Printed
on:
11.29.

21

Xifaxan
(Brand) Covered

Form:
Tablet Strength:
200
MG
Medication
appearance
subject
to
change.

NEW
SEARCH

Prices Proper
Use Possible
Side
Effects Alternative
Medications

Alert
1
of
2:
This
drug
requires
a
prior
authorization
from
your
provider.
Please
contact
your
provider
to
complete.
If
the
prior
...
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MORE

Pricing
for
6
Pharmacies
near Sort
By: Price
Per
Day:
Low
to
High

95014

Prior
Authorization
Alternative For
3
day
supply

Starting
From:
$0.00
Medications$0.00
per
day
Update
Your
Search
Available VIEW
ALTERNATIVES
You Total
Medication
Details
may Quantity
be 9
EA
Make
a
change
below
and
click
Update able Tablet
Results
to
see
new
pricing. to
save
Brand
or
Generic
Options money
by
Xifaxan
(Brand) switching
to
a
generic
Form or
alternative
Tablet drug.

Strength

200
MG CVS
PHARMACY
#09198
Total
Quantity
1675 Total
HOLLENBECK
Quantity
For
3
day
supply
How
is
your
visit?
AVE


9
EA
You
Pay:
$0.00
SUNNYVALE,
 9
EA CA
94087 Tablet $0.00
per
day
0.3
Miles Plan
Pays:
$212.24 Printed
on:
11.29.21
Away Total
Price:
$212.24
Days
Supply (408) Phone
7357922
3
Days
711 TTY
HOW
TO
FILL

Location

Where
RITE
AID
PHARMACY
21030
GARDENA
DR
CUPERTINO
CA
95014
05967
05967
20572 Total For
3
day
supply

Change
Location HOMESTEADQuantity
ROAD


9
EA
You
Pay:
$0.00
CUPERTINO,
CA
95014 Tablet $0.00
per
day
0.5
Miles Plan
Pays:
$212.24
Away Total
Price:
$212.24
(408) Phone
2532005
711 TTY
HOW
TO
FILL
Additi
onal
Locati
ons
(2)

SAFEWAY
PHARMACY
#3251
20620 Total For
3
day
supply
HOMESTEADQuantity
RD


9
EA
You
Pay:
$0.00
CUPERTINO,
CA
95014 Tablet $0.00
per
day
0.5
Miles Plan
Pays:
$212.24
Away
(408) Total
Price:
$212.24
Phone
2530122
711 TTY
HOW
TO
FILL
Additi
onal
Locati
ons
(2)
 JADE
2
PHARMACY
Printed
on:
11.29.21
10133
S
DE
Total For
3
day
supply
ANZA
BLVD


Quantity
CUPERTINO,
9
EA
You
Pay:
$0.00
CA
95014
1.0 Tablet $0.00
per
day
Miles
Away Plan
Pays:
$212.24
(408) Phone Total
Price:
$212.24
8994199
711 TTY

Additi HOW
TO
FILL
onal
Locati
ons
(2)

CVS
PHARMACY
#09894
10455
S
DE
Total For
3
day
supply
ANZA
BLVD


Quantity
CUPERTINO,
9
EA
You
Pay:
$0.00
CA
95014
1.3 Tablet $0.00
per
day
Miles
Away Plan
Pays:
$212.24
(408) Phone Total
Price:
$212.24
9961911
711 TTY

Additi HOW
TO
FILL
onal
Locati
ons
(1)

Medication
Costs
The
drug
costs
displayed
are
estimates
and
may
vary
based
on
the
specific
quantity,
strength
and/or
dosage
of
the
medication,
the
pharmacy
you
select,
and
the
drug
payment
stage
you
are
in
on
the
date
the
prescription
is
filled.
Your
actual
costs
may
be
higher
or
lower.
You
are
responsible
for
costs
not
covered
and
for
obtaining
pre-authorization
as
required.

Generic
Drugs
UnitedHealthcare
plans
cover
both
brand
name
and
generic
drugs.
Generic
drugs
have
the
same
active-ingredient
formula
as
a
brand
name
drug.
Generic
drugs
usually
cost
less
than
brand
name
drugs
and
are
rated
by
the
Food
and
Drug
Administration
(FDA)
to
be
as
safe
and
effective
as
brand
name
drugs.
Printed
on:
11.29.21