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June 5, 2008

Benzonatate 100mg cap Ceron DM syrup Ceron drops* Dec-Chlorphen drops* Dec-Chlorphen DM syrup* Loratadine 10mg tab Promethazine DM syrup Trivent DPC syrup*

14 120ml 30ml 30ml 118ml 30 120ml 120ml

42 360ml 90ml 90ml 354ml 90 360ml 360ml

Amoxicillin 125mg/5ml suspension Amoxicillin 125mg/5ml suspension Amoxicillin 125mg/5ml suspension Amoxicillin 200mg/5ml suspension Amoxicillin 200mg/5ml suspension* Amoxicillin 200mg/5ml suspension* Amoxicillin 250mg/5ml suspension Amoxicillin 250mg/5ml suspension Amoxicillin 250mg/5ml suspension Amoxicillin 400mg/5ml suspension Amoxicillin 400mg/5ml suspension* Amoxicillin 400mg/5ml suspension* Amoxicillin 250mg cap Amoxicillin 500mg cap Amoxil 50mg/ml drops* Cephalexin 250mg cap Cephalexin 500mg cap Ciprofloxacin 250mg tab Ciprofloxacin 500mg tab Doxycycline Hyclate 50mg cap Doxycycline Hyclate 100mg tab Erythrocin 250mg tab* Erythromycin EC 250mg cap* Metronidazole 250mg tab Metronidazole 500mg tab Penicillin VK 125mg/5ml suspension Penicillin VK 250mg/5ml suspension Penicillin VK 250mg tab SMZ-TMP 400mg-80mg tab SMZ-TMP DS 800mg-160mg tab SMZ-TMP 200mg-40mg/5ml susp. Tetracycline 250mg cap Tetracycline 500mg cap

80ml 100ml 150ml 50ml 75ml 100ml 80ml 100ml 150ml 50ml 75ml 100ml 30 30 30ml 28 30 14 20 30 20 40 28 28 14 200ml 100ml 28 28 20 120ml 60 60

240ml 300ml 450ml 150ml 225ml 300ml 240ml 300ml 450ml 150ml 225ml 300ml 90 90 90ml 84 90 42 60 90 60 N/A 84 84 42 600ml 300ml 84 84 60 360ml 180 180

Allopurinol 100mg tab Allopurinol 300mg tab

30 30

90 90

30

90

30

90

30

90

30

90

30

90

12

36

6

18

60

180

120ml

360ml

90

270

60

180

30

90

60

180

30

90

30

90

60

180

60

180

30

90

60

180

90

270

60

180

120ml

360ml

20ml

60ml

75ml

225ml

(25 vials)

(75 vials)

75ml

225ml

(25 vials)

(75vials)

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

60

180

30

90

30

90

30

90

30

90

Baclofen 10mg tab Colchicine 0.6mg tab Cyclobenzaprine 5mg tab Cyclobenzaprine 10mg tab Dexamethasone 0.5mg tab Dexamethasone 0.75mg tab Dexamethasone 4mg tab Diclofenac DR 75mg tab Ibuprofen 100mg/5ml suspension* Ibuprofen 400mg tab Ibuprofen 600mg tab Ibuprofen 800mg tab Indomethacin 25mg tab* Meloxicam 7.5mg tab Meloxicam 15mg tab Naproxen 375mg tab* Naproxen 500mg tab* Piroxicam 20mg cap Salsalate 500mg tab

Albuterol 2mg tab Albuterol 4mg tab Albuterol 2mg/5ml syrup Albuterol 0.5% nebulizer solution Albuterol 0.083% neb. Solution*

Ipratropium 0.02% neb. sol’n*

Lovastatin 10mg tab Lovastatin 20mg tab* Pravastatin 10mg tab Pravastatin 20mg tab Pravastatin 40mg tab*

Chlorpropamide 100mg tab* Glimepiride 1mg tab Glimepiride 2mg tab Glimepiride 4mg tab Glipizide 5mg tab Glipizide 10mg tab* Glyburide 2.5mg tab Glyburide 5mg tab (blue) Glyburide 5mg tab (green) Glyburide, micronized 3mg tab

$4 Program covers up to a 30day supply of eligible drugs at commonly prescribed dosages. $10 Program covers a 90day supply of eligible drugs at commonly prescribed dosages. Prices for less than a 90day supply are prorated based on $4 Program price, not to exceed $10. Prices for more than a 90day supply are prorated based on $10 Program price. Physician permission may be required to change 30day prescription to 90day prescription. Not all drugs eligible for $4 Program are eligible for $10 Program. Certain plans, including governmentfunded programs, may not cover a 90day supply.

Prescription Program available at all WalMart, Samʹs Club & Neighborhood Markets except in ND. Only eligible drugs are covered. List may change and vary by state. Prescriptions must initially be filled in person. Refills must be picked up in store. No substitutions or mail orders. Prices may be higher in some states. Certain plans may entitle you to pay less. See Walmart.com or pharmacist for details.

  • *

    These drugs may be priced higher in CA, HI, MN, MT, PA, TN, WI, WY.

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