TIER 1 (Mail)
$20.00 Co-Pay
UP TO 90 DAYS SUPPLY

Medication

Generic for

Albuterol 2mg

Proventil

Albuterol 90mcg Inhaler

Proventil

Allopurinol 100mg, 300mg

Zyloprim

Amitriptyline 10mg, 25mg, 50mg, 75mg, 100mg

Elavil

Atenolol 50mg, 100mg

Tenormin

Atenolol/Chlorthalidone 50-25mg

Tenoretic

Benztropine 0.5mg, 1mg, 2mg

Cogentin

Captopril 12.5mg, 25mg

Capoten

Clonidine 0.1mg

Catapress

Digoxin 0.25mg

Lanoxin

Doxazosin 1mg, 2mg, 4mg, 8mg

Cardura

Enalapril 5mg

Vasotec

Estradiol 0.5mg, 1mg

Estrace

Folic Acid 1mg

Folacin

Furosemide 20mg, 40mg, 80mg

Lasix

Glipizide 5mg, 10mg

Glucotrol

Glyburide 5mg

Micronase, Diabeta

Hydrochlorothiazide 25mg, 50mg

Microzide

Ibuprofen 400mg, 600mg

Motrin

Indapamide 1.25mg, 2.5mg

Lozol

Medroxyprogesterone 5mg, 10mg

Provera

Metformin ER 500mg

Glucophage XR, Fortamet

Metoprolol 50mg, 100mg

Lopressor

Nortriptyline 25mg, 50mg

Pamelor

Potassium Chloride 10mEq

K-Dur

Prednisone 5mg, 10mg, 20mg

Deltasone

Propranolol 10mg, 20mg, 40mg

Inderal

Trazodone 50mg, 100mg

Desyrel

Triamterene/Hydrochlorothiazide 75-50mg

Maxzide

Verapamil 80mg

Calan