| DRUG |
COVERED |
CASH |
| Absorica 8mg-40mg |
$25 |
- |
| Aklief |
$20 |
$90 |
| Amzeeq |
$25 |
$50 |
| Arazlo |
$0 |
$90 |
| Botox |
$0 |
- |
| Bryhali 0.01% Lotion |
$25 |
$65 |
| Cabtreo |
$0 |
$75 |
| Cibinqo |
$10 |
- |
| Clobex |
$0 |
- |
| Cloderm |
$0 |
- |
| Cordran Tape |
$35 |
$150 |
| Differin |
$20 |
- |
| Doryx MPC 120mg |
$0 |
- |
| Duobrii |
$25 |
$65 |
| Ebglyss |
$5 |
$25 |
| Enstilar Foam |
$30 |
- |
| Epiduo Forte Gel |
$20 |
- |
| Epsolay |
$20 |
$75 |
| Ertaczo Cream |
$0 |
- |
| Eucrisa |
$10 |
$100 |
| Exelderm Cream/Solution |
$0 |
- |
| Fabior Foam 100mg |
$0 |
- |
| Finacea Foam |
$30 |
- |
| Genadur Nail Sol |
$0 |
$365 |
| Jubila 4ml |
$0 |
$130 |
| Klisyri 1% (5 packets) |
$25 |
$150 |
| Lexette (50mg) |
$0 |
$65 |
| Litfulo 50mg Capsules |
$0 |
- |
July 2025