2010 Medicare Part D Plan Formulary Information |
Aetna Medicare Rx Premier (PDP) (S5810-195-0)
Sanctioned Plan
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The Aetna Medicare Rx Premier (PDP) (S5810-195-0) Formulary Drugs Starting with the Letter A in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
A METHAPRED METHLYPREDNISOLONE SODIUM SUCCINATE FOR INJECTION 125 MG ![Compare how all Medicare Part D PDP plans in IA cover A METHAPRED METHLYPREDNISOLONE SODIUM SUCCINATE FOR INJECTION 125 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
A-HYDROCORT 100MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover A-HYDROCORT 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
A-METHAPRED 40MG UNIVIAL ![Compare how all Medicare Part D PDP plans in IA cover A-METHAPRED 40MG UNIVIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ABILIFY 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ABILIFY 15MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ABILIFY 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:30 /1Days |
ABILIFY 20MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ABILIFY 2MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ABILIFY 30MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ABILIFY 5MG TABLET (OTSUKA) ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY 5MG TABLET (OTSUKA).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABILIFY DISCMELT 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY DISCMELT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:2 /1Days |
ABILIFY DISCMELT 15MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY DISCMELT 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:2 /1Days |
ABILIFY INJ 9.75MG ![Compare how all Medicare Part D PDP plans in IA cover ABILIFY INJ 9.75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ACARBOSE 100MG TABLET S ![Compare how all Medicare Part D PDP plans in IA cover ACARBOSE 100MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ACARBOSE 25MG TABLET S ![Compare how all Medicare Part D PDP plans in IA cover ACARBOSE 25MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ACARBOSE 50MG TABLET S ![Compare how all Medicare Part D PDP plans in IA cover ACARBOSE 50MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ACCOLATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACCOLATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ACCOLATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACCOLATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ACEBUTOLOL 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ACEBUTOLOL 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | S |
ACEBUTOLOL 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ACEBUTOLOL 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACEON 2MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACEON 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ACEON 4MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACEON 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ACEON 8MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACEON 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ACETAMINOPHEN AND CODEINE PHOSPHATE SOLUTION ORAL USP 120;12MG/5ML;MG/ 12.5 ML CUPUD ![Compare how all Medicare Part D PDP plans in IA cover ACETAMINOPHEN AND CODEINE PHOSPHATE SOLUTION ORAL USP 120;12MG/5ML;MG/ 12.5 ML CUPUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:167 /1Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:13 /1Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-60MG (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-60MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:13 /1Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:13 /1Days |
ACETASOL HC OTIC SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover ACETASOL HC OTIC SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACETASOL HC SOLUTION 10ML 10 ML BOT ![Compare how all Medicare Part D PDP plans in IA cover ACETASOL HC SOLUTION 10ML 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACETAZOLAMIDE SOD 500MG VL ![Compare how all Medicare Part D PDP plans in IA cover ACETAZOLAMIDE SOD 500MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ACETIC ACID 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in IA cover ACETIC ACID 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACETIC ACID IN AQUEOUS ALUMINUM ACETATE OTIC SOLUTION 2% 60 ML BOT ![Compare how all Medicare Part D PDP plans in IA cover ACETIC ACID IN AQUEOUS ALUMINUM ACETATE OTIC SOLUTION 2% 60 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in IA cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN ![Compare how all Medicare Part D PDP plans in IA cover ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ACTHIB VACCINE VIAL 10-24UNT/5ML ![Compare how all Medicare Part D PDP plans in IA cover ACTHIB VACCINE VIAL 10-24UNT/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTICIN 5% CREAM ![Compare how all Medicare Part D PDP plans in IA cover ACTICIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACTIMMUNE SOLUTION FOR INJECTION 100MCG ![Compare how all Medicare Part D PDP plans in IA cover ACTIMMUNE SOLUTION FOR INJECTION 100MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ACTIVELLA 0.5-0.1MG TABLET 28 DLPK ![Compare how all Medicare Part D PDP plans in IA cover ACTIVELLA 0.5-0.1MG TABLET 28 DLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ACTONEL 150MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTONEL 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | Q:1 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTONEL 30MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTONEL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTONEL 35MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTONEL 35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | Q:4 /28Days |
ACTONEL 5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTONEL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTONEL 75MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTONEL 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | Q:2 /28Days |
ACTONEL WITH CALCIUM TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTONEL WITH CALCIUM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | Q:1 /1Days |
ACTOPLUS MET 15MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTOPLUS MET 15MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTOPLUS MET 15MG/850MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTOPLUS MET 15MG/850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTOS 15MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTOS 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTOS 30MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACTOS 30MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACTOS 45MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ACTOS 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ACULAR 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover ACULAR 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACULAR LS 0.4% OPHTH SOL ![Compare how all Medicare Part D PDP plans in IA cover ACULAR LS 0.4% OPHTH SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ACYCLOVIR 200MG CAPSULE (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACYCLOVIR 200MG CAPSULE (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACYCLOVIR 200MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in IA cover ACYCLOVIR 200MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ACYCLOVIR 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACYCLOVIR 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ACYCLOVIR SODIUM 500MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover ACYCLOVIR SODIUM 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ACYCLOVIR TABLET USP 800MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ACYCLOVIR TABLET USP 800MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in IA cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ADCIRCA TABLETS 20MG 60 BOT ![Compare how all Medicare Part D PDP plans in IA cover ADCIRCA TABLETS 20MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ADVAIR DISKU MIS 100/50 ![Compare how all Medicare Part D PDP plans in IA cover ADVAIR DISKU MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ADVAIR DISKU MIS 250/50 ![Compare how all Medicare Part D PDP plans in IA cover ADVAIR DISKU MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADVAIR DISKU MIS 500/50 ![Compare how all Medicare Part D PDP plans in IA cover ADVAIR DISKU MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in IA cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ADVAIR HFA INHALER 230;21MCG;MCG ![Compare how all Medicare Part D PDP plans in IA cover ADVAIR HFA INHALER 230;21MCG;MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in IA cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ADVICOR ER 20-750MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IA cover ADVICOR ER 20-750MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ADVICOR EXTENDED RELEASE TABLETS 20;1000MG;MG 90 BOTPL ![Compare how all Medicare Part D PDP plans in IA cover ADVICOR EXTENDED RELEASE TABLETS 20;1000MG;MG 90 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ADVICOR EXTENDED RELEASE TABLETS 20;500MG;MG 90 BOTPL ![Compare how all Medicare Part D PDP plans in IA cover ADVICOR EXTENDED RELEASE TABLETS 20;500MG;MG 90 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
ADVICOR EXTENDED RELEASE TABLETS 40;1000MG;MG 90 BOTPL ![Compare how all Medicare Part D PDP plans in IA cover ADVICOR EXTENDED RELEASE TABLETS 40;1000MG;MG 90 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:2 /1Days |
AEROBID-M AEROSOL W/ADAPTER ![Compare how all Medicare Part D PDP plans in IA cover AEROBID-M AEROSOL W/ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:1 /1Days |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AK-CON 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover AK-CON 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AK-POLY-BAC EYE OINTMENT 500UNT/1000UNT ![Compare how all Medicare Part D PDP plans in IA cover AK-POLY-BAC EYE OINTMENT 500UNT/1000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AKNE-MYCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in IA cover AKNE-MYCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AKTOB 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover AKTOB 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALA-CORT 1% CREAM ![Compare how all Medicare Part D PDP plans in IA cover ALA-CORT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALA-CORT 1% LOTION ![Compare how all Medicare Part D PDP plans in IA cover ALA-CORT 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALA-SCALP HP 2% LOTION ![Compare how all Medicare Part D PDP plans in IA cover ALA-SCALP HP 2% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALAMAST 0.1% DROPS ![Compare how all Medicare Part D PDP plans in IA cover ALAMAST 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALBENZA 200MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ALBENZA 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALBUTEROL SULFATE 0.63MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE 0.63MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ALBUTEROL SULFATE 2.5MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE 2.5MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALBUTEROL SULFATE TABLET 2MG (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL SULFATE TABLET 2MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALBUTEROL TABLET 4MG (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover ALBUTEROL TABLET 4MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALCLOMETASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in IA cover ALCLOMETASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in IA cover ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALCOHOL 5%/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in IA cover ALCOHOL 5%/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALDARA IMIQUIMOD CREAM 5% 24 PKT X 250 MG CRTN ![Compare how all Medicare Part D PDP plans in IA cover ALDARA IMIQUIMOD CREAM 5% 24 PKT X 250 MG CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ALENDRONATE SODIUM 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ALENDRONATE SODIUM 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALENDRONATE SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ALENDRONATE SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALENDRONATE SODIUM 5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ALENDRONATE SODIUM 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALENDRONATE SODIUM 70MG TABLET 4 BLPK ![Compare how all Medicare Part D PDP plans in IA cover ALENDRONATE SODIUM 70MG TABLET 4 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:4 /28Days |
ALENDRONATE SODIUM TABLET 35MG 20 CRTN ![Compare how all Medicare Part D PDP plans in IA cover ALENDRONATE SODIUM TABLET 35MG 20 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | Q:4 /28Days |
ALIMTA 500MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover ALIMTA 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ALINIA 100MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover ALINIA 100MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALINIA 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ALINIA 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALKERAN FOR INJECTION 50MG/VIAL 1 VIALSU ![Compare how all Medicare Part D PDP plans in IA cover ALKERAN FOR INJECTION 50MG/VIAL 1 VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALLOPURINOL SODIUM 500MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover ALLOPURINOL SODIUM 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ALLOPURINOL TABLET 300MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover ALLOPURINOL TABLET 300MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALLOPURINOL TABLET USP 100MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover ALLOPURINOL TABLET USP 100MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ALOCRIL 2% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover ALOCRIL 2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALOMIDE 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover ALOMIDE 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALORA 0.025MG PATCH ![Compare how all Medicare Part D PDP plans in IA cover ALORA 0.025MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:8 /28Days |
ALORA 0.05MG PATCH ![Compare how all Medicare Part D PDP plans in IA cover ALORA 0.05MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:8 /28Days |
ALORA 0.075MG PATCH ![Compare how all Medicare Part D PDP plans in IA cover ALORA 0.075MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:8 /28Days |
ALORA 0.1MG PATCH ![Compare how all Medicare Part D PDP plans in IA cover ALORA 0.1MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | Q:8 /28Days |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in IA cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ALPHAGAN P 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover ALPHAGAN P 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ALTABAX 1% OINTMENT ![Compare how all Medicare Part D PDP plans in IA cover ALTABAX 1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALTOPREV 20MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IA cover ALTOPREV 20MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ALTOPREV 40MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IA cover ALTOPREV 40MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ALTOPREV 60MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IA cover ALTOPREV 60MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:1 /1Days |
ALVESCO 160MCG/ACT AERS ![Compare how all Medicare Part D PDP plans in IA cover ALVESCO 160MCG/ACT AERS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ALVESCO 80MCG/ACT AERS ![Compare how all Medicare Part D PDP plans in IA cover ALVESCO 80MCG/ACT AERS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMANTADINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMANTADINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMCINONIDE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in IA cover AMCINONIDE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMCINONIDE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in IA cover AMCINONIDE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMCINONIDE 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in IA cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMERGE 1MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMERGE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | Q:9 /30Days |
AMERGE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMERGE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | Q:9 /30Days |
AMEVIVE ADMISTRATION PACK FOR INTRAMUSCULAR ADMINISTRATION KIT 15MG 1 X 4 PKGCOM ![Compare how all Medicare Part D PDP plans in IA cover AMEVIVE ADMISTRATION PACK FOR INTRAMUSCULAR ADMINISTRATION KIT 15MG 1 X 4 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
AMIFOSTINE FOR INJECTION 500MG/VIAL ![Compare how all Medicare Part D PDP plans in IA cover AMIFOSTINE FOR INJECTION 500MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
AMIKACIN 250MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover AMIKACIN 250MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMIKACIN 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover AMIKACIN 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMILORIDE HCL W/HCTZ 5MG-50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMILORIDE HCL W/HCTZ 5MG-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMINOPHYLLINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMINOPHYLLINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMINOPHYLLINE 200MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMINOPHYLLINE 200MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOPHYLLINE INJECTION 250MG 10ML X 25 VIALSD ![Compare how all Medicare Part D PDP plans in IA cover AMINOPHYLLINE INJECTION 250MG 10ML X 25 VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMINOSYN 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN 3.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN 3.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN 5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN 5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN 7%-ELECTROLYTE SOL ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN 7%-ELECTROLYTE SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN 8.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN 8.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 3.5% IN D25W IV ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 3.5% IN D25W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 3.5% M/D5W IV ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 3.5% M/D5W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN II 3.5% W/ELEC DEX ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 3.5% W/ELEC DEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 4.25% IN D10W ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 4.25% IN D10W.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 4.25% IN D20W ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 4.25% IN D20W.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 4.25% W/ELEC DW ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 4.25% W/ELEC DW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 4.25%-D25W IV ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 4.25%-D25W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 5% IN D25W IV ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 5% IN D25W IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN II 8.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN II 8.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN M 3.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN M 3.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN-HBC 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN-HBC 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN-HF 8% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN-HF 8% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AMIODARONE HCL 200MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMIODARONE HCL 200MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMIODARONE HCL 400MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMIODARONE HCL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMIODARONE HCL INJECTION ![Compare how all Medicare Part D PDP plans in IA cover AMIODARONE HCL INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | P S Q:60 /30Days |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in IA cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:60 /30Days |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIP/PERPHEN 10-2 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIP/PERPHEN 10-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIP/PERPHEN 25-2 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIP/PERPHEN 25-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIP/PERPHEN 25-4 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIP/PERPHEN 25-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIPTYLINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIPTYLINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIPTYLINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMITRIPTYLINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIPTYLINE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMITRIPTYLINE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIPTYLINE HCL 25MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMITRIPTYLINE HCL 25MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIPTYLINE HCL 75MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMITRIPTYLINE HCL 75MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMITRIPTYLINE HCL TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover AMITRIPTYLINE HCL TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMLODIPINE BESYLATE 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | S |
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE 2.5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | S Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE BESYLATE 5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE 5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | S Q:1 /1Days |
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMMONIUM CHLORIDE 5 MEQ/ML ![Compare how all Medicare Part D PDP plans in IA cover AMMONIUM CHLORIDE 5 MEQ/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMMONIUM LACTATE 12% CREAM ![Compare how all Medicare Part D PDP plans in IA cover AMMONIUM LACTATE 12% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in IA cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMNESTEEM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMNESTEEM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | P |
AMNESTEEM 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMNESTEEM 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | P |
AMNESTEEM 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMNESTEEM 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOCLAN 200-28.5/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover AMOCLAN 200-28.5/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOCLAN 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover AMOCLAN 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in IA cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in IA cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 500-125MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOX TR-POTASSIUM CLAVULANATE 500-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 200MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 200MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 400MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 400MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXICILLIN TABLET USP CHEWABLE 250MG (250 CT) ![Compare how all Medicare Part D PDP plans in IA cover AMOXICILLIN TABLET USP CHEWABLE 250MG (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXIL 250MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover AMOXIL 250MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMOXIL CAPSULES 500MG ![Compare how all Medicare Part D PDP plans in IA cover AMOXIL CAPSULES 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMPHET ASP/ AMPHET/ D-AMPHET 5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMPHET ASP/ AMPHET/ D-AMPHET 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P Q:2 /1Days |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P Q:2 /1Days |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P Q:2 /1Days |
AMPHETAMINE SALT COMBO 30MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMPHETAMINE SALT COMBO 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P Q:2 /1Days |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALTS 20MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AMPHETAMINE SALTS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P Q:3 /1Days |
AMPHOTERICIN B FOR INJECTION 50 MG ![Compare how all Medicare Part D PDP plans in IA cover AMPHOTERICIN B FOR INJECTION 50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMPICILLIN AND SULBACTAM FOR INJECTION 10-5 1 VIAL ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN AND SULBACTAM FOR INJECTION 10-5 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMPICILLIN AND SULBACTAM FOR INJECTION 2-1 10 VIAL ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN AND SULBACTAM FOR INJECTION 2-1 10 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMPICILLIN CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMPICILLIN FOR INJECTION POWDER ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN FOR INJECTION POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMPICILLIN FOR INJECTION USP 125MG/ML 1 VIAL ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN FOR INJECTION USP 125MG/ML 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AMPICILLIN POWDER FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in IA cover AMPICILLIN POWDER FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANADROL-50 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ANADROL-50 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ANAGRELIDE HCL 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANAGRELIDE HCL 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ANAGRELIDE HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANAGRELIDE HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
ANCOBON 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANCOBON 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ANCOBON 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANCOBON 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ANDRODERM 2.5MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in IA cover ANDRODERM 2.5MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ANDRODERM 5MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in IA cover ANDRODERM 5MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ANDROGEL 1%(50MG) GEL PACKET ![Compare how all Medicare Part D PDP plans in IA cover ANDROGEL 1%(50MG) GEL PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ANDROID 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANDROID 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | P |
ANESTACON 15ML ![Compare how all Medicare Part D PDP plans in IA cover ANESTACON 15ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ANTABUSE 250MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANTABUSE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANTABUSE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANTABUSE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ANTARA 130MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANTARA 130MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ANTARA 43MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ANTARA 43MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ANTIVERT 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANTIVERT 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ANTIVERT 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANTIVERT 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ANTIVERT 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANTIVERT 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ANZEMET 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANZEMET 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | P S Q:5 /30Days |
ANZEMET 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ANZEMET 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | P S Q:5 /30Days |
APAP-CAFFEINE-DIHYDROCODE TAB 30 EA ![Compare how all Medicare Part D PDP plans in IA cover APAP-CAFFEINE-DIHYDROCODE TAB 30 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | Q:5 /1Days |
APHTHASOL 5% PASTE ![Compare how all Medicare Part D PDP plans in IA cover APHTHASOL 5% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
APIDRA 100UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover APIDRA 100UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APOKYN FOR INJECTION 30MG 5 CTG ![Compare how all Medicare Part D PDP plans in IA cover APOKYN FOR INJECTION 30MG 5 CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in IA cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in IA cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ARALAST 500MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARALAST 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in IA cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ARANESP 100MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 100MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP 200MCG/0.4ML SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 200MCG/0.4ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP 200MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 200MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP 25MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 25MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | P |
ARANESP 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP 500MCG/1ML SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 500MCG/1ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP 60MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARANESP 60MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 100MCG/0.5ML 1 SYR ![Compare how all Medicare Part D PDP plans in IA cover ARANESP PREFILLED SYRINGE SINGLE USE 100MCG/0.5ML 1 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR ![Compare how all Medicare Part D PDP plans in IA cover ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 25MCG/0.42ML SYR ![Compare how all Medicare Part D PDP plans in IA cover ARANESP PREFILLED SYRINGE SINGLE USE 25MCG/0.42ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | P |
ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR ![Compare how all Medicare Part D PDP plans in IA cover ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR ![Compare how all Medicare Part D PDP plans in IA cover ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | P |
ARANESP PREFILLED SYRINGE SINGLE USE 60MCG/0.3ML 60MCG/ 0.3ML SYR ![Compare how all Medicare Part D PDP plans in IA cover ARANESP PREFILLED SYRINGE SINGLE USE 60MCG/0.3ML 60MCG/ 0.3ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD ![Compare how all Medicare Part D PDP plans in IA cover ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | P |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ARICEPT 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ARICEPT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARICEPT 5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ARICEPT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ARICEPT ODT 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ARICEPT ODT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ARICEPT ODT 5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ARICEPT ODT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ARIMIDEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ARIMIDEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ARIXTRA 10MG SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ARIXTRA 10MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ARIXTRA 2.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ARIXTRA 2.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ARIXTRA 5MG SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ARIXTRA 5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ARIXTRA 7.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ARIXTRA 7.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
AROMASIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AROMASIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ARRANON 250MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover ARRANON 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ARTHROTEC 50 50MG TABLET -200MCG (60 CT) ![Compare how all Medicare Part D PDP plans in IA cover ARTHROTEC 50 50MG TABLET -200MCG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARTHROTEC 75 TABLET EC ![Compare how all Medicare Part D PDP plans in IA cover ARTHROTEC 75 TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ASACOL 400MG TABLET EC ![Compare how all Medicare Part D PDP plans in IA cover ASACOL 400MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:12 /1Days |
ASACOL HD DELAYED RELEASE TABLETS 800MG 180 BOT ![Compare how all Medicare Part D PDP plans in IA cover ASACOL HD DELAYED RELEASE TABLETS 800MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:6 /1Days |
ASCOMP W/CODEINE 30-50-325 CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ASCOMP W/CODEINE 30-50-325 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | Q:6 /1Days |
ASMANEX 220MCG(14) AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in IA cover ASMANEX 220MCG(14) AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ASMANEX TWISTHALER 220MCG #120 ![Compare how all Medicare Part D PDP plans in IA cover ASMANEX TWISTHALER 220MCG #120.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ASMANEX TWISTHALER 220MCG #30 ![Compare how all Medicare Part D PDP plans in IA cover ASMANEX TWISTHALER 220MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ASMANEX TWISTHALER 220MCG #60 ![Compare how all Medicare Part D PDP plans in IA cover ASMANEX TWISTHALER 220MCG #60.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
ASTELIN 137MCG AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in IA cover ASTELIN 137MCG AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ASTEPRO NASAL SPRAY 137 MCG/SPRY ![Compare how all Medicare Part D PDP plans in IA cover ASTEPRO NASAL SPRAY 137 MCG/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ASTRAMORPH-PF 0.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ASTRAMORPH-PF 0.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASTRAMORPH-PF 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover ASTRAMORPH-PF 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ATACAND 16MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ATACAND 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:2 /1Days |
ATACAND 32MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ATACAND 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ATACAND 4MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ATACAND 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:2 /1Days |
ATACAND 8MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ATACAND 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:2 /1Days |
ATACAND HCT 16/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ATACAND HCT 16/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S Q:2 /1Days |
ATACAND HCT 32/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ATACAND HCT 32/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ATACAND HCT TABLETS 32;25MG;MG 90 TABLETS BOT ![Compare how all Medicare Part D PDP plans in IA cover ATACAND HCT TABLETS 32;25MG;MG 90 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |
ATAMET ![Compare how all Medicare Part D PDP plans in IA cover ATAMET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ATENOLOL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ATENOLOL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ATENOLOL TABLET USP 50MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ATENOLOL TABLET USP 50MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATENOLOL TABLETS USP 100MG 1 BLPK ![Compare how all Medicare Part D PDP plans in IA cover ATENOLOL TABLETS USP 100MG 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
ATGAM 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IA cover ATGAM 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
ATRIPLA TABLET 600MG/200MG ![Compare how all Medicare Part D PDP plans in IA cover ATRIPLA TABLET 600MG/200MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
ATROPINE 0.05MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ATROPINE 0.05MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ATROPINE 0.1MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover ATROPINE 0.1MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in IA cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
ATTENUVAX VACCINE W/DILUENT 1 DOSE/0.5ML ![Compare how all Medicare Part D PDP plans in IA cover ATTENUVAX VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AUGMENTIN XR 1000-62.5 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AUGMENTIN XR 1000-62.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AVANDAMET 2MG/1000MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDAMET 2MG/1000MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVANDAMET 2MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDAMET 2MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDAMET 4MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDAMET 4MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDAMET TABLET 4-1000MG ![Compare how all Medicare Part D PDP plans in IA cover AVANDAMET TABLET 4-1000MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDARYL 4MG/1MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDARYL 4MG/1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDARYL 4MG/2MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDARYL 4MG/2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDARYL 4MG/4MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDARYL 4MG/4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDARYL 8MG-2MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDARYL 8MG-2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDARYL 8MG-4MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDARYL 8MG-4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDIA 2MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVANDIA 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDIA 4MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IA cover AVANDIA 4MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AVANDIA 8MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IA cover AVANDIA 8MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
AVELOX 400MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVELOX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AVELOX ABC PACK 400MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVELOX ABC PACK 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AVELOX IV 400MG/250ML ![Compare how all Medicare Part D PDP plans in IA cover AVELOX IV 400MG/250ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in IA cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AVITA 0.025% CREAM ![Compare how all Medicare Part D PDP plans in IA cover AVITA 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AVODART 0.5MG SOFTGEL ![Compare how all Medicare Part D PDP plans in IA cover AVODART 0.5MG SOFTGEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | P |
AVONEX ADMIN PACK 30MCG SYR ![Compare how all Medicare Part D PDP plans in IA cover AVONEX ADMIN PACK 30MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
AVONEX ADMIN PACK 30MCG VL ![Compare how all Medicare Part D PDP plans in IA cover AVONEX ADMIN PACK 30MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
AXID 15MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover AXID 15MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AZACTAM 2GM VIAL ![Compare how all Medicare Part D PDP plans in IA cover AZACTAM 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZACTAM INJECTION 1GM 50ML BAG ![Compare how all Medicare Part D PDP plans in IA cover AZACTAM INJECTION 1GM 50ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AZACTAM/ISO-OSMOT 2GM/50ML ![Compare how all Medicare Part D PDP plans in IA cover AZACTAM/ISO-OSMOT 2GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AZASAN 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AZASAN 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | P |
AZASAN 75MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AZASAN 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | P |
AZASITE 1% DROPS ![Compare how all Medicare Part D PDP plans in IA cover AZASITE 1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AZATHIOPRINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AZATHIOPRINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | P |
AZATHIOPRINE SOD 100MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover AZATHIOPRINE SOD 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
AZELEX 20% CREAM 30GM TUBE ![Compare how all Medicare Part D PDP plans in IA cover AZELEX 20% CREAM 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | None |
AZILECT 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AZILECT 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AZILECT 1MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover AZILECT 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$37.00 | $96.00 | None |
AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AZITHROMYCIN 250MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IA cover AZITHROMYCIN 250MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AZITHROMYCIN 500MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IA cover AZITHROMYCIN 500MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AZITHROMYCIN FOR INJECTION 500MG 10 VIALSD ![Compare how all Medicare Part D PDP plans in IA cover AZITHROMYCIN FOR INJECTION 500MG 10 VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$36.00 | $93.00 | None |
AZITHROMYCIN TABLET 600MG (30 CT) ![Compare how all Medicare Part D PDP plans in IA cover AZITHROMYCIN TABLET 600MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$6.00 | $18.00 | None |
AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in IA cover AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$81.00 | $228.00 | S |