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

Transcription

1 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 15gm $20 per tube Alendronate tablet 70mg (Once a week dosage) $25 (limit 12) $45 (limit 24) Allopurinol tablet 100mg, 300mg $25 Alprazolam tablet (CS) 0.25mg, 0.5mg, 1mg, 2mg $15 for up to 90 tablets Amantadine tablet 100mg $35 Amitriptyline tablet 10mg, 25mg, 50mg, 75mg, 100mg, 150mg $25 Amlodipine tablet 2.5mg, 5mg, 10mg $25 $45 Amlodipine/Benazepril capsule 10/40mg $17 for up to 30 capsules Amlodipine/Benazepril capsule 5/10mg, 5/20mg, 10/20mg $55 for up to 90 capsules Amlodipine/Valsartan tablet 5/160mg, 5/320mg, 10/160mg, 10/320mg $30 for up to 30 tablets Amlodipine/Valsartan/HCTZ tablet 5/160/12.5mg, 5/160/25mg, 10/160/12.5mg,10/160/25mg, 10/320/25mg $65 for up to 30 tablets Amoxapine tablet 100mg $37 for up to 30 tablets Anastrozole tablet 1mg $35 for up to 90 tablets Androxy tablet (CS) 10mg $45 Aripiprazole tablet 20mg, 30mg $72 for up to 30 tablets Aripiprazole tablet 2mg, 5mg, 10mg, 15mg $62 for up to 30 tablets Artificial Tears 1.4% drops (OTC) 15ml bottle (no prescription required) $14 per bottle Aspirin EC tablet (OTC) 325mg (no prescription required) $12 for a bottle of 100 Aspirin EC tablet (OTC) 81mg (no prescription required) $15 for a bottle of 120 Atenolol tablet 25mg, 50mg, 100mg $14 $23 Atenolol/Chlorthalidone tablet 50/25mg, 100/25mg $25 Atorvastatin tablet 10mg, 20mg, 40mg, 80mg $30 $50 Azathioprine tablet 50mg $25 for up to 90 tablets Azathioprine tablet 50mg $25 for up to 90 tablets Azelastine nasal spray 137 mcg $35 per nasal spray Baclofen tablet 10mg, 20mg $20 Balsalazide Disodium capsule 750mg $45 for up to 90 capsules Benazepril tablet 5mg, 10mg, 20mg, 40mg $25

2 Benazepril/HCTZ tablet 5/6.25mg, 10/12.5mg, 20/12.5mg, 20/25mg $30 $50 Benzonatate capsule 100mg $17 for up to 30 capsules Benzonatate capsule 200mg $20 for up to 30 capsules Benztropine tablet 0.5mg, 1mg, 2mg $25 Betamethasone Dipropionate Cream, Augmented 15gm $30 per tube Bethanechol tablet 5mg, 10mg, 25mg $30 Bethanechol tablet 50mg $50 Bicalutamide tablet 50mg $40 $70 Bicalutamide tablet 50mg $40 $70 Bisoprolol/HCTZ tablet 2.5/6.25mg, 5/6.25mg, 10/6.25mg $25 Blood Glucose Monitor Control Solution, Low (Prodigy) 4mL vial - No prescription required $10 per vial Blood Glucose Strips, No Coding (Prodigy) Box of 50 - No prescription required $20 per box Blood Glucose Twist Top Lancets 28G (Prodigy) Box of 100 (minimum order - 2 boxes) No prescription required $10 per box, minimum order $10 Brimonidine Tartrate 0.2% Solution 0.2%/10ml dropper $20 per dropper Bromocriptine tablet 2.5mg $70 for up to 30 tablets Budesonide Inhalation Solution 0.25mg/2mL $37 for up to 10 vials Budesonide Inhalation Solution 0.5mg/2mL $42 for up to 10 vials Budesonide nasal spray 8.6g/32mcg $67 per nasal spray Bupropion HCL SR tablet 100mg, 150mg, 200mg $70 Bupropion HCL XL tablet 150mg, 300mg $70 Bupropion HCL tablet 75mg $45 Bupropion HCL tablet 100mg $45 for up to 90 tablets Buspirone tablet 5mg, 10mg, 15mg $25 Buspirone tablet 30mg $40 Calcitriol capsule 0.25mcg $22 for up to 30 capsules Calcitriol capsule 0.5mcg $25 for up to 30 capsules Calcium acetate capsule 667mg $30 for up to 90 capsules Candesartan Cilexetil tablet 4mg, 8mg, 16mg $35 for up to 30 tablets Candesartan Cilexetil tablet 32mg $45 for up to 30 tablets Candesartan Cilexetil-HCTZ tablet 16/12.5mg $40 for up to 90 tablets

3 Candesartan Cilexetil-HCTZ tablet 32/12.5mg, 32/25mg $50 for up to 90 tablets Capsaicin Cream, 0.025% (OTC) 60gm (no prescription required) $17 per tube Captopril tablet 12.5mg, 25mg, 50mg, 100mg $45 for up to 90 tablets Carbamazepine ER tablet 200mg, 400mg $30 for up to 90 tablets Carbamazepine tablet 200mg $30 for up to 90 tablets Carbidopa / Levodopa SR tablet 25/100mg, 50/200mg $50 $90 Carbidopa / Levodopa tablet 10/100mg, 25/100mg, 25/250mg $50 $90 Carbidopa/Levodopa/Entacapone tablet 12.5/50mg, 18.75/75mg, 25/100mg, 31.25/125mg, 37.5/150mg, 50/200mg $50 for up to 60 tablets Carvedilol tablet 3.125mg, 6.25mg, 12.5mg, 25mg $25 Celecoxib capsule 50mg, 100mg $20 for up to 30 capsules Celecoxib capsule 200mg, 400mg $40 for up to 30 capsules Cetirizine HCI tablet OTC 10mg (no prescription required) $15 per bottle of 100 tablets (minimum 2 bottles) Cevimeline HCI capsule 30mg $85 for up to 90 capsules Chlordiazepoxide capsule (CS) 5mg, 10mg, 25mg $20 for up to 180 capsules Chlorpromazine HCL tablet 10mg, 25mg, 50mg, 100mg, 200mg $40 Chlorthalidone tablet 25mg, 50mg $35 $60 Chlorzoxazone tablet 500mg $30 for up to 90 tablets Cilostazol tablet 50mg, 100mg $35 $60 Citalopram tablet 10mg, 20mg, 40mg $25 Clindamycin HCL capsule 150mg $50 $90 Clonazepam tablet (CS) 1mg, 2mg $15 for up to 90 tablets Clonazepam tablet (CS) 0.5mg $15 for up to 90 tablets Clonidine HCL tablet 0.1mg, 0.2mg, 0.3mg $25 Clonidine patch 0.3mg/day $85 per pack of 4 Clopidogrel tablet 75mg $25 for up to 90 tablets Clotrimazole/Betamethasone Cream 15gm (1%/0.05%) $20 per tube Cyclobenzaprine tablet 5mg,10mg $30 Dexmethylphenidate HCI tablet (CS) 2.5mg $22 for up to 30 tablets Dexmethylphenidate HCI tablet (CS) 5mg $27 for up to 30 tablets Dexmethylphenidate HCI tablet (CS) 10mg $30 for up to 30 tablets Dextroamphetamine sulfate ER capsule (CS) 5mg, 10mg $55 for up to 30 capsules

4 Dextroamphetamine sulfate ER capsule (CS) 15mg $65 for up to 30 capsules Dextroamphetamine-Amphetamine tablet (CS) 5mg, 7.5mg, 10mg, 12.5mg, 15mg, 20mg, 30mg $25 for up to 30 tablets Dextroamphetamine-Amphetamine ER capsule (CS) 5mg, 10mg, 15mg, 20mg $75 for up to 30 capsules Dextroamphetamine-Amphetamine ER capsule (CS) 25mg, 30mg $85 for up to 30 capsules Diazepam tablet (CS) 2mg, 5mg, 10mg $80 for up to 90 tablets Diclofenac EC tablet 50mg, 75mg $30 Diclofenac ER tablet 100mg $45 Dicyclomine capsule 10mg $25 Dicyclomine tablet 20mg $25 Digoxin tablet 0.125mg, 0.25mg $40 for up to 90 tablets Diltiazem ER capsule (24hr) (Dilt-XR) 120mg, 180mg, 240mg $45 for up to 90 capsules Diltiazem ER capsule (Dilt-CD) 120mg, 180mg, 240mg, 300mg $45 for up to 90 capsules Diphenoxylate/Atropine tablet (CS) 2.5/0.025mg $40 DIvalproex SOD ER tablet 250mg $70 for up to 90 tablets DIvalproex SOD ER tablet 500mg $100 for up to 90 tablets Divalproex NA DR tablet 125mg, 250mg, 500mg $40 $70 Donepezil tablet 5mg, 10mg $20 Dorzolamide HCI 2% Solution 10ml dropper $20 per dropper Dorzolamide/Timolol Solution 2%/0.5% 10ml dropper $20 per dropper Doxazosin Mesylate tablet 1mg, 2mg, 4mg, 8mg $40 for up to 90 tablets Doxepin capsule 10mg, 25mg, 50mg, 75mg, 100mg $30 Duloxetine HCL DR capsule 20mg, 30mg, 60mg $50 Dutasteride capsule 0.5mg $45 for up to 30 capsules Enalapril Maleate tablet 2.5mg, 5mg, 10mg, 20mg $25 Enalapril/HCTZ tablet 5/12.5mg, 10/25mg $25 Epinephrine Auto Injector 0.15mg/0.15mL, 0.3mg/0.3mL $205 for a 2 unit pack Eplerenone tablet 25mg, 50mg $40 for a 30-day supply Escitalopram tablet 5mg, 10mg, 20mg $20 Esomeprazole DR capsule 20mg, 40mg $25 for up to 30 capsules Estradiol tablet 0.5mg, 1mg, 2 mg $25 Estropipate tablet 0.625(0.75mg), 1.25(1.5mg) $25

5 Eszopiclone tablet (CS) 1mg, 2mg, 3mg $45 for up to 90 tablets Etodolac capsule 200mg, 300mg $45 for up to 90 capsules Etodolac tablet 400mg, 500mg $45 for up to 90 tablets Famciclovir tablet 250mg $50 for up to 60 tablets Famciclovir tablet 500mg $60 for up to 60 tablets Famotidine tablet 20mg, 40mg $25 Felodipine ER tablet 2.5mg, 5mg $45 for up to 90 tablets Felodipine ER tablet 10mg $75 for up to 90 tablets Fenofibrate tablet 48mg $60 $100 Fenofibrate tablet 54mg, 160mg $60 $100 Fenofibrate tablet 145mg $60 for up to 30 tablets Fenofibrate, micronized capsule 134mg $75 Fenofibric acid DR capsule 135mg $65 for up to 30 capsules Ferrous Sulfate EC tablet 325mg (no prescription required) $11 per bottle of 100 tablets (minimum 2 bottles) Fexofenadine OTC tablet 60mg, 180mg (no prescription required) $45 for 100 tablets Finasteride tablet 5mg $30 $50 Flecainide Acetate tablet 50mg, 100mg, 150mg $40 for up to 90 tablets Fluconazole tablet 100mg, 200mg $40 for up to 30 tablets Fluoxetine capsule 10mg, 20mg, 40mg $20 Fluticasone nasal spray 50mcg $20 per nasal spray Fluvoxamine Maleate tablet 100mg $17 for up to 30 tablets Folgard OS tablet 500 mg calcium/ 1.1 mg folic acid/ 300 IU vitamin D3/ 12.5 mg vitamin B6/ 250 mcg vitamin B12/ 100 mg magnesium/ 1.5 mg boron $27 for 60 tablets Folgard RX tablet 2.2 mg folic acid/25 mg vitamin B6/1 mg vitamin B12 $35 for 90 tablets Folgard tablet (OTC) 2000 IU vitamin D3/800 mcg folic acid/ 12 mg vitamin B6/ 120 mcg vitamin B12 (no prescription required) $30 for 60 tablets Folic Acid 2.2 tablet 2.2 mg folic acid/25 mg vitamind B6/ 500mcg vitamin B12 $15 for 90 tablets Folic Acid tablet 1mg $25 Folic Acid tablet 1mg $25 Fortical Nasal Spray 2200 IU/ml (3.7mL bottle) $50 per bottle Furosemide tablet 20mg, 40mg, 80mg $14 $23

6 Gabapentin capsule 100mg, 300mg, 400mg $30 for up to 270 capsules Gabapentin tablet 600mg, 800mg $50 for up to 270 tablets Gemfibrozil tablet 600mg $35 $60 Glimepiride tablet 1mg, 2mg, 4mg $25 Glipizide ER tablet 2.5mg, 5mg, 10mg $40 $70 Glipizide tablet 5mg, 10mg $25 Glyburide tablet 1.25mg, 2.5mg, 5mg $25 Glyburide, micronized tablet 1.5mg, 3mg, 6mg $25 Glyburide/Metformin tablet 1.25/250mg, 2.5/500mg, 5/500mg $35 $60 Guanfacine ER tablet 1mg, 2mg, 3mg, 4mg $55 for up to 60 tablets Halobetasol Prop ointment 0.05% 15gm $40 per tube Haloperidol tablet 0.5mg, 1mg, 2mg, 5mg $30 Hexalen capsule 50mg $45 for a 30 day supply Hydralazine tablet 10mg, 25mg, 50mg, 100mg $30 $50 Hydrochlorothiazide capsule 12.5mg $25 Hydrochlorothiazide tablet 25mg, 50mg $25 Hydrocortisone tablet 5mg $20 for up to 90 tablets Hydrocortisone tablet 5mg $20 for up to 90 tablets Hydrocortisone tablet 5mg $20 for up to 90 tablets Hydrocortisone tablet 10mg $30 for up to 90 tablets Hydrocortisone tablet 10mg $30 for up to 90 tablets Hydrocortisone tablet 10mg $30 for up to 90 tablets Hydroxychloroquine tablet 200mg $27 for up to 30 tablets Hydroxyurea capsule 500mg $30 for up to 90 capsules Hydroxyurea capsule 500mg $30 for up to 90 capsules Hydroxyzine HCL tablet 25mg, 50mg $30 Hydroxyzine pamoate capsule 25mg, 50mg $30 Ibuprofen tablet 400mg, 600mg, 800mg $25 Indapamide tablet 1.25mg, 2.5mg $25 Insulin Syringes (Prodigy) 28G 12.7mm-1cc, 31G 8mm-1/2cc, 31G 8mm-1/3cc $18 for a box of 100 Ipratropium/Albuterol Inhalation Solution 0.5-3(2.5)mg/3mL $30 for up to 90 vials

7 Irbesartan tablet 75mg, 150mg, 300mg $35 $60 Irbesartan/HCTZ tablet 150mg/12.5mg, 300mg/12.5mg $35 $60 Isoniazid tablet 300mg $25 Isosorbide Mononitrate ER tablet 30mg, 60mg 120mg $25 Isosorbide Mononitrate tablet 10mg, 20mg $25 Jantoven (Warfarin) tablet 1mg, 2mg, 2.5mg, 3mg, 4mg, 5mg, 6mg, 7.5mg, 10mg $30 Ketotifen Fumerate OTC Solution 0.025%/5mL (no prescription required) $14 per dropper Labetalol HCL tablet 100mg, 200mg, 300mg $35 for up to 90 tablets Lactulose Oral Solution 10gm/15mL $15 per bottle Lamotrigine tablet 25mg, 100mg, 150mg, 200mg $35 $60 Lansoprazole DR capsule 30mg $25 for up to 30 capsules Latanoprost 0.005% Solution 2.5ml dropper $50 (limit 3) Letrozole tablet 2.5mg $35 $60 Levalbuterol Solution 1.25mg/3mL $60 for up to 24 vials Levetiracetam ER tablet 500mg, 750mg $85 for up to 180 tablets Levetiracetam tablet 1000mg $25 for up to 90 tablets Levetiracetam tablet 250mg, 500mg 750mg $55 $100 Levocetirizine tablet 5mg $40 $70 Levothyroxine tablet 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg Lidocain 5% patch 5% of lidocaine per patch $104 for box of 30 patches Lidocaine 2% viscous solution 100ml $12 per bottle Liothyronine Sodium tablet 5mcg, 25mcg $20 for up to 30 tablets Liothyronine Sodium tablet 50mcg $25 for up to 30 tablets Lisinopril tablet 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg $14 $23 Lisinopril/HCTZ tablet 10/12.5mg, 20/12.5mg, 20/25mg $14 $23 Lithium Carbonate ER tablet 300mg $40 Lithium Carbonate ER tablet 450mg $40 Lithium Carbonate capsule 150mg, 300mg $15 for up to 270 capsules Loperamide capsule 2mg $15 for up to 30 capsules Loratadine OTC tablet 10mg (no prescription required) $15 per bottle of 100 tablets (minimum 2 bottles) $25

8 Lorazepam tablet (CS) 0.5mg $30 Lorazepam tablet (CS) 1mg, 2mg $35 Losartan Potassium tablet 25mg, 50mg, 100mg $25 $45 Losartan/HCTZ tablet 50/12.5mg, 100/12.5mg, 100/25mg $30 $50 Lovastatin tablet 10mg, 20mg, 40mg $14 $23 Loxapine capsule 5mg, 10mg $25 for up to 60 capsules Loxapine capsule 25mg, 50mg $50 for up to 60 capsules Magnesium Oxide tablet (OTC) 400mg (no prescription required) $13 for a bottle of 120 Meclizine HCL tablet 12.5mg, 25mg $35 $60 Meclizine HCL tablet 12.5mg, 25mg $35 $60 Medroxyprogesterone tablet 2.5mg, 5mg, 10mg $20 Meloxicam tablet 7.5mg, 15mg $25 Memantine HCL tablet 5mg, 10mg $30 for up to 60 tablets Metformin HCL tablet 500mg, 850mg, 1000mg $25 Metformin HCL ER tablet 500mg, 750mg $25 Methimazole tablet 5mg, 10mg $15 for up to 30 tablets Methocarbamol tablet 500mg, 750mg $20 for up to 90 tablets Methotrexate tablet 2.5mg $25 per 12 tablets Methotrexate tablet 2.5mg $25 per 12 tablets Methylphenidate CD capsule (CS) 10mg $70 for up to 30 capsules Methylphenidate CD capsule (CS) 20mg, 30mg $80 for up to 30 capsules Methylphenidate CD capsule (CS) 40mg, 50mg, 60mg $100 for up to 30 capsules Methylphenidate LA capsule (CS) 20mg, 30mg, 40mg Methylphenidate tablet (CS) 5mg, 10mg $20 for up to 30 tablets Methylphenidate tablet (CS) 20mg $30 for up to 30 tablets Metoclopramide HCL tablet 5mg, 10mg $25 (1 fill only; no refills) Metolazone tablet 2.5mg, 5mg $40 $70 Metoprolol Succinate ER tablet 25mg, 50mg, 100mg $40 $70 Metoprolol Succinate ER tablet 200mg $50 $90 Metoprolol Tartrate tablet 25mg, 50mg, 100mg $25 Midodrine HCI tablet 2.5mg, 5mg, 10mg $40 for up to 90 tablets

9 Minocycline capsule 50mg, 75mg, 100mg $50 $90 Mirtazapine tablet 15mg, 30mg, 45mg $35 Modafinil tablet (CS) 100mg, 200mg $85 Mometasone Furoate Cream 15gm $20 per tube Mometasone Furoate Ointment 15gm $20 per tube Montelukast Sodium tablet 10mg, 5mg chewable $45 up to 90 tablets Mycophenolate Mofetil capsule 250mg $70 for up to 180 capsules Mycophenolate Mofetil tablet 500mg $70 for up to 180 tablets Nabumetone tablet 500mg, 750mg $45 Naproxen Sodium tablet 550mg $30 Naproxen tablet 250mg, 375mg, 500mg $25 Niacin ER tablet 500mg $50 for up to 30 tablets Niacin ER tablet 1000mg $55 for up to 30 tablets Niacin SA capsule (OTC) 250mg (no prescription required) $15 for a bottle of 100 Niacor tablet 500mg $30 for up to 180 tablets Nifedipine ER tablet 30mg, 60mg, 90mg $55 $100 Nitroglycerin SA capsule 2.5mg, 6.5mg, 9mg $50 $90 Norethindrone Acetate tablet 5mg $80 for up to 50 tablets Norethindrone tablet 28 s (0.35mg) $40 $70 Norethindrone/Ethinyl Estradiol tablet 28 s (0.4mg/0.035mg) $40 $70 Nortriptyline HCL capsule 10mg, 25mg, 50mg, 75mg $25 Nyamyc Topical Powder 100,000U/g (60g bottle) $35 per bottle Nystatin tablet units $30 for up to 90 tablets Olanzapine tablet 2.5mg, 5mg, 7.5mg, 10mg $30 for up to 90 tablets Olanzapine tablet 15mg, 20mg $55 for up to 90 tablets Omega-3-acid ethyl esters capsule 1gm $85 for up to 120 capsules Omeprazole capsule 10mg, 20mg, 40mg $40 $70 Ondansetron ODT tablet 4mg $55 for up to 135 tablets Ondansetron ODT tablet 8mg $55 for up to 90 tablets Ondansetron tablet 4mg $55 for up to 135 tablets Ondansetron tablet 8mg $55 for up to 90 tablets

10 Oxandrolone tablet (CS) 2.5mg, 10mg - Requires statement of diagnosis by provider $55 for up to 30 tablets Oxcarbazepine tablet 150mg, 300mg, 600mg $35 Oxybutynin Chloride ER tablet 5mg, 10mg, 15mg $50 $90 Oxybutynin tablet 5mg $25 Pacerone tablet 100mg, 200mg, 400mg $30 $50 Panretin gel 0.1% 60gm $45 per tube Pantoprazole tablet 20mg, 40mg $25 Paroxetine HCL tablet 10mg, 20mg, 30mg, 40mg $25 Pentoxifylline ER tablet 400mg $35 $60 Perphenazine tablet 2mg, 4mg $25 for up to 30 tablets Perphenazine tablet 8mg, 16mg $40 for up to 30 tablets Phenytoin Sodium capsule 100mg $25 for up to 180 capsules Pioglitazone HCL tablet 15mg, 30mg, 45mg $30 PNV Prenatal Multivitamin Plus Iron & Folic Acid tablet 27mg/1mg $15 for up to 30 tablets Potassium Chloride ER tablet 8mEQ, 10mEQ, 20mEQ $30 for up to 90 tablets Potassium Chloride ER tablet 8mEQ, 10mEQ, 20mEQ $30 for up to 90 tablets Potassium Citrate tablet 5mEQ, 10mEQ $20 for up to 90 tablets Potassium Citrate tablet 5mEQ, 10mEQ $20 for up to 90 tablets Pramipexole tablet 0.125mg, 0.25mg, 0.5mg, 1mg, 1.5mg $30 for up to 180 tablets Pravastatin tablet 10mg, 20mg, 40mg, 80mg $30 for up to 90 tablets Prazosin capsule 1mg, 2mg, 5mg $25 $45 Prednisone tablet 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg $25 Prednisone tablet 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg $25 Prednisone tablet 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg $25 Prevalite Powder 4g/5.5g dose packet $30 for a carton of 42 packets Prevalite Powder 4g/5.5g powder can (231g) $30 per can Prevalite Powder 4g/5.5g dose packet $40 for a carton of 60 packets Primidone tablet 50mg $15 for up to 60 tablets Primidone tablet 250mg $21 for up to 60 tablets ProAir RespiClick Powder Inhaler 0.65g (200 inhalations) $40 per inhaler canister Prochlorperazine tablet 5mg, 10mg $25

11 Progesterone capsule 100mg, 200mg $35 for up to 36 capsules Propafenone HCL tablet 150mg, 225mg, 300mg $45 $80 Propranolol HCL ER capsule 60mg, 80mg, 120mg, 160mg $50 for up to 90 capsules Propranolol tablet 10mg, 20mg, 40mg, 80mg $25 Propylthiouracil tablet 50mg $50 for up to 90 tablets Pyridostigmine BR tablet 60mg $42 for up to 90 tablets Qudexy XR capsule 25mg, 50mg, 100mg, 150mg, 200mg $55 $100 Quetiapine Fumarate tablet 25mg, 50mg, 100mg $30 for up to 90 tablets Quetiapine Fumarate tablet 200mg, 300mg $45 for up to 90 tablets Quetiapine Fumarate tablet 400mg $55 for up to 90 tablets Quinapril tablet 5mg, 10mg, 20mg, 40mg $35 $60 Quinapril/HCTZ tablet 10/12.5mg, 20/12.5mg, 20/25mg $35 for up to 90 tablets Raloxifene tablet 60mg $50 for up to 30 tablets Ramipril capsule 1.25mg, 2.5mg, 5mg, 10mg $30 $50 Ranitidine tablet 150mg, 300mg $25 Repaglinide tablet 0.5mg, 1mg, 2mg $45 for up to 90 tablets Risedronate Sodium tablet 35mg (once a week dosage) $55 per pack of 4 tablets Risedronate Sodium tablet 35mg (once a week dosage) $80 per pack of 12 tablets Risedronate Sodium tablet 150mg (once a month dosage) $85 per dosage Risperidone tablet 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg $50 Rivastigmine tartrate capsule 1.5mg, 3mg, 4.5mg, 6mg $55 for up to 60 capsules Ropinirole HCL tablet 0.25mg, 0.5mg, 1mg, 2mg $50 $90 Sertraline tablet 25mg, 50mg, 100mg $30 Sildenafil Citrate tablet 20mg $25 for up to 30 tablets Simvastatin tablet 5mg, 10mg, 20mg, 40mg, 80mg $25 $40 Sorine tablet 80mg, 120mg, 160mg, 240mg $25 Spironolactone tablet 25mg $25 Spironolactone/HCTZ tablet 25mg/25mg $25 for up to 90 tablets Sprintec tablet 28 s $40 (limit 3) $70 (limit 6) SSKI oral solution 1g/ml dropper $25 per dropper SSKI oral solution 8 fl. oz. bottle (237ml) $40 per bottle

12 Sucralfate tablet 1gm $35 for up to 120 tablets Sulfamethoxazole/Trimethoprim DS tablet 800mg/160mg $25 Sulfasalazine DR tablet 500mg $25 for up to 90 tablets Sulfasalazine DR tablet 500mg $25 for up to 90 tablets Sulfasalazine tablet 500mg $55 $100 Sumatriptan Succ tablet 100mg $40 for up to 27 tablets Sumatriptan Succ tablet 50mg $40 for up to 54 tablets Sumatriptan Succ tablet 25mg $40 for up to 72 tablets Tacrolimus capsule 0.5mg $65 for up to 90 capsules Tacrolimus capsule 1mg $85 for up to 90 capsules Tamoxifen Citrate tablet 10mg, 20mg $30 $50 Tamsulosin capsule 0.4mg $35 $60 Telmisartan tablet 20mg, 40mg, 80mg $40 $70 Temazepam capsule (CS) 15mg, 30mg $21 for up to 90 capsules Terazosin capsule 1mg, 2mg, 5mg, 10mg $25 Testosterone Gel packet (CS) 50mg (5g of gel per packet) $80 for a carton of 30 packets Testosterone Gel tube (CS) 50mg (5g of gel per tube) $80 for a carton of 30 tubes Testosterone Gel pump (CS) 75g pump - 2 pumps per carton (12.5mg per pump actuation) $100 for a carton of 2 pumps Tizanidine HCL tablet 2mg, 4mg $60 Tolterodine Tartrate tablet 1mg, 2mg $35 for up to 30 tablets Topiramate tablet 25mg, 50mg, 100mg, 200mg $40 $70 Tramadol HCI ER tablet (CS) 100mg, 200mg $45 for up to 30 tablets Tramadol HCI ER tablet (CS) 300mg $65 for up to 30 tablets Tramadol tablet (CS) 50mg $12 for up to 90 tablets Tramadol/Acetaminophen tablet (CS) 37.5mg/325mg $35 for up to 120 tablets Trandolapril tablet 1mg, 2mg, 4mg $35 $60 Trazodone tablet 50mg, 100mg, 150mg $15 Triamcinolone cream 0.1% 454gm (0.1%) $23 per jar Triamcinolone ointment 0.1% 454gm (0.1%) $25 per jar Triamterene/HCTZ capsule 37.5/25mg $25 Triamterene/HCTZ tablet 37.5/25mg, 75/50mg $25

13 Trifluoperazine HCI tablet 1mg, 2mg, 5mg, 10mg $55 Tri-Sprintec tablet 28 s $40 (limit 3) $70 (limit 6) Trospium Chloride tablet 20mg $55 for up to 60 tablets Valacyclovir HCI tablet 500mg $55 for up to 90 tablets Valacyclovir HCI tablet 1gm $80 for up to 90 tablets Valproic acid capsule 250mg $40 $70 Valsartan tablet 40mg, 80mg $35 for 90 tablets Valsartan tablet 160mg, 320mg $45 for 90 tablets Valsartan/HCTZ tablet 80/12.5mg, 160/12.5mg, 160/25mg, 320/12.5mg, 320/25mg $40 $70 Venlafaxine ER capsule 37.5mg, 75mg, 150mg $50 Venlafaxine tablet 25mg, 37.5mg, 50mg, 75mg, 100mg $50 Verapamil SR tablet 120mg, 180mg, 240mg $30 $45 Verapamil tablet 40mg, 80mg, 120mg $25 Vitamin B Complex capsule (OTC) 60mg/60mg/5mg (no prescription required) $21 for a bottle of 100 Vitamin B-6 tablet (OTC) 50mg (no prescription required) $16 for a bottle of 100 Vitamin B-6 tablet (OTC) 100mg (no prescription required) $12 for a bottle of 100 Vitamin D3 capsule (OTC) 50,000IU (no prescription required) $20 for 12 capsules Vitamin D3 tablet (OTC) (cholecalciferol) 400IU (no prescription required) $16 for a bottle of 100 Zafirlukast tablet 10mg, 20mg $35 for 60 tablets Zaleplon capsule (CS) 5mg, 10mg $40 for up to 90 capsules Zidovudine tablet 300mg $35 for up to 60 tablets Ziprasidone capsule 20mg, 40mg, 60mg, 80mg $70 for up to 90 capsules Zolpidem ER tablet (CS) 6.25mg, 12.5mg $50 for up to 30 tablets Zolpidem tablet (CS) 5mg, 10mg $35 Zonegran capsule 25mg, 100mg $25 for up to 90 capsules Zonisamide capsule 50mg $25 for up to 90 capsules