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
V-C FORTE CAP30.00
VERAPAMIL TAB 120MG30.00
VIC-FORTE CAP30.00
VINATE M TAB30.00
VIRT-CAPS CAP30.00
DRUG NAME (DOSE)QTY
VITA S FORTE TAB30.00
VITAMIN D CAP 50000UNT4.00
VITAROCA PLU TAB30.00
VOL-CARE RX TAB30.00
Second Tier
DRUG NAME (DOSE)QTY
VALPROIC ACD SOL 250/5ML480.00
VALPROIC ACD SYP 250/5ML480.00
VENLAFAXINE CAP 37.5 ER30.00
VERAPAMIL CAP 120MG ER30.00
VERAPAMIL CAP 120MG SR30.00
VERAPAMIL TAB 180MG ER30.00
VERAPAMIL TAB 40MG60.00
VERAPAMIL TAB 80MG60.00
VINATE AZ EX TAB30.00
VINATE CAL TAB30.00
VINATE IC CAP30.00
VINATE II TAB30.00
VINATE ONE TAB30.00
VIRT NATE TAB 28-1MG30.00
DRUG NAME (DOSE)QTY
VIRT-ADVANCE TAB 90-1MG30.00
VIRTRATE-2 SOL1500.00
VIRT-VITE TAB30.00
VIRT-VITE TAB PLUS30.00
VIRT-VITE GT TAB 90-1MG30.00
VITACEL TAB30.00
VITAJECT INJ10.00
VITAL-D RX TAB30.00
VITALET PRO MIS100.00
VITAMAX PED DRO90.00
VITA-PREN TAB30.00
VOGELXO GEL 1%(50MG)5.00
VOL-NATE TAB30.00

Third Tier

DRUG NAME (DOSE)QTY
VALPROIC ACD CAP 250MG120.00
VALSART/HCTZ TAB 160-12.530.00
VALSART/HCTZ TAB 160-25MG30.00
VALSART/HCTZ TAB 80-12.530.00
VANDAZOLE GEL 0.75%70.00
VASCAZEN CAP 1GM30.00
VAYAROL CAP30.00
VELIVET PAK28.00
VENA-BAL MIS DHA60.00
VENLAFAXINE CAP 75MG ER30.00
VENLAFAXINE TAB 25MG60.00
VENLAFAXINE TAB 37.5MG60.00
VENLAFAXINE TAB 50MG60.00
VENLAFAXINE TAB 75MG60.00
VENTOLIN HFA AER8.50
VERAPAMIL CAP 100MG ER30.00
VERAPAMIL CAP 180MG ER30.00
VERAPAMIL CAP 180MG SR30.00
VERAPAMIL CAP 240MG ER30.00
VERAPAMIL CAP 240MG SR30.00
VERAPAMIL CAP 360MG SR30.00
DRUG NAME (DOSE)QTY
VERAPAMIL TAB 120MG ER30.00
VERAPAMIL TAB 240MG ER30.00
VIBRAMYCIN SUS 25MG/5ML60.00
VINATE C TAB30.00
VINATE CARE CHW30.00
VIORELE TAB28.00
VIRT-C DHA CAP30.00
VIRT-CARE CAP ONE30.00
VIRT-PHOS TAB 250 NEUT60.00
VIRTPREX CAP30.00
VIRT-VITE TAB FORTE30.00
VIT B-COMPLX INJ 10030.00
VITALET PRO MIS PLUS100.00
VITAMIN C INJ 222MG/ML100.00
VITA-RESPA TAB30.00
VOL-PLUS TAB30.00
VOL-TAB RX TAB30.00
VP-GGR-B6 TAB PRENATAL30.00
VP-HEME OB MIS + DHA60.00
VP-PRECIP CAP120.00
VYFEMLA TAB 0.4-3528.00

Fourth Tier
DRUG NAME (DOSE)QTY
VAGIFEM TAB 10MCG
VALACYCLOVIR TAB 1GM
VALACYCLOVIR TAB 500MG
VALCHLOR GEL 0.016%
VALCYTE SOL 50MG/ML
VALCYTE TAB 450MG
VALGANCICLOV TAB 450MG
VALIDERM CRE
VALIUM TAB 10MG
VALIUM TAB 2MG
VALIUM TAB 5MG
VALSART/HCTZ TAB 320-12.5
VALSART/HCTZ TAB 320-25MG
VALSARTAN TAB 160 MG
VALSARTAN TAB 160MG
VALSARTAN TAB 320MG
VALSARTAN TAB 40MG
VALSARTAN TAB 80MG
VALSTAR SOL 40MG/ML
VALTREX TAB 1GM
VALTREX TAB 500MG
VANATOL LQ SOL
VANCOCIN HCL CAP 125MG
VANCOCIN HCL CAP 250MG
VANCOMYCIN CAP 125MG
VANCOMYCIN CAP 250MG
VANCOMYCN 25 SOL 25MG/ML
VANCOMYCN 50 SOL 50MG/ML
VANIQA CRE 13.9%
VANOS CRE 0.1%
VANOXIDE-HC LOT 5-0.5%
VANTAS KIT 50MG
VAQTA INJ 25/0.5ML
VAQTA INJ 50UNT/ML
VARIVAX INJ
VARIZIG INJ 125UNIT
VASCEPA CAP 1GM
VASERETIC TAB 10-25MG
VASOPRESSIN INJ 20UNT/ML
VASOTEC TAB 10MG
VASOTEC TAB 2.5MG
VASOTEC TAB 20MG
VASOTEC TAB 5MG
VAYACOG CAP
VAYARIN CAP
VECAMYL TAB 2.5MG
VECTICAL OIN 3MCG/GM
VELCADE INJ 3.5MG
VELMA PAD 16-4-2%
VELPHORO CHW 500MG
VELTIN GEL
VEMAVITE- CAP PRX 2
VENELEX OIN
VENLAFAXINE CAP 150MG ER
VENLAFAXINE TAB 100MG
VENLAFAXINE TAB 150MG ER
VENLAFAXINE TAB 225MG ER
VENLAFAXINE TAB 37.5 ER
VENLAFAXINE TAB 75MG ER
VENTAVIS SOL 10MCG/ML
VENTAVIS SOL 20MCG/ML
VERAMYST SPR 27.5MCG
VERAPAMIL CAP 200MG ER
VERAPAMIL CAP 300MG ER
VERDESO AER 0.05%
VERDROCET TAB 2.5-325
VEREGEN OIN 15%
VERELAN CAP 120MG SR
VERELAN CAP 180MG SR
VERELAN CAP 240MG SR
VERELAN CAP 360MG SR
VERELAN PM CAP 100MG ER
VERELAN PM CAP 200MG ER
VERELAN PM CAP 300MG ER
VERIPRED 20 SOL 20MG/5ML
VERRUNEX CRE
VERSACLOZ SUS 50MG/ML
VESICARE TAB 10MG
VESICARE TAB 5MG
VESTURA TAB 3-0.02MG
VEXA PAD 2-4-30%
VEXOL SUS 1% OP
VFEND SUS 40MG/ML
VFEND TAB 200MG
VFEND TAB 50MG
VIAGRA TAB 100MG
VIAGRA TAB 25MG
VIAGRA TAB 50MG
VIBRAMYCIN CAP 100MG
VIBRAMYCIN SYP 50MG/5ML
VICODIN TAB 5-300MG
VICODIN ES TAB 7.5-300
VICODIN HP TAB 10-300MG
VICOPROFEN TAB 7.5-200
VICTORY TES AGM-4000
VICTOZA INJ 18MG/3ML
VICTRELIS CAP 200MG
VIDAZA INJ 100MG
VIDEX SOL 2GM
VIDEX SOL 4GM
VIDEX EC CAP 125MG
DRUG NAME (DOSE)QTY
VIDEX EC CAP 200MG
VIDEX EC CAP 250MG
VIDEX EC CAP 400MG
VIEKIRA PAK TAB
VIGAMOX DRO 0.5%
VIIBRYD KIT
VIIBRYD TAB 10MG
VIIBRYD TAB 20MG
VIIBRYD TAB 40MG
VIMOVO TAB 375-20MG
VIMOVO TAB 500-20MG
VIMPAT SOL 10MG/ML
VIMPAT TAB 100MG
VIMPAT TAB 150MG
VIMPAT TAB 200MG
VIMPAT TAB 50MG
VINACAL B MIS
VINATE DHA CAP 27-1.13
VIOKACE TAB
VIRACEPT TAB 250MG
VIRACEPT TAB 625MG
VIRAMUNE SUS 50MG/5ML
VIRAMUNE TAB 200MG
VIRAMUNE XR TAB 100MG
VIRAMUNE XR TAB 400MG
VIRASAL LIQ 27.5%
VIRAZOLE INH 6GM
VIREAD POW 40MG/GM
VIREAD TAB 150MG
VIREAD TAB 200MG
VIREAD TAB 250MG
VIREAD TAB 300MG
VIROPTIC SOL 1% OP
VIRT-PN TAB
VIRT-PN DHA CAP
VIRT-PN PLUS CAP
VIRTRATE-3 SOL
VIRTRATE-K SOL
VIRT-SELECT CAP
VISCOAT SOL
VISIONBLUE SOL 0.06%
VISTARIL CAP 25MG
VISTARIL CAP 50MG
VITAFOL CAP ULTRA
VITAFOL TAB
VITAFOL-NANO TAB
VITAFOL-OB PAK +DHA
VITAFOL-OB TAB 65-1MG
VITAFOL-ONE CAP
VITAMEDMD CAP ONE RX
VITAMEDMD MIS PLUS RX
VITAMIN K1 INJ 10MG/ML
VITAMIN K1 INJ 1MG/0.5
VITAPEARL CAP
VITEKTA TAB 150MG
VITEKTA TAB 85MG
VITRASE INJ 200/ML
VITRAVENE INJ 6.6MG/ML
VITUZ SOL 5-4MG
VIVA DHA CAP
VIVELLE-DOT DIS 0.025MG
VIVELLE-DOT DIS 0.0375MG
VIVELLE-DOT DIS 0.05MG
VIVELLE-DOT DIS 0.075MG
VIVELLE-DOT DIS 0.1MG
VIVITROL INJ 380MG
VIVOTIF BERN CAP EC
VOCAL POINT TES BLD GLUC
VOGELXO GEL PUMP 1%
VOLTAREN GEL 1%
VOPAC CRE 10-2%
VOPAC GB CRE 5-2-5%
VOPAC KT CRE 5-5-2%
VORICONAZOLE SUS 40MG/ML
VORICONAZOLE TAB 200MG
VORICONAZOLE TAB 50MG
VOSPIRE ER TAB 4MG
VOSPIRE ER TAB 8MG
VOTRIENT TAB 200MG
VP-CH PLUS CAP
VP-CH-PNV CAP
VP-GSTN CAP
VP-HEME ONE CAP
VP-HEME-OB TAB 28-6-1MG
VP-PNV-DHA CAP
VP-ZEL TAB
VSL#3 DS PAK
VUSION OIN
VYTONE CRE 1-1.9%
VYTORIN TAB 10-10MG
VYTORIN TAB 10-20MG
VYTORIN TAB 10-40MG
VYTORIN TAB 10-80MG
VYVANSE CAP 10MG
VYVANSE CAP 20MG
VYVANSE CAP 30MG
VYVANSE CAP 40MG
VYVANSE CAP 50MG
VYVANSE CAP 60MG
VYVANSE CAP 70MG
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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.