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
HALOPERIDOL TAB 0.5MG30.00
HALOPERIDOL TAB 1MG30.00
HEMATINIC PL TAB VIT/MIN30.00
HEMATINIC/FA TAB30.00
HEMATOGEN CAP30.00
HEMOCYTE TAB -PLUS30.00
HEMOCYTE-F TAB30.00
HLTHY ACCNTS MIS LANC 30G100.00
DRUG NAME (DOSE)QTY
HYDROCHLOROT TAB 25MG30.00
HYDROCHLOROT TAB 50MG30.00
HYDROCORT CRE 2.5%20.00
HYDROCORT OIN 1%28.35
HYDROCORT OIN 2.5%28.35
HYDROCORT/AB OIN 1%28.35
HYDROXYZ HCL TAB 10MG30.00
Second Tier
DRUG NAME (DOSE)QTY
HALOPERIDOL CON 2MG/ML15.00
HALOPERIDOL TAB 2MG30.00
HEMATOGEN CAP FORTE30.00
HEMATOGEN FA CAP30.00
HEMOCYTE PLS CAP30.00
HOMATROPAIRE SOL 5% OP5.00
HOMATROPINE SOL 5% OP5.00
HYDRALAZINE TAB 10MG90.00
HYDRALAZINE TAB 25MG90.00
HYDROCHLOROT CAP 12.5MG30.00
DRUG NAME (DOSE)QTY
HYDROCHLOROT TAB 12.5MG30.00
HYDROCODONE/ TAB HOMATROP30.00
HYDROCORT LOT 2.5%59.00
HYDROMORPHON INJ 50MG/5ML10.00
HYDROMORPHON TAB 2MG90.00
HYDROXYUREA CAP 500MG30.00
HYDROXYZ HCL INJ 50MG/ML25.00
HYDROXYZ HCL TAB 25MG60.00
HYDROXYZ PAM CAP 25MG60.00

Third Tier

DRUG NAME (DOSE)QTY
HAEMOLANCE MIS HIGH FLO100.00
HAEMOLANCE MIS PLUS100.00
HAEMOLANCE MIS PLUS LOW100.00
HAEMOLANCE MIS PLUS MAX100.00
HAEMOLANCE MIS PLUS PED100.00
HALOPER DEC INJ 100MG/ML1.00
HALOPER DEC INJ 50MG/ML1.00
HALOPERIDOL TAB 10MG30.00
HALOPERIDOL TAB 5MG30.00
HALOTIN CRE 1%20.00
HEATHER TAB 0.35MG28.00
HEMATRON-AF TAB30.00
HEMETAB TAB30.00
HEPARIN SOD INJ 5000/0.55.00
HYDRALAZINE TAB 100MG90.00
HYDRALAZINE TAB 50MG90.00
HYDREA CAP 500MG30.00
HYDROCO/APAP TAB 10-325MG120.00
HYDROCO/APAP TAB 5-325MG60.00
HYDROCO/APAP TAB 7.5-32590.00
HYDROCOD/HOM SYP 5-1.5/5200.00
HYDROCOD/IBU TAB 7.5-20060.00
HYDROCORT TAB 20MG30.00
HYDROCORT TAB 5MG30.00
DRUG NAME (DOSE)QTY
HYDROMET SYP 5-1.5/5200.00
HYDROMORPHON INJ 10MG/ML10.00
HYDROMORPHON INJ 1MG/ML10.00
HYDROMORPHON INJ 2MG/ML10.00
HYDROMORPHON INJ 4MG/ML10.00
HYDROMORPHON INJ 500/50ML10.00
HYDROMORPHON TAB 4MG120.00
HYDROXOCOBAL INJ 1000MCG30.00
HYDROXYCHLOR TAB 200MG60.00
HYDROXYZ HCL SOL 10MG/5ML473.00
HYDROXYZ HCL SYP 10MG/5ML473.00
HYDROXYZ HCL TAB 50MG60.00
HYDROXYZ PAM CAP 100MG30.00
HYDROXYZ PAM CAP 50MG60.00
HYOMAX-SL SUB 0.125MG60.00
HYOSCYAMINE DRO 0.125/ML15.00
HYOSCYAMINE ELX 0.125/5473.00
HYOSCYAMINE SUB 0.125MG60.00
HYOSCYAMINE TAB 0.125MG60.00
HYOSYNE DRO 0.125/ML15.00
HYOSYNE ELX 0.125/5473.00
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
HALAC KIT
HALCION TAB 0.25MG
HALDOL INJ 5MG/ML
HALDOL DECAN INJ 100MG/ML
HALDOL DECAN INJ 50MG/ML
HALOBETASOL CRE 0.05%
HALOBETASOL OIN 0.05%
HALOG CRE 0.1%
HALOG OIN 0.1%
HALOPER LAC INJ 5MG/ML
HALOPERIDOL TAB 20MG
HARVONI TAB 90-400MG
HAVRIX INJ 1440UNIT
HAVRIX INJ 720UNIT
HC BUTYRATE CRE 0.1%
HC BUTYRATE OIN 0.1%
HC BUTYRATE SOL 0.1%
HC PRAMOXINE CRE 1-1%
HC PRAMOXINE CRE 2.5-1%
HC VALERATE CRE 0.2%
HC VALERATE OIN 0.2%
HC/ACET ACID SOL OTIC
HEALON INJ 10MG/ML
HEALON GV INJ 14MG/ML
HEALON5 INJ 23MG/ML
HEALTHPRO TES STRIPS
HECTOROL CAP 0.5MCG
HECTOROL CAP 1MCG
HECTOROL CAP 2.5MCG
HEMABATE INJ 250MCG
HEMANGEOL SOL 4.28/ML
HEMENATAL OB MIS + DHA
HEMENATAL OB TAB 28-6-1MG
HEMOCYTE-F ELX
HEP SOD/NACL INJ 1000UNIT
HEP SOD/NACL INJ 12500UNT
HEP SOD/NACL INJ 2000UNIT
HEP SOD/NACL INJ 25000UNT
HEP SOD/NACL INJ 2UNIT/ML
HEPAGAM B INJ
HEPARIN SOD INJ 1000/ML
HEPARIN SOD INJ 10000/ML
HEPARIN SOD INJ 20000/ML
HEPARIN SOD INJ 2500/ML
HEPARIN SOD INJ 5000/ML
HEPSERA TAB 10MG
HETLIOZ CAP 20MG
HEXABRIX INJ
HEXALEN CAP 50MG
HIBERIX SOL 10MCG
HIPREX TAB 1GM
HIZENTRA INJ 10/50ML
HIZENTRA INJ 1GM/5ML
HIZENTRA INJ 2GM/10ML
HIZENTRA INJ 4GM/20ML
HORIZANT TAB 300MG
HORIZANT TAB 600MG
HPR AER
HPR PLUS AER
HPR PLUS CRE
HPR PLUS KIT
HPR PLUS MB KIT HYDROGEL
HUMALOG 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
HUMATROPE INJ 12MG
HUMATROPE INJ 24MG
HUMATROPE INJ 5MG
HUMATROPE INJ 6MG
HUMIRA INJ 10MG/0.2
HUMIRA INJ 40MG/0.8
HUMIRA KIT 20MG/0.4
DRUG NAME (DOSE)QTY
HUMIRA PEDIA INJ CROHNS
HUMIRA PEN INJ 40MG/0.8
HUMIRA PEN INJ CROHNS
HUMIRA PEN INJ PSORIASI
HUMULIN R INJ U-500
HYALGAN INJ 20MG/2ML
HYALURONATE GEL 0.2%
HYALURONIC/ INJ LIDOCAIN
HYALURONIDAS INJ 150/ML
HYCAMTIN CAP 0.25MG
HYCAMTIN CAP 1MG
HYCET SOL 7.5-325
HYD POL/CPM LIQ 10-8/5ML
HYDRALAZINE INJ 20MG/ML
HYDRO 35 AER
HYDRO 40 AER FOAM
HYDRO/CHLOR/ LIQ PSE HCL
HYDROCO/APAP SOL
HYDROCO/APAP SOL 10-325MG
HYDROCO/APAP SOL 5-217/10
HYDROCO/APAP SOL 7.5-325
HYDROCO/APAP SOL 7.5-500
HYDROCO/APAP TAB 10-300MG
HYDROCO/APAP TAB 2.5-325
HYDROCO/APAP TAB 5-300MG
HYDROCO/APAP TAB 7.5-300
HYDROCOD/IBU TAB 10-200MG
HYDROCOD/IBU TAB 2.5-200
HYDROCOD/IBU TAB 5-200MG
HYDROCORT CRE IODOQUIN
HYDROCORT ENE 100MG
HYDROCORT TAB 10MG
HYDROCORT AC SUP 25MG
HYDROCORT AC SUP 30MG
HYDROCORT/ CRE IODOQUIN
HYDROCORT/ KIT PRAMOXIN
HYDROMORPHON LIQ 1MG/ML
HYDROMORPHON SUP 3MG
HYDROMORPHON TAB 12MG ER
HYDROMORPHON TAB 16MG ER
HYDROMORPHON TAB 32MG ER
HYDROMORPHON TAB 8MG
HYDROMORPHON TAB 8MG ER
HYDROQUINONE CRE 4%
HYDROQUINONE CRE 4% TR
HYDROXYZ HCL INJ 25MG/ML
HYGEL GEL 0.2%
HYLASE WOUND GEL
HYLATOPIC AER
HYLATOPIC AER PLUS
HYLATOPIC CRE PLUS
HYLENEX INJ 150 UNIT
HYLIRA GEL 0.2%
HYLIRA LOT 0.1%
HYOPHEN TAB
HYOSCYAMINE TAB 0.375 ER
HYOSCYAMINE TAB 0.375 SR
HYPERHEP B INJ S/D
HYPERRAB S/D INJ 150/ML
HYPERRHO S/D INJ 300MCG
HYPERRHO S/D INJ 50MCG
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
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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.