4dollarrxplannocostpublicfolder.xls

THE HVHS $4.00 PRESCRIPTION PROGRAM
ALL DRUGS LISTED AND PRICES ARE SUBJECT TO CHANGE- 06/18/2013
DRUG NAME
BRAND NAME
QUANITY $4/$10 $4/$12 $9/$24
Albuterol Syrup
PROVENTIL
Allopurinol
ZYLOPRIM
Amitriptyline
Amitriptyline
Amitriptyline
Amlodipine
Amlodipine
Amlodipine
Amoxicillin
Amoxicillin
Amoxicillin
Amoxicillin
Amoxicillin
Atenolol
TENORMIN
Atenolol
TENORMIN
Atenolol
TENORMIN
Baclofen
LIORESAL
Bumetanide
Bumetanide
Buspirone BUSPAR
Captopril
Captopril
Carbamazepine
TEGRETOL
Carvedilol
Carvedilol
Carvedilol
Carvedilol
Cephalexin
Ciprofloxin CIPRO
Citalopram CELEXA
Citalopram CELEXA
Citalopram CELEXA
Clomiphene Citrate
Clonidine CATAPRES
Clonidine CATAPRES
Clonidine CATAPRES
Cyclobenzaprine FLEXERIL
DRUG NAME
BRAND NAME
QUANITY $4/$10 $4/$12 $9/$24
Dexamethasone
DECADRON
Doxepin SINEQUAN
Enalapril VASOTEC
Enalapril VASOTEC
Enalapril VASOTEC
Enalapril VASOTEC
Famotidine
Famotidine
Fluconazole
DIFLUCAN
Fluconazole
DIFLUCAN
Fluconazole
DIFLUCAN
Fluoxetine
Fluoxetine
Folic Acid
Furosemide
Furosemide
Furosemide
Glimepiride
Glimepiride
Glimepiride
Glipizide
GLUCOTROL
Haloperidol
Hydrochlorothiazide
HYDRODIURIL
Hydrochlorothiazide
HYDRODIURIL
Ibuprofen MOTRIN
Ibuprofen MOTRIN
Lactulose Syrup
CHRONULAC
Levothyroxine
SYNTHROID
Levothyroxine
SYNTHROID
Lidocaine Viscous
XYLOCAINE
Lisinopril
PRINIVIL/ZESTRIL
Lisinopril
PRINIVIL/ZESTRIL
Lisinopril
PRINIVIL/ZESTRIL
Lisinopril
PRINIVIL/ZESTRIL
Lisinopril
PRINIVIL/ZESTRIL
Lithium Carbonate
ESKALITH
Meloxicam
Meloxicam
Metformin
GLUCOPHAGE
DRUG NAME
BRAND NAME
QUANITY $4/$10 $4/$12 $9/$24
Metformin
GLUCOPHAGE
Metformin ER
GLUCOPHAGE XR
Metoprolol tartrate
LOPRESSOR
Metoprolol tartrate
LOPRESSOR
Metoprolol tartrate
LOPRESSOR
Paroxetine
Phenazopyridine
PYRIDIUM
Prednisone
DELTASONE
Prednisone
DELTASONE
Prednisone
DELTASONE
Prednisone
DELTASONE
Propranolol
Propranolol
Ranitidine
Sertraline
Sertraline
Simvastatin
Simvastatin
Simvastatin
Spironolactone ALDACTONE
Terazosin
Trazodone
Trazodone
Trihexyphenidyl HCL
Trimeth/Sulfa
BACTRIM DS
Warfarin COUMADIN
Warfarin
COUMADIN
Warfarin JANTOVEN
COUMADIN
Warfarin COUMADIN
Warfarin COUMADIN
Warfarin COUMADIN
Warfarin JANTOVEN
COUMADIN
Warfarin
COUMADIN

Source: http://www.heritagevalley.org/Media/Releases/4dollar.pdf