Drug rider $10/$15
Your drug benefit provides coverage for Tier 1 medications for a $10 copayment and for Tier 2 medications with a $15 copayment. Drugs in Tier 3 are not covered unless your physician and BCN agree that the nonformulary drug is medically necessary. Go to our Drug Formulary for a definition of Tier 1, Tier 2 and Tier 3.
Please check your drug rider for information regarding contraceptive coverage. Note also that coverage and copayment for lifestyle and health habit drugs (such as drugs for weight loss, smoking cessation, and erectile dysfunction) may vary depending on your drug rider.
Note that some drugs require prior authorization (PA) or step therapy (ST), and certain clinical criteria must be met prior to coverage. Refer to Some Drugs Require Prior Authorization for more details. The members' rider has specific information regarding the mail order copayment..
Blue Care Network requires that prescriptions for Tier 1 drugs be automatically filled with the generic equivalent, if available. The brand-name version can be dispensed if the member pays the difference between the cost of the brand and generic versions in addition to the required Tier 2 copayment. The following table identifies the tier for some of our more commonly prescribed drugs.
The following table lists the tier and copay for some of our more commonly prescribed drugs. Click on a letter in the index below to find Brand Name drugs beginning with that letter.
| Brand Name | Generic Name | Generic Available | PA / ST |
Tier | Copay |
|---|---|---|---|---|---|
| - A - | [ Return to Top ] | ||||
| Abilify, Discmelt | aripiprazole | No | 2 | $15 | |
| Accolate | zafirlukast | No | 2 | $15 | |
| Accuneb | albuterol sulfate | Yes | 1 | $10 | |
| Accupril | quinapril hcl | Yes | 1 | $10 | |
| Accuretic | quinapril/hydrochlorothiazide | Yes | 1 | $10 | |
| Accutane (req Derm Consult) | isotretinoin | Yes | 1 | $10 | |
| Accuzyme, Ethezyme, Gladase | papain/urea | Yes | 1 | $10 | |
| Aceon | perindopril erbumine | Yes | 1 | $10 | |
| Acetasol, HC/vosol, HC | acetic acid/hydrocortisone | Yes | 1 | $10 | |
| Aclovate | alclometasone dipropionate | Yes | 1 | $10 | |
| Actigall | ursodiol | Yes | 1 | $10 | |
| Actimmune | interferon gamma-1b,recomb. | No | 2 | $15 | |
| Actiq | fentanyl citrate | Yes | PA | 1 | $10 |
| Activella | estradiol/noreth ac | Yes | 1 | $10 | |
| Actonel with Calcium | risedron sod/calcium carbonate | No | ST | 2 | $15 |
| Actonel, Weekly, 150mg | risedronate sodium | No | ST | 2 | $15 |
| Actos | pioglitazone hcl | No | ST | 2 | $15 |
| Acular, LS | ketorolac tromethamine | Yes | 1 | $10 | |
| Adderall, XR | amphet asp/amphet/d-amphet | Yes | 1 | $10 | |
| Adipex-P | phentermine hcl | Yes | PA | 1 | $10 |
| Adoxa | doxycycline monohydrate | Yes | 1 | $10 | |
| Advair | fluticasone/salmeterol | No | 2 | $15 | |
| Afinitor | everolimus | No | PA | 2 | $15 |
| Agrylin | anagrelide hcl | Yes | 1 | $10 | |
| Albalon | naphazoline hcl | Yes | 1 | $10 | |
| Albuterol Nebulizer Soln | albuterol sulfate | Yes | 1 | $10 | |
| Aldactazide | spironolact/hydrochlorothiazid | Yes | 1 | $10 | |
| Aldactone | spironolactone | Yes | 1 | $10 | |
| Aldomet | methyldopa | Yes | 1 | $10 | |
| Aldoril | methyldopa/hydrochlorothiazide | Yes | 1 | $10 | |
| Alesse, Levlite | levonorgestrel-eth estra | Yes | 1 | $10 | |
| Alferon N | interferon alfa-n3 | No | 2 | $15 | |
| Alinia | nitazoxanide | No | 2 | $15 | |
| Alkeran | melphalan | No | 2 | $15 | |
| Allegra | fexofenadine hcl | Yes | 1 | $10 | |
| Allegra-D 12 Hour | p-ephed hcl/fexofenadine hcl | Yes | ST | 1 | $10 |
| Allegra-D 24 Hour | p-ephed hcl/fexofenadine hcl | No | ST | 2 | $15 |
| Alocril | nedocromil sodium | No | 2 | $15 | |
| Alomide | lodoxamide tromethamine | No | 2 | $15 | |
| Alora | estradiol | No | 2 | $15 | |
| Alphagan, P | brimonidine tartrate | Yes | 1 | $10 | |
| Altace Capsule | ramipril | Yes | 1 | $10 | |
| Alupent | metaproterenol sulfate | Yes | 1 | $10 | |
| Alvesco (tier 1-BCN only) | ciclesonide | No | 1 | $10 | |
| Amaryl | glimepiride | Yes | 1 | $10 | |
| Ambien | zolpidem tartrate | Yes | 1 | $10 | |
| Amicar | aminocaproic acid | Yes | 1 | $10 | |
| Amoxapine | amoxapine | Yes | 1 | $10 | |
| Amoxil | amoxicillin trihydrate | Yes | 1 | $10 | |
| Ampicillin | ampicillin trihydrate | Yes | 1 | $10 | |
| Anafranil | clomipramine hcl | Yes | 1 | $10 | |
| Analpram HC | hc acetate/pramoxine hcl | Yes | 1 | $10 | |
| Anamantle HC | lidocaine hcl/hc | Yes | 1 | $10 | |
| Anaprox, DS | naproxen sodium | Yes | 1 | $10 | |
| Ancobon | flucytosine | No | 2 | $15 | |
| Androderm | testosterone | No | 2 | $15 | |
| Androxy 10mg | fluoxymesterone | Yes | 1 | $10 | |
| Annusol HC, Proctocream HC | hydrocortisone | Yes | 1 | $10 | |
| Ansaid | flurbiprofen | Yes | 1 | $10 | |
| Antabuse | disulfiram | No | 2 | $15 | |
| Antivert | meclizine hcl | Yes | 1 | $10 | |
| Apidra | insulin glulisine | No | 2 | $15 | |
| Apokyn | apomorphine hcl | No | 2 | $15 | |
| Apresoline | hydralazine hcl | Yes | 1 | $10 | |
| Aptivus (must be used with Norvir) | tipranavir | No | 2 | $15 | |
| Aralen | chloroquine phosphate | Yes | 1 | $10 | |
| Arava | leflunomide | Yes | 1 | $10 | |
| Arcalyst | rilonacept | No | PA | 2 | $15 |
| Aricept, ODT | donepezil hcl | No | 2 | $15 | |
| Arimidex | anastrozole | No | 2 | $15 | |
| Aristocort, Kenalog | triamcinolone acetonide | Yes | 1 | $10 | |
| Aristocort, Kenalog 0.5% CR | triamcinolone acetonide | Yes | 1 | $10 | |
| Aromasin | exemestane | No | 2 | $15 | |
| Artane | trihexyphenidyl hcl | Yes | 1 | $10 | |
| Asacol, HD | mesalamine | No | 2 | $15 | |
| Asmanex (tier 1-BCN only) | mometasone furoate | No | 1 | $10 | |
| Aspirin w/codeine | codeine phos/aspirin | Yes | 1 | $10 | |
| Astelin/Astepro nasal spray | azelastine hcl | No | 2 | $15 | |
| Astepro | azelastine hcl | No | 2 | $15 | |
| Atarax, Vistaril | hydroxyzine | Yes | 1 | $10 | |
| Ativan | lorazepam | Yes | 1 | $10 | |
| Atripla | efavirenz/emtricitab/tenofovir | No | 2 | $15 | |
| Atrovent Inhaler | ipratropium bromide | No | 2 | $15 | |
| Atrovent Nasal Spray | ipratropium bromide | Yes | 1 | $10 | |
| Atrovent Soln | ipratropium bromide | Yes | 1 | $10 | |
| Augmentin, ES | amox tr/potassium clavulanate | Yes | 1 | $10 | |
| Auralgan | aa/antpy/bcaine/polico/al acet | Yes | 1 | $10 | |
| Avandia | rosiglitazone maleate | No | ST | 2 | $15 |
| Avelox, ABC | moxifloxacin hcl | No | 2 | $15 | |
| Avonex | interferon beta-1a | No | 2 | $15 | |
| Axid (Rx only) | nizatidine | Yes | 1 | $10 | |
| Aygestin | norethindrone acetate | Yes | 1 | $10 | |
| Azmacort (tier 1-BCN only) | triamcinolone acetonide | No | 1 | $10 | |
| Azopt | brinzolamide | No | 2 | $15 | |
| Azulfidine, En-tab | sulfasalazine | Yes | 1 | $10 | |
| - B - | [ Return to Top ] | ||||
| Bacitracin | bacitracin | Yes | 1 | $10 | |
| Bactrim, DS, Septra, DS | sulfamethoxazole/trimethoprim | Yes | 1 | $10 | |
| Bactroban Cream, Nasal | mupirocin calcium | No | 2 | $15 | |
| Bactroban Ointment | mupirocin | Yes | 1 | $10 | |
| Banzel | rufinamide | No | 2 | $15 | |
| Baraclude | entecavir | No | 2 | $15 | |
| Bellamine/bellaspas | ergotamine tart/bellad alk/pb | Yes | 1 | $10 | |
| Benadryl | diphenhydramine hcl | Yes | 1 | $10 | |
| Benicar, HCT | olmesartan medoxomil | No | ST | 2 | $15 |
| Bentyl | dicyclomine hcl | Yes | 1 | $10 | |
| Benzamycin | erythromycin base/benz per | Yes | 1 | $10 | |
| Benzashave, Brevoxyl Gel | benzoyl peroxide | Yes | 1 | $10 | |
| Benzoyl Peroxide-Rx | benzoyl peroxide | Yes | 1 | $10 | |
| Betagan | levobunolol hcl | Yes | 1 | $10 | |
| Betapace, AF | sotalol hcl | Yes | 1 | $10 | |
| Betoptic S | betaxolol hcl | No | 2 | $15 | |
| Betoptic Soln | betaxolol hcl | Yes | 1 | $10 | |
| Biaxin, XL | clarithromycin | Yes | 1 | $10 | |
| Bidil | isosorb dinit/hydralazine hcl | No | 2 | $15 | |
| Biltricide | praziquantel | No | 2 | $15 | |
| Bleph-10, Sodium Sulamyde | sulfacetamide sodium | Yes | 1 | $10 | |
| Blephamide Drops, Oint | na sulfacetm/prednisol ac | No | 2 | $15 | |
| Blocadren | timolol maleate | Yes | 1 | $10 | |
| Bontril | phendimetrazine tartrate | Yes | PA | 1 | $10 |
| Bravelle | urofollitropin (fsh) | No | 2 | $15 | |
| Brethine | terbutaline sulfate | Yes | 1 | $10 | |
| Bromfed, PD, DM | p-ephed hcl/brompheniramin | Yes | 1 | $10 | |
| Bumex | bumetanide | Yes | 1 | $10 | |
| Bupap | butalbital/acetaminophen | Yes | 1 | $10 | |
| Buspar | buspirone hcl | Yes | 1 | $10 | |
| - C - | [ Return to Top ] | ||||
| Cafergot | ergotamine tartrate/caffeine | Yes | 1 | $10 | |
| Calan SR/Isoptin SR | verapamil hcl | Yes | 1 | $10 | |
| Calciferol | ergocalciferol | Yes | 1 | $10 | |
| Canasa | mesalamine | No | 2 | $15 | |
| Capex Shampoo | fluocinolone acetonide | No | 2 | $15 | |
| Capoten | captopril | Yes | 1 | $10 | |
| Capozide | captopril/hydrochlorothiazide | Yes | 1 | $10 | |
| Carafate, Susp | sucralfate | Yes | 1 | $10 | |
| Cardene | nicardipine hcl | Yes | 1 | $10 | |
| Cardizem, SR, CD | diltiazem hcl | Yes | 1 | $10 | |
| Cardura | doxazosin mesylate | Yes | 1 | $10 | |
| Carnitor | levocarnitine | Yes | 1 | $10 | |
| Casodex | bicalutamide | Yes | 1 | $10 | |
| Cataflam | diclofenac potassium | Yes | 1 | $10 | |
| Catapres | clonidine hcl | Yes | 1 | $10 | |
| Catapres-TTS | clonidine hcl | No | 2 | $15 | |
| Caverject | alprostadil | No | PA | 2 | $15 |
| Ceclor, ER | cefaclor | Yes | 1 | $10 | |
| Ceenu | lomustine | No | 2 | $15 | |
| Ceftin | cefuroxime axetil | Yes | 1 | $10 | |
| Cefzil | cefprozil | Yes | 1 | $10 | |
| Celexa | citalopram hydrobromide | Yes | 1 | $10 | |
| Cellcept | mycophenolate mofetil | Yes | 1 | $10 | |
| Cellcept Susp | mycophenolate mofetil | No | 2 | $15 | |
| Celontin | methsuximide | No | 2 | $15 | |
| Cetrotide | cetrorelix acetate | No | 2 | $15 | |
| Chantix | varenicline tartrate | No | 2 | $15 | |
| Chloral Hydrate | chloral hydrate | Yes | 1 | $10 | |
| Chlorpromazine HCL | chlorpromazine hcl | Yes | 1 | $10 | |
| Cialis | tadalafil | No | PA | 2 | $15 |
| Ciloxan Drops | ciprofloxacin hcl | Yes | 1 | $10 | |
| Ciloxan Oint | ciprofloxacin hcl | No | 2 | $15 | |
| Cipro | ciprofloxacin hcl | Yes | 1 | $10 | |
| Cipro 500mg | ciprofloxacin hcl | No | 2 | $15 | |
| Cipro HC | ciprofloxacin hcl/hc | No | 2 | $15 | |
| Cipro XR | ciprofloxacin hcl-betaine comb | Yes | PA | 1 | $10 |
| Ciprodex | ciprofloxacin hcl/dexameth | No | 2 | $15 | |
| Claritin, Alavert(OTC) | loratadine | Yes | 1 | $10 | |
| Claritin-d 12hr, 24hr(OTC) | p-ephed sul/loratadine | Yes | 1 | $10 | |
| Cleocin | clindamycin hcl | Yes | 1 | $10 | |
| Cleocin T | clindamycin phosphate | Yes | 1 | $10 | |
| Cleocin Vag Cream | clindamycin phosphate | Yes | 1 | $10 | |
| Climara | estradiol | Yes | 1 | $10 | |
| Clinoril | sulindac | Yes | 1 | $10 | |
| Cloderm | clocortolone pivalate | No | 2 | $15 | |
| Clomid | clomiphene citrate | Yes | 1 | $10 | |
| Clozaril | clozapine | Yes | 1 | $10 | |
| CNL 8 | ciclopirox/nail lacquer removr | Yes | 1 | $10 | |
| Coartem | artemether/lumefantrine | No | 2 | $15 | |
| Codeine Sulfate | codeine sulfate(g) | Yes | 1 | $10 | |
| Cogentin | benztropine mesylate | Yes | 1 | $10 | |
| Colazal | balsalazide disodium | Yes | 1 | $10 | |
| Colbenemid | colchicine/probenecid | Yes | 1 | $10 | |
| Colchicine | colchicine | Yes | 1 | $10 | |
| Colestid | colestipol hcl | Yes | 1 | $10 | |
| Colyte | sod sulf/sod/nahco3/kcl/peg's | Yes | 1 | $10 | |
| Combivent | albuterol sulfate/ipratropium | No | 2 | $15 | |
| Combivir | lamivudine/zidovudine | No | 2 | $15 | |
| Commit Lozenge OTC | nicotine polacrilex | Yes | 1 | $10 | |
| Compazine | prochlorperazine maleate | Yes | 1 | $10 | |
| Comtan | entacapone | No | 2 | $15 | |
| Concerta | methylphenidate hcl | No | 2 | $15 | |
| Condylox Gel | podofilox | No | 2 | $15 | |
| Condylox Soln | podofilox | Yes | 1 | $10 | |
| Copaxone | glatiramer acetate | No | 2 | $15 | |
| Copegus | ribavirin | Yes | PA | 1 | $10 |
| Cordarone | amiodarone hcl | Yes | 1 | $10 | |
| Cordran, Tape, SP | flurandrenolide | No | 2 | $15 | |
| Coreg | carvedilol | Yes | 1 | $10 | |
| Corgard | nadolol | Yes | 1 | $10 | |
| Cortef, Hydrocortisone | hydrocortisone | Yes | 1 | $10 | |
| Cortenema | hydrocortisone acetate | Yes | 1 | $10 | |
| Corticosteroids | see chapter 7c | Yes | 1 | $10 | |
| Cortifoam | hydrocortisone acetate | No | 2 | $15 | |
| Cortisone Acetate | cortisone acetate | Yes | 1 | $10 | |
| Cortisporin | neomy sulf/polymyx b sulf/hc | Yes | 1 | $10 | |
| Corzide | nadolol/bendroflumethiazide | Yes | 1 | $10 | |
| Cosopt | timolol maleate/dorzolam hcl | Yes | 1 | $10 | |
| Coumadin | warfarin sodium | Yes | 1 | $10 | |
| Covera-HS | verapamil hcl | No | 2 | $15 | |
| Cozaar | losartan potassium | No | ST | 2 | $15 |
| Creon | amylase/lipase/protease | No | 2 | $15 | |
| Crestor | rosuvastatin calcium | No | ST | 2 | $15 |
| Crinone | progesterone,micronized | No | 2 | $15 | |
| Crixivan | indinavir sulfate | No | 2 | $15 | |
| Cuprimine | penicillamine | No | 2 | $15 | |
| Cutivate | fluticasone propionate | Yes | 1 | $10 | |
| Cyanocobalamin Inj | cyanocobalamin | Yes | 1 | $10 | |
| Cyclessa | desogestrel-ethinyl estradiol | Yes | 1 | $10 | |
| Cyclocort | amcinonide | Yes | 1 | $10 | |
| Cyclogyl | cyclopentolate hcl | Yes | 1 | $10 | |
| Cytomel | liothyronine sodium | Yes | 1 | $10 | |
| Cytotec | misoprostol | Yes | 1 | $10 | |
| Cytovene | ganciclovir | Yes | 1 | $10 | |
| Cytoxan | cyclophosphamide | Yes | 1 | $10 | |
| Cytra-2, 3, K | citric acid/potassium citrate | Yes | 1 | $10 | |
| - D - | [ Return to Top ] | ||||
| D.H.E.45 | dihydroergotamine mesylate | Yes | 1 | $10 | |
| Dalmane | flurazepam hcl | Yes | 1 | $10 | |
| Danocrine | danazol | Yes | 1 | $10 | |
| Dantrium | dantrolene sodium | Yes | 1 | $10 | |
| Dapsone | dapsone | Yes | 1 | $10 | |
| Daraprim | pyrimethamine | No | 2 | $15 | |
| Darvocet-N | propoxyphene hcl/acetaminophen | Yes | 1 | $10 | |
| Darvon | propoxyphene hcl | Yes | 1 | $10 | |
| Darvon Compound | propoxyphene hcl/asa/caffeine | Yes | 1 | $10 | |
| Daypro | oxaprozin | Yes | 1 | $10 | |
| DDAVP Soln/Spray | desmopressin acetate | Yes | 1 | $10 | |
| DDAVP Tabs | desmopressin acetate | Yes | 1 | $10 | |
| Decadron | dexamethasone | Yes | 1 | $10 | |
| Decadron Opth | dexamethasone sod phosphate | Yes | 1 | $10 | |
| Deconamine CX, SrR | guaifenesin/p-ephed hcl/hcod | Yes | 1 | $10 | |
| Deconamine Syrup, SR | pseudoephedrine hcl/chlor-mal | Yes | 1 | $10 | |
| Delatestryl | testosterone enanthate | No | 2 | $15 | |
| Demadex | torsemide | Yes | 1 | $10 | |
| Demerol | meperidine hcl | Yes | 1 | $10 | |
| Demulen | ethynodiol d-ethinyl estradiol | Yes | 1 | $10 | |
| Depakene | valproate sodium | Yes | 1 | $10 | |
| Depakote, ER | divalproex sodium | Yes | 1 | $10 | |
| Depo-provera 150mg | medroxyprogesterone acet | Yes | 1 | $10 | |
| Depo-provera 400mg | medroxyprogesterone acet | No | 2 | $15 | |
| Depo-subq Provera 104 | medroxyprogesterone acet | No | 2 | $15 | |
| Depo-testosterone | testosterone cypionate | Yes | 1 | $10 | |
| Dermacort, Hytone (Rx only) | hydrocortisone | Yes | 1 | $10 | |
| Dermatop | prednicarbate | Yes | 1 | $10 | |
| Desferal | deferoxamine mesylate | Yes | 1 | $10 | |
| Desogen, Ortho-cept | desogestrel-ethinyl estradiol | Yes | 1 | $10 | |
| Desowen, Tridesilon | desonide | Yes | 1 | $10 | |
| Desoxyn | methamphetamine hcl | No | 2 | $15 | |
| Desyrel | trazodone hcl | Yes | 1 | $10 | |
| Detrol | tolterodine tartrate | No | 2 | $15 | |
| Detrol LA | tolterodine tartrate | No | 2 | $15 | |
| Dexedrine | d-amphetamine sulfate | Yes | 1 | $10 | |
| Diabeta, Micronase | glyburide | Yes | 1 | $10 | |
| Diabinese | chlorpropamide | Yes | 1 | $10 | |
| Diamox, Sequels | acetazolamide | Yes | 1 | $10 | |
| Diastat | diazepam | No | 2 | $15 | |
| Dicloxacillin | dicloxacillin sodium | Yes | 1 | $10 | |
| Didrex | benzphetamine hcl | Yes | PA | 1 | $10 |
| Didronel | etidronate disodium | Yes | 1 | $10 | |
| Differin | adapalene | No | 2 | $15 | |
| Diflucan | fluconazole | Yes | 1 | $10 | |
| Digoxin Elixir | digoxin | No | 2 | $15 | |
| Digoxin Tabs | digoxin | Yes | 1 | $10 | |
| Dilantin | phenytoin sodium extended | Yes | 1 | $10 | |
| Dilantin Chew Tabs | phenytoin | No | 2 | $15 | |
| Dilatrate-SR | isosorbide dinitrate | No | 2 | $15 | |
| Dilaudid | hydromorphone hcl | Yes | 1 | $10 | |
| Diprolene AF, Gel, Cr, Lot, Oint | betamet diprop/prop gly | Yes | 1 | $10 | |
| Diprosone, Maxivate | betamethasone dipropionate | Yes | 1 | $10 | |
| Disalcid, Salflex | salsalate | Yes | 1 | $10 | |
| Ditropan, XL | oxybutynin chloride | Yes | 1 | $10 | |
| Diuril | chlorothiazide | Yes | 1 | $10 | |
| Dolobid | diflunisal | Yes | 1 | $10 | |
| Domeboro Otic | acetic acid/aluminum acetate | Yes | 1 | $10 | |
| Donnatal | belladonna alkaloids/phenobarb | Yes | 1 | $10 | |
| Dostinex | cabergoline | Yes | 1 | $10 | |
| Dovonex | calcipotriene | No | 2 | $15 | |
| Dovonex Solution | calcipotriene | Yes | 1 | $10 | |
| Doxycycline Hyclate | doxycycline hyclate | Yes | 1 | $10 | |
| Dritho-scalp | anthralin | No | 2 | $15 | |
| Droxia | hydroxyurea | No | 2 | $15 | |
| Drysol | aluminum chloride | Yes | 1 | $10 | |
| Duoneb | ipratropium/albuterol sulfate | Yes | 1 | $10 | |
| Duragesic | fentanyl | Yes | 1 | $10 | |
| Duricef | cefadroxil hydrate | Yes | 1 | $10 | |
| Dygase | amylase/lipase/protease | No | 2 | $15 | |
| Dynacirc | isradipine | Yes | 1 | $10 | |
| Dyrenium | triamterene | No | 2 | $15 | |
| - E - | [ Return to Top ] | ||||
| Ec-naprosyn | naproxen | Yes | 1 | $10 | |
| Edecrin | ethacrynic acid | No | 2 | $15 | |
| Effexor | venlafaxine hcl | Yes | 1 | $10 | |
| Effexor XR | venlafaxine hcl | No | ST | 2 | $15 |
| Effient | prasugrel hydrochloride | No | 2 | $15 | |
| Efudex | fluorouracil | Yes | 1 | $10 | |
| Elavil | amitriptyline hcl | Yes | 1 | $10 | |
| Eldepryl | selegiline hcl | Yes | 1 | $10 | |
| Elidel | pimecrolimus | No | ST | 2 | $15 |
| Elimite | permethrin | Yes | 1 | $10 | |
| Elmiron | pentosan polysulfate sodium | No | 2 | $15 | |
| Elocon | mometasone furoate | Yes | 1 | $10 | |
| Emcyt | estramustine phosphate sodium | No | 2 | $15 | |
| Emend 80,125mg Capsules | aprepitant | No | 2 | $15 | |
| Emla | lidocaine/prilocaine | Yes | 1 | $10 | |
| Emtriva | emtricitabine | No | 2 | $15 | |
| Enbrel | etanercept | No | PA | 2 | $15 |
| Endometrin | progesterone, micronized | No | 2 | $15 | |
| Epipen, JR | epinephrine | No | 2 | $15 | |
| Epivir | lamivudine | No | 2 | $15 | |
| Epivir HBV | lamivudine | No | 2 | $15 | |
| Epzicom | abacavir sulfate/lamivudine | No | 2 | $15 | |
| Ergomar | ergotamine tartrate | No | 2 | $15 | |
| Erythromycin Topical Soln, Gel | erythromycin base/ethanol | Yes | 1 | $10 | |
| Erythromycin, Stearate, Base | erythromycin base | Yes | 1 | $10 | |
| Eskalith, CR | lithium carbonate | Yes | 1 | $10 | |
| Estrace | estradiol | Yes | 1 | $10 | |
| Estraderm | estradiol | No | 2 | $15 | |
| Estratest, H.S. | estrogen,ester/me-testosterone | Yes | 1 | $10 | |
| Estring | estradiol | No | 2 | $15 | |
| Estrostep FE | noreth a-et estra/fe fumarate | Yes | 1 | $10 | |
| Ethambutol | ethambutol hcl | Yes | 1 | $10 | |
| Etrafon | amitriptyline hcl/perphenazine | Yes | 1 | $10 | |
| Eulexin | flutamide | Yes | 1 | $10 | |
| Eurax | crotamiton | No | 2 | $15 | |
| Evista | raloxifene hcl | No | 2 | $15 | |
| Exelon | rivastigmine tartrate | No | 2 | $15 | |
| - F - | [ Return to Top ] | ||||
| Famvir | famciclovir | Yes | 1 | $10 | |
| Fareston | toremifene citrate | No | 2 | $15 | |
| Faslodex | fulvestrant | No | 2 | $15 | |
| Felbatol | felbamate | No | 2 | $15 | |
| Feldene | piroxicam | Yes | 1 | $10 | |
| Femara | letrozole | No | 2 | $15 | |
| Femhrt | ethinyl estradiol/noreth ac | No | 2 | $15 | |
| Fertinex | urofollitropin (fsh) | No | 2 | $15 | |
| Fibricor | fenofibric acid | Yes | 1 | $10 | |
| Fioricet w/codeine | codeine/butalbut/acetamin/caff | Yes | 1 | $10 | |
| Fioricet;esgic, Plus | butalb/acetaminophen/caffeine | Yes | 1 | $10 | |
| Fiorinal | butalbital/aspirin/caffeine | Yes | 1 | $10 | |
| Fiorinal w/codeine | codeine/butalbital/asa/caffein | Yes | 1 | $10 | |
| Flagyl | metronidazole | Yes | 1 | $10 | |
| Flagyl ER | metronidazole | No | 2 | $15 | |
| Flexeril | cyclobenzaprine hcl | Yes | 1 | $10 | |
| Flonase | fluticasone propionate | Yes | 1 | $10 | |
| Florinef | fludrocortisone acetate | Yes | 1 | $10 | |
| Flovent HFA, Diskus (tier 1-BCN only) | fluticasone propionate | No | 1 | $10 | |
| Floxin | ofloxacin | Yes | 1 | $10 | |
| Floxin Otic | ofloxacin | Yes | 1 | $10 | |
| Flumadine | rimantadine hcl | Yes | 1 | $10 | |
| Fluvoxamine Maleate | fluvoxamine maleate | Yes | 1 | $10 | |
| FML | fluorometholone | No | 2 | $15 | |
| Folvite | folic acid | Yes | 1 | $10 | |
| Foradil | formoterol fumarate | No | 2 | $15 | |
| Fosamax, Weekly | alendronate sodium | Yes | 1 | $10 | |
| Fuzeon | enfuvirtide | No | 2 | $15 | |
| - G - | [ Return to Top ] | ||||
| Gabitril | tiagabine hcl | No | 2 | $15 | |
| Ganirelix Acetate | ganirelix acetate | No | 2 | $15 | |
| Garamycin | gentamicin sulfate | Yes | 1 | $10 | |
| Gentamicin Cr, Oint | gentamicin sulfate | Yes | 1 | $10 | |
| Geodon | ziprasidone hcl | No | 2 | $15 | |
| Gleevec | imatinib mesylate | No | 2 | $15 | |
| Glucagon Emergency Kit | glucagon,human recombinant | No | 2 | $15 | |
| Glucophage, XR | metformin hcl | Yes | 1 | $10 | |
| Glucotrol, XL | glipizide | Yes | 1 | $10 | |
| Glucovance | glyburide/metformin hcl | Yes | 1 | $10 | |
| Glycolax | polyethylene glycol 3350 | Yes | 1 | $10 | |
| Glynase | glyburide,micronized | Yes | 1 | $10 | |
| Golytely | peg 3350/na sulf,bicarb,cl/kcl | Yes | 1 | $10 | |
| Gonal-f, RFF | follitropin alpha,recomb | No | 2 | $15 | |
| Granulex | trypsin/balsam peru/castor oil | Yes | 1 | $10 | |
| Grifulvin V 500mg | griseofulvin,microsize | No | 2 | $15 | |
| Grifulvin V Susp | griseofulvin,microsize | Yes | 1 | $10 | |
| Gris Peg | griseofulvin ultramicrosize | No | 2 | $15 | |
| Guaifed, Entex Pse | guaifenesin/p-ephed hcl | Yes | 1 | $10 | |
| Guaifed-PD | guaifenesin/phenylephrine hcl | Yes | 1 | $10 | |
| - H - | [ Return to Top ] | ||||
| Halcion | triazolam | Yes | 1 | $10 | |
| Haldol | haloperidol | Yes | 1 | $10 | |
| Helidac | tetracyc hcl/bis ss/metronid | No | 2 | $15 | |
| Heparin | heparin sodium,porcine | Yes | 1 | $10 | |
| Hepsera | adefovir dipivoxil | No | 2 | $15 | |
| Hexalen | altretamine | No | 2 | $15 | |
| Hiprex/urex | methenamine hippurate | Yes | 1 | $10 | |
| Humabid DM | guaifenesin/d-methorphan hb | Yes | 1 | $10 | |
| Humalog, Mix | insulin npl/insulin lispro | No | 2 | $15 | |
| Humatin | paromomycin sulfate | Yes | 1 | $10 | |
| Humira | adalimumab | No | PA | 2 | $15 |
| Humulin 70/30 | humulin | No | 2 | $15 | |
| Humulin N | nph, human insulin isophane | No | 2 | $15 | |
| Humulin R | insulin regular human rec | No | 2 | $15 | |
| Hycamtin | topotecan hcl | No | PA | 2 | $15 |
| Hydrea | hydroxyurea | Yes | 1 | $10 | |
| Hydrodiuril, Microzide | hydrochlorothiazide | Yes | 1 | $10 | |
| Hygroton, Thalitone | chlorthalidone | Yes | 1 | $10 | |
| Hytrin | terazosin hcl | Yes | 1 | $10 | |
| Hyzaar | losartan/hydrochlorothiazide | No | ST | 2 | $15 |
| - I - | [ Return to Top ] | ||||
| Ilotycin | erythromycin base | Yes | 1 | $10 | |
| Imdur | isosorbide mononitrate | Yes | 1 | $10 | |
| Imitrex Injection | sumatriptan succinate | Yes | 1 | $10 | |
| Imitrex Nasal Spray | sumatriptan | Yes | 1 | $10 | |
| Imitrex Tablets | sumatriptan succinate | Yes | 1 | $10 | |
| Imuran | azathioprine | Yes | 1 | $10 | |
| Inderal, LA | propranolol hcl | Yes | 1 | $10 | |
| Inderide | propranolol/hydrochlorothiazid | Yes | 1 | $10 | |
| Indocin Suppository | indomethacin | No | 2 | $15 | |
| Indocin, SR | indomethacin | Yes | 1 | $10 | |
| Infergen | interferon alfacon-1 | No | PA | 2 | $15 |
| Inflamase, Forte | prednisolone sod phosphate | Yes | 1 | $10 | |
| Inspra | eplerenone | Yes | 1 | $10 | |
| Intal Solution | cromolyn sodium | Yes | 1 | $10 | |
| Intelence | etravirine | No | 2 | $15 | |
| Intron A | interferon alfa-2b,recomb. | No | 2 | $15 | |
| Invirase | saquinavir mesylate | No | 2 | $15 | |
| Ionamin | phentermine resin | No | PA | 2 | $15 |
| Iopidine Drops | apraclonidine hcl | Yes | 1 | $10 | |
| Iressa | gefitinib | No | PA | 2 | $15 |
| Isentress | raltegravir potassium | No | 2 | $15 | |
| Ismo, Monoket | isosorbide mononitrate | Yes | 1 | $10 | |
| Isoniazid | isoniazid | Yes | 1 | $10 | |
| Isopto Atropine | atropine sulfate | Yes | 1 | $10 | |
| Isopto Carbachol | carbachol | No | 2 | $15 | |
| Isopto Homatropine | homatropine hbr | Yes | 1 | $10 | |
| Isopto Hyoscine | scopolamine hydrobromide | No | 2 | $15 | |
| Isordil | isosorbide dinitrate | Yes | 1 | $10 | |
| - K - | [ Return to Top ] | ||||
| Kaletra | ritonavir/lopinavir | No | 2 | $15 | |
| Kayciel, Kaon-CL, Kaon Liquid | potassium chloride | Yes | 1 | $10 | |
| Kayexalate | sodium polystyrene sulfonate | Yes | 1 | $10 | |
| Keflex | cephalexin monohydrate | Yes | 1 | $10 | |
| Keppra | levetiracetam | Yes | 1 | $10 | |
| Kerlone | betaxolol hcl | Yes | 1 | $10 | |
| Ketoprofen | ketoprofen | Yes | 1 | $10 | |
| Klonopin, Wafer | clonazepam | Yes | 1 | $10 | |
| K-lor, Klor-con | potassium chloride | Yes | 1 | $10 | |
| K-lyte, Klor-con/EF | potassium bicarbonate/cit ac | Yes | 1 | $10 | |
| K-phos Neutral | phosphorus #1 | Yes | 1 | $10 | |
| K-tab, K-dur, Slow-k, Kaon Cl | potassium chloride | Yes | 1 | $10 | |
| Kuvan | sapropterin dihydrochloride | No | PA | 2 | $15 |
| Kytril | granisetron hcl | Yes | 1 | $10 | |
| - L - | [ Return to Top ] | ||||
| Lacrisert | hydroxypropyl cellulose | No | 2 | $15 | |
| Lactulose | lactulose | Yes | 1 | $10 | |
| Lamictal, Dispertabs | lamotrigine | Yes | 1 | $10 | |
| Lamisil Tablets | terbinafine hcl | Yes | 1 | $10 | |
| Lantus | insulin glargine,hum.rec.anlog | No | 2 | $15 | |
| Lapase | amylase/lipase/protease | No | 2 | $15 | |
| Lariam | mefloquine hcl | Yes | 1 | $10 | |
| Lasix | furosemide | Yes | 1 | $10 | |
| Letairis | ambrisentan | No | PA | 2 | $15 |
| Leucovorin | leucovorin calcium | Yes | 1 | $10 | |
| Leukeran | chlorambucil | No | 2 | $15 | |
| Leukine | sargramostim | No | 2 | $15 | |
| Levbid | hyoscyamine sulfate | Yes | 1 | $10 | |
| Levemir | insulin detemir | No | 2 | $15 | |
| Levothyroxine | levothyroxine sodium | Yes | 1 | $10 | |
| Levsin, SL | hyoscyamine sulfate | Yes | 1 | $10 | |
| Levsinex | hyoscyamine sulfate | Yes | 1 | $10 | |
| Lexapro | escitalopram oxalate | No | ST | 2 | $15 |
| Lexiva | fosamprenavir calcium | No | 2 | $15 | |
| Librax | clidinium br/chlordiazepoxide | Yes | 1 | $10 | |
| Librium | chlordiazepoxide hcl | Yes | 1 | $10 | |
| Lidex, E | fluocinonide | Yes | 1 | $10 | |
| Limbitrol, DS | amitrip hcl/chlordiazepoxide | Yes | 1 | $10 | |
| Lindane | lindane | Yes | 1 | $10 | |
| Lioresal | baclofen | Yes | 1 | $10 | |
| Lipram-ul20 | amylase/lipase/protease | No | 2 | $15 | |
| Lithium Citrate | lithium citrate | Yes | 1 | $10 | |
| Lithobid | lithium carbonate | Yes | 1 | $10 | |
| Lo/ovral | norgestrel-ethinyl estradiol | Yes | 1 | $10 | |
| Locoid Cm, Oint, Soln | hydrocortisone butyrate | Yes | 1 | $10 | |
| Locoid Lipocream | hydrocortisone butyrate/emoll | Yes | 1 | $10 | |
| Lodine, XL | etodolac | Yes | 1 | $10 | |
| Loestrin, FE | noreth a-et estra/fe fumarate | Yes | 1 | $10 | |
| Lofibra | fenofibrate | Yes | 1 | $10 | |
| Lomotil | diphenoxylate hcl/atrop sulf | Yes | 1 | $10 | |
| Loniten | minoxidil | Yes | 1 | $10 | |
| Lopid | gemfibrozil | Yes | 1 | $10 | |
| Lopressor, HCT | metoprol/hydrochlorothiazide | Yes | 1 | $10 | |
| Loprox Cr, Lotion, Gel | ciclopirox olamine | Yes | 1 | $10 | |
| Loprox Shampoo | ciclopirox | Yes | 1 | $10 | |
| Lotensin, HCT | benazepril/hydrochlorothiazide | Yes | 1 | $10 | |
| Lotrel | amlodipine besylate/benazepril | Yes | 1 | $10 | |
| Lotrel 5/40, 10/40 | amlodipine besylate/benazepril | No | 2 | $15 | |
| Lotrimin | clotrimazole | Yes | 1 | $10 | |
| Lotrisone Cr, Lotion | clotrimazole/betamet diprop | Yes | 1 | $10 | |
| Lovenox | enoxaparin sodium | No | 2 | $15 | |
| Loxitane | loxapine succinate | Yes | 1 | $10 | |
| Lozol | indapamide | Yes | 1 | $10 | |
| Lumigan | bimatoprost | No | 2 | $15 | |
| Lupron | leuprolide acetate | Yes | 1 | $10 | |
| Lupron Depot, Ped | leuprolide acetate | No | 2 | $15 | |
| Luride | sodium fluoride | Yes | 1 | $10 | |
| Lybrel | levonorgestrel-eth estra | No | 2 | $15 | |
| Lysodren | mitotane | No | 2 | $15 | |
| - M - | [ Return to Top ] | ||||
| Macrobid | nitrofurantoin/nitrofuran mac | Yes | 1 | $10 | |
| Macrodantin | nitrofurantoin macrocrystal | Yes | 1 | $10 | |
| Malarone | atovaquone/proguanil hcl | No | 2 | $15 | |
| Mandelamine | methenamine mandelate | Yes | 1 | $10 | |
| Maprotiline HCL | maprotiline hcl | Yes | 1 | $10 | |
| Marinol | dronabinol | Yes | 1 | $10 | |
| Matulane | procarbazine hcl | No | 2 | $15 | |
| Mavik | trandolapril | Yes | 1 | $10 | |
| Maxair Autohaler | pirbuterol acetate | No | 2 | $15 | |
| Maxalt, MLT | rizatriptan benzoate | No | ST | 2 | $15 |
| Maxitrol | neo/polymyx b sulf/dexameth | Yes | 1 | $10 | |
| Maxzide, Dyazide | triamterene/hydrochlorothiazid | Yes | 1 | $10 | |
| Mebaral | mephobarbital | Yes | 1 | $10 | |
| Mebaral 50mg | mephobarbital | No | 2 | $15 | |
| Meclomen | meclofenamate sodium | Yes | 1 | $10 | |
| Medrol, Dosepak | methylprednisolone | Yes | 1 | $10 | |
| Megace | megestrol acetate | Yes | 1 | $10 | |
| Mellaril | thioridazine hcl | Yes | 1 | $10 | |
| Mephyton | phytonadione | No | 2 | $15 | |
| Mepron | atovaquone | No | 2 | $15 | |
| Mesnex | mesna | No | 2 | $15 | |
| Mestinon | pyridostigmine bromide | Yes | 1 | $10 | |
| Mestinon Timespan, Syrup | pyridostigmine bromide | No | 2 | $15 | |
| Metadate CD | methylphenidate hcl | No | 2 | $15 | |
| Metaglip | glipizide/metformin hcl | Yes | 1 | $10 | |
| Metaproterenol Soln | metaproterenol sulfate | Yes | 1 | $10 | |
| Methadone | methadone hcl | Yes | 1 | $10 | |
| Methergine | methylergonovine maleate | No | 2 | $15 | |
| Methotrexate | methotrexate sodium/pf | Yes | 1 | $10 | |
| Metrocream, Gel, Lotion | metronidazole | Yes | 1 | $10 | |
| Metrogel 1% | metronidazole/skin cleanser | No | 2 | $15 | |
| Metrogel-vaginal | metronidazole | Yes | 1 | $10 | |
| Mevacor | lovastatin | Yes | 1 | $10 | |
| Mexitil | mexiletine hcl | Yes | 1 | $10 | |
| Miacalcin Nasal Spray | calcitonin,salmon,synthetic | Yes | 1 | $10 | |
| Miacalcin Vial | calcitonin,salmon,synthetic | No | 2 | $15 | |
| Micro-k | potassium chloride | Yes | 1 | $10 | |
| Midamor | amiloride hcl | Yes | 1 | $10 | |
| Midrin | isometheptene/apap/dichlphen | Yes | 1 | $10 | |
| Migranal | dihydroergotamine mesylate | No | 2 | $15 | |
| Miltown, Equanil | meprobamate | Yes | 1 | $10 | |
| Minipress | prazosin hcl | Yes | 1 | $10 | |
| Minocin, Dynacin | minocycline hcl | Yes | 1 | $10 | |
| Mirapex | pramipexole di-hcl | No | 2 | $15 | |
| Mircette | desog-et estra/ethin estra | Yes | 1 | $10 | |
| Moban | molindone hcl | No | 2 | $15 | |
| Mobic | meloxicam | Yes | 1 | $10 | |
| Modicon | norethindrone-ethinyl estrad | Yes | 1 | $10 | |
| Moduretic | amiloride/hydrochlorothiazide | Yes | 1 | $10 | |
| Monistat-derm | miconazole nitrate | Yes | 1 | $10 | |
| Monodox | doxycycline monohydrate | Yes | 1 | $10 | |
| Monopril, HCT | fosinopril/hydrochlorothiazide | Yes | 1 | $10 | |
| Motrin | ibuprofen | Yes | 1 | $10 | |
| Ms Contin/Oramorph SR | morphine sulfate | Yes | 1 | $10 | |
| MSIR | morphine sulfate | Yes | 1 | $10 | |
| Mucomyst | acetylcysteine | Yes | 1 | $10 | |
| Muse | alprostadil | No | PA | 2 | $15 |
| Mycelex Troche | clotrimazole | Yes | 1 | $10 | |
| Mycobutin | rifabutin | No | 2 | $15 | |
| Mycostatin | nystatin | Yes | 1 | $10 | |
| Mydriacyl | tropicamide | Yes | 1 | $10 | |
| Myleran | busulfan | No | 2 | $15 | |
| Mysoline | primidone | Yes | 1 | $10 | |
| - N - | [ Return to Top ] | ||||
| Nalfon | fenoprofen calcium | No | 2 | $15 | |
| Namenda, Soln | memantine hcl | No | 2 | $15 | |
| Naprosyn | naproxen | Yes | 1 | $10 | |
| Nardil | phenelzine sulfate | No | 2 | $15 | |
| Nasacort AQ | triamcinolone acetonide | No | ST | 2 | $15 |
| Nasalide | flunisolide 0.025% spray | Yes | 1 | $10 | |
| Nasarel | flunisolide | Yes | 1 | $10 | |
| Natacyn | natamycin | No | 2 | $15 | |
| Navane | thiothixene | Yes | 1 | $10 | |
| Nebupent Aerosol | pentamidine isethionate | No | 2 | $15 | |
| Necon 10/11 | norethindrone-ethinyl estrad | Yes | 1 | $10 | |
| Neomycin | neomycin sulfate | Yes | 1 | $10 | |
| Neoral | cyclosporine, modified | Yes | 1 | $10 | |
| Neosporin Ophth Soln | neomycin/gramicidin/polymyxn b | Yes | 1 | $10 | |
| Neosporin Opth Oint | neomy sulf/bacitra/polymyxin b | Yes | 1 | $10 | |
| Neo-synephrine | phenylephrine hcl | Yes | 1 | $10 | |
| Neumega | oprelvekin | No | 2 | $15 | |
| Neupogen | filgrastim | No | 2 | $15 | |
| Neurontin | gabapentin | Yes | 1 | $10 | |
| Neurontin Solution | gabapentin | No | 2 | $15 | |
| Nexavar | sorafenib tosylate | No | PA | 2 | $15 |
| Niaspan | niacin | No | 2 | $15 | |
| Nicotine Gum, Nicorette | nicotine polacrilex | Yes | 1 | $10 | |
| Nicotine Patch | nicotine | Yes | 1 | $10 | |
| Nilandron | nilutamide | No | 2 | $15 | |
| Nimotop | nimodipine | Yes | 1 | $10 | |
| Niravam | alprazolam | Yes | 1 | $10 | |
| Nitorglycerin Patch | nitroglycerin | Yes | 1 | $10 | |
| Nitro-bid Ointment | nitroglycerin | No | 2 | $15 | |
| Nitroglycerin Sa Cap | nitroglycerin | Yes | 1 | $10 | |
| Nitrolingual Spray | nitroglycerin | No | 2 | $15 | |
| Nitrostat | nitroglycerin | No | 2 | $15 | |
| Nizoral | ketoconazole | Yes | 1 | $10 | |
| Nizoral Cream | ketoconazole | Yes | 1 | $10 | |
| Nizoral Shampoo 2% | ketoconazole | Yes | 1 | $10 | |
| Nordette, Levlen | levonorgestrel-eth estra | Yes | 1 | $10 | |
| Norflex | orphenadrine citrate | Yes | 1 | $10 | |
| Norgesic, Forte | orphenadrine/aspirin/caffeine | Yes | 1 | $10 | |
| Norinyl 1/35, Ortho-novum 1/35 | norethindrone-mestranol | Yes | 1 | $10 | |
| Norinyl 1/50, Ortho-novum 1/50 | norethindrone-ethinyl estrad | Yes | 1 | $10 | |
| Normodyne | labetalol hcl | Yes | 1 | $10 | |
| Norpace | disopyramide phosphate | Yes | 1 | $10 | |
| Norpace Cr | disopyramide phosphate | No | 2 | $15 | |
| Norpramin | desipramine hcl | Yes | 1 | $10 | |
| Norvasc | amlodipine besylate | Yes | 1 | $10 | |
| Norvir | ritonavir | No | 2 | $15 | |
| Novarel, Pregnyl, Profasi | gonadotropin,chorionic,human | No | 2 | $15 | |
| Novolin | insulin regular human rec | No | 2 | $15 | |
| Novolog | insulin aspart | No | 2 | $15 | |
| Noxafil | posaconazole | No | 2 | $15 | |
| Nulytely | sod sulf/sod/nahco3/kcl/peg's | Yes | 1 | $10 | |
| Nutropin, Aq, Nuspin | somatropin | No | PA | 2 | $15 |
| Nystatin | nystatin | Yes | 1 | $10 | |
| Nystatin W/triamcinolone | nystatin/triamcinolone | Yes | 1 | $10 | |
| - O - | [ Return to Top ] | ||||
| Ocufen | flurbiprofen sodium | Yes | 1 | $10 | |
| Ocuflox | ofloxacin | Yes | 1 | $10 | |
| Ocupress | carteolol hcl | Yes | 1 | $10 | |
| Ogen, Ortho-est | estropipate | Yes | 1 | $10 | |
| Olux | clobetasol propionate | Yes | 1 | $10 | |
| Omeprazole OTC | omeprazole | Yes | 1 | $10 | |
| Omnicef | cefdinir | Yes | 1 | $10 | |
| Opticrom | cromolyn sodium | Yes | 1 | $10 | |
| Optipranolol | metipranolol | Yes | 1 | $10 | |
| Optivar | azelastine hcl | Yes | 1 | $10 | |
| Orap | pimozide | No | 2 | $15 | |
| Orapred | prednisolone sod phosphate | Yes | 1 | $10 | |
| Orfadin | nitisinone | No | 2 | $15 | |
| Orinase | tolbutamide | Yes | 1 | $10 | |
| Ortho Evra | ethinyl estradiol/norelgest | No | 2 | $15 | |
| Ortho Micronor, Nor-qd | norethindrone | Yes | 1 | $10 | |
| Ortho Tri-cyclen | norgestimate-ethinyl estradiol | Yes | 1 | $10 | |
| Ortho Tri-cyclen Lo | norgestimate-ethinyl estradiol | No | 2 | $15 | |
| Ortho-cyclen | norgestimate-ethinyl estradiol | Yes | 1 | $10 | |
| Ortho-novum 7/7/7 | norethindrone-ethinyl estrad | Yes | 1 | $10 | |
| Orudis | ketoprofen | Yes | 1 | $10 | |
| Ovcon 35 | norethindrone-ethinyl estrad | Yes | 1 | $10 | |
| Ovide | malathion | Yes | 1 | $10 | |
| Ovidrel | hcg alpha,recombinant | No | 2 | $15 | |
| Ovral | norgestrel-ethinyl estradiol | Yes | 1 | $10 | |
| Oxandrin | oxandrolone | Yes | PA | 1 | $10 |
| Oxsoralen, Ultra | methoxsalen, rapid | No | 2 | $15 | |
| Oxycodone Immediate Release | oxycodone hcl | Yes | 1 | $10 | |
| - P - | [ Return to Top ] | ||||
| Pacerone | amiodarone hcl | Yes | 1 | $10 | |
| Pamelor, Aventyl | nortriptyline hcl | Yes | 1 | $10 | |
| Pancrease Mt 4, 10, 16, 20 | amylase/lipase/protease | No | 2 | $15 | |
| Pancrelipase EC | amylase/lipase/protease | No | 2 | $15 | |
| Pangestyme UL 12 | amylase/lipase/protease | No | 2 | $15 | |
| Panretin | alitretinoin | No | 2 | $15 | |
| Papaverine Caps | papaverine hcl | Yes | 1 | $10 | |
| Paraflex, Parafon Forte DSC | chlorzoxazone | Yes | 1 | $10 | |
| Parcopa | carbidopa/levodopa | Yes | 1 | $10 | |
| Paregoric | paregoric | Yes | 1 | $10 | |
| Parlodel | bromocriptine mesylate | Yes | 1 | $10 | |
| Parnate | tranylcypromine sulfate | Yes | 1 | $10 | |
| Patanol | olopatadine hcl | No | 2 | $15 | |
| Paxil, Cr | paroxetine hcl | Yes | 1 | $10 | |
| Pediazole | ery e-succ/sulfisoxazole | Yes | 1 | $10 | |
| Peganone | ethotoin | No | 2 | $15 | |
| Pegasys | peginterferon alfa-2a | No | PA | 2 | $15 |
| Peg-intron, Redipen | peginterferon alfa-2b | No | PA | 2 | $15 |
| Penicillin VK | penicillin v potassium | Yes | 1 | $10 | |
| Penlac | ciclopirox | Yes | 1 | $10 | |
| Pentasa | mesalamine | No | 2 | $15 | |
| Pepcid (Rx only) | famotidine | Yes | 1 | $10 | |
| Percocet | oxycodone hcl/acetaminophen | Yes | 1 | $10 | |
| Percodan | oxycodone hcl/aspirin | Yes | 1 | $10 | |
| Periactin | cyproheptadine hcl | Yes | 1 | $10 | |
| Peridex | chlorhexidine gluconate | Yes | 1 | $10 | |
| Periostat | doxycycline hyclate | Yes | 1 | $10 | |
| Perphenazine | perphenazine | Yes | 1 | $10 | |
| Persantine | dipyridamole | Yes | 1 | $10 | |
| Phenergan | promethazine hcl | Yes | 1 | $10 | |
| Phenergan DM | d-methorphan hb/prometh hcl | Yes | 1 | $10 | |
| Phenergan VC | phenylephrine hcl/prometh hcl | Yes | 1 | $10 | |
| Phenergan w/codeine | codeine/promethazine hcl | Yes | 1 | $10 | |
| Phenobarbital | phenobarbital | Yes | 1 | $10 | |
| Phoslo | calcium acetate | Yes | 1 | $10 | |
| Phospholine Iodide | echothiophate iodide | No | 2 | $15 | |
| Phrenilin | butalbital/acetaminophen | Yes | 1 | $10 | |
| Phrenilin Forte | butalbital/acetaminophen | No | 2 | $15 | |
| Pilocar, Isopto-carpine | pilocarpine hcl | Yes | 1 | $10 | |
| Pilopine HS | pilocarpine hcl | No | 2 | $15 | |
| Pindolol | pindolol | Yes | 1 | $10 | |
| Plan B | levonorgestrel | Yes | 1 | $10 | |
| Plaquenil | hydroxychloroquine sulfate | Yes | 1 | $10 | |
| Plavix | clopidogrel bisulfate | No | 2 | $15 | |
| Plendil | felodipine | Yes | 1 | $10 | |
| Pletal | cilostazol | Yes | 1 | $10 | |
| Plexion, TS | sulfacetamide sodium/sulfur | Yes | 1 | $10 | |
| Polaramine | dexchlorpheniramine maleate | Yes | 1 | $10 | |
| Polycitra | sod/potass/k cit/sod cit/ca | Yes | 1 | $10 | |
| Poly-pred | neomy sulf/polymyx b sulf/pred | No | 2 | $15 | |
| Polysporin | bacitracin/polymyxin b sulfate | Yes | 1 | $10 | |
| Polytrim | polymyxin b sulfate/tmp | Yes | 1 | $10 | |
| Poly-vi-flor | fluoride ion/multivitamins | Yes | 1 | $10 | |
| Ponstel | mefenamic acid | No | 2 | $15 | |
| Pramosone Cream | hc acetate/pramoxine hcl | Yes | 1 | $10 | |
| Prandin | repaglinide | No | 2 | $15 | |
| Pravachol | pravastatin sodium | Yes | 1 | $10 | |
| Precose | acarbose | Yes | 1 | $10 | |
| Pred Forte | prednisolone acetate | Yes | 1 | $10 | |
| Pred Mild | prednisolone acetate | No | 2 | $15 | |
| Prednisolone, Tabs, Syrup | prednisolone | Yes | 1 | $10 | |
| Prednisone | prednisone | Yes | 1 | $10 | |
| Premarin Cream | estrogens,conjugated | No | 2 | $15 | |
| Premarin, Premarin Low Dose | estrogens,conjugated | No | 2 | $15 | |
| Prempro, Low Dose/premphase | estrogen,con/m-progest acet | No | 2 | $15 | |
| Prenatal Vits | prenatal vit/iron,carb/doss/fa | Yes | 1 | $10 | |
| Prevacid | lansoprazole | Yes | ST | 1 | $10 |
| Prevacid Solutab | lansoprazole | No | PA | 2 | $15 |
| Prevident | sodium fluoride | Yes | 1 | $10 | |
| Prevpac | lansoprazole/amox tr/clarith | No | 2 | $15 | |
| Prezista(must be used with Norvir) | darunavir ethanolate | No | 2 | $15 | |
| Prilosec | omeprazole | Yes | 1 | $10 | |
| Prilosec 40mg | omeprazole | Yes | PA | 1 | $10 |
| Prilosec OTC | omeprazole magnesium | Yes | 1 | $10 | |
| Primaquine | primaquine phosphate | No | 2 | $15 | |
| Prinivil, Zestril | lisinopril | Yes | 1 | $10 | |
| Prinzide, Zestoretic | lisinopril/hydrochlorothiazide | Yes | 1 | $10 | |
| Proair, Proventil,Ventolin, HFA | albuterol | No | 2 | $15 | |
| Proamatine | midodrine hcl | Yes | 1 | $10 | |
| Pro-banthine 15mg | propantheline bromide | Yes | 1 | $10 | |
| Probenecid | probenecid | Yes | 1 | $10 | |
| Procardia, Xl;Adalat CC | nifedipine | Yes | 1 | $10 | |
| Prochieve | progesterone,micronized | No | 2 | $15 | |
| Procrit | epoetin alfa | No | PA | 2 | $15 |
| Proctocort Suppository | hydrocortisone acetate | Yes | 1 | $10 | |
| Profasi 5000units | gonadotropin,chorionic,human | No | 2 | $15 | |
| Progesterone In Oil (inj) | progesterone | Yes | 1 | $10 | |
| Prograf | tacrolimus anhydrous | Yes | 1 | $10 | |
| Prolixin | fluphenazine hcl | Yes | 1 | $10 | |
| Promacta | eltrombopag olamine | No | PA | 2 | $15 |
| Prometrium | progesterone,micronized | No | 2 | $15 | |
| Pronestyl, SR | procainamide hcl | Yes | 1 | $10 | |
| Propine | dipivefrin hcl | No | 2 | $15 | |
| Propylthiouracil | propylthiouracil | Yes | 1 | $10 | |
| Proscar | finasteride | Yes | 1 | $10 | |
| Prosom | estazolam | Yes | 1 | $10 | |
| Prostigmin | neostigmine bromide | No | 2 | $15 | |
| Protonix | pantoprazole sodium | Yes | PA | 1 | $10 |
| Proventil Solution | albuterol sulfate | Yes | 1 | $10 | |
| Provera | medroxyprogesterone acet | Yes | 1 | $10 | |
| Provigil | modafinil | No | PA | 2 | $15 |
| Prozac, Sarafem | fluoxetine hcl | Yes | 1 | $10 | |
| Psorcon, Florone | diflorasone diacetate | Yes | 1 | $10 | |
| Pulmicort (tier 1-BCN only) | budesonide | No | 1 | $10 | |
| Pulmozyme | dornase alfa | No | 2 | $15 | |
| Purinethol | mercaptopurine | Yes | 1 | $10 | |
| Pyrazinamide | pyrazinamide | Yes | 1 | $10 | |
| Pyridium | phenazopyridine hcl | Yes | 1 | $10 | |
| - Q - | [ Return to Top ] | ||||
| Questran, Questran Light | cholestyramine | Yes | 1 | $10 | |
| Quinidex | quinidine sulfate | Yes | 1 | $10 | |
| Quinidine Gluconate SA | quinidine gluconate | Yes | 1 | $10 | |
| Qvar (tier 1-BCN only) | beclomethasone dipropionate | No | 1 | $10 | |
| - R - | [ Return to Top ] | ||||
| Radiogardase | prussian blue | No | 2 | $15 | |
| Rapamune Tabs, Solution | sirolimus | No | 2 | $15 | |
| Razadyne Solution | galantamine hydrobromide | Yes | 1 | $10 | |
| Razadyne,ER | galantamine hydrobromide | Yes | 1 | $10 | |
| Rebetol | ribavirin | Yes | PA | 1 | $10 |
| Rebetol Solution | ribavirin | No | PA | 2 | $15 |
| Rebif | interferon beta-1a/albumin | No | 2 | $15 | |
| Reglan Tab, Solution | metoclopramide hcl | Yes | 1 | $10 | |
| Relafen | nabumetone | Yes | 1 | $10 | |
| Relenza | zanamivir | No | 2 | $15 | |
| Relistor | methylnaltrexone | No | PA | 2 | $15 |
| Remeron, Soltab | mirtazapine | Yes | 1 | $10 | |
| Renacidin | mag carb/citric acid/g-lactone | No | 2 | $15 | |
| Renagel | sevelamer hcl | No | 2 | $15 | |
| Renvela Packet 2.4g | sevelamer carbonate | No | 2 | $15 | |
| Renvela Tablet | sevelamer carbonate | No | 2 | $15 | |
| Repronex | menotropins | No | 2 | $15 | |
| Requip | ropinirole hcl | Yes | 1 | $10 | |
| Rescriptor | delavirdine mesylate | No | 2 | $15 | |
| Reserpine | reserpine | Yes | 1 | $10 | |
| Restasis | cyclosporine | No | 2 | $15 | |
| Restoril | temazepam | Yes | 1 | $10 | |
| Retin-A Micro | tretinoin microspheres | No | 2 | $15 | |
| Retin-A, Avita | tretinoin | Yes | 1 | $10 | |
| Retrovir | zidovudine | Yes | 1 | $10 | |
| Revatio | sildenafil citrate | No | PA | 2 | $15 |
| Revia | naltrexone hcl | Yes | 1 | $10 | |
| Reyataz | atazanavir sulfate | No | 2 | $15 | |
| Rheumatrex, Trexall | methotrexate sodium | No | 2 | $15 | |
| Rheumatrex, Trexall Injection | methotrexate sodium/pf | Yes | 1 | $10 | |
| Ridaura | auranofin | No | 2 | $15 | |
| Rifadin | rifampin | Yes | 1 | $10 | |
| Rifamate | rifampin/isoniazid | Yes | 1 | $10 | |
| Rilutek | riluzole | No | 2 | $15 | |
| Risperdal M-tab | risperidone | Yes | 1 | $10 | |
| Ritalin, Ritalin-SR; Methylin, ER | methylphenidate hcl | Yes | 1 | $10 | |
| Rms Suppository | morphine sulfate | Yes | 1 | $10 | |
| Robaxin | methocarbamol | Yes | 1 | $10 | |
| Robinul, Forte | glycopyrrolate | Yes | 1 | $10 | |
| Rocaltrol | calcitriol | Yes | 1 | $10 | |
| Rondec, DM | phenylephrine hcl/chlor-mal | Yes | 1 | $10 | |
| Rosula | sulfacetamide sod/sulfur/urea | Yes | 1 | $10 | |
| Rowasa Enema | mesalamine | Yes | 1 | $10 | |
| Roxanol | morphine sulfate | Yes | 1 | $10 | |
| Rynatan, Ped Susp | phenylephrine/chlor-tan | Yes | 1 | $10 | |
| Rythmol | propafenone hcl | Yes | 1 | $10 | |
| - S - | [ Return to Top ] | ||||
| Sabril | vigabatrin | No | 2 | $15 | |
| Saizen | somatropin | No | PA | 2 | $15 |
| Salagen | pilocarpine hcl | Yes | 1 | $10 | |
| Samsca | tolvaptan | No | 2 | $15 | |
| Sandimmune | cyclosporine | No | 2 | $15 | |
| Sandostatin | octreotide acetate | Yes | PA | 1 | $10 |
| Sandostatin LAR | octreotide acetate | No | PA | 2 | $15 |
| Santyl | collagenase | No | 2 | $15 | |
| Seasonale | levonorgestrel-eth estra | Yes | 1 | $10 | |
| Sectral | acebutolol hcl | Yes | 1 | $10 | |
| Selsun Rx | selenium sulfide | Yes | 1 | $10 | |
| Selzentry | maraviroc | No | 2 | $15 | |
| Sensipar | cinacalcet hcl | No | 2 | $15 | |
| Serax | oxazepam | Yes | 1 | $10 | |
| Serevent Diskus | salmeterol xinafoate | No | 2 | $15 | |
| Seromycin | cycloserine | Yes | 1 | $10 | |
| Seroquel | quetiapine fumarate | No | 2 | $15 | |
| Silvadene | silver sulfadiazine | Yes | 1 | $10 | |
| Sinemet, Cr | carbidopa/levodopa | Yes | 1 | $10 | |
| Sinequan, Adapin | doxepin hcl | Yes | 1 | $10 | |
| Singulair | montelukast sodium | No | ST | 2 | $15 |
| Skelaxin | metaxalone | No | 2 | $15 | |
| Solodyn | minocycline hcl | Yes | PA | 1 | $10 |
| Soma | carisoprodol | Yes | 1 | $10 | |
| Soma Compound | carisoprodol/aspirin | Yes | 1 | $10 | |
| Soma Compound w/codeine | codeine phos/carisoprodol/asa | Yes | 1 | $10 | |
| Somatuline Depot | lanreotide acetate | No | 2 | $15 | |
| Somavert | pegvisomant | No | 2 | $15 | |
| Sonata | zaleplon | Yes | 1 | $10 | |
| Soriatane | acitretin | No | 2 | $15 | |
| Spectazole | econazole nitrate | Yes | 1 | $10 | |
| Spiriva | tiotropium bromide | No | 2 | $15 | |
| Sporanox Caps | itraconazole | Yes | 1 | $10 | |
| Sporanox Soln | itraconazole | No | 2 | $15 | |
| Sprycel | dasatinib | No | PA | 2 | $15 |
| SSKI | potassium iodide | Yes | 1 | $10 | |
| Stadol NS | butorphanol tartrate | Yes | 1 | $10 | |
| Stalevo | carbidopa/levodopa/entacapone | No | 2 | $15 | |
| Starlix | nateglinide | Yes | 1 | $10 | |
| Stelazine | trifluoperazine hcl | Yes | 1 | $10 | |
| Stimate | desmopressin acetate | No | 2 | $15 | |
| Stromectrol - Single Dose | ivermectin | No | 2 | $15 | |
| Suboxone | buprenorphine hcl/naloxone hcl | No | PA | 2 | $15 |
| Sular | nisoldipine | Yes | 1 | $10 | |
| Sulfacet-R | sulfacetamide sodium/sulfur | Yes | 1 | $10 | |
| Sulfadiazine | sulfadiazine | Yes | 1 | $10 | |
| Surmontil | trimipramine maleate | Yes | 1 | $10 | |
| Surmontil 100mg | trimipramine maleate | No | 2 | $15 | |
| Sustiva | efavirenz | No | 2 | $15 | |
| Sutent | sunitinib malate | No | PA | 2 | $15 |
| Symbicort | budesonide/formoterol fumarate | No | 2 | $15 | |
| Symmetrel | amantadine hcl | Yes | 1 | $10 | |
| Synalar 0.025% Cream, Oint | fluocinolone acetonide | Yes | 1 | $10 | |
| Synalar Cream, Soln | fluocinolone acetonide | Yes | 1 | $10 | |
| Synalgos-DC | dihydrocodeine/aspirin/caffein | No | 2 | $15 | |
| Synarel | nafarelin acetate | No | 2 | $15 | |
| - T - | [ Return to Top ] | ||||
| Tagamet (Rx only) | cimetidine | Yes | 1 | $10 | |
| Talacen | pentazocine hcl/acetaminophen | Yes | 1 | $10 | |
| Talwin NX | pentazocine hcl/naloxone hcl | Yes | 1 | $10 | |
| Tambocor | flecainide acetate | Yes | 1 | $10 | |
| Tamiflu Cap, Susp | oseltamivir phosphate | No | 2 | $15 | |
| Tamoxifen Citrate | tamoxifen citrate | Yes | 1 | $10 | |
| Tapazole | methimazole | Yes | 1 | $10 | |
| Tarceva | erlotinib hcl | No | PA | 2 | $15 |
| Tasigna | nilotinib hydrochloride | No | 2 | $15 | |
| Tavist Rx (2.68mg, Syrup) | clemastine fumarate | Yes | 1 | $10 | |
| Tazorac | tazarotene | No | 2 | $15 | |
| Tegretol, XR | carbamazepine | Yes | 1 | $10 | |
| Temodar | temozolomide | No | 2 | $15 | |
| Temovate, Clobevate | clobetasol propionate | Yes | 1 | $10 | |
| Tenex | guanfacine hcl | Yes | 1 | $10 | |
| Tenoretic | atenolol/chlorthalidone | Yes | 1 | $10 | |
| Tenormin | atenolol | Yes | 1 | $10 | |
| Tenuate | diethylpropion hcl | Yes | PA | 1 | $10 |
| Terazol- 3, 7 | terconazole | Yes | 1 | $10 | |
| Tessalon, Perles | benzonatate | Yes | 1 | $10 | |
| Tetracycline | tetracycline hcl | Yes | 1 | $10 | |
| Thalomid | thalidomide | No | 2 | $15 | |
| Theo-24 | theophylline anhydrous | No | 2 | $15 | |
| Theophylline Anhydrous | theophylline anhydrous | Yes | 1 | $10 | |
| Thioguanine | thioguanine | No | 2 | $15 | |
| Thorazine | chlorpromazine hcl | Yes | 1 | $10 | |
| Thyrolar | liotrix | No | 2 | $15 | |
| Tiazac | diltiazem hcl | Yes | 1 | $10 | |
| Ticlid | ticlopidine hcl | Yes | 1 | $10 | |
| Tigan | trimethobenzamide hcl | Yes | 1 | $10 | |
| Tikosyn | dofetilide | No | 2 | $15 | |
| Timoptic - XE | timolol maleate | Yes | 1 | $10 | |
| Timoptic, Istalol | timolol maleate | Yes | 1 | $10 | |
| Tindamax | tinidazole | No | 2 | $15 | |
| Tobi | tobramycin/0.25 normal saline | No | 2 | $15 | |
| Tobradex | tobramycin sulfate/dexameth | Yes | 1 | $10 | |
| Tobradex Oint | tobramycin sulfate/dexameth | No | 2 | $15 | |
| Tobrex | tobramycin sulfate | Yes | 1 | $10 | |
| Tofranil, PM | imipramine hcl, pamoate | Yes | 1 | $10 | |
| Tolectin, DS | tolmetin sodium | Yes | 1 | $10 | |
| Tolinase | tolazamide | Yes | 1 | $10 | |
| Topamax, Sprinkle | topiramate | Yes | 1 | $10 | |
| Topicort Cr, Gel, Oint, Lp | desoximetasone | Yes | 1 | $10 | |
| Toprol XL | metoprolol succinate | Yes | 1 | $10 | |
| Toradol | ketorolac tromethamine | Yes | 1 | $10 | |
| Tracleer | bosentan | No | PA | 2 | $15 |
| Transderm-scop | scopolamine hydrobromide | No | 2 | $15 | |
| Tranxene | clorazepate dipotassium | Yes | 1 | $10 | |
| Travatan, Z | travoprost | No | 2 | $15 | |
| Trelstar Depot, LA | triptorelin pamoate | No | 2 | $15 | |
| Trental | pentoxifylline | Yes | 1 | $10 | |
| Trileptal, Susp | oxcarbazepine | Yes | 1 | $10 | |
| Trilisate | chol sal/magnesium salicylate | Yes | 1 | $10 | |
| Trimethoprim | trimethoprim | Yes | 1 | $10 | |
| Tri-nornyl | norethindrone-ethinyl estrad | Yes | 1 | $10 | |
| Triphasil, Trilevlen | levonorgestrel-eth estra | Yes | 1 | $10 | |
| Tri-vi-flor | fluoride ion/vit a,c&d | Yes | 1 | $10 | |
| Trizivir | abacavir/lamivudine/zidovudine | No | 2 | $15 | |
| Trusopt | dorzolamide hcl | Yes | 1 | $10 | |
| Truvada | emtricitabine/tenofovir | No | 2 | $15 | |
| Tussicaps | hydrocodone/chlorphen polis | No | 2 | $15 | |
| Tussionex | hydrocodone/chlorphen polis | No | 2 | $15 | |
| Tykerb | lapatinib ditosylate | No | PA | 2 | $15 |
| Tylenol w/codeine | codeine phos/acetaminophen | Yes | 1 | $10 | |
| Tylox | oxycodone hcl/acetaminophen | Yes | 1 | $10 | |
| Tyvaso | treprostinil/nebulizer/accesor | No | PA | 2 | $15 |
| - U - | [ Return to Top ] | ||||
| Ultracet | tramadol hcl/acetaminophen | Yes | 1 | $10 | |
| Ultram | tramadol hcl | Yes | 1 | $10 | |
| Ultram ER 100, 200mg | tramadol hcl | Yes | PA | 1 | $10 |
| Ultrase MT | amylase/lipase/protease | No | 2 | $15 | |
| Ultravate | halobetasol propionate | Yes | 1 | $10 | |
| Uniphyl | theophylline anhydrous | Yes | 1 | $10 | |
| Uniretic | moexipril/hydrochlorothiazide | Yes | 1 | $10 | |
| Univasc | moexipril hcl | Yes | 1 | $10 | |
| Urecholine | bethanechol chloride | Yes | 1 | $10 | |
| Uretron D-S | mth/me blue/ba/salicy/atp/hyos | No | 2 | $15 | |
| Urispas | flavoxate hcl | Yes | 1 | $10 | |
| Urocit-K | potassium citrate | Yes | 1 | $10 | |
| Uroxatral | alfuzosin hcl | No | 2 | $15 | |
| Urso | ursodiol | Yes | 1 | $10 | |
| Urso Forte | ursodiol | Yes | 1 | $10 | |
| - V - | [ Return to Top ] | ||||
| Valcyte | valganciclovir hydrochloride | No | 2 | $15 | |
| Valisone Cr, Lotion, Oint | betamethasone valerate | Yes | 1 | $10 | |
| Valium | diazepam | Yes | 1 | $10 | |
| Valtrex | valacyclovir hcl | Yes | 1 | $10 | |
| Vancocin HCL | vancomycin hcl | No | 2 | $15 | |
| Vantin | cefpodoxime proxetil | Yes | 1 | $10 | |
| Vaseretic | enalapril/hydrochlorothiazide | Yes | 1 | $10 | |
| Vasocidin | na sulfacetm/prednis sp | Yes | 1 | $10 | |
| Vasodilan | isoxsuprine hcl | Yes | 1 | $10 | |
| Vasotec | enalapril maleate | Yes | 1 | $10 | |
| Venlafaxine HCL Er | venlafaxine hcl | No | PA/ST | 2 | $15 |
| Ventavis | iloprost | No | PA | 2 | $15 |
| Vepesid | etoposide | Yes | 1 | $10 | |
| Verelan, PM | verapamil hcl | Yes | 1 | $10 | |
| Vermox | mebendazole | Yes | 1 | $10 | |
| Vesanoid | tretinoin | No | 2 | $15 | |
| Vexol | rimexolone | No | 2 | $15 | |
| Vfend | voriconazole | No | 2 | $15 | |
| Viagra | sildenafil citrate | No | PA | 2 | $15 |
| Vibramycin, Vibratabs | doxycycline hyclate | Yes | 1 | $10 | |
| Vicodin, Lortab | hydrocodone bit/acetaminophen | Yes | 1 | $10 | |
| Vicoprofen | hydrocodone/ibuprofen | Yes | 1 | $10 | |
| Videx | didanosine | No | 2 | $15 | |
| Videx EC | didanosine | Yes | 1 | $10 | |
| Vigamox | moxifloxacin hcl | No | 2 | $15 | |
| Vimpat | lacosamide | No | 2 | $15 | |
| Viokase | amylase/lipase/protease | No | 2 | $15 | |
| Viracept | nelfinavir mesylate | No | 2 | $15 | |
| Viramune | nevirapine | No | 2 | $15 | |
| Viread | tenofovir disoproxil fumarate | No | 2 | $15 | |
| Viroptic | trifluridine | Yes | 1 | $10 | |
| Vivactil | protriptyline hcl | Yes | 1 | $10 | |
| Vivelle | estradiol | Yes | 1 | $10 | |
| Vivelle-dot | estradiol | No | 2 | $15 | |
| Voltaren, XR | diclofenac sodium | Yes | 1 | $10 | |
| Vospire ER | albuterol sulfate | Yes | 1 | $10 | |
| - W - | [ Return to Top ] | ||||
| Welchol | colesevelam hcl | No | 2 | $15 | |
| Wellbutrin, SR, XL | bupropion hcl | Yes | 1 | $10 | |
| Westcort | hydrocortisone valerate | Yes | 1 | $10 | |
| - X - | [ Return to Top ] | ||||
| Xanax, XR | alprazolam | Yes | 1 | $10 | |
| Xeloda | capecitabine | No | 2 | $15 | |
| Xenazine | tetrabenazine | No | PA | 2 | $15 |
| Xopenex 1.25mg/0.5ml | levalbuterol hcl | Yes | 1 | $10 | |
| Xylocaine (Rx only) | lidocaine hcl | Yes | 1 | $10 | |
| Xylocaine Viscous | lidocaine hcl | Yes | 1 | $10 | |
| - Y - | [ Return to Top ] | ||||
| Yasmin 28 | ethinyl estradiol/drospirenone | Yes | 1 | $10 | |
| Yaz | ethinyl estradiol/drospirenone | No | 2 | $15 | |
| Yohimbine HCL | yohimbine hcl | Yes | 1 | $10 | |
| - Z - | [ Return to Top ] | ||||
| Zantac (Rx only) | ranitidine hcl | Yes | 1 | $10 | |
| Zarontin | ethosuximide | Yes | 1 | $10 | |
| Zaroxolyn | metolazone | Yes | 1 | $10 | |
| Zebeta | bisoprolol fumarate | Yes | 1 | $10 | |
| Zebutal | butalb/acetaminophen/caffeine | No | 2 | $15 | |
| Zerit | stavudine | Yes | 1 | $10 | |
| Zetia | ezetimibe | No | ST | 2 | $15 |
| Ziac | bisoprol/hydrochlorothiazide | Yes | 1 | $10 | |
| Ziagen | abacavir sulfate | No | 2 | $15 | |
| Zithromax | azithromycin | Yes | 1 | $10 | |
| Zocor | simvastatin | Yes | 1 | $10 | |
| Zofran, ODT | ondansetron | Yes | 1 | $10 | |
| Zoladex | goserelin acetate | No | 2 | $15 | |
| Zolinza | vorinostat | No | PA | 2 | $15 |
| Zoloft | sertraline hcl | Yes | 1 | $10 | |
| Zonalon, Prudoxin | doxepin hcl | No | 2 | $15 | |
| Zonegran | zonisamide | Yes | 1 | $10 | |
| Zorprin | aspirin | No | 2 | $15 | |
| Zovirax | acyclovir | Yes | 1 | $10 | |
| Zovirax Cream, Oint | acyclovir | No | 2 | $15 | |
| Zyban | bupropion hcl | Yes | 1 | $10 | |
| Zyloprim | allopurinol | Yes | 1 | $10 | |
| Zyprexa, Zydis | olanzapine | No | 2 | $15 | |
| Zyrtec, D (OTC) | cetirizine hcl | Yes | 1 | $10 | |
| Zyvox | linezolid | No | 2 | $15 | |
page modified 03/09/2009