2009 Medicare Part D Plan Formulary Information |
MedicareBlue Rx Option 2 (S5743-003-0)
Benefit Details
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The MedicareBlue Rx Option 2 (S5743-003-0) Formulary Drugs Starting with the Letter E in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
E.E.S. 200MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in SD cover E.E.S. 200MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
E.E.S. 400 TABLET 400MG ![Compare how all Medicare Part D PDP plans in SD cover E.E.S. 400 TABLET 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
E.E.S. 400MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in SD cover E.E.S. 400MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in SD cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ED DOXY-CAPS 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover ED DOXY-CAPS 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ED K+10 TABLET ![Compare how all Medicare Part D PDP plans in SD cover ED K+10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
EFFEXOR 37.5MG CAPSULE ER (90 CT) ![Compare how all Medicare Part D PDP plans in SD cover EFFEXOR 37.5MG CAPSULE ER (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | S |
EFFEXOR XR 150MG CAPSULE ER 15 CAPSULES BOT ![Compare how all Medicare Part D PDP plans in SD cover EFFEXOR XR 150MG CAPSULE ER 15 CAPSULES BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | S |
EFFEXOR XR 75MG CAPSULE ER 15 CAPSULES BOT ![Compare how all Medicare Part D PDP plans in SD cover EFFEXOR XR 75MG CAPSULE ER 15 CAPSULES BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | S |
ELAPRASE 6MG/3ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover ELAPRASE 6MG/3ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIGARD 22.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover ELIGARD 22.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ELIGARD 30MG SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover ELIGARD 30MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ELIGARD 45MG SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover ELIGARD 45MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ELIGARD 7.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover ELIGARD 7.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ELITEK 1.5MG VIAL ![Compare how all Medicare Part D PDP plans in SD cover ELITEK 1.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
ELITEK 7.5MG VIAL ![Compare how all Medicare Part D PDP plans in SD cover ELITEK 7.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
ELLENCE 2MG/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover ELLENCE 2MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
ELOXATIN 100MG/20ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover ELOXATIN 100MG/20ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
ELOXATIN 50MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover ELOXATIN 50MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
ELSPAR INJ 10000UNT ![Compare how all Medicare Part D PDP plans in SD cover ELSPAR INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMEND 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EMEND 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | P |
EMEND 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EMEND 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | P |
EMEND 80MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EMEND 80MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | P |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in SD cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | P |
EMSAM 12MG/24 HOURS PATCH ![Compare how all Medicare Part D PDP plans in SD cover EMSAM 12MG/24 HOURS PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
EMSAM 6MG/24 HOURS PATCH ![Compare how all Medicare Part D PDP plans in SD cover EMSAM 6MG/24 HOURS PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
EMSAM 9MG/24 HOURS PATCH ![Compare how all Medicare Part D PDP plans in SD cover EMSAM 9MG/24 HOURS PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ENABLEX 15MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENABLEX 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | Q:30 /30Days |
ENABLEX 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENABLEX 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in SD cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENALAPRIL MALEATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in SD cover ENALAPRIL MALEATE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENALAPRIL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in SD cover ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in SD cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENBREL 50MG/ML SURECLICK SYR ![Compare how all Medicare Part D PDP plans in SD cover ENBREL 50MG/ML SURECLICK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | S |
ENBREL INJECTION 50MG/ML SYR ![Compare how all Medicare Part D PDP plans in SD cover ENBREL INJECTION 50MG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | S |
ENBREL INJECTION KIT 25MG 1 DOSE TRAY PKGCOM ![Compare how all Medicare Part D PDP plans in SD cover ENBREL INJECTION KIT 25MG 1 DOSE TRAY PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | S |
ENDOCET 10/650MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENDOCET 10/650MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENDOCET 7.5/500MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENDOCET 7.5/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in SD cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | P |
ENGERIX-B 10MCG/0.5ML SYRN ![Compare how all Medicare Part D PDP plans in SD cover ENGERIX-B 10MCG/0.5ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | P |
ENGERIX-B 20MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover ENGERIX-B 20MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | P |
ENPRESSE-28 TABLET ![Compare how all Medicare Part D PDP plans in SD cover ENPRESSE-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ENTOCORT EC 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover ENTOCORT EC 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
ENULOSE SYRUP 10GM/15ML 1 PINT BOTPL ![Compare how all Medicare Part D PDP plans in SD cover ENULOSE SYRUP 10GM/15ML 1 PINT BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in SD cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in SD cover EPIPEN JR 0.15MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
EPIVIR 10MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover EPIVIR 10MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EPIVIR 150MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EPIVIR 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EPIVIR 300MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EPIVIR 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EPIVIR HBV 100MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EPIVIR HBV 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in SD cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in SD cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | P |
EPOGEN 2000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in SD cover EPOGEN 2000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | P |
EPOGEN 3000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in SD cover EPOGEN 3000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | P |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in SD cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in SD cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | P |
EPOGEN INJECTION 40000U 10 X 4ML VIALS VIALSD ![Compare how all Medicare Part D PDP plans in SD cover EPOGEN INJECTION 40000U 10 X 4ML VIALS VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | P |
EPZICOM TABLET ![Compare how all Medicare Part D PDP plans in SD cover EPZICOM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EQUETRO 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EQUETRO 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
EQUETRO 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EQUETRO 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
EQUETRO 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EQUETRO 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
ERGOTAMINE-CAFFEINE 1-100MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ERGOTAMINE-CAFFEINE 1-100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERRIN 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ERRIN 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERY 2% SWAB MEDICATED ![Compare how all Medicare Part D PDP plans in SD cover ERY 2% SWAB MEDICATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYDERM 2% TOP SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover ERYDERM 2% TOP SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROCIN 250MG FILMTAB ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROCIN 250MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ERYTHROCIN 500MG FILMTAB ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROCIN 500MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROCIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROCIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ERYTHROCIN LACTOBIONATE IV POWDER FOR INJECTION ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROCIN LACTOBIONATE IV POWDER FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ERYTHROMYCIN 2% GEL ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN 2% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROMYCIN 2% SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROMYCIN 200MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN 200MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROMYCIN 400MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN 400MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROMYCIN ETHYLSUCCINATE 400MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN ETHYLSUCCINATE 400MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ERYTHROMYCIN OPHTHALMIC OINTMENT 5MG 1/8 OZ TUBE ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN OPHTHALMIC OINTMENT 5MG 1/8 OZ TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in SD cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADERM 0.05MG/24H PATCH TRANSDERMAL SEMIWEEKLY ![Compare how all Medicare Part D PDP plans in SD cover ESTRADERM 0.05MG/24H PATCH TRANSDERMAL SEMIWEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
ESTRADERM 0.1MG/24HR PATCH TRANSDERMAL SEMIWEEKLY ![Compare how all Medicare Part D PDP plans in SD cover ESTRADERM 0.1MG/24HR PATCH TRANSDERMAL SEMIWEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
ESTRADIOL .025MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL .025MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL .0375MG/24 PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL .0375MG/24 PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL .075MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL .075MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL 0.05MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL 0.05MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL 0.06MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL 0.06MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL 0.1MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL 0.1MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTROPIPATE 0.625 TABLET ![Compare how all Medicare Part D PDP plans in SD cover ESTROPIPATE 0.625 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTROPIPATE 1.25 TABLET ![Compare how all Medicare Part D PDP plans in SD cover ESTROPIPATE 1.25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ESTROPIPATE 2.5 TABLET ![Compare how all Medicare Part D PDP plans in SD cover ESTROPIPATE 2.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETHAMBUTOL HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ETHAMBUTOL HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETHAMBUTOL HCL 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in SD cover ETHAMBUTOL HCL 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETHOSUXIMIDE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover ETHOSUXIMIDE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in SD cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETIDRONATE DISODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover ETIDRONATE DISODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETIDRONATE DISODIUM 400MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in SD cover ETIDRONATE DISODIUM 400MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETODOLAC 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETODOLAC 400MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 400MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETODOLAC 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in SD cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
ETOPOPHOS 100MG VIAL ![Compare how all Medicare Part D PDP plans in SD cover ETOPOPHOS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Level 3: Covered Brand |
50% | 50% | None |
ETOPOSIDE INJECTION 20MG 25ML VIALMD ![Compare how all Medicare Part D PDP plans in SD cover ETOPOSIDE INJECTION 20MG 25ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Level 1: Covered Generic |
$4.00 | $8.00 | None |
EVISTA 60MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in SD cover EVISTA 60MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXELON 1.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EXELON 1.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EXELON 2MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover EXELON 2MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXELON 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EXELON 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXELON 4.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EXELON 4.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in SD cover EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXELON 6MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover EXELON 6MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in SD cover EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | None |
EXFORGE 10MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXFORGE 10MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | S |
EXFORGE 10MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXFORGE 10MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | S |
EXFORGE 5MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXFORGE 5MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | S |
EXFORGE 5MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXFORGE 5MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Level 2: Covered Preferred Brand |
$32.00 | $64.00 | S |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Covered Specialty |
33% | 33% | None |