2009 Medicare Part D Plan Formulary Information |
Aetna Medicare Rx Essentials (S5810-052-0)
Benefit Details
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The Aetna Medicare Rx Essentials (S5810-052-0) Formulary Drugs Starting with the Letter E in CMS PDP Region 18 which includes: MO
|
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 GRANULES ![Compare how all Medicare Part D PDP plans in MO cover E.E.S. 200MG/5ML GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
E.E.S. 200MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MO cover E.E.S. 200MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
E.E.S. 400 TABLET 400MG ![Compare how all Medicare Part D PDP plans in MO cover E.E.S. 400 TABLET 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
E.E.S. 400MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MO cover E.E.S. 400MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
EC-NAPROSYN 375MG TABLET EC ![Compare how all Medicare Part D PDP plans in MO cover EC-NAPROSYN 375MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EC-NAPROSYN 500MG TABLET EC ![Compare how all Medicare Part D PDP plans in MO cover EC-NAPROSYN 500MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in MO cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ECONOPRED PLUS 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in MO cover ECONOPRED PLUS 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ED DOXY-CAPS 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ED DOXY-CAPS 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | P |
ED K+10 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ED K+10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EDECRIN 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover EDECRIN 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EDECRIN SODIUM 50MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover EDECRIN SODIUM 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EFFEXOR 100MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | S Q:3 /1Days |
EFFEXOR 25MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR 25MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | S Q:3 /1Days |
EFFEXOR 37.5MG CAPSULE ER (90 CT) ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR 37.5MG CAPSULE ER (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | S Q:1 /1Days |
EFFEXOR 37.5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR 37.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | S Q:4 /1Days |
EFFEXOR 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | S Q:6 /1Days |
EFFEXOR 75MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR 75MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | S Q:5 /1Days |
EFFEXOR XR 150MG CAPSULE ER 15 CAPSULES BOT ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR XR 150MG CAPSULE ER 15 CAPSULES BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | S Q:2 /1Days |
EFFEXOR XR 75MG CAPSULE ER 15 CAPSULES BOT ![Compare how all Medicare Part D PDP plans in MO cover EFFEXOR XR 75MG CAPSULE ER 15 CAPSULES BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | S Q:1 /1Days |
EFUDEX 2% SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover EFUDEX 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EFUDEX 5% CREAM ![Compare how all Medicare Part D PDP plans in MO cover EFUDEX 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EFUDEX 5% SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover EFUDEX 5% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EFUDEX OCCLUSION PACK ![Compare how all Medicare Part D PDP plans in MO cover EFUDEX OCCLUSION PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELAPRASE 6MG/3ML VIAL ![Compare how all Medicare Part D PDP plans in MO cover ELAPRASE 6MG/3ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ELDEPRYL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ELDEPRYL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELESTAT 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in MO cover ELESTAT 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELESTRIN 0.87G GEL IN METERED-DOSE PUMP ![Compare how all Medicare Part D PDP plans in MO cover ELESTRIN 0.87G GEL IN METERED-DOSE PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELIDEL 1% CREAM ![Compare how all Medicare Part D PDP plans in MO cover ELIDEL 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | S |
ELIGARD 22.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in MO cover ELIGARD 22.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P |
ELIGARD 30MG SYRINGE ![Compare how all Medicare Part D PDP plans in MO cover ELIGARD 30MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P |
ELIGARD 45MG SYRINGE ![Compare how all Medicare Part D PDP plans in MO cover ELIGARD 45MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIGARD 7.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in MO cover ELIGARD 7.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P |
ELIMITE 5% CREAM ![Compare how all Medicare Part D PDP plans in MO cover ELIMITE 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELITEK 1.5MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover ELITEK 1.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ELITEK 7.5MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover ELITEK 7.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ELIXOPHYLLIN 80MG/15ML ELIX ![Compare how all Medicare Part D PDP plans in MO cover ELIXOPHYLLIN 80MG/15ML ELIX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELLENCE 2MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MO cover ELLENCE 2MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ELMIRON 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ELMIRON 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELOCON 0.1% CREAM ![Compare how all Medicare Part D PDP plans in MO cover ELOCON 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELOCON 0.1% LOTION ![Compare how all Medicare Part D PDP plans in MO cover ELOCON 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELOCON 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in MO cover ELOCON 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ELOXATIN 100MG/20ML VIAL ![Compare how all Medicare Part D PDP plans in MO cover ELOXATIN 100MG/20ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELOXATIN 50MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in MO cover ELOXATIN 50MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
ELSPAR INJ 10000UNT ![Compare how all Medicare Part D PDP plans in MO cover ELSPAR INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
EMADINE 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in MO cover EMADINE 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
EMEND 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EMEND 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:5 /30Days |
EMEND 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EMEND 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:5 /30Days |
EMEND 80MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EMEND 80MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:5 /30Days |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in MO cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:6 /30Days |
EMLA CREAM 25MG/25MG ![Compare how all Medicare Part D PDP plans in MO cover EMLA CREAM 25MG/25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EMLA CREAM W/TEGADERM 25MG/25MG ![Compare how all Medicare Part D PDP plans in MO cover EMLA CREAM W/TEGADERM 25MG/25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EMSAM 12MG/24 HOURS PATCH ![Compare how all Medicare Part D PDP plans in MO cover EMSAM 12MG/24 HOURS PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P S Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMSAM 6MG/24 HOURS PATCH ![Compare how all Medicare Part D PDP plans in MO cover EMSAM 6MG/24 HOURS PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P S Q:1 /1Days |
EMSAM 9MG/24 HOURS PATCH ![Compare how all Medicare Part D PDP plans in MO cover EMSAM 9MG/24 HOURS PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P S Q:1 /1Days |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENABLEX 15MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENABLEX 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENABLEX 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENABLEX 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | Q:2 /1Days |
ENALAPRIL MALEATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENALAPRIL MALEATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | Q:2 /1Days |
ENALAPRIL MALEATE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MO cover ENALAPRIL MALEATE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENALAPRIL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | Q:2 /1Days |
ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ENBREL 50MG/ML SURECLICK SYR ![Compare how all Medicare Part D PDP plans in MO cover ENBREL 50MG/ML SURECLICK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ENBREL INJECTION 50MG/ML SYR ![Compare how all Medicare Part D PDP plans in MO cover ENBREL INJECTION 50MG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ENBREL INJECTION KIT 25MG 1 DOSE TRAY PKGCOM ![Compare how all Medicare Part D PDP plans in MO cover ENBREL INJECTION KIT 25MG 1 DOSE TRAY PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ENDOCET 10/650MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENDOCET 10/650MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ENDOCET 7.5/500MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENDOCET 7.5/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in MO cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | P |
ENGERIX-B 10MCG/0.5ML SYRN ![Compare how all Medicare Part D PDP plans in MO cover ENGERIX-B 10MCG/0.5ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENGERIX-B 20MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MO cover ENGERIX-B 20MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | P |
ENJUVIA 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENJUVIA 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENJUVIA 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENJUVIA 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENJUVIA 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENJUVIA 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENJUVIA 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENJUVIA 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENJUVIA 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENJUVIA 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENPRESSE-28 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENPRESSE-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ENTOCORT EC 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ENTOCORT EC 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ENULOSE SYRUP 10GM/15ML 1 PINT BOTPL ![Compare how all Medicare Part D PDP plans in MO cover ENULOSE SYRUP 10GM/15ML 1 PINT BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ENZYMAX 500MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ENZYMAX 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EPIDUO GEL 0.1;2.5%;% 45 TRADE SIZE TUBE ![Compare how all Medicare Part D PDP plans in MO cover EPIDUO GEL 0.1;2.5%;% 45 TRADE SIZE TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPINEPHRINE 0.1MG/ML ABBJCT ![Compare how all Medicare Part D PDP plans in MO cover EPINEPHRINE 0.1MG/ML ABBJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in MO cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in MO cover EPIPEN JR 0.15MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL ![Compare how all Medicare Part D PDP plans in MO cover EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
EPIVIR 10MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover EPIVIR 10MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EPIVIR 150MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EPIVIR 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EPIVIR 300MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EPIVIR 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EPIVIR HBV 100MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EPIVIR HBV 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MO cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EPLERENONE 25MG TABS ![Compare how all Medicare Part D PDP plans in MO cover EPLERENONE 25MG TABS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPLERENONE 50MG TABS ![Compare how all Medicare Part D PDP plans in MO cover EPLERENONE 50MG TABS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in MO cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
EPOGEN 2000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in MO cover EPOGEN 2000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:12 /30Days |
EPOGEN 3000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in MO cover EPOGEN 3000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:12 /30Days |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in MO cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P Q:12 /30Days |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in MO cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
EPOGEN INJECTION 40000U 10 X 4ML VIALS VIALSD ![Compare how all Medicare Part D PDP plans in MO cover EPOGEN INJECTION 40000U 10 X 4ML VIALS VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
EPZICOM TABLET ![Compare how all Medicare Part D PDP plans in MO cover EPZICOM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EQUAGESIC TABLET ![Compare how all Medicare Part D PDP plans in MO cover EQUAGESIC TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | P |
EQUETRO 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EQUETRO 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EQUETRO 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EQUETRO 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EQUETRO 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EQUETRO 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERAXIS 100MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover ERAXIS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
ERAXIS 50MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover ERAXIS 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in MO cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ERGOLOID MESYLATES 1MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MO cover ERGOLOID MESYLATES 1MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERGOMAR SUBLINGUAL TABLET 2MG ![Compare how all Medicare Part D PDP plans in MO cover ERGOMAR SUBLINGUAL TABLET 2MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERGOTAMINE-CAFFEINE 1-100MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ERGOTAMINE-CAFFEINE 1-100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERRIN 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ERRIN 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERTACZO 2% CREAM ![Compare how all Medicare Part D PDP plans in MO cover ERTACZO 2% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERY 2% SWAB MEDICATED ![Compare how all Medicare Part D PDP plans in MO cover ERY 2% SWAB MEDICATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERY-TAB 250MG TABLET EC ![Compare how all Medicare Part D PDP plans in MO cover ERY-TAB 250MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERY-TAB 333MG TABLET EC ![Compare how all Medicare Part D PDP plans in MO cover ERY-TAB 333MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERY-TAB 500MG TABLET EC ![Compare how all Medicare Part D PDP plans in MO cover ERY-TAB 500MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYDERM 2% TOP SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover ERYDERM 2% TOP SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYGEL 2% GEL ![Compare how all Medicare Part D PDP plans in MO cover ERYGEL 2% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYPED 100MG/2.5ML DROPS ![Compare how all Medicare Part D PDP plans in MO cover ERYPED 100MG/2.5ML DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYPED 400MG/5ML GRANULES ![Compare how all Medicare Part D PDP plans in MO cover ERYPED 400MG/5ML GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYPED-200MG/5ML GRANULES ![Compare how all Medicare Part D PDP plans in MO cover ERYPED-200MG/5ML GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYTHROCIN 250MG FILMTAB ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROCIN 250MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYTHROCIN 500MG FILMTAB ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROCIN 500MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROCIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROCIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROCIN LACTOBIONATE IV POWDER FOR INJECTION ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROCIN LACTOBIONATE IV POWDER FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ERYTHROMYCIN 2% GEL ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 2% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERYTHROMYCIN 2% SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROMYCIN 200MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 200MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERYTHROMYCIN 250MG CAP EC ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 250MG CAP EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROMYCIN 250MG FILMTAB ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 250MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROMYCIN 400MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 400MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ERYTHROMYCIN 500MG FILMTAB ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN 500MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROMYCIN ETHYLSUCCINATE 400MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN ETHYLSUCCINATE 400MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROMYCIN OPHTHALMIC OINTMENT 5MG 1/8 OZ TUBE ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN OPHTHALMIC OINTMENT 5MG 1/8 OZ TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN/SULFISOX SUSP ![Compare how all Medicare Part D PDP plans in MO cover ERYTHROMYCIN/SULFISOX SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ESTRACE 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTRACE 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ESTRACE 2MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTRACE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ESTRACE TABLET 1MG (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover ESTRACE TABLET 1MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ESTRACE VAG CREAM 0.1MG/GM ![Compare how all Medicare Part D PDP plans in MO cover ESTRACE VAG CREAM 0.1MG/GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ESTRADERM 0.05MG/24H PATCH TRANSDERMAL SEMIWEEKLY ![Compare how all Medicare Part D PDP plans in MO cover ESTRADERM 0.05MG/24H PATCH TRANSDERMAL SEMIWEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | Q:8 /28Days |
ESTRADERM 0.1MG/24HR PATCH TRANSDERMAL SEMIWEEKLY ![Compare how all Medicare Part D PDP plans in MO cover ESTRADERM 0.1MG/24HR PATCH TRANSDERMAL SEMIWEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | Q:8 /28Days |
ESTRADIOL .025MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL .025MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | Q:4 /28Days |
ESTRADIOL .0375MG/24 PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL .0375MG/24 PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | Q:4 /28Days |
ESTRADIOL .075MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL .075MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | Q:4 /28Days |
ESTRADIOL 0.05MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL 0.05MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL 0.06MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL 0.06MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | Q:4 /28Days |
ESTRADIOL 0.1MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL 0.1MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | Q:4 /28Days |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ESTRADIOL VALERATE INJECTION ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL VALERATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ESTRADIOL VALERATE INJECTION ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL VALERATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ESTRADIOL VALERATE INJECTION ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL VALERATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ESTRASORB 2.5MG 56 POU ![Compare how all Medicare Part D PDP plans in MO cover ESTRASORB 2.5MG 56 POU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in MO cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTROGEL 0.06% GEL ![Compare how all Medicare Part D PDP plans in MO cover ESTROGEL 0.06% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ESTROPIPATE 0.625 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTROPIPATE 0.625 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | P |
ESTROPIPATE 1.25 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTROPIPATE 1.25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | P |
ESTROPIPATE 2.5 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTROPIPATE 2.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | P |
ESTROSTEP FE-28 TABLET ![Compare how all Medicare Part D PDP plans in MO cover ESTROSTEP FE-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
ETHAMBUTOL HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ETHAMBUTOL HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETHAMBUTOL HCL 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover ETHAMBUTOL HCL 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETHOSUXIMIDE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ETHOSUXIMIDE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in MO cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETHYOL POWDER FOR INJECTION 500MG 3 X 10ML VILSU CRTN ![Compare how all Medicare Part D PDP plans in MO cover ETHYOL POWDER FOR INJECTION 500MG 3 X 10ML VILSU CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
ETIDRONATE DISODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover ETIDRONATE DISODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETIDRONATE DISODIUM 400MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MO cover ETIDRONATE DISODIUM 400MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 400MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 400MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MO cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | None |
ETOPOPHOS 100MG VIAL ![Compare how all Medicare Part D PDP plans in MO cover ETOPOPHOS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | P |
ETOPOSIDE INJECTION 20MG 25ML VIALMD ![Compare how all Medicare Part D PDP plans in MO cover ETOPOSIDE INJECTION 20MG 25ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$13.00 | $26.00 | P |
EURAX 10% CREAM ![Compare how all Medicare Part D PDP plans in MO cover EURAX 10% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EURAX 10% LOTION ![Compare how all Medicare Part D PDP plans in MO cover EURAX 10% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EVAMIST 1.53/SPRAY SPRAY NON-AEROSOL ![Compare how all Medicare Part D PDP plans in MO cover EVAMIST 1.53/SPRAY SPRAY NON-AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EVISTA 60MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MO cover EVISTA 60MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EVOCLIN 1% FOAM ![Compare how all Medicare Part D PDP plans in MO cover EVOCLIN 1% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EVOXAC 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EVOXAC 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EXELDERM 1% CREAM ![Compare how all Medicare Part D PDP plans in MO cover EXELDERM 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EXELDERM 1% SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover EXELDERM 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |
EXELON 1.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EXELON 1.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EXELON 2MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MO cover EXELON 2MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EXELON 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EXELON 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EXELON 4.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EXELON 4.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in MO cover EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EXELON 6MG CAPSULE ![Compare how all Medicare Part D PDP plans in MO cover EXELON 6MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in MO cover EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | None |
EXFORGE 10MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXFORGE 10MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | Q:1 /1Days |
EXFORGE 10MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXFORGE 10MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | Q:1 /1Days |
EXFORGE 5MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXFORGE 5MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | Q:1 /1Days |
EXFORGE 5MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXFORGE 5MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$26.00 | $52.00 | Q:1 /1Days |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MO cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
25% | 25% | None |
EXTINA 2% FOAM ![Compare how all Medicare Part D PDP plans in MO cover EXTINA 2% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $134.00 | None |