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PREFERRED DRUG LIST

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.

Tiers indicate retail pharmacy pricing and position. Drug quantities listed must be adhered to in order to receive tier pricing at participating retail network pharmacies. Any change in quantity may result in higher prices. Company cannot be responsible for changes in network pharmacies which accept this program. A mail order option is available for additional savings based upon a three month supply. Mail order tiers will vary due to differing quantities.

Drug pricing is based on the quantity indicated by the retail and mail order columns. This may or may not be a 30 day supply based on how your Doctor prescribed your dosage. Quantities greater than those listed will result in a higher member cost.

* By law, schedule II drugs are only allowed to be dispensed for a 30 day supply through the mail order pharmacy.
* Pricing is subject to change without notice.


Search Results for Keyword:  j

First Tier

Second Tier

Third Tier
Drug NameRetail QtyRetailMail Order
(3 x Retail Qty)
JAYCOF-HC LIQ473$45.34$114.54 *
JAYCOF-XP LIQ473$45.82$115.83 *
JAY-GIC DS LIQ473$37.37$93.13
JAY-RX SYP473$35.40$87.82
JAY-RX PD LIQ473$31.05$76.12
J-MAX TAB30$38.47$96.08
J-TAN D PD DRO 1-7.5MG30$39.75$99.52
J-TAN D SR TAB 6-30MG30$44.93$113.44
J-TAN PD DRO 1MG/ML30$39.75$99.52

Fourth Tier
Drug NameRetail QtyRetailMail Order
(3 x Retail Qty)
JANUMET TAB 50-1000

$96.94

$251.64

JANUMET TAB 50-500MG

$96.94

$251.64

J-COF DHC LIQ

$104.18

$272.82

J-MAX SYP

$108.41

$284.20

J-MAX DHC LIQ

$104.18

$272.82

J-TAN SUS

$117.57

$308.82

J-TAN D SUS

$140.27

$369.89

J-TAN D HC LIQ

$82.59

$214.75

JUNIPER TAR OIL USP

$74.53

$193.05

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* This is not an insured product *

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