Submit a Script. Get a Quote.

Please include these fields in your spreadsheet document.
These are required to find you savings.

  • Drug Name
  • NDC 11
  • Date of Service
  • Days Supply
  • Dosage
  • Plan Cost (Include rebates for a more accurate quote)
  • Copay/Ded

Optional Fields:

  • Ingredient Cost
  • Pharmacy

Security Code:
security code
Please enter the security code:

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