MENTAL HEALTH Amitriptyline 10, 25 mg Benztropine 0.5, 1,2 mg Buspirone 5, 10, 15 mg Citalopram 10, 20, 40 mg Divalproex DR 125, 250, 500 mg (2/day) Donepezil 5, 10 mg Dulaxetine 20, 30, 60 mg Escitalopram 5, 10, 20 mg Fluoxetine 10, 20 mg cap/40 mg cap Hydraxyzine Pamoate 25, 50 mg Imipramine 10, 25 mg Lamotrigine 25, 100, 150, 200 mg (2/day Lithium 150, 300 mg CAP R WEBB'S PRESCRIPTION SAVINGS PROGRAM WEBB'S PRESCRIPTION SAVINGS PROGRAM Tier Tier I Tier Tier Tier I 100 DAYS 200 DAYS 365 DAYS TIER TIER I $20 $10 $20 TIER II $35 $65 $100 Tier Tier Ill $37 AKRON (574) 893-4413 NORTH MANCHESTER (260) 982-1000 ROCHESTER (574) 223-2216 www.webbrx.com $30 $60 Webb's Tier ll Tier Terl Tier I FAMILY PHARMACY HEART HEALTH AND BLOOD PRESSSURE Tier I Tier Acebutolol 200mg Amiodarone 200 mg Amlodipine 2.5, 5, 10 mg Atenolol 25, 50, 100 mg Benazepril 5, 10, 20, 40 mg Carvedilol (2/day) 3.125, 6.25, 12.5,25 mg Clonidine 0.1,0.2,0.3 mg tab Clopidogrel 75 mg Diltiazem 120, 180 ER (CD) Doxazosin 1, 2, 4, 8 mg Enalapril 2.5, 5, 10, 20 mg Fosinopril 10, 20, 40 mg Furosemide 20, 40, 80 mg HCTZ 12.5 mg cap/tab, 25, 50 mg tab Hydralazine 10, 25/50 mg Irbesartan 75, 150, 300 mg Tier TierI Tier II Mirtazapine 15, 30 mg tab Nortriptyline 10, 25, 50 mg Tier Ill Tier I Tier Il Tier I TierI Tier I Save Time-Save Money on the medicine you take every day Olanzapine 2.5, 5, 7.5, 10 mg Oxcarbazepine 150, 300 mg Paroxetine 10, 20, 30, 40 mg Primidone 50 mg Quetiapine 25, 50, 100 mg Risperidone 0.25, 0.5, 1,2, 3,4 mg Sertraline 25, 50, 100 mg Topiramate (2/day)25, 50, 100, 200 mg Trazodone 50, 100 mg Venlafaxine ER 37.5, 75, 150 mg cap Zonisamide 25, 50, 100 mg PARKINSON'S/RESTLESS LEGS No cost to join, simply take the list to your doctor and start saving today Tier l Formulary list is subject to change at anytime without notice-Please refer to website for updates Program prices cannot be pro-rated and all prices are based on one dose per day unless specified oftherwise If you do not see your drug on the list, please ask and we will be sure to give you a competitive price Tier I Tier i Tier I Tier I Tier II Tier I Tier Tier ill Tier Ill Tier I 100 DAYS 200 DAYS 365 DAYS $10 TIERI TIER II TIER II $20 $20 $35 $65 Tier Il Tier Ill Tier I Tier II $37 $60 $100 Tier Tier Ill $30 Tier I Tierl Tier Ter ALLERGIES Cetirizine 10 mg Fluticasone Nasal Spray (3 inhalers) Hydroxyzine HCI 10, 25, 50 mg Levocetirizine 5 mg Loratadine 10 mg DIABETES Tier Il Tier Il Pramipexole 0.125,0.25,0.5,0.75, 1,15 mg Ropinirole 0.25, 0.5, 1,2, 3,4,5 mg Tier Tier Tier I Tier Tier Il Easy Touch Lancets (3x100) Glimepiride 1, 2,4 mg Gipizide 5, 10 mg Glipizide ER, 2.5, 5 mg Ghburide Micronized 1.5, 3 mg Gyturide Metbormin 125/250,15/500 5/50 (2da Tier l Isosorbide Mononitrate 30, 60 mg Lisinopril 2.5, 5, 10, 20, 30, 40 mg Lisinopril HCTZ 10/12.5,20/125,20/25 mg Losartan 25, 50, 100 mg Losartan-HCTZ 50/12.5, 100/12.5, 100/25 Metoprolol Tartate (2/day) 25, 50, 100 mg Potassium Chloride 10, 20 meq Quinapril 5, 10, 20, 40 mg Tier Il Tier Il Tier Il Tier I WOMEN'S HEALTH Anastrozole 1 mg Estradiol 0.5, 1, 2 mg evonorgestrelEthinyl Esradiol 0.1/0.02 mg packs Tier Il Medroxyprogesterone 2.5, 5, 10 mg Tier Norethindrone 0.35 mg (3 packs) Norethindrone/Ethinyl Estradiol 1 me02 g 3padsi Tier lIl Prenatal Plus Sprintec (3 packs) Trinessa Lo (3 packs) Tri-Sprintec (3 packs) Tier I Tier Tier Il Tier Il Tier I Tier Il Tier TierI Tier I ARTHRITIS AND PAIN Cyclobenzaprine 5, 10 mg Diclofenac DR 50, 75 mg Gabapentin 100, 300, 400/600, 800 mg lbuprofen 400, 600, 800 mg Indomethacin 25, 50 mg Tierl Metformin (2/day) 500, 500 ER, 850, 1000mg Tier Tier l Tier Il Tier Pioglitazone 15, 30, 45 mg Tier Ill Tier Tier /Tier Tier I Ramipril 2.5, 5, 10 mg Spironolactone 25 mg/50 mg Terazosin 1, 2, 5, 10 mg Torsemide 5, 10, 20 mg Triaterene/HCTZ 375/25 cap/tab, 75/25 mg tab- Valsartan 80, 160 mg Valsartan/HCTZ 80/12.5, 160/12.5, 160/25mg Verapamil 80, 120 mg tab Verapamil ER, 120, 180 mg tab Warfarin-all strengths TierI Tier I Tier I Tier I Tier Ill Tier l Ter Tier GASTROINTESTINAL HEALTH Tier I Tier Tier Tier II Dicyclomine 10, 20 mg Famotidine (2/day) 20 mg/40 mg Tier Ill Meloxicam 7.5, 15 mg Tier II Tier /Tier l Tier Naproxen (2/day) 375, 500 mg Tier II OTHER MEDICAL CONDITIONS Acyclovir 200, 400 mg Alendronate 35, 70 mg Allopurinol 100, 300 mg Folic Acid 1 mg Latanoprost Opth (3x2.5ml) Megestrol 20 mg Methimazole 5, 10 mg Poly-iron 150mg/Poly-iron 150mg Forte Prednisone 1, 2.5, 5, 10, 20 mg Terbinafine 250 mg Timolol 0.25 % , 0.5% opth. (15ml) Metoclopramide (2/day) 5, 10 mg Omeprazole 10, 20, 40 mg Pantoprazole 20, 40 mg Ranitidine 150mg/300mg Tier I Tier ASTHMA Montelukast 4, 5, 10 mg tablet CHOLESTEROL Tier Ill Tier I Tier Il Tier Il Tier Il Tier I Tier I Tier I Tier /Tier Tier lIl Tier II Tier Tier Il Tier Tier Il Tier Tier II Atorvastatin 10, 20, 40, 80 mg Gemfibroil (2/day) 600 mg Lovastatin 10, 20, 40 mg Pravastatin 10, 20, 40 mg Rosuvastatin 5, 10, 20, 40 mg Simvastatin 5, 10, 20, 40/80 mg MEN'S HEALTH Finasteride 5 mg Sildenafil 25, 50, 100 mg-4 tabs Tamsulosin 0.4 mg Ter er Tier I Tier Ill Tier Il Tier II Tier Ill Tier I Tier Il Tier Tierl UFDATED 1/2019 Tier MENTAL HEALTH Amitriptyline 10, 25 mg Benztropine 0.5, 1,2 mg Buspirone 5, 10, 15 mg Citalopram 10, 20, 40 mg Divalproex DR 125, 250, 500 mg (2/day) Donepezil 5, 10 mg Dulaxetine 20, 30, 60 mg Escitalopram 5, 10, 20 mg Fluoxetine 10, 20 mg cap/40 mg cap Hydraxyzine Pamoate 25, 50 mg Imipramine 10, 25 mg Lamotrigine 25, 100, 150, 200 mg (2/day Lithium 150, 300 mg CAP R WEBB'S PRESCRIPTION SAVINGS PROGRAM WEBB'S PRESCRIPTION SAVINGS PROGRAM Tier Tier I Tier Tier Tier I 100 DAYS 200 DAYS 365 DAYS TIER TIER I $20 $10 $20 TIER II $35 $65 $100 Tier Tier Ill $37 AKRON (574) 893-4413 NORTH MANCHESTER (260) 982-1000 ROCHESTER (574) 223-2216 www.webbrx.com $30 $60 Webb's Tier ll Tier Terl Tier I FAMILY PHARMACY HEART HEALTH AND BLOOD PRESSSURE Tier I Tier Acebutolol 200mg Amiodarone 200 mg Amlodipine 2.5, 5, 10 mg Atenolol 25, 50, 100 mg Benazepril 5, 10, 20, 40 mg Carvedilol (2/day) 3.125, 6.25, 12.5,25 mg Clonidine 0.1,0.2,0.3 mg tab Clopidogrel 75 mg Diltiazem 120, 180 ER (CD) Doxazosin 1, 2, 4, 8 mg Enalapril 2.5, 5, 10, 20 mg Fosinopril 10, 20, 40 mg Furosemide 20, 40, 80 mg HCTZ 12.5 mg cap/tab, 25, 50 mg tab Hydralazine 10, 25/50 mg Irbesartan 75, 150, 300 mg Tier TierI Tier II Mirtazapine 15, 30 mg tab Nortriptyline 10, 25, 50 mg Tier Ill Tier I Tier Il Tier I TierI Tier I Save Time-Save Money on the medicine you take every day Olanzapine 2.5, 5, 7.5, 10 mg Oxcarbazepine 150, 300 mg Paroxetine 10, 20, 30, 40 mg Primidone 50 mg Quetiapine 25, 50, 100 mg Risperidone 0.25, 0.5, 1,2, 3,4 mg Sertraline 25, 50, 100 mg Topiramate (2/day)25, 50, 100, 200 mg Trazodone 50, 100 mg Venlafaxine ER 37.5, 75, 150 mg cap Zonisamide 25, 50, 100 mg PARKINSON'S/RESTLESS LEGS No cost to join, simply take the list to your doctor and start saving today Tier l Formulary list is subject to change at anytime without notice-Please refer to website for updates Program prices cannot be pro-rated and all prices are based on one dose per day unless specified oftherwise If you do not see your drug on the list, please ask and we will be sure to give you a competitive price Tier I Tier i Tier I Tier I Tier II Tier I Tier Tier ill Tier Ill Tier I 100 DAYS 200 DAYS 365 DAYS $10 TIERI TIER II TIER II $20 $20 $35 $65 Tier Il Tier Ill Tier I Tier II $37 $60 $100 Tier Tier Ill $30 Tier I Tierl Tier Ter ALLERGIES Cetirizine 10 mg Fluticasone Nasal Spray (3 inhalers) Hydroxyzine HCI 10, 25, 50 mg Levocetirizine 5 mg Loratadine 10 mg DIABETES Tier Il Tier Il Pramipexole 0.125,0.25,0.5,0.75, 1,15 mg Ropinirole 0.25, 0.5, 1,2, 3,4,5 mg Tier Tier Tier I Tier Tier Il Easy Touch Lancets (3x100) Glimepiride 1, 2,4 mg Gipizide 5, 10 mg Glipizide ER, 2.5, 5 mg Ghburide Micronized 1.5, 3 mg Gyturide Metbormin 125/250,15/500 5/50 (2da Tier l Isosorbide Mononitrate 30, 60 mg Lisinopril 2.5, 5, 10, 20, 30, 40 mg Lisinopril HCTZ 10/12.5,20/125,20/25 mg Losartan 25, 50, 100 mg Losartan-HCTZ 50/12.5, 100/12.5, 100/25 Metoprolol Tartate (2/day) 25, 50, 100 mg Potassium Chloride 10, 20 meq Quinapril 5, 10, 20, 40 mg Tier Il Tier Il Tier Il Tier I WOMEN'S HEALTH Anastrozole 1 mg Estradiol 0.5, 1, 2 mg evonorgestrelEthinyl Esradiol 0.1/0.02 mg packs Tier Il Medroxyprogesterone 2.5, 5, 10 mg Tier Norethindrone 0.35 mg (3 packs) Norethindrone/Ethinyl Estradiol 1 me02 g 3padsi Tier lIl Prenatal Plus Sprintec (3 packs) Trinessa Lo (3 packs) Tri-Sprintec (3 packs) Tier I Tier Tier Il Tier Il Tier I Tier Il Tier TierI Tier I ARTHRITIS AND PAIN Cyclobenzaprine 5, 10 mg Diclofenac DR 50, 75 mg Gabapentin 100, 300, 400/600, 800 mg lbuprofen 400, 600, 800 mg Indomethacin 25, 50 mg Tierl Metformin (2/day) 500, 500 ER, 850, 1000mg Tier Tier l Tier Il Tier Pioglitazone 15, 30, 45 mg Tier Ill Tier Tier /Tier Tier I Ramipril 2.5, 5, 10 mg Spironolactone 25 mg/50 mg Terazosin 1, 2, 5, 10 mg Torsemide 5, 10, 20 mg Triaterene/HCTZ 375/25 cap/tab, 75/25 mg tab- Valsartan 80, 160 mg Valsartan/HCTZ 80/12.5, 160/12.5, 160/25mg Verapamil 80, 120 mg tab Verapamil ER, 120, 180 mg tab Warfarin-all strengths TierI Tier I Tier I Tier I Tier Ill Tier l Ter Tier GASTROINTESTINAL HEALTH Tier I Tier Tier Tier II Dicyclomine 10, 20 mg Famotidine (2/day) 20 mg/40 mg Tier Ill Meloxicam 7.5, 15 mg Tier II Tier /Tier l Tier Naproxen (2/day) 375, 500 mg Tier II OTHER MEDICAL CONDITIONS Acyclovir 200, 400 mg Alendronate 35, 70 mg Allopurinol 100, 300 mg Folic Acid 1 mg Latanoprost Opth (3x2.5ml) Megestrol 20 mg Methimazole 5, 10 mg Poly-iron 150mg/Poly-iron 150mg Forte Prednisone 1, 2.5, 5, 10, 20 mg Terbinafine 250 mg Timolol 0.25 % , 0.5% opth. (15ml) Metoclopramide (2/day) 5, 10 mg Omeprazole 10, 20, 40 mg Pantoprazole 20, 40 mg Ranitidine 150mg/300mg Tier I Tier ASTHMA Montelukast 4, 5, 10 mg tablet CHOLESTEROL Tier Ill Tier I Tier Il Tier Il Tier Il Tier I Tier I Tier I Tier /Tier Tier lIl Tier II Tier Tier Il Tier Tier Il Tier Tier II Atorvastatin 10, 20, 40, 80 mg Gemfibroil (2/day) 600 mg Lovastatin 10, 20, 40 mg Pravastatin 10, 20, 40 mg Rosuvastatin 5, 10, 20, 40 mg Simvastatin 5, 10, 20, 40/80 mg MEN'S HEALTH Finasteride 5 mg Sildenafil 25, 50, 100 mg-4 tabs Tamsulosin 0.4 mg Ter er Tier I Tier Ill Tier Il Tier II Tier Ill Tier I Tier Il Tier Tierl UFDATED 1/2019 Tier