Formulary 2Medications Available For Patients who need to pay by cash.  Home PageFormulary #4
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Anti-Inflammatory

 
P0358020   Diclofenac Sod. (Voltaren) 50mg Tablets #20  Call
P0071030   Diclofenac Sod. (Voltaren) 75mg Tablets #30  Call
P0095030   Etodolac (Lodine) 400mg Tablets #30  Call
P0486030   Flurbiprofen (Ansaid) 100mg Tablets #30  $Call
R0282004   Ibuprofen (Motrin) 100Mg Child Susp 4oz  $  Call
P0116030   Ibuprofen (Motrin) 400mg Tablets #30  $Call
P0117030   Ibuprofen (Motrin) 600mg Tablets #30            $Call
P0117040   Ibuprofen (Motrin) 600mg Tablets #40            $Call
P0118030   Ibuprofen (Motrin) 800mg Tablets #30            $Call
P0118040   Ibuprofen (Motrin) 800mg Tablets #40  $Call
R0295021   Methylprednisolone (Medrol) 4mg Dospak Tablets #21  $Call
P0482014   Nabumetone (Relafen) 500mg Tablets #14  $Call
P0152020   Naproxen (Naprosyn) 375mg Tablets #20  $Call
P0153030   Naproxen (Naprosyn) 500mg Tablets #30            $Call
P0153060   Naproxen (Naprosyn) 500mg Tablets #60  $Call
P0154021   Naproxen Sod (Anaprox) 550mg Tablets #21  $Call
P0407030   Oxaprozin (Daypro) 600mg Tablets #30  $Call
P0168020   Piroxicam 20mg Capsules #20  $Call
R0453004   Prednisolone (Prelone) Syrup 4oz  $Call
P0173030   Prednisone (Deltasone) 5mg Tablets #30            $Call
P0171020   Prednisone (Deltasone) 10mg Tablets #20  $Call
P0172020   Prednisone (Deltasone) 20mg Tablets #20  $Call
P0192040   Salsalate (Disalcid) 750mg Tablets #40  $Call
P0192180   Salsalate (Disalcid) 750mg Tablets #180 $Call
P0197030   Sulindac (Clinoril) 200mg Tablets #30  $Call

Antivertigo Medications

 
P0139030   Meclizine (Antivert) 25mg Tablets #30  $Call
P0222010   Trimethobenzamide (Tigan) 100mg Suppositories #10  $Call
R0401010   Trimethobenzamide (Tigan) 200mg Supp's 10/Box  $Call

Antivirals

 
P0007025   Acyclovir (Zovirax) 400mg Tablets #25  $Call
P0015014   Amantadine (Symmetrel) 100mg Capsules #14  $Call

Contraceptives

 
R0548028   Nortrel (Ortho Novum) 1/35 28d Tablets 1 mo.  $Call
    Velevet (Cyclessa) 28 day Tablets 1 mo.  $Call

Cough and Cold Medications

 
R0218004   Acetaminophen (Tylenol) Elixir 4oz            $  Call
R0221030   Acetaminophen (Tylenol) 80mg Chew Tablets #30  $  Call
P0033015   Benzonatate (Tessalon) 100mg Capsules #15  $Call
R0247004   Bromanate (Dimetapp) Elixir 4oz  $  Call
P0220030   Guaifenesin/PSE (Entex PSE) 600-120mg Tablets #30  $Call
R0274004   Guiatuss AC (Robitussin AC) Syrup 4oz  $Call
R0276004   Guiatuss DM (Robitussin DM) Syrup 4oz  $Call
R0400015   Oxymetazoline (Afrin) Nasal Spray 15ml  $  Call
R0622015   Ped Relief VR (Pediacare) Drops 15ml  $  Call
R0327004   Promethazine (Phenergan) Plain Syrup 4oz  $Call
R0360004   Promethazine DM (Phenergan) Syrup 4oz  $Call
R0330004   Promethazine/Codeine (Phenergan/Cod) Syrup 4oz  $Call

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