# Product Title Product Size Product Covered NC/HIGH CASH
1 **Aklief 0.005% 45g 0 90 90
2 **Amzeeq 4% 30 75 75 N/A
3 **Arazlo 0.045% Lotion 45g 0 90 90
4 **Bryhali Lotion 0.01% 60g/100g 0 65 65
5 **Cordran Tape 1 Roll copay 150 N/A
6 **Doubrii 100g 25 75 75
7 **Eucrisa 60 10 100 N/A
8 **Jublia 4ml Varies 65 75
9 **Klisyri (Tirbanibulin) Ointment 5% 5 pack 25 223.78 na
10 **Onexton (generic) 50 Varies 75 75
11 **Qbrexza 30 cloths 75 75 75
12 **Retin A Micro 0.06% or 0.08% 50 Varies 65 65
13 **Soolantra Cream 1% 45 Varies NA NA
14 **Taclonex (Generic) 60 copay N/A N/A
15 **Twyneo 0.1%/3% 30 0 75 75
16 **Vtama 1% Cream 60 Varies 75 NA
17 **Winlevi 1% Cream 60g 25-200 200 N/A
18 **Zilxi (Minocycline topical foam 1.5%) 30g 75 75 N/A
19 Adapalene 0.3% 45 copay 30 30
20 Altreno 45 copay 135 135
21 Benzaclin Gel 50 copay 35 35
22 Betamethasone dip Lotion .05% 60 copay 45 45
23 Betamethasone Valerate Ointment 0.1% 45 copay 45 45
24 Cabtreo 1.2%/0.15%/3.15% Gel 50gm Varies 90 N/A
25 Calcipotriene 0.005% Cream 60gm copay 95 95
26 Ciclopirox Cream 0.77% 30g copay 45 45
27 Ciclopirox Shampoo 1% 120 copay 45 45
28 Clindamycin Gel 60g copay 35 35
29 Clindamycin Lotion 60ml copay 35 35
30 Clindamycin Pledgets 60ct copay 45 45
31 Clindamycin Solution 1% 60ml copay 35 35
32 Clobetasol Cream .05% 60 copay 25 25
33 Clobetasol Foam .05% 50g copay 35 35
34 Clobetasol Ointment .05% 60 copay 25 25
35 Clobetasol Solution 0.005% 50ml copay 25 25
36 Clobetasol Spray 0.05% 125ml copay 35 35
37 Desonide Cream 60g copay 35 35
38 Diclofenac Gel 3% 100g copay 45 45
39 Doxycycline 40 mg DR capsule 30 90 90 90
40 Doxycycline Monohydrate 100mg 30/60ct copay 15-$25 15-$25
41 Doxycycline Monohydrate 75mg 30/60ct copay 25/35 25/35
42 Doxycyline Hyclate 20mg 30ct copay 25 25
43 Drysol 20% 60ml copay 25 25
44 Duac (Generic) 45 copay 30 30
45 Econazole Nitrate 1% 85 copay 30 30
46 Epiduo (Generic) 45 copay 55 55
47 Epiduo Forte (Generic) 45g Varies 45 45
48 Finacea Gel (generic) 50g copay 50 50
49 Finasteride 5mg 30ct/90ct copay 10/30 10/30
50 Fluocinolone (Body Oil) 4oz copay 45 45
51 Fluocinolone (Scalp Oil) 118ml copay 45 45
52 Fluocinonide Cream 0.1% 120 copay 125 125
53 Fluorouracil Cream 5% 40 copay 45 45
54 Hydrocortisone Valerate Oint 0.2% 60 copay 75 75
55 Hydroquinone 4% 28.4g copay 35 35
56 Imiquimod 5% 24 pack $copay 35 35
57 Isotretinoin 10mg-20mg-40mg 30 copay 50 50
58 Isotretinoin 30mg 30 copay 50 50
59 Ketoconazole Cream 2% 60 copay 35 35
60 Ketoconazole Shampoo 118ml copay 25 25
61 Latisse (Generic) 3ml/5ml copay 95/115 95/115
62 Lux-MD Medical Repair Emulsion (OTC) 85g 35 35 35
63 Metronidazole Cream 0.75% 45 copay 35 35
64 Metronidazole Gel 1% 55 copay 55 55
65 Minocycline 100mg 30/60ct copay 20/$35 20/$35
66 Pimecrolimus Cream 1% 30 copay 75 75
67 Slynd 28/84 copay 35/75 35/75
68 Sodium Sulfacetimide 8%/4% Wash 16oz copay 55 55
69 Spironolactone 25/50/100mg 90ct copay 25 25
70 SS/Sulfur Cleanser 5/10 170g copay 35 35
71 Tacrolimus 0.1% Oin 30g copay 65 65
72 Test 3 34 34 34
73 Tretinion Cream 0.025% 45 copay 45 45
74 Tretinion Cream 0.05% 45 copay 65 65
75 Tretinion Cream 0.1% 45 copay 75 75
76 Triamcinolone 0.025% 80g/454g cream/oint copay 20/$35 20/$35
77 Triamcinolone 0.1% 80g/454g cream/oint copay 20/$35 20/$35
78 YAZ (Generic) 28 pills copay 20 20