Pricing Sheet

Pricing Sheet

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 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 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 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 5 Trusted Service.

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