FEATURED GENERIC DRUG LIST

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Alexandrina Greene
7 years ago
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1 FREE 30 DAY SUPPLY ON SELECT PRENATALS AND FLUORIDE SUPPLEMENTS Annual enrollment fee of $10 per family applies. SM *** -- A -- ACYCLOVIR 400 MG TABLET ALBUTEROL SULFATE 2 MG/5 ML SYRUP ALBUTEROL SULFATE 2.5 MG/3ML VIAL-NEB AMANTADINE 50 MG/5 ML SOLN AMIODARONE HCL 200 MG TABLET AMLODIPINE BESYLATE 2.5 MG TAB AMLODIPINE BESYLATE 5 MG TAB AMLODIPINE BESYLATE 10 MG TAB AMOXICILLIN 250 MG CAPSULE AMOXICILLIN 500 MG CAPSULE AMOXICILLIN 125 MG/5 ML SUSP AMOXICILLIN 200 MG/5 ML SUSP AMOXICILLIN 250 MG/5 ML SUSP AMOXICILLIN 400 MG/5 ML SUSP ANTIPYRINE/BENZOCAINE 5.4 %-1.4% DROPS ATENOLOL 25 MG TABLET ATENOLOL 50 MG TABLET ATENOLOL 100 MG TABLET ATORVASTATIN CALCIUM 10 MG TAB ATORVASTATIN CALCIUM 20 MG TAB ATORVASTATIN CALCIUM 40 MG TAB ATORVASTATIN CALCIUM 80 MG TAB B -- BACLOFEN 10 MG TABLET BENAZEPRIL HCL 5 MG TABLET BENAZEPRIL HCL 10 MG TABLET BENAZEPRIL HCL 20 MG TABLET MAY 2016

5 MG/3ML VIAL-NEB 75 225 AMANTADINE 50 MG/5 ML SOLN 100 300 AMIODARONE HCL 200 MG TABLET 30 90 AMLODIPINE BESYLATE 2.

2 BENAZEPRIL HCL 40 MG TABLET BENZONATATE 100 MG CAPSULE BISOPROLOL FUMARATE/HCTZ MG TAB BISOPROLOL FUMARATE/HCTZ MG TAB BISOPROLOL FUMARATE/HCTZ MG TAB BUPROPION HCL 100 MG TAB BUSPIRONE HCL 5 MG TABLET BUSPIRONE HCL 10 MG TABLET C -- CARVEDILOL MG TABLET CARVEDILOL 6.25 MG TABLET CARVEDILOL 12.5 MG TABLET CARVEDILOL 25 MG TABLET CEPHALEXIN 250 MG CAPSULE CEPHALEXIN 500 MG CAPSULE CETIRIZINE HCL 10 MG TAB CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH CIPROFLOXACIN 0.3% EYE DROP 5 15 CIPROFLOXACIN HCL 250 MG TAB CIPROFLOXACIN HCL 500 MG TAB CITALOPRAM HBR 10 MG TABLET CITALOPRAM HBR 20 MG TABLET CITALOPRAM HBR 40 MG TABLET CITRIC ACID/SODIUM CITRATE MG SOLN CLOMIPHENE CITRATE 50 MG TAB 5 15 CLONIDINE HCL 0.1 MG TABLET CLONIDINE HCL 0.2 MG TABLET CLOPIDOGREL BISULFATE 75 MG TAB CYCLOBENZAPRINE HCL 5 MG TABLET CYCLOBENZAPRINE HCL 10 MG TABLET D -- DEXAMETHASONE 0.5 MG TABLET DEXAMETHASONE 0.75 MG TAB DEXAMETHASONE 4 MG TAB DICYCLOMINE 10 MG CAPSULE DICYCLOMINE 20 MG TABLET DILTIAZEM HCL 30 MG TABLET DIPHENHYDRAMINE HCL 50 MG CAPS DONEPEZIL HCL 5 MG TABLET DONEPEZIL HCL 10 MG TABLET E -- ESTRADIOL 0.5 MG TABLET ESTRADIOL 1 MG TABLET ESTRADIOL 2 MG TABLET F -- FAMOTIDINE 20 MG TABLET FAMOTIDINE 40 MG TABLET FERROUS GLUCONATE 324(37.5) TAB FERROUS GLUCONATE 324 (38) MG TAB FERROUS SULFATE 325 (65) MG TAB FLUCONAZOLE 150 MG TABLET 1 3 FLUOXETINE HCL 10 MG CAP FLUOXETINE HCL 20 MG CAPSULE FLUOXETINE HCL 40 MG CAPSULE FLUPHENAZINE 1 MG TABLET FOLIC ACID 1 MG TABLET FOSINOPRIL SODIUM 10 MG TAB FOSINOPRIL SODIUM 20 MG TAB FUROSEMIDE 20 MG TABLET FUROSEMIDE 40 MG TABLET

3 FUROSEMIDE 80 MG TABLET G -- GABAPENTIN 100 MG CAPSULE GABAPENTIN 300 MG CAPSULE GLIMEPIRIDE 1 MG TABLET GLIMEPIRIDE 2 MG TABLET GLIMEPIRIDE 4 MG TABLET GLIPIZIDE 2.5 MG TAB GLIPIZIDE 5 MG TABLET GLIPIZIDE 10 MG TABLET GLIPIZIDE ER 5 MG TABLET GLYBURIDE 1.25 MG TABLET GLYBURIDE 2.5 MG TABLET GLYBURIDE 5 MG TABLET GLYBURIDE MICRO 3 MG TABLET GLYBURIDE MICRO 6 MG TABLET GLYBURIDE/METFORMIN HCL MG TAB GLYBURIDE/METFORMIN HCL MG TAB GLYBURIDE/METFORMIN HCL 5 MG-500MG TAB GUANFACINE 1 MG TABLET GUANFACINE 2 MG TABLET H -- HALOPERIDOL 0.5 MG TABLET HYDRALAZINE 10 MG TABLET HYDRALAZINE 25 MG TABLET HYDROCHLOROTHIAZIDE 12.5 MG CP HYDROCHLOROTHIAZIDE 25 MG TB HYDROCHLOROTHIAZIDE 50 MG TB HYDROCORTISONE 1% CREAM HYDROCORTISONE 1% PACKET HYDROCORTISONE 2.5% CREAM HYDROCORTISONE/ALOE VERA 1% CRM HYDROXYZINE PAM 25 MG CAP HYDROXYZINE PAM 50 MG CAP I -- IBUPROFEN 400 MG TABLET IBUPROFEN 600 MG TABLET IBUPROFEN 800 MG TABLET IMIPRAMINE HCL 10 MG TABLET IMIPRAMINE HCL 25 MG TABLET IMIPRAMINE HCL 50 MG TABLET INDOMETHACIN 25 MG CAPSULE IPRATROPIUM BR 0.02% MG/ML SOLN ISONIAZID 300 MG TABLET L -- LACTULOSE 10 GM/15 ML SOLUTION LACTULOSE 10 GM/15 ML SYRUP LACTULOSE 20 G/30 ML SOLN LAMOTRIGINE 25 MG TABLET LAMOTRIGINE 100 MG TABLET LEVOTHYROXINE 25 MCG TABLET LEVOTHYROXINE 50 MCG TABLET LEVOTHYROXINE 75 MCG TABLET LEVOTHYROXINE 88 MCG TABLET LEVOTHYROXINE 100 MCG TABLET LIDOCAINE HCL 2 % SOLN LISINOPRIL 2.5 MG TABLET LISINOPRIL 5 MG TABLET LISINOPRIL 10 MG TABLET LISINOPRIL 20 MG TABLET

5 MG TABLET 30 90 GLYBURIDE 5 MG TABLET 30 90 GLYBURIDE MICRO 3 MG TABLET 30 90 GLYBURIDE MICRO 6 MG TABLET 30 90 GLYBURIDE/METFORMIN HCL 1.25-250MG TAB 60 180 GLYBURIDE/METFORMIN HCL 2.

4 LISINOPRIL 30 MG TABLET LISINOPRIL 40 MG TABLET LISINOPRIL-HCTZ MG TAB LISINOPRIL-HCTZ MG TAB LISINOPRIL-HCTZ MG TAB LITHIUM CARBONATE 300 MG CAP LORATADINE 10 MG TABLET LOSARTAN POTASSIUM 25 MG TAB LOSARTAN POTASSIUM 50 MG TAB LOSARTAN POTASSIUM 100 MG TAB LOSARTAN-HCTZ MG TAB LOSARTAN-HCTZ MG TAB LOSARTAN-HCTZ MG TAB LOVASTATIN 10 MG TABLET LOVASTATIN 20 MG TABLET M -- MAGNESIUM CHLORIDE 64 MG TAB MAGNESIUM OXIDE 400 MG TABLET MEDROXYPROGESTERONE 2.5 MG TAB MEDROXYPROGESTERONE 5 MG TAB MEDROXYPROGESTERONE 10 MG TB MEGESTROL ACETATE 20 MG TAB MELOXICAM 7.5 MG TABLET MELOXICAM 15 MG TABLET METFORMIN HCL 500 MG TABLET METFORMIN HCL 750 MG TABLET METFORMIN HCL 850 MG TABLET METFORMIN HCL 1,000 MG TABLET METFORMIN HCL ER 500 MG TABLET METHOCARBAMOL 500 MG TABLET METOCLOPRAMIDE HCL 5 MG TABLET METOCLOPRAMIDE HCL 10 MG TABLET METOPROLOL TARTRATE 25 MG TAB METOPROLOL TARTRATE 50 MG TAB METOPROLOL TARTRATE 100 MG TAB MIRTAZAPINE 15 MG TABLET MIRTAZAPINE 30 MG TABLET N -- NAPROXEN 250 MG TABLET NAPROXEN 375 MG TABLET NAPROXEN 500 MG TABLET NEO/POLYMYX B SULF/DEXAMETH K-.1 OINT 4 12 NORTRIPTYLINE HCL 10 MG CAP NORTRIPTYLINE HCL 25 MG CAP O -- ONDANSETRON 4 MG ODT TABLET ONDANSETRON 8 MG ODT TABLET ONDANSETRON HCL 8 MG TABLET P -- PANTOPRAZOLE SOD 20 MG TAB PANTOPRAZOLE SOD 40 MG TAB PAROXETINE HCL 10 MG TABLET PAROXETINE HCL 20 MG TABLET PAROXETINE HCL 30 MG TABLET PAROXETINE HCL 40 MG TABLET PENICILLIN V POTASSIUM 125 MG/5ML SOLN PENICILLIN V POTASSIUM 250 MG/5ML SOLN PENICILLIN V POTASSIUM 250 MG TAB PIOGLITAZONE HCL 15 MG TABLET POLYMYXIN B SULF/TRIMETHOPRIM /ML DROPS

POTASSIUM 100 MG TAB 30 90 LOSARTAN-HCTZ 50-12.5 MG TAB 30 90 LOSARTAN-HCTZ 100-12.

5 PREDNISONE 1 MG TABLET PREDNISONE 2.5 MG TABLET PREDNISONE 5 MG TABLET PRENATAL LOW IRON TAB PRENATAL PLUS TAB PROCHLORPERAZINE MALEATE 5 MG TABLET PROCHLORPERAZINE MALEATE 10 MG TAB PROMETHAZINE 6.25 MG/5 ML SYR PROMETHAZINE 25 MG TABLET PROMETHAZINE/DEXTROMETHORPHAN /5 SYRUP Q -- QUINAPRIL 5 MG TAB QUINAPRIL 10 MG TAB QUINAPRIL 20 MG TAB R -- RANITIDINE 150 MG TABLET RANITIDINE 300 MG TABLET RISPERIDONE 0.25 MG TABLET RISPERIDONE 0.5 MG TABLET RISPERIDONE 1 MG TABLET RISPERIDONE 2 MG TABLET S -- SERTRALINE HCL 25 MG TABLET SERTRALINE HCL 50 MG TABLET SERTRALINE HCL 100 MG TABLET SIMVASTATIN 5 MG TABLET SIMVASTATIN 10 MG TABLET SIMVASTATIN 20 MG TABLET SIMVASTATIN 40 MG TABLET SMZ/TMP 400MG-80MG TAB SMZ/TMP MG TAB SODIUM FLUORIDE 0.25 (0.55) TAB SODIUM FLUORIDE 0.5 (1.1) MG TAB SODIUM FLUORIDE 1MG (2.2MG) TAB SOTALOL 80 MG TABLET SPIRONOLACTONE 25 MG TABLET T -- TERAZOSIN 1 MG CAPSULE TERAZOSIN 2 MG CAPSULE TERAZOSIN 5 MG CAPSULE TERAZOSIN 10 MG CAPSULE TERBINAFINE HCL 250 MG TABLET TIMOLOL MALEATE 0.25% DROPS 5 15 TIMOLOL MALEATE 0.5% DROPS TOBRAMYCIN 0.3% EYE DROPS 5 15 TOPIRAMATE 25 MG TABLET TOPIRAMATE 50 MG TABLET TOPIRAMATE 100 MG TABLET TOPIRAMATE 200 MG TABLET TORSEMIDE 20 MG TABLET TRAZODONE HCL 50 MG TAB TRAZODONE HCL 100 MG TAB TRIAMCINOLONE ACETONIDE % CRM TRIAMCINOLONE ACETONIDE 0.1 % CRM TRIAMTERENE-HCTZ MG CP TRIAMTERENE-HCTZ MG TB TRIAMTERENE/HCTZ 75/50 TAB V -- VERAPAMIL 80 MG TABLET VERAPAMIL 120 MG TABLET

25 MG/5 ML SYR 180 540 PROMETHAZINE 25 MG TABLET 12 36 PROMETHAZINE/DEXTROMETHORPHAN 6.

6 -- W -- WARFARIN SODIUM 1 MG TAB WARFARIN SODIUM 2 MG TAB WARFARIN SODIUM 2.5 MG TAB WARFARIN SODIUM 3 MG TAB WARFARIN SODIUM 4 MG TAB WARFARIN SODIUM 5 MG TAB WARFARIN SODIUM 6 MG TAB WARFARIN SODIUM 7.5 MG TAB WARFARIN SODIUM 10 MG TAB Select Women s and Men s Health prescription medications are available in up to a 30-day supply** for $9.00 each or up to a 90-day supply** for $24.00 each. WOMEN S HEALTH MEDICATIONS $9.00 QTY $24.00 QTY ALENDRONATE SODIUM 35 MG TAB 4 12 ALENDRONATE SODIUM 70 MG TAB 4 12 PREVIFEM TAB TAMOXIFEN CITRATE 10 MG TAB TAMOXIFEN CITRATE 20 MG TAB TRI-PREVIFEM TAB MEN S HEALTH MEDICATIONS $9.00 QTY $24.00 QTY FINASTERIDE 5 MG TAB *Prescriptions paid for in whole or in part by publicly funded health care programs, such as Medicare and Medicaid, are ineligible. Membership discount prices cannot be combined with any insurance. **The day supply is based upon the average dispensing patterns for the specifi c drug and strength. The Program, as well as the prices and the list of covered drugs, can be modifi ed at any time without notice. ***This discount program is NOT a health insurance policy and is not intended as a substitute for insurance. The program does not qualify as minimum creditable coverage under Massachusetts law or where prohibited by law. The program only provides for discounts on certain medications from participating pharmacies, and the range of the discounts will vary depending on the pharmacy and the medication received. The program does not make payments to pharmacies. Members are required to pay for all prescription purchases, but will receive a discount from participating pharmacies. The program is not available in the states of California, Oregon, and Washington. This program is administered by Medical Security Card Company, LLC (MSC), 4911 E. Broadway Boulevard, Tucson, AZ 85711, , and is marketed by Shopko, P.O. Box 19060, Green Bay, WI If you are not completely satisfi ed, you may call us at or us at customercare@scriptsave. com to cancel at any time. If you cancel within the fi rst 30 days after receiving your membership materials, you will receive a refund of all enrollment fees. If you cancel after the fi rst 30 days, your membership will terminate and no refund will be issued. A0152_SS_SHOPKO_DL_ Shopko s Prescription Program administered by 6

5 MG TAB 30 90 WARFARIN SODIUM 10 MG TAB 30 90 Select Women s and Men s Health prescription medications are available in up to a 30-day supply** for $9.00 each or up to a 90-day supply** for $24.

PREFERRED GENERIC DRUG LIST

PREFERRED GENERIC DRUG LIST These discount programs are NOT health insurance policies and are not intended as a substitute for insurance. The programs do not qualify as a minimum creditable coverage under Massachusetts law or where