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Drug, Strength
Drug, Strength |
90 Day Supply Quantity |
Price |
Category |
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| Amiloride/HCTZ 5/50 |
90 |
$12.00 |
Cardiovascular |
Notes: |
|
| Atenolol 25 |
90 |
$12.00 |
Cardiovascular |
-Cash price only |
|
| Atenolol 50 |
90 |
$12.00 |
Cardiovascular |
-Insurance Co-Pay may be less |
|
| Atenolol 100 |
90 |
$15.00 |
Cardiovascular |
-Medication must be a 90 day supply and |
| Atenolol/Chlorth 50/25 |
90 |
$15.00 |
Cardiovascular |
conform to specified quantity indicated |
| Atenolol/Chlorth 100/25 |
90 |
$15.00 |
Cardiovascular |
|
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| Benazepril 5 |
90 |
$15.00 |
Cardiovascular |
|
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| Benazepril 10 |
90 |
$15.00 |
Cardiovascular |
|
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| Benazepril 20 |
90 |
$15.00 |
Cardiovascular |
|
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| Benazepril 40 |
90 |
$15.00 |
Cardiovascular |
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| Captopril 12.5 |
180 |
$15.00 |
Cardiovascular |
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| Captopril 25 |
180 |
$15.00 |
Cardiovascular |
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| Captopril 50 |
180 |
$15.00 |
Cardiovascular |
|
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| Captopril 100 |
180 |
$15.00 |
Cardiovascular |
|
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| Clonidine 0.1 |
90 |
$15.00 |
Cardiovascular |
|
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| Clonidine 0.2 |
90 |
$15.00 |
Cardiovascular |
|
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| Clonidine 0.3 |
90 |
$15.00 |
Cardiovascular |
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| Digoxin 0.125 |
90 |
$15.00 |
Cardiovascular |
|
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| Digoxin 0.25 |
90 |
$15.00 |
Cardiovascular |
|
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| Diltiazem 30 |
180 |
$15.00 |
Cardiovascular |
|
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| Diltiazem 60 |
180 |
$15.00 |
Cardiovascular |
|
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| Diltiazem 90 |
180 |
$15.00 |
Cardiovascular |
|
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| Diltiazem 120 |
180 |
$15.00 |
Cardiovascular |
|
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| Doxazosin 1 |
90 |
$15.00 |
Cardiovascular |
|
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| Doxazosin 2 |
90 |
$15.00 |
Cardiovascular |
|
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| Doxazosin 4 |
90 |
$15.00 |
Cardiovascular |
|
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| Doxazosin 8 |
90 |
$15.00 |
Cardiovascular |
|
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| Enalapril 2.5 |
90 |
$12.00 |
Cardiovascular |
|
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| Enalapril 5 |
90 |
$12.00 |
Cardiovascular |
|
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| Enalapril 10 |
90 |
$12.00 |
Cardiovascular |
|
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| Enalapril 20 |
90 |
$15.00 |
Cardiovascular |
|
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| Isosorb Mono 30 |
90 |
$15.00 |
Cardiovascular |
|
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| Isosorb Mono 60 |
90 |
$15.00 |
Cardiovascular |
|
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| Isosorb Mono 120 |
90 |
$15.00 |
Cardiovascular |
|
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| Metoprolol 25 |
180 |
$15.00 |
Cardiovascular |
|
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| Metoprolol 50 |
180 |
$15.00 |
Cardiovascular |
|
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| Metoprolol 100 |
180 |
$15.00 |
Cardiovascular |
|
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| Potassium K 8 meq |
90 |
$15.00 |
Cardiovascular |
|
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| Potassium K 10 meq |
90 |
$15.00 |
Cardiovascular |
|
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| Ranitidine 150 |
180 |
$15.00 |
Gastrointestinal |
|
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| Ranitidine 300 |
90 |
$15.00 |
Gastrointestinal |
|
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| Furosemide 20 |
90 |
$12.00 |
Diuretics |
|
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| Furosemide 40 |
90 |
$12.00 |
Diuretics |
|
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| Furosemide 80 |
90 |
$15.00 |
Diuretics |
|
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| Hydrochlorothiazide 12.5 |
90 |
$15.00 |
Diuretics |
|
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| Hydrochlorothiazide 25 |
90 |
$12.00 |
Diuretics |
|
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| Hydrochlorothiazide 50 |
90 |
$12.00 |
Diuretics |
|
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| Estradiol 0.5 |
90 |
$15.00 |
Women's Health |
|
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| Estradiol 1 |
90 |
$15.00 |
Women's Health |
|
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| Estradiol 2 |
90 |
$15.00 |
Women's Health |
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| Amitriptyline 10 |
90 |
$12.00 |
Mental Health |
|
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| Amitriptyline 25 |
90 |
$12.00 |
Mental Health |
|
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| Amitriptyline 50 |
90 |
$12.00 |
Mental Health |
|
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| Amitriptyline 75 |
90 |
$12.00 |
Mental Health |
|
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| Amitriptyline 100 |
90 |
$15.00 |
Mental Health |
|
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| Amitriptyline 150 |
90 |
$15.00 |
Mental Health |
|
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| Benztropine 0.5 |
90 |
$12.00 |
Mental Health |
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| Benztropine 1 |
90 |
$12.00 |
Mental Health |
|
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| Benztropine 2 |
90 |
$12.00 |
Mental Health |
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| Carbamzepine 100 |
180 |
$15.00 |
Mental Health |
|
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| Carbamzepine 200 |
180 |
$15.00 |
Mental Health |
|
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| Doxepin 10 |
90 |
$15.00 |
Mental Health |
|
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| Doxepin 25 |
90 |
$15.00 |
Mental Health |
|
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| Doxepin 50 |
90 |
$15.00 |
Mental Health |
|
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| Doxepin 75 |
90 |
$15.00 |
Mental Health |
|
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| Doxepin 100 |
90 |
$15.00 |
Mental Health |
|
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| Fluoxetine 10 |
90 |
$15.00 |
Mental Health |
|
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| Fluoxetine 20 |
90 |
$15.00 |
Mental Health |
|
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| Fluoxetine 40 |
90 |
$15.00 |
Mental Health |
|
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| Nortriptyline 10 |
90 |
$15.00 |
Mental Health |
|
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| Nortriptyline 25 |
90 |
$15.00 |
Mental Health |
|
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| Nortriptyline 50 |
90 |
$15.00 |
Mental Health |
|
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| Nortriptyline 75 |
90 |
$15.00 |
Mental Health |
|
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| Glipizide 5 |
90 |
$12.00 |
Diabetes |
|
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| Glipizide 10 |
90 |
$12.00 |
Diabetes |
|
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| Glyburide 1.25 |
90 |
$15.00 |
Diabetes |
|
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| Glyburide 2.5 |
90 |
$15.00 |
Diabetes |
|
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| Glyburide 5 |
90 |
$15.00 |
Diabetes |
|
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| Meloxicam 7.5 |
90 |
$15.00 |
Pain/Inflammation |
|
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| Meloxicam 15 |
90 |
$15.00 |
Pain/Inflammation |
|
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| Piroxicam 10 |
90 |
$15.00 |
Pain/Inflammation |
|
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| Piroxicam 20 |
90 |
$15.00 |
Pain/Inflammation |
|
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| Allopurinol 100 |
90 |
$12.00 |
Misc. |
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| Allopurinol 300 |
90 |
$12.00 |
Misc. |
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| Colchicine 0.6 |
90 |
$12.00 |
Misc. |
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| Folic Acid 1 |
90 |
$12.00 |
Misc.
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