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Winn-Dixie Prescription Plan

$4 & $10 GENERICS

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Men's Health | Women's Health | Baby Club Benefits

Antibiotics

QTY 30 Day Qty 90 Day 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 ML (100 ML BOTTLE) 100    
AMOXICILLIN 200 MG/5 ML (75 ML BOTTLE) 75    
AMOXICILLIN 200 MG/5 ML (50 ML BOTTLE) 50    
AMOXICILLIN 250 MG CAPSULES 30    
AMOXICILLIN 250 MG/5 ML (150 ML BOTTLE) 150    
AMOXICILLIN 250 MG/5 ML (100 ML BOTTLE) 100    
AMOXICILLIN 250 MG/5 ML (80 ML BOTTLE) 80    
AMOXICILLIN 400 MG/5 ML (100 ML BOTTLE) 100    
AMOXICILLIN 400 MG/5 ML (75 ML BOTTLE) 75    
AMOXICILLIN 400 MG/5 ML (50 ML BOTTLE) 50    
AMOXICILLIN 500 MG CAPSULES 30    
AMOXICILLIN 875 MG TABLETS 20    
AMPICILLIN 250 MG CAPSULES 28    
AMPICILLIN 500 MG CAPSULES 28    
CEPHALEXIN 125 MG/5 ML (100 ML BOTTLE) 100    
CEPHALEXIN 125 MG/5 ML (200 ML BOTTLE) 200    
CEPHALEXIN 250 MG CAPSULES 30    
CEPHALEXIN 250 MG/5 ML (100 ML BOTTLE) 100    
CEPHALEXIN 250 MG/5 ML (200 ML BOTTLE) 200    
CEPHALEXIN 500 MG CAPSULES 30    
CIPROFLOXACIN 250 MG TABLETS 20    
CIPROFLOXACIN 500 MG TABLETS 20    
CIPROFLOXACIN 750 MG TABLETS 14    
CLINDAMYCIN 150 MG CASULES   30 90
ISONIAZID 300 MG TABLETS   30 90
MINOCYCLINE 50 MG CAPSULES   28 84
MINOCYCLINE 100 MG CAPSULES   28 84
PENICILLIN V Pot 125/5 100 ML (100 ML BOTTLE) 100    
PENICILLIN V Pot 125/5 200 ML (200 ML BOTTLE) 200    
PENICILLIN VK 250 MG TABLETS 28    
PENICILLIN VK 250/5 ML (100 ML BOTTLE) 100    
PENICILLIN VK 250/5 ML (200 ML BOTTLE) 200    
PENICILLIN VK 500 MG TABLETS 28    
SULFAMETH/TRIMETH 200/40/5 ML 120    
SULFAMETH/TRIMETH 400/80 MG TABLETS 28    
SULFAMETH/TRIMETH 800/160 MG TABLETS 20    
SULFASALAZINE 500 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $8.00 $24.00
AMOX/K CLAV 500 MG TABLETS   20  
AMOX/K CLAV 875 MG TABLETS   20  
METRONIDAZOLE 250 MG TABLETS   28 84
METRONIDAZOLE 500 MG TABLETS   14 42
    30 Day Qty 90 Day Qty
    $15.00
AZITHROMYCIN 250 MG PAK (6 TABLETS) (NEW)   6 N/A

Antifungal

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
FLUCONAZOLE 150 MG TABLETS   1 3
KETOCONAZOLE 2% CREAM   15 45
NYSTATIN 100 MU/ML ORAL SUSP DROP   60 180
NYSTATIN 100 MU/ML ORAL SUSP   60 180
TERBINAFINE 250 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $8.00 $24.00
KETOCONAZOLE 2% CREAM   30 90
    30 Day Qty 90 Day Qty
    $12.00 $36.00
KETOCONAZOLE 2% CREAM   60 180

Antiviral

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
AMANTADINE 50 MG/5 ML SYRUP   120 360
ACYCLOVIR 200 MG CAPSULES   30 90
ACYCLOVIR 400 MG TABLETS   30 90
ACYCLOVIR 800 MG TABLETS   30 90

Arthritis/ Pain

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
ALLOPURINOL 100 MG TABLETS   30 90
ALLOPURINOL 300 MG TABLETS   30 90
BACLOFEN 10 MG TABLETS   30 90
BACLOFEN 20 MG TABLETS   30 90
DICLOFENAC POT 50 MG TABLETS   60 180
IBUPROFEN 400 MG TABLETS   90 270
IBUPROFEN 600 MG TABLETS   60 180
IBUPROFEN 800 MG TABLETS   30 90
INDOMETHACIN 25 MG CAPSULES   60 180
INDOMETHACIN 50 MG CAPSULES   30 90
MELOXICAM 15 MG TABLETS   30 90
MELOXICAM 7.5 MG TABLETS   30 90
NAPROXEN 250 MG TABLETS   60 180
NAPROXEN 375 MG TABLETS   60 180
NAPROXEN 500 MG TABLETS   60 180
    30 Day Qty 90 Day Qty
    $8.00 $24.00
DICLOFENAC SOD DR 50 MG TABLETS   60 180
DICLOFENAC SOD DR 75 MG TABLETS   60 180
KETOPROFEN 50 MG CAPSULES   30 90
KETOPROFEN 75 MG CAPSULES   30 90

Asthma/ Resp/Allergies

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
ALBUTEROL 2 MG/5 ML SYRUP   120 473
CETIRIZINE 10 MG TABLETS   30 90
LORATADINE 10 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $4.00 $10.00
ALBUTEROL SULFATE 0.083 % NEB SOLN   75 225
IPRATROPIUM BROMIDE 0.02% AMPULE   75 225
    30 Day Qty 90 Day Qty
    $15.00
IPRATROPIUM BROM/ALBUTEROL SUL 0.5-2.5   90  
    30 Day Qty 90 Day Qty
    $15.00 $45.00
FLUTICASONE 50 MCG NASAL SPRAY   16 48

Cholesterol

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
LOVASTATIN 10 MG TABLETS   30 90
LOVASTATIN 20 MG TABLETS   30 90
LOVASTATIN 40 MG TABLETS   30 90
SIMVASTATIN 20 MG TABLETS   30 90
SIMVASTATIN 40 MG TABLETS   30 90
SIMVASTATIN 10 MG TABLETS   30 90
SIMVASTATIN 5 MG TABLETS   30 90
SIMVASTATIN 80 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $10.00 $30.00
GEMFIBROZIL 600 MG TABLETS   60 180
    30 Day Qty 90 Day Qty
    $15.00 $45.00
PRAVASTATIN 10 MG TABLETS   30 90
PRAVASTATIN 20 MG TABLETS   30 90
PRAVASTATIN 40 MG TABLETS   30 90

CNS

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
BENZTROPINE 0.5 MG TABLETS   30 90
BENZTROPINE 1 MG TABLETS   30 90
CARBAMAZEPINE 100 MG CHEWABLES   60 180
CARBAMAZEPINE 200 MG TABLETS   60 180
DIVALPROEX SODIUM DR 125 MG TABLETS   60 180
DIVALPROEX SODIUM DR 250 MG TABLETS   60 180
DIVALPROEX SODIUM DR 500 MG TABLETS   30 90
GABAPENTIN 100 MG CAPSULES   60 180
GABAPENTIN 300 MG CAPSULES   30 90
GABAPENTIN 400 MG CAPSULES   30 90
HYDROXYZINE HCL 10 MG TABLETS   30 90
HYDROXYZINE HCL 25 MG TABLETS   30 90
HYDROXYZINE HCL 50 MG TABLETS   30 90
HYDROXYZINE PAM 25 MG CAPSULES   30 90
LAMOTRIGINE 100 MG TABLETS   30 90
LAMOTRIGINE 150 MG TABLETS   30 90
LAMOTRIGINE 200 MG TABLETS   30 90
LAMOTRIGINE 25 MG TABLETS   30 90
LAMOTRIGINE 25 MG CHEW TABS   30 90
MIRTAZAPINE 15 MG TABLETS   30 90
MIRTAZAPINE 30 MG TABLETS   30 90
PRIMIDONE 50 MG TABLETS   30 90
PRIMIDONE 250 MG TABLETS   30 90
ROPINIROLE 0.25 MG TABLETS   30 90
ROPINIROLE 0.5 MG TABLETS   30 90
ROPINIROLE 1 MG TABLETS   30 90
ROPINIROLE 2 MG TABLETS   30 90
ROPINIROLE 3 MG TABLETS   30 90
ROPINIROLE 4 MG TABLETS   30 90
ROPINIROLE 5 MG TABLETS   30 90
TOPIRAMATE 25 MG TABLETS   30 90
TOPIRAMATE 50 MG TABLETS   30 90
TOPIRAMATE 100 MG TABLETS   30 90
TOPIRAMATE 200 MG TABLETS   30 90
ZONISAMIDE 25 MG CAPSULES   30 90
ZONISAMIDE 50 MG CAPSULES   30 90
ZONISAMIDE 100 MG CAPSULES   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $8.00 $22.00
BENZTROPINE 2 MG TABLETS   30 90
HYDROXYZINE PAM 50 MG CAPSULES   30 90
MIRTAZAPINE 45 MG TABLETS   30 90
OXCARBAZEPINE 150 MG TABLETS   60 180
OXCARBAZEPINE 300 MG TABLETS   60  
OXCARBAZEPINE 600 MG TABLETS   30 90
PHENYTOIN 100 MG CAPSULES   90 270
    30 Day Qty 90 Day Qty
    $24.00 N/A
SUMATRIPTAN 25 MG TABLETS   9  
SUMATRIPTAN 50 MG TABLETS   9  
SUMATRIPTAN 100 MG TABLETS   9  

Cough

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
BENZONATATE 100 MG CAPSULES   14 42
BENZONATATE 100 MG CAPSULES   14 42
PROMETHAZINE/DM 15-6.25 MG/5 ML SYRUP   120 360
PROMETHAZINE 6.25/5 ML SYRUP*   120 360

Diabetes

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
BLOOD GLUCOSE KIT BY TOPCARE   1 N/A
BLOOD GLUCOSE TEST STRIPS 25 CT BY TOPCARE   25 N/A
BLOOD GLUCOSE LANCETS BY TOPCARE (NEW)   100 N/A
GLIMEPIRIDE 1 MG TABLETS   30 90
GLIMEPIRIDE 2 MG TABLETS   30 90
GLIMEPIRIDE 4 MG TABLETS   30 90
GLIPIZIDE 10 MG TABLETS   60 180
GLIPIZIDE 5 MG TABLETS   60 180
GLYBURIDE 1.25 MG TABLETS   30 90
GLYBURIDE 2.5 MG TABLETS   30 90
GLYBURIDE 5 MG TABLETS   30 90

Diabetes

QTY 30 Day Qty 90 Day Qty
DRUG NAME $0.00 Copay $4.00 $10.00
GLYBURIDE MCR 3 MG TABLETS   30 90
GLYBURIDE/METFORMIN 1.25/250 MG TABLETS   60 180
GLYBURIDE/METFORMIN 2.5/500 MG TABLETS   30 90
GLYBURIDE/METFORMIN 5/500 MG TABLETS   30 90
METFORMIN 1000 MG TABLETS 90    
METFORMIN 500 MG TABLETS 90    
METFORMIN 850 MG TABLETS 90    
METFORMIN ER 500 MG TABLETS   60 180
METFORMIN ER 750 MG TABLETS   60 180
    30 Day Qty 90 Day Qty
    $8.00 $20.00
BLOOD GLUCOSE TEST STRIPS 50 CT BY TOPCARE   50 n/a
GLYBURIDE MCR 6 MG TABLETS   30 90

Ear/Eye

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
ANTIPYRINE/BENZO OTIC SOL   10 30
CIPROFLOXACIN 0.3% OPTHALMIC SOL   5 15
GENTAMICIN SUL 0.3% OPTHALMIC SOL   5 15
OFLOXACIN OPTH 0.3 % SOL   5 15
TIMOLOL MAL 0.25% OPTHALMIC SOL (5 ML)   5 N/A
TIMOLOL MAL 0.5% OPTHALMIC SOL (5 ML or 15ML)   5 15
TOBRAMYCIN 0.3% OPHTHALMIC SOLUTION   5 15
TRIMETHOPRIM-POLY B OPTHALMIC SOL   10 30
    30 Day Qty 90 Day Qty
    $8.00 $24.00
TIMOLOL MAL 0.5% OPTHALMIC SOL (10 ML)   10 N/A

Gastrointestinal

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
FAMOTIDINE 20 MG TABLETS   60 180
FAMOTIDINE 40 MG TABLETS   60 180
METOCLOPRAMIDE 10 MG TABLETS   60 180
METOCLOPRAMIDE 5 MG   60 180
METOCLOPRAMIDE 5 MG/5 ML SYRUP   240  
OMEPRAZOLE 20 MG CAPSULES   30 90
ONDANSETRON 4 MG TABLETS   20 60
ONDANSETRON 8 MG TABLETS   20 60
ONDANSETRON ODT 4 MG TABLETS   14 42
ONDANSETRON ODT 8 MG TABLETS   7 21
PROMETHAZINE 25 MG TABLETS   12 36
RANITIDINE 150 MG TABLETS   60 180
RANITIDINE 300 MG TABLETS   30 90
RANITIDINE 15MG/ML SYRUP   150 473
    30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $12.00
LACTULOSE 10 MG/15 ML SOLUTION   240 960
    30 Day Qty 90 Day Qty
DRUG NAME   $8.00 $24.00
DICYCLOMINE 10 MG CAPSULES   90 270
DICYCLOMINE 20 MG TABLETS   60 180
LOPERAMIDE 2 MG CAPSULES   60 180
OMEPRAZOLE 40 MG CAPSULES   30 90

Heart and Blood Pressure

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
AMLODIPINE BES 10 MG TABLETS   30 90
AMLODIPINE BES 2.5 MG TABLETS   30 90
AMLODIPINE BES 5 MG TABLETS   30 90
AMLODIPINE/BENZ 2.5/10 MG CAPSULES   30 90
AMLODIPINE/BENZ 5/10 MG CAPSULES   30 90
AMLODIPINE/BENZ 5/20 MG CAPSULES   30 90
AMLODIPINE/BENZ 10/20 MG CAPSULES   30 90
ATENOLOL/CHLOR 50/25 MG TABLETS   30 90
ATENOLOL/CHLOR 100/25 MG TABLETS   30 90
ATENOLOL 100 MG TABLETS   30 90
ATENOLOL 25 MG TABLETS   30 90
ATENOLOL 50 MG TABLETS   30 90
BENAZEPRIL 10 MG TABLETS   30 90
BENAZEPRIL 20 MG TABLETS   30 90
BENAZEPRIL 40 MG TABLETS   30 90
BENAZEPRIL 5 MG TABLETS   30 90

Heart and Blood Pressure

QTY 30 Day Qty 90 Day Qty
DRUG NAME $0.00 Copay $4.00 $10.00
BETHANECHOL 10 MG TABLETS   30 90
BETHANECHOL 25 MG TABLETS   30 90
BETHANECHOL 50 MG TABLETS   30 90
BUMETANIDE 0.5 MG TABLETS   30 90
BUMETANIDE 1 MG TABLETS   30 90
BUMETANIDE 2 MG TABLETS   30 90
BISOPROLOL 5 MG TABLETS   30 90
BISOPROLOL 10 MG TABLETS   30 90
BISOPROLOL/HCTZ 10/6.25 TABLETS   30 90
BISOPROLOL/HCTZ 5/6.25 TABLETS   30 90
BISOPROLOL/HCTZ 2.5/6.25 TABLETS   30 90
CARVEDILOL 12.5 MG TABLETS   60 180
CARVEDILOL 25 MG TABLETS   60 180
CARVEDILOL 3.125 MG TABLETS   60 180
CARVEDILOL 6.25 MG TABLETS   60 180
CLONIDINE 0.1 MG TABLETS   60 180
CLONIDINE 0.2 MG TABLETS   60 180
CLONIDINE 0.3 MG TABLETS   60 180
CLOPIDOGREL 75 MG TABLETS   30 90
DIPYRIDAMOLE 25 MG TABLETS   30 90
DIPYRIDAMOLE 50 MG TABLETS   30 90
DIPYRIDAMOLE 75 MG TABLETS   30 90
ENALAPRIL 10 MG TABLETS   30 90
ENALAPRIL 2.5 MG TABLETS   30 90
ENALAPRIL 5 MG TABLETS   30 90
ENALAPRIL/HCTZ 10-25 MG   30 90
ENALAPRIL/HCTZ 5 MG/12.5 MG TABLETS   30 90
FUROSEMIDE 10 MG/ ML SOLUTION   60  
FUROSEMIDE 20 MG TABLETS   30 90
FUROSEMIDE 40 MG TABLETS   30 90
FUROSEMIDE 80 MG TABLETS   30 90
GUANFACINE 1 MG TABLETS   30 90
GUANFACINE 2 MG TABLETS   30 90
HYDRALAZINE 10 MG TABLETS   60 180
HYDRALAZINE 25 MG TABLETS   60 180
HYDRALAZINE 50 MG TABLETS   60 180
HYDRALAZINE 100 MG TABLETS   60 180
HYDROCHLOROTHIAZIDE 12.5 MG CAPSULES   30 90
HYDROCHLOROTHIAZIDE 12.5 MG TABLETS   30 90
HYDROCHLOROTHIAZIDE 25 MG TABLETS   30 90
HYDROCHLOROTHIAZIDE 50 MG TABLETS   30 90
INDAPAMIDE 1.25 MG TABLETS   30 90
INDAPAMIDE 2.5 MG TABLETS   30 90
ISOSORBIDE MONONITRATE 20 MG TABLETS   30 90
LISINOPRIL 10 MG TABLETS 60    
LISINOPRIL 2.5 MG TABLETS 60    
LISINOPRIL 20 MG TABLETS 60    
LISINOPRIL 30 MG TABLETS 60    
LISINOPRIL 40 MG TABLETS 60    
LISINOPRIL 5 MG TABLETS 60    
LISINOPRIL-HCTZ 10-12.5 MG TABLETS   30 90
LISINOPRIL-HCTZ 20-12.5 MG TABLETS   30 90
LISINOPRIL-HCTZ 20-25 MG TABLETS   30 90
METHYLDOPA 250 MG TABLETS   60 180
METHYLDOPA 500 MG TABLETS   30 90
METOPROLOL 100 MG TABLETS   60 180
METOPROLOL 25 MG TABLETS   60 180
METOPROLOL 50 MG TABLETS   60 180

Heart and Blood Pressure

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
PENTOXIFLYLINE 400 MG TABLETS   30 90
PROPRANOLOL 10 MG TABLETS   60 180
PROPRANOLOL 20 MG TABLETS   60 180
PROPRANOLOL 40 MG TABLETS   60 180
PROPRANOLOL 60 MG TABLETS   60 180
PROPRANOLOL 80 MG TABLETS   60 180
QUINAPRIL 10 MG TABLETS   30 90
QUINAPRIL 20 MG TABLETS   30 90
QUINAPRIL 40 MG TABLETS   30 90
QUINAPRIL 5 MG TABLETS   30 90
SOTALOL HCL 80 MG TABLETS   30 90
SOTALOL HCL 120 MG TABLETS   30 90
SOTALOL HCL 160 MG TABLETS   30 90
SPIRONOLACTONE 25 MG TABLETS   30 90
SPIRONOLACTONE 50 MG TABLETS   30 90
SPIRONOLACTONE 100 MG TABLETS   30 90
TERAZOSIN 10 MG CAPSULES   30 90
TERAZOSIN 1 MG CAPSULES   30 90
TERAZOSIN 2 MG CAPSULES   30 90
TERAZOSIN 5 MG CAPSULES   30 90
TRIAMTERENE/HCTZ 37.5-25 TABLETS   30 90
VERAPAMIL 120 MG TABLETS   30 90
VERAPAMIL 80 MG TABLETS   30 90
WARFARIN 10 MG TABLETS   30 90
WARFARIN 1 MG TABLETS   30 90
WARFARIN 2.5 MG TABLETS   30 90
WARFARIN 2 MG TABLETS   30 90
WARFARIN 3 MG TABLETS   30 90
WARFARIN 4 MG TABLETS   30 90
WARFARIN 5 MG TABLETS   30 90
WARFARIN 6 MG TABLETS   30 90
WARFARIN 7.5 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $8.00 $22.00
AMILORIDE/HCTZ 5 MG/50 MG TABLETS   30 90
AMIODARONE 200 MG TABLETS   30 90
AMLODIPINE/BENZ 5/40 MG CAPSULES   30 90
AMLODIPINE/BENZ 10/40 MG CAPSULES   30 90
CILOSTAZOL 50 MG TABLETS   60 180
CILOSTAZOL 100 MG TABLETS   60 180
DILTIAZEM 30 MG TABLETS   60 180
DILTIAZEM 60 MG TABLETS   60 180
DILTIAZEM 90 MG TABLETS   60 180
DILTIAZEM 120 MG TABLETS   30 90
ENALAPRIL 20 MG TABLETS   30 90
FOSINOPRIL 10 MG TABLETS   30 90
FOSINOPRIL 20 MG TABLETS   30 90
FOSINOPRIL 40 MG TABLETS   30 90
FOSINOPRIL/HCTZ 10-12.5 MG TABLETS   30 90
FOSINOPRIL/HCTZ 20-12.5 MG TABLETS   30 90
LABETALOL HCL 100 MG TABLETS   30 90
LABETALOL HCL 200 MG TABLETS   30 90
LABETALOL HCL 300 MG TABLETS   30 90
TRIAMTERENE/HCTZ37.5-25 CAPSULES   30 90
TRIAMTERENE/HCTZ 75-50 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $12.00 $36.00
CHLORTHALIDONE 50 MG TABLETS   30 90
DILTIAZEM CD 120 MG CAPSULES   30 90
DILTIAZEM CD 180 MG CAPSULES   30 90
DILTIAZEM CD 240 MG CAPSULES   30 90
LOSARTAN POT 25 MG   30 90
LOSARTAN POT 50 MG   30 90
LOSARTAN POT 100 MG   30 90
LOSARTAN-HCTZ 50/12.5 MG TABLETS   30 90
LOSARTAN-HCTZ 100/12.5 MG TABLETS   30 90
LOSARTAN-HCTZ 100/25 MG TABLETS   30 90
RAMIPRIL 1.25 MG CAPSULES   30 90
RAMIPRIL 10 MG CAPSULES   30 90
RAMIPRIL 2.5 MG CAPSULES   30 90
RAMIPRIL 5 MG CAPSULES   30 90

Mental Health

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
AMITRIPTYLINE 100 MG TABLETS   30 90
AMITRIPTYLINE 10 MG TABLETS   30 90
AMITRIPTYLINE 150 MG TABLETS   30 90
AMITRIPTYLINE 25 MG TABLETS   30 90
AMITRIPTYLINE 50 MG TABLETS   30 90
AMITRIPTYLINE 75 MG TABLETS   30 90
BUSPIRONE 5 MG TABLETS   60 180
BUSPIRONE 10 MG TABLETS   60 180
CITALOPRAM 10 MG TABLETS   30 90
CITALOPRAM 20 MG TABLETS   30 90
CITALOPRAM 40 MG TABLETS   30 90
FLUOXETINE 10 MG CAPSULES   30 90
FLUOXETINE 20 MG CAPSULES   30 90
FLUOXETINE 40 MG CAPSULES   30 90
FLUPHENAZINE 1 MG TABLETS   30 90
FLUPHENAZINE 5 MG TABLETS   30 90
FLUPHENAZINE 10 MG TABLETS   30 90
HALOPERIDOL 2 MG/ ML 15 ML Concentrate   15 45
LITHIUM CARBONATE 300 MG CAPSULES   90 270
NORTRIPTYLINE 10 MG CAPSULES   30 90
NORTRIPTYLINE 25 MG CAPSULES   30 90
PAROXETINE 10 MG TABLETS   30 90
PAROXETINE 20 MG TABLETS   30 90
PAROXETINE 30 MG TABLETS   30 90
PAROXETINE 40 MG TABLETS   30 90
PROCHLORPERAZINE 10 MG TABLETS   30 90
PROCHLORPERAZINE 5 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
RISPERIDONE 0.25 MG TABLETS   60 180
RISPERIDONE 0.5 MG TABLETS   60 180
RISPERIDONE 1 MG TABLETS   60 180
RISPERIDONE 2 MG TABLETS   60 180
RISPERIDONE 3 MG TABLETS   60 180
SERTRALINE 100 MG TABLETS   30 90
SERTRALINE 25 MG TABLETS   30 90
SERTRALINE 50 MG TABLETS   30 90
TRAZODONE 100 MG TABLETS   30 90
TRAZODONE 150 MG TABLETS   30 90
TRAZODONE 50 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $8.00 $22.00
BUSPIRONE 15 MG TABLETS   60 180
NORTRIPTYLINE 50 MG CAPSULES   30 90
NORTRIPTYLINE 75 MG CAPSULES   30 90
RISPERIDONE 4 MG TABLETS   60 180
THIOTHIXENE 1 MG   30 90
THIORIDAZINE 10 MG TABLETS   30 90
THIORIDAZINE 25 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $12.00 $36.00
DOXEPIN HCL 10 MG CAPSULES   30 90
DOXEPIN HCL 25 MG CAPSULES   30 90
DOXEPIN HCL 50 MG CAPSULES   30 90
DOXEPIN HCL 75 MG CAPSULES   30 90
DOXEPIN HCL 100 MG CAPSULES   30 90
THIORIDAZINE 50 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
DRUG NAME   $18.00 $50.00
VENLAFAXINE 25 MG TABLETS   60 180
VENLAFAXINE 37.5 MG TABLETS   60 180
VENLAFAXINE 50 MG TABLETS   60 180
VENLAFAXINE 75 MG TABLETS   60 180
VENLAFAXINE 100 MG TABLETS   60 180

Muscle Relaxants

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
CYCLOBENZAPRINE 10 MG TABLETS   30 90
CYCLOBENZAPRINE 5 MG TABLETS   30 90
METHOCARBAMOL 500 MG TABLETS   30 90
METHOCARBAMOL 750 MG TABLETS   30 90

Other

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
CHLORHEXADINE GLUCOSE 0.12% SOLN   480  
DEXAMETHASONE .5 MG TABLETS   12 36
DEXAMETHASONE 0.75 MG TABLETS   12 36
DEXAMETHASONE 4 MG TABLETS   6 18
LIDOCAINE 2% VISCOUS SOLUTION   100 300
OXYBUTYNIN 5 MG/5 ML SYRUP   150 N/A
PHENAZOPYRIDINE 100 MG TABLETS   6 18
PHENAZOPYRIDINE 200 MG TABLETS   30 90
PREDNISOLONE DROPS 15 MG/5 ML SYRUP (PRELONE)   120 360
PREDNISOLONE SOD PHOS 15 MG/5 ML SYRUP (ORAPRED)   120 360
PREDNISONE 1 MG TABLETS   90 270
PREDNISONE 2.5 MG TABLETS   30 90
PREDNISONE 20 MG TABLETS   30 90
PREDNISONE 5 MG TABLETS   30 90
PREDNISONE 10 MG TABLETS   30 90
PREDNISONE 5 MG DOSEPACK 21   N/A 21
PREDNISONE 10 MG DOSEPACK 21   N/A 21
S.F. 5000 PLUS 1.1 % GM CREAM   51 N/A
VITAMIN D 50,000 UNIT CAPSULES   8 24
    30 Day Qty 90 Day Qty
    $8.00 $12.00
S.F. 5000 PLUS 1.1 % GM CREAM   102 153

Skin

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
HYDROCORTISONE 1% CREAM 30 GM   30 90
HYDROCORTISONE 2.5% CREAM 30 GM   30 90
MICONAZOLE 2% (OTC) 28 GM CREAM   28 84
SILVER SULFADIAZINE 1% (25 GM) CREAM   25 75
TRIAMCINOLONE 0.025% 15 GM (tube) CREAM   15 45
TRIAMCINOLONE 0.1% 15 GM (tube) CREAM   15 45
    30 Day Qty 90 Day Qty
DRUG NAME   $8.00 $18.00
CLOBETASOL PROPIONATE 0.05% SOL   50 150
SILVER SULFADIAZINE 1% (50 GM) CREAM   50  
TRIAMCINOLONE 0.025% 15 GM (tube) CREAM   15 45
TRIAMCINOLONE 0.025% 15 GM (tube) OINTMENT   15 45
TRIAMCINOLONE 0.025% 80 GM (tube) CREAM   80 240
TRIAMCINOLONE 0.025% 80 GM (tube) OINTMENT   80 240
TRIAMCINOLONE 0.1% 15 GM (tube) CREAM   15 45
TRIAMCINOLONE 0.1% 15 GM (tube) OINTMENT   15 45
TRIAMCINOLONE 0.1% 80 GM (tube) CREAM   80 240
TRIAMCINOLONE 0.1% 80 GM (tube) OINTMENT   80 240
TRIAMCINOLONE 0.5% 15 GM (tube) CREAM   15 45
TRIAMCINOLONE 0.5% 15 GM (tube) OINTMENT   15 45
    30 Day Qty 90 Day Qty
    $24.00
MUPIROCIN 2% OINTMENT   22  

Thyroid

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
METHIMAZOLE 5 MG TABLETS   30 90
METHIMAZOLE 10 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $8.00 $24.00
LEVOTHYROXINE 25 MCG TABLETS   30 90
LEVOTHYROXINE 50 MCG TABLETS   30 90
LEVOTHYROXINE 75 MCG TABLETS   30 90
LEVOTHYROXINE 88 MCG TABLETS   30 90
LEVOTHYROXINE 100 MCG TABLETS   30 90
LEVOTHYROXINE 112 MCG TABLETS   30 90
LEVOTHYROXINE 125 MCG TABLETS   30 90
LEVOTHYROXINE 137 MCG TABLETS   30 90
LEVOTHYROXINE 150 MCG TABLETS   30 90
LEVOTHYROXINE 175 MCG TABLETS   30 90
LEVOTHYROXINE 200 MCG TABLETS   30 90

Vaccines

     
DRUG NAME Price    
ADACEL $56.99    
DECAVAC $56.99    
ENERGIX-B $59.99    
GARDASIL $159.99    
HAVRIX $79.99    
MENACTRA $125.99    
MMR $54.99    
PNEUMOVAX $88.99    
SEASONAL INFLUENZA (INCLUDING INTRA-DERMAL) $24.99    
SEASONAL INFLUENZA HIGH DOSE $44.99    
SEASONAL INFLUENZA MIST $39.99    
SEASONAL INFLUENZA QUADRAVALENT $34.99    
TWINRIX $114.99    
TYPHIM $65.99    
VARIVAX $121.99    
VIVOTIF $51.99    
ZOSTAVAX $199.99    

Vitamins/ Nutritional

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
FOLIC ACID 1 MG TABLETS   30 90
LUDENT CHEW FL 0.5 MG TABLETS   120 360
LUDENT CHEW FL 1 MG TABLETS   120 360
MAG 64 MG TABLETS   30 90
MAG-OXIDE 400 MG TABLETS   60 180
PRENATABS FA TABLETS   30 90
PRENATAL 27 TABLETS   30 90
PRENATAL PLUS 27 TABLETS   30 90

Mens Health

  30 Day Qty 90 Day Qty
DRUG NAME   $9.00 $27.00
FINASTERIDE 5 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $10.00 $30.00
TAMSULOSIN 0.4 MG CAPSULES   30 90

Womens Health

  30 Day Qty 90 Day Qty
DRUG NAME   $4.00 $10.00
ESTRADIOL 0.5 MG TABLETS   30 90
ESTRADIOL 1 MG TABLETS   30 90
ESTRADIOL 2 MG TABLETS   30 90
MEDROXYPROGESTERONE AC 10 MG TABLETS   30 90
MEDROXYPROGESTERONE AC 2.5 MG TABLETS   30 90
MEDROXYPROGESTERONE AC 5 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $9.00 $24.00
ALENDRONATE SOD 35 MG TABLETS   4 12
ALENDRONATE SOD 70 MG TABLETS   4 12
CLOMIPHENE 50 MG TABLETS   5 15
ESTROPIPATE 0.75 MG TABLETS   30 90
ESTROPIPATE 1.5 MG TABLETS   30 90
    30 Day Qty 90 Day Qty
    $9.00 $27.00
PREVIFEM 28 TABLETS   28 84
TRI-PREVIFEM TABLETS   28 84
    30 Day Qty 90 Day Qty
    $12.00 $30.00
TAMOXIFEN 10 MG TABLETS   60 180
TAMOXIFEN 20 MG TABLETS   30 90

Baby Club Benefits

  Qty  
DRUG NAME   $0.00 Copay  
MULTI-VIT/FLUORIDE 0.25 MG/ML DROPS (POLY-VI-FLOR)   50  
MULTI-VIT/FLUORIDE 0.5 MG CHEW (POLY-VI-FLOR)   30  
MULTI-VIT/FLUORIDE 0.5 MG/ML DROPS (POLY-VI-FLOR)   50  
MULTI-VIT/FLUORIDE 1 MG CHEW (POLY-VI-FLOR)   30  
MULTI-VIT/IRON/FLUORIDE 0.25 MG/ML DROPS (POLY-VI-FLOR/FE)   50  
MULTIVITAMIN/FLUORIDE 0.25 MG CHEW (POLY-VI-FLOR)   30  
MULTIVITAMIN/FLUORIDE 0.5 MG CHEW (POLY-VI-FLOR)   30  
MULTIVITAMIN/FLUORIDE 1 MG CHEW (POLY-VI-FLOR)   30  
MVC-FLUORIDE 0.25 MG CHEW (POLY-VI-FLOR)   30  
MVC CHEW W FL 0.25 MG TABLETS   30  
MVC CHEW W FL 0.5 MG TABLETS   30  
PNV FOLIC ACID PLUS MULTI 27-1 MG TAB (PRENATAL PLUS)   30  
POLY-VITAMIN/IRON/FLUORIDE 0.25 MG/ML DROPS (POLY-VI-FLOR/FE)   50  
PRENATABS FA 29-1 MG TAB (NATATAB FA)   30  
PRENATABS RX 29-1 MG TAB (PRENATAL PLUS IRON)   30  
PRENATAL 19, 29-1 MG CHEW   30  
PRENATAL 19, 29-1 MG TAB   30  
PRENATAL AD 90-1 MG TAB (iNATAL ADVANCE)   30  
PRENATAL PLUS 27-1 MG TAB   30  
PRENATAL- U 106.5-1 MG CAP   30  
TRINATE 28-1 MG TAB (STUARTNATAL PLUS)   30  
TRI-VIT/FLUORIDE 0.25 MG/ML DROPS (TRI-VI-FLOR)   50  
TRI-VIT/FLUORIDE/IRON 0.25 MG/ML DROPS (TRI-VIT-FLOR/FE)   50  
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