Download Wegmans 90 day Generic Pricing Program List

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Wegmans 90 day Generic Formulary Item List
Generic Formulary Item
ACYCLOVIR 200MG CAP
ALLOPURINOL 100MG TAB
ALLOPURINOL 300MG TAB
ALPRAZOLAM 0.25MG TAB
ALPRAZOLAM 0.5MG TAB
AMILORIDE HCTZ 5/50 TAB
AMITRIPTYLINE 10MG TAB
AMITRIPTYLINE 25MG TAB
AMITRIPTYLINE 50MG TAB
AMITRIPTYLINE 75MG TAB
AMITRIPTYLINE 100MG TAB
ATENOLOL 25MG
TAB
ATENOLOL 50MG
TAB
ATENOLOL 100MG
TAB
ATENOLOL+CHL 50/25 TAB
ATENOLOL+CHL 100/25 TAB
ATROPINE SULFATE 1% 5ML
BELLAD ALK+PB
TAB
BENAZEPRIL/HCT 20/25MG TAB
BENZTROPINE 2MG TAB
BETAMETHASONE DIPR 45GM CRM
BETAMETHASONE VAL 45GM CRM
BETAMETHASONE VAL 45GM OINT
BISOPROLOL/HCTZ 10-6.25 TAB
BISOPROLOL/HCTZ 2.5-6.25 TAB
BISOPROLOL/HCTZ 5-6.25 TAB
BUMETANIDE 0.5MG TAB
BUMETANIDE 1MG
TAB
BUSPIRONE 15MG
TAB
CAPTOPRIL 100MG TAB
CAPTOPRIL 12.5MG TAB
CAPTOPRIL 25MG
TAB
CAPTOPRIL 50MG
TAB
CARBAMAZEPINE 100MG CTB
CEPHALEXIN 500MG CAP **
CHLORPROPAMIDE 100MG TB
CHLORTHALIDONE 25MG TAB
CHLORTHALIDONE 50MG TAB
CHLORZOXAZONE 500MG TAB
CIMETIDINE 300MG TAB
CIMETIDINE 400MG TAB
CIMETIDINE 800MG TAB
CIPROFLOXACIN 250MG TAB
CITALOPRAM 10MG TAB
CITALOPRAM 20MG TAB
CLONAZEPAM 0.5MG TAB
CLONAZEPAM 1MG
TAB
CLONIDINE 0.1MG TAB
CLONIDINE 0.2MG TAB
COLCHICINE 0.6MG TAB
DEXAMETHASONE 0.5MG TAB
DEXAMETHASONE 0.75MG TAB
DEXAMETHASONE 4MG TAB
DIALYVITE
TAB
DIAZEPAM 2MG
TAB
DIAZEPAM 5MG
TAB
DIAZEPAM 10MG
TAB
DICYCLOMINE 10MG CAP
DILTIAZEM 30MG TAB
DILTIAZEM 60MG TAB
DILTIAZEM 90MG TAB
DIPHENHYDRAMINE 50MG CP **
DOXAZOSIN 1MG
TAB
DOXAZOSIN 2MG
TAB
DOXAZOSIN 4MG
TAB
DOXAZOSIN 8MG
TAB
DOXEPIN HCL 10MG CAP
Therapeutic Category
Antiviral
Arthritis
Arthritis
Anti-Anxiety
Anti-Anxiety
Cardiac
Antidepressant
Antidepressant
Antidepressant
Antidepressant
Antidepressant
Cardiac
Cardiac
Cardiac
Cardiac
Cardiac
Opthalmic
Gastrointestinal
Cardiac
Parkinsons
Anti-Inflammatory
Anti-Inflammatory
Anti-Inflammatory
Cardiac
Cardiac
Cardiac
Cardiac
Cardiac
Antidepressant
Cardiac
Cardiac
Cardiac
Cardiac
Seizure
Antibiotic
Diabetes
Cardiac
Cardiac
Analgesic
Gastrointestinal
Gastrointestinal
Gastrointestinal
Antibiotic
Antidepressant
Antidepressant
Anti-Anxiety
Anti-Anxiety
Cardiac
Cardiac
Arthritis
Anti-Inflammatory
Anti-Inflammatory
Anti-Inflammatory
Vitamins
Anti-Anxiety
Anti-Anxiety
Anti-Anxiety
Gastrointestinal
Cardiac
Cardiac
Cardiac
Allergy
Cardiac
Cardiac
Cardiac
Cardiac
Antidepressant
Brand Name
Zovirax
Zyloprim
Zyloprim
Xanax
Xanax
Moduretic
Elavil
Elavil
Elavil
Elavil
Elavil
Tenormin
Tenormin
Tenormin
Tenoretic
Tenoretic
Isopto-Atropine
N/A
Lotensin/HCTZ
Cogentin
Diprosone
Valisone
Valisone
Ziac
Ziac
Ziac
Bumex
Bumex
Buspar
Capoten
Capoten
Capoten
Capoten
Tegretol
Keflex
Diabinese
Hygroton
Hygroton
Parafon
Tagamet
Tagamet
Tagamet
Cipro
Celexa
Celexa
Klonopin
Klonopin
Catapress
Catapress
N/A
Decadron
Decadron
Decadron
N/A
Valium
Valium
Valium
Bentyl
Cardizem
Cardizem
Cardizem
Benadryl
Cardura
Cardura
Cardura
Cardura
Sinequan
90 Day
Quantity
Most Commonly
Prescribed Directions
90
90
90
270
270
90
90
90
90
90
90
90
90
90
90
90
5
360
90
180
45
45
45
90
90
90
90
90
180
180
180
180
180
180
90
90
90
90
360
180
180
90
90
90
90
270
270
180
180
90
90
90
90
90
180
180
180
180
270
270
270
180
90
90
90
90
90
(1) daily
(1) daily
(1) daily
(1) three times daily
(1) three times daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) drop daily
(1) four times daily
(1) daily
(1) twice daily
Apply as directed
Apply as directed
Apply as directed
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) four times daily
(1) twice daily
(1) twice daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) three times daily
(1) three times daily
(1) twice daily
(1) twice daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) three times daily
(1) three times daily
(1) three times daily
(1) twice daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
Wegmans 90 day Generic Formulary Item List
Generic Formulary Item
DOXEPIN HCL 25MG CAP
DOXEPIN HCL 50MG CAP
DOXEPIN HCL 100MG CAP
DOXYCYCLINE 50MG CAP
DOXYCYCLINE 100MG CAP
DOXYCYCLINE 100MG TAB
ENALAPRIL 5MG
TAB
ENALAPRIL 10MG
TAB
ENALAPRIL 2.5MG TAB
ENALAPRIL 20MG
TAB
ERYTHROMYCIN 2% SOL
ESTRADIOL 0.5MG TAB
ESTRADIOL 1MG
TAB
ESTRADIOL 2MG
TAB
ESTROPIPATE 0.625 TAB
ESTROPIPATE 1.25 TAB
ETHEDENT 0.25MG CTB
ETHEDENT 0.5MG
CTB
ETHEDENT 1MG
CTB
FAMOTIDINE 20MG TAB
FLUOCINOLONE 0.01% SOL
FLUOXETINE 10MG CAP
FLUOXETINE 20MG CAP
FLUPHENAZINE 1MG TAB
FOLIC ACID 1MG
TAB
FUROSEMIDE 20MG TAB
FUROSEMIDE 40MG TAB
FUROSEMIDE 80MG TAB
GLIMEPIRIDE 1MG TAB
GLIMEPIRIDE 2MG TAB
GLIPIZIDE 5MG
TAB
GLIPIZIDE 10MG
TAB
GLYBURIDE 5MG
TAB
GLYBURIDE 1.25MG TAB
GLYBURIDE 2.5MG TAB
GLYBURIDE MICR 1.5MG TB
GLYBURIDE MICR 3MG TAB
GLYBURIDE MICR 6MG TAB
HALOPERIDOL 1MG TAB
HALOPERIDOL 2MG TAB
HALOPERIDOL 0.5MG TAB
H-CHLOROTHIAZIDE 12.5MG
H-CHLOROTHIAZIDE 25MG
H-CHLOROTHIAZIDE 50MG
HYDRALAZINE 10MG TAB
HYDRALAZINE 25MG TAB
IBUPROFEN 400MG TAB
IBUPROFEN 600MG TAB
IBUPROFEN 800MG TAB
INDAPAMIDE 1.25MG TAB
INDAPAMIDE 2.5MG TAB
INDOMETHACIN 25MG CAP
ISONIAZID 300MG TAB
ISOSORBIDE DIN 20MG TAB **
ISOSORBIDE MONO ER 30MG
ISOSORBIDE MONO ER 60MG
KLOR-CON 8mEq TAB
LEVOTHYROXINE 25MCG TB
LEVOTHYROXINE 50MCG TB
LEVOTHYROXINE 75MCG TB
LEVOTHYROXINE 88MCG TB
LEVOTHYROXINE 100MCG TB
LEVOTHYROXINE 125MCG TB
LEVOTHYROXINE 150MCG TB
LISINOPRIL 5MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 20MG TAB
Therapeutic Category
Antidepressant
Antidepressant
Antidepressant
Antibiotic
Antibiotic
Antibiotic
Cardiac
Cardiac
Cardiac
Cardiac
Antibiotic
Hormone
Hormone
Hormone
Hormone
Hormone
Vitamins
Vitamins
Vitamins
Gastrointestinal
Anti-Inflammatory
Antidepressant
Antidepressant
Antipsychotic
Vitamins
Cardiac
Cardiac
Cardiac
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Antipsychotic
Antipsychotic
Antipsychotic
Cardiac
Cardiac
Cardiac
Cardiac
Cardiac
Anti-Inflammatory
Anti-Inflammatory
Anti-Inflammatory
Cardiac
Cardiac
Anti-Inflammatory
Antibiotic
Cardiac
Cardiac
Cardiac
Vitamins
Thyroid
Thyroid
Thyroid
Thyroid
Thyroid
Thyroid
Thyroid
Cardiac
Cardiac
Cardiac
Brand Name
Sinequan
Sinequan
Sinequan
Vibramycin
Vibramycin
Vibratab
Vasotec
Vasotec
Vasotec
Vasotec
Eryderm
Estrace
Estrace
Estrace
Ogen
Ogen
Luride
Luride
Luride
Pepcid
Fluonid
Prozac
Prozac
Prolixin
N/A
Lasix
Lasix
Lasix
Amaryl
Amaryl
Glucotrol
Glucotrol
Micronase
Micronase
Micronase
Glynase
Glynase
Glynase
Haldol
Haldol
Haldol
Hydrodiuril
Hydrodiuril
Hydrodiuril
Apresoline
Apresoline
Motrin
Motrin
Motrin
Lozol
Lozol
Indocin
N/A
Isordil
Imdur ER
ImdurER
Slow K
Synthroid
Synthroid
Synthroid
Synthroid
Synthroid
Synthroid
Synthroid
Zestril
Zestril
Zestril
90 Day
Quantity
Most Commonly
Prescribed Directions
90
90
90
90
90
90
90
90
90
90
60
90
90
90
90
90
90
90
90
180
60
90
90
270
90
90
90
90
90
90
180
180
180
180
180
180
180
180
90
90
180
90
90
90
90
180
270
270
270
90
90
180
90
270
90
90
90
90
90
90
90
90
90
90
90
90
90
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
Apply as directed
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
Apply as directed
(1) daily
(1) daily
(1) three times daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) daily
(1) daily
(1) twice daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) three times daily
(1) three times daily
(1) three times daily
(1) daily
(1) daily
(1) twice daily
(1) daily
(1) three times daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
Wegmans 90 day Generic Formulary Item List
Generic Formulary Item
LISINOPRIL 2.5MG TAB
LISINOPRIL/HCTZ 10/12.5
LITHIUM CARB 300MG CAP
LORAZEPAM 0.5MG TAB
MAGNESIUM OXIDE 400MG TAB
MEDROXYPROGEST 5MG TAB
MEDROXYPROGEST 10MG TAB
MEDROXYPROGEST 2.5MG TB
METFORMIN ER 500MG TAB
METHYLDOPA 250MG TAB
METHYLDOPA 500MG TAB
METHYLPREDNISOLONE 4MG
METOCLOPRAMIDE 10MG TAB
METOPROLOL 25MG TAB
METOPROLOL 50MG TAB
METOPROLOL 100MG TAB
METRONIDAZOLE 250MG TAB
METRONIDAZOLE 500MG TAB
MICRON GLYBURIDE 6MG TB
MULTI VIT+FL 0.25MG CTB
MULTI VIT+FL 0.5MG CTB
MULTI VIT+FL 1MG CTB
MULTI VIT+FL+FE .5MG CTB
NADOLOL 20MG
TAB
NADOLOL 40MG
TAB
NAPROXEN 375MG TAB
NAPROXEN 500MG
TAB
NORTRIPTYLINE 10MG CAP
NORTRIPTYLINE 25MG CAP
OXYBUTYNIN 5MG
TAB
PENICILLIN-V 250MG TAB
PENTOXIFYLLINE 400MG TB
PHENOBARBITAL 15MG TAB **
PHENOBARBITAL 30MG TAB **
PHENOBARBITAL 100MG TAB **
PHENOBARBITAL 32.4MG TB
PILOCARPINE 1% 15ML
PILOCARPINE 2% 15ML
PINDOLOL 5MG
TAB
PINDOLOL 10MG
TAB
PIROXICAM 20MG
CAP
POTASSIUM CL 10% LIQ
POTASSIUM CL 10MEQ TAB
POTASSIUM CL 10MEQ TAB
PREDNISONE 5MG TAB
PREDNISONE 10MG DF TAB
PREDNISONE 2.5MG TAB
PREDNISONE 20MG TAB **
PRENATAL PLUS
TAB
PRENATAL Z A/F
TAB
PROPRANOLOL 10MG TAB
PROPRANOLOL 20MG TAB
PROPRANOLOL 40MG TAB
PROPRANOLOL 80MG TAB
RANITIDINE 150MG TAB
SALSALATE 500MG TAB
SULFAMETH/TRIMETHOPRIM SS TAB
SULFATRIM PED
SUS
TERAZOSIN HCL 1MG CAP
TERAZOSIN HCL 2MG CAP
TERAZOSIN HCL 5MG CAP
TERAZOSIN HCL 10MG CAP
TETRACYCLINE 250MG CAP
TETRACYCLINE 500MG CAP
THIORIDAZINE 10MG TAB
THIORIDAZINE 25MG TAB
THIORIDAZINE 50MG TAB
Therapeutic Category
Cardiac
Cardiac
Antipsychotic
Anti-Anxiety
Vitamins
Hormone
Hormone
Hormone
Diabetes
Cardiac
Cardiac
Anti-Inflammatory
Gastrointestinal
Cardiac
Cardiac
Cardiac
Antibiotic
Antibiotic
Diabetes
Vitamins
Vitamins
Vitamins
Vitamins
Cardiac
Cardiac
Anti-Inflammatory
Anti-Inflammatory
Antidepressant
Antidepressant
Incontinence
Antibiotic
Peripheral Vascular Disease
Seizure
Seizure
Seizure
Seizure
Opthalmic
Opthalmic
Cardiac
Cardiac
Anti-Inflammatory
Vitamins
Vitamins
Vitamins
Anti-Inflammatory
Anti-Inflammatory
Anti-Inflammatory
Anti-Inflammatory
Vitamins
Vitamins
Cardiac
Cardiac
Cardiac
Cardiac
Gastrointestinal
Arthritis
Antibiotic
Antibiotic
Cardiac
Cardiac
Cardiac
Cardiac
Antibiotic
Antibiotic
Antipsychotic
Antipsychotic
Antipsychotic
Brand Name
Zestril
Zestoretic
Eskalith
Ativan
N/A
Provera
Provera
Provera
Glucophage XR
Aldomet
Aldomet
Medrol
Reglan
Lopressor
Lopressor
Lopressor
Flagyl
Flagyl
Glynase
Poly-Vi-Flor
Poly-Vi-Flor
Poly-Vi-Flor
Poly-Vi-Flor
Corgard
Corgard
Naprosyn
Naprosyn
Pamelor
Pamelor
Ditropan
V-Cillin K
Trental
Phenobarbital
Phenobarbital
Phenobarbital
Phenobarbital
Isopto-Carpine
Isopto-Carpine
Visken
Visken
Feldene
Klorvess
K-Dur
K-Tab
Deltasone
Deltasone
Deltasone
Deltasone
Stuart Natal Plus
N/A
Inderal
Inderal
Inderal
Inderal
Zantac
Disalcid
Bactrim
Bactrim
Hytrin
Hytrin
Hytrin
Hytrin
Achromycin-V
Achromycin-V
Mellaril
Mellaril
Mellaril
90 Day
Quantity
Most Commonly
Prescribed Directions
90
90
270
270
180
30
30
30
180
180
180
90
360
180
180
180
90
90
180
90
90
90
90
90
90
180
180
180
180
180
180
270
270
270
180
270
15
15
180
180
90
1350
90
90
90
90
90
90
90
90
180
180
180
180
180
180
90
473
90
90
90
90
90
90
180
180
180
(1) daily
(1) daily
(1) three times daily
(1) three times daily
(1) twice daily
(1) daily on certain days of cycle
(1) daily on certain days of cycle
(1) daily on certain days of cycle
(1) twice daily
(1) twice daily
(1) twice daily
(1) daily
(1) four times daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) daily
(1) daily
(1) twice daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) three times daily
(1) three times daily
(1) three times daily
(1) twice daily
(1) three times daily
Use as dirrected
Use as dirrected
(1) twice daily
(1) twice daily
(1) daily
(1) tablespoonful daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) twice daily
(1) daily
(1) teaspoonful daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) daily
(1) twice daily
(1) twice daily
(1) twice daily
Wegmans 90 day Generic Formulary Item List
Generic Formulary Item
THIOTHIXENE 2MG TAB
TIMOLOL 0.25% 10ML DRP
TIMOLOL 0.25% 15ML DRP
TIMOLOL 0.5% 10ML DRP
TIMOLOL 0.5% 15ML DRP
TRAZODONE 50MG TAB
TRAZODONE 100MG TAB
TRAZODONE 150MG TAB
TRIAM/HCTZ 37.5/25 CAP
TRIAMCINOLONE 0.025% 80GM CRM
TRIAMCINOLONE 0.1% 80GM CRM
TRIAMCINOLONE 0.1% 80GM OIN
TRIAMTERENE/HCTZ 75/50
TRIHEXYPHENIDYL 2MG TAB
ULTRA NATAL CARE TAB
VERAPAMIL 80MG TAB
VERAPAMIL 120MG TAB
VITACON FORTE
CAP
WARFARIN 5MG
TAB
Therapeutic Category
Antipsychotic
Opthalmic
Opthalmic
Opthalmic
Opthalmic
Antidepressant
Antidepressant
Antidepressant
Cardiac
Anti-Inflammatory
Anti-Inflammatory
Anti-Inflammatory
Cardiac
Parkinsons
Vitamins
Cardiac
Cardiac
Vitamins
Cardiac
Brand Name
Navane
Timoptic
Timoptic
Timoptic
Timoptic
Desyrel
Desyrel
Desyrel
Dyazide
Kenalog
Kenalog
Kenalog
Maxide
Artane
N/A
Calan
Calan
Vicon Forte
Coumadin
90 Day
Quantity
Most Commonly
Prescribed Directions
180
10
15
10
15
90
90
90
90
80
80
80
90
270
90
180
180
90
90
(1) twice daily
(1) drop twice daily
(1) drop twice daily
(1) drop twice daily
(1) drop twice daily
(1) daily
(1) daily
(1) daily
(1) daily
Apply as directed
Apply as directed
Apply as directed
(1) daily
(1) three times daily
(1) daily
(1) twice daily
(1) twice daily
(1) daily
(1) daily
The generics and prices in this program may be subject to change at any time
Wegmans 10% senior citizen discount does not apply to the items on this list
Updated as of 1/23/09
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