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
HAIR FORMULA TAB EX STREN30.00
HAIR SKIN TAB NAILS30.00
HAIR VITAMIN TAB30.00
HAIR/SKIN CAP NAILS60.00
HAIR/SKIN/ CAP NAILS60.00
HAIR/SKIN/ CHW NAILS80.00
HAIR/SKIN/ CHW NAILS80.00
HAIR/SKIN/ TAB NAILS30.00
HAIR/SKIN/ TAB NAILS30.00
HAIR/SKIN/ TAB NAILS30.00
HAIR/SKIN/ TAB NAILS30.00
HALLS COUGH LOZ SF CHERR25.00
HALLS COUGH LOZ SF HN/LM25.00
HALLS COUGH LOZ SF MENTH25.00
HALOPER LAC INJ 5MG/ML1.00
HALOPERIDOL CON 2MG/ML15.00
HALOPERIDOL INJ 50/10ML1.00
HALOPERIDOL INJ 5MG/ML1.00
HALOPERIDOL TAB 0.5MG30.00
HEADACHE TAB RELIEF24.00
HEADACHE TAB RELIEF24.00
HEADACHE PM TAB 25-500MG14.00
HEADACHE PM TAB 25-500MG14.00
HEADACHE PM TAB 500-25MG14.00
HEADACHE REL TAB24.00
HEADACHE REL TAB ADDED ST24.00
HEALTHY EYES TAB30.00
HEALTHY EYES TAB LUTEIN30.00
HEALTHY HAIR TAB SKN/NAIL30.00
HEALTHY KIDS CHW GUMMIES30.00
HEARTBRN ANT CHW 160-105100.00
HEARTBRN REL TAB 200MG60.00
HEARTBRN RLF CHW 160-105100.00
HEARTBURN CHW EX ST100.00
HEARTBURN CHW EX ST100.00
HEARTBURN SUS RELIEF355.00
HEARTBURN TAB 20MG60.00
HEARTBURN TAB 20MG60.00
HEARTBURN TAB RELIEF60.00
HEARTBURN TAB RELIEF30.00
HEMATEX LIQ 100/5ML118.00
HEMATINIC PL TAB VIT/MIN30.00
HEMATINIC/FA TAB30.00
HEMOCYTE TAB 324MG30.00
HEMOCYTE-F TAB30.00
HEMORRHIDAL CRE MAX FORM26.00
HEMORRHOIDAL CRE26.00
HEMORRHOIDAL CRE26.00
HEMORRHOIDAL CRE26.00
HEMORRHOIDAL CRE MAX ST26.00
HEMORRHOIDAL CRE MAX ST26.00
HEMORRHOIDAL CRE MAX ST26.00
HEMORRHOIDAL CRE MAX STR26.00
HEMORRHOIDAL GEL 0.25-50%26.00
HEMORRHOIDAL GEL 0.25-50%26.00
HEMORRHOIDAL GEL COOLING26.00
HEMORRHOIDAL GEL COOLING26.00
HEMORRHOIDAL OIN28.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN28.00
HEMORRHOIDAL OIN28.00
HEMORRHOIDAL OIN28.00
HEMORRHOIDAL OIN28.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP24.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP 0.25%12.00
HEP SOD/D5W INJ 25000UNT500.00
HEPARIN LOCK INJ 100/ML5.00
HEPARIN LOCK INJ 100/ML5.00
HEPARIN LOCK INJ 100/ML5.00
HERPECIN-L MIS2.80
HGH-POT IRON TAB 325MG30.00
HISTEX SYP 2.5MG/560.00
HISTEX-DM SYP120.00
HISTEX-PE SYP 2.5-10/5120.00
HM ALLERGY CAP 25MG30.00
HM ALLERGY TAB 25MG30.00
HM ALLERGY TAB 4MG30.00
HM ANTACID SUS355.00
HM ANTACID SUS ANTI-GAS355.00
HM ANTACID SUS ANTI-GAS355.00
HM ASPIRIN CHW 81MG30.00
HM ASPIRIN TAB 325MG30.00
DRUG NAME (DOSE)QTY
HM BIOTIN CAP 5000MCG30.00
HM CA/VIT D3 TAB 600-40060.00
HM CHEST RUB OIN50.00
HM COLD/CGH ELX CHILDREN118.00
HM COMPLETE TAB30.00
HM COMPLETE TAB30.00
HM COMPLETE TAB 50+30.00
HM COMPLETE TAB WOMEN30.00
HM COUGH DM SUS 30MG/5ML89.00
HM CRANBERRY TAB 500MG60.00
HM DRY EYE SOL RELIEF15.00
HM ENEMA ENE R-T-U266.00
HM ENEMA ENE R-T-U266.00
HM EPSOM GRA SALT454.00
HM EYE DROPS SOL 0.05% OP15.00
HM EYE DROPS SOL RED RELF15.00
HM FIBER POW 28.3%368.00
HM FIBER POW 30.9%822.00
HM FIBER POW 48.57%368.00
HM FIBER POW 58.6%425.00
HM FIBER TAB 500MG60.00
HM FISH OIL CAP 1000MG30.00
HM FISH OIL CAP 1000MG30.00
HM FISH OIL CAP 1200MG30.00
HM GAS RELF CHW 80MG30.00
HM GLUCOSE CHW ORANGE50.00
HM GLUCOSE CHW RASPBERY50.00
HM IBUPROFEN CHW 100MG24.00
HM IBUPROFEN TAB 200MG30.00
HM IBUPROFEN TAB 200MG30.00
HM IRON TAB 45MG30.00
HM IRON TAB 65MG30.00
HM LAXATIVE SUP 10MG2.00
HM LAXATIVE TAB 5MG4.00
HM LAXATIVE TAB 5MG EC4.00
HM MAGNESIUM TAB 250MG30.00
HM MINERAL OIL473.00
HM MUCUS REL TAB CONG/CLD24.00
HM NASAL SPR 0.05%30.00
HM ONE DAILY TAB /IRON30.00
HM ONE DAILY TAB ESSENTIA30.00
HM PAIN RLF TAB 650MG60.00
HM PRENATAL TAB30.00
HM SALINE SPR 0.65%45.00
HM SENNA TAB 8.6MG60.00
HM SENNA-S TAB 8.6-50MG60.00
HM SEVERE TAB COLD/FLU24.00
HM SLEEP AID TAB 25MG30.00
HM STOMACH SUS 262/15ML236.00
HM STOOL SOF TAB 8.6-50MG60.00
HM TRUEPLUS CHW FIBER60.00
HM TUSSIN LIQ ADLT DM118.00
HM TUSSIN LIQ DM MAX237.00
HM VIT B12 TAB 500MCG30.00
HM VIT D3 CAP 2000UNIT30.00
HM VITAMIN C TAB 1000MG30.00
HM VITAMIN D TAB 1000UNIT30.00
HM VITAMIN E CAP 400UNIT30.00
HOMOCYSTEINE TAB FORMULA60.00
HONEY LEMON LOZ DROPS18.00
HURRICAINE GEL 20%9.00
HYDRALAZINE TAB 100MG90.00
HYDRALAZINE TAB 10MG90.00
HYDRALAZINE TAB 25MG90.00
HYDROCHLOROT CAP 12.5MG30.00
HYDROCHLOROT TAB 12.5MG30.00
HYDROCHLOROT TAB 25MG30.00
HYDROCHLOROT TAB 50MG30.00
HYDROCO/APAP TAB 5-325MG30.00
HYDROCO/APAP TAB 5-325MG30.00
HYDROCORT CRE 1%28.35
HYDROCORT CRE 2.5%30.00
HYDROCORT OIN 2.5%28.35
HYDROMORPHON INJ 1MG/ML1.00
HYDROMORPHON INJ 2MG/ML1.00
HYDROMORPHON INJ 2MG/ML1.00
HYDROMORPHON INJ 2MG/ML1.00
HYDROMORPHON INJ 2MG/ML1.00
HYDROMORPHON TAB 2MG30.00
HYDROXYZ HCL SYP 10MG/5ML120.00
HYDROXYZ HCL TAB 10MG30.00
HYDROXYZ HCL TAB 25MG30.00
HYDROXYZ HCL TAB 25MG30.00
HYDROXYZ HCL TAB 50MG30.00
HYDROXYZ HCL TAB 50MG30.00
HYDROXYZ PAM CAP 25MG30.00
HYDROXYZ PAM CAP 50MG30.00
HYOSCYAMINE ELX 0.125/5120.00
HYOSCYAMINE TAB 0.125MG30.00
HYOSYNE ELX 0.125/5120.00
HYPERCARE SOL 15%35.00
HYPO NEEDLE MIS 32GX5/16100.00
HYPOTEARS SOL 1-1%15.00
Second Tier
DRUG NAME (DOSE)QTY
HALOPERIDOL TAB 1MG30.00
HALOPERIDOL TAB 2MG30.00
HEALTHY EYES CAP SUPERVIS60.00
HEARTBURN TAB 200MG60.00
HEARTBURN TR CAP 15MG30.00
HEARTBURN TR CAP 24H 20MG30.00
HEATHER TAB 0.35MG28.00
HEMATOGEN CAP30.00
HEMATOGEN CAP FORTE30.00
HEMATOGEN FA CAP30.00
HEMOCYTE TAB -PLUS30.00
HEMOCYTE PLS CAP30.00
HEP SOD/NACL INJ 25000UNT500.00
HEPARIN LOCK INJ 100/ML5.00
HEPARIN SOD INJ 1000/ML10.00
HIBERIX SOL 10MCG1.00
HISTEX PD DRO 0.938MG30.00
HISTEX-AC SYP120.00
HM 4X TAB PROBIOTI30.00
HM CLEARLAX POW527.00
HM GAS RELF CHW 125MG60.00
DRUG NAME (DOSE)QTY
HM MUCUS ER TAB 1200MG28.00
HM PROBIOTIC CAP30.00
HOMATROPAIRE SOL 5% OP5.00
HYDRALAZINE TAB 100MG90.00
HYDRALAZINE TAB 50MG90.00
HYDROCIL POW 95%368.00
HYDROCIL INS POW 95%30.00
HYDROCO/APAP SOL 7.5-325120.00
HYDROCO/APAP TAB 7.5-32560.00
HYDROCO/APAP TAB 7.5-32560.00
HYDROCOD/HOM SYP 5-1.5/5120.00
HYDROCOD/HOM SYP 5-1.5/5120.00
HYDROMET SYP 5-1.5/5120.00
HYDROMORPHON INJ 4MG/ML6.00
HYDROMORPHON LIQ 1MG/ML30.00
HYDROMORPHON TAB 4MG120.00
HYOSCYAMINE DRO 0.125/ML15.00
HYOSCYAMINE SUB 0.125MG30.00
HYOSCYAMINE TAB 0.125MG30.00
HYOSCYAMINE TAB 0.125MG30.00
HYOSYNE DRO 0.125/ML15.00

Third Tier

DRUG NAME (DOSE)QTY
HALDOL INJ 5MG/ML1.00
HALOPER DEC INJ 100MG/ML1.00
HALOPER DEC INJ 500/5ML1.00
HALOPER DEC INJ 50MG/ML1.00
HALOPERIDOL TAB 10MG30.00
HALOPERIDOL TAB 5MG30.00
HAVRIX INJ 720UNIT0.50
H-CHLOR 6 SOL 0.062%973.00
HEALTHY MOM LIQ VANILLA5688.00
HECTOROL INJ 2MCG/ML9.00
HEMATRON-AF TAB30.00
HEMAX TAB30.00
HEMETAB TAB30.00
HEPARIN LOCK INJ 10UNT/ML150.00
HEPARIN LOCK INJ 10UNT/ML150.00
HEPARIN SOD INJ 10000/ML7.00
HEPARIN SOD INJ 5000/ML25.00
HISTAFLEX TAB 325-25MG30.00
HM NICOTINE DIS 14MG/24H28.00
HM NICOTINE DIS 7MG/24HR28.00
HM NICOTINE GUM 2MG MINT100.00
HM NICOTINE GUM 4MG MINT100.00
HM NICOTINE LOZ 2MG MINT72.00
HM NICOTINE LOZ 4MG MINT72.00
DRUG NAME (DOSE)QTY
HOMATROPINE SOL 5% OP5.00
HURRICAINE SOL 20%200.00
HURRICAINE SPR 20%57.00
HYDROC/HOMAT TAB 5-1.5MG30.00
HYDROCO/APAP TAB 10-325MG120.00
HYDROCO/APAP TAB 10-325MG120.00
HYDROCO/APAP TAB 5-300MG20.00
HYDROCO/APAP TAB 7.5-30020.00
HYDROCOD/IBU TAB 7.5-20060.00
HYDROCORT CRE 1%28.40
HYDROCORT TAB 10MG60.00
HYDROCORT TAB 20MG30.00
HYDROCORT TAB 5MG90.00
HYDROMORPHON INJ 1MG/ML10.00
HYDROXOCOBAL INJ 1000MCG30.00
HYDROXYUREA CAP 500MG60.00
HYDROXYZ PAM CAP 100MG30.00
HYOSCYAMINE TAB 0.375 ER60.00
HYOSCYAMINE TAB 0.375 SR60.00
HYPERRHO S/D INJ 50MCG1.00
HYPERSAL NEB 3.5%240.00
HYPERSAL NEB 7%240.00
HYPER-SAL NEB 7%240.00

Fourth Tier
DRUG NAME (DOSE)QTY
H.P. ACTHAR INJ 80UNIT
HAEGARDA INJ 2000UNIT
HAEGARDA INJ 3000UNIT
HALAVEN INJ 1MG/2ML
HALCION TAB 0.25MG
HALDOL DECAN INJ 100MG/ML
HALDOL DECAN INJ 50MG/ML
HALOBETASOL OIN 0.05%
HALOG CRE 0.1%
HALOPERIDOL TAB 20MG
HARVONI TAB 90-400MG
HAVRIX INJ 1440UNIT
HC PRAMOXINE CRE 1-1%
HC PRAMOXINE CRE 2.5-1%
HC/ACET ACID SOL OTIC
HECTOROL INJ 4MCG/2ML
HELIXATE FS INJ 1000UNIT
HELIXATE FS INJ 2000UNIT
HELIXATE FS INJ 250UNIT
HELIXATE FS INJ 3000UNIT
HELIXATE FS INJ 500UNIT
HEMABATE INJ 250MCG
HEMANGEOL SOL 4.28/ML
HEMENATAL OB MIS + DHA
HEMLIBRA INJ 105/0.7
HEMLIBRA INJ 150/ML
HEMLIBRA INJ 30MG/ML
HEMLIBRA INJ 60/0.4
HEMMOREX-HC SUP 25MG
HEMOFIL M INJ 1000UNIT
HEMOFIL M INJ 1700UNIT
HEMOFIL M INJ 250UNIT
HEMOFIL M INJ 500UNIT
HEPARIN LOCK INJ 10UNT/ML
HEPARIN LOCK INJ 10UNT/ML
HEPARIN LOCK INJ 1UNIT/ML
HEPARIN SOD INJ 10000/ML
HEPARIN SOD INJ 20000/ML
HEPARIN SOD INJ 20000/ML
HEPARIN SOD INJ 5000/0.5
HEPLISAV-B INJ 20MCG
HEPSERA TAB 10MG
HERCEPTIN INJ 150MG
HERCEPTIN INJ 440MG
HETLIOZ CAP 20MG
HIPREX TAB 1GM
HIZENTRA INJ 10/50ML
HIZENTRA INJ 1GM/5ML
HIZENTRA INJ 2GM/10ML
HIZENTRA INJ 4GM/20ML
HM NICOTINE DIS 14MG/24H
HM NICOTINE DIS 21MG/24H
HORIZANT TAB 300MG ER
HORIZANT TAB 600MG ER
HUMALOG INJ 100/ML
HUMALOG INJ 100/ML
HUMALOG JR INJ 100/ML
HUMALOG KWIK INJ 100/ML
HUMALOG KWIK INJ 200/ML
HUMALOG MIX INJ 50/50
HUMALOG MIX INJ 50/50KWP
HUMALOG MIX INJ 75/25KWP
HUMALOG MIX SUS 75/25
HUMATE-P SOL 2400UNIT
HUMATE-P SOL 250-600
HUMATE-P SOL 500-1200
HUMATROPE INJ 12MG
HUMATROPE INJ 24MG
HUMATROPE INJ 5MG
HUMATROPE INJ 6MG
HUMIRA INJ 10MG/0.2
HUMIRA INJ 20/0.2ML
HUMIRA INJ 40/0.4ML
HUMIRA KIT 20MG/0.4
HUMIRA KIT 40MG/0.8
HUMIRA PEDIA INJ CROHNS
HUMIRA PEDIA INJ CROHNS
HUMIRA PEDIA INJ CROHNS
DRUG NAME (DOSE)QTY
HUMIRA PEN INJ 40/0.4ML
HUMIRA PEN INJ 40MG/0.8
HUMIRA PEN INJ CD/UC/HS
HUMIRA PEN INJ PS/UV
HUMIRA PEN KIT CD/UC/HS
HUMIRA PEN KIT PS/UV
HUMULIN INJ 70/30
HUMULIN INJ 70/30KWP
HUMULIN N INJ U-100
HUMULIN N INJ U-100KWP
HUMULIN R INJ U-100
HUMULIN R INJ U-500
HUMULIN R INJ U-500
HURRICAINE SPR ONE 20%
HYALGAN INJ 20MG/2ML
HYALGAN INJ 20MG/2ML
HYCAMTIN CAP 1MG
HYCLODEX SOL 0.012%
HYD POL/CPM SUS 10-8/5ML
HYDR/CPM/PSE LIQ 5-4-60MG
HYDRALAZINE INJ 20MG/ML
HYDREA CAP 500MG
HYDROCO/APAP TAB 10-300MG
HYDROCOD/IBU TAB 10-200MG
HYDROCOD/IBU TAB 5-200MG
HYDROCORT ENE 100MG
HYDROCORT AC SUP 25MG
HYDROCORT AC SUP 25MG
HYDROCORT AC SUP 30MG
HYDROCORTISO CRE 2.5%
HYDROCORTISO LOT 0.1%
HYDROMORPHON INJ 10MG/ML
HYDROMORPHON INJ 10MG/ML
HYDROMORPHON INJ 500/50ML
HYDROMORPHON INJ 50MG/5ML
HYDROMORPHON POW HCL
HYDROMORPHON SUP 3MG
HYDROMORPHON TAB 12MG ER
HYDROMORPHON TAB 16MG ER
HYDROMORPHON TAB 32MG ER
HYDROMORPHON TAB 32MG ER
HYDROMORPHON TAB 8MG
HYDROMORPHON TAB 8MG ER
HYDROMORPHON TAB 8MG ER
HYDROQUINONE CRE 4%
HYDROQUINONE CRE 4% TR
HYDROXY CAPR INJ 1.25/5ML
HYDROXYCHLOR TAB 200MG
HYDROXYPROG INJ 250MG/ML
HYDROXYZ HCL INJ 25MG/ML
HYDROXYZ HCL INJ 50MG/ML
HYDROXYZINE POW PAMOATE
HYLATOPIC CRE PLUS
HYLAVITE TAB
HYMOVIS INJ 24MG/3ML
HYOPHEN TAB
HYPERHEP B INJ S/D
HYPERRAB S/D INJ 150/ML
HYPERRAB S/D INJ 300/2ML
HYPERRHO S/D INJ 300MCG
HYPERTENSA CAP
HYPERTET S/D INJ 250/ML
HYQVIA INJ 10-800
HYQVIA INJ 2.5-200
HYQVIA INJ 20-1600
HYQVIA INJ 30-2400
HYQVIA INJ 5-400
HYSINGLA ER TAB 100 MG
HYSINGLA ER TAB 120 MG
HYSINGLA ER TAB 20 MG
HYSINGLA ER TAB 30 MG
HYSINGLA ER TAB 40 MG
HYSINGLA ER TAB 60 MG
HYSINGLA ER TAB 80 MG
HYZAAR TAB 100-12.5
HYZAAR TAB 100-25
HYZAAR TAB 50-12.5
A B C D E
F G H I J
K L M N O
P Q R S T
U V W X Y
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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.