1824 Hooper Ave Toms River, NJ 08753 732-255-4788 Phone 732-255-1816 FAX www.SilvertonRx.com

Terms and Conditions: The $9.99 program covers up to a 90-day supply of the eligible drugs at commonly dispensed dosages and quantities as determined

New Prescription Plan

by Silverton Pharmacy. Prescription prices for less than a 90-day supply of eligible drugs will be pro-rated and will be priced based on $4.99/30 day supply, or Silverton Pharmacy's usual and customary retail price. Prices for more than a 90-day supply of covered medication will be pro-rated and will be priced

90 Day Generic Drug Supply

based on $9.99/90 day supply. No other discounts apply, for eligible drugs under this program.

Silverton Pharmacy Covered Medications

The list of eligible drugs and quantities are subject to change without notice. Silverton Pharmacy reserves the right to modify or discontinue this program or modify the terms and conditions of this program at any time without notice. Not all manufacturers' products are covered by this program. Physician authorization may be required to change 30-day prescription to 90-day prescription. Only prescriptions initially filled in person at Silverton Pharmacy are eligible for this $9.99 – 90 Day Generic Drug Pricing.

Effective date August 21, 2008

See Terms & Conditions on Page 1 of this document. The list of eligible drugs and quantities are subject to change without notice

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1824 Hooper Ave Toms River, NJ 08753 732-255-4788 Phone 732-255-1816 FAX www.SilvertonRx.com

Allergies & Cold

90-day QTY Anti-Fungal

Ceron DM Drops C-Tanna 12 suspension Loratadine 10mg tab Promethazine DM s

30ml 120ml 90 120ml

Promethazine syrup

120ml

Promethazine VC syrup

120ml

Promethazine DM syrup

120ml

Antibiotics

Commonly Dispensed Dosage

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 100mg cap Metronidazole 250mg tab Metronidazole 500mg tab Penicillin VK 125mg/5ml suspension Penicillin VK 250mg/5ml suspension Penicillin VK 250mg tab SMZ-TMP DS 800mg-160mg tab SMZ-TMP 200mg-40mg/5ml susp. Tetracycline 250mg cap Tetracycline 500mg cap Effective date August 21, 2008

Fluconazole 100mg tab Fluconazole 150mg tab Fluconazole 200mg tab Nystatin/Triamcin cream Nystatin/Triamcin ointment Nystatin cream Nystatin ointment Terbinafine 250mg tab

90-day QTY 3 3 3 90gm 90gm 90gm 90gm 90

80ml 100ml 150ml 50ml 75ml Arthritis & Pain 100ml 80ml 100ml 150ml 50ml 75ml 100ml 30 30 30ml 30 30 14 20 60 84 42 200ml

Allopurinol 100mg tab Allopurinol 300mg tab Baclofen 10mg tab Colchicine 0.6mg tab Cyclobenzaprine 5mg tab Cyclobenzaprine 10mg tab Dexamethasone 0.5mg tab Dexamethasone 0.75mg tab Dexamethasone 4mg tab Ibuprofen 100mg/5ml suspension Ibuprofen 400mg tab Ibuprofen 600mg tab Ibuprofen 800mg tab Meloxicam 7.5mg tab Meloxicam 15mg tab Naproxen 375mg tab Naproxen 500mg tab Piroxicam 20mg cap Salsalate 500mg tab

90-day QTY 90 90 90 90 90 90 90 36 18 360ml 270 180 90 90 90 180 180 90 180

100ml 28 60 360ml 120 120

See Terms & Conditions on Page 1 of this document. The list of eligible drugs and quantities are subject to change without notice

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1824 Hooper Ave Toms River, NJ 08753 732-255-4788 Phone 732-255-1816 FAX www.SilvertonRx.com

Asthma Albuterol Albuterol Albuterol Albuterol Albuterol

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

Ipratropium 0.02% neb. Sol’n

90-day QTY 270 180 360ml 60ml 225ml (75 vials) 225ml (75vials)

Pilocarpine 1% op. solution Pilocarpine 2% op. solution Polymyxin Sulfate/TMP op. solution* Sulfacet Sodium 10% op. solution Timolol Maleate 0.25% op. solution Timolol Maleate 0.5% op solution Tobramycin 0.3% op. solution

Gastrointestinal Cholesterol

90-day QTY 90 90 90 90

Lovastatin 10mg tab Lovastatin 20mg tab Pravastatin 10mg tab Pravastatin 20mg tab

Diabetes 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 Glyburide, micronized 6mg tab Metformin 500mg tab Metformin 850mg tab Metformin 1000mg tab Metformin ER 500mg tab

Eye Care & Glaucoma

90-day QTY 90 90 90 90 180 90 90 90 90 90 180 180 180 180

90-day QTY Atropine Sulfate 1% op. solution 15ml Bacitracin op. ointment 12gm Erythromycin op. ointment 12gm Gentamicin 0.3% op. solution 15ml Levobunolol 0.5% op solution 15ml Neomycin/Polymyxin/Dexamethasone 12gm 0.1% op. ointment Neomycin/Polymyxin/Dexamethaso 15ml ne 0.1% op. suspension Effective date August 21, 2008

Belladonna Alkaloid/PB tab Cimetidine 300mg tab Cimetidine 400mg tab Cimetidine 800mg tab Dicyclomine 10mg cap Dicyclomine 20mg tab Famotidine 20mg tab Hyoscyamine ER 0.375mg Lactulose syrup Metoclopramide 5mg tab Metoclopramide 10mg tab Metoclopramide syrup Promethazine 25mg tab Promethazine plain syrup Ranitidine 150mg tab Ranitidine 300mg tab

Heart Health & Blood Pressure Amlodipine 2.5mg Amlodipine 5mg Amlodipine 10mg Amiloride-HCTZ 5mg-50mg tab Atenolol-Chlorthalidone 50mg25mg tab Atenolol-Chlorthalidone 100mg25mg tab Atenolol 25mg tab Atenolol 50mg tab Atenolol 100mg tab Benazepril 5mg tab Benazepril 10mg tab Benazepril 20mg tab

See Terms & Conditions on Page 1 of this document. The list of eligible drugs and quantities are subject to change without notice

45ml 45ml 30ml 45ml 15ml 15ml 15ml

90-day QTY 180 90 90 90 270 180 180 711ml 180 180 180ml 36 540ml 180 90

90-day QTY 90 90 90 90 90 90 90 90 90 90 90 90

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1824 Hooper Ave Toms River, NJ 08753 732-255-4788 Phone 732-255-1816 FAX www.SilvertonRx.com

Heart Health & Blood Pressure Benazepril 40mg tab Bisoprolol-HCTZ 2.5mg-6.25mg tab Bisoprolol-HCTZ 5mg-6.25mg tab Bisoprolol-HCTZ 10mg-6.25mg tab Bumetanide 0.5mg tab Bumetanide 1mg tab Captopril 12.5mg tab Captopril 25mg tab Captopril 50mg tab Captopril 100mg tab Carvedilol 3.125mg tab Carvedilol 6.25mg tab Carvedilol 12.5mg tab Carvedilol 25mg tab Chlorthalidone 25mg tab Clonidine 0.1mg tab Clonidine 0.2mg tab Digoxin 0.25mg tab Diltiazem 30mg tab Diltiazem 60mg tab Doxazosin 1mg tab Doxazosin 2mg tab Doxazosin 4mg tab Doxazosin 8mg tab Enalapril-HCTZ 5mg-12.5mg tab Enalapril 2.5mg tab Enalapril 5mg tab Enalapril 10mg tab Enalapril 20mg tab Furosemide 20mg tab Furosemide 40mg tab Furosemide 80mg tab Guanfacine 1mg tab Hydrochlorothiazide(HCTZ)12.5mg cap* Hydrochlorothiazide (HCTZ) 25mg tab Hydrochlorothiazide (HCTZ) 50mg tab Indapamide 1.25mg tab Indapamide 2.5mg tab Isosorbide MononitrateER 30mg ertab Isosorbide MononitrateER 60mg ertab Lisinopril-HCTZ 10mg-12.5mg tab

Effective date August 21, 2008

Continued 90 90 90 90 90 90 180 180 180 180 180 180 180 180 90 90 90 90 180 180 90 90 90 90 90 90 90 90 90 90 90 90 90 90

Lisinopril-HCTZ 20mg-12.5mg tab Lisinopril-HCTZ 20mg-25mg tab Lisinopril 2.5mg tab Lisinopril 5mg tab Lisinopril 10mg tab Lisinopril 20mg tab Metoprolol Tartrate 25mg tab Metoprolol Tartrate 50mg tab Metoprolol Tartrate 100mg tab Nadolol 20mg tab Nitroquick 0.3mg sublingual tab Nitroquick 0.4mg sublingual tab Pindolol 5mg tab Pindolol 10mg tab Propranolol 10mg tab Propranolol 20mg tab Propranolol 40mg tab Propranolol 80mg tab Sotalol HCL 80mg tab Spironolactone 25mg tab Terazosin 1mg cap Terazosin 2mg cap Terazosin 5mg cap Terazosin 10mg cap Triamterene-HCTZ 37.5mg-25mg cap & tab Triamterene-HCTZ 75mg-50mg tab Verapamil 80mg tab Verapamil 120mg tab Warfarin 1mg tab Warfarin 2mg tab Warfarin 2.5mg tab Warfarin 3mg tab Warfarin 4mg tab Warfarin 5mg tab Warfarin 6mg tab

90 90 90 90 90 90 180 180 180 90 300 300 90 90 180 180 180 180 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90

90 90 Mental health 90 90 90 90 90

Amitriptyline 10mg tab Amitriptyline 25mg tab Amitriptyline 50mg tab Amitriptyline 75mg tab Amitriptyline 100mg tab Benztropine 0.5mg tab Benztropine 1.0mg tab

See Terms & Conditions on Page 1 of this document. The list of eligible drugs and quantities are subject to change without notice

90-day QTY 90 90 90 90 90 90 90 Page 4 of 6

1824 Hooper Ave Toms River, NJ 08753 732-255-4788 Phone 732-255-1816 FAX www.SilvertonRx.com

Mental Health Benztropine 2mg tab Buspirone 5mg tab Buspirone 10mg tab Carbamazepine 200mg tab Citalopram 10mg DR Citalopram 20mg tab Citalopram 40mg tab Doxepin HCL 10mg cap Doxepin HCL 25mg cap Doxepin HCL 50mg cap Doxepin HCL 75mg cap Doxepin HCL 100mg cap Fluoxetine 10mg tab Fluoxetine 10mg cap Fluoxetine 20mg cap Fluphenazine 1mg tab Fluphenazine 2.5mg tab Fluphenazine 5mg tab Haloperidol 0.5mg tab Haloperidol 1mg tab Haloperidol 2mg tab Haloperidol 5mg tab Lithium Carbonate 300mg cap Nortriptyline 10mg cap Nortriptyline 25mg cap Prochlorperazine 10mg tab Thioridazine 25mg tab Thioridazine 50mg tab Thiothixene 1mg cap Thiothixene 2mg cap Trazodone 50mg tab Trazodone 100mg tab Trazodone 150mg tab Trihexyphenidyl 2mg tab Skin Conditions Betamethasone 15gm Betamethasone 0.05% cream Betamethasone 0.05% cream – Betamethasone cream Betamethasone

Effective date August 21, 2008

Continued 90 180 180 180 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 270 90 90 90 90 90 90 90 90 90 90 180

Dipropionate

90-day QTY $4.99

Dipropionate

45gm

Dipropionate 15gm Valerate 0.1%

$4.99

Val. 0.1% cream

135gm

Betamethasone Val. 0.1% ointment Betamethasone Val. 0.1% ointment Fluocinolone Acet. 0.01% solution Fluocinonide 0.05% cream Fluocinonide 0.05% cream Gentamicin 0.1% cream Gentamicin 0.1% ointment Hydrocortisone 1% cream Hydrocortisone 2.5% cream Selenium Sulfide 2.5% lotion Silver Sulfadiazine 1% cream Triamcinolone 0.025% cream 15mg Triamcinolone 0.025% cream Triamcinolone 0.1% cream 15mg Triamcinolone 0.1% cream Triamcinolone 0.1% ointment 15mg Triamcinolone 0.1% ointment Triamcinolone 0.5% cream 15mg

Thyroid Conditions Levothyroxine Levothyroxine Levothyroxine Levothyroxine Levothyroxine

25mcg tab 50mcg tab 75mcg tab 88mcg tab 100mcg tab

Viruses Acyclovir 200mg cap Acyclovir 400mg cap

15gm 45gm 180ml 30gm 60gm 45gm 45gm $4.99 30gm 120ml 50gm $4.99 $9.99 $4.99 80gm $4.99 80gm $4.99

90-day QTY 90 90 90 90 90

90-day QTY 90 90

45gm

See Terms & Conditions on Page 1 of this document. The list of eligible drugs and quantities are subject to change without notice

Page 5 of 6

1824 Hooper Ave Toms River, NJ 08753 732-255-4788 Phone 732-255-1816 FAX www.SilvertonRx.com

Vitamins & Nutritional Health Ethedent 0.25mg chewable Ethedent 0.50mg chewable Ethedent 1.00mg chewable Folic Acid 1mg tab Klorcon 8 8mEq ER tab Mag 64 64mg tab $4.99 Magnesium Oxide 400mg tab Atalcare Plus Potassium Chloride 10% liquid Potassium Chloride ER 8meq Potassium Chloride ER 20meq Prenatal Rx tab

Women’s Health Estradiol 0.5mg tab Estradiol 1mg tab Estradiol 2mg tab Estropipate 0.75mg tab Estropipate 1.5mg tab MedroxyprogesteroneAcetate 2.5mg tab Medroxyprogesterone Acetate 5mg tab Medroxyprogesterone Acetate 10mg tab

Women’s Health Alendronate SOD 35mg tab Alendronate SOD 70mg tab Clomiphene 50mg tab Tamoxifen 10mg tab Tamoxifen 20mg tab

Effective date August 21, 2008

90-day QTY N/A N/A N/A 90 90 N/A 100 100 473ml 90 90 90

90-day QTY 90 90 90 90 90 90

Additional Medicines Isoniazid 100mg tab Isoniazid 300mg tab Lidocaine 2% viscous solution Oxybutynin 5mg tab Prednisone 2.5mg tab Prednisone 5mg tab Prednisone 10mg tab Prednisone 20mg tab

Additional 30 day Supply or Normal Course of Treatment Benzonatate Capsules 100mg 30 caps Chlorhexidine Gluconate 0.12% solution – 473ml Hydrocortisone AC 25mg Suppositories 24 Phenazopyridine 100mg 6 tabs Phenazopyridine 200mg 6 tabs

90-day QTY 90 90 300ml 180 90 90 90 90

$9.99 $9.99 $9.99 $9.99 $9.99

90 30

30-day QTY $4.99 4 4 5 60 30

See Terms & Conditions on Page 1 of this document. The list of eligible drugs and quantities are subject to change without notice

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