scripts program - shared health alliance1.the process starts with us getting some preliminary...

(314) 594-0600 [email protected]

SCRIPTSPROGRAM

SHAREDHEALTHALLIANCE.COM(314) 594-0600

SHARED HEALTH ALLIANCE2

Shared Health Alliance has long-standing relationships

in the health share world and delivers essential benefits

and solutions to help make healthcare more affordable

and more accessible. We have partnered with industry

leading organizations that help our members get and

stay healthy.

SHARED HEALTH ALLIANCEContents

About SHAMembership ID InformationScripts Sharing LevelSHARx Precription AssistanceAbout SHARxHealth Share RXAcute FormularyChronic FormularyFair Price LabsCancellation & Refund Policy Contact

02030405060708091112

FINALLY,PRESCRIPTION

PEACE OF MINDHealth Share Ministry programs offer an incredible alternative to traditional major medical insurance.

However, the ever-increasing specialty and injectable drug costs do not make it economically

feasible for a health share to maintain low monthly contribution membership amounts and

share in these expenses as needs. SHARx eliminates these bills as “shareable” needs while

still providing members with access to all the medications they need. The health share ministry

and the member can both rest easy knowing this is not an exposure that will financially crush them.

“SHARx offers access to prescriptions the way a health share program should provide access –

through alternate channels that either eliminate or mitigate the expense,

without eliminating access to the drugs.”

(314) 594-0600 [email protected] 3

1. On the healthsharerx.com home page, click on the Member Resource Center tab.

2. Login to the Member Resource page by entering the criteria below.

3. For your initial prescriptions to be filled by the APS Home delivery, you must agree to the Notice of Privacy practices, as well as, the Terms and Conditions by checking the “I agree” check box at the end of each page. This is a one-time requirement on your initial setup for using the home delivery.

4. On the left-hand side of the page you will see Actions Needed: Complete Patient Enrollment Form.

5. Once you get into the form, you need to review family information and verify it is correct.

6. For APS to fill any prescriptions, the Allergy and Medical conditions sections need to be completed by checking any applicable allergies or medical known conditions.

7. Once you have this information completed on the webpage, APS will need a valid Prescription on file to fill your order. It is advised that your prescription be written/submitted for a 90-day supply for the best pricing.

Have your physician call in your prescriptions at 1-888-519-8188 option 2 for the pharmacyHave your Physician e-scribe your prescription (send electronically using the information for APS NPI: 1356814529

Have your Physician fax your prescription to the fax# 855-636-5473Have APS call your pharmacy to transfer your prescription.

Mail in your prescriptions to the address below:America’s Pharmacy Source 947 W. Waterloo Rd., Akron, OH 44313

What is my username and password?Username Info: MemberID+Person Code (e.g 123456701 person code is based on family member)Password Info: Lastname+Birthdate (e.g sample01011978)

visit healthsharerx.com

Order your medications through APS

Below are the options for getting a prescription to APS Home delivery:

To get a temporary card

Click on the Member Resource Center tab. Once you login you will be able to print a copy of your HealthShareRX member ID card.

*Sample ID is for HealthShareRX Prescription Card.

SCRIPTS

SINGLE SINGLE +1 FAMILY

$39

The Solution to High Cost Rx Expenses

$43 $50

Experienced advocates workon your behalf to help withhigh cost medications!

MONTHLY CONTRIBUTION

Acute MedicationsMaintenance Medications - Tier 1/ Tier 2 / Tier 3Name Brand/Specialty Medications

$5 for up to a 21 day supply$15 / $30 / $45 for a 90 day supply

SHARx

Access to expensive brand name and generic maintenance and specialty medications such as...

and MANY, MANY More!! *See Acute Medication formulary


SCRIPTS

SINGLE SINGLE +1 FAMILY

$39

The Solution to High Cost Rx Expenses

$43 $50

Experienced advocates workon your behalf to help withhigh cost medications!

MONTHLY CONTRIBUTION

Acute MedicationsMaintenance Medications - Tier 1/ Tier 2 / Tier 3Name Brand/Specialty Medications

$5 for up to a 21 day supply$15 / $30 / $45 for a 90 day supply

SHARx

Access to expensive brand name and generic maintenance and specialty medications such as...

and MANY, MANY More!!

Congratulations! We are thrilled to bring you a program that gives you a personal prescription advocate!

Shared Health Alliance is proud to work on your behalf to save you money on prescription medicine. We believe that you should be able to receive the medicine you need without creating financial duress. Our programs are designed to give you the most assistance on all of your medications so you can concentrate on living life instead of worrying about money.

Many clients get their medications for free!

Others receive their medications at 75% -90% off!

Taking a high cost maintenance, brand or specialty medication?

SHARx PrescriptionAssistance

Let’s Start the Process!

We are here to help!

1.The process starts with us getting some preliminary information from you. 2.Within 48-72 hours after you submit the enrollment form, one of our advocates will contact you directly.3.START SAVING

Use the secure link to fill out our prescription analysis, and get started!

sharxplan.com/sha


About SHARxThe Shared Health Alliance Rx program was designed with health share

ministry members in mind. High cost maintenance drugs and high cost specialty medications and injectables create a very expensive burden to

those that participate in health share programs. The SHARx program procures these medications for members through alternate access points

– many times at $0 cost to the member. For medications that are not available at zero cost, SHARx helps members access these medications

through its interactive portal at a very small fraction of the cost.

SHARx is a non-insurance solution for helping procure high cost maintenance, specialty medications, IVG Therapies, and drugs that treat orphan conditions through roughly six different avenues. Our advocates are led by a Director of Advocacy Services and a pharmacist with a combined 26 years experience in the patient assistance space. Our advocates move rapidly to help identify the best source for procurement of the high cost medications for members. Whether it is an insulin such as Victoza or Humalog, or a specialty medication such as Humira or Harvoni, or an orphan drug such as Spinraza, the SHARx team will go to great lengths to help members get the access they need.

SHARx seeks first to fill medications through $0 cost channels, and if there is not a “free” avenue available, then SHARx will refer members to access points that generally provide access at ten to fifteen cents on the dollar. We want our members to get the medications they need at the absolute lowest cost possible.

SHARx was designed to help members with their high cost maintenance and specialty drugs. In order to provide a comprehensive solution, SHARx has partnered with HealthShareRx. HealthShareRx has a fee-based program that essentially turns the acquisition of “acute” care medications and lower cost maintenance medications into an equivalent co-pay type of expense.

The drugs available through HealthShareRx do not create overlap with SHARx, but rather are the perfect complement to help members access these commonly prescribed acute and maintenance medications at set pricing schedules – the lowest in the industry.

SHARx Advocacy Services

SHARx & HealthShareRx


The HealthShareRx SolutionACUTE CARE AND LOWER MAINTENANCE ACCESS

Members receive a prescription card for use at retail pharmacies nationwide. The card provides access to the top 83 most prescribed acute medications at over 64,000 pharmacies across the USA.

These medications for chronic, long term conditions are taken on a regular basis. These conditions include: high blood pressure, high cholesterol and diabetes, to name just a few. These drugs are well established medications that have proven safety and efficacy and are considered first line therapy options for the treatment of common chronic conditions.

SaveOneDiabetes is a game changing program for members with diabetes inwhich they will get a FREE meter, low cost testing strips, lancets, and more. Many people have diabetes and one in three are pre diabetic. The diabetes program will increase adherence and utilization by making medications and testing kits more affordable and accessible.

The most common OTC medications, such as Ibuprofen, Aceteminophen,Fexofenadine, Diphenhydramine, and others at a fraction of the price.Save money on the medications that get used nearly everyday, and have them delivered right to your door!

Acute Medications (Immediate Need)

Maintenance Medications (Chronic Needs)

Diabetes Program (SaveOneDiabetes)

Over The Counter Medications (Everyday)

$5

$15/ $30/ $45

FREE

Prices better thanbig box stores

Up to 21 Day Supply

Top 100+ maintenancedrugs 90 day supply

(includes free delivery)

Free Glucometer, Lancing Device, Solution, Lancets, & 12 of the most used oral

diabetic medications

19 of the most purchased OTC meds

for daily use


ACUTE FORMULARY (Immediate Need)

The most utilized acute medications in our formulary can be purchased up to a 21-Day supply for a $5.00 payment! If there is an emergency, sickness or injury and you need your medications fast, our

membership card will allow you to fill your prescription at any of 64,000 pharmacies nationwide for only $5.00. We have relationships with most major pharmacies to save you money when you can’t wait 3-5

days for home-delivery. We are changing the way you think about prescription drug pricing!

$5Guaranteed

All Medications on this

Formulary

only

Anti-BurnSilver Sulfadiazine 1% Cream (50 grams)

AntiDiarrhealDiphenox w/Atropine 2.5/.025mg TabletsLoperamide 2 mg Capsules

Anti FungalClotrimazole 0.01% (45gm) Vag CreamFluconazole 150mg (#1) TabletMetronidazole 500mg TabletsNystatin 100000/ml(60ml) SuspensionTerbinafine 250mg Tablets

Anti Gout AgentsAllopurinol 100 mg TabletsAllopurinol 300 mg Tablets

AntihistamineDiphenhydramine 50mg CapsulesHydroxyzine HCl 25mg Tablets

Anti InflammatoryDiclofenac Potassium 50 mg TabletsDiclofenac Sodium ER 75 mg TabletsIndomethacin 25 mg CapsulesIbuprofen 600mg TabletsIbuprofen 800mg TabletsMeloxicam 7.5 mg TabletsNaproxen 375 mg TabletsNaproxen 500 mg TabletsMethylprednisolone (Dose pack) 4mg (#21) TabletsPrednisone 5 mg TabletsPrednisone 20 mg Tablets

Topical Anti-InflammatoryTriamcinolone Acetonide 0.1% (15gm) CreamMometasone Furoate 0.1% (15gm) Cream

Anti NauseaOndansetron ODT 4 mg TabletsOndansetron 8 mg TabletsPromethazine HCl 25 mg Tablets

AntiviralAcyclovir 400 mg TabletsAcyclovir 800 mg TabletsValacyclovir 500 mg Tablets

AsthmaAlbuterol Sulfate 24 30 X 3ml UD 0.08% (for nebulizer)Albuterol Sulfate/ Ipratropium Bromide 2430X3ml UD NEB 3mg/0.5mgMontelukast 4mg Chewable TabletsMontelukast 5mg Chewable TabletsMontelukast 10 mg Tablets

Cough SuppressantsBenzonatate 100mg Capsules

Gastro-IntestinalDicyclomine HCl 20 mg TabletsFamotidine 20mg TabletsPantoprazole Sodium DR 40mg Tablets

MigraineSumatriptan Succinate 50 mg TabletsSumatriptan Succinate 100mg Tablets

Muscle RelaxersCyclobenzaprine HCl 10mg TabletsMethocarbamol 500 mg TabletsMethocarbamol 750 mg TabletsTizanidine HCl 4mg Tablets

Nasal SprayFluticasone Propionate 16gm 50mcg NasalSpray

Pain RelieversAcetaminophen/Tramadol HCl 37.5/ 325 mg TabletsGabapentin 300 mg CapsulesGabapentin 600 mg TabletsPhenazopyridine HCl 95mg TabletsTramadol 50 mg Tablets

Anesthetics (Topical)Lidocaine Vicious HCl 20mg/ml (100ml)Solution

AntibioticsAmoxicillin 250 mg CapsulesAmoxicillin 500 mg CapsulesAmoxicillin 875 mg TabletsAmoxicillin 250mg/5ml (150ml) SuspensionAmoxicillin 400mg/5ml (100ml) SuspensionAmoxicillin/Potassium Clav 500/125 mg TabletsAmoxicillin/Potassium Clav 875/125 mg TabletsAmoxicillin/Potassium Clav 400-57mg/5ml(100ml) SuspensionAzithromycin 250 mg (card#6) TabletsAzithromycin 500mg (card#3) TabletsAzithromycin 20mg/ml (30ml) SuspensionCephalexin 250 mg CapsulesCephalexin 500 mg CapsulesCephalexin 250mgmg/5ml (200ml) SuspensionCiprofloxacin HCI 250mg TabletsCiprofloxacin HCl 500mg TabletsClindamycin HCl 150mg CapsulesClindamycin HCl 300mg CapsulesDoxycycline Hyclate 100mg CapsulesLevofloxacin 250 mg TabletsLevofloxacin 500 mg TabletsPenicillin V Potassium 500 mg TabletsPenicillin V Potassium 250 mg/5ml (200ml) SolutionSulfamethoxazole-Trimethoprim 800/160mg TabletsSulfamethoxazole-Trimethoprim 200mg/40mg SuspensionNitrofurantoin monohydrate/ macrocrystals 100mg Capsules

Antibiotics (Topical)Erythromycin OPTH (3.5mg) OintmentMupirocin 2% (22gm) OintmentPolymyxin B Sulf/Trimethoprim 10K/ml-0.1 (10ml) DropsTobramycin 0.3%(5ml) Opth. Drops


CHRONIC FORMULARY (Maintenance Medications)

The top 75 most utilized chronic medications in our formulary can be purchased in a 90-Day supply for the lowest prices around! We purchase our medications direct from American Producers and Suppliers cutting out the middle-man and passing the savings on to you. To get the pricing below, these chronic

medications can only be ordered from our Akron, Ohio home delivery pharmacy.

Allergy/AntihistaminesCetirizine 10 mg tabletsLoratadine 10 mg tabletsLevocetirizine 5mg tabletsFexofenadine 180mg tabletsFluticasone Nasal 50mcg

Alzheimer’s/DementiaDonepezil 5mg oral tabletsDonepezil 10mg oral tablets

AnticoagulantWarfarin 1mg tabletsWarfarin 2.5mg tabletsWarfarin 5mg tabletsWarfarin 7.5mg tablets

AnticonvulsantsLevetiracetam 500mg tabletsPhenytoin Sodium 100mg

AntidepressantsBupropion SR 150mg tabletsBupropion XL 150mg tabletsBupropion XL 300mg tabletsCitalopram 10mg tabletsCitalopram 20mg tabletsCitalopram 40mg tabletsDuloxetine 30mg capsulesDuloxetine 60mg capsulesEscitalopram 5mg tabletsEscitalopram 10mg tabletsEscitalopram 20mg tabletsFluoxetine 10mg capsulesFluoxetine 20mg capsulesParoxetine 20mg tabletsSertraline 50mg tabletsSertraline 100mg tabletsTrazodone 50mg tabletsTrazodone 100mg tabletsVenlafaxine ER 37.5mg capsulesVenlafaxine ER 75mg capsulesVenlafaxine ER 150mg capsules

AntiGout AgentAllopurinol 100mg tabletsAllopurinol 300mg tablets

Anti-Inflammatory/NSAIDSCelecoxib 200mg capsulesDiclofenac 75mg tabletsDiclofenac Sodium 1% GelIbuprofen 400mg tabletsIbuprofen 600mg tabletsIbuprofen 800mg tabletsMeloxicam 7.5mg oral tabletsMeloxicam 15mg oral tabletsNaproxen 375mg tabletsNaproxen 500mg tablets

Digoxin 0.125mg tabletsDigoxin 0.25mg tabletsDiltiazem ER 120mg capsulesDiltiazem ER 180mg capsules Diltiazem ER 240mg capsulesDoxazosin 2mg tablets tabletsDoxazosin 4mg tablets tabletsEnalapril 5mg tablets tabletsEnalapril 10mg tablets tabletsEnalapril 20mg tablets tabletsEzetimbe 10mg tabletsFurosemide 20mg tabletsFurosemide 40mg tabletsHydrochlorothiazide (HCTZ) 12.5mg capsulesHydrochlorothiazide (HCTZ) 25mg tabletsHydralazine 25mg tabletsIrbesartan 150mg tabletsIrbesartan 300mg tabletsIsosorbide mononitrate ER 30mg tabletsIsosorbide mononitrate ER 60mg tabletsLabetalol 100mg tabletsLabetalol 200mg tabletsLisinopril 5mg tabletsLisinopril 10mg tabletsLisinopril 20mg tabletsLisinopril 40mg tabletsLisinopril/HCTZ 10-12.5mg tabletsLisinopril/HCTZ 20-12.5mg tabletsLisinopril/HCTZ 20-25mg tabletsLosartan 25mg tabletsLosartan 50mg tabletsLosartan 100mg tabletsLosartan/HCTZ 50-12.5mg tabletsLosartan/HCTZ 100-12.5mg tabletsLosartan/HCTZ 100-25 mg tabletsMetoprolol Succinate ER 25mg tabletsMetoprolol Succinate ER 50mg tabletsMetoprolol Succinate ER 100mg tabletsMetoprolol Tartrate 25mg tabletsMetoprolol Tartrate 50mg tabletsMetoprolol Tartrate 100mg tabletsNifedipine ER 30mg tabletsNifedipine ER 60mg tabletsOlmesartan 20mg tabletsOlmesartan 40mg tabletsOlmesartan/HCTZ 20-12.5mg tabletsOlmesartan/HCTZ 40-12.5mg tabletsOlmesartan/HCTZ 40-25mg tabletsPotassium Chloride 10 mEq tabletsPotassium Chloride 20 mEq tabletsRamipril 5mg capsulesRamipril 10mg capsulesSpironolactone 25mg tabletsTriamterene/HCTZ 37.5-25mg capsulesValsartan 80mg tabletsValsartan 160mg tabletsValsartan 320mg tabletsValsartan/HCTZ 80-12.5mg tabletsValsartan/HCTZ 160-12.5mg tabletsValsartan/HCTZ 160-25mg tabletsValsartan/HCTZ 320-25mg tabletsVerapamil SR 180mg tabletsVerapamil SR 240mg tablets

Anti-PsychoticsAripiprazole 2mg oral tabletsAripiprazole 5mg oral tabletsAripiprazole 10mg oral tabletsAripiprazole 15mg oral tabletsAripiprazole 20mg oral tabletsAripiprazole 30mg oral tabletsOlanzapine 2.5mg oral tabletsOlanzapine 5mg oral tabletsOlanzapine 7.5mg oral tabletsOlanzapine 10mg oral tabletsQuetiapine 25mg oral tabletsQuetiapine 50mg oral tabletsQuetiapine 100mg oral tabletsQuetiapine 200mg oral tabletsRisperidone 0.25mg oral tabletsRisperidone 0.5mg oral tabletsRisperidone 1mg oral tabletsRisperidone 2mg oral tabletsRisperidone 3mg oral tabletsRisperidone 4mg oral tablets

AntiviralAcyclovir 400mg tablets

AnxiolyticsBuspirone 10mg tabletsBuspirone 15mg tabletsMirtazapine 15mg oral tabletsMirtazapine 30mg oral tabletsMirtazapine 45mg oral tablets

Anti-RejectionTacrolimus 0.5mg capsulesTacrolimus 1mg capsules

Bronchodilator/AsthmaAlbuterol Sulfate InhalationAlbuterol Sulfate (HFA) 1 UnitAlbuterol & Ipratropium Inhalation Solution 3mLMontelukast Sodium 5mg chewable tabletsMontelukast Sodium 10mg oral tablets

Cardiac/HypertensionAmiodarone 200mg tabletsAmlodipine 2.5mg tabletsAmlodipine 5mg tabletsAmlodipine 10mg tablets Amlodipine/Benazepril 5-10mg capsules Amlodipine/Benazepril 5-20mg capsulesAmlodipine/Benazepril 10-20mg capsulesAmlodipine/Benazepril 10-40mg capsulesAtenolol 25mg tabletsAtenolol 50mg tabletsAtenolol 100mg tabletsBenazepril 20mg tabletsBenazepril 40mg tabletsCarvedilol 3.125mg tabletsCarvedilol 6.25mg tabletsCarvedilol 12.5mg tabletsCarvedilol 25mg tabletsChlorthalidone 25mg tabletsClonidine 0.1mg tabletsClonidine 0.2mg tabletsClopidogrel 75mg tablets


CHRONIC FORMULARY (Maintenance Medications)

The top 75 most utilized chronic medications in our formulary can be purchased in a 90-Day supply for the lowest prices around! We purchase our medications direct from American Producers and Suppliers cutting out the middle-man and passing the savings on to you. To get the pricing below, these chronic

medications can only be ordered from our Akron, Ohio home delivery pharmacy.

Oral ContraceptivesAll cycles sold in 28 countEE 30mcg/Desogestrel 0.15mg(Ortho-Cept/Desogen/Reclipsen) -$15.00 (1) $45.00 (3)

EE 20mcg/Drospirenone 3mg X 24 days (Yaz/ Loryna/Gianvi) - $10.00 (1) $30.00 (3)

EE 30mcg/Drospirenone 3mg(Yasmin/Ocella/Zarah) - $10.00 (1) $30.00 (3)

EE 30mcg/Levonorgestrel 0.15mg(Nordette 28/Levora) - $10.00 (1) $30.00 (3)

EE 20mcg/Northindrone1mg/Iron(Junel Fe 1/20/ Loestrin Fe 1/20/Microgestin 1/20) - $10.00 (1) $30.00 (3)

EE 30mcg/Northindrone 0.15mg/IronLoestrin Fe 1.5/30/Larin Fe 1.5/30 $10.00 (1) $30.00 (3)

EE 35mcg/Norethindrone 1mg(Norinyl 1/35/ Ortho-Novum 1/35) $10.00 (1) $30.00 (3)

EE35mcg/Norethindrone-Total of 15.75mg/cycle(Alyacen 7/7/7/Necon 7/7/7) $10.00 (1) $30.00 (3)

EE 35mcg/Norgestimate 0.25mgOrtho-cyclen 28/Sprintec/Mono-Nessa $10.00 (1) $30.00 (3)

EE35mcg/Norgestimate0.18mg/0.215mg/0.25mg x 7 days(Tri-Nessa/ Tri-Sprintec/Ortho-Tri-Cyclen) $10.00 (1) $30.00 (3)

EE 25mcg/Norgestimate0.18mg/0.215mg/0.25mg X 7 daysOrtho-Tri-Cyclen Lo/Trinessa Lo/ Tri-Lo-Sprintec $10.00 (1) $30.00 (3)

EE 35mg/Norethridrone 0.5mg (total of 10, 5mg/cycle) (Modicon-28/Brevicon-28) $15.00 (1) $45.00 (3)

Norethindrone 0.35mg (progesterone only) (Errin/ Aygestin) $10.00 (1) $30.00 (3)

Mens HealthFinasteride 5mg tabletsSildenafil 50mg tablets (10 tablets/30 days)Sildenafil 50mg tablets (30 tablets/90 days)Sildenafil 100mg tablets (10 tablets/30 days)Sildenafil 100mg tablets (30 tablets/90 days)Tadalafil 2.5mg tablets (10 tablets/30 days)Tadalafil 2.5mg tablets (30 tablets/90 days)Tamsulosin 0.4mg capsules

OsteoporosisAlendronate 35mgAlendronate 70mgHydroxychloroquine 200mg tabletsRaloxifene HCl 60mg tablets

ThyroidLevothyroxine Sodium 25mcg tabletsLevothyroxine Sodium 50mcg tabletsLevothyroxine Sodium 75mcg tabletsLevothyroxine Sodium 88mcg tabletsLevothyroxine Sodium 100mcg tabletsLevothyroxine Sodium 112mcg tabletsLevothyroxine Sodium 125mcg tabletsLevothyroxine Sodium 137mcg tabletsLevothyroxine Sodium 150mcg tabletsLevothyroxine Sodium 175mcg tabletsLevothyroxine Sodium 200mcg tabletsLiothyronine Sodium 5mcg tablets

Cholesterol/TriglyceridesAtorvastatin 10mg tabletsAtorvastatin 20mg tabletsAtorvastatin 40mg tabletsAtorvastatin 80mg tabletsGemfibrozil 600mg tabletsFenofibrate 145mg capsulesFenofibrate 160mg capsulesLovastatin 20mg tabletsLovastatin 40mg tabletsPravastatin 20mg tabletsPravastatin 40mg tabletsRosuvastatin 5mg tabletsRosuvastatin 10mg tabletsRosuvastatin 20mg tabletsRosuvastatin 40mg tabletsSimvastatin 10mg tabletsSimvastatin 20mg tabletsSimvastatin 40mg tabletsSimvastatin 80mg tablets

DiabetesGlimepride 2mg tabletsGlimepride 4mg tabletsGlipizide 5mg tabletsGlipizide 10mg tabletsGlipizide ER 5mg tabletsGlipizide ER 10mg tabletsGlyburide 5mg tabletsGlyburide/Metformin 2.5-500mg tabletsGlyburide/Metformin 5-500mg tabletsMetformin 500mg tabletsMetformin 850mg tabletsMetformin 1000mg tabletsPioglitazone 15mg tabletsPioglitazone 30mg tabletsPioglitazone 45mg tablets

EstrogenEstradiol oral 0.5mg tabletsEstradiol oral 1mg tabletsEstradiol oral 2mg tablets

GastrointestinalEsomeprazole 40mg capsulesFamotidine 20mg tabletsLansoprazole 30mg capsulesOmeprazole 20mg capsulesOmeprazole 40mg capsulesPantoprazole 40mg tabletsRantidine 150mg tablets

GlaucomaBrimonidine 0.2% (15 ml Bottle)Timolol 0.5% Solution (15 ml Bottle)

Hormone-Based Chemo (Breast Cancer)Anastrozole 1mgLetrozole 2.5mg

Formulary Pricing Key

$15 / 90-Day

$30 / 90-Day

$45 / 90-Day


How to use your Fair Price Labs Member CardGo to: fairpricelabs.com/lab-card

Register your card to activate the additional discounts provided in your membership.

You MUST PAY for your lab online prior to having them completed at a Quest Diagnostic Patient Draw Center. ENTER your member ID in the coupon box at check-out. You will receive an order confirmation by email.

You will receive a 2nd email from Fair Price Labs with your Physician Signed Lab Order. Print and take this order with you to your appointment or scan and take in your phone.

appointment.questdiagnostics.com/patient/confirmation

That’s 400% Average Savings!

Fair Price Labs

1

2

3

4

CBC

UA Complete

Cholesterol Total

DHEA

PSA Total

Hepatic Function Panel

CMP

Estradiol

A1C

TSH

Testosterone Total

Testosterone Free & TotalTotal

$15

$15

$15

$39

$35

$25

$15

$49

$19

$20

$30

$125$402

$45.50

$47.59

$39

$128.23

$148.48

$74.36

$65.08

$223.85

$74.25

$130.49

$197.97

$283.46$1,458.26

$83

$79

$89

$240

$295

$179

$89

$299

$159

$175

$401

$1,200$3,288

LAB NAME FAIR PRICE LABS QUEST DIAGNOSTICS CASH PRICE

HOSPICE/PHYSICIAN POINT OF CARE PRICING

Member Cost with Discount

$402 $1,458.26 $3,288

To Find a Test Center

Cancellations must be sent to

Cancellation/Refund Policy

[email protected]

All SHA Scripts cancellations must be received in writing by 4pm central time the last business day of the month to avoid contributions being withdrawn for the following

month. Upon receipt of your cancellation notice, coverage will be terminated to the last day of the month of your membership period.

There are no retroactive cancellations or refunds.

Get In Touch(314) 594-0600memberservices@sharedhealthalliance.comwww.sharedhealthalliance.com

scripts program - shared health alliance1.the process starts with us getting some preliminary...

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