2015 pharmacy savertm drug list - … · 1 2015 pharmacy savertm drug list . click on a...

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1 2015 Pharmacy Saver TM drug list Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy Saver program Important Note: The 2015 Pharmacy Saver drug list is effective January 1, 2015. Ahold Baker’s Carrs City Market Delhaize Dillion Duane Reade Food Lion Fred Meyer Fry’s Gerbes Giant Hannaford H-E-B Hy-Vee JayC King Soopers Kroger Martins Pavilions Publix QFC Ralph’s Randals Safeway Sams Scott’s Smith’s Stop & Shop Target Thifty White Tom Thumb Vons Walgreens Walmart Wegmans Retailer Prescription Name Quantity Pharmacy Saver™ Price Ahold, Giant, Martins, Stop & Shop Amlodipine Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Amlodipine Tab 2.5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Amlodipine Tab 5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Atorvastatin Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Nortriptyline Cap 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Nortriptyline Cap 25MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Nortriptyline Cap 50MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Omeprazole Cap 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Omeprazole Cap 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Paroxetine Tab 30MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Paroxetine Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sertraline Tab 100MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sertraline Tab 25MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sertraline Tab 50MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 80MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 10MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 20MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 40MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 5MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glimepiride Tab 1MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glimepiride Tab 2MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glimepiride Tab 4MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glipizide Tab 10MG 60 $1.50

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Page 1: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

1

2015 Pharmacy SaverTM drug list

Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy Saver program

Important Note: The 2015 Pharmacy Saver drug list is effective January 1, 2015.

Ahold Baker’s Carrs City Market Delhaize Dillion

Duane Reade Food Lion Fred Meyer Fry’s Gerbes Giant

Hannaford H-E-B Hy-Vee JayC King Soopers Kroger

Martins Pavilions Publix QFC Ralph’s Randals

Safeway Sams Scott’s Smith’s Stop & Shop Target

Thifty White Tom Thumb Vons Walgreens Walmart Wegmans

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Ahold, Giant, Martins, Stop & Shop Amlodipine Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Amlodipine Tab 2.5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Amlodipine Tab 5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Atorvastatin Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Nortriptyline Cap 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Nortriptyline Cap 25MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Nortriptyline Cap 50MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Omeprazole Cap 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Omeprazole Cap 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Paroxetine Tab 30MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Paroxetine Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sertraline Tab 100MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sertraline Tab 25MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sertraline Tab 50MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Simvastatin Tab 80MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 10MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 20MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 40MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Benazepril Tab 5MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glimepiride Tab 1MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glimepiride Tab 2MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glimepiride Tab 4MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Glipizide Tab 10MG 60 $1.50

Page 2: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

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Retailer Prescription Name Quantity Pharmacy Saver™ Price

Ahold, Giant, Martins, Stop & Shop Glipizide Tab 5MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop IRBESARTAN 75 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lisinopril &

Hydrochlorothiazide Tab 10-12.5MG

30 $1.50

Ahold, Giant, Martins, Stop & Shop Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $1.50

Ahold, Giant, Martins, Stop & Shop Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $1.50

Ahold, Giant, Martins, Stop & Shop Lisinopril Tab 10MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lisinopril Tab 2.5MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lisinopril Tab 20MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lisinopril Tab 30MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lisinopril Tab 40MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lisinopril Tab 5MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop LOSARTAN 100 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop LOSARTAN 25 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop LOSARTAN 50 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop LOSARTAN/HCTZ TAB

100/12.5 MG 30 $1.50

Ahold, Giant, Martins, Stop & Shop LOSARTAN/HCTZ TAB 100/25MG

30 $1.50

Ahold, Giant, Martins, Stop & Shop LOSARTAN/HCTZ TAB 50/12.5 MG

30 $1.50

Ahold, Giant, Martins, Stop & Shop LOVASTATIN 40 MG TABLET

30 $1.50

Ahold, Giant, Martins, Stop & Shop Lovastatin Tab 10MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Lovastatin Tab 20MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop METFORMIN HCL 1000

MG TABLET 60 $1.50

Ahold, Giant, Martins, Stop & Shop METFORMIN HCL 850 MG TABLET

60 $1.50

Ahold, Giant, Martins, Stop & Shop Metformin Tab 500MG 60 $1.50 Ahold, Giant, Martins, Stop & Shop PIOGLIAZONE TAB 15MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop RAMIPRIL CAP 10 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop RAMIPRIL CAP 2.5 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop RAMIPRIL CAP 5 MG 30 $1.50 Ahold, Giant, Martins, Stop & Shop Acyclovir Cap 200 MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Allopurinol Tab 100MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Allopurinol Tab 300MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Amoxicillin Cap 250MG 30 $2.00

Page 3: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

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Retailer Prescription Name Quantity Pharmacy Saver™ Price

Ahold, Giant, Martins, Stop & Shop Amoxicillin Cap 500MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Ampicillin Cap 250MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Atenolol Tab 100MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Atenolol Tab 25MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Atenolol Tab 50MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Bisoprolol &

Hydrochlorothiazide Tab 10-6.25 MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Carbamazepine Tab 200MG

60 $2.00

Ahold, Giant, Martins, Stop & Shop Carvedilol Tab 12.5MG 60 $2.00 Ahold, Giant, Martins, Stop & Shop Carvedilol Tab 25MG 60 $2.00 Ahold, Giant, Martins, Stop & Shop Carvedilol Tab 3.125MG 60 $2.00 Ahold, Giant, Martins, Stop & Shop Carvedilol Tab 6.25MG 60 $2.00 Ahold, Giant, Martins, Stop & Shop Cephalexin Cap 250MG 28 $2.00 Ahold, Giant, Martins, Stop & Shop Cephalexin Cap 500MG 28 $2.00 Ahold, Giant, Martins, Stop & Shop Ciprofloxacin Tab 250MG 20 $2.00 Ahold, Giant, Martins, Stop & Shop Ciprofloxacin Tab 500MG 20 $2.00 Ahold, Giant, Martins, Stop & Shop Citalopram Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Citalopram Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Citalopram Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Clonidine Tab 0.1MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Clonidine Tab 0.2MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Clonidine Tab 0.3MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Diltiazem Tab 30MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Enalapril Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Enalapril Tab 2.5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Enalapril Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Enalapril Tab 5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Fluconazole Tab 150MG 1 $2.00 Ahold, Giant, Martins, Stop & Shop Fluoxetine Cap 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Fluoxetine Cap 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Furosemide Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Furosemide Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Furosemide Tab 80MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Hydralazine Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Hydralazine Tab 25MG 30 $2.00

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Retailer Prescription Name Quantity Pharmacy Saver™ Price

Ahold, Giant, Martins, Stop & Shop Hydrochlorothiazide Cap 12.5MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Hydrochlorothiazide Tab 25MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Hydrochlorothiazide Tab 50MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop IRBESARTAN 150MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Levobunolol Opt 0.5% 5 $2.00 Ahold, Giant, Martins, Stop & Shop Meloxicam Tab 15MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Meloxicam Tab 7.5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Metocloropramide Tab

10MG 60 $2.00

Ahold, Giant, Martins, Stop & Shop Metoprolol Tartrate Tab 100MG

60 $2.00

Ahold, Giant, Martins, Stop & Shop Metoprolol Tartrate Tab 25MG

60 $2.00

Ahold, Giant, Martins, Stop & Shop Metoprolol Tartrate Tab 50MG

60 $2.00

Ahold, Giant, Martins, Stop & Shop Metronidazole Tab 250MG

28 $2.00

Ahold, Giant, Martins, Stop & Shop Metronidazole Tab 500MG

14 $2.00

Ahold, Giant, Martins, Stop & Shop Paroxetine Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Paroxetine Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Propanolol Tab 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Propanolol Tab 20MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Propanolol Tab 40MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Propanolol Tab 80MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Ranitidine Tab 150MG 60 $2.00 Ahold, Giant, Martins, Stop & Shop Ranitidine Tab 300MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Spironolactone Tab 25MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Sufameth/Trimeth DS Tab

400-80MG 20 $2.00

Ahold, Giant, Martins, Stop & Shop Sufameth/Trimeth DS Tab 800-160MG

28 $2.00

Ahold, Giant, Martins, Stop & Shop Terazosin Cap 10MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Terazosin Cap 1MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Terazosin Cap 2MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Terazosin Cap 5MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Trazadone Tab 100MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Trazadone Tab 50MG 30 $2.00

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Retailer Prescription Name Quantity Pharmacy Saver™ Price

Ahold, Giant, Martins, Stop & Shop Triamterene & Hydrochlorothiazide Cap 37.5-25MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Triamterene & Hydrochlorothiazide Tab 75-50MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Verapamil Tab 120MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Verapamil Tab 80MG 30 $2.00 Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab

10MG 30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 1MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 2.5MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 2MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 3MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 4MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 5MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 6MG

30 $2.00

Ahold, Giant, Martins, Stop & Shop Warfarin Sodium Tab 7.5 MG

30 $2.00

Delhaize, Food Lion, Hannaford Albuterol Syp 2MG/5ML 90 $2.00 Delhaize, Food Lion, Hannaford Alendronate Sodium Tab

35MG 4 $4.00

Delhaize, Food Lion, Hannaford Alendronate Sodium Tab 70MG

4 $4.00

Delhaize, Food Lion, Hannaford Allopurinol Tab 100MG 30 $2.00 Delhaize, Food Lion, Hannaford Allopurinol Tab 300MG 30 $2.00 Delhaize, Food Lion, Hannaford Amlodipine Tab 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Amlodipine Tab 2.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Amlodipine Tab 5MG 30 $2.00 Delhaize, Food Lion, Hannaford Amoxicillin Cap 250MG 30 $2.00 Delhaize, Food Lion, Hannaford Amoxicillin Cap 500MG 30 $4.00 Delhaize, Food Lion, Hannaford Amoxicillin SUS

125MG/5ML 100 $2.00

Delhaize, Food Lion, Hannaford Amoxicillin SUS 200MG/5ML

100 $2.00

Delhaize, Food Lion, Hannaford Amoxicillin SUS 250MG/5ML

100 $2.00

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Retailer Prescription Name Quantity Pharmacy Saver™ Price

Delhaize, Food Lion, Hannaford Amoxicillin SUS 400MG/5ML

75 $2.00

Delhaize, Food Lion, Hannaford Atenolol & Chlorthalidone Tab 50-25MG

30 $4.00

Delhaize, Food Lion, Hannaford Atenolol Tab 100MG 30 $2.00 Delhaize, Food Lion, Hannaford Atenolol Tab 25MG 30 $2.00 Delhaize, Food Lion, Hannaford Atenolol Tab 50MG 30 $2.00 Delhaize, Food Lion, Hannaford ATORVASTATIN TAB

10MG 30 $4.00

Delhaize, Food Lion, Hannaford ATORVASTATIN TAB 20MG

30 $4.00

Delhaize, Food Lion, Hannaford ATORVASTATIN TAB 40MG

30 $4.00

Delhaize, Food Lion, Hannaford Baclofen Tab 10 MG 30 $2.00 Delhaize, Food Lion, Hannaford Benazepril Tab 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Benazepril Tab 20MG 30 $4.00 Delhaize, Food Lion, Hannaford Benazepril Tab 40MG 30 $4.00 Delhaize, Food Lion, Hannaford Benazepril Tab 5MG 30 $4.00 Delhaize, Food Lion, Hannaford Bisoprolol &

Hydrochlorothiazide Tab 10-6.25 MG

30 $2.00

Delhaize, Food Lion, Hannaford Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG

30 $2.00

Delhaize, Food Lion, Hannaford Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

Delhaize, Food Lion, Hannaford Bumetanide Tab 1MG 30 $4.00 Delhaize, Food Lion, Hannaford Buspirone Tab 10MG 60 $4.00 Delhaize, Food Lion, Hannaford Buspirone Tab 5MG 60 $4.00 Delhaize, Food Lion, Hannaford Captopril Tab 100MG 30 $4.00 Delhaize, Food Lion, Hannaford Captopril Tab 25MG 60 $2.00 Delhaize, Food Lion, Hannaford Captopril Tab 50MG 60 $2.00 Delhaize, Food Lion, Hannaford Carbamazepine Tab

200MG 60 $4.00

Delhaize, Food Lion, Hannaford Carvedilol Tab 12.5MG 60 $4.00 Delhaize, Food Lion, Hannaford Carvedilol Tab 3.125MG 60 $4.00 Delhaize, Food Lion, Hannaford Carvedilol Tab 6.25MG 60 $4.00 Delhaize, Food Lion, Hannaford Cephalexin Cap 250MG 40 $4.00 Delhaize, Food Lion, Hannaford Cimetidine Tab 300MG 60 $4.00 Delhaize, Food Lion, Hannaford Cimetidine Tab 400MG 60 $4.00 Delhaize, Food Lion, Hannaford Cimetidine Tab 800MG 30 $4.00 Delhaize, Food Lion, Hannaford Citalopram Tab 10MG 30 $2.00

Page 7: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

7

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Delhaize, Food Lion, Hannaford Citalopram Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Citalopram Tab 40MG 30 $2.00 Delhaize, Food Lion, Hannaford Clonidine Tab 0.1MG 30 $2.00 Delhaize, Food Lion, Hannaford Clonidine Tab 0.2MG 30 $2.00 Delhaize, Food Lion, Hannaford Diltiazem Tab 30MG 60 $4.00 Delhaize, Food Lion, Hannaford Doxazosin Tab 2MG 30 $4.00 Delhaize, Food Lion, Hannaford Doxazosin Tab 4MG 30 $4.00 Delhaize, Food Lion, Hannaford Doxazosin Tab 1MG 30 $4.00 Delhaize, Food Lion, Hannaford Enalapril Tab 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Enalapril Tab 2.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Enalapril Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Enalapril Tab 5MG 30 $2.00 Delhaize, Food Lion, Hannaford Famotidine Tab 20MG 60 $4.00 Delhaize, Food Lion, Hannaford Famotidine Tab 40MG 30 $4.00 Delhaize, Food Lion, Hannaford Fluconazole Tab 150MG 1 $2.00 Delhaize, Food Lion, Hannaford Fluoxetine Cap 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Fluoxetine Cap 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Furosemide Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Furosemide Tab 40MG 30 $2.00 Delhaize, Food Lion, Hannaford Glimepiride Tab 1MG 30 $2.00 Delhaize, Food Lion, Hannaford Glimepiride Tab 2MG 30 $2.00 Delhaize, Food Lion, Hannaford Glimepiride Tab 4MG 30 $2.00 Delhaize, Food Lion, Hannaford GLIPIZIDE ER TAB 2.5MG 30 $4.00 Delhaize, Food Lion, Hannaford GLIPIZIDE ER TAB 5MG 30 $4.00 Delhaize, Food Lion, Hannaford Glipizide Tab 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Glipizide Tab 5MG 60 $2.00 Delhaize, Food Lion, Hannaford Haloperidol Tab 0.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Haloperidol Tab 1MG 30 $2.00 Delhaize, Food Lion, Hannaford Haloperidol Tab 2MG 30 $2.00 Delhaize, Food Lion, Hannaford Haloperidol Tab 5MG 30 $2.00 Delhaize, Food Lion, Hannaford Hydralazine Tab 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Hydralazine Tab 25MG 30 $4.00 Delhaize, Food Lion, Hannaford Hydrochlorothiazide Cap

12.5MG 30 $2.00

Delhaize, Food Lion, Hannaford Hydrochlorothiazide Tab 25MG

30 $2.00

Delhaize, Food Lion, Hannaford Hydrochlorothiazide Tab 50MG

30 $2.00

Delhaize, Food Lion, Hannaford Ibuprofen Tab 600MG 60 $2.00 Delhaize, Food Lion, Hannaford Ibuprofen Tab 800MG 30 $2.00 Delhaize, Food Lion, Hannaford Indapamide Tab 1.25MG 30 $2.00 Delhaize, Food Lion, Hannaford Indapamide Tab 2.5MG 30 $2.00

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Retailer Prescription Name Quantity Pharmacy Saver™ Price

Delhaize, Food Lion, Hannaford IRBESARTAN TAB 150MG

30 $4.00

Delhaize, Food Lion, Hannaford IRBESARTAN TAB 75MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 10 MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 1MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 2.5MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 2MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 3MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 4MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 5MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantoven Tab 7.5MG 30 $4.00 Delhaize, Food Lion, Hannaford Jantovin Tab 6MG 30 $4.00 Delhaize, Food Lion, Hannaford Lisinopril &

Hydrochlorothiazide Tab 10-12.5MG

30 $2.00

Delhaize, Food Lion, Hannaford Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $2.00

Delhaize, Food Lion, Hannaford Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $2.00

Delhaize, Food Lion, Hannaford Lisinopril Tab 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Lisinopril Tab 2.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Lisinopril Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Lisinopril Tab 30MG 30 $2.00 Delhaize, Food Lion, Hannaford Lisinopril Tab 40MG 30 $2.00 Delhaize, Food Lion, Hannaford Lisinopril Tab 5MG 30 $2.00 Delhaize, Food Lion, Hannaford LOSARTAN POT TAB

100MG 30 $2.00

Delhaize, Food Lion, Hannaford LOSARTAN POT TAB 25MG

30 $2.00

Delhaize, Food Lion, Hannaford LOSARTAN POT TAB 50MG

30 $2.00

Delhaize, Food Lion, Hannaford LOSARTAN/HCT TAB 100-12.5

30 $4.00

Delhaize, Food Lion, Hannaford LOSARTAN/HCT TAB 100-25

30 $4.00

Delhaize, Food Lion, Hannaford LOSARTAN/HCT TAB 50-12.5

30 $4.00

Delhaize, Food Lion, Hannaford Lovastatin Tab 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Lovastatin Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Lovastatin Tab 40MG 30 $2.00 Delhaize, Food Lion, Hannaford Medroxyprogesterone

Tab 10MG 10 $4.00

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9

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Delhaize, Food Lion, Hannaford Medroxyprogesterone Tab 2.5MG

30 $4.00

Delhaize, Food Lion, Hannaford Medroxyprogesterone Tab 5MG

30 $4.00

Delhaize, Food Lion, Hannaford Meloxicam Tab 15MG 30 $2.00 Delhaize, Food Lion, Hannaford Meloxicam Tab 7.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Metformin Tab 1000MG 60 $4.00 Delhaize, Food Lion, Hannaford Metformin Tab 850MG 60 $4.00 Delhaize, Food Lion, Hannaford Metformin ER Tab

500MG 60 $4.00

Delhaize, Food Lion, Hannaford Metformin ER Tab 750MG

30 $4.00

Delhaize, Food Lion, Hannaford Metformin Tab 500MG 90 $4.00 Delhaize, Food Lion, Hannaford Metocloropramide Tab

10MG 60 $4.00

Delhaize, Food Lion, Hannaford Metocloropramide Tab 5MG

60 $4.00

Delhaize, Food Lion, Hannaford Metoprolol Tartrate Tab 100MG

60 $4.00

Delhaize, Food Lion, Hannaford Metoprolol Tartrate Tab 25MG

60 $4.00

Delhaize, Food Lion, Hannaford Metoprolol Tartrate Tab 50MG

60 $4.00

Delhaize, Food Lion, Hannaford Mirtazapine Tab 15MG 30 $4.00 Delhaize, Food Lion, Hannaford Naproxen Tab 250MG 60 $4.00 Delhaize, Food Lion, Hannaford Nortriptyline Cap 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Nortriptyline Cap 25MG 30 $4.00 Delhaize, Food Lion, Hannaford Oflaxacin OTIC DR 0.3% 5 $2.00 Delhaize, Food Lion, Hannaford Oflaxacin Sol Falc 0.3% 5 $2.00 Delhaize, Food Lion, Hannaford Ondanestron Tab 4MG 20 $4.00 Delhaize, Food Lion, Hannaford Oxaprozin Tab 600MG 30 $4.00 Delhaize, Food Lion, Hannaford Oxybutynin Chloride Tab

5MG 60 $4.00

Delhaize, Food Lion, Hannaford Paroxetine Tab 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Paroxetine Tab 20MG 30 $4.00 Delhaize, Food Lion, Hannaford PIOGLITAZONE TAB 15MG 30 $4.00 Delhaize, Food Lion, Hannaford PIOGLITAZONE TAB 30MG 30 $4.00 Delhaize, Food Lion, Hannaford PIOGLITAZONE TAB 45MG 30 $4.00 Delhaize, Food Lion, Hannaford Prednisone Tab 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Prednisone Tab 1MG 30 $2.00 Delhaize, Food Lion, Hannaford Prednisone Tab 2.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Prednisone Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Prednisone Tab 5MG 30 $2.00

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10

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Delhaize, Food Lion, Hannaford Prochloroperazine Tab 5MG

30 $2.00

Delhaize, Food Lion, Hannaford Prochlorperazine Tab 10MG

30 $2.00

Delhaize, Food Lion, Hannaford Propanolol Tab 10MG 120 $4.00 Delhaize, Food Lion, Hannaford Propanolol Tab 20MG 120 $4.00 Delhaize, Food Lion, Hannaford Propanolol Tab 40MG 120 $4.00 Delhaize, Food Lion, Hannaford QUINAPRIL TAB 40MG 30 $4.00 Delhaize, Food Lion, Hannaford Quinapril Tab 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Quinapril Tab 20MG 30 $4.00 Delhaize, Food Lion, Hannaford Quinapril Tab 5MG 30 $4.00 Delhaize, Food Lion, Hannaford RAMIPRIL CAP 10MG 30 $2.00 Delhaize, Food Lion, Hannaford RAMIPRIL CAP 2.5MG 30 $2.00 Delhaize, Food Lion, Hannaford RAMIPRIL CAP 5MG 30 $2.00 Delhaize, Food Lion, Hannaford Ranitidine Tab 150MG 60 $4.00 Delhaize, Food Lion, Hannaford Ranitidine Tab 300MG 30 $4.00 Delhaize, Food Lion, Hannaford Risperidone Tab 0.25MG 30 $2.00 Delhaize, Food Lion, Hannaford Risperidone Tab 0.5MG 30 $2.00 Delhaize, Food Lion, Hannaford Risperidone Tab 1MG 30 $2.00 Delhaize, Food Lion, Hannaford Risperidone Tab 2MG 30 $2.00 Delhaize, Food Lion, Hannaford Sertraline Tab 100MG 30 $4.00 Delhaize, Food Lion, Hannaford Sertraline Tab 25MG 30 $4.00 Delhaize, Food Lion, Hannaford Sertraline Tab 50MG 30 $4.00 Delhaize, Food Lion, Hannaford SIMVASTATIN TAB 80MG 30 $4.00 Delhaize, Food Lion, Hannaford Simvastatin Tab 10MG 30 $2.00 Delhaize, Food Lion, Hannaford Simvastatin Tab 20MG 30 $2.00 Delhaize, Food Lion, Hannaford Simvastatin Tab 40MG 30 $2.00 Delhaize, Food Lion, Hannaford Simvastatin Tab 5MG 30 $2.00 Delhaize, Food Lion, Hannaford Sotalol Tab 80MG 30 $4.00 Delhaize, Food Lion, Hannaford Spironolactone Tab 25MG 30 $2.00 Delhaize, Food Lion, Hannaford Sufameth/Trimeth DS Tab

800-160MG 20 $2.00

Delhaize, Food Lion, Hannaford Terazosin Cap 10MG 30 $4.00 Delhaize, Food Lion, Hannaford Terazosin Cap 1MG 30 $4.00 Delhaize, Food Lion, Hannaford Terazosin Cap 2MG 30 $4.00 Delhaize, Food Lion, Hannaford Terazosin Cap 5MG 30 $4.00 Delhaize, Food Lion, Hannaford Tetracycline Cap 250MG 60 $4.00 Delhaize, Food Lion, Hannaford Tetracycline Cap 500MG 60 $4.00 Delhaize, Food Lion, Hannaford Topiramate Tab 25MG 30 $4.00 Delhaize, Food Lion, Hannaford Topiramate Tab 50MG 30 $4.00 Delhaize, Food Lion, Hannaford Torsemide Tab 20MG 30 $4.00 Delhaize, Food Lion, Hannaford Trazadone Tab 100MG 30 $2.00 Delhaize, Food Lion, Hannaford Trazadone Tab 150MG 30 $2.00

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11

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Delhaize, Food Lion, Hannaford Trazadone Tab 50MG 30 $2.00 Delhaize, Food Lion, Hannaford Triamterene &

Hydrochlorothiazide Tab 75-50MG

30 $2.00

Delhaize, Food Lion, Hannaford Verapamil Tab 120MG 30 $4.00 Delhaize, Food Lion, Hannaford Verapamil Tab 80MG 30 $4.00 HEB BENZAPRIL TAB 40MG 30 $2.00 HEB CARVEDILOL TAB 12.5MG 30 $4.00 HEB CARVEDILOL TAB

3.125MG 30 $4.00

HEB CARVEDILOL TAB 6.25MG 30 $4.00 HEB PRAMIPEXOLE TAB

0.75MG 30 $4.00

HEB PRAMIPEXOLE TAB 1.5MG

30 $4.00

HEB PRAMIPEXOLE TAB 1MG 30 $4.00 HEB ROPINIROLE TAB 0.25MG 30 $2.00 HEB ROPINIROLE TAB 0.5MG 30 $2.00 HEB ROPINIROLE TAB 1MG 30 $2.00 HEB ROPINIROLE TAB 2MG 30 $2.00 HEB ROPINIROLE TAB 3MG 30 $2.00 HEB Benazepril Tab 10MG 30 $1.00 HEB Benazepril Tab 20MG 30 $1.00 HEB Enalapril Tab 2.5MG 30 $1.75 HEB Enalapril Tab 5MG 30 $1.75 HEB Glimepiride Tab 1MG 30 $1.75 HEB Glimepiride Tab 2MG 30 $1.75 HEB Glimepiride Tab 4MG 60 $1.75 HEB Glipizide Tab 10MG 60 $1.75 HEB Glipizide Tab 5MG 30 $1.75 HEB Lisinopril Tab 10MG 30 $1.75 HEB Lisinopril Tab 2.5MG 30 $1.75 HEB Lisinopril Tab 20MG 30 $1.75 HEB Lisinopril Tab 30MG 30 $1.75 HEB Lisinopril Tab 40MG 30 $1.75 HEB Lisinopril Tab 5MG 30 $1.75 HEB Losartan Tab 25 mg 60 $1.75 HEB Losartan Tab 50 mg 60 $1.75 HEB Lovastatin Tab 10MG 30 $1.75 HEB Lovastatin Tab 20MG 30 $1.75 HEB Lovastatin Tab 40MG 30 $1.75 HEB Metformin Tab 1000MG 60 $1.75 HEB Metformin Tab 850MG 60 $1.75

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12

Retailer Prescription Name Quantity Pharmacy Saver™ Price

HEB Metformin Tab 500MG 60 $1.00 HEB Ramipril Cap 10 mg 30 $1.75 HEB Ramipril Cap 2.5 mg 30 $1.75 HEB Ramipril Cap 5 mg 30 $1.75 HEB Alendronate Sodium Tab

35MG 4 $4.00

HEB Alendronate Sodium Tab 70MG

4 $4.00

HEB Allopurinol Tab 100MG 30 $2.00 HEB Allopurinol Tab 300MG 30 $2.00 HEB Amlodipine Tab 10MG 30 $2.00 HEB Amlodipine Tab 2.5MG 30 $2.00 HEB Amlodipine Tab 5MG 30 $2.00 HEB Anastrozole Tab 1MG 30 $2.00 HEB Atenolol & Chlorthalidone

Tab 50-25MG 30 $2.00

HEB Atenolol Tab 100MG 30 $2.00 HEB Atenolol Tab 25MG 30 $2.00 HEB Atenolol Tab 50MG 30 $2.00 HEB Bisoprolol &

Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

HEB Clonidine Tab 0.1MG 60 $2.00 HEB Clonidine Tab 0.2MG 60 $2.00 HEB Clonidine Tab 0.3MG 60 $2.00 HEB Enalapril Tab 10MG 30 $2.00 HEB Enalapril Tab 20MG 60 $2.00 HEB Famotidine Tab 20MG 60 $2.00 HEB Famotidine Tab 40MG 30 $2.00 HEB Fluoxetine Cap 10MG 30 $2.00 HEB Fluoxetine Cap 20MG 30 $2.00 HEB Fluoxetine Cap 40MG 30 $2.00 HEB Furosemide Tab 20MG 30 $2.00 HEB Furosemide Tab 40MG 30 $2.00 HEB Furosemide Tab 80MG 60 $2.00 HEB Hydrochlorothiazide Cap

12.5MG 30 $2.00

HEB Hydrochlorothiazide Tab 25MG

30 $2.00

HEB Hydrochlorothiazide Tab 50MG

30 $2.00

HEB Indamapide Tab 2.5MG 30 $2.00 HEB Lamotrigine Tab 100MG 60 $2.00

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13

Retailer Prescription Name Quantity Pharmacy Saver™ Price

HEB Lamotrigine Tab 25MG 60 $2.00 HEB Meloxicam Tab 15MG 30 $4.00 HEB Meloxicam Tab 7.5MG 30 $4.00 HEB Metoprolol Tartrate Tab

100MG 60 $2.00

HEB Metoprolol Tartrate Tab 25MG

60 $2.00

HEB Metoprolol Tartrate Tab 50MG

60 $2.00

HEB Naproxen Tab 375MG 60 $2.00 HEB Naproxen Tab 500MG 60 $2.00 HEB Paroxetin Tab 40MG 30 $4.00 HEB Pramipexole

Dihydrochloride Tab 0.125MG

30 $4.00

HEB Pramipexole Dihydrochloride Tab 0.25MG

30 $4.00

HEB Pramipexole Dihydrochloride Tab 0.5MG

30 $4.00

HEB Prochlorperazine Tab 10MG

30 $2.00

HEB Propanolol Tab 10MG 60 $2.00 HEB Propanolol Tab 20MG 60 $2.00 HEB Propanolol Tab 40MG 60 $2.00 HEB Quinapril Tab 40MG 30 $2.00 HEB Quinapril Tab 20MG 30 $2.00 HEB Ranitidine Tab 150MG 60 $2.00 HEB Ranitidine Tab 300MG 30 $2.00 HEB Risperidone Tab 0.25MG 30 $2.00 HEB Simvastatin Tab 10MG 30 $4.00 HEB Simvastatin Tab 20MG 30 $4.00 HEB Simvastatin Tab 40MG 30 $4.00 HEB Simvastatin Tab 5MG 30 $4.00 HEB Simvastatin Tab 80MG 30 $4.00 HEB Trazadone Tab 100MG 30 $2.00 HEB Trazadone Tab 150MG 30 $2.00 HEB Trazadone Tab 50MG 30 $2.00 HEB Triamterene &

Hydrochlorothiazide Cap 37.5-25MG

30 $2.00

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14

Retailer Prescription Name Quantity Pharmacy Saver™ Price

HEB Triamterene & Hydrochlorothiazide Tab 37.5-25MG

30 $2.00

HEB Triamterene & Hydrochlorothiazide Tab 75-50MG

30 $2.00

HEB Warfarin Sodium Tab 1MG

30 $4.00

HEB Warfarin Sodium Tab 2.5MG

30 $4.00

HEB Warfarin Sodium Tab 2MG

30 $4.00

HEB Warfarin Sodium Tab 3MG

30 $4.00

HEB Warfarin Sodium Tab 4MG

30 $4.00

HEB Warfarin Sodium Tab 5MG

30 $4.00

HEB Warfarin Sodium Tab 6MG

30 $4.00

HEB Warfarin Sodium Tab 7.5MG

30 $4.00

Hy Vee Allopurinol Tab 100MG 30 $1.50 Hy Vee Allopurinol Tab 300MG 30 $1.50 Hy Vee Atenolol Tab 100MG 30 $1.50 Hy Vee Atenolol Tab 25MG 30 $1.50 Hy Vee Atenolol Tab 50MG 30 $1.50 Hy Vee Baclofen Tab 10 MG 30 $1.50 Hy Vee Benazepril Tab 10MG 30 $1.50 Hy Vee Benazepril Tab 20MG 30 $1.50 Hy Vee Benazepril Tab 40MG 30 $1.50 Hy Vee Benazepril Tab 5MG 30 $1.50 Hy Vee Carvedilol Tab 12.5MG 60 $1.50 Hy Vee Carvedilol Tab 25MG 60 $1.50 Hy Vee Carvedilol Tab 3.125MG 60 $1.50 Hy Vee Carvedilol Tab 6.25MG 60 $1.50 Hy Vee Citalopram Tab 20MG 30 $1.50 Hy Vee Citalopram Tab 40MG 30 $1.50 Hy Vee Furosemide Tab 20MG 30 $1.50 Hy Vee Furosemide Tab 40MG 30 $1.50 Hy Vee Furosemide Tab 80MG 30 $1.50 Hy Vee Glimepiride Tab 4MG 30 $1.50 Hy Vee Glimepiride Tab 1 MG 30 $1.50

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15

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Hy Vee Glimepiride Tab 2MG 30 $1.50 Hy Vee Glipizide Tab 10MG 60 $1.50 Hy Vee Hydrochlorothiazide Cap

12.5MG 30 $1.50

Hy Vee Hydrochlorothiazide Tab 25MG

30 $1.50

Hy Vee Hydrochlorothiazide Tab 50MG

30 $1.50

Hy Vee Lisinopril & Hydrochlorothiazide Tab 10-12.5MG

30 $1.50

Hy Vee Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $1.50

Hy Vee Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $1.50

Hy Vee Lisinopril Tab 10MG 30 $1.50 Hy Vee Lisinopril Tab 2.5MG 30 $1.50 Hy Vee Lisinopril Tab 20MG 30 $1.50 Hy Vee Lisinopril Tab 5MG 30 $1.50 Hy Vee Lovastatin Tab 10MG 30 $1.50 Hy Vee Lovastatin Tab 20MG 30 $1.50 Hy Vee Metformin Tab 1000MG 60 $1.50 Hy Vee Metformin Tab 850MG 60 $1.50 Hy Vee Metformin ER Tab

500MG 60 $1.50

Hy Vee Metformin Tab 500MG 60 $1.50 Hy Vee Metoprolol Tartrate Tab

100MG 60 $1.50

Hy Vee Metoprolol Tartrate Tab 25MG

60 $1.50

Hy Vee Metoprolol Tartrate Tab 50MG

60 $1.50

Hy Vee Propanolol Tab 10MG 60 $1.50 Hy Vee Propanolol Tab 20MG 60 $1.50 Hy Vee Propanolol Tab 40MG 60 $1.50 Hy Vee Propanolol Tab 80MG 60 $1.50 Hy Vee Warfarin Sodium Tab

1MG 30 $1.50

Hy Vee Warfarin Sodium Tab 2.5MG

30 $1.50

Hy Vee Warfarin Sodium Tab 2MG

30 $1.50

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16

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Hy Vee Warfarin Sodium Tab 3MG

30 $1.50

Hy Vee Warfarin Sodium Tab 4MG

30 $1.50

Hy Vee Warfarin Sodium Tab 5MG

30 $1.50

Hy Vee Warfarin Sodium Tab 6MG

30 $1.50

Hy Vee Warfarin Sodium Tab 7.5 MG

30 $1.50

Hy Vee Acyclovir Cap 200 MG 30 $2.00 Hy Vee Amoxicillin Cap 250MG 30 $2.00 Hy Vee Amoxicillin Cap 500MG 30 $2.00 Hy Vee Amoxicillin SUS

125MG/5ML 150 $2.00

Hy Vee Amoxicillin SUS 400MG/5ML

100 $2.00

Hy Vee Bisoprolol & Hydrochlorothiazide Tab 10-6.25 MG

30 $2.00

Hy Vee Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG

30 $2.00

Hy Vee Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

Hy Vee Bumetanide Tab 0.5MG 30 $2.00 Hy Vee Bumetanide Tab 1MG 30 $2.00 Hy Vee Buspirone Tab 10MG 60 $2.00 Hy Vee Buspirone Tab 5MG 60 $2.00 Hy Vee Carbamazepine Tab

200MG 60 $2.00

Hy Vee Cephalexin Cap 250MG 28 $2.00 Hy Vee Cephalexin Cap 500MG 30 $2.00 Hy Vee Ciprofloxacin Tab 250MG 14 $2.00 Hy Vee Ciprofloxacin Tab 500MG 20 $2.00 Hy Vee Clonidine Tab 0.1MG 30 $2.00 Hy Vee Clonidine Tab 0.2MG 30 $2.00 Hy Vee Dexamethasone Tab

0.5MG 30 $2.00

Hy Vee Dexamethasone Tab 0.75MG

12 $2.00

Hy Vee Dexamethasone Tab 4MG 6 $2.00 Hy Vee Enalapril Tab 10MG 30 $2.00

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17

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Hy Vee Enalapril Tab 2.5MG 30 $2.00 Hy Vee Enalapril Tab 5MG 30 $2.00 Hy Vee Enalapril/HCTZ Tab 5-

12.5MG 30 $2.00

Hy Vee Famotidine Tab 20MG 60 $2.00 Hy Vee Fluconazole Tab 150MG 1 $2.00 Hy Vee Fluoxetine Cap 10MG 30 $2.00 Hy Vee Fluoxetine Cap 10MG 30 $2.00 Hy Vee Fluoxetine Cap 20MG 30 $2.00 Hy Vee Fluoxetine Cap 40MG 30 $2.00 Hy Vee Haloperidol Tab 0.5MG 30 $2.00 Hy Vee Haloperidol Tab 1MG 30 $2.00 Hy Vee Haloperidol Tab 2MG 30 $2.00 Hy Vee Hydralazine Tab 25MG 30 $2.00 Hy Vee Hydrochlorothiazide Tab

25MG 30 $2.00

Hy Vee Hydrochlorothiazide Tab 50MG

30 $2.00

Hy Vee Hydrocortisone Crm 1% 30 $2.00 Hy Vee Ibuprofen Tab 400MG 90 $2.00 Hy Vee Ibuprofen Tab 600MG 60 $2.00 Hy Vee Ibuprofen Tab 800MG 30 $2.00 Hy Vee Isoniazid Tab 300MG 30 $2.00 Hy Vee Lactulose Sol

10GM/15ML 240 $2.00

Hy Vee Lidocaine Viscous Sol 2% 100 $2.00 Hy Vee Lithium Carbonate Cap

300MG 90 $2.00

Hy Vee Medroxyprogesterone Tab 10MG

10 $2.00

Hy Vee Medroxyprogesterone Tab 2.5MG

30 $2.00

Hy Vee Medroxyprogesterone Tab 5MG

30 $2.00

Hy Vee Meloxicam Tab 15MG 30 $2.00 Hy Vee Meloxicam Tab 7.5MG 30 $2.00 Hy Vee Metoclopramide Syp

5MG/5ML 60 $2.00

Hy Vee Metocloropramide Tab 10MG

60 $2.00

Hy Vee Naproxen Tab 375MG 60 $2.00 Hy Vee Naproxen Tab 500MG 60 $2.00 Hy Vee Nortriptyline Cap 10MG 30 $2.00

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18

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Hy Vee Paroxetine Tab 10MG 30 $2.00 Hy Vee Paroxetine Tab 20MG 30 $2.00 Hy Vee Penicillin VK 125MG/5ML 100 $2.00 Hy Vee Penicillin VK 250MG/5ML 100 $2.00 Hy Vee Penicillin VK Tab 250MG 28 $2.00 Hy Vee Prednisone Tab 2.5MG 30 $2.00 Hy Vee Prednisone Tab 5MG 30 $2.00 Hy Vee Prochlorperazine Tab

10MG 30 $2.00

Hy Vee Ranitidine Tab 300MG 30 $2.00 Hy Vee Sotalol Tab 80MG 30 $2.00 Hy Vee Spironolactone Tab 25MG 30 $2.00 Hy Vee Sufameth/Trimeth DS Tab

400-80MG 28 $2.00

Hy Vee Sufameth/Trimeth DS Tab 800-160MG

20 $2.00

Hy Vee Terazosin Cap 10MG 30 $2.00 Hy Vee Terazosin Cap 1MG 30 $2.00 Hy Vee Terazosin Cap 2MG 30 $2.00 Hy Vee Terazosin Cap 5MG 30 $2.00 Hy Vee Terbinafine Tab 250MG 30 $2.00 Hy Vee Timolol Opt Sol 0.25% 5 $2.00 Hy Vee Trazadone Tab 100MG 30 $2.00 Hy Vee Trazadone Tab 150MG 30 $2.00 Hy Vee Trazadone Tab 50MG 30 $2.00 Hy Vee Triamcinolone Crm

0.025% 15 $2.00

Hy Vee Triamcinolone Oint 0.1% 15 $2.00 Hy Vee Verapamil Tab 120MG 30 $2.00 Hy Vee Verapamil Tab 80MG 30 $2.00 Hy Vee Warfarin Sodium Tab

10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Benazepril Tab 10MG 30 $1.50

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Benazepril Tab 20MG 30 $1.50

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Benazepril Tab 40MG 30 $1.50

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Benazepril Tab 5MG 30 $1.50

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lovastatin Tab 10MG 30 $1.50

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19

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lovastatin Tab 20MG 30 $1.50

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metformin Tab 1000MG 60 $1.75

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metformin Tab 850MG 60 $1.75

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metformin ER Tab 500MG

60 $1.75

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metformin Tab 500MG 60 $1.75

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

acetamide Sodium 10% 15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Acyclovir Cap 200 MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Albuterol Syp 2MG/5ML 120 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Albuterol Tab 2MG 90 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Albuterol Tab 4MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Alendronate Sodium Tab 35MG

4 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Alendronate Sodium Tab 70MG

4 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Allopurinol Tab 100MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Allopurinol Tab 300MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amiloride/Hydrochlorothiazide Tab 5-50MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amoxicillin Cap 250MG 150 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amoxicillin Cap 500MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amoxicillin SUS 125MG/5ML

150 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amoxicillin SUS 200MG/5ML

100 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amoxicillin SUS 250MG/5ML

80 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Amoxicillin SUS 400MG/5ML

100 $2.00

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20

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Atenolol & Chlorothalidone Tab 100-25MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Atenolol & Chlorthalidone Tab 50-25MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Atenolol Tab 100MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Atenolol Tab 25MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Atenolol Tab 50MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Baclofen Tab 10 MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Bisoprolol & Hydrochlorothiazide Tab 10-6.25 MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Bumetanide Tab 0.5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Bumetanide Tab 1MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Buspirone Tab 10MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Buspirone Tab 5MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Captopril Tab 100MG 90 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Captopril Tab 12.5MG 90 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Captopril Tab 25MG 90 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Captopril Tab 50MG 90 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Carbamazepine Tab 200MG

100 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Carvedilol Tab 12.5MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Carvedilol Tab 25MG 60 $2.00

Page 21: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

21

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Carvedilol Tab 3.125MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Carvedilol Tab 6.25MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Cephalexin Cap 250MG 40 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Cephalexin Cap 500MG 40 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Cimetidine Tab 800MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ciprofloxacin Tab 250MG 20 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ciprofloxacin Tab 500MG 20 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Citalopram Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Citalopram Tab 40MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Clonidine Tab 0.1MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Clonidine Tab 0.2MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Dexamethasone Tab 0.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Dexamethasone Tab 0.75MG

18 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Dexamethasone Tab 4MG 12 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Diclofenac Sod Dr 75MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Diltiazem Tab 120MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Diltiazem Tab 30MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Diltiazem Tab 60MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Diltiazem Tab 90MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Doxazosin Tab 2MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Doxazosin Tab 4MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Doxazosin Tab 1MG 30 $2.00

Page 22: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

22

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Doxazosin Tab 8MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Enalapril Tab 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Enalapril Tab 2.5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Enalapril Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Enalapril Tab 5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Enalapril/HCTZ Tab 5-12.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Erythromycin Opt Oint 5MG

3.5 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Famotidine Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Fluconazole Tab 150MG 1 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Fluocinonide Crm 0.05% 15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Fluoxetine Cap 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Fluoxetine Cap 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Fluoxetine Cap 40MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Fluphenazine Tab 1MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Furosemide Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Furosemide Tab 40MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Furosemide Tab 80MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Gentamicin Crm 0.1% 15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Gentamicin Opt Sol 0.3% 5 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Glimepiride Tab 1MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Glimepiride Tab 2MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Glimepiride Tab 4MG 30 $2.00

Page 23: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

23

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Glipizide Tab 10MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Glipizide Tab 5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Haloperidol Tab 0.5MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Haloperidol Tab 1MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Haloperidol Tab 2MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Haloperidol Tab 5MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydralazine Tab 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydralazine Tab 25MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydrochlorothiazide Cap 12.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydrochlorothiazide Tab 25MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydrochlorothiazide Tab 50MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydrocortisone Crm 1% 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Hydrocortisone Crm 2.5% 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ibuprofen Tab 400MG 90 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ibuprofen Tab 600MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ibuprofen Tab 800MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Indapamide Tab 1.25MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Indapamide Tab 2.5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Isoniazid Tab 300MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Isosorbide Mono ER Tab 30MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Isosorbide Mono ER Tab 60MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levobunolol Opt 0.5% 5 $2.00

Page 24: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

24

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 100MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 112MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 125MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 137MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 150MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 175MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 200MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 25MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 50MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 75MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Levothyroxine Sodium Tab 88MCG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lidocaine Viscous Sol 2% 100 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril & Hydrochlorothiazide Tab 10-12.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril Tab 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril Tab 2.5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lisinopril Tab 5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Lithium Carbonate Cap 300MG

90 $2.00

Page 25: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

25

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Medroxyprogesterone Tab 10MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Medroxyprogesterone Tab 2.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Medroxyprogesterone Tab 5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Meloxicam Tab 15MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Meloxicam Tab 7.5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Methylprednisolon Tab 4MG

21 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Methylprednisolon Tab 4MG

21 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metoclopramide Syp 5MG/5ML

120 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metocloropramide Tab 10MG

60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metoprolol Tartrate Tab 100MG

60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metoprolol Tartrate Tab 25MG

60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Metoprolol Tartrate Tab 50MG

60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nadolol Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nadolol Tab 40MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Naproxen Tab 375MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Naproxen Tab 500MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Neo/Polymx/Dexamethasone Oint 0.1%

3.5 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Neo/Polymx/Dexamethasone Sus 0.1%

5 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nortriptyline Cap 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nortriptyline Cap 25MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nystatin Crm 100,000U 15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nystatin/Triamcinolone Crm

30 $2.00

Page 26: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

26

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Nystatin/Triamcinolone Oint

15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Oxybutynin Chloride Tab 5MG

60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Paroxetine Tab 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Paroxetine Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Penicillin VK 125MG/5ML 200 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Penicillin VK 250MG/5ML 100 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Penicillin VK Tab 250MG 40 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Polymixin ate/Trimeth Opt Sol

10 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Pravastatin Sodium Tab 10MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Pravastatin Sodium Tab 20MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Pravastatin Sodium Tab 40MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prazosin Cap 1MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prednisone 5MG/5ML 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prednisone DSPK Tab 10MG

48 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prednisone DSPK Tab 5MG

48 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prednisone Tab 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prednisone Tab 2.5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prednisone Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Prochlorperazine Tab 10MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Propanolol Tab 10MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Propanolol Tab 20MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Propanolol Tab 40MG 60 $2.00

Page 27: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

27

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Propanolol Tab 80MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ranitidine Tab 150MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Ranitidine Tab 300MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Silver adiazine Crm 1% 50 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Sotalol Tab 80MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Spironolactone Tab 25MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Sprintec Tab 0.25-0.035 28 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Sufameth/Trimeth DS Tab 400-80MG

20 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Sufameth/Trimeth DS Tab 800-160MG

20 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Sufameth/Trimeth Ped SUS 473ML

120 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Tamoxifen Tab 10MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Tamoxifen Tab 20MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Terazosin Cap 10MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Terazosin Cap 1MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Terazosin Cap 2MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Terazosin Cap 5MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Terbinafine Tab 250MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Tetracycline Cap 250MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Tetracycline Cap 500MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Timolol Opt Sol 0.25% 5 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Timolol Opt Sol 0.5% 5 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Tobramycin Opt Sol 0.3% 5 $2.00

Page 28: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

28

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Tramadol Tab 50MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Trazadone Tab 100MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Trazadone Tab 150MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Trazadone Tab 50MG 30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Triamcinolone Crm 0.025%

15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Triamcinolone Crm 0.1% 80 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Triamcinolone Crm 0.5% 15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Triamcinolone Oint 0.1% 15 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Triamterene & Hydrochlorothiazide Cap 37.5-25MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Triamterene & Hydrochlorothiazide Tab 75-50MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Trinessa 28 Tab 28 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Verapamil Tab 120MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Verapamil Tab 80MG 60 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 10MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 1MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 2.5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 2MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 3MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 4MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 5MG

30 $2.00

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 6MG

30 $2.00

Page 29: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

29

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Kroger, Baker's, City Market, Dillion, Fed Meyer, Fry's, Gerbes, JayC, King Soopers, QFC, Ralph's, Scotts, Smiths

Warfarin Sodium Tab 7.5 MG

30 $2.00

Publix Allopurinol Tab 100MG 30 $2.00 Publix Allopurinol Tab 300MG 30 $2.00 Publix Atenolol Tab 100MG 30 $2.00 Publix Atenolol Tab 25MG 30 $2.00 Publix Atenolol Tab 50MG 30 $2.00 Publix Benazepril Tab 10MG 30 $2.00 Publix Benazepril Tab 20MG 30 $2.00 Publix Benazepril Tab 40MG 30 $2.00 Publix Benazepril Tab 5MG 30 $2.00 Publix Bisoprolol &

Hydrochlorothiazide Tab 10-6.25 MG

30 $2.00

Publix Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG

30 $2.00

Publix Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

Publix Buspirone Tab 10MG 30 $2.00 Publix Carvedilol Tab 12.5MG 60 $2.00 Publix Carvedilol Tab 3.125MG 60 $2.00 Publix Carvedilol Tab 6.25MG 30 $2.00 Publix Citalopram Tab 10MG 30 $2.00 Publix Citalopram Tab 20MG 30 $2.00 Publix Citalopram Tab 40MG 30 $2.00 Publix Clonidine Tab 0.1MG 30 $2.00 Publix Clonidine Tab 0.2MG 30 $2.00 Publix Clonidine Tab 0.3MG 30 $2.00 Publix Enalapril Tab 10MG 30 $2.00 Publix Enalapril Tab 2.5MG 30 $2.00 Publix Enalapril Tab 5MG 30 $2.00 Publix Famotidine Tab 20MG 30 $2.00 Publix Fluoxetine Cap 10MG 30 $2.00 Publix Fluoxetine Cap 20MG 30 $2.00 Publix Furosemide Tab 20MG 30 $2.00 Publix Furosemide Tab 40MG 30 $2.00 Publix Furosemide Tab 80MG 30 $2.00 Publix Glimepiride Tab 1MG 30 $2.00 Publix Glimepiride Tab 2MG 30 $2.00 Publix Glimepiride Tab 4MG 30 $2.00 Publix Glipizide Tab 10MG 30 $2.00

Page 30: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

30

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Publix Glipizide Tab 5MG 30 $2.00 Publix Hydralazine 50MG 30 $2.00 Publix Hydralazine Tab 10MG 30 $2.00 Publix Hydralazine Tab 25MG 30 $2.00 Publix Hydrochlorothiazide Cap

12.5MG 30 $2.00

Publix Hydrochlorothiazide Tab 25MG

30 $2.00

Publix Hydrochlorothiazide Tab 50MG

30 $2.00

Publix Lisinopril & Hydrochlorothiazide Tab 10-12.5MG

30 $2.00

Publix Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $2.00

Publix Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $2.00

Publix LOSARTAN POT TAB 100MG

30 $2.00

Publix LOSARTAN POT TAB 25MG

30 $2.00

Publix LOSARTAN POT TAB 50MG

30 $2.00

Publix LOSARTAN/HCT TAB 100-12.5

30 $2.00

Publix LOSARTAN/HCT TAB 100-25

30 $2.00

Publix LOSARTAN/HCT TAB 50-12.5

30 $2.00

Publix Lovastatin Tab 10MG 30 $2.00 Publix Lovastatin Tab 20MG 30 $2.00 Publix Lovastatin Tab 40MG 30 $2.00 Publix Meloxicam Tab 15MG 30 $2.00 Publix Meloxicam Tab 7.5MG 60 $2.00 Publix Metocloropramide Tab

10MG 30 $2.00

Publix Metocloropramide Tab 5MG

60 $2.00

Publix Metoprolol Tartrate Tab 100MG

60 $2.00

Publix Metoprolol Tartrate Tab 25MG

60 $2.00

Page 31: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

31

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Publix Metoprolol Tartrate Tab 50MG

60 $2.00

Publix Propanolol Tab 10MG 60 $2.00 Publix Propanolol Tab 20MG 60 $2.00 Publix Propanolol Tab 40MG 60 $2.00 Publix Sertraline Tab 25MG 30 $2.00 Publix Sertraline Tab 50MG 30 $2.00 Publix Simvastatin Tab 10MG 30 $2.00 Publix Simvastatin Tab 20MG 30 $2.00 Publix Simvastatin Tab 40MG 30 $2.00 Publix Simvastatin Tab 5MG 30 $2.00 Publix Simvastatin Tab 80MG 30 $2.00 Publix Terazosin Cap 10MG 30 $2.00 Publix Terazosin Cap 1MG 30 $2.00 Publix Terazosin Cap 2MG 30 $2.00 Publix Terazosin Cap 5MG 30 $2.00 Publix Trazadone Tab 100MG 30 $2.00 Publix Trazadone Tab 50MG 30 $2.00 Publix Triamterene &

Hydrochlorothiazide Tab 37.5-25MG

30 $2.00

Publix Triamterene & Hydrochlorothiazide Tab 75-50MG

30 $2.00

Publix Verapamil Tab 80MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Albuterol Sulf Syrup

2mg/5mL 120 $2.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Amoxicillin 5000mg cap 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Atenolol 100mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Glipizide 5 mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Glyburide 1.25mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lisinopril 10mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lisinopril 20mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lisinopril/HCTZ

10/12.5mg tab 30 $2.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lisinopril/HCTZ 20/12.5mg tab

30 $2.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Loratidine 10mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lovastatin 10mg tab 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Metformin 1000mg tab 90 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Metformin 500mg tab 90 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Metformin 850mg tab 90 $4.00

Page 32: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

32

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Metoclopramide 5mg/5mL soln

60 $2.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Nortriptyline 25mg cap 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Pramipexole 0.5mg tab 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Promethazine 25mg tab 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Propranolol 10mg tab 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Propranolol 20mg tab 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Propranolol 40mg tab 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Propranolol 80mg tab 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Ropinirole 0.25mg tab 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Verapamil 80mg tab 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Alendronate Sodium Tab

35MG 4 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Alendronate Sodium Tab 70MG

4 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Enalapril Tab 10MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Enalapril Tab 2.5MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Enalapril Tab 20MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Enalapril Tab 5MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Famotidine Tab 20MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Fluoxetine Cap 10MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Hydrochlorothiazide Cap

12.5MG 30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Ibuprofen Tab 400MG 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Ibuprofen Tab 600MG 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Ibuprofen Tab 800MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lovastatin Tab 40MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Omeprazole Cap 20MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Pantoprazole Tab 20MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Pantoprazole Tab 40MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Paroxetin Tab 30MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Paroxetin Tab 40MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Paroxetine Tab 10MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Paroxetine Tab 20MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Prednisone Tab 10MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Prednisone Tab 2.5MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Prednisone Tab 5MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Ranitidine Tab 150MG 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Ranitidine Tab 300MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Spironolactone Tab 50MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Trazadone Tab 150MG 30 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab

10MG 30 $4.00

Page 33: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

33

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 1MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 2.5MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 2MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 3MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 4MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 5MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 6MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Warfarin Sodium Tab 7.5MG

30 $4.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Allopurinol Tab 100MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Allopurinol Tab 300MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Clonidine Tab 0.1MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Clonidine Tab 0.2MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Fluoxetine Cap 20MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Furosemide Tab 20MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Furosemide Tab 40MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Furosemide Tab 80MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Glimepiride Tab 1MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Glimepiride Tab 2MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Glimepiride Tab 4MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Hydrochlorothiazide Tab

25MG 30 $2.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Hydrochlorothiazide Tab 50MG

30 $2.00

Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Lovastatin Tab 20MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Naproxen Tab 250MG 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Naproxen Tab 375MG 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Naproxen Tab 500MG 60 $4.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Spironolactone Tab 25MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Trazadone Tab 100MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Trazadone Tab 50MG 30 $2.00 Safeway, Carrs, Pavillions, Randals, Tom Thumb, Vons Triamterene &

Hydrochlorothiazide Cap 37.5-25MG

30 $4.00

Target DICLOFEN POT 50MG TAB TEVA

30 $4.00

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34

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target DILTIAZEM 120 MG ER CAP TEVA

30 $4.00

Target MIRTAZAPINE 15 MG TAB TEVA

30 $2.00

Target MIRTAZAPINE 30 MG TAB TEVA

30 $2.00

Target NORTRIPTYLINE 50 MG CAP TEVA

30 $4.00

Target NORTRIPTYLINE 75 MG CAP TEVA

30 $4.00

Target PAROXETINE 30 MG TAB TEVA

30 $4.00

Target PRAMIPEXOLE 0.5MG TAB TORR

30 $1.50

Target PRAMIPEXOLE 0.75MG TAB TORR

30 $4.00

Target PRAMIPEXOLE 1.5MG TAB TORR

30 $2.00

Target PRAMIPEXOLE 1MG TAB TORR

30 $2.00

Target ROPINIROLE 0.5MG TAB SOLC

30 $2.00

Target ROPINIROLE 1MG TAB SOLC

30 $2.00

Target ROPINIROLE 2MG TAB SOLC

30 $2.00

Target ROPINIROLE 3MG TAB SOLC

30 $2.00

Target VENLAFAXINE 150MGER CAP TEVA

30 $4.00

Target Amoxicillin Cap 500MG 30 $1.50 Target Atenolol Tab 100MG 30 $1.50 Target Atenolol Tab 25MG 30 $1.50 Target Atenolol Tab 50MG 30 $1.50 Target Baclofen Tab 10 MG 30 $4.00 Target Bumetanide Tab 1MG 30 $4.00 Target Captopril Tab 100MG 60 $4.00 Target Captopril Tab 12.5MG 60 $4.00 Target Captopril Tab 25MG 60 $4.00 Target Captopril Tab 50MG 60 $4.00 Target Ciprofloxacin Tab 250MG 14 $1.50 Target Ciprofloxacin Tab 500MG 20 $1.50 Target Diclofenac Sod Dr 75MG 60 $4.00 Target Doxazosin Tab 2MG 30 $4.00

Page 35: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

35

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Doxazosin Tab 4MG 30 $4.00 Target Doxazosin Tab 1MG 30 $4.00 Target Doxazosin Tab 8MG 30 $4.00 Target Fluocinonide Crm 0.05% 30 $4.00 Target Gentamicin Crm 0.1% 30 $4.00 Target Gentamicin Oint 0.1% 15 $4.00 Target Hydrochlorothiazide Tab

25MG 30 $1.50

Target Indapamide Tab 1.25MG 30 $4.00 Target Indapamide Tab 2.5MG 30 $4.00 Target Levothyroxine Sodium

Tab 100MCG 30 $4.00

Target Levothyroxine Sodium Tab 112MCG

30 $4.00

Target Levothyroxine Sodium Tab 125MCG

30 $4.00

Target Levothyroxine Sodium Tab 137MCG

30 $4.00

Target Levothyroxine Sodium Tab 150MCG

30 $4.00

Target Levothyroxine Sodium Tab 175MCG

30 $4.00

Target Levothyroxine Sodium Tab 200MCG

30 $4.00

Target Levothyroxine Sodium Tab 25MCG

30 $4.00

Target Levothyroxine Sodium Tab 50MCG

30 $4.00

Target Levothyroxine Sodium Tab 75MCG

30 $4.00

Target Levothyroxine Sodium Tab 88MCG

30 $4.00

Target Lisinopril Tab 10MG 30 $1.50 Target Lisinopril Tab 20MG 30 $1.50 Target Lisinopril Tab 30MG 30 $1.50 Target Lisinopril Tab 40MG 30 $1.50 Target LOSARTAN/HCT TAB 100-

12.5 30 $2.00

Target LOSARTAN/HCT TAB 100-25

30 $2.00

Target LOSARTAN/HCT TAB 50-12.5

30 $2.00

Target Metformin Tab 500MG 60 $1.50

Page 36: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

36

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Metoprolol Tartrate Tab 100MG

60 $1.50

Target Metoprolol Tartrate Tab 25MG

60 $1.50

Target Metoprolol Tartrate Tab 50MG

60 $1.50

Target Neo/Polymx/Dexamethasone Oint 0.1%

5 $4.00

Target Neo/Polymx/Dexamethasone Sus 0.1%

4 $4.00

Target Nystatin Crm 100,000U 30 $4.00 Target Nystatin/Triamcinolone

Oint 15 $4.00

Target Pilocarpine 1% Ophth Sol (Falcon Brand Only)

15 $4.00

Target Pilocarpine 2% Ophth Sol (Falcon Brand Only)

15 $4.00

Target Pravastatin Sodium Tab 10MG

30 $4.00

Target Pravastatin Sodium Tab 20MG

30 $4.00

Target Pravastatin Sodium Tab 40MG

30 $4.00

Target Silver adiazine Crm 1% 50 $4.00 Target SIMVASTATIN TAB 20MG 30 $2.00 Target Sufameth/Trimeth DS Tab

800-160MG 20 $1.50

Target acetamide Sodium 10% 15 $2.00 Target Acyclovir Cap 200 MG 30 $2.00 Target Albuterol Syp 2MG/5ML 120 $2.00 Target Allopurinol Tab 100MG 30 $2.00 Target Allopurinol Tab 300MG 30 $2.00 Target Amiloride/Hydrochlorothi

azide Tab 5-50MG 30 $2.00

Target Amoxicillin Cap 250MG 30 $2.00 Target Amoxicillin SUS

125MG/5ML 150 $2.00

Target Amoxicillin SUS 200MG/5ML

100 $2.00

Target Amoxicillin SUS 250MG/5ML

150 $2.00

Target Amoxicillin SUS 400MG/5ML

100 $2.00

Page 37: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

37

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Atenolol & Chlorothalidone Tab 100-25MG

30 $2.00

Target Atenolol & Chlorthalidone Tab 50-25MG

30 $2.00

Target ATORVASTATIN TAB 10MG

30 $4.00

Target ATORVASTATIN TAB 20MG

30 $4.00

Target ATORVASTATIN TAB 40MG

30 $4.00

Target ATORVASTATIN TAB 80MG

30 $4.00

Target Benazepril Tab 10MG 30 $2.00 Target Benazepril Tab 20MG 30 $2.00 Target Benazepril Tab 40MG 30 $2.00 Target Benazepril Tab 5MG 30 $2.00 Target Bisoprolol &

Hydrochlorothiazide Tab 10-6.25 MG

30 $2.00

Target Bisoprolol & Hydrochlorothiazide Tab 2.5-6.25 MG

30 $2.00

Target Bisoprolol & Hydrochlorothiazide Tab 5-6.25 MG

30 $2.00

Target Bumetanide Tab 0.5MG 30 $2.00 Target Buspirone Tab 10MG 60 $2.00 Target Buspirone Tab 5MG 60 $2.00 Target Carbamazepine Tab

200MG 60 $2.00

Target Carvedilol Tab 12.5MG 60 $2.00 Target Carvedilol Tab 25MG 60 $2.00 Target Carvedilol Tab 3.125MG 60 $2.00 Target Carvedilol Tab 6.25MG 60 $2.00 Target Cephalexin Cap 250MG 28 $2.00 Target Cephalexin Cap 500MG 30 $2.00 Target Cimetidine Tab 800MG 30 $2.00 Target Citalopram Tab 20MG 30 $2.00 Target Citalopram Tab 40MG 30 $2.00 Target Clonidine Tab 0.1MG 30 $2.00 Target Clonidine Tab 0.2MG 30 $2.00 Target Dexamethasone Tab

0.5MG 30 $2.00

Page 38: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

38

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Dexamethasone Tab 0.75MG

12 $2.00

Target Dexamethasone Tab 4MG 6 $2.00 Target Diltiazem Tab 120MG 30 $2.00 Target Diltiazem Tab 30MG 60 $2.00 Target Diltiazem Tab 60MG 60 $2.00 Target Diltiazem Tab 90MG 60 $2.00 Target Enalapril Tab 10MG 30 $2.00 Target Enalapril Tab 2.5MG 30 $2.00 Target Enalapril Tab 20MG 30 $2.00 Target Enalapril Tab 5MG 30 $2.00 Target Enalapril/HCTZ Tab 5-

12.5MG 30 $2.00

Target Erythromycin Opt Oint 5MG

4 $2.00

Target Famotidine Tab 20MG 60 $2.00 Target Fluconazole Tab 150MG 1 $2.00 Target Fluoxetine Cap 10MG 30 $2.00 Target Fluoxetine Cap 10MG 30 $2.00 Target Fluoxetine Cap 20MG 30 $2.00 Target Fluoxetine Cap 40MG 30 $2.00 Target Fluphenazine Tab 1MG 30 $2.00 Target Furosemide Tab 20MG 30 $2.00 Target Furosemide Tab 40MG 30 $2.00 Target Furosemide Tab 80MG 30 $2.00 Target Gentamicin Opt Sol 0.3% 5 $2.00 Target Glimepiride Tab 2MG 30 $2.00 Target Glimepiride Tab 4MG 30 $2.00 Target GlimepirideTab 1MG 30 $2.00 Target GLIPIZIDE ER TAB 10MG 60 $4.00 Target GLIPIZIDE ER TAB 2.5MG 60 $4.00 Target GLIPIZIDE ER TAB 5MG 60 $4.00 Target Glipizide Tab 10MG 60 $2.00 Target Glipizide Tab 5MG 30 $2.00 Target Haloperidol Tab 0.5MG 30 $2.00 Target Haloperidol Tab 1MG 30 $2.00 Target Haloperidol Tab 2MG 30 $2.00 Target Haloperidol Tab 5MG 30 $2.00 Target Hydralazine Tab 10MG 30 $2.00 Target Hydralazine Tab 25MG 30 $2.00 Target Hydrochlorothiazide Cap

12.5MG 30 $2.00

Page 39: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

39

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Hydrochlorothiazide Tab 50MG

30 $2.00

Target Hydrocortisone Crm 1% 30 $2.00 Target Hydrocortisone Crm 2.5% 30 $2.00 Target Ibuprofen 100MG/5ML 120 $2.00 Target Ibuprofen Tab 400MG 90 $2.00 Target Ibuprofen Tab 600MG 60 $2.00 Target Ibuprofen Tab 800MG 30 $2.00 Target IRBESARTAN TAB

150MG 30 $4.00

Target IRBESARTAN TAB 300MG

30 $4.00

Target IRBESARTAN TAB 75MG 30 $4.00 Target Isoniazid Tab 300MG 30 $2.00 Target Isosorbide Mono ER Tab

30MG 30 $2.00

Target Isosorbide Mono ER Tab 60MG

30 $2.00

Target Lactulose Sol 10GM/15ML

237 $2.00

Target Levobunolol Opt 0.5% 5 $2.00 Target Lidocaine Viscous Sol 2% 100 $2.00 Target Lisinopril &

Hydrochlorothiazide Tab 10-12.5MG

30 $2.00

Target Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $2.00

Target Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $2.00

Target Lisinopril Tab 2.5MG 30 $2.00 Target Lisinopril Tab 5MG 30 $2.00 Target Lithium Carbonate Cap

300MG 90 $2.00

Target LOSARTAN POT TAB 100MG

30 $4.00

Target LOSARTAN POT TAB 25MG

30 $4.00

Target LOSARTAN POT TAB 50MG

30 $4.00

Target Lovastatin Tab 10MG 30 $2.00 Target Lovastatin Tab 20MG 30 $2.00

Page 40: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

40

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Medroxyprogesterone Tab 10MG

10 $2.00

Target Medroxyprogesterone Tab 2.5MG

30 $2.00

Target Medroxyprogesterone Tab 5MG

30 $2.00

Target Meloxicam Tab 15MG 30 $2.00 Target Meloxicam Tab 7.5MG 30 $2.00 Target Metformin Tab 1000MG 60 $2.00 Target Metformin Tab 850MG 60 $2.00 Target Metformin ER Tab

500MG 60 $2.00

Target Metoclopramide Syp 5MG/5ML

60 $2.00

Target Metocloropramide Tab 10MG

60 $2.00

Target Nadolol Tab 20MG 30 $2.00 Target Nadolol Tab 40MG 30 $2.00 Target Naproxen Tab 375MG 60 $2.00 Target Naproxen Tab 500MG 60 $2.00 Target Nortriptyline Cap 10MG 30 $2.00 Target Nortriptyline Cap 25MG 30 $2.00 Target Paroxetine Tab 10MG 30 $2.00 Target Paroxetine Tab 20MG 30 $2.00 Target Penicillin VK 125MG/5ML 200 $2.00 Target Penicillin VK 250MG/5ML 100 $2.00 Target Penicillin VK Tab 250MG 28 $2.00 Target Polymixin ate/Trimeth

Opt Sol 10 $2.00

Target Pravastatin Sodium Tab 80MG

30 $4.00

Target Prazosin Cap 1MG 30 $2.00 Target Prazosin Cap 2MG 30 $2.00 Target Prazosin Cap 5MG 30 $2.00 Target Prednisone Tab 10MG 30 $2.00 Target Prednisone Tab 2.5MG 30 $2.00 Target Prednisone Tab 20MG 30 $2.00 Target Prednisone Tab 5MG 30 $2.00 Target Prochlorperazine Tab

10MG 30 $2.00

Target Propanolol Tab 10MG 60 $2.00 Target Propanolol Tab 20MG 60 $2.00 Target Propanolol Tab 40MG 60 $2.00

Page 41: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

41

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Propanolol Tab 80MG 60 $2.00 Target RAMIPRIL CAP 1.25MG 30 $4.00 Target RAMIPRIL CAP 10MG 30 $4.00 Target RAMIPRIL CAP 2.5MG 30 $4.00 Target RAMIPRIL CAP 5MG 30 $4.00 Target Ranitidine Tab 150MG 60 $2.00 Target Ranitidine Tab 300MG 30 $2.00 Target SIMVASTATIN TAB 10MG 30 $4.00 Target SIMVASTATIN TAB 40MG 30 $4.00 Target SIMVASTATIN TAB 5MG 30 $4.00 Target SIMVASTATIN TAB 80MG 30 $4.00 Target Sotalol Tab 80MG 30 $2.00 Target Spironolactone Tab 25MG 30 $2.00 Target Sufameth/Trimeth DS Tab

400-80MG 28 $2.00

Target Sufameth/Trimeth Ped SUS 473ML

120 $2.00

Target Terazosin Cap 10MG 30 $2.00 Target Terazosin Cap 1MG 30 $2.00 Target Terazosin Cap 2MG 30 $2.00 Target Terazosin Cap 5MG 30 $2.00 Target Terbinafine Tab 250MG 30 $2.00 Target Tetracycline Cap 250MG 60 $2.00 Target Tetracycline Cap 500MG 60 $2.00 Target Thiothixene Cap 2MG 30 $2.00 Target Timolol Opt Sol 0.25% 5 $2.00 Target Timolol Opt Sol 0.5% 5 $2.00 Target Tobramycin Opt Sol 0.3% 5 $2.00 Target Trazadone Tab 100MG 30 $2.00 Target Trazadone Tab 150MG 30 $2.00 Target Trazadone Tab 50MG 30 $2.00 Target Triamcinolone Crm

0.025% 80 $2.00

Target Triamcinolone Crm 0.5% 15 $2.00 Target Triamcinolone Oint 0.1% 80 $2.00 Target Triamterene &

Hydrochlorothiazide Cap 37.5-25MG

30 $2.00

Target Triamterene & Hydrochlorothiazide Tab 37.5-25MG

30 $2.00

Page 42: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

42

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Target Triamterene & Hydrochlorothiazide Tab 75-50MG

30 $2.00

Target Verapamil Tab 120MG 30 $2.00 Target Verapamil Tab 80MG 30 $2.00 Target Warfarin Sodium Tab

10MG 30 $2.00

Target Warfarin Sodium Tab 1MG

30 $2.00

Target Warfarin Sodium Tab 2.5MG

30 $2.00

Target Warfarin Sodium Tab 2MG

30 $2.00

Target Warfarin Sodium Tab 3MG

30 $2.00

Target Warfarin Sodium Tab 4MG

30 $2.00

Target Warfarin Sodium Tab 5MG

30 $2.00

Target Warfarin Sodium Tab 6MG

30 $2.00

Target Warfarin Sodium Tab 7.5 MG

30 $2.00

Thrifty White GABAPENTIN 600MG TAB 30 $6.00 Thrifty White MODAFINIL 100MG

TABLET 30 $6.00

Thrifty White MODAFINIL 200MG TABLET

30 $6.00

Thrifty White NABUMETONE 500MG TAB

30 $6.00

Thrifty White OLANZAPINE 10MG TABLET

30 $6.00

Thrifty White PRAMIPEXOLE 0.125MG TAB

30 $6.00

Thrifty White PRAMIPEXOLE 0.25MG TAB

30 $6.00

Thrifty White PRAMIPEXOLE 0.5 MG TABLET

30 $6.00

Thrifty White ROPINIROLE 0.25MG TAB 30 $7.00 Thrifty White ROPINIROLE 0.5MG TAB 30 $7.00 Thrifty White ROPINIROLE 1MG TAB 30 $7.00 Thrifty White ROPINIROLE 2MG TAB 30 $7.00 Thrifty White ROPINIROLE 3MG TAB 30 $7.00 Thrifty White ROPINIROLE 5MG TAB 30 $7.00

Page 43: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

43

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White TIZANIDINE HCL 2MG TAB 30 $7.00 Thrifty White TIZANIDINE HCL 4MG TAB 30 $7.00 Thrifty White VENLAFAXINE 150MG ER

CAP 30 $6.00

Thrifty White VENLAFAXINE HCL ER 75 MG CAP

30 $6.00

Thrifty White BENAZEPRIL HCL 10 MG 30 $1.75 Thrifty White BENAZEPRIL HCL 20 MG 30 $1.75 Thrifty White BENAZEPRIL HCL 40 MG 30 $1.75 Thrifty White BENAZEPRIL HCL 5 MG 30 $1.75 Thrifty White ENALAPRIL MALEATE 10

MG 30 $4.00

Thrifty White ENALAPRIL MALEATE 2.5 MG

30 $4.00

Thrifty White ENALAPRIL MALEATE 20 MG

30 $4.00

Thrifty White ENALAPRIL MALEATE 5 MG

30 $4.00

Thrifty White ENALAPRIL/HYDROCHLOROTHIAZIDE 10MG-25MG

30 $4.00

Thrifty White ENALAPRIL/HYDROCHLOROTHIAZIDE 5MG-12.5MG

30 $4.00

Thrifty White LISINOPRIL 10 MG 30 $1.75 Thrifty White LISINOPRIL 2.5 MG 30 $1.75 Thrifty White LISINOPRIL 20 MG 30 $1.75 Thrifty White LISINOPRIL 30 MG 30 $1.75 Thrifty White LISINOPRIL 40 MG 30 $1.75 Thrifty White LISINOPRIL 5 MG 30 $1.75 Thrifty White LISINOPRIL/HYDROCHLOR

OTHIAZIDE 10-12.5MG 30 $1.75

Thrifty White LISINOPRIL/HYDROCHLOROTHIAZIDE 20-12.5 MG

30 $1.75

Thrifty White LISINOPRIL/HYDROCHLOROTHIAZIDE 20-25MG

30 $1.75

Thrifty White OMEPRAZOLE 20 MG 30 $6.00 Thrifty White QUINAPRIL HCL 10 MG 30 $4.00 Thrifty White QUINAPRIL HCL 20 MG 30 $4.00 Thrifty White QUINAPRIL HCL 40 MG 30 $4.00 Thrifty White QUINAPRIL HCL 5 MG 30 $4.00 Thrifty White SERTRALINE 50MG TAB 30 $6.00 Thrifty White SIMVASTATIN 10 MG 30 $1.75 Thrifty White SIMVASTATIN 20 MG 30 $1.75 Thrifty White SIMVASTATIN 40 MG 30 $1.75

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44

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White SIMVASTATIN 5 MG 30 $1.75 Thrifty White Albuterol Syp 2MG/5ML 120 $2.00 Thrifty White Alendronate Sodium

10MG 30 $4.00

Thrifty White Alendronate Sodium 5MG

30 $4.00

Thrifty White ALENDRONATE SODIUM 70 MG TAB

4 $2.00

Thrifty White ALLOPURINOL 100 MG TABLET

30 $2.00

Thrifty White ALLOPURINOL 300 MG TABLET

30 $2.00

Thrifty White AMLODIPINE BESYLATE 10 MG

30 $2.00

Thrifty White AMLODIPINE BESYLATE 2.5 MG

30 $2.00

Thrifty White AMLODIPINE BESYLATE 5 MG

30 $2.00

Thrifty White Amoxicillin Cap 500MG 30 $2.00 Thrifty White Amoxicillin Chw 250MG 30 $2.00 Thrifty White Amoxicillin SUS

125MG/5ML 100 $2.00

Thrifty White Amoxicillin SUS 200MG/5ML

100 $2.00

Thrifty White Amoxicillin SUS 250MG/5ML

100 $2.00

Thrifty White Amoxicillin SUS 400MG/5ML

100 $2.00

Thrifty White ATENOLOL 100 MG 30 $2.00 Thrifty White ATENOLOL 25 MG 30 $2.00 Thrifty White ATENOLOL 50 MG 30 $2.00 Thrifty White ATENOLOL/CHLORTHALID

ONE 100MG-25MG 30 $2.00

Thrifty White ATENOLOL/CHLORTHALIDONE 50 MG-25MG

30 $2.00

Thrifty White ATORVASTATIN 10MG 30 $4.00 Thrifty White ATORVASTATIN 20MG 30 $4.00 Thrifty White ATORVASTATIN 40MG 30 $4.00 Thrifty White ATORVASTATIN 80MG 30 $4.00 Thrifty White BISOPROLOL

FUMARATE/HCTZ 10-6.25MG

30 $2.00

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45

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White BISOPROLOL FUMARATE/HCTZ 2.5-6.25MG

30 $2.00

Thrifty White BISOPROLOL FUMARATE/HCTZ 5-6.25MG

30 $2.00

Thrifty White Bumetanide 0.5MG 30 $4.00 Thrifty White Bumetanide 1MG 30 $4.00 Thrifty White BUSPIRONE HCL 10 MG 60 $2.00 Thrifty White BUSPIRONE HCL 5 MG 60 $2.00 Thrifty White CARVEDILOL 12.5 MG 60 $2.00 Thrifty White CARVEDILOL 25 MG 60 $2.00 Thrifty White CARVEDILOL 3.125MG 60 $2.00 Thrifty White CARVEDILOL 6.25 MG 60 $2.00 Thrifty White Cephalexin Cap 250MG 28 $2.00 Thrifty White Cephalexin Cap 500MG 30 $2.00 Thrifty White CHLORTHALIDONE 25 MG 30 $4.00 Thrifty White Ciprofloxacin 250MG 14 $2.00 Thrifty White Ciprofloxacin 500MG 20 $2.00 Thrifty White CITALOPRAM

HYDROBROMIDE 10 MG 30 $4.00

Thrifty White CITALOPRAM HYDROBROMIDE 20 MG

30 $2.00

Thrifty White CITALOPRAM HYDROBROMIDE 40 MG

30 $2.00

Thrifty White CLINDAMYCIN 150MG CAP

30 $2.00

Thrifty White CLINDAMYCIN HCL 300 MG CAPSULE

30 $2.00

Thrifty White Clonidine HCL 0.1 MG 30 $2.00 Thrifty White CLONIDINE HCL 0.2 MG 30 $2.00 Thrifty White CLONIDINE HCL 0.3 MG 30 $2.00 Thrifty White Clopidogril 75 mg 30 $2.00 Thrifty White DILTIAZEM CD 120MG

CAP 30 $4.00

Thrifty White DILTIAZEM ER 120MG CAP

30 $4.00

Thrifty White DILTIAZEM ER 180MG CAP

30 $4.00

Thrifty White DILTIAZEM ER 180MG TAB

30 $4.00

Thrifty White DILTIAZEM ER 240MG CAP

30 $4.00

Page 46: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

46

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White DILTIAZEM ER 240MG TAB

30 $4.00

Thrifty White DILTIAZEM ER 300MG CAP

30 $4.00

Thrifty White DILTIAZEM HCL 120 MG 30 $2.00 Thrifty White DILTIAZEM HCL 30 MG 60 $2.00 Thrifty White DILTIAZEM HCL 60 MG 60 $2.00 Thrifty White DILTIAZEM HCL 90 MG 60 $2.00 Thrifty White DOXAZOSIN MESYLATE 1

MG 30 $2.00

Thrifty White DOXAZOSIN MESYLATE 2 MG

30 $2.00

Thrifty White DOXAZOSIN MESYLATE 4 MG

30 $2.00

Thrifty White DOXAZOSIN MESYLATE 8 MG

30 $2.00

Thrifty White Erythromycin Opt Oint 5MG

4 $2.00

Thrifty White ESCITALOPRAM 10MG TABLET

30 $2.00

Thrifty White ESCITALOPRAM 20MG TABLET

30 $2.00

Thrifty White ESCITALOPRAM 5MG TABLET

30 $2.00

Thrifty White FAMOTIDINE 20 MG 60 $2.00 Thrifty White FAMOTIDINE 40 MG 30 $2.00 Thrifty White Fluconazole 150MG 1 $2.00 Thrifty White FLUOXETINE HCL 10 MG 30 $2.00 Thrifty White FLUOXETINE HCL 20 MG 30 $2.00 Thrifty White FLUPHENAZINE HCL 1 MG 30 $2.00 Thrifty White FLUPHENAZINE HCL 5 MG 30 $2.00 Thrifty White FUROSEMIDE 20 MG 30 $2.00 Thrifty White FUROSEMIDE 40 MG 30 $2.00 Thrifty White FUROSEMIDE 80 MG 30 $2.00 Thrifty White GEMFIBROZIL 600 MG 60 $4.00 Thrifty White Gentamicin Opt Sol 0.3% 5 $2.00 Thrifty White GLIMEPIRIDE 1 MG 30 $2.00 Thrifty White GLIMEPIRIDE 2 MG 30 $2.00 Thrifty White GLIMEPIRIDE 4 MG 30 $2.00 Thrifty White GLIPIZIDE 10 MG 60 $2.00 Thrifty White GLIPIZIDE 5 MG 30 $2.00 Thrifty White HALOPERIDOL 0.5 MG 30 $2.00 Thrifty White HALOPERIDOL 1 MG 30 $2.00

Page 47: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

47

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White HALOPERIDOL 2 MG 30 $2.00 Thrifty White HALOPERIDOL 5 MG 30 $2.00 Thrifty White HYDRALAZINE HCL 25 MG 30 $2.00 Thrifty White HYDROCHLOROTHIAZIDE

12.5 MG 30 $2.00

Thrifty White HYDROCHLOROTHIAZIDE 25 MG

30 $2.00

Thrifty White HYDROCHLOROTHIAZIDE 50 MG

30 $2.00

Thrifty White INDAPAMIDE 1.25 MG 30 $2.00 Thrifty White INDAPAMIDE 2.5 MG 30 $2.00 Thrifty White ISOSORBIDE

MONONITRATE 20 MG 30 $4.00

Thrifty White ISOSORBIDE MONONITRATE 30 MG

30 $2.00

Thrifty White ISOSORBIDE MONONITRATE 60 MG

30 $2.00

Thrifty White Isosorbide Sub 2.5MG 60 $4.00 Thrifty White Lidocaine Viscous Sol 2% 100 $4.00 Thrifty White LITHIUM CARBONATE 300

MG 90 $2.00

Thrifty White LOVASTATIN 10 MG 30 $2.00 Thrifty White LOVASTATIN 20 MG 30 $2.00 Thrifty White LOVASTATIN 40 MG 30 $2.00 Thrifty White METFORMIN HCL 1000

MG 60 $2.00

Thrifty White METFORMIN HCL 500 MG 60 $2.00 Thrifty White METFORMIN HCL 850 MG 60 $2.00 Thrifty White METOPROLOL TARTRATE

100 MG 60 $2.00

Thrifty White METOPROLOL TARTRATE 25 MG

60 $2.00

Thrifty White METOPROLOL TARTRATE 50 MG

60 $2.00

Thrifty White MIRTAZAPINE 15 MG 30 $2.00 Thrifty White Neo/Polymx/Dexamethas

one Oint 0.1% 4 $2.00

Thrifty White Neo/Polymx/Dexamethasone Sus 0.1%

5 $2.00

Thrifty White NORTRIPTYLINE HCL 10 MG

30 $2.00

Thrifty White NORTRIPTYLINE HCL 25 MG

30 $2.00

Page 48: 2015 Pharmacy SaverTM drug list - … · 1 2015 Pharmacy SaverTM drug list . Click on a participating retailer below to begin reviewing the 2015 list of drugs and pricing in the Pharmacy

48

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White NORTRIPTYLINE HCL 50 MG

30 $2.00

Thrifty White NORTRIPTYLINE HCL 75 MG

30 $2.00

Thrifty White PAROXETINE HCL 10 MG 30 $2.00 Thrifty White PAROXETINE HCL 20 MG 30 $2.00 Thrifty White PAROXETINE HCL 30 MG 30 $2.00 Thrifty White PAROXETINE HCL 40 MG 30 $2.00 Thrifty White Penicillin VK 250MG 28 $4.00 Thrifty White Penicillin VK 125MG/5ML 100 $4.00 Thrifty White Penicillin VK 250MG/5ML 100 $4.00 Thrifty White PIOGLITAZONE 15MG

TABLET 30 $4.00

Thrifty White PIOGLITAZONE 30MG TABLET

30 $4.00

Thrifty White PIOGLITAZONE 45MG TABLET

30 $4.00

Thrifty White PRAZOSIN HCL 1 MG 30 $4.00 Thrifty White PRAZOSIN HCL 5 MG 30 $4.00 Thrifty White PROPRANOLOL HCL 10

MG 60 $2.00

Thrifty White PROPRANOLOL HCL 20 MG

60 $2.00

Thrifty White PROPRANOLOL HCL 40 MG

60 $2.00

Thrifty White PROPRANOLOL HCL 80 MG

60 $2.00

Thrifty White QUETIAPINE 100MG TABLET

30 $2.00

Thrifty White QUETIAPINE 200MG TABLET

30 $2.00

Thrifty White QUETIAPINE 25MG TABLET

30 $2.00

Thrifty White QUETIAPINE 300MG TABLET

30 $2.00

Thrifty White QUETIAPINE 400MG TABLET

30 $2.00

Thrifty White QUETIAPINE 50MG TABLET

30 $2.00

Thrifty White RAMIPRIL 10 MG 30 $2.00 Thrifty White RAMIPRIL 2.5 MG 30 $2.00 Thrifty White RAMIPRIL 5 MG 30 $2.00 Thrifty White RANITIDINE HCL 150 MG 60 $2.00 Thrifty White RANITIDINE HCL 300 MG 30 $2.00

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49

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Thrifty White RISPERIDONE 0.25 MG TABLET

30 $2.00

Thrifty White RISPERIDONE 0.5 MG TABLET

30 $2.00

Thrifty White RISPERIDONE 1 MG TABLET

30 $2.00

Thrifty White RISPERIDONE 2 MG TABLET

30 $2.00

Thrifty White RISPERIDONE 3 MG TABLET

30 $2.00

Thrifty White RISPERIDONE 4 MG TABLET

30 $2.00

Thrifty White SERTRALINE HCL 100 MG 30 $2.00 Thrifty White SERTRALINE HCL 25 MG 30 $2.00 Thrifty White SIMVASTATIN 80 MG 30 $2.00 Thrifty White Sufameth/Trimeth DS

400-80MG 28 $2.00

Thrifty White Sufameth/Trimeth DS 800-160MG

20 $2.00

Thrifty White Sufameth/Trimeth Ped SUS 473ML

120 $4.00

Thrifty White THIOTHIXENE 2 MG 30 $2.00 Thrifty White Tobramycin Opt Sol 0.3% 5 $2.00 Thrifty White TRAZODONE HCL 100 MG 30 $2.00 Thrifty White TRAZODONE HCL 150 MG 30 $2.00 Thrifty White TRAZODONE HCL 50 MG 30 $2.00 Walgreens, Duane Reade DICLOFENAC SODIUM ER

100MG 30 $5.00

Walgreens, Duane Reade NORTRIPTYLINE HCL 50MG

30 $5.00

Walgreens, Duane Reade NORTRIPTYLINE HCL CAP 10MG

30 $5.00

Walgreens, Duane Reade NORTRIPTYLINE HCL CAP 25MG

30 $5.00

Walgreens, Duane Reade Bethanechol Tab 10MG 60 $5.00 Walgreens, Duane Reade Acetamide Sodium 10% 15 $5.00 Walgreens, Duane Reade Acyclovir Cap 200 MG 30 $5.00 Walgreens, Duane Reade Albuterol Syp 2MG/5ML 120 $5.00 Walgreens, Duane Reade Alendronate Sodium Tab

10MG 30 $5.00

Walgreens, Duane Reade Alendronate Sodium Tab 5MG

30 $5.00

Walgreens, Duane Reade ALLOPURINOL 100MG TABLETS

30 $5.00

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50

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walgreens, Duane Reade ALLOPURINOL 300MG TABLETS

30 $5.00

Walgreens, Duane Reade Amoxicillin Cap 250MG 30 $5.00 Walgreens, Duane Reade Amoxicillin SUS

400MG/5ML 100 $5.00

Walgreens, Duane Reade BENAZEPRIL 10MG TABLETS

30 $2.00

Walgreens, Duane Reade BENAZEPRIL 20MG TABLETS

30 $2.00

Walgreens, Duane Reade BENAZEPRIL 40MG TABLETS

30 $2.00

Walgreens, Duane Reade BENAZEPRIL 5MG TABLETS

30 $2.00

Walgreens, Duane Reade BISOPROLOL/HCTZ 10MG/6.25MG TABS

30 $5.00

Walgreens, Duane Reade BISOPROLOL/HCTZ 2.5MG/6.25MG TABS

30 $5.00

Walgreens, Duane Reade BISOPROLOL/HCTZ 5MG/6.25MG TABS

30 $5.00

Walgreens, Duane Reade Buspirone Tab 10MG 60 $5.00 Walgreens, Duane Reade Buspirone Tab 5MG 60 $5.00 Walgreens, Duane Reade Cephalexin Cap 250MG 28 $5.00 Walgreens, Duane Reade CIMETIDINE 200MG

TABLETS 60 $5.00

Walgreens, Duane Reade CIMETIDINE 300MG TABLETS

60 $5.00

Walgreens, Duane Reade Dexamethasone Tab 0.5MG

30 $5.00

Walgreens, Duane Reade Dexamethasone Tab 0.75MG

12 $5.00

Walgreens, Duane Reade Dexamethasone Tab 1.5MG

45 $5.00

Walgreens, Duane Reade Diltiazem Tab 120MG 30 $5.00 Walgreens, Duane Reade Diltiazem Tab 30MG 60 $5.00 Walgreens, Duane Reade Diltiazem Tab 60MG 60 $5.00 Walgreens, Duane Reade Diltiazem Tab 90MG 60 $5.00 Walgreens, Duane Reade Divalproex Sodium Dr Tab

125MG 60 $5.00

Walgreens, Duane Reade Enalapril Tab 10MG 30 $2.00 Walgreens, Duane Reade Enalapril Tab 2.5MG 30 $2.00 Walgreens, Duane Reade Enalapril Tab 20MG 30 $2.00 Walgreens, Duane Reade Enalapril Tab 5MG 30 $2.00 Walgreens, Duane Reade Fluoxetine Cap 10MG 30 $5.00 Walgreens, Duane Reade Fluoxetine Tab 10MG 30 $5.00

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51

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walgreens, Duane Reade FLUPHENAZINE 1MG TABLETS

30 $2.00

Walgreens, Duane Reade FOSINOPRIL 20MG TABLETS

60 $5.00

Walgreens, Duane Reade Fosinopril Sodium Tab 10MG

30 $5.00

Walgreens, Duane Reade Fosinopril Sodium Tab 40MG

30 $5.00

Walgreens, Duane Reade FUROSEMIDE 20MG TABLETS

30 $2.00

Walgreens, Duane Reade FUROSEMIDE 40MG TABLETS

30 $2.00

Walgreens, Duane Reade Furosemide Tab 80MG 30 $2.00 Walgreens, Duane Reade Gentamicin Eye Drops

3MG/ML 5 $5.00

Walgreens, Duane Reade GLIMEPIRIDE 1MG TABLETS

30 $2.00

Walgreens, Duane Reade GLIMEPIRIDE 2MG TABLETS

30 $2.00

Walgreens, Duane Reade GLIPIZIDE 10MG TABLETS 60 $2.00 Walgreens, Duane Reade GLIPIZIDE 5MG TABLETS 30 $2.00 Walgreens, Duane Reade GLIPIZIDE XL 2.5MG

TABLETS 30 $5.00

Walgreens, Duane Reade Hydralazine Tab 10MG 30 $5.00 Walgreens, Duane Reade HYDROCHLOROTHIAZIDE

25MG TABLETS 30 $2.00

Walgreens, Duane Reade HYDROCHLOROTHIAZIDE 50MGTABLETS

30 $2.00

Walgreens, Duane Reade Hydrocortisone 1% Cream 28.35 GM

28.35 $2.00

Walgreens, Duane Reade HYDROCORTISONE 1% OINTMENT 28.35GM

28.35 $2.00

Walgreens, Duane Reade HYDROCORTISONE 2.5% OINT 28.35GM

28.35 $5.00

Walgreens, Duane Reade Hydrocortisone Crm 2.5% 30 $5.00 Walgreens, Duane Reade IBUPROFEN 600MG

TABLETS 60 $5.00

Walgreens, Duane Reade Ibuprofen Tab 400MG 90 $5.00 Walgreens, Duane Reade Indapamide Tab 1.25MG 30 $5.00 Walgreens, Duane Reade Indapamide Tab 2.5MG 30 $5.00 Walgreens, Duane Reade Isoniazid Tab 100MG 30 $2.00 Walgreens, Duane Reade Isoniazid Tab 300MG 30 $2.00 Walgreens, Duane Reade Isosorbide Sub Tab

2.5MG 60 $5.00

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52

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walgreens, Duane Reade Lidocaine Viscous Sol 2% 100 $5.00 Walgreens, Duane Reade LITHIUM CARBONATE

150MG CAPSULES 60 $5.00

Walgreens, Duane Reade LITHIUM CARBONATE 300MG CAPSULES

90 $5.00

Walgreens, Duane Reade LITHIUM CARBONATE 300MG TABLETS

60 $5.00

Walgreens, Duane Reade LITHIUM CARBONATE 600MG CAPSULES

60 $5.00

Walgreens, Duane Reade LOSARTAN/HCTZ 100/12.5MG TABLETS

30 $2.00

Walgreens, Duane Reade LOSARTAN/HCTZ 50/12.5MG TABLETS

30 $2.00

Walgreens, Duane Reade Medroxyprogesterone Tab 10MG

30 $5.00

Walgreens, Duane Reade Medroxyprogesterone Tab 2.5MG

30 $5.00

Walgreens, Duane Reade Medroxyprogesterone Tab 5MG

30 $5.00

Walgreens, Duane Reade METFORMIN ER 750MG 24HR TABS

30 $5.00

Walgreens, Duane Reade Metoclopramide Syp 5MG/5ML

60 $5.00

Walgreens, Duane Reade Naproxen Sodium Tab 275MG

30 $5.00

Walgreens, Duane Reade Naproxen Tab 250MG 60 $5.00 Walgreens, Duane Reade Penicillin VK 125MG/5ML 200 $5.00 Walgreens, Duane Reade PRAZOSIN 1MG

CAPSULES 30 $5.00

Walgreens, Duane Reade PRAZOSIN 2MG CAPSULES

30 $5.00

Walgreens, Duane Reade PRAZOSIN HCL 5MG CAPSULES

30 $5.00

Walgreens, Duane Reade Prednisone Tab 2.5MG 30 $5.00 Walgreens, Duane Reade Propanolol Tab 10MG 60 $2.00 Walgreens, Duane Reade Propanolol Tab 20MG 60 $2.00 Walgreens, Duane Reade Propanolol Tab 40MG 60 $2.00 Walgreens, Duane Reade Propanolol Tab 80MG 60 $2.00 Walgreens, Duane Reade QUINAPRIL 10MG

TABLETS 30 $5.00

Walgreens, Duane Reade QUINAPRIL 20MG TABLETS

30 $5.00

Walgreens, Duane Reade QUINAPRIL 40MG TABLETS

30 $5.00

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53

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walgreens, Duane Reade QUINAPRIL 5MG TABLETS 30 $5.00 Walgreens, Duane Reade RAMIPRIL 1.25MG

CAPSULES 30 $5.00

Walgreens, Duane Reade RAMIPRIL 10MG CAPSULES

30 $5.00

Walgreens, Duane Reade RAMIPRIL 2.5MG CAPSULES

30 $5.00

Walgreens, Duane Reade RAMIPRIL 5MG CAPSULES 30 $5.00 Walgreens, Duane Reade SPIRONOLACTONE 25MG

TABLETS 30 $5.00

Walgreens, Duane Reade Sufameth/Trimeth DS Tab 400-80MG

28 $2.00

Walgreens, Duane Reade Sufameth/Trimeth Ped SUS 473ML

120 $5.00

Walgreens, Duane Reade THIOTHIXENE 2MG CAPSULES

30 $5.00

Walgreens, Duane Reade Timolol Opt Sol 0.25% 5 $2.00 Walgreens, Duane Reade Triamcinolone Crm

0.025% 15 $5.00

Walgreens, Duane Reade Verapamil Tab 120MG 30 $5.00 Walgreens, Duane Reade Verapamil Tab 80MG 30 $5.00 Walmart, Sams NADOLOL TAB 20MG 30 $15.00 Walmart, Sams ALLOPURINOL TAB

100MG 30 $1.98

Walmart, Sams ALLOPURINOL TAB 300MG

30 $3.98

Walmart, Sams ATENOL/CHLOR TAB 100-25MG

30 $2.98

Walmart, Sams ATENOL/CHLOR TAB 50-25MG

30 $2.98

Walmart, Sams ATENOLOL TAB 100MG 30 $2.98 Walmart, Sams ATENOLOL TAB 25MG 30 $2.98 Walmart, Sams ATENOLOL TAB 50MG 30 $2.98 Walmart, Sams BACLOFEN TAB 10MG 30 $1.98 Walmart, Sams BACLOFEN TAB 20MG 30 $4.98 Walmart, Sams BENAZEPRIL TAB 10MG 30 $2.98 Walmart, Sams BENAZEPRIL TAB 40MG 30 $2.98 Walmart, Sams BENAZEPRIL TAB 5MG 30 $2.98 Walmart, Sams BISOPRL/HCTZ TAB

10/6.25 30 $3.98

Walmart, Sams BISOPRL/HCTZ TAB 2.5/6.25

30 $3.98

Walmart, Sams BISOPRL/HCTZ TAB 5-6.25MG

30 $3.98

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54

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walmart, Sams CARB/LEVO TAB 25-100MG

30 $4.98

Walmart, Sams CARVEDILOL TAB 12.5MG

60 $2.98

Walmart, Sams CARVEDILOL TAB 25MG 60 $2.98 Walmart, Sams CARVEDILOL TAB

3.125MG 60 $2.98

Walmart, Sams CARVEDILOL TAB 6.25MG

60 $2.98

Walmart, Sams CITALOPRAM SOL 10MG/5ML

150 $13.27

Walmart, Sams CITALOPRAM TAB 20MG 30 $2.98 Walmart, Sams CITALOPRAM TAB 40MG 30 $2.98 Walmart, Sams DESIPRAMINE TAB 10MG 30 $39.71 Walmart, Sams DESIPRAMINE TAB 25MG 30 $42.31 Walmart, Sams ENALAPR/HCTZ TAB 5-

12.5MG 30 $3.98

Walmart, Sams ENALAPRIL TAB 10MG 30 $3.98 Walmart, Sams ENALAPRIL TAB 2.5MG 30 $1.98 Walmart, Sams ENALAPRIL TAB 20MG 30 $3.98 Walmart, Sams ENALAPRIL TAB 5MG 30 $3.98 Walmart, Sams FLUOXETINE CAP 10MG 30 $1.98 Walmart, Sams FLUOXETINE CAP 20MG 30 $1.98 Walmart, Sams FLUOXETINE CAP 40MG 30 $3.98 Walmart, Sams FLUOXETINE TAB 10MG 30 $3.98 Walmart, Sams FUROSEMIDE SOL

10MG/ML 21 $4.98

Walmart, Sams FUROSEMIDE TAB 20MG 30 $3.98 Walmart, Sams FUROSEMIDE TAB 40MG 30 $3.98 Walmart, Sams FUROSEMIDE TAB 80MG 30 $1.98 Walmart, Sams GABAPENTIN CAP

100MG 30 $4.98

Walmart, Sams GABAPENTIN CAP 300MG

30 $4.98

Walmart, Sams GABAPENTIN CAP 400MG

30 $6.66

Walmart, Sams GABAPENTIN SOL 250/5ML

30 $4.98

Walmart, Sams GLIMEPIRIDE TAB 1MG 30 $1.98 Walmart, Sams GLIMEPIRIDE TAB 2MG 30 $3.98 Walmart, Sams GLIMEPIRIDE TAB 4MG 30 $3.98 Walmart, Sams GLIPIZIDE TAB 5MG 30 $2.98

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55

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walmart, Sams HYDROCHLOROT CAP 12.5MG

30 $3.98

Walmart, Sams HYDROCHLOROT TAB 25MG

30 $1.98

Walmart, Sams HYDROCHLOROT TAB 50MG

30 $3.98

Walmart, Sams INDAPAMIDE TAB 1.25MG

30 $3.98

Walmart, Sams INDAPAMIDE TAB 2.5MG

30 $3.98

Walmart, Sams ISOSORB MONO TAB 30MG ER

30 $4.69

Walmart, Sams ISOSORB MONO TAB 60MG ER

30 $4.83

Walmart, Sams KLOR-CON 10 TAB 10MEQ ER

30 $14.04

Walmart, Sams KLOR-CON 8 TAB 8MEQ ER

30 $14.71

Walmart, Sams LAMOTRIGINE TAB 25MG 30 $4.66 Walmart, Sams LEVOBUNOLOL SOL 0.5%

OP 5 $3.98

Walmart, Sams LISINOP/HCTZ TAB 10-12.5

30 $2.98

Walmart, Sams LISINOPRIL TAB 10MG 30 $2.98 Walmart, Sams LISINOPRIL TAB 2.5MG 30 $2.98 Walmart, Sams LISINOPRIL TAB 20MG 30 $2.98 Walmart, Sams LISINOPRIL TAB 5MG 30 $2.98 Walmart, Sams LOVASTATIN TAB 10MG 30 $3.98 Walmart, Sams LOVASTATIN TAB 20MG 30 $3.98 Walmart, Sams METFORMIN TAB

1000MG 60 $2.98

Walmart, Sams METFORMIN TAB 500MG

60 $2.98

Walmart, Sams METFORMIN TAB 500MG ER

60 $4.98

Walmart, Sams METFORMIN TAB 850MG

60 $2.98

Walmart, Sams METOPRL/HCTZ TAB 50-25MG

30 $43.94

Walmart, Sams METOPROL TAR TAB 100MG

30 $2.98

Walmart, Sams METOPROL TAR TAB 25MG

60 $2.98

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56

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walmart, Sams METOPROL TAR TAB 50MG

60 $2.98

Walmart, Sams METOPROLOL TAB 100MG ER

30 $40.62

Walmart, Sams METOPROLOL TAB 25MG ER

30 $30.84

Walmart, Sams METOPROLOL TAB 50MG ER

30 $26.27

Walmart, Sams NADOLOL TAB 40MG 30 $30.00 Walmart, Sams NADOLOL TAB 80MG 30 $30.33 Walmart, Sams NORTRIPTYLIN CAP 10MG 30 $3.98 Walmart, Sams NORTRIPTYLIN CAP 25MG 30 $3.98 Walmart, Sams NORTRIPTYLIN CAP 50MG 30 $4.98 Walmart, Sams OXCARBAZEPIN TAB

150MG 30 $22.82

Walmart, Sams OXCARBAZEPIN TAB 300MG

30 $29.09

Walmart, Sams OXCARBAZEPIN TAB 600MG

30 $29.02

Walmart, Sams PANTOPRAZOLE TAB 20MG

30 $4.98

Walmart, Sams PAROXETINE TAB 10MG 30 $3.98 Walmart, Sams PAROXETINE TAB 20MG 30 $3.98 Walmart, Sams POT CITRATE TAB

1080MG 30 $23.86

Walmart, Sams POT CITRATE TAB 540MG 30 $29.76 Walmart, Sams PRAVASTATIN TAB 40MG 30 $2.98 Walmart, Sams TIMOLOL MAL SOL 0.25%

OP 5 $3.98

Walmart, Sams TIMOLOL MAL SOL 0.5% OP

5 $3.43

Walmart, Sams TIZANIDINE TAB 2MG 30 $4.98 Walmart, Sams TIZANIDINE TAB 4MG 30 $4.98 Walmart, Sams TOPIRAMATE TAB 25MG 30 $5.55 Walmart, Sams TRIAMT/HCTZ TAB 37.5-

25 30 $4.93

Walmart, Sams TRIAMT/HCTZ TAB 75-50MG

30 $4.78

Walmart, Sams VENLAFAXINE TAB 25MG 30 $35.22 Walmart, Sams VENLAFAXINE TAB

37.5MG 30 $40.53

Walmart, Sams VENLAFAXINE TAB 50MG 30 $43.35 Walmart, Sams VENLAFAXINE TAB 75MG 30 $29.03

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57

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Walmart, Sams VERAPAMIL TAB 180MG ER

30 $4.98

Walmart, Sams VERAPAMIL TAB 240MG ER

30 $4.98

Walmart, Sams WARFARIN TAB 10MG 30 $3.98 Walmart, Sams WARFARIN TAB 1MG 30 $3.98 Walmart, Sams WARFARIN TAB 2.5MG 30 $3.98 Walmart, Sams WARFARIN TAB 2MG 30 $3.98 Walmart, Sams WARFARIN TAB 3MG 30 $3.98 Walmart, Sams WARFARIN TAB 4MG 30 $3.98 Walmart, Sams WARFARIN TAB 5MG 30 $1.98 Walmart, Sams WARFARIN TAB 6MG 30 $3.98 Walmart, Sams WARFARIN TAB 7.5MG 30 $3.98 Wegmans Allopurinol Tab 100MG 30 $3.00 Wegmans Allopurinol Tab 300MG 30 $3.00 Wegmans Amoxicillin Cap 500MG 56 $3.00 Wegmans Atenolol Tab 100MG 30 $3.00 Wegmans Atenolol Tab 25MG 30 $3.00 Wegmans Atenolol Tab 50MG 30 $3.00 Wegmans Baclofen Tab 10 MG 30 $3.00 Wegmans Benazepril Tab 10MG 30 $3.00 Wegmans Benazepril Tab 20MG 30 $3.00 Wegmans Benazepril Tab 40MG 30 $3.00 Wegmans Benazepril Tab 5MG 30 $3.00 Wegmans Bumetanide Tab 0.5MG 30 $3.00 Wegmans Carbamazepine Tab

200MG 60 $3.00

Wegmans Carvedilol Tab 12.5MG 60 $3.00 Wegmans Carvedilol Tab 25MG 60 $3.00 Wegmans Carvedilol Tab 3.125MG 60 $3.00 Wegmans Carvedilol Tab 6.25MG 60 $3.00 Wegmans Citalopram Tab 20MG 30 $3.00 Wegmans Citalopram Tab 40MG 30 $3.00 Wegmans Clonidine Tab 0.1MG 60 $3.00 Wegmans Clonidine Tab 0.2MG 60 $3.00 Wegmans Dexamethasone Tab

0.5MG 30 $3.00

Wegmans Dexamethasone Tab 0.75MG

30 $3.00

Wegmans Diltiazem Tab 120MG 90 $3.00 Wegmans Diltiazem Tab 30MG 90 $3.00 Wegmans Diltiazem Tab 60MG 90 $3.00 Wegmans Diltiazem TAB 90MG 90 $3.00

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58

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Wegmans Enalapril Tab 10MG 30 $3.00 Wegmans Enalapril Tab 2.5MG 30 $3.00 Wegmans Enalapril Tab 20MG 30 $3.00 Wegmans Enalapril Tab 5MG 30 $3.00 Wegmans Enalapril/HCTZ Tab 5-

12.5MG 30 $3.00

Wegmans Famotidine Tab 20MG 60 $3.00 Wegmans Fluoxetine Cap 10MG 30 $3.00 Wegmans Fluoxetine Cap 20MG 30 $3.00 Wegmans Furosemide Tab 20MG 30 $3.00 Wegmans Furosemide Tab 40MG 30 $3.00 Wegmans Furosemide Tab 80MG 30 $3.00 Wegmans Glimepiride Tab 1MG 30 $3.00 Wegmans Glimepiride Tab 2MG 30 $3.00 Wegmans Glimepiride Tab 4MG 30 $3.00 Wegmans Glipizide Tab 10MG 60 $3.00 Wegmans Glipizide Tab 5MG 60 $3.00 Wegmans Hydrochlorothiazide Cap

12.5MG 30 $3.00

Wegmans Hydrochlorothiazide Tab 25MG

30 $3.00

Wegmans Hydrochlorothiazide Tab 50MG

30 $3.00

Wegmans Ibuprofen Tab 400MG 90 $3.00 Wegmans Ibuprofen Tab 800MG 90 $3.00 Wegmans IbuprofenTab 600MG 90 $3.00 Wegmans Indapamide Tab 1.25MG 30 $3.00 Wegmans Lidocaine Viscous Sol 2% 100 $3.00 Wegmans Lisinopril &

Hydrochlorothiazide Tab 10-12.5MG

30 $3.00

Wegmans Lisinopril & Hydrochlorothiazide Tab 20-12.5MG

30 $3.00

Wegmans Lisinopril & Hydrochlorothiazide Tab 20-25MG

30 $3.00

Wegmans Lisinopril Tab 10MG 30 $3.00 Wegmans Lisinopril Tab 2.5MG 30 $3.00 Wegmans Lisinopril Tab 20MG 30 $3.00 Wegmans Lisinopril Tab 5MG 30 $3.00 Wegmans Lovastatin Tab 10MG 30 $3.00 Wegmans Lovastatin Tab 20MG 30 $3.00

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59

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Wegmans Medroxypregestrone Tab 2.5MG

30 $3.00

Wegmans Medroxypregestrone Tab 5MG

30 $3.00

Wegmans Medroxyprogesterone Tab 10MG

10 $3.00

Wegmans Meloxicam Tab 15MG 30 $3.00 Wegmans Meloxicam Tab 7.5MG 30 $3.00 Wegmans Metformin HC Tab

1000MG 60 $3.00

Wegmans Metformin HC Tab 850MG

60 $3.00

Wegmans Metformin Tab 500MG 60 $3.00 Wegmans Metoprolol Tartrate Tab

100MG 60 $3.00

Wegmans Metoprolol Tartrate Tab 25MG

60 $3.00

Wegmans Metoprolol Tartrate Tab 50MG

60 $3.00

Wegmans Naproxen Tab 375MG 60 $3.00 Wegmans Prednisone 5MG/ML 30 $3.00 Wegmans Prednisone Tab 2.5MG 30 $3.00 Wegmans Propanolol Tab 10MG 60 $3.00 Wegmans Propanolol Tab 20MG 60 $3.00 Wegmans Propanolol Tab 40MG 60 $3.00 Wegmans Ranitidine Tab 150MG 60 $3.00 Wegmans Ranitidine Tab 300MG 30 $3.00 Wegmans Spironolactone Tab 25MG 30 $3.00 Wegmans Terazosin Cap 10MG 30 $3.00 Wegmans Terazosin Cap 1MG 30 $3.00 Wegmans Terazosin Cap 2MG 30 $3.00 Wegmans Terazosin Cap 5MG 30 $3.00 Wegmans Trazadone Tab 100MG 30 $3.00 Wegmans Trazadone Tab 50MG 30 $3.00 Wegmans Triamcinolone Crm

0.025% 15 $3.00

Wegmans Triamterene & Hydrochlorothiazide Cap 37.5-25MG

30 $3.00

Wegmans Triamterene & Hydrochlorothiazide Tab 75-50MG

30 $3.00

Wegmans Warfarin Sodium Tab 10MG

30 $3.00

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60

Retailer Prescription Name Quantity Pharmacy Saver™ Price

Wegmans Warfarin Sodium Tab 1MG

30 $3.00

Wegmans Warfarin Sodium Tab 2.5MG

30 $3.00

Wegmans Warfarin Sodium Tab 2MG

30 $3.00

Wegmans Warfarin Sodium Tab 3MG

30 $3.00

Wegmans Warfarin Sodium Tab 4MG

30 $3.00

Wegmans Warfarin Sodium Tab 5MG

30 $3.00

Wegmans Warfarin Sodium Tab 6MG

30 $3.00

Wegmans Warfarin Sodium Tab 7.5MG

30 $3.00

Drugs and prices may vary between pharmacies and are subject to change during the plan year. Prices are based on quantity filled at the pharmacy. Quantities may be limited by pharmacy based on their dispensing policy or by the plan based on Quantity Limit requirements; if prescription is in excess of a limit, co-pay amounts may be higher. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, co-payments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Other pharmacies are available in our network. Members may use any pharmacy in the network, but may not receive Pharmacy Saver pricing. Pharmacies participating in the Pharmacy Saver program may not be available in all areas. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Y0066_141020_004635 Accepted SPRJ20961