Allergy, Cough and Cold
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BENZONATATE 100 MG |
Capsule |
14
|
42
|
| CERON 1-3.5 MG/ML* |
Drops |
30
|
90
|
| CERON DM 12.5/4/15 MG/5 ML |
Syrup |
120
|
360
|
| DEC-CHLORPHEN 1-3.5 MG/ML* |
Drops |
30
|
90
|
| DEC-CHLORPHEN DM 12.5/4/15 MG/5 ML* |
Syrup |
118
|
354
|
| LORATADINE 10 MG |
Tablet |
30
|
90
|
| PROMETHAZINE 6.25 MG/5 ML* |
Syrup |
180
|
540
|
| PROMETHAZINE DM |
Syrup |
120
|
360
|
| TRIVENT DPC 6/2/15/5 ML* |
Syrup |
120
|
360
|
Analgesic
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BACLOFEN 10 MG |
Tablet |
30
|
90
|
| CYCLOBENZAPRINE 5 MG |
Tablet |
30
|
90
|
| CYCLOBENZAPRINE 10 MG |
Tablet |
30
|
90
|
| DICLOFENAC ER 75 MG |
Tablet |
60
|
180
|
| IBUPROFEN 100 MG/5 ML* |
Suspension |
120
|
360
|
| IBUPROFEN 400 MG |
Tablet |
90
|
270
|
| IBUPROFEN 600 MG |
Tablet |
60
|
180
|
| IBUPROFEN 800 MG |
Tablet |
30
|
90
|
| INDOMETHACIN 25 MG* |
Capsule |
60
|
180
|
| MELOXICAM 7.5 MG |
Tablet |
30
|
90
|
| MELOXICAM 15 MG |
Tablet |
30
|
90
|
| NAPROXEN 375 MG* |
Tablet |
60
|
180
|
| NAPROXEN 500 MG* |
Tablet |
60
|
180
|
| PIROXICAM 20 MG |
Capsule |
30
|
90
|
| SALSALATE 500 MG |
Tablet |
60
|
180
|
Anti-Anxiety
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BUSPIRONE 5 MG |
Tablet |
60
|
180
|
| BUSPIRONE 10 MG* |
Tablet |
60
|
180
|
| DOXEPIN HCL 10 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 25 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 50 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 75 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 100 MG |
Capsule |
30
|
90
|
| PAROXETINE 10 MG* |
Tablet |
30
|
90
|
| PAROXETINE 20 MG* |
Tablet |
30
|
90
|
Antibiotic
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| AMOXICILLIN 125 MG/5 ML |
Suspension |
80
|
240
|
| AMOXICILLIN 125 MG/5 ML |
Suspension |
100
|
300
|
| AMOXICILLIN 125 MG/5 ML |
Suspension |
150
|
450
|
| AMOXICILLIN 200 MG/5 ML |
Suspension |
50
|
150
|
| AMOXICILLIN 200 MG/5 ML* |
Suspension |
75
|
225
|
| AMOXICILLIN 200 MG/5 ML* |
Suspension |
100
|
300
|
| AMOXICILLIN 250 MG |
Capsule |
30
|
90
|
| AMOXICILLIN 250 MG/5 ML |
Suspension |
80
|
240
|
| AMOXICILLIN 250 MG/5 ML |
Suspension |
100
|
300
|
| AMOXICILLIN 250 MG/5 ML |
Suspension |
150
|
450
|
| AMOXICILLIN 400 MG/5 ML |
Suspension |
50
|
150
|
| AMOXICILLIN 400 MG/5 ML* |
Suspension |
75
|
225
|
| AMOXICILLIN 400 MG/5 ML* |
Suspension |
100
|
300
|
| AMOXICILLIN 500 MG |
Capsule |
30
|
90
|
| AMOXIL 50 MG/ML* |
Drops |
30
|
90
|
| CEPHALEXIN 250 MG |
Capsule |
28
|
84
|
| CEPHALEXIN 500 MG |
Capsule |
30
|
90
|
| CIPROFLOXACIN 250 MG |
Tablet |
14
|
42
|
| CIPROFLOXACIN 500 MG |
Tablet |
20
|
60
|
| DOXYCYCLINE HYCLATE 50 MG |
Capsule |
30
|
90
|
| DOXYCYCLINE HYCLATE 100 MG |
Capsule/Tablet |
20
|
60
|
| ERYTHROCIN 250 MG* |
Tablet |
40
|
N/A
|
| ERYTHROMYCIN EC 250 MG* |
Capsule |
28
|
84
|
| ISONIAZID 300 MG |
Tablet |
30
|
90
|
| METRONIDAZOLE 250 MG |
Tablet |
28
|
84
|
| METRONIDAZOLE 500 MG |
Tablet |
14
|
42
|
| PENICILLIN VK 125 MG/5 ML |
Solution |
200
|
600
|
| PENICILLIN VK 250 MG/5 ML |
Solution |
100
|
300
|
| PENICILLIN VK 250 MG |
Tablet |
28
|
84
|
| SMZ/TMP 200/40/5 ML |
Suspension |
120
|
360
|
| SMZ/TMP 400/80 MG |
Tablet |
28
|
84
|
| SMZ/TMP DS 800/160 MG |
Tablet |
20
|
60
|
| TETRACYCLINE 250 MG |
Capsule |
60
|
180
|
| TETRACYCLINE 500 MG |
Capsule |
60
|
180
|
Antidepressant
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| AMITRIPTYLINE 10 MG |
Tablet |
30
|
90
|
| AMITRIPTYLINE 25 MG |
Tablet |
30
|
90
|
| AMITRIPTYLINE 50 MG |
Tablet |
30
|
90
|
| AMITRIPTYLINE 75 MG |
Tablet |
30
|
90
|
| AMITRIPTYLINE 100 MG |
Tablet |
30
|
90
|
| CITALOPRAM 20 MG |
Tablet |
30
|
90
|
| CITALOPRAM 40 MG |
Tablet |
30
|
90
|
| DOXEPIN HCL 10 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 25 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 50 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 75 MG |
Capsule |
30
|
90
|
| DOXEPIN HCL 100 MG |
Capsule |
30
|
90
|
| FLUOXETINE 10 MG* |
Tablet |
30
|
90
|
| FLUOXETINE 10 MG |
Capsule |
30
|
90
|
| FLUOXETINE 20 MG |
Capsule |
30
|
90
|
| FLUOXETINE 40 MG* |
Capsule |
30
|
90
|
| NORTRIPTYLINE 10 MG |
Capsule |
30
|
90
|
| NORTRIPTYLINE 25 MG |
Capsule |
30
|
90
|
| PAROXETINE 10 MG* |
Tablet |
30
|
90
|
| PAROXETINE 20 MG* |
Tablet |
30
|
90
|
| TRAZODONE 50 MG |
Tablet |
30
|
90
|
| TRAZODONE 100 MG |
Tablet |
30
|
90
|
| TRAZODONE 150 MG |
Tablet |
30
|
90
|
Antifungal
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| FLUCONAZOLE 150 MG |
Tablet |
1
|
3
|
| TERBINAFINE 250 MG* |
Tablet |
30
|
90
|
Anti-Inflammatory
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| DICLOFENAC ER 75 MG |
Tablet |
60
|
180
|
| IBUPROFEN 100 MG/5 ML* |
Suspension |
120
|
360
|
| IBUPROFEN 400 MG |
Tablet |
90
|
270
|
| IBUPROFEN 600 MG |
Tablet |
60
|
180
|
| IBUPROFEN 800 MG |
Tablet |
30
|
90
|
| INDOMETHACIN 25 MG* |
Capsule |
60
|
180
|
| MELOXICAM 7.5 MG |
Tablet |
30
|
90
|
| MELOXICAM 15 MG |
Tablet |
30
|
90
|
| NAPROXEN 375 MG* |
Tablet |
60
|
180
|
| NAPROXEN 500 MG* |
Tablet |
60
|
180
|
| PIROXICAM 20 MG |
Capsule |
30
|
90
|
| SALSALATE 500 MG |
Tablet |
60
|
180
|
Antipsychotic
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| FLUPHENAZINE 1 MG |
Tablet |
30
|
90
|
| HALOPERIDOL 0.5 MG |
Tablet |
30
|
90
|
| HALOPERIDOL 1 MG |
Tablet |
30
|
90
|
| HALOPERIDOL 2 MG |
Tablet |
30
|
90
|
| HALOPERIDOL 5 MG |
Tablet |
30
|
90
|
| LITHIUM CARB 300 MG* |
Capsule |
90
|
270
|
| THIORIDAZINE 25 MG |
Tablet |
30
|
90
|
| THIORIDAZINE 50 MG |
Tablet |
30
|
90
|
| THIOTHIXENE 2 MG |
Capsule |
30
|
90
|
Antiviral
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ACYCLOVIR 200 MG |
Capsule |
30
|
90
|
Arthritis
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| DICLOFENAC ER 75 MG |
Tablet |
60
|
180
|
| IBUPROFEN 400 MG |
Tablet |
90
|
270
|
| IBUPROFEN 600 MG |
Tablet |
60
|
180
|
| IBUPROFEN 800 MG |
Tablet |
30
|
90
|
| INDOMETHACIN 25 MG* |
Capsule |
60
|
180
|
| MELOXICAM 7.5 MG |
Tablet |
30
|
90
|
| MELOXICAM 15 MG |
Tablet |
30
|
90
|
| NAPROXEN 375 MG* |
Tablet |
60
|
180
|
| NAPROXEN 500 MG* |
Tablet |
60
|
180
|
| PIROXICAM 20 MG |
Capsule |
30
|
90
|
| SALSALATE 500 MG |
Tablet |
60
|
180
|
Asthma
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ALBUTEROL 2 MG/5 ML |
Syrup |
120
|
360
|
| ALBUTEROL 2 MG |
Tablet |
90
|
270
|
| ALBUTEROL 4 MG |
Tablet |
60
|
180
|
| ALBUTEROL NEB 0.083%* |
Solution |
75
|
225
|
| ALBUTEROL NEB 0.5% |
Solution |
20
|
60
|
| IPRATROPIUM NEB 0.2 MG/ML* |
Solution |
75
|
225
|
Cancer/Oncology
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| MEGESTROL 20 MG* |
Tablet |
30
|
90
|
Cardiac/Hypertension
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| AMILORIDE/HCTZ 5-50 MG |
Tablet |
30
|
90
|
| ATENOLOL 25 MG |
Tablet |
30
|
90
|
| ATENOLOL 50 MG |
Tablet |
30
|
90
|
| ATENOLOL 100 MG |
Tablet |
30
|
90
|
| ATENOLOL/CHLORTHAL 50/25 MG |
Tablet |
30
|
90
|
| ATENOLOL/CHLORTHAL 100/25 MG |
Tablet |
30
|
90
|
| BENAZEPRIL 5 MG |
Tablet |
30
|
90
|
| BENAZEPRIL 10 MG |
Tablet |
30
|
90
|
| BENAZEPRIL 20 MG |
Tablet |
30
|
90
|
| BENAZEPRIL 40 MG |
Tablet |
30
|
90
|
| BISOPROLOL/HCTZ 2.5/6.25 MG |
Tablet |
30
|
90
|
| BISOPROLOL/HCTZ 5/6.25 MG |
Tablet |
30
|
90
|
| BISOPROLOL/HCTZ 10/6.25 MG |
Tablet |
30
|
90
|
| BUMETANIDE 0.5 MG |
Tablet |
30
|
90
|
| BUMETANIDE 1 MG |
Tablet |
30
|
90
|
| CAPTOPRIL 12.5 MG |
Tablet |
60
|
180
|
| CAPTOPRIL 25 MG |
Tablet |
60
|
180
|
| CAPTOPRIL 50 MG |
Tablet |
60
|
180
|
| CAPTOPRIL 100 MG |
Tablet |
60
|
180
|
| CARVEDILOL 3.125 MG |
Tablet |
60
|
180
|
| CARVEDILOL 6.25 MG |
Tablet |
60
|
180
|
| CARVEDILOL 12.5 MG |
Tablet |
60
|
180
|
| CARVEDILOL 25 MG* |
Tablet |
60
|
180
|
| CHLORTHALIDONE 25 MG |
Tablet |
30
|
90
|
| CHLORTHALIDONE 50 MG |
Tablet |
30
|
90
|
| CLONIDINE 0.1 MG |
Tablet |
30
|
90
|
| CLONIDINE 0.2 MG |
Tablet |
30
|
90
|
| DIGOXIN 0.125 MG |
Tablet |
30
|
90
|
| DIGOXIN 0.25 MG |
Tablet |
30
|
90
|
| DILTIAZEM 30 MG |
Tablet |
60
|
180
|
| DILTIAZEM 60 MG |
Tablet |
60
|
180
|
| DILTIAZEM 90 MG* |
Tablet |
60
|
180
|
| DILTIAZEM 120 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 1 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 2 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 4 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 8 MG |
Tablet |
30
|
90
|
| ENALAPRIL 2.5 MG |
Tablet |
30
|
90
|
| ENALAPRIL 5 MG |
Tablet |
30
|
90
|
| ENALAPRIL 10 MG |
Tablet |
30
|
90
|
| ENALAPRIL 20 MG |
Tablet |
30
|
90
|
| ENALAPRIL/HCTZ 5/12.5 MG |
Tablet |
30
|
90
|
| FUROSEMIDE 20 MG |
Tablet |
30
|
90
|
| FUROSEMIDE 40 MG |
Tablet |
30
|
90
|
| FUROSEMIDE 80 MG |
Tablet |
30
|
90
|
| GUANFACINE 1 MG |
Tablet |
30
|
90
|
| HYDRALAZINE 10 MG |
Tablet |
30
|
90
|
| HYDRALAZINE 25 MG |
Tablet |
30
|
90
|
| HYDROCHLOROTHIAZIDE 12.5 MG* |
Capsule |
30
|
90
|
| HYDROCHLOROTHIAZIDE 25 MG |
Tablet |
30
|
90
|
| HYDROCHLOROTHIAZIDE 50 MG |
Tablet |
30
|
90
|
| INDAPAMIDE 1.25 MG |
Tablet |
30
|
90
|
| INDAPAMIDE 2.5 MG |
Tablet |
30
|
90
|
| ISOSORBIDE MONONITRATE ER 30 MG |
Tablet |
30
|
90
|
| ISOSORBIDE MONONITRATE ER 60 MG |
Tablet |
30
|
90
|
| LISINOPRIL 2.5 MG |
Tablet |
30
|
90
|
| LISINOPRIL 5 MG |
Tablet |
30
|
90
|
| LISINOPRIL 10 MG |
Tablet |
30
|
90
|
| LISINOPRIL 20 MG |
Tablet |
30
|
90
|
| LISINOPRIL/HCTZ 10-12.5 MG |
Tablet |
30
|
90
|
| LISINOPRIL/HCTZ 20-12.5 MG* |
Tablet |
30
|
90
|
| LISINOPRIL/HCTZ 20-25 MG* |
Tablet |
30
|
90
|
| METHYLDOPA 250 MG* |
Tablet |
60
|
180
|
| METHYLDOPA 500 MG* |
Tablet |
30
|
90
|
| METOPROLOL TARTRATE 25 MG |
Tablet |
60
|
180
|
| METOPROLOL TARTRATE 50 MG |
Tablet |
60
|
180
|
| METOPROLOL TARTRATE 100 MG* |
Tablet |
60
|
180
|
| NADOLOL 20 MG |
Tablet |
30
|
90
|
| NADOLOL 40 MG* |
Tablet |
30
|
90
|
| PINDOLOL 5 MG |
Tablet |
30
|
90
|
| PINDOLOL 10 MG |
Tablet |
30
|
90
|
| PRAZOSIN HCL 1 MG |
Capsule |
30
|
90
|
| PRAZOSIN HCL 2 MG* |
Capsule |
30
|
90
|
| PRAZOSIN HCL 5 MG* |
Capsule |
30
|
90
|
| PROPRANOLOL 10 MG |
Tablet |
60
|
180
|
| PROPRANOLOL 20 MG |
Tablet |
60
|
180
|
| PROPRANOLOL 40 MG |
Tablet |
60
|
180
|
| PROPRANOLOL 80 MG |
Tablet |
60
|
180
|
| SOTALOL HCL 80 MG* |
Tablet |
30
|
90
|
| SPIRONOLACTONE 25 MG* |
Tablet |
30
|
90
|
| TERAZOSIN 1 MG |
Capsule |
30
|
90
|
| TERAZOSIN 2 MG |
Capsule |
30
|
90
|
| TERAZOSIN 5 MG |
Capsule |
30
|
90
|
| TERAZOSIN 10 MG |
Capsule |
30
|
90
|
| TRIAMTERENE/HCTZ 37.5/25 MG |
Capsule/Tablet |
30
|
90
|
| TRIAMTERENE/HCTZ 75/50 MG |
Tablet |
30
|
90
|
| VERAPAMIL 80 MG |
Tablet |
30
|
90
|
| VERAPAMIL 120 MG |
Tablet |
30
|
90
|
| WARFARIN 1 MG |
Tablet |
30
|
90
|
| WARFARIN 2 MG |
Tablet |
30
|
90
|
| WARFARIN 2.5 MG |
Tablet |
30
|
90
|
| WARFARIN 3 MG |
Tablet |
30
|
90
|
| WARFARIN 4 MG |
Tablet |
30
|
90
|
| WARFARIN 5 MG* |
Tablet |
30
|
90
|
| WARFARIN 6 MG |
Tablet |
30
|
90
|
| WARFARIN 7.5 MG |
Tablet |
30
|
90
|
| WARFARIN 10 MG |
Tablet |
30
|
90
|
Cholesterol
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| LOVASTATIN 10 MG* |
Tablet |
30
|
90
|
| LOVASTATIN 20 MG* |
Tablet |
30
|
90
|
| PRAVASTATIN 10 MG |
Tablet |
30
|
90
|
| PRAVASTATIN 20 MG |
Tablet |
30
|
90
|
| PRAVASTATIN 40 MG* |
Tablet |
30
|
90
|
Diabetes
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| CHLORPROPAMIDE 100 MG* |
Tablet |
30
|
90
|
| GLIMEPIRIDE 1 MG |
Tablet |
30
|
90
|
| GLIMEPIRIDE 2 MG |
Tablet |
30
|
90
|
| GLIMEPIRIDE 4 MG |
Tablet |
30
|
90
|
| GLIPIZIDE 5 MG |
Tablet |
30
|
90
|
| GLIPIZIDE 10 MG* |
Tablet |
60
|
180
|
| GLYBURIDE 2.5 MG |
Tablet |
30
|
90
|
| GLYBURIDE 5 MG |
Tablet |
30
|
90
|
| GLYBURIDE MICRO 3 MG |
Tablet |
30
|
90
|
| GLYBURIDE MICRO 6 MG |
Tablet |
30
|
90
|
| METFORMIN 500 MG |
Tablet |
60
|
180
|
| METFORMIN 850 MG |
Tablet |
60
|
180
|
| METFORMIN 1000 MG* |
Tablet |
60
|
180
|
| METFORMIN ER 500 MG* |
Tablet |
60
|
180
|
Ear Preparations
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ANTIPYRINE/BENZOCAINE |
Otic Solution |
10
|
30
|
Eye Preparations
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ATROPINE SULFATE 1% |
Ophthalmic Solution |
5
|
15
|
| BACITRACIN |
Ophthalmic Ointment |
4
|
12
|
| ERYTHROMYCIN 5 MG/GM |
Ophthalmic Ointment |
4
|
12
|
| GENTAMICIN 0.3% |
Ophthalmic Solution |
5
|
15
|
| LEVOBUNOLOL 0.5% |
Ophthalmic Solution |
5
|
15
|
| NEO/POLYMX/DEXAMETHASONE 0.1% |
Ophthalmic Ointment |
4
|
12
|
| NEO/POLYMX/DEXAMETHASONE 0.1% |
Ophthalmic Suspension |
5
|
15
|
| PILOCARPINE 1% |
Ophthalmic Solution |
15
|
45
|
| PILOCARPINE 2% |
Ophthalmic Solution |
15
|
45
|
| POLYMYXIN SULFATE/TMP* |
Ophthalmic Solution |
10
|
30
|
| SULFACETAMIDE SODIUM 10% |
Ophthalmic Solution |
15
|
45
|
| TIMOLOL MALEATE 0.25% |
Ophthalmic Solution |
5
|
15
|
| TIMOLOL MALEATE 0.5% |
Ophthalmic Solution |
5
|
15
|
| TOBRAMYCIN 0.3% |
Ophthalmic Solution |
5
|
15
|
Hormones
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ESTRADIOL 0.5 MG |
Tablet |
30
|
90
|
| ESTRADIOL 1 MG |
Tablet |
30
|
90
|
| ESTRADIOL 2 MG |
Tablet |
30
|
90
|
| ESTROPIPATE 0.75 MG |
Tablet |
30
|
90
|
| ESTROPIPATE 1.5 MG* |
Tablet |
30
|
90
|
| MEDROXYPROGESTERONE 2.5 MG |
Tablet |
30
|
90
|
| MEDROXYPROGESTERONE 5 MG |
Tablet |
30
|
90
|
| MEDROXYPROGESTERONE 10 MG |
Tablet |
10
|
30
|
Incontinence
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| HYOSCYAMINE 0.125/5 ML* |
Drops |
15
|
45
|
| OXYBUTYNIN 5 MG |
Tablet |
60
|
180
|
Muscle Relaxants
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BACLOFEN 10 MG |
Tablet |
30
|
90
|
| CYCLOBENZAPRINE 5 MG |
Tablet |
30
|
90
|
| CYCLOBENZAPRINE 10 MG |
Tablet |
30
|
90
|
Other
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ALLOPURINOL 100 MG |
Tablet |
30
|
90
|
| ALLOPURINOL 300 MG |
Tablet |
30
|
90
|
| CARBAMAZEPINE 200 MG* |
Tablet |
60
|
180
|
| CHLORHEXIDINE GLUCONATE 0.12% |
Solution |
473
|
1419
|
| COLCHICINE 0.6 MG |
Tablet |
30
|
90
|
| CYTRA-2 |
Solution |
180
|
540
|
| PHENAZOPYRIDINE 100 MG |
Tablet |
6
|
18
|
| PHENAZOPYRIDINE 200 MG |
Tablet |
30
|
90
|
| PROCHLORPERAZINE 10 MG |
Tablet |
30
|
90
|
Parkinson's Disease
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BENZTROPINE 2 MG |
Tablet |
30
|
90
|
| TRIHEXYPHENIDYL 2 MG |
Tablet |
60
|
180
|
Prostate/BPH
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| DOXAZOSIN 1 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 2 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 4 MG |
Tablet |
30
|
90
|
| DOXAZOSIN 8 MG |
Tablet |
30
|
90
|
| MEGESTROL 20 MG* |
Tablet |
30
|
90
|
| PRAZOSIN HCL 1 MG |
Capsule |
30
|
90
|
| PRAZOSIN HCL 2 MG* |
Capsule |
30
|
90
|
| PRAZOSIN HCL 5 MG* |
Capsule |
30
|
90
|
| TERAZOSIN 1 MG |
Capsule |
30
|
90
|
| TERAZOSIN 2 MG |
Capsule |
30
|
90
|
| TERAZOSIN 5 MG |
Capsule |
30
|
90
|
| TERAZOSIN 10 MG |
Capsule |
30
|
90
|
Seizure/Epilepsy
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| CARBAMAZEPINE 200 MG* |
Tablet |
60
|
180
|
Steroids
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| DEXAMETHASONE .075 MG |
Tablet |
12
|
36
|
| DEXAMETHASONE 0.5 MG |
Tablet |
30
|
90
|
| DEXAMETHASONE 4 MG |
Tablet |
6
|
18
|
| METHYLPREDNISOLONE 4 MG |
Dose Pak/Tablet |
21
|
63
|
| PREDNISONE 2.5 MG |
Tablet |
30
|
90
|
| PREDNISONE 5 MG |
Dose Pak |
21
|
63
|
| PREDNISONE 5 MG* |
Dose Pak |
48
|
144
|
| PREDNISONE 5 MG |
Tablet |
30
|
90
|
| PREDNISONE 10 MG |
Dose Pak |
21
|
63
|
| PREDNISONE 10 MG* |
Dose Pak |
48
|
N/A
|
| PREDNISONE 10 MG |
Tablet |
30
|
90
|
| PREDNISONE 20 MG |
Tablet |
30
|
90
|
Stomach Disorders/Gastrointestinal
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BELLADONNA ALKALOIDS/PB |
Tablet |
60
|
180
|
| CIMETIDINE 800 MG* |
Tablet |
30
|
90
|
| DICYCLOMINE 10 MG |
Capsule |
90
|
270
|
| DICYCLOMINE 20 MG |
Tablet |
60
|
180
|
| FAMOTIDINE 20 MG |
Tablet |
60
|
90
|
| HYDROCORTISONE AC 25 MG |
Suppository |
12
|
36
|
| HYOSCYAMINE 0.125/5 ML* |
Drops |
15
|
45
|
| LACTULOSE 10 GM/15 ML |
Syrup |
237
|
711
|
| METOCLOPRAMIDE 5 MG/5 ML |
Syrup |
60
|
180
|
| METOCLOPRAMIDE 10 MG |
Tablet |
60
|
180
|
| PROCHLORPERAZINE 10 MG |
Tablet |
30
|
90
|
| PROMETHAZINE 25 MG* |
Tablet |
12
|
36
|
| RANITIDINE 150 MG |
Tablet |
60
|
180
|
| RANITIDINE 300 MG |
Tablet |
30
|
90
|
Thyroid
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| LEVOTHYROXINE 25 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 50 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 75 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 88 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 100 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 112 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 125 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 137 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 150 MCG |
Tablet |
30
|
90
|
| LEVOTHYROXINE 175 MCG* |
Tablet |
30
|
90
|
| LEVOTHYROXINE 200 MCG* |
Tablet |
30
|
90
|
Topical Preparations
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| BENZOYL PEROXIDE 4%* |
Creamy Wash |
171
|
N/A
|
| BETAMETHASONE DIPROPIONATE 0.05% |
Cream |
15
|
45
|
| BETAMETHASONE DIPROPIONATE 0.05% |
Cream |
45
|
135
|
| BETAMETHASONE VALERATE 0.1% |
Cream |
15
|
45
|
| BETAMETHASONE VALERATE 0.1% |
Cream |
45
|
135
|
| BETAMETHASONE VALERATE 0.1% |
Ointment |
15
|
45
|
| BETAMETHASONE VALERATE 0.1% |
Ointment |
45
|
135
|
| FLUOCINONIDE 0.05% |
Cream |
15
|
45
|
| FLUOCINONIDE 0.05% |
Cream |
30
|
90
|
| FLUOCINOLONE ACETIDE 0.01% |
Solution |
60
|
180
|
| GENTAMICIN 0.1% |
Cream/Ointment |
15
|
45
|
| HYDROCORTISONE 1% |
Cream |
30
|
90
|
| HYDROCORTISONE 2.5% |
Cream |
30
|
90
|
| LIDOCAINE VISCOUS 2% |
Solution |
100
|
300
|
| NYSTATIN 100,000U |
Cream/Ointment |
15
|
45
|
| NYSTATIN 100,000U |
Cream/Ointment |
30
|
90
|
| NYSTATIN/TRIAMCINOLONE |
Cream |
15
|
45
|
| NYSTATIN/TRIAMCINOLONE |
Cream |
30
|
90
|
| NYSTATIN/TRIAMCINOLONE |
Ointment |
15
|
45
|
| SELENIUM SULFIDE 2.5%* |
Lotion |
120
|
360
|
| SILVER SULFADIAZINE 1%* |
Cream |
50
|
150
|
| TRIAMCINOLONE 0.025% |
Cream |
15
|
45
|
| TRIAMCINOLONE 0.025% |
Cream |
80
|
240
|
| TRIAMCINOLONE 0.1% |
Cream/Ointment |
15
|
45
|
| TRIAMCINOLONE 0.1% |
Cream/Ointment |
80
|
240
|
| TRIAMCINOLONE 0.5% |
Cream |
15
|
45
|
Tuberculosis
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| ISONIAZID 300 MG |
Tablet |
30
|
90
|
Vitamins/Supplements
Generic Drug Name/Strength |
Form |
$4 30-Day QTY
|
$10 90-Day QTY
|
| FOLIC ACID 1 MG |
Tablet |
30
|
90
|
| MAGNESIUM OXIDE 400 MG |
Tablet |
30
|
90
|
| MAG64 64 MG* |
Tablet |
60
|
180
|
| POTASSIUM CHLORIDE 10% |
Liquid |
473
|
1419
|
| POTASSIUM CHLORIDE CR 8 MEQ |
Tablet |
30
|
90
|
| POTASSIUM CHLORIDE CR 10 MEQ |
Tablet |
30
|
90
|
| PRENATAL RX* |
Tablet |
30
|
N/A
|
| SODIUM FLUORIDE 0.5 MG |
Tablet |
120
|
N/A
|