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 NAILS30.00
HAIR/SKIN/ CAP NAILS30.00
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 RELIEF30.00
HEADACHE TAB RELIEF30.00
HEADACHE PM TAB 25-500MG14.00
HEADACHE PM TAB 25-500MG14.00
HEADACHE REL TAB30.00
HEADACHE REL TAB ADDED ST30.00
HEALTHY EYES CAP SUPERVIS30.00
HEALTHY EYES TAB30.00
HEALTHY EYES TAB LUTEIN30.00
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 RELIEF30.00
HEMATINIC PL TAB VIT/MIN30.00
HEMATINIC/FA TAB30.00
HEMOCYTE TAB 324MG30.00
HEMOCYTE-F TAB30.00
HEMORRHIDAL CRE MAX FORM51.00
HEMORRHOIDAL CRE51.00
HEMORRHOIDAL CRE51.00
HEMORRHOIDAL CRE51.00
HEMORRHOIDAL CRE MAX ST51.00
HEMORRHOIDAL CRE MAX ST51.00
HEMORRHOIDAL CRE MAX ST51.00
HEMORRHOIDAL CRE MAX STR51.00
HEMORRHOIDAL GEL 0.25-50%25.00
HEMORRHOIDAL GEL 0.25-50%25.00
HEMORRHOIDAL GEL COOLING25.00
HEMORRHOIDAL GEL COOLING25.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL OIN57.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP24.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP12.00
HEMORRHOIDAL SUP30.00
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
HGH-POT IRON TAB 325MG30.00
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
HM CA/VIT D3 TAB 600-40060.00
HM CHEST RUB OIN50.00
DRUG NAME (DOSE)QTY
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 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 CAP 0.52GM60.00
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 65MG60.00
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 ER TAB 1200MG14.00
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 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 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
HONEY LEMON LOZ DROPS18.00
HURRICAINE GEL 20%14.00
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 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
Second Tier
DRUG NAME (DOSE)QTY
HALOPERIDOL TAB 1MG30.00
HALOPERIDOL TAB 2MG30.00
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
HEMOCYTE TAB -PLUS30.00
HEMOCYTE PLS CAP30.00
HEMORRHOIDAL SUP30.00
HEPARIN LOCK INJ 100/ML5.00
HM 4X TAB PROBIOTI30.00
HM CLEARLAX POW527.00
HM GAS RELF CHW 125MG60.00
HM PROBIOTIC CAP30.00
HOMATROPAIRE SOL 5% OP5.00
DRUG NAME (DOSE)QTY
HYDRALAZINE TAB 100MG90.00
HYDRALAZINE TAB 50MG90.00
HYDROCIL POW 95%368.00
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
HEALTHY MOM LIQ VANILLA5688.00
HEMATRON-AF TAB30.00
HEMAX TAB30.00
HEPARIN LOCK INJ 10UNT/ML150.00
HEPARIN LOCK INJ 10UNT/ML150.00
HEPARIN SOD INJ 1000/ML10.00
HEPARIN SOD INJ 10000/ML7.00
HEPARIN SOD INJ 5000/ML25.00
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
HYDROXYUREA CAP 500MG60.00
HYDROXYZ PAM CAP 100MG30.00
HYOSCYAMINE TAB 0.375 ER60.00
HYOSCYAMINE TAB 0.375 SR60.00
HYPERSAL NEB 7%240.00
HYPER-SAL NEB 7%240.00

Fourth Tier
DRUG NAME (DOSE)QTY
H.P. ACTHAR INJ 80UNIT
HALCION TAB 0.25MG
HALDOL DECAN INJ 100MG/ML
HALDOL DECAN INJ 50MG/ML
HALOBETASOL OIN 0.05%
HALOPERIDOL TAB 20MG
HARVONI TAB 90-400MG
HC BUTYRATE CRE 0.1%
HC PRAMOXINE CRE 1-1%
HC PRAMOXINE CRE 2.5-1%
HC/ACET ACID SOL OTIC
HECTOROL INJ 4MCG/2ML
HEMMOREX-HC SUP 25MG
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
HEPSERA TAB 10MG
HIPREX TAB 1GM
HM NICOTINE DIS 14MG/24H
HM NICOTINE DIS 21MG/24H
HORIZANT TAB 600MG ER
HUMALOG INJ 100/ML
HUMALOG JR INJ 100/ML
HUMALOG KWIK INJ 100/ML
HUMALOG MIX INJ 50/50KWP
HUMALOG MIX INJ 75/25KWP
HUMALOG MIX SUS 75/25
HUMIRA KIT 40MG/0.8
HUMIRA PEDIA INJ CROHNS
HUMIRA PEN INJ 40MG/0.8
HUMIRA PEN INJ CD/UC/HS
HUMIRA PEN INJ PS/UV
HUMULIN INJ 70/30
HUMULIN INJ 70/30KWP
HUMULIN N INJ U-100
HUMULIN N INJ U-100KWP
DRUG NAME (DOSE)QTY
HUMULIN R INJ U-100
HURRICAINE SPR ONE 20%
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 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
HYLATOPIC CRE PLUS
HYOPHEN TAB
HYQVIA INJ 10-800
HYZAAR TAB 100-12.5
HYZAAR TAB 100-25
HYZAAR TAB 50-12.5
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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.