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