KIONEX POW USP (454 GM BOTPL) (NDC: 00574200416)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | None | $2,686.04 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | None | $2,686.04 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | None | $2,686.04 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | None | $2,686.04 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $2,909.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,075.57 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,075.57 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,075.57 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,075.57 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,102.81 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,102.81 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,102.81 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $3,034.71 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $3,034.71 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $3,034.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,517.62 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,497.19 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,497.19 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,474.04 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,648.38 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,430.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,620.09 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,966.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,380.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,049.59 |
Browse Plan Formulary |
Arcadian Health Plan - Dual Plus (HMO)
|
$31.40 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | None | $2,686.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $3,804.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,517.62 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $24.00 | None | $5,542.57 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,497.19 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,497.19 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |