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.†
The price may be as low as:


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
Blood Pressure/Heart Health (cont.)
Antifungal
Drug Name
FLUCONAZOLE 150MG TAB
TERBINAFINE 250MG TAB
Tier
2
2
Quantity
30 90
1
30
3
90
Antiviral
Drug Name
ACYCLOVIR 200MG CAPS
Tier
3
Arthritis or Pain
Drug Name
BACLOFEN 10MG TAB
CYCLOBENZAPRINE 5MG TAB
CYCLOBENZAPRINE 10MG TAB
DICLOFENAC SODIUM 75MG EC 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 30MG/ML INJ, 2ML
MELOXICAM 7.5MG TAB
MELOXICAM 15MG TAB
NAPROXEN 250MG TAB
NAPROXEN 500MG TAB
NAPROXEN 375MG TAB
NAPROXEN DR 500MG TAB
Tier
3
2
2
3
2
2
2
2
2
1
3
3
3
2
2
2
2
2
3
Quantity
30 90
60
180
Quantity
30 90
30
30
30
60
120
90
60
60
60
30
90
60
15
30
30
60
60
60
60
90
90
90
180
360
270
180
180
180
90
270
180
45
90
90
180
180
180
180
Asthma
Drug Name
ALBUTEROL 0.083% INH SOLN 25X3ML
AMINOPHYLLINE 100MG TAB
AMINOPHYLLINE 200MG TAB
DYPHYLLINE-GG 100-100 ELIXIR
DYPHYLLIN-GG TAB
IPRATROPIUM INHAL SOLN 60 X 2.5ML
Tier
2
2
2
2
3
2
Quantity
30 90
75
60
60
240
30
75
225
180
180
720
90
225
Blood Pressure/Heart Health
Drug Name
AMILORIDE 5MG / HCTZ 50MG TAB
AMIODARONE 200MG TAB
AMLODIPINE BESYLATE 2.5MG TAB
AMLODIPINE BESYLATE 5MG TAB
Tier
2
2
2
2
Quantity
30 90
30
30
30
30
90
90
90
90
Drug Name
AMLODIPINE BESYLATE 10MG TAB
ATENOLOL 100MG 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
CARVEDILOL 3.125MG TAB
CARVEDILOL 6.25MG TAB
CARVEDILOL 12.5MG TAB
CARVEDILOL 25MG TAB
CLONIDINE 0.1MG TAB
CLONIDINE 0.2MG TAB
CLONIDINE 0.3MG TAB
DILTIAZEM 30MG TAB
DILTIAZEM 60MG TAB
DILTIAZEM 120MG TAB
DOXAZOSIN 1MG TAB
DOXAZOSIN 2MG TAB
DOXAZOSIN 4MG TAB
ENALAPRIL 2.5MG TAB
ENALAPRIL 5MG TAB
ENALAPRIL-HCTZ 5-12.5MG TAB
ENALAPRIL-HCTZ 10-25MG TAB
FOSINOPRIL 10MG TAB
FOSINOPRIL 20MG TAB
FOSINOPRIL 40MG TAB
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
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 30MG ER TAB
ISOSORBIDE MONONITRATE 60MG ER TAB
LISINOPRIL 2.5MG TAB
LISINOPRIL 5MG TAB
Tier
3
1
2
2
3
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
3
2
3
3
3
2
2
2
2
2
2
3
3
1
1
1
2
2
1
2
2
3
1
1
2
2
2
3
2
2
2
2
Quantity
30 90
30
30
60
60
30
30
30
30
30
30
30
30
30
60
60
60
60
60
60
60
60
60
30
30
30
30
60
60
60
30
30
30
30
90
60
60
30
30
30
60
60
30
30
30
30
30
30
30
120
30
30
30
30
90
90
180
180
90
90
90
90
90
90
90
90
90
180
180
180
180
180
180
180
180
180
90
90
90
90
180
180
180
90
90
90
90
270
180
180
90
90
90
90
180
90
90
90
90
90
90
90
360
90
90
90
90
Blood Pressure/Heart Health (cont.)
Drug Name
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
METHYLDOPA 250MG TAB
METHYLDOPA 500MG TAB
METOPROLOL TARTRATE 25MG TAB
METOPROLOL TARTRATE 50MG TAB
METOPROLOL TARTRATE 100MG TAB
PRAZOSIN 1MG CAP
PROPRANOLOL 60MG TAB
QUINAPRIL 5MG TAB
QUINAPRIL 10MG TAB
QUINAPRIL 20MG TAB
QUINAPRIL 40MG TAB
RAMIPRIL 1.25MG CAP
SOTALOL 120MG TAB
SPIRONOLACTONE 25MG TAB
SPIRONOLACTONE 50MG 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
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
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
Tier
1
1
2
2
2
2
2
3
3
2
2
2
3
3
2
2
3
2
3
2
2
2
2
2
2
2
3
3
3
3
2
2
2
2
3
1
3
1
2
2
2
2
2
2
2
2
2
2
Quantity
30 90
30
30
30
30
30
30
30
60
60
60
60
60
30
60
30
30
30
30
30
60
30
30
30
30
30
30
60
30
30
30
30
30
30
30
30
30
60
30
30
30
30
30
30
30
30
30
30
30
90
90
90
90
90
90
90
180
180
180
180
180
90
180
90
90
90
90
90
180
90
90
90
90
90
90
180
90
90
90
90
90
90
90
90
90
180
90
90
90
90
90
90
90
90
90
90
90
Cholesterol
Drug Name
FENOFIBRATE 54MG TAB
LOVASTATIN 10MG TAB
LOVASTATIN 20MG TAB
LOVASTATIN 40MG TAB
PRAVASTATIN 10MG TAB
PRAVASTATIN 20MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 10MG TAB
SIMVASTATIN 20MG TAB
SIMVASTATIN 40MG TAB
SIMVASTATIN 80MG TAB
Eye Care (cont.)
Tier
3
2
2
2
2
2
2
2
2
3
3
ALLER-CHLOR 4MG TAB
BENZONATATE 100MG CAP
BENZONATATE 200MG CAP
CETIRIZINE 1MG/ML SYRUP
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
30
30
30
30
30
30
30
30
30
30
30
90
90
90
90
90
90
90
90
90
90
90
Tier
1
2
3
3
3
2
2
3
2
3
1
3
3
3
2
2
1
2
2
Quantity
30 90
100
30
30
120
120
120
180
240
30
16
30
30
120
120
240
30
12
60
180
300
90
90
360
360
360
540
720
90
48
90
90
360
360
720
90
36
180
540
Cough/Cold/Allergy (cont.)
Drug Name
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
Tier
3
3
3
1
1
3
3
Quantity
30 90
30
240
150
120
120
30
120
90
720
450
360
360
90
360
Diabetes
Drug Name
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
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
METFORMIN 500MG TAB
METFORMIN 850MG TAB
METFORMIN 1000MG TAB
METFORMIN ER 500MG 24HR TAB
Tier
1
1
2
1
2
3
3
3
1
2
2
1
1
2
2
2
1
1
1
1
Quantity
30 90
30
30
30
30
60
30
60
30
30
30
30
30
30
30
60
60
90
90
60
60
90
90
90
90
180
90
180
90
90
90
90
90
90
90
180
180
270
270
180
180
Ear Care
Drug Name
ACETIC ACID 2% OTIC SOLN
ANTIPYRINE BENZOCAINE OTIC SOL 15ML
Drug Name
BACITRACIN/POLYMYX OPHTHOINT 3.5GM
ERYTHROMYCIN OPHTH OINT 3.5GM
GENTAMICIN 0.3% 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
Infections (cont.)
Tier
3
2
2
2
3
2
2
2
2
2
Quantity
30 90
3.5
3.5
5
5
15
10
15
5
5
5
10.5
10.5
15
15
45
30
45
15
15
15
Gastrointestinal Health
Cough/Cold/Allergy
Drug Name
Quantity
30 90
Tier
3
2
Quantity
30 90
15
15
45
45
Drug Name
CIMETIDINE ORAL LIQ 300MG/5ML
DICYCLOMINE 10MG CAP
DICYCLOMINE 20MG TAB
DOC-Q-LACE 100MG CAP
FAMOTIDINE 20MG TAB
FAMOTIDINE 40MG TAB
METOCLOPRAMIDE 5MG TAB
METOCLOPRAMIDE 10MG TAB
METOCLOPRAMIDE HCL 5MG/5ML SOLN
NIZATIDINE 150MG CAP
RANITIDINE 150MG TAB
RANITIDINE 300MG TAB
Tier
3
2
2
2
2
3
2
2
1
3
2
2
Gout
Drug Name
ALLOPURINOL 100MG TAB
ALLOPURINOL 300MG TAB
Tier
2
3
Quantity
30 90
240
90
60
60
60
30
60
60
60
60
60
30
720
270
180
180
180
90
180
180
180
180
180
90
Quantity
30 90
60
60
180
180
Infections
Drug Name
AMOX-CLAV 200MG/5ML SUSP 100ML
AMOX-CLAV 400MG/5ML SUSP 100ML
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 80ML
AMOXICILLIN 250MG/5ML SUSP 100ML
AMOXICILLIN 250MG/5ML SUSP 150ML
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
CEFPROZIL 125MG/5ML SUSP 50ML
CEFPROZIL 125MG/5ML SUSP 75ML
CEFPROZIL 125MG/5ML SUSP 100ML
CEPHALEXIN 250MG CAP
CEPHALEXIN 500MG CAP
CIPROFLOXACIN 250MG TAB
CIPROFLOXACIN 500MG TAB
CIPROFLOXACIN 750MG TAB
CLINDAMYCIN 150MG CAP
CLINDAMYCIN 300MG CAP
METRONIDAZOLE 250MG TAB
METRONIDAZOLE 500MG TAB
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
Tier
3
3
1
1
2
3
2
2
2
1
1
1
1
1
1
1
1
3
3
2
3
3
3
3
1
2
1
1
3
3
3
2
3
2
2
2
2
1
1
Quantity
30 90
100
100
30
30
30
40
150
150
150
100
100
150
150
150
100
100
100
30
20
40
60
100
100
100
28
30
14
20
20
30
28
28
14
200
200
100
100
30
20
300
300
90
90
90
120
450
450
450
300
300
450
450
450
300
300
300
90
60
120
180
300
300
300
84
90
42
60
60
90
84
84
42
600
600
300
300
90
60
Drug Name
SMZ/TMP REGULAR STRENGTH TAB
SULFAMETH/TRIMETHOPRIM 800/160 TAB
TRIMETHOPRIM 100MG TAB
Tier
2
2
3
Quantity
30 90
28
28
30
84
84
90
Medical Devices
Drug Name
PROCHAMBER AERO SPACER
Tier
Quantity
30 90
Tier
Quantity
30 90
3
1
3
Mental Health
Drug Name
AMITRIPTYLINE 10MG TAB
AMITRIPTYLINE 25MG TAB
AMITRIPTYLINE 50MG TAB
BENZTROPINE 0.5MG TAB
BENZTROPINE 1MG TAB
BENZTROPINE 2MG TAB
BUSPIRONE 5MG TAB
BUSPIRONE 10MG TAB
CITALOPRAM 10MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 40MG TAB
CLOZAPINE 25MG TAB
DOXEPIN 10MG CAP
DOXEPIN 25MG CAP
DOXEPIN HCL 10MG/ML CONC 118ML
FLUOXETINE 10MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 40MG CAP
FLUPHENAZINE 2.5MG TAB
FLUVOXAMINE 25MG TAB
GABAPENTIN 100MG CAP
GABAPENTIN 250MG/5ML SOLN
HALOPERIDOL 0.5MG TAB
HALOPERIDOL 1MG TAB
HALOPERIDOL 2MG TAB
HYDROXYZINE 10MG/5ML SYRUP
HYDROXYZINE HCL 25MG TAB
HYDROXYZINE HCL 50MG TAB
HYDROXYZINE PAMOATE 25MG CAP
IMIPRAMINE 10MG TAB
IMIPRAMINE 25MG TAB
IMIPRAMINE 50MG TAB
LITHIUM CARBONATE 150MG CAP
LITHIUM CARBONATE 300MG CAP
LITHIUM CARBONATE 300MG TAB
LITHIUM CARBONATE 600MG CAP
METHOCARBAMOL 500MG TAB
METHOCARBAMOL 750MG TAB
MIRTAZAPINE 15MG TAB
NORTRIPTYLINE 10MG CAP
NORTRIPTYLINE 25MG CAP
NORTRIPTYLINE 75MG CAP
PAROXETINE 10MG TAB
PAROXETINE 20MG TAB
PAROXETINE 30MG TAB
PRAMIPEXOLE 0.25MG TAB
PRIMIDONE 50MG TAB
PROCHLORPERAZINE 5MG TAB
PROCHLORPERAZINE 10MG TAB
SERTRALINE 25MG TAB
SERTRALINE 50MG TAB
SERTRALINE 100MG TAB
TRAZODONE 50MG TAB
TRAZODONE 100MG TAB
TRAZODONE 150MG TAB
TRIHEXYPHENIDYL 2MG TAB
TRIHEXYPHENIDYL 5MG TAB
1
2
3
2
3
2
2
2
2
2
2
3
3
3
3
2
1
2
3
3
2
3
3
2
3
3
2
3
3
3
3
3
3
2
3
3
2
3
2
2
2
3
2
2
3
3
3
2
2
2
3
3
2
1
2
2
3
30
30
30
30
60
30
60
60
30
30
30
30
30
30
90
30
30
30
30
30
90
236
60
30
30
240
30
30
90
60
60
30
60
90
60
60
30
60
30
30
30
30
30
30
30
30
60
30
30
30
30
30
30
30
30
60
90
90
90
90
90
180
90
180
180
90
90
90
90
90
90
270
90
90
90
90
90
270
708
180
90
90
720
90
90
270
180
180
90
180
270
180
180
90
180
90
90
90
90
90
90
90
90
180
90
90
90
90
90
90
90
90
180
270
Urinary Health
Mouth/Throat/Dental
Drug Name
CHLORHEXIDINE ORAL RINSE 473ML
LIDOCAINE VISCOUS 2% ORAL SOL 100ML
SF 5000 PLUS 1.1% CREAM 51GM
SOD FLUORIDE 0.2% MINT SOLUTION
STANNOUS FLUORIDE 0.63% RINSE
Tier
Quantity
30 90
2
2
3
2
3
473 1419
100 300
60 180
473 1419
300 900
BENZOYL PEROXIDE 5% AQ GEL 60GM
BETAMETHASONE VAL 0.1% CRM 15GM
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 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
Tier
3
3
2
2
2
3
3
3
3
3
3
3
3
2
1
2
2
3
3
3
Quantity
30 90
60 180
15
45
28.35 85.05
28.35 85.05
30
90
60 180
60 180
30
90
15
45
45 135
60 180
15
45
177 531
118 354
15
45
15
45
80 240
80 240
236.6 709.8
18
54
Thyroid Conditions
Drug Name
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
Tier
2
2
2
2
2
2
2
2
2
2
2
2
2
2
3
3
Quantity
30 90
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
60
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
180
Tier
OXYBUTYNIN 5MG/5ML SYRUP
3
240
720
Vitamins and Nutritional Health
Drug Name
Skin Conditions
Drug Name
Drug Name
Women’s Health
Quantity
30 90
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 10
KLOR-CON 10MEQ TAB
MULTIVIT/F 0.25MG CHEWABLE TAB
MULTI-VITA-F 0.5MG CHEW TAB
MULTI-VIT/FLUORIDE 1MG CHEW TAB
MULTIVITAMINS W/ FL 1.0MG CHEW TAB
MULTIVITS W/FL 1MG & IRON CHEW TAB
NATALCARE PLUS TAB (1MG FOLIC ACID)
POLY-IRON 150 CAP
POLY-IRON 150 FORTE CAP
POTASSIUM CL 10MEQ ER TAB
PRENAFIRST TAB
PRENATAB FA 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
THEROBEC PLUS TAB
VINATE AZ TAB
VINATE CARE CHEWABLE TAB
VINATE C TAB
VINATE GT TAB
VINATE M TAB
VINATE ONE TAB
VITAMIN B-12 100MCG TAB
VITAMIN D 50,000IU CAP
Tier
3
3
3
2
2
1
2
3
3
3
1
2
3
3
2
1
2
3
1
1
3
3
3
3
3
2
3
3
3
2
3
3
3
3
3
2
2
2
1
1
Quantity
30 90
30
30
60
45
120
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
60
45
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
100
4
90
90
180
135
360
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
180
135
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
300
12
Drug Name
ALENDRONATE 10MG TAB
ALENDRONATE 35MG TAB
ALENDRONATE 70MG TAB
CLOMIPHENE CITRATE 50MG TAB
ESTRADIOL 0.5MG TAB
ESTRADIOL 1MG TAB
ESTRADIOL 2MG TAB
ESTROPIPATE 0.625MG (0.75MG) TAB
MEDROXYPROGESTERONE 2.5MG TAB
MEDROXYPROGESTERONE 5MGTAB
MEDROXYPROGESTERONE 10MGTAB
MEGESTROL ACETATE 20MG TAB
Tier
3
3
3
2
1
1
1
3
2
1
1
2
Quantity
30 90
30
4
4
5
30
30
30
30
30
30
10
30
90
12
12
15
90
90
90
90
90
90
30
90
Other
Drug Name
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
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
Tier
2
2
3
3
2
2
3
2
2
3
2
3
2
2
1
2
Quantity
30 90
60
12
30
45
30
30
50
100
50
60
30
90
60
30
30
30
180
36
90
135
90
90
150
300
150
180
90
270
180
90
90
90
VALUE BRAND-NAME
LIFESTYLE MEDICATIONS
Insulins
LEVEMIR FLEXTOUCH PEN
LEVEMIR 100 UNITS/ML VIAL
NOVOLIN N 100 UNITS/ML VIAL
NOVOLIN R 100 UNITS/ML VIAL
NOVOLIN 70/30 100 UNIT/ML VIAL
NOVOLOG MIX 70/30 VIAL
NOVOLOG MIX 70/30 FLEXPEN
NOVOLOG FLEXPEN
NOVOLOG PENFILL 3 ML
NOVOLOG 100 UNIT/ML VIAL
1 BOX
1 VIAL
1 VIAL
1 VIAL
1 VIAL
1 VIAL
1 BOX
1 BOX
1 BOX
1 VIAL
$367.19
$244.79
$104.68
$104.68
$104.68
$240.26
$426.00
$426.00
$418.83
$241.68
MONONESSA TAB
WALGREENS TRUE METRIX METER
1 METER
WALGREENS TRUE METRIX STRIPS 25’S 1 BOX
WALGREENS TRUE METRIX STRIPS 50’S 1 BOX
WALGREENS TRUE METRIX STRIPS 100’S 1 BOX
FREE
$19.99
$29.99
$52.99
CONTOUR NEXT METER
CONTOUR NEXT EZ METER
CONTOUR NEXT ONE
1 METER
1 METER
1 METER
FREE
FREE
FREE
CONTOUR NEXT STRIPS 25’S
CONTOUR NEXT STRIPS 50’S
CONTOUR NEXT STRIPS 100’S
1 BOX
1 BOX
1 BOX
$23.99
$39.99
$78.99
CONTOUR TEST STRIPS 50’S
CONTOUR TEST STRIPS 100’S
1 BOX
1 BOX
$47.99
$93.99
BREEZE 2 TEST DISCS 100'S
1 BOX
$93.99
28
$18.99 for 1-month supply
MICROGESTIN 1.5/30 FE TAB
MICROGESTIN 1/20 FE TAB
28
28
90-day supply of a
value-priced generic
Tier 1
Tier 2
Tier 3
$50.41
$52.54
$118.08
Commonly prescribed quantities
of all other generics
$21.79
Brand-name drugs
$31.16
$24.99 for 1-month supply
LEVORA 0.15/30 TAB
RECLIPSEN 0.15MG-30MCG TAB
Diabetic Supplies
AVERAGE SAVINGS-
Birth Control –
Special Price at $12 for 1-month supply
28
28
$26.99 for 1-month supply
LOW-OGESTREL TAB
NECON 1/35 TAB
28
28
$29.99 for 1-month supply
JOLIVETTE 0.35MG TAB
LUTERA TAB
28
28
Discounted Lifestyle Medications
CIALIS 5MG TAB (QTY 6)
CIALIS 10MG TAB (QTY 6)
CIALIS 20MG TAB (QTY 6)
VIAGRA 50MG TAB (QTY 6)
VIAGRA 100MG TAB (QTY 6)
$58.99
$319.99
$349.99
$299.99
$299.99
This Program is NOT Insurance. Membership fee required ($20 individual or $35 family per year). Persons receiving benefits from a Medicare or Medicaid
program are ineligible. Program offers Member the right to purchase specified health care services from participating providers at a discounted rate. The
average savings on purchases of a 90-day supply of a value-priced generic at: Tier 1 ($10) $50.41; Tier 2 ($20) $52.54; Tier 3 ($30) $118.08. The average
savings for purchase of commonly prescribed quantities of covered: (i) brand-name drugs is $31.16 and (ii) generics that are not value-priced is $21.79.
Amount of the discount may vary based on type of item/service Member purchases but provider will not charge Member more than the discounted rate.
Program does not make any payments to providers. Member is entirely responsible for paying discounted price to provider at time of service. Membership may
be cancelled within 30 days of the enrollment effective date for a full refund. To request: (i) a list of discounted services; (ii) a list of participating providers
(name, city, state, specialty) and/or (iii) the full terms and conditions of the Program before joining, call 866-922-7312 or visit Walgreens.com/RxSavingsClub.
WAGDCO, LLC, 104 Wilmot Rd., Deerfield, IL 60015 is a discount medical plan organization regulated by State Insurance Commissioners.
The Program does not meet the minimum creditable coverage requirements under Mass. Gen. Law c. 111M and 956 CMR 5.00.
The Program is not a Medicare prescription drug plan.
*List of drugs is not all-inclusive. Ask your Walgreens pharmacist if your medication is a value-priced generic.
†The day supply is based on the average quantity dispensed for the specific drug and strength as indicated in the list. Larger quantities cost more.
Drug names are the property of their respective owners.
©2015 Walgreen Co. All rights reserved. 000026550-626-642 - Revised: 04/18/2017