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 Alphabetical Drug List 

    90-Day Supply
Medication Name Category 30-Day Supply  
A  
ACYCLOVIR CAP 200MG Antiviral 30 90
ALBUTEROL INH SOL 0.083% *† Asthma 75 ML 225 ML
ALBUTEROL SOL 0.5% † Asthma 20 ML 60 ML
ALBUTEROL SYRUP Asthma 120 ML 360 ML
ALBUTEROL TAB 2MG Asthma 90 270
ALBUTEROL TAB 4MG Asthma 60 180
ALLOPURINOL TAB 100MG Anti-Gout 30 90
ALLOPURINOL TAB 300MG Anti-Gout 30 90
AMILORIDE/HCTZ TAB 5-50 Heart Health 30 90
AMITRIPTYLINE TAB  10MG Antidepressant 60 180
AMITRIPTYLINE TAB  25MG Antidepressant 60 180
AMITRIPTYLINE TAB  50MG Antidepressant 60 180
AMITRIPTYLINE TAB  75MG Antidepressant 30 90
AMITRIPTYLINE TAB 100MG Antidepressant 30 90
AMOXICILLIN CAP 250MG Antibiotic 30 90
AMOXICILLIN CAP 500MG Antibiotic 30 90
AMOXICILLIN SUSP 125MG † Antibiotic 80 ML 240 ML
AMOXICILLIN SUSP 125MG † Antibiotic 100 ML 300 ML
AMOXICILLIN SUSP 125MG † Antibiotic 150 ML 450 ML
AMOXICILLIN SUSP 200MG † Antibiotic 50 ML 150 ML
AMOXICILLIN SUSP 200MG *† Antibiotic 75 ML 225 ML
AMOXICILLIN SUSP 200MG *† Antibiotic 100 ML 300 ML
AMOXICILLIN SUSP 250MG † Antibiotic 80 ML 240 ML
AMOXICILLIN SUSP 250MG † Antibiotic 100 ML 300 ML
AMOXICILLIN SUSP 250MG † Antibiotic 150 ML 450 ML
AMOXICILLIN SUSP 400MG † Antibiotic 50 ML 150 ML
AMOXICILLIN SUSP 400MG *† Antibiotic 75 ML 225 ML
AMOXICILLIN SUSP 400MG *† Antibiotic 100 ML 300 ML
ANUCORT-HC SUPP 25MG * Topical Medications 12 36
ATENOLOL TAB  25MG Heart Health 30 90
ATENOLOL TAB 100MG Heart Health 30 90
ATENOLOL TAB 50MG Heart Health 30 90
ATENOLOL/CHLRTHAL TAB 100-25 Heart Health 30 90
ATENOLOL/CHLRTHAL TAB 50-25 Heart Health 30 90
ATROPINE SUL OPTH SOL 1% † Glaucoma/Eye 5 ML 15 ML
B  
BACLOFEN TAB 10MG Muscle Relaxant 60 180
BELLADONNA ALK W/PB TAB Gastro Intestinal 60 180
BENAZEPRIL TAB 10MG Heart Health 30 90
BENAZEPRIL TAB 20MG Heart Health 30 90
BENAZEPRIL TAB 40MG Heart Health 30 90
BENAZEPRIL TAB 5MG Heart Health 30 90
BENZONATATE CAP 100MG Cough/Cold 14 42
BENZTROPINE MES TAB 2MG Parkinson's 30 90
BISOPROLOL/HCTZ TAB 10MG Heart Health 30 90
BISOPROLOL/HCTZ TAB 2.5MG Heart Health 30 90
BISOPROLOL/HCTZ TAB 5MG Heart Health 30 90
BUMETANIDE TAB 0.5MG Heart Health 30 90
BUMETANIDE TAB 1MG Heart Health 30 90
BUSPIRONE TAB  5MG Anti Anxiety 60 180
BUSPIRONE TAB 10MG * Anti Anxiety 60 180
C  
CAPTOPRIL TAB 100MG Heart Health 90 270
CAPTOPRIL TAB 12.5MG Heart Health 90 270
CAPTOPRIL TAB 25MG Heart Health 90 270
CAPTOPRIL TAB 50MG Heart Health 90 270
CARBAMAZEPINE TAB 200MG * Miscellaneous 100 300
CARVEDILOL TAB 12.5MG Heart Health 60 180
CARVEDILOL TAB 25MG * Heart Health 60 180
CARVEDILOL TAB 3.125MG Heart Health 60 180
CARVEDILOL TAB 6.25MG Heart Health 60 180
CEPHALEXIN CAP 250MG Antibiotic 40 120
CEPHALEXIN CAP 500MG Antibiotic 40 120
CHLORHEXIDINE RNSE 0.12% † Antibiotic 473 ML 1419 ML
CHLORPROPAMIDE TAB 100MG * Diabetes 30 90
CIMETIDINE TAB 800MG * Gastro Intestinal 30 90
CIPROFLOXACIN TAB 250MG Antibiotic 20 60
CIPROFLOXACIN TAB 500MG Antibiotic 20 60
CITALOPRAM TAB 20MG Antidepressant 30 90
CITALOPRAM TAB 40MG Antidepressant 30 90
CLONIDINE TAB 0.1MG Heart Health 30 90
CLONIDINE TAB 0.2MG Heart Health 30 90
CYCLOBENZAPRINE TAB 10MG Muscle Relaxant 30 90
CYCLOBENZAPRINE TAB 5MG Muscle Relaxant 30 90
CYTRA-2 SOL † Miscellaneous 473 ML 1419 ML
D  
DEXAMETHASONE TAB 0.5MG Anti Inflammatory 30 90
DEXAMETHASONE TAB 0.75M Anti Inflammatory 18 54
DEXAMETHASONE TAB 4MG Anti Inflammatory 12 36
DICLOFENAC SOD TAB 75MG Anti Inflammatory 60 180
DICYCLOMINE CAP 10MG Gastro Intestinal 90 270
DICYCLOMINE TAB 20MG Gastro Intestinal 60 180
DIGOXIN TAB 0.125MG Heart Health 30 90
DIGOXIN TAB 0.25MG Heart Health 30 90
DILTIAZEM TAB 120MG Heart Health 30 90
DILTIAZEM TAB 30MG Heart Health 60 180
DILTIAZEM TAB 60MG Heart Health 60 180
DILTIAZEM TAB 90MG * Heart Health 60 180
DOXAZOSIN TAB 1MG Heart Health 30 90
DOXAZOSIN TAB 2MG Heart Health 30 90
DOXAZOSIN TAB 4MG Heart Health 30 90
DOXAZOSIN TAB 8MG Heart Health 30 90
DOXYCYCLINE CAP 100MG Antibiotic 20 60
DOXYCYCLINE TAB 100MG Antibiotic 20 60
E  
ENALAPRIL MAL TAB 10MG Heart Health 30 90
ENALAPRIL MAL TAB 2.5MG Heart Health 30 90
ENALAPRIL MAL TAB 20MG Heart Health 30 90
ENALAPRIL MAL TAB 5MG Heart Health 30 90
ENALAPRIL/HCTZ TAB 5/12.5 Heart Health 30 90
ERYTHROMYCIN OPTH OINT † Antibiotic 3.5 GM 10.5 GM
ESTRADIOL TAB 0.5MG Hormone 30 90
ESTRADIOL TAB 1MG Hormone 30 90
ESTRADIOL TAB 2MG Hormone 30 90
F  
FAMOTIDINE TAB 20MG Gastro Intestinal 30 90
FLUCONAZOLE TB 150MG U/U Antifungal 1 3
FLUOCINONIDE CRM 0.05% † Topical Medications 15 GM 45 GM
FLUOCINONIDE CRM 0.05% † Topical Medications 30 GM 90 GM
FLUORIDE CHW TAB 0.25MG* Supplements & Vitamins 30 90
FLUOXETINE CAP 10MG Antidepressant 30 90
FLUOXETINE CAP 20MG Antidepressant 30 90
FLUOXETINE CAP 40MG Antidepressant 30 90
FLUOXETINE TAB 10MG * Antidepressant 30 90
FLUPHENAZINE TAB  1MG Antipsychotic 60 180
FLUVOXAMINE MALEATE TAB 25MG Antipsychotic 30 90
FOLIC ACID TAB 1MG Supplements & Vitamins 30 90
FUROSEMIDE TAB 20MG Diuretic 30 90
FUROSEMIDE TAB 40MG Diuretic 30 90
FUROSEMIDE TAB 80MG Diuretic 30 90
G  
GENTAMICIN OPTH SOL 0.3% † Antibiotic 5 ML 15 ML
GENTAMICIN SULF CRM 0.1% † Antibiotic 15 GM 45 GM
GENTAMICIN SULF OINT 0.1% † Antibiotic 15 GM 45 GM
GLIMEPIRIDE TAB 1MG Diabetes 30 90
GLIMEPIRIDE TAB 2MG Diabetes 30 90
GLIMEPIRIDE TAB 4MG Diabetes 30 90
GLIPIZIDE TAB  5MG Diabetes 30 90
GLIPIZIDE TAB 10MG * Diabetes 60 180
GLYBURIDE MICRO TAB 3MG Diabetes 30 90
GLYBURIDE MICRO TAB 6MG Diabetes 30 90
GLYBURIDE TAB 1.5MG Diabetes 30 90
GLYBURIDE TAB 2.5MG Diabetes 30 90
GLYBURIDE TAB 5MG Diabetes 30 90
GUANFACINE TAB 1MG Heart Health 30 90
H  
HALOPERIDOL TAB  0.5MG Antipsychotic 60 180
HALOPERIDOL TAB  1MG Antipsychotic 60 180
HALOPERIDOL TAB  2MG Antipsychotic 60 180
HALOPERIDOL TAB  5MG Antipsychotic 60 180
HYDRALAZINE TAB  10MG Heart Health 30 90
HYDRALAZINE TAB  25MG Heart Health 30 90
HYDROCHLOROTHIAZIDE (HCTZ) CAP 12.5MG * Diuretic 30 90
HYDROCHLOROTHIAZIDE (HCTZ) TAB 25MG Diuretic 30 90
HYDROCHLOROTHIAZIDE (HCTZ) TAB 50MG Diuretic 30 90
HYDROCORTISONE CRM 1% † Topical Medications 30 GM 90 GM
HYDROCORTISONE CRM 2.5% † Topical Medications 30 GM 90 GM
I  
IBUPROFEN  SUSP 100MG/5ML * Anti Inflammatory 120 ML 360 ML
IBUPROFEN TAB 400MG Anti Inflammatory 90 270
IBUPROFEN TAB 600MG Anti Inflammatory 60 180
IBUPROFEN TAB 800MG Anti Inflammatory 60 180
INDAPAMIDE TAB 1.25MG Diuretic 30 90
INDAPAMIDE TAB 2.5MG Diuretic 30 90
INDOMETHACIN CAP 25MG * Anti Inflammatory 60 180
IPRATROPIUM SOL .02% UDV *† Asthma 62.5 ML 187.5 ML
ISONIAZID TAB 300MG Antibiotic 30 90
ISOSORBIDE DINITRATE SL 2.5MG Heart Health 60 180
ISOSORBIDE DINITRATE SL 5MG Heart Health 60 180
ISOSORBIDE MON ER TAB 30MG Heart Health 30 90
ISOSORBIDE MON ER TAB 60MG Heart Health 30 90
L  
LACTULOSE SYP 10G/15ML † Miscellaneous 473 ML 1419 ML
LEVOBUNOLOL OPTH 0.5% Glaucoma/Eye 5 ML 15 ML
LEVOTHYROXINE TAB  50MCG Thyroid 30 90
LEVOTHYROXINE TAB  75MCG Thyroid 30 90
LEVOTHYROXINE TAB  88MCG Thyroid 30 90
LEVOTHYROXINE TAB 100MCG Thyroid 30 90
LEVOTHYROXINE TAB 112 MCG Thyroid 30 90
LEVOTHYROXINE TAB 125MCG Thyroid 30 90
LEVOTHYROXINE TAB 137MCG Thyroid 30 90
LEVOTHYROXINE TAB 150MCG Thyroid 30 90
LEVOTHYROXINE TAB 175MCG * Thyroid 30 90
LEVOTHYROXINE TAB 200MCG * Thyroid 30 90
LEVOTHYROXINE TAB 25MCG Thyroid 30 90
LIDOCAINE VISCOUS SOL 2% † Miscellaneous 100 ML 300 ML
LISINOPRIL TAB  2.5MG Heart Health 30 90
LISINOPRIL TAB  5MG Heart Health 30 90
LISINOPRIL TAB 10MG Heart Health 30 90
LISINOPRIL TAB 20MG Heart Health 30 90
LISINOPRIL/HCTZ TAB 10/12.5 Heart Health 30 90
LISINOPRIL/HCTZ TAB 20/12.5 * Heart Health 30 90
LISINOPRIL/HCTZ TAB 20/25 * Heart Health 30 90
LITHIUM CARB CAP 300MG * Miscellaneous 90 270
LORATADINE TAB 10MG Allergy 30 90
LOVASTATIN TAB 10MG * Heart Health 30 90
LOVASTATIN TAB 20MG * Heart Health 30 90
M  
MAGNESIUM OXIDE TAB 400MG Supplements & Vitamins 60 180
MAG-SR TAB 64MG * Supplements & Vitamins 30 90
MEDROXYPROGST ACE TAB  10MG Hormone 30 90
MEDROXYPROGST ACE TAB  2.5MG Hormone 30 90
MEDROXYPROGST ACE TAB  5MG Hormone 30 90
MEGESTROL TAB 20MG * Miscellaneous 30 90
MELOXICAM TAB 15MG Anti Inflammatory 30 90
MELOXICAM TAB 7.5MG Anti Inflammatory 30 90
METFORMIN ER TAB 500MG * Diabetes 60 180
METFORMIN TAB 1000MG * Diabetes 60 180
METFORMIN TAB 500MG Diabetes 60 180
METFORMIN TAB 850MG Diabetes 60 180
METHYLDOPA TAB 250MG * Heart Health 60 180
METHYLDOPA TAB 500MG * Heart Health 30 90
METOCLOPRAMIDE SYRUP 5MG Gastro Intestinal 120 ML 360 ML
METOCLOPRAMIDE TAB 10MG Gastro Intestinal 60 180
METOPROLOL TARTRATE TAB  50MG Heart Health 60 180
METOPROLOL TARTRATE TAB 100MG * Heart Health 60 180
METOPROLOL TARTRATE TAB 25MG Heart Health 60 180
N  
NADOLOL TAB 20MG Heart Health 30 90
NADOLOL TAB 40MG Heart Health 30 90
NAPROXEN TAB 250MG Antil Inflammatory 60 180
NAPROXEN TAB 375MG * Anti Inflammatory 60 180
NAPROXEN TAB 500MG * Anti Inflammatory 60 180
NEO/POLY/DEX OPTH OINT .1% *† Antibiotic 3.5 GM 10.5 GM
NEO/POLY/DEX OPTH SUSP .1% † Antibiotic 5 ML 15 ML
NORTRIPTYLINE CAP 10MG Antidepressant 30 90
NORTRIPTYLINE CAP 25MG Antidepressant 30 90
NYSTATIN CRM † Topical Medications 15 GM 45 GM
NYSTATIN CRM † Topical Medications 30 GM 90 GM
O  
OXYBUTYNIN TAB 5MG Miscellaneous 60 180
P  
PAROXETINE TAB 10MG * Antidepressant 30 90
PAROXETINE TAB 20MG * Antidepressant 30 90
PENICILLIN VK SOL 125MG † Antibiotic 100 ML 300 ML
PENICILLIN VK SOL 125MG † Antibiotic 200 ML 600 ML
PENICILLIN VK SOL 250MG † Antibiotic 100 ML 300 ML
PENICILLIN VK TAB 250MG Antibiotic 40 120
PHENAZOPYRIDINE TAB 100MG Analgesic 30 90
PHENAZOPYRIDINE TAB 200MG Analgesic 30 90
POLYMYXIN/TRIMETH OPTH SOL *† Antibiotic 10 ML 30 ML
POTASSIUM CL ORAL SOL 10% † Supplements & Vitamins 473 ML 1419 ML
PRAVASTATIN TAB 10MG Heart Health 30 90
PRAVASTATIN TAB 20MG Heart Health 30 90
PRAVASTATIN TAB 40MG * Heart Health 30 90
PRAZOSIN CAP 1MG Heart Health 30 90
PRAZOSIN CAP 2MG Heart Health 30 90
PRAZOSIN CAP 5MG Heart Health 30 90
PREDNISONE TAB  2.5MG Anti Inflammatory 30 90
PREDNISONE TAB  5MG Anti Inflammatory 30 90
PREDNISONE TAB 10MG Anti Inflammatory 30 90
PREDNISONE TAB 10MG DSPK † Anti Inflammatory 21 63
PREDNISONE TAB 10MG DSPK *† Anti Inflammatory 48 144
PREDNISONE TAB 20MG Anti Inflammatory 30 90
PREDNISONE TAB 5MG DSPK † Anti Inflammatory 21 63
PREDNISONE TAB 5MG DSPK *† Anti Inflammatory 48 144
PRENATAL PLUS TAB* Supplements & Vitamins 30 90
PROCHLORPERAZINE TAB 5MG Gastro Intestinal 30 90
PROCHLORPERAZINE TAB 10MG Gastro Intestinal 30 90
PROMETHAZINE PLAIN SYRUP * Cough/Cold 120 ML 360 ML
PROMETHAZINE TAB 25MG Gastro Intestinal 30 90
PROMETHAZINE W/DM SYRUP Cough/Cold 120 ML 360 ML
PROPRANOLOL TAB 10MG Heart Health 60 180
PROPRANOLOL TAB 20MG Heart Health 60 180
PROPRANOLOL TAB 40MG Heart Health 60 180
PROPRANOLOL TAB 80MG Heart Health 60 180
R  
RANITIDINE TAB 150MG Gastro Intestinal 60 180
RANITIDINE TAB 300MG Gastro Intestinal 30 90
S  
SILVER SULFADIAZINE (SSD) CRM 1% *† Topical Medications 50 GM 150 GM
SOTALOL HCL TAB  80MG * Heart Health 30 90
SPIRONOLACTONE TAB 25MG * Diuretic 30 90
SULFACET SOD OPTH SOL 10% † Antibiotic 15 GM 45 GM
SULFAMETH/TRIMETH DS TAB Antibiotic 20 60
SULFAMETH/TRIMETH TAB Antibiotic 20 60
SULFATRIM PED SUSP Antibiotic 120 ML 360 ML
T  
TERAZOSIN CAP  1MG Heart Health 30 90
TERAZOSIN CAP  2MG Heart Health 30 90
TERAZOSIN CAP  5MG Heart Health 30 90
TERAZOSIN CAP 10MG Heart Health 30 90
TERBINAFINE TAB 250MG * Antifungal 30 90
TETRACYCLINE CAP 250MG Antibiotic 60 180
TETRACYCLINE CAP 500MG Antibiotic 60 180
THIORIDAZINE TAB  25MG Antipsychotic 30 90
THIORIDAZINE TAB  50MG Antipsychotic 30 90
THIOTHIXENE CAP  2MG Antipsychotic 30 90
TIMOLOL MAL OPTH SOL .25% † Glaucoma/Eye 5 ML 15 ML
TIMOLOL MAL OPTH SOL 0.5% † Glaucoma/Eye 5 ML 15 ML
TOBRAMYCIN OPTH SOL 0.3% † Antibiotic 5 ML 15 ML
TRANDOLAPRIL TAB 1MG Heart Health 30 90
TRAZODONE TAB  50MG Antidepressant 30 90
TRAZODONE TAB 100MG Antidepressant 30 90
TRAZODONE TAB 150MG Antidepressant 30 90
TRIAMCINOLONE ACE CRM 0.025% † Topical Medications 15 GM 45 GM
TRIAMCINOLONE ACE CRM 0.025% † Topical Medications 80 GM 240 GM
TRIAMCINOLONE ACE CRM 0.1% † Topical Medications 15 GM 45 GM
TRIAMCINOLONE ACE CRM 0.1% † Topical Medications 80 GM 240 GM
TRIAMCINOLONE ACE CRM 0.5% † Topical Medications 15 GM 45 GM
TRIAMCINOLONE ACE OINT 0.1% † Topical Medications 15 GM 45 GM
TRIAMCINOLONE ACE OINT 0.1% † Topical Medications 80 GM 240 GM
TRIAMTEREN/HCTZ CAP 37.5/25 Heart Health 30 90
TRIAMTEREN/HCTZ TAB 37.5/25 Heart Health 30 90
TRIAMTEREN/HCTZ TAB 75/50 Heart Health 30 90
TRIHEXYPHENIDYL TAB 2MG Parkinson's 60 180
TRI-VENT DPC SYRUP * Cough/Cold 120 ML 360 ML
V  
VERAPAMIL TAB  80MG Heart Health 60 180
VERAPAMIL TAB 120MG Heart Health 60 180
W  
WARFARIN SODIUM TAB  1MG Anticoagulant 30 90
WARFARIN SODIUM TAB  2.5MG Anticoagulant 30 90
WARFARIN SODIUM TAB  2MG Anticoagulant 30 90
WARFARIN SODIUM TAB  3MG Anticoagulant 30 90
WARFARIN SODIUM TAB  4MG Anticoagulant 30 90
WARFARIN SODIUM TAB  5MG * Anticoagulant 30 90
WARFARIN SODIUM TAB  6MG Anticoagulant 30 90
WARFARIN SODIUM TAB  7.5MG Anticoagulant 30 90
WARFARIN SODIUM TAB 10MG Anticoagulant 30 90
Women's Health                                            
ALENDRONATE SOD TAB 35MG Women's Health 4 - $9 12 - $24
ALENDRONATE SOD TAB 70MG Women's Health 4 - $9 12 - $24
CLOMIPHENE CIT TAB 50MG  Women's Health 5 - $9 15 - $24
SPRINTEC TAB 0.25/0.035 * Women's Health 28 - $9 84 - $24
TAMOXIFEN TAB 10MG Women's Health 60 - $9 180 - $24
TAMOXIFEN TAB 20MG Women's Health 30 - $9 90 - $24
TRINESSA 28 TAB * Women's Health 28 - $9 84 - $24

 

*Certain medications are priced higher in California and Montana due to state laws.

†Prepackaged drugs are covered only in unit sizes specified on the list.

 

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