2010 Medicare Part D Plan Formulary Information |
Windsor Medicare Extra Fusion Plan (HMO) (H5698-135-0)
Benefit Details
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The Windsor Medicare Extra Fusion Plan (HMO) (H5698-135-0) Formulary Drugs Starting with the Letter C in Statewide County, MS: CMS MA Region 16 which includes: MS
|
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CALCIPOTRIENE TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover CALCIPOTRIENE TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in MS cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CALCITRIOL 0.25MCG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CALCITRIOL 0.25MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CALCITRIOL 0.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CALCITRIOL 0.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CALCITRIOL INJECTION SOLUTION 1MCG 50 X 01ML AMP ![Compare how all Medicare Part D PDP plans in MS cover CALCITRIOL INJECTION SOLUTION 1MCG 50 X 01ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in MS cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CAMILA 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAMILA 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | Q:28 /28Days |
CAMPATH 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CAMPATH 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CAMPRAL 333MG DOSE PAK ![Compare how all Medicare Part D PDP plans in MS cover CAMPRAL 333MG DOSE PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CAMPTOSAR 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CAMPTOSAR 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX ![Compare how all Medicare Part D PDP plans in MS cover CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | Q:60 /30Days |
CANCIDAS IV 50MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover CANCIDAS IV 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CANCIDAS IV 70MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover CANCIDAS IV 70MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CAPASTAT SULFATE 1GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover CAPASTAT SULFATE 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CAPEX SHA 0.01% ![Compare how all Medicare Part D PDP plans in MS cover CAPEX SHA 0.01%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CAPTOPRIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CAPTOPRIL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CAPTOPRIL 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CAPTOPRIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CAPTOPRIL/HCTZ 25/15 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL/HCTZ 25/15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CAPTOPRIL/HCTZ 25/25 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL/HCTZ 25/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAPTOPRIL/HCTZ 50/15 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL/HCTZ 50/15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CAPTOPRIL/HCTZ 50/25 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CAPTOPRIL/HCTZ 50/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARAFATE SUS 1GM/10ML ![Compare how all Medicare Part D PDP plans in MS cover CARAFATE SUS 1GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARBAMAZEPINE 100MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in MS cover CARBAMAZEPINE 100MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBAMAZEPINE EXTENDED RELEASE TABLETS 200MG ![Compare how all Medicare Part D PDP plans in MS cover CARBAMAZEPINE EXTENDED RELEASE TABLETS 200MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBAMAZEPINE EXTENDED RELEASE TABLETS 400MG ![Compare how all Medicare Part D PDP plans in MS cover CARBAMAZEPINE EXTENDED RELEASE TABLETS 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBAMAZEPINE TABLET CHEWABLE 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARBAMAZEPINE TABLET CHEWABLE 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBAMAZEPINE TABLET USP 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARBAMAZEPINE TABLET USP 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBATROL 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover CARBATROL 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CARBATROL 200MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover CARBATROL 200MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CARBATROL 300MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover CARBATROL 300MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA-LEVODOPA 25MG-100MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover CARBIDOPA-LEVODOPA 25MG-100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBIDOPA-LEVODOPA 50MG-200MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover CARBIDOPA-LEVODOPA 50MG-200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBIDOPA/LEVO 10/100 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CARBIDOPA/LEVO 10/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBIDOPA/LEVO 25/100 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CARBIDOPA/LEVO 25/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBIDOPA/LEVO 25/250 TABLET ![Compare how all Medicare Part D PDP plans in MS cover CARBIDOPA/LEVO 25/250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARBOPLATIN AQUEOUS SOLUTION INJECTION 150MG 15ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CARBOPLATIN AQUEOUS SOLUTION INJECTION 150MG 15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARDIZEM CD 360MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM CD 360MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARDIZEM LA EXTENDED RELEASE TABLETS 120MG 90 BOT ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM LA EXTENDED RELEASE TABLETS 120MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARDIZEM LA EXTENDED RELEASE TABLETS 180MG 90 BOT ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM LA EXTENDED RELEASE TABLETS 180MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARDIZEM LA EXTENDED RELEASE TABLETS 240MG 90 BOT ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM LA EXTENDED RELEASE TABLETS 240MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARDIZEM LA EXTENDED RELEASE TABLETS 300MG 90 BOT ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM LA EXTENDED RELEASE TABLETS 300MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARDIZEM LA EXTENDED RELEASE TABLETS 360MG 30 BOT ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM LA EXTENDED RELEASE TABLETS 360MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARDIZEM LA EXTENDED RELEASE TABLETS 420MG 30 BOT ![Compare how all Medicare Part D PDP plans in MS cover CARDIZEM LA EXTENDED RELEASE TABLETS 420MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CARIMUNE NF 3GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover CARIMUNE NF 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CARISOPRODOL TABLET USP 350MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARISOPRODOL TABLET USP 350MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | Q:120 /30Days |
CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MS cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARTIA XT 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in MS cover CARTIA XT 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CARVEDILOL 12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARVEDILOL 12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CARVEDILOL 25MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARVEDILOL 25MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARVEDILOL 3.125MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARVEDILOL 3.125MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CARVEDILOL 6.25MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CARVEDILOL 6.25MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CATAPRES-TTS DIS 0.3/24HR ![Compare how all Medicare Part D PDP plans in MS cover CATAPRES-TTS DIS 0.3/24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CATAPRES-TTS-1 PATCH 2.52.5MG/UNT 1 X 4 CRTN ![Compare how all Medicare Part D PDP plans in MS cover CATAPRES-TTS-1 PATCH 2.52.5MG/UNT 1 X 4 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CATAPRES-TTS-2 PATCH 52.5MG/UNT 1 X 4 CRTN ![Compare how all Medicare Part D PDP plans in MS cover CATAPRES-TTS-2 PATCH 52.5MG/UNT 1 X 4 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CEENU 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CEENU 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CEENU 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CEENU 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CEENU 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CEENU 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CEFACLOR 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MS cover CEFACLOR 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFACLOR 375MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MS cover CEFACLOR 375MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFACLOR CAPSULES USP 250MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFACLOR CAPSULES USP 250MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFACLOR CAPSULES USP 500MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFACLOR CAPSULES USP 500MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFACLOR ER 500MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in MS cover CEFACLOR ER 500MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CEFACLOR POWDER FOR ORAL SUSPENSION USP 125MG 75ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CEFACLOR POWDER FOR ORAL SUSPENSION USP 125MG 75ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFADROXIL 1G TABLET ![Compare how all Medicare Part D PDP plans in MS cover CEFADROXIL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFADROXIL 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CEFADROXIL 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFADROXIL 500MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover CEFADROXIL 500MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFADROXIL FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CEFADROXIL FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFAZOLIN 20GM BULK VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFAZOLIN 20GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFAZOLIN FOR INJECTION ![Compare how all Medicare Part D PDP plans in MS cover CEFAZOLIN FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFAZOLIN FOR INJECTION 1MG 25 VIALGL ![Compare how all Medicare Part D PDP plans in MS cover CEFAZOLIN FOR INJECTION 1MG 25 VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFDINIR CAPSULES 300MG (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFDINIR CAPSULES 300MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | P |
CEFEPIME INJ 1GM 20ML APX 10x1G VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFEPIME INJ 1GM 20ML APX 10x1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | P |
CEFOTAXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in MS cover CEFOTAXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFOTAXIME FOR INJECTION 1GM 50 BOX VIALGL ![Compare how all Medicare Part D PDP plans in MS cover CEFOTAXIME FOR INJECTION 1GM 50 BOX VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFOTAXIME FOR INJECTION 2GM 25 VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFOTAXIME FOR INJECTION 2GM 25 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFOTAXIME FOR INJECTION 500MG 10 VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFOTAXIME FOR INJECTION 500MG 10 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFOTETAN 10 GM SOLR ![Compare how all Medicare Part D PDP plans in MS cover CEFOTETAN 10 GM SOLR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CEFOXITIN FOR INJECTION 10GM 10 X 100ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFOXITIN FOR INJECTION 10GM 10 X 100ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFOXITIN FOR INJECTION 1GM 25 X 20ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFOXITIN FOR INJECTION 1GM 25 X 20ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFOXITIN FOR INJECTION 2GM 20ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFOXITIN FOR INJECTION 2GM 20ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFPODOXIME PROXETIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CEFPODOXIME PROXETIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 50MG 50ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 50MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEFPROZIL 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFPROZIL 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFPROZIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover CEFPROZIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFPROZIL FOR ORAL SUSPENSION 125MG/5ML 75ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CEFPROZIL FOR ORAL SUSPENSION 125MG/5ML 75ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFPROZIL TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover CEFPROZIL TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFTRIAXONE 10GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEFTRIAXONE 10GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CEFTRIAXONE FOR INJECTION 250MG BOX OF 10 VIALGL ![Compare how all Medicare Part D PDP plans in MS cover CEFTRIAXONE FOR INJECTION 250MG BOX OF 10 VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFTRIAXONE FOR INJECTION 500MG BOX OF 10 VIALGL ![Compare how all Medicare Part D PDP plans in MS cover CEFTRIAXONE FOR INJECTION 500MG BOX OF 10 VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CEFUROXIME 250MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CEFUROXIME 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFUROXIME AXETIL 125MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover CEFUROXIME AXETIL 125MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFUROXIME AXETIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover CEFUROXIME AXETIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEFUROXIME AXETIL 500MG TABLET (20 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEFUROXIME AXETIL 500MG TABLET (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CELEBREX 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CELEBREX 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | S |
CELEBREX 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CELEBREX 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | S |
CELEBREX 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CELEBREX 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | S |
CELEBREX 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CELEBREX 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | S |
CELLCEPT 200MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MS cover CELLCEPT 200MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CELLCEPT 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CELLCEPT 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CELLCEPT CAPSULES 250MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CELLCEPT CAPSULES 250MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | P |
CELLCEPT IV INJ 500MG ![Compare how all Medicare Part D PDP plans in MS cover CELLCEPT IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | P |
CELONTIN 300MG KAPSEAL ![Compare how all Medicare Part D PDP plans in MS cover CELONTIN 300MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CEPHALEXIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CEPHALEXIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEPHALEXIN 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MS cover CEPHALEXIN 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEPHALEXIN CAPSULES 500MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CEPHALEXIN CAPSULES 500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CEPHALEXIN POWDER FOR SUSPENSION ORAL USP 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CEPHALEXIN POWDER FOR SUSPENSION ORAL USP 125MG 200ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CEREDASE 80UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CEREDASE 80UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CEREZYME INJ 200UNIT ![Compare how all Medicare Part D PDP plans in MS cover CEREZYME INJ 200UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CETIRIZINE HCL 5MG/5ML ![Compare how all Medicare Part D PDP plans in MS cover CETIRIZINE HCL 5MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | S |
CHANTIX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHANTIX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHANTIX 1MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHANTIX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CHANTIX STARTING MONTH PAK ![Compare how all Medicare Part D PDP plans in MS cover CHANTIX STARTING MONTH PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CHEMET 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CHEMET 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH ![Compare how all Medicare Part D PDP plans in MS cover CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLOROQUINE PH 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLOROQUINE PH 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT) ![Compare how all Medicare Part D PDP plans in MS cover CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLOROTHIAZIDE 250MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLOROTHIAZIDE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLOROTHIAZIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLOROTHIAZIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROMAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROMAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROMAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROMAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORPROMAZINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROMAZINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROMAZINE 25MG/ML AMP ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROMAZINE 25MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROMAZINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROMAZINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROMAZINE HCL 200MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROMAZINE HCL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROPAMIDE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROPAMIDE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORPROPAMIDE 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover CHLORPROPAMIDE 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHLORTHALIDONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CHLORTHALIDONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CHLORTHALIDONE 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover CHLORTHALIDONE 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CHOLESTYRAMINE LIGHT ORAL SUSP USP POWDER 4GM 60 X 5 SINGLE DOSE CRTN ![Compare how all Medicare Part D PDP plans in MS cover CHOLESTYRAMINE LIGHT ORAL SUSP USP POWDER 4GM 60 X 5 SINGLE DOSE CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHOLESTYRAMINE POWDER FOR ORAL SUSPENSION USP 4GM 60 X 9GM SINGLE DOSE CRTN ![Compare how all Medicare Part D PDP plans in MS cover CHOLESTYRAMINE POWDER FOR ORAL SUSPENSION USP 4GM 60 X 9GM SINGLE DOSE CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CHOLESTYRAMINE POWDER FOR ORAL SUSPENSION USP 4GM 378GM CAN ![Compare how all Medicare Part D PDP plans in MS cover CHOLESTYRAMINE POWDER FOR ORAL SUSPENSION USP 4GM 378GM CAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in MS cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | P |
CICLOPIROX 0.77% CREAM ![Compare how all Medicare Part D PDP plans in MS cover CICLOPIROX 0.77% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CICLOPIROX 0.77% GEL ![Compare how all Medicare Part D PDP plans in MS cover CICLOPIROX 0.77% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CICLOPIROX 0.77% TOPICAL SUSPENSION ![Compare how all Medicare Part D PDP plans in MS cover CICLOPIROX 0.77% TOPICAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CILOSTAZOL 50MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover CILOSTAZOL 50MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CILOSTAZOL TABLET 100MG (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover CILOSTAZOL TABLET 100MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CILOXAN 0.3% OINTMENT ![Compare how all Medicare Part D PDP plans in MS cover CILOXAN 0.3% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CIMETIDINE TABLET USP 300MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover CIMETIDINE TABLET USP 300MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIMETIDINE TABLET USP 400MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover CIMETIDINE TABLET USP 400MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIMETIDINE TABLET USP 800MG (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover CIMETIDINE TABLET USP 800MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIMZIA KIT ![Compare how all Medicare Part D PDP plans in MS cover CIMZIA KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPROFLOXACIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CIPROFLOXACIN 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIPROFLOXACIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIPROFLOXACIN ER 1000MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN ER 1000MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CIPROFLOXACIN ER 500MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN ER 500MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CIPROFLOXACIN HCL 0.3% DROPS ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN HCL 0.3% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIPROFLOXACIN HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CIPROFLOXACIN TABLETS 750MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover CIPROFLOXACIN TABLETS 750MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CITALOPRAM HBR 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CITALOPRAM HBR 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | Q:90 /30Days |
CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL ![Compare how all Medicare Part D PDP plans in MS cover CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | Q:600 /30Days |
CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in MS cover CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CITOLOPRAM HBR 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CITOLOPRAM HBR 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days |
CLADRIBINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CLADRIBINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CLARAVIS 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLARAVIS 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CLARAVIS 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLARAVIS 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CLARAVIS 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLARAVIS 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | P |
CLARITHROMYCIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CLARITHROMYCIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLARITHROMYCIN 250MG/5ML. SUS. 100ML ![Compare how all Medicare Part D PDP plans in MS cover CLARITHROMYCIN 250MG/5ML. SUS. 100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLARITHROMYCIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CLARITHROMYCIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLARITHROMYCIN ER 500MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLARITHROMYCIN ER 500MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | Q:60 /30Days |
CLARITHROMYCIN FOR ORAL SUSPENSION 125/5ML 125MG BOT ![Compare how all Medicare Part D PDP plans in MS cover CLARITHROMYCIN FOR ORAL SUSPENSION 125/5ML 125MG BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | Q:400 /10Days |
CLEMASTINE FUM 2.68MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CLEMASTINE FUM 2.68MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLEMASTINE FUMARATE 0.67MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in MS cover CLEMASTINE FUMARATE 0.67MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN HCL 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN HCL 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN HCL 300MG CAPS ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN HCL 300MG CAPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN PHOSPHATE 1% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN PHOSPHATE 1% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN PHOSPHATE 2% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN PHOSPHATE 2% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in MS cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in MS cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOBETASOL 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover CLOBETASOL 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOBETASOL E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in MS cover CLOBETASOL E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOBETASOL PROPIONATE 0.05% FOAM ![Compare how all Medicare Part D PDP plans in MS cover CLOBETASOL PROPIONATE 0.05% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOMIPRAMINE HCL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLOMIPRAMINE HCL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOMIPRAMINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLOMIPRAMINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOMIPRAMINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CLOMIPRAMINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLONIDINE HCL 0.2MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLONIDINE HCL 0.2MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CLONIDINE HCL TABLET 0.1MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLONIDINE HCL TABLET 0.1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CLONIDINE HCL TABLET 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLONIDINE HCL TABLET 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in MS cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CLOTRIMAZOLE 10MG TROCHE ![Compare how all Medicare Part D PDP plans in MS cover CLOTRIMAZOLE 10MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL ![Compare how all Medicare Part D PDP plans in MS cover CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION ![Compare how all Medicare Part D PDP plans in MS cover CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE CREAM USP .5MG-10GM 45GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE CREAM USP .5MG-10GM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CLOZAPINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLOZAPINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CLOZAPINE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLOZAPINE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CLOZAPINE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CLOZAPINE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CLOZAPINE TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover CLOZAPINE TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COGENTIN 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in MS cover COGENTIN 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COGNEX 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover COGNEX 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COGNEX 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover COGNEX 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COGNEX 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover COGNEX 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COGNEX 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover COGNEX 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COLCHICINE TABLET USP 0.6MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover COLCHICINE TABLET USP 0.6MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $15.00 | None |
COLESTIPOL HCL 1G TABLET ![Compare how all Medicare Part D PDP plans in MS cover COLESTIPOL HCL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
COLESTIPOL HCL 5G GRANULES ![Compare how all Medicare Part D PDP plans in MS cover COLESTIPOL HCL 5G GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
COLISTIMETHATE 150MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover COLISTIMETHATE 150MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
COMBIVENT INHALER ![Compare how all Medicare Part D PDP plans in MS cover COMBIVENT INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COMBIVIR TABLET ![Compare how all Medicare Part D PDP plans in MS cover COMBIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COMTAN 200MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COMTAN 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COMVAX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in MS cover COMVAX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CONSTULOSE 10GM/15ML SYRUP ![Compare how all Medicare Part D PDP plans in MS cover CONSTULOSE 10GM/15ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in MS cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COREG CR 10MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in MS cover COREG CR 10MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COREG CR 20MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in MS cover COREG CR 20MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COREG CR 40MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in MS cover COREG CR 40MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COREG CR 80MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in MS cover COREG CR 80MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CORTIFOAM 10% FOAM ![Compare how all Medicare Part D PDP plans in MS cover CORTIFOAM 10% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CORTOMYCIN EAR SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover CORTOMYCIN EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CORTOMYCIN EAR SUSPENSION ![Compare how all Medicare Part D PDP plans in MS cover CORTOMYCIN EAR SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
COUMADIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 1MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COUMADIN 3MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 4MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 5MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 6MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COUMADIN 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover COUMADIN 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COVERA-HS 180MG SA TABLET ![Compare how all Medicare Part D PDP plans in MS cover COVERA-HS 180MG SA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
COVERA-HS 240MG SA TABLET ![Compare how all Medicare Part D PDP plans in MS cover COVERA-HS 240MG SA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CRESTOR 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CRESTOR 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRESTOR 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CRESTOR 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRESTOR 40MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CRESTOR 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRESTOR 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CRESTOR 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRIXIVAN 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CRIXIVAN 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRIXIVAN 333MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CRIXIVAN 333MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CRIXIVAN 400MG CAPSULE (120 CT) ![Compare how all Medicare Part D PDP plans in MS cover CRIXIVAN 400MG CAPSULE (120 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CROMOLYN NEBULIZER SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover CROMOLYN NEBULIZER SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CRYSELLE-28 TABLET 28 TABLET S ![Compare how all Medicare Part D PDP plans in MS cover CRYSELLE-28 TABLET 28 TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CUBICIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover CUBICIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | 33% | P |
CUPRIMINE 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CUPRIMINE 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CUPRIMINE CAPSULES 250MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover CUPRIMINE CAPSULES 250MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CYCLOBENZAPRINE HCL 5MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover CYCLOBENZAPRINE HCL 5MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | None |
CYCLOPHOSPHAMIDE 1GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover CYCLOPHOSPHAMIDE 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOPHOSPHAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CYCLOPHOSPHAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOPHOSPHAMIDE 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover CYCLOPHOSPHAMIDE 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOPHOSPHAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover CYCLOPHOSPHAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOSPORINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CYCLOSPORINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOSPORINE 50MG/ML AMP ![Compare how all Medicare Part D PDP plans in MS cover CYCLOSPORINE 50MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in MS cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYKLOKAPRON 100MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in MS cover CYKLOKAPRON 100MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | P |
CYMBALTA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CYMBALTA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CYMBALTA 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover CYMBALTA 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $75.00 | None |
CYSTADANE POWDER FOR ORAL SOLUTION 180GM ![Compare how all Medicare Part D PDP plans in MS cover CYSTADANE POWDER FOR ORAL SOLUTION 180GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$45.00 | $135.00 | None |
CYTARABINE 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover CYTARABINE 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
CYTARABINE 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover CYTARABINE 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD ![Compare how all Medicare Part D PDP plans in MS cover CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $30.00 | P |