This charge is from Express Scripts. Most health care plans require all medicine to be delivered via mail if taken for more than three months. This is the charge for the refill.
You can see in the BBB link below the URL is for Express Scripts:
http://www.bbb.org/pittsburgh/business-reviews/pharmacies/medco-health-solutions-of-n-versaills-llc-in-north-versailles-pa-18002484/