Prescription Services	Gold EPO	Silver EPO	Bronze EPO
Rx: Retail (30 days)
Tier 1	$5 copay	$5 copay	70% after deductible
Tier 2	$45 copay	$45 copay
Tier 3	$90 copay	$90 copay
Tier 4	$250 copay	$250 copay