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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

nyspef.org

Effective January 1, 2012 2012 EMPIRE PLAN FLEXIBLE FORMULARY Administered by UnitedHealthcare The following is a list of the most commonly prescribed generic and brand-name drugs included on the 2012 Empire Plan Flexible Formulary. This is not a complete list of all prescription drugs on the flexible formulary or covered under The Empire Plan. This list and excluded medications are

bmj-tobacco.highwire.org

Tobacco Control 2000; 9 (Suppl I):i42–i45 Implementing tobacco tracking codes in anindividual practice association or a network modelhealth maintenance organisation Make up of PHS smoking cessation task force Oregon is an individual practice associationmodel health maintenance organisation withcapitated model and more than 360 000 mem-bers in our preferred provider model, which isa disc

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