2009 Medicare Part D Plan Formulary Information |
Windsor Rx (S2505-005-0)
Benefit Details
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The Windsor Rx (S2505-005-0) Formulary Drugs Starting with the Letter A in CMS PDP Region 20 which includes: MS
|
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ABILIFY 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY 2MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY 30MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY 5MG TABLET (OTSUKA) ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 5MG TABLET (OTSUKA).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY DISCMELT 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY DISCMELT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY DISCMELT 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY DISCMELT 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ABILIFY INJ 9.75MG ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY INJ 9.75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ACARBOSE 100MG TABLET S ![Compare how all Medicare Part D PDP plans in MS cover ACARBOSE 100MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ACARBOSE 25MG TABLET S ![Compare how all Medicare Part D PDP plans in MS cover ACARBOSE 25MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ACARBOSE 50MG TABLET S ![Compare how all Medicare Part D PDP plans in MS cover ACARBOSE 50MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ACCOLATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACCOLATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:60 /23Days |
ACCOLATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACCOLATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:60 /23Days |
ACEBUTOLOL 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ACEBUTOLOL 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACEBUTOLOL 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ACEBUTOLOL 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETADOTE 200MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACETADOTE 200MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-15MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-15MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:390 /25Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:390 /25Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-60MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-60MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:390 /25Days |
ACETAMINOPHEN/COD SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN/COD SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:960 /30Days |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETIC ACID 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in MS cover ACETIC ACID 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETIC ACID-HYDROCORTISONE 2%-1% DROPS ![Compare how all Medicare Part D PDP plans in MS cover ACETIC ACID-HYDROCORTISONE 2%-1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN ![Compare how all Medicare Part D PDP plans in MS cover ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACTHIB VACCINE VIAL 10-24UNT/5ML ![Compare how all Medicare Part D PDP plans in MS cover ACTHIB VACCINE VIAL 10-24UNT/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ACTIMMUNE SOLUTION FOR INJECTION 100MCG ![Compare how all Medicare Part D PDP plans in MS cover ACTIMMUNE SOLUTION FOR INJECTION 100MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTONEL 150MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTONEL 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ACTONEL 30MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTONEL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:30 /23Days |
ACTONEL 35MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTONEL 35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:4 /23Days |
ACTONEL 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTONEL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:30 /23Days |
ACTONEL 75MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTONEL 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:4 /23Days |
ACTONEL WITH CALCIUM TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTONEL WITH CALCIUM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:28 /23Days |
ACTOPLUS MET 15MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTOPLUS MET 15MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ACTOPLUS MET 15MG/850MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTOPLUS MET 15MG/850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ACTOS 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTOS 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ACTOS 30MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACTOS 30MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ACTOS 45MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTOS 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACULAR 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ACULAR 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ACYCLOVIR 200MG CAPSULE (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR 200MG CAPSULE (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACYCLOVIR 200MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR 200MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACYCLOVIR 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ACYCLOVIR SOD 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR SOD 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
ACYCLOVIR SODIUM 1GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR SODIUM 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
ACYCLOVIR SODIUM 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR SODIUM 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
ACYCLOVIR TABLET USP 800MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR TABLET USP 800MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in MS cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ADDERALL XR 10MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover ADDERALL XR 10MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADDERALL XR 15MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover ADDERALL XR 15MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ADDERALL XR 20MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover ADDERALL XR 20MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ADDERALL XR 25MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover ADDERALL XR 25MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ADDERALL XR 30MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover ADDERALL XR 30MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ADDERALL XR 5MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover ADDERALL XR 5MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ADVAIR DISKU MIS 100/50 ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR DISKU MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:60 /23Days |
ADVAIR DISKU MIS 250/50 ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR DISKU MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:60 /23Days |
ADVAIR DISKU MIS 500/50 ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR DISKU MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:60 /23Days |
ADVAIR HFA 115/21MCG INHALER ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR HFA 115/21MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:60 /23Days |
ADVAIR HFA 230/21MCG INHALER ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR HFA 230/21MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:60 /23Days |
ADVAIR HFA 45/21MCG INHALER ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR HFA 45/21MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:60 /23Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFINITOR TABLETS ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AK-CON 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover AK-CON 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AK-POLY-BAC EYE OINTMENT 500UNT/1000UNT ![Compare how all Medicare Part D PDP plans in MS cover AK-POLY-BAC EYE OINTMENT 500UNT/1000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AK-SPORE EYE OINTMENT 3.5 MG ![Compare how all Medicare Part D PDP plans in MS cover AK-SPORE EYE OINTMENT 3.5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AKTOB 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover AKTOB 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALAMAST 0.1% DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALAMAST 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ALBUTEROL SULFATE 0.63MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 0.63MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
ALBUTEROL SULFATE 2.5MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 2.5MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALBUTEROL SULFATE TABLET 2MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE TABLET 2MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALBUTEROL TABLET 4MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL TABLET 4MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALCLOMETASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in MS cover ALCLOMETASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in MS cover ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALCOHOL ANTISEPTIC PADS ![Compare how all Medicare Part D PDP plans in MS cover ALCOHOL ANTISEPTIC PADS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ALDARA 5% CREAM ![Compare how all Medicare Part D PDP plans in MS cover ALDARA 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:30 /23Days |
ALENDRONATE SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:30 /23Days |
ALENDRONATE SODIUM 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:30 /23Days |
ALENDRONATE SODIUM 70MG TABLET 4 BLPK ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 70MG TABLET 4 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:4 /23Days |
ALENDRONATE SODIUM TABLET 35MG 20 CRTN ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM TABLET 35MG 20 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:4 /23Days |
ALIMTA 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALIMTA 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
ALIMTA INJECTION ![Compare how all Medicare Part D PDP plans in MS cover ALIMTA INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
ALINIA 100MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MS cover ALINIA 100MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ALINIA 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALINIA 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ALKERAN 50MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALKERAN 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
ALLOPURINOL SODIUM 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALLOPURINOL SODIUM 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALLOPURINOL TABLET 300MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover ALLOPURINOL TABLET 300MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALLOPURINOL TABLET USP 100MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover ALLOPURINOL TABLET USP 100MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ALOCRIL 2% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALOCRIL 2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ALOMIDE 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALOMIDE 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ALPHAGAN P 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALPHAGAN P 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AMANTADINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMANTADINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMCINONIDE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in MS cover AMCINONIDE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMCINONIDE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in MS cover AMCINONIDE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMCINONIDE 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMIFOSTINE FOR INJECTION 500MG/VIAL ![Compare how all Medicare Part D PDP plans in MS cover AMIFOSTINE FOR INJECTION 500MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
AMILORIDE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMILORIDE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMILORIDE HCL W/HCTZ 5MG-50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMILORIDE HCL W/HCTZ 5MG-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMINOPHYLLINE 100MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMINOPHYLLINE 100MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMINOPHYLLINE 200MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMINOPHYLLINE 200MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMINOPHYLLINE INJECTION 250MG 10ML X 25 VIALSD ![Compare how all Medicare Part D PDP plans in MS cover AMINOPHYLLINE INJECTION 250MG 10ML X 25 VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMINOSYN 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN 3.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN 3.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN 5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN 5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN 7%-ELECTROLYTE SOL ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN 7%-ELECTROLYTE SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN 8.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN 8.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 3.5% IN D25W IV ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 3.5% IN D25W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 3.5% IN D5W IV ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 3.5% IN D5W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 3.5% M/D5W IV ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 3.5% M/D5W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 3.5% W/ELEC DEX ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 3.5% W/ELEC DEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 4.25% IN D10W ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 4.25% IN D10W.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 4.25% IN D20W ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 4.25% IN D20W.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 4.25% M/D10W IV ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 4.25% M/D10W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 4.25% W/ELEC DW ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 4.25% W/ELEC DW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN II 4.25%-D25W IV ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 4.25%-D25W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 5% IN D25W IV ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 5% IN D25W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN M 3.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN M 3.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN-HBC 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN-HBC 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN-HF 8% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN-HF 8% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
AMIODARONE HCL 200MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL 200MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMIODARONE HCL 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMIODARONE HCL INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIP/PERPHEN 10-2 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 10-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIP/PERPHEN 25-2 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 25-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIP/PERPHEN 25-4 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 25-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIPTYLINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIPTYLINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIPTYLINE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL 25MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 25MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIPTYLINE HCL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMITRIPTYLINE HCL 75MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 75MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE 2.5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE 5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE 5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMMONIUM CHLORIDE 5 MEQ/ML ![Compare how all Medicare Part D PDP plans in MS cover AMMONIUM CHLORIDE 5 MEQ/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMMONIUM LACTATE 12% CREAM ![Compare how all Medicare Part D PDP plans in MS cover AMMONIUM LACTATE 12% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in MS cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOCLAN 200-28.5/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AMOCLAN 200-28.5/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AMOCLAN 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AMOCLAN 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AMOX TR-K CLV 400-57 CHW TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-K CLV 400-57 CHW TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOX TR-K CLV 400-57/5 SUSP ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-K CLV 400-57/5 SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOX TR-K CLV 500-125MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-K CLV 500-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICIILIN CLAVULNATE POTASSIUM FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in MS cover AMOXICIILIN CLAVULNATE POTASSIUM FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 200MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 200MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 400MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 400MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN CLAVULANATE POTASSIUM TABLET 875-125MG 1 BLPK ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN CLAVULANATE POTASSIUM TABLET 875-125MG 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMOXICILLIN TABLET USP CHEWABLE 250MG (250 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN TABLET USP CHEWABLE 250MG (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHET ASP/ AMPHET/ D-AMPHET 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHET ASP/ AMPHET/ D-AMPHET 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHET ASP/ AMPHET/ D-AMPHET 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHET ASP/ AMPHET/ D-AMPHET 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALTS 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALTS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHETAMINE SALTS 30MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALTS 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPHOTERICIN B FOR INJECTION 50 MG ![Compare how all Medicare Part D PDP plans in MS cover AMPHOTERICIN B FOR INJECTION 50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
AMPICILLIN FOR INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN FOR INJECTION 2GM/ML 10 VIAL ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR INJECTION 2GM/ML 10 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN FOR INJECTION 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR INJECTION 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN FOR INJECTION POWDER ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR INJECTION POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN FOR INJECTION USP 125MG/ML 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR INJECTION USP 125MG/ML 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN POWDER FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN POWDER FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPICILLIN SODIUM STERILE 2 GM/VIAL ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN SODIUM STERILE 2 GM/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN TR 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN TR 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AMPICILLIN TR 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN TR 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ANADROL-50 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ANADROL-50 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ANAGRELIDE HCL 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ANAGRELIDE HCL 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ANAGRELIDE HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ANAGRELIDE HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ANCOBON 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ANCOBON 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ANCOBON 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ANCOBON 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
ANDRODERM 2.5MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in MS cover ANDRODERM 2.5MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ANDRODERM 5MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in MS cover ANDRODERM 5MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ANTABUSE 250MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ANTABUSE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANTABUSE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ANTABUSE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
APIDRA 100UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover APIDRA 100UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | Q:80 /23Days |
APOKYN FOR INJECTION 30MG 5 CTG ![Compare how all Medicare Part D PDP plans in MS cover APOKYN FOR INJECTION 30MG 5 CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | None |
ARALAST 1000MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARALAST 1000MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARALAST 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARALAST 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP 100MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 100MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP 200MCG/0.4ML SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 200MCG/0.4ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP 200MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 200MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP 25MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 25MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ARANESP 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP 500MCG/1ML SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 500MCG/1ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP 60MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARANESP 60MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR ![Compare how all Medicare Part D PDP plans in MS cover ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP PREFILLED SYRINGE SINGLE USE 25MCG/0.42ML SYR ![Compare how all Medicare Part D PDP plans in MS cover ARANESP PREFILLED SYRINGE SINGLE USE 25MCG/0.42ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | P |
ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR ![Compare how all Medicare Part D PDP plans in MS cover ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP SINGLE USE PREFILLED AUTOINJECTOR SOLUTION 100MCG/.5ML ![Compare how all Medicare Part D PDP plans in MS cover ARANESP SINGLE USE PREFILLED AUTOINJECTOR SOLUTION 100MCG/.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP SINGLE USE PREFILLED SURECLICK AUTOINJECTOR SOLUTION 500MCG/ML ![Compare how all Medicare Part D PDP plans in MS cover ARANESP SINGLE USE PREFILLED SURECLICK AUTOINJECTOR SOLUTION 500MCG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP SINGLE USE PREFILLED SURECLIK AUTOINJECTOR 60MCG/.3ML ![Compare how all Medicare Part D PDP plans in MS cover ARANESP SINGLE USE PREFILLED SURECLIK AUTOINJECTOR 60MCG/.3ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP SINGLE USE VIAL 150MCG 4 X 150MCG/ 0.75ML VIALSD ![Compare how all Medicare Part D PDP plans in MS cover ARANESP SINGLE USE VIAL 150MCG 4 X 150MCG/ 0.75ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD ![Compare how all Medicare Part D PDP plans in MS cover ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARICEPT 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ARICEPT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARICEPT 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ARICEPT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ARICEPT ODT 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ARICEPT ODT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ARICEPT ODT 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ARICEPT ODT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ARIMIDEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ARIMIDEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ARIXTRA 10MG SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ARIXTRA 10MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARIXTRA 2.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ARIXTRA 2.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARIXTRA 5MG SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ARIXTRA 5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
ARIXTRA 7.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ARIXTRA 7.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
AROMASIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AROMASIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ARRANON 250MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARRANON 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | P |
ASACOL 400MG TABLET EC ![Compare how all Medicare Part D PDP plans in MS cover ASACOL 400MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:240 /23Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASTELIN 137MCG AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in MS cover ASTELIN 137MCG AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:30 /23Days |
ATENOLOL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ATENOLOL TABLET 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL TABLET 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ATENOLOL TABLET USP 50MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL TABLET USP 50MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
ATRIPLA TABLET 600MG/200MG ![Compare how all Medicare Part D PDP plans in MS cover ATRIPLA TABLET 600MG/200MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in MS cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
ATTENUVAX VACCINE W/DILUENT 1 DOSE/0.5ML ![Compare how all Medicare Part D PDP plans in MS cover ATTENUVAX VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
AVANDIA 2MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AVANDIA 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AVANDIA 4MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AVANDIA 4MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVANDIA 8MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AVANDIA 8MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
AVELOX 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AVELOX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:21 /23Days |
AVELOX ABC PACK 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AVELOX ABC PACK 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | Q:21 /30Days |
AVELOX IV 400MG/250ML ![Compare how all Medicare Part D PDP plans in MS cover AVELOX IV 400MG/250ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
AVODART 0.5MG SOFTGEL ![Compare how all Medicare Part D PDP plans in MS cover AVODART 0.5MG SOFTGEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
AVONEX ADMIN PACK 30MCG SYR ![Compare how all Medicare Part D PDP plans in MS cover AVONEX ADMIN PACK 30MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
AVONEX ADMIN PACK 30MCG VL ![Compare how all Medicare Part D PDP plans in MS cover AVONEX ADMIN PACK 30MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Speciality (Brand or Generic) |
25% | N/A | P |
AZACTAM 1GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover AZACTAM 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
AZACTAM 2GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover AZACTAM 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
AZACTAM INJECTION 1GM 50ML BAG ![Compare how all Medicare Part D PDP plans in MS cover AZACTAM INJECTION 1GM 50ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZACTAM/ISO-OSMOT 2GM/50ML ![Compare how all Medicare Part D PDP plans in MS cover AZACTAM/ISO-OSMOT 2GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |
AZATHIOPRINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZATHIOPRINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
AZATHIOPRINE SOD 100MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover AZATHIOPRINE SOD 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
AZELEX 20% CREAM 30GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover AZELEX 20% CREAM 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AZITHROMYCIN 1G PACKET ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 1G PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | None |
AZITHROMYCIN 250MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 250MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:30 /23Days |
AZITHROMYCIN 500MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 500MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:30 /23Days |
AZITHROMYCIN FOR INJECTION 500MG 10 VIALSD ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN FOR INJECTION 500MG 10 VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | P |
AZITHROMYCIN TABLET 600MG (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN TABLET 600MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generics |
$10.00 | N/A | Q:30 /23Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZMACORT AER 75MCG ![Compare how all Medicare Part D PDP plans in MS cover AZMACORT AER 75MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - NonPreferred Brand, NonPreferred Generic |
$50.00 | N/A | None |
AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Preferred Brand |
$25.00 | N/A | None |