Skin Conditions
*Due to state laws, these drugs are not covered under the 30-day program in MN and WI; however, they have been competitively priced. Please ask your pharmacist for specific pricing in these states.
†Due to state laws, these drugs are not covered under the 90-day program in MN and WI; however, they have been competitively priced. Please ask your pharmacist for specific pricing in these states.
$4 prescriptions are for up to a 30-day supply at commonly prescribed dosages. List subject to change.
| GENERIC NAME | BRAND NAME | QTY | FORM |
| BETAMETHASONE DIPROPIONATE 0.05% | DIPROSONE® | 15 | CREAM |
| *† BETAMETHASONE DIPROPIONATE 0.05% | DIPROSONE® | 45 | CREAM |
| BETAMETHASONE VALERATE 0.10% | VALISONE® | 15 | CREAM |
| BETAMETHASONE VALERATE 0.10% | VALISONE® | 15 | OINTMENT |
| BETAMETHASONE VALERATE 0.10% | VALISONE® | 45 | OINTMENT |
| BETAMETHASONE VALERATE 0.10% | VALISONE® | 45 | CREAM |
| FLUOCINOLONE ACETONIDE 0.01% | SYNALAR® | 60 | SOLUTION |
| FLUOCINONIDE 0.05% | LIDEX® | 15 | CREAM |
| FLUOCINONIDE 0.05% | LIDEX® | 30 | CREAM |
| GENTAMICIN 0.10% | GARAMYCIN® | 15 | CREAM |
| GENTAMICIN 0.10% | GARAMYCIN® | 15 | OINTMENT |
| HYDROCORTISONE 1% | HYTONE® | 15 | CREAM |
| HYDROCORTISONE 1% | HYTONE® | 30 | CREAM |
| HYDROCORTISONE 2.50% | HYTONE® | 30 | OINTMENT |
| HYDROCORTISONE 2.50% | HYTONE® | 30 | CREAM |
| † SELENIUM SULFIDE 2.50% | SELSUN® | 120 | LOTION |
| *† SILVER SULFADIAZINE 1% | SILVADENE® | 50 | CREAM |
| TRIAMCINOLONE 0.025% | ARISTOCORT® | 15 | CREAM |
| TRIAMCINOLONE 0.025% | ARISTOCORT® | 80 | CREAM |
| TRIAMCINOLONE 0.10% | ARISTOCORT® | 15 | OINTMENT |
| TRIAMCINOLONE 0.10% | KENALOG® | 15 | CREAM |
| TRIAMCINOLONE 0.10% | KENALOG® | 30 | CREAM |
| TRIAMCINOLONE 0.10% | ARISTOCORT® | 80 | OINTMENT |
| TRIAMCINOLONE 0.10% | KENALOG® | 80 | CREAM |
| TRIAMCINOLONE 0.50% | ARISTOCORT® | 15 | CREAM |
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