2009 Medicare Part D Plan Formulary Information |
Health Net Orange Option 2 (S5678-065-0)
Benefit Details
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The Health Net Orange Option 2 (S5678-065-0) Formulary Drugs Starting with the Letter B in CMS PDP Region 33 which includes: HI
|
Drugs Starting with Letter B
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
BACIIM POWDER FOR INJECTION SOLUTION 50000UNT/VIAL ![Compare how all Medicare Part D PDP plans in HI cover BACIIM POWDER FOR INJECTION SOLUTION 50000UNT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BACITRACIN 500U/GM EYE OINT ![Compare how all Medicare Part D PDP plans in HI cover BACITRACIN 500U/GM EYE OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BACITRACIN INJ 50000UNT ![Compare how all Medicare Part D PDP plans in HI cover BACITRACIN INJ 50000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT ![Compare how all Medicare Part D PDP plans in HI cover BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BACLOFEN 10MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BACLOFEN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BACLOFEN 20MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BACLOFEN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BACTRIM 400-80MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BACTRIM 400-80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BACTRIM DS TABLET 800-160 ![Compare how all Medicare Part D PDP plans in HI cover BACTRIM DS TABLET 800-160.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BACTROBAN 2% CREAM ![Compare how all Medicare Part D PDP plans in HI cover BACTROBAN 2% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:15 /30Days |
BACTROBAN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in HI cover BACTROBAN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:22 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BACTROBAN NASAL 2% OINTMENT ![Compare how all Medicare Part D PDP plans in HI cover BACTROBAN NASAL 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
BALACET 325 TABLET ![Compare how all Medicare Part D PDP plans in HI cover BALACET 325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT) ![Compare how all Medicare Part D PDP plans in HI cover BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BALZIVA 0.4-0.035 TABLET ![Compare how all Medicare Part D PDP plans in HI cover BALZIVA 0.4-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:1 /1Days |
BANZEL TABLET ![Compare how all Medicare Part D PDP plans in HI cover BANZEL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:16 /1Days |
BANZEL TABLET ![Compare how all Medicare Part D PDP plans in HI cover BANZEL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:8 /1Days |
BARACLUDE 0.05MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in HI cover BARACLUDE 0.05MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | P |
BARACLUDE 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BARACLUDE 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
33% | N/A | P |
BARACLUDE 1MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BARACLUDE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
33% | N/A | P |
BD INSULIN SYRINGE ULT-FINE II ![Compare how all Medicare Part D PDP plans in HI cover BD INSULIN SYRINGE ULT-FINE II.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:200 /30Days |
BD INSULIN SYRINGE ULT-FINE II ![Compare how all Medicare Part D PDP plans in HI cover BD INSULIN SYRINGE ULT-FINE II.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:200 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BD INSULIN SYRINGE ULTRA-FINE SYRING ![Compare how all Medicare Part D PDP plans in HI cover BD INSULIN SYRINGE ULTRA-FINE SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:200 /30Days |
BD ORGINAL PEN NEEDLES 29G ![Compare how all Medicare Part D PDP plans in HI cover BD ORGINAL PEN NEEDLES 29G.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:200 /30Days |
BECONASE AQ 0.042% SPRAY ![Compare how all Medicare Part D PDP plans in HI cover BECONASE AQ 0.042% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:50 /30Days |
BENAZEPRIL HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL 40MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENICAR 20MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENICAR 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BENICAR 40MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENICAR 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BENICAR 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENICAR 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BENICAR HCT 20-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENICAR HCT 20-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BENICAR HCT 40-25MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENICAR HCT 40-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BENICAR HCT TABLET 12.5-40MG (30 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENICAR HCT TABLET 12.5-40MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BENOQUIN 20% CREAM ![Compare how all Medicare Part D PDP plans in HI cover BENOQUIN 20% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
BENTYL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover BENTYL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BENTYL 10MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in HI cover BENTYL 10MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BENTYL 20MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENTYL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BENTYL INJECTION 20MG/2ML AMP ![Compare how all Medicare Part D PDP plans in HI cover BENTYL INJECTION 20MG/2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENZACLIN GEL 1-5% ![Compare how all Medicare Part D PDP plans in HI cover BENZACLIN GEL 1-5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:1 /1Days |
BENZAMYCIN GEL ![Compare how all Medicare Part D PDP plans in HI cover BENZAMYCIN GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:46 /30Days |
BENZTROPINE MES 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BENZTROPINE MES 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BENZTROPINE MES TABLET 1MG (1000 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENZTROPINE MES TABLET 1MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BENZTROPINE MES TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in HI cover BENZTROPINE MES TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETA-VAL 0.1% CREAM ![Compare how all Medicare Part D PDP plans in HI cover BETA-VAL 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETA-VAL 0.1% LOTION ![Compare how all Medicare Part D PDP plans in HI cover BETA-VAL 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETAGAN 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BETAGAN 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:10 /30Days |
BETAGAN 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BETAGAN 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:10 /30Days |
BETAMETHASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:50 /30Days |
BETAMETHASONE DIPROPIONATE 0.05% GEL ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DIPROPIONATE 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:50 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAMETHASONE DIPROPIONATE 0.05% GEL ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DIPROPIONATE 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:50 /30Days |
BETAMETHASONE DIPROPIONATE 0.05% OINT ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DIPROPIONATE 0.05% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:50 /30Days |
BETAMETHASONE DIPROPIONATE LOTION 60ML ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DIPROPIONATE LOTION 60ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:1 /1Days |
BETAMETHASONE DP 0.05% CREAM ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DP 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:45 /30Days |
BETAMETHASONE DP 0.05% LOTION ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DP 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETAMETHASONE DP 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE DP 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETAMETHASONE VA 0.1% CREAM ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE VA 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETAMETHASONE VA 0.1% LOTION ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE VA 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETAMETHASONE VA 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in HI cover BETAMETHASONE VA 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETAPACE 120MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BETAPACE 160MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE 160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAPACE 240MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE 240MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BETAPACE 80MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BETAPACE AF 120MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE AF 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BETAPACE AF 160MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE AF 160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BETAPACE AF 80MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAPACE AF 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BETASERON 0.3MG VIAL ![Compare how all Medicare Part D PDP plans in HI cover BETASERON 0.3MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
33% | N/A | P |
BETAXOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAXOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
BETAXOLOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETAXOLOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
BETAXOLOL HCL 0.5% EYE DROP ![Compare how all Medicare Part D PDP plans in HI cover BETAXOLOL HCL 0.5% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETHANECHOL CHLORIDE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BETHANECHOL CHLORIDE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETHANECHOL CHLORIDE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BETHANECHOL CHLORIDE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETHANECHOL CHLORIDE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BETHANECHOL CHLORIDE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETHANECHOL CHLORIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BETHANECHOL CHLORIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BETIMOL 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BETIMOL 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:10 /30Days |
BETIMOL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BETIMOL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:10 /30Days |
BETOPTIC S 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BETOPTIC S 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:15 /30Days |
BIAXIN 125MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in HI cover BIAXIN 125MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:40 /1Days |
BIAXIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BIAXIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:42 /14Days |
BIAXIN 250MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in HI cover BIAXIN 250MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:20 /1Days |
BIAXIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BIAXIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:42 /14Days |
BIAXIN XL 500MG TABLET 56 BOX ![Compare how all Medicare Part D PDP plans in HI cover BIAXIN XL 500MG TABLET 56 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:28 /14Days |
BIAXIN XL 500MG TABLET SA ![Compare how all Medicare Part D PDP plans in HI cover BIAXIN XL 500MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:28 /14Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BICILL LA PFS 600MU 1ML PED ![Compare how all Medicare Part D PDP plans in HI cover BICILL LA PFS 600MU 1ML PED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BICILLIN C-R 1.2MM UNITS SYR 2ML x 10 ![Compare how all Medicare Part D PDP plans in HI cover BICILLIN C-R 1.2MM UNITS SYR 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BICILLIN C-R 900/300 SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in HI cover BICILLIN C-R 900/300 SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BICILLIN LA PFS 1200MU 2ML ![Compare how all Medicare Part D PDP plans in HI cover BICILLIN LA PFS 1200MU 2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BICILLIN LA. 600000UNIT/ML 1ML ![Compare how all Medicare Part D PDP plans in HI cover BICILLIN LA. 600000UNIT/ML 1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BICNU 100MG VIAL ![Compare how all Medicare Part D PDP plans in HI cover BICNU 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BIDIL TABLET 20MG/37.5MG ![Compare how all Medicare Part D PDP plans in HI cover BIDIL TABLET 20MG/37.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
BILTRICIDE 600MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BILTRICIDE 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BISOPROLOL FUMARATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BISOPROLOL FUMARATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BISOPROLOL FUMARATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BISOPROLOL FUMARATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT) ![Compare how all Medicare Part D PDP plans in HI cover BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in HI cover BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BLENOXANE 15 UNITS VIAL ![Compare how all Medicare Part D PDP plans in HI cover BLENOXANE 15 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BLEOMYCIN FOR INJECTION USP 15UNITS 1 X 10ML VIALSD ![Compare how all Medicare Part D PDP plans in HI cover BLEOMYCIN FOR INJECTION USP 15UNITS 1 X 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BLEOMYCIN SULFATE 30UNITS VIA ![Compare how all Medicare Part D PDP plans in HI cover BLEOMYCIN SULFATE 30UNITS VIA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BLEPH-10 10% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BLEPH-10 10% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BLEPHAMIDE 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover BLEPHAMIDE 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:10 /10Days |
BLEPHAMIDE 10-0.2% EYE OINT ![Compare how all Medicare Part D PDP plans in HI cover BLEPHAMIDE 10-0.2% EYE OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BONIVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BONIVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /30Days |
BONIVA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BONIVA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BONIVA 3MG/3ML SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover BONIVA 3MG/3ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BOOSTRIX INJECTION SUSPENSION 2.5UNT-5ML 5 X .5ML SYR ![Compare how all Medicare Part D PDP plans in HI cover BOOSTRIX INJECTION SUSPENSION 2.5UNT-5ML 5 X .5ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BOROFAIR SOL 2% OTIC ![Compare how all Medicare Part D PDP plans in HI cover BOROFAIR SOL 2% OTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BOTOX 100UNITS VIAL ![Compare how all Medicare Part D PDP plans in HI cover BOTOX 100UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | P |
BRETHINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover BRETHINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BRETHINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BRETHINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BRETHINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BRETHINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BREVICON TABLET 0.5/35 ![Compare how all Medicare Part D PDP plans in HI cover BREVICON TABLET 0.5/35.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL ![Compare how all Medicare Part D PDP plans in HI cover BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:10 /30Days |
BROMOCRIPTINE MESYLATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BROMOCRIPTINE MESYLATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BROMOCRIPTINE MESYLATE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover BROMOCRIPTINE MESYLATE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BROVANA 15MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in HI cover BROVANA 15MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:4 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUDEPRION SR 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in HI cover BUDEPRION SR 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUDEPRION SR 150MG TABLET SA ![Compare how all Medicare Part D PDP plans in HI cover BUDEPRION SR 150MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUDEPRION XL 300MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in HI cover BUDEPRION XL 300MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:1 /1Days |
BUDEPRION XL TABLETS 150MG 500 TABLETS BOT ![Compare how all Medicare Part D PDP plans in HI cover BUDEPRION XL TABLETS 150MG 500 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | Q:1 /1Days |
BUMETANIDE 0.25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover BUMETANIDE 0.25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BUMETANIDE 0.5MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUMETANIDE 0.5MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUMETANIDE 1MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUMETANIDE 1MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUMETANIDE 2MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUMETANIDE 2MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUMEX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUMEX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BUMEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUMEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BUMEX 2MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUMEX 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPHENYL 500MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUPHENYL 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
33% | N/A | None |
BUPHENYL POWDER ![Compare how all Medicare Part D PDP plans in HI cover BUPHENYL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
33% | N/A | None |
BUPRENEX 0.3MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in HI cover BUPRENEX 0.3MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BUPRENORPHINE 0.3MG/ML SYRN ![Compare how all Medicare Part D PDP plans in HI cover BUPRENORPHINE 0.3MG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BUPROBAN ER TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUPROBAN ER TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | P |
BUPROPION HCL 100MG ER TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUPROPION HCL 100MG ER TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUPROPION HCL 75MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUPROPION HCL 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUPROPION HCL SR 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in HI cover BUPROPION HCL SR 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUPROPION HCL TABLET 100MG ![Compare how all Medicare Part D PDP plans in HI cover BUPROPION HCL TABLET 100MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUPROPION HCL TABLET SUSTAINED RELEASE ![Compare how all Medicare Part D PDP plans in HI cover BUPROPION HCL TABLET SUSTAINED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | P |
BUSPAR 10MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPAR 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUSPAR 15MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPAR 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BUSPAR 30MG DIVIDOSE TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPAR 30MG DIVIDOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BUSPAR 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPAR 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | None |
BUSPIRONE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPIRONE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUSPIRONE HCL 15MG TABLET (180 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUSPIRONE HCL 15MG TABLET (180 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUSPIRONE HCL 30MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUSPIRONE HCL 30MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUSPIRONE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPIRONE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUSPIRONE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BUSPIRONE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $10.00 | None |
BUSULFEX 6MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in HI cover BUSULFEX 6MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BUTALBITAL ASPIRIN CAFFEINE CODEINE PHOSPHATE 325-50-40MG (500 CT) ![Compare how all Medicare Part D PDP plans in HI cover BUTALBITAL ASPIRIN CAFFEINE CODEINE PHOSPHATE 325-50-40MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
BUTALBITAL/CAFF/APAP/COD CP ![Compare how all Medicare Part D PDP plans in HI cover BUTALBITAL/CAFF/APAP/COD CP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUTORPHANOL 10MG/ML SPRAY ![Compare how all Medicare Part D PDP plans in HI cover BUTORPHANOL 10MG/ML SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:5 /30Days |
BUTORPHANOL TARTRATE INJECTION 1MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover BUTORPHANOL TARTRATE INJECTION 1MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BUTORPHANOL TARTRATE INJECTION 2MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover BUTORPHANOL TARTRATE INJECTION 2MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | None |
BYETTA 10MCG/0.04ML PEN INJ ![Compare how all Medicare Part D PDP plans in HI cover BYETTA 10MCG/0.04ML PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | P |
BYETTA 5MCG/0.02ML PEN INJ ![Compare how all Medicare Part D PDP plans in HI cover BYETTA 5MCG/0.02ML PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable |
33% | N/A | P |
BYSTOLIC 10MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BYSTOLIC 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:4 /1Days |
BYSTOLIC 5MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover BYSTOLIC 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
BYSTOLIC NEBIVOLOL HCL 2.5MG TABLET ORAL ![Compare how all Medicare Part D PDP plans in HI cover BYSTOLIC NEBIVOLOL HCL 2.5MG TABLET ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |