Medicaid Rx AAC Pricing Montana Medicaid AAC Pricing Last Updated: April 22, 2021 Current Pricing Browse records in all searchable columns Generic_Name Brand_Reference Manufacturer Strength Dosage_Form Route BrandGeneric Package_Size Case_Size AAC_Rate Change that contain start with end with are equal to Search Generic_NameBrand_ReferenceManufacturerStrengthDosage_FormRouteBrandGenericPackage_SizeCase_SizeAAC_RateChange 0.9 % sodium chlorideSODIUM CHLORIDE 0.9 %INTRAVENOUS SOLUTIONINTRAVENOUSGeneric250 $0.01676 abacavir sulfate/dolutegravir sodium/lamivudineTRIUMEQ 600-50-300TABLETORALBrand $103.40838 abacavir sulfate/lamivudineEPZICOM 600-300MGTABLETORALBrand $42.05980 abacavir sulfate/lamivudineEPZICOM 600-300MGTABLETORALGeneric $5.37749 abataceptORENCIA 125 MG/MLSYRINGESUBCUTANEOUSBrand $1,179.04343 abataceptORENCIA CLICKJECT 125 MG/MLAUTO INJCTSUBCUTANEOUSBrand $1,165.54936 acamprosate calciumCAMPRAL 333 MGTABLET DRORALGeneric $0.72572 acarbosePRECOSE 100 MGTABLETORALGeneric $0.22520 acarbosePRECOSE 25 MGTABLETORALGeneric $0.31960 acebutolol hclACEBUTOLOL HCL 400 MGCAPSULEORALGeneric $0.67213 acebutolol hclSECTRAL 200 MGCAPSULEORALGeneric $0.50588 acetaminophen with codeine phosphateTYLENOL-CODEINE NO.3 300MG-30MGTABLETORALGeneric $0.13066 acetaminophen with codeine phosphateTYLENOL-CODEINE NO.4 300MG-60MGTABLETORALGeneric $0.22848 acetazolamideDIAMOX 250 MGTABLETORALGeneric $0.57028 acetazolamideDIAMOX SEQUELS 500 MGCAPSULE ERORALGeneric $0.68023 acetic acidVOSOL 2 %SOLUTION, NON-ORALOTIC (EAR)Generic $1.24870 acetic acid/hydrocortisoneVOSOL HC 2 %-1 %DROPSOTIC (EAR)Generic $7.60575 acetylcysteineACETYLCYSTEINE 200 MG/MLVIAL (ML)MISCELLANEOUSGeneric30 $0.32235 acetylcysteineMUCOMYST 200 MG/MLVIALMISCELLANEOUSGeneric4 $3.07823 acitretinSORIATANE 25 MGCAPSULEORALGeneric $21.79810 aclidinium bromideTUDORZA PRESSAIR 400 MCGAER POW BAINHALATIONBrand $509.61009 acyclovirZOVIRAX 200 MG/5MLSUSPENSION, ORAL (FINAL DOSE FORM)ORALGeneric $0.58665 acyclovirZOVIRAX 5 %OINTMENT (GRAM)TOPICALGeneric30 $5.11553 acyclovirZOVIRAX 5 %OINTMENT (GRAM)TOPICALGeneric15 $2.54750 acyclovirZOVIRAX 5 %CREAM (G)TOPICALBrand $163.70750 acyclovirZOVIRAX 200 MGCAPSULEORALGeneric $0.13377 acyclovirZOVIRAX 400 MGTABLETORALGeneric $0.11635 acyclovirZOVIRAX 800 MGTABLETORALGeneric $0.19119 adalimumabHUMIRA 40MG/0.8MLSYRINGE KIT (EA)SUBCUTANEOUSBrand $2,912.90280 adalimumabHUMIRA PEN 40MG/0.8MLPEN IJ KITSUBCUTANEOUSBrand6 $2,932.12743 adalimumabHUMIRA PEN 40MG/0.8MLPEN INJECTOR KIT (EA)SUBCUTANEOUSBrand2 $2,908.09688 adalimumabHUMIRA(CF) 40MG/0.4MLSYRINGEKITSUBCUTANEOUSBrand $2,898.35082 adalimumabHUMIRA(CF) PEN 40MG/0.4MLPEN IJ KITSUBCUTANEOUSBrand $2,914.24100 adapaleneDIFFERIN 0.1 %LOTION (ML)TOPICALBrand $7.92360 adapaleneDIFFERIN 0.3 %GEL WITH PUMP (GRAM)TOPICALGeneric $5.49570 adapaleneDIFFERIN 0.1 %GEL (GRAM)TOPICALBrand $12.40420 adapaleneDIFFERIN 0.3 %GEL (GRAM)TOPICALGeneric $3.37559 adapaleneDIFFERIN 0.1 %GEL (GRAM)TOPICALGeneric $2.20300 adapaleneDIFFERIN 0.1 %CREAM (GRAM)TOPICALGeneric $3.42489 adapaleneDIFFERIN 0.1 %CREAM (GRAM)TOPICALBrand $11.12517 adapaleneDIFFERIN 0.3 %GEL WITH PUMP (GRAM)TOPICALBrand $11.79756 adapalene/benzoyl peroxideEPIDUO 0.1 %-2.5%GEL WITH PUMP (GRAM)TOPICALBrand $8.69507 adapalene/benzoyl peroxideEPIDUO 0.1 %-2.5%GEL W/PUMPTOPICALGeneric $1.42672 adapalene/benzoyl peroxideEPIDUO FORTE 0.3 %-2.5%GEL WITH PUMP (GRAM)TOPICALBrand $11.85333 albendazoleALBENZA 200 MGTABLETORALBrand $237.78553 albiglutideTANZEUM 30MG/0.5MLPEN INJECTOR (EA)SUBCUTANEOUSBrand $127.00550 albiglutideTANZEUM 50MG/0.5MLPEN INJECTOR (EA)SUBCUTANEOUSBrand $125.64800 albuterol sulfateACCUNEB 0.63MG/3MLVIAL-NEBINHALATIONGeneric 0000030$0.21694 albuterol sulfateALBUTEROL SULFATE 0.63MG/3MLVIAL, NEBULIZER (ML)INHALATIONGeneric 0000025$0.24605 albuterol sulfateALBUTEROL SULFATE 2.5 MG/3MLVIAL, NEBULIZER (ML)INHALATIONGeneric 0000025$0.03984 Page 1 of 66First Previous [1] 2 3 4 5 6 7 8 9 10 Next Last Previous Pricing Live Accordion 2021 April 15, 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