4-Tier Drug Program

Preferred Drug List

Powered By: PHARMACY NETWORK Your prescription card is accepted at over 54,000 participating pharmacies throughout the United States. The network includes pharmacy chains, such as Welcome... CVS, Rite Aid, Medicine Shoppe, Walgreens, Wal-Mart, and more, as well as thousands of independent pharmacies throughout the country. This plan is designed to save you money

ALBERTSONS KROGER PHARMACY on your prescription drug costs! A AND P PHARMACY LEGEND ARBOR DRUGS LEWIS FAMILY DRUG Your Prescription Plan is recognized at most pharmacies in the United States. ARROW CENTER LONG'S AURORA PHARMACY MARC'S BARTELL DRUGS MED-X DRUG BIG BEAR PHARMACY MEDIC DISCOUNT DRUG This product guide has four tiers: BI-LO PHARMACY MEDIC DRUG BI-MART PHARMACY MEDICAP PHARMACY The first tier is preferred brand and generic drugs that will be available to you for BROOKS PHARMACY MEDICINE SHOPPE, THE BROOKSHIRE BROS. MEIJER PHARMACY $10 or less for the scheduled quantity and dose. BROOKSHIRE PHARMACY METRO PHARMACY BRUNO'S PHARMACY MORE 4 FAMILY CASHWISE NCS HEALTHCARE The second tier is preferred brand and generic drugs that will be available to COSTCO OSCO DRUG you for $20 or less for the scheduled quantity and dose. CUB PHARMACY PAMIDA PHARMACY CVS PHARMACY PATHMARK PHARMACY DILLON PHARMACY PHAR-MOR DISCOUNT DRUG MART PRICE CHOPPER The third tier is preferred brand and generic drugs that will be available to you DOMINICK'S PHARMACY PUBLIX PHARMACY for $ 40 or less for the scheduled quantity and dose. DRUG EMPORIUM RAINBOW PHARMACY D & W FOOD CENTERS RITE AID PHARMACY EAGLE PHARMACY SAFEWAY PHARMACY The fourth tier is non-preferred brand and generic drugs that we have ECONOFOODS SAVE-ON ECKERD DRUG SAVE MART PHARMACY negotiated a special discount price for you. EDWARDS PHARMACY SCHNUCKS PHARMACY EPIC SEELY SNYDER DRUG FAGEN PHARMACY SENTRY DRUGS INC FAIRVIEW PHARMACY SENTRY DRUGS INC To get the most out of this program you should ask your doctor to prescribe a FARMCO DRUG CENTER SHOP'N SAVE drug within the first three tiers if possible. Often times drugs within the same FARMER JACK SHOPKO PHARMACY therapeutic class can be prescribed in place of an expensive brand name drug. FOOD TOWN PHARMACY SHOPRITE PHARMACY FRED MEYER PHARMACY STAR PHARMACY Of course if you choose the higher price non-preferred brand or generic name FRED'S PHARMACY STOP & SHOP drug we have negotiated a substantial discount for you. FRUTH PHARMACY TARGET PHARMACY FRY'S FOOD & DRUG TIMES PHARMACY FURR'S PHARMACY TOPS PHARMACY GENOVESE DRUG STORE UKROPS PHARMACY Please review this entire book. Read the “frequently asked questions” section GIANT EAGLE UNITED PHARMACY for information about this plan. Feel free to contact our customer service center GRAND UNION VON'S PHARMACY if you have additional questions. HARRIS TEETER WAL-MART PHARMACY HOMELAND PHARMACY WALDBAUM'S PHARMACY HORIZON PHARMACY WALGREENS HY-VEE PHARMACY WEGMAN PHARMACY Our knowledgeable Help Desk and Customer Service department ensures that KERR DRUG WEIS PHARMACY K MART PHARMACY WHITE DRUG all physician, member, and pharmacy calls are responded to swiftly and accu- KASH N' KARRY WINN DIXIE PHARMACY rately. Our prompt customer service help desk is available toll free from Monday KING SOOPERS through Friday - 8:30 a.m. to 8 p.m. (Eastern time). KINNEY DRUGS

Preferred Brand & Generic Drugs Non-Preferred What is the difference between brand name and generic drugs? $10 Tier $20 Tier $40 Tier Discounts The brand name is the trade name under which the product is advertised and sold, and is protected by patents so that it can only be produced by one manu- ANALGESICS - ANTI-INFLAMMATORY facturer for a pre-determined number of years. Once a patent expires, other DICLOFENAC TAB DICLOFEN POT TAB DICLOFENAC TAB ARTHROTEC 50 TABS companies may manufacture a generic equivalent, providing they follow strin- 50MG EC - 30 TABS 50MG - 30 TABS 100MG ER - 30 TABS ARTHROTEC 75 TABS gent FDA regulations for safety. Generic drugs are drugs for which the patent DICLOFENAC TAB ETODOLAC CAP ETODOLAC CAP has expired, allowing other manufacturers to produce and distribute the product 75MG DR - 30 TABS 300MG - 30 CAPS 200MG - 30 CAPS CELEBREX CAPS under a generic name. Generics are essentially a chemical copy of their brand

IBUPROFEN SUS ETODOLAC TAB ETODOLAC ER TAB ETODOLAC ER TABS name equivalents. The color or shape may be different, but the active ingredi- 100/5ML - 120 ML 400MG - 30 TABS 400MG - 30 TABS ents must be the same for both. The preferred drug list contains only FDA ap- INDOMETHACIN CAPS IBUPROFEN TAB ETODOLAC TAB ETODOLAC ER TAB proved generic medications. 400MG - 30 TABS 500MG - 30 TABS 500MG - 30 TABS KETOPROFEN CAPS

IBUPROFEN TAB INDOMETHACIN LEFLUNOMIDE TAB NAPRELAN TABS What is a preferred drug list? 600MG - 30 TABS CAP 25MG - 30 CAPS 10MG - 30 TABS A preferred drug list is a list of recommended prescription medications that is PONSTEL CAPS created, reviewed and continually updated by a team of physicians and pharma- IBUPROFEN TAB INDOMETHACIN CAP LEFLUNOMIDE TAB 800MG - 30 TABS 50MG - 30 CAPS 20MG - 30 TABS cists. The preferred drug list contains a wide range of generic and brand name preferred products that have been approved by the Food and Drug Administra- KETOPROFEN CAP KETOROLAC TAB NALFON CAP 50MG - 30 CAPS 10MG - 30 TABS 200MG - 30 CAPS tion (FDA). Your doctor can use this list to select medications for your health care needs, while helping you maximize your prescription drug benefit. A medi- KETOPROFEN CAP MELOXICAM TAB cation becomes a preferred drug based first on safety and efficacy, then on 75MG - 15 CAPS 7.5MG - 30 TABS cost-effectiveness. MELOXICAM TAB NABUMETONE TAB 15MG - 30 TABS 500MG - 30 TABS What is the difference between a preferred brand name drug vs. a non- NAPROXEN TAB NABUMETONE TAB preferred 250MG - 30 TABS 750MG - 30 TABS brand name drug? NAPROXEN TAB NAPROXEN DR TAB A preferred brand name drug is a medication that has been reviewed and ap- 375MG - 30 TABS 375MG - 30 TABS proved by a group of physicians and pharmacists, and has been selected for NAPROXEN TAB NAPROXEN DR TAB preferred status based on its proven clinical and cost effectiveness. A non- 500MG - 30 TABS 500MG - 30 TABS preferred brand name drug is a medication that has been reviewed by the same

PIROXICAM CAP NAPROXEN SOD TAB team of physicians and pharmacists who determined that an alternative drug 10MG - 30 CAPS 550MG - 30 TABS that is clinically equivalent and most cost effective is available. These designa-

PIROXICAM CAP OXAPROZIN TAB tions may change as new clinical information becomes available. 20MG - 30 CAPS 600MG - 30 TABS

SULINDAC TAB What drugs are considered preferred (formulary) on Discount Plans? 150MG - 30 TABS The Product Guide contains certain brand drugs for which the member's price is the scheduled amount listed. Drugs that are chemically or therapeutically similar SULINDAC TAB 200MG - 30 TABS to drugs listed on the Product Guide are not discounted. Prices are subject to ANALGESICS - NONNARCOTIC change due to manufacturer price changes to pharmacies. On these drugs, the participant enjoys two distinct discounts; one through the pharmacy network ASPIRIN TAB 325MG - ACUFLEX TAB - BUT/APAP/CAF DOLGIC LQ ELX 30 TABS 20 TABS TAB - 30 TABS and the second through the manufacturer. DOLGIC PLUS TABS ASPIRIN TAB 325MG BUT/ASA/CAFF DIFLUNISAL EC - 30 TABS CAP - 30 CAPS TAB 500MG - 30 TABS PHRENILIN CAP FORTE What if the brand drug I am taking is not discounted? If you are currently taking a medication that has similar active ingredients or is ASPIRIN TAB 81MG BUT/ASA/CAFF DURABAC ZEBUTAL used to treat the same conditions as the preferred brand drugs on the product EC - 30 TABS TAB - 30 TABS TAB FORTE - 28 TABS guide, it will still be discounted. You will pay the negotiated price for that drug. BUT/APAP/CAF BUTAL/APAP To take advantage of the potential program savings on listed preferred drugs, TAB - 30 TABS TAB 50-325 - 30 TABS you should ask your Pharmacist (where regulations permit) or a Doctor to change your medication, where medically appropriate, to a less expensive prod- uct listed in the product guide. FREQUENTLY ASKED QUESTIONS Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts Where can I use my card? ANALGESICS - NONNARCOTIC Your card is accepted at over 54,000 participating pharmacies throughout the Q-PAP LIQ 160/5ML CEPHADYN TAB United States. The network includes pharmacy chains, such as CVS, Rite Aid, - 180 ML 650-50MG - 30 TABS Medicine Shoppe, Walgreens, Wal-Mart, and more, as well as thousands of independent pharmacies throughout the country. Pharmacy location information Q-PAP TAB 325MG FLEXTRA DS - 30 TABS TAB - 24 TABS can be obtained by contacting customer service. If a neighborhood pharmacy is not already participating in our network, please have them call us. We will send SALSALATE TAB 500MG - 30 TABS them information about how then can participate in the network so that you can take advantage of the savings as soon as possible. SALSALATE TAB 750MG - 30 TABS What if my pharmacy doesn't recognize the card? ANALGESICS - OPIOIDS (PAIN RELIEF) Pharmacies may not be familiar with every prescription program in which they APAP/CODEINE TAB APAP/CODEINE SOL BUT/APAP/CAF CAP AVINZA CAPS participate. If the pharmacist does not recognize your card or if you encounter a 300-15MG - 20 TABS 120-12/5 - CODEINE - 30 CAPS 360 ML BALACET 325 TABS problem at the pharmacy, DO NOT leave without having the pharmacy call the APAP/CODEINE TAB BUT/ASA/CAF/ CAP COD toll-free number printed on the ID card. 300-30MG - 30 TABS APAP/CODEINE TAB 30MG - 30 CAPS BUPRENEX INJ 300-60MG - HYDROCO/APAP TAB 30 TABS CAPITAL/COD SUS 120- BUTORPHANOL SOL What is my average discount on Non-Preferred Drugs? 10-500MG - 30 TABS 12/5 - 200 ML CODEINE SULF TAB COMBUNOX TABS Members are currently receiving an average discount of approximately 19% on HYDROCO/APAP TAB 30MG - 30 TABS CODEINE SULF brand name drugs. There is no guaranteed percentage savings on every pre- 10-650MG - 30 TABS TAB 60MG - 30 TABS FENTORA TABS scription purchase. The price paid depends upon the pharmacy and the type DARVON-N TAB 100MG - HYDROCO/APAP TAB 10 TABS ENDOCET TAB 10- HYCET and quantity of drug purchased. Pharmacies, just like other retail stores, com- 2.5-500 - 30 TABS 325MG - 30 TABS pete against each other and may have special prices on some products. When DISKETS TAB 40MG - 30 KADIAN CAPS HYDROCO/APAP TAB TABS ENDOCET TAB 7.5-500M this is the case, we cannot discount the pharmacy's already low price, but a 5-500MG - 30 TABS - 30 TABS MORPHINE SUL SOL member will receive the advantage of the pharmacy's special pricing. THE HYDROCO/APAP TAB HYDROCO/APAP TAB 10/660MG - 30 TABS HYDROCO/APAP TAB MORPHINE SUL TABS MEMBER ALWAYS RECEIVES THE LOWER OF THE CONTRACT PRICE 7.5-500 - 30 TABS 10-750MG - 30 TABS OR THE PHARMACY'S PRICE. HYDROCO/APAP TAB OPANA ER TABS HYDROCO/APAP TAB 10-325MG - 30 TABS HYDROMORPHON TAB 7.5-650 - 30 TABS 8MG - 30 TABS OPANA TABS What is a generic drug? HYDROCO/APAP TAB 5- Once a patent on a brand name drug expires, other drug companies may make HYDROCO/APAP TAB 325MG - 30 TABS LEVORPHANOL TAB PERCOCET TABS 7.5-750 - 2MG - 30 TABS a generic version of the drug, with the approval of the Food and Drug Admini- 30 TABS HYDROCO/APAP TAB PERLOXX TABS stration (FDA). The FDA's standards for quality are the same for all manufactur- 7.5-325 - 30 TABS METHADONE CON METHADONE TAB 10MG 10MG/ML - 30 CONC ROXICET SOL ers. This means the generic drug contains the same active ingredients as the - 30 TABS HYDROCOD/IBU TAB brand name whose patent has expired, and that its as safe, potent and effec- 7.5-200 - 30 TABS MORPHINE SUL TAB TALWIN INJ tive. METHADONE TAB 5MG - 60MG ER - 30 TABS 30 TABS HYDROCODONE/ SOL ULTRAM ER TABS APAP - 240 ML OPANA TAB 5MG - 15 How can I keep my prescription drug costs down? MORPHINE SUL TAB TABS XODOL TABS 15MG - 30 TABS HYDROMORPHON TAB The use of generic prescription drugs, whenever available, is most cost effec- 2MG - 30 TABS OXYCOD/APAP TAB 10- tive. Don't be shy - discuss your prescription options with your doctor. Ask MORPHINE SUL TAB 650MG - 30 TABS 30MG - 30 TABS HYDROMORPHON TAB whether an alternative, less expensive option would work for your condition. 4MG - 30 TABS OXYCOD/ASA TAB - 30 TABS How will I know if there's a generic equivalent available? MEPERIDINE TAB 100MG - 30 TABS OXYCOD-APAP TAB 7.5- Simply ask your local pharmacist or call the Customer Service Department to 325 - 30 TABS find out about generic equivalents for your prescription. Also ask your doctor to MEPERIDINE TAB 50MG - 30 TABS PENTA/APAP TAB 25- prescribe generics whenever possible and appropriate. (Your enrollment packet 650MG - 30 TABS will include helpful materials you can share with your doctor.) Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts

ANALGESICS - OPIOIDS (PAIN RELIEF) VITAMINS OXYCOD/APAP TAB MEPROZINE CAP PROPO-N/APAP TAB PRENATAL MTR TAB NEPHROCAPS CAP - 5-325MG - 30 TABS 50-25MG - 30 CAPS 100-500 - 25 TABS SELENIUM - 30 TABS 30 CAPS

PROPO-N/APAP TAB MORPHINE SUL SOL TRAMADL/APAP PRENATAL PLS TAB / NOVANATAL TAB - 100-650 - 30 TABS 10MG/5ML - 120 ML TAB - 30 TABS IRON - 30 TABS 30 TABS

PROPOXY/APAP TAB MORPHINE SUL TAB ZERLOR TAB - 20 TABS PRENATAL RX1 TAB - NUTRINATE CHW - 65-650MG - 30 TABS 15MG CR - 30 TABS 30 TABS 30 CHEW ZYDONE TAB 10-400MG TRAMADOL HCL TAB MORPHINE SUL TAB - 30 TABS PSORIACAP CAP - POTABA CAP 500MG - 50MG - 30 TABS 30MG ER - 30 TABS 30 CAPS 30 CAPS

OXYCOD/APAP CAP SLO-NIACIN TAB PRENATAL-U CAP - 5-500MG - 30 CAPS 500MG CR - 30 TABS 30 CAPS

PROPO-N/APAP TAB TRI-VIT/FE DRO RENA-VITE RX TAB - 50/325 - 30 TABS FL 0.25 - 50 ML 30 TABS

PROPOXY HCL CAP ULTRA NATAL TAB SELECT-OB CHW - 65MG - 30 CAPS CARE - 30 TABS 30 CHEW

V-C FORTE CAP - TANDEM OB CAP - 30 CAPS 30 CAPS ANTIANXIETY AGENTS VITAMIN B-1 TAB TRINATE TAB - ALPRAZOLAM TAB BUSPIRONE TAB ALPRAZOLAM TAB ALPRAZOLAM TABS 100MG - 30 TABS 30 TABS 0.25MG - 30 TABS 15MG - 30 TABS 0.5MG ER - 30 TABS MEPROBAMATE TABS VITAMIN C TAB VINATE AZ TAB - ALPRAZOLAM TAB CLORAZ DIPOT TAB ALPRAZOLAM TAB 500MG - 30 TABS 30 TABS 0.5MG - 30 TABS 15MG - 30 TABS 2MG ER - 30 TABS NIRAVAM TABS VITAMIN D TAB VINATE II TAB - ALPRAZOLAM TAB CLORAZ DIPOT TAB ALPRAZOLAM TAB TRANXENE-SD TABS 400UNIT - 30 TABS 30 TABS 1MG - 30 TABS 7.5MG - 30 TABS XR 1MG - 30 TABS VITAMIN D CAP ALPRAZOLAM TAB HYDROXYZ HCL TAB BUSPIRONE TAB 50000UNT - 12 CAPS 2MG - 30 TABS 10MG - 30 TABS 30MG - 30 TABS VITAPLEX TAB - BUSPIRONE TAB HYDROXYZ HCL MEPROBAMATE TAB 30 TABS 10MG - 30 TABS TAB 25MG - 30 TABS 200MG - 30 TABS

BUSPIRONE TAB HYDROXYZ HCL NIRAVAM TAB 5MG - 30 TABS TAB 50MG - 30 TABS 0.25MG - 30 TABS

CHLORDIAZEP CAP OXAZEPAM CAP 10MG - 30 CAPS 10MG - 30 CAPS

CHLORDIAZEP CAP 25MG - 30 CAPS

CHLORDIAZEP CAP 5MG - 30 CAPS

CLORAZ DIPOT TAB 3.75MG - 30 TABS

DIAZEPAM SOL 1MG/ML - 5 ML

DIAZEPAM TAB 10MG - 30 TABS

Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts

VAGINAL PRODUCTS ANTIANXIETY AGENTS TRIMO-SAN GEL - 113.4 ACID JELLY GEL VAG/ AVC CREAM DIAZEPAM TAB QTY APPL - 85 QTY 2MG - 30 TABS CLEOCIN SUP RELAGARD GEL - 50 DIAZEPAM TAB QTY CLINDAMAX CREAM 5MG - 30 TABS

TERCONAZOLE CRE CLINDESSE CREAM HYDROXYZ HCL SYP 0.004 - 45 QTY 10MG/5ML - 120 ML CRINONE GEL TERCONAZOLE CRE HYDROXYZ PAM CAP 0.008 - 20 QTY ESTRACE VAG CREAM 25MG - 30 CAPS

GYNAZOLE-1 CREAM HYDROXYZ PAM CAP 50MG - 30 CAPS METRONIDAZOL GEL LORAZEPAM TAB PREMARIN VAG CREAM 0.5MG - 30 TABS

TERCONAZOLE SUP LORAZEPAM TAB 1MG - 30 TABS VAGIFEM TAB LORAZEPAM TAB VITAMINS 2MG - 30 TABS CAL-NATE TAB - 5 TABS ADEKS CHW - 30 CHEW ELDERTONIC ELX - CALCITRIOL CAP ANTIARRHYTHMICS 480 ML CEROVITE ADV TAB ADVANCED-RF TAB PRENATE DHA CAP FLECAINIDE TAB DISOPYRAMIDE CAP FLECAINIDE TABS FORMULA - 30 TABS NATALCAR - 30 TABS GLUTOFAC-ZX TAB - 50MG - 30 TABS 150MG ER - 30 CAPS 30 TABS PRIMACARE CAP ONE RYTHMOL SR CAPS CVS VIT B-6 TAB CALCITRIOL CAP PACERONE TAB FLECAINIDE TAB 50MG - 30 TABS 0.25MCG - 10 CAPS NATAFORT TAB - VITAFOL SYP - 480 ML 200MG - 30 TABS 100MG - 30 TABS TIKOSYN CAPS 30 TABS DIALYVITE/ TAB ZINC - CENTRUM LIQ - 450 ML MEXILETINE CAP 30 TABS NICOMIDE TAB - 150MG - 30 CAPS CITRACAL TAB PREN 30 TABS MEPHYTON TAB 5MG - RX - 30 TABS PROPAFENONE TAB 4 TABS OB COMPLETE CAP 150MG - 30 TABS DIATX ZN TAB - WITH DHA - 30 CAPS MULT VIT-BET CHW FL 30 TABS PROPAFENONE TAB 0.5MG - 30 CHEW POLY-VITAMIN DRO - 225MG - 30 TABS FOLBEE PLUS TAB - 450 ML MULTI VIT/FL CHW 30 TABS 0.25MG - 30 CHEW PRECARE CHW - FOLGARD OS TAB - 30 CHEW MULTIVITAMIN TAB - 30 TABS ANTIASTHMATIC AND BRONCHODILATOR AGENTS 30 TABS PRECARE TAB ACCOLATE TAB ALBUTEROL AER ALBUTEROL TAB ACCOLATE HEMATINIC PL TAB VIT/ PREMIER - 30 TABS 10MG - 5 TABS 90MCG - 17 GM 4MG ER - 30 TABS ADVAIR HFA NATATAB FA TAB - MIN - 30 TABS AEROBID AER 30 TABS PRECARE TAB ALBUTEROL SYP DIFIL-G TAB 200- ALUPENT INH AER ALBUTEROL HEMOCYTE PLU CAP - 2MG/5ML - 120 ML 300 - 30 TABS 0.65/ACT - 14 GM ATROVENT HFA AER NEEVO TAB - 5 TABS 30 CAPS PRENATAL - 30 TABS AZMACORT AER NIACOR TAB 500MG - ALBUTEROL TAB TERBUTALINE TAB IPRATROPIUM SOL COMBIVENT 30 TABS LACTOCAL-F TAB - PREFERA OB TAB - 2MG - 30 TABS 2.5MG - 30 TABS INHAL - 300 ML FLOVENT HFA AER 30 TABS 30 TABS FORADIL CAPS POLY-VIT/FE DRO /FL ALBUTEROL TAB TERBUTALINE TAB PROAIR HFA AER - INTAL INH AER 0.25 - 50 ML MULT FOL 500 TAB PREMESIS RX TAB - 4MG - 30 TABS 5MG - 30 TABS 8.5 QTY PULMICORT SUS CR - 30 TABS 30 TABS QVAR AER POLY-VIT/FL DRO AMINOPHYLLIN TAB THEOPHYLLINE TAB THEO-24 CAP 200MG SINGULAIR 0.25MG - 50 ML NATATAB RX TAB PRENATE ELIT TAB - 100MG - 30 TABS 200MG ER - 30 TABS CR - 30 CAPS SPIRIVA CAPS 29-1MG - 30 TABS 30 TABS SYMBICORT AER POLY-VITAMIN DRO THEOPHYLLINE TAB THEOPHYLLINE TAB THEOPHYLLINE TAB THEO-24 CAPS 0.5MG - 50 ML NATELLE EZ TAB - 100MG CR - 30 TABS 300MG ER - 30 TABS 400MG ER - 30 TABS THEOPHYLLINE TABS 30 TABS XOPENEX HFA

ZYFLO CR TABS

Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts

ANTICOAGULANTS (BLOOD MODIFIERS) ULCER DRUGS

WARFARIN TAB ARIXTRA SOLS BELLA ALK/PB TAB ATROPINE SUL INJ BELLATAL ER TAB - 30 ACIPHEX TAB 10MG - 30 TABS 16.2MG - 30 TABS 0.4MG/ML - 25 ML TABS WARFARIN TAB HEPARIN LOCK INJ CARAFATE SUS 1MG - 30 TABS CHLORD/CLIDI CAP 5- AXID SOL 15MG/ML - 30 GLYCOPYRROL TAB WARFARIN TAB HEPARIN SOD INJ 2.5MG - 30 CAPS ML 1MG - 30 TABS DICYCLOMINE SOL 2.5MG - 30 TABS WARFARIN TAB LOVENOX INJ CIMETIDINE TAB BELLA ALK/PB ELX - 480 MISOPROSTOL TAB GLYCOPYRROL TAB 2MG - 30 TABS 300MG - 30 TABS ML 200MCG - 30 TABS WARFARIN TAB METHSCOPOLAM 3MG - 30 TABS CIMETIDINE TAB CIMETIDINE TAB 800MG OMEPRAZOLE CAP WARFARIN TAB 400MG - 30 TABS - 30 TABS 20MG - 30 CAPS NEXIUM 4MG - 30 TABS WARFARIN TAB DICYCLOMINE CAP FAMOTIDINE TAB 40MG PRILOSEC OTC TAB NIZATIDINE CAP 5MG - 30 TABS 10MG - 30 CAPS - 30 TABS 20MG - 30 TABS WARFARIN TAB NIZATIDINE CAP 6MG - 30 TABS DICYCLOMINE TAB HYOSCYAMINE DRO RANITIDINE CAP 300MG WARFARIN TAB 20MG - 30 TABS 0.125/ML - 15 ML - 30 CAPS OMEPRAZOLE CAP 7.5MG - 30 TABS ANTICONVULSANTS FAMOTIDINE TAB HYOSCYAMINE TAB RANITIDINE SYP 15MG/ PANTOPRAZOLE 20MG - 30 TABS 0.125MG - 30 TABS ML - 30 ML CARBAMAZEPIN CHW DILANTIN CAP 30MG - CLONAZEP ODT CARBATROL CAPS PEPCID 100MG - 30 CHEW 30 CAPS TAB 0.125MG - 30 TABS HYOSCYAMINE CAP HYOSCYAMINE TAB DEPAKOTE ER TAB 0.375 ER - 30 CAPS 0.375 ER - 30 TABS PREVACID CARBAMAZEPIN TAB DILANTIN CHW CLONAZEP ODT 200MG - 30 TABS 50MG - 30 CHEW TAB 0.25MG - 30 TABS DIASTAT ACDL GEL HYOSCYAMINE TAB MISOPROSTOL TAB PRILOSEC 0.125MG - 30 TABS 100MCG - 30 TABS CLONAZEPAM TAB GABAPENTIN TAB CLONAZEP ODT TAB ETHOSUXIMIDE SOL PYLERA 0.5MG - 30 TABS 300MG - 30 TABS 0.5MG - 30 TABS RANITIDINE TAB PROPANTHELIN TAB FELBATOL TABS 150MG - 30 TABS 15MG - 30 TABS ZEGERID CLONAZEPAM TAB GABAPENTIN TAB CLONAZEP ODT TAB 1MG - 30 TABS 600MG - 30 TABS 1MG - 30 TABS GABAPENTIN TAB RANITIDINE TAB 75MG - RANITIDINE CAP 150MG 30 TABS - 30 CAPS CLONAZEPAM TAB GABAPENTIN TAB DEPAKOTE SPR CAP GABITRIL TABS 2MG - 30 TABS 800MG - 30 TABS 125 MG - 30 CAPS RANITIDINE TAB 300MG KEPPRA SOL - 30 TABS GABAPENTIN CAP PHENYTOIN EX CAP DEPAKOTE TAB 125MG 100MG - 30 CAPS 100MG - 30 CAPS DR - 30 TABS KEPPRA TABS SUCRALFATE TAB 1GM - 30 TABS GABAPENTIN CAP PRIMIDONE TAB ETHOSUXIMIDE CAP LAMICTAL TABS URINARY ANTI-INFECTIVES & ANTISPASMODICS 300MG - 30 CAPS 250MG - 30 TABS 250MG - 30 CAPS LYRICA CAPS UROGESIC-BLU TAB - BETHANECHOL TAB MACRODANTIN CAP BETHANECHOL TAB GABAPENTIN CAP PRIMIDONE TAB OXCARBAZEPIN TAB 30 TABS 10MG - 30 TABS 25MG - 30 CAPS 400MG - 30 CAPS 50MG - 30 TABS 150MG - 30 TABS NEURONTIN SOL DETROL OXYBUTYNIN TAB 5MG - BETHANECHOL TAB NITROFUR MAC CAP GABAPENTIN TAB TEGRETOL XR TAB PHENYTEK CAP OXCARBAZEPIN TAB 30 TABS 25MG - 30 TABS 100MG - 30 CAPS ENABLEX 100MG - 30 TABS 100MG - 30 TABS 200MG - 30 CAPS TEGRETOL XR TABS NITROFUR MAC CAP OXYBUTYNIN TAB 10MG VALPROIC ACD CAP TEGRETOL XR TAB 50MG - 30 CAPS 250MG - 30 CAPS 200MG - 30 TABS TOPAMAX SPR CAPS OXYBUTYNIN TAB 15MG NITROFURANTN CAP ZONISAMIDE CAP TOPAMAX TABS 100MG - 30 CAPS OXYBUTYNIN TAB 5MG 100MG - 30 CAPS TRILEPTAL SUS OXYBUTYNIN SYP ER - 30 TABS ZONISAMIDE CAP 5MG/5ML - 300 ML 25MG - 30 CAPS PYRIDIUM TAB PLUS PROSED/DS TAB - 30 ZONISAMIDE CAP TABS ANCTURA 50MG - 30 CAPS URELLE TAB - 30 TABS VESICARE TAB

URISED TAB - 30 TABS

UTA CAP - 30 CAPS Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts TETRACYCLINES ANTIDEPRESSANTS

DOXYCYCL HYC CAP MINOCYCLINE CAP DOXYCYC MONO CAP ADOXA CAP AMITRIPTYLIN TAB BUPROPION TAB AMOXAPINE TAB BUDEPRION XL TABS 100MG - 30 CAPS 100MG - 30 CAPS 100MG - 30 CAPS 100MG - 30 TABS 100MG - 30 TABS 50MG - 30 TABS DORYX TAB BUPROPION TABS DOXYCYCL HYC CAP MINOCYCLINE CAP DOXYCYC MONO CAP AMITRIPTYLIN TAB BUPROPION TAB BUDEPRION TAB 50MG - 30 CAPS 50MG - 30 CAPS 50MG - 30 CAPS DOXYCYC MONO TAB 10MG - 30 TABS 75MG - 30 TABS 150MG SR - 30 TABS CYMBALTA CAPS

DOXYCYCL HYC TAB VIBRAMYCIN SYP DOXYCYCLINE TAB MINOCYCLINE TAB AMITRIPTYLIN TAB CITALOPRAM TAB BUPROPION TAB DESYREL TABS 100MG - 30 TABS 50MG/5ML - 20 ML 20MG - 30 TABS 150MG - 30 TABS 10MG - 30 TABS 100MG SR - 30 TABS SOLODYN TAB EFFEXOR XR CAPS TETRACYCLINE CAP MINOCYCLINE CAP AMITRIPTYLIN TAB CITALOPRAM TAB DESIPRAMINE TAB 250MG - 30 CAPS 75MG - 30 CAPS 25MG - 30 TABS 20MG - 30 TABS 100MG - 30 TABS IMIPRAM PAM CAPS

TETRACYCLINE CAP AMITRIPTYLIN TAB CITALOPRAM TAB FLUOXETINE CAP LEXAPRO SOL 500MG - 30 CAPS 50MG - 30 TABS 40MG - 30 TABS 40MG - 30 CAPS LEXAPRO TABS THYROID AGENTS AMITRIPTYLIN TAB CLOMIPRAMINE CAP FLUOXETINE TAB 75MG - 30 TABS 25MG - 30 CAPS 20MG - 30 TABS MIRTAZAPINE TABS ARMOUR THYRO TAB ARMOUR THYRO TAB CYTOMEL TAB 25MCG - CYTOMEL TAB 50MCG 15MG - 30 TABS 120MG - 30 TABS 30 TABS DOXEPIN HCL CAP CLOMIPRAMINE FLUVOXAMINE TAB PAROXETINE SUS 10MG - 30 CAPS CAP 50MG -30CAP 100MG - 30 TABS ARMOUR THYRO TAB ARMOUR THYRO TAB CYTOMEL TAB 5MCG - PAXIL CR TABS 30MG - 30 TABS 180MG - 30 TABS 30 TABS DOXEPIN HCL CAP DESIPRAMINE TAB MIRTAZAPINE TAB 25MG - 30 CAPS 10MG - 30 TABS 45MG - 30 TABS PEXEVA TABS ARMOUR THYRO TAB LEVOTHYROXIN TAB THYROLAR-1 TAB 60MG 60MG - 30 TABS 100MCG - 30 TABS - 30 TABS DOXEPIN HCL CAP DESIPRAMINE TAB NARDIL TAB 15MG - PROZAC 50MG - 30 CAPS 25MG - 30 TABS 30 TABS ARMOUR THYRO TAB LEVOTHYROXIN TAB TOFRANIL-PM CAPS 90MG - 30 TABS 112MCG - 30 TABS FLUOXETINE CAP DESIPRAMINE TAB NEFAZODONE TAB 20MG - 30 CAPS 50MG - 30 TABS 150MG - 30 TABS VENLAFAXINE TABS LEVOTHYROXIN TAB LEVOTHYROXIN TAB 25MCG - 30 TABS 125MCG - 30 TABS NORTRIPTYLIN CAP DESIPRAMINE TAB NEFAZODONE TAB VIVACTIL TABS 10MG - 30 CAPS 75MG - 30 TABS 250MG - 30 TABS LEVOTHYROXIN TAB LEVOTHYROXIN TAB WELLBUTRIN TABS XL 50MCG - 30 TABS 137MCG - 30 TABS NORTRIPTYLIN CAP DOXEPIN HCL CAP PAROXETINE TAB 25MG - 30 CAPS 100MG - 30 CAPS 10MG - 30 TABS PROPYLTHIOUR TAB LEVOTHYROXIN TAB 50MG - 30 TABS 150MCG - 30 TABS NORTRIPTYLIN CAP DOXEPIN HCL CAP PAROXETINE TAB 50MG - 30 CAPS 150MG - 30 CAPS 40MG - 30 TABS LEVOTHYROXIN TAB 175MCG - 30 TABS TRAZODONE TAB FLUOXETINE CAP 100MG - 30 TABS 10MG - 30 CAPS LEVOTHYROXIN TAB 200MCG - 30 TABS TRAZODONE TAB FLUOXETINE SOL 50MG - 30 TABS 20MG/5ML - 75 ML LEVOTHYROXIN TAB 300MCG - 30 TABS FLUOXETINE TAB 10MG - 30 TABS LEVOTHYROXIN TAB 75MCG - 30 TABS FLUVOXAMINE TAB 25MG - 30 TAB LEVOTHYROXIN TAB 88MCG - 30 TABS FLUVOXAMINE TAB 50MG - 30 TAB METHIMAZOLE TAB 10MG - 30 TABS IMIPRAM HCL TAB 10MG - 30 TABS METHIMAZOLE TAB 5MG - 30 TABS IMIPRAM HCL TAB 25MG - 30 TABS THYROLAR-1/4 TAB 15MG - 30 TABS

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ANTIDEPRESSANTS PENICILLINS IMIPRAM HCL TAB AMOXICILLIN SUS AMOXICILLIN SUS AUGMENTIN SUS 50MG - 30 TABS 125/5ML - 200 ML 200/5ML - 100 ML 125/5ML - 100 ML

MIRTAZAPINE TAB AMPICILLIN CAP AMOXICILLIN SUS DICLOXACILL CAP 15MG - 30 TABS 250MG - 30 CAPS 250/5ML - 300 ML 500MG - 30 CAPS

MIRTAZAPINE TAB PENICILLN VK TAB AMOXICILLIN SUS 30MG - 30 TABS 250MG - 30 TABS 400/5ML - 150 ML

NEFAZODONE TAB AMOXICILLIN TAB 50MG - 30 TABS 500MG - 20 TABS

NORTRIPTYLIN CAP AMOXICILLIN TAB 75MG - 30 CAPS 875MG - 30 TABS

NORTRIPTYLIN SOL AMPICILLIN CAP 10MG/5ML - 150 ML 500MG - 30 CAPS

PAROXETINE TAB DICLOXACILL CAP 20MG - 30 TABS 250MG - 30 CAPS

PAROXETINE TAB PENICILLN VK TAB 30MG - 30 TABS 500MG - 30 TABS

SERTRALINE TAB PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENT 100MG - 30 TABS PERPHEN/AMIT TAB PERPHEN/AMIT TAB PERPHEN/AMIT TAB ANTABUSE TAB

2-10MG - 30 TABS 2-25MG - 30 TABS 4-25MG - 30 TABS SERTRALINE TAB ARICEPT TAB 25MG - 30 TABS PERPHEN/AMIT TAB BUPROBAN TAB

4-10MG - 30 TABS 150MG - 30 TABS CHANTIX SERTRALINE TAB

50MG - 30 TABS CAMPRAL TAB EXELON

333MG - 30 TABS TRAZODONE TAB NAMENDA 150MG - 30 TABS CDP/AMITRIP TAB ANTIDIABETICS 5-12.5MG - 30 TABS NICOTROL

CHLORPROPAM TAB GLIMEPIRIDE TAB GLIP/METFORM TAB ACTOPLUS MET TAB ORAP TAB 1MG - RAZADYNE 100MG - 30 TABS 4MG - 30 TABS 2.5-250M - 30 TABS 30 TABS ACTOS TABS SARAFEM GLIMEPIRIDE TAB GLIPIZIDE ER TAB GLIP/METFORM TAB 1MG - 30 TABS 10MG - 30 TABS 2.5-500M - 30 TABS AVANDAMET TAB SYMBYAX

GLIMEPIRIDE TAB GLIPIZIDE ER TAB GLIP/METFORM TAB AVANDARYL TABS 2MG - 30 TABS 2.5MG - 30 TABS 5-500MG - 30 TABS RESPIRATORY AGENTS AVANDIA TABS PSEUDOEPHEDR TAB FLUTICASONE SPR ASTELIN NASA SPRAY GLIPIZIDE TAB GLIPIZIDE XL TAB GLUMETZA TAB 30MG - 30 TABS 50MCG - 16 ML 10MG - 30 TABS 5MG - 30 TABS 500MG - 30 TABS BYETTA INJ BECONASE AQ SUS

PSEUDOEPHEDR TAB IPRATROPIUM SPR GLIPIZIDE TAB GLYB/METFORM TAB GLYSET TAB 25MG - DUETACT TABS 60MG - 30 TABS 0.0003 - 30 ML FLUNISOLIDE SPRAY 5MG - 30 TABS 1.25/250 - 30 TABS 30 TABS

FORTAMET TABS IPRATROPIUM SPR NASACORT AQ AER GLYBURID MCR TAB GLYB/METFORM TAB GLYSET TAB 50MG - 0.0006 - 15 ML 1.5MG - 30 TABS 2.5/500 - 30 TABS 30 TABS HUMALOG INJ NASAREL SPRAY

NASALCROM SPR GLYBURIDE TAB GLYB/METFORM TAB PRECOSE TAB HUMALOG PEN INJ 5.2/ACT - 52 GM NASONEX SPRAY 1.25MG - 30 TABS 5/500MG - 30 TABS 100MG - 30 TABS

HUMULIN INJ 50/50 RHINOCORT SUS AQUA GLYBURIDE TAB GLYBURID MCR TAB PRECOSE TAB

2.5MG - 30 TABS 3MG - 30 TABS 25MG - 30 TABS HUMULIN R INJ VERAMYST SPRAY

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OPHTHALMIC AGENTS ANTIDIABETICS

LEVOBUNOLOL SOL MURO 128 OIN 5% NEO/POLY/GRA SOL CILOXAN OINT GLYBURIDE TAB GLYBURID MCR TAB PRECOSE TAB JANUMET TABS 0.5% OP - 5 ML OP - 3.5 GM OP - 10 ML COSOPT SOL 5MG - 30 TABS 6MG - 30 TABS 50MG - 30 TABS CYCLOGYL SOL JANUVIA TABSLANTUS NEO/POLY/DEX OIN MURO 128 SOL 5% PRED MILD SUS 0.12% ELESTAT METFORMIN TAB METFORMIN TAB INJ 0.1% OP - 3.5 GM OP - 15 ML OP - 10 ML ISTALOL SOL 500MG - 30 TABS 1000MG - 30 TABS KETOTIFEN LEVEMIR INJ FLEXPEN SOD SULFACET SOL NEO/BAC/POLY OIN PRED SOD PHO SOL LOTEMAX METFORMIN TAB METFORMIN TAB 10% OP - 15 ML OP - 3.5 GM 1% OP - 10 ML LUMIGAN 500MG ER - 30 TABS 750MG ER - 30 TABS NOVOLIN INJ NEVANAC SULFACET SOD OIN NEO/POLY/DEX SUS SULF/PRED NA SOL OFLOXACIN METFORMIN TAB NOVOLIN N INJ 10% OP - 3.5 GM 0.1% OP - 10 ML OP - 10 ML OPTIVAR 850MG - 30 TABS PATADAY SOL NOVOLOG MIX INJ TETRACAINE SOL PILOCARPINE SOL PATANOL SOL 0.5% OP - 15 ML 1% OP - 15 ML QUIXIN SOL PRANDIN TABS RESTASIS TIMOLOL MAL SOL PILOCARPINE SOL TOBRADEX STARLIX TABS 0.5% OP - 5 ML 4% OP - 15 ML TOBREX TRAVATAN Z SYMLIN INJ TOBRAMYCIN SOL PREDNISOLONE TRIFLURIDINE 0.3% OP - 5 ML SUS 1% OP - 10 ML TRUSOPT ANTIDIARRHEALS VIGAMOX DIPHEN/ATROP LOPERAMIDE CAP FLORA-Q CAP - TIMOLOL MAL SOL VOLTAREN LIQ 2.5/5 - 60 ML 2MG - 30 CAPS 30 CAPS 0.25% OP - 10 ML XALATAN XIBROM LONOX TAB 2.5MG - FLORASTOR CAP TRIMETHOPRIM SOL ZYLET 30 TABS 250MG - 30 CAPS POLYMYXN - 10 ML ZYMAR

TROPICAMIDE SOL 1% OP - 15 ML

OTIC AGENTS ANTIEMETICS

A/B OTIC SOL - 15 ML OTICAINE SOL 20% ACETIC ACID SOL /HC AURALGAN MECLIZINE CHW SCOPACE TAB TRIMETHOBENZ CAP EMEND OTIC - 15 ML OTIC - 10 ML 25MG - 30 CHEW 0.4MG - 30 TABS 300MG - 30 CAPS DEBROX SOL 6.5% CIPRO HC SUS OTIC - GRANISETRON TABS OT - 15 ML ZOTANE HC DRO ACETIC ACID SOL 2% MECLIZINE TAB TRIMETHOBENZ SUP AQUEOUS - 10 ML OTIC - 15 ML CIPRODEX SUS 12.5MG - 30 TABS 200MG - 20 QYT MARINOL CAPS

CORTANE-B DROP OFLOXACIN SOL MECLIZINE TAB ONDANSETRON TABS OTIC - 10 ML 25MG - 30 TABS

NEO/POLY/HC SOL TRIMETHOBENZ 1% OTIC - 10 ML SUP 100MG - 5 QYT

NEO/POLY/HC SUS ANTIFUNGALS 1% OTIC - 10 ML FLUCONAZOLE TAB FLUCONAZOLE SUS SPORANOX SOL FLUCONAZOLE SUS PRAMOTIC DROP 50MG - 2 TABS 10MG/ML - 35 ML 10MG/ML - 10 ML 1-0.1% - 10 ML GRIFULVIN V TABS NYSTATIN TAB FLUCONAZOLE TAB 500000 - 30 TABS 100MG - 30 TABS GRISEOFULVIN SUS

PENICILLINS FLUCONAZOLE TAB GRIS-PEG TABS 150MG - 4 TABS AMOXICILLIN CAP AMOX/K CLAV SUS AMOX/K CLAV CHW AUGMENTIN SUS ITRACONAZOLE CAPS 250MG - 30 CAPS 200/5ML - 50 ML 200MG - 30 CHEW FLUCONAZOLE TAB AUGMENTIN XR 200MG - 30 TABS VFEND TABS AMOXICILLIN CAP AMOXICILLIN CHW AMOX/K CLAV SUS 500MG - 30 CAPS 200MG - 30 CHEW 400/5ML - 100 ML BICILLIN L-A INJ KETOCONAZOLE TAB 200MG - 30 TABS AMOXICILLIN CHW AMOXICILLIN CHW AMPICILLIN SUS 250MG - 30 CHEW 400MG - 30 CHEW 250/5ML - 300 ML TERBINAFINE TAB 250MG - 30 TABS

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CHLORPHENIR CAP CETIRIZINE TAB ALLEGRA SUS CLARINEX RDT TABS BELLAMINE S TAB ISOMETH/APAP CAP AMERGE TAB 12MG TR - 30 CAPS 10MG - 30 TABS 30MG/5ML - 150 ML - 30 TABS DICHLOR - 30 CAPS AXERT TAB CLARINEX SYP CAFERGOT CLEMASTINE SYP CLEMASTINE TAB BROMPHENIRAM DEPAKOTE 0.5/5ML - 75 ML 2.68MG - 30 TABS CHW 12MG - 20CT CLARINEX TABS FROVA TAB IMITREX DIPHEN AF SYP CYPROHEPTAD TAB CYPROHEPTAD SYP FEXOFENADINE TABS MAXALT 12.5/5ML - 120 ML 4MG - 30 TABS 2MG/5ML - 240 ML RELPAX PHENADOZ SUP ZOMIG DIPHENHIST ELX FEXOFENADINE TAB DIPHENHYDRAM INJ 12.5/5ML - 120 ML 30MG - 30 TABS 50MG/ML - 25 ML PROMETHAZINE INJ NEUROMUSCULAR DRUGS

BACLOFEN TAB CARISOPR/ASA TAB CARISOPRODOL TAB EUFLEXXA DIPHENHIST LIQ LORATADINE SYP DIPHENMAX CHW PROMETHEGAN SUP 10MG - 30 TABS 200-325 - 30 TABS ASA/COD - 30 TABS 12.5/5ML - 30 ML 5MG/5ML - 150 ML 25MG - 20 CHEW FEXMID XYZAL TABS BACLOFEN TAB CYCLOBENZAPR TAB ORPHENADRINE TAB DIPHENHYDRAM CAP LORATADINE TAB FEXOFENADINE TAB 20MG - 30 TABS 5MG - 30 TABS 100MG ER - 30 TABS ORPHEN CPD TAB 25MG - 30 CAPS 10MG - 30 TABS 60MG - 30 TABS ZYRTEC CHW

CARISOPRODOL TAB SKELAXIN TAB DIPHENHYDRAM CAP NOHIST-EXT TAB PALGIC TAB 4MG - ZYRTEC TABS 350MG - 30 TABS 50MG - 30 CAPS 8-2.5MG - 30 TABS 30 TABS SOMA TAB

CHLORZOXAZON TAB PROMETHAZINE SYP PROMETHAZINE INJ 500MG - 30 TABS ZANAFLEX CAP 6.25/5ML - 240 ML 50MG/ML - 10 ML

CYCLOBENZAPR TAB PROMETHAZINE TAB PROMETHAZINE TAB 10MG - 30 TABS 12.5MG - 30 TABS 50MG - 30 TABS

METHOCARBAM TAB PROMETHAZINE TAB PROMETHEGAN SUP 500MG - 30 TABS 25MG - 30 TABS 25MG - 30 QYT

METHOCARBAM TAB ZYRTEC SYP 750MG - 30 TABS 1MG/ML - 75 ML

ANTIHYPERLIPIDEMICS (CHOLESTERAL LOWERING AGENTS) TIZANIDINE TAB 2MG - 30 TABS SIMVASTATIN TAB GEMFIBROZIL TAB COLESTIPOL TAB ADVICOR TABS 80MG - 15 TABS 600MG - 30 TABS 1GM - 30 TABS TIZANIDINE TAB ALTOPREV TABS 4MG - 30 TABS LOVASTATIN TAB FENOFIBRATE CAP 10MG - 30 TABS 67MG - 30 CAPS ANTARA CAPS OPHTHALMIC AGENTS

LOVASTATIN TAB FENOFIBRATE TAB CRESTOR TABS ATROPINE SUL SOL BACIT/POLYMY OIN BETAXOLOL SOL ACULAR 20MG - 30 TABS 54MG - 30 TABS 1% OP - 15 ML OP - 3.5 GM 0.5% OP - 5 ML FENOFIBRATE CAPS ALAMAST PRAVASTATIN TAB LOVASTATIN TAB BAC/POLY/NEO BRIMONIDINE SOL CARTEOLOL SOL 10MG - 30 TABS 40MG - 30 TABS LESCOL CAPS OIN /HC OP1% - 3.5 GM 0.2% OP - 5 ML OPHTH 1% - 10 ML ALOCRIL

PRAVASTATIN TAB LOVAZA CAP LESCOL XL TABS BACITRACIN OIN OP - CROMOLYN SOD CIPROFLOXACN SOL ALOMIDE 20MG - 30 TABS 1GM - 30 CAPS 3.5 GM SOL 4% OP - 10 ML 0.3% OP - 5 ML LIPITOR TABS ALPHAGAN SIMVASTATIN TAB PRAVASTATIN TAB CYCLOPENTOL GENTAK OIN 0.3% FLUOROMETHOL SUS 10MG - 30 TABS 40MG - 30 TABS NIASPAN TABS SOL 1% OP - 15 ML OP - 3.5 GM 0.1% OP - 15 ML ALREX

SIMVASTATIN TAB TRICOR TAB PRAVASTATIN ERYTHROMYCIN HOMATROPAIRE SOL FML S.O.P. OIN 0.1% AZASITE 20MG - 30 TABS 48MG - 30 TABS TABS OIN OP - 3.5 GM 5% OP - 5 ML OP - 3.5 GM AZOPT SIMVASTATIN TAB WELCHOL TAB TRICOR TABS FLURBIPROFEN SOL LACRI-LUBE OIN FRESHKOTE DRO - 40MG - 30 TABS 625MG - 30 TABS 0.03% OP - 2.5 ML S.O.P. - 3.5 GM 15 ML BETIMOL TRIGLIDE TABS SIMVASTATIN TAB GENTAMICIN LEVOBUNOLOL SOL ISO HYOSCINE SOL BETOPTIC-S 5MG - 30 TABS VYTORIN TABS SOL 0.3% OP - 5 ML 0.25% OP - 10 ML 0.25% OP - 5 ML BLEPHAMIDE SUS ZETIA TABS

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HYPNOTICS ANTIHYPERTENSIVES

CHLORAL HYDR SYP ESTAZOLAM TAB ESTAZOLAM TAB AMBIEN CR ATENOL/CHLOR TAB ATENOL/CHLOR TAB CAPTOPR/HCTZ TAB ACEON TABS 500/5ML - 25 ML 1MG - 30 TABS 2MG - 30 TABS 50-25MG - 30 TABS 100-25MG - 30 TABS 50-15MG - 30 TABS LUNESTA ALTACE CAPS FLURAZEPAM CAP PHENOBARB ELX CAPTOPR/HCTZ TAB BENAZEP/HCTZ TAB DOXAZOSIN TAB 15MG - 30 CAPS 20MG/5ML - 565 ML RESTORIL 25-15MG - 30 TABS 10-12.5 - 30 TABS 1MG - 30 TABS AMLOD/BENAZP CAPS

FLURAZEPAM CAP TRIAZOLAM TAB ROZEREM CAPTOPRIL TAB BENAZEP/HCTZ TAB DOXAZOSIN TAB ATACAND HCT TABS 30MG - 30 CAPS 0.25MG - 30 TABS 12.5MG - 30 TABS 20-12.5 - 30 TABS 4MG - 30 TABS SONATA ATACAND TABS PHENOBARB TAB ZOLPIDEM TAB CAPTOPRIL TAB BENAZEP/HCTZ TAB FOSINOP/HCTZ TAB 15MG - 30 TABS 10MG - 30 TABS 25MG - 30 TABS 20-25MG - 30 TABS 10/12.5 - 30 TABS AVALIDE TABS

PHENOBARB TAB ZOLPIDEM TAB CAPTOPRIL TAB BENAZEPRIL TAB FOSINOP/HCTZ TAB AVAPRO TABS 16.2MG - 30 TABS 5MG - 30 TABS 50MG - 30 TABS 10MG - 30 TABS 20/12.5 - 30 TABS AZOR TABS PHENOBARB TAB CLONIDINE TAB BENAZEPRIL TAB HYDRALAZINE TAB 30MG - 30 TABS 0.1MG - 30 TABS 20MG - 30 TABS 100MG - 30 TABS BENICAR HCT TABS

PHENOBARB TAB CLONIDINE TAB BENAZEPRIL TAB METOPRL/HCTZ TAB BENICAR TABS 32.4MG - 30 TABS 0.2MG - 30 TABS 40MG - 30 TABS 50-25MG - 30 TABS CORZIDE TABS PHENOBARB TAB CLONIDINE TAB BENAZEPRIL TAB MOEXIPR/HCTZ TAB 60MG - 30 TABS 0.3MG - 30 TABS 5MG - 30 TABS 15-12.5 - 30 TABS COZAAR TABS

PHENOBARB TAB ENALAPRIL TAB BISOPRL/HCTZ TAB MOEXIPR/HCTZ TAB DIBENZYLINE CAPS 64.8MG - 30 TABS 10MG - 30 TABS 10/6.25 - 30 TABS 15-25MG - 30 TABS DIOVAN HCT TABS PHENOBARB TAB ENALAPRIL TAB BISOPRL/HCTZ TAB MOEXIPR/HCTZ TAB 97.2MG - 30 TABS 2.5MG - 15 TABS 2.5/6.25 - 30 TABS 7.5-12.5 - 30 TABS DIOVAN TABS

TEMAZEPAM CAP ENALAPRIL TAB BISOPRL/HCTZ TAB MOEXIPRIL TAB EXFORGE TABS 15MG - 30 CAPS 5MG - 30 TABS 5/6.25MG - 30 TABS 15MG - 30 TABS HYZAAR TABS TEMAZEPAM CAP LISINOPRIL TAB DOXAZOSIN TAB MOEXIPRIL TAB 30MG - 30 CAPS 10MG - 30 TABS 2MG - 30 TABS 7.5MG - 30 TABS INSPRA TABS

TRIAZOLAM TAB LISINOPRIL TAB DOXAZOSIN TAB QNAPRIL/HCTZ TAB LEXXEL TABS 0.125MG - 15 TABS 2.5MG - 30 TABS 8MG - 30 TABS 10-12.5 - 30 TABS LOTREL CAPS IMPOTENCE AGENTS LISINOPRIL TAB ENALAPR/HCTZ TAB QNAPRIL/HCTZ TAB 20MG - 30 TABS 10-25MG - 30 TABS 20-12.5 - 30 TABS METOPRL/HCTZ TABS YOHIMBINE TAB CIALIS

5.4MG - 30 TABS LEVITRA LISINOPRIL TAB ENALAPR/HCTZ TAB QUINARETIC TAB MICARDIS HCT TABS VIAGRA 5MG - 30 TABS 5-12.5MG - 30 TABS 20-25MG - 30 TABS

MICARDIS TABS LAXATIVES METHYLDOPA TAB ENALAPRIL TAB TRANDOLAPRIL 250MG - 30 TABS 20MG - 30 TABS TAB 1MG - 30 TABS NADOLOL/BEND TABS BISACODYL TAB 5MG COLACE LIQ OSMOPREP TAB EC - 30 TABS 150/15ML - 60 ML PRAZOSIN HCL CAP FOSINOPRIL TAB TRANDOLAPRIL RAMIPRIL CAPS 1MG - 30 CAPS 10MG - 30 TABS TAB 2MG - 30 TABS DOCUSATE SOD CAP LACTULOSE SOL TARKA TABS 100MG - 30 CAPS 10GM/15 - 473 ML PROPRAN/HCTZ TAB FOSINOPRIL TAB TRANDOLAPRIL 40/25 - 30 TABS 20MG - 30 TABS TAB 4MG - 30 TABS TEKTURNA HCT TABS DOCUSATE SOD CAP 250MG - 30 CAPS FOSINOPRIL TAB TEKTURNA TABS 40MG - 30 TABS MAG CITRATE SOL TEVETEN HCT TAB LEMON - 296 ML GUANFACINE TAB 1MG - 30 TABS SENNA LAX TAB 8.6MG - 30 TABS GUANFACINE TAB 2MG - 30 TABS SENNA S TAB 8.6-50MG - 30 TABS Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts ANTIHYPERTENSIVES HEART/HIGH BLOOD PRESSURE HYDRALAZINE TAB VERAPAMIL CAP 10MG - 30 TABS 240MG ER - 30 CAPS

HYDRALAZINE TAB VERAPAMIL TAB 25MG - 30 TABS 120MG ER - 30 TABS

HYDRALAZINE TAB 50MG - 30 TABS

LISINOP/HCTZ TAB HEMATOLOGICAL AGENTS 10-12.5 - 30 TABS FE C TAB - 30 TABS CILOSTAZOL TAB ANAGRELIDE CAP 1MG - AGGRENOX CAP LISINOP/HCTZ TAB 100MG - 30 TABS 30 CAPS 20-12.5 - 30 TABS FERREX 150 CAP CEREFOLIN TAB CILOSTAZOL TAB ANIMI-3 CAP - 30 CAPS LISINOP/HCTZ TAB FORTE - 30 CAPS 50MG - 30 TABS PLAVIX TAB 20-25MG - 30 TABS CHROMAGEN CAP - FERROUS GLUC TAB DIPYRIDAMOLE TAB 30 CAPS LISINOPRIL TAB 324MG - 30 TABS 25MG - 30 TABS 30MG - 30 TABS CHROMAGEN CAP FERROUS GLUC TAB FABB TAB - 30 TABS FORTE - 30 CAPS LISINOPRIL TAB 325MG - 30 TABS 40MG - 30 TABS FOLBEE TAB - 30 TABS CHROMAGEN FA TAB FERROUS SULF - 30 TABS METHYLDOPA TAB DRO - 50 ML FOLBIC TAB - 30 TABS 500MG - 30 TABS CHROMAGEN TAB FERROUS SULF ELX FOLCAPS TAB - 30TABS - 30 TABS MINOXIDIL TAB 220/5ML - 150 ML 10MG - 15 TABS FOLIC ACID TAB CHROMAGEN TAB FERROUS SULF TAB 1MG - 30 TABS FORTE - 30 TABS MINOXIDIL TAB 325MG - 30 TABS 2.5MG - 30 TABS FOLITAB TAB - 30 TABS DEXFERRUM INJ FERROUS SULF TAB 50MG/ML - 2 ML PRAZOSIN HCL CAP 325MG EC - 30 TABS FOLPACE RX TAB - 2MG - 30 CAPS 30 TABS DIPYRIDAMOLE TAB FOLGARD TAB - 75MG - 30 TABS PRAZOSIN HCL CAP 30 TABS FOLTRIN CAP - 30 CAPS 5MG - 30 CAPS EPOGEN INJ FOLIC ACID TAB HEMOCYTE TAB 2000/ML - 1 ML QUINAPRIL TAB 400MCG - 30 TABS 324MG - 30 TABS 10MG - 30 TABS FOLIC ACID INJ NU-IRON 150 CAP HEMOCYTE-F TAB - 5MG/ML - 10 ML QUINAPRIL TAB 150MG - 30 CAPS 30 TABS 20MG - 30 TABS METANX TAB - 30 TABS PENTOXIFYLLI TAB ICAR-C PLUS TAB - QUINAPRIL TAB 400MG ER - 30 TABS 30 TABS NIFEREX-150 CAP - 40MG - 30 TABS 30 CAPS VITAMIN B-12 TAB NIFEREX CAP - 30 CAP QUINAPRIL TAB 1000MCG - 30 TABS NIFEREX-150 CAP - 5MG - 30 TABS NIFEREX ELX 30 CAPS 100/5ML - 75 ML TERAZOSIN CAP REPLIVA 21/7 TAB - 30 10MG - 30 CAPS TANDEM CAP - 30 CAPS TABS

TERAZOSIN CAP TANDEM F CAP - 30 1MG - 30 CAPS CAPS

TERAZOSIN CAP TANDEM PLUS CAP - 2MG - 30 CAPS 30 CAPS

TERAZOSIN CAP TICLOPIDINE TAB 5MG - 30 CAPS 250MG - 30 TABS Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts

HEART/HIGH BLOOD PRESSURE ANTI-INFECTIVE AGENTS

CARVEDILOL TAB DIGOXIN SOL DILTIAZEM CAP DYNACIRC CR TAB ERY-TAB TAB 250MG ALBENZA TAB CLARITHROMYC SUS AVELOX TABS 6.25MG - 30 TABS 0.05/ML - 24 ML 240MG/24 - 30 CAPS EC - 30 TABS 200MG - 12 TABS 125/5ML - 100 ML FELODIPINE TAB AZITHROMYCIN SUS DIGITEK TAB DILTIAZEM TAB DILT-XR CAP ERYTHROCIN TAB CIPROFLOXACN TAB CLARITHROMYC TAB 0.25MG - 30 TABS 120MG - 30 TABS 180MG - 30 CAPS INNOPRAN XL 250MG - 30 TABS 250MG - 30 TABS 250MG - 28 TABS AZITHROMYCIN TABS

DIGOXIN TAB DILT-XR CAP FELODIPINE TAB ISRADIPINE CAP ERYTHROCIN TAB CIPROFLOXACN TAB OFLOXACIN TAB CIPRO XR TABS 0.125MG - 30 TABS 120MG - 30 CAPS 2.5MG ER - 30 TABS 500MG - 30 TABS 500MG - 30 TABS 200MG - 6 TABS LEVATOL TAB CIPROFLOXACN TABS DILTIAZEM TAB DILT-XR CAP FELODIPINE TAB ERYTHROM ETH CIPROFLOXACN TAB 30MG - 30 TABS 240MG - 30 CAPS 5MG ER - 30 TABS METOPROLOL TAB SUS 400/5ML - 50 ML 750MG - 30 TABS CLARITHROMYC SUS

DILTIAZEM TAB ISOSORB MONO TAB ISORDIL TAB NIFEDIAC CC TAB ERYTHROM ETH TAB ERY-TAB TAB 333MG CLARITHROMYC TABS 60MG - 30 TABS 120MG ER - 30 TABS 40MG - 30 TABS 400MG - 30 TABS EC - 30 TABS NIFEDICAL XL TAB FACTIVE TABS DILTIAZEM TAB ISOSORB MONO TAB ISRADIPINE CAP ERYTHROMYCIN CAP ERY-TAB TAB 500MG 90MG - 30 TABS 20MG - 30 TABS 2.5MG - 30 CAPS NIFEDIPINE TAB 250MG EC - 30 CAPS EC - 30 TABS LEVAQUIN TABS

ISOSORB DIN TAB ISOSORB MONO TAB METOPROLOL TAB NIMODIPINE CAP ERYTHROMYCIN TAB ERYTHROM ETH SUS OFLOXACIN TABS 10MG - 30 TABS 60MG ER - 30 TABS 100MG ER - 30 TABS 250MG - 30 TABS 200/5ML - 200 ML NITROLINGUAL SPR PAROMOMYCIN CAPS ISOSORB DIN TAB LABETALOL TAB METOPROLOL TAB ERYTHROMYCIN TAB MEBENDAZOLE CHW 20MG - 30 TABS 200MG - 30 TABS 25MG ER - 30 TABS PUMPSPRA - 12 ML BS 500MG - 30 TABS 100MG - 2 CHEW PROQUIN XR TABS

ISOSORB DIN TAB LABETALOL TAB METOPROLOL TAB PAPAVERINE CAP NEOMYCIN TAB ZMAX SUS 5MG - 9 TABS 300MG - 30 TABS 50MG ER - 30 TABS 500MG - 6 TABS PROPRANOLOL ISOSORB MONO TAB LANOXICAPS CAP NIFEDIAC CC TAB STROMECTOL TAB 30MG ER - 30 TABS 0.1MG - 30 CAPS 30MG ER - 30 TABS RANEXA 3MG - 2 TABS

LABETALOL TAB LANOXICAPS CAP NIFEDIPINE CAP REVATIO TABS ANTI-INFECTIVE AGENTS - MISC. 100MG - 30 TABS 0.2MG - 30 CAPS 10MG - 30 CAPS SULAR TABS DAPSONE TAB CLINDAMYCIN CAP CLINDAMYCIN CAP CLEOCIN CAPS METOPROLOL TAB NADOLOL TAB NIFEDIPINE TAB 100MG - 30 TABS 150MG - 30 CAPS 300MG - 30 CAPS 100MG - 30 TABS 20MG - 30 TABS 30MG ER - 30 TABS VERAPAMIL CAPS KETEK PAK TABS METRONIDAZOL TAB SMZ/TMP DS TAB EES/SULFISOX SUS METOPROLOL TAB NADOLOL TAB PINDOLOL TAB VERELAN PM CAP 250MG - 30 TABS 800-160 - 30 TABS 200-600 - 200 ML METRONIDAZOL CAPS 25MG - 30 TABS 40MG - 30 TABS 5MG - 30 TABS METRONIDAZOL TAB SMZ-TMP TAB TINDAMAX TABS METOPROLOL TAB NADOLOL TAB PROPRANOLOL CAP 500MG - 30 TABS 400-80MG - 30 TABS 50MG - 30 TABS 80MG - 30 TABS 60MG ER - 30 CAPS VANCOCIN HCL CAPS SULFATRIM SUS NITROGLYCER CAP NITRO-BID OIN PROPRANOLOL CAP 200-40/5 - 150 ML XIFAXAN TABS 6.5MG ER - 30 CAPS 0.02 - 60 GM 80MG ER - 30 CAPS TRIMETHOPRIM TAB PROPRANOLOL TAB SOTALOL AF TAB PROPRANOLOL TAB 100MG - 30 TABS 10MG - 30 TABS 80MG - 30 TABS 60MG - 30 TABS ANTIMALARIALS PROPRANOLOL TAB SOTALOL HCL TAB TAZTIA XT CAP HYDROXYCHLOR CHLOROQUINE MALARONE TABS 20MG - 30 TABS 120MG - 30 TABS 120MG/24 - 30 CAPS TAB 200MG - 30CT TAB 500MG - 7 CT

PROPRANOLOL TAB SOTALOL HCL TAB TAZTIA XT CAP QUININE SULF CAP MEFLOQUINE TAB QUALAQUIN CAPS 40MG - 30 TABS 160MG - 30 TABS 180MG/24 - 30 CAPS 200MG - 30 CAPS 250MG - 4 TABS

PROPRANOLOL TAB VERAPAMIL TAB TAZTIA XT CAP QUININE SULF CAP QUININE SULF TAB 80MG - 30 TABS 180MG ER - 30 TABS 360MG/24 - 30 CAPS 325MG - 30 CAPS 260MG - 30 TABS

SOTALOL HCL TAB VERAPAMIL TAB VERAPAMIL CAP 80MG - 30 TABS 240MG ER - 30 TABS 120MG ER - 30 CAPS

VERAPAMIL TAB VERAPAMIL TAB VERAPAMIL CAP 120MG - 30 TABS 40MG - 30 TABS 180MG ER - 30 CAPS

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ANTINEOPLASTICS GASTROINTESTINAL AGENTS

LEUCOVOR CA TAB CEENU CAP 10MG - FLUTAMIDE CAP ALKERAN TABS METOCLOPRAM SOL DIPENTUM CAPS 5MG - 4 TABS 1 CAPS 125MG - 30 CAPS 5MG/5ML - 30 ML ARIMIDEX TABS LIALDA TABS METHOTREXATE INJ HYDROXYUREA CAP LEUKERAN TAB METOCLOPRAM TAB 25MG/ML - 2 ML 500MG - 30 CAPS 2MG - 15 TABS AROMASIN TABS 10MG - 30 TABS PENTASA CAPS

MEGESTROL AC TAB TAMOXIFEN TAB CASODEX TABS METOCLOPRAM TAB RENAGEL 40MG - 30 TABS 20MG - 30 TABS 5MG - 30 TABS CYCLOPHOSPH TABS URSO 250 METHOTREXATE TAB RA ANTACID CHW 2.5MG - 30 TABS FEMARA TABS 500MG - 30 CHEW URSO FORTE TAB

TAMOXIFEN TAB LYSODREN TABS SIMETHICONE CHW ZELNORM TABS 10MG - 30 TABS 80MG - 30 CHEW MATULANE CAPS SODIUM BICAR TAB MEGESTROL AC SUS 650MG - 30 TABS

MERCAPTOPUR TABS SULFASALAZIN TAB 500MG - 30 TABS NILANDRON TABS GENITOURINARY AGENTS SUTENT CAPC PHENAZOPYRID TAB POT CITRATE TAB AVODART CAPS

100MG - 16 TABS 1080MG - 30 TABS TARCEVA TABS ELMIRON CAPS

PHENAZOPYRID TAB POT CITRATE TAB TAXOL INJ 200MG - 30 TABS 540MG - 30 TABS FINASTERIDE TABS

XELODA TABS SODIUM CHLOR SOL FLOMAX

0.9% IRR - 1000 ML

UROXATRAL TABS ANTIPARKINSON AGENTS GOUT AGENTS AMANTADINE SYP AMANTADINE CAP KEMADRIN TAB AZILECT TABS ALLOPURINOL TAB PROBENECID TAB PROBEN/COLCH TAB 50MG/5ML - 21 ML 100MG - 30 CAPS 5MG - 30 TABS 100MG - 30 TABS 500MG - 30 TABS 500-0.5 - 30 TABS BROMOCRIPTIN CAPS

BENZTROPINE TAB CARB/LEVO ER TAB SELEGILINE TAB ALLOPURINOL TAB 0.5MG - 30 TABS 25/100 - 30 TABS 5MG - 30 TABS BROMOCRIPTIN TAB 300MG - 30 TABS

BENZTROPINE TAB CARB/LEVO TAB CARB/LEVO ER TAB COLCHICINE TAB 1MG - 30 TABS 10-100MG - 30 TAB 0.6MG - 30 TABS COMTAN TABS BENZTROPINE TAB CARB/LEVO TAB 2MG - 30 TABS 25-100MG - 30 TAB MIRAPEX TABS HEART/HIGH BLOOD PRESSURE

TRIHEXYPHEN TAB CARB/LEVO TAB REQUIP TABS ATENOLOL TAB ACEBUTOLOL CAP BETAXOLOL TAB BYSTOLIC TAB 2MG - 30 TABS 25-250MG - 30 TAB 100MG - 30 TABS 200MG - 30 CAPS 10MG - 30 TABS STALEVO 150 TABS CADUET SELEGILINE CAP ATENOLOL TAB ACEBUTOLOL CAP BISOPROL FUM TAB 5MG - 30 CAPS STALEVO 100 TABS 25MG - 30 TABS 400MG - 30 CAPS 10MG - 30 TABS CARDIZEM CD

TRIHEXYPHEN TAB STALEVO 50 TABS ATENOLOL TAB AMLODIPINE TAB CARTIA XT CAP CARDIZEM LA 5MG - 30 TABS 50MG - 30 TABS 10MG - 30 TABS 240/24HR - 30 CAPS ZELAPAR TABS CARTIA XT CARVEDILOL TAB AMLODIPINE TAB DILTIAZEM CAP 12.5MG - 30 TABS 2.5MG - 30 TABS 120MG CD - 30 CAPS COREG CR

CARVEDILOL TAB AMLODIPINE TAB DILTIAZEM CAP COVERA-HS 25MG - 30 TABS 5MG - 30 TABS 120MG ER - 30 CAPS DILTIAZEM CAPS CARVEDILOL TAB BISOPROL FUM TAB DILTIAZEM CAP 3.125MG - 30 TABS 5MG - 15 TABS 180MG CD - 30 CAPS DYNACIRC CR TAB

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HYDROCHLOROT TAB TORSEMIDE TAB CHLORPROMAZ TAB FLUPHENAZINE TAB EQUETRO CAP ABILIFY TABS 50MG - 30 TABS 10MG - 30 TABS 10MG - 10 TABS 1MG - 30 TABS 200MG - 30 CAPS CLOZAPINE TABS INDAPAMIDE TAB TORSEMIDE TAB HALOPERIDOL TAB FLUPHENAZINE TAB FLUPHENAZ DE INJ 1.25MG - 30 TABS 20MG - 30 TABS 0.5MG - 30 TABS 2.5MG - 30 TABS 25MG/ML - 5 ML GEODON CAPS

INDAPAMIDE TAB TRIAMT/HCTZ CAP HALOPERIDOL TAB FLUPHENAZINE TAB HALOPERIDOL TAB HALOPER DEC INJ 2.5MG - 30 TABS 50-25MG - 30 CAPS 1MG - 30 TABS 5MG - 30 TABS 10MG - 30 TABS INVEGA TABS TRIAM/HCTZ CAP HALOPERIDOL TAB LITHIUM CARB TAB 37.5-25 - 30 CAPS 2MG - 30 TABS 300MG ER - 30 TABS PROCHLORPER SUP

TRIAMT/HCTZ TAB HALOPERIDOL TAB LITHIUM CARB TAB RISPERDAL M TABS 37.5-25 - 30 TABS 5MG - 30 TABS 450MG ER - 30 TABS SEROQUEL TABS TRIAMT/HCTZ TAB LITHIUM CARB CAP PERPHENAZINE TAB 75-50MG - 30 TABS 150MG - 30 CAPS 2MG - 30 TABS SEROQUEL XR TABS

ENDOCRINE AND METABOLIC AGENTS LITHIUM CARB CAP PERPHENAZINE TAB ZYPREXA TABS 300MG - 30 CAPS 4MG - 30 TABS ALENDRONATE TAB ACTONEL TABS ZYPREXA ZYDI TABS 35MG - 4 TABS ALENDRONATE TABS LITHIUM CARB TAB THIORIDAZINE TAB BONIVA TABS 300MG - 30 TABS 100MG - 30 TABS ALENDRONATE TAB CABERGOLINE TABS

70MG - 4 TABS DESMOPRESSIN PROCHLORPER TAB THIORIDAZINE TAB EVISTA TABS 10MG - 30 TABS 10MG - 30 TABS CLOMIPHENE TAB FORTEO

50MG - 5 TABS FORTICAL PROCHLORPER TAB THIORIDAZINE TAB FOSAMAX + D 5MG - 30 TABS 50MG - 30 TABS LEVOCARNITIN TAB SENSIPAR TABS

330MG - 30 TABS THIOTHIXENE CAP THIOTHIXENE CAP ESTROGENS 1MG - 30 CAPS 5MG - 30 CAPS

ESTRADIOL TAB ESTROPIPATE TAB ENJUVIA TAB ACTIVELLA TABS THIOTHIXENE CAP 0.5MG - 30 TABS 0.75MG - 30 TABS 0.625MG - 30 TABS 2MG - 30 CAPS CENESTIN TABS ANTIVIRALS ESTRADIOL TAB ESTROPIPATE TAB EST ESTROGEN TAB 1MG - 30 TABS 1.5MG - 30 TABS MTEST DS - 30 TABS ENJUVIA TABS ACYCLOVIR CAP RIMANTADINE TAB ACYCLOVIR SUS 200MG - 30 CAPS 100MG - 14 T COMBIVIR ESTRADIOL TAB EST ESTROGEN TAB ESTROGEL DIDANOSINE CAPS 2MG - 30 TABS MTEST HS - 30 TABS ACYCLOVIR TAB EPIVIR HBV TABS FEMHRT 400MG - 30 TABS EPZICOM TABS ESTRASORB FAMCICLOVIR EMU - 48.72 QTY FEMTRACE TAB ACYCLOVIR TAB KALETRA TABS 800MG - 30 TABS NORVIR CAPS MENEST TAB PREFEST TABS PEGASYS INJ 0.625MG - 30 TABS PREZISTA TABS PREMARIN TABS RETROVIR TABS MENEST TAB REYATAZ CAPS 1.25MG - 30 TABS PREMPHASE TABS SUSTIVA TABS TAMIFLU CAPS PREMARIN TAB PREMPRO TABS TRIZIVIR 0.9MG - 15 TABS TRUVADA GASTROINTESTINAL AGENTS VALTREX TABS VIRAMUNE TAB ENULOSE SOL PHOSLO CAP PENTASA CAP AMITIZA CAPS VIREAD TABS 10GM/15 - 450 ML 667MG - 30 CAPS 250MG CR - 30 CAPS ZIAGEN TABS ASACOL TABS MAG OXIDE TAB SULFAZINE EC TAB URSODIOL CAP 400MG - 30 TABS 500MG - 30 TABS 300MG - 30 CAPS BALSALAZIDE CAP

CANASA

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CENTRAL NERVOUS SYSTEM DRUGS DERMATOLOGICALS

DEXTROAMPHET TAB DEXTROAMPHET DEXMETHYLPH TAB ADDERALL XR CAPS U-CORT CRE 0.01 - TRI-LUMA 5MG - 30 TABS TAB 10MG - 30 TABS 5MG - 30 TABS 28.35 QTY CAFCIT SOL UMECTA METHYLIN TAB 5MG - DIETHYLPROP TAB DEXTROAMPHET CAP XOLEGEL GEL 0.02 - 30 TABS 25MG - 30 TABS 10MG CR - 30 CAPS CONCERTA TABS 15 QTY UREA

METHYLPHENID TAB FOCALIN TAB 2.5MG - DEXTROAMPHET CAP FOCALIN TABS ZACLIR LOT 0.08 - VANIQA CREAM 10MG - 30 TABS 30 TABS 15MG CR - 30 CAPS 170.1 QTY FOCALIN XR CAPS VANOS CREAM PHENDIMETRAZ METHYLIN TAB 20MG - DEXTROAMPHET CAP 8-MOP CAP 10MG - TAB 35MG - 30 TABS 30 TABS 5MG CR - 30 CAPS MERIDIA CAPS 8 CAPS VUSION OINT

PHENTERMINE CAP DIETHYLPROP TAB METADATE CD CAPS ZACLIR LOTION 30MG - 30 CAPS 75MG ER - 30 TABS PHENTERMINE CAPS ZIANA GEL PHENTERMINE TAB METHYLIN ER TAB 37.5MG - 30 TABS 20MG - 30 TABS PROVIGIL TABS ZIOX OINT

PHENDIMETRAZ CAP RITALIN LA CAPS ZONALON CREAM 105MG ER - 30 CAPS STRATTERA CAPS ZOVIRAX PHENTERMINE CAP 15MG - 30 CAPS VYVANSE CAPS DIGESTIVE AIDS

PANCREASE MT CAP CREON 10 CAP EC - PALCAPS 20 CAP - XENICAL CAPS 4 - 30 CAPS 30 CAPS 30 CAPS CEPHALOSPORINS PANOKASE TAB - PANGES MT 16 CAP - PANCREASE MT CAP CEPHALEXIN CAP CEPHALEXIN CAP CEFACLOR CAP CEDAX CAPS 30 TABS 30 CAPS 20 - 30 CAPS 250MG - 30 CAPS 500MG - 30 CAPS 250MG - 30 CAPS CEFACLOR SUS PANGES UL 20 CAP - CEPHALEXIN SUS CEFACLOR CAP 30 CAPS 125/5ML - 100 ML 500MG - 30 CAPS CEFADROXIL SUS VIOKASE 16 TAB - SUPRAX TAB CEFACLOR SUS CEFDINIR CAPS 30 TABS 400MG - 1 TABS 125/5ML - 150 ML CEFDINIR SUS DIURETICS CEFACLOR SUS 375/5ML - 100 ML CEFPODOXIME TABS ACETAZOLAMID TAB ACETAZOLAMID TAB DYRENIUM CAP DIAMOX CAP 125MG - 24 TABS 250MG - 30 TABS 50MG - 30 CAPS CEFADROXIL CAP CEFPROZIL SUS 500MG - 30 CAPS AMILOR/HCTZ TAB BUMETANIDE TAB METOLAZONE TAB CEFPROZIL TABS 18384 - 30 TABS 1MG - 30 TABS 2.5MG - 30 TABS CEFPROZIL SUS 125/5ML - 100 ML CEFTIN SUS BUMETANIDE TAB BUMETANIDE TAB METOLAZONE TAB 0.5MG - 30 TABS 2MG - 30 TABS 5MG - 30 TABS CEFUROXIME TAB CEFUROXIME TABS 250MG - 30 TABS CHLORTHALID TAB FUROSEMIDE SOL SPIRONOLACT TAB SPECTRACEF TAB 25MG - 30 TABS 10MG/ML - 60 ML 100MG - 30 TABS CEPHALEXIN SUS 250/5ML - 200 ML SUPRAX SUS FUROSEMIDE TAB HYDROCHLOROT CAP TORSEMIDE TAB 20MG - 30 TABS 12.5MG - 30 CAPS 100MG - 30 TABS KEFLEX CAP 750MG - 10 CAPS FUROSEMIDE TAB SPIRONO/HCTZ TAB 40MG - 30 TABS 25/25 - 30 TABS CONTRACEPTIVES FUROSEMIDE TAB SPIRONOLACT TAB ARANELLE TAB - FEMCON FE CHW 80MG - 15 TABS 25MG - 30 TABS 28 TABS JOLESSA TABS HYDROCHLOROT TAB SPIRONOLACT TAB AVIANE TAB - 28 TABS 25MG - 30 TABS 50MG - 30 TABS KARIVA TABS BALZIVA TAB - 28 TABS LOESTRIN 21 TABS Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts

DERMATOLOGICALS CONTRACEPTIVES SILVER SULFA CRE HYDROQUINONE LUSTRA-ULTRA CREAM MICROGESTIN TAB FE LOESTRIN 24 TAB 0.01 - 50 QTY CRE 0.04 - 28.35 QTY 1/20 - 28 TABS MENTAX CREAM LYBREL TABS SWEEN CRE - 340 QTY KENALOG AER MICROGESTIN TAB TERBINAFINE CRE SPRAY - 63 GM METROGEL GEL FE1.5/30 - 28 TABS 0.01 - 24 QTY MEDROXYPR AC INJ KETOCONAZOLE METRONIDAZOL NECON 7/7/7 TAB TRIAMCINOLON CRE CRE 0.02 - 60 QTY 28 DAY - 28 TABS OGESTREL TABS - 0.001 - 160 QTY MIMYX CREAM LACTIC ACID LOT NECON TAB 1/50- ORTHO TRI-CY TAB LO ULTRALYTIC 2 CRE - 0.1 - 354.84 QTY NAFTIN CREAM 28 - 28 TABS 113 QTY OVCON 50 TABS LIDOCAINE CRE NAFTIN GEL NECON TAB 47037 - ZOSTRIX-HP CRE 0.03 - 28.35 QTY 28 TABS TILIA FE TAB 0.00075 - 56.6 QTY NEOBENZ MICR CREAM LMX 4 CRE 0.04 - 15 QTY NORTREL (28) TAB YASMIN 28 TAB NORITATE CREAM 12785 - 28 TABS LOKARA LOT 0.0005 - YAZ TAB 3-0.02MG 118 QTY ORACEA CAPS NORTREL 28 TAB 0.5/35 - 28 TABS MOMETASONE OSCION CLNSR LOT CRE 0.001 - 45 QTY PLAN B TAB 0.75MG - OXISTAT 2 TABS MOMETASONE OIN 0.001 - 30 GM PANDEL CREAM RECLIPSEN TAB - 28 TABS MOMETASONE SOL PODOFILOX SOL 0.001 - 30 ML SPRINTEC 28 TAB PRAMOSONE 28 DAY - 28 TABS MUPIROCIN OIN 0.02 - 44 GM PROPECIA TABS TRINESSA TAB - 28 TABS NICOMIDE-T CRE PROTOPIC 0.04 - 30 QTY TRIVORA-28 TAB - PSORCON E 28 TABS NUOX GEL 6-3% - 43 QTY RENOVA CREAM VELIVET PAK - 28 TABS

OSCION CLNSR RETIN-A ZOVIA 1/35E TAB - LOT 0.09 - 170.3 QTY 28 TABS ROSULA PRAMOSONE CRE ZOVIA 1/50E TAB - 0.01 - 28.4 QTY SEB-PREV LIQ WASH - 28 TABS

ROGAINE SOL 2% SILVASORB GEL CORTICOSTEROIDS WOMEN - 60 ML DEXAMETHASON TAB DEXAMETH PHO INJ DEXPAK PAK 13 DAY - DEXAMETHASON ELX SOLAGE SOL 0.5MG - 30 TABS 4MG/ML - 30 ML 30 TABS SOD SUL/SULF LOT ENTOCORT EC 10%-5% - 25 QTY SOLARAZE GEL 3% DEXAMETHASON TAB DEXAMETHASON TAB FLUDROCORT TAB CAPS

0.75MG - 30 TABS 2MG - 30 TABS 0.1MG - 30 TABS TRETINOIN GEL 0.0001 - SORIATANE METHYLPR ACE INJ 15 QTY DEXAMETHASON TAB HYDROCORT TAB 10MG MEDROL TAB 16MG - 12 SOTRET CAPS 1.5MG - 30 TABS - 30 TABS TABS ORAPRED ODT TABS TRETINOIN GEL 0.00025

- 15 QTY SULFACETAMID DEXAMETHASON TAB METHYLPRED TAB 4MG PREDNISOLONE SOL ORAPRED ODT TABS

1MG - 12 TABS - 30 TABS 15MG/5ML - 120 ML TRIAMCINOLON LOT SUPHERA CREAM

0.001 - 60 QTY DEXAMETHASON TAB PRED SOD PHO LIQ TACLONEX 4MG - 30 TABS 6.7/5ML - 100 ML TRIAMCINOLON OIN

0.005 - 60 GM TAZORAC HYDROCORT TAB 20MG

- 30 TABS TRETINOIN

TRIAZ CLEANS LOT Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts CORTICOSTEROIDS DERMATOLOGICALS HYDROCORT TAB PREDNISONE PAK PREDNISOLONE SYP HYDROCORT CRE EURAX CRE 0.1 - 60 QTY CLINAC BPO GEL CLOBETASOL E CREAM 5MG - 30 TABS 10MG - 30 TABS 15MG/5ML - 240 ML 0.005 - 28.35 QTY 0.07 - 45 QTY FLUOCIN ACET CRE CLOBEX METHYLPRED PAK PREDNISONE SOL PREDNISOLONE SYP HYDROCORT OIN 0.00025 - 60 QTY CLINDAMYCIN LOT 4MG - 21 TABS 5MG/5ML - 85 ML 5MG/5ML - 180 ML 0.01 - 56.7 GM 0.01 - 60 QTY CLODERM CREAM FLUOCIN ACET OIN METHYLPRED TAB HYPERCARE SOL 0.00025 - 60 GM CLOBETASOL OIN CONDYLOX GEL 8MG - 4 TABS 0.2 - 60 ML 0.0005 - 45 GM FLUOCIN ACET SOL CORDRAN LOTION PREDNISOLONE MICONAZOLE CRE 0.0001 - 60 ML CLOBETASOL SOL TAB 5MG - 30 TABS 0.02 - 30 QTY 0.0005 - 100 ML CORTISPORIN CREAM FLUOCINONIDE CRE PREDNISONE PAK NUTRADERM LOT - 0.0005 - 60 QTY CLOBEVATE GEL - CUTIVATE LOTION 5MG - 30 TABS 255 QTY 45 QTY FLUOCINONIDE CRE DERMATOP OINT PREDNISONE TAB NYSTAT/TRIAM 0.0005 - 60 QTY CLOTRIM/BETA LOT 10MG - 30 TABS CRE - 30 QTY DIPROP - 30 QTY DESONATE GEL FLUOCINONIDE SOL PREDNISONE TAB NYSTAT/TRIAM 0.0005 - 60 ML CLOTRIMAZOLE CRE DESOXIMETAS 1MG - 30 TABS OIN - 60 GM 0.01 - 90 QTY FLUTICASONE OIN DIFFERIN PREDNISONE TAB NYSTATIN CRE 0.00005 - 30 GM DENAVIR CRE 0.01 - 2.5MG - 30 TABS 100000 - 60 QTY 1.5 QTY DIFLORASONE GRANULEX AER - PREDNISONE TAB NYSTATIN OIN 113.4 GM DESONIDE CRE DIPROLENE LOTION 20MG - 30 TABS 100000 - 15 GM 0.0005 - 60 QTY HYDROCORT CRE DOVONEX PREDNISONE TAB PROCTO-KIT CRE 0.025 - 60 QTY DESONIDE OIN 50MG - 15 TABS 0.01 - 28.35 QTY 0.0005 - 60 GM DUAC GEL HYDROCORT LOT PREDNISONE TAB TOLNAFTATE CRE 0.01 - 120 QTY DESOXIMETAS CRE ELIDEL CREAM 5MG - 30 TABS 0.01 - 60 QTY 0.0025 - 60 QTY HYDROCORT OIN EPIQUIN MICR CREAM COUGH/COLD/ALLERGY TRIAMCINOLON CRE 0.025 - 56.7 GM ERYTHROMYCIN GEL / 0.00025 - 60 QTY BENZOYL - 23.3 QTY ERTACZO CREAM BIDEX TAB 400MG - ACETYLCYST SOL ALACOL DM DRO - ALDEX-CT CHW HYDROCORT SOL 30 TABS 0.2 - 30 ML 60 ML TRIAMCINOLON CRE BUTYRATE - 60 ML FLUOCINONIDE GEL ETHEZYME 830 OINT ALLEGRA-D TAB 0.005 - 30 QTY 0.0005 - 60 QTY BROMETANE DX ANAPLEX DMX SUS - ALLERGY RELF TAB HYDROQUINONE FINACEA GEL SYP - 150 ML 100 ML 10-240MG - 30 TABS ALLERGY DN TAB - TRIAMCINOLON OIN SOL 0.03 - 30 ML FLUOCINONIDE OIN ANDEHIST DM 0.00025 - 30 GM 0.0005 - 60 GM FLUOROPLEX CREAM CHLORDEX GP BENZONATATE CAP ALLFEN CX TAB - KERALYT GEL SYP - 180 ML 100MG - 30 CAPS 30 TABS ATUSS DS SUS TRIAMCINOLON OIN 0.03 - 28.4 QTY FLUTICASONE CRE FLUOROURACIL CREAM 0.001 - 80 GM 0.0005 - 30 QTY CHLOR-MES D SYP BROMAXEFED SYP AMBI 40/1000 TAB - ATUSS HS SUS LAC-HYDRIN LOT HALOBETASOL LIQUID - 113 ML RF - 70 ML 30 TABS WOUND WASH SOL FIVE - 240 QTY FUNGOID TINC SOL BROMFED CAPS 0.009 - 210 ML 0.02 - 29.57 ML HALOG CREAM CODAL-DH SYP - BROMFENEX CAP AMBI 60/580/ TAB 30 - LACLOTION LOT 20 ML 12-120CR - 30 CAPS 30 TABS BROMFED-PD CAP 0.12 - 225 QTY HC BUTYRATE OIN HYLIRA LOT 0.001 - 45 GM DALLERGY TAB - BROMFENEX PD CAP AMBI 80/780 TAB - CLARINEX-D TABS LIDOCAINE GEL KERALAC SOL NAILSTIK 20 TABS 6-60MGCR - 30 CAPS 30 TABS 2% JELLY - 30 QTY HC VALERATE CRE CODIMAL DH SYP 0.002 - 45 QTY KERALYT GEL DE-CHLOR DM SYP BROMHIST-PDX AMBI 80/780/ TAB 40 - OCCLUSAL-HP LIQ LIQUID - 120 ML SYP - 180 ML 30 TABS DALLERGY-JR SUS 0.17 - 10 ML HC VALERATE OIN LIDOC/PRILOC CREAM 0.002 - 30 GM DE-CHLOR HC SYP BROMPLEX HD SOL AMBIFED-G DM TAB - DUOTAN PD SUS - PERMETHRIN CRE LIDOCAINE OINT LIQUID - 120 ML 30-2-1.7 - 200 ML 30 TABS 0.05 - 60 QTY HYDROCORT LOT DURATUSS DM ELX 0.025 - 59 QTY LINDANE LOTION DEHISTINE SYP - CARBATUSS-CL AMBIFED-G TAB 60- PERMETHRIN LOT 120 ML LIQ - 120 ML 1000M - 30 TABS DURATUSS HD ELX 0.01 - 120 QTY HYDROCORT/ CRE LOCOID LIPO CREAM IODOQUIN - 28.4 QTY DURATUSS PE TABS SELENIUM SUL LOT 0.025 - 240 QTY

Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts

COUGH/COLD/ALLERGY COUGH/COLD/ALLERGY RU-TUSS TAB - 30 TABS SUDAL 12 TAN CHW DONATUSSIN SYP - CARBOFED DM SYP - ATUSS HD CAP DURATUSS SUS 4-30MG - 30 CHEW 120 ML 210 ML 30-2-5MG - 30 CAPS SERADEX LIQ - 120 ML DYTAN-CS SYMTAN SUS - 60 ML ED-TLC SYP 5-2-1.67 - CERON-DM DRO ATUSS HX CAP SUDATRATE TAB - 30 CT TANNATE 12 S SUS - 120 ML 3.5-1-3 - 30 ML 5-300MG - 30 CAPS HC TUSS-NR SYP 180 ML TRIALL SYP - 300 ML GUAIFENESIN LIQ CHERATUSSIN SOL BENZONATATE CAP HC/GUAI SYP TRIKOF-D TAB SR AC - 180 ML DAC - 500 ML 200MG - 30 CAPS TRIPLEX DM LIQ - 12HR - 30 TABS NOVASUS SUS - 180 ML GUIATUSS AC SYP CHLOREX-A TAB BIDEX-A TAB TUSSO-DM TAB - 10-100/5 - 118 ML 4-40-20 - 30 TABS 25-600MG - 30 TABS PYRLEX CB SUS - TRI-VENT DM SYP - 30 TABS GUIATUSS DM SYP CHLOR-MES TAB - BPM PE HC LIQ - 250 ML RESPI-TANN TUSSI-BID TAB - XPECT-HC TAB 100-10/5 - 120 ML 30 TABS BROMHIST PDX LIQ - 30 30 TABS 5-600MG - 30 TABS ML RYNATAN PEDI CHW HYDRO GP SYP - CHLORPHEN CAP VANACON SOL - 180 ML ZOTEX LAX TAB - 240 ML PHENYLEP - 30 CAPS BROMHIST-DM SIMUC TABS 30 TABS DRO - 30 ML WELLBID-D TAB 40- HYDRON EX SYP COLDCOUGH PD TANNATE DMP- SUS 600MG - 30 TABS ZYRTEC-D TAB LIQUID - 120 ML SYP - 120 ML BROMPHEN/PSE DEX 5-120MG - 30 TABS CAP 9-90MG - 20 CAPS HYPHED SYP - 120 ML COLDCOUGH SYP TANNATE-12D SUS DERMATOLOGICALS IOPHEN C-NR LIQ 100- HCM - 240 ML BROVEX HC LIQ A-200 MAX ST LIQ - BENZOYL PER GEL ALCLOMETASON OIN ACLARO EMU 10/5 - 240 ML 30-3-2.5 - 120 ML TUSSI-12D TABS 10 ML 0.025 - 60 QTY 0.0005 - 30 GM CORFEN-DM LIQ - AKNE-MYCIN OINT IOPHEN DM-NR LIQ 180 ML CARBETAPEN/ TAB TUSSIDEN C 10-100/5 - 120 ML CHLORPHN - 30 TABS AQUANIL SKIN LOT BENZOYL PER A-MANTLE CRE - 240 COUGHTUSS LIQ TUSSIDEN DM LIQ CLEANSER - 240 QTY GEL 0.05 - 60 QTY QTY ALCLOMETASON CRE NOHIST TAB 38474 - 120 ML CLARITIN-D TAB AQUAPHOR OIN - BETA-VAL LOT AMMONIUM LAC CRE ALCORTIN GEL 8-20MG - 30 TABS 5-120MG - 30 TABS TUSSO-C LIQ 30 GM 0.001 - 60 QTY 0.12 - 280 QTY C-PHEN DM SYP - ALDARA CREAM P CHLOR GG SOL 120 ML C-PHEN DRO - 30 ML VAZOBID SUS DROPS - 30 ML BACIT/POLYMY CARMOL 20 CRE AUG BETAMET CRE CPM 8/PE 20/ TAB C-PHEN SYP - 240 ML VAZOTAN SUS OIN - 28.35 GM 0.2 - 90 QTY 0.0005 - 50 QTY ALLANDERM-T OINT PHENYLHIST LIQ MSC 1.25 - 30 TABS

BACITRACIN OIN CLINDAMYCIN GEL AUG BETAMET OIN ALTABAX OINT DH - 180 ML CPM/PSE CAP VAZOTUSS HC SUS 500/GM - 28 GM 0.01 - 30 QTY 0.0005 - 50 GM CPM/PSE/MSC TAB - 8-120 CR - 30 CAPS AVAGE CREAM PROMETH/COD 30 TABS Z-COF 8DM SUS BETAMETH DIP CRE CLINDAMYCIN SOL BENZOYL PER GEL SYP 6.25-10 - 120 ML CRANTEX SYP CRANTEX LA TAB 7.5/100 - 240 ML 0.0005 - 15 QTY 0.01 - 60 ML 0.1 - 90 QTY AVAR GEL PROMETHAZINE 30-600MG - 30 TABS

BETAMETH VAL CRE CLOBETASOL CRE BENZOYL PER LIQ AZELEX CREAM SYP DM - 240 ML DECONSAL DM 0.001 - 45 QTY 0.0005 - 30 QTY WASH 10% - 227 ML DALLERGY JR CAP CHW - 20 CHEW BACTROBAN CREAM PSEUDOVENT CAP 4-20MG - 30 CAPS BETAMETH VAL CLOTRIM/BETA CRE BENZOYL PER LIQ CR - 10 CAPS DICEL DM SUS - 120 ML DE-CHLOR MR OIN 0.001 - 45 GM DIPROP - 45 QTY WASH 5% - 227 ML BENPROX LIQ SYP - 120 ML DICEL SUS - 120 ML

CAPSICUM OLE CRE CLOTRIMAZOLE BETAMETH DIP LOT BENZACLIN GEL 0.00025 - 56.6 QTY SOL 0.01 - 30 ML 0.0005 - 180 QTY DONATUSS DM DIPHENMAX D CHW BENZASHAVE 5 CREAM SYP - 120 ML 25/10MG - 30 CHEW FLUOCIN ACET CRE DERMANAIL LIQ - 30 ML BETAMETH DIP OIN DURATAN SUS DONATUSSIN DRO - 0.0001 - 30 QTY ECONAZOLE CRE 0.01 - 0.0005 - 90 GM BENZL PEROX LIQ FORTE - 35 ML 30 ML 30 QTY

GENTAMICIN CRE BIAFINE EMU - 90 QTY BREVOXYL 0.001 - 15 QTY ERYTHROMYCIN CASTELLANI LIQ PAINT/ DUR-TANN DM DONATUSSIN DRO GEL 0.02 - 30 QTY CL - 29.57 ML CARAC CREAM SUS - 80 ML DM - 30 ML GENTAMICIN OIN 0.001 - 15 GM ERYTHROMYCIN CICLOPIROX CRE CARMOL SCALP LOT ENDACOF-XP DONATUSSIN SUS SYP - 240 ML DM - 120 ML SOL 0.02 - 60 ML 0.0077 - 30 QTY

HC-1% HEMORR CICLOPIROX EXECLEAR SYP DONATUSSIN SYP OIN 0.01 - 30 GM CLENIA EMU FOAMING - 170 QTY 3.5-100 - 120 ML DC - 240 ML

Preferred Brand & Generic Drugs Non-Preferred Preferred Brand & Generic Drugs Non-Preferred $10 Tier $20 Tier $40 Tier Discounts $10 Tier $20 Tier $40 Tier Discounts COUGH/COLD/ALLERGY COUGH/COLD/ALLERGY EXEFEN-DM TAB DURADEX TAB MARCOF SYP PE/GUAI/DM TAB - 55-1000 - 30 TABS FORTE - 30 TABS EXPCTRNT - 180 ML 30 TABS

EXTENDRYL SR DURAFLU TAB - M-CLEAR SYP - 120 ML PHENAVENT CAP TAB - 30 TABS 20 TABS MEDENT-DMI TAB - 15-400MG - 14 CAPS 30 TABS GFN1000/DM60 DURAHIST D TAB - PHENAVENT LA CAP TAB - 30 TABS 30 TABS M-END LIQ (REFORM) - 30-400MG - 30 CAPS 240 ML GFN600/PE20 DURAMAX TAB - PHENAVENT PE CAP TAB - 30 TABS 30 TABS MUCINEX DM TAB 7.5-200 - 30 CAPS 30-600ER - 30 TABS GUAIFE/PSEUD DURAPHEN II TAB PHENYL CHLOR TAB - 30 TABS DM - 30 TABS MUCINEX TAB 600MG SUS TAN - 150 ML ER - 30 TABS GUAIFENEX GP TAB DURATUSS SUS PHLEMEX TAB - 120/1200 - 30 TABS DM 12 - 60 ML NEO DM SUS - 120 ML 30 TABS PHENAVENT D TAB GUAIFENEX TAB DYTAN-HC SUS - 60 ML 40-1200 - 30 TABS PHLEMEX TAB PSE 120 - 30 TABS FORTE - 30 TABS ENTEX PSE TAB 50- POLY-TUSSIN SYP GUAIFENEX TAB 525MG - 30 TABS HD - 120 ML POLY HIST HC LIQ - PSE 60 - 30 TABS 240 ML EXETUSS-GP TAB PROMETH VC SYP HISTA-VENT TAB 25-1200 - 30 TABS PLAIN - 240 ML POLY-TUSSIN SYP - 12HR - 30 TABS 180 ML GENTEX HC LIQ - PROMETH VC/ SYP HISTINEX HC SYP - 180 ML CODEINE - 200 ML PROLEX PD TAB 180 ML 10-600MG - 30 TABS GENTEX LA TAB - PRO-RED SYP - 240 ML HYDROCOD/GG SYP 30 TABS PSE BROM DM SYP - PROTID TAB CR - 5-100/5 - 300 ML 120 ML 30 TABS GG/CARBETA TAB - HYDROCODONE SYP 30 TABS PSE/GG TAB 85- PSE/CPM CAP POT GUAI - 120 ML 795MG - 30 TABS 100-12MG - 30 CAPS GG-PE TAB 900-30MG - HYDROCODONE/ TAB 30 TABS PSEUDO MAX TAB - PSEUDOVENT HOMATROP - 30 TABS 30 TABS CAP 400 - 20 CAPS GUAIFEN PE TAB - HYDRO-DP SYP - 30 TABS PSEUDOVENT CAP QUAD-TUSS SUS 200 ML PED CR - 30 CAPS TANN/PED - 120 ML HUMIBID TAB HYDRON CP SYP 1200MG - 30 TABS PSEUDOVENT TAB RESCON TAB - 30 TABS LIQUID - 300 ML DM - 30 TABS HYDROMET SYP RESCON-MX TAB - HYDRON PSC LIQ - 5-1.5/5 - 450 ML QUINTEX HC LIQ - 30 TABS 180 ML 120 ML L-ALL 12 SUS - 118 ML RESPA DM TAB 28- HYDRO-PC II SYP - RE-DRYLEX JR TAB - 600MG - 30 TABS 240 ML LEV/PSE/GG CAP 30 TABS 90-400MG - 20 CAPS RESPA-PE TAB HYDRO-TUSSIN SOL REME TUSSIN SYP 18-600 - 30 TABS HD - 180 ML LODRANE 24D CAP DM - 120 ML 12-90MG - 30 CAPS RESPI-TANN HYDRO-TUSSIN SYP RESCON-JR TAB - G SUS - 120 ML 15-2-3MG - 180 ML MAXIFED-G TAB 30 TABS 60-580CR - 30 TABS R-TANNA TAB HYDRO-TUSSIN SYP RESPA-1ST TAB CR - 9-25MG - 30 TABS EXP - 180 ML MAXIPHEN DM TAB - 30 TABS 30 TABS SITREX TAB - 30 TABS K-TAN TAB 60-25MG - RESPAIRE-60 CAP 14 TABS NOREL SR TAB - CR - 30 CAPS SUDAL 12 CHW 30 TABS 4-30MG - 30 CHEW