state of montana · alendronate sodium fosamax 35 mg tablet oral generic $0.44857 alendronate...

State of Montana

Average Acquisition Cost (AAC) Price List - June 18, 2020

Generic Name Brand Reference Manufacturer Strength Dosage Form Route Brand/Generic Package

Size Case Size AAC Rate Change

0.9 % sodium chloride SODIUM CHLORIDE 0.9 % INTRAVENOUS

SOLUTION INTRAVENOUS Generic 250 $0.01676

abacavir sulfate/dolutegravir sodium/lamivudine

TRIUMEQ 600-50-300 TABLET ORAL Brand $98.41539

abacavir sulfate/lamivudine EPZICOM 600-300MG TABLET ORAL Brand $42.05980

abacavir sulfate/lamivudine EPZICOM 600-300MG TABLET ORAL Generic $5.37749

abatacept ORENCIA 125 MG/ML SYRINGE (ML) SUBCUTANEOUS Brand $1,122.00044

abatacept ORENCIA CLICKJECT 125 MG/ML AUTO INJCT SUBCUTANEOUS Brand $1,113.33187

acamprosate calcium CAMPRAL 333 MG

TABLET, DELAYED RELEASE (ENTERIC COATED)

ORAL Generic $0.90988

acarbose PRECOSE 100 MG TABLET ORAL Generic $0.22520

acarbose PRECOSE 25 MG TABLET ORAL Generic $0.31960

acebutolol hcl ACEBUTOLOL HCL 400 MG CAPSULE ORAL Generic $0.67213

acebutolol hcl SECTRAL 200 MG CAPSULE ORAL Generic $0.50588

acetaminophen with codeine phosphate

TYLENOL-CODEINE NO.3 300MG-30MG TABLET ORAL Generic $0.11946

acetaminophen with codeine phosphate

TYLENOL-CODEINE NO.4 300MG-60MG TABLET ORAL Generic $0.26809

acetazolamide DIAMOX 250 MG TABLET ORAL Generic $0.97255

acetazolamide DIAMOX SEQUELS 500 MG CAPSULE,

EXTENDED RELEASE


acetic acid VOSOL 2 % SOLUTION, NON-ORAL

OTIC (EAR) Generic $1.24870

acetic acid/hydrocortisone VOSOL HC 2 %-1 % DROPS OTIC (EAR) Generic $7.60575

acetylcysteine ACETYLCYSTEINE 200 MG/ML VIAL (ML) MISCELLANEOUS Generic 30 $0.32235

acetylcysteine MUCOMYST 200 MG/ML VIAL MISCELLANEOUS Generic 4 $3.07823

acitretin SORIATANE 25 MG CAPSULE ORAL Generic $21.79810

aclidinium bromide TUDORZA PRESSAIR 400 MCG AER POW BA INHALATION Brand $509.61009

acyclovir ZOVIRAX 200 MG CAPSULE ORAL Generic $0.08892

acyclovir ZOVIRAX 200 MG/5ML SUSPENSION,

ORAL (FINAL DOSE FORM)


acyclovir ZOVIRAX 400 MG TABLET ORAL Generic $0.06538

acyclovir ZOVIRAX 800 MG TABLET ORAL Generic $0.12254

State of Montana




acyclovir ZOVIRAX 5 % CREAM (GRAM) TOPICAL Brand $161.56750

acyclovir ZOVIRAX 5 % OINTMENT (GRAM) TOPICAL Generic 15 $2.54750

acyclovir ZOVIRAX 5 % OINTMENT (GRAM) TOPICAL Generic 30 $5.11553

adalimumab HUMIRA 40MG/0.8ML SYRINGE KIT (EA) SUBCUTANEOUS Brand $2,707.29780

adalimumab HUMIRA PEN 40MG/0.8ML PEN IJ KIT SUBCUTANEOUS Brand 6 $2,726.51910

adalimumab HUMIRA PEN 40MG/0.8ML PEN INJECTOR KIT

(EA) SUBCUTANEOUS Brand 2 $2,702.49188

adalimumab HUMIRA(CF) PEN 40MG/0.4ML PEN IJ KIT SUBCUTANEOUS Brand $2,708.63600

adapalene DIFFERIN 0.1 % CREAM (GRAM) TOPICAL Brand $11.12517

adapalene DIFFERIN 0.1 % CREAM (GRAM) TOPICAL Generic $3.42489

adapalene DIFFERIN 0.1 % GEL (GRAM) TOPICAL Brand $12.40420

adapalene DIFFERIN 0.1 % GEL (GRAM) TOPICAL Generic $2.20300

adapalene DIFFERIN 0.3 % GEL (GRAM) TOPICAL Generic $3.37559

adapalene DIFFERIN 0.3 % GEL WITH PUMP

(GRAM) TOPICAL Brand $11.57764

adapalene DIFFERIN 0.3 % GEL WITH PUMP

(GRAM) TOPICAL Generic $5.49570

adapalene DIFFERIN 0.1 % LOTION (ML) TOPICAL Brand $7.92360

adapalene/benzoyl peroxide EPIDUO 0.1 %-2.5% GEL W/PUMP TOPICAL Generic $1.42672

adapalene/benzoyl peroxide EPIDUO 0.1 %-2.5% GEL WITH PUMP


adapalene/benzoyl peroxide EPIDUO FORTE 0.3 %-2.5% GEL WITH PUMP


albendazole ALBENZA 200 MG TABLET ORAL Brand $237.78553

albiglutide TANZEUM 30MG/0.5ML PEN INJECTOR

(EA) SUBCUTANEOUS Brand $127.00550

albiglutide TANZEUM 50MG/0.5ML PEN INJECTOR

(EA) SUBCUTANEOUS Brand $125.64800

albuterol sulfate ACCUNEB 0.63MG/3ML VIAL-NEB INHALATION Generic 0000030 $0.21694

albuterol sulfate ALBUTEROL SULFATE 0.63MG/3ML VIAL, NEBULIZER

(ML) INHALATION Generic 0000025 $0.24605

albuterol sulfate ALBUTEROL SULFATE 1.25MG/3ML VIAL, NEBULIZER


albuterol sulfate ALBUTEROL SULFATE 2.5 MG/3ML VIAL, NEBULIZER




State of Montana






albuterol sulfate ALBUTEROL SULFATE HFA 90 MCG HFA AER AD INHALATION Generic 6.7 $5.04776

albuterol sulfate PROAIR HFA 90 MCG HFA AEROSOL

WITH ADAPTER (GRAM)

INHALATION Brand 8.5 $7.55764

albuterol sulfate PROAIR RESPICLICK 90 MCG AEROSOL

POWDER, BREATH ACTIVATED (EA)

INHALATION Brand $59.58778

albuterol sulfate PROVENTIL HFA 90 MCG HFA AEROSOL

WITH ADAPTER (GRAM)


albuterol sulfate VENTOLIN HFA 90 MCG HFA AER AD INHALATION Generic 18 $1.99884

albuterol sulfate VENTOLIN HFA 90 MCG HFA AER AD INHALATION Generic 8.5 $4.32834

albuterol sulfate VENTOLIN HFA 90 MCG HFA AEROSOL

WITH ADAPTER (GRAM)

INHALATION Brand 18 $2.93618

alcaftadine LASTACAFT 0.25 % DROPS OPHTHALMIC

(EYE) Brand $72.05167

alclometasone dipropionate ACLOVATE 0.05 % CREAM (G) TOPICAL Generic 15 $0.92160

alclometasone dipropionate ACLOVATE 0.05 % OINT. (G) TOPICAL Generic 15 $1.88987

alendronate sodium FOSAMAX 10 MG TABLET ORAL Generic $0.14177



alfuzosin hcl UROXATRAL 10 MG TABLET,

EXTENDED RELEASE 24 HR


alirocumab PRALUENT PEN 75 MG/ML PEN INJCTR SUBCUTANEOUS Brand $445.39714

aliskiren hemifumarate TEKTURNA 150 MG TABLET ORAL Brand $7.13231

aliskiren hemifumarate TEKTURNA 300 MG TABLET ORAL Brand $9.07591

allergenic extract,grass pollen-timothy,standard

GRASTEK 2800 UNIT TABLET,

SUBLINGUAL SUBLINGUAL Brand $9.41323

allopurinol ZYLOPRIM 100 MG TABLET ORAL Generic $0.08659

allopurinol ZYLOPRIM 300 MG TABLET ORAL Generic $0.09714

almotriptan malate AXERT 12.5 MG TABLET ORAL Generic $21.20020

alprazolam XANAX 0.25 MG TABLET ORAL Generic $0.01853

alprazolam XANAX 0.5 MG TABLET ORAL Generic $0.02301

alprazolam XANAX 1 MG TABLET ORAL Brand $7.05309

State of Montana




alprazolam XANAX 1 MG TABLET ORAL Generic $0.02043

alprazolam XANAX 2 MG TABLET ORAL Generic $0.05519

alprazolam XANAX XR 0.5 MG TABLET,



alprazolam XANAX XR 1 MG TABLET,



alprazolam XANAX XR 2 MG TABLET,



amantadine hcl AMANTADINE 50 MG/5 ML SOLUTION, ORAL ORAL Generic $0.02061

amantadine hcl SYMMETREL 100 MG CAPSULE ORAL Generic $0.30744

amantadine hcl SYMMETREL 100 MG TABLET ORAL Generic $1.29368

amiloride hcl MIDAMOR 5 MG TABLET ORAL Generic $0.18890

amiloride hcl/hydrochlorothiazide

MODURETIC 5 MG-50 MG TABLET ORAL Generic $0.33610

amiodarone hcl CORDARONE 200 MG TABLET ORAL Generic $0.12555

amiodarone hcl PACERONE 100 MG TABLET ORAL Generic $2.52020

amiodarone hcl PACERONE 400 MG TABLET ORAL Generic $2.34570

amitriptyline hcl ELAVIL 10 MG TABLET ORAL Generic $0.05343






amitriptyline hcl/chlordiazepoxide

LIMBITROL DS 25 MG-10MG TABLET ORAL Generic $1.58720

amlodipine besylate NORVASC 10 MG TABLET ORAL Brand $9.15132

amlodipine besylate NORVASC 10 MG TABLET ORAL Generic $0.02056

amlodipine besylate NORVASC 2.5 MG TABLET ORAL Generic $0.01490

amlodipine besylate NORVASC 5 MG TABLET ORAL Generic $0.01306

amlodipine besylate/atorvastatin calcium

CADUET 10 MG-40MG TABLET ORAL Generic $3.73570

amlodipine besylate/benazepril hcl

LOTREL 10 MG-20MG CAPSULE ORAL Generic $0.12247

State of Montana





LOTREL 10 MG-40MG CAPSULE ORAL Generic $0.16513


LOTREL 2.5MG-10MG CAPSULE ORAL Generic $0.22770


LOTREL 5 MG-10 MG CAPSULE ORAL Generic $0.21535





amlodipine besylate/olmesartan medoxomil

AMLODIPINE-OLMESARTAN 10 MG-40MG TABLET ORAL Generic $0.80527


AZOR 10 MG-40MG TABLET ORAL Brand $11.68895


AZOR 5 MG-20 MG TABLET ORAL Brand $8.67360


AZOR 5 MG-40 MG TABLET ORAL Brand $10.75011

amlodipine besylate/valsartan EXFORGE 10MG-320MG TABLET ORAL Generic $0.57300

amlodipine besylate/valsartan EXFORGE 5 MG-160MG TABLET ORAL Generic $0.45471

amlodipine besylate/valsartan EXFORGE 5MG-320MG TABLET ORAL Generic $0.57130

ammonium lactate LAC-HYDRIN 12 % CREAM (GRAM) TOPICAL Generic $0.07329

amoxapine ASENDIN 50 MG TABLET ORAL Generic $0.73520

amoxicillin AMOXICILLIN 125 MG/5ML SUSP RECON ORAL Generic 100 $0.02652



amoxicillin AMOXICILLIN 400 MG/5ML SUSPENSION,

RECONSTITUTED, ORAL (ML)

ORAL Generic 100 $0.02341







amoxicillin AMOXICILLIN 500 MG TABLET ORAL Generic $0.21210

amoxicillin AMOXIL 250 MG CAPSULE ORAL Generic $0.08400

amoxicillin AMOXIL 500 MG CAPSULE ORAL Generic $0.05378

amoxicillin AMOXIL 875 MG TABLET ORAL Generic $0.16778

State of Montana




amoxicillin AMOXIL 250 MG TABLET,

CHEWABLE ORAL Generic $0.31463

amoxicillin WYMOX 250 MG/5ML SUSPENSION,



amoxicillin WYMOX 250 MG/5ML SUSPENSION,



amoxicillin/potassium clav AMOXICILLIN-CLAVULANATE

POTASS 400-57MG/5 SUSP RECON ORAL Generic 75 $0.08680

amoxicillin/potassium clav AMOXICILLIN-CLAVULANATE

POTASS 600-42.9/5 SUSP RECON ORAL Generic 200 $0.06252

amoxicillin/potassium clav AUGMENTIN 250-62.5/5 SUSP RECON ORAL Generic 100 $0.54456

amoxicillin/potassium clav AUGMENTIN 250-62.5/5 SUSP RECON ORAL Generic 150 $0.45777

amoxicillin/potassium clavulanate

AMOXICILLIN-CLAVULANATE POTASS

400-57MG/5 SUSPENSION,





600-42.9/5 SUSPENSION,





600-42.9/5 SUSPENSION,




AUGMENTIN 250-125 MG TABLET ORAL Generic $4.22170





amoxicillin/potassium

clavulanate AUGMENTIN 400-57MG

TABLET,



AUGMENTIN XR 1000-62.5 TABLET,



ampicillin trihydrate PRINCIPEN 500 MG CAPSULE ORAL Generic $0.11180

ampicillin trihydrate PRINCIPEN 250 250 MG CAPSULE ORAL Generic $0.05800

anastrozole ARIMIDEX 1 MG TABLET ORAL Generic $0.15201

apixaban ELIQUIS 2.5 MG TABLET ORAL Brand $7.53742

apixaban ELIQUIS 5 MG TABLET ORAL Brand $7.52279

apremilast OTEZLA 30 MG TABLET ORAL Brand $57.68676

arformoterol tartrate BROVANA 15MCG/2ML VIAL-NEB INHALATION Brand 0000030 $8.77130

State of Montana




arformoterol tartrate BROVANA 15MCG/2ML VIAL-NEB INHALATION Brand 0000060 $8.57653

aripiprazole ABILIFY 10 MG TABLET ORAL Brand $28.64032

aripiprazole ABILIFY 10 MG TABLET ORAL Generic $0.20835











aripiprazole ABILIFY MAINTENA 400 MG SUSER SYR INTRAMUSCULAR Brand $2,148.32000

aripiprazole ABILIFY MAINTENA 300 MG SUSER VIAL INTRAMUSCULAR Brand $1,636.20382

aripiprazole ABILIFY MAINTENA 400 MG SUSPENSION,EXTENDED RELEASE

VIAL INTRAMUSCULAR Brand $2,167.02167

armodafinil ARMODAFINIL 150 MG TABLET ORAL Generic $0.93763

armodafinil NUVIGIL 150 MG TABLET ORAL Brand $27.87423



armodafinil NUVIGIL 250 MG TABLET ORAL Generic $1.28790

asenapine maleate SAPHRIS 10 MG TABLET,


asenapine maleate SAPHRIS 5 MG TABLET,


aspirin ASPIRIN 325 MG TABLET ORAL Generic $0.00960

aspirin BAYER CHEWABLE ASPIRIN 81 MG TABLET,


aspirin ECOTRIN 325 MG



State of Montana




aspirin SUREPRIN 81 81 MG



aspirin/acetaminophen/caffeine EXCEDRIN EXTRA

STRENGTH 250-250-65 TABLET ORAL Brand $0.14411

aspirin/acetaminophen/caffeine GENACED 250-250-65 TABLET ORAL Generic $0.03403

aspirin/dipyridamole AGGRENOX 25MG-200MG

CAPSULE,EXTEND

ED RELEASE MULTIPHASE

12HR

ORAL Brand $9.08579

aspirin/dipyridamole AGGRENOX 25MG-200MG

CAPSULE,EXTENDED RELEASE MULTIPHASE

12HR


atazanavir sulfate REYATAZ 300 MG CAPSULE ORAL Brand $46.16507

atenolol TENORMIN 100 MG TABLET ORAL Generic $0.04557



atenolol/chlorthalidone TENORETIC 100 100MG-25MG TABLET ORAL Generic $0.54790

atenolol/chlorthalidone TENORETIC 50 50 MG-25MG TABLET ORAL Generic $0.44630

atomoxetine hcl ATOMOXETINE HCL 10 MG CAPSULE ORAL Generic $2.05567

atomoxetine hcl ATOMOXETINE HCL 100 MG CAPSULE ORAL Generic $2.92222

atomoxetine hcl STRATTERA 10 MG CAPSULE ORAL Brand $12.65583



atomoxetine hcl STRATTERA 18 MG CAPSULE ORAL Generic $2.87533









atorvastatin calcium LIPITOR 10 MG TABLET ORAL Brand $10.73685

State of Montana




atorvastatin calcium LIPITOR 10 MG TABLET ORAL Generic $0.04864




atovaquone/proguanil hcl MALARONE 250-100 MG TABLET ORAL Generic $3.25944

atropine sulfate ATROPINE SULFATE 1 % DROPS OPHTHALMIC

(EYE) Brand 5 $8.87750


(EYE) Generic 2 $13.04688



azathioprine IMURAN 50 MG TABLET ORAL Generic $0.26173

azelaic acid AZELEX 20 % CREAM (GRAM) TOPICAL Brand 50 $13.48308

azelaic acid FINACEA 15 % GEL (GRAM) TOPICAL Brand $7.05262

azelastine hcl ASTELIN 137 MCG AEROSOL, SPRAY

WITH PUMP (ML) NASAL Generic $0.33761

azelastine hcl ASTEPRO 205.5MCG AEROSOL, SPRAY

WITH PUMP (ML) NASAL Brand $5.27368

azelastine hcl ASTEPRO 205.5MCG AEROSOL, SPRAY


azelastine hcl OPTIVAR 0.05 % DROPS OPHTHALMIC

(EYE) Generic $1.24667

azelastine hcl/fluticasone propionate

DYMISTA 137-50 MCG AEROSOL, SPRAY

WITH PUMP (GRAM)

NASAL Brand $8.32739

azilsartan medoxomil EDARBI 40 MG TABLET ORAL Brand $6.31349

azithromycin AZASITE 1 % DROPS OPHTHALMIC

(EYE) Brand $79.24600

azithromycin AZITHROMYCIN 200 MG/5ML SUSPENSION,





ORAL Generic 22.5 $0.52384




azithromycin ZITHROMAX 100 MG/5ML SUSPENSION,



State of Montana




azithromycin ZITHROMAX 250 MG TABLET ORAL Generic $0.41860

azithromycin ZITHROMAX 500 MG TABLET ORAL Generic $1.20916

bacitracin BACIGUENT 500 UNIT/G OINTMENT (GRAM) OPHTHALMIC


bacitracin BACITRACIN 500 UNIT/G OINT. (G) TOPICAL Generic 28 $0.07159

bacitracin BACITRACIN 500 UNIT/G OINT. (G) TOPICAL Generic 28.4 $0.05669

bacitracin/polymyxin b sulfate POLYSPORIN 500-10K/G OINTMENT (GRAM) OPHTHALMIC


baclofen LIORESAL 10 MG TABLET ORAL Generic $0.08287

baclofen LIORESAL 20 MG TABLET ORAL Generic $0.18253

balsalazide disodium COLAZAL 750 MG CAPSULE ORAL Generic $0.32953

beclomethasone dipropionate QNASL 80 MCG HFA AEROSOL

WITH ADAPTER (GRAM)


beclomethasone dipropionate QVAR 40 MCG AEROSOL WITH

ADAPTER (GRAM) INHALATION Brand $18.70943

beclomethasone dipropionate QVAR 80 MCG AEROSOL WITH

ADAPTER (GRAM) INHALATION Brand $25.01501

beclomethasone dipropionate QVAR REDIHALER 40 MCG HFA AEROBA INHALATION Brand $17.09256

beclomethasone dipropionate QVAR REDIHALER 80 MCG HFA AEROBA INHALATION Brand $22.94402

benazepril hcl LOTENSIN 10 MG TABLET ORAL Generic $0.05943




benazepril

hcl/hydrochlorothiazide

BENAZEPRIL-HYDROCHLOR

OTHIAZIDE 20 MG-25MG TABLET ORAL Generic $0.84922

benazepril hcl/hydrochlorothiazide

LOTENSIN HCT 10-12.5MG TABLET ORAL Generic $0.62189

benazepril hcl/hydrochlorothiazide

LOTENSIN HCT 20-12.5 MG TABLET ORAL Generic $0.85573

benzonatate TESSALON 200 MG CAPSULE ORAL Generic $0.18795

benzonatate TESSALON PERLE 100 MG CAPSULE ORAL Generic $0.10886

benztropine mesylate COGENTIN 0.5 MG TABLET ORAL Generic $0.08734

benztropine mesylate COGENTIN 1 MG TABLET ORAL Generic $0.08097

benztropine mesylate COGENTIN 2 MG TABLET ORAL Generic $0.16150

State of Montana




bepotastine besilate BEPREVE 1.5 % DROPS OPHTHALMIC

(EYE) Brand 5 $44.98800

betamethasone dipropionate BETAMETHASONE

DIPROPIONATE 0.05 % CREAM (GRAM) TOPICAL Generic 15 $1.67963


DIPROPIONATE 0.05 % CREAM (GRAM) TOPICAL Generic 45 $1.08683


DIPROPIONATE 0.05 % OINTMENT (GRAM) TOPICAL Generic 15 $3.09319


DIPROPIONATE 0.05 % OINTMENT (GRAM) TOPICAL Generic 45 $1.92278

betamethasone dipropionate MAXIVATE 0.05 % LOTION (ML) TOPICAL Generic $0.45372

betamethasone dipropionate/propylene glycol

BETAMETHASONE DIPROPIONATE

0.05 % CREAM (GRAM) TOPICAL Generic 15 $0.46533

betamethasone dipropionate/propylene glycol

BETAMETHASONE DIPROPIONATE

0.05 % CREAM (GRAM) TOPICAL Generic 50 $0.14860

betamethasone valerate BETAMETHASONE

VALERATE 0.1 % CREAM (GRAM) TOPICAL Generic 15 $1.02950


VALERATE 0.1 % CREAM (GRAM) TOPICAL Generic 45 $0.64049


VALERATE 0.1 % OINTMENT (GRAM) TOPICAL Generic 15 $0.77733


VALERATE 0.1 % OINTMENT (GRAM) TOPICAL Generic 45 $0.58880

betamethasone valerate VALISONE 0.1 % LOTION (ML) TOPICAL Generic $0.64990

betamethasone/propylene glyc BETAMETHASONE DIPROP

AUGMENTED 0.05 % LOTION TOPICAL Generic 60 $1.47626

betamethasone/propylene glyc DIPROLENE 0.05 % OINT. (G) TOPICAL Generic 15 $1.59763



bethanechol chloride URECHOLINE 10 MG TABLET ORAL Generic $0.15140

bethanechol chloride URECHOLINE 25 MG TABLET ORAL Generic $0.60030

bevacizumab AVASTIN 25 MG/ML VIAL (ML) INTRAVENOUS Brand $194.84959

bicalutamide CASODEX 50 MG TABLET ORAL Generic $0.30430

bictegrav/emtricit/tenofov ala BIKTARVY 50-200-25 TABLET ORAL Brand $105.31147

bimatoprost LATISSE 0.03 % DROP W/APP TOPICAL Generic 3 $35.22467

bimatoprost LATISSE 0.03 % DROPS, WITH

APPLICATOR (ML) TOPICAL Brand $41.25917

State of Montana




bimatoprost LUMIGAN 0.01 % DROPS OPHTHALMIC

(EYE) Brand 2.5 $79.40267


(EYE) Brand 5 $81.47424


(EYE) Brand 7.5 $78.43052

bisacodyl DULCOLAX 5 MG



bisacodyl FLEET BISACODYL 10 MG SUPPOSITORY,

RECTAL RECTAL Generic $0.19583

bismuth/metronid/tetracycline PYLERA 125-125 MG CAPSULE ORAL Brand $7.43208

bisoprolol fumarate ZEBETA 10 MG TABLET ORAL Generic $0.51282

bisoprolol fumarate ZEBETA 5 MG TABLET ORAL Generic $0.54014

bisoprolol fumarate/hydrochlorothiazide

ZIAC 10-6.25MG TABLET ORAL Generic $0.44210

bisoprolol

fumarate/hydrochlorothiazide ZIAC 2.5-6.25MG TABLET ORAL Generic $0.49499

bisoprolol fumarate/hydrochlorothiazide

ZIAC 5-6.25MG TABLET ORAL Generic $0.50077

brexpiprazole REXULTI 1 MG TABLET ORAL Brand $36.92017




brimonidine tartrate ALPHAGAN 0.2 % DROPS OPHTHALMIC


brimonidine tartrate ALPHAGAN P 0.1 % DROPS OPHTHALMIC

(EYE) Brand 10 $32.05359


(EYE) Brand 15 $32.66093


(EYE) Brand 5 $32.31840

brimonidine tartrate BRIMONIDINE TARTRATE 0.15 % DROPS OPHTHALMIC

(EYE) Brand 5 $34.70299


(EYE) Generic 10 $25.46200



State of Montana








brimonidine tartrate MIRVASO 0.33 % GEL (GRAM) TOPICAL Brand $17.14720

brimonidine tartrate MIRVASO 0.33 % GEL W/PUMP TOPICAL Brand $16.82507

brimonidine tartrate/timolol

maleate COMBIGAN 0.2%-0.5% DROPS

OPHTHALMIC

(EYE) Brand 10 $35.59724

brimonidine tartrate/timolol maleate

COMBIGAN 0.2%-0.5% DROPS OPHTHALMIC

(EYE) Brand 5 $35.72457

brinzolamide AZOPT 1 %

SUSPENSION, DROPS(FINAL

DOSAGE FORM)(ML)

OPHTHALMIC (EYE)

Brand 10 $31.10299

brinzolamide/brimonidine tartrate

SIMBRINZA 1 %-0.2 %


DOSAGE FORM)(ML)

OPHTHALMIC (EYE)

Brand $20.53313

brivaracetam BRIVIACT 100 MG TABLET ORAL Brand $19.07424

bromocriptine mesylate PARLODEL 2.5 MG TABLET ORAL Generic $3.00360

brompheniramine maleate/pseudoephedrine hcl/dextromethorphan

BROMPHENIRAMINE-PSEUDOEPHED-DM

2-30-10/5 SYRUP ORAL Generic 118 $0.16250

budesonide BUDESONIDE 0.25MG/2ML AMPUL-NEB INHALATION Brand $4.19825

budesonide BUDESONIDE 1 MG/2 ML AMPUL-NEB INHALATION Generic 0000030 $4.50050

budesonide ENTOCORT EC 3 MG

CAPSULE, DELAYED, AND

EXTENDED RELEASE


budesonide PULMICORT 0.25MG/2ML AMPUL FOR

NEBULIZATION (ML)

INHALATION Generic $0.72886

budesonide PULMICORT 0.5 MG/2ML AMPUL FOR

NEBULIZATION (ML)


budesonide PULMICORT 0.5 MG/2ML AMPUL FOR

NEBULIZATION (ML)

INHALATION Generic $0.82298

budesonide PULMICORT 1 MG/2 ML AMPUL-NEB INHALATION Brand 0000030 $10.02958

budesonide PULMICORT FLEXHALER 180 MCG AEROSOL



State of Montana




budesonide PULMICORT FLEXHALER 90 MCG AEROSOL



budesonide RHINOCORT AQUA 32MCG AEROSOL, SPRAY

WITH PUMP (GRAM)

NASAL Generic $10.26980

budesonide UCERIS 9 MG TABLET, DELAYED

AND EXTENDED RELEASE

ORAL Brand $57.50002

budesonide/formoterol fumarate SYMBICORT 160-4.5MCG HFA AER AD INHALATION Brand 6 $39.64221

budesonide/formoterol fumarate SYMBICORT 160-4.5MCG HFA AEROSOL

WITH ADAPTER (GRAM)


budesonide/formoterol fumarate SYMBICORT 80-4.5 MCG HFA AEROSOL

WITH ADAPTER (GRAM)


bumetanide BUMEX 0.5 MG TABLET ORAL Generic $0.51068

bumetanide BUMEX 1 MG TABLET ORAL Generic $0.36869

bumetanide BUMEX 2 MG TABLET ORAL Generic $0.65003

buprenorphine BUPRENORPHINE 20 MCG/HR PATCH TDWK TRANSDERMAL Generic $121.59750

buprenorphine BUPRENORPHINE 5 MCG/HR PATCH TDWK TRANSDERMAL Generic $46.45250

buprenorphine BUTRANS 10 MCG/HR PATCH TDWK TRANSDERMAL Generic $87.42667

buprenorphine BUTRANS 10 MCG/HR PATCH,

TRANSDERMAL WEEKLY

TRANSDERMAL Brand $110.32500


TRANSDERMAL WEEKLY



TRANSDERMAL WEEKLY



TRANSDERMAL WEEKLY


buprenorphine BUTRANS 7.5 MCG/HR PATCH,

TRANSDERMAL WEEKLY


buprenorphine hcl BELBUCA 150 MCG FILM BUCCAL Brand $5.54245

buprenorphine hcl SUBUTEX 2 MG TABLET,

SUBLINGUAL SUBLINGUAL Generic $0.89170

buprenorphine hcl SUBUTEX 8 MG TABLET,


State of Montana




buprenorphine hcl/naloxone hcl BUPRENORPHINE-NALOXON

E 8 MG-2 MG FILM SUBLINGUAL Generic $4.60648

buprenorphine hcl/naloxone hcl SUBOXONE 4MG-1MG FILM SUBLINGUAL Brand $8.54704

buprenorphine hcl/naloxone hcl SUBOXONE 2 MG-0.5MG FILM, MEDICATED

(EA) SUBLINGUAL Brand $4.76651

buprenorphine hcl/naloxone hcl SUBOXONE 8 MG-2 MG FILM, MEDICATED

(EA) SUBLINGUAL Brand $8.56027

buprenorphine hcl/naloxone hcl SUBOXONE 2 MG-0.5MG TABLET,


buprenorphine hcl/naloxone hcl SUBOXONE 8 MG-2 MG TABLET,


buprenorphine hcl/naloxone hcl ZUBSOLV 8.6-2.1 MG TAB SUBL SUBLINGUAL Brand $12.96206

buprenorphine hcl/naloxone hcl ZUBSOLV 5.7-1.4 MG TABLET,


bupropion hcl FORFIVO XL 450 MG TABLET,



bupropion hcl WELLBUTRIN 100 MG TABLET ORAL Generic $0.29129

bupropion hcl WELLBUTRIN 75 MG TABLET ORAL Generic $0.22932

bupropion hcl WELLBUTRIN SR 100 MG TABLET,

EXTENDED RELEASE



EXTENDED RELEASE



EXTENDED RELEASE


bupropion hcl WELLBUTRIN XL 150 MG TABLET,












bupropion hcl ZYBAN 150 MG TABLET,

EXTENDED RELEASE


State of Montana




buspirone hcl BUSPAR 10 MG TABLET ORAL Generic $0.05325




buspirone hcl VANSPAR 7.5 MG TABLET ORAL Generic $0.41803

butalbital/acetaminophen/caffeine

ESGIC 50-325-40 TABLET ORAL Generic $0.34189

butalbital/acetaminophen/caffeine

ORBIVAN 50-300-40 CAPSULE ORAL Generic $1.63520

butalbital/acetaminophen/caffeine/codeine phosphate

FIORICET W/CODEINE 50-325-30 CAPSULE ORAL Generic $0.92883

butalbital/aspirin/caffeine FIORINAL 50-325-40 CAPSULE ORAL Generic $0.87641

butorphanol tartrate STADOL NS 10 MG/ML AEROSOL, SPRAY

(ML) NASAL Generic $13.53467

cabergoline DOSTINEX 0.5 MG TABLET ORAL Generic $5.53029

calcipotriene CALCIPOTRIENE 0.005 % CREAM (GRAM) TOPICAL Generic 60 $1.60772

calcipotriene DOVONEX 0.005 % OINT. (G) TOPICAL Generic 60 $2.19146

calcipotriene DOVONEX 0.005 % SOLUTION, NON-ORAL

TOPICAL Generic $1.56010

calcitonin,salmon,synthetic MIACALCIN 200/SPRAY AEROSOL, SPRAY


calcitriol CALCITRIOL 1 MCG/ML SOLUTION ORAL Generic $4.89750

calcitriol ROCALTROL 0.25 MCG CAPSULE ORAL Generic $0.19318

calcitriol ROCALTROL 0.5 MCG CAPSULE ORAL Generic $0.39356

calcium acetate PHOSLO 667 MG CAPSULE ORAL Generic $0.30059

calcium carbonate CALCIUM 600 MG TABLET ORAL Generic $0.01715

calcium carbonate MAALOX QUICK DISSOLVE 400(1000) TABLET,

CHEWABLE ORAL Brand $0.04974

calcium carbonate TUMS 200(500)MG TABLET,


calcium carbonate TUMS 200(500)MG TABLET,


calcium carbonate TUMS X-STR 300MG(750) TABLET,


calcium carbonate TUMS X-STR 300MG(750) TABLET,


State of Montana




calcium carbonate/cholecalciferol (vitamin d3)

CALCIUM 600 + VIT D 600 MG-400 TABLET ORAL Generic $0.01759

calcium polycarbophil FIBERCON 625 MG TABLET ORAL Generic $0.05439

canagliflozin INVOKANA 100 MG TABLET ORAL Brand $16.58497

canagliflozin INVOKANA 300 MG TABLET ORAL Brand $16.48222

canagliflozin/metformin hcl INVOKAMET 150-1000MG TABLET ORAL Brand $8.46958

canagliflozin/metformin hcl INVOKAMET XR 150-1000MG TAB BP 24H ORAL Brand $8.34524

candesartan cilexetil ATACAND 16 MG TABLET ORAL Generic $2.24660



candesartan cilexetil/hydrochlorothiazide

ATACAND HCT 32-12.5MG TABLET ORAL Generic $2.06960

capsaicin ZOSTRIX 0.025 % CREAM (GRAM) TOPICAL Generic $0.05590

captopril CAPOTEN 12.5 MG TABLET ORAL Generic $0.95900

captopril CAPOTEN 50 MG TABLET ORAL Generic $1.20410

carbamazepine CARBATROL 100 MG


12HR




12HR

ORAL Brand $1.72360



12HR




12HR

ORAL Brand $1.72250



12HR


carbamazepine TEGRETOL 100 MG/5ML SUSPENSION,



carbamazepine TEGRETOL 200 MG TABLET ORAL Brand $2.40906

carbamazepine TEGRETOL 200 MG TABLET ORAL Generic $0.28054

State of Montana




carbamazepine TEGRETOL 100 MG TABLET,


carbamazepine TEGRETOL XR 100 MG TABLET,


ORAL Brand $1.30576






ORAL Brand $2.56967






ORAL Brand $5.13580




carbidopa/levodopa RYTARY 23.75-95MG CAPSULE ER ORAL Brand $3.22625

carbidopa/levodopa RYTARY 36.25-145 CAPSULE ER ORAL Brand $3.19376

carbidopa/levodopa RYTARY 48.75-195 CAPSULE ER ORAL Brand $3.23819

carbidopa/levodopa SINEMET CR 25MG-100MG TABLET,

EXTENDED RELEASE


carbidopa/levodopa SINEMET CR 50MG-200MG TABLET,

EXTENDED RELEASE


carbidopa/levodopa SINEMET-10/100 10MG-100MG TABLET ORAL Generic $0.12172



carbidopa/levodopa/entacapone STALEVO 100 25-100-200 TABLET ORAL Generic $1.41020

carbidopa/levodopa/entacapone STALEVO 200 50-200-200 TABLET ORAL Generic $2.73420

carboxymethylcellulose sodium REFRESH CELLUVISC 1 % DROPPERETTE,

GEL OPHTHALMIC

(EYE) Brand $0.32170

carboxymethylcellulose sodium REFRESH PLUS 0.5 % DROPPERETTE,

SINGLE-USE DROP DISPENSER

OPHTHALMIC (EYE)

Brand 30 $0.27579

carboxymethylcellulose sodium REFRESH PLUS 0.5 % DROPPERETTE,


OPHTHALMIC (EYE)

Brand 50 $0.24550

State of Montana




carboxymethylcellulose sodium REFRESH TEARS 0.5 % DROPS OPHTHALMIC

(EYE) Brand 15 $0.46658

carboxymethylcellulose sodium/glycerin

REFRESH OPTIVE 1 %-0.9 % DROPS, GEL (ML) OPHTHALMIC


carboxymethylcellulose sodium/glycerin/polysorbate 80

REFRESH OPTIVE ADVANCED

0.5-1-0.5% DROPS OPHTHALMIC


cariprazine hcl VRAYLAR 1.5 MG CAPSULE ORAL Brand $38.79530

cariprazine hcl VRAYLAR 3 MG CAPSULE ORAL Brand $38.99838

cariprazine hcl VRAYLAR 4.5 MG CAPSULE ORAL Brand $38.81665

cariprazine hcl VRAYLAR 6 MG CAPSULE ORAL Brand $38.91680

carisoprodol SOMA 250 MG TABLET ORAL Generic $1.97232

carisoprodol SOMA 350 MG TABLET ORAL Generic $0.05930

carvedilol COREG 12.5 MG TABLET ORAL Generic $0.02214

carvedilol COREG 25 MG TABLET ORAL Generic $0.03165



carvedilol phosphate COREG CR 10 MG


24HR

ORAL Brand $8.80040



24HR

ORAL Brand $8.90800



24HR

ORAL Brand $8.95042



24HR

ORAL Brand $8.90860

carvedilol phosphate COREG CR 20 MG CPMP 24HR ORAL Generic $6.92567

carvedilol phosphate COREG CR 40 MG CPMP 24HR ORAL Generic $6.41033

cefadroxil ULTRACEF 500 MG CAPSULE ORAL Generic $0.15310

cefazolin sodium KEFZOL 1 G VIAL (EA) INJECTION Generic $0.94270

cefdinir CEFDINIR 125 MG/5ML SUSPENSION,



State of Montana













cefdinir OMNICEF 300 MG CAPSULE ORAL Generic $0.46317

cefpodoxime proxetil VANTIN 200 MG TABLET ORAL Generic $5.27325

cefprozil CEFZIL 500 MG TABLET ORAL Generic $1.18440

ceftriaxone sodium CEFTRIAXONE 1 G VIAL (EA) INJECTION Generic 0000010 $1.95823

cefuroxime axetil CEFTIN 250 MG TABLET ORAL Generic $0.56788

cefuroxime axetil CEFTIN 500 MG TABLET ORAL Generic $0.62660

celecoxib CELEBREX 100 MG CAPSULE ORAL Generic $0.15000

celecoxib CELEBREX 200 MG CAPSULE ORAL Brand $13.09196




cephalexin CEPHALEXIN 250 MG/5ML SUSPENSION,



cephalexin CEPHALEXIN 250 MG/5ML SUSPENSION,



cephalexin KEFLEX 250 MG CAPSULE ORAL Generic $0.08597

cephalexin KEFLEX 500 MG CAPSULE ORAL Generic $0.11869

ceramides 1,3,6-11 CERAVE 0% CREAM (GRAM) TOPICAL Brand $0.02388

certolizumab pegol CIMZIA 400MG/2ML SYRINGE KIT (EA) SUBCUTANEOUS Brand $4,420.25276

cetirizine hcl ZYRTEC 1 MG/ML SOLUTION, ORAL ORAL Generic $0.02425

cetirizine hcl ZYRTEC 10 MG TABLET ORAL Generic $0.06804

cetirizine hcl ZYRTEC 5 MG TABLET ORAL Generic $0.08040

cetirizine hcl/pseudoephedrine hcl

ZYRTEC-D 5 MG-120MG TABLET,



cevimeline hcl EVOXAC 30 MG CAPSULE ORAL Generic $0.91265

State of Montana




chlordiazepoxide hcl LIBRIUM 10 MG CAPSULE ORAL Generic $0.07050



chlordiazepoxide/clidinium bromide

LIBRAX 5 MG-2.5MG CAPSULE ORAL Generic $1.54950

chlorhexidine gluconate PERIDEX 0.12 % MOUTHWASH MUCOUS

MEMBRANE Generic $0.00535

chlorpheniramine maleate CHLOR-TRIMETON 4 MG TABLET ORAL Generic $0.00630

chlorpromazine hcl THORAZINE 100 MG TABLET ORAL Generic $5.00995




chlorthalidone HYGROTON 25 MG TABLET ORAL Generic $0.37272

chlorthalidone HYGROTON 50 MG TABLET ORAL Generic $0.55940

chlorzoxazone PARAFON FORTE DSC 500 MG TABLET ORAL Generic $0.27215

cholecalciferol (vitamin d3) D-VI-SOL 400/ML DROPS ORAL Brand $0.14260

cholecalciferol (vitamin d3) VITAMIN D3 2000 UNIT CAPSULE ORAL Generic $0.02872

cholecalciferol (vitamin d3) VITAMIN D3 5000 UNIT CAPSULE ORAL Generic $0.01875

cholecalciferol (vitamin d3) VITAMIN D3 400/ML DROPS ORAL Generic $0.05458

cholecalciferol (vitamin d3) VITAMIN D3 2000 UNIT TABLET ORAL Generic $0.02330

cholestyramine (with sugar) QUESTRAN 4 G POWDER (GRAM) ORAL Generic $0.16624

cholestyramine (with sugar) QUESTRAN 4 G POWDER IN

PACKET (EA) ORAL Generic $1.70548

cholestyramine/aspartame PREVALITE 4 G POWDER ORAL Generic 210 $0.29228

cholestyramine/aspartame PREVALITE 4 G POWDER ORAL Generic 239.4 $0.21015

cholestyramine/aspartame QUESTRAN LIGHT 4 G POWDER IN

PACKET (EA) ORAL Generic $1.58667

chorionic gonadotropin, human CHORIONIC GONADOTROPIN 10000 UNIT VIAL INTRAMUSCULAR Brand $93.06500

ciclesonide ALVESCO 160 MCG HFA AER AD INHALATION Brand $39.23497

ciclesonide OMNARIS 50 MCG AEROSOL, SPRAY

WITH PUMP (GRAM)


ciclopirox LOPROX 1 % SHAMPOO TOPICAL Generic $0.72280

ciclopirox PENLAC 8 % SOLUTION, NON-ORAL

TOPICAL Generic $2.22159

State of Montana




ciclopirox olamine CICLOPIROX 0.77 % CREAM (GRAM) TOPICAL Generic 30 $0.31607

ciclopirox olamine LOPROX 0.77 % CREAM (G) TOPICAL Generic 90 $0.13458

cilostazol PLETAL 100 MG TABLET ORAL Generic $0.13214

cilostazol PLETAL 50 MG TABLET ORAL Generic $0.10523

cimetidine TAGAMET 200 MG TABLET ORAL Generic $0.28911




cinacalcet hcl SENSIPAR 30 MG TABLET ORAL Brand $26.57619

cinacalcet hcl SENSIPAR 60 MG TABLET ORAL Brand $53.12390

ciprofloxacin CIPRO 500 MG/5ML SUSPENSION,

MICROCAPSULE RECONSTITUTED

ORAL Brand $1.46296

ciprofloxacin CIPROFLOXACIN 250 MG/5ML SUS MC REC ORAL Brand $1.26425

ciprofloxacin hcl CIPRO 250 MG TABLET ORAL Generic $0.10574



ciprofloxacin hcl CIPROFLOXACIN HCL 0.3 % DROPS OPHTHALMIC



(EYE) Generic 2.5 $2.76646



ciprofloxacin

hcl/dexamethasone CIPRODEX 0.3 %-0.1%


DOSAGE FORM)(ML)

OTIC (EAR) Brand $31.65162

ciprofloxacin hcl/hydrocortisone CIPRO HC 0.2 %-1 %


DOSAGE FORM)(ML)

OTIC (EAR) Brand $30.67683

citalopram hydrobromide CELEXA 10 MG/5 ML SOLUTION, ORAL ORAL Generic $0.22840

citalopram hydrobromide CELEXA 10 MG TABLET ORAL Generic $0.02566



citric acid/sodium citrate SODIUM CITRATE & CITRIC

ACID 334-500MG SOLUTION ORAL Generic $0.02406

State of Montana




clarithromycin BIAXIN 250 MG TABLET ORAL Generic $0.88030

clarithromycin BIAXIN 500 MG TABLET ORAL Generic $0.50388

clindamycin hcl CLEOCIN HCL 150 MG CAPSULE ORAL Generic $0.14073

clindamycin hcl CLEOCIN HCL 300 MG CAPSULE ORAL Generic $0.25230

clindamycin palmitate hcl CLEOCIN PALMITATE 75 MG/5 ML SOLUTION,

RECONSTITUTED, ORAL


clindamycin phos/benzoyl perox CLINDAMYCIN-BENZOYL

PEROXIDE 1 %-5 % GEL (GRAM) TOPICAL Generic 25 $2.06680


PEROXIDE 1 %-5 % GEL W/PUMP TOPICAL Generic 35 $7.48286


PEROXIDE 1 %-5 % GEL W/PUMP TOPICAL Generic 50 $6.97613

clindamycin phosphate CLEOCIN 2 % CREAM WITH APPLICATOR

VAGINAL Generic $2.51730

clindamycin phosphate CLEOCIN 100 MG SUPPOSITORY,

VAGINAL VAGINAL Brand $56.71800

clindamycin phosphate CLEOCIN T 1 % LOTION (ML) TOPICAL Generic $1.19892

clindamycin phosphate CLEOCIN T 1 % SWAB,

MEDICATED TOPICAL Generic $0.27740

clindamycin phosphate CLINDAMYCIN PHOSPHATE 1 % GEL (GRAM) TOPICAL Generic 30 $1.14933

clindamycin phosphate CLINDAMYCIN PHOSPHATE 1 % GEL (GRAM) TOPICAL Generic 60 $1.36436

clindamycin phosphate CLINDAMYCIN PHOSPHATE 1 % SOLUTION, NON-ORAL

TOPICAL Generic 30 $0.36710

clindamycin phosphate CLINDAMYCIN PHOSPHATE 1 % SOLUTION, NON-ORAL


clindamycin phosphate CLINDESSE 2 % CRM ER (G) VAGINAL Brand $23.21200

clindamycin phosphate/benzoyl peroxide

BENZACLIN 1 %-5 % GEL (GRAM) TOPICAL Brand 25 $9.74143


BENZACLIN 1 %-5 % GEL WITH PUMP

(GRAM) TOPICAL Brand 35 $10.07910


BENZACLIN 1 %-5 % GEL WITH PUMP

(GRAM) TOPICAL Brand 50 $8.44082


CLINDAMYCIN-BENZOYL PEROXIDE

1 %-5 % GEL (GRAM) TOPICAL Generic 50 $1.94718


DUAC 1.2(1)%-5% GEL (GRAM) TOPICAL Generic $1.11770

clobazam ONFI 2.5 MG/ML SUSPENSION,


ORAL Brand $9.19306

State of Montana




clobazam ONFI 10 MG TABLET ORAL Brand $21.26941

clobazam ONFI 20 MG TABLET ORAL Brand $41.98859

clobetasol propionate CLOBETASOL PROPIONATE 0.05 % CREAM (GRAM) TOPICAL Generic 30 $0.60512

clobetasol propionate CLOBETASOL PROPIONATE 0.05 % CREAM (GRAM) TOPICAL Generic 45 $1.79300

clobetasol propionate CLOBETASOL PROPIONATE 0.05 % GEL (GRAM) TOPICAL Generic 30 $1.92350

clobetasol propionate CLOBETASOL PROPIONATE 0.05 % SOLUTION, NON-ORAL


clobetasol propionate CLOBETASOL PROPIONATE 0.05 % SOLUTION, NON-ORAL


clobetasol propionate CLOBEX 0.05 % SHAMPOO TOPICAL Brand $6.79500

clobetasol propionate CLOBEX 0.05 % SHAMPOO TOPICAL Generic $1.34720

clobetasol propionate TEMOVATE 0.05 % CREAM (G) TOPICAL Generic 15 $0.54547

clobetasol propionate TEMOVATE 0.05 % CREAM (G) TOPICAL Generic 60 $0.76745

clobetasol propionate TEMOVATE 0.05 % OINTMENT (GRAM) TOPICAL Generic 15 $0.83933




clobetasol propionate/emoll TEMOVATE EMOLLIENT 0.05 % CREAM (G) TOPICAL Generic 30 $1.27073

clomiphene citrate CLOMID 50 MG TABLET ORAL Generic $0.90837

clomipramine hcl ANAFRANIL 50 MG CAPSULE ORAL Generic $5.41815

clomipramine hcl ANAFRANIL 75 MG CAPSULE ORAL Generic $8.08520

clomipramine hcl CLOMIPRAMINE HCL 25 MG CAPSULE ORAL Generic $4.31947

clonazepam KLONOPIN 0.5 MG TABLET ORAL Generic $0.02231

clonazepam KLONOPIN 1 MG TABLET ORAL Generic $0.02503

clonazepam KLONOPIN 2 MG TABLET ORAL Generic $0.02688

clonazepam KLONOPIN 0.25 MG TABLET,DISINTEG

RATING ORAL Generic $0.66946

clonazepam KLONOPIN 1 MG TABLET,DISINTEG


clonidine CATAPRES-TTS 1 0.1MG/24HR PATCH,

TRANSDERMAL WEEKLY



TRANSDERMAL WEEKLY

TRANSDERMAL Generic $12.75313

State of Montana





TRANSDERMAL WEEKLY



TRANSDERMAL WEEKLY



TRANSDERMAL WEEKLY



TRANSDERMAL WEEKLY


clonidine hcl CATAPRES 0.1 MG TABLET ORAL Generic $0.03169



clonidine hcl CLONIDINE HCL ER 0.1 MG TAB ER 12H ORAL Brand $7.10083

clonidine hcl KAPVAY 0.1 MG TABLET,



clopidogrel bisulfate PLAVIX 75 MG TABLET ORAL Brand $6.28100

clopidogrel bisulfate PLAVIX 75 MG TABLET ORAL Generic $0.06215

clorazepate dipotassium TRANXENE T-TAB 3.75 MG TABLET ORAL Generic $0.98589

clorazepate dipotassium TRANXENE T-TAB 7.5 MG TABLET ORAL Generic $2.07575

clotrimazole CLOTRIMAZOLE 1 % CREAM WITH APPLICATOR

VAGINAL Generic 45 $0.07844

clotrimazole MYCELEX 10 MG TROCHE MUCOUS

MEMBRANE Generic $0.39225

clotrimazole MYCELEX 1 % CREAM (GRAM) TOPICAL Generic $0.18707

clotrimazole/betamethasone dipropionate

CLOTRIMAZOLE-BETAMETHASONE

1 %-0.05 % CREAM (GRAM) TOPICAL Generic 15 $0.32926


CLOTRIMAZOLE-BETAMETHASONE

1 %-0.05 % CREAM (GRAM) TOPICAL Generic 45 $0.19311


LOTRISONE 1 %-0.05 % LOTION (ML) TOPICAL Generic $2.86400

clozapine CLOZAPINE 200 MG TABLET ORAL Generic $1.83580

clozapine CLOZARIL 100 MG TABLET ORAL Generic $0.73471

clozapine CLOZARIL 25 MG TABLET ORAL Generic $0.33550

codeine phosphate/butalbital/aspirin/caffeine

FIORINAL W/CODEINE #3 30-50-325 CAPSULE ORAL Generic $1.19262

State of Montana




codeine phosphate/guaifenesin GUAIFENESIN-CODEINE 10-100MG/5 LIQUID (ML) ORAL Generic 118 $0.06242

codeine sulfate CODEINE SULFATE 30 MG TABLET ORAL Generic $0.68684

codeine sulfate CODEINE SULFATE 60 MG TABLET ORAL Generic $0.50213

colchicine COLCHICINE 0.6 MG CAPSULE ORAL Brand $5.72003

colchicine COLCRYS 0.6 MG TABLET ORAL Brand $6.86027

colchicine COLCRYS 0.6 MG TABLET ORAL Generic $5.35140

colchicine MITIGARE 0.6 MG CAPSULE ORAL Generic $4.28864

colchicine/probenecid COL-PROBENECID 0.5-500MG TABLET ORAL Generic $0.70473

colesevelam hcl WELCHOL 3.75 G POWDER IN

PACKET (EA) ORAL Brand $22.20175

colesevelam hcl WELCHOL 625 MG TABLET ORAL Brand $3.53552

colestipol hcl COLESTID 1 G TABLET ORAL Generic $0.70494

collagenase clostridium histolyticum

SANTYL 250 UNIT/G OINTMENT (GRAM) TOPICAL Brand 30 $8.02939

compound veh.susp sugar-free 1

ORA-BLEND SF SUSPENSION,




SYRSPEND SF SUSPENSION,




SYRSPEND SF SUSPENSION,



compound vehicle susp sf no.18

ORAL MIX SF VEHICLE SUSPENSION,



compound vehicle susp sf no.21

MX-SOL BLEND SF SUSPENSION,



compounding vehicle no.8 ORAL SYRUP LIQUID (ML) ORAL Generic $0.03000

compounding vehicle sf no.22 MX-SOL SF LIQUID (ML) ORAL Generic $0.03000

compounding vehicle sugar-free no.9

SWEET-SF LIQUID (ML) ORAL Generic $0.03000

compounding vehicle susp no.11

FLAVOR PLUS SUSPENSION,



compounding vehicle susp

no.14

BLENDED SUSPENDING

COMPOUND

SUSPENSION, ORAL (FINAL DOSE FORM)


State of Montana





ORAL MIX VEHICLE SUSPENSION,




MX-SOL BLEND SUSPENSION,



compounding vehicle susp no.7 ORAL SUSPEND VEHICLE SUSPENSION,



compounding vehicle suspension no.5

PCCA-PLUS SUSPENSION,



compounding vehicle suspension sugar-free no.20

ORA PLUS SUSPENSION,



compounding vehicle syrup 10 BASE, PCCA SYRUP VEHICLE LIQUID (ML) ORAL Generic $0.10000

compounding vehicle syrup no15

SYRPALTA SYRUP ORAL Generic $0.03000

compounding vehicle syrup no23

SWEETENING SUSPEND COMPOUND

SYRUP ORAL Generic $0.03000

cpd vehicle sol.sugarfree no.1 VERSA FREE SOLUTION, ORAL ORAL Generic $0.03000

cpd vehicle susp.sugar-free 12 SUSPENSION VEHICLE

NATURAL

SUSPENSION, ORAL (FINAL DOSE FORM)


crisaborole EUCRISA 2 % OINT. (G) TOPICAL Brand $10.40251

cromolyn sodium CROMOLYN SODIUM 20 MG/ML CONCENTRATE,

ORAL ORAL Generic $0.84800

cromolyn sodium OPTICROM 4 % DROPS OPHTHALMIC


cyanocobalamin (vitamin b-12) CYANOCOBALAMIN

INJECTION 1000MCG/ML VIAL (ML) INJECTION Generic 1 $4.20500

cyclobenzaprine hcl AMRIX 15 MG CAPSULE, EXT

RELEASE 24 HR ORAL Brand $41.34650

cyclobenzaprine hcl FLEXERIL 10 MG TABLET ORAL Generic $0.02245

cyclobenzaprine hcl FLEXERIL 5 MG TABLET ORAL Generic $0.04183

cyclopentolate hcl CYCLOGYL 1 % DROPS OPHTHALMIC


cyclosporine CYCLOSPORINE 25 MG CAPSULE ORAL Brand $3.79862

cyclosporine RESTASIS 0.05 % DROPPERETTE,

SINGLE-USE

DROP DISPENSER

OPHTHALMIC (EYE)

Brand 30 $9.34976

State of Montana




cyclosporine RESTASIS 0.05 % DROPPERETTE,


OPHTHALMIC (EYE)

Brand 60 $9.38332

cyclosporine RESTASIS MULTIDOSE 0.05 % DROPS OPHTHALMIC

(EYE) Brand $103.88073

cyclosporine SANDIMMUNE 100 MG CAPSULE ORAL Generic $6.28930

cyclosporine SANDIMMUNE 25 MG CAPSULE ORAL Generic $1.63670

cyclosporine, modified CYCLOSPORINE MODIFIED ABBVIE US LLC 25 MG CAPSULE ORAL Brand $1.73957

cyclosporine, modified NEORAL 100 MG CAPSULE ORAL Generic $1.97930

cyclosporine, modified NEORAL 25 MG CAPSULE ORAL Generic $0.57054

cyproheptadine hcl PERIACTIN 4 MG TABLET ORAL Generic $0.25705

dabigatran etexilate mesylate PRADAXA 150 MG CAPSULE ORAL Brand $7.33475

dabigatran etexilate mesylate PRADAXA 75 MG CAPSULE ORAL Brand $7.40925

dantrolene sodium DANTRIUM 25 MG CAPSULE ORAL Generic $0.68340

dantrolene sodium DANTRIUM 50 MG CAPSULE ORAL Generic $1.13290

dapagliflozin propanediol FARXIGA 10 MG TABLET ORAL Brand $16.25867

dapagliflozin propanediol FARXIGA 5 MG TABLET ORAL Brand $16.19746

dapagliflozin propanediol/metformin hcl

XIGDUO XR 10-1000 MG TABLET,IMMED

AND EXTEND REL BIPHASE 24HR


dapagliflozin propanediol/metformin hcl

XIGDUO XR 5MG-1000MG TABLET,IMMED

AND EXTEND REL BIPHASE 24HR

ORAL Brand $8.04042

dapsone ACZONE 5 % GEL (GRAM) TOPICAL Brand 30 $8.47870



dapsone ACZONE 7.5 % GEL W/PUMP TOPICAL Brand 60 $11.15754

dapsone ACZONE 7.5 % GEL W/PUMP TOPICAL Brand 90 $9.81979

dapsone AVLOSULFON 100 MG TABLET ORAL Generic $1.99033

dapsone AVLOSULFON 25 MG TABLET ORAL Generic $1.90694

darifenacin hydrobromide ENABLEX 15 MG TABLET,



darifenacin hydrobromide ENABLEX 15 MG TABLET,



State of Montana




darifenacin hydrobromide ENABLEX 7.5 MG TABLET,



darunavir ethanolate PREZISTA 600 MG TABLET ORAL Brand $28.67129

darunavir ethanolate PREZISTA 800 MG TABLET ORAL Brand $56.54173

darunavir/cobicistat PREZCOBIX 800-150 MG TABLET ORAL Brand $64.98225

denosumab PROLIA 60 MG/ML SYRINGE (ML) SUBCUTANEOUS Brand $1,218.61799

denosumab XGEVA 120 MG/1.7 VIAL SUBCUTANEOUS Brand $1,326.89884

desipramine hcl NORPRAMIN 100 MG TABLET ORAL Generic $3.18180



desloratadine CLARINEX 5 MG TABLET ORAL Generic $0.56200

desmopressin (nonrefrigerated) DESMOPRESSIN ACETATE 10/SPRAY SPRAY/PUMP NASAL Generic $18.88571

desmopressin acetate DDAVP 0.1 MG TABLET ORAL Generic $0.98630

desmopressin acetate DDAVP 0.2 MG TABLET ORAL Generic $0.47278

desogestrel-ethinyl estradiol CYCLESSA 7 DAYS X 3 TABLET ORAL Generic $0.82030

desogestrel-ethinyl estradiol DESOGEN 0.15-0.03 TABLET ORAL Generic $0.29078

desogestrel-ethinyl estradiol/ethinyl estradiol

MIRCETTE 21-5 TABLET ORAL Generic $0.57379

desonide DESONIDE 0.05 % CREAM (GRAM) TOPICAL Generic 15 $2.25233

desonide DESONIDE 0.05 % CREAM (GRAM) TOPICAL Generic 60 $2.97050

desonide DESONIDE 0.05 % OINTMENT (GRAM) TOPICAL Generic 15 $2.43780

desonide DESONIDE 0.05 % OINTMENT (GRAM) TOPICAL Generic 60 $2.59400

desoximetasone DESOXIMETASONE 0.25 % CREAM (GRAM) TOPICAL Generic 15 $1.41360

desoximetasone TOPICORT 0.25 % CREAM (GRAM) TOPICAL Generic 60 $0.64800

desvenlafaxine succinate DESVENLAFAXINE

SUCCINATE ER 100 MG

TABLET, EXTENDED

RELEASE 24 HR ORAL Generic $0.86592

desvenlafaxine succinate PRISTIQ 25 MG TAB ER 24H ORAL Generic $0.80892

desvenlafaxine succinate PRISTIQ 50 MG TABLET,



desvenlafaxine succinate PRISTIQ ER 100 MG TABLET,



State of Montana










dexamethasone DECADRON 0.5 MG/5ML ELIXIR ORAL Generic $0.10940

dexamethasone DECADRON 0.5 MG TABLET ORAL Generic $0.04860

dexamethasone DECADRON 4 MG TABLET ORAL Generic $0.73750

dexamethasone DEXAMETHASONE 0.5 MG/5ML SOLUTION ORAL Generic $0.02873

dexamethasone DEXAMETHASONE 1 MG TABLET ORAL Generic $0.21630

dexamethasone DEXAMETHASONE 2 MG TABLET ORAL Generic $0.47440

dexamethasone MAXIDEX 0.1 %


DOSAGE FORM)(ML)

OPHTHALMIC (EYE)

Brand $14.77364

dexamethasone sod phosphate DECADRON 0.1 % DROPS OPHTHALMIC


dexamethasone sodium phosphate

HEXADROL 4 MG/ML VIAL INJECTION Generic 1 $0.79340

dexlansoprazole DEXILANT 30 MG

CAPSULE, DELAYED RELEASE, BIPHASIC

ORAL Brand $9.25689

dexlansoprazole DEXILANT 60 MG

CAPSULE, DELAYED RELEASE, BIPHASIC

ORAL Brand $9.21546

dexmethylphenidate hcl DEXMETHYLPHENIDATE HCL 10 MG TABLET ORAL Brand $1.26388

dexmethylphenidate hcl FOCALIN 5 MG TABLET ORAL Brand $0.85638

dexmethylphenidate hcl FOCALIN 5 MG TABLET ORAL Generic $0.68620

dexmethylphenidate hcl FOCALIN XR 10 MG CAPSULE,EXTEND

ED RELEASE BIPHASIC 50-50











State of Montana






















dexmethylphenidate hcl FOCALIN XR 25 MG CPBP 50-50 ORAL Brand $13.58527

dextroamphetamine sulf-saccharate/amphetamine sulf-aspartate

ADDERALL 10 MG TABLET ORAL Generic $0.45716










ADDERALL XR 10 MG CAPSULE, EXT








dextroamphetamine

sulf-saccharate/amphetamine sulf-aspartate



State of Montana




























dextroamphetamine sulfate DEXAMPEX 10 MG TABLET ORAL Generic $0.72688

dextroamphetamine sulfate DEXEDRINE 10 MG CAPSULE,

EXTENDED RELEASE


dextroamphetamine sulfate DEXEDRINE 15 MG CAPSULE,

EXTENDED RELEASE


dextroamphetamine sulfate DEXEDRINE 5 MG TABLET ORAL Generic $0.51817

dextromethorphan hbr/quinidine sulfate

NUEDEXTA 20 MG-10MG CAPSULE ORAL Brand $19.85402

dextrose 5 % in water DEXTROSE IN WATER 5 % IV SOLN INTRAVENOUS Generic $0.01406

diazepam DIASTAT 2.5 MG KIT RECTAL Generic $225.77330

diazepam DIASTAT ACUDIAL 5-7.5-10MG KIT RECTAL Brand $343.68081

diazepam DIAZEPAM 5-7.5-10MG KIT RECTAL Generic $231.41800

diazepam VALIUM 5 MG/ML SYRINGE (ML) INJECTION Generic $10.77090

diazepam VALIUM 10 MG TABLET ORAL Generic $0.02447



State of Montana




diclofenac epolamine FLECTOR 1.3 % PATCH TD12 TRANSDERMAL Generic $6.23900

diclofenac epolamine FLECTOR 1.3 % PATCH,

TRANSDERMAL 12 HOURS


diclofenac potassium CATAFLAM 50 MG TABLET ORAL Generic $0.49252

diclofenac sodium DICLOFENAC SODIUM 0.1 % DROPS OPHTHALMIC

(EYE) Generic 2.5 $1.98720

diclofenac sodium DICLOFENAC SODIUM 0.1 % DROPS OPHTHALMIC


diclofenac sodium SOLARAZE 3 % GEL (GRAM) TOPICAL Generic $0.57058

diclofenac sodium VOLTAREN 25 MG TABLET DR ORAL Generic $0.92784

diclofenac sodium VOLTAREN 50 MG



diclofenac sodium VOLTAREN 75 MG



diclofenac sodium VOLTAREN 1 % GEL (GRAM) TOPICAL Brand $0.51356

diclofenac sodium VOLTAREN 1 % GEL (GRAM) TOPICAL Generic $0.19752

diclofenac sodium VOLTAREN-XR 100 MG TABLET,



diclofenac sodium/misoprostol ARTHROTEC 50 50 MG-200

TABLET,IMMEDIATE,DELAY

RELEASE,BIPHASE


diclofenac sodium/misoprostol ARTHROTEC 75 75 MG-200

TABLET,IMMEDIATE,DELAY

RELEASE,BIPHASE


diclofenac submicronized ZORVOLEX 18 MG CAPSULE ORAL Brand $7.79787

diclofenac submicronized ZORVOLEX 35 MG CAPSULE ORAL Brand $7.65996

dicloxacillin sodium PATHOCIL 250 MG CAPSULE ORAL Generic $0.21800

dicloxacillin sodium PATHOCIL 500 MG CAPSULE ORAL Generic $0.88148

dicyclomine hcl BENTYL 10 MG CAPSULE ORAL Generic $0.12205

dicyclomine hcl BENTYL 20 MG TABLET ORAL Generic $0.20409

diethylpropion hcl TENUATE 75 MG TABLET,

EXTENDED RELEASE


State of Montana




diflunisal DOLOBID 500 MG TABLET ORAL Generic $0.92860

difluprednate DUREZOL 0.05 % DROPS OPHTHALMIC

(EYE) Brand $37.84320

digoxin LANOXIN 125 MCG TABLET ORAL Generic $0.24955

digoxin LANOXIN 250 MCG TABLET ORAL Generic $0.41124

diltiazem hcl CARDIZEM 5 MG/ML VIAL (ML) INTRAVENOUS Generic $0.28430

diltiazem hcl CARDIZEM 120 MG TABLET ORAL Generic $0.31360




diltiazem hcl CARDIZEM CD 120 MG CAPSULE, EXT








diltiazem hcl CARDIZEM LA 180 MG TABLET,









diltiazem hcl CARDIZEM SR 120 MG CAPSULE,









diltiazem hcl DILACOR XR 120 MG CAPSULE,

EXTENDED-RELEASE DEGRADABLE





State of Montana







diltiazem hcl MATZIM LA 420 MG TAB ER 24H ORAL Generic $2.51217

diltiazem hcl TIAZAC 120 MG CAPSULE,

EXTENDED RELEASE



EXTENDED RELEASE



EXTENDED RELEASE



EXTENDED RELEASE



EXTENDED RELEASE



EXTENDED RELEASE


dimethicone REMEDY SKIN REPAIR 1.5 % CREAM(ML) TOPICAL Generic $0.03682

diph,pertuss(acell),tet vac/pf ADACEL TDAP 2-2.5-5/.5 SYRINGE INTRAMUSCULAR Brand $86.82774

diphenhydramine hcl BENADRYL 50 MG/ML VIAL (ML) INJECTION Generic $0.65680

diphenhydramine hcl BENADRYL 25 MG CAPSULE ORAL Generic $0.02017

diphenhydramine hcl BENADRYL 50 MG CAPSULE ORAL Generic $0.02040

diphenhydramine hcl CHILDREN'S ALLERGY 12.5MG/5ML LIQUID (ML) ORAL Generic 118 $0.00886

diphenhydramine hcl DIPHEN AF 12.5MG/5ML LIQUID ORAL Generic 473 $0.00498

diphenoxylate hcl/atropine sulfate

LOMOTIL 2.5-.025MG TABLET ORAL Generic $0.28947

disulfiram ANTABUSE 250 MG TABLET ORAL Generic $1.88896

divalproex sodium DEPAKOTE 250 MG TABLET DR ORAL Brand $3.35001

divalproex sodium DEPAKOTE 125 MG




TABLET, DELAYED RELEASE (ENTERIC

COATED)


State of Montana






ORAL Brand $6.19590




divalproex sodium DEPAKOTE ER 250 MG TABLET,





ORAL Brand $5.39735




divalproex sodium DEPAKOTE SPRINKLE 125 MG CAPSULE, SPRINKLE

ORAL Brand $1.63742

divalproex sodium DEPAKOTE SPRINKLE 125 MG CAPSULE, SPRINKLE


docusate calcium SURFAK 240 MG CAPSULE ORAL Generic $0.05194

docusate sodium COLACE 50 MG CAPSULE ORAL Brand $0.22040

docusate sodium COLACE 50 MG/5 ML LIQUID (ML) ORAL Generic $0.00670

docusate sodium DOCUSATE SODIUM 250 MG CAPSULE ORAL Generic $0.04540

docusate sodium GENASOFT 100 MG CAPSULE ORAL Generic $0.01868

dofetilide DOFETILIDE 250 MCG CAPSULE ORAL Generic $4.94150

dofetilide DOFETILIDE 500 MCG CAPSULE ORAL Generic $4.61917

dofetilide TIKOSYN 250 MCG CAPSULE ORAL Brand $10.11984

dofetilide TIKOSYN 500 MCG CAPSULE ORAL Brand $10.18977

dolutegravir sodium TIVICAY 50 MG TABLET ORAL Brand $59.05888

donepezil hcl ARICEPT 10 MG TABLET ORAL Generic $0.04978



donepezil hcl ARICEPT ODT 10 MG TABLET,DISINTEG


dornase alfa PULMOZYME 1 MG/ML SOLUTION, NON-ORAL


dorzolamide hcl TRUSOPT 2 % DROPS OPHTHALMIC


State of Montana




dorzolamide hcl/timolol maleate COSOPT 22.3-6.8/1 DROPS OPHTHALMIC


dorzolamide hcl/timolol maleate/pf

COSOPT PF 2 %-0.5 % DROPPERETTE,


OPHTHALMIC (EYE)

Brand $2.72394

doxazosin mesylate CARDURA 1 MG TABLET ORAL Generic $0.40328




doxepin hcl DOXEPIN HCL 10 MG/ML ORAL CONC ORAL Generic 118 $0.05161

doxepin hcl SILENOR 6 MG TABLET ORAL Brand $16.17452

doxepin hcl SINEQUAN 10 MG CAPSULE ORAL Generic $0.37822






doxycycline hyclate PERIOSTAT 20 MG TABLET ORAL Generic $0.33295

doxycycline hyclate VIBRA-TABS 100 MG TABLET ORAL Generic $0.19353

doxycycline hyclate VIBRAMYCIN 100 MG CAPSULE ORAL Generic $0.19050

doxycycline hyclate VIBRAMYCIN 50 MG CAPSULE ORAL Generic $0.33500

doxycycline monohydrate ADOXA 50 MG TABLET ORAL Generic $0.37600

doxycycline monohydrate ADOXA PAK 100 MG TABLET ORAL Generic $0.54170

doxycycline monohydrate DOXYCYCLINE 25 MG/5 ML SUSP RECON ORAL Generic $0.30033

doxycycline monohydrate MONODOX 100 MG CAPSULE ORAL Generic $0.24201

doxycycline monohydrate MONODOX 50 MG CAPSULE ORAL Generic $0.24258

doxycycline monohydrate ORACEA 40 MG

CAPSULE,IMMEDIATE, DELAY

RELEASE,BIPHASE


doxycycline monohydrate ORACEA 40 MG

CAPSULE,IMMEDIATE, DELAY

RELEASE,BIPHASE


doxylamine succinate SLEEP AID 25 MG TABLET ORAL Brand $0.12000

doxylamine succinate SLEEP AID 25 MG TABLET ORAL Generic $0.12000

State of Montana




doxylamine succinate/pyridoxine hcl

DICLEGIS 10 MG-10MG


ORAL Brand $6.75750

dronabinol MARINOL 10 MG CAPSULE ORAL Generic $8.73800

dronabinol MARINOL 2.5 MG CAPSULE ORAL Generic $2.90900

dronabinol MARINOL 5 MG CAPSULE ORAL Generic $4.18283

dronedarone hcl MULTAQ 400 MG TABLET ORAL Brand $10.45706

drospir/eth estra/levomefol ca BEYAZ 3-0.02(24) TABLET ORAL Generic $3.66607

drospirenone/ethinyl estradiol/levomefolate calcium

BEYAZ 3-0.02(24) TABLET ORAL Brand $7.70432

dulaglutide TRULICITY 0.75MG/0.5 PEN INJECTOR

(ML) SUBCUTANEOUS Brand $379.83429

dulaglutide TRULICITY 1.5 MG/0.5 PEN INJECTOR

(ML) SUBCUTANEOUS Brand $381.25825

duloxetine hcl CYMBALTA 20 MG

CAPSULE,DELAYED RELEASE

(ENTERIC

COATED)




(ENTERIC COATED)

ORAL Brand $8.27289



(ENTERIC COATED)




(ENTERIC COATED)

ORAL Brand $8.33403


state of montana · alendronate sodium fosamax 35 mg tablet oral generic $0.44857 alendronate...

Documents