Program Overview Drug Pricing Pharmacy Network FAQ's
Pharmacy Network
This program is designed to educate you on the use of generic and other low cost brand name drugs. This program is designed to help you find drugs within the same therapeutic class as a drug you may currently be taking. Most of all this program is designed to save you money on your prescription drug costs.
Drug quantities listed must be adhered to in order to receive Tier pricing. Any change in listed quantity may result in higher prices. Company cannot be responsible for changes in network pharmacies which accept this program.
Brand name drugs are signifed in UPPER case text. Generic drugs are signifed in Standard case text.
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First Tier
DRUG NAME (DOSE)QTY
B6 FOLIC ACD CAP30.00
BD LANCET UF MIS 30G100.00
BENAZEPRIL TAB 20MG30.00
BENZALKONIUM SOL 50%1.00
BENZOIN CMPD TIN1.00
BIOCEL TAB30.00
DRUG NAME (DOSE)QTY
BIOTUSS LIQ473.00
BIOTUSS LIQ PEDIATRC30.00
BORIC ACID GRA1.00
B-PLEX TAB30.00
B-PLEX PLUS TAB30.00
BUMETANIDE INJ 0.25/ML2.00
Second Tier
DRUG NAME (DOSE)QTY
B3/AZEL/TURM TAB FA/B6/ZN30.00
BACIT/POLYMY OIN OP3.50
BACLOFEN TAB 10MG90.00
BACLOFEN TAB 20MG90.00
BAYER MICRLT MIS LANCETS100.00
B-COMPLEX INJ 10030.00
BD LANCET UF MIS 33G100.00
BENAZEP/HCTZ TAB 5-6.2530.00
BENAZEPRIL TAB 10MG30.00
BENAZEPRIL TAB 40MG30.00
BENAZEPRIL TAB 5MG30.00
BENZTROPINE TAB 0.5MG60.00
BETHANECHOL TAB 5MG30.00
DRUG NAME (DOSE)QTY
BIO GLO TES 1MG OP100.00
BIO-STATIN CAP 100000030.00
BIO-STATIN CAP 50000030.00
BISOPRL/HCTZ TAB 10/6.2530.00
BISOPRL/HCTZ TAB 2.5/6.2530.00
BISOPRL/HCTZ TAB 5-6.25MG30.00
BRIMONIDINE SOL 0.2% OP5.00
BUCALSEP SOL30.00
BUCALSEP SPR30.00
BUMETANIDE TAB 0.5MG30.00
BUSPIRONE TAB 5MG60.00
BUT/APAP/CAF CAP 50-325-40 MG30.00

Third Tier

DRUG NAME (DOSE)QTY
BACITRACIN OIN OP1.00
BACMIN TAB30.00
BACTRIM TAB 400-80MG30.00
BALZIVA TAB28.00
BD MICROTAIN MIS LANCETS100.00
BD PEN MIS1.00
BD PEN MINI MIS1.00
BD PEN NEEDL MIS 29GX1/2"100.00
BD PEN NEEDL MIS 31GX3/16100.00
BD PEN NEEDL MIS 31GX5/16100.00
BD PEN NEEDL MIS 32GX4MM100.00
BENAZEP/HCTZ TAB 10-12.530.00
BENAZEP/HCTZ TAB 20-12.530.00
BENAZEP/HCTZ TAB 20-25MG30.00
BENZONATATE CAP 200MG60.00
BENZTROPINE TAB 1MG60.00
BENZTROPINE TAB 2MG60.00
BETAMETH DIP LOT 0.05%60.00
BETAMETH VAL CRE 0.1%45.00
BETA-PHOS/AC INJ 3-3MG/ML5.00
BETAXOLOL TAB 10MG30.00
BETAXOLOL TAB 20MG30.00
BETHANECHOL TAB 25MG90.00
BICALUTAMIDE TAB 50MG30.00
BIOSCANNER TES GLUCOSE100.00
BISOPROL FUM TAB 10MG30.00
BISOPROL FUM TAB 5MG30.00
DRUG NAME (DOSE)QTY
BLEOMYCIN INJ 15UNIT1.00
BOOSTRIX INJ0.50
BP FOAMING LIQ WASH 10%227.00
BP FOLINATAL TAB PLUS B30.00
BP MULTINATL CHW PLUS30.00
BP MULTINATL TAB PLUS30.00
BP VIT 3 CAP PLUS30.00
BP WASH LIQ 2.5%227.00
BRIELLYN TAB28.00
BROM/PSE/DM SYP118.00
BROMFED DM SYP118.00
BULLSEYE MIS LANCETS100.00
BULLSEYE MIS MINI LNC100.00
BUMETANIDE TAB 1MG30.00
BUMETANIDE TAB 2MG30.00
BUPIVACAINE INJ SPINAL20.00
BUPRENORPHIN INJ 0.3MG/ML5.00
BUPROPION TAB 100MG ER30.00
BUPROPION TAB 100MG SR30.00
BUPROPION TAB 75MG60.00
BUPROPN HCL TAB 300MG XL30.00
BUSPIRONE TAB 10MG60.00
BUSPIRONE TAB 15MG60.00
BUTORPHANOL INJ 1MG/ML10.00
BUTORPHANOL INJ 2MG/ML10.00
BUTORPHANOL SOL 10MG/ML2.50

Fourth Tier
DRUG NAME (DOSE)QTY
B-12 COMP KIT 1000MCG
BACIIM INJ 50000UNT
BACITRACIN INJ 50000UNT
BACLOFEN CRE
BACLOFEN CRE 1%
BACTRIM DS TAB 800-160
BACTROBAN CRE 2%
BACTROBAN OIN 2%
BACTROBAN OIN NASAL 2%
BAL IN OIL INJ 100MG/ML
BAL-CARE MIS DHA
BALSALAZIDE CAP 750MG
BANZEL SUS 40MG/ML
BANZEL TAB 200MG
BANZEL TAB 400MG
BARACLUDE SOL .05MG/ML
BARACLUDE TAB 0.5MG
BARACLUDE TAB 1MG
BAYER BREEZE MIS 2 TEST
BAYER CONTOR TES BLD GLUC
BAYER CONTOR TES NEXT
BCG VACCINE INJ
B-COMPLEX INJ
BEAU RX GEL
BECONASE AQ SUS 0.042%
BELLA/OPIUM SUP 16.2-30
BELLA/OPIUM SUP 16.2-60
BELSOMRA TAB 10MG
BELSOMRA TAB 15MG
BELSOMRA TAB 20MG
BELSOMRA TAB 5MG
BELVIQ TAB 10MG
BENICAR TAB 20MG
BENICAR TAB 40MG
BENICAR TAB 5MG
BENICAR HCT TAB 20-12.5
BENICAR HCT TAB 40-12.5
BENICAR HCT TAB 40-25MG
BENSAL HP OIN
BENTYL CAP 10MG
BENTYL INJ 10MG/ML
BENTYL TAB 20MG
BENZAC AC LIQ 5% WASH
BENZAC W LIQ 5% WASH
BENZACLIN GEL 1-5%
BENZACLIN GEL 1-5%PUMP
BENZALKONIUM SOL NF
BENZAMYCIN GEL 5-3%
BENZAMYCIN GEL PAK
BENZEFOAM AER 5.3%
BENZEFOAM AER 9.8%
BENZEPRO AER 5.3%
BENZEPRO LIQ CREAMY
BENZEPRO MIS 6%
BENZEPRO SC AER 9.8%
BENZIQ GEL 5.25%
BENZIQ LS GEL 2.75%
BENZIQ WASH LIQ 5.25%
BENZOIN TIN NF
BENZONATATE CAP 100MG
BENZONATATE CAP 150MG
BENZOYL PER AER 5.3%
BENZOYL PER AER 9.8%
BENZOYL PERO AER 9.8%
BENZPHETAMIN TAB 50MG
BENZTROPINE INJ 1MG/ML
BEPREVE DRO 1.5%
BESIVANCE SUS 0.6%
BETADINE SOL 5% OP
BETAGAN SOL 0.5% OP
BETALIDO KIT
BETAMETH COM INJ 7MG/ML
BETAMETH DIP CRE 0.05%
BETAMETH DIP OIN 0.05%
BETAMETH PF INJ 12MG/2ML
BETAMETH SP INJ 24MG/2ML
BETAMETH VAL AER 0.12%
BETAMETH VAL LOT 0.1%
BETAMETH VAL OIN 0.1%
BETAPACE TAB 120MG
BETAPACE TAB 160MG
BETAPACE TAB 80MG
BETAPACE AF TAB 120MG
BETAPACE AF TAB 160MG
BETAPACE AF TAB 80MG
BETASERON INJ 0.3MG
BETAXOLOL SOL 0.5% OP
BETHANECHOL TAB 10MG
BETHANECHOL TAB 50MG
BETHKIS NEB 300/4ML
BETIMOL SOL 0.25%
BETIMOL SOL 0.5%
BETOPTIC-S SUS 0.25% OP
BEXSERO INJ
BEYAZ TAB
BG STAR TES BLD GLUC
BIAXIN SUS 250/5ML
BIAXIN TAB 250MG
BIAXIN TAB 500MG
BICILLIN C-R INJ 1200000
BICILLIN C-R INJ 900/300
BICILLIN L-A INJ 1200000
BICILLIN L-A INJ 2400000
BICILLIN L-A INJ 600000
BIDIL TAB
BIEST/PROGES CRE
BIFERARX TAB
BILTRICIDE TAB 600MG
BIMATOPROST SOL 0.03%
BINOSTO TAB 70MG
BIONECT AER 0.2%
BIONECT CRE 0.2%
DRUG NAME (DOSE)QTY
BIONECT GEL 0.2%
BIONECT SPR 0.2%
BIOPSY TRAY KIT MARROW
BIO-STATIN POW
BIOSTEP MIS 2"X2"
BIOSTEP MIS 4"X4"
BIOSTEP AG MIS 2"X2"
BIOSTEP AG MIS 4"X4"
BIOTHRAX INJ
BIOVANCE MIS 1CMX2CM
BIOVANCE MIS 6CMX6CM
BLANCHE CRE 4%
BLEOMYCIN INJ 30UNIT
BLEPH-10 SOL 10% OP
BLEPHAMIDE OIN S.O.P.
BLEPHAMIDE SUS OP
BLOOD GLUCOS TES
BLOOD GLUCOS TES PREMIUM
BLOOD GLUCOS TES STRIPS
BONE MARROW KIT BIOPSY
BONIVA TAB 150MG
BONTRIL PDM TAB 35MG
BOSULIF TAB 100MG
BOSULIF TAB 500MG
BOTOX INJ 100UNIT
BOTOX INJ 200UNIT
BOTOX COSMET INJ 100UNIT
BOTOX COSMET INJ 50UNIT
BP 10-1 EMU
BP CLEANSING EMU 10-4%
BP FOAM AER 5.3%
BP FOAM AER 9.8%
BP VIT 3 CAP
BP WASH LIQ 7%
BPO GEL 4%
BPO GEL 8%
BPO CLOTHS MIS 3%
BPO CLOTHS MIS 6%
BPO CLOTHS MIS 9%
BRAVELLE INJ 75UNIT
BREO ELLIPTA INH 100-25
BREO ELLIPTA INH 200-25
BREVICON TAB 0.5/35
BREVITAL SOD INJ 2.5GM
BREVITAL SOD INJ 500MG
BRILINTA TAB 90MG
BRIMONIDINE SOL 0.15%
BRINTELLIX TAB 10MG
BRINTELLIX TAB 20MG
BRINTELLIX TAB 5MG
BRISDELLE CAP 7.5MG
BROMFENAC SOL 0.09% Once-Daily
BROMFENAC SOLN 0.09%
BROMOCRIPTIN CAP 5MG
BROMOCRIPTIN TAB 2.5MG
BROMPHENIRAM CHW 12MG
BROMPHENIRAM INJ 10MG/ML
BROVANA NEB 15MCG
BUDESONIDE CAP 3MG/24HR
BUDESONIDE SUS 0.25MG/2
BUDESONIDE SUS 0.5MG/2
BUDESONIDE SUS 32MCG
BUNAVAIL MIS 2.1-0.3
BUNAVAIL MIS 4.2-0.7
BUNAVAIL MIS 6.3-1MG
BUPAP TAB 50-300MG
BUPHENYL POW
BUPHENYL TAB 500MG
BUPIVACAINE INJ 0.25%
BUPIVACAINE INJ 0.5%
BUPIVACAINE INJ 0.75%
BUPIVACAINE/ INJ EPI 0.25
BUPIVACAINE/ INJ EPI 0.5%
BUPIVILOG KIT
BUPREN/NALOX SUB 2-0.5MG
BUPREN/NALOX SUB 8-2MG
BUPRENEX INJ 0.3MG/ML
BUPRENORPHIN SUB 2MG
BUPRENORPHIN SUB 8MG
BUPROBAN TAB 150MG
BUPROPION TAB 100MG
BUPROPION TAB 150MG
BUPROPION TAB 150MG ER
BUPROPION TAB 150MG SR
BUPROPION TAB 200MG ER
BUPROPION TAB 200MG SR
BUPROPN HCL TAB 150MG XL
BUSPIRONE TAB 30MG
BUSPIRONE TAB 7.5MG
BUT/APAP/CAF CAP
BUT/APAP/CAF CAP CODEINE 50-300-40-30 MG
BUT/APAP/CAF CAP CODEINE 50-325-40-30 MG
BUT/APAP/CAF TAB
BUT/ASA/CAF/ CAP COD 30MG
BUT/ASA/CAFF CAP
BUTAL/APAP TAB 50-325MG
BUTISOL SOD TAB 30MG
BUTISOL SOD TAB 50MG
BUTRANS DIS 10MCG/HR
BUTRANS DIS 15MCG/HR
BUTRANS DIS 20MCG/HR
BUTRANS DIS 5MCG/HR
BUTRANS DIS 7.5/HR
BXN MOUTHWSH SUS
BYDUREON INJ
BYETTA INJ 10MCG
BYETTA INJ 5MCG
BYSTOLIC TAB 10MG
BYSTOLIC TAB 2.5MG
BYSTOLIC TAB 20MG
BYSTOLIC TAB 5MG
A B C D E
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 * THIS IS NOT INSURANCE – DISCOUNTS ONLY Dispute Resolution Procedure  Terms & Conditions  Privacy Policy 
 * Pricing is subject to change without notice.
 * Pricing is only for quantities stated, additional quantities may incur higher costs.
 * Network pharmacies can be contracted at different rates resulting in some pricing differences.