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Organization Department of Vermont Health Access Maximum Allowable Cost List / / Person Carbamazepine Tab SR / Acetazolamide Cap SR / Dextroamphetamine Cap SR / Sulfate Tab SR / Calcium Carbonate (Antacid) / Carbamazepine Cap SR / Budesonide Cap SR / Alprazolam Tab SR / / Product Alfentanil Inj 500 MCG/ML Last Refreshed / Calcitriol / Atracurium Besylate Preservative Free / Ampicillin Sodium / Bacitracin / Albuterol Sulfate / Alprostadil / Bumetanide / Acetaminophen / MG CP12 / MG CP24 / Bethanechol Chloride / Amphotericin B / Abacavir Sulfate / Azithromycin / MG TB12 / Acetylcysteine / Baclofen / Balsalazide Disodium / Amifostine / Acyclovir / Amoxicillin / Naloxone HCl / Bicalutamide / Alfentanil / Alendronate Sodium / Amlodipine Besylate / Bisoprolol Fumarate / Butalbital / Bleomycin Sulfate / Carbamazepine / Acetic Acid / Candesartan Cilexetil / Atracurium Besylate / Benzonatate / Calcium Acetate / Vitamin D / Aminophylline / Cabergoline / Bromocriptine Mesylate / Chlorthalidone / Caffeine Citrate / Ampicillin / Alprazolam / Calcipotriene / Benztropine Mesylate / Captopril / Allopurinol / Azathioprine / Betamethasone Dipropionate / Butorphanol Tartrate / Buspirone HCl / Acyclovir Sodium / Erythromycin / Allopurinol Sodium / MG TB24 / Adenosine / Aminocaproic Acid / Acetazolamide / Betaxolol / Alclometasone Dipropionate / Atenolol / Betamethasone Valerate / Hydrochlorothiazide / Brimonidine Tartrate / Anastrozole / / ProvinceOrState Vermont / / SocialTag 
Department of Vermont Health Access Maximum Allowable Cost List as of[removed]FORM CURRENT