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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:  x

First Tier
Drug NameRetail QtyRetailMail Order
(3 x Retail Qty)
XERAC-AC SOL 6.25%35$8.21$14.70
XYRALID LP KIT1$3.13$1.01

Second Tier
Drug NameRetail QtyRetailMail Order
(3 x Retail Qty)
XYLENES LIQ REAGENT500$15.28$33.69
XYLO/EPI INJ 1%50$16.29$36.41
XYLOCAINE INJ 1%50$14.06$30.42
XYLOCAINE INJ MPF 0.5%50$14.16$30.68

Third Tier
Drug NameRetail QtyRetailMail Order
(3 x Retail Qty)
XANAX TAB 0.25MG30$38.84$97.06 *
XANAX TAB 0.5MG30$46.72$118.25 *
XIRAHIST LIQ 2-2MG/ML30$35.37$87.73
XIRAHISTDM LIQ30$39.72$99.43
XIRATUSS SUS120$38.63$96.50
XODOL TAB30$32.01$78.69 *
XODOL TAB 5-300MG30$25.99$62.51 *
XODOL TAB 7.5/30030$27.39$66.26 *
XPECT-AT TAB30$31.46$77.21
XYLENES LIQ ACS GRAD3785$46.24$116.96
XYLOCAINE INJ 2%50$44.76$113.00
XYLOCAINE INJ -MPF 1%20$22.23$52.39
XYLOCAINE INJ MPF 1.5%50$38.84$97.06
XYLOCAINE INJ -MPF 2%20$30.54$74.74
XYLOCAINE SOL 2% VISC100$22.28$52.53
XYLOCAINE SOL 4%50$22.36$52.74
XYLO-MPF/EPI INJ 1%50$36.21$90.00
XYLO-MPF/EPI INJ 1.5%50$40.52$101.58
XYLO-MPF/EPI INJ 2%50$43.21$108.81

Fourth Tier
Drug NameRetail QtyRetailMail Order
(3 x Retail Qty)
XALATAN SOL 0.005%

$79.48

$202.57

XANAX TAB 1MG

$72.99

$188.93

XANAX TAB 2MG

$94.86

$247.74

XANAX XR TAB 0.5MG

$82.38

$214.18

XANAX XR TAB 1MG

$101.83

$266.50

XANAX XR TAB 2MG

$134.25

$353.70

XANAX XR TAB 3MG

$199.99

$530.52

XELODA TAB 150MG

$234.47

$623.25

XELODA TAB 500MG

$775.05

$2077.23

XENADERM OIN

$63.20

$162.58

XENICAL CAP 120MG

$123.40

$324.52

XIBROM SOL 0.09%

$245.00

$651.57

XIFAXAN TAB 200MG

$261.21

$695.16

XIGRIS INJ 20MG

$1426.07

$3828.24

XIGRIS INJ 5MG

$358.58

$957.06

XODOL TAB 10-300MG

$73.18

$189.42

XOLAIR SOL 150MG

$651.10

$1743.84

XOLEGEL GEL 2%

$109.02

$285.83

XOLEGEL DUO KIT

$98.11

$256.49

XOPENEX NEB 0.31MG

$114.45

$300.45

XOPENEX NEB 0.63MG

$114.45

$300.45

XOPENEX NEB 1.25/3ML

$114.45

$300.45

XOPENEX CONC NEB 1.25/0.5

$72.57

$187.79

XOPENEX HFA AER

$50.32

$127.95

XYLO/DEXTROS INJ 1.5-7.5%

$111.20

$291.70

XYLOCAINE GEL 2%

$78.86

$204.70

XYLOCAINE INJ -MPF 4%

$71.14

$183.95

XYRALID KIT

$114.76

$301.28

XYRALID RC KIT

$141.95

$374.40

XYREM SOL 500MG/ML

$276.28

$735.70

XYZAL SOL

$95.69

$249.97

XYZAL TAB 5MG

$76.16

$197.45

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