Memorial Rx – Maintenance Generic Savings Program
$4 (30-day supply) / $10 (90-day supply)
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Blood Pressure / Heart
Medication | Strength | Supply | Pricing |
|---|---|---|---|
Lisinopril | All strengths | 30-day supply | $4 |
Lisinopril | All strengths | 90-day supply | $10 |
Amlodipine | All strengths | 30-day supply | $4 |
Amlodipine | All strengths | 90-day supply | $10 |
Hydrochlorothiazide (tablet only) | All strengths | 30-day supply | $4 |
Hydrochlorothiazide (tablet only) | All strengths | 90-day supply | $10 |
Atenolol | All strengths | 30-day supply | $4 |
Atenolol | All strengths | 90-day supply | $10 |
Metoprolol tartrate only | All strengths | 30-day supply | $4 |
Metoprolol tartrate only | All strengths | 90-day supply | $10 |
Losartan | All strengths | 30-day supply | Discounted cash price – ask pharmacist |
Losartan | All strengths | 90-day supply | Discounted cash price – ask pharmacist |
Diabetes
Medication | Strength | Supply | Pricing |
|---|---|---|---|
Glimepiride | All strengths | 90-day supply | $10 |
Glimepiride | All strengths | 30-day supply | $4 |
Glipizide IR | All strengths | 90-day supply | $10 |
Metformin IR | 500 mg | 30-day supply | $4 |
Metformin IR | 500 mg | 90-day supply | $10 |
Metformin IR | 850 mg | 30-day supply | $4 |
Metformin IR | 850 mg | 90-day supply | $10 |
Metformin IR | 1000 mg | 30-day supply | $4 |
Metformin IR | 1000 mg | 90-day supply | $10 |
Glipizide IR | All strengths | 30-day supply | $4 |
Mental Health
Medication | Strength | Supply | Pricing |
|---|---|---|---|
Quetiapine | Selected strengths | 90-day supply | Discounted cash price – ask pharmacist |
Quetiapine | Selected strengths | 30-day supply | Discounted cash price – ask pharmacist |
Venlafaxine IR | Selected strengths | 90-day supply | Discounted cash price – ask pharmacist |
Venlafaxine IR | Selected strengths | 30-day supply | Discounted cash price – ask pharmacist |
Bupropion SR | Selected strengths | 90-day supply | Discounted cash price – ask pharmacist |
Bupropion SR | Selected strengths | 30-day supply | Discounted cash price – ask pharmacist |
Duloxetine (capsules only) | Selected strengths | 90-day supply | Discounted cash price – ask pharmacist |
Duloxetine (capsules only) | Selected strengths | 30-day supply | Discounted cash price – ask pharmacist |
Amitriptyline | All strengths | 90-day supply | $10 |
Trazodone | All strengths | 30-day supply | $4 |
Trazodone | All strengths | 90-day supply | $10 |
Sertraline | All strengths | 30-day supply | $4 |
Sertraline | All strengths | 90-day supply | $10 |
Fluoxetine | All strengths | 30-day supply | $4 |
Fluoxetine | All strengths | 90-day supply | $10 |
Citalopram | All strengths | 30-day supply | $4 |
Citalopram | All strengths | 90-day supply | $10 |
Amitriptyline | All strengths | 30-day supply | $4 |
Cholesterol
Medication | Strength | Supply | Pricing |
|---|---|---|---|
Simvastatin | All strengths | 90-day supply | $10 |
Simvastatin | All strengths | 30-day supply | $4 |
Atorvastatin | 20 mg only | 90-day supply | $10 |
Atorvastatin | 20 mg only | 30-day supply | $4 |
Atorvastatin | 10 mg only | 30-day supply | $4 |
Atorvastatin | 10 mg only | 90-day supply | $10 |
GI / Acid Reduction
Medication | Strength | Supply | Pricing |
|---|---|---|---|
Famotidine | All strengths | 90-day supply | $10 |
Famotidine | All strengths | 30-day supply | $4 |
Pantoprazole | All strengths | 90-day supply | $10 |
Pantoprazole | All strengths | 30-day supply | $4 |
Omeprazole | All strengths | 90-day supply | $10 |
Omeprazole | All strengths | 30-day supply | $4 |
Thyroid
Medication | Strength | Supply | Pricing |
|---|---|---|---|
Levothyroxine | Most strengths | 30-day supply | $4 |
Levothyroxine | Most strengths | 90-day supply | $10 |
Pricing applies to select strengths and approved manufacturers only. Maintenance medications only. Prices are subject to change without notice. This list is reviewed monthly and adjusted as needed. Final pricing is confirmed by the pharmacist at the time of dispensing.
The Memorial Rx – Maintenance Generic Savings Program list represents medications available at posted pricing for select strengths and approved manufacturers. This is not an all-inclusive list. Products not represented on this list may be available at different pricing. Pricing applies to maintenance medications only and is subject to change without notice. This list is reviewed monthly and adjusted as needed.
Void where prohibited by law. Your prescription benefit plan design may apply restrictions, regardless of the drug's appearance in this document. For coverage and copay information, log into www.MemorialRX.com or call Customer Care using the toll-free number on your prescription benefit ID card.
Final pricing is confirmed by the pharmacist at the time of dispensing. Memorial Rx Pharmacy may receive rebates, discounts, and service fees from pharmaceutical manufacturers for certain listed products.
Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.
Copyright 2026 Memorial Rx Pharmacy. All rights reserved. This document contains confidential and proprietary information of Memorial Rx Pharmacy and cannot be reproduced, distributed, or printed without written permission from Memorial Rx Pharmacy.