Exhibit A-4 - Medical, Prescription Drug and Claim Information.xlsx

XLSX spreadsheet 5 MB Posted Apr 23, 2026

Attached to: Medical, Dental, Vision Insurance Services
Solicitation number: 2604-002
Issued by: Travis County, Austin City, Texas

View the file

Other files

File	Type	Posted
Exhibit A-3 - 2026 Vision Member Summary.pdf	PDF	Apr 23, 2026
EXHIBIT C - Acknowledgement of Receipt Form.pdf	PDF	Apr 23, 2026
Exhibit A-13 - Medical ASO, Dental, Vision Questionnaire.xlsx	XLSX spreadsheet	Apr 23, 2026
Exhibit A-11 - Vision Provider Report.xlsx	XLSX spreadsheet	Apr 23, 2026
EXHIBIT K - Insurance Coverage.pdf	PDF	Apr 23, 2026
Exhibit A-6 - Vision Plan and Claim Information.xlsx	XLSX spreadsheet	Apr 23, 2026
Exhibit A-15 - Data Requirements.pdf	PDF	Apr 23, 2026
Exhibit A-12 - Census.xlsx	XLSX spreadsheet	Apr 23, 2026
Exhibit B-1 - Medical ASO Pricing Sheet.pdf	PDF	Apr 23, 2026
Exhibit A-7 - Medical, prescription drug, Large Claim Report.xls	XLS spreadsheet	Apr 23, 2026
Exhibit B-3 - Fully-insured Vision Pricing Sheet.pdf	PDF	Apr 23, 2026
Exhibit B-2 - Fully-insured Dental Pricing Sheet.pdf	PDF	Apr 23, 2026
Exhibit A-1 -2026 Medical, Prescription Drug, Summary of Benefit Coverages.pdf	PDF	Apr 23, 2026
EXHIBIT E - Conflict of Interest.pdf	PDF	Apr 23, 2026
Exhibit A-5 - Dental Plan and Claim Information.xlsx	XLSX spreadsheet	Apr 23, 2026
Exhibit A-10 - DPPO Provider Report.xls	XLS spreadsheet	Apr 23, 2026
Exhibit A-14 - PBM Questionnaire.xlsx	XLSX spreadsheet	Apr 23, 2026
EXHIBIT I - Form 1295 Certificate of Interested Parties.pdf	PDF	Apr 23, 2026
Exhibit A-9 - Medical, prescription drug, Provider Utilization Report.xls	XLS spreadsheet	Apr 23, 2026
ESBD_510133_1776997796981_RFP 2604-002 Medical, Dental, Vision.pdf	PDF	Apr 23, 2026
EXHIBIT D - Business Development Form.pdf	PDF	Apr 23, 2026
Exhibit A-8 - Top 50 Drugs Report.xlsx	XLSX spreadsheet	Apr 23, 2026
EXHIBIT G - Sample Contract.pdf	PDF	Apr 23, 2026
Exhibit A-2 - 2026 Dental Summary of Benefit Coverages.pdf	PDF	Apr 23, 2026
Exhibit A - Scope of Work.pdf	PDF	Apr 23, 2026
EXHIBIT F - Certificate of Secretary.pdf	PDF	Apr 23, 2026

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Medical Membership

TRAVIS COUNTY HEALTHCARE DISTRICT - CENT - 0000000097013764

Membership Reporting Time Period January 01, 2023 - January 31, 2026

Month/Year	Employee Only	Employee+Spouse	Employee+Child(ren)	Employee+Family	Total Employees	Total Members
Jan-23	785	71	266	139	1,261	2,295
Feb-23	807	74	269	142	1,292	2,339
Mar-23	834	78	276	139	1,327	2,383
Apr-23	833	75	281	143	1,332	2,404
May-23	849	78	284	143	1,354	2,442
Jun-23	870	78	288	147	1,383	2,492
Jul-23	876	80	295	148	1,399	2,516
Aug-23	902	79	301	149	1,431	2,569
Sep-23	912	79	309	152	1,452	2,612
Oct-23	926	78	316	155	1,475	2,648
Nov-23	932	79	320	157	1,488	2,677
Dec-23	937	79	317	162	1,495	2,696
Jan-24	951	78	328	161	1,518	2,732
Feb-24	990	83	340	162	1,575	2,807
Mar-24	1,012	95	372	157	1,636	2,929
Apr-24	1,030	96	368	156	1,650	2,930
May-24	1,038	97	371	159	1,665	2,955
Jun-24	1,043	94	370	162	1,669	2,971
Jul-24	1,047	98	379	164	1,688	3,015
Aug-24	1,074	94	383	166	1,717	3,051
Sep-24	1,081	91	390	167	1,729	3,068
Oct-24	1,090	89	385	169	1,733	3,056
Nov-24	1,093	94	387	168	1,742	3,066
Dec-24	1,095	97	392	165	1,749	3,066
Jan-25	1,123	98	389	168	1,778	3,100
Feb-25	1,115	96	391	167	1,769	3,086
Mar-25	1,180	96	396	172	1,844	3,205
Apr-25	1,176	96	398	172	1,842	3,205
May-25	1,171	93	400	171	1,835	3,190
Jun-25	1,169	94	398	172	1,833	3,198
Jul-25	1,189	95	402	178	1,864	3,240
Aug-25	1,192	98	403	185	1,878	3,285
Sep-25	1,212	102	408	182	1,904	3,311
Oct-25	1,231	100	404	184	1,919	3,326
Nov-25	1,246	102	403	184	1,935	3,338
Dec-25	1,265	107	409	184	1,965	3,393
Jan-26	1,292	108	419	176	1,995	3,410
Feb-26	1,311	111	412	174	2,008	3,404
Total	39,879	3,430	13,619	6,201	63,129	111,410

Claim History Group

Group ID	Pharmacy Name	Claim Fill Date	Product/Drug Name	Drug Strength Name	Total Dispensed Unit Quantity	Total Days Supply	Total Member Cost Amount	Total Net Cost	Total Gross Cost
0181116110001-A	CVS PHARMACY	1/1/23	GUANFACINE HYDROCHLORIDE	3MG ER	30.00	30	$15.00	$59.98	$74.98
0181116100001-A	CAREMARK PRESCRIPTION SVC-CHI	1/1/23	TRI-ESTARYLLA		84.00	84	$0.00	$34.64	$34.64
0181116110002-B	HEB PHARMACY	1/1/23	ESCITALOPRAM OXALATE	20MG	30.00	30	$5.92	$0.00	$5.92
0181116110001-A	HEB PHARMACY	1/1/23	SERTRALINE HYDROCHLORIDE	100MG	45.00	30	$5.96	$0.00	$5.96
0181116110002-B	HEB PHARMACY	1/1/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	25	$15.00	$26.04	$41.04
0181116110002-B	HEB PHARMACY	1/1/23	BENZONATATE	100MG	30.00	5	$4.00	$0.00	$4.00
0181116110002-B	HEB PHARMACY	1/1/23	METHYLPREDNISOLONE DOSE P	4MG DPAK	21.00	6	$11.57	$0.00	$11.57
0181116110002-B	HEB PHARMACY	1/1/23	PROPRANOLOL HYDROCHLORIDE	10MG	60.00	30	$15.00	$1.97	$16.97
0181116110002-B	HEB PHARMACY	1/1/23	GABAPENTIN	400MG	270.00	30	$15.00	$20.13	$35.13
0181116110002-B	HEB PHARMACY	1/1/23	MUPIROCIN	2%	22.00	7	$8.64	$0.00	$8.64
0181116110002-B	HEB PHARMACY	1/1/23	JARDIANCE	10MG	90.00	90	$100.00	$1,587.90	$1,687.90
0181116110002-B	HEB PHARMACY	1/1/23	CLOBETASOL PROPIONATE	0.05%	50.00	30	$15.00	$101.87	$116.87
0181116110001-A	HEB PHARMACY	1/1/23	BUPROPION HYDROCHLORIDE E	200MG	30.00	30	$10.18	$0.00	$10.18
0181116110001-A	CAREMARK PRESCRIPTION SVC-CHI	1/1/23	LISINOPRIL	5MG	90.00	90	$3.81	$0.00	$3.81
0181116110001-A	CAREMARK PRESCRIPTION SVC-CHI	1/1/23	GLIPIZIDE ER	10MG	180.00	90	$37.50	$9.51	$47.01
0181116130102BB	HEB PHARMACY	1/1/23	GABAPENTIN	300MG	30.00	15	$4.20	$0.00	$4.20
0181116110002-B	HEB PHARMACY	1/1/23	CLARAVIS	20MG	30.00	30	$15.00	$50.42	$65.42
0181116110002-B	CVS PHARMACY	1/1/23	BUPROPION HYDROCHLORIDE E	300MG	30.00	30	$15.00	$3.67	$18.67
0181116110002-B	HEB PHARMACY	1/1/23	AMOXICILLIN/CLAVULANATE P	875-125	14.00	7	$9.88	$0.00	$9.88
0181116100001-A	CVS PHARMACY	1/1/23	BINAXNOW COVID-19 AG CARD	HOME TES	8.00	30	$0.00	$103.88	$103.88
0181116100001-A	WALGREENS	1/1/23	OZEMPIC	4MG/3ML	3.00	28	$40.00	$822.43	$862.43
0181116110001-A	WALGREENS	1/1/23	IBUPROFEN	600MG	28.00	7	$2.87	$0.00	$2.87
0181116100001-A	CVS PHARMACY	1/2/23	OZEMPIC	8MG/3ML	3.00	28	$40.00	$822.43	$862.43
0181116110001-A	WALGREENS	1/2/23	FLUOXETINE HYDROCHLORIDE	20MG	30.00	30	$3.71	$0.00	$3.71
0181116110002-B	WALGREENS	1/2/23	EMTRICITABINE/TENOFOVIR D	200-300	30.00	30	$0.00	$1,208.32	$1,208.32
0181116100001-A	WALGREENS	1/2/23	LAMOTRIGINE	100MG	30.00	30	$3.79	$0.00	$3.79
0181116100001-A	WALGREENS	1/2/23	SPIRONOLACTONE	100MG	30.00	30	$10.18	$0.00	$10.18
0181116110002-B	WALMART PHARMACY	1/2/23	TACROLIMUS	1MG	240.00	30	$15.00	$159.99	$174.99
0181116100001-A	HEB PHARMACY	1/2/23	TACROLIMUS	0.1%	100.00	30	$15.00	$604.95	$619.95
0181116110001-A	HEB PHARMACY	1/2/23	BLISOVI FE 1.5/30	1.5/30	84.00	63	$0.00	$40.08	$40.08
0181116110001-A	HEB PHARMACY	1/2/23	LEVOTHYROXINE SODIUM	112MCG	90.00	90	$36.91	$0.00	$36.91
0181116110001-A	HEB PHARMACY	1/2/23	LAMOTRIGINE	200MG	180.00	90	$26.26	$0.00	$26.26
0181116110001-A	HEB PHARMACY	1/2/23	HYDRALAZINE HYDROCHLORIDE	25MG	90.00	30	$10.91	$0.00	$10.91
0181116110001-A	HEB PHARMACY	1/2/23	OMEPRAZOLE	40MG	30.00	30	$9.82	$0.00	$9.82
0181116100001-A	WALGREENS	1/2/23	SERTRALINE HYDROCHLORIDE	100MG	90.00	90	$11.06	$0.00	$11.06
0181116110002-B	CVS PHARMACY	1/2/23	ONDANSETRON ODT	4MG	15.00	4	$5.77	$0.00	$5.77
0181116110001-A	WALGREENS	1/2/23	VYVANSE	70MG	30.00	30	$40.00	$317.46	$357.46
0181116110002-B	CVS PHARMACY	1/2/23	DICYCLOMINE HYDROCHLORIDE	20MG	30.00	8	$3.63	$0.00	$3.63
0181116110002-B	WALMART PHARMACY	1/2/23	JARDIANCE	25MG	30.00	30	$40.00	$533.83	$573.83
0181116110002-B	WALGREENS	1/2/23	LISINOPRIL	20MG	180.00	90	$13.49	$0.00	$13.49
0181116110001-A	CVS PHARMACY	1/2/23	FORFIVO XL	450MG	30.00	30	$75.00	$379.03	$454.03
0181116110001-A	WALGREENS	1/2/23	ARIPIPRAZOLE	5MG	90.00	90	$37.50	$703.32	$740.82
0181116100002-B	HEB PHARMACY	1/2/23	ESCITALOPRAM OXALATE	10MG	30.00	30	$4.76	$0.00	$4.76
0181116110002-B	CVS PHARMACY	1/2/23	OZEMPIC	4MG/3ML	6.00	28	$40.00	$1,684.16	$1,724.16
0181116110002-B	CVS PHARMACY	1/2/23	ARMOUR THYROID	60MG	30.00	30	$28.81	$0.00	$28.81
0181116110002-B	CVS PHARMACY	1/2/23	METFORMIN HYDROCHLORIDE E	500MG GP	270.00	90	$15.82	$0.00	$15.82
0181116100001-A	CVS PHARMACY	1/2/23	DESCOVY	200/25MG	30.00	30	$40.00	$2,046.41	$2,086.41
0181116110002-B	CVS PHARMACY	1/2/23	IBUPROFEN	100/5ML	240.00	14	$10.69	$0.00	$10.69
0181116110001-A	CVS PHARMACY	1/2/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116110001-A	CVS PHARMACY	1/2/23	ERYTHROMYCIN	0.5% OP	3.50	5	$13.37	$0.00	$13.37
0181116110001-A	CVS PHARMACY	1/2/23	PROMETHAZINE HYDROCHLORID	DM	120.00	10	$9.58	$0.00	$9.58
0181116110002-B	HEB PHARMACY	1/2/23	MONTELUKAST SODIUM	10MG	30.00	30	$8.90	$0.00	$8.90
0181116110002-B	HEB PHARMACY	1/2/23	OZEMPIC	4MG/3ML	3.00	28	$40.00	$822.43	$862.43
0181116100002-B	SAV-ON PHARMACY	1/2/23	DOXYCYCLINE HYCLATE	100MG	60.00	30	$15.00	$23.74	$38.74
0181116120001BA	WALGREENS	1/2/23	METFORMIN HYDROCHLORIDE E	500MG GP	90.00	90	$5.64	$0.00	$5.64
0181116110002-B	HEB PHARMACY	1/2/23	TRULICITY	1.5/0.5	2.00	28	$40.00	$817.12	$857.12
0181116110002-B	HEB PHARMACY	1/2/23	DESONIDE	0.05%	30.00	28	$15.00	$114.16	$129.16
0181116110001-A	WALMART PHARMACY	1/1/23	SERTRALINE HYDROCHLORIDE	100MG	135.00	90	$16.33	$0.00	$16.33
0181116130101BA	COSTCO PHARMACY	1/2/23	BUPROPION HYDROCHLORIDE E	300MG	90.00	90	$37.50	$16.96	$54.46
0181116130102BB	WALGREENS	1/2/23	PFIZER-BIONTECH COVID-19	BA4/BA5	0.30	1	$0.00	$40.00	$40.00
0181116110002-B	CVS PHARMACY	1/2/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	25	$15.00	$26.04	$41.04
0181116110002-B	HEB PHARMACY	1/2/23	SULFAMETHOXAZOLE/TRIMETHO	800-160	14.00	7	$2.72	$0.00	$2.72
0181116110002-B	HEB PHARMACY	1/2/23	AMOXICILLIN/CLAVULANATE P	875-125	20.00	10	$13.81	$0.00	$13.81
0181116100001-A	WALGREENS	1/2/23	ATORVASTATIN CALCIUM	10MG	90.00	90	$0.00	$14.26	$14.26
0181116130102BB	HEB PHARMACY	1/2/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116130102BB	HEB PHARMACY	1/2/23	PREDNISONE	20MG	10.00	5	$2.77	$0.00	$2.77
0181116130102BB	HEB PHARMACY	1/2/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	25	$15.00	$26.04	$41.04
0181116110002-B	WALGREENS	1/2/23	MILI	0.25/35	84.00	84	$0.00	$35.83	$35.83
0181116100001-A	RANDALLS PHARMACY	1/2/23	MODERNA COVID-19 VACCINE/	BA4/BA5	0.50	1	$0.00	$40.00	$40.00
0181116110002-B	WALGREENS	1/2/23	BINAXNOW COVID-19 AG CARD	HOME TES	2.00	1	$0.00	$21.70	$21.70
0181116110002-B	HEB PHARMACY	1/2/23	FLUOXETINE HYDROCHLORIDE	40MG	30.00	30	$7.85	$0.00	$7.85
0181116110001-A	CVS PHARMACY	1/2/23	LEVOTHYROXINE SODIUM	88MCG	90.00	90	$30.04	$0.00	$30.04
0181116110001-A	CVS PHARMACY	1/2/23	BINAXNOW COVID-19 AG CARD	HOME TES	8.00	30	$0.00	$103.88	$103.88
0181116110002-B	WALGREENS	1/2/23	LEVOTHYROXINE SODIUM	75MCG	90.00	90	$27.53	$0.00	$27.53
0181116110002-B	WALGREENS	1/2/23	NOVOLOG PENFILL	100U/ML	15.00	30	$40.00	$479.89	$519.89
0181116100102-B	CVS PHARMACY	1/2/23	TOUJEO SOLOSTAR	300U/ML	13.50	90	$100.00	$1,006.06	$1,106.06
0181116130102BB	HEB PHARMACY	1/2/23	ONDANSETRON ODT	4MG	14.00	5	$5.44	$0.00	$5.44
0181116110001-A	CVS PHARMACY	1/3/23	PANTOPRAZOLE SODIUM	40MG	180.00	90	$34.99	$0.00	$34.99
0181116110002-B	CAREMARK PRESCRIPTION SVC-CHI	1/3/23	SYNTHROID	150MCG	90.00	90	$115.92	$0.00	$115.92
0181116110002-B	HEB PHARMACY	1/3/23	AMITRIPTYLINE HYDROCHLORI	50MG	30.00	30	$4.00	$0.00	$4.00
0181116100001-A	HEB PHARMACY	1/3/23	SIMVASTATIN	20MG	90.00	90	$0.00	$3.32	$3.32
0181116100001-A	CVS PHARMACY	1/3/23	OXYCODONE/ACETAMINOPHEN	10-325MG	120.00	30	$13.60	$0.00	$13.60
0181116130102BB	CVS PHARMACY	1/3/23	METFORMIN HYDROCHLORIDE	500MG	120.00	30	$7.17	$0.00	$7.17
0181116130102BB	HEB PHARMACY	1/3/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116110002-B	WALGREENS	1/3/23	BENZONATATE	200MG	21.00	7	$11.69	$0.00	$11.69
0181116110002-B	WALGREENS	1/3/23	PREDNISONE	10MG	5.00	5	$1.64	$0.00	$1.64
0181116110002-B	WALGREENS	1/3/23	CLOTRIMAZOLE/BETAMETHASON	1%-0.05%	45.00	21	$15.00	$59.48	$74.48
0181116110002-B	WALGREENS	1/3/23	BASAGLAR KWIKPEN	100U/ML	18.00	82	$100.00	$271.82	$371.82
0181116110001-A	HEB PHARMACY	1/3/23	LORYNA	3-0.02MG	84.00	84	$0.00	$66.53	$66.53
0181116110002-B	CVS PHARMACY	1/3/23	BLISOVI FE 1/20	1/20	28.00	28	$0.00	$18.30	$18.30
0181116130101BA	CVS PHARMACY	1/3/23	XIIDRA	5%	60.00	30	$40.00	$572.90	$612.90
0181116130102BB	CVS PHARMACY	1/3/23	BINAXNOW COVID-19 AG CARD	HOME TES	6.00	6	$0.00	$77.91	$77.91
0181116110001-A	HEB PHARMACY	1/3/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	25	$15.00	$26.04	$41.04
0181116130102BB	WALGREENS	1/3/23	BENZONATATE	100MG	20.00	6	$6.17	$0.00	$6.17
0181116120001BA	WALGREENS	1/3/23	LEVOTHYROXINE SODIUM	125MCG	90.00	90	$29.04	$0.00	$29.04
0181116130102BB	WALGREENS	1/3/23	PAXLOVID	300-100	30.00	5	$0.00	$10.00	$10.00
0181116130102BB	WALGREENS	1/3/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	25	$15.00	$26.04	$41.04
0181116100001-A	WALMART PHARMACY	1/3/23	BUPROPION HYDROCHLORIDE E	150MG(W)	30.00	30	$15.00	$0.00	$15.00
0181116110001-A	HEB PHARMACY	1/3/23	METOPROLOL SUCCINATE ER	100MG ER	60.00	30	$15.00	$11.94	$26.94
0181116130102BB	HEB PHARMACY	1/3/23	FARXIGA	5MG	30.00	30	$40.00	$506.77	$546.77
0181116110001-A	HEB PHARMACY	1/3/23	PROPRANOLOL HYDROCHLORIDE	10MG	60.00	20	$15.00	$1.97	$16.97
0181116110002-B	WALMART PHARMACY	1/3/23	LORAZEPAM	0.5MG	20.00	7	$1.13	$0.00	$1.13
0181116100001-A	HEB PHARMACY	1/3/23	VALACYCLOVIR HYDROCHLORID	500MG	90.00	90	$37.50	$24.38	$61.88
0181116110001-A	WALGREENS	1/3/23	NURTEC	75MG	8.00	16	$40.00	$879.80	$919.80
0181116110002-B	CVS PHARMACY	1/3/23	FLUCONAZOLE	150MG	2.00	2	$7.28	$0.00	$7.28
0181116120001BA	WALGREENS	1/3/23	MODERNA COVID-19 VACCINE/	BA4/BA5	0.50	1	$0.00	$40.00	$40.00
0181116110003-C	38TH ST PHARMACY INC	1/3/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	16	$15.00	$26.04	$41.04
0181116110001-A	ALTO PHARMACY	1/3/23	LETROZOLE	2.5MG	10.00	5	$3.23	$0.00	$3.23
0181116110001-A	HEB PHARMACY	1/3/23	FLUOXETINE HYDROCHLORIDE	20MG	30.00	30	$3.71	$0.00	$3.71
0181116100001-A	CVS PHARMACY	1/3/23	TRIAMCINOLONE ACETONIDE	0.1%	30.00	30	$8.09	$0.00	$8.09
0181116110002-B	HEB PHARMACY	1/3/23	ROSUVASTATIN CALCIUM	40MG	30.00	30	$15.00	$80.56	$95.56
0181116100002-B	HEB PHARMACY	1/3/23	LOSARTAN POTASSIUM	100MG	90.00	90	$10.82	$0.00	$10.82
0181116110002-B	HEB PHARMACY	1/3/23	DICYCLOMINE HYDROCHLORIDE	20MG	30.00	8	$3.63	$0.00	$3.63
0181116100002-B	WALGREENS	1/3/23	LACTULOSE	10GM/15	600.00	30	$10.29	$0.00	$10.29
0181116100001-A	CVS PHARMACY	1/3/23	BINAXNOW COVID-19 AG CARD	HOME TES	8.00	8	$0.00	$103.88	$103.88
0181116110002-B	CVS PHARMACY	1/3/23	FLUCONAZOLE	150MG	12.00	84	$37.50	$2.50	$40.00
0181116110001-A	CVS PHARMACY	1/3/23	ATORVASTATIN CALCIUM	10MG	90.00	90	$0.00	$14.26	$14.26
0181116110001-A	CVS PHARMACY	1/3/23	DILTIAZEM HYDROCHLORIDE	120MG	180.00	90	$37.50	$41.11	$78.61
0181116110002-B	CVS PHARMACY	1/3/23	METRONIDAZOLE VAGINAL	0.75%VAG	70.00	90	$37.50	$24.09	$61.59
0181116110002-B	HEB PHARMACY	1/3/23	LEVEMIR FLEXTOUCH	FLEXTOUC	30.00	30	$40.00	$853.69	$893.69
0181116110002-B	HEB PHARMACY	1/3/23	PREDNISONE	10MG	20.00	20	$4.43	$0.00	$4.43
0181116110002-B	HEB PHARMACY	1/3/23	AMOXICILLIN	500MG	60.00	20	$8.00	$0.00	$8.00
0181116100002-B	WALGREENS	1/3/23	OZEMPIC	8MG/3ML	3.00	28	$40.00	$822.43	$862.43
0181116110002-B	HEB PHARMACY	1/3/23	LIDOCAINE VISCOUS	2% VISC	100.00	5	$3.81	$0.00	$3.81
0181116100001-A	CVS PHARMACY	1/3/23	EPINEPHRINE	0.3MG	2.00	30	$15.00	$94.99	$109.99
0181116100002-B	WALGREENS	1/3/23	BINAXNOW COVID-19 AG CARD	HOME TES	8.00	30	$0.00	$79.30	$79.30
0181116100001-A	RANDALLS PHARMACY	1/3/23	TRAZODONE HYDROCHLORIDE	50MG	30.00	30	$2.18	$0.00	$2.18
0181116100001-A	RANDALLS PHARMACY	1/3/23	ESOMEPRAZOLE MAGNESIUM	40MG DR	30.00	30	$15.00	$197.58	$212.58
0181116100001-A	RANDALLS PHARMACY	1/3/23	TRI-LO-ESTARYLLA	ESTARYLL	28.00	28	$0.00	$25.89	$25.89
0181116110002-B	CVS PHARMACY	1/3/23	GABAPENTIN	100MG	90.00	30	$7.49	$0.00	$7.49
0181116110002-B	CVS PHARMACY	1/3/23	PROPRANOLOL HYDROCHLORIDE	20MG	90.00	90	$34.44	$0.00	$34.44
0181116100002-B	HEB PHARMACY	1/3/23	LISINOPRIL	10MG	90.00	90	$4.90	$0.00	$4.90
0181116100002-B	WALGREENS	1/3/23	VYVANSE	50MG	30.00	30	$40.00	$317.46	$357.46
0181116110001-A	HEB PHARMACY	1/3/23	METOPROLOL SUCCINATE ER	25MG ER	30.00	30	$7.60	$0.00	$7.60
0181116110001-A	HEB PHARMACY	1/3/23	LEVOTHYROXINE SODIUM	100MCG	30.00	30	$10.11	$0.00	$10.11
0181116110002-B	CVS PHARMACY	1/3/23	CEPHALEXIN	500MG	28.00	7	$4.01	$0.00	$4.01
0181116100002-B	WALGREENS	1/3/23	OZEMPIC	4MG/3ML	3.00	28	$40.00	$822.43	$862.43
0181116110002-B	CVS PHARMACY	1/3/23	AMPHETAMINE/DEXTROAMPHETA	15MG ER	30.00	30	$15.00	$24.73	$39.73
0181116110002-B	HEB PHARMACY	1/3/23	AMOXICILLIN/CLAVULANATE P	875-125	20.00	10	$13.81	$0.00	$13.81
0181116100002-B	WALGREENS	1/3/23	MUPIROCIN	2%	22.00	10	$8.64	$0.00	$8.64
0181116110002-B	HEB PHARMACY	1/3/23	TRULICITY	4.5/0.5	2.00	28	$40.00	$859.93	$899.93
0181116110002-B	GRAND AVENUE PHARMACY	1/3/23	FLOWFLEX COVID-19 ANTIGEN	TEST	8.00	30	$0.00	$112.00	$112.00
0181116100001-A	CVS PHARMACY	1/4/23	GABAPENTIN	300MG	60.00	30	$7.69	$0.00	$7.69
0181116100002-B	CVS PHARMACY	1/4/23	MONTELUKAST SODIUM	10MG	90.00	90	$25.14	$0.00	$25.14
0181116110001-A	CVS PHARMACY	1/4/23	AMITRIPTYLINE HYDROCHLORI	50MG	60.00	30	$15.00	$3.99	$18.99
0181116100002-B	WALGREENS	1/4/23	GABAPENTIN	300MG	30.00	30	$4.20	$0.00	$4.20
0181116110002-B	WALGREENS	1/4/23	METFORMIN HYDROCHLORIDE E	500MG GP	360.00	90	$20.92	$0.00	$20.92
0181116110001-A	HEB PHARMACY	1/4/23	HYDROCORTISONE	10MG	120.00	30	$15.00	$19.37	$34.37
0181116110002-B	CVS PHARMACY	1/4/23	METFORMIN HYDROCHLORIDE E	500MG GP	180.00	90	$10.74	$0.00	$10.74
0181116110002-B	CVS PHARMACY	1/4/23	ATORVASTATIN CALCIUM	40MG	90.00	90	$17.50	$0.00	$17.50
0181116110001-A	WALGREENS	1/4/23	VYVANSE	30MG	30.00	30	$40.00	$317.46	$357.46
0181116100001-A	CVS PHARMACY	1/4/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	30	$15.00	$26.04	$41.04
0181116130102BB	COMMUNITYCARE CENTRAL PHARMACY	1/4/23	OZEMPIC	2/1.5ML	1.50	28	$40.00	$822.43	$862.43
0181116100001-A	WALGREENS	1/4/23	MELOXICAM	15MG	90.00	90	$2.98	$0.00	$2.98
0181116100002-B	CVS PHARMACY	1/4/23	FLUTICASONE PROPIONATE	50MCG RX	16.00	30	$7.04	$0.00	$7.04
0181116100001-A	SAFEWAY PHARMACY	1/4/23	FAMOTIDINE	40MG	90.00	90	$8.88	$0.00	$8.88
0181116100002-B	WALMART PHARMACY	1/4/23	ATORVASTATIN CALCIUM	40MG	90.00	90	$17.50	$0.00	$17.50
0181116110002-B	WALGREENS	1/4/23	FLUTICASONE PROPIONATE	50MCG RX	16.00	30	$7.04	$0.00	$7.04
0181116110002-B	CHOICE SPECIALTY PHARMACY	1/4/23	XYOSTED	75/0.5ML	2.00	28	$75.00	$511.30	$586.30
0181116120001BA	HEB PHARMACY	1/4/23	TRAZODONE HYDROCHLORIDE	50MG	90.00	90	$5.01	$0.00	$5.01
0181116110002-B	MANOR PHARMACY	1/4/23	TIZANIDINE HYDROCHLORIDE	4MG	30.00	10	$8.18	$0.00	$8.18
0181116110002-B	MANOR PHARMACY	1/4/23	METHYLPREDNISOLONE DOSE P	4MG DPAK	1.00	6	$1.22	$0.00	$1.22
0181116100001-A	SAFEWAY PHARMACY	1/4/23	OZEMPIC	2/1.5ML	4.00	90	$100.00	$1,591.89	$1,691.89
0181116130101BA	SYMPHONY PHARMACY	1/4/23	SODIUM SULFACETAMIDE/SULF	8-4%	473.00	30	$15.00	$380.12	$395.12
0181116110001-A	WALMART PHARMACY	1/4/23	OZEMPIC	8MG/3ML	3.00	28	$40.00	$822.43	$862.43
0181116130101BA	SYMPHONY PHARMACY	1/4/23	SPIRONOLACTONE	50MG	30.00	30	$7.32	$0.00	$7.32
0181116110002-B	WALGREENS	1/4/23	BENZONATATE	200MG	30.00	10	$15.00	$1.41	$16.41
0181116110002-B	WALGREENS	1/4/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116130101BA	CVS PHARMACY	1/4/23	DOXYCYCLINE HYCLATE	100MG	14.00	7	$9.58	$0.00	$9.58
0181116100001-A	CVS PHARMACY	1/4/23	UBRELVY	100MG	10.00	30	$40.00	$911.24	$951.24
0181116100001-A	WALGREENS	1/4/23	PANTOPRAZOLE SODIUM	40MG	90.00	90	$17.78	$0.00	$17.78
0181116110002-B	WALGREENS	1/4/23	ACCU-CHEK GUIDE TEST STRI	GUIDE	100.00	50	$38.47	$0.00	$38.47
0181116110001-A	HEB PHARMACY	1/4/23	BUPROPION HYDROCHLORIDE E	150MG(W)	60.00	60	$14.87	$0.00	$14.87
0181116100001-A	WALMART PHARMACY	1/4/23	PANTOPRAZOLE SODIUM	40MG	30.00	30	$6.44	$0.00	$6.44
0181116110002-B	WALGREENS	1/4/23	TRULICITY	1.5/0.5	6.00	84	$100.00	$2,547.98	$2,647.98
0181116110002-B	WALGREENS	1/4/23	NURTEC	75MG	8.00	28	$40.00	$879.80	$919.80
0181116100002-B	CVS PHARMACY	1/4/23	FLUCONAZOLE	150MG	2.00	2	$7.28	$0.00	$7.28
0181116100001-A	CAREMARK SPECIALTY PHARMACY	1/4/23	HUMIRA PEN	40/0.4ML	2.00	28	$40.00	$6,792.62	$6,832.62
0181116110003-C	WALGREENS	1/4/23	CLONIDINE HYDROCHLORIDE	0.1MG	30.00	15	$2.77	$0.00	$2.77
0181116130102BB	WALMART PHARMACY	1/4/23	OZEMPIC	2/1.5ML	1.50	56	$100.00	$746.22	$846.22
0181116130102BB	HEB PHARMACY	1/4/23	METFORMIN HYDROCHLORIDE E	500MG GP	180.00	90	$10.00	$0.00	$10.00
0181116110002-B	MANOR PHARMACY	1/4/23	MEDROXYPROGESTERONE ACETA	10MG	21.00	7	$6.62	$0.00	$6.62
0181116100002-B	WALMART PHARMACY	1/4/23	IBUPROFEN	800MG	60.00	15	$6.13	$0.00	$6.13
0181116110001-A	HEB PHARMACY	1/4/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116110001-A	HEB PHARMACY	1/4/23	AMOXICILLIN	500MG	42.00	7	$5.60	$0.00	$5.60
0181116110002-B	CVS PHARMACY	1/4/23	METRONIDAZOLE	500MG	14.00	7	$8.85	$0.00	$8.85
0181116110001-A	HEB PHARMACY	1/4/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	17	$15.00	$26.04	$41.04
0181116110002-B	VINA PHARMACY	1/4/23	DROSPIRENONE/ETHINYL ESTR	3-0.03MG	28.00	28	$0.00	$19.54	$19.54
0181116110002-B	CVS PHARMACY	1/4/23	NITROFURANTOIN MONOHYDRAT	100MG	14.00	7	$11.87	$0.00	$11.87
0181116100001-A	WALGREENS	1/4/23	AMPHETAMINE/DEXTROAMPHETA	10MG ER	30.00	30	$15.00	$23.33	$38.33
0181116110002-B	HEB PHARMACY	1/4/23	FARXIGA	5MG	30.00	30	$40.00	$506.77	$546.77
0181116110002-B	HEB PHARMACY	1/4/23	VIENVA	0.1-20	84.00	84	$0.00	$29.77	$29.77
0181116110002-B	CVS PHARMACY	1/4/23	CETIRIZINE HYDROCHLORIDE	1MG/ML	118.00	23	$9.73	$0.00	$9.73
0181116110002-B	CVS PHARMACY	1/4/23	OFLOXACIN	0.3% OP	10.00	15	$11.02	$0.00	$11.02
0181116110002-B	CVS PHARMACY	1/4/23	CETIRIZINE HYDROCHLORIDE	1MG/ML	75.00	30	$6.44	$0.00	$6.44
0181116110002-B	WALMART PHARMACY	1/4/23	AMLODIPINE BESYLATE	5MG	90.00	90	$9.46	$0.00	$9.46
0181116110002-B	WALMART PHARMACY	1/4/23	ATORVASTATIN CALCIUM	20MG	90.00	90	$0.00	$17.48	$17.48
0181116130101BA	HEB PHARMACY	1/4/23	LOSARTAN POTASSIUM	50MG	90.00	90	$7.78	$0.00	$7.78
0181116100002-B	WALGREENS	1/4/23	HUMULIN R U-500 KWIKPEN	U-500KWP	18.00	29	$40.00	$1,624.73	$1,664.73
0181116100001-A	CVS PHARMACY	1/4/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	17	$15.00	$26.04	$41.04
0181116100001-A	CVS PHARMACY	1/4/23	ALPRAZOLAM	0.25MG	30.00	30	$1.37	$0.00	$1.37
0181116100001-A	CVS PHARMACY	1/4/23	MONTELUKAST SODIUM	10MG	90.00	90	$25.14	$0.00	$25.14
0181116100001-A	PUBLIX PHARMACY	1/5/23	MONTELUKAST SODIUM	10MG	30.00	30	$8.90	$0.00	$8.90
0181116100001-A	CVS PHARMACY	1/5/23	PFIZER-BIONTECH COVID-19	5-11Y	0.20	1	$0.00	$40.00	$40.00
0181116100001-A	CVS PHARMACY	1/5/23	PFIZER-BIONTECH COVID-19	5-11Y	0.20	1	$0.00	$40.00	$40.00
0181116100001-A	WALGREENS	1/5/23	XIFAXAN	550MG	60.00	30	$40.00	$3,013.06	$3,053.06
0181116110002-B	HEB PHARMACY	1/5/23	AMANTADINE HCL	100MG	180.00	90	$37.50	$68.62	$106.12
0181116110002-B	HEB PHARMACY	1/5/23	TRAZODONE HYDROCHLORIDE	100MG	30.00	30	$4.00	$0.00	$4.00
0181116110002-B	HEB PHARMACY	1/5/23	LIDOCAINE VISCOUS	2% VISC	200.00	4	$6.91	$0.00	$6.91
0181116110002-B	HEB PHARMACY	1/5/23	PRAVASTATIN SODIUM	40MG	90.00	90	$32.28	$0.00	$32.28
0181116110002-B	HEB PHARMACY	1/5/23	NOVOLOG PENFILL	100U/ML	30.00	30	$40.00	$999.09	$1,039.09
0181116100001-A	HEB PHARMACY	1/5/23	METOPROLOL SUCCINATE ER	50MG ER	90.00	90	$21.25	$0.00	$21.25
0181116110002-B	HEB PHARMACY	1/5/23	IPRATROPIUM BROMIDE	0.03%	30.00	23	$11.69	$0.00	$11.69
0181116130101BA	HEB PHARMACY	1/5/23	VENLAFAXINE HYDROCHLORIDE	75MG ER	30.00	30	$7.27	$0.00	$7.27
0181116130102BB	HEB PHARMACY	1/5/23	AMOXICILLIN	500MG	21.00	7	$3.30	$0.00	$3.30
0181116130102BB	HEB PHARMACY	1/5/23	CHLORHEXIDINE GLUCONATE	0.12%	473.00	16	$4.00	$0.00	$4.00
0181116100001-A	HEB PHARMACY	1/5/23	ALPRAZOLAM	0.5MG	6.00	6	$0.86	$0.00	$0.86
0181116110002-B	WALGREENS	1/5/23	IBUPROFEN	600MG	30.00	7	$3.03	$0.00	$3.03
0181116110002-B	WALGREENS	1/5/23	OXYCODONE HYDROCHLORIDE	5MG	30.00	5	$5.78	$0.00	$5.78
0181116130102BB	HEB PHARMACY	1/5/23	TRANEXAMIC ACID	650MG	30.00	5	$15.00	$47.18	$62.18
0181116110002-B	HEB PHARMACY	1/5/23	CEPHALEXIN	500MG	14.00	7	$2.36	$0.00	$2.36
0181116110002-B	WALGREENS	1/5/23	LEVOTHYROXINE SODIUM	125MCG	90.00	90	$29.04	$0.00	$29.04
0181116100002-B	HEB PHARMACY	1/5/23	TRAZODONE HYDROCHLORIDE	50MG	90.00	90	$5.01	$0.00	$5.01
0181116110001-A	CVS PHARMACY	1/5/23	QUETIAPINE FUMARATE	300MG	90.00	90	$25.90	$0.00	$25.90
0181116120001BA	HEB PHARMACY	1/5/23	LEVOTHYROXINE SODIUM	50MCG	90.00	90	$23.14	$0.00	$23.14
0181116100001-A	WALGREENS	1/5/23	SIMVASTATIN	20MG	90.00	90	$3.32	$0.00	$3.32
0181116110003-C	CVS PHARMACY	1/5/23	DOXYCYCLINE HYCLATE	100MG	14.00	7	$9.58	$0.00	$9.58
0181116110001-A	TOM THUMB PHARMACY	1/5/23	NITROFURANTOIN MONOHYDRAT	100MG	10.00	5	$8.68	$0.00	$8.68
0181116110003-C	CVS PHARMACY	1/5/23	PREDNISONE	20MG	10.00	5	$2.77	$0.00	$2.77
0181116110002-B	EXPRESS PHARMACY	1/5/23	OZEMPIC	4MG/3ML	3.00	28	$40.00	$864.65	$904.65
0181116110001-A	WALMART PHARMACY	1/5/23	BIJUVA	1-100MG	30.00	30	$75.00	$159.87	$234.87
0181116110002-B	HEB PHARMACY	1/5/23	JARDIANCE	10MG	90.00	90	$100.00	$1,587.90	$1,687.90
0181116130102BB	HEB PHARMACY	1/5/23	LOSARTAN POTASSIUM	100MG	90.00	90	$10.82	$0.00	$10.82
0181116130102BB	HEB PHARMACY	1/5/23	MONTELUKAST SODIUM	10MG	90.00	90	$25.14	$0.00	$25.14
0181116110001-A	HEB PHARMACY	1/5/23	SILVER SULFADIAZINE	1%	100.00	30	$15.00	$14.72	$29.72
0181116110002-B	WALGREENS	1/5/23	FIASP FLEXTOUCH	100U/ML	18.00	30	$40.00	$608.50	$648.50
0181116100002-B	WALGREENS	1/5/23	LEVOFLOXACIN	500MG	7.00	7	$2.70	$0.00	$2.70
0181116100001-A	CAREMARK PRESCRIPTION SVC-CHI	1/5/23	ACCU-CHEK SOFTCLIX LANCET	SOFTCLIX	100.00	90	$10.79	$0.00	$10.79
0181116130102BB	HEB PHARMACY	1/5/23	OZEMPIC	4MG/3ML	3.00	28	$40.00	$864.65	$904.65
0181116130102BB	HEB PHARMACY	1/5/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	17	$15.00	$26.04	$41.04
0181116110001-A	WALGREENS	1/5/23	PREDNISONE	20MG	11.00	9	$2.96	$0.00	$2.96
0181116100001-A	CVS PHARMACY	1/5/23	TRETINOIN	0.025%	45.00	30	$15.00	$64.99	$79.99
0181116110001-A	WALGREENS	1/5/23	ESTRADIOL	0.01%	42.50	90	$37.50	$59.05	$96.55
0181116100002-B	WALMART PHARMACY	1/5/23	ZENATANE	40MG	60.00	30	$15.00	$113.52	$128.52
0181116110002-B	HEB PHARMACY	1/5/23	FLUOXETINE HYDROCHLORIDE	10MG	90.00	90	$9.59	$0.00	$9.59
0181116100001-A	KROGER PHARMACY	1/5/23	GABAPENTIN	600MG	90.00	30	$12.74	$0.00	$12.74
0181116100001-A	KROGER PHARMACY	1/5/23	BUPROPION HYDROCHLORIDE E	300MG	30.00	30	$15.00	$3.67	$18.67
0181116100001-A	HEB PHARMACY	1/5/23	OZEMPIC	8MG/3ML	3.00	28	$40.00	$864.65	$904.65
0181116110002-B	CVS PHARMACY	1/5/23	IPRATROPIUM BROMIDE	0.06%	15.00	13	$8.51	$0.00	$8.51
0181116110001-A	WALGREENS	1/5/23	FLUCONAZOLE	150MG	2.00	3	$7.28	$0.00	$7.28
0181116110001-A	WALGREENS	1/5/23	XIFAXAN	550MG	42.00	14	$40.00	$2,097.35	$2,137.35
0181116120001BA	CVS PHARMACY	1/5/23	AMPHETAMINE/DEXTROAMPHETA	25MG ER	60.00	30	$15.00	$63.76	$78.76
0181116100001-A	CVS PHARMACY	1/5/23	NITROFURANTOIN MONOHYDRAT	100MG	20.00	30	$15.00	$1.66	$16.66
0181116100001-A	HEB PHARMACY	1/5/23	ESCITALOPRAM OXALATE	10MG	90.00	90	$12.73	$0.00	$12.73
0181116100001-A	HEB PHARMACY	1/5/23	BUSPIRONE HYDROCHLORIDE	10MG	360.00	90	$20.00	$0.00	$20.00
0181116110001-A	HEB PHARMACY	1/5/23	FLOVENT HFA	44MCG	10.60	30	$40.00	$158.29	$198.29
0181116100001-A	WALGREENS	1/5/23	HALOBETASOL PROPIONATE	0.05%	50.00	20	$15.00	$138.78	$153.78
0181116100001-A	HEB PHARMACY	1/5/23	PEG-3350/ELECTROLYTES	ELECTROL	4000.00	1	$13.12	$0.00	$13.12
0181116100002-B	HEB PHARMACY	1/5/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116110002-B	COMMUNITYCARE CENTRAL PHARMACY	1/5/23	FLUTICASONE PROPIONATE	50MCG RX	16.00	30	$7.04	$0.00	$7.04
0181116110001-A	INTEGRATED RX ASSOCIATES	1/5/23	PLENVU		3.00	2	$0.00	$134.72	$134.72
0181116100002-B	HEB PHARMACY	1/5/23	OZEMPIC	2/1.5ML	1.50	28	$40.00	$864.65	$904.65
0181116110002-B	HEB PHARMACY	1/5/23	LINZESS	72MCG	90.00	90	$100.00	$1,365.66	$1,465.66
0181116100002-B	AURO PHARMACY	1/5/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	30	$15.00	$21.68	$36.68
0181116100002-B	AURO PHARMACY	1/5/23	TRAZODONE HYDROCHLORIDE	50MG	90.00	90	$5.01	$0.00	$5.01
0181116100002-B	AURO PHARMACY	1/5/23	MONTELUKAST SODIUM	10MG	90.00	90	$25.14	$0.00	$25.14
0181116100002-B	AURO PHARMACY	1/5/23	LOSARTAN POTASSIUM/HYDROC	100-12.5	90.00	90	$37.50	$41.60	$79.10
0181116110002-B	WALGREENS	1/5/23	ATORVASTATIN CALCIUM	40MG	30.00	30	$6.35	$0.00	$6.35
0181116110001-A	WALGREENS	1/5/23	NORTRIPTYLINE HYDROCHLORI	10MG	90.00	44	$11.91	$0.00	$11.91
0181116110002-B	CVS PHARMACY	1/5/23	OFLOXACIN	0.3% OP	10.00	34	$11.02	$0.00	$11.02
0181116100002-B	AURO PHARMACY	1/5/23	ADVAIR DISKUS	100/50	60.00	30	$15.00	$291.97	$306.97
0181116130102BB	HEB PHARMACY	1/5/23	TRIAZOLAM	0.125MG	6.00	1	$15.00	$1.08	$16.08
0181116110002-B	HEB PHARMACY	1/5/23	ATORVASTATIN CALCIUM	40MG	90.00	90	$17.50	$0.00	$17.50
0181116110002-B	HEB PHARMACY	1/5/23	METFORMIN HYDROCHLORIDE	1000MG	180.00	90	$10.00	$0.00	$10.00
0181116110002-B	HEB PHARMACY	1/5/23	AMOXICILLIN	500MG	28.00	7	$4.00	$0.00	$4.00
0181116110002-B	HEB PHARMACY	1/5/23	FLUCONAZOLE	150MG	2.00	2	$7.28	$0.00	$7.28
0181116110002-B	HEB PHARMACY	1/5/23	DESVENLAFAXINE ER	100MG ER	90.00	90	$37.50	$277.98	$315.48
0181116110002-B	HEB PHARMACY	1/5/23	LORAZEPAM	0.5MG	20.00	20	$1.13	$0.00	$1.13
0181116110002-B	HEB PHARMACY	1/5/23	VYVANSE	60MG	30.00	30	$40.00	$317.46	$357.46
0181116130102BB	WALMART PHARMACY	1/5/23	CYCLOBENZAPRINE HYDROCHLO	5MG	30.00	10	$6.51	$0.00	$6.51
0181116110001-A	WALGREENS	1/5/23	METRONIDAZOLE	500MG	21.00	7	$12.32	$0.00	$12.32
0181116110001-A	WALGREENS	1/5/23	CIPROFLOXACIN HYDROCHLORI	500MG	14.00	7	$3.75	$0.00	$3.75
0181116110002-B	HEB PHARMACY	1/5/23	BENZONATATE	200MG	60.00	20	$15.00	$17.11	$32.11
0181116100002-B	HEB PHARMACY	1/5/23	BENZONATATE	200MG	30.00	10	$15.00	$1.41	$16.41
0181116130102BB	WALMART PHARMACY	1/5/23	IBUPROFEN	600MG	30.00	8	$3.03	$0.00	$3.03
0181116100002-B	WALGREENS	1/5/23	CEPHALEXIN	250/5ML	300.00	10	$15.00	$54.70	$69.70
0181116110001-A	WALGREENS	1/5/23	AMOXICILLIN	400/5ML	200.00	10	$15.00	$1.40	$16.40
0181116110001-A	WALGREENS	1/5/23	BINAXNOW COVID-19 AG CARD	HOME TES	8.00	30	$0.00	$79.30	$79.30
0181116130102BB	HEB PHARMACY	1/5/23	TRIAMCINOLONE ACETONIDE	0.1%	30.00	15	$9.29	$0.00	$9.29
0181116130101BA	HEB PHARMACY	1/5/23	HYDROXYZINE HYDROCHLORIDE	10MG	30.00	30	$5.61	$0.00	$5.61
0181116110001-A	WALGREENS	1/5/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116110001-A	WALGREENS	1/5/23	HYDROCODONE POLISTIREX/CH	10-8/5ML	70.00	7	$15.00	$6.14	$21.14
0181116110001-A	CAREMARK SPECIALTY PHARMACY	1/5/23	NORDITROPIN FLEXPRO	15/1.5ML	6.00	28	$40.00	$8,860.92	$8,900.92
0181116110002-B	CVS PHARMACY	1/5/23	NOVOLOG FLEXPEN	100U/ML	45.00	90	$100.00	$1,489.87	$1,589.87
0181116110002-B	CVS PHARMACY	1/5/23	ATORVASTATIN CALCIUM	20MG	90.00	90	$17.48	$0.00	$17.48
0181116110001-A	CVS PHARMACY	1/6/23	ESCITALOPRAM OXALATE	10MG	90.00	90	$12.73	$0.00	$12.73
0181116130102BB	CVS PHARMACY	1/6/23	SPIRIVA RESPIMAT	1.25MCG	4.00	30	$40.00	$455.32	$495.32
0181116110002-B	CVS PHARMACY	1/6/23	SERTRALINE HYDROCHLORIDE	100MG	90.00	90	$11.06	$0.00	$11.06
0181116100002-B	CVS PHARMACY	1/6/23	FLUOXETINE HYDROCHLORIDE	20MG	90.00	90	$9.59	$0.00	$9.59
0181116100002-B	WALGREENS	1/6/23	HYDROCODONE BITARTRATE/AC	5-325MG	7.00	1	$2.43	$0.00	$2.43
0181116100002-B	WALGREENS	1/6/23	PENICILLIN V POTASSIUM	500MG	14.00	7	$3.44	$0.00	$3.44
0181116110001-A	WALGREENS	1/6/23	ADVAIR DISKUS	250/50	180.00	90	$37.50	$1,083.40	$1,120.90
0181116100002-B	HEB PHARMACY	1/6/23	IMVEXXY MAINTENANCE PACK	4MCG	8.00	28	$40.00	$169.01	$209.01
0181116130102BB	HEB PHARMACY	1/6/23	NOVOLOG FLEXPEN	100U/ML	15.00	25	$40.00	$500.53	$540.53
0181116110002-B	HEB PHARMACY	1/6/23	FLUVOXAMINE MALEATE	50MG	60.00	30	$15.00	$1.01	$16.01
0181116110002-B	CVS PHARMACY	1/6/23	LEVOTHYROXINE SODIUM	88MCG	90.00	90	$30.04	$0.00	$30.04
0181116130101BA	WALGREENS	1/6/23	VILAZODONE HYDROCHLORIDE	20MG	30.00	30	$15.00	$191.99	$206.99
0181116100001-A	PEOPLES PHARMACY	1/6/23	LOSARTAN POTASSIUM	50MG	90.00	90	$7.78	$0.00	$7.78
0181116100002-B	WALGREENS	1/6/23	FLUOXETINE HYDROCHLORIDE	20MG	30.00	30	$3.71	$0.00	$3.71
0181116100002-B	WALGREENS	1/6/23	DICYCLOMINE HYDROCHLORIDE	10MG	30.00	7	$2.84	$0.00	$2.84
0181116100002-B	WALGREENS	1/6/23	OMEPRAZOLE	40MG	30.00	30	$9.82	$0.00	$9.82
0181116110001-A	HEB PHARMACY	1/6/23	EMTRICITABINE/TENOFOVIR D	200-300	30.00	30	$0.00	$1,208.32	$1,208.32
0181116110001-A	TOM THUMB PHARMACY	1/6/23	SULFAMETHOXAZOLE/TRIMETHO	800-160	6.00	3	$1.56	$0.00	$1.56
0181116110001-A	CVS PHARMACY	1/6/23	CLONAZEPAM	1MG	90.00	90	$6.00	$0.00	$6.00
0181116110001-A	SAM'S CLUB PHARMACY	1/6/23	TRETINOIN	0.025%	45.00	30	$15.00	$127.64	$142.64
0181116110002-B	HEB PHARMACY	1/6/23	BUPROPION HYDROCHLORIDE E	150MG(W)	30.00	30	$15.00	$1.19	$16.19
0181116110002-B	CVS PHARMACY	1/6/23	PANTOPRAZOLE SODIUM	40MG	90.00	90	$17.78	$0.00	$17.78
0181116110002-B	CVS PHARMACY	1/6/23	ETODOLAC	400MG	20.00	10	$8.81	$0.00	$8.81
0181116130101BA	HEB PHARMACY	1/6/23	METFORMIN HYDROCHLORIDE E	500MG GP	360.00	90	$20.00	$0.00	$20.00
0181116130101BA	HEB PHARMACY	1/6/23	GLIPIZIDE ER	5MG	90.00	90	$18.72	$0.00	$18.72
0181116130101BA	HEB PHARMACY	1/6/23	LEVEMIR FLEXTOUCH	FLEXTOUC	15.00	83	$100.00	$338.72	$438.72
0181116130102BB	WALGREENS	1/6/23	NORETHINDRONE	0.35MG	84.00	84	$0.00	$36.79	$36.79
0181116110002-B	CVS PHARMACY	1/6/23	MONTELUKAST SODIUM	10MG	30.00	30	$8.90	$0.00	$8.90
0181116110002-B	CVS PHARMACY	1/6/23	BENZONATATE	200MG	30.00	10	$15.00	$1.41	$16.41
0181116130102BB	WALMART PHARMACY	1/6/23	PAXLOVID	300-100	30.00	5	$0.00	$10.00	$10.00
0181116100001-A	WALGREENS	1/6/23	GAVILYTE-G	LEMON PK	4000.00	1	$13.12	$0.00	$13.12
0181116110002-B	HEB PHARMACY	1/6/23	MODERNA COVID-19 VACCINE/	BA4/BA5	0.50	1	$0.00	$40.00	$40.00
0181116110002-B	HEB PHARMACY	1/6/23	AMOXICILLIN/CLAVULANATE P	875-125	14.00	7	$9.88	$0.00	$9.88
0181116100002-B	CVS PHARMACY	1/6/23	ERRIN	0.35MG	84.00	84	$0.00	$36.79	$36.79
0181116110002-B	HEB PHARMACY	1/6/23	BENZONATATE	200MG	30.00	10	$15.00	$1.41	$16.41
0181116130102BB	CVS PHARMACY	1/6/23	NIFEDIPINE ER	30MG ER	30.00	30	$10.50	$0.00	$10.50
0181116110002-B	HEB PHARMACY	1/6/23	PROMETHAZINE DM	DM	120.00	6	$4.00	$0.00	$4.00
0181116110002-B	HEB PHARMACY	1/6/23	BENZONATATE	100MG	30.00	10	$4.00	$0.00	$4.00
0181116110002-B	HEB PHARMACY	1/6/23	LETROZOLE	2.5MG	5.00	30	$1.97	$0.00	$1.97
0181116110002-B	HEB PHARMACY	1/6/23	METHYLPHENIDATE HYDROCHLO	54MG OSM	20.00	20	$15.00	$8.04	$23.04
0181116110002-B	HEB PHARMACY	1/6/23	LATANOPROST	0.005%	2.50	25	$11.77	$0.00	$11.77
0181116110002-B	HEB PHARMACY	1/6/23	MEDROXYPROGESTERONE ACETA	150MG/ML	1.00	90	$0.00	$50.48	$50.48
0181116100001-A	HEB PHARMACY	1/6/23	FLUCONAZOLE	150MG	2.00	1	$7.28	$0.00	$7.28
0181116100001-A	HEB PHARMACY	1/6/23	AMOXICILLIN	875MG	14.00	7	$4.87	$0.00	$4.87
0181116110002-B	HEB PHARMACY	1/6/23	ESCITALOPRAM OXALATE	20MG	90.00	90	$16.20	$0.00	$16.20
0181116120002BB	CVS PHARMACY	1/6/23	JARDIANCE	10MG	90.00	90	$100.00	$1,587.90	$1,687.90
0181116110002-B	HEB PHARMACY	1/6/23	NURTEC	75MG	16.00	30	$40.00	$1,798.90	$1,838.90
0181116120002BB	CVS PHARMACY	1/6/23	LISINOPRIL	10MG	90.00	90	$4.90	$0.00	$4.90
0181116120002BB	CVS PHARMACY	1/6/23	ATORVASTATIN CALCIUM	40MG	90.00	90	$17.50	$0.00	$17.50
0181116120002BB	CVS PHARMACY	1/6/23	NOVOLOG FLEXPEN	100U/ML	15.00	16	$40.00	$500.53	$540.53
0181116110002-B	WALGREENS	1/6/23	HYOSCYAMINE SULFATE ODT	0.125MG	90.00	30	$15.00	$46.90	$61.90
0181116110002-B	HEB PHARMACY	1/6/23	TRAMADOL HYDROCHLORIDE	50MG	40.00	10	$1.62	$0.00	$1.62
0181116110002-B	HEB PHARMACY	1/6/23	MELOXICAM	7.5MG	60.00	30	$2.60	$0.00	$2.60
0181116100001-A	WALMART PHARMACY	1/6/23	SERTRALINE HYDROCHLORIDE	100MG	90.00	90	$11.06	$0.00	$11.06
0181116110002-B	WALGREENS	1/6/23	BINAXNOW COVID-19 AG CARD	HOME TES	6.00	4	$0.00	$60.10	$60.10
0181116110001-A	WALGREENS	1/6/23	PREDNISONE	20MG	6.00	3	$1.93	$0.00	$1.93
0181116110001-A	WALGREENS	1/6/23	MONTELUKAST SODIUM	10MG	30.00	30	$8.90	$0.00	$8.90
0181116130102BB	HEB PHARMACY	1/6/23	ACETAMINOPHEN/CODEINE	300-30MG	20.00	5	$4.96	$0.00	$4.96
0181116120002BB	HEB PHARMACY	1/6/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	50	$37.50	$3.39	$40.89
0181116120002BB	HEB PHARMACY	1/6/23	CEFDINIR	250/5ML	120.00	7	$15.00	$107.73	$122.73
0181116100001-A	CAREMARK PRESCRIPTION SVC-CHI	1/6/23	OZEMPIC	4MG/3ML	9.00	84	$100.00	$2,426.57	$2,526.57
0181116100001-A	CVS PHARMACY	1/6/23	TOUJEO SOLOSTAR	300U/ML	13.50	33	$100.00	$1,083.54	$1,183.54
0181116110002-B	CAPSULE PHARMACY	1/6/23	MEDROXYPROGESTERONE ACETA	5MG	10.00	5	$2.55	$0.00	$2.55
0181116110002-B	CAPSULE PHARMACY	1/6/23	MELOXICAM	7.5MG	30.00	30	$1.65	$0.00	$1.65
0181116130102BB	HEB PHARMACY	1/6/23	METRONIDAZOLE VAGINAL	0.75%VAG	70.00	5	$15.00	$88.77	$103.77
0181116110002-B	HEB PHARMACY	1/6/23	CHLORTHALIDONE	25MG	30.00	30	$15.00	$12.77	$27.77
0181116110002-B	CVS PHARMACY	1/6/23	CEFDINIR	300MG	20.00	10	$13.57	$0.00	$13.57
0181116110002-B	CVS PHARMACY	1/6/23	LIDOCAINE VISCOUS	2% VISC	100.00	3	$3.81	$0.00	$3.81
0181116110002-B	WALGREENS	1/6/23	ALLOPURINOL	100MG	60.00	30	$15.00	$1.79	$16.79
0181116130101BA	CVS PHARMACY	1/6/23	CEPHALEXIN	500MG	30.00	10	$4.24	$0.00	$4.24
0181116120001BA	CVS PHARMACY	1/6/23	ATORVASTATIN CALCIUM	10MG	30.00	30	$5.27	$0.00	$5.27
0181116120001BA	CVS PHARMACY	1/6/23	AMLODIPINE BESYLATE	5MG	30.00	30	$3.67	$0.00	$3.67
0181116110002-B	CVS PHARMACY	1/7/23	PFIZER-BIONTECH COVID-19	BA4/BA5	0.30	1	$0.00	$40.00	$40.00
0181116130101BA	HEB PHARMACY	1/7/23	ESCITALOPRAM OXALATE	10MG	90.00	90	$12.73	$0.00	$12.73
0181116130101BA	HEB PHARMACY	1/7/23	GLYCOPYRROLATE	2MG	120.00	30	$15.00	$11.12	$26.12
0181116110002-B	WALGREENS	1/7/23	DICLOFENAC SODIUM	1%	100.00	7	$15.00	$25.09	$40.09
0181116110002-B	CVS PHARMACY	1/7/23	LIDOCAINE VISCOUS	2% VISC	100.00	7	$3.81	$0.00	$3.81
0181116110002-B	CVS PHARMACY	1/7/23	FLUTICASONE PROPIONATE	50MCG RX	16.00	30	$7.04	$0.00	$7.04
0181116110002-B	CVS PHARMACY	1/7/23	IBUPROFEN	600MG	30.00	7	$3.03	$0.00	$3.03
0181116110002-B	HEB PHARMACY	1/7/23	IBUPROFEN	800MG	30.00	7	$3.41	$0.00	$3.41
0181116110001-A	HEB PHARMACY	1/7/23	GABAPENTIN	300MG	90.00	30	$11.20	$0.00	$11.20
0181116110002-B	HEB PHARMACY	1/7/23	FLUTICASONE PROPIONATE	50MCG RX	16.00	30	$7.04	$0.00	$7.04
0181116110002-B	HEB PHARMACY	1/7/23	VALACYCLOVIR HYDROCHLORID	500MG	30.00	30	$15.00	$6.15	$21.15
0181116110002-B	WALGREENS	1/7/23	RYBELSUS	7MG	90.00	90	$100.00	$2,561.87	$2,661.87
0181116100001-A	WALGREENS	1/7/23	AMOXICILLIN	400/5ML	200.00	10	$15.00	$1.40	$16.40
0181116130102BB	CVS PHARMACY	1/7/23	DEXAMETHASONE	6MG	5.00	5	$5.31	$0.00	$5.31
0181116130102BB	CVS PHARMACY	1/7/23	LIDOCAINE VISCOUS	2% VISC	200.00	8	$6.91	$0.00	$6.91
0181116120002BB	HEB PHARMACY	1/7/23	METRONIDAZOLE VAGINAL	0.75%VAG	70.00	5	$15.00	$88.77	$103.77
0181116100001-A	CVS PHARMACY	1/7/23	OZEMPIC	2/1.5ML	1.50	30	$40.00	$864.65	$904.65
0181116110001-A	BUDA DRUG STORE	1/7/23	NP THYROID 120	120MG	90.00	90	$37.50	$109.03	$146.53
0181116110002-B	RANDALLS PHARMACY	1/7/23	VALACYCLOVIR HYDROCHLORID	500MG	90.00	30	$15.00	$47.03	$62.03
0181116100001-A	WALGREENS	1/7/23	DOXYCYCLINE HYCLATE	100MG	20.00	10	$13.38	$0.00	$13.38
0181116110002-B	HEB PHARMACY	1/7/23	METRONIDAZOLE	500MG	14.00	7	$8.00	$0.00	$8.00
0181116110001-A	WALGREENS	1/7/23	LEVETIRACETAM	250MG	270.00	90	$37.50	$9.06	$46.56
0181116110001-A	WALGREENS	1/7/23	PROPRANOLOL HYDROCHLORIDE	20MG	60.00	30	$15.00	$8.29	$23.29
0181116110003-C	CVS PHARMACY	1/7/23	OSELTAMIVIR PHOSPHATE	75MG	10.00	5	$15.00	$55.59	$70.59
0181116100002-B	WALGREENS	1/7/23	CYCLOBENZAPRINE HYDROCHLO	10MG	30.00	30	$3.20	$0.00	$3.20
0181116110001-A	HEB PHARMACY	1/7/23	TERAZOSIN HYDROCHLORIDE	1MG	60.00	30	$10.53	$0.00	$10.53
0181116110001-A	WALGREENS	1/7/23	PANTOPRAZOLE SODIUM	40MG	90.00	90	$17.78	$0.00	$17.78
0181116110001-A	CVS PHARMACY	1/8/23	PFIZER-BIONTECH COVID-19	BA4/BA5	0.30	1	$0.00	$40.00	$40.00
0181116100001-A	WALGREENS	1/8/23	SERTRALINE HCL	50MG	30.00	30	$3.87	$0.00	$3.87
0181116110001-A	WALGREENS	1/8/23	ARIPIPRAZOLE	10MG	30.00	30	$15.00	$220.71	$235.71
0181116100002-B	HEB PHARMACY	1/8/23	TRI-LO-ESTARYLLA	ESTARYLL	28.00	28	$0.00	$25.89	$25.89
0181116100002-B	WALGREENS	1/8/23	LISINOPRIL/HYDROCHLOROTHI	20-12.5	30.00	30	$1.68	$0.00	$1.68
0181116110002-B	WALGREENS	1/8/23	NOVOLOG MIX 70/30 PREFILL	70/30	9.00	30	$40.00	$284.60	$324.60
0181116110001-A	HEB PHARMACY	1/8/23	SYEDA	3-0.03MG	84.00	84	$0.00	$57.07	$57.07
0181116110002-B	HEB PHARMACY	1/8/23	LITHIUM CARBONATE ER	300MG ER	120.00	30	$15.00	$4.51	$19.51
0181116100001-A	HEB PHARMACY	1/8/23	LORYNA	3-0.02MG	84.00	84	$0.00	$66.53	$66.53
0181116110002-B	CVS PHARMACY	1/8/23	ONDANSETRON ODT	4MG	20.00	5	$7.46	$0.00	$7.46
0181116110002-B	CVS PHARMACY	1/8/23	PANTOPRAZOLE SODIUM	40MG	21.00	21	$4.71	$0.00	$4.71
0181116110002-B	CVS PHARMACY	1/8/23	POTASSIUM CHLORIDE ER	20MEQ ER	8.00	4	$3.40	$0.00	$3.40
0181116110001-A	WALGREENS	1/8/23	AIMOVIG	140MG/ML	1.00	28	$40.00	$673.47	$713.47
0181116110001-A	WALMART PHARMACY	1/8/23	DIAZEPAM	5MG	30.00	30	$1.67	$0.00	$1.67
0181116110002-B	WALGREENS	1/8/23	AMOXICILLIN/CLAVULANATE P	875-125	14.00	7	$9.88	$0.00	$9.88
0181116110001-A	CVS PHARMACY	1/8/23	LEVOTHYROXINE SODIUM	50MCG	90.00	90	$23.14	$0.00	$23.14
0181116100001-A	HEB PHARMACY	1/8/23	HYDROXYZINE HYDROCHLORIDE	10MG/5ML	300.00	30	$15.00	$4.43	$19.43
0181116110002-B	WALGREENS	1/8/23	NABUMETONE	500MG	20.00	10	$5.32	$0.00	$5.32
0181116110002-B	WALGREENS	1/8/23	CYCLOBENZAPRINE HYDROCHLO	10MG	20.00	6	$2.37	$0.00	$2.37
0181116100002-B	WALGREENS	1/8/23	CLOPIDOGREL	75MG	30.00	30	$4.46	$0.00	$4.46
0181116110003-C	WALGREENS	1/8/23	AMOXICILLIN/CLAVULANATE P	875-125	10.00	5	$7.26	$0.00	$7.26
0181116100002-B	CVS PHARMACY	1/8/23	DOXYCYCLINE HYCLATE	100MG	14.00	7	$9.58	$0.00	$9.58
0181116130102BB	HEB PHARMACY	1/8/23	OXYCODONE HYDROCHLORIDE	5MG	7.00	2	$1.88	$0.00	$1.88
0181116130102BB	CVS PHARMACY	1/8/23	ALBUTEROL SULFATE HFA	HFA (PA)	8.50	30	$15.00	$26.04	$41.04
0181116130102BB	CVS PHARMACY	1/8/23	BENZONATATE	200MG	20.00	5	$11.17	$0.00	$11.17
0181116110001-A	WALGREENS	1/8/23	ATORVASTATIN CALCIUM	40MG	30.00	30	$6.35	$0.00	$6.35
0181116110002-B	HEB PHARMACY	1/8/23	MONTELUKAST SODIUM	4MG	30.00	30	$5.24	$0.00	$5.24
0181116110001-A	HEB PHARMACY	1/8/23	ESCITALOPRAM OXALATE	10MG	90.00	90	$12.73	$0.00	$12.73
0181116110002-B	CVS PHARMACY	1/8/23	DEXAMETHASONE	0.5/5ML	300.00	14	$15.00	$49.39	$64.39
0181116110002-B	RALEY'S DRUG CENTER	1/8/23	SERTRALINE HCL	50MG	90.00	90	$10.06	$0.00	$10.06
0181116110001-A	CVS PHARMACY	1/9/23	SERTRALINE HCL	50MG	90.00	90	$10.06	$0.00	$10.06
0181116130101BA	HEB PHARMACY	1/9/23	GABAPENTIN	600MG	30.00	30	$4.71	$0.00	$4.71
0181116110001-A	WALGREENS	1/9/23	LITHIUM CARBONATE ER	300MG ER	60.00	30	$10.11	$0.00	$10.11
0181116110003-C	CVS PHARMACY	1/9/23	BREO ELLIPTA	200-25	60.00	30	$40.00	$342.62	$382.62
0181116110002-B	HEB PHARMACY	1/9/23	NORTRIPTYLINE HCL	75MG	30.00	30	$7.44	$0.00	$7.44
0181116130102BB	HEB PHARMACY	1/9/23	OZEMPIC	4MG/3ML	3.00	28	$40.00	$864.65	$904.65
0181116110002-B	HEB PHARMACY	1/9/23	LORYNA	3-0.02MG	84.00	84	$0.00	$66.53	$66.53
0181116100001-A	HEB PHARMACY	1/9/23	GABAPENTIN	600MG	60.00	30	$8.73	$0.00	$8.73
0181116110002-B	HEB PHARMACY	1/9/23	TOPIRAMATE	50MG	30.00	30	$6.74	$0.00	$6.74
0181116130101BA	HEB PHARMACY	1/9/23	ZOLPIDEM TARTRATE	10MG	30.00	30	$2.34	$0.00	$2.34
0181116130101BA	HEB PHARMACY	1/9/23	CLONAZEPAM	0.5MG	16.00	30	$1.08	$0.00	$1.08
0181116110001-A	CVS PHARMACY	1/9/23	UNITHROID	112MCG	30.00	30	$13.69	$0.00	$13.69
0181116110002-B	HEB PHARMACY	1/9/23	AMPHETAMINE/DEXTROAMPHETA	20MG ER	30.00	30	$15.00	$136.97	$151.97
0181116110002-B	HEB PHARMACY	1/9/23	CLONAZEPAM	0.5MG	30.00	30	$1.41	$0.00	$1.41
0181116110002-B	CVS PHARMACY	1/9/23	METRONIDAZOLE	500MG	14.00	7	$8.85	$0.00	$8.85
0181116110002-B	RANDALLS PHARMACY	1/9/23	VENLAFAXINE HYDROCHLORIDE	75MG ER	90.00	90	$20.26	$0.00	$20.26
0181116110002-B	HEB PHARMACY	1/9/23	CYCLOBENZAPRINE HYDROCHLO	5MG	30.00	10	$4.00	$0.00	$4.00
0181116110002-B	SAM'S CLUB PHARMACY	1/9/23	OZEMPIC	8MG/3ML	3.00	28	$40.00	$864.65	$904.65
0181116100001-A	HEB PHARMACY	1/9/23	DICYCLOMINE HYDROCHLORIDE	10MG	90.00	30	$4.00	$0.00	$4.00
0181116110002-B	RANDALLS PHARMACY	1/9/23	HYDROCODONE BITARTRATE/AC	5-325MG	31.00	10	$8.34	$0.00	$8.34
0181116100001-A	WALGREENS	1/9/23	EPINEPHRINE	0.3MG(E)	2.00	2	$15.00	$285.70	$300.70
0181116130102BB	HEB PHARMACY	1/9/23	PROMETHAZINE DM	DM	180.00	18	$6.00	$0.00	$6.00
0181116110002-B	COMMUNITYCARE CENTRAL PHARMACY	1/9/23	CLARITHROMYCIN	500MG	28.00	14	$15.00	$11.82	$26.82
0181116110002-B	COMMUNITYCARE CENTRAL PHARMACY	1/9/23	METRONIDAZOLE	500MG	42.00	14	$15.00	$8.63	$23.63
0181116110002-B	COMMUNITYCARE CENTRAL PHARMACY	1/9/23	OMEPRAZOLE	40MG	14.00	14	$4.96	$0.00	$4.96
0181116130102BB	COOPER SPECIALTY PHARMACY	1/9/23	SLYND	4MG	84.00	84	$0.00	$552.29	$552.29
0181116110001-A	WALGREENS	1/9/23	LOSARTAN POTASSIUM	100MG	90.00	90	$10.82	$0.00	$10.82
0181116110001-A	CVS PHARMACY	1/9/23	LEVOTHYROXINE SODIUM	125MCG	30.00	30	$10.20	$0.00	$10.20
0181116110001-A	WALGREENS	1/9/23	BUPROPION HYDROCHLORIDE E	150MG(W)	90.00	90	$37.50	$9.53	$47.03
0181116110001-A	CVS PHARMACY	1/9/23	DEXMETHYLPHENIDATE HYDROC	35MG ER	30.00	30	$15.00	$206.80	$221.80
0181116130102BB	HEB PHARMACY	1/9/23	CLINDAMYCIN PHOSPHATE	2% VAG	40.00	7	$15.00	$71.73	$86.73
0181116110001-A	WALGREENS	1/9/23	TRULICITY	0.75/0.5	2.00	28	$40.00	$859.93	$899.93
0181116110002-B	WALMART PHARMACY	1/9/23	OMEPRAZOLE	40MG	60.00	30	$15.00	$3.93	$18.93
0181116110001-A	WALGREENS	1/9/23	FLUOXETINE HYDROCHLORIDE	10MG	60.00	30	$6.73	$0.00	$6.73
0181116130102BB	HEB PHARMACY	1/9/23	AZITHROMYCIN	500MG	2.00	1	$3.29	$0.00	$3.29
0181116110001-A	WALGREENS	1/9/23	ESCITALOPRAM OXALATE	5MG	90.00	90	$12.29	$0.00	$12.29
0181116110002-B	HEB PHARMACY	1/9/23	ARAZLO	0.045%	45.00	30	$40.00	$462.49	$502.49
0181116130101BA	HEB PHARMACY	1/9/23	BENZONATATE	200MG	21.00	7	$11.69	$0.00	$11.69
0181116120002BB	CVS PHARMACY	1/9/23	BASAGLAR KWIKPEN	100U/ML	30.00	70	$100.00	$519.33	$619.33
0181116110001-A	TOM THUMB PHARMACY	1/9/23	AMOXICILLIN/CLAVULANATE P	500-125	10.00	5	$6.63	$0.00	$6.63
0181116130101BA	CVS PHARMACY	1/9/23	LEVOTHYROXINE SODIUM	25MCG	90.00	90	$25.34	$0.00	$25.34
0181116130101BA	CVS PHARMACY	1/9/23	TRAZODONE HYDROCHLORIDE	100MG	90.00	90	$11.12	$0.00	$11.12
0181116110001-A	HEB PHARMACY	1/9/23	AZITHROMYCIN	250MG	6.00	5	$4.32	$0.00	$4.32
0181116110001-A	HEB PHARMACY	1/9/23	METHYLPREDNISOLONE DOSE P	4MG DPAK	21.00	6	$11.57	$0.00	$11.57
0181116130101BA	CVS PHARMACY	1/9/23	ESCITALOPRAM OXALATE	20MG	90.00	90	$16.20	$0.00	$16.20
0181116100002-B	WALGREENS	1/9/23	CHLORHEXIDINE GLUCONATE	0.12%	473.00	23	$4.83	$0.00	$4.83
0181116100002-B	WALGREENS	1/9/23	HYDROCODONE BITARTRATE/AC	5-325MG	12.00	2	$3.66	$0.00	$3.66
0181116110002-B	WALMART PHARMACY	1/9/23	PREGABALIN	75MG	60.00	30	$15.00	$80.31	$95.31
0181116130101BA	HEB PHARMACY	1/9/23	AZELASTINE HYDROCHLORIDE/	137-50	23.00	30	$15.00	$118.64	$133.64
0181116110002-B	HEB PHARMACY	1/9/23	PAXLOVID	300-100	30.00	5	$0.00	$10.00	$10.00
0181116110002-B	HEB PHARMACY	1/9/23	BROMPHEN/PSEUDOEPHEDRINE	2-30-10	473.00	24	$15.00	$58.88	$73.88
0181116100001-A	HEB PHARMACY	1/9/23	OMEPRAZOLE	40MG	90.00	90	$20.00	$0.00	$20.00
0181116110002-B	CVS PHARMACY	1/9/23	BUPROPION HYDROCHLORIDE E	150MG(W)	30.00	30	$15.00	$1.19	$16.19
0181116110001-A	HEB PHARMACY	1/9/23	MODERNA COVID-19 VACCINE/	BA4/BA5	0.50	1	$0.00	$40.00	$40.00
0181116130101BA	CVS PHARMACY	1/9/23	VALSARTAN/HYDROCHLOROTHIA	320-12.5	90.00	90	$36.23	$0.00	$36.23
0181116110002-B	CVS PHARMACY	1/9/23	DEXAMETHASONE	4MG	30.00	30	$9.41	$0.00	$9.41
0181116110002-B	CVS PHARMACY	1/9/23	MEDROXYPROGESTERONE ACETA	10MG	10.00	10	$3.52	$0.00	$3.52
0181116110002-B	CVS PHARMACY	1/9/23	LETROZOLE	2.5MG	5.00	9	$1.97	$0.00	$1.97
0181116100002-B	WALMART PHARMACY	1/9/23	EMGALITY	120MG/ML	1.00	28	$40.00	$616.81	$656.81
0181116100001-A	HEB PHARMACY	1/9/23	ROSUVASTATIN CALCIUM	20MG	30.00	30	$15.00	$80.60	$95.60
0181116110002-B	HEB PHARMACY	1/9/23	NITROFURANTOIN MONOHYDRAT	100MG	90.00	90	$37.50	$34.86	$72.36
0181116110001-A	WALGREENS	1/9/23	LEVOTHYROXINE SODIUM	50MCG	90.00	90	$23.14	$0.00	$23.14
0181116110002-B	WALGREENS	1/9/23	HYDROCODONE BITARTRATE/AC	5-325MG	20.00	5	$5.62	$0.00	$5.62
0181116130102BB	WALGREENS	1/9/23	METHYLPREDNISOLONE DOSE P	4MG DPAK	21.00	6	$11.57	$0.00	$11.57
0181116110001-A	CVS PHARMACY	1/9/23	OMEPRAZOLE	40MG	10.00	10	$3.74	$0.00	$3.74
0181116110001-A	CVS PHARMACY	1/9/23	TIZANIDINE HYDROCHLORIDE	2MG	30.00	30	$6.67	$0.00	$6.67
0181116110001-A	CVS PHARMACY	1/9/23	PREDNISONE	20MG	18.00	9	$4.43	$0.00	$4.43
0181116110002-B	WALGREENS	1/9/23	ETONOGESTREL/ETHINYL ESTR	ETHY EST	3.00	84	$0.00	$329.29	$329.29
0181116130102BB	WALGREENS	1/9/23	FLUCELVAX QUADRIVALENT 20	2022-23	0.50	1	$0.00	$42.23	$42.23
0181116100002-B	WALMART PHARMACY	1/9/23	DEXMETHYLPHENIDATE HYDROC	15MG ER	30.00	30	$15.00	$51.11	$66.11
0181116130102BB	WALGREENS	1/9/23	PFIZER-BIONTECH COVID-19	BA4/BA5	0.30	1	$0.00	$40.00	$40.00
0181116130101BA	CVS PHARMACY	1/9/23	KETOCONAZOLE	2%	30.00	30	$15.00	$31.53	$46.53
0181116130101BA	CVS PHARMACY	1/9/23	MONTELUKAST SODIUM	10MG	90.00	90	$25.14	$0.00	$25.14
0181116130101BA	CVS PHARMACY	1/9/23	CLOBETASOL PROPIONATE	0.05%	60.00	30	$15.00	$358.10	$373.10
0181116130102BB	WALGREENS	1/9/23	FLUCELVAX QUADRIVALENT 20	2022-23	0.50	1	$0.00	$42.23	$42.23
0181116110002-B	CVS PHARMACY	1/9/23	BENZONATATE	100MG	21.00	7	$6.45	$0.00	$6.45
0181116110002-B	CVS PHARMACY	1/9/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	30	$15.00	$26.04	$41.04
0181116130102BB	WALGREENS	1/9/23	PFIZER-BIONTECH COVID-19	BA4/BA5	0.30	1	$0.00	$40.00	$40.00
0181116100002-B	WALGREENS	1/9/23	MONTELUKAST SODIUM	10MG	90.00	90	$25.14	$0.00	$25.14
0181116110002-B	WALGREENS	1/9/23	PREDNISONE	20MG	10.00	5	$2.75	$0.00	$2.75
0181116110002-B	WALGREENS	1/9/23	MONTELUKAST SODIUM	10MG	30.00	30	$8.90	$0.00	$8.90
0181116110002-B	WALGREENS	1/9/23	ALBUTEROL SULFATE HFA	HFA (PV)	6.70	50	$37.50	$3.39	$40.89
0181116130102BB	CVS PHARMACY	1/9/23	ALBUTEROL SULFATE	0.083%	75.00	6	$5.31	$0.00	$5.31
0181116100001-A	WALGREENS	1/9/23	NORETHINDRONE	0.35MG	28.00	28	$0.00	$12.78	$12.78
0181116110002-B	WALGREENS	1/9/23	NITROFURANTOIN MONOHYDRAT	100MG	10.00	5	$8.68	$0.00	$8.68
0181116100001-A	WALGREENS	1/9/23	PREDNISOLONE ACETATE	1% OP	15.00	25	$15.00	$84.49	$99.49
0181116110001-A	WALGREENS	1/9/23	METHYLPHENIDATE HYDROCHLO	20MG	60.00	30	$15.00	$3.70	$18.70
0181116110001-A	CVS PHARMACY	1/10/23	LO LOESTRIN FE	FE 1/10	28.00	28	$0.00	$165.93	$165.93
0181116110001-A	CAREMARK SPECIALTY PHARMACY	1/10/23	XOLAIR	150MG	2.00	28	$40.00	$2,552.63	$2,592.63
0181116100001-A	CAREMARK SPECIALTY PHARMACY	1/10/23	SIMPONI	50/0.5ML	0.50	30	$75.00	$5,441.40	$5,516.40
0181116100002-B	WALGREENS	1/10/23	XARELTO	20MG	30.00	30	$40.00	$459.77	$499.77
0181116130102BB	WALGREENS	1/10/23	KURVELO	0.15/30	84.00	84	$0.00	$37.04	$37.04
0181116110002-B	WALMART PHARMACY	1/10/23	AMLODIPINE/OLMESARTAN MED	10-40MG	90.00	90	$37.50	$156.28	$193.78
0181116120002BB	HEB PHARMACY	1/10/23	ZAFEMY	150/35	3.00	28	$0.00	$114.33	$114.33
0181116130101BA	HEB PHARMACY	1/10/23	METHYLPHENIDATE HYDROCHLO	20MG LA	30.00	30	$15.00	$120.23	$135.23
0181116130101BA	WALGREENS	1/10/23	AMPHETAMINE/DEXTROAMPHETA	25MG ER	30.00	30	$15.00	$132.86	$147.86
0181116120001BA	HEB PHARMACY	1/10/23	METHYLPREDNISOLONE DOSE P	4MG DPAK	21.00	6	$11.57	$0.00	$11.57
0181116110002-B	CVS PHARMACY	1/10/23	FENOFIBRATE	54MG	90.00	90	$29.81	$0.00	$29.81
0181116130102BB	WALMART PHARMACY	1/10/23	IBUPROFEN	800MG	60.00	15	$6.13	$0.00	$6.13
0181116110001-A	WALGREENS	1/10/23	BUPROPION HYDROCHLORIDE E	150MG(W)	30.00	30	$15.00	$1.19	$16.19
0181116110001-A	CVS PHARMACY	1/10/23	METFORMIN HYDROCHLORIDE	500MG	360.00	90	$19.96	$0.00	$19.96
0181116110002-B	WALGREENS	1/10/23	NITROFURANTOIN MONOHYDRAT	100MG	30.00	30	$15.00	$9.63	$24.63
0181116100001-A	INTEGRATED RX ASSOCIATES	1/10/23	SUTAB		24.00	2	$0.00	$154.43	$154.43
0181116100001-A	WALMART PHARMACY	1/10/23	BUPROPION HYDROCHLORIDE E	150MG(W)	90.00	90	$37.50	$0.50	$38.00
0181116100001-A	WALMART PHARMACY	1/10/23	PRAVASTATIN SODIUM	10MG	90.00	90	$33.89	$0.00	$33.89
0181116100001-A	WALMART PHARMACY	1/10/23	GLIMEPIRIDE	4MG	90.00	90	$10.00	$0.00	$10.00
0181116100001-A	WALMART PHARMACY	1/10/23	SERTRALINE HCL	50MG	90.00	90	$10.06	$0.00	$10.06
0181116110002-B	HEB PHARMACY	1/10/23	NORETHINDRONE	0.35MG	28.00	28	$0.00	$12.78	$12.78
0181116110002-B	WALMART PHARMACY	1/10/23	SPRINTEC 28	0.25/35	84.00	84	$0.00	$24.00	$24.00
0181116110002-B	WALMART PHARMACY	1/10/23	VALACYCLOVIR HYDROCHLORID	500MG	30.00	15	$15.00	$6.15	$21.15
0181116100001-A	PEOPLES PHARMACY	1/10/23	XIIDRA	5%	60.00	30	$40.00	$621.88	$661.88
0181116110001-A	WALMART PHARMACY	1/10/23	DICYCLOMINE HYDROCHLORIDE	20MG	90.00	30	$9.49	$0.00	$9.49
0181116110002-B	HEB PHARMACY	1/10/23	NYSTATIN/TRIAMCINOLONE		30.00	30	$15.00	$57.95	$72.95
0181116110002-B	WALGREENS	1/10/23	TRIAMCINOLONE ACETONIDE	0.1%	30.00	15	$6.46	$0.00	$6.46
0181116110002-B	CAPSULE PHARMACY	1/10/23	AMLODIPINE BESYLATE	5MG	90.00	90	$9.46	$0.00	$9.46
0181116110002-B	WALMART PHARMACY	1/10/23	DICYCLOMINE HYDROCHLORIDE	20MG	40.00	10	$4.61	$0.00	$4.61
0181116110002-B	CAPSULE PHARMACY	1/10/23	METOPROLOL SUCCINATE ER	50MG ER	90.00	90	$30.71	$0.00	$30.71
0181116110002-B	WALMART PHARMACY	1/10/23	IBUPROFEN	600MG	60.00	15	$5.36	$0.00	$5.36
0181116110002-B	CAPSULE PHARMACY	1/10/23	LISINOPRIL/HYDROCHLOROTHI	20-25MG	90.00	90	$3.40	$0.00	$3.40
0181116110002-B	WALMART PHARMACY	1/10/23	TRAMADOL HYDROCHLORIDE	50MG	10.00	3	$0.93	$0.00	$0.93

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 Apr 27, 2026.