Montana Medicaid AAC Pricing

Last Updated:  April 9, 2021

Current Pricing

Generic_NameBrand_ReferenceManufacturerStrengthDosage_FormRouteBrandGenericPackage_SizeCase_SizeAAC_RateChange
0.9 % sodium chlorideSODIUM CHLORIDE 0.90%INTRAVENOUS SOLUTIONINTRAVENOUSGeneric250 $0.02 
abacavir sulfate/dolutegravir sodium/lamivudineTRIUMEQ 600-50-300TABLETORALBrand  $103.41 
abacavir sulfate/lamivudineEPZICOM 600-300MGTABLETORALBrand  $42.06 
abacavir sulfate/lamivudineEPZICOM 600-300MGTABLETORALGeneric  $5.38 
abataceptORENCIA 125 MG/MLSYRINGESUBCUTANEOUSBrand  $1,179.04 
abataceptORENCIA CLICKJECT 125 MG/MLAUTO INJCTSUBCUTANEOUSBrand  $1,165.55 
acamprosate calciumCAMPRAL 333 MGTABLET DRORALGeneric  $0.73 
acarbosePRECOSE 100 MGTABLETORALGeneric  $0.23 
acarbosePRECOSE 25 MGTABLETORALGeneric  $0.32 
acebutolol hclACEBUTOLOL HCL 400 MGCAPSULEORALGeneric  $0.67 
acebutolol hclSECTRAL 200 MGCAPSULEORALGeneric  $0.51 
acetaminophen with codeine phosphateTYLENOL-CODEINE NO.3 300MG-30MGTABLETORALGeneric  $0.13 
acetaminophen with codeine phosphateTYLENOL-CODEINE NO.4 300MG-60MGTABLETORALGeneric  $0.23 
acetazolamideDIAMOX 250 MGTABLETORALGeneric  $0.57 
acetazolamideDIAMOX SEQUELS 500 MGCAPSULE ERORALGeneric  $0.68 
acetic acidVOSOL 2%SOLUTION, NON-ORALOTIC (EAR)Generic  $1.25 
acetic acid/hydrocortisoneVOSOL HC 2 %-1 %DROPSOTIC (EAR)Generic  $7.61 
acetylcysteineACETYLCYSTEINE 200 MG/MLVIAL (ML)MISCELLANEOUSGeneric30 $0.32 
acetylcysteineMUCOMYST 200 MG/MLVIALMISCELLANEOUSGeneric4 $3.08 
acitretinSORIATANE 25 MGCAPSULEORALGeneric  $21.80 
aclidinium bromideTUDORZA PRESSAIR 400 MCGAER POW BAINHALATIONBrand  $509.61 
acyclovirZOVIRAX 200 MG/5MLSUSPENSION, ORAL (FINAL DOSE FORM)ORALGeneric  $0.59 
acyclovirZOVIRAX 5%OINTMENT (GRAM)TOPICALGeneric30 $5.12 
acyclovirZOVIRAX 5%OINTMENT (GRAM)TOPICALGeneric15 $2.55 
acyclovirZOVIRAX 5%CREAM (G)TOPICALBrand  $163.71 
acyclovirZOVIRAX 200 MGCAPSULEORALGeneric  $0.13 
acyclovirZOVIRAX 400 MGTABLETORALGeneric  $0.12 
acyclovirZOVIRAX 800 MGTABLETORALGeneric  $0.19 
adalimumabHUMIRA 40MG/0.8MLSYRINGE KIT (EA)SUBCUTANEOUSBrand  $2,912.90 
adalimumabHUMIRA PEN 40MG/0.8MLPEN IJ KITSUBCUTANEOUSBrand6 $2,932.13 
adalimumabHUMIRA PEN 40MG/0.8MLPEN INJECTOR KIT (EA)SUBCUTANEOUSBrand2 $2,908.10 
adalimumabHUMIRA(CF) 40MG/0.4MLSYRINGEKITSUBCUTANEOUSBrand  $2,898.35 
adalimumabHUMIRA(CF) PEN 40MG/0.4MLPEN IJ KITSUBCUTANEOUSBrand  $2,914.24 
adapaleneDIFFERIN 0.10%LOTION (ML)TOPICALBrand  $7.92 
adapaleneDIFFERIN 0.30%GEL WITH PUMP (GRAM)TOPICALGeneric  $5.50 
adapaleneDIFFERIN 0.10%GEL (GRAM)TOPICALBrand  $12.40 
adapaleneDIFFERIN 0.30%GEL (GRAM)TOPICALGeneric  $3.38 
adapaleneDIFFERIN 0.10%GEL (GRAM)TOPICALGeneric  $2.20 
adapaleneDIFFERIN 0.10%CREAM (GRAM)TOPICALGeneric  $3.42 
adapaleneDIFFERIN 0.10%CREAM (GRAM)TOPICALBrand  $11.13 
adapaleneDIFFERIN 0.30%GEL WITH PUMP (GRAM)TOPICALBrand  $11.80 
adapalene/benzoyl peroxideEPIDUO 0.1 %-2.5%GEL WITH PUMP (GRAM)TOPICALBrand  $8.70 
adapalene/benzoyl peroxideEPIDUO 0.1 %-2.5%GEL W/PUMPTOPICALGeneric  $1.43 
adapalene/benzoyl peroxideEPIDUO FORTE 0.3 %-2.5%GEL WITH PUMP (GRAM)TOPICALBrand  $11.23 
albendazoleALBENZA 200 MGTABLETORALBrand  $237.79 
albiglutideTANZEUM 30MG/0.5MLPEN INJECTOR (EA)SUBCUTANEOUSBrand  $127.01 
albiglutideTANZEUM 50MG/0.5MLPEN INJECTOR (EA)SUBCUTANEOUSBrand  $125.65 
albuterol sulfateACCUNEB 0.63MG/3MLVIAL-NEBINHALATIONGeneric 30$0.22 
albuterol sulfateALBUTEROL SULFATE 0.63MG/3MLVIAL, NEBULIZER (ML)INHALATIONGeneric 25$0.25 
albuterol sulfateALBUTEROL SULFATE 2.5 MG/3MLVIAL, NEBULIZER (ML)INHALATIONGeneric 25$0.04 
Page 1 of 27First   Previous   [1]  2  3  4  5  6  7  8  9  10  Next   Last   

Previous Pricing