TIER 2 (Mail)
$40.00 Co-Pay
UP TO 90 DAYS SUPPLY

Medication

Generic for

Albuterol 4mg

Proventil

Atenolol 25mg

Tenormin

Atenolol/Chlorthalidone 100-25mg

Tenoretic

Captopril 50mg

Capoten

Clonidine 0.2mg, 0.3mg

Catapress

Enalapril 2.5mg, 10mg

Vasotec

Estradiol 2mg

Estrace

Fluoxetine 10mg, 20mg

Prozac

Glipizide ER 5mg

Glucotrol XL

Glyburide Micronized 1.5mg, 3mg

Glynase Prestab

Ibuprofen 800mg

Motrin

Levothyroxine 0.15mg

Synthroid

Lisinopril 2.5mg, 5mg, 10mg

Prinivil, Zestril

Medroxyprogesterone 2.5mg

Provera

Metformin 500mg

Glucophage

Metoclopramide 10mg

Reglan

Naproxen 250mg, 375mg, 500mg

Anaprox, Naprosyn

Nortriptyline 75mg

Pamelor

Prazosin 1mg

Minipress

Prometrium 100mg

Prometrium

Ranitidine 300mg

Zantac

Sotalol 160mg

Betapace

Spironolactone 25mg

Aldactone

Trazodone 150mg

Desyrel

Triamterene/Hydrochlorothiazide 37.5-25mg

Diazyde

Verapamil 40mg,120mg

Calan

Verapamil SR 240mg

Calan SR

Warfarin 1mg, 2mg, 5mg, 7.5mg

Coumadin