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Preferred Drug List
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.
Search Results for Letter : L
01  TIER ONE - UPTO $10
DRUG NAME(DOSE) DRUG CATEGORY TYPE QUANTITY PRICE
Lanoxin Tab 0.25mg Heart/high Blood Pressure Medications BRAND 30 $8.61
Lohist-12d Tab 6-45mg Cough/cold/allergy Products GENERIC 14 $6.77
Lodrane 12d Tab 6-45mg Cough/cold/allergy Products BRAND 14 $8.15
Lactinex Chw Antidiarrheals BRAND 34 $7.38
Lithium Carb Cap 150mg Antipsychotics GENERIC 30 $5.88
Luride Chw 0.25mg F Dental/fluoride Agents BRAND 30 $4.07
Luride Chw 0.5mg F Dental/fluoride Agents BRAND 30 $4.15
Luride Chw 1mg F Dental/fluoride Agents BRAND 30 $4.07
Lac-hydrin Lot Five Dermatologicals GENERIC 120 $8.64
Lidocaine Gel 2% Jelly Dermatologicals GENERIC 15 $9.10
Lipo Cream Cre Base Miscellaneous Products BRAND 1 $2.89
Lanolin Oin Alcohol Miscellaneous Products BRAND 1 $2.88
Lanolin Anhy Oin Miscellaneous Products BRAND 1 $2.60
Lanolin/urea Oin Base Miscellaneous Products BRAND 1 $2.71

02  TIER TWO - UPTO $20
DRUG NAME(DOSE) DRUG CATEGORY TYPE QUANTITY PRICE
Leucovor Ca Tab 5mg Antineoplastic Agents GENERIC 4 $15.44
Levothroid Tab 25mcg Thyroid Medication GENERIC 30 $12.58
Levothyroxin Tab 25mcg Thyroid Medication GENERIC 30 $14.87
Levoxyl Tab 25mcg Thyroid Medication GENERIC 30 $17.10
Levothroid Tab 50mcg Thyroid Medication GENERIC 30 $13.26
Levothyroxin Tab 50mcg Thyroid Medication GENERIC 30 $16.07
Levoxyl Tab 50mcg Thyroid Medication GENERIC 30 $18.60
Levothroid Tab 75mcg Thyroid Medication GENERIC 30 $14.00
Levothyroxin Tab 75mcg Thyroid Medication GENERIC 30 $14.37
Levoxyl Tab 75mcg Thyroid Medication GENERIC 30 $19.38
Levothroid Tab 88mcg Thyroid Medication GENERIC 30 $14.20
Levothyroxin Tab 88mcg Thyroid Medication GENERIC 30 $17.32
Levothroid Tab 100mcg Thyroid Medication GENERIC 30 $14.28
Levothyroxin Tab 100mcg Thyroid Medication GENERIC 30 $14.58
Levothroid Tab 112mcg Thyroid Medication GENERIC 30 $14.98
Levothyroxin Tab 112mcg Thyroid Medication GENERIC 30 $15.91
Levothroid Tab 125mcg Thyroid Medication GENERIC 30 $15.60
Levothyroxin Tab 125mcg Thyroid Medication GENERIC 30 $16.05
Levothroid Tab 137mcg Thyroid Medication GENERIC 30 $12.11
Levothyroxin Tab 137mcg Thyroid Medication GENERIC 30 $19.55
Levothroid Tab 150mcg Thyroid Medication GENERIC 30 $15.89
Levothyroxin Tab 150mcg Thyroid Medication GENERIC 30 $16.35
Levothroid Tab 175mcg Thyroid Medication GENERIC 30 $17.17
Levothroid Tab 200mcg Thyroid Medication GENERIC 30 $18.25
Lanoxin Tab 0.125mg Heart/high Blood Pressure Medications BRAND 30 $10.45
Lasix Tab 20mg Diuretics BRAND 30 $10.48
Lasix Tab 40mg Diuretics BRAND 30 $13.68
Loratadine Sol 5mg/5ml Antihistamines GENERIC 150 $16.62
Loratadine Syp 5mg/5ml Antihistamines GENERIC 150 $17.74
Lonox Tab 2.5mg Antidiarrheals GENERIC 30 $18.62
Lithium Carb Tab 300mg Antipsychotics BRAND 90 $18.96
Limbitrol Tab 5-12.5mg Psychotherapeutic Agents - Misc. BRAND 14 $17.13
Levacet Tab Analgesics BRAND 20 $15.14
Lysiplex Tab Plus Vitamins & Minerals GENERIC 30 $16.00
Lactocal-f Tab Prenatal Vitamins BRAND 30 $12.67
Lacri-lube Oin S.o.p. Ophthalmic Agents BRAND 4 $10.15
Lidocaine Sol 2% Visc Mouth/throat/dental Agents GENERIC 100 $11.99
Lotrimin Ult Cre 1% Antifungals - Topical BRAND 30 $15.49
Lotrimin Af Cre 1% Antifungals - Topical BRAND 30 $12.88
Lidocaine Oin 5% Dermatologicals GENERIC 35 $18.34

03  TIER THREE - UPTO $40
DRUG NAME(DOSE) DRUG CATEGORY TYPE QUANTITY PRICE
Levaquin Tab 250mg Antibiotics BRAND 3 $36.55
Lutera Tab Contraceptives GENERIC 28 $35.62
Levlen-28 Tab Contraceptives BRAND 28 $34.82
Levora-28 Tab 0.15/30 Contraceptives GENERIC 28 $36.93
Low-ogestrel Tab Contraceptives GENERIC 28 $36.52
Levoxyl Tab 88mcg Thyroid Medication GENERIC 30 $20.16
Levoxyl Tab 100mcg Thyroid Medication GENERIC 30 $20.27
Levoxyl Tab 112mcg Thyroid Medication GENERIC 30 $22.50
Levoxyl Tab 125mcg Thyroid Medication GENERIC 30 $22.73
Levoxyl Tab 137mcg Thyroid Medication GENERIC 30 $22.96
Levoxyl Tab 150mcg Thyroid Medication GENERIC 30 $23.22
Levothyroxin Tab 175mcg Thyroid Medication GENERIC 30 $22.36
Levoxyl Tab 175mcg Thyroid Medication GENERIC 30 $26.46
Levothyroxin Tab 200mcg Thyroid Medication GENERIC 30 $22.39
Levoxyl Tab 200mcg Thyroid Medication GENERIC 30 $26.51
Levothroid Tab 300mcg Thyroid Medication GENERIC 30 $23.03
Levothyroxin Tab 300mcg Thyroid Medication GENERIC 30 $28.31
Liothyronine Tab 5mcg Thyroid Medication GENERIC 30 $22.91
Liothyronine Tab 25mcg Thyroid Medication GENERIC 30 $29.31
Labetalol Tab 100mg Heart/high Blood Pressure Medications GENERIC 60 $36.17
Lisinopril Tab 2.5mg Heart/high Blood Pressure Medications GENERIC 30 $25.45
Lisinopril Tab 5mg Heart/high Blood Pressure Medications GENERIC 30 $34.57
Lisinopril Tab 10mg Heart/high Blood Pressure Medications GENERIC 30 $35.23
Lisinopril Tab 20mg Heart/high Blood Pressure Medications GENERIC 30 $37.60
Lisinop/hctz Tab 10-12.5 Heart/high Blood Pressure Medications GENERIC 30 $39.61
Lasix Tab 80mg Diuretics BRAND 30 $22.21
Lipofen Cap 50mg Cholesterol-lowering Agents BRAND 30 $38.48
Lofibra Tab 54mg Cholesterol-lowering Agents BRAND 30 $29.07
Lofibra Cap 67mg Cholesterol-lowering Agents BRAND 30 $29.07
Levitra Tab 5mg Impotence Agents BRAND 2 $29.66
Lodrane 24 Cap Antihistamines BRAND 20 $20.42
Lohist-12 Tab 12 Hour Antihistamines GENERIC 60 $20.80
Lodrane 12hr Tab Antihistamines BRAND 60 $26.70
Loratadine Tab 10mg Antihistamines GENERIC 30 $30.75
Liquibid Tab 400mg Cough/cold/allergy Products GENERIC 120 $39.75
Lemohist Cap Plus Cough/cold/allergy Products BRAND 90 $30.01
Lofene Tab 2.5mg Antidiarrheals GENERIC 30 $20.40
Lomotil Tab 2.5mg Antidiarrheals BRAND 30 $29.49
Lomotil Liq 2.5/5 Antidiarrheals BRAND 60 $28.11
Loperamide Cap 2mg Antidiarrheals GENERIC 30 $26.46
Lorazepam Tab 0.5mg Antianxiety Agents GENERIC 30 $25.86
Lorazepam Tab 1mg Antianxiety Agents GENERIC 30 $31.30
Loxapine Cap 5mg Antipsychotics GENERIC 30 $35.79
Lithium Carb Cap 300mg Antipsychotics GENERIC 90 $20.56
Lithium Carb Cap 600mg Antipsychotics BRAND 60 $22.45
Lithium Carb Tab 300mg Er Antipsychotics GENERIC 60 $33.91
Lithium Carb Tab 450mg Er Antipsychotics GENERIC 60 $36.03
Lortab 5 Tab Analgesics BRAND 30 $34.45
Lodosyn Tab 25mg Parkinsons Drugs BRAND 30 $23.88
Lactrex Cre 12% Dermatologicals GENERIC 280 $36.36
Lactic Acid Cre /vit E Dermatologicals GENERIC 113 $30.96
Lactic Acid Cre E Dermatologicals GENERIC 113 $34.18
Lidocream Cre 4% Dermatologicals GENERIC 30 $30.65
Lidocaine Cre 3% Dermatologicals GENERIC 28 $31.98

04  TIER FOUR - SPECIAL DISCOUNTED PRICE
DRUG NAME(DOSE) DRUG CATEGORY TYPE QUANTITY PRICE
Levaquin Tab 500mg Antibiotics BRAND 10 $132.58
Levaquin Tab 750mg Antibiotics BRAND 5 $124.29
Levaquin Tab Leva-pak Antibiotics BRAND 5 $124.29
Lamisil Tab 250mg Antifungals BRAND 30 $449.95
Lexiva Tab 700mg Antivirals BRAND 60 $729.42
Leukeran Tab 2mg Antineoplastic Agents BRAND 15 $49.38
Lysodren Tab 500mg Antineoplastic Agents BRAND 15 $70.58
Leucovor Ca Tab 10mg Antineoplastic Agents BRAND 120 $775.41
Lessina-28 Tab Contraceptives GENERIC 28 $40.96
Loestrin Tab 1/20-21 Contraceptives BRAND 21 $64.98
Loestrin 21 Tab 1.5/30 Contraceptives BRAND 21 $64.98
Lo/ovral-28 Tab Contraceptives BRAND 28 $54.57
Loestrin Fe Tab 1/20 Contraceptives BRAND 28 $60.15
Loestrin 24 Tab Fe Contraceptives BRAND 28 $57.39
Loestrin Fe Tab 1.5/30 Contraceptives BRAND 28 $64.98
Leena Tab Contraceptives GENERIC 28 $41.41
Lybrel Tab 90-20mcg Contraceptives BRAND 28 $49.25
Lantus Inj 100/ml Antidiabetics BRAND 10 $93.84
Lantus Inj Solostar Antidiabetics BRAND 10 $120.12
Lantus For Inj Opticlik Antidiabetics BRAND 10 $120.12
Levemir Inj Antidiabetics BRAND 15 $139.54
Levemir Inj Flexpen Antidiabetics BRAND 15 $178.94
Liothyronine Tab 50mcg Thyroid Medication GENERIC 30 $43.45
Levatol Tab 20mg Heart/high Blood Pressure Medications BRAND 30 $73.31
Lopressor Tab 50mg Heart/high Blood Pressure Medications BRAND 60 $81.41
Lopressor Tab 100mg Heart/high Blood Pressure Medications BRAND 60 $132.71
Labetalol Tab 200mg Heart/high Blood Pressure Medications GENERIC 60 $50.14
Labetalol Tab 300mg Heart/high Blood Pressure Medications GENERIC 60 $62.93
Lotensin Tab 5mg Heart/high Blood Pressure Medications BRAND 30 $48.52
Lotensin Tab 10mg Heart/high Blood Pressure Medications BRAND 30 $48.52
Lotensin Tab 20mg Heart/high Blood Pressure Medications BRAND 30 $48.52
Lotensin Tab 40mg Heart/high Blood Pressure Medications BRAND 30 $48.52
Lisinopril Tab 30mg Heart/high Blood Pressure Medications GENERIC 30 $49.34
Lisinopril Tab 40mg Heart/high Blood Pressure Medications GENERIC 30 $52.25
Lotrel Cap 2.5-10mg Heart/high Blood Pressure Medications BRAND 30 $93.34
Lotrel Cap 5-10mg Heart/high Blood Pressure Medications BRAND 30 $95.14
Lotrel Cap 5-20mg Heart/high Blood Pressure Medications BRAND 30 $100.33
Lotrel Cap 5-40mg Heart/high Blood Pressure Medications BRAND 30 $106.17
Lotrel Cap 10-20mg Heart/high Blood Pressure Medications BRAND 30 $116.15
Lotrel Cap 10-40mg Heart/high Blood Pressure Medications BRAND 30 $127.73
Lotensin Hct Tab 5-6.25mg Heart/high Blood Pressure Medications BRAND 30 $48.52
Lotensin Hct Tab 10-12.5 Heart/high Blood Pressure Medications BRAND 30 $48.52
Lotensin Hct Tab 20-12.5 Heart/high Blood Pressure Medications BRAND 30 $48.52
Lotensin Hct Tab 20-25mg Heart/high Blood Pressure Medications BRAND 30 $48.52
Lisinop/hctz Tab 20-12.5 Heart/high Blood Pressure Medications GENERIC 30 $42.38
Lisinop/hctz Tab 20-25mg Heart/high Blood Pressure Medications GENERIC 30 $42.45
Lopress Hct Tab 50-25mg Heart/high Blood Pressure Medications BRAND 30 $52.22
Lopress Hct Tab 100/25mg Heart/high Blood Pressure Medications BRAND 30 $80.20
Lipofen Cap 150mg Cholesterol-lowering Agents BRAND 30 $81.41
Lofibra Tab 160mg Cholesterol-lowering Agents BRAND 30 $78.42
Lofibra Cap 134mg Cholesterol-lowering Agents BRAND 30 $53.69
Lofibra Cap 200mg Cholesterol-lowering Agents BRAND 30 $82.22
Lopid Tab 600mg Cholesterol-lowering Agents BRAND 60 $133.74
Lipitor Tab 10mg Cholesterol-lowering Agents BRAND 30 $87.80
Lipitor Tab 20mg Cholesterol-lowering Agents BRAND 30 $124.17
Lipitor Tab 40mg Cholesterol-lowering Agents BRAND 30 $124.17
Lipitor Tab 80mg Cholesterol-lowering Agents BRAND 30 $124.17
Lescol Cap 20mg Cholesterol-lowering Agents BRAND 30 $82.41
Lescol Cap 40mg Cholesterol-lowering Agents BRAND 30 $82.41
Lescol Xl Tab 80mg Cholesterol-lowering Agents BRAND 30 $105.01
Lovastatin Tab 10mg Cholesterol-lowering Agents GENERIC 30 $46.37
Lovastatin Tab 20mg Cholesterol-lowering Agents GENERIC 30 $77.18
Lovastatin Tab 40mg Cholesterol-lowering Agents GENERIC 30 $134.15
Lovaza Cap 1gm Cholesterol-lowering Agents BRAND 120 $157.29
Levitra Tab 2.5mg Impotence Agents BRAND 10 $149.72
Levitra Tab 10mg Impotence Agents BRAND 10 $149.72
Levitra Tab 20mg Impotence Agents BRAND 6 $90.83
Lodrane 24d Cap 12-90mg Cough/cold/allergy Products BRAND 60 $62.43
Lohist-dm Syp 5-2-10mg Cough/cold/allergy Products GENERIC 473 $56.82
Lufyllin Tab 200mg Antiasthmatic & Respiratory Agents BRAND 120 $323.61
Lufyllin Tab 400mg Antiasthmatic & Respiratory Agents BRAND 120 $474.02
Levsin Tab 0.125mg Gastrointestinal Agents BRAND 40 $40.84
Levsinex Cap 0.375 Cr Gastrointestinal Agents BRAND 60 $88.51
Levbid Tab 0.375 Er Gastrointestinal Agents BRAND 60 $86.62
Librax Cap 5-2.5mg Gastrointestinal Agents BRAND 60 $196.40
Lipram-ul12 Cap Digestive Aids BRAND 90 $77.00
Lipram-ul18 Cap Digestive Aids BRAND 90 $119.31
Lipram-ul20 Cap Digestive Aids BRAND 300 $432.79
Lialda Tab 1.2gm Gastrointestinal Agents BRAND 60 $301.07
Lotronex Tab 0.5mg Gastrointestinal Agents BRAND 60 $767.50
Lotronex Tab 1mg Gastrointestinal Agents BRAND 30 $504.83
Lithostat Tab 250mg Genitourinary Products BRAND 90 $112.47
Librium Cap 10mg Antianxiety Agents BRAND 30 $44.43
Lorazepam Tab 2mg Antianxiety Agents GENERIC 30 $44.54
Lexapro Tab 5mg Antidepressants BRAND 30 $84.78
Lexapro Tab 10mg Antidepressants BRAND 30 $88.53
Lexapro Tab 20mg Antidepressants BRAND 30 $92.27
Luvox Cr Cap 100mg Antidepressants BRAND 30 $133.19
Luvox Cr Cap 150mg Antidepressants BRAND 30 $145.94
Loxitane Cap 5mg Antipsychotics BRAND 30 $43.67
Loxapine Cap 10mg Antipsychotics GENERIC 30 $44.16
Loxitane Cap 10mg Antipsychotics BRAND 30 $55.69
Loxapine Cap 25mg Antipsychotics GENERIC 30 $63.74
Loxitane Cap 25mg Antipsychotics BRAND 30 $82.88
Loxapine Cap 50mg Antipsychotics GENERIC 60 $160.29
Loxitane Cap 50mg Antipsychotics BRAND 60 $216.98
Lithobid Tab 300mg Cr Antipsychotics BRAND 60 $118.23
Lunesta Tab 1mg Hypnotic & Sedative Agents BRAND 30 $164.43
Lunesta Tab 2mg Hypnotic & Sedative Agents BRAND 30 $164.43
Lunesta Tab 3mg Hypnotic & Sedative Agents BRAND 30 $164.43
Lagesic Tab 66-600mg Analgesics BRAND 90 $48.78
Levorphanol Tab 2mg Analgesics BRAND 120 $111.88
Lortab 7.5 Tab Analgesics BRAND 60 $66.20
Lortab 10 Tab Analgesics BRAND 120 $150.90
Lorcet Plus Tab 7.5-650 Analgesics BRAND 60 $57.55
Lorcet Tab 10/650 Analgesics BRAND 120 $186.47
Leflunomide Tab 10mg Analgesics GENERIC 30 $498.46
Leflunomide Tab 20mg Analgesics GENERIC 30 $498.46
Lamotrigine Tab 25mg Anticonvulsants GENERIC 60 $255.58
Lamictal Tab 25mg Anticonvulsants BRAND 60 $273.36
Lamotrigine Tab 100mg Anticonvulsants GENERIC 30 $148.50
Lamictal Tab 100mg Anticonvulsants BRAND 30 $157.19
Lamotrigine Tab 150mg Anticonvulsants GENERIC 30 $162.22
Lamictal Tab 150mg Anticonvulsants BRAND 30 $172.05
Lamotrigine Tab 200mg Anticonvulsants GENERIC 30 $176.08
Lamictal Tab 200mg Anticonvulsants BRAND 30 $187.07
Lamictal Chw 5mg Anticonvulsants BRAND 30 $133.54
Lamotrigine Chw 5mg Anticonvulsants GENERIC 30 $137.99
Lamotrigine Chw 25mg Anticonvulsants GENERIC 16 $57.17
Lamictal Chw 25mg Anticonvulsants BRAND 16 $77.53
Levetiraceta Tab 250mg Anticonvulsants GENERIC 60 $178.71
Levetiraceta Tab 500mg Anticonvulsants GENERIC 60 $216.86
Levetiraceta Tab 750mg Anticonvulsants GENERIC 60 $291.98
Levetiraceta Tab 1000mg Anticonvulsants GENERIC 60 $428.13
Levetiraceta Sol 100mg/ml Anticonvulsants GENERIC 120 $83.02
Lyrica Cap 25mg Anticonvulsants BRAND 60 $139.04
Lyrica Cap 50mg Anticonvulsants BRAND 90 $207.32
Lyrica Cap 75mg Anticonvulsants BRAND 60 $139.04
Lyrica Cap 100mg Anticonvulsants BRAND 90 $207.32
Lyrica Cap 150mg Anticonvulsants BRAND 60 $139.04
Lyrica Cap 200mg Anticonvulsants BRAND 90 $207.32
Lyrica Cap 225mg Anticonvulsants BRAND 60 $139.04
Lyrica Cap 300mg Anticonvulsants BRAND 60 $139.04
Limbrel Cap 250mg Nutritional Products BRAND 60 $87.71
Limbrel Cap 500mg Nutritional Products BRAND 60 $100.51
Lister-v Cap Nutritional Products BRAND 30 $84.81
Lovenox Inj 30/0.3ml Blood Modifiers BRAND 8 $582.09
Lovenox Inj 100/1ml Blood Modifiers BRAND 8 $582.74
Lovenox Inj 40/0.4ml Blood Modifiers BRAND 8 $611.03
Lovenox Inj 60/0.6ml Blood Modifiers BRAND 8 $611.77
Lovenox Inj 80/0.8ml Blood Modifiers BRAND 8 $611.77
Lovenox Inj 150/1ml Blood Modifiers BRAND 8 $873.16
Lovenox Inj 120/0.8 Blood Modifiers BRAND 8 $916.68
Lumigan Sol 0.03% Ophthalmic Agents BRAND 3 $73.81
Lidazone Cre Rectal Preparations GENERIC 98 $81.50
Lotrisone Cre Antifungals - Topical BRAND 45 $80.10
Locoid Cre 0.1% Corticosteroids - Topical BRAND 30 $102.46
Locoid Lot 0.1% Corticosteroids - Topical BRAND 59 $184.19
Locoid Oin 0.1% Corticosteroids - Topical BRAND 15 $50.14
Locoid Lipo Cre 0.1% Corticosteroids - Topical BRAND 45 $173.94
Lidocaine/hc Cre 3%-0.5% Corticosteroids - Topical GENERIC 85 $79.05
Lidamantle Cre Hc3-0.5% Corticosteroids - Topical BRAND 85 $159.53
Lac-hydrin Cre 12% Dermatologicals BRAND 280 $44.00
Lactic Acid Lot 10% Dermatologicals GENERIC 355 $42.00
Lactinol-e Cre Dermatologicals BRAND 113 $47.37
Lidamantle Cre 3% Dermatologicals BRAND 28 $49.04
Lidoc/priloc Cre 2.5-2.5% Dermatologicals GENERIC 30 $52.07
Lustra Cre 4% Dermatologicals BRAND 28 $60.79
Lustra-af Cre 4% Dermatologicals BRAND 57 $130.94
Lustra-ultra Cre 4% Dermatologicals BRAND 57 $156.49
Lindane Lot 1% Dermatologicals GENERIC 60 $113.20


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