9.99 generic list - 2 sided - GLrevised 8-13 - Giant

Drug NameGeneric Drug Formulary$9.99 MAXQUANTDrug Name$9.99 MAXQUANTDrug Name$9.99 MAXQUANTACYCLOVIR 200MG CAP 90 CARVEDILOL 12.5MG TAB 180 ERYTHROMYCIN Opth Oint 3.5g 10.5gALBUTEROL 0.083% INH SOLN (25X3) 225 CARVEDILOL 25MG TAB 180 ESTRADIOL 0.5MG TAB 90ALBUTEROL 0.5% INH SOLN 60 CARVEDILOL 3.125MG TAB 180 ESTRADIOL 1MG TAB 90ALBUTEROL 2MG TAB 270 CARVEDILOL 6.25MG TAB 180 ESTRADIOL 2MG TAB 90ALBUTEROL 4MG TAB 180 CEPHALEXIN 250MG CAPS 84 ESTROPIPATE 0.75MG TAB 90ALBUTEROL SYRUP 360 CEPHALEXIN 500MG CAPS 90 FAMOTIDINE 20MG TAB 180ALLOPURINOL 100MG TAB 90 CERON DM SYRUP 360 FLUCONAZOLE 150MG TAB 3ALLOPURINOL 300MG TAB 90 C-PHEN DM DROPS 1oz. 90 FLUOCINOLONE .01% SOLN 180AMILORIDE HCL/HCTZ 5/50 90 CHLORTHALIDONE 25 MG TAB 90 FLUOCINONIDE CR 0.05% 90AMITRIPTYLINE 100MG TAB 90 CHLORTHALIDONE 50 MG TAB 90 FLUOXETINE 10MG CAPS 90AMITRIPTYLINE 10MG TAB 90 CIPROFLOXACIN 250MG TAB 42 FLUOXETINE 10MG TAB 90AMITRIPTYLINE 25MG TAB 90 CIPROFLOXACIN 500MG TAB 60 FLUOXETINE 20MG CAPS 90AMITRIPTYLINE 50MG TAB 90 CITALOPRAM 10MG TAB 90 FLUPHENAZINE 5 MG 90AMITRIPTYLINE 75MG TAB 90 CITALOPRAM 20MG TAB 90 FOLIC ACID 1MG TAB 90AMOXICILLIN 125MG/5ML 450 CITALOPRAM 40MG TAB 90 FUROSEMIDE 20MG TAB 90AMOXICILLIN 250MG CAP 90 CLONIDINE 0.1MG TAB 90 FUROSEMIDE 40MG TAB 90AMOXICILLIN 250MG/5ML 450 CLONIDINE 0.2MG TAB 90 FUROSEMIDE 80MG TAB 90AMOXICILLIN 500MG CAP 90 CYCLOBENZAPRINE 10MG TAB 90 GENTAMICIN SULFATE OPTH SOLN 15AMOXICILLIN ORAL SUSP 200MG/5 300 CYCLOBENZAPRINE 5MG TAB 90 GLIMEPIRIDE 1MG TAB 90AMOXICILLIN ORAL SUSP 400MG/5 300 CYTRA-2 SOLUTION 540 GLIMEPIRIDE 2MG TAB 90AMOXICILLIN 875mg 90 DEXAMETHASONE 4MG TAB 18 GLIMEPIRIDE 4MG TAB 90ATENOLOL 100 MG TAB 90 DICLOFENAC SOD 75MG TAB 180 GLIPIZIDE 10MG 90ATENOLOL 25MG TAB. 90 DICYCLOMINE 10MG CAPS 270 GLIPIZIDE 5MG 90ATENOLOL 50 MG TAB 90 DICYCLOMINE 20MG TAB 180 GLYBURIDE 2.5 MG (DIA) TAB 90ATENOLOL/CHLORTHAL 100/25 TAB 90 DIGOXIN 0.125MG TAB 90 GLYBURIDE 5 MG (DIA) TAB 90ATENOLOL/CHLORTHAL 50/25 TAB 90 DIGOXIN 0.25MG TAB 90 GLYBURIDE MICRO 3MG TAB 90BACLOFEN 10MG TAB 90 DILTIAZEM 30MG TAB 180 GLYBURIDE MICRO 6 MG TAB 90BELLADONNA ALK/PB TAB 180 DILTIAZEM 60MG TAB 180 GUANFACINE 1MG TAB 90BENAZEPRIL 10MG TAB 90 DOXAZOSIN 1MG TAB 90 HALOPERIDOL 0.5MG TAB 90BENAZEPRIL 20MG TAB 90 DOXAZOSIN 2MG TAB 90 HALOPERIDOL 1MG TAB 90BENAZEPRIL 40MG TAB 90 DOXAZOSIN 4MG TAB 90 HALOPERIDOL 2MG TAB 90BENAZEPRIL 5MG TAB 90 DOXAZOSIN 8MG TAB 90 HALOPERIDOL 5MG TAB 90BENZONATATE 100 MG CAP 42 DOXEPIN HCL CAPS 10 MG CAP 90 HCTZ 12.5MG CAPS 90BENZTROPINE 2MG TAB 90 DOXEPIN HCL CAPS 100MG CAP 90 HCTZ 25MG TAB 90BISOPROLOL/HCTZ 10/6.25MG TAB 90 DOXEPIN HCL CAPS 25MG CAP 90 HCTZ 50 MG TAB 90BISOPROLOL/HCTZ 2.5/6.25MG TAB 90 DOXEPIN HCL CAPS 50MG CAP 90 HEMORRHOIDAL HC 25MG SUPP 36BISOPROLOL/HCTZ 5/6.25MG TAB 90 DOXEPIN HCL CAPS 75MG CAP 90 HYDRALAZINE TAB 10MG 90BUMETANIDE 0.5 MG TAB 180 DOXYCYCLINE HYCLATE 100MG CAP 60 HYDRALAZINE TAB 25MG 90BUMETANIDE 1 MG TAB 90 DOXYCYCLINE HYCLATE 100MG TAB 60 HYDROCORTISONE 2.5% CR 90BUSPIRONE 10MG TAB 180 DOXYCYCLINE HYCLATE 50MG CAP 90 HYDROXYZINE SYR 360BUSPIRONE 5MG TAB 180 ENALAPRIL 10MG TAB 90 IBUPROFEN 100MG SUSP (RX) 360CAPTOPRIL 100MG TAB 180 ENALAPRIL 2.5MG TAB 90 IBUPROFEN 400MG TAB 270CAPTOPRIL 12.5MG TAB 270 ENALAPRIL 20MG TAB 90 IBUPROFEN 600MG TAB 180CAPTOPRIL 25MG TAB 180 ENALAPRIL 5MG TAB 90 IBUPROFEN 800MG TAB 90CAPTOPRIL 50MG TAB 180 ENALAPRIL/HCTZ 5/12.5MG TAB 90 INDAPAMIDE 1.25MG TAB 90CARBAMAZEPINE TAB 200MG 180 ERYTHROMYCIN 2% TOP SOL 180 INDAPAMIDE 2.5MG TAB 90Rev 8/13/11 *Covers up to a 90 day supply at commonly dispensed dosages as determined by Pharmacy*Prices for more than 90 day supplies will be prorated based on$9.99 price for a 90 day supply**Prescriber may need to be contacted to dispense a 90 day supply**List of eligible drugs and quantities subject to change without notice.

Drug Name$9.99 MAXQUANTDrug Name$9.99 MAXQUANTDrug Name$9.99 MAXQUANTINDOMETHACIN CAP 25MG 180 METRONIDAZOLE 500MG TAB 42 SMX-TMP SS TAB 84IPRATROPIUM 0.02% NEB SOLN 2.5ML 225 MULTI VIT W/F TAB .5MG TAB 90 SOD FLUORIDE CHEW TAB 1MG 120ISONIAZID 300MG TABS 90 MULTI VITA-BETS W/F C TAB .25 90 SOD FLUORIDE CHEW TAB 0.5MG 120KCL 10% SF LIQUID 1440 NADOLOL 20MG TAB 90 SOD FLUORIDE CHEW TAB 0.25MG 120LACTULOSE 10GM/15ML SOL 720 NADOLOL 40MG TAB 90 SOTALOL 80MG TAB 90LEVOBUNOLOL OPTH SOLN .5% 15 NAPROXEN 375MG TAB 180 SPIRONOLACTONE 25 MG TAB 90LEVOTHYROXINE 100 MCG TAB 90 NAPROXEN 500MG TAB 180 SULFACETAMIDE 10% OPHTH SOL. 45LEVOTHYROXINE 112MCG TAB 90 NEO/POLY/DEXA OPHTH OINT 10.5 TERAZOSIN 10MG CAPS 90LEVOTHYROXINE 125 MCG TAB 90 NEO/POLY/DEXA OPTHAL SUSP 15 TERAZOSIN 1MG CAP 90LEVOTHYROXINE 137MCG TAB 90 NORTRIPTYLINE 10 MG CAP 90 TERAZOSIN 2MG CAPS 90LEVOTHYROXINE 150 MCG TAB 90 NORTRIPTYLINE 25 MG CAP 90 TERAZOSIN 5MG CAPS 90LEVOTHYROXINE 175MCG TAB 90 OXYBUTYNIN 5 MG TAB 180 TERBINAFINE 250MG TAB 90LEVOTHYROXINE 200MCG TAB 90 PAROXETINE 10MG TAB 90 TETRACYCLINE 250MG CAPS 180LEVOTHYROXINE 25MCG TABS 90 PAROXETINE 20MG TAB 90 TETRACYCLINE 500MG CAPS 180LEVOTHYROXINE 50MCG TABS 90 PENICILLIN VK 250MG TAB 84 THIORIDAZINE 25MG TAB 90LEVOTHYROXINE 75 MCG TAB 90 PENICILLIN VK 250MG/5ML 600 TIMOLOL MAL OPHTH SOLN 0.25% 15LEVOTHYROXINE 88MCG TAB 90 PENICILLIN VK 500mg 120 TIMOLOL MAL OPHTH SOLN 0.5% 15LIDOCAINE 2% VISCOUS 300 PHENAZOPYRIDINE 100MG TAB 18 TOBRAMYCIN OPTH SOLN .3% 15LISINOPRIL 10MG TAB 90 PHENAZOPYRIDINE 200MG TAB 90 TRAMADOL 50MG TAB 180LISINOPRIL 2.5MG TAB 90 TRIAM/HCTZ 37.5/25MG CAPS 90 TRAZODONE 100MG TAB 90LISINOPRIL 20MG ,30mg 40 mgTAB 90 TRIAM/HCTZ 37.5/25MG TAB 90 TRAZODONE 150MG TAB 90LISINOPRIL 5MG TAB 90 TRIAM/HCTZ 75/50MG TAB 90 TRAZODONE 50MG TAB 90LISINOPRIL/HCTZ 10/12.5MG TAB 90 TRIAMCINOLONE 0.025% CR 240 TRIAMCINOLONE 0.1% OINT 240LISINOPRIL/HCTZ 20/12.5MG TAB 90 TRIAMCINOLONE 0.1% CR 240 TRIAMCINOLONE 0.5% CR 45LISINOPRIL/HCTZ 20/25MG TAB 90 PRAVASTATIN 10MG TAB 90 TRIHEXYPHENIDYL 2 MG 180LITHIUM CARB 300MG CAP 270 PRAVASTATIN 20MG TAB 90 TRIVENT DPC 6212/5 SYR 360LORATADINE 10MG TAB 90 PRAVASTATIN 40MG TAB 90 VERAPAMIL 120MG TAB 90LOVASTATIN 10MG TAB 90 PRAZOSIN 1MG CAP 90 VERAPAMIL 80MG TAB 90LOVASTATIN 20MG TAB 90 PRAZOSIN 2MG CAP 90 WARFARIN 10MG TAB (JANTOVEN) 90MAGNESIUM OXIDE 400MG TAB 90 PRAZOSIN 5MG CAP 90 WARFARIN 1MG TAB (JANTOVEN) 90MEDROXYPROGESTERONE 10MG TAB 30 PREDNISONE 10MG TAB 90 WARFARIN 2.5MG TAB (JANTOVEN) 90MEDROXYPROGESTERONE 2.5MG TAB 90 PREDNISONE 2.5MG TAB 90 WARFARIN 2MG TAB (JANTOVEN) 90MEDROXYPROGESTERONE 5MG TAB 90 PREDNISONE 20MG TAB 90 WARFARIN 3MG TAB (JANTOVEN) 90MEGESTROL ACET 20 MG TAB 90 PREDNISONE 5MG TAB 90 WARFARIN 4MG TAB (JANTOVEN) 90MELOXICAM 15MG TAB 90 PRENATAL PLUS TAB 90 WARFARIN 5MG TAB (JANTOVEN) 90MELOXICAM 7.5MG TAB 90 PROCHLORPERAZINE 10MG TAB 90 WARFARIN 6MG TAB (JANTOVEN) 90METFORMIN 1000MG TAB 180 PROMETH DM SYRUP 360 WARFARIN 7.5MG TAB (JANTOVEN) 90METFORMIN 500MG TAB 180 PROMETH SYRUP PLAIN 6.25MG/ML 540METFORMIN 850MG TAB 180 PROMETHAZINE 25MG TAB 36METFORMIN ER 500MG TAB 180 PROPRANOLOL TAB 10MG 180 Drug Name / $29.99 MAX QUANTMETHYLDOPA 250MG TAB 180 PROPRANOLOL TAB 20MG 180 ALENDRONATE 35MG TAB 12METHYLDOPA 500MG TAB 90 PROPRANOLOL TAB 40MG 180 ALENDRONATE 70MG TAB 12METOCLOPRAMIDE 10MG TAB 180 PROPRANOLOL TAB 80MG 180 CLOMIPHENE CITRATE 50MG TAB 15METOCLOPRAMIDE SYRUP 180 RANITIDINE 150MG TAB 90 E.E.M.T. DS TAB (ic Estratest DS) 90METOPROLOL TARTRATE 100MG TAB 180 RANITIDINE 300MG TAB 90 E.E.M.T. HS TAB (ic Estratest HS) 90METOPROLOL TARTRATE 25MG TAB 180 SELENIUM SULF 2.5% LOTION 360 SPRINTEC 28-DAY TAB 84METOPROLOL TARTRATE 50MG TAB 180 SMX/TMP PEDIATRIC SUSP 360 TAMOXIFEN 10MG TAB 180METRONIDAZOLE 250MG TAB 84 SMX-TMP DS TAB 60 TAMOXIFEN 20MG TAB 90TRINESSA-28 DAY TAB 84List subject to change without notice.