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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.

Drug pricing is based on the quantity indicated. 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.

* Pricing is subject to change without notice.
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First Tier
Drug NameRetail QtyRetail
ULTILET MIS 26G100$7.97
ULTILET MIS 28G100$7.97
ULTILET MIS 30G100$7.97
ULTILET MIS LANCETS100$7.97
ULTRA THIN MIS LANCETS100$7.25
ULTRAQUIN SOL 560MG1$7.10
UNILET COMFO MIS COMFOR100$7.65
UNILET EX II MIS 28G100$6.38
UNILET EXCEL MIS 23 GAUGE100$6.38
UNILET G.P. MIS 21G100$7.15
UNILET GP 28 MIS ULT THIN100$6.23
UNILET SUPER MIS 23G100$7.43
UNILET SUPER MIS G.P. 23G100$7.43
UNI-SERP TAB30$5.05
Urea Cream 40%28$6.61
Urea Cream 40%28$6.61

Second Tier
Drug NameRetail QtyRetail
ULTICARE THI MIS 28G100$10.57
UNGUENTUM BO CRE60$10.27
UNILET MIS 21G200$11.39
URETRON D/S TAB30$19.29
URIMAR-T TAB30$16.72
URISYM CAP30$17.81
URO BLUE TAB30$19.99
URO-KP-NEUTR TAB30$16.88
UROLENE BLUE TAB 65MG30$18.68
UROQID #2 TAB30$13.88

Third Tier
Drug NameRetail QtyRetail
UDAMIN TAB30$25.57
UDAMIN SP TAB30$23.50
ULTIMA TES50$31.03
ULTRACAPS CAP MT 2030$41.31
ULTRALYTIC 2 AER100$41.90
ULTRAM TAB 50MG30$37.35
ULTRASE MT12 CAP30$46.20
UNI-CHECK TES50$24.43
UNIPHYL TAB 400MG CR30$33.63
UNIPHYL TAB 600MG CR30$47.38
UNISTIK 2 MIS NEONATAL100$26.68
UNISTIK II MIS LANCETS100$21.24
UNI-TANN CS CHW 10-25-3030$34.20
UNIVASC TAB 15MG30$38.23
UNIVASC TAB 7.5MG30$38.23
Urea Cream 40%198$28.28
Urea Cream 40%199$28.35
Urea Cream 40%199$28.30
Urea Ointment 50%45$41.61
Urea Ointment 50%45$41.61
Urea-HC Acetate Cream 1%30$26.53
URECHOLINE INJ 5MG/ML6$32.07
URECHOLINE TAB 5MG30$38.14
URIMAX TAB30$40.78
URISED TAB30$23.84
UROCIT-K 10 TAB 1080MG30$32.93
UROCIT-K 5 TAB 540MG30$24.28
Ursodiol Cap 300 MG30$20.51

Fourth Tier
Drug NameRetail QtyRetail
UCEPHAN SOL 10%

$75.64
ULTANE SOL

$207.20
ULTIVA INJ 1MG

$276.37
ULTIVA INJ 2MG

$521.10
ULTIVA INJ 5MG

$1073.46
ULTRABAG/ SOL DIANEAL

$291.95
ULTRABAG/PD2 SOL DIANEAL

$262.31
ULTRACET TAB

$51.46
ULTRAFOAM MIS 2X6.25X7

$88.23
ULTRAFOAM MIS 8X12.5X1

$209.98
ULTRAFOAM MIS 8X12.5X3

$209.59
ULTRAFOAM MIS 8X25X1

$370.11
ULTRAFOAM MIS 8X6.25X1

$141.34
ULTRAM ER TAB 100MG

$123.56
ULTRAM ER TAB 200MG

$202.54
ULTRAM ER TAB 300MG

$281.52
ULTRASE MT18 CAP

$74.68
ULTRASE MT20 CAP

$82.61
ULTRAVATE CRE 0.05%

$55.81
ULTRAVATE OIN 0.05%

$55.81
ULTRAVIST INJ 150MG/ML

$182.19
ULTRAVIST INJ 240MG/ML

$209.38
ULTRAVIST INJ 300MG/ML

$231.13
ULTRAVIST INJ 370MG/ML

$263.75
UMECTA EMU

$187.90
UMECTA NAIL SUS 40%

$3359.00
UMECTA PD EMU 40%

$156.74
UMECTA PD SUS 40%

$164.26
UNASYN INJ 1.5GM

$90.43
UNASYN INJ 1.5GM PB

$98.53
UNASYN INJ 15GM

$80.75
UNASYN INJ 3GM

$163.75
UNASYN INJ 3GM PBU

$172.63
UNIPEN INJ 10GM

$460.92
UNIPEN INJ 1GM

$59.70
UNIPEN INJ 2GM

$105.58
UNIRETIC TAB 15/25MG

$59.00
UNIRETIC TAB 15-12.5

$59.00
UNIRETIC TAB 7.5/12.5

$59.00
Urea Cream 50%

$78.22
Urea Cream 50%

$85.80
Urea Emulsion 40%

$81.97
Urea Gel 40%

$82.01
Urea Gel 40%

$93.98
Urea Gel 40%

$93.98
Urea Gel 50%

$82.87
Urea Gel 50%

$76.68
Urea Gel 50%

$70.46
Urea Gel 50%

$67.11
Urea Lotion 35%

$77.75
Urea Lotion 35%

$50.61
Urea Lotion 40%

$60.54
Urea Lotion 40%

$60.45
Urea Lotion 40%

$60.45
Urea Lotion 40%

$60.45
Urea Lotion 40%

$73.87
Urea Soln 50%

$68.97
Urea Suspension 40%

$94.59
URECHOLINE TAB 10MG

$60.50
URECHOLINE TAB 25MG

$91.28
URECHOLINE TAB 50MG

$125.93
URELLE TAB

$89.18
UREX TAB 1GM

$63.47
URISPAS TAB 100MG

$50.49
UROXATRAL TAB 10MG

$116.48
URSO TAB 250MG

$99.21
UTA CAP

$54.62
UVADEX INJ 20MCG/ML

$436.01

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