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Company HP / / MedicalCondition ALEVE ARTHRITIS / / Person Acetazolamide Cap SR / Dalfampridine Tab SR / LANCE LITE / Dextroamphetamine Cap SR / Sulfate Tab SR / VESTA PROTECTIVE / LANCE LANCETS / Alprazolam Tab SR / / Position ADVOCATE / / Product Diflorasone Diacetate / Albuterol Sulfate / Acetaminophen / MG CP12 / Fentanyl Citrate / Levonorgestrel / Estradiol / MG CP24 / Amcinonide / APOKYN / MG TB12 / Ibuprofen / ALKERAN / ARANESP / Acetylcysteine / Acyclovir / Amoxicillin / Zolpidem Tartrate / Alendronate Sodium / Amlodipine Besylate / Sumatriptan Succinate / Acetic Acid / Vitamin D / ACTIQ / Aminophylline / ANTIVERT / ALBALON / Ampicillin / Alprazolam / ALOXI / Vitamin A / ALEVE / Allopurinol / MG TB24 / Albuterol / Acetazolamide / AMBIEN / Aminocaproic Acid / Alclometasone Dipropionate / ACTHAR / ADVIL / Hydrochlorothiazide / Corticotropin / Anastrozole / Naproxen Sodium / / Technology ALPHA / LAN / / SocialTag 
Maine State Maximum Allowable Cost List as of[removed]FORM CURRENT MAC PRICE