9f9f4d5 | 01 | f7491796-40a8-43a6-8911-f243fa3668ba | >= 65 | 2023-01-02 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1548287865 | 1820580 | 1386617322 | KY | 41559 | 1 |
| df5e65b3-a7a5-4100-91f8-efcc216b241a | 01 | b3c12f88-60f2-4c9b-9951-0acfabfd2a9c | >= 65 | 2023-01-02 | 00093317431 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 17 | 1588028997 | 1835391 | 1861807489 | KY | 41539 | 1 |
| e6e981cf-f2a1-4b5d-a2b3-037a1aac09ea | 01 | e4c0c325-ff7e-49c4-9195-e4c7445fab5b | < 65 | 2023-01-02 | 16571041250 | Ciprofloxacin HCl Tab 500 MG (Base Equiv) | 0 | 20 | 10 | 1912000654 | 1814107 | 1194191072 | KY | 40828 | 1 |
| 2bed6603-e86c-4af6-b90e-485faaccfc71 | 01 | e4c0c325-ff7e-49c4-9195-e4c7445fab5b | < 65 | 2023-01-02 | 59746017506 | Prednisone Tab 20 MG | 0 | 10 | 5 | 1912000654 | 1814107 | 1194191072 | KY | 40828 | 1 |
| 9f9bb5cc-0064-467c-b167-25259a189629 | 01 | 601a21fa-1327-4f65-a1bf-380ea5323ec0 | >= 65 | 2023-01-02 | 00093681573 | Budesonide Inhalation Susp 0.25 MG/2ML | 0 | 120 | 30 | 1760416580 | 1815565 | 1851398838 | KY | 40977 | 1 |
| 1b4406f0-0782-41d6-939f-6b3a1f3d0331 | 01 | 5538a3f8-aa48-4f36-b1f3-42e770d91f15 | >= 65 | 2023-01-02 | 52244020010 | Theophylline Cap ER 24HR 200 MG | 0 | 30 | 30 | 1639114416 | 1814195 | 1821627068 | KY | 41858 | 1 |
| 21a628e2-c07a-4fa5-a2e7-400be4a04093 | 01 | f02a4998-be11-438d-bb0f-40cccc5c3ec4 | >= 65 | 2023-01-02 | 72578010092 | Levofloxacin Tab 750 MG | 0 | 10 | 10 | 1770676934 | 1829211 | 1396974234 | KY | 41740 | 1 |
| c8e17b38-1990-43e3-9957-74caccb3b4a8 | 01 | ee8ee1fe-7725-422d-9dd4-28dadcd98f43 | < 65 | 2023-01-02 | 50383070016 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1215913959 | 1813612 | 1144622416 | KY | 41528 | 1 |
| e9408dd9-b1ef-42f8-a734-2ca5e1cb211f | 01 | ee8ee1fe-7725-422d-9dd4-28dadcd98f43 | < 65 | 2023-01-02 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 30 | 1215913959 | 1813612 | 1144622416 | KY | 41528 | 1 |
| 1bef5b6f-1725-4776-8c53-c8cf933accaa | 01 | 2523d052-1be6-4439-b9ce-e09f933f27f9 | < 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1295748051 | 1806201 | 1598859464 | KY | 41230 | 1 |
| d6de0054-72d6-4f77-ac30-9c46e822272c | 01 | dbb61f4d-4267-41d8-803e-4c12c1d142fe | < 65 | 2023-01-02 | 31722072610 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1669954681 | 1837838 | 1912326158 | KY | 41465 | 1 |
| 353dde57-016b-4ea5-ba34-695638b32949 | 01 | dbb61f4d-4267-41d8-803e-4c12c1d142fe | < 65 | 2023-01-02 | 00487020160 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 360 | 30 | 1669954681 | 1837838 | 1912326158 | KY | 41465 | 1 |
| c1ab4932-709b-4588-a220-059008642bf5 | 01 | dbb61f4d-4267-41d8-803e-4c12c1d142fe | < 65 | 2023-01-02 | 63824007235 | Dextromethorphan-Guaifenesin Tab ER 12HR 60-1200 MG | 0 | 60 | 30 | 1669954681 | 1837838 | 1912326158 | KY | 41465 | 1 |
| 99aa2054-c790-46a4-a8ec-4c6f0a516eae | 01 | dbb61f4d-4267-41d8-803e-4c12c1d142fe | < 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1669954681 | 1837838 | 1912326158 | KY | 41465 | 1 |
| c5df75c5-1f4b-4922-9c3c-2fd2b0b1c92d | 01 | dbb61f4d-4267-41d8-803e-4c12c1d142fe | < 65 | 2023-01-02 | 00093317431 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 16 | 1669954681 | 1837838 | 1912326158 | KY | 41465 | 1 |
| 4d58b471-c26f-47cc-bafa-78688c88470b | 01 | a5d7defb-327d-4652-8d9e-05d6d881b4a9 | < 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1356375174 | 1823106 | 1073525861 | KY | 40741 | 1 |
| e47d51f6-f549-4e5f-864f-8954446725da | 01 | a1fa8624-08cb-4341-8f1e-83977cbfd9c7 | >= 65 | 2023-01-02 | 59746017310 | Prednisone Tab 10 MG | 0 | 30 | 12 | 1558446849 | 1823409 | 1215358411 | KY | 41501 | 1 |
| ef36f98e-5a70-4a6b-b692-e02852b5603f | 01 | a1fa8624-08cb-4341-8f1e-83977cbfd9c7 | >= 65 | 2023-01-02 | 65862001501 | Amoxicillin (Trihydrate) Tab 875 MG | 0 | 20 | 10 | 1558446849 | 1823409 | 1215358411 | KY | 41501 | 1 |
| 759ccc12-8f86-4893-9de7-da6ad8086c09 | 01 | a1fa8624-08cb-4341-8f1e-83977cbfd9c7 | >= 65 | 2023-01-02 | 51224000160 | Benzonatate Cap 200 MG | 0 | 30 | 10 | 1558446849 | 1823409 | 1215358411 | KY | 41501 | 1 |
| 26f706af-ca14-4c8e-aa86-fcde5390d07e | 01 | dc8ae8c7-7069-41dd-9b06-1b98fde93b14 | >= 65 | 2023-01-02 | 00597008717 | Ipratropium Bromide HFA Inhal Aerosol 17 MCG/ACT | 0 | 12.9 | 30 | 1780078782 | 1834832 | 1841234614 | KY | 41653 | 1 |
| b2a8b616-2b2c-4f1f-b76f-17c629e46164 | 01 | dc8ae8c7-7069-41dd-9b06-1b98fde93b14 | >= 65 | 2023-01-02 | 68462072101 | Theophylline Tab ER 12HR 300 MG | 0 | 30 | 30 | 1780078782 | 1834832 | 1841234614 | KY | 41653 | 1 |
| 644b3cd1-79f8-4808-93e5-69f499445564 | 01 | dc8ae8c7-7069-41dd-9b06-1b98fde93b14 | >= 65 | 2023-01-02 | 00597016061 | Tiotropium Bromide Monohydrate Inhal Aerosol 1.25 MCG/ACT | 0 | 4 | 30 | 1780078782 | 1834832 | 1841234614 | KY | 41653 | 1 |
| b92ba47e-5577-40f3-98ca-3c354f926ddd | 01 | eec8b232-1088-494f-a142-d998c1e1b7f4 | >= 65 | 2023-01-02 | 76204020060 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 540 | 30 | 1235160284 | 1809029 | 1912331323 | KY | 40962 | 1 |
| b4f2e8a8-114d-4c4b-99b3-4abe29fdfa71 | 01 | 0d577f15-56d7-4a61-96ae-ef7192ba6ecd | >= 65 | 2023-01-02 | 42858070101 | Theophylline Tab ER 24HR 400 MG | 0 | 30 | 30 | 1013258649 | 1833563 | 1821627068 | KY | 41858 | 1 |
| 8ce86953-6bb0-478c-99ef-75e16a209821 | 01 | 0d577f15-56d7-4a61-96ae-ef7192ba6ecd | >= 65 | 2023-01-02 | 00173068220 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 18 | 1013258649 | 1833563 | 1083669741 | KY | 41858 | 1 |
| 5168bc43-c6b8-41da-b014-6beff3cc03d7 | 01 | 0d577f15-56d7-4a61-96ae-ef7192ba6ecd | >= 65 | 2023-01-02 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1013258649 | 1833563 | 1083669741 | KY | 41858 | 1 |
| 9ff26dd8-f9f3-4151-a346-d91e913a1be9 | 01 | 50beedcf-ca56-4b36-86cb-1627f7ffabc1 | < 65 | 2023-01-01 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 30 | 1619994811 | 4435613 | 1275547234 | TN | 37857 | 1 |
| f4948f4a-9d2b-4706-8471-8f77abb3accf | 01 | 13e05a17-92b0-4553-9681-e07fb8958503 | < 65 | 2023-01-01 | 16729018317 | Hydrochlorothiazide Tab 25 MG | 0 | 30 | 30 | 1376949362 | 1834678 | 1295406494 | KY | 41557 | 1 |
| 4c4c3023-5481-4254-a4c3-5039351fed04 | 01 | 11299030-f3e0-43eb-a62d-41da2df95e29 | < 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 17 | 1730294760 | 1828207 | 1023066032 | KY | 41522 | 1 |
| 2f463b29-96ea-4d2f-baa3-2a92b93601b4 | 01 | 11299030-f3e0-43eb-a62d-41da2df95e29 | < 65 | 2023-01-02 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1730294760 | 1828207 | 1144312562 | KY | 41522 | 1 |
| eaa81eed-2a50-41bb-a899-c1c52cd1730f | 01 | 426d9e52-83a1-4939-8d18-eaba396cae29 | >= 65 | 2023-01-01 | 00115168974 | Budesonide Inhalation Susp 0.5 MG/2ML | 0 | 180 | 90 | 1194828830 | 1813220 | 1205861333 | KY | 41544 | 1 |
| 81c8c020-d0d3-4684-a933-fae62c803079 | 01 | 66341d9c-9351-4b68-8acf-f51e192b9be0 | >= 65 | 2023-01-02 | 65862018730 | Ondansetron HCl Tab 4 MG | 0 | 20 | 8 | 1407436264 | 1839200 | 1962416602 | KY | 41719 | 1 |
| 31359a83-be6e-4083-abb7-ea9b141dc76f | 01 | c52931d4-6786-4e55-a4d8-a68bf0e9f8e5 | >= 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 16 | 1255346805 | 1807936 | 1437441953 | KY | 41554 | 1 |
| 546bb568-d5f0-46cd-ad47-7cdaea7e34c0 | 01 | 40303373-daca-478d-a6e3-d16671643e59 | >= 65 | 2023-01-01 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 60 | 1164449492 | 1826518 | 1689758799 | KY | 41531 | 1 |
| ae53e12e-6a82-433c-9f62-1f365f2e2220 | 01 | 40303373-daca-478d-a6e3-d16671643e59 | >= 65 | 2023-01-01 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 60 | 1164449492 | 1826518 | 1689758799 | KY | 41531 | 1 |
| bf8e2a95-2e1a-485b-8df6-ef9604c070d2 | 01 | 4133d871-db4b-471b-91d0-42bd262145ce | >= 65 | 2023-01-01 | 47335075649 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 90 | 30 | 1194828830 | 1813220 | 1265485544 | KY | 41553 | 1 |
| e0ad307b-457c-4167-ad5b-19c9420a0bb5 | 01 | 4133d871-db4b-471b-91d0-42bd262145ce | >= 65 | 2023-01-02 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1194828830 | 1813220 | 1265485544 | KY | 41553 | 1 |
| 769df2d5-fbe7-4062-9bd5-31005db5a63d | 01 | 4133d871-db4b-471b-91d0-42bd262145ce | >= 65 | 2023-01-02 | 00093317431 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 30 | 1194828830 | 1813220 | 1265485544 | KY | 41553 | 1 |
| 8807eb43-d386-4700-8edf-e886f502881a | 01 | 4133d871-db4b-471b-91d0-42bd262145ce | >= 65 | 2023-01-02 | 65862057490 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1194828830 | 1813220 | 1699053579 | KY | 41553 | 1 |
| 8b7d5b61-c1db-4521-9b1d-cc2443f2b15a | 01 | 11f468f9-0f20-4379-96b4-47bf59b80635 | >= 65 | 2023-01-02 | 49502080693 | Revefenacin Inhalation Solution 175 MCG/3ML | 0 | 90 | 30 | 1366469785 | 1818028 | 1194798934 | KY | 40744 | 1 |
| 2708c9e3-ac23-4ef1-b90c-8828d637be66 | 01 | 11f468f9-0f20-4379-96b4-47bf59b80635 | >= 65 | 2023-01-02 | 68180098430 | Budesonide Inhalation Susp 0.5 MG/2ML | 0 | 120 | 30 | 1366469785 | 1818028 | 1427369206 | KY | 40744 | 1 |
| f9a4a1bb-57c1-42bf-b615-6ba5548a259b | 01 | e7eaa6de-675e-411e-b7a8-289c3bc27263 | < 65 | 2023-01-02 | 16729022516 | Spironolactone Tab 25 MG | 0 | 30 | 30 | 1992705339 | 4828539 | 1154392025 | VA | 24634 | 1 |
| b3fc03c1-4d9b-4a92-a65c-bf2827dc180b | 01 | 7f8e9e46-955c-4053-bc00-bf1c3d7a6406 | < 65 | 2023-01-02 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1831271626 | 1828803 | 1194798934 | KY | 40972 | 1 |
| ef37f37d-0cdb-4a00-944a-e687421eb372 | 01 | 7f8e9e46-955c-4053-bc00-bf1c3d7a6406 | < 65 | 2023-01-02 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 30 | 1831271626 | 1828803 | 1427369206 | KY | 40972 | 1 |
| 4e495372-3628-4822-8fa6-4353e35e363c | 01 | 7f8e9e46-955c-4053-bc00-bf1c3d7a6406 | < 65 | 2023-01-02 | 70748017560 | Arformoterol Tartrate Soln Nebu 15 MCG/2ML (Base Equiv) | 0 | 120 | 30 | 1831271626 | 1828803 | 1194798934 | KY | 40972 | 1 |
| 4d033e4d-76b0-419f-ae9d-275b6ccd80f2 | 01 | 93da86db-e949-476c-9765-36065478a27a | < 65 | 2023-01-02 | 31722072610 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1679527675 | 1828435 | 1285059394 | VA | 242637992 | 1 |
| ffa3337b-c8ba-4fde-be21-04193769c12a | 01 | 93da86db-e949-476c-9765-36065478a27a | < 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1679527675 | 1828435 | 1285059394 | VA | 242637992 | 1 |
| 7ef0b985-eede-4a36-8144-91c9c91e7ae9 | 01 | 93da86db-e949-476c-9765-36065478a27a | < 65 | 2023-01-02 | 31722095801 | Benzonatate Cap 200 MG | 0 | 90 | 30 | 1679527675 | 1828435 | 1285059394 | VA | 242637992 | 1 |
| ae2563f3-12ce-4a65-9d78-e14e07d64d8d | 01 | 93da86db-e949-476c-9765-36065478a27a | < 65 | 2023-01-02 | 31722062330 | Roflumilast Tab 500 MCG | 0 | 30 | 30 | 1679527675 | 1828435 | 1285059394 | VA | 242637992 | 1 |
| 4d3e137f-31f5-42a4-893d-ed36eb465288 | 01 | 93da86db-e949-476c-9765-36065478a27a | < 65 | 2023-01-02 | 59746017310 | Prednisone Tab 10 MG | 0 | 30 | 30 | 1679527675 | 1828435 | 1285059394 | VA | 242637992 | 1 |
| 56cea596-a2f9-4835-ad1e-d5aaf9528b99 | 01 | 93da86db-e949-476c-9765-36065478a27a | < 65 | 2023-01-02 | 00487020160 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 360 | 30 | 1679527675 | 1828435 | 1285059394 | VA | 242637992 | 1 |
| 464b88ff-3f8c-415f-8932-7560f10fc7c1 | 01 | af5ff943-4431-439e-bc9d-701ecf519d48 | < 65 | 2023-01-02 | 00597002402 | Ipratropium-Albuterol Inhal Aerosol Soln 20-100 MCG/ACT | 0 | 4 | 30 | 1780775981 | 1821645 | 1891766101 | KY | 41764 | 1 |
| c4998b42-6d9b-4218-9559-e43f37533c99 | 01 | 69141940-3bdc-4c08-9684-1cce5cf2ff4a | < 65 | 2023-01-02 | 00310009530 | Roflumilast Tab 500 MCG | 8 | 30 | 30 | 1770676934 | 1829211 | 1821627068 | KY | 41822 | 1 |
| 1f82de54-6da2-4982-8981-c2a46a24883f | 01 | 0d2a7382-ae7d-4644-a788-61f59cc7f75b | < 65 | 2023-01-01 | 47335075649 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 540 | 30 | 1568565208 | 1812937 | 1750749065 | KY | 40962 | 1 |
| deaea4c8-d9ac-4fbe-ba63-d3313fd9a5ce | 01 | 0d2a7382-ae7d-4644-a788-61f59cc7f75b | < 65 | 2023-01-02 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1568565208 | 1812937 | 1326016460 | KY | 40962 | 1 |
| a8036b1d-c7d0-4d91-be54-2df713d041b7 | 01 | 736c1fc5-11fb-44c4-b62d-007e03be1603 | >= 65 | 2023-01-02 | 00310461612 | Budesonide-Glycopyrrolate-Formoterol Aers 160-9-4.8 MCG/ACT | 0 | 10.7 | 30 | 1275518953 | 1808964 | 1275528937 | KY | 408290095 | 1 |
| 6e82505d-076a-44c2-b739-fc29fc8fd3bb | 01 | aea8fea1-0cb7-42ff-ad1e-3f4aaa8ce202 | >= 65 | 2023-01-02 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1407436264 | 1839200 | 1881075570 | KY | 41776 | 1 |
| 540ee1b9-96d5-4a84-a6c5-6846a3d3dd6d | 01 | 1759f7fd-0c1d-49f9-a177-c160bc3db840 | >= 65 | 2023-01-02 | 59746017310 | Prednisone Tab 10 MG | 0 | 33 | 12 | 1326065509 | 4423543 | 1427047745 | TN | 37879 | 1 |
| 810aa223-a49e-46f1-a5d6-4eec5b8af087 | 01 | 9a33f22c-e812-44df-a750-709a47fdc1aa | >= 65 | 2023-01-02 | 64380078308 | Prednisone Tab 5 MG | 0 | 30 | 30 | 1407829369 | 4407157 | 1841223039 | TN | 37347 | 1 |
| 38418d9b-4363-4e57-a873-814716d6244b | 01 | 9a33f22c-e812-44df-a750-709a47fdc1aa | >= 65 | 2023-01-02 | 72205020030 | Roflumilast Tab 500 MCG | 0 | 30 | 30 | 1407829369 | 4407157 | 1841223039 | TN | 37347 | 1 |
| 32e83d8c-5f68-4270-a708-c378fe8fa003 | 01 | 9a33f22c-e812-44df-a750-709a47fdc1aa | >= 65 | 2023-01-02 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1407829369 | 4407157 | 1467965707 | TN | 37347 | 1 |
| db764bd5-1798-4d3e-8a39-26e146bd3c5e | 01 | 9a33f22c-e812-44df-a750-709a47fdc1aa | >= 65 | 2023-01-02 | 13668008190 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1407829369 | 4407157 | 1467965707 | TN | 37347 | 1 |
| d41c5551-c3af-403e-bf9d-50bcefe84e23 | 01 | 9a33f22c-e812-44df-a750-709a47fdc1aa | >= 65 | 2023-01-02 | 00173069700 | Fluticasone-Salmeterol Aer Powder BA 500-50 MCG/ACT | 1 | 60 | 30 | 1407829369 | 4407157 | 1467965707 | TN | 37347 | 1 |
| 6deeb4e5-27eb-4e28-88e6-868e81a8d903 | 01 | 44375955-45ed-4718-8dea-c08ddffd8569 | >= 65 | 2023-01-02 | 68462010530 | Ondansetron HCl Tab 4 MG | 0 | 30 | 5 | 1245272434 | 1479117 | 1760424584 | IL | 62703 | 1 |
| 6d078196-3c69-4a5a-83dc-d4ba0b7953dd | 01 | 286c543f-16aa-4da2-9eef-6f1a34c4ae2b | >= 65 | 2023-01-01 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1497858104 | 1517397 | 1912900291 | IN | 47660 | 1 |
| 1695021f-8ec8-42b2-ae6e-372bc050257e | 01 | 286c543f-16aa-4da2-9eef-6f1a34c4ae2b | >= 65 | 2023-01-02 | 64380071207 | Benzonatate Cap 100 MG | 0 | 30 | 5 | 1497858104 | 1517397 | 1043213390 | IN | 47660 | 1 |
| 051739d1-03a3-41fa-9838-137264d37a6b | 01 | bc98d3aa-dd2b-46d6-9b9e-c06c05b6e6e2 | >= 65 | 2023-01-02 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 30 | 1568974830 | 4614017 | 1508951328 | UT | 845010513 | 1 |
| d9ec875f-1495-430c-9294-03618467dda6 | 01 | bc98d3aa-dd2b-46d6-9b9e-c06c05b6e6e2 | >= 65 | 2023-01-02 | 43547040111 | Furosemide Tab 20 MG | 0 | 28 | 28 | 1568974830 | 4614017 | 1508951328 | UT | 845010513 | 1 |
| 7a6d94e8-5c8b-44a2-85be-794ced5172cf | 01 | bc98d3aa-dd2b-46d6-9b9e-c06c05b6e6e2 | >= 65 | 2023-01-02 | 70010013610 | Potassium Chloride Microencapsulated Crys ER Tab 10 mEq | 0 | 28 | 28 | 1568974830 | 4614017 | 1508951328 | UT | 845010513 | 1 |
| f2a9e559-8624-47da-80a3-bef287809832 | 01 | 4fede097-d2ec-4d51-8bf0-ae45024813d0 | >= 65 | 2023-01-01 | 00597015561 | Tiotropium Br-Olodaterol Inhal Aero Soln 2.5-2.5 MCG/ACT | 0 | 4 | 30 | 1750484457 | 4403907 | 1427105212 | WV | 25206 | 1 |
| 1022b334-7334-4eb1-8400-4e08aa3f12a1 | 01 | 4fede097-d2ec-4d51-8bf0-ae45024813d0 | >= 65 | 2023-01-02 | 00093317431 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 25 | 1750484457 | 4403907 | 1427105212 | WV | 25206 | 1 |
| 6f080517-f876-427c-a24e-f32dd27dafd7 | 01 | 65b4115b-f273-4dee-bcdb-4cb584eac305 | >= 65 | 2023-01-03 | 00054327099 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1922160548 | 3967683 | 1871568162 | PA | 15076 | 1 |
| 380895de-3067-427c-9b58-c155d6330df5 | 01 | e242ecbb-54cb-4817-818c-6ada9e62ede8 | >= 65 | 2023-01-03 | 00310737220 | Budesonide-Formoterol Fumarate Dihyd Aerosol 80-4.5 MCG/ACT | 0 | 10.2 | 30 | 1770598310 | 3980655 | 1902273055 | PA | 15489 | 1 |
| ac03aa2a-cddc-4b7d-8a21-c067abbeb944 | 01 | e242ecbb-54cb-4817-818c-6ada9e62ede8 | >= 65 | 2023-01-03 | 69315011710 | Furosemide Tab 40 MG | 0 | 30 | 30 | 1770598310 | 3980655 | 1851348189 | PA | 15489 | 1 |
| f3e66bb8-9666-49d1-a6f2-d9cbc5991306 | 01 | 620f362f-e5a6-437d-a489-81aaa57640c1 | >= 65 | 2023-01-03 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1689772329 | 3938428 | 1104823798 | PA | 17921 | 1 |
| bab1e673-ab82-4b0d-a2df-3524209253dd | 01 | 541c4d59-a17d-4a8b-a47c-c4ea2c04a4ca | >= 65 | 2023-01-03 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1609898337 | 3981405 | 1598756371 | PA | 16001 | 1 |
| ccd4b9b2-7d4e-4d5b-94b8-60d8d6f38452 | 01 | 824c28a3-f33c-4021-a95f-5d63fed62ea0 | >= 65 | 2023-01-03 | 31722062330 | Roflumilast Tab 500 MCG | 0 | 30 | 30 | 1477150951 | 3688338 | 1871079392 | OH | 43701 | 1 |
| 0bf14290-bcf5-4e6d-888c-8d85c90c012c | 01 | 824c28a3-f33c-4021-a95f-5d63fed62ea0 | >= 65 | 2023-01-03 | 00591292754 | Levalbuterol Tartrate Inhal Aerosol 45 MCG/ACT (Base Equiv) | 0 | 15 | 33 | 1477150951 | 3688338 | 1871079392 | OH | 43701 | 1 |
| bd8c0d39-cbe7-4bb2-bc45-76fa0bf2e686 | 01 | fb725f78-4d3e-42a7-8f75-8278ecddbf77 | >= 65 | 2023-01-03 | 72578009918 | Levofloxacin Tab 500 MG | 0 | 7 | 7 | 1306212444 | 6002632 | 1689689341 | PA | 18507 | 1 |
| 7c04e826-3467-4bdf-af39-17647f75ed98 | 01 | 921afe97-b12e-4a90-b92f-06bb2a7a11b2 | >= 65 | 2023-01-03 | 00093751831 | Fluticasone-Salmeterol Aer Powder BA 250-50 MCG/ACT | 0 | 60 | 30 | 1073602728 | 3949178 | 1902067614 | PA | 15627 | 1 |
| c84d11d8-93b5-4aad-ac71-d889cb0cf575 | 01 | 29acdcae-5b32-4498-9b2c-09e8f723e071 | >= 65 | 2023-01-03 | 76204020060 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 360 | 30 | 1376648659 | 1816327 | 1699053579 | KY | 41566 | 1 |
| b6523313-443a-4d07-8d4f-1e75b218437a | 01 | 29acdcae-5b32-4498-9b2c-09e8f723e071 | >= 65 | 2023-01-03 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 18 | 17 | 1376648659 | 1816327 | 1679861611 | KY | 41566 | 1 |
| 608d30d9-253f-4e37-a97a-6b17ecacbd5f | 01 | 700f778c-ce3a-4eab-b6c6-23167baf9b08 | < 65 | 2023-01-03 | 00597007541 | Tiotropium Bromide Monohydrate Inhal Cap 18 MCG (Base Equiv) | 0 | 30 | 30 | 1720430358 | 4448937 | 1629659883 | VA | 24211 | 1 |
| 16936c2a-761e-44b7-ad7a-08a5b9391d97 | 01 | d1ab01e5-43d8-407d-9c9b-d285f9c1675e | < 65 | 2023-01-03 | 69097031987 | Budesonide Inhalation Susp 0.5 MG/2ML | 0 | 60 | 30 | 1760551584 | 4831790 | 1487930905 | VA | 24656 | 1 |
| 595dcdb4-39b2-4d50-8a24-ae409f2efc06 | 01 | d1ab01e5-43d8-407d-9c9b-d285f9c1675e | < 65 | 2023-01-03 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1760551584 | 4831790 | 1780228528 | VA | 24656 | 1 |
| 8c450b82-8296-49e5-aa7d-fa7f1cf1da3f | 01 | d1ab01e5-43d8-407d-9c9b-d285f9c1675e | < 65 | 2023-01-03 | 00597010061 | Tiotropium Bromide Monohydrate Inhal Aerosol 2.5 MCG/ACT | 0 | 4 | 30 | 1760551584 | 4831790 | 1780228528 | VA | 24656 | 1 |
| a27c9bf2-3dea-4281-b7ce-bd9ef783eef1 | 01 | d1ab01e5-43d8-407d-9c9b-d285f9c1675e | < 65 | 2023-01-03 | 68382096906 | Roflumilast Tab 500 MCG | 0 | 30 | 30 | 1760551584 | 4831790 | 1780228528 | VA | 24656 | 1 |
| 02bc9adc-145c-4b86-99cb-0dd6d7a8f911 | 01 | d1ab01e5-43d8-407d-9c9b-d285f9c1675e | < 65 | 2023-01-03 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 17 | 1760551584 | 4831790 | 1780228528 | VA | 24656 | 1 |
| 915cc5c5-63b4-4b35-8f02-8e42f2531797 | 01 | d1ab01e5-43d8-407d-9c9b-d285f9c1675e | < 65 | 2023-01-03 | 33342010215 | Montelukast Sodium Tab 10 MG (Base Equiv) | 0 | 30 | 30 | 1760551584 | 4831790 | 1487930905 | VA | 24656 | 1 |
| 6f202d0f-57be-4f09-a829-5bec7af72602 | 01 | 2e6eaceb-23f0-416b-b725-5751b8d97267 | >= 65 | 2023-01-03 | 00904698640 | Guaifenesin Tab ER 12HR 600 MG | 0 | 180 | 90 | 1053424721 | 4817411 | 1386689230 | VA | 24263 | 1 |
| d4d372c2-2d54-4b81-b14b-a549c7d49386 | 01 | 2aed1836-256a-4c70-bbe4-776c463a4e95 | >= 65 | 2023-01-03 | 76204060030 | Ipratropium-Albuterol Nebu Soln 0.5-2.5(3) MG/3ML | 0 | 270 | 30 | 1366541229 | 4819984 | 1922049212 | VA | 24658 | 1 |
| 46da5013-3ee8-409a-9901-7db4e8bf1099 | 01 | 2aed1836-256a-4c70-bbe4-776c463a4e95 | >= 65 | 2023-01-03 | 00310737020 | Budesonide-Formoterol Fumarate Dihyd Aerosol 160-4.5 MCG/ACT | 0 | 10.2 | 30 | 1366541229 | 4819984 | 1245209402 | VA | 24658 | 1 |
| 577315f9-9e7d-4866-9982-3b827b6a32fc | 01 | c2f3ce21-e432-4dd3-92d5-4cbae49f2932 | >= 65 | 2023-01-03 | 00310009530 | Roflumilast Tab 500 MCG | 1 | 30 | 30 | 1669995536 | 4848985 | 1205861333 | VA | 24263 | 1 |
| 866517f9-96eb-4979-b711-601a2640adde | 01 | c2f3ce21-e432-4dd3-92d5-4cbae49f2932 | >= 65 | 2023-01-03 | 00597015561 | Tiotropium Br-Olodaterol Inhal Aero Soln 2.5-2.5 MCG/ACT | 0 | 4 | 30 | 1669995536 | 4848985 | 1205861333 | VA | 24263 | 1 |
| 8681ed21-814d-4cc0-b132-9e0e8a1bd05a | 01 | c2f3ce21-e432-4dd3-92d5-4cbae49f2932 | >= 65 | 2023-01-03 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 25 | 1669995536 | 4848985 | 1205861333 | VA | 24263 | 1 |
| 418694a8-22a4-41b6-9e52-ce5a0e38d0fa | 01 | c2f3ce21-e432-4dd3-92d5-4cbae49f2932 | >= 65 | 2023-01-03 | 70010019905 | Guaifenesin Tab ER 12HR 600 MG | 0 | 120 | 30 | 1669995536 | 4848985 | 1205861333 | VA | 24263 | 1 |
| 710156b2-ecab-4ecc-beae-eb3f43ab72d3 | 01 | 98911f69-ab24-40d7-b3a3-7fe068e9c3da | < 65 | 2023-01-03 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1366541229 | 4819984 | 1780228528 | VA | 24614 | 1 |
| a0679f7e-1b41-4f03-b35a-5c83ddb82087 | 01 | c2d362ac-eb72-49b3-9c26-c9f59cfea537 | < 65 | 2023-01-03 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 25 | 1255381265 | 4839253 | BG9031066 | VA | 24279 | 1 |
| 0669662a-e209-46d6-8333-67ec15abf06f | 01 | 906f2277-3908-4cb9-9683-8e54e76edec0 | >= 65 | 2023-01-03 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1801813910 | 4837033 | 1235755844 | VA | 24266 | 1 |
| c086f737-c19d-43b7-98d2-cec30234f77d | 01 | 906f2277-3908-4cb9-9683-8e54e76edec0 | >= 65 | 2023-01-03 | 66993001968 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 1 | 18 | 17 | 1801813910 | 4837033 | 1235755844 | VA | 24266 | 1 |
| 081ae209-3b52-4c56-a778-9f419b708e09 | 01 | 906f2277-3908-4cb9-9683-8e54e76edec0 | >= 65 | 2023-01-03 | 29300022019 | Montelukast Sodium Tab 10 MG (Base Equiv) | 1 | 90 | 90 | 1801813910 | 4837033 | 1235755844 | VA | 24266 | 1 |
| a25704a3-09a2-4bf2-8544-11699e0c31b6 | 01 | 0cc376ae-b095-448c-a9fe-e9f0bfce6caa | >= 65 | 2023-01-03 | 00597002402 | Ipratropium-Albuterol Inhal Aerosol Soln 20-100 MCG/ACT | 0 | 4 | 30 | 1760551584 | 4831790 | 1487622320 | VA | 24603 | 1 |
| f163a04c-b3a1-40f0-b792-bbd2d85eb484 | 01 | 53d2cf40-df8e-4ad8-b3e3-4f50c9e7e33f | >= 65 | 2023-01-03 | 60219170805 | Prednisone Tab 20 MG | 0 | 10 | 5 | 1770802480 | 4842274 | 1205861333 | VA | 242287144 | 1 |
| 48c95388-3e21-4bc2-adf3-a515a8283e02 | 01 | 61dcd40f-63db-4a6e-8967-0da68079795e | >= 65 | 2023-01-03 | 00173089310 | Fluticasone-Umeclidinium-Vilanterol AEPB 200-62.5-25 MCG/ACT | 0 | 60 | 30 | 1053424721 | 4817411 | 1083160519 | VA | 24277 | 1 |
| 824ea710-f2c6-45df-aa34-f5f332a918fc | 01 | 122156ce-018a-4ab7-8bbb-44cde0454093 | >= 65 | 2023-01-03 | 43547040111 | Furosemide Tab 20 MG | 0 | 30 | 30 | 1053424721 | 4817411 | 1205981115 | VA | 24221 | 1 |
| 43eb662e-0ab1-4cb9-a512-932a5cf08fbb | 01 | 122156ce-018a-4ab7-8bbb-44cde0454093 | >= 65 | 2023-01-03 | 60505082901 | Fluticasone Propionate Nasal Susp 50 MCG/ACT | 0 | 16 | 30 | 1053424721 | 4817411 | 1205981115 | VA | 24221 | 1 |
| efd54fb3-f299-4ebc-82fd-0cb25306a71d | 01 | 122156ce-018a-4ab7-8bbb-44cde0454093 | >= 65 | 2023-01-03 | 00093317431 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 30 | 1053424721 | 4817411 | 1205981115 | VA | 24221 | 1 |
| 6a346447-a389-4728-b32f-c2506e5c6152 | 01 | b0dc691e-253e-453e-b264-eac1f2e10e31 | >= 65 | 2023-01-03 | 43547040211 | Furosemide Tab 40 MG | 0 | 180 | 90 | 1942499223 | 5054604 | 1871929554 | WY | 82604 | 1 |
| 8ac4362f-9068-437a-9ec4-23ca27fe0201 | 01 | 48c57fb7-9766-43d5-ba48-44b711a9e5db | >= 65 | 2023-01-03 | 00173086910 | Umeclidinium-Vilanterol Aero Powd BA 62.5-25 MCG/ACT | 0 | 60 | 30 | 1376849372 | 4842793 | 1780228528 | VA | 24657 | 1 |
| e9e11d33-72dc-42ba-b290-ee618eae6776 | 01 | 48c57fb7-9766-43d5-ba48-44b711a9e5db | >= 65 | 2023-01-03 | 16729018317 | Hydrochlorothiazide Tab 25 MG | 0 | 30 | 30 | 1376849372 | 4842793 | 1316443922 | VA | 24657 | 1 |
| ada3f079-3d05-4162-8c45-2c2237306479 | 01 | 48c57fb7-9766-43d5-ba48-44b711a9e5db | >= 65 | 2023-01-03 | 00832532311 | Potassium Chloride Tab ER 10 mEq | 0 | 120 | 30 | 1376849372 | 4842793 | 1316443922 | VA | 24657 | 1 |
| cd287ad3-7721-41b7-8d8e-a8cbbbac656f | 01 | 40ae7f07-285f-4f3c-97a7-248b0b8fef4c | >= 65 | 2023-01-03 | 47335070349 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 225 | 25 | 1801813910 | 4837033 | 1669650354 | VA | 24260 | 1 |
| c358086f-0aa9-4d69-bcc6-fd351ef71844 | 01 | ecb15854-ca86-4c25-a4b6-153bb717a041 | < 65 | 2023-01-03 | 00597008717 | Ipratropium Bromide HFA Inhal Aerosol 17 MCG/ACT | 0 | 12.9 | 30 | 1083790976 | 4806658 | MF1822104 | VA | 24220 | 1 |
| 254df68c-9bae-420c-a5da-3f1e6c83c641 | 01 | ecb15854-ca86-4c25-a4b6-153bb717a041 | < 65 | 2023-01-03 | 00173088710 | Fluticasone-Umeclidinium-Vilanterol AEPB 100-62.5-25 MCG/ACT | 0 | 60 | 30 | 1083790976 | 4806658 | MG1415288 | VA | 24220 | 1 |
| ace57cdf-159e-4e3d-84c5-755ccd728b16 | 01 | 36f93963-6a10-42ef-8ebe-ee4f66dd77de | >= 65 | 2023-01-03 | 68001024604 | Ondansetron Orally Disintegrating Tab 4 MG | 0 | 30 | 10 | 1760551584 | 4831790 | 1417192543 | VA | 24614 | 1 |
| 0677068e-b370-43b8-bfe7-f0504f73de24 | 01 | 302286ff-c3dd-4c3d-af48-a14f59118ee1 | >= 65 | 2023-01-03 | 00378163191 | Formoterol Fumarate Soln Nebu 20 MCG/2ML | 0 | 120 | 30 | 1598820755 | 3407461 | 1336802115 | VA | 24646 | 1 |
| bcd205e2-e171-407b-9f64-0d8577bffbee | 01 | d37434fd-10c2-47ad-a019-836b12b7fabe | >= 65 | 2023-01-03 | 76204020025 | Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) | 0 | 300 | 25 | 1063446854 | 5011248 | 1720172760 | WV | 25208 | 1 |
| 5dc44fa3-f120-40a6-863e-d780e1bf5413 | 01 | 3ca2cc4f-c60f-4825-9bfb-5abf4722430c | >= 65 | 2023-01-03 | 68180096301 | Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) | 0 | 8.5 | 25 | 1780639286 | 5004332 | 1700262581 | WV | 251210264 | 1 |
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .