Pricing Sheet

Home , Cream (pharmacy)

Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 Dermatology Compounds UPDATED 9/3/2020

Medication QTY Price

Fluorouracil/ Calcipotriene Cream 4.5/ 0.005% 30 g $55 Fluorouracil Cream 4.5% or 1.5% 30 g $50 Wart Peel Cream (Salicylic Acid/ Fluorouracil 17/ 2%) 30 g $45 Ivermectin Lotion 1.5% 30 g $45 Double Rosacea Cream (Metronidazole/ Ivermectin 1/ 1%) 30 g $55 Triple Rosacea Cream (Azelaic Acid/ Metronidazole/ Ivermectin 15/ 1/ 1%) 30 g $45 Azelaic Acid Cream 17% 30 g $45 Calcipotriene/ Clobetasol Cream 0.005/ 0.045% 60 g $85 Clioquinol/ Hydrocortisone Cream 1/ 1% 30 g $55 Tretinoin Micro Cream 0.033/ 0.055/ 0.09% 45 g $55 Clindamycin/ Tretinoin Micro Cream 1/0.03% 30 g $75 Triamcinolone/ Hydroquinone/ Tretinoin Cream 0.025/ 4/ 0.05% 30 g $55 Hydrocortisone/ Hydroquinone/ Tretinoin Cream 2.5/ 8/ 0.05% 30 g $55 Hydroquinone/ Kojic Acid Cream 12/ 6% or 10/ 3% 30 g $65 Hydroquinone/ Tretinoin Cream 4/ 0.05% 30 g $65 Squaric Acid Solution 0.1 / 0.01 / 0.001% 15 ml $85 Urea Cream 35% 90 g $45 Dapsone 6% Cream 60 g $55 Costmetic Numbing Oint. (Lidocain 23%/Tetracain 7%) 60g $35

General topical compound pricing for other compounds QTY Price Variations to the compounds above will fall into the pricing below. One Active Ingredient 30g $79 Two Active Ingredients 30g $89 Three Active Ingredients 30g $99

*This applies to most compounds (90%) not all, if exceptionally expensive we will call the oﬃce to discuss*

All cash, no rebates or insurance to mess with! Medicare patients get medications at these great prices too! Free Delivery in 3-5 business days for compounds Page 1 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Rating Medication QTY Covered Covered with Not Self-Pay High Deductible Covered (Uninsured)

ACNE / RETINOID-PO

M Myorisan 40mg 30 caps 0-20 65 65 65 M Myorisan 30mg 30 caps 0-20 65 65 65 M Myorisan 20mg 30 caps 0-20 65 65 65 M Myorisan 10mg 30 caps 0-20 65 65 65 Absorica 30 caps 25 700 700 X Absorica LD 30 caps 0 700 700 X Claravis 20/40mg 30 caps 0-20 100/100 100/100 100/100 Zenatane 40mg 30 caps 0-20 65 65 65 RETINOID-TOPICAL

Aklief Cream 0.005% 45 gm 0 75 75 75 *NEW* Arazlo Lot 0.045% 45 gm 0 65 65 65 Differin Cream 0.1% 45 gm 35 120 120 120 Differin Gel 0.1% 45 gm 35 35 35 35 Differin Gel 0.3% (generic) 45 gm 35 75 75 75 *UPDATE* Epiduo Gel 0.1/2.5% (generic) 45 gm 35 55 55 55 Epiduo Forte Gel 45 gm 0 75 75 75 Retin-A-Micro 0.06% or 0.08% Gel 50 gm 0 65 65 65 Fabior (Tazarotene) 0.1% Foam 50/100 gm 0 65/90 65/90 65 (50gm) Tazorac Gel/Cream 0.05%/0.1% 30 gm 35 125 125 X M Tretinoin Cream 0.025%/0.05%/0.1% 45 gm 0-20 65/75/90 65/75/90 65/75/90 Veltin Gel 60 gm 35 X X X Ziana Gel 60 gm 40 X X X 3 Steps to send Big Country Pharmacy a prescription o Make sure to Include Patient Phone # o Find us on your EMR or fax to (325) 777-4819 o We call patient to verify their information then deliver or mail at no cost in 2-3 business days

Prices are subject to change without prior notice Prices are not valid for patients with state or other federally funded insurance programs including but not limited to Medicare, Medicaid, Medigap, VA or Tricare Page 2 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Rating Medication QTY Covered Covered with Not Self-Pay High Deductible Covered (Uninsured) ANTIBIOTICS-PO Acticlate 150 mg (generic) 30-60 tabs 0 45 0 45 Acticlate 75 mg (generic) 30-60 tabs 0 45 0 45 Doxycycline HYC 100mg 30/60 caps 0-10 15/25 15/25 15/25 Doryx DR 50 or 200 mg (generic) 30-60 tabs 0 45 0 45 Doryx DR 100 mg (generic) 30 tabs 0 45 0 45 Doryx DR 150 mg (generic) 30 tabs 0-25 150 150 x Doryx MPC 120 mg 30 tabs 0 65 65 65 M Minocycline 50/100 mg 30/60 caps 5-25 15/25 15/25 15/25 Morgidox 100 mg 30 tabs 0-20 X X X Seysara 60/100/150 mg 30 tabs 0 125 125 X Solodyn (generic) 30 tabs 10-25 100 100 100 Targadox 50mg (generic) 30 tabs 0 0 0 X Ximino ER 45/90/135 mg (generic) 30 caps 0 0 0 X ANTIBIOTICS TOPICALS Amzeeq Foam 4% 30 gm 35 400 75 X M Benzaclin Gel 1/5% (Generic) 50 gm 10-25 75 75 75 M Clindamycin Gel 30 gm 20 20-55 55 55 Clindagel 75 gm 40 100 100 X M Clindamycin Pads 1% 60 pads 0-20 35 35 35 M Clindamycin Solution 1% 60 ml 0-20 35 35 35 Duac 1.2/5% 45 gm 35 65 65 65 Onexton 50 gm 0 65 65 65 OTHER Aczone 5% 60 gm < 25 X X 175 Aczone 7.5% 60 gm 35 X X 500 M Diclofenac Gel 3% 100 gm 0-15 75 75 75 Nuvail Sol 16% 15 ml 25 75 75 X M Panoxyl Wash 9.8% 60 gm 15 15 15 15 Spironolactone 25/50/100 mg 60 tabs 20 25 25 25 Tranex Acid 650mg 30 tabs 10-20 65 65 65

3 Steps to send Big Country Pharmacy a prescription o Make sure to Include Patient Phone # o Find us on your EMR or fax to (325) 777-4819 o We call patient to verify their information then deliver or mail at no cost in 2-3 business days Page 3 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Rating Medication QTY Covered Covered with Not Self-Pay High Deductible Covered (Uninsured)

ROSACEA

M Azelaic Acid 15% Gel 50 gm 10-20 85 85 85 Finacea Foam 50 gm 35 X X X M Metronidazole 0.75% Cream 45 gm 35 65 65 65 M Metronidazole 0.75% Gel 45 gm 20 20-90 90 90 Metronidazole 1% Gel 55 gm 35 85 95 95 Metronidazole 0.75% Lotion 59 ml 35 120 120 120 Mirvaso 30 gm 35 X X X Noritate Cream 1% 60 gm 40 X X X Oracea 40mg 30 caps 0 65 65 75 Rhofade Cream 1% 30 gm 0 50 50 x M S. Sulfacet & Sulfa Cleanser 10/5% 340 gm 10 35 35 35 M S. Sulfacet & Sulfa Cream 10/5% 28 gm 20 85 85 85 M Sodium Sulfa 10% Cleanser 177 gm 0-20 60 60 60 M Sodium Sulfa 10% Lotion 118 ml 0-20 115 115 115 Soolantra Cream 45 gm 0 65 65 75

Page 4 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Rating Medication QTY Covered Covered with Not Self-Pay High Deductible Covered (Uninsured)

CHEMOTHERAPY CREAMS

M Efudex 5% 40 gm 0 45 / 75(Medicare) 0 / 75(Medicare) 45/75(Medicare) Fluoroplex 1% 30 gm 35 X X X M Imiquimod 5% 24 pack 10 45 45 45 Picato 0.015% and 0.05% 3 or 2 gm 20 125 75 X Zyclara 3.75% 7.5 gm 40 X X X COSMETIC

M Latisse (Generic) 5 ml 20 125 125 125 M Tri-LUMA 30 gm 35 120 125 (M 150) 125 M Tretinoin 0.025/0.05/0.1% Cream 45 gm 20 65/75/90 65/75/90 65/75/90 M Melamix (Hydroquinone) 4% 80 gm 65 65 65 65 M Melamin (Hydroquinone) 4% 80 gm 65 65 65 65 Vaniqa Cream 45 gm 15 X X 185 KERATOLYTIC

Avar Ls 10/2% 227 ml 0-40 X X X Utopic 41% 227 ml 0 125 125 125 Selrx 2.3% 180 ml 0 75 X X

Page 5 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Rating Medication QTY Covered Covered with Not Self-Pay High Deductible Covered (Uninsured)

STEROIDS M Betamethasone Lot. 0.05% 60 ml 10 40 40 40 M Betamethasone dip. Oint 45 gm 0-20 60 60 60 Bryhali lot 0.01% 100 gm 25 65 65 65 M Clobetasol Cream 0.05% 60 gm 0-20 50 50 50 M Clobetasol Foam 0.05% 50/100gm 0 60/90 60/90 60/90 M Clobetasol Oint 0.05% 60 gm 0-20 50 50 50 M Clobetasol Shampoo 0.05% 118 ml 10-20 75 75 75 M Clobetasol Sol. 0.05% 50 ml 10 50 50 50 Clobex Lotion 0.05% 59 ml 10 120 120 120 M Clobetasol Spray 0.05% 4 oz 35 85 85 85 Cordran Tape 1 Roll 35 150 150 X Cordran Cream/Lotion 60 gm 35 X X X Diﬂorasone Cream or Ointment 0.05% 60 gm 0-20 X X 450 DuoBrii 100 gm 0 25 25 25 Enstilar 60 gm 20 125 75 X Flurandrenolide 0.05% Oint 60 gm 0 45 0 45 Halobetasol Ointment 0.05% 50 gm 0-20 60 60 60 Lexette (Halobetasol) Foam 0.05% 50 gm 0 45 45 65 M Lidex Cream 60 gm 0-20 50 50 50 M Lidex Ointment 60 gm 0-20 50 75 75 Locoid Lotion (Generic) 4 oz 0 45 0 45 Taclonex Suspension 60 ml 20 800 X X Triamcinolone Ace. 0.05% Oint 430 gm 0 45 0 45 Ultravate Lot 0.05% 60 ml 0 75 75 X M Vanos Cream (Fluocinonide) 0.1% 120 gm 0-20 50 50 50

3 Steps to send Big Country Pharmacy a prescription o Make sure to Include Patient Phone # o Find us on your EMR or fax to (325) 777-4819 o We call patient to verify their information then deliver or mail at no cost in 2-3 business days Page 6 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Rating Medication QTY Covered Covered with Not Self-Pay High Deductible Covered (Uninsured)

NON-STEROIDAL TOPICALS Calcipotriene Oint. 60 gm 20 155 155 155 M Calcipotriene Cream 0.005% 60 gm 20 80 80 80 Elidel Cream 30 or 60 gm 25 65 65 65 Eucrisa Oint 2% 60 gm 10 60 60 X Hylatopic Plus Cream 450 gm 35 105 105 105 M Protopic 0.1% Oint 30 gm 25 70 70 70 M Protopic 0.1% or 0.03% Oint 60/100 gm 25 200/350 260/450 260/450 Sorilux 0.005% AER 60 gm 0 65 65 65 Vectical Oint. 100 gm 35 X X X OTHERS Bensal HP oint 30 gm 0 0 0 X M Cellcept 500 mg (generic) 120 Tabs 0-20 45 45 45 M Cyclosporin Mod 25 mg 30 caps 0-20 35 35 35 M Cyclosporin Mod 100 mg 30 caps 0-20 60 60 60 M Dermazene 1%/1% Generic 29 gm 10 75 75 75 Plaquenil (Generic) 200 mg 60 tabs X X X X Qbrexza Pads 2.4% 30 35 X X X Recedo Gel 20 gm 25 88 88 X Vytone 60 gm 0 X X X

Prices are subject to change without prior notice Prices are not valid for patients with state or other federally funded insurance programs including but not limited to Medicare, Medicaid, Medigap, VA or Tricare Page 7 Trusted Service. Proven Savings. Pharmacy: (325) 704-5222 Fax: (325) 777-4819 17 Windmill Circle Suite B Abilene, TX 79606 bigcountry.clarxpharmacy.com SureScript ID: 1171544616 M-Not Covered pricing applies to Medicare and other government insurance UPDATED 9/3/2020 COVERED pricing below is based on average copays. Copays can vary based on patient’s plans and/or insurers

Covered with Self-Pay Rating Medication High Not QTY Covered Deductible Covered (Uninsured) ANTI-FUNGAL

*UPDATE* Ecoza Foam (Econazole) 1% 70 gm 0 25 25 X

*UPDATE* Exelderm Sol 1% (generic) 30 ml 0 0 0 X

*NEW* Exelderm Cream 1% (generic) 60 gm 0 0 0 X

*UPDATE* Jublia 4 ml 0 65 65 65

M Ketoconazole Shampoo 2% 118 ml 0-20 20 20 20

Kerydin 10/4 ml 0 750 750 X

Loprox Shampoo 1% 120 ml 40 X X X

Luzu Cream 1% 60 gm 25 X X X

Naftin Gel 2% 60 gm 22 30 40 X

M Terbinaﬁne 250mg 30 Tabs 0-20 20 20 20

Xolegel (Ketoconazole) 2% 45 gm 10 X X X

ANTIVIRAL

M Acyclovir Oint 5% 30 gm 0-20 75 75 75

Sitavig 50mg Buccal Tabs 2 Tabs 0 0 0 X

M Valtrex 500 mg 30/60 Tabs 0-20 20/35 20/35 20/35

M Valtrex 1 gm 30 Tabs 0-20 40 40 40

Xerese Cream 5%/1% 5 gm 40 40 50 50

Zovirax Cream 5% 5 gm 40 X X X