Alabama Medicaid Maximum Allowable Cost List
Alabama Medicaid Maximum Allowable Cost List
Alabama Medicaid Maximum Allowable Cost List
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Drug Brand Name<br />
<strong>Alabama</strong> <strong>Medicaid</strong> <strong>Maximum</strong> <strong>Allowable</strong> <strong>Cost</strong> <strong>List</strong><br />
GCN - Generic Drug Description<br />
Drug Strength/Dosage<br />
Description<br />
Dose Form<br />
Description<br />
ASPIRIN ASPIRIN 130MG SUPP.RECT<br />
ASPIRIN ASPIRIN 195MG SUPP.RECT<br />
ASPIRIN ASPIRIN 300MG SUPP.RECT<br />
ASPIRIN ASPIRIN 325MG TABLET<br />
ASPIRIN ASPIRIN 325MG TABLET DR<br />
ASPIRIN ASPIRIN 325MG TABLET EC<br />
ASPIRIN ASPIRIN 500MG TABLET<br />
ASPIRIN ASPIRIN 500MG TABLET DR<br />
ASPIRIN ASPIRIN 500MG TABLET EC<br />
ASPIRIN ASPIRIN 600MG SUPP.RECT<br />
ASPIRIN ASPIRIN 650MG TABLET DR<br />
ASPIRIN ASPIRIN 800MG TABLET SA<br />
ASPIRIN ASPIRIN 81MG TAB CHEW<br />
ASPIRIN ASPIRIN 81MG TABLET<br />
ASPIRIN ASPIRIN 81MG TABLET DR<br />
ASPIRIN ASPIRIN 81MG TABLET EC<br />
ASPIRIN ASPIRIN 975MG TABLET DR<br />
ASPIRIN EC ASPIRIN 81MG TABLET DR<br />
ASPIRIN EC LOW DOSE ASPIRIN 81MG TABLET DR<br />
ASPIRIN ENTERIC COATED ASPIRIN 325MG TABLET DR<br />
ASPIRIN EXTRA STRENGTH EC ASPIRIN 500MG TABLET DR<br />
ASPIRIN LITE COAT ASPIRIN 325MG TABLET<br />
ASPIRIN LOW-STRENGTH ASPIRIN 81MG TAB CHEW<br />
ASPIRIN LOW-STRENGTH ASPIRIN 81MG TABLET DR<br />
ASPIR-LOW ASPIRIN 81MG TABLET DR<br />
CHILD ASPIRIN ASPIRIN 81MG TAB CHEW<br />
CHILDREN'S ASPIRIN ASPIRIN 81MG TAB CHEW<br />
CHILDREN'S CHEWABLE ASPIRIN ASPIRIN 81MG TAB CHEW<br />
EASPRIN ASPIRIN 975MG TABLET DR<br />
ECASPIRIN ASPIRIN 325MG TABLET DR<br />
ECO-10 ASPIRIN 650MG TABLET EC<br />
ECO-5 ASPIRIN 325MG TABLET EC<br />
ECOTRIN ASPIRIN 325MG TABLET DR<br />
ECOTRIN ASPIRIN 500MG TABLET DR<br />
ECOTRIN ASPIRIN 81MG TABLET DR<br />
ECPIRIN ASPIRIN 325MG TABLET DR<br />
ENTERIC COATED ASA ASPIRIN 325MG TABLET DR<br />
ENTERIC COATED ASPIRIN ASPIRIN 325MG TABLET DR<br />
GENACOTE ASPIRIN 325MG TABLET DR<br />
GENACOTE ASPIRIN 500MG TABLET DR<br />
HCA ASPIRIN ASPIRIN 500MG TABLET DR<br />
LITE COAT ASPIRIN ASPIRIN 325MG TABLET<br />
LOW DOSE ASPIRIN ASPIRIN 81MG TABLET DR<br />
ST. JOSEPH ASPIRIN ASPIRIN 81MG TAB CHEW<br />
ST. JOSEPH ASPIRIN ASPIRIN 81MG TABLET DR<br />
SUREPRIN 81 ASPIRIN 81MG TABLET DR<br />
TASPRIN ASPIRIN 325MG TABLET DR<br />
TASPRIN ASPIRIN 81MG TABLET DR<br />
V-R ASPIRIN ASPIRIN 325MG TABLET DR<br />
V-R ASPIRIN ASPIRIN 81MG TABLET DR<br />
V-R CHILDREN'S ASPIRIN ASPIRIN 81MG TAB CHEW<br />
ZORPRIN ASPIRIN 800MG TABLET SA<br />
BUTALBITAL COMPOUND ASPIRIN/BUTALBITAL/CAFFEINE 325-40-50 CAPSULE<br />
BUTALBITAL COMPOUND ASPIRIN/BUTALBITAL/CAFFEINE 325-40-50 TABLET<br />
FARBITAL ASPIRIN/BUTALBITAL/CAFFEINE 325-40-50 CAPSULE<br />
FARBITAL ASPIRIN/BUTALBITAL/CAFFEINE 325-40-50 TABLET<br />
FIORINAL ASPIRIN/BUTALBITAL/CAFFEINE 325-40-50 CAPSULE<br />
FORTABS ASPIRIN/BUTALBITAL/CAFFEINE 325-40-50 TABLET<br />
AA & C ASPIRIN/CAFFEINE 400-32MG TABLET<br />
ADULT STRENGTH ANALGESIC ASPIRIN/CAFFEINE 400-32MG TABLET<br />
ANACIN ASPIRIN/CAFFEINE 400-32MG TABLET<br />
ANALGESIC ASPIRIN/CAFFEINE 400-32MG TABLET<br />
AS-CAFF ASPIRIN/CAFFEINE 400-32MG TABLET<br />
ASPIRCAF ASPIRIN/CAFFEINE 400-32MG TABLET<br />
BIOCIN ASPIRIN/CAFFEINE 400-32MG TABLET<br />
FAST ACTING PAIN RELIEF ASPIRIN/CAFFEINE 400-32MG TABLET<br />
MAJORCIN ASPIRIN/CAFFEINE 400-32MG TABLET<br />
NORGESIC ASPIRIN/CAFFEINE/ORPHENADRINE 25-385-30 TABLET<br />
NORGESIC FORTE ASPIRIN/CAFFEINE/ORPHENADRINE 50-770-60 TABLET<br />
ORPHENADRINE COMPOUND ASPIRIN/CAFFEINE/ORPHENADRINE 25-385-30 TABLET<br />
ORPHENADRINE COMPOUND FORTE ASPIRIN/CAFFEINE/ORPHENADRINE 50-770-60 TABLET<br />
ORPHENGESIC ASPIRIN/CAFFEINE/ORPHENADRINE 25-385-30 TABLET<br />
ORPHENGESIC FORTE ASPIRIN/CAFFEINE/ORPHENADRINE 50-770-60 TABLET<br />
ASPIRIN ASPIRIN/CALCIUM CARB/MAGNESIUM 325MG TABLET<br />
ASPIRIN BUFFERED ASPIRIN/CALCIUM CARB/MAGNESIUM 325MG TABLET<br />
Page 11<br />
MAC list as of February 03.xls
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