$ day. $4-30day $10-90day. 473mL. 4-$9 Alendronate Sodium 35mg tablets 12-$24 12-$ $24 12-$24 12-$24 4-$9. 80mL.

Size: px
Start display at page:

Download "$ day. $4-30day $10-90day. 473mL. 4-$9 Alendronate Sodium 35mg tablets 12-$24 12-$ $24 12-$24 12-$24 4-$9. 80mL."

Transcription

1 Acyclovir 200mg capsules Acyclovir 400mg tablets Acyclovir 800mg tablets Albuterol 0.083% Nebulizing Solution (75ml- 30days/225ml-s) Albuterol 0.5% Nebulizer Solution (20mL-30days, 60mL-s) Albuterol 2mg tablets Albuterol 2mg/5ml Syrup Albuterol 4mg tablets 4-$9 4-$9 4-$9 4-$9 Alendronate Sodium 35mg tablets 12-$24 12-$ $24 12-$24 12-$24 4-$9 4-$9 4-$9 4-$9 Alendronate Sodium 70mg tablets 12-$24 12-$ $24 12-$24 12-$24 Allopurinol 100mg tablets Allopurinol 300mg tablets Amantadine 50mg/5mL Syrup Amiloride/HCTZ 5/50mg tablets Amiodarone 200mg tablets Amitriptyline 10mg tablets Amitriptyline 25mg tablets Amitriptyline 50mg tablets Amitriptyline 75mg tablets Amitriptyline 100mg tablets Amitriptyline 150mg tablets Amlodipine Besylate 2.5mg tablets Amlodipine Besylate 5mg tablets Amlodipine Besylate 10mg tablets Amlodipine 2.5mg/ Benazepril 10mg tablets Amlodipine 5mg/ Benazepril 10mg tablets Amlodipine 5mg/ Benazepril 20mg tablets Amlodipine 10mg/ Benazepril 20mg tablets Amlodipine 5mg/ Benazepril 40mg capsules Amlodipine 10mg/ Benazepril 40mg capsules Amoicillin 125mg Chewables Amoicillin 125mg/5ml Suspension (80mL bottle) Amoicillin 125mg/5ml Suspension ( bottle) Amoicillin 125mg/5ml Suspension ( bottle) Amoicillin 200mg/5ml Suspension (50mL bottle) Amoicillin 200mg/5ml Suspension (75mL bottle) mL 240mL 450mL 50mL 75mL 225mL 450mL 80mL 240mL 450mL 50mL 75mL 225mL Amoicillin 200mg/5ml Suspension ( bottle) Amoicillin 250mg Chewable tablets 80mL 80mL Amoicillin 250mg/5ml Suspension (80mL bottle) mL 240mL Amoicillin 250mg capsules #30

2 Amoicillin 400mg Chewable Tablets 50mL 50mL Amoicillin 400mg/5ml Suspension (50mL bottle) 75mL 75mL Amoicillin 400mg/5ml Suspension (75mL bottle) 225mL 225mL Amoicillin 400mg/5ml Suspension ( bottle) Amoicillin 500mg capsules #30 Amoicillin 875mg tablets #20 #20; #60 Amoicillin Tri-K Clauvulanate mg Chewable tablets #20; #60 Amoicillin Tri-K Clauvulanate mg capsules 20-$8 Amoicillin Tri-K Clauvulanate mg capsules 20-$8 Ampicillin 250mg capsules #28 #56; #168 Ampicillin 500mg capsules #28 #56; #168 Atenolol 25mg tablets Atenolol 50mg tablets Atenolol 100mg tablets Atenolol/Chlorthalidone 50/25mg tabs Atenolol/Chlorthalidone 100/25mg tabs Azithromycin 250mg pak (#6 tabs) $15 Baclofen 10mg tablets Baclofen 20mg tablets Belladonna Alkaloids/Phenobarbital tabs Benazepril 5mg tablets Benazepril 10mg tablets Benazepril 20mg tablets Benazepril 40mg tablets Benazepril/HCTZ 10/12.5mg tablets Benazepril/HCTZ 20/12.5mg tablets Benazepril/HCTZ 20/25mg tablets Benztropine 0.5mg tablets Benztropine 1mg tablets Benztropine 2mg tablets Bethanechol 5mg tablets Bethanechol 10mg tablets Bethanechol 25 mg tablets Bethanechol 50 mg tablets Bisoprolol 5mg tablets Bisprolol 10mg tablets Bisoprolol/HCTZ 2.5/6.25mg tablets Bisoprolol/HCTZ 5/6.25mg tablets Bisoprolol/HCTZ 10/6.25mg tablets Bumetanide 0.5mg tablets Bumetanide 1mg tablets Bumetanide 2mg tablets Buspirone 5mg tablets Buspirone 10mg tablets Buspirone 15mg tablets 180-$22 Buspirone 30mg tablets Captopril 12.5mg tablets Captopril 25mg tablets

3 Captopril 50mg tablets Captopril 100mg tablets Carbamazepine 100mg Chewables Carbamazepine 200mg tablets Cartia XT 120mg capsules Carvedilol 3.125mg tablets Carvedilol 6.25mg tablets Carvedilol 12.5mg tablets Carvedilol 25mg tablets Cephalein 125mg/5mL Liquid mL Cephalein 250mg/5mL Liquid mL Cephalein 250mg capsules #30 #40; #120 #28; #84 #28; #84 Cephalein 500mg capsules #30 #40; #120 #40; #120 Chlorheidine Gluconate 0.12% Solution 480mL - $4 1419mL 1419mL 1419mL Chlorpromazine 25mg tablets Chlorpromazine 50mg tablets Chlorthalidone 25mg tablets Chlorthalidone 50mg tablets Chlorothiazide 250mg Chlorothiazide 500mg Chlorzoazone 500mg tablets Cilostazol 50mg 180-$24 Cilostazol 100mg 180-$24 Cimetidine 300mg tablets Cimetidine 400mg tablets Cimetidine 800mg tablets Ciprofloacin 250mg tablets -20 #20; #60 #14; #42 #28; #84 Ciprofloacin 500mg tablets -20 #20; #60 #20; #60 Ciprofloacin 750mg tablets -14 Citalopram 10mg tablets Citalopram 20mg tablets Citalopram 40mg tablets Clindamycin 150mg capsules Clomiphene 50mg tablets 5-$9 15-$24 5-$9 15-$24 #5; #15 5-$9 15-$24 5-$9 15-$24 Clonidine 0.1mg tablets Clonidine 0.2mg tablets Clonidine 0.3mg tablets Clopidogrel 75mg tablets Cyclobenzaprine 5mg tablets Cyclobenzaprine 10mg tablets Cyproheptadine 4mg tablets Deamethasone 0.5mg tablets #12; #36 Deamethasone 0.75mg tablets #12; #36 #18; #54 #12; #36 Deamethasone 4mg tablets #6; #18 #12; #36 #6; #18 Diclofenac Potassium 50mg tablets Diclofenac Sodium DR 50mg tablets 180-$24

4 Diclofenac Sodium DR 75mg tablets 180-$24 Diclofenac Sodium SA 100mg tablets Dicloacillin 250mg capsule #40; #120 Dicyclomine 10mg capsules Dicyclomine 20mg tablets Digoin 0.125mg tablets Digoin 0.25mg tablets Diltiazem 30mg tablets 180-$22 Diltiazem 60mg tablets 180-$22 Diltiazem 90mg tablets 180-$22 Diltiazem 120mg tablets Diltiazem CD 120mg capsules Diltiazem CD 180mg capsules Diltiazem CD 240mg capsules Dipyridamole 25mg tablets Dipyridamole 50mg tablets Dipyridamole 75mg tablets Divalproe Sodium DR 125mg tablets Divalproe Sodium DR 250mg tablets Divalproe Sodium DR 500mg tablets Doazosin 1mg tablets Doazosin 2mg tablets Doazosin 4mg tablets Doazosin 8mg tablets Doepin 10mg capsules Doepin 25mg capsules Doepin 50mg capsules Doepin 75mg capsules Doepin 100mg capsules 60-$19.99 Doycycline 20mg capsules 180-$ $19.99 Doycycline Hyclate 50mg capsules 120-$ $19.99 Doycycline Hyclate 100mg capsules 60-$59.97 Enalapril 2.5mg tablets Enalapril 5mg tablets Enalapril 10mg tablets

5 Enalapril 20mg tablets Enalapril/HCTZ 5/12.5mg tablets Enalapril/HCTZ 10/25mg tablets Estradiol 0.5mg tablets Estradiol 1mg tablets Estradiol 2mg tablets 30-$9 Estropipate 0.75mg tablets 90-$24 30-$9 Estropipate 1.5mg tablets 90-$24 Famotidine 20mg tablets Famotidine 40mg tablets 30-$9 Finasteride 5mg tablets 90-$27 30-$9 30-$9 Fluconazole 100mg tablets ma: #12 #10; #30 Fluconazole 150mg tablets #1; #3 #1; #3 #1; #3 #1; #3 #1; #3 Fluconazole 200mg tablets ma: #12 #10; #30 Fluoetine 10mg capsules Fluoetine 10mg tablets Fluoetine 20mg capsules Fluoetine 40mg capsules Fluphenazine 1mg tablets Fluphenazine 2.5mg tablets Fluphenazine 5mg tablets Fluphenazine 10mg tablets Fluvoamine Maleate 25mg Fosinopril 10mg tablets Fosinopril 20mg tablets Fosinopril 40mg tablets Fosinopril/HCTZ mg tablets Fosinopril/HCTZ mg tablets Furosemide 10mg/mL Liquid 60mL-$4 Furosemide 20mg tablets Furosemide 40mg tablets Furosemide 80mg tablets Gabapentin 100mg capsules #60; #180 #270 Gabapentin 300mg capsules Gabapentin 400mg capsules Gemfibrozil 600mg 60-$ $30 Glimepiride 1mg tablets Glimepiride 2mg tablets Glimepiride 4mg tablets Glipizide 5mg tablets Glipizide 10mg tablets Glipizide XL 2.5mg tablets Glipizide XL 5mg tablets Glipizide XL 10mg tablets Glyburide (micronized) 1.5mg tablets

6 Glyburide (micronized) 3mg tablets Glyburide (micronized) 6mg tablets 90-$20 Glyburide 1.25mg tablets Glyburide 2.5mg tablets Glyburide 5mg tablets Glyburide/Metformin 1.25/250m tablets Glyburide/Metformin 2.5/500mg tablets Glyburide/Metformin 5/500mg tablets Guanfacine 1mg tablets Guanfacine 2mg tablets Haloperidol 2mg/mL Concentrate 15mL; 45mL Haloperidol 0.5mg tablets Haloperidol 1mg tablets Haloperidol 2mg tablets Haloperidol 5mg tablets Hydrochlorothiazide (HCTZ) 12.5mg capsules Hydrochlorothiazide (HCTZ) 12.5mg tablets Hydrochlorothiazide (HCTZ) 25mg tablets Hydrochlorothiazide (HCTZ) 50mg tablets Hydralazine 10mg tablets Hydralazine 25mg tablets Hydralazine 50mg tablets Hydralazine 100mg tablets Hydrocortisone 20mg tablets Hydroyzine HCl 10mg/5ml Syrup Hydroyzine HCl 10mg tablets Hydroyzine HCl 25mg tablets Hydroyzine HCl 50mg tablets Hydroyzine Pamoate 25mg capsules Hydroyzine Pamoate 50mg capsules Ibuprofen 100mg/5ml Suspension Ibuprofen 400mg tablets Ibuprofen 600mg tablets Ibuprofen 800mg tablets Imipramine 10mg tablets Imipramine 25mg tablets Indapamide 1.25mg tablets Indapamide 2.5mg tablets Indomethacin 25mg capsules Indomethacin 50mg capsules Ipratropium 0.02% Nebulizing Solution (62.5ml- 30days/187.5ml-s) 75mL 225mL 75mL 225mL Ipratropium Brom/ Albuterol Sulf Nebulizing Solution $15-90 Isoniazid 300mg tablets Isosorbide Dinitrate (DN) 2.5mg SL tablets Isosorbide Dinitrate (DN) 5mg SL tablets Isosorbide Dinitrate (DN) 5mg tablets Isosorbide Dinitrate (DN) 10mg tablets Isosorbide Dinitrate (DN) 30mg tablets Isosorbide Mononitrate 10mg tablets Isosorbide Mononitrate 20mg tablets

7 Isosorbide Mononitrate ER 30mg tablets Isosorbide Mononitrate ER 60mg tablets Isosorbide Mononitrate ER 120mg Ketoprofen 50mg capsules 180-$24 Ketoprofen 75mg capsules 180-$24 Labetalol 100mg tablets Labetalol 200mg tablets Labetalol 300mg tablets 240mL-$4 237mL Lactulose 10gm/15mL Syrup 960mL-$12 720mL 1419mL 1419mL 711mL Lamotrigine 25mg chewable tablets Lamotrigine 25mg tablet Lamotrigine 100mg tablet Lamotrigine 150mg tablet Lamotrigine 200mg tablet Levothyroine 25mcg tablets 90-$24 Levothyroine 50mcg tablets 90-$24 Levothyroine 75mcg tablets 90-$24 Levothyroine 88mcg tablets 90-$24 Levothyroine 100mcg tablets 90-$24 Levothyroine 112mcg tablets 90-$24 Levothyroine 125mcg tablets 90-$24 Levothyroine 137mcg tablets 90-$24 Levothyroine 150mcg tablets 90-$24 Levothyroine 175mcg tablets 90-$24 Levothyroine 200mcg tablets 90-$24 Levothyroine 300mcg tablets Lidocaine 2% Viscous Solution 2.5mg tablets #60 5mg tablets #60 10mg tablets #60 20mg tablets #60 30mg tablets #60 40mg tablets #60 /HCTZ 10/12.5mg tablets /HCTZ 20/12.5mg tablets /HCTZ 20/25mg tablets Lithium Carbonate 300mg capsules #90; #270 #90; #270 #90; #270 #90; #270

8 Loperamide 2mg capsules 180-$24 Losartan 25mg tablets Losartan 50mg tablets Losartan 100mg tablets Losartan-HCTZ 50/12.5mg tablets Losartan-HCTZ 100/12.5mg tablets Losartan-HCTZ 100/25mg tablets Lovastatin 10mg tablets Lovastatin 20mg tablets Lovastatin 40mg tablets Meclizine 12.5mg tablets Medroyprogesterone Acet. 2.5mg tabs Medroyprogesterone Acet. 5mg tabs Medroyprogesterone Acet. 10mg tabs Megestrol 20mg tablets Megestrol 40mg tablets Meloicam 7.5mg tablets Meloicam 15mg tablets Metformin 500mg tablets #90 -ma120 Metformin 850mg tablets #90 -ma90 Metformin 1000mg tablets #90 -ma90 Metformin ER 500mg tablets Metformin ER 750mg tablets Methimazole 5mg tablets Methimazole 10mg tablets Methocarbamol 500mg tablets Methocarbamol 750mg tablets Methyldopa 250mg tablets Methyldopa 500mg tablets Methylprednisolone 4mg tablets Metoclopramide 5mg/5ml Syrup 240-$4 60mL 180mL Metoclopramide 5mg tablets Metoclopramide 10mg tablets Metolazone 2.5mg tablets Metolazone 5mg tablets Metoprolol Tartrate 25mg tablets Metoprolol Tartrate 50mg tablets Metoprolol Tartrate 100mg tablets Metronidazole 250mg tablets 28-$8 84-$24 #28; #84 Metronidazole 500mg tablets 14-$8 42-$24 #14; #42 Minocycline 50mg capsules #28; #84 Minocycline 100mg capsules #28; #84 Mirtazapine 15mg tablets Mirtazapine 30mg tablets

9 Mirtazapine 45mg tablets Nadolol 20mg tablets Nadolol 40mg tablets Naproen 250mg tablets Naproen 375mg tablets Naproen 500mg tablets Naproen Sodium 275mg tablets Naproen Sodium 550mg tablets Nortriptyline 10mg capsules Nortriptyline 25mg capsules Nortriptyline 50mg capsules Nortriptyline 75mg capsules 60mL Nystatin 100 mu/ml suspension 180mL 60mL Nystatin 100 mu/ml suspension drops 180mL Omeprazole 20mg capsule Omeprazole 40mg capsule 90-$24 Ondansetron 4mg tablets #20; #60 Ondansetron 8mg tablets #20; #60 Ondansetron ODT 4mg tablets #14; #42 Ondansetron ODT 8mg tablets #7; #21 Oybutynin 5mg/5mL syrup -$4 Oybutynin 5mg tablets Ocarbazepine 150mg tablets 180-$22 Ocarbazepine 300mg tablets Ocarbazepine 600mg tablets Pantoprazole 20mg tablets Pantoprazole 40mg tablets 90-$24 Paroetine 10mg tablets Paroetine 20mg tablets Paroetine 30mg tablets Paroetine 40mg tablets Penicillin VK 125mg/5ml Suspension () 200mL 200mL 200mL Penicillin VK 125mg/5ml Suspension (200mL) 600mL 600mL 600mL Penicillin VK 250mg tablets #28 #40; #120 #28; #84 Penicillin VK 500mg tablets #28 Pentoifylline 400mg tablets Phenazopyridine 100mg tablets #6; #18 #12; #36 #6; #18 Phenazopyridine 200mg tablets #12; #36 90-$8 Phenytoin 100mg capsules 270-$22 30-$10 Pravastatin 10mg tablets 90-$30 30-$10 Pravastatin 20mg tablets 90-$30

10 30-$10 Pravastatin 40mg tablets 90-$30 30-$10 Pravastatin 80mg tablets 90-$30 Prazosin 1mg capsules Prazosin 2mg capsules Prazosin 5mg capsules Prednisolone Sodium Phosphate 15mg/5mL (OraPred) Prednisolone Drops 15mg/5mL syrup (Prelone) PrednisoLONE 5mg tablets Prednisone 1mg tablets #90; #270 Prednisone 2.5mg tablets Prednisone 5mg tablets Prednisone 10mg tablets Prednisone 20mg tablets Prednisone 5mg dosepak (#21) 1 pack-$10 #1; #3 Prednisone 5mg dosepak (#48) Prednisone 10mg dosepak (#21) 1 pack - $10 #1; #3 Prednisone 10mg dosepak (#48) Primidone 50mg tablets Primidone 250mg tablets Prochlorperazine 5mg tablets Prochlorperazine 10mg tablets Promethazine (6.25mg/5mL) Syrup 240mL 720mL 180mL 540mL Promethazine 12.5mg tablets #120; #360 Promethazine 25mg tablets #12; #36 #12; #36 Promethazine 50mg tablets #60; #180 Promethazine DM ( /5mL) Syrup 240mL 720mL Propranolol 10mg tablets Propranolol 20mg tablets Propranolol 40mg tablets Propranolol 60mg tablets Propranolol 80mg tablets Propranolol-HCTZ 40-25mg tablets Propranolol-HCTZ 80-25mg tablets Quinapril 5mg tablets Quinapril 10mg tablets Quinapril 20mg tablets Quinapril 40mg tablets Ramipril 1.25mg capsules Ramipril 2.5mg capsules Ramipril 5mg capsules Ramipril 10mg capsules Ranitidine 15mg/mL syrup Ranitidine 150mg tablets Ranitidine 300mg tablets Risperidone 0.25mg tablets

11 Risperidone 0.5mg tablets Risperidone 1mg tablets Risperidone 2mg tablets Risperidone 3mg tablets Risperidone 4mg tablets 180-$22 Ropinirole 0.25mg tablets Ropinirole 0.5mg tablets Ropinirole 1mg tablets Ropinirole 2mg tablets Ropinirole 3mg tablets Ropinirole 4mg tablets Ropinirole 5mg tablets Sertraline 25mg tablets Sertraline 50mg tablets Sertraline 100mg tablets Simvastatin 5mg tablets Simvastatin 10mg tablets Simvastatin 20mg tablets Simvastatin 40mg tablets Simvastatin 80mg tablets Sulfamethoazole/Trimethoprim (SMZ/TMP) 200mg- 40mg/5ml Suspension - 200mL 600mL Sulfamethoazole/Trimethoprim (SMZ/TMP) 400mg- 80mg tablets #28 #20; #60 #28; #84 #28; #84 Sulfamethoazole/Trimethoprim (SMZ/TMP) DS 800mg-160mg tablets #20 #20; #60 #28; #84 #20; #60 Sotalol 80mg tablets Sotalol 120mg tablets Sotalol 160mg tablets Spironolactone 25mg tablets Spironolactone 50mg tablets Spironolactone 100mg tablets Spironolactone/HCTZ 25mg/25mg tablets Sulfasalazine 500mg tablets Sumatriptan 25mg tablets 9-$24 Sumatriptan 50mg tablets 9-$24 Sumatriptan 100mg tablets 9-$24 60-$12 Tamoifen 10mg tablets 180-$36 Tamoifen 20mg tablets 180- $ $ $10 90-$30 60-$9 180-$24 #60; # $9 90-$24 60-$9 180-$24 30-$9 90-$24 Tamsulosin 0.4mg capsules Terazosin 1mg capsules Terazosin 2mg capsules Terazosin 5mg capsules Terazosin 10mg capsules Terbinafine 250mg tablets #30 Theophylline SA 100mg tablets Theophylline SA 200mg tablets Thioridazine 10mg tablets Thioridazine 25mg tablets

12 Thioridazine 50mg tablets Thioridazine 100mg tablets Thiothiene 1mg capsule Thiothiene 2mg capsules Tizanidine 2mg tablets Tizanidine 4mg tablets Topiramate 25mg tablets Topiramate 50mg tablets Topiramate 100mg tablets Topiramate 200mg tablets Torsemide 10mg tablets Torsemide 20mg tablets Trandolapril 1mg tablets Trazodone 50mg tablets Trazodone 100mg tablets Trazodone 150mg tablets Triamterene/HCTZ 37.5/25mg capsules Triamterene/HCTZ 37.5/25mg tablets Triamterene/HCTZ 75/50mg tablets Triheyphenidyl 2mg tablets Triheyphenidyl 5mg tablets 60-$18 Venlafaine 25mg tablets 180-$50 60-$18 Venlafaine 37.5mg tablets 180-$50 60-$18 Venlafaine 50mg tablets 180-$50 60-$18 Venlafaine 75mg tablets 180-$50 60-$18 Venlafaine 100mg tablets 180-$50 Verapamil 40mg tablets Verapamil 80mg tablets Verapamil 120mg tablets Verapamil SA 180mg tablets Verapamil SA 240mg tablets Warfarin 1mg tablets Warfarin 2mg tablets Warfarin 2.5mg tablets Warfarin 3mg tablets Warfarin 4mg tablets Warfarin 5mg tablets Warfarin 6mg tablets Warfarin 7.5mg tablets Warfarin 10mg tablets 30-$19.99 Zolpidem Tartrate 5mg tablets 90-$59.97 Zolpidem Tartrate 10mg tablets Zonisamide 25mg capsules Zonisamide 50mg capsules Zonisamide 100mg capsules 30-$ $59.97

13 COUGH, COLD, ALLERGY Benzonatate 100mg capsules #14; #42 #14; #42 #28; #84 #14; #42 14-$4 42-$10 Benzonatate 200mg capsules #14; #42 #28; #84 C-Phen Drops 90mL Cetirizine 10mg tablets Cetirizine 1mg/mL syrup (30 days=, 90 days=) Feofenadine 30mg tablets 16-$15 Fluticasone 50mcg Nasal Spray 48-$45 Loratadine 10mg tablets DIABETES SUPPLIES Blood glucose kit by TopCare $4 25-$4 Blood glucose test strips by TopCare 50-$8 Lancets 100-$4 True Test Strips 50-$ $29.99 EAR DROPS Antipyrine/Benzocaine Ear Drops Ofloacin 0.3% Ear Drops 10mL 30mL 15mL 45mL 10mL 30mL EYE DROPS Atropine Sulfate 1% Ophth Solution 5mL 15mL 15mL 45mL 3.5mL 10.50mL Bacitracin/Polymiin B Ophth Ointment Brimonidine 0.2% Ophth Drops (5mL bottle) Ciprofloacin 0.3% Ophth Solution (5mL bottle) Cyclopentolate 1% Eye Ophth Soln Diclofenac 0.1% Ophth Solution (5mL) Erythromycin Ophth. Ointment 5mg/GM 3.5gm 10.5gm Flurbiprofen 0.03% Ophth Soln Gentak 0.3% Ophth Soln (5mL) Gentamicin 0.3% Ophth Drops (3mg/ml) -5mL Levobunolol 0.5% Ophth Solution Neomycin/Polymiin/De. 0.1% Ophth. Oint 5mL 15mL 5mL 15mL Neomycin/Polymiin/De. 0.1% Ophth. Susp 5mL 15mL Ofloacin 0.3% Ophth. Solution (5mL bottle) Pilocarpine 1% Ophth Solution Pilocarpine 2% Ophth Solution Polymiin Sulfate/Trimethoprin Ophth Soln 10mL 30mL 10mL 30mL 10mL 30mL 10mL 30mL

14 15mL 15mL Sulfacet Sodium 10% Ophth Solution 45mL 45mL Timolol Maleate 0.25% Ophth Soln (5 ml bottle) Timolol Maleate 0.5% Ophth Solution (5 ml bottle) Timolol Maleate 0.5% Ophth Soln (10 ml bottle) $8 Tobramycin 0.3% Ophth Solution (5mL bottle) ORAL CONTRACEPTIVES Alyacen 7/7/7 Aranelle -28day Aviane -28day Balziva -28day Cryselle -28day Emoquette -28day Errin 0.35mg -28day Gildess 1/20-21 day Gildess 1.5/30-21day Gildess Fe 1/20-28 day Gildess Fe 1.5/30-28 day Heather -28day Jolessa mg 91-day Kelnor 1/35-28day Lessina 0.1/0.02mg -28day Marlissa - 28 day Myzilra -28day Necon 1/50-28day Nore-Ethin-Estra Norgestimate Eth, Estradiol Nortrel 0.5/35-28day Nortrel 1/35 tablet -28day Previfem-28day Sprintec 28-day tablets Tri-Previfem Tri-Sprintec 28 day tablets Velivet -28day 28-$9 84-$27 28-$9 84-$27 1pk-$ pk-$9 3pk-$24 1pk-$9 1pk-$9 1pk-$9 3pks$24 1pk-$9 1pk-$9 TOPICAL AGENTS Betamethasone Diprop. Aug. 0.05% Cream Ciclopiro 0.77% Cream Ciclopiro 8% Topical Solution Clindamycin Phosphate 1% Topical Solution Clobetasol 0.05% Cream Clobetasol 0.05% Ointment 50gm 150gm 270gm 6.60mL 19.80mL 60mL 180mL 60mL 180mL 60mL 180mL

15 Clobetasol Propionate 0.05% Solution 50mL-$8 -$18 Clotrimazole 1% Cream Desonide 0.05% Cream Econazole Nitrate 1% Cream Erythromycin 2% Gel FluocinoLONE 0.01% Solution FluocinoLONE 0.025% Cream FluocinoLONE 0.025% Ointment FluocinoNIDE 0.05% Cream FluocinoNIDE-E 0.05% Cream Fluticasone Propionate 0.05% Cream Fluticasone Propionate 0.005% Ointment Gentamicin 0.1% Cream Gentamicin 0.1% Ointment Hydrocortisone 1% Cream Hydrocortisone 2.5% Cream -$12 $36 30gm 85gm 225gm 60gm 1 60gm 1 60gm 1 -$12 $36 30gm 30gm Hydrocortisone 2.5% Ointment 30gm 30gm 28.35gm 85.05gm 28.35gm 85.05gm 30gm Hydrocortisone AC 25mg RECTAL Suppositories 12-$8 #12; #36 Ketoconazole 2% Cream 60gm 1 Lidocaine-Prilocaine 2.5% Cream 30gm Miconazole 2% Cream (OTC) 28gm 84gm Mometasone Furoate 0.1% Cream 135gm Mometasone Furoate 0.1% Ointment 135gm Mupirocin 2% Ointment 22gm-$24 Nystatin Cream ( tube) Nystatin Cream (30gm tube) 30gm Povidone Iodine 10% Solution Selenium Sulfide 2.5% Lotion/Shampoo Silver Sulfadiazine 1% Cream Triamcinolone 0.025% Cream ( tube) Triamcinolone 0.025% Cream ( tube) 25-$4 50-$8 75-$10 -$8 -$18 118mL 354mL 50gm 150gm

16 Triamcinolone 0.025% Ointment ( tube) Triamcinolone 0.025% Ointment ( tube) Triamcinolone 0.1% Cream ( tube) Triamcinolone 0.1% Cream ( tube) Triamcinolone 0.1% Ointment ( tube) Triamcinolone 0.1% Ointment ( tube) Triamcinolone 0.5% Cream ( tube) Triamcinolone 0.5% Ointment ( tube) Urea 40% Cream Urea 40% Gel -$8 -$18 -$8 -$18 -$8 -$18 -$8 -$18 -$8 -$18 -$8 -$18 -$8 -$ gm 255. VITAMINS & SUPPLEMEMENTS Cytra-2 Solution Cytra-K Oral Solution 1419mL 1419mL 180mL 540mL 51gm-$4 102gm-$8 Denta (S.F.) 5000 Plus 1.1% gram Cream 153gm-$12 Fluoride chewtab 0.25 mg (Ludent) Fluoride chewtab 0.5 mg (Ludent) #120; #360 Fluoride chewtab 1 mg (Ludent) #120; #360 Folic Acid 1mg tablets Klor-Con M10 tablets Mag SR 64mg tablets Magnesium Oide 400mg tablets Multi-Vita Bets/Fl 0.25mg liquid 50mL Multi-Vita Bets/Fl 0.5mg liquid 50mL Multivita-Beta/Fl, Iron 1mg tablets Multivit-Iron-Fl 0.25mg/mL 50mL MVC Chew with Fluoride 0.25 tablets 100-$8 300-$22 MVC Chew with Fluoride 0.50 tablets 100-$8 300-$22 Natalcare PIC tablets Phospha 250mg neutral tablets PolyVit w/ Iron & Fluor 0.25mg/ml Drops Potassium Chloride 10% Liquid 1419mL Potassium Chloride 20% Liquid 1419mL Prenatabs FA 29 1mg tablets Prenatabs RX tablets

17 Prenatal 27 (0.8mg) tablets Prenatal Plus tablets 30-$4 Prenatal Plus 27 1mg tablets Prenatal RX tablets Sodium Fluoride 0.5mg/1.1mg tablets 120-$4 Sodium Fluoride 0.5mg/ml Drops Sodium Fluoride Dental Rinse 50mL Tri-Vit-Fluoride with Iron 0.25mg/ml Drops Ultra Natalcare tablets Vinate-M tablet Vitacon Forte capsules Vitamin D 50,000 Int. unit capsules (Drisdol) #8; #24

Professionalism & Service with Great Prices

Professionalism & Service with Great Prices Acyclovir Capsules 200mg Viruses 30 90 Albuterol Syrup 2mg/5ml Asthma 120 360 Albuterol Sulfate Solution 0.05% * Asthma ----- ----- 20 60 Albuterol Sulfate Solution 0.083% Asthma ----- ----- 75 225 Alendronate

More information

Riesbeck's Pharmacy Reward Club Generic Medication List October 2017

Riesbeck's Pharmacy Reward Club Generic Medication List October 2017 Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml

More information

$4 Prescription Program May 5, 2008

$4 Prescription Program May 5, 2008 Allergies & Cold and Flu Benzonatate 100mg 14 42 Ceron DM syrup 120ml 360ml Ceron drops* 30ml 90ml Dec-Chlorphen drops* 30ml 90ml Dec-Chlorphen DM syrup* 118ml 354ml Loratadine 10mg 30 90 Promethazine

More information

Riesbeck's Pharmacy Reward Club Generic Medication List September 2017

Riesbeck's Pharmacy Reward Club Generic Medication List September 2017 Drug Category Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Riesbeck's Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml 2160ml Hydroxyzine

More information

Riesbeck's Pharmacy Reward Club Generic Medication List February 2018 $4 30 Day Supply

Riesbeck's Pharmacy Reward Club Generic Medication List February 2018 $4 30 Day Supply Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml

More information

90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15.

90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15. 90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15.00 Allergy/Cold&Flu C-Phen Drops n/a Drops 90 $15.00 Allergy/Cold&Flu

More information

PRESCRIPTION SAVINGS CLUB FLAT- PRICED GENERIC DRUG LIST (EMDEON) Effective August 20, 2014

PRESCRIPTION SAVINGS CLUB FLAT- PRICED GENERIC DRUG LIST (EMDEON) Effective August 20, 2014 PRESCRIPTION SAVINGS CLUB FLAT- PRICED GENERIC DRUG LIST (EMDEON) Effective August 20, 2014 The Prescription Savings Club provides its members with significant savings on prescription medications. The

More information

Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY. Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition.

Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY. Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition. Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition. 30- day 90- day 30- day 90- day quantity quantity quantity quantity

More information

$4 Prescription Program October 23, 2007

$4 Prescription Program October 23, 2007 Allergies & Cold and Flu Benzonatate 100mg 14 Ceron DM syrup Ceron drops Dec-Chlorphen drops Dec-Chlorphen DM syrup 118ml* Loratadine 10mg Promethazine DM syrup Trivent DPC syrup * Antibiotic Treatments

More information

RETAIL PRESCRIPTION PROGRAM DRUG LIST -- WALMART Revised 8/24/11

RETAIL PRESCRIPTION PROGRAM DRUG LIST -- WALMART Revised 8/24/11 Allergies & Cold and Flu $4, 30-day $10, 90-day Benzonatate 100mg cap 14 42 Loratadine 10mg tab 30 90 Promethazine DM syrup 120ml 360ml Antibiotic Treatments Amoxicillin 125mg/5ml susp (80ml bottle) 1

More information

Pharmacy Savings Program

Pharmacy Savings Program Pharmacy Savings Program SELECT GENERICS DRUG LIST The Pharmacy Savings Program provides you with savings on select generic medications included on this list. The prices for these select generic medications

More information

Generic Drug List - Alphabetical

Generic Drug List - Alphabetical Generic Drug List - Alphabetical *** Individual pages can be printed by entering the page number in the Print Range field of the Print menu (Ctrl+P)*** Medication Name Category 30-Day 90-Day ACYCLOVIR

More information

AMANTADINE 50 MG/5 ML SYRUP ACYCLOVIR 200 MG CAPSULES ACYCLOVIR 400 MG TABLETS ACYCLOVIR 800 MG TABLETS 30 90

AMANTADINE 50 MG/5 ML SYRUP ACYCLOVIR 200 MG CAPSULES ACYCLOVIR 400 MG TABLETS ACYCLOVIR 800 MG TABLETS 30 90 Antibiotics Qty* DRUG NAME $0.00 Copay $ 4.00 $ 10.00 AMOXICILLIN 125 MG/5 ML (150 ML BOTTLE) 150 AMOXICILLIN 125 MG/5 ML (100 ML BOTTLE) 100 AMOXICILLIN 125 MG/5 ML (80 ML BOTTLE) 80 AMOXICILLIN 200 MG/5

More information

Club Members save even more with the $4 Plus Plan!

Club Members save even more with the $4 Plus Plan! Club Members save even more with the $4 Plus Plan! ITEM DESCRIPTION Acephen Supp 650MG 12 Acetam Tab 325MG 30 90 Acyclovir Cap 200MG 30 90 Albuterol Syr 2MG/5ML 120 360 Albuterol Sulfate Nebulizer Ud Sol

More information

Allergy, Cough and Cold. Analgesic. Anti-Anxiety. Antibiotic

Allergy, Cough and Cold. Analgesic. Anti-Anxiety. Antibiotic For your convenience, this list is sorted by drug category. Drugs are categorized based on their most common use and may be included in more than one category. Drugs are not categorized by all of their

More information

Alaska Medicaid 90 Day** Generic Prescription Medication List

Alaska Medicaid 90 Day** Generic Prescription Medication List 1 ACYCLOVIR 200 MG CAPSULE BUPROPION HCL 150 MG TAB ER 24H ACYCLOVIR 200 MG/5ML BUPROPION HCL 150 MG TABLET ER ACYCLOVIR 400 MG TABLET BUPROPION HCL 150 MG TABLET ER ACYCLOVIR 800 MG TABLET BUPROPION HCL

More information

Fruth Pharmacy Prescription Savings Club Prescription Club October 2010 Generics item list 30 Day Qty

Fruth Pharmacy Prescription Savings Club Prescription Club October 2010 Generics item list 30 Day Qty Fruth Pharmacy Prescription Savings Club Prescription Club October 2010 Generics item list Antihistamine Drugs Cyproheptadine HCl Tab 4 mg Anti-Infective Agents Diphenhydramine HCl Cap mg Promethazine

More information

Oakwood Healthcare Low Cost Drug List for OHSCare & BCN

Oakwood Healthcare Low Cost Drug List for OHSCare & BCN Oakwood Healthcare Low Cost Drug List for OHSCare & BCN ACETAMINOPHEN-CODEINE ELIXIR Analgesic 240 720 ACYCLOVIR CAP 200MG Antiviral 30 90 AKTOB 0.3% EYE DROPS Miscellaneous 5 15 ALBUTEROL INH SOL 0.083%

More information

Everyday Low Cost Generics

Everyday Low Cost Generics Antibiotics Antifungal Antiviral Arthritis/ Pain 30 Day Qty* Free AMOXICILLIN 125 MG/5 ML (150 ML BOTTLE) AMOXICILLIN 125 MG/5 ML (100 ML BOTTLE) AMOXICILLIN 125 MG/5 ML (80 ML BOTTLE) AMOXICILLIN 200

More information

Hundreds of Choices. More Savings Every Day. 8 and $ 12 Generics Also Available. Based on 30-day supply at commonly prescribed doses

Hundreds of Choices. More Savings Every Day. 8 and $ 12 Generics Also Available. Based on 30-day supply at commonly prescribed doses 4$ Hundreds of Choices. More Savings Every Day. $ 8 and $ 12 Generics Also Available. Based on 30-day supply at commonly prescribed doses EFF. DATE 09/2017 List subject to change ALLERGIES, COLD AND FLU

More information

Special Generic Drug Pricing Program

Special Generic Drug Pricing Program FREE PICK-UP & DELIVERY Flu-Shots Specialty prescription Compounding Wellness center providing health screenings for hypertension and diabetes $3 Special Generic Prescription Drug Program only offered

More information

Home Delivery Prescription Program Drug List

Home Delivery Prescription Program Drug List Home Delivery Prescription Program Drug List Low-cost prescriptions, right in your mailbox. Now you can have your generic prescriptions mailed right to your home, no matter where you live. Because we think

More information

Home Delivery Prescription Program Drug List

Home Delivery Prescription Program Drug List Home Delivery Prescription Program Drug List Low-cost prescriptions, right in your mailbox. Now you can have your generic prescriptions mailed right to your home, no matter where you live. Because we think

More information

Formulary for the JHM Outpatient Medication Assistance Program (OMAP)

Formulary for the JHM Outpatient Medication Assistance Program (OMAP) Note: The JHM Outpatient is a clinic-based program and may only be used by outpatient clinics and JHCP sites approved to participate in the program. To be eligible for OMAP, the patient must not have any

More information

Ambetter 90-Day-Supply Maintenance Drug List

Ambetter 90-Day-Supply Maintenance Drug List Ambetter 90-Day-Supply Maintenance Drug List What is the Ambetter 90-Day-Supply Maintenance Drug List? Ambetter 90-Day-Supply Maintenance Drug List is a list of maintenance medications that are available

More information

REWARDS. Picture the. of good health. Sign-up today to enjoy the benefits. Discounts on Generics: 30 and 90 day supply*

REWARDS. Picture the. of good health. Sign-up today to enjoy the benefits. Discounts on Generics: 30 and 90 day supply* Picture the REWARDS of good health Sign-up today to enjoy the benefits Discounts on Generics: 30 and 90 day supply* Discounts on ALL Generic and Brand Medications Discounts on Immunizations Discounts on

More information

All Pharmacy and Prescribing Providers. Subject: State Maximum Allowable Cost (MAC) Updates

All Pharmacy and Prescribing Providers. Subject: State Maximum Allowable Cost (MAC) Updates INDIANA HEALTH COVERAGE PROGRAMS P R O V I D E R B U L L E T I N B T 2 0 0 7 1 2 M A Y 2 9, 2 0 0 7 To: All Pharmacy and Prescribing Providers Subject: State Maximum Allowable Cost (MAC) Updates Effective

More information

GENERIC DISCOUNT FORMULARY March 2015

GENERIC DISCOUNT FORMULARY March 2015 Antibiotic Amoxicillin Amoxil 250mg Amoxicillin Amoxil 500mg Amoxicillin Amoxil 125mg/5ml Amoxicillin Amoxil 250mg/5ml Amoxicillin Bid Amoxil 400mg/5ml Amoxicillin Bid Amoxil 200mg/5ml Ampicillin Polycillin

More information

Penicillin VK Vcillin K 250gm/5ml Penicillin VK Vcillin K 250mg Sulfameth/Trimeth Bactrim 400/80mg Sulfameth/Trimeth Bactrim/Septra DS 800/160mg

Penicillin VK Vcillin K 250gm/5ml Penicillin VK Vcillin K 250mg Sulfameth/Trimeth Bactrim 400/80mg Sulfameth/Trimeth Bactrim/Septra DS 800/160mg Antibiotic Amoxicillin Amoxil 250mg Amoxicillin Amoxil 500mg Amoxicillin Amoxil 125mg/5ml Amoxicillin Amoxil 250mg/5ml Amoxicillin Bid Amoxil 400mg/5ml Amoxicillin Bid Amoxil 200mg/5ml Ampicillin Polycillin

More information

TennCare Program TN MAC Price Change List As of: 03/30/2017

TennCare Program TN MAC Price Change List As of: 03/30/2017 1 TN List Run : 03/30/17 Old PRAZOSIN HCL 5 MG CAPSULE ORAL 03/29/2017 1.11209 1.12560 ( 1.2) CAPTOPRIL 12.5 MG TABLET ORAL 07/07/2015 1.07191 1.10416 ( 2.9) ISOSORBIDE DINITRATE 5 MG TABLET ORAL 03/29/2017

More information

NALC Health Benefit Plan High Option 2019 Prescription Benefits Overview

NALC Health Benefit Plan High Option 2019 Prescription Benefits Overview NALC Health Benefit Plan High Option 2019 Prescription Benefits Overview This booklet is a summary of some of the features of the NALC Health Benefit Plan High Option. Detailed information on the benefits

More information

TN Cover Rx Tennessee CoverRx MAC Price Change List As of: 04/26/2018

TN Cover Rx Tennessee CoverRx MAC Price Change List As of: 04/26/2018 1 Tennessee CoverRx List Run : 04/26/18 Dosage Form amiodarone HCl 200 MG TABLET ORAL 04/25/2018 0.16102 0.14405 11.8 hydralazine HCl 100 MG TABLET ORAL 04/25/2015 0.11390 0.10854 4.9 hydralazine HCl 25

More information

Members enjoy more Pharmacy savings *

Members enjoy more Pharmacy savings * Sam s Plus Members enjoy more Pharmacy savings 5 prescription drugs available for FREE Generic medications: Donepezil, Pioglitazone, Escitalopram, Finasteride and Vitamin D2 50,000 IU are $ 0 for a 30-day

More information

Pharma X Consultancy Inc. Inventory List

Pharma X Consultancy Inc. Inventory List Pharma X Consultancy Inc. Inventory List Location: Pharma X Consultancy Inc 2 Aceclofenac 100mg Tablets 60S 1205 ID Aciclovir 200mg Tablets 25S 1213 Aciclovir 400mg Tablets 56S 1214 Aciclovir 5% Cream

More information

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M %

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M % June 2016 On 13th May, the DH announced that there would be reductions to Category M prices from June until September. http://psnc.org.uk/our-news/contractor-notice-category-m-price-reduction/ This has

More information

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil Antiviral Acyclovir 400mg Zovirax Asthma Advair Diskus Diskus 250/50 Fluticasone/Salmeterol Asthma Albuterol Sulfate 2.5 mg/3 ml Proventil Arthritis and Pain Allendronate Sodium 70 mg Fosamax Arthritis

More information

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil School Corp Formulary Antiviral Acyclovir 400mg Zovirax Asthma Advair Diskus Diskus 250/50 Fluticasone/Salmeterol Asthma Albuterol Sulfate 2.5 mg/3 ml Proventil Arthritis and Pain Allendronate Sodium 70

More information

Pharmacy Provider Training

Pharmacy Provider Training Pharmacy Provider Training Texas Managed Care Medicaid STAR and CHIP Programs Question and Answers How often are price increases updated in your system and is Navitus current with its price updates? Navitus

More information

AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR

AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR NDC Code HCPCS Code Medication Name & Amount Inpatient Fee 00904525646 J8499 ACETAMINOPHEN 80 MG CHEWABLE TABLET 1.00 00904198261 J3490 ACETAMINOPHEN 325 MG TABLET 1.00 50580050110 J3490 ACETAMINOPHEN

More information

Members enjoy more Pharmacy savings *

Members enjoy more Pharmacy savings * Sam s Plus Members enjoy more Pharmacy savings 5 prescription drugs available for FREE Generic medications: Donepezil, Pioglitazone, Escitalopram, Finasteride and Vitamin D2 50,000 IU are $ 0 for a 30-day

More information

Members enjoy more Pharmacy savings *

Members enjoy more Pharmacy savings * Sam s Plus Members enjoy more Pharmacy savings 5 prescription drugs available for FREE Generic medications: Donepezil, Pioglitazone, Escitalopram, Finasteride and Vitamin D2 50,000 IU are $ 0 for a 30-day

More information

AETNA BETTER HEALTH January 2017 Formulary Change(s)

AETNA BETTER HEALTH January 2017 Formulary Change(s) AETNA BETTER HEALTH January 2017 Formulary Change(s) The following updates will be made to the Aetna Better Health of MI formulary on March 1, 2017 Drug Name, Strength, Dosage Form ALFUZOSIN HCL ER 10

More information

$0 Preferred Generics List

$0 Preferred Generics List 2017 HMO/POS/Select $0 Preferred Generics List Members enrolled in one of the listed HMO/POS/Select plans beginning on or after January 1, 2016 will have a zero-dollar copayment for the following Preferred

More information

ANTI COLD / ANTI ALLERGIC / ANTI-ASTHMATICS GIT PRODUCTS

ANTI COLD / ANTI ALLERGIC / ANTI-ASTHMATICS GIT PRODUCTS SR. NO 1 ANTI COLD / ANTI ALLERGIC / ANTI-ASTHMATICS Paracetamol 500 mg, Phenylephrine HCL 5 mg With Chlorpheniramine Maleate 2 mg & Caffeine 30 mg Tablets 2 Salbutamol Tablets BP 2 mg 3 Salbutamol Tablets

More information

DT Description Price Category Price change

DT Description Price Category Price change Tariff T Watch October 2014 Readers are no doubt aware of this quarter's bad news for primary care prescribing allocations: NHS England has d the remuneration mechanism for community pharmacies gaining

More information

Introducing exciting new Rx benefits 2019

Introducing exciting new Rx benefits 2019 Introducing exciting new x benefits 2019 In 2019, the Middlesex prescription plan is aligning with best-in-class evidence-based practices. Two new tiers will be added that evaluate drugs on the basis of

More information

QTY LIMIT COPAY (30 DAY/90 DAY) BENIGN PROSTATIC HYPERPLASIA FINASTERIDE $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8

QTY LIMIT COPAY (30 DAY/90 DAY) BENIGN PROSTATIC HYPERPLASIA FINASTERIDE $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 $4/$8 2019 LiveWELL Health Plan PREVENTIVE DRUG LIST - GENERIC Names ( Copay) - ALPHABETICAL by DRUG CATEGORY You should always check with your prescriber and/or pharmacist to determine if these alternatives

More information

Nebraska Medicaid Program NE Weekly MAC Price Change List For Period: 12/14/ /20/2017

Nebraska Medicaid Program NE Weekly MAC Price Change List For Period: 12/14/ /20/2017 1 Medicaid Run : 12/21/17 NE Weekly List Old AMIODARONE HCL 200 MG TABLET ORAL 12/20/2017 0.15321 0.14370 6.6 HYDRALAZINE HCL 10 MG TABLET ORAL 12/20/2017 0.05226 0.05213 0.2 LISINOPRIL 10 MG TABLET ORAL

More information

Generic Medications 2,500 + available Call or MEDSerivces for medications not listed.

Generic Medications 2,500 + available Call or  MEDSerivces for medications not listed. AcipHex tablet 20mg $15 for up to 30 tablets Acyclovir capsule 200mg $25 Acyclovir tablet 400mg, 800mg $25 Albuterol Inhalation Solution 0.083%/3mL $20 for up to 75 vials Alclometasone Dipropionate Cream

More information

FORMULARY Revised January 2019

FORMULARY Revised January 2019 MEDICATION STRENGTH NOTES ANTIMICROBIALS-ANTIBIOTICS AMOXICILLIN CAPS 500 MG AMOXICILLIN SUSP 125 MG/5 ML 250 MG/5 ML 400 MG/5 ML AMOXICILLIN CHEW 250 MG AMOXICILLIN AND CLAVULANIC ACID CAPS (AUGMENTIN)

More information

UWSP Student Health Service Pharmacy Formulary 1/22/2015

UWSP Student Health Service Pharmacy Formulary 1/22/2015 UWSP Student Health Service Pharmacy Formulary 1/22/2015 UWSP Student Health Service Pharmacy Formulary 1/22/2015 Medication Name Strength DosageForm Route Acetaminophen 325 MG Tablet Oral Acetaminophen-Codeine

More information

While there is around a 3% increase shown in costs for Category M lines, I think this is due to the inclusion of more lines in Category M.

While there is around a 3% increase shown in costs for Category M lines, I think this is due to the inclusion of more lines in Category M. April 2018 The usual quarterly of Category M prices Another set of similar comments as I made in January: significant increases in many lines which have been subject to price concessions but even more

More information

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 702 M %

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 702 M % December 16 No Category M changes so the reductions imposed in May which were only supposed to last until September continue As in November, most changes are Category A lines with a few Category C. Significant

More information

WAL-MART BRINGS $4 GENERIC PROGRAM TO OHIO

WAL-MART BRINGS $4 GENERIC PROGRAM TO OHIO WAL-MART BRINGS $4 GENERIC PROGRAM TO OHIO Customer demand leads to $4 prescription program launching in 12 new states today three months earlier than projected BENTONVILLE, Ark. Oct. 26, 2006 Wal-Mart

More information

Effective January 2018

Effective January 2018 Effective January 2018 MultiCare Health System employee medical plan members can receive preventive medications covered at 100%, not subject to deductible, when dispensed at MultiCare Pharmacies. Drugs

More information

DRUG CLASSIFICATION. Prevention of Cardiovascular Disease

DRUG CLASSIFICATION. Prevention of Cardiovascular Disease Generic Preventive Care/ Safe Harbor Drug Program List Preventive care/safe harbor drugs are drugs that can help keep you from developing a health condition or related complications of a health condition.

More information

ASEBP and ARTA TARP Drugs and Reference Price by Categories

ASEBP and ARTA TARP Drugs and Reference Price by Categories ASEBP Pantoprazole Sodium 40 mg (generic) $0.2016 ASEBP Dexlansoprazole 30 mg Dexlansoprazole 60 mg Esomeprazole 10 mg Esomeprazole 20 mg Esomeprazole 40 mg Lansoprazole 15 mg Lansoprazole 30 mg Omeprazole

More information

DT Description Price Category Price change Percentage

DT Description Price Category Price change Percentage June 2017 A slight inflationary pressure in most CCGs from mainly Category A increases. Significant price increases: Most of low concern although those involving the less frequently used tamoxifen strengths

More information

PRIOR ADAP FORMULARY - RX OPTIONS

PRIOR ADAP FORMULARY - RX OPTIONS PRIOR ADAP FORMULARY - RX OPTIONS Created by Care Directions Case Manageent - 602-264-2273 MEDICATION Pharacies ALLERGY/COUGH/COLD DIPHENHYDRAMINE 50 MG FLUTICASONE $35 HYDROXYZINE 25 MG, 50 MG X LORATIDINE

More information

Product List Finished Dosage Forms (FDF) B2B Business

Product List Finished Dosage Forms (FDF) B2B Business Product List 2017 Finished Dosage Forms (FDF) B2B Business Anaesthetics Dermatology Lidocaine Lidocaine and Prilocaine Dexmedetomidine Hydrochloride Anti-Infectives Amoxicillin Trihydrate and Potassium

More information

FORMULARY NOTES ABOUT FORMULARY AND PHARMACY

FORMULARY NOTES ABOUT FORMULARY AND PHARMACY FORMULARY NOTES ABOUT FORMULARY AND PHARMACY 1. Purposes: Assist team leaders in preparing for trips Limit the number of interchangeable drugs Limit pharmacy errors Improve efficiency and organization

More information

UWSP Student Health Service Pharmacy Formulary updated: 1/2017

UWSP Student Health Service Pharmacy Formulary updated: 1/2017 UWSP Student Health Service Pharmacy Formulary updated: 1/2017 Medication Name Strength DosageForm Route Acetaminophen 325 MG Tablet Oral Acetaminophen-Codeine #2 300-15 MG Tablet Oral Acetaminophen-Codeine

More information

PACKAGE GENERIC DRUG. Page 1 of 39

PACKAGE GENERIC DRUG. Page 1 of 39 ABACAVIR SULFATE 300 MG TAB 0000 4.94966 02/05/2016 ACAMPROSATE CALCIUM 333 MG TAB DR 0000 1.07161 11/05/2015 ACARBOSE 100 MG TAB 0000 0.47754 11/05/2015 ACARBOSE 25 MG TAB 0000 0.41100 08/05/2015 ACARBOSE

More information

Hospital Unit Dose Unit Dose Plus Liquid Unit Dose. BARCODE LISTING Spring See our new Barcode Scanning Guide on page 26

Hospital Unit Dose Unit Dose Plus Liquid Unit Dose. BARCODE LISTING Spring See our new Barcode Scanning Guide on page 26 Hospital Unit Dose Unit Dose Plus Liquid Unit Dose BARCODE LISTING Spring 2018 See our new Barcode Scanning Guide on page 26 YOU ASKED. WE DELIVERED! New proprietary offering from AHP! LIQUID UNIT DOSE

More information

All Indiana Health Coverage Program Pharmacy Providers and Prescribing Practitioners. Subject: Update to State MAC Fee Schedule for Legend Drugs

All Indiana Health Coverage Program Pharmacy Providers and Prescribing Practitioners. Subject: Update to State MAC Fee Schedule for Legend Drugs P R O V I D E R B U L L E T I N BT200435 DECEMBER 30, 2004 To: All Indiana Health Coverage Program Pharmacy Providers and Prescribing Practitioners Subject: Update to State MAC Fee Schedule for Legend

More information

North Carolina Department of Health and Human Services State Maximum Allowable Cost (SMAC) Rate Listing for Generic Drugs

North Carolina Department of Health and Human Services State Maximum Allowable Cost (SMAC) Rate Listing for Generic Drugs ABACAVIR SULFATE 300 MG TAB 0000 4.94966 02/05/2016 ACAMPROSATE CALCIUM 333 MG TAB DR 0000 1.07161 11/05/2015 ACARBOSE 100 MG TAB 0000 0.47754 11/05/2015 ACARBOSE 25 MG TAB 0000 0.41100 08/05/2015 ACARBOSE

More information

Rx Outreach Medication List Rx Outreach Medication Available Strengths 90-Day Supply 180-Day Supply

Rx Outreach Medication List Rx Outreach Medication Available Strengths 90-Day Supply 180-Day Supply Rx Outreach Medication List Rx Outreach Medication Available Strengths 90-Day Supply 180-Day Supply Allergies/Asthma Albuterol Inhalation Solution 0.083%/3mL $15 for up to 75 vials Azelastine nasal spray

More information

Select Preventive Prescription Drugs Jan. 1, 2018

Select Preventive Prescription Drugs Jan. 1, 2018 Select Preventive Prescription Drugs Jan. 1, 2018 In addition to a healthy lifestyle, preventive medications can help you avoid some illnesses and conditions. Zimmer Biomet's medical options Value HSA,

More information

PACKAGE SIZE SMAC GENERIC DRUG. Page 1 of 38

PACKAGE SIZE SMAC GENERIC DRUG. Page 1 of 38 GENERIC DRUG PACKAGE SIZE SMAC EFFECTIVE DATE ABACAVIR SULFATE 300 MG TAB 0000 2.34765 05/05/2017 ACAMPROSATE CALCIUM 333 MG TAB DR 0000 0.95908 01/05/2017 ACARBOSE 100 MG TAB 0000 0.38753 03/05/2017 ACARBOSE

More information

Generic Preventive Care/ Safe Harbor Drug Program List

Generic Preventive Care/ Safe Harbor Drug Program List Preventive care/safe harbor drugs are drugs that can help keep you from developing a health condition or related complications of a health condition. The Generic Preventive Care/Safe Harbor Drug Program

More information

AETNA BETTER HEALTH January 2017 Formulary Change(s)

AETNA BETTER HEALTH January 2017 Formulary Change(s) AETNA BETTER HEALTH January 2017 Formulary Change(s) The following updates will be made to the Aetna Better Health of MI formulary on February 1, 2017 Drug Name, Strength, Dosage Form IVERMECTIN 3 MG TABLET

More information

PACKAGE SIZE SMAC GENERIC DRUG

PACKAGE SIZE SMAC GENERIC DRUG GENERIC DRUG PACKAGE SIZE SMAC EFFECTIVE DATE ABACAVIR SULFATE 300 MG TAB 0000 1.71356 06/05/2017 ACAMPROSATE CALCIUM 333 MG TAB DR 0000 0.95908 01/05/2017 ACARBOSE 100 MG TAB 0000 0.38753 03/05/2017 ACARBOSE

More information

Neighborhood Medicaid Formulary Changes: June 2017

Neighborhood Medicaid Formulary Changes: June 2017 Neighborhood Medicaid Formulary Changes: June 2017 The following changes to the Neighborhood Medicaid Formulary were recently approved by the Pharmacy and Therapeutics (P&T) Committee. All changes were

More information

ALLERGIC RHINITIS-NASAL

ALLERGIC RHINITIS-NASAL ALLERGIC RHINITIS-NASAL FLUNISOLIDE Patient needs to have paid claims for any one of the following Step 1 drugs: NasaCort OTC, fluticasone Rx, fluticasone OTC, Budesonide OTC. Prior to filling the Step

More information

Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers

Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers This formulary is current as of February 11, 2010. Important Notes: Pharmacists must submit a claim on PharmaNet at the time

More information

FORMULARY Revised January 2018 NOTES ABOUT FORMULARY AND PHARMACY

FORMULARY Revised January 2018 NOTES ABOUT FORMULARY AND PHARMACY FORMULARY Revised NOTES ABOUT FORMULARY AND PHARMACY 1. Purposes: Assist team leaders in preparing for trips Limit the number of interchangeable drugs Limit pharmacy errors Improve efficiency and organization

More information

Chapter 2 ~ Cardiovascular system

Chapter 2 ~ Cardiovascular system Chapter 2 ~ Cardiovascular System: General Section 1 of 6 Chapter 2 ~ Cardiovascular system 2.1 Positive inotropic drugs 2.1.1 Cardiac glycosides DIGOXIN 2.2 Diuretics Elixir 50micrograms in 1ml Injection

More information

Hospital Unit Dose Unit Dose Plus BARCODE LISTING. Spring See our new Barcode Scanning Guide on page 30

Hospital Unit Dose Unit Dose Plus BARCODE LISTING. Spring See our new Barcode Scanning Guide on page 30 Hospital Unit Dose Unit Dose Plus BARCODE LISTING Spring 2017 See our new Barcode Scanning Guide on page 30 Our latest market introductions include: Ezetimibe 10 mg Tablet, Loperamide HCl 2 mg Capsule,

More information

IEHP Medi-Cal Formulary Maintenance Drug List

IEHP Medi-Cal Formulary Maintenance Drug List IEHP Medi-Cal Formulary Maintenance Drug List The following formulary medications may be approvable up to a three-month supply. FDA-approved generic products must be used if available. Brand name products

More information

Step Therapy Criteria 2019

Step Therapy Criteria 2019 Step Therapy 2019 For information on obtaining an updated coverage determination or an exception to a coverage determination please call Freedom Health Member Services at 1-800-401-2740 or, for TTY/TDD

More information

2019 Preventive medications and your plan

2019 Preventive medications and your plan 2019 Preventive medications and your plan Managing your health with preventive medications Your pharmacy benefit plan includes special coverage for generic preventive medications. These medications help

More information

IEHP Medi-Cal Formulary Maintenance Drug List

IEHP Medi-Cal Formulary Maintenance Drug List IEHP Medi-Cal Formulary Maintenance Drug List The following formulary medications may be approvable up to a three-month supply. FDA-approved generic products must be used if available. Brand name products

More information

2017 Formulary Changes Year to Date

2017 Formulary Changes Year to Date 2017 Formulary Changes Year to Date Health Choice Arizona may add or remove drugs from our formulary during the year. If we remove drugs from our formulary, add prior authorization, quantity limits and/or

More information

Approved USP Compounded Monographs

Approved USP Compounded Monographs APPROVED USP COMPOUNDED MONOGRAPHS Acacia Syrup Acetazolamide Oral Suspension Acetylcysteine Compounded Solution Diluted Acetic Acid Diluted Alcohol Allopurinol Oral Suspension Alprazolam Oral Suspension

More information

Intel Connected Care with Providence 2015 Preventive Drug List

Intel Connected Care with Providence 2015 Preventive Drug List Intel Connected Care with Providence 2015 Preventive Drug List Formulary drugs listed below are covered at 100%, not subject to the deductible for the High Deductible Health Plan (HDHP) and Primary Care

More information

CITY OF JOPLIN, MISSOURI

CITY OF JOPLIN, MISSOURI CITY OF JOPLIN, MISSOURI BID PACKAGE 2016-RFP-11 for PHARMACY SERVICES 2016 JOPLIN HEALTH DEPARTMENT 321 E. 4 th Street JOPLIN, MO 64801 (417) 623-6122 (417) 624-6453 (FAX) NOTICE TO BIDDERS The City of

More information

November 2016 CAPS Monthly Product Promotions

November 2016 CAPS Monthly Product Promotions MUTUAL SKU NO. DESCRIPTION VENDOR NAME NDC DISCOUNT PERCENTAGE 229-104 ACETIC ACID HC OTIC SOLUTION 2% 10 ML TARO TARO PHARMACEUTICALS USA 51672-3007-01 5% 214-270 ACYCLOVIR CAP 200 MG 100 QUINN QUINN

More information

General products list. NDC Product Description Strength Form Brand Name Therapeutic Class Class Size

General products list. NDC Product Description Strength Form Brand Name Therapeutic Class Class Size PharmRCE USA General products list NDC Product Description Strength Form Brand Name Therapeutic Class Class Size 65162-0669-10 Acebutolol HCl 200 mg Capsules Sectral Antihypertensive RX 100 65162-0670-10

More information

Active Pharmaceutical Ingredient (API) List List Updated March 1st, 2019

Active Pharmaceutical Ingredient (API) List List Updated March 1st, 2019 5-Fluorouracil 5-FU, Fluorouracil Stability Indicating HPLC-UV USP 7-keto DHEA Stability Indicating HPLC-UV Medisca Tier 1 Acetaminophen Stability Indicating HPLC-UV USP Adenosine Alprostadil PGE-1, Prostaglandin

More information

PRODUCT LIST GENERAL - TABLETS

PRODUCT LIST GENERAL - TABLETS SR. NO. PRODUCT LIST GENERAL - TABLETS 1 Ciprofloxacin Tablets IP 500 mg 2 Ciprofloxacin And Tinidazole Tablets 3 Cefpodoxime Proxetil Tablets IP 4 Cefixime Dispersible Tablets 200 mg 5 Cefixime Dispersible

More information

INDIANA MEDICAID UPDATE

INDIANA MEDICAID UPDATE INDIANA MEDICAID UPDATE August 28, 1998 TO: All Indiana Medicaid Pharmacy Providers SUBJECT: Updated and Revised "FUL" List Accompanying this bulletin are COMPREHENSIVE updated and revised "FUL" (Attachment

More information

TLS HEALTH Product list up-dated 2017 (Origin: Portugal)

TLS HEALTH Product list up-dated 2017 (Origin: Portugal) TLS HEALTH Product list up-dated 2017 (Origin: Portugal) 1 Alendronic acid 70 mg tablet 4 units 2 Amlodipine 10 mg tablet 20,60 units 3 Amlodipine 5 mg tablet 20,60 units 5 Aripiprazole 10 mg tablet 14,

More information

Office of Medicaid Policy and Planning Over-the-Counter Drug Formulary ANALGESICS ANTACIDS ANTI-FLATULENTS

Office of Medicaid Policy and Planning Over-the-Counter Drug Formulary ANALGESICS ANTACIDS ANTI-FLATULENTS Acetaminophen 80mg/0.8mL Suspension Drops Acetaminophen 120mg Suppository Acetaminophen 160mg/5mL Suspension Acetaminophen 325mg Suppository Acetaminophen 325mg Tablet, Caplet, or Capsule Acetaminophen

More information

Step Therapy Criteria (Criteria for Step Therapy-2 [ST-2] Drugs)

Step Therapy Criteria (Criteria for Step Therapy-2 [ST-2] Drugs) CareAdvantage CMC 2018 Formulary Supplement II (List of Covered Drugs) Step Therapy Criteria (Criteria for Step Therapy-2 [ST-2] Drugs) Formulary ID: 00018157 Formulary Version:11 19 CMS Approved: 08/21/2018

More information

2019 Preventive Drug List

2019 Preventive Drug List 2019 Preventive Drug List Managing your health with preventive medications Your pharmacy benefit plan includes special coverage for generic preventive medications. These medications help protect against

More information

Rajasthan Medical Services Corporation Limited, Jaipur

Rajasthan Medical Services Corporation Limited, Jaipur Rajasthan Medical Services Corporation Limited, Jaipur List of Drugs- Purchase order placed to successful Bidders Tendered on 05/07/2011 S.No. Name of Drug 1 Atropine Sulphate Injection 0.6 mg /ml (SC/IM/IV

More information

Step Therapy Requirements

Step Therapy Requirements An Independent Licensee of the Blue Cross and Blue Shield Association Step Therapy Requirements Effective: 12/01/2017 Updated 11/2017 H0302_2_2014 CMS Accepted 05/05/2014 1 ABILIFY Abilify 10 mg tablet

More information