ENBREL 25 MG/0.5 ML SYRINGE (0.5 ML ) (NDC: 58406001004)
2020 Medicare Prescription Drug Plan (MAPD) Information
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Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Additional 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 |
Aetna Medicare Value (PPO)
|
$0.00 |
$150 | No | 5 |
Tier 5 |
30% | n/a | P Q:8 /28Days | $1,401.78 |
Browse Plan Formulary |
BCN Advantage HMO HealthyValue (HMO)
|
$0.00 |
$250 | No | 5 |
Tier 5 |
28% | n/a | P Q:8 /28Days | $1,342.61 |
Browse Plan Formulary |
BCN Advantage HMO HealthyValue (HMO)
|
$0.00 |
$250 | No | 5 |
Tier 5 |
28% | n/a | P Q:8 /28Days | $1,352.66 |
Browse Plan Formulary |
BCN Advantage HMO HealthyValue (HMO)
|
$0.00 |
$250 | No | 5 |
Tier 5 |
28% | n/a | P Q:8 /28Days | $1,325.34 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,334.56 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,328.12 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
HAP Senior Plus (HMO)
|
$0.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (PPO)
|
$0.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H8908-004 (HMO)
|
$0.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,458.70 |
Browse Plan Formulary |
Principle (HMO)
|
$0.00 |
$125 | No | 5 |
Tier 5 |
30% | n/a | P | $1,382.56 |
Browse Plan Formulary |
PriorityMedicare Edge (PPO)
|
$0.00 |
$75 | No | 5 |
Tier 5 |
31% | n/a | P | $1,361.66 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P | $1,365.78 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P | $1,345.94 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P | $1,349.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P | $1,361.66 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P | $1,359.88 |
Browse Plan Formulary |
WellCare Essential (HMO-POS)
|
$0.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | n/a |
Browse Plan Formulary |
WellCare Explore (HMO-POS)
|
$0.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | n/a |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,333.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,324.16 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No | 5 |
Tier 5 |
30% | n/a | P | $1,365.78 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No | 5 |
Tier 5 |
30% | n/a | P | $1,360.61 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No | 5 |
Tier 5 |
30% | n/a | P | $1,345.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No | 5 |
Tier 5 |
30% | n/a | P | $1,349.51 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No | 5 |
Tier 5 |
30% | n/a | P | $1,361.66 |
Browse Plan Formulary |
WellCare Elite Smile (HMO-POS)
|
$14.10 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | n/a |
Browse Plan Formulary |
Humana Value Plus H8087-002 (PPO)
|
$15.60 |
$260 | No | 5 |
Tier 5 |
28% | n/a | P Q:8 /28Days | $1,458.70 |
Browse Plan Formulary |
WellCare Extra Plus (HMO-POS D-SNP)
|
$18.60 |
$435 | No | 5 |
Tier 5 |
25% | n/a | P Q:8 /28Days | $1,467.03 |
Browse Plan Formulary |
HumanaChoice H8087-001 (PPO)
|
$19.00 |
$195 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,458.70 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H8908-005 (HMO D-SNP)
|
$20.20 |
$425 | No | 5 |
Tier 5 |
25% | n/a | P Q:8 /28Days | $1,458.70 |
Browse Plan Formulary |
WellCare Plus (HMO)
|
$20.60 |
$435 | No | 5 |
Tier 5 |
25% | n/a | P Q:8 /28Days | $1,467.03 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
|
$23.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,325.34 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
|
$23.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,352.66 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
|
$23.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,342.61 |
Browse Plan Formulary |
HumanaChoice R3887-002 (Regional PPO)
|
$23.00 |
$210 | No | 5 |
Tier 5 |
29% | n/a | P Q:8 /28Days | $1,458.70 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
WellCare Extra Smile (HMO-POS D-SNP)
|
$23.30 |
$435 | No | 5 |
Tier 5 |
25% | n/a | P Q:8 /28Days | $1,467.03 |
Browse Plan Formulary |
HAP Empowered Duals (HMO D-SNP)
|
$30.20 |
$435 | No | 5 |
Tier 5 |
$0.00 | $0.00 | P | $1,370.13 |
Browse Plan Formulary |
Molina Medicare Complete Care (HMO D-SNP)
|
$30.20 |
$435 | No | 5 |
Tier 5 |
25% | n/a | P Q:8 /28Days | $1,354.53 |
Browse Plan Formulary |
PriorityMedicare D-SNP (HMO D-SNP)
|
$30.20 |
$435 | No | 5 |
Tier 5 |
$0.00 | $0.00 | P | $1,363.68 |
Browse Plan Formulary |
Aetna Medicare Premier Plus (PPO)
|
$32.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,401.78 |
Browse Plan Formulary |
Cardinal (HMO)
|
$40.00 |
$0 | No | 5 |
Tier 5 |
30% | n/a | P | $1,382.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 | No | 5 |
Tier 5 |
31% | n/a | P | $1,361.66 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 | No | 5 |
Tier 5 |
31% | n/a | P | $1,349.51 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 | No | 5 |
Tier 5 |
31% | n/a | P | $1,345.94 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 | No | 5 |
Tier 5 |
31% | n/a | P | $1,365.78 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 | No | 5 |
Tier 5 |
31% | n/a | P | $1,359.88 |
Browse Plan Formulary |
Humana Gold Plus H8908-001 (HMO)
|
$44.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,458.70 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
WellCare Elite (HMO-POS)
|
$47.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | n/a |
Browse Plan Formulary |
BCN Advantage HMO ConnectedCare (HMO)
|
$56.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,342.61 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (PPO)
|
$56.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (HMO-POS)
|
$76.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$79.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$79.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,333.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Vitality (PPO)
|
$79.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$79.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$79.00 |
$100 | No | 5 |
Tier 5 |
31% | n/a | P Q:8 /28Days | $1,324.16 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,365.78 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,360.61 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,361.66 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,345.94 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,349.51 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$103.30 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$103.30 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$103.30 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,334.56 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$103.30 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$103.30 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,328.12 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,361.66 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,349.51 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,345.94 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,365.78 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,359.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Signature (PPO)
|
$121.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,333.45 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$121.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$121.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$121.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$121.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,324.16 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (PPO)
|
$149.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HAP Senior Plus Option 2 (HMO-POS)
|
$181.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,361.66 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,349.51 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,345.94 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,365.78 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,360.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HAP Senior Plus Option 4 (PPO)
|
$200.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P | $1,355.65 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$226.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$226.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,328.12 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$226.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$226.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$226.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,334.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Assure (PPO)
|
$259.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,344.95 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$259.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,333.45 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$259.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,389.25 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$259.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,336.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$259.00 |
$0 | No | 5 |
Tier 5 |
33% | n/a | P Q:8 /28Days | $1,324.16 |
Browse Plan Formulary |