Program Overview Preferred Drug List 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
Valproate Sodium Syrup 250 MG/5ML200.00
Valproic Acid Cap 250 MG30.00
VALUE PLUS MIS LANCETS200.00
VANACHOL CAP30.00
Verapamil HCl Tab 120 MG30.00
Verapamil HCl Tab 40 MG30.00
Verapamil HCl Tab 80 MG30.00
VERTIGOHEEL TAB30.00
DRUG NAME (DOSE)QTY
Vincristine Sulfate IV Soln 1 MG/ML1.00
VITALET 23 MIS LANCETS200.00
VITALET 26 MIS LANCETS100.00
VITAROCA TAB30.00
VITAROCA PLU TAB30.00
VIVELLE DIS 0.1MG1.00
VIVELLE-DOT DIS 0.1MG1.00
Second Tier
DRUG NAME (DOSE)QTY
VAGISTAT-1 OIN 6.5%4.60
VALERTEST #1 INJ 90MG-4MG10.00
VANCOCIN HCL INJ 1GM1.00
VANCOCIN/DEX INJ 500MG100.00
VASODILAN TAB 10MG30.00
VEGETABLE OIL HYDROGEN500.00
Venlafaxine HCl Tab 25 MG30.00
Venlafaxine HCl Tab 37.5 MG30.00
Venlafaxine HCl Tab 50 MG30.00
Verapamil HCl Cap SR 24HR 120 MG30.00
Verapamil HCl Cap SR 24HR 180 MG30.00
Verapamil HCl Cap SR 24HR 240 MG30.00
Verapamil HCl Tab CR 120 MG30.00
Verapamil HCl Tab CR 180 MG30.00
Verapamil HCl Tab CR 240 MG30.00
VERTIGOHEEL DRO50.00
VESPRIN INJ 20MG/ML1.00
DRUG NAME (DOSE)QTY
VICON FORTE CAP30.00
VI-DAYLIN/F DRO50.00
VI-DAYLIN/F DRO /ADC50.00
VI-DAYLIN/F DRO ADC/FE50.00
VI-DAYLIN/F DRO FE50.00
VIDEX BUFFER CHW 25MG30.00
VINATE AZ TAB30.00
VINATE AZ EX TAB30.00
VINATE CAL TAB30.00
VINATE II TAB30.00
VITAJECT INJ10.00
VITAL-D RX TAB30.00
VITA-NUMONYL SOL118.30
VITA-NUMONYL SOL DM120.00
VITA-NUMONYL SOL EX120.00
VITA-PREN TAB30.00
VOPAC TAB 650-30MG30.00

Third Tier

DRUG NAME (DOSE)QTY
VANIQA CRE 13.9%30.00
VANSPAR TAB 7.5MG30.00
VANTIN SUS 50MG/5ML50.00
VASERETIC TAB 5-12.5MG30.00
VASODILAN TAB 20MG30.00
VEGETABLE LIQ HYDROGEN500.00
VELOSEF CAP 250MG30.00
VELOSEF SUS 250/5ML100.00
Venlafaxine HCl Tab 100 MG30.00
Venlafaxine HCl Tab 75 MG30.00
VENTOLIN HFA AER18.00
Verapamil HCl Cap SR 24HR 100 MG30.00
Verapamil HCl Cap SR 24HR 200 MG30.00
Verapamil HCl Cap SR 24HR 360 MG30.00
VERTIGOHEEL LIQ11.00
VEXOL SUS 1% OP5.00
VIBRAMYCIN SUS 25MG/5ML60.00
VI-CAL MIS112.00
VICODIN TAB 5-500MG30.00
VIDEX BUFFER CHW 50MG30.00
DRUG NAME (DOSE)QTY
VINBLASTINE INJ 1MG/ML10.00
Vincristine Sulfate IV Soln 1 MG/ML1.00
VIOKASE 8 TAB30.00
VIRA-A OIN 3% OP3.50
VIRAVAN DM CHW 25-30-2530.00
VISTARIL CAP 100MG30.00
VISTARIL CAP 25MG30.00
VITAFOL TAB30.00
VITAFOL-OB MIS +DHA60.00
VITAFOL-PN TAB30.00
VITALET PRO MIS150.00
VITALET PRO MIS PLUS100.00
VITAPHIL TAB30.00
VITA-RESPA TAB30.00
VIVELLE DIS 0.05MG8.00
VOLTAREN GEL 1%100.00
VOLTAREN SOL 0.1% OP2.50
VOLTAREN TAB 25MG EC30.00
VOSPIRE ER TAB 4MG30.00
V-TANN CHW 30-25MG30.00

Fourth Tier
DRUG NAME (DOSE)QTY
VAGIFEM TAB 25MCG
VALCYTE TAB 450MG
VALERIAN EXT ROOT
VALIUM INJ 5MG/ML
VALIUM TAB 10MG
VALIUM TAB 2MG
VALIUM TAB 5MG
Valproate Sodium Inj 100 MG/ML
VALPROIC ACI LIQ
VALSTAR SOL 40MG/ML
VALTREX TAB 1GM
VALTREX TAB 500MG
VANACOF LIQ
VANACOF CD LIQ
VANACOF DX LIQ
VANAMIDE CRE 40%
VANCOCIN HCL CAP 125MG
VANCOCIN HCL CAP 250MG
VANCOCIN HCL INJ
VANCOCIN HCL INJ 10GM
VANCOCIN HCL INJ 500MG
VANCOMYCIN INJ 5000MG
Vancomycin HCl For Inj 10 GM
Vancomycin HCl For Inj 1000 MG
Vancomycin HCl For Inj 500 MG
Vancomycin HCl For Inj 5000 MG
VANOS CRE 0.1%
VANOXIDE-HC LOT
VANTIN SUS 100/5ML
VANTIN TAB 100MG
VANTIN TAB 200MG
VAQTA INJ 50UNT/ML
VASERETIC TAB 10-25MG
Vasopressin Inj 20 Unit/ML
VASOTEC TAB 10MG
VASOTEC TAB 2.5MG
VASOTEC TAB 20MG
VASOTEC TAB 5MG
VAZOBID SUS 6-10MG/5
VAZOL LIQ 2MG/5ML
VAZOL-D LIQ 2-7.5/5
VAZOL-D LIQ4-7.5/5
VAZOTAB CHW
VAZOTAN SUS
VAZOTUSS HC SUS
VECTIBIX INJ 100MG
VECTIBIX INJ 200MG
VECTIBIX INJ 400MG
Vecuronium Bromide For Inj 10 MG
Vecuronium Bromide For Inj 20 MG
VELCADE INJ 3.5MG
VELOSEF CAP 500MG
VENLAFAXINE TAB 150MG
VENLAFAXINE TAB 150MG
VENLAFAXINE TAB 225MG
VENLAFAXINE TAB 37.5MG
VENLAFAXINE TAB 75MG
VENOFER INJ 20MG/ML
VENTAVIS SOL 10MCG/ML
VEPESID CAP 50MG
VEPESID INJ 20MG/ML
Verapamil HCl Cap SR 24HR 300 MG
Verapamil HCl IV Soln 2.5 MG/ML
VERDESO AER 0.05%
VEREGEN OIN 15%
VERELAN CAP 120MG SR
VERELAN CAP 180MG
VERELAN CAP 240MG SR
VERELAN CAP 360MG SR
VERELAN PM CAP 100MG
VERELAN PM CAP 200MG
VERELAN PM CAP 300MG
VERMOX CHW 100MG
VERSED INJ 5MG/ML
VESANOID CAP 10 MG
VFEND SUS 40MG/ML
VFEND TAB 200MG
VFEND TAB 50MG
VFEND IV INJ 200MG
VIADUR KIT
DRUG NAME (DOSE)QTY
VIAGRA TAB 100MG
VIAGRA TAB 25MG
VIAGRA TAB 50MG
VIASPAN SOL
VIBRAMYCIN CAP 100MG
VIBRAMYCIN SYP 50MG/5ML
VIBRATAB TAB 100MG
VICODIN ES TAB 7.5-750
VICODIN HP TAB 10-660
VICOPROFEN TAB
VIDAZA INJ 100MG
VIDEX POW 100MG
VIDEX SOL 2GM
VIDEX SOL 4GM
VIDEX BUFFER CHW 100MG
VIDEX BUFFER CHW 150MG
VIDEX BUFFER CHW 200MG
VIDEX EC CAP 125MG
VIDEX EC CAP 200MG
VIDEX EC CAP 250MG
VIDEX EC CAP 400MG
VIGAMOX DRO 0.5%
VINBLASTINE INJ 10MG
Vinorelbine Tartrate Inj 10 MG/ML
VIOKASE 16 TAB
VIRACEPT TAB 250MG
VIRACEPT TAB 625MG
VIRAMUNE SUS 50MG/5ML
VIRAMUNE TAB 200MG
VIRAVAN DM SUS
VIRAVAN-P SUS 15-15MG
VIRAVAN-PDM SUS 15-15-15
VIRAVAN-S SUS 30-12.5
VIRAVAN-T CHW 30-25MG
VIRAZOLE INH 6GM
VIREAD TAB 300MG
VIRILEX CAP
VIROPTIC SOL 1% OP
VISCOAT SOL
VISICOL TAB 1.5GM
VISIONBLUE SOL 0.06%
VISIPAQUE INJ 270MG/ML
VISIPAQUE INJ 320MG/ML
VISTARIL CAP 50MG
VISTARIL SUS 25MG/5ML
VISTIDE INJ 75MG/ML
VISUDYNE INJ 15MG
VITAFOL SYP
Vitamin B1 & B12 Inj 100-1 MG/ML
VITA-NUMONYL INJ
VITRASERT IMP 4.5MG
VITRAVENE INJ 6.6MG/ML
VITRAX INJ 30MG/ML
VIVA DHA CAP
VIVACTIL TAB 10MG
VIVACTIL TAB 5MG
VIVAGLOBIN SOL 160MG/ML
VIVELLE-DOT DIS 0.025MG
VIVELLE-DOT DIS 0.0375MG
VIVELLE-DOT DIS 0.05MG
VIVELLE-DOT DIS 0.075MG
VIVITROL INJ 380MG
VOLTAREN TAB 50MG EC
VOLTAREN TAB 75MG EC
VOLTAREN-XR TAB 100MG
VOLUMEN SUS 0.1%
VOSOL SOL 2% OTIC
VOSOL-HC SOL OTIC
VOSPIRE ER TAB 8MG
VUMON INJ 50MG/5ML
VUSION OIN
VYTONE CRE 1%
VYTORIN TAB 10-10MG
VYTORIN TAB 10-20MG
VYTORIN TAB 10-40MG
VYTORIN TAB 10-80MG
VYVANSE CAP 20MG
VYVANSE CAP 40MG
VYVANSE CAP 60MG
A B C D E
F G H I J
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P Q R S T
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 * Pricing is subject to change without notice.
 * Pricing is only for quantities stated, additional quantities may incur higher costs.
 * This is not an insured product.
 * Network pharmacies can be contracted at different rates resulting in some pricing differences.