Prescription Medications

Common Conditions

Ear & Eye Infections
Skin Infections
Fungal Infections
Pain & Injuries
Migraines
Stomach Viruses
Upper Respiratory Infections (URI)
Urinary Tract Infections (UTI)
Asthma/Allergic Reactions

ADHD

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ATOMOXETINE	Strattera	10	MG	CAP	90
ATOMOXETINE	Strattera	18	MG	CAP	90
ATOMOXETINE	Strattera	25	MG	CAP	90
ATOMOXETINE	Strattera	40	MG	CAP	90
ATOMOXETINE	Strattera	60	MG	CAP	90
ATOMOXETINE	Strattera	100	MG	CAP	90
GUANFACINE	Intuniv	1	MG	ER TAB (24HR)	90
GUANFACINE	Intuniv	2	MG	ER TAB (24HR)	90
GUANFACINE	Intuniv	3	MG	ER TAB (24HR)	90
GUANFACINE	Intuniv	4	MG	ER TAB (24HR)	90

Anti-Infective

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ACYCLOVIR	Zovirax	5	%	OINT	30
ACYCLOVIR	Zovirax	200	MG	CAP	180
ACYCLOVIR	Zovirax	400	MG	TAB	180
ACYCLOVIR	Zovirax	800	MG	TAB	105
AMANTADINE	Gocovri	100	MG	CAP	180
AMOXICILLIN	Amoxil	250	MG	CAP	90
AMOXICILLIN	Amoxil	500	MG	CAP	180
AMOXICILLIN	Amoxil	500	MG	TAB	90
AMOXICILLIN	Amoxil	875	MG	TAB	56
AMOXICILLIN/CLAVULANIC ACID	Augmentin	500-125	MG	TAB	84
AMOXICILLIN/CLAVULANIC ACID	Augmentin	875-125	MG	TAB	84
AMPICILLIN	Omnipen	250	MG	CAP	180
AMPICILLIN	Omnipen	500	MG	CAP	180
AZITHROMYCIN	Zithromax	250	MG	TAB	6
AZITHROMYCIN	Zithromax	500	MG	TAB	3
CEFADROXIL	Duricef	500	MG	CAP	180
CEFDINIR	Omnicef	300	MG	CAP	28
CEFPROZIL	Cefzil	250	MG	TAB	180
CEFUROXIME AXETIL	Ceftin	250	MG	TAB	180
CEFUROXIME AXETIL	Ceftin	500	MG	TAB	180
CEPHALEXIN	Keﬂex	250	MG	CAP	90
CEPHALEXIN	Keﬂex	500	MG	CAP	90
CHLORHEXIDINE	Peridex	0.12	%	SOLN	473
CIPROFLOXACIN	Cipro	250	MG	TAB	60
CIPROFLOXACIN	Cipro	500	MG	TAB	60
CIPROFLOXACIN	Cipro	750	MG	TAB	60
CLARITHROMYCIN	Biaxin	250	MG	TAB	60
CLARITHROMYCIN	Biaxin	500	MG	TAB	60
CLINDAMYCIN HCL	Cleocin	150	MG	CAP	90
CLINDAMYCIN HCL	Cleocin	300	MG	CAP	90
DAPSONE	Dapsone	25	MG	TAB	180
DICLOXACILLIN	Diclocil	250	MG	CAP	180
ENTECAVIR	Baraclude	0.5	MG	TAB	90
ENTECAVIR	Baraclude	1	MG	TAB	90
FAMCICLOVIR	Famvir	250	MG	TAB	90
FAMCICLOVIR	Famvir	500	MG	TAB	90
IMIQUIMOD	Aldara	5	%	CREAM	24
ISONIAZID	Hydra	100	MG	TAB	90
ISONIAZID	Hydra	300	MG	TAB	90
LAMIVUDINE	Epivir	50	MG	TAB	90
LEVOFLOXACIN	Levaquin	250	MG	TAB	30
LEVOFLOXACIN	Levaquin	500	MG	TAB	30
LEVOFLOXACIN	Levaquin	750	MG	TAB	15
METHENAMINE	Hiprex	1	G	TAB	270
METRONIDAZOLE	Flagyl	250	MG	TAB	90
METRONIDAZOLE	Flagyl	500	MG	TAB	90
NEVIRAPINE	Viramune	200	MG	TAB	180
NITROFURANTOIN	Macrodantin	50	MG	CAP	180
NITROFURANTOIN	Macrodantin	100	MG	CAP	180
PHENAZOPYRIDINE	Pyridium	100	MG	TAB	36
PHENAZOPYRIDINE	Pyridium	200	MG	TAB	18
SMZ/TMP DS	Bactrim DS	800/160	MG	TAB	90
TENOFOVIR	Viread	300	MG	TAB	90
TETRACYCLINE	Sumycin	250	MG	CAP	360
TETRACYCLINE	Sumycin	500	MG	CAP	360
VALACYCLOVIR	Valtrex	500	MG	TAB	90
VALACYCLOVIR	Valtrex	1	GM	TAB	30

Cardiovascular

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ACEBUTOLOL	Sectral	200	MG	CAP	180
ACEBUTOLOL	Sectral	400	MG	CAP	180
AMILORIDE	Midamor	5	MG	TAB	90
AMILORIDE/HCTZ	Midamor/HCTZ	5/50	MG	TAB	90
AMIODARONE	Cordarone	200	MG	TAB	90
AMLODIPINE	Norvasc	2.5	MG	TAB	90
AMLODIPINE	Norvasc	5	MG	TAB	90
AMLODIPINE	Norvasc	10	MG	TAB	90
AMLODIPINE/BENAZEPRIL	Lotrel	2.5-10	MG	CAP	90
AMLODIPINE/BENAZEPRIL	Lotrel	5-10	MG	CAP	90
AMLODIPINE/BENAZEPRIL	Lotrel	5-20	MG	CAP	90
AMLODIPINE/BENAZEPRIL	Lotrel	5-40	MG	CAP	90
AMLODIPINE/BENAZEPRIL	Lotrel	10-20	MG	CAP	90
AMLODIPINE/BENAZEPRIL	Lotrel	10-40	MG	CAP	90
AMLODIPINE/OLMESARTAN	Azor	5-20	MG	TAB	90
AMLODIPINE/OLMESARTAN	Azor	5-40	MG	TAB	90
AMLODIPINE/OLMESARTAN	Azor	10-20	MG	TAB	90
AMLODIPINE/OLMESARTAN	Azor	10-40	MG	TAB	90
AMLODIPINE/VALSARTAN	Exforge	5-160	MG	TAB	90
AMLODIPINE/VALSARTAN	Exforge	5-320	MG	TAB	90
AMLODIPINE/VALSARTAN	Exforge	10-160	MG	TAB	90
ATENOLOL	Tenormin	25	MG	TAB	90
ATENOLOL	Tenormin	50	MG	TAB	90
ATENOLOL	Tenormin	100	MG	TAB	90
ATENOLOL/CHLORTHALIDONE	Tenoretic	50-25	MG	TAB	90
ATENOLOL/CHLORTHALIDONE	Tenoretic	100-25	MG	TAB	90
ATORVASTATIN	Lipitor	10	MG	TAB	90
ATORVASTATIN	Lipitor	20	MG	TAB	90
ATORVASTATIN	Lipitor	40	MG	TAB	90
ATORVASTATIN	Lipitor	80	MG	TAB	90
BENAZEPRIL	Lotensin	5	MG	TAB	90
BENAZEPRIL	Lotensin	10	MG	TAB	90
BENAZEPRIL	Lotensin	20	MG	TAB	90
BENAZEPRIL	Lotensin	40	MG	TAB	90
BENAZEPRIL/HCTZ	Lotensin HCT	10-12.5	MG	TAB	90
BENAZEPRIL/HCTZ	Lotensin HCT	20-12.5	MG	TAB	90
BENAZEPRIL/HCTZ	Lotensin HCT	20-25	MG	TAB	90
BETAXOLOL	Kerlone	10	MG	TAB	90
BISOPROLOL FUMARATE	Zebeta	5	MG	TAB	90
BISOPROLOL FUMARATE	Zebeta	10	MG	TAB	90
BISOPROLOL/HCTZ	Ziac	2.5-6.25	MG	TAB	90
BISOPROLOL/HCTZ	Ziac	5-6.25	MG	TAB	90
BISOPROLOL/HCTZ	Ziac	10-6.25	MG	TAB	90
BUMETANIDE	Bumex	0.5	MG	TAB	90
BUMETANIDE	Bumex	1	MG	TAB	90
BUMETANIDE	Bumex	2	MG	TAB	90
CAPTOPRIL	Capoten	12.5	MG	TAB	180
CAPTOPRIL	Capoten	25	MG	TAB	180
CAPTOPRIL	Capoten	50	MG	TAB	180
CAPTOPRIL/HCTZ	Capozide	25-15	MG	TAB	180
CAPTOPRIL/HCTZ	Capozide	25-25	MG	TAB	180
CAPTOPRIL/HCTZ	Capozide	50-25	MG	TAB	180
CARVEDILOL	Coreg	3.125	MG	TAB	180
CARVEDILOL	Coreg	6.25	MG	TAB	180
CARVEDILOL	Coreg	12.5	MG	TAB	180
CARVEDILOL	Coreg	25	MG	TAB	180
CHLOROTHIAZIDE	Diuril	500	MG	TAB	180
CHLORTHALIDONE	Hygroton	25	MG	TAB	90
CHLORTHALIDONE	Hygroton	50	MG	TAB	90
CHOLINE FENOFIBRATE	Trilipix	45	MG	CAP	90
CHOLINE FENOFIBRATE	Trilipix	135	MG	CAP	90
CILOSTAZOL	Pletal	50	MG	TAB	180
CILOSTAZOL	Pletal	100	MG	TAB	180
CLONIDINE	Catapres	0.1	MG	TAB	90
CLONIDINE	Catapres	0.2	MG	TAB	90
CLONIDINE	Catapres	0.3	MG	TAB	90
CLOPIDOGREL	Plavix	75	MG	TAB	90
DIGOXIN	Lanoxin	125	MCG	TAB	90
DIGOXIN	Lanoxin	250	MCG	TAB	90
DILTIAZEM	Cardizem	30	MG	TAB	180
DILTIAZEM	Cardizem	60	MG	TAB	180
DILTIAZEM	Cardizem	90	MG	TAB	90
DILTIAZEM	Cardizem	120	MG	TAB	90
DILTIAZEM ER	Cardizem CD	120	MG	ER CAP (24HR)	90
DILTIAZEM ER	Cardizem CD	180	MG	ER CAP (24HR)	90
DILTIAZEM ER	Cardizem CD	240	MG	ER CAP (24HR)	90
DILTIAZEM ER	Cardizem CD	300	MG	ER CAP (24HR)	90
DILTIAZEM ER	Cardizem CD	360	MG	ER CAP (24HR)	90
DIPYRIDAMOLE	Persantin	25	MG	TAB	90
DIPYRIDAMOLE	Persantin	50	MG	TAB	90
DIPYRIDAMOLE	Persantin	75	MG	TAB	90
DOFETILIDE	Tikosyn	125	MG	CAP	180
DOFETILIDE	Tikosyn	250	MG	CAP	180
DOFETILIDE	Tikosyn	500	MG	CAP	180
DOXAZOSIN	Cardura	1	MG	TAB	90
DOXAZOSIN	Cardura	2	MG	TAB	90
DOXAZOSIN	Cardura	4	MG	TAB	90
DOXAZOSIN	Cardura	8	MG	TAB	90
ENALAPRIL	Vasotec	2.5	MG	TAB	90
ENALAPRIL	Vasotec	5	MG	TAB	90
ENALAPRIL	Vasotec	10	MG	TAB	90
ENALAPRIL	Vasotec	20	MG	TAB	90
ENALAPRIL/HCTZ	Vaseretic	5-12.5	MG	TAB	90
ENALAPRIL/HCTZ	Vaseretic	10-25	MG	TAB	90
EPLERENONE	Inspra	25	MG	TAB	90
EZETIMIBE	Zetia	10	MG	TAB	90
EZETIMIBE/SIMVASTATIN	Vytorin	10-10	MG	TAB	90
EZETIMIBE/SIMVASTATIN	Vytorin	10-20	MG	TAB	90
EZETIMIBE/SIMVASTATIN	Vytorin	10-40	MG	TAB	90
EZETIMIBE/SIMVASTATIN	Vytorin	10-80	MG	TAB	90
FELODIPINE ER	Plendil ER	2.5	MG	ER TAB	90
FELODIPINE ER	Plendil ER	5	MG	ER TAB	90
FELODIPINE ER	Plendil ER	10	MG	ER TAB	90
FENOFIBRATE	Tricor	48	MG	TAB	90
FENOFIBRATE	Tricor	54	MG	TAB	90
FENOFIBRATE	Tricor	145	MG	TAB	90
FENOFIBRATE	Tricor	160	MG	TAB	90
FENOFIBRATE (MICRONIZED)	Antara	43	MG	CAP	90
FENOFIBRATE (MICRONIZED)	Antara	67	MG	CAP	90
FENOFIBRATE (MICRONIZED)	Antara	134	MG	CAP	90
FENOFIBRATE (MICRONIZED)	Loﬁbra	200	MG	CAP	90
FLECAINIDE	Tambocor	50	MG	TAB	180
FLECAINIDE	Tambocor	100	MG	TAB	180
FLECAINIDE	Tambocor	150	MG	TAB	180
FOSINOPRIL	Monopril	10	MG	TAB	90
FOSINOPRIL	Monopril	20	MG	TAB	90
FOSINOPRIL	Monopril	40	MG	TAB	90
FUROSEMIDE	Lasix	20	MG	TAB	90
FUROSEMIDE	Lasix	40	MG	TAB	90
FUROSEMIDE	Lasix	80	MG	TAB	90
GEMFIBROZIL	Lopid	600	MG	TAB	180
HCTZ	Microzide	12.5	MG	CAP	90
HCTZ	HydroDiuril	12.5	MG	TAB	90
HCTZ	HydroDiuril	25	MG	TAB	90
HCTZ	HydroDiuril	50	MG	TAB	90
HYDRALAZINE	Apresoline	10	MG	TAB	270
HYDRALAZINE	Apresoline	25	MG	TAB	270
HYDRALAZINE	Apresoline	50	MG	TAB	180
HYDRALAZINE	Apresoline	100	MG	TAB	90
HYDRALAZINE/HCTZ	Apresazide	50-50	MG	TAB	90
INDAPAMIDE	Lozol	1.25	MG	TAB	90
INDAPAMIDE	Lozol	2.5	MG	TAB	90
IRBESARTAN	Avapro	75	MG	TAB	90
IRBESARTAN	Avapro	150	MG	TAB	90
IRBESARTAN	Avapro	300	MG	TAB	90
IRBESARTAN/HCTZ	Avalide	150/12.5	MG	TAB	90
IRBESARTAN/HCTZ	Avalide	300/12.5	MG	TAB	90
ISOSORBIDE MONONITRATE	Imdur	30	MG	ER TAB (24HR)	90
ISOSORBIDE MONONITRATE	Imdur	60	MG	ER TAB (24HR)	90
ISOSORBIDE MONONITRATE	Imdur	120	MG	ER TAB (24HR)	90
JANTOVEN	Coumadin	1	MG	TAB	90
JANTOVEN	Coumadin	2	MG	TAB	90
JANTOVEN	Coumadin	7.5	MG	TAB	90
JANTOVEN	Coumadin	10	MG	TAB	90
LABETOLOL	Trandate	100	MG	TAB	180
LABETOLOL	Trandate	200	MG	TAB	180
LABETOLOL	Trandate	300	MG	TAB	180
LISINOPRIL	Zestril	2.5	MG	TAB	180
LISINOPRIL	Zestril	5	MG	TAB	180
LISINOPRIL	Zestril	10	MG	TAB	180
LISINOPRIL	Zestril	20	MG	TAB	180
LISINOPRIL	Zestril	30	MG	TAB	180
LISINOPRIL	Zestril	40	MG	TAB	180
LISINOPRIL/HCTZ	Zestoretic	10-12.5	MG	TAB	180
LISINOPRIL/HCTZ	Zestoretic	20-12.5	MG	TAB	180
LISINOPRIL/HCTZ	Zestoretic	20-25	MG	TAB	180
LOSARTAN	Cozaar	25	MG	TAB	180
LOSARTAN	Cozaar	50	MG	TAB	180
LOSARTAN	Cozaar	100	MG	TAB	180
LOSARTAN/HCTZ	Hyzaar	50-12.5	MG	TAB	180
LOSARTAN/HCTZ	Hyzaar	100-12.5	MG	TAB	180
LOSARTAN/HCTZ	Hyzaar	100-25	MG	TAB	180
LOVASTATIN	Mevacor	10	MG	TAB	90
LOVASTATIN	Mevacor	20	MG	TAB	90
LOVASTATIN	Mevacor	40	MG	TAB	90
METHYLDOPA	Aldomet	250	MG	TAB	270
METHYLDOPA	Aldomet	500	MG	TAB	270
METOPROLOL SUCCINATE	Toprol XL	25	MG	ER TAB (24HR)	90
METOPROLOL SUCCINATE	Toprol XL	50	MG	ER TAB (24HR)	90
METOPROLOL SUCCINATE	Toprol XL	100	MG	ER TAB (24HR)	90
METOPROLOL SUCCINATE	Toprol XL	200	MG	ER TAB (24HR)	90
METOPROLOL TARTRATE	Lopressor	25	MG	TAB	180
METOPROLOL TARTRATE	Lopressor	50	MG	TAB	180
METOPROLOL TARTRATE	Lopressor	100	MG	TAB	180
MIDODRINE	ProAmatine	2.5	MG	TAB	270
MIDODRINE	ProAmatine	5	MG	TAB	270
MIDODRINE	ProAmatine	10	MG	TAB	270
MINOXIDIL	Loniten	2.5	MG	TAB	90
MINOXIDIL	Loniten	10	MG	TAB	90
NADOLOL	Corgard	20	MG	TAB	90
NADOLOL	Corgard	80	MG	TAB	90
NADOLOL	Corgard	40	MG	TAB	90
NEBIVOLOL	Bystolic	2.5	MG	TAB	90
NEBIVOLOL	Bystolic	5	MG	TAB	90
NEBIVOLOL	Bystolic	10	MG	TAB	90
NEBIVOLOL	Bystolic	20	MG	TAB	90
NIACIN ER	Niaspan	500	MG	TAB	90
NIACIN ER	Niaspan	750	MG	TAB	90
NIACIN ER	Niaspan	1000	MG	TAB	90
NIFEDIPINE XL	Procardia XL	30	MG	ER OSM TAB (24HR)	90
NIFEDIPINE XL	Procardia XL	60	MG	ER OSM TAB (24HR)	90
NIFEDIPINE XL	Procardia XL	90	MG	ER OSM TAB (24HR)	90
NIFEDIPINE ER	Adalat CC	30	MG	ER TAB (24HR)	90
NIFEDIPINE ER	Adalat CC	60	MG	ER TAB (24HR)	90
NIFEDIPINE ER	Adalat CC	90	MG	ER TAB (24HR)	90
NITROGLYCERIN	Nitro Dur	0.1	MG/HR	PATCHES	90
NITROGLYCERIN	Nitro Dur	0.2	MG/HR	PATCHES	90
NITROGLYCERIN	Nitro Dur	0.4	MG/HR	PATCHES	90
NITROGLYCERIN	Nitro Dur	0.6	MG/HR	PATCHES	90
NITROGLYCERIN	Nitrostat	0.3	MG	SL TAB	300

Dermatology

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ADAPALENE	Differin	0.1	%	GEL	45
ADAPALENE	Differin	0.3	%	GEL	45
ADAPALENE/BENZOYL PEROXIDE	Epiduo	0.1/2.5	%	GEL	45
AMINOBENZOATE	Potaba	500	MG	TAB	90
BENZOYL PEROXIDE WASH	Benzac AC	5	%	WASH	474
BENZOYL PEROXIDE WASH	Benzac AC	10	%	WASH	474
CICLOPIROX	Penlac	8	%	SOLN	19.8
CLINDAMYCIN PHOSPHATE	Cleocin-T	1	%	SOLN	180
CLINDAMYCIN PHOSPHATE	Clindagel	1	%	GEL	60
CLINDAMYCIN/BENZOYL PEROXIDE	Duac	1.2/5	%	GEL	135
CLINDAMYCIN/BENZOYL PEROXIDE	Benzaclin	1/5	%	GEL	50
CLOBETASOL	Temovate	0.05	%	CREAM	60
CLOBETASOL	Temovate	0.05	%	GEL	60
CLOBETASOL	Temovate	0.05	%	OINT	60
CLOBETASOL	Temovate	0.05	%	SOLN	100
DESONIDE	DesOwen	0.05	%	CREAM	120
DESONIDE	DesOwen	0.05	%	LOTION	177
DESONIDE	DesOwen	0.05	%	OINT	120
DESOXIMETASONE	Topicort	0.25	%	CREAM	45
DOXYCYCLINE HYCLATE	Vibramycin	50	MG	CAP	180
DOXYCYCLINE HYCLATE	Vibramycin	100	MG	CAP	180
DOXYCYCLINE MONOHYDRATE	Monodox	50	MG	CAP	90
DOXYCYCLINE MONOHYDRATE	Monodox	100	MG	CAP	90
ECONAZOLE NITRATE	Spectazole	1	%	CREAM	60
FLUOCINONIDE	Vanos	0.05	%	CREAM	180
FLUOCINONIDE	Vanos	0.1	%	CREAM	120
FLUOCINONIDE	Vanos	0.05	%	OINT	90
HYDROCORTISONE	Cortaid	1	%	CREAM	84
HYDROCORTISONE	Ala-Cort	1	%	OINT	85
HYDROCORTISONE	Ala-cort	2.5	%	CREAM	85
HYDROCORTISONE	Ala-Cort	2.5	%	OINT	60
HYDROCORTISONE	Anusol HC	2.5	%	CREAM	30
HYDROQUINONE	Lustra	4	%	CREAM	90
HYDROXYZINE HCL	Atarax	10	MG	TAB	180
HYDROXYZINE HCL	Atarax	25	MG	TAB	180
HYDROXYZINE HCL	Atarax	50	MG	TAB	90
KETOCONAZOLE	Nizoral	200	MG	TAB	60
KETOCONAZOLE	Nizoral	2	%	CREAM	90
KETOCONAZOLE	Nizoral	2	%	SHAMPOO	360
LIDOCAINE	Xylocaine	5	%	OINT	106
LIDOCAINE/PRILOCAINE	Emla	2.5	%	CREAM	90
METRONIDAZOLE	ROSADAN	0.75	%	CREAM	135
METRONIDAZOLE	ROSADAN	0.75	%	GEL	135
MINOCYCLINE	Minocin	50	MG	CAP	90
MINOCYCLINE	Minocin	75	MG	CAP	90
MINOCYCLINE	Minocin	100	MG	CAP	90
MUPIROCIN	Bactroban	2	%	OINT	90
NYSTATIN	Mycostatin	100	MU	CREAM	90
NYSTATIN	Mycostatin	100	MU	OINT	45
NYSTATIN	Nystop	100	MU	POWDER	180
NYSTATIN/TRIAMCINOLONE	Mycolog-II	100	MU	CREAM	90
SILVER SULFADIAZINE	Silvadene	1	%	CREAM	150
SPIRONOLACTONE	Aldactone	25	MG	TAB	90
SPIRONOLACTONE	Aldactone	50	MG	TAB	90
SPIRONOLACTONE	Aldactone	100	MG	TAB	90
SULFACETAMIDE/SULFUR	Plexion	10/5	%	CLEANSER	170.3
TERBINAFINE	Lamisil	250	MG	TAB	90
TERBINAFINE	Lamisil	1	%	CREAM	90
TRIAMCINOLONE	Kenalog	0.025	%	OINT	240
TRIAMCINOLONE	Kenalog	0.1	%	OINT	240
TRIAMCINOLONE	Kenalog	0.5	%	OINT	45
TRIAMCINOLONE	Kenalog	0.025	%	CREAM	240
TRIAMCINOLONE	Kenalog	0.1	%	CREAM	270
TRIAMCINOLONE	Kenalog	0.5	%	CREAM	45

Diabetes

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ACARBOSE	Precose	25	MG	TAB	270
ACARBOSE	Precose	50	MG	TAB	270
ACARBOSE	Precose	100	MG	TAB	270
CHLORPROPAMIDE	Diabinese	250	MG	CAP	180
GLIMEPIRIDE	Amaryl	1	MG	TAB	90
GLIMEPIRIDE	Amaryl	2	MG	TAB	180
GLIMEPIRIDE	Amaryl	4	MG	TAB	180
GLIPIZIDE	Glucotrol	5	MG	TAB	180
GLIPIZIDE	Glucotrol	10	MG	TAB	180
GLIPIZIDE	Glucotrol XL	2.5	MG	ER TAB (24HR)	90
GLIPIZIDE	Glucotrol XL	5	MG	ER TAB (24HR)	180
GLIPIZIDE	Glucotrol XL	10	MG	ER TAB (24HR)	180
GLIPIZIDE/METFORMIN	Metaglip	2.5-250	MG	TAB	180
GLIPIZIDE/METFORMIN	Metaglip	5-500	MG	TAB	180
GLYBURIDE	Glynase	1.25	MG	TAB	90
GLYBURIDE	Glynase	2.5	MG	TAB	90
GLYBURIDE	Glynase	5	MG	TAB	180
GLYBURIDE/METFORMIN	Glucovance	1.25-250	MG	TAB	180
GLYBURIDE/METFORMIN	Glucovance	2.5-500	MG	TAB	180
GLYBURIDE/METFORMIN	Glucovance	5-500	MG	TAB	180
METFORMIN	Glucophage	500	MG	TAB	360
METFORMIN	Glucophage	850	MG	TAB	360
METFORMIN	Glucophage	1000	MG	TAB	360
METFORMIN	Glucophage XR	500	MG	ER TAB (24HR)	360
METFORMIN	Glucophage XR	750	MG	ER TAB (24HR)	360
NATEGLINIDE	Starlix	60	MG	TAB	270
NATEGLINIDE	Starlix	120	MG	TAB	270
PIOGLITAZONE	Actos	15	MG	TAB	90
PIOGLITAZONE	Actos	30	MG	TAB	90
PIOGLITAZONE	Actos	45	MG	TAB	90
PIOGLITAZONE/METFORMIN	Actoplus Met	15/500	MG	TAB	180
PIOGLITAZONE/METFORMIN	Actoplus Met	15/850	MG	TAB	180
PRODIGY DIABETIC TEST STRIPS				STRIPS	150
PRODIGY GLUCOSE METER					1
PRODIGY LANCETS					200
REPAGLINIDE	Prandin	0.5	MG	TAB	270
REPAGLINIDE	Prandin	1	MG	TAB	270
REPAGLINIDE	Prandin	2	MG	TAB	270

Endocrinology

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
CINACALCET	Sensipar	30	MG	TAB	90
DESMOPRESSIN	DDAVP	0.1	MG	TAB	90
DESMOPRESSIN	DDAVP	0.2	MG	TAB	90
LEVOTHYROXINE	Synthroid	25	MCG	TAB	90
LEVOTHYROXINE	Synthroid	50	MCG	TAB	90
LEVOTHYROXINE	Synthroid	75	MCG	TAB	90
LEVOTHYROXINE	Synthroid	88	MCG	TAB	90
LEVOTHYROXINE	Synthroid	100	MCG	TAB	90
LEVOTHYROXINE	Synthroid	112	MCG	TAB	90
LEVOTHYROXINE	Synthroid	125	MCG	TAB	90
LEVOTHYROXINE	Synthroid	137	MCG	TAB	90
LEVOTHYROXINE	Synthroid	150	MCG	TAB	90
LEVOTHYROXINE	Synthroid	175	MCG	TAB	90
LEVOTHYROXINE	Synthroid	200	MCG	TAB	90
LEVOTHYROXINE	Synthroid	300	MCG	TAB	90
LIOTHYRONINE	Cytomel	5	MCG	TAB	90
LIOTHYRONINE	Cytomel	25	MCG	TAB	90
LIOTHYRONINE	Cytomel	50	MCG	TAB	90
METHIMAZOLE	Tapazole	5	MG	TAB	90
METHIMAZOLE		10	MG	TAB	9
DESMOPRESSIN	DDAVP	0.1	MG	TAB	90
DESMOPRESSIN	DDAVP	0.2	MG	TAB	90
LEVOTHYROXINE	Synthroid	25	MCG	TAB	90
LEVOTHYROXINE	Synthroid	50	MCG	TAB	90
LEVOTHYROXINE	Synthroid	75	MCG	TAB	90
LEVOTHYROXINE	Synthroid	88	MCG	TAB	90
LEVOTHYROXINE	Synthroid	100	MCG	TAB	90
LEVOTHYROXINE	Synthroid	112	MCG	TAB	90
LEVOTHYROXINE	Synthroid	125	MCG	TAB	90
LEVOTHYROXINE	Synthroid	137	MCG	TAB	90
LEVOTHYROXINE	Synthroid	150	MCG	TAB	90
LEVOTHYROXINE	Synthroid	175	MCG	TAB	90
LEVOTHYROXINE	Synthroid	200	MCG	TAB	90
LEVOTHYROXINE	Synthroid	300	MCG	TAB	90
LIOTHYRONINE	Cytomel	5	MCG	TAB	90
LIOTHYRONINE	Cytomel	25	MCG	TAB	90
LIOTHYRONINE	Cytomel	50	MCG	TAB	90
METHIMAZOLE	Tapazole	5	MG	TAB	90
METHIMAZOLE	Tapazole	10	MG	TAB	90

Gastrointestinal

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
DICYCLOMINE	Bentyl	10	MG	CAP	180
DICYCLOMINE	Bentyl	20	MG	TAB	90
DOCUSATE SODIUM	Colace	100	MG	CAP	90
ESOMEPRAZOLE	Nexium	20	MG	DR CAP	90
ESOMEPRAZOLE	Nexium	40	MG	DR CAP	90
FAMOTIDINE	Pepcid	20	MG	TAB	180
FAMOTIDINE	Pepcid	40	MG	TAB	90
GLYCOPYRROLATE	Robinul	1	MG	TAB	90
GLYCOPYRROLATE	Robinul	2	MG	TAB	90
HYOSCYAMINE	Levsin	0.125	MG	TAB	360
HYOSCYAMINE	Anaspaz	0.125	MG	ODT TAB	360
HYOSCYAMINE SR	Levbid	0.375	MG	SR TAB (12HR)	90
LANSOPRAZOLE	Prevacid	15	MG	DR CAP	180
LANSOPRAZOLE	Prevacid	30	MG	DR CAP	180
LIDOCAINE	Xylocaine	2	%	SOLN	300
LOPERAMIDE	Imodium	2	MG	CAP	90
METOCLOPRAMIDE	Reglan	5	MG	TAB	180
METOCLOPRAMIDE	Reglan	10	MG	TAB	180
OMEPRAZOLE	Prilosec	10	MG	DR CAP	180
OMEPRAZOLE	Prilosec	20	MG	DR CAP	180
OMEPRAZOLE	Prilosec	40	MG	DR CAP	180
ONDANSETRON	Zofran	4	MG	TAB	90
ONDANSETRON	Zofran	8	MG	TAB	90
ONDANSETRON	Zofran ODT	4	MG	ODT TAB	90
ONDANSETRON	Zofran ODT	8	MG	ODT TAB	90
PANTOPRAZOLE	Protonix	20	MG	DR TAB	180
PANTOPRAZOLE	Protonix	40	MG	DR TAB	180
POLYETHYLENE GLYCOL	Miralax	17	GM	POWDER	476
PROMETHAZINE	Phenergan	12.5	MG	TAB	90
PROMETHAZINE	Phenergan	25	MG	TAB	90
PROMETHAZINE	Phenergan	50	MG	TAB	90
RABEPRAZOLE	Aciphex	20	MG	TAB	90

Men's Health

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ALFUZOSIN	Uroxatrol	10	MG	TAB	90
BETHANECHOL	Urecholine	5	MG	TAB	180
BETHANECHOL	Urecholine	10	MG	TAB	180
BETHANECHOL	Urecholine	25	MG	TAB	180
BETHANECHOL	Urecholine	50	MG	TAB	180
BICALUTAMIDE	Casodex	50	MG	CAP	90
DUTASTERIDE	Avodart	0.5	MG	CAP	90
EMTRICITABINE-TENOFOVIR	Truvada	200-300	MG	TAB	90
FINASTERIDE	Propecia	1	MG	TAB	90
FINASTERIDE	Proscar	5	MG	TAB	90
MINOXIDIL	Rogaine	5	%	SOLN	180
OXYBUTYNIN	Ditropan	5	MG	TAB	180
OXYBUTYNIN	Ditropan XL	5	MG	ER TAB (24HR)	90
OXYBUTYNIN	Ditropan XL	10	MG	ER TAB (24HR)	90
OXYBUTYNIN	Ditropan XL	15	MG	ER TAB (24HR)	90
SILDENAFIL	Revatio	20	MG	TAB	90
SILDENAFIL	Viagra	25	MG	TAB	45
SILDENAFIL	Viagra	50	MG	TAB	45
SILDENAFIL	Viagra	100	MG	TAB	30
SILODOSIN	Rapaﬂo	4	MG	CAP	90
SILODOSIN	Rapaﬂo	8	MG	CAP	90
SOLIFENACIN	VESICARE	5	MG	TAB	90
SOLIFENACIN	VESICARE	10	MG	TAB	90
TADALAFIL	Cialis	2.5	MG	TAB	90
TADALAFIL	Cialis	5	MG	TAB	90
TADALAFIL	Cialis	10	MG	TAB	45
TADALAFIL	Cialis	20	MG	TAB	30
TAMSULOSIN	Flomax	0.4	MG	CAP	90
TOLTERODINE ER	Detrol LA	2	MG	CAP	90
TROSPIUM	Sanctura	20	MG	TAB	90

Mental Health

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
AMITRIPTYLINE	Elavil	10	MG	TAB	90
AMITRIPTYLINE	Elavil	25	MG	TAB	90
AMITRIPTYLINE	Elavil	50	MG	TAB	90
AMITRIPTYLINE	Elavil	75	MG	TAB	90
AMITRIPTYLINE	Elavil	100	MG	TAB	90
AMITRIPTYLINE	Elavil	150	MG	TAB	90
ARIPIPRAZOLE	Abilify	2	MG	TAB	90
ARIPIPRAZOLE	Abilify	5	MG	TAB	90
ARIPIPRAZOLE	Abilify	10	MG	TAB	90
ARIPIPRAZOLE	Abilify	15	MG	TAB	90
ARIPIPRAZOLE	Abilify	20	MG	TAB	90
ARIPIPRAZOLE	Abilify	30	MG	TAB	90
BENZTROPINE	Cogentin	0.5	MG	TAB	180
BENZTROPINE	Cogentin	1	MG	TAB	180
BENZTROPINE	Cogentin	2	MG	TAB	180
BUPROPION	Wellbutrin	75	MG	TAB	270
BUPROPION	Wellbutrin	100	MG	TAB	270
BUPROPION	Wellbutrin SR	100	MG	SR TAB (12HR)	180
BUPROPION	Wellbutrin SR	150	MG	SR TAB (12HR)	180
BUPROPION	Wellbutrin SR	200	MG	SR TAB (12HR)	180
BUPROPION	Wellbutrin XL	150	MG	XL TAB (24HR)	90
BUPROPION	Wellbutrin XL	300	MG	XL TAB (24HR)	90
BUSPIRONE	Buspar	5	MG	TAB	270
BUSPIRONE	Buspar	7.5	MG	TAB	270
BUSPIRONE	Buspar	10	MG	TAB	270
BUSPIRONE	Buspar	15	MG	TAB	270
BUSPIRONE	Buspar	30	MG	TAB	180
CARBAMAZEPINE	Tegretol	200	MG	TAB	180
CARBIDOPA	Lodosyn	25	MG	TAB	360
CARBIDOPA/LEVODOPA	Sinemet	10-100	MG	TAB	270
CARBIDOPA/LEVODOPA	Sinemet	25-100	MG	TAB	270
CARBIDOPA/LEVODOPA	Sinemet	25-250	MG	TAB	270
CARBIDOPA/LEVODOPA	Sinemet CR	25-100	MG	ER TAB	180
CARBIDOPA/LEVODOPA	Sinemet CR	50-200	MG	ER TAB	180
CHLORPROMAZINE	Thorazine	25	MG	CAP	180
CITALOPRAM	Celexa	10	MG	TAB	90
CITALOPRAM	Celexa	20	MG	TAB	90
CITALOPRAM	Celexa	40	MG	TAB	90
CLOMIPRAMINE	Anafranil	25	MG	CAP	90
CLOMIPRAMINE	Anafranil	50	MG	CAP	90
CLOMIPRAMINE	Anafranil	75	MG	CAP	90
DESIPRAMINE	Norpramin	10	MG	TAB	90
DESIPRAMINE	Norpramin	25	MG	TAB	90
DESIPRAMINE	Norpramin	50	MG	TAB	90
DESIPRAMINE	Norpramin	100	MG	TAB	90
DESVENLAFAXINE ER	Pristiq	25	MG	ER TAB	90
DESVENLAFAXINE ER	Pristiq	50	MG	ER TAB	90
DESVENLAFAXINE ER	Pristiq	100	MG	ER TAB	90
DIVALPROEX	Depakote	125	MG	DR TAB	180
DIVALPROEX	Depakote	250	MG	DR TAB	180
DIVALPROEX	Depakote	500	MG	DR TAB	180
DIVALPROEX	Depakote ER	250	MG	ER TAB (24HR)	90
DIVALPROEX	Depakote ER	500	MG	ER TAB (24HR)	90
DONEPEZIL	Aricept	5	MG	TAB	90
DONEPEZIL	Aricept	10	MG	TAB	90
DONEPEZIL	Aricept	23	MG	TAB	90
DONEPEZIL	Aricept	5	MG	ODT TAB	90
DONEPEZIL	Aricept	10	MG	ODT TAB	90
DOXEPIN	Silenor	10	MG	CAP	90
DOXEPIN	Silenor	25	MG	CAP	90
DOXEPIN	Silenor	50	MG	CAP	90
DOXEPIN	Silenor	75	MG	CAP	90
DOXEPIN	Silenor	100	MG	CAP	90
DULOXETINE	Cymbalta	20	MG	DR CAP	90
DULOXETINE	Cymbalta	30	MG	DR CAP	180
DULOXETINE	Cymbalta	60	MG	DR CAP	180
ESCITALOPRAM	Lexapro	5	MG	TAB	90
ESCITALOPRAM	Lexapro	10	MG	TAB	90
ESCITALOPRAM	Lexapro	20	MG	TAB	90
ETHOSUXIMIDE	Zarontin	250	MG	CAP	90
FLUOXETINE	Prozac	10	MG	CAP	90
FLUOXETINE	Prozac	20	MG	CAP	90
FLUOXETINE	Prozac	40	MG	CAP	90
FLUOXETINE	Prozac	10	MG	TAB	90
FLUOXETINE	Prozac	20	MG	TAB	90
FLUOXETINE	Prozac	60	MG	TAB	90
FLUPHENAZINE	Modecate	2.5	MG	TAB	270
FLUPHENAZINE	Modecate	5	MG	TAB	270
FLUVOXAMINE	Luvox	25	MG	TAB	90
FLUVOXAMINE	Luvox	50	MG	TAB	90
FLUVOXAMINE	Luvox	100	MG	TAB	90
GALANTAMINE	Razadyne	4	MG	TAB	180
GALANTAMINE	Razadyne	8	MG	TAB	180
GALANTAMINE	Razadyne	12	MG	TAB	180
HALOPERIDOL	Haldol	0.5	MG	TAB	270
HALOPERIDOL	Haldol	1	MG	TAB	270
HYDROXYZINE PAMOATE	Vistaril	25	MG	CAP	90
HYDROXYZINE PAMOATE	Vistaril	50	MG	CAP	90
IMIPRAMINE	Tofranil	10	MG	TAB	180
IMIPRAMINE	Tofranil	25	MG	TAB	180
IMIPRAMINE	Tofranil	50	MG	TAB	180
LAMOTRIGINE	Lamictal	25	MG	TAB	90
LAMOTRIGINE	Lamictal	100	MG	TAB	90
LAMOTRIGINE	Lamictal	150	MG	TAB	90
LAMOTRIGINE	Lamictal	200	MG	TAB	90
LAMOTRIGINE ER	Lamictal ER	25	MG	TAB	90
LAMOTRIGINE ER	Lamictal ER	50	MG	TAB	90
LAMOTRIGINE ER	Lamictal ER	100	MG	TAB	90
LAMOTRIGINE ER	Lamictal ER	200	MG	TAB	90
LEVETIRACETAM	Keppra	250	MG	TAB	180
LEVETIRACETAM	Keppra	500	MG	TAB	180
LEVETIRACETAM	Keppra	750	MG	TAB	180
LEVETIRACETAM XR	Keppra XR	500	MG	TAB	90
LITHIUM	Lithobid	150	MG	CAP	270
LITHIUM	Lithobid	300	MG	CAP	270
LITHIUM	Lithobid	600	MG	CAP	270
LITHIUM	Lithobid	300	MG	ER TAB	180
LITHIUM	Lithobid	450	MG	ER TAB	180
LOXAPINE	Loxitane	5	MG	CAP	180
LOXAPINE	Loxitane	10	MG	CAP	180
MEMANTINE	Namenda	5	MG	TAB	180
MEMANTINE	Namenda	10	MG	TAB	180
MIRTAZAPINE	Remeron	15	MG	TAB	90
MIRTAZAPINE	Remeron	30	MG	TAB	90
MIRTAZAPINE	Remeron	45	MG	TAB	90
NEFAZODONE	Serzone	50	MG	TAB	180
NEFAZODONE	Serzone	100	MG	TAB	180
NEFAZODONE	Serzone	150	MG	TAB	180
NEFAZODONE	Serzone	200	MG	TAB	180
NEFAZODONE	Serzone	250	MG	TAB	180
NORTRIPTYLINE	Pamelor	10	MG	CAP	90
NORTRIPTYLINE	Pamelor	25	MG	CAP	90
NORTRIPTYLINE	Pamelor	50	MG	CAP	90
NORTRIPTYLINE	Pamelor	75	MG	CAP	90
OLANZAPINE	Zyprexa Zydis	5	MG	ODT TAB	90
OLANZAPINE	Zyprexa Zydis	10	MG	ODT TAB	90
OLANZAPINE	Zyprexa Zydis	15	MG	ODT TAB	90
OLANZAPINE	Zyprexa Zydis	20	MG	ODT TAB	90
OLANZAPINE	Zyprexa	2.5	MG	TAB	90
OLANZAPINE	Zyprexa	5	MG	TAB	90
OLANZAPINE	Zyprexa	7.5	MG	TAB	90
OLANZAPINE	Zyprexa	10	MG	TAB	90
OLANZAPINE	Zyprexa	15	MG	TAB	90
OLANZAPINE	Zyprexa	20	MG	TAB	90
OXCARBAZEPINE	Trileptal	150	MG	TAB	180
OXCARBAZEPINE	Trileptal	300	MG	TAB	180
OXCARBAZEPINE	Trileptal	600	MG	TAB	180
PAROXETINE	Paxil	10	MG	TAB	90
PAROXETINE	Paxil	20	MG	TAB	90
PAROXETINE	Paxil	30	MG	TAB	90
PAROXETINE	Paxil	40	MG	TAB	90
PAROXETINE CR	Paxil CR	12.5	MG	TAB	90
PAROXETINE CR	Paxil CR	25	MG	TAB	90
PAROXETINE CR	Paxil CR	37.5	MG	MG TAB	90
PERPHANAZINE	Trilafon	2	MG	TAB	270
PERPHENAZINE	Trilafon	4	MG	TAB	270
PERPHENAZINE	Trilafon	8	MG	TAB	270
PHENYTOIN ER	Dilantin ER	100	MG	ER CAP	270
PRAMIPEXOLE	Mirapex	0.125	MG	TAB	270
PRAMIPEXOLE	Mirapex	0.25	MG	TAB	270
PRAMIPEXOLE	Mirapex	0.5	MG	TAB	270
PRAMIPEXOLE	Mirapex	1	MG	TAB	180
PRAMIPEXOLE	Mirapex	1.5	MG	TAB	180
PRIMIDONE	Mysoline	50	MG	TAB	90
PRIMIDONE	Mysoline	250	MG	TAB	90
PROCHLORPERAZINE	Compazine	5	MG	TAB	90
PYRIDOSTIGMINE	Rifater	60	MG	TAB	270
QUETIAPINE	Seroquel	25	MG	TAB	90
QUETIAPINE	Seroquel	50	MG	TAB	90
QUETIAPINE	Seroquel	100	MG	TAB	90
QUETIAPINE	Seroquel	200	MG	TAB	90
QUETIAPINE	Seroquel	300	MG	TAB	90
QUETIAPINE	Seroquel	400	MG	TAB	90
QUETIAPINE	Seroquel XR	50	MG	ER TAB (24HR)	90
QUETIAPINE	Seroquel XR	150	MG	ER TAB (24HR)	90
QUETIAPINE	Seroquel XR	200	MG	ER TAB (24HR)	90
QUETIAPINE	Seroquel XR	300	MG	ER TAB (24HR)	90
QUETIAPINE	Seroquel XR	400	MG	ER TAB (24HR)	90
RILUZOLE	Rilutek	50	MG	TAB	180
RISPERIDONE	Risperdal	0.25	MG	TAB	180
RISPERIDONE	Risperdal	0.5	MG	TAB	180
RISPERIDONE	Risperdal	1	MG	TAB	180
RISPERIDONE	Risperdal	2	MG	TAB	180
RISPERIDONE	Risperdal	3	MG	TAB	90
RISPERIDONE	Risperdal	4	MG	TAB	90
RIVASTIGMINE	Exelon	1.5	MG	CAP	180
RIVASTIGMINE	Exelon	3	MG	CAP	180
RIVASTIGMINE	Exelon	4.5	MG	CAP	180
RIVASTIGMINE	Exelon	6	MG	CAP	180
SELEGILINE	Eldepryl	5	MG	TAB	90
SERTRALINE	Zoloft	25	MG	TAB	90
SERTRALINE	Zoloft	50	MG	TAB	90
SERTRALINE	Zoloft	100	MG	TAB	90
THIORIDAZINE	Mellaril	10	MG	TAB	270
THIORIDAZINE	Mellaril	25	MG	TAB	270
THIORIDAZINE	Mellaril	100	MG	TAB	270
THIOTHIXENE	Navane	1	MG	CAP	180
THIOTHIXENE	Navane	2	MG	CAP	180
THIOTHIXENE	Navane	5	MG	CAP	180
TOPIRAMATE	Topamax	25	MG	TAB	180
TOPIRAMATE	Topamax	50	MG	TAB	180
TOPIRAMATE	Topamax	100	MG	TAB	180
TOPIRAMATE	Topamax	200	MG	TAB	90
TRAZODONE	Oleptro	50	MG	TAB	90
TRAZODONE	Oleptro	100	MG	TAB	90
TRAZODONE	Oleptro	150	MG	TAB	90
TRIHEXYPHENIDYL	Artane	2	MG	TAB	180
TRIHEXYPHENIDYL	Artane	5	MG	TAB	180
VALPROIC ACID	Depakene	250	MG	CAP	180
VENLAFAXINE	Effexor	25	MG	TAB	180

Migraine

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
NARATRIPTAN	Amerge	1	MG	TAB	27
NARATRIPTAN	Amerge	2.5	MG	TAB	27
RIZATRIPTAN	Maxalt	5	MG	TAB	18
RIZATRIPTAN	Maxalt	10	MG	TAB	18
RIZATRIPTAN	Maxalt MLT	5	MG	ODT TAB	18
RIZATRIPTAN	Maxalt MLT	10	MG	ODT TAB	18
SUMATRIPTAN	Imitrex	25	MG	TAB	27
SUMATRIPTAN	Imitrex	50	MG	TAB	27
SUMATRIPTAN	Imitrex	100	MG	TAB	27
ZOLMITRIPTAN	Zomig ODT	2.5	MG	ODT TAB	18
ZOLMITRIPTAN	Zomig ODT	5	MG	ODT TAB	18
ZOLMITRIPTAN	Zomig	2.5	MG	TAB	18
ZOLMITRIPTAN	Zomig	5	MG	TAB	9

Oncology

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
CAPECITABINE	Xeloda	150	MG	TAB	180
HYDROXYUREA	Hydrea	500	MG	CAP	180
PILOCARPINE	Salagen	5	MG	TAB	270

Opthalmic

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ACETAZOLAMIDE	Diamox	125	MG	TAB	270
ACETAZOLAMIDE	Diamox	250	MG	TAB	270
BRIMONIDINE TARTRATE	Alphagan	0.2	%	OPTH SOLN	15
CIPROFLOXACIN	Ciloxan	0.3	%	OPTH SOLN	5
DICLOFENAC	Voltaren	0.1	%	OPTH SOLN	15
DORZOLAMIDE	Trusopt	2	%	OPTH SOLN	20
DORZOLAMIDE/TIMOLOL	Cosopt	2/0.5	%	OPTH SOLN	20
ERYTHROMYCIN	Illotycin	0.5	%	OPTH OINT	3.5
GENTAMICIN	Garamycin	0.3	%	OPTH SOLN	5
LATANOPROST	Xalatan	0.005	%	OPTH SOLN	7.5
METHAZOLAMIDE	Neptazane	25	MG	TAB	270
METHAZOLAMIDE	Neptazane	50	MG	TAB	270
MOXIFLOXACIN	Vigamox	0.5	%	OPTH SOLN	6
NEOMYCIN/POLY/DEX	Maxitrol			OPTH SUSP	15
NEOMYCIN/POLY/DEX	Maxitrol			OPTH OINT	10.5
OFLOXACIN	Ocuﬂox	0.3	%	OPTH SOLN	5
OLOPATADINE	Pataday	0.1	%	OPTH SOLN	10
SULFACETAMIDE/PREDNISOLONE	Blephamide	10/0.23	%	OPTH SOLN	1
TIMOLOL	Timoptic	0.25	%	OPTH SOLN	15
TIMOLOL	Timoptic	0.5	%	OPTH SOLN	15
TOBRAMYCIN	Tobrex	0.3	%	OPTH SOLN	15

Pain Management

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
BACLOFEN	Lioresal	5	MG	TAB	200
BACLOFEN	Lioresal	10	MG	TAB	200
BACLOFEN	Lioresal	20	MG	TAB	200
CELECOXIB	Celebrex	50	MG	CAP	180
CELECOXIB	Celebrex	100	MG	CAP	180
CELECOXIB	Celebrex	200	MG	CAP	90
CELECOXIB	Celebrex	400	MG	CAP	90
CHLORZOXAZONE	Lorzone	500	MG	TAB	180
CHOLINE MAG TRISALICYLATE	Trilisate	500	MG	TAB	180
CHOLINE MAG TRISALICYLATE	Trilisate	750	MG	TAB	180
CHOLINE MAG TRISALICYLATE	Trilisate	1000	MG	TAB	180
CYCLOBENZAPRINE	Flexeril	5	MG	TAB	90
CYCLOBENZAPRINE	Flexeril	10	MG	TAB	90
DANTROLENE SODIUM	Dantrium	25	MG	CAP	90
DICLOFENAC	Voltaren	1	%	GEL	200
DICLOFENAC	Voltaren	50	MG	DR TAB	180
DICLOFENAC	Voltaren	75	MG	DR TAB	180
ETODOLAC	Lodine	200	MG	CAP	180
ETODOLAC	Lodine	300	MG	CAP	180
ETODOLAC	Lodine	400	MG	TAB	180
ETODOLAC	Lodine	500	MG	TAB	180
FENOPROFEN	Nalfon	600	MG	TAB	270
FLURBIPROFEN	Ansaid	50	MG	TAB	270
FLURBIPROFEN	Ansaid	100	MG	TAB	270
IBUPROFEN	Motrin	400	MG	TAB	180
IBUPROFEN	Motrin	600	MG	TAB	180
IBUPROFEN	Motrin	800	MG	TAB	180
INDOMETHACIN	Indocin	25	MG	CAP	90
INDOMETHACIN	Indocin	50	MG	CAP	90
KETOROLAC	Toradol	10	MG	TAB	180
MELOXICAM	Mobic	7.5	MG	TAB	90
MELOXICAM	Mobic	15	MG	TAB	90
METHOCARBAMOL	Robaxin	500	MG	TAB	180
METHOCARBAMOL	Robaxin	750	MG	TAB	180
NABUMETONE	Relafen	500	MG	TAB	180
NABUMETONE	Relafen	750	MG	TAB	180
NAPROXEN	Naprosyn	250	MG	TAB	180
NAPROXEN	Naprosyn	375	MG	TAB	180
NAPROXEN	Naprosyn	500	MG	TAB	180
NAPROXEN	Anaprox-DS	550	MG	TAB	180
ORPHENADRINE ER	Norﬂex	100	MG	ER TAB	180
OXAPROZIN	Daypro	600	MG	TAB	180
PIROXICAM	Feldene	10	MG	CAP	90
PIROXICAM	Feldene	20	MG	CAP	90
ROPINIROLE	Requip	0.25	MG	TAB	90
ROPINIROLE	Requip	0.5	MG	TAB	90
ROPINIROLE	Requip	1	MG	TAB	90
ROPINIROLE	Requip	2	MG	TAB	90
ROPINIROLE	Requip	3	MG	TAB	90
ROPINIROLE	Requip	4	MG	TAB	90
ROPINIROLE	Requip	5	MG	TAB	90
SALSALATE	Disalcid	500	MG	TAB	180
SALSALATE	Disalcid	750	MG	TAB	180
SULFASALAZINE	Azulﬁdine	500	MG	TAB	180
SULINDAC	Clinoril	150	MG	TAB	180
SULINDAC	Clinoral	200	MG	TAB	180
TIZANIDINE	Zanaﬂex	2	MG	TAB	180
TIZANIDINE	Zanaﬂex	4	MG	TAB	180
TIZANIDINE	Zanaﬂex	2	MG	CAP	180
TIZANIDINE	Zanaﬂex	4	MG	CAP	90
TIZANIDINE	Zanaﬂex	6	MG	CAP	90

Respiratory/Asthma

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ALBUTEROL HFA	Proventil HFA	90	MCG	INHALER	1
ALBUTEROL INH SOLN	Proventil	2.5/3	MG/ML		3
AMINOPHYLLINE	Norphyl	100	MG	TAB	180
AMINOPHYLLINE	Norphyl	200	MG	TAB	180
AZELASTINE	Astepro	137	MCG	NASAL SPRAY	3
BENZONATATE	Tessalon Perles	100	MG	CAP	90
BENZONATATE	Tessalon Perles	200	MG	CAP	90
BUDESONIDE	Rhinocort	32	MCG	NASAL SPRAY	3
CARBINOXAMINE	Palgic	4	MG	TAB	180
CETIRIZINE	Zyrtec	5	MG	TAB	90
CETIRIZINE	Zyrtec	10	MG	TAB	90
CHLORPHENIRAMINE	ChlorTabs	4	MG	TAB	180
CLEMASTINE FUMARATE	Tavist	2.68	MG	TAB	180
CYPROHEPTADINE	Periactin	4	MG	TAB	180
DESLORATIDINE	Clarinex	5	MG	TAB	90
DEXAMETHASONE	Decadron	0.5	MG	TAB	90
DEXAMETHASONE	Decadron	0.75	MG	TAB	90
DEXAMETHASONE	Decadron	1	MG	TAB	90
DEXAMETHASONE	Decadron	4	MG	TAB	30
DEXCHLORPHENIRAMINE	DexPhen	4	MG	CAP	90
DEXCHLORPHENIRAMINE	DexPhen	6	MG	CAP	90
DIMENHYDRINATE	Dramamine	50	MG	TAB	180
DIPHENHYDRAMINE	Benadryl	25	MG	TAB	270
DIPHENHYDRAMINE	Benadryl	50	MG	TAB	270
FEXOFENADINE	Allegra	60	MG	TAB	90
FEXOFENADINE	Allegra	180	MG	TAB	90
FLUTICASONE	Flonase	50	MCG/ACT	NASAL SPRAY	3
GUAIFEN/DM	Mucinex DM	600-30	MG	TAB	40
GUAIFENESIN ER	Mucinex	600	MG	TAB	30
IPRATROPIUM	Atrovent	0.02	%	(0.5MG/3ML) NEBULES	180
IPRATROPIUM	Atrovent	0.03	%	NASAL SPRAY	3
IPRATROPIUM	Atrovent	0.06	%	NASAL SPRAY	3
IPRATROPIUM/ALBUTEROL INH SOLN	Duoneb	0.5-3/3	MG/ML		3
LEVALBUTEROL INH SOLN	Xopenex	0.31/3	MG/ML	NEBULES	144
LEVALBUTEROL INH SOLN	Xopenex	0.63/3	MG/ML	NEBULES	150
LEVALBUTEROL INH SOLN	Xopenex	1.25/3	MG/ML	NEBULES	180
LEVOCETIRIZINE	Xyzal	5	MG	TAB	90
LORATIDINE	Claritin	10	MG	TAB	90
MECLIZINE	Antivert	12.5	MG	TAB	90
MECLIZINE	Antivert	25	MG	TAB	90
METHYLPREDNISOLONE	Medrol DosePack	4	MG	DOSE PACK	63
MONTELUKAST	Singulair	4	MG	CHEWABLE TAB	90
MONTELUKAST	Singulair	5	MG	CHEWABLE TAB	90
MONTELUKAST	Singulair	10	MG	TAB	90
PREDNISONE	Deltasone	1	MG	TAB	90
PREDNISONE	Deltasone	2.5	MG	TAB	90
PREDNISONE	Deltasone	5	MG	TAB	90
PREDNISONE	Deltasone	10	MG	TAB	90
PREDNISONE	Deltasone	20	MG	TAB	30
PREDNISONE	Deltasone	50	MG	TAB	30
PREDNISONE	Steripred	5	MG	DOSE PACK-6 day	1
PREDNISONE	Steripred	5	MG	DOSE PACK-12 day	1
PREDNISONE	Steripred DS	10	MG	DOSE PACK-6 day	1
PREDNISONE	Steripred DS	10	MG	DOSE PACK-12 day	1
THEOPHYLLINE ER	Uniphyl	100	MG	ER TAB	180
THEOPHYLLINE ER	Uniphyl	200	MG	ER TAB	180
THEOPHYLLINE ER	Uniphyl	300	MG	ER TAB	180
TRIAMCINOLONE	Nasacort	55	MCG	NASAL SPRAY	3

Rheumatology

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ALLOPURINOL	Zyloprim	100	MG	TAB	180
ALLOPURINOL	Zyloprim	300	MG	TAB	90
AZATHIOPRINE	Imuran	50	MG	TAB	90
CALCITRIOL	Rocaltrol	0.25	MCG	CAP	180
CALCITRIOL	Rocaltrol	0.5	MCG	CAP	180
COLCHICINE	Colcrys	0.6	MG	TAB	90
FEBUXOSTAT	Uloric	40	MG	TAB	90
FEBUXOSTAT	Uloric	80	MG	TAB	90
HYDROXYCHLOROQUINE	Plaquenil	200	MG	TAB	90
LEFLUNOMIDE	Arava	10	MG	TAB	90
LEFLUNOMIDE	Arava	20	MG	TAB	90
METHOTREXATE	Trexall	2.5	MG	TAB	120

Vitamin

Medication Name	Amount	Amount Unit	Type	Max Qty
ASPIRIN	81	MG	CHEWABLE TAB	90
ASPIRIN	81	MG	EC TAB	90
ASPIRIN	325	MG	EC TAB	90
CHOLECALCIFEROL (Vit D3)	1000	IU	TAB	180
CHOLECALCIFEROL (Vit D3)	50000	IU	CAP	13
CYANOCOBALAMIN	1000	MCG/ML	SOLN	3
ERGOCALCIFEROL, (VIT D2)	1.25	MG	CAP	13
FERROUS SULFATE	325	MG	TAB	90
FOLBIC	2-2.5-25	MG	TAB	90
FOLIC ACID	1	MG	TAB	90
FOLIVANE-F	125-1-40-3	MG	CAP	90
FOLIVANE-PLUS	125-1	MG	CAP	90
HEMATINIC F	106-1	MG	TAB	90
MAGNESIUM	400	MG	TAB	90
NIVA-FOL	2.5-25	MG	TAB	90
PRENATAL VITAMIN PLUS IRON	1/27	MG	TAB	90
ZINC SULFATE	50	MG	CAP	90

Women's Health

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ALENDRONATE	Fosamax	10	MG	TAB	90
ALENDRONATE	Fosamax	35	MG	TAB	12
ALENDRONATE	Fosamax	70	MG	TAB	12
ANASTROZOLE	Arimidex	1	MG	TAB	90
DESOGESTREL-ETH ESTRADIOL	Desogen;Apri;Isibloom	0.15/0.03	MG/MG (BCP)	TAB	84
DESOGESTREL-ETH ESTRADIOL	Mircette;Kariva	0.15/0.01-0.02	MG/MG (BCP)	TAB	84
DROSPIRENONE-ETH ESTRADIOL	Yaz;Gianvi	3/0.02	MG/MG (BCP)	TAB	84
DROSPIRENONE-ETH ESTRADIOL	Yasmin;Ocella	3/0.03	MG/MG (BCP)	TAB	84
E STRADIOL	Estrace	0.5	MG	TAB	90
E STRADIOL	Estrace	1	MG	TAB	90
E STRADIOL	Estrace	2	MG	TAB	90
E STRADIOL VAGINAL	Estrace	0.01	%	CREAM	1
FLUCONAZOLE	Diﬂucan	50	MG	TAB	60
FLUCONAZOLE	Diﬂucan	100	MG	TAB	21
FLUCONAZOLE	Diﬂucan	150	MG	TAB	3
FLUCONAZOLE	Diﬂucan	200	MG	TAB	18
LETROZOLE	Femara	2.5	MG	TAB	90
LEVONORGESTREL-ETH ESTRADIOL	Levora;Portia;Aviane;Jolsessa	0.15/30	MG/MCG (BCP)		84/91
MEDROXYPROGESTERONE	Provera	2.5	MG	TAB	90
MEDROXYPROGESTERONE	Provera	5	MG	TAB	90
MEDROXYPROGESTERONE	Provera	10	MG	TAB	90
MEDROXYPROGESTERONE DEPOT	Depo-Provera	150	MG	INJ	1
NORETHINDRONE	Aygestin	5	MG	TAB	60
NORETHINDRONE	Ortho-Micronor;Camila;Heather	0.35	MG	(BCP) TAB	84
NORETHINDRONE-ETH ESTRADIOL	Loestrin 21;Microgestin	1/20	MG/MCG (BCP)	TAB	63
NORETHINDRONE-ETH ESTRADIOL	Nortrel	1/35	MG/MCG (BCP)		63
NORGESTIMATE-ETH ESTRADIOL	OrthoCyclen Sprintec	0.25/35	MG/MCG (BCP)	TAB	84
NORGESTIMATE-ETH ESTRADIOL	OrthoTriCyclen;Tri-Sprintec	0.18 - 0.215 - 0.25/35	MG/MCG (BCP)	TAB	84
NORGESTIMATE-ETH ESTRADIOL	OrthoTriCyclen-Lo;Tri-Lo Sprintec	0.18 - 0.215 - 0.25/25	MG/MCG (BCP)	TAB	84
PROGESTERONE	Prometrium	100	MG	CAP	90
PROGESTERONE	Prometrium	200	MG	CAP	30
RALOXIFENE	Evista	60	MG	TAB	90
RISEDRONATE	Actonel	150	MG	TAB	3
TAMOXIFEN	Nolvadex	10	MG	TAB	90
TAMOXIFEN	Nolvadex	20	MG	TAB	90

URGENT CARE @ RETAIL

Antibiotic

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
AMOXICILLIN	Amoxil	250	MG	CAP	60
AMOXICILLIN	Amoxil	500	MG	CAP	30
AMOXICILLIN	Amoxil	875	MG	TAB	28
AMOXICILLIN	Amoxil	250/5	MG/ML	SUSP	200
AMOXICILLIN	Amoxil	400/5	MG/ML	SUSP	300
AMOXICILLIN/CLAVULANIC ACID	Augmentin	500-125	MG	TAB	28
AMOXICILLIN/CLAVULANIC ACID	Augmentin	875-125	MG	TAB	28
AMOXICILLIN/CLAVULANIC ACID	Augmentin	400-57/5	MG/ML	SUSP	200
AMOXICILLIN/CLAVULANIC ACID	Augmentin	600-42.9/5	MG/ML	SUSP	200
AZITHROMYCIN	Zithromax	250	MG	TAB	6
AZITHROMYCIN	Zithromax	500	MG	TAB	3
AZITHROMYCIN	Zithromax	100/5	MG/ML	SUSP	15
AZITHROMYCIN	Zithromax	200/5	MG/ML	SUSP	30
CEFDINIR	Omnicef	300	MG	CAP	14
CEPHALEXIN	Keﬂex	250	MG	CAP	56
CEPHALEXIN	Keﬂex	500	MG	CAP	40
CEPHALEXIN	Keﬂex	250/5	MG/ML	SUSP	200
CIPROFLOXACIN	Cipro	250	MG	TAB	28
CIPROFLOXACIN	Cipro	500	MG	TAB	28
CLINDAMYCIN	Cleocin	150	MG	CAP	28
CLINDAMYCIN	Cleocin	300	MG	CAP	28
DOXYCYCLINE HYCLATE	Vibramycin	100	MG	TAB	28
LEVOFLOXACIN	Levaquin	250	MG	TAB	21
LEVOFLOXACIN	Levaquin	500	MG	TAB	21
METRONIDAZOLE	Flagyl	500	MG	TAB	28
NITROFURANTOIN	Macrobid	100	MG	CAP	28
PENICILLIN VK	Veetids	500	MG	TAB	28
PENICILLIN VK	Veetids	250/5	MG/ML	SUSP	200
SMZ/TMP DS	Bactrim	800-160	MG	TAB	28
SMZ/TMP	Bactrim	200-40/5	MG/ML	SUSP	120

Antibiotic Topical

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ERYTHROMYCIN	Illotycin	0.5	%	OPTH OINT	3.5
MUPIROCIN	Bactroban	2	%	OINT	22
NEO/POLY/HC	Cortisporin			OTIC SOLN	10
POLYMYXIN B/TRIMETH	Polytrim			OPTH SOLN	10
SILVER SULFADIAZINE	Silvadene	1	%	CREAM	50
TOBRAMYCIN	Tobrex	0.3	%	OPTH SUSP	5

Antifungal

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
FLUCONAZOLE	Diﬂucan	150	MG	TAB	2
NYSTATIN	Mycostatin	100000	USP	CREAM	30
NYSTATIN	Mycostatin	100000	USP	OINT	30

Antihistamine

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
CETIRIZINE	Zyrtec	10	MG	TAB	30
HYDROXYZINE	Atarax	25	MG	TAB	30

Cardiovascular

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
NITROGLYCERIN	Nitrostat	0.4	MG	SL TAB	25
PROPRANOLOL	Inderal	10	MG	TAB	15

Corticosteroid

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
METHYLPREDNISOLONE	Medrol Dosepak	4	MG	PACK	21
PREDNISONE	Deltasone	10	MG	TAB	20
PREDNISONE	Deltasone	20	MG	TAB	20
PREDNISOLONE	Orapred	15/5	MG/ML	SOLN	120

Corticosteroid Topical

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
HYDROCORTISONE	Hytone	2.5	%	CREAM	30
PREDNISOLONE	Pred Forte	1	%	OPTH SOLN	5
TRIAMCINOLONE	Kenalog	0.1	%	CREAM	30
TRIAMCINOLONE	Kenalog	0.1	%	OINT	30

Cough & Cold

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
BENZONATATE	Tessalon Perles	100	MG	CAP	30
BENZONATATE	Tessalon Perles	200	MG	CAP	30
BROMPH/PSE/DM SYR	Bromfed DM	30	MG	SOLN	120

Diabetes

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
INSULIN LISPRO	Humalog	100	U/ML	INJ	2 vials / 90 days

Gastrointestinal

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
DICYCLOMINE	Bentyl	20	MG	TAB	60
DIPHENOX-ATROPINE	Lomotil	2.5-0.025	MG	TAB	30
PANTOPROZOLE	Protonix	40	MG	TAB	21
PROMETHAZINE	Phenergan	25	MG	TAB	30
ONDANSETRON ODT	Zofran ODT	4	MG	TAB	6
ONDANSETRON ODT	Zofran ODT	8	MG	TAB	6

Gout

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ALLOPURINOL	Zyloprim	100	MG	TAB	21
ALLOPURINOL	Zyloprim	300	MG	TAB	21

Migraine

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
SUMATRIPTAN	Imitrex	50	MG	TAB	9
SUMATRIPTAN	Imitrex	100	MG	TAB	9

Muscle Relaxant

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
CYCLOBENZAPRINE	Flexeril	10	MG	TAB	30

Pain Management

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
IBUPROFEN	Motrin	800	MG	TAB	60
NAPROXEN	Naprosyn	500	MG	TAB	30
TRAMADOL	Ultram	50	MG	TAB	30
PHENAZOPYRIDINE	Pyridium	200	MG	TAB	10

Respiratory

Medication Name	Brand Name	Amount	Amount Unit	Type	Max Qty
ALBUTEROL MDI	Proventil HFA	90	MCG	INH	1 (6.7g) / year

Prescription Medications

Common Conditions

Ear & Eye Infections

Skin Infections

Fungal Infections

Pain & Injuries

Migraines

Stomach Viruses

Upper Respiratory Infections (URI)

Urinary Tract Infections (UTI)

Asthma/Allergic Reactions

ADHD

Anti-Infective

Cardiovascular

Dermatology

Diabetes

Endocrinology

Gastrointestinal

Men's Health

Mental Health

Migraine

Oncology

Opthalmic

Pain Management

Respiratory/Asthma

Rheumatology

Vitamin

Women's Health

URGENT CARE @ RETAIL

Antibiotic

Antibiotic Topical

Antifungal

Antihistamine

Cardiovascular

Corticosteroid

Corticosteroid Topical

Cough & Cold

Diabetes

Gastrointestinal

Gout

Migraine

Muscle Relaxant

Pain Management

Respiratory