Value-Priced Medication List

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1 Value-Priced Medication List In addition to the discounts on thousands of brand-name and most other generic medications that Walgreens Prescription Savings Club members enjoy, club members receive greater discounts on three-tiers of value priced generics.* The price for a generic drug is based on its tier and whether it is a 30-day or 90-day supply: 30-day-supply drugs cost $5 (tier 1), $10 (tier 2) or $15 (tier 3) 90-day-supply drugs cost $10 (tier 1), $20 (tier 2) or $30 (tier 3) VALUE GENERICS Antifungal FLUCONAZOLE 150MG TAB TERBINAFINE 250MG TAB Antimalaria MEFLOQUINE HCL 250MG TAB Antiviral ACYCLOVIR 200MG TAB Arthritis or Pain BACLOFEN 10MG TAB BACLOFEN 20MG TAB CYCLOBENZAPRINE 5MG TAB CYCLOBENZAPRINE 10MG TAB DICLOFENAC POTASSIUM 50MG TAB DICLOFENAC SODIUM 25MG TAB DICLOFENAC SODIUM 50MG TAB DICLOFENAC SODIUM 75MG EC TAB DICLOFENAC SODIUM 100MG ER TAB FLURBIPROFEN 50MG TAB FLURBIPROFEN 100MG TAB IBUPROFEN 100MG/5ML ORAL SUSP IBUPROFEN 400MG TAB IBUPROFEN 600MG TAB IBUPROFEN 800MG TAB INDOMETHACIN 25MG CAP INDOMETHACIN 50MG CAP KETOPROFEN 50MG CAP KETOPROFEN 75MG CAP KETOROLAC 10MG TAB KETOROLAC 30MG/ML INJ, 2ML LEFLUNOMIDE 10MG TAB MELOXICAM 7.5MG TAB MELOXICAM 15MG TAB NABUMETONE 500MG TAB NAPROXEN 250MG TAB NAPROXEN 375MG TAB NAPROXEN 500MG TAB NAPROXEN 375MG DR TAB NAPROXEN DR 500MG TAB NAPROXEN SODIUM 275MG TAB NAPROXEN SODIUM 550MG TAB SULINDAC 150MG TAB TIZANIDINE 2MG TAB TRAMADOL 50MG TAB Asthma ALBUTEROL 0.083% INH SOLN 25X3ML ALBUTEROL 0.5% INH SOL 20ML ALBUTEROL SULF INH SOLN 1.25MG/3ML ALBUTEROL SULFATE SYRUP (2MG/5ML) AMINOPHYLLINE 100MG TAB AMINOPHYLLINE 200MG TAB DYPHYLLINE-GG ELIXIR DYPHYLLIN-GG TAB IPRATROPIUM INHAL SOLN 60 X 2.5ML THEOPHYLLINE 200MG CR TAB THEOPHYLLINE 300MG CR TAB THEOPHYLLINE 100MG ER TAB THEOPHYLLINE 200MG ER TAB Blood Pressure/Heart Health AMILORIDE 5MG / HCTZ 50MG TAB AMIODARONE 200MG TAB AMLODIPINE BESYLATE 2.5MG TAB AMLODIPINE BESYLATE 5MG TAB AMLODIPINE BESYLATE 10MG TAB AMLODIPINE-BENAZ 2.5/10MG CAP AMLODIPINE-BENAZ 5/10MG CAP AMLODIPINE-BENAZ 5/20MG CAP AMLODIPINE-BENAZ 10/20MG CAP ATENOLOL 100MG TAB ATENOLOL 100MG/CHLORTHAL 25MG TAB ATENOLOL 25MG TAB ATENOLOL 50MG TAB ATENOLOL/CHLORTHALIDONE 50/25 TAB BENAZEPRIL 5MG TAB BENAZEPRIL 10MG TAB BENAZEPRIL 20MG TAB BENAZEPRIL 40MG TAB BISOPROLOL FUMARATE 5MG TAB BISOPROLOL/HCTZ 2.5MG/6.25MG TAB BISOPROLOL/HCTZ 5MG/6.25MG TAB BISOPROLOL/HCTZ 10MG/6.25MG TAB BUMETANIDE 0.5MG TAB BUMETANIDE 1MG TAB BUMETANIDE 2MG TAB CAPTOPRIL/HCTZ 25/25 TAB CARTIA 120MG XT CAP CARVEDILOL 3.125MG TAB CARVEDILOL 6.25MG TAB CARVEDILOL 12.5MG TAB CARVEDILOL 25MG TAB CHLOROTHIAZIDE 250MG TAB CHLORTHALIDONE 25MG TAB CHLORTHALIDONE 50MG TAB CILOSTAZOL 50MG TAB CILOSTAZOL 100MG TAB CLONIDINE 0.1MG TAB CLONIDINE 0.2MG TAB CLONIDINE 0.3MG TAB Blood Pressure/Heart Health (cont.) DILTIAZEM 30MG TAB DILTIAZEM 60MG TAB DILTIAZEM 90MG TAB DILTIAZEM 120MG TAB DILTIAZEM ER 120MG CAP (XR-24HR) DIPYRIDAMOLE 25MG TAB DIPYRIDAMOLE 50MG TAB DIPYRIDAMOLE 75MG TAB DOXAZOSIN 1MG TAB DOXAZOSIN 2MG TAB DOXAZOSIN 4MG TAB ENALAPRIL 2.5MG TAB ENALAPRIL 5MG TAB ENALAPRIL 10MG TAB ENALAPRIL 20MG TAB ENALAPRIL-HCTZ MG TAB ENALAPRIL-HCTZ 10-25MG TAB FELODIPINE 2.5MG TAB FOSINOPRIL 10MG TAB FOSINOPRIL 20MG TAB FOSINOPRIL 40MG TAB FUROSEMIDE 8MG/ML SOLN FUROSEMIDE 10MG/ML ORAL SOLN 60ML FUROSEMIDE 20MG TAB FUROSEMIDE 40MG TAB FUROSEMIDE 80MG TAB GUANFACINE 1MG TAB GUANFACINE 2MG TAB HYDRALAZINE 10MG TAB HYDRALAZINE 25MG TAB HYDRALAZINE 50MG TAB HYDROCHLOROTHIAZIDE 12.5MG CAP HYDROCHLOROTHIAZIDE 12.5MG TAB HYDROCHLOROTHIAZIDE 25MG TAB HYDROCHLOROTHIAZIDE 50MG TAB INDAPAMIDE 1.25MG TAB INDAPAMIDE 2.5MG TAB ISOSORBIDE DINITRATE 2.5MG SL TAB ISOSORBIDE DINITRATE 5MG SUBL TAB ISOSORBIDE MONONITRATE 10MG TAB ISOSORBIDE MONONITRATE 20MG TAB ISOSORBIDE MONONITRATE 30MG ER TAB ISOSORBIDE MONONITRATE 60MG ER TAB LISINOPRIL 2.5MG TAB LISINOPRIL 5MG TAB LISINOPRIL 10MG TAB LISINOPRIL 20MG TAB LISINOPRIL 30MG TAB LISINOPRIL 40MG TAB LISINOPRIL-HCTZ 10/12.5MG TAB LISINOPRIL-HCTZ 20/12.5MG TAB LISINOPRIL-HCTZ 20/25MG TAB LOSARTAN/HCTZ 100/12.5MG TAB METHYLDOPA 250MG TAB METHYLDOPA 500MG TAB METOLAZONE 2.5MG TAB

2 Valued Priced Medication List (cont.) 2 Blood Pressure/Heart Health (cont.) METOLAZONE 5MG TAB METOLAZONE 10MG TAB METOPROLOL TARTRATE 25MG TAB METOPROLOL TARTRATE 50MG TAB METOPROLOL TARTRATE 100MG TAB PENTOXIFYLLINE 400MG ER TAB PRAZOSIN 1MG CAP PRAZOSIN 2MG CAP PROPAFENONE 150MG TAB PROPRANOLOL 10MG TAB PROPRANOLOL 20MG TAB PROPRANOLOL 40MG TAB PROPRANOLOL 60MG TAB PROPRANOLOL 80MG TAB PROPRANOLOL ER 60MG CAP PROPRANOLOL ER 80MG CAP QUINAPRIL 5MG TAB QUINAPRIL 10MG TAB QUINAPRIL 20MG TAB QUINAPRIL 40MG TAB QUINAPRIL/HCTZ MG TAB RAMIPRIL 1.25MG CAP SOTALOL 120MG TAB SOTALOL 160MG TAB SPIRONOLACTONE 25MG TAB SPIRONOLACTONE 50MG TAB SPIRONOLACTONE 25MG W/HCTZ 25MG TAB TERAZOSIN 1MG CAP TERAZOSIN 2MG CAP TERAZOSIN 5MG CAP TERAZOSIN 10MG CAP TICLOPIDINE 250MG TAB TORSEMIDE 5MG TAB TORSEMIDE 10MG TAB TORSEMIDE 20MG TAB TORSEMIDE 100MG** TAB TRANDOLAPRIL 1MG TAB TRANDOLAPRIL 2MG TAB TRANDOLAPRIL 4MG TAB TRIAMTERENE 37.5MG/ HCTZ 25MG CAP TRIAMTERENE 37.5MG/ HCTZ 25MG TAB TRIAMTERENE 75MG/ HCTZ 50MG TAB VERAPAMIL 40MG TAB VERAPAMIL 80MG TAB VERAPAMIL 120MG TAB VERAPAMIL ER 100MG CAP (24 HR) WARFARIN SOD 1MG TAB WARFARIN SOD 2.5MG TAB WARFARIN SOD 2MG TAB WARFARIN SOD 3MG TAB WARFARIN SOD 4MG TAB WARFARIN SOD 5MG TAB WARFARIN SOD 6MG TAB WARFARIN SOD 7.5MG TAB WARFARIN SOD 10MG** TAB Cholesterol FENOFIBRATE 54MG TAB GEMFIBROZIL 600MG TAB LOVASTATIN 10MG TAB LOVASTATIN 20MG TAB LOVASTATIN 40MG TAB PRAVASTATIN 10MG TAB PRAVASTATIN 20MG TAB PRAVASTATIN 40MG TAB PRAVASTATIN 80MG TAB SIMVASTATIN 5MG TAB SIMVASTATIN 10MG TAB SIMVASTATIN 20MG TAB SIMVASTATIN 40MG TAB SIMVASTATIN 80MG TAB Cough/Cold/Allergy ALLER-CHLOR 4MG TAB BENZONATATE 100MG CAP BENZONATATE 200MG CAP BROMDEX D SYRUP CETIRIZINE 1MG/ML SYRUP CETIRIZINE 10MG TAB CYPROHEPTADINE 2MG/5ML SYRUP DE-CHLOR DM LIQUID DE-CHLOR DR SYRUP DEHISTINE SYRUP DIPHENHYDRAMINE 50MG CAP FLUTICASONE NASAL SP (120INH) 16GM LORATADINE 10MG TAB NOHIST TAB ORGAN-I NR 200MG TAB PBM ALLERGY SYRUP PHENYLTOLOXAMINE PE CPM SYRUP PROMETHAZINE 12.5MG TAB PROMETHAZINE 25MG TAB PROMETHAZINE 50MG TAB PROMETHAZINE DM SYRUP QUARTUSS DM DROPS 30ML QV-ALLERGY SYRUP REME TUSSIN DM SYRUP SILDEC PE-DM SYRUP SILDEC-PE SYRUP SUPRESS-DX PED DROPS 30ML TRIPOHIST LIQUID Diabetes GLIMEPIRIDE 1MG TAB GLIMEPIRIDE 2MG TAB GLIMEPIRIDE 4MG TAB GLIPIZIDE 5MG TAB GLIPIZIDE 10MG TAB GLIPIZIDE ER 10MG TAB GLIPIZIDE XL 2.5MG TAB GLIPIZIDE XL 5MG TAB GLIPIZIDE-METFORMIN 2.5MG/500MG TAB GLIPIZIDE-METFORMIN 5MG/500MG TAB GLYBURIDE 1.25MG TAB GLYBURIDE 2.5MG TAB GLYBURIDE 5MG TAB GLYBURIDE MICRO 1.5MG TAB GLYBURIDE MICRO 3MG TAB GLYBURIDE MICRO 6MG TAB GLYBURIDE/METFORMIN 1.25/250MG TAB GLYBURIDE/METFORMIN 2.5/500MG TAB GLYBURIDE/METFORMIN 5/500MG TAB METFORMIN 500MG TAB METFORMIN 850MG TAB METFORMIN 1000MG TAB METFORMIN ER 500MG 24HR TAB METFORMIN ER 750MG 24HR TAB Ear Care ACETIC ACID 2% OTIC SOLN ANTIPYRINE BENZOCAINE OTIC SOL 15ML Eye Care BACITRACIN/POLYMYX OPHTHOINT 3.5GM CARTEOLOL HCL 1% OPH SOL 5ML CARTEOLOL HCL 1% OPH SOL 10ML CARTEOLOL HCL 1% OPH SOL 15ML CROMOLYN SODIUM 4% OPHTH SOLN 10ML CYCLOPENTOL 1% OPTH SOLN 15ML DEXAMETHASONE 0.1% OPHTH SOLN 5ML DORZOLAMIDE 2% OPHTH SOLN 10ML ERYTHROMYCIN OPHTH OINT 3.5GM Eye Care (cont.) GENTAMICIN 0.3% OPHTH SOLN 5ML KETOROLAC 0.4% OPTH SOLN 5ML KETOROLAC 0.5% OPHTH SOLN 5ML LEVOBUNOLOL 0.5% OPTH SOLN 5ML PILOCARPINE 0.5% OPHTH SOLN POLYMYXIN-B/TRIMETHOPRIMOPHTH SOLN SULFACETAMIDE NA 10% OPH SOL 15ML TIMOLOL MALEATE.25% OPHTH SOL 5ML TIMOLOL MALEATE 0.5% OPHTH SOLN 5ML TOBRAMYCIN 0.3% OPH SOL 5ML TROPICAMIDE 1% OP SOLN Gastrointestinal Health CIMETIDINE 200MG TAB CIMETIDINE 300MG TAB CIMETIDINE 400MG TAB CIMETIDINE ORAL LIQ 300MG/5ML DICYCLOMINE 10MG CAP DICYCLOMINE 20MG TAB DOC-Q-LACE 100MG CAP FAMOTIDINE 20MG TAB FAMOTIDINE 40MG TAB GENERLAC 10GM/15ML SOLN LACTULOSE 10GM/15ML SOLN ,419 METOCLOPRAMIDE 5MG TAB METOCLOPRAMIDE 10MG TAB METOCLOPRAMIDE HCL 5MG/5ML SOLN NIZATIDINE 150MG CAP NIZATIDINE 300MG CAP OMEPRAZOLE 20MG CAP RANITIDINE 150MG TAB RANITIDINE 300MG TAB RANITIDINE 15MG/ML (75MG/5ML) SYRUP Gout ALLOPURINOL 100MG TAB ALLOPURINOL 300MG TAB Infections AMOX-CLAV 400MG CHEW TAB AMOX-CLAV 200MG/5ML SUSP 100ML AMOX-CLAV 400MG/5ML SUSP 100ML AMOX-CLAV 500MG TAB AMOX-CLAV ES 600MG/5ML SUSP 125ML AMOXICILLIN 250MG CAP AMOXICILLIN 500MG CAP AMOXICILLIN 125MG CHEWABLE TAB AMOXICILLIN 250MG CHEW TAB AMOXICILLIN 125MG/5ML SUSP 80ML AMOXICILLIN 125MG/5ML SUSP 100ML AMOXICILLIN 125MG/5ML SUSP 150ML AMOXICILLIN 200MG/5ML SUSP 75ML AMOXICILLIN 200MG/5ML SUSP 100ML AMOXICILLIN 250MG/5ML SUSP 150ML AMOXICILLIN 250MG/5ML SUSP 100ML AMOXICILLIN 250MG/5ML SUSP 80ML AMOXICILLIN 400MG/5ML SUSP 50ML AMOXICILLIN 400MG/5ML SUSP 75ML AMOXICILLIN 400MG/5ML SUSP 100ML AMOXICILLIN 500MG TAB AMOXICILLIN 875MG TAB AMPICILLIN 250MG CAP AMPICILLIN 500MG CAP CEFACLOR 250MG CAP CEFADROXIL 500MG CAP CEFPROZIL 125MG/5ML SUSP 50ML

3 Valued Priced Medication List (cont.) 3 Infections (cont.) CEFPROZIL 125MG/5ML SUSP 75ML CEFPROZIL 125MG/5ML SUSP 100ML CEFUROXIME 250MG TAB CEPHALEXIN 125MG/5ML SUSP 100ML CEPHALEXIN 250MG/5ML SUSP 100ML CEPHALEXIN 125MG/5ML SUSP 200ML CEPHALEXIN 250MG/5ML SUSP 200ML CEPHALEXIN 250MG CAP CEPHALEXIN 500MG CAP CIPROFLOXACIN 250MG TAB CIPROFLOXACIN 500MG TAB CIPROFLOXACIN 750MG TAB CLINDAMYCIN 150MG CAP CLINDAMYCIN 300MG CAP DICLOXACILLIN 250MG CAP DOXYCYCLINE MONOHYDRATE 50MG TAB DOXYCYCLINE MONOHYDRATE 100MG TAB METRONIDAZOLE 250MG TAB METRONIDAZOLE 500MG TAB MINOCYCLINE 50MG CAP MINOCYCLINE 75MG CAP MINOCYCLINE 100MG CAP PENICILLIN VK 125MG/5ML SOLN 100ML PENICILLIN VK 125MG/5ML SOLN 200ML PENICILLIN VK 250MG/5ML SOLN 100ML PENICILLIN VK 250MG/5ML SOLN 200ML PENICILLIN VK 250MG TAB PENICILLIN VK 500MG TAB SMZ/TMP REGULAR STRENGTH TAB SULFAMETH/TRIMETHOPRIM 800/160 TAB SULFAMETH-TRIMETH SUSP TRIMETHOPRIM 100MG TAB Medical Devices PROCHAMBER AERO SPACER Mental Health AMITRIPTYLINE 10MG TAB AMITRIPTYLINE 25MG TAB AMITRIPTYLINE 50MG TAB AMITRIPTYLINE 75MG TAB AMITRIPTYLINE 100MG** TAB AMITRIPTYLINE 150MG TAB BENZTROPINE 0.5MG TAB BENZTROPINE 1MG TAB BENZTROPINE 2MG TAB BUSPIRONE 5MG TAB BUSPIRONE 10MG TAB BUSPIRONE 15MG TAB CARBAMAZEPINE 100MG CHEWABLE TAB CARBAMAZEPINE 200MG TAB CARBIDOPA/LEVODOPA MG CR TAB CITALOPRAM 10MG TAB CITALOPRAM 20MG TAB CITALOPRAM 40MG TAB CLOZAPINE 25MG TAB DIVALPROEX DR 125MG TAB DOXEPIN 10MG CAP DOXEPIN 25MG CAP DOXEPIN 50MG CAP DOXEPIN 75MG CAP DOXEPIN 100MG** CAP DOXEPIN HCL 10MG/ML CONC 118ML FLUOXETINE 10MG CAP FLUOXETINE 20MG CAP FLUOXETINE 40MG CAP FLUOXETINE 10MG TAB FLUOXETINE 20MG TAB FLUOXETINE 20MG/5ML LIQUID FLUPHENAZINE 2.5MG TAB FLUPHENAZINE 5MG TAB Mental Health (cont.) FLUVOXAMINE 25MG TAB FLUVOXAMINE 100MG TAB GABAPENTIN 100MG CAP GABAPENTIN 300MG CAP GABAPENTIN 400MG CAP GABAPENTIN 250MG/5ML SOLN HALOPERIDOL 0.5MG TAB HALOPERIDOL 1MG TAB HALOPERIDOL 2MG TAB HALOPERIDOL 2MG/ML CONCENTRATE HYDROXYZINE 10MG/5ML SYRUP HYDROXYZINE HCL 10MG TAB HYDROXYZINE HCL 25MG TAB HYDROXYZINE HCL 50MG TAB HYDROXYZINE PAMOATE 25MG CAP IMIPRAMINE 10MG TAB IMIPRAMINE 25MG TAB IMIPRAMINE 50MG TAB LAMOTRIGINE 5MG CHEWABLE TAB LAMOTRIGINE 25MG CHEWABLE TAB LITHIUM CARBONATE 150MG CAP LITHIUM CARBONATE 300MG CAP LITHIUM CARBONATE 300MG TAB LITHIUM CARBONATE 600MG CAP LITHIUM CARBONATE ER 450MG TAB METHOCARBAMOL 500MG TAB METHOCARBAMOL 750MG TAB MIRTAZAPINE 7.5MG TAB MIRTAZAPINE 15MG TAB MIRTAZAPINE 30MG TAB NORTRIPTYLINE 10MG CAP NORTRIPTYLINE 25MG CAP NORTRIPTYLINE 50MG CAP NORTRIPTYLINE 75MG CAP OXCARBAZEPINE 150MG TAB PAROXETINE 10MG TAB PAROXETINE 20MG TAB PAROXETINE 30MG TAB PRAMIPEXOLE 0.125MG TAB PRAMIPEXOLE 0.25MG TAB PRAMIPEXOLE 0.5MG TAB PRAMIPEXOLE 1.5MG TAB PRIMIDONE 50MG TAB PROCHLORPERAZINE 5MG TAB PROCHLORPERAZINE 10MG TAB RISPERIDONE 0.25MG TAB RISPERIDONE ODT 0.5MG TAB RISPERIDONE ODT 1MG TAB RISPERIDONE ODT 2MG TAB ROPINIROLE 0.25MG TAB ROPINIROLE 3MG TAB SERTRALINE 25MG TAB SERTRALINE 50MG TAB SERTRALINE 100MG TAB THIORIDAZINE 10MG TAB THIORIDAZINE 25MG TAB THIORIDAZINE 50MG TAB THIOTHIXENE 1MG CAP THIOTHIXENE 2MG CAP TRAZODONE 50MG TAB TRAZODONE 100MG TAB TRAZODONE 150MG TAB TRIHEXYPHENIDYL 2MG TAB TRIHEXYPHENIDYL 5MG TAB VALPROIC ACID 250MG/5ML SYRUP VENLAFAXINE 25MG TAB VENLAFAXINE 37.5MG TAB VENLAFAXINE 50MG TAB VENLAFAXINE 75MG TAB VENLAFAXINE 100MG TAB Mouth/Throat/Dental CHLORHEXIDINE ORAL RINSE 473ML LIDOCAINE VISCOUS 2% ORAL SOL 100ML PILOCARPINE 5MG TAB SF 5000 PLUS 1.1% CREAM 51GM SOD FLUORIDE 0.2% MINT SOLUTION STANNOUS FLUORIDE 0.63% RINSE Skin Conditions BENZOYL PEROXIDE 2.5% AQ GEL 60GM BENZOYL PEROXIDE 5% AQ GEL 60GM BETAMETHASONE VAL 0.1% CRM 15GM CICLOPIROX TOPICAL SUSPENSION 30ML CICLOPIROX TOPICAL SUSPENSION 60ML CLOBETASOL PROP 0.05% GEL 15GM CLOTRIMAZOLE 1% SOLN 30ML FLUTICASONE 0.005% OINT 30GM HYDROCORTISONE 1% CREAM 28.35GM HYDROCORTISONE 1% OINT 28.35GM HYDROCORTISONE 2.5% CREAM 30GM HYDROCORTISONE 2.5% OINT 28.35GM HYPERCARE 20% SOL DAB-O-MATIC 60ML MELQUIN 3% SOLN 30ML MOMETASONE 0.1% OINT 15GM MOMETASONE 0.1% OINT 45GM MOMETASONE 0.1% TOPICAL SOLN 30ML MOMETASONE 0.1% TOPICAL SOLN 60ML NYSTATIN OINT 15GM SALICYLIC AC 6% SHAMPOO 177ML SELENIUM SULFIDE 2.5% SHAMPOO (LOTN) TRIAMCINOLONE 0.025% CREAM 15GM TRIAMCINOLONE 0.5% CREAM 15GM TRIAMCINOLONE 0.1% CREAM 80GM TRIAMCINOLONE 0.1% OINT 80GM UREA 40% LOTION 236.6ML UREA 50% NAIL GEL 18ML Thyroid Conditions LEVOTHROID 0.1MG TAB LEVOTHYROXINE 0.025MG (25MCG) TAB LEVOTHYROXINE 0.05MG (50MCG) TAB LEVOTHYROXINE 0.075MG (75MCG) TAB LEVOTHYROXINE 0.088MG (88MCG) TAB LEVOTHYROXINE 0.100MG (100MCG) TAB LEVOTHYROXINE 0.112MG (112MCG) TAB LEVOTHYROXINE 0.125MG (125MCG) TAB LEVOTHYROXINE 0.137MG (137MCG) TAB LEVOTHYROXINE 0.150MG (150MCG) TAB LEVOTHYROXINE 0.175MG (175MCG) TAB LEVOTHYROXINE 0.2MG (200MCG) TAB LEVOTHYROXINE 0.3MG (300MCG) TAB METHIMAZOLE 5MG TAB METHIMAZOLE 10MG TAB NATURE-THROID 0.5GR (32.5MG) TAB Urinary Health BETHANECHOL 5MG TAB BETHANECHOL 10MG TAB BETHANECHOL 25MG TAB OXYBUTYNIN 5MG/5ML SYRUP OXYBUTYNIN ER 5MG TAB OXYBUTYNIN ER 10MG TAB OXYBUTYNIN ER 15MG TAB

4 Valued Priced Medication List (cont.) 4 Vitamins and Nutritional Health CYANOCOBALAMIN 1000MCG/ML INJ, 1ML FABB TAB FE C PLUS TAB FEROTRIN CAP FERREX 150 FORTE CAP FLUORIDE 0.25MG F CHEWABLE TAB FLUORIDE 0.5MG F CHEWABLE TAB FLUORIDE 1.0MG F CHEWABLE TAB FOLBECAL TAB FOLBEE PLUS TAB FOLBEE TAB FOLIC ACID 1MG TAB HEMATINIC/ FA TAB HEMATINIC PLUS TAB 10 X KLOR-CON 10MEQ TAB MULTIGEN FOLIC TAB MULTIGEN TAB MULTIVIT/F 0.25MG CHEWABLE TAB MULTI-VIT/FL 0.25MG DROPS 50ML MULTI-VITA-F 0.5MG CHEW TAB MULTI-VIT/FLUORIDE 1MG CHEW TAB MULTIVITAMIN W/FL.5MG/ML ORAL DROP MULTIVITAMINS W/ FL 1.0MG CHEW TAB MULTIVITS W/FL 1MG & IRON CHEW TAB NATALCARE PLUS TAB (1MG FOLIC ACID) OB-NATAL ONE CAP PHOSPHA 250 NEUTRAL TAB POLY-IRON 150 CAP POLY-IRON 150 FORTE CAP POT CHLOR 10% LIQ SF (20MEQ/15ML) POTASSIUM CL 10MEQ ER TAB PRENAFIRST TAB PRENATAB FA TAB PRENATAL - U CAP Vitamins and Nutritional Health (cont.) PRENATAL 19 CHEWABLE TAB PRENATAL 19 TAB PRENATAL PLUS TAB RE DUALVIT F CAP RE PRENATAL MULTIVIT W/IRON CHEW TB RENA-VITE RX TAB RENAL SOFTGEL CAP SE-NATAL 19 TAB THEROBEC PLUS TAB TRI-VIT/FE FL.25MG DROPS 50ML VINATE AZ TAB VINATE CARE CHEWABLE TAB VINATE C TAB VINATE GT TAB VINATE M TAB VINATE ONE TAB VITAMIN B MCG TAB VITAMIN D 50,000IU CAP Women s Health ALENDRONATE 5MG TAB ALENDRONATE 10MG TAB ALENDRONATE 35MG TAB ALENDRONATE 70MG TAB ANASTROZOLE 1MG TAB CLOMIPHENE CITRATE 50MG TAB ESTRADIOL 0.5MG TAB ESTRADIOL 1MG TAB ESTRADIOL 2MG TAB ESTROPIPATE 0.625MG (0.75MG) TAB ESTROPIPATE 1.5MG (1.25MG) TAB Women s Health (cont.) MEDROXYPROGESTERONE 2.5MG TAB MEDROXYPROGESTERONE 5MGTAB MEDROXYPROGESTERONE 10MGTAB MEGESTROL ACETATE 20MG TAB TAMOXIFEN 10MG TAB TAMOXIFEN 20MG TAB Other ANAGRELIDE 0.5MG CAP ANAGRELIDE 1MG CAP CYTRA-2 SOLN CYTRA-K ORAL SOLN DEXAMETHASONE 0.5MG TAB DEXAMETHASONE 0.75MG TAB DEXAMETHASONE 1MG TAB DEXAMETHASONE 1.5MG TAB DEXAMETHASONE 4MG TAB FINASTERIDE 5MG TAB HYDROCORTISONE 5MG TAB ISONIAZID 100MG TAB LIDOCAINE 4% TOP SOLN 50ML PHENAZOPYRIDINE 100MG TAB PHENAZOPYRIDINE 200MG TAB PREDNISOLONE 15MG/5ML SOLN PREDNISOLONE SOD PHOS 15MG/5ML SOL PREDNISONE 1MG TAB PREDNISONE 2.5MG TAB PREDNISONE 5MG TAB PREDNISONE 10MG** TAB PREDNISONE 20MG TAB PREDNISONE 5MG TAB PACK 21 S PREDNISONE 5MG PAK 48 S PREDNISONE 10MG TAB PACK 21 S

5 Valued Priced Medication List (cont.) Insulins VALUE BRAND-NAME LEVEMIR FLEXPEN 1 BOX $ LEVEMIR 100 UNITS/ML VIAL 1 VIAL $ NOVOLIN N 100 UNITS/ML VIAL 1 VIAL $58.12 NOVOLIN R 100 UNITS/ML VIAL 1 VIAL $58.12 NOVOLIN 70/ UNIT/ML VIAL 1 VIAL $58.12 NOVOLOG MIX 70/30 VIAL 1 VIAL $ NOVOLOG MIX 70/30 FLEXPEN 1 BOX $ NOVOLOG FLEXPEN 1 BOX $ NOVOLOG PENFILL 3 ML 1 BOX $ NOVOLOG 100 UNIT/ML VIAL 1 VIAL $ Diabetic Supplies WALGREENS TRUE RESULT METER 1 METER FREE WALGREENS TRUE TEST STRIPS 25 S 1 BOX $17.99 WALGREENS TRUE TEST STRIPS 50 S 1 BOX $24.99 WALGREENS TRUE TEST STRIPS 100 S 1 BOX $41.99 Discounted Lifestyle Medications CIALIS 5MG TAB (QTY 6) $39.99 CIALIS 10MG TAB (QTY 6) $ CIALIS 20MG TAB (QTY 6) $ LATISSE 0.03% OPHTH SOLN $ VIAGRA 50MG TAB (QTY 6) $ VIAGRA 100MG TAB (QTY 6) $ AVERAGE SAVINGS- 90-day supply of a value-priced generic Commonly prescribed quantities of all other generics Tier 1 $33.12 Tier 2 $32.99 Tier 3 $ $25.60 Brand-name drugs $ BAYER CONTOUR NEXT METER 1 METER FREE BAYER CONTOUR NEXT STRIPS 25 S 1 BOX $23.99 BAYER CONTOUR NEXT STRIPS 50 S 1 BOX $39.99 BAYER CONTOUR NEXT STRIPS 100 S 1 BOX $78.99 BAYER CONTOUR METER 1 METER FREE BAYER CONTOUR USB METER 1 METER FREE BAYER CONTOUR TEST STRIPS 50 S 1 BOX $47.99 BAYER CONTOUR TEST STRIPS 100 S 1 BOX $93.99 BAYER BREEZE 2 METER KIT 1 METER FREE BAYER BREEZE 2 TEST DISCS 50'S 1 BOX $48.99 BAYER BREEZE 2 TEST DISCS 100'S 1 BOX $93.99 LIFESTYLE MEDICATIONS Birth Control Special Price at $12 for 1-month supply MONONESSA TAB 28 TRINESSA TAB 28 $21.99 for 1-month supply MICROGESTIN 1.5/30 FE TAB 28 MICROGESTIN 1/20 FE TAB 28 RECLIPSEN 0.15MG-30MCG TAB 28 $23.99 for 1-month supply LOW-OGESTREL TAB 28 NECON 1/35 TAB 28 $24.99 for 1-month supply JOLIVETTE 0.35MG TAB 28 $25.99 for 1-month supply LEVORA 0.15/30 TAB 28 LUTERA TAB 28 Membership fee required ($20 individual or $35 family per year). Persons receiving benefits from Medicare, Medicaid or other federal or state healthcare programs are ineligible. Some restrictions apply to 10% bonus. Pet medications are for human-equivalent medications only. Membership may be cancelled within 30 days of issue date for a full refund. If by the end of the 1-year membership, member has not achieved total savings on all eligible Pharmacy and Walgreens Bonus Program items and services purchased with the PSC card that is equal to or greater than membership fee, member is eligible for store credit equal to the difference between membership fee and the member's total savings. For complete terms and conditions, call or visit Walgreens.com/rxsavingsclub. WAGDCO, LLC, 104 Wilmot Road, Deerfield, IL THIS PROGRAM DOES NOT CONSTITUTE INSURANCE. *List of drugs is not all-inclusive. Ask your Walgreens pharmacist if your medication is a value-priced generic. Drug names are the property of their respective owners Walgreen Co. All rights reserved. 12SC Revised: 01/13/2014

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