Enter Your Group Number
Then Enter the Drug Name
TIER 1 - GENERIC DRUG
TIER 2 - FORMULARY BRAND NAME DRUGTIER 3 - NONFORMULARY BRAND NAME DRUG*
BRAND NAME DRUG WITH AVAILABLE GENERIC DRUG*
* Sav-Rx will provide the available therapeutic alternative(s) or the available generic alternative(s). If one has not been provided, Sav-Rx recommends that you discuss your treatment with your physician. You may also contact Sav-Rx to discuss possible alternatives that may be suitable for you. If you can't find your drug, please call we will find it for you.
The prices are representative of the cost of your medication(s). Specific prices may vary based on recent manufacturer price increases.
Co-Payment tier level and formulary status do not indicate coverage and benefit limitations for your plan. Please contact Sav-Rx to confirm your coverage.