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List Effective October 5, 2006 WAL-MART/SAM'S $4 PROGRAM Therapeutic Category Medication ANTIVIRAL ACYCLOVIR 200MG ASTHMA ALBUTEROL 0.5% NEB CAP ASTHMA ALBUTEROL 2MG TAB ASTHMA ALBUTEROL 2MG/5ML SYP ASTHMA ALBUTEROL 4MG MISCELLANEOUS ALLOPURINOL 100MG TAB TAB MISCELLANEOUS ALLOPURINOL 300MG TAB COUGH COLD AMIBID DM 30600CR TAB CARDIAC AMILOR/HCTZ 550 ANTIDEPRESSANT AMITRIPTYLIN 100MG TAB ANTIDEPRESSANT AMITRIPTYLIN 10MG TAB ANTIDEPRESSANT AMITRIPTYLIN 25MG TAB ANTIDEPRESSANT AMITRIPTYLIN 50MG TAB ANTIDEPRESSANT AMITRIPTYLIN 75MG TAB ANITBIOTIC AMOXICILLIN 125/5ML SUS ANITBIOTIC AMOXICILLIN 125/5ML SUS ANITBIOTIC AMOXICILLIN 125/5ML SUS ANITBIOTIC AMOXICILLIN 200/5ML SUS ANITBIOTIC AMOXICILLIN 250/5ML SUS ANITBIOTIC AMOXICILLIN 250/5ML SUS ANITBIOTIC AMOXICILLIN 250/5ML SUS ANITBIOTIC AMOXICILLIN 250MG CAP ANITBIOTIC AMOXICILLIN 250MG CAP ANITBIOTIC AMOXICILLIN 400/5ML SUS ANITBIOTIC AMOXICILLIN 400/5ML SUS ANITBIOTIC AMOXICILLIN 500MG CAP ANITBIOTIC AMOXICILLIN 500MG CAP TAB ANITBIOTIC AMOXIL 50MG/ML ANALGESICS ANTIPY/BENZO OTIC SOL DRO CARDIAC ATENOL/CHLOR 5025MGTAB CARDIAC ATENOLOL 100MG TAB CARDIAC ATENOLOL 25MG TAB CARDIAC ATENOLOL 50MG TAB CARDIAC ATENOLOL 50MG TAB GLUCOMA EYE ATROPINE SUL 1% OP SOL ANITBIOTIC BACITRACIN OP ANALGESICS BACLOFEN 10MG OIN GASTRO INTESTINAL BELLA ALK/PB CARDIAC BENAZEPRIL 10MG TAB CARDIAC BENAZEPRIL 20MG TAB CARDIAC BENAZEPRIL 40MG TAB CARDIAC BENAZEPRIL 5MG TAB COUGH COLD BENZONATATE 100MG CAP PARKINSONS BENZTROPINE 2MG TAB TAB TAB ANTI INFLAMMATORY BETAMETH DIP 0.05% CRE ANTI INFLAMMATORY BETAMETH DIP 0.05% CRE ANTI INFLAMMATORY BETAMETH VAL 0.1% CRE ANTI INFLAMMATORY BETAMETH VAL 0.1% CRE ANTI INFLAMMATORY BETAMETH VAL 0.1% OIN ANTI INFLAMMATORY BETAMETH VAL 0.1% OIN CARDIAC BISOPR/HCTZ 2.5/6.25TAB CARDIAC BISOPR/HCTZ 56.25MGTAB CARDIAC BUMETANIDE 0.5MG CARDIAC CAPTOPRIL 100MG CARDIAC CAPTOPRIL 12.5MG TAB CARDIAC CAPTOPRIL 25MG TAB CARDIAC CAPTOPRIL 50MG TAB SEIZURE CARBAMAZEPINE 200MG TAB ANITBIOTIC CEPHALEXIN 250MG CAP ANITBIOTIC CEPHALEXIN 250MG CAP ANITBIOTIC CEPHALEXIN 500MG CAP ANITBIOTIC CEPHALEXIN 500MG CAP MISCELLANEOUS CHLORHEX GLU 0.12% SOL TAB TAB DIABETES CHLORPROPAM 100MG TAB CARDIAC CHLORTHALID 25MG CARDIAC CHLORTHALID 50MG GASTRO INTESTINAL CIMETIDINE 800MG TAB TAB TAB ANITBIOTIC CIPROFLOXACN 500MG TAB ANTIDEPRESSANT CITALOPRAM 20MG CARDIAC CLONIDINE 0.1MG TAB CARDIAC CLONIDINE 0.1MG TAB CARDIAC CLONIDINE 0.2MG TAB CARDIAC CLONIDINE 0.2MG TAB MISCELLANEOUS COLCHICINE 0.6MG COUGH COLD CPM/PSE 8120 CR ANALGESICS CYCLOBENZAPR 10MG TAB TAB TAB CAP GASTRO INTESTINAL CYTRA2 COUGH COLD DECCHLORPHN SOL COUGH COLD DECCHLORPHN DM LIQ SYP ANTI INFLAMMATORY DEXAMETHASON 0.5MG TAB ANTI INFLAMMATORY DEXAMETHASON 0.75MG TAB ANTI INFLAMMATORY DEXAMETHASON 4MG TAB ANTI INFLAMMATORY DICLOFENAC 75MG DR TAB ANTI INFLAMMATORY DICLOFENAC 75MG DR TAB GASTRO INTESTINAL DICYCLOMINE 10MG CARDIAC DIGITEK 0.125MG TAB CAP CARDIAC DIGITEK 0.25MG TAB CARDIAC DILTIAZEM 120MG TAB CARDIAC DILTIAZEM 30MG TAB CARDIAC DILTIAZEM 60MG TAB CARDIAC DILTIAZEM 90MG TAB CARDIAC DOXAZOSIN 1MG TAB CARDIAC DOXAZOSIN 2MG TAB CARDIAC DOXAZOSIN 4MG TAB CARDIAC DOXAZOSIN 8MG TAB ANTIDEPRESSANT DOXEPIN HCL 100MG CAP ANTIDEPRESSANT DOXEPIN HCL 10MG CAP ANTIDEPRESSANT DOXEPIN HCL 25MG CAP ANTIDEPRESSANT DOXEPIN HCL 50MG CAP ANTIDEPRESSANT DOXEPIN HCL 75MG CAP ANITBIOTIC DOXYCYCL HYC 100MG CAP ANITBIOTIC DOXYCYCL HYC 100MG TAB ANITBIOTIC DOXYCYCL HYC 50MG CAP CARDIAC ENALAP/HCTZ 512.5MGTAB CARDIAC ENALAPRIL 10MG TAB CARDIAC ENALAPRIL 2.5MG TAB CARDIAC ENALAPRIL 20MG TAB CARDIAC ENALAPRIL 5MG TAB ANITBIOTIC ERYTHROCIN 250MG TAB ANITBIOTIC ERYTHROMYCIN 2% SOL ANITBIOTIC ERYTHROMYCIN OP OIN ANITBIOTIC ERYTHROMYCIN250MG ECCAP HORMONE ESTRADIOL 0.5MG TAB HORMONE ESTRADIOL 1MG TAB HORMONE ESTRADIOL 2MG TAB HORMONE ESTROPIPATE 0.75MG TAB HORMONE ESTROPIPATE 1.5MG TAB VITAMINS ETHEDENT 0.25MG CHW GASTRO INTESTINAL FAMOTIDINE 20MG TAB GASTRO INTESTINAL FAMOTIDINE 20MG TAB ANTIFUNGAL FLUCONAZOLE 150MG TAB ANTI INFLAMMATORY FLUOCIN ACET 0.01% SOL ANTI INFLAMMATORY FLUOCINONIDE 0.05% CRE ANTI INFLAMMATORY FLUOCINONIDE 0.05% CRE ANTIDEPRESSANT FLUOXETINE 20MG ANTIPSYCHOTIC FLUPHENAZINE 1MG CAP VITAMINS FOLIC ACID 1MG CARDIAC FUROSEMIDE 20MG TAB CARDIAC FUROSEMIDE 20MG TAB CARDIAC FUROSEMIDE 40MG TAB CARDIAC FUROSEMIDE 40MG TAB CARDIAC FUROSEMIDE 80MG ANITBIOTIC GENTAMICIN 0.1% CRE ANITBIOTIC GENTAMICIN 0.1% OIN ANITBIOTIC GENTAMICIN 0.3% OP SOL DIABETES GLIMEPIRIDE 1MG DIABETES GLIPIZIDE 10MG TAB DIABETES GLIPIZIDE 5MG TAB DIABETES GLYBURID MCR 3MG TAB DIABETES GLYBURID MCR 6MG TAB DIABETES GLYBURIDE 2.5MG TAB DIABETES GLYBURIDE 5MG TAB DIABETES GLYBURIDE 5MG TAB COUGH COLD GUAIFENESIN DM SYP COUGH COLD GUAIFENEX PSE 120 TAB TAB TAB TAB TAB COUGH COLD GUAIFENEX PSE 60 TAB CARDIAC GUANFACINE 1MG TAB ANTIPSYCHOTIC HALOPERIDOL 0.5MG TAB ANTIPSYCHOTIC HALOPERIDOL 1MG TAB ANTIPSYCHOTIC HALOPERIDOL 2MG TAB ANTIPSYCHOTIC HALOPERIDOL 5MG TAB CARDIAC HYDRALAZINE 10MG TAB CARDIAC HYDRALAZINE 25MG CARDIAC HYDROCHLOROT 12.5MG CAP CARDIAC HYDROCHLOROT 25MG TAB CARDIAC HYDROCHLOROT 50MG TAB ANTI INFLAMMATORY HYDROCORT 1% MISCELLANEOUS TAB CRE HYDROCORT AC 25MG SUP ANTI INFLAMMATORY HYDROCORTISONE 2.5% CRM ANXIETY HYDROXYZ HCL10MG/5MLSYP GASTRO INTESTINAL HYOSCYAMINE 0.125/MLDRO GASTRO INTESTINAL HYOSCYAMINE 0.125MG SUB GASTRO INTESTINAL HYOSCYAMINE 0.125MG TAB GASTRO INTESTINAL HYOSCYAMINE 0.375 ERTAB ANTI INFLAMMATORY IBUPROFEN 100/5ML SUS ANTI INFLAMMATORY IBUPROFEN 400MG TAB ANTI INFLAMMATORY IBUPROFEN 600MG TAB ANTI INFLAMMATORY IBUPROFEN 800MG TAB CARDIAC INDAPAMIDE 1.25MG TAB CARDIAC INDAPAMIDE 2.5MG TAB ANTI INFLAMMATORY INDOMETHACIN 25MG CAP ANITBIOTIC ISONIAZID 300MG CARDIAC ISOSORB MONO 30MG ERTAB TAB CARDIAC ISOSORB MONO 60MG ERTAB VITAMINS KLORCON 10 10MEQ ERTAB VITAMINS KLORCON 8 TAB 8MEQ ER VITAMINS KLORCON M10 GASTRO INTESTINAL LACTULOSE 10GM/15 SYP THYROID LEVOTHYROXIN 100MCG TAB THYROID LEVOTHYROXIN 125MCG TAB THYROID LEVOTHYROXIN 150MCG TAB THYROID LEVOTHYROXIN 25MCG TAB THYROID LEVOTHYROXIN 50MCG TAB TAB THYROID LEVOTHYROXIN 75MCG TAB MISCELLANEOUS LIDOCAINE 2% VISC SOL CARDIAC LISINO-HCTZ 10-12.5MTAB CARDIAC LISINO-HCTZ 20-25MG TAB CARDIAC LISINOP-HCTZ 20-12.5TAB CARDIAC LISINOPRIL 10MG TAB CARDIAC LISINOPRIL 2.5MG TAB CARDIAC LISINOPRIL 20MG TAB CARDIAC LISINOPRIL 5MG TAB ANTIPSYCHOTIC LITHIUM CARB 300MG CAP ALLERGY LORATADINE 10MG ALLERGY LORATADINE 5MG/5ML SYP CHOLESTEROL LOVASTATIN 10MG TAB VITAMINS MAG OXIDE 400MG VITAMINS MAG64 64MG GASTRO INTESTINAL MECLIZINE 12.5MG TAB GASTRO INTESTINAL MECLIZINE 25MG TAB HORMONE MEDROXYPR AC 10MG TAB HORMONE MEDROXYPR AC 2.5MG TAB HORMONE MEDROXYPR AC 5MG ONCOLOGY/CANCER MEGESTROL 20MG TAB TAB TAB TAB DIABETES METFORMIN 1000MG TAB DIABETES METFORMIN 500MG TAB DIABETES METFORMIN 500MG ER TAB DIABETES METFORMIN 850MG CARDIAC METHYLDOPA 250MG TAB TAB CARDIAC METHYLDOPA 500MG TAB ANTI INFLAMMATORY METHYLPRED 4MG PAK ANTI INFLAMMATORY METHYLPRED 4MG TAB GASTRO INTESTINAL METOCLOPRAM 10MG GASTRO INTESTINAL METOCLOPRAM 5MG/5ML SYP TAB CARDIAC METOPROLOL 100MG TAB CARDIAC METOPROLOL 25MG TAB CARDIAC METOPROLOL 50MG TAB ANITBIOTIC METRONIDAZOL 250MG TAB ANITBIOTIC METRONIDAZOL 500MG TAB VITAMINS MULTI VITA 0.25MG CHW VITAMINS MULTI VITA/FL/FE VITAMINS MULTVITBET /FL 1MGCHW CHW VITAMINS MULVITBET 0.5MGFL CHW CARDIAC NADOLOL 20MG TAB CARDIAC NADOLOL 40MG TAB ANTI INFLAMMATORY NAPROXEN 500MG TAB VITAMINS NATALCARE PIC TAB VITAMINS NATALCARE PLUS ANITBIOTIC NEO/POLY/DEX 0.1% OPOIN TAB ANITBIOTIC NEO/POLY/DEX 0.1% OPSUS ANTIDEPRESSANT NORTRIPTYLIN 10MG CAP ANTIDEPRESSANT NORTRIPTYLIN 25MG CAP ANTIFUNGAL NYSTAT/TRIAM CRE ANTIFUNGAL NYSTAT/TRIAM CRE ANTIFUNGAL NYSTAT/TRIAM OIN ANTIFUNGAL NYSTATIN 100000U CRE ANTIFUNGAL NYSTATIN 100000U CRE ANTIFUNGAL NYSTATIN 100000U OIN ANTIFUNGAL NYSTATIN 100000U OIN MISCELLANEOUS OXYBUTYNIN 5MG TAB ANTIDEPRESSANT PAROXETINE 20MG TAB ANITBIOTIC PENICILLN VK 125/5MLSOL ANITBIOTIC PENICILLN VK 125/5MLSOL ANITBIOTIC PENICILLN VK 250/5MLSOL ANITBIOTIC PENICILLN VK 250/5MLSOL ANITBIOTIC PENICILLN VK 250MG TAB CARDIAC PENTOXIFYLLI400MG ERTAB GASTRO INTESTINAL PHENAZOPYRID 100MG TAB GASTRO INTESTINAL PHENAZOPYRID 200MG TAB GLUCOMA EYE PILOCARPINE 1% OP SOL GLUCOMA EYE PILOCARPINE 2% OP SOL CARDIAC PINDOLOL 10MG TAB CARDIAC PINDOLOL 5MG TAB ANTI INFLAMMATORY PIROXICAM 20MG CAP VITAMINS POT CHLORIDE 10% LIQ CARDIAC PRAZOSIN HCL 1MG CAP CARDIAC PRAZOSIN HCL 2MG CAP CARDIAC PRAZOSIN HCL 5MG CAP ANTI INFLAMMATORY PREDNISONE 10MG TAB ANTI INFLAMMATORY PREDNISONE 10MG TAB ANTI INFLAMMATORY PREDNISONE 2.5MG TAB ANTI INFLAMMATORY PREDNISONE 20MG TAB ANTI INFLAMMATORY PREDNISONE 5MG TAB ANTI INFLAMMATORY PREDNISONE 5MG 6DAYPAK VITAMINS PRENATAL RX ANTIPSYCHOTIC PROCHLORPER 10MG TAB GASTRO INTESTINAL PROMETHAZINE 25MG TAB COUGH COLD PROMETHAZINE DM GASTRO INTESTINAL PROMETHAZINE6.25/5MLSYP CARDIAC PROPRANOLOL 10MG TAB CARDIAC PROPRANOLOL 20MG TAB CARDIAC PROPRANOLOL 40MG TAB CARDIAC PROPRANOLOL 80MG TAB GASTRO INTESTINAL RANITIDINE 150MG TAB GASTRO INTESTINAL RANITIDINE 150MG TAB TAB SYP ANTI INFLAMMATORY SALSALATE 500MG TAB ANITBIOTIC SELENIUM SUL 2.5% LOT ANITBIOTIC SMZ/TMP DS 800160 TAB ANITBIOTIC SMZ/TMP DS 800160 TAB ANITBIOTIC SMZTMP 20040/5 ANITBIOTIC SMZTMP 40080MG CARDIAC SOTALOL HCL 80MG TAB CARDIAC SPIRONOLACT 25MG TAB ANITBIOTIC SULFACET SOD 10% OP SOL CARDIAC TERAZOSIN 10MG CAP CARDIAC TERAZOSIN 1MG CAP CARDIAC TERAZOSIN 2MG CAP CARDIAC TERAZOSIN 5MG CAP ANITBIOTIC TETRACYCLINE 250MG CAP SUS TAB ANITBIOTIC TETRACYCLINE 500MG CAP ANTIPSYCHOTIC THIORIDAZINE 25MG TAB ANTIPSYCHOTIC THIORIDAZINE 50MG TAB ANTIPSYCHOTIC THIOTHIXENE 2MG ANITBIOTIC TOBRAMYCIN 0.3% OP SOL ANALGESICS TRAMADOL HCL 50MG TAB ANTIDEPRESSANT TRAZODONE 100MG ANTIDEPRESSANT TRAZODONE 150MG TAB ANTIDEPRESSANT TRAZODONE 50MG TAB CARDIAC TRIAM/HCTZ 37.5-25 CAP CAP TAB ANTI INFLAMMATORY TRIAMCINOLON 0.025% CRE ANTI INFLAMMATORY TRIAMCINOLON 0.025% CRE ANTI INFLAMMATORY TRIAMCINOLON 0.1% CRE ANTI INFLAMMATORY TRIAMCINOLON 0.1% CRE ANTI INFLAMMATORY TRIAMCINOLON 0.1% OIN ANTI INFLAMMATORY TRIAMCINOLON 0.1% OIN ANTI INFLAMMATORY TRIAMCINOLON 0.5% CRE CARDIAC TRIAMT/HCTZ 37.525 TAB CARDIAC TRIAMT/HCTZ 7550MG TAB CARDIAC TRIAMT/HCTZ 7550MG TAB PARKINSONS TRIHEXYPHEN 2MG COUGH COLD TRIVENT DPC6215/5SYP TAB CARDIAC VERAPAMIL 120MG TAB CARDIAC VERAPAMIL 80MG TAB CARDIAC WARFARIN 5MG TAB
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